| 1. |
- Hergens, Maria-Pia, et al.
(författare)
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Use of Scandinavian Moist Smokeless Tobacco (Snus) and the Risk of Atrial Fibrillation
- 2014
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Ingår i: Epidemiology. - 1044-3983 .- 1531-5487. ; 25:6, s. 872-876
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Snus is a smokeless tobacco product, widely used among Swedish men and increasingly so elsewhere. There is debate as to whether snus is an acceptable "harm-reduction" tobacco product. Since snus use delivers a dose of nicotine equivalent to cigarettes, and has been implicated in cardiac arrhythmia because of associations with sudden cardiovascular death, a relation with atrial fibrillation is plausible and important to investigate.METHODS:: To assess the relation between use of snus and risk of atrial fibrillation, we carried out a pooled analysis of 7 prospective Swedish cohort studies. In total, 274,882 men, recruited between 1978 and 2004, were followed via the National Patient Register for atrial fibrillation. Primary analyses were restricted to 127,907 never-smokers. Relative risks were estimated using Cox proportional hazard regression.RESULTS:: The prevalence of snus use was 25% among never-smokers. During follow-up, 3,069 cases of atrial fibrillation were identified. The pooled relative risk of atrial fibrillation was 1.07 (95% confidence interval = 0.97-1.19) in current snus users, compared with nonusers.CONCLUSION:: Findings from this large national pooling project indicate that snus use is unlikely to confer any important increase in risk of atrial fibrillation.
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| 2. |
- Andersen, Kasper, et al.
(författare)
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Risk of arrhythmias in 52 755 long-distance cross-country skiers : a cohort study
- 2013
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Ingår i: European Heart Journal. - : Oxford University Press (OUP). - 0195-668X .- 1522-9645. ; 34:47, s. 3624-3631
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Tidskriftsartikel (refereegranskat)abstract
- AIMS:We aimed to investigate the association of number of completed races and finishing time with risk of arrhythmias among participants of Vasaloppet, a 90 km cross-country skiing event.METHODS AND RESULTS:All the participants without cardiovascular disease who completed Vasaloppet during 1989-98 were followed through national registries until December 2005. Primary outcome was hospitalization for any arrhythmia and secondary outcomes were atrial fibrillation/flutter (AF), bradyarrhythmias, other supraventricular tachycardias (SVT), and ventricular tachycardia/ventricular fibrillation/cardiac arrest (VT/VF/CA). Among 52 755 participants, 919 experienced arrhythmia during follow-up. Adjusting for age, education, and occupational status, those who completed the highest number of races during the period had higher risk of any arrhythmias [hazard ratio (HR)1.30; 95% CI 1.08-1.58; for ≥5 vs. 1 completed race], AF (HR 1.29; 95% CI 1.04-1.61), and bradyarrhythmias (HR 2.10; 95% CI 1.28-3.47). Those who had the fastest relative finishing time also had higher risk of any arrhythmias (HR 1.30; 95% CI 1.04-1.62; for 100-160% vs. >240% of winning time), AF (1.20; 95% CI 0.93-1.55), and bradyarrhythmias (HR 1.85; 95% CI 0.97-3.54). SVT or VT/VF/CA was not associated with finishing time or number of completed races.CONCLUSIONS:Among male participants of a 90 km cross-country skiing event, a faster finishing time and a high number of completed races were associated with higher risk of arrhythmias. This was mainly driven by a higher incidence of AF and bradyarrhythmias. No association with SVT or VT/VF/CA was found.
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| 3. |
- Carlsson, Sofia, et al.
(författare)
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Body mass index and mortality : is the association explained by genetic factors?
- 2011
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Ingår i: Epidemiology. - 1044-3983 .- 1531-5487. ; 22:1, s. 98-103
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Numerous studies have shown that higher body mass index (BMI) is associated with higher mortality. We investigated the extent to which this association might be explained by genetic factors. METHODS: We used data from the Swedish Twin Registry on twins born 1886-1958 who answered a questionnaire in 1969/1970 or 1972 (n = 44,258). Information on mortality from all-causes (n = 14,217), cardiovascular disease (CVD; n = 9009), and coronary heart disease (CHD; n = 3564) was obtained by linkage to the national Causes of Death Registry for the years 1972-2004. The association between BMI and mortality was studied without control for genetic factors in cohort analyses and with control for genetic factors in co-twin control analyses. RESULTS: In cohort analyses, there was a clear dose-response relationship between BMI and mortality. Hazard ratios per 1 unit increase in BMI in subjects with BMI ≥18.5 were 1.05 (95% confidence interval = 1.05-1.06) for all-cause mortality, 1.07 (1.07-1.09) for CVD mortality, and 1.09 (1.08-1.10) for CHD mortality. Similar results were seen in co-twin control analyses of dizygotic twins. However, within monozygotic twins, BMI was associated with death from CHD (OR = 1.06; 1.00-1.12), whereas the association with all-cause mortality (1.01, 0.98-1.04) and CVD mortality (1.02, 0.98-1.06) was weak. CONCLUSIONS: Our findings indicate that there is an association between high BMI and mortality from CHD that is not explained by genetic confounding. However, a large part of the association between BMI and other causes of death may be explained by genes rather than by a causal link between these factors.
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| 4. |
- Carlsson, Sofia, et al.
(författare)
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Late retirement is not associated with increased mortality, results based on all Swedish retirements 1991-2007
- 2012
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Ingår i: European Journal of Epidemiology. - : Springer Science and Business Media LLC. - 0393-2990 .- 1573-7284. ; 27:6, s. 483-486
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- In their recent paper based on German old-age pensioners, Kühntopf and Tivig [1] show that early retirement is associated with considerably higher mortality in men. This is in line with previous reports from British, Danish, US, German and Greek populations showing an increased mortality risk related to retirement, especially in the case of early retirement [2–6]. As pointed out by Kühntopf and Tivig, interpretation of these results is complicated, since a “Healthy worker selection effect” may be operating. To reduce this bias, they used information on credited periods of disease in the public insurance system [1]. Other strategies include adjustment for baseline medical problems [2, 6], using a time lag during follow up [5] or exclusion of subjects retiring for health reasons [3, 4]. It is however questionable, whether these strategies have been sufficient to eliminate the effect of health on retirement.
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| 5. |
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| 6. |
- Hansson, Jenny, et al.
(författare)
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Use of snus and acute myocardial infarction: pooled analysis of eight prospective observational studies
- 2012
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Ingår i: European Journal of Epidemiology. - : Springer Science and Business Media LLC. - 1573-7284 .- 0393-2990. ; 27:10, s. 771-779
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Tidskriftsartikel (refereegranskat)abstract
- The use of snus (also referred to as Scandinavian or Swedish moist smokeless tobacco), which is common in Sweden and increasing elsewhere, is receiving increasing attention since considered a tobacco smoke "potential reduction exposure product". Snus delivers a high dose of nicotine with possible hemodynamic effects, but its impact on cardiovascular morbidity and mortality is uncertain. The aim of this study was to investigate whether snus use is associated with risk of and survival after acute myocardial infarction (AMI). Data from eight prospective cohort studies set in Sweden was pooled and reanalysed. The relative risk of first time AMI and 28-day case-fatality was calculated for 130,361 men who never smoked. During 2,262,333 person-years of follow-up, 3,390 incident events of AMI were identified. Current snus use was not associated with risk of AMI (pooled multivariable hazard ratio 1.04, 95 % confidence interval 0.93 to 1.17). The short-term case fatality rate appeared increased in snus users (odds ratio 1.28, 95 % confidence interval 0.99 to 1.68). This study does not support any association between use of snus and development of AMI. Hence, toxic components other than nicotine appear implicated in the pathophysiology of smoking related ischemic heart disease. Case fatality after AMI is seemingly increased among snus users, but this relationship may be due to confounding by socioeconomic or life style factors.
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| 7. |
- Jacobs, Kevin B, et al.
(författare)
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Detectable clonal mosaicism and its relationship to aging and cancer.
- 2012
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Ingår i: Nature Genetics. - New York : Nature Publishing Group. - 1061-4036 .- 1546-1718. ; 44:6, s. 651-658
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Tidskriftsartikel (refereegranskat)abstract
- In an analysis of 31,717 cancer cases and 26,136 cancer-free controls from 13 genome-wide association studies, we observed large chromosomal abnormalities in a subset of clones in DNA obtained from blood or buccal samples. We observed mosaic abnormalities, either aneuploidy or copy-neutral loss of heterozygosity, of >2 Mb in size in autosomes of 517 individuals (0.89%), with abnormal cell proportions of between 7% and 95%. In cancer-free individuals, frequency increased with age, from 0.23% under 50 years to 1.91% between 75 and 79 years (P = 4.8 × 10(-8)). Mosaic abnormalities were more frequent in individuals with solid tumors (0.97% versus 0.74% in cancer-free individuals; odds ratio (OR) = 1.25; P = 0.016), with stronger association with cases who had DNA collected before diagnosis or treatment (OR = 1.45; P = 0.0005). Detectable mosaicism was also more common in individuals for whom DNA was collected at least 1 year before diagnosis with leukemia compared to cancer-free individuals (OR = 35.4; P = 3.8 × 10(-11)). These findings underscore the time-dependent nature of somatic events in the etiology of cancer and potentially other late-onset diseases.
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| 8. |
- László, Krisztina D, et al.
(författare)
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Job insecurity and prognosis after myocardial infarction : The SHEEP Study
- 2013
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Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754. ; 167:6, s. 2824-2830
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:The prognostic role of job insecurity in coronary heart disease is unknown. We aimed to analyze whether job insecurity predicts mortality and recurrent events after a first acute myocardial infarction (AMI).METHODS:We studied non-fatal AMI cases involved in the Stockholm Heart Epidemiology Program who were in paid employment and younger than 65years (n=676). Shortly after their AMI, patients completed a questionnaire about job insecurity, demographic, work-related, clinical and lifestyle factors and participated in a clinical examination three months after discharge from the hospital. They were followed for 8.5years for mortality and cardiovascular events.RESULTS:After adjusting for previous morbidity, demographic and work-related factors, job insecurity was associated with an increased risk of the combined endpoint of cardiac death and non-fatal AMI, of total mortality and of heart failure; the hazard ratios (HR) and the 95% confidence intervals (CI) were 1.50 (1.02-2.22), 1.69 (1.04-2.75) and 1.62 (1.07-2.44), respectively. Similar associations, but with less statistical power were observed between job insecurity and cardiac death (HR (95% CI): 1.57 (0.80-3.09)) and stroke (HR (95% CI): 1.46 (0.71-3.02)), respectively. Adjustment for potential mediators, i.e. sleep problems, health behaviour, hypertension, blood lipids, glucose, inflammatory and coagulation factors did not alter considerably the relationship between job insecurity and the combination of cardiac mortality and non-fatal AMI.CONCLUSIONS:Our results suggest that job insecurity is an adverse prognostic factor in patients with a first AMI. Future studies are needed to confirm this finding and to determine the mechanisms underlying the observed relationship.
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| 9. |
- Michaëlsson, Karl, et al.
(författare)
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Risk of Severe Knee and Hip Osteoarthritis in Relation to Level of Physical Exercise : A Prospective Cohort Study of Long-Distance Skiers in Sweden
- 2011
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 6:3, s. e18339-
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Tidskriftsartikel (refereegranskat)abstract
- Background: To complete long-distance ski races, regular physical exercise is required. This includes not only cross-country skiing but also endurance exercise during the snow-free seasons. The aim of this study was to determine whether the level of physical exercise is associated with future risk of severe osteoarthritis independent of previous diseases and injuries. Methodology/Principal Findings: We used a cohort that consisted of 48 574 men and 5 409 women who participated in the 90 km ski race Vasaloppet at least once between 1989 and 1998. Number of performed races and finishing time were used as estimates of exercise level. By matching to the National Patient Register we identified participants with severe osteoarthritis, defined as arthroplasty of knee or hip due to osteoarthritis. With an average follow-up of 10 years, we identified 528 men and 42 women with incident osteoarthritis. The crude rate was 1.1/1000 person-years for men and 0.8/1000 person-years for women. Compared with racing once, participation in >= 5 races was associated with a 70% higher rate of osteoarthritis (multivariable-adjusted hazard ratio (HR) 1.72, 95% confidence interval (CI) 1.33 to 2.22). The association was dose-dependent with an adjusted HR of 1.09, 95% CI 1.05 to 1.13 for each completed race. A faster finishing time, in comparison with a slow finishing time, was also associated with an increased rate (adjusted HR 1.51, 95% CI 1.14 to 2.01). Contrasting those with 5 or more ski races and a fast finish time to those who only participated once with a slow finish time, the adjusted HR of osteoarthritis was 2.73, 95% CI 1.78 to 4.18. Conclusions/Significance: Participants with multiple and fast races have an increased risk of subsequent arthroplasty of knee and hip due to osteoarthritis, suggesting that intensive exercise may increase the risk.
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| 10. |
- Pyshchyta, Ganna, et al.
(författare)
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Tea consumption, incidence and long-term prognosis of a first acute myocardial infarction : The SHEEP study
- 2012
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Ingår i: Clinical Nutrition. - : Elsevier BV. - 0261-5614 .- 1532-1983. ; 31:2, s. 267-272
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND & AIMS: Results of previous studies on tea consumption and incidence or prognosis of acute myocardial infarction (AMI) are conflicting. The aim of the present study was to examine the potential role of tea consumption in the previous 12 months in primary and secondary prevention of AMI. METHODS: We studied a total of 1340 individuals with a first non-fatal AMI and 2303 frequency matched control participants on age, gender and hospital catchment area including querying their tea consumption over the previous 12 months. The cohort of AMI cases was then followed for total and cardiac mortality and for non-fatal cardiovascular events with national registers over 8 years. Estimates of relative risks for a first AMI were based on odds ratios from unconditional logistic regression and Cox proportional hazards models were used to examine the prognostic importance of tea consumption in the cohort of cases. RESULTS: The prevalence of daily tea consumption was 20.5% among cases and 21.5% among controls. Tea consumption was associated with a lower risk for a first AMI with adjustment for matching criteria alone, with an odds ratio of 0.78 (95% confidence interval, 0.64-0.95) comparing those who consumed tea daily to those never consuming tea. However, in multivariable adjusted model there was no evidence for an association, the corresponding odds ratio was 1.08(0.86-1.36). There was also no association between tea consumption and cardiac mortality and non-fatal cardiovascular events, with a corresponding adjusted hazard ratio of 0.99(0.77-1.27). CONCLUSIONS: In this epidemiological study, greater tea consumption in the previous year was associated with a lower risk of AMI. However, a clear association between tea consumption and the incidence or prognosis of AMI was not demonstrated, probably because of tea drinkers having a healthier lifestyle.
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