Factors associated with coronary heart disease in COPD patients and controls.

Background: COPD and coronary heart disease (CHD) frequently co-occur, yet which COPD phenotypes are most prone to CHD is poorly understood. The aim of this study was to see whether COPD patients did have a true higher risk for CHD than subjects without COPD, and to examine a range of potential factors associated with CHD in COPD patients and controls.

Methods: 347 COPD patients and 428 non-COPD controls, were invited for coronary computed tomography angiography (CCTA) and pulmonary CT.

Frailty Status and Patient-Reported Outcomes in Octogenarians Following Transcatheter or Surgical Aortic Valve Replacement.

Background: Frailty status and patient-reported outcomes are especially pertinent in octogenarians following transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR) to guide treatment decisions and promote patient-centred care.

Aim: We aimed to determine if frailty changed 6 months after aortic valve replacement (AVR) in octogenarians, and to describe changes in self-rated health according to frailty status in patients who underwent TAVI or SAVR.

Method: In a prospective cohort study, frailty and self-rated health were measured one day prior to and 6 months after AVR.

Octogenarian patients' sleep and delirium experiences in hospital and four years after aortic valve replacement: a qualitative interview study.

Objectives: Sleep disturbances and delirium are frequently observed complications after surgical aortic valve replacement (SAVR) and transcutaneous aortic valve implantation (TAVI), especially in octogenarian patients. However, a knowledge gap exists on patient experiences of sleep and delirium. In particular, patients' long-term sleep and delirium experiences are unknown.

Baseline frailty status and outcomes important for shared decision-making in older adults receiving transcatheter aortic valve implantation, a prospective observational study.

Aims: The objective of this study was to examine baseline frailty status (including cognitive deficits) and important clinical outcomes, to inform shared decision-making in older adults receiving transcatheter aortic valve implantation (TAVI).

Methods And Results: We conducted a prospective, observational study of 82 TAVI patients, recruited 2013 to 2015, with 2-year follow-up. Mean age was 83 years (standard deviation (SD) 4.

Indwelling urinary catheters, aortic valve treatment and delirium: a prospective cohort study.

Objectives: To determine whether an association exists between delirium and length of time indwelling urine catheters (IUC) are used in octogenarian patients treated with surgical aortic valve treatment (SAVR) or transcatheter aortic valve implantation (TAVI).

Design: Prospective cohort study.

Setting: Tertiary university hospital covering the western region of Norway.

A novel geriatric assessment frailty score predicts 2-year mortality after transcatheter aortic valve implantation.

Aims: Established surgical scores have limitations in delineating risk among candidates for transcatheter aortic valve implantation (TAVI). Assessment of frailty might help to estimate the mortality risk and identify patients likely to benefit from treatment. The aim of the study was to develop a frailty score to guide the decision for TAVI.

"Eight Days of Nightmares … " - Octogenarian Patients' Experiences of Postoperative Delirium after Transcatheter or Surgical Aortic Valve Replacement.

Background: Surgical aortic valve replacement (SAVR) and transcatheter aortic valve implantation (TAVI) are increasingly performed in octogenarian patients with severe aortic stenosis (AS), including those with high surgical risk. Postoperative delirium (PD) is a common and serious complication in older patients, characterised by reduced awareness, change in consciousness, disturbance in logical thinking and hallucinations.

Methods: To explore how octogenarian patients experienced PD, a qualitative study was conducted including five women and five men between 81 and 88 years.

Readmissions and mortality in delirious versus non-delirious octogenarian patients after aortic valve therapy: a prospective cohort study.

Objectives: To determine whether postoperative delirium predicts first-time readmissions and mortality in octogenarian patients within 180 days after aortic valve therapy with surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI), and to determine the most common diagnoses at readmission.

Design: Prospective cohort study of patients undergoing elective SAVR or TAVI.

Setting: Tertiary university hospital that performs all SAVRs and TAVIs in Western Norway.

Delirium as a Predictor of Physical and Cognitive Function in Individuals Aged 80 and Older After Transcatheter Aortic Valve Implantation or Surgical Aortic Valve Replacement.

Objectives: To determine how development of delirium after surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI) could predict activity of daily living (ADL) and instrumental ADLs (IADL) disability, cognitive function, and self-reported health in individuals aged 80 and older.

Design: Prospective cohort study.

Setting: Tertiary university hospital.

Changes in self-reported health and quality of life in octogenarian patients one month after transcatheter aortic valve implantation.

Background: In addition to favourable results regarding mortality and morbidity it is important to identify the impact transcatheter aortic valve implantation (TAVI) has on patients' quality of life.

Aims: The aims were: (i) to describe clinical characteristics, self-reported health and quality of life in octogenarians before TAVI intervention; (ii) to determine changes in self-reported health and quality of life one month after TAVI; and (iii) to establish the clinical importance of the findings.

Methods: A prospective cohort study was conducted on consecutively enrolled octogenarians with severe aortic stenosis undergoing TAVI ( N = 65).

Sleep in octogenarians during the postoperative phase after transcatheter or surgical aortic valve replacement.

Background: Octogenarians with aortic stenosis are an increasing population of patients admitted for surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI). Although adequate sleep is important after illness and surgery, it has scarcely been studied in the immediate postoperative phase.

Aims: To determine and compare the nature of self-reported sleep and insomnia, and recorded sleep-wake patterns in octogenarians during the in-hospital postoperative phase after SAVR or TAVI.

Comparison of frequency, risk factors, and time course of postoperative delirium in octogenarians after transcatheter aortic valve implantation versus surgical aortic valve replacement.

Postoperative delirium (PD) after transcatheter aortic valve implantation (TAVI) remains to be explored. We sought to (1) determine the incidence of PD in octogenarians who underwent TAVI or surgical aortic valve replacement (SAVR), (2) identify its risk factors, and (3) describe possible differences in the onset and course of PD between treatment groups. A prospective cohort study of consecutive patients aged ≥80 years with severe aortic stenosis who underwent elective TAVI or SAVR (N = 143) was conducted.

The Norwegian Stroke in the Young Study (NOR-SYS): rationale and design.

Background: Ischemic stroke in young adults is a major health problem being associated with a higher vascular morbidity and mortality compared to controls, and a stroke recurrence rate of 25% during the first decade. The assumed cause of infarction and the detected risk factors determine the early- and long-term treatment. However, for many patients the cause of stroke remains unknown.

Effects of local delivery of tetradecylthioacetic acid within the injured coronary vessel wall.

Objectives: Inflammation is involved in cell proliferation and collagen deposition causing vessel wall remodeling and restenosis after plain balloon angioplasty. Local drug delivery of bioactive agents that reduce the incidence of adverse wall remodeling is of considerable interest concerning treatment strategies for coronary vessel disease and could alter the need of repeated revascularization.

Design: In this study, 34 domestic pigs undergoing coronary balloon injury were randomly assigned to Tetradecylthioacetic acid (TTA) or placebo delivered locally.

Competing risk analysis of events 10 years after revascularization.

Objectives: To evaluate the influence of competing risk (CR) non-cardiac death during long-term follow-up of revascularized patients on the interpretation of the cardiac outcomes.

Methods: Retrospectively, we compared outcomes estimated with the Kaplan-Meier and the cumulative incidence function (CIF) methods after a median 10.8 years follow-up in 1,234 consecutive patients (594 CABG, 640 PCI) undergoing first time non-emergent revascularization in a community cohort.

Dose-dependent coronary artery intimal thickening after local delivery of the anti-oxidant tetradecylthioacetic acid from stents.

Objective: To examine the in vitro uptake and elution of the anti-oxidant tetradecylthioacetic acid (TTA) from phosphorylcholine (PC)-coated stents, and the in vivo uptake, retention, inflammatory response and histomorphometric changes after overstretch injury of the porcine coronary artery.

Methods: PC-coated stents were loaded in one of three different concentrations of TTA (87, 174 and 347 mmol/L, i.e.

Implementing a best-treatment strategy with intracoronary brachytherapy for in-stent restenosis in patients at high risk for recurrence.

Background: The deployment of drug-eluting stents (DES) to treat bare-metal stent restenosis [in-stent restenosis (ISR)] has become routine practice, with a consequential decline in the use of intracoronary brachytherapy (ICBT). However, there are concerns as to the long-term safety profile of DES, particularly in terms of late stent thrombosis. In addition, an appropriate treatment strategy for stenosis within DES has not been developed.

Nonemergent coronary angioplasty without on-site surgical backup: a randomized study evaluating outcomes in low-risk patients.

Background: Percutaneous coronary intervention (PCI) in nonemergent patients with coronary artery disease in hospitals without on-site cardiac surgery backup is still controversial. To prospectively evaluate a set of low procedural risk criteria for PCI, patients with stable or unstable angina were randomized to treatment in either a community hospital, which had all supportive services except for on-site cardiac surgery, or a regional surgical hospital 213 km away.

Methods And Results: During a 4-year period, 609 (57%) of 1064 consecutive patients with stable or unstable angina who underwent coronary angiography at a teaching community hospital in Norway fulfilled the predefined low-risk criteria for PCI.

Sirolimus-eluting stent in chronic total occlusion: the SICTO study.

Coronary stenting can significantly reduce the restenosis and reocclusion rates after successful balloon angioplasty for chronic total occlusions (CTO). Nevertheless, recanalization of CTO remains among the worst predictors for in-stent restenosis and reocclusion. This multicenter, nonrandomized study assessed the safety and effectiveness of the CYPHER sirolimus-eluting stent in reducing angiographic in-stent late loss in totally occluded native coronary arteries.

Release of cardiac biochemical markers after percutaneous myocardial laser or sham procedures.

Background: Percutaneous myocardial laser (PML) reduces symptoms in patients with intractable angina. PML leads to a certain loss of viable myocardium, we therefore assessed if troponin or cardiac markers release may explain the clinical effect, and furthermore assessed the markers release during percutaneous sham procedures.

Methods: Eighty-two patients with chronic refractory angina were randomized to either percutaneous myocardial laser or a true sham procedure.

Only transient increase of vascular growth factors and microvascular density after percutaneous myocardial laser.

Objective: We tested the hypothesis that percutaneous myocardial laser may stimulate microvascular growth in areas surrounding the laser channels.

Methods: We conducted a study of 24 domestic pigs, which underwent percutaneous myocardial laser to left ventricular myocardium using holmium:YAG laser. The pigs were sacrificed in groups of four after one day, 3-4 days, one week, three weeks and six weeks.

[Modern treatment of acute myocardial infarction without ST elevation].

The term unstable coronary syndromes represents a continuum of patients with unstable chest pain with or without small or large acute myocardial infarctions. There is a tendency towards an epidemiological shift to fewer large infarctions with ST elevation in the ECG (STEMI) to increased numbers of small infarctions without ST elevation (nSTEMI). Patients with unstable angina or nSTEMI should start antithrombotic medication with aspirin, heparin and clopidogrel upon arrival in hospital.

Release of cardiac troponin I after temporally graded acute coronary ischaemia with electrocardiographic ST depression.

Background: Elevation of cardiac biochemical markers and ST segment depression in the electrocardiogram have important roles in the risk stratification of unstable coronary syndromes. We assessed graded duration of acute coronary ischaemia with ST depression versus release of cardiac troponin I (cTnI) and conventional cardiac markers in 15 ischaemic pigs and 11 controls.

Methods: Coronary ischaemia was induced via percutaneous technique by semiinflating an angioplasty balloon in the left circumflex artery.