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The AAA with a challenging neck: outcome of open versus endovascular repair with standard and fenestrated stent-grafts.

https://arctichealth.org/en/permalink/ahliterature88967
Source
J Endovasc Ther. 2009 Apr;16(2):137-46
Publication Type
Article
Date
Apr-2009
Author
Chisci Emiliano
Kristmundsson Thorarinn
de Donato Gianmarco
Resch Timothy
Setacci Francesco
Sonesson Björn
Setacci Carlo
Malina Martin
Author Affiliation
Vascular and Endovascular Surgery Unit, University of Siena, Italy. e.chisci@gmail.com
Source
J Endovasc Ther. 2009 Apr;16(2):137-46
Date
Apr-2009
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Aortic Aneurysm, Abdominal - mortality - radiography - surgery
Aortography - methods
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation - adverse effects - instrumentation - mortality
Female
Humans
Italy
Kaplan-Meiers Estimate
Male
Middle Aged
Odds Ratio
Prosthesis Design
Prosthesis Failure
Reoperation
Retrospective Studies
Risk assessment
Stents
Sweden
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Abstract
PURPOSE: To compare the outcome of endovascular aneurysm repair (EVAR) versus conventional open repair (OR) in patients with a short, angulated or otherwise challenging proximal neck. METHODS: The definition of a challenging proximal neck was based on diameter (>or=28 mm), length (or=60 degrees ), shape (reverse tapered or bulging), and thrombus lining (>50%). Between January 2005 and December 2007, 187 consecutive patients (159 men; mean age 73 years, range 48-92) operated for asymptomatic abdominal aortic aneurysm (AAA) were identified as having challenging proximal neck morphology. Of these, 61 patients were treated with OR at center I (group A), 71 with standard EVAR (group B; 45 center I, 29 center II) and 52 with fenestrated EVAR (group C) at center II. Clinical examination and computed tomography were performed at 1 month and yearly thereafter. RESULTS: There was no statistically significant difference between groups A, B, and C regarding primary technical success rate, 30-day mortality, or late AAA-related mortality. The mean length of follow-up was 19.5 months (range 0-40). Freedom from reintervention at 3 years was 91.8%, 79.7%, and 82.7% for groups A, B, and C, respectively (p = 0.042). The only statistically significant difference between standard and fenestrated EVAR was a higher incidence of late sac expansion [9 (12.2%) versus 1 (1.9%), p = 0.036] in the standard stent-graft group. Reinterventions were more frequent after EVAR (p = NS), but open reinterventions were more common after OR. Reinterventions after EVAR were related to the presence of an angulated (p = 0.039) or short neck (p = 0.024). CONCLUSION: The results of EVAR and OR were similar for AAAs with a challenging proximal neck. Endovascular reinterventions were more frequent after EVAR, particularly in patients with an angulated or short neck. Open reinterventions were more common after OR. More patients and long-term data are needed to confirm these findings.
Notes
Comment In: J Endovasc Ther. 2009 Apr;16(2):147-819456195
PubMed ID
19456190 View in PubMed
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Angiographic morphology impacts outcomes in STEMI patients with LAD occlusion.

https://arctichealth.org/en/permalink/ahliterature143251
Source
Catheter Cardiovasc Interv. 2011 Jan 1;77(1):29-34
Publication Type
Article
Date
Jan-1-2011
Author
Karin Arinell
Johan Josefsson
Anders Magnuson
Ole Fröbert
Author Affiliation
Department of Cardiology, Örebro University Hospital, Örebro, Sweden.
Source
Catheter Cardiovasc Interv. 2011 Jan 1;77(1):29-34
Date
Jan-1-2011
Language
English
Publication Type
Article
Keywords
Aged
Analysis of Variance
Angioplasty, Balloon, Coronary - adverse effects - mortality
Coronary Angiography
Coronary Occlusion - complications - mortality - radiography - therapy
Female
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Myocardial Infarction - etiology - mortality - radiography - therapy
Predictive value of tests
Proportional Hazards Models
Registries
Retrospective Studies
Risk assessment
Risk factors
Severity of Illness Index
Sweden
Time Factors
Treatment Outcome
Abstract
Acute proximal occlusion of the left anterior descendent coronary artery (LAD) is a critical medical condition often leading to heart failure and death. Our objective was to investigate how additional angiographic findings might influence prognosis.
In a single center setting by using consecutive data from the Swedish angiography and angioplasty registry (SCAAR), we identified all patients with acute myocardial infarction (AMI) related to the proximal LAD referred for primary coronary angioplasty. Clinical and angiographic data were collected from January 2004 to December 2008.
In the study period, 359 patients (mean age 67.9 ± 12.3 years, 111 women) were identified as having proximal LAD-related culprit lesion. Follow-up was up to 5.5 years. Compared to patients with LAD occlusion only, having both a small conus branch (
Notes
Comment In: Catheter Cardiovasc Interv. 2011 Jun 1;77(7):108621452225
PubMed ID
20506285 View in PubMed
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Arthroplasty as primary treatment for distal humeral fractures produces reliable results with regards to revisions and adverse events: a registry-based study.

https://arctichealth.org/en/permalink/ahliterature299856
Source
J Shoulder Elbow Surg. 2019 Apr; 28(4):e104-e110
Publication Type
Journal Article
Date
Apr-2019
Author
Jens Nestorson
Hans Rahme
Lars Adolfsson
Author Affiliation
Department of Experimental and Clinical Medicine, Linköping University, Linköping, Sweden. Electronic address: jens.nestorson@regionostergotland.se.
Source
J Shoulder Elbow Surg. 2019 Apr; 28(4):e104-e110
Date
Apr-2019
Language
English
Publication Type
Journal Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Arthroplasty, Replacement, Elbow - adverse effects - instrumentation
Elbow Joint - surgery
Elbow Prosthesis
Female
Hemiarthroplasty
Humans
Humeral Fractures - surgery
Kaplan-Meier Estimate
Male
Middle Aged
Proportional Hazards Models
Prosthesis Failure
Registries
Reoperation
Retrospective Studies
Sweden
Treatment Outcome
Young Adult
Abstract
Primary prosthetic replacement has become an accepted method for the treatment of complex distal humeral fractures. The present study investigated implant survival and adverse events related to this procedure based on available Swedish registries and examined the completeness of the Swedish Elbow Arthroplasty register.
Patients treated in Sweden with a primary elbow replacement due to a distal humeral fracture between 1999 and 2014 were identified through 3 different registries: The Swedish Elbow Arthroplasty Register, National Board of Health and Welfare inpatient register, and local registries of all orthopedic departments. Prosthetic survival was examined using Cox regression analysis with Kaplan-Meier plots. Adverse events, defined as medical treatment of the affected elbow besides revision, were analyzed separately. The study included 406 elbows in 405 patients, and no register was complete.
Implant survival at 10 years was 90% (95% confidence interval, 85%-96%), but only 45 patients had an observation time of 10 years or more because 46% of the patients had died, resulting in a mean observation time of 67 (standard deviation, 47) months. An increase in the use of hemiarthroplasties and a proportional decrease of total elbow arthroplasties was detected. There were 18 revisions (4%), and 26 patients (6%) experienced an adverse event, of whom 16 (4%) required surgery. The completeness of the Swedish Elbow Arthroplasty Register regarding primary arthroplasty was 81%.
Primary arthroplasty as treatment of distal humeral fractures produces reliable results with regards to revisions and other adverse events.
PubMed ID
30342824 View in PubMed
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Biochemical recurrence after robot-assisted radical prostatectomy in a European single-centre cohort with a minimum follow-up time of 5 years.

https://arctichealth.org/en/permalink/ahliterature124035
Source
Eur Urol. 2012 Nov;62(5):768-74
Publication Type
Article
Date
Nov-2012
Author
Prasanna Sooriakumaran
Leif Haendler
Tommy Nyberg
Henrik Gronberg
Andreas Nilsson
Stefan Carlsson
Abolfazl Hosseini
Christofer Adding
Martin Jonsson
Achilles Ploumidis
Lars Egevad
Gunnar Steineck
Peter Wiklund
Author Affiliation
Department of Urology, Karolinska University Hospital, Stockholm, Sweden.
Source
Eur Urol. 2012 Nov;62(5):768-74
Date
Nov-2012
Language
English
Publication Type
Article
Keywords
Aged
Confounding Factors (Epidemiology)
Disease-Free Survival
Follow-Up Studies
Hospitals, University
Humans
Kallikreins - blood
Kaplan-Meier Estimate
Male
Middle Aged
Multivariate Analysis
Neoplasm Grading
Neoplasm Staging
Proportional Hazards Models
Prostate-Specific Antigen - blood
Prostatectomy - adverse effects - methods - mortality
Prostatic Neoplasms - blood - mortality - pathology - surgery
Recurrence
Risk assessment
Risk factors
Robotics
Surgery, Computer-Assisted - adverse effects - mortality
Sweden
Time Factors
Treatment Outcome
Abstract
Robot-assisted radical prostatectomy (RARP) is an increasingly commonly used surgical treatment option for prostate cancer (PCa); however, its longer-term oncologic results remain uncertain.
To report biochemical recurrence-free survival (BRFS) outcomes for men who underwent RARP =5 yr ago at a single European centre.
A total of 944 patients underwent RARP as monotherapy for PCa from January 2002 to December 2006 at Karolinska University Hospital, Stockholm, Sweden. Standard clinicopathologic variables were recorded and entered into a secure, ethics-approved database made up of those men with registered domiciles in Stockholm. The median follow-up time was 6.3 yr (interquartile range: 5.6-7.2).
The outcome of this study was biochemical recurrence (BCR), defined as a confirmed prostate-specific antigen (PSA) of =0.2 ng/ml. Kaplan-Meier survival plots with log-rank tests, as well as Cox univariable and multivariable regression analyses, were used to determine BRFS estimates and determine predictors of PSA relapse, respectively.
The BRFS for the entire cohort at median follow-up was 84.8% (95% confidence interval [CI], 82.2-87.1); estimates at 5, 7, and 9 yr were 87.1% (95% CI, 84.8-89.2), 84.5% (95% CI, 81.8-86.8), and 82.6% (95% CI, 79.0-85.6), respectively. Nine and 19 patients died of PCa and other causes, respectively, giving end-of-follow-up Kaplan-Meier survival estimates of 98.0% (95% CI, 95.5-99.1) and 94.1% (95% CI, 90.4-96.4), respectively. Preoperative PSA >10, postoperative Gleason sum =4 + 3, pathologic T3 disease, positive surgical margin status, and lower surgeon volume were associated with increased risk of BCR on multivariable analysis. This study is limited by a lack of nodal status and tumour volume, which may have confounded our findings.
This case series from a single, high-volume, European centre demonstrates that RARP has satisfactory medium-term BRFS. Further follow-up is necessary to determine how this finding will translate into cancer-specific and overall survival outcomes.
Notes
Comment In: Eur Urol. 2012 Nov;62(5):775-6; discussion 777-822790290
PubMed ID
22633365 View in PubMed
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Breast cancer in young women and prognosis: How important are proliferation markers?

https://arctichealth.org/en/permalink/ahliterature286255
Source
Eur J Cancer. 2017 Oct;84:278-289
Publication Type
Article
Date
Oct-2017

Cardiac function in relation to rhythm outcome after intraoperative epicardial left atrial cryoablation.

https://arctichealth.org/en/permalink/ahliterature132447
Source
Scand Cardiovasc J. 2011 Dec;45(6):327-35
Publication Type
Article
Date
Dec-2011
Author
Birgitta Johansson
Birgitta Houltz
Nils Edvardsson
Henrik Scherstén
Thomas Karlsson
Birger Wandt
Eva Berglin
Author Affiliation
Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden. birgitta.ingrid.johansson@vgregion.se
Source
Scand Cardiovasc J. 2011 Dec;45(6):327-35
Date
Dec-2011
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Atrial Fibrillation - complications - diagnosis - mortality - physiopathology - surgery
Atrial Flutter - etiology - physiopathology
Atrial Function, Left
Case-Control Studies
Coronary Artery Bypass - adverse effects - mortality
Coronary Artery Disease - complications - mortality - physiopathology - surgery
Cryosurgery - adverse effects - mortality
Echocardiography, Doppler
Electrocardiography
Female
Heart Atria - physiopathology - surgery
Humans
Kaplan-Meier Estimate
Logistic Models
Male
Middle Aged
Pericardium - physiopathology - surgery
Predictive value of tests
Recurrence
Risk assessment
Risk factors
Sweden
Time Factors
Treatment Outcome
Ventricular Function, Left
Abstract
To assess the effects of intraoperative left atrial epicardial cryoablation on rhythm and atrial and ventricular function.
Thirty five patients with coronary artery disease and documented atrial fibrillation underwent coronary artery bypass surgery and concomitant cryoablation. An age and gender matched control group of 35 patients with atrial fibrillation underwent bypass surgery alone. Echocardiography was performed 9 ? 32 days before and 22 ? 6 months after surgery.
The proportion of patients in sinus rhythm at follow-up was 63% and 34% (p = 0.04) in the cryoablation and control groups, respectively. In patients with sinus rhythm both before surgery and at follow-up, the left atrial area increased (p = 0.002) and the mitral annular excursion during atrial contraction decreased (p = 0.01) after cryoablation. The mitral flow velocity during atrial systole decreased after cryoablation (p = 0.002). The LV diameter increased (p = 0.03) and the left ventricular ejection fraction (LVEF) decreased (p = 0.03) in cryoablated but not in control patients. Continued deterioration was seen in patients with atrial fibrillation both pre- and postoperatively.
At long-term follow-up, a significantly higher proportion of patients was in sinus rhythm in the cryoablation than in the control group. The atrial and ventricular function had decreased at follow-up two years after surgery. This decrease was small and occurred within or close to the reference values in patients with sinus rhythm at follow-up, while patients remaining in atrial fibrillation showed a significant continued deterioration. Some subgroups were small, and the findings, although statistically significant, should be interpreted with caution.
Notes
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Cites: J Am Coll Cardiol. 2001 May;37(6):1622-711345375
PubMed ID
21815868 View in PubMed
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Cardiovascular disease and mortality in patients with type 2 diabetes after bariatric surgery in Sweden: a nationwide, matched, observational cohort study.

https://arctichealth.org/en/permalink/ahliterature275224
Source
Lancet Diabetes Endocrinol. 2015 Nov;3(11):847-54
Publication Type
Article
Date
Nov-2015
Author
Björn Eliasson
Vasileios Liakopoulos
Stefan Franzén
Ingmar Näslund
Ann-Marie Svensson
Johan Ottosson
Soffia Gudbjörnsdottir
Source
Lancet Diabetes Endocrinol. 2015 Nov;3(11):847-54
Date
Nov-2015
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Cardiovascular Diseases - complications - mortality - surgery
Child
Child, Preschool
Cohort Studies
Diabetes Mellitus, Type 2 - complications - surgery
Female
Gastric Bypass
Humans
Infant
Infant, Newborn
Kaplan-Meier Estimate
Male
Middle Aged
Obesity - complications - surgery
Proportional Hazards Models
Risk factors
Sweden
Treatment Outcome
Young Adult
Abstract
In patients with diabetes and obesity specifically, no studies have examined mortality after bariatric surgery. We did a nationwide study in Sweden to examine risks of cardiovascular disease and mortality in patients with obesity and diabetes who had undergone bariatric surgery (Roux-en-Y gastric bypass [RYGB]).
In this nationwide, matched, observational cohort study, we merged data for patients who had undergone RYGB registered in the Scandinavian Obesity Surgery Registry with other national databases, and identified matched controls (on the basis of sex, age, BMI, and calendar time [year]) who had not undergone bariatric surgery from the National Diabetes Registry. We assessed risks of cardiovascular disease and death using a Cox proportional-hazards regression model and other methods to examine the treatment effect while accounting for residual confounding. Primary outcomes were total mortality, cardiovascular death, and fatal or non-fatal myocardial infarction.
Between Jan 1, 2007, and Dec 31, 2014, we obtained data for 6132 patients who had undergone RYGB and 6132 control patients who had not. Median follow-up was 3·5 years (IQR 2·1-4·7). We noted a 58% relative risk reduction (hazard ratio [HR] 0·42, 95% CI 0·30-0·57; p
Notes
Comment In: Lancet Diabetes Endocrinol. 2015 Nov;3(11):828-926429403
PubMed ID
26429401 View in PubMed
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Cardiovascular diseases and risk of hip fracture.

https://arctichealth.org/en/permalink/ahliterature94958
Source
JAMA. 2009 Oct 21;302(15):1666-73
Publication Type
Article
Date
Oct-21-2009
Author
Sennerby Ulf
Melhus Håkan
Gedeborg Rolf
Byberg Liisa
Garmo Hans
Ahlbom Anders
Pedersen Nancy L
Michaëlsson Karl
Author Affiliation
Department of Surgical Sciences, Section of Orthopaedics, Uppsala University, SE-751 85 Uppsala, Sweden.
Source
JAMA. 2009 Oct 21;302(15):1666-73
Date
Oct-21-2009
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Cardiovascular Diseases - epidemiology - genetics
Diseases in Twins - epidemiology - genetics
Female
Genetic Predisposition to Disease
Hip Fractures - epidemiology - genetics
Humans
Kaplan-Meiers Estimate
Life Style
Male
Middle Aged
Osteoporosis - epidemiology - genetics
Proportional Hazards Models
Registries
Risk
Sweden
Twins
Abstract
CONTEXT: Recent studies indicate common etiologies for cardiovascular disease (CVD) and osteoporotic fractures. OBJECTIVES: To examine the relation between CVD and risk of hip fracture in twins and evaluate the relative importance of genetics and lifestyle factors in this association. DESIGN, SETTING, AND PARTICIPANTS: A cohort of all 31,936 Swedish twins born from 1914-1944 was followed up from the age of 50 years. The National Patient Registry identified twins with CVDs and fractures from 1964 through 2005. Time-dependent exposures using Cox proportional hazard regression models were evaluated. MAIN OUTCOME MEASURE: Time to hip fracture after diagnosis of CVD. RESULTS: The crude absolute rate of hip fractures was 12.6 per 1000 person-years after a diagnosis of heart failure, 12.6 per 1000 person-years after a stroke, 6.6 per 1000 person-years after a diagnosis of peripheral atherosclerosis, and 5.2 per 1000 person-years after a diagnosis of ischemic heart disease compared with 1.2 per 1000 person-years for those without a CVD diagnosis. The multivariable-adjusted hazard ratio (HR) of hip fracture after a diagnosis of heart failure was 4.40 (95% confidence interval [CI], 3.43-5.63); after a stroke, the HR was 5.09 (95% CI, 4.18-6.20); after a diagnosis of peripheral atherosclerosis, the HR was 3.20 (95% CI, 2.28-4.50); and after an ischemic heart disease event, the HR was 2.32 (95% CI, 1.91-2.84). Identical twins without heart failure and stroke also had, after their co-twins had been exposed to these respective diseases, an increased rate of hip fracture. These sibling twins pseudoexposed for heart failure had a multivariable-adjusted HR of 3.74 (95% CI, 1.97-7.10) for hip fracture, whereas pseudoexposure for stroke had an HR of 2.29 (95% CI, 1.20-4.35). CONCLUSIONS: A diagnosis of CVD was significantly associated with risk of subsequent hip fracture. Increased risks in co-twins without an index diagnosis suggest genetic factors in the association between CVD and osteoporotic fractures.
PubMed ID
19843901 View in PubMed
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Carotid artery longitudinal displacement predicts 1-year cardiovascular outcome in patients with suspected coronary artery disease.

https://arctichealth.org/en/permalink/ahliterature134917
Source
Arterioscler Thromb Vasc Biol. 2011 Jul;31(7):1668-74
Publication Type
Article
Date
Jul-2011
Author
Sara Svedlund
Charlotte Eklund
Per Robertsson
Milan Lomsky
Li-Ming Gan
Author Affiliation
Department of Clinical Physiology, Sahlgrenska University Hospital, S:413 45 Göteborg, Sweden. sara.svedlund@gu.se
Source
Arterioscler Thromb Vasc Biol. 2011 Jul;31(7):1668-74
Date
Jul-2011
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Analysis of Variance
Cardiovascular Diseases - etiology - mortality - physiopathology
Carotid Artery, Common - physiopathology - ultrasonography
Chi-Square Distribution
Compliance
Coronary Artery Disease - complications - diagnosis - mortality - physiopathology
Coronary Circulation
Disease Progression
Disease-Free Survival
Female
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Myocardial Perfusion Imaging - methods
Odds Ratio
Predictive value of tests
Prognosis
Proportional Hazards Models
Risk assessment
Risk factors
Survival Rate
Sweden
Time Factors
Tomography, Emission-Computed, Single-Photon
Abstract
Total longitudinal displacement (tLoD) of the common carotid artery can be measured using the ultrasound-based velocity vector imaging (VVI) technique. This study aimed to investigate clinical correlates and the possible predictive value of tLoD for cardiovascular outcome.
Four hundred forty-one patients referred for myocardial perfusion scintigraphy examination for suspected coronary artery disease were recruited and underwent VVI-assisted tLoD measurement. Patients were followed up with regard to major adverse cardiovascular event (MACE) 1 year later. Low tLoD (= 0.055 mm) was associated with greater clinically determined myocardial ischemia (P0.055 mm) predicted 1-year event-free survival (P
PubMed ID
21527749 View in PubMed
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A Case-Control Study of Risk Markers and Mortality in Takotsubo Stress Cardiomyopathy.

https://arctichealth.org/en/permalink/ahliterature275904
Source
J Am Coll Cardiol. 2016 Apr 26;67(16):1931-6
Publication Type
Article
Date
Apr-26-2016
Author
Per Tornvall
Olov Collste
Ewa Ehrenborg
Hans Järnbert-Petterson
Source
J Am Coll Cardiol. 2016 Apr 26;67(16):1931-6
Date
Apr-26-2016
Language
English
Publication Type
Article
Keywords
Aged
Case-Control Studies
Cause of Death
Coronary Angiography - methods
Coronary Artery Disease - mortality - radiography - therapy
Electrocardiography - methods
Female
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Prognosis
Proportional Hazards Models
Registries
Risk assessment
Severity of Illness Index
Statistics, nonparametric
Survival Analysis
Sweden
Takotsubo Cardiomyopathy - diagnosis - mortality - therapy
Time Factors
Abstract
Takotsubo stress cardiomyopathy (TSC) is a syndrome characterized by transient myocardial dysfunction with unknown etiology. Although recent studies have suggested that the syndrome is associated with comorbidity and has a dismal prognosis, there is a lack of comprehensive data describing the epidemiology and prognosis of TSC.
This study compared risk markers and mortality in patients with TSC with that of individuals with or without coronary artery disease (CAD).
Patients with TSC and control subjects were identified from the Swedish Coronary Angiography and Angioplasty Register between 2009 and 2013 and linked with the Swedish national patient registry, cause of death registry, prescription drug registry, and education and income registries.
Patients with TSC were characterized by a low cardiovascular risk factor profile but with increased chronic obstructive pulmonary disease, migraine, and affective disorders. The use of beta-blockers was less common but use of ß2-adrenergic agonist agents was more common in patients with TSC compared with either of the control groups. Being a patient with TSC was associated with a hazard ratio of 2.1 for death compared with the control subjects without CAD (95% confidence interval: 1.4 to 3.2). This was similar to the excess mortality risk seen among the CAD control subjects compared with control subjects without CAD (hazard ratio: 2.5; 95% confidence interval: 1.8 to 3.3). These associations remained significant after adjusting for CAD risk factors and risk markers for TSC.
The findings of increased risk associated with ß2-adrenergic agonist agents together with stress related to affective disorders emphasize the pathogenic role of sympathetic stimulation. The prognosis regarding mortality is worse than in control subjects without CAD and similar to patients with CAD emphasizing the urgent need for studies on optimal treatment of TSC.
Notes
Comment In: J Am Coll Cardiol. 2016 Apr 26;67(16):1937-4027102509
PubMed ID
27102508 View in PubMed
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151 records – page 1 of 16.