Marco Trevisan

Marco Trevisan
Karolinska Institutet | KI · Department of Medical Epidemiology and Biostatistics

Master of Science

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62
Publications
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805
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Publications

Publications (62)
Conference Paper
Full-text available
BACKGROUND AND AIMS Novel oral anticoagulants (NOAC) are currently the first-line choice for stroke prevention in patients with atrial fibrillation (AF), as they have a better risk/benefit profile compared with vitamin K antagonists (VKA). Secondary analyses of trials suggest that NOAC also reduces kidney outcomes, but this has been less explored....
Preprint
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Background: While clinical trials have demonstrated efficacy for SGLT2 inhibitors (SGLT2i) on preventing cardiovascular and kidney damage, few high-quality studies have expanded to routine-care settings of low-risk patients. Previous observational studies were limited by immortal time bias or did not adjust for laboratory measurements. Methods: We...
Article
Full-text available
Background. Stopping renin-angiotensin system inhibitors (RASi) after an episode of hyperkalemia is common but may involve therapeutic compromises, in that the cessation of RASi deprives patients of their beneficial cardiovascular effects. Methods and Results. Observational study from the Stockholm Creatinine Measurements (SCREAM) project including...
Article
Full-text available
Background Whether hyperkalemia in CKD is chronic or transient, and whether this has different outcome implications, is not known. Methods Observational study of adults with CKD G3-5 from Stockholm, Sweden 2006-11. We examined individual trajectories of potassium from all measurements obtained through routine outpatient care. For each month of fol...
Article
Albuminuria is an under-recognized component of chronic kidney disease definition, staging, and prognosis. Guidelines, particularly for hypertension, conflict on recommendations for urine albumin-to-creatinine ratio (ACR) measurement. Separately among 1 344 594 adults with diabetes and 2 334 461 nondiabetic adults with hypertension from the chronic...
Article
Aims: Whether to continue or stop mineralocorticoid receptor antagonists (MRA) after an episode of hyperkalemia is a challenge in clinical practice. While stopping MRA may prevent recurrent hyperkalemias, it deprives patients of their cardioprotection. We here assessed the association between stopping vs continuing MRA therapy after hyperkalemia a...
Article
Full-text available
In severe viral pneumonia, including Coronavirus disease 2019 (COVID-19), the viral replication phase is often followed by hyperinflammation, which can lead to acute respiratory distress syndrome, multi-organ failure, and death. We previously demonstrated that alpha-1 adrenergic receptor (⍺ 1 -AR) antagonists can prevent hyperinflammation and death...
Conference Paper
Full-text available
Background and Aims While clinical trials have demonstrated the efficacy of SGLT2 inhibitors on preventing cardiovascular and renal damage, few studies have expanded this evidence to routine-care settings. Method We compared clinical outcomes of adults who started SGLT2i or DPP4i therapy in Stockholm, Sweden, during 2013-2019. The primary outcome...
Article
Full-text available
Background and Aims Patients with CKD are often described as having chronic hyperkalemia, but earlier studies have relied on a single potassium measurement. Whether the hyperkalemia in CKD is chronic or transient, and whether temporal patterns have different outcome implications, is unknown. Method Observational study from the Stockholm Creatinine...
Article
Full-text available
Objective Community-based reports regarding the association between the estimated glomerular filtration rate (eGFR) and dementia risk show conflicting results. This study aims is to investigate the links between kidney function, kidney function decline and dementia incidence. Methods We analyzed the association of eGFR with the risk of dementia (d...
Article
Full-text available
Aims The increasing prevalence of ischaemic stroke (IS) can partly be explained by the likewise growing number of patients with chronic kidney disease (CKD). Risk scores have been developed to identify high-risk patients, allowing for personalized anticoagulation therapy. However, predictive performance in CKD is unclear. The aim of this study is...
Article
Full-text available
Randomized controlled trials on drug safety and effectiveness are the foundation of medical evidence, but they may have limited generalizability and be unpowered to detect rare and long-term kidney outcomes. Observational studies in routine care data can complement and expand trial evidence on the use, safety and effectiveness of medications and ai...
Article
Full-text available
Observational pharmacoepidemiological studies using routinely collected healthcare data are increasingly being used in the field of nephrology to answer questions on the effectiveness and safety of medications. This review discusses a number of biases that may arise in such studies and proposes solutions to minimize them during the design or statis...
Article
Community‐based studies regarding the association between chronic kidney disease and dementia risk are conflicting. In a large Swedish population‐based cohort, we explored the incidence and population attributable fractions (PAFs) of dementia risk in patients with chronic kidney disease (CKD). In the Stockholm CREAtinine Measurements (SCREAM) proje...
Article
Aims: Heart failure (HF) is the most common complication of patients with atrial fibrillation (AF), but possible risk factors or health consequences are not well described. Low kidney function is a risk factor for both AF and HF. We evaluated estimated glomerular filtration rate (eGFR) as a predictor of HF in patients with AF, and then quantified t...
Article
Aims The cardiorenal syndrome refers to a bidirectional relationship between the kidney and the heart. However, epidemiological evidence of cardiovascular disease (CVD) as a risk factor for chronic kidney disease (CKD) progression is actually scarce. Methods and Results We examined the slopes of estimated glomerular filtration rate (eGFR) decline...
Article
Background and Aims The cardiorenal syndrome refers to a bidirectional relationship between the kidney and the heart. However, epidemiological evidence of cardiovascular disease (CVD) as a risk factor for chronic kidney disease (CKD) progression is actually scarce. We here quantified slopes of kidney function decline before and after the incidence...
Article
Background and Aims Stopping mineralocorticoid receptor antagonists (MRAs) after an episode of hyperkalemia is common, particularly among patients with chronic kidney disease (CKD). This may involve therapeutic compromises, in that the cessation of MRAs deprives patients of their beneficial cardiovascular effects. The aim of this study is to determ...
Article
Background and Aims Community-based reports regarding the association between the estimated glomerular filtration rate (eGFR) and dementia risk are conflicting. In this large Swedish population-based cohort, we explore the links between kidney function, kidney function decline and dementia incidence. Method In the Stockholm CREAtinine Measurements...
Article
Bisphosphonates are the most common treatment for osteoporosis but there are concerns regarding its use in CKD. We evaluated the frequency of BSP by eGFR categories among patients with osteoporosis from two healthcare systems. Our results show that 56% of patients were treated, with reduced odds in those with lower eGFR.IntroductionOsteoporosis is...
Article
Background: The cardiorenal syndrome suggests a bidirectional relationship between worsening kidney function and cardiac dysfunction. However, to our knowledge, no studies have quantified changes in slopes of kidney function decline before and after the incidence of major cardiovascular disease (CVD) subtypes. Methods: We compared the individual sl...
Article
Full-text available
Aims: Trial evidence indicates that glucagon-like peptide-1 receptor agonists (GLP-1 RAs) may reduce the risk of cardiovascular events in patients with diabetes and myocardial infarction (MI). We aimed to expand this observation to routine care settings. Methods: Prospective observational study including all patients with diabetes surviving an M...
Article
Introduction: Non-vitamin K antagonist oral anticoagulants represent a new option for prevention of embolic events in patients with atrial fibrillation (AF). However, little is known about the impact of non-cardiac comorbidities on the efficacy and safety profile of these drugs. Methods: In a post-hoc analysis of the ENGAGE AF-TIMI 48 trial, we...
Article
Full-text available
Background and objectives: Data from observational and interventional studies provide discordant results regarding the relationship between creatinine increase after renin-angiotensin system inhibition (RASi) and adverse outcomes. We compared health outcomes among patients with different categories of increase in creatinine upon initiation of RASi...
Article
Full-text available
Background: Despite long-standing clinical use of sodium polystyrene sulphonate (SPS) for hyperkalaemia management in chronic kidney disease (CKD), its safety profile remains poorly investigated. Methods: We undertook an observational analysis of nephrology-referred adults with incident CKD Stage 4+ in Sweden during 2006-16 and with no previous...
Article
Full-text available
Introduction: People undergoing maintenance dialysis are at high risk for fractures, but less is known about fracture incidence and associated outcomes in earlier stages of chronic kidney disease (CKD). Methods: We conducted an observational analysis from the Stockholm Creatinine Measurements project, a Swedish health care utilization cohort dur...
Article
Full-text available
Background: Little is known about the health sequelae of pneumonia in persons with chronic kidney disease (CKD). Methods: We studied adults with CKD in Stockholm during 2006-11, who not previously been diagnosed with lower respiratory tract infections. We used multivariable-adjusted Cox regression with pneumonia as a time-varying exposure to est...
Article
Background and objectives: Community-based reports regarding eGFR and the risk of cancer are conflicting. We here explore plausible links between kidney function and cancer incidence in a large Scandinavian population-based cohort. Design, setting, participants, & measurements: In the Stockholm Creatinine Measurements project, we quantified the...
Article
Background: Chronic kidney disease (CKD) and aortic stenosis (AS) share many risk factors. Objectives: This study sought to evaluate whether kidney dysfunction is associated with the development of AS in the community. Methods: The study included 1,121,875 Stockholm citizens without a prior diagnosis of AS from the SCREAM (Stockholm CREAtinine...
Article
Objectives: This study investigated 1-year incidence and predictors of dyskalemia (dysK) and its outcome associations in heart failure with preserved ejection fraction (HFpEF), HF with mid-range EF (HFmrEF), and HF with reduced EF (HFrEF). Background: DysK in real-world HF is insufficiently characterized. Fear of dyskalemia may lead to underuse...
Article
On page 1217 of this article, in the middle of the abstract, “3 monthsnthsnthsnthsnths of therapy” should be “3 months of therapy”. The online published version has been corrected. © 2018 The Authors. European Journal of Heart Failure
Article
Full-text available
Background Stromal vascular fraction cells (SVFs) hold great promise for use in regenerative medicine applications, as a result of their ability to promote the healing process through in situ differentiation and the secretion of paracrine factors. The aim of this paper was to evaluate whether and how the topical application of SVF with platelet-ric...
Article
Aims: Clinical heart failure (HF) guidelines recommend monitoring of creatinine and potassium throughout the initial weeks of mineralocorticoid receptor antagonists (MRAs) therapy. We here assessed the extent to which this occurs in our health care. Methods and results: Observational study in 2007-2010 HF patients starting MRA therapy in Stockho...
Article
Rationale & objective: Low estimated glomerular filtration rate (eGFR) increases infection risk, but its contribution to hospital-acquired infection following major surgery is unknown. Study design: Retrospective cohort study. Setting & participants: Residents of Stockholm, Sweden, 18 years or older with at least 1 recorded serum creatinine me...
Article
Full-text available
Background and objectives: Patients with CKD have a high risk of atrial fibrillation. Both CKD and atrial fibrillation are associated with higher risk of stroke and death. However, the effect of incident atrial fibrillation on stroke risk among patients with CKD is unknown. Design, setting, participants, & measurements: Our study included adults...
Article
Background: The incidence of dyskalemias and associated outcomes in acute myocardial infarction (AMI) are unknown in real-world settings and likely differ from the controlled environment of randomized controlled trials. Methods: We examined consecutive survivors of an AMI during 2006-2011 in SWEDEHEART registry and with plasma potassium at disch...
Article
Full-text available
Background Concerns for hyperkalaemia limit the use of mineralocorticoid receptor antagonists (MRAs). The frequency of MRA‐associated hyperkalaemia in real‐world settings and the extent of subsequent MRA discontinuation are poorly quantified. Methods and results Observational study including all Stockholm citizens initiating MRA therapy during 200...
Article
Background & Aims Proton pump inhibitors (PPI) have been associated with acute kidney injury (AKI) and recent studies suggest that they may be associated with the risk of chronic kidney disease (CKD). Methods We performed a retrospective analysis using the Stockholm creatinine measurements database, which contains information on diagnoses, dispens...
Article
Full-text available
Background: The use of non-vitamin K antagonist oral anticoagulants (NOACs) instead of vitamin K antagonists (VKAs) in patients with atrial fibrillation (AF) and coexisting valvular heart disease (VHD) is of substantial interest. Objectives: This study explored outcomes in patients with AF with and without VHD in the ENGAGE AF-TIMI 48 (Effective...
Article
Full-text available
Atrial fibrillation (AF) and valvular heart disease (VHD) frequently coexist and independently increase mortality1. Bioprosthetic valve implantation (surgical or transcatheter), is a common, increasingly utilized treatment for VHD2. Patients with AF and bioprosthetic valves require anticoagulation to prevent thromboembolic events. Non-vitamin K ora...
Article
Aims: The choice between initiating a non-vitamin K antagonist oral anticoagulant (NOAC) and a vitamin K antagonist (VKA) in patients with atrial fibrillation (AF) may be challenging. To assist in this decision, we developed a risk score to identify patients for whom a therapeutic benefit of NOACs over VKA is predicted. Methods and results: ENGA...

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Projects (2)
Project
To determine the effectiveness and safety of (cardiovascular) drugs and treatments for individuals with chronic kidney disease. We combine large-scale observational data with innovative target trial emulation techniques to study treatment effects in routinely cared patients.
Project
Published articles focusing on statistical and epidemiologic methods