| 1. |
|
|
| 2. |
|
|
| 3. |
|
|
| 4. |
|
|
| 5. |
|
|
| 6. |
- Kotseva, K, et al.
(författare)
-
Lifestyle and impact on cardiovascular risk factor control in coronary patients across 27 countries: Results from the European Society of Cardiology ESC-EORP EUROASPIRE V registry
- 2019
-
Ingår i: European journal of preventive cardiology. - : Oxford University Press (OUP). - 2047-4881 .- 2047-4873. ; 26:8, s. 824-835
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to determine whether the Joint European Societies guidelines on secondary cardiovascular prevention are followed in everyday practice. Design A cross-sectional ESC-EORP survey (EUROASPIRE V) at 131 centres in 81 regions in 27 countries. Methods Patients (<80 years old) with verified coronary artery events or interventions were interviewed and examined ≥6 months later. Results A total of 8261 patients (females 26%) were interviewed. Nineteen per cent smoked and 55% of them were persistent smokers, 38% were obese (body mass index ≥30 kg/m2), 59% were centrally obese (waist circumference: men ≥102 cm; women ≥88 cm) while 66% were physically active <30 min 5 times/week. Forty-two per cent had a blood pressure ≥140/90 mmHg (≥140/85 if diabetic), 71% had low-density lipoprotein cholesterol ≥1.8 mmol/L (≥70 mg/dL) and 29% reported having diabetes. Cardioprotective medication was: anti-platelets 93%, beta-blockers 81%, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers 75% and statins 80%. Conclusion A large majority of coronary patients have unhealthy lifestyles in terms of smoking, diet and sedentary behaviour, which adversely impacts major cardiovascular risk factors. A majority did not achieve their blood pressure, low-density lipoprotein cholesterol and glucose targets. Cardiovascular prevention requires modern preventive cardiology programmes delivered by interdisciplinary teams of healthcare professionals addressing all aspects of lifestyle and risk factor management, in order to reduce the risk of recurrent cardiovascular events.
|
|
| 7. |
|
|
| 8. |
- Schrieks, I. C., et al.
(författare)
-
Adiponectin, Free Fatty Acids, and Cardiovascular Outcomes in Patients With Type 2 Diabetes and Acute Coronary Syndrome
- 2018
-
Ingår i: Diabetes Care. - : American Diabetes Association. - 0149-5992 .- 1935-5548. ; 41:8, s. 1792-1800
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE In observational cohorts, adiponectin is inversely associated and free fatty acids (FFAs) are directly associated with incident coronary heart disease (CHD). Adiponectin tends to be reduced and FFAs elevated in type 2 diabetes. We investigated relationships of adiponectin and FFA and major adverse cardiovascular events (MACEs) and death in patients with acute coronary syndrome (ACS) and type 2 diabetes using data from the AleCardio (Effect of Aleglitazar on Cardiovascular Outcomes After Acute Coronary Syndrome in Patients With Type 2 Diabetes Mellitus) trial, which compared the PPAR-alpha/gamma agonist aleglitazar with placebo. Using Cox regression adjusted for demographic, laboratory, and treatment variables, we determined associations of baseline adiponectin and FFAs, or the change in adiponectin and FFAs from baseline, with MACEs (cardiovascular death, myocardial infarction, or stroke) and death. A twofold higher baseline adiponectin (n = 6,998) was directly associated with risk of MACEs (hazard ratio [HR] 1.17 [95% CI 1.08-1.27]) and death (HR 1.53 [95% CI 1.35-1.73]). A doubling of adiponectin from baseline to month 3 (n = 6,325) was also associated with risk of death (HR 1.20 [95% CI 1.03-1.41]). Baseline FFAs (n = 7,038), but not change in FFAs from baseline (n = 6,365), were directly associated with greater risk of MACEs and death. There were no interactions with study treatment. In contrast to prior observational data for incident CHD, adiponectin is prospectively associated with MACEs and death in patients with type 2 diabetes and ACS, and an increase in adiponectin from baseline is directly related to death. These findings raise the possibility that adiponectin has different effects in patients with type 2 diabetes and ACS than in populations without prevalent cardiovascular disease. Consistent with prior data, FFAs are directly associated with adverse outcomes.
|
|
| 9. |
|
|
| 10. |
- Stahli, B. E., et al.
(författare)
-
Homeostasis Model Assessment of Insulin Resistance and Survival in Patients With Diabetes and Acute Coronary Syndrome
- 2018
-
Ingår i: Journal of Clinical Endocrinology & Metabolism. - : The Endocrine Society. - 0021-972X .- 1945-7197. ; 103:7, s. 2522-2533
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: Insulin resistance has been linked to development and progression of atherosclerosis and is present in most patients with type 2 diabetes. Whether the degree of insulin resistance predicts adverse outcomes in patients with type 2 diabetes and acute coronary syndrome (ACS) is uncertain. Design: The Effect of Aleglitazar on Cardiovascular Outcomes after Acute Coronary Syndrome in Patients with Type 2 Diabetes Mellitus trial compared the peroxisome proliferator-activated receptor-a/g agonist aleglitazar with placebo in patients with type 2 diabetes and recent ACS. In participants not treated with insulin, we determined whether baseline homeostasis model assessment of insulin resistance (HOMA-IR; n = 4303) or the change in HOMA-IR on assigned study treatment (n = 3568) was related to the risk of death or major adverse cardiovascular events (cardiovascular death, myocardial infarction, and stroke) in unadjusted and adjusted models. Because an inverse association of HOMA-IR with N-terminal pro-B-type natriuretic peptide (NT-proBNP) has been described, we specifically examined effects of adjustment for the latter. Results: In unadjusted analysis, twofold higher baseline HOMA-IR was associated with lower risk of death [hazard ratio (HR): 0.79, 95% CI: 0.68 to 0.91, P = 0.002]. Adjustment for 24 standard demographic and clinical variables had minimal effect on this association. However, after further adjustment for NT-proBNP, the association of HOMA-IR with death was no longer present (adjusted HR: 0.99, 95% CI: 0.83 to 1.19, P = 0.94). Baseline HOMA-IR was not associated with major adverse cardiovascular events, nor was the change in HOMA-IR on study treatment associated with death or major adverse cardiovascular events. Conclusions: After accounting for levels of NT-proBNP, insulin resistance assessed by HOMA-IR is not related to the risk of death or major adverse cardiovascular events in patients with type 2 diabetes and ACS.
|
|
| 11. |
|
|
| 12. |
|
|
| 13. |
|
|
| 14. |
|
|
| 15. |
|
|
| 16. |
|
|
| 17. |
|
|
| 18. |
|
|
| 19. |
|
|
| 20. |
|
|
| 21. |
- Mellbin, L. G., et al.
(författare)
-
The relationship between glycaemic variability and cardiovascular complications in patients with acute myocardial infarction and type 2 diabetes: a report from the DIGAMI 2 trial
- 2013
-
Ingår i: European Heart Journal. - : Oxford University Press (OUP). - 0195-668X .- 1522-9645. ; 34:5, s. 374-379
-
Tidskriftsartikel (refereegranskat)abstract
- AimsHyperglycaemia during hospitalization for acute myocardial infarction (AMI) is a risk predictor, but attempts to improve the prognosis by insulin-based glucose control have not been consistently successful. Increased glycaemic variability, a potential effect of insulin treatment, has been linked to a worse prognosis in critically ill patients. The present aim was to study the possibility of such a relation in patients with type 2 diabetes (T2DM) and AMI.Method and resultsWe studied 578 T2DM patients who had glucose levels measured hourly while receiving an insulin-glucose infusion during the first 48 h of hospitalization for AMI. Three measures of glycaemic variability: root mean square error (RMSE), range, and slope were studied in relation to a composite endpoint of mortality, stroke, and reinfarction and to mortality.In unadjusted analyses, the mean level of glycaemic variability did not differ between patients who died during 12 months of follow-up compared with those who survived. In a Cox regression model adjusting for age and previous congestive heart failure, there was no increased risk for the composite endpoint associated with increased glycaemic variability; RMSE: hazard ratio (HR) 1.09 [95% confidence interval (CI) 0.93-1.27; P = 0.28], range: HR 1.01 (95% CI: 0.98-1.05; P = 0.47), and slope: HR 1.01 (95% CI: 0.99-1.04; P = 0.40). There was furthermore no increased risk in mortality; RMSE HR 1.14 (95% CI: 0.93-1.38; P = 0.21), range HR 1.03 (95% CI: 0.98-1.08; P = 0.28), and slope HR 1.01 (95% CI: 0.98-1.04; P = 0.55).ConclusionThe 1-year risk for death, reinfarction, or stroke did not relate to glycaemic variability in T2DM patients with AMI treated with insulin infusion.
|
|
| 22. |
|
|
| 23. |
- Rautio, E., et al.
(författare)
-
Patients With Type 2 Diabetes Have an Increased Demand for Pacemaker Treatment: A Comparison With Age- and Sex-Matched Control Subjects From the General Population
- 2020
-
Ingår i: Diabetes care. - : American Diabetes Association. - 0149-5992 .- 1935-5548. ; 43:11, s. 2853-2858
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE Patients with type 2 diabetes have an increased risk for cardiovascular disease, including arrhythmias. The prevalence of bradyarrhythmia and the subsequent need for treatment with pacemakers (PMs) is less well explored in a contemporary patient population. The current study explores1) whether patients with type 2 diabetes have an increased demand for PM implantation compared with an age- and sex-matched control population without diabetes and2) patient characteristics associated with an increased demand for receiving a PM. RESEARCH DESIGN AND METHODS In this population-matched registry study, a total of 416,247 patients with type 2 diabetes from the Swedish National Diabetes Registry and 2,081,235 age- and sex-matched control subjects selected from the general population were included between 1 January 1998 and 31 December 2012 and followed until 31 December 2013. Mean follow-up time was 7 years. Cox proportional hazards regression analyses were performed to estimate the demand of PM treatment and the factors identifying patients with such demand. RESULTS Type 2 diabetes was associated with an increased need of PM treatment (hazard ratio 1.65 [95% CI 1.60-1.69];P< 0.0001), which remained (1.56 [1.51-1.60];P< 0.0001) after adjustments for age, sex, educational level, marital status, country of birth, and coronary heart disease. Risk factors for receiving a PM included increasing age, HbA(1c), BMI, diabetes duration, and lipid- and blood pressure-lowering medication. CONCLUSIONS The need for PM treatment is higher in patients with type 2 diabetes than in matched population-based control subjects. Age, diabetes duration, and HbA(1c)seem to be risk factors for PM treatment.
|
|
| 24. |
|
|
| 25. |
- Ryden, L, et al.
(författare)
-
Risk factor reduction in type 2 diabetes demands a multifactorial approach
- 2019
-
Ingår i: European journal of preventive cardiology. - : Oxford University Press (OUP). - 2047-4881 .- 2047-4873. ; 26:2_SUPPL2_suppl, s. 81-91
-
Tidskriftsartikel (refereegranskat)abstract
- Dysglycaemia (i.e. type 2 diabetes mellitus or impaired glucose tolerance) is not only common in patients with cardiovascular disease but increases the risk for future cardiovascular complications. Hyperglycaemia, the hallmark of diabetes, has since long been considered to be the link between diabetes and cardiovascular disease. Diabetes is, however, a complex, multifactorial disorder to which, for example, insulin resistance, endothelial dysfunction and factors such as increased thrombogenicity, hypertension and dyslipidaemia contribute. Thus, treatment needs to be multifactorial and to take cardiovascular aspects into account. Life-style adjustments are, together with blood pressure, lipid and glucose control, important parts of such management. Recent trial data reveal a beneficial effect on cardiovascular prognosis and mortality of blood glucose lowering agents belonging to the classes: sodium-glucose-transporter 2 inhibitors and glucagon-like peptide 1 agonists. The precise mechanisms by which certain sodium-glucose-transporter 2 inhibitors and glucagon-like peptide receptor agonists lead to these beneficial effects are only partly understood. An important impact of the benefits of sodium-glucose-transporter 2 inhibitors is a reduction in heart failure while glucagon-like peptide receptor agonists may retard the development of atherosclerotic vascular disease or stabilising plaques. Although there has been a considerable improvement in the prognosis for people with atherosclerotic diseases over the last decades there is still a gap between those with dysglycaemia, who are at higher risk, than those without dysglycaemia. This residual risk is reasonably related to two major factors: a demand for improved management and a need for new and improved therapeutic opportunities of type 2 diabetes, both routes to an improved prognosis that are at hands. This review is a comprehensive description of the possibilities to improve the prognosis for patients with dysglycaemia by a multifactorial management according to the most recent European guidelines issued in 2019 by the European Society of Cardiology in collaboration with the European Association for the Study of Diabetes.
|
|
| 26. |
- Smaradottir, M. I., et al.
(författare)
-
Copeptin is associated with mortality in elderly people
- 2021
-
Ingår i: European Journal of Clinical Investigation. - : John Wiley and Sons Inc. - 0014-2972 .- 1365-2362. ; 51:7
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Elevated copeptin, a marker for vasopressin release, has been associated with impaired prognosis in acute myocardial infarction (MI). The aim was to investigate whether this association extends beyond the acute phase and whether it is related to markers of stress (cortisol) and heart failure (NTproBNP). Methods: Copeptin, cortisol and NTproBNP were measured in 926 participants (age: 76.0; male: 48.5%) in the ICELAND MI study whereof 246 had a previous MI (91 recognizable (RMI) and 155 previously unrecognizable (UMI) detected by cardiac magnetic resonance imaging). The primary endpoint was cardiovascular events (CVEs), and secondary endpoints were total mortality, heart failure and MI (median follow-up was 9.1 years). The relation between copeptin and prognosis was assessed with the Cox proportional hazard regression (unadjusted, adjusted for cortisol and NTproBNP, respectively, and a multiple model: copeptin, cortisol, NTproBNP, age, sex, serum creatinine, heart failure). Results: Copeptin was higher in participants with MI (8.9 vs. 6.4 pmol/L; P <.01), with no difference between RMI vs. UMI. Increased copeptin correlated with evening cortisol (r =.11; P <.01) and NTproBNP (r =.07; P =.04). Copeptin was associated with CVE and total mortality after adjusting for cortisol and NTproBNP separately, and remained significantly associated with total mortality in the multiple model. Conclusions: Copeptin was higher in subjects with previous MI regardless whether previously recognized or not. Copeptin correlated weakly with cortisol and NTproBNP, and was independently associated with total mortality. This indicates that the prognostic implications of copeptin are not only mediated by heart failure or stress, supporting the assumption that copeptin is a marker of general vulnerability.
|
|
| 27. |
- Smaradottir, M I, et al.
(författare)
-
Vasopressin, measured as copeptin, in elderly individuals with or without unrecognized myocardial infarction. A report from the ICELAND MI Cohort.
- 2017
-
Ingår i: European Heart Journal. - Barcelona, Spain. - 0195-668X .- 1522-9645. ; 38:suppl_1, s. 863-864
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background: A subset of patients with myocardial infarction (MI) has minimal or no symptoms, i.e. clinically unrecognized MI (UMI). Copeptin, a marker of vasopressin, predicts cardiovascular events (CVE).Purpose: To investigate the prognostic implication of copeptin in people with or without MI and to study whether it differs between UMI and recognized MI (RMI).Methods: Copeptin was measured in 926 participants (age 76.0; male 48.5%) in the observational ICELAND MI study. At baseline 246 patients had hospital/surveillance records supporting a RMI (n=91) or myocardial scars detected by magnetic resonance imaging (UMI, n=155). Cox proportional hazard regression was used to assess the prognostic capability of (log) copeptin, in the multiple model adjusted for prior heart failure, fasting blood glucose, age groups and creatinine. The primary endpoint was CVE (cardiovascular death/MI/stroke/PCI/CABG) and the secondary endpoint was total mortality during 9.1 years of follow-up.Results: Copeptin levels were significantly higher in participants with compared to those without a MI (8.9 pmol/L vs. 6.4 pmol/L; p<0.01), but did not differ between the subsets with RMI vs. UMI.In the unadjusted analysis CVE:s were predicted by copeptin in the total cohort (HR 1.60; 95% CI 1.17–2.19; p<0.01) but not after adjustments (HR 1.18; 95% CI 0.84–1.65; p=0.33).Total mortality in the total cohort was predicted by copeptin in the unadjusted analysis. The same was found in patients with and without MI as well as in the subset with RMI, however, not in those with UMI. In the adjusted model copeptin remained as a predictor in the total cohort (HR 1.77; 95% CI 1.24–2.51; p<0.01), in all patients with MI (HR 2.20; 95% CI 1.25–3.87; p<0.01), and in those with RMI (HR 5.73; 95% CI 2.13–15.36; p<0.01).Conclusion: Copeptin levels were higher for participants with MI, however no difference was seen for those with RMI or UMI. Copeptin did not remain as a significant predictor for CVE after adjustments while it was an independent predictor for total mortality in patients with MI including the subset with RMI. This implies that copeptin is a general marker of disease rather than a specific marker for cardiovascular disease.
|
|
| 28. |
|
|
| 29. |
|
|
| 30. |
- Bäck, M, et al.
(författare)
-
Highlights from 2022 in EHJ Open
- 2022
-
Ingår i: European heart journal open. - : Oxford University Press (OUP). - 2752-4191. ; 2:6, s. oeac084-
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
|
|
| 31. |
- Bäck, M, et al.
(författare)
-
Open Up your Science in EHJ Open
- 2021
-
Ingår i: European heart journal open. - : Oxford University Press (OUP). - 2752-4191. ; 1:1, s. oeab021-
-
Tidskriftsartikel (refereegranskat)
|
|
| 32. |
|
|
| 33. |
|
|
| 34. |
|
|
| 35. |
|
|
| 36. |
- Smaradottir, M. I., et al.
(författare)
-
Copeptin in patients with acute myocardial infarction and newly detected glucose abnormalities - A marker of increased stress susceptibility? : A report from the Glucose in Acute Myocardial Infarction cohort
- 2017
-
Ingår i: Diabetes & Vascular Disease Research. - : Sage Publications. - 1479-1641 .- 1752-8984. ; 14:2, s. 69-76
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: To characterize copeptin levels and to explore its prognostic importance in patients with acute myocardial infarction with newly detected glucose abnormalities. Methods: Copeptin was measured in 166 patients with acute myocardial infarction without known diabetes and in 168 age- and gender-matched controls. Participants were classified as having normal glucose tolerance or abnormal glucose tolerance (impaired glucose tolerance + type 2 diabetes mellitus) by oral glucose tolerance test. Study participants were followed over a decade for major cardiovascular event (acute myocardial infarction/stroke/congestive heart failure/cardiovascular death), cardiovascular and total death. Results: Median copeptin level was higher in patients (10.5 pmol/L) than controls (5.9 pmol/L; p < 0.01). Patients with abnormal glucose tolerance had higher copeptin (12.2 pmol/L) than those with normal glucose tolerance (7.9 pmol/L; p < 0.01) but levels of copeptin did not differ in controls with abnormal glucose tolerance or normal glucose tolerance. Copeptin predicted major cardiovascular events [n = 64; hazard ratio = 1.15 (1.01-1.32; p = 0.04)], cardiovascular mortality [n = 29; hazard ratio = 1.24 (1.06-1.46; p = 0.01)] and total death [n = 51; hazard ratio = 1.21 (1.05-1.40; p = 0.01)] in unadjusted Cox regression analyses in the patient cohort. In controls, copeptin predicted major cardiovascular events [n = 26; hazard ratio = 1.17 (1.01-1.36; p = 0.03)]. Conclusion: Copeptin levels are highest among acute myocardial infarction patients with glucose disturbances and predict an adverse prognosis in unadjusted analyses. These findings imply that raised copeptin reflects stress rather than acting as a pathogenic factor for glucose abnormalities.
|
|
| 37. |
- Wang, A, et al.
(författare)
-
Testosterone and sex hormone-binding globulin in dysglycemic women at high cardiovascular risk: A report from the Outcome Reduction with an Initial Glargine Intervention trial
- 2021
-
Ingår i: Diabetes & vascular disease research. - : SAGE Publications. - 1752-8984 .- 1479-1641. ; 18:2, s. 14791641211002475-
-
Tidskriftsartikel (refereegranskat)abstract
- Total and free testosterone and sex hormone-binding globulin may affect cardiovascular prognosis in women. The objective was to study the association between sex hormones and prognosis in women with dysglycemia and high cardiovascular risk. Methods: This epidemiological report included dysglycemic women from the Outcome Reduction with an Initial Glargine Intervention trial ( n = 2848) with baseline total testosterone and sex hormone-binding globulin. Free testosterone was calculated with the Vermeulen formula. Cox regression analyses adjusted for variables including age, previous diseases and pharmacological treatments were used to estimate the association between these levels and the composite cardiovascular outcome (death from cardiovascular causes, nonfatal myocardial infarction or nonfatal stroke) and all-cause mortality per one standard deviation. Results: Patients (73% post-menopausal) were followed for a median of 6.1 years during which 377 cardiovascular events and 389 deaths occurred. In Cox analyses, total and free testosterone were not associated with any outcomes, but sex hormone-binding globulin was related to all-cause mortality in age adjusted (HR 1.15; 95% CI 1.06–1.24; p < 0.01) and fully adjusted analyses (HR 1.14; 95% CI 1.05–1.24; p < 0.01). Conclusions: Increasing levels of baseline sex hormone-binding globulin were associated with an increased risk of all-cause mortality in dysglycemic women at high cardiovascular risk. Trial registration ClinicalTrials.gov no. NCT00069784.
|
|
