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- Herlitz, Johan, 1949, et al.
(author)
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Rate of admission and long-term prognosis among patients with acute chest pain in the 1990s compared with the 1980s
- 2005
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In: Cardiology. - : S. Karger AG. - 0008-6312 .- 1421-9751. ; 104:1, s. 51-6
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Journal article (peer-reviewed)abstract
- We describe the incidence of acute chest pain (requiring admission to the emergency department) and the prognosis during two time periods in all patients admitted to the emergency department at Sahlgrenska University Hospital in Goteborg, Sweden, with acute chest pain 1986 and 1987 (period 1) and 1996 and 1997 (period 2). The rate of admission for chest pain/100,000 inhabitants was 4.7/day during period 1 and 5.0/day during period 2. The risk ratio for death adjusted for eight risk factors during period 2 in relation to period 1 was 0.88 (95% CI 0.79-0.97). There was a significant interaction between time period and the severity of the final diagnosis (p=0.02), indicating a greater reduction in mortality among patients with acute myocardial infarction.
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| 3. |
- Libungan, Berglind, et al.
(author)
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Secondary prevention in coronary artery disease. Achieved goals and possibilities for improvements.
- 2012
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In: International journal of cardiology. - : Elsevier BV. - 1874-1754 .- 0167-5273. ; 161:1, s. 18-24
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Journal article (peer-reviewed)abstract
- AIM: To describe presence of risk indicators of recurrence 6months after hospitalisation due to coronary artery disease at a university clinic. METHODS: The presence of risk indicators, including tobacco use, lipid levels, blood pressure and glucometabolic status, including 24-hour blood pressure monitoring and an oral glucose-tolerance test, was analysed. RESULTS: Of 1465 patients who were screened, 402 took part in the survey (50% previous myocardial infarction and 50% angina pectoris). Mean age was 64years (range 40-85years) and 23% were women. Present medications were: lipid lowering drugs (statins; 94%), beta-blockers (85%), aspirin or warfarin (100%) and ACE-inhibitors or angiotensin II blockers (66%). Values above target levels recommended in guidelines were: a) low density lipoprotein (LDL) in 40%; b) mean blood pressure (day or night) in 38% and c) smoking in 13%. Of all patients, 66% had at least one risk factor (LDL or blood pressure above target levels or current smoking). An abnormal glucose-tolerance test was found in 59% of patients without known diabetes. If no history of diabetes, 85% had either LDL or blood pressure above target levels, current smoking or an abnormal glucose-tolerance test. However, with treatment intensification to patients with elevated risk factors 56% reached target levels for blood pressure and 79% reached target levels for LDL. CONCLUSION: Six months after hospitalisation due to coronary artery disease, despite the high use of medication aimed at prophylaxis against recurrence, the majority were either above target levels for LDL or blood pressure or continued to smoke.
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| 4. |
- Sjöland, Helen, 1959, et al.
(author)
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Lack of very strong association between pre-treatment fibrinogen and PAI-1 with long-term mortality after coronary bypass surgery
- 2007
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In: Cardiology. - : S. Karger AG. - 1421-9751 .- 0008-6312. ; 108:2, s. 82-89
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Journal article (peer-reviewed)abstract
- Aim: To explore the association between the coagulation protein fibrinogen and the fibrinolytic biomarker plasminogen activator inhibitor-1 ( PAI- 1) and the long- term mortality after coronary artery bypass grafting ( CABG). Patients and Methods: In 729 patients undergoing CABG at Sahlgrenska University Hospital, a blood sample for fibrinogen and PAI-1 was collected prior to the procedure. Patients were followed for 10 years. Results: Among patients with high levels of fibrinogen (> 3.6 g/ l; median), the 10-year mortality was 32.3 vs. 20.7% among patients with fibrinogen levels below the median ( p = 0.0005). However, patients with higher levels of fibrinogen were older and had an adverse risk factor pattern. When adjusting for these differences, pre- operative fibrinogen levels did not clearly appear as an independent predictor of long- term mortality. The 10- year mortality was similar in patients with high ( 25.3%) and low ( 26.5%) levels of PAI-1. Conclusion: Our results do not suggest that fibrinogen and PAI- 1, when evaluated prior to the operative procedure, arestrongly associated with increased mortality in the longterm after CABG, when other co-morbidity factors are simultaneously considered.
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