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Added predictive ability of the CHA2DS2VASc risk score for stroke and death in patients with atrial fibrillation: the prospective Danish Diet, Cancer, and Health cohort study.

https://arctichealth.org/en/permalink/ahliterature124928
Source
Circ Cardiovasc Qual Outcomes. 2012 May;5(3):335-42
Publication Type
Article
Date
May-2012
Author
Torben Bjerregaard Larsen
Gregory Y H Lip
Flemming Skjøth
Karen Margrete Due
Kim Overvad
Lars Hvilsted Rasmussen
Author Affiliation
Department of Cardiology, Aalborg AF Study Group, Cardiovascular Research Centre, Aarhus University Hospital, Aalborg, Denmark. tobl@rn.dk
Source
Circ Cardiovasc Qual Outcomes. 2012 May;5(3):335-42
Date
May-2012
Language
English
Publication Type
Article
Keywords
Administration, Oral
Aged
Anticoagulants - administration & dosage
Atrial Fibrillation - drug therapy - epidemiology - mortality
Denmark - epidemiology
Diet - adverse effects
Female
Humans
Incidence
Life Style
Male
Middle Aged
Neoplasms - epidemiology
Predictive value of tests
Prognosis
Prospective Studies
ROC Curve
Registries
Risk assessment
Risk factors
Stroke - epidemiology - mortality - prevention & control
Time Factors
Abstract
The objective of this study was to evaluate the added predictive ability of the CHA(2)DS(2)VASc prediction rule for stroke and death in a nonanticoagulated population of patients with atrial fibrillation.
We included 1603 nonanticoagulated patients with incident atrial fibrillation from a Danish prospective cohort study of 57 053 middle-aged men and women. The Net Reclassification Improvement was calculated as a measure to estimate any overall improvement in reclassification with the CHA(2)DS(2)VASc sore as an alternative to the CHADS(2) score. After 1-year follow-up, crude incidence rates were 3.4 per 100 person-years for stroke and 13.6 for death. After a mean follow-up of 5.4 years (± 3.7 years), the crude incidence rates for stroke and death were 1.9 and 5.6, respectively. During the entire observation period, the c-statistics and negative predictive values were similar for both risk scores. The Net Reclassification Improvement analysis showed that 1 of 10 reclassified atrial fibrillation patients would have been upgraded correctly using the CHA(2)DS(2)VASc score.
Both the CHADS(2) as well as the CHA(2)DS(2)VASc risk score can exclude a large proportion of patients from having high risk of stroke or death. However, using the CHA(2)DS(2)VASc risk score, fewer patients will fulfill the criterion for low risk (and are truly low risk for thromboembolism). For every 10 extra patients transferred to the treatment group at 5 years, using the CHA(2)DS(2)VASc risk score, 1 patient would have had a stroke that might have been avoided with effective treatment.
PubMed ID
22534406 View in PubMed
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Adipose tissue trans-fatty acids and changes in body weight and waist circumference.

https://arctichealth.org/en/permalink/ahliterature105926
Source
Br J Nutr. 2014 Apr 14;111(7):1283-91
Publication Type
Article
Date
Apr-14-2014
Author
Camilla P Hansen
Tina L Berentzen
Jane N Østergaard
Christina C Dahm
Lars I Hellgren
Erik B Schmidt
Anne Tjønneland
Thorkild I A Sørensen
Kim Overvad
Marianne U Jakobsen
Author Affiliation
Section for Epidemiology, Department of Public Health, Aarhus University, Bartholins Allé 2, DK-8000 Aarhus C, Denmark.
Source
Br J Nutr. 2014 Apr 14;111(7):1283-91
Date
Apr-14-2014
Language
English
Publication Type
Article
Keywords
Adipose Tissue, White - metabolism
Biological Markers - metabolism
Biopsy, Needle
Cohort Studies
Denmark
Dietary Fats - adverse effects - metabolism
Female
Follow-Up Studies
Humans
Linoleic Acids, Conjugated - adverse effects - metabolism
Lost to Follow-Up
Male
Middle Aged
Obesity - etiology - metabolism - pathology
Oleic Acids - adverse effects - metabolism
Questionnaires
Registries
Trans Fatty Acids - adverse effects - metabolism
Waist Circumference
Weight Gain
Abstract
Previous studies have suggested that the intake of trans-fatty acids (TFA) plays a role in the development of obesity. The proportions of adipose tissue fatty acids not synthesised endogenously in humans, such as TFA, usually correlate well with the dietary intake. Hence, the use of these biomarkers may provide a more accurate measure of habitual TFA intake than that obtained with dietary questionnaires. The objective of the present study was to investigate the associations between the proportions of specific TFA in adipose tissue and subsequent changes in weight and waist circumference (WC). The relative content of fatty acids in adipose tissue biopsies from a random sample of 996 men and women aged 50-64 years drawn from a Danish cohort study was determined by GC. Baseline data on weight, WC and potential confounders were available together with information on weight and WC 5 years after enrolment. The exposure measures were total trans-octadecenoic acids (18:1t), 18:1 ?6-10t, vaccenic acid (18:1 ?11t) and rumenic acid (18:2 ?9c, 11t). Data were analysed using multiple regression with cubic spline modelling. The median proportion of total adipose tissue 18:1t was 1.52% (90% central range 0.98, 2.19) in men and 1.47% (1.01, 2.19) in women. No significant associations were observed between the proportions of total 18:1t, 18:1 ?6-10t, vaccenic acid or rumenic acid and changes in weight or WC. The present study suggests that the proportions of specific TFA in adipose tissue are not associated with subsequent changes in weight or WC within the exposure range observed in this population.
PubMed ID
24286469 View in PubMed
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Air pollution from traffic and risk for lung cancer in three Danish cohorts.

https://arctichealth.org/en/permalink/ahliterature99386
Source
Cancer Epidemiol Biomarkers Prev. 2010 May;19(5):1284-91
Publication Type
Article
Date
May-2010
Author
Ole Raaschou-Nielsen
Helle Bak
Mette Sørensen
Steen Solvang Jensen
Matthias Ketzel
Martin Hvidberg
Peter Schnohr
Anne Tjønneland
Kim Overvad
Steffen Loft
Author Affiliation
Institute of Cancer Epidemiology, Danish Cancer Society, Strandboulevarden 49, 2100 Copenhagen Ø, Denmark. ole@cancer.dk
Source
Cancer Epidemiol Biomarkers Prev. 2010 May;19(5):1284-91
Date
May-2010
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Air Pollution - adverse effects
Case-Control Studies
Cohort Studies
Denmark - epidemiology
Female
Humans
Lung Neoplasms - epidemiology - etiology
Male
Middle Aged
Prospective Studies
Risk factors
Vehicle Emissions
Young Adult
Abstract
BACKGROUND: Air pollution is suspected to cause lung cancer. The purpose was to investigate whether the concentration of nitrogen oxides (NOx) at the residence, used as an indicator of air pollution from traffic, is associated with risk for lung cancer. METHODS: We identified 679 lung cancer cases in the Danish Cancer Registry from the members of three prospective cohorts and selected a comparison group of 3,481 persons from the same cohorts in a case-cohort design. Residential addresses from January 1, 1971, were traced in the Central Population Registry. The NOx concentration at each address was calculated by dispersion models, and the time-weighted average concentration for all addresses was calculated for each person. We used Cox models to estimate incidence rate ratios after adjustment for smoking (status, duration, and intensity), educational level, body mass index, and alcohol consumption. RESULTS: The incidence rate ratios for lung cancer were 1.30 [95% confidence interval (95% CI), 1.07-1.57] and 1.45 (95% CI, 1.12-1.88) for NOx concentrations of 30 to 72 and >72 microg/m3, respectively, when compared with
PubMed ID
20447920 View in PubMed
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Alcohol intake and prognosis of atrial fibrillation.

https://arctichealth.org/en/permalink/ahliterature113075
Source
Heart. 2013 Aug;99(15):1093-9
Publication Type
Article
Date
Aug-2013
Author
Thure Filskov Overvad
Lars Hvilsted Rasmussen
Flemming Skjøth
Kim Overvad
Ida Ehlers Albertsen
Deirdre A Lane
Gregory Y H Lip
Torben Bjerregaard Larsen
Author Affiliation
Department of Cardiology, Cardiovascular Research Centre, Aalborg University Hospital, Aalborg, Denmark.
Source
Heart. 2013 Aug;99(15):1093-9
Date
Aug-2013
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Alcohol Drinking - adverse effects - epidemiology
Anticoagulants - therapeutic use
Atrial Fibrillation - complications - drug therapy - epidemiology
Cohort Studies
Comorbidity
Denmark - epidemiology
Female
Humans
Male
Medical Records, Problem-Oriented - statistics & numerical data
Middle Aged
Outcome Assessment (Health Care) - statistics & numerical data
Risk assessment
Risk factors
Sex Factors
Thromboembolism - epidemiology - etiology - prevention & control
Abstract
To assess alcohol intake as a risk factor for adverse events among patients with incident atrial fibrillation (AF).
Prospective cohort study.
Population based cohort study and nationwide Danish registries.
The Danish Diet, Cancer and Health study included 57 053 participants (27 178 men and 29 875 women) aged between 50 and 64 years. The study population for this study included the 3107 participants (1999 men, 1108 women) who developed incident AF after inclusion.
A composite of thromboembolism or death.
During a median follow-up of 4.9 years 608 deaths and 211 thromboembolic events occurred. Of those who developed AF, 690 (35%) men and 233 (21%) women had a high intake of alcohol (>20 drinks/week for men and >13 drinks/week for women). After adjustment for use of oral anticoagulation and components of the CHA2DS2-VASc score, men with an intake of >27 drinks/week had a higher risk for thromboembolism or death (hazard ratio (HR) 1.33, 95% CI 1.08 to 1.63) than men with an intake of 20 drinks/week also had a higher risk (HR 1.23, 95% CI 0.78 to 1.96) than women in the low intake category. The higher risk among men was primarily driven by mortality (HR 1.51, 95% CI 1.20 to 1.89), whereas the risk found among women was driven by thromboembolism (HR 1.71, 95% CI 0.81 to 3.60).
High alcohol intake predicts thromboembolism or death, even after adjustment for established clinical risk factors, and may help identify high risk AF patients who could be targeted for stroke and cardiovascular prevention strategies.
PubMed ID
23766449 View in PubMed
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Alcohol intake, drinking patterns and risk of postmenopausal breast cancer in Denmark: a prospective cohort study.

https://arctichealth.org/en/permalink/ahliterature9707
Source
Cancer Causes Control. 2003 Apr;14(3):277-84
Publication Type
Article
Date
Apr-2003
Author
Anne Tjønneland
Birthe L Thomsen
Connie Stripp
Jane Christensen
Kim Overvad
Lene Mellemkaer
Morten Grønbaek
Jørgen H Olsen
Author Affiliation
Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark. annet@cancer.dk
Source
Cancer Causes Control. 2003 Apr;14(3):277-84
Date
Apr-2003
Language
English
Publication Type
Article
Keywords
Alcohol Drinking - adverse effects
Breast Neoplasms - epidemiology - etiology
Cohort Studies
Denmark - epidemiology
Female
Humans
Incidence
Life Style
Middle Aged
Postmenopause
Prospective Studies
Research Support, Non-U.S. Gov't
Risk factors
Abstract
OBJECTIVE: The available epidemiological evidence indicates that drinking alcohol per se is associated with breast cancer. However, it has not been investigated how the breast cancer risk for a given total alcohol consumption depends on the drinking frequency. METHODS: Within the prospective study on 'Diet, Cancer and Health', we examined the relationship between breast cancer, intake of total alcohol and frequency of drinking among 23,778 postmenopausal women, among whom 425 cases of breast cancer accrued during a median follow-up of 4.8 years. RESULTS: The dose-response relationship between total alcohol intake and breast cancer showed an increase in the rate ratio of 1.10 per 10 g/day (95% CI: 1.04-1.16) with no evidence for differences by type of alcohol beverage. No interaction was found between drinking frequency and total alcohol intake in the risk of breast cancer (p = 0.40). CONCLUSIONS: The present study supports previous ones in showing a monotonic increase in the risk of breast cancer among postmenopausal women with increasing average daily intake of alcohol, and this relationship with alcohol intake did not depend on drinking frequency.
PubMed ID
12814207 View in PubMed
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Association of adherence to lifestyle recommendations and risk of colorectal cancer: a prospective Danish cohort study.

https://arctichealth.org/en/permalink/ahliterature139798
Source
BMJ. 2010;341:c5504
Publication Type
Article
Date
2010
Author
Helene Kirkegaard
Nina Føns Johnsen
Jane Christensen
Kirsten Frederiksen
Kim Overvad
Anne Tjønneland
Author Affiliation
Institute of Cancer Epidemiology, Danish Cancer Society, Strandboulevarden 49, DK-2100 Copenhagen Ø, Denmark. helene.kirkegaard@webspeed.dk
Source
BMJ. 2010;341:c5504
Date
2010
Language
English
Publication Type
Article
Keywords
Alcohol Drinking - adverse effects
Colorectal Neoplasms - epidemiology - prevention & control
Denmark - epidemiology
Diet
Educational Status
Exercise
Female
Humans
Incidence
Life Style
Male
Middle Aged
Patient compliance
Prospective Studies
Risk factors
Smoking - adverse effects
Waist Circumference
Abstract
To evaluate the association between a simple lifestyle index based on the recommendations for five lifestyle factors and the incidence of colorectal cancer, and to estimate the proportion of colorectal cancer cases attributable to lack of adherence to the recommendations.
Prospective cohort study.
General population of Copenhagen and Aarhus, Denmark.
55?487 men and women aged 50-64 years at baseline (1993-7), not previously diagnosed with cancer.
Risk of colorectal cancer in relation to points achieved in the lifestyle index (based on physical activity, waist circumference, smoking, alcohol intake, and diet (dietary fibre, energy percentage from fat, red and processed meat, and fruits and vegetables)) modelled through Cox regression.
During a median follow-up of 9.9 years, 678 men and women had colorectal cancer diagnosed. After adjustment for potential confounders, each additional point achieved on the lifestyle index, corresponding to one additional recommendation that was met, was associated with a lower risk of colorectal cancer (incidence rate ratio 0.89 (95% confidence interval 0.82 to 0.96). In this population an estimated total of 13% (95% CI 4% to 22%) of the colorectal cancer cases were attributable to lack of adherence to merely one additional recommendation among all participants except the healthiest. If all participants had followed the five recommendations 23% (9% to 37%) of the colorectal cancer cases might have been prevented. Results were similar for colon and rectal cancer, but only statistically significant for colon cancer.
Adherence to the recommendations for physical activity, waist circumference, smoking, alcohol intake, and diet may reduce colorectal cancer risk considerably, and in this population 23% of the cases might be attributable to lack of adherence to the five lifestyle recommendations. The simple structure of the lifestyle index facilitates its use in public health practice.
Notes
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PubMed ID
20978063 View in PubMed
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Associations between GPX1 Pro198Leu polymorphism, erythrocyte GPX activity, alcohol consumption and breast cancer risk in a prospective cohort study.

https://arctichealth.org/en/permalink/ahliterature76101
Source
Carcinogenesis. 2006 Apr;27(4):820-5
Publication Type
Article
Date
Apr-2006
Author
Gitte Ravn-Haren
Anja Olsen
Anne Tjønneland
Lars O Dragsted
Bjørn A Nexø
Håkan Wallin
Kim Overvad
Ole Raaschou-Nielsen
Ulla Vogel
Author Affiliation
Department of Toxicology and Risk Assessment, Danish Institute for Food and Veterinary Research, Søborg, Denmark. grh@dfvf.dk
Source
Carcinogenesis. 2006 Apr;27(4):820-5
Date
Apr-2006
Language
English
Publication Type
Article
Keywords
Alcohol Drinking - adverse effects
Breast Neoplasms - etiology - genetics
Case-Control Studies
Denmark
Female
Genetic Predisposition to Disease
Genotype
Glutathione Peroxidase - genetics - metabolism
Humans
Middle Aged
Polymorphism, Genetic
Prospective Studies
Research Support, Non-U.S. Gov't
Risk factors
Abstract
Breast cancer may be related to oxidative stress. Breast cancer patients have been reported to have lower antioxidant enzyme activity than healthy controls and the polymorphism GPX1 Pro198Leu has been associated with risk of lung and breast cancer. The purpose of the present nested case-control study was to determine whether GPX1 Pro198Leu and glutathione peroxidase (GPX) activity in prospectively collected blood samples are associated with breast cancer risk among postmenopausal women and whether GPX activity levels are associated with other known breast cancer risk factors. We matched 377 female breast cancer cases with 377 controls all nested within the prospective 'Diet, Cancer and Health' study of 57 000 Danes. Carriers of the variant T-allele of GPX1 Pro198Leu were at 1.43-fold higher risk of breast cancer compared with non-carriers (95% CI=1.07-1.92). Pre-diagnostic GPX activity tended to be lower in cases compared with controls. GPX activity was positively correlated with intake of alcohol (P
PubMed ID
16287877 View in PubMed
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Bulky DNA adducts as risk indicator of lung cancer in a Danish case-cohort study.

https://arctichealth.org/en/permalink/ahliterature16706
Source
Int J Cancer. 2006 Apr 1;118(7):1618-22
Publication Type
Article
Date
Apr-1-2006
Author
Helle Bak
Herman Autrup
Birthe Lykke Thomsen
Anne Tjønneland
Kim Overvad
Ulla Vogel
Ole Raaschou-Nielsen
Steffen Loft
Author Affiliation
Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark. ole@cancer.dk
Source
Int J Cancer. 2006 Apr 1;118(7):1618-22
Date
Apr-1-2006
Language
English
Publication Type
Article
Keywords
Case-Control Studies
DNA Adducts
Denmark - epidemiology
Epidemiologic Studies
Female
Humans
Incidence
Lung Neoplasms - epidemiology - genetics
Male
Middle Aged
Research Support, Non-U.S. Gov't
Risk factors
Smoking - adverse effects
Abstract
Little is known of the predictive value of the levels of DNA adducts in terms of cancer risk. We examined the association between bulky DNA adducts and risk of lung cancer in a population-based cohort, comprising of 25,717 men and 27,972 women aged 50-64 years at entry. We included 245 cases (137 men and 108 women) with lung cancer and a comparison group of 255 individuals (137 men and 118 women), matched on sex, age and smoking duration. Bulky adducts in white blood cells collected at enrollment and stored at -150 degrees C were analyzed by (32)P-postlabeling method, using the butanol enrichment procedure. The median level of bulky DNA adducts was 0.196 adduct/10(8) nucleotides (5-95 percentiles: 0.094-0.595) among current smokers who were later diagnosed with lung cancer and 0.163 adduct/10(8) nucleotides (5-95 percentiles: 0.091-0.455) among current smokers in the comparison group. The smoking adjusted incidence rate ratios (IRR) for lung cancer in relation to one log unit (natural logarithm) difference in adduct levels were 1.22 (95% CI 0.85-1.74), 1.33 (95% CI 0.89-1.98) and 0.76 (95% CI 0.39-1.47) among all, current and former smokers, respectively. Current smokers with bulky DNA adduct levels above the median had a significant higher lung cancer rate than those with adduct levels below the median (IRR = 1.61; 95% CI 1.04-2.49). The results are compatible with previous studies, suggesting a slightly higher risk of lung cancer with higher levels of adducts among smokers. Our results indicate that bulky DNA adducts may have a weak association with lung cancer risk.
PubMed ID
16217769 View in PubMed
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Chocolate intake and risk of clinically apparent atrial fibrillation: the Danish Diet, Cancer, and Health Study.

https://arctichealth.org/en/permalink/ahliterature284864
Source
Heart. 2017 Aug;103(15):1163-1167
Publication Type
Article
Date
Aug-2017
Author
Elizabeth Mostofsky
Martin Berg Johansen
Anne Tjønneland
Harpreet S Chahal
Murray A Mittleman
Kim Overvad
Source
Heart. 2017 Aug;103(15):1163-1167
Date
Aug-2017
Language
English
Publication Type
Article
Keywords
Atrial Fibrillation - epidemiology - etiology
Chocolate - adverse effects
Denmark - epidemiology
Diet
Feeding Behavior
Female
Humans
Incidence
Male
Middle Aged
Neoplasms
Prospective Studies
Registries
Risk Assessment - methods
Risk factors
Abstract
To evaluate the association between chocolate intake and incident clinically apparent atrial fibrillation or flutter (AF).
The Danish Diet, Cancer, and Health Study is a large population-based prospective cohort study. The present study is based on 55 502 participants (26 400 men and 29 102 women) aged 50-64 years who had provided information on chocolate intake at baseline. Incident cases of AF were ascertained by linkage with nationwide registries.
During a median of 13.5 years there were 3346 cases of AF. Compared with chocolate intake less than once per month, the rate of AF was lower for people consuming 1-3 servings/month (hazard ratio (HR) 0.90, 95% confidence interval (CI) 0.82 to 0.98), 1 serving/week (HR 0.83, 95% CI 0.74 to 0.92), 2-6 servings/week (HR 0.80, 95% CI 0.71 to 0.91) and =1 servings/day (HR 0.84, 95% CI 0.65 to 1.09; p-linear trend
PubMed ID
28536115 View in PubMed
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Combined effects of road traffic noise and ambient air pollution in relation to risk for stroke?

https://arctichealth.org/en/permalink/ahliterature257180
Source
Environ Res. 2014 Aug;133:49-55
Publication Type
Article
Date
Aug-2014
Author
Mette Sørensen
Pernille Lühdorf
Matthias Ketzel
Zorana J Andersen
Anne Tjønneland
Kim Overvad
Ole Raaschou-Nielsen
Author Affiliation
Diet, Genes and Environment, Danish Cancer Society Research Centre, Strandboulevarden 49, 2100 Copenhagen, Denmark. Electronic address: mettes@cancer.dk.
Source
Environ Res. 2014 Aug;133:49-55
Date
Aug-2014
Language
English
Publication Type
Article
Keywords
Air Pollutants - adverse effects
Air Pollution - adverse effects
Brain Ischemia - epidemiology - etiology
Denmark - epidemiology
Female
Humans
Male
Middle Aged
Nitrogen Dioxide - adverse effects
Noise - adverse effects
Stroke - etiology - mortality
Vehicle Emissions - toxicity
Abstract
Exposure to road traffic noise and air pollution have both been associated with risk for stroke. The few studies including both exposures show inconsistent results. We aimed to investigate potential mutual confounding and combined effects between road traffic noise and air pollution in association with risk for stroke. In a population-based cohort of 57,053 people aged 50-64 years at enrollment, we identified 1999 incident stroke cases in national registries, followed by validation through medical records. Mean follow-up time was 11.2 years. Present and historical residential addresses from 1987 to 2009 were identified in national registers and road traffic noise and air pollution were modeled for all addresses. Analyses were done using Cox regression. A higher mean annual exposure at time of diagnosis of 10 µg/m(3) nitrogen dioxide (NO2) and 10 dB road traffic noise at the residential address was associated with ischemic stroke with incidence rate ratios (IRR) of 1.11 (95% CI: 1.03, 1.20) and 1.16 (95% CI: 1.07, 1.24), respectively, in single exposure models. In two-exposure models road traffic noise (IRR: 1.15) and not NO2 (IRR: 1.02) was associated with ischemic stroke. The strongest association was found for combination of high noise and high NO2 (IRR=1.28; 95% CI=1.09-1.52). Fatal stroke was positively associated with air pollution and not with traffic noise. In conclusion, in mutually adjusted models road traffic noise and not air pollution was associated ischemic stroke, while only air pollution affected risk for fatal strokes. There were indications of combined effects.
PubMed ID
24906068 View in PubMed
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49 records – page 1 of 5.