| 1. |
- Andersson Shams Hakimi, Caroline, et al.
(författare)
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Effects of fibrinogen and platelet supplementation on clot formation and platelet aggregation in blood samples from cardiac surgery patients.
- 2014
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Ingår i: Thrombosis research. - : Elsevier BV. - 1879-2472 .- 0049-3848. ; 134:4, s. 895-900
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Tidskriftsartikel (refereegranskat)abstract
- Bleeding after cardiac surgery may be caused by surgical factors, impaired haemostasis, or a combination of both. Transfusion of blood products is used to improve haemostasis, but little is known about what combination is optimal. We hypothesized that addition of both fibrinogen and platelets to blood samples from cardiac surgery patients would improve clot formation and platelet aggregation to a greater extent than if the components were added separately.
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| 2. |
- Chung, Sheng-Chia, et al.
(författare)
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Acute myocardial infarction : a comparison of short-term survival in national outcome registries in Sweden and the UK
- 2014
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Ingår i: The Lancet. - 0140-6736 .- 1474-547X. ; 383:9925, s. 1305-1312
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Tidskriftsartikel (refereegranskat)abstract
- Background International research for acute myocardial infarction lacks comparisons of whole health systems. We assessed time trends for care and outcomes in Sweden and the UK. Methods We used data from national registries on consecutive patients registered between 2004 and 2010 in all hospitals providing care for acute coronary syndrome in Sweden and the UK. The primary outcome was all-cause mortality 30 days after admission. We compared effectiveness of treatment by indirect casemix standardisation. This study is registered with ClinicalTrials.gov, number NCT01359033. Findings We assessed data for 119 786 patients in Sweden and 391 077 in the UK. 30-day mortality was 7.6% (95% CI 7.4-7.7) in Sweden and 10.5% (10.4-10.6) in the UK. Mortality was higher in the UK in clinically relevant subgroups defined by troponin concentration, ST-segment elevation, age, sex, heart rate, systolic blood pressure, diabetes mellitus status, and smoking status. In Sweden, compared with the UK, there was earlier and more extensive uptake of primary percutaneous coronary intervention (59% vs 22%) and more frequent use of beta blockers at discharge (89% vs 78%). After casemix standardisation the 30-day mortality ratio for UK versus Sweden was 1.37 (95% CI 1.30-1.45), which corresponds to 11 263 (95% CI 9620-12 827) excess deaths, but did decline over time (from 1.47, 95% CI 1.38-1.58 in 2004 to 1.20, 1.12-1.29 in 2010; p=0.01). Interpretation We found clinically important differences between countries in acute myocardial infarction care and outcomes. International comparisons research might help to improve health systems and prevent deaths.
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| 3. |
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| 4. |
- Holzmann, Martin J, et al.
(författare)
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Renal dysfunction and long-term risk of heart failure after coronary artery bypass grafting.
- 2013
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Ingår i: American heart journal. - : Elsevier BV. - 1097-6744 .- 0002-8703. ; 166:1, s. 142-9
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Tidskriftsartikel (refereegranskat)abstract
- Renal dysfunction is associated with increased long-term mortality and incidence of myocardial infarction after coronary artery bypass grafting (CABG). The aim was to investigate the relationship between renal dysfunction and long-term risk of heart failure after CABG.
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| 5. |
- Holzmann, M. J., et al.
(författare)
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Renal dysfunction and long-term risk of ischemic and hemorrhagic stroke following coronary artery bypass grafting
- 2013
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Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754. ; 168:2, s. 1137-1142
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Tidskriftsartikel (refereegranskat)abstract
- Background: Renal dysfunction is associated with increased long-term mortality and incidence of myocardial infarction following coronary artery bypass grafting (CABG). Little is known about the relationship between renal dysfunction and long-term risk of stroke following CABG. Methods and results: All 29 057 patients who underwent primary isolated CABG from 2000 through 2008 in Sweden, with no myocardial infarction within 14 days before surgery and no prior stroke, were included from the SWEDEHEART registry. During a mean follow-up of 4.5 years, there were 1563 (5.4%) first strokes (74% ischemic, 8% hemorrhagic, and 18% unspecified). Glomerular filtration rates (eGFR) were estimated using the Modification of Diet in Renal Disease equation. Hazard ratios (HR) with 95% confidence intervals (CI) were calculated for stroke in relation to eGFR. Adjusted HR for all stroke in patients with eGFR 45 to 60, 30 to 45 and 15 to 30 mL/min/1.73 m(2) were; 1.17 (1.03 to 1.34), 1.52 (1.25 to 1.85) and 1.79 (1.20 to 2.65), respectively compared to patients with eGFR >60 mL/min/1.73 m(2). Gender-specific analysis did not show any major differences between men and women. The adjusted risk of hemorrhagic stroke was somewhat higher than for ischemic stroke: HR 2.07 (1.15 to 3.73) vs. 1.55 (1.26 to 1.91), in patients with eGFR 15 to 45 mL/min/1.73 m(2). Conclusions: Renal dysfunction is associated with increased long-term risk of stroke after primary isolated CABG. The impact of renal dysfunction on risk of stroke appears to be similar for both men and women. (c) 2012 Elsevier Ireland Ltd. All rights reserved.
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| 6. |
- Jernberg, Tomas, et al.
(författare)
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The Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies (SWEDEHEART)
- 2010
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Ingår i: Heart. - : BMJ. - 1355-6037 .- 1468-201X. ; 96:20, s. 1617-1621
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Tidskriftsartikel (refereegranskat)abstract
- Aims The aims of the Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies (SWEDEHEART) are to support the improvement of care and evidence-based development of therapy of coronary artery disease (CAD). Interventions To provide users with online interactive reports monitoring the processes of care and outcomes and allowing direct comparisons over time and with other hospitals. National, regional and county-based reports are publicly presented on a yearly basis. Setting Every hospital (n=74) in Sweden providing the relevant services participates. Launched in 2009 after merging four national registries on CAD. Population Consecutive acute coronary syndrome (ACS) patients, and patients undergoing coronary angiography/angioplasty or heart surgery. Includes approximately 80 000 new cases each year. Startpoints On admission in ACS patients, at coronary angiography in patients with stable CAD. Baseline data 106 variables for patients with ACS, another 75 variables regarding secondary prevention after 12-14 months, 150 variables for patients undergoing coronary angiography/angioplasty, 100 variables for patients undergoing heart surgery. Data capture Web-based registry with all data registered online directly by the caregiver. Data quality A monitor visits approximately 20 hospitals each year. In 2007, there was a 96% agreement. Endpoints and linkages to other data Merged with the National Cause of Death Register, including information about vital status of all Swedish citizens, the National Patient Registry, containing diagnoses at discharge for all hospital stays in Sweden and the National Registry of Drug prescriptions recording all drug prescriptions in Sweden. Access to data Available for research by application to the SWEDEHEART steering group.
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| 7. |
- McNamara, R. L., et al.
(författare)
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International comparisons of the management of patients with non-ST segment elevation acute myocardial infarction in the United Kingdom, Sweden, and the United States: The MINAP/NICOR, SWEDEHEART/RIKS-HIA, and ACTION Registry-GWTG/NCDR registries
- 2014
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Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754. ; 175:2, s. 240-247
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To compare management of patients with acute non-ST segment elevation myocardial infarction (NSTEMI) in three developed countries with national ongoing registries. Background: Results from clinical trials suggest significant variation in care across the world. However, international comparisons in "real world" registries are limited. Methods: We compared the use of in-hospital procedures and discharge medications for patients admitted with NSTEMI from 2007 to 2010 using the unselective MINAP/NICOR [England and Wales (UK); n = 137,009], the unselective SWEDEHEART/RIKS-HIA (Sweden; n = 45,069), and the selective ACTION Registry-GWTG/NCDR [United States (US); n = 147,438] clinical registries. Results: Patients enrolled among the three registries were generally similar except those in the US who were younger but had higher rates of smoking, diabetes, hypertension, prior heart failure, and prior MI than in Sweden or in UK. Angiography and percutaneous coronary intervention (PCI) were performed more often in the US (76% and 44%) and Sweden (65% and 42%) relative to the UK (32% and 22%). Discharge betablockers were also prescribed more often in the US (89%) and Sweden (89%) than in the UK (76%). In contrast, discharge statins, angiotensin converting enzyme inhibitors/angiotensin receptor blockers (ACEI/ARB), and dual antiplatelet agents (among those not receiving PCI) were higher in the UK (92%, 79%, and 71%) than in the US (85%, 65%, 41%) and Sweden (81%, 69%, and 49%). Conclusions: The care for patients with NSTEMI differed substantially among the three countries. These differences in care among countries provide an opportunity for future comparative effectiveness research as well as identify opportunities for global quality improvement. (C) 2014 The Authors. Published by Elsevier Ireland Ltd.
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