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- Vardeny, O., et al.
(författare)
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Influenza Vaccination in Patients With Chronic Heart Failure The PARADIGM-HF Trial
- 2016
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Ingår i: Jacc-Heart Failure. - : Elsevier BV. - 2213-1779. ; 4:2, s. 152-158
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES This study sought to examine the prevalence and predictors of influenza vaccination among participants in the PARADIGM-HF (Prospective Comparison of ARNI with ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure) study and investigate associations between receiving influenza vaccine and cardiovascular death or heart failure hospitalizations, all-cause hospitalizations, and cardiopulmonary or influenza-related hospitalizations. BACKGROUND Influenza is associated with an increased risk for cardiovascular events in patients with heart failure. METHODS We used data from the PARADIGM-HF trial in which patients with heart failure were randomized to the angiotensin receptor neprilysin inhibitor LCZ696 (sacubitril/valsartan) or enalapril. We assessed predictors of receiving influenza vaccination, and examined the relationship between influenza vaccination and outcomes in a propensity adjusted model. RESULTS Of 8,099 study participants, 1,769 (21%) received influenza vaccination. We observed significant regional variation in vaccination rates, with highest rates in the Netherlands (77.5%), Great Britain (77.2%), and Belgium (67.5%), and lowest rates in Asia (2.6%), with intermediate rates in North America (52.8%). Top predictors of vaccination included enrolling country, white race, implanted defibrillator, older age, Lower New York Heart Association functional class, lower heart rate, and a history of diabetes mellitus. Influenza vaccination was associated with a reduced risk for all-cause mortality in propensity-adjusted (hazard ratio: 0.81; 95% confidence interval: 0.67 to 0.97; p = 0.015) models. CONCLUSIONS Influenza vaccination rates varied widely in patients with heart failure with reduced ejection fraction enrolled in the PARADIGM-HF trial, and vaccination was associated with reduced risk for death, although whether this association was causal cannot be determined. (C) 2016 by the American College of Cardiology Foundation.
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- Ost, J, et al.
(författare)
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Familiarity breeds distortion: The effects of media exposure on false reports concerning media coverage of the terrorist attacks in London on 7 July 2005
- 2008
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Ingår i: Memory. - : Informa UK Limited. - 0965-8211 .- 1464-0686. ; 1:16, s. 76-85
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Tidskriftsartikel (refereegranskat)abstract
- The present experiment investigated whether increased media exposure could lead to an increase in memory distortions regarding a traumatic public event: the explosion of the No. 30 bus in Tavistock Square, London on 7 July 2005. A total of 150 Swedish and 150 UK participants completed a series of questionnaires about their memory of either (i) the aftermath of the explosion, (ii) a non-existent computerised reconstruction of the moment of the explosion, or (iii) non-existent closed circuit television footage of the moment of the explosion. In line with the availability heuristic, UK participants were more likely than Swedish participants to claim to have seen all three types of footage. Furthermore, a subsample of UK participants who appeared to have developed false ‘‘memories’’ of seeing the No. 30 bus explode scored significantly higher on measures of dissociation and fantasy proneness than participants who did not develop false ‘‘memories’’. This experiment provides further support for the role of imaginative processes in the development of false memories.
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- Udell, J. A., et al.
(författare)
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Inhibition of the Renin-Angiotensin System Reduces the Rise in Serum Aldosterone in Acute Coronary Syndrome Patients with Preserved Left Ventricular Function: Observations from the AVANT GARDE-TIMI 43 Trial
- 2013
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Ingår i: Clinical Chemistry. - : Oxford University Press (OUP). - 0009-9147 .- 1530-8561. ; 59:6, s. 959-967
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Acute coronary syndrome (ACS) activates neurohormonal pathways, including elevations in circulating aldosterone, with deleterious cardiovascular effects. We aimed to determine if early, more complete renin-angiotensin-aldosterone system inhibition (RAASI) in post-ACS patients without ventricular dysfunction or heart failure would result in a graded reduction in aldosterone concentrations.METHODS: We performed serial measurement of serum aldosterone within the Aliskiren and Valsartan to Reduce NT-proBNP via Renin-Angiotensin-Aldosterone-System Blockade (AVANT GARDE)/Thrombolysis in Myocardial Infarction (TIMI) 43 trial, a randomized double-blind, placebo controlled trial of RAASI by valsartan, aliskiren, or both in post-ACS patients with preserved ventricular function but increased natriuretic peptides. Aldosterone was measured at randomization and week 8.RESULTS: Median aldosterone concentrations were comparable across treatment arms at baseline (9.26 ng/dL; interquartile range 7.11-12.76; n = 1073). In the placebo group, there was a significant increase in aldosterone over 8 weeks (19.7% rise, 2.20 (0.36) ng/dL, P < 0.0001) that was significantly reduced across active RAASI therapies (1.36 (0.40) ng/dL with aliskiren; 1.02 (0.37) ng/dL with valsartan; and 0.85 (0.37) ng/dL with combination therapy, P trend = 0.008). Compared to placebo, RAASI monotherapy resulted in a pooled relative absolute aldosterone change of -1.01 (0.45) ng/dL (P = 0.026 vs placebo), and combination therapy resulted in a relative absolute aldosterone change of -1.35 (0.52) ng/dL (P = 0.01 vs placebo). No significant difference in aldosterone concentrations was achieved between dual vs single RAASI (P = 0.47).CONCLUSIONS: In ACS patients with preserved ventricular function but increased natriuretic peptides, serum aldosterone rises over time and is blunted by more complete RAASI. The clinical implications and role for RAASI in this population warrant further investigation.
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