| 231. |
- Akhtar, Zubair, et al.
(författare)
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Optimal timing of influenza vaccination among patients with acute myocardial infarction - Findings from the IAMI trial
- 2023
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Ingår i: Vaccine. - : Elsevier. - 0264-410X .- 1873-2518. ; 41:48, s. 7159-7165
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Tidskriftsartikel (refereegranskat)abstract
- Influenza vaccination reduces the risk of adverse cardiovascular events. The IAMI trial randomly assigned 2571 patients with acute myocardial infarction (AMI) to receive influenza vaccine or saline placebo during their index hospital admission. It was conducted at 30 centers in 8 countries from October 1, 2016 to March 1, 2020. In this post-hoc exploratory sub-study, we compare the trial outcomes in patients receiving early season vaccination (n = 1188) and late season vaccination (n = 1344). The primary endpoint was the composite of all-cause death, myocardial infarction (MI), or stent thrombosis at 12 months. The cumulative incidence of the primary and key secondary endpoints by randomized treatment and early or late vaccination was estimated using the Kaplan-Meier method. In the early vaccinated group, the primary composite endpoint occurred in 36 participants (6.0%) assigned to influenza vaccine and 49 (8.4%) assigned to placebo (HR 0.69; 95% CI 0.45 to 1.07), compared to 31 participants (4.7%) assigned to influenza vaccine and 42 (6.2%) assigned to placebo (HR 0.74; 95% CI 0.47 to 1.18) in the late vaccinated group (P = 0.848 for interaction on HR scale at 1 year). We observed similar estimates for the key secondary endpoints of all-cause death and CV death. There was no statistically significant difference in vaccine effectiveness against adverse cardiovascular events by timing of vaccination. The effect of vaccination on all-cause death at one year was more pronounced in the group receiving early vaccination (HR 0.50; 95% CI, 0.29 to 0.86) compared late vaccination group (HR 0.75; 35% CI, 0.40 to 1.40) but there was no statistically significant difference between these groups (Interaction P = 0.335). In conclusion, there is insufficient evidence from the trial to establish whether there is a difference in efficacy between early and late vaccination but regardless of vaccination timing we strongly recommend influenza vaccination in all patients with cardiovascular diseases.
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| 232. |
- Fröbert, Ole, 1964-, et al.
(författare)
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Clinical Impact of Influenza Vaccination after ST- and Non-ST-segment elevation Myocardial Infarction Insights from the IAMI trial
- 2023
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Ingår i: American Heart Journal. - : Elsevier. - 0002-8703 .- 1097-6744. ; 255, s. 82-89
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Influenza vaccination early after myocardial infarction (MI) improves prognosis but vaccine effectiveness may differ dependent on type of MI.METHODS: A total of 2571 participants were prospectively enrolled in the IAMI trial and randomly assigned to receive in-hospital inactivated influenza vaccine or saline placebo. The trial was conducted at 30 centers in 8 countries from October 1, 2016 to March 1, 2020. Here we report vaccine effectiveness in the 2467 participants with ST-segment elevation MI (STEMI, n=1348) or non-ST-segment elevation MI (NSTEMI, n=1119). The primary endpoint was the composite of all-cause death, MI, or stent thrombosis at 12 months. Cumulative incidence of the primary and key secondary endpoints by randomized treatment and NSTEMI/STEMI was estimated using the Kaplan-Meier method. Treatment effects were evaluated with formal interaction testing to assess for effect modification.RESULTS: Baseline risk was higher in participants with NSTEMI. In the NSTEMI group the primary endpoint occurred in 6.5% of participants assigned to influenza vaccine and 10.5% assigned to placebo (hazard ratio [HR], 0.60; 95% CI, 0.39-0.91), compared to 4.1% assigned to influenza vaccine and 4.5% assigned to placebo in the STEMI group (HR, 0.90; 95% CI, 0.54-1.50, P=0.237 for interaction). Similar findings were seen for the key secondary endpoints of all-cause death and cardiovascular death. The Kaplan-Meier risk difference in all-cause death at 1 year was more pronounced in participants with NSTEMI (NSTEMI: HR, 0.47; 95% CI 0.28-0.80, STEMI: HR, 0.86; 95% CI, 0.43-1.70, interaction P=0.028).CONCLUSIONS: The beneficial effect of influenza vaccination on adverse cardiovascular events may be enhanced in patients with NSTEMI compared to those with STEMI.
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| 233. |
- Fröbert, Ole, 1964-, et al.
(författare)
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Influenza Vaccination after Myocardial Infarction : A Randomized, Double-Blind, Placebo-Controlled, Multicenter Trial
- 2021
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Ingår i: Circulation. - : Lippincott Williams & Wilkins. - 0009-7322 .- 1524-4539. ; 144:18, s. 1476-1484
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Tidskriftsartikel (refereegranskat)abstract
- Background: Observational and small randomized studies suggest that influenza vaccine may reduce future cardiovascular events in patients with cardiovascular disease.Methods: We conducted an investigator-initiated, randomized, double-blind trial to compare inactivated influenza vaccine with saline placebo administered shortly after myocardial infarction (MI) (99.7% of patients) or high-risk stable coronary heart disease (0.3%). The primary endpoint was the composite of all-cause death, MI, or stent thrombosis at 12 months. A hierarchical testing strategy was used for the key secondary endpoints: all-cause death, cardiovascular death, MI, and stent thrombosis.Results: Due to the Covid-19 pandemic, the data safety and monitoring board decided to halt the trial before attaining the prespecified sample size. Between October 1, 2016, and March 1, 2020, 2571 participants were randomized at 30 centers across eight countries; 1290 assigned to influenza vaccine and 1281 to placebo. Over the 12-month follow-up, the primary outcome occurred in 67 participants (5.3%) assigned influenza vaccine and 91 participants (7.2%) assigned placebo (hazard ratio, 0.72; 95% confidence interval, 0.52 to 0.99; P=0.040). Rates of all-cause death were 2.9% and 4.9% (hazard ratio, 0.59; 0.39 to 0.89; P=0.010), of cardiovascular death 2.7% and 4.5%, (hazard ratio, 0.59; 0.39 to 0.90; P=0.014), and of MI 2.0% and 2.4% (hazard ratio, 0.86; 0.50 to 1.46, P=0.57) in the influenza vaccine and placebo groups, respectively. Conclusions: Influenza vaccination early after an MI or in high-risk coronary heart disease resulted in a lower risk of a composite of all-cause death, MI, or stent thrombosis, as well as a lower risk of all-cause death and cardiovascular death at 12 months compared with placebo.Clinical Trial Registration: URL: http://www.clinicaltrials.gov Unique identifier: NCT02831608.
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| 234. |
- Heindel, Jerrold J., et al.
(författare)
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Obesity II : Establishing causal links between chemical exposures and obesity
- 2022
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Ingår i: Biochemical Pharmacology. - : Elsevier. - 0006-2952 .- 1356-1839 .- 1873-2968. ; 199
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Forskningsöversikt (refereegranskat)abstract
- Obesity is a multifactorial disease with both genetic and environmental components. The prevailing view is that obesity results from an imbalance between energy intake and expenditure caused by overeating and insufficient exercise. We describe another environmental element that can alter the balance between energy intake and energy expenditure: obesogens. Obesogens are a subset of environmental chemicals that act as endocrine disruptors affecting metabolic endpoints. The obesogen hypothesis posits that exposure to endocrine disruptors and other chemicals can alter the development and function of the adipose tissue, liver, pancreas, gastrointestinal tract, and brain, thus changing the set point for control of metabolism. Obesogens can determine how much food is needed to maintain homeostasis and thereby increase the susceptibility to obesity. The most sensitive time for obesogen action is in utero and early childhood, in part via epigenetic programming that can be transmitted to future generations. This review explores the evidence supporting the obesogen hypothesis and highlights knowledge gaps that have prevented widespread acceptance as a contributor to the obesity pandemic. Critically, the obesogen hypothesis changes the narrative from curing obesity to preventing obesity.
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| 235. |
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| 236. |
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| 237. |
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| 238. |
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| 239. |
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| 240. |
- Mahanta, C., et al.
(författare)
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Preliminary assessment of arsenic distribution in brahmaputra river basin of India based on examination of 56,180 public groundwater wells
- 2015
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Ingår i: Safe and Sustainable Use of Arsenic-Contaminated Aquifers in the Gangetic Plain: A Multidisciplinary Approach. - Cham : Springer. - 9783319161242 ; , s. 57-64
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Arsenic (As) rich groundwater in alluvial aquifers is a worldwide problem (Nriagu JO, Bhattacharya P, Mukherjee AB, Bundschuh J, Zevenhoven R, Loeppert RH, Arsenic in soil and groundwater: an introduction. In: Bhattacharya P, Mukherjee AB, Bundschuh J, Zevenhoven R, Loeppert RH (eds) Arsenic in soil and groundwater environment: biogeochemical interactions, health effects and remediation. Trace metals and other contaminants in the environment, vol 9 (Ser Ed Nriagu JO). Elsevier, Amsterdam, 2007). Elevated arsenic concentrations have long been detected in Southeast Asia (e.g. Thailand, Myanmar, Vietnam, Cambodia and Lao), India, Bangladesh, China, Mongolia, Nepal and Pakistan (Smedley PL, Kinniburgh DG, Appl Geochem 17:517-568, 2002). Recent reports of discovery of arsenic (As) enrichment in groundwater of the Brahmaputra river basin (Bhattacharya P, Mukherjee A, Mukherjee AB, Arsenic contaminated groundwater of India. In: Nriagu J (ed) Encyclopedia of environmental health. Elsevier B.V, Amsterdam, 2011) has exposed a significantly large population inhabiting in the river valley to serious health threats, although the actual distribution and extent of the As affected groundwater in the aquifers are yet to be established. Because of its vicinity to the highly As rich groundwater regions of Bengal basin (Bangladesh and West Bengal state of India), the extent of the polluted areas within the Brahmaputra basin may be much wider than what is initially understood. Groundwater arsenic contamination in the Brahmaputra basin aquifers in Assam, a state in the northeastern part of India, has started gaining attention relatively recently. Singh (Arsenic contamination in groundwater of North Eastern India. In: Proceedings of 11th national symposium on hydrology with focal theme on water quality. National Institute of Hydrology, Roorkee, 2004) reported maximum groundwater arsenic concentrations in Jorhat district (Fig. 4.1), located in the southern bank of the Brahmaputra river in Assam (maximum groundwater As concentration ranges between 194 and 657 μg/L), with relatively lower concentrations in the northern bank like Lakhimpur district (50-550 μg/L). Based on studies conducted in Darrang and Bongaigaon districts located in the northern bank (Fig. 4.1) of the Brahmaputra river in Assam, Enmark and Nordborg (Arsenic in the groundwater of the Brahmaputra floodplains, Assam, India-Source, distribution and release, mechanisms. Retrieved from the url: www2.lwr.kth.se/Publikationer/PDF_Files/MFS_2007_131.pdf, 2007) reported the concentration of arsenic in the two districts between 5 and 606 μg/L. In a study conducted in 2010 (Mahanta C, Pathak N, Bhattacharya P, Enmark G, Nordborg D, Source, distribution and release mechanisms of arsenic in the groundwater of Assam floodplains of Northeast India. In: Proceedings of the World Environmental and Water Resources Congress sponsored by Environmental and Water Resources Institute (EWRI) of the American Society of Civil Engineers, 2008), concentrations beyond 50 μg/L have been confirmed in 72 blocks out of 214 blocks in 22 districts of Assam. A study by Chetia M, Chatterjee S, Banerjee S, Nath MJ, Singh D, Srivastava RB, Sarma HP (Environ Monit Assess 173:1393-1398, 2011) in the Golaghat district reported As concentration ranging between 1 and 128 μg/L in six blocks of the district. These studies so far have remained spatially limited and a comprehensive picture is yet to emerge. To comprehensively evaluate the extent of As contamination in the region, a blanket rapid assessment study was undertaken in large parts of the Brahmaputra basin in Assam. This paper reports the preliminary assessment of arsenic distribution in the Brahmaputra basin in Assam based upon results from 56,180 public groundwater wells, tested during the rapid assessment programme.
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