Publications by authors named "Gunnar Engstrom"

Objective: Meat intake is suggested to affect gut microbiome composition and the risk of chronic diseases. We aimed to identify meat-associated gut microbiome features and their association with host factors.

Design: Gut microbiota species were profiled by deep shotgun metagenomics sequencing in 9669 individuals.

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Background: Metabolic syndrome (MetS) is characterized by coexisting risk factors for type 2 diabetes and cardiovascular disease. Diet is of importance in their aetiology, and gut microbiota (GM) may constitute a link between diet and metabolic health. Understanding the interplay between diet and GM could contribute novel insights for future dietary guidelines, and aid in preventive actions to motivate adherence to dietary guidelines.

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To investigate whether coronary artery disease (CAD) burden is associated with plasma levels of the myocardial biomarkers Troponin I (TropI) and NT-proBNP in a large population-based sample using a cross-sectional design. Coronary computerized tomography (CT) angiography was performed in 25,859 subjects without a history of atherosclerotic disease from SCAPIS study (age 50-65, 52% women). TropI and NT-proBNP were measured in plasma.

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Background: There is a well-known comorbidity between chronic obstructive pulmonary disease (COPD) and coronary artery disease (CAD) which is only partially explained by common risk factors. Markers of cardiovascular autonomic dysfunction (CVAD), such as orthostatic hypotension and increased resting heart rate, are strongly associated with CAD. The autonomic nervous system also innervates the airways, and several studies have shown an association between autonomic dysfunction and COPD.

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Article Synopsis
  • * In a study of 9,628 participants, the biomarker KIM-1 was found to significantly associate with coronary artery stenosis and coronary artery calcium score, even after controlling for common cardiovascular risk factors.
  • * KIM-1 indicates proximal tubular damage in kidneys and its association with atherosclerosis suggests potential early risk signals for cardiovascular issues in individuals who seem otherwise healthy, highlighting a need for more research on this biomarker.
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Introduction: Cardiovascular drug use may help prevent dementia; however, current evidence is mixed. Using a case-control design, we investigated the association between duration and combination of multiple cardiovascular drug classes and incident dementia.

Methods: From the Swedish national registers, we included 88,065 incident dementia cases aged ≥ 70 at diagnosis between 2011 and 2016 and 880,650 age- and sex-matched controls.

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Background: The relationship between sleeping habits and aortic stiffness remains inconclusive and is not fully explored in the European general population.

Methods: We examined cross-sectionally 8659 participants from the Swedish population-based cohort Swedish CArdioPulmonary bioImage Study (SCAPIS), mean age 57.5 years, 52.

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Background: Dyslipidaemia in patients with diabetes contributes to the risk of atherosclerotic cardiovascular disease. We aimed to identify a dyslipidemic profile associated with both dysglycemia and subclinical coronary atherosclerosis.

Methods: Study participants (n = 5050) were classified in three groups: normoglycemia, pre-diabetes, and diabetes.

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Background: Uric acid closely relates to both kidney disease and atrial fibrillation (AF), yet the extent to which it influences the kidney-AF association remains uncertain. We examined the relationship between kidney function and risk of AF, accounting for uric acid levels.

Methods: A total of 308,509 individuals in the Swedish Apolipoprotein-Related Mortality Risk (AMORIS) cohort were included and their serum creatinine and uric acid were measured during 1985-1996.

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Article Synopsis
  • This study investigated the relationship between transportation noise and atrial fibrillation (AF) using data from 11 Nordic cohorts, totaling over 161,000 participants.
  • Researchers found that higher road traffic noise exposure is linked to an increased risk of developing AF, particularly in women and overweight individuals.
  • Aircraft noise also showed a potential association with AF risk, while railway noise did not appear to be related; overall, road and aircraft noise combined raised the risk significantly.
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Objectives: To examine cardiovascular autonomic function in middle-aged people with long-term cervical and upper thoracic spinal cord injury (SCI) compared with the general population, and explore if the neurological level of injury (NLI) is related to cardiovascular autonomic function.

Design: Population-based cross-sectional study with matched controls.

Setting: Outpatient SCI unit in Southern Sweden.

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Background: The ankle-brachial index (ABI) is the ratio of the ankle and brachial systolic blood pressures. In the clinical setting, low ABI (< 0.9) is an indicator of peripheral atherosclerosis, while high ABI (> 1.

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Myocardial infarction is a leading cause of death globally but is notoriously difficult to predict. We aimed to identify biomarkers of an imminent first myocardial infarction and design relevant prediction models. Here, we constructed a new case-cohort consortium of 2,018 persons without prior cardiovascular disease from six European cohorts, among whom 420 developed a first myocardial infarction within 6 months after the baseline blood draw.

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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.
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Knowledge regarding the prevalence and shared and unique characteristics of the restrictive spirometric pattern (RSP) and preserved ratio impaired spirometry (PRISm) is lacking for a general population investigated with post-bronchodilator spirometry and computed tomography of the lungs. To investigate shared and unique features for RSP and PRISm. In the Swedish CArdioPulmonary bioImage Study (SCAPIS), a general population sample of 28,555 people aged 50-64 years (including 14,558 never-smokers) was assessed.

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  • The study aimed to evaluate the day-to-day variability in the frequency of premature atrial complexes (PACs) and premature ventricular complexes (PVCs) using 14-day ECG recordings from 8245 patients.
  • Results showed that significant daily variability exists; for PACs, 25% of patients had daily frequencies that differed by over 50% from their 14-day average after just 3 days, while for PVCs, it took 7 days to see similar variation.
  • The findings indicate that when patients report very high frequencies (≥10,000), single-day ECG results are highly specific and do not require longer recordings for confirmation.
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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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Background: Coronary atherosclerosis detected by imaging is a marker of elevated cardiovascular risk. However, imaging involves large resources and exposure to radiation. The aim was, therefore, to test whether nonimaging data, specifically data that can be self-reported, could be used to identify individuals with moderate to severe coronary atherosclerosis.

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Background: Liver disease and dementia are both highly prevalent and share common pathological mechanisms. We aimed to investigate the associations between metabolic dysfunction-associated fatty liver disease (MAFLD), metabolic dysfunction-associated steatotic liver disease (MASLD) and the risk of all-cause and cause-specific dementia.

Methods: We conducted a prospective study with 403,506 participants from the UK Biobank.

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Article Synopsis
  • The study investigates how the autonomic nervous system (ANS) affects the progression of atrial fibrillation (AF) and proposes a new ECG-based method to assess this activity, focusing on respiratory modulation of AV nodal conduction.
  • A 1-dimensional convolutional neural network (1D-CNN) was trained on synthetic ECG data to estimate respiratory effects on AV node properties, showing strong correlations in its predictions.
  • Initial results from clinical tests indicate that this method is promising for monitoring autonomic modulation in AF patients, but more research is needed to confirm its reliability and clinical relevance.
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  • The study investigates the relationship between low plasma levels of soluble RAGE (sRAGE) and cardiovascular risk, specifically major adverse coronary events (MACE), in a cohort of 4,338 individuals.
  • Researchers found that certain genetic variants, particularly the minor allele of SNP rs2070600, are linked to lower levels of sRAGE and an increased risk for MACE, although other SNPs did not show a similar association.
  • This research is significant as it is the largest to establish a genetic link between sRAGE and cardiovascular risk, emphasizing rs2070600's role in enhancing RAGE function and its impact on MACE.
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Importance: Identification of individuals at high risk for atherosclerotic cardiovascular disease within the population is important to inform primary prevention strategies.

Objective: To evaluate the prognostic value of routinely available cardiovascular biomarkers when added to established risk factors.

Design, Setting, And Participants: Individual-level analysis including data on cardiovascular biomarkers from 28 general population-based cohorts from 12 countries and 4 continents with assessments by participant age.

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Background: The molecular pathways linking short and long sleep duration with incident diabetes mellitus (iDM) and incident coronary heart disease (iCHD) are not known. We aimed to identify circulating protein patterns associated with sleep duration and test their impact on incident cardiometabolic disease.

Methods: We assessed sleep duration and measured 78 plasma proteins among 3336 participants aged 46-68 years, free from DM and CHD at baseline, and identified cases of iDM and iCHD using national registers.

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Background: Increased aortic stiffness (arteriosclerosis) is associated with early vascular aging independent of age and sex. The underlying mechanisms of early vascular aging remain largely unexplored in the general population. We aimed to investigate the plasma metabolomic profile in aortic stiffness (vascular aging) and associated risk of incident cardiovascular disease and mortality.

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