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30-year nationwide trends in incidence of atrial fibrillation in Denmark and associated 5-year risk of heart failure, stroke, and death.

https://arctichealth.org/en/permalink/ahliterature286741
Source
Int J Cardiol. 2016 Dec 15;225:30-36
Publication Type
Article
Date
Dec-15-2016
Author
Morten Schmidt
Sinna Pilgaard Ulrichsen
Lars Pedersen
Hans Erik Bøtker
Jens Cosedis Nielsen
Henrik Toft Sørensen
Source
Int J Cardiol. 2016 Dec 15;225:30-36
Date
Dec-15-2016
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Atrial Fibrillation - epidemiology - mortality - therapy
Cohort Studies
Death
Denmark - epidemiology
Female
Follow-Up Studies
Heart Failure - epidemiology - mortality - therapy
Hospitalization - trends
Humans
Incidence
Male
Middle Aged
Population Surveillance - methods
Registries
Risk factors
Stroke - epidemiology - mortality - therapy
Time Factors
Abstract
Long-term nationwide trends in atrial fibrillation (AF) incidence and 5-year outcomes are rare.
We conducted a population-based cohort study using the Danish National Patient Registry covering all Danish hospitals. We computed standardized incidence rates during 1983-2012. We used Cox regression to estimate hazard ratios (HRs) of heart failure, stroke, and death within 5years, comparing 5-year calendar periods with the earliest period (1983-1987) as reference.
We identified 312,420 patients with first-time hospital-diagnosed AF. The incidence rate per 100,000person-years increased from 98 in 1983 to 307 in 2012. The mean annual increase during the 30-year study period was 4%, with a 6% increase annually until 2000 and a 1.4% increase annually thereafter. The incidence trends were most pronounced among men and persons above 70years. Among high-risk subgroups, AF incidence was consistently highest in patients with valvular heart disease or heart failure. The rate of heart failure following AF declined by 50% over the entire study period (HR: 0.49, 95% confidence interval (CI): 0.48-0.51) and the mortality rate declined by 40% (HR: 0.62, 95% CI: 0.61-0.63). Within the last two decades, the rate for ischemic stroke declined by 20% (HR 0.81, 95% CI: 0.78-0.84), but increased almost as much for haemorrhagic stroke (HR: 1.14, 95% CI: 1.01-1.29).
The long-term risk of heart failure, ischemic stroke, and death following onset of AF has decreased remarkably over the last three decades. Still, the threefold increased incidence of hospital-diagnosed AF during the same period is a major public health concern.
PubMed ID
27705839 View in PubMed
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A 32-year longitudinal study of alcohol consumption in Swedish women: Reduced risk of myocardial infarction but increased risk of cancer.

https://arctichealth.org/en/permalink/ahliterature275258
Source
Scand J Prim Health Care. 2015;33(3):153-62
Publication Type
Article
Date
2015
Author
Dominique Hange
Jóhann A Sigurdsson
Cecilia Björkelund
Valter Sundh
Calle Bengtsson
Source
Scand J Prim Health Care. 2015;33(3):153-62
Date
2015
Language
English
Publication Type
Article
Keywords
Adult
Alcohol Drinking - adverse effects
Beer
Diabetes Mellitus - epidemiology
Ethanol - adverse effects - therapeutic use
Female
Humans
Incidence
Longitudinal Studies
Middle Aged
Myocardial Infarction - prevention & control
Neoplasms - etiology
Proportional Hazards Models
Prospective Studies
Risk factors
Risk Reduction Behavior
Stroke - epidemiology
Sweden - epidemiology
Abstract
To assess associations between the intake of different types of alcoholic beverages and the 32-year incidence of myocardial infarction, stroke, diabetes, and cancer, as well as mortality, in a middle-aged female population.
Prospective study.
Gothenburg, Sweden, population about 430 000.
Representative sample of a general population of women (1462 in total) aged 38 to 60 years in 1968-1969, followed up to the ages of 70 to 92 years in 2000-2001.
Associations between alcohol intake and later risk of mortality and morbidity from myocardial infarction, stroke, diabetes, and cancer, studied longitudinally.
During the follow-up period, 185 women developed myocardial infarction, 162 developed stroke, 160 women became diabetic, and 345 developed cancer. Women who drank beer had a 30% lower risk (hazards ratio (HR) 0.70, 95% confidence interval (CI) 0.50-0.95) of developing myocardial infarcion and almost half the risk (HR 0.51 CI 0.33-0.80). A significant association between increased risk of death from cancer and high spirits consumption was also shown (hazards ratio [HR] 1.47, CI 1.06-2.05).
Women with moderate consumption of beer had a reduced risk of developing myocardial infarction. High spirits consumption was associated with increased risk of cancer mortality.
Notes
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PubMed ID
26194171 View in PubMed
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Abdominal and gynoid adiposity and the risk of stroke.

https://arctichealth.org/en/permalink/ahliterature136783
Source
Int J Obes (Lond). 2011 Nov;35(11):1427-32
Publication Type
Article
Date
Nov-2011
Author
F. Toss
P. Wiklund
P W Franks
M. Eriksson
Y. Gustafson
G. Hallmans
P. Nordström
A. Nordström
Author Affiliation
Department of Surgical and Perioperative Sciences, Sports Medicine, Umeå University, Umeå, Sweden.
Source
Int J Obes (Lond). 2011 Nov;35(11):1427-32
Date
Nov-2011
Language
English
Publication Type
Article
Keywords
Abdominal Fat - pathology - radiography
Absorptiometry, Photon
Adult
Age Distribution
Aged
Body Fat Distribution
Body mass index
Cardiovascular Diseases - epidemiology - pathology
Cohort Studies
Female
Follow-Up Studies
Humans
Hypertension - epidemiology - pathology
Incidence
Male
Middle Aged
Obesity - complications - epidemiology - pathology - radiography
Proportional Hazards Models
Risk factors
Stroke - epidemiology - etiology - pathology
Sweden - epidemiology
Abstract
Previous studies have indicated that fat distribution is important in the development of cardiovascular disease (CVD). We investigated the association between fat distribution, as measured by dual energy X-ray absorptiometry (DXA), and the incidence of stroke.
A cohort of 2751 men and women aged =40 years was recruited. Baseline levels of abdominal, gynoid and total body fat were measured by DXA. Body mass index (BMI, kg?m(-2)) was calculated. Stroke incidence was recorded using the regional stroke registry until subjects reached 75 years of age.
During a mean follow-up time of 8 years and 9 months, 91 strokes occurred. Of the adiposity indices accessed abdominal fat mass was the best predictor of stroke in women (hazard ratio (HR)=1.66, 95% confidence interval (CI)=1.23-2.24 per standard deviation increase), whereas the ratio of gynoid fat to total fat mass was associated with a decreased risk of stroke (HR=0.72, 95% CI=0.54-0.96). Abdominal fat mass was the only of the adiposity indices assessed that was found to be a significant predictor of stroke in men (HR=1.49, 95% CI=1.06-2.09). The associations between abdominal fat mass and stroke remained significant in both women and men after adjustment for BMI (HR=1.80, 95% CI=1.06-3.07; HR=1.71, 95% CI=1.13-2.59, respectively). However, in a subgroup analyses abdominal fat was not a significant predictor after further adjustment for diabetes, smoking and hypertension.
Abdominal fat mass is a risk factor for stroke independent of BMI, but not independent of diabetes, smoking and hypertension. This indicates that the excess in stroke risk associated with abdominal fat mass is at least partially mediated through traditional stroke risk factors.
PubMed ID
21343905 View in PubMed
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[Abdominal aortic aneurysm and the risk of stroke and myocardial infarction].

https://arctichealth.org/en/permalink/ahliterature114769
Source
Ugeskr Laeger. 2013 Mar 18;175(12):799
Publication Type
Article
Date
Mar-18-2013

Acromegaly incidence, prevalence, complications and long-term prognosis: a nationwide cohort study.

https://arctichealth.org/en/permalink/ahliterature280006
Source
Eur J Endocrinol. 2016 Sep;175(3):181-90
Publication Type
Article
Date
Sep-2016
Author
Jakob Dal
Ulla Feldt-Rasmussen
Marianne Andersen
Lars Ø Kristensen
Peter Laurberg
Lars Pedersen
Olaf M Dekkers
Henrik Toft Sørensen
Jens Otto L Jørgensen
Source
Eur J Endocrinol. 2016 Sep;175(3):181-90
Date
Sep-2016
Language
English
Publication Type
Article
Keywords
Acromegaly - diagnosis - epidemiology
Adult
Aged
Cohort Studies
Comorbidity
Denmark - epidemiology
Diabetes Mellitus - epidemiology
Female
Heart Failure - epidemiology
Humans
Incidence
Male
Middle Aged
Myocardial Infarction - epidemiology
Prevalence
Prognosis
Registries
Stroke - epidemiology
Abstract
Valid data on acromegaly incidence, complications and mortality are scarce. The Danish Health Care System enables nationwide studies with complete follow-up and linkage among health-related databases to assess acromegaly incidence, prevalence, complications and mortality in a population-based cohort study.
All incident cases of acromegaly in Denmark (1991-2010) were identified from health registries and validated by chart review. We estimated the annual incidence rate of acromegaly per 10(6) person-years (py) with 95% confidence intervals (95% CIs). For every patient, 10 persons were sampled from the general population as a comparison cohort. Cox regression and hazard ratios (HRs) with 95% confidence intervals (95% CIs) were used.
Mean age at diagnosis (48.7 years (CI: 95%: 47.2-50.1)) and annual incidence rate (3.8 cases/10(6) persons (95% CI: 3.6-4.1)) among the 405 cases remained stable. The prevalence in 2010 was 85 cases/10(6) persons. The patients were at increased risk of diabetes mellitus (HR: 4.0 (95% CI: 2.7-5.8)), heart failure (HR: 2.5 (95% CI: 1.4-4.5)), venous thromboembolism (HR: 2.3 (95% CI: 1.1-5.0)), sleep apnoea (HR: 11.7 (95% CI: 7.0-19.4)) and arthropathy (HR: 2.1 (95% CI: 1.6-2.6)). The complication risk was also increased before the diagnosis of acromegaly. Overall mortality risk was elevated (HR: 1.3 (95% CI: 1.0-1.7)) but uninfluenced by treatment modality.
(i) The incidence rate and age at diagnosis of acromegaly have been stable over decades, and the prevalence is higher than previously reported. (ii) The risk of complications is very high even before the diagnosis. (iii) Mortality risk remains elevated but uninfluenced by mode of treatment.
PubMed ID
27280374 View in PubMed
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Acute and long-term increase in fracture risk after hospitalization for stroke.

https://arctichealth.org/en/permalink/ahliterature195446
Source
Stroke. 2001 Mar;32(3):702-6
Publication Type
Article
Date
Mar-2001
Author
J. Kanis
A. Oden
O. Johnell
Author Affiliation
Center for Metabolic Bone Diseases (World Health Organization Collaborating Center), University of Sheffield Medical School (UK). w.j.pontefract@sheffield.ac.uk
Source
Stroke. 2001 Mar;32(3):702-6
Date
Mar-2001
Language
English
Publication Type
Article
Keywords
Acute Disease
Age Distribution
Aged
Aged, 80 and over
Comorbidity
Female
Follow-Up Studies
Fractures, Bone - epidemiology
Hip Fractures - epidemiology
Hospitalization - statistics & numerical data
Humans
Incidence
Male
Middle Aged
Poisson Distribution
Proportional Hazards Models
Risk
Risk Assessment - statistics & numerical data
Sex Distribution
Stroke - epidemiology - therapy
Sweden - epidemiology
Time
Abstract
The aims of this study were to determine the magnitude of the increase in fracture risk after hospitalization for stroke, and in particular to determine the time course of this risk.
The records of the Swedish register of patients admitted during 1987-1996 were examined to identify all patients who were admitted to the hospital for stroke. Patients were followed for subsequent hospitalizations for hip and all fractures combined. We analyzed 16.3 million hospitalizations, from which 273 288 individuals with stroke were identified. A Poisson model was used to determine the absolute risk of subsequent fractures and the risk compared with that of the general population.
After hospitalization for stroke, there was a >7-fold increase in fracture risk, including that for hip fracture within the first year after hospitalization for stroke. Thereafter, fracture risk declined toward, but did not attain, the baseline risk except in men and women aged >/=80 years.
The high incidence of new fractures within the first year of hospitalization for stroke suggests that such patients should be preferentially targeted for treatment. It is possible that short courses of treatment at the time of stroke would provide important therapeutic dividends.
PubMed ID
11239190 View in PubMed
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Acute headache: a prospective diagnostic work-up of patients admitted to a general hospital.

https://arctichealth.org/en/permalink/ahliterature155164
Source
Eur J Neurol. 2008 Dec;15(12):1293-9
Publication Type
Article
Date
Dec-2008
Author
S H Bø
E M Davidsen
P. Gulbrandsen
E. Dietrichs
Author Affiliation
Department of Neurology, University of Oslo, Oslo, Norway. siri.bo@ahus.no
Source
Eur J Neurol. 2008 Dec;15(12):1293-9
Date
Dec-2008
Language
English
Publication Type
Article
Keywords
Acute Disease - therapy
Adolescent
Adult
Aged
Aged, 80 and over
Comorbidity
Diagnosis, Differential
Diagnostic Tests, Routine - methods - statistics & numerical data
Emergency Medical Services - statistics & numerical data - trends
Female
Headache Disorders, Primary - diagnosis - epidemiology - physiopathology
Humans
Male
Middle Aged
Migraine with Aura - epidemiology
Neurologic Examination - methods - statistics & numerical data
Norway
Prospective Studies
Questionnaires
Stroke - epidemiology
Subarachnoid Hemorrhage - diagnosis - epidemiology
Young Adult
Abstract
To find a specified diagnosis for every patient investigated in the hospital emergency room for acute headache suspicious of subarachnoid haemorrhage (SAH), and to describe similarities and differences between the diagnostic groups.
We used a standardized set of questionnaires and supplementary tests, including cerebral computed tomography (CT) and if needed lumbar puncture, in the investigation of the patients. Two neurologists diagnosed the same cases independently.
We found 30 different diagnoses as the cause of acute headache. Sixteen per cent had a SAH, and 57% had a primary headache. Patient characteristics, conditions at headache onset and accompanying symptoms were surprisingly similar in the diagnostic groups. For three SAH patients, it took 30 min to reach maximum pain intensity. In all diagnostic groups, a large proportion of the patients reached maximum pain within 60 s.
To distinguish between benign and malignant causes of acute headache is difficult based on clinical features. The consistent use of CT and lumbar puncture is valuable when investigating sudden onset 'first or worst headache ever'. This can reduce the risk of missing a SAH diagnosis, and make it possible to give more exact diagnoses to patients suffering from both primary and secondary headaches.
PubMed ID
18795944 View in PubMed
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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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Acute stroke alert activation, emergency service use, and reperfusion therapy in Sweden.

https://arctichealth.org/en/permalink/ahliterature282026
Source
Brain Behav. 2017 Apr;7(4):e00654
Publication Type
Article
Date
Apr-2017
Author
Marie Eriksson
Eva-Lotta Glader
Bo Norrving
Birgitta Stegmayr
Kjell Asplund
Source
Brain Behav. 2017 Apr;7(4):e00654
Date
Apr-2017
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Emergency Medical Services - methods - statistics & numerical data
Female
Humans
Male
Middle Aged
Registries
Reperfusion - statistics & numerical data
Socioeconomic Factors
Stroke - epidemiology - therapy
Sweden - epidemiology
Time Factors
Young Adult
Abstract
Ambulance services and stroke alerts reduce the time from stroke onset to acute stroke diagnosis. We describe the use of stroke alerts and ambulance services in different hospitals and patient groups and their relationship with reperfusion therapy.
This nationwide study included 49,907 patients admitted with acute stroke who were registered in The Swedish Stroke Register (Riksstroke) in 2011-2012.
The proportions of patients admitted as stroke alerts out of all acute stroke admissions varied from 12.2% to 45.7% in university hospitals (n = 9), 0.5% to 38.7% in specialized nonuniversity hospitals (n = 22), and 4.2% to 40.3% in community hospitals (n = 41). Younger age, atrial fibrillation (AF), living in an institution, reduced consciousness upon admission, and hemorrhagic stroke were factors associated with a higher probability of stroke alerts. Living alone, primary school education, non-European origin, previous stroke, diabetes, smoking, and dependency in activities of daily living (ADL) were associated with a lower probability of stroke alert. The proportion of patients arriving at the hospital by ambulance varied from 60.3% to 94.5%. Older age, living alone, primary school education, being born in a European country, previous stroke, AF, dependency in ADL, living in an institution, reduced consciousness upon admission, and hemorrhagic stroke were associated with ambulance services. Hospital stroke alert frequencies correlated strongly with reperfusion rates (r = .75).
Acute stroke alerts have a significant potential to improve stroke reperfusion rates. Prehospital stroke management varies conspicuously between hospitals and patient groups, and the elderly and patients living alone have a markedly reduced likelihood of stroke alerts.
Notes
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PubMed ID
28413705 View in PubMed
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Adaptive behavior in stressful situations and stroke incidence in hypertensive men: results from prospective cohort study "men born in 1914" in Malmö, Sweden.

https://arctichealth.org/en/permalink/ahliterature193833
Source
Stroke. 2001 Aug;32(8):1712-20
Publication Type
Article
Date
Aug-2001
Author
L. André-Petersson
G. Engström
B. Hagberg
L. Janzon
G. Steen
Author Affiliation
Division of Epidemiology, Department of Community Medicine, Malmö University Hospital, Lund University, Malmö, Sweden. Lena.Andre-Petersson@psychology.lu.ses
Source
Stroke. 2001 Aug;32(8):1712-20
Date
Aug-2001
Language
English
Publication Type
Article
Keywords
Adaptation, Psychological - classification
Cohort Studies
Comorbidity
Disease-Free Survival
Follow-Up Studies
Humans
Hypertension - epidemiology
Incidence
Male
Multivariate Analysis
Neuropsychological Tests
Prospective Studies
Risk factors
Stress, Psychological - epidemiology - psychology
Stroke - epidemiology
Sweden - epidemiology
Abstract
Although hypertension is a major risk factor for stroke, many hypertensive persons remain healthy. The aim of the present study was to analyze whether adaptation in a stressful situation was associated with the incidence of stroke in hypertensive men.
Two hundred thirty-eight hypertensive men were followed from baseline in 1982/1983 until first stroke, death, or December 31, 1996. Adaptation to stress was studied with the serial Color-Word Test. In the Regression dimension, 4 patterns of adaptation could be distinguished according to mastering of the test. Successful mastering of the test was shown in stabilized patterns, increasing difficulty in cumulative patterns, fluctuating difficulty in dissociative patterns, and fluctuating difficulty that increased during testing in cumulative-dissociative patterns. The patterns were compared regarding stroke incidence.
Forty-three men experienced a stroke during follow-up. Stroke rates per 1000 person-years were 12.6 for men with stabilized patterns, 14.3 for men with cumulative patterns, 16.2 for men with dissociative patterns, and 31.2 for men with cumulative-dissociative patterns. Multivariate analysis, adjusted for relevant cerebrovascular risk factors, showed that the cumulative-dissociative pattern of the Regression dimension was associated with an increased risk of stroke during follow-up (relative risk 3.00, 95% CI 1.32 to 6.81).
The specific behavior pattern, characterized by the greatest difficulties in managing the test, was associated with incidence of stroke in hypertensive men. One interpretation is that hypertensive men who chronically fail to find successful strategies in stressful situations are vulnerable to the damaging effects of stress and thereby at an increased risk of a future stroke.
PubMed ID
11486095 View in PubMed
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537 records – page 1 of 54.