| 1. |
- Björkenheim, Anna, 1980-, et al.
(författare)
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Patient-reported Outcomes In Relation To Continuously Monitored Rhythm Before And During Two Years After Atrial Fibrillation Ablation Using A Disease-specific And A Generic Instrument
- 2018
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Konferensbidrag (refereegranskat)abstract
- Background: Patients with AF have a lower health-related quality of life (HRQoL) than the general population.Objective: To assess the effect of AF ablation on AF-specific and generic patient-reported outcomes (PRO), compare it to a Swedish age- and sex-matched population and evaluate any association with the AF burden.Methods: Patients scheduled for AF ablation completed the generic SF-36 and the AF-specific PRO questionnaires before and six, 12 and 24 months after AF ablation. All patients underwent continuous ECG monitoring via an implantable loop recorder.Results: 54 patients completed the follow-up. After ablation, the generic SF-36 improved and both summary scores reached normative levels at 24 months, while physical functioning, role-physical and vitality remained lower than norms. Responders with an AF burden ≤0.5% at each visit after ablation reached the norms in all domains, while non-responders reached norms in only social functioning and MCS. All AF6 items and the sum score showed moderate to large improvement in both responders and non-responders. Higher AF burden was independently associated with poorer PCS and AF6 sum score. The AF sum score correlated with all SF-36 domains, but all AF6 items did not correlate with the SF-36 summary scores.Conclusion: The AF-specific AF6 questionnaire was more sensitive to changes in PRO related to AF burden than was the generic SF-36. Higher AF burden after ablation was associated with poorer AF-specific PRO and poorer generic physical but not mental health. Focusing on AF-specific symptoms and their impact on quality of life as an outcome after AF ablation is reasonable, as improving PROs is the main goal of AF ablation.
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| 2. |
- Lind, Karin, et al.
(författare)
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The Gaia-ESO Survey : A globular cluster escapee in the Galactic halo
- 2015
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 575
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Tidskriftsartikel (refereegranskat)abstract
- A small fraction of the halo field is made up of stars that share the light element (Z <= 13) anomalies characteristic of second generation globular cluster (GC) stars. The ejected stars shed light on the formation of the Galactic halo by tracing the dynamical history of the clusters, which are believed to have once been more massive. Some of these ejected stars are expected to show strong Al enhancement at the expense of shortage of Mg, but until now no such star has been found. We search for outliers in the Mg and Al abundances of the few hundreds of halo field stars observed in the first eighteen months of the Gaia-ESO public spectroscopic survey. One halo star at the base of the red giant branch, here referred to as 22593757-4648029 is found to have [Mg/Fe] = -0.36 +/- 0.04 and [Al/Fe] = 0.99 +/- 0.08, which is compatible with the most extreme ratios detected in GCs so far. We compare the orbit of 22593757-4648029 to GCs of similar metallicity and find it unlikely that this star has been tidally stripped with low ejection velocity from any of the clusters. However, both chemical and kinematic arguments render it plausible that the star has been ejected at high velocity from the anomalous GC omega Centauri within the last few billion years. We cannot rule out other progenitor GCs, because some may have disrupted fully, and the abundance and orbital data are inadequate for many of those that are still intact.
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| 3. |
- Poci, Dritan, 1969-, et al.
(författare)
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Do Some Patients Younger Than 65 Years Old And With Incident Atrial Fibrillation Need Anticoagulation Treatment? : Conclusions From A Swedish Nationwide Registry Study
- 2018
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Konferensbidrag (refereegranskat)abstract
- Background: It is still under debate whether patients with atrial fibrillation (AF) and a low risk of cerebral infarction would benefit from anticoagulation.Objective: We aimed to assess whether younger patients with AF and lower CHA2DS2-VASc score would benefit from anticoagulation treatment.Methods: In a retrospective, nationwide cohort study, using the Swedish national registries, 59981 hospitalized patients were identified with incident AF. After exclusion of 11548 patients because of warfarin use before the AF diagnosis, or death, emigration or stroke within 30 days of AF diagnosis, the remaining 48 433 patients, among whom 27166 patients had no warfarin treatment, were, after adjustment for age, sex and year of AF diagnosis, divided according to age, sex and CHA2DS2-VASc score 0, 1, 2 and ≥3 and included in a time-varying analysis of warfarin treatment versus no treatment. Patients were followed up to 48 months after the inclusion.Results: In men <65 years and with a CHA2DS2-VASc score 2 or ≥3, the relative risk of having a stroke or cerebral infarction was lower when they received warfarin treatment, HR 0.35 (95% CI 0.18-0.69) and HR 0.37 (95% CI 0.23-0.59) respectively, as compared to HR 1.11 (95% CI 0.56-2.23) when the score was 1. Women younger than 65 years had a low relative risk when CHA2DS2-VASc score was ≥3 points, HR 0.31 (95% CI 0.16-0.59), as compared to HR 1.84 (95% CI 0.86-3.94) and HR 2.13 (95% CI 0.94-4.84) when the score was 2 and 1 respectively. The risk of intracranial bleeding was low and similar in all subgroups on anticoagulation except in the youngest men without risk factors.Conclusion: Women and men <65 years had a beneficial effect of warfarin if they had two risk factors other than age and sex, without an increased risk of bleeding. Our results support prophylactic anticoagulation treatment in patients under 65 years and a CHA2DS2-VASc score ≥2, other than age and sex.
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