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- Fedchenko, Maria, 1988, et al.
(författare)
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Ischemic heart disease in children and young adults with congenital heart disease in Sweden
- 2017
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Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273. ; 248, s. 143-148
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Tidskriftsartikel (refereegranskat)abstract
- Background: An increasing proportion of congenital heart disease (CoHD) patients survive to an age associated with increased risk of developing ischemic heart disease (IHD). The aim was to investigate the risk of developing IHD among children and young adults with CoHD. Methods: Using the Swedish National Patient Register, we created a cohort of all CoHD patients born between January 1970 and December 1993. Ten controls matched for age, sex, county were randomly selected from the general population for each patient (n = 219,816). Patients and controls were followed from birth until first IHD event, death, or December 31, 2011. Results: We identified 21,982 patients with CoHD (51.6% men), mean follow-up was 26.4 (21.2-33.9) years. CoHD patients had 16.5 times higher risk of being hospitalized with or dying from IHD compared to controls (95% CI: 13.7-19.9), p < 0.0001. Patients with conotruncal defects and severe nonconotruncal defects, had the highest IHD incidence rate (71.1 and 56.3 cases per 100,000 person-years, respectively, compared to 2.9 and 2.3 in controls). Hypertension and diabetes were less common among CoHD patients with IHD than among controls with IHD (hypertension 9.7% vs 19.7%, diabetes 1.8% vs 7.7% in CoHD patients and controls). Patients with aortic coarctation did not have a specific increase in the risk of developing IHD or acute myocardial infarction. Conclusions: In this large case-control cohort study, the relative risk of developing IHD was markedly higher in CoHD patients than in controls. However, the absolute risk was low in both groups. (C) 2017 Elsevier B.V. All rights reserved.
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| 2. |
- Giang, Kok Wai, 1984, et al.
(författare)
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Long-term trends in the prevalence of patients hospitalized with ischemic stroke from 1995 to 2010 in Sweden
- 2017
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Ingår i: Plos One. - : Public Library of Science (PLoS). - 1932-6203. ; 12:6
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Tidskriftsartikel (refereegranskat)abstract
- Objective The prevalence of stroke is expected to increase partly because of prolonged life expectancy in the general population. The objective of this study was to investigate trends in the prevalence of patients hospitalized with ischemic stroke (IS) in Sweden from 1995-2010. The Swedish inpatient and cause-specific death registries were used to estimate the absolute numbers and prevalence of patients who were hospitalized with and survived an IS from 1995-2010. The overall number of IS increased from 129,418 in 1995 to 148,778 in 2010. In 1995, the prevalence of IS was 189 patients per 10,000 population. An increase in overall prevalence was observed until 2000, and then it remained stable, followed by a decline with an annual percentage change of (APC)-0.8% (95% CI -1.0 to 0.6) and with a final prevalence of 199 patients per 10,000 population in 2010. The prevalence of IS in people aged <45 years increased from 6.4 in 1995 to 7.6 patients per 10,000 population in 2010, with an APC of 2.1% (95% CI 0.9 to 3.4) from 1995-1998 and 0.7% (95% CI 0.6-0.9) from 1998-2010. Among those aged 45-54 years, the prevalence rose through the mid to late 1990s, followed by a slight decrease (APC:-0.7%, 95% CI -1.1 to -0.4) until 2006 and then remained stable with a prevalence of 43.8 patients per 10,000 population in 2010. Among >= 85 years, there was a minor decrease (APC: -0.3%, 95% CI -0.5 to -0.1) in overall prevalence after 2002 from 1481 to 1453 patients per 10,000 population in 2010. The overall prevalence of IS increased until 2000, but then remained stable followed by a slight decline. However, the prevalence of IS in the young increased through the study period. The absolute number of IS survivors has markedly increased, mainly because of demographic changes.
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| 4. |
- Mandalenakis, Zacharias, 1979, et al.
(författare)
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Survivorship in Children and Young Adults With Congenital Heart Disease in Sweden
- 2017
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Ingår i: JAMA internal medicine. - : American Medical Association (AMA). - 2168-6106 .- 2168-6114. ; 177:2, s. 224-230
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Tidskriftsartikel (refereegranskat)abstract
- Importance: Mortality in patients with congenital heart disease (CHD) has markedly decreased during recent decades because of advancement in pediatric care. However, there are limited data on survival trends in children and young adults with CHD compared with the general population. Objective: To determine survivorship in children and young adults with CHD compared with matched controls. Design, Setting, and Participants: A registry-based, prospective, matched-cohort study was conducted in Sweden. Data from the national patient and cause of death registers were linked to identify individuals with CHD born between January 1, 1970, and December 31, 1993, who were registered at or after birth. Follow-up and comorbidity data were collected until December 31, 2011. Survival analyses were performed with the Cox proportional hazards model; these analyses were performed from January 1, 1970, to December 31, 2011. A total of 21982 patients with CHD in Sweden were identified. The mean (SD) follow-up time was 27.0 (8.86) years. Children serving as controls (n = 219816) (10 for each patient), matched for birth year, sex, and county, were randomly selected from the general population. Main Outcomes and Measures: Survivorship in young patients with CHD and controls. Results: Of the 21982 patients who were born between 1970 and 1993 and were registered with the diagnosis of CHD, 10650 were female (48.4%). Median age at index registration was 4.22 years (interquartile range, 17.07 years). Survivorship among children younger than 5 years was increased from 96% in those born in 1970-1979 to 98% in those born in 1990-1993. Hazard ratios (HRs) of death in relation to that in control individuals decreased from 225.84 (95% CI, 136.84-372.70) to 33.47 (95% CI, 22.54-49.70). A substantial, but less pronounced, absolute and relative increase in survivorship was found in older patients (HRs ranged from 24.52; 95% CI, 11.72-51.26, at 5-9 years to 4.27; 95% CI, 2.29-7.95, at 18-29 years). According to a hierarchical CHD classification, the group of patients with the most severe complex defects (ie, common arterial trunk, transposition of the great vessels, double inlet ventricle, hypoplastic left heart syndrome, tetralogy of Fallot, and atrioventricular septal defect) had the highest risk for death (HR, 64.07; 95% CI, 53.39-76.89). Conclusions and Relevance: Despite substantially increasing absolute and relative survivorship in children and young adults with CHD, the mortality risk remains high compared with the risk in matched controls. Further research on reducing the death rate in this vulnerable group is required.
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| 5. |
- Zhong, You, et al.
(författare)
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Secular changes in cardiovascular risk factors in Swedish 50-year-old men over a 50-year period : The study of men born in 1913, 1923, 1933, 1943, 1953 and 1963
- 2017
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Ingår i: European Journal of Preventive Cardiology. - : Oxford University Press (OUP). - 2047-4873 .- 2047-4881. ; 24:6, s. 612-620
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Tidskriftsartikel (refereegranskat)abstract
- Background: During the past decades, declining trends in mean cholesterol levels and smoking have been observed in Western Europe, whereas obesity and a sedentary lifestyle have increased. Simultaneously, there has been a marked decrease in mortality from cardiovascular (CV) diseases. Methods: The aim of the study was to determine whether these trends in CV risk factors continued over a period of 50 years. Six systematic or random population samples of 50-year-old men (n = 3563) living in Gothenburg, Sweden, were investigated between 1963 and 2013. Results: During the 50 years, mean body mass index (BMI) at 50 years of age increased by 2 kg/m(2), from 24.8 kg/m(2) in 1963 to 26.8 kg/m(2) in 2013 (p< 0.001). A decrease in systolic blood pressure of nearly 10mmHg was observed from 1963 to 1993, but was not sustained through the past two decades. Mean serum cholesterol fell from 6.42 (SD 1.12) mmol/L to 5.34 (SD 0.97) mmol/L. The prevalence of smoking at 50 years of age decreased markedly from 56.1% in 1963 to 11.9% in 2013. The number of participants with a sedentary lifestyle during leisure time decreased until 1993, but has remained unchanged since. In 2013, 50-year-old men had a 6.9-times higher likelihood of lacking CV risk factors than 50-year-old men in 1963 (95% confidence interval (CI): 3.5-13.3, p< 0.001). The odds ratio for having four or more risk factors was only 0.13 (95% CI: 0.062-0.29, p< 0.001). Conclusion: Despite increasing body weight, the total CV risk factor burden has decreased in 50-year-old men over the past 50 years.
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