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Incremental prognostic value of coronary and systemic atherosclerosis aftermyocardial infarction
Örebro University, School of Medical Sciences.ORCID iD: 0000-0002-9821-0510
Örebro University, Faculty of Health, Department of Cardiology, Sweden.
Centre for Clinical Research, Uppsala University and Department of Clinical Physiology, Västmanland County Hospital, Västerås, Sweden.
Centre for Clinical Research, Uppsala University Västmanland County Hospital, Västerås, Sweden.
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(English)Manuscript (preprint) (Other academic)
National Category
General Practice Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:oru:diva-65425OAI: oai:DiVA.org:oru-65425DiVA, id: diva2:1187049
Available from: 2018-03-02 Created: 2018-03-02 Last updated: 2018-03-02Bibliographically approved
In thesis
1. Coronary artery disease and prognosis in relation to cardiovascular risk factors, interventional techniques and systemic atherosclerosis
Open this publication in new window or tab >>Coronary artery disease and prognosis in relation to cardiovascular risk factors, interventional techniques and systemic atherosclerosis
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aim: To evaluate the prognosis associated with location and severity of coronary and systemic atherosclerosis in patients with coronary artery disease (CAD) in relation to risk factors and interventional techniques.

Methods: The thesis comprised six longitudinal studies based on three patient cohorts: The Swedish Coronary Angiography and Angioplasty Registry, the Västmanland Myocardial Infarction Survey, and the Thrombus Aspiration in ST-Elevation myocardial infarction in Scandinavia study, to evaluate clinical outcome relative to coronary lesion location and severity, extracoronary artery disease (ECAD), intervention techniques, and leisuretime physical inactivity (LTPI).

Results: Stent placement in the proximal left anterior descending artery (LAD) was more often associated with restenosis than was stenting in the other coronary arteries. The use of drug-eluting stents in the LAD was associated with a lower risk of restenosis and death compared to baremetal stents. Thrombus aspiration in in the LAD during acute ST elevation myocardial infarction (MI) did not improve clinical outcome, irrespective of adjunct intervention technique. Clinical, but not subclinical, ECAD was associated with poor prognosis in patients with MI. Longitudinal extent of CAD at the time of MI was a predictor of ECAD, and coexistence of extensive CAD and ECAD was associated with particularly poor prognosis following MI. Self-reported LTPI was associated with MI and all-cause mortality independent of ECAD.

Conclusions: Drug-eluting stents, but not thrombus aspiration, improved prognosis following percutaneous coronary intervention in the proximal LAD. Self- reported LTPI, clinical ECAD, and systemic atherosclerosis defined groups with poor prognosis after MI.

Place, publisher, year, edition, pages
Örebro: Örebro University, 2018. p. 78
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 173
Keywords
Atherosclerosis, Myocardial infarction, Coronary artery disease, Extra-cardiac artery disease, Coronary stent, Thrombus aspiration, physical inactivity, Prognosis
National Category
General Practice Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:oru:diva-64410 (URN)978-91-7529-232-8 (ISBN)
Public defence
2018-03-23, Örebro universitet, Campus USÖ, hörsal C3, Södra Grev Rosengatan 32, Örebro, 09:00 (English)
Opponent
Supervisors
Available from: 2018-01-19 Created: 2018-01-19 Last updated: 2018-03-02Bibliographically approved

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Calais, FredrikFröbert, Ole

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