Sök i SwePub databas

  Utökad sökning

Träfflista för sökning "WFRF:(Jernberg T) "

Sökning: WFRF:(Jernberg T)

Sortera/gruppera träfflistan
  • Neumann, J. T., et al. (författare)
  • Application of High-Sensitivity Troponin in Suspected Myocardial Infarction
  • 2019
  • Ingår i: New England Journal of Medicine. - : MASSACHUSETTS MEDICAL SOC. - 0028-4793 .- 1533-4406. ; 380:26, s. 2529-2540
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundData regarding high-sensitivity troponin concentrations in patients presenting to the emergency department with symptoms suggestive of myocardial infarction may be useful in determining the probability of myocardial infarction and subsequent 30-day outcomes. MethodsIn 15 international cohorts of patients presenting to the emergency department with symptoms suggestive of myocardial infarction, we determined the concentrations of high-sensitivity troponin I or high-sensitivity troponin T at presentation and after early or late serial sampling. The diagnostic and prognostic performance of multiple high-sensitivity troponin cutoff combinations was assessed with the use of a derivation-validation design. A risk-assessment tool that was based on these data was developed to estimate the risk of index myocardial infarction and of subsequent myocardial infarction or death at 30 days. ResultsAmong 22,651 patients (9604 in the derivation data set and 13,047 in the validation data set), the prevalence of myocardial infarction was 15.3%. Lower high-sensitivity troponin concentrations at presentation and smaller absolute changes during serial sampling were associated with a lower likelihood of myocardial infarction and a lower short-term risk of cardiovascular events. For example, high-sensitivity troponin I concentrations of less than 6 ng per liter and an absolute change of less than 4 ng per liter after 45 to 120 minutes (early serial sampling) resulted in a negative predictive value of 99.5% for myocardial infarction, with an associated 30-day risk of subsequent myocardial infarction or death of 0.2%; a total of 56.5% of the patients would be classified as being at low risk. These findings were confirmed in an external validation data set. ConclusionsA risk-assessment tool, which we developed to integrate the high-sensitivity troponin I or troponin T concentration at emergency department presentation, its dynamic change during serial sampling, and the time between the obtaining of samples, was used to estimate the probability of myocardial infarction on emergency department presentation and 30-day outcomes.
  • Gudmundsson, T., et al. (författare)
  • Does the quality index of adherence to the evidence-based guidelines predict mortality in patients with myocardial infarction?
  • 2022
  • Ingår i: European Heart Journal. - : Oxford University Press. - 0195-668X .- 1522-9645. ; 43:Suppl. 2, s. 2282-2282
  • Tidskriftsartikel (övrigt vetenskapligt)abstract
    • Background: The SWEDEHEART quality index of hospitals’ adherence to the evidence-based (EB) guidelines for myocardial infarction (MI) patients has been continuously used for several decades in Sweden. The grading protocol is based on the consensus among hospitals. The hospitals are awarded points (0, 0.5, 1) for each of the 11 indicators depending on the proportion of patients who received EB treatment and achieved treatment goals. The 11 indicators at present are reperfusion treatment in STEMI (yes/no), time to-reperfusion treatment in STEMI, time to revascularisation in NSTEMI, P2Y12 antagonists at discharge, ACE-inhibitor/ARB at discharge, the proportion of patients at follow-up, smoking cessation at one-year, participation in a physical exercise program, target LDL-cholesteroland target blood pressure at one year.Purpose: To evaluate whether the SWEDEHEART quality index predicts mortality in patients with MI.Methods: We used data for all MI patients reported to the SWEDEHEAR Tregistry from 72 hospitals in Sweden between 2015–2021. We calculated the difference in quality index between 2021 and 2015. The hospitals were divided into quintiles based on the difference in the score. Logistic regression with log-time offset was used to adjust for confounders (age, gender, diabetes, hypertension, hyperlipidemia, STEMI/NSTEMI, cardiac arrest before admission, occupation status, history of heart failure, prior MI, prior PCI, prior CABG, cardiogenic shock).Results: We identified 98,635 patients with MI, 32,608 (33.1%) were women and 34,198 (34.7%) had STEMI. The average age was 70.8±12.2 years. The median follow-up time was 2.7 years (IQR 1.06–4.63). The crude all-cause mortality rate was 5.5% at 30-days and 22.3% after long-term follow-up. Most hospitals (72.1%) improved their quality index on average by 3.4% per year (P<0.001). The increase in the quality index continued during COVID-19 pandemic (2020–2021) with average increase of 8.6%, 95% CI, 0.97–1.02; P<0.001. The median change in SWEDE-HEART quality index score among the quintiles were −1.5 (Q1), 0,5 (Q2), 2,5 (Q3), 3 (Q4), and 4 (Q5). We found no difference in mortality between the quintiles at 30-days (OR 0.99; 95% CI 0.97–1.02; p=1.02) and long-term (OR 1.01; 95% CI 0,99–1.02; p=0.850).Conclusion: The SWEDEHEART quality index provides valuable descriptive information about hospitals’ adherence to the guidelines. However, the index, in its current form, does not predict mortality in patients with MI.
  • Kristensen, AMD, et al. (författare)
  • Design and rationale of the Danish trial of beta-blocker treatment after myocardial infarction without reduced ejection fraction: study protocol for a randomized controlled trial
  • 2020
  • Ingår i: Trials. - : Springer Science and Business Media LLC. - 1745-6215. ; 21:1, s. 415-
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundTreatment with beta-blockers is currently recommended after myocardial infarction (MI). The evidence relies on trials conducted decades ago before implementation of revascularization and contemporary medical therapy or in trials enrolling patients with heart failure or reduced left ventricular ejection fraction (LVEF ≤ 40%). Accordingly, the impact of beta-blockers on mortality and morbidity following acute MI in patients without reduced LVEF or heart failure is unclear.Methods/designThe Danish trial of beta-blocker treatment after myocardial infarction without reduced ejection fraction (DANBLOCK) is a prospective, randomized, controlled, open-label, non-blinded endpoint clinical trial designed to evaluate the efficacy of beta-blocker treatment in post-MI patients in the absence of reduced LVEF or heart failure. We will randomize 3570 patients will be randomized within 14 days of index MI to beta-blocker or control for a minimum of 2 years. The primary endpoint is a composite of all-cause mortality, recurrent MI, acute decompensated heart failure, unstable angina pectoris, or stroke. The primary composite endpoint will be assessed through locally reported and adjudicated endpoints supplemented by linkage to the Danish national registers. A number of secondary endpoints will be investigated including patient reported outcomes and cardiovascular mortality. Data from similar ongoing trials in Norway and Sweden will be pooled to perform an individual patient data meta-analysis.DiscussionDANBLOCK is a randomized clinical trial investigating the effect of long-term beta-blocker therapy after myocardial infarction in patients without heart failure and reduced LVEF. Results from the trial will add important scientific evidence to inform future clinical guidelines.Trial registrationClinicaltrials.gov,NCT03778554. Registered on 19 December 2018.European Clinical Trials Database,2018-002699-42, registered on 28 September 2018.
  • Lindahl, Bertil, 1957-, et al. (författare)
  • Poor long-term prognosis in patients admitted with strong suspicion of acute myocardial infarction but discharged with another diagnosis
  • 2021
  • Ingår i: Journal of Internal Medicine. - : Wiley-Blackwell. - 0954-6820 .- 1365-2796. ; 290:2, s. 359-372
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Characteristics and prognosis of patients admitted with strong suspicion of myocardial infarction (MI) but discharged without an MI diagnosis are not well-described. Objectives: To compare background characteristics and cardiovascular outcomes in patients discharged with or without MI diagnosis. Methods: The DETermination of the role of Oxygen in suspected Acute Myocardial Infarction (DETO2X-AMI) trial compared 6629 patients with strong suspicion of MI randomized to oxygen or ambient air. The main composite end-point of this subgroup analysis was the incidence of all-cause death, rehospitalization with MI, heart failure (HF) or stroke during a follow-up of 2.1 years (median; range: 1–3.7 years) irrespective of randomized treatment. Results: 1619 (24%) received a non-MI discharge diagnosis, and 5010 patients (76%) were diagnosed with MI. Groups were similar in age, but non-MI patients were more commonly female and had more comorbidities. At thirty days, the incidence of the composite end-point was 2.8% (45 of 1619) in non-MI patients, compared to 5.0% (250 of 5010) in MI patients with lower incidences in all individual end-points. However, for the long-term follow-up, the incidence of the composite end-point increased in the non-MI patients to 17.7% (286 of 1619) as compared to 16.0% (804 of 5010) in MI patients, mainly driven by a higher incidence of all-cause death, stroke and HF. Conclusions: Patients admitted with a strong suspicion of MI but discharged with another diagnosis had more favourable outcomes in the short-term perspective, but from one year onwards, cardiovascular outcomes and death deteriorated to a worse long-term prognosis.
Skapa referenser, mejla, bekava och länka
Typ av publikation
tidskriftsartikel (142)
konferensbidrag (93)
forskningsöversikt (1)
recension (1)
Typ av innehåll
övrigt vetenskapligt (124)
refereegranskat (113)
Jernberg, T (223)
Szummer, K. (36)
Erlinge, D. (33)
Lindahl, B (31)
Carrero, JJ (27)
Spaak, J. (24)
visa fler...
Tornvall, P (19)
Wallentin, L (18)
Hambraeus, K. (18)
Evans, M. (17)
James, S. (16)
Svensson, P (16)
Lindahl, Bertil (16)
Hofman-Bang, C (15)
Lindahl, Bertil, 195 ... (15)
Lundman, P (13)
Baron, Tomasz (13)
Frick, M (12)
Agewall, S (11)
Persson, H (10)
Alfredsson, J (10)
Ueda, P (10)
Hemingway, H (10)
Hofmann, R. (9)
Omerovic, E. (9)
Edfors, R (9)
Gabrielsen, A (8)
Lund, LH (8)
Persson, J. (8)
Linder, R. (8)
Discacciati, A (8)
Ljung, L (8)
Trevisan, M (8)
Erlinge, David (7)
Fröbert, Ole, 1964- (7)
Hall, M. (7)
Hagstrom, E (7)
Sundstrom, J (7)
Askling, J (7)
Timmis, A (7)
Jacobson, SH (6)
James, Stefan, 1964- (6)
Gale, CP (6)
Sundström, Johan (6)
Andell, P. (6)
Lagerqvist, B. (6)
Baron, T (6)
Ravn-Fischer, A (6)
Desta, L (6)
Lofman, I (6)
visa färre...
Karolinska Institutet (182)
Uppsala universitet (48)
Göteborgs universitet (25)
Örebro universitet (13)
Lunds universitet (10)
Umeå universitet (9)
visa fler...
Högskolan i Borås (3)
Kungliga Tekniska Högskolan (2)
Stockholms universitet (1)
Mittuniversitetet (1)
RISE (1)
visa färre...
Engelska (237)
Forskningsämne (UKÄ/SCB)
Medicin och hälsovetenskap (60)
Naturvetenskap (2)
Teknik (1)
Samhällsvetenskap (1)


Kungliga biblioteket hanterar dina personuppgifter i enlighet med EU:s dataskyddsförordning (2018), GDPR. Läs mer om hur det funkar här.
Så här hanterar KB dina uppgifter vid användning av denna tjänst.

pil uppåt Stäng

Kopiera och spara länken för att återkomma till aktuell vy