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[A centralised screening program for abdominal aortic aneurysms in Stockholm. Experiences from the first 18 months].

https://arctichealth.org/en/permalink/ahliterature108754
Source
Lakartidningen. 2013 Jun 5-18;110(23-24):1161-4
Publication Type
Article

Age at detection of abdominal aortic aneurysms in siblings of patients with abdominal aortic aneurysms.

https://arctichealth.org/en/permalink/ahliterature275171
Source
J Vasc Surg. 2016 Apr;63(4):883-7
Publication Type
Article
Date
Apr-2016
Author
Anneli Linné
Johan Forsberg
David Lindström
Ester Ideskog
Rebecka Hultgren
Source
J Vasc Surg. 2016 Apr;63(4):883-7
Date
Apr-2016
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Aged, 80 and over
Aorta, Abdominal - ultrasonography
Aortic Aneurysm, Abdominal - epidemiology - genetics - ultrasonography
Dilatation, Pathologic
Female
Genetic Predisposition to Disease
Heredity
Humans
Male
Mass Screening - methods
Middle Aged
Pedigree
Phenotype
Predictive value of tests
Prevalence
Risk assessment
Risk factors
Sex Factors
Siblings
Sweden - epidemiology
Abstract
Few countries offer organized screening of siblings of patients with abdominal aortic aneurysms (AAAs), although a hereditary trait is well known to exist. Male relatives, but not female, are invited within the population-based screening programs for elderly men in Sweden. Evidence regarding the optimal age to screen siblings is scarce. The aim of this study was to describe the age at detection in siblings found with AAAs.
All patients treated for AAAs in two Swedish counties were screened for siblings. Consenting siblings aged 80 and younger were examined (N = 529) with ultrasound and were interviewed per protocol.
In the cohort of 529 siblings to AAA patients, 53 siblings were diagnosed with AAAs (sisters 16/276 [5.8%] and brothers 37/253 [14.6%]). The prevalence of AAAs in the siblings 65 years of age or younger was 16/207 (7.7%). One-third of the siblings found with AAAs were young (16/53 [30%]). Among the young siblings with AAAs, 8/16 (50%) had an aneurysm larger than 50 mm or were already surgically treated. The prevalence of AAAs in siblings older than 65 years of age was 37/322 (12%).
The AAA prevalence in this sibling cohort is strikingly high compared to the prevalence in the population (in Sweden, 1.4%-2.2% in 65-year-old men). The young ages among diagnosed siblings reinforce that male siblings of AAA patients should be screened before age 65 (before the population-based program) and that structured programs for female siblings are called for.
PubMed ID
26826057 View in PubMed
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The effect of ticagrelor on growth of small abdominal aortic aneurysms-a randomized controlled trial.

https://arctichealth.org/en/permalink/ahliterature309477
Source
Cardiovasc Res. 2020 02 01; 116(2):450-456
Publication Type
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Date
02-01-2020
Author
Anders Wanhainen
Kevin Mani
Joel Kullberg
Sverker Svensjö
Adam Bersztel
Lars Karlsson
Jan Holst
Anders Gottsäter
Anneli Linné
Peter Gillgren
Marcus Langenskiöld
Rebecka Hultgren
Joy Roy
Nils-Peter Gilgen
Håkan Ahlström
Frank A Lederle
Martin Björck
Author Affiliation
Department of Surgical Sciences, Vascular Surgery, Uppsala University, Uppsala SE-751 85, Sweden.
Source
Cardiovasc Res. 2020 02 01; 116(2):450-456
Date
02-01-2020
Language
English
Publication Type
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Keywords
Aged
Aged, 80 and over
Aortic Aneurysm, Abdominal - complications - diagnostic imaging - drug therapy
Disease Progression
Double-Blind Method
Female
Hemorrhage - chemically induced
Humans
Magnetic Resonance Angiography
Male
Middle Aged
Platelet Aggregation Inhibitors - adverse effects - therapeutic use
Sweden
Thrombosis - diagnostic imaging - etiology - prevention & control
Ticagrelor - adverse effects - therapeutic use
Time Factors
Treatment Outcome
Abstract
To evaluate if ticagrelor, an effective platelet inhibitor without known non-responders, could inhibit growth of small abdominal aortic aneurysms (AAAs).
In this multi-centre randomized controlled trial, double-blinded for ticagrelor and placebo, acetylic salicylic acid naïve patients with AAA and with a maximum aortic diameter 35-49?mm were included. The primary outcome was mean reduction in log-transformed AAA volume growth rate (%) measured with magnetic resonance imaging (MRI) at 12?months compared with baseline. Secondary outcomes include AAA-diameter growth rate and intraluminal thrombus (ILT) volume enlargement rate. A total of 144 patients from eight Swedish centres were randomized (72 in each group). MRI AAA volume increase was 9.1% for the ticagrelor group and 7.5% for the placebo group (P?=?0.205) based on intention-to-treat analysis, and 8.5% vs. 7.4% in a per-protocol analysis (P?=?0.372). MRI diameter change was 2.5?mm vs. 1.8?mm (P?=?0.113), US diameter change 2.3?mm vs. 2.2?mm (P?=?0.778), and ILT volume change 12.9% vs. 10.4% (P?=?0.590).
In this RCT, platelet inhibition with ticagrelor did not reduce growth of small AAAs. Whether the ILT has an important pathophysiological role for AAA growth cannot be determined based on this study due to the observed lack of thrombus modulating effect of ticagrelor.
The TicAAA trial is registered at the US National Institutes of Health (ClinicalTrials.gov) #NCT02070653.
PubMed ID
31135888 View in PubMed
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High prevalence of abdominal aortic aneurysms in brothers and sisters of patients despite a low prevalence in the population.

https://arctichealth.org/en/permalink/ahliterature126085
Source
J Vasc Surg. 2012 Aug;56(2):305-10
Publication Type
Article
Date
Aug-2012
Author
Anneli Linné
David Lindström
Rebecka Hultgren
Author Affiliation
Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden. anneli.linne@sodersjukhuset.se
Source
J Vasc Surg. 2012 Aug;56(2):305-10
Date
Aug-2012
Language
English
Publication Type
Article
Keywords
Aged
Aortic Aneurysm, Abdominal - epidemiology - genetics - ultrasonography
Female
Humans
Male
Mass Screening
Middle Aged
Prevalence
Risk factors
Siblings
Smoking - epidemiology
Sweden - epidemiology
Abstract
Population-based screening for abdominal aortic aneurysms (AAAs) in elderly men is organized in many regions and countries in the Western world, and the prevalence of disease is reported to decline. Whether the prevalence among those with a family history also is declining is unknown. The primary purpose of this study was to assess the prevalence of AAAs among siblings of persons with AAAs and to investigate the proportion of siblings already diagnosed by opportunistic screening.
Patients treated for AAAs from January 2008 through December 2010 (n = 412) in Stockholm, Sweden, were screened for siblings. Seven hundred seventy-nine siblings were identified. All siblings 65 (odds ratio, 10.8; 95% confidence interval, 1.3-86.4; P = .03). Ever smoking was not statistically significant as a risk.
A strikingly high prevalence of AAAs in siblings was found as compared to the reported declining aneurysm prevalence in elderly men in the Western world. Systematic improvements regarding screening of first-degree relatives is mandated and selective screening of siblings is an underused tool to prevent death from aneurysm disease, both among men and women.
PubMed ID
22425245 View in PubMed
Less detail

[Misleading study in The Lancet on the outcome of the Swedish AAA screening program].

https://arctichealth.org/en/permalink/ahliterature296834
Source
Lakartidningen. 2018 09 05; 115:
Publication Type
Journal Article
Comment
Date
09-05-2018
Author
Anders Wanhainen
Martin Björck
Sverker Svensjö
Anders Gottsäter
Jan Holst
Rebecka Hultgren
Anneli Linne
Joakim Nordanstig
Marcus Langenskiöld
Elisabet Skagius
Sven-Erik Persson
Carl-Magnus Wahlgren
Author Affiliation
Uppsala Universitet - Institutionen för Kirurgiska Vetenskaper Uppsala, Sweden Uppsala Universitet - Institutionen för Kirurgiska Vetenskaper Uppsala, Sweden.
Source
Lakartidningen. 2018 09 05; 115:
Date
09-05-2018
Language
Swedish
Publication Type
Journal Article
Comment
Keywords
Aortic Aneurysm, Abdominal
Cohort Studies
Humans
Male
Registries
Research Design
Sweden
Abstract
In a recent publication in The Lancet Johansson and colleagues claim no effect on aneurysm mortality among men participating in the Swedish AAA screening program, and question its justification. The study is, however, limited by a corrupt study design and incorrect data, making the publication misleading. On the contrary, several RCTs and contemporary nationwide data with sufficient follow-up clearly show that AAA screening saves lives and is highly cost-effective. The program has so far identified about 6000 men with an AAA, of whom 1500 have been operated on to prevent rupture. Thus, more than 750 men have experienced a longer life (by a mean of 8 years) as a result of the program. Continuous evaluation of the program is important but requires a scientifically sound methodology.
Notes
CommentOn: Lancet. 2018 Jun 16;391(10138):2441-2447 PMID 29916384
CommentIn: Lakartidningen. 2018 Sep 5;115: PMID 30204226
PubMed ID
30204225 View in PubMed
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Screening of siblings to patients with abdominal aortic aneurysms in Sweden.

https://arctichealth.org/en/permalink/ahliterature284721
Source
Scand Cardiovasc J. 2017 Jun;51(3):167-171
Publication Type
Article
Date
Jun-2017
Author
Anneli Linné
Johan Forsberg
Karin Leander
Rebecka Hultgren
Source
Scand Cardiovasc J. 2017 Jun;51(3):167-171
Date
Jun-2017
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Aortic Aneurysm, Abdominal - diagnostic imaging - epidemiology - genetics
Female
Genetic Predisposition to Disease
Humans
Male
Mass Screening - methods
Middle Aged
Phenotype
Predictive value of tests
Prevalence
Risk factors
Siblings
Sweden - epidemiology
Ultrasonography
Abstract
The prevalence of Abdominal Aortic Aneurysm (AAA) is higher for First Degree Relatives to AAA-patients compared to the general population, regardless of sex. The prevalence of AAA is also higher in the North of Sweden compared to the Mid and South. A regional strong hereditary trait has been suggested as an explanation to this. The aim of this study was to investigate if siblings to AAA-patients in the North have a higher prevalence of AAA compared to siblings in the Mid-region.
Cohort study.
All patients treated for AAA in a northern region (Norrbotten county, North) were screened for siblings. Consenting siblings, age 40-80, were examined (n?=?379) with ultrasound. The results were compared to the previously published results of 150 ultrasound-screened siblings in the Mid-region (Stockholm county).
The male/female ratio in the sibling cohort was 48% vs 52%. The prevalence of AAA in siblings in the North was 37/379 (brothers 14%, sisters 6%). This was not different from the prevalence among the Mid-region siblings 16/150 (brothers 17%, sisters 6% (p?=?0.75). The distribution of risk factors was similar in the two regions.
The results reinforce the importance of a more systematic approach towards selective screening of all siblings to AAA patients. Ultrasound should be performed in all eligible siblings, since the distribution of AAA is similar over regions. A correlation between the familial distribution and the reported high prevalence of AAA in general population in the North could not be shown.
PubMed ID
28325098 View in PubMed
Less detail

6 records – page 1 of 1.