43 results on '"Bønaa, Kaare Harald"'
Search Results
2. Influenza vaccination and risk for cardiovascular events: a nationwide self-controlled case series study
- Author
-
Sen, Abhijit, Bakken, Inger Johanne, Govatsmark, Ragna Elise Støre, Varmdal, Torunn, Bønaa, Kaare Harald, Mukamal, Kenneth Jay, Håberg, Siri Eldevik, and Janszky, Imre
- Published
- 2021
- Full Text
- View/download PDF
3. Risk of incident myocardial infarction by gender: Interactions with serum lipids, blood pressure and smoking. The Tromsø Study 1979–2012
- Author
-
Albrektsen, Grethe, Heuch, Ivar, Løchen, Maja-Lisa, Thelle, Dag Steinar, Wilsgaard, Tom, Njølstad, Inger, and Bønaa, Kaare Harald
- Published
- 2017
- Full Text
- View/download PDF
4. Comparison of the validity of stroke diagnoses in a medical quality register and an administrative health register
- Author
-
VARMDAL, TORUNN, BAKKEN, INGER JOHANNE, JANSZKY, IMRE, WETHAL, TORGEIR, ELLEKJÆR, HANNE, ROHWEDER, GITTA, FJÆRTOFT, HILD, EBBING, MARTA, and BØNAA, KAARE HARALD
- Published
- 2016
5. Cardiovascular outcomes after curative prostate cancer treatment: A population-based cohort study
- Author
-
Kjellstadli, Camilla, Forster, Rachel Bedenis, Myklebust, Tor Åge, Bjørge, Tone, Bønaa, Kaare Harald, Helle, Svein Inge, and Kvåle, Rune
- Subjects
Cancer Research ,Oncology - Abstract
ObjectiveTo investigate differences in cardiovascular disease (CVD) morbidity and mortality after radical prostatectomy or definitive radiotherapy with or without androgen deprivation therapy (ADT).Materials and methodsWe used population-based data from the Cancer Registry of Norway, the Norwegian Patient Registry and the Norwegian Cause of Death Registry including 19 289 men ≤80 years diagnosed with non-metastatic prostate cancer during 2010-2019. Patients were treated with radical prostatectomy or definitive radiotherapy. We used competing risk models to compare morbidity from overall CVD, acute myocardial infarction (AMI), cerebral infarction, thromboembolism, and CVD-specific mortality for the overall cohort and stratified by prognostic risk groups.ResultsAfter a median follow-up time of 5.4 years (IQR 4.6 years), there were no differences in adjusted rates of AMI, cerebral infarction, and CVD-specific death between radical prostatectomy and definitive radiotherapy in any of the prognostic risk groups. Rates of overall CVD (0.82; 95% CI 0.76-0.89) and thromboembolism (0.30; 95% CI 0.20-0.44) were lower for definitive radiotherapy than radical prostatectomy during the first year of follow-up. After this overall CVD rates (1.19; 95% CI 1.11-1.28) were consistently higher across all risk groups in patients treated with definitive radiotherapy, but there were no differences regarding thromboembolism.ConclusionsDuring the first years after treatment, no differences were found in rates of AMI, cerebral infarction, and CVD-specific death between radiotherapy and radical prostatectomy in any of the prognostic risk groups. This suggests that ADT use in combination with radiotherapy may not increase the risks of these outcomes in a curative setting. The increased overall CVD rate for definitive radiotherapy after the first year indicates a possible relationship between definitive radiotherapy and other CVDs than AMI and cerebral infarction.
- Published
- 2023
6. Lipid Levels During Adult Lifetime in Men and Women With and Without a Subsequent Incident Myocardial Infarction: A Longitudinal Analysis of Data From the Tromsø Study 1974 to 2016.
- Author
-
Albrektsen, Grethe, Wilsgaard, Tom, Heuch, Ivar, Løchen, Maja-Lisa, Thelle, Dag Steinar, Njølstad, Inger, Grimsgaard, Sameline, and Bønaa, Kaare Harald
- Published
- 2023
- Full Text
- View/download PDF
7. Seasonal variation in cardiovascular disease risk factors in a subarctic population: the Tromsø Study 1979-2008
- Author
-
Hopstock, Laila Arnesdatter, Barnett, Adrian Gerard, Bønaa, Kaare Harald, Mannsverk, Jan, Njølstad, Inger, and Wilsgaard, Tom
- Published
- 2013
8. Treatment and 30-Day Mortality after Myocardial Infarction in Prostate Cancer Patients: A Population-Based Study from Norway.
- Author
-
Forster, Rachel Bedenis, Kjellstadli, Camilla, Myklebust, Tor Åge, Egeland, Grace, Sulo, Gerhard, Bjørge, Tone, Bønaa, Kaare Harald, Juliusson, Petur Benedikt, and Kvåle, Rune
- Subjects
PROSTATE cancer ,CORONARY artery bypass ,PROSTATE cancer patients ,MYOCARDIAL infarction ,PERCUTANEOUS coronary intervention ,MYOCARDIAL perfusion imaging - Abstract
Introduction: There is limited knowledge about the use of invasive treatment and mortality after acute myocardial infarction (AMI) in prostate cancer (PCa) patients. We therefore wanted to compare rates of invasive treatment and 30-day mortality between AMIs in patients with PCa and AMIs in the general Norwegian male population. Methods: Norwegian population-based registry data from 2013 to 2019 were used in this cohort study to identify AMIs in patients with a preceding PCa diagnosis. We compared invasive treatment rates and 30-day mortality in AMI patients with PCa to the same outcomes in all male AMI patients in Norway. Invasive treatment was defined as performed angiography with or without percutaneous coronary intervention or coronary artery bypass graft surgery. Standardized mortality (SMR) and incidence ratios, and logistic regression were used to evaluate the association between PCa risk groups and invasive treatment. Results: In 1,018 patients with PCa of all risk groups, the total rates of invasive treatment for AMIs were similar to the rates in the general AMI population. In patients with ST-segment elevation AMIs, rates were lower in metastatic PCa compared to localized PCa (OR 0.15, 95% CI: 0.04–0.49). For non-ST-segment elevation AMIs, there were no differences between PCa risk groups. The 30-day mortality after AMI was lower in PCa patients than in the total population of similarly aged AMI patients (SMR 0.77, 95% CI: 0.61–0.97). Conclusion: Except for patients with metastatic PCa experiencing an ST-segment elevation AMI, PCa patients were treated as frequent with invasive treatment for their AMI as the general AMI population. 30-day all-cause mortality was lower after AMI in PCa patients compared to the general AMI population. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
9. The effect of daily weather conditions on myocardial infarction incidence in a subarctic population: the Tromsø Study 1974—2004
- Author
-
Hopstock, Laila Arnesdatter, Fors, Ane Schwenke, Bønaa, Kaare Harald, Mannsverk, Jan, Njølstad, Inger, and Wilsgaard, Tom
- Published
- 2012
10. Age and gender differences in incidence and case fatality trends for myocardial infarction: a 30-year follow-up. The Tromsø Study
- Author
-
Mannsverk, Jan, Wilsgaard, Tom, Njølstad, Inger, Hopstock, Laila Arnesdatter, Løchen, Maja-Lisa, Mathiesen, Ellisiv B, Thelle, Dag S, Rasmussen, Knut, and Bønaa, Kaare Harald
- Published
- 2012
- Full Text
- View/download PDF
11. Drug-Eluting versus Bare-Metal Stents in Saphenous Vein Grafts Compared to Native Coronary Vessels: The Norwegian Coronary Stent Trial Study.
- Author
-
Mølstad, Per Morten, Nordrehaug, Jan Erik, Steigen, Terje K., Wilsgaard, Tom, Wiseth, Rune, Rotevatn, Svein, Mannsverk, Jan, Larsen, Tommy, Larsby, Kristina Elisabet, Skarstad, Sigrun Ådnegard, Fosse, Eivind Øygard, Dahl-Eriksen, Øystein, and Bønaa, Kaare Harald
- Subjects
SAPHENOUS vein ,CORONARY arteries ,PERCUTANEOUS coronary intervention ,MYOCARDIAL infarction - Abstract
Background: Drug-eluting stents (DES) reduce target lesion revascularization (TLR) with no effect on mortality or myocardial infarction (MI) compared to bare-metal stents (BMS) in native vessels. Randomized stent studies in saphenous vein grafts (SVG) are few and the reported effects are ambiguous. The Norwegian Coronary Stent Trial study is the first to randomize lesions to percutaneous coronary intervention in native vessels and SVG. Aims: The aim of this study was to compare the rate of mortality, MI, and TLR across stent and vessel types. Methods: In this substudy, 6,087 patients with a single lesion in native vessels and 164 in SVG were followed for 5 years. Results: MI was more frequent in SVG (subdistributional hazard ratio [SHR] 4.95 (3.75–6.54, p < 0.001), but not affected by stent type. In the first 500 days, DES reduced TLR in native vessels (SHR 0.21 (0.15–0.30) p < 0.001) and SVG (SHR 0.18 (0.04–0.80) p = 0.02). Thereafter, DES and BMS were equivalent in native vessels, but DES had a higher TLR rate than BMS in SVG (SHR 3.31 (1.23–8.94) p = 0.02). After 5 years, the TLR rate was still significantly lower for DES in native vessels (3.2% vs. 7.8%, p < 0.001) but not in SVG (21.4% vs. 18. 4%). Conclusion: In SVG, no difference in TLR between DES and BMS was observed after 5 years in contrast to persistent benefit in native vessels. The high rate of TLR and MI in SVG makes treatment of native vessels a preference whenever feasible and better treatment options for SVG are warranted. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
12. Cancer Incidence and Mortality After Treatment With Folic Acid and Vitamin B12
- Author
-
Ebbing, Marta, Bønaa, Kaare Harald, Nygård, Ottar, Arnesen, Egil, Ueland, Per Magne, Nordrehaug, Jan Erik, Rasmussen, Knut, Njølstad, Inger, Refsum, Helga, Nilsen, Dennis W., Tverdal, Aage, Meyer, Klaus, and Vollset, Stein Emil
- Published
- 2009
- Full Text
- View/download PDF
13. Coronary stents reduce restenosis and repeat revascularizations and may also improve survival
- Author
-
Vik-Mo, Harald and Bønaa, Kaare Harald
- Published
- 2004
14. Validating Acute Myocardial Infarction Diagnoses in National Health Registers for Use as Endpoint in Research: The Tromsø Study.
- Author
-
Varmdal, Torunn, Mathiesen, Ellisiv B, Wilsgaard, Tom, Njølstad, Inger, Nyrnes, Audhild, Grimsgaard, Sameline, Bønaa, Kaare Harald, Mannsverk, Jan, and Løchen, Maja-Lisa
- Subjects
DIAGNOSIS ,CARDIOVASCULAR diseases ,REPORTING of diseases - Abstract
Purpose: To assess whether acute myocardial infarction (MI) diagnoses in national health registers are sufficiently correct and complete to replace manual collection of endpoint data for a population-based, epidemiological study. Patients and Methods: Using the Tromsø Study Cardiovascular Disease Register for 2013– 2014 as gold standard, we calculated correctness (defined as positive predictive value (PPV)) and completeness (defined as sensitivity) of MI cases in the Norwegian Myocardial Infarction Register and the Norwegian Patient Register separately and in combination. We calculated the sensitivity and PPV with 95% confidence intervals using the Clopper-Pearson Exact test. Results: We identified 153 MI cases in the gold standard. In the Norwegian Myocardial Infarction Register, we found a PPV of 97.1% (95% confidence interval (CI) 92.8– 99.2) and a sensitivity of 88.2% (95% CI 82.0– 92.9). In the Norwegian Patient Register, the PPV was 96.3% (95% CI 91.6– 98.8) and the sensitivity was 85.6% (95% CI 79.0– 90.8). The combined dataset of the Norwegian Myocardial Infarction Register and the Norwegian Patient Register had a PPV of 96.6% (95% CI 92.1– 98.9) and a sensitivity of 91.5% (95% CI 85.9– 95.4). Conclusion: MI diagnoses in both the Norwegian Myocardial Infarction Register and the Norwegian Patient Register were highly correct and complete, and each of the registers could be considered as endpoint sources for the Tromsø Study. A combination of the two national registers seemed, however, to represent the most comprehensive data source overall. The benefits of using data from national registers as endpoints in epidemiological studies include faster, less resource-intensive access to nationwide data and considerably lower loss to follow-up, compared to manual data collection in a limited geographical area. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
15. Incidence and risk factors for major bleeding among patients undergoing percutaneous coronary intervention: Findings from the Norwegian Coronary Stent Trial (NORSTENT).
- Author
-
Samuelsen, Per-Jostein, Eggen, Anne Elise, Steigen, Terje, Wilsgaard, Tom, Kristensen, Andreas, Skogsholm, Anne, Holme, Elizabeth, van den Heuvel, Christian, Nordrehaug, Jan Erik, Bendz, Bjørn, Nilsen, Dennis W. T., and Bønaa, Kaare Harald
- Subjects
DRUG-eluting stents ,PERCUTANEOUS coronary intervention ,ACUTE coronary syndrome ,CLINICAL trial registries ,CHRONIC kidney failure ,HEMORRHAGE - Abstract
Introduction: Bleeding is a concern after percutaneous coronary intervention (PCI) and subsequent dual antiplatelet therapy (DAPT). We herein report the incidence and risk factors for major bleeding in the Norwegian Coronary Stent Trial (NORSTENT). Materials and methods: NORSTENT was a randomized, double blind, pragmatic trial among patients with acute coronary syndrome or stable coronary disease undergoing PCI during 2008–11. The patients (N = 9,013) were randomized to receive either a drug-eluting stent or a bare-metal stent, and were treated with at least nine months of DAPT. The patients were followed for a median of five years, with Bleeding Academic Research Consortium (BARC) 3–5 major bleeding as one of the safety endpoints. We estimated cumulative incidence of major bleeding by a competing risks model and risk factors through cause-specific Cox models. Results: The 12-month cumulative incidence of major bleeding was 2.3%. Independent risk factors for major bleeding were chronic kidney disease, low bodyweight (< 60 kilograms), diabetes mellitus, and advanced age (> 80 years). A myocardial infarction (MI) or PCI during follow-up increased the risk of major bleeding (HR = 1.67, 95% CI 1-29-2.15). Conclusions: The 12-month cumulative incidence of major bleeding in NORSTENT was higher than reported in previous, explanatory trials. This analysis strengthens the role of chronic kidney disease, advanced age, and low bodyweight as risk factors for major bleeding among patients receiving DAPT after PCI. The presence of diabetes mellitus or recurrent MI among patients is furthermore a signal of increased bleeding risk. Clinical trial registration: Unique identifier NCT00811772; http://www.clinicaltrial.gov. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
16. Does a history of cardiovascular disease or cancer affect mortality after SARS-CoV-2 infection?
- Author
-
KVÅLE, RUNE, BØNAA, KAARE HARALD, FORSTER, RACHEL, GRAVNINGEN, KIRSTEN, JÚLÍUSSON, PÉTUR BENEDIKT, and MYKLEBUST, TOR ÅGE
- Published
- 2020
- Full Text
- View/download PDF
17. Inter-rater reliability of a national acute stroke register
- Author
-
Varmdal, Torunn, Ellekjær, Hanne, Fjærtoft, Hild, Indredavik, Bent, Lydersen, Stian, and Bønaa, Kaare Harald
- Subjects
Medicine(all) ,Male ,Observer Variation ,Biochemistry, Genetics and Molecular Biology(all) ,Data quality ,Reproducibility of Results ,Stroke ,VDP::Medical disciplines: 700::Clinical medical disciplines: 750::Neurosurgery: 786 ,Humans ,VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Nevrokirurgi: 786 ,Female ,Registries ,Inter-rater reliability ,Quality registers ,Research Article ,Aged - Abstract
Background Medical quality registers are useful sources of knowledge about diseases and the health services. However, there are challenges in obtaining valid and reliable data. This study aims to assess the reliability in a national medical quality register. Methods We randomly selected 111 patients having had a stroke in 2012. An experienced stroke nurse completed the Norwegian Stroke Register paper forms for all 111 patients by review of the medical records. We then extracted all registered data on the same patients from the Norwegian Stroke Register and calculated Cohen’s kappa and Gwet’s AC1 with 95 % confidence intervals for 51 nominal variables and Cohen’s quadratic weighted kappa and Gwet’s AC2 for three ordinal variables. For two time variables, we calculated the Intraclass Correlation Coefficient. Results Substantial to excellent reliability (kappa > 0.60/AC1 > 0.80) was observed for most variables related to past medical history, functional status, stroke subtype and discharge destination. Although excellent reliability was observed for time of stroke onset (ICC 0.93), this variable was hampered with a substantial amount of missing values. Some variables related to treatment and examinations in hospital displayed low levels of agreement. This applies to heart rate monitoring (kappa 0.17/AC1 0.46), swallowing test performed (kappa 0.19/AC1 0.27) and mobilized out of bed within 24 h after admission (kappa 0.04/AC1 −0.11). Conclusion A majority of the variables in The Norwegian Stroke Register have substantial to excellent reliability. The problem areas seem to be the lack of completeness in the time variable indicating stroke onset and poor reliability in some variables concerning examinations and treatment received in hospital. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
- Published
- 2015
18. Data on gender contrasts in the risk of incident myocardial infarction by age. The Tromsø Study 1979–2012
- Author
-
Albrektsen, Grethe, Heuch, Ivar, Løchen, Maja-Lisa, Thelle, Dag Steinar, Wilsgaard, Tom, Njølstad, Inger, and Bønaa, Kaare Harald
- Published
- 2017
- Full Text
- View/download PDF
19. Lifelong Gender Gap in Risk of Incident Myocardial Infarction: The Tromsø Study.
- Author
-
Albrektsen, Grethe, Heuch, Ivar, Løchen, Maja-Lisa, Thelle, Dag Steinar, Wilsgaard, Tom, Njølstad, Inger, and Bønaa, Kaare Harald
- Published
- 2016
- Full Text
- View/download PDF
20. Interrater reliability of a national acute myocardial infarction register.
- Author
-
Støre Govatsmark, Ragna Elise, Sneeggen, Sylvi, Karlsaune, Hanne, Slørdahl, Stig Arild, and Bønaa, Kaare Harald
- Subjects
INTER-observer reliability ,MYOCARDIAL infarction diagnosis ,MYOCARDIAL infarction treatment ,MEDICAL registries ,DATA quality - Abstract
Background: Disease-specific registers may be used for measuring and improving healthcare and patient outcomes, and for disease surveillance and research, provided they contain valid and reliable data. The aim of this study was to assess the interrater reliability of all variables in a national myocardial infarction register. Methods: We randomly selected 280 patients who had been enrolled from 14 hospitals to the Norwegian Myocardial Infarction Register during the year 2013. Experienced audit nurses, who were blinded to the data about the 280 patients already in the register, completed the Norwegian Myocardial Infarction paper forms for 240 patients by review of medical records. We then extracted all registered data on the same patients from the Norwegian Myocardial Infarction Register. To compare the interrater reliability between the register and the audit nurses, we calculated intraclass correlations coefficient for continuous variables, Cohen's kappa and Gwet's first agreement coefficient (AC1) for nominal variables, and quadratic weighted Cohen's kappa and Gwet's second AC for ordinal variables. Results: We found excellent (AC1 >0.80) or good (AC1 0.61-0.80) agreement for most variables, including date and time variables, medical history, investigations and treatments during hospitalization, medication at discharge, and ST-segment elevation or non-ST-segment elevation acute myocardial infarction. However, only moderate agreement (AC1 0.41-0.60) was found for family history of coronary heart disease, diagnostic electrocardiography, and complications during hospitalization, whereas fair agreement (AC1 0.21-0.40) was found for acute myocardial infarction location. A high percentage of missing data was found for symptom onset, family history, body mass index, infarction location, and new Q-wave. Conclusion: Most variables in Norwegian Myocardial Infarction Register had excellent or good reliability. However, some important variables had lower reliability than expected or had missing data. Precise definitions of data elements and proper training of data abstractors are necessary to ensure that clinical registries contain valid and reliable data. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
21. Trends in Modifiable Risk Factors Are Associated With Declining Incidence of Hospitalized and Nonhospitalized Acute Coronary Heart Disease in a Population.
- Author
-
Mannsverk, Jan, Wilsgaard, Tom, Mathiesen, Ellisiv B., Løchen, Maja-Lisa, Rasmussen, Knut, Thelle, Dag S., Njølstad, Inger, Arnesdatter Hopstock, Laila, Harald Bønaa, Kaare, Hopstock, Laila Arnesdatter, and Bønaa, Kaare Harald
- Published
- 2016
- Full Text
- View/download PDF
22. Longitudinal and Secular Trends in Blood Pressure Among Women and Men in Birth Cohorts Born Between 1905 and 1977.
- Author
-
Hopstock, Laila Arnesdatter, Bønaa, Kaare Harald, Eggen, Anne Elise, Grimsgaard, Sameline, Jacobsen, Bjarne K., Løchen, Maja-Lisa, Mathiesen, Ellisiv B., Njølstad, Inger, and Wilsgaard, Tom
- Abstract
High blood pressure is a modifiable risk factor for cardiovascular disease. Previous studies showing a blood pressure decline in recent decades lack data to follow individuals born in different decades from early and middle adulthood to older age. We investigated changes in age-specific blood pressure by repeated measurements in 37 973 women and men born 1905 to 1977 (aged 20–89 years) examined ≤5× between 1979 and 2008 in the population-based Tromsø Study. Mixed models were used to estimate time trends. Mean systolic and diastolic blood pressure decreased from 1979 to 2008 in both genders in the age groups 30 to 89 years. The decrease was similar in the 80th percentile and the 20th percentile of the population blood pressure distribution. The decrease in systolic blood pressure in age group 40 to 49 years was 10.6 mm Hg in women and 4.5 mm Hg in men. Systolic blood pressure increased with age in women and men born 1920 to 1949, whereas a decrease or flattening of curve was observed in the younger birth cohorts. Thus, we found both time periodic and cohort effects, and trends were more pronounced in women than in men. The findings suggest changes in blood pressure in the population rather than an effect of treatment of high-risk individuals. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
23. Longitudinal and Secular Trends in Blood Pressure Among Women and Men in Birth Cohorts Born Between 1905 and 1977.
- Author
-
Arnesdatter Hopstock, Laila, Bønaa, Kaare Harald, Eggen, Anne Elise, Grimsgaard, Sameline, Jacobsen, Bjarne K., Løchen, Maja-Lisa, Mathiesen, Ellisiv B., Njølstad, Inger, and Wilsgaard, Tom
- Published
- 2015
- Full Text
- View/download PDF
24. Clinically Significant Novel Biomarkers for Prediction of First Ever Myocardial Infarction.
- Author
-
Wilsgaard, Tom, Mathiesen, Ellisiv Bøgeberg, Patwardhan, Anil, Rowe, Michael W., Schirmer, Henrik, Løchen, Maja-Lisa, Sudduth-Klinger, Julie, Hamren, Sarah, Bønaa, Kaare Harald, and Njølstad, Inger
- Subjects
BIOMARKERS ,MYOCARDIAL infarction risk factors ,APOLIPOPROTEIN B ,KALLIKREIN ,MATRIX metalloproteinases ,LONGITUDINAL method - Abstract
The article discusses a research which examines the association of multiple protein biomarkers with the 10-year risk of incident first-ever myocardial infarction (MI) and identifies a clinically significant risk model in samples from a longitudinal study of men and women in Tromsø, Norway. The study found several clinically significant biomarkers adjusted for traditional risk factors including apolipoprotein B/apolipoprotein A1 ratio, kallikrein, and matrix metalloproteinase 9.
- Published
- 2015
- Full Text
- View/download PDF
25. Potential Implications of NORSTENT (Norwegian Coronary Stent Trial) in Contemporary Practice.
- Author
-
Wiseth, Rune and Bønaa, Kaare Harald
- Subjects
- *
SURGICAL stents , *DRUG-eluting stents , *CORONARY disease , *CLINICAL trials , *THROMBOSIS risk factors , *STANDARDS , *SAFETY - Abstract
The article focuses on comparison of comparing contemporary bare-metal stents (BMS) and second-generation drug-eluting stents (DES) inpatients with stable or unstable coronary artery disease, done by Norwegian Coronary Stent Trial (NORSTENT). Topics discussed are test conducted on the basis of factors such as sex, age and medical history, European guidelines for safety outcomes, and growing evidence of stent thrombosis in DES stents compared to BMS stents.
- Published
- 2017
- Full Text
- View/download PDF
26. Circulating Folate, Vitamin B12, Homocysteine, Vitamin B12 Transport Proteins, and Risk of Prostate Cancer: a Case-Control Study, Systematic Review, and Meta-analysis.
- Author
-
Collin, Simon M., Metcalfe, Chris, Refsum, Helga, Lewis, Sarah J., Zuccolo, Luisa, Smith, George Davey, Chen, Lina, Harris, Ross, Davis, Michael, Marsden, Gemma, Johnston, Carole, Lane, J. Athene, Ebbing, Marta, Bønaa, Kaare Harald, Nygård, Ottar, Ueland, Per Magne, Grau, Maria V., Baron, John A., Donovan, Jenny L., and Neal, David E.
- Abstract
The article presents a study on the relationship between blood levels of folate, vitamin B12, homocysteine and vitamin B12 transport proteins, and prostate cancer risk. The case-control study was done by investigating prostate-specific antigen-detected prostate cancer of the Prostate Testing for Cancer and Treatment in Great Britain, which measured 1,461 cases and 1,507 controls. The authors found that increased risk for prostate cancer can be attributed to vitamin B12 and folate based on the cohort studies in Great Britain.
- Published
- 2010
- Full Text
- View/download PDF
27. Cancer Incidence and Mortality After Treatment With Folie Acid and Vitamin B12.
- Author
-
Ebbing, Marta, Bønaa, Kaare Harald, Nygård, Ottar, Arnesen, Egil, Ueland, Per Magne, Nordrehaug, Jan Erik, Rasmussen, Knut, Njølstad, Inger, Refsum, Helga, Nilsen, Dennis w., Tverdal, Aage, Meyer, Klaus, and Vollset, Stein Emil
- Subjects
- *
VITAMIN B6 , *VITAMIN B12 , *FOLIC acid , *CANCER treatment , *CANCER-related mortality , *RANDOMIZED controlled trials , *PLACEBOS - Abstract
The article offers information on a study which investigated the effects of treatment with B vitamins on cancer outcomes and all-cause mortality. A total of 6837 patients were recruited to participate in two randomized, double-blind, placebo-controlled clinical trials conducted in Norway between 1998 and 2005, and followed up through December 31, 2007. Treatment interventions included oral treatment with folic acid combined with vitamin B12 and vitamin 6, folic acid combined with vitamin B12, vitamin 6 alone and placebo. Presented in details are the research findings.
- Published
- 2009
- Full Text
- View/download PDF
28. Cancer Incidence and Mortality After Treatment With Folie Acid and Vitamin B12.
- Author
-
Ebbing, Marta, Bønaa, Kaare Harald, Nygård, Ottar, Arnesen, Egil, Ueland, Per Magne, Nordrehaug, Jan Erik, Rasmussen, Knut, Njølstad, Inger, Refsum, Helga, Nilsen, Dennis w., Tverdal, Aage, Meyer, Klaus, and Vollset, Stein Emil
- Subjects
VITAMIN B6 ,VITAMIN B12 ,FOLIC acid ,CANCER treatment ,CANCER-related mortality ,RANDOMIZED controlled trials ,PLACEBOS - Abstract
The article offers information on a study which investigated the effects of treatment with B vitamins on cancer outcomes and all-cause mortality. A total of 6837 patients were recruited to participate in two randomized, double-blind, placebo-controlled clinical trials conducted in Norway between 1998 and 2005, and followed up through December 31, 2007. Treatment interventions included oral treatment with folic acid combined with vitamin B
12 and vitamin6 , folic acid combined with vitamin B12 , vitamin6 alone and placebo. Presented in details are the research findings.- Published
- 2009
- Full Text
- View/download PDF
29. Body Iron Stores and the Gender Gap in Risk of Incident Myocardial Infarction-Reply.
- Author
-
Albrektsen, Grethe and Bønaa, Kaare Harald
- Published
- 2017
- Full Text
- View/download PDF
30. Prognostic indicators of cardiac-related events and the effect of exercise in Norwegian post-myocardial infarction participants
- Author
-
Lynghaug, Sofie Johnsen, Wisløff, Ulrik, and Bønaa, Kaare Harald
- Abstract
Hensikt: Å studere forskjellene mellom VE/VCO2 slope og VO2peak som prognostisk indikator blant norske studiedeltakere som har gjennomgått hjerteinfarkt, og å studere effekten av åtte måneder veiledet trening på prognostisk indikasjon i et utvalg av den norske hjerteinfarkt populasjonen. Metode: Et randomisert utvalg fra det pågående prosjektet Norwegian Trial of Physical Exercise After Myocardial Infarction, resulterte i totalt 109 deltakere (64.2±8.7 år, 176.1±7.9 cm, 87.4±16.8 kg). Utgangsverdiene for de prognostiske indikatorene, VE/VCO2 slope og VO2peak, var målt ved hjelp av en kardiopulmonal belastningstest (CPET) på tredemølle eller ergometersykkel. Innenfor de opprinnelige 109 deltakerne, gjennomførte 10 deltakere ytterligere CPET målinger av tilsvarende variabler etter åtte måneder med veiledet trening. Fysisk aktivitet og trening var målt kontinuerlig gjennom intervensjonen ved hjelp av en smartklokke. De prognostiske indikatorverdiene var kategorisert ved bruk av Weber og det ventilatoriske klassifikasjonssystemet for å kartlegge risikoen for hjerterelaterte hendelser innenfor populasjonen. Resultater: Et gjennomsnitt på 31.29±4.47 and 30.9±8.3 ble observert i henholdsvis VE/VCO2 slope (L⋅min-1) og VO2peak (mL·kg-1·min-1). Forholdet mellom VE/VCO2 slope (L⋅min-1) og VO2peak (mL·kg-1·min-1) viste en svak negativ korrelasjon (r=-0.093, p=0.336). Fordeling av variabler ved bruk av Weber- og det ventilatoriske klassifikasjonssystemet viste store variasjoner basert på hvilken variabel som ble brukt som prognostisk indikator. Etter åtte måneder med veiledet trening viste deltakerne forbedringer på henholdsvis -1.91±1.72 [CI: 0.67-3.12] og 1.35±2.53 [CI: -3.16 to 0.46], i VE/VCO2 slope (L⋅min-1) og VO2peak (mL·kg-1·min-1). Forbedringene innen både VE/VCO2 slope (r=-0.721, p=
- Published
- 2022
31. Change in peak oxygen uptake after eight-month exercise intervention in post-myocardial infarction men and women
- Author
-
Langmo, Ingrid Haagenrud, Wisløff, Ulrik, and Bønaa, Kaare Harald
- Abstract
Hensikt: Studere endringen i oksygenopptak etter åtte måneders treningsintervensjon blant menn og kvinner som tidligere har vært utsatt for hjerteinfarkt. Metode: Oksygenopptak ble målt ved oppstart og slutten av intervensjonen hos elleve menn og kvinner som tidligere har vært utsatt for hjerteinfarkt (63.4 ± 9.6 år, 178 ± 10 cm, 90 ± 14 kg). Målingene ble gjennomført på tredemølle eller ergometersykkel gjennom en kardiopulmonær belastningstest (CPET). Fysisk aktivitet og trening ble målt kontinuerlig med en Amazfit NorEx treningsklokke gjennom hele intervensjonsperioden. Deltakerne ble oppfordret til å opprettholde ≥100 PAI per uke, foretrukket gjennom trening i høy intensitet. Resultater: En økning i oksygenopptak på 1.4 ± 2.4 mL·kg-1·min-1 (p=0.08 [CI: -3.03 til 0.21]) ble observert på gruppenivå. Økning i oksygenopptak som en funksjon av gjennomsnittlig total tid, tid i de ulike intensitetssonene høy, moderat og lav samt antall dager med oppnådd ≥100 PAI per uke var henholdsvis β=0.09 (p=0.29, [CI: -0.10 to 0.28]), β=0.20 (p=0.81 [CI: -1.62 til 2.01]), β=0.24 (p=0.24 [CI: -0.19 til 0.66]), β=0.16 (p=0.35 [CI: -0.20 til 0.51]) og β=0.58 (p=0.10 [CI: -0.15 to 1.31]). Deltakerne hadde et 9.9 mL·kg-0.75·min-1 høyere oksygenopptak etter treningsintervensjonen sammenliknet med referansematerialet fra NorEx (p=0.21 [CI: -25.20 to 5.59]). Konklusjon: Trening viser å ha en positiv innflytelse på kardiorespiratorisk form etter åtte måneders treningsintervensjon, hvor ukentlig dager ≥100 PAI viser å ha sterkest sammenheng med økning i oksygenopptak. En større studiepopulasjon er nødvendig for å fastslå den faktiske effekten av trening da ingen av resultatene viser å være statistisk signifikante. Videre forskning på denne pasientgruppen er nødvendig for å bedre kliniske beslutninger og belyse viktigheten av trening som sekundærforebygging etter hjerteinfarkt. Purpose: To investigate the change in peak oxygen uptake (V ̇O2peak) after eight-month exercise intervention in post-myocardial infarction (MI) men and women. Methods: V ̇O2peak was measured in 11 post-MI men and women (63.4 ± 9.6 years, 178 ± 10 cm, 90 ± 14 kg) at baseline and after eight-month exercise intervention, performed on a treadmill or cycle ergometer by cardiopulmonary exercise test (CPET). Physical activity and exercise were monitored continuously with an Amazfit Health Watch NorEx during the intervention. Participants were encouraged to obtain ≥100 PAI per week, preferably by high intensity exercise training. Results: An improvement in V ̇O2peak of 1.4 ± 2.4 mL·kg-1·min-1 (p=0.08 [CI: -3.03 to 0.21]) was observed at group level. The increase of V ̇O2peak as a function of total time, high-, moderate-, and low- intensity exercise training per week performed and amount of days obtaining ≥100 PAI per week was β=0.09 (p=0.29, [CI: -0.10 to 0.28]), β=0.20 (p=0.81, [CI: -1.62 to 2.01]), β=0.24 (p=0.24, [CI: -0.19 to 0.66]), β=0.16 (p=0.35, [CI: -0.20 to 0.51]), and β=0.58 (p=0.10, [CI: -0.15 to 1.31]), respectively. Participants demonstrated a 9.9 mL·kg-0.75·min-1 greater V ̇O2peak compared to reference material from The Norwegian Trial of Exercise after Myocardial Infarction (p=0.21, [CI: -25.20 to 5.59]). Conclusion: Exercise positively influences cardiorespiratory fitness after eight-month exercise intervention, where weekly days ≥100 PAI seems to demonstrate the greatest association. A larger sample size is crucial to determine the actual effect as results are not statistically significant. Further research on post-MI patients is necessary to improve clinical decisions and raise awareness of the importance of exercise as secondary prevention after MI.
- Published
- 2022
32. The epidemiology of myocardial infarction. Trends in incidence, risk factors, severity, treatment and outcomes of myocardial infarction in a general population
- Author
-
Mannsverk, Jan Torbjørn and Bønaa, Kaare Harald
- Subjects
VDP::Medical disciplines: 700::Health sciences: 800::Epidemiology medical and dental statistics: 803 ,VDP::Medisinske Fag: 700::Helsefag: 800::Epidemiologi medisinsk og odontologisk statistikk: 803 ,The Tromsø Study ,Tromsøundersøkelsen ,VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Kardiologi: 771 ,VDP::Medical disciplines: 700::Clinical medical disciplines: 750::Cardiology: 771 - Abstract
Paper 1 and 2 were based on the Tromsø Study, a population-based, prospective cohort study with repeated screenings for cardiovascular risk factors and follow-up with regard to disease incidence and mortality. Paper 3 was based on a local registry of consecutively patients with presumed ST-elevation myocardial infarction who had been given prehospital thrombolytic therapy, and then admitted to the University Hospital in Tromsø. In paper 1, we showed that a substantial part of the decline in coronary heart disease mortality in the young and middle-aged population was due to a decreased incidence of myocardial infarction. The study indicates that the population burden of coronary heart disease may be shifting towards women and elderly patients, suggesting that preventive gains have not penetrated equally throughout the population. The severity and case fatality of the disease, however, was declining in all groups. In paper 2, we found that age- and sex-adjusted incidence of total coronary heart disease decreased by 3% annually over 15 years of follow-up. The decrease was found primarily in reductions in out-of-hospital sudden cardiac death and hospitalized ST-elevation myocardial infarction. Reductions in serum cholesterol accounted for approximately one-third of the event decline, but decreases in smoking, blood pressure, and heart rate and increased physical activity all contributed. Increases in body mass index and diabetes mellitus were associated with modest increases in disease outcomes. Overall, risk factors accounted for 66% of the decline in incidence. Furthermore, the decline in event rates and the decline in case fatality each explained 50% of the decline in coronary heart disease mortality. This was partly explained by less severe disease in those afflicted, but also by a major improvement in treatment. In paper 3, we showed that ambulance clinicians with the support of hospital cardiologists could safely and effectively perform prehospital thrombolytic therapy. The implementation of this system was associated with significant reduction in time delays of reperfusion therapy, and reduction in post-infarct systolic heart failure, and high survival rates among ST-elevation myocardial infarction-patients suffering out-of hospital cardiac arrest.
- Published
- 2019
33. Gender contrasts in adverse effect of diabetes on the risk of incident myocardial infarction. The Tromsø study 1979-2012.
- Author
-
Albrektsen, Grethe, Heuch, Ivar, Løchen, Maja-Lisa, Thelle, Dag S., Wilsgaard, Tom, Njølstad, Inger, and Bønaa, Kaare Harald
- Subjects
- *
CORONARY heart disease risk factors , *MYOCARDIAL infarction , *DIABETES risk factors , *GENDER differences (Psychology) , *DISEASE incidence - Abstract
Introduction: Diabetes is associated with increased risk of coronary heart disease (CHD). The relative risk has been found to be higher in women than men, and the more pronounced adverse effect has even been claimed to eliminate the female advantage in risk. However, few previous studies have quantified the difference in risk between men and women among individuals with diabetes. Aims: To evaluate interaction between gender and diabetes in relation to the risk of incident myocardial infarction (MI). Methods: Population-based prospective study of 33,859 individuals (51% women) in Tromsø, Norway. Median follow-up time at ages 35-94 years was 17.6 years; 2,746 individuals (854 women) were diagnosed with MI during follow-up. At their last visit, a total of 1063 individuals (3.1%) reported they had diabetes (530 men, 533 women); 170 (74 women) were later diagnosed with MI. Incidence rate ratios (IRR) were calculated as estimates of relative risk in Poisson regression analysis of person-years at risk. Interaction terms were included in the model to evaluate heterogeneity in risk estimates across subgroups. Results: Adjusted for age, gender and established CHD risk factors, diabetes was associated with a doubling in risk of MI (IRR=2.18, 95% CI=1.86-2.55). The adverse effect was slightly more pronounced for women than men (IRR of 2.55 vs. 1.96, p=0.11, test for interaction). Accordingly, the gender contrast in risk was less pronounced among individuals with diabetes (IRR of 1.63 vs 2.11), but the elevated risk in men remained significant. Considering combined categories of interacting factors, women with diabetes had a risk level close to men without diabetes, but men with diabetes had a risk about four times as high as women without diabetes. Some heterogeneity across age groups was seen, but risk estimates were imprecise. These results are preliminary. Gender heterogeneity in associations with adjustment factors may influence risk estimates. Analyses based on data with 5 year extended follow-up are planned. Conclusions: In terms of relative risk, the association between diabetes and risk of MI was more pronounced for women than men, but the female advantage in risk of MI was not erased in persons with diabetes. [ABSTRACT FROM AUTHOR]
- Published
- 2018
34. Exploring variation in timely reperfusion treatment in ST-segment elevation myocardial infarction in Norway: a national register-based cohort study.
- Author
-
Uleberg B, Bønaa KH, Govatsmark RES, Olsen F, Jacobsen BK, Stensland E, Hauglann B, Vonen B, and Førde OH
- Subjects
- Humans, Middle Aged, Cohort Studies, Treatment Outcome, Reperfusion, Registries, Myocardial Reperfusion, Percutaneous Coronary Intervention, ST Elevation Myocardial Infarction epidemiology, ST Elevation Myocardial Infarction surgery, Myocardial Infarction epidemiology, Myocardial Infarction therapy
- Abstract
Objectives: This study aimed to investigate determinants of reperfusion within recommended time limits (timely reperfusion) for ST-segment elevation myocardial infarction patients, exploring the impact of geography, patient characteristics and socio-economy., Design: National register-based cohort study., Setting: Multilevel logistic regression models were applied to examine the associations between timely reperfusion and residency in hospital referral areas and municipalities, patient characteristics, and socio-economy., Participants: 7607 Norwegian ST-segment elevation myocardial infarction patients registered in the Norwegian Registry of Myocardial Infarction during 2015-2018., Main Outcome Measures: The odds of timely reperfusion by primary percutaneous coronary intervention (PCI) or fibrinolysis., Results: Among 7607 ST-segment elevation myocardial infarction patients in Norway, 56% received timely reperfusion. The Norwegian goal is 85%. While 81% of the patients living in the Oslo hospital referral area received timely reperfusion, only 13% of the patients living in Finnmark did so.Patients aged 75-84 years had lower odds of timely reperfusion than patients below 55 years of age (OR 0.73, 95% CI 0.61 to 0.87). Patients with moderate or high comorbidity had lower odds than patients without (OR 0.81, 95% CI 0.68 to 0.95 and OR 0.61, 95% CI 0.44 to 0.84). More than 2 hours from symptom onset to first medical contact gave lower odds than less than 30 min (OR 0.63, 95% CI 0.54 to 0.72). 1-2 hours of travel time to a PCI centre (OR 0.39, 95% CI 0.31 to 0.49) and more than 2 hours (OR 0.22, 95% CI 0.16 to 0.30) gave substantially lower odds than less than 1 hour of travel time., Conclusions: The varying proportion of patients receiving timely reperfusion across hospital referral areas implies inequity in fundamental healthcare services, not compatible with established Norwegian health policy. The importance of travel time to PCI centre points at the expanded use of prehospital pharmacoinvasive strategy to obtain the goals of timely reperfusion in Norway., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2024
- Full Text
- View/download PDF
35. Does a history of cardiovascular disease or cancer affect mortality after SARS-CoV-2 infection?
- Author
-
Kvåle R, Bønaa KH, Forster R, Gravningen K, Júlíusson PB, and Myklebust TÅ
- Subjects
- Female, Humans, Male, Norway epidemiology, Risk Factors, COVID-19 mortality, Cardiovascular Diseases complications, Neoplasms complications
- Abstract
Background: Cardiovascular disease and cancer have been described as possible risk factors for COVID-19 mortality. The purpose of this study was to investigate whether a history of cardiovascular disease or cancer affects the risk of dying after a COVID-19 diagnosis in Norway., Material and Method: Data were compiled from the Norwegian Surveillance System for Communicable Diseases, the Norwegian Cardiovascular Disease Registry and the Cancer Registry of Norway. Univariable and multivariable regression models were used to calculate both relative and absolute risk., Results: In the first half of 2020, 8 809 people tested positive for SARS-CoV-2 and 260 COVID-19-associated deaths were registered. Increasing age, male sex (relative risk (RR): 1.5; confidence interval (CI): 1.2-2.0), prior stroke (RR: 1.5; CI: 1.0-2.1) and cancer with distant metastasis at the time of diagnosis (RR: 3.0; CI: 1.1-8.2) were independent risk factors for death after a diagnosis of COVID-19. After adjusting for age and sex, myocardial infarction, atrial fibrillation, heart failure, hypertension, and non-metastatic cancer were no longer statistically significant risk factors for death., Interpretation: The leading risk factor for death among individuals who tested positive for SARS-CoV-2 was age. Male sex, and a previous diagnosis of stroke or cancer with distant metastasis were also associated with an increased risk of death after a COVID-19 diagnosis.
- Published
- 2020
- Full Text
- View/download PDF
36. Treatment of ST-elevation myocardial infarction - an observational study.
- Author
-
Arnesen JS, Strøm KH, Bønaa KH, and Wiseth R
- Subjects
- Fibrinolytic Agents, Humans, Norway, Thrombolytic Therapy, Time Factors, Treatment Outcome, Angioplasty, Balloon, Coronary, Percutaneous Coronary Intervention, ST Elevation Myocardial Infarction therapy
- Abstract
Background: ST-elevation myocardial infarction is treated with reperfusion, either in the form of primary percutaneous coronary intervention (PCI) or thrombolytic therapy. The choice of treatment depends on transport time to the nearest PCI centre. Norway's geography means that thrombolytic therapy will be appropriate for many patients. Irrespective of treatment choice, it is important to avoid delays. We wished to compare the outcomes of primary PCI and thrombolytic therapy in our healthcare region and to examine whether reperfusion therapy was administered within the recommended time window., Material and Method: Using registry data and patient medical records, we compared the outcomes of primary PCI and thrombolytic therapy in cases of ST-elevation myocardial infarction in the Central Norway Regional Health Authority in the period 2015-16. The outcomes analysed were 30-day mortality, ejection fraction measured by echocardiography during the hospital stay, incidence of bleeding complications, and time from diagnosis to start of treatment., Results: The study population comprised 648 patients with ST-elevation myocardial infarction. Of these, 382 were treated with primary PCI and 266 received thrombolytic therapy. The 30-day mortality was 5.5 % in the primary PCI group and 5.6 % in the thrombolysis group (p = 1.0). There were no significant differences in ejection fraction and no cases of serious bleeding. In 45 % of the total population, reperfusion therapy was started later than recommended in guidelines., Interpretation: There was no statistically significant difference in mortality or ejection fraction when comparing primary PCI and thrombolytic therapy in an unselected population with ST-elevation myocardial infarction. Many patients experienced delayed start of treatment . It is important to take action to reduce delays at all stages of the therapeutic chain. Thrombolytic therapy should be considered when it is unclear whether transport time to a PCI centre will exceed that recommended in guidelines.
- Published
- 2019
- Full Text
- View/download PDF
37. Coronary angiography in non-ST-elevation acute myocardial infarction - whom and when?
- Author
-
Bønaa KH and Steigen T
- Subjects
- Early Diagnosis, Humans, Practice Guidelines as Topic, Time Factors, Coronary Angiography statistics & numerical data, Non-ST Elevated Myocardial Infarction diagnostic imaging
- Published
- 2017
- Full Text
- View/download PDF
38. Longitudinal and secular trends in total cholesterol levels and impact of lipid-lowering drug use among Norwegian women and men born in 1905-1977 in the population-based Tromsø Study 1979-2016.
- Author
-
Hopstock LA, Bønaa KH, Eggen AE, Grimsgaard S, Jacobsen BK, Løchen ML, Mathiesen EB, Njølstad I, and Wilsgaard T
- Subjects
- Adult, Age Distribution, Aged, Aged, 80 and over, Cardiovascular Diseases blood, Cardiovascular Diseases epidemiology, Female, Humans, Life Style, Linear Models, Longitudinal Studies, Male, Middle Aged, Norway, Risk Factors, Sex Distribution, Young Adult, Cholesterol blood, Hypolipidemic Agents therapeutic use
- Abstract
Objectives: Elevated blood cholesterol is a modifiable risk factor for cardiovascular disease. Cholesterol level surveillance is necessary to study population disease burden, consider priorities for prevention and intervention and understand the effect of diet, lifestyle and treatment. Previous studies show a cholesterol decline in recent decades but lack data to follow individuals born in different decades throughout life., Methods: We investigated changes in age-specific and birth cohort-specific total cholesterol (TC) levels in 43 710 women and men born in 1905-1977 (aged 20-95 years at screening) in the population-based Tromsø Study. Fifty-nine per cent of the participants had more than one and up to six repeated TC measurements during 1979-2016. Linear mixed models were used to test for time trends., Results: Mean TC decreased during 1979-2016 in both women and men and in all age groups. The decrease in TC in age group 40-49 years was 1.2 mmol/L in women and 1.0 mmol/L in men. Both the 80th and the 20th percentile of the population TC distribution decreased in both sexes and all age groups. Longitudinal analysis showed that TC increased with age to a peak around middle age followed by a decrease. At any given age, TC significantly decreased with increase in year born. Lipid-lowering drug use was rare in 1994, increased thereafter, but was low (<3% in women and <5% in men) among those younger than 50 years in all surveys. Between 1994 and 2016, lipid-lowering drug treatment in individuals 50 years and older explained 21% and 28% of the decrease in TC levels in women and men, respectively., Conclusions: We found a substantial decrease in mean TC levels in the general population between 1979 and 2016 in all age groups. In birth cohorts, TC increased with age to a peak around middle age followed by a decrease., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)
- Published
- 2017
- Full Text
- View/download PDF
39. Interrater reliability of a national acute myocardial infarction register.
- Author
-
Govatsmark RE, Sneeggen S, Karlsaune H, Slørdahl SA, and Bønaa KH
- Abstract
Background: Disease-specific registers may be used for measuring and improving healthcare and patient outcomes, and for disease surveillance and research, provided they contain valid and reliable data. The aim of this study was to assess the interrater reliability of all variables in a national myocardial infarction register., Methods: We randomly selected 280 patients who had been enrolled from 14 hospitals to the Norwegian Myocardial Infarction Register during the year 2013. Experienced audit nurses, who were blinded to the data about the 280 patients already in the register, completed the Norwegian Myocardial Infarction paper forms for 240 patients by review of medical records. We then extracted all registered data on the same patients from the Norwegian Myocardial Infarction Register. To compare the interrater reliability between the register and the audit nurses, we calculated intraclass correlations coefficient for continuous variables, Cohen's kappa and Gwet's first agreement coefficient (AC1) for nominal variables, and quadratic weighted Cohen's kappa and Gwet's second AC for ordinal variables., Results: We found excellent (AC1 >0.80) or good (AC1 0.61-0.80) agreement for most variables, including date and time variables, medical history, investigations and treatments during hospitalization, medication at discharge, and ST-segment elevation or non-ST-segment elevation acute myocardial infarction. However, only moderate agreement (AC1 0.41-0.60) was found for family history of coronary heart disease, diagnostic electrocardiography, and complications during hospitalization, whereas fair agreement (AC1 0.21-0.40) was found for acute myocardial infarction location. A high percentage of missing data was found for symptom onset, family history, body mass index, infarction location, and new Q-wave., Conclusion: Most variables in Norwegian Myocardial Infarction Register had excellent or good reliability. However, some important variables had lower reliability than expected or had missing data. Precise definitions of data elements and proper training of data abstractors are necessary to ensure that clinical registries contain valid and reliable data.
- Published
- 2016
- Full Text
- View/download PDF
40. Seasonal variation in incidence of acute myocardial infarction in a sub-Arctic population: the Tromsø Study 1974-2004.
- Author
-
Hopstock LA, Wilsgaard T, Njølstad I, Mannsverk J, Mathiesen EB, Løchen ML, and Bønaa KH
- Subjects
- Adult, Female, Humans, Incidence, Male, Middle Aged, Myocardial Infarction mortality, Norway epidemiology, Prospective Studies, Registries, Risk Assessment, Risk Factors, Time Factors, Myocardial Infarction epidemiology, Seasons
- Abstract
Background: A seasonal pattern with higher winter morbidity and mortality has been reported for acute myocardial infarction (MI). The magnitude of the difference between peak and nadir season has been associated with latitude, but results are inconsistent. Studies of seasonal variation of MI in population-based cohorts, based on adjudicated MI cases,are few.We investigated the monthly and seasonal variation in first-ever nonfatal and fatal MI in the population of Tromsø in northern Norway, a region with a harsh climate and extreme seasonal variation in daylight exposure., Design: Prospective population-based cohort study., Methods: A total of 37 392 participants from the Tromsø Study enrolled between 1974 and 2001 were followed throughout 2004. Each incident case of MI was validated by the review of medical records and death certificates. MI incidence rates for months and seasons were analyzed for seasonal patterns with Poisson regression and the Cosinor procedure. All analyses were stratified by sex, age and smoking status., Results: A total of 1893 first-ever MIs were registered, of which 592 were fatal. There was an 11 % (95% confidence interval: 1.00-1.23, P=0.04) increased risk of incident MI during winter (November-January) compared with non-winter seasons, with no statistically significant interaction with sex, age, smoking or calendar year. Other seasonal modelling gave similar but not statistically significant results., Conclusion: We found a small increase in risk of incident MI during the darkest winter months. Populations living in sub-Arctic areas may be adapted to face climate exposure during winter through behavioural protection.
- Published
- 2011
- Full Text
- View/download PDF
41. Myocardial infarction mortality.
- Author
-
Bønaa KH
- Subjects
- Female, Humans, Male, Norway epidemiology, Risk Factors, Myocardial Infarction mortality
- Published
- 2011
- Full Text
- View/download PDF
42. Circulating folate, vitamin B12, homocysteine, vitamin B12 transport proteins, and risk of prostate cancer: a case-control study, systematic review, and meta-analysis.
- Author
-
Collin SM, Metcalfe C, Refsum H, Lewis SJ, Zuccolo L, Smith GD, Chen L, Harris R, Davis M, Marsden G, Johnston C, Lane JA, Ebbing M, Bønaa KH, Nygård O, Ueland PM, Grau MV, Baron JA, Donovan JL, Neal DE, Hamdy FC, Smith AD, and Martin RM
- Subjects
- Aged, Case-Control Studies, Humans, Male, Middle Aged, Risk Factors, Folic Acid blood, Homocysteine blood, Prostatic Neoplasms blood, Transcobalamins metabolism, Vitamin B 12 blood
- Abstract
Background: Disturbed folate metabolism is associated with an increased risk of some cancers. Our objective was to determine whether blood levels of folate, vitamin B(12), and related metabolites were associated with prostate cancer risk., Methods: Matched case-control study nested within the U.K. population-based Prostate testing for cancer and Treatment (ProtecT) study of prostate-specific antigen-detected prostate cancer in men ages 50 to 69 years. Plasma concentrations of folate, B(12) (cobalamin), holo-haptocorrin, holo-transcobalamin total transcobalamin, and total homocysteine (tHcy) were measured in 1,461 cases and 1,507 controls. ProtecT study estimates for associations of folate, B(12), and tHcy with prostate cancer risk were included in a meta-analysis, based on a systematic review., Results: In the ProtecT study, increased B(12) and holo-haptocorrin concentrations showed positive associations with prostate cancer risk [highest versus lowest quartile of B(12) odds ratio (OR) = 1.17 (95% confidence interval, 0.95-1.43); P(trend) = 0.06; highest versus lowest quartile of holo-haptocorrin OR = 1.27 (1.04-1.56); P(trend) = 0.01]; folate, holo-transcobalamin, and tHcy were not associated with prostate cancer risk. In the meta-analysis, circulating B(12) levels were associated with an increased prostate cancer risk [pooled OR = 1.10 (1.01-1.19) per 100 pmol/L increase in B(12); P = 0.002]; the pooled OR for the association of folate with prostate cancer was positive [OR = 1.11 (0.96-1.28) per 10 nmol/L; P = 0.2) and conventionally statistically significant if ProtecT (the only case-control study) was excluded [OR = 1.18 (1.00-1.40) per 10 nmol/L; P = 0.02]., Conclusion: Vitamin B(12) and (in cohort studies) folate were associated with increased prostate cancer risk., Impact: Given current controversies over mandatory fortification, further research is needed to determine whether these are causal associations., (Copyright 2010 AACR.)
- Published
- 2010
- Full Text
- View/download PDF
43. Homocysteine lowering and cardiovascular events after acute myocardial infarction.
- Author
-
Bønaa KH, Njølstad I, Ueland PM, Schirmer H, Tverdal A, Steigen T, Wang H, Nordrehaug JE, Arnesen E, and Rasmussen K
- Subjects
- Adult, Aged, Aged, 80 and over, Death, Sudden, Cardiac epidemiology, Death, Sudden, Cardiac prevention & control, Double-Blind Method, Drug Therapy, Combination, Female, Folic Acid blood, Humans, Hyperhomocysteinemia complications, Male, Middle Aged, Myocardial Infarction complications, Myocardial Infarction prevention & control, Proportional Hazards Models, Secondary Prevention, Stroke epidemiology, Vitamin B 12 blood, Vitamin B 6 blood, Folic Acid therapeutic use, Hyperhomocysteinemia drug therapy, Myocardial Infarction drug therapy, Vitamin B 12 therapeutic use, Vitamin B 6 therapeutic use
- Abstract
Background: Homocysteine is a risk factor for cardiovascular disease. We evaluated the efficacy of homocysteine-lowering treatment with B vitamins for secondary prevention in patients who had had an acute myocardial infarction., Methods: The trial included 3749 men and women who had had an acute myocardial infarction within seven days before randomization. Patients were randomly assigned, in a two-by-two factorial design, to receive one of the following four daily treatments: 0.8 mg of folic acid, 0.4 mg of vitamin B12, and 40 mg of vitamin B6; 0.8 mg of folic acid and 0.4 mg of vitamin B12; 40 mg of vitamin B6; or placebo. The primary end point during a median follow-up of 40 months was a composite of recurrent myocardial infarction, stroke, and sudden death attributed to coronary artery disease., Results: The mean total homocysteine level was lowered by 27 percent among patients given folic acid plus vitamin B12, but such treatment had no significant effect on the primary end point (risk ratio, 1.08; 95 percent confidence interval, 0.93 to 1.25; P=0.31). Also, treatment with vitamin B6 was not associated with any significant benefit with regard to the primary end point (relative risk of the primary end point, 1.14; 95 percent confidence interval, 0.98 to 1.32; P=0.09). In the group given folic acid, vitamin B12, and vitamin B6, there was a trend toward an increased risk (relative risk, 1.22; 95 percent confidence interval, 1.00 to 1.50; P=0.05)., Conclusions: Treatment with B vitamins did not lower the risk of recurrent cardiovascular disease after acute myocardial infarction. A harmful effect from combined B vitamin treatment was suggested. Such treatment should therefore not be recommended. (ClinicalTrials.gov number, NCT00266487.)., (Copyright 2006 Massachusetts Medical Society.)
- Published
- 2006
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.