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A hypothesis testing approach, based on the theorem of probability integral transformation and the Kolmogorov–Smirnov one-sample test, for performance evaluation of probabilistic seasonal rainfall forecasts is proposed in this study. By considering the probability distribution of monthly rainfalls, the approach transforms the tercile forecast probabilities into a forecast distribution and tests whether the observed data truly come from the forecast distribution. The proposed approach provides not only a quantitative measure for performance evaluation but also a cumulative probability plot for insightful interpretations of forecast characteristics such as overconfident, underconfident, mean-overestimated, and mean-underestimated. The approach has been applied for the performance evaluation of probabilistic season rainfall forecasts in northern Taiwan, and it was found that the forecast performance is seasonal dependent. Probabilistic seasonal rainfall forecasts of the Meiyu season are likely to be overconfident and mean-underestimated, while forecasts of the winter-to-spring season are overconfident. A relatively good forecast performance is observed for the summer season. [ABSTRACT FROM AUTHOR]

Background: Vascular adhesion protein-1 (VAP-1), a dual-function glycoprotein, has been reported to play a crucial role in inflammation and tumor progression. We conducted a community-based cohort study to investigate whether serum VAP-1 could be a potential biomarker for predicting incident cancers and mortality. Method: From 2006 to 2018, we enrolled 889 cancer-free subjects at baseline. Serum VAP-1 levels were measured using a time-resolved immunofluorometric assay. Cancer and vital status of the participants were obtained by linking records with the computerized cancer registry and death certificates in Taiwan. Results: During a median follow-up of 11.94 years, 69 subjects developed incident cancers and 66 subjects died, including 29 subjects who died from malignancy. Subjects in the highest tertile of serum VAP-1 had a significantly higher risk of cancer incidence (p=0.0006), cancer mortality (p=0.0001), and all- cause mortality (p=0.0002) than subjects in the other tertiles. The adjusted hazard ratios per one standard deviation increase in serumVAP-1 concentrations were 1.28 for cancer incidence (95% CI=1.01-1.62), 1.60 for cancer mortality (95% CI=1.14-2.23), and 1.38 for all-cause mortality (95% CI=1.09-1.75). The predictive performance of serum VAP-1 was better than that of gender, smoking, body mass index, hypertension, diabetes, and estimated glomerular filtration rate but lower than that of age for cancer incidence, cancer mortality, and all-cause mortality, as evidenced by higher increments in concordance statistics and area under the receiver operating characteristic curve. Conclusion: Serum VAP-1 levels are associated with a 12-year risk of incident cancer, cancer mortality, and all-cause mortality in a general population. [ABSTRACT FROM AUTHOR]

Background: Hyperglycemia in pregnancy (HIP) increases the risk of adverse pregnancy outcomes. The increasing prevalence of overweight or obesity and the increasing proportion of pregnant women with advanced maternal age (AMA) in the recent decade may affect its prevalence. We analyzed the secular trend of HIP prevalence in 2008-2017 in Taiwan and investigated the impact of AMA in this study. Methods: This cross-sectional study used data from Health and Welfare Data Science Center. Pregnant women who registered their data in the Birth Certificate Application in 2008-2017 were recruited. Diagnosis of HIP was defined by ICD-9-CM and ICD-10-CM codes. Results: In 2008-2017, 151,306-211,768 pregnant women were recruited in different years. The proportion of women with AMA increased from 15.8% to 32.1%. Meanwhile, the prevalence increased from 0.5% to 0.9% for preexisting diabetes, 0.2% to 0.4% for undiagnosed diabetes, and 11.4% to 14.5% for GDM. Maternal age was significantly associated with the prevalence of HIP. For women aged <30 years, 30-34 years and ≥35 years, the prevalence of preexisting diabetes were 0.51%, 0.75% and 1.24%, respectively (p<0.05); the prevalence of undiagnosed diabetes were 0.18%, 0.24% and 0.37%, respectively (p<0.05); and the prevalence of GDM were 10.57%, 14.77% and 18.13%, respectively (p<0.05). In all age groups, the prevalence of HIP increased over time in 2008-2017. Conclusion: The prevalence of HIP increased in Taiwan in 2008-2017, which may result from the increasing proportion of pregnant women with AMA and the change in the diagnostic criteria for GDM. [ABSTRACT FROM AUTHOR]

Background: The goal of this study was to investigate the prognostic factors for locoregional recurrence and metastasis in patients with cutaneous melanoma (CM) who underwent surgery, especially in the acral lentiginous melanoma (ALM) subtype. Methods: This study was a retrospective review of patients who underwent surgery for CM at Taipei Veterans General Hospital between 2000 and 2018. We investigated the risk factors for locoregional and distant metastases. The association between clinicopathological factors and locoregional recurrence and distant metastasis of the CM and ALM subtypes was analyzed. In addition, the outcomes between the ALM and non-ALM groups were compared. Results: A total of 161 patients were included in the analysis. The most common histological subtype was ALM. The overall locoregional recurrence rate of CM was 13.0% and the distant metastasis rate was 42.9%, whereas that of the ALM subtype was 12.5% and 45.5%, respectively. In patients with CM, male sex, tumor with lymphovascular invasion, and positive lymph node status were the prognostic factors for both locoregional recurrence and distant metastasis. Among the patients with ALM, positive lymph node status was significantly associated with both locoregional recurrence and distant metastasis. Conclusion: In this cohort, factors influencing locoregional recurrence and distant metastasis were similar between the ALM and non-ALM groups. The above-recommended surgical margin did not show any benefit in either the CM or the ALM subtype. ALM can be handled using the same surgical strategy as CM in the Asian population. [ABSTRACT FROM AUTHOR]

Context: Maternal lipids during pregnancy and placental growth factors are associated with excess fetal growth. However, how these factors interact to increase the risk of delivering large-for-gestational-age (LGA) neonates remains unclear. In this study, we investigated the relationship between maternal plasma triglycerides (TGs) and free fatty acids (FFAs) during pregnancy, cord blood insulin-like growth factors (IGF), and LGA.Objective: In a cell model, we studied the effect of different FAs on placental IGF-1 secretion.Methods: This cohort study included pregnant women with term pregnancy and without diabetes or hypertensive disorders in pregnancy. Maternal fasting plasma TGs and FFAs were measured in the second trimester. Cord blood IGF-1, IGF-2, and IGF binding protein-1 and protein-3 were measured at the time of delivery. A human trophoblast cell line, 3A-sub-E, was used to evaluate the effect of different FFAs on placental IGF-1 secretion.Results: We recruited 598 pregnant women-neonate pairs. Maternal plasma TG (180 mg/dL [152.5-185.5 mg/dL] vs 166 mg/dL [133-206 mg/dL], P = .04) and cord blood IGF-1 concentrations (72.7 ± 23.0 vs 54.1 ± 22.8 ng/mL, P < .001) were higher in the LGA group and were significantly associated with birth weight z score. Maternal plasma free palmitic acid (PA) and stearic acid (SA), but not oleic acid (OA) or linoleic acid (LA), were significantly associated with cord blood IGF-1 concentrations. In 3A-sub-E cells, treatment with PA, SA, and LA, but not OA, induced IGF-1 expression and secretion.Conclusion: Certain FFAs can induce placental IGF-1 secretion, which suggests a potential pathophysiology linking maternal plasma lipids and LGA. [ABSTRACT FROM AUTHOR]

Background: The clinical effect of atrial fibrillation (AF)-related ischemic cardiovascular events in patients undergoing peritoneal dialysis (PD) remains uncertain. This study aimed to investigate the risk of ischemic events in patients undergoing PD with new-onset AF compared with that in patients without AF and ascertain the association between the CHA2DS2-VASc score and risk of ischemic stroke. Methods: This nationwide, population-based cohort study used data from Taiwan's National Health Insurance Research Database from 1998 to 2011 for patients receiving PD with or without new-onset AF. The clinical endpoints included ischemic stroke, allcause death, and in-hospital cardiovascular death. Results: Patients undergoing PD with new-onset AF (N = 505) had significantly higher risks of ischemic stroke (adjusted hazard ratio [aHR], 1.98; 95% CI, 1.40-2.80), all-cause death (aHR, 1.61; 95% CI, 1.40-1.85), and in-hospital cardiovascular death (aHR, 1.82; 95% CI, 1.50.2.21) compared with those in patients undergoing PD without AF. After considering in-hospital death as a competing risk, AF remained associated with an increased risk of ischemic stroke (hazard ratio [HR], 1.67; 95% CI, 1.17-2.37). The CHA2DS2-VASc score was associated with the risk of ischemic stroke (HR, 1.28; 95% CI, 1.12-1.46). Conclusion: The risks of ischemic stroke, all-cause death, and in-hospital cardiovascular death were significantly higher in patients undergoing PD with AF than those in patients without AF. The CHA2DS2-VASc score remained associated with the risk of ischemic stroke in patients undergoing PD with AF. [ABSTRACT FROM AUTHOR]

Early Cenozoic rift basins developed commonly on the Mesozoic basement along the SE Asia Continent. However, Eocene–Oligocene sequences were only exposed widely onshore Taiwan. We study benthic foraminifera and determine U–Pb geochronology of detrital zircon grains in the Early Cenozoic sequence onshore Taiwan for understanding if there was any significant change in faunal content and sediment provenance between the Eocene syn-rift sequences and the overlying Oligocene post-rift strata across the breakup unconformity. The Eocene syn-rift sequences are mostly of thick, cross-bedded sandstones of fluvial-deltaic depositions without marine fauna. Intensive study on the Eocene stratigraphy in more than ten sections all over the Taiwan mountain belt in the last three decades, shallow marine benthic foraminifera of Gaudryina hayasakai-Hanzawaia asterizana-Planularia okinoshimaensis-Heterolepa praecinta assemblage were found only in very limited exposures in the Western Foothills, central Taiwan. This study shows that the Eocene benthic foraminiferal assemblage is similar to the Shihtsaoan fauna in the overlying Oligocene post-rift marine strata. This indicates no significant faunal break across the breakup unconformity. As a consequence, Gaudryina hayasakai Zone of the Shihtsaoan age can extend downward to the Eocene and the Shihtsaoan Stage would be equivalent to the Hsuehshanian Stage established previously from northern Taiwan. The Taiwan Eocene marine sequences could be deposited in a normal-fault bounded narrow seaway or gulf connecting southeastward to the open Huatung Basin. U–Pb geochronology of detrital zircons in the Taiwan Eocene syn-rift sandstones shows a prominent age peak centered in Yenshanian (100–155 Ma) similar to the Paleocene–Oligocene fluvial-deltaic deposits in the East China Sea and is also comparable to the U–Pb zircon age spectrum of modern river sands of the Fujian Province, SE China. Petrographic study also suggests a prevailing sediment provenance of the Cathaysia granites and volcanics. These Cathaysia detritals were transported to the Taiwan Eocene grabens through some SE-flowing rivers. Structural reconstructions in previous study indicated that the mountain belt with the Eocene sequences in NE Taiwan had been shortened by imbricated thrusting westward for 160–200 km wide during the arc-continent collision in the last 6.5 Ma. Integrating paleontology and sedimentology evidence reveal that the Eocene coast was located along the modern shelf break of the East China Sea ~ 350–400 km east off the modern Chinese coast line. This implies that in the Eocene time (~ 40 Ma) there was no wide Asian epi-continental marginal seas off Chinese coast until the onset sedimentation of the Oligocene post-rift strata during opening of the South China Sea in the Early Oligocene time (~ 33 Ma). [ABSTRACT FROM AUTHOR]

Tremella fuciformis Berk (TF) is a common edible and medicinal mushroom, and has long been used in food and in Chinese medicine. It possesses anticancer, anti-inflammation, anti-oxidative, and neuroprotective abilities. Since their cultivation is a problem, TFs in Taiwan are primarily imported from China, which has a problem with pesticide residues. Thus, the question of whether the Taiwan cultivated TFs, T1, and T6 showed similar or even better results than TFs from China (CH) was assessed in the present study. The results of the physicochemical tests of these TFs showed that T1 extracted by hot water (T1H) has the highest concentration of polysaccharide; meanwhile, T6 extracted by cold water (T6C) showed the highest amount of protein. Regarding the immune modulatory effects of these TFs, hot water extracts of these TFs augmented significantly the inducible nitric oxide synthetase (iNOS), interleukin (IL)-6, and tumor necrosis factor (TNF)- mRNA expression than those of cold water extracts. On the other hand, the cold water extracts of TFs, especially of T1C, obviously suppressed cancer cell survival better than those of hot water extracts. Interestingly, we found that hot water extracts of TFs may augment necrotic cell death, whereas, cold water extracts of TFs induce apoptosis. Furthermore, we also showed that these TFs activate caspase-3 cleavage, up regulate the Bax/Bcl-2 ratio, and decrease MMP-9 expressions in PC-3 cells. Taken together, our results indicated that T1 and T6 strains of TFs showed the similar immune modulatory and anticancer abilities were better than the CH strain of TFs. [ABSTRACT FROM AUTHOR]

The purpose of this study was aimed at employing classification algorithms to mine specific rules from the disabled vehicle tax-exempt application cases. The inductive conclusions of classification results would be expected to provide the Taiwan government with a powerful assistance in overcoming the difficulties encountered. 17 important attribute parameters were selected and 19,002 valid samples were screened from Taiwan's government database in 2010. Rough set theory, decision tree C4.5, Bayesian classifier and back propagation neural network were adopted with the aim at selecting a best classifier for this problem and obtaining the best classification results. The findings include: 1) Rough set theory was the best classifier with the classification accuracy, 94.39%; 2) 1,644 rules and nine key attribute parameters were discovered and used to generate rule conclusions for quickly and effectively checking application cases; and 3) Part of application cases were suggested to receive re-checking due to their doubtful situation. [ABSTRACT FROM AUTHOR]

The article discusses the economic benefits of income distribution in Taiwan dealing on topics including economic development, private capital formation and employment.

Amaranthus spinosus L. (thorny amaranth) is traditionally selected to be an anti-diabetic herb in Taiwan. This study assessed the immuno-modulatory effects of wild A. spinosus water extract (WASWE) on spontaneous and dexamethasone (DEX)-induced apoptosis in murine primary splenocytes. The cultured splenocytes treated with WASWE products were harvested and analyzed to assess their apoptotic status according to DNA fragmentation by flow cytometry and agarose gel electrophoresis. The results showed WASWE inhibited the spontaneous and DEX-induced apoptosis of splenocytes. Furthermore, both WASWE and its activated charcoal-treated sample administered at concentration of 1.250 mg/mL inhibited intracellular protein levels of p53 (an apoptotic inducer protein) and p80 (a form of tumor necrosis factor (TNF) receptor), which are involved in apoptosis. The present study suggested the existence of a heat-labile anti-apoptotic component with high molecular weight in WASWE. [ABSTRACT FROM AUTHOR]

Genetic affinities between aboriginal Taiwanese and populations from Oceania and Southeast Asia have previously been explored through analyses of mitochondrial DNA (mtDNA), Y chromosomal DNA, and human leukocyte antigen loci. Recent genetic studies have supported the ‘slow boat’ and ‘entangled bank’ models according to which the Polynesian migration can be seen as an expansion from Melanesia without any major direct genetic thread leading back to its initiation from Taiwan. We assessed mtDNA variation in 640 individuals from nine tribes of the central mountain ranges and east coast regions of Taiwan. In contrast to the Han populations, the tribes showed a low frequency of haplogroups D4 and G, and an absence of haplogroups A, C, Z, M9, and M10. Also, more than 85% of the maternal lineages were nested within haplogroups B4, B5a, F1a, F3b, E, and M7. Although indicating a common origin of the populations of insular Southeast Asia and Oceania, most mtDNA lineages in Taiwanese aboriginal populations are grouped separately from those found in China and the Taiwan general (Han) population, suggesting a prevalence in the Taiwanese aboriginal gene pool of its initial late Pleistocene settlers. Interestingly, from complete mtDNA sequencing information, most B4a lineages were associated with three coding region substitutions, defining a new subclade, B4a1a, that endorses the origin of Polynesian migration from Taiwan. Coalescence times of B4a1a were 13.2 ± 3.8 thousand years (or 9.3 ± 2.5 thousand years in Papuans and Polynesians). Considering the lack of a common specific Y chromosomal element shared by the Taiwanese aboriginals and Polynesians, the mtDNA evidence provided here is also consistent with the suggestion that the proto-Oceanic societies would have been mainly matrilocal. [ABSTRACT FROM AUTHOR]

Highlights the interdependence between the economic and noneconomic elements that will shape Taiwan's future. Taiwan's Perestroika or structural transformation; Reform of economic institutions and market behaviors; Innovation, new technology and industrial policy; Privatization of government-owned banks and other enterprises; Restructuring external markets.

OBJECTIVE -- To validate the performance of current diabetes risk scores (DRSs) based on simple clinical information in detecting type 2 diabetes, metabolic syndrome (MetSyn), and chronic kidney disease (CKD). RESEARCH DESIGN AND METHODS -- The performance of 10 DRSs was evaluated in a cross-sectional population screening of 2,759 Taiwanese subjects. RESULTS -- All DRSs significantly correlated with measures of insulin resistance, estimated glomerular filtration rate, and urine albumin excretion. The prevalence of screening-detected diabetes (SDM), MetSyn, and CKD increased with higher DRSs. For prediction of SDM, the Cambridge DRS by Griffin et al. and the Finnish DRS outperformed other DRSs in terms of discriminative power and model fit. For prediction of MetSyn and CKD, the Atherosclerosis Risk in Community Study score by Schmidt et al. outperformed other DRSs. CONCLUSIONS -- Risk scores based on simple clinical information are useful to identify individuals at high risk for diabetes, MetSyn, and CKD in different ethnic populations. [ABSTRACT FROM AUTHOR]

Diabetic subjects have been found to have low-grade inflammation, which has been thought to result in diabetic complications. Vascular adhesion protein-1 (VAP-1) is an adhesion molecule participating in inflammation and is elevated in subjects with diabetic complications, such as stroke, retinopathy, and nephropathy. We examined if serum VAP-1 is elevated in hyperglycemic stares. From 2005 to 2006, 386 subjects, including 225 female and 161 male, in Yun-Lin County, Taiwan, with fasting plasma glucose (FPG) < 126mg/dl during screening and did not take medication for diabetes were included. Anthropometric and biochemical profiles were measured. Serum VAP-1 levels were checked by immunofluorometrical method. During oral glucose tolerance test, serum VAP-1 levels were significantly elevated 2 hours after glucose challenge (540±138 vs. 561±119 ng/ml, p=0.0019). Those who had FPG ≥ 126 mg/dl had significantly higher fasting VAP- 1 levels (628±189 ng/ml) than those with impaired fasting glucose (531 ±165 ng/ml) or with normal fasting glucose (540±128 ng/ml, p=0.021 by ANOVA). Fasting VAP-1 levels were elevated in those who had 2-hour post-challenge plasma glucose ≥ 200 mg/dl (617±149 ng/ml) than that in impaired glucose tolerance (533±154 ng/ml) or normal glucose tolerance (531±128 ng/ml, p=0.015 by ANOVA). The average values of fasting and post-challenge VAP-1 were significantly associated to A1c, after adjusting for age and gender (regression coefficient, 35.2, p<0.001). In conclusion, serum VAP-1 levels were elevated in acute and chronic hyperglycemia. Serum VAP-1 may be a novel marker for low-grade inflammation in diabetic subjects. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the long-term survival rate of critically ill sepsis survivors following cardiopulmonary resuscitation on a national scale.Design: Retrospective and observational cohort study.Setting: Data were extracted from Taiwan's National Health Insurance Research Database.Patients: A total of 272,897 ICU patients with sepsis were identified during 2000-2010. Patients who survived to hospital discharge were enrolled. Post-discharge survival outcomes of ICU sepsis survivors who received cardiopulmonary resuscitation were compared with those of patients who did not experience cardiopulmonary arrest using propensity score matching with a 1:1 ratio.Intervention: None.Measurements and Main Results: Only 7% (n = 3,207) of sepsis patients who received cardiopulmonary resuscitation survived to discharge. The overall 1-, 2-, and 5-year postdischarge survival rates following cardiopulmonary resuscitation were 28%, 23%, and 14%, respectively. Compared with sepsis survivors without cardiopulmonary arrest, sepsis survivors who received cardiopulmonary resuscitation had a greater risk of all-cause mortality after discharge (hazard ratio, 1.38; 95% CI, 1.34-1.46). This difference in mortality risk diminished after 2 years (hazard ratio, 1.11; 95% CI, 0.96-1.28). Multivariable analysis showed that independent risk factors for long-term mortality following cardiopulmonary resuscitation were male sex, older age, receipt of care in a nonmedical center, higher Charlson Comorbidity Index score, chronic kidney disease, cancer, respiratory infection, vasoactive agent use, and receipt of renal replacement therapy during ICU stay.Conclusion: The long-term outcome was worse in ICU survivors of sepsis who received in-hospital cardiopulmonary resuscitation than in those who did not, but this increased risk of mortality diminished at 2 years after discharge. [ABSTRACT FROM AUTHOR]

Background: Whether oral anticoagulant use should be considered in patients undergoing hemodialysis with atrial fibrillation (AF) remains controversial because of the uncertainty regarding risk-benefit assessments. The purpose of this study was to investigate the risk of ischemic stroke in patients undergoing hemodialysis with new-onset AF, in comparison with those without arrhythmia.Methods and Results: This nationwide, population-based, propensity score-matched cohort study used data from Taiwan's National Health Insurance Research Database during 1998 to 2011 for patients on hemodialysis with new-onset nonvalvular AF and matched subjects without arrhythmia. The clinical end points were ischemic stroke (fatal or nonfatal), all-cause death, and other serious adverse cardiovascular events. In comparison with the matched cohort, patients with AF (n=6772) had higher risks of ischemic stroke (adjusted hazard ratio [aHR], 1.27; 95% confidence interval [CI], 1.13-1.43), all-cause death (aHR, 1.59; 95% CI, 1.52-1.67), in-hospital cardiovascular death (aHR, 1.83; 95% CI, 1.71-1.94), myocardial infarction (aHR, 1.33; 95% CI, 1.17-1.51), and hospitalization for heart failure (aHR, 1.90; 95% CI, 1.76-2.05). After considering in-hospital death as a competing risk, AF significantly increased the risk of heart failure (HR, 1.56; 95% CI, 1.45-1.68), but not those of ischemic stroke and myocardial infarction. Additionally, the predictive value of the CHA2DS2-VASc score for ischemic stroke was diminished in the competing-risk model.Conclusions: The risk of stroke was only modestly higher in patients undergoing hemodialysis with new-onset AF than in those without AF, and it became insignificant when accounting for the competing risk of in-hospital death. [ABSTRACT FROM AUTHOR]

Background There is substantial debate regarding the development of acute coronary syndrome in patients using proton pump inhibitors (PPIs) combined with clopidogrel. However, data remain limited to address the effect of PPIs alone on the subsequent risk of myocardial infarction (MI). We aimed to explore the subsequent risk of MI in PPI users who had no previous history of MI. Methods The records of inpatients and outpatients with PPI prescriptions were retrieved from the Taiwan National Health Insurance Research Database between 2000 and 2009. We conducted two different study designs, the first using propensity score (PS)-matching analyses and the second using case-crossover analyses. The risk of developing MI for PPI users was analyzed in the PS-matched study. The association between risk of MI and prior PPI exposure was further validated in the case-crossover study. Results In the PS-matched study, we included 126,367 PPI users and 126,367 PS-matched PPI non-users. After 120 days of follow-up, PPI use was associated with a 1.58-fold greater risk of MI (adjusted hazard ratio [HR] = 1.58, 95% confidence interval [CI] = 1.11 to 2.25). In the case-crossover study, adjusted odds ratios of PPI for MI risk were 4.61 (95% CI = 1.76 to 12.07) for the 7-day window and 3.47 (95% CI = 1.76 to 6.83) for the 14-day window. Conclusions Use of PPIs may be independently associated with an increased risk of MI. However, the benefits of PPIs may greatly outweigh the risks of adverse cardiovascular effects, with number needed to harm of 4357. [ABSTRACT FROM AUTHOR]

The aim of our study was to determine whether pre-emptive statin therapy was associated with improved outcome of infective endocarditis (IE). We conducted a nationwide, population-based, propensity score-matched cohort study with the Taiwan's National Health Insurance Research Database. All patients with IE between January 2000 and December 2010 were enrolled. The primary outcome was in-hospital mortality. The secondary outcome included all-cause mortality within the first 3 months, 6 months, and one year after the diagnosis of IE. Among 13,584 patients with IE, we applied propensity score-matching on a 1:4 ratio, in which 370 statin users were matched to 1,480 statin non-users. Compared with statin non-users, statin users had a significantly lower risk of in-hospital mortality (adjusted hazard ratio [aHR] 0.65, 95% confidence interval [CI], 0.49-0.86). The reduction in mortality from IE remained significant for follow-up 3 months (aHR 0.68, 95% CI, 0.53e0.88), 6 months (aHR 0.73, 95% CI, 0.58e0.91), and 12 months (aHR 0.68, 95% CI, 0.55e0.84). Statin therapy was associated with a reduced risk of ICU admission rates, shock events, the need for mechanical ventilation, but not significantly with the need for heart valvular replacement surgery. In conclusion, our study found that statin therapy is associated with a reduced risk of in-hospital and subsequent mortality of IE. [ABSTRACT FROM AUTHOR]