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LIBRIS Formathandbok  (Information om MARC21)
FältnamnIndikatorerMetadata
00004726naa a2200481 4500
001oai:DiVA.org:uu-262954
003SwePub
008150923s2015 | |||||||||||000 ||eng|
0247 a https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-2629542 URI
0247 a https://doi.org/10.1161/CIRCULATIONAHA.114.0132432 DOI
040 a (SwePub)uu
041 a engb eng
042 9 SwePub
072 7a ref2 swepub-contenttype
072 7a art2 swepub-publicationtype
1001 a Bekwelem, Wobou Univ Minnesota, Sch Med, Lillehei Heart Inst, Minneapolis, MN 55455 USA.;Univ Minnesota, Sch Med, Div Cardiovasc, Minneapolis, MN 55455 USA.4 aut
2451 0a Extracranial Systemic Embolic Events in Patients With Nonvalvular Atrial Fibrillation Incidence, Risk Factors, and Outcomes
264 1c 2015
338 a print2 rdacarrier
520 a Background Nonvalvular atrial fibrillation is a major cause of thromboembolic events. In comparison with atrial fibrillation-related stroke, extracranial systemic embolic events (SEEs) remain poorly defined. Methods and Results All suspected SEEs reported among 37973 participants of 4 large contemporary randomized clinical trials of anticoagulation in atrial fibrillation were independently readjudicated for clinical and objective evidence of sudden loss of perfusion of a limb or organ. Over 91746 patient-years of follow-up, 221 SEEs occurred in 219 subjects. The SEE incidence was 0.24 of 100 and stroke incidence was 1.92 of 100 patient-years. In comparison with patients with stroke, those with SEE were more often female (56% versus 47%; P=0.01) and had comparable mean age (73.18.5 versus 73.5 +/- 8.8 years; P=0.57) and mean CHADS(2) scores (2.4 +/- 1.3 versus 2.5 +/- 1.2; P=0.33). SEEs more frequently involved the lower extremity (58%) than visceral-mesenteric (31%) or upper extremity (10%). SEE-related care involved clinic assessment alone in 5%, 30% were hospitalized without procedures, 60% underwent endovascular or surgical intervention, and 5% underwent amputation. Within 30 days, 54% of patients recovered fully, 20% survived with deficits, and 25% died. Thirty-day mortality was greater after visceral-mesenteric than lower- or upper-extremity SEE (55%, 17%, and 9%, respectively, P0.0001). The relative risk of death throughout follow-up was 4.33 (95% confidence interval, 3.29-5.70) after SEE versus 6.79 (95% confidence interval, 6.22-7.41) after stroke in comparison with patients without either event. Conclusions SEE constituted 11.5% of clinically recognized thromboembolic events in patients with atrial fibrillation and was associated with high morbidity and mortality. SEE mortality was comparable to that of ischemic stroke and varied by anatomic site.
650 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Kardiologi0 (SwePub)302062 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Cardiac and Cardiovascular Systems0 (SwePub)302062 hsv//eng
653 a arrhythmias
653 a cardiac
653 a atrial fibrillation
653 a embolism
653 a peripheral artery disease
653 a risk factors
7001 a Connolly, Stuart J.u McMaster Univ, Dept Med, Hamilton, ON, Canada.4 aut
7001 a Halperin, Jonathan L.u Mt Sinai Sch Med, New York, NY USA.4 aut
7001 a Adabag, Selcuku Minneapolis Vet Adm Med Ctr, Div Cardiol, Minneapolis, MN USA.4 aut
7001 a Duval, Sueu Univ Minnesota, Sch Med, Lillehei Heart Inst, Minneapolis, MN 55455 USA.;Univ Minnesota, Sch Med, Div Cardiovasc, Minneapolis, MN 55455 USA.4 aut
7001 a Chrolavicius, Susanu McMaster Univ, Dept Med, Hamilton, ON, Canada.4 aut
7001 a Pogue, Janiceu McMaster Univ, Dept Med, Hamilton, ON, Canada.4 aut
7001 a Ezekowitz, Michael D.u Lankenau Inst Med Res, Wynnewood, PA USA.4 aut
7001 a Eikelboom, John W.u McMaster Univ, Dept Med, Hamilton, ON, Canada.4 aut
7001 a Wallentin, Larsu Uppsala universitet,Uppsala kliniska forskningscentrum (UCR)4 aut0 (Swepub:uu)larswall
7001 a Yusuf, Salimu McMaster Univ, Dept Med, Hamilton, ON, Canada.4 aut
7001 a Hirsch, Alan T.u Univ Minnesota, Sch Med, Lillehei Heart Inst, Minneapolis, MN 55455 USA.;Univ Minnesota, Sch Med, Div Cardiovasc, Minneapolis, MN 55455 USA.4 aut
7102 a Univ Minnesota, Sch Med, Lillehei Heart Inst, Minneapolis, MN 55455 USA.;Univ Minnesota, Sch Med, Div Cardiovasc, Minneapolis, MN 55455 USA.b McMaster Univ, Dept Med, Hamilton, ON, Canada.4 org
7730 t Circulationg 132:9, s. 796-803q 132:9<796-803x 0009-7322x 1524-4539
8564 8u https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-262954
8564 8u https://doi.org/10.1161/CIRCULATIONAHA.114.013243

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