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  • 1.
    Andersson, Tommy
    et al.
    Dept Cardiol, Örebro Univ Hosp, Örebro, Sweden.
    Magnuson, Anders
    Clin Epidemiol & Biostat Unit, Örebro University Hospital, Örebro, Sweden.
    Bryngelsson, Ing-Liss
    Dept Occupat & Environm Med, Örebro University Hospital, Örebro, Sweden.
    Fröbert, Ole
    Örebro University Hospital. Dept Cardiol, Örebro University Hospital, Örebro, Sweden.
    Henriksson, Karin M.
    Dept Med Sci, Uppsala Univ, Uppsala, Sweden; AstraZeneca R&D, Mölndal, Sweden.
    Edvardsson, Nils
    Sahlgrenska Univ Hosp, Sahlgrenska Acad, Gothenburg, Sweden.
    Poci, Dritan
    Örebro University Hospital. Dept Cardiol, Örebro University Hospital, Örebro, Sweden.
    Gender-related differences in risk of cardiovascular morbidity and all-cause mortality in patients hospitalized with incident atrial fibrillation without concomitant diseases: A nationwide cohort study of 9519 patients2014In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 177, no 1, p. 91-99Article in journal (Refereed)
    Abstract [en]

    Background: Previous studies of patients with "lone" and "idiopathic" atrial fibrillation (AF) have provided conflicting evidence concerning the development, management and prognosis of this condition.

    Methods: In this nation-wide, retrospective, cohort study, we studied patients diagnosed with incidental AF recorded in national Swedish registries between 1995 and 2008. Controls were matched for age, sex and calendar year of the diagnosis of AF in patients. All subjects were free of any in-hospital diagnosis from 1987 and until patients were diagnosed with AF and also free of any diagnosis within one year from the time of inclusion. Follow-up continued until 2009. We identified 9519 patients (31% women) and 12,468 matched controls.

    Results: Relative risks (RR) versus controls for stroke or transient ischemic attack (TIA) in women were 19.6, 4.4, 3.4 and 2.5 in the age categories <55, 55-64, 65-74 and 75-85, years respectively. Corresponding figures for men were 3.4, 2.5, 1.7 and 1.9. RR for heart failure were 6.6, 6.6, 6.3 and 3.8 in women and 7.8, 4.6, 4.9 and 2.9 in men. All RR were statistically significant with p < 0.01. RR for myocardial infarction and all-cause mortality were statistically significantly increased only in the two oldest age categories in women and 65-74 years in men.

    Conclusions: Patients with AF and no co-morbidities at inclusion had at least a doubled risk of stroke or TIA and a tripled risk of heart failure, through all age categories, as compared to controls. Women were at higher RR of stroke or TIA than men. (C) 2014 The Authors. Published by Elsevier Ireland Ltd. This is an open access article under the CC BY-NC-SA license (http://creativecommons.org/licenses/by-nc-sa/3.0/).

  • 2.
    Berghammer, Malin
    et al.
    Inst Hlth & Care Sci, Sahlgrenska Acad, Univ Gothenburg, Gothenburg, Sweden.
    Karlsson, Jan
    Örebro University Hospital. Inst Hlth & Care Sci, Sahlgrenska Acad, Univ Gothenburg, Gothenburg, Sweden.
    Ekman, Inger
    Inst Hlth & Care Sci, Sahlgrenska Acad, Univ Gothenburg, Gothenburg, Sweden; Ctr Person Ctr Care, Univ Gothenburg, Gothenburg, Sweden.
    Eriksson, Peter
    Inst Med, Sahlgrenska Acad, Univ Gothenburg, Gothenburg, Sweden; Sahlgrenska Univ Hosp, Gothenburg, Sweden.
    Dellborg, Mikael
    Inst Med, Sahlgrenska Acad, Univ Gothenburg, Gothenburg, Sweden; Sahlgrenska Univ Hosp, Gothenburg, Sweden.
    Self-reported health status (EQ-5D) in adults with congenital heart disease2013In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 165, no 3, p. 537-543Article in journal (Refereed)
    Abstract [en]

    Purpose: Today, more patients with congenital heart disease (CHD) reach adulthood. There are conflicting findings concerning the relationship between quality of life (QoL) or health state for adults with CHD and the complexity of their CHD. The aim of the study was, firstly, to compare the reported health status and health perception of adult patients with CHD and, secondly, to investigate what variables influenced the patients' health status and health perception. Methods: Data from 1435 patients completing the EQ-5D questionnaire, which includes reported health status and health perception, were analyzed. Results: Valid EQ-5D data were reported by 1274 patients, showing overall results indicating a good health status. Problems were most frequently reported in the dimension "pain/discomfort" (31.9%) and "anxiety/depression" (29.8%). Higher occurrence of problems were reported by patients with complex disease i.e. single ventricle (p<0.001) and by female patients (p<0.0001). Symptomatic patients reported a lower health status (p<0.0001) and a lower perceived health on EQ-VAS (p<0.0001). Of the asymptomatic patients, 20.5% nevertheless reported problems in "pain/discomfort" and 22.2% in the "anxiety/depression" dimension. Conclusion: The health status of adults with CHD is influenced by symptoms, NYHA-classification, age and gender. Adults with CHD report a lower occurrence of problems in comparison to previously published results from a general population, but the importance of actively asking about the patient's experience is demonstrated by the high degree of asymptomatic patients reporting problems on EQ-5D. (c) 2011 Elsevier Ireland Ltd. All rights reserved.

  • 3.
    Calais, Fredrik
    et al.
    Department of Cardiology, Örebro University Hospital, Örebro, Sweden.
    Fröbert, Ole
    Örebro University Hospital. Department of Cardiology, Örebro University Hospital, Örebro, Sweden.
    Rosenblad, Andreas
    Clinical Research Center, Uppsala University, Västerås, Sweden.
    Hedberg, Pär O.
    Clinical Research Center, Uppsala University, Västerås, Sweden; Department of Clinical Physiology, Västmanland Hospital, Västerås, Sweden.
    Wachtell, Kristian
    Department of Cardiology, Örebro University Hospital, Örebro, Sweden.
    Leppert, Jerzy
    Clinical Research Center, Uppsala University, Västerås, Sweden.
    Leisure-time physical inactivity and risk of myocardial infarction and all-cause mortality: A case-control study2014In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 177, no 2, p. 599-600Article in journal (Refereed)
  • 4.
    Calais, Fredrik
    et al.
    Dept Cardiol, Örebro University Hospital, Öörebro, Sweden.
    Lagerqvist, Bo
    Dept Med Sci, Uppsala University, Uppsala, Sweden.
    Leppert, Jerzy
    Clin Res Ctr, Cent Hosp Västerås, Uppsala University, Uppsala, Sweden.
    James, Stefan K.
    Dept Med Sci, Uppsala University, Uppsala, Sweden.
    Fröbert, Ole
    Dept Cardiol, Örebro University Hospital, Region Örebro County, Örebro, Sweden.
    Proximal coronary artery intervention: Stent thrombosis, restenosis and death2013In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 170, no 2, p. 227-232Article in journal (Refereed)
    Abstract [en]

    Background: Percutaneous coronary intervention (PCI) of lesions in the proximal left anterior descending coronary artery (LAD) may confer a worse prognosis compared with the proximal right coronary artery (RCA) and left circumflex coronary artery (LCX). Methods: From May 2005, to May 2011 we identified all PCIs for proximal, one-vessel coronary artery disease in the Swedish Coronary Angiography and Angioplasty Registry (SCAAR). We evaluated restenosis, stent thrombosis (ST) and mortality in the LAD as compared to the RCA and LCX according to stent type, bare metal (BMS) or drug-eluting stents (DES). Results: 7840 single vessel proximal PCI procedures were identified. Mean follow-up time was 792 days. No differences in restenosis or ST were seen between the LAD and the RCA. The frequency of restenosis and ST was higher in the proximal LAD compared to the proximal LCX (restenosis: hazard ratio (HR) 2.28, confidence interval (CI) 1.56-3.34 p < 0.001; ST: HR 2.32, CI 1.11-4.85 p = 0.024). We found no difference in mortality related to coronary artery. In the proximal LAD, DES implantation was associated with a lower restenosis rate (HR 0.39, CI 0.27-0.55 < 0.001) and mortality (HR 0.58, CI 0.41-0.82 p = 0.002) compared with BMS. In the proximal RCA and LCX, DES use was not associated with lower frequency of clinical restenosis or mortality. Conclusions: Following proximal coronary artery intervention restenosis was more frequent in the LAD than in the LCX. Solely in the proximal LAD we found DES use to be associated with a lower risk of restenosis and death weighted against BMS. (C) 2013 Elsevier Ireland Ltd. All rights reserved.

  • 5.
    Calais, Fredrik
    et al.
    Department of Cardiology, Örebro University Hospital, Örebro, Sweden; Faculty of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Östman, Maja Eriksson
    Department of Cardiology, Örebro, Sweden; , Faculty of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Hedberg, Pär
    Centre for Clinical Research, Uppsala University, Uppsala, Sweden; Department of Clinical Physiology, Västmanland County Hospital, Västerås, Sweden.
    Rosenblad, Andreas
    Centre for Clinical Research, Uppsala University Västmanland County Hospital, Västerås, Sweden.
    Leppert, Jerzy
    Centre for Clinical Research, Uppsala University Västmanland County Hospital, Västerås, Sweden.
    Fröbert, Ole
    Örebro University, School of Medical Sciences. Department of Cardiology.
    Incremental prognostic value of coronary and systemic atherosclerosis after myocardial infarction2018In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 261, p. 6-11Article in journal (Refereed)
    Abstract [en]

    Background: The role of systemic atherosclerosis in myocardial infarction (MI) patients is not fully understood. We investigated the incremental prognostic value of coronary and systemic atherosclerosis after acute MI by estimating extra-cardiac artery disease (ECAD) and extent of coronary atherosclerosis.

    Methods and results: The study included 544 prospective MI patients undergoing coronary angiography. For all patients, the longitudinal coronary atherosclerotic extent, expressed as Sullivan extent score (SES) was calculated. In addition, the patients underwent non-invasive screening for ECAD in the carotid, aortic, renal and lower limb. SES was found to be associated with ECAD independent of baseline clinical parameters [adjusted odds ratio (OR) 1.04 95% confidence interval (CI) 1.02-1.06, P < 0.001]. Extensive systemic atherosclerosis, defined as the combination of extensive coronary disease (SES >= 17) and ECAD, was associated with higher risk for all-cause mortality compared to limited systemic atherosclerosis (SES < 17 and no ECAD) (hazard ratio [HR] 2.9 95% CI 1.9-4.5, P < 0.001, adjusted for Global Registry of Acute Coronary Events risk score parameters 1.8, 95% CI 1.1-3.0, P = 0.019). The risk for the composite endpoint of cardiovascular death or hospitalization was significantly higher in patients with extensive systemic atherosclerosis compared to patients with limited systemic atherosclerosis (HR 3.1, 95% CI 2.1-4.7, P < 0.001, adjusted HR 1.9, 95% CI 1.2-3.1, P < 0.004).

    Conclusions: Visual estimation of the longitudinal coronary atherosclerotic extent at the time of MI predicts ECAD. Coexistence of extensive coronary disease and ECAD defines a group with particularly poor prognosis after MI.

  • 6.
    Calais, Fredrik
    et al.
    Örebro University, Faculty of Health, Department of Cardiology, Sweden.
    Östman, Maja Eriksson
    Örebro University, Faculty of Health, Department of Cardiology, Sweden.
    Hedberg, Pär
    Centre for Clinical Research, Uppsala University, Department of Clinical Physiology, Västmanland County Hospital, Västerås, Sweden.
    Rosenblad, Andreas
    Centre for Clinical Research, Uppsala University Västmanland County Hospital, Västerås, Sweden.
    Leppert, Jerzy
    Centre for Clinical Research, Uppsala University Västmanland County Hospital, Västerås, Sweden.
    Fröbert, Ole
    Örebro University, School of Medical Sciences. Department of Cardiology.
    Reply to "Letter to editor, Assessing the effect of coronary and systemic atherosclerosis following myocardial infarction" by dr Su Yueqiu et al.2018In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 271, p. 29-29Article in journal (Refereed)
  • 7.
    Djekic, Demir
    et al.
    Department of Public Health and Clinical Medicine, Umeå University And Heart Centre, Umeå, Sweden.
    Pinto, Rui
    Computational Life Science Cluster, Department of Chemistry, Umeå University, Umeå, Sweden.
    Vorkas, Panagiotis A
    Section of Biomolecular Medicine, Division of Computational and Systems Medicine, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK.
    Henein, Michael Y
    Department of Public Health and Clinical Medicine, Umeå University And Heart Centre, Umeå, Sweden.
    Replication of LC-MS untargeted lipidomics results in patients with calcific coronary disease: an interlaboratory reproducibility study2016In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 222, p. 1042-1048Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Recently a lipidomics approach was able to identify perturbed fatty acyl chain (FAC) and sphingolipid moieties that could stratify patients according to the severity of coronary calcification, a form of subclinical atherosclerosis. Nevertheless, these findings have not yet been reproduced before generalising their application. The aim of this study was to evaluate the reproducibility of lipidomics approaches by replicating previous lipidomic findings in groups of patients with calcific coronary artery disease (CCAD).

    METHODS: Patients were separated into the following groups based on their calcium score (CS); no calcification (CS: 0; n=26), mild calcification (CS: 1-250; n=27) and severe calcification (CS: >250; n=17). Two serum samples were collected from each patient and used for comparative analyses by 2 different laboratories, in different countries and time points using liquid chromatography coupled to mass spectrometry untargeted lipidomics methods.

    RESULTS: Six identical metabolites differentiated patients with severe coronary artery calcification from those with no calcification were found by both laboratories independently. Additionally, relative intensities from the two analyses demonstrated high correlation coefficients. Phosphatidylcholine moieties with 18-carbon FAC were identified in lower intensities and 20:4 FAC in higher intensities in the serum of diseased group. Moreover, 3 common sphingomyelins were detected.

    CONCLUSION: This is the first interlaboratory reproducibility study utilising lipidomics applications in general and specifically in patients with CCAD. Lipid profiling applications in patients with CCAD are very reproducible in highly specialised and experienced laboratories and could be applied in clinical practice in order to spare patients diagnostic radiation.

  • 8.
    Fröbert, Ole
    et al.
    Faculty of Health, Department of Cardiology, Örebro University, Örebro, Sweden.
    Arevström, Lilith
    Faculty of Health, Department of Cardiology, Örebro University, Örebro, Sweden.
    Calais, Fredrik
    Örebro University, School of Medical Sciences.
    James, Stefan K.
    Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden; Uppsala Clinical research center, Uppsala University, Uppsala, Sweden.
    Lagerqvist, Bo
    Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden; Uppsala Clinical research center, Uppsala University, Uppsala, Sweden.
    Height and prognosis following percutaneous coronary intervention2016In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 224, p. 188-190Article in journal (Refereed)
  • 9.
    Henriksson, Catrin
    et al.
    Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden.
    Larsson, Margareta
    Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
    Arnetz, Judy
    Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit MI, United States; Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Berglin-Jarlöv, Marianne
    Institution of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Herlitz, Johan
    Institution of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Karlsson, Jan-Erik
    Department of Cardiology, Ryhov Hospital, Jönköping, Sweden.
    Svensson, Leif
    Department of Clinical Science and Education, Karolinska Institute, Stockholm, Sweden.
    Thuresson, Marie
    Örebro University, School of Health and Medical Sciences.
    Zedigh, Crister
    Department of Cardiology, Falu Hospital, Falun, Sweden.
    Wernroth, Lisa
    Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden.
    Lindahl, Bertil
    Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden; Department of Cardiology, Uppsala University Hospital, Uppsala, Sweden.
    Knowledge and attitudes toward seeking medical care for AMI-symptoms2011In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 147, no 2, p. 224-227Article in journal (Refereed)
    Abstract [en]

    Background: Time is crucial when an acute myocardial infarction (AMI) occurs, but patients often wait before seeking medical care.

    Aim: To investigate and compare patients' and relatives' knowledge of AMI, attitudes toward seeking medical care, and intended behaviour if AMI-symptoms occur.

    Methods: The present study was a descriptive, multicentre study. Participants were AMI-patients <= 75 years (n = 364) and relatives to AMI-patients (n = 319). Questionnaires were used to explore the participants' knowledge of AMI and attitudes toward seeking medical care.

    Results: Both patients and relatives appeared to act more appropriate to someone else's chest pain than to their own. Patients did not have better knowledge of AMI-symptoms than relatives. Women would more often contact someone else before seeking medical care. A greater percentage of elderly (65-75 years), compared to younger individuals, reported that they would call for an ambulance if chest pain occurred.

    Conclusions: There were only minor differences between patients and relatives, regarding both knowledge and attitudes. It seems easier to act correctly as a bystander than as a patient. Therefore, in order to decrease patients' delay time it is important to educate relatives as well as patients on how to respond to symptoms of an AMI.

  • 10. Herlitz, Johan
    et al.
    Thuresson, Marie
    Örebro University, School of Health and Medical Sciences.
    Svensson, L.
    Lindqvist, J.
    Lindahl, B.
    Zedigh, C.
    Jarlöv, M.
    Factors of importance for patients' decision time in acute coronary syndrome2010In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 141, no 3, p. 236-242Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Not much is known about the patients' decision time in acute coronary syndrome (ACS). The aim of the survey was therefore to describe patients' decision time and factors associated with this parameter in ACS. METHODS: We conducted a national survey comprising intensive cardiac care units at 11 hospitals in Sweden in which patients with ACS diagnosis and symptoms onset outside hospital participated. Main outcome measures were patients' decision time and factors associated with patients' decision time. RESULTS: In all, 1939 patients took part in the survey. The major factors associated with a shorter patient decision time were: 1) ST-elevation ACS, 2) associated symptoms such as vertigo or near syncope, 3) interpreting the symptoms as cardiac in origin, 4) pain appearing suddenly and reaching a maximum within minutes, 5) having knowledge of the importance of quickly seeking medical care and 6) experiencing the symptoms as frightening. The following aspects of the disease were associated with a longer decision time: 1) pain was localised in the back and 2) symptom onset at home when alone. CONCLUSION: A number of factors, including the type of ACS, the type and localisation of symptoms, the place where symptoms occurred, patients' interpretation of symptoms and knowledge were all associated with patients' decision time in connection with ACS.

  • 11.
    Jashari, Haki
    et al.
    Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
    Lannering, Katarina
    Department of Public Health and Clinical Medicine, Umeå University And Heart Centre, Umeå, Sweden.
    Ibrahimi, Pranvera
    Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
    Djekic, Demir
    Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
    Mellander, Mats
    Department of Pediatric Cardiology, Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Göteborg, Sweden.
    Rydberg, Annika
    Department of Clinical Sciences, Umeå University, Umeå, Sweden.
    Henein, Michael Y
    Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
    Persistent reduced myocardial deformation in neonates after CoA repair2016In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 221, p. 886-891Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Surgical repair of coarctation of the aorta (CoA) is a safe procedure in children, however the condition is known for its potential recurrence and other related complications. The available evidence shows abnormal intrinsic properties of the aorta in CoA, thus suggesting additional effect, even after CoA repair, on left ventricular (LV) function. Accordingly, we sought to obtain a better understanding of LV myocardial mechanics in very early-corrected CoA using two-dimensional STE.

    METHODS AND RESULTS: We retrospectively studied 21 patients with corrected CoA at a median age of 9 (2-53) days at three time points: 1) just before intervention, 2) at short-term follow-up and 3) at medium-term follow-up after intervention and compared them with normal values. Speckle tracking analysis was conducted via vendor independent software, Tomtec. After intervention, LV function significantly improved (from -12.8±3.9 to -16.7±1.7; p<0.001), however normal values were not reached even at medium term follow-up (-18.3±1.7 vs. -20±1.6; p=0.002). Medium term longitudinal strain correlated with pre intervention EF (r=0.58, p=0.006). Moreover, medium term subnormal values were more frequently associated with bicuspid aortic valve (33.3% vs. 66.6%; p<0.05).

    CONCLUSION: LV myocardial function in neonates with CoA can be feasibly evaluated and followed up by speckle tracking echocardiography. LV subendocardial dysfunction however, remains in early infancy coarctation long after repair. Long-term follow-up through adulthood using myocardial deformation measurements should shed light on the natural history and consequences of this anomaly.

  • 12.
    Ljungberg, Liza U.
    et al.
    Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
    Alehagen, Urban
    Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
    De Basso, Rachel
    ivision of Cardiovascular Medicine, Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
    Persson, Karin
    Division of Drug Research, Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
    Dahlström, Ulf
    Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
    Länne, Toste
    Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
    Circulating angiotensin-converting enzyme is associated with left ventricular dysfunction, but not with central aortic hemodynamics2013In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 166, no 2, p. 540-1Article in journal (Refereed)
  • 13.
    Nordenskjöld, Anna M.
    et al.
    Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Cardiology.
    Baron, T.
    Department of Medical Sciences, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden.
    Eggers, K. M.
    Department of Medical Sciences, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden.
    Jernberg, T.
    Department of Clinical Sciences, Cardiology, Danderyd Hospital, Karolinska Institute, Stockholm, Sweden.
    Lindahl, B.
    Department of Medical Sciences, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden.
    Predictors of adverse outcome in patients with myocardial infarction with non-obstructive coronary artery (MINOCA) disease2018In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 261, p. 18-23Article in journal (Refereed)
    Abstract [en]

    Background: Myocardial infarction (MI) with non-obstructive coronary arteries (MINOCAs) is an increasingly recognized entity. No previous study has evaluated predictors for new major adverse cardiacvascular events (MACEs) and death in patients with MINOCA.

    Methods: We conducted an observational study of MINOCA patients recorded between July 2003 and June 2013 and followed until December 2013 for outcome events. Out of 199,163 MI admissions, 9092 consecutive unique patients with MINOCA were identified. The mean age was 65.5 years and 62% were women. MACE was defined as all-cause mortality, rehospitalization for acute MI, ischemic stroke and heart failure. Hazard ratio and 95% confidence interval (HR; 95% CI) was calculated using Cox-regression.

    Results: A total of 2147 patients (24%) experienced a new MACE and 1254 patients (14%) died during the mean follow-up of 4.5 years. Independent predictors for MACE after adjustment, were older age (1.05; 1.04-1.06), diabetes (1.44; 1.21-1.70), hypertension (1.25; 1.09-1.43), current smoking (1.38; 1.15-1.66), previous myocardial infarction (1.38; 1.04-2.82), previous stroke (1.69; 1.35-2.11), peripheral vascular disease (1.55; 1.97-2.23), chronic obstructive pulmonary disease (1.63; 1.32-2.00), reduced left ventricular ejection fraction (2.00; 1.54-2.60), lower level of total cholesterol (0.88; 0.83-0.94) and higher level of creatinine (1.01; 1.00-1.03). Independent predictors for all cause death were age, current smoking, diabetes, cancer, chronic obstructive pulmonary disease, previous stroke, reduced left ventricular fraction, lower level of total cholesterol and higher levels of creatinine and CRP.

    Conclusions: The clinical factors predicting new MACE and death of MINOCA patients seem to be strikingly similar to factors previously shown to predict new cardiovascular events in patients with MI and obstructive coronary artery disease.

  • 14.
    Saha, Samir Kanti
    et al.
    Umeå University, Umeå, Sweden.
    Kiotsekoglou, Anatoli
    Örebro University Hospital. Örebro University, School of Medical Sciences. Department of Clinical Physiology.
    Taking a deeper insight into the burden of cardiac amyloidosis: Has 3D speckle tracking echocardiographic strain come of age?2018In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 271, p. 396-397Article in journal (Other academic)
  • 15.
    Saha, Samir Kanti
    et al.
    Heart Center, Umeå University Hospital, Umeå, Sweden.
    Kiotsekoglou, Anatoli
    Örebro University Hospital. Örebro University, School of Medical Sciences. Department of Clinical Physiology, Örebro University Hospital, Örebro, Sweden.
    Söderberg, Stephan
    Heart Center, Umeå University Hospital, Umeå, Sweden.
    Dobutamine stress echocardiography in pulmonary hypertension: A taste of old wine in a new bottle2018In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 270, p. 355-356Article in journal (Other academic)
  • 16.
    Sarno, Giovanna
    et al.
    Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden; Uppsala Clinical Research Center, Uppsala University Hospital, Uppsala University, Uppsala, Sweden .
    Lagerqvist, Bo
    Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden; Uppsala Clinical Research Center, Uppsala University Hospital, Uppsala University, Uppsala, Sweden .
    Carlsson, Jörg
    Department of Medicine, Länssjukhuset, Kalmar, Sweden .
    Olivecrona, Göran
    Department of Cardiology, Lund University Hospital, Lund, Sweden.
    Nilsson, Johan
    Department of Cardiology, Norrlands University Hospital, Umeå, Sweden .
    Calais, Fredrik
    Department of Cardiology, Örebro University Hospital, Örebro, Sweden .
    Götberg, Matthias
    Department of Cardiology, Lund University Hospital, Lund, Sweden .
    Nilsson, Tage
    Department of Cardiology, Karlstad Hospital, Karlstad, Sweden .
    Sjögren, Iwar
    Department of Cardiology, Falun Lasarett, Falun, Sweden .
    James, Stefan
    Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden; University Hospital, Uppsala Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden .
    Initial clinical experience with an everolimus eluting platinum chromium stent (Promus Element) in unselected patients from the Swedish Coronary Angiography and Angioplasty Registry (SCAAR)2013In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 167, no 1, p. 146-150Article in journal (Refereed)
    Abstract [en]

    Background: The safety and efficacy of the Promus Element stent have been recently demonstrated in a selected population from one randomized trial. The aim of this study was to describe the initial clinical experience with the everolimus eluting platinum chromium stent (Promus Element) in unselected patients from a real life nationwide registry.

    Methods: The Promus Element DES was compared to all other DES implanted in Sweden (with more than 500 implants) from November 2009 to March 2011. The results were assessed using Cox regression.

    Results: A total of 13,577 stents (Promus Element, n = 2724, Cypher, n = 782; Endeavor, n = 747; Taxus Liberte, n = 1393, Xience V/Promus, n = 4832, Resolute, n = 1566, Xience Prime, n = 4832) were implanted at 8375 procedures. At one year the restenosis rate in the Promus Element was not significantly different from the overall DES group (2.8% vs. 2.7%, adjusted HR: 1.17, 95% CI: 0.75-1.75). A significantly lower restenosis rate was observed in the Promus Element when compared with Endeavor (2.8% vs. 5.8%; adjusted HR: 0.44; 95% CI: 0.26-0.74). The stent thrombosis (ST) rate at one year was not significantly different in the Promus Element as compared with the overall DES group (0.2% vs. 0.5% adjusted HR: 0.59; 95% CI: 025-1.40). ST rate was significantly lower as compared with Endeavor stent (0.2% vs. 0.8%; HR: 0.24; 95% CI: 0.08-0.67).

    Conclusions: In a large unselected population the Promus Element stent appears to be safe and effective with a low risk of restenosis and ST. (C) 2011 Elsevier Ireland Ltd. All rights reserved.

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