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Fröbert, Ole
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Publications (10 of 67) Show all publications
Buccheri, S., Sarno, G., Fröbert, O., Gudnason, T., Lagerqvist, B., Lindholm, D., . . . James, S. (2019). Assessing the Nationwide Impact of a Registry-Based Randomized Clinical Trial on Cardiovascular Practice The TASTE Trial in Perspective. Circulation. Cardiovascular Interventions, 12(3), Article ID e007381.
Open this publication in new window or tab >>Assessing the Nationwide Impact of a Registry-Based Randomized Clinical Trial on Cardiovascular Practice The TASTE Trial in Perspective
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2019 (English)In: Circulation. Cardiovascular Interventions, ISSN 1941-7640, E-ISSN 1941-7632, Vol. 12, no 3, article id e007381Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Registry-based randomized clinical trials have emerged as useful tools to provide evidence on the comparative efficacy and safety of different therapeutic strategies. However, it remains unknown whether the results of registry-based randomized clinical trials have a sizable impact on daily clinical practice. We sought, therefore, to describe the temporal trends in thrombus aspiration (TA) use in Sweden before, during, and after dissemination of the TASTE trial (Thrombus Aspiration in ST-Elevation Myocardial Infarction in Scandinavia) results.

METHODS AND RESULTS: From January 1, 2006, to December 31, 2017, we included all consecutive patients with ST-segment-elevation myocardial infarction undergoing percutaneous revascularization in Sweden. All patients were registered in the Swedish Coronary Angiography and Angioplasty Registry. A total of 55 809 ST-segment-elevation myocardial infarction patients were included. TA use in Sweden substantially decreased after dissemination of TASTE results (from 39.8% to 11.8% during and after TASTE, respectively). Substantial variability in TA use across treating centers was observed before TASTE (TA use ranging from 0% to 70%), but after TASTE both the interhospital variability and the frequency of TA use were markedly reduced. A constant shift in medical practice was seen about 4 months after dissemination of the TASTE trial results. Time trends for all-cause mortality and definite stent thrombosis at 30 days were not associated with variations in TA use (P values >0.05 using the Granger test).

CONCLUSIONS: In Sweden, the results of the TASTE trial were impactful in daily clinical practice and led to a relevant decrease in TA use in ST-segment-elevation myocardial infarction patients undergoing percutaneous revascularization.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2019
Keywords
clinical trial, mortality, myocardial infarction, registry, thrombosis
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:oru:diva-74645 (URN)10.1161/CIRCINTERVENTIONS.118.007381 (DOI)000469353600004 ()30841711 (PubMedID)2-s2.0-85062595619 (Scopus ID)
Note

Funding Agencies:

Swedish government  

Swedish Association of Local Authorities and Regions 

Available from: 2019-06-10 Created: 2019-06-10 Last updated: 2019-06-10Bibliographically approved
Buccheri, S., James, S., Lindholm, D., Fröbert, O., Olivecrona, G. K., Persson, J., . . . Sarno, G. (2019). Clinical and angiographic outcomes of bioabsorbable vs. permanent polymer drug-eluting stents in Sweden: a report from the Swedish Coronary and Angioplasty Registry (SCAAR). European Heart Journal, 40(31), 2607-2615
Open this publication in new window or tab >>Clinical and angiographic outcomes of bioabsorbable vs. permanent polymer drug-eluting stents in Sweden: a report from the Swedish Coronary and Angioplasty Registry (SCAAR)
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2019 (English)In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 40, no 31, p. 2607-2615Article in journal (Refereed) Published
Abstract [en]

AIMS: Randomized clinical trials have consistently demonstrated the non-inferiority of bioabsorbable polymer drug-eluting stents (BP-DES) with respect to DES having permanent polymers (PP-DES). To date, the comparative performance of BP- and PP-DES in the real world has not been extensively investigated.

METHODS AND RESULTS: From October 2011 to June 2016, we analysed the outcomes associated with newer generation DES use in Sweden. After stratification according to the type of DES received at the index procedure, a total of 16 504 and 79 106 stents were included in the BP- and PP-DES groups, respectively. The Kaplan-Meier estimates for restenosis at 2 years were 1.2% and 1.4% in BP- and PP-DES groups, respectively. Definite stent thrombosis (ST) was low in both groups (0.5% and 0.7% in BP- and PP-DES groups, respectively). The adjusted hazard ratio (HR) for either restenosis or definite ST did not differ between BP- and PP-DES [adjusted HR 0.95, 95% confidence interval (CI) 0.74-1.21; P = 0.670 and adjusted HR 0.79, 95% CI 0.57-1.09; P = 0.151, respectively]. Similarly, there were no differences in the adjusted risk of all-cause death and myocardial infarction (MI) between the two groups (adjusted HR for all-cause death 1.01, 95% CI 0.82-1.25; P = 0.918 and adjusted HR for MI 1.05, 95% CI 0.93-1.19; P = 0.404).

CONCLUSION: In a large, nationwide, and unselected cohort of patients, percutaneous coronary intervention with BP-DES implantation was not associated with an incremental clinical benefit over PP-DES use at 2 years follow-up.

Place, publisher, year, edition, pages
Oxford University Press, 2019
Keywords
Bioabsorbable polymer, Clinical outcomes, Drug-eluting stents, Permanent polymer, Stent failure
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:oru:diva-75831 (URN)10.1093/eurheartj/ehz244 (DOI)31079155 (PubMedID)
Available from: 2019-08-23 Created: 2019-08-23 Last updated: 2019-08-23Bibliographically approved
Ritsinger, V., Jensen, J., Ohm, D., Omerovic, E., Koul, S., Fröbert, O., . . . Norhammar, A. (2019). Elevated admission glucose is common and associated with high short-term complication burden after acute myocardial infarction: Insights from the VALIDATE-SWEDEHEART study. Diabetes & Vascular Disease Research, Article ID 1479164119871540.
Open this publication in new window or tab >>Elevated admission glucose is common and associated with high short-term complication burden after acute myocardial infarction: Insights from the VALIDATE-SWEDEHEART study
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2019 (English)In: Diabetes & Vascular Disease Research, ISSN 1479-1641, E-ISSN 1752-8984, article id 1479164119871540Article in journal (Refereed) Epub ahead of print
Abstract [en]

OBJECTIVE: To investigate the association between admission plasma glucose and cardiovascular events in patients with acute myocardial infarction treated with modern therapies including early percutaneous coronary intervention and modern stents.

METHODS: = 5309) with established diabetes and patients without previously known diabetes with a reported admission plasma glucose, included in the VALIDATE trial 2014-2016, were followed for cardiovascular events (first of mortality, myocardial infarction, stroke, heart failure) within 180 days. Event rates were analysed by four glucose categories according to the World Health Organization criteria for hyperglycaemia and definition of diabetes. Odds ratios were calculated in a multivariate logistic regression model.

RESULTS: < 0.001), while bleeding complications did not differ significantly (9.1%, 8.5%, 8.4%, 12.2% and 8.5%, respectively). After adjustment, odds ratio (95% confidence interval) was 1.00 (0.65-1.53) for group II, 1.62 (1.14-2.29) for group III and 3.59 (1.99-6.50) for group IV compared to the lowest admission plasma glucose group (group I). The corresponding number for known diabetes was 2.42 (1.71-3.42).

CONCLUSION: In a well-treated contemporary population of acute myocardial infarction patients, 42% of those without diabetes had elevated admission plasma glucose levels with a greater risk for clinical events already within 180 days. Event rate increased with increasing admission plasma glucose levels. These findings highlight the importance of searching for undetected diabetes in the setting of acute myocardial infarction and that new treatment options are needed to improve outcome.

Place, publisher, year, edition, pages
Sage Publications, 2019
Keywords
Myocardial infarction, diabetes, hyperglycaemia, prognosis
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:oru:diva-76167 (URN)10.1177/1479164119871540 (DOI)31476896 (PubMedID)
Available from: 2019-09-10 Created: 2019-09-10 Last updated: 2019-09-10Bibliographically approved
Athlin, S., Larsson, E., Nordenskjöld, A. M. & Fröbert, O. (2019). Evaluation of the novel IMMUVIEW RSV antigen test for detection of respiratory syncytial virus in adults and children. In: : . Paper presented at 29th European Congress of Clinical Microbiology & Infectious Diseases (ECCMID), Amsterdam, Netherlands, 13-16 April, 2019.
Open this publication in new window or tab >>Evaluation of the novel IMMUVIEW RSV antigen test for detection of respiratory syncytial virus in adults and children
2019 (English)Conference paper, Poster (with or without abstract) (Other academic)
National Category
Infectious Medicine
Identifiers
urn:nbn:se:oru:diva-73799 (URN)
Conference
29th European Congress of Clinical Microbiology & Infectious Diseases (ECCMID), Amsterdam, Netherlands, 13-16 April, 2019
Available from: 2019-04-16 Created: 2019-04-16 Last updated: 2019-04-24Bibliographically approved
Arevström, L., Bergh, C., Landberg, R., Wu, H., Rodriguez-Mateos, A., Waldenborg, M., . . . Fröbert, O. (2019). Freeze-dried bilberry (Vaccinium myrtillus) dietary supplement improves walking distance and lipids after myocardial infarction: an open-label randomized clinical trial. Nutrition Research, 62, 13-22
Open this publication in new window or tab >>Freeze-dried bilberry (Vaccinium myrtillus) dietary supplement improves walking distance and lipids after myocardial infarction: an open-label randomized clinical trial
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2019 (English)In: Nutrition Research, ISSN 0271-5317, E-ISSN 1879-0739, Vol. 62, p. 13-22Article in journal (Refereed) Published
Abstract [en]

Bilberries, Vaccinium myrtillus, have a high content of phenolic compounds including anthocyanins, which could provide cardiometabolic health benefits following acute myocardial infarction (AMI). We hypothesized that standard medical therapy supplemented with freeze-dried bilberry after AMI would have a more beneficial effect on cardiovascular risk markers and exercise capacity than medical therapy alone. Patients were allocated in a 1:1 ratio within 24 hours of percutaneous coronary intervention in an 8-week trial either to V myrtillus powder (40 g/d, equivalent to 480 g fresh bilberries) and standard medical therapy or to a control group receiving standard medical therapy alone. High-sensitivity C-reactive protein and exercise capacity measured with the 6-minute walk test were the primary biochemical and clinical end points, respectively. Fifty subjects completed the study. No statistically significant difference in high-sensitivity C-reactive protein was detected between groups. The mean 6-minute walk test distance increased significantly more in the bilberry group compared to the control group: mean difference 38 m at follow-up (95% confidence interval 14-62, P = .003). Ex vivo oxidized low-density lipoprotein was significantly lowered in the bilberry group compared to control, geometric mean ratio 0.80 (95% confidence interval 0.66-0.96, P = .017), whereas total cholesterol and low-density lipoprotein cholesterol did not differ significantly between groups. Anthocyanin-derived metabolites in blood increased significantly in the bilberry group during the intervention and were different after 8 weeks between the bilberry group and control. Findings in the present study suggest that bilberries may have clinically relevant beneficial effects following AMI; a larger, double-blind clinical trial is warranted to confirm this.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Anthocyanins, Bilberries, Cholesterol, Exercise test, Inflammation, Myocardial Infarction
National Category
Nutrition and Dietetics
Identifiers
urn:nbn:se:oru:diva-73342 (URN)10.1016/j.nutres.2018.11.008 (DOI)000460848800002 ()30803503 (PubMedID)2-s2.0-85058196483 (Scopus ID)
Note

Funding Agency:

Örebro University Hospital Research Foundation

Available from: 2019-03-26 Created: 2019-03-26 Last updated: 2019-03-26Bibliographically approved
Karlsson, S., Andell, P., Mohammad, M. A., Koul, S., Olivecrona, G. K., James, S. K., . . . Erlinge, D. (2019). Heparin pre-treatment in patients with ST-segment elevation myocardial infarction and the risk of intracoronary thrombus and total vessel occlusion: Insights from the TASTE trial. European heart journal. Acute cardiovascular care., 8(1), 15-23
Open this publication in new window or tab >>Heparin pre-treatment in patients with ST-segment elevation myocardial infarction and the risk of intracoronary thrombus and total vessel occlusion: Insights from the TASTE trial
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2019 (English)In: European heart journal. Acute cardiovascular care., ISSN 2048-8726, Vol. 8, no 1, p. 15-23Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Pre-treatment with unfractionated heparin is common in ST-segment elevation myocardial infarction (STEMI) protocols, but the effect on intracoronary thrombus burden is unknown. We studied the effect of heparin pre-treatment on intracoronary thrombus burden and Thrombolysis in Myocardial Infarction (TIMI) flow prior to percutaneous coronary intervention in patients with STEMI.

METHODS: The Thrombus Aspiration in ST-Elevation Myocardial Infarction in Scandinavia (TASTE) trial angiographically assessed intracoronary thrombus burden and TIMI flow, prior to percutaneous coronary intervention, in patients with STEMI. In this observational sub-study, patients pre-treated with heparin were compared with patients not pre-treated with heparin. Primary end points were a visible intracoronary thrombus and total vessel occlusion prior to percutaneous coronary intervention. Secondary end points were in-hospital bleeding, in-hospital stroke and 30-day all-cause mortality.

RESULTS: Heparin pre-treatment was administered in 2898 out of 7144 patients (41.0%). Patients pre-treated with heparin less often presented with an intracoronary thrombus (61.3% vs. 66.0%, p<0.001) and total vessel occlusion (62.9% vs. 71.6%, p<0.001). After adjustments, heparin pre-treatment was independently associated with a reduced risk of intracoronary thrombus (odds ratio (OR) 0.73, 95% confidence interval (CI)=0.65-0.83) and total vessel occlusion (OR 0.64, 95% CI=0.56-0.73), prior to percutaneous coronary intervention. There were no significant differences in secondary end points of in-hospital bleeding (OR 0.84, 95% CI=0.55-1.27), in-hospital stroke (OR 1.17, 95% CI=0.48-2.82) or 30-day all-cause mortality (hazard ratio 0.88, 95% CI=0.60-1.30).

CONCLUSIONS: Heparin pre-treatment was independently associated with a lower risk of intracoronary thrombus and total vessel occlusion before percutaneous coronary intervention in patients with STEMI, without evident safety concerns, in this large multi-centre observational study.

Place, publisher, year, edition, pages
Sage Publications, 2019
Keywords
Heparin, STEMI, pre-treatment
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:oru:diva-61684 (URN)10.1177/2048872617727723 (DOI)000458875700004 ()28862032 (PubMedID)2-s2.0-85061236039 (Scopus ID)
Funder
Swedish Heart Lung Foundation, 20160495Swedish Research Council, K2013-65X-13130-15-5Knut and Alice Wallenberg Foundation, Dnr KAW 2014.0292
Note

Funding Agencies:

SSF (TOTAL-AMI)  KF10-0024

ALF  

Skåne University Hospital funds 

Available from: 2017-11-14 Created: 2017-11-14 Last updated: 2019-03-07Bibliographically approved
Redfors, B. B., Jha, S., Tholeifsson, S., Jernberg, T., Angeras, O., Fröbert, O., . . . Omerovic, E. (2019). Incidence and outcome of takotsubo syndrome compared to acute myocardial infarction, in men versus women. European Journal of Heart Failure, 21, 268-268
Open this publication in new window or tab >>Incidence and outcome of takotsubo syndrome compared to acute myocardial infarction, in men versus women
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2019 (English)In: European Journal of Heart Failure, ISSN 1388-9842, E-ISSN 1879-0844, Vol. 21, p. 268-268Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
John Wiley & Sons, 2019
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:oru:diva-74734 (URN)000468990703057 ()
Available from: 2019-07-22 Created: 2019-07-22 Last updated: 2019-07-22Bibliographically approved
Redfors, B. B., Jha, S., Thorleifsson, S., Angeras, O., Dworeck, C., Ravn-Fischer, A., . . . Omerovic, E. (2019). Incidence and prognosis of the takotsubo syndrome compared to acute myocardial infarction. European Journal of Heart Failure, 21, 267-267
Open this publication in new window or tab >>Incidence and prognosis of the takotsubo syndrome compared to acute myocardial infarction
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2019 (English)In: European Journal of Heart Failure, ISSN 1388-9842, E-ISSN 1879-0844, Vol. 21, p. 267-267Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Background: Takotsubo syndrome (TS) is a potentially life-threatening acute cardiac syndrome with a clinical presentation very similar to myocardial infarction (MI) and for which the natural history, management and outcome remain incompletely understood.

Purpose: The aims of this study were to assess the relative short- and long-term mortality risk of TS , ST-elevation MI (STEMI) and non STEMI (NSTEMI) and to identify predictors of in-hospital complications and poor prognosis in patients with TS.

Methods: Using the nationwide Swedish Angiography and Angioplasty Registry (SCAAR) we identified almost all (n=117,720) patients who underwent coronary angiography due to TS (N=2,898 [2.5%]), STEMI (N=48,493 [41.2%]) or NSTEMI (N=66,329 [56.3%]) in Sweden between January 2009 and February 2018.

Results: Patients with TS were more often women as compared with patients with STEMI or NSTEMI. TS was associated with unadjusted and adjusted 30-day mortality risks lower than STEMI (adjusted hazard ratio [adjHR] 0.60, 95% confidence interval [CI]0.48-0.76, p<0.001), but higher than NSTEMI (adjHR 2.70, 95% CI 2.14-3.41, p<0.001). Compared to STEMI, TS was associated with similar risk of acute heart failure (adjHR 1.26, 95% CI 0.91–1.76, p=0.16) but lower risk of cardio-genic shock (adjHR 0.55, 95% CI 0.34–0.89, p=0.02). The relative 30-day mortality risk for TS versus STEMI and NSTEMI was higher for smokers than non-smokers (adjusted pinteractionSTEMI=0.01 and pinteractionNSTEMI=0.01).

Conclusion: Thirty-day mortality in TS was higher than in NSTEMI but lower than STEMI, despite a similar risk of acute heart failure in TS and STEMI. Among patients with TS, smoking was an independent predictor of mortality

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:oru:diva-74733 (URN)000468990703054 ()
Available from: 2019-07-22 Created: 2019-07-22 Last updated: 2019-07-22Bibliographically approved
Nyström, T., James, S. K., Lindahl, B., Östlund, O., Erlinge, D., Herlitz, J., . . . Hofmann, R. (2019). Oxygen Therapy in Myocardial Infarction Patients With or Without Diabetes: A Predefined Subgroup Analysis From the DETO2X-AMI Trial. Diabetes Care, Article ID dc190590.
Open this publication in new window or tab >>Oxygen Therapy in Myocardial Infarction Patients With or Without Diabetes: A Predefined Subgroup Analysis From the DETO2X-AMI Trial
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2019 (English)In: Diabetes Care, ISSN 0149-5992, E-ISSN 1935-5548, article id dc190590Article in journal (Refereed) Epub ahead of print
Abstract [en]

OBJECTIVE: To determine the effects of oxygen therapy in myocardial infarction (MI) patients with and without diabetes.

RESEARCH DESIGN AND METHODS: In the Determination of the Role of Oxygen in Suspected Acute Myocardial Infarction (DETO2X-AMI) trial, 6,629 normoxemic patients with suspected MI were randomized to oxygen at 6 L/min for 6-12 h or ambient air. In this prespecified analysis involving 5,010 patients with confirmed MI, 934 had known diabetes. Oxidative stress may be of particular importance in diabetes, and the primary objective was to study the effect of supplemental oxygen on the composite of all-cause death and rehospitalization with MI or heart failure (HF) at 1 year in patients with and without diabetes.

RESULTS: = 0.81). There was no statistically significant difference for the individual components of the composite end point or the rate of cardiovascular death up to 1 year. Likewise, corresponding end points in patients without diabetes were similar between the treatment groups.

CONCLUSIONS: Despite markedly higher event rates in patients with MI and diabetes, oxygen therapy did not significantly affect 1-year all-cause death, cardiovascular death, or rehospitalization with MI or HF, irrespective of underlying diabetes, in line with the results of the entire study.

Place, publisher, year, edition, pages
American Diabetes Association, 2019
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:oru:diva-76099 (URN)10.2337/dc19-0590 (DOI)31473600 (PubMedID)
Available from: 2019-09-09 Created: 2019-09-09 Last updated: 2019-09-09Bibliographically approved
Völz, S., Angerås, O., Koul, S., Haraldsson, I., Sarno, G., Venetsanos, D., . . . Omerovic, E. (2019). Radial versus femoral access in patients with acute coronary syndrome undergoing invasive management: A prespecified subgroup analysis from VALIDATE-SWEDEHEART. European heart journal. Acute cardiovascular care., Article ID 2048872618817217.
Open this publication in new window or tab >>Radial versus femoral access in patients with acute coronary syndrome undergoing invasive management: A prespecified subgroup analysis from VALIDATE-SWEDEHEART
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2019 (English)In: European heart journal. Acute cardiovascular care., ISSN 2048-8726, article id 2048872618817217Article in journal (Refereed) Epub ahead of print
Abstract [en]

AIMS: In the Bivalirudin versus Heparin in ST-Segment and Non-ST-Segment Elevation Myocardial Infarction in Patients on Modern Antiplatelet Therapy in the Swedish Web System for Enhancement and Development of Evidence-based Care in Heart Disease Evaluated according to Recommended Therapies Registry Trial (VALIDATE-SWEDEHEART), bivalirudin was not superior to unfractionated heparin in patients with acute coronary syndrome undergoing invasive management. We assessed whether the access site had an impact on the primary endpoint of death, myocardial infarction or major bleeding at 180 days and whether it interacted with bivalirudin/unfractionated heparin.

METHODS AND RESULTS: =0.801).

CONCLUSIONS: Transradial access was associated with lower risk of death, myocardial infarction or major bleeding at 180 days. Bivalirudin was not associated with less bleeding, irrespective of access site.

Place, publisher, year, edition, pages
Sage Publications, 2019
Keywords
Acute coronary syndrome, anticoagulants, antithrombins, femoral artery, haemorrhage, heparin, hirudins, peptide fragments, percutaneous coronary intervention, radial artery, recombinant proteins
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:oru:diva-75619 (URN)10.1177/2048872618817217 (DOI)31237158 (PubMedID)
Available from: 2019-08-20 Created: 2019-08-20 Last updated: 2019-08-20Bibliographically approved
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