1,630 results on '"Gentofte University Hospital"'
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2. Improving Information to Caregivers Via Adaptation and Implementation of the HERMES Intervention (HERMESII)
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Herlev Gentofte University Hospital, Denmark, Rigshospitalet, University of Copenhagen, Denmark, South Jutland Hospital, Denmark, and Mogens Groenvold, Professor
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- 2022
3. Implementation of lung cancer CT screening in the Nordic countries
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[ 1 ] Univ Copenhagen, Dept Cardiothorac Surg, RT Rigshosp, Copenhagen, Denmark Show more [ 2 ] Rigshosp Copenhagen, Dept Oncol, Finsen Ctr, Copenhagen, Denmark Show more [ 3 ] Gentofte Univ Hosp, Dept Pulm Med, Hellerup, Denmark [ 4 ] Haukeland Univ Sjukehus, Dept Pulm Med, Bergen, Norway [ 5 ] Vestre Viken Hosp Trust, Drammen Hosp, Sect Oncol, Drammen, Norway Show more [ 6 ] Akershus Univ Hosp, Dept Radiol, Loerenskog, Norway Show more [ 7 ] Canc Registry Norway, Registry Dept, Oslo, Norway Show more [ 8 ] Karolinska Inst, Karolinska Univ Hosp, Stockholm, Sweden [ 9 ] Gavle Cent Hosp, Dept Resp Med, Gavle, Sweden Show more [ 10 ] Skane Univ Hosp, Dept Heart & Lung Dis, Lund, Sweden Show more [ 11 ] Karolinska Univ Hosp, Dept Thoraxradiol, Stockholm, Sweden Show more [ 12 ] Karolinska Univ Hosp, Dept Cardiothorac Surg, Stockholm, Sweden Show more [ 13 ] Turku Univ, Vaasa Oncol Clin, Turku, Finland Show more [ 14 ] Univ Helsinki, Helsinki Univ Hosp, Heart & Lung Ctr, Helsinki, Finland Show more [ 15 ] Univ Iceland, Landspitli Univ Hosp, Dept Cardiothorac Surg, Fac Med, Reykjavik, Iceland, Department of Cardiothoracic Surgery RT Rigshospitalet, University of Copenhagen, Copenhagen, Denmark, Department of Oncology, Finsen Centre/Rigshospitalet Copenhagen, Copenhagen, Denmark, Department of Pulmonary Medicine, Gentofte University Hospital, Hellerup, Denmark, Department of Pulmonary Medicine, Haukeland universitetssjukehus, Bergen, Norway, Section of Oncology, Drammen Hospital, Vestre Viken Hospital Trust, Drammen, Norway, Registry Department, Cancer Registry of Norway, Oslo, Norway, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden, Department of Respiratory Medicine, Gävle Hospital, Gävle, Sweden, Department of Heart and Lung Diseases, Skåne University Hospital, Sweden, Department of Thoraxradiology, Karolinska University Hospital, Stockholm, Sweden, Department of Cardiothoracic Surgery, Karolinska University Hospital, Stockholm, Sweden, Vaasa Oncology Clinic, Turku University, Turku, Finland, Helsinki University, Helsinki University Hospital, Heart and Lung Centre, Helsinki, Finland, Department of Cardiothoracic Surgery, Faculty of Medicine, Landspitli University Hospital, University of Iceland, Reykjavik, Iceland, Pedersen, Jesper Holst, Sørensen, Jens Benn, Saghir, Zaigham, Fløtten, Øystein, Brustugun, Odd Terje, Ashraf, Haseem, Strand, Trond-Eirik, Friesland, Signe, Koyi, Hirsh, Ek, Lars, Nyrén, Sven, Bergman, Per, Jekunen, Antti, Nieminen, Eeva-Maija, Gudbjartsson, Tomas, [ 1 ] Univ Copenhagen, Dept Cardiothorac Surg, RT Rigshosp, Copenhagen, Denmark Show more [ 2 ] Rigshosp Copenhagen, Dept Oncol, Finsen Ctr, Copenhagen, Denmark Show more [ 3 ] Gentofte Univ Hosp, Dept Pulm Med, Hellerup, Denmark [ 4 ] Haukeland Univ Sjukehus, Dept Pulm Med, Bergen, Norway [ 5 ] Vestre Viken Hosp Trust, Drammen Hosp, Sect Oncol, Drammen, Norway Show more [ 6 ] Akershus Univ Hosp, Dept Radiol, Loerenskog, Norway Show more [ 7 ] Canc Registry Norway, Registry Dept, Oslo, Norway Show more [ 8 ] Karolinska Inst, Karolinska Univ Hosp, Stockholm, Sweden [ 9 ] Gavle Cent Hosp, Dept Resp Med, Gavle, Sweden Show more [ 10 ] Skane Univ Hosp, Dept Heart & Lung Dis, Lund, Sweden Show more [ 11 ] Karolinska Univ Hosp, Dept Thoraxradiol, Stockholm, Sweden Show more [ 12 ] Karolinska Univ Hosp, Dept Cardiothorac Surg, Stockholm, Sweden Show more [ 13 ] Turku Univ, Vaasa Oncol Clin, Turku, Finland Show more [ 14 ] Univ Helsinki, Helsinki Univ Hosp, Heart & Lung Ctr, Helsinki, Finland Show more [ 15 ] Univ Iceland, Landspitli Univ Hosp, Dept Cardiothorac Surg, Fac Med, Reykjavik, Iceland, Department of Cardiothoracic Surgery RT Rigshospitalet, University of Copenhagen, Copenhagen, Denmark, Department of Oncology, Finsen Centre/Rigshospitalet Copenhagen, Copenhagen, Denmark, Department of Pulmonary Medicine, Gentofte University Hospital, Hellerup, Denmark, Department of Pulmonary Medicine, Haukeland universitetssjukehus, Bergen, Norway, Section of Oncology, Drammen Hospital, Vestre Viken Hospital Trust, Drammen, Norway, Registry Department, Cancer Registry of Norway, Oslo, Norway, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden, Department of Respiratory Medicine, Gävle Hospital, Gävle, Sweden, Department of Heart and Lung Diseases, Skåne University Hospital, Sweden, Department of Thoraxradiology, Karolinska University Hospital, Stockholm, Sweden, Department of Cardiothoracic Surgery, Karolinska University Hospital, Stockholm, Sweden, Vaasa Oncology Clinic, Turku University, Turku, Finland, Helsinki University, Helsinki University Hospital, Heart and Lung Centre, Helsinki, Finland, Department of Cardiothoracic Surgery, Faculty of Medicine, Landspitli University Hospital, University of Iceland, Reykjavik, Iceland, Pedersen, Jesper Holst, Sørensen, Jens Benn, Saghir, Zaigham, Fløtten, Øystein, Brustugun, Odd Terje, Ashraf, Haseem, Strand, Trond-Eirik, Friesland, Signe, Koyi, Hirsh, Ek, Lars, Nyrén, Sven, Bergman, Per, Jekunen, Antti, Nieminen, Eeva-Maija, and Gudbjartsson, Tomas
- Abstract
To access publisher's full text version of this article click on the hyperlink below, INTRODUCTION: We review the current knowledge of CT screening for lung cancer and present an expert-based, joint protocol for the proper implementation of screening in the Nordic countries. MATERIALS AND METHODS: Experts representing all the Nordic countries performed literature review and concensus for a joint protocol for lung cancer screening. RESULTS AND DISCUSSION: Areas of concern and caution are presented and discussed. We suggest to perform CT screening pilot studies in the Nordic countries in order to gain experience and develop specific and safe protocols for the implementation of such a program.
4. The SGLT2 inhibitor empagliflozin in patients hospitalized for acute heart failure
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Voors, Adriaan, Angermann, Christiane, Teerlink, John, Collins, Sean, Kosiborod, Mikhail, Biegus, Jan, Ferreira, João Pedro, Nassif, Michael, Psotka, Mitchell, Tromp, Jasper, Borleffs, C. Jan Willem, Ma, Changsheng, Comin-Colet, Joseph, Fu, Michael, Janssens, Stefan, Kiss, Robert, Mentz, Robert, Sakata, Yasushi, Schirmer, Henrik, Schou, Morten, Schulze, P. Christian, Spinarova, Lenka, Volterrani, Maurizio, Wranicz, Jerzy, Zeymer, Uwe, Zieroth, Shelley, Brueckmann, Martina, Blatchford, Jonathan, Salsali, Afshin, Ponikowski, Piotr, University Medical Center Groningen [Groningen] (UMCG), University Hospital of Würzburg, University of California [San Francisco] (UC San Francisco), University of California (UC), Vanderbilt University Medical Center [Nashville], Vanderbilt University [Nashville], Saint Luke's Mid America Heart Institute, The George Institute for Global Health [Sydney] (GIGH), The University of Sydney, University of New South Wales [Sydney] (UNSW), University of Missouri School of Medicine, University of Missouri System, Wrocław Medical University, Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Centre d'investigation clinique plurithématique Pierre Drouin [Nancy] (CIC-P), Centre d'investigation clinique [Nancy] (CIC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Cardiovascular and Renal Clinical Trialists [Vandoeuvre-les-Nancy] (INI-CRCT), Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy], Faculdade de Medicina da Universidade do Porto (FMUP), Universidade do Porto = University of Porto, Inova Heart and Vascular Institute, Saw Swee Hock School of Public Health [Singapore, Singapore], National University of Singapore (NUS), Haga Teaching Hospital [Hague], Capital University of Medical Sciences [Beijing] (CUMS), Institut d'Investigació Biomèdica de Bellvitge [Barcelone] (IDIBELL), Sahlgrenska University Hospital [Gothenburg], Department of Cardiovascular Sciences [Leuven], Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven), Department of Cardiology, Military Hospital [Budapest], Duke University Medical Center, Osaka University [Osaka], Akershus University Hospital [Lørenskog], Gentofte University Hospital, Jena University Hospital [Jena], Faculty of Medicine [Brno] (MED / MUNI), Masaryk University [Brno] (MUNI), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS San Raffaele Pisana), Medical University of Łódź (MUL), Klinikum Ludwigshafen [Germany], University of Manitoba [Winnipeg], Boehringer Ingelheim International GmbH, Medizinische Fakultät Mannheim, Boehringer Ingelheim Pharma GmbH & Co. KG, Boehringer Ingelheim Pharmaceuticals, Inc, Ridgefield, Rutgers, The State University of New Jersey [New Brunswick] (RU), Rutgers University System (Rutgers), The sponsors of the trial were Boehringer Ingelheim and Eli Lilly and Company, and BOZEC, Erwan
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[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,[SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system - Abstract
International audience; The sodium–glucose cotransporter 2 inhibitor empagliflozin reduces the risk of cardiovascular death or heart failure hospitalization in patients with chronic heart failure, but whether empagliflozin also improves clinical outcomes when initiated in patients who are hospitalized for acute heart failure is unknown. In this double-blind trial (EMPULSE; NCT04157751 ), 530 patients with a primary diagnosis of acute de novo or decompensated chronic heart failure regardless of left ventricular ejection fraction were randomly assigned to receive empagliflozin 10 mg once daily or placebo. Patients were randomized in-hospital when clinically stable (median time from hospital admission to randomization, 3 days) and were treated for up to 90 days. The primary outcome of the trial was clinical benefit, defined as a hierarchical composite of death from any cause, number of heart failure events and time to first heart failure event, or a 5 point or greater difference in change from baseline in the Kansas City Cardiomyopathy Questionnaire Total Symptom Score at 90 days, as assessed using a win ratio. More patients treated with empagliflozin had clinical benefit compared with placebo (stratified win ratio, 1.36; 95% confidence interval, 1.09–1.68; P = 0.0054), meeting the primary endpoint. Clinical benefit was observed for both acute de novo and decompensated chronic heart failure and was observed regardless of ejection fraction or the presence or absence of diabetes. Empagliflozin was well tolerated; serious adverse events were reported in 32.3% and 43.6% of the empagliflozin- and placebo-treated patients, respectively. These findings indicate that initiation of empagliflozin in patients hospitalized for acute heart failure is well tolerated and results in significant clinical benefit in the 90 days after starting treatment.
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- 2022
5. Immediate vs Delayed Stenting in ST-Elevation Myocardial Infarction: Rationale and Design of the International PRIMACY Bayesian Randomized Controlled Trial
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Lars Køber, Thomas Engstrøm, Grégoire Rangé, Patrick Bélisle, E. Marc Jolicoeur, Nicolas Delarche, Brahim Harbaoui, Colin Berry, David Carrick, Michael McGillion, Jean-François Tanguay, Géraud Souteyrand, Frédéric Bouisset, François Roubille, Simon Kouz, Samer Mansour, Jean-Claude Tardif, Dan Eik Høfsten, Guillaume Cayla, James M. Brophy, Erick Schampaert, Cheol Woong Yu, Gilles Zemour, Loic Belle, Nandini Dendukuri, Henning Kelbæk, X. Marcaggi, Ziad Boueri, MORNET, Dominique, Montreal Heart Institute, Université de Montréal, Montréal, Québec, Canada., Centre for Outcomes Research, McGill University Health Centre-Research Institute, Montreal, Quebec, Canada, HOPITAL CHARTRES - DEPT CARDIOL, Montreal Health Innovation Coordination Center, Montreal, Quebec, CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand, Service Cardiologie [CHU Toulouse], Pôle Cardiovasculaire et Métabolique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre Hospitalier de Cannes (Centre Hospitalier de Cannes), Centre Hospitalier de Cannes, Centre hospitalier de Pau, Imagerie Ultrasonore, Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé (CREATIS), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hopital Sacre-Coeur, Interventional Cardiology, Université de Montréal, Montreal, Quebec, Centre Hospitalier Régional de Lanaudiere [Joliette, QC, Canada] (CHRDL), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Hôpital de Bastia, Ctr Hosp Vichy, Montreal Heart Institute Coordinating Centre (MHICC), Université de Montréal (UdeM), Montreal Heart Institute - Institut de Cardiologie de Montréal, Department of Cardiology, Gentofte University Hospital, Rigshospitalet [Copenhagen], Copenhagen University Hospital, Service de Cardiologie, Centre hospitalier de la région d'Annecy, Service de cardiologie [Toulouse], Hôpital de Rangueil, CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Université Jean Monnet [Saint-Étienne] (UJM)-Hospices Civils de Lyon (HCL)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Jean Monnet [Saint-Étienne] (UJM)-Hospices Civils de Lyon (HCL)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional de Lanaudiere, Joliette, Quebec, and Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)
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medicine.medical_specialty ,medicine.medical_treatment ,[SDV]Life Sciences [q-bio] ,030204 cardiovascular system & hematology ,Prosthesis Design ,law.invention ,Time-to-Treatment ,03 medical and health sciences ,0302 clinical medicine ,Percutaneous Coronary Intervention ,Randomized controlled trial ,law ,St elevation myocardial infarction ,Internal medicine ,medicine ,Humans ,cardiovascular diseases ,030212 general & internal medicine ,Myocardial infarction ,ComputingMilieux_MISCELLANEOUS ,Randomized Controlled Trials as Topic ,business.industry ,Antithrombin ,Stent ,Percutaneous coronary intervention ,Bayes Theorem ,medicine.disease ,3. Good health ,[SDV] Life Sciences [q-bio] ,surgical procedures, operative ,medicine.anatomical_structure ,Heart failure ,Cardiology ,ST Elevation Myocardial Infarction ,Stents ,Cardiology and Cardiovascular Medicine ,business ,medicine.drug ,Artery - Abstract
Background Primary percutaneous coronary intervention is used to restore blood flow in the infarct-related coronary artery, followed by immediate stenting to prevent reocclusion. Stents implanted in thrombus-laden arteries cause distal embolization, which paradoxically impairs myocardial reperfusion and ventricular function. Whether a strategy of delayed stenting improves outcomes in patients with acute ST-elevation myocardial infarction (STEMI) is uncertain. Methods The Primary Reperfusion Secondary Stenting (PRIMACY) is a Bayesian prospective, randomized, open-label, blinded end point trial in which delayed vs immediate stenting in patients with STEMI were compared for prevention of cardiovascular death, nonfatal myocardial infarction, heart failure, or unplanned target vessel revascularization at 9 months. All participants were immediately reperfused, but those assigned to the delayed arm underwent stenting after an interval of 24 to 48 hours. This interval was bridged with antithrombin therapy to reduce thrombus burden. In the principal Bayesian hierarchical random effects analysis, data from exchangeable trials will be combined into a study prior and updated with PRIMACY into a posterior probability of efficacy. Results A total of 305 participants were randomized across 15 centres in France and Canada between April 2014 and September 2017. At baseline, the median age of participants was 59 years, 81% were male, and 3% had a history of percutaneous coronary intervention. Results from PRIMACY will be updated from the patient-level data of 1568 participants enrolled in the Deferred Stent Trial in STEMI (DEFER; United Kingdom), Minimalist Immediate Mechanical Intervention (MIMI; France), Danish Trial in Acute Myocardial Infarction-3 (DANAMI-3; Denmark), and Impact of Immediate Stent Implantation Versus Deferred Stent Implantation on Infarct Size and Microvascular Perfusion in Patients With ST Segment–Elevation Myocardial Infarction (INNOVATION, South Korea) trials. Conclusions We expect to clarify whether delayed stenting can safely reduce the occurrence of adverse cardiovascular end points compared with immediate stenting in patients with STEMI.
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- 2020
6. The 10th Biennial Hatter Cardiovascular Institute workshop: cellular protection—evaluating new directions in the setting of myocardial infarction, ischaemic stroke, and cardio-oncology
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John Cunningham, Sapna Arjun, Sean M. Davidson, Marlène Wiart, Sandrine Lecour, Petra Kleinbongard, R. D. Carr, Malcolm Walker, Borja Ibanez, Derek M. Yellon, Arjun K. Ghosh, Gerd Heusch, Daniel I. Bromage, Robert M. Bell, Helen Maddock, Michel Ovize, Hans Erik Bøtker, Maryna V. Basalay, DFRL, Royal Institution of GB, London, DFRL, RI, Department of Cardiology, Gentofte University Hospital, Trinity College Dublin, Medical School, Institute for Pathophysiology, West-German Heart and VascularCenter, Essen University Hospital, Fundación Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Institut National de la Recherche Agronomique (INRA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hospices Civils de Lyon (HCL), British Heart Foundation, Deutsche Forschungsgemeinschaft (Alemania), and Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)
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HEART POSITION PAPER ,medicine.medical_specialty ,Physiology ,[SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging ,Medizin ,Ischemia ,PERCUTANEOUS CORONARY INTERVENTION ,Cardioprotection ,Meeting Report ,030204 cardiovascular system & hematology ,Myocardial ischaemia ,Neuroprotection ,03 medical and health sciences ,ARTERY-BYPASS SURGERY ,0302 clinical medicine ,Reperfusion therapy ,Physiology (medical) ,Internal medicine ,medicine ,Anthracycline cardiotoxicity ,ST-SEGMENT ELEVATION ,Myocardial infarction ,REPERFUSION INJURY ,Ischaemic stroke ,ComputingMilieux_MISCELLANEOUS ,Cardiotoxicity ,CEREBRAL-ISCHEMIA ,business.industry ,WORKING GROUP ,Cancer ,RANDOMIZED CONTROLLED-TRIAL ,medicine.disease ,NO-REFLOW PHENOMENON ,3. Good health ,MITOCHONDRIAL PERMEABILITY TRANSITION ,Heart failure ,Reperfusion ,Cardiology ,Cardiology and Cardiovascular Medicine ,business ,030217 neurology & neurosurgery - Abstract
Due to its poor capacity for regeneration, the heart is particularly sensitive to the loss of contractile cardiomyocytes. The onslaught of damage caused by ischaemia and reperfusion, occurring during an acute myocardial infarction and the subsequent reperfusion therapy, can wipe out upwards of a billion cardiomyocytes. A similar program of cell death can cause the irreversible loss of neurons in ischaemic stroke. Similar pathways of lethal cell injury can contribute to other pathologies such as left ventricular dysfunction and heart failure caused by cancer therapy. Consequently, strategies designed to protect the heart from lethal cell injury have the potential to be applicable across all three pathologies. The investigators meeting at the 10th Hatter Cardiovascular Institute workshop examined the parallels between ST-segment elevation myocardial infarction (STEMI), ischaemic stroke, and other pathologies that cause the loss of cardiomyocytes including cancer therapeutic cardiotoxicity. They examined the prospects for protection by remote ischaemic conditioning (RIC) in each scenario, and evaluated impasses and novel opportunities for cellular protection, with the future landscape for RIC in the clinical setting to be determined by the outcome of the large ERIC-PPCI/CONDI2 study. It was agreed that the way forward must include measures to improve experimental methodologies, such that they better reflect the clinical scenario and to judiciously select combinations of therapies targeting specific pathways of cellular death and injury. NIHR Biomedical Research Council (SD) and the British Heart Foundation PG/18/44/33790, PG/16/85/32471 (SD, DY). German Research Foundation SFB 1116 B08 (GH, PK). This work has been supported by the OPeRa program (ANR-10-IBHU-0004 OPeRa) and completed within the framework of the RHU MARVELOUS (ANR-16-RHUS-0009) (MO). Sí
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- 2018
7. Targeting reperfusion injury in patients with ST-segment elevation myocardial infarction:trials and tribulations
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Gerd Heusch, David Garcia-Dorado, Derek M. Yellon, Robert A. Kloner, David Erlinge, Michel Ovize, Derek J. Hausenloy, Thomas Engstrøm, Hans Erik Bøtker, Borja Ibanez, Cardiovascular and Metabolic Disorders Program, Duke-NUS Medical School [Singapore], Hatter Cardiovascular Institute, Institute Cardiovascular Science, University College London (UCL), Biomedical Research Center, National Institute Health Research, University College London Hospitals (UCLH), Department of Cardiology, Gentofte University Hospital, Medical School, Institute for Pathophysiology, West-German Heart and VascularCenter, Essen University Hospital, Spanish National Centre for Cardiovascular Research, IIS Hospital Universitario Fundación Jiménez Díaz, Huntington Medical Research Institute, School Medicine Department Medicine, Division Cardiovascular Medicine, University of Southern California (USC), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National de la Recherche Agronomique (INRA), Biomedical Research Centertr, National Institute Health research, British Heart Foundation, Rosetrees Trust, National Institute for Health Research University College London Hospitals Biomedical Research Centre, Cardiovascular Research Network of the Spanish Institute of Health Instituto de Salud Carlos III (ISCiii RETICS-RIC) RD12/0042/0021, German Research Foundation He 1320/18-3 SFB 1116 B8, Carlos III Institute of Health, European Regional Development Fund (ERDF/FEDER)PI13/01979, ISCiii Cardiovascular Research Network RD12/0042/0054, Red de Investigacion Cardiovascular del Instituto de Salud Carlos III, grupo Hospital Universitari Vall d'Hebron RETICS 2012 RD12/0042/0021, Duke NUS Medical School, Institut National de la Recherche Agronomique (INRA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hospices Civils de Lyon (HCL), National Institute for Health Research (Reino Unido), Centro de Investigación Biomédica en Red - CIBERCV (Enfermedades Cardiovasculares), Deutsche Forschungsgemeinschaft (Alemania), Instituto de Salud Carlos III, and Unión Europea. Fondo Europeo de Desarrollo Regional (FEDER/ERDF)
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0301 basic medicine ,Adenosine ,medicine.medical_treatment ,[SDV]Life Sciences [q-bio] ,Vasodilator Agents ,Medizin ,030204 cardiovascular system & hematology ,Mitochondrial Membrane Transport Proteins ,0302 clinical medicine ,Hypothermia, Induced ,Oximes ,Medicine ,Myocardial infarction ,Enzyme Inhibitors ,Ischemic Postconditioning ,Protein Kinase C ,Metoprolol ,Cause of death ,Cardioprotection ,Clinical Trials as Topic ,Cardiogenic shock ,BYPASS GRAFT-SURGERY ,RANDOMIZED CONTROLLED-TRIAL ,NO-REFLOW PHENOMENON ,Combined Modality Therapy ,Coronary Vessels ,3. Good health ,reperfusion ,LONG-TERM BENEFIT ,Current Opinion ,Cardiology ,cardiovascular system ,Cyclosporine ,Nucleotides, Cyclic ,Cardiology and Cardiovascular Medicine ,Oligopeptides ,medicine.drug ,Signal Transduction ,medicine.medical_specialty ,Cardiotonic Agents ,CONTROLLED CLINICAL-TRIAL ,wound ,PERCUTANEOUS CORONARY INTERVENTION ,Myocardial Reperfusion ,Myocardial Reperfusion Injury ,Nitric Oxide ,ISCHEMIA-REPERFUSION ,03 medical and health sciences ,LEFT-VENTRICULAR FUNCTION ,Internal medicine ,infarctus du myocarde ,Journal Article ,Humans ,Secosteroids ,cardiovascular diseases ,Nitrites ,PROTEIN KINASE-C ,business.industry ,Mitochondrial Permeability Transition Pore ,Patient Selection ,Percutaneous coronary intervention ,medicine.disease ,MITOCHONDRIAL PERMEABILITY TRANSITION ,030104 developmental biology ,Heart failure ,ST Elevation Myocardial Infarction ,business ,Reperfusion injury ,blessure - Abstract
Ischaemic heart disease (IHD) remains the leading cause of death and disability in Europe and worldwide. A major cause of morbidity and mortality in IHD patients is an acute ST-segment elevation myocardial infarction (STEMI), which despite prompt reperfusion by primary percutaneous coronary intervention (PPCI) has significant mortality (7% death at 1 year) and morbidity (22% prolonged or new hospitalization for heart failure at 1 year) in patients with large infarcts.1 When high-risk STEMI patients presenting with cardiogenic shock are not excluded, mortality at 1 year is even higher, at 12% after 1 year.2 As such, there remains an urgent need to discover novel therapies which can be given prior to or at the time of PPCI to reduce myocardial infarct (MI) size in order to preserve left ventricular (LV) systolic function, prevent the onset of heart failure, and improve survival in reperfused STEMI patients. In patients presenting with STEMI, rapid access to the emergency medical services and timely reperfusion by PPCI minimize the total ischaemic time, a major determinant of MI size. Although myocardial reperfusion is essential to salvage myocardium following a STEMI, the process of restoring coronary blood flow to the ischaemic tissue can, in itself, induce myocardial injury and cardiomyocyte death, a phenomenon which is known as ‘myocardial reperfusion injury’.3,4 Crucially, there is currently no effective therapy for reducing myocardial reperfusion injury in STEMI patients, and therefore, it remains a valid target for cardioprotection. However, the search for an effective therapy capable of targeting myocardial reperfusion injury and reducing MI size has been quite challenging, with a large number of failures to translate novel cardioprotective therapies into the …
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- 2016
8. Allergy immunotherapy across the life cycle to promote active and healthy ageing: from research to policies: An AIRWAYS Integrated Care Pathways (ICPs) programme item (Action Plan B3 of the European Innovation Partnership on active and healthy ageing) and the Global Alliance against Chronic Respiratory Diseases (GARD), a World Health Organization GARD research demonstration project
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Oliver Pfaar, Luciana Kase Tanno, Antonella Muraro, M. Bewick, G.W. Canonica, Pascal Demoly, Mohamed H. Shamji, Cezmi A. Akdis, T. Zuberbier, Dirceu Solé, H.-J. Malling, J Mullol, Alain Didier, Gunter J. Sturm, B. Samolinski, Claus Bachert, G. Passalacqua, Carmen Vidal, Andrew Bush, L. Cox, Stephen R. Durham, Anca-Mirela Chiriac, V. Cardona, Ana I. Tabar, M. T. Ventura, P. Devillier, G. Du Toit, Eva-Maria Varga, David Price, Thomas B. Casale, P. Rodriguez del Rio, Barbara Bohle, D. Larenas-Linnemann, Aziz Sheikh, G. Di Lorenzo, Margitta Worm, R. Rueff, R. van Ree, Susanne Halken, Davide Caimmi, Alessandro Fiocchi, J. C. Sisul, F. de Blay, Piotr Kuna, R. Gerth van Wijk, M. Matricardi, Moises A. Calderon, Ludger Klimek, Sergio Bonini, R. M. Gomez, Gabriela Senti, G. K. Scadding, Peter Eng, Nikolaos G. Papadopoulos, Adam T. Fox, Jean Bousquet, B. M. Bilo, Elideanna Pastorello, Edward F. Knol, Jörg Kleine-Tebbe, T. Haathela, Lars Jacobsen, R. Moesges, Adnan Custovic, Allan Linneberg, Peter Hellings, J. Just, Imperial College London, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'allergologie et de pneumologie [Hôpital Arnaud de Villeneuve], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), University of South Florida [Tampa] (USF), Universität Zürich [Zürich] = University of Zurich (UZH), Ghent University Hospital, iQ4U consultants Ltd, University hospital Ospedali Riuniti, Medizinische Universität Wien = Medical University of Vienna, National Research Council of Italy | Consiglio Nazionale delle Ricerche (CNR), University of Naples Federico II = Università degli studi di Napoli Federico II, Università degli studi di Genova = University of Genoa (UniGe), Vall d'Hebron University Hospital [Barcelona], Nova Southeastern University (NSU), Pôle de pathologie thoracique, CHU Strasbourg-Hopital Civil, Laboratoire de recherche sur les mécanismes moléculaires et pharmacologiques de l’obstruction bronchique (LOBIP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Pôle Clinique des Voies respiratoires [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), King‘s College London, Università degli studi di Palermo - University of Palermo, Children's hospital Aarau, IRCCS Ospedale Pediatrico Bambino Gesù [Roma], Erasmus University Medical Center [Rotterdam] (Erasmus MC), Hospital San Bernardo, Helsinki University Hospital, Odense University Hospital, University Hospitals Leuven [Leuven], Allergy Learning and Consulting, CHU Montpellier, Hospital Sírio Libanês, Allergy and Asthma Center Westend, German Society for Otorhinolaryngology HNS, University Medical Center [Utrecht], Medical University of Łódź (MUL), Hospital Medica Sur, ARIA, University of Copenhagen = Københavns Universitet (UCPH), Research Centre for Prevention and Health (RCPH), Department of Public Health [Copenhagen], Faculty of Health and Medical Sciences, University of Copenhagen = Københavns Universitet (UCPH)-University of Copenhagen = Københavns Universitet (UCPH)-Faculty of Health and Medical Sciences, University of Copenhagen = Københavns Universitet (UCPH)-University of Copenhagen = Københavns Universitet (UCPH)-Capital Region of Denmark, Rigshospitalet [Copenhagen], Copenhagen University Hospital, Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Gentofte University Hospital, Institute of Medical Statistics, Informatics and Epidemiology (IMSIE), University of Cologne, Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), Università degli Studi di Padova = University of Padua (Unipd), ASST Grande Ospedale Metropolitano Niguarda, Universität Mannheim, Center for Rhinology and Allergology, University Medical Centre Mannheim, Heidelberg University, University of Aberdeen, Research in Real Life (RiRL), Optimum Patient Care Ltd, Singapore, Hospital Infantil Universitario Niño Jesús (HIUNJ), Ludwig-Maximillians University, Medical University of Warsaw - Poland, University College of London [London] (UCL), Royal National Throat, Nose and Ear Institute, University hospital of Zurich [Zurich], MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, University of Edinburgh, Sociedad Latinoamericana de alergia, asma e inmunolgia (SLaai), Federal University of Sao Paulo (Unifesp), Medical University Graz, Allergy Outpatient Clinic Reumannplatz, Complejo Hospitalario de Navarra, University of Amsterdam [Amsterdam] (UvA), Università degli studi di Bari Aldo Moro = University of Bari Aldo Moro (UNIBA), Universidade de Santiago de Compostela [Spain] (USC ), Vieillissement et Maladies chroniques : approches épidémiologique et de santé publique (VIMA), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), European Innovation Partnership on Active and Healthy Ageing Reference Site MACVIA-France, European Structural and Development Funds of Region Languedoc Roussillon., Centre Hospitalier Universitaire de Montpellier (CHU Montpellier ), Consiglio Nazionale delle Ricerche (CNR), Centre de l'Asthme et des Allergies [CHU Trousseau], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Unité Asthme et allergologie [CHU Trousseau], Service d'Allergologie pédiatrique [CHU Trousseau], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), University of Mannheim, Universidade Federal de São Paulo (UNIFESP), BMC, BMC, University of Naples Federico II, University of Genoa (UNIGE), Service des maladies respiratoires [Rangueil-Larrey], CHU Toulouse [Toulouse], Unité Asthme et allergologie, University of Copenhagen = Københavns Universitet (KU), University of Copenhagen = Københavns Universitet (KU)-University of Copenhagen = Københavns Universitet (KU)-Faculty of Health and Medical Sciences, University of Copenhagen = Københavns Universitet (KU)-University of Copenhagen = Københavns Universitet (KU)-Capital Region of Denmark, Universita degli Studi di Padova, Hospital Infantil Universitario Niño Jesús, Università degli studi di Bari Aldo Moro (UNIBA), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université Montpellier 1 (UM1)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), and Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)
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Pulmonary and Respiratory Medicine ,Gerontology ,Allergen immunotherapy ,medicine.medical_specialty ,Allergy ,Al·lèrgia ,EIP on AHA ,[SDV]Life Sciences [q-bio] ,Immunology ,Alternative medicine ,Immunoteràpia ,Review ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Journal Article ,Immunology and Allergy ,030212 general & internal medicine ,Asthma ,Rhinitis ,business.industry ,Precision medicine ,medicine.disease ,3. Good health ,Integrated care ,[SDV] Life Sciences [q-bio] ,Ageing ,AIRWAYS ICPs ,030228 respiratory system ,General partnership ,Action plan ,Immunotherapy ,business - Abstract
Allergic diseases often occur early in life and persist throughout life. This life-course perspective should be considered in allergen immunotherapy. In particular it is essential to understand whether this al treatment may be used in old age adults. The current paper was developed by a working group of AIRWAYS integrated care pathways for airways diseases, the model of chronic respiratory diseases of the European Innovation Partnership on active and healthy ageing (DG CONNECT and DG Santé). It considered (1) the political background, (2) the rationale for allergen immunotherapy across the life cycle, (3) the unmet needs for the treatment, in particular in preschool children and old age adults, (4) the strategic framework and the practical approach to synergize current initiatives in allergen immunotherapy, its mechanisms and the concept of active and healthy ageing. ispartof: Clinical and Translational Allergy vol:6 issue:1 pages:41-47 ispartof: location:England status: published
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- 2016
9. The effect of a new communication template on anticipated willingness to initiate or resume allergen immunotherapy: an internet-based patient survey
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Hans-Jørgen Malling, Moises A. Calderon, Musa Khaitov, Oliver Pfaar, Ralph Mösges, Thomas B. Casale, Linda Cox, Joaquín Sastre, Pascal Demoly, Administateur, HAL Sorbonne Université, Section of Allergy and Clinical Immunology, Imperial College London-Faculty of Medicine-Royal Brompton Hospital, Nova Southeastern University (NSU), Internal Medicine, University of South Florida [Tampa] (USF), Universität zu Köln = University of Cologne, Center for Rhinology and Allergology Wiesbaden, University Hospital Mannheim, Department of Otorhinolaryngology, Universität Heidelberg [Heidelberg], Allergy clinic, Gentofte University Hospital, Allergy department, Fundacion Jimenez Diaz [Madrid] (FJD), NRC Institute of immunology FMBA, Moscow Russian federation, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Department of pulmonology, Hôpital Arnaud de Villeneuve [CHRU Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Universität zu Köln, and Universität Heidelberg [Heidelberg] = Heidelberg University
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Pulmonary and Respiratory Medicine ,Patient-physician communication close ,Allergen immunotherapy ,medicine.medical_specialty ,Allergy ,Patient physician communication ,Alternative medicine ,03 medical and health sciences ,0302 clinical medicine ,Internet based ,Information ,medicine ,Immunology and Allergy ,030212 general & internal medicine ,Symptom onset ,Medical prescription ,business.industry ,Research ,[SDV.IMM.IMM]Life Sciences [q-bio]/Immunology/Immunotherapy ,General Medicine ,medicine.disease ,Patient-physician communication ,3. Good health ,030228 respiratory system ,Adherence ,Family medicine ,Immunology ,Patient survey ,[SDV.IMM.IMM] Life Sciences [q-bio]/Immunology/Immunotherapy ,business - Abstract
Background A patient’s knowledge of his/her allergic condition and treatment is a key factor in adherence and effectiveness. Methods To assess patients’ understanding of allergy and acceptance of allergen immunotherapy on the basis of (i) information given by their physician at the time of prescription and (ii) a new communication template viewed some months later, we performed an Internet-based survey of patient panels in France, Germany, Spain, the USA and Russia. The survey participants were either recent “early abandoners” (having discontinued allergen immunotherapy before the end of the prescribed course) or “non-starters” (having decided not to initiate a course of allergen immunotherapy recommended by their physician). All participants completed an on-line questionnaire immediately before and immediately after viewing the new communication template. The study’s main objectives were to validate the new communication template and to assess its impact on anticipated willingness to initiate or resume allergen immunotherapy. Results We surveyed a total of 261 patients (France: 57; Germany: 51; Spain: 52; USA: 51; Russia: 50), comprising 127 “early abandoners” and 134 “non-starters”. The mean time since symptom onset and selection for the study was 14.5 years. Subcutaneous allergen immunotherapy had been prescribed in 60 % of cases. Twenty-eight percent of the participants did not know for which allergy they were being treated. Early abandoners reported a perception of low effectiveness (39 %) and complained about expense (39 %) and practical constraints (32 %). Twenty-two percent of the non-starters feared side effects. The communication template was considered to be clear (by 92 % of the patients), convincing (by 75 %) and reassuring (by 89 %); 80 % of the participants felt better informed afterwards, and 67 % stated that viewing the communication template would have made them more likely to continue or initiate allergen immunotherapy (overall willingness score: 5.65 out of 10 before viewing and 7.1 out of 10 afterwards). Conclusions After viewing a new communication template on allergy and allergen immunotherapy, patients participating in the survey felt better informed and more likely to initiate or complete this therapy. It now remains to investigate the communication template’s effect on actual acceptance of and adherence to allergen immunotherapy. Electronic supplementary material The online version of this article (doi:10.1186/s13223-015-0083-z) contains supplementary material, which is available to authorized users.
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- 2015
10. 'The value of pre-and co-seasonal sublingual immunotherapy in pollen-induced allergic rhinoconjunctivitis'
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Pascal Demoly, Hans-Jørgen Malling, Ulrich Wahn, Moises A. Calderon, Thomas B. Casale, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Allergy division, Pulmonology Department, Hôpital Arnaud de Villeneuve [CHRU Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Section of Allergy and Clinical Immunology, Imperial College London-Faculty of Medicine-Royal Brompton Hospital, Internal Medicine, University of South Florida [Tampa] (USF), Allergy clinic, Gentofte University Hospital, Department of paediatric pneumology and immunology, Charité Campus Virchow-Klinikum (CVK), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Université de Montpellier (UM), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Imperial College London, and Humboldt-Universität zu Berlin
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Pulmonary and Respiratory Medicine ,Allergy ,Allergen immunotherapy ,medicine.medical_specialty ,Immunology ,Review ,medicine.disease_cause ,Allergic rhinitis ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Allergen ,Randomized controlled trial ,law ,Pollen ,medicine ,otorhinolaryngologic diseases ,Immunology and Allergy ,030212 general & internal medicine ,Pre-seasonal ,[SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology ,Sublingual immunotherapy ,business.industry ,Birch ,Grass ,food and beverages ,[SDV.IMM.IMM]Life Sciences [q-bio]/Immunology/Immunotherapy ,medicine.disease ,Slit ,Dermatology ,3. Good health ,Clinical trial ,Regimen ,030228 respiratory system ,business ,Co-seasonal - Abstract
International audience; Allergen immunotherapy (AIT) is a guidelines-approved, disease-modifying treatment option for respiratory allergies, including allergic rhinitis (AR) induced by pollen. The various AIT regimens employed to date in pollen-induced AR can be classified as continuous (i.e. year-round) or discontinuous (i.e.pre-seasonal alone, co-seasonal alone or pre-and co-seasonal). Pre-and co-seasonal regimens are typically used for sublingual allergen immunotherapy (SLIT) and have economic and compliance advantages over perennial (year-round) regimens. However, these advantages must not come at the expensive of poor effiicacy or safety. The results of recent double-blind, placebo-controlled, randomized clinical trials show that pre-and co-seasonal SLIT is safe and effiective in patients with AR induced by grass pollen (treated with a tablet formulation) or by birch pollen (treated with a liquid formulation). Progress in SLIT has been made in defining the optimal dose of major allergen, the administration frequency (daily), the duration of pre-seasonal treatment (four months) and the number of treatment seasons (at least three). Post-marketing,"real-life" trials of pre-and co-seasonal birch or grass pollen SLIT regimens have confirmed the effiicacy and safety observed in the clinical trials. In the treatment of pollen-induced AR, pre-and co-seasonal SLIT regimens appear to be at least as effiective and safe as perennial SLIT regimens, and are associated with lower costs and good compliance. Good compliance may mean that pre-and co-seasonal SLIT regimens are inherently more effiective and safer than perennial SLIT regimens. When considering the pre-and co-seasonal discontinuous regimen in particular, a 300 IR five-grass-pollen formulation is the only SLIT tablet with a clinical development programme having provided evidence of short-term, sustained and post-treatment effiicacy.
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- 2015
11. Women's experiences of their osteoporosis diagnosis at the time of diagnosis and 6 months later: a phenomenological hermeneutic study
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Hanne Konradsen, Bo Abrahamsen, Carrinna Hansen, Birthe D. Pedersen, University of Southern Denmark, Gentofte University Hospital, Capital Region, Research Foundation for Health Research, Aase and Ejnar Danielsens Foundation, The Osteoporosis Society, and Cabinetmaker Sophus Jacobsen and wife Astrid Jacobsens Fond
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Research design ,Empirical Study ,medicine.medical_specialty ,Osteoporosis ,Health Behavior ,Psychological intervention ,Nursing research ,Health Promotion ,Interviews as Topic ,Absorptiometry, Photon ,Quality of life ,Ricoeur ,Qualitative research ,nursing research ,medicine ,Humans ,Women ,Interview ,Medical prescription ,Osteoporosis, Postmenopausal ,Aged ,Nursing ,Caring Science ,lcsh:R5-920 ,business.industry ,Interpretation ,Nursing Research ,Qualitative Research ,Health Policy ,interview ,medicine.disease ,Issues, ethics and legal aspects ,Health promotion ,Research Design ,Family medicine ,Physical therapy ,Quality of Life ,Fundamentals and skills ,Female ,lcsh:Medicine (General) ,business ,Gerontology ,Attitude to Health ,Osteoporotic Fractures ,qualitative research ,Follow-Up Studies - Abstract
This paper describes a phenomenological hermeneutic study of experiences of women who were recently diagnosed with osteoporosis. The research objective was to investigate women’s experiences of living with osteoporosis during the first 6 months after diagnosis when treatment was first prescribed. Fifteen women were included in the study. The inclusion criteria were a DXA scan at one of the two hospitals showing a T-score below 2.5 (lower back or hip), age 65 years or older; no previous known osteoporotic fracture; at least one of the known risk factors for osteoporosis; and prescription of anti-osteoporotic treatment. Exclusion criteria were previous diagnosis of osteoporosis or previous treatment with anti-osteoporotic medication. Data were collected through in-depth interviews shortly after diagnosis and 6 months later. The performed analyses were inspired by Paul Ricoeur’s theory of interpretation of texts comprising three levels: nai¨ve reading, structural analysis, and critical interpretation and discussion. Three key themes emerged: 1) being diagnosed, 2) being prescribed medical treatment, and 3) being on the path of learning to live with osteoporosis. The findings suggest a need for improved support for the patients to gain understanding of their diagnosis and the risk of osteoporotic fracture as well as to learn to live with osteoporosis. The study highlights new health promotion areas for targeting interventions at newly diagnosed patients, helping them accept and interpret the diagnosis, and the medical treatment. Key words: Interpretation, interview, nursing research, Ricoeur, qualitative research (Published: 21 February 2014) Citation: Int J Qualitative Stud Health Well-Being 2014, 9 : 22438 - http://dx.doi.org/10.3402/qhw.v9.22438
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- 2014
12. Warfarin therapy and incidence of cerebrovascular complications in left-sided native valve endocarditis
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Rune Andersson, Ulrika Snygg-Martin, Rasmus V. Rasmussen, Christian Hassager, Niels Eske Bruun, Lars Olaison, Department of Infectious Diseases, Institute of Biomedicine, University of Gothenburg (GU), Sahlgrenska University Hospital [Gothenburg], Department of Cardiology, Gentofte University Hospital, Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Research and Development Centre, and Skaraborgs Hospital
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Microbiology (medical) ,Male ,medicine.medical_specialty ,Staphylococcus aureus ,Administration, Oral ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Meningoencephalitis ,Risk Factors ,Internal medicine ,Medicine ,Endocarditis ,Humans ,030212 general & internal medicine ,Prospective cohort study ,Aged ,Native Valve Endocarditis ,business.industry ,Incidence (epidemiology) ,Incidence ,Warfarin ,Life Sciences ,Anticoagulants ,General Medicine ,Odds ratio ,Endocarditis, Bacterial ,Middle Aged ,medicine.disease ,equipment and supplies ,Confidence interval ,3. Good health ,Surgery ,Infectious Diseases ,Heart failure ,Female ,business ,medicine.drug - Abstract
International audience; Anticoagulant therapy has been anticipated to increase the risk of cerebrovascular complications (CVC) in native valve endocarditis (NVE). This study investigates the relationship between ongoing oral anticoagulant therapy and the incidence of symptomatic CVC in left-sided NVE. In a prospective cohort study, the CVC incidence was compared between NVE patients with and without ongoing warfarin. Among 587 NVE episodes, 48 (8%) occurred in patients on warfarin. A symptomatic CVC was seen in 144 (25%) patients, with only three on warfarin. CVC were significantly less frequent in patients on warfarin (6% vs. 26%, odds ratio [OR] 0.20, 95% confidence interval [CI] 0.06-0.6, = 0.006). No increase in haemorrhagic lesions was detected in patients on warfarin. aetiology (adjusted OR [aOR] 6.3, 95% CI 3.8-10.4) and vegetation length (aOR 1.04, 96% CI 1.01-1.07) were risk factors for CVC, while warfarin on admission (aOR 0.26, 95% CI 0.07-0.94), history of congestive heart failure (adjusted OR 0.22, 95% CI 0.1-0.52) and previous endocarditis (aOR 0.1, 95% CI 0.01-0.79) correlated with lower CVC frequency.
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- 2010
13. Reclassification of neuroendocrine tumors improves the separation of carcinoids and the prediction of survival
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Elisabeth Brambilla, Mark Krasnik, Torsten Skov, Sylvie Lantuejoul, Birgit Guldhammer Skov, Department of Pathology, Herlev and Gentofte Hospital, Department of Cardiothoracic Surgery, Gentofte University Hospital, Département d'anatomie et cythologie pathologique, CHU Grenoble-Hôpital Michallon, Broenshoej Kirkevej, and Lantuejoul, Sylvie
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Oncology ,Male ,Lung Neoplasms ,Survival ,MESH: Carcinoid Tumor ,MESH: Lymphatic Metastasis ,MESH: Lymph Nodes ,Neuroendocrine tumors ,TNM ,Metastasis ,MESH: Aged, 80 and over ,Size ,Carcinoma, Non-Small-Cell Lung ,Medical diagnosis ,Young adult ,MESH: Bronchial Neoplasms ,Aged, 80 and over ,MESH: Aged ,MESH: Middle Aged ,Bronchial Neoplasms ,Middle Aged ,Classification ,Prognosis ,Survival Rate ,MESH: Young Adult ,Lymphatic Metastasis ,MESH: Carcinoma, Large Cell ,Female ,Pulmonary and Respiratory Medicine ,Adult ,medicine.medical_specialty ,Adolescent ,MESH: Survival Rate ,[SDV.CAN]Life Sciences [q-bio]/Cancer ,Carcinoid Tumor ,Adenocarcinoma ,MESH: Prognosis ,Young Adult ,Text mining ,[SDV.CAN] Life Sciences [q-bio]/Cancer ,Neuroendocrine tumor ,Internal medicine ,medicine ,Carcinoma ,Humans ,Survival rate ,Aged ,Retrospective Studies ,MESH: Adolescent ,MESH: Humans ,business.industry ,MESH: Adenocarcinoma ,Retrospective cohort study ,MESH: Retrospective Studies ,MESH: Adult ,medicine.disease ,MESH: Male ,MESH: Lung Neoplasms ,Endobronchial ,Carcinoma, Large Cell ,Lymph Nodes ,business ,MESH: Female ,MESH: Carcinoma, Non-Small-Cell Lung - Abstract
International audience; INTRODUCTION: The classification of neuroendocrine lung tumors has changed over the last decades. Reliable diagnoses are crucial for the quality of clinical databases. The purpose of this study is to determine to which extent the use of different diagnostic criteria of neuroendocrine lung tumors has influenced the classification of these tumors. The prognostic information of tumor, node, metastasis descriptors was also evaluated. METHODS: We retrieved 110 tumors from the period 1989 to 2007. All tumors were reclassified according to the World Health Organization classification of 2004. Tumor, node, metastasis descriptors were evaluated. RESULTS: By reclassification, the diagnoses on 48 tumors (44%) were changed. More diagnoses were changed in the older part of the material. A significantly different survival was shown for all patients in relation to tumor size (p < 0.0001). An endobronchial component was seen in 54%, 31%, and 11% of typical carcinoid, atypical carcinoid, and large cell neuroendocrine carcinoma, respectively with no impact on survival (p = 0.90). For all included patients the survival was significantly worse for patients having metastasis to N1 nodes as compared with N0 (p = 0.03). However, the number of removed lymph nodes were insufficient for definitive determination of the prognostic impact of node metastases. Regarding the revised diagnoses, a significant difference in survival between typical carcinoid, atypical carcinoid, large cell neuroendocrine carcinoma and small cell carcinoma was noted (p < 0.005). CONCLUSION: Tumors must be rediagnosed before entering a central database. Tumor and node seem to be useful predictors of survival.
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- 2008
14. Finerenone in Heart Failure with Mildly Reduced or Preserved Ejection Fraction.
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Solomon SD, McMurray JJV, Vaduganathan M, Claggett B, Jhund PS, Desai AS, Henderson AD, Lam CSP, Pitt B, Senni M, Shah SJ, Voors AA, Zannad F, Abidin IZ, Alcocer-Gamba MA, Atherton JJ, Bauersachs J, Chang-Sheng M, Chiang CE, Chioncel O, Chopra V, Comin-Colet J, Filippatos G, Fonseca C, Gajos G, Goland S, Goncalvesova E, Kang S, Katova T, Kosiborod MN, Latkovskis G, Lee AP, Linssen GCM, Llamas-Esperón G, Mareev V, Martinez FA, Melenovský V, Merkely B, Nodari S, Petrie MC, Saldarriaga CI, Saraiva JFK, Sato N, Schou M, Sharma K, Troughton R, Udell JA, Ukkonen H, Vardeny O, Verma S, von Lewinski D, Voronkov L, Yilmaz MB, Zieroth S, Lay-Flurrie J, van Gameren I, Amarante F, Kolkhof P, and Viswanathan P
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- Aged, Female, Humans, Male, Middle Aged, Double-Blind Method, Follow-Up Studies, Hospitalization statistics & numerical data, Kaplan-Meier Estimate, Aged, 80 and over, Treatment Outcome, Heart Failure drug therapy, Heart Failure mortality, Heart Failure physiopathology, Mineralocorticoid Receptor Antagonists administration & dosage, Mineralocorticoid Receptor Antagonists adverse effects, Naphthyridines administration & dosage, Naphthyridines adverse effects, Stroke Volume drug effects, Stroke Volume physiology
- Abstract
Background: Steroidal mineralocorticoid receptor antagonists reduce morbidity and mortality among patients with heart failure and reduced ejection fraction, but their efficacy in those with heart failure and mildly reduced or preserved ejection fraction has not been established. Data regarding the efficacy and safety of the nonsteroidal mineralocorticoid receptor antagonist finerenone in patients with heart failure and mildly reduced or preserved ejection fraction are needed., Methods: In this international, double-blind trial, we randomly assigned patients with heart failure and a left ventricular ejection fraction of 40% or greater, in a 1:1 ratio, to receive finerenone (at a maximum dose of 20 mg or 40 mg once daily) or matching placebo, in addition to usual therapy. The primary outcome was a composite of total worsening heart failure events (with an event defined as a first or recurrent unplanned hospitalization or urgent visit for heart failure) and death from cardiovascular causes. The components of the primary outcome and safety were also assessed., Results: Over a median follow-up of 32 months, 1083 primary-outcome events occurred in 624 of 3003 patients in the finerenone group, and 1283 primary-outcome events occurred in 719 of 2998 patients in the placebo group (rate ratio, 0.84; 95% confidence interval [CI], 0.74 to 0.95; P = 0.007). The total number of worsening heart failure events was 842 in the finerenone group and 1024 in the placebo group (rate ratio, 0.82; 95% CI, 0.71 to 0.94; P = 0.006). The percentage of patients who died from cardiovascular causes was 8.1% and 8.7%, respectively (hazard ratio, 0.93; 95% CI, 0.78 to 1.11). Finerenone was associated with an increased risk of hyperkalemia and a reduced risk of hypokalemia., Conclusions: In patients with heart failure and mildly reduced or preserved ejection fraction, finerenone resulted in a significantly lower rate of a composite of total worsening heart failure events and death from cardiovascular causes than placebo. (Funded by Bayer; FINEARTS-HF ClinicalTrials.gov number, NCT04435626.)., (Copyright © 2024 Massachusetts Medical Society.)
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- 2024
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- View/download PDF
15. Glucagon-like peptide-1 increases heart rate by a direct action on the sinus node.
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Lubberding AF, Veedfald S, Achter JS, Nissen SD, Soattin L, Sorrentino A, Vega ET, Linz B, Eggertsen CHE, Mulvey J, Toräng S, Larsen SA, Nissen A, Petersen LG, Bilir SE, Bentzen BH, Rosenkilde MM, Hartmann B, Lilleør TNB, Qazi S, Møller CH, Tfelt-Hansen J, Sattler SM, Jespersen T, Holst JJ, and Lundby A
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- Animals, Female, Glucagon-Like Peptide-1 Receptor metabolism, Glucagon-Like Peptide-1 Receptor genetics, Glucagon-Like Peptide-1 Receptor agonists, Isolated Heart Preparation, Sus scrofa, Phosphorylation, Swine, Calcium Signaling drug effects, Hyperpolarization-Activated Cyclic Nucleotide-Gated Channels metabolism, Hyperpolarization-Activated Cyclic Nucleotide-Gated Channels genetics, Cyclic AMP-Dependent Protein Kinases metabolism, Sinoatrial Node metabolism, Sinoatrial Node drug effects, Heart Rate drug effects, Glucagon-Like Peptide 1 metabolism, Action Potentials drug effects
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Aims: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly used to treat type 2 diabetes and obesity. Albeit cardiovascular outcomes generally improve, treatment with GLP-1 RAs is associated with increased heart rate, the mechanism of which is unclear., Methods and Results: We employed a large animal model, the female landrace pig, and used multiple in vivo and ex vivo approaches including pharmacological challenges, electrophysiology, and high-resolution mass spectrometry to explore how GLP-1 elicits an increase in heart rate. In anaesthetized pigs, neither cervical vagotomy, adrenergic blockers (alpha, beta, or combined alpha-beta blockade), ganglionic blockade (hexamethonium), nor inhibition of hyperpolarization-activated cyclic nucleotide-gated (HCN) channels (ivabradine) abolished the marked chronotropic effect of GLP-1. GLP-1 administration to isolated perfused pig hearts also increased heart rate, which was abolished by GLP-1 receptor blockade. Electrophysiological characterization of GLP-1 effects in vivo and in isolated perfused hearts localized electrical modulation to the atria and conduction system. In isolated sinus nodes, GLP-1 administration shortened the action potential cycle length of pacemaker cells and shifted the site of earliest activation. The effect was independent of HCN blockade. Collectively, these data support a direct effect of GLP-1 on GLP-1 receptors within the heart. Consistently, single nucleus RNA sequencing showed GLP-1 receptor expression in porcine pacemaker cells. Quantitative phosphoproteomics analyses of sinus node samples revealed that GLP-1 administration leads to phosphorylation changes of calcium cycling proteins of the sarcoplasmic reticulum, known to regulate heart rate., Conclusion: GLP-1 has direct chronotropic effects on the heart mediated by GLP-1 receptors in pacemaker cells of the sinus node, inducing changes in action potential morphology and the leading pacemaker site through a calcium signalling response characterized by PKA-dependent phosphorylation of Ca2+ cycling proteins involved in pacemaking. Targeting the pacemaker calcium clock may be a strategy to lower heart rate in people treated with GLP-1 RAs., Competing Interests: Conflict of interest: J.J.H. has been on advisory boards for Novo Nordisk. The other authors report no conflict of interest., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)
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- 2024
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16. Utilizing echocardiography and unsupervised machine learning for heart failure risk identification.
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Simonsen JØ, Modin D, Skaarup K, Djernæs K, Lassen MCH, Johansen ND, Marott JL, Jensen MT, Jensen GB, Schnohr P, Martínez SS, Claggett BL, Møgelvang R, and Biering-Sørensen T
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Background: Global longitudinal strain (GLS) is recognized as a powerful predictor of heart failure (HF). However, the entire strain curve may entail important prognostic information regarding HF risk that might be undiscovered by only focusing on the peak strain value., Objective: The hypothesis of the present study was, that analysis of the entire strain curve using unsupervised machine learning (uML) would reveal novel ventricular deformation patterns capable of predicting incident HF independently of GLS., Methods: Longitudinal strain curves from 3710 subjects from the general population without prevalent HF were analyzed using uML., Results: Mean age was 56 years and 43 % were male. During a median follow-up of 5.3 years, 92 subjects (2.5 %) developed HF. The uML algorithm generated a hierarchical clustering tree (HCT) resulting in 10 different clusters. Generally, the strain curves displayed reduced early diastolic strain to peak-strain ratio with an increasing incidence rate of HF. In multivariable Cox regressions, cluster 9 was significantly associated with increased risk of HF when compared to cluster 2-5, and 7-8 [For cluster 3: HR 8.95, 95 %CI: 2.08;38.48, P = 0.003] even though the subjects of cluster 9 were younger, displayed healthier clinical baseline characteristics, and only had slightly reduced GLS. The mean strain curve of cluster 9 displayed an early systolic lengthening followed by a late and reduced contraction specifically related to the basal lateral segment., Conclusion: The unsupervised machine learning algorithm identified unknown strain patterns beyond GLS presumably related to increased risk of HF., Competing Interests: Declaration of competing interest Nothing to Disclose., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)
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- 2024
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17. Addressing gaps in cardiovascular health assessment in adolescents.
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Peronard R and Mayntz S
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Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interests.
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- 2024
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18. Letter to the editor: Concerns on invasive management in elderly ACS patients.
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Peronard R and Mayntz S
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Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interests.
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- 2024
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19. Association between Apgar scores within normal range and development of asthma, allergic rhinitis and eczema in childhood: A Danish nationwide register study.
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Halvard Hansen ES, Kaiser H, Hansen KT, Bønnelykke K, Chawes B, Backer V, Torp-Pedersen C, Ulrik CS, and Brustad N
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- Humans, Denmark epidemiology, Female, Child, Male, Infant, Newborn, Child, Preschool, Infant, Asthma epidemiology, Asthma diagnosis, Asthma etiology, Registries, Rhinitis, Allergic epidemiology, Eczema epidemiology, Eczema etiology, Apgar Score
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- 2024
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20. Role of human plasma metabolites in prediabetes and type 2 diabetes from the IMI-DIRECT study.
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Sharma S, Dong Q, Haid M, Adam J, Bizzotto R, Fernandez-Tajes JJ, Jones AG, Tura A, Artati A, Prehn C, Kastenmüller G, Koivula RW, Franks PW, Walker M, Forgie IM, Giordano G, Pavo I, Ruetten H, Dermitzakis M, McCarthy MI, Pedersen O, Schwenk JM, Tsirigos KD, De Masi F, Brunak S, Viñuela A, Mari A, McDonald TJ, Kokkola T, Adamski J, Pearson ER, and Grallert H
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Aims/hypothesis: Type 2 diabetes is a chronic condition that is caused by hyperglycaemia. Our aim was to characterise the metabolomics to find their association with the glycaemic spectrum and find a causal relationship between metabolites and type 2 diabetes., Methods: As part of the Innovative Medicines Initiative - Diabetes Research on Patient Stratification (IMI-DIRECT) consortium, 3000 plasma samples were measured with the Biocrates AbsoluteIDQ p150 Kit and Metabolon analytics. A total of 911 metabolites (132 targeted metabolomics, 779 untargeted metabolomics) passed the quality control. Multivariable linear and logistic regression analysis estimates were calculated from the concentration/peak areas of each metabolite as an explanatory variable and the glycaemic status as a dependent variable. This analysis was adjusted for age, sex, BMI, study centre in the basic model, and additionally for alcohol, smoking, BP, fasting HDL-cholesterol and fasting triacylglycerol in the full model. Statistical significance was Bonferroni corrected throughout. Beyond associations, we investigated the mediation effect and causal effects for which causal mediation test and two-sample Mendelian randomisation (2SMR) methods were used, respectively., Results: In the targeted metabolomics, we observed four (15), 34 (99) and 50 (108) metabolites (number of metabolites observed in untargeted metabolomics appear in parentheses) that were significantly different when comparing normal glucose regulation vs impaired glucose regulation/prediabetes, normal glucose regulation vs type 2 diabetes, and impaired glucose regulation vs type 2 diabetes, respectively. Significant metabolites were mainly branched-chain amino acids (BCAAs), with some derivatised BCAAs, lipids, xenobiotics and a few unknowns. Metabolites such as lysophosphatidylcholine a C17:0, sum of hexoses, amino acids from BCAA metabolism (including leucine, isoleucine, valine, N-lactoylvaline, N-lactoylleucine and formiminoglutamate) and lactate, as well as an unknown metabolite (X-24295), were associated with HbA
1c progression rate and were significant mediators of type 2 diabetes from baseline to 18 and 48 months of follow-up. 2SMR was used to estimate the causal effect of an exposure on an outcome using summary statistics from UK Biobank genome-wide association studies. We found that type 2 diabetes had a causal effect on the levels of three metabolites (hexose, glutamate and caproate [fatty acid (FA) 6:0]), whereas lipids such as specific phosphatidylcholines (PCs) (namely PC aa C36:2, PC aa C36:5, PC ae C36:3 and PC ae C34:3) as well as the two n-3 fatty acids stearidonate (18:4n3) and docosapentaenoate (22:5n3) potentially had a causal role in the development of type 2 diabetes., Conclusions/interpretation: Our findings identify known BCAAs and lipids, along with novel N-lactoyl-amino acid metabolites, significantly associated with prediabetes and diabetes, that mediate the effect of diabetes from baseline to follow-up (18 and 48 months). Causal inference using genetic variants shows the role of lipid metabolism and n-3 fatty acids as being causal for metabolite-to-type 2 diabetes whereas the sum of hexoses is causal for type 2 diabetes-to-metabolite. Identified metabolite markers are useful for stratifying individuals based on their risk progression and should enable targeted interventions., (© 2024. The Author(s).)- Published
- 2024
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21. Finerenone Improves Outcomes in Patients with Heart Failure with Mildly Reduced or Preserved Ejection Fraction Irrespective of Age: A Prespecified Analysis of FINEARTS-HF.
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Chimura M, Petrie MC, Schou M, Martinez FA, Henderson AD, Claggett BL, Desai AS, Kolkhof P, Viswanathan P, Lage A, Lam CSP, Senni M, Shah SJ, Rohwedder K, Mueller K, Voors AA, Zannad F, Pitt B, Vaduganathan M, Jhund PS, Solomon S, and McMurray JJV
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Background: Finerenone improves outcomes in patients with HF and mildly reduced or preserved ejection fraction (HFmrHF/HFpEF). It is important to understand the efficacy and safety of finerenone in these patients according to age. Methods: The aim of this analysis was to evaluate the interaction between age and the efficacy and safety of finerenone in the FINEARTS-HF trial (Finerenone trial to investigate efficacy and safety compared to placebo in patients with heart failure). A total of 6,001 patients aged 40-97 years were stratified by quartile (Q 1-4) of baseline age: Q1 40-66 years (n=1,581), Q2 67-73 years (n=1,587), Q 3 74-79 years (n=1,421), and Q4 ≧ 80 years (n=1,412). FINEARTS-HF evaluated the impact of age on the efficacy of finerenone with respect to the primary composite outcome of cardiovascular death and total (first and recurrent) HF events, including HF hospitalization or urgent HF event, along with secondary efficacy and safety outcomes. Results: The incidence of primary outcome increased with age. Finerenone reduced the risk of the primary outcome consistently across all age categories: RR (95% CI) Q1 0.70 (0.53- 0.92), Q2 0.83 (0.64-1.07), Q3 0.98 (0.76-1.26), and Q4 0.85 (0.67-1.07); p for interaction =0.27. Similarly, a consistent effect was observed for the components of the primary outcome. The mean increase in Kansas City Cardiomyopathy Questionnaire-total symptom score from baseline to 12 months was greater with finerenone than placebo, with a consistent effect across all age categories: mean placebo-corrected change (95% CI) Q1 2.87 (1.09-4.66), Q2 1.24 (-0.59-3.07), Q3 0.94 (-0.98-2.86), and Q4 1.24 (-0.90-3.38); P-interaction=0.50. Adverse events were similar across all age categories. The odds of experiencing hypotension, elevated creatinine, or hyperkalemia (increased) or hypokalemia (decreased) related to finerenone did not differ by age. Conclusions: In the FINEARTS-HF trial, finerenone reduced the primary outcome and components of the primary outcome, and improved symptoms across a wide age spectrum. In addition, finerenone was safe and well-tolerated, irrespective of age. Trial Registration: URL: https://clinicaltrials.gov Unique Identifiers: NCT04435626 and EudraCT 2020-000306-29.
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- 2024
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22. Can deep learning-derived IVUS predict outcomes in deferred CAD?
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Mayntz S, Rosenbech K, and Peronard R
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Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interests.
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- 2024
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23. Translating the 2021 ESC heart failure guideline recommendations in daily practice: Results from a heart failure survey. A scientific statement of the ESC Council for Cardiology Practice and the Heart Failure Association of the ESC.
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Christodorescu R, Geavlete O, Ferrini M, Kümler T, Toutoutzas K, Bayes-Genis A, Seferovic P, Metra M, Chioncel O, Rosano GMC, and Savarese G
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Aims: Real-world data show that guidelines are insufficiently implemented, and particularly guideline-directed medical therapies (GDMT) are underused in patients with heart failure and reduced ejection fraction (HFrEF) in clinical practice. The Council for Cardiology Practice and the Heart Failure Association of the European Society of Cardiology (ESC) developed a survey aiming to (i) evaluate the perspectives of the cardiology community on the 2021 ESC heart failure (HF) guidelines, (ii) pinpoint disparities in disease management, and (iii) propose strategies to enhance adherence to HF guidelines., Methods and Results: A 22-question survey regarding the diagnosis and treatment of HFrEF was delivered between March and June 2022. Of 457 physicians, 54% were general cardiologists, 19.4% were HF specialists, 18.9% other cardiac specialists, and 7.7% non-cardiac specialists. For diagnosis, 52.1% employed echocardiography and natriuretic peptides (NPs), 33.2% primarily used echocardiography, and 14.7% predominantly relied on NPs. The first drug class initiated in HFrEF was angiotensin-converting enzyme inhibitors/angiotensin receptor-neprilysin inhibitor (ACEi/ARNi) (91.2%), beta-blockers (BB) (73.8%), mineralocorticoid receptor antagonists (MRAs) (53.4%), and sodium-glucose cotransporter 2 (SGLT2) inhibitors (48.1%). The combination ACEi/ARNi + MRA+ BB was preferred by 39.3% of physicians, ACEi/ARNi + SGLT2 inhibitors + BB by 33.3%, and ACEi/ARNi + BB by 22.2%. The time required to initiate and optimize GDMT was estimated to be <1 month by 8.3%, 1-3 months by 52%, 3-6 months by 31.8%, and >6 months by 7.9%. Compared to general cardiologists, HF specialists/academic cardiologists reported lower estimated time-to-initiation, and more commonly preferred a parallel initiation of GDMT rather than a sequential approach., Conclusion: Participants generally followed diagnostic and treatment guidelines, but variations in HFrEF management across care settings or HF specialties were noted. The survey may raise awareness and promote standardized HF care., (© 2024 European Society of Cardiology.)
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- 2024
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24. Patients' use of Danish emergency medical services before and during the COVID-19 pandemic: a register-based study.
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Lindskou TA, Bogh SB, Kløjgaard TA, Fløjstrup M, Folke F, Væggemose U, Christensen HC, Christensen EF, Brabrand M, and Mikkelsen S
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- Humans, Denmark epidemiology, Female, Male, Middle Aged, SARS-CoV-2, Pandemics, Aged, Adult, COVID-19 epidemiology, Registries, Emergency Medical Services statistics & numerical data, Ambulances statistics & numerical data
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Background: During the COVID-19 pandemic, disturbing images of ambulances unable to respond to the demands for prehospital assistance appeared from several parts of the world. In Denmark, however, a notion occurred that the demands for emergency medical assistance declined. The purpose of this study was to compare the patients' use of the Danish Emergency Medical Services (EMS) before and during the COVID-19 pandemic. Furthermore, we investigated the overall mortality of the ambulance population, the main reason for calling the emergency medical dispatch centre, and the diagnosis assigned to the admitted patients., Methods: The study was a nationwide registry-based cohort study based on the national prehospital medical records and the Danish National Patient Registry. The primary outcome was the requested number of ambulances. Secondary outcomes included the primary reason for contact with the dispatch centre (reflected by the dispatch criteria), patient mortality, and the diagnoses assigned to the patients transported to the hospital by ambulance during the COVID-19 pandemic in Denmark in March-December 2020. Comparisons were made using a similar period in 2019 before the pandemic., Results: In comparison with the baseline values before the pandemic, the total number of patients treated by the EMS was reduced by 4.5% during the COVID-19 pandemic. The number of patients transported to the hospital during the pandemic was similarly reduced by 3.5%. Compared with baseline values, fewer were patients hospitalised with respiratory diseases during the pandemic (a reduction of 53.3% from April 2019 to April 2020). Compared to the baseline period, there were significant increases in both the 48-h mortality (from 1.4% to 1.5%) and the 30-day mortality (from 4.9% to 5.4%) (p < 0.03 and p < 0.001, respectively), in patients hospitalised during the pandemic., Conclusion: During the first wave of the COVID-19 pandemic, the Danish EMS experienced an overall reduction in the requests for and the use of ambulances and, especially, in the number of patients admitted to hospitals for respiratory diseases. Despite the overall reduction in EMS requests, the mortality of the ambulance population increased, indicating that despite the reduced ambulance use, the prehospital population was more severely ill during the pandemic., (© 2024. The Author(s).)
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- 2024
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25. Using simulation scenarios and a debriefing structure to promote feedback skills among interprofessional team members in clinical practice.
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Svendsen BT, Petersen LF, Skjelsager A, Lippert A, and Østergaard D
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Background: Team reflexivity and peer feedback in daily clinical work can improve patient safety. However, teams do not always engage in reflection after patient care. A reason could be that team members may lack skills in engaging in team reflection. This study explores the use of interprofessional team-based simulations to encourage and equip teams for reflective conversations in the real-world clinical practice., Methods: This was a prospective, explorative study of team members' perceptions of the use of in situ simulation-based scenarios with critically ill patient cases to train team-based reflections and peer feedback. The study took place in two neurological wards. Prior to the intervention, a 1-day observation in each ward and semi-structured short interviews with physicians and nurses were conducted., Results: A total of 94 staff members, 57 nurses, 8 nurse assistants and 29 physicians participated in the in situ simulation scenarios. All team members showed appreciation of the safe learning environment. The authors found that the simulations and the debriefing structure provided an opportunity for training of team reflexivity and feedback. The team members evaluated the simulation-based training very positively, and their initial reaction indicated that they found peer feedback useful for the individual and the team. This approach allowed them to reflect on their own clinical practice., Conclusion: The simulation-based training scenarios and the debriefing structure promoted team members' team reflexivity and peer feedback skills. The method is feasible and could be used in other specialties and situations. The team members' reactions to feedback were positive, and based on their reflections, there is a potential to increase both individual and team skills as well as improve patient treatment., (© 2024. The Author(s).)
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- 2024
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26. Exercise-based cardiac rehabilitation for adults with atrial fibrillation.
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Buckley BJ, Long L, Risom SS, Lane DA, Berg SK, Gluud C, Palm P, Sibilitz KL, Svendsen JH, Zwisler AD, Lip GY, Neubeck L, and Taylor RS
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- Humans, Bias, Randomized Controlled Trials as Topic, Stroke etiology, Stroke prevention & control, Atrial Fibrillation complications, Atrial Fibrillation psychology, Atrial Fibrillation rehabilitation, Cardiac Rehabilitation methods, Exercise Therapy methods, Quality of Life
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Background: Atrial fibrillation (AF), the most prevalent cardiac arrhythmia, disrupts the heart's rhythm through numerous small re-entry circuits in the atrial tissue, leading to irregular atrial contractions. The condition poses significant health risks, including increased stroke risk, heart failure, and reduced quality of life. Given the complexity of AF and its growing incidence globally, exercise-based cardiac rehabilitation (ExCR) may provide additional benefits for people with AF or those undergoing routine treatment for the condition., Objectives: To assess the benefits and harms of ExCR compared with non-exercise controls for people who currently have AF or who have been treated for AF., Search Methods: We searched the following electronic databases: CENTRAL in the Cochrane Library, MEDLINE Ovid, Embase Ovid, PsycINFO Ovid, Web of Science Core Collection Thomson Reuters, CINAHL EBSCO, LILACS BIREME, and two clinical trial registers on 24 March 2024. We imposed no language restrictions., Selection Criteria: We included randomised clinical trials (RCTs) that investigated ExCR interventions compared with any type of non-exercise control. We included adults 18 years of age or older with any subtype of AF or those who had received treatment for AF., Data Collection and Analysis: Five review authors independently screened and extracted data in duplicate. We assessed risk of bias using Cochrane's RoB 1 tool as outlined in the Cochrane Handbook for Systematic Reviews of Interventions. We assessed clinical and statistical heterogeneity by visual inspection of the forest plots and by using standard Chi² and I² statistics. We performed meta-analyses using random-effects models for continuous and dichotomised outcomes. We calculated standardised mean differences where different scales were used for the same outcome. We used the GRADE approach to assess the certainty of the evidence., Main Results: We included 20 RCTs involving a total of 2039 participants with AF. All trials were conducted between 2006 and 2024, with a follow-up period ranging from eight weeks to five years. We assessed the certainty of evidence as moderate to very low. Five trials assessed comprehensive ExCR programmes, which included educational or psychological interventions, or both; the remaining 15 trials compared exercise-only cardiac rehabilitation with controls. The overall risk of bias in the included studies was mixed. Details on random sequence generation, allocation concealment, and use of intention-to-treat analysis were typically poorly reported. Evidence from nine trials (n = 1173) suggested little to no difference in mortality between ExCR and non-exercise controls (risk ratio (RR) 1.06, 95% confidence interval (CI) 0.76 to 1.49; I² = 0%; 101 deaths; low-certainty evidence). Based on evidence from 10 trials (n = 825), ExCR may have little to no effect on SAEs (RR 1.30, 95% CI 0.63 to 2.67; I² = 0%; 28 events; low-certainty evidence). Evidence from four trials (n = 378) showed that ExCR likely reduced AF recurrence (measured via Holter monitoring) compared to controls (RR 0.70, 95% CI 0.56 to 0.88; I² = 2%; moderate-certainty evidence). ExCR may reduce AF symptom severity (mean difference (MD) -1.59, 95% CI -2.98 to -0.20; I² = 61%; n = 600; low-certainty evidence); likely reduces AF symptom burden (MD -1.61, 95% CI -2.76 to -0.45; I² = 0%; n = 317; moderate-certainty evidence); may reduce AF episode frequency (MD -1.29, 95% CI -2.50 to -0.07; I² = 75%; n = 368; low-certainty evidence); and likely reduces AF episode duration (MD -0.58, 95% CI -1.14 to -0.03; I² = 0%; n = 317; moderate-certainty evidence), measured via the AF Severity Scale (AFSS) questionnaire. Moderate-certainty evidence from six trials (n = 504) showed that ExCR likely improved the mental component summary measure in health-related quality of life (HRQoL) of the 36-item Short Form Health Survey (SF-36) (MD 2.66, 95% CI 1.22 to 4.11; I² = 2%), but the effect of ExCR on the physical component summary measure was very uncertain (MD 1.75, 95% CI -0.31 to 3.81; I² = 52%; very low-certainty evidence). ExCR also may improve individual components of HRQoL (general health, vitality, emotional role functioning, and mental health) and exercise capacity (peak oxygen uptake (VO
2peak ) and 6-minute walk test) following ExCR. The effects of ExCR on serious adverse events and exercise capacity were consistent across different models of ExCR delivery: centre compared to home-based, exercise dose, exercise only compared to comprehensive programmes, and aerobic training alone compared to aerobic plus resistance programmes. Using univariate meta-regression, there was evidence of significant association between location of trial and length of longest follow-up on exercise capacity., Authors' Conclusions: Due to few randomised participants and typically short-term follow-up, the impact of ExCR on all-cause mortality or serious adverse events for people with AF is uncertain. ExCR likely improves AF-specific measures including reduced AF recurrence, symptom burden, and episode duration, as well as the mental components of HRQoL. ExCR may improve AF symptom severity, episode frequency, and VO2peak . Future high-quality RCTs are needed to assess the benefits of ExCR for people with AF on patient-relevant outcomes including AF symptom severity and burden, AF recurrence, AF-specific quality of life, and clinical events such as mortality, readmissions, and serious adverse events. High-quality trials are needed to investigate how AF subtype and clinical setting (i.e. primary and secondary care) may influence ExCR effectiveness., (Copyright © 2024 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.)- Published
- 2024
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27. Incidence of Staphylococcus aureus Bacteremia in Patients Following Implantation of Cardiac Implantable Electronic Devices: A Danish Nationwide Cohort Study.
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Bengtsen KH, Falkentoft AC, Le MV, Haugan K, Philbert BT, Johansen JB, Torp-Pedersen C, Riahi S, Nielsen JC, Larroudé C, Petersen A, Larsen AR, Østergaard L, Fosbøl E, Bruun NE, and Ruwald AC
- Abstract
Background: Staphylococcus aureus bacteremia (SAB) is a high-risk condition associated with high morbidity and mortality. In the presence of cardiac implantable electronic devices (CIEDs), SAB may cause or clinically indicate device infection. We aimed to estimate the 10-year absolute risk of SAB in adult Danish first-time CIED carriers. Secondary aims included identification of risk factors associated with SAB., Methods: A registry-based study utilizing Danish nationwide registers and including consecutive Danish patients undergoing first CIED implantation between 2000 and 2020 was conducted. The primary outcome was first-time SAB after CIED implantation., Results: A total of 87 257 patients with first CIED implantation in the study period were identified (median age, 75 years; 62.6% were male; median follow-up, 3.8 years). Patients with pacemakers (PMs) were older and with more noncardiovascular comorbidities compared to patients with implantable cardioverter defibrillators (ICDs) and cardiac resynchronization therapy devices with or without defibrillator capacity (CRTs). In total, 1366 patients (1.6%) developed SAB. The 10-year absolute risk (95% confidence interval) of SAB was 2.0% (1.9%-2.1%) for PM, 2.6% (2.2%-3.1%) for ICD, and 3.7% (3.0%-4.5%) for CRT. A multivariable Cox analysis identified hemodialysis (hazard ratio [HR], 8.51), SAB before CIED (HR, 2.76), liver disease (HR, 2.35), and carrying a CRT device (HR, 1.68) among the covariates associated with increased risk of SAB., Conclusions: The absolute risk of SAB in Danish CIED carriers increased with more advanced CIED systems. The risk was highest within the first 3 months after CIED implantation and increased with the presence of certain covariates including renal dialysis, SAB before CIED, male sex, and advancing age., Competing Interests: Potential conflicts of interest. N. E. B. reports grants/contracts not related to this study from the Novo Nordisk Foundation and Health Insurance Denmark, and participation on a data and safety monitoring board or advisory board in the Heart Runner Project. E. F. reports grants/contracts not related to this study from the Novo Nordisk Foundation. J. B. J. reports payment or honoraria for lectures, presentations, speaker’s bureaus, manuscript writing, or educational events not related to this project from Medtonic and Merit Medical. J. C. N. reports a role as executive editor for Europace. S. R. reports grants/contracts not related to this study from the Novo Nordisk Foundation. A. C. R. reports payment or honoraria for lectures, presentations, speaker’s bureaus, manuscript writing, or educational events nor related to this project from Novartis, Bristol-Myers Squibb, and AstraZeneca. L. Ø. reports grants/contracts not related to this study from the Novo Nordisk Foundation. All other authors report no potential conflicts., (© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)
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- 2024
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28. Debulking surgery after muscular paraffin oil injections: Effects on calcium homeostasis and patient satisfaction.
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Yahyavi SK, Wall-Gremstrup G, Makki A, Juel J, Theilade S, Berg JO, Juul A, Momsen O, Eldrup E, and Blomberg Jensen M
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Objective: Cosmetic paraffin oil injections can lead to granuloma formation causing hypercalcemia and kidney failure. This study explores whether debulking surgery is an effective treatment for improving calcium homeostasis, inflammation and clinical symptoms., Materials and Methods: In a retrospective study, we reviewed 33 patients undergoing debulking surgery. Changes in calcium, inflammatory markers, and renal function from baseline up to twelve months post-surgery were assessed. Patients were interviewed post-surgery., Results: The patients were 34.6 years (SD 6.9) and had 1,104 grams (SD 591) of granuloma tissue removed following injection of 1,329 mL (SD 803) paraffin oil 7.9 years (SD 3.2) earlier. Seventeen patients had hypercalcemia and experienced a significant decline in ionized calcium from 1.48 mmol/L (SD 0.16) at baseline to 1.33 mmol/L (SD 0.03) at twelve months (p<0.002), although only four men (23.5%) became normocalcemic. Serum ferritin was reduced by 50% after twelve months (p=0.048). Sixteen patients were normocalcemic and had no change in calcium homeostasis but experienced a 20% drop in serum ferritin levels (p=0.025) after surgery. Fifteen patients completed all their planned surgeries within the study period and experienced a decline in serum ionized calcium (p=0.031), ferritin (p=0.011), and interleukin 2-receptor (p=0.037). A patient satisfaction survey showed that 55% of patients reported post-operative satisfaction scores of 10/10, and 59% of the patients reported reduced pain., Conclusion: Surgery improved calcium homeostasis in a fraction of patients, reduced inflammation and subjective symptoms such as pain and mental well-being in a patient group left with few treatment options except high-dose prednisolone., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com. See the journal About page for additional terms.)
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- 2024
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29. Association of sodium glucose co-transporter-2 inhibitors with risk of diabetic ketoacidosis among hospitalized patients: A multicentre cohort study.
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Sarma S, Hodzic-Santor B, Raissi A, Colacci M, Verma AA, Razak F, Højbjerg Lassen MC, and Fralick M
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- Humans, Male, Female, Middle Aged, Cohort Studies, Aged, Adult, Dipeptidyl-Peptidase IV Inhibitors therapeutic use, Dipeptidyl-Peptidase IV Inhibitors adverse effects, Risk Factors, Hypoglycemic Agents adverse effects, Hypoglycemic Agents therapeutic use, Diabetic Ketoacidosis epidemiology, Diabetic Ketoacidosis chemically induced, Sodium-Glucose Transporter 2 Inhibitors therapeutic use, Sodium-Glucose Transporter 2 Inhibitors adverse effects, Hospitalization statistics & numerical data, Diabetes Mellitus, Type 2 drug therapy, Diabetes Mellitus, Type 2 complications, Diabetes Mellitus, Type 2 blood, Diabetes Mellitus, Type 2 epidemiology
- Abstract
Introduction: Sodium glucose co-transporter-2 inhibitors (SGLT-2i) are increasingly being used among hospitalized patients. Our objective was to assess the risk of diabetic ketoacidosis (DKA) among hospitalized patients receiving an SGLT-2i., Research Design and Methods: We conducted a multicentre cohort study of patients hospitalized at 19 hospitals. We included patients over 18 years of age who received an SGLT-2i or a dipeptidyl peptidase-4 inhibitor (DPP-4i) in hospital. The primary outcome was the risk of DKA during their hospitalization., Results: 61,517 patients received a DPP-4i and 11,061 received an SGLT-2i. The risk of inpatient DKA was 0.07 % (N = 41 events) among adults who received a DPP-4i and 0.18 % (N = 20 events) among adults who received an SGLT-2i; adjusted odds ratio of 3.30 (95 % CI: 1.85-5.72)., Conclusions: In hospitalized patients, the absolute risk of DKA was 0.2 %, which corresponded to a three-fold higher relative risk., Competing Interests: Declaration of competing interest MF was a consultant for ProofDx, a start-up company creating point of care diagnostic tests for COVID-19 using CRISPR. MF is an advisor for SIGNAL1, a start-up company deploying machine learned models to improve inpatient care. MF has been paid for medicolegal cases unrelated to the content of this study. FR is a provincial clinical lead for quality improvement at Ontario Health (as a part-time salaried employee). This research was undertaken, in part, with funding from the Canada Research Chairs Program. AV is a part-time employee of Ontario Health and is supported by the Temerty Professorship of AI Research and Education in Medicine at the University of Toronto., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
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- 2024
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30. The fibroblast hormone Endotrophin is a biomarker of mortality in chronic diseases.
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Genovese F, Bager C, Frederiksen P, Vazquez D, Sand JMB, Jenkins RG, Maher TM, Stewart ID, Molyneaux PL, Fahy WA, Wain LV, Vestbo J, Nanthakumar C, Shaker SB, Hoyer N, Leeming DJ, George J, Trebicka J, Rasmussen DGK, Hansen MK, Cockwell P, Kremer D, Bakker SJ, Selby NM, Reese-Petersen AL, González A, Núñez J, Rossing P, Nissen NI, Boisen MK, Chen IM, Zhao L, Karsdal MA, and Schuppan D
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- Humans, Chronic Disease, Collagen Type VI blood, Collagen Type VI metabolism, Collagen Type VI genetics, Fibroblasts metabolism, Fibroblasts pathology, Fibrosis, Peptide Fragments, Biomarkers blood
- Abstract
Fibrosis, driven by fibroblast activities, is an important contributor to morbidity and mortality in most chronic diseases. Endotrophin, a signaling molecule derived from processing of type VI collagen by highly activated fibroblasts, is involved in fibrotic tissue remodeling. Circulating levels of endotrophin have been associated with an increased risk of mortality in multiple chronic diseases. We conducted a systematic literature review collecting evidence from original papers published between 2012 and January 2023 that reported associations between circulating endotrophin (PROC6) and mortality. Cohorts with data available to the study authors were included in an Individual Patient Data (IPD) meta-analysis that evaluated the association of PROC6 with mortality (PROSPERO registration number: CRD42023340215) after adjustment for age, sex and BMI, where available. In the IPD meta-analysis including sixteen cohorts of patients with different non-communicable chronic diseases (NCCDs) (N = 15,205) the estimated summary hazard ratio for 3-years all-cause mortality was 2.10 (95 % CI 1.75-2.52) for a 2-fold increase in PROC6, with some heterogeneity observed between the studies (I
2 =70 %). This meta-analysis is the first study documenting that fibroblast activities, as quantified by circulating endotrophin, are independently associated with mortality across a broad range of NCCDs. This indicates that, irrespective of disease, interstitial tissue remodeling, and consequently fibroblast activities, has a central role in adverse clinical outcomes, and should be considered with urgency from drug developers as a target to treat., Competing Interests: Declaration of competing interest Federica Genovese, Cecilie Bager, Peder Frederiksen, Dario Vazquez, Jannie Marie Bülow Sand, Diana Julie Leeming, Daniel Guldager Kring Rasmussen, Alexander Lynge Reese-Petersen, Neel I Nissen and Morten Karsdal are or have been at the time of writing, full-time employees at Nordic Bioscience. Federica Genovese, Cecilie Bager, Jannie Maria Bülow Sand, Diana Julie Leeming, Daniel Guldager Kring Rasmussen, Alexander Lynge Reese-Petersen and Morten Karsdal hold Nordic Bioscience stocks. Nordic Bioscience holds the patent for the PROC6 assays and commercializes the assay. Peter Rossing has received research support from Astra Zeneca, Novo Nordisk and Bayer, and has received honoraria (to Steno Diabetes Center Copenhagen) from Astra Zeneca, Boehringer Ingelheim, Bayer, Novo Nordisk, Gilead, Sanofi, Abbott for consultancy or education. Louise V. Wain has received research funding or collaborative support from Orion Pharma, GSK, Genentech, AstraZeneca and Sysmex, outside of the submitted work and provided consultancy for GSK and Galapagos., (Copyright © 2024. Published by Elsevier B.V.)- Published
- 2024
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31. Fibroblast activation protein and disease severity, progression, and survival in idiopathic pulmonary fibrosis.
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Prior TS, Hoyer N, Davidsen JR, Shaker SB, Hundahl MP, Lomholt S, Deleuran BW, Bendstrup E, and Kragstrup TW
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- Humans, Male, Female, Aged, Middle Aged, Prospective Studies, Respiratory Function Tests, Quality of Life, Denmark, Follow-Up Studies, Idiopathic Pulmonary Fibrosis mortality, Idiopathic Pulmonary Fibrosis blood, Disease Progression, Biomarkers blood, Severity of Illness Index
- Abstract
Idiopathic pulmonary fibrosis (IPF) is characterized by progressive fibrosis in the lungs. Activated fibroblasts play a central role in fibrogenesis and express fibroblast activation protein α. A truncated, soluble form (sFAP) can be measured in blood and is a potential novel biomarker of disease activity. The aim was to study the association between sFAP and clinical, radiological, and histopathological measures of disease severity, progression, and survival in a prospective, multicentre, real-world cohort of patients with IPF. Patients with IPF were recruited from the tertiary interstitial lung disease centres in Denmark and followed for up to 3 years. Baseline serum levels of sFAP were measured by ELISA in patients with IPF and compared to healthy controls. Pulmonary function tests, 6-minute walk test and quality of life measures were performed at baseline and during follow-up. The study included 149 patients with IPF. Median sFAP in IPF was 49.6 ng/mL (IQR: 43.1-61.6 ng/mL) and in healthy controls 73.8 ng/mL (IQR: 62.1-92.0 ng/mL). Continuous sFAP was not associated with disease severity, progression or survival (p > 0.05). After dichotomization of sFAP below or above mean sFAP + 2 SD for healthy controls, higher levels of sFAP were associated with lower FVC % predicted during follow-up (p < 0.01). Higher than normal serum levels of sFAP were associated with longitudinal changes in FVC % predicted, but sFAP did not show clear associations with other baseline or longitudinal parameters. As such, sFAP has limited use as a biomarker of disease progression or survival in patients with IPF., (© 2024 The Author(s). Scandinavian Journal of Immunology published by John Wiley & Sons Ltd on behalf of The Scandinavian Foundation for Immunology.)
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- 2024
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32. Disparities in the access to atrial fibrillation ablation in Denmark: who gets ablated, who neglected?
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Zörner CR, Tønnesen J, Riis-Vestergaard LD, Middelfart C, Hein R, Rasmussen PV, Ruwald MH, Gislason G, and Hansen ML
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- Humans, Denmark epidemiology, Male, Female, Middle Aged, Adult, Aged, Aged, 80 and over, Health Services Accessibility statistics & numerical data, Employment statistics & numerical data, Age Factors, Sex Factors, Risk Factors, Unemployment statistics & numerical data, Atrial Fibrillation surgery, Atrial Fibrillation epidemiology, Catheter Ablation statistics & numerical data, Healthcare Disparities, Registries, Educational Status
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Aims: Atrial fibrillation (AF) is a common arrhythmia associated with reduced quality of life that can lead to serious complications such as stroke and heart failure. Ablation is a safe and effective treatment for AF but is not offered equally to all patients. The aim of this study is to identify demographic groups more or less likely to undergo AF ablation., Methods and Results: All patients with newly diagnosed AF between 2010 and 2018 were identified in the Danish nationwide registries. The association between gender, age, level of education and attachment to the job market, and the likelihood of receiving AF ablation was investigated using multivariable Cox proportional hazard analysis. Cumulative incidence was calculated using the Aalen-Johansen estimator. A total of 176 248 patients were included. Men were more likely to receive ablation than women (7% vs. 3%). Patients aged 25-44 and 45-64 were most likely to receive ablation, while only 0.7% of patients aged 80 or above received ablation. The rate of ablation significantly decreased with decreasing level of education. Full-time employed patients were most likely to receive ablation, followed by self-employed, unemployed, on sick leave, undergoing education, and early retired patients. Retired patients were the least likely to receive ablation (3%)., Conclusion: This study found that women, older patients, patients with lower levels of education, and patients on social benefits are less likely to receive AF ablation. These findings suggest that there are significant social and economic disparities in AF ablation treatment in Denmark., Competing Interests: Conflict of interest: none declared., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)
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- 2024
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33. Temporal trends in infection-related hospitalizations among patients with heart failure: A Danish nationwide study from 1997 to 2017.
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Lundberg S, Knigge P, Strange JE, Nouhravesh N, Wagner AK, Malik ME, Butt JH, Andersson C, Biering-Sorensen T, Gislason G, Petrie MC, McMurray J, Køber L, Fosbol EL, and Schou M
- Abstract
Background: Despite improved survival, hospitalization is still common among patients with heart failure (HF)., Objective: This study aimed to examine temporal trends in infection-related hospitalization among HF patients and compare it to temporal trends in the risk of HF hospitalization and death., Methods: Using Danish nationwide registers, we included all patients aged 18 to 100 years, with HF diagnosed between January 1, 1997 and December 31, 2017, resulting in a total population of 147.737 patients. The outcomes of interest were primarily infection-related hospitalization and HF hospitalization and secondarily all-cause mortality. The Aalen Johansen's estimator was used to estimate 5-year absolute risks for the primary outcomes. Additionally, cox analysis was used for adjusted analyses., Results: The population had a median age of 74 [64, 82] years and 57.6 % were males. Patients with HF had a higher risk of infection over time 16.4 % (95% CI 16.0-16.8) in 1997 to 2001 vs 24.5% (95% CI 24.0-24.9) in 2012 to 2017. In contrast, they had a lower risk of HF hospitalization 26.5% (95% CI 26.1-27.0) in 1997 to 2001 vs 23.2% (95% CI 22.8-23.7) in 2012 to 2017. The risk of infection stratified by infection type showed similar trends for all infection types and marked the risk of pneumonia infection as the most significant in all subintervals., Conclusion: In the period from 1997 to 2017, we observed patients with HF had an increased risk of infection-related hospitalization, driven by pneumonia infections. In contrast, the risk of HF hospitalization decreased over time., Competing Interests: Conflict of interest None reported., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)
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- 2024
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34. Modifiable risk factors and self-reported health after percutaneous coronary intervention - with and without a history of atrial fibrillation.
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Kjølseth AJ, Norekvål TM, Brørs G, Hendriks JM, Risom SS, Rotevatn S, Wentzel-Larsen T, and Pettersen TR
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Aims: Atrial fibrillation (AF) and coronary artery disease (CAD) have several common risk factors, and 10-15% of patients with AF undergo percutaneous coronary intervention (PCI). Little is known about changes over time in modifiable risk factors and self-reported health in patients with and without a history of AF after PCI. Therefore, the aims were to determine and compare changes in modifiable risk factors and self-reported health in patients with and without a history of AF after PCI., Methods and Results: CONCARDPCI, a prospective multicentre cohort study including patients after PCI, was conducted at seven high-volume PCI centres in Norway and Denmark (N=3417). Of these, 408 had a history of AF. Data collection was conducted at the index admission and at 2-, 6- and 12 months after discharge. Self-reported health was assessed with RAND-12 and the Myocardial Infarction Dimensional Assessment Scale (MIDAS). Patients with a history of AF reported a poorer health at baseline. However, the physical (p=0.012) and mental (p<0.001) health improved over time in both groups. The patients with a history of AF reported more emotional reactions (p=0.029) and insecurities (p=0.015). The proportion of smokers increased from 2- to 12 months in patients with a history of AF (p=0.041), however, decreased in patients without AF from baseline to 6 months (p<0.001)., Conclusion: An intensified focus on lifestyle interventions is needed to improve modifiable risk factors and self-reported health in patients with and without a history of AF after PCI., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)
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- 2024
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35. Titration of anti-IL-5 biologics in severe asthma: an open-label randomised controlled trial (the OPTIMAL study).
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Soendergaard MB, Bjerrum AS, Rasmussen LM, Lock-Johansson S, Hilberg O, Hansen S, von Bulow A, and Porsbjerg C
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- Humans, Male, Female, Middle Aged, Adult, Pilot Projects, Treatment Outcome, Biological Products administration & dosage, Biological Products therapeutic use, Antibodies, Monoclonal, Humanized administration & dosage, Antibodies, Monoclonal, Humanized therapeutic use, Aged, Severity of Illness Index, Asthma drug therapy, Interleukin-5 antagonists & inhibitors, Anti-Asthmatic Agents administration & dosage, Anti-Asthmatic Agents therapeutic use, Algorithms
- Abstract
Background: Anti-interleukin (IL)-5 biologics effectively reduce exacerbations and the need for maintenance oral corticosteroids (mOCS) in severe eosinophilic asthma. However, it is unknown how long anti-IL-5 treatment should be continued. Data from clinical trials indicate a gradual but variable loss of control after treatment cessation. In this pilot study of titration, we evaluated a dose-titration algorithm in patients who had achieved clinical control on an anti-IL-5 biologic., Methods: In this open-label randomised controlled trial conducted over 52 weeks, patients with clinical control (no exacerbations or mOCS) on anti-IL-5 treatment were randomised to continue with unchanged intervals or have dosing intervals adjusted according to a titration algorithm that gradually extended dosing intervals and reduced them again at signs of loss of disease control. The OPTIMAL algorithm was designed to down-titrate dosing until signs of loss of control, to enable assessment of the longest dosing interval possible., Results: Among 73 patients enrolled, 37 patients were randomised to the OPTIMAL titration arm; 78% of patients tolerated down-titration of treatment. Compared to the control arm, the OPTIMAL arm tended to have more exacerbations during the study (32% versus 17%; p=0.13). There were no severe adverse events related to titration, and lung function and symptoms scores remained stable and comparable in both study arms throughout., Conclusion: This study serves as a proof of concept for titration of anti-IL-5 biologics in patients with severe asthma with clinical control on treatment, and the OPTIMAL algorithm provides a potential framework for individualising dosing intervals in the future., Competing Interests: Conflict of interest: M.B. Soendergaard reports payment or honoraria for lectures, presentations, manuscript writing or educational events from GSK and AstraZeneca, and participation on a data safety monitoring board or advisory board with AstraZeneca. A-S. Bjerrum reports payment or honoraria for lectures, presentations, manuscript writing or educational events from GSK and AstraZeneca. L.M. Rasmussen reports payment or honoraria for lectures, presentations, manuscript writing or educational events from AstraZeneca, GSK, Teva and ALK, support for attending meetings from AstraZeneca and Chiesi, and participation on a data safety monitoring board or advisory board with AstraZeneca, GSK, Teva and Sanofi. A. von Bulow reports consultancy fees from Novartis, payment or honoraria for lectures, presentations, manuscript writing or educational events from AstraZeneca, Novartis and GSK, and participation on a data safety monitoring board or advisory board with AstraZeneca and Novartis. C. Porsbjerg reports grants paid to their institution from AstraZeneca, GSK, Novartis, Teva, Sanofi, Chiesi and ALK, consultancy fees (paid both to institution and as personal honoraria) from AstraZeneca, GSK, Novartis, Teva, Sanofi, Chiesi and ALK, payment or honoraria for lectures, presentations, manuscript writing or educational events (paid both to institution and as personal honoraria) from AstraZeneca, GSK, Novartis, Teva, Sanofi, Chiesi and ALK, and participation on a data safety monitoring board or advisory board (fees paid both to institution and as personal honoraria) with AstraZeneca, Novartis, Teva, Sanofi and ALK. The remaining authors have no potential conflicts of interest to disclose., (Copyright ©The authors 2024.)
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- 2024
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36. Self-reported mental and physical health is associated with not returning to work in patients with ischemic heart disease.
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Saarinen SL, Borregaard B, Ekholm O, Christensen AV, Thorup CB, Thomsen T, Thrysoee L, Mols RE, Juel K, Berg SK, and Rasmussen TB
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- Humans, Male, Female, Middle Aged, Adult, Sick Leave statistics & numerical data, Follow-Up Studies, Cohort Studies, Health Status, Patient Reported Outcome Measures, Return to Work psychology, Return to Work statistics & numerical data, Myocardial Ischemia psychology, Myocardial Ischemia epidemiology, Self Report, Mental Health
- Abstract
Background: Ischemic Heart Disease (IHD) can lead to prolonged sick leave and loss of ability to work. This study aimed to describe non-return to work (non-RTW) across three IHD subgroups at 3 and at 12 months post discharge, and explore whether baseline characteristics, and patient-reported mental and physical health were associated with work detachment., Methods: Data from the national cohort study DenHeart were used, including the patient-reported outcomes (PROs) Short-Form 12, Hospital Anxiety and Depression Scale, Edmonton Symptom Assessment Scale and HeartQoL measured at discharge and register-based follow-up at 3 and at 12 months. A total of 3873 patients with IHD ≤ 63 years old and part of the workforce prior to hospitalisation, were included in the analyses and divided into three groups: chronic IHD/stable angina, non-STEMI (non-ST-Elevation Myocardial Infarction)/unstable angina and STEMI (ST-Elevation Myocardial Infarction). A composite outcome of 'prolonged sick leave' and/or 'left the workforce' was defined as non-return to work (non-RTW). Adjusted logistic regression models were performed., Results: Overall, the frequency of non-RTW was 37.7% and 38.0% at 3 and 12 months, respectively, thus not improving with time. The largest proportion of non-RTW was found in STEMI patients, followed by non-STEMI/unstable angina and IHD/stable angina patients. Several clinical and socio-demographic factors, as well as patient-reported mental and physical health were associated with non-RTW among the subgroups., Conclusion: The findings demonstrate a need for identifying IHD patients at risk of non-RTW after discharge based on their mental and physical health and a need for initiatives to minimize unwanted non-RTW., Competing Interests: Declaration of competing interest The Author(s) declare(s) that there is no conflict of interest., (Copyright © 2024. Published by Elsevier B.V.)
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- 2024
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37. General anaesthesia compared to conscious sedation for first-time atrial fibrillation catheter ablation-a Danish nationwide cohort study.
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Riis-Vestergaard LD, Tønnesen J, Ruwald MH, Zörner CR, Middelfart C, Hein R, Johannessen A, Hansen J, Worck RH, Gislason G, and Hansen ML
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- Humans, Male, Female, Denmark epidemiology, Middle Aged, Aged, Treatment Outcome, Risk Factors, Anti-Arrhythmia Agents therapeutic use, Atrial Fibrillation surgery, Atrial Fibrillation epidemiology, Anesthesia, General statistics & numerical data, Catheter Ablation statistics & numerical data, Conscious Sedation statistics & numerical data, Recurrence, Registries
- Abstract
Aims: Catheter ablation (CA) is a well-established treatment option for atrial fibrillation (AF), where sedation and analgesia are pivotal for patient comfort and lesion formation. The impact of anaesthesia type on AF recurrence rates remains uncertain. This study aimed to examine AF recurrence rates depending on conscious sedation (CS) vs. general anaesthesia (GA) during CA., Methods and Results: Utilizing nationwide data from the Danish healthcare registries, we conducted this cohort study involving adults (≥18 years) undergoing first-time CA for AF between 2010 and 2018. Patients were categorized by anaesthesia type (CS or GA), with the primary endpoint being AF recurrence, defined by a composite endpoint of either antiarrhythmic drug (AAD) prescriptions, AF-related hospital admissions, electrical cardioversions, or AF re-ablation. The impact of anaesthesia type was evaluated using multivariable Cox proportional hazards analysis. The study cohort comprised 7957 (6421 CS and 1536 GA) patients. Persistent AF, hypertension, and heart failure, as well as use of AAD, were more prevalent in the GA group. Cumulative incidences of recurrent AF were higher in the CS group at 1 (46% vs. 37%) and at 5 (68% vs. 63%) years. Multivariate analysis revealed CS as significantly associated with increased risk of AF recurrence at 5-year follow-up [hazard ratio 1.26 (95% confidence interval 1.15-1.38)], consistent across paroxysmal and persistent AF subtypes., Conclusion: This nationwide cohort study suggests a higher risk of AF recurrence with CS during CA compared to GA. These results advocate for considering GA as the preferred anaesthesia type for improved CA outcomes., Competing Interests: Conflict of interest: L.D.R.-V., J.T., C.R.Z., C.M., R.H., A.J., R.H.W., G.G.: none. M.H.R.: Speaker honoraria from Boston Scientific and CardioFocus. J.H.: Speaker fees and consultant honoraria from Boston Scientific and Biosense Webster. M.L.H.: Received research grants from Biosense Webster and Medtronic., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)
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- 2024
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38. Source-specific nitrate intake and all-cause mortality in the Danish Diet, Cancer, and Health Study.
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Bondonno NP, Pokharel P, Bondonno CP, Erichsen DW, Zhong L, Schullehner J, Frederiksen K, Kyrø C, Hendriksen PF, Hodgson JM, Dalgaard F, Blekkenhorst LC, Raaschou-Nielsen O, Sigsgaard T, Dahm CC, Tjønneland A, and Olsen A
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- Humans, Denmark epidemiology, Male, Middle Aged, Female, Aged, Adult, Nitrites adverse effects, Nitrites analysis, Nitrites administration & dosage, Cause of Death, Risk Factors, Nitrates analysis, Nitrates adverse effects, Nitrates administration & dosage, Neoplasms mortality, Diet statistics & numerical data, Cardiovascular Diseases mortality, Proportional Hazards Models
- Abstract
Introduction: Nitrate and nitrite are naturally occurring in both plant- and animal-sourced foods, are used as additives in the processing of meat, and are found in water. There is growing evidence that they exhibit a spectrum of health effects, depending on the dietary source. The aim of the study was to examine source-dependent associations between dietary intakes of nitrate/nitrite and both all-cause and cause-specific mortality., Methods: In 52,247 participants of the Danish Diet, Cancer and Health Study, associations between source-dependent nitrate and nitrite intakes--calculated using comprehensive food composition and national drinking water quality monitoring databases--and all-cause, cardiovascular disease (CVD)-related, and cancer-related mortality over 27 years were examined using restricted cubic splines within Cox proportional hazards models adjusting for demographic, lifestyle, and dietary confounders. Analyses were stratified by factors hypothesised to influence the formation of carcinogenic N-nitroso compounds (namely, smoking and dietary intakes of vitamin C, vitamin E, folate, and polyphenols)., Results: Plant-sourced nitrate intake was inversely associated with all-cause mortality [HR
Q5vsQ1 : 0.83 (0.80, 0.87)] while higher risks of all-cause mortality were seen for higher intakes of naturally occurring animal-sourced nitrate [1.09 (1.04, 1.14)], additive permitted meat-sourced nitrate [1.19 (1.14, 1.25)], and tap water-sourced nitrate [1.19 (1.14, 1.25)]. Similar source-dependent associations were seen for nitrite and for CVD-related and cancer-related mortality except that naturally occurring animal-sourced nitrate and tap water-sourced nitrate were not associated with cancer-related mortality and additive permitted meat-sourced nitrate was not associated with CVD-related mortality. No clear patterns emerged in stratified analyses., Conclusion: Nitrate/nitrite from plant sources are inversely associated while those from naturally occurring animal-sources, additive-permitted meat sources, and tap water-sources are positively associated with mortality., (© 2024. The Author(s).)- Published
- 2024
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39. Seizure and movement disorder in CACNA1E developmental and epileptic encephalopathy: Two sides of the same coin or same side of two different coins?
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Di Micco V, Affronte L, Khinchi MS, Rønde G, Miranda MJ, Hammer TB, Specchio N, Beniczky S, Olofsson K, Møller RS, and Gardella E
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- Humans, Female, Child, Preschool, Seizures genetics, Seizures physiopathology, Movement Disorders genetics, Movement Disorders physiopathology, Electroencephalography
- Abstract
Pathogenic variants in CACNA1E are associated with early-onset epileptic and developmental encephalopathy (DEE). Severe to profound global developmental delay, early-onset refractory seizures, severe hypotonia, and macrocephaly are the main clinical features. Patients harboring the recurrent CACNA1E variant p.(Gly352Arg) typically present with the combination of early-onset DEE, dystonia/dyskinesia, and contractures. We describe a 2-year-and-11-month-old girl carrying the p.(Gly352Arg) CACNA1E variant. She has a severe DEE with very frequent drug-resistant seizures, profound hypotonia, and episodes of dystonia and dyskinesia. Long-term video-EEG-monitoring documented subsequent tonic asymmetric seizures during wakefulness and mild paroxysmal dyskinesias of the trunk out of sleep which were thought to be a movement disorder and instead turned out to be focal hyperkinetic seizures. This is the first documented description of the EEG findings in this disorder. Our report highlights a possible overlap between cortical and subcortical phenomena in CACNA1E-DEE. We also underline how a careful electro-clinical evaluation might be necessary for a correct discernment between the two disorders, playing a fundamental role in the clinical assessment and proper management of children with CACNA1E-DEE., (© 2024 The Author(s). Epileptic Disorders published by Wiley Periodicals LLC on behalf of International League Against Epilepsy.)
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- 2024
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40. Nurses' Experiences With Virtual Consultations and Home-Monitoring in Patients With Cardiac Disease: A Systematic Review and Qualitative Meta-Synthesis of Results.
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Rosenstrøm S, Groth S, Risom SS, Hove JD, and Brødsgaard A
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- Humans, Nurses psychology, Nurses statistics & numerical data, Telemedicine standards, Monitoring, Physiologic methods, Home Care Services standards, Qualitative Research, Heart Diseases psychology
- Abstract
To explore how nurses experience facilitators and barriers to the use of video-consultations for home-monitoring of patients with cardiac disease. A systematic literature search in PubMed, CINAHL, Scopus, and Web of Science was undertaken, inclusion criteria were qualitative data published between 2013 and 2023 written in English, Norwegian, Swedish, or Danish. Ten studies were included in the qualitative synthesis conducted as described by Braun and Clarke. From the synthesis, a main theme emerged: Nurses' uncertainty toward telemedicine is a risk toward the use of video-consultations and home-monitoring. The essence of the findings range from nurses' positive experiences to their frustration concerning the implementation process and the lack of technical support for clinicians and patients. Nurses often felt frustration and uncertainty about the quality of delivered care through virtual consultations. Working with technology in caring for patients with cardiac disease, including video-consultations and home-monitoring, nurses experienced a sense of insecurity. Insecurity was identified as a lack of technological knowledge, nurses' feelings of apathy, poorer observation through a video-consultation, and the lack of organizational support., (© 2024 John Wiley & Sons Australia, Ltd.)
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- 2024
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41. Validity of a smartwatch for detecting atrial fibrillation in patients after heart valve surgery: a prospective observational study.
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Müller M, Hanssen TA, Johansen D, Jakobsen Ø, Pedersen JE, Aamot Aksetøy IL, Rasmussen TB, Hartvigsen G, Skogen V, and Thrane G
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- Humans, Male, Prospective Studies, Female, Aged, Middle Aged, Reproducibility of Results, Norway, Time Factors, Mobile Applications, Treatment Outcome, Electrocardiography, Ambulatory instrumentation, Telemetry instrumentation, Cardiac Surgical Procedures adverse effects, Wearable Electronic Devices, Electrocardiography, Heart Valves surgery, Heart Valves physiopathology, Atrial Fibrillation diagnosis, Atrial Fibrillation physiopathology, Predictive Value of Tests, Heart Rate
- Abstract
Objectives: Atrial fibrillation (AF) is a common early arrhythmia after heart valve surgery that limits physical activity. We aimed to evaluate the criterion validity of the Apple Watch Series 5 single-lead electrocardiogram (ECG) for detecting AF in patients after heart valve surgery., Design: We enrolled 105 patients from the University Hospital of North Norway, of whom 93 completed the study. All patients underwent single-lead ECG using the smartwatch three times or more daily on the second to third or third to fourth postoperative day. These results were compared with continuous 2-4 days ECG telemetry monitoring and a 12-lead ECG on the third postoperative day., Results: On comparing the Apple Watch ECGs with the ECG monitoring, the sensitivity and specificity to detect AF were 91% (75, 100) and 96% (91, 99), respectively. The accuracy was 95% (91, 99). On comparing Apple Watch ECG with a 12-lead ECG, the sensitivity was 71% (62, 100) and the specificity was 92% (92, 100)., Conclusion: The Apple smartwatch single-lead ECG has high sensitivity and specificity, and might be a useful tool for detecting AF in patients after heart valve surgery.
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- 2024
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42. Time of day for vaccination, outcomes, and relative effectiveness of high-dose vs. standard-dose quadrivalent influenza vaccine: A post hoc analysis of the DANFLU-1 randomized clinical trial.
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Christensen J, Johansen ND, Janstrup KH, Modin D, Skaarup KG, Nealon J, Samson S, Loiacono M, Harris R, Larsen CS, Jensen AMR, Landler NE, Claggett BL, Solomon SD, Gislason GH, Køber L, Landray MJ, Sivapalan P, Jensen JUS, and Biering-Sørensen T
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- Humans, Female, Aged, Male, Time Factors, Vaccine Efficacy, Immunization Schedule, Middle Aged, Treatment Outcome, Influenza Vaccines administration & dosage, Influenza Vaccines immunology, Influenza, Human prevention & control, Hospitalization statistics & numerical data, Vaccination
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Objectives: Morning influenza vaccination enhances antibody response. In this post hoc analysis of the DANFLU-1 trial, we sought to evaluate the association between time of day for vaccination (ToV) and outcomes and whether ToV modified the relative effectiveness of high-dose (QIV-HD) vs. standard-dose (QIV-SD) quadrivalent influenza vaccine., Methods: DANFLU-1 was a pragmatic feasibility trial of QIV-HD vs. QIV-SD. Outcomes included hospitalizations and mortality. For subgroup analysis, the population was dichotomized at median ToV into two groups (early and late)., Results: The study population included 12,477 participants. Mean age was 71.7 ± 3.9 years with 5877 (47.1%) female participants. Median ToV was 11.29 AM. Earlier ToV was associated with fewer respiratory hospitalizations independent of vaccine type, which persisted in adjusted analysis (IRR 0.88 per 1-hour decrement (95% CI 0.78- 0.98, p = 0.025). No effect modification by continuous or dichotomous ToV was found. In subgroup analysis, effects consistently favored QIV-HD against hospitalizations for pneumonia or influenza (early: IRR 0.30; late: 0.29), all-cause hospitalizations (early: IRR 0.87; late: 0.86), and mortality (early: HR 0.53; late: 0.50)., Conclusion: In this exploratory post hoc analysis, earlier ToV was associated with fewer respiratory hospitalizations. The relative effectiveness of QIV-HD vs. QIV-SD was not modified by ToV. Further research is needed to confirm findings., Trial Registration: Clinicaltrials.gov: NCT05048589., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships that may be considered as potential competing interests: JN was previously employed by Sanofi and may own shares and/or stock options in the company. SS, ML, and RCH are full-time employees of Sanofi and may own shares and/or stock options in the company. CSL is chief physician at Danske Lægers Vaccinations Service, part of European LifeCare Group, and has received speaker fees and served on advisory boards for GSK, MSD, Pfizer, Takeda, and Valneva. BLC has received consulting fees from Amgen, Cardurion, Corvia, Myokardia, and Novartis. SDS has received research grants from Actelion, Alnylam, Amgen, AstraZeneca, Bellerophon, Bayer, BMS, Celladon, Cytokinetics, Eidos, Gilead, GSK, Ionis, Lilly, Mesoblast, MyoKardia, NIH/NHLBI, Neurotronik, Novartis, Novo Nordisk, Respicardia, Sanofi, Theracos, US2. AI and consulted for Abbott, Action, Akros, Alnylam, Amgen, Arena, AstraZeneca, Bayer, Boehringer Ingelheim, BMS, Cardior, Cardurion, Corvia, Cytokinetics, Daiichi-Sankyo, GSK, Lilly, Merck, Myokardia, Novartis, Roche, Theracos, Quantum Genomics, Cardurion, Janssen, Cardiac Dimensions, Tenaya, Sanofi, Dinaqor, Tremeau, CellProThera, Moderna, American Regent, Sarepta, Lexicon, Anacardio, Akros, and Puretech Health. LK has received speaker fees from Novo Nordisk, Novartis, AstraZeneca, Boehringer Ingelheim, and Bayer. TB-S is chief investigator of the Boston Scientific financed “DANLOGIC-HF” trial, the Sanofi financed “NUDGE-FLU” trial, the Sanofi financed “DANFLU-1” trial, the Sanofi financed “DANFLU-2″ trial and steering committee member of the Boston Scientific sponsored “LUX-Dx TRENDS Evaluates Diagnostics Sensors in Heart Failure Patients Receiving Boston Scientific's Investigational ICM System” trial, the Amgen sponsored GALACTIC-HF trial, the Boehringer Ingelheim financed EASi-KIDNEY trial and served on advisory boards for Sanofi, Amgen, CSL Seqirus and GSK and received speaker honorariums from Bayer, Novartis, Sanofi, GE Healthcare and GSK and received research grants from Boston Scientific, GE Healthcare, AstraZeneca, Novo Nordisk, and Sanofi and consulted for Novo Nordisk, IQVIA and Parexel. The remaining authors have nothing to disclose., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
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- 2024
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43. Oral fluoroquinolones and the risk of Achilles tendon rupture.
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Rasmussen PV, Strange JE, and Holt A
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- Humans, Rupture chemically induced, Tendon Injuries chemically induced, Administration, Oral, Risk Factors, Achilles Tendon injuries, Fluoroquinolones adverse effects, Fluoroquinolones administration & dosage, Anti-Bacterial Agents adverse effects, Anti-Bacterial Agents administration & dosage
- Abstract
Competing Interests: Competing Interest The authors declare that they have no competing interests.
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- 2024
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44. Re: Complications Following Transrectal and Transperineal Prostate Biopsy: Results of the ProBE-PC Randomized Clinical Trial.
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Boesen L and Chapin BF
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- 2024
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45. Temporal trends in mortality, heart failure hospitalisation, and stroke in heart failure patients with and without atrial fibrillation: a nationwide study from 1997-2018 on 152,059 patients.
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Austreim M, Nouhravesh N, Malik ME, Abassi N, Zahir D, Garred CH, Andersen CF, Hansen ML, Olesen JB, Fosbøl E, Østergaard L, Køber L, and Schou M
- Abstract
Aims: We aimed to investigate temporal trends in all-cause mortality, heart failure (HF) hospitalisation, and stroke from 1997 to 2018 in patients diagnosed with both HF and atrial fibrillation (AF)., Methods and Results: From Danish nationwide registers, we identified 152 059 patients with new-onset HF between 1997 and 2018. Patients were grouped according to year of new-onset HF and AF-status: Prevalent AF (n = 34 734), New-onset AF (n = 12 691), and No AF (n = 104 634). Median age decreased from 76 to 73 years between 1997 and 2018. The proportion of patients with prevalent or new-onset AF increased from 24.7% (n = 9256) to 35.8% (n = 14 970). Five-year risk of all-cause mortality went from 69.1% (CI: 67.9%-70.2%) to 51.3% (CI: 49.9%-52.7%), 62.3% (CI: 60.5%-64.4%) to 43.0% (CI: 40.5%-45.5%), and 61.9% (CI: 61.3%-62.4%) to 36.7% (CI: 35.9%-37.6%) for the Prevalent AF, New-onset AF and No AF-group, respectively. Minimal changes were observed in the risk of HF-hospitalisation. Five-year stroke risk decreased from 8.5% (CI: 7.8%-9.1%) to 5.0% (CI: 4.4%-5.5%) for the prevalent AF group, 8.2% (CI: 7.2%-9.2%) to 4.6% (CI: 3.7%-5.5%) for new-onset AF, and 6.3% (CI: 6.1%-6.6%) to 4.9% (CI: 4.6%-5.3%) for the No AF group. Simultaneously, anticoagulant therapy increased for patients with prevalent (from 42.7% to 93.1%) and new-onset AF (from 41.9% to 92.5%)., Conclusion: From 1997 to 2018, we observed an increase in patients with HF and co-existing AF. Mortality decreased for all patients, regardless of AF-status. Anticoagulation therapy increased, and stroke risk for patients with AF was reduced to a similar level as patients without AF in 2013-2018., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)
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46. Prognosis and antithrombotic practice patterns in patients with recurrent and transient atrial fibrillation following acute coronary syndrome: A nationwide study.
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Petersen JK, Butt JH, Yafasova A, Torp-Pedersen C, Sørensen R, Kruuse C, Vinding NE, Gundlund A, Køber L, Fosbøl EL, and Østergaard L
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- Humans, Male, Female, Aged, Denmark epidemiology, Middle Aged, Prognosis, Practice Patterns, Physicians' statistics & numerical data, Aged, 80 and over, Follow-Up Studies, Registries, Ischemic Stroke epidemiology, Ischemic Stroke etiology, Ischemic Stroke diagnosis, Acute Coronary Syndrome epidemiology, Acute Coronary Syndrome drug therapy, Atrial Fibrillation epidemiology, Atrial Fibrillation drug therapy, Atrial Fibrillation diagnosis, Recurrence, Fibrinolytic Agents therapeutic use
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Background: First-time detected atrial fibrillation (AF) is associated with aggravated prognosis in patients admitted with acute coronary syndrome (ACS). Yet, among patients surviving beyond one year after ACS, it remains unclear how the recurrence of AF within the initial year after ACS affects the risk of stroke., Methods: With Danish nationwide data from 2000 to 2021, we identified all patients with first-time ACS who were alive one year after discharge (index date). Patients were categorized into: i) no AF; ii) first-time detected AF during ACS admission without a recurrent hospital contact with AF (transient AF); and iii) first-time detected AF during ACS admission with a subsequent recurrent hospital contact with AF (recurrent AF). From index date, two-year rates of ischemic stroke were compared using multivariable adjusted Cox regression analysis. Treatment with antithrombotic therapy was assessed as filled prescriptions between 12 and 15 months following ACS discharge., Results: We included 139,137 patients surviving one year post ACS discharge: 132,944 (95.6%) without AF, 3920 (2.8%) with transient AF, and 2273 (1.6%) with recurrent AF. Compared to those without AF, the adjusted two-year hazard ratios of ischemic stroke were 1.45 (95% CI, 1.22-1.71) for patients with transient AF and 1.47 (95% CI: 1.17-1.85) for patients with recurrent AF. Prescription rates of oral anticoagulation increased over calendar time, reaching 68.3% and 78.7% for transient and recurrent AF, respectively, from 2019 to 2021., Conclusion: In patients surviving one year after ACS with first-time detected AF, recurrent and transient AF were associated with a similarly increased long-term rate of ischemic stroke., Competing Interests: Declaration of competing interest Jeppe Kofoed Petersen: None. Jawad Haider Butt: Advisory board honoraria from Bayer. Adelina Yafasova: None. Christian Torp-Pedersen: Grants for studies from Bayer and Novo Nordisk. Rikke Sørensen: None. Christina Kruuse: Independent research grant from Novo Nordisk Foundation. Local PI in trials from Bayer and Bristol-Myers Squibb. Naja Emborg Vinding: None. Anna Gundlund: None. Lars Køber: Speakers honorarium from Novo, Novartis, AstraZeneca and Boehringer. Emil Loldrup Fosbøl: Independent research grant from Novo Nordisk foundation. Lauge Østergaard: Independent research grant from Novo Nordisk foundation., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)
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- 2024
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47. Understanding the incidence of atrial fibrillation and stroke in hypertrophic cardiomyopathy patients: insights from Danish nationwide registries.
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Zörner CR, Schjerning AM, Jensen MK, Christensen AH, Tfelt-Hansen J, Tønnesen J, Riis-Vestergaard LD, Middelfart C, Rasmussen PV, Gislason G, and Hansen ML
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- Humans, Male, Female, Denmark epidemiology, Incidence, Middle Aged, Risk Factors, Aged, Adult, Risk Assessment, Atrial Fibrillation epidemiology, Atrial Fibrillation diagnosis, Atrial Fibrillation drug therapy, Cardiomyopathy, Hypertrophic epidemiology, Cardiomyopathy, Hypertrophic complications, Registries, Stroke epidemiology
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Aims: The treatment of atrial fibrillation (AF) in hypertrophic cardiomyopathy (HCM) can be challenging since AF aggravates symptoms and increases the risk of stroke. Which factors contribute to the development of AF and stroke in HCM remains unknown. The aim of this study was to determine the incidence of AF and stroke in HCM patients and identify the risk factors., Methods and Results: Using Danish national registries, all HCM patients from 2005 to 2018 were included. The association between HCM, incident AF, and stroke was investigated using multivariable Cox proportional hazards analysis. Cumulative incidences were calculated using the Aalen-Johansen estimator. Among the 3367 patients without prevalent AF, 24% reached the endpoint of incident AF with death as a competing risk. Median follow-up time was 4 years. Atrial fibrillation incidence was equal between sexes and increased for patients with ischaemic heart disease [IHD; hazard ratio (HR) 1.33, 95% confidence interval (CI) 1.08-1.63], hypertension (HT) (HR 1.36, 95% CI 1.14-1.67), and obstructive HCM (HR 1.27, 95% CI 1.05-1.52). Seven per cent developed stroke, with no difference detected stratifying for the presence of AF. Sub-analysis revealed that when AF was treated with oral anticoagulants (OACs), stroke was less likely (HR 0.4, 95% CI 0.18-0.86, P = 0.02). However, 34% of patients were not receiving adequate anticoagulation following AF diagnosis., Conclusion: Obstructive HCM, HT, and IHD were associated with increased risk of AF. Prevalent AF alone was not predictive of stroke; however, AF patients treated with OAC were significantly less likely to develop stroke, suggesting that this development is driven by the protective effect of OAC. Despite this, 34% of patients did not receive OAC., Competing Interests: Conflict of interest: None declared., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)
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- 2024
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48. Impact of breast-, gastrointestinal-, and lung cancer on prognosis in patients with first-time pulmonary embolism: A Danish nationwide cohort study.
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Nouhravesh N, Strange JE, Sindet-Pedersen C, Holt A, Tønnesen J, Andersen CF, Nielsen SK, Grove EL, Nielsen D, Schou M, and Lamberts M
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- Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Cohort Studies, Denmark epidemiology, Follow-Up Studies, Prognosis, Registries, Risk Factors, Young Adult, Adult, Breast Neoplasms complications, Breast Neoplasms diagnosis, Breast Neoplasms mortality, Gastrointestinal Neoplasms complications, Gastrointestinal Neoplasms diagnosis, Gastrointestinal Neoplasms mortality, Lung Neoplasms complications, Lung Neoplasms diagnosis, Lung Neoplasms mortality, Pulmonary Embolism diagnosis, Pulmonary Embolism epidemiology, Pulmonary Embolism etiology
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Background: Pulmonary embolism (PE) is described as a prognostic factor in patients with cancer however, the prognostic impact of PE remains unknown. This study investigated, the 1-year prognosis following PE in patients with breast-, gastrointestinal-, or lung cancer stratified by cancer status., Methods: All Danish patients with first-time PE from 2008 to 2018 were included. Cancer status was categorized as no cancer, history of cancer, non-active cancer and active cancer. Unadjusted and age-stratified 1-year risk of death was estimated using the Kaplan-Meier estimator. Cause of death was reported using the Aalen-Johansen method., Results: Of 35,679 patients with PE, 18% had a breast-, gastrointestinal-, or lung cancer. Patients with cancer were older compared with no cancer (69.8 years [IQR: 56.2-79.8]). One-year risk of death (95% confidence interval) for active breast-, gastrointestinal-, and lung cancer was 49.5% (44.0%-54.9%), 75.0% (72.5%-77.4%) and 80.1% (78.0%-82.3%) respectively, compared with 18.9% (18.4%-19.3%) for no cancer. Age-stratified analysis revealed no association with increasing age in non-active lung cancer and all active cancers. Further, non-cardiovascular death accounted for an increasing proportion by cancer status (no cancer < history of cancer < non-active cancer < active cancer)., Conclusions: One-year risk of death was dependent on both cancer type and status; no association with age was found for patients with active cancers. Non-cardiovascular death was leading in non-active and active cancers. Thus, the occurrence of first-time PE could be regarded as a marker of cancer severity for patients with breast-, gastrointestinal-, and lung cancer., Competing Interests: Declaration of competing interest The authors report the following relationships unrelated to this study. NN reports speaker fees from Bayer and AstraZeneca. CFA reports research grants from The Danish Heart Foundation, Toyota Foundation, Aase & Ejnar Danielsen's Foundation, Arvid Nilsson's Foundation, The Research and Innovation Foundation of the Department of Cardiology, Herlev and Gentofte University Hospital, Fru Asta Florida Bolding's Memorial Grant and the KV Foundation; support for attending meetings from AstraZeneca and European Heart Foundation Association. ML reports research grants from Karen Elise Jensen Fonden, Danish Heart Foundation, Bayer, and BMS; speaker fees from BMS, Pfizer, Bayer and Astra Zeneca; and advisory board positions with Pfizer and Astra Zeneca. MS reports speaker fees from Novartis, Boehringer Ingelheim, Bayer, Novo, and Astra Zeneca. ELG research grants from Boehringer Ingelheim; speaker fees from Pfizer, Bayer, AstraZeneca and Bristol Myers-Squibb; consulting fees from Bayer, Bristol Myers-Squibb, MSD and Boehringer Ingelheim. AH, JES, SKN, CS, DN and JT report no conflict of interest., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)
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- 2024
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49. Long-Term Risk of VTE in Sarcoidosis: A Nationwide Cohort Study.
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Yafasova A, Fosbøl EL, Gustafsson F, Krintel SB, Kristensen SL, Schou M, Petersen JK, Sun G, Rossing K, Doi SN, Køber L, and Butt JH
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- Humans, Male, Female, Denmark epidemiology, Adult, Middle Aged, Risk Factors, Cohort Studies, Pulmonary Embolism epidemiology, Pulmonary Embolism etiology, Incidence, Risk Assessment methods, Follow-Up Studies, Venous Thromboembolism epidemiology, Venous Thromboembolism etiology, Sarcoidosis epidemiology, Sarcoidosis complications, Registries
- Abstract
Background: Chronic inflammation is increasingly recognized as a risk factor for VTE, but unlike other inflammatory diseases including systemic lupus erythematosus and rheumatoid arthritis, data on the risk of VTE in patients with sarcoidosis are sparse., Research Question: Do patients with sarcoidosis have a higher long-term risk of VTE (pulmonary embolism or DVT, and each of these individually) compared with the background population?, Study Design and Methods: Using Danish nationwide registries, patients aged ≥ 18 years with newly diagnosed sarcoidosis (two or more inpatient/outpatient visits, 1996-2020) without prior VTE were matched 1:4 by age, sex, and comorbidities with individuals from the background population. The primary outcome was VTE., Results: We included 14,742 patients with sarcoidosis and 58,968 matched individuals (median age, 44.7 years; 57.2% male). The median follow-up was 8.8 years. Absolute 10-year risks of outcomes for patients with sarcoidosis vs the background population were the following: VTE, 2.9% vs 1.6% (P < .0001), pulmonary embolism, 1.5% vs 0.7% (P < .0001), and DVT, 1.6% vs 1.0% (P < .0001), respectively. In multivariable Cox regression, sarcoidosis was associated with an increased rate of all outcomes in the first year after diagnosis (VTE: hazard ratio [HR], 4.94; 95% CI, 3.61-6.75) and after the first year (VTE: HR, 1.65; 95% CI, 1.45-1.87) compared with the background population. These associations persisted when excluding patients with a history of cancer and censoring patients with incident cancer during follow-up. Three-month mortality was not significantly different between patients with VTE with and without sarcoidosis (adjusted HR, 0.84; 95% CI, 0.61-1.15)., Interpretation: In this nationwide cohort study, sarcoidosis was associated with a higher long-term risk of VTE compared with a matched background population., Competing Interests: Financial/Nonfinancial Disclosures The authors have reported to CHEST the following: A. Y. reports a grant from the Foundation of Rigshospitalet. E. L. F. reports independent and unrelated research funding from the Danish Heart Association and the Novo Nordisk Foundation. F. G. reports being an advisor for Abbott, Fineheart, AdjuCor, Bayer, Ionis, Alnylam, AstraZeneca, and Pfizer; and a speaker for Novartis, all outside the submitted work. S. L. K. reports being on the advisory board for Bayer, outside the submitted work. M. S. reports lecture fees from Novo Nordisk, Bohringer, Astra Zeneca, and Novartis, outside the submitted work. K. R. reports being an advisory board member for Abbott, Novo Nordisk, and Boehringer-Ingelheim; and speaking fees from AstraZeneca, Boehringer-Ingelheim, Abbott, and MSD, all outside the submitted work. L. K. reports compensation from Novartis, Novo Nordisk, and AstraZeneca for other services, outside the submitted work. J. H. B. reports advisory board honoraria from AstraZeneca and Bayer, consultant honoraria from Novartis and AstraZeneca, and travel grants from AstraZeneca, all outside the submitted work. None declared (S. B. K., J. K. P., G. S., S. N. D.)., (Copyright © 2024 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.)
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- 2024
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50. The interplay between birth weight and obesity in determining childhood and adolescent cardiometabolic risk.
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Stinson SE, Kromann Reim P, Lund MAV, Lausten-Thomsen U, Aas Holm L, Huang Y, Brøns C, Vaag A, Thiele M, Krag A, Fonvig CE, Grarup N, Pedersen O, Christiansen M, Ängquist L, Sørensen TIA, Holm JC, and Hansen T
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- Humans, Male, Female, Child, Adolescent, Cross-Sectional Studies, Cardiometabolic Risk Factors, Risk Factors, Biomarkers blood, Insulin Resistance, Body Mass Index, Birth Weight, Cardiovascular Diseases etiology, Cardiovascular Diseases blood, Cardiovascular Diseases epidemiology, Pediatric Obesity blood
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Background: Birth weight (BW) is associated with risk of cardiometabolic disease (CMD) in adulthood, which may depend on the state of obesity, in particular if developed at a young age. We hypothesised that BW and a polygenic score (PGS) for BW were associated with cardiometabolic risk and related plasma protein levels in children and adolescents. We aimed to determine the modifying effect of childhood obesity on these associations., Methods: We used data from The cross-sectional HOLBAEK Study with 4263 participants (median [IQR] age, 11.7 [9.2, 14.3] years; 57.1% girls and 42.9% boys; 48.6% from an obesity clinic and 51.4% from a population-based group). We gathered information on BW and gestational age, anthropometrics, cardiometabolic risk factors, calculated a PGS for BW, and measured plasma proteins using Olink Inflammation and Cardiovascular II panels. We employed multiple linear regression to examine the associations with BW as a continuous variable and performed interaction analyses to assess the effect of childhood obesity on cardiometabolic risk and plasma protein levels., Findings: BW and a PGS for BW associated with cardiometabolic risk and plasma protein levels in childhood and adolescence. Childhood obesity modified the associations between BW and measures of insulin resistance, including HOMA-IR (βadj [95% CI per SD] for obesity: -0.12 [-0.15, -0.08]; normal weight: -0.04 [-0.08, 0.00]; Pinteraction = 0.004), c-peptide (obesity: -0.11 [-0.14, -0.08]; normal weight: -0.02 [-0.06, 0.02]; Pinteraction = 5.05E-04), and SBP SDS (obesity: -0.12 [-0.16, -0.08]; normal weight: -0.06 [-0.11, -0.01]; Pinteraction = 0.0479). Childhood obesity also modified the associations between BW and plasma levels of 14 proteins (e.g., IL15RA, MCP1, and XCL1; Pinteraction < 0.05)., Interpretation: We identified associations between lower BW and adverse metabolic phenotypes, particularly insulin resistance, blood pressure, and altered plasma protein levels, which were more pronounced in children with obesity. Developing effective prevention and treatment strategies for this group is needed to reduce the risk of future CMD., Funding: Novo Nordisk Foundation (NNF15OC0016544, NNF0064142 to T.H., NNF15OC0016692 to T.H. and A.K., NNF18CC0033668 to S.E.S, NNF18SA0034956 to C.E.F., NNF20SA0067242 to DCA, NNF18CC0034900 to NNF CBMR), The Innovation Fund Denmark (0603-00484B to T.H.), The Danish Cardiovascular Academy (DCA) and the Danish Heart Foundation (HF) (PhD2021007-DCA to P.K.R, 18-R125-A8447-22088 (HF) and 21-R149-A10071-22193 (HF) to M.A.V.L., PhD2023009-HF to L.A.H), EU Horizon (668031, 847989, 825694, 964590 to A.K.), Innovative Health Initiative (101132901 for A.K.), A.P. Møller Foundation (19-L-0366 to T.H.), The Danish National Research Foundation, Steno Diabetes Center Sjælland, and The Region Zealand and Southern Denmark Health Scientific Research Foundation., Competing Interests: Declaration of interests C.E.F. has received speaker honoria from The Danish Society for General Practice, Novo Nordisk, Nestlé and payment for manuscript writing from The Danish Health Authority. C.B. and T.H. have stocks in Novo Nordisk. A.K. receives royalties from Gyldendal, payment for lectures from Norgine, Siemens, Nordic Bioscience, Novo Nordisk. A.K. has two patents planned/pending, participates on an advisory board for Norgine, Siemens, Novo Nordisk, B&I. A.K. has a leadership role as the Secretary General European Association for the Study of The Liver (EASL) 2023–2025. A.K. has received equipment, materials, and drugs from Norgine (Rifaximin), Siemens (ELF Test), Echosence (FibroScan), and Nordic Bioscience (ECM markers). A.K. has finical interest as the Board member and co-founder Evido. J-C.H. has received payment for expert testimony from Novo Nordisk and support for meetings and travel from Rhytm, provides training and treatment of obesity. We declare no other competing interests from remaining coauthors., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)
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- 2024
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