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Acute kidney injury and long-term risk of stroke after coronary artery bypass surgery.

https://arctichealth.org/en/permalink/ahliterature107407
Source
Int J Cardiol. 2013 Oct 15;168(6):5405-10
Publication Type
Article
Date
Oct-15-2013
Author
Martin J Holzmann
Linda Rydén
Ulrik Sartipy
Author Affiliation
Department of Emergency Medicine, Karolinska University Hospital, Stockholm, Sweden; Department of Internal Medicine, Karolinska Institutet, Stockholm, Sweden. Electronic address: martin.holzmann@karolinska.se.
Source
Int J Cardiol. 2013 Oct 15;168(6):5405-10
Date
Oct-15-2013
Language
English
Publication Type
Article
Keywords
Acute Kidney Injury - epidemiology - mortality
Age Distribution
Aged
Cerebral Hemorrhage - epidemiology - mortality
Coronary Artery Bypass - adverse effects - mortality
Coronary Artery Disease - epidemiology - mortality - surgery
Female
Follow-Up Studies
Glomerular Filtration Rate
Heart Failure - epidemiology - mortality
Humans
Incidence
Male
Middle Aged
Prognosis
Proportional Hazards Models
Registries - statistics & numerical data
Risk factors
Sex Distribution
Stroke - epidemiology - mortality
Sweden - epidemiology
Abstract
Acute kidney injury (AKI) is associated with death, end-stage renal disease, and heart failure in patients with coronary heart disease. This study investigated the association between AKI and long-term risk of stroke.
50,244 patients who underwent coronary artery bypass grafting (CABG) in Sweden between 2000 and 2008 were identified from the SWEDEHEART registry. After exclusions 23,584 patients without prior stroke who underwent elective, primary, isolated, CABG were included. AKI was categorized according to absolute increases in postoperative creatinine values compared with preoperative values: stage 1, 0.3-0.5 mg/dL (26-44 µmol/L); stage 2, 0.5-1.0mg/dL (44-88 µmol/L); and stage 3, >1.0 mg/dL (=88 µmol/L). Cox proportional hazards regression was used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) for stroke. There were 1156 (4.9%) strokes during a mean follow-up of 4.1 years. After adjustment for confounders, HRs (95% CIs) for stroke in AKI stages 1, 2 and 3 were 1.12 (0.89-1.39), 1.31 (1.04-1.66) and 1.31 (0.92-1.87), respectively, compared with no AKI. This association disappeared after taking death into account in competing risk analysis. There was a significant association between AKI and stroke in men (HR: 1.26 [1.05-1.50]) but not in women (HR: 1.07 [0.75-1.53]), and in younger (
PubMed ID
24012170 View in PubMed
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Association between warfarin combined with serotonin-modulating antidepressants and increased case fatality in primary intracerebral hemorrhage: a population-based study.

https://arctichealth.org/en/permalink/ahliterature256819
Source
J Neurosurg. 2014 Jun;120(6):1358-63
Publication Type
Article
Date
Jun-2014
Author
Pekka Löppönen
Sami Tetri
Seppo Juvela
Juha Huhtakangas
Pertti Saloheimo
Michaela K Bode
Matti Hillbom
Author Affiliation
Departments of Neurosurgery.
Source
J Neurosurg. 2014 Jun;120(6):1358-63
Date
Jun-2014
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Anticoagulants - adverse effects - therapeutic use
Antidepressive Agents - adverse effects - therapeutic use
Cerebral Hemorrhage - epidemiology - mortality
Depression - drug therapy
Drug Therapy, Combination
Female
Finland - epidemiology
Humans
Kaplan-Meier Estimate
Male
Retrospective Studies
Risk factors
Serotonin Uptake Inhibitors - adverse effects - therapeutic use
Stroke - prevention & control
Survival Rate
Treatment Outcome
Warfarin - adverse effects - therapeutic use
Abstract
Patients receiving oral anticoagulants run a higher risk of cerebral hemorrhage with a poor outcome. Serotonin-modulating antidepressants (selective serotonin reuptake inhibitors [SSRIs], serotonin-norepinephrine reuptake inhibitors [SNRIs]) are frequently used in combination with warfarin, but it is unclear whether this combination of drugs influences outcome after primary intracerebral hemorrhage (PICH). The authors investigated case fatality in PICH among patients from a defined population who were receiving warfarin alone, with aspirin, or with serotonin-modulating antidepressants.
Nine hundred eighty-two subjects with PICH were derived from the population of Northern Ostrobothnia, Finland, for the years 1993-2008, and those with warfarin-associated PICH were eligible for analysis. Their hospital records were reviewed, and medication data were obtained from the national register of prescribed medicines. Kaplan-Meier survival curves were drawn to illustrate cumulative case fatality, and a Cox proportional-hazards analysis was performed to demonstrate predictors of death.
Of the 176 patients eligible for analysis, 17 had been taking aspirin and 19 had been taking SSRI/SNRI together with warfarin. The 30-day case fatality rates were 50.7%, 58.8%, and 78.9%, respectively, for those taking warfarin alone, with aspirin, or with SSRI/SNRI (p = 0.033, warfarin plus SSRI/SNRI compared with warfarin alone). Warfarin combined with SSRI/SNRI was a significant independent predictor of case fatality (adjusted HR 2.10, 95% CI 1.13-3.92, p = 0.019).
Concurrent use of warfarin and a serotonin-modulating antidepressant, relative to warfarin alone, seemed to increase the case fatality rate for PICH. This finding should be taken into account if hematoma evacuation is planned.
PubMed ID
24506245 View in PubMed
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Eleven-year trends of stroke in Turku, Finland.

https://arctichealth.org/en/permalink/ahliterature185705
Source
Neuroepidemiology. 2003 May-Jun;22(3):196-203
Publication Type
Article
Author
Pirjo Immonen-Räihä
Cinzia Sarti
Jaakko Tuomilehto
Jorma Torppa
Aapo Lehtonen
Juhani Sivenius
Annikki Mononen
Erkki Vihtori Narva
Author Affiliation
General Practice, Raisio Region Hospital, University of Turku, Turku, Finland. pirjo.immonen-raiha@tyks.fi
Source
Neuroepidemiology. 2003 May-Jun;22(3):196-203
Language
English
Publication Type
Article
Keywords
Adult
Age Distribution
Aged
Aged, 80 and over
Cerebral Hemorrhage - epidemiology - mortality
Female
Finland
Humans
Male
Middle Aged
Sex Distribution
Stroke - epidemiology - mortality
Subarachnoid Hemorrhage - epidemiology - mortality
Time Factors
Abstract
The Turku Stroke Register included stroke events at all ages during the years 1982-1992. The incidence of stroke declined in all age groups, even in the oldest one. An even steeper decline was observed in mortality from stroke. Ischemic strokes contributed most to the observed decline, while subarachnoid and intracerebral hemorrhage showed mainly flat trends. Flat trends were also observed for recurrent strokes. The absolute number of strokes remained stable through the study years, but the population above 75 years of age doubled. More than half of the strokes occurred in people aged 75 years or older, and three fourths of them occurred in women. The incidence and mortality rate of ischemic stroke declined steeply in all age groups. Due to an increase in elderly people in the background population, the total number of strokes remained stable. Thus, in spite of the observed declining trends in incidence, the need for stroke care has not diminished.
PubMed ID
12711852 View in PubMed
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Impact of preadmission treatment with calcium channel blockers or beta blockers on short-term mortality after stroke: a nationwide cohort study.

https://arctichealth.org/en/permalink/ahliterature271794
Source
BMC Neurol. 2015;15:24
Publication Type
Article
Date
2015
Author
Jens Sundbøll
Morten Schmidt
Erzsébet Horváth-Puhó
Christian F Christiansen
Lars Pedersen
Hans Erik Bøtker
Henrik T Sørensen
Source
BMC Neurol. 2015;15:24
Date
2015
Language
English
Publication Type
Article
Keywords
Adrenergic beta-Antagonists - therapeutic use
Aged
Aged, 80 and over
Calcium Channel Blockers - therapeutic use
Cardiovascular Diseases - drug therapy - epidemiology
Cerebral Hemorrhage - epidemiology - mortality
Cohort Studies
Comorbidity
Denmark - epidemiology
Female
Humans
Male
Middle Aged
Prognosis
Proportional Hazards Models
Registries
Risk factors
Stroke - epidemiology - mortality
Subarachnoid Hemorrhage - epidemiology - mortality
Abstract
The prognostic impact of preadmission use of calcium channel blockers (CCBs) and beta blockers (BBs) on stroke mortality remains unclear. We aimed to examine whether preadmission use of CCBs or BBs was associated with improved short-term mortality following ischemic stroke, intracerebral hemorrhage (ICH), or subarachnoid hemorrhage (SAH).
We conducted a nationwide population-based cohort study using Danish medical registries. We identified all patients with a first-time inpatient diagnosis of stroke between 2004 and 2012 and their comorbidities. We defined CCB/BB use as current use, former use, or non-use. Current use was further classified as new or long-term use. We used Cox regression modeling to compute 30-day mortality rate ratios (MRRs) with 95% confidence intervals (CIs), controlling for potential confounders.
We identified 100,043 patients with a first-time stroke. Of these, 83,736 (83.7%) patients had ischemic stroke, 11,779 (11.8%) had ICH, and 4,528 (4.5%) had SAH. Comparing current users of CCBs or BBs with non-users, we found no association with mortality for ischemic stroke [adjusted 30-day MRR?=?0.99 (95% CI: 0.94-1.05) for CCBs and 1.01 (95% CI: 0.96-1.07) for BBs], ICH [adjusted 30-day MRR?=?1.05 (95% CI: 0.95-1.16) for CCBs and 0.95 (95% CI: 0.87-1.04) for BBs], or SAH [adjusted 30-day MRR?=?1.05 (95% CI: 0.85-1.29) for CCBs and 0.89 (95% CI: 0.72-1.11) for BBs]. Former use of CCBs or BBs was not associated with mortality.
Preadmission use of CCBs or BBs was not associated with 30-day mortality following ischemic stroke, ICH, or SAH.
Notes
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PubMed ID
25884780 View in PubMed
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Intracerebral hemorrhage in southern Norway--a hospital-based incidence study.

https://arctichealth.org/en/permalink/ahliterature125999
Source
Eur Neurol. 2012;67(4):240-5
Publication Type
Article
Date
2012
Author
Arnstein Tveiten
Unn Ljøstad
Ase Mygland
Lars Thomassen
Are Hugo Pripp
Halvor Naess
Author Affiliation
Department of Neurology, Sørlandet Sykehus Kristiansand, Kristiansand, Norway. arnstein.tveiten@sshf.no
Source
Eur Neurol. 2012;67(4):240-5
Date
2012
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Cerebral Hemorrhage - epidemiology - mortality
Cohort Studies
Female
Hospitals - statistics & numerical data
Humans
International Classification of Diseases
Male
Middle Aged
Norway - epidemiology
Retrospective Studies
Risk factors
Sex Factors
Tomography, X-Ray Computed
Abstract
Newer Scandinavian data on intracerebral hemorrhage (ICH) are scarce. We aimed at providing updated community-based data on the incidence, characteristics and outcome of ICH leading to hospitalization in the southernmost region in Norway.
We analyzed data from all consecutive patients hospitalized with a first-ever ICH in the five-year period 2005-2009 in a well-defined area served by one single hospital. Cases were found by computerized search in a register covering all in- and outpatients.
Adjusted to the standard European population the annual incidence rate per 100,000 was 16.9 for men, 8.8 for women (p
PubMed ID
22433160 View in PubMed
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Physical activity and stroke risk: a meta-analysis.

https://arctichealth.org/en/permalink/ahliterature71250
Source
Stroke. 2003 Oct;34(10):2475-81
Publication Type
Article
Date
Oct-2003
Author
Chong Do Lee
Aaron R Folsom
Steven N Blair
Author Affiliation
Department of Sports and Exercise Sciences, West Texas A&M University, Canyon, TX 79016, USA. CLee@wtamu.edu
Source
Stroke. 2003 Oct;34(10):2475-81
Date
Oct-2003
Language
English
Publication Type
Article
Keywords
Aged
Australia - epidemiology
Brain Ischemia - epidemiology - mortality - prevention & control
Case-Control Studies
Cerebral Hemorrhage - epidemiology - mortality - prevention & control
Cerebrovascular Accident - epidemiology - mortality - prevention & control
Cohort Studies
England - epidemiology
Female
Humans
Iceland - epidemiology
Incidence
Italy - epidemiology
Japan - epidemiology
Male
Middle Aged
Motor Activity
Netherlands - epidemiology
Norway - epidemiology
Odds Ratio
Physical Fitness
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Risk
Risk Reduction Behavior
United States - epidemiology
Abstract
BACKGROUND AND PURPOSE: Whether physical activity reduces stroke risk remains controversial. We used a meta-analysis to examine the overall association between physical activity or cardiorespiratory fitness and stroke incidence or mortality. METHODS: We searched MEDLINE from 1966 to 2002 and identified 23 studies (18 cohort and 5 case-control) that met inclusion criteria. We estimated the overall relative risk (RR) of stroke incidence or mortality for highly and moderately active individuals versus individuals with low levels of activity using the general variance-based method. RESULTS: The meta-analysis documented that there was a reduction in stroke risk for active or fit individuals compared with inactive or unfit persons in cohort, case-control, and both study types combined. For cohort studies, highly active individuals had a 25% lower risk of stroke incidence or mortality (RR=0.75; 95% CI, 0.69 to 0.82) compared with low-active individuals. For case-control studies, highly active individuals had a 64% lower risk of stroke incidence (RR=0.36; 95% CI, 0.25 to 0.52) than their low-active counterparts. When we combined both the cohort and case-control studies, highly active individuals had a 27% lower risk of stroke incidence or mortality (RR=0.73; 95% CI, 0.67 to 0.79) than did low-active individuals. We observed similar results in moderately active individuals compared with inactive persons (RRs were 0.83 for cohort, 0.52 for case-control, and 0.80 for both combined). Furthermore, moderately and highly active individuals had lower risk of both ischemic and hemorrhagic strokes than low-active individuals. CONCLUSIONS: We conclude that moderate and high levels of physical activity are associated with reduced risk of total, ischemic, and hemorrhagic strokes.
Notes
Comment In: Stroke. 2003 Oct;34(10):2481-214512585
Comment In: Stroke. 2004 Apr;35(4):e79-80; author reply e79-8015001792
PubMed ID
14500932 View in PubMed
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Seasonal patterns of incidence and case fatality of stroke in Malmo, Sweden: the STROMA study.

https://arctichealth.org/en/permalink/ahliterature178127
Source
Neuroepidemiology. 2005;24(1-2):26-31
Publication Type
Article
Date
2005
Author
Farhad Ali Khan
Gunnar Engstrom
Ingela Jerntorp
Hélène Pessah-Rasmussen
Lars Janzon
Author Affiliation
Department of Community Medicine, Malmö University Hospital, Malmö, Sweden. farhard.khan@smi.mas.lu.se
Source
Neuroepidemiology. 2005;24(1-2):26-31
Date
2005
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Cerebral Hemorrhage - epidemiology - mortality
Cerebral Infarction - epidemiology - mortality
Female
Humans
Male
Middle Aged
Registries
Seasons
Stroke - epidemiology - mortality
Subarachnoid Hemorrhage - epidemiology - mortality
Sweden - epidemiology
Urban Population
Abstract
Studies on the temporal variation in stroke incidence have reported inconsistent results. Few have studied the temporal variations in case fatality. No study on incidence and case fatality of stroke by season in Sweden has been found. This study explores the weekly, monthly and seasonal variations in incidence and 28-day case fatality of stroke.
A total of 7,129 patients with first-ever stroke during the period 1989-1999 were retrieved from the Stroke Register of Malmo, Sweden. chi(2) test was performed to test the seasonal differences and Poisson regression analysis was used to calculate the case fatality ratios adjusted for sex and age.
The stroke cases were on the whole randomly distributed over the study period of 4,017 days. Incidence of all types of stroke, intracerebral hemorrhage and subarachnoid hemorrhage showed no variation by season, month or weekday, but incidence of cerebral infarction for the total population was higher in autumn and winter. Twenty-eight-day case fatality (930 fatal events, 13%) clustered significantly over the study period. Winter emerged as the peak season among men (12.5%), women (17.2%) and total population (15.1%). No consistent variation of incidence and case fatality of stroke by month or weekday was found.
Case fatality after stroke demonstrates a seasonal variation with a peak in winter. Incidence of stroke showed no consistent association with season, month or weekday.
PubMed ID
15459506 View in PubMed
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Stroke hospitalization trends of the working-aged in Finland.

https://arctichealth.org/en/permalink/ahliterature298047
Source
PLoS One. 2018; 13(8):e0201633
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
2018
Author
Jussi O T Sipilä
Jussi P Posti
Jori O Ruuskanen
Päivi Rautava
Ville Kytö
Author Affiliation
Department of Neurology, North Karelia Central Hospital, Siun Sote, Joensuu, Finland.
Source
PLoS One. 2018; 13(8):e0201633
Date
2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adult
Age Distribution
Cerebral Hemorrhage - epidemiology - mortality
Female
Finland - epidemiology
Hospital Mortality - trends
Hospitalization - trends
Humans
Length of Stay
Male
Middle Aged
Sex Factors
Stroke - epidemiology - mortality
Subarachnoid Hemorrhage - epidemiology - mortality
Young Adult
Abstract
The age-standardized incidence of stroke has decreased globally but, for reasons unknown, conflicting results have been observed regarding trend in incidence of major stroke subtypes in young adults. We studied these trends among people of working age in a population-based setting in Finland, where cardiovascular risk factor profiles have developed favorably.
All hospitalizations for stroke in 2004-2005 and 2013-2014 for persons 18-64 years of age were identified from a national register. The search included all hospitals that provide acute stroke care on mainland Finland.
Hospitalizations for both intracerebral hemorrhage (ICH; -15.2%; p = 0.0008) and subarachnoid hemorrhage (SAH; -26.5%; p
PubMed ID
30067825 View in PubMed
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12 records – page 1 of 2.