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Association between antithrombotic treatment and hemorrhagic stroke in patients with atrial fibrillation-a cohort study in primary care.

https://arctichealth.org/en/permalink/ahliterature280552
Source
Eur J Clin Pharmacol. 2017 Feb;73(2):215-221
Publication Type
Article
Date
Feb-2017
Author
Per Wändell
Axel C Carlsson
Martin Holzmann
Johan Ärnlöv
Sven-Erik Johansson
Jan Sundquist
Kristina Sundquist
Source
Eur J Clin Pharmacol. 2017 Feb;73(2):215-221
Date
Feb-2017
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Anticoagulants - therapeutic use
Aspirin - therapeutic use
Atrial Fibrillation - drug therapy
Cohort Studies
Female
Fibrinolytic Agents - therapeutic use
Humans
Intracranial Hemorrhages - epidemiology
Male
Middle Aged
Platelet Aggregation Inhibitors - therapeutic use
Primary Health Care
Stroke - epidemiology
Sweden - epidemiology
Ticlopidine - analogs & derivatives - therapeutic use
Warfarin - therapeutic use
Abstract
The objective of this study was to study the association between antithrombotic treatment and risk of hemorrhagic stroke (HS) in patients with atrial fibrillation (AF) treated in primary health care.
Study population included all adults (n = 12,215) 45 years and older diagnosed with AF at 75 primary care centers in Sweden 2001-2007. Outcome was defined as a first hospital episode with a discharge episode of HS after the AF diagnosis. Association between HS and persistent treatment with antithrombotic agents (warfarin, acetylsalicylic acid (ASA), clopidogrel) was explored using Cox regression analysis, with hazard ratios (HRs) and 95 % CIs. Adjustment was made for age, socioeconomic status, and co-morbid cardiovascular conditions.
During a mean of 5.8 years (SD 2.4) of follow-up, 162 patients (1.3 %; 67 women and 95 men) with HS were recorded. The adjusted risk associated with persistent warfarin treatment compared to no antithrombotic treatment consistently showed no increased HS risk, HR for women 0.53 (95 % CI 0.23-1.27) and for men 0.55 (95 % CI 0.29-1.04); corresponding HRs for ASA were, for women, 0.45 (95 % CI 0.14-1.44) and, for men, 0.56 (95 % CI 0.24-1.29).
In this clinical setting, we found no evidence pointing to an increased risk of HS with antithrombotic treatment.
Notes
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PubMed ID
27826643 View in PubMed
Less detail

The association between circulating endostatin levels and incident myocardial infarction.

https://arctichealth.org/en/permalink/ahliterature299297
Source
Scand Cardiovasc J. 2018 Dec; 52(6):315-319
Publication Type
Journal Article
Multicenter Study
Date
Dec-2018
Author
Toralph Ruge
Axel C Carlsson
Jan-Håkan Jansson
Stefan Söderberg
Anders Larsson
Johan Ärnlöv
Author Affiliation
a Department of Emergency Medicine , Karolinska University Hospital , Stockholm , Sweden.
Source
Scand Cardiovasc J. 2018 Dec; 52(6):315-319
Date
Dec-2018
Language
English
Publication Type
Journal Article
Multicenter Study
Keywords
Adult
Aged
Biomarkers - blood
C-Reactive Protein - analysis
Case-Control Studies
Endostatins - blood
Female
Humans
Incidence
Male
Middle Aged
Myocardial Infarction - blood - diagnosis - epidemiology
Prognosis
Prospective Studies
Registries
Risk assessment
Risk factors
Sex Factors
Sweden - epidemiology
Time Factors
Up-Regulation
Abstract
Increased levels of circulating endostatin have been observed in patients with prevalent ischemic heart disease. However, the association between circulating endostatin, and incident myocardial infarction (MI) is less studied. Our main aim was to study the association between circulating endostatin and incident MI in the community adjusted for established cardiovascular risk factors in men and women.
Circulating endostatin was measured in a nested case control study based on three large community-based Swedish cohorts, including 533?MI cases, and 1003 age-, sex- and cohort-matched controls. Odds ratios (OR) with 95% confidence intervals (CI) were calculated with adjustments for established cardiovascular risk factors.
Higher endostatin was associated with a higher incidence of MI independently of established cardiovascular risk factors (OR 1.19, 95% CI 1.03-1.37, p?=?.02), but this association was abolished after additional adjustment for C-reactive protein. Sex-stratified analyses suggest that the association was substantially stronger in women as compared to men.
In our community based sample, higher endostatin predicted incident myocardial infarction predominantly in women but not independently of CRP. Thus, our findings do not support a broad utility of endostatin measurements for the prediction of incident myocardial infarction in clinical practice.
PubMed ID
30474426 View in PubMed
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The association between "hypertriglyceridemic waist" and sub-clinical atherosclerosis in a multiethnic population: a cross-sectional study.

https://arctichealth.org/en/permalink/ahliterature104927
Source
Lipids Health Dis. 2014;13:38
Publication Type
Article
Date
2014
Author
Danijela Gasevic
Axel C Carlsson
Iris A Lesser
Gb John Mancini
Scott A Lear
Author Affiliation
Department of Biomedical Physiology and Kinesiology, Simon Fraser University, 2600-515 W Hastings Street, Vancouver V6B 5K3, BC, Canada. danijela.gasevic@gmail.com.
Source
Lipids Health Dis. 2014;13:38
Date
2014
Language
English
Publication Type
Article
Keywords
Adult
Atherosclerosis - pathology
Carotid Artery Diseases - pathology
Carotid Intima-Media Thickness
Cross-Sectional Studies
Female
Humans
Hypertriglyceridemia - pathology
Male
Middle Aged
Phenotype
Risk factors
Waist Circumference
Abstract
"Hypertriglyceridemic waist" (HTGW) phenotype, an inexpensive early screening tool for detection of individuals at risk for type 2 diabetes and cardiovascular disease was found to be associated with subclinical atherosclerosis in various patient populations such as those with diabetes mellitus, chronic kidney disease, and those infected with human immunodeficiency virus. However, less is known regarding an association between HTGW and subclinical atherosclerosis in the apparently healthy, multiethnic population. Therefore, the aim of the study was to explore the association between HTGW and sub-clinical atherosclerosis in an apparently healthy, multiethnic population; and to investigate whether the effect of HTGW on sub-clinical atherosclerosis persists over and above the traditional atherosclerosis risk factors.
We studied 809 individuals of Aboriginal, Chinese, European and South Asian origin who were assessed for indices of sub-clinical atherosclerosis (intima-media thickness (IMT), total area and presence of carotid plaques), socio-demographic and lifestyle characteristics, anthropometrics, lipids, glucose, blood pressure, and family history of cardiovascular disease.
We found that, compared to individuals without HTGW and after adjusting for age, ethnicity, smoking, and physical activity; men and women with HTGW had a significantly higher: IMT (men: B (95%CI?=?0.084 (0.037, 1.133), p?
Notes
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PubMed ID
24558974 View in PubMed
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The association between relevant co-morbidities and prevalent as well as incident heart failure in patients with atrial fibrillation.

https://arctichealth.org/en/permalink/ahliterature303045
Source
J Cardiol. 2018 07; 72(1):26-32
Publication Type
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Date
07-2018
Author
Per Wändell
Axel C Carlsson
Martin J Holzmann
Johan Ärnlöv
Jan Sundquist
Kristina Sundquist
Author Affiliation
Division of Family Medicine and Primary Care, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Huddinge, Sweden. Electronic address: per.wandell@ki.se.
Source
J Cardiol. 2018 07; 72(1):26-32
Date
07-2018
Language
English
Publication Type
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Keywords
Aged
Aged, 80 and over
Atrial Fibrillation - epidemiology
Cardiomyopathies - epidemiology
Comorbidity
Coronary Disease - epidemiology
Depression - epidemiology
Diabetes Mellitus - epidemiology
Female
Heart Failure - epidemiology
Heart Valve Diseases - epidemiology
Humans
Hypertension - epidemiology
Male
Middle Aged
Obesity - epidemiology
Prevalence
Pulmonary Disease, Chronic Obstructive - epidemiology
Registries
Risk factors
Sex Factors
Sweden - epidemiology
Abstract
Congestive heart failure (CHF) is a serious complication in patients with atrial fibrillation (AF).
To study associations between relevant co-morbidities and CHF in patients with AF.
Study population included all adults (n=12,283) =45 years diagnosed with AF at 75 primary care centers in Sweden 2001-2007. Logistic regression was used to calculate odds ratios with 95% confidence intervals (CIs) for the associations between co-morbidities, and prevalent CHF. In a subsample (n=9424), (excluding patients with earlier CHF), Cox regression was used to estimate hazard ratios with 95% CIs for the association between co-morbidities, and a first hospital diagnosis of CHF, after adjustment for age and socio-economic factors.
During 5.4 years' follow-up (standard deviation 2.5), 2259 patients (24.0%; 1135 men, 21.8%, and 1124 women, 26.7%) were diagnosed with CHF. Patients with hypertension were less likely to have CHF, while a diagnosis of coronary heart disease, valvular heart disease, diabetes, or chronic obstructive pulmonary disease (COPD), was consistently associated with CHF among men and women. CHF was more common among women with depression. The relative fully adjusted risk of incident CHF was increased for the following diseases in men with AF: valvular heart disease, cardiomyopathy, and diabetes; and for the following diseases in women: valvular heart disease, diabetes, obesity, and COPD. The corresponding risk was decreased among women for hypertension.
In this clinical setting we found hypertension to be associated with a decreased risk of CHF among women; valvular heart disease and diabetes to be associated with an increased risk of CHF in both sexes; and cardiomyopathy to be associated with an increased risk of CHF among men.
PubMed ID
29358024 View in PubMed
Less detail

The association between serum cathepsin L and mortality in older adults.

https://arctichealth.org/en/permalink/ahliterature287844
Source
Atherosclerosis. 2016 Nov;254:109-116
Publication Type
Article
Date
Nov-2016
Author
Tobias Feldreich
Axel C Carlsson
Ulf Risérus
Anders Larsson
Lars Lind
Johan Ärnlöv
Source
Atherosclerosis. 2016 Nov;254:109-116
Date
Nov-2016
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Cardiovascular Diseases - blood - mortality
Cathepsin L - blood
Female
Humans
Inflammation
Kidney Diseases - blood
Kidney Function Tests
Longitudinal Studies
Male
Prevalence
Proportional Hazards Models
Sex Factors
Sweden
Abstract
Research suggests that the protease cathepsin L is causally involved in atherosclerosis. However, data on cathepsin L as a risk marker are lacking. Therefore, we investigated associations between circulating cathepsin L and cardiovascular mortality.
Two independent community-based cohorts were used: Uppsala Longitudinal Study of Adult Men (ULSAM); n = 776; mean age 77 years; baseline 1997-2001; 185 cardiovascular deaths during 9.7 years follow-up, and Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS); n = 993; 50% women; mean age 70 years; baseline 2001-2004; 42 cardiovascular deaths during 10.0 years follow-up.
Higher serum cathepsin L was associated with an increased risk for cardiovascular mortality in age- and sex-adjusted models in both cohorts (ULSAM: hazard ratio (HR) for 1-standard deviation (SD) increase, 1.17 [95% CI, 1.01-1.34], p = 0.032 PIVUS: HR 1.35 [95% CI, 1.07-1.72], p = 0.013). When merging the cohorts, these associations were independent of inflammatory markers and cardiovascular risk factors, but non-significant adjusting for kidney function. Individuals with a combination of elevated cathepsin L and increased inflammation, kidney dysfunction, or prevalent cardiovascular disease had a markedly increased risk, while no increased risk was associated with elevated cathepsin L, in the absence of these disease states.
An association between higher serum cathepsin L and increased risk of cardiovascular mortality was found in two independent cohorts. Impaired kidney function appears to be an important moderator or mediator of these associations. Further studies are needed to delineate the underlying mechanisms and to evaluate whether the measurement of cathepsin L might have clinical utility.
PubMed ID
27718373 View in PubMed
Less detail

The association between sociodemographic characteristics and dementia in patients with atrial fibrillation.

https://arctichealth.org/en/permalink/ahliterature307336
Source
Aging Clin Exp Res. 2020 Nov; 32(11):2319-2327
Publication Type
Journal Article
Date
Nov-2020
Author
Per Wändell
Axel C Carlsson
Xinjun Li
Danijela Gasevic
Jan Sundquist
Kristina Sundquist
Author Affiliation
Division of Family Medicine and Primary Care, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Alfred Nobels Allé 12, 141 83, Huddinge, Sweden. per.wandell@ki.se.
Source
Aging Clin Exp Res. 2020 Nov; 32(11):2319-2327
Date
Nov-2020
Language
English
Publication Type
Journal Article
Keywords
Atrial Fibrillation - epidemiology
Comorbidity
Dementia - epidemiology
Female
Humans
Male
Registries
Risk factors
Sweden - epidemiology
Abstract
Association between socio-demographic factors and dementia risk is studied in general but not for atrial fibrillation (AF) patients.
We studied AF patients?=?45 years in Sweden 1998-2012 (n?=?537,513) using the Total Population Register for socio-demographic factors, the Swedish Cause of Death Register, and the National Patient Register (NPR) for incident dementia. Cox regression with hazard ratios (HR) and 95% confidence intervals (CI) was used for the association between exposure and outcome, adjusting for age and comorbidities.
Totally 30,332 patients (5.6%) were diagnosed with dementia during the follow-up (mean 5.4 years). Of these, 14,097 were men (4.9%) and 16,235 were women (6.5%). Lower educational levels (reference: highest level) were associated with increased dementia, HRs (95% CI) for basic school for men 1.23 (1.18-1.29) and women 1.36 (1.30-1.42), and middle-level school for men 1.17 (1.11-1.22) and women 1.28 (1.22-1.34). Divorced men and women (reference: married) showed increased risk of dementia, HR 1.07 (1.01-1.13) and 1.12 (1.06-1.18), respectively, while widowed men showed lower risk, HR 0.84 (0.80-0.88). High deprivation neighborhood socio-economic status (NSES; reference: medium level) was associated with increased dementia in men, HR 1.11 (1.05-1.17), and low deprivation neighborhood socio-economic status (NSES) with increased dementia in men and women, HR 1.12 (1.06-1.18) and 1.18 (1.12-1.24), respectively.
Some results were expected, i.e. association between lower educational level and dementia. The higher risk of dementia in low deprivation NSES-areas could be due to a higher awareness about dementia, and subsequent earlier diagnosis and treatment of dementia.
PubMed ID
31927710 View in PubMed
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Associations between relevant cardiovascular pharmacotherapies and incident heart failure in patients with atrial fibrillation: a cohort study in primary care.

https://arctichealth.org/en/permalink/ahliterature301160
Source
J Hypertens. 2018 09; 36(9):1929-1935
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
09-2018
Author
Per Wändell
Axel C Carlsson
Martin J Holzmann
Johan Ärnlöv
Jan Sundquist
Kristina Sundquist
Author Affiliation
Division of Family Medicine and Primary Care, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Huddinge.
Source
J Hypertens. 2018 09; 36(9):1929-1935
Date
09-2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adrenergic beta-Antagonists - therapeutic use
Aged
Aged, 80 and over
Atrial Fibrillation - epidemiology
Calcium Channel Blockers - therapeutic use
Cohort Studies
Female
Heart Failure - epidemiology
Humans
Male
Middle Aged
Primary Health Care
Protective factors
Risk factors
Sodium Potassium Chloride Symporter Inhibitors - therapeutic use
Sotalol - therapeutic use
Sweden - epidemiology
Thiazides - therapeutic use
Abstract
To study association between relevant cardiovascular pharmacotherapy and incident congestive heart failure (CHF) in patients with atrial fibrillation treated in primary health care.
Study population included all adults (n?=?7975) aged 45 years and older diagnosed with atrial fibrillation at 75 primary care centers in Sweden between 2001 and 2007. Outcome was defined as a first diagnosis of CHF post-atrial fibrillation diagnosis. Association between CHF and treatment with relevant cardiovascular pharmacotherapies (beta blockers, calcium blockers, digitalis, diuretics, RAS blockers, and statins) was explored using Cox regression analysis with hazard ratios and 95% CIs. Adjustments were made for age, sociodemographic variables, and comorbid conditions (with or without cardiovascular disorders).
During a mean of 5.7 years (SD 2.3) of follow-up, totally 1552 patients (19.5%; 803 women and 749 men) had a recorded CHF diagnosis. Thiazides (hazard ratio 0.74, 95% CI 0.65-0.84), vessel-active calcium channel blockers (hazard ratio 0.76, 95% CI 0.67-0.86), and nonselective beta blockers (hazard ratio 0.84, 95% CI 0.72-0.98), with specifically sotalol representing 80% of nonselective beta blockers (hazard ratio 0.81, 95% CI 0.69-0.97), were associated with lower CHF risk in fully adjusted models. Loop diuretics (hazard ratio 1.41, 95% CI 1.25-1.57) were associated with a higher risk. Findings for thiazides and vessel-active channel blockers were consistent in the tested subgroups.
In this clinical setting, we found that thiazides, vessel-active calcium channel blockers, and nonselective beta blockers (specifically sotalol) were associated with a lower risk of incident CHF among patients with atrial fibrillation. The findings of the present study need to be confirmed in other settings.
PubMed ID
29870433 View in PubMed
Less detail

Atrial fibrillation in immigrant groups: a cohort study of all adults 45 years of age and older in Sweden.

https://arctichealth.org/en/permalink/ahliterature290383
Source
Eur J Epidemiol. 2017 09; 32(9):785-796
Publication Type
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Date
09-2017
Author
Per Wändell
Axel C Carlsson
Xinjun Li
Danijela Gasevic
Johan Ärnlöv
Martin J Holzmann
Jan Sundquist
Kristina Sundquist
Author Affiliation
Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Huddinge, Sweden. per.wandell@ki.se.
Source
Eur J Epidemiol. 2017 09; 32(9):785-796
Date
09-2017
Language
English
Publication Type
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Keywords
Aged
Atrial Fibrillation - ethnology
Cohort Studies
Emigrants and Immigrants - statistics & numerical data
Ethnic Groups - statistics & numerical data
Female
Humans
Incidence
Male
Middle Aged
Proportional Hazards Models
Registries - statistics & numerical data
Risk factors
Socioeconomic Factors
Sweden - epidemiology
Abstract
To study the association between country of birth and incident atrial fibrillation (AF) in several immigrant groups in Sweden. The study population included all adults (n = 3,226,752) aged 45 years and older in Sweden. AF was defined as having at least one registered diagnosis of AF in the National Patient Register. The incidence of AF in different immigrant groups, using Swedish-born as referents, was assessed by Cox regression, expressed in hazard ratios (HRs) and 95% confidence intervals (CI). All models were stratified by sex and adjusted for age, geographical residence in Sweden, educational level, marital status, and neighbourhood socioeconomic status. Compared to their Swedish-born counterparts, higher incidence of AF [HR (95% CI)] was observed among men from Bosnia 1.74 (1.56-1.94) and Latvia 1.29 (1.09-1.54), and among women from Iraq 1.96 (1.67-2.31), Bosnia 1.88 (1.61-1.94), Finland 1.14 (1.11-1.17), Estonia 1.14 (1.05-1.24) and Germany 1.08 (1.03-1.14). Lower incidence of AF was noted among men (HRs = 0.60) from Iceland, Southern Europe (especially Greece, Italy and Spain), Latin America (especially Chile), Africa, Asia (including Iraq, Turkey, Lebanon and Iran), and among women from Nordic countries (except Finland), Southern Europe, Western Europe (except Germany), Africa, North America, Latin America, Iran, Lebanon and other Asian countries (except Turkey and Iraq). In conclusion, we observed substantial differences in incidence of AF between immigrant groups and the Swedish-born population. A greater awareness of the increased risk of AF development in some immigrant groups may enable for a timely diagnosis, treatment and prevention of its debilitating complications, such as stroke.
Notes
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PubMed ID
28702880 View in PubMed
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Blood pressure measures and their predictive ability of cardiovascular mortality: a 26-year follow-up.

https://arctichealth.org/en/permalink/ahliterature116529
Source
Blood Press Monit. 2013 Apr;18(2):72-7
Publication Type
Article
Date
Apr-2013
Author
Axel C Carlsson
Sven-Erik Johansson
Holger Theobald
Per E Wändell
Author Affiliation
Department of Neurobiology, Centre for Family Medicine, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden. axelcefam@hotmail.com
Source
Blood Press Monit. 2013 Apr;18(2):72-7
Date
Apr-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Blood pressure
Cardiovascular Diseases - mortality
Coronary Disease - epidemiology
Diastole
Female
Follow-Up Studies
Humans
Male
Middle Aged
Prognosis
Proportional Hazards Models
Risk
Sampling Studies
Sweden - epidemiology
Systole
Young Adult
Abstract
Our aim was to calculate the predictability of different blood pressure measures for cardiovascular mortality in a cohort of both men and women. We also aimed to determine whether clinically applicable cut-off levels for cardiovascular mortality risk of these measures work well.
A healthcare need investigation from the 1970s was used. Participants aged 46-65 were included, n=788 (390 men and 398 women). The following blood pressure measures were studied: systolic, diastolic, mean, mid, and pulse pressure. The participants were followed for 26 years with respect to cardiovascular mortality through the Swedish Cause-of-Death Register. Isolated diastolic hypertension failed to show significant associations with cardiovascular mortality.
Combined systolic and diastolic hypertension showed twice as high cardiovascular mortality in men and women compared with those with normal blood pressure. Mid arterial blood pressure showed increased significant hazard ratios for all three grades of hypertension in men and for grades 2 and 3 in women with good predictability (area under the curve=0.72 and 0.80, respectively).
Mid arterial blood pressure is strongly associated with cardiovascular mortality. Additional studies in larger populations and with a wider age range comparing mid arterial blood pressure with clinically useful cut-offs of other blood pressure measures are required to corroborate our findings.
PubMed ID
23388402 View in PubMed
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Cardiovascular medication in relation to renal function after coronary artery bypass surgery.

https://arctichealth.org/en/permalink/ahliterature260160
Source
Int J Cardiol. 2013 Oct 9;168(4):4033-8
Publication Type
Article
Date
Oct-9-2013
Author
Ulrik Sartipy
Erik Rampell
Axel C Carlsson
Per Wändell
Martin J Holzmann
Source
Int J Cardiol. 2013 Oct 9;168(4):4033-8
Date
Oct-9-2013
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Cardiovascular Agents - pharmacology - therapeutic use
Cohort Studies
Coronary Artery Bypass - adverse effects - trends
Coronary Artery Disease - drug therapy - epidemiology - surgery
Female
Glomerular Filtration Rate - physiology
Humans
Kidney - drug effects - physiology
Male
Middle Aged
Population Surveillance - methods
Retrospective Studies
Sweden - epidemiology
Treatment Outcome
Abstract
Guidelines for recommended medication use for the secondary prevention of coronary heart disease are exceedingly important in patients with chronic kidney disease. Despite a high risk for recurrent cardiovascular events, these patients are less likely to use evidence-based recommended medications. The objective of the current study was to analyze the association between renal function and guideline-recommended drug therapy in patients with coronary heart disease.
In this nationwide population-based cohort study, we included 12,332 patients with established coronary heart disease who underwent primary isolated coronary artery bypass grafting in Sweden between 2005 and 2008. Medication use was retrieved from the national Prescribed Drug Register.
During the first year after coronary surgery, 94% of patients had at least two dispensed prescriptions for an antiplatelet agent, 68% for an angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker, 92% for a beta-blocker, and 93% for a statin. Only 57% of all patients had prescriptions for all four medication classes. Reduced renal function (estimated glomerular filtration rate (eGFR) of 30 to 45 mL/min per 1.73 m(2) and 60 mL/min per 1.73 m(2)).
In patients with established coronary heart disease, moderate to severe renal dysfunction was associated with significantly lower use of guideline-recommend medications as compared to normal renal function.
PubMed ID
23880581 View in PubMed
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