The incidence of cardiovascular events remains high in patients with myocardial infarction (MI) despite advances in current therapies. New and better methods for identifying patients at high risk of recurrent cardiovascular (CV) events are needed. This study aimed to analyze the predictive value of an oral glucose tolerance test (OGTT) in patients with acute myocardial infarction without known diabetes mellitus (DM).
The prospective cohort study consisted of 123 men and women aged between 31-80 years who had suffered a previous MI 3-12 months before the examinations. The exclusion criteria were known diabetes mellitus. Patients were followed up over 6.03???1.36 years for CV death, recurrent MI, stroke and unstable angina pectoris. A standard OGTT was performed at baseline.
The aim of the present study was to evaluate acute kidney injury (AKI) with cystatin C following transcatheter aortic valve implantation (TAVI) and to assess the impact of postoperative AKI on outcome and late renal function.
A prospective study.
Single, tertiary referral center.
Sixty-eight consecutive patients with severe aortic stenosis and advanced comorbidity.
Blood samples were collected on 4 occasions pre- and postoperatively to determine levels of s-creatinine and cystatin C. Additionally, a sample was collected at followup 12 months postoperatively for the determination of s-creatinine.
The mean preoperative eGFR (s-creatinine) was 67±24 mL/min/1.73 m² compared to 45±21 mL/min/1.73 m² with eGFR (cystatin C) (p
BACKGROUND: Studies show that both incidence and mortality in acute myocardial infarction are declining. It was expected that introduction of the troponin biomarkers in 2000 would lead to an increase in the number of diagnosed myocardial infarctions. We aimed at establishing how introduction of troponin and the fact that elderly comprise an increasing part of the population with an inherent increased risk for myocardial infarction, affected myocardial infarctions in our region with respect to incidence, age distribution and mortality. MATERIAL AND METHODS: All patients admitted to our hospital with a diagnosis of acute myocardial infarction (ICD 9 and 10) from 1990 to 2005 were included in the study. Data were imported from our electronic journal system with a database tool (Qlikview). Information about the incidence of myocardial infarction in all of Norway was taken from The Norwegian Inpatient Registry and population data were taken from Statistics Norway. Data were transferred from Qlikview to Excel and SPSS for statistical analysis. RESULTS: The incidence of myocardial infarction varied from year to year in our hospital area; it increased from 2000, but then decreased during the last two years. The proportion of patients aged 80 and older increased from 13 to 36% (p
BACKGROUND: The objective of the study was to analyse the number of AMI (acute myocardial infarctions) registered in the period 1991 - 2007, with special emphasis on the development after 1999, and with this background discuss changes in incidence. MATERIAL AND METHODS: We analysed data from NPR (the Norwegian Patient Register), on patients discharged from hospitals in the period 1991 - 2007 with the main diagnosis AMI. For the year 2004, a patient-based dataset was made available from SINTEF Health Research/NPR. The time for when troponin assays (for diagnosing AMI) were implemented in Norwegian hospitals was recorded through a questionnaire survey. RESULTS: The number of discharges for these patients decreased during the 90 s. From 2000 to 2007, the total number of discharges increased considerably (from 11,892 to 19,757 [66 %]). In patients below 80 years of age the number of discharges per 100,000 inhabitants was 283 in 1991 and 196 in 1999. After controlling for patient transfers between hospitals and introduction of troponins for diagnosing of AMI, the number of patients below 80 years admitted to hospital in 2004 was estimated to 142 - 162 per 100,000 inhabitants. INTERPRETATION: The trend for a decrease in AMI incidence seems to have continued from the 1990 s to after 2000 for the age groups below 80.
Adiponectin is viewed as an insulin-sensitizing hormone with anti-inflammatory effects. In accordance, plasma adiponectin is decreased in metabolic disorders including type 2 diabetes mellitus (T2DM). However, in spite of the apparently beneficially effects, recent data from large prospective studies have consistently linked high adiponectin levels with increased cardiovascular (CV) disease and mortality, thus questioning the positive view on adiponectin. Accordingly, we investigated the relationship between adiponectin, incident T2DM and subsequently CV events.
We prospectively followed 5349 randomly selected men and women from the community, without T2DM or CV disease. Plasma adiponectin was measured at study entry. Median follow-up time was 8.5 years (IQR 8.0-9.1 years). During follow up, 136 participants developed T2DM. Following their diagnosis, 36 of the 136 participants experienced a CV event (myocardial infarction, ischaemic stroke, or CV death).
Participants with increasing adiponectin had reduced risk of developing T2DM (p?
An observational study determining the long-term impact of chronic kidney disease (CKD) on patients undergoing percutaneous coronary intervention at a tertiary cardiac referral center. CKD is associated with poor in-hospital outcomes after percutaneous coronary intervention, but its effect beyond 1 year, particularly in the drug-eluting stent (DES) era, has not been reported.
Baseline creatinine was available for 11,953 patients entered into a prospective registry (April 2000 to September 2007). Patients were stratified: those with or without at least moderate CKD (creatinine clearance,
Glucometabolic disturbances are associated with myocardial dysfunction. Brain natriuretic peptides (BNP) are used for detecting myocardial dysfunction in clinical practice. However, studies on elderly subjects and gender-specific analyses are sparse.
We examined cross-sectional associations between Nt-proBNP and 1) fasting plasma glucose (FPG), and 2) categories of glucometabolic disturbances, in middle-aged and older subjects (1266 men, 526 women), applying multivariate linear regression analysis.
FPG was positively correlated with Nt-proBNP among middle-aged men (p = 0.04) and negatively albeit non-significantly (p = 0.1) among middle-aged women. Weaker non-significant correlations were seen among older subjects. Middle-aged men with new-onset and prevalent diabetes had higher Nt-proBNP than the reference group (FPG =5.0 mmol/L): 9.53 (p = 0.002) and 8.23 (p = 0.02) vs. 5.71 pmol/L. No differences in Nt-proBNP between categories of glucometabolic disturbance were observed among older men or women.
The results indicate an age- and gender difference in the ability of Nt-proBNP to identify myocardial dysfunction in relation to glucometabolic disturbances. Therefore, Nt-proBNP should be used with caution as a general surrogate marker for myocardial dysfunction in this setting.
BACKGROUND: The purpose of this study was to determine the incidence, risk factors and prognostic impact of anaemia and thrombocytopenia in patients with bone metastases (BM) from prostate cancer. METHODS: Retrospective cohort study including 51 consecutive patients treated at a community hospital. Twenty-nine patients (57%) received taxotere after diagnosis of BM. RESULTS: Haemoglobin (Hb)
It has been suggested that a reduced HDL particle size could be another feature of the atherogenic dyslipidemia found among viscerally obese subjects.
To investigate, in women, the relationship between HDL particle size and coronary artery disease (CAD).
Average HDL particle size was measured in a sample of 239 women on whom CAD was assessed by angiography.
Overall, women who had CAD were characterized by a deteriorated fasting metabolic risk profile, which was accompanied by smaller HDL particles compared to women without CAD (80.4???2.2?? vs. 81.5???2.7??, p?
Exposure to particulate air pollution increases respiratory and cardiovascular morbidity and mortality, especially in elderly, possibly through inflammation and vascular dysfunction.
We examined potential beneficial effects of indoor air filtration in the homes of elderly, including people taking vasoactive drugs.Forty-eight nonsmoking subjects (51 to 81 years) in 27 homes were included in this randomized, double-blind, crossover intervention study with consecutive two-week periods with or without the inclusion of a high-efficiency particle air filter in re-circulating custom built units in their living room and bedroom. We measured blood pressure, microvascular and lung function and collected blood samples for hematological, inflammation, monocyte surface and lung cell damage markers before and at day 2, 7 and 14 during each exposure scenario.
The particle filters reduced the median concentration of PM2.5 from approximately 8 to 4 µg/m3 and the particle number concentration from 7669 to 5352 particles/cm3. No statistically significant effects of filtration as category were observed on microvascular and lung function or the biomarkers of systemic inflammation among all subjects, or in the subgroups taking (n = 11) or not taking vasoactive drugs (n = 37). However, the filtration efficacy was variable and microvascular function was within 2 days significantly increased with the actual PM2.5 decrease in the bedroom, especially among 25 subjects not taking any drugs.
Substantial exposure contrasts in the bedroom and no confounding by drugs appear required for improved microvascular function by air filtration, whereas no other beneficial effect was found in this elderly population.
Cites: Am J Physiol Heart Circ Physiol. 2008 Feb;294(2):H944-5318083905
Cites: Occup Environ Med. 2008 May;65(5):319-2417704195