| 1. |
- Christiansen, Mia N., et al.
(author)
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Age-specific Trends in Incidence, Mortality and Comorbidities of Heart Failure in Denmark 1995-2012
- 2017
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In: Circulation. - 0009-7322. ; 135:13, s. 1214-1223
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Journal article (peer-reviewed)abstract
- BACKGROUND—: The cumulative burden and importance of cardiovascular risk factors have changed over the last decades. Specifically, obesity rates have increased among younger people, whereas cardiovascular health has improved in the elderly. Little is known regarding how these changes have impacted the incidence and the mortality rates of heart failure. Therefore, we aimed to investigate the age-specific trends in the incidence and 1-year mortality rates following a first time diagnosis of heart failure in Denmark between 1995 and 2012. METHODS—: We included all Danish individuals over the age of 18 years with a first-time in-hospital diagnosis of heart failure. Data was collected from 3 nationwide Danish registries. Annual incidence rates of heart failure and 1-year standardized mortality rates were calculated under the assumption of a Poisson distribution. RESULTS—: We identified 210,430 individuals with a first-time diagnosis of heart failure between 1995 and 2012; the annual incidence rates per 10,000 person-years declined among older individuals (rates in 1995 vs. 2012: 164 vs. 115 in >74 years, 63 vs. 35 in 65-74 years, and 20 vs. 17 in 55-64 years, p<0.0001 for all) but increased among the younger (0.4 vs. 0.7 in 18-34 years, 1.3 vs. 2.0 in 35-44 years, and 5.0 vs. 6.4 in 45-54 years, p<0.0001 for all). The proportion of patients with incident heart failure below 51 years doubled from 3% in 1995 to 6% in 2012 (p<0.0001). Sex- and age-adjusted incidence rate ratios for 2012 vs. 1996 were 0.69 (95%CI 0.67-0.71; p <0.0001) among people >50 years, and 1.52 (95%CI 1.33-1.73; p<0.0001) among individuals ≤50 years; it remained essentially unchanged upon additional adjustment for diabetes, ischemic heart disease, and hypertension. Standardized 1-year mortality rates declined for middle-aged patients with heart failure but remained constant for younger (<45 years) and elderly (≥65 years). The prevalence of comorbidities (including diabetes, hypertension, and atrial fibrillation) increased, especially in younger patients with heart failure. CONCLUSIONS—: Over the last two decades, the incidence of heart failure in Denmark declined among older (>50 years), but increased among younger (≤50 years) individuals. These observations may portend a rising burden of heart failure in the community.
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| 2. |
- Hodges, Gethin W., et al.
(author)
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SuPAR Predicts Cardiovascular Events and Mortality in Patients With Asymptomatic Aortic Stenosis
- 2016
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In: Canadian Journal of Cardiology. - : Elsevier. - 0828-282X .- 1916-7075. ; 32:12, s. 1462-1469
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Journal article (peer-reviewed)abstract
- Background: Soluble urokinase plasminogen activator receptor (suPAR) is an inflammatory marker associated with subclinical cardiovascular damage and cardiovascular events. Whether suPAR is of prognostic value in asymptomatic patients with aortic stenosis (AS) remains unknown. Methods: Plasma suPAR levels were measured in 1503 patients with a mean age of 68 years who were recruited in the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) study. Cox regression analysis was performed to evaluate associations between suPAR and the composite end points of ischemic cardiovascular events (ICEs), aortic valve events (AVEs), cardiovascular and all-cause mortality after adjusting for traditional cardiovascular risk factors, and allocation to treatment. Results: The multivariate adjusted hazard ratio (HR) (95% confidence interval [CI]) per unit log2 ng/mL increase in suPAR was HR, 1.5; 95% CI, 1.2-1.9; P = 0.002 for ICEs; HR, 1.2; 95% CI, 0.9-1.5; P = 0.071) for AVEs; HR, 2.0; 95% CI, 1.2-3.3; P = 0.007) for cardiovascular mortality, and HR, 2.0; 95% CI, 1.4-2.9; P < 0.001 for all-cause mortality. Conclusions: In patients with mild-moderate AS, suPAR is independently associated with the incidence of ICEs, cardiovascular mortality, and all-cause mortality.
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| 3. |
- Hodges, Gethin W., et al.
(author)
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SuPAR predicts postoperative complications and mortality in patients with asymptomatic aortic stenosis
- 2018
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In: Open heart. - : BMJ Publishing Group Ltd. - 2053-3624. ; 5:1
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Journal article (peer-reviewed)abstract
- Background We evaluated whether early measurement of soluble urokinase plasminogen activator receptor (suPAR) could predict future risk of postoperative complications in initially asymptomatic patients with mild-moderate aortic stenosis (AS) undergoing aortic valve replacement (AVR) surgery.Methods Baseline plasma suPAR levels were available in 411 patients who underwent AVR surgery during in the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) study. Cox analyses were used to evaluate suPAR in relation to all-cause mortality and the composite endpoint of postoperative complications (all-cause mortality, congestive heart failure, stroke and renal impairment) occurring in the 30-day postoperative period.Results Patients with initially higher levels of suPAR were at increased risk of postoperative mortality with a HR of 3.5 (95% CI 1.4 to 9.0, P=0.008) and postoperative complications with a HR of 2.7 (95% CI 1.5 to 5.1, P=0.002), per doubling in suPAR. After adjusting for the European System for Cardiac Operative Risk Evaluation or Society of Thoracic Surgeons risk score, suPAR remained associated with postoperative mortality with a HR 3.2 (95% CI 1.2 to 8.6, P=0.025) and 2.7 (95% CI 1.0 to 7.8, P=0.061); and postoperative complications with a HR of 2.5 (95% CI 1.3 to 5.0, P=0.007) and 2.4 (95% CI 1.2 to 4.8, P=0.011), respectively.Conclusion Higher baseline suPAR levels are associated with an increased risk for postoperative complications and mortality in patients with mild-moderate, asymptomatic AS undergoing later AVR surgery. Further validation in other subsets of AS individuals are warranted.
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| 4. |
- Sollie, Ove, et al.
(author)
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Protein intake in the early recovery period after exhaustive exercise improves performance the following day.
- 2018
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In: Journal of applied physiology. - : American Physiological Society. - 8750-7587 .- 1522-1601. ; 125:6, s. 1731-1742
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Journal article (peer-reviewed)abstract
- The aim of the present study was to investigate the effect of protein and carbohydrate ingestion during early recovery from exhaustive exercise on performance after 18 h recovery. Eight elite cyclists (VO2max 74.0±1.6 ml∙kg-1∙min-1) completed two exercise and diet interventions in a double-blinded, randomized, crossover design. Participants cycled first at 73% of VO2max (W73%) followed by one-min intervals at 90% of VO2max until exhaustion. During the first two hours of recovery, participants ingested either 1.2 g carbohydrate∙kg-1∙h-1 (CHO) or 0.8 g carbohydrate + 0.4 g protein∙kg-1∙h-1 (CHO+PROT). The diet during the remaining recovery period was similar for both interventions and adjusted to body weight. After an 18 h recovery, cycling performance was assessed with a 10 s sprint test, 30 min of cycling at W73%, and a cycling time trial (TT). The TT was 8.5% faster (41:53±1:51 min vs 45:26±1:32 min; p<0.03) after CHO+PROT compared to CHO. Mean power output during the sprints was 3.7% higher in CHO-PROT compared to CHO (1063±54 W vs 1026±53 W; p<0.01). Nitrogen balance in the recovery period was negative in CHO and neutral in CHO+PROT (-82.4±11.5 vs 7.0±15.4 mg∙kg-1; p<0.01).IN CONCLUSION: TT and sprint performances were improved 18 h after exhaustive cycling by CHO-PROT supplementation during the first two hours of recovery compared with isoenergetic CHO supplementation. Our results indicate that intake of carbohydrate plus protein after exhaustive endurance exercise more rapidly converts the body from a catabolic to an anabolic state than carbohydrate alone, thus speeding recovery and improving subsequent cycling performance.
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