| 1. |
- Alehagen, Urban, 1951-, et al.
(författare)
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Utility of the amino-terminal fragment of pro-brain natriuretic peptide in plasma for the evaluation of cardiac dysfunction in elderly patients in primary health care
- 2003
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Ingår i: Clinical Chemistry. - : Oxford University Press (OUP). - 0009-9147 .- 1530-8561. ; 49:8, s. 1337-1346
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aims of this study were to measure the N-terminal fragment of pro-brain natriuretic peptide (proBNP) in plasma in medical conditions commonly found in primary care and to evaluate the utility of these measurements in identifying impaired cardiac function in elderly patients with symptoms associated with heart failure.Methods: We studied 415 patients (221 men and 194 women; mean age, 72 years) who had contacted a primary healthcare center for dyspnea, fatigue, and/or peripheral edema. One cardiologist evaluated the patients in terms of history, physical examination, functional capacity, electrocardiography, and suspicion of heart failure. Plasma N-terminal proBNP was measured by an in-house RIA. An ejection fraction ≤40% by Doppler echocardiography was regarded as reduced cardiac function. Abnormal diastolic function was defined as an abnormal mitral inflow defined as reduced ratio of peak early diastolic filling velocity to peak filling velocity at atrial contraction (E/A ratio), or as abnormal pulmonary venous flow pattern.Results: Patients with impaired functional capacity, impaired systolic function, and/or impaired renal function had significantly increased N-terminal proBNP concentrations. By multiple regression analysis, N-terminal proBNP concentrations were also influenced by ischemic heart disease, cardiac enlargement, and certain medications but not by increased creatinine. No gender differences were observed. Patients with isolated diastolic dysfunction attributable to relaxation abnormali-ties had lower concentrations than those with normal cardiac function, whereas those with pseudonormal E/A ratios or restrictive filling patterns had higher concentrations.Conclusions: Plasma N-terminal proBNP concentrations increase as a result of impaired systolic function, age, impaired renal function, cardiac ischemia and enlargement, and certain medications. Values are high in diastolic dysfunction with pseudonormal patterns, but not in patients with relaxation abnormalities. An increase in plasma N-terminal proBNP might be an earlier sign of abnormal cardiac function than abnormalities identified by currently used echocardiographic measurements.
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| 2. |
- Blomgren, J., et al.
(författare)
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[New routines makes tooth extraction possible during warfarin treatment]
- 2004
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Ingår i: Lakartidningen. - 0023-7205. ; 101:25, s. 2168-70
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Tidskriftsartikel (refereegranskat)abstract
- We conclude that it is possible to successfully extract teeth without interrupting or reducing the dose of anticoagulant medication with warfarin. We also conclude that patients with anticoagulant medication are treated differently depending on where they have their dental treatment done.
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| 3. |
- Eriksson, Henry, 1946
(författare)
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Treatment of venous thromboembolism and long-term prevention of recurrence: present treatment options and ximelagatran
- 2004
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Ingår i: Drugs. - 0012-6667. ; 64 Suppl 1, s. 37-46
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Tidskriftsartikel (refereegranskat)abstract
- Despite the effectiveness of anticoagulant therapy for the treatment of acute venous thromboembolism and the prevention of recurrent venous thromboembolism, existing antithrombotic therapies are suboptimal. Unfractionated heparin, low-molecular-weight heparin (LMWH) and warfarin have practical limitations and carry the risk of treatment-related adverse events that restrict their clinical benefits and reduce cost-effectiveness. Efforts to achieve optimal venous thromboembolism prophylaxis by modifying the intensity of oral warfarin treatment have produced equivocal results, and there is a need for new, efficacious antithrombotic drugs providing predictable, well-tolerated oral dosing without the need for coagulation monitoring. Such agents would ideally have no significant food or drug interactions, and be suitable for both short- and long-term treatment. Ximelagatran, the first oral direct thrombin inhibitor, has the potential to fulfill many of the unmet needs in the management of venous thromboembolism.
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| 4. |
- Rosengren, Annika, 1951, et al.
(författare)
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Serum lipids in fathers and sons at middle age. The study of sons to men born in 1913.
- 2003
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Ingår i: Journal of Internal Medicine. - 0954-6820. ; :254, s. 126-131
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To relate lipid levels in middle-aged men to that of their fathers at 50 years of age measured 30 years earlier. DESIGN AND SUBJECTS: In 1963, 855 men born in 1913 took part in a cardiovascular risk factor survey when they were at 50 years of age. In 1993, 475 sons to these men, aged 44-56, were invited to another examination; 263 of these men were examined (response rate: 56%) and compared with their 217 fathers when they were examined at 50 years of age in 1963. In the 1993 survey, 798 men aged 50, were also examined, from a general population sample of men born in 1943 (response rate: 55%). SETTING: City of Goteborg, Sweden. MAIN OUTCOME MEASURES: Serum lipids in sons as a function of lipids in their fathers. RESULTS: Compared with the men born in 1913, both sons and men born in 1943 had lower mean serum cholesterol, but higher body mass index (BMI) and serum triglycerides. There was a significant relation between serum cholesterol in sons and their fathers (r = 0.25; P < 0.0001). Amongst sons to fathers in the highest cholesterol quartile (>6.9 mmol x L(-1)), 37% had serum cholesterol above 6.5 mmol x L(-1), compared with 16% amongst sons to fathers in the lowest quartile (<5.7 mmol x L(-1)) [adjusted odds ratio 3.73 (1.52-9.12)]. Sons to fathers with the highest serum cholesterol levels had slightly lower BMI; otherwise there was no relation between serum cholesterol in the father and any other lifestyle or biological risk factor in the sons. Serum triglyceride concentration in the father was unrelated to any variable in the son. CONCLUSIONS: There was a moderately strong association between serum cholesterol concentration in fathers and sons at middle age. However, secular trends were also important in determining serum cholesterol concentrations in those born at a later period, indicating a major role of environmental factors. PMID: 12859693 [PubMed - indexed for MEDLINE]
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| 5. |
- Strandhagen, Elisabeth, 1960, et al.
(författare)
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High fruit intake may reduce mortality among middle-aged and elderly men. The Study of Men Born in 1913.
- 2000
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Ingår i: European journal of clinical nutrition. - 0954-3007. ; 54:4, s. 337-41
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: A number of long-term population-based studies have tried to study fruit and vegetable consumption in relation to cardiovascular disease, cancer and total mortality. Few of these studies are based on randomly selected population samples. The aim of the study was to investigate the long-term effect of fruit and vegetable consumption on mortality, cardiovascular disease, cardiovascular death, cancer morbidity and cancer death among middle-aged and elderly men. DESIGN: Prospective cohort study. SETTING: General community. The Study of Men Born in 1913. SUBJECTS: 792 men at age 54 who participated in a screening examination in 1967. MAIN OUTCOME MEASURES: A food frequency questionnaire was used to obtain information of the dietary habits in 730 of the men (92%). All men were followed up with repeated examinations until the age of 80. RESULTS: Cardiovascular as well as total mortality was significantly lower among men with high fruit consumption in univariate analysis. There was no correlation between fruit or vegetable consumption in relation to cancer incidence, cancer death and cardiovascular disease. In multivariate survival analysis where smoking, cholesterol and hypertension were taken into account, there was a significantly lower mortality among men with a high fruit consumption during 16 y follow up until the age of 70 (P=0.042), but this finding was no longer statistically significant during 26 y follow-up at the age of 80 (P=0.051). CONCLUSIONS: Daily fruit consumption seems to have positive effect on long-term survival independently of other traditional cardiovascular risk factors like smoking, hypertension and cholesterol. SPONSORSHIP: This study was supported by grants from the Swedish Medical Research Council (K98-274-06276-17) King Gustav V and Queen Victoria's Foundation, and the Göteborg University.
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| 6. |
- Welin, Lennart, 1941, et al.
(författare)
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Insulin resistance, glucose intolerance, physical activity and other risk factors for coronary heart disease in elderly men. The study of men born in 1913 and 1923.
- 2003
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Ingår i: European Journal of Cardiovascular Prevention and Rehabilitation. - 1741-8267. ; :10, s. 283-288
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: We have previously shown that insulin is not a major risk factor for CHD. Our data have been re-analysed with longer follow-up and the homeostasis model assessment (HOMA) method. DESIGN: Prospective cohort study of 57- and 67-year-old men. METHODS: Insulin resistance was estimated with the HOMA equation. Standard methods were used to measure risk factors. The endpoint (CHD) was the combination of non-fatal myocardial infarction and fatal CHD during 13 years of follow-up. RESULTS: The risk of CHD increased 2.5-fold in known diabetics compared with those with normal glucose tolerance, 2.2-fold among those in the highest compared with the lowest quintile of insulin resistance, and 2.4-fold among those in the highest compared with the lowest quintile of fasting insulin. Increased physical activity decreased the risk of CHD by 65%. Cholesterol was also a significant risk factor for CHD but blood pressure, obesity and smoking were not related to the incidence of CHD. CONCLUSION: Insulin resistance is a significant risk factor for CHD. Whether it is a causal risk factor remains to be proven. Regular physical activity protects against CHD. PMID: 14555884 [PubMed - indexed for MEDLINE]
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