| 1. |
- Ekerstad, Niklas, et al.
(författare)
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Clinical Frailty Scale classes are independently associated with 6-month mortality for patients after acute myocardial infarction
- 2022
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Ingår i: European Heart Journal. - : Oxford University Press. - 2048-8726 .- 2048-8734. ; 11:2, s. 89-98
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Tidskriftsartikel (refereegranskat)abstract
- Aims: Data on the prognostic value of frailty to guide clinical decision-making for patients with myocardial infarction (MI) are scarce. To analyse the association between frailty classification, treatment patterns, in-hospital outcomes, and 6-month mortality in a large population of patients with MI.Methods and results: An observational, multicentre study with a retrospective analysis of prospectively collected data using the SWEDEHEART registry. In total, 3381 MI patients with a level of frailty assessed using the Clinical Frailty Scale (CFS-9) were included. Of these patients, 2509 (74.2%) were classified as non-vulnerable non-frail (CFS 1–3), 446 (13.2%) were vulnerable non-frail (CFS 4), and 426 (12.6%) were frail (CFS 5–9). Frailty and non-frail vulnerability were associated with worse in-hospital outcomes compared with non-frailty, i.e. higher rates of mortality (13.4% vs. 4.0% vs. 1.8%), cardiogenic shock (4.7% vs. 2.5% vs. 1.9%), and major bleeding (4.5% vs. 2.7% vs. 1.1%) (allP < 0.001), and less frequent use of evidence-based therapies. In Cox regression analyses, frailty was strongly and independently associated with 6-month mortality compared with non-frailty, after adjustment for age, sex, the GRACE risk score components, and other potential risk factors [hazard ratio (HR) 3.32, 95% confidence interval (CI) 2.30–4.79]. A similar pattern was seen for vulnerable non-frail patients (fully adjusted HR 2.07, 95% CI1.41–3.02).Conclusion: Frailty assessed with the CFS was independently and strongly associated with all-cause 6-month mortality, also after comprehensive adjustment for baseline differences in other risk factors. Similarly, non-frail vulnerability was independently associated with higher mortality compared with those with preserved functional ability.
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| 2. |
- Lyth, Johan, 1980-, et al.
(författare)
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Cost-effectiveness of population screening for atrial fibrillation : the STROKESTOP study
- 2023
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Ingår i: European Heart Journal. - : Oxford University Press. - 0195-668X .- 1522-9645. ; 3:3, s. 196-204
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Tidskriftsartikel (refereegranskat)abstract
- Aims Previous studies on the cost-effectiveness of screening for atrial fibrillation (AF) are based on assumptions of long-term clinical effects. The STROKESTOP study, which randomised 27 975 persons aged 75/76 years into a screening invitation group and a control group, has a median follow-up time of 6.9 years. The aim of this study was to estimate the cost-effectiveness of population-based screening for AF using clinical outcomes. Methods and results The analysis is based on a Markov cohort model. The prevalence of AF, the use of oral anticoagulation, clinical event data, and all-cause mortality were taken from the STROKESTOP study. The cost for clinical events, age-specific utilities, utility decrement due to stroke, and stroke death was taken from the literature. Uncertainty in the model was considered in a probabilistic sensitivity analysis. Per 1000 individuals invited to the screening, there were 77 gained life years and 65 gained quality-adjusted life years. The incremental cost was euro1.77 million lower in the screening invitation group. Gained quality-adjusted life years to a lower cost means that the screening strategy was dominant. The result from 10 000 Monte Carlo simulations showed that the AF screening strategy was cost-effective in 99.2% and cost-saving in 92.7% of the simulations. In the base-case scenario, screening of 1000 individuals resulted in 10.6 [95% confidence interval (CI): -22.5 to 1.4] fewer strokes (8.4 ischaemic and 2.2 haemorrhagic strokes), 1.0 (95% CI: -1.9 to 4.1) more cases of systemic embolism, and 2.9 (95% CI: -18.2 to 13.1) fewer bleedings associated with hospitalization. Conclusion Based on the STROKESTOP study, this analysis shows that a broad AF screening strategy in an elderly population is cost-effective. Efforts should be made to increase screening participation.
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| 3. |
- Svennberg, Emma, et al.
(författare)
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NT-proBNP is a powerful predictor for incident atrial fibrillation : Validation of a multimarker approach
- 2016
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Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754. ; 223, s. 74-81
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Biomarkers may be of value to identify individuals at risk of developing atrial fibrillation (AF). Using a multimarker approach, this study investigated if the biomarkers; NT-proBNP, high-sensitivity cardiac troponin (hs-cTn), growth differentiation factor-15 (GDF-15), cystatin C and high-sensitivity C-reactive protein (CRP) are independent predictors for incident AF.METHODS: Blood samples were collected from 883 individuals in the Uppsala Longitudinal Study of Adult Men (ULSAM) and 978 individuals in the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study. Participants were followed for 10-13years with n=113 incident AF cases in ULSAM and n=148 in PIVUS. The associations between biomarkers and incident AF were analysed in Cox proportional hazards regression models.RESULTS: The hazard ratio (HR) for incident AF was significant for all five biomarkers in unadjusted analyses in both cohorts. Only NT-proBNP remained significant when adjusting for cardiovascular risk factors and the other biomarkers (HR (1SD) 2.05 (1.62-2.59) (ULSAM) and 1.56 (1.30-1.86) (PIVUS), both p<0.001). The C-index improved from 0.64 to 0.69 in ULSAM and from 0.62 to 0.68 in PIVUS, by adding NT-proBNP to cardiovascular risk factors (both p<0.001). The C-index of the CHARGE-AF risk score increased from 0.62 to 0.68 (ULSAM) and 0.60 to 0.66 (PIVUS) by addition of NT-proBNP (p<0.001).CONCLUSIONS: Using a multimarker approach NT-proBNP was the strongest predictor of incident AF in two cohorts, and improved risk prediction when added to traditional risk factors. NT-proBNP significantly improved the predictive ability of the novel CHARGE-AF risk score, although the predictive value remained modest.
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| 4. |
- Aronsson, Mattias, et al.
(författare)
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Cost-effectiveness of mass screening for untreated atrial fibrillation using intermittent ECG recording
- 2015
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Ingår i: Europace. - : Oxford University Press (OUP): Policy B - Oxford Open Option B - CC-BY. - 1099-5129 .- 1532-2092. ; 17:7, s. 1023-1029
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Tidskriftsartikel (refereegranskat)abstract
- Aims The aim of this study was to estimate the cost-effectiveness of 2 weeks of intermittent screening for asymptomatic atrial fibrillation (AF) in 75/76-year-old individuals. Methods and results The cost-effectiveness analysis of screening in 75-year-old individuals was based on a lifelong decision analytic Markov model. In this model, 1000 hypothetical individuals, who matched the population of the STROKESTOP study, were simulated. The population was analysed for different parameters such as prevalence, AF status, treatment with oral anticoagulation, stroke risk, utility, and costs. In the base-case scenario, screening of 1000 individuals resulted in 263 fewer patient-years with undetected AF. This implies eight fewer strokes, 11 more life-years, and 12 more quality-adjusted life years (QALYs) per 1000 screened individuals. The screening implies an incremental cost of (sic)50 012, resulting in a cost of (sic)4313 per gained QALY and (sic)6583 per avoided stroke. Conclusions With the use of a decision analytic simulation model, it has been shown that screening for asymptomatic AF in 75/76-year-old individuals is cost-effective.
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| 5. |
- Aronsson, Mattias, 1989-, et al.
(författare)
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Designing an optimal screening program for unknown atrial fibrillation : a cost-effectiveness analysis.
- 2017
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Ingår i: Europace. - Oxford : Oxford University Press. - 1099-5129 .- 1532-2092. ; 19:10, s. 1650-1656
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Tidskriftsartikel (refereegranskat)abstract
- Aims: The primary objective of this study was to use computer simulations to suggest an optimal age for initiation of screening for unknown atrial fibrillation and to evaluate if repeated screening will add value.Methods and results: In the absence of relevant clinical studies, this analysis was based on a simulation model. More than two billion different designs of screening programs for unknown atrial fibrillation were simulated and analysed. Data from the published scientific literature and registries were used to construct the model and estimate lifelong effects and costs. Costs and effects generated by 2 147 483 648 different screening designs were calculated and compared. Program designs that implied worse clinical outcome and were less cost-effective compared to other programs were excluded from the analysis. Seven program designs were identified, and considered to be cost effective depending on what the health-care decision makers are ready to pay for gaining a quality-adjusted life-year (QALY). Screening at the age of 75 implied the lowest cost per gained QALY (€4 800/QALY).Conclusion: In conclusion, examining the results of more than two billion simulated screening program designs for unknown atrial fibrillation, seven designs were deemed cost-effective depending on how much we are prepared to pay for gaining QALYs. Our results showed that repeated screening for atrial fibrillation implied additional health benefits to a reasonable cost compared to one-off screening.
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| 6. |
- Brinck, Jonas, et al.
(författare)
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E78.0A – en unik, ny ICD-10-kod för familjär hyperkolesterolemi [Sweden introduces a new specific ICD-10 code for the disease familial hypercholesterolemia]
- 2019
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Ingår i: Läkartidningen. - Stockholm, Sweden : Sveriges Läkarförbund. - 0023-7205 .- 1652-7518. ; 116
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Tidskriftsartikel (refereegranskat)abstract
- At the turn of the year 2018/19, a new ICD-10 code (E78.0A) will be introduced in Sweden for the hereditary blood lipid disorder familial hypercholesterolemia (FH). Patients with FH have a significantly increased risk of developing atherosclerotic disease, such as myocardial infarction before the age of 50. However, early diagnosis and start of treatment of FH can ameliorate the diseases negative long term effects. The Swedish National Board of Health and Welfare gave in its guidelines from 2015 a high priority to the work of identifying and diagnosing individuals with FH in the general population. The introduction of the ICD-10 code E78.0A for FH may, when properly used, be an effective tool in this work.
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| 7. |
- Brinck, Jonas, et al.
(författare)
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[Sweden introduces a new specific ICD-10 code for the disease familial hypercholesterolemia].
- 2019
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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 116
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Tidskriftsartikel (refereegranskat)abstract
- At the turn of the year 2018/19, a new ICD-10 code (E78.0A) will be introduced in Sweden for the hereditary blood lipid disorder familial hypercholesterolemia (FH). Patients with FH have a significantly increased risk of developing atherosclerotic disease, such as myocardial infarction before the age of 50. However, early diagnosis and start of treatment of FH can ameliorate the disease's negative long term effects. The Swedish National Board of Health and Welfare gave in its guidelines from 2015 a high priority to the work of identifying and diagnosing individuals with FH in the general population. The introduction of the ICD-10 code E78.0A for FH may, when properly used, be an effective tool in this work.
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| 8. |
- Fabritz, Larissa, et al.
(författare)
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Dynamic risk assessment to improve quality of care in patients with atrial fibrillation : the 7th AFNET/EHRA Consensus Conference
- 2021
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Ingår i: Europace. - : Oxford University Press. - 1099-5129 .- 1532-2092. ; 23:3, s. 329-344
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Tidskriftsartikel (refereegranskat)abstract
- AimsThe risk of developing atrial fibrillation (AF) and its complications continues to increase, despite good progress in preventing AF-related strokes.Methods and resultsThis article summarizes the outcomes of the 7th Consensus Conference of the Atrial Fibrillation NETwork (AFNET) and the European Heart Rhythm Association (EHRA) held in Lisbon in March 2019. Sixty-five international AF specialists met to present new data and find consensus on pressing issues in AF prevention, management and future research to improve care for patients with AF and prevent AF-related complications. This article is the main outcome of an interactive, iterative discussion between breakout specialist groups and the meeting plenary. AF patients have dynamic risk profiles requiring repeated assessment and risk-based therapy stratification to optimize quality of care. Interrogation of deeply phenotyped datasets with outcomes will lead to a better understanding of the cardiac and systemic effects of AF, interacting with comorbidities and predisposing factors, enabling stratified therapy. New proposals include an algorithm for the acute management of patients with AF and heart failure, a call for a refined, data-driven assessment of stroke risk, suggestions for anticoagulation use in special populations, and a call for rhythm control therapy selection based on risk of AF recurrence.ConclusionThe remaining morbidity and mortality in patients with AF needs better characterization. Likely drivers of the remaining AF-related problems are AF burden, potentially treatable by rhythm control therapy, and concomitant conditions, potentially treatable by treating these conditions. Identifying the drivers of AF-related complications holds promise for stratified therapy.
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| 9. |
- Freedman, Ben, et al.
(författare)
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Screening for Atrial Fibrillation A Report of the AF-SCREEN International Collaboration
- 2017
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Ingår i: Circulation. - : LIPPINCOTT WILLIAMS & WILKINS. - 0009-7322 .- 1524-4539. ; 135:19, s. 1851-
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Tidskriftsartikel (refereegranskat)abstract
- Approximately 10% of ischemic strokes are associated with atrial fibrillation (AF) first diagnosed at the time of stroke. Detecting asymptomatic AF would provide an opportunity to prevent these strokes by instituting appropriate anticoagulation. The AF-SCREEN international collaboration was formed in September 2015 to promote discussion and research about AF screening as a strategy to reduce stroke and death and to provide advocacy for implementation of country-specific AF screening programs. During 2016, 60 expert members of AF-SCREEN, including physicians, nurses, allied health professionals, health economists, and patient advocates, were invited to prepare sections of a draft document. In August 2016, 51 members met in Rome to discuss the draft document and consider the key points arising from it using a Delphi process. These key points emphasize that screen-detected AF found at a single timepoint or by intermittent ECG recordings over 2 weeks is not a benign condition and, with additional stroke factors, carries sufficient risk of stroke to justify consideration of anticoagulation. With regard to the methods of mass screening, handheld ECG devices have the advantage of providing a verifiable ECG trace that guidelines require for AF diagnosis and would therefore be preferred as screening tools. Certain patient groups, such as those with recent embolic stroke of uncertain source (ESUS), require more intensive monitoring for AF. Settings for screening include various venues in both the community and the clinic, but they must be linked to a pathway for appropriate diagnosis and management for screening to be effective. It is recognized that health resources vary widely between countries and health systems, so the setting for AF screening should be both country-and health system-specific. Based on current knowledge, this white paper provides a strong case for AF screening now while recognizing that large randomized outcomes studies would be helpful to strengthen the evidence base.
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| 10. |
- Friberg, Leif, et al.
(författare)
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Population screening of 75- and 76-year-old men and women for silent atrial fibrillation (STROKESTOP)
- 2013
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Ingår i: Europace. - : Oxford University Press (OUP): Policy B. - 1099-5129 .- 1532-2092. ; 15:1, s. 135-140
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Tidskriftsartikel (refereegranskat)abstract
- Atrial fibrillation (AF) is important because it is common and is a major cause of stroke unless treated with oral anticoagulant. The prevalence of AF increases with age as does the risk of stroke. At 75 years the risk from age alone is so high that current guidelines recommend anticoagulation even in the absence of other risk factors. Atrial fibrillation is often asymptomatic and only discovered by chance or when a stroke already has occurred. less thanbrgreater than less thanbrgreater thanWe have launched a major screening study for silent AF in which 25 000 Swedes aged 75 and 76 years are randomized to either participate in a screening programme using ambulant intermittent electrocardiogram (ECG) recording to detect silent AF, or act as a control group. Patients in whom AF is detected are offered cardiological examination and anticoagulant treatment according to current guidelines. The cohort and the controls will be followed prospectively for 5 years after the inclusion of the first participant. An interim analysis will be made after 3 years. less thanbrgreater than less thanbrgreater thanOur hypothesis is that screening for AF will reduce stroke incidence in the screened population, and that this screening will prove to be cost effective. Secondary endpoints are: any thromboembolic event, intracranial bleeding, other major bleeding, first ever diagnosis of dementia, death from any cause, and a composite of these endpoints.
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| 11. |
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| 12. |
- Harnek, Jan, et al.
(författare)
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The 2011 outcome from the Swedish Health Care Registry on Heart Disease (SWEDEHEART)
- 2013
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Ingår i: Scandinavian Cardiovascular Journal. - : Informa UK Limited. - 1401-7431 .- 1651-2006. ; 47, s. 1-10
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Tidskriftsartikel (refereegranskat)abstract
- Objectives. The Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies (SWEDEHEART) collects data to support the improvement of care for heart disease. Design. SWEDEHEART collects on-line data from consecutive patients treated at any coronary care unit n = (74), followed for secondary prevention, undergoing any coronary angiography, percutaneous coronary intervention, percutaneous valve or cardiac surgery. The registry is governed by an independent steering committee, the software is developed by Uppsala Clinical Research Center and it is funded by The Swedish national health care provider independent of industry support. Approximately 80,000 patients per year enter the database which consists of more than 3 million patients. Results. Base-line, procedural, complications and discharge data consists of several hundred variables. The data quality is secured by monitoring. Outcomes are validated by linkage to other registries such as the National Cause of Death Register, the National Patient Registry, and the National Registry of Drug prescriptions. Thanks to the unique social security number provided to all citizens follow-up is complete. The 2011 outcomes with special emphasis on patients more than 80 years of age are presented. Conclusion. SWEDEHEART is a unique complete national registry for heart disease.
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| 13. |
- Schnabel, Renate B, et al.
(författare)
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Early diagnosis and better rhythm management to improve outcomes in patients with atrial fibrillation : the 8th AFNET/EHRA consensus conference
- 2023
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Ingår i: Europace. - : Oxford University Press. - 1099-5129 .- 1532-2092. ; 25:1, s. 6-27
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Tidskriftsartikel (refereegranskat)abstract
- Despite marked progress in the management of atrial fibrillation (AF), detecting AF remains difficult and AF-related complications cause unacceptable morbidity and mortality even on optimal current therapy. This document summarizes the key outcomes of the 8th AFNET/EHRA Consensus Conference of the Atrial Fibrillation NETwork (AFNET) and the European Heart Rhythm Association (EHRA). Eighty-three international experts met in Hamburg for 2 days in October 2021. Results of the interdisciplinary, hybrid discussions in breakout groups and the plenary based on recently published and unpublished observations are summarized in this consensus paper to support improved care for patients with AF by guiding prevention, individualized management, and research strategies. The main outcomes are (i) new evidence supports a simple, scalable, and pragmatic population-based AF screening pathway; (ii) rhythm management is evolving from therapy aimed at improving symptoms to an integrated domain in the prevention of AF-related outcomes, especially in patients with recently diagnosed AF; (iii) improved characterization of atrial cardiomyopathy may help to identify patients in need for therapy; (iv) standardized assessment of cognitive function in patients with AF could lead to improvement in patient outcomes; and (v) artificial intelligence (AI) can support all of the above aims, but requires advanced interdisciplinary knowledge and collaboration as well as a better medico-legal framework. Implementation of new evidence-based approaches to AF screening and rhythm management can improve outcomes in patients with AF. Additional benefits are possible with further efforts to identify and target atrial cardiomyopathy and cognitive impairment, which can be facilitated by AI.
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| 14. |
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| 15. |
- Svedsäter, Göran, et al.
(författare)
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Performance and image enhancing substance use among young people in Sweden
- 2021
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Ingår i: Performance Enhancement & Health. - : Elsevier. - 2211-2669. ; 9:2
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate the prevalence of performance- and image-enhancing substances (PIES) use, and factors related to this, among a representative sample of the general Swedish population aged 16–25. We used a quantitative cross-sectional self-report design to examine prevalence and possible relationships between PIES use and socio-demographics, physical activity, attitudes towards muscle building and doping, friends’ use, body image, and body modification. Approximately 12% of the respondents reported that they used or had used PIES. A logistic regression analysis pointed out the importance of the social context – friends who used PIES, how body image affected social life, and how others viewed one's body – as more important factors for using PIES than attitudes towards muscle building and doping. Taken together, these results indicate a need to pay attention to the use of PIES among young people as a potential public health problem.
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| 16. |
- Svennberg, Kaisa, et al.
(författare)
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A modified cup-method for lightweight and highly permeable materials
- 2003
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Ingår i: Research in Building Physics. - 9789058095657 - 9058095657 ; , s. 177-182
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Konferensbidrag (refereegranskat)abstract
- With an increasing interest for dynamic hygrothermal calculation models for short time periods, there is a need for uncomplicated and reliable methods to determine the moisture properties for materials used in the indoor environment. The traditional cup-method is commonly used for building materials to determine the water vapor permeability. When used on lightweight and highly permeable materials, the unidentified inner surface resistance of the cup-method will be problematic and fastening the sample to the cup can be troublesome. To address these problems, we have developed a modified cup-method based on standard laboratory crimp cap vials to determine the water vapor resistance for lightweight and highly permeable materials, such as textiles and paper. This modified cup-method together with a validation is presented in the paper.
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| 17. |
- Svennberg, Kaisa, et al.
(författare)
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Measurements of microclimates in beds in relation to the climatic requirements of house dust mites
- 2005
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Ingår i: [Host publication title missing]. - 9979917466
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Konferensbidrag (refereegranskat)abstract
- House dust mites are animals of a size less than 0.5 mm that can live in beds, carpets and furniture feeding on skin scales. They are a common source of allergy in, e.g., Scandinavia, where their major habitat is in beds. Previous studies show that in drier environments the house dust mite occurrence is lower, and persons with dust mite allergy have fewer symptoms during the winter when the indoor relative humidity (RH) is low. There have also been attempts to alter the microclimatic conditions in beds to reduce the house dust mite occurrence. The microclimatic conditions in beds have been studied both in field measurements and by modeling but there is still a lack of knowledge of how the hygrothermal material properties of the mattress and bedding affect the environmental conditions for the house dust mites. This paper presents diurnal temperature and RH variations in mattresses and beddings under normal use measured for two different mattress types. The climatic results from the beds have been compared to microclimatic requirements that govern the house dust mite activity levels. This study is a part of a multidisciplinary project aiming to find technical solutions for reduction of house dust mites in bedrooms by environmental control.
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| 18. |
- Svennberg, Kaisa, et al.
(författare)
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Moisture penetration in a chair seat as a response to daily RH variations in the indoor air
- 2005
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Ingår i: [Host publication title missing]. - 9979917466
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Konferensbidrag (refereegranskat)abstract
- In the indoor environment there are a number of materials with potential to act as moisture buffers including both building materials and furnishing materials. For daily moisture variations in the indoor air furniture with upholstery can play an important role as moisture buffers. Material properties and calculation models describing the response to moisture variations in the ambient climate for these material combinations are limited. In this project the moisture properties for a chair seat with a wool fabric and plastic foam padding were determined. The moisture penetration in the chair seat was measured using small temperature and relative humidity sensors. A numerical calculation model describing the step-response as well as the response to ramp variations is described. A comparison between measurements and theoretical calculations was performed. The difficulties with determination of material properties for highly permeable materials are also discussed as well as suitable methods and special considerations.
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| 19. |
- Svennberg, Kaisa, et al.
(författare)
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Previous experimental studies and field measurements on moisture buffering by indoor surface materials
- 2007
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Ingår i: Journal of Building Physics. - : SAGE Publications. - 1744-2583 .- 1744-2591. ; 30:3, s. 261-274
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Forskningsöversikt (refereegranskat)abstract
- An increased interest in moisture buffering in the indoor environment and the development of more refined hygrothermal calculation tools call for a better understanding of the phenomenon. There are many materials indoors with potential to act as moisture buffers, ranging from traditional finishing materials as gypsum plaster to textiles. The objective of this study is to show that the interest in moisture buffering is not a new issue. There have been significant laboratory studies made in the past. This study presents a review of such previous studies (1960-2000) on indoor surface materials from Germany and Sweden, not published in English before.
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| 20. |
- Svennberg, Kaisa, et al.
(författare)
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Sorption isotherms for textile fabrics, foams and batting used in the indoor environment
- 2008
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Ingår i: Journal of the Textile Institute. - : Informa UK Limited. - 1754-2340 .- 0040-5000. ; 99:2, s. 125-132
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Tidskriftsartikel (refereegranskat)abstract
- An increasing interest in the moisture buffering of indoor surface materials and new tools for calculation of energy demands and indoor climate calls for relevant material properties of all materials exposed to the indoor air. Textile fabric represents a large portion of the surface materials present in dwellings and offices and is therefore of special interest. This paper presents the sorption isotherms for nine fabrics, two foams and one batting, all of material compositions that are commonly found in the indoor environment. The data are fitted to the Hailwood-Horrobin sorption isotherm equation and good agreement is found for all materials. The difference in moisture capacity and hysteresis between different materials is discussed.
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| 21. |
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| 22. |
- Tomasdottir, Maria, et al.
(författare)
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Risk markers of incident atrial fibrillation in patients with coronary heart disease
- 2021
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Ingår i: American Heart Journal. - : Elsevier. - 0002-8703 .- 1097-6744. ; 233, s. 92-101
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundIn patients with coronary heart disease (CHD), atrial fibrillation (AF) is associated with increased morbidity and mortality. We investigated the associations between clinical risk factors and biomarkers with incident AF in patients with CHD.Methods and resultsAround 13,153 patients with optimally treated CHD included in the STabilization of Atherosclerotic plaque By Initiation of darapLadIb TherapY (STABILITY) trial with plasma samples obtained at randomization. Mean follow-up time was 3.5 years. The association between clinical risk factors and biomarkers with incident AF was estimated with Cox-regression models. Validation was performed in 1,894 patients with non-ST-elevation acute coronary syndrome included in the FRISC-II trial.The median (min-max) age was 64 years (range 26-92) and 2,514 (19.1%) were women. A total of 541 patients, annual incidence rate of 1.2%, developed AF during follow-up. In multivariable models, older age, higher levels of NT-proBNP, higher body mass index (BMI), male sex, geographic regions, low physical activity, and heart failure were independently associated with increased risk of incident AF with hazard ratios ranging from 1.04 to 1.79 (P ≤ .05). NT-proBNP improved the C-index from 0.70 to 0.71. In the validation cohort, age, BMI, and NT-proBNP were associated with increased risk of incident AF with similar hazard ratios.ConclusionsIn patients with optimally treated CHD, the incidence of new AF was 1.2% per year. Age, NT-proBNP as a marker of impaired cardiac function, and BMI were the strongest factors, independently and consistently associated with incident AF. Male sex and low physical activity may also contribute to the risk of AF in patients with CHD.
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| 23. |
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| 24. |
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| 25. |
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| 26. |
- Varma, Niraj, et al.
(författare)
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Контроль аритмий с помощью технологий мобильного здравоохранения: цифровые медицинские технологии для специалистов по сердечному ритму. Консенсус экспертов 2021
- 2021
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Ingår i: Russian Journal of Cardiology. - : Silicea - Poligraf, LLC. - 1560-4071 .- 2618-7620. ; 26:S1
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Tidskriftsartikel (refereegranskat)abstract
- This collaborative statement from the International Society for Holter and Noninvasive Electrocardiology/Heart Rhythm Society/European Heart Rhythm Association/Asia Pacific Heart Rhythm Society describes the current status of mobile health (“mHealth”) technologies in arrhythmia management. The range of digital medical tools and heart rhythm disorders that they may be applied to and clinical decisions that may be enabled are discussed. The facilitation of comorbidity and lifestyle management (increasingly recognized to play a role in heart rhythm disorders) and patient self-management are novel aspects of mHealth. The promises of predictive analytics but also operational challenges in embedding mHealth into routine clinical care are explored.
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| 27. |
- Wadsö, Lars, et al.
(författare)
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An experimentally simple method for measuring sorption isotherms
- 2004
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Ingår i: Drying Technology. - 1532-2300. ; 22:10, s. 2427-2440
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Tidskriftsartikel (refereegranskat)abstract
- We describe a simple, yet practical and precise. way of measuring sorption isotherms with each sample in its own glass jar with a saturated salt solution. The measurements are done with below-balance weighing and with the sample kept inside the closed jar during the whole measurement period, providing constant relative humidity (RH) conditions. The technique has been tested on microcrystalline cellulose and bentonite clay. The agreement with literature values was good; the differences seen for bentonite at high RH are discussed in terms of the slow attainment of equilibrium for this material.
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| 28. |
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| 29. |
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| 30. |
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