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Abnormal glucose regulation in patients with acute ST- elevation myocardial infarction-a cohort study on 224 patients.

https://arctichealth.org/en/permalink/ahliterature90209
Source
Cardiovasc Diabetol. 2009;8:6
Publication Type
Article
Date
2009
Author
Knudsen Eva C
Seljeflot Ingebjørg
Abdelnoor Michael
Eritsland Jan
Mangschau Arild
Arnesen Harald
Andersen Geir O
Author Affiliation
Center for Clinical Heart Research, Ullevål University Hospital, University of Oslo, Oslo, Norway. evacecilie.knudsen@ulleval.no
Source
Cardiovasc Diabetol. 2009;8:6
Date
2009
Language
English
Publication Type
Article
Keywords
Blood Glucose - analysis
Cohort Studies
Comorbidity
Diabetes Mellitus, Type 2 - blood - diagnosis - epidemiology
Diagnostic Tests, Routine
Fasting - blood
Female
Follow-Up Studies
Glucose Intolerance - blood - diagnosis - epidemiology
Glucose Tolerance Test
Hemoglobin A, Glycosylated - analysis
Humans
Male
Middle Aged
Myocardial Infarction - blood - epidemiology
Norway - epidemiology
Practice Guidelines as Topic
Predictive value of tests
Prevalence
Prospective Studies
Reproducibility of Results
Risk factors
Unnecessary Procedures
Abstract
BACKGROUND: A high prevalence of impaired glucose tolerance and unknown type 2-diabetes in patients with coronary heart disease and no previous diagnosis of diabetes have been reported. The aims of the present study were to investigate the prevalence of abnormal glucose regulation (AGR) 3 months after an acute ST-elevation myocardial infarction (STEMI) in patients without known glucometabolic disturbance, to evaluate the reliability of a 75-g oral glucose tolerance test (OGTT) performed very early after an acute STEMI to predict the presence of AGR at 3 months, and to study other potential predictors measured in-hospital for AGR at 3 months. METHODS: This was an observational cohort study prospectively enrolling 224 STEMI patients treated with primary PCI. An OGTT was performed very early after an acute STEMI and was repeated in 200 patients after 3 months. We summarised the exact agreement observed, and assessed the observed reproducibility of the OGTTs performed in-hospital and at follow up. The patients were classified into glucometabolic categories defined according to the World Health Organisation criteria. AGR was defined as the sum of impaired fasting glucose, impaired glucose tolerance and type 2-diabetes. RESULTS: The prevalence of AGR at three months was 24.9% (95% CI 19.1, 31.4%), reduced from 46.9% (95% CI 40.2, 53.6) when measured in-hospital. Only, 108 of 201 (54%) patients remained in the same glucometabolic category after a repeated OGTT. High levels of HbA1c and admission plasma glucose in-hospital significantly predicted AGR at 3 months (p
PubMed ID
19183453 View in PubMed
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Admission blood glucose and short term survival in primary intracerebral haemorrhage: a population based study.

https://arctichealth.org/en/permalink/ahliterature176129
Source
J Neurol Neurosurg Psychiatry. 2005 Mar;76(3):349-53
Publication Type
Article
Date
Mar-2005
Author
R. Fogelholm
K. Murros
A. Rissanen
S. Avikainen
Author Affiliation
Pappilantie 10 B 8, 02400 Kirkkonummi, Finland. r.fogel@kolumbus.fi
Source
J Neurol Neurosurg Psychiatry. 2005 Mar;76(3):349-53
Date
Mar-2005
Language
English
Publication Type
Article
Keywords
Aged
Blood Glucose - analysis
Cerebral Hemorrhage - mortality - pathology
Diabetes Complications - mortality - pathology
Epidemiologic Studies
Female
Finland - epidemiology
Humans
Male
Predictive value of tests
Prognosis
Retrospective Studies
Severity of Illness Index
Survival Analysis
Abstract
The role of admission blood glucose level on the prognosis of patients with intracerebral haemorrhage has not been elucidated.
To examine this association on the basis of an epidemiologically representative patient material.
249 500 people living in the catchment area of the Central Hospital of Central Finland. The diagnosis of ICH was established if verified by cranial computed tomography (CT) or autopsy.
Of the 416 patients who fulfilled the diagnostic criteria, 30 died before admission and 386 were admitted to the Central Hospital. All 329 patients (290 nondiabetics and 39 diabetics) with both admission blood glucose and cranial CT data were included in the study. The mean blood glucose level was 10.6 mmol/l for nondiabetics who died on the day of onset, 8.6 mmol/l for those dying during days 1 to 28, and 6.8 mmol/l for the 28 day survivors. The corresponding figures for diabetics were 13.9 mmol/l, 12.5 mmol/l, and 9.3 mmol/l. In both nondiabetics and diabetics, patients who died had significantly higher mean glucose than the 28 day survivors (p
Notes
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PubMed ID
15716524 View in PubMed
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Age and follow-up time affect the prognostic value of the ECG and conventional cardiovascular risk factors for stroke in adult men.

https://arctichealth.org/en/permalink/ahliterature162462
Source
J Epidemiol Community Health. 2007 Aug;61(8):704-12
Publication Type
Article
Date
Aug-2007
Author
Christina Ström Möller
Jonas Häggström
Björn Zethelius
Bernice Wiberg
Johan Sundström
Lars Lind
Author Affiliation
Department of Public Health and Caring Sciences, Section of Geriatrics, Uppsala Science Park, SE-751 85 Uppsala, Sweden. christina.strom_moller@pubcare.uu.se
Source
J Epidemiol Community Health. 2007 Aug;61(8):704-12
Date
Aug-2007
Language
English
Publication Type
Article
Keywords
Aged
Atrial Fibrillation - complications - epidemiology - physiopathology
Blood Glucose - analysis
Blood Pressure - physiology
Cardiovascular Diseases - epidemiology - physiopathology
Electrocardiography - methods
Humans
Incidence
Insulin - blood
Longitudinal Studies
Male
Middle Aged
Myocardial Ischemia - epidemiology - physiopathology
Predictive value of tests
Prognosis
Risk factors
Smoking - adverse effects - physiopathology
Stroke - epidemiology - etiology
Sweden - epidemiology
Abstract
To explore whether the predictive power of mid-life ECG abnormalities and conventional cardiovascular risk factors for future stroke change over a 30-year follow-up period, and whether a repeated examination improves their predictive power.
Longitudinal population-based study.
2,322 men aged 50 years, with a follow-up period of 30 years. 1,221 subjects were re-examined at age 70 years
Risk for fatal and non-fatal stroke during three decades of follow-up. Investigations included resting ECG and traditional cardiovascular risk factors.
When measured at age 50 years, ST segment depression and T wave abnormalities, together with ECG-left ventricular hypertrophy, were of importance only during the first 20 years, but regained importance when re-measured at age 70 years. Blood pressure was a significant predictor for stroke over all three decades of follow-up. In elderly people only, there is evidence that apolipoprotein A1 may protect from future stroke.
Mid-life values for blood pressure and ECG abnormalities retain their predictive value over long follow-up periods even though they improved in predictive power when re-measured in elderly people. Despite lower prevalence, ECG abnormalities had greater impact at age 50 years than at age 70 years. By contrast, apolipoprotein A1 was protective for future stroke only at age 70 years.
Notes
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PubMed ID
17630370 View in PubMed
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Age and gender differences in the association between Nt-proBNP and glucometabolic disturbances.

https://arctichealth.org/en/permalink/ahliterature134279
Source
Scand Cardiovasc J. 2011 Oct;45(5):294-300
Publication Type
Article
Date
Oct-2011
Author
Margret Leosdottir
Ronnie Willenheimer
Christian Hall
Solve Tjora
Johan Malm
Olle Melander
Peter M Nilsson
Author Affiliation
Department of Cardiology, Skane University Hospital, Malmö, Sweden. Margret.Leosdottir@med.lu.se
Source
Scand Cardiovasc J. 2011 Oct;45(5):294-300
Date
Oct-2011
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Biological Markers - blood
Blood Glucose - analysis
Cross-Sectional Studies
Fasting - blood
Female
Glucose Metabolism Disorders - blood - diagnosis
Heart Diseases - blood - diagnosis - physiopathology
Humans
Linear Models
Male
Middle Aged
Natriuretic Peptide, Brain - blood
Peptide Fragments - blood
Predictive value of tests
Sex Factors
Sweden
Abstract
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.
PubMed ID
21604967 View in PubMed
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Assessment of Traub formula and ketone bodies in cause of death investigations.

https://arctichealth.org/en/permalink/ahliterature106879
Source
Int J Legal Med. 2013 Nov;127(6):1131-7
Publication Type
Article
Date
Nov-2013
Author
Terhi Keltanen
Antti Sajantila
Jukka U Palo
Teija Partanen
Tiina Valonen
Katarina Lindroos
Author Affiliation
Laboratory of Forensic Biology, Department of Forensic Medicine, Hjelt Institute, PO Box 40, FI-00014, University of Helsinki, Finland, terhi.keltanen@helsinki.fi.
Source
Int J Legal Med. 2013 Nov;127(6):1131-7
Date
Nov-2013
Language
English
Publication Type
Article
Keywords
3-Hydroxybutyric Acid - blood
Acetoacetates - blood
Acetone - blood
Alcoholism - blood - pathology
Algorithms
Autopsy
Biological Markers - blood
Blood Glucose - analysis
Cause of Death
Diabetes Mellitus - blood - pathology
Diabetic Ketoacidosis - blood - pathology
Diagnosis, Differential
Finland
Hemoglobin A, Glycosylated - analysis
Humans
Hyperglycemia - blood - pathology
Ketone Bodies - blood
Lactic Acid - blood
Postmortem Changes
Predictive value of tests
Abstract
Diabetes and alcohol abuse may cause severe metabolic disturbances that can be fatal. These may be difficult to diagnose in autopsies based solely on macroscopical and histological findings. In such cases, metabolic markers, such as postmortem glucose and ketone levels, can provide supporting information. Glucose or combined glucose and lactate, the Traub value, is often used to indicate hyperglycemia. The use of the Traub value, however, has been questioned by some, because the lactate levels are known to elevate in postmortem samples also due to other reasons than glycolysis of glucose molecules. Ketoacidosis can be detected by analyzing ketone body levels, especially beta-hydroxybutyric acid (BHB). Acetone is also elevated in severe cases of ketoacidosis. Here, we have evaluated the value of these biomarkers for postmortem determination of the metabolic disturbances. Retrospective data of 980 medico-legal autopsies performed in Finland, where glucose, lactate and ketone bodies were analyzed, was collected. Our findings show that the Traub value indicates hyperglycemia, even when glucose levels are low. For diagnosis, evaluation of complementing markers, e.g. ketone bodies and glycated hemoglobin is needed. Our results show that BHB can be used for screening and diagnosis of ketoacidosis. Acetone alone is not sufficient, since it is elevated only in the most severe cases. We also found that alcohol abuse rarely causes severe ketoacidosis. However, sporadic cases do exist where ketone body levels are extremely high. Despite this, alcoholic ketoacidosis is very rarely diagnosed as the cause of death.
PubMed ID
24091723 View in PubMed
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Association between stimulated plasma C-peptide and age: the Wadena City Health Study.

https://arctichealth.org/en/permalink/ahliterature73500
Source
J Am Geriatr Soc. 1992 Apr;40(4):309-15
Publication Type
Article
Date
Apr-1992
Author
L R French
F C Goetz
A M Martinez
J R Boen
S A Bushhouse
J M Sprafka
Author Affiliation
Chronic Disease and Environmental Epidemiology Section, Minnesota Department of Health.
Source
J Am Geriatr Soc. 1992 Apr;40(4):309-15
Date
Apr-1992
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Aging - blood - metabolism - urine
Blood Glucose - analysis
Body mass index
C-Peptide - blood - urine
Cholesterol - blood
Creatinine - blood - urine
Cross-Sectional Studies
Eating - physiology
Fasting
Fatty Acids, Nonesterified - blood
Female
Hemoglobin A, Glycosylated - analysis
Hemoglobins - analysis
Humans
Least-Squares Analysis
Linear Models
Lipoproteins - blood
Male
Middle Aged
Minnesota
Predictive value of tests
Research Support, U.S. Gov't, P.H.S.
Sex Factors
Triglycerides - blood
Abstract
OBJECTIVE: To assess age-related changes in stimulated plasma C-peptide in a population-based sample of adults. DESIGN: Cross-sectional study. SETTING: Wadena, Minnesota, a city of 4,699 residents (1980 census) in west central Minnesota, approximately 150 miles from Minneapolis/St. Paul. STUDY SUBJECTS: 344 non-diabetic subjects (NDDG standards) from a stratified random sample of the total adult population of Wadena, MN. The six-study strata were men and women from three age groups: young, 20-39 years of age; middle-aged, 40-59; and older, greater than 60 years of age. MEASUREMENTS: During a liquid meal of Ensure-Plus (Ensure-Plus challenge test; EPCT; Ross Laboratories), blood samples were taken for glucose, free fatty acids, creatinine, and C-peptide. Plasma C-peptide taken 90 minutes after the EPCT was used as a surrogate measure for insulin. Clinical tests included one-time samples for hemoglobin, glycosylated hemoglobin, plasma cholesterol, triglycerides, and lipoproteins. Physical measurements included height, weight, and blood pressure. Urine was assayed for C-peptide and creatinine. Assays of urine and plasma C-peptide used antibody M1221 (from Novo; Copenhagen, Denmark). MAIN RESULTS: No differences were observed for the relationship between age and C-peptide within each of the three age groups for men and the three age groups for women. However, the levels of plasma C-peptide for older men or women were statistically significantly higher than levels for the young age groups of the same sex; fasting plasma glucose also was higher for older groups of both sexes, and postmeal glucose was significantly higher for older women. There were decreases with age in urine C-peptide clearance for women and men; the decline for women was statistically significant. In multiple regression models for men alone and women alone, that controlled for age, post-meal plasma glucose best explained plasma C-peptide levels. For young men, plasma glucose alone provided the best prediction of plasma C-peptide levels; body mass index (BMI) and plasma glucose provided the best prediction for young women. For older men and both middle-aged and older women, a combination of urine C-peptide clearance and plasma glucose best predicted plasma C-peptide levels; for middle-aged men, BMI also contributed to the prediction. CONCLUSIONS: Secretion of insulin in response to an orally administered mixed meal is undiminished with age in non-diabetic adults.
PubMed ID
1556356 View in PubMed
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Cardiometabolic profile of people screened for high risk of type 2 diabetes in a national diabetes prevention programme (FIN-D2D).

https://arctichealth.org/en/permalink/ahliterature138828
Source
Prim Care Diabetes. 2010 Dec;4(4):231-9
Publication Type
Article
Date
Dec-2010
Author
Timo Saaristo
Leena Moilanen
Jari Jokelainen
Eeva Korpi-Hyövälti
Mauno Vanhala
Juha Saltevo
Leo Niskanen
Markku Peltonen
Heikki Oksa
Henna Cederberg
Jaakko Tuomilehto
Matti Uusitupa
Sirkka Keinänen-Kiukaanniemi
Author Affiliation
Pirkanmaa Hospital District, Tampere, Finland. timo.saaristo@pshp.fi
Source
Prim Care Diabetes. 2010 Dec;4(4):231-9
Date
Dec-2010
Language
English
Publication Type
Article
Keywords
Adult
Aged
Analysis of Variance
Blood Glucose - analysis
Cardiovascular Diseases - epidemiology
Chi-Square Distribution
Diabetes Mellitus, Type 2 - blood - diagnosis - epidemiology - prevention & control
Diabetes, Gestational - blood - epidemiology
Female
Finland
Glucose Intolerance - blood - epidemiology
Glucose Tolerance Test
Humans
Male
Mass Screening - methods
Middle Aged
National Health Programs
Predictive value of tests
Pregnancy
Primary Health Care
Risk assessment
Risk factors
Abstract
To study screening of high-risk individuals as part of a national diabetes prevention programme in primary health care settings in Finland between 2003 and 2007, and evaluate the cardiometabolic risk profile of persons identified for intervention.
High-risk individuals were identified by the Finnish Diabetes Risk Score (FINDRISC), history of impaired fasting glucose (IFG), impaired glucose tolerance (IGT), cardiovascular disease (CVD), or gestational diabetes. Participants subsequently underwent an oral glucose tolerance test. CVD morbidity risk was estimated by the Framingham Study Risk Equation and CVD mortality risk by the Systematic Coronary Risk Evaluation Formula (SCORE).
A high-risk cohort of 10,149 (of whom 30.3% men) was identified (mean age 54.7 for men, 53.0 for women). Altogether 18.8% of men and 11.5% of women had screen-detected diabetes. In total 68.1% of men and 49.4% of women had abnormal glucose tolerance (IFG, IGT or screen-detected diabetes). Furthermore, 43.2% and 41.5% of men, and 13.3% and 11.3% of women, respectively, had a high predicted risk of CVD morbidity or mortality.
Prevalence of dysglycemia including undiagnosed diabetes and the predicted risk for CVD was alarmly high in the identified high-risk cohort, particularly in men.
PubMed ID
21134669 View in PubMed
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Comparison of different stepwise screening strategies for type 2 diabetes: Finding from Danish general practice, Addition-DK.

https://arctichealth.org/en/permalink/ahliterature141806
Source
Prim Care Diabetes. 2010 Dec;4(4):223-9
Publication Type
Article
Date
Dec-2010
Author
Else-Marie Dalsgaard
Jesper O Christensen
Mette Vinter Skriver
Knut Borch-Johnsen
Torsten Lauritzen
Annelli Sandbaek
Author Affiliation
Department of General Health, Aarhus University, Denmark. emdl@alm.au.dk
Source
Prim Care Diabetes. 2010 Dec;4(4):223-9
Date
Dec-2010
Language
English
Publication Type
Article
Keywords
Adult
Aged
Appointments and Schedules
Biological Markers - blood
Blood Glucose - analysis
Chi-Square Distribution
Cost Savings
Denmark
Diabetes Mellitus, Type 2 - blood - diagnosis - economics
Female
General Practice - economics
Glucose Tolerance Test - economics
Health Care Costs
Hemoglobin A, Glycosylated - metabolism
Humans
Male
Mass Screening - economics - methods
Middle Aged
Predictive value of tests
Questionnaires - economics
Referral and Consultation - economics
Risk assessment
Risk factors
Abstract
To examine attendance, number of people with T2DM and costs of three different stepwise screening strategies for T2DM in general practice (GP).
Diabetes risk questionnaires were mailed to individuals aged 40-69 years from 45 general practices in 2001-2002 and individuals at high risk for T2DM, were asked to contact their GP to arrange a screening test. In 2005-2006, 26 general practices were randomised into two different opportunistic screening programmes (OP-direct and OP-subsequent) and risk questionnaires were distributed to individuals aged 40-69 years during GP consultations. In the OP-direct approach, high-risk individuals were offered to start the screening during the actual consultation while high-risk individuals in the OP-subsequent approach, were invited to a screening test at a later date. We report attendance, number of people with T2DM and costs of each screening approach.
The mail-distributed approach identified 0.8% of the target population with T2DM, the OP-direct approach and the OP-subsequent approach, 0.9% and 0.5% respectively. Cost per person with T2DM was in the mail-distributed approach: € 1058, OP-direct approach: € 707 and the OP-subsequent approach: € 727.
This study indicates that opportunistic screening identifies the same level of unknown diabetes as a mail-distributed approach but with lower costs.
PubMed ID
20675208 View in PubMed
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Cumulative deficits and physiological indices as predictors of mortality and long life.

https://arctichealth.org/en/permalink/ahliterature91526
Source
J Gerontol A Biol Sci Med Sci. 2008 Oct;63(10):1053-9
Publication Type
Article
Date
Oct-2008
Author
Kulminski Alexander M
Ukraintseva Svetlana V
Culminskaya Irina V
Arbeev Konstantin G
Land Kenneth C
Akushevich Lucy
Yashin Anatoli I
Author Affiliation
Center for Population Health and Aging, Duke University Population Research Institute, Durham, NC 27708, USA. alexander.kulminski@duke.edu
Source
J Gerontol A Biol Sci Med Sci. 2008 Oct;63(10):1053-9
Date
Oct-2008
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Blood Glucose - analysis
Blood Pressure - physiology
Cholesterol - blood
Diastole - physiology
Female
Hematocrit
Humans
Longevity - physiology
Male
Middle Aged
Mortality
Predictive value of tests
Pulse
Regression Analysis
Risk factors
Abstract
We evaluated the predictive potential for long-term (24-year) survival and longevity (85+ years) of an index of cumulative deficits (DI) and six physiological indices (pulse pressure, diastolic blood pressure, pulse rate, serum cholesterol, blood glucose, and hematocrit) measured in mid- to late life (44-88 years) for participants of the 9th and 14th Framingham Heart Study examinations. For all ages combined, the DI, pulse pressure, and blood glucose are the strongest determinants of both long-term survival and longevity, contributing cumulatively to their explanation. Diastolic blood pressure and hematocrit are less significant determinants of both of these outcomes. The pulse rate is more relevant to survival, whereas serum cholesterol is more relevant to longevity. Only the DI is a significant predictor of longevity and mortality for each 5-year age group ranging from 45 to 85 years. The DI appears to be a more important determinant of long-term risks of death and longevity than are the physiological indices.
PubMed ID
18948555 View in PubMed
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The Danish Cardiovascular Screening Trial (DANCAVAS): study protocol for a randomized controlled trial.

https://arctichealth.org/en/permalink/ahliterature275754
Source
Trials. 2015;16:554
Publication Type
Article
Date
2015
Author
Axel Cosmus Pyndt Diederichsen
Lars Melholt Rasmussen
Rikke Søgaard
Jess Lambrechtsen
Flemming Hald Steffensen
Lars Frost
Kenneth Egstrup
Grazina Urbonaviciene
Martin Busk
Michael Hecht Olsen
Hans Mickley
Jesper Hallas
Jes Sanddal Lindholt
Source
Trials. 2015;16:554
Date
2015
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Algorithms
Ankle Brachial Index
Biomarkers - blood
Blood Chemical Analysis
Blood Glucose - analysis
Blood pressure
Cardiovascular Diseases - blood - diagnosis - economics - epidemiology - mortality - prevention & control
Cholesterol - blood
Clinical Protocols
Coronary Angiography
Cost-Benefit Analysis
Denmark - epidemiology
Health Care Costs
Heart rate
Humans
Male
Mass Screening - economics - methods
Predictive value of tests
Preventive Health Services - economics - methods
Prognosis
Registries
Research Design
Risk assessment
Risk factors
Sex Factors
Telemetry
Time Factors
Tomography, X-Ray Computed
Abstract
The significant increase in the average life expectancy has increased the societal challenge of managing serious age-related diseases, especially cancer and cardiovascular diseases. A routine check by a general practitioner is not sufficient to detect incipient cardiovascular disease.
Population-based randomized clinically controlled screening trial.
45,000 Danish men aged 65-74 years living on the Island of Funen, or in the surrounding communities of Vejle and Silkeborg. No exclusion criteria are used.
One-third will be invited to cardiovascular seven-faceted screening examinations at one of four locations. The screening will include: (1) low-dose non-contrast CT scan to detect coronary artery calcification and aortic/iliac aneurysms, (2) brachial and ankle blood pressure index to detect peripheral arterial disease and hypertension, (3) a telemetric assessment of the heart rhythm, and (4) a measurement of the cholesterol and plasma glucose levels. Up-to-date cardiovascular preventive treatment is recommended in case of positive findings.
To investigate whether advanced cardiovascular screening will prevent death and cardiovascular events, and whether the possible health benefits are cost effective.
Registry-based follow-up on all cause death (primary outcome), and costs after 3, 5 and 10 years (secondary outcome).
Each of the 45,000 individuals is, by EPIDATA, given a random number from 1-100. Those numbered 67+ will be offered screening; the others will act as a control group.
Only those randomized to the screening will be invited to the examination;the remaining participants will not. Numbers randomized: A total of 45,000 men will be randomized 1:2. Recruitment: Enrollment started October 2014.
A 5% reduction in overall mortality (HR=0.95), with the risk for a type 1 error=5% and the risk for a type II error=80%, is expected. We expect a 2-year enrollment, a 10-year follow-up, and a median survival of 15 years among the controls. The attendance to screening is assumed to be 70%.
The primary aim of this so far stand-alone population-based, randomized trial will be to evaluate the health benefits and costeffectiveness of using non-contrast full truncus computer tomography (CT) scans (to measure coronary artery calcification (CAC) and identify aortic/iliac aneurysms) and measurements of the ankle brachial blood pressure index (ABI) as part of a multifocal screening and intervention program for CVD in men aged 65-74. Attendance rate and compliance to initiated preventive actions must be expected to become of major importance.
Current Controlled Trials: ISRCTN12157806 (21 March 2015).
Notes
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PubMed ID
26637993 View in PubMed
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