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Publications (240)
Background
Recently Sodium Glucose Lowering Transport 2 receptor inhibitors (SGLT2i) and Glucagon Like Peptide Receptor Agonists (GLP-1 RA) have demonstrated preventive effects in patients with established diabetes and evidence of cardiovascular disease, and is recommended in guidelines regardless of glucose control. Less is known about the real up...
Aims:
To investigate if addition of metformin to standard care (life-style advice) reduces the occurrence of cardiovascular events and death after myocardial infarction (MI) in patients with newly detected prediabetes.
Methods:
The Myocardial Infarction and new treatment with Metformin study (MIMET) is a large multicentre registry-based randomis...
Background
Women have a worse prognosis after ST-segment elevation myocardial infarction (STEMI) than men. The prognostic role of thrombus burden (TB) in influencing the sex-related differences in clinical outcomes after STEMI has not been clearly investigated.
Objectives
The aim of this study was to assess the sex-related differences in TB and it...
Background
Women have a worse prognosis after ST-segment elevation myocardial infarction (STEMI) than men. The prognostic role of thrombus burden (TB) in influencing the sex-related differences in clinical outcomes after STEMI has not been clearly investigated.
Objectives
The aim of this study was to assess the sex-related differences in TB and it...
Purpose
Adjuvant radiotherapy (RT) for breast cancer is associated with an increased risk of ischemic heart disease. We examined the risk of coronary artery stenosis in a large cohort of women with breast cancer receiving adjuvant RT.
Methods
A cohort of women diagnosed with breast cancer between 1992 and 2012 in three Swedish health care regions...
Introduction: Intense and prolonged antithrombotic treatment after acute coronary syndrome (ACS) reduces ischemia but increases bleeding. Risk prediction tools might help individualize antithrombotic treatment.
Hypothesis: We have previously developed the ABC (age, biomarkers, clinical history) score for major bleeding in patients with atrial fibri...
Background
Dysglycemia at acute myocardial infarction (AMI) is common and is associated with mortality. Information on other outcomes is less well explored in patients without diabetes in a long‐term perspective. We aimed to explore the relationship between admission glucose level and long‐term outcomes in patients with AMI without diabetes in a na...
Background
The aim of the present study was to compare the quantitative flow responses of regadenoson against adenosine using cardiac ¹⁵ O-water PET imaging in patients with suspected or known coronary artery disease (CAD).
Methods
Hyperemic myocardial blood flow (MBF) after adenosine and regadenoson was compared using correlation and Bland–Altman...
Background
Near-infrared spectroscopy (NIRS) and intravascular ultrasound are promising imaging modalities to identify non-obstructive plaques likely to cause coronary-related events. We aimed to assess whether combined NIRS and intravascular ultrasound can identify high-risk plaques and patients that are at risk for future major adverse cardiac ev...
Objectives
To analyze the clinical outcome of percutaneous coronary intervention (PCI) using the Xience drug eluting stent (DES) versus other modern DES.
Methods
This retrospective study based on the Swedish Coronary Angiography and Angioplasty Registry (SCAAR) analyzed the outcome of PCI using Xience versus other commonly used modern DES, 2007 to...
Background:
Incretins are a group of glucose-lowering drugs with favourable cardiovascular (CV) effects against neoatherosclerosis. Incretins' potential effect in stent failure is unknown. The aim of this study is to determine if incretin treatment decreases the risk of stent-thrombosis (ST), and/or in-stent restenosis (ISR) after percutaneous cor...
Objective
To explore real-life use of glucose lowering drugs and prognosis after acute myocardial infarction (AMI) with a special focus on metformin.
Methods
Patients ( n = 70270) admitted for AMI 2012–2017 were stratified by diabetes status and glucose lowering treatment and followed for mortality and MACE+ (AMI, heart failure (HF), stroke, morta...
Aim
To evaluate utilization and outcomes of rotational atherectomy (RA) using data from the Swedish Coronary and Angioplasty Registry (SCAAR)
Methods
We included 1476 patients with 2218 lesions who underwent RA from 2005 to 2016. To study temporal changes, the study period was divided into three equal time-periods, period A, B and C.
Results
Alth...
Aims:
To assess the real-world clinical performance of a sirolimus-eluting ultrathin-strut drug-eluting stent (DES) [Orsiro, Biotronik AG] in a large nationwide cohort of patients undergoing percutaneous coronary intervention (PCI).
Methods and results:
From the Swedish Coronary Angiography and Angioplasty Registry, the 2-year outcomes of 4,561...
Eurointervention
Reply to the letter to the editor by Jurado-Román A. et al “Very long-term outcome of coronary covered stents. Not all covered stents are the same.”
1Jan Harnek MD, PhD
2Stefan K. James MD, PhD
2Bo Lagerqvist MD, PhD
1Department of Coronary Heart Disease and Institution of Clinical Sciences, Lund University, Sweden.
2Departme...
Background
Several glucose lowering drugs with preventive effects on heart failure and death have entered the market, however, still used in low proportions after acute myocardial infarction. We explored the complication rates of heart failure and death after acute myocardial infarction in patients with and without diabetes.
Methods
All patients (...
Objectives:
The aim of this study was to investigate the outcomes of patients with de novo lesions in small coronary vessels undergoing percutaneous coronary intervention (PCI) with drug-coated balloons (DCBs) or newer generation drug-eluting stents (n-DES).
Background:
Notwithstanding the available evidence from a few randomized clinical trials...
We aimed to investigate whether the concomitant use of tamoxifen with warfarin is associated with higher risk for bleeding among patients with early estrogen‐receptor (ER)‐positive breast in a population‐based nested case‐control study. We identified 1787 patients taking warfarin and 92 cases hospitalized for bleeding and found an adjusted odds rat...
Background:The incidence and short- and long-term outcomes of coronary artery perforation (CAP) are not well described.
Methods and Results:We analyzed the characteristics and the short- and long-term outcomes of CAP among 243,149 patients undergoing percutaneous coronary interventions (PCI) from 2005 until 2017 in the national Swedish registry. We...
Background
Impressive improved one-year survival rates after acute myocardial infarction (AMI) have been achieved the last decades while long-term cardiovascular events still are a challenge particularly when diabetes is present. Recently several glucose lowering drugs with preventive effects on heart failure (HF) and MACE have entered the market h...
Background:
We hypothesized that the transition from bare-metal stents (BMS) to newer generation drug-eluting stents (n-DES) in clinical practice may have reduced the risk also in patients with kidney dysfunction.
Methods:
Observational study in the national SWEDEHEART registry, that compared the 1-year risk of in-stent restenosis (RS) and stent...
Objective
To investigate the association between admission plasma glucose and cardiovascular events in patients with acute myocardial infarction treated with modern therapies including early percutaneous coronary intervention and modern stents.
Methods
Patients ( n = 5309) with established diabetes and patients without previously known diabetes wi...
Aims:
Randomized clinical trials have consistently demonstrated the non-inferiority of bioabsorbable polymer drug-eluting stents (BP-DES) with respect to DES having permanent polymers (PP-DES). To date, the comparative performance of BP- and PP-DES in the real world has not been extensively investigated.
Methods and results:
From October 2011 to...
Background
To assess the relationship between radiation doses to the coronary arteries (CAs) and location of a coronary stenosis that required intervention after three-dimensional conformal radiotherapy (3DCRT) for breast cancer (BC).
Methods
The study population consisted of 182 women treated for BC in Sweden between 1992 and 2012. All women rece...
Background:
Registry-based randomized clinical trials have emerged as useful tools to provide evidence on the comparative efficacy and safety of different therapeutic strategies. However, it remains unknown whether the results of registry-based randomized clinical trials have a sizable impact on daily clinical practice. We sought, therefore, to de...
Background:
The aim of this study was to assess one-year outcomes of invasive and non-invasive strategies in ST-elevation myocardial infarction (STEMI) among multimorbid older people with complex health needs.
Methods:
We included patients, registered between 2006 and 2013 in the SWEDEHEART registry, who were 70 years old or older with STEMI, ha...
Aims:
This nationwide study aimed to analyse the first 2 years of routine clinical use of cangrelor in all Swedish patients undergoing percutaneous coronary intervention (PCI).
Methods and results:
This observational Swedish Coronary Angiography and Angioplasty Registry (SCAAR) study identified 915 cangrelor-treated patients. As 899 were ST-segm...
Background:
In the DETO2X-AMI trial (Determination of the Role
of Oxygen in Suspected Acute Myocardial Infarction), we compared
supplemental oxygen with ambient air in normoxemic patients presenting
with suspected myocardial infarction and found no significant survival
benefit at 1 year. However, important secondary end points were
not yet availab...
Aims:
To elucidate the short and long-term outcome of patients treated with covered stents compared to all other stented patients. Covered stents are mostly used for coronary perforations with high risk of early adverse events, but their long-term outcome are unknown.
Methods and results:
The Swedish national registries from 2005 - 2017 disclose...
Background:
Myocardial infarction (MI) with nonobstructive coronary arteries (MINOCA) is common. There are limited data on the mechanisms and prognosis for reinfarction in MINOCA patients.
Methods:
In this observational study of MINOCA patients hospitalized in Sweden and registered in the SWEDEHEART registry between July 2003 and June 2013 and f...
Objectives
Old-generation drug-eluting coronary stents (o-DES) have despite being safe and effective been associated with an increased propensity of late stent thrombosis (ST). We evaluated ST rates in o-DES, new-generation DES (n-DES) and bare metal stents (BMS) the first year (< 1 year) and beyond 1 year (> 1 year). Methods
We evaluated all impla...
Aims:
To determine whether supplemental oxygen in patients with ST-elevation myocardial infarction (STEMI) impacts on procedure-related and clinical outcomes.
Methods and results:
The DETermination of the role of Oxygen in suspected Acute Myocardial Infarction (DETO2X-AMI) trial randomized patients with suspected myocardial infarction (MI) to re...
Aims:
The clinical performance of the SYNERGY drug-eluting stent (DES) in patients with acute myocardial infarction (MI) has not been investigated in detail. We sought to report on the outcomes after SYNERGY DES (Boston Scientific, Marlborough, MA, USA) implantation in patients with MI undergoing percutaneous revascularisation (PCI).
Methods and...
Aims:
Preliminary studies suggest that direct stenting (DS) during percutaneous coronary intervention (PCI) may reduce microvascular obstruction and improve clinical outcome. Thrombus aspiration may facilitate DS. We assessed the impact of DS on clinical outcome and myocardial reperfusion and its interaction with thrombus aspiration among ST-segme...
Objectives We aimed to analyse outcomes of ticagrelor and clopidogrel stratified by estimated glomerular filtration rate (eGFR) in a large unselected cohort of patients with acute myocardial infarction (MI).
Methods We used follow-up data in MI survivors discharged on ticagrelor or clopidogrel enrolled in the Swedish Web-System for Enhancement and...
Background:
The effects of ticagrelor pretreatment in patients with ST-segment-elevation myocardial infarction undergoing primary percutaneous coronary intervention (PCI) is debated. This study investigated the effects of ticagrelor pretreatment on clinical outcomes in this patient group.
Methods and results:
Patients with ST-segment-elevation m...
Objective:
To describe sex aspects on extent of coronary artery disease (CAD) and prognosis in a contemporary population with type 1 diabetes.
Research design and methods:
All patients undergoing coronary angiography, 2001-2013, included in the Swedish Coronary Angiography and Angioplasty Registry and the Swedish National Diabetes Register as ty...
Aims:
We studied the relationship between taking part in a long-distance ski race and incidence of cardiovascular diseases (CVDs) to address the hypothesis that lifestyle lowers the incidence.
Methods and results:
A cohort of 399 630 subjects in Sweden, half were skiers in the world's largest ski race, and half were non-skiers. Non-skiers were f...
Background
Long‐term disease progression after myocardial infarction (MI) is inadequately understood. We evaluated the pattern and angiographic properties (culprit lesion [CL]/non‐CL [NCL]) of recurrent MI (re‐MI) in a large real‐world patient population.
Methods and Results
Our observational study used prospectively collected data in 108 615 pati...
Table S1. Baseline Characteristics at the Index Infarction of Patients With First‐Occurrence Myocardial Infarction With Culprit Lesion Identified and Indeterminate Recurrent Myocardial Infarction During Follow‐Up
Table S2. Angiographic Findings in the Subgroup of Patients With Identified Culprit Lesion at the Index Infarction and Indeterminate Rec...
Background
The comparative efficacy of various anticoagulation strategies has not been clearly established in patients with acute myocardial infarction who are undergoing percutaneous coronary intervention (PCI) according to current practice, which includes the use of radial-artery access for PCI and administration of potent P2Y12 inhibitors withou...
Aims:
Randomised trials indicate higher rates of stent thrombosis (ST) and target lesion failure (TLF) after percutaneous coronary intervention (PCI) with the Absorb bioresorbable scaffold (BRS) compared with modern drug eluting stents (DES). We aimed to investigate the outcome of all Swedish patients treated with the Absorb BRS.
Methods and resu...
Aims:
The study investigated whether regional differences in choice of coronary revascularization affected outcomes in Sweden.
Methods and results:
We conducted a prospective nationwide study of outcome in patients undergoing coronary artery bypass grafting (CABG, n = 47 065) or percutaneous coronary intervention (PCI, n = 140 945) from 2001 thr...
Objectives
To investigate whether gender disparities are found in referrals of patients with acute coronary syndromes (ACS) to percutaneous coronary interventions (PCI) or coronary artery bypass grafting (CABG). Furthermore, to study gender differences in complications and mortality.
Methods
All consecutive coronary angiographies (CA) and PCIs per...
Background:
No previous studies have evaluated the performance of the Synergy stent in a large real-life population.
Objectives:
To describe the initial real-life experience with a novel everolimus eluting platinum chromium stent with abluminal biodegradable polymer (SYNERGY) in unselected patients from a nationwide registry.
Methods:
All impl...
Sparsely populated and with wide non-urbanised areas, Sweden faces specific challenges in providing publicly financed, high-quality and equal healthcare to all parts of the country. As a result, a decentralised organisation for acute coronary care has been developed with coronary care units and catheterisation laboratories in several small- and med...
Background:
Small observational studies have indicated better outcome with intravascular ultrasound (IVUS) guidance when performing unprotected left main coronary artery (LMCA) percutaneous coronary intervention (PCI), but the overall picture remains inconclusive and warrants further investigation. We studied the impact of IVUS guidance on outcome...
Background:
Registry studies and case-control studies have demonstrated that the risk of acute myocardial infarction (AMI) is increased following influenza infection. Small randomized trials, underpowered for clinical end points, indicate that future cardiovascular events can be reduced following influenza vaccination in patients with established...
Background In a modern perspective there is limited information on mortality by affected coronary vessels assessed by coronary angiography in patients with type 1 diabetes. The aim of the present study was to characterise distribution of coronary artery disease and impact on long-term mortality in patients with type 1 diabetes undergoing coronary a...
Aims:
To compare outcome in unfractionated heparin (UFH) and bivalirudin treated patients undergoing primary percutaneous coronary intervention (PPCI).
Methods and results:
This observational study contained 20,614 PPCI patients treated with either UFH monotherapy or bivalirudin with or without concomitant UFH. Patients with oral anticoagulant o...
Background:
-Thrombus aspiration during percutaneous coronary intervention (PCI) for the treatment of ST elevation myocardial infarction (STEMI) has been widely used; however, recent trials have questioned its value and safety. In this meta-analysis, we, the trial investigators, aimed to pool the individual patient data from these trials to determ...
Scarce and conflicting evidence exists on whether clopidogrel is effective and whether dual antiplatelet treatment (DAPT) is safe in patients with acute coronary syndrome and chronic kidney disease (CKD). To study this, we performed an observational, prospective, multicenter cohort study of 36,001 patients of the SWEDEHEART registry. The exposure w...
To determine gender differences and predictors of all-cause mortality (30-days and 1-year) following percutaneous coronary intervention (PCI) among patients with stable angina pectoris (SAP) and ACS (Non ST elevation myocardial infarction/unstable angina pectoris- NSTEMI/UAP; ST elevation myocardial infarction- STEMI) in the British Cardiovascular...
Aims
Although routine invasive management is recommended in NSTEMI patients, the optimal timing of the procedure is not defined. The aim of this study was to assess outcomes in relation to timing of PCI in NSTEMI patients.
Methods and Results
This was an observational, prospective, multicenter cohort study from the SWEDEHEART registry including al...
Aims:
Ticagrelor reduces ischaemic events and mortality in acute coronary syndrome (ACS) vs. clopidogrel. We wished to study clinical outcomes in a large real-world population post-ACS.
Methods and results:
We performed a prospective cohort study in 45 073 ACS patients enrolled into Swedish Web system for Enhancement and Development of Evidence-...
Background:
In recent studies of primary percutaneous coronary intervention (PCI), bivalirudin compared with heparin has been associated with increased risk of stent thrombosis (ST). Our aim was to describe incidence and outcome of definite, early ST in a large contemporary primary PCI population divided in antithrombotic therapy subgroups.
Metho...
Aims:
The aim of this study was to evaluate clinical outcome for different indications for PCI in an unselected, nationwide PCI population at short- and long-term follow-up.
Methods and results:
We evaluated clinical outcome up to six years after PCI in all patients undergoing a PCI procedure for different indications in Sweden between 2006 and...
Background:
Women irradiated for left-sided breast cancer (BC) have an increased risk of coronary artery disease compared to women with right-sided BC. We describe the distribution of radiation dose in segments of coronary arteries in women receiving adjuvant radiotherapy (RT) for left- or right-sided BC.
Material and methods:
Fifteen women with...
Background:
Routine thrombus aspiration during primary percutaneous coronary intervention (PCI) in ST-elevation myocardial infarction (STEMI) did not reduce the primary composite endpoint in the "A Randomised Trial of Routine Aspiration ThrOmbecTomy With PCI Versus PCI ALone in Patients With STEMI Undergoing Primary PCI" (TOTAL) trial. We aimed to...
Objectives:
The aim of this study was to describe current practice regarding completeness of revascularization in patients with multivessel disease undergoing percutaneous coronary intervention (PCI) and to investigate the association of incomplete revascularization (IR) with death, repeat revascularization, and myocardial infarction (MI) in a lar...
Background The TASTE trial did not demonstrate clinical benefit of thrombus aspiration (TA). High-risk patients might benefit from TA. Methods The TASTE trial was a multicenter, randomized, controlled, open-label trial obtaining end points from national registries. Patients (n = 7,244) with ST-segment elevation myocardial infarction (STEMI) undergo...
In ST-elevation myocardial infarction (STEMI), thrombus material is often present in partial or total coronary occlusion of the coronary vessel. However, prior to the thrombus aspiration during ST-Segment Elevation Myocardial Infarction in Scandinavia (TASTE) trial, it remained unclear whether routine thrombus aspiration during percutaneous coronar...
Aims To study the association between renal function and outcomes in a nationwide cohort of unselected consecutive patients with stable coronary artery disease (SCAD) symptoms and with a defined coronary anatomy by a coronary angiogram (CA).
Methods and results We included 45 348 consecutive patients with available plasma creatinine undergoing CA f...
Objective: To evaluate the risk of hard clinical endpoints of different types of PCI stents in relation to renal function.
Methods: During 2007 and 2013, 103.747 patients enrolled in the Swedish Coronary Angiography & Angioplasty Registry (SCAAR) with a known serum creatinine were treated with PCI using new generation drug eluting stents (n-DES) (n...
