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Cardiovascular biomarkers predict fragility fractures in older adults.

https://arctichealth.org/en/permalink/ahliterature299736
Source
Heart. 2019 03; 105(6):449-454
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
03-2019
Author
Madeleine Johansson
Fabrizio Ricci
Giuseppe Di Martino
Cecilia Rogmark
Richard Sutton
Viktor Hamrefors
Olle Melander
Artur Fedorowski
Author Affiliation
Department of Clinical Sciences, Faculty of Medicine, Clinical Research Center, Lund University, Malmö, Sweden.
Source
Heart. 2019 03; 105(6):449-454
Date
03-2019
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adrenomedullin - blood
Aged
Atrial Natriuretic Factor - blood
Biomarkers - blood
Body mass index
Cardiovascular System - metabolism
Cohort Studies
Correlation of Data
Endothelin-1 - blood
Female
Fractures, Bone - blood
Humans
Independent Living - statistics & numerical data
Male
Middle Aged
Peptide Fragments - blood
Prospective Studies
Protein Precursors - blood
Reproducibility of Results
Risk assessment
Risk factors
Sweden
Vasopressins - blood
Abstract
To assess the role of four biomarkers of neuroendocrine activation and endothelial dysfunction in the longitudinal prediction of fragility fractures.
We analysed a population-based prospective cohort of 5415 community-dwelling individuals (mean age, 68.9±6.2 years) enrolled in the Malmö Preventive Project followed during 8.1±2.9 years, and investigated the longitudinal association between C-terminal pro-arginine vasopressin (CT-proAVP), C-terminal endothelin-1 precursor fragment (CT-proET-1), the mid-regional fragments of pro-adrenomedullin (MR-proADM) and pro-atrial natriuretic peptide (MR-proANP), and incident vertebral, pelvic and extremity fractures.
Overall, 1030 (19.0%) individuals suffered vertebral, pelvic or extremity fracture. They were older (70.7±5.8 vs 68.4±6.3 years), more likely women (46.9% vs 26.3%), had lower body mass index and diastolic blood pressure, were more often on antihypertensive treatment (44.1% vs 38.4%) and had more frequently history of fracture (16.3% vs 8.1%). Higher levels of MR-proADM (adjusted HR (aHR) per 1 SD: 1.51, 95% CI 1.01 to 2.28, p
Notes
CommentIn: Heart. 2019 Mar;105(6):427-428 PMID 30361269
PubMed ID
30322844 View in PubMed
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Polypharmacy and adverse outcomes after hip fracture surgery.

https://arctichealth.org/en/permalink/ahliterature282454
Source
J Orthop Surg Res. 2016 Nov 24;11(1):151
Publication Type
Article
Date
Nov-24-2016
Author
Maria Härstedt
Cecilia Rogmark
Richard Sutton
Olle Melander
Artur Fedorowski
Source
J Orthop Surg Res. 2016 Nov 24;11(1):151
Date
Nov-24-2016
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Analgesics, Opioid - administration & dosage - adverse effects
Anticoagulants - administration & dosage - adverse effects
Cause of Death - trends
Female
Follow-Up Studies
Hip Fractures - diagnosis - mortality - surgery
Hospitalization - trends
Humans
Male
Patient Readmission - trends
Polypharmacy
Postoperative Complications - chemically induced - diagnosis - mortality
Registries
Sweden - epidemiology
Treatment Outcome
Abstract
We aimed to explore the effects of polypharmacy and specific drug classes on readmissions and mortality after hip surgery.
We analyzed data on 272 consecutive hip fracture patients (72.1% females; age 82?±?9 years) who underwent acute hip replacement. We collected detailed data on the pharmacological treatment upon admission and discharge. Patients were followed up over a period of 6 months after discharge using the Swedish National Hospital Discharge Register and the Swedish National Cause of Death Register.
After 6 months, 86 patients (31.6%) were readmitted, while 36 patients (13.2%) died. The total number of medications upon discharge was predictive of rehospitalization (odds ratio (OR) 1.08, 95%CI 1.01-1.17, p?=?0.030) but not predictive of mortality. The use of antiosteoporotic agents (OR 1.86, 95%CI 1.06-3.26, p?=?0.03), SSRIs (OR 1.90, 95%CI 1.06-3.42, p?=?0.03), and eye drops (OR 4.12, 95%CI 1.89-8.97, p?=?0.0004) were predictive of rehospitalization. Treatment with vitamin K antagonists (OR 4.29, 95%CI 1.19-15.39, p?=?0.026), thiazides (OR 4.10, 95%CI 1.30-12.91, p?=?0.016), and tramadol (OR 2.84, 95%CI 1.17-6.90, p?=?0.021) predicted readmissions due to a new fall/trauma.
The total number of medications, use of antiosteoporotic agents, SSRIs, and eye drops predicted rehospitalization after hip fracture surgery, while use of vitamin K antagonists, thiazides, and tramadol was associated with readmissions due to a traumatic fall.
Hip fractures and polypharmacy in the elderly. Stimulus Project for the Elderly 2009-2011 (Reg no 2009-11-26). Swedish National Board of Health and Welfare.
Notes
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PubMed ID
27881180 View in PubMed
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