Publications by authors named "Elmir Omerovic"
Background And Aims: The long-term outcomes of percutaneous coronary intervention (PCI) vs. coronary artery bypass grafting (CABG) in patients with non-ST-segment elevation myocardial infarction (NSTEMI) and multivessel disease remain debated.
Methods: The Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies registry was used to analyse 57 097 revascularized patients with NSTEMI with multivessel disease in Sweden from January 2005 to June 2022.
Background: ST-elevation myocardial infarction (STEMI) and Takotsubo syndrome (TS) are two distinct cardiac conditions that both result in sudden loss of cardiac dysfunction and that are difficult to distinguish clinically. This study compared plasma protein changes in 24 women with STEMI and 12 women with TS in the acute phase (days 0-3 post symptom onset) and the stabilization phase (days 7, 14, and 30) to examine the molecular differences between these conditions.
Methods: Plasma proteins from STEMI and TS patients were extracted during the acute and stabilization phases and analyzed via quantitative proteomics.
Article Synopsis
- * A study analyzed 15,856 ECGs from emergency patients in Sweden and trained a convolutional neural network (ResNet) to predict troponin elevation, achieving an accuracy of 71.43% and a high negative predictive value of 0.8660.
- * The model's promising performance suggests that similar neural networks could be used in emergency settings for rapid triage of patients suspected of having heart issues.
Inotropes and mortality in patients with cardiogenic shock: an instrumental variable analysis from the SWEDEHEART registry.
Eur Heart J Cardiovasc Pharmacother
October 2024
Article Synopsis
- This study examines the impact of inotropic agents on 30-day mortality rates in patients suffering from cardiogenic shock (CS), using data from the SWEDEHEART registry in Sweden.
- The research involved 16,214 CS patients, indicating that those treated with inotropes generally faced higher mortality risks compared to those who did not, with an adjusted hazard ratio of 1.72.
- The findings suggest that inotropes may be associated with increased mortality, particularly influenced by factors like age and the underlying cause of CS.
Article Synopsis
- Lipid content in nonobstructive coronary lesions can lead to poor clinical outcomes, particularly in relation to complications after stenting during percutaneous coronary intervention (PCI).
- A study using near-infrared spectroscopy and intravascular ultrasound evaluated the relationship between lipid levels and major adverse cardiac events (MACE) in patients who underwent PCI for myocardial infarction.
- Findings showed that high lipid levels and plaque burden at stent edges increased the risk of stent edge-related MACE, while pre- and post-PCI lipid content did not correlate with in-stent MACE.
Article Synopsis
- - The study aimed to explore whether percutaneous coronary intervention (PCI) provides better outcomes than just medical therapy (MT) for patients with chronic coronary syndrome (CCS), analyzing data from the Swedish Coronary Angiography and Angioplasty Registry from 2010 to 2020.
- - Two groups of 7,220 patients each were compared, one receiving PCI along with MT and the other receiving MT alone, using statistical methods to account for differences between the groups.
- - Results indicated that PCI was associated with improved outcomes in terms of net adverse clinical events and major adverse cardiovascular events, particularly for myocardial infarction and urgent revascularization, but there was no notable difference for all-cause mortality or bleeding.
Article Synopsis
- The study aimed to explore sex differences in the prevalence of imaging-detected atherosclerosis in men and women, revealing that men are more likely to experience cardiovascular issues such as myocardial infarction.
- Participants aged 50-65 from the SCAPIS study underwent advanced imaging, finding significantly higher rates of coronary and carotid atherosclerosis in men compared to women (e.g., 56.2% vs. 29.5% for coronary atherosclerosis).
- Even after adjusting for factors like hypertension and diabetes, these sex differences in atherosclerosis prevalence persisted, indicating a greater cardiovascular risk for men, with older women showing comparable rates to younger men.
Impact and Implications of Neurocognitive Dysfunction in the Management of Ischemic Heart Failure.
J Soc Cardiovasc Angiogr Interv
December 2023
Neurocognitive dysfunction is common in heart failure (HF), with 30% to 80% of patients experiencing some degree of deficits in one or more cognitive domains, including memory, attention, learning ability, executive function, and psychomotor speed. Although the mechanism is not fully understood, reduced cardiac output, comorbidities, chronic cerebral hypoperfusion, and cardioembolic brain injury leading to cerebral hypoxia and brain damage seem to trigger the neurocognitive dysfunction in HF. Cognitive impairment is independently associated with worse outcomes including mortality, rehospitalization, and reduced quality of life.
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- Takotsubo syndrome (TTS) is a serious condition mimicking heart attacks, often triggered by stress, and has high rates of morbidity and mortality.
- This study utilized data from the Swedish Coronary Angiography and Angioplasty Registry between 2015-2022, employing machine learning (specifically gradient boosting) to identify factors predicting 30-day mortality in TTS patients.
- Results revealed that the treating hospital was the strongest predictor of mortality, followed by factors like the clinical reason for angiography, creatinine levels, Killip class, and patient age, highlighting the need for tailored treatments based on these predictors.
Aims: Adequate animal models are necessary to understand human conditions, such as takotsubo syndrome (TS) characterized by the heart's transient regional wall motion abnormalities. This study aims to develop a reproducible, low-mortality TS model that closely mimics the human condition and addresses the limitations of existing models.
Methods And Results: We conducted six experiments using 309 Sprague Dawley rats, each approximately 300 g and aged 7-8 weeks.
Background: Dual antiplatelet therapy (DAPT) reduces ischemic events but increases bleeding risk, especially in patients with high bleeding risk (HBR). This study aimed to compare outcomes of abbreviated versus standard DAPT strategies in patients with HBR with acute coronary syndrome undergoing percutaneous coronary intervention.
Methods And Results: Patients from the SWEDEHEART (Swedish Web-system for Enhancement and Development of Evidence-Based Bare in Heart Disease Evaluated According to Recommended Therapies) registry with at least 1 HBR criterion who underwent percutaneous coronary intervention for acute coronary syndrome were identified and included.
Modelling human diseases serves as a crucial tool to unveil underlying mechanisms and pathophysiology. Takotsubo syndrome (TS), an acute form of heart failure resembling myocardial infarction, manifests with reversible regional wall motion abnormalities (RWMA) of the ventricles. Despite its mortality and clinical similarity to myocardial infarction, TS aetiology remains elusive, with stress and catecholamines playing central roles.
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- The study investigates long-term trends and risk factors for peripheral arterial complications in individuals with type 2 diabetes compared to the general population, using data from the Swedish National Diabetes Register from 2001 to 2019.
- It includes a large sample size of 655,250 people with diabetes, analyzing the incidence rates of various complications over the years, such as lower extremity artery disease and diabetic foot disease.
- Key findings reveal that risk factors like hemoglobin A1c levels, systolic blood pressure, smoking, and lipid levels significantly influence these complications, with higher risk for those not meeting target levels.
Article Synopsis
- This study analyzed long-term trends and risk factors for non-coronary complications in individuals with type 1 diabetes compared to matched controls using a large dataset from the Swedish National Diabetes Register.
- Between 2001 and 2019, the incidence rates of complications like large artery disease and diabetic foot syndrome decreased significantly in those with type 1 diabetes, while certain risk factors like education and blood sugar levels had a substantial impact on these outcomes.
- Interestingly, people with type 1 diabetes who maintained cardiometabolic risk factors at target levels showed lower risks for some complications, but had a significantly higher risk for diabetic foot disease if all risk factors were present.
Background: The registry-based randomized VALIDATE-SWEDEHEART trial (NCT02311231) compared bivalirudin vs. heparin in patients undergoing percutaneous coronary intervention (PCI) for myocardial infarction (MI). It showed no difference in the composite primary endpoint of death, MI, or major bleeding at 180 days.
View Article and Find Full Text PDFBackground And Aims: Ischemic preconditioning (IPC), i.e., brief periods of ischemia, protect the heart from subsequent prolonged ischemic injury, and reduces infarction size.
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- Takotsubo syndrome (TS) is a heart condition that imitates a heart attack, often triggered by stress, leading to weakened heart muscles; the study aimed to explore how different medications impact mortality rates in TS patients.
- The analysis included 1,724 TS patients from the SWEDEHEART registry, predominantly older women, with a significant portion presenting types of acute coronary syndrome and most showing non-obstructive coronary artery disease.
- Findings indicated that certain medications, like intravenous inotropes and diuretics, increased 30-day mortality, while long-term use of angiotensin-converting enzyme inhibitors and statins improved survival rates.
In an era focused on value-based healthcare, the quality of healthcare and resource allocation should be underpinned by empirical evidence. Pragmatic clinical trials (pRCTs) are essential in this endeavor, providing randomized controlled trial (RCT) insights that encapsulate real-world effects of interventions. The rising popularity of pRCTs can be attributed to their ability to mirror real-world practices, accommodate larger sample sizes, and provide cost advantages over traditional RCTs.
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- This study examines out-of-hospital cardiac arrests (OHCA) in young adults (ages 16-49) in Sweden from 1990 to 2020, focusing on survival rates and causes of cardiac arrests.
- Over the 30-year period, there was a notable annual increase of 5.9% in 30-day survival rates without decline in neurological function, despite rising cases related to overdoses and suicides.
- By 2020, an impressive 88% of OHCA cases received bystander CPR, while EMS response times increased from 6 to 10 minutes, indicating both improvement in immediate care and challenges in emergency response.
Coronary calcification in patients presenting with acute coronary syndromes: insights from the MATRIX trial.
Eur Heart J Acute Cardiovasc Care
November 2023
Aims: The role of coronary calcification on clinical outcomes among different revascularization strategies in patients presenting with acute coronary syndromes (ACSs) has been rarely investigated. The aim of this investigation is to evaluate the role of coronary calcification, detected by coronary angiography, in the whole spectrum of patients presenting with acute ACS.
Methods And Results: The present study was a post hoc analysis of the MATRIX programme.
Article Synopsis
- The study examined the survival rates of patients with left-sided valvular heart disease (VHD) after experiencing out-of-hospital cardiac arrest (OHCA) through data from the Swedish Registry for Cardiopulmonary Resuscitation.* -
- Among the cases analyzed (55,615 patients), those with aortic stenosis (AS) showed significantly lower survival rates (5.2%) compared to aortic regurgitation (AR, 10.4%), mitral regurgitation (MR, 9.2%), and those without VHD (11.4%).* -
- While survival after 30 days was worse for AS patients, neurological outcomes for AS survivors were similar to those without VHD
Article Synopsis
- * The study included over 11,000 patients, revealing that those who underwent PCI were generally older with more health issues but had better three-vessel disease profiles than CABG patients.
- * Results indicated that CABG was linked to lower mortality rates and fewer major adverse cardiovascular and cerebrovascular events (MACCE) compared to PCI, especially notable in diabetic patients who had a significant survival advantage with CABG.