Change search
Refine search result
1 - 32 of 32
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Rows per page
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sort
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
Select
The maximal number of hits you can export is 250. When you want to export more records please use the Create feeds function.
  • 1.
    Andersson, Mats
    Barometern.
    Bergman, Patrick (Contributor)
    Linnaeus University, Faculty of Social Sciences, Department of Sport Science.
    Carlsson, Jörg
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Hospital.
    Kompressionskläder ger ingen medicinsk effekt2018In: Barometern, ISSN 1103-906X, no September, p. 4-5Article in journal (Other (popular science, discussion, etc.))
  • 2.
    Bertilsson, Emelie
    et al.
    Kalmar County Hospital.
    Semark, Birgitta
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Schildmeijer, Kristina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Bremer, Anders
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Carlsson, Jörg
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Usage of Do-not-attempt-to resuscitate-orders in a Swedish community hospital: patient involvement, documentation and compliance2018In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 130, no s1, p. e93-e94Article in journal (Refereed)
  • 3.
    Carlsson, Jörg
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Hospital.
    Geht auch weniger? Stand der Diskussion in Schweden: "Is it possible to do less?" the current state of the debate in Sweden2013In: Zeitschrift fur Evidenz, Fortbildung und Qualitat im Gesundheitswesen, ISSN 1865-9217, E-ISSN 2212-0289, Vol. 107, no 2, p. 140-147Article in journal (Refereed)
    Abstract [en]

    The question "Is it possible to do less?" and the claim "Less is more!" can be answered and construed in different ways. One possible interpretation, which is well established in the Swedish health system, is "Accomplishing more (of the things that are important) by doing less (of the things that are dispensable)". Essentially, this is the basis of prioritisation in Swedish health care. While the concept of prioritisation is very well established in Sweden, the discussion about prioritising in Germany has always been difficult. It is, from a Swedish perspective, unclear why, of all things, health care should be exempted from prioritisation which otherwise is a necessity concerning all aspects of human and societal life. Some conditions complicate prioritisation in German health care, including the system of private and statutory health insurance and economic incentives which do not reward procedures based on indications. It will be argued that the Swedish health care system is more effective than the German not at least because of the system of prioritisation that allows for providing more necessary and essential health care instead of offering unnecessary and dubious procedures, thereby also improving patient outcome.

  • 4.
    Carlsson, Jörg
    et al.
    Kalmar County Hospital.
    Danielsson, Tom
    Linnaeus University, Faculty of Social Sciences, Department of Sport Science.
    Bergman, Patrick
    Linnaeus University, Faculty of Social Sciences, Department of Sport Science.
    A two-peaked increase of serum myosin heavy chain-α after full distance triathlon demonstrates heart muscle cell death2017In: Clinical Research in Cardiology, ISSN 1861-0684, E-ISSN 1861-0692, Vol. 106, no Suppl 1, article id P1159Article in journal (Refereed)
    Abstract [en]

    Background: There is an ongoing debate about the significance of cardiac troponin T (cTnT) elevation after strenuous exercise: heart muscle cell death versus physiologic mechanism of release through an intact cell membrane. While cTnT is a small molecule (37 kDa), cardiac specific myosin heavy chain-alpha (MHC-α) is much larger (224 kDa) and an increase after exercise could hardly be explained by passage through an intact cardiac cell membrane. PURPOSE: To measure MHC-α, and other biomarkers (C-reactive protein (CRP); cTnT, creatine kinase (CK), myoglobin (MG), creatinine (C), and N-terminal prohormone of brain natriuretic peptide (NT-proBNP) before and after a full distance Ironman in order to answer the question of heart muscle cell death versus physiologic changes. 

    Methods: In 52 non-elite athletes (14 female, 38 male; age 41.1 ± 9.7, range 24-70 years; all completed the race) biomarkers were measured by standard laboratory methods 7 days before, directly after, and day 1, 4 and 6 after the race. MHC-α was measured with a commercially available ELISA with no cross reactivity with other myosins. 

    Results: The course of MHC-α concentration [µg/L] was 1.33 ± 0.53 (before), 2.57 ± 0.78 (directly after), 1.51 ± 0.53 (day 1), 2.74 ± 0.55 (day 4) and 1.83 ± 0.76 (day 6). Other biomarkers showed a one-peaked increase with maximal values either directly after the race or at day 1: cTnT 76 ± 80 ng/L (12-440; reference <15), NT-proBNP 776 ± 684 ng/L (92-4700; ref. < 300), CK 68 ± 55 µkat/L (5-280; ref. < 1.9), MG 2088 ± 2350 µg/L (130-17000; ref.< 72), and creatinine 100 ± 20 µmol/L (74-161; ref. < 100), CRP 49 ± 23 mg/L (15-119; ref.< 5). There was a significant correlation between MHC-α and NT-proBNP (R=0.48; p<0.001) but neither between MHC-α and cTnT (R=0.13; p=0.36) nor MHC-α and myoglobin (R=0.18; p=0.2). 

    Conclusion: An Ironman leads to remarkable disturbances in biomarkers as e.g. cTnT was in the range of myocardial infarction in 100% of women and 97% of men. This is to our best knowledge the first investigation of MHC-α after strenuous exercise and its two-peaked increase most likely represents first release from the cytosolic pool and later from cell necrosis including the contractile apparatus. However, many questions remain, not at least why MHC-α baseline levels are as high as 1.33 ± 0.53 µg/L. 

  • 5.
    Carlsson, Jörg
    et al.
    Kalmar County Hospital.
    Danielsson, Tom
    Linnaeus University, Faculty of Social Sciences, Department of Sport Science.
    Bergman, Patrick
    Linnaeus University, Faculty of Social Sciences, Department of Sport Science.
    Two-peaked increase of serum myosin heavy chain-α after Ironman demonstrates heart muscle cell death2017In: Medicine & Science in Sports & Exercise, ISSN 0195-9131, E-ISSN 1530-0315, Vol. 47, no 5 Supplement 1, p. 186-, article id 734Article in journal (Other academic)
  • 6.
    Carlsson, Jörg
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Danielsson, Tom
    Linnaeus University, Faculty of Social Sciences, Department of Sport Science.
    Bergman, Patrick
    Linnaeus University, Faculty of Social Sciences, Department of Sport Science.
    Schreyer, Hendrik
    Kalmar County Hospital.
    Echocardiographic Findings and Cardiac Biomarkers in Non-Elite Triathletes – Data from the Kalmar Ironwoman Study2018Conference paper (Refereed)
    Abstract [en]

    INTRODUCTION: There is an ongoing debate about the impact of endurance exercise on cardiovascular health. Not at least data on cardiac biomarker changes (e.g. troponin T (cTnT), N-terminal prohormone of brain natriuretic peptide (NT-proBNP) and cardiac specific myosin heavy chain-alpha (MHC-α) have raised questions about exercise related cardiac injury. METHODS: In 52 non-elite athletes (14 female, 38 male; age 41.1 ± 9.7, range 24-70 years; all completed the race) biomarkers were measured by standard laboratory methods 7 days before, directly after, and day 1, 4 and 6 after a full Ironman distance triathlon (Swim 3.9 km, Bike 180 km, Run 42.2 km) . In 19 of these athletes (9 female, 10 male) echocardiography with 30 different standard measurements was performed before and directly after the race. RESULTS: Only MHC-α [µg/L] showed a two-peaked increase directly after (2.57 ± 0.78) and on day 4 (2.74 ± 0.55). Other biomarkers showed a one-peaked increase with maximal values either directly after the race or at day 1: cTnT 76 ± 80 ng/L (12-440; reference <15), NT-proBNP 776 ± 684 ng/L (92-4700; ref. < 300), CK 68 ± 55 µkat/L (5-280; ref. < 1.9), MG 2088 ± 2350 µg/L (130-17000; ref.< 72), and creatinine 100 ± 20 µmol/L (74-161; ref. < 100), CRP 49 ± 23 mg/L (15-119; ref.< 5). No significant echocardiographic changes were recorded. E.g. left ventricular end diastolic diameter (49.0 ± 4.7 mm before, 47.7 ± 5.0 mm after the race, right ventricular end diastolic diameter (34.3 ± 4.3 mm before, 33.3 ± 5.7 mm after the race), right atrial area (17.5 ± 2.9 cm2 before, 17.7 ± 3.6 cm2 after the race) and left atrial area (18.8 ± 3.7 cm2 before, 17.8 ± 2.2 cm2 after the race) did not show any significant acute changes. CONCLUSION: While an Ironman leads to remarkable disturbances in biomarkers as e.g. cTnT after the race was in the range of myocardial infarction in 100% of women and 97% of men, these alterations were not correlated to any acute echocardiographic changes in heart size or function. However, the significance of biochemical evidence of cardiac injury on long-term heart function and cardiovascular health remains unclear.

  • 7.
    Carlsson, Jörg
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Justus Liebig University Giessen, Germany;Kalmar County Hospital.
    Lynøe, Niels
    Karolinska Institutet.
    100-åringen som inte lät sig återupplivas2015In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 112, article id C9S3Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    Sverige ligger efter i frågan om livstestamenten. Exemplet med 100-åringen här nedan bör även väcka tankar kring så kallade vårddirektiv. Ämnet är mycket större än fallet med 100-åringen, men vi måste börja någonstans, skriver Jörg Carlsson och Niels Lynøe.

  • 8.
    Carlsson, Jörg
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Ragnarsson, Thony
    Linnaeus University, Faculty of Social Sciences, Department of Sport Science.
    Danielsson, Tom
    Linnaeus University, Faculty of Social Sciences, Department of Sport Science.
    Bergman, Patrick
    Linnaeus University, Faculty of Social Sciences, Department of Sport Science.
    Increase of biomarkers after the Kalmar Ironman in male and female non-elite triathletes2016Conference paper (Refereed)
    Abstract [en]

    Strenuous and prolonged exercise like marathon, ultra running and triathlon can lead to changes in biomarkers of cardiac, muscle and kidney functional damage.

    We present the data of 29 (15 male, 14 female) non-elite participants of the Kalmar Ironman 2015 3.8 km swimming, 180 km cycling, 42 km running). Pre-race electrocardiograms and echocardiograms showed a high frequency of abnormalities. Post race elevations of troponin T, creatine kinase, myoglobin, N-terminal pro b-type natriuretic peptide, aspartataminotransferas, creatinine and leucocytes returned to normal in almost all cases within 5-8 days. In 100% of male and 93% of female participants’ troponin T increase was compatible with the diagnosis of minor myocardial infarction. Some results are shown in the table (* denotes level of significance between male and female results).

                                               Before race         Directly after race        5-8 days after race

    CK [µkat/L]                                      

    male                                                 3.7 ± 2.1**       48,1 ± 44.1                4.5 ± 4.0

    female                                   1.5 ± 0.7          30.5 ± 41.5                3.1 ± 3.6

    Myoglobin [µg/L

    male                                      58.3 ± 35.9        2449 ± 1923             51.3 ± 38.5

    female                                    30.6 ± 11.0         1134 ± 756*             50.4 ± 67.7

    Creatinine [µmol/L]

    male                                       87.4 ± 11.4         119.9 ± 23.4           85.1 ± 12.1

    female                                     73.0 ± 13.4         84.1 ± 14.1***        69.6 ± 6.3

    p-NT-proBNP [ng/L]

    male                                        60.1 ± 25.2          658.7 ± 354.9        61.9 ± 22.7

    female                                      95.5 ± 69.5          907.9 ± 433.1        76.9 ± 26.9

    Troponin T [ng/L]

    male                                         8.5 ± 4.3             68.1 ± 41.1           7.4 ± 4.4

    female                                       7.1 ± 4.9             54.3 ± 49.5           5.8 ± 1.7

    The results will be discussed in the light of the current literature and the so far unanswered question about the long-term significance of repetitive organ damage due to strenuous exercise. Long-term follow-up of these athletes is needed.

  • 9.
    Carlsson, Jörg
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Hospital, Sweden;Justus-Liebig Universität Giessen, Germany.
    Ragnarsson, Thony
    Linnaeus University, Faculty of Social Sciences, Department of Sport Science.
    Danielsson, Tom
    Linnaeus University, Faculty of Social Sciences, Department of Sport Science.
    Johansson, Therése
    Kalmar County Hospital, Sweden.
    Schreyer, Hendrik
    Kalmar County Hospital, Sweden.
    Breyne, Antonia
    Justus-Liebig Universität Giessen, Germany.
    Bergman, Patrick
    Linnaeus University, Faculty of Social Sciences, Department of Sport Science.
    Hjärtmarkörer ökar efter intensiv motion - oklar klinisk betydelse: Data från förstudie av Kalmar IronWoman-studien visar på troponin T-värden som vid hjärtinfarkt2016In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 113, no 31-33, article id D3CRArticle in journal (Refereed)
    Abstract [en]

    Biochemical changes after strenuous exercise - data from the Kalmar Ironman

    Strenuous and prolonged exercise like marathon, ultra running and triathlon can lead to changes in biomarkers of cardiac, muscle and kidney functional damage. We present the data of 30 (15 men, 15 women) participants of the Kalmar Ironman 2015. Pre-race electrocardiograms and echocardiograms showed a high frequency of abnormalities. Post race elevations of troponin T, creatine kinase, myoglobin, N-terminal prohormone of brain natriuretic peptide, and creatinine returned to normal in almost all cases within 5-8 days. In all but one participant the troponin T pattern was compatible with the diagnosis of myocardial infarction. It is an up-to-date unanswered question whether the increase of troponin represents myocardial damage or just is a benign consequence of an intermittent change of the permeability of myocardial cell membranes.

  • 10.
    Danielsson, Tom
    et al.
    Linnaeus University, Faculty of Social Sciences, Department of Sport Science.
    Carlsson, Jörg
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Bergman, Patrick
    Linnaeus University, Faculty of Social Sciences, Department of Sport Science.
    Maximal Oxygen Consumption Predicts Skeletal and Heart Muscle Biomarkers Changes after a Full Distance Ironman2017In: Medicine & Science in Sports & Exercise, ISSN 0195-9131, E-ISSN 1530-0315, Vol. 49, no 5, p. 519-, article id 1905Article in journal (Refereed)
    Abstract [en]

    Strenuous exercise like marathon or triathlon leads to disturbances of several biomarkers, not at least markers of skeletal and heart muscle damage. Different predictors of biomarker changes, e.g. sex, age and training experience have been discussed in the literature with contradictory results. To our best knowledge, maximal oxygen consumption (VO2 max) has not been investigated in this setting.

    PURPOSE:  To evaluate predictors of biomarker changes in an Ironman triathlon.

    METHODS: In 39 non-elite athletes (10 female, 29 male; age 41.1 ± 9.7, range 24-70 years) who had performed a 20 m shuttle run test to predict VO2 max, biomarkers (cardiac troponin T (cTnT; reference < 14 ng/L), creatine kinase (CK; ref. < 1.9 µkat/L), myoglobin (MG; ref. <72 µg/L), and N-terminal prohormone of brain natriuretic peptide (NT-proBNP; ref. < 300 ng/L) were measured by standard laboratory methods 7 days before, directly after, and day 1, and 6 after the race.

    RESULTS: VO2 max was on average 49.9 ± 6.4 O2 ml/kg/minute (range 36.5-63.9). Three biomarkers measured directly after the race were predicted by VO2 max: CK (53 ± 50 µkat/L; R= -0.44; p=0.005), MG (2137 ± 2614 µg/L; R= -0.31; p=0.056) and NT-proBNP (772 ±2614 ng/L; R= -0.35; p=0.027). cTnT (75 ± 89) was not significantly predicted by VO2 max but cTnT leakage was, in contrast to the other biomarkers, higher with higher VO2 max (R= 0.10; p=0.55) and return to normal appeared to be faster with higher VO2 max.

    CONCLUSION: Earlier research into predictors of biomarker changes after strenuous exercise has found contradictory results concerning age, sex and training experience. In the present Kalmar IronWoMan study VO2 max was found to be a good predictor of biomarker changes with higher VO2 max values being correlated to lower values for CK, NT-proBNP and MG.           

  • 11.
    Danielsson, Tom
    et al.
    Linnaeus University, Faculty of Social Sciences, Department of Sport Science.
    Carlsson, Jörg
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Bergman, Patrick
    Linnaeus University, Faculty of Social Sciences, Department of Sport Science.
    Ahnesjö, Jonas
    Linnaeus University, Faculty of Social Sciences, Department of Sport Science.
    Peak oxygen uptake predicts finishing- and segment time in a full distance Ironman2018In: Presented at the 23rd annual Congress of the European College of Sport Science (ECSS), Dublin, Ireland, July 4-7, 2018, 2018Conference paper (Refereed)
    Abstract [en]

    INTRODUCTION: Ironman competitions and other extreme endurance events has spread worldwide attracting thousands of endurance-trained athletes, athletes who differ in anthropometric and training characteristics. The relationship between peak oxygen uptake and finishing- and segment time during a full distance IRONMAN competition (Swim 3.9km, Bike 180km and Run 42.2km) has not been examined thoroughly in non-elite athletes.

    PURPOSE: The aim of the present study was to investigate the relationship between peak oxygen uptake (VO2peak), finishing time and segment time in non-elite athletes.

    METHODS: 39 non-elite athletes (10 female; age 41.1 ± 9.7, range 24-70 years) performed a 20 m shuttle run test to assess VO2peak. Association between VO2 and finishing- and segment time was estimated using bivariate correlation tests. Gender specific analysis was also performed.

    RESULTS: VO2peak peak was on average 49.9 ± 6.4 O2 ml/kg/minute, range 36.5-63.9 (pooled genders). Finishing time was on average 11h and 52 min. The average times for the different segments were; Swim 1h 21m, Bike 5h 46min and Run 4h 33min. The relationship between VO2peak and finishing time was significant to p<0.001 and                         0.51. The relationship between segment times were Swim  0.19, Bike  0.37 and Run  0.46 all at p<0.001. Gender specific analyses revealed that the association between VO2peak and finishing time was   0.80 for females and  0.49 for males. 

    CONCLUSION: Our results suggest that VO2peak is a good predictor of finishing time (approx. 50%) as well as for segment time with 19%, 37% and 46% for Swim, Bike and Run respectively (pooled genders). For females VO2peak explains as much as 80% of the variation in finishing time.

  • 12.
    Danielsson, Tom
    et al.
    Linnaeus University, Faculty of Social Sciences, Department of Sport Science.
    Carlsson, Jörg
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Hospital.
    Schreyer, Hendrik
    Kalmar County Hospital.
    Ahnesjö, Jonas
    Linnaeus University, Faculty of Social Sciences, Department of Sport Science.
    ten Siethoff, Lasse
    Linnaeus University, Faculty of Social Sciences, Department of Sport Science.
    Ragnarsson, Thony
    Linnaeus University, Faculty of Social Sciences, Department of Sport Science.
    Tugetam, Åsa
    Linnaeus University, Faculty of Social Sciences, Department of pedagogy. Linnaeus University, Faculty of Social Sciences, Department of Sport Science.
    Bergman, Patrick
    Linnaeus University, Faculty of Social Sciences, Department of Sport Science.
    Blood biomarkers in male and female participants after an Ironman-distance triathlon2017In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 12, no 6, p. 1-9, article id e0179324Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: While overall physical activity is clearly associated with a better short-term and long-term health, prolonged strenuous physical activity may result in a rise in acute levels of blood-biomarkers used in clinical practice for diagnosis of various conditions or diseases. In this study, we explored the acute effects of a full Ironman-distance triathlon on biomarkers related to heart-, liver-, kidney- and skeletal muscle damage immediately post-race and after one week's rest. We also examined if sex, age, finishing time and body composition influenced the post-race values of the biomarkers.

    METHODS: A sample of 30 subjects was recruited (50% women) to the study. The subjects were evaluated for body composition and blood samples were taken at three occasions, before the race (T1), immediately after (T2) and one week after the race (T3). Linear regression models were fitted to analyse the independent contribution of sex and finishing time controlled for weight, body fat percentage and age, on the biomarkers at the termination of the race (T2). Linear mixed models were fitted to examine if the biomarkers differed between the sexes over time (T1-T3).

    RESULTS: Being male was a significant predictor of higher post-race (T2) levels of myoglobin, CK, and creatinine levels and body weight was negatively associated with myoglobin. In general, the models were unable to explain the variation of the dependent variables. In the linear mixed models, an interaction between time (T1-T3) and sex was seen for myoglobin and creatinine, in which women had a less pronounced response to the race.

    CONCLUSION: Overall women appear to tolerate the effects of prolonged strenuous physical activity better than men as illustrated by their lower values of the biomarkers both post-race as well as during recovery.

  • 13.
    Danielsson, Tom
    et al.
    Linnaeus University, Faculty of Social Sciences, Department of Sport Science.
    Schreyer, Hendrik
    Kalmar County Hospital, Sweden.
    Woksepp, Hanna
    Kalmar County Hospital, Sweden.
    Johansson, Therese
    Kalmar County Hospital, Sweden.
    Bergman, Patrick
    Linnaeus University, Faculty of Social Sciences, Department of Sport Science.
    Månsson, Alf
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Carlsson, Jörg
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Hospital, Sweden.
    Two-peaked increase of serum myosin heavy chain-α after triathlon suggests heart muscle cell death2019In: BMJ Open Sport & Exercise Medicine, ISSN 2055-7647, Vol. 5, article id e000486Article in journal (Refereed)
    Abstract [en]

    Objective It has been suggested that the mechanism behind cardiac troponin elevation after strenuous exercise is passage through a cell membrane with changed permeability rather than myocardial cell death. We hypothesised that an increase of cardiac specific myosin heavy chain-alpha (MHC-α; 224 kDa compared with cardiac troponin T’s (cTnT) 37 kDa) could hardly be explained by passage through a cell membrane.

    Methods Blood samples were collected from 56 athletes (15 female, age 42.5±9.7, range 24–70 years) before, directly after and on days 1–8 after an Ironman. Biomarkers (C reactive protein (CRP), cTnT, creatinekinase (CK), MHC-α, myoglobin (MG), creatinine (C) and N-terminal prohormone of brain natriuretic peptide (NTproBNP) were measured.

    Results The course of MHC-α concentration (μg/L) was 1.33±0.53 (before), 2.57±0.78 (directly after), 1.51±0.53 (day 1), 2.74±0.55 (day 4) and 1.83±0.76 (day 6). Other biomarkers showed a one-peaked increase with maximal values either directly after the race or at day 1: cTnT 76 ±80 ng/L (12–440; reference<15), NT-proBNP 776±684 ng/L (92–4700; ref.<300), CK 68±55 μkat/L (5–280; ref.<1.9), MG 2088±2350 μg/L (130–17 000; ref.<72) and creatinine 100±20 μmol/L (74–161; ref.<100), CRP 49±23 mg/L(15–119; ref.<5).

    Conclusion MHC-α exhibited a two-peaked increase which could represent a first release from the cytosolic pool and later from cell necrosis. This is the first investigation of MHC-α plasma concentration afterexercise.

  • 14.
    Djukanovic, Ingrid
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Carlsson, Jörg
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Peterson, Ulla
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Group discussions with structured reminiscence and a problem-based method as an intervention to prevent depressive symptoms in older people2016In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 25, no 7-8, p. 992-1000Article in journal (Refereed)
    Abstract [en]

    Aims and objectives: To evaluate the effect of group discussions, in which structured reminiscence and a problem-based method were used, on depressive symptoms, quality of life and self-rated health among older people. Background: Depressive symptoms in older people have a considerable impact on self-rated health and quality of life, with a high rate of co-morbidity and mortality. As the ageing population is growing, late-life depression is becoming an important public health problem and there is a need to find preventive interventions to avert unnecessary suffering. Design: The study was quasi-experimental, with a one-group pretest-post-test design and follow-up after one year. Methods: Initially, a questionnaire was sent to the total population of 55-80-year-old retirees in a community in the northeast of Sweden, (n=679). The questionnaire concerned demographics and covered areas such as health, depression and quality of life. The intervention consisted of group discussions where structured reminiscence and a problem-based method were used. The participants (n=18) met 10 times under the guidance of a group-leader, a registered nurse educated in the method. Each session had different themes with a focus on positive memories but also on the present situation and the future. Parametric, nonparametric tests and content analysis were used.Results: Participants evaluated the intervention positively, showed a decrease in depressive symptoms, an increase in self-rated health and experienced an increased autonomy. No long- lasting effect was seen. Conclusion: Group discussions where structured reminiscence and a problem-based method are used might be an option to prevent depressive symptoms in older people. Relevance to clinical practice: This method might provide an opportunity for older people with depressive symptoms to improve their quality of life, however, to maintain the positive outcome the intervention should probably be continuous.

  • 15.
    Djukanovic, Ingrid
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Carlsson, Jörg
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Peterson, Ulla
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Reminiscence and problem-based method as an intervention to prevent depressive symptoms in elderly2016In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 72, p. 67-68Article in journal (Other academic)
  • 16.
    Djukanovic, Ingrid
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Carlsson, Jörg
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Hospital ; Linköping University.
    Is the Hospital Anxiety and Depression Scale (HADS) a valid measure in a general population 65-80 years old?: A psychometric evaluation study2017In: Health and Quality of Life Outcomes, ISSN 1477-7525, E-ISSN 1477-7525, Vol. 15, p. 1-10, article id 193Article in journal (Refereed)
    Abstract [en]

    Background: The HADS (Hospital Anxiety and Depression Scale) aims to measure symptoms of anxiety (HADS Anxiety) and depression (HADS Depression). The HADS is widely used but has shown ambiguous results both regarding the factor structure and sex differences in the prevalence of depressive symptoms. There is also a lack of psychometric evaluations of the HADS in non-clinical samples of older people. The aim of the study was to evaluate the factor structure of the HADS in a general population 65-80 years old and to exam possible presence of differential item functioning (DIF) with respect to sex. Methods: This study was based on data from a Swedish sample, randomized from the total population in the age group 65-80 years (n = 6659). Confirmatory factor analyses (CFA) were performed to examine the factor structure. Ordinal regression analyses were conducted to detect DIF for sex. Reliability was examined by both ordinal as well as traditional Cronbach's alpha. Results: The CFA showed a two-factor model with cross-loadings for two items (7 and 8) had excellent model fit. Internal consistency was good in both subscales, measured with ordinal and traditional alpha. Floor effects were presented for all items. No indication for meaningful DIF regarding sex was found for any of the subscales. Conclusions: HADS Anxiety and HADS Depression are unidimensional measures with acceptable internal consistency and are invariant with regard to sex. Despite pronounced ceiling effects and cross-loadings for item 7 and 8, the hypothesized two-factor model of HADS can be recommended to assess psychological distress among a general population 65-80 years old.

  • 17.
    Escaned, Javier
    et al.
    Hosp Clin San Carlos, Spain;Univ Complutense Madrid, Spain.
    Ryan, Nicola
    Hosp Clin San Carlos, Spain;Univ Complutense Madrid, Spain.
    Mejia-Renteria, Hernan
    Hosp Clin San Carlos,Spain;Univ Complutense Madrid, Spain.
    Cook, Christopher M.
    Imperial Coll London, UK.
    Dehbi, Hakim-Moulay
    UCL, UK.
    Alegria-Barrero, Eduardo
    Hosp Univ Torrejon, Spain;Univ Francisco de Vitoria, Spain.
    Alghamdi, Ali
    King Abdulaziz Med City Cardiac Ctr, Saudi Arabia.
    Al-Lamee, Rasha
    Imperial Coll London, UK.
    Altman, John
    Colorado Heart & Vasc, USA.
    Ambrosia, Alphonse
    Baptista, Sergio B.
    Hosp Prof Doutor Fernando Fonseca, Portugal.
    Bertilsson, Maria
    Uppsala University.
    Bhindi, Ravinay
    Royal North Shore Hosp, Australia.
    Birgander, Mats
    Lund University;Skåne University Hospital.
    Bojara, Waldemar
    Kemperhof Koblenz, Germany.
    Brugaletta, Salvatore
    Inst Invest Biomed August Pi & Sunyer, Spain.
    Buller, Christopher
    St Michaels Hosp, Canada.
    Calais, Fredrik
    Örebro University.
    Silva, Pedro Canas
    Hosp Santa Maria, Portugal.
    Carlsson, Jörg
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Hospital.
    Christiansen, Evald H.
    Aarhus Univ Hosp, Denmark.
    Danielewicz, Mikael
    Karlstad Hospital.
    Di Mario, Carlo
    Imperial Coll London, UK;Univ Florence, Italy.
    Doh, Joon-Hyung
    Inje Univ, South Korea.
    Erglis, Andrejs
    Pauls Stradins Clin Univ Hosp, Latvia.
    Erlinge, David
    Lund University;Skåne University Hospital.
    Gerber, Robert T.
    Conquest Hosp, UK.
    Going, Olaf
    Sana Klinikum Lichtenberg, Germany.
    Gudmundsdottir, Ingibjorg
    Reykjavik Univ Hosp, Iceland.
    Haerle, Tobias
    Carl von Ossietzky Univ Oldenburg, Germany.
    Hauer, Dario
    Linköping University.
    Hellig, Farrel
    Sunninghill Hosp, South Africa.
    Indolfi, Ciro
    Magna Graecia Univ Catanzaro, Italy.
    Jakobsen, Lars
    Aarhus Univ Hosp, Denmark.
    Janssens, Luc
    Imelda Hosp, Belgium.
    Jensen, Jens
    Karolinska Institutet;Södersjukhuset;Capio St Görans Sjukhus;Sundsvall Hospital.
    Jeremias, Allen
    SUNY Stony Brook, USA.
    Karegren, Amra
    Västmanland Hospital Västerås.
    Karlsson, Ann-Charlotte
    Halmstad County Hospital.
    Kharbanda, Rajesh K.
    Oxford Univ Hosp Fdn Trust, UK.
    Khashaba, Ahmed
    Ain Shams Univ, Egypt.
    Kikuta, Yuetsu
    Fukuyama Cardiovasc Hosp, Japan.
    Krackhardt, Florian
    Univ Med, Germany.
    Koo, Bon-Kwon
    Seoul Natl Univ Hosp, South Korea.
    Koul, Sasha
    Lund University;Skåne University Hospital.
    Laine, Mika
    Helsinki Univ Hosp, Finland.
    Lehman, Sam J.
    Flinders Univ S Australia, Australia.
    Lindroos, Pontus
    St Göran Hospital.
    Malik, Iqbal S.
    Imperial Coll London, UK.
    Maeng, Michael
    Aarhus Univ Hosp, Denmark.
    Matsuo, Hitoshi
    Gifu Heart Ctr, Japan.
    Meuwissen, Martijn
    Amphia Hosp, Netherlands.
    Nam, Chang-Wook
    Keimyung Univ, South Korea.
    Niccoli, Giampaolo
    Univ Cattolica Sacro Cuore, Italy.
    Nijjer, Sukhjinder S.
    Imperial Coll London, UK.
    Olsson, Hans
    Karlstad Hospital.
    Olsson, Sven-Erik
    Helsingborg Hospital.
    Omerovic, Elmir
    Sahlgrenska;University of Gothenburg.
    Panayi, Georgios
    Linköping University.
    Petraco, Ricardo
    Imperial Coll London, UK.
    Piek, Jan J.
    Acad Med Ctr, Netherlands.
    Ribichini, Flavo
    Univ Hosp Verona, Italy.
    Samady, Habib
    Emory Univ, USA.
    Samuels, Bruce
    Cedars Sinai Heart Inst, USA.
    Sandhall, Lennart
    Helsingborg Hospital.
    Sapontis, James
    MonashHeart,Australia;Monash Univ, Australia.
    Sen, Sayan
    Imperial Coll London, UK.
    Seto, Arnold H.
    Vet Affairs Long Beach Healthcare Syst, USA.
    Sezer, Murat
    Istanbul Univ, Turkey.
    Sharp, Andrew S. P.
    Royal Devon & Exeter Hosp, UK;Univ Exeter, UK.
    Shin, Eun-Seok
    Univ Ulsan, South Korea.
    Singh, Jasvindar
    Washington Univ, USA.
    Takashima, Hiroaki
    Aichi Med Univ Hosp, Japan.
    Talwar, Suneel
    Royal Bournemouth Gen Hosp, UK.
    Tanaka, Nobuhiro
    Tokyo Med Univ, Japan.
    Tang, Kare
    Essex Cardiothorac Ctr, UK;Anglia Ruskin Univ, UK.
    Van Belle, Eric
    Lille Univ Hosp, France;INSERM, France.
    van Royen, Niels
    Vrije Univ Amsterdam Med Ctr, Netherlands.
    Varenhorst, Christoph
    Uppsala University.
    Vinhas, Hugo
    Hosp Garcia de Horta, Portugal.
    Vrints, Christiaan J.
    Antwerp Univ Hosp, Belgium.
    Walters, Darren
    Prince Charles Hosp, Australia.
    Yokoi, Hiroyoshi
    Fukuoka Sannou Hosp, Japan.
    Frobert, Ole
    Örebro University.
    Patel, Manesh R.
    Duke Univ, USA.
    Serruys, Patrick
    Imperial Coll London, UK.
    Davies, Justin E.
    Imperial Coll London, UK.
    Gotberg, Matthias
    Lund University;Skåne University Hospital.
    Safety of the Deferral of Coronary Revascularization on the Basis of Instantaneous Wave-Free Ratio and Fractional Flow Reserve Measurements in Stable Coronary Artery Disease and Acute Coronary Syndromes2018In: JACC: Cardiovascular Interventions, ISSN 1936-8798, E-ISSN 1876-7605, Vol. 11, no 15, p. 1437-1449Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES The aim of this study was to investigate the clinical outcomes of patients deferred from coronary revascularization on the basis of instantaneous wave-free ratio (iFR) or fractional flow reserve (FFR) measurements in stable angina pectoris (SAP) and acute coronary syndromes (ACS). BACKGROUND Assessment of coronary stenosis severity with pressure guidewires is recommended to determine the need for myocardial revascularization. METHODS The safety of deferral of coronary revascularization in the pooled per-protocol population (n = 4,486) of the DEFINE-FLAIR (Functional Lesion Assessment of Intermediate Stenosis to Guide Revascularisation) and iFR-SWEDEHEART (Instantaneous Wave-Free Ratio Versus Fractional Flow Reserve in Patients With Stable Angina Pectoris or Acute Coronary Syndrome) randomized clinical trials was investigated. Patients were stratified according to revascularization decision making on the basis of iFR or FFR and to clinical presentation (SAP or ACS). The primary endpoint was major adverse cardiac events (MACE), defined as the composite of all-cause death, nonfatal myocardial infarction, or unplanned revascularization at 1 year. RESULTS Coronary revascularization was deferred in 2,130 patients. Deferral was performed in 1,117 patients (50%) in the iFR group and 1,013 patients (45%) in the FFR group (p < 0.01). At 1 year, the MACE rate in the deferred population was similar between the iFR and FFR groups (4.12% vs. 4.05%; fully adjusted hazard ratio: 1.13; 95% confidence interval: 0.72 to 1.79; p = 0.60). A clinical presentation with ACS was associated with a higher MACE rate compared with SAP in deferred patients (5.91% vs. 3.64% in ACS and SAP, respectively; fully adjusted hazard ratio: 0.61 in favor of SAP; 95% confidence interval: 0.38 to 0.99; p = 0.04). CONCLUSIONS Overall, deferral of revascularization is equally safe with both iFR and FFR, with a low MACE rate of about 4%. Lesions were more frequently deferred when iFR was used to assess physiological significance. In deferred patients presenting with ACS, the event rate was significantly increased compared with SAP at 1 year. (C) 2018 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation.

  • 18.
    Fröbert, Ole
    et al.
    Örebro University Hospital.
    Scherstén, Fredrik
    Skåne University Hospital.
    James, Stefan K.
    Uppsala University.
    Carlsson, Jörg
    Kalmar County Hospital.
    Lagerqvist, Bo
    Uppsala University.
    Long-term safety and efficacy of drug-eluting and bare metal stents in saphenous vein grafts2012In: American Heart Journal, ISSN 0002-8703, E-ISSN 1097-6744, Vol. 164, no 1, p. 87-93Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Long-term safety and efficacy data of drug-eluting stents (DESs) in saphenous vein grafts (SVGs) are lacking. This study sought to compare the clinical outcomes of DES versus bare metal stents (BMS) in SVGs.

    METHODS: We studied all stent implantations in SVGs in Sweden during 74 months between 2005 and 2011 registered in the Swedish Coronary Angiography and Angioplasty Registry. We evaluated outcome in patients who received DES compared with those who received BMS after adjustments for differences in clinical, vessel, and lesion characteristics.

    RESULTS: Mean follow-up time was 3 years and 4 months. A total of 4,576 stents, implanted at 3,063 procedures, were included in the analysis of which 2,499 stents (54.6 %) were BMS and 2,077 (45.4%) were DES. The outcome analysis was based on 190 stent thromboses, 898 restenoses, and 523 deaths. The incidence of stent thrombosis did not differ between groups. When adjusted for baseline characteristics, including a propensity score for receiving DES, the incidence of restenosis was significantly lower with DES as compared with BMS (risk ratio 0.83, 95% CI 0.70-0.97, P = .019). There was a difference in mortality in the crude analysis between DES and BMS, and after multivariable adjustment, this difference remained statistically significant (risk ratio 0.80, CI 0.65-0.99, P = .038).

    CONCLUSIONS: The use of DES compared with BMS in SVGs was associated with a significantly lower adjusted incidence of restenosis and death in this large, national, all-encompassing propensity adjusted observational study.

  • 19.
    Gotberg, M.
    et al.
    Lund University.
    Christiansen, E. H.
    Aarhus Univ Hosp, Denmark.
    Gudmundsdottir, I. J.
    Reykjavik Univ Hosp, Iceland.
    Sandhall, L.
    Helsingborg Hosp.
    Danielewicz, M.
    Karlstad Hosp.
    Jakobsen, L.
    Aarhus Univ Hosp, Denmark.
    Olsson, S. -E
    Ohagen, P.
    Uppsala University.
    Olsson, H.
    Karlstad Hosp.
    Omerovic, E.
    Sahlgrenska Univ.
    Calais, F.
    Örebro University.
    Lindroos, P.
    St Göran Hosp.
    Maeng, M.
    Aarhus Univ Hosp, Denmark.
    Todt, T.
    Lund Univ, Skåne Univ Hosp.
    Venetsanos, D.
    Linköping University.
    James, S. K.
    Uppsala University.
    Karegren, A.
    Västmanland Hosp Västerås.
    Nilsson, M.
    Lund Univ, Skåne Univ Hosp.
    Carlsson, Jörg
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Hospital.
    Hauer, D.
    Linköping University.
    Jensen, J.
    Karolinska Institutet ; Capio St Görans Sjukhus ; Sundsvall Hosp.
    Karlsson, A. -C
    Panayi, G.
    Linköping University.
    Erlinge, D.
    Lund University, Skåne Univ Hosp.
    Frobert, O.
    Örebro University.
    Instantaneous Wave-free Ratio versus Fractional Flow Reserve to Guide PCI2017In: New England Journal of Medicine, ISSN 0028-4793, E-ISSN 1533-4406, Vol. 376, no 19, p. 1813-1823Article in journal (Refereed)
    Abstract [en]

    BACKGROUND The instantaneous wave-free ratio (iFR) is an index used to assess the severity of coronary-artery stenosis. The index has been tested against fractional flow reserve (FFR) in small trials, and the two measures have been found to have similar diagnostic accuracy. However, studies of clinical outcomes associated with the use of iFR are lacking. We aimed to evaluate whether iFR is noninferior to FFR with respect to the rate of subsequent major adverse cardiac events. METHODS We conducted a multicenter, randomized, controlled, open-label clinical trial using the Swedish Coronary Angiography and Angioplasty Registry for enrollment. A total of 2037 participants with stable angina or an acute coronary syndrome who had an indication for physiologically guided assessment of coronary-artery stenosis were randomly assigned to undergo revascularization guided by either iFR or FFR. The primary end point was the rate of a composite of death from any cause, nonfatal myocardial infarction, or unplanned revascularization within 12 months after the procedure. RESULTS A primary end-point event occurred in 68 of 1012 patients (6.7%) in the iFR group and in 61 of 1007 (6.1%) in the FFR group (difference in event rates, 0.7 percentage points; 95% confidence interval [CI], -1.5 to 2.8; P = 0.007 for noninferiority; hazard ratio, 1.12; 95% CI, 0.79 to 1.58; P = 0.53); the upper limit of the 95% confidence interval for the difference in event rates fell within the prespecified noninferiority margin of 3.2 percentage points. The results were similar among major subgroups. The rates of myocardial infarction, target-lesion revascularization, restenosis, and stent thrombosis did not differ significantly between the two groups. A significantly higher proportion of patients in the FFR group than in the iFR group reported chest discomfort during the procedure. CONCLUSIONS Among patients with stable angina or an acute coronary syndrome, an iFR-guided revascularization strategy was noninferior to an FFR-guided revascularization strategy with respect to the rate of major adverse cardiac events at 12 months.

  • 20.
    Israelsson, Johan
    et al.
    Linnaeus University, Faculty of Technology, Kalmar Maritime Academy. Kalmar County Hospital ; Linköping University.
    von Wangenheim, Burkard
    Kalmar County Hospital.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköping University.
    Semark, Birgitta
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Schildmeijer, Kristina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Carlsson, Jörg
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Hospital.
    Sensitivity and specificity of two different automated external defibrillators2017In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 120, p. 108-112Article in journal (Refereed)
    Abstract [en]

    Aim: The aim was to investigate the clinical performance of two different types of automated external defibrillators (AEDs). Methods: Three investigators reviewed 2938 rhythm analyses performed by AEDs in 240 consecutive patients (median age 72, q1-q3 = 62-83) who had suffered cardiac arrest between January 2011 and March 2015. Two different AEDs were used (AED A n = 105, AED B n = 135) in-hospital (n = 91) and out-of-hospital (n = 149). Results: Among 194 shockable rhythms, 17 (8.8%) were not recognized by AED A, while AED B recognized 100% (n = 135) of shockable episodes (sensitivity 91.2 vs 100%, p < 0.01). In AED A, 8 (47.1%) of these episodes were judged to be algorithm errors while 9 (52.9%) were caused by external artifacts. Among 1039 non-shockable rhythms, AED A recommended shock in 11 (1.0%), while AED B recommended shock in 63 (4.1%) of 1523 episodes (specificity 98.9 vs 95.9, p < 0.001). In AED A, 2 (18.2%) of these episodes were judged to be algorithm errors (AED B, n = 40, 63.5%), while 9 (81.8%) were caused by external artifacts (AED B, n = 23, 36.5%). Conclusions: There were significant differences in sensitivity and specificity between the two different AEDs. A higher sensitivity of AED B was associated with a lower specificity while a higher specificity of AED A was associated with a lower sensitivity. AED manufacturers should work to improve the algorithms. In addition, AED use should always be reviewed with a routine for giving feedback, and medical personnel should be aware of the specific strengths and shortcomings of the device they are using. (C) 2017 Elsevier B.V. All rights reserved.

  • 21.
    Lagerqvist, Bo
    et al.
    Uppsala Univ.
    Frobert, Ole
    Örebro Univ Hosp.
    Olivecrona, Göran K.
    Lund Univ.
    Gudnason, Thorarinn
    Landspitali Univ Hosp.
    Maeng, Michael
    Aarhus Univ Hosp.
    Alstrom, Patrik
    Karolinska Inst.
    Andersson, Jonas
    Umeå Univ Hosp.
    Calais, Fredrik
    Örebro Univ Hosp.
    Carlsson, Jörg
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Hospital.
    Collste, Olov
    Karolinska Inst.
    Gotberg, Matthias
    Lund Univ.
    Hardhammar, Peter
    Ioanes, Dan
    Kallryd, Anders
    Linder, Rickard
    Karolinska Inst.
    Lundin, Anders
    Odenstedt, Jacob
    Omerovic, Elmir
    Puskar, Verner
    Todt, Tim
    Zelleroth, Eva
    Ostlund, Ollie
    James, Stefan K.
    Outcomes 1 Year after Thrombus Aspiration for Myocardial Infarction2014In: New England Journal of Medicine, ISSN 0028-4793, E-ISSN 1533-4406, Vol. 371, no 12, p. 1111-1120Article in journal (Refereed)
    Abstract [en]

    BACKGROUND Routine intracoronary thrombus aspiration before primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI) has not been proved to reduce short-term mortality. We evaluated clinical outcomes at 1 year after thrombus aspiration. METHODS We randomly assigned 7244 patients with STEMI to undergo manual thrombus aspiration followed by PCI or to undergo PCI alone, in a registry-based, randomized clinical trial. The primary end point of all-cause mortality at 30 days has been reported previously. Death from any cause at 1 year was a prespecified secondary end point of the trial. RESULTS No patients were lost to follow-up. Death from any cause occurred in 5.3% of the patients (191 of 3621 patients) in the thrombus-aspiration group, as compared with 5.6% (202 of 3623) in the PCI-only group (hazard ratio, 0.94; 95% confidence interval [CI], 0.78 to 1.15; P = 0.57). Rehospitalization for myocardial infarction at 1 year occurred in 2.7% and 2.7% of the patients, respectively (hazard ratio, 0.97; 95% CI, 0.73 to 1.28; P = 0.81), and stent thrombosis in 0.7% and 0.9%, respectively (hazard ratio, 0.84; 95% CI, 0.50 to 1.40; P = 0.51). The composite of death from any cause, rehospitalization for myocardial infarction, or stent thrombosis occurred in 8.0% and 8.5% of the patients, respectively (hazard ratio, 0.94; 95% CI, 0.80 to 1.11; P = 0.48). The results were consistent across all the major subgroups, including grade of thrombus burden and coronary flow before PCI. CONCLUSIONS Routine thrombus aspiration before PCI in patients with STEMI did not reduce the rate of death from any cause or the composite of death from any cause, rehospitalization for myocardial infarction, or stent thrombosis at 1 year.

  • 22.
    Nord, Anette
    et al.
    Linköping University, Sweden.
    Lundgren, Johan
    Bremer, Anders
    University of Borås, Sweden.
    Carlsson, Jörg
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Israelsson, Johan
    Linköping University, Sweden.
    Apropå! – HLR och rätten till en värdig död2016In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, no 20, article id 113:DZEHArticle in journal (Other (popular science, discussion, etc.))
  • 23.
    Panayi, Georgios
    et al.
    Linköping University.
    Wieringa, Wouter G.
    Univ Groningen, Netherlands.
    Alfredsson, Joakim
    Linköping University.
    Carlsson, Jörg
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Hospital.
    Karlsson, Jan-Erik
    County Hospital Ryhov, Jönköping ; Linköping University.
    Persson, Anders
    Linköping University.
    Engvall, Jan
    Linköping University.
    Pundziute, Gabija
    Univ Groningen, Netherlands.
    Swahn, Eva
    Linköping University.
    Computed tomography coronary angiography in patients with acute myocardial infarction and normal invasive coronary angiography2016In: BMC Cardiovascular Disorders, ISSN 1471-2261, E-ISSN 1471-2261, Vol. 16, article id 78Article in journal (Refereed)
    Abstract [en]

    Background: Three to five percent of patients with acute myocardial infarction (AMI) have normal coronary arteries on invasive coronary angiography (ICA). The aim of this study was to assess the presence and characteristics of atherosclerotic plaques on computed tomography coronary angiography (CTCA) and describe the clinical characteristics of this group of patients. Methods: This was a multicentre, prospective, descriptive study on CTCA evaluation in thirty patients fulfilling criteria for AMI and without visible coronary plaques on ICA. CTCA evaluation was performed head to head in consensus by two experienced observers blinded to baseline patient characteristics and ICA results. Analysis of plaque characteristics and plaque effect on the arterial lumen was performed. Coronary segments were visually scored for the presence of plaque. Seventeen segments were differentiated, according to a modified American Heart Association classification. Echocardiography performed according to routine during the initial hospitalisation was retrieved for analysis of wall motion abnormalities and left ventricular systolic function in most patients. Results: Twenty-five patients presented with non ST-elevation myocardial infarction (NSTEMI) and five with ST-elevation myocardial infarction (STEMI). Mean age was 60.2 years and 23/30 were women. The prevalence of risk factors of coronary artery disease (CAD) was low. In total, 452 coronary segments were analysed. Eighty percent (24/30) had completely normal coronary arteries and twenty percent (6/30) had coronary atherosclerosis on CTCA. In patients with atherosclerotic plaques, the median number of segments with plaque per patient was one. Echocardiography was normal in 4/22 patients based on normal global longitudinal strain (GLS) and normal wall motion score index (WMSI); 4/22 patients had normal GLS with pathological WMSI; 3/22 patients had pathological GLS and normal WMSI; 11/22 patients had pathological GLS and WMSI and among them we could identify 5 patients with a Takotsubo pattern on echo. Conclusions: Despite a diagnosis of AMI, 80 % of patients with normal ICA showed no coronary plaques on CTCA. The remaining 20 % had only minimal non-obstructive atherosclerosis. Patients fulfilling clinical criteria for AMI but with completely normal ICA need further evaluation, suggestively with magnetic resonance imaging (MRI).

  • 24.
    Schildmeijer, Kristina
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Israelsson, Johan
    Kalmar County Hospital, Sweden.
    von Wangenheim, Burkard
    Kalmar County Hospital, Sweden.
    Semark, Birgitta
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Carlsson, Jörg
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Sensitivitet och specificitet hos två olika hjärtstartare2016In: Presented at HLR2016: "Ett hjärtsäkert Sverige”, Gothenburg, Sweden, October 11-12, 2016, 2016Conference paper (Other academic)
  • 25.
    Schildmeijer, Kristina
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Semark, Birgitta
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Israelsson, Johan
    Kalmar County Hospital.
    Carlsson, Jörg
    Kalmar County Hospital.
    von Wangenheim, Burkard
    Kalmar County Hospital.
    Quality of chest compressions by healthcare professionals using real-time audiovisual feedback during in-hospital cardiopulmonary resusscitation2017In: Paper presented at the 2nd International Nursing Conference (Nursing-2017), Barcelona, Spain, November 1-3, 2017, Madridge , 2017Conference paper (Other academic)
  • 26.
    Schildmeijer, Kristina
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Semark, Birgitta
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Israelsson, Johan
    Linnaeus University, Faculty of Technology, Kalmar Maritime Academy.
    von Wangenheim, Burkard
    Carlsson, Jörg
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Quality of chest compressions and complaince by healthcare professionals with real-time audiovisual feedback during in-hospital cardiopulmonary resuscitation2017In: 2nd International Nursing Conference, November 1-3, 2017, Barcelona, Spain, 2017Conference paper (Other academic)
  • 27. Schwalm, Torsten
    et al.
    Carlsson, Jörg
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Hospital.
    Meissner, Axel
    Lagerqvist, Bo
    James, Stefan
    Current treatment and outcome of coronary in-stent restenosis in Sweden: a report from the Swedish Coronary Angiography and Angioplasty Registry (SCAAR)2013In: EuroIntervention, ISSN 1774-024X, E-ISSN 1969-6213, Vol. 9, no 5, p. 564-572Article in journal (Refereed)
    Abstract [en]

    Aims: The aim of this study was to evaluate treatment of coronary in-stent restenosis (ISR). Methods and results: We investigated interventions for ISR and the occurrence of re-restenosis in the Swedish Angiography and Angioplasty Registry (SCAAR). From January 1st 2005 to March 3rd 2012, 212,166 coronary segments were treated and 7,806 restenoses analysed. During seven years of follow-up 1,079 re-restenoses were registered on clinically driven angiography. For BMS-ISR the adjusted risk of re-restenosis was significantly lower with DES (adjusted hazard ratio [BR] 0.71,95% confidence interval [CI]: 0.61-0.82), tended to be lower with DEB (HR 0.84, 95% CI: 0.62-1.16), but higher with BMS (BR 1.24, 95% CI: 1.0-1.55) as compared to balloon angioplasty. For DES-ISR a new DES was associated with a significantly lower adjusted risk of re-restenosis (HR. 0.80, 95% CI: 0.66-0.99), and a similar but non-significant reduction with DEB (BR 0.86, 95% CI: 0.57-1.30) and BMS (BR 0.81, 95% CI: 0.53-1.24) compared to balloon angioplasty. For DES-ISR a DES with a different drug was not more effective than a DES with the same drug. Conclusions: ISR in BMS should be treated with DES or DEB while the optimal treatment of ISR in DES remains to be proven.

  • 28.
    Semark, Birgitta
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Israelsson, Johan
    Kalmar County Hospital.
    Carlsson, Jörg
    Kalmar County Hospital.
    von Wangenheim, Burkard
    Kalmar County Hospital.
    Schildmeijer, Kristina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Quality of chest compressions during CPR-comparison between manual and automatic review2015In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 96, no Supplement 1, p. 66-66, article id AP058Article in journal (Refereed)
  • 29.
    Semark, Birgitta
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköping University.
    Israelsson, Johan
    Linnaeus University, Faculty of Technology, Kalmar Maritime Academy. Linköping University ; Kalmar County Hospital.
    von Wangenheim, Burkard
    Kalmar County Hospital.
    Carlsson, Jörg
    Kalmar County Hospital.
    Schildmeijer, Kristina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Quality of chest compressions by healthcare professionals using real-time audiovisual feedback during in-hospital cardiopulmonary resuscitation2017In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, no 5, p. 453-457Article in journal (Refereed)
    Abstract [en]

    Introduction: A high quality of chest compressions, e.g. sufficient depth (5-6 cm) and rate (100-120 per min), has been associated with survival. The patient's underlay affects chest compression depth. Depth and rate can be assessed by feedback systems to guide rescuers during cardiopulmonary resuscitation. Aim: The purpose of this study was to describe the quality of chest compressions by healthcare professionals using real-time audiovisual feedback during in-hospital cardiopulmonary resuscitation. Method: An observational descriptive study was performed including 63 cardiac arrest events with a resuscitation attempt. Data files were recorded by Zoll AED Pro, and reviewed by RescueNet Code Review software. The events were analysed according to depth, rate, quality of chest compressions and underlay. Results: Across events, 12.7% (median) of the compressions had a depth of 5-6 cm. Compression depth of >6 cm was measured in 70.1% (median). The underlay could be identified from the electronic patient records in 54 events. The median compression depth was 4.5 cm (floor) and 6.7 cm (mattress). Across events, 57.5% (median) of the compressions were performed with a median frequency of 100-120 compressions/min and the most common problem was a compression rate of <100 (median=22.3%). Conclusions: Chest compression quality was poor according to the feedback system. However, the distribution of compression depth with regard to underlay points towards overestimation of depth when treating patients on a mattress. Audiovisual feedback devices ought to be further developed. Healthcare professionals need to be aware of the strengths and weaknesses of their devices.

  • 30.
    Varenhorst, Christoph
    et al.
    Uppsala University.
    Lindholm, Martin
    Västerås County Hospital.
    Sarno, Giovanna
    Uppsala University.
    Olivecrona, Goran
    Lund University.
    Jensens, Ulf
    Karolinska Institutet.
    Nilsson, Johan
    Umeå University.
    Carlsson, Jörg
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    James, Stefan
    Uppsala University.
    Lagergvist, Bo
    Uppsala University.
    Stent thrombosis rates the first year and beyond with new- and old-generation drug-eluting stents compared to bare metal stents2018In: Clinical Research in Cardiology, ISSN 1861-0684, E-ISSN 1861-0692, Vol. 107, no 9, p. 816-823Article in journal (Refereed)
    Abstract [en]

    Old-generation drug-eluting coronary stents (o-DES) have despite being safe and effective been associated with an increased propensity of late stent thrombosis (ST). We evaluated ST rates in o-DES, new-generation DES (n-DES) and bare metal stents (BMS) the first year (< 1 year) and beyond 1 year (> 1 year). We evaluated all implantations with BMS, o-DES (Cordis Cypher, Boston Scientific Taxus Libert, and Medtronic Endeavor) and n-DES in the Swedish coronary angiography and angioplasty registry (SCAAR) between 1 January 2007 and 8 January 2014 (n = 207 291). All cases of ST (n = 2 268) until 31 December 2014 were analyzed. The overall risk of ST was lower in both n-DES and o-DES compared with BMS up to 1 year (n-DES versus BMS: adjusted risk ratio (RR) 0.48 (0.41-0.58) and o-DES versus BMS: 0.56 (0.46-0.67), both p < 0.001). From 1 year after stent implantation and onward, the risk for ST was higher in o-DES compared with BMS [adjusted RR, 1.82 (1.47-2.25], p < 0.001). N-DES were associated with similar low ST rates as BMS from 1 year and onward [adjusted RR 1.21 (0.94-1.56), p = 0.135]. New-generation DES were associated with lower ST rates in comparison to BMS during the first-year post-stenting. After 1 year, n-DES and BMS were associated with similar ST rates. This study was a retrospective observational study and as such did not require clinical trial database registration.

  • 31.
    Velders, Matthijs A.
    et al.
    Uppsala University ; Leiden University Medical Center, The Netherlands.
    James, Stefan K.
    Uppsala University.
    Libungan, Berglind
    Sahlgrenska University Hospital.
    Sarno, Giovanna
    Uppsala University.
    Fröbert, Ole
    Örebro University Hospital.
    Carlsson, Jörg
    Kalmar County Hospital.
    Schalij, Martin J.
    Leiden University Medical Center, The Netherlands.
    Albertsson, Per
    Sahlgrenska University Hospital.
    Lagerqvist, Bo
    Uppsala University.
    Prognosis of elderly patients with ST-elevation myocardial infarction treated with primary percutaneous coronary intervention in 2001 to 2011: a report from the Swedish Coronary Angiography and Angioplasty Registry (SCAAR) registry2014In: American Heart Journal, ISSN 0002-8703, E-ISSN 1097-6744, Vol. 167, no 5, p. 666-673Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Elderly patients constitute a growing part of the population presenting with ST-elevation myocardial infarction (STEMI). The use of primary percutaneous coronary intervention (PCI) in this high-risk population remains poorly investigated.

    METHODS: Using the Swedish Coronary Angiography and Angioplasty Registry (SCAAR), we identified consecutive patients with STEMI 80 years or older undergoing primary PCI during a 10-year period. Temporal trends in care and 1-year prognosis were investigated, and long-term outcome was compared with a reference group of patients with STEMI aged 70 to 79 years. Relative survival was calculated by dividing the observed survival rate with the expected survival rate of the general population. Adjusted end points were calculated using Cox regression.

    RESULTS: In total, 4,876 elderly patients with STEMI were included. During the study period, average age and presence of comorbidity increased, as well as the use of antithrombotic therapy. Procedural success remained constant. One-year mortality was exclusively reduced between the most recent vs the earliest cohort, whereas the risk of reinfarction, heart failure, stroke, and bleeding remained similar. The risk of death was higher for elderly patients early after PCI, after which the prognosis was slightly better compared with the general population. Long-term risk of adverse events increased markedly with age.

    CONCLUSIONS: The prognosis of patients older than 80 years treated with primary PCI for STEMI was relatively unchanged during the 10-year inclusion period, despite changes in patient characteristics and treatment. Advanced age increased the risk of adverse events, but survivors of the early phase after PCI had a slightly improved prognosis compared with the general population.

  • 32. Von Wangenheim, Burkard
    et al.
    Israelsson, Johan
    Lindstaedt, Michael
    Carlsson, Jörg
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Hospital, Sweden.
    Halvautomatiska hjärtstartare tolkar inte alltid rätt: fem patienter defibrillerades trots icke-defibrillerbar rytm2015In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 112, no 32-33, p. 1-4Article in journal (Refereed)
    Abstract [sv]

    Halvautomatiska defibrillatorer är en viktig del i kampen mot plötslig hjärtdöd. 

    Höga krav på sensitivitet och specificitet vid rytmtolkning ska säkerställa effektivt och säkert bruk. 

    Vi rapporterar fem fall där brister i specificitet hos defibrillatorn ledde till defibrillering av icke-defibrillerbara rytmer.

    Systematisk undersökning av halvautomatiska defibrillatorers prestationsförmåga vid rytmtolkning är nödvändig och skulle kunna bidra till utveckling av förbättrade analysalgoritmer och utbildningsprogram.

1 - 32 of 32
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf