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  • 1551.
    Yeo, Astrid
    et al.
    GlaxoSmithKline Med Res Ctr, Dept Genet, Stevenage, Herts, England..
    Li, Li
    GlaxoSmithKline Med Res Ctr, Dept Genet, Res Triangle Pk, NC USA.;PAREXEL Int, Genom Med, Durham, NC USA..
    Warren, Liling
    GlaxoSmithKline Med Res Ctr, Dept Genet, Res Triangle Pk, NC USA.;Teva Pharmaceut, Raleigh, NC USA..
    Aponte, Jennifer
    GlaxoSmithKline Med Res Ctr, Dept Genet, Res Triangle Pk, NC USA.;PAREXEL Int, Genom Med, Durham, NC USA..
    Fraser, Dana
    GlaxoSmithKline Med Res Ctr, Dept Genet, Res Triangle Pk, NC USA.;PAREXEL Int, Genom Med, Durham, NC USA..
    King, Karen
    GlaxoSmithKline Med Res Ctr, Dept Genet, Res Triangle Pk, NC USA.;PAREXEL Int, Genom Med, Durham, NC USA..
    Johansson, Kelley
    GlaxoSmithKline Med Res Ctr, Dept Genet, Res Triangle Pk, NC USA.;PAREXEL Int, Genom Med, Durham, NC USA..
    Barnes, Allison
    GlaxoSmithKline Med Res Ctr, Clin Stat, Res Triangle Pk, NC USA.;PAREXEL Int, Biostat, Durham, NC USA..
    MacPhee, Colin
    GlaxoSmithKline Med Res Ctr, Dept Vasc Biol & Thrombosis, King Of Prussia, PA USA..
    Davies, Richard
    GlaxoSmithKline Med Res Ctr, Metab Pathways & Cardiovasc Therapeut Area, King Of Prussia, PA USA..
    Chissoe, Stephanie
    GlaxoSmithKline Med Res Ctr, Dept Genet, Res Triangle Pk, NC USA.;GlaxoSmithKline, Elliott Ave, Seattle, WA USA..
    Tarka, Elizabeth
    GlaxoSmithKline Med Res Ctr, Metab Pathways & Cardiovasc Therapeut Area, King Of Prussia, PA USA.;Janssen Pharmaceut, Spring House, PA USA..
    O'Donoghue, Michelle L.
    Brigham & Womens Hosp, Div Cardiovasc, TIMI Study Grp, 75 Francis St, Boston, MA 02115 USA..
    White, Harvey D.
    Auckland City Hosp, Green Lane Cardiovasc Serv, Auckland, New Zealand.;Univ Auckland, Auckland, New Zealand..
    Wallentin, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Waterworth, Dawn
    GlaxoSmithKline Med Res Ctr, Dept Genet, Philadelphia, PA USA..
    Pharmacogenetic meta-analysis of baseline risk factors, pharmacodynamic, efficacy and tolerability endpoints from two large global cardiovascular outcomes trials for darapladib2017In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 12, no 7, article id e0182115Article in journal (Refereed)
    Abstract [en]

    Darapladib, a lipoprotein-associated phospholipase A2 (Lp-PLA(2)) inhibitor, failed to demonstrate efficacy for the primary endpoints in two large phase III cardiovascular outcomes trials, one in stable coronary heart disease patients (STABILITY) and one in acute coronary syndrome (SOLID-TIMI 52). No major safety signals were observed but tolerability issues of diarrhea and odor were common (up to 13%). We hypothesized that genetic variants associated with Lp-PLA(2) activity may influence efficacy and tolerability and therefore performed a comprehensive pharmacogenetic analysis of both trials. We genotyped patients within the STABILITY and SOLID-TIMI 52 trials who provided a DNA sample and consent (n = 13,577 and 10,404 respectively, representing 86% and 82% of the trial participants) using genomewide arrays with exome content and performed imputation using a 1000 Genomes reference panel. We investigated baseline and change from baseline in Lp-PLA(2) activity, two efficacy endpoints (major coronary events and myocardial infarction) as well as tolerability parameters at genome-wide and candidate gene level using a meta-analytic approach. We replicated associations of published loci on baseline Lp-PLA2 activity (APOE, CELSR2, LPA, PLA2G7, LDLR and SCARB1) and identified three novel loci (TOMM5, FRMD5 and LPL) using the GWAS-significance threshold P <= 5E-08. Review of the PLA2G7 gene (encoding Lp-PLA(2)) within these datasets identified V279F null allele carriers as well as three other rare exonic null alleles within various ethnic groups, however none of these variants nor any other loci associated with Lp-PLA(2) activity at baseline were associated with any of the drug response endpoints. The analysis of darapladib efficacy endpoints, despite low power, identified six low frequency loci with main genotype effect (though with borderline imputation scores) and one common locus (minor allele frequency 0.24) with genotype by treatment interaction effect passing the GWAS-significance threshold. This locus conferred risk in placebo subjects, hazard ratio (HR) 1.22 with 95% confidence interval (CI) 1.11-1.33, but was protective in darapladib subjects, HR 0.79 ( 95% CI 0.71-0.88). No major loci for tolerability were found. Thus, genetic analysis confirmed and extended the influence of lipoprotein loci on Lp-PLA(2) levels, identified some novel null alleles in the PLA2G7 gene, and only identified one potentially efficacious subgroup within these two large clinical trials.

  • 1552.
    Yusuf, Salim
    et al.
    McMaster Univ, Hamilton Hlth Sci, Populat Hlth Res Inst, Hamilton, ON, Canada.;McMaster Univ, Dept Med, Hamilton, ON, Canada..
    Lonn, Eva
    McMaster Univ, Hamilton Hlth Sci, Populat Hlth Res Inst, Hamilton, ON, Canada.;McMaster Univ, Dept Med, Hamilton, ON, Canada..
    Pais, Prem
    St Johns Res Inst, Bangalore, Karnataka, India..
    Bosch, Jackie
    McMaster Univ, Hamilton Hlth Sci, Populat Hlth Res Inst, Hamilton, ON, Canada.;McMaster Univ, Sch Rehabil Sci, Hamilton, ON, Canada..
    Lopez-Jaramillo, Patricio
    Univ Santander, Fdn Oftalmol Santander, Bucaramanga, Colombia.;Univ Santander, Inst Masira, Sch Med, Bucaramanga, Colombia..
    Zhu, Jun
    Chinese Acad Med Sci, Fu Wai Hosp, Beijing 100730, Peoples R China.;Peking Union Med Coll, Beijing 100021, Peoples R China..
    Xavier, Denis
    St Johns Res Inst, Bangalore, Karnataka, India.;St Johns Med Coll, Bangalore, Karnataka, India..
    Avezum, Alvaro
    Dante Pazzanese Inst Cardiol, Sao Paulo, Brazil..
    Leiter, Lawrence A.
    Univ Toronto, St Michaels Hosp, Li Ka Shing Knowledge Inst, Toronto, ON, Canada.;Univ Toronto, St Michaels Hosp, Keenan Res Ctr Biomed Sci, Toronto, ON, Canada..
    Piegas, Leopoldo S.
    HCor Heart Hosp, Sao Paulo, Brazil..
    Parkhomenko, Alexander
    Inst Cardiol, Kiev, Ukraine..
    Keltai, Matyas
    Semmelweis Univ, Hungarian Inst Cardiol, H-1085 Budapest, Hungary..
    Keltai, Katalin
    Semmelweis Univ, Hungarian Inst Cardiol, H-1085 Budapest, Hungary..
    Sliwa, Karen
    Univ Cape Town, Hatter Inst Cardiovasc Res Africa, Dept Med, Soweto Cardiovasc Res Grp, ZA-7925 Cape Town, South Africa..
    Chazova, Irina
    Inst Clin Cardiol, Russian Cardiol Res Complex, Moscow, Russia..
    Peters, Ron J. G.
    Univ Amsterdam, Acad Med Ctr, Dept Cardiol, Meibergdreef 9, NL-1105 AZ Amsterdam, Netherlands..
    Held, Claes
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Yusoff, Khalid
    Univ Teknologi Majlis Amansh Rakyat, Selayang, Malaysia.;Univ Coll Sedaya Int Univ, Kuala Lumpur, Malaysia..
    Lewis, Basil S.
    Technion Israel Inst Technol, Ruth & Bruce Rappaport Sch Med, Lady Davis Carmel Med Ctr, Haifa, Israel..
    Jansky, Petr
    Univ Hosp Motol, Prague, Czech Republic..
    Khunti, Kamlesh
    Univ Leicester, Diabet Res Ctr, Leicester, Leics, England..
    Toff, William D.
    Univ Leicester, Dept Cardiovasc Sci, Leicester, Leics, England.;Glenfield Hosp, Natl Inst Hlth Res, Leicester Cardiovasc Biomed Res Unit, Leicester, Leics, England..
    Reid, Christopher M.
    Monash Ctr Cardiovasc Res & Educ Therapeut, Primary Care Diabet & Vasc Med, Melbourne, Vic, Australia.;Curtin Univ, Sch Publ Hlth, Perth, WA 6845, Australia..
    Varigos, John
    Monash Univ, Dept Epidemiol & Prevent Med, Melbourne, Vic 3004, Australia..
    Accini, Jose L.
    Univ Norte, Barranquilla, Colombia..
    McKelvie, Robert
    McMaster Univ, Hamilton Hlth Sci, Populat Hlth Res Inst, Hamilton, ON, Canada.;McMaster Univ, Dept Med, Hamilton, ON, Canada..
    Pogue, Janice
    McMaster Univ, Hamilton Hlth Sci, Populat Hlth Res Inst, Hamilton, ON, Canada.;McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON, Canada..
    Jung, Hyejung
    McMaster Univ, Hamilton Hlth Sci, Populat Hlth Res Inst, Hamilton, ON, Canada..
    Liu, Lisheng
    Chinese Acad Med Sci, Fu Wai Hosp, Beijing 100730, Peoples R China.;Peking Union Med Coll, Beijing 100021, Peoples R China..
    Diaz, Rafael
    Inst Cardiovasc Rosario, Rosario, Santa Fe, Argentina..
    Dans, Antonio
    Univ Philippines, Coll Med, Manila, Philippines..
    Dagenais, Gilles
    Univ Laval, Inst Univ Cardiol & Pneumol Quebec, Quebec City, PQ, Canada..
    Blood-Pressure and Cholesterol Lowering in Persons without Cardiovascular Disease2016In: New England Journal of Medicine, ISSN 0028-4793, E-ISSN 1533-4406, Vol. 374, no 21, p. 2032-2043Article in journal (Refereed)
    Abstract [en]

    BACKGROUND Elevated blood pressure and elevated low-density lipoprotein (LDL) cholesterol increase the risk of cardiovascular disease. Lowering both should reduce the risk of cardiovascular events substantially.

    METHODS In a trial with 2-by-2 factorial design, we randomly assigned 12,705 participants at intermediate risk who did not have cardiovascular disease to rosuvastatin (10 mg per day) or placebo and to candesartan (16 mg per day) plus hydrochlorothiazide (12.5 mg per day) or placebo. In the analyses reported here, we compared the 3180 participants assigned to combined therapy (with rosuvastatin and the two antihypertensive agents) with the 3168 participants assigned to dual placebo. The first coprimary outcome was the composite of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke, and the second coprimary outcome additionally included heart failure, cardiac arrest, or revascularization. The median follow-up was 5.6 years.

    RESULTS The decrease in the LDL cholesterol level was 33.7 mg per deciliter (0.87 mmol per liter) greater in the combined-therapy group than in the dual-placebo group, and the decrease in systolic blood pressure was 6.2 mm Hg greater with combined therapy than with dual placebo. The first coprimary outcome occurred in 113 participants (3.6%) in the combined-therapy group and in 157 (5.0%) in the dual-placebo group (hazard ratio, 0.71; 95% confidence interval [CI], 0.56 to 0.90; P=0.005). The second coprimary outcome occurred in 136 participants (4.3%) and 187 participants (5.9%), respectively (hazard ratio, 0.72; 95% CI, 0.57 to 0.89; P=0.003). Muscle weakness and dizziness were more common in the combined-therapy group than in the dual-placebo group, but the overall rate of discontinuation of the trial regimen was similar in the two groups.

    CONCLUSIONS The combination of rosuvastatin (10 mg per day), candesartan (16 mg per day), and hydrochlorothiazide (12.5 mg per day) was associated with a significantly lower rate of cardiovascular events than dual placebo among persons at intermediate risk who did not have cardiovascular disease. (ClinicalTrials.gov number, NCT00468923.)

  • 1553.
    Zetterström, Andreas
    et al.
    Kontigo Care AB, Pavel Snickares Grand 12, S-75320 Uppsala, Sweden.
    Hämäläinen, Markku D.
    Kontigo Care AB, Pavel Snickares Grand 12, S-75320 Uppsala, Sweden.
    Karlberg, Elin
    Uppsala Univ Hosp, Innovat Akad, S-75185 Uppsala, Sweden.
    Winkvist, Maria
    Kontigo Care AB, Pavel Snickares Grand 12, S-75320 Uppsala, Sweden.
    Söderquist, Marcus
    Kontigo Care AB, Pavel Snickares Grand 12, S-75320 Uppsala, Sweden.
    Öhagen, Patrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Andersson, Karl
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Medical Radiation Science. Ridgeview Instruments AB, Skillsta 4, S-74020 Vange, Sweden.
    Nyberg, Fred
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences.
    Maximum Time Between Tests: A Digital Biomarker to Detect Therapy Compliance and Assess Schedule Quality in Measurement-Based eHealth Systems for Alcohol Use Disorder2019In: Alcohol and Alcoholism, ISSN 0735-0414, E-ISSN 1464-3502, Vol. 54, no 1, p. 70-72Article in journal (Refereed)
    Abstract [en]

    Aim: To evaluate, in a breathalyzer-based eHealth system, whether the time-based digital biomarker maximum time between tests' (MTBT) brings valuable information on alcohol consumption patterns as confirmed by correlation with blood phosphatidyl ethanol (PEth), serum carbohydrate deficient transferrin (CDT) and timeline follow-back data.

    Method: Data on 54 patients in follow-up for treatment of alcohol use disorder were analysed.

    Results: The model of weekly averages of 24-log transformed MTBT adequately described timeline follow-back data (P < 0.0001, R = 0.27-0.38, n = 650). Significant correlations were noted between MTBT and PEth (P < 0.0001, R = 0.41, n = 148) and between MTBT and CDT (P < 0.0079, R = 0.22, n = 120).

    Conclusions: The time-based digital biomarker maximum time between tests' described here has the potential to become a generally useful metric for all scheduled measurement-based eHealth systems to monitor test behaviour and compliance, factors important for dosing' of eHealth systems and for early prediction and interventions of lapse/relapse.

  • 1554.
    Zewinger, Stephen
    et al.
    Saarland Univ Hosp, Dept Internal Med 4, Homburg, Germany..
    Kleber, Marcus E.
    Friedrich Schiller Univ, Inst Nutr, Jena, Germany..
    Tragante, Vinicius
    McCubrey, Raymond O.
    Univ Utah Sch Med, Intermountain Heart Inst, Intermountain Med Ctr, Salt Lake City, UT USA..
    Schmidt, Amand F.
    Direk, Kenan
    Laufs, Ulrich
    Saarland Univ Hosp, Dept Internal Med 3, Homburg, Germany..
    Werner, Christian
    Saarland Univ Hosp, Dept Internal Med 3, Homburg, Germany..
    Koenig, Wolfgang
    Univ Ulm Med Ctr, Dept Internal Med Cardiol 2, Ulm, Germany.;Tech Univ Munich, Deutsch Herzzentrum M nchen, Munich, Germany.;Partner site Munich Heart Alliance, German Ctr Cardiovasc Res DZHK, Munich, Germany..
    Rothenbacher, Dietrich
    German Canc Ctr DKFZ, Div Clin Epidemiol & Ageing Res, Heidelberg, Germany.;Univ Ulm, Inst Epidemiol & Med Biometry, Ulm, Germany.;German Ctr Cardiovasc Res DZHK eV, Kiel, Germany..
    Mons, Ute
    German Canc Ctr DKFZ, Div Clin Epidemiol & Ageing Res, Heidelberg, Germany..
    Breitling, Lutz P.
    German Canc Ctr DKFZ, Div Clin Epidemiol & Ageing Res, Heidelberg, Germany.;Univ Heart Ctr Hamburg, Clin Gen & Intervent Cardiol, Hamburg, Germany..
    Brenner, Herrmann
    Heidelberg Univ, Dept Med, Network Ageing Res, Mannheim, Germany.;German Canc Ctr DKFZ, Div Clin Epidemiol & Ageing Res, Heidelberg, Germany..
    Jennings, Richard T.
    Saarland Univ Hosp, Dept Internal Med 4, Homburg, Germany.;Univ Heart Ctr Hamburg, Clin Gen & Intervent Cardiol, Hamburg, Germany..
    Petrakis, Ioannis
    Saarland Univ Hosp, Dept Internal Med 4, Homburg, Germany..
    Triem, Sarah
    Saarland Univ Hosp, Dept Internal Med 4, Homburg, Germany..
    Klug, Mira
    Saarland Univ Hosp, Dept Internal Med 4, Homburg, Germany..
    Filips, Alexandra
    Saarland Univ Hosp, Dept Internal Med 4, Homburg, Germany.;UCL, Inst Cardiovasc Sci Facultyof Populat Hlth Sc, London, England..
    Blankenberg, Stefan
    Waldeyer, Christoph
    Sinning, Christoph
    Schnabel, Renate B.
    Lackner, Karl J.
    Univ Med Ctr Mainz, Inst Clin Chem & Lab Med, Mainz, Germany..
    Vlachopoulou, Efthymia
    Univ Helsinki, Haartman Inst, Transplantat Lab, Helsinki, Finland..
    Nygard, Ottar
    Univ Bergen, Dept Clin Sci, Bergen, Norway.;Haukeland Hosp, Dept Heart Dis, Bergen, Norway..
    Svingen, Gard Frodahl Tveitevag
    Univ Bergen, Dept Clin Sci, Bergen, Norway.;Haukeland Hosp, Dept Heart Dis, Bergen, Norway..
    Pedersen, Eva Ringdal
    Univ Bergen, Dept Clin Sci, Bergen, Norway.;Haukeland Hosp, Dept Heart Dis, Bergen, Norway..
    Tell, Grethe S.
    Univ Bergen, Dept Global Publ Hlth & Primary Care, Bergen, Norway.;Helsinki Univ Hosp, Heart & Lung Ctr, Helsinki, Finland..
    Sinisalo, Juha
    Med Univ Graz, Clin Inst Med & Chem Lab Diagnost, Graz, Austria..
    Nieminen, Markku S.
    Natl Univ Singapore, Cardiovasc Res Inst, Singapore, Singapore..
    Laaksonen, Reijo
    Tampere Univ, Sch Med, Tampere, Finland.;Tampere Univ Hosp, Finnish Clin Biobank Tampere, Tampere, Finland..
    Trompet, Stella
    German Ctr Cardiovasc Res DZHK eV, Kiel, Germany.;Leiden Univ Med Ctr, Dept Geriat & Gerontol, Leiden, Netherlands.;Leiden Univ Med Ctr, Dept Cardiol, Leiden, Netherlands.;Leiden Univ Med Ctr, Einthoven Lab Expt Vasc Med, Leiden, Netherlands..
    Smit, Roelof A. J.
    Univ Utah Sch Med, Intermountain Heart Inst, Intermountain Med Ctr, Salt Lake City, UT USA.;Leiden Univ Med Ctr, Dept Geriat & Gerontol, Leiden, Netherlands.;Leiden Univ Med Ctr, Dept Cardiol, Leiden, Netherlands..
    Sattar, Naveed
    Heidelberg Univ, Dept Med, Mannheim, Germany.;Helsinki Univ Hosp, Heart & Lung Ctr, Helsinki, Finland..
    Jukema, J. Wouter
    Helsinki Univ Hosp, Heart & Lung Ctr, Helsinki, Finland.;Leiden Univ Med Ctr, Einthoven Lab Expt Vasc Med, Leiden, Netherlands.;Leiden Univ Med Ctr, Einthoven Lab Expt Vasc Med, Leiden, Netherlands.;Inst Netherlands, Interunivers Cardiol, Utrecht, Netherlands..
    Groesdonk, Heinrich V.
    Saarland Univ Hosp, Dept Anesthesiol Intens Care Med & Pain Med, Homburg, Germany.;German Ctr Cardiovasc Res DZHK eV, Kiel, Germany.;Leiden Univ Med Ctr, Einthoven Lab Expt Vasc Med, Leiden, Netherlands.;Leiden Univ Med Ctr, Einthoven Lab Expt Vasc Med, Leiden, Netherlands.;Univ Otago, Christchurch Heart Inst, Christchurch, New Zealand..
    Delgado, Graciela
    Univ Utah Sch Med, Intermountain Heart Inst, Intermountain Med Ctr, Salt Lake City, UT USA.;Univ Glasgow, Inst Cardiovascular & Med Sci, Cardiovascular Res Ctr, BHF Glasgow, Glasgow, Lanark, Scotland.;Inst Netherlands, Interunivers Cardiol, Utrecht, Netherlands..
    Stojakovic, Tatjana
    Heidelberg Univ, Dept Med, Mannheim, Germany.;Leiden Univ Med Ctr, Einthoven Lab Expt Vasc Med, Leiden, Netherlands.;Univ Glasgow, Inst Cardiovascular & Med Sci, Cardiovascular Res Ctr, BHF Glasgow, Glasgow, Lanark, Scotland..
    Pilbrow, Anna P.
    Leiden Univ Med Ctr, Einthoven Lab Expt Vasc Med, Leiden, Netherlands..
    Cameron, Vicky A.
    Heart & Lungs Div, Dept Cardiol, Utrecht, Netherlands.;Helsinki Univ Hosp, Heart & Lung Ctr, Helsinki, Finland.;Univ Glasgow, Inst Cardiovascular & Med Sci, Cardiovascular Res Ctr, BHF Glasgow, Glasgow, Lanark, Scotland.;Univ Otago, Christchurch Heart Inst, Christchurch, New Zealand..
    Richards, A. Mark
    Univ Otago, Christchurch Heart Inst, Christchurch, New Zealand.;Natl Univ Singapore, Cardiovasc Res Inst, Singapore, Singapore..
    Doughty, Robert N.
    Univ Glasgow, Inst Cardiovascular & Med Sci, Cardiovascular Res Ctr, BHF Glasgow, Glasgow, Lanark, Scotland.;Univ Auckland, Hlth Res Grp, Auckland, New Zealand..
    Gong, Yan
    Heart & Lungs Div, Dept Cardiol, Utrecht, Netherlands.;Univ Utah Sch Med, Intermountain Heart Inst, Intermountain Med Ctr, Salt Lake City, UT USA.;Univ Glasgow, Inst Cardiovascular & Med Sci, Cardiovascular Res Ctr, BHF Glasgow, Glasgow, Lanark, Scotland..
    Cooper-DeHoff, Rhonda
    Johnson, Julie
    German Ctr Cardiovasc Res DZHK eV, Kiel, Germany.;Univ Otago, Christchurch Heart Inst, Christchurch, New Zealand..
    Scholz, Markus
    Univ Utah Sch Med, Intermountain Heart Inst, Intermountain Med Ctr, Salt Lake City, UT USA.;Natl Univ Singapore, Cardiovasc Res Inst, Singapore, Singapore.;Univ Leipzig, D-RES CTR C Leipzig, Germany..
    Beutner, Frank
    Univ Leipzig, Leipzig, Germany..
    Thiery, Joachim
    Univ Hosp, Leipzig, Germany..
    Smith, J. Gustav
    Lund Univ, Dept Cardiol, Clin Sci, Lund, Sweden.;Skane Univ Hoswpital, Lund, Sweden..
    Vilmundarson, Ragnar O.
    Univ Ottawa Heart Inst, Ruddy Canadian Cardiovasc Genet Ctr, Ottawa, ON, Canada..
    McPherson, Ruth
    Univ Ottawa Heart Inst, Ruddy Canadian Cardiovasc Genet Ctr, Ottawa, ON, Canada..
    Stewart, Alexandre F. R.
    Natl Univ Singapore, Cardiovasc Res Inst, Singapore, Singapore.;Univ Florida, Dept Pharmacotherapy, Colleges Pharm, Gainesville, FL USA.;Univ Florida, Dept Pharmacotherapy, Translat Res & Ctr Pharmac, Gainesville, FL USA.;Univ Ottawa Heart Inst, Ruddy Canadian Cardiovasc Genet Ctr, Ottawa, ON, Canada.;Washington Univ, Sch Med, St Louis, MO USA..
    Cresci, Sharon
    Univ Ottawa Heart Inst, Ruddy Canadian Cardiovasc Genet Ctr, Ottawa, ON, Canada.;Washington Univ, Sch Med, Dept Med, St Louis, MO USA.;Washington Univ, Sch Med, Dept Genet, St Louis, MO USA..
    Lenzini, Petra A.
    Inst Med Informat, Stat & Epidemiol, Leipzig, Germany.;Univ Ottawa Heart Inst, Ruddy Canadian Cardiovasc Genet Ctr, Ottawa, ON, Canada.;Washington Univ, Sch Med, Stat Genom Div, Dept Genet, St Louis, MO USA..
    Spertus, John A.
    Inst Med Informat, Stat & Epidemiol, Leipzig, Germany.;St Lukes Mid Amer Heart Inst, Kansas City, MO USA.;Univ Missouri, Dept Biomed Hlth Informat, Kansas City, MO USA..
    Olivieri, Oliviero
    Heart & Lungs Div, Dept Cardiol, Utrecht, Netherlands.;Univ Verona, Dept Med, Verona, Italy..
    Girelli, Domenico
    Univ Florida, Dept Pharmacotherapy, Colleges Pharm, Gainesville, FL USA.;Univ Florida, Dept Pharmacotherapy, Translat Res & Ctr Pharmac, Gainesville, FL USA.;Univ Verona, Dept Med, Verona, Italy..
    Martinelli, Nicola I.
    Univ Verona, Dept Med, Verona, Italy..
    Leiherer, Andreas
    Univ Florida, Dept Pharmacotherapy, Colleges Pharm, Gainesville, FL USA.;Univ Florida, Dept Pharmacotherapy, Translat Res & Ctr Pharmac, Gainesville, FL USA.;Inst Med Informat, Stat & Epidemiol, Leipzig, Germany.;Vorarlberg Inst Vasc Invest & Treatment, Feldkirch, Austria.;Principal Liechtenstein, Private Univ, Triesen, Liechtenstein..
    Saely, Christoph H.
    Vorarlberg Inst Vasc Invest & Treatment, Feldkirch, Austria.;Principal Liechtenstein, Private Univ, Triesen, Liechtenstein..
    Drexel, Heinz
    Heart & Lungs Div, Dept Cardiol, Utrecht, Netherlands.;Univ Florida, Dept Pharmacotherapy, Colleges Pharm, Gainesville, FL USA.;Univ Florida, Dept Pharmacotherapy, Translat Res & Ctr Pharmac, Gainesville, FL USA.;Vorarlberg Inst Vasc Invest & Treatment, Feldkirch, Austria.;Principal Liechtenstein, Private Univ, Triesen, Liechtenstein.;Acad Teaching Hosp Feldkirch, Dept Med & Cardiol, Feldkirch, Austria.;Drexel Univ, Coll Med, Philadelphia, PA USA..
    Muendlein, Axel
    Vorarlberg Inst Vasc Invest & Treatment, Feldkirch, Austria..
    Braund, Peter S.
    Univ Florida, Dept Pharmacotherapy, Colleges Pharm, Gainesville, FL USA.;Univ Florida, Dept Pharmacotherapy, Translat Res & Ctr Pharmac, Gainesville, FL USA.;Univ Leicester, Glenfield Hosp, Dept Cardiovascular Sci, BHF Cardiovascular Res Ctr, Leicester, Leics, England..
    Nelson, Christopher P.
    Univ Leicester, Glenfield Hosp, Dept Cardiovascular Sci, BHF Cardiovascular Res Ctr, Leicester, Leics, England..
    Samani, Nilesh J.
    Heart & Lungs Div, Dept Cardiol, Utrecht, Netherlands.;Leicester NIHR Biomed Res Unit Cardiovasc Dis, Glenfield Hosp, Leicester, Leics, England.;Uppsala Univ, Uppsala Clin Res Ctr, Uppsala, Sweden.;Uppsala Univ, Dept Med Sci, Cardiol, Uppsala, Sweden..
    Kofink, Daniel
    Hoefer, Imo E.
    Pasterkamp, Gerard
    Quyyumi, Arshed A.
    Emory Univ, Emory Clin Cardiovascular Res Inst, Atlanta, GA USA.;Uppsala Univ, Uppsala Clin Res Ctr, Uppsala, Sweden.;Uppsala Univ, Dept Med Sci, Clin Chem, Uppsala, Sweden..
    Ko, Yi-An
    Hartiala, Jaana A.
    Univ Southern Calif, Los Angeles, CA USA.;Uppsala Univ, Dept Med Sci, Cardiol, Uppsala, Sweden..
    Allayee, Hooman
    Tang, W. H. Wilson
    Hazen, Stanley L.
    Heidelberg Univ, Dept Med, Mannheim, Germany..
    Eriksson, Niclas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    Held, Claes
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    Hagström, Emil
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    Wallentin, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    Åkerblom, Axel
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    Siegbahn, A
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Karp, Igor
    Univ Western Ontario, Schulich Sch Med & Dent, Dept Epidemiol & Biostat, London, England..
    Labos, Christopher
    Uppsala Univ, Dept Med Sci, Cardiol, Uppsala, Sweden.;McGill Univ, Dept Med, Montreal, PQ, Canada..
    Pilote, Louise
    McGill Univ, Dept Med, Montreal, PQ, Canada..
    Engert, James C.
    McGill Univ, Dept Med, Montreal, PQ, Canada..
    Brophy, James M.
    McGill Univ, Dept Med, Montreal, PQ, Canada.;Univ Laval, Dept Med, Laval, PQ, Canada..
    Thanassoulis, George
    McGill Univ, Dept Med, Montreal, PQ, Canada..
    Bogaty, Peter
    McGill Univ, Dept Med, Montreal, PQ, Canada..
    Szczeklik, Wojciech
    Uppsala Univ, Dept Med Sci, Cardiol, Uppsala, Sweden.;Jagielonian Univ, Coll Med, Krakow, Poland..
    Kaczor, Marcin
    Jagielonian Univ, Coll Med, Krakow, Poland..
    Sanak, Marek
    Jagielonian Univ, Coll Med, Krakow, Poland..
    Virani, Salim S.
    Baylor Coll Med, Cardiol Sect, Michael DeBakey Vet Affairs Med Ctr, Houston, TX USA..
    Ballantyne, Christie M.
    Baylor Coll Med, Sect Cardiovasc, Dept Med, Houston, TX USA..
    Lee, Vei-Vei
    Texas Heart Inst, Dept Biostat 7, Houston, TX USA..
    Boerwinkle, Eric
    Uppsala Univ, Dept Med Sci, Cardiol, Uppsala, Sweden.;Univ Texas Houston, Sch Publ Hlth, Houston, TX USA..
    Holmes, Michael V.
    Univ Oxford, Med Res Council Populat Hlth Res Unit, Oxford, England.;Univ Oxford, Natl Inst Hlth Res Oxford Biomed Res Ctr, Oxford, England..
    Horne, Benjamin D.
    Univ Oxford, Clin Trial Serv Unit, Oxford, England.;Univ Oxford, Epidemiol Studies Unit CTSU, Nuffield Dept Populat Hlth, Oxford, England..
    Hingorani, Aroon
    Asselbergs, Folkert W.
    Durrer Ctr Cardiogenet Res, ICIN, Utrecht, Netherlands..
    Patel, Riyaz S.
    Kraemer, Bernhard K.
    Scharnagl, Hubert
    Fliser, Danilo
    Maerz, Winfried
    Saarland Univ Hosp, Dept Internal Med 4, Homburg, Germany.;Synlab Acad, Synlab Holding, Mannheim, Germany..
    Speer, Thimoteus
    Relations between lipoprotein(a) concentrations, LPA genetic variants, and the risk of mortality in patients with established coronary heart disease: a molecular and genetic association study2017In: The Lancet Diabetes and Endocrinology, ISSN 2213-8587, E-ISSN 2213-8595, Vol. 5, no 7, p. 534-543Article in journal (Refereed)
    Abstract [en]

    Background: Lipoprotein(a) concentrations in plasma are associated with cardiovascular risk in the general population. Whether lipoprotein(a) concentrations or LPA genetic variants predict long-term mortality in patients with established coronary heart disease remains less clear.

    Methods: We obtained data from 3313 patients with established coronary heart disease in the Ludwigshafen Risk and Cardiovascular Health (LURIC) study. We tested associations of tertiles of lipoprotein(a) concentration in plasma and two LPA single-nucleotide polymorphisms ([SNPs] rs10455872 and rs3798220) with all-cause mortality and cardiovascular mortality by Cox regression analysis and with severity of disease by generalised linear modelling, with and without adjustment for age, sex, diabetes diagnosis, systolic blood pressure, BMI, smoking status, estimated glomerular filtration rate, LDL-cholesterol concentration, and use of lipid-lowering therapy. Results for plasma lipoprotein(a) concentrations were validated in five independent studies involving 10 195 patients with established coronary heart disease. Results for genetic associations were replicated through large-scale collaborative analysis in the GENIUS-CHD consortium, comprising 106 353 patients with established coronary heart disease and 19 332 deaths in 22 studies or cohorts.

    Findings: The median follow-up was 9.9 years. Increased severity of coronary heart disease was associated with lipoprotein(a) concentrations in plasma in the highest tertile (adjusted hazard radio [HR] 1.44, 95% CI 1.14-1.83) and the presence of either LPA SNP (1.88, 1.40-2.53). No associations were found in LURIC with all-cause mortality (highest tertile of lipoprotein(a) concentration in plasma 0.95, 0.81-1.11 and either LPA SNP 1.10, 0.92-1.31) or cardiovascular mortality (0.99, 0.81-1.2 and 1.13, 0.90-1.40, respectively) or in the validation studies.

    Interpretation: In patients with prevalent coronary heart disease, lipoprotein(a) concentrations and genetic variants showed no associations with mortality. We conclude that these variables are not useful risk factors to measure to predict progression to death after coronary heart disease is established.

  • 1555. Zeymer, Uwe
    et al.
    James, Stefan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    Berkenboom, Guy
    Mohacsi, Attila
    Iñiguez, Andres
    Coufal, Zdenek
    Sartral, Magali
    Paget, Marie-Ange
    Norrbacka, Kirsi
    Ferrieres, Jean
    Bakhai, Ameet
    Differences in the use of guideline-recommended therapies among 14 European countries in patients with acute coronary syndromes undergoing PCI2013In: European Journal of Preventive Cardiology, ISSN 2047-4873, E-ISSN 2047-4881, Vol. 20, no 2, p. 218-228Article in journal (Refereed)
    Abstract [en]

    Aims:

    Despite common European Society of Cardiology recommendations, adherence to guideline therapy varies, both temporally and geographically. We sought to examine current differences in the use of guideline-recommended therapies among 14 European countries in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI).

    Methods and Results:

    Data were obtained from the Antiplatelet Therapy Observational Registry (APTOR), a non-interventional, prospective observational cohort study enrolling patients with ACS undergoing PCI. Medication data were captured through 1 year. The large majority of patients in the APTOR registry received statins at hospital discharge (89%) and remained on statins at 1 year (87%), a finding that was consistent across countries. Likewise, beta-blocker use was similar at discharge and 1 year (83 and 81%, respectively). There was large disparity in aspirin loading dose between countries, but the discharge maintenance dose was more consistent, with most receiving ≤100 mg (87%). While 95% of patients were discharged on dual antiplatelet therapy, 71% remained on both treatments by 1 year, with wide variation by country in 1-year use.

    Conclusions:

    These data from the APTOR study provide key information on current European ACS patient care management from hospitalization through 1 year. Even with European Society of Cardiology (ESC) guidelines, variations in practice patterns exist among ACS patients treated with PCI between the 14 European countries studied, including the use of proven therapies, as well as appropriate duration and dosing of antiplatelet regimens. Efforts are needed to further explain why such variation exists and to continue to improve adherence to ESC guidelines to improve patient care.

  • 1556.
    Zhou, Bin
    et al.
    Imperial Coll London, London W2 1PG, England.
    Bentham, James
    Imperial Coll London, London W2 1PG, England;Univ Kent, Canterbury, Kent, England.
    Di Cesare, Mariachiara
    Middlesex Univ, London, England.
    Bixby, Honor
    Imperial Coll London, London W2 1PG, England.
    Danaei, Goodarz
    Harvard TH Chan, Sch Publ Hlth, Boston, MA USA.
    Hajifathalian, Kaveh
    Cleveland Clin, Cleveland, OH USA.
    Taddei, Cristina
    Imperial Coll London, London W2 1PG, England.
    Carrillo-Larco, Rodrigo M.
    Univ Peruana Cayetano Heredia, Lima, Peru.
    Djalalinia, Shirin
    Univ Tehran Med Sci, Tehran, Iran. Minist Hlth & Med Educ, Qods, Iran.
    Khatibzadeh, Shahab
    Brandeis Univ, Waltham, MA USA.
    Lugero, Charles
    Mulago Hosp, Kampala, Uganda.
    Peykari, Niloofar
    Univ Tehran Med Sci, Tehran, Iran. Minist Hlth & Med Educ, Qods, Iran;Minist Hlth & Med Educ, Tehran, Iran.
    Zhang, Wan Zhu
    Uganda Heart Inst, Kampala, Uganda.
    Bennett, James
    Imperial Coll London, London W2 1PG, England.
    Bilano, Ver
    Imperial Coll London, London W2 1PG, England.
    Stevens, Gretchen A.
    World Hlth Org, Geneva, Switzerland.
    Cowan, Melanie J.
    World Hlth Org, Geneva, Switzerland.
    Riley, Leanne M.
    World Hlth Org, Geneva, Switzerland.
    Chen, Zhengming
    Univ Oxford, Oxford, England.
    Hambleton, Ian R.
    Univ West Indies, Kingston, Barbados.
    Jackson, Rod T.
    Univ Auckland, Auckland, New Zealand.
    Kengne, Andre Pascal
    South African Med Res Council, Pietermaritzburg, South Africa.
    Khang, Young-Ho
    Seoul Natl Univ, Seoul, South Korea.
    Laxmaiah, Avula
    Natl Inst Nutr, Hyderabad, Telangana, India.
    Liu, Jing
    Capital Med Univ, Beijing An Zhen Hosp, Beijing, Peoples R China;Capital Med Univ, Beijing Zhen Hosp, Beijing, Peoples R China.
    Malekzadeh, Reza
    Univ Tehran Med Sci, Tehran, Iran. Minist Hlth & Med Educ, Qods, Iran;Shiraz Univ Med Sci, Shiraz, Iran.
    Neuhauser, Hannelore K.
    Robert Koch Inst, Berlin, Germany;Robert Koch Inst, Berlin, Germany;German Ctr Cardiovasc Res, Munich, Germany;German Ctr Cardiovascular Res, Gottingen, Germany.
    Soric, Maroje
    Univ Zagreb, Zagreb, Croatia;Univ Zagreb, Zagreb, Croatia.
    Starc, Gregor
    Univ Ljubljana, Ljubljana, Slovenia;Univ Ljubljana, Ljubljana, Slovenia.
    Sundström, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Woodward, Mark
    Univ Oxford, Oxford, England;Univ Oxford, Oxford, England;Univ New South Wales, Sydney, NSW, Australia;Univ New South Wales, Kensington, NSW, Australia.
    Ezzati, Majid
    Imperial Coll London, London W2 1PG, England.
    Abarca-Gomez, Leandra
    Caja Costarricense Seguro Social, San Jose, Costa Rica.
    Abdeen, Ziad A.
    Al Quds Univ, Al bireh, Palestine.
    Abu-Rmeileh, Niveen M.
    Birzeit Univ, Birzeit, Israel.
    Acosta-Cazares, Benjamin
    Inst Mexicano Seguro Social, Mexico City, DF, Mexico.
    Adams, Robert J.
    Univ Adelaide, Adelaide, SA, Australia.
    Aekplakorn, Wichai
    Mahidol Univ, Salaya, Nakhon Pathom, Thailand.
    Afsana, Kaosar
    BRAC, Dhaka, Bangladesh.
    Aguilar-Salinas, Carlos A.
    Inst Nacl Ciencias Med & Nutr Salvador Zubiran, Mexico City, DF, Mexico.
    Agyemang, Charles
    Univ Amsterdam, Amsterdam, Netherlands.
    Ahmad, Noor Ani
    Minist Hlth Malaysia, Putrajaya, Malaysia.
    Ahmadvand, Alireza
    Non Communicable Dis Res Ctr, Shiraz, Iran.
    Ahrens, Wolfgang
    BIPS, Leibniz Inst Prevent Res & Epidemiol, Bremen, Germany.
    Ajlouni, Kamel
    Natl Ctr Diabet & Endocrinol, Amman, Jordan.
    Akhtaeva, Nazgul
    Kazakh Natl Med Univ, Alma Ata, Kazakhstan.
    Al-Raddadi, Rajaa
    King Abdulaziz Univ, Jeddah, Saudi Arabia.
    Ali, Mohamed M.
    World Hlth Org, Geneva, Switzerland.
    Ali, Osman
    Univ Malaysia Sabah, Kota Kinabalu, Malaysia.
    Alkerwi, Ala'a
    Luxembourg Inst Hlth, Strassen, Luxembourg.
    Aly, Eman
    World Hlth Org Reg Off Eastern Mediterranean, Nasr City, Egypt.
    Amarapurkar, Deepak N.
    Bombay Hosp & Med Res Ctr, Bombay, Maharashtra, India;Med Res Ctr, Bombay, Maharashtra, India.
    Amouyel, Philippe
    Lille Univ & Hosp, Lille, France.
    Amuzu, Antoinette
    London Sch Hyg Trop Med, London, England.
    Andersen, Lars Bo
    Western Norway Univ Appl Sci, Bergen, Norway.
    Anderssen, Sigmund A.
    Norwegian Sch Sport Sci, Oslo, Norway.
    Angquist, Lars H.
    Frederiksberg Univ Hosp, Frederiksberg, Denmark;Bispebjerg Hosp, Copenhagen, Denmark.
    Anjana, Ranjit Mohan
    Madras Diabet Res Fdn, Madras, Tamil Nadu, India.
    Ansong, Daniel
    Komfo Anokye Teaching Hosp, Kumasi, Ghana.
    Aounallah-Skhiri, Hajer
    Natl Inst Publ Hlth, Tunis, Tunisia.
    Araujo, Joana
    Univ Porto, Porto, Portugal.
    Ariansen, Inger
    Norwegian Inst Publ Hlth, Oslo, Norway.
    Aris, Tahir
    Minist Hlth Malaysia, Putrajaya, Malaysia.
    Arlappa, Nimmathota
    Natl Inst Nutr, Hyderabad, Telangana, India.
    Arveiler, Dominique
    Strasbourg Univ & Hosp, Strasbourg, France.
    Aryal, Krishna K.
    Nepal Hlth Res Council, Kathmandu, Nepal.
    Aspelund, Thor
    Univ Iceland, Reykjavik, Iceland.
    Assah, Felix K.
    Univ Yaounde I, Yaounde, Cameroon.
    Assuncao, Maria Cecilia F.
    Univ Fed Pelotas, Pelotas, Brazil.
    Avdicova, Maria
    Reg Author Publ Hlth, Banska Bystrica, Slovakia.
    Azevedo, Ana
    Univ Porto, Med Sch, Porto, Portugal.
    Azizi, Fereidoun
    Shahid Beheshti Univ Med Sci, Tehran, Iran.
    Babu, Bontha V.
    Indian Council Med Res, New Delhi, India.
    Bahijri, Suhad
    King Abdulaziz Univ, Jeddah, Saudi Arabia.
    Balakrishna, Nagalla
    Natl Inst Nutr, Hyderabad, Telangana, India.
    Bamoshmoosh, Mohamed
    Univ Sci & Technol, Taizi, Yemen.
    Banach, Maciej
    Bandosz, Piotr
    Banegas, Jose R.
    Univ Autonoma Madrid, Madrid, Spain.
    Barbagallo, Carlo M.
    Univ Palermo, Palermo, Italy.
    Barcelo, Alberto
    Pan Amer Hlth Org, Washington, DC USA.
    Barkat, Amina
    Univ Mohammed V Rabat, Rabat, Morocco.
    Barros, Aluisio J. D.
    Univ Fed Pelotas, Pelotas, Brazil.
    Barros, Mauro V.
    Univ Pernambuco, Recife, PE, Brazil.
    Bata, Iqbal
    Dalhousie Univ, Halifax, NS, Canada.
    Batieha, Anwar M.
    Jordan Univ Sci & Technol, Irbid, Jordan.
    Batyrbek, Assembekov
    Kazakh Natl Med Univ, Alma Ata, Kazakhstan.
    Baur, Louise A.
    Univ Sydney, Sydney, NSW, Australia.
    Beaglehole, Robert
    Univ Auckland, Auckland, New Zealand.
    Ben Romdhane, Habiba
    Univ Tunis El Manar, Tunis, Tunisia.
    Benet, Mikhail
    CAFAM Univ Fdn, Bogota, Colombia.
    Benson, Lowell S.
    Univ Utah, Sch Med, Salt Lake City, UT USA.
    Bernabe-Ortiz, Antonio
    Univ Peruana Cayetano Heredia, Lima, Peru.
    Bernotiene, Gailute
    Lithuanian Univ Hlth Sci, Kaunas, Lithuania.
    Bettiol, Heloisa
    Univ Sao Paulo, Sao Paulo, Brazil.
    Bhagyalaxmi, Aroor
    BJ Med Coll, Ahmadabad, Gujarat, India.
    Bharadwaj, Sumit
    Chirayu Med Coll, Bhopal, India.
    Bhargava, Santosh K.
    SL Jain Hosp, Delhi, India.
    Bi, Yufang
    Shanghai Jiao Tong Univ, Sch Med, Shanghai, Peoples R China.
    Bikbov, Mukharram
    Ufa Eye Res Inst, Ufa, Russia.
    Bista, Bihungum
    Nepal Hlth Res Council, Kathmandu, Nepal.
    Bjerregaard, Peter
    Univ Greenland, Nuuk, Greenland;Univ Southern, Odense, Denmark.
    Bjertness, Espen
    Univ Oslo, Oslo, Norway.
    Bjertness, Marius B.
    Univ Oslo, Oslo, Norway.
    Bjorkelund, Cecilia
    Univ Gothenburg, Gothenburg, Sweden.
    Blokstra, Anneke
    Natl Inst Publ Hlth & Environm, Bilthoven, Netherlands.
    Bo, Simona
    Univ Turin, Turin, Italy.
    Bobak, Martin
    UCL, London, England.
    Boeing, Heiner
    German Inst Human Nutr, Berlin, Germany.
    Boggia, Jose G.
    Univ Republica, Montevideo, Uruguay.
    Boissonnet, Carlos P.
    CEMIC, Buenos Aires, DF, Argentina.
    Bongard, Vanina
    Toulouse Univ, Sch Med, Toulouse, France.
    Borchini, Rossana
    Univ Hosp Varese, Varese, Italy.
    Bovet, Pascal
    Minist Hlth, Victoria, Seychelles;Univ Lausanne, Lausanne, Switzerland.
    Braeckman, Lutgart
    Univ Ghent, Ghent, Belgium.
    Brajkovich, Imperia
    Univ Cent Venezuela, Caracas, Venezuela.
    Branca, Francesco
    World Hlth Org, Geneva, Switzerland.
    Breckenkamp, Juergen
    Bielefeld Univ, Bielefeld, Germany.
    Brenner, Hermann
    German Canc Res Ctr, Heidelberg, Germany.
    Brewster, Lizzy M.
    Univ Amsterdam, Amsterdam, Netherlands.
    Bruno, Graziella
    Univ Turin, Turin, Italy.
    Bueno-de-Mesquita, H.B.
    National Institute for Public Health and the Environment, The Netherlands.
    Bugge, Anna
    Univ Southern Denmark, Odense, Denmark.
    Burns, Con
    Cork Inst Technol, Cork, Ireland.
    Bursztyn, Michael
    Hadassah Hebrew Univ, Med Ctr, Jerusalem, Israel.
    Cabrera de Leon, Antonio
    Univ La Laguna, San Cristobal la Laguna, Spain.
    Cacciottolo, Joseph
    Univ Malta, Msida, Malta.
    Cai, Hui
    Vanderbilt Univ, 221 Kirkland Hall, Nashville, TN 37235 USA.
    Cameron, Christine
    Canadian Fitness & Lifestyle Res Inst, Ottawa, ON, Canada.
    Can, Gunay
    Istanbul Univ, Istanbul, Turkey.
    Candido, Ana Paula C.
    Univ Fed Juiz De Fora, Juiz De Fora, Brazil.
    Capuano, Vincenzo
    Cardiol Mercato S Severino, Mercato San Severino, Italy.
    Cardoso, Viviane C.
    Univ Sao Paulo, Sao Paulo, Brazil.
    Carlsson, Axel C.
    Karolinska Inst, Solna, Sweden.
    Carvalho, Maria J.
    Univ Porto, Porto, Portugal.
    Casanueva, Felipe F.
    Univ Santiago Compostela, Santiago, Spain.
    Casas, Juan-Pablo
    UCL, London, England.
    Caserta, Carmelo A.
    Chamukuttan, Snehalatha
    Chan, Angelique W.
    Duke NUS Med Sch, Singapore, Singapore.
    Chan, Queenie
    Imperial Coll London, London W2 1PG, England.
    Chaturvedi, Himanshu K.
    Natl Inst Med Stat, New Delhi, India.
    Chaturvedi, Nishi
    UCL, London, England.
    Chen, Chien-Jen
    Acad Sinica, Taipei, Taiwan.
    Chen, Fangfang
    Capital Inst Pediat, Beijing, Peoples R China. Duke Univ, Durham, NC USA.
    Chen, Huashuai
    Chen, Shuohua
    Kailuan Gen Hosp, Tangshan, Peoples R China.
    Cheng, Ching-Yu
    Duke NUS Med Sch, Singapore, Singapore.
    Cherkaoui Dekkaki, Imane
    Univ Mohammed V Rabat, Rabat, Morocco.
    Chetrit, Angela
    Gertner Inst Epidemiol & Hlth Policy Res, Tel Aviv, Israel.
    Chiolero, Arnaud
    Univ Bern, Bern, Switzerland.
    Chiou, Shu-Ti
    Minist Hlth & Welf, Taipei, Taiwan.
    Chirita-Emandi, Adela
    Victor Babes Univ Med & Pharm Timisoara, Timisoara, Romania.
    Chirlaque, Maria-Dolores
    Murcia Reg Hlth Council, Murcia, Spain.
    Cho, Belong
    Seoul Natl Univ, Coll Med, Seoul, South Korea.
    Cho, Yumi
    Korea Centers Dis Control & Prevent, Cheongju, South Korea.
    Christofaro, Diego G.
    Univ Estadual Paulista, Sao Paulo, Brazil.
    Chudek, Jerzy
    Med Univ Silesia, Katowice, Poland.
    Cifkova, Renata
    Charles Univ Prague, Prague, Czech Republic.
    Cinteza, Eliza
    Carol Davila Univ Med & Pharm, Bucharest, Romania.
    Claessens, Frank
    Katholieke Univ Leuven, Leuven, Belgium.
    Clays, Els
    Univ Ghent, Ghent, Belgium.
    Concin, Hans
    Agcy Prevent & Social Med, Vienna, Austria.
    Cooper, Cyrus
    Univ Southampton, Southampton, Hants, England.
    Cooper, Rachel
    UCL, London, England.
    Coppinger, Tara C.
    Cork Inst Technol, Cork, Ireland.
    Costanzo, Simona
    IRCCS Ist Neurol Mediterraneo Neuromed, Pozzilli, Italy.
    Cottel, Dominique
    Inst Pasteur, Lille, France.
    Cowell, Chris
    Univ Sydney, Sydney, NSW, Australia.
    Craig, Cora L.
    Canadian Fitness & Lifestyle Res Inst, Ottawa, ON, Canada.
    Crujeiras, Ana B.
    CIBEROBN, Madrid, Spain.
    Cruz, Juan J.
    Univ Autonoma Madrid, Madrid, Spain.
    D'Arrigo, Graziella
    Natl Council Res, Rome, Italy.
    d'Orsi, Eleonora
    Univ Fed Santa Catarina, Florianopolis, SC, Brazil.
    Dallongeville, Jean
    Inst Pasteur, Lille, France.
    Damasceno, Albertino
    Eduardo Mondlane Univ, Maputo, Mozambique.
    Dankner, Rachel
    Gertner Inst Epidemiol & Hlth Policy Res, Tel Aviv, Israel.
    Dantoft, Thomas M.
    Bispebjerg & Frederiksberg Hosp, Copenhagen, Denmark.
    Dauchet, Luc
    Lille Univ & Hosp, Lille, France.
    Davletov, Kairat
    Kazakh Natl Med Univ, Alma Ata, Kazakhstan.
    De Backer, Guy
    Univ Ghent, Ghent, Belgium.
    De Bacquer, Dirk
    Univ Ghent, Ghent, Belgium.
    de Gaetano, Giovanni
    IRCCS Ist Neurol Mediterraneo Neuromed, Pozzilli, Italy.
    De Henauw, Stefaan
    Univ Ghent, Ghent, Belgium.
    de Oliveira, Paula Duarte
    Univ Fed Pelotas, Pelotas, Brazil.
    De Smedt, Delphine
    Univ Ghent, Ghent, Belgium.
    Deepa, Mohan
    Madras Diabet Res Fdn, Madras, Tamil Nadu, India.
    Dehghan, Abbas
    Erasmus MC, Rotterdam, Netherlands.
    Delisle, Helene
    Univ Montreal, Montreal, PQ, Canada.
    Deschamps, Valerie
    French Publ Hlth Agcy, St Maurice, France.
    Dhana, Klodian
    Erasmus MC, Rotterdam, Netherlands.
    Di Castelnuovo, Augusto F.
    IRCCS Ist Neurol Mediterraneo Neuromed, Pozzilli, Italy.
    Dias-da-Costa, Juvenal Soares
    Univ Do Vale Do Rio Dos Sinos, Sao Leopoldo, Brazil.
    Diaz, Alejandro
    Natl Council Sci & Tech Res, Buenos Aires, DF, Argentina.
    Dickerson, Ty T.
    Univ Utah, Sch Med, Salt Lake City, UT USA.
    Do, Ha T. P.
    Natl Inst Nutr, Hyderabad, Telangana, India.
    Dobson, Annette J.
    Univ Queensland, Brisbane, Qld, Australia.
    Donfrancesco, Chiara
    Ist Super Sanita, Rome, Italy.
    Donoso, Silvana P.
    Univ Cuenca, Cuenca, Ecuador.
    Doering, Angela
    Helmholtz Zentrum Munchen, Oberschleissheim, Germany.
    Dorobantu, Maria
    Carol Davila Univ Med & Pharm, Bucharest, Romania.
    Doua, Kouamelan
    Minist Sante & Lutte Contre Sida, Abidjan, Cote Ivoire.
    Drygas, Wojciech
    Cardinal Wyszynski Inst Cardiol, Warsaw, Poland.
    Dulskiene, Virginija
    Dzakula, Aleksandar
    Lithuanian Univ Hlth Sci, Kaunas, Lithuania;Univ Zagreb, Zagreb, Croatia.
    Dzerve, Vilnis
    Univ Latvia, Riga, Latvia.
    Dziankowska-Zaborszczyk, Elzbieta
    Eggertsen, Robert
    Univ Gothenburg, Gothenburg, Sweden.
    Ekelund, Ulf
    Norwegian Sch Sport Sci, Oslo, Norway.
    El Ati, Jalila
    Natl Inst Nutr & Food Technol, Tunis, Tunisia. Inst Hosp Del Mar dInvest Med, Barcelona, Spain.
    Elliott, Paul
    Imperial Coll London, London W2 1PG, England.
    Elosua, Roberto
    Erasmus, Rajiv T.
    Univ Stellenbosch, Stellenbosch, South Africa.
    Erem, Cihangir
    Karadeniz Tech Univ, Trabzon, Turkey.
    Eriksen, Louise
    Univ Southern Denmark, Odense, Denmark.
    Eriksson, Johan G.
    Natl Inst Hlth & Welf, Helsinki, Finland.
    Escobedo-de la Pena, Jorge
    Inst Mexicano Seguro Social, Mexico City, DF, Mexico.
    Evans, Alun
    Queens Univ Belfast, Belfast, Antrim, North Ireland.
    Faeh, David
    Univ Zurich, Zurich, Switzerland.
    Fall, Caroline H.
    Univ Southampton, Southampton, Hants, England.
    Farzadfar, Farshad
    Univ Tehran Med Sci, Tehran, Iran. Minist Hlth & Med Educ, Qods, Iran.
    Felix-Redondo, Francisco J.
    Centro Salud Villanueva Norte, Villanueva de la Serena, Spain.
    Ferguson, Trevor S.
    Univ West Indies, Kingston, Jamaica.
    Fernandes, Romulo A.
    Univ Estadual Paulista, Sao Paulo, Brazil.
    Fernandez-Berges, Daniel
    Hosp Don Benito Villanueva Serena, Badajoz, Spain.
    Ferrante, Daniel
    Minist Hlth, Buenos Aires, DF, Argentina.
    Ferrari, Marika
    Council Agr Res & Econ, Arezzo, Italy.
    Ferreccio, Catterina
    Pontificia Univ Catolica Chile, Santiago, Chile.
    Ferrieres, Jean
    Toulouse Univ, Sch Med, Toulouse, France.
    Finn, Joseph D.
    Univ Manchester, Manchester, Lancs, England.
    Fischer, Krista
    Univ Tartu, Tartu, Estonia.
    Foger, Bernhard
    Agcy Prevent & Social Med, Vienna, Austria.
    Foo, Leng Huat
    Univ Sains Malaysia, George Town, Malaysia.
    Forslund, Ann-Sofie
    Umea Univ, Umea, Sweden.
    Forsner, Maria
    Dalarna Univ, Falun, Sweden.
    Fouad, Heba M.
    World Hlth Org Reg Off Eastern Mediterranean, Nasr City, Egypt.
    Francis, Damian K.
    Univ West Indies, Kingston, Barbados.
    Franco, Maria do Carmo
    Univ Fed Sao Paulo, Sao Paulo, Brazil.
    Franco, Oscar H.
    Erasmus MC, Rotterdam, Netherlands.
    Frontera, Guillermo
    Hosp Univ Son Espases, Palma de Mallorca, Spain.
    Fuchs, Flavio D.
    Hosp Clin Porto Alegre, Porto Alegre, RS, Brazil.
    Fuchs, Sandra C.
    Univ Fed Rio Grande, Porto Alegre, RS, Brazil.
    Fujita, Yuki
    Kindai Univ, Higashiosaka, Osaka, Japan.
    Furusawa, Takuro
    Kyoto Univ, Kyoto, Japan.
    Gaciong, Zbigniew
    Med Univ Warsaw, Warsaw, Poland.
    Galvano, Fabio
    Univ Catania, Catania, Italy.
    Garcia-de-la-Hera, Manoli
    CIBER Epidemiol & Salud Publ, Madrid, Spain.
    Gareta, Dickman
    Univ KwaZulu Natal, Durban, South Africa.
    Garnett, Sarah P.
    Univ Sydney, Sydney, NSW, Australia.
    Gaspoz, Jean-Michel
    Geneva Univ Hosp, Geneva, Switzerland.
    Gasull, Magda
    CIBER Epidemiol & Salud Publ, Madrid, Spain.
    Gates, Louise
    Australian Bur Stat, Canberra, ACT, Australia.
    Geleijnse, Johanna M.
    Wageningen Univ, Wageningen, Netherlands.
    Ghasemian, Anoosheh
    Non Communicable Dis Res Ctr, Shiraz, Iran.
    Ghimire, Anup
    B P Koirala Inst Hlth Sci, Dharan, Nepal.
    Giampaoli, Simona
    Ist Super Sanita, Rome, Italy.
    Gianfagna, Francesco
    IRCCS Ist Neurol Mediterraneo Neuromed, Pozzilli, Italy;Univ Insubria, Varese, Italy.
    Gill, Tiffany K.
    Univ Adelaide, Adelaide, SA, Australia.
    Giovannelli, Jonathan
    Lille Univ & Hosp, Lille, France.
    Goldsmith, Rebecca A.
    Minist Hlth, Buenos Aires, DF, Argentina.
    Goncalves, Helen
    Univ Fed Pelotas, Pelotas, Brazil.
    Gonzalez-Gross, Marcela
    Univ Politecn Madrid, Madrid, Spain.
    Gonzalez-Rivas, Juan P.
    Andes Clin Cardio Metab Studies, Merida, Venezuela.
    Bonet Gorbea, Mariano
    Natl Inst Hyg Epidemiol & Microbiol, Havana, Cuba.
    Gottrand, Frederic
    Univ Lille 2, Lille, France.
    Graff-Iversen, Sidsel
    Norwegian Inst Publ Hlth, Oslo, Norway.
    Grafnetter, Dusan
    Inst Clin & Expt Med, Prague, Czech Republic.
    Grajda, Aneta
    Childrens Mem Hlth Inst, Warsaw, Poland.
    Grammatikopoulou, Maria G.
    Alexander Technol Educ Inst, Thessaloniki, Greece.
    Gregor, Ronald D.
    Dalhousie Univ, Halifax, NS, Canada.
    Grodzicki, Tomasz
    Jagiellonian Univ, Med Coll, Krakow, Poland.
    Grontved, Anders
    Univ Southern Denmark, Odense, Denmark.
    Grosso, Giuseppe
    Azienda Ospedaliera Univ Policlinico Vittorio Ema, Catania, Italy.
    Gruden, Gabriella
    Univ Turin, Turin, Italy.
    Grujic, Vera
    Univ Novi Sad, Novi Sad, Serbia.
    Gu, Dongfeng
    Natl Ctr Cardiovasc Dis, Beijing, Peoples R China.
    Guan, Ong Peng
    Singapore Eye Res Inst, Singapore, Singapore.
    Gudmundsson, Elias F.
    Iceland Heart Assoc, Reykjavik, Iceland.
    Gudnason, Vilmundur
    Univ Iceland, Reykjavik, Iceland.
    Guerrero, Ramiro
    Univ Icesi, Cali, Colombia.
    Guessous, Idris
    Geneva Univ Hosp, Geneva, Switzerland.
    Guimaraes, Andre L.
    Univ Estadual Montes Claros, Montes Claros, Brazil. Kings Coll London, London, England.
    Gulliford, Martin C.
    Gunnlaugsdottir, Johanna
    Iceland Heart Assoc, Reykjavik, Iceland.
    Gunter, Marc
    Int Agcy Res Canc, Lyon, France.
    Gupta, Prakash C.
    Healis Sekhsaria Inst Publ Hlth, Navi Mumbai, India.
    Gupta, Rajeev
    Eternal Heart Care Ctr & Res Inst, Jaipur, Rajasthan, India.
    Gureje, Oye
    Univ Ibadan, Ibadan, Nigeria.
    Gurzkowska, Beata
    Inst Clin & Expt Med, Prague, Czech Republic.
    Gutierrez, Laura
    Inst Clin Effectiveness & Hlth Policy, Buenos Aires, DF, Argentina.
    Gutzwiller, Felix
    Univ Zurich, Zurich, Switzerland.
    Hadaegh, Farzad
    Shahid Beheshti Univ Med Sci, Tehran, Iran.
    Halkjaer, Jytte
    Danish Canc Soc Res Ctr, Copenhagen, Denmark.
    Hardy, Rebecca
    UCL, London, England.
    Kumar, Rachakulla Hari
    Natl Inst Nutr, Hyderabad, Telangana, India.
    Hata, Jun
    Kyushu Univ, Fukuoka, Fukuoka, Japan.
    Hayes, Alison J.
    Univ Sydney, Sydney, NSW, Australia.
    He, Jiang
    Tulane Univ, New Orleans, LA USA.
    He, Yuna
    Chinese Ctr Dis Control & Prevent, Beijing, Peoples R China.
    Hendriks, Marleen Elisabeth
    Univ Amsterdam, Acad Med Ctr, Amsterdam, Netherlands.
    Henriques, Ana
    Univ Porto, Porto, Portugal.
    Hernandez Cadena, Leticia
    Natl Inst Publ Hlth, Cuernavaca, Morelos, Mexico.
    Herrala, Sauli
    Oulu Univ Hosp, Oulu, Finland.
    Heshmat, Ramin
    Chron Dis Res Ctr, Tehran, Iran.
    Hihtaniemi, Ilpo Tapani
    Imperial Coll London, London W2 1PG, England.
    Ho, Sai Yin
    Univ Hong Kong, Hong Hom, Hong Kong, Peoples R China.
    Ho, Suzanne C.
    Chinese Univ Hong Kong, Hong Hom, Hong Kong, Peoples R China.
    Hobbs, Michael
    Univ Western Australia, Perth, WA, Australia.
    Hofman, Albert
    Erasmus MC, Rotterdam, Netherlands.
    Dinc, Gonul Horasan
    Celal Bayar Univ, Manisa, Turkey.
    Horimoto, Andrea R. V. R.
    Heart Inst, Sao Paulo, Brazil.
    Hormiga, Claudia M.
    Fdn Oftalmol Santander, Bucaramanga, Colombia.
    Horta, Bernardo L.
    Univ Fed Pelotas, Pelotas, Brazil.
    Houti, Leila
    Howitt, Christina
    Univ West Indies, Kingston, Barbados.
    Htay, Thein Thein
    Independent Publ Hlth Specialist, Yangon, Myanmar.
    Htet, Aung Soe
    Minist Hlth, Buenos Aires, DF, Argentina.
    Htike, Maung Maung Than
    Minist Hlth, Buenos Aires, DF, Argentina.
    Hu, Yonghua
    Peking Univ, Beijing, Peoples R China.
    Maria Huerta, Jose
    CIBER Epidemiol & Salud Publ, Madrid, Spain.
    Huisman, Martijn
    Vrije Univ Amsterdam, Med Ctr, Amsterdam, Netherlands;Vrije Univ Amsterdam, Amsterdam, Netherlands.
    Husseini, Abdullatif S.
    Birzeit Univ, Birzeit, Palestine.
    Huybrechts, Inge
    Int Agcy Res Canc, Lyon, France.
    Hwalla, Nahla
    Amer Univ Beirut, Beirut, Lebanon.
    Iacoviello, Licia
    IRCCS Ist Neurol Mediterraneo Neuromed, Pozzilli, Italy;Univ Insubria, Varese, Italy.
    Iannone, Anna G.
    Cardiol Mercato S Severino, Mercato San Severino, Italy.
    Ibrahim, Mohsen M.
    Cairo Univ, Cairo, Egypt.
    Wong, Norazizah Ibrahim
    Minist Hlth Malaysia, Putrajaya, Malaysia.
    Ikeda, Nayu
    Ikram, M. Arfan
    Erasmus MC, Rotterdam, Netherlands.
    Irazola, Vilma E.
    Inst Clin Effectiveness & Hlth Policy, Buenos Aires, DF, Argentina.
    Islam, Muhammad
    Aga Khan Univ, Karachi, Pakistan.
    Ismail, Aziz al-Safi
    Univ Sains Malaysia, George Town, Malaysia.
    Ivkovic, Vanja
    UHC Zagreb, Zagreb, Croatia.
    Iwasaki, Masanori
    Niigata Univ, Niigata, Japan.
    Jacobs, Jeremy M.
    Hadassah Univ Med Ctr, Jerusalem, Israel.
    Jaddou, Hashem
    Jordan Univ Sci & Technol, Irbid, Jordan.
    Jafar, Tazeen
    Duke NUS Med Sch, Singapore, Singapore.
    Jamrozik, Konrad
    Univ Adelaide, Adelaide, SA, Australia.
    Janszky, Imre
    Norwegian Univ Sci & Technol, Trondheim, Norway.
    Jasienska, Grazyna
    Jagiellonian Univ, Med Coll, Krakow, Poland.
    Jelakovic, Ana
    UHC Zagreb, Zagreb, Croatia.
    Jelakovic, Bojan
    Univ Zagreb, Coll Med, Zagreb, Croatia.
    Jennings, Garry
    Heart Fdn, Melbourne, Vic, Australia.
    Jeong, Seung-lyeal
    Natl Hlth Insurance Serv, Jeonju, South Korea.
    Jiang, Chao Qiang
    Guangzhou 12th Hosp, Guangzhou, Peoples R China.
    Joffres, Michel
    Simon Fraser Univ, Burnaby, BC, Canada.
    Johansson, Mattias
    Int Agcy Res Canc, Lyon, France.
    Jokelainen, Jari J.
    Oulu Univ Hosp, Oulu, Finland.
    Jonas, Jost B.
    Heidelberg Univ, Heidelberg, Germany.
    Jorgensen, Torben
    Res Ctr Prevent & Hlth, Glostrup, Denmark.
    Joshi, Pradeep
    World Hlth Org Country Off, Delhi, India.
    Jozwiak, Jacek
    Czestochowa Tech Univ, Czestochowa, Poland.
    Juolevi, Anne
    Natl Inst Hlth & Welf, Helsinki, Finland.
    Jurak, Gregor
    Univ Ljubljana, Ljubljana, Slovenia.
    Juresa, Vesna
    Univ Zagreb, Zagreb, Croatia.
    Kaaks, Rudolf
    German Canc Res Ctr, Heidelberg, Germany.
    Kafatos, Anthony
    Univ Crete, Iraklion, Greece.
    Kajantie, Eero O.
    Natl Inst Hlth & Welf, Helsinki, Finland.
    Kalter-Leibovici, Ofra
    Gertner Inst Epidemiol & Hlth Policy Res, Tel Aviv, Israel.
    Kamaruddin, Nor Azmi
    Univ Kebangsaan Malaysia, Bangi, Malaysia.
    Karki, Khem B.
    Kasaeian, Amir
    Univ Tehran Med Sci, Tehran, Iran. Minist Hlth & Med Educ, Qods, Iran.
    Katz, Joanne
    Johns Hopkins Bloomberg Sch Publ Hlth, Baltimore, MD USA.
    Kauhanen, Jussi
    Univ Eastern Finland, Kuopio, Finland.
    Kaur, Prabhdeep
    Natl Inst Epidemiol, Madras, Tamil Nadu, India.
    Kavousi, Maryam
    Erasmus MC, Rotterdam, Netherlands.
    Kazakbaeva, Gyulli
    Ufa Eye Res Inst, Ufa, Russia.
    Keil, Ulrich
    Univ Munster, Munster, Germany.
    Boker, Lital Keinan
    Israel Ctr Dis Control, Tel Hashomer, Israel.
    Keinanen-Kiukaanniemi, Sirkka
    Oulu Univ Hosp, Oulu, Finland.
    Kelishadi, Roya
    Res Inst Primordial Prevent Non communicable Dis, Esfahan, Iran.
    Kemper, Han C. G.
    Vrije Univ Amsterdam, Med Ctr, Amsterdam, Netherlands.
    Kengne, Andre P.
    South African Med Res Council, Durban, South Africa.
    Kerimkulova, Alina
    Kyrgyz State Med Acad, Bishkek, Kyrgyzstan.
    Kersting, Mathilde
    Res Inst Child Nutr, Bonn, Germany.
    Key, Timothy
    Univ Oxford, Oxford, England.
    Khader, Yousef Saleh
    Jordan Univ Sci & Technol, Irbid, Jordan.
    Khalili, Davood
    Shahid Beheshti Univ Med Sci, Tehran, Iran.
    Khateeb, Mohammad
    Natl Ctr Diabet & Endocrinol, Amman, Jordan.
    Khaw, Kay-Tee
    Univ Cambridge, Cambridge, England.
    Kiechl-Kohlendorfer, Ursula
    Med Univ Innsbruck, Innsbruck, Austria.
    Kiechl, Stefan
    Med Univ Innsbruck, Innsbruck, Austria.
    Killewo, Japhet
    Muhimbili Univ Hlth & Allied Sci, Dar Es Salaam, Tanzania.
    Kim, Jeongseon
    Natl Canc Ctr, Goyang, South Korea.
    Kim, Yeon-Yong
    Natl Hlth Insurance Serv, Jeonju, South Korea.
    Klumbiene, Jurate
    Lithuanian Univ Hlth Sci, Kaunas, Lithuania.
    Knoflach, Michael
    Med Univ Innsbruck, Innsbruck, Austria.
    Kolle, Elin
    Norwegian Sch Sport Sci, Oslo, Norway.
    Kolsteren, Patrick
    Inst Trop Med, Antwerp, Belgium.
    Korrovits, Paul
    Tartu Univ Clin, Tartu, Estonia.
    Koskinen, Seppo
    Natl Inst Hlth & Welf, Helsinki, Finland.
    Kouda, Katsuyasu
    Kindai Univ, Higashiosaka, Osaka, Japan.
    Kowlessur, Sudhir
    Minist Hlth & Qual Life, Port Louis, Mauritius.
    Koziel, Slawomir
    Polish Acad Sci, Anthropol Unit, Wroclaw, Poland.
    Kriemler, Susi
    Univ Zurich, Zurich, Switzerland.
    Kristensen, Peter Lund
    Univ Southern Denmark, Odense, Denmark.
    Krokstad, Steinar
    Norwegian Univ Sci & Technol, Trondheim, Norway.
    Kromhout, Daan
    Univ Groningen, Groningen, Netherlands.
    Kruger, Herculina S.
    North West Univ, Potchefstroom, South Africa.
    Kubinova, Ruzena
    Natl Inst Publ Hlth, Prague, Czech Republic.
    Kuciene, Renata
    Lithuanian Univ Hlth Sci, Kaunas, Lithuania.
    Kuh, Diana
    UCL, London, England.
    Kujala, Urho M.
    Univ Jyvaskyla, Jyvaskyla, Finland.
    Kulaga, Zbigniew
    Childrens Mem Hlth Inst, Warsaw, Poland.
    Kumar, R. Krishna
    Amrita Inst Med Sci, Kochi, Kerala, India. Cardinal Wyszynski Inst Cardiol, Warsaw, Poland.
    Kurjata, Pawel
    Kusuma, Yadlapalli S.
    All India Inst Med Sci, New Delhi, India.
    Kuulasmaa, Kari
    Natl Inst Hlth & Welf, Helsinki, Finland.
    Kyobutungi, Catherine
    African Populat & Hlth Res Ctr, Nairobi, Kenya.
    Laatikainen, Tiina
    Natl Inst Hlth & Welf, Helsinki, Finland.
    Lachat, Carl
    Univ Ghent, Ghent, Belgium.
    Lam, Tai Hing
    Univ Hong Kong, Hong Hom, Hong Kong, Peoples R China.
    Landrove, Orlando
    Minist Salud Publ, Havana, Cuba.
    Lanska, Vera
    Inst Clin & Expt Med, Prague, Czech Republic.
    Lappas, Georg
    Sahlgrens Acad, Gothenburg, Sweden.
    Larijani, Bagher
    Endocrinol & Metab Res Ctr, Tehran, Iran.
    Laugsand, Lars E.
    Norwegian Univ Sci & Technol, Trondheim, Norway.
    Bao, Khanh Le Nguyen
    Le, Tuyen D.
    Natl Inst Nutr, Hyderabad, Telangana, India.
    Leclercq, Catherine
    Food & Agr Org United Nat, Rome, Italy.
    Lee, Jeannette
    Natl Univ Singapore, Singapore, Singapore.
    Lee, Jeonghee
    Natl Canc Ctr, Goyang, South Korea.
    Lehtimaki, Terho
    Tampere Univ Hosp, Tampere, Finland.
    Leon-Munoz, Luz M.
    Univ Autonoma Madrid, Madrid, Spain.
    Levitt, Naomi S.
    Univ Cape Town, Rondebosch, South Africa.
    Li, Yanping
    Harvard TH Chan, Sch Publ Hlth, Boston, MA USA.
    Lilly, Christa L.
    West Virginia Univ, Morgantown, WV USA.
    Lim, Wei-Yen
    Natl Univ Singapore, Singapore, Singapore.
    Fernanda Lima-Costa, M.
    Oswaldo Cruz Fdn Rene Rachou Res Inst, Rio De Janeiro, Brazil.
    Lin, Hsien-Ho
    Natl Taiwan Univ, Taipei, Taiwan.
    Lin, Xu
    Univ Chinese Acad Sci, Beijing, Peoples R China.
    Lind, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    Linneberg, Allan
    Bispebjerg & Frederiksberg Hosp, Copenhagen, Denmark.
    Lissner, Lauren
    Univ Gothenburg, Gothenburg, Sweden.
    Litwin, Mieczyslaw
    Childrens Mem Hlth Inst, Warsaw, Poland.
    Lorbeer, Roberto
    Univ Med Greifswald, Greifswald, Germany.
    Lotufo, Paulo A.
    Univ Sao Paulo, Sao Paulo, Brazil.
    Eugenio Lozano, Jose
    Consejeria Sanidad Junta de Castilla & Leon, Valladolid, Spain.
    Luksiene, Dalia
    Lithuanian Univ Hlth Sci, Kaunas, Lithuania.
    Lundqvist, Annamari
    Natl Inst Hlth & Welf, Helsinki, Finland.
    Lunet, Nuno
    Univ Porto, Porto, Portugal.
    Lytsy, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Ma, Jun
    Peking Univ, Beijing, Peoples R China.
    Machado-Coelho, George L. L.
    Univ Fed Ouro Preto, Ouro Preto, MG, Brazil.
    Machi, Suka
    Jikei Univ, Sch Med, Tokyo, Japan.
    Maggi, Stefania
    CNR, Rome, Italy.
    Magliano, Dianna J.
    Baker Heart & Diabet Inst, Melbourne, Vic, Australia.
    Magriplis, Emmanuella
    Agr Univ Athens, Athens, Greece.
    Majer, Marjeta
    Univ Zagreb, Zagreb, Croatia.
    Makdisse, Marcia
    Hosp Israelita Albert Einstein, Sao Paulo, Brazil.
    Malhotra, Rahul
    Duke NUS Med Sch, Singapore, Singapore.
    Rao, Kodavanti Mallikharjuna
    Natl Inst Nutr, Hyderabad, India.
    Malyutina, Sofia
    Inst Internal & Prevent Med, Moscow, Russia.
    Manios, Yannis
    Harokopio Univ, Kallithea, Greece.
    Mann, Jim I.
    Univ Otago, Dunedin, New Zealand.
    Manzato, Enzo
    Univ Padua, I-35100 Padua, Italy.
    Margozzini, Paula
    Pontificia Univ Catolica Chile, Santiago, Chile.
    Marques-Vidal, Pedro
    Lausanne Univ Hosp, Lausanne, Switzerland.
    Marques, Larissa Pruner
    Univ Fed Santa Catarina, Florianopolis, SC, Brazil.
    Marrugat, Jaume
    CIBERCV, Madrid, Spain.
    Martorell, Reynaldo
    Emory Univ, Atlanta, GA USA.
    Mathiesen, Ellisiv B.
    UiT Arctic Univ Norway, Tromso, Norway.
    Matijasevich, Alicia
    Univ Sao Paulo, Sao Paulo, Brazil.
    Matsha, Tandi E.
    Cape Peninsula Univ Technol, Cape Town, South Africa.
    Mbanya, Jean Claude N.
    Univ Yaounde I, Yaounde, Cameroon.
    Posso, Anselmo J. Mc Donald
    Gorgas Mem Inst Hlth Studies, Panama City, Panama.
    McFarlane, Shelly R.
    Univ West Indies, Kingston, Jamaica.
    McGarvey, Stephen T.
    Brown Univ, Providence, RI USA.
    McLachlan, Stela
    Univ Edinburgh, Edinburgh, Midlothian, Scotland.
    McLean, Rachael M.
    Univ Otago, Dunedin, New Zealand.
    McLean, Scott B.
    Stat Canada, Ottawa, ON, Canada.
    McNulty, Breige A.
    Univ Coll Dublin, Dublin, Ireland.
    Mediene-Benchekor, Sounnia
    Univ Oran 1, Oran, Algeria.
    Medzioniene, Jurate
    Lithuanian Univ Hlth Sci, Kaunas, Lithuania.
    Meirhaeghe, Aline
    INSERM, Paris, France.
    Meisinger, Christa
    Helmholtz Zentrum Munchen, Munich, Germany.
    Menezes, Ana Maria B.
    Univ Fed Pelotas, Pelotas, Brazil.
    Menon, Geetha R.
    Indian Council Med Res, New Delhi, India.
    Meshram, Indrapal I.
    Natl Inst Nutr, Hyderabad, India.
    Metspalu, Andres
    Univ Tartu, Tartu, Estonia.
    Meyer, Haakon E.
    Univ Oslo, Oslo, Norway.
    Mi, Jie
    Capital Inst Pediat, Beijing, Peoples R China.
    Mikkel, Kairit
    Univ Tartu, Tartu, Estonia.
    Miller, Jody C.
    Univ Otago, Dunedin, New Zealand.
    Minderico, Claudia S.
    Lusofona Univ, Lisbon, Portugal.
    Francisco, Juan
    Pontificia Univ Catolica Chile, Santiago, Chile.
    Jaime Miranda, J.
    Univ Peruana Cayetano Heredia, Lima, Peru.
    Mirrakhimov, Erkin
    Kyrgyz State Med Acad, Bishkek, Kyrgyzstan.
    Misigoj-Durakovic, Marjeta
    Univ Zagreb, Zagreb, Croatia.
    Modesti, Pietro A.
    Univ Firenze, Florence, Italy.
    Mohamed, Mostafa K.
    Ain Shams Univ, Cairo, Egypt.
    Mohammad, Kazem
    Univ Tehran Med Sci, Tehran, Iran.
    Mohammadifard, Noushin
    Hypertens Res Ctr, Tehran, Iran.
    Mohan, Viswanathan
    Madras Diabet Res Fdn, Madras, Tamil Nadu, India.
    Mohanna, Salim
    Univ Peruana Cayetano Heredia, Lima, Peru.
    Yusoff, Muhammad Fadhli Mohd
    Minist Hlth Malaysia, Putrajaya, Malaysia.
    Mollehave, Line T.
    Bispebjerg & Frederiksberg Hosp, Copenhagen, Denmark.
    Moller, Niels C.
    Univ Southern Denmark, Odense, Denmark.
    Molnar, Denes
    Univ Pecs, Pecs, Hungary.
    Momenan, Amirabbas
    Shahid Beheshti Univ Med Sci, Tehran, Iran.
    Mondo, Charles K.
    Mulago Hosp, Kampala, Uganda.
    Monyeki, Kotsedi Daniel K.
    Univ Limpopo, Polokwane, South Africa.
    Moon, Jin Soo
    Seoul Natl Univ, Childrens Hosp, Seoul, South Korea.
    Moreira, Leila B.
    Univ Oran 1, Oran, Algeria;Univ Fed Rio Grande do Sul, Porto Alegre, RS, Brazil.
    Morejon, Alain
    Univ Med Sci, Havana, Cuba.
    Moreno, Luis A.
    Univ Zaragoza, Zaragoza, Spain.
    Morgan, Karen
    RCSI Dublin, Dublin, Ireland.
    Moschonis, George
    La Trobe Univ, Bundoora, Vic, Australia.
    Mossakowska, Malgorzata
    Int Inst Mol & Cell Biol, Warsaw, Poland.
    Mostafa, Aya
    Ain Shams Univ, Cairo, Egypt.
    Mota, Jorge
    Univ Porto, Porto, Portugal.
    Motlagh, Mohammad Esmaeel
    Ahvaz Jundishapur Univ Med Sci, Ahwaz, Khuzestan, Iran.
    Motta, Jorge
    Gorgas Mem Inst Publ Hlth, Panama City, Panama.
    Msyamboza, Kelias P.
    WHO, Country Off, Lilongwe, Malawi.
    Mu, Thet Thet
    Dept Publ Hlth, Pyinmana, Myanmar.
    Muiesan, Maria L.
    Univ Brescia, Brescia, Italy.
    Mueller-Nurasyid, Martina
    Helmholtz Zentrum Munchen, Munich, Germany.
    Murphy, Neil
    Int Agcy Res Canc, Lyon, France.
    Mursu, Jaakko
    Univ Eastern Finland, Kuopio, Finland.
    Musil, Vera
    Univ Zagreb, Zagreb, Croatia.
    Nabipour, Iraj
    Bushehr Univ Med Sci, Bushehr, Iran.
    Nagel, Gabriele
    Ulm Univ, Ulm, Germany.
    Naidu, Balkish M.
    Minist Hlth Malaysia, Putrajaya, Malaysia.
    Nakamura, Harunobu
    Kobe Univ, Kobe, Hyogo, Japan.
    Namesna, Jana
    Reg Author Publ Hlth, Banska Bystrica, Slovakia.
    Nang, Ei Ei K.
    Natl Univ Singapore, Singapore, Singapore.
    Nangia, Vinay B.
    Suraj Eye Inst, Nagpur, Maharashtra, India.
    Narake, Sameer
    Healis Sekhsaria Inst Publ Hlth, Navi Mumbai, India.
    Nauck, Matthias
    Univ Med Greifswald, Greifswald, Germany.
    Maria Navarrete-Munoz, Eva
    CIBER Epidemiol & Salud Publ, Madrid, Spain.
    Ndiaye, Ndeye Coumba
    INSERM, Paris, France.
    Neal, William A.
    West Virginia Univ, Morgantown, WV USA.
    Nenko, Ilona
    Jagiellonian Univ, Med Coll, Krakow, Poland.
    Neovius, Martin
    Karolinska Inst, Stockholm, Sweden.
    Nervi, Flavio
    Pontificia Univ Catolica Chile, Santiago, Chile.
    Nguyen, Chung T.
    Natl Inst Hyg & Epidemiol, Hanoi, Vietnam.
    Nguyen, D. Nguyen
    Univ Pharm & Med Ho Chi Minh City, Ho Chi Minh City, Vietnam.
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    Shanghai Jiao Tong Univ, Sch Med, Shanghai, Peoples R China.
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    Imperial Coll London, London, England.
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    Univ Palermo, Palermo, Italy.
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    Queens Univ Belfast, Belfast, Antrim, North Ireland.
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    Kobe Univ, Kobe, Hyogo, Japan.
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    Univ Coimbra, Coimbra, Portugal.
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    Acad Sinica, Taipei, Taiwan.
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    Heidelberg Univ, Heidelberg, Germany.
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    IRCCS Casa Sollievo Sofferenza, San Giovanni Rotondo, Italy.
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    Zayed Univ, Abu Dhabi, U Arab Emirates.
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    Univ Tehran Med Sci, Tehran, Iran.
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    Healis Sekhsaria Inst Publ Hlth, Navi Mumbai, India.
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    South African Med Res Council, Cape Town, South Africa.
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    Natl Inst Hlth & Welf, Helsinki, Finland.
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    Lithuanian Univ Hlth Sci, Kaunas, Lithuania.
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    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.
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    UCL, London, England.
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    Univ Sarajevo, Sarajevo, Bosnia & Herceg.
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    Cardiovasc Prevent Ctr, Udine, Italy.
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    Minist Hlth & Med Serv, Honiara, Solomon Islands.
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    Cardinal Wyszynski Inst Cardiol, Warsaw, Poland.
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    Univ Split, Split, Croatia.
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    Pontificia Univ Catolica Chile, Santiago, Chile;Inst Hosp Mar Invest Med, Barcelona, Spain.
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    Univ Valencia, Valencia, Spain.
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    Imperial Coll London, London, England.
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    Singapore Eye Res Inst, Singapore, Singapore.
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    London Sch Hyg & Trop Med, London, England.
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    Peking Univ, Beijing, Peoples R China.
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    Univ Adelaide, Adelaide, SA, Australia.
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    Karolinska Inst, Stockholm, Sweden.
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    Karadeniz Tech Univ, Trabzon, Turkey.
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    Jagiellonian Univ, Coll Med, Warsaw, Poland.
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    IB SALUT Area Salut Menorca, Ciutadella De Menorca, Spain.
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    Inst Rech Dev, Marseille, France.
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    Norwegian Univ Sci & Technol, Oslo, Norway.
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    Univ Fed Minas Gerais, Belo Horizonte, MG, Brazil.
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    Univ Insubria, Varese, VA, Italy.
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    Natl Inst Publ Hlth & Environm, Bilthoven, Netherlands.
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    Finnish Inst Occupat Hlth, Helsinki, Finland.
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    Imperial Coll London, London, England.
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    Univ Miguel Hernandez, Elche, Spain.
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    INSERM, Paris, France.
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    Univ West Indies, Kingston, Jamaica.
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    Univ Teknol MARA, Shah Alam, Selangor, Malaysia.
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    Univ Padua, Padua, Italy.
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    Agr Univ Athens, Athens, Greece.
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    Med Univ Gdansk, Gdansk, Poland.
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    Peking Univ, Beijing, Peoples R China;Duke Univ, Durham, NC USA.
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    Capital Med Univ, Beijing An Zhen Hosp, Beijing, Peoples R China.
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    Chinese Ctr Dis Control & Prevent, Beijing, Peoples R China.
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    Vanderbilt Univ, Nashville, TN USA.
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    Contributions of mean and shape of blood pressure distribution to worldwide trends and variations in raised blood pressure: a pooled analysis of 1018 population-based measurement studies with 88.6 million participants2018In: International Journal of Epidemiology, ISSN 0300-5771, E-ISSN 1464-3685, Vol. 47, no 3, p. 872-883iArticle in journal (Refereed)
    Abstract [en]

    Background

    Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hypertensive population). Our aim was to quantify the contributions of these two phenomena to the worldwide trends in the prevalence of raised blood pressure.

    Methods

    We pooled 1018 population-based studies with blood pressure measurements on 88.6 million participants from 1985 to 2016. We first calculated mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP) and prevalence of raised blood pressure by sex and 10-year age group from 20–29 years to 70–79 years in each study, taking into account complex survey design and survey sample weights, where relevant. We used a linear mixed effect model to quantify the association between (probit-transformed) prevalence of raised blood pressure and age-group- and sex-specific mean blood pressure. We calculated the contributions of change in mean SBP and DBP, and of change in the prevalence-mean association, to the change in prevalence of raised blood pressure.

    Results

    In 2005–16, at the same level of population mean SBP and DBP, men and women in South Asia and in Central Asia, the Middle East and North Africa would have the highest prevalence of raised blood pressure, and men and women in the high-income Asia Pacific and high-income Western regions would have the lowest. In most region-sex-age groups where the prevalence of raised blood pressure declined, one half or more of the decline was due to the decline in mean blood pressure. Where prevalence of raised blood pressure has increased, the change was entirely driven by increasing mean blood pressure, offset partly by the change in the prevalence-mean association.

    Conclusions

    Change in mean blood pressure is the main driver of the worldwide change in the prevalence of raised blood pressure, but change in the high-blood-pressure tail of the distribution has also contributed to the change in prevalence, especially in older age groups.

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    Moller, Niels C.
    Univ So Denmark, Odense, Denmark..
    Molnar, Denes
    Univ Pecs, Pecs, Hungary..
    Mondo, Charles K.
    Mulago Hosp, Kampala, Uganda..
    Morejon, Alain
    Univ Med Sci, Havana, Cuba..
    Moreno, Luis A.
    Univ Zaragoza, E-50009 Zaragoza, Spain..
    Morgan, Karen
    RCSI Dublin, Dublin, Ireland..
    Moschonis, George
    Harokopio Univ, Kallithea, Greece..
    Mossakowska, Malgorzata
    Int Inst Mol & Cell Biol, Warsaw, Poland..
    Mostafa, Aya
    Ain Shams Univ, Cairo, Egypt..
    Mota, Jorge
    Univ Porto, Rua Campo Alegre 823, P-4100 Oporto, Portugal..
    Motta, Jorge
    Gorgas Mem Inst Publ Hlth, Panama City, Panama..
    Mu, Thet Thet
    Dept Publ Hlth, Naypyidaw, Myanmar..
    Muiesan, Maria Lorenza
    Univ Brescia, Brescia, Italy..
    Mueller-Nurasyid, Martina
    Helmholtz Zentrum Munchen, Munich, Germany..
    Mursu, Jaakko
    Univ Eastern Finland, Joensuu, Finland..
    Nagel, Gabriele
    Univ Ulm, D-89069 Ulm, Germany..
    Namesna, Jana
    Reg Author Publ Hlth, Banska Bystrica, Slovakia..
    Nang, Ei Ei K.
    Natl Univ Singapore, Singapore 117548, Singapore..
    Nangia, Vinay B.
    Suraj Eye Inst, Nagpur, Maharashtra, India..
    Maria Navarrete-Munoz, Eva
    CIBER Epidemiol & Salud Publ, Barcelona, Spain..
    Ndiaye, Ndeye Coumba
    INSERM, F-75654 Paris 13, France..
    Nenko, Ilona
    Jagiellonian Univ, Coll Med, PL-31007 Krakow, Poland..
    Nervi, Flavio
    Pontificia Univ Catolica Chile, Santiago, Chile..
    Nguyen, Nguyen D.
    Univ Pharm & Med Ho Chi Minh City, Ho Chi Minh City, Vietnam..
    Nguyen, Quang Ngoc
    Nieto-Martinez, Ramfi S. E.
    Univ Ctr Occidental Lisandro Alvarado, Caracas, Venezuela..
    Ning, Guang
    Shanghai Jiao Tong Univ, Sch Med, Shanghai 200030, Peoples R China..
    Ninomiya, Toshiharu
    Kyushu Univ, Fukuoka 812, Japan..
    Noale, Marianna
    CNR, Milan, Italy..
    Noto, Davide
    Univ Palermo, Palermo, Italy..
    Al Nsour, Mohannad
    Eastern Mediterranean Publ Hlth Network, Amman, Jordan..
    Ochoa-Aviles, Angelica M.
    Univ Cuenca, Cuenca, Ecuador..
    Oh, Kyungwon
    Korea Ctr Dis Control & Prevent, Seoul, South Korea..
    Ordunez, Pedro
    Pan Amer Hlth Org, Washington, DC USA..
    Osmond, Clive
    MRC Lifecourse Epidemiol Unit, Southampton, Hants, England..
    Otero, Johanna A.
    Fdn Oftalmol Santander, Santander, Colombia..
    Owusu-Dabo, Ellis
    Kwame Nkrumah Univ Sci & Technol, Kumasi, Ghana..
    Pahomova, Elena
    Univ Latvia, Riga, Latvia..
    Palmieri, Luigi
    Ist Super Sanita, Milan, Italy..
    Panda-Jonas, Songhomitra
    Heidelberg Univ, Heidelberg, Germany..
    Panza, Francesco
    Univ Bari, Bari, Italy..
    Parsaeian, Mahboubeh
    Noncommunicable Dis Res Ctr, Tehran, Iran..
    Peixoto, Sergio Viana
    Fundacao Oswaldo Cruz, Rene Rachou Res Inst, Rio De Janeiro, Brazil..
    Peltonen, Markku
    Natl Inst Hlth & Welf, Helsinki, Finland..
    Peters, Annette
    Helmholtz Zentrum Munchen, Munich, Germany..
    Peykari, Niloofar
    Noncommunicable Dis Res Ctr, Tehran, Iran..
    Pham, Son Thai
    Pilav, Aida
    Fed Minist Hlth, Sarajevo, Bosnia & Herceg.;Fed Minist Hlth, Mostar, Bosnia & Herceg..
    Pitakaka, Freda
    Univ New S Wales, Sydney, NSW 2052, Australia..
    Piwonska, Aleksandra
    Cardinal Wyszynski Inst Cardiol, Warsaw, Poland..
    Piwonski, Jerzy
    Cardinal Wyszynski Inst Cardiol, Warsaw, Poland..
    Plans-Rubio, Pedro
    Publ Hlth Agcy Catalonia, Catalonia, Spain..
    Porta, Miquel
    Inst Hosp Mar Invest Med, Madrid, Spain..
    Portegies, Marileen L. P.
    Erasmus MC, Rotterdam, Netherlands..
    Poustchi, Hossein
    Univ Tehran Med Sci, Tehran, Iran..
    Pradeepa, Rajendra
    Madras Diabet Res Fdn, Madras, Tamil Nadu, India..
    Price, Jacqueline F.
    Univ Edinburgh, Edinburgh, Midlothian, Scotland..
    Punab, Margus
    Tartu Univ Clin, Tartu, Estonia..
    Qasrawi, Radwan F.
    Qorbani, Mostafa
    Alborz Univ Med Sci, Alborz, Iran..
    Radisauskas, Ricardas
    Lithuanian Univ Hlth Sci, Kaunas, Lithuania..
    Rahman, Mahmudur
    Raitakari, Olli
    Univ Turku, Turku, Finland..
    Rao, Sudha Ramachandra
    Natl Inst Epidemiol, Delhi, India..
    Ramke, Jacqueline
    Univ New S Wales, Sydney, NSW 2052, Australia..
    Ramos, Rafel
    Inst Univ Invest Atencio Primaria Jordi Gol, Barcelona, Spain..
    Rampal, Sanjay
    Univ Malaya, Kuala Lumpur, Malaysia..
    Rathmann, Wolfgang
    German Diabet Ctr, Berlin, Germany..
    Redon, Josep
    Univ Valencia, Valencia, Spain..
    Reganit, Paul Ferdinand M.
    Univ Philippines, Quezon City 1101, Philippines..
    Rigo, Fernando
    Hlth Ctr San Agustin, San Agustin, Spain..
    Robinson, Sian M.
    Univ Southampton, Southampton SO9 5NH, Hants, England..
    Robitaille, Cynthia
    Publ Hlth Agcy Canada, Toronto, ON, Canada..
    Rodriguez-Artalejo, Fernando
    Univ Autonoma Madrid, Madrid, Spain..
    del Cristo Rodriguez-Perez, Maria
    Rodriguez-Villamizar, Laura A.
    Univ Ind Santander, Santander, Colombia..
    Rojas-Martinez, Rosalba
    Inst Nacl Salud Publ, Mexico City, DF, Mexico..
    Ronkainen, Kimmo
    Rosengren, Annika
    Univ Gothenburg, Gothenburg, Sweden..
    Rubinstein, Adolfo
    Inst Clin Effectiveness & Hlth Policy, Buenos Aires, DF, Argentina..
    Rui, Ornelas
    Univ Madeira, Funchal, Portugal..
    Sandra Ruiz-Betancourt, Blanca
    Inst Mexicano Seguro Social, Mexico City, DF, Mexico..
    Russo Horimoto, Andrea R. V.
    Inst Heart, Sao Paulo, Brazil..
    Rutkowski, Marcin
    Med Univ Gdansk, Gdansk, Poland..
    Sabanayagam, Charumathi
    Singapore Eye Res Inst, Singapore, Singapore..
    Sachdev, Harshpal S.
    Sitaram Bhartia Inst Sci & Res, Delhi, India..
    Saidi, Olfa
    Univ Tunis El Manar, Tunis, Tunisia..
    Sakarya, Sibel
    Marmara Univ, Istanbul, Turkey..
    Salanave, Benoit
    French Inst Hlth Surveillance, Paris, France..
    Salonen, Jukka T.
    Univ Helsinki, Helsinki, Finland..
    Salvetti, Massimo
    Univ Brescia, Brescia, Italy..
    Sanchez-Abanto, Jose
    Santos, Diana
    Univ Lisbon, P-1699 Lisbon, Portugal..
    dos Santos, Renata Nunes
    Univ Sao Paulo, Clin Hosp, BR-05508 Sao Paulo, Brazil..
    Santos, Rute
    Univ Porto, Rua Campo Alegre 823, P-4100 Oporto, Portugal..
    Saramies, Jouko L.
    Sardinha, Luis B.
    Univ Lisbon, P-1699 Lisbon, Portugal..
    Sarrafzadegan, Nizal
    Isfahan Cardiovasc Res Ctr, Esfahan, Iran..
    Saum, Kai-Uwe
    German Canc Res Ctr, Berlin, Germany..
    Scazufca, Marcia
    Univ Sao Paulo, Clin Hosp, BR-05508 Sao Paulo, Brazil..
    Schargrodsky, Herman
    Hosp Italiano Buenos Aires, Buenos Aires, DF, Argentina..
    Scheidt-Nave, Christa
    Robert Koch Inst, Berlin, Germany..
    Sein, Aye Aye
    Sharma, Sanjb K.
    Shaw, Jonathan E.
    Shibuya, Kenji
    Univ Tokyo, Tokyo, Japan..
    Shin, Youchan
    Singapore Eye Res Inst, Singapore, Singapore..
    Shiri, Rahman
    Siantar, Rosalynn
    Singapore Eye Res Inst, Singapore, Singapore..
    Sibai, Abla M.
    Amer Univ Beirut, Beirut, Lebanon..
    Simon, Mary
    Simons, Judith
    Simons, Leon A.
    Univ New S Wales, Sydney, NSW 2052, Australia..
    Sjostrom, Michael
    Karolinska Inst, S-10401 Stockholm, Sweden..
    Slowikowska-Hilczer, Jolanta
    Med Univ Lodz, Lodz, Poland..
    Slusarczyk, Przemyslaw
    Smeeth, Liam
    London Sch Hyg & Trop Med, London, England..
    Snijder, Marieke B.
    Univ Amsterdam, Acad Med Ctr, Meibergdreef 9, NL-1105 AZ Amsterdam, Netherlands..
    So, Hung-Kwan
    Chinese Univ Hong Kong, Hong Kong, Hong Kong, Peoples R China..
    Sobngwi, Eugene
    Univ Yaounde I, Yaounde, Cameroon..
    Soderberg, Stefan
    Umea Univ, Umea, Sweden..
    Solfrizzi, Vincenzo
    Univ Bari, Bari, Italy..
    Sonestedt, Emily
    Lund Univ, Lund, Sweden..
    Soumare, Aicha
    Univ Bordeaux, Bordeaux, France..
    Staessen, Jan A.
    Univ Leuven, Leuven, Belgium..
    Stathopoulou, Maria G.
    INSERM, F-75654 Paris 13, France..
    Steene-Johannessen, Jostein
    Stehle, Peter
    Univ Bonn, Bonn, Germany..
    Stein, Aryeh D.
    Emory Univ, Atlanta, GA 30322 USA..
    Stessman, Jochanan
    Hadassah Univ, Med Ctr, Jerusalem, Israel..
    Stoeckl, Doris
    Helmholtz Zentrum mUNCHEN, Munich, Germany..
    Stokwiszewski, Jakub
    Stronks, Karien
    Univ Amsterdam, Amsterdam, Netherlands..
    Strufaldi, Maria Wany
    Univ Fed Sao Paulo, Sao Paulo, Brazil..
    Sun, Chien-An
    Fu Jen Catholic Univ, Taipei, Taiwan..
    Sundström, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    Sung, Yn-Tz
    Chinese Univ Hong Kong, Hong Kong, Hong Kong, Peoples R China..
    Suriyawongpaisal, Paibul
    Mahidol Univ, Bangkok 10700, Thailand..
    Sy, Rody G.
    Univ Philippines, Quezon City 1101, Philippines..
    Tai, E. Shyong
    Natl Univ Singapore, Singapore 117548, Singapore..
    Tamosiunas, Abdonas
    Tang, Line
    Tarawneh, Mohammed
    Tarqui-Mamani, Carolina B.
    Taylor, Anne
    Univ Adelaide, Adelaide, SA 5005, Australia..
    Theobald, Holger
    Karolinska Inst, S-10401 Stockholm, Sweden..
    Thijs, Lutgarde
    Univ Leuven, Leuven, Belgium..
    Thuesen, Betina H.
    Tolonen, Hanna K.
    Tolstrup, Janne S.
    Topbas, Murat
    Torrent, Maties
    Traissac, Pierre
    Trinh, Oanh T. H.
    Univ Pharm & Med Ho Chi Minh City, Ho Chi Minh City, Vietnam..
    Tulloch-Reid, Marshall K.
    Univ W Indies, Kingston, Jamaica..
    Tuomainen, Tomi-Pekka
    Univ Eastern Finland, Joensuu, Finland..
    Turley, Maria L.
    Tzourio, Christophe
    Univ Bordeaux, Bordeaux, France..
    Ueda, Peter
    Harvard Univ, TH Chan Sch Publ Hlth, Cambridge, MA 02138 USA..
    Ukoli, Flora A. M.
    Meharry Med Coll, Nashville, TN USA..
    Ulmer, Hanno
    Med Univ Innsbruck, A-6020 Innsbruck, Austria..
    Uusitalo, Hannu M. T.
    Tampere Univ Hosp, Tampere, Finland..
    Valdivia, Gonzalo
    Pontificia Univ Catolica Chile, Santiago, Chile..
    Valvi, Damaskini
    Harvard Univ, TH Chan Sch Publ Hlth, Cambridge, MA 02138 USA..
    van Rossem, Lenie
    Univ Med Ctr Utrecht, Utrecht, Netherlands..
    van Valkengoed, Irene G. M.
    Univ Amsterdam, Acad Med Ctr, Meibergdreef 9, NL-1105 AZ Amsterdam, Netherlands..
    Vanderschueren, Dirk
    Katholieke Univ Leuven, Leuven, Belgium..
    Vanuzzo, Diego
    Ctr Prevenz Cardiovasc Udine, Udine, Italy..
    Vega, Tomas
    Consejeria Sanidad Junta Castilla & Leon, Leon, Spain..
    Velasquez-Melendez, Gustavo
    Univ Fed Minas Gerais, Belo Horizonte, MG, Brazil..
    Veronesi, Giovanni
    Univ Insubria, Insubria, Italy..
    Verschuren, W. M. Monique
    Natl Inst Publ Hlth & Environm, Amsterdam, Netherlands..
    Verstraeten, Roosmarijn
    Inst Trop Med, Brussels, Belgium..
    Viet, Lucie
    Natl Inst Publ Hlth & Environm, Amsterdam, Netherlands..
    Vioque, Jesus
    Univ Miguel Hernandez, Elche, Spain..
    Virtanen, Jyrki K.
    Univ Eastern Finland, Joensuu, Finland. INSERM, F-75654 Paris 13, France..
    Viswanathan, Bharathi
    Minist Hlth, Victoria, Seychelles..
    Vollenweider, Peter
    Univ Lausanne Hosp, Lausanne, Switzerland..
    Voutilainen, Sari
    Univ Eastern Finland, Tampere, Finland..
    Vrijheid, Martine
    Ctr Res Environm Epidemiol, Barcelona, Spain..
    Wade, Alisha N.
    Univ Witwatersrand, ZA-2050 Johannesburg, South Africa..
    Wagner, Aline
    Univ Strasbourg, Strasbourg, France..
    Walton, Janette
    Univ Coll Cork, Cork, Ireland..
    Mohamud, Wan Nazaimoon Wan
    Inst Med Res, Kuala Lumpur, Malaysia..
    Wang, Feng
    Peking Univ, Hosp 6, Beijing, Peoples R China..
    Wang, Ming-Dong
    Publ Hlth Agcy Canada, Toronto, ON, Canada..
    Wang, Qian
    Xinjiang Med Univ, Urumqi, Xinjiang, Peoples R China..
    Wang, Ya Xing
    Beijing Tongren Hosp, Beijing, Peoples R China..
    Wannamethee, S. Goya
    UCL, London WC1E 6BT, England..
    Weerasekera, Deepa
    Minist Hlth, Auckland, New Zealand..
    Whincup, Peter H.
    St Georges Univ London, London, England..
    Widhalm, Kurt
    Med Univ Vienna, Vienna, Austria. Med Univ Silesia, Katowice, Poland. Natl Inst Publ Hlth & Environm, Amsterdam, Netherlands..
    Wijga, Alet H.
    Wilks, Rainford J.
    Univ W Indies, Kingston, Jamaica..
    Willeit, Johann
    Med Univ Innsbruck, A-6020 Innsbruck, Austria..
    Wilsgaard, Tom
    UiT Arct Univ Norway, Oslo, Norway..
    Wojtyniak, Bogdan
    Natl Inst Hyg, Warsaw, Poland..
    Wong, Tien Yin
    Duke NUS Grad Med Sch, Singapore, Singapore..
    Woo, Jean
    Chinese Univ Hong Kong, Hong Kong, Hong Kong, Peoples R China..
    Woodward, Mark
    Univ Sydney, Sydney, NSW 2006, Australia.;Univ Oxford, Oxford, England..
    Wu, Frederick C.
    Univ Manchester, Manchester, Lancs, England..
    Wu, Shou Ling
    Kailuan Gen Hosp, Tangshan, Peoples R China..
    Xu, Haiquan
    Minist Agr, Inst Food & Nutr Dev, Beijing, Peoples R China..
    Yan, Weili
    Fudan Univ, Shanghai, Peoples R China..
    Yang, Xiaoguang
    Chinese Ctr Dis Control & Prevent, Beijing, Peoples R China..
    Ye, Xingwang
    Univ Chinese Acad Sci, Beijing, Peoples R China..
    Yoshihara, Akihiro
    Niigata Univ, Niigata 95021, Japan..
    Younger-Coleman, Novie O.
    Univ W Indies, Kingston, Jamaica..
    Zambon, Sabina
    Univ Padua, Padua, Italy..
    Zargar, Abdul Hamid
    Ctr Diabet & Endocrine Care, New Delhi, India..
    Zdrojewski, Tomasz
    Med Univ Gdansk, Gdansk, Poland..
    Zhao, Wenhua
    Chinese Ctr Dis Control & Prevent, Beijing, Peoples R China..
    Zheng, Yingfeng
    Singapore Eye Res Inst, Singapore, Singapore..
    Zuniga Cisneros, Julio
    Gorgas Mem Inst Publ Hlth, Panama City, Panama..
    Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4.4 million participants2016In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 387, no 10027, p. 1513-1530Article in journal (Refereed)
    Abstract [en]

    Background One of the global targets for non-communicable diseases is to halt, by 2025, the rise in the age-standardised adult prevalence of diabetes at its 2010 levels. We aimed to estimate worldwide trends in diabetes, how likely it is for countries to achieve the global target, and how changes in prevalence, together with population growth and ageing, are affecting the number of adults with diabetes. Methods We pooled data from population-based studies that had collected data on diabetes through measurement of its biomarkers. We used a Bayesian hierarchical model to estimate trends in diabetes prevalence-defined as fasting plasma glucose of 7.0 mmol/L or higher, or history of diagnosis with diabetes, or use of insulin or oral hypoglycaemic drugs-in 200 countries and territories in 21 regions, by sex and from 1980 to 2014. We also calculated the posterior probability of meeting the global diabetes target if post-2000 trends continue. Findings We used data from 751 studies including 4 372 000 adults from 146 of the 200 countries we make estimates for. Global age-standardised diabetes prevalence increased from 4.3% (95% credible interval 2.4-7.0) in 1980 to 9.0% (7.2-11.1) in 2014 in men, and from 5.0% (2.9-7.9) to 7.9% (6.4-9.7) in women. The number of adults with diabetes in the world increased from 108 million in 1980 to 422 million in 2014 (28.5% due to the rise in prevalence, 39.7% due to population growth and ageing, and 31.8% due to interaction of these two factors). Age-standardised adult diabetes prevalence in 2014 was lowest in northwestern Europe, and highest in Polynesia and Micronesia, at nearly 25%, followed by Melanesia and the Middle East and north Africa. Between 1980 and 2014 there was little change in age-standardised diabetes prevalence in adult women in continental western Europe, although crude prevalence rose because of ageing of the population. By contrast, age-standardised adult prevalence rose by 15 percentage points in men and women in Polynesia and Micronesia. In 2014, American Samoa had the highest national prevalence of diabetes (>30% in both sexes), with age-standardised adult prevalence also higher than 25% in some other islands in Polynesia and Micronesia. If post-2000 trends continue, the probability of meeting the global target of halting the rise in the prevalence of diabetes by 2025 at the 2010 level worldwide is lower than 1% for men and is 1% for women. Only nine countries for men and 29 countries for women, mostly in western Europe, have a 50% or higher probability of meeting the global target. Interpretation Since 1980, age-standardised diabetes prevalence in adults has increased, or at best remained unchanged, in every country. Together with population growth and ageing, this rise has led to a near quadrupling of the number of adults with diabetes worldwide. The burden of diabetes, both in terms of prevalence and number of adults affected, has increased faster in low-income and middle-income countries than in high-income countries. Funding Wellcome Trust.

  • 1558.
    Zimerman, Andre
    et al.
    Duke Med, Duke Clin Res Inst, Durham, NC USA..
    Lopes, Renato D.
    Duke Med, Duke Clin Res Inst, Durham, NC USA..
    Stebbins, Amanda L.
    Duke Med, Duke Clin Res Inst, Durham, NC USA..
    Guimaraes, Patricia O.
    Duke Med, Duke Clin Res Inst, Durham, NC USA..
    Haque, Ghazala
    Duke Med, Duke Clin Res Inst, Durham, NC USA..
    Melloni, Chiara
    Duke Med, Duke Clin Res Inst, Durham, NC USA..
    Trollinger, Kathleen
    Duke Med, Duke Clin Res Inst, Durham, NC USA..
    James, Stefan K.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Alexander, John H.
    Duke Med, Duke Clin Res Inst, Durham, NC USA..
    Tricoci, Pierluigi
    Duke Med, Duke Clin Res Inst, Durham, NC USA..
    Roe, Matthew T.
    Duke Med, Duke Clin Res Inst, Durham, NC USA..
    Ohman, Erik Magnus
    Duke Med, Duke Clin Res Inst, Durham, NC USA..
    Mahaffey, Kenneth W.
    Stanford Univ, Dept Med, Stanford, CA 94305 USA..
    Held, Claes
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Tinga, Brian
    Duke Med, Duke Clin Res Inst, Durham, NC USA..
    Pieper, Karen S.
    Duke Med, Duke Clin Res Inst, Durham, NC USA..
    Alexander, Karen P.
    Duke Med, Duke Clin Res Inst, Durham, NC USA..
    Pooled analysis of adverse event collection from 4 acute coronary syndrome trials2016In: American Heart Journal, ISSN 0002-8703, E-ISSN 1097-6744, Vol. 174, p. 60-67Article in journal (Refereed)
    Abstract [en]

    Background: Adverse event collection in randomized clinical trials establishes drug safety. Although costly and regulated, it is rarely studied.

    Methods: Adverse event data from 4 clinical trials (APPRAISE-2, PLATO, TRACER, TRILOGY ACS) comprising 48,118 participants with acute coronary syndromes were pooled to compare patterns and determinants of reporting. Events were classified as serious (SAE) or nonserious (AE) from hospital discharge to 1 year; study end points were excluded.

    Results: In total, 84,901 events were reported. Of those, 12,266 (14.4%) were SAEs and 72,635 (85.6%) were AEs. Of all participants, 7,823 (16.3%) had SAEs, 18,124 (37.7%) had only AEs, and 22,171 (46.1%) had neither. Nonserious adverse events were distributed across system organ classes: general disorders (11%), infection (10%), gastrointestinal (10%), respiratory (9%), cardiovascular (8.4%), and other (35%). Serious adverse events had a higher proportion of cardiovascular causes (14.0%). Event reporting was highest after hospital discharge, decreasing rapidly during the following 3 months. In a Cox proportional hazards model, chronic obstructive pulmonary disease (hazard ratio 1.58, 95% CI 1.44-1.74), heart failure (1.55, 1.40-1.70), older age, and female sex were independent predictors of more SAEs, whereas enrollment in Eastern Europe (0.63, 0.58-0.69) or Asia (0.84, 0.75-0.94) were independent predictors of fewer SAEs.

    Conclusions: Half of all participants reported adverse events in the year after acute coronary syndrome; most were AEs and occurred within 3 months. The high volume of events, as well as the variation in SAE reporting by characteristics and enrollment region, indicates that efforts to refine event collection in large trials are warranted.

  • 1559.
    Ärnlöv, Johan
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    Ingelsson, Erik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    Sundström, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Lind, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Impact of body mass index and the metabolic syndrome on the risk of cardiovascular disease and death in middle-aged men2010In: Circulation, ISSN 0009-7322, E-ISSN 1524-4539, Vol. 121, no 2, p. 230-236Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The purpose of this study was to investigate associations between combinations of body mass index (BMI) categories and metabolic syndrome (MetS) and the risk of cardiovascular disease and death in middle-aged men. METHODS AND RESULTS: At age 50 years, cardiovascular risk factors were assessed in 1758 participants without diabetes in the community-based Uppsala Longitudinal Study of Adult Men (ULSAM). According to BMI-MetS status, they were categorized as normal weight (BMI <25 kg/m(2)) without MetS (National Cholesterol Education Program criteria; n=891), normal weight with MetS (n=64), overweight (BMI 25 to 30 kg/m(2)) without MetS (n=582), overweight with MetS (n=125), obese (BMI >30 kg/m(2)) without MetS (n=30), or obese with MetS (n=66). During follow-up (median 30 years), 788 participants died, and 681 developed cardiovascular disease (composite of cardiovascular death or hospitalization for myocardial infarction, stroke, or heart failure). In Cox proportional-hazards models that adjusted for age, smoking, and low-density lipoprotein cholesterol, an increased risk for cardiovascular disease was observed in normal-weight participants with MetS (hazard ratio 1.63, 95% confidence interval 1.11 to 2.37), overweight participants without MetS (hazard ratio 1.52, 95% confidence interval 1.28 to 1.80), overweight participants with MetS (hazard ratio 1.74, 95% confidence interval 1.32 to 2.30), obese participants without MetS (hazard ratio 1.95, 95% confidence interval 1.14 to 3.34), and obese participants with MetS (hazard ratio 2.55, 95% confidence interval 1.81 to 3.58) compared with normal-weight individuals without MetS. These BMI-MetS categories significantly predicted total mortality rate in a similar pattern. CONCLUSIONS: Middle-aged men with MetS had increased risk for cardiovascular events and total death regardless of BMI status during more than 30 years of follow-up. In contrast to previous reports, overweight and obese individuals without MetS also had an increased risk. The present data refute the notion that overweight and obesity without MetS are benign conditions.

  • 1560.
    Åkerblom, Axel
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center. Duke Clin Res Inst, Durham, NC USA..
    Clare, Robert M.
    Duke Clin Res Inst, Durham, NC USA..
    Lokhnygina, Yuliya
    Duke Clin Res Inst, Durham, NC USA..
    Wallentin, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    Held, Claes
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Van de Werf, Frans
    Univ Leuven, Dept Cardiol, Leuven, Sweden..
    Moliterno, David J.
    Univ Kentucky, Gill Heart Inst, Lexington, KY USA.;Univ Kentucky, Div Cardiovasc Med, Lexington, KY USA..
    Patel, Uptal D.
    Duke Clin Res Inst, Durham, NC USA..
    Leonardi, Sergio
    Fdn IRCCS Policlin San Matteo, Pavia, Italy..
    Armstrong, Paul W.
    Univ Alberta, Div Cardiol, Edmonton, AB, Canada..
    Harrington, Robert A.
    Stanford Univ, Dept Med, Stanford, CA 94305 USA..
    White, Harvey D.
    Auckland City Hosp, Green Lane Cardiovasc Serv, Auckland, New Zealand..
    Aylward, Philip E.
    Flinders Univ & Med Ctr, South Australian Hlth & Med Res Inst, Adelaide, SA, Australia..
    Mahaffey, Kenneth W.
    Stanford Univ, Dept Med, Stanford, CA 94305 USA..
    Tricoci, Pierluigi
    Duke Clin Res Inst, Durham, NC USA..
    Albuminuria and cardiovascular events in patients with acute coronary syndromes: Results from the TRACER trial2016In: American Heart Journal, ISSN 0002-8703, E-ISSN 1097-6744, Vol. 178, p. 1-8Article in journal (Refereed)
    Abstract [en]

    Background Albuminuria is associated with cardiovascular (CV) outcomes. We evaluated albuminuria, alone and in combination with estimated glomerular filtration rate (eGFR), as a predictor of mortality and CV morbidity in 12,944 patients with non-ST-segment elevation acute coronary syndromes. Methods Baseline serum creatinine and urinary dipsticks were obtained, with albuminuria stratified into no/trace albuminuria, microalbuminuria (>= 30 but <300 mg/dL), or macroalbuminuria (>= 300 mg/dL). Kaplan-Meier rates and proportional Cox hazards models of CV death, overall mortality, CV death or myocardial infarction (MI), and bleeding were calculated. Incidence of acute kidney injury, identified by adverse event reporting and creatinine increase (absolute >= 0.3 mg/dL or relative >= 50%), was descriptively reported. Results Both dipstick albuminuria and creatinine values were available in 9473 patients (73.2%). More patients with macroalbuminuria, versus no/trace albuminuria, had diabetes (66% vs 27%) or hypertension (86% vs 68%). Rates for CV death and overall mortality per strata were 3.1% and 4.8% (no/trace albuminuria); 5.8% and 9.0% (microalbuminuria); and 7.7% and 12.6% (macroalbuminuria) at 2 years of follow-up. Corresponding rates for CV death or MI were 12.2%, 16.9%, and 23.5%, respectively. Observed acute kidney injury rates were 0.6%, 1.2%, and 2.9% (n = 79), respectively. Adjusted HRs for macroalbuminuria on CV mortality were 1.65 (95% CI 1.15-2.37), and after adjustment with eGFR, 1.37 (95% CI 0.93-2.01). Corresponding HRs for overall mortality were 1.82 (95% CI 1.37-2.42) and 1.47 (95% CI 1.08-1.98). Conclusions High-risk patients with non-ST-segment elevation acute coronary syndromes and albuminuria have increased morbidity and increased overall mortality independent of eGFR.

  • 1561.
    Åkerblom, Axel
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Eriksson, Niclas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Wallentin, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Siegbahn, Agneta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Coagulation and inflammation science. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Becker, Richard C.
    Duke Clinical Research Institute, Durham, NC, USA.
    Budaj, Andrzej
    Postgraduate Medical School, Grochowski Hospital, Warsaw, Poland.
    Himmelmann, Anders
    AstraZeneca Research and Development, Mölndal, Sweden.
    Husted, Steen
    Department of Cardiology, Århus University Hospital, Århus, Denmark.
    Storey, Robert F.
    Department of Cardiovascular Science, University of Sheffield, Sheffield, UK.
    Johansson, Åsa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    James, Stefan K.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Polymorphism of the cystatin C gene in patients with acute coronary syndromes: Results from the PLATelet Inhibition and Patient Outcomes (PLATO) Study2014In: American Heart Journal, ISSN 0002-8703, E-ISSN 1097-6744, Vol. 168, no 1, p. 96-102Article in journal (Other academic)
    Abstract [en]

    Purpose: Plasma cystatin C is independently associated with cardiovascular (CV) risk in non-ST-elevation acute coronary syndromes (NSTE-ACS). The effect of genetic variability on cystatin C concentrations and outcome is unclear.

    Methods: Plasma cystatin C concentrations were measured in blood, obtained within 24 hours of admission, in 16279 ACS patients from the PLATelet inhibition and patient Outcomes trial. 9978 patients were genome-wide genotyped with up to 2.5 million SNPs. The first occurrence of CV death or myocardial infarction (MI) within one year was evaluated by multivariable (clinical variables and biomarkers) Cox regression analysis and c-statistics both overall (all ACS) and in NSTE-ACS.

    Results: We observed SNPs association with cystatin C levels (up to p=7.82 x 10-16). The most significant SNP (rs6048952) was adjacent the CST3 gene with additive effect on cystatin C concentrations: 0.85mg/L, 0.80mg/L and 0.73mg/L for the A/A, A/G and G/G genotypes respectively. Multivariable c-statistics regarding the combined endpoint (CV death or MI) was 0.6619. Adding cystatin C concentrations or genetically adjusted cystatin C levels, exhibited c-statistics of 0.6705 and 0.6703, respectively.

    The overall hazard ratio for rs6048952 was 0.93 (95%CI 0.82-1.04) regarding the CV death or MI while 0.85 (95%CI 0.70-1.03) regarding CV death in all ACS patients. In the NSTE-ACS subgroup, the hazard ratio for rs6048952 was 0.72 (95%CI 0.54-0.95).

    Conclusions: Genetic polymorphism, independently of kidney function, affects cystatin C concentrations, but does not appear to influence ischemic outcome in an overall ACS population. However, genetic variation appears to affect cardiovascular mortality in moderate-to-high risk NSTE-ACS patients.

  • 1562.
    Åkerblom, Axel
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Helmersson, Johanna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Weitoft, Tomas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Seasonal variations of urate in a Swedish adult population2017In: Clinical Rheumatology, ISSN 0770-3198, E-ISSN 1434-9949, Vol. 36, no 7, p. 1595-1598Article in journal (Refereed)
    Abstract [en]

    Seasonality in the incidence and prevalence of gout has previously been reported but the cause of this seasonality in gout is not explained. The aim of this study was to evaluate possible seasonal variations of urate in a large unselected Swedish adult population. We analyzed 170,915 urate test results from patients at a tertiary care hospital between 2000 and 2016. The results were divided according to sex and sampling month of the year. The median urate values were overall higher in males compared to females and both males and females had peak urate concentrations in the summer months (June-August). There is a seasonal pattern for urate concentrations in a large Swedish population similar to the previously reported seasonality for gout. This may be clinically important and could contribute to the circannual variation of gout. The seasonal pattern should be recognized when evaluating patient results both in clinical practice and in research studies.

  • 1563.
    Åkerblom, Axel
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Helmersson-Karlqvist, Johanna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Flodin, Mats
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Comparison between cystatin C and creatinine estimated GFR in cardiology patients2015In: Cardiorenal medicine, ISSN 1664-5502, Vol. 5, no 4, p. 289-296Article in journal (Refereed)
    Abstract [en]

    Objective: Estimation of the glomerular filtration rate (GFR) is essential for identification, evaluation and risk prediction in patients with kidney disease. Estimated GFR (eGFR) is also needed for the correct dosing of drugs eliminated by the kidneys and to identify high-risk individuals in whom coronary angiography or other procedures may lead to kidney failure. Both cystatin C and creatinine are used for the determination of GFR, and we aimed to investigate if eGFR by the two methods differ in cardiology patients.

     Methods: We compared cystatin C and creatinine (CKD-EPI) eGFR calculated from the same request from a cardiology outpatient unit (n = 2,716), a cardiology ward (n = 980), a coronary care unit (n = 1,464), and an advanced coronary care unit (n = 518) in an observational, cross-sectional study. 

    Results: The median creatinine eGFR results are approximately 10 ml/min/1.73 m2 higher than the median cystatin C eGFR that is up to 90 ml/min/1.73 m2, irrespective of the level of care. Creatinine eGFR resulted in a less advanced eGFR category in the majority of patients with a cystatin C eGFR <60 ml/min/1.73 m2.

    Conclusions: Our study demonstrates a difference between creatinine and cystatin C eGFR in cardiology patients. It is important to be aware of which marker is used for the reported eGFR to minimize erroneous interpretations of the test results, as this could lead to under- or overmedication. Further studies are needed to determine the best method of estimating the GFR in cardiology units.

  • 1564.
    Åkerblom, Axel
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    James, Stefan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Bertilsson, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Himmelmann, Anders
    Huhn, Monika
    Pieper, Karen
    Husted, Steen
    Storey, Robert
    Becker, Richard
    Wallentin, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    Serum Uric Acid Is Associated With Cardiovascular Outcomes In Patients With Acute Coronary Syndromes: Results From The Platelet Inhibition And Patient Outcomes (Plato) Trial2016In: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 67, no 13, p. 556-556Article in journal (Other academic)
  • 1565.
    Åkerblom, Axel
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    James, Stefan K.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Koutouzis, Michail
    Lagerqvist, Bo
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Stenestrand, Ulf
    Svennblad, Bodil
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Oldgren, Jonas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Eptifibatide Is Noninferior to Abciximab in Primary Percutaneous Coronary Intervention Results From the SCAAR (Swedish Coronary Angiography and Angioplasty Registry)2010In: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 56, no 6, p. 470-475Article in journal (Refereed)
    Abstract [en]

    Objectives The aim of this study was to test the noninferiority of eptifibatide relative to abciximab in patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI). Background Glycoprotein IIb/IIIa inhibitors are recommended by international guidelines in patients with acute coronary syndromes undergoing PCI. Abciximab is recommended with a higher level of evidence than eptifibatide in patients with STEMI. No large, prospective, randomized trial comparing abciximab and eptifibatide has been published. Methods All (n = 11,479) STEMI patients in Sweden who underwent primary PCI and received either eptifibatide or abciximab from 2004 to 2007 were derived from the SCAAR ( Swedish Coronary Angiography and Angioplasty Registry). The primary end point was death or myocardial infarction (MI) during 1-year follow-up, with adjustment for baseline differences with a multivariate logistic regression analysis including propensity score. The pre-specified noninferiority margin was set to 1.29. Results The combined end point occurred in 353 of 2,355 patients (15.0%) treated with eptifibatide and in 1,432 of 9,124 patients (15.7%) treated with abciximab. The unadjusted odds ratio ( OR) for eptifibatide versus abciximab was 0.95 (95% confidence interval [CI]: 0.84 to 1.08). Multivariate adjustment (n = 11,317) confirmed noninferiority, with an OR of 0.94 ( 95% CI: 0.82 to 1.09). The adjusted secondary end points of death and MI separately also showed noninferiority, with ORs of 0.99 ( 95% CI: 0.82 to 1.19) and 0.88 ( 95% CI: 0.73 to 1.05), respectively. Conclusions This large registry study suggests that eptifibatide is noninferior to abciximab in patients with STEMI undergoing primary PCI with respect to death or MI during 1 year, thereby supporting the use of either drug in clinical practice.

  • 1566.
    Åkerblom, Axel
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Oldgren, Jonas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Latva-Rasku, Aino
    Univ Turku, Turku PET Ctr, Turku, Finland;Turku Univ Hosp, Dept Endocrinol, Turku, Finland.
    Johansson, Lars
    Antaros Med AB, Gothenburg, Sweden.
    Lisovskaja, Vera
    AstraZeneca, Gothenburg, Sweden.
    Karlsson, Cecilia
    AstraZeneca, Gothenburg, Sweden.
    Oscarsson, Jan
    AstraZeneca, Gothenburg, Sweden.
    Nuutila, Pirjo
    Univ Turku, Turku PET Ctr, Turku, Finland;Turku Univ Hosp, Dept Endocrinol, Turku, Finland.
    Effects of DAPAgliflozin on CARDiac substrate uptake, myocardial efficiency, and myocardial contractile work in type 2 diabetes patients - a description of the DAPACARD study2019In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 124, no 1, p. 59-64Article in journal (Refereed)
    Abstract [en]

    Background: Diabetes increases the risk for cardiovascular (CV) events. It has recently been shown that the use of sodium-glucose cotransporter 2 (SGLT2) inhibitors leads to a reduction in CV outcomes in patients with type 2 diabetes mellitus (T2DM), including mortality and heart failure hospitalization. The exact mechanisms of how SGLT2 inhibitors lead to this CV risk reduction remain incompletely understood. The study of DAPAgliflozin on CARDiac substrate uptake, myocardial efficiency and myocardial contractile work in type 2 diabetes patients (DAPACARD) (NCT03387683) explores the possible effects of dapagliflozin, an SGLT2 inhibitor, on cardiac work, metabolism, and biomarker levels.

    Methods: DAPACARD is an international, randomized, double-blind trial that aims to examine the effects of dapagliflozin versus matching placebo in 52 patients with T2DM that are on stable metformin therapy prior to and during the 6 weeks of treatment. The primary efficacy endpoint is change in global longitudinal strain of the left ventricle (GLSLV) measured with magnetic resonance imaging (MRI) between baseline (pre-treatment) and end of study (on-treatment). The secondary endpoint is the corresponding change in myocardial efficiency measured as external left ventricular work divided by total left ventricular work, which is estimated using [11C]-acetate clearance using positron emission tomography (PET).

    Conclusion: The DAPACARD study is an extensive investigation of cardiac function and metabolism, by advanced imaging with PET and MRI, as well as biomarkers, performed in order to further explore how the SGLT2 inhibitor dapagliflozin could influence cardiovascular outcomes in patients with T2DM.

  • 1567.
    Åkerblom, Axel
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Wallentin, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Chemistry.
    Siegbahn, Agneta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Coagulation and inflammation science.
    Becker, Richard C.
    Duke Clinical Research Institute, Durham, NC, USA.
    Budaj, Andrzej
    Postgraduate Medical School, Grochowski Hospital, Warsaw, Poland.
    Himmelmann, Anders
    AstraZeneca Research and Development, Mölndal, Sweden.
    Horrow, Jay
    AstraZeneca Research and Development, Wilmington, USA.
    Husted, Steen
    Department of Cardiology, Århus University Hospital, Århus, Denmark.
    Storey, Robert F.
    Department of Cardiovascular Science, University of Sheffield, Sheffield, UK.
    Åsenblad, Nils
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    James, Stefan K.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Cystatin C- and Creatinine-based Estimates of Renal Function and Their Value for Risk Prediction in Patients with Acute Coronary Syndrome: Results from the PLATelet Inhibition and Patient Outcomes (PLATO) Study2013In: Clinical Chemistry, ISSN 0009-9147, E-ISSN 1530-8561, Vol. 59, no 9, p. 1369-1375Article in journal (Refereed)
    Abstract [en]

    Background: The estimated glomerular filtration rate (eGFR) independently predicts cardiovascular (CV) death or myocardial infarction (MI), and can be estimated by creatinine and cystatin C concentrations. We evaluated two different cystatin C assays, alone or combined with creatinine, in patients with acute coronary syndromes.

    Methods: Plasma cystatin C, measured with assays from Gentian and Roche, and serum creatinine was analyzed in 16279 patients from the PLATelet inhibition and patient Outcomes trial. Pearson’s correlation and agreement (Bland–Altman) between methods was evaluated. Prognostic value in relation to CV death or MI during one year of follow up was evaluated by multivariable logistic regression analysis including clinical variables and biomarkers, c-statistics and relative Integrated Discrimination Improvement (IDI).

    Results: Median cystatin C concentrations (interquartile intervals) were 0.83 (0.68 - 1.01) mg/L (Gentian) and 0.94 (0.80 - 1.14) mg/L (Roche). Overall correlation was 0.86 (95% confidence interval 0.85-0.86). The level of agreement was ±0.39mg/L (±2 standard deviations) (n=16279).

    The area under curve (AUC) in the multivariable risk prediction model with cystatin C (Gentian, Roche) or Chronic Kidney Disease - Epidemiology (CKD-EPI) added was 0.6914, 0.6913 and 0.6932. Corresponding relative IDIs were 2.96%, 3.86% and 4.68%, respectively (n=13050). Addition of eGFR by the combined creatinine-cystatin C equation yielded AUC of 0.6923(Gentian) and 0.6924(Roche) with relative IDIs of 3.54% and 3.24% respectively.

    Conclusions: Despite differences in cystatin C concentrations, overall correlation between the Gentian and Roche assays was good while agreement was moderate.  The combined creatinine-cystatin C equation did not outperform risk prediction compared to CKD-EPI.

  • 1568.
    Åkerblom, Axel
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    Wallentin, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    Siegbahn, Agneta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Coagulation and inflammation science.
    Becker, R. C.
    Budaj, A.
    Horrow, J.
    Husted, S.
    Katus, H.
    Claeys, M. J.
    Storey, R. F.
    Åsenblad, Nils
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    James, Stefan K.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    Outcome and causes of renal deterioration evaluated by serial cystatin C measurements in acute coronary syndrome patients: Results from the PLATelet inhibition and patient Outcomes (PLATO) study2012In: American Heart Journal, ISSN 0002-8703, E-ISSN 1097-6744, Vol. 164, no 5, p. 728-734Article in journal (Refereed)
    Abstract [en]

    Background: To investigate if ticagrelor treatment and other clinical characteristics were associated with increased cystatin C concentrations and if a deterioration in estimated renal function was associated with worse outcome in patients with acute coronary syndromes (ACS). Methods: Plasma cystatin C concentrations were determined within 24 hours of admission (baseline), at discharge, 1 month, and 6 months in the PLATO trial. The changes over time in relation to randomized treatment were analyzed by analysis of covariance. C-statistics and the relative Integrated Discrimination Improvement of the cystatin C concentrations regarding the primary outcome (cardiovascular death or myocardial infarction) was evaluated by multivariable analysis including background characteristics and biomarkers: N-terminal-pro-B-type natriuretic peptide and Troponin I. Results: Mean cystatin C concentrations in 2133 ticagrelor- and 2162 clopidogrel-treated patients were at baseline (0.86 mg/L and 0.86 mg/L), discharge (1.01 mg/L and 0.98 mg/L) (P <.0005), 1 month (1.00 mg/L and 0.98 mg/L) (P =.12), and 6 months (1.00 mg/L and 0.99 mg/L) (P =.17), respectively. Age, heart failure, and type of ACS were major determinants of the cystatin C concentration. c Statistics and the relative Integrated Discrimination Improvement of the primary outcome for the baseline cystatin C concentration were 0.687 and 5.2%, compared to 0.684 and 4.5% at discharge (n = 4034) and 0.693 and 5.1% at one month (n = 3096), respectively. Conclusions: Mean cystatin C concentrations increased in ACS patients, most importantly determined by age. The initial greater increase in ticagrelor-treated patients was not sustained over time. Risk prediction did not improve with serial measurements of renal markers.

  • 1569.
    Åkerblom, Axel
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Wallentin, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    Siegbahn, Agneta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Coagulation and inflammation science.
    Becker, R. C.
    Budaj, A.
    Katus, H.
    Claeys, M. J.
    Storey, R. F.
    Åsenblad, Nils Gunnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    James, Stefan K.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    Serial cystatin C measurements and changes in glomerular filtration rate as predictors for death or myocardial infarction in ACS patients2012In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 33, no Suppl 1, p. 135-135Article in journal (Other academic)
  • 1570.
    Åkerblom, Axel
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Wallentin, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Siegbahn, Agneta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Becker, Richard C
    Budaj, Andrzej
    Buck, Kristen
    Giannitsis, Evangelos
    Horrow, Jay
    Husted, Steen
    Katus, Hugo A
    Steg, Philippe Gabriel
    Storey, Robert F
    Åsenblad, Nils
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    James, Stefan K
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Cystatin C and Estimated Glomerular Filtration Rate as Predictors for Adverse Outcome in Patients with ST-Elevation and Non-ST-Elevation Acute Coronary Syndromes: Results from the Platelet Inhibition and Patient Outcomes Study2012In: Clinical Chemistry, ISSN 0009-9147, E-ISSN 1530-8561, Vol. 58, no 1, p. 190-199Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    We evaluated the predictive ability of cystatin C and creatinine-based estimations of glomerular filtration rate (eGFR), including the Chronic Kidney Disease-Epidemiology (CKD-EPI) equation, in acute coronary syndrome (ACS) patients with (STE-ACS) or without (NSTE-ACS) ST elevation in a large contemporary ACS population.

    METHODS:

    Concentrations of cystatin C and creatinine, as well as eGFR at randomization, were measured in 16 401 patients in the Platelet Inhibition and Patient Outcomes (PLATO) study and evaluated as predictors of the composite end point of cardiovascular death or myocardial infarction within 1 year. Two Cox proportional hazards models were used, the first adjusting for clinical characteristics and the second for clinical characteristics plus the biomarkers N-terminal pro-B-type natriuretic peptide, troponin I, and C-reactive protein.

    RESULTS:

    The median cystatin C value was 0.83 mg/L. Increasing quartiles of cystatin C were strongly associated with poor outcome (6.9%, 7.1%, 9.5%, and 16.2%). The fully adjusted hazard ratios per SD of cystatin C in the NSTE-ACS and STE-ACS populations were 1.12 (95% CI 1.04-1.20) (n = 8053) and 1.06 (95% CI 0.97-1.17) (n = 5278), respectively. There was no significant relationship of cystatin C with type of ACS (STE or NSTE). c Statistics ranged from 0.6923 (cystatin C) to 0.6941 (CKD-EPI).

    CONCLUSIONS:

    Cystatin C concentration contributes independently in predicting the risk of cardiovascular death or myocardial infarction in NSTE-ACS, with no interaction by type of ACS. CKD-EPI exhibited the largest predictive value of all renal markers. Nevertheless, the additive predictive value of cystatin C or creatinine-based eGFR measures in the unselected ACS patient is small.

  • 1571.
    Åkerblom, Axel
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Wallentin, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    Siegbahn, Agneta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Coagulation and inflammation science.
    Becker, Richard C.
    Budaj, Andrzej
    Himmelmann, Anders
    Husted, Steen
    Storey, Robert F.
    Eriksson, Niclas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Johansson, Åsa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    James, Stefan K.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Genetic Polymorphism and Relationship to Cystatin C Concentrations and Outcome - Results From the Platelet Inhibition and Patient Outcomes Study2013In: Circulation, ISSN 0009-7322, E-ISSN 1524-4539, Vol. 128, no 22Article in journal (Other academic)
  • 1572.
    Åsberg, S.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Hijazi, Ziad
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Siegbahn, Agneta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Andersson, Ulrika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Granger, C. B.
    Hanna, M.
    Horowitz, J. D.
    Lopes, R. D.
    Lindahl, Bertil
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Wallentin, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Galectin-3 is associated with worse clinical outcome in patients with atrial fibrillation: A substudy from the ARISTOTLE trial2014In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 35, p. 426-426Article in journal (Refereed)
  • 1573.
    Åsberg, Signild
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology. Riksstroke, Västerbotten County Council, Umeå, Sweden.
    Hijazi, Ziad
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Norrving, Bo
    Riksstroke, Västerbotten County Council, Umeå, Sweden.; Department of Neurology, Lund University, Lund, Sweden.
    Terént, Andreas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology. Riksstroke, Västerbotten County Council, Umeå, Sweden.
    Öhagen, Patrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Oldgren, Jonas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    Timing of oral anticoagulant therapy in acute ischemic stroke with atrial fibrillation: study protocol for a registry-based randomised controlled trial2017In: Trials, ISSN 1745-6215, E-ISSN 1745-6215, Vol. 18, no 1, article id 581Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Oral anticoagulation therapy is recommended for the prevention of recurrent ischemic stroke in patients with atrial fibrillation (AF). Current guidelines do not provide evidence-based recommendations on optimal time-point to start anticoagulation therapy after an acute ischemic stroke. Non-vitamin K antagonist oral anticoagulants (NOACs) may offer advantages compared to warfarin because of faster and more predictable onset of action and potentially a lower risk of intracerebral haemorrhage also in the acute phase after an ischemic stroke. The TIMING study aims to establish the efficacy and safety of early vs delayed initiation of NOACs in patients with acute ischemic stroke and AF.

    METHODS/DESIGN: The TIMING study is a national, investigator-led, registry-based, multicentre, open-label, randomised controlled study. The Swedish Stroke Register is used for enrolment, randomisation and follow-up of 3000 patients, who are randomised (1:1) within 72 h from ischemic stroke onset to either early (≤ 4 days) or delayed (≥ 5-10 days) start of NOAC therapy. The primary outcome is the composite of recurrent ischemic stroke, symptomatic intracerebral haemorrhage, or all-cause mortality within 90 days after randomisation. Secondary outcomes include: individual components of the primary outcome at 90 and 365 days; major haemorrhagic events; functional outcome by the modified Rankin Scale at 90 days; and health economics. In an optional biomarker sub-study, blood samples will be collected after randomisation from approximately half of the patients for central analysis of cardiovascular biomarkers after study completion. The study is funded by the Swedish Medical Research Council. Enrolment of patients started in April 2017.

    CONCLUSION: The TIMING study addresses the ongoing clinical dilemma of when to start NOAC after an acute ischemic stroke in patients with AF. By the inclusion of a randomisation module within the Swedish Stroke Register, the advantages of a prospective randomised study design are combined with the strengths of a national clinical quality register in allowing simplified enrolment and follow-up of study patients. In addition, the register adds the possibility of directly assessing the external validity of the study findings.

    TRIAL REGISTRATION: ClinicalTrials.gov, NCT02961348 . Registered on 8 November 2016.

  • 1574.
    Östman, Bengt
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
    Michaëlsson, Karl
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , UCR-Uppsala Clinical Research center.
    Byberg, Liisa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , UCR-Uppsala Clinical Research center.
    Helmersson, Johanna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Oxidative Stress and Inflammation.
    Basu, Samar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Oxidative Stress and Inflammation.
    Gedeborg, Rolf
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , UCR-Uppsala Clinical Research center.
    Melhus, Håkan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , UCR-Uppsala Clinical Research center.
    Oxidative stress and bone mineral density in elderly men: antioxidant activity of alpha-tocopherol2009In: Free Radical Biology & Medicine, ISSN 0891-5849, E-ISSN 1873-4596, Vol. 47, no 5, p. 668-673Article in journal (Refereed)
    Abstract [en]

    Oxidative stress has recently been identified as a pivotal pathogenetic factor of bone loss in mice, but its importance in humans is not clear. We aimed to investigate the association between urinary 8-iso-PGF(2 alpha) levels, a major F(2)-isoprostane and a reliable in vivo biomarker of oxidative stress, and bone mineral density (BMD), and to study whether vitamin E in the form of serum alpha-tocopherol, a scavenger of peroxyl radicals, modifies the association. In 405 men, urinary 8-iso-PGF(2 alpha) and serum alpha-tocopherol were measured at age 77 years and BMD at age 82 years. One SD increase in 8-iso-PGF(2 alpha) corresponded to an approximately 2-4% decrease in average adjusted BMD values of total body, lumbar spine, and proximal femur (all P<0.001). Serum alpha-tocopherol levels seemed to modify the association between urinary 8-iso-PGF(2 alpha) and BMD. Men with alpha-tocopherol levels below the median combined with high oxidative stress, i.e., 8-iso-PGF(2 alpha) above the median, had 7% (95% CI 3-11%) lower BMD at the lumbar spine and 5% (95% CI 2-9%) lower BMD at the proximal femur. In elderly men high oxidative stress is associated with reduced BMD, which is more pronounced in individuals with low serum levels of the antioxidant vitamin E.

29303132 1551 - 1574 of 1574
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