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Age and gender differences in incidence and case fatality trends for myocardial infarction: a 30-year follow-up. The Tromso Study.

https://arctichealth.org/en/permalink/ahliterature131944
Source
Eur J Prev Cardiol. 2012 Oct;19(5):927-34
Publication Type
Article
Date
Oct-2012
Author
Jan Mannsverk
Tom Wilsgaard
Inger Njølstad
Laila Arnesdatter Hopstock
Maja-Lisa Løchen
Ellisiv B Mathiesen
Dag S Thelle
Knut Rasmussen
Kaare Harald Bønaa
Author Affiliation
Department of Heart Disease, Division of Cardiothoracic and Respiratory Medicine, University Hospital of North Norway, Tromsø, Norway. jan.mannsverk@unn.no
Source
Eur J Prev Cardiol. 2012 Oct;19(5):927-34
Date
Oct-2012
Language
English
Publication Type
Article
Keywords
Adult
Age Distribution
Age Factors
Aged
Aged, 80 and over
Cause of Death
Death Certificates
Female
Follow-Up Studies
Forecasting
Heart Arrest - epidemiology
Humans
Incidence
Male
Middle Aged
Myocardial Infarction - mortality
Norway - epidemiology
Population Surveillance
Prospective Studies
Sex Distribution
Sex Factors
Young Adult
Abstract
Although the mortality of coronary heart disease (CHD) has declined in Western countries during the last decades, studies have suggested that the prevention and treatment of CHD may not have been as effective in women as in men. We examined gender- and age-specific trends in incidence, case fatality and the severity of first myocardial infarction (MI) in a large Norwegian population-based study.
Prospective population-based cohort study.
A total of 31,323 participants enrolled between 1974 and 2001 were followed throughout 2004 for a total of 400,572 person-years. Suspected coronary events were adjudicated by a review of hospital records and death certificates. A total of 1669 events fulfilled standardized criteria of first-ever fatal or non-fatal MI.
In the age group 35-79 years, the age-adjusted incidence of MI declined significantly in men, whereas an increase was observed in women. For men and women = 80 years the incidence rates remained unchanged. The severity of MI and the 28-day and 1-year case fatality rates declined significantly and similarly in men and women.
Trends in MI incidence differed by sex and age; in the age group 35-79 years a marked decrease was observed among men but an increase was observed among women, while no change was observed among older patients. MI severity and case fatality were clearly reduced for both sexes. These data suggest that the burden of CHD is shifting from middle-aged men toward middle-aged women and elderly patients.
PubMed ID
21859780 View in PubMed
Less detail

Anthropometric measures of obesity and risk of venous thromboembolism: the Tromso study.

https://arctichealth.org/en/permalink/ahliterature147924
Source
Arterioscler Thromb Vasc Biol. 2010 Jan;30(1):121-7
Publication Type
Article
Date
Jan-2010
Author
Knut H Borch
Sigrid K Braekkan
Ellisiv B Mathiesen
Inger Njølstad
Tom Wilsgaard
Jan Størmer
John-Bjarne Hansen
Author Affiliation
Center for Atherothrombotic Research in Tromsø, Department of Medicine, Institute of Clinical Medicine, University of Tromsø, N-9037 Tromsø, Norway. knut.borch@fagmed.uit.no
Source
Arterioscler Thromb Vasc Biol. 2010 Jan;30(1):121-7
Date
Jan-2010
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Anthropometry
Body mass index
Female
Humans
Incidence
Male
Middle Aged
Multivariate Analysis
Obesity - epidemiology - pathology
Predictive value of tests
Prospective Studies
ROC Curve
Registries
Risk factors
Venous Thromboembolism - epidemiology
Waist-Hip Ratio
Abstract
The purpose of this study was to assess the impact of various obesity measures on identification of subjects at risk and their respective risk estimates for VTE in a prospective population-based study.
Measures of body composition such as body mass index (BMI), waist circumference (WC), hip circumference (HC), and waist-hip ratio (WHR) were registered in 6708 subjects aged 25 to 84 years, who participated in the Tromsø Study (1994-1995). Incident VTE-events were registered during follow-up until September 1, 2007. There were 222 VTE-events during a median of 12.3 years of follow-up. All measures of obesity exhibited significantly increased HR for VTE in multivariable models with highest risk estimates for WC in both genders. The risk of VTE increased across quartiles of BMI, WC, and HC in both genders, but not for WHR. WC identified more subjects at risk using established criteria for obesity. WC had the highest area under the curve in both genders in ROC analysis, and WC above ROC-derived cut-off values (WC > or =85 cm in women and > or =95 cm in men) were associated with HRs of 1.92 (95% CI: 1.05 to 3.48) in women and 2.78 (95% CI: 1.47 to 5.27) in men.
Our findings indicate that WC is the preferable anthropometric measure of obesity to identify subjects at risk and to predict risk of VTE.
PubMed ID
19834110 View in PubMed
Less detail

Association between diastolic dysfunction and future atrial fibrillation in the Tromsø Study from 1994 to 2010.

https://arctichealth.org/en/permalink/ahliterature262594
Source
Heart. 2015 May 13;
Publication Type
Article
Date
May-13-2015
Author
Sweta Tiwari
Henrik Schirmer
Bjarne K Jacobsen
Laila A Hopstock
Audhild Nyrnes
Geir Heggelund
Inger Njølstad
Ellisiv B Mathiesen
Maja-Lisa Løchen
Source
Heart. 2015 May 13;
Date
May-13-2015
Language
English
Publication Type
Article
Abstract
To investigate the association between echocardiographic measurements with emphasis on diastolic dysfunction and risk of atrial fibrillation (AF) in a population-based cohort study.
We followed 2406 participants from the Tromsø Study from 1994 to 2010. Left atrial (LA) size and mitral Doppler indices as measured by echocardiography were used for evaluating diastolic dysfunction. Information concerning age, systolic blood pressure, height, heart rate, body mass index, total and high-density lipoprotein cholesterol, self-reported use of alcohol, smoking, coffee, physical activity, antihypertensive treatment, prevalent coronary heart disease, valvular heart disease, heart failure, hypertrophy, diabetes and palpitations were obtained at baseline. The outcome measure was clinical AF, documented by an ECG.
AF was detected in 462 subjects (193 women). Mean age at baseline was 62.6 years. Incidence rate of clinical AF was 12.6 per 1000 person-years. In multivariable Cox proportional hazards regression analysis, moderately enlarged LA was associated with 60% (95% CI 1.2 to 2.0) increased risk of AF. Severely enlarged LA had HR for AF of 4.2 (95% CI 2.7 to 6.5) with p value for linear trend
PubMed ID
25972269 View in PubMed
Less detail

The association between red cell distribution width and venous thromboembolism is not explained by myocardial infarction, stroke, or cancer.

https://arctichealth.org/en/permalink/ahliterature293397
Source
Res Pract Thromb Haemost. 2018 Apr; 2(2):327-333
Publication Type
Journal Article
Date
Apr-2018
Author
Trygve S Ellingsen
Jostein Lappegård
Tove Skjelbakken
Ellisiv B Mathiesen
Inger Njølstad
Sigrid K Brækkan
John-Bjarne Hansen
Author Affiliation
K.G. Jebsen Thrombosis Research and Expertise Center (TREC) Department of Clinical Medicine UiT-The Arctic University of Norway Tromsø Norway.
Source
Res Pract Thromb Haemost. 2018 Apr; 2(2):327-333
Date
Apr-2018
Language
English
Publication Type
Journal Article
Abstract
Red cell distribution width (RDW) is a risk marker of venous thromboembolism (VTE), myocardial infarction (MI), stroke, and cancer. Due to interrelations between these diseases, the association between RDW and VTE may be explained by MI, stroke, or cancer.
To investigate whether the effect of RDW on VTE could be explained by intermediate development of MI, stroke, or cancer.
RDW was measured in 24 363 participants of the Tromsø Study in 1994-1995. Incident VTE, MI, stroke, and cancer were registered until December 31, 2010. Conventional and cause-specific Cox-regression models were used to estimate hazard ratios (HR) for VTE with 95% confidence intervals (CI) across categories of RDW.
There were 502 first VTEs during a median follow-up of 16 years. In conventional Cox regression analysis, RDW in the highest quartile was associated with a 71% (HR 1.71, 95% CI 1.09-2.67) and 27% (HR 1.27, 95% CI 0.88-1.85) higher risk of VTE in men and women, respectively, compared to subjects in the lowest quartiles. The risk of VTE among subjects with RDW in the highest quartile was similar for men and women of postmenopausal age. In cause-specific analysis, where each individual contributed with person-time until the first occurring event only, the risk estimates were similar to those of the conventional Cox-regression analysis.
Our findings suggest that the association between RDW and future risk of VTE is not explained by intermediate development of MI, stroke, or cancer.
Notes
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PubMed ID
30046735 View in PubMed
Less detail

Association of occasional smoking with total mortality in the population-based Tromsø study, 2001-2015.

https://arctichealth.org/en/permalink/ahliterature294424
Source
BMJ Open. 2017 12 28; 7(12):e019107
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
12-28-2017
Author
Maja-Lisa Løchen
Inger Torhild Gram
Jan Mannsverk
Ellisiv B Mathiesen
Inger Njølstad
Henrik Schirmer
Tom Wilsgaard
Bjarne K Jacobsen
Author Affiliation
Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
Source
BMJ Open. 2017 12 28; 7(12):e019107
Date
12-28-2017
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adult
Aged
Aged, 80 and over
Female
Humans
Longitudinal Studies
Male
Middle Aged
Mortality
Motivation
Norway - epidemiology
Proportional Hazards Models
Risk factors
Smoking - epidemiology
Surveys and Questionnaires
Abstract
There is a shift in the smoking population from daily smokers to light or occasional smokers. The knowledge about possible adverse health effects of this new smoking pattern is limited. We investigated smoking habits with focus on occasional smoking in relation to total mortality in a follow-up study of a Norwegian general population.
A population study in Tromsø, Norway.
We collected smoking habits and relevant risk factors in 4020 women and 3033 men aged 30-89 years in the Tromsø Study in 2001. The subjects were followed up regarding total mortality through June 2015.
Among the participants, there were 7% occasional smokers. Occasional smokers were younger, more educated and used alcohol more frequently than other participants. A total of 766 women and 882 men died during the follow-up. After the adjustment for confounders, we found that occasional smoking significantly increased mortality by 38% (95% CI 8% to 76%) compared with never smokers. We report a dose-response relationship in the hazards of smoking (daily, occasional, former and never smoking).
Occasional smoking is not a safe smoking alternative. There is a need for information to the general public and health workers about the health hazards of occasional smoking. More work should be done to motivate this often well-educated group to quit smoking completely.
Notes
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PubMed ID
29288187 View in PubMed
Less detail

Association of occasional smoking with total mortality in the population-based Tromsø study, 2001-2015.

https://arctichealth.org/en/permalink/ahliterature288019
Source
BMJ Open. 2017 12 28;7(12):e019107
Publication Type
Article
Date
12-28-2017
Author
Maja-Lisa Løchen
Inger Torhild Gram
Jan Mannsverk
Ellisiv B Mathiesen
Inger Njølstad
Henrik Schirmer
Tom Wilsgaard
Bjarne K Jacobsen
Source
BMJ Open. 2017 12 28;7(12):e019107
Date
12-28-2017
Language
English
Publication Type
Article
Abstract
There is a shift in the smoking population from daily smokers to light or occasional smokers. The knowledge about possible adverse health effects of this new smoking pattern is limited. We investigated smoking habits with focus on occasional smoking in relation to total mortality in a follow-up study of a Norwegian general population.
A population study in Tromsø, Norway.
We collected smoking habits and relevant risk factors in 4020 women and 3033 men aged 30-89 years in the Tromsø Study in 2001. The subjects were followed up regarding total mortality through June 2015.
Among the participants, there were 7% occasional smokers. Occasional smokers were younger, more educated and used alcohol more frequently than other participants. A total of 766 women and 882 men died during the follow-up. After the adjustment for confounders, we found that occasional smoking significantly increased mortality by 38% (95% CI 8% to 76%) compared with never smokers. We report a dose-response relationship in the hazards of smoking (daily, occasional, former and never smoking).
Occasional smoking is not a safe smoking alternative. There is a need for information to the general public and health workers about the health hazards of occasional smoking. More work should be done to motivate this often well-educated group to quit smoking completely.
Notes
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PubMed ID
29288187 View in PubMed
Less detail

Associations Between Common and Rare Exonic Genetic Variants and Serum Levels of Twenty Cardiovascular-Related Proteins: The Tromsø Study.

https://arctichealth.org/en/permalink/ahliterature273771
Source
Circ Cardiovasc Genet. 2016 Jun 21;
Publication Type
Article
Date
Jun-21-2016
Author
Terry Solomon
Erin N Smith
Hiroko Matsui
Sigrid K Braekkan
Tom Wilsgaard
Inger Njølstad
Ellisiv B Mathiesen
John-Bjarne Hansen
Kelly A Frazer
Source
Circ Cardiovasc Genet. 2016 Jun 21;
Date
Jun-21-2016
Language
English
Publication Type
Article
Abstract
-Genetic variation can be used to study causal relationships between biomarkers and diseases. Here, we identify new common and rare genetic variants associated with cardiovascular-related protein levels (protein quantitative trait loci, pQTLs). We functionally annotate these pQTLs, predict and experimentally confirm a novel molecular interaction and determine which pQTLs are associated with diseases and physiological phenotypes.
-As part of a larger case/control study of VTE, serum levels of 51 proteins implicated in cardiovascular diseases were measured in 330 individuals from the Tromsø Study. Exonic genetic variation near each protein's respective gene (cis) was identified using sequencing and arrays. Using single site and gene-based tests, we identified 27 genetic associations between pQTLs and the serum levels of 20 proteins: 14 associated with common variation in cis, of which six are novel (i.e. not previously reported); seven associations with rare variants in cis, of which four are novel; and six associations in trans Of the 20 proteins, 15 were associated with single sites and seven with rare variants. cis-pQTLs for kallikrein and F12 also show trans associations for proteins (uPAR, kininogen) known to be cleaved by kallikrein as well as with NTproBNP. We experimentally demonstrate that kallikrein can cleave proBNP (NTproBNP precursor) in vitro Nine of the pQTLs have previously identified associations with 17 diseases and/or physiological phenotypes.
-We have identified cis and trans genetic variation associated with the serum levels of 20 proteins and utilized these pQTLs to study molecular mechanisms underlying diseases and/or physiological phenotypes.
PubMed ID
27329291 View in PubMed
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Atherosclerotic Risk Factors and Risk of Myocardial Infarction and Venous Thromboembolism; Time-Fixed versus Time-Varying Analyses. The Tromsø Study.

https://arctichealth.org/en/permalink/ahliterature276266
Source
PLoS One. 2016;11(9):e0163242
Publication Type
Article
Date
2016
Author
Birgit Småbrekke
Ludvig Balteskard Rinde
Kristian Hindberg
Erin Mathiesen Hald
Anders Vik
Tom Wilsgaard
Maja-Lisa Løchen
Inger Njølstad
Ellisiv B Mathiesen
John-Bjarne Hansen
Sigrid Brækkan
Source
PLoS One. 2016;11(9):e0163242
Date
2016
Language
English
Publication Type
Article
Abstract
Single measurements of modifiable risk factors may underestimate associations with outcomes in cohorts. We aimed to compare risk estimates of myocardial infarction (MI) and venous thromboembolism (VTE) by atherosclerotic risk factors during long follow-up using time-fixed analyses without and with correction for regression dilution and time-varying analyses.
The study included 5970 subjects enrolled in the fourth survey of the Tromsø Study (1994/95). Blood pressure, lipid levels, body mass index (BMI), diabetes and smoking status were measured at baseline, and subjects still alive at the fifth (2001/02, n = 5179) and sixth (2007/08, n = 4391) survey were re-measured. Incident events of MI (n = 714) and VTE (n = 214) were recorded until December 2010. Time-fixed and time-varying Cox regression models were used to estimate hazard ratios (HR) for MI and VTE adjusted for age and sex.
Variations in BMI, blood pressure and lipid levels were small, and did not alter the risk estimates when time-varying analyses were compared to time-fixed analyses. For MI, variables that changed considerably over time yielded the greatest changes in risk estimates (HR for smoking changed from 1.80 (95% CI 1.55-2.10) to 2.08 (95% CI 1.78-2.42)). For VTE, only BMI was associated with increased risk in both time-fixed and time-varying analysis, but the risk estimates weakened in the time-varying analysis. Correction of time-fixed HRs with Rosner´s method tended to overestimate risk estimates compared to time-varying analysis.
For MI and VTE, risk estimates based on baseline and repeated measures corresponded well, whereas correction for regression dilution tended to overestimate risks.
PubMed ID
27635655 View in PubMed
Less detail

Atrial Fibrillation and Cause-Specific Risks of Pulmonary Embolism and Ischemic Stroke.

https://arctichealth.org/en/permalink/ahliterature289402
Source
J Am Heart Assoc. 2018 Jan 29; 7(3):
Publication Type
Journal Article
Date
Jan-29-2018
Author
Erin M Hald
Ludvig B Rinde
Maja-Lisa Løchen
Ellisiv B Mathiesen
Tom Wilsgaard
Inger Njølstad
Sigrid K Brækkan
John-Bjarne Hansen
Author Affiliation
Department of Clinical Medicine, K. G. Jebsen Thrombosis Research and Expertise Center, UiT The Arctic University of Norway, Tromsø, Norway erin.mathiesen.hald@uit.no.
Source
J Am Heart Assoc. 2018 Jan 29; 7(3):
Date
Jan-29-2018
Language
English
Publication Type
Journal Article
Abstract
Atrial fibrillation (AF) is a well-established risk factor for ischemic stroke (IS). Emerging evidence also indicates an association between AF and pulmonary embolism (PE). Because IS may potentially mediate the observed risk of PE in AF, we aimed to assess the impact of AF on the cause-specific risks of PE and IS in a large cohort recruited from the general population.
We observed 29 842 participants from 3 surveys of the Tromsø study (inclusion in 1994-1995, 2001-2002, and 2007-2008) to the end of 2012. Incident events of AF, IS, and PE during follow-up were recorded, and information on potential confounders was obtained at baseline. Cox regression models, with AF as a time-dependent variable, were used to calculate cause-specific hazard ratios (HRs) with 95% confidence intervals (CIs) for PE and IS. There were 2067 participants diagnosed as having AF, 296 with PE and 1164 with IS, during a median of 17.6 years of follow-up. The risks of PE (HR, 10.88; 95% CI, 6.23-18.89) and IS (HR, 6.16; 95% CI, 4.47-8.48) were substantially increased during the first 6 months after AF diagnosis, with crude incidence rates of 18.5 per 1000 person-years for PE and 52.8 per 1000 person-years for IS. The risk estimates remained elevated for both PE (HR, 1.72; 95% CI, 1.10-2.71) and IS (HR, 2.45; 95% CI, 2.05-2.92) throughout the study period.
AF was associated with increased cause-specific risks of both PE and IS. Our findings infer that the risk of PE in AF is not explained by intermediate IS.
Notes
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PubMed ID
29378729 View in PubMed
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Atrial fibrillation and future risk of venous thromboembolism - the Tromsø study.

https://arctichealth.org/en/permalink/ahliterature257483
Source
J Thromb Haemost. 2014 Oct 21;
Publication Type
Article
Date
Oct-21-2014
Author
Kristin F Enga
Ina Rye-Holmboe
Erin M Hald
Maja-Lisa Løchen
Ellisiv B Mathiesen
Inger Njølstad
Tom Wilsgaard
Sigrid K Braekkan
John-Bjarne Hansen
Author Affiliation
K.G. Jebsen Thrombosis Research and Expertise Center, Department of Clinical Medicine, University of Tromsø, Norway; Hematological Research Group, Department of Clinical Medicine, University of Tromsø, Tromsø, Norway.
Source
J Thromb Haemost. 2014 Oct 21;
Date
Oct-21-2014
Language
English
Publication Type
Article
Abstract
Whether atrial fibrillation is related to risk of venous thromboembolism (VTE) is not extensively studied. Therefore, we investigated the association between atrial fibrillation and future risk of VTE in a population-based cohort.
In total, 29 975 subjects were recruited from three surveys of the Tromsø study and followed from enrolment (1994-95, 2001-02 and 2007-08) through 2010. Incident events of atrial fibrillation and VTE during follow-up were recorded. Information on potential confounders was obtained at baseline. Cox-regression models with atrial fibrillation as time-dependent variable were used to calculate hazard ratios (HR) for VTE with 95% confidence intervals (CI).
During 16 years of median follow-up, 1604 subjects were diagnosed with atrial fibrillation and 614 with incident VTE. The risk of VTE was substantially increased during the first 6 months after diagnosis of atrial fibrillation (HR 8.44, 95% CI: 5.61-12.69), and remained increased throughout the study period (HR: 1.43, 95% CI 1.43-1.99) compared to those without atrial fibrillation. Atrial fibrillation displayed higher risk estimates for pulmonary embolism (HR: 11.84, 6.80-20.63) than for deep vein thrombosis (HR: 6.20, 3.37-11.39), during the first 6 months, and was still associated with pulmonary embolism (HR: 1.96, 95% CI: 1.24-3.10) but not with deep vein thrombosis (HR: 1.08, 95% CI: 0.66-1.75) more than 6 months after diagnosis.
Atrial fibrillation was associated with increased risk of VTE, and pulmonary embolism in particular. Our findings support the concept that isolated pulmonary embolism may originate from right atrial thrombi due to atrial fibrillation. This article is protected by copyright. All rights reserved.
PubMed ID
25330989 View in PubMed
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