1,103 results match your criteria: "Uppsala Clinical Research Center[Affiliation]"

Aims/hypothesis: The potential impact of childhood bereavement-a severe psychological stressor-on childhood type 1 diabetes development remains unclear. Here, we aimed to bridge this knowledge gap and assess whether bereavement characteristics influenced any impact.

Methods: We conducted a register-based cohort study encompassing 3,598,159 children born in Sweden between 1987 and 2020.

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Background: Transcatheter aortic valve implantation (TAVI) has shown similar or improved clinical outcomes compared with surgical aortic valve replacement (SAVR) in patients with symptomatic severe aortic stenosis at low risk for surgical mortality. This cost-utility analysis compared TAVI with SAPIEN 3 versus SAVR in symptomatic severe aortic stenosis patients at low risk of surgical mortality from the perspective of the Swedish healthcare system.

Methods: A published, two-stage, Markov-based cost-utility model that captured clinical outcomes from the (SWEDEHEART) registry (2018-2020) was adapted from the perspective of the Swedish healthcare system using local general population mortality, utility and costs data.

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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: Percutaneous coronary intervention (PCI) of saphenous vein grafts (SVG) is associated with poor outcomes and is often regarded as inferior to native vessel PCI. We investigated clinical outcomes of SVG-PCI using contemporary drug-eluting stents (DES), in a complete, nationwide population.

Methods: The complete Swedish Coronary Angiography and Angioplasty Registry (SCAAR) was used to identify all patients in Sweden who underwent SVG-PCI with a contemporary DES between 2013 and 2020.

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Background: Cardiac biomarkers improve risk prediction in patients with atrial fibrillation (AF). We recently demonstrated that the neuron-specific protein neurofilament light chain (NFL) was associated with ischemic stroke in patients with AF not receiving oral anticoagulation (OAC). The association of other neuroglial biomarkers reflecting brain injury, i.

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Lipoproteins and lipoprotein lipid composition are associated with stages of dysglycemia and subclinical coronary atherosclerosis.

Int J Cardiol

January 2025

Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; CMIV Centre of Medical Image Science and Visualization, Linköping University, Linköping, Sweden.

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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Article Synopsis
  • The study investigates the effectiveness of a new implant called the DynamX bioadaptor compared to a traditional drug-eluting stent (DES) in improving outcomes for patients undergoing percutaneous coronary intervention (PCI) due to heart disease.
  • Conducted across 20 hospitals in Sweden, the study randomly assigned eligible patients aged 18-85 to receive either the bioadaptor or a zotarolimus-eluting DES, measuring outcomes such as target lesion failure after 12 months.
  • The primary goal is to ensure the new device is not worse than the DES by measuring specific heart-related adverse events and ensuring that the risk difference remains within a predefined limit, indicating safety and efficacy.
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Background: European guidelines recommend the use of a 0h/1h hs-cTn (high-sensitivity cardiac troponin) protocol in patients with acute chest pain. We aimed to determine the performance of this protocol in routine care when supplemented with patient history and ECG and a recommendation to refrain from noninvasive testing in low-risk patients.

Methods And Results: This was a pre- and postimplementation study with concurrent controls.

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Background: This study aimed to compare the incidence and prognostic implications of new-onset conduction disturbances after surgical aortic valve replacement (SAVR) in patients with bicuspid aortic valve (BAV) aortic stenosis (AS) versus patients with tricuspid aortic valve (TAV) AS (ie, BAV-AS and TAV-AS, respectively). Additionally, the study included stratification of BAV patients according to subtype.

Methods: In this cohort study, the incidence of postoperative third-degree atrioventricular (AV) block with subsequent permanent pacemaker requirement and new-onset left bundle-branch block (LBBB) was investigated in 1147 consecutive patients without preoperative conduction disorder who underwent isolated SAVR (with or without ascending aortic surgery) between January 1, 2005, and December 31, 2022.

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Aims: Among patients with myocardial infarction (MI) with preserved left ventricular ejection fraction (LVEF), the REDUCE-AMI trial did not demonstrate a benefit of beta-blocker vs. no beta-blocker treatment on all-cause mortality and recurrent myocardial infarction. The aim of this pre-specified sub-study was to investigate effects of beta-blockers on self-reported symptoms of anxiety and depression.

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Article Synopsis
  • Women with a history of hypertensive disorders during pregnancy face a significantly higher risk of major adverse cardiovascular events after undergoing coronary artery stenting compared to those without such a history.
  • In a study involving over 8,000 women, 13.4% reported hypertensive disorders, and after a median follow-up of 5 years, a notable percentage experienced severe cardiovascular outcomes.
  • The increased hazard rate for these women became evident after 4-8 years following the procedure, particularly impacting those with gestational hypertension.
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Article Synopsis
  • The study examined the prevalence of sexually transmitted infections (STIs) and associated risk factors among 384 female university students in Uppsala, Sweden, using an online questionnaire.
  • Results showed that 20% of participants reported having an STI, with common pathogens including Chlamydia trachomatis and Herpes simplex virus.
  • Key risk factors identified included low condom use, first-date sexual activity without protection, a younger age at first intercourse, multiple sexual partners, and substance-related regrettable sexual encounters.
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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.
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The percutaneous treatment of structural, valvular, and non-valvular heart disease (SHD) is rapidly evolving. The Core Curriculum (CC) proposed by the EAPCI describes the knowledge, skills, and attitudes that define competency levels required by newly trained SHD interventional cardiologists (IC) and provides guidance for training centres. SHD ICs are cardiologists who have received complete interventional cardiology training.

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Background: Intrusive memories of psychologically traumatic events bring distress both sub-clinically and clinically. This parallel-group, two-arm randomised controlled trial evaluated the effect of a brief behavioural intervention on reducing intrusive memories in frontline healthcare workers exposed to traumatic events during the COVID-19 pandemic.

Methods: Participants with at least two intrusive memories of work-related trauma in the week before recruitment were randomised 1:1 to an imagery-competing task intervention (n = 73) or attention-based control task (n = 71).

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Article Synopsis
  • - The SPIRRIT-HFpEF trial aims to evaluate the benefits of mineralocorticoid receptor antagonists (MRAs) like spironolactone for patients with heart failure and preserved or mildly reduced ejection fraction, focusing on a cost-effective registry-based approach.
  • - This multicenter trial involves randomizing patients to receive either MRAs with usual care or just usual care, measuring outcomes such as cardiovascular deaths and heart failure-related hospitalizations over a 6-year enrollment period, with a target of around 2400 patients.
  • - The study’s findings will provide insights into the effectiveness of MRAs for heart failure patients and demonstrate the viability of using pragmatic, registry-based trials for research in chronic conditions.
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Background: To determine the frequency of pregnancy complications and their association with the risk of cardiovascular outcomes in women with structural heart disease (SHD).

Methods: This nationwide registry-based cohort study included women in Sweden with SHD (pulmonary arterial hypertension, congenital heart disease or acquired valvular heart disease) with singleton births registered in the national Medical Birth Register (MBR) between 1973 and 2014. Exposures were pregnancy complications; pre-eclampsia/gestational hypertension (PE/gHT), preterm birth and small for gestational age (SGA) collected from MBR.

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Background: Sodium-glucose co-transporter 2 (SGLT2) inhibitors have been shown to reduce rates of heart failure hospitalisations and cardiovascular death in patients with type 2 diabetes and prior cardiovascular disease. We hypothesised that SGLT2 inhibitors could provide cardiovascular benefits in the post-myocardial infarction setting. We aimed to investigate cardiovascular outcomes of SGLT2 inhibitor therapy in patients with type 2 diabetes mellitus after myocardial infarction in a Swedish nationwide registry.

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Long-Term Oxygen Therapy for 24 or 15 Hours per Day in Severe Hypoxemia.

N Engl J Med

September 2024

From Respiratory Medicine, Allergology, and Palliative Medicine, Department of Clinical Sciences in Lund, Faculty of Medicine, Lund University, Lund (M.E., F.B.), the Department of Medicine, Blekinge Hospital, Karlskrona (M.E.), the COPD Center, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg (A.A.), and the Department of Respiratory Medicine and Allergology, Sahlgrenska University Hospital (S.P.), Gothenburg, Karlstad County Hospital, Karlstad (T.K.), Northern Älvsborg County Hospital, Trollhättan (B.P.), Linköping University Hospital, Linköping (O.K.), Falun Hospital, Falun (P.S.), the Department of Respiratory Medicine and Allergology, Faculty of Medicine, Karolinska University Hospital (M.R.), and Karolinska University Hospital Huddinge (R.H.), Stockholm, the Department of Medical Sciences, Respiratory, Allergy, and Sleep Research, Uppsala University (A.P., E.L., C.J.), and the Uppsala Clinical Research Center (N.H.), Uppsala, the Center for Research and Development, Gävle Hospital, Gävle (A.P.), the Department of Public Health and Clinical Medicine, Umeå University, Umeå (A.B.), Sundsvall-Härnösand County Hospital, Sundsvall (B.S.), and the Department of Respiratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro (J.S.) - all in Sweden; the Institute for Breathing and Sleep and the Department of Respiratory and Sleep Medicine, Austin Health, Melbourne, VIC (C.F.M.), and the Graduate School of Medicine, Faculty of Science, Medicine, and Health, University of Wollongong, Wollongong, NSW (D.C.C.) - both in Australia.

Background: Long-term oxygen supplementation for at least 15 hours per day prolongs survival among patients with severe hypoxemia. On the basis of a nonrandomized comparison, long-term oxygen therapy has been recommended to be used for 24 hours per day, a more burdensome regimen.

Methods: To test the hypothesis that long-term oxygen therapy used for 24 hours per day does not result in a lower risk of hospitalization or death at 1 year than therapy for 15 hours per day, we conducted a multicenter, registry-based, randomized, controlled trial involving patients who were starting oxygen therapy for chronic, severe hypoxemia at rest.

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Heart Failure Risk Assessment Using Biomarkers in Patients With Atrial Fibrillation: Analysis From COMBINE-AF.

J Am Coll Cardiol

October 2024

TIMI Study Group, Division of Cardiovascular Medicine, Brigham & Women's Hospital, and Harvard Medical School, Boston, Massachusetts, USA. Electronic address:

Article Synopsis
  • Heart failure is a common issue for patients with atrial fibrillation, making risk assessment crucial for clinicians.
  • This study analyzed data from three large trials to evaluate how well NT-proBNP, hs-cTnT, and GDF-15 predict heart failure risk in these patients.
  • Results showed that higher levels of these biomarkers correlate with a higher risk for cardiovascular death and heart failure-related hospitalization, enhancing the predictive accuracy of clinical assessments.
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Asundexian versus Apixaban in Patients with Atrial Fibrillation.

N Engl J Med

January 2025

From Duke Clinical Research Institute, Duke University School of Medicine (J.P.P., M.R.P., R.D.L., W.S.J., J. Harrington, S.J.E., F.W.R., J.H.A.), and Duke University Medical Center (J.P.P., M.R.P., R.D.L., W.S.J., J. Harrington, F.W.R., J.H.A.) - both in Durham, NC; Hirslanden Clinic Zurich, Zurich, Switzerland (J.S.); the School of Medicine, Tulane University, New Orleans (K.F.); the University Medical Center, University of Groningen, Groningen (I.C.V.G., M.R.), Radboud University Medical Center, Nijmegen (M.H.), Rijnstate Hospital, Arnhem (M.H.), and the Dutch Network for Cardiovascular Research, Utrecht (M.H.) - all in the Netherlands; Cooper Medical School of Rowan University, Camden (A.M.R.), and Bayer U.S., Whippany (R.C.) - both in New Jersey; the Cardiology Center of Beijing, Anzhen Hospital No. 2, Beijing (C.-S.M.); the Canadian VIGOUR Centre, University of Alberta, Edmonton, and St. Michael's Hospital, Unity Health Toronto, and Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto - all in Canada (S.G.G.); the Uppsala Clinical Research Center and the Department of Medical Sciences, Uppsala University, Uppsala, Sweden (J.O.); the Department of Cardiology, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia (C.H.); the Department of Cardiology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan (M.A.); the School of Cardiology, University of Pisa, and the Cardiology Division, Pisa University Hospital, Pisa (R.D.C.), and Santa Maria della Misericordia Hospital, University of Perugia, Perugia (V.C.) - all in Italy; the Department of Cardiology, University Heart and Vascular Center Hamburg, and the German Center for Cardiovascular Research, Hamburg (P.K.), and Bayer, Wuppertal (C.N., T.V., H.M.) - all in Germany; the Institute of Cardiovascular Sciences, University of Birmingham, Birmingham (P.K.), the Faculty of Medicine, National Heart and Lung Institute, Imperial College, London (D.A.G.), the Centre for Health Services and Clinical Research, Faculty of Life and Medical Sciences, University of Hertfordshire, Hatfield (D.A.G.), and the Liverpool Centre for Cardiovascular Science at University of Liverpool and John Moores University and Liverpool Heart and Chest Hospital, Liverpool (G.Y.H.L.) - all in the United Kingdom; the Department of Clinical Medicine, Danish Center for Health Services Research, Aalborg University, Aalborg, Denmark (G.Y.H.L.); and Bayer, São Paulo (J. Hung).

Background: Stroke prevention with direct-acting oral anticoagulant agents in patients with atrial fibrillation confers a risk of bleeding and limits their use. Asundexian, an activated factor XI (XIa) inhibitor, is an oral anticoagulant that may prevent strokes with less bleeding.

Methods: In a phase 3, international, double-blind trial, we randomly assigned high-risk patients with atrial fibrillation in a 1:1 ratio to receive asundexian at a dose of 50 mg once daily or standard-dose apixaban.

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Article Synopsis
  • - The study investigated the relationship between non-HDL cholesterol (non-HDL-C) levels after a myocardial infarction (MI) and the risk of negative cardiovascular outcomes using data from over 56,000 patients.
  • - Findings showed that achieving low non-HDL-C levels (below 2.2 mmol/L) quickly and maintaining them over time significantly reduced the risk of major adverse cardiovascular events (MACE), including death and non-fatal MI.
  • - The results suggest that early and sustained cholesterol management after MI may lead to better health outcomes, challenging traditional gradual approaches to cholesterol reduction that could delay reaching these important targets.
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Effects of beta-blockers on quality of life and well-being in patients with myocardial infarction and preserved left ventricular function-a prespecified substudy from REDUCE-AMI.

Eur Heart J Cardiovasc Pharmacother

September 2024

Department of Clinical Science and Education, Division of Cardiology, Karolinska Institutet, Södersjukhuset, Stockholm, Sjukhusbacken 10, 188 83, Sweden.

Aims: In the Randomized Evaluation of Decreased Usage of Beta-Blockers after Acute Myocardial Infarction (REDUCE-AMI) study, long-term beta-blocker use in patients after acute myocardial infarction (AMI) with preserved left ventricular ejection fraction demonstrated no effect on death or cardiovascular outcomes. The aim of this prespecified substudy was to investigate effects of beta-blockers on self-reported quality of life and well-being.

Methods And Results: From this parallel-group, open-label, registry-based randomized clinical trial, EQ-5D, and World Health Organization well-being index-5 (WHO-5) questionnaires were obtained at 6-10 weeks and 11-13 months after AMI in 4080 and 806 patients, respectively.

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