Anders E Henriksson

Sundsvall Hospital, Sundsvall, Västernorrland, Sweden

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Publications (17)34.14 Total impact

  • Gertrud Viklander, Jonas Wallinder, Anders E Henriksson
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    ABSTRACT: Earlier studies have indicated an association between blood group non-O and atherosclerosis related vascular diseases. Abdominal aortic aneurysm (AAA) is traditionally regarded as a consequence of atherosclerosis. The aim of the present study was to investigate the association between ABO blood groups and AAA with special regard to a relation to AAA rupture. Prospectively, 504 patients operated on for AAA were investigated. Patients operated on for AAA have similar ABO blood group distributions as a population based control group. Furthermore, there was no significant difference in distribution of ABO blood group between patients operated on for ruptured AAA (n=174) and non-ruptured AAA (n=330). In conclusion, this study fails to demonstrate an association between ABO blood groups and AAA.
    Transfusion and Apheresis Science 09/2012; · 1.23 Impact Factor
  • Markus Lindqvist, Jonas Wallinder, Anders E Henriksson
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    ABSTRACT: In the present study we investigated the impact of soluble urokinase plasminogen activator receptor (suPAR) as a biomarker in patients with abdominal aortic aneurysm (AAA) in relation to conventional inflammatory markers, aneurysm size, and rupture. suPAR and conventional inflammatory markers were measured in 119 patients with AAA and 36 controls without aneurysm matched by age, gender and smoking habit. The results support earlier studies suggesting a state of activated inflammatory response in patients with nonruptured AAA as expressed by elevated CRP and IL-6 compared with the controls. In contrast, suPAR showed similar levels in patients with nonruptured AAA compared with the controls. Unexpectedly, all follow-up patients (n=16) have significant (p<0.001) elevated suPAR levels three years postoperatively compared preoperatively. suPAR does not seem to be a useful biomarker in the AAA disease. The role of the postoperative elevation of suPAR needs to be further elucidated.
    Thrombosis Research 05/2012; 130(3):511-3. · 3.13 Impact Factor
  • Jonas Wallinder, Jörgen Bergström, Anders E Henriksson
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    ABSTRACT: Abdominal aortic aneurysm (AAA) is a common condition with high mortality when ruptured. Most clinicians agree that small AAAs are best managed by ultrasonographic surveillance. However, it has been stated in recent reviews that a serum/plasma biomarker that predicts AAA rupture risk would be a powerful tool in stratifying patients with small AAA. Identification of such circulating biomarkers has been to date unsuccessful. In this study, we used a proteomic approach to find new, potential plasma AAA biomarker candidates. Prefractionated plasma samples were analyzed by two-dimensional differential in-gel electrophoresis to identify differentially expressed proteins between four patients with small AAA and four controls without aneurysm. Protein spots that differed significantly between patients and controls were selected and identified by mass spectrometry. Three protein spots had significantly different expression between patients and controls. The most interesting finding was that patients with small AAA had increased levels of the enzyme glycosylphosphatidylinositol-specific phospholipase D (GPI-PLD) compared with the controls without aneurysm. In conclusion, by using a proteomic approach, this pilot-study provides evidence of GPI-PLD as a novel potential plasma biomarker for AAA.
    Clinical and Translational Science 02/2012; 5(1):56-9. · 2.33 Impact Factor
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    Markus Lindqvist, Anders Hellström, Anders E Henriksson
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    ABSTRACT: Previous investigations have shown hyperhomocysteinemi in patients with abdominal aortic aneurysm (AAA). In the present study we evaluated the circulating level of homocysteine (Hcy) in relation to renal function, vitamins B6, B12 and folate status in AAA patients with special regard to aneurysm size, and rupture. Hcy, Creatinine, B6, B12 and folate were measured in 119 patients with AAA and 36 controls without aneurysm matched by age, gender and smoking habit. As expected there was a weak correlation between Hcy and vitamins B6, B12 or folate. We found similar levels of Hcy, B6 and folic acid in patients with nonruptured AAA compared to the control group matched by age, gender and smoking habit. There was no correlation between maximum diameter of the nonruptured AAA (n=78) and Hcy, B6 or folate. However, the present study shows a significant inverse correlation between maximum diameter of the nonruptured AAA (n=78) and B12 (r = -0.304, p=0.007) with significant higher levels in small AAA compared to large AAA. In conclusion, Hcy does not seem to be a useful biomarker in AAA disease. The unexpected finding of B12 levels correlating to aneurysm diameter warrants urgent further investigation of B12 supplement to prevent progression of small AAA.
    American journal of cardiovascular disease. 01/2012; 2(4):318-22.
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    ABSTRACT: Recent reviews state that a circulating biomarker predicting aortic rupture risk would be a powerful tool to stratify patients with small screen-detected abdominal aortic aneurysm (AAA). In a current proteomic pilot-study elevated levels of the enzyme Glycosylphosphatidylinositol-specific phospholipase D (GPI-PLD) was shown in patients with small AAA compared with controls without aneurysm. In the present study we investigated the impact of plasma GPI-PLD as a biomarker in patients with AAA in relation to aneurysm size, and rupture. Plasma GPI-PLD was measured in patients with AAA (nonruptured, n=78 and ruptured, n=55) and controls without aneurysm (n=41) matched by age, sex and smoking habit. The plasma GPI-PLD levels were significantly lower in patients with ruptured compared nonruptured AAA which we interpreted as a result of hemodilution due to hemorrhage in patients with ruptured AAA. The plasma GPI-PLD levels were similar in patients with nonruptured AAA compared to the controls without aneurysm. Furthermore, there was no correlation between plasma GPI-PLD and aneurysm size in the group of patients with nonruptured AAA. In conclusion, the present study fails to show a connection between GPI-PLD and AAA. However, the definite role of GPI-PLD as a predictive marker needs to be further clarified in a follow-up cohort study.
    International journal of clinical and experimental medicine 01/2012; 5(4):306-9.
  • Maria Fransson, Hans Rydningen, Anders E Henriksson
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    ABSTRACT: Ruptured abdominal aortic aneurysm (AAA) is associated with a high mortality despite surgical management. Earlier reports indicate that a major cause of immediate intraoperative death in patients with ruptured AAA is related to hemorrhage due to coagulopathy. Acidosis is, besides hypothermia and hemodilution, a possible cause of coagulopathy. The aim of the present study was to investigate the incidence of coagulopathy and acidosis preoperatively in patients with ruptured AAA in relation to the clinical outcome with special regard to the influence of shock. For this purpose, 95 consecutive patients who underwent surgery for AAA (43 ruptured with shock, 12 ruptured without shock, and 40 nonruptured) were included. Coagulopathy was defined as prothrombin time (international normalized ratio [INR]) ≥1.5 and acidosis was defined as base deficit ≥6 mmol/L. Mortality and postoperative complications were recorded. The present study shows a state of acidosis at the start of surgery in 30 of 55 patients with ruptured AAA. However, only in 7 of 55 patients with ruptured AAA a state of preoperative coagulopathy was demonstrated. Furthermore, in our patients with shock due to ruptured AAA only 2 of 12 deaths were due to coagulopathy and bleeding. Indeed, our results show a relatively high incidence of thrombosis-related causes of death in patients with ruptured AAA, indicating a relation to an activated coagulation in these patients. These findings indicate that modern emergency management of ruptured AAA has improved in the attempt to prevent fatal coagulopathy.
    Clinical and Applied Thrombosis/Hemostasis 07/2011; 18(1):96-9. · 1.02 Impact Factor
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    ABSTRACT: Multiorgan failure is the main cause of death in patients operated for ruptured abdominal aortic aneurysm (rAAA). The systemic inflammatory response plays a central role in the generation and maintenance of multiorgan dysfunction. The aim of the current study was to investigate the inflammatory response preoperatively in patients with ruptured and nonruptured AAA in relation to the clinical outcome. A total of 95 patients about to undergo repair of AAA (43 ruptured with shock, 12 ruptured without shock, and 40 elective) and 41 controls without aneurysm matched by age, gender, and smoking habits were investigated by inflammatory markers. There were significantly higher levels of interleukin 6 (IL-6; proinflammatory cytokine) and IL-10 (anti-inflammatory cytokine) in patients operated for ruptured compared to nonruptured AAA. In conclusion, the current data indicate that rupture of an AAA activates the inflammatory system with a compensatory anti-inflammatory response.
    Vascular and Endovascular Surgery 11/2009; 44(1):32-5. · 0.88 Impact Factor
  • Jonas Wallinder, David Bergqvist, Anders E Henriksson
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    ABSTRACT: Abdominal aortic aneurysm is a common condition with high mortality when rupturing. However, the condition is also associated with nonaneurysmal cardiovascular mortality. A possible contributing mechanism for the thrombosis related cardiovascular mortality is an imbalance between the activation of the coagulation system and the fibrinolytic system. The aim of the present study was to investigate haemostatic markers in patients with nonruptured abdominal aortic aneurysm with special regard to the influence of aneurysm size and smoking habits. Seventy-eight patients with infrarenal aortic aneurysm and forty-one controls without aneurysm matched by age, gender and smoking habits were studied. Thrombin-antithrombin (TAT), prothrombin fragment 1+2 (F 1+2)--markers of thrombin generation, and von Willebrand factor antigen (vWFag)--considered as a reliable marker of endothelial dysfunction--were measured. Plasma levels of tissue plasminogen activator antigen (tPAag), and plasminogen activator inhibitor type 1 (PAI-1) were measured as markers of fibrinolytic activity. D-dimer, a marker of fibrin turnover, was also measured. There were significantly higher levels of TAT and D-dimer in patients with abdominal aortic aneurysm. The highest level of TAT and D-dimer were detected in patients with large compared to small AAA. The present data indicate a state of activated coagulation in patients with abdominal aortic aneurysm which is dependent by aneurysm size. The activated coagulation in AAA patients could contribute to an increased cardiovascular risk in patients also with small AAA. The possible impact of secondary prevention apart from smoking cessation has to be further evaluated and is maybe as important as finding patients at risk of rupture.
    Thrombosis Research 04/2009; 124(4):423-6. · 3.13 Impact Factor
  • Jonas Wallinder, David Bergqvist, Anders E Henriksson
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    ABSTRACT: Abdominal aortic aneurysm is a common condition with high mortality due to rupture; however, the condition also is associated with nonaneurysmal cardiovascular mortality. A possible contributing mechanism for the cardiovascular mortality is an imbalance between the proinflammatory and anti-inflammatory systemic response. In the present study, 78 patients with abdominal aortic aneurysm and 41 controls without aneurysm matched by age, gender and smoking habits were investigated. Cytokines such as interleukin-6, interleukin-10, and monocyte chemoattractant protein-1 were measured in plasma. There was significantly higher level of interleukin-6 in patients with AAA compared to controls. The interleukin-6/ interleukin-10 ratio was highest in patients with large compared to small abdominal aortic aneurysm. In conclusion, the present data indicate a proinflammatory response and a proinflammatory to antiinflammatory imbalance in patients with abdominal aortic aneurysm which is dependent by aneurysm size.
    Vascular and Endovascular Surgery 02/2009; 43(3):258-61. · 0.88 Impact Factor
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    ABSTRACT: Little is known about the biological processes causing aortic aneurysm rupture. Chronic Chlamydophila pneumoniae infection has been suggested as a possible contributing factor to the development and expansion of abdominal aortic aneurysm (AAA). The importance of infection in AAA may be related to the previous pathogen burden, that is, the number of significant titres of antibodies against infectious pathogens rather than to single infectious agents. The aim of this study was to examine the relationship between infectious burden and AAA rupture. In a case-control study, 119 patients with abdominal aortic aneurysm and 36 matched controls without aneurysm were prospectively investigated for specific IgG class antibodies against C. pneumoniae, Helicobacter pylori, Cytomegalovirus, and Herpes simplex virus. Patients with ruptured AAA have similar levels of pathogen burden as patients with nonruptured electively operated AAA, small AAA, and controls without aneurysm. The present study fails to demonstrate a connection between infectious burden and abdominal aortic aneurysm rupture.
    European journal of vascular and endovascular surgery: the official journal of the European Society for Vascular Surgery 07/2008; 36(3):292-6. · 2.92 Impact Factor
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    ABSTRACT: Cytomegalovirus (CMV) has been implicated in the pathogenesis of atherosclerosis. Abdominal aortic aneurysm is regarded traditionally as a consequence of atherosclerosis. Several microorganisms have been suggested as possible contributing factors for the development of abdominal aortic aneurysm. The relevance of CMV in the processes underlying the development, expansion, and rupture of abdominal aortic aneurysm is unknown. The aim of the present study was to investigate whether CMV infection is related to abdominal aortic aneurysm rupture. One hundred nineteen patients with abdominal aortic aneurysm and 36 matched controls without abdominal aortic aneurysm were investigated prospectively by CMV serology. Patients with ruptured abdominal aortic aneurysm have similar levels of IgG antibodies against CMV as patients with nonruptured abdominal aortic aneurysm, small abdominal aortic aneurysm, and controls without abdominal aortic aneurysm. In conclusion, this study fails to demonstrate a connection between CMV infection and abdominal aortic aneurysm rupture.
    Journal of Medical Virology 05/2008; 80(4):667-9. · 2.37 Impact Factor
  • E Skagius, A Siegbahn, D Bergqvist, A Henriksson
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    ABSTRACT: Ruptured abdominal aortic aneurysm is associated with a high operative mortality. Postoperative thrombosis related complications are common, a possible mechanism being activation of the coagulation system and endothelial stimulation. The aim of the present study was to investigate the coagulation activity preoperatively in patients with ruptured and nonruptured abdominal aortic aneurysm in relation to the clinical outcome with special regard to the influence of shock. Ninety-five patients with repair of infrarenal aortic aneurysm and forty-one controls without aneurysm matched by age, gender and smoking habits were studied. Thrombin-antithrombin (TAT), prothrombin fragment 1+2 (F 1+2), and von Willebrand factor antigen (vWFAg) were measured. There were significantly higher levels of TAT, F 1+2, and vWFAg in patients operated for ruptured compared to nonruptured abdominal aortic aneurysm. The highest level of TAT and F 1+2 were detected in patients with rupture and shock. The present data indicate a state of activated coagulation in patients with ruptured abdominal aortic aneurysm which is reinforced by shock.
    European journal of vascular and endovascular surgery: the official journal of the European Society for Vascular Surgery 02/2008; 35(1):37-40. · 2.92 Impact Factor
  • E Skagius, A Siegbahn, D Bergqvist, A E Henriksson
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    ABSTRACT: A ruptured abdominal aortic aneurysm (AAA) is associated with high mortality. Postoperative complications such as hemorrhage, multiple organ failure, myocardial infarction, and thromboembolism are common. An active and balanced hemostatic system is essential to avoid bleeding as well as thrombosis. When these activities are not properly regulated the patient is at risk of developing either excessive bleeding or thrombosis-related complications. Previous studies have shown a state of activated coagulation in patients with ruptured AAA. However, there are conflicting results regarding the fibrinolytic response. The aim of the present study was to investigate the fibrinolytic state pre-operatively in patients with ruptured and non-ruptured AAA in relation to the clinical outcome with special regard to the influence of shock. A prospective study was performed on 95 patients who underwent surgery for a ruptured AAA with shock (n = 43), a ruptured AAA without shock (n = 12), and a non-ruptured AAA (n = 40). Forty-one controls without an aneurysm were matched to the AAA patients according to age, gender and smoking habits. Plasma levels of tissue plasminogen activator antigen (tPAag), and plasminogen activator inhibitor type-1 (PAI-1) were measured as markers of fibrinolytic activity. D-dimer, a marker of fibrin turnover, was also measured. D-dimer was significantly higher in patients with a non-ruptured AAA compared with controls without AAA. There were significantly higher levels of D-dimer, tPAag, and PAI-1 in patients operated for ruptured compared with non-ruptured AAA. tPAag was also significantly higher in ruptured AAA patients with shock compared with without shock. No deaths occurred in patients operated on for a non-ruptured AAA or ruptured AAA without shock. There were 12 deaths after repair of a ruptured AAA with shock, of which two patients died from bleeding and the remaining 10 from multiple organ failure and cardiac failure. Our results indicate a state of activated coagulation in patients with a non-ruptured AAA, the state being intensified by rupture. The present data show normal fibrinolytic activities in patients with a non-ruptured AAA, but increased systemic fibrinolysis, as demonstrated by elevated tPAag level, in patients with a ruptured AAA. The elevated PAI-1 level indicates a simultaneous inhibition of the systemic fibrinolysis. Furthermore, the hyperfibrinolytic state was reinforced by shock in this study. However, the clinical outcome, with a relatively high incidence of thrombosis-related deaths, indicate a prothrombotic state instead of a hyperfibrinolytic state as a major point of attention in patients with shock as a result of a ruptured AAA.
    Journal of Thrombosis and Haemostasis 02/2008; 6(1):147-50. · 6.08 Impact Factor
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    ABSTRACT: The aim of the present study was to investigate whether virulent CagA positive Helicobacter pylori strains are those preferentially related to abdominal aortic aneurysm (AAA) rupture. Several microorganisms have been linked to aneurysm development. Chronic Chlamydophila pneumoniae infection has been suggested as a possible contributing factor for the development and expansion of AAA. Previous studies have shown increased risk of carotid atherosclerosis and coronary heart disease in subjects harbouring CagA positive strains of H. pylori. The relevance of CagA positive H. pylori involved in the processes underlying aneurysmal development, expansion, and rupture is unknown. In a case-control study, 119 patients with AAA and 36 matched controls were prospectively investigated with H. pylori serology. Patients with ruptured AAA have similar levels of IgG antibodies against H. pylori to patients with electively operated AAA, small AAA, and controls. In conclusion, this study fails to demonstrate a connection between H. pylori CagA seropositivity and abdominal aortic aneurysm rupture.
    Scandinavian Journal of Infectious Diseases 02/2008; 40(3):204-7. · 1.71 Impact Factor
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    Journal of Clinical Pathology 08/2007; 60(7):837-8. · 2.44 Impact Factor
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    ABSTRACT: Chronic Chlamydophila pneumoniae infection has been suggested as a possible contributing factor for the development and expansion of abdominal aortic aneurysm (AAA). The relevance of C pneumoniae involved in the processes underlying aneurysmal rupture is unknown. The aim of this study was to examine the relationship between C pneumoniae seropositivity and AAA rupture. In a case-control study, 119 patients with AAA and 36 matched controls were prospectively investigated with C pneumoniae serology. Patients with ruptured AAA have similar levels of IgG antibodies against C pneumoniae as patients with an electively operated AAA, a small AAA, and controls. In conclusion, this study fails to demonstrate a connection between C pneumoniae seropositivity and AAA rupture.
    Vascular and Endovascular Surgery 01/2007; 41(3):246-8. · 0.88 Impact Factor
  • Anders E Henriksson, David Bergqvist
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    ABSTRACT: A condition of massive pancreatic hemorrhage without relation to injury, inflammation, or aneurysm is described. Seven patients treated between 1972 and 2001 with spontaneous pancreatic bleeding were reviewed. Follow-up examinations were performed in 1999. At the time of presentation, all patients had abdominal pain, upper abdominal tenderness, and shock, findings that led laparotomy, where the diagnosis was made. The treatment was suture ligation in every case. The postoperative course was uncomplicated for five of the seven patients. The other two patients died. In conclusion, spontaneous pancreatic bleeding is rare and, because of shock and the need for urgent surgery, the diagnosis cannot be made preoperatively. The immediate mortality seems to be high.
    World Journal of Surgery 03/2003; 27(2):187-9. · 2.23 Impact Factor