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1. The Danish Cardiac Rehabilitation Database

Author

Zwisler AD, Rossau HK, Nakano A, Foghmar S, Eichhorst R, Prescott E, Cerqueira C, Soja AMB, Gislason GH, Larsen ML, Andersen UO, Gustafsson I, Thomsen KK, Boye Hansen L, Hammer S, Viggers L, Christensen B, Kvist B, Lindström Egholm C, and May O

Subjects
cardiac rehabilitation, coronary heart disease, cardiovascular prevention, clinical quality registry, clinical database, quality improvement., Infectious and parasitic diseases, RC109-216
Abstract

Ann-Dorthe Zwisler,1 Henriette Knold Rossau,1 Anne Nakano,2,3 Sussie Foghmar,4 Regina Eichhorst,5 Eva Prescott,6 Charlotte Cerqueira,7 Anne Merete Boas Soja,4 Gunnar H Gislason,8–10 Mogens Lytken Larsen,5 Ulla Overgaard Andersen,11 Ida Gustafsson,4 Kristian K Thomsen,12 Lene Boye Hansen,13 Signe Hammer,14 Lone Viggers,15 Bo Christensen,16 Birgitte Kvist,17 Cecilie Lindström Egholm,18 Ole May19 On behalf of the Working Group of Preventive Cardiology and Rehabilitation, Danish Society of Cardiology, and the Working Group of Cardiac Clinical Registries, Danish Society of Cardiology 1Danish Centre for Rehabilitation and Palliative Care, Odense University Hospital and University of Southern Denmark, Odense, 2Department of Clinical Epidemiology, Aarhus University Hospital, 3Registry Support Centre (West) – Clinical Quality Improvement & Health Informatics, Aarhus, 4Department of Cardiology, Copenhagen University Hospital, Hvidovre, 5Department of Cardiology, Aalborg University Hospital, Aalborg, 6Department of Cardiology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, 7Registry Support Centre (East) – Epidemiology and Biostatistics, Research Centre for Prevention and Health, the Capital Region of Denmark, Glostrup, 8Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, 9The Danish Heart Foundation, Copenhagen, 10The National Institute of Public Health, University of Southern Denmark, 11Department of Cardiology, Holbaek Hospital, University of Copenhagen, Copenhagen, 12Department of Cardiology, Hospital of Southwest Jutland, Esbjerg, 13Department of Cardiology, Gentofte Hospital, Gentofte, 14Department of Occupational Therapy and Physiotherapy, Herlev Hospital, Herlev, 15Department of Nutrition, Regional Hospital West Jutland, Holstebro, 16Department of General Medicine, School of Public Health, Aarhus University, Aarhus, 17Department of Health Care and Prevention, Municipality of Frederikshavn, Frederikshavn, 18The Regional Research Unit, Region Zealand, Roskilde, 19Department of Medicine, Cardiovascular Research Unit, Regional Hospital Herning, Herning, Denmark Aim of database: The Danish Cardiac Rehabilitation Database (DHRD) aims to improve the quality of cardiac rehabilitation (CR) to the benefit of patients with coronary heart disease (CHD).Study population: Hospitalized patients with CHD with stenosis on coronary angiography treated with percutaneous coronary intervention, coronary artery bypass grafting, or medication alone. Reporting is mandatory for all hospitals in Denmark delivering CR. The database was initially implemented in 2013 and was fully running from August 14, 2015, thus comprising data at a patient level from the latter date onward.Main variables: Patient-level data are registered by clinicians at the time of entry to CR directly into an online system with simultaneous linkage to other central patient registers. Follow-up data are entered after 6 months. The main variables collected are related to key outcome and performance indicators of CR: referral and adherence, lifestyle, patient-related outcome measures, risk factor control, and medication. Program-level online data are collected every third year.Descriptive data: Based on administrative data, approximately 14,000 patients with CHD are hospitalized at 35 hospitals annually, with 75% receiving one or more outpatient rehabilitation services by 2015. The database has not yet been running for a full year, which explains the use of approximations.Conclusion: The DHRD is an online, national quality improvement database on CR, aimed at patients with CHD. Mandatory registration of data at both patient level as well as program level is done on the database. DHRD aims to systematically monitor the quality of CR over time, in order to improve the quality of CR throughout Denmark to benefit patients. Keywords: secondary prevention, coronary heart disease, cardiovascular prevention, clinical quality registry, clinical database, quality improvement

Published
2016

6. Cardiac rehabilitation do not diminish the socioeconomic and ethnical disparity in patients with coronary heart disease

Author

Kjesbu, I., Prescott, E., Rasmusen, H. K., Osler, M., Larsen, M. L., Gustafsson, I., Zwisler, A. D., and Sibilitz, K. L.

Subjects
Cardiology and Cardiovascular Medicine
Abstract

Aims Cardiac patients with low socioeconomic status and non-western ethnic background have worse outcomes. The aim of this nationwide study was to determine whether the immediate effect of CR differs between groups defined by socioeconomic status and ethnic background, and whether disparity in the prognosis of cardiac patients is diminished by CR participation. Methods We included all patients in Denmark with myocardial infarction and/or coronary revascularization from August 2015 until March 2018. Level of education, as a marker for socioeconomic status, was divided into four groups, and ethnicity into Danish, non-Western and Western. Participation in CR was identified through the Danish Cardiac Rehabilitation Database (DHRD) and the Danish National Patient Register. Primary outcome was achievement of CR quality indicators, including risk factor control and medication, from DHRD, and secondary outcome a composite endpoint of cardiovascular disease hospitalization and all-cause mortality (MACE). Results We identified 34,511 patients of whom 19,383 had participated in CR and 9,882 provided information on CR data from DHRD. Higher education was associated with greater improvement in VO2peak and non-western patients were less likely to be screened for depression or receive dietary consulting. No other significant disparity in CR quality indicators, was found across education and ethnicity. There was a strong socioeconomic gradient in MACE irrespective of CR participation, medication and risk factor control (adjusted HR 0.71 (0.58–0.86) for high versus low education). Similarly, non-western origin was associated with higher risk of MACE (adjusted HR 1.2 (1.1–1.4). Conclusion We found strong socioeconomic and ethnic disparity in prognosis of CHD patients which were unaffected by CR participation. The results indicate that CR, conventional risk factor control and medical treatment have limited impact on these disparities. Funding Acknowledgement Type of funding sources: Foundation. Main funding source(s): The Danish Heart Foundation Figure 1Figure 2

Published
2021
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8. Circulating levels and prognostic cut-offs of sST2, high-sensitivity troponin T, and NT-proBNP in women vs. men with chronic heart failure

Author

Gentile, F, Aimo, A, Jannuzzi, JL, Richards, M, Lam, CS, De Boer, RA, Meems, LM, Latini, R, Staszewsky, L, Anand, IS, Cohn, JN, Ueland, T, Guellestad, L, Aukrust, P, Rocca, HPBL, Bayes-Genis, A, Lupon, J, Yoshihisa, A, Egstrup, M, Gustafsson, I, Gaggin, HK, Eggers, KM, Huber, K, Gamble, GD, Ling, LH, Leong, KTG, Yeo, PSD, Ong, HY, Jaufeerally, F, Ng, TP, Troughton, R, Doughty, RN, Devlin, G, Lund, M, Giannoni, A, Passino, C, Emdin, M, and Vergaro, G

Published
2021

24. Prognostic Value of High-Sensitivity Troponin T in Chronic Heart Failure An Individual Patient Data Meta-Analysis

Author

Aimo, A, Januzzi, JL, Vergaro, G, Ripoli, A, Latini, R, Masson, S, Magnoli, M, Anand, IS, Cohn, JN, Tavazzi, L, Tognoni, G, Gravning, J, Ueland, T, Nymo, SH, Brunner-La Rocca, HP, Genis, AB, Lupon, J, de Boer, RA, Yoshihisa, A, Takeishi, Y, Egstrup, M, Gustafsson, I, Gaggin, HK, Eggers, KM, Huber, K, Tentzeris, I, Tang, WHW, Grodin, J, Passino, C, and Emdin, M

Subjects
meta-analysis, troponin T, heart failure, prognosis, ventricular dysfunction, left
Abstract

BACKGROUND: Most patients with chronic heart failure have detectable troponin concentrations when evaluated by high-sensitivity assays. The prognostic relevance of this finding has not been clearly established so far. We aimed to assess high-sensitivity troponin assay for risk stratification in chronic heart failure through a meta-analysis approach. METHODS: Medline, EMBASE, Cochrane Library, and Scopus were searched in April 2017 by 2 independent authors. The terms were "troponin" AND "heart failure" OR "cardiac failure" OR "cardiac dysfunction" OR "cardiac insufficiency" OR "left ventricular dysfunction." Inclusion criteria were English language, clinical stability, use of a high-sensitivity troponin assay, follow-up studies, and availability of individual patient data after request to authors. Data retrieved from articles and provided by authors were used in agreement with the PRISMA statement. The end points were all-cause death, cardiovascular death, and hospitalization for cardiovascular cause. RESULTS: Ten studies were included, reporting data on 11 cohorts and 9289 patients (age 6612 years, 77% men, 60% ischemic heart failure, 85% with left ventricular ejection fraction

Published
2018

26. REPORT FROM THE HLA CLASS II TYPING BY PCR-SSP MULTICENTRE STUDY

Author

Zetterquist, H., Bengtsson, M., Bäckström, G., Egle-Jansson, I., Ekdahl, A.-M., Grunnet, N., Gustafsson, I., Knutsen, I., Kuhle, A., Rydberg, L., Spurkland, A., Steffensen, R., Storgärds, M., Szojmer, E., Söderholm, G., Thuresson, B., Turesson, H., and Olerup, O.

Published
1997

27. 2016 European Guidelines on cardiovascular disease prevention in clinical practice The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts) Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR)

Author

Piepoli MF, Hoes AW, Agewall S, Albus C, Brotons C, Catapano AL, Cooney MT, Corrà U, Cosyns B, Deaton C, Graham I, Hall MS, Hobbs FDR, Løchen ML, Löllgen H, Marques-Vidal P, Perk J, Prescott E, Redon J, Richter DJ, Sattar N, Smulders Y, Tiberi M, van der Worp HB, van Dis I, Verschuren WMM1, Binno S, De Backer G, Roffi M, Aboyans V, Bachl N, Bueno H, Carerj S, Cho L, Cox J, De Sutter J, Egidi G, Fisher M, Fitzsimons D, Franco OH, Guenoun M, Jennings C, Jug B, Kirchhof P, Kotseva K, Lip GY, Mach F, Mancia G, Bermudo FM, Mezzani A, Niessner A, Ponikowski P, Rauch B, Rydén L, Stauder A, Turc G, Wiklund O, Windecker S, Zamorano JL, Achenbach S, Badimon L, Barón-Esquivias G, Baumgartner H, Bax JJ, Dean V, Erol Ç, Gaemperli O, Kolh P, Lancellotti P, Nihoyannopoulos P, Torbicki A, Vaz Carneiro A, Metzler B, Najafov R, Stelmashok V, De Maeyer C, Dilic M, Gruev I, Milicic D, Vaverkova H, Gustafsson I, Attia I, Duishvili D, Kostova N, Ferrières J, Klimiashvili Z, Hambrecht R, Tsioufis K, Szabados E, Andersen K, Vaughan C, Zafrir B, Novo S, Davletov K, Jashari F, Kerimkulova A, Mintale I, Saade G, Petrulioniene Z, Delagardelle C, Magri CJ, Rudi V, Oukerraj L, Çölkesen BE, Schirmer H, Jankowski P, Dos Reis RP, Gherasim D, Nedogoda S, Zavatta M, Giga V, Filipova S, Padial LR, Kiessling A, Mahdhaoui A, Ural D, Nesukay E, Gale C., Internal medicine, ICaR - Circulation and metabolism, Piepoli MF, Hoes AW, Agewall S, Albus C, Brotons C, Catapano AL, Cooney MT, Corrà U, Cosyns B, Deaton C, Graham I, Hall MS, Hobbs FDR, Løchen ML, Löllgen H, Marques-Vidal P, Perk J, Prescott E, Redon J, Richter DJ, Sattar N, Smulders Y, Tiberi M, van der Worp HB, van Dis I, Verschuren WMM1, Binno S, De Backer G, Roffi M, Aboyans V, Bachl N, Bueno H, Carerj S, Cho L, Cox J, De Sutter J, Egidi G, Fisher M, Fitzsimons D, Franco OH, Guenoun M, Jennings C, Jug B, Kirchhof P, Kotseva K, Lip GY, Mach F, Mancia G, Bermudo FM, Mezzani A, Niessner A, Ponikowski P, Rauch B, Rydén L, Stauder A, Turc G, Wiklund O, Windecker S, Zamorano JL, Zamorano JL, Aboyans V, Achenbach S, Agewall S, Badimon L, Barón-Esquivias G, Baumgartner H, Bax JJ, Bueno H, Carerj S, Dean V, Erol Ç, Fitzsimons D, Gaemperli O, Kirchhof P, Kolh P, Lancellotti P, Lip GY, Nihoyannopoulos P, Piepoli MF, Ponikowski P, Roffi M, Torbicki A, Vaz Carneiro A, Windecker S, Metzler B, Najafov R, Stelmashok V, De Maeyer C, Dilic M, Gruev I, Milicic D, Vaverkova H, Gustafsson I, Attia I, Duishvili D, Kostova N, Ferrières J, Klimiashvili Z, Hambrecht R, Tsioufis K, Szabados E, Andersen K, Vaughan C, Zafrir B, Novo S, Davletov K, Jashari F, Kerimkulova A, Mintale I, Saade G, Petrulioniene Z, Delagardelle C, Magri CJ, Rudi V, Oukerraj L, Çölkesen BE, Schirmer H, Jankowski P, Dos Reis RP, Gherasim D, Nedogoda S, Zavatta M, Giga V, Filipova S, Padial LR, Kiessling A, Mach F, Mahdhaoui A, Ural D, Nesukay E, Gale C., Cardio-vascular diseases, and Clinical sciences

Subjects
Cost-Benefit Analysis, General Practice, 030204 cardiovascular system & hematology, Guideline, Diabete, 0302 clinical medicine, Hyperlipidemia, Stakeholder, Medicine, 030212 general & internal medicine, Multiple Chronic Conditions, Practice Patterns, Physicians', Societies, Medical, Risk assessment, education.field_of_study, Cardiac Rehabilitation, Diabetes, Rehabilitation, Smoking, Psychosocial factor, Age Factors, Lipid, Middle Aged, Primary care, Pedigree, Europe, Cardiovascular Diseases, Psychosocial factors, Hypertension, Blood pressure, Diet, Healthy, Cardiology and Cardiovascular Medicine, Adult, Diagnostic Imaging, medicine.medical_specialty, Ambulatory blood pressure, Population, Cardiology, Healthy lifestyle, Hyperlipidemias, Health Promotion, Diabetic angiopathy, Guidelines, Risk Assessment, 03 medical and health sciences, Sex Factors, Diabetes mellitus, Journal Article, Humans, Clinical settings, Healthy Lifestyle, Intensive care medicine, education, Exercise, Antihypertensive Agents, Nutrition, Aged, business.industry, Vascular disease, Physical activity, Prevention, medicine.disease, body regions, Clinical setting, Risk management, Socioeconomic Factors, Smoking Cessation, Joint Esc Guidelines, business, Biomarkers, Diabetic Angiopathies
Abstract

ABI : ankle–brachial (blood pressure) index ABPM : ambulatory blood pressure monitoring ACCORD : Action to Control Cardiovascular Risk in Diabetes ACE-I : angiotensin-converting enzyme inhibitor ACS : acute coronary syndromes ADVANCE : Action in Diabetes and Vascular disease: PreterAx

Published
2016
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28. 2016 European Guidelines on cardiovascular disease prevention in clinical practice

Author

Piepoli, MF, Hoes, AW, Agewall, S, Albus, C, Brotons, C, Catapano, AL, Cooney, MT, Corrà, U, Cosyns, B, Deaton, C, Graham, I, Hall, MS, Hobbs, FDR, Løchen, ML, Löllgen, H, Marques-Vidal, P, Perk, J, Prescott, E, Redon, J, Richter, DJ, Sattar, N, Smulders, Y, Tiberi, M, Van Der Worp, HB, Van Dis, I, Verschuren, WM M, Binno, S, De Backer, G, Roffi, M, Aboyans, V, Bachl, N, Carerj, S, Cho, Le, Cox, J, De Sutter, J, Egidi, G, Fisher, M, Fitzsimons, D, Franco, OH, Guenoun, M, Jennings, C, Jug, B, Kirchhof, P, Kotseva, K, Lip, GYH, Mach, F, Mancia, G, Bermudo, FM, Mezzani, A, Niessner, A, Ponikowski, P, Rauch, B, Stauder, A, Turc, G, Wiklund, O, Windecker, S, Zamorano, JL, Achenbach, S, Badimon, L, Barón-Esquivias, G, Baumgartner, H, Bax, JJ, Dean, V, Erol, Ç, Gaemperli, O, Kolh, P, Lancellotti, P, Nihoyannopoulos, P, Torbicki, A, Carneiro, AV, Metzler, B, Najafov, R, Stelmashok, V, De Maeyer, C, Dilić, M, Gruev, I, Miličić, D, Vaverkova, H, Gustafsson, I, Attia, I, Duishvili, D, Ferrières, J, Kostova, N, Klimiashvili, Z, Hambrecht, R, Tsioufis, K, Szabados, E, Andersen, K, Vaughan, C, Zafrir, B, Novo, S, Davletov, K, Jashari, F, Kerimkulova, A, Mintale, I, Saade, G, Petrulioniene, Z, Delagardelle, C, Magri, CJ, Rudi, V, Oukerraj, L, Çölkesen, BE, Schirmer, H, Dos Reis, RP, Gherasim, D, Nedogoda, S, Zavatta, M, Giga, V, Filipova, S, Padial, LR, Kiessling, A, Mahdhaoui, A, Ural, D, Nesukay, E, Gale, C, Piepoli, M, Hoes, A, Agewall, S, Albus, C, Brotons, C, Catapano, A, Cooney, M, Corrà, U, Cosyns, B, Deaton, C, Graham, I, Hall, M, Hobbs, F, Løchen, M, Löllgen, H, Marques-Vidal, P, Perk, J, Prescott, E, Redon, J, Richter, D, Sattar, N, Smulders, Y, Tiberi, M, Van Der Worp, H, Van Dis, I, Verschuren, W, Binno, S, De Backer, G, Roffi, M, Aboyans, V, Bachl, N, Carerj, S, Cho, L, Cox, J, De Sutter, J, Egidi, G, Fisher, M, Fitzsimons, D, Franco, O, Guenoun, M, Jennings, C, Jug, B, Kirchhof, P, Kotseva, K, Lip, G, Mach, F, Mancia, G, Bermudo, F, Mezzani, A, Niessner, A, Ponikowski, P, Rauch, B, Stauder, A, Turc, G, Wiklund, O, Windecker, S, Zamorano, J, Achenbach, S, Badimon, L, Barón-Esquivias, G, Baumgartner, H, Bax, J, Dean, V, Erol, Ç, Gaemperli, O, Kolh, P, Lancellotti, P, Nihoyannopoulos, P, Torbicki, A, Carneiro, A, Metzler, B, Najafov, R, Stelmashok, V, De Maeyer, C, Dilić, M, Gruev, I, Miličić, D, Vaverkova, H, Gustafsson, I, Attia, I, Duishvili, D, Ferrières, J, Kostova, N, Klimiashvili, Z, Hambrecht, R, Tsioufis, K, Szabados, E, Andersen, K, Vaughan, C, Zafrir, B, Novo, S, Davletov, K, Jashari, F, Kerimkulova, A, Mintale, I, Saade, G, Petrulioniene, Z, Delagardelle, C, Magri, C, Rudi, V, Oukerraj, L, Çölkesen, B, Schirmer, H, Dos Reis, R, Gherasim, D, Nedogoda, S, Zavatta, M, Giga, V, Filipova, S, Padial, L, Kiessling, A, Mahdhaoui, A, Ural, D, Nesukay, E, and Gale, C

Subjects
Adult, Diagnostic Imaging, Diabetic Angiopathie, Healthy Diet, General Practice, Population, Healthy lifestyle, Health Promotion, Sex Factor, Guideline, Guidelines, Diabete, Socioeconomic Factor, Blood pressure, Clinical settings, Diabetes, Lipid, Nutrition, Physical activity, Prevention, Primary care, Psychosocial factors, Rehabilitation, Risk assessment, Risk management, Smoking, Stakeholder, Cardiology and Cardiovascular Medicine, Cardiovascular Disease, Age Factor, Cost-Benefit Analysi, Practice Patterns, Physicians', Exercise, Aged, Cardiac Rehabilitation, Psychosocial factor, Biomarker, Middle Aged, Multiple Chronic Condition, Pedigree, Clinical setting, Antihypertensive Agent, Hyperlipidemia, Hypertension, Smoking Cessation, Human
Published
2016

36. 2016 European Guidelines on cardiovascular disease prevention in clinical practice

Author

Piepoli, M, Hoes, A, Agewall, S, Albus, C, Brotons, C, Catapano, A, Cooney, M, Corrà, U, Cosyns, B, Deaton, C, Graham, I, Hall, M, Hobbs, F, Løchen, M, Löllgen, H, Marques-Vidal, P, Perk, J, Prescott, E, Redon, J, Richter, D, Sattar, N, Smulders, Y, Tiberi, M, Van Der Worp, H, Van Dis, I, Verschuren, W, Binno, S, De Backer, G, Roffi, M, Aboyans, V, Bachl, N, Carerj, S, Cho, L, Cox, J, De Sutter, J, Egidi, G, Fisher, M, Fitzsimons, D, Franco, O, Guenoun, M, Jennings, C, Jug, B, Kirchhof, P, Kotseva, K, Lip, G, Mach, F, Mancia, G, Bermudo, F, Mezzani, A, Niessner, A, Ponikowski, P, Rauch, B, Stauder, A, Turc, G, Wiklund, O, Windecker, S, Zamorano, J, Achenbach, S, Badimon, L, Barón-Esquivias, G, Baumgartner, H, Bax, J, Dean, V, Erol, Ç, Gaemperli, O, Kolh, P, Lancellotti, P, Nihoyannopoulos, P, Torbicki, A, Carneiro, A, Metzler, B, Najafov, R, Stelmashok, V, De Maeyer, C, Dilić, M, Gruev, I, Miličić, D, Vaverkova, H, Gustafsson, I, Attia, I, Duishvili, D, Ferrières, J, Kostova, N, Klimiashvili, Z, Hambrecht, R, Tsioufis, K, Szabados, E, Andersen, K, Vaughan, C, Zafrir, B, Novo, S, Davletov, K, Jashari, F, Kerimkulova, A, Mintale, I, Saade, G, Petrulioniene, Z, Delagardelle, C, Magri, C, Rudi, V, Oukerraj, L, Çölkesen, B, Schirmer, H, Dos Reis, R, Gherasim, D, Nedogoda, S, Zavatta, M, Giga, V, Filipova, S, Padial, L, Kiessling, A, Mahdhaoui, A, Ural, D, Nesukay, E, Gale, C, Piepoli, MF, Hoes, AW, Catapano, AL, Cooney, MT, Hall, MS, Hobbs, FDR, Løchen, ML, Richter, DJ, Van Der Worp, HB, Verschuren, WM M, Cho, Le, Franco, OH, Lip, GYH, Bermudo, FM, Zamorano, JL, Bax, JJ, Carneiro, AV, Magri, CJ, Çölkesen, BE, Dos Reis, RP, Padial, LR, Piepoli, M, Hoes, A, Agewall, S, Albus, C, Brotons, C, Catapano, A, Cooney, M, Corrà, U, Cosyns, B, Deaton, C, Graham, I, Hall, M, Hobbs, F, Løchen, M, Löllgen, H, Marques-Vidal, P, Perk, J, Prescott, E, Redon, J, Richter, D, Sattar, N, Smulders, Y, Tiberi, M, Van Der Worp, H, Van Dis, I, Verschuren, W, Binno, S, De Backer, G, Roffi, M, Aboyans, V, Bachl, N, Carerj, S, Cho, L, Cox, J, De Sutter, J, Egidi, G, Fisher, M, Fitzsimons, D, Franco, O, Guenoun, M, Jennings, C, Jug, B, Kirchhof, P, Kotseva, K, Lip, G, Mach, F, Mancia, G, Bermudo, F, Mezzani, A, Niessner, A, Ponikowski, P, Rauch, B, Stauder, A, Turc, G, Wiklund, O, Windecker, S, Zamorano, J, Achenbach, S, Badimon, L, Barón-Esquivias, G, Baumgartner, H, Bax, J, Dean, V, Erol, Ç, Gaemperli, O, Kolh, P, Lancellotti, P, Nihoyannopoulos, P, Torbicki, A, Carneiro, A, Metzler, B, Najafov, R, Stelmashok, V, De Maeyer, C, Dilić, M, Gruev, I, Miličić, D, Vaverkova, H, Gustafsson, I, Attia, I, Duishvili, D, Ferrières, J, Kostova, N, Klimiashvili, Z, Hambrecht, R, Tsioufis, K, Szabados, E, Andersen, K, Vaughan, C, Zafrir, B, Novo, S, Davletov, K, Jashari, F, Kerimkulova, A, Mintale, I, Saade, G, Petrulioniene, Z, Delagardelle, C, Magri, C, Rudi, V, Oukerraj, L, Çölkesen, B, Schirmer, H, Dos Reis, R, Gherasim, D, Nedogoda, S, Zavatta, M, Giga, V, Filipova, S, Padial, L, Kiessling, A, Mahdhaoui, A, Ural, D, Nesukay, E, Gale, C, Piepoli, MF, Hoes, AW, Catapano, AL, Cooney, MT, Hall, MS, Hobbs, FDR, Løchen, ML, Richter, DJ, Van Der Worp, HB, Verschuren, WM M, Cho, Le, Franco, OH, Lip, GYH, Bermudo, FM, Zamorano, JL, Bax, JJ, Carneiro, AV, Magri, CJ, Çölkesen, BE, Dos Reis, RP, and Padial, LR

Published
2016

44. Abnormal glucose metabolism is associated with reduced left ventricular contractile reserve and exercise intolerance in patients with chronic heart failure

Author

Egstrup, M, Kistorp, C N, Schou, M, Høfsten, Dan Eik, Møller, J E, Tuxen, C D, Gustafsson, I, Egstrup, M, Kistorp, C N, Schou, M, Høfsten, Dan Eik, Møller, J E, Tuxen, C D, and Gustafsson, I

Abstract

AIMS: To investigate the associations between glucose metabolism, left ventricular (LV) contractile reserve, and exercise capacity in patients with chronic systolic heart failure (HF). METHODS AND RESULTS: From an outpatient HF clinic, 161 patients with systolic HF were included (mean age 70 ± 10 years, 69% male, 59% had ischaemic heart disease, mean LV ejection fraction (LVEF) 37 ± 9%). Thirty-four (21%) patients had known diabetes mellitus (DM). Oral glucose tolerance testing (OGTT) classified patients without a prior DM diagnosis as normal glucose tolerance (NGT), impaired glucose tolerance or new DM. All patients completed low-dose dobutamine echocardiography (LDDE) and 154 patients a 6-min walking distance test (6MWD). Compared with patients with NGT, patients with known DM had lower resting LVEF (33.4 vs. 39.1%, P <0.05) and higher E/e' (13.9 vs. 11.4, P <0.05). During LDDE, an increase in LVEF could be observed in all glycemic groups (mean 8.2% absolute increase), but the contractile reserve was lower in patients with known DM (-5.4%, P = 0.001) and new DM (-3.5%, P = 0.035) compared to patients with NGT. 6MWD was lower in known DM (349 m) and new DM (379 m) compared with NGT (467 m) (P <0.001). Differences in clinical variables, resting echocardiographic parameters or contractile reserve, did not explain the exercise intolerance related to diabetes. CONCLUSION: Diabetes, known or newly detected by OGTT, is independently associated with reduced LV contractile reserve and exercise intolerance in outpatients with systolic HF. These findings may offer one explanation for the excess mortality related to diabetes in HF.

Published
2013

46. In Situ Mass Spectrometry Imaging and Ex Vivo Characterization of Renal Crystalline Deposits Induced in Multiple Preclinical Drug Toxicology Studies

Author

Nilsson, Anna, Forngren, B., Bjurström, S., Goodwin, R. J. A., Basmaci, E., Gustafsson, I., Annas, A., Hellgren, D., Svanhagen, A., Andrén, Per E., Lindberg, J., Nilsson, Anna, Forngren, B., Bjurström, S., Goodwin, R. J. A., Basmaci, E., Gustafsson, I., Annas, A., Hellgren, D., Svanhagen, A., Andrén, Per E., and Lindberg, J.

Abstract

Drug toxicity observed in animal studies during drug development accounts for the discontinuation of many drug candidates, with the kidney being a major site of tissue damage. Extensive investigations are often required to reveal the mechanisms underlying such toxicological events and in the case of crystalline deposits the chemical composition can be problematic to determine. In the present study, we have used mass spectrometry imaging combined with a set of advanced analytical techniques to characterize such crystalline deposits in situ. Two potential microsomal prostaglandin E synthase 1 inhibitors, with similar chemical structure, were administered to rats over a seven day period. This resulted in kidney damage with marked tubular degeneration/regeneration and crystal deposits within the tissue that was detected by histopathology. Results from direct tissue section analysis by matrix-assisted laser desorption ionization mass spectrometry imaging were combined with data obtained following manual crystal dissection analyzed by liquid chromatography mass spectrometry and nuclear magnetic resonance spectroscopy. The chemical composition of the crystal deposits was successfully identified as a common metabolite, bisulphonamide, of the two drug candidates. In addition, an un-targeted analysis revealed molecular changes in the kidney that were specifically associated with the area of the tissue defined as pathologically damaged. In the presented study, we show the usefulness of combining mass spectrometry imaging with an array of powerful analytical tools to solve complex toxicological problems occurring during drug development., De två första författarna delar förstaförfattarskapet.De två sista författarna delar sistaförfattarskapet.

Published
2012
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48. Replacing dairy fat with rapeseed oil causes rapid improvement of hyperlipidaemia : a randomized controlled study

Author

Iggman, David, Gustafsson, I. -B, Berglund, L., Vessby, Bengt, Marckmann, P., Risérus, Ulf, Iggman, David, Gustafsson, I. -B, Berglund, L., Vessby, Bengt, Marckmann, P., and Risérus, Ulf

Abstract

Background. Rapeseed oil (RO), also known as canola oil, principally contains the unsaturated fatty acids 18:1n-9, 18:2n-6 and 18:3n-3 and may promote cardiometabolic health. Objective. To investigate the effects on lipoprotein profile, factors of coagulation and insulin sensitivity of replacing a diet rich in saturated fat from dairy foods (DF diet) with a diet including RO-based fat (RO diet). Design. During a 2 x 3-week randomized, controlled, cross-over trial, 20 free-living hyperlipidaemic subjects were provided with isocaloric test diets that differed in fat composition alone. Blood lipoprotein profile, coagulation and fibrinolytic factors and insulin sensitivity (euglycaemic clamp) were determined before and after the dietary intervention. Results. All subjects completed the study, and compliance was high according to changes in serum fatty acids. The RO diet, but not the DF diet, reduced the levels of serum cholesterol (-17%), triglycerides (-20%) and low-density lipoprotein cholesterol (-17%), cholesterol/high-density lipoprotein (HDL) cholesterol ratio (-21%), apolipoprotein (apo) B/apo A-I ratio (-4%) and factor VII coagulant activity (FVIIc) (-5%) from baseline. These changes were significantly different between the diets (P = 0.05 to P < 0.0001), except for FVIIc (P = 0.1). The RO diet, but not the DF diet, modestly increased serum lipoprotein( a) (+6%) and tended to increase the glucose disappearance rate (K-value, +33%). HDL cholesterol, insulin sensitivity, fibrinogen and tissue plasminogen activator inhibitor-1 levels did not change from baseline or differ between the two diets. Conclusions. In a diet moderately high in total fat, replacing dairy fat with RO causes a rapid and clinically relevant improvement in serum lipoprotein profile including lowering of triglycerides in hyperlipidaemic individuals.

Published
2011
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50. Increased plasma levels of asymmetric dimethylarginine in patients with carotid stenosis : No evidence for the role of the common FABP2 A54T gene polymorphism

Author

Wanby, Pär, Nilsson, I, Brudin, Lars, Nyhammar, I, Gustafsson, I, Carlsson, M, Wanby, Pär, Nilsson, I, Brudin, Lars, Nyhammar, I, Gustafsson, I, and Carlsson, M

Abstract

Objective - Both asymmetric dimethylarginine (ADMA), which is an inhibitor of endothelial nitric oxide synthase and the fatty acid-binding protein 2 (FABP2) A54T gene polymorphism have been associated with cerebrovascular disease. The objective of the present study was to investigate the role of ADMA and the FABP2 A54T polymorphism in carotid atherosclerosis. Material and methods - 54 patients with severe carotid stenosis and 54 matched controls without significant carotid stenosis were compared. ADMA was analysed with an ELISA method. The FABP2 A54T polymorphism was determined with a polymerase chain reaction-restriction fragment length polymorphism technique. Results - Patients with carotid stenosis had higher ADMA levels (0.76 ± 0.16 μmol/l) than the controls (0.70 ± 0.14 μmol/l, P < 0,01). Allele and genotype frequencies of the FABP2 polymorphism did not differ between patients and controls. Conclusions - ADMA levels in subjects with carotid stenosis are increased which emphasize the role of ADMA as a novel risk factor for atherosclerosis and future cardiovascular risk. The FABP2 A54T polymorphism is not associated with severe carotid stenosis. © 2007 The Authors.

Published
2007
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