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Fröbert, Ole
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Publications (10 of 82) Show all publications
Sundh, J., Magnuson, A., Montgomery, S., Andell, P., Rindler, G., Fröbert, O., . . . Lokke, A. (2020). Beta-blockeRs tO patieNts with CHronIc Obstructive puLmonary diseasE (BRONCHIOLE) - Study protocol from a randomized controlled trial. Trials, 21(1), Article ID 123.
Open this publication in new window or tab >>Beta-blockeRs tO patieNts with CHronIc Obstructive puLmonary diseasE (BRONCHIOLE) - Study protocol from a randomized controlled trial
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2020 (English)In: Trials, ISSN 1745-6215, E-ISSN 1745-6215, Vol. 21, no 1, article id 123Article in journal (Refereed) Published
Abstract [en]

Background: Observational studies indicate that beta-blockers are associated with a reduced risk of exacerbation and mortality in patients with chronic obstructive pulmonary disease (COPD) even without overt cardiovascular disease, but data from randomized controlled trials (RCT) are lacking. The aim of this RCT is to investigate whether beta-blocker therapy in patients with COPD without diagnosed cardiovascular disease is associated with a decreased 1-year risk of the composite endpoint of death, exacerbations, or cardiovascular events.

Methods: The Beta-blockeRs tO patieNts with CHronIc Obstructive puLmonary diseasE (BRONCHIOLE) study is an open-label, multicentre, prospective RCT. A total of 1700 patients with COPD will be randomly assigned to either standard COPD care and metoprolol at a target dose of 100 mg per day or to standard COPD care only. The primary endpoint is a composite of death, COPD exacerbations, and cardiovascular events. Major exclusion criteria are ischemic heart disease, left-sided heart failure, cerebrovascular disease, critical limb ischemia, and atrial fibrillation/flutter. Study visits are an inclusion visit, a metoprolol titration visit at 1 month, follow-up by telephone at 6 months, and a final study visit after 1 year. Outcome data are obtained from medical history and record review during study visits, as well as from national registries.

Discussion: BRONCHIOLE is a pragmatic randomized trial addressing the potential of beta-blockers in patients with COPD. The trial is expected to provide relevant clinical data on the efficacy of this treatment on patient-related outcomes in patients with COPD.

Place, publisher, year, edition, pages
BioMed Central, 2020
Keywords
Beta-blocker, Cardiovascular event, COPD, Exacerbation, Mortality, Pragmatic randomized trial, Real-world evidence
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:oru:diva-80376 (URN)10.1186/s13063-019-3907-1 (DOI)000513538600001 ()32000825 (PubMedID)2-s2.0-85078711805 (Scopus ID)
Funder
Swedish Research Council, 2018-00511
Note

Funding Agencies:

Swedish Respiratory Society  

Uppsala-Örebro Regional Research Council  RFR-851601

Örebro University  ORU 2018/01219

Region Örebro County through ALF research funding  OLL-843061

Available from: 2020-03-04 Created: 2020-03-04 Last updated: 2020-03-04Bibliographically approved
Adolfsson, E., Helenius, G., Friberg, Ö., Samano, N., Fröbert, O. & Johansson, K. (2020). Bone marrow- and adipose tissue-derived mesenchymal stem cells from donors with coronary artery disease: growth, yield, gene expression and the effect of oxygen concentration. Scandinavian Journal of Clinical and Laboratory Investigation, 1-9
Open this publication in new window or tab >>Bone marrow- and adipose tissue-derived mesenchymal stem cells from donors with coronary artery disease: growth, yield, gene expression and the effect of oxygen concentration
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2020 (English)In: Scandinavian Journal of Clinical and Laboratory Investigation, ISSN 0036-5513, E-ISSN 1502-7686, p. 1-9Article in journal (Refereed) Epub ahead of print
Abstract [en]

Mesenchymal stem cells (MSCs) for cardiovascular cell therapy are procured from different sources including bone marrow and adipose tissue. Differently located MSCs differ in growth potential, differentiation ability and gene expression when cultured in vitro, and studies show different healing abilities for different MSC subgroups. In this study, bone marrow derived MSCs (BMSCs) and adipose tissue derived MSCs (ADSCs) from six human donors with coronary artery disease were compared for growth potential and expression of target genes (Angpt1, LIF, HGF, TGF-β1 and VEGF-A) in response to exposure to 1% and 5% O2, for up to 48 h. We found greater growth of ADSCs compared to BMSCs. ADSCs expressed higher levels of Angpt1, LIF and TGF-β1 and equal levels of VEGF-A and HGF as BMSCs. In BMSCs, exposure to low oxygen resulted in upregulation of TGF-β1, whereas other target genes were unaffected. Upregulation was only present at 1% O2. In ADSCs, LIF was upregulated in both oxygen concentrations, whereas Angpt1 was upregulated only at 1% O2. Different response to reduced oxygen culture conditions is of relevance when expanding cells in vitro prior to administration. These findings indicate ADSCs as better suited for cardiovascular cell therapy compared to BMSCs.

Place, publisher, year, edition, pages
Taylor & Francis, 2020
Keywords
Adipose tissue, bone marrow, cardiovascular diseases, cell- and tissue-based therapy, heart failure, humans, hypoxia, mesenchymal stem cells
National Category
Cell and Molecular Biology
Identifiers
urn:nbn:se:oru:diva-80807 (URN)10.1080/00365513.2020.1741023 (DOI)000524023000001 ()32189529 (PubMedID)
Available from: 2020-03-23 Created: 2020-03-23 Last updated: 2020-04-20Bibliographically approved
James, S. K., Erlinge, D., Herlitz, J., Alfredsson, J., Koul, S., Fröbert, O., . . . Hofmann, R. (2020). Effect of Oxygen Therapy on Cardiovascular Outcomes in Relation to Baseline Oxygen Saturation. JACC: Cardiovascular Interventions, 13(4), 502-513
Open this publication in new window or tab >>Effect of Oxygen Therapy on Cardiovascular Outcomes in Relation to Baseline Oxygen Saturation
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2020 (English)In: JACC: Cardiovascular Interventions, ISSN 1936-8798, E-ISSN 1876-7605, Vol. 13, no 4, p. 502-513Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: The aim of this study was to determine the effect of supplemental oxygen in patients with myocardial infarction (MI) on the composite of all-cause death, rehospitalization with MI, or heart failure related to baseline oxygen saturation. A secondary objective was to investigate outcomes in patients developing hypoxemia.

BACKGROUND: In the DETO2X-AMI (Determination of the Role of Oxygen in Suspected Acute Myocardial Infarction) trial, 6,629 normoxemic patients with suspected MI were randomized to oxygen at 6 l/min for 6 to 12 h or ambient air.

METHODS: The study population of 5,010 patients with confirmed MI was divided by baseline oxygen saturation into a low-normal (90% to 94%) and a high-normal (95% to 100%) cohort. Outcomes are reported within 1 year. To increase power, all follow-up time (between 1 and 4 years) was included post hoc, and interaction analyses were performed with oxygen saturation as a continuous covariate.

RESULTS: The composite endpoint of all-cause death, rehospitalization with MI, or heart failure occurred significantly more often in patients in the low-normal cohort (17.3%) compared with those in the high-normal cohort (9.5%) (p < 0.001), and most often in patients developing hypoxemia (23.6%). Oxygen therapy compared with ambient air was not associated with improved outcomes regardless of baseline oxygen saturation (interaction p values: composite endpoint, p = 0.79; all-cause death, p = 0.33; rehospitalization with MI, p = 0.86; hospitalization for heart failure, p = 0.35).

CONCLUSIONS: Irrespective of oxygen saturation at baseline, we found no clinically relevant beneficial effect of routine oxygen therapy in normoxemic patients with MI regarding cardiovascular outcomes. Low-normal baseline oxygen saturation or development of hypoxemia was identified as an independent marker of poor prognosis. (An Efficacy and Outcome Study of Supplemental Oxygen Treatment in Patients With Suspected Myocardial Infarction; NCT01787110)

Place, publisher, year, edition, pages
Elsevier, 2020
Keywords
cardiovascular outcomes, myocardial infarction, oxygen therapy, randomized clinical trial, reactive oxygen species
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:oru:diva-80368 (URN)10.1016/j.jcin.2019.09.016 (DOI)000513913200017 ()31838113 (PubMedID)2-s2.0-85079163189 (Scopus ID)
Funder
Swedish Research Council, VR20130307Swedish Heart Lung Foundation, HLF20130262 HLF20160688Swedish Foundation for Strategic Research , SSF KF10-0024
Available from: 2020-03-04 Created: 2020-03-04 Last updated: 2020-03-04Bibliographically approved
Waltenberger, J., Brachmann, J., van der Heyden, J., Richardt, G., Fröbert, O., Seige, M., . . . Hoffmann, S. (2020). Five-Year Results of the Bioflow-III Registry: Real-World Experience with a Biodegradable Polymer Sirolimus-Eluting Stent. Cardiovascular Revascularization Medicine, 21(1), 63-69
Open this publication in new window or tab >>Five-Year Results of the Bioflow-III Registry: Real-World Experience with a Biodegradable Polymer Sirolimus-Eluting Stent
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2020 (English)In: Cardiovascular Revascularization Medicine, ISSN 1553-8389, E-ISSN 1878-0938, Vol. 21, no 1, p. 63-69Article in journal (Refereed) Published
Abstract [en]

Purpose: We aimed to assess long-term safety and performance of the Orsiro sirolimus-eluting coronary stent with biodegradable polymer in a large unselected population and in pre-specified subgroups.

Methods: BIOFLOW-III is a prospective, multicenter, international, observational registry with follow-up visits scheduled at 6 and 12 months, and at 3 and 5 years (NCT01553526).

Results: 1356 patients with 1738 lesions were enrolled. Of those, 392 (28.9%) declined to participate in the study extension from 18 months to 5 years, 37 (2.7%) withdrew consent, and 89 (6.6%) were lost to follow-up. At 5-years, Kaplan-Meier estimates of target lesion failure, defined as a composite of cardiac death, target-vessel myocardial infarction, coronary artery bypass grafting and clinically driven target lesion revascularization was 10.0% [95% confidence interval (CI): 8.4; 12.0] in the overall population, and 14.0% [95% CI: 10.5; 18.6], 10.3% [95% CI: 7.8; 13.5], 1.8% [95% CI: 0.3; 12.0], and 11.3% [95% CI: 8.5; 15.1] in the pre-defined risk groups of patients with diabetes mellitus, small vessels <= 2.75 mm, chronic total occlusion, and acute myocardial infarction. Definite stent thrombosis was observed in 0.3% [95% CI: 0.1; 0.9] of patients.

Conclusion: These long-term outcomes provide further evidence on the safety and performance of a sirolimus-eluting biodegradable polymer stent within daily clinical practice. The very lowdefinite stent thrombosis rate affirms biodegradable polymer safety and performance.

Place, publisher, year, edition, pages
Elsevier, 2020
Keywords
Coronary artery stenosis, Drug-eluting stent, Biodegradable polymer, Hybrid stent, Diabetes
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:oru:diva-80381 (URN)10.1016/j.carrev.2019.03.004 (DOI)000513939400014 ()30922870 (PubMedID)2-s2.0-85063250131 (Scopus ID)
Note

Funding Agency:

BIOTRONIK AG, Buelach, Switzerland

Available from: 2020-03-04 Created: 2020-03-04 Last updated: 2020-03-04Bibliographically approved
Olsson, A., Ring, C., Josefsson, J., Eriksson, A., Rylance, R., Fröbert, O., . . . Erlinge, D. (2020). Patient experience of the informed consent process during acute myocardial infarction: a sub-study of the VALIDATE-SWEDEHEART trial. Trials, 21(1), Article ID 246.
Open this publication in new window or tab >>Patient experience of the informed consent process during acute myocardial infarction: a sub-study of the VALIDATE-SWEDEHEART trial
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2020 (English)In: Trials, ISSN 1745-6215, E-ISSN 1745-6215, Vol. 21, no 1, article id 246Article in journal (Refereed) Published
Abstract [en]

Objective: We aimed to assess the patient experience of informed consent (IC) during acute myocardial infarction (AMI) in a sub-study of the VALIDATE-SWEDEHEART trial. The original trial compared two anticoagulant agents in patients undergoing coronary intervention. A witnessed oral IC was required prior to randomization in patients with ST-segment elevation myocardial infarction, which was subsequently complemented with a written IC after percutaneous coronary intervention. Written consent was obtained before angiography in patients with non-ST-segment elevation myocardial infarction.

Background: The IC process in patients with AMI is under debate. Earlier trials in this population have required prospective consent before randomization. A trial published some years ago used deferred consent, but the patient experience of this process is poorly studied.

Methods: A total of 414 patients who participated in the main trial were enrolled and asked the following questions: (1) Do you remember being asked to participate in a study? (2) How was your experience of being asked to participate; do you remember it being positive or negative? (3) Would you have liked more information about the study? (4) Do you think it would have been better if you were included in the study without being informed until a later time?

Results: Of these patients, 94% remembered being included; 85% of them experienced this positively, 12% were neutral and 3% negative. Regarding more information, 88% did not want further information, and 68% expressed that they wanted to be consulted before inclusion. Of the patients, 5% thought it would have been better to have study inclusion without consent, and 27% considered it of no importance.

Conclusion: It is reasonable to ask patients for verbal IC in the acute phase of AMI. Most patients felt positively about being asked to participate and had knowledge of being enrolled in a scientific study. In addition they objected to providing IC after randomization and treatment.

Place, publisher, year, edition, pages
BMC, 2020
Keywords
Myocardial infarction, Informed consent
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:oru:diva-80933 (URN)10.1186/s13063-020-4147-0 (DOI)000519787700005 ()32143733 (PubMedID)2-s2.0-85081253081 (Scopus ID)
Funder
Swedish Heart Lung FoundationSwedish Research CouncilAstraZenecaSwedish Foundation for Strategic Research
Available from: 2020-04-01 Created: 2020-04-01 Last updated: 2020-04-01Bibliographically approved
Holm, N. R., Mäkikallio, T., Lindsay, M. M., Spence, M. S., Erglis, A., Menown, I. B. A., . . . Christiansen, E. H. (2020). Percutaneous coronary angioplasty versus coronary artery bypass grafting in the treatment of unprotected left main stenosis: updated 5-year outcomes from the randomised, non-inferiority NOBLE trial. The Lancet, 395(10219), 191-199
Open this publication in new window or tab >>Percutaneous coronary angioplasty versus coronary artery bypass grafting in the treatment of unprotected left main stenosis: updated 5-year outcomes from the randomised, non-inferiority NOBLE trial
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2020 (English)In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 395, no 10219, p. 191-199Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Percutaneous coronary intervention (PCI) is increasingly used in revascularisation of patients with left main coronary artery disease in place of the standard treatment, coronary artery bypass grafting (CABG). The NOBLE trial aimed to evaluate whether PCI was non-inferior to CABG in the treatment of left main coronary artery disease and reported outcomes after a median follow-up of 3·1 years. We now report updated 5-year outcomes of the trial.

METHODS: The prospective, randomised, open-label, non-inferiority NOBLE trial was done at 36 hospitals in nine northern European countries. Patients with left main coronary artery disease requiring revascularisation were enrolled and randomly assigned (1:1) to receive PCI or CABG. The primary endpoint was major adverse cardiac or cerebrovascular events (MACCE), a composite of all-cause mortality, non-procedural myocardial infarction, repeat revascularisation, and stroke. Non-inferiority of PCI to CABG was defined as the upper limit of the 95% CI of the hazard ratio (HR) not exceeding 1·35 after 275 MACCE had occurred. Secondary endpoints included all-cause mortality, non-procedural myocardial infarction, and repeat revascularisation. Outcomes were analysed in the intention-to-treat population. This trial is registered with ClinicalTrials.gov, NCT01496651.

FINDINGS: Between Dec 9, 2008, and Jan 21, 2015, 1201 patients were enrolled and allocated to PCI (n=598) or CABG (n=603), with 17 subsequently lost to early follow-up. 592 patients in each group were included in this analysis. At a median of 4·9 years of follow-up, the predefined number of events was reached for adequate power to assess the primary endpoint. Kaplan-Meier 5-year estimates of MACCE were 28% (165 events) for PCI and 19% (110 events) for CABG (HR 1·58 [95% CI 1·24-2·01]); the HR exceeded the limit for non-inferiority of PCI compared to CABG. CABG was found to be superior to PCI for the primary composite endpoint (p=0·0002). All-cause mortality was estimated in 9% after PCI versus 9% after CABG (HR 1·08 [95% CI 0·74-1·59]; p=0·68); non-procedural myocardial infarction was estimated in 8% after PCI versus 3% after CABG (HR 2·99 [95% CI 1·66-5·39]; p=0·0002); and repeat revascularisation was estimated in 17% after PCI versus 10% after CABG (HR 1·73 [95% CI 1·25-2·40]; p=0·0009).

INTERPRETATION: In revascularisation of left main coronary artery disease, PCI was associated with an inferior clinical outcome at 5 years compared with CABG. Mortality was similar after the two procedures but patients treated with PCI had higher rates of non-procedural myocardial infarction and repeat revascularisation.

Place, publisher, year, edition, pages
Elsevier, 2020
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:oru:diva-78894 (URN)10.1016/S0140-6736(19)32972-1 (DOI)000507614200032 ()31879028 (PubMedID)2-s2.0-85077932447 (Scopus ID)
Note

Funding Agency:

Biosensors

Available from: 2020-01-07 Created: 2020-01-07 Last updated: 2020-01-31Bibliographically approved
Kumsars, I., Holm, N. R., Niemelä, M., Erglis, A., Kervinen, K., Christiansen, E. H., . . . Lassen, J. F. (2020). Randomised comparison of provisional side branch stenting versus a two-stent strategy for treatment of true coronary bifurcation lesions involving a large side branch: the Nordic-Baltic Bifurcation Study IV. Open heart, 7(1), Article ID e000947.
Open this publication in new window or tab >>Randomised comparison of provisional side branch stenting versus a two-stent strategy for treatment of true coronary bifurcation lesions involving a large side branch: the Nordic-Baltic Bifurcation Study IV
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2020 (English)In: Open heart, E-ISSN 2053-3624, Vol. 7, no 1, article id e000947Article in journal (Refereed) Published
Abstract [en]

Background: It is still uncertain whether coronary bifurcations with lesions involving a large side branch (SB) should be treated by stenting the main vessel and provisional stenting of the SB (simple) or by routine two-stent techniques (complex). We aimed to compare clinical outcome after treatment of lesions in large bifurcations by simple or complex stent implantation.

Methods: The study was a randomised, superiority trial. Enrolment required a SB >= 2.75 mm, >= 50% diameter stenosis in both vessels, and allowed SB lesion length up to 15 mm. The primary endpoint was a composite of cardiac death, non-procedural myocardial infarction and target lesion revascularisation at 6 months. Two-year clinical follow-up was included in this primary reporting due to lower than expected event rates.

Results: A total of 450 patients were assigned to simple stenting (n = 221) or complex stenting (n=229) in 14 Nordic and Baltic centres. Two-year follow-up was available in 218 (98.6%) and 228 (99.5%) patients, respectively. The primary endpoint of major adverse cardiac events (MACE) at 6 months was 5.5% vs 2.2% (risk differences 3.2%, 95% CI -0.2 to 6.8, p=0.07) and at 2 years 12.9% vs 8.4% (HR 0.63, 95% CI 0.35 to 1.13, p = 0.12) after simple versus complex treatment. In the subgroup treated by newer generation drug-eluting stents, MACE was 12.0% vs 5.6% (HR 0.45, 95% CI 0.17 to 1.17, p = 0.10) after simple versus complex treatment.

Conclusion: In the treatment of bifurcation lesions involving a large SB with ostial stenosis, routine two-stent techniques did not improve outcome significantly compared with treatment by the simpler main vessel stenting technique after 2 years.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2020
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:oru:diva-81576 (URN)10.1136/openhrt-2018-000947 (DOI)000527748100006 ()32076558 (PubMedID)2-s2.0-85078475367 (Scopus ID)
Note

Funding Agency:

Cordis Corp

Available from: 2020-05-06 Created: 2020-05-06 Last updated: 2020-05-06Bibliographically approved
Sharma, T., Rylance, R., Karlsson, S., Koul, S., Venetsanos, D., Omerovic, E., . . . Erlinge, D. (2020). Relationship between degree of heparin anticoagulation and clinical outcome in patients receiving potent P2Y12-inhibitors with no planned GPI during primary percutaneous coronary intervention in acute myocardial infarction: a VALIDATE-SWEDEHEART substudy. European Heart Journal - Cardiovascular Pharmacotherapy, 6(1), 6-13
Open this publication in new window or tab >>Relationship between degree of heparin anticoagulation and clinical outcome in patients receiving potent P2Y12-inhibitors with no planned GPI during primary percutaneous coronary intervention in acute myocardial infarction: a VALIDATE-SWEDEHEART substudy
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2020 (English)In: European Heart Journal - Cardiovascular Pharmacotherapy, ISSN 2055-6837, E-ISSN 2055-6845, Vol. 6, no 1, p. 6-13Article in journal (Refereed) Published
Abstract [en]

Aims: Heparin is the preferred choice of anticoagulant in percutaneous coronary intervention (PCI) for acute myocardial infarction (MI). An established dosage of heparin has not yet been determined, but treatment may be optimized through monitoring of activating clotting time (ACT). The aim of this study was to determine the relationship between heparin dose or ACT with a composite outcome of death, MI or bleeding using data from the registry-based, randomized, controlled and open-label VALIDATE-SWEDEHEART-trial, although patients were not randomized to heparin dose in this sub-study.

Methods and results: Patients with MI undergoing PCI and receiving treatment with a potent P2Y12-inhibitor and anticoagulation with heparin, without the planned use of glycoprotein IIb/IIIa inhibitor (GPI), were enrolled in this substudy. The primary endpoint was a composite end point of death, MI and bleeding at 30 days. The individual components and stent thrombosis were analyzed separately. We divided patients into groups according to the initial dose of unfractionated heparin during PCI (<70U/kg, 70-100U/kg and >100U/kg) or ACT (ACT <250 sec, 250-350 sec and >350 sec) as well as investigating them as continuous variables in Cox proportional hazards models using univariable and multivariable analyses. No major differences were noted between heparin stratified in groups (p = 0.22) or heparin as a continuous variable in relation to the primary composite endpoint HR 1.0 CI (0.99-1.01) for heparin dose/kg. No differences were found between ACT stratified in groups (p = 0.453) or ACT in seconds HR 1.0 CI (0.99-1.00) regarding the primary endpoint. The individual components of death, MI, major bleeding and stent thrombosis were not significantly different across heparin doses or ACT levels either.

Conclusion: We found no association between heparin dose or ACT levels and death, MI bleeding complications or stent thrombosis. Therefore, there is no strong support for a specific heparin dose or mandatory ACT monitoring in patients treated with potent P2Y12-inhibitors with no planned GPI.

Place, publisher, year, edition, pages
Oxford University Press, 2020
Keywords
Heparin, NSTEMI, PCI, STEMI, activated clotting time
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:oru:diva-74319 (URN)10.1093/ehjcvp/pvz015 (DOI)000521326600003 ()31093662 (PubMedID)2-s2.0-85077667087 (Scopus ID)
Funder
Swedish Heart Lung FoundationKnut and Alice Wallenberg Foundation
Note

Funding Agencies:

Medicines Company

Region of Scania  

ALF-medel  

AstraZeneca

Available from: 2019-05-20 Created: 2019-05-20 Last updated: 2020-04-07Bibliographically approved
Fröbert, O., Frøbert, A. M., Kindberg, J., Arnemo, J. M. & Overgaard, M. T. (2020). The brown bear as a translational model for sedentary lifestyle related diseases. Journal of Internal Medicine, 287(3), 263-270
Open this publication in new window or tab >>The brown bear as a translational model for sedentary lifestyle related diseases
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2020 (English)In: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 287, no 3, p. 263-270Article in journal (Refereed) Published
Abstract [en]

Sedentary lifestyle accelerates biological aging, is a major risk factor for developing metabolic syndrome and is associated with cardiovascular disease, diabetes mellitus, kidney failure, sarcopenia and osteoporosis. In contrast to the linear path to worsening health in humans with metabolic syndrome, brown bears have developed a circular metabolic plasticity enabling these animals to tolerate obesity and a "sedentary lifestyle" during hibernation and exit the den metabolically healthy in spring. Bears are close to humans physiology-wise, much closer than rodents, the preferred experimental animals in medical research, and may better serve as translational model to develop treatments for lifestyle-related diseases. In this review aspects of brown bear hibernation survival strategies are outlined and conceivable experimental strategies to learn from bears are described.

Place, publisher, year, edition, pages
Wiley-Blackwell Publishing Inc., 2020
Keywords
Brown bear, hibernation, metabolic syndrome, translational research
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:oru:diva-77259 (URN)10.1111/joim.12983 (DOI)000492139900001 ()31595572 (PubMedID)
Note

Funding Agencies:

Lundbeckfonden R126-2012-12408 R194-2015-1108 R286-2018-367

Augustinus Foundation 

Available from: 2019-10-14 Created: 2019-10-14 Last updated: 2020-03-02Bibliographically approved
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
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