98 results on '"Martinsson, Andreas"'
Search Results
52. Association of FADS1/2 Locus Variants and Polyunsaturated Fatty Acids With Aortic Stenosis
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Chen, Hao Yu, Cairns, Benjamin J., Small, Aeron M., Burr, Hannah A., Ambikkumar, Athithan, Martinsson, Andreas, Thériault, Sébastien, Munter, Hans Markus, Steffen, Brian, Zhang, Richard, Levinson, Rebecca T., Shaffer, Christian M., Rong, Jian, Sonestedt, Emily, Dufresne, Line, Ljungberg, Johan, Näslund, Ulf, Johansson, Bengt, Ranatunga, Dilrini K., Whitmer, Rachel A., Budoff, Matthew J., Nguyen, Albert, Vasan, Ramachandran S., Larson, Martin G., Harris, William S., Damrauer, Scott M., Stark, Ken D., Boekholdt, S. Matthijs, Wareham, Nicholas J., Pibarot, Philippe, Arsenault, Benoit J., Mathieu, Patrick, Gudnason, Vilmundur, O'Donnell, Christopher J., Rotter, Jerome I., Tsai, Michael Y., Post, Wendy S., Clarke, Robert, Söderberg, Stefan, Bossé, Yohan, Wells, Quinn S., Smith, J. Gustav, Rader, Daniel J., Lathrop, Mark, Engert, James C., Thanassoulis, George, Chen, Hao Yu, Cairns, Benjamin J., Small, Aeron M., Burr, Hannah A., Ambikkumar, Athithan, Martinsson, Andreas, Thériault, Sébastien, Munter, Hans Markus, Steffen, Brian, Zhang, Richard, Levinson, Rebecca T., Shaffer, Christian M., Rong, Jian, Sonestedt, Emily, Dufresne, Line, Ljungberg, Johan, Näslund, Ulf, Johansson, Bengt, Ranatunga, Dilrini K., Whitmer, Rachel A., Budoff, Matthew J., Nguyen, Albert, Vasan, Ramachandran S., Larson, Martin G., Harris, William S., Damrauer, Scott M., Stark, Ken D., Boekholdt, S. Matthijs, Wareham, Nicholas J., Pibarot, Philippe, Arsenault, Benoit J., Mathieu, Patrick, Gudnason, Vilmundur, O'Donnell, Christopher J., Rotter, Jerome I., Tsai, Michael Y., Post, Wendy S., Clarke, Robert, Söderberg, Stefan, Bossé, Yohan, Wells, Quinn S., Smith, J. Gustav, Rader, Daniel J., Lathrop, Mark, Engert, James C., and Thanassoulis, George more...
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Importance: Aortic stenosis (AS) has no approved medical treatment. Identifying etiological pathways for AS could identify pharmacological targets. Objective: To identify novel genetic loci and pathways associated with AS. Design, Setting, and Participants: This genome-wide association study used a case-control design to evaluate 44 703 participants (3469 cases of AS) of self-reported European ancestry from the Genetic Epidemiology Research on Adult Health and Aging (GERA) cohort (from January 1, 1996, to December 31, 2015). Replication was performed in 7 other cohorts totaling 256 926 participants (5926 cases of AS), with additional analyses performed in 6942 participants from the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium. Follow-up biomarker analyses with aortic valve calcium (AVC) were also performed. Data were analyzed from May 1, 2017, to December 5, 2019. Exposures: Genetic variants (615 643 variants) and polyunsaturated fatty acids (ω-6 and ω-3) measured in blood samples. Main Outcomes and Measures: Aortic stenosis and aortic valve replacement defined by electronic health records, surgical records, or echocardiography and the presence of AVC measured by computed tomography. Results: The mean (SD) age of the 44 703 GERA participants was 69.7 (8.4) years, and 22 019 (49.3%) were men. The rs174547 variant at the FADS1/2 locus was associated with AS (odds ratio [OR] per C allele, 0.88; 95% CI, 0.83-0.93; P = 3.0 × 10-6), with genome-wide significance after meta-analysis with 7 replication cohorts totaling 312 118 individuals (9395 cases of AS) (OR, 0.91; 95% CI, 0.88-0.94; P = 2.5 × 10-8). A consistent association with AVC was also observed (OR, 0.91; 95% CI, 0.83-0.99; P = .03). A higher ratio of arachidonic acid to linoleic acid was associated with AVC (OR per SD of the natural logarithm, 1.19; 95% CI, 1.09-1.30; P = 6.6 × 10-5). In mendelian randomization, increased FADS1 liver expression and arachidonic acid were associa more...
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- 2020
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53. Lipoprotein-associated phospholipase A2 activity, genetics and calcific aortic valve stenosis in humans
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Perrot, Nicolas, Thériault, Sébastien, Rigade, Sidwell, Chen, Hao Yu, Dina, Christian, Martinsson, Andreas, Boekholdt, Matthijs, Capoulade, Romain, Le Tourneau, Thierry, Messika-Zeitoun, David, Engert, James, Wareham, Nicholas J., Clavel, Marie-Annick, Pibarot, Philippe, Smith, J. Gustav, Schott, Jean Jacques, Mathieu, Patrick, Bossé, Yohan, Thanassoulis, George, Arsenault, Benoit, Perrot, Nicolas, Thériault, Sébastien, Rigade, Sidwell, Chen, Hao Yu, Dina, Christian, Martinsson, Andreas, Boekholdt, Matthijs, Capoulade, Romain, Le Tourneau, Thierry, Messika-Zeitoun, David, Engert, James, Wareham, Nicholas J., Clavel, Marie-Annick, Pibarot, Philippe, Smith, J. Gustav, Schott, Jean Jacques, Mathieu, Patrick, Bossé, Yohan, Thanassoulis, George, and Arsenault, Benoit more...
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Background Lipoprotein-associated phospholipase A2 (Lp-PLA2) activity has been shown to predict calcific aortic valve stenosis (CAVS) outcomes. Our objective was to test the association between plasma Lp-PLA2 activity and genetically elevated Lp-PLA2 mass/activity with CAVS in humans. Methods and results Lp-PLA2 activity was measured in 890 patients undergoing cardiac surgery, including 476 patients undergoing aortic valve replacement for CAVS and 414 control patients undergoing coronary artery bypass grafting. After multivariable adjustment, Lp-PLA2 activity was positively associated with the presence of CAVS (OR=1.21 (95% CI 1.04 to 1.41) per SD increment). We selected four single nucleotide polymorphisms (SNPs) at the PLA2G7 locus associated with either Lp-PLA2 mass or activity (rs7756935, rs1421368, rs1805017 and rs4498351). Genetic association studies were performed in eight cohorts: Quebec-CAVS (1009 cases/1017 controls), UK Biobank (1350 cases/349 043 controls), European Prospective Investigation into Cancer and Nutrition-Norfolk (504 cases/20 307 controls), Genetic Epidemiology Research on Aging (3469 cases/51 723 controls), Malmö Diet and Cancer Study (682 cases/5963 controls) and three French cohorts (3123 cases/6532 controls), totalling 10 137 CAVS cases and 434 585 controls. A fixed-effect metaanalysis using the inverse-variance weighted method revealed that none of the four SNPs was associated with CAVS (OR=0.99 (95% CI 0.96 to 1.02, p=0.55) for rs7756935, 0.97 (95% CI 0.93 to 1.01, p=0.11) for rs1421368, 1.00 (95% CI 1.00 to 1.01, p=0.29) for rs1805017, and 1.00 (95% CI 0.97 to 1.04, p=0.87) for rs4498351). Conclusions Higher Lp-PLA2 activity is significantly associated with the presence of CAVS and might represent a biomarker of CAVS in patients with heart disease. Results of our genetic association study suggest that Lp-PLA2 is however unlikely to represent a causal risk factor or therapeutic target for CAVS. more...
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- 2020
54. Lipoprotein-associated phospholipase A2 activity, genetics and calcific aortic valve stenosis in humans
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Thériault, Sébastien, Arsenault, Benoit, Rigade, Sidwell, Capoulade, Romain, Chen, Hao Yu, Bossé, Yohan, Dina, Christian, Pibarot, Philippe, Martinsson, Andreas, Perrot, Nicolas, Boekholdt, Matthijs, Clavel, Marie-Annick, Mathieu, Patrick, Le Tourneau, Thierry, Messika-Zeitoun, David, Engert, James, Wareham, Nicholas J., Smith, J. Gustav, Schott, Jean Jacques, Thanassoulis, George, Thériault, Sébastien, Arsenault, Benoit, Rigade, Sidwell, Capoulade, Romain, Chen, Hao Yu, Bossé, Yohan, Dina, Christian, Pibarot, Philippe, Martinsson, Andreas, Perrot, Nicolas, Boekholdt, Matthijs, Clavel, Marie-Annick, Mathieu, Patrick, Le Tourneau, Thierry, Messika-Zeitoun, David, Engert, James, Wareham, Nicholas J., Smith, J. Gustav, Schott, Jean Jacques, and Thanassoulis, George more...
- Abstract
Background Lipoprotein-associated phospholipase A2 (Lp-PLA2) activity has been shown to predict calcific aortic valve stenosis (CAVS) outcomes. Our objective was to test the association between plasma Lp-PLA2 activity and genetically elevated Lp-PLA2 mass/activity with CAVS in humans. Methods and results Lp-PLA2 activity was measured in 890 patients undergoing cardiac surgery, including 476 patients undergoing aortic valve replacement for CAVS and 414 control patients undergoing coronary artery bypass grafting. After multivariable adjustment, Lp-PLA2 activity was positively associated with the presence of CAVS (OR=1.21 (95% CI 1.04 to 1.41) per SD increment). We selected four single nucleotide polymorphisms (SNPs) at the PLA2G7 locus associated with either Lp-PLA2 mass or activity (rs7756935, rs1421368, rs1805017 and rs4498351). Genetic association studies were performed in eight cohorts: Quebec-CAVS (1009 cases/1017 controls), UK Biobank (1350 cases/349 043 controls), European Prospective Investigation into Cancer and Nutrition-Norfolk (504 cases/20 307 controls), Genetic Epidemiology Research on Aging (3469 cases/51 723 controls), Malmö Diet and Cancer Study (682 cases/5963 controls) and three French cohorts (3123 cases/6532 controls), totalling 10 137 CAVS cases and 434 585 controls. A fixed-effect meta-analysis using the inverse-variance weighted method revealed that none of the four SNPs was associated with CAVS (OR=0.99 (95% CI 0.96 to 1.02, p=0.55) for rs7756935, 0.97 (95% CI 0.93 to 1.01, p=0.11) for rs1421368, 1.00 (95% CI 1.00 to 1.01, p=0.29) for rs1805017, and 1.00 (95% CI 0.97 to 1.04, p=0.87) for rs4498351). Conclusions Higher Lp-PLA2 activity is significantly associated with the presence of CAVS and might represent a biomarker of CAVS in patients with heart disease. Results of our genetic association study suggest that Lp-PLA2 is however unlikely to represent a causal risk factor or therapeutic target for CAVS. more...
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- 2020
55. Genetic and in vitro inhibition of PCSK9 and calcific aortic valve stenosis
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Thériault, Sébastien, Valerio, Vincenza, Arsenault, Benoit, Moschetta, Donato, Capoulade, Romain, Boekholdt, S. Matthijs, Bossé, Yohan, Dina, Christian, Pibarot, Philippe, Chen, Hao Yu, Perrot, Nicolas, Abner, Erik, Clavel, Marie-Annick, Martinsson, Andreas, Mathieu, Patrick, Manikpurage, Hasanga D., Rigade, Sidwell, Mass, Elvira, Le Tourneau, Thierry, Messika-Zeitoun, David, Wareham, Nicholas J., Engert, James, Polvani, Gianluca, Esko, Tõnu, Smith, J. Gustav, Thanassoulis, George, Schott, Jean-Jacques, Camera, Marina, Poggio, Paolo, Thériault, Sébastien, Valerio, Vincenza, Arsenault, Benoit, Moschetta, Donato, Capoulade, Romain, Boekholdt, S. Matthijs, Bossé, Yohan, Dina, Christian, Pibarot, Philippe, Chen, Hao Yu, Perrot, Nicolas, Abner, Erik, Clavel, Marie-Annick, Martinsson, Andreas, Mathieu, Patrick, Manikpurage, Hasanga D., Rigade, Sidwell, Mass, Elvira, Le Tourneau, Thierry, Messika-Zeitoun, David, Wareham, Nicholas J., Engert, James, Polvani, Gianluca, Esko, Tõnu, Smith, J. Gustav, Thanassoulis, George, Schott, Jean-Jacques, Camera, Marina, and Poggio, Paolo more...
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The authors investigated whether PCSK9 inhibition could represent a therapeutic strategy in calcific aortic valve stenosis (CAVS). A meta-analysis of 10 studies was performed to determine the impact of the PCSK9 R46L variant on CAVS, and the authors found that CAVS was less prevalent in carriers of this variant (odds ratio: 0.80 [95% confidence interval: 0.70 to 0.91]; p ¼ 0.0011) compared with noncarriers. PCSK9 expression was higher in the aortic valves of patients CAVS compared with control patients. In human valve interstitials cells submitted to a pro-osteogenic medium, PCSK9 levels increased and a PCSK9 neutralizing antibody significantly reduced calcium accumulation. (J Am Coll Cardiol Basic Trans Science 2020;5:649–61) © 2020 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation. more...
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- 2020
56. Incidence of Ischemic Stroke in Individuals With and Without Aortic Valve Stenosis:A Danish Retrospective Cohort Study
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Andreasen, Charlotte, Gislason, Gunnar H, Køber, Lars, Abdulla, Jawdat, Martinsson, Andreas, Smith, J Gustav, Torp-Pedersen, Christian, Andersson, Charlotte, Andreasen, Charlotte, Gislason, Gunnar H, Køber, Lars, Abdulla, Jawdat, Martinsson, Andreas, Smith, J Gustav, Torp-Pedersen, Christian, and Andersson, Charlotte more...
- Abstract
Background and Purpose- Aortic valve stenosis may lead to atrial and ventricular remodeling, predisposes to atrial fibrillation, and may also be an independent risk factor of ischemic stroke. However, information on stroke rates among persons with aortic valve stenosis are sparse. We aimed to determine the incidence rates and relative risks of ischemic stroke in individuals with diagnosed aortic valve stenosis compared with age- and sex-matched controls. Methods- All patients with incident aortic valve stenosis aged >18 years (n=79 310) and age- and sex-matched controls were identified using the Danish nationwide registries (1997-2017). Incidence rates per 1000 person-years (PY) and multivariable adjusted hazard ratios with 95% CIs were reported. Results- In total, 873 373 individuals (median age 77 years, 51.5% men, 9.1% with aortic valve stenosis) were included. Ischemic stroke occurred in 70 205 (8.0%) individuals during 4 880 862 PY of follow-up. Incidence rates of ischemic stroke were 13.3/1000 PY among the controls compared with 30.4/1000 PY in patients with aortic valve stenosis, corresponding to a hazard ratio of 1.31 (95% CI, 1.28-1.34). In all age-groups, the incidence rates and relative risks were significantly increased in patients with aortic valve stenosis compared with controls, but the relative risk was greater for younger individuals (eg, age group, 18-45 years: hazard ratio, 5.94 [95% CI, 4.10-8.36]). In patients with aortic valve stenosis above 65 years of age, the risk of ischemic stroke was markedly lower after aortic valve replacement (30.3 versus 19.6/1000 PY before and after valve replacement). Among people with atrial fibrillation the incidence rate of ischemic stroke was 1.5 times higher when aortic valve stenosis was present (33.0/1000 PY versus 49.9/1000 PY). Conclusions- People with aortic valve stenosis have a significantly increased risk of ischemic stroke compared with age- and sex-matched controls. Future studies are warranted more...
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- 2020
57. Secondary prevention medications after coronary artery bypass grafting and long-term survival: a population-based longitudinal study from the SWEDEHEART registry
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Björklund, Erik, primary, Nielsen, Susanne J, additional, Hansson, Emma C, additional, Karlsson, Martin, additional, Wallinder, Andreas, additional, Martinsson, Andreas, additional, Tygesen, Hans, additional, Romlin, Birgitta S, additional, Malm, Carl Johan, additional, Pivodic, Aldina, additional, and Jeppsson, Anders, additional more...
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- 2019
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58. Genetic inhibition ofPCSK9, atherogenic lipoprotein concentrations, and calcific aortic valve stenosis
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Perrot, Nicolas, primary, Moschetta, Donato, additional, Boekholdt, S. Matthijs, additional, Valerio, Vincenza, additional, Martinsson, Andreas, additional, Capoulade, Romain, additional, Mass, Elvira, additional, Clavel, Marie-Annick, additional, Wareham, Nicholas J., additional, Dina, Christian, additional, Chen, Hao Yu, additional, Engert, James C., additional, Thanassoulis, George, additional, Mathieu, Patrick, additional, Bossé, Yohan, additional, Pibarot, Philippe, additional, Smith, J. Gustav, additional, Camera, Marina, additional, Thériault, Sébastien, additional, Poggio, Paolo, additional, and Arsenault, Benoit J., additional more...
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- 2019
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59. Secondary prevention medications after coronary artery bypass grafting and long-term survival : a population-based longitudinal study from the SWEDEHEART registry.
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Björklund, Erik, Nielsen, Susanne J, Hansson, Emma C, Karlsson, Martin, Wallinder, Andreas, Martinsson, Andreas, Tygesen, Hans, Romlin, Birgitta S, Malm, Carl Johan, Pivodic, Aldina, Jeppsson, Anders, Björklund, Erik, Nielsen, Susanne J, Hansson, Emma C, Karlsson, Martin, Wallinder, Andreas, Martinsson, Andreas, Tygesen, Hans, Romlin, Birgitta S, Malm, Carl Johan, Pivodic, Aldina, and Jeppsson, Anders more...
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AIMS: To evaluate the long-term use of secondary prevention medications [statins, β-blockers, renin-angiotensin-aldosterone system (RAAS) inhibitors, and platelet inhibitors] after coronary artery bypass grafting (CABG) and the association between medication use and mortality. METHODS AND RESULTS: All patients who underwent isolated CABG in Sweden from 2006 to 2015 and survived at least 6 months after discharge were included (n = 28 812). Individual patient data from SWEDEHEART and other mandatory nationwide registries were merged. Multivariable Cox regression models using time-updated data on dispensed prescriptions were used to assess associations between medication use and long-term mortality. Statins were dispensed to 93.9% of the patients 6 months after discharge and to 77.3% 8 years later. Corresponding figures for β-blockers were 91.0% and 76.4%, for RAAS inhibitors 72.9% and 65.9%, and for platelet inhibitors 93.0% and 79.8%. All medications were dispensed less often to patients ≥75 years. Treatment with statins [hazard ratio (HR) 0.56, 95% confidence interval (95% CI) 0.52-0.60], RAAS inhibitors (HR 0.78, 95% CI 0.73-0.84), and platelet inhibitors (HR 0.74, 95% CI 0.69-0.81) were individually associated with lower mortality risk after adjustment for age, gender, comorbidities, and use of other secondary preventive drugs (all P < 0.001). There was no association between β-blockers and mortality risk (HR 0.97, 95% CI 0.90-1.06; P = 0.54). CONCLUSION: The use of secondary prevention medications after CABG was high early after surgery but decreased significantly over time. The results of this observational study, with inherent risk of selection bias, suggest that treatment with statins, RAAS inhibitors, and platelet inhibitors is essential after CABG whereas the routine use of β-blockers may be questioned. more...
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- 2019
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60. Secondary prevention medications after coronary artery bypass grafting and long-term survival: a population-based longitudinal study from the SWEDEHEART registry.
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Björklund, Erik, Nielsen, Susanne J, Hansson, Emma C, Karlsson, Martin, Wallinder, Andreas, Martinsson, Andreas, Tygesen, Hans, Romlin, Birgitta S, Malm, Carl Johan, Pivodic, Aldina, and Jeppsson, Anders more...
- Abstract
Aims To evaluate the long-term use of secondary prevention medications [statins, β-blockers, renin–angiotensin–aldosterone system (RAAS) inhibitors, and platelet inhibitors] after coronary artery bypass grafting (CABG) and the association between medication use and mortality. Methods and results All patients who underwent isolated CABG in Sweden from 2006 to 2015 and survived at least 6 months after discharge were included (n = 28 812). Individual patient data from SWEDEHEART and other mandatory nationwide registries were merged. Multivariable Cox regression models using time-updated data on dispensed prescriptions were used to assess associations between medication use and long-term mortality. Statins were dispensed to 93.9% of the patients 6 months after discharge and to 77.3% 8 years later. Corresponding figures for β-blockers were 91.0% and 76.4%, for RAAS inhibitors 72.9% and 65.9%, and for platelet inhibitors 93.0% and 79.8%. All medications were dispensed less often to patients ≥75 years. Treatment with statins [hazard ratio (HR) 0.56, 95% confidence interval (95% CI) 0.52–0.60], RAAS inhibitors (HR 0.78, 95% CI 0.73–0.84), and platelet inhibitors (HR 0.74, 95% CI 0.69–0.81) were individually associated with lower mortality risk after adjustment for age, gender, comorbidities, and use of other secondary preventive drugs (all P < 0.001). There was no association between β-blockers and mortality risk (HR 0.97, 95% CI 0.90–1.06; P = 0.54). Conclusion The use of secondary prevention medications after CABG was high early after surgery but decreased significantly over time. The results of this observational study, with inherent risk of selection bias, suggest that treatment with statins, RAAS inhibitors, and platelet inhibitors is essential after CABG whereas the routine use of β-blockers may be questioned. Open in new tab Download slide Open in new tab Download slide [ABSTRACT FROM AUTHOR] more...
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- 2020
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61. Association of Timing of Aortic Valve Replacement Surgery After Stroke With Risk of Recurrent Stroke and Mortality
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Andreasen, Charlotte, primary, Jørgensen, Mads Emil, additional, Gislason, Gunnar H., additional, Martinsson, Andreas, additional, Sanders, Robert D., additional, Abdulla, Jawdat, additional, Jensen, Per Føge, additional, Torp-Pedersen, Christian, additional, Køber, Lars, additional, and Andersson, Charlotte, additional more...
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- 2018
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62. Longitudinal evaluation of ventricular ejection fraction and NT-proBNP across heart failure subgroups
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Martinsson, Andreas, primary, Oest, Petter, additional, Wiborg, Maj-Britt, additional, Reitan, Öyvind, additional, and Smith, J. Gustav, additional
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- 2018
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63. Genome-wide analysis yields new loci associating with aortic valve stenosis
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Helgadottir, Anna, primary, Thorleifsson, Gudmar, additional, Gretarsdottir, Solveig, additional, Stefansson, Olafur A., additional, Tragante, Vinicius, additional, Thorolfsdottir, Rosa B., additional, Jonsdottir, Ingileif, additional, Bjornsson, Thorsteinn, additional, Steinthorsdottir, Valgerdur, additional, Verweij, Niek, additional, Nielsen, Jonas B., additional, Zhou, Wei, additional, Folkersen, Lasse, additional, Martinsson, Andreas, additional, Heydarpour, Mahyar, additional, Prakash, Siddharth, additional, Oskarsson, Gylfi, additional, Gudbjartsson, Tomas, additional, Geirsson, Arnar, additional, Olafsson, Isleifur, additional, Sigurdsson, Emil L., additional, Almgren, Peter, additional, Melander, Olle, additional, Franco-Cereceda, Anders, additional, Hamsten, Anders, additional, Fritsche, Lars, additional, Lin, Maoxuan, additional, Yang, Bo, additional, Hornsby, Whitney, additional, Guo, Dongchuan, additional, Brummett, Chad M., additional, Abecasis, Gonçalo, additional, Mathis, Michael, additional, Milewicz, Dianna, additional, Body, Simon C., additional, Eriksson, Per, additional, Willer, Cristen J., additional, Hveem, Kristian, additional, Newton-Cheh, Christopher, additional, Smith, J. Gustav, additional, Danielsen, Ragnar, additional, Thorgeirsson, Gudmundur, additional, Thorsteinsdottir, Unnur, additional, Gudbjartsson, Daniel F., additional, Holm, Hilma, additional, and Stefansson, Kari, additional more...
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- 2018
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64. Association of timing of aortic valve replacement surgery after stroke with risk of recurrent stroke and mortality
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Andreasen, Charlotte, Jørgensen, Mads Emil, Gislason, Gunnar H., Martinsson, Andreas, Sanders, Robert D., Abdulla, Jawdat, Jensen, Per Føge, Torp-Pedersen, Christian, Køber, Lars, Andersson, Charlotte, Andreasen, Charlotte, Jørgensen, Mads Emil, Gislason, Gunnar H., Martinsson, Andreas, Sanders, Robert D., Abdulla, Jawdat, Jensen, Per Føge, Torp-Pedersen, Christian, Køber, Lars, and Andersson, Charlotte more...
- Abstract
IMPORTANCE Timing of surgical aortic valve replacement (SAVR) in patients with aortic valve stenosis and previous stroke for the risk of recurrent stroke is insufficiently investigated. OBJECTIVE To evaluate the association of time elapsed between previous stroke and SAVR with the risk of recurrent perioperative stroke, major adverse cardiovascular events (MACE), and mortality among patients with aortic valve stenosis. DESIGN, SETTING, AND PARTICIPANTS This cohort study using data from Danish administrative registries included all patients with aortic valve stenosis older than 18 years who underwent SAVR between 1996 and 2014 (n = 14 030). Patients who received simultaneous mitral, tricuspid, or pulmonary valve surgery and patients with endocarditis 1 year prior to surgery were excluded. Data were analyzed from March 2017 to January 2018. EXPOSURES Time elapsed between prior stroke and SAVR (<3 months, 3-<12 months,12 months, and no prior stroke). MAIN OUTCOMES AND MEASURES Thirty-day risks of MACE, ischemic stroke, and all-cause mortality reported as absolute events and multivariable adjusted odds ratios with 95% confidence intervals. Restricted cubic spline regression models were additionally applied on the subgroup with prior stroke. RESULTS Of the 14 030 included patients, 616 patients (190 [30.8%] women; mean [SD] age, 72.0 [9.1] years) with prior stroke underwent surgery, and 13 414 (4837 [36.1%] women; mean [SD] age, 69.8 [10.8] years) without prior stroke underwent surgery. The absolute risk of ischemic stroke was significantly increased in patients with stroke less than 3 months prior to surgery compared with patients with no prior stroke (18.4%[37 of 201] vs 1.2%[160 of 13 219]; odds ratio, 14.69; 95%CI, 9.69-22.27). Likewise, compared with patients without stroke, patients with stroke less than 3 months prior surgery were at significantly increased risk of MACE (23.3%[53 of 227] vs 5.7%[768 of 13 414]; odds ratio, 4.57; 95%CI, 3.24-6.44) but not more...
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- 2018
65. Longitudinal evaluation of ventricular ejection fraction and NT-proBNP across heart failure subgroups
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Martinsson, Andreas, Oest, Petter, Wiborg, Maj Britt, Reitan, Öyvind, Smith, J. Gustav, Martinsson, Andreas, Oest, Petter, Wiborg, Maj Britt, Reitan, Öyvind, and Smith, J. Gustav
- Abstract
Objectives: Left ventricular ejection fraction (EF) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) are important surrogate markers of cardiac function and wall stress. Randomized trials of heart failure (HF) have shown improvements in survival in patients with reduced EF (<40%, HFrEF) but not with preserved EF (≥50%, HFpEF) or mid-range EF (40-49%, HFmrEF). Limited information is available on the trajectory of EF in contemporary heart failure management programs (HFMPs). Design: 201 HF patients consecutively enrolled 2010–2011 in the outpatient-based HFMP of Skåne University Hospital in Lund were included in the study. Probable etiology, EF, NT-proBNP and medications were assessed at baseline and 1 year after enrollment. Results: HFrEF was the most common heart failure subgroup (78.1% of patients) in this HFMP, followed by HFmrEF (14.9%) and HFpEF (7.0%). The most common etiology was ischemic heart disease (IHD, 40.8%). Complete recovery of EF (>50%) was rare (14.1% of patients with HFrEF and 26.7% with HFmrEF), some degree of improvement was observed in 57.7% and 46.7% of patients. LVEF improved on average 9.1% in patients with HFrEF (p < .001) and NT-proBNP decreased from 4,202 to 2,030 pg/ml (p < .001). A similar trend was noticed for the HFmrEF group but was not statistically significant. The improvement in LVEF was consistent across subgroups with HF attributable to IHD (6.2%), idiopathic dilated cardiomyopathy (7.1%) and tachycardia-induced HF (17.5%). Conclusions: This study provides estimates of the improvement in LVEF and NT-proBNP that can be expected with contemporary management across subgroups of HF and different etiologies in a contemporary HFMP. more...
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- 2018
66. Genome-wide analysis yields new loci associating with aortic valve stenosis
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Helgadottir, Anna, Thorleifsson, Gudmar, Gretarsdottir, Solveig, Stefansson, Olafur A., Tragante, Vinicius, Thorolfsdottir, Rosa B., Jonsdottir, Ingileif, Bjornsson, Thorsteinn, Steinthorsdottir, Valgerdur, Verweij, Niek, Nielsen, Jonas B., Zhou, Wei, Folkersen, Lasse Westergaard, Martinsson, Andreas, Heydarpour, Mahyar, Prakash, Siddharth, Oskarsson, Gylfi, Gudbjartsson, Tomas, Geirsson, Arnar, Olafsson, Isleifur, Sigurdsson, Emil L., Almgren, Peter, Melander, Olle, Franco-Cereceda, Anders, Hamsten, Anders, Fritsche, Lars, Lin, Maoxuan, Yang, Bo, Hornsby, Whitney, Guo, Dongchuan, Brummett, Chad M., Abecasis, Goncalo, Mathis, Michael, Milewicz, Dianna, Body, Simon C., Eriksson, Per, Willer, Cristen J., Hveem, Kristian, Newton-Cheh, Christopher, Smith, J. Gustav, Danielsen, Ragnar, Thorgeirsson, Gudmundur, Thorsteinsdottir, Unnur, Gudbjartsson, Daniel F., Holm, Hilma, Stefansson, Kari, Helgadottir, Anna, Thorleifsson, Gudmar, Gretarsdottir, Solveig, Stefansson, Olafur A., Tragante, Vinicius, Thorolfsdottir, Rosa B., Jonsdottir, Ingileif, Bjornsson, Thorsteinn, Steinthorsdottir, Valgerdur, Verweij, Niek, Nielsen, Jonas B., Zhou, Wei, Folkersen, Lasse Westergaard, Martinsson, Andreas, Heydarpour, Mahyar, Prakash, Siddharth, Oskarsson, Gylfi, Gudbjartsson, Tomas, Geirsson, Arnar, Olafsson, Isleifur, Sigurdsson, Emil L., Almgren, Peter, Melander, Olle, Franco-Cereceda, Anders, Hamsten, Anders, Fritsche, Lars, Lin, Maoxuan, Yang, Bo, Hornsby, Whitney, Guo, Dongchuan, Brummett, Chad M., Abecasis, Goncalo, Mathis, Michael, Milewicz, Dianna, Body, Simon C., Eriksson, Per, Willer, Cristen J., Hveem, Kristian, Newton-Cheh, Christopher, Smith, J. Gustav, Danielsen, Ragnar, Thorgeirsson, Gudmundur, Thorsteinsdottir, Unnur, Gudbjartsson, Daniel F., Holm, Hilma, and Stefansson, Kari more...
- Abstract
Aortic valve stenosis (AS) is the most common valvular heart disease, and valve replacement is the only definitive treatment. Here we report a large genome-wide association (GWA) study of 2,457 Icelandic AS cases and 349,342 controls with a follow-up in up to 4,850 cases and 451,731 controls of European ancestry. We identify two new AS loci, on chromosome 1p21 near PALMD (rs7543130; odds ratio (OR) = 1.20, P = 1.2 x 10(-22)) and on chromosome 2q22 in TEX41 (rs1830321; OR = 1.15, P = 1.8 x 10(-13)). Rs7543130 also associates with bicuspid aortic valve (BAV) (OR = 1.28, P = 6.6 x 10(-10)) and aortic root diameter (P = 1.30 x 10(-8)), and rs1830321 associates with BAV (OR = 1.12, P = 5.3 x 10(-3)) and coronary artery disease (OR = 1.05, P = 9.3 x 10(-5)). The results implicate both cardiac developmental abnormalities and atherosclerosis-like processes in the pathogenesis of AS. We show that several pathways are shared by CAD and AS. Causal analysis suggests that the shared risk factors of Lp(a) and non-high-density lipoprotein cholesterol contribute substantially to the frequent co-occurence of these diseases. more...
- Published
- 2018
67. Epidemiological aspects of aortic stenosis
- Author
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Martinsson, Andreas
- Subjects
Epidemiologi ,Aortastenos ,Medical and Health Sciences - Published
- 2017
68. Kommunicera mera : En studie av svenska kommuners närvaro på sociala medier
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Martinsson, Andreas and Marcusson, Linus
- Abstract
Our methods of communication have recently undergone a massive shift towards increased use of social media as a primary communication tool. The purpose of this study is to gauge the state of social media use among Swedish municipalities, to explore the underlying goals behind their use of the technology and to find common themes among the municipalities with the most successful social media presence. Using a quantitative research method we have created several visualiations of the general state of social media usage and using these insights we have conducted an interview study with seven of the most successful municipalities. In our study we find that the municipalities most successful in social media share an array of traits and have similar goals for their social media presence. We find that the primary goals common among the successful municipalities happen to be goals concerning increased benefit to citizens; increased speed of communications, interactivity and transparency. more...
- Published
- 2016
69. Genome-wide analysis yields new loci associating with aortic valve stenosis
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Helgadottir, Anna, primary, Thorleifsson, Gudmar, additional, Gretarsdottir, Solveig, additional, Stefansson, Olafur A., additional, Tragante, Vinicius, additional, Thorolfsdottir, Rosa B., additional, Jonsdottir, Ingileif, additional, Bjornsson, Thorsteinn, additional, Steinthorsdottir, Valgerdur, additional, Verweij, Niek, additional, Nielsen, Jonas B., additional, Zhou, Wei, additional, Folkersen, Lasse, additional, Martinsson, Andreas, additional, Heydarpour, Mahyar, additional, Prakash, Siddharth, additional, Oskarsson, Gylfi, additional, Gudbjartsson, Tomas, additional, Geirsson, Arnar, additional, Olafsson, Isleifur, additional, Sigurdsson, Emil L., additional, Almgren, Peter, additional, Melander, Olle, additional, Franco-Cereceda, Anders, additional, Hamsten, Anders, additional, Fritsche, Lars, additional, Lin, Maoxuan, additional, Yang, Bo, additional, Hornsby, Whitney, additional, Guo, Dongchuan, additional, Brummett, Chad M., additional, Abecasis, Gonçalo, additional, Mathis, Michael, additional, Milewicz, Dianna, additional, Body, Simon C., additional, Eriksson, Per, additional, Willer, Cristen J., additional, Hveem, Kristian, additional, Newton-Cheh, Christopher, additional, Smith, J. Gustav, additional, Danielsen, Ragnar, additional, Thorgeirsson, Gudmundur, additional, Thorsteinsdottir, Unnur, additional, Gudbjartsson, Daniel F., additional, Holm, Hilma, additional, and Stefansson, Kari, additional more...
- Published
- 2017
- Full Text
- View/download PDF
70. Sclerosing Aortic and Coronary Arteritis Due to IgG4-Related Disease
- Author
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Barbu, Mikael, primary, Lindström, Ulf, additional, Nordborg, Claes, additional, Martinsson, Andreas, additional, Dworeck, Christian, additional, and Jeppsson, Anders, additional
- Published
- 2017
- Full Text
- View/download PDF
71. Noncardiac Surgery in Patients With Aortic Stenosis: A Contemporary Study on Outcomes in a Matched Sample From the Danish Health Care System
- Author
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Andersson, Charlotte, Jørgensen, Mads Emil, Martinsson, Andreas, Hansen, Peter Wæde, Smith, Gustav, Jensen, Per Føge, Gislason, Gunnar H., Køber, Lars, and Torp-Pedersen, Christian
- Subjects
Male ,Denmark ,Matched-Pair Analysis ,Clinical Investigations ,Myocardial Infarction ,Aortic Valve Stenosis ,Stroke ,Elective Surgical Procedures ,Surgical Procedures, Operative ,Humans ,Female ,cardiovascular diseases ,Registries ,Emergencies ,Aged - Abstract
BACKGROUND: Past research has identified aortic stenosis (AS) as a major risk factor for adverse outcomes in noncardiac surgery; however, more contemporary studies have questioned the grave prognosis. To further our understanding of this, the risks of a 30-day major adverse cardiovascular event (MACE) and all-cause mortality were investigated in a contemporary Danish cohort.HYPOTHESIS: AS is not an independent risk factor for adverse outcomes in noncardiac surgery.METHODS: All patients with and without diagnosed AS who underwent noncardiac surgery in 2005 to 2011 were identified through nationwide administrative registers. AS patients (n = 2823; mean age, 75.5 years, 53% female) were matched with patients without AS (n = 2823) on propensity score for AS and surgery type.RESULTS: In elective surgery, MACE (ie, nonfatal myocardial infarction, ischemic stroke, or cardiovascular death) occurred in 66/1772 (3.7%) of patients with AS and 52/1772 (2.9%) of controls (P = 0.19), whereas mortality occurred in 67/1772 (3.8%) AS patients and 51/1772 (2.9%) controls (P = 0.13). In emergency surgery, 163/1051 (15.5%) AS patients and 120/1051 (11.4%) controls had a MACE (P = 0.006), whereas 225/1051 (21.4%) vs 179/1051 (17.0%) AS patients and controls died, respectively (P = 0.01). Event rates were higher for those with symptoms (defined as use of nitrates, congestive heart failure, or use of loop diuretics), compared with those without symptoms (P CONCLUSIONS: AS is associated with high perioperative rates of MACE and mortality, but perhaps prognosis is, in practice, not much worse for patients with AS than for matched controls. Symptomatic patients and patients undergoing emergency surgery are at considerable risks of a MACE and mortality. more...
- Published
- 2014
- Full Text
- View/download PDF
72. En studie om svenska bolagsstyrningsaktörers riskpreferenser
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Limbasiya, Hiten and Martinsson, Andreas
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bolagsstyrningssystemet ,riskaversion ,riskpreferenser ,Business Administration ,Företagsekonomi - Published
- 2012
73. Response to Letter Regarding Article “Temporal Trends in the Incidence and Prognosis of Aortic Stenosis: A Nationwide Study of the Swedish Population”
- Author
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Martinsson, Andreas, primary, Li, Xinjun, additional, Andersson, Charlotte, additional, Nilsson, Johan, additional, Smith, J. Gustav, additional, and Sundquist, Kristina, additional
- Published
- 2015
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74. Temporal Trends in the Incidence and Prognosis of Aortic Stenosis
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Martinsson, Andreas, primary, Li, Xinjun, additional, Andersson, Charlotte, additional, Nilsson, Johan, additional, Smith, J. Gustav, additional, and Sundquist, Kristina, additional
- Published
- 2015
- Full Text
- View/download PDF
75. Impact of chronic obstructive pulmonary disease on morbidity and mortality after myocardial infarction
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Andell, Pontus, Koul, Sasha, Martinsson, Andreas, Sundström, Johan, Jernberg, Tomas, Smith, J Gustav, James, Stefan, Lindahl, Bertil, Erlinge, David, Andell, Pontus, Koul, Sasha, Martinsson, Andreas, Sundström, Johan, Jernberg, Tomas, Smith, J Gustav, James, Stefan, Lindahl, Bertil, and Erlinge, David more...
- Abstract
AIM: To gain a better understanding of the impact of chronic obstructive pulmonary disease (COPD) on long-term mortality in patients with myocardial infarction (MI) and identify areas where the clinical care for these patients may be improved. METHODS: Patients hospitalised for MI between 2005 and 2010 were identified from the nationwide Swedish SWEDEHEART registry. Patients with MI and a prior COPD hospital discharge diagnosis were compared to patients with MI without a prior COPD hospital discharge diagnosis for the primary endpoint of all-cause mortality at 1 year after MI. Secondary endpoints included rates of reinfarction, new-onset stroke, new-onset bleeding and new-onset heart failure at 1 year. RESULTS: A total of 81 191 MI patients were included, of which 4867 (6%) had a COPD hospital discharge diagnosis at baseline. Patients with COPD showed a significantly higher unadjusted 1-year mortality (24.6 vs 13.8%) as well as a higher rate of reinfarction, new-onset bleeding and new-onset heart failure post-MI. After adjustment for potential confounders, including comorbidities and treatment, the patients with COPD still showed a significantly higher 1-year mortality (HR 1.14, 95% CI 1.07 to 1.21) as well as a higher rate of new-onset heart failure (HR 1.35, 95% CI 1.24 to 1.47), whereas no significant association between COPD and myocardial reinfarction or new-onset bleeding remained. CONCLUSIONS: In this nationwide contemporary study, patients with COPD frequently had an atypical presentation, less often underwent revascularisation and less often received guideline-recommended secondary preventive medications of established benefit. Prior COPD was associated with a higher 1-year mortality and a higher risk of subsequent new-onset heart failure after MI. The association seems to be mainly explained by differences in background characteristics, comorbidities and treatment, although a minor part might be explained by COPD in itself. Improved in-hospital MI treatmen more...
- Published
- 2014
- Full Text
- View/download PDF
76. Delay From First Medical Contact to Primary PCI and All-Cause Mortality : A Nationwide Study of Patients With ST-Elevation Myocardial Infarction
- Author
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Koul, Sasha, Andell, Pontus, Martinsson, Andreas, Smith, J. Gustav, van der Pals, Jesper, Schersten, Fredrik, Jernberg, Tomas, Lagerqvist, Bo, Erlinge, David, Koul, Sasha, Andell, Pontus, Martinsson, Andreas, Smith, J. Gustav, van der Pals, Jesper, Schersten, Fredrik, Jernberg, Tomas, Lagerqvist, Bo, and Erlinge, David more...
- Abstract
Background-Early reperfusion in the setting of an ST-elevation myocardial infarction (STEMI) is of utmost importance. However, the effects of early versus late reperfusion in this patient group undergoing primary percutaneous coronary intervention (PCI) have so far been inconsistent in previous studies. The purpose of this study was to evaluate in a nationwide cohort the effects of delay from first medical contact to PCI (first medical contact [FMC]-to-PCI) and secondarily delay from symptom-to-PCI on clinical outcomes. Methods and Results-Using the national Swedish Coronary Angiography and Angioplasty Register (SCAAR) registry, STEMI patients undergoing primary PCI between the years 2003 and 2008 were screened for. A total of 13 790 patients were included in the FMC-to-PCI analysis and 11 489 patients were included in the symptom-to-PCI analyses. Unadjusted as well as multivariable analyses showed an overall significant association between increasing FMC-to-PCI delay and 1-year mortality. A statistically significant increase in mortality was noted at FMC-to-PCI delays exceeding 1 hour in an incremental fashion. FMC-to-PCI delays in excess of 1 hour were also significantly associated with an increase in severe left ventricular dysfunction at discharge. An overall significant association between increasing symptom-to-PCI delays and 1-year mortality was noted. However, when stratified into time delay cohorts, no symptom-to-PCI delay except for the highest time delay showed a statistically significant association with increased mortality. Conclusions-Delays in FMC-to-PCI were strongly associated with increased mortality already at delays of more than 1 hour, possibly through an increase in severe heart failure. A goal of FMC-to-PCI of less than 1 hour might save patient lives. more...
- Published
- 2014
- Full Text
- View/download PDF
77. Noncardiac Surgery in Patients With Aortic Stenosis:A Contemporary Study on Outcomes in a Matched Sample From the Danish Health Care System
- Author
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Andersson, Charlotte, Jørgensen, Mads Emil, Martinsson, Andreas, Hansen, Peter Waede, Gustav Smith, J, Jensen, Per Føge, Gislason, Gunnar H, Køber, Lars, Torp-Pedersen, Christian, Andersson, Charlotte, Jørgensen, Mads Emil, Martinsson, Andreas, Hansen, Peter Waede, Gustav Smith, J, Jensen, Per Føge, Gislason, Gunnar H, Køber, Lars, and Torp-Pedersen, Christian more...
- Abstract
BACKGROUND: Past research has identified aortic stenosis (AS) as a major risk factor for adverse outcomes in noncardiac surgery; however, more contemporary studies have questioned the grave prognosis. To further our understanding of this, the risks of a 30-day major adverse cardiovascular event (MACE) and all-cause mortality were investigated in a contemporary Danish cohort.HYPOTHESIS: AS is not an independent risk factor for adverse outcomes in noncardiac surgery.METHODS: All patients with and without diagnosed AS who underwent noncardiac surgery in 2005 to 2011 were identified through nationwide administrative registers. AS patients (n = 2823; mean age, 75.5 years, 53% female) were matched with patients without AS (n = 2823) on propensity score for AS and surgery type.RESULTS: In elective surgery, MACE (ie, nonfatal myocardial infarction, ischemic stroke, or cardiovascular death) occurred in 66/1772 (3.7%) of patients with AS and 52/1772 (2.9%) of controls (P = 0.19), whereas mortality occurred in 67/1772 (3.8%) AS patients and 51/1772 (2.9%) controls (P = 0.13). In emergency surgery, 163/1051 (15.5%) AS patients and 120/1051 (11.4%) controls had a MACE (P = 0.006), whereas 225/1051 (21.4%) vs 179/1051 (17.0%) AS patients and controls died, respectively (P = 0.01). Event rates were higher for those with symptoms (defined as use of nitrates, congestive heart failure, or use of loop diuretics), compared with those without symptoms (P < 0.0001).CONCLUSIONS: AS is associated with high perioperative rates of MACE and mortality, but perhaps prognosis is, in practice, not much worse for patients with AS than for matched controls. Symptomatic patients and patients undergoing emergency surgery are at considerable risks of a MACE and mortality. more...
- Published
- 2014
78. A pharmacodynamic comparison of 5 anti-platelet protocols in patients with ST-elevation myocardial infarction undergoing primary PCI.
- Author
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Koul, Sasha, Andell, Pontus, Martinsson, Andreas, Smith, Gustav, Scherstén, Fredrik, Harnek, Jan, Götberg, Matthias, Norström, Eva, Björnsson, Sven, Erlinge, David, Koul, Sasha, Andell, Pontus, Martinsson, Andreas, Smith, Gustav, Scherstén, Fredrik, Harnek, Jan, Götberg, Matthias, Norström, Eva, Björnsson, Sven, and Erlinge, David more...
- Abstract
Despite advances in anti-platelet treatments, there still exists an early increase in both ischemic as well as bleeding events following primary PCI in patients with ST-elevation myocardial infarction (STEMI). Platelet inhibition data of different anti-platelet treatments in the acute phase of a myocardial infarction might offer some insight into these problems. The aim of this study was to evaluate the pharmacodynamic profile of 5 different anti-platelet treatments in the acute phase of STEMI in patients undergoing primary PCI. more...
- Published
- 2014
79. A pharmacodynamic comparison of 5 anti-platelet protocols in patients with ST-elevation myocardial infarction undergoing primary PCI
- Author
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Koul, Sasha, primary, Andell, Pontus, additional, Martinsson, Andreas, additional, Smith, J Gustav, additional, Scherstén, Fredrik, additional, Harnek, Jan, additional, Götberg, Matthias, additional, Norström, Eva, additional, Björnsson, Sven, additional, and Erlinge, David, additional more...
- Published
- 2014
- Full Text
- View/download PDF
80. Carotid Plaque, Intima-Media Thickness, and Incident Aortic Stenosis
- Author
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Martinsson, Andreas, primary, Östling, Gerd, additional, Persson, Margaretha, additional, Sundquist, Kristina, additional, Andersson, Charlotte, additional, Melander, Olle, additional, Engström, Gunnar, additional, Hedblad, Bo, additional, and Smith, J. Gustav, additional more...
- Published
- 2014
- Full Text
- View/download PDF
81. Noncardiac Surgery in Patients With Aortic Stenosis: A Contemporary Study on Outcomes in a Matched Sample From the Danish Health Care System
- Author
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Andersson, Charlotte, primary, Jørgensen, Mads Emil, additional, Martinsson, Andreas, additional, Hansen, Peter Waede, additional, Gustav Smith, J., additional, Jensen, Per Føge, additional, Gislason, Gunnar H., additional, Køber, Lars, additional, and Torp-Pedersen, Christian, additional more...
- Published
- 2014
- Full Text
- View/download PDF
82. Delay From First Medical Contact to Primary PCI and All‐Cause Mortality: A Nationwide Study of Patients With ST‐Elevation Myocardial Infarction
- Author
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Koul, Sasha, primary, Andell, Pontus, additional, Martinsson, Andreas, additional, Gustav Smith, J., additional, van der Pals, Jesper, additional, Scherstén, Fredrik, additional, Jernberg, Tomas, additional, Lagerqvist, Bo, additional, and Erlinge, David, additional more...
- Published
- 2014
- Full Text
- View/download PDF
83. Impact of chronic obstructive pulmonary disease on morbidity and mortality after myocardial infarction
- Author
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Andell, Pontus, primary, Koul, Sasha, additional, Martinsson, Andreas, additional, Sundström, Johan, additional, Jernberg, Tomas, additional, Smith, J Gustav, additional, James, Stefan, additional, Lindahl, Bertil, additional, and Erlinge, David, additional more...
- Published
- 2014
- Full Text
- View/download PDF
84. DELAY FROM FIRST MEDICAL CONTACT TO PCI AND ALL-CAUSE MORTALITY IN PATIENTS WITH ST-ELEVATION MYOCARDIAL INFARCTION UNDERGOING PRIMARY PCI
- Author
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Koul, Sasha, primary, Andell, Pontus, additional, Martinsson, Andreas, additional, Smith, J. Gustav, additional, Pals, Jesper van der, additional, Scherstén, Fredrik, additional, Jernberg, Tomas, additional, Lagerqvist, Bo, additional, and Erlinge, David, additional more...
- Published
- 2013
- Full Text
- View/download PDF
85. UPSTREAM CLOPIDOGREL FOLLOWED BY PRE-PCI PRASUGREL GIVES RAPID PLATELET INHIBITION AND REPRESENTS A FEASIBLE OPTION IN STEMI PATIENTS UNDERGOING PRIMARY PCI
- Author
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Koul, Sasha, primary, Andell, Pontus, additional, Martinsson, Andreas, additional, Smith, Jan Gustav, additional, Scherstén, Fredrik, additional, Harnek, Jan, additional, Götberg, Matthias, additional, Norström, Eva, additional, Björnsson, Sven, additional, and Erlinge, David, additional more...
- Published
- 2012
- Full Text
- View/download PDF
86. A pharmacodynamic comparison of 5 anti-platelet protocols in patients with ST-elevation myocardial infarction undergoing primary PCI.
- Author
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Kou, Sasha, Andell, Pontus, Martinsson, Andreas, Smith, J. Gustav, Scherstén, Fredrik, Harnek, Jan, Götberg, Matthias, Norström, Eva, Björnsson, Sven, and Erlinge, David
- Subjects
PHARMACODYNAMICS ,PLATELET aggregation inhibitors ,MYOCARDIAL infarction treatment ,COMPARATIVE studies ,MEDICAL protocols ,PHOSPHOPROTEINS ,CLOPIDOGREL ,THERAPEUTICS - Abstract
Background: Despite advances in anti-platelet treatments, there still exists an early increase in both ischemic as well as bleeding events following primary PCI in patients with ST-elevation myocardial infarction (STEMI). Platelet inhibition data of different anti-platelet treatments in the acute phase of a myocardial infarction might offer some insight into these problems. The aim of this study was to evaluate the pharmacodynamic profile of 5 different anti-platelet treatments in the acute phase of STEMI in patients undergoing primary PCI. Methods: A total of 223 STEMI patients undergoing primary PCI were prospectively included. Patients received either pre-hospital clopidogrel only, pre-hospital clopidogrel followed by prasugrel switch in the cath lab, prasugrel treatment only, pre-hospital clopidogrel followed by ticagrelor switch in the cath lab or pre-hospital ticagrelor only. Platelet reactivity was measured serially using vasodilator-stimulated phosphoprotein (VASP). Results: Patients receiving pre-hospital clopidogrel followed by prasugrel switch showed similar platelet inhibition data as patients receiving prasugrel only, with more than 90% being good responders the day after PCI. Average time from prasugrel administration to a VASP value of <50% was 1.5 hours. In patients receiving pre-hospital ticagrelor, 50% were good responders at completion of PCI and average time to a VASP-value of <50% was 2.3 hours. Only 32% of patients receiving clopidogrel only were responders the day after PCI. Conclusions: Switching from an upstream bolus dose of clopidogrel to prasugrel at the time of PCI, appeared as a safe and feasible option with no tendency for overshoot or attenuation of platelet inhibition. Pre-hospital administration of ticagrelor was associated with a 50% good responder rate at completion of PCI. [ABSTRACT FROM AUTHOR] more...
- Published
- 2014
- Full Text
- View/download PDF
87. Lipoprotein-associated phospholipase A2 activity, genetics and calcific aortic valve stenosis in humans
- Author
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Perrot, Nicolas, Thériault, Sébastien, Rigade, Sidwell, Chen, Hao Yu, Dina, Christian, Martinsson, Andreas, Boekholdt, S Matthijs, Capoulade, Romain, Le Tourneau, Thierry, Messika-Zeitoun, David, Engert, James C, Wareham, Nicholas J, Clavel, Marie-Annick, Pibarot, Philippe, Smith, J Gustav, Schott, Jean Jacques, Mathieu, Patrick, Bossé, Yohan, Thanassoulis, George, and Arsenault, Benoit J more...
- Subjects
cardiovascular system ,aortic stenosis ,Valvular heart disease ,coronary artery disease ,3. Good health - Abstract
Background: Lipoprotein-associated phospholipase A2 (Lp-PLA2) activity has been shown to predict calcific aortic valve stenosis (CAVS) outcomes. Our objective was to test the association between plasma Lp-PLA2 activity and genetically elevated Lp-PLA2 mass/activity with CAVS in humans. Methods and results: Lp-PLA2 activity was measured in 890 patients undergoing cardiac surgery, including 476 patients undergoing aortic valve replacement for CAVS and 414 control patients undergoing coronary artery bypass grafting. After multivariable adjustment, Lp-PLA2 activity was positively associated with the presence of CAVS (OR=1.21 (95% CI 1.04 to 1.41) per SD increment). We selected four single nucleotide polymorphisms (SNPs) at the PLA2G7 locus associated with either Lp-PLA2 mass or activity (rs7756935, rs1421368, rs1805017 and rs4498351). Genetic association studies were performed in eight cohorts: Quebec-CAVS (1009 cases/1017 controls), UK Biobank (1350 cases/349 043 controls), European Prospective Investigation into Cancer and Nutrition-Norfolk (504 cases/20 307 controls), Genetic Epidemiology Research on Aging (3469 cases/51 723 controls), Malmö Diet and Cancer Study (682 cases/5963 controls) and three French cohorts (3123 cases/6532 controls), totalling 10 137 CAVS cases and 434 585 controls. A fixed-effect meta-analysis using the inverse-variance weighted method revealed that none of the four SNPs was associated with CAVS (OR=0.99 (95% CI 0.96 to 1.02, p=0.55) for rs7756935, 0.97 (95% CI 0.93 to 1.01, p=0.11) for rs1421368, 1.00 (95% CI 1.00 to 1.01, p=0.29) for rs1805017, and 1.00 (95% CI 0.97 to 1.04, p=0.87) for rs4498351). Conclusions: Higher Lp-PLA2 activity is significantly associated with the presence of CAVS and might represent a biomarker of CAVS in patients with heart disease. Results of our genetic association study suggest that Lp-PLA2 is however unlikely to represent a causal risk factor or therapeutic target for CAVS. more...
88. Lipoprotein-associated phospholipase A2 activity, genetics and calcific aortic valve stenosis in humans
- Author
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Perrot, Nicolas, Thériault, Sébastien, Rigade, Sidwell, Chen, Hao Yu, Dina, Christian, Martinsson, Andreas, Boekholdt, S Matthijs, Capoulade, Romain, Le Tourneau, Thierry, Messika-Zeitoun, David, Engert, James C, Wareham, Nicholas J, Clavel, Marie-Annick, Pibarot, Philippe, Smith, J Gustav, Schott, Jean Jacques, Mathieu, Patrick, Bossé, Yohan, Thanassoulis, George, and Arsenault, Benoit J more...
- Subjects
cardiovascular system ,aortic stenosis ,Valvular heart disease ,coronary artery disease ,3. Good health - Abstract
Background: Lipoprotein-associated phospholipase A2 (Lp-PLA2) activity has been shown to predict calcific aortic valve stenosis (CAVS) outcomes. Our objective was to test the association between plasma Lp-PLA2 activity and genetically elevated Lp-PLA2 mass/activity with CAVS in humans. Methods and results: Lp-PLA2 activity was measured in 890 patients undergoing cardiac surgery, including 476 patients undergoing aortic valve replacement for CAVS and 414 control patients undergoing coronary artery bypass grafting. After multivariable adjustment, Lp-PLA2 activity was positively associated with the presence of CAVS (OR=1.21 (95% CI 1.04 to 1.41) per SD increment). We selected four single nucleotide polymorphisms (SNPs) at the PLA2G7 locus associated with either Lp-PLA2 mass or activity (rs7756935, rs1421368, rs1805017 and rs4498351). Genetic association studies were performed in eight cohorts: Quebec-CAVS (1009 cases/1017 controls), UK Biobank (1350 cases/349 043 controls), European Prospective Investigation into Cancer and Nutrition-Norfolk (504 cases/20 307 controls), Genetic Epidemiology Research on Aging (3469 cases/51 723 controls), Malmö Diet and Cancer Study (682 cases/5963 controls) and three French cohorts (3123 cases/6532 controls), totalling 10 137 CAVS cases and 434 585 controls. A fixed-effect meta-analysis using the inverse-variance weighted method revealed that none of the four SNPs was associated with CAVS (OR=0.99 (95% CI 0.96 to 1.02, p=0.55) for rs7756935, 0.97 (95% CI 0.93 to 1.01, p=0.11) for rs1421368, 1.00 (95% CI 1.00 to 1.01, p=0.29) for rs1805017, and 1.00 (95% CI 0.97 to 1.04, p=0.87) for rs4498351). Conclusions: Higher Lp-PLA2 activity is significantly associated with the presence of CAVS and might represent a biomarker of CAVS in patients with heart disease. Results of our genetic association study suggest that Lp-PLA2 is however unlikely to represent a causal risk factor or therapeutic target for CAVS. more...
89. Heritability of Mitral Regurgitation
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Delling, Francesca N., Li, Xinjun, Li, Shuo, Yang, Qiong, Xanthakis, Vanessa, Martinsson, Andreas, Andell, Pontus, Lehman, Birgitta T., Osypiuk, Ewa W., Stantchev, Plamen, Zöller, Bengt, Benjamin, Emelia J., Sundquist, Kristina, Vasan, Ramachandran S., and Smith, J. Gustav more...
- Full Text
- View/download PDF
90. Lipoprotein-associated phospholipase A2 activity, genetics and calcific aortic valve stenosis in humans
- Author
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Perrot, Nicolas, Thériault, Sébastien, Rigade, Sidwell, Chen, Hao Yu, Dina, Christian, Martinsson, Andreas, Boekholdt, S Matthijs, Capoulade, Romain, Le Tourneau, Thierry, Messika-Zeitoun, David, Engert, James C, Wareham, Nicholas J, Clavel, Marie-Annick, Pibarot, Philippe, Smith, J Gustav, Schott, Jean Jacques, Mathieu, Patrick, Bossé, Yohan, Thanassoulis, George, and Arsenault, Benoit J more...
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Aged, 80 and over ,Male ,aortic stenosis ,Calcinosis ,Aortic Valve Stenosis ,Polymorphism, Single Nucleotide ,Risk Assessment ,3. Good health ,Up-Regulation ,Europe ,Phenotype ,Meta-Analysis as Topic ,Risk Factors ,Aortic Valve ,Case-Control Studies ,1-Alkyl-2-acetylglycerophosphocholine Esterase ,cardiovascular system ,Humans ,Female ,Genetic Predisposition to Disease ,coronary artery disease ,Biomarkers ,Genetic Association Studies ,Aged - Abstract
BACKGROUND: Lipoprotein-associated phospholipase A2 (Lp-PLA2) activity has been shown to predict calcific aortic valve stenosis (CAVS) outcomes. Our objective was to test the association between plasma Lp-PLA2 activity and genetically elevated Lp-PLA2 mass/activity with CAVS in humans. METHODS AND RESULTS: Lp-PLA2 activity was measured in 890 patients undergoing cardiac surgery, including 476 patients undergoing aortic valve replacement for CAVS and 414 control patients undergoing coronary artery bypass grafting. After multivariable adjustment, Lp-PLA2 activity was positively associated with the presence of CAVS (OR=1.21 (95% CI 1.04 to 1.41) per SD increment). We selected four single nucleotide polymorphisms (SNPs) at the PLA2G7 locus associated with either Lp-PLA2 mass or activity (rs7756935, rs1421368, rs1805017 and rs4498351). Genetic association studies were performed in eight cohorts: Quebec-CAVS (1009 cases/1017 controls), UK Biobank (1350 cases/349 043 controls), European Prospective Investigation into Cancer and Nutrition-Norfolk (504 cases/20 307 controls), Genetic Epidemiology Research on Aging (3469 cases/51 723 controls), Malmö Diet and Cancer Study (682 cases/5963 controls) and three French cohorts (3123 cases/6532 controls), totalling 10 137 CAVS cases and 434 585 controls. A fixed-effect meta-analysis using the inverse-variance weighted method revealed that none of the four SNPs was associated with CAVS (OR=0.99 (95% CI 0.96 to 1.02, p=0.55) for rs7756935, 0.97 (95% CI 0.93 to 1.01, p=0.11) for rs1421368, 1.00 (95% CI 1.00 to 1.01, p=0.29) for rs1805017, and 1.00 (95% CI 0.97 to 1.04, p=0.87) for rs4498351). CONCLUSIONS: Higher Lp-PLA2 activity is significantly associated with the presence of CAVS and might represent a biomarker of CAVS in patients with heart disease. Results of our genetic association study suggest that Lp-PLA2 is however unlikely to represent a causal risk factor or therapeutic target for CAVS. more...
91. New-onset atrial fibrillation after coronary surgery and stroke risk: a nationwide cohort study.
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Taha A, Martinsson A, Nielsen SJ, Rezk M, Pivodic A, Gudbjartsson T, Herrmann FEM, Bergfeldt LB, and Jeppsson A
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- Humans, Female, Male, Aged, Risk Assessment methods, Risk Factors, Sweden epidemiology, Middle Aged, Anticoagulants therapeutic use, Anticoagulants administration & dosage, Ischemic Stroke epidemiology, Ischemic Stroke etiology, Ischemic Stroke diagnosis, Postoperative Complications epidemiology, Postoperative Complications etiology, Aged, 80 and over, Prospective Studies, Incidence, Stroke epidemiology, Stroke etiology, Atrial Fibrillation epidemiology, Atrial Fibrillation etiology, Atrial Fibrillation diagnosis, Coronary Artery Bypass adverse effects, Registries
- Abstract
Background: New-onset postoperative atrial fibrillation (POAF) after coronary artery bypass grafting (CABG) increases ischaemic stroke risk, yet factors influencing this risk remain unclear. We sought to identify factors associated with 1-year ischaemic stroke risk, compare the CHA
2 DS2 -VASc (Congestive heart failure, Hypertension, Age ≥75 years, Diabetes, previous Stroke/transient ischaemic attack (TIA), Vascular disease, Age 65-74 years, Sex category) and ATRIA (Anticoagulation and Risk Factors in Atrial Fibrillation) scores' predictive abilities for ischaemic stroke, and assess oral anticoagulation (OAC) dispensing at discharge in patients with POAF., Methods: This nationwide cohort study used prospectively collected data from four mandatory Swedish national registries. All first-time isolated CABG patients who developed POAF during 2007-2020 were included. Multivariable logistic models were used to identify ischaemic stroke predictors and C-statistics to assess the predictive abilities of the CHA2 DS2 -VASc and ATRIA scores in patients without OAC. OAC dispensing patterns were described based on stroke-associated factors., Results: In total, 10 435 patients with POAF were identified. Out of those not receiving OAC (n=6903), 3.1% experienced an ischaemic stroke within 1 year. Advancing age (adjusted OR (aOR) 1.86 per 10-year increase, 95% CI 1.45 to 2.38), prior ischaemic stroke (aOR 18.56, 95% CI 10.05 to 34.28 at 60 years, aOR 5.95, 95% CI 3.78 to 9.37 at 80 years, interaction p<0.001), myocardial infarction (aOR 1.55, 95% CI 1.14 to 2.10) and heart failure (aOR 1.53, 95% CI 1.06 to 2.21) were independently associated with ischaemic stroke. The area under the receiver-operating characteristic curve was 0.72 (0.69-0.76) and 0.74 (0.70-0.78) for CHA2 DS2 -VASc and ATRIA, respectively (p=0.021). Altogether, 71.0% of patients with a stroke risk >2%/year, according to the CHA2 DS2 -VASc score, were not discharged on OAC., Conclusions: Prior ischaemic stroke, advancing age, history of heart failure and myocardial infarction were associated with 1-year ischaemic stroke risk in patients with POAF after CABG. CHA2 DS2 -VASc and ATRIA scores predicted stroke risk with similar accuracy as in non-surgical atrial fibrillation cohorts. OAC dispense at discharge does not seem to reflect individual stroke risk., Competing Interests: Competing interests: AJ discloses financial relationships with AstraZeneca, Werfen, LFB Biotechnologies, Pharmacosmos, Boehringer-Ingelheim and Bayer unrelated to the present study. AT discloses a financial relationship with Bayer and Medtronic unrelated to the present study. LB reports personal fees from Bayer, Boehringer Ingelheim and Sanofi, outside the submitted work. No other disclosures were reported., (© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.) more...- Published
- 2024
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92. The four-item PRECISE-DAPT score identifies coronary artery bypass grafting patients with increased risk for post-discharge major bleeding.
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Enström P, Martinsson A, Rezk M, Nielsen S, Björklund E, Landenhed-Smith M, Pan E, and Jeppsson A
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Aims: Early identification of patients with increased bleeding risk increases the possibility to individualize antithrombotic treatment. We validated the PRECISE-DAPT score, originally developed to estimate bleeding risk in patients on dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI), in coronary artery bypass grafting (CABG) patients., Methods and Results: All patients who underwent first time, isolated CABG in Sweden 2009-2020 and survived until discharge were included. The four-item PRECISE-DAPT score, based on age, estimated glomerular filtration rate, preoperative haemoglobin concentration, and previous spontaneous bleeding, was calculated in patients discharged on DAPT (n = 6 838), or antiplatelet monotherapy (n = 15 406). High bleeding risk was defined as a score ≥ 25 in accordance with previous studies and major bleeding as hospitalization due to bleeding. Associations were assessed by C-statistics and Cox regression models.Major bleeding occurred during the first postoperative year in 130 patients (1.9%) in the DAPT group, and in 197 patients (1.3%) in the monotherapy group. The score identified 32.9% of the patients in the DAPT group and 38.2% in monotherapy groups as having high bleeding risk. The area under the ROC-curve for the score was 0.67 (95%CI 0.62-0.72) for DAPT and 0.71 (0.67-0.74) for monotherapy. The hazard ratio for high bleeding risk vs. very low risk was 4.14 (2.07-8.26) for DAPT patients, and 4.95 (2.61-9.39) for monotherapy patients, both p < 0.001., Conclusions: The PRECISE-DAPT identifies patients with increased risk for major bleeding after discharge following CABG with moderate accuracy. The accuracy is comparable to what previously has been reported for patients after PCI., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.) more...
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- 2024
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93. Prediction of survival in out-of-hospital cardiac arrest: the updated Swedish cardiac arrest risk score (SCARS) model.
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Sultanian P, Lundgren P, Louca A, Andersson E, Djärv T, Hessulf F, Henningsson A, Martinsson A, Nordberg P, Piasecki A, Gupta V, Mandalenakis Z, Taha A, Redfors B, Herlitz J, and Rawshani A
- Abstract
Aims: Out-of-hospital cardiac arrest (OHCA) is a major health concern worldwide. Although one-third of all patients achieve a return of spontaneous circulation and may undergo a difficult period in the intensive care unit, only 1 in 10 survive. This study aims to improve our previously developed machine learning model for early prognostication of survival in OHCA., Methods and Results: We studied all cases registered in the Swedish Cardiopulmonary Resuscitation Registry during 2010 and 2020 ( n = 55 615). We compared the predictive performance of extreme gradient boosting (XGB), light gradient boosting machine (LightGBM), logistic regression, CatBoost, random forest, and TabNet. For each framework, we developed models that optimized (i) a weighted F1 score to penalize models that yielded more false negatives and (ii) a precision-recall area under the curve (PR AUC). LightGBM assigned higher importance values to a larger set of variables, while XGB made predictions using fewer predictors. The area under the curve receiver operating characteristic (AUC ROC) scores for LightGBM were 0.958 (optimized for weighted F1) and 0.961 (optimized for a PR AUC), while for XGB, the scores were 0.958 and 0.960, respectively. The calibration plots showed a subtle underestimation of survival for LightGBM, contrasting with a mild overestimation for XGB models. In the crucial range of 0-10% likelihood of survival, the XGB model, optimized with the PR AUC, emerged as a clinically safe model., Conclusion: We improved our previous prediction model by creating a parsimonious model with an AUC ROC at 0.96, with excellent calibration and no apparent risk of underestimating survival in the critical probability range (0-10%). The model is available at www.gocares.se., Competing Interests: Conflict of interest: none declared., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.) more...
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- 2024
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94. Dyslipidemia, inflammation, calcification, and adiposity in aortic stenosis: a genome-wide study.
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Yu Chen H, Dina C, Small AM, Shaffer CM, Levinson RT, Helgadóttir A, Capoulade R, Munter HM, Martinsson A, Cairns BJ, Trudsø LC, Hoekstra M, Burr HA, Marsh TW, Damrauer SM, Dufresne L, Le Scouarnec S, Messika-Zeitoun D, Ranatunga DK, Whitmer RA, Bonnefond A, Sveinbjornsson G, Daníelsen R, Arnar DO, Thorgeirsson G, Thorsteinsdottir U, Gudbjartsson DF, Hólm H, Ghouse J, Olesen MS, Christensen AH, Mikkelsen S, Jacobsen RL, Dowsett J, Pedersen OBV, Erikstrup C, Ostrowski SR, O'Donnell CJ, Budoff MJ, Gudnason V, Post WS, Rotter JI, Lathrop M, Bundgaard H, Johansson B, Ljungberg J, Näslund U, Le Tourneau T, Smith JG, Wells QS, Söderberg S, Stefánsson K, Schott JJ, Rader DJ, Clarke R, Engert JC, and Thanassoulis G more...
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- Humans, Genome-Wide Association Study methods, Adiposity genetics, Genetic Predisposition to Disease, Obesity, Risk Factors, Inflammation, Apolipoproteins genetics, Mendelian Randomization Analysis, Polymorphism, Single Nucleotide genetics, Aortic Valve Stenosis genetics, Dyslipidemias complications, Dyslipidemias genetics
- Abstract
Aims: Although highly heritable, the genetic etiology of calcific aortic stenosis (AS) remains incompletely understood. The aim of this study was to discover novel genetic contributors to AS and to integrate functional, expression, and cross-phenotype data to identify mechanisms of AS., Methods and Results: A genome-wide meta-analysis of 11.6 million variants in 10 cohorts involving 653 867 European ancestry participants (13 765 cases) was performed. Seventeen loci were associated with AS at P ≤ 5 × 10-8, of which 15 replicated in an independent cohort of 90 828 participants (7111 cases), including CELSR2-SORT1, NLRP6, and SMC2. A genetic risk score comprised of the index variants was associated with AS [odds ratio (OR) per standard deviation, 1.31; 95% confidence interval (CI), 1.26-1.35; P = 2.7 × 10-51] and aortic valve calcium (OR per standard deviation, 1.22; 95% CI, 1.08-1.37; P = 1.4 × 10-3), after adjustment for known risk factors. A phenome-wide association study indicated multiple associations with coronary artery disease, apolipoprotein B, and triglycerides. Mendelian randomization supported a causal role for apolipoprotein B-containing lipoprotein particles in AS (OR per g/L of apolipoprotein B, 3.85; 95% CI, 2.90-5.12; P = 2.1 × 10-20) and replicated previous findings of causality for lipoprotein(a) (OR per natural logarithm, 1.20; 95% CI, 1.17-1.23; P = 4.8 × 10-73) and body mass index (OR per kg/m2, 1.07; 95% CI, 1.05-1.9; P = 1.9 × 10-12). Colocalization analyses using the GTEx database identified a role for differential expression of the genes LPA, SORT1, ACTR2, NOTCH4, IL6R, and FADS., Conclusion: Dyslipidemia, inflammation, calcification, and adiposity play important roles in the etiology of AS, implicating novel treatments and prevention strategies., Competing Interests: Conflict of interest Scott M. Damrauer receives research support (to the University of Pennsylvania) from RenalytixAI and personal fees from Caico Ibs, both outside the scope of the present work. SMD is also named as a co-inventor on a government-owned US Patent application related to the use of genetic risk prediction for venous thromboembolic disease filed by the US Department of Veterans Affairs in accordance with Federal regulatory requirements. SMD is named as a co-inventor on a Government-owned US Patent application related to the use of PDE3B inhibition for preventing cardiovascular disease filed by the US Department of Veterans Affairs in accordance with Federal regulatory requirements. Stefan Söderberg has received speaker honoraria and consulting fees from Actelion Ltd. George Thanassoulis has received consulting fees from Ionis Pharmaceuticals and has participated in advisory boards for Amgen, Sanofi, Novartis, HLS Therapeutics and Silence. Morten Salling Olesen has received 5.000.000 dkrfra Sundhedsdonationer.Journalnr. 2022-0243. David O. Arnar has received travel support from Pfizer to attend the ESC 2022 Scientific Meeting in Barcelona and has stock options in Sidekick Health Digital Therapeutics. Henning Bundgaard has received lecture fees from Amgen, MSD, Sanofi-Avensis, BMS and grants from NordForsk, Innovation Fond, Denmark, The Capital Regions Research Foundation. Alex Hoerby Christensen—Novo Nordisk Foundation NNF20OC0065799. Romaine Capoulade has received an Honorarium for one lecture from Novartis. Robert Clarke has received support from BAYER (China Kadoorie Biobank). Unnur Thorsteinsdottir’s research is funded by deCODE genetics/Amgen. Daniel F. Gudbjartsson receives funds from deCODE Genetics/Amgen. Until 1 June 2022, Gudmundur Thorgeirsson was a part time employee of deCode Genetics that is owned by Amgen. Hilma Holm is an employee of deCODE genetics/Amgen Inc. Anna Helgadottir is an employee of deCODE genetics/Amgen Inc., (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.) more...
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- 2023
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95. Associations between medical therapy after surgical aortic valve replacement for aortic stenosis and long-term mortality: a report from the SWEDEHEART registry.
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Baranowska J, Törngren C, Nielsen SJ, Lindgren M, Björklund E, Ravn-Fischer A, Skoglund K, Jeppsson A, and Martinsson A
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- Humans, Aortic Valve surgery, Treatment Outcome, Registries, Hydroxymethylglutaryl-CoA Reductase Inhibitors adverse effects, Heart Valve Prosthesis Implantation adverse effects, Heart Valve Prosthesis Implantation methods, Aortic Valve Stenosis surgery
- Abstract
Aims: The association between the use of statins, renin-angiotensin system (RAS) inhibitors, and/or β-blockers and long-term mortality in patients with aortic stenosis (AS) who underwent surgical aortic valve replacement (SAVR) is unknown., Methods and Results: All patients with AS who underwent isolated first-time SAVR in Sweden from 2006 to 2017 and survived 6 months after discharge were included. Individual patient data from four mandatory nationwide registries were merged. Cox proportional hazards models, with time-updated data on medication status and adjusted for age, sex, comorbidities, type of prosthesis, and year of surgery, were used to investigate associations between dispensed statins, RAS inhibitors, and β-blockers and all-cause mortality. In total, 9553 patients were included, and the median follow-up time was 4.9 years (range 0-11); 1738 patients (18.2%) died during follow-up. Statins were dispensed to 49.1% and 49.0% of the patients within 6 months of discharge from the hospital and after 10 years, respectively. Corresponding figures were 51.4% and 53.9% for RAS inhibitors and 79.3% and 60.7% for β-blockers. Ongoing treatment was associated with lower mortality risk for statins {adjusted hazard ratio (aHR) 0.67 [95% confidence interval (95% CI) 0.60-0.74]; P < 0.001} and RAS inhibitors [aHR 0.84 (0.76-0.93); P < 0.001] but not for β-blockers [aHR 1.17 (1.05-1.30); P = 0.004]. The associations were robust in subgroups based on age, sex, and comorbidities (P for interactions >0.05)., Conclusions: The results of this large population-based real-world study support the use of statins and RAS inhibitors for patients who underwent SAVR due to AS., (© The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology.) more...
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- 2022
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96. Beta blockers and long-term outcome after coronary artery bypass grafting: a nationwide observational study.
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Lindgren M, Nielsen SJ, Björklund E, Pivodic A, Perrotta S, Hansson EC, Jeppsson A, and Martinsson A
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- Adrenergic beta-Antagonists adverse effects, Coronary Artery Bypass adverse effects, Humans, Stroke Volume, Treatment Outcome, Ventricular Function, Left, Heart Failure complications, Heart Failure diagnosis, Heart Failure epidemiology, Myocardial Infarction, Stroke epidemiology, Stroke prevention & control
- Abstract
Aims: Beta blockers are associated with improved outcomes for selected patients with cardiovascular disease. We assessed long-term utilization of beta blockers after coronary artery bypass grafting (CABG) and its association with outcome., Methods and Results: All 35 184 patients in Sweden who underwent first-time isolated CABG between 1 January 2006 and 31 December 2017 and were followed for at least 6 months were included in a nationwide observational study. Multivariable Cox regression models using time-updated data on dispensed prescriptions were used to assess associations between different types of beta blockers and outcomes. The primary outcome was major adverse cardiovascular events (MACEs), a composite of all-cause mortality, stroke, and myocardial infarction (MI). Subgroup analyses were performed in patients with and without previous MI, heart failure, and reduced left ventricular ejection fraction (LVEF). Median follow-up was 5.2 years (range 0-11). At baseline, 33 159 (94.2%) patients were dispensed beta blockers, 30 563 (92.2%) of which were cardioselective beta blockers. After 10 years, the dispensing of cardioselective beta blockers had declined to 73.7% of all patients. Ongoing treatment with cardioselective beta blockers was associated with a slight reduction in MACEs [hazard ratio (HR) 0.93, 95% confidence interval (CI) 0.89-0.98, P = 0.0063]. The reduction was largely driven by a reduced risk of MI (HR 0.83, 95% CI 0.75-0.92, P = 0.0003), while there was no significant reduction in all-cause mortality (HR 0.99, 95% CI 0.93-1.05) and stroke (HR 0.96, 95% CI 0.87-1.05). The reduced risk for MI was consistent in all the investigated subgroups., Conclusion: Ongoing treatment with cardioselective beta blockers after CABG is associated with a reduction in MACEs, mainly because of reduced long-term risk for MI. The association between cardioselective beta blockers and MI was consistent in patients with and patients without previous MI, heart failure, atrial fibrillation, or reduced LVEF., (© The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology.) more...
- Published
- 2022
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97. Short- and long-term outcome after surgical aortic valve replacement in patients on dialysis.
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Perrotta S, Nielsen SJ, Hansson EC, Lepore V, Martinsson A, Jeppsson A, and Lindgren M
- Abstract
Background: There is no consensus on the choice of aortic valve prosthesis for patients with end-stage renal failure. We analyzed short- and long-term complications in dialysis patients who underwent aortic valve replacement (AVR) with either a biological (bAVR) or a mechanical (mAVR) prosthesis., Methods: All patients on dialysis who underwent bAVR or mAVR in Sweden from 1995 to 2017 (n=335) were included in a nationwide, population-based, observational, cohort study. Short and long-term complications were compared. Long-term mortality was compared with multivariable Cox regression analysis adjusted for age, sex, comorbidities, and a propensity score-matched model. Median follow-up was 2.8 (range, 0-16) years., Results: Biological and mechanical valves were implanted in 253 (75.5%) and 82 (24.5%) patients, respectively. The bAVR patients were older and had more comorbidities. There was no significant difference in early complication rate. Thirty-day mortality was 9.1% in bAVR and 7.3% in mAVR patients (P=0.62). The multivariable Cox regression model did not show significant difference in mortality risk between bAVR and mAVR patients [adjusted hazard ratio (aHR) 1.33; 95% CI: 0.84-2.13; P=0.22]. The results were confirmed in the propensity-score matched model. The rate of aortic valve reoperations did not differ significantly between the bAVR and mAVR group., Conclusions: The short- and long-term complication rate is high, and the expected life expectancy limited, in dialysis patients undergoing AVR, without significant difference between biological and mechanical prostheses. The results suggest that biological valve prosthesis, avoiding systemic anticoagulation, is appropriate in most dialysis patients., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jtd.amegroups.com/article/view/10.21037/jtd-21-1410/coif). AJ reports personal fees from Boehringer-Ingelheim, Werfen, Alexion, Baxter, and LFB Biomedicaments, research grants from Swedish state, Swedish Heart Lung Foundation, Västra Götaland Region and Winberg Foundation, and he was a member of the Clinical Guideline Committee for the European Association for Cardiothoracic Surgery, outside the submitted work. ECH reports personal fees from AstraZeneca and Boehringer-Ingelheim, outside the submitted work. The other authors have no conflicts of interest to declare., (2022 Journal of Thoracic Disease. All rights reserved.) more...
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- 2022
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98. Genetically determined NLRP3 inflammasome activation associates with systemic inflammation and cardiovascular mortality.
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Schunk SJ, Kleber ME, März W, Pang S, Zewinger S, Triem S, Ege P, Reichert MC, Krawczyk M, Weber SN, Jaumann I, Schmit D, Sarakpi T, Wagenpfeil S, Kramann R, Boerwinkle E, Ballantyne CM, Grove ML, Tragante V, Pilbrow AP, Richards AM, Cameron VA, Doughty RN, Dubé MP, Tardif JC, Feroz-Zada Y, Sun M, Liu C, Ko YA, Quyyumi AA, Hartiala JA, Tang WHW, Hazen SL, Allayee H, McDonough CW, Gong Y, Cooper-DeHoff RM, Johnson JA, Scholz M, Teren A, Burkhardt R, Martinsson A, Smith JG, Wallentin L, James SK, Eriksson N, White H, Held C, Waterworth D, Trompet S, Jukema JW, Ford I, Stott DJ, Sattar N, Cresci S, Spertus JA, Campbell H, Tierling S, Walter J, Ampofo E, Niemeyer BA, Lipp P, Schunkert H, Böhm M, Koenig W, Fliser D, Laufs U, and Speer T more...
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- Humans, Leukocytes, Mononuclear, Cardiovascular Diseases mortality, Inflammasomes genetics, Inflammation genetics, NLR Family, Pyrin Domain-Containing 3 Protein genetics
- Abstract
Aims: Inflammation plays an important role in cardiovascular disease (CVD) development. The NOD-like receptor protein-3 (NLRP3) inflammasome contributes to the development of atherosclerosis in animal models. Components of the NLRP3 inflammasome pathway such as interleukin-1β can therapeutically be targeted. Associations of genetically determined inflammasome-mediated systemic inflammation with CVD and mortality in humans are unknown., Methods and Results: We explored the association of genetic NLRP3 variants with prevalent CVD and cardiovascular mortality in 538 167 subjects on the individual participant level in an explorative gene-centric approach without performing multiple testing. Functional relevance of single-nucleotide polymorphisms on NLRP3 inflammasome activation has been evaluated in monocyte-enriched peripheral blood mononuclear cells (PBMCs). Genetic analyses identified the highly prevalent (minor allele frequency 39.9%) intronic NLRP3 variant rs10754555 to affect NLRP3 gene expression. rs10754555 carriers showed significantly higher C-reactive protein and serum amyloid A plasma levels. Carriers of the G allele showed higher NLRP3 inflammasome activation in isolated human PBMCs. In carriers of the rs10754555 variant, the prevalence of coronary artery disease was significantly higher as compared to non-carriers with a significant interaction between rs10754555 and age. Importantly, rs10754555 carriers had significantly higher risk for cardiovascular mortality during follow-up. Inflammasome inducers (e.g. urate, triglycerides, apolipoprotein C3) modulated the association between rs10754555 and mortality., Conclusion: The NLRP3 intronic variant rs10754555 is associated with increased systemic inflammation, inflammasome activation, prevalent coronary artery disease, and mortality. This study provides evidence for a substantial role of genetically driven systemic inflammation in CVD and highlights the NLRP3 inflammasome as a therapeutic target., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2021. For permissions, please email: journals.permissions@oup.com.) more...
- Published
- 2021
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