liu.seSearch for publications in DiVA
Change search
Refine search result
1 - 33 of 33
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Rows per page
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sort
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
Select
The maximal number of hits you can export is 250. When you want to export more records please use the Create feeds function.
  • 1.
    Alfredsson, Joakim
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping. Duke Clin Research Institute, NC USA.
    Neely, Benjamin
    Duke Clin Research Institute, NC USA.
    Neely, Megan L.
    Duke Clin Research Institute, NC USA.
    Bhatt, Deepak L.
    Brigham and Womens Hospital, MA 02115 USA; Harvard Medical Sch, MA USA.
    Goodman, Shaun G.
    St Michaels Hospital, Canada; University of Alberta, Canada; University of Alberta, Canada.
    Tricoci, Pierluigi
    Duke Clin Research Institute, NC USA; Duke University, NC 27706 USA.
    Mahaffey, Kenneth W.
    Stanford University, CA 94305 USA.
    Cornel, Jan H.
    Medical Centre Alkmaar, Netherlands.
    White, Harvey D.
    Auckland City Hospital, New Zealand.
    Fox, Keith A. A.
    University of Edinburgh, Scotland.
    Prabhakaran, Dorairaj
    Centre Chron Disease Control and Public Health Fdn India, India.
    Winters, Kenneth J.
    Eli Lilly and Co, IN 46285 USA.
    Armstrong, Paul W.
    University of Alberta, Canada; University of Alberta, Canada.
    Magnus Ohman, E.
    Duke Clin Research Institute, NC USA; Duke University, NC 27706 USA.
    Roe, Matthew T.
    Duke Clin Research Institute, NC USA; Duke University, NC 27706 USA.
    Predicting the risk of bleeding during dual antiplatelet therapy after acute coronary syndromes2017In: Heart, ISSN 1355-6037, E-ISSN 1468-201X, Vol. 103, no 15, p. 1168-1176Article in journal (Refereed)
    Abstract [en]

    Objectives Dual antiplatelet therapy (DAPT) with aspirin + a P2Y12 inhibitor is recommended for at least 12 months for patients with acute coronary syndrome (ACS), with shorter durations considered for patients with increased bleeding risk. However, there are no decision support tools available to predict an individual patients bleeding risk during DAPT treatment in the post-ACS setting. Methods To develop a longitudinal bleeding risk prediction model, we analysed 9240 patients with unstable angina/non-ST segment elevation myocardial infarction (NSTEMI) from the Targeted Platelet Inhibition to Clarify the Optimal Strategy to Medically Manage Acute Coronary Syndromes (TRILOGY ACS) trial, who were managed without revascularisation and treated with DAPT for a median of 14.8 months. Results We identified 10 significant baseline predictors of non-coronary artery bypass grafting (CABG)-related Global Use of Strategies to Open Occluded Arteries (GUSTO) severe/life-threatening/moderate bleeding: age, sex, weight, NSTEMI (vs unstable angina), angiography performed before randomisation, prior peptic ulcer disease, creatinine, systolic blood pressure, haemoglobin and treatment with beta-blocker. The five significant baseline predictors of Thrombolysis In Myocardial Infarction (TIMI) major or minor bleeding included age, sex, angiography performed before randomisation, creatinine and haemoglobin. The models showed good predictive accuracy with Therneaus C-indices: 0.78 (SE=0.024) for the GUSTO model and 0.67 (SE=0.023) for the TIMI model. Internal validation with bootstrapping gave similar C-indices of 0.77 and 0.65, respectively. External validation demonstrated an attenuated C-index for the GUSTO model (0.69) but not the TIMI model (0.68). Conclusions Longitudinal bleeding risks during treatment with DAPT in patients with ACS can be reliably predicted using selected baseline characteristics. The TRILOGY ACS bleeding models can inform riskbenefit considerations regarding the duration of DAPT following ACS.

  • 2.
    Alfredsson, Joakim
    et al.
    Linköping University, Department of Medicine and Health Sciences, Cardiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Stenestrand, Ulf
    Linköping University, Department of Medicine and Health Sciences, Cardiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Wallentin, Lars
    Uppsala Clinical Research Center, Uppsala University, Sweden.
    Swahn, Eva
    Linköping University, Department of Medicine and Health Sciences, Cardiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Gender differences in management and outcome in non-ST-elevation acute coronary syndrome2007In: Heart, ISSN 1355-6037, E-ISSN 1468-201X, Vol. 93, no 11, p. 1357-1362Article in journal (Refereed)
    Abstract [en]

    Objective: To study gender differences in management and outcome in patients with non-ST-elevation acute coronary syndrome. Design, setting and patients: Cohort study of 53 781 consecutive patients (37% women) from the Register of Information and Knowledge about Swedish Heart Intensive care Admissions (RIKS-HIA), with a diagnosis of either unstable angina pectoris or non-ST-elevation myocardial infarction. All patients were admitted to intensive coronary care units in Sweden, between 1998 and 2002, and followed for 1 year. Main outcome measures: Treatment intensity and in-hospital, 30-day and 1 -year mortality. Results: Women were older (73 vs 69 years, p<0.001) and more likely to have a history of hypertension and diabetes, but less likely to have a history of myocardial infarction or revascularisation. After adjustment, there were no major differences in acute pharmacological treatment or prophylactic medication at discharge. Revascularisation was, however, even after adjustment, performed more often in men (OR 1.15, 95% CI, 1.09 to 1.21). After adjustment, there was no significant difference in in-hospital (OR 1.03, 95% CI, 0.94 to 1.13) or 30-days (OR 1.07, 95% CI, 0.99 to 1.15) mortality, but at 1 year being male was associated with higher mortality (OR 1.12, 95% CI, 1.06 to 1.19). Conclusion: Although women are somewhat less intensively treated, especially regarding invasive procedures, after adjustment for differences in background characteristics, they have better long-term outcomes than men.

  • 3.
    Berglund, Elisabeth
    et al.
    Umeå University, Sweden.
    Johansson, Bengt
    Umeå University, Sweden.
    Dellborg, Mikael
    University of Gothenburg, Sweden.
    Sörensson, Peder
    Karolinska Institute, Sweden.
    Christersson, Christina
    Uppsala University, Sweden.
    Nielsen, Niels Erik
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping. Linköping University, Faculty of Medicine and Health Sciences.
    Rinnstrom, Daniel
    Umeå University, Sweden.
    Thilen, Ulf
    Lund University, Sweden; Skåne University Hospital, Sweden.
    High incidence of infective endocarditis in adults with congenital ventricular septal defect2016In: Heart, ISSN 1355-6037, E-ISSN 1468-201X, Vol. 102, no 22, p. 1835-+Article in journal (Refereed)
    Abstract [en]

    Objective Ventricular septal defects (VSDs), if haemodynamically important, are closed whereas small shunts are left without intervention. The long-term prognosis in congenital VSD is good but patients are still at risk for long-term complications. The aim of this study was to clarify the incidence of infective endocarditis (IE) in adults with VSD. Methods The Swedish registry for congenital heart disease (SWEDCON) was searched for adults with VSD. 779 patients were identified, 531 with small shunts and 248 who had the VSD previously closed. The National Patient Register was then searched for hospitalisations due to IE in adults during a 10-year period. Results Sixteen (2%) patients were treated for IE, 6 men and 10 women, with a mean age of 46.3 +/- 12.2 years. The incidence of IE was 1.7-2.7/1000 years in patients without previous intervention, 20-30 times the risk in the general population. Thirteen had small shunts without previous intervention. There was no mortality in these 13 cases. Two patients had undergone repair of their VSD and also aortic valve replacement before the episode of endocarditis and a third patient with repaired VSD had a bicuspid aortic valve, all of these three patients needed reoperation because of their IE and one patient died. No patient with isolated and operated VSD was diagnosed with IE. Conclusions A small unoperated VSD in adults carries a substantially increased risk of IE but is associated with a low risk of mortality.

  • 4.
    Cosedis Nielsen, Jens
    et al.
    Aarhus University Hospital, Denmark.
    Johannessen, Arne
    Gentofte University Hospital, Copenhagen, Denmark .
    Raatikainen, Pekka
    Heart Center Co. Tampere University Hospital, Tampere, Finland .
    Hindricks, Gerhard
    Leipzig University Hospital, Leipzig, Germany .
    Walfridsson, Håkan
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.
    Pehrson, Steen Michael
    Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen, Denmark .
    Englund, Anders
    Department of Medicine, University Hospital, Örebro, Sweden .
    Hartikainen, Juha
    Kuopio University Hospital, Kuopio, Finland .
    Spange Mortensen, Leif
    UNI-C, Danish Information Technology Centre for Education and Research, Aarhus, Denmark .
    Steen Hansen, Peter
    MANTRA-PAF Investigators. UNI-C, Danish Information Technology Centre for Education and Research, Aarhus, Denmark .
    Long-term efficacy of catheter ablation as first-line therapy for paroxysmal atrial fibrillation: 5-year outcome in a randomised clinical trial2017In: Heart, ISSN 1355-6037, E-ISSN 1468-201X, Vol. 103, no 5, p. 370-378Article in journal (Refereed)
    Abstract [en]

    Objective The Medical ANtiarrhythmic Treatment or Radiofrequency Ablation in Paroxysmal Atrial Fibrillation (MANTRA-PAF) trial compared radiofrequency catheter ablation (RFA) with antiarrhythmic drug therapy (AAD) as first-line treatment for paroxysmal atrial fibrillation (AF). Endpoint of ablation was elimination of electrical activity inside pulmonary veins. We present the results of the 5-year follow-up.

    Methods This pre-specified 5-year follow-up included assessment of any AF and symptomatic AF burden by one 7-day Holter recording and quality of life (QoL) assessment, using SF-36 questionnaire physical and mental component scores. Analysis was intention-to-treat. Imputation was used to compensate for missing Holter data.

    Results 245 of 294 patients (83%) randomised to RFA (n=125) or AAD (n=120) attended the 5-year follow-up, 227 with Holter recording. Use of class I or III AAD was more frequent in AAD group (N=61 vs 13, p<0.001). More patients in the RFA group were free from AF (126/146 (86%) vs 105/148 (71%), p=0.001, relative risk (RR) 0.82; 95% CI 0.73 to 0.93) and symptomatic AF (137/146 (94%) vs 126/148 (85%), p=0.015, χ2 test, RR 0.91; 95% CI 0.84 to 0.98) in 7-day Holter recording. AF burden was significantly lower in the RFA group (any AF: p=0.003; symptomatic AF: p=0.02). QoL scores did not differ between randomisation groups. QoL scores remained improved from baseline (both components p<0.001), and did not differ from 2-year scores.

    Conclusions At 5 years, the occurrence and burden of any AF and symptomatic AF were significantly lower in the RFA group than in the AAD group. Improved QoL scores observed after 2 years persisted after 5 years without between-group differences.

  • 5.
    Damman, P.
    et al.
    Department of Cardiology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, Netherlands.
    Clayton, T.
    London School of Hygiene and Tropical Medicine, Keppel Street, London, United Kingdom.
    Wallentin, L.
    Department of Cardiology, Cardiothoracic Center, University Hospital, Uppsala, Sweden.
    Lagerqvist, B.
    Department of Cardiology, Cardiothoracic Center, University Hospital, Uppsala, Sweden.
    Fox, K.A.A.
    Cardiovascular Research, Department of Medical and Radiological Sciences, Royal Infirmary, Edinburgh, United Kingdom.
    Hirsch, A.
    Department of Cardiology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, Netherlands.
    Windhausen, F.
    Department of Cardiology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, Netherlands.
    Swahn, Eva
    Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Centre, Department of Cardiology UHL.
    Pocock, S.J.
    London School of Hygiene and Tropical Medicine, Keppel Street, London, United Kingdom.
    Tijssen, J.G.P.
    Department of Cardiology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, Netherlands.
    de Winter, R.J.
    De Winter, R.J., Department of Cardiology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, Netherlands.
    Effects of age on long-term outcomes after a routine invasive or selective invasive strategy in patients presenting with non-ST segment elevation acute coronary syndromes: A collaborative analysis of individual data from the FRISC II - ICTUS - RITA-3 (FIR) trials2012In: Heart, ISSN 1355-6037, E-ISSN 1468-201X, Vol. 98, no 3, p. 207-213Article in journal (Refereed)
    Abstract [en]

    Objective: To perform a patient-pooled analysis of a routine invasive versus a selective invasive strategy in elderly patients with non-ST segment elevation acute coronary syndrome. Methods: A meta-analysis was performed of patientpooled data from the FRISC IIeICTUSeRITA-3 (FIR) studies. (Un)adjusted HRs were calculated by Cox regression, with adjustments for variables associated with age and outcomes. The main outcome was 5-year cardiovascular death or myocardial infarction (MI) following routine invasive versus selective invasive management. Results: Regarding the 5-year composite of cardiovascular death or MI, the routine invasive strategy was associated with a lower hazard in patients aged 65-74 years (HR 0.72, 95% CI 0.58 to 0.90) and those aged ≥75 years (HR 0.71, 95% CI 0.55 to 0.91), but not in those aged less than65 years (HR 1.11, 95% CI 0.90 to 1.38), p=0.001 for interaction between treatment strategy and age. The interaction was driven by an excess of early MIs in patients less than65 years of age; there was no heterogeneity between age groups concerning cardiovascular death. The benefits were smaller for women than for men (p=0.009 for interaction). After adjustment for other clinical risk factors the HRs remained similar. Conclusion: The current analysis of the FIR dataset shows that the long-term benefit of the routine invasive strategy over the selective invasive strategy is attenuated in younger patients aged less than65 years and in women by the increased risk of early events which seem to have no consequences for long-term cardiovascular mortality. No other clinical risk factors were able to identify patients with differential responses to a routine invasive strategy. Trial registration: http://www.controlled-trials.com/ISRCTN82153174 (ICTUS), http://www.controlled-trials.com/ISRCTN07752711 (RITA-3).

  • 6.
    Gijsberts, Crystel M.
    et al.
    ICIN Netherlands Heart Institute, Netherlands; University of Medical Centre Utrecht, Netherlands.
    Benson, Lina
    Karolinska Institute, Sweden.
    Dahlström, Ulf
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.
    Sim, David
    Singhealth, Singapore.
    Yeo, Daniel P. S.
    Tan Tock Seng Hospital, Singapore.
    Yee Ong, Hean
    Khoo Teck Puat Hospital, Singapore.
    Jaufeerally, Fazlur
    Singapore Gen Hospital, Singapore; Duke NUS, Singapore.
    Leong, Gerard K. T.
    Changi Gen Hospital, Singapore.
    Ling, Lieng H.
    National University of Singapore, Singapore; National University of Health Syst, Singapore.
    Mark Richards, A.
    National University of Singapore, Singapore; National University of Health Syst, Singapore; National University of Singapore, Singapore; University of Otago, New Zealand.
    de Kleijn, Dominique P. V.
    ICIN Netherlands Heart Institute, Netherlands; University of Medical Centre Utrecht, Netherlands; National University of Singapore, Singapore; National University of Singapore, Singapore.
    Lund, Lars H.
    Karolinska Institute, Sweden; Karolinska Institute, Sweden.
    Lam, Carolyn S. P.
    Singhealth, Singapore; National University of Singapore, Singapore; National University of Singapore, Singapore.
    Ethnic differences in the association of QRS duration with ejection fraction and outcome in heart failure2016In: Heart, ISSN 1355-6037, E-ISSN 1468-201X, Vol. 102, no 18, p. 1464-1471Article in journal (Refereed)
    Abstract [en]

    Background QRS duration (QRSd) criteria for device therapy in heart failure (HF) were derived from predominantly white populations and ethnic differences are poorly understood. Methods We compared the association of QRSd with ejection fraction (EF) and outcomes between 839 Singaporean Asian and 11221 Swedish white patients with HF having preserved EF (HFPEF)and HF having reduced EF (HFREF) were followed in prospective population-based HF studies. Results Compared with whites, Asian patients with HF were younger (62 vs 74years, pamp;lt;0.001), had smaller body size (height 163 vs 171cm, weight 70 vs 80kg, both pamp;lt;0.001) and had more severely impaired EF (EF was amp;lt;30% in 47% of Asians vs 28% of whites). Overall, unadjusted QRSd was shorter in Asians than whites (101 vs 104ms, pamp;lt;0.001). Lower EF was associated with longer QRSd (pamp;lt;0.001), with a steeper association among Asians than whites (p(interaction)amp;lt;0.001), independent of age, sex and clinical covariates (including body size). Excluding patients with left bundle branch block (LBBB) and adjusting for clinical covariates, QRSd was similar in Asians and whites with HFPEF, but longer in Asians compared with whites with HFREF (p=0.001). Longer QRSd was associated with increased risk of HF hospitalisation or death (absolute 2-year event rate for 120ms was 40% and for amp;gt;120ms it was 52%; HR for 10ms increase of QRSd was 1.04 (1.03 to 1.06), pamp;lt;0.001), with no interaction by ethnicity. Conclusion We found ethnic differences in the association between EF and QRSd among patients with HF. QRS prolongation was similarly associated with increased risk, but the implications for ethnicity-specific QRSd cut-offs in clinical decision-making require further study.

  • 7.
    Hedman, Kristofer
    et al.
    Department of Medicine, Division of Cardiovascular Medicine, Stanford, California, USA / Department of Medicine, Stanford Cardiovascular Institute, Stanford, California, USA.
    Moneghetti, Kegan J.
    Department of Medicine, Division of Cardiovascular Medicine, Stanford, California, USA / Stanford University, Stanford Sports Cardiology, Stanford, California, USA .
    Christle, Jeffrey W.
    Department of Medicine, Division of Cardiovascular Medicine, Stanford, California, USA / Stanford University, Stanford Sports Cardiology, Stanford, California, USA.
    Bagherzadeh, Shadi P.
    Department of Medicine, Division of Cardiovascular Medicine, Stanford, California, USA / Department of Medicine, Stanford Cardiovascular Institute, Stanford, California, USA .
    Amsallem, Myriam
    Department of Medicine, Division of Cardiovascular Medicine, Stanford, California, USA / Department of Medicine, Stanford Cardiovascular Institute, Stanford, California, USA .
    Ashley, Euan
    Department of Medicine, Division of Cardiovascular Medicine, Stanford, California, USA / Stanford University, Stanford Sports Cardiology, Stanford, California, USA.
    Froelicher, Victor
    Department of Medicine, Division of Cardiovascular Medicine, Stanford, California, USA / Stanford University, Stanford Sports Cardiology, Stanford, California, USA.
    Haddad, Francois
    Department of Medicine, Division of Cardiovascular Medicine, Stanford, California, USA / Department of Medicine, Stanford Cardiovascular Institute, Stanford, California, USA.
    Blood pressure in athletic preparticipation evaluation and the implication for cardiac remodelling2019In: Heart, ISSN 1355-6037, E-ISSN 1468-201X, Vol. 105, no 16, p. 1223-1230Article in journal (Refereed)
    Abstract [en]

    Objectives To explore blood pressure (BP) in athletes at preparticipation evaluation (PPE) in the context of recently updated US and European hypertension guidelines, and to determine the relationship between BP and left ventricular (LV) remodelling.Methods In this retrospective study, athletes aged 13–35 years who underwent PPE facilitated by the Stanford Sports Cardiology programme were considered. Resting BP was measured in both arms; repeated once if >=140/90 mm Hg. Athletes with abnormal ECGs or known hypertension were excluded. BP was categorised per US/European hypertension guidelines. In a separate cohort of athletes undergoing routine PPE echocardiography, we explored the relationship between BP and LV remodelling (LV mass, mass/volume ratio, sphericity index) and LV function.Results In cohort 1 (n=2733, 65.5% male), 34.3% of athletes exceeded US hypertension thresholds. Male sex (B=3.17, p&lt;0.001), body mass index (BMI) (B=0.80, p&lt;0.001) and height (B=0.25, p&lt;0.001) were the strongest independent correlates of systolic BP. In the second cohort (n=304, ages 17–26), systolic BP was an independent correlate of LV mass/volume ratio (B=0.002, p=0.001). LV longitudinal strain was similar across BP categories, while higher BP was associated with slower early diastolic relaxation.Conclusion In a large contemporary cohort of athletes, one-third presented with BP levels above the current US guidelines’ thresholds for hypertension, highlighting that lowering the BP thresholds at PPE warrants careful consideration as well as efforts to standardise measurements. Higher systolic BP was associated with male sex, BMI and height and with LV remodelling and diastolic function, suggesting elevated BP in athletes during PPE may signify a clinically relevant condition.

  • 8.
    Hendriks, Jeroen
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Univ Adelaide, Australia.
    Gallagher, Celine
    Univ Adelaide, Australia.
    Middeldorp, Melissa E.
    Univ Adelaide, Australia.
    Sanders, Prashanthan
    Univ Adelaide, Australia.
    New approaches to detection of atrial fibrillation2018In: Heart, ISSN 1355-6037, E-ISSN 1468-201X, Vol. 104, no 23, p. 1898-1899Article in journal (Other academic)
    Abstract [en]

    n/a

  • 9.
    Henriksson, Martin
    et al.
    Linköping University, Department of Medicine and Health Sciences, Health Technology Assessment. Linköping University, Faculty of Health Sciences.
    Epstein, David
    Centre for Health Economics, University of York, UK .
    Palmer, Stephen
    Centre for Health Economics, University of York, UK .
    Sculpher, Mark
    Centre for Health Economics, University of York, UK .
    Clayton, Tim
    Medical Statistics Unit, London School of Hygiene and Tropical Medicine, London, UK .
    Pocock, Stuart
    Medical Statistics Unit, London School of Hygiene and Tropical Medicine, London, UK .
    Henderson, Robert
    Nottingham City Hospital NHS Trust, Nottingham UK.
    Buxton, Martin
    Health Economics Research Group, Brunel University, Uxbridge, UK.
    Fox, Keith A. A.
    Centre for Cardiovascular Science, Department of Medical and Radiological Sciences, University of Edinburgh, UK .
    The cost-effectiveness of an early interventional strategy in non-ST-elevation acute coronary syndrome based on the RITA 3 trial2008In: Heart, ISSN 1355-6037, E-ISSN 1468-201X, Vol. 94, p. 717-723Article in journal (Refereed)
    Abstract [en]

    Background: Evidence suggests that an early interventional strategy for patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) can improve health outcomes but also increase costs when compared with a conservative strategy.

    Objective: The aim of this study was to assess the cost-effectiveness of an early interventional strategy in different risk groups from a UK health-service perspective.

    Design: Decision-analytic model based on randomised clinical trial data.

    Main outcome measures: Costs in UK Sterling at 2003/2004 prices and quality-adjusted life years (QALYs) combined into an incremental cost-effectiveness ratio.

    Methods: Data from the third Randomised Intervention Trial of unstable Angina (RITA 3) was employed to estimate rates of cardiovascular death and myocardial infarction, costs and health-related quality of life. Cost-effectiveness was estimated over patients’ lifetimes within the decision-analytic model.

    Results: The mean incremental cost per QALY gained for an early interventional strategy was approximately £55 000, £22 000 and £12 000 for patients at low, intermediate and high risk, respectively. The early interventional strategy is approximately 1%, 35% and 95% likely to be cost-effective for patients at low, intermediate and high risk, respectively, at a threshold of £20 000 per QALY. The cost-effectiveness of early intervention in low-risk patients is sensitive to assumptions about the duration of the treatment effect.

    Conclusion: An early interventional strategy in patients presenting with NSTE-ACS is likely to be considered cost-effective for patients at high and intermediate risk, but this is less likely to be the case for patients at low risk.

  • 10.
    Hoekstra, Tialda
    et al.
    University of Groningen, Netherlands .
    Lesman-Leegte, Ivonne
    University of Groningen, Netherlands .
    Louise Luttik, Marie
    University of Groningen, Netherlands .
    Sanderman, Robbert
    University of Groningen, Netherlands .
    van Veldhuisen, Dirk J
    University of Groningen, Netherlands .
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Sexual problems in elderly male and female patients with heart failure2012In: Heart, ISSN 1355-6037, E-ISSN 1468-201X, Vol. 98, no 22, p. 1647-1652Article in journal (Refereed)
    Abstract [en]

    Objectives To investigate perceived sexual problems in a large group of younger and older patients with heart failure (HF), with and without a partner, focusing on a broad range of perceived sexual problems, and compare this with a sample of healthy community-dwelling elderly people. less thanbrgreater than less thanbrgreater thanDesign Cross-sectional study. less thanbrgreater than less thanbrgreater thanSetting 17 HF clinics and general practices in The Netherlands. less thanbrgreater than less thanbrgreater thanParticipants 438 patients with HF and 459 healthy community-dwelling elderly people. less thanbrgreater than less thanbrgreater thanMain Outcome Measures Differences in sexual functioning, related factors and perceived causes of sexual problems between patients with HF and healthy community controls. less thanbrgreater than less thanbrgreater thanResults In total, 59% of HF patients reported sexual problems, mostly problems with erectile function. HF patients with a partner (67%) and younger patients (65%) reported significantly more sexual problems than healthy community controls (58%, p=0.011 and 53%, p=0.011, respectively). Multivariate analyses show that sexual problems in HF patients with a partner were more common in men (OR 2.73, 95% CI 1.572 to 4.753) and in those with a prescription of beta-blockers (OR 2.00, 95% CI 1.10 to 3.586). In younger patients, sexual problems were independently associated with male gender (OR 3.21, 95% CI 2.099 to 4.908) and having a partner (OR 2.00, 95% CI 1.283 to 3.110). HF patients mainly attribute their sexual problems to symptoms of HF. less thanbrgreater than less thanbrgreater thanConclusion Sexual problems are common in patients with HF, particularly in younger patients and those with a partner. As patients attribute their sexual problems mostly to HF symptoms, adequate treatment and education of HF patients is needed.

  • 11.
    Jaarsma, Tiny
    University Hospital Groningen.
    Inter-professional team approach to patients with heart failure2005In: Heart, ISSN 1355-6037, E-ISSN 1468-201X, Vol. 91, no 6, p. 832-8Article in journal (Refereed)
  • 12.
    Jaarsma, Tiny
    University of Maastricht.
    Nurse led, multidisciplinary intervention in chronic heart failure1999In: Heart, ISSN 1355-6037, E-ISSN 1468-201X, Vol. 81, no 6, p. 676-Article in journal (Refereed)
  • 13.
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Secondary prevention of coronary heart disease and heart failure in primary care.2008In: Heart, ISSN 1355-6037, E-ISSN 1468-201X, Vol. 94, no 9, p. 1211; author reply 1211-Article in journal (Refereed)
  • 14.
    Janson Fagring, A.
    et al.
    The Sahlgrenska Academy, Göteborg University, Sweden.
    Lappas, G.
    The Sahlgrenska Academy, Göteborg University, Sweden.
    Kjellgren, Karin
    The Sahlgrenska Academy, Göteborg University, Sweden.
    Welin, C.
    The Sahlgrenska Academy, Göteborg University, Sweden.
    Manhem, K.
    The Sahlgrenska Academy, Göteborg University, Sweden.
    Rosengren, A.
    The Sahlgrenska Academy, Göteborg University, Sweden.
    Twenty-year trends in incidence and 1-year mortality in Swedish patients hospitalised with non-AMI chest pain. Data from 1987-2006 from the Swedish hospital and death registries2010In: Heart, ISSN 1355-6037, E-ISSN 1468-201X, Vol. 96, no 13, p. 1043-1049Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE:

    To study trends for 20 years in incidence and 1-year mortality in hospitalised patients who received a diagnosis of either angina or unexplained chest pain (UCP) in Sweden.

    DESIGN AND SETTING:

    Register study of all patients aged 25-84 years identified from the Swedish National Hospital Discharge Register who were hospitalised with a first-time diagnosis of UCP or angina pectoris during 1987 to 2006.

    PARTICIPANTS:

    A total of 378 454 patients, 235 855 with UCP and 142 599 with angina.

    MAIN OUTCOME MEASURES:

    1-Year mortality and standardised mortality ratios (SMRs).

    RESULTS:

    From the period 1987-1991 to 2002-2006, the observed 1-year mortality rate in men and women with UCP aged 25-74 years decreased from 2.19% to 1.45% and from 1.85% to 0.91%, respectively. SMRs decreased from 1.67 (95% CI 1.39 to 1.95) and 1.63 (1.27 to 2.00) to 1.09 (0.96 to 1.23) and 0.88 (0.75 to 1.00). Corresponding decreases in 1-year mortality for a discharge diagnosis of angina were from 6.50% to 2.49% in men and from 4.80% to 1.68% in women, with SMRs decreasing from 2.69 (2.33-3.05) and 2.59 (2.06-3.12) to 1.09 (0.93-1.25) and 1.05 (0.81-1.29), respectively. Similar changes occurred in patients aged 75-84 years. Only men with UCP aged 75-84 years still retained a slightly increased mortality (SMR 1.14 (1.01-1.28)).

    CONCLUSIONS:

    The prognosis of patients admitted with chest pain in which acute myocardial infarction has been ruled out has improved for the past 20 years, such that the 1-year mortality of these patients is now similar to that in the general population.

  • 15.
    Janzon, Magnus
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.
    James, S
    Uppsala Univ, Dept Med Sci, Uppsala, Sweden Uppsala Univ, Uppsala Clin Res Ctr, Uppsala, Sweden.
    Cannon, C P
    ] Brigham & Womens Hosp, Thrombolysis Myocardial Infarct TIMI Study Grp, Boston, MA 02115 USA Harvard Univ, Sch Med, Boston, MA USA .
    Storey, R F
    Univ Sheffield, Dept Cardiovasc Sci, Sheffield, S Yorkshire, England.
    Mellström, C
    AstraZeneca R&D, Molndal, Sweden.
    Nicolau, J C
    Univ Sao Paulo Med Sch, Heart Inst InCor, Sao Paulo, Brazil.
    Wallentin, L
    Uppsala Univ, Dept Med Sci, Uppsala, Sweden Uppsala Univ, Uppsala Clin Res Ctr, Uppsala, Sweden.
    Henriksson, Martin
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Medicine and Health Sciences. AstraZeneca Nord Balt, Sodertalje, Sweden.
    Health economic analysis of ticagrelor in patients with acute coronary syndromes intended for non-invasive therapy2015In: Heart, ISSN 1355-6037, E-ISSN 1468-201X, Vol. 101, no 2, p. 119-25Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To investigate the cost effectiveness of ticagrelor versus clopidogrel in patients with acute coronary syndromes (ACS) in the Platelet Inhibition and Patient Outcomes (PLATO) study who were scheduled for non-invasive management.

    METHODS: A previously developed cost effectiveness model was used to estimate long-term costs and outcomes for patients scheduled for non-invasive management. Healthcare costs, event rates and health-related quality of life under treatment with either ticagrelor or clopidogrel over 12 months were estimated from the PLATO study. Long-term costs and health outcomes were estimated based on data from PLATO and published literature sources. To investigate the importance of different healthcare cost structures and life expectancy for the results, the analysis was carried out from the perspectives of the Swedish, UK, German and Brazilian public healthcare systems.

    RESULTS: Ticagrelor was associated with lifetime quality-adjusted life-year (QALY) gains of 0.17 in Sweden, 0.16 in the UK, 0.17 in Germany and 0.13 in Brazil compared with generic clopidogrel, with increased healthcare costs of €467, €551, €739 and €574, respectively. The cost per QALY gained with ticagrelor was €2747, €3395, €4419 and €4471 from a Swedish, UK, German and Brazilian public healthcare system perspective, respectively. Probabilistic sensitivity analyses indicated that the cost per QALY gained with ticagrelor was below conventional threshold values of cost effectiveness with a high probability.

    CONCLUSIONS: Treatment of patients with ACS scheduled for 12 months' non-invasive management with ticagrelor is associated with a cost per QALY gained below conventional threshold values of cost effectiveness compared with generic clopidogrel.

    TRIAL REGISTRATION NUMBER: NCT000391872.

  • 16.
    Janzon, Magnus
    et al.
    Linköping University, Department of Medicine and Care, Cardiology. Linköping University, Faculty of Health Sciences.
    Levin, Lars-Åke
    Linköping University, Department of Department of Health and Society, Center for Medical Technology Assessment. Linköping University, Faculty of Health Sciences.
    Swahn, Eva
    Linköping University, Department of Medicine and Care, Cardiology. Linköping University, Faculty of Health Sciences.
    Cost effectiveness of extended treatment with low molecular weight heparin (dalteparin) in unstable coronary artery disease: results from the FRISC II trial2003In: Heart, ISSN 1355-6037, E-ISSN 1468-201X, Vol. 89, no 3, p. 287-292Article in journal (Refereed)
    Abstract [en]

    Background: In unstable coronary artery disease short term treatment with low molecular weight heparin in addition to aspirin has been shown to be effective.

    Objective: To assess the cost effectiveness of extended treatment with dalteparin in patients managed with a non-invasive treatment strategy.

    Design: Prospective, randomised, multicentre study.

    Setting: 58 centres in Sweden, Denmark, and Norway, of which 16 were interventional.

    Patients: After at least five days’ treatment with open label dalteparin, 2267 patients were randomised to continue double blind treatment with either subcutaneous dalteparin twice daily or placebo for three months. The patients’ use of health service resources was recorded prospectively.

    Main outcome measure: Death/myocardial infarction.

    Results: After one month into the double blind period there was a 47% relative reduction in death or myocardial infarction in the dalteparin group compared with the placebo group (p = 0.002). There was a non-significant mean cost difference, favouring the placebo group, of 849 Swedish crowns (SEK) per patient (equivalent to £58). The incremental cost effectiveness ratio for giving dalteparin treatment for one month was SEK 30 300 (range −78 000 to 139 000) (£2060, range −£5300 to £9400) per avoided death or myocardial infarct. At three months, the decrease in death or myocardial infarction was not significant, precluding cost effectiveness analyses.

    Conclusions: There is a marginal and non-significant increase in costs for one month of extended dalteparin treatment compared with placebo. Extended dalteparin treatment lowers the risk of death or myocardial infarction in patients with unstable coronary artery disease. While in many countries the resources for early intervention are limited, extended dalteparin treatment up to one month is a cost effective bridge to invasive intervention.

  • 17.
    Jernberg, Tomas
    et al.
    Department of Medicine, Section of Cardiology, Huddinge, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden .
    Attebring, Mona F
    School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
    Hambraeus, Kristina
    Department of Cardiology, Falu Hospital, Falun, Sweden .
    Ivert, Torbjorn
    Department of Cardiothoracic Surgery and Anesthesiology, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden .
    James, Stefan
    Uppsala Clinical Research Centre, Uppsala University, Uppsala, Sweden .
    Jeppsson, Anders
    Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden .
    Lagerqvist, Bo
    Uppsala Clinical Research Centre, Uppsala University, Uppsala, Sweden .
    Lindahl, Bertil
    Uppsala Clinical Research Centre, Uppsala University, Uppsala, Sweden .
    Stenestrand, Ulf
    Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Wallentin, Lars
    Uppsala Clinical Research Centre, Uppsala University, Uppsala, Sweden .
    The Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies (SWEDEHEART)2010In: Heart, ISSN 1355-6037, E-ISSN 1468-201X, Vol. 96, no 20, p. 1617-1621Article, book review (Refereed)
    Abstract [en]

    Aims The aims of the Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies (SWEDEHEART) are to support the improvement of care and evidence-based development of therapy of coronary artery disease (CAD). Interventions To provide users with online interactive reports monitoring the processes of care and outcomes and allowing direct comparisons over time and with other hospitals. National, regional and county-based reports are publicly presented on a yearly basis. Setting Every hospital (n=74) in Sweden providing the relevant services participates. Launched in 2009 after merging four national registries on CAD. Population Consecutive acute coronary syndrome (ACS) patients, and patients undergoing coronary angiography/angioplasty or heart surgery. Includes approximately 80 000 new cases each year. Startpoints On admission in ACS patients, at coronary angiography in patients with stable CAD. Baseline data 106 variables for patients with ACS, another 75 variables regarding secondary prevention after 12-14 months, 150 variables for patients undergoing coronary angiography/angioplasty, 100 variables for patients undergoing heart surgery. Data capture Web-based registry with all data registered online directly by the caregiver. Data quality A monitor visits approximately 20 hospitals each year. In 2007, there was a 96% agreement. Endpoints and linkages to other data Merged with the National Cause of Death Register, including information about vital status of all Swedish citizens, the National Patient Registry, containing diagnoses at discharge for all hospital stays in Sweden and the National Registry of Drug prescriptions recording all drug prescriptions in Sweden. Access to data Available for research by application to the SWEDEHEART steering group.

  • 18.
    Johansson, Isabelle
    et al.
    Karolinska Institute, Sweden.
    Dahlström, Ulf
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.
    Edner, Magnus
    Karolinska Institute, Sweden.
    Nasman, Per
    KTH Royal Institute Technology, Sweden.
    Ryden, Lars
    Karolinska Institute, Sweden.
    Norhammar, Anna
    Karolinska Institute, Sweden.
    Risk factors, treatment and prognosis in men and women with heart failure with and without diabetes2015In: Heart, ISSN 1355-6037, E-ISSN 1468-201X, Vol. 101, no 14, p. 1139-1148Article in journal (Refereed)
    Abstract [en]

    Objective To test the hypothesis that risk factor pattern, treatment and prognosis differ between men and women with heart failure (HF) with and without diabetes in the Swedish Heart Failure Registry. Methods Patients with (n=8809) and without (n=27 465) type 2 diabetes (T2DM) included in the Swedish Heart Failure Registry (2003-2011) were followed for mortality during a median follow-up of 1.9 years (range 0-8.7 years). All-cause mortality, differences in background and HF characteristics were analysed in women and men with and without T2DM and with a special regard to different age groups. Results Of 36 274 patients, 24% had T2DM and 39% were women. In patients with T2DM, women were older than men (78 years vs 73 years), more frequently had hypertension, renal dysfunction and preserved ventricular function. Regardless of T2DM status, women with reduced ventricular function, compared with their male counterparts, were less frequently offered, for example, ACE inhibitors/angiotensin receptor II blockers (ARB). Absolute mortality was 48% in women with T2DM, 40% in women without; corresponding male mortality rates were 43% and 35%, respectively. Kaplan-Meier curves revealed shorter longevity in women with T2DM but female sex did not remain a significant mortality predictor following adjustment (OR 95% CI 0.90; 0.79 to 1.03). In those without T2DM, women compared with men lived longer; this pattern remained after adjustment (OR 0.72; 0.66 to 0.78). T2DM was a stronger predictor of mortality in women (OR 1.72; 1.53 to 1.94) than in men (OR 1.47; 1.34 to 1.61). Conclusions T2DM is a strong mortality predictor in men and women with HF, somewhat stronger in women. The shorter survival time in women with T2DM and HF related to comorbidities rather than sex per se. Evidence-based management was less prevalent in women. Mechanisms behind these findings remain incompletely understood and need further attention.

  • 19.
    Järemo, Petter
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Cardiology. Östergötlands Läns Landsting, Local Health Care Services in the East of Östergötland, Department of Internal Medicine VHN.
    Richter, Arina
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Cardiology. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Neutrophils, smoking and coronary heart disease2003In: Heart, ISSN 1355-6037, E-ISSN 1468-201XArticle in journal (Other academic)
  • 20.
    Kleijn, Lennaert
    et al.
    University Medical Center Groningen, Netherlands.
    Belonje, Anne M S
    University Medical Center Groningen, Netherlands.
    Voors, Adriaan A
    University Medical Center Groningen, Netherlands.
    De Boer, Rudolf A
    University Medical Center Groningen, Netherlands.
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. University Medical Center Groningen, Netherlands.
    Ghosh, Sudip
    Amgen Ltd, Cambridge, UK .
    Kim, Joseph
    Amgen Ltd, Cambridge, UK .
    Hillege, Hans L
    University Medical Center Groningen, Netherlands.
    Van Gilst, Wiek H
    University Medical Center Groningen, Netherlands.
    van Veldhuisen, Dirk J
    University Medical Center Groningen, Netherlands.
    van der Meer, Peter
    University Medical Center Groningen, Netherlands.
    Inflammation and anaemia in a broad spectrum of patients with heart failure2012In: Heart, ISSN 1355-6037, E-ISSN 1468-201X, Vol. 98, no 16, p. 1237-1241Article in journal (Refereed)
    Abstract [en]

    AIMS: Anaemia in heart failure (HF) is associated with a poor prognosis. Although inflammation is assumed to be an important cause of anaemia, the association between anaemia and inflammatory markers in patients with HF has not been well established.

    METHODS: Data from a multicentre randomised clinical trial, in which patients were eligible if they were >18 years of age and admitted for HF (New York Heart Association II-IV), were used. In a subset of 326 patients, haemoglobin (Hb), haematocrit, high sensitivity C-reactive protein (hsCRP), interleukin-(IL) 6, soluble tumour necrosis factor receptor (sTNFR)-1 and erythropoietin (Epo) were measured at discharge and the primary endpoint was all-cause mortality. Follow-up was 18 months.

    RESULTS: Anaemia (Hb <13 g/dl (men) and <12 g/dl (women)) was present in 40% (130/326) of the study population. Median levels of IL-6, hsCRP and sTNFR-1 were significantly higher in anaemic patients than in non-anaemic patients. Logistic regression demonstrated that each increase in hsCRP values (OR 1.58 per SD log hsCRP; 95% CI 1.09 to 2.29; p=0.016) and each increase in sTNFR-1 values (OR 1.62 per SD log sTNFR-1; 95% CI 1.24 to 2.11; p<0.001) were independently associated with anaemia. Epo (HR 1.31 per log Epo; 95% CI 1.01 to 1.69; p=0.041) and sTNFR-1 (HR 1.47 per log sTNFR-1; 95% CI 1.16 to 1.86; p=0.001) levels were independently associated with outcome.

    CONCLUSION: Anaemia is present in 40% of patients hospitalised for HF and is independently associated with inflammation.

  • 21.
    Lagerqvist, B.
    et al.
    Department of Cardiology, University Hospital, S-751 85 Uppsala, Sweden, Department of Medical Sciences, Cardiology, University Hospital, Uppsala, Sweden.
    Diderholm, E.
    Department of Medical Sciences, Cardiology, University Hospital, Uppsala, Sweden.
    Lindahl, B.
    Department of Medical Sciences, Cardiology, University Hospital, Uppsala, Sweden.
    Husted, S.
    Department of Cardiology, University Hospital, Aarhus, Denmark.
    Kontny, F.
    Department of Cardiology, Ullevål University Hospital, Oslo, Norway.
    Stahle, E.
    Ståhle, E., Department of Thoracic Surgery, University Hospital, Uppsala, Sweden.
    Swahn, Eva
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Cardiology . Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Venge, P.
    Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala, Sweden.
    Siegbahn, A.
    Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala, Sweden.
    Wallentin, L.
    Department of Medical Sciences, Cardiology, University Hospital, Uppsala, Sweden.
    FRISC score for selection of patients for an early invasive treatment strategy in unstable coronary artery disease2005In: Heart, ISSN 1355-6037, E-ISSN 1468-201X, Vol. 91, no 8, p. 1047-1052Article in journal (Refereed)
    Abstract [en]

    Objective: To develop a scoring system for risk stratification and evaluation of the effect of an early invasive strategy for treatment of unstable coronary artery disease (CAD). Design: Retrospective analysis of a randomised study (FRISC II, fast revascularisation in instability in coronary disease). Setting: 58 Scandinavian hospitals. Patients: 2457 patients with unstable CAD from the FRISC II study. Main outcome measures: One year rates of mortality and death/myocardial infarction (MI). Methods: Patients were randomly assigned to an early invasive or a non-invasive strategy. From the non-invasive cohort independent variables of death or death/MI were identified. Results: Seven factors, age > 70 years, male sex, diabetes, previous MI, ST depression, and increased concentrations of troponins and markers of inflammation (interleukin 6 or C reactive protein), were associated with an independent increased risk for death or death/MI. In patients with = 5 of these factors the invasive strategy reduced mortality from 15.4% (20 of 130) to 5.2% (7 of 134) (risk ratio (RR) 0.34, 95% confidence interval (CI) 0.15 to 0.78, p = 0.006). Death/MI was also reduced in patients with 3-4 factors from 15.7% (80 of 511) to 10.8% (58 of 538) (RR 0.69, 95% CI 0.50 to 0.94, p = 0.02). Neither death nor death/MI was reduced in patients with 0-2 risk factors. Conclusion: In unstable CAD, this scoring system based on factors independently associated with an adverse outcome can be used shortly after admission to the hospital for risk stratification and for selection of patients to an early invasive treatment strategy.

  • 22.
    Lawesson, Sofia
    et al.
    Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Stenestrand, Ulf
    Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Lagerqvist, Bo
    Uppsala University Hospital.
    Wallentin, Lars
    Uppsala University Hospital.
    Swahn, Eva
    Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Gender perspective on risk factors, coronary lesions and long-term outcome in young patients with ST-elevation myocardial infarction2010In: Heart, ISSN 1355-6037, E-ISSN 1468-201X, Vol. 96, no 6, p. 453-459Article in journal (Refereed)
    Abstract [en]

    Objective Previous data on young patients with acute coronary syndrome (ACS) have indicated higher rates of normal coronary angiograms but higher mortality in women than men. However, ST-elevation myocardial infarction (STEMI) differs from non-ST-elevation ACS in many aspects. We elucidated sex differences in risk factors, angiographic findings and outcome in consecutive STEMI patients below 46 years of age. Design Retrospective cohort study. Setting The Swedish registers for CCU care and coronary angioplasty; RIKS-HIA and SCAAR. Patients 2132 STEMI patients below 46 years of age admitted to intensive coronary care units in Sweden between 1995 and 2006 and followed for at least 1 year. Main outcome measures Angiographic findings and short-term and long-term mortality. Results Risk factors were more common in women. Significant coronary lesions were equally common (92.1% vs 93.1%, p=0.64) while single vessel disease was more common (72.9% vs 59.3%; pandlt;0.001) in women. Women had higher multivariable adjusted in-hospital mortality, OR 2.85 (95% CI 1.31 to 6.19) while long-term mortality was the same, HR 0.93 (95% CI 0.60 to 1.45). The catch-up of mortality in men might be related to a higher occurrence of re-infarctions, HR 1.82 (95% CI 1.25 to 2.65). Conclusions STEMI below age 46 is a more rare condition in women than in men and more often related to cardiovascular risk factors. More than 90% of both men and women had coronary lesions, in women more often single vessel lesions. Female sex is associated with higher in-hospital mortality, while long-term mortality is low without difference between genders.

  • 23.
    Lawesson, Sofia
    et al.
    Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Tödt, Tim
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medical and Health Sciences, Cardiology.
    Alfredsson, Joakim
    Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Janzon, Magnus
    Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Stenestrand, Ulf
    Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Swahn, Eva
    Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Gender difference in prevalence and prognostic impact of renal insufficiency in patients with ST-elevation myocardial infarction treated with primary percutaneous coronary intervention2011In: Heart, ISSN 1355-6037, E-ISSN 1468-201X, Vol. 97, no 4, p. 308-314Article in journal (Refereed)
    Abstract [en]

    Objective To evaluate if female gender is associated with renal insufficiency in patients with ST-elevation myocardial infarction (STEMI) and if there is a gender difference in the prognostic importance of renal insufficiency in STEMI. Design Single-centre observational study. Setting One tertiary cardiac centre. Patients All consecutive patients with STEMI planned for primary percutaneous coronary intervention in one Swedish county in 2005 (98 women and 176 men). Main outcome measures Logistic regression analyses were conducted to evaluate the predictors of renal insufficiency, associations between estimated glomerular filtration rate (eGFR) and outcome in each gender and a possible interaction between gender and eGFR regarding outcome. Results Renal insufficiency was defined as eGFR less than 60 ml/min per 1.73 m(2). 67% of women had renal insufficiency compared with 26% of men, OR 5.06 (95% CI 2.66 to 9.59) after multivariable adjustment. In women each 10 ml/min per 1.73 m 2 increment of eGFR was associated with a 63% risk reduction for 1-year mortality, OR 0.37 (95% CI 0.15 to 0.89). No such association was found in men, OR 1.05 (95% CI 0.63 to 1.76). A trend towards a significant interaction between gender and eGFR regarding 1-year mortality was found, OR 2.05 (95% CI 0.93 to 4.50). Conclusions A considerable gender difference in the prevalence of renal insufficiency in STEMI was found and renal insufficiency seemed to be a more important prognostic marker in women. These results are important as previous STEMI studies have shown higher multivariable adjusted mortality in women than in men but renal function has seldom been taken into consideration.

  • 24.
    Lindholm, Daniel
    et al.
    AstraZeneca RandD, Sweden.
    Sarno, Giovanna
    Uppsala Univ, Sweden.
    Erlinge, David
    Lund Univ, Sweden.
    Svennblad, Bodil
    Uppsala Univ, Sweden.
    Hasvold, Lars Pal
    AstraZeneca, Sweden.
    Janzon, Magnus
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.
    Jernberg, Tomas
    Karolinska Inst, Sweden.
    James, Stefan K.
    Uppsala Univ, Sweden.
    Combined association of key risk factors on ischaemic outcomes and bleeding in patients with myocardial infarction2019In: Heart, ISSN 1355-6037, E-ISSN 1468-201X, Vol. 105, no 15, p. 1175-1181Article in journal (Refereed)
    Abstract [en]

    Objective In patients with myocardial infarction (MI), risk factors for bleeding and ischaemic events tend to overlap, but the combined effects of these factors have scarcely been studied in contemporary real-world settings. We aimed to assess the combined associations of established risk factors using nationwide registries. Methods Using the Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies registry, patients with invasively managed MI in 2006-2014 were included. Six factors were assessed in relation to cardiovascular death (CVD)/MI/stroke, and major bleeding: age amp;gt;= 65, chronic kidney disease, diabetes, multivessel disease, prior bleeding and prior MI. Results We studied 100 879 patients, of whom 20 831 (20.6%) experienced CVD/MI/stroke and 5939 (5.9%) major bleeding, during 3.6 years median follow-up. In adjusted Cox models, all factors were associated with CVD/MI/stroke, and all but prior MI were associated with major bleeding. The majority (53.5%) had amp;gt;= 2 risk factors. With each added risk factor, there was a marked but gradual increase in incidence of the CVD/MI/stroke. This was seen also for major bleeding, but to a lesser extent, largely driven by prior bleeding as the strongest risk factor. Conclusions The majority of patients with MI had two or more established risk factors. Increasing number of risk factors was associated with higher rate of ischaemic events. When excluding patients with prior major bleeding, bleeding incidence rate increased only minimally with increasing number of risk factors. The high ischaemic risk in those with multiple risk factors highlights an unmet need for additional preventive measures.

  • 25.
    Lindström, Lena
    et al.
    Linköping University, Department of Medicine and Care, Clinical Physiology. Linköping University, Faculty of Health Sciences.
    Wilkenshoff, U.
    Linköping University, Department of Medicine and Care, Clinical Physiology. Linköping University, Faculty of Health Sciences.
    Larsson, H.
    Linköping University, Department of Medicine and Care, Cardiology. Linköping University, Faculty of Health Sciences.
    Wranne, Bengt
    Linköping University, Department of Medicine and Care, Clinical Physiology. Linköping University, Faculty of Health Sciences.
    Echocardiographic assessment of arrhythmogenic right ventricular cardiomyopathy2001In: Heart, ISSN 1355-6037, E-ISSN 1468-201X, Vol. 86, no 1, p. 31-38Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE To evaluate new echocardiographic modes in the diagnosis of arrhythmogenic right ventricular cardiomyopathy (ARVC).

    DESIGN Prospective observational study.

    SETTING University Hospital.

    SUBJECTS 15 patients with ARVC and a control group of 25 healthy subjects.

    METHODS Transthoracic echocardiography included cross sectional measurements of the right ventricular outflow tract, right ventricular inflow tract, and right ventricular body. Wall motion was analysed subjectively. M mode and pulsed tissue Doppler techniques were used for quantitative measurement of tricuspid annular motion at the lateral, septal, posterior, and anterior positions. Doppler assessment of tricuspid flow and systemic venous flow was also performed.

    RESULTS Assessed by M mode, the total amplitude of the tricuspid annular motion was significantly decreased in the lateral, septal, and posterior positions in the patients compared with the controls. The tissue Doppler velocity pattern showed decreased early diastolic peak annular (EA) velocity and an accompanying decrease in early (EA) to late diastolic (AA) velocity ratio in all positions; the systolic annular velocity was significantly decreased only in the lateral position. Four patients had normal right ventricular dimensions and three were judged to have normal right ventricular wall motion. The patient group had also a significantly decreased tricuspid flow E:A ratio.

    CONCLUSIONS Tricuspid annular measurements are valuable, easy to obtain, and allow quantitative assessment of right ventricular function. ARVC patients showed an abnormal velocity pattern that may be an early but non-specific sign of the disease. Normal right ventricular dimensions do not exclude ARVC, and subjective detection of early changes in wall motion may be difficult.

  • 26.
    Nilsson, Lennart
    et al.
    Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Centre, Department of Cardiology UHL.
    Hallen, Jonas
    Oslo University Hospital Ulleval.
    Atar, Dan
    Oslo University Hospital Ulleval.
    Jonasson, Lena
    Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Centre, Department of Cardiology UHL.
    Swahn, Eva
    Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Centre, Department of Cardiology UHL.
    Early measurements of plasma matrix metalloproteinase-2 predict infarct size and ventricular dysfunction in ST-elevation myocardial infarction2012In: Heart, ISSN 1355-6037, E-ISSN 1468-201X, Vol. 98, no 1, p. 31-36Article in journal (Refereed)
    Abstract [en]

    Background Immediate reopening of the acutely occluded infarct-related artery via primary PCI is the preferred treatment in ST-elevation myocardial infarction (STEMI). However, the sudden reinitiation of blood flow can lead to a local acute inflammatory response with further endothelial and myocardial damage, so-called reperfusion injury. The activation of matrix metalloproteinases (MMPs) is suggested to be a key event in this process. Objectives To investigate circulating MMPs, tissue inhibitors of metalloproteinases (TIMPs) and myeloperoxidase (MPO) in relation to infarct size, left ventricular dysfunction and remodelling in a STEMI population undergoing PCI. Methods 58 Patients with STEMI undergoing primary PCI were included. Blood samples were collected at baseline before PCI and at 12, 24 and 48 h for later analysis of MMPs, TIMPs and MPO by ELISA. Infarct size, left ventricular (LV) dysfunction and remodelling were assessed by cardiac MRI at 5 days and 4 month after STEMI. Results Plasma MMP-2 at 0 and 12 h showed a consistent and significant correlation with infarct size and LV dysfunction measured both at 5 days and at 4 months and correlated well with troponin I measurements. For TIMP-1 and TIMP-2 some support was found for associations with infarct size and LV dysfunction, but these were not as consistent as for MMP-2. MMP-8, MMP-9 and MPO did not overall correlate with measures of infarct size, LV dysfunction or remodelling. Conclusions In patients with STEMI, circulating levels of MMP-2, measured early and even before reperfusion therapy, are strongly associated with infarct size and LV dysfunction. This provides further evidence for the role of MMP-2 in ischaemia-reperfusion injury.

  • 27. Norhammar, A
    et al.
    Lindbäck, J
    Rydén, L
    Wallentin, L
    Stenestrand, Ulf
    Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences.
    Improved but still high short- and long-term mortality rates after myocardial infarction in patients with diabetes mellitus: A time-trend report from the Swedish Register of Information and Knowledge about Swedish Heart Intensive Care Admission2007In: Heart, ISSN 1355-6037, E-ISSN 1468-201X, Vol. 93, no 12, p. 1577-1583Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of the study was to compare time-trends in mortality rates and treatment patterns between patients with and without diabetes based on the Swedish register of coronary care (Register of Information and Knowledge about Swedish Heart Intensive Care Admission [RIKS-HIA]). Methods: Post myocardial infarction mortality rate is high in diabetic patients, who seem to receive less evidence-based treatment. Mortality rates and treatment in 1995-1998 and 1999-2002 were studied in 70 882 patients (age

  • 28.
    Norhammar, A
    et al.
    Karolinska Institute.
    Stenestrand, Ulf
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Cardiology .
    Lindback, J
    Uppsala University Hospital.
    Wallentin , L
    Uppsala University Hospital.
    Women younger than 65 years with diabetes mellitus are a high-risk group after myocardial infarction: a report from the Swedish Register of Information and Knowledge about Swedish Heart Intensive Care Admission (RIKS-HIA)2008In: Heart, ISSN 1355-6037, E-ISSN 1468-201X, Vol. 94, no 12, p. 1565-1570Article in journal (Refereed)
    Abstract [en]

    Objective: To analyse gender differences in prognosis, risk factors and evidence-based treatment in patients with diabetes and myocardial infarction.

    Methods: Mortality in 1995-2002 was analysed in 70 882 Swedish patients (age,80) with a first registry-recorded acute myocardial infarction stratified by gender and age. Owing to gender differences in mortality, specifically characterising patients below the age of 65 years, a more detailed analysis was performed within this cohort of 25 555 patients. In this group, 5786 (23%) were women and 4473 (18%) had diabetes. Differences in clinical and other parameters were adjusted for using a propensity score model.

    Results: Long-term mortality in diabetic patients aged,65 years was significantly higher in women than men (RR 1.34; 95% CI 1.16 to 1.55). Compared with diabetic men, women had an increased risk factor burden (hypertension 49 vs 43%; RR 1.12; 95% CI 1.05 to 1.20; heart failure 10 vs 8%; RR 1.25; 95% CI 1.03 to 1.53). Diabetic women aged,65 years were less frequently treated with intravenous beta-blockade during the acute hospital phase and with angiotensin-converting enzyme inhibitors at hospital discharge. However, this under-use was not associated with the mortality differences, nor was female gender by itself.

    Conclusion: Women below 65 years of age with diabetes have a poorer outcome than men after a myocardial infarction. This relates to an increased risk factor burden. It is suggested that greater awareness of this situation and improved prevention have the potential to improve what is an unfavourable situation for these women.

  • 29.
    Olsson, Anders
    Linköping University, Department of Medical and Health Sciences, Internal Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Endocrinology and Gastroenterology.
    NICE lipid modification guideline:both absolute and obsolete!2008In: Heart, ISSN 1355-6037, E-ISSN 1468-201X, Vol. 94, no 10, p. 1256-1257Article in journal (Other academic)
    Abstract [en]

    Guidelines for the prevention of cardiovascular disease (CVD)are greatly time-dependent owing to the rapid increase in knowledgein this important research area. However, at each point in timethe knowledge base behind all guidelines on CVD prevention—forexample, blood lipid modification, is common, internationaland easily available to all clinical scientists and opinionleaders engaged in the formulation of these guidelines. Nevertheless,they differ markedly between continents, countries and regions.There are several reasons for this: from factual differencesin risk factor distribution between different populations tolocal customs and traditions and individual influences fromscientists and clinicians involved in the authorship of theguidelines. Recently a new guideline for lipid modificationby the National Institute for Health and Clinical Excellencein the United Kingdom was issued

  • 30. Pontoppidan, J
    et al.
    Nielsen, J C
    Poulsen, S H
    Jensen, H K
    Walfridsson, Håkan
    Heart Center Varde.
    Pedersen, A K
    Hansen, P S
    Prophylactic cavotricuspid isthmus block during atrial fibrillation ablation in patients without atrial flutter: a randomised controlled trial.2009In: Heart, ISSN 1355-6037, E-ISSN 1468-201X, Vol. 95, p. 994-999Article in journal (Refereed)
    Abstract [en]

    Objectives: This randomised trial evaluated if patients with atrial fibrillation (AF) and no history of atrial flutter (AFL) had any benefit of prophylactic cavotricuspid isthmus block (CTIB) in addition to circumferential pulmonary vein ablation (CPVA).

    Methods: 149 patients with AF (54% paroxysmal) were randomised to CPVA and CTIB (group CTIB+, n = 73) or CPVA alone (group CTIB–, n = 76). Patients were followed for 12 months with repetitive 7-day Holter monitoring after 3, 6 and 12 months.

    Results: Six patients (4%) had cardiac tamponade, and one patient had a stroke. No difference was found in the cumulative AFL-free rate between the two treatment groups (CTIB+: 88% vs CTIB–: 84%, hazard ratio (HR) 0.80, 95% CI (0.34 to 1.90), p = 0.61). There was no difference in the cumulative AF-free rate between the groups (CTIB+: 34% vs CTIB–: 32%, HR 0.93, 95% CI (0.63 to 1.38), p = 0.71). Overall, 33% of the patients were free of AF after a single procedure. Including reprocedures, a complete or partial beneficial effect was noted in 62% of the patients at 12 months. At 12-month follow-up, 24 (50%) patients with documented AF or AFL in the Holter recordings were asymptomatic.

    Conclusions: It was not possible to demonstrate any beneficial effect of CTIB in addition to CPVA with regard to AFL or AF recurrences during follow-up. Repetitive long-term Holter monitoring demonstrated a 33% rate of freedom from AF during a 1-year follow-up. Including additional CPVA procedures, a clinical effect was noted in 62% of the patients at 12 months. Patients with AF or AFL recurrences were often asymptomatic.

  • 31.
    Savarese, Gianluigi
    et al.
    Division of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
    Sartipy, Ulrik
    Karolinska Institutet, Stockholm, Sweden; Karolinska University Hospital, Stockholm, Sweden.
    Friberg, Leif
    Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.
    Dahlström, Ulf
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.
    Lund, Lars H
    Karolinska Institutet, Stockholm, Sweden; Karolinska University Hospital, Stockholm, Sweden.
    Reasons for and consequences of oral anticoagulant underuse in atrial fibrillation with heart failure.2018In: Heart, ISSN 1355-6037, E-ISSN 1468-201X, Vol. 104, no 13, p. 1093-1100Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Atrial fibrillation (AF) is common in patients with heart failure (HF), and oral anticoagulants (OAC) are indicated. The aim was to assess prevalence of, predictors of and consequences of OAC non-use.

    METHODS: We included patients with AF, HF and no previous valve replacement from the Swedish Heart Failure Registry. High and low CHA2DS2-VASc and HAS-BLED scores were defined as above/below median. Multivariable logistic regressions were used to assess the associations between baseline characteristics and OAC use and between CHA2DS2-VASc and HAS-BLED scores and OAC use. Multivariable Cox regressions were used to assess associations between CHA2DS2-VASc and HAS-BLED scores, OAC use and two composite outcomes: all-cause death/stroke and all-cause death/major bleeding.

    RESULTS: Of 21 865 patients, only 12 659 (58%) received OAC. Selected predictors of OAC non-use were treatment with platelet inhibitors, less use of HF treatments, paroxysmal AF, history of bleeding, no previous stroke, planned follow-up in primary care, older age, living alone, lower income and variables associated with more severe HF. For each 1-unit increase in CHA2DS2-VASc and HAS-BLED, the ORs (95% CI) of OAC use were 1.24 (1.21-1.27) and 0.32 (0.30-0.33), and the HRs for death/stroke were 1.08 (1.06-1.10) and for death/major bleeding 1.18 (1.15-1.21), respectively. For high versus low CHA2DS2-VASc and HAS-BLED, the ORs of OAC use were 1.23 (1.15-1.32) and 0.20 (0.19-0.21), and the HRs for death/stroke were 1.25 (1.19-1.30) and for death/major bleeding 1.28 (1.21-1.34), respectively.

    CONCLUSIONS: Patients with AF and concomitant HF do not receive OAC on rational grounds. Bleeding risk inappropriately affects decision-making more than stroke risk.

  • 32.
    Schou, M
    et al.
    Hillerod University Hospital, Denmark.
    Alehagen, Urban
    Linköping University, Department of Medicine and Health Sciences, Cardiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Goetze, J P
    The Heart Centre, Copenhagen, Denmark.
    Dahlström, Ulf
    Linköping University, Department of Medicine and Health Sciences, Cardiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
    Effect of estimated glomerular filtration rate on plasma concentrations of B-type natriuretic peptides measured with multiple immunoassays in elderly individuals.2009In: Heart, ISSN 1355-6037, E-ISSN 1468-201X, no 95, p. 1514-1519Article in journal (Refereed)
    Abstract [en]

    Objetive: This study was designed to quantify the crude and adjusted effects of estimated glomerular filtration rate (eGFR) on N-terminal-pro-brain-natriuretic peptide (proBNP) measured with three immunoassays and brain natriuretic peptide (BNP) in elderly individuals.

    Design: Cross-sectional study.

    Setting: 474 elderly outpatients with suspected heart failure (prevalence 13%) from the primary care.

    Main outcome measures: The effects of eGFR on proBNP, measured with three different immunoassays (Roche Diagnostics, Oslo and Copenhagen), and BNP (Shionogi) concentrations were evaluated by multiple linear regression models.

    Results: In univariate analyses the effect of a 10% decrease in eGFR on proBNP concentrations was a 15% (95% confidence interval 11% to 18%), 9% (5% to 13%) and 21% (14% to 28%) increase. In multivariate models the effect was a 7% (3% to 11%), 4% (2% to 6%) and 13% (4% to 20%) increase. The effect of a 10% decrease in eGFR on BNP concentrations (Shionogi) was a 10% (5% to 15%) (univariate) and a 4% (1% to 9%) (multivariate) increase.

    Conclusions: The effect of eGFR on proBNP measured with three different immunoassays and BNP is modest and within the same range. The effect of eGFR on proBNP and BNP concentrations is reduced substantially after adjustment for important clinical and echocardiographic confounders. These findings should be considered before renal function is offered as an explanation for increased proBNP or BNP levels.

  • 33.
    Wandt, Birger
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology.
    Bojö, L
    Tolhagen, K
    Wranne, Bengt
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Echocardiographic assessment of ejection fraction in left ventricular hypertrophy.1999In: Heart, ISSN 1355-6037, E-ISSN 1468-201X, Vol. 82, p. 192-198Article in journal (Refereed)
1 - 33 of 33
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf