| 1. |
- Andersson, Bert, 1952, et al.
(författare)
-
Recovery from left ventricular asynergy in ischemic cardiomyopathy following long-term beta blockade treatment.
- 1994
-
Ingår i: Cardiology. - : S. Karger AG. - 0008-6312 .- 1421-9751. ; 85:1, s. 14-22
-
Tidskriftsartikel (refereegranskat)abstract
- It has been suggested that long-term beta blockade treatment in congestive heart failure might be less effective in patients with ischemic cardiomyopathy as compared with patients having idiopathic dilated cardiomyopathy. This study was performed to evaluate the effect of long-term adrenergic beta blockade treatment on regional myocardial function in patients with ischemic cardiomyopathy. The regional wall motion (RWM) was evaluated in 12 patients with ischemic cardiomyopathy before and after long-term open treatment with metoprolol. On average, the patients were treated over 11 months (range 6-36 months). The regional left ventricular function was assessed using two-dimensional echocardiographic recordings by two independent blinded observers. The RWM score was evaluated in 16 segments of the left ventricle on a scale from 0 (hypercontractility) to 5 (dyskinesia). Following treatment, there was an improvement in general ventricular function (ejection fraction 0.24-0.31; p = 0.01) as well as in RWM (86 improved segments, 48 deteriorated, 49 unchanged; p < 0.002). Ventricular segments with poor contractility (RWM score > or = 3.5) tended to improve (53 improved segments, 16 deteriorated, 13 unchanged; p < 0.0001), whereas less severely impaired segments (RWM score < 3.5) did not improve (33 improved segments, 32 deteriorated, 36 unchanged; NS). It is suggested that poorly contracting myocardial segments might improve following beta blockade treatment, while an effect on less impaired segments might be lacking. An improvement in overall myocardial function would then be harder to detect.
|
|
| 2. |
- Andersson, Staffan, et al.
(författare)
-
24-hour electrocardiographic study in myotonic dystrophy
- 1988
-
Ingår i: Cardiology. - : S. Karger AG. - 0008-6312 .- 1421-9751. ; 75:4, s. 241-249
-
Tidskriftsartikel (refereegranskat)abstract
- Thirty-eight consecutive adult patients with myotonic dystrophy were included in a study with electrocardiography at rest and 24-hour ambulatory electrocardiography. The patients were subdivided into three groups according to the severity of the disease. The prevalence of abnormal electrocardiograms at rest was 31, 50 and 100% in patients with mild, moderate and severe disease, respectively. The main characteristics observed at ambulatory electrocardiography were a high frequency of sinus bradycardia (58%) and intermittent atrioventricular block II (8%). These bradyarrhythmias were not correlated to the severity of the disease. Sustained atrial fibrillation or flutter was found in 3 patients (8%), all with the most severe form of the disease. Ambulatory electrocardiography should be used deliberately in the evaluation of patients with myotonic dystrophy and symptoms compatible with cardiac arrhythmias.
|
|
| 3. |
- Atar, Dan, et al.
(författare)
-
Rationale and Design of the 'MITOCARE' Study: A Phase II, Multicenter, Randomized, Double-Blind, Placebo-Controlled Study to Assess the Safety and Efficacy of TRO40303 for the Reduction of Reperfusion Injury in Patients Undergoing Percutaneous Coronary Intervention for Acute Myocardial Infarction
- 2012
-
Ingår i: Cardiology. - : S. Karger AG. - 1421-9751 .- 0008-6312. ; 123:4, s. 201-207
-
Tidskriftsartikel (refereegranskat)abstract
- Treatment of acute ST-elevation myocardial infarction (STEMI) by reperfusion using percutaneous coronary intervention (PCI) or thrombolysis has provided clinical benefits; however, it also induces considerable cell death. This process is called reperfusion injury. The continuing high rates of mortality and heart failure after acute myocardial infarction (AMI) emphasize the need for improved strategies to limit reperfusion injury and improve clinical outcomes. The objective of this study is to assess safety and efficacy of TRO40303 in limiting reperfusion injury in patients treated for STEMI. TRO40303 targets the mitochondrial permeability transition pore, a promising target for the prevention of reperfusion injury. This multicenter, double-blind study will randomize patients with STEMI to TRO40303 or placebo administered just before balloon inflation or thromboaspiration during PCI. The primary outcome measure will be reduction in infarct size (assessed as plasma creatine kinase and troponin I area under the curve over 3 days). The main secondary endpoint will be infarct size normalized to the myocardium at risk (expressed by the myocardial salvage index assessed by cardiac magnetic resonance). The study is being financed under an EU-FP7 grant and conducted under the auspices of the MITOCARE research consortium, which includes experts from clinical and basic research centers, as well as commercial enterprises, throughout Europe. Results from this study will contribute to a better understanding of the complex pathophysiology underlying myocardial injury after STEMI. The present paper describes the rationale, design and the methods of the trial. Copyright (c) 2012 S. Karger AG, Basel
|
|
| 4. |
- Attar, Rubina, et al.
(författare)
-
Time Trends in the Use of Coronary Procedures, Guideline-Based Therapy, and All-Cause Mortality following the Acute Coronary Syndrome in Patients with Schizophrenia
- 2020
-
Ingår i: Cardiology. - : S. Karger AG. - 1421-9751 .- 0008-6312. ; 145:7, s. 401-409
-
Tidskriftsartikel (refereegranskat)abstract
- AIM: Schizophrenia is associated with high cardiovascular mortality predominantly as a result of acute coronary syndrome (ACS). The aim of this study is to analyze time trends of coronary procedures, guideline-based therapy, and all-cause mortality in patients diagnosed with schizophrenia.METHODS AND RESULTS: This Danish nationwide register-based study analyzed 734 patients with a baseline diagnosis of schizophrenia and an incident diagnosis of ACS in the period between January 1, 1996, and December 31, 2015. The 734 patients with schizophrenia were matched to 2,202 psychiatric healthy controls (PHC). No change over time was seen in the relative difference between the population with schizophrenia and the PHC in the use of coronary angiography, percutaneous coronary intervention, and coronary bypass grafting, nor in 1-year mortality or guideline-based therapy following ACS. Patients with schizophrenia had higher prevalence rates of diabetes, chronic obstructive pulmonary disease, and stroke, and a lower prevalence of hypertension (p < 0.05).CONCLUSION: The gap in the use of coronary procedures, guideline-based therapy, and all-cause mortality following ACS in patients with schizophrenia compared to those without has remained constant over the past 2 decades.
|
|
| 5. |
- Bager, Johan-Emil, et al.
(författare)
-
Vernakalant for Cardioversion of Recent-Onset Atrial Fibrillation in the Emergency Department: The SPECTRUM Study
- 2022
-
Ingår i: Cardiology. - : S. Karger AG. - 0008-6312 .- 1421-9751. ; 147:5-6, s. 566-577
-
Tidskriftsartikel (refereegranskat)abstract
- Introduction: Intravenous vernakalant is a therapeutic option for symptomatic, recent-onset atrial fibrillation (AF). This secondary analysis from the large SPECTRUM study assessed the safety and effectiveness of vernakalant when used in the emergency department setting (ED group) or in an inpatient hospital setting (non-ED group). Methods: This post hoc analysis of the international, observational, post-authorization SPECTRUM study included 1,289 and 720 recent-onset AF episodes in adults in the ED and non-ED groups, respectively. Safety endpoints included the evaluation of pre-defined health outcomes of interest (HOIs) and other serious adverse events (SAEs) during vernakalant treatment and during the first 24 h after the last infusion. Effectiveness endpoints comprised the rate of successful vernakalant cardioversion, the time from the start of the vernakalant infusion to cardioversion, and the length of hospital stay. Data were analysed using descriptive statistics. Results: The safety profile of vernakalant was similar in the ED and non-ED groups. In the ED group, 12 pre-defined HOIs were reported in 11 patients (0.9%); all but one occurred within 2 h after start of the first infusion. These events comprised nine significant bradycardia cases, of which one was associated with transient hypotension and three with sinus arrest, and 2 cases of atrial flutter with 1:1 conduction. Five other SAEs were reported. All patients with vernakalant-related events recovered without sequelae. No Torsade de Pointes, ventricular fibrillation, or deaths occurred. Successful cardioversion was reported in 67.8% (95% confidence interval: 65.2-70.4) and 66.4% (62.5-70.1) of episodes, with a median time to conversion of 11.0 and 10.0 min in the ED and non-ED groups, respectively. Patients had a median length of hospital stay of 7.4 h and 17.1 h in the ED and non-ED groups, respectively. Conclusion: Intravenous vernakalant was well tolerated with similar cardioversion rates in patients treated in the ED or non-ED setting and does not require admission to a coronary care unit or intensive care unit. First-line treatment with vernakalant could allow an early discharge in patients with recent-onset AF treated in the ED.
|
|
| 6. |
|
|
| 7. |
|
|
| 8. |
- Bjorkander, Inge, et al.
(författare)
-
Differential Index : A Simple Time Domain Heart Rate Variability Analysis with Prognostic Implications in Stable Angina Pectoris
- 2008
-
Ingår i: Cardiology. - : S. Karger AG. - 0008-6312 .- 1421-9751. ; 111:2, s. 126-133
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To examine the usefulness of time domain heart rate variability (HRV) measurements by a simple graphical method, the differential index (DI), in prognostic assessments of patients with chronic stable angina pectoris. METHODS: HRV measurements in the time domain by DI were compared to conventional measurements of standard deviation of all normal-to-normal intervals (SDNN), percent of differences between adjacent normal RR intervals >50 ms (PNN50) and square root of the mean of the sum of squares of differences between adjacent normal RR intervals (RMSSD) from 24-hour ambulatory electrocardiographic recordings in 678 patients in the Angina Prognosis Study in Stockholm. The patients received double-blind treatment with metoprolol or verapamil. Main outcome measures were cardiovascular death or non-fatal myocardial infarction during follow-up (median 40 months). RESULTS: Patients suffering cardiovascular death (n = 30) had lower DI, SDNN and PNN50 (all p < 0.001). In a multivariate Cox model, DI below median independently predicted cardiovascular death (p = 0.002), as did SDNN (p = 0.016) and PNN50 (p = 0.030), but not RMSSD (p = 0.10). The separation of survival curves was most pronounced and specificity was slightly better with DI. DI and PNN50 increased with metoprolol but not verapamil treatment. Short-term treatment effects were not related to prognosis. CONCLUSIONS: Low time domain HRV carries independent prognostic information regarding cardiovascular death in stable angina pectoris. The simple DI method provided equally good or better prognostic information than conventional, more laborious HRV methods.
|
|
| 9. |
- Blomström, Per, et al.
(författare)
-
Pre- and intraoperative identification of multiple accessory pathways. Experience of 19 pathways in 9 patients
- 1989
-
Ingår i: Cardiology. - : S. Karger AG. - 0008-6312 .- 1421-9751. ; 76:1, s. 42-52
-
Tidskriftsartikel (refereegranskat)abstract
- The pre- and intraoperative electrophysiological studies in 9 patients with two or more accessory pathways are described. The presence of multiple accessory pathways was clinically suspected in only 2 patients. During the preoperative electrophysiological study two accessory pathways were identified in 7 patients and a single pathway in 2 patients. At operation, additionally three accessory pathways were identified in 3 patients. One out of two pathways, found preoperatively, could not be confirmed in 1 patient. It is concluded that the clinical or preoperative electrophysiological evidence of only one accessory pathway should not distract one's attention from considering multiple accessory pathways in patients presenting only one type of tachycardia.
|
|
| 10. |
- Bocchi, E. A., et al.
(författare)
-
Effect of Combining Ivabradine and beta-Blockers: Focus on the Use of Carvedilol in the SHIFT Population
- 2015
-
Ingår i: Cardiology. - : S. Karger AG. - 0008-6312 .- 1421-9751. ; 131:4, s. 218-224
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives: We explored the prescription of beta-blockers with ivabradine in patients with systolic heart failure, focusing on the most frequently coprescribed beta-blocker, carvedilol. Methods: We analyzed outcomes in SHIFT patients with systolic heart failure who were prescribed beta-blockers (carvedilol, bisoprolol, metoprolol, or nebivolol) with ivabradine or placebo. Analysis was by intention to treat in patients prescribed a beta-blocker at the time of the event. Results: Data were available for 2,596 patients receiving carvedilol, 1,483 bisoprolol, 1,424 metoprolol, and 197 nebivolol. Mean treatment duration was 19 months. There was no difference in the effect of ivabradine on the primary composite endpoint of cardiovascular death or heart failure hospitalization between the various beta-blockers [hazard ratios (HR) for risk reduction, 0.75-0.89; p for interaction = 0.86]. Patients prescribed carvedilol with ivabradine had lower rates of primary composite endpoint (HR 0.80, 95% CI: 0.68-0.94), heart failure hospitalization (HR 0.73, 95% CI: 0.61-0.88), and cardiovascular hospitalization (HR 0.80, 95% CI: 0.69-0.92) versus carvedilol with placebo. The dosage of carvedilol had no detectable effect and there were no unexpected safety issues. Conclusions: Whatever beta-blocker was coprescribed with ivabradine, there were improvements in cardiovascular outcomes in patients with systolic heart failure, especially with the most prescribed beta-blocker - carvedilol. (C) 2015 S. Karger AG, Basel
|
|
| 11. |
- Borer, J. S., et al.
(författare)
-
Efficacy Profile of Ivabradine in Patients with Heart Failure plus Angina Pectoris
- 2017
-
Ingår i: Cardiology. - : S. Karger AG. - 0008-6312 .- 1421-9751. ; 136:2, s. 138-144
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: In the Systolic Heart Failure Treatment with the If Inhibitor Ivabradine Trial (SHIFT), slowing of the heart rate with ivabradine reduced cardiovascular death or heart failure hospitalizations among patients with systolic chronic heart failure (CHF). Subsequently, in the Study Assessing the Morbidity-Mortality Benefits of the If Inhibitor Ivabradine in Patients with Coronary Artery Disease (SIGNIFY) slowing of the heart rate in patients without CHF provided no benefit for cardiovascular death or nonfatal myocardial infarction (primary composite end point), with secondary analyses suggesting possible harm in the angina subgroup. Therefore, we examined the impact of ivabradine in the patients with CHF plus angina in SHIFT. METHODS: SHIFT enrolled adults with stable, symptomatic CHF, a left ventricular ejection fraction /=70 bpm. Outcomes were the SHIFT and SIGNIFY primary composite end points and their components. RESULTS: Of 6,505 patients in SHIFT, 2,220 (34%) reported angina at randomization. Ivabradine numerically, but not significantly, reduced the SIGNIFY primary composite end point by 8, 11 and 11% in the SHIFT angina subgroup, nonangina subgroup and overall population, respectively. Ivabradine also reduced the SHIFT primary composite end point in all 3 subgroups. CONCLUSIONS: In SHIFT, ivabradine showed consistent reduction of cardiovascular outcomes in patients with CHF; similar results were seen in the subgroup of SHIFT patients with angina.
|
|
| 12. |
- Chaudhry, Uzma, et al.
(författare)
-
Vectorcardiography Findings Are Associated with Recurrent Ventricular Arrhythmias and Mortality in Patients with Heart Failure Treated with Implantable Cardioverter-Defibrillator Device
- 2020
-
Ingår i: Cardiology. - : S. Karger AG. - 0008-6312 .- 1421-9751. ; 145:12, s. 784-794
-
Tidskriftsartikel (refereegranskat)abstract
- Background: There is a need for refined risk stratification of sudden cardiac death and prediction of ventricular arrhythmias to correctly identify patients who are expected to benefit the most from implantable cardioverter-defibrillator (ICD) therapy. Methods: We conducted a registry-based retrospective observational study on patients with either ischemic (ICMP) or nonischemic dilated cardiomyopathy (NICMP) treated with ICD between 2002 and 2013 at a tertiary referral center. We evaluated 3 vectorcardiography (VCG) indices; spatial QRS-T angle, QRS vector magnitude (QRSvm), and T-wave vector magnitude (Twvm), and their association with all-cause mortality and ventricular arrhythmias. The VCG indices were automatically computed from resting 12-lead electrocardiograms before ICD implantation. Results: 178 patients were included in the study; 53.4% had ICMP, 79.2% were male, and mean ejection fraction was 27.4%. During the follow-up (median 89 months), 40 patients (23%) died; 31% had appropriate ICD therapy. In multivariate analysis with dichotomized variables, QRS-T angle >152° and Twvm <0.38 mV were significantly associated with increased mortality: HR 2.64 (95% CI 1.14-6.12, p = 0.02) and HR 5.30 (95% CI 2.31-12.11, p < 0.001), respectively. QRSvm <1.54 mV was borderline significant with mortality outcome (p = 0.10). The composite score of all 3 VCG indices, a score of 3, conferred an increased risk of mortality (including heart failure mortality) in multivariate analysis: HR 13.80 (95% CI 3.44-55.39, p < 0.001). Conclusion: The spatial QRS-T angle and Twvm are emerging VCG indices which are independently associated with mortality in patients with reduced left ventricular ejection fraction due to ICMP or NICMP. Using a composite score of all 3 vector indices, a maximum score was associated with poor long-term survival.
|
|
| 13. |
- De Blois, Jonathan, et al.
(författare)
-
The Effects of Climate Change on Cardiac Health
- 2015
-
Ingår i: Cardiology. - : S. Karger AG. - 1421-9751 .- 0008-6312. ; 131:4, s. 209-217
-
Tidskriftsartikel (refereegranskat)abstract
- The earth's climate is changing and increasing ambient heat levels are emerging in large areas of the world. An important cause of this change is the anthropogenic emission of greenhouse gases. Climate changes have a variety of negative effects on health, including cardiac health. People with preexisting medical conditions such as cardiovascular disease (including heart failure), people carrying out physically demanding work and the elderly are particularly vulnerable. This review evaluates the evidence base for the cardiac health consequences of climate conditions, with particular reference to increasing heat exposure, and it also explores the potential further implications.
|
|
| 14. |
- Edner, M, et al.
(författare)
-
Long-term effects on cardiac output and peripheral resistance in patients treated with enalapril after acute myocardial infarction. CONSENSUS II Multi-Echo Study Group. Cooperative New Scandinavian Enalapril Survival Study
- 1998
-
Ingår i: Cardiology. - : S. Karger AG. - 0008-6312 .- 1421-9751. ; 89:4, s. 291-296
-
Tidskriftsartikel (refereegranskat)abstract
- In the Cooperative New Scandinavian Enalapril Survival Study (CONSENSUS II), in which enalapril treatment was initiated intravenously within 24 h after acute myocardial infarction, there was a neutral effect on 6-month mortality, whereas a beneficial effect on the progression of congestive heart failure was noted. We studied the effect of enalapril on left ventricular systolic function in terms of cardiac output and mean acceleration time measured by pulsed-wave Doppler in the left ventricular outflow tract and peripheral resistance. Early angiotensin-converting enzyme inhibition after acute myocardial infarction did not result in a general improvement of cardiac output. However, a small increase in cardiac output was observed in a subgroup of enalapril-treated patients with ejection fraction ≥45%, probably due to a reduction in peripheral resistance in these patients.
|
|
| 15. |
- Eliasson, T, et al.
(författare)
-
Myocardial turnover of endogenous opioids and calcitonin-gene-related peptide in the human heart and the effects of spinal cord stimulation on pacing-induced angina pectoris.
- 1998
-
Ingår i: Cardiology. - : S. Karger AG. - 0008-6312 .- 1421-9751. ; 89:3, s. 170-7
-
Tidskriftsartikel (refereegranskat)abstract
- Earlier studies have shown that spinal cord stimulation (SCS) has antianginal and anti-ischemic effects in severe coronary artery disease. In the present study, 14 patients were subjected to right-sided atrial catheterization and atrial pacing. The patients were paced to angina during a control session and during spinal cord stimulation. Myocardial extraction of beta-endorphin (BE) during control pacing (8 +/- 22%) changed to release at the maximum pacing rate during treatment (-21 +/- 47%, a negative value representing release). Furthermore, the results indicate local myocardial turnover of leuenkephalin, BE and calcitonin-gene-related peptide. In addition, it is implied that SCS may induce myocardial release of BE which could explain the beneficial effects in myocardial ischemia.
|
|
| 16. |
|
|
| 17. |
- Eriksson, SV, et al.
(författare)
-
Diastolic and systolic function as predictors of exercise capacity after myocardial infarction in young Men
- 1998
-
Ingår i: Cardiology. - : S. Karger AG. - 0008-6312 .- 1421-9751. ; 90:1, s. 8-12
-
Tidskriftsartikel (refereegranskat)abstract
- We evaluated the power of measurements of left ventricular (LV) systolic and diastolic function for predicting exercise capacity in 97 young male survivors of a myocardial infarction. The patients were evaluated with M-mode echocardiography, a symptom-limited exercise test and coronary and LV angiography. In univariate analyses, maximum exercise workload was most closely related to the atrial emptying index, an index of diastolic function (r = 0.37, p < 0.005), but not to LV ejection fraction (r = 0.001, NS). This relationship was stronger in the 42 patients without signs of ischemia during exercise (r = 0.51, p < 0.005). Multivariate analyses indicated that the atrial emptying index (p < 0.005) provided independent contribution to the prediction of maximum exercise capacity. LV diastolic function but not LV systolic function was related to exercise capacity in young survivors of myocardial infarction.
|
|
| 18. |
|
|
| 19. |
|
|
| 20. |
- Everts, B, et al.
(författare)
-
Pain recollection after chest pain of cardiac origin
- 1999
-
Ingår i: Cardiology. - : S. Karger AG. - 0008-6312 .- 1421-9751. ; 92:2, s. 115-120
-
Tidskriftsartikel (refereegranskat)abstract
- Memory for pain is an important research and clinical issue since patients ability to accurately recall pain plays a prominent role in medical practice. The purpose of this prospective study was to find out if patients, with an episode of chest pain due to suspected acute myocardial infarction could accurately retrieve the pain initially experienced at home and during the first day of hospitalization after 6 months. A total of 177 patients were included in this analysis. The patients rated their experience of pain on a numerical rating scale. The maximal pain at home was retrospectively assessed, thereafter pain assessments were made at several points of time after admission. After 6 months they were asked to recall the intensity of pain and once again rate it on the numerical rating scale. The results from the initial and 6-month registrations were compared. In general, patients rated their maximal intensity of chest pain as being higher at the 6-month recollection as compared with the assessments made during the initial hospitalization. In particular, in patients with a high level of emotional distress, there was a systematic overestimation of the pain intensity at recall.
|
|
| 21. |
- Faergeman,, et al.
(författare)
-
Efficacy and Tolerability of Rosuvastatin and Atorvastatin when Force-Titrated in Patients with Primary Hypercholesterolemia. Results from the ECLIPSE Study.
- 2008
-
Ingår i: Cardiology. - : S. Karger AG. - 1421-9751 .- 0008-6312. ; 111:4, s. 219-228
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Patients at high risk of cardiovascular disease frequently fail to reach recommended low-density lipoprotein cholesterol (LDL-C) goals, partly because statin doses are not titrated to optimal effect. The ECLIPSE study was designed to compare the efficacy and safety of force-titrated treatment with rosuvastatin (10-40 mg) with that of atorvastatin (10-80 mg) in high-risk patients with hypercholesterolemia. Methods: In this 24-week, open-label, randomized, multinational, parallel-group study, 1,036 patients were randomized to rosuvastatin (n = 522) or atorvastatin (n = 514). Results: At all time points, a significantly greater percentage of patients on rosuvastatin treatment achieved the NCEP ATP III LDL-C goal of <100 mg/dl (2.5 mmol/l), the 2003 European LDL-C target of <2.5 or 3.0 mmol/l (100 or 115 mg/dl) and the LDL-C goal of <70 mg/dl (1.8 mmol/l), a goal suggested for very high-risk patients (p < 0.001 for all). Rosuvastatin also achieved significantly greater improvements in components of the atherogenic lipid profile versus atorvastatin. Both treatments were well tolerated. Conclusion: Rosuvastatin titrated across its recommended dose range provides a more favorable effect on lipoprotein variables than atorvastatin, enabling more high-risk patients to achieve recommended LDL-C goals.
|
|
| 22. |
- Ferrari, R, et al.
(författare)
-
The BEAUTIFUL study: andomized trial of ivabradine in patients with stable coronary artery disease and left ventricular systolic dysfunction - baseline characteristics of the study population
- 2008
-
Ingår i: Cardiology. - : S. Karger AG. - 0008-6312 .- 1421-9751. ; 110, s. 271-82
-
Tidskriftsartikel (refereegranskat)abstract
- <i>Objectives:</i> Ivabradine is a selective heart rate-lowering agent that acts by inhibiting the pacemaker current <i>I</i><sub>f</sub> in sinoatrial node cells. Patients with coronary artery disease and left ventricular dysfunction are at high risk of death and cardiac events, and the BEAUTIFUL study was designed to evaluate the effects of ivabradine on outcome in such patients receiving optimal medical therapy. This report describes the study population at baseline. <i>Methods:</i> BEAUTIFUL is an international, multicentre, randomized, double-blind trial to compare ivabradine with placebo in reducing mortality and cardiovascular events in patients with stable coronary artery disease and left ventricular systolic dysfunction (ejection fraction <40%). <i>Results:</i> A total of 10,917 patients were randomized. At baseline, their mean age was 65 years, 83% were male, 98% Caucasian, 88% had previous myocardial infarction, 37% had diabetes, and 40% had metabolic syndrome. Mean ejection fraction was 32% and resting heart rate was 71.6 bpm. Concomitant medications included beta-blockers (87%), renin-angiotensin system agents (89%), antithrombotic agents (94%), and lipid-lowering agents (76%). <i>Conclusions:</i> Main results from BEAUTIFUL are expected in 2008, and should show whether ivabradine, on top of optimal medical treatment, reduces mortality and cardiovascular events in this population of high-risk patients.
|
|
| 23. |
- Furenäs, Eva, et al.
(författare)
-
Cardiac Complications during Pregnancy Related to Parity in Women with Congenital Heart Disease
- 2020
-
Ingår i: Cardiology. - : S. Karger AG. - 0008-6312 .- 1421-9751. ; 145:8, s. 533-541
-
Tidskriftsartikel (refereegranskat)abstract
- Objective:To describe the frequency of cardiac complications during pregnancy related to parity in women with congenital heart defects.Methods:A retrospective tertiary single-center study at the Adult Congenital Heart Disease Centre that followed 307 women with congenital heart disease during the years 1997-2015 in Gothenburg, Sweden. Ma-ternal cardiac complications were noted for each pregnancy using medical and obstetric records. The CARPREG I and modified WHO (mWHO) risk classifications were used. Twin pregnancies, miscarriages before gestational week 13, and pregnancy terminations were excluded.Results:Five hundred seventy-one deliveries and 9 late miscarriages were analyzed. The mean parity was 1.74 per woman (range 1-8). Eighty-four (14.6%) maternal cardiac complications were experienced; arrhythmia (5.7%) and heart failure (4.4%) being the most prevalent, and there was 1 maternal death. Heart failure occurred during the first pregnancy in 12 women (3.9%), in the second pregnancy in 8 women (4.3%), and in the third pregnancy in 4 women (7.7%). CARPREG I and mWHO scores were associated with an increased risk of having a cardiac complication, while parity per se was not associated. The OR for having a maternally uneventful second pregnancy if the first pregnancy was without cardiac complications was 5.47 (95% CI 1.76-16.94) after controlling for CARPREG I and mWHO scores.Conclusion:The risk of severe maternal cardiac complications during pregnancy in women with congenital heart disease is low. In this largest analysis to date with a focus on parity in 307 women, the risk classification predicts the maternal outcome more than parity per se. If the first pregnancy is uneventful, the OR is 5.5 for an uneventful second pregnancy if CARPREG I and mWHO scores remain unchanged.
|
|
| 24. |
- Gidlöf, Olof, et al.
(författare)
-
Cardiospecific microRNA Plasma Levels Correlate with Troponin and Cardiac Function in Patients with ST Elevation Myocardial Infarction, Are Selectively Dependent on Renal Elimination, and Can Be Detected in Urine Samples.
- 2011
-
Ingår i: Cardiology. - : S. Karger AG. - 1421-9751 .- 0008-6312. ; 118:4, s. 217-226
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives: Circulating microRNAs (miRNAs) are promising as biomarkers for various diseases. We examined the release patterns of cardiospecific miRNAs in a closed-chest, large animal ischemia-reperfusion model and in patients with ST elevation myocardial infarction (STEMI). Methods: Six anesthetized pigs were subjected to coronary occlusion-reperfusion. Plasma, urine, and clinical parameters were collected from 25 STEMI patients undergoing primary percutaneous coronary intervention. miRNA was extracted and measured with qPCR. Results: In the pig reperfusion model miR-1, miR-133a, and miR-208b increased rapidly in plasma with a peak at 120 min, while miR-499-5p remained elevated longer. In patients with STEMI all 4 miRNAs increased abruptly from 70-fold to 3,000-fold in plasma, with a peak within 12 h (p < 0.01). miR-1 and miR-133a both correlated strongly with the glomerular filtration rate (GFR), indicating renal elimination. This was confirmed by detection of miR-1 and miR-133a, but not miR-208b or miR-499-5p, in urine. Peak values of miR-208b correlated with peak troponin and the ejection fraction. Conclusion: We demonstrate a distinct and rapid increase in levels of cardiospecific miRNA in the circulation after myocardial infarction. Release of miRNAs correlated with cardiomyocyte necrosis markers, the ejection fraction, and the GFR, indicating a possible role for these molecules as biomarkers for the diagnosis of STEMI as well as the prediction of long-term complications.
|
|
| 25. |
- Govind, Satish C., et al.
(författare)
-
Isolated Type 2 Diabetes mellitus Causes Myocardial Dysfunction That Becomes Worse in the Presence of Cardiovascular Diseases : Results of the Myocardial Doppler in Diabetes (MYDID): Study 1
- 2005
-
Ingår i: Cardiology. - : S. Karger AG. - 0008-6312 .- 1421-9751. ; 103:4, s. 189-195
-
Tidskriftsartikel (refereegranskat)abstract
- Aims: Patients with type 2 diabetes mellitus (DM) often suffer disproportionately and have a worse outcome when burdened with cardiovascular complications compared with those without DM. A specific heart muscle disease reportedly caused by DM per se may explain this. We sought to investigate whether an echo Doppler diagnosis of such a myocardial disease is clinically relevant in DM with or without coexistent coronary artery disease (CAD) and/or hypertension ( HTN). Subjects and Methods: Two hundred subjects (127 males, 73 females, 56 +/- 10 years) including controls (n=23), patients with HTN (n=20), CAD (n=35), uncomplicated DM (n=59), DM+HTN (n=27), DM+ CAD (n=16) and DM+CAD+HTN (n=20) underwent tissue Doppler-enhanced dobutamine stress echocardiography. Myocardial function was assessed by measuring left ventricular myocardial peak systolic velocity (PSV) and early diastolic velocity at rest and during peak stress, besides measurements of standard Doppler variables. Results: Average left ventricular PSV at rest was significantly lower in CAD (4.7 +/- 1.5) compared with controls (5.7 center dot +/- 1.2) and in DM+CAD+HTN (4.6 +/- 1.4) compared with DM (5.6 +/- 1.3; all p < 0.05). During peak stress, lower PSV persisted in CAD (9.5 +/- 3.1) and DM+CAD+HTN (8.1 +/- 2.7), while appearing de novo in DM (11.3 +/- 2.6) and HTN (11.0 +/- 2.3) unlike in the controls (12.5 +/- 2.5; all p < 0.001). When pooled together, DM subjects with CAD and/or HTN or both had significantly lower PSV (9.1 +/- 2.7) than those without (10.0 +/- 2.8; p < 0.001). Early diastolic velocity response was equally lower in both groups compared with the controls. Conclusion: The results suggest that dobutamine stress unmasks myocardial functional disturbances caused by uncomplicated DM. The discrete disturbances become quantitatively more pronounced in the presence of coexistent cardiovascular diseases.
|
|
| 26. |
|
|
| 27. |
- Gudnadottir, Gudny Stella, 1979, et al.
(författare)
-
Multimorbidity and Readmissions in Older People with Acute Coronary Syndromes.
- 2022
-
Ingår i: Cardiology. - : S. Karger AG. - 1421-9751 .- 0008-6312. ; 147:2, s. 121-132
-
Tidskriftsartikel (refereegranskat)abstract
- This study aimed to examine the multimorbidity as well as the 30-day and 1-year readmission rates in a large, unselected cohort of elderly patients with acute coronary syndrome (ACS).All patients ≥70 years hospitalized due to ACS during January 1, 2006, to December 31, 2013, and registered in the SWEDEHEART registry were included. In-hospital multimorbidity and disease burden were determined. Outcomes included 30-day and 1-year all-cause mortality, any readmission, and readmissions due to ACS, heart failure, ischaemic stroke or transient ischaemic attack (TIA), and bleeding events. Out of 80,176 patients, 25.6% had ST-elevation myocardial infarction (STEMI) and 74.4% non-ST-segment elevation ACS (NSTE-ACS). The mean age was 79.8 (±6.4 standard deviation) and 43.4% were women. Multimorbidity, or two chronic diseases, was present in 67.7%, thereof in 53.0% of STEMI patients and 72.7% of NSTE-ACS patients. In-hospital mortality was 7.0%. Of the 74,577 patients who survived to discharge, 24.6% were readmitted within 30 days and 59.5% were readmitted during the following year. Multimorbid patients had a higher risk of readmissions than those without multimorbidity. Multimorbid STEMI patients were admitted the following year in 56.2% of cases compared to 44.5% of STEMI patients without multimorbidity, adjusted odds ratio (OR) 1.35 (95% confidence interval: 1.26-1.45). Multimorbid patients with NSTE-ACS were readmitted in 63.4% of cases the following year compared with 49.1% of those without multimorbidity, adjusted OR 1.42 (1.35-1.50). More than half of the readmissions were due to cardiovascular causes (ACS, stroke, TIA, or heart failure) or bleeding events.Older people with ACS have a high multimorbidity burden and a high readmission rate both within 30 days and 1 year. Half of the readmissions were due to a cardiovascular event or a bleeding event. The presence of multimorbidity increases the risk of readmissions for patients with ACS. As hospital admissions are costly for the health care system and can include risks, especially for older patients, there may be opportunities in better risk stratifying this group at discharge for subsequent decrease in readmission rates.
|
|
| 28. |
|
|
| 29. |
- Helgason, Hrodmar, 1950, et al.
(författare)
-
Sizing of atrial septal defects in adults
- 2005
-
Ingår i: Cardiology. - : S. Karger AG. - 0008-6312 .- 0008-6312 .- 1421-9751. ; 104:1, s. 1-5
-
Tidskriftsartikel (refereegranskat)abstract
- In a retrospective study of 51 consecutive patients undergoing transcatheter closure of secundum type atrial septal defects (ASDs), we examined the reliability of transesophageal echocardiography (TEE) prior to catheterization and compared the diameter with that obtained by balloon measurement during catheterization. The TEE diameter was 16.3+/-4.6 mm compared with 22.5+/-6.0 mm for the stretched diameter obtained during catheterization (p<0.001). There was no gender difference. The degree of left-to-right shunting correlated poorly with the size of the defect. We conclude that although TEE is accurate for diagnosis of an ASD, the measurement of its size to determine the size of the closure device is at best inaccurate.
|
|
| 30. |
- Herlitz, Johan, 1949, et al.
(författare)
-
Delay time between onset of myocardial infarction and start of thrombolysis in relation to prognosis.
- 1993
-
Ingår i: Cardiology. - : S. Karger AG. - 0008-6312 .- 1421-9751. ; 82:5, s. 347-53
-
Tidskriftsartikel (refereegranskat)abstract
- In 292 patients with suspected acute myocardial infarction given thrombolytic agents, we describe the delay time between the onset of pain and the start of thrombolysis and relate the observations to the prognosis. In 3%, treatment was started 1 h or less and in 22% 2 h or less after onset of symptoms. The median delay time between onset of symptoms and arrival in hospital was 1 h 38 min, and the median delay time between the arrival in hospital and start of thrombolysis was 1 h 25 min. A very strong association between delay time to thrombolysis and mortality during 2 weeks and 1 year of follow-up was observed.
|
|
| 31. |
- Herlitz, Johan, et al.
(författare)
-
Diagnostic accuracy of physicians for identifying patients with acute myocardial infarction without an electrocardiogram. Experiences from the TEAHAT trial
- 1995
-
Ingår i: Cardiology. - : S. Karger AG. - 0008-6312 .- 1421-9751. ; 86:1, s. 25-27
-
Tidskriftsartikel (refereegranskat)abstract
- AIM: To determine the diagnostic accuracy of physicians for identifying patients with acute myocardial infarction (AMI) without an electrocardiogram (ECG). PATIENTS: All patients in Göteborg with suspected AMI below 75 years of age who called for an ambulance or came directly to one of the two city hospitals with a delay time of less than 2 h 45 min from the start of symptoms. METHODS: As part of the TEAHAT study (comparing rt-PA and placebo in AMI), we asked physicians to judge on a 1-5 scale (1 = no suspicion; 5 = convinced) how strong their suspicion of AMI was prior to interpreting the ECG. RESULTS: Among patients evaluated outside hospital with 4 or 5 on the scale, i.e. either a strong suspicion of AMI or the physician felt convinced about the diagnosis, 45% had ST elevation and 48% developed AMI during the first 3 days in hospital. The corresponding values for patients evaluated in hospital were 67 and 70%, respectively. CONCLUSION: We found that physicians could not accurately distinguish patients with AMI from those without based on clinical criteria without the help of an ECG.
|
|
| 32. |
- Herlitz, Johan, et al.
(författare)
-
Effects of a media campaign to reduce delay times for acute myocardial infarction on the burden of chest pain patients in the emergency department
- 1991
-
Ingår i: Cardiology. - : S. Karger AG. - 0008-6312 .- 1421-9751. ; 79:2, s. 127-134
-
Tidskriftsartikel (refereegranskat)abstract
- We evaluated the effect of a media campaign aimed at reducing delay times in suspected acute myocardial infarction (AMI) on the volume of chest pain patients seen in the emergency department. During the 1st week of the campaign, the mean number of chest pain patients increased from 10.5 per day prior to the start to 25.4. However, the number declined rapidly in subsequent months. The greatest increase was observed in patients with chest pain in whom AMI was not suspected on examination. During the campaign, 4,805 patients with chest pain appeared in the emergency department as compared with 4,407 patients during the same time period prior to its start, an increase of 9%. The number of patients with confirmed AMI increased from 595 to 629 (6%).
|
|
| 33. |
- Herlitz, Johan, et al.
(författare)
-
Enzymatically and electrocardiographically estimated infarct size in relation to pain in acute myocardial infarction
- 1984
-
Ingår i: Cardiology. - : S. Karger AG. - 0008-6312 .- 1421-9751. ; 71:5, s. 239-246
-
Tidskriftsartikel (refereegranskat)abstract
- In 563 patients with acute myocardial infarction and no previous myocardial infarction, the estimated infarct size was related to the estimated duration of pain and the amount of analgesics given. The size of infarction estimated from analyses of heat-stable lactate dehydrogenase (EC 1.1.1.27) at 12-hour intervals for 48-108 h and from Q- and R-wave changes in the ECG correlated positively, although weakly with duration of the pain and the amount of analgesics given. These data support the hypothesis that larger infarcts, as a group, evolve over a longer time period than smaller infarcts and that the duration of pain in many patients might be an indicator of the infarct size. In the individual patient, however, one cannot predict the size of the infarction from the severity of pain.
|
|
| 34. |
|
|
| 35. |
- Herlitz, Johan, et al.
(författare)
-
Infarct size limitation after early intervention with metoprolol in the MIAMI Trial
- 1988
-
Ingår i: Cardiology. - : Karger AG. - 0008-6312 .- 1421-9751. ; 75:2, s. 117-122
-
Tidskriftsartikel (refereegranskat)abstract
- One of the secondary objectives of the MIAMI Trial which evaluated the role of the beta-1-selective blocker metoprolol in suspected acute myocardial infarction was to further assess whether early intervention with beta-blockade can limit infarct size. A total of 5,778 patients from 104 worldwide centres were randomized into the trial. Various enzymes such as aspartate aminotransferase (ASAT), creatine kinase (CK), CK MB, CK B, lactate dehydrogenase (LD) and LD isoenzyme I were analysed. All enzymes were used according to the clinical routine of the respective hospital, except ASAT which was analysed once daily for 3 days in the majority of cases and LD I which was analysed every 12 h for 72 h in a subsample. A consistent observation was the lower serum enzyme activity among patients receiving metoprolol and randomized early after onset of symptoms, whereas no difference between metoprolol and placebo was observed in patients treated later in the course. The results of the MIAMI Trial support previous observations that early institution of metoprolol therapy limits infarct size, as indicated by the maximum serum enzyme activity.
|
|
| 36. |
- Herlitz, Johan, 1949, et al.
(författare)
-
Long-term survival after development of acute myocardial infarction has improved after a more widespread use of thrombolysis and aspirin.
- 1999
-
Ingår i: Cardiology. - : S. Karger AG. - 0008-6312 .- 1421-9751. ; 91:4, s. 250-5
-
Tidskriftsartikel (refereegranskat)abstract
- We describe the mortality during the subsequent 5 years after development of acute myocardial infarction prior to and after the introduction of a more widespread use of thrombolytic agents and aspirin in the community of Göteborg. During period I, 4% received thrombolysis as compared with 32% during period II (p < 0.0001). The corresponding figures for prescription of aspirin at discharge were 14 and 84%, respectively (p < 0.0001). The overall 5-year mortality was 48% during period I and 46% during period II (p = 0.09). However, the age-adjusted mortality during period II was significantly reduced (risk ratio 0.86; 95% confidence interval 0.78-0.95; p = 0. 004). There was no significant interaction between improvement in survival and sex or any other parameter reflecting patients' clinical history.
|
|
| 37. |
|
|
| 38. |
- Herlitz, Johan, 1949, et al.
(författare)
-
Morbidity and quality of life 5 years after early intervention with metoprolol in suspected acute myocardial infarction.
- 1988
-
Ingår i: Cardiology. - : Karger AG. - 0008-6312 .- 1421-9751. ; 75:5, s. 357-64
-
Tidskriftsartikel (refereegranskat)abstract
- In 1,395 patients in the age range 40-74 years participating in a double-blind trial with metoprolol in suspected acute myocardial infarction morbidity and quality of life were assessed during the first 5 years after randomization. During the first 3 months patients were given 200 mg metoprolol daily or placebo. Thereafter the two groups were treated similarly. Mortality during 5 years was 24.2% in patients originally randomized to metoprolol versus 25.7% in patients originally randomized to placebo (p greater than 0.2). No difference was observed regarding reinfarction rate, stroke or occurrence of bypass surgery during the 5-year follow-up. During the first 3 months 10% of patients in the metoprolol group were rehospitalized for various reasons versus 13% in the placebo group. The corresponding figures for 5 years were 59 and 60%, respectively. Among patients surviving 5 years 84% in both groups were on some medication of which beta-blockade was the dominating one. Symptoms of chest pain, dyspnea, claudicatio, smoking habits and working capacity did not differ and neither did quality of life according to the Nottingham Health Profile. We thus conclude that morbidity and quality of life were not significantly affected 5 years after early intervention with metoprolol in patients with suspected acute myocardial infarction.
|
|
| 39. |
- Herlitz, Johan, et al.
(författare)
-
Mortality and risk indicators for death during five years after acute myocardial infarction among patients with and without ST-elevation on admission electrocardiogram
- 1998
-
Ingår i: Cardiology. - : S. Karger AG. - 0008-6312 .- 1421-9751. ; 89:1, s. 33-39
-
Tidskriftsartikel (refereegranskat)abstract
- We related observations in the electrocardiogram (ECG) on admission to hospital among consecutive patients hospitalized in one single hospital with acute myocardial infarction (AMI) and related the prognosis during the following 5 years to these observations. Results: Of 863 patients, 63% had ECG signs of myocardial ischemia, but only 41% had ST elevation on ED admission. Patients with ST elevation had a 5-year mortality of 44% as compared with 58% in patients without ST elevation (p < 0.001). Patients with the highest mortality were those with a pathologic ECG including signs of previous AMI, bundle branch block and pacemaker ECG, but with no ECG sign of acute ischemia. Patients with the lowest mortality were those with a nonpathologic ECG on admission. Conclusion: Among consecutive patients hospitalized with AMI, less than half had ST elevation on admission to hospital. These patients had a lower mortality during 5 years of follow-up than patients without ST elevation.
|
|
| 40. |
- Herlitz, Johan, et al.
(författare)
-
Mortality, place and mode of death and reinfarction during a period of five years after acute myocardial infarction in diabetic and non diabetic patients
- 1996
-
Ingår i: Cardiology. - : S. Karger AG. - 0008-6312 .- 1421-9751. ; 87:5, s. 423-428
-
Tidskriftsartikel (refereegranskat)abstract
- We describe the prognosis during a 5-year follow-up of 858 consecutive patients with confirmed acute myocardial infarction (AMI), of which 97 (11%) had a history of diabetes mellitus. Diabetic patients had a 5-year mortality of 72% versus 50% for non-diabetic patients (p < 0.001). In a multivariate analysis considering age, sex, diabetes and a history of cardiovascular disease, diabetes was an independent predictor of death (p < 0.001) together with age (p < 0.001), previous AMI (p < 0.001) and a history of congestive heart failure (p < 0.05). Among diabetic patients, 55% developed a reinfarction versus 22% among non-diabetic patients (p < 0.001). Mode and place of death appeared to be similar in diabetic and non-diabetic patients.
|
|
| 41. |
- Herlitz, Johan, et al.
(författare)
-
Occurence of chest pain more than 24 hours after hospital admission in acute myocardial infarction and its relation to prognosis
- 1992
-
Ingår i: Cardiology. - : S. Karger AG. - 0008-6312 .- 1421-9751. ; 81:1, s. 46-53
-
Tidskriftsartikel (refereegranskat)abstract
- In 857 consecutive patients with acute myocardial infarction (AMI), the occurrence of chest pain more than 24 h after hospital admission is described and related to death or reinfarction during one year of follow-up. Prolonged chest pain was observed in 333 patients (39%). In this group 15% died and 7% developed reinfarction during the first month as compared with 10% (p < 0.05) and 2% (p < 0.01) respectively in patients without prolonged pain. However, during one year of follow-up mortality did not differ significantly between patients with (27%) and without (24%) prolonged pain. The 1-year reinfarction rate was similar in the two groups (18% and 14%, respectively; NS). We conclude that AMI patients with prolonged chest pain have a particularly high mortality during the first month. However, during a longer follow-up the prognosis is similar in patients with and without prolonged chest pain.
|
|
| 42. |
- Herlitz, Johan, et al.
(författare)
-
One year mortality after acute myocardial infarction prior to and after the implementation of a widespread use of thrombolysis and aspirin
- 1997
-
Ingår i: Cardiology. - : S. Karger AG. - 0008-6312 .- 1421-9751. ; 89:3, s. 216-221
-
Tidskriftsartikel (refereegranskat)abstract
- During 1 year of follow-up, we compared the mortality after acute myocardial infarction (AMI) prior to and after the introduction of a more widespread use of thrombolytic agents and aspirin. STUDY PERIOD: Two periods (I = 1986-1987 and II = 1989-1990) were compared. PATIENTS: All patients admitted to the coronary care units at the two city hospitals in the community of Goteborg who fulfilled the criteria for development of AMI participated in the evaluation. RESULTS: The overall 1-year mortality rate was 27% [corrected] during period I and 23% during period II (NS). However, among patients up to 70 years of age, the mortality was reduced from 15 to 11% (p < 0.05), whereas among patients aged over 70 years the mortality remained almost unchanged (34 vs. 35%; NS). CONCLUSION: The introduction of a more widespread use of thrombolytic agents and aspirin has not substantially changed the overall mortality in AMI. However, among younger patients, the mortality appears to have been reduced but not among the elderly.
|
|
| 43. |
- Herlitz, Johan, et al.
(författare)
-
Prediction of the severity of acute myocardial infarction
- 1985
-
Ingår i: Cardiology. - : S. Karger AG. - 0008-6312 .- 1421-9751. ; 72:4, s. 174-184
-
Tidskriftsartikel (refereegranskat)abstract
- In 698 patients with suspected and definite acute myocardial infarction we tried to predict the severity of the infarction from clinical history and simple bedside evaluation soon after arrival in hospital. The severity of the infarction was judged from serum enzyme activity, 2-year survival, incidence and severity of congestive heart failure and incidence of severe ventricular arrhythmias during initial hospitalization. Entry characteristics which were positively associated with the severity of the infarction were intensity of pain, sign of congestive heart failure, high heart rate, ECG signs of acute myocardial infarction and presence of Q waves. Elderly patients and those with a history of hypertension also had a more severe clinical course.
|
|
| 44. |
- Herlitz, Johan, et al.
(författare)
-
Predictors of death and other cardiac events within two years after coronary artery bypass grafting
- 1998
-
Ingår i: Cardiology. - : S. Karger AG. - 0008-6312 .- 1421-9751. ; 90:2, s. 110-114
-
Tidskriftsartikel (refereegranskat)abstract
- RESULTS: In 1,841 patients who underwent coronary artery bypass grafting (CABG) we evaluated risk indicators for death and other cardiac events during 2 years of follow-up. Independent predictors of death were: a history of congestive heart failure, diabetes mellitus and renal dysfunction prior to CABG. Independent predictors of death, acute myocardial infarction (AMI), CABG or percutaneous transluminal coronary angioplasty (PTCA) were: a small body surface area, a history of congestive heart failure, diabetes mellitus and smoking prior to CABG. Independent predictors of death, AMI, CABG, PTCA or rehospitalization for a cardiac reason were: angina functional class, previous AMI, a history of congestive heart failure and renal dysfunction prior to CABG. CONCLUSION: When using various definitions of a cardiac event after CABG, various risk indicators for death or such an event can be found. Our data suggest that anamnestic information prior to CABG indicating a depressed myocardial function or severe myocardial ischemia are more important predictors of outcome than the information gained from cardioangiography.
|
|
| 45. |
- Herlitz, Johan, et al.
(författare)
-
Prognosis in diabetics with chest pain or other symptoms suggestive of acute myocardial infarction
- 1992
-
Ingår i: Cardiology. - : S. Karger AG. - 0008-6312 .- 1421-9751. ; 80:3-4, s. 237-245
-
Tidskriftsartikel (refereegranskat)abstract
- We evaluated the prognosis of 599 diabetics who came to the emergency department with chest pain or other symptoms suggestive of acute myocardial infarction (AMI). They made up 8% of the patients with such symptoms (n = 7,157). Diabetics had a 1-year mortality rate of 25% as compared with 10% for nondiabetics (p less than 0.001). The difference remained significant regardless of whether there was a strong or a vague initial suspicion of AMI. On admission, independent risk factors for death were age, acute congestive heart failure and initial degree of suspicion of AMI. We conclude that among diabetics who appear in the emergency department with chest pain or other symptoms suggestive of AMI, 25% are dead within 1 year. The prognosis is directly related to the initial suspicion of AMI.
|
|
| 46. |
- Herlitz, Johan, et al.
(författare)
-
Prognosis in patients with acute chest pain in relation to chronic beta-blocker treatment prior to admission to hospital
- 1995
-
Ingår i: Cardiology. - : S. Karger AG. - 0008-6312 .- 1421-9751. ; 86:1, s. 56-59
-
Tidskriftsartikel (refereegranskat)abstract
- We evaluated the prognosis among consecutive patients hospitalized for acute chest pain or other symptoms suggestive of acute myocardial infarction (AMI) in relation to whether they were on chronic treatment with beta-blockers at onset of symptoms or not. In all, 3,504 patients were included in the analyses, of whom 936 (27%) were on chronic beta-blockade. Of the patients on beta-blockade, 25% developed AMI as compared with 21% of the remaining patients (p > 0.2). The mortality during the first 28 days was 7% in patients on chronic beta-blockade as compared with 5% in those not on beta-blockade (p > 0.2). When correcting for differences at baseline, chronic treatment with beta-blockers did not significantly influence the outcome.
|
|
| 47. |
|
|
| 48. |
- Herlitz, Johan, 1949, et al.
(författare)
-
Rate of admission and long-term prognosis among patients with acute chest pain in the 1990s compared with the 1980s
- 2005
-
Ingår i: Cardiology. - : S. Karger AG. - 0008-6312 .- 1421-9751. ; 104:1, s. 51-6
-
Tidskriftsartikel (refereegranskat)abstract
- We describe the incidence of acute chest pain (requiring admission to the emergency department) and the prognosis during two time periods in all patients admitted to the emergency department at Sahlgrenska University Hospital in Goteborg, Sweden, with acute chest pain 1986 and 1987 (period 1) and 1996 and 1997 (period 2). The rate of admission for chest pain/100,000 inhabitants was 4.7/day during period 1 and 5.0/day during period 2. The risk ratio for death adjusted for eight risk factors during period 2 in relation to period 1 was 0.88 (95% CI 0.79-0.97). There was a significant interaction between time period and the severity of the final diagnosis (p=0.02), indicating a greater reduction in mortality among patients with acute myocardial infarction.
|
|
| 49. |
- Herlitz, Johan, et al.
(författare)
-
Relationship between serum enzyme activity in acute myocardial infarction and morbidity during a 2-year follow-up
- 1986
-
Ingår i: Cardiology. - : S. Karger AG. - 0008-6312 .- 1421-9751. ; 73:2, s. 85-93
-
Tidskriftsartikel (refereegranskat)abstract
- In 585 patients with a first myocardial infarction the enzymatically estimated infarct size was related to the clinical course during a 2-year follow-up. Infarct size was estimated from maximum heat-stable lactate dehydrogenase activity. A higher maximum serum activity was associated with a higher mortality rate, more treatment with diuretics, digitalis and antiarrhythmics and a lower frequency of return to work. Patients with smaller infarcts according to maximum serum activity, however, had a higher incidence of angina pectoris and a higher reinfarction rate. We conclude that although there is a strong association between serum enzyme activity and mortality during a 2-year follow-up, the relation with morbidity appears to be more complex.
|
|
| 50. |
- Herlitz, Johan, et al.
(författare)
-
Short- and long term prognosis after coronary artery bypass grafting in relation to smoking habits
- 1997
-
Ingår i: Cardiology. - : S. Karger AG. - 0008-6312 .- 1421-9751. ; 88:6, s. 492-497
-
Tidskriftsartikel (refereegranskat)abstract
- We describe the 2- and 5-year prognoses following coronary artery bypass grafting (CABG) in relation to smoking habits among consecutive patients being operated on in western Sweden during a 3-year period. Among the 2,121 patients, 10.2% admitted smoking at coronary angiography as compared with 7.5% 2 years after CABG (NS). Among smokers, the mortality during the subsequent 2 years was 8.9% as compared with 6.5% for exsmokers and 7.3% for never smokers (NS). During the 5-year follow-up, smokers had a mortality of 18.8% as compared with 13.6% for exsmokers and 12.5% for never smokers (p = 0.03). When correcting for dissimilarities in previous history, smoking was a strongly significant independent (p < 0.0001) predictor of 5-year mortality.
|
|
