Publications by authors named "Conen D"

Background: There is some evidence of reduced major cardiovascular event (MACE) rates associated with moderate coffee consumption in the general population. However, there is concern about the potential risks of coffee consumption in patients with atrial fibrillation (AF). Therefore, we aimed to investigate the association between coffee consumption and MACE in AF patients.

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Background: Atrial fibrillation is an independent risk factor for the development of cognitive impairments. Regular coffee consumption has shown cognitive benefits in healthy individuals. Whether regular consumption reduces cognitive decline in vulnerable patients is controversial.

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Background: Clinically important perioperative atrial fibrillation (POAF) is a common cardiac complication after noncardiac surgery. Little is known about how patients with POAF are managed acutely and whether practices have changed over time.

Methods: We conducted an observational substudy of patients who had POAF, were at elevated cardiovascular risk, and were enrolled in the PeriOperative Ischemic Evaluation (POISE)-1, 2 and 3 trials between 2002 and 2021.

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  • The study examined the relationship between smoking habits and brain health in patients with atrial fibrillation (AF), focusing on brain lesions and volumes using MRI scans.
  • A total of 1,728 patients were analyzed, revealing that heavy smoking and longer smoking duration were linked to reduced gray matter volume and increased risk of white matter lesions (WMLs).
  • Additionally, patients who quit smoking for at least 16 years had fewer small noncortical infarcts and smaller WML volumes, indicating that long-term cessation may improve brain health.
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  • * A total of 7062 patients participated, and the results showed no significant difference in primary cardiovascular outcomes between the colchicine group (9.1%) and the placebo group (9.3%) over a 3-year follow-up period.
  • * Colchicine did lower C-reactive protein levels, indicating some anti-inflammatory effect, but it also caused more diarrhea compared to placebo, though serious infections were similar in both groups.
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Background: Mineralocorticoid receptor antagonists have been shown to reduce mortality in patients after myocardial infarction with congestive heart failure. Whether routine use of spironolactone is beneficial after myocardial infarction is uncertain.

Methods: In this multicenter trial with a 2-by-2 factorial design, we randomly assigned patients with myocardial infarction who had undergone percutaneous coronary intervention to receive either spironolactone or placebo and either colchicine or placebo.

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Atrial fibrillation (AF) is a common arrhythmia encountered in acute and critical illness and is associated with poor short and long-term outcomes. Given the consequences of developing AF, research into prevention, prediction and treatment of this arrhythmia in the critically ill are of great potential benefit, however, study of AF in critically ill patients faces unique challenges, leading to a sparse evidence base to guide management in this population. Major obstacles to the study of AF in acute and critical illness include absence of a common definition, challenges in designing studies that capture complex etiology and assess causality, lack of a clear outcome set, difficulites in recruitment in acute environments with respect to timing, consent, and workflow, and failure to embed studies into clinical care platforms and capitalize on emerging technologies.

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  • * This study analyzed data from over 900 high-risk AF patients to compare outcomes between those receiving LAAO and those getting traditional treatment (mostly oral anticoagulants).
  • * Results showed no significant differences in stroke or cardiovascular death rates, but LAAO patients experienced significantly less clinically relevant bleeding compared to those on conventional treatments.
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Objective: To investigate the longitudinal dynamics of serum glial fibrillary acidic protein (sGFAP) and serum neurofilament light chain (sNfL) levels in people with multiple sclerosis (pwMS) under B-cell depleting therapy (BCDT) and their capacity to prognosticate future progression independent of relapse activity (PIRA) events.

Methods: A total of 362 pwMS (1,480 samples) starting BCDT in the Swiss Multiple Sclerosis (MS) Cohort were included. sGFAP levels in 2,861 control persons (4,943 samples) provided normative data to calculate adjusted Z scores.

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Background: The influence of atrial fibrillation (AF) and blood pressure (BP) on brain lesions and cognitive function is unclear. We aimed to investigate the association of BP with different types of brain lesions and cognitive decline in patients with AF.

Methods: Overall, 1,213 AF patients underwent standardized brain magnetic resonance imaging at baseline and after 2 years, as well as yearly neurocognitive testing.

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Background And Aims: The role of biomarkers in diagnosing pulmonary hypertension (PH) and distinguishing between pre- and post-capillary PH remains poorly understood. We aimed to identify biomarkers with a strong association with mean pulmonary arterial pressure, mPAP (PH diagnosis) and pulmonary vascular resistance, PVR (pre-capillary component), but not with pulmonary arterial wedge pressure, PAWP (post-capillary component).

Methods: Blood samples were collected in patients undergoing right heart catheterization within a prospective cross-sectional study.

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Article Synopsis
  • After heart surgery, some patients develop a condition called atrial fibrillation (AF), which can lead to important health issues.
  • Researchers are studying how to predict, prevent, and manage this condition in people who have had surgery.
  • There are currently 121 studies happening, mostly focusing on preventing AF, but more work is needed to understand how to control it over time.
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  • * It included over 2,300 patients, with a focus on comparing outcomes based on how many ECV procedures each patient had undergone.
  • * The results indicated no significant link between the number of ECVs and either existing or new brain infarcts, nor with clinical issues like strokes, hospitalizations for heart failure, or mortality.
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Objectives: Sex differences occur in atrial fibrillation (AF), including age at first manifestation, pathophysiology, treatment allocation, complication rates and quality of life. However, optimal doses of cardiovascular pharmacotherapy used in women with AF with or without heart failure (HF) are unclear. We investigated sex-specific associations of beta-blocker and renin-angiotensin system (RAS) inhibitor doses with cardiovascular outcomes in patients with AF or AF with concomitant HF.

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Although both short and long sleep duration are associated with elevated hypertension risk, our understanding of their interplay with biological pathways governing blood pressure remains limited. To address this, we carried out genome-wide cross-population gene-by-short-sleep and long-sleep duration interaction analyses for three blood pressure traits (systolic, diastolic, and pulse pressure) in 811,405 individuals from diverse population groups. We discover 22 novel gene-sleep duration interaction loci for blood pressure, mapped to 23 genes.

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Importance: Numerous prospective cohort studies have reported a J-shaped association of urinary sodium excretion with cardiovascular events and mortality.

Objective: To study the association between sodium intake and incident atrial fibrillation (AF).

Design, Setting, And Participants: This cohort study included participants in the Ongoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial (ONTARGET) and Telmisartan Randomised Assessment Study in ACE Intolerant Subjects With Cardiovascular Disease (TRANSCEND) multicenter, randomized clinical trials comparing the effect of ramipril 10 mg daily with telmisartan 80 mg daily, or their combination (ONTARGET) or 80 mg telmisartan daily with placebo (TRANSCEND) for the outcome of death from cardiovascular causes, myocardial infarction, stroke, or hospitalization for heart failure.

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Article Synopsis
  • * In a study of 1,265 AF patients, those with heart failure (HFpEF and HFrEF) faced significantly higher risks of hospitalisation due to heart failure, mortality, and progression of AF compared to those without HF.
  • * HFpEF patients received the fewest rhythm control interventions and reported the poorest quality of life, indicating a critical need for better treatments in this population.
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Background: Noncardiac surgery is associated with an inflammatory response. Whether increased inflammation in the perioperative period is associated with subsequent morbidity and mortality is unknown.

Methods: MEDLINE, EMBASE, and CENTRAL were systematically searched from date of inception until May 2023.

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Objective: To determine timing and risk factors associated with readmission within 30 days of discharge following noncardiac surgery.

Background: Hospital readmission after noncardiac surgery is costly. Data on the drivers of readmission have largely been derived from single-center studies focused on a single surgical procedure with uncertainty regarding generalizability.

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Objective: Smoking cessation interventions are underutilized in the surgical setting. We aimed to systematically identify the barriers and facilitators to smoking cessation in the surgical setting.

Methods: Following the Joanna Briggs Institute (JBI) framework for scoping reviews, we searched 5 databases (MEDLINE, Embase, Cochrane CENTRAL, CINAHL, and PsycINFO) for quantitative or qualitative studies published in English (since 2000) evaluating barriers and facilitators to perioperative smoking cessation interventions.

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  • Stroke is a major risk for patients with atrial fibrillation (AF), potentially linked to issues with the autonomic nervous system.
  • A study involving 1,922 AF patients analyzed various heart rate variability (HRV) measures to see if they correlate with stroke risk.
  • Results showed that a specific HRV measure (HRVI <15) in patients with normal sinus rhythm (SR) significantly predicted stroke risk, while no HRV measures were linked to stroke risk in the AF group.
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  • * The research showed that individuals with high polygenic risk scores have significantly higher blood pressure (almost 17 mmHg more) and over seven times the risk of developing hypertension compared to those with low scores.
  • * Incorporating these genetic risk scores into hypertension prediction models improved their accuracy, and excitingly, similar genetic associations were found in a large African-American sample, underscoring the potential of these findings for precision health initiatives.
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