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  • 1.
    Bilchick, Kenneth C.
    et al.
    University of Virginia Health Syst, VA USA.
    Wang, Yongfei
    Yale New Haven Medical Centre, CT 06504 USA; Yale University, CT USA.
    Cheng, Alan
    Johns Hopkins Medical Institute, MD 21205 USA.
    Curtis, Jeptha P.
    Yale New Haven Medical Centre, CT 06504 USA; Yale University, CT USA.
    Dharmarajan, Kumar
    Yale New Haven Medical Centre, CT 06504 USA; Yale University, CT USA.
    Stukenborg, George J.
    University of Virginia, VA USA.
    Shadman, Ramin
    Southern Calif Permanente Medical Grp, CA USA.
    Anand, Inder
    University of Minnesota, MN USA.
    Lund, Lars H.
    Karolinska University Hospital, Sweden.
    Dahlström, Ulf
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    Sartipy, Ulrik
    Karolinska Institute, Sweden; Karolinska University Hospital, Sweden.
    Maggioni, Aldo
    Italian Assoc Hospital Cardiologists, Italy.
    Swedberg, Karl
    University of Gothenburg, Sweden; Imperial Coll, England.
    OConner, Chris
    Inova Healthcare Syst, VA USA.
    Levy, Wayne C.
    University of Washington, WA USA.
    Seattle Heart Failure and Proportional Risk Models Predict Benefit From Implantable Cardioverter-Defibrillators2017Ingår i: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 69, nr 21, s. 2606-2618Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND Recent clinical trials highlight the need for better models to identify patients at higher risk of sudden death. OBJECTIVES The authors hypothesized that the Seattle Heart Failure Model (SHFM) for overall survival and the Seattle Proportional Risk Model (SPRM) for proportional risk of sudden death, including death from ventricular arrhythmias, would predict the survival benefit with an implantable cardioverter-defibrillator (ICD). METHODS Patients with primary prevention ICDs from the National Cardiovascular Data Registry (NCDR) were compared with control patients with heart failure (HF) without ICDs with respect to 5-year survival using multivariable Cox proportional hazards regression. RESULTS Among 98,846 patients with HF (87,914 with ICDs and 10,932 without ICDs), the SHFM was strongly associated with all-cause mortality (p amp;lt; 0.0001). The ICD-SPRM interaction was significant (p amp;lt; 0.0001), such that SPRM quintile 5 patients had approximately twice the reduction in mortality with the ICD versus SPRM quintile 1 patients (adjusted hazard ratios [HR]: 0.602; 95% confidence interval [CI]: 0.537 to 0.675 vs. 0.793; 95% CI: 0.736 to 0.855, respectively). Among patients with SHFM-predicted annual mortality amp;lt;= 5.7%, those with a SPRM-predicted risk of sudden death below the median had no reduction in mortality with the ICD (adjusted ICD HR: 0.921; 95% CI: 0.787 to 1.08; p = 0.31), whereas those with SPRM above the median derived the greatest benefit (adjusted HR: 0.599; 95% CI: 0.530 to 0.677; p amp;lt; 0.0001). CONCLUSIONS The SHFM predicted all-cause mortality in a large cohort with and without ICDs, and the SPRM discriminated and calibrated the potential ICD benefit. Together, the models identified patients less likely to derive a survival benefit from primary prevention ICDs. (J Am Coll Cardiol 2017;69:2606-18) (C) 2017 by the American College of Cardiology Foundation.

  • 2.
    Bolger, Ann F
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Fysiologiska kliniken US. Univ Calif San Francisco, CA USA.
    Preventing Endocarditis No Rest for the Worrier2018Ingår i: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 72, nr 20, s. 2455-2456Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    n/a

  • 3.
    Carlhäll, Carljohan
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Klinisk fysiologi. Östergötlands Läns Landsting, Hjärtcentrum, Fysiologiska kliniken.
    Lindström, Lena
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Klinisk fysiologi.
    Wranne, Bengt
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Klinisk fysiologi. Östergötlands Läns Landsting, Hjärtcentrum, Fysiologiska kliniken.
    Nylander, Eva
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Klinisk fysiologi. Östergötlands Läns Landsting, Hjärtcentrum, Fysiologiska kliniken.
    Atrioventricular plane displacement correlates closely to circulatory dimensions but not to ejection fraction in normal subjects2001Ingår i: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 37, nr 2, s. 388A-388AKonferensbidrag (Övrigt vetenskapligt)
  • 4.
    Charytan, David M.
    et al.
    NYU Langone Med Ctr, NY USA; Brigham and Womens Hosp, MA 02115 USA; Harvard Med Sch, MA 02115 USA.
    Sabatine, Marc S.
    Brigham and Womens Hosp, MA 02115 USA; Harvard Med Sch, MA 02115 USA; Brigham and Womens Hosp, MA 02115 USA.
    Pedersen, Terje R.
    Oslo Univ Hosp, Norway.
    Im, KyungAh
    Brigham and Womens Hosp, MA 02115 USA; Harvard Med Sch, MA 02115 USA; Brigham and Womens Hosp, MA 02115 USA.
    Park, Jeong-Gun
    Brigham and Womens Hosp, MA 02115 USA; Harvard Med Sch, MA 02115 USA; Brigham and Womens Hosp, MA 02115 USA.
    Pineda, Armando Lira
    Amgen Inc, CA USA.
    Wasserman, Scott M.
    Amgen Inc, CA USA.
    Deedwania, Prakash
    Vet Affairs Cent Calif Healthcare Syst, CA USA.
    Olsson, Anders G.
    Univ Calif San Francisco, CA USA.
    Sever, Peter S.
    Not Found:Linkoping Univ, Dept Med and Hlth Sci, Linkoping, Sweden.
    Keech, Anthony C.
    Imperial Coll London, England; Univ Sydney, Australia.
    Giugliano, Robert P.
    Brigham and Womens Hosp, MA 02115 USA; Harvard Med Sch, MA 02115 USA; Brigham and Womens Hosp, MA 02115 USA.
    Efficacy and Safety of Evolocumab in Chronic Kidney Disease in the FOURIER Trial2019Ingår i: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 73, nr 23, s. 2961-2970Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACK GROUND Data on PCSK9 inhibition in chronic kidney disease (CKD) is limited. OBJECTIVES The purpose of this study was to compare outcomes with evolocumab and placebo according to kidney function. METHODS The FOURIER (Further Cardiovascular Outcomes Research with PCSK9 Inhibition in Subjects with Elevated Risk) trial randomized individuals with clinically evident atherosclerosis and low-density lipoprotein cholesterol (LDL-C) amp;gt;= 70 mg/dl or non-high-density lipoprotein cholesterol amp;gt;= 100 mg/dl to evolocumab or placebo. The primary endpoint (cardiovascular death, myocardial infarction, stroke, hospitalization for unstable angina, or coronary revascularization), key secondary endpoint (cardiovascular death, myocardial infarction, or stroke), and safety were analyzed according to chronic kidney disease (CKD) stage estimated from CKD-epidemiology estimated glomerular filtration rate. RESULTS There were 8,077 patients with preserved kidney function, 15,034 with stage 2 CKD, and 4,443 with amp;gt;= stage 3 CKD. LDL-C reduction with evolocumab compared with placebo at 48 weeks was similar across CKD groups at 59%, 59%, and 58%, respectively. Relative risk reduction for the primary endpoint was similar for preserved function (hazard ratio [HR]: 0.82; 95% CI: 0.71 to 0.94), stage 2 (HR: 0.85; 95% CI: 0.77 to 0.94), and stage amp;gt;= 3 CKD (HR: 0.89; 95% CI: 0.76 to 1.05); p(int) = 0.77. Relative risk reduction for the secondary endpoint was similar across CKD stages (p(int) = 0.75)-preserved function (HR: 0.75; 95% CI: 0.62 to 0.90), stage 2 (HR: 0.82; 95% CI: 0.72 to 0.93), stage amp;gt;= 3 (HR: 0.79; 95% CI: 0.65 to 0.95). Absolute RRs at 30 months for the secondary endpoint were -2.5% (95% CI: -0.4% to -4.7%) for stage amp;gt;= 3 CKD compared with -1.7% (95% CI: 0.5% to -2.8%) with preserved kidney function. Adverse events, including estimated glomerular filtration rate decline, were infrequent and similar regardless of CKD stage. CONCLUSIONS LDL-C lowering and relative clinical efficacy and safety of evolocumab versus placebo were consistent across CKD groups. Absolute reduction in the composite of cardiovascular death, MI, or stroke with evolocumab was numerically greater with more advanced CKD. (C) 2019 by the American College of Cardiology Foundation.

  • 5.
    Cowper, Patricia A.
    et al.
    Duke University, NC USA.
    Pan, Wenqin
    Duke University, NC USA.
    Anstrom, Kevin J.
    Duke University, NC USA.
    Kaul, Padma
    University of Alberta, Canada.
    Wallentin, Lars
    Uppsala University, Sweden.
    Davidson-Ray, Linda
    Duke University, NC USA.
    Lundborg, Elisabet
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för hälso- och sjukvårdsanalys. Linköpings universitet, Medicinska fakulteten.
    Janzon, Magnus
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    Levin, Lars-Åke
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för hälso- och sjukvårdsanalys. Linköpings universitet, Medicinska fakulteten.
    Cannon, Christopher P.
    Brigham and Womens Hospital, MA 02115 USA.
    Harrington, Robert A.
    Stanford University, CA 94305 USA.
    Mark, Daniel B.
    Duke University, NC USA.
    Economic Analysis of Ticagrelor Therapy From a US Perspective2015Ingår i: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 65, nr 5, s. 465-476Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND Based on results of the PLATO (Platelet Inhibition and Patient Outcomes) trial comparing ticagrelor with clopidogrel therapy, the U.S. Food and Drug Administration approved ticagrelor in 2011 for reducing thrombotic cardiovascular events in patients with acute coronary syndrome (ACS) with the proviso that it be taken with low-dose aspirin. OBJECTIVES This study sought to assess the cost and cost effectiveness of ticagrelor therapy relative to clopidogrel in treating ACS patients from the perspective of the U.S. health care system. METHODS We estimated within-trial resource use and costs using U.S. low-dose aspirin patients in PLATO (n = 547). Quality-adjusted life expectancy was estimated using the total PLATO population (n = 18,624), combined with baseline risk and long-term survival data from an external ACS patient cohort. Study drugs were valued at current costs. Cost effectiveness was assessed, as was the sensitivity of results to sampling and methodological uncertainties. RESULTS One year of ticagrelor therapy, relative to that of generic clopidogrel, cost $29,665/quality-adjusted life-year gained, with 99% of bootstrap estimates falling under a $100,000 willingness-to-pay threshold. Results were robust to extensive sensitivity analyses, including variations in clopidogrel cost, exclusion of costs in extended years of life, and a recalibrated estimate of survival reflecting a lower underlying mortality risk in the United States. CONCLUSIONS For PLATO-eligible ACS patients, a U.S. perspective comparison of the current standard of dual antiplatelet therapy of aspirin with clopidogrel versus aspirin plus ticagrelor showed that the ticagrelor regimen increased life expectancy at an incremental cost well within accepted benchmarks of good value for money. (C) 2015 by the American College of Cardiology Foundation.

  • 6.
    Erlinge, David
    et al.
    Lund University, Sweden .
    Gurbel, Paul A.
    Sinai Centre Thrombosis Research, MD USA .
    James, Stefan
    Uppsala University, Sweden .
    Lindahl, Tomas
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för mikrobiologi och molekylär medicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Diagnostikcentrum, Klinisk kemi.
    Svensson, Peter
    Lund University, Sweden .
    Ten Berg, Jurrien M.
    St Antonius Hospital, Netherlands .
    Foley, David P.
    Beaumont Hospital, Ireland .
    Wagner, Henrik
    Lund University, Sweden .
    Brown, Patricia B.
    Eli Lilly and Co, IN USA .
    Luo, Junxiang
    Eli Lilly and Co, IN USA .
    Zhou, Chunmei
    Eli Lilly and Co, IN USA .
    Moser, Brian A.
    Eli Lilly and Co, IN USA .
    Jakubowski, Joseph A.
    Eli Lilly and Co, IN USA .
    Small, David S.
    Eli Lilly and Co, IN USA .
    Winters, Kenneth J.
    Eli Lilly and Co, IN USA .
    Angiolillo, Dominick J.
    University of Florida, FL USA .
    Prasugrel 5 mg in the Very Elderly Attenuates Platelet Inhibition But Maintains Noninferiority to Prasugrel 10 mg in Nonelderly Patients2013Ingår i: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 62, nr 7, s. 577-583Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives This study assessed pharmacodynamic (PD) response to the reduced prasugrel maintenance dose of 5 mg in very elderly (VE) patients (andgt;= 75 years of age). less thanbrgreater than less thanbrgreater thanBackground In the TRITON-TIMI 38 (TRial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet InhibitioN with Prasugrel-Thrombolysis In Myocardial Infarction 38) study prasugrel 10 mg reduced ischemic events versus clopidogrel 75 mg, but increased bleeding in VE patients. less thanbrgreater than less thanbrgreater thanMethods We examined PD and active metabolite pharmacokinetics (PKs) with prasugrel 5 and 10 mg and clopidogrel 75 mg in a 3-period (12 days each) blinded, crossover study in VE (n = 73; mean: 79 +/- 3 years of age) or (n 82) nonelderly (NE) (andgt;= 45 to andlt;65 years of age; mean: 56 +/- 5 years of age) stable coronary artery disease (CAD) patients receiving background aspirin. Assays included light transmission aggregometry (LTA), VerifyNow P2Y12 (VN-P2Y12), and vasodilator-associated stimulated phosphoprotein (VASP). The primary comparison was noninferiority of maximum platelet aggregation (MPA) comparing the median for prasugrel 5 mg in VE versus the 75th percentile for prasugrel 10 mg in NE, using a pre-specified 1-sided 97.5% confidence interval for the difference andlt;15%. less thanbrgreater than less thanbrgreater thanResults Prasugrel 5 mg in VE met the primary PD noninferiority criterion versus prasugrel 10 mg in NE. For prasugrel 5 mg, MPA was significantly lower (57 +/- 14%) than clopidogrel (63 +/- 14%; p andlt; 0.001) in VE but higher than prasugrel 10 mg in NE (46 +/- 12%; p andlt; 0.001). PD response by LTA, VN-P2Y12, and VASP during all treatments appeared similar between age cohorts. Prasugrel 5 mg resulted in fewer VE poor responders than clopidogrel. Rates of mild bleeding were higher with prasugrel 10 mg but similar for prasugrel 5 mg versus clopidogrel 75 mg. less thanbrgreater than less thanbrgreater thanConclusions In aspirin-treated stable CAD patients, prasugrel 5 mg in VE attenuated platelet inhibition while meeting pre-specified noninferiority criterion versus prasugrel 10 mg in NE, with significantly better PD response and fewer poor responders compared to clopidogrel 75 mg in VE. (Comparison of Prasugrel and Clopidogrel in Very Elderly and Non-Elderly Patients With Stable Coronary Artery Disease [GENERATIONS]; NCT01107912)

  • 7. Fraser, A.G.
    et al.
    Wilkenshoff, U.
    Janerot-Sjöberg, B.
    Linköpings universitet, Institutionen för medicinsk teknik, Fysiologisk mätteknik. Linköpings universitet, Tekniska högskolan.
    Rosenhek, R.
    Payne, N.
    Brodin, L-A.
    Quantitative stress echocardiography using tissue Doppler for the diagnosis of coronary artery disease2000Ingår i: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597Artikel i tidskrift (Refereegranskat)
  • 8. Frostfeldt, G
    et al.
    Ahlberg, G
    Gustafsson, G
    Helmius, G
    Lindahl, B
    Nygren, A
    Siegbahn, A
    Swahn, Eva
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Venge, P
    Wallentin, L
    Low molecular weight Heparin as adjusted treatment to thrombolysis in acute myocardial infarction - a pilot study: biochemic markers in acute coronary syndroms.1999Ingår i: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 33, s. 627-633Artikel i tidskrift (Refereegranskat)
  • 9.
    Holmes, Michael V.
    et al.
    UCL, England .
    Simon, Tabassome
    Hop St Antoine, France .
    J Exeter, Holly
    UCL, England .
    Folkersen, Lasse
    Karolinska Institute, Sweden .
    Asselbergs, Folkert W.
    University of Medical Centre Utrecht, Netherlands .
    Guardiola, Montse
    University of Rovira and Virgili, Spain .
    Cooper, Jackie A.
    UCL, England .
    Palmen, Jutta
    UCL, England .
    Hubacek, Jaroslav A.
    Institute Clin and Expt Med, Czech Republic .
    Carruthers, Kathryn F.
    University of Edinburgh, Scotland .
    Horne, Benjamin D.
    Intermt Medical Centre, UT USA .
    Brunisholz, Kimberly D.
    Intermt Medical Centre, UT USA .
    Mega, Jessica L.
    Brigham and Womens Hospital, MA USA .
    Van Iperen, Erik P A
    Durrer Centre Cardiogenet Research, Netherlands .
    Li, Mingyao
    University of Penn School Med, PA USA .
    Leusink, Maarten
    University of Utrecht, Netherlands .
    Trompet, Stella
    Leiden University of Medical Centre, Netherlands .
    Verschuren, Jeffrey J W.
    Leiden University of Medical Centre, Netherlands .
    Kees Hovingh, G
    University of Amsterdam, Netherlands .
    Dehghan, Abbas
    Erasmus MC, Netherlands .
    Nelson, Christopher P.
    University of Leicester, England .
    Kotti, Salma
    Hop St Antoine, France .
    Danchin, Nicolas
    University of Ulm, Germany .
    Scholz, Markus
    University of Leipzig, Germany .
    Haase L., Christiane
    Copenhagen University Hospital, Denmark .
    Rothenbacher, Dietrich
    University of Ulm, Germany .
    Swerdlow, Daniel I.
    UCL, England .
    Kuchenbaecker, Karoline B.
    University of Cambridge, England .
    Staines-Urias, Eleonora
    London School Hyg and Trop Med, England .
    Goel, Anuj
    University of Oxford, England .
    van t Hooft, Ferdinand
    Karolinska Institute, Sweden .
    Gertow, Karl
    Karolinska Institute, Sweden .
    de Faire, Ulf
    Karolinska Institute, Sweden .
    Panayiotou, Andrie G.
    Cyprus Cardiovasc Educ and Research Trust, Cyprus .
    Tremoli, Elena
    University of Milan, Italy .
    Baldassarre, Damiano
    University of Milan, Italy .
    Veglia, Fabrizio
    IRCCS, Italy .
    Holdt, Lesca M.
    University of Leipzig, Germany .
    Beutner, Frank
    University of Leipzig, Germany .
    Gansevoort, Ron T.
    University of Groningen, Netherlands .
    Navis, Gerjan J.
    University of Groningen, Netherlands .
    Mateo Leach, Irene
    University of Groningen, Netherlands .
    Breitling, Lutz P.
    German Cancer Research Centre, Germany .
    Brenner, Hermann
    German Cancer Research Centre, Germany .
    Thiery, Joachim
    University of Leipzig, Germany .
    Dallmeier, Dhayana
    University of Ulm Medical Centre, Germany .
    Franco-Cereceda, Anders
    Karolinska Institute, Sweden .
    Boer, Jolanda M A.
    National Institute Public Health and Environm, Netherlands .
    Stephens, Jeffrey W.
    Swansea University, Wales .
    Hofker, Marten H.
    University of Groningen, Netherlands .
    Tedgui, Alain
    INSERM, France .
    Hofman, Albert
    Erasmus MC, Netherlands .
    Uitterlinden, Andre G.
    Erasmus MC, Netherlands .
    Adamkova, Vera
    Institute Clin and Expt Med, Czech Republic .
    Pitha, Jan
    Institute Clin and Expt Med, Czech Republic .
    Onland-Moret, Charlotte N.
    University of Medical Centre Utrecht, Netherlands .
    Cramer, Maarten J.
    University of Medical Centre Utrecht, Netherlands .
    Nathoe, Hendrik M.
    University of Medical Centre Utrecht, Netherlands .
    Spiering, Wilko
    University of Medical Centre Utrecht, Netherlands .
    Klungel, Olaf H.
    University of Utrecht, Netherlands .
    Kumari, Meena
    UCL, England .
    Whincup, Peter H.
    University of London, England .
    Morrow, David A.
    Brigham and Womens Hospital, MA USA .
    Braund, Peter S.
    University of Leicester, England .
    Hall, Alistair S.
    University of Leeds, England .
    Olsson, Anders G.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Endokrinmedicinska enheten. Stockholm Heart Centre, Sweden .
    Doevendans, Pieter A.
    University of Medical Centre Utrecht, Netherlands .
    Trip, Mieke D.
    University of Amsterdam, Netherlands .
    Tobin, Martin D.
    University of Leicester, England .
    Hamsten, Anders
    Karolinska Institute, Sweden .
    Watkins, Hugh
    University of Oxford, England .
    Koenig, Wolfgang
    University of Ulm Medical Centre, Germany .
    Nicolaides, Andrew N.
    University of London Imperial Coll Science Technology and Med, England .
    Teupser, Daniel
    University of Leipzig, Germany .
    Day, Ian N M
    Hop St Antoine, France .
    F Carlquist, John
    Intermt Medical Centre, UT USA .
    Gaunt, Tom R.
    University of Bristol, England .
    Ford, Ian
    University of Glasgow, Scotland .
    Sattar, Naveed
    University of Glasgow, Scotland .
    Tsimikas, Sotirios
    University of Calif San Diego, CA USA .
    Schwartz, Gregory G.
    VA Medical Centre, CO USA .
    Lawlor, Debbie A.
    University of Bristol, England .
    Morris, Richard W.
    UCL, England .
    Sandhu, Manjinder S.
    VA Medical Centre, CO USA .
    Poledne, Rudolf
    Institute Clin and Expt Med, Czech Republic .
    Maitland-van der Zee, Anke H.
    University of Utrecht, Netherlands .
    Khaw, Kay-Tee
    University of Cambridge, England .
    Keating, Brendan J.
    Childrens Hospital Philadelphia, PA USA .
    van der Harst, Pim
    University of Groningen, Netherlands .
    Price, Jackie F.
    University of Edinburgh, Scotland .
    Mehta, Shamir R.
    McMaster University, Canada .
    Yusuf, Salim
    McMaster University, Canada .
    Witteman, Jaqueline C M
    Erasmus MC, Netherlands .
    Franco, Oscar H.
    Erasmus MC, Netherlands .
    Jukema, Wouter J.
    Durrer Centre Cardiogenet Research, Netherlands .
    de Knijff, Peter
    Leiden University of Medical Centre, Netherlands .
    Tybjaerg-Hansen, Anne
    Copenhagen University Hospital, Denmark .
    Rader, Daniel J.
    Penn Heart and Vasc Centre, PA USA .
    Farrall, Martin
    University of Oxford, England .
    Samani, Nilesh J.
    University of Leicester, England .
    Kivimaki, Mika
    UCL, England .
    Fox, Keith A A.
    University of Edinburgh, Scotland .
    Humphries, Steve E.
    UCL, England .
    Anderson, Jeffrey L.
    Intermt Medical Centre, UT USA .
    Boekholdt, Matthijs S.
    University of Amsterdam, Netherlands .
    Palmer, Tom M.
    University of Warwick, England .
    Eriksson, Per
    Karolinska Institute, Sweden .
    Pare, Guillaume
    McMaster University, Canada .
    Hingorani, Aroon D.
    UCL, England .
    Sabatine, Marc S.
    Brigham and Womens Hospital, MA USA .
    Mallat, Ziad
    INSERM, France .
    Casas, Juan P.
    UCL, England .
    Talmud, Philippa J.
    UCL, England .
    Secretory Phospholipase A(2)-IIA and Cardiovascular Disease2013Ingår i: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 62, nr 21, s. 1966-1976Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives This study sought to investigate the role of secretory phospholipase A(2) (sPLA(2))-IIA in cardiovascular disease. less thanbrgreater than less thanbrgreater thanBackground Higher circulating levels of sPLA(2)-IIA mass or sPLA(2) enzyme activity have been associated with increased risk of cardiovascular events. However, it is not clear if this association is causal. A recent phase III clinical trial of an sPLA(2) inhibitor (varespladib) was stopped prematurely for lack of efficacy. less thanbrgreater than less thanbrgreater thanMethods We conducted a Mendelian randomization meta-analysis of 19 general population studies (8,021 incident, 7,513 prevalent major vascular events [MVE] in 74,683 individuals) and 10 acute coronary syndrome (ACS) cohorts (2,520 recurrent MVE in 18,355 individuals) using rs11573156, a variant in PLA2G2A encoding the sPLA(2)-IIA isoenzyme, as an instrumental variable. less thanbrgreater than less thanbrgreater thanResults PLA2G2A rs11573156 C allele associated with lower circulating sPLA(2)-IIA mass (38% to 44%) and sPLA(2) enzyme activity (3% to 23%) per C allele. The odds ratio (OR) for MVE per rs11573156 C allele was 1.02 (95% confidence interval [CI]: 0.98 to 1.06) in general populations and 0.96 (95% CI: 0.90 to 1.03) in ACS cohorts. In the general population studies, the OR derived from the genetic instrumental variable analysis for MVE for a 1-log unit lower sPLA(2)-IIA mass was 1.04 (95% CI: 0.96 to 1.13), and differed from the non-genetic observational estimate (OR: 0.69; 95% CI: 0.61 to 0.79). In the ACS cohorts, both the genetic instrumental variable and observational ORs showed a null association with MVE. Instrumental variable analysis failed to show associations between sPLA2 enzyme activity and MVE. less thanbrgreater than less thanbrgreater thanConclusions Reducing sPLA(2)-IIA mass is unlikely to be a useful therapeutic goal for preventing cardiovascular events.

  • 10.
    Jaarsma, Tiny
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Hälsouniversitetet.
    Lesman, Ivonne
    van Veldhuisen, Dirk J.
    Letter: Disease Management for Nondepressed Heart Failure Patients Only Fact or Artifact? Reply2010Ingår i: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 56, nr 24, s. 2049-2050Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    n/a

  • 11. Jaarsma, Tiny
    et al.
    Lesman-Leegte, Ivonne
    Hillege, Hans L
    Veeger, Nic J
    Sanderman, Robbert
    van Veldhuisen, Dirk J
    Depression and the usefulness of a disease management program in heart failure: insights from the COACH (Coordinating study evaluating Outcomes of Advising and Counseling in Heart failure) study.2010Ingår i: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 55, nr 17, s. 1837-43Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: Our aim was to study the possible role of depressive symptoms in the effectiveness of a disease management program (DMP) in heart failure (HF) patients. BACKGROUND: Disease management programs are recommended in current HF guidelines, but certain patient groups, such as those with depression, might be less responsive to such programs. METHODS: From the data of a large multicenter study, in which we examined the effect of a DMP in HF patients, we investigated a potential interaction between depressive symptoms at baseline and the effect of such a program. RESULTS: Of the 958 HF patients (37% female; age 71 +/- 11 years; New York Heart Association functional class II to IV), 377 (39%) reported depressive symptoms at baseline. During 18 months of follow-up, the primary end point (composite of all-cause mortality and HF readmission) occurred in 39% of the nondepressed patients and 42% of depressed patients. In the overall sample, there was no significant effect of DMP on the composite primary end point. The effect of the DMP was significantly different in nondepressed than in depressed HF patients. A significant effect modification by depressive symptoms was observed in evaluating the effect of the DMP on all-cause mortality and HF readmission (p = 0.03). In patients without depressive symptoms, DMP resulted in a trend for lower incidence of the primary end point (hazard ratio: 0.8, 95% confidence interval: 0.61 to 1.04), whereas the reverse was observed in patients with depressive symptoms (hazard ratio: 1.3, 95% confidence interval: 0.95 to 1.98). CONCLUSIONS: Depressive symptoms in patients with HF have a major effect on the usefulness of DMP. Identification of depressive symptoms before enrollment in a DMP might lead to more accurate use of a DMP, because depressive patients might not benefit from a general program. (Netherlands Heart Foundation Coordinating study evaluating Outcomes of Advising and Counselling in Heart Failure; ISRCTN98675639).

  • 12.
    Jaarsma, Tiny
    et al.
    University Hospital Groningen.
    van Veldhuisen, Dirk J
    University Hospital Groningen.
    The optimal "dose" of disease management programs in HF2002Ingår i: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 39, nr 12, s. 2080-1Artikel i tidskrift (Refereegranskat)
  • 13.
    Jackowski, Christian
    et al.
    University of Bern, Switzerland .
    Schwendener, Nicole
    University of Bern, Switzerland .
    Grabherr, Silke
    University of Lausanne, Switzerland .
    Persson, Anders
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för radiologiska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Diagnostikcentrum, Röntgenkliniken i Linköping. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV.
    Post-Mortem Cardiac 3-T Magnetic Resonance Imaging Visualization of Sudden Cardiac Death?2013Ingår i: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 62, nr 7, s. 617-629Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives This study aimed to investigate post-mortem magnetic resonance imaging (pmMRI) for the assessment of myocardial infarction and hypointensities on post-mortem T-2-weighted images as a possible method for visualizing the myocardial origin of arrhythmic sudden cardiac death. less thanbrgreater than less thanbrgreater thanBackground Sudden cardiac death has challenged clinical and forensic pathologists for decades because verification on post-mortem autopsy is not possible. pmMRI as an autopsy-supporting examination technique has been shown to visualize different stages of myocardial infarction. less thanbrgreater than less thanbrgreater thanMethods In 136 human forensic corpses, a post-mortem cardiac MR examination was carried out prior to forensic autopsy. Short-axis and horizontal long-axis images were acquired in situ on a 3-T system. less thanbrgreater than less thanbrgreater thanResults In 76 cases, myocardial findings could be documented and correlated to the autopsy findings. Within these 76 study cases, a total of 124 myocardial lesions were detected on pmMRI (chronic: 25; subacute: 16; acute: 30; and peracute: 53). Chronic, subacute, and acute infarction cases correlated excellently to the myocardial findings on autopsy. Peracute infarctions (age range: minutes to approximately 1 h) were not visible on macroscopic autopsy or histological examination. Peracute infarction areas detected on pmMRI could be verified in targeted histological investigations in 62.3% of cases and could be related to a matching coronary finding in 84.9%. A total of 15.1% of peracute lesions on pmMRI lacked a matching coronary finding but presented with severe myocardial hypertrophy or cocaine intoxication facilitating a cardiac death without verifiable coronary stenosis. less thanbrgreater than less thanbrgreater thanConclusions 3-T pmMRI visualizes chronic, subacute, and acute myocardial infarction in situ. In peracute infarction as a possible cause of sudden cardiac death, it demonstrates affected myocardial areas not visible on autopsy. pmMRI should be considered as a feasible post-mortem investigation technique for the deceased patient if no consent for a clinical autopsy is obtained.

  • 14. Jacobsson, F
    et al.
    Dellborg, M
    Sahlgrens Univ Hosp, S-41345 Gothenburg, Sweden Univ Hosp, Linkoping, Sweden Akad Hosp, Uppsala, Sweden.
    Swahn, Eva
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Wallentin, L
    Sahlgrens Univ Hosp, S-41345 Gothenburg, Sweden Univ Hosp, Linkoping, Sweden Akad Hosp, Uppsala, Sweden.
    Tolerance and safety of cangrelor, a novel purin receptor antagonist, used as a platelet aggregation inhibitor in the acute coronary syndrome2000Ingår i: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 35, nr 2, s. 343A-343AKonferensbidrag (Övrigt vetenskapligt)
  • 15.
    Janzon, Magnus
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Levin, Lars-Åke
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Utvärdering och hälsoekonomi.
    Swahn, Eva
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Cast-comparison of early invasive versus non-invasive treatment in unstable coronary artery disease - A six months follow-up from the FRISC II invasive trial2000Ingår i: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 35, nr 2, s. 358A-358AKonferensbidrag (Övrigt vetenskapligt)
  • 16.
    Janzon, Magnus
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Levin, Lars-Åke
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Utvärdering och hälsoekonomi.
    Swahn, Eva
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Cost-effectiveness of early invasive treatment in unstable coronary artery disease: A one-year follow-up from the FRISC II invasive trial2001Ingår i: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 37, nr 2, s. 376A-376AKonferensbidrag (Övrigt vetenskapligt)
  • 17.
    Janzon, Magnus
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Levin, Lars-Åke
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Utvärdering och hälsoekonomi.
    Swahn, Eva
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Quality of life in unstable coronary artery disease - A comparison of early invasive versus non-invasive treatment. Six months follow-up from the FRISC II invasive trial2000Ingår i: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 35, nr 2, s. 357A-358AKonferensbidrag (Övrigt vetenskapligt)
  • 18.
    Janzon, Magnus
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Levin, Lars-Åke
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Utvärdering och hälsoekonomi.
    Swahn, Eva
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Quality of life one year after invasive intervention in unstable coronary artery disease: Results from the FRISC II invasive trial2001Ingår i: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 37, nr 2, s. 360A-360AKonferensbidrag (Övrigt vetenskapligt)
  • 19.
    Jekell, A
    et al.
    Linkoping Univ, S-58183 Linkoping, Sweden.
    Hossain, A
    Rosen, A
    Dahlström, Ulf
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Thioredoxin: A new marker of oxidative stress in patients with chronic heart failure2002Ingår i: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 39, nr 5, s. 176A-176AKonferensbidrag (Övrigt vetenskapligt)
  • 20.
    Johansson, Isabelle
    et al.
    Karolinska Institute, Sweden.
    Dahlström, Ulf
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    Edner, Magnus
    Karolinska Institute, Sweden.
    Nasman, Per
    KTH Royal Institute Technology, Sweden.
    Ryden, Lars
    Karolinska Institute, Sweden.
    Norhammar, Anna
    Karolinska Institute, Sweden.
    Prognostic Implications of Type 2 Diabetes Mellitus in Ischemic and Nonischemic Heart Failure2016Ingår i: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 68, nr 13, s. 1404-1416Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND Heart failure (HF) is a common and serious complication in type 2 diabetes mellitus (T2DM). The prognosis of ischemic HF and impact of revascularization in such patients have not been investigated fully in a patient population representing everyday practice. OBJECTIVES This study examined the impact of ischemic versus nonischemic HF and previous revascularization on long-term prognosis in an unselected population of patients with and without T2DM. METHODS Patients stratified by diabetes status and ischemic or nonischemic HF and history of revascularization in the Swedish Heart Failure Registry (SwedeHF) from 2003 to 2011 were followed up for mortality predictors and longevity. A propensity score analysis was applied to evaluate the impact of previous revascularization. RESULTS Among 35,163 HF patients, those with T2DM were younger, and 90% had 1 or more associated comorbidities. Ischemic heart disease (IHD) occurred in 62% of patients with T2DM and 47% of those without T2DM, of whom 53% and 48%, respectively, had previously undergone revascularization. T2DM predicted mortality regardless of the presence of IHD, with adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of 1.40 (1.33 to 1.46) and 1.30 (1.22 to 1.39) in those with and without IHD, respectively. Patients with both T2DM and IHD had the highest mortality, which was further accentuated by the absence of previous revascularization (adjusted HR: 0.82 in favor of such treatment; 95% CI: 0.75 to 0.91). Propensity score adjustment did not change these results (HR: 0.87; 95% CI: 0.78 to 0.96). Revascularization did not abolish the impact of T2DM, which predicted mortality in those with (HR: 1.36; 95% CI: 1.24 to 1.48) and without (HR: 1.45; 95% CI: 1.33 to 1.56) a history of revascularization. CONCLUSIONS Ninety percent of HF patients with T2DM have preventable comorbidities. IHD in patients with T2DM had an especially negative influence on mortality, an impact that was beneficially influenced by previous revascularization. (C) 2016 by the American College of Cardiology Foundation.

  • 21. Kvitting, JPE
    et al.
    Ebbers, Tino
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Klinisk fysiologi. Östergötlands Läns Landsting, Hjärtcentrum, Fysiologiska kliniken.
    Wigström, Lars
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Klinisk fysiologi. Östergötlands Läns Landsting, Hjärtcentrum, Fysiologiska kliniken.
    Engvall, Jan
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Klinisk fysiologi. Östergötlands Läns Landsting, Hjärtcentrum, Fysiologiska kliniken.
    Bolger, Ann F
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Klinisk fysiologi. Östergötlands Läns Landsting, Hjärtcentrum, Fysiologiska kliniken.
    Olin, CL
    Assessment of the 3-D flow pattern in the sinuses of Valsalva2003Ingår i: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 41, nr 6, s. 437A-437AKonferensbidrag (Övrigt vetenskapligt)
  • 22.
    Lagerqvist, B.
    et al.
    Department of Cardiology, University Hospital, S-751 85 Uppsala, Sweden.
    Husted, S.
    Department of Cardiology, University Hospital, Aarhus, Denmark.
    Kontny, F.
    Heart and Lung Centre, Ullevål University Hospital, Oslo, Norway.
    Naslund, U.
    Näslund, U., Department of Cardiology, Heart Centre, University Hospital, Umeå, Sweden.
    Stahle, E.
    Ståhle, E., Department of Thoracic Surgery, University Hospital, S-751 85 Uppsala, Sweden.
    Swahn, Eva
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Wallentin, L.
    Department of Cardiology, University Hospital, S-751 85 Uppsala, Sweden.
    A long-term perspective on the protective effects of an early invasive strategy in unstable coronary artery disease: Two-year follow-up of the FRISC-II Invasive Study2002Ingår i: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 40, nr 11, s. 1902-1914Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: We sought to report the first and repeat events and to separate spontaneous and procedure-related events over two years in the Fast Revascularization during InStability in Coronary artery disease (FRISC-II) invasive trial. BACKGROUND: The FRISC-II invasive trial compared the long-term effects of an early invasive versus noninvasive strategy, in terms of death and myocardial infarction (MI) and the need for repeat hospital admissions and late revascularization procedures in patients with coronary artery disease (UCAD). METHODS: In the FRISC-II trial, 2,457 patients with UCAD were randomized to an early invasive or noninvasive strategy. RESULTS: At 24 month follow-up, there were reductions in mortality (n = 45 [3.7%] vs. 67 [5.4%], risk ratio 0.68 [95% confidence interval (CI) 0.47 to 0.98], p = 0.038), MI (n = 111 [9.2%] vs. 156 [12.7%], risk ratio 0.72 [95% CI 0.57 to 0.91], p = 0.005), and the composite end point of death or MI (n = 146 [12.1%] vs. 200 [16.3%], risk ratio 0.74 [95% CI 0.61 to 0.90], p = 0.003) in the invasive compared with the noninvasive group. Procedure-related MIs were two to three times more common, but spontaneous ones were three times less common in the invasive than in the noninvasive group. After the first year, there was no difference in mortality (n = 20 [1.7%]) between the two groups and fewer MIs in the invasive group (p = 0.031). CONCLUSIONS: In UCAD, the early invasive approach leads to a sustained reduction in mortality, cardiac morbidity, and the need for repeat hospital admissions and late revascularization procedures. Although the benefits are greatest during the first months, during the second year, cardiac morbidity is lower and the need for hospital care is less in the invasive group. © 2002 by the American College of Cardiology Foundation.

  • 23. Lagerqvist, B
    et al.
    Säfström, Kåge
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Ståhle, E
    Wallentin, L
    Swahn, Eva
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Is early invasive treatment of unstable coronary artery disease equally effective for both women and men?2001Ingår i: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 38, nr 1, s. 41-48Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: The Fragmin and fast Revascularization during InStability in Coronary artery disease (FRISC II) trial compared the effectiveness of an early invasive versus a noninvasive strategy in terms of the incidence of death and myocardial infarction (MI) in patients with unstable coronary artery disease (CAD). OBJECTIVES: In this subanalysis, we sought to evaluate gender differences in the effect of these different strategies. METHODS: The patients (749 women and 1,708 men) were randomized to early invasive or noninvasive strategies. Coronary angiography was performed within the first 7 days in 96% and 10% of the invasive and noninvasive groups, respectively, and revascularization was performed within the first 10 days in 71% and 9% of the invasive and noninvasive groups, respectively. RESULTS: Women presenting with unstable CAD were older, but fewer had previous infarctions, left ventricular dysfunction and elevated troponin T levels. Women had fewer angiographic changes. There was no difference in MI or death at 12 months among women in the invasive and noninvasive groups (12.4% vs. 10.5%, respectively), in contrast to the favorable effect in the invasively treated group of men (9.6% vs. 15.8%, p < 0.001). In an interaction analysis, there was a different effect of the early invasive strategy for the two genders (p = 0.008). CONCLUSIONS: Women with symptoms and/or signs of unstable CAD are older, but still have less severe CAD and a better prognosis compared with men. In contrast to its beneficial effect in men, an early invasive strategy did not reduce the risk of future events among women. Further research is warranted to identify the most appropriate treatment strategy in women with unstable CAD. ⌐ 2001 American College of Cardiology.

  • 24.
    Melki, Dina
    et al.
    Karolinska Institute, Sweden.
    Lugnegard, Johan
    Uppsala University, Sweden.
    Alfredsson, Joakim
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    Lind, Suzanne
    Karolinska Institute, Sweden.
    Eggers, Kai M.
    Uppsala University, Sweden.
    Lindahl, Bertil
    Uppsala University, Sweden.
    Jernberg, Tomas
    Karolinska Institute, Sweden.
    Implications of Introducing High-Sensitivity Cardiac Troponin T Into Clinical Practice Data From the SWEDEHEART Registry2015Ingår i: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 65, nr 16, s. 1655-1664Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND Cardiac troponin is the preferred biomarker for diagnosing myocardial infarction (MI). OBJECTIVES The aim of this study was to examine the implications of introducing high-sensitivity cardiac troponin T (hs-cTnT) into clinical practice and to define at what hs-cTnT level risk starts to increase. METHODS We analyzed data from 48,594 patients admitted because of symptoms suggesting an acute coronary syndrome and who were entered into a large national registry. Patients were divided into Group 1, those with hs-cTnT less than6 ng/l; Group 2, those with hs-cTnT 6 to 13 ng/l; Group 3, those with hs-cTnT 14 to 49 ng/l (i.e., a group in which most patients would have had a negative cardiac troponin T with older assays); and Group 4, those with hs-cTnT greater than= 50 ng/l. RESULTS There were 5,790 (11.9%), 6,491 (13.4%), 10,476 (21.6%), and 25,837 (53.2%) patients in Groups 1, 2, 3, and 4, respectively. In Groups 1 to 4, the proportions with MI were 2.2%, 2.6%, 18.2%, and 81.2%. There was a stepwise increase in the proportion of patients with significant coronary stenoses, left ventricular systolic dysfunction, and death during follow-up. When dividing patients into 20 groups according to hs-cTnT level, the adjusted mortality started to increase at an hs-cTnT level of 14 ng/l. CONCLUSIONS Introducing hs-cTnT into clinical practice has led to the recognition of a large proportion of patients with minor cardiac troponin increases (14 to 49 ng/l), the majority of whom do not have MI. Although a heterogeneous group, these patients remain at high risk, and the adjusted mortality rate started to increase at the level of the 99th percentile in healthy controls.

  • 25. Nijm, J
    et al.
    Wikby, A
    Jonasson, Lena
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Proinflammatory cytokines and neutrophil activation in stable angina2004Ingår i: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 41, s. 359a-359aArtikel i tidskrift (Refereegranskat)
  • 26.
    ODonoghue, Michelle L.
    et al.
    Brigham and Womens Hospital, USA .
    Vaidya, Ajay
    University of Calif San Francisco, USA .
    Afsal, Rizwan
    McMaster University, Canada .
    Alfredsson, Joakim
    Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    Boden, William E.
    Albany Stratton VA Medical Centre, USA .
    Braunwald, Eugene
    Brigham and Womens Hospital, USA .
    Cannon, Christopher P.
    Brigham and Womens Hospital, USA .
    Clayton, Tim C.
    London School Hyg and Trop Med, England .
    de Winter, Robbert J.
    University of Amsterdam, Netherlands .
    Fox, Keith A. A.
    University of Edinburgh, Scotland Royal Infirm Edinburgh NHS Trust, Scotland .
    Lagerqvist, Bo
    University of Uppsala Hospital, Sweden .
    McCullough, Peter A.
    St John Providence Health Syst Providence Pk Heart, MI USA .
    Murphy, Sabina A.
    Brigham and Womens Hospital, USA .
    Spacek, Rudolf
    3rd Medical Fac Prague, Czech Republic .
    Swahn, Eva
    Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    Windhausen, Fons
    University of Amsterdam, Netherlands .
    Sabatine, Marc S.
    Brigham and Womens Hospital, USA .
    An Invasive or Conservative Strategy in Patients With Diabetes Mellitus and Non-ST-Segment Elevation Acute Coronary Syndromes A Collaborative Meta-Analysis of Randomized Trials2012Ingår i: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 60, nr 2, s. 106-111Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives The purpose of this study was to conduct a meta-analysis to examine an invasive or conservative strategy in diabetic versus nondiabetic patients. Background Diabetic patients are at increased risk of cardiovascular events after an acute coronary syndrome, yet it remains unknown whether they derive enhanced benefit from an invasive strategy. Methods Randomized trials comparing an invasive versus conservative treatment strategy were identified. The prevalence of cardiovascular events through 12 months was reported for each trial, stratified by diabetes mellitus status and randomized treatment strategy. Relative risk (RR) ratios and absolute risk reductions were combined using random-effects models. Results Data were combined across 9 trials comprising 9,904 subjects of whom 1,789 (18.1%) had diabetes mellitus. The RRs for death, nonfatal myocardial infarction (MI), or rehospitalization with an acute coronary syndrome for an invasive versus conservative strategy were similar between diabetic patients (RR: 0.87; 95% confidence interval [CI]: 0.73 to 1.03) and nondiabetic patients (RR: 0.86; 95% CI: 0.70 to 1.06; p interaction = 0.83). An invasive strategy reduced nonfatal MI in diabetic patients (RR: 0.71; 95% CI: 0.55 to 0.92), but not in nondiabetic patients (RR: 0.98; 95% CI: 0.74 to 1.29; p interaction = 0.09). The absolute risk reduction in MI with an invasive strategy was greater in diabetic than nondiabetic patients (absolute risk reduction: 3.7% vs. 0.1%; p interaction = 0.02). There were no differences in death or stroke between groups (p interactions 0.68 and 0.20, respectively). Conclusions An early invasive strategy yielded similar RR reductions in overall cardiovascular events in diabetic and nondiabetic patients. However, an invasive strategy appeared to reduce recurrent nonfatal MI to a greater extent in diabetic patients. These data support the updated guidelines that recommend an invasive strategy for patients with diabetes mellitus and non-ST-segment elevation acute coronary syndromes.

  • 27.
    Sarno, Giovanna
    et al.
    Uppsala University, Sweden .
    Lagerqvist, Bo
    Uppsala University, Sweden .
    Nilsson, Johan
    Umeå University Hospital, Sweden .
    Frobert, Ole
    Örebro University Hospital, Sweden .
    Hambraeus, Kristina
    Falun Central Hospital, Sweden .
    Varenhorst, Christoph
    Uppsala University, Sweden .
    Jensen, Ulf J.
    Karolinska University Hospital, Sweden .
    Tödt, Tim
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    Gotberg, Matthias
    Lund University, Sweden .
    James, Stefan K.
    Uppsala University, Sweden .
    Stent Thrombosis in New-Generation Drug-Eluting Stents in Patients With STEMI Undergoing Primary PCI2014Ingår i: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 64, nr 1, s. 16-24Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND:

    Some concerns still have not been resolved about the long-term safety of drug-eluting stents (DES) in patients with acute STEMI.

    OBJECTIVES:

    The aim of this study was to evaluate the stent thrombosis (ST) rate up to 3 years in patients with ST-segment elevation myocardial infarction (STEMI) treated by primary percutaneous coronary intervention (PCI) with new-generation drug-eluting stents (n-DES) compared with bare-metal stents (BMS) and old-generation drug-eluting stents (o-DES) enrolled in the SCAAR (Swedish Coronary Angiography and Angioplasty Registry).

    METHODS:

    From January 2007 to January 2013, 34,147 patients with STEMI were treated by PCI with n-DES (n = 4,811), o-DES (n = 4,271), or BMS (n = 25,065). The risks of early/late (up to 1 year) and very late definite ST (after 1 year) were estimated.

    RESULTS:

    Cox regression landmark analysis showed a significantly lower risk of early/late ST in patients treated with n-DES (hazard ratio [HR]: 0.65; 95% confidence interval [CI]: 0.43 to 0.99; p = 0.04) and o-DES (HR: 0.60; 95% CI: 0.41 to 0.89; p = 0.01) compared with the BMS group. The risk of very late ST was similar between the n-DES and BMS groups (HR: 1.52; 95% CI: 0.78 to 2.98; p = 0.21), whereas a higher risk of very late ST was observed with o-DES compared with BMS (HR: 2.88; 95% CI: 1.70 to 4.89; p < 0.01).

    CONCLUSIONS:

    Patients treated with n-DES have a lower risk of early/late ST than patients treated with BMS. The risk of very late ST is low and comparable between n-DES and BMS up to 3 years of follow-up, whereas o-DES treatment is associated with an increased risk of very late ST. The current STEMI guidelines might require an update in light of the results of this and other recent studies.

  • 28.
    Schwartz, Gregory G.
    et al.
    Denver VA Medical Centre, CO 80220 USA; University of Colorado, CO 80202 USA.
    Abt, Markus
    F Hoffmann La Roche, Switzerland.
    Bao, Weihang
    Pfizer Inc, NY USA.
    DeMicco, David
    Pfizer Inc, NY USA.
    Kallend, David
    F Hoffmann La Roche, Switzerland.
    Miller, Michael
    University of Maryland, MD 21201 USA.
    Mundl, Hardi
    F Hoffmann La Roche, Switzerland.
    Olsson, Anders
    Region Östergötland, Hjärt- och Medicincentrum, Endokrinmedicinska kliniken. Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Stockholm Heart Centre, Sweden.
    Fasting Triglycerides Predict Recurrent Ischemic Events in Patients With Acute Coronary Syndrome Treated With Statins2015Ingår i: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 65, nr 21, s. 2267-2275Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND Most patients with acute coronary syndrome (ACS) are treated with statins, which reduce atherogenic triglyceride-rich lipoproteins. It is uncertain whether triglycerides predict risk after ACS on a background of statin treatment. OBJECTIVES This study examined the relationship of fasting triglyceride levels to outcomes after ACS in patients treated with statins. METHODS Long-term and short-term relationships of triglycerides to risk after ACS were examined in the dal-OUTCOMES trial and atorvastatin arm of the MIRACL (Myocardial Ischemia Reduction with Acute Cholesterol Lowering) trial, respectively. Analysis of dal-OUTCOMES included 15,817 patients (97% statin-treated) randomly assigned 4 to 12 weeks after ACS to treatment with dalcetrapib (a cholesteryl ester transfer protein inhibitor) or placebo and followed for a median 31 months. Analysis of MIRACL included 1,501 patients treated with atorvastatin 80 mg daily beginning 1 to 4 days after ACS and followed for 16 weeks. Fasting triglycerides at initial random assignment were related to risk of coronary heart disease death, nonfatal myocardial infarction, stroke, and unstable angina in models adjusted for age, sex, hypertension, smoking, diabetes, high-density lipoprotein cholesterol, and body mass index. RESULTS Fasting triglyceride levels were associated with both long-term and short-term risk after ACS. In dalOUTCOMES, long-term risk increased across quintiles of baseline triglycerides (p less than 0.001). The hazard ratio in the highest/lowest quintile (greater than 175/less than= 80 mg/dl) was 1.50 (95% confidence interval: 1.05 to 2.15). There was no interaction of triglycerides and treatment assignment on the primary outcome. In the atorvastatin group of MIRACL, short-term risk increased across tertiles of baseline triglycerides (p = 0.03), with a hazard ratio of 1.51 (95% confidence interval: 1.05 to 2.15) in highest/lowest tertiles (greater than195/less than= 135 mg/dl). The relationship of triglycerides to risk was independent of lowdensity lipoprotein cholesterol in both studies. CONCLUSIONS Among patients with ACS treated effectively with statins, fasting triglycerides predict long-term and short-term cardiovascular risk. Triglyceride-rich lipoproteins may be an important additional target for therapy. (C) 2015 by the American College of Cardiology Foundation.

  • 29.
    Stenestrand, Ulf
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Wallentin, L
    Linkoping Univ Hosp, Ctr Heart, S-58185 Linkoping, Sweden Univ Uppsala Hosp, Dept Cardiol, Uppsala, Sweden.
    Early statin treatment improves long-term survival in patients discharged alive after acute myocardial infarction2001Ingår i: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 37, nr 2, s. 369A-369AKonferensbidrag (Övrigt vetenskapligt)
  • 30.
    Stenestrand, Ulf
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Kardiologi. Östergötlands Läns Landsting, Hjärtcentrum, Kardiologiska kliniken.
    Wallentin, L
    Linkoping Univ Hosp, Ctr Heart, S-58185 Linkoping, Sweden Univ Uppsala Hosp, Dept Cardiol, Uppsala, Sweden.
    Thrombolysis is beneficial in elderly acute myocardial infarction patients2001Ingår i: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 37, nr 2, s. 323S-323SKonferensbidrag (Övrigt vetenskapligt)
  • 31. Sun, Ying
    et al.
    Ask, Per
    Linköpings universitet, Institutionen för medicinsk teknik, Fysiologisk mätteknik. Linköpings universitet, Tekniska högskolan.
    Sjöberg, Birgitta Janero
    Linköpings universitet, Institutionen för medicin och hälsa, Klinisk fysiologi. Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Fysiologiska kliniken US.
    Eindvall, Lars
    Loyd, Dan
    Linköpings universitet, Institutionen för ekonomisk och industriell utveckling, Mekanisk värmeteori och strömningslära. Linköpings universitet, Tekniska högskolan.
    Wranne, Bengt
    Linköpings universitet, Institutionen för medicin och vård, Klinisk fysiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Fysiologiska kliniken US.
    Estimation of volume flow rate by surface integration of velocity vectors from color Doppler images1997Ingår i: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 8, nr 6, s. 904-914Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    A new Doppler echocardiographically based method has been developed to quantify volume flow rate by surface integration of velocity vectors (SIVV). Electrocardiographic-gated color Doppler images acquired in two orthogonal planes were used to estimate volume flow rate through a bowl-shaped surface at a given time and distance from the probe. To provide in vitro validation, the method was tested in a hydraulic model representing a pulsatile flow system with a restrictive orifice. Accurate estimates of stroke volume (±10%) were obtained in a window between 1.2 and 1.6 cm proximal to the orifice, just before the region of prestenotic acceleration. By use of the Bernoulli's equation, the estimated flows were used to generate pressure gradient waveforms across the orifice, which agreed well with the measured flows. To demonstrate in vivo applicability, the SIVV method was applied retrospectively to the determination of stroke volume and subaortic flow from the apical three-chamber and five-chamber views in two patients. Stroke volume estimates along the left ventricular outflow tract showed a characteristic similar to that in the in vitro study and agreed well with those obtained by the Fick oxygen method. The region where accurate measurements can be obtained is affected by instrumental factors including Nyquist velocity limit, wall motion filter cutoff, and color flow sector angle. The SIVV principle should be useful for quantitative assessment of the severity of valvular abnormalities and noninvasive measurement of pulsatile volume flows in general.

  • 32.
    Säfström, Kåge
    et al.
    Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Linköpings universitet, Hälsouniversitetet.
    Swahn, Eva
    Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Linköpings universitet, Hälsouniversitetet.
    Lindahl, Bertil
    Department of Cardiology, University of Uppsala, Uppsala, Sweden.
    Risk stratification in unstable coronary artery disease: Exercise test and troponin T from a gender perspective2000Ingår i: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 35, nr 7, s. 1791-1800Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES

    The study was done to determine the prognostic yield of an early symptom-limited exercise test (ET) and measurement of troponin T (TnT) in men and women with unstable coronary artery disease (CAD), with special reference to gender differences.

    BACKGROUND

    Early risk assessment is essential for the application of appropriate treatment and further management in patients with unstable CAD. The early symptom-limited ET together with specific biochemical marker determination is an inexpensive, widely applicable method for early risk stratification. In women, however, the ET is considered less reliable, and there are few data on biochemical markers for risk stratification in women.

    METHODS

    In a substudy of the Fragmin during InStability in Coronary artery disease (FRISC I) trial, 395 women and 778 men with unstable CAD who performed an early ET were followed for six months. Blood samples for TnT determination were taken in 342 women and 621 men at inclusion.

    RESULTS

    Based on the ET results, low-, intermediate-, and high-risk response groups were identified with event rates of cardiac death or myocardial infarction (MI) of 1%, 9%, and 19%, respectively, among women and 8%, 14%, and 20%, respectively, among men. Patients who could not perform the ET had an event rate similar to the high-risk group. The TnT levels were divided into three groups: <0.06, 0.06–0.19, and ≥0.20 μg/liter with event rates of 1%, 10%, and 18%, respectively, among women and 9%, 14%, and 18%, respectively, among men. Combining the ET results with TnT levels identified a low-risk group with an event rate of 3% in the male population and no events in the female population.

    CONCLUSIONS

    Direct comparison between men and women from the same population with a high pretest likelihood of disease suggests that both TnT and the early symptom-limited ET are at least as useful as prognostic risk indicators in women as they are in men.

  • 33.
    Takahashi, Yoshihide
    et al.
    Hôpital Cardiologique du Haut-Lévêque, Bordeaux-Pessac, France.
    Hocini, Mélèze
    ONeill, Mark D.
    British Heart Foundation International Fellowship.
    Sanders, Prashanthan
    National Health and Medical Research Council of Australia and the Ralph Reader Fellowship from the National Heart Foundation of Australia.
    Rotter, Martin
    Swiss National Foundation for Scientific Research, Bern, Switzerland.
    Rostock, Thomas
    German Cardiac Society.
    Jönsson, Anders
    Swedish Society of Cardiology.
    Sacher, Frédéric
    Clémenty, Jacques
    Jais, Pierre
    Biosense Webster.
    Haissaguerre, Michel
    Biosense Webster.
    Sites of focal atrial activity characterized by endocardial mapping during atrial fibrillation2006Ingår i: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 47, nr 10, s. 2005-2012Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives

    The aim of the present study was to assess the feasibility of identifying sites of focal atrial activity by localized high-density endocardial mapping during atrial fibrillation (AF).

    Background

    Sites of focal activity in the left atrium have been demonstrated by epicardial mapping during AF.

    Methods

    Twenty-four patients (15 with paroxysmal, 3 with persistent, and 6 with permanent AF) underwent endocardial mapping during AF. A 20-pole catheter with five radiating spines was used to map both atria for 30 s in each of 10 pre-determined segments. A focal activity was defined as ≥3 atrial cycles with activation spreading from center to periphery of the mapping catheter. Catheter ablation was performed independent of the mapping results.

    Results

    Spontaneous focal activities were observed in 13 sites in the left atrium (9%; anterior 1, roof 2, posterior 6, inferior 4) in 12 patients (9 paroxysmal, 3 persistent). Focal activity was observed continuously (two sites) or intermittently (11 sites, median 5 episodes), and associated with shortening of the cycle length (from 183 ± 33 ms to 172 ± 29 ms; p < 0.05). The mean duration of an intermittent episode was 1.5 s (range 0.4 to 7.1 s). Atrial fibrillation terminated without ablation at the foci in all of 12 patients, but in 2 of them, re-initiated arrhythmia was successfully ablated at these foci. Nine of these 12 patients (75%) were arrhythmia-free without antiarrhythmic drugs during a follow-up period of 7.0 ± 3.1 months.

    Conclusions

    Termination of AF without ablation at the sites of atrial focal activity suggests that this activity may be triggered by impulses originating from other regions, such as the pulmonary veins.

      

  • 34.
    Takahashi, Yoshihide
    et al.
    Hôpital Cardiologique du Haut-Lévêque.
    ONeill, Mark D
    Hôpital Cardiologique du Haut-Lévêque.
    Hocini, Méléze
    Hôpital Cardiologique du Haut-Lévêque.
    Dubois, Rémi
    Hôpital Cardiologique du Haut-Lévêque.
    Matsuo, Seiichiro
    Hôpital Cardiologique du Haut-Lévêque.
    Knecht, Sébastien
    Hôpital Cardiologique du Haut-Lévêque.
    Mahapatra, Srijoy
    Hôpital Cardiologique du Haut-Lévêque.
    Lim, Kang-Teng
    Hôpital Cardiologique du Haut-Lévêque.
    Jaïs, Pierre
    Hôpital Cardiologique du Haut-Lévêque.
    Jönsson, Anders
    Hôpital Cardiologique du Haut-Lévêque.
    Sacher, Frédéric
    Hôpital Cardiologique du Haut-Lévêque.
    Sanders, Prashanthan
    Hôpital Cardiologique du Haut-Lévêque.
    Rostock, Thomas
    Hôpital Cardiologique du Haut-Lévêque.
    Bordachar, Pierre
    Hôpital Cardiologique du Haut-Lévêque.
    Clémenty, Jacques
    Hôpital Cardiologique du Haut-Lévêque.
    Klein, George J.
    Hôpital Cardiologique du Haut-Lévêque.
    Haïssaguerre, Michel
    Hôpital Cardiologique du Haut-Lévêque.
    Characteriztion of electrograms associated with termination of chronic atrial fibrillation by catheter ablation2008Ingår i: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 51, s. 1003-1010Artikel i tidskrift (Refereegranskat)
  • 35.
    Thorvaldsen, Tonje
    et al.
    Karolinska Institute, Sweden Karolinska University Hospital, Sweden .
    Benson, Lina
    Karolinska Institute, Sweden .
    Stahlberg, Marcus
    Karolinska Institute, Sweden Karolinska University Hospital, Sweden .
    Dahlström, Ulf
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    Edner, Magnus
    Karolinska Institute, Sweden .
    Lund, Lars H.
    Karolinska Institute, Sweden Karolinska University Hospital, Sweden .
    Triage of Patients With Moderate to Severe Heart Failure2014Ingår i: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 63, nr 7, s. 661-671Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives The purpose of this study was to evaluate simple criteria for referral of patients from the general practitioner to a heart failure (HF) center. Background In advanced HF, the criteria for heart transplantation, left ventricular assist device, and palliative care are well known among HF specialists, but criteria for referral to an advanced HF center have not been developed for generalists. Methods We assessed observed and expected all-cause mortality in 10,062 patients with New York Heart Association (NYHA) functional class III to IV HF and ejection fraction less than 40% registered in the Swedish Heart Failure Registry between 2000 and 2013. Next, 5 pre-specified universally available risk factors were assessed as potential triggers for referral, using multivariable Cox regression: systolic blood pressure less than= 90 mm Hg; creatinine greater than= 160 mmol/l; hemoglobin less than= 120 g/l; no renin-angiotensin system antagonist; and no beta-blocker. Results In NYHA functional class III to IV and age groups less than= 65 years, 66 to 80 years, and greater than 80 years, there were 2,247, 4,632, and 3,183 patients, with 1-year observed versus expected survivals of 90% versus 99%, 79% versus 97%, and 61% versus 89%, respectively. In the age less than= 80 years group, the presence of 1, 2, or 3 to 5 of these risk factors conferred an independent hazard ratio for all-cause mortality of 1.40, 2.30, and 4.07, and a 1-year survival of 79%, 60%, and 39%, respectively (p less than 0.001). Conclusions In patients less than= 80 years of age with NYHA functional class III to IV HF and ejection fraction less than 40%, mortality is predominantly related to HF or its comorbidities. Potential heart transplantation/left ventricular assist device candidacy is suggested by greater than= 1 risk factor and potential palliative care by multiple universally available risk factors. These patients may benefit from referral to an advanced HF center.

  • 36.
    Tikkanen, Matti J
    et al.
    Univ Helsinki, Cent Hosp, Dept Med, Div Cardiol, FIN-00290 Helsinki, Finland.
    Szarek, Michael
    Pfizer Inc, New York, NY USA.
    Fayyad, Rana
    Pfizer Inc, New York, NY USA.
    Holme, Ingar
    Ullevaal Univ Hosp, Ctr Prevent Med, Oslo, Norway.
    Cater, Nilo B
    Pfizer Inc, New York, NY USA.
    Faergeman, Ole
    Aarhus Univ Hosp, Dept Med Cardiol A, DK-8000 Aarhus, Denmark.
    Kastelein, John J P
    Acad Hosp Amsterdam, Dept Vasc Med, Amsterdam, Netherlands.
    Olsson, Anders
    Linköpings universitet, Institutionen för medicin och hälsa, Internmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Medicincentrum, Endokrin- och magtarmmedicinska kliniken US.
    Lytken Larsen, Mogens
    Department of Medicine-Cardiology A, Århus University Hospital, Århus, Denmark.
    Lindahl, Christina
    Pfizer Sweden, Sollentuna, Sweden.
    Pedersen, Terje R
    Ullevaal Univ Hosp, Ctr Prevent Med, Oslo, Norway.
    Total Cardiovascular Disease Burden: Comparing Intensive With Moderate Statin Therapy Insights From the IDEAL (Incremental Decrease in End Points Through Aggressive Lipid Lowering) Trial2009Ingår i: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 54, nr 25, s. 2353-2357Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives This post-hoc analysis of the IDEAL (Incremental Decrease in End Points Through Aggressive Lipid Lowering) trial was designed to assess the comparative treatment efficacy of high-dose atorvastatin and usual-dose simvastatin for the prevention of events subsequent to the first event, using the Wei, Lin, and Weissfeld method. Background Time-to-first-event analysis of data is frequently utilized to provide efficacy outcome information in coronary heart disease prevention trials. However, during the course of such long-term trials, a large number of events occur subsequent to the first event, the analysis of which will be precluded by this approach. Methods The Wei, Lin, and Weissfeld method allows the analysis of repeated occurrence of events of the same type or of entirely different natures. It regards the recurrence times as multivariate event (failure) times, and models the marginal (individual) distribution for each event with the Cox proportional hazards model. Results In the IDEAL trial, compared with patients taking simvastatin 20 to 40 mg daily, patients receiving atorvastatin 80 mg daily had their relative risk of a first cardiovascular event reduced by 17% (p less than 0.0001), of a second by 24% (p less than 0.0001), of a third by 19% (p = 0.035), of a fourth by 24% (p = 0.058), and of a fifth by 28% (p = 0.117). Conclusions Our results indicate that intensive statin therapy continues to be more effective than standard statin therapy, even beyond the first event, and suggest that clinicians should not hesitate to prescribe high-dose statin therapy for patients experiencing multiple recurrent cardiovascular events.

  • 37.
    Ueda, Peter
    et al.
    Karolinska Inst, Sweden.
    Jernberg, Tomas
    Karolinska Inst, Sweden.
    James, Stefan
    Uppsala Univ, Sweden.
    Alfredsson, Joakim
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    Erlinge, David
    Lund Univ, Sweden.
    Omerovic, Elmir
    Sahlgrens Univ Hosp, Sweden.
    Persson, Jonas
    Karolinska Inst, Sweden.
    Ravn-Fischer, Annica
    Sahlgrens Univ Hosp, Sweden.
    Tornvall, Per
    Karolinska Inst, Sweden.
    Svennblad, Bodil
    Uppsala Univ, Sweden.
    Varenhorst, Christoph
    Uppsala Univ, Sweden; Pfizer AB, Sweden.
    External Validation of the DAPT Score in a Nationwide Population2018Ingår i: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 72, nr 10, s. 1069-1078Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND The dual antiplatelet therapy (DAPT) score guides decisions on DAPT duration after coronary stenting by simultaneously predicting ischemic and bleeding risk. OBJECTIVES This study sought to assess the performance of the DAPT score in a nationwide real-world population. METHODS The study used register data in Sweden (2006 to 2014) and followed 41,101 patients who had undergone 12 months of event-free DAPT, from months 12 to 30 after stenting. Risk of myocardial infarction (MI) or stent thrombosis, major adverse cardiovascular and cerebrovascular events (MACCE) (MI, stroke, and all-cause death), and fatal or major bleeding were compared according to DAPT score. RESULTS The score had a discrimination of 0.58 (95% confidence interval [CI]: 0.56 to 0.60) for MI or stent thrombosis, 0.54 (95% CI: 0.53 to 0.55) for MACCE, and 0.49 (95% CI: 0.45 to 0.53) for fatal or major bleeding. Risk of MI or stent thrombosis was significantly increased at scores of amp;gt;= 3 while MACCE risk followed a J-shaped pattern and increased at scores of amp;gt;= 4. Absolute differences in fatal or major bleeding risk were small between scores. Event rates of ischemic and bleeding outcomes in patients with high (amp;gt;= 2) and low (amp;lt; 2) scores differed compared to the DAPT Study from which the score was derived; fatal or major bleeding rates were approximately one-half of those in the placebo arm of the DAPT Study. CONCLUSIONS In a nationwide population, the DAPT score did not adequately discriminate ischemic and bleeding risk, the relationship between score and ischemic risk did not correspond to the suggested decision rule for extended DAPT, and risk of bleeding was lower compared with the DAPT Study. The score and its decision rule may not be generalizable to real-world populations. (C) 2018 by the American College of Cardiology Foundation.

  • 38.
    van, der Steeg W.A.
    et al.
    van der Steeg, W.A., Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands.
    Holme, I.
    Center for Preventive Medicine, Ullevål University Hospital, Oslo, Norway.
    Boekholdt, S.M.
    Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands.
    Larsen, M.L.
    Department of Medicine-Cardiology A, Århus, Denmark.
    Lindahl, C.
    Pfizer Sweden, Täby, Sweden.
    Stroes, E.S.G.
    Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands.
    Tikkanen, M.J.
    Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland.
    Wareham, N.J.
    Medical Research Council Epidemiology Unit, Cambridge, United Kingdom.
    Faergeman, O.
    Department of Medicine-Cardiology A, Århus, Denmark.
    Olsson, Anders G
    Linköpings universitet, Institutionen för medicin och hälsa, Internmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Endokrin- och magtarmmedicinska kliniken US.
    Pedersen, T.R.
    Center for Preventive Medicine, Ullevål University Hospital, Oslo, Norway.
    Khaw, K.-T.
    Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, United Kingdom.
    Kastelein, J.J.P.
    Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands.
    High-Density Lipoprotein Cholesterol, High-Density Lipoprotein Particle Size, and Apolipoprotein A-I: Significance for Cardiovascular Risk. The IDEAL and EPIC-Norfolk Studies2008Ingår i: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 51, nr 6, s. 634-642Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: This study was designed to assess the relationship of high-density-lipoprotein cholesterol (HDL-C), HDL particle size, and apolipoprotein A-I (apoA-I) with the occurrence of coronary artery disease (CAD), with a focus on the effect of very high values of these parameters. Background: High plasma levels of HDL-C and apoA-I are inversely related to the risk of CAD. However, recent data suggest that this relationship does not hold true for very high HDL-C levels, particularly when a preponderance of large HDL particles is observed. Methods: We conducted a post-hoc analysis of 2 prospective studies: the IDEAL (Incremental Decrease in End Points through Aggressive Lipid Lowering, n = 8,888) trial comparing the efficacy of high-dose to usual-dose statin treatment for the secondary prevention of cardiovascular events, and the EPIC (European Prospective Investigation into Cancer and Nutrition)-Norfolk case-control study, including apparently healthy individuals who did (cases, n = 858) or did not (control patients, n = 1,491) develop CAD during follow-up. In IDEAL, only HDL-C and apoA-I were available, in EPIC-Norfolk, nuclear magnetic resonance spectroscopy-determined HDL particle sizes were also available. Results: In the IDEAL study, higher HDL-C proved a significant major cardiac event risk factor following adjustment for age, gender, smoking, apoA-I, and apoB. A similar association was observed for HDL particle size in EPIC-Norfolk. Increased risk estimates were particularly present in the high ends of the distributions. In contrast, apoA-I remained negatively associated across the major part of its distribution in both studies. Conclusions: When apoA-I and apoB are kept constant, HDL-C and HDL particle size may confer risk at very high values. This does not hold true for very high levels of apoA-I at fixed levels of HDL-C and apoB. These findings may have important consequences for assessment and treatment of CAD risk. © 2008 American College of Cardiology Foundation.

  • 39.
    van Veldhuisen, Dirk J
    et al.
    University Medical Center Groningen, University of Groningen, the Netherlands .
    Jaarsma, Tiny
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Hälsouniversitetet.
    Hillege, Hans L
    University Medical Center Groningen, University of Groningen, Netherlands .
    Reply2013Ingår i: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 62, nr 6, s. 567-568Artikel i tidskrift (Övrigt vetenskapligt)
  • 40.
    van Veldhuisen, Dirk J.
    et al.
    University of Groningen, Netherlands .
    Linssen, Gerard C M
    University of Groningen, Netherlands .
    Jaarsma, Tiny
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Hälsouniversitetet.
    van Gilst, Wiek H
    University of Groningen, Netherlands .
    Hoes, Arno W
    University of Medical Centre, Netherlands .
    Tijssen, Jan G P
    University of Medical Centre Groningen, Netherlands .
    Paulus, Walter J.
    Free University of Amsterdam, Netherlands .
    Voors, Adriaan A.
    University of Groningen, Netherlands .
    Hillege, Hans L.
    University of Groningen, Netherlands .
    B-Type Natriuretic Peptide and Prognosis in Heart Failure Patients With Preserved and Reduced Ejection Fraction2013Ingår i: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 61, nr 14, s. 1498-1506Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives This study sought to determine the prognostic value of B-type natriuretic peptide (BNP) in patients with heart failure with preserved ejection fraction (HFPEF), in comparison to data in HF patients with reduced left ventricular (LV) EF (andlt;= 40%). less thanbrgreater than less thanbrgreater thanBackground Management of patients with HFPEF is difficult. BNP is a useful biomarker in patients with reduced LVEF, but data in HFPEF are scarce. less thanbrgreater than less thanbrgreater thanMethods In this study, 615 patients with mild to moderate HF (mean age 70 years, LVEF 33%) were followed for 18 months. BNP concentrations were measured at baseline and were related to the primary outcome, that is, a composite of all-cause mortality and HF hospitalization, and to mortality alone. The population was divided in quintiles, according to LVEF, and patients with reduced LVEF were compared with those with HFPEF. less thanbrgreater than less thanbrgreater thanResults There were 257 patients (42%) who had a primary endpoint and 171 (28%) who died. BNP levels were significantly higher in patients with reduced LVEF than in those with HFPEF (p andlt; 0.001). BNP was a strong predictor of outcome, but LVEF was not. Importantly, if similar levels of BNP were compared across the whole spectrum of LVEF, and for different cutoff levels of LVEF, the associated risk of adverse outcome was similar in HFPEF patients as in those with reduced LVEF. less thanbrgreater than less thanbrgreater thanConclusions BNP levels are lower in patients with HFPEF than in patients with HF with reduced LVEF, but for a given BNP level, the prognosis in patients with HFPEF is as poor as in those with reduced LVEF. (J Am Coll Cardiol 2013;61:1498-506)

  • 41.
    Wandt, Birger
    et al.
    Departments of Clinical Physiology and Radiology, Central Hospital, Karlstad, Sweden.
    Kähäri, Anders
    Departments of Clinical Physiology and Radiology, Central Hospital, Karlstad, Sweden.
    Zizala, Jan
    Departments of Clinical Physiology and Radiology, Central Hospital, Karlstad, Sweden.
    Bojö, Leif
    Departments of Clinical Physiology and Radiology, Central Hospital, Karlstad, Sweden.
    Wranne, Bengt
    Departments of Clinical Physiology and Radiology, Central Hospital, Karlstad, Sweden.
    Usefulness of coronary angiography for assessing left ventricular function1998Ingår i: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 82, nr 3, s. 384-386Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    No abstract available.

  • 42.
    Yoon, EJ
    et al.
    Univ Calif San Francisco, San Francisco, CA 94143 USA Linkoping Univ, Linkoping, Sweden.
    Engvall, J
    Ebbers, Tino
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Klinisk fysiologi. Östergötlands Läns Landsting, Hjärtcentrum, Fysiologiska kliniken.
    Brandt, E
    Univ Calif San Francisco, San Francisco, CA 94143 USA Linkoping Univ, Linkoping, Sweden.
    Wigström, Lars
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Klinisk fysiologi. Östergötlands Läns Landsting, Hjärtcentrum, Fysiologiska kliniken.
    Wranne, Bengt
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Klinisk fysiologi. Östergötlands Läns Landsting, Hjärtcentrum, Fysiologiska kliniken.
    Bolger, A
    Reversal of blood flow in the descending aorta: Implications for Doppler quantitation of aortic insufficiency2002Ingår i: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 39, nr 5, s. 425A-425AKonferensbidrag (Övrigt vetenskapligt)
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