| 1. |
- Almroth, Henrik, et al.
(författare)
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Atorvastatin and persistent atrial fibrillation following cardioversion : a randomized placebo-controlled multicentre study
- 2009
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Ingår i: European Heart Journal. - Philadelphia : Oxford University Press (OUP). - 0195-668X .- 1522-9645. ; 30:7, s. 827-833
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To evaluate the effect of atorvastatin in achieving stable sinus rhythm (SR) 30 days after electrical cardioversion (CV) in patients with persistent atrial fibrillation (AF). METHODS AND RESULTS: The study included 234 patients. The patients were randomized to treatment with atorvastatin 80 mg daily (n = 118) or placebo (n = 116) in a prospective, double-blinded fashion. Treatment was initiated 14 days before CV and was continued 30 days after CV. The two groups were well-balanced with respect to baseline characteristics. Mean age was 65 +/- 10 years, 76% of the patients were male and 4% had ischaemic heart disease. Study medication was well-tolerated in all patients but one. Before primary endpoint 12 patients were excluded. In the atorvastatin group 99 patients (89%) converted to SR at electrical CV compared with 95 (86%) in the placebo group (P = 0.42). An intention-to-treat analysis with the available data, by randomization group, showed that 57 (51%) in the atorvastatin group and 47 (42%) in the placebo group were in SR 30 days after CV (OR 1.44, 95%CI 0.85-2.44, P = 0.18). CONCLUSION: Atorvastatin was not statistically superior to placebo with regards to maintaining SR 30 days after CV in patients with persistent AF.
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| 2. |
- Andersson, Jonas, 1977-, et al.
(författare)
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C-reactive protein is a determinant of first-ever stroke: prospective nested case-referent study.
- 2009
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Ingår i: Cerebrovascular diseases (Basel, Switzerland). - : S. Karger AG. - 1421-9786 .- 1015-9770. ; 27:6, s. 544-51
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: C-reactive protein (CRP) is a determinant of stroke, but there are no prospective studies on CRP and first ischemic stroke divided into etiologic subtypes. Our primary aim was to study CRP as a determinant of ischemic stroke, classified according to Trial of ORG 10172 in Acute Stroke Treatment (TOAST) criteria, and intracerebral hemorrhage (ICH) in a prospective study. A secondary aim was to study the relationship between the 1444C>T polymorphism, plasma levels of CRP and stroke. METHODS: The study was a prospective population-based case-referent study nested within the Northern Sweden Cohorts. We defined 308 cases of ischemic stroke and 61 ICH. Two controls for each case were defined from the same cohort. RESULTS: The OR for the highest (>3 mg/l) versus lowest group (<1 mg/l) of CRP was 2.58 (95% CI 1.74-3.84) for ischemic stroke and 1.63 (95% CI 0.67-3.93) for ICH. In a multivariate model including traditional risk factors, CRP remained associated with ischemic stroke (OR 2.06; 95% CI 1.29-3.29). Small-vessel disease was associated with CRP in the multivariate model (OR 3.88; 95% CI 1.10-13.7). The CRP 1444 (CC/CT vs. TT) polymorphism was associated with plasma levels of CRP but neither with ischemic stroke nor with ICH. CONCLUSIONS: This prospective population-based study shows that CRP is significantly associated with the risk of having a first ischemic stroke, especially for small-vessel disease. No significant associations were found between the CRP 1444C>T polymorphism and any stroke subtype.
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| 3. |
- Andersson, Jonas, 1977-, et al.
(författare)
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Effect of intensive lifestyle intervention on C-reactive protein in subjects with impaired glucose tolerance and obesity : results from a randomized controlled trial with 5-year follow-up
- 2008
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Ingår i: Biomarkers: biochemical indicators of exposure, response, and susceptibility to chemicals. - : Informa UK Limited. - 1366-5804. ; 13:7, s. 671-679
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Tidskriftsartikel (refereegranskat)abstract
- C-reactive protein (CRP) is a marker of metabolic and cardiovascular disease. To study the effects of lifestyle on CRP in a high-risk population we conducted a randomized controlled trial on 200 obese subjects (BMI > 27 kg m(-2)) with impaired glucose tolerance recruited from primary care settings. They were randomized to either a 1-month stay at a wellness centre focusing on diet, exercise and stress management (intervention group) or 30-60 min of oral and written information on lifestyle intervention (control group). A significant reduction of CRP was observed after 1 month and 1 year in the intervention group. They reduced their CRP levels more than the control group 1 year after intervention (p=0.004). In conclusion lifestyle intervention can decrease CRP in obese individuals with impaired glucose tolerance for up to 1 year. Further research is needed to evaluate whether the CRP level reduction translates into a decreased risk for cardiovascular morbidity.
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| 4. |
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| 5. |
- Bergström, Erik, et al.
(författare)
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[Do better next time]
- 2009
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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 106:8, s. 527-
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 6. |
- Boman, Kurt, et al.
(författare)
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Exercise and cardiovascular outcomes in hypertensive patients in relation to structure and function of left ventricular hypertrophy : the LIFE study.
- 2009
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Ingår i: European Journal of Cardiovascular Prevention & Rehabilitation. - 1741-8267 .- 1741-8275. ; 16:2, s. 242-248
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Exercise lowers blood pressure and improves cardiovascular function, but little is known about whether exercise impacts cardiovascular morbidity and mortality independent of left ventricular hypertrophy (LVH) and LV geometry. DESIGN: Observational analysis of prospectively obtained echocardiographic data within the context of a randomized trial of antihypertensive treatment. METHODS: A total of 937 hypertensive patients with ECG LVH were studied by echocardiography in the Losartan Intervention For Endpoint reduction in hypertension study. Baseline exercise status was categorized as sedentary (never exercise), intermediate (30 min twice/week). During 4.8-year follow-up, 105 patients suffered the primary composite endpoint of myocardial infarction (MI), stroke, or cardiovascular death. MI occurred in 39, stroke in 60, and cardiovascular death in 33 patients. RESULTS: Sedentary individuals (n = 212) had, compared with those physically active (n = 511), higher heart rate (P<0.001), weight (P<0.001), body surface area (P = 0.02), body mass index (P<0.001), LV mass (LVM, P = 0.04), LVM indexed for height or body surface area (P = 0.004); thicker ventricular septum (P = 0.012) and posterior wall (P = 0.016); and larger left atrium (P = 0.006). Systolic variables did not differ. In Cox regression analysis, physically active compared with sedentary patients had lower risk of primary composite endpoint [odds ratio (OR): 0.42, 95% confidence interval (CI): 0.26-0.68, P < 0.001], cardiovascular death (OR: 0.50, 95% CI: 0.22-0.1.10, NS), and stroke (OR: 0.26, 95% CI: 0.13-0.49, P < 0.001) without significant difference for MI (OR: 0.79, 95% CI: 0.35-1.75, NS) independent of systolic blood pressure, LVM index, or treatment. CONCLUSION: In hypertensive patients with LVH, physically active patients had improved prognosis for cardiovascular endpoints, mortality, and stroke that was independent of LVM.
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| 8. |
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| 9. |
- Boman, Kurt, et al.
(författare)
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Remote-controlled robotic arm for real-time echocardiography : the diagnostic future for patients in rural areas?
- 2009
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Ingår i: Telemedicine journal and e-health. - : Mary Ann Liebert Inc. - 1530-5627 .- 1556-3669. ; 15:2, s. 142-147
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Tidskriftsartikel (refereegranskat)abstract
- There exists a great clinical need for improving specialist consultation and utilization of echocardiography in areas remote from hospital-based care. This paper presents the development and first technical assessment of a concept of cardiovascular consultation utilizing long distance, real-time echocardiography as a diagnostic tool in rural areas. The development of CARdiological consultation at a DISTance (CARDISTA) was achieved in three stages, comprising tests of different broadband infrastructures, videoconference systems, microphones, cameras, monitors, and loudspeakers. The CARDISTA concept includes a cardiologist and a sonographer, a robotic arm (Medirob), a portable ultrasound machine, and presently available information technology using an advanced broadband backbone. The three stages provided, with some remaining doubts, echocardiographic examination at a distance comparable to hospital-based examinations. A continuous broadband capacity of 20 megabits per second (Mbps) seemed to be a vital component of CARDISTA for achieving the highest-quality imaging. With this broadband capacity, it was possible to achieve a transmission delay below 200 ms. The technical tests of the CARDISTA concept revealed promising results in enabling long distance real-time echocardiography for specialist consultation. CARDISTA is now ready for clinical testing and evaluation in rural areas for patients with heart diseases, especially heart failure.
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