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- Hagnelius, Nils-Olof, 1953-, et al.
(författare)
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Fibrinolysis and von Willebrand factor in Alzheimer's disease and vascular dementia : a case-referent study
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: The importance of vascular risk factors for Alzheimer’s disease (AD) is not settled. Our aim was to compare patients with AD or vascular dementia (VaD) with non-demented subjects with regard to endothelial derived fibrinolytic and hemostatic factors.Materials and methods: In a cross-sectional mono-center case-referent study in Örebro, Sweden, we consecutively included 95 patients with AD and 55 with VaD and 154 non-demented active seniors (AS). Plasma biomarkers including the endothelial derived fibrinolytic factors: mass concentrations of tissue plasminogen activator (tPA), plasminogen activator inhibitor-1 (PAI-1), tPA/PAI-1 complex and von Willebrand factor (vWF), as well as clinical data were analyzed.Results: None of the endothelial derived fibrinolytic markers or vWF differed between AD vs. VaD. In comparison with the AS group, tPA was higher in AD (p=0.001) and VaD (p=0.023) but its inhibitor, PAI-1 mass concentration did not differ significantly; tPA/PAI-1 complex was higher in both VaD (p=0.038) and AD (p=0.005). vWF concentration was lower in the AS group (p<0.001) than in both dementia groups.Conclusion: Thus, endothelial derived fibrinolytic factors, tPA/PAI-1 complex and vWF, discriminated between the reference group of non-demented elderly and the AD and VaD groups, but not between AD and VaD. This suggests similar disturbances for endothelial derived fibrinolytic and hemostatic factors among AD and VaD patients and may reflect shared vascular pathophysiological mechanisms in the dementias.
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- Karlström, Patric, et al.
(författare)
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Time since heart failure diagnosis influences outcomes more than age when handling heart failure patients : Results from the UPSTEP study
- 2016
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Background: Heart failure (HF) is a life-threatening condition and optimal handling is necessary to reduce risk of therapy failure.Objectives: The aims of this study were (I) to evaluate the impact of patient age on clinical outcomes, (II) to evaluate the impact of duration of the HF disease on outcomes, and (III) to evaluate the impact of age and HF duration on B-type Natriuretic Peptide (BNP) concentration.Methods and Results: With data from the UPSTEP (Use of PeptideS in Tailoring hEart failure Project) study we retrospectively evaluated how age and HF duration affected HF outcome. HF duration was divided into <1 year (group 1), 1-5 years (group 2) and >5 years (group 3). The multivariate Cox proportional hazard regression analysis showed that HF duration influenced outcome more than age, even when adjusted for comorbidities(<1 year versus >5 years: HR 1.65; 95 % CI 1.28-2.14; p <0.0002) on HF mortality and hospitalizations. The influence of age on BNP showed increased BNP as age increased. However, there was a significant effect on BNP concentration comparing HF duration of < one year to HF duration >five years even when adjusted for age.Conclusions: Patients with longer HF duration had significantly worse outcome compared to those with short duration, even when adjusted for patient age and comorbidities. Age itself did not influence outcome in this evaluation. Age had impact on BNP concentration; however BNP concentration increased as HF duration increased even when adjusted for age.
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