| 1. |
- Adielsson, Anna, 1973, et al.
(författare)
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A 20-year perspective of in hospital cardiac arrest : Experiences from a university hospital with focus on wards with and without monitoring facilities.
- 2016
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Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754. ; 216, s. 194-199
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Knowledge about change in the characteristics and outcome of in hospital cardiac arrests (IHCAs) is insufficient.AIM: To describe a 20year perspective of in hospital cardiac arrest (IHCA) in wards with and without monitoring capabilities.SETTINGS: Sahlgrenska University Hospital (800 beds). The number of beds varied during the time of survey from 850-746 TIME: 1994-2013.METHODS: Retrospective registry study. Patients were assessed in four fiveyear intervals.INCLUSION CRITERIA: Witnessed and nonwitnessed IHCAs when cardiopulmonary resuscitation (CPR) was attempted.EXCLUSION CRITERIA: Age below 18years.RESULTS: In all, there were 2340 patients with IHCA during the time of the survey. 30-Day survival increased significantly in wards with monitoring facilities from 43.5% to 55.6% (p=0.002) for trend but not in wards without such facilities (p=0.003 for interaction between wards with/without monitoring facilities and time period). The CPC-score among survivors did not change significantly in any of the two types of wards. In wards with monitoring facilities there was a significant reduction of the delay time from collapse to start of CPR and an increase in the proportion of patients who were defibrillated before the arrival of the rescue team. In wards without such facilities there was a significant reduction of the delay from collapse to defibrillation. However, the latter observation corresponds to a marked decrease in the proportion of patients found in ventricular fibrillation.CONCLUSION: In a 20year perspective the treatment of in hospital cardiac arrest was characterised by a more rapid start of treatment. This was reflected in a significant increase in 30-day survival in wards with monitoring facilities. In wards without such facilities there was a decrease in patients found in ventricular fibrillation.
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| 2. |
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| 3. |
- Agewall, S, et al.
(författare)
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Cardiovascular pharmacotherapy
- 2016
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Ingår i: International journal of cardiology. - : Elsevier BV. - 1874-1754 .- 0167-5273. ; 224, s. 412-415
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Tidskriftsartikel (refereegranskat)
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| 4. |
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| 5. |
- Agewall, S
(författare)
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The large clinical statin trials
- 2011
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Ingår i: International journal of cardiology. - : Elsevier BV. - 1874-1754 .- 0167-5273. ; 150:1, s. 108-111
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Forskningsöversikt (refereegranskat)
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| 6. |
- Agvall, Björn, et al.
(författare)
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Resource use and cost implications of implementing a heart failure program for patients with systolic heart failure in Swedish primary health care
- 2014
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Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754. ; 176, s. 731-738
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Tidskriftsartikel (refereegranskat)abstract
- Aim: Heart failure (HF) is a common but serious condition which involves a significant economic burden on the health care economy. The purpose of this study was to evaluate cost and quality of life (QoL) implications of implementing a HF management program (HFMP) in primary health care (PHC).Methods and results: This was a prospective randomized open-label study including 160 patientswith a diagnosis of HF from five PHC centers in south-eastern Sweden. Patients randomized to the intervention group received information about HF from HF nurses and from a validated computer-based awareness program. HF nurses and physicians followed the patients intensely in order to optimize HF treatment according to current guidelines. The patients in the control group were followed by their regular general practitioner (GP) and received standard treatment according to local management routines. No significant changes were observed in NYHA class and quality-adjusted life years (QALY), implying that functional class and QoL were preserved. However, costs for hospital care (HC) and PHC were reduced by EUR 2167, or 33%. The total cost was EUR 4471 in the intervention group and EUR 6638 in the control group.Conclusions: Introducing HFMP in Swedish PHC in patients with HF entails a significant reduction in resource utilization and costs, and maintains QoL. Based on these results, a broader implementation of HFMP in PHC may be recommended. However, results should be confirmed with extended follow-up to verify long-term effects.
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| 7. |
- Aimo, Alberto, et al.
(författare)
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High-sensitivity troponin T, NT-proBNP and glomerular filtration rate : A multimarker strategy for risk stratification in chronic heart failure
- 2019
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Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754. ; 277, s. 166-172
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Tidskriftsartikel (refereegranskat)abstract
- Background: In a recent individual patient data meta-analysis, high-sensitivity troponin T (hs-TnT) emerged as robust predictor of prognosis in stable chronic heart failure (HF). In the same population, we compared the relative predictive performances of hs-TnT, N-terminal fraction of pro-B-type natriuretic peptide (NT-proBNP), hs-C-reactive protein (hs-CRP), and estimated glomerular filtration rate (eGFR) for prognosis.Methods and results: 9289 patients (66 ± 12 years, 77% men, 85% LVEF <40%, 60% ischemic HF) were evaluated over a 2.4-year median follow-up. Median eGFR was 58 mL/min/1.73 m2 (interquartile interval 46–70; n = 9220), hs-TnT 16 ng/L (8–20; n = 9289), NT-proBNP 1067 ng/L (433–2470; n = 8845), and hs-CRP 3.3 mg/L (1.4–7.8; n = 7083). In a model including all 3 biomarkers, only hs-TnT and NT-proBNP were independent predictors of all-cause and cardiovascular mortality and cardiovascular hospitalization. hs-TnT was a stronger predictor than NT-proBNP: for example, the risk for all-cause death increased by 54% per doubling of hs-TnT vs. 24% per doubling of NT-proBNP. eGFR showed independent prognostic value from both hs-TnT and NT-proBNP. The best hs-TnT and NT-proBNP cut-offs for the prediction of all-cause death increased progressively with declining renal function (eGFR ≥ 90: hs-TnT 13 ng/L and NT-proBNP 825 ng/L; eGFR < 30: hs-TnT 40 ng/L and NT-proBNP 4608 ng/L). Patient categorization according to these cut-offs effectively stratified patient prognosis across all eGFR classes.Conclusions: hs-TnT conveys independent prognostic information from NT-proBNP, while hs-CRP does not. Concomitant assessment of eGFR may further refine risk stratification. Patient classification according to hs-TnT and NT-proBNP cut-offs specific for the eGFR classes holds prognostic significance.
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| 8. |
- Akhter, Tansim, 1967-, et al.
(författare)
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Serum Pentraxin 3 is associated with signs of arterial alteration in women with preeclampsia.
- 2017
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Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754. ; 241, s. 417-422
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Preeclampsia (PE) in pregnancy is a state of exaggerated inflammation and is associated with an increased risk of cardiovascular disease (CVD) later in life. Levels of pentraxin 3 (PTX3), a novel inflammation marker, are increased during PE and in individuals with CVD. The primary aim of this study was to assess whether serum PTX3 in women with PE is associated with adverse arterial effects; a thicker intima and higher intima/media (I/M) ratio in the common carotid artery (CCA).METHODS: Serum PTX3 levels were measured using commercially available enzyme-linked immunosorbent assay kits, and individual CCA intima and media thicknesses were estimated by 22MHz non-invasive ultrasound in 55 women at PE diagnosis and 64 women with normal pregnancies at a similar gestational age, and about one year postpartum. A thick intima, thin media and high I/M ratio indicate a less healthy artery wall.RESULTS: During pregnancy serum PTX3 correlated positively with intima thickness and I/M ratio but negatively with media thickness (all p<0.0001), indicating adverse arterial effects. About one year postpartum, PTX3 levels had decreased in both groups and there remained no significant group difference or significant correlation with CCA wall layers.CONCLUSIONS: Higher levels of serum PTX3 in women with PE were significantly associated with signs of adverse arterial effects during pregnancy, but not one year postpartum, supporting the rapid dynamics of PTX3.
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| 9. |
- Alehagen, Urban, et al.
(författare)
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Cardiovascular mortality and N-terminal-proBNP reduced after combined selenium and coenzyme Q10 supplementation : a 5-year prospective randomized double-blind placebo-controlled trial among elderly Swedish citizens
- 2013
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Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754. ; 167:5, s. 1860-1866
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundSelenium and coenzyme Q10 are essential for the cell. Low cardiac contents of selenium and coenzyme Q10 have been shown in patients with cardiomyopathy, but inconsistent results are published on the effect of supplementation of the two components separately. A vital relationship exists between the two substances to obtain optimal function of the cell. However, reports on combined supplements are lacking.MethodsA 5-year prospective randomized double-blind placebo-controlled trial among Swedish citizens aged 70 to 88 was performed in 443 participants given combined supplementation of selenium and coenzyme Q10 or a placebo. Clinical examinations, echocardiography and biomarker measurements were performed. Participants were monitored every 6th month throughout the intervention.The cardiac biomarker N-terminal proBNP (NT-proBNP) and echocardiographic changes were monitored and mortalities were registered. End-points of mortality were evaluated by Kaplan–Meier plots and Cox proportional hazard ratios were adjusted for potential confounding factors. Intention-to-treat and per-protocol analyses were applied.ResultsDuring a follow up time of 5.2 years a significant reduction of cardiovascular mortality was found in the active treatment group vs. the placebo group (5.9% vs. 12.6%; P = 0.015). NT-proBNP levels were significantly lower in the active group compared with the placebo group (mean values: 214 ng/L vs. 302 ng/L at 48 months; P = 0.014). In echocardiography a significant better cardiac function score was found in the active supplementation compared to the placebo group (P = 0.03).ConclusionLong-term supplementation of selenium/coenzyme Q10 reduces cardiovascular mortality. The positive effects could also be seen in NT-proBNP levels and on echocardiography.
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