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1. Quality of Life After Fractional Flow Reserve–Guided PCI Compared With Coronary Bypass Surgery

Author

William F, Fearon, Frederik M, Zimmermann, Victoria Y, Ding, Jo M, Zelis, Zsolt, Piroth, Giedrius, Davidavicius, Samer, Mansour, Rajesh, Kharbanda, Nikolaos, Östlund-Papadogeorgos, Keith G, Oldroyd, Olaf, Wendler, Michael J, Reardon, Y Joseph, Woo, Alan C, Yeung, Nico H J, Pijls, Bernard, De Bruyne, Manisha, Desai, and Mark A, Hlatky

Subjects
Canada, Coronary Artery Disease, Angina Pectoris, Fractional Flow Reserve, Myocardial, Percutaneous Coronary Intervention, Treatment Outcome, surgical procedures, operative, Physiology (medical), Quality of Life, Humans, cardiovascular diseases, Coronary Artery Bypass, Cardiology and Cardiovascular Medicine, Aged
Abstract

Background: Previous studies have shown that quality of life improves after coronary revascularization more so after coronary artery bypass grafting (CABG) than after percutaneous coronary intervention (PCI). This study aimed to evaluate the effect of fractional flow reserve guidance and current generation, zotarolimus drug-eluting stents on quality of life after PCI compared with CABG. Methods: The FAME 3 trial (Fractional Flow Reserve Versus Angiography for Multivessel Evaluation) is a multicenter, international trial including 1500 patients with 3-vessel coronary artery disease who were randomly assigned to either CABG or fractional flow reserve–guided PCI. Quality of life was measured using the European Quality of Life–5 Dimensions (EQ-5D) questionnaire at baseline and 1 and 12 months. The Canadian Cardiovascular Class angina grade and working status were assessed at the same time points and at 6 months. The primary objective was to compare EQ-5D summary index at 12 months. Secondary end points included angina grade and work status. Results: The EQ-5D summary index at 12 months did not differ between the PCI and CABG groups (difference, 0.001 [95% CI, –0.016 to 0.017]; P =0.946). The trajectory of EQ-5D during the 12 months differed ( P Conclusions: In the FAME 3 trial, quality of life after fractional flow reserve–guided PCI with current generation drug-eluting stents compared with CABG was similar at 1 year. The rate of significant angina was low in both groups and not significantly different. The trajectory of improvement in quality of life was significantly better after PCI, as was working status in those Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT02100722.

Published
2022

2. Changes in Index of Microcirculatory Resistance during PCI in the Left Anterior Descending Coronary Artery in Relation to Total Length of Implanted Stents

Author

Christina Ekenbäck, Fadi Jokhaji, Nikolaos Östlund-Papadogeorgos, Habib Mir-Akbari, Rikard Linder, Nils Witt, Mattias Törnerud, Bassem Samad, and Jonas Persson

Subjects
Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Aim. To investigate the relationship between stent length and changes in microvascular resistance during PCI in stable coronary artery disease (CAD). Methods and Results. We measured fractional flow reserve (FFR), index of microcirculatory resistance (IMR), and coronary flow reserve (CFR) before and after stenting in 42 consecutive subjects with stable coronary artery undergoing PCI with stent in the LAD. Patients that had very long stent length (38–78 mm) had lower FFR before stenting than patients that had long (23–37 mm) and moderate (12–22 mm) stent length (0.59 (±0.16), 0.70 (±0.12), and 0.75 (±0.07); p=0.002). FFR improved after stenting and more so in subjects with very long stent length compared to long and moderate stent length (0.27 (s.d ± 16), 0.15 (s.d ± 0.12), and 0.12 (s.d ± 0.07); p for interaction = 0.013). Corrected IMR (IMRcorr) increased after stenting in subjects who had very long stent length, whereas IMRcorr was lower after stenting in subjects who had long or moderate stent length (4.6 (s.d. ± 10.7), −1.4 (s.d. ± 9,9), and −4.2 (s.d. ± 7.8); p for interaction = 0.009). Conclusions. Changes in IMR during PCI in the LAD in stable CAD seem to be related to total length of stents implanted, possibly influencing post-PCI FFR. Larger studies are needed to confirm the relationship.

Published
2019
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3. Fractional flow reserve–guided PCI as compared with coronary bypass surgery

Author

Filip Casselman, Kreton Mavromatis, Adel Aminian, Gintaras Kalinauskas, Victoria Y. Ding, Philip MacCarthy, Nawwar Al-Attar, Bernard De Bruyne, Nico H.J. Pijls, Oskar Angerås, Giedrius Davidavičius, Y. Joseph Woo, Di Lu, Petr Kala, Jan-Henk E. Dambrink, Nikolaos Östlund-Papadogeorgos, Michael J. Reardon, Laszlo Szekely, Jaydeep Sarma, Manisha Desai, Keith G. Oldroyd, Kenneth W. Mahaffey, Rajesh Kharbanda, Pim A.L. Tonino, Albert H.M. van Straten, Nils Witt, Nikola Jagic, Evald Høj Christiansen, Fame Study Investigators, Zsolt Piroth, William F Fearon, Mark A. Hlatky, Samer Mansour, Steven E S Miner, Alan C. Yeung, Yuhei Kobayashi, Frederik M. Zimmermann, Thomas Engstrøm, and Olaf Wendler

Subjects
Reoperation, Male, medicine.medical_specialty, CLINICAL-OUTCOMES, EVEROLIMUS-ELUTING STENTS, Coronary Artery Bypass/adverse effects, medicine.medical_treatment, Operative Time, UNIVERSAL DEFINITION, Fractional flow reserve, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, ANGIOGRAPHY, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, 030212 general & internal medicine, Myocardial infarction, cardiovascular diseases, Stroke, Coronary Stenosis/mortality, Percutaneous Coronary Intervention/adverse effects, Aged, FAME 3 TRIAL, GRAFT-SURGERY, business.industry, Cardiovascular Diseases/epidemiology, Hazard ratio, Percutaneous coronary intervention, General Medicine, Length of Stay, Middle Aged, medicine.disease, 3. Good health, Fractional Flow Reserve, Myocardial, surgical procedures, operative, Bypass surgery, Conventional PCI, Cardiology, REVASCULARIZATION, Female, Stents, business, INTERVENTION
Abstract

BACKGROUND: Patients with three-vessel coronary artery disease have been found to have better outcomes with coronary-artery bypass grafting (CABG) than with percutaneous coronary intervention (PCI), but studies in which PCI is guided by measurement of fractional flow reserve (FFR) have been lacking.METHODS: In this multicenter, international, noninferiority trial, patients with three-vessel coronary artery disease were randomly assigned to undergo CABG or FFR-guided PCI with current-generation zotarolimus-eluting stents. The primary end point was the occurrence within 1 year of a major adverse cardiac or cerebrovascular event, defined as death from any cause, myocardial infarction, stroke, or repeat revascularization. Noninferiority of FFR-guided PCI to CABG was prespecified as an upper boundary of less than 1.65 for the 95% confidence interval of the hazard ratio. Secondary end points included a composite of death, myocardial infarction, or stroke; safety was also assessed.RESULTS: A total of 1500 patients underwent randomization at 48 centers. Patients assigned to undergo PCI received a mean (±SD) of 3.7±1.9 stents, and those assigned to undergo CABG received 3.4±1.0 distal anastomoses. The 1-year incidence of the composite primary end point was 10.6% among patients randomly assigned to undergo FFR-guided PCI and 6.9% among those assigned to undergo CABG (hazard ratio, 1.5; 95% confidence interval [CI], 1.1 to 2.2), findings that were not consistent with noninferiority of FFR-guided PCI (P = 0.35 for noninferiority). The incidence of death, myocardial infarction, or stroke was 7.3% in the FFR-guided PCI group and 5.2% in the CABG group (hazard ratio, 1.4; 95% CI, 0.9 to 2.1). The incidences of major bleeding, arrhythmia, and acute kidney injury were higher in the CABG group than in the FFR-guided PCI group.CONCLUSIONS: In patients with three-vessel coronary artery disease, FFR-guided PCI was not found to be noninferior to CABG with respect to the incidence of a composite of death, myocardial infarction, stroke, or repeat revascularization at 1 year. (Funded by Medtronic and Abbott Vascular; FAME 3 ClinicalTrials.gov number, NCT02100722.).

Published
2022

4. Selective endothelin A-receptor blockade attenuates coronary microvascular dysfunction after coronary stenting in patients with type 2 diabetes

Author

Nikolaos Östlund Papadogeorgos, Mattias Bengtsson, and Majid Kalani

Subjects
Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Nikolaos Östlund Papadogeorgos, Mattias Bengtsson, Majid KalaniKarolinska Institute, Department of Clinical Sciences, Department of Cardiology, Danderyd Hospital, Stockholm, SwedenBackground: Endothelin-1 may be involved in the development of diabetic microangiopathy. We studied the effect of endothelin-1 blockade on myocardial microcirculation during coronary stenting.Patients and methods: Patients with type 2 diabetes and stable coronary artery disease undergoing elective percutaneous coronary intervention (PCI) were randomized to bolus dose of 500 mg bosentan (n = 4), a dual endothelin receptor blocker, or intracoronary administration of 0.03 mmol BQ123 (n = 6), a selective endothelin A-receptor blocker, or placebo (n = 5), respectively. Coronary flow reserve (CFR) was measured immediately post-PCI. CFR was also measured in five nondiabetic controls post-coronary stenting.Results: Patients in the placebo group had (P < 0.05) lower values of CFR (2.3 ± 1.2) as compared to those who received endothelin blockade (n = 10; 3.1 ± 0.7) and nondiabetic controls (4.9 ± 2.3). Patients who received BQ123 showed significantly higher CFR (3.3 ± 0.5; P < 0.05) as compared to those on placebo. Nondiabetic patients had significantly higher CFR as compared to patients with diabetes (4.9 ± 2.3 and 2.8 ± 1.0, respectively; P < 0.05). Conclusion: Coronary microvascular dysfunction is present during coronary stenting in patients with type 2 diabetes and may be reversed by selective endothelin A-receptor blockade. Targeting endothelin system may be of importance in protecting the myocardium against ischemic events during elective PCI in type 2 diabetic patients.Keywords: coronary flow reserve, diabetes, endothelin-1, coronary artery disease, coronary angioplasty

Published
2009

5. Effects of exenatide on microvascular reactivity in patients with type 2 diabetes and coronary artery disease: A randomized controlled study

Author

Majid Kalani, Angela C. Shore, Thomas Kahan, Gun Jörneskog, Jeanette Kuhl, and Nikolaos Östlund Papadogeorgos

Subjects
Blood Glucose, medicine.medical_specialty, Physiology, Urology, Coronary Artery Disease, Type 2 diabetes, 030204 cardiovascular system & hematology, law.invention, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, Forearm, law, Physiology (medical), Diabetes mellitus, medicine, Humans, Hypoglycemic Agents, Molecular Biology, Glycated Hemoglobin, medicine.diagnostic_test, Venoms, business.industry, Body Weight, medicine.disease, medicine.anatomical_structure, Blood pressure, Diabetes Mellitus, Type 2, Exenatide, Peptides, Cardiology and Cardiovascular Medicine, Lipid profile, business, 030217 neurology & neurosurgery, medicine.drug
Abstract

OBJECTIVE We studied the effect of the GLP-1RA exenatide on skin microvascular function in patients with T2DM and CAD. METHODS Thirty-five patients with T2DM, CAD, and HbA1C 42-86 mmol/mol were randomized to treatment with exenatide or conventional non-GLP-1-based therapy for 12 weeks. Skin microvascular function was examined in the forearm by LDF and iontophoretic application of acetyl choline and SNP, and by PORH at baseline and after 12 weeks. Blood samples for fasting plasma glucose, HbA1C, and lipid profile were collected. RESULTS At 12 weeks, patients on exenatide showed reductions in HbA1C (from 63.5 ± 13 to 60.7 ± 14 mmol/mol, p = .065), body weight (from 92.6 ± 16 to 89 ± 16 kg, p

Published
2020

6. Outcome and selection of revascularization strategy in left main coronary artery stenosis

Author

Bassem A. Samad, Nikolaos Östlund-Papadogeorgos, Christina Ekenbäck, Jonas Persson, Fadi Jokhaji, Rikard Linder, and Thomas Gripenberg

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Clinical Decision-Making, Left Main Coronary Artery Stenosis, 030204 cardiovascular system & hematology, Coronary Angiography, Revascularization, Coronary artery disease, 03 medical and health sciences, Percutaneous Coronary Intervention, 0302 clinical medicine, Risk Factors, Internal medicine, Odds Ratio, Humans, Medicine, Registries, cardiovascular diseases, 030212 general & internal medicine, Coronary Artery Bypass, Propensity Score, Aged, Proportional Hazards Models, Retrospective Studies, Aged, 80 and over, medicine.diagnostic_test, business.industry, Proportional hazards model, Patient Selection, Coronary Stenosis, Percutaneous coronary intervention, Middle Aged, medicine.disease, Stenosis, Logistic Models, Treatment Outcome, surgical procedures, operative, Multivariate Analysis, Conventional PCI, Angiography, Cardiology, Female, Cardiology and Cardiovascular Medicine, business
Abstract

OBJECTIVES To investigate clinical outcome in unselected real-life patients with unprotected left main coronary artery (ULMCA) stenosis and determine factors associated with selection of revascularization strategy. DESIGN Consecutive patients with ULMCA stenosis at our institution in 2009-2013 (n = 308) were retrospectively analyzed with propensity score adjusted Cox proportional hazards models for outcome. Baseline characteristics in relation to selection of revascularization strategy were analyzed with multivariate logistic regression. RESULTS Patients that underwent PCI (n = 94) had a higher risk of major adverse cardiac and cerebrovascular events (MACCE; adjusted HR 2.13 [95% CI 1.08-4.19]) than patients that had CABG surgery but there was no difference in the combination of death and MI (adjusted HR 1.17 [95% CI 0.50-2.75]). Later year of index angiography, age, Euroscore II and angiographer favoring PCI was associated with PCI as revascularization strategy. Higher SYNTAX score, higher systolic blood pressure and angiographer favoring CABG was associated with CABG. CONCLUSIONS In consecutive patients with ULMCA stenosis PCI is associated with higher MACCE rates than CABG but there is no difference in death and MI. Later year of index angiography, higher age, lower systolic blood pressure, higher predicted per-procedural surgical risk, less complex coronary anatomy and angiographer favoring PCI increased the probability of revascularization with PCI instead of CABG.

Published
2018

7. Changes in Index of Microcirculatory Resistance during PCI in the Left Anterior Descending Coronary Artery in Relation to Total Length of Implanted Stents

Author

Nils Witt, Rikard Linder, Nikolaos Östlund-Papadogeorgos, Jonas Persson, Habib Mir-Akbari, Fadi Jokhaji, Christina Ekenbäck, Mattias Törnerud, and Bassem A. Samad

Subjects
Male, lcsh:Diseases of the circulatory (Cardiovascular) system, medicine.medical_specialty, Article Subject, medicine.medical_treatment, Coronary Artery Disease, Fractional flow reserve, Anterior Descending Coronary Artery, Coronary Angiography, Coronary artery disease, Percutaneous Coronary Intervention, Internal medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, cardiovascular diseases, Aged, business.industry, Microcirculation, Percutaneous coronary intervention, Coronary flow reserve, Stent, Equipment Design, medicine.disease, equipment and supplies, Fractional Flow Reserve, Myocardial, medicine.anatomical_structure, surgical procedures, operative, lcsh:RC666-701, Conventional PCI, Cardiology, Female, Stents, Vascular Resistance, Cardiology and Cardiovascular Medicine, business, Research Article, Artery
Abstract

Aim. To investigate the relationship between stent length and changes in microvascular resistance during PCI in stable coronary artery disease (CAD). Methods and Results. We measured fractional flow reserve (FFR), index of microcirculatory resistance (IMR), and coronary flow reserve (CFR) before and after stenting in 42 consecutive subjects with stable coronary artery undergoing PCI with stent in the LAD. Patients that had very long stent length (38–78 mm) had lower FFR before stenting than patients that had long (23–37 mm) and moderate (12–22 mm) stent length (0.59 (±0.16), 0.70 (±0.12), and 0.75 (±0.07); p=0.002). FFR improved after stenting and more so in subjects with very long stent length compared to long and moderate stent length (0.27 (s.d ± 16), 0.15 (s.d ± 0.12), and 0.12 (s.d ± 0.07); p for interaction = 0.013). Corrected IMR (IMRcorr) increased after stenting in subjects who had very long stent length, whereas IMRcorr was lower after stenting in subjects who had long or moderate stent length (4.6 (s.d. ± 10.7), −1.4 (s.d. ± 9,9), and −4.2 (s.d. ± 7.8); p for interaction = 0.009). Conclusions. Changes in IMR during PCI in the LAD in stable CAD seem to be related to total length of stents implanted, possibly influencing post-PCI FFR. Larger studies are needed to confirm the relationship.

Published
2019
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8. Annual report SWEDEHEART 2012

Author

Anna-Maria Wahlberg, Magdalena Alenström, Stina Udin, Tore Johansson, Anna Lundgren, Birgitta Romany Johansson, Carin Ekström, Nils Eriksson, Lisbeth Andersson, Hanna Eklund, Lotta Robertsson, Gunilla Bjerhag, Ann-Charlotte Gustavsson, Madelene Israelsson, Sofia Karlsson, Maria Westerlund, Yvonne Ek, Birgitta Stenbäck, Barbro Andersson, Elisabeth Andersson, Kristina Leppämäki, Anette Ramirez, Victoria Wallin, Alexandra Lundberg, Benny Sahlin, Hasse Mälberg, Maria Liljeroos, Caroline Gustafsson, Kerstin Nyström, Susanne Siklo, Eva Zelleroth, Finn Hjortevang, Kamaran Mohammed, Agneta Hellblad, Iwona Schön, Kristina Carlsson, Marita Ole´rs, Pär Lennart Ågren, Iwar Sjögren, Crister Zedigh, Kristina Eriksson, Kristina Sundkvist, Anna-Karin Thorsell, Ann-Kristin Kuoljok, Linda Liinanki, Mona Liljergren, Sara Turtola, Britt-Marie Nylander, Lena Nordvall, Malin Nilsson, Annelie Blomqvist, Håkan Sjöberg, Jenny Nylander, Linda Berglund, Linda Mossberg, Lars Svennberg, Espen Haugen, Lars Hellsten, Staffan Johansson, Birgitta Johansson, Pethra Larsson, Susanne Kellerth, Monika Bergström, Carola Gustafsson, Cecilia Nährström, Eva Evenås, Hanna Sundin, Helena Lönn, Johan Svensson, Moa Kihlgren, Per Larsson, Pirjo Palosaari, Susann Johansson, Malin Cedermark magnusson, Annica Ravn-Fischer, Ann Wittfeldt, Elisabeth Perers, Nina Hellberg, Mikael Holmberg, Bert Andersson, Berit Jangsten, Nedim Selimovic, Anna Enström, Göran Dellgren, Henrik Scherstén, Anna Biveby-Nilsson, Johan Lundberg, Elmir Omerovic, Petur Petursson, Per Albertsson, Carina Ankarstrand, Agneta Flinck, Titti Larsson, Maria Samuelsson, Peter Bergman, Lotten Nyström, Magnus Bågenholm, Anneli Linnér, Björn Hornestam, Helén Sjöland, Anne-Marie Kirkhoff, Hugo Månsson, Ida Karlsson, Maria Olausson, Charlotte Berne, Christina Backe, Ali Tabandeh, Ann-Charlotte Karlsson, Peter Hårdhammar, Sven-Erik Olsson, Henrik Persson, Ole Wagner, Henrik Wagner, Lennart Sandhall, Carina Wåhlander, Kristina Rova, Lina Fischer, Maria Nilsson, Mari Stjernberg, Sylvia Gustavsson, Camilla Hedberg, Jan Thollander, Katarina Collberg, Jörg Lauermann, Werner Puskar, Margareta Larsson, Ann Johansson, Lina Brindstedt, Marina Olofsson, Jörg Carlsson, Katarina Månsson, Ulla Jeppsson, Ingbritt Söderlind, Malinn Hultman, Sara Ronnelin, Carina Fredriksson, Gerd Skogman, Ingela Ågren, Inger Almroth, Sara Trege Nilsson, Gerd Pettersson, Ing-Marie Åkesson, Sofia Carlfelter, Jan Medin, Karim Mokhtar, Carl-Magnus Pripp, Linda Malmsten, Annelie Karlsson, Anna Lenberg, Annika Lettenström, Anna Jost-Widén, Gunilla Johnson, Håkan Ahlmark, Hannah Brevik, IngaLill Nordberg, Jessica Österberg-Persson, Jeanette Smedberg, Maria Eklund, Urban Haaga, Anne-Marie Henriksson, Mats Allared, Hans Olsson, Tage Nilsson, Lisa Juhlin, Karin Eriksson, Leif Hedquist, Ulla Lundin, Christin Jonsson, Monica Pedersen, Julia Marainen, Moa Bylund, Monica Alsterdal, Anna Sjöberg, Ewa Wigenstorp, Gunilla Peterzen, Kerstin Skeppstedt, Anette Berlin, Helena Wikström, Kerstin Pihl, Lehna Ferm, Petra Larsson, Vanja Johansson, Gunvor Finnas, Helen Ahlm, Anders Ekelind, Eva Larsson, Gull-Britt Eriksson, Veronica Sass, Åsa Johansson, Lennart Malmqvist, Lars Westin, Eydis Sigurjonsdottir, Frida Skuladottir, Maria Ottesen, Olga Birgitta Bjarnadottir, Gunnar Myrdal, Edda Traustadottir, Friðrika Sigvaldadóttir, Gerður Garðarsdóttir, Gudrun Valgeirsdottir, Sigurlaug Magnusdottir, Thora Bjornsdottir, Thorarinn Gudnason, Svava Matthiasdottir, Maria Jonsson, Ulrika Pettersson, Magnus Peterson, Karin Molander, Micael Larsson, Berit Samuelsson, Catarina Svensson, Elisabeth Augustsson, Evelin BertilssonFröjd, Joakim Alfredsson, Wolfgang Freter, Linda Lilja, Gunnel Andersson, Dimitrios Venetsanos, Anders Björkholm, Tim Tödt, Ulf Berglund, Niels Erik Nielsen, Jenny Johansson, Johanna Svensson, Rosie-Marie Larsson, Liselotte Lundmark, Gunilla Brolin, Annika Westergren, Anna Duckert, Vesna Steffan, Matthias Götberg, David Erlinge, Fredrik Scherstén, Göran Olivecrona, Jan Harnek, Per Bondesson, Pernilla Knutsson, Evy Stenlund, Peter Thorén, Siv Algotsson, Enisa Durakovic, Lisa Gustafsson, Marie Nilsson, Margareta Nilson, Pallonji Bhiladvala, Monica Håkansson, Carina Svensson, Ingela Olsson, Amelie Kjellstenius, Jenny Åslund, Linnéa Alledal, Nina Varblane, Victoria Nilsson, Maria Thudén, Siv-Britt Jensen, Elisabet Svensson, Maria Pettersson, Sanna Lindgren, Anita Pehrsson, Maria Olsson, Anneli Rudenäs, Eva Öhman, Stig-Åke Falk, Annelie Jaensson, Lena Thell, Annette Billqvist, Barbro Efraimsson-Nilsson, Ingalill Allansson, Malin Jansson, Ann Ingström, Christina Lundqvist, Ingela Nyström, Ingrid Bergman, Johan Ekman, Lena Carlson, Solveig Person, Ingrid Lindberg, Leif Thuesen, Erik Lindberg, Gunnilla Lundberg, Kerstin Hedberg, Inga-Lill Kotka, Anja Fogelberg, Anna Johansson, Lis Ståhl, Anders Kallryd, Agneta Ramén, Henrik Löfmark, Senait Fessahaie, Malin Brandrup-Wognsen, Claire Salomonsson, Petra Ardin, Eva Balcker, Filippa Högberg, Fredrik Högberg, Eva Hultin Ånnegård, Marcus Svensson, Marie Tornestedt, Inge Björkander, Cathrine Edström, Lars Eurenius, Ann Samnegård, Jonas Persson, Nikolaos Östlund Papadogeorgos, Habib Mir-Akbari, Görel Stengård, Elin Bacsovics Brolin, Katarina Brehmer, Fauzia Osman, Marie Törnblom, Katja Sundkvist, Caroline Kumhala, Ellinor Jonsson, Alexandra Yazar, Anwar Siddiqui, Andreas Rück, Loghman Henareh, Kerstin Cederlund, Ewa Lemberg, Elin Larsson, Amanda Persson, Karolin Andersson, Per Svensson, Fauzia A - Moalim, Ann Lundgren, Ellen Gustavsson-segerhag, Agneta Nordvall, Gunnel Söderlund, Christina Jarnert, Linda Mellbin, Torbjörn Ivert, Rikard Linder, Mattias Törnerud, Birgit Edén, Kristina Lockne, Sebastian Rennerskog, Jan Kosmack, Marianne Erlandsson, Pontus Lindroos, Armi Peltonen, Christine Creutziger, Ellinor Berglund, Marie Henriksson, Carina Ingeborn, Olov Collste, Mikael Aasa, Karin Karlsson, Ulla Andersson, Lis Kohlström Englund, Mia Henning, Anna-Greta Vinblad v Walter, Christina Nilsson, Helena Schilken, Inger Johansson, Ingrid Wallgren, Kristina Niemi, Oili Niva, Margareta Dofs, Agneta Johansson, Jan Haupt, Christina Näslund, Henrik Drewsen, Maria Söderlund, Birgitta Berts, Bo Lindvall, Daniel Wadell, Jens Jensen, Åsa Hedh, Karin Johnson, Cecilia Nikitin, Eva-Lena Eriksson, Elisabeth Westlund, Inger Karlsson, Peter Björkdahl, Radim Uher, Ulf Nyman, Troels Yndigegn, Anette Broberg, Linda Lamreus, Alexandra Söderström, Marianne Lång, Henrik Olsson, Madhat Hussien Al-Saadi, Emma Landén, Maria Holmgren, Tomas Rivera San Martin, Karin Nyström, Magnus Wahlin, Oskar Angerås, Johan Nilsson, Peter Eriksson, Anna Sundberg, Inger Sandström, Olov Duvernoy, Maria Andreasson, Johanna Ekström, Marie Essermark, Helena Wall, Elisabeth Marklund, Cecilia Östlund, Maria Willehadson, Christina Björklund, Axel Dimberg, Vitas Zemgulis, Agneta Olsson, Susanne Hagström, Carina Bergman, Annika Gunnarsson, My Huhta, Christina Svensson, Per Hultman, Christoph Varenhorst, Per Kvidal, Annika Stener Bengtsson, Ann-Lis Wännman, Lisbeth Nilsson, Tomas Andersson, Maritha Josefsson, Maria Morén, Lena Hultman-Berg, Anna-Karin Almqwist, Monica Cederblad, Katarina Ekberg, Gunilla Kvarnvik, Eston Jönsson, Annelie Hammerman, Pia Claesson, Gith Widerström, Sandra Pettersson Olsson, Åsa Hofvander, Martin Lindholm, Saman Saidi, Per Grimfjärd, Amra Kåregren, Madeleine Runesson, Anders Josefsson, Lena Henriksson-Fri, Miriam Johansson, Solgärd Gustavsson, Minna Markljung, Olle Bergström, Thomas Aronsson, Ewa Karlsson, Pernilla Boström, Sofia Hansson, Inger Andreasson, Lena Palmqvist, Anders Kähäri, Mats Lidén, Frida Oskarsson, Ingela Östman, Johanna Kronberg, Marie Johansson, Marie Thuresson, Håkan Geijer, Ole Fröbert, Thomas Kellerth, Maud Tillkvist, Kirsti Ajax, Fredrik Björklund, and Anna Björklund

Subjects
business.industry, media_common.quotation_subject, Incidence (epidemiology), Medicine, Infarction, Annual report, Cardiology and Cardiovascular Medicine, business, medicine.disease, Welfare, Deca, Demography, media_common
Abstract

According to Swedish National Board of Health and Welfare statistics, a dramatic decrease in both the incidence of and mortality from acute myo-cardial infarction has been seen in the past two deca...

Published
2014

9. Cross-professional improvement actions to reduce time from first ECG to primary PCI in patients with ST-elevation myocardial infarction

Author

Jonas Persson, Lars Eurenius, Ewa Cedergren, and Nikolaos Östlund-Papadogeorgos

Subjects
medicine.medical_specialty, medicine.medical_treatment, Time to treatment, 030204 cardiovascular system & hematology, Time-to-Treatment, Electrocardiography, 03 medical and health sciences, Percutaneous Coronary Intervention, 0302 clinical medicine, St elevation myocardial infarction, Internal medicine, medicine, Humans, In patient, 030212 general & internal medicine, Myocardial infarction, Patient Care Team, Patient care team, medicine.diagnostic_test, business.industry, Percutaneous coronary intervention, medicine.disease, Conventional PCI, Cardiology, ST Elevation Myocardial Infarction, Cardiology and Cardiovascular Medicine, business
Published
2016

10. Severely impaired microvascular reactivity in diabetic patients with an acute coronary syndrome

Author

Gun Jörneskog, Nikolaos Östlund Papadogeorgos, Majid Kalani, Thomas Kahan, and Mattias Bengtsson

Subjects
Adult, Blood Glucose, Male, medicine.medical_specialty, Acute coronary syndrome, Laser Doppler fluxmetry, Endocrinology, Diabetes and Metabolism, 030209 endocrinology & metabolism, Coronary Artery Disease, 030204 cardiovascular system & hematology, Coronary Angiography, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, Diabetes mellitus, Interquartile range, Internal medicine, medicine, Laser-Doppler Flowmetry, Humans, Angiology, Aged, Skin, Original Investigation, Aged, 80 and over, Glucose tolerance test, medicine.diagnostic_test, integumentary system, business.industry, Microcirculation, Type 2 Diabetes Mellitus, Glucose Tolerance Test, Middle Aged, medicine.disease, Microvascular reactivity, Diabetes Mellitus, Type 2, Cardiology, Female, business, Cardiology and Cardiovascular Medicine, Perfusion
Abstract

Background Microvascular function is impaired in patients with stable coronary artery disease. The aim was to study microvascular function in patients with diabetes and acute coronary syndrome (ACS). Methods Microvascular function was evaluated in 83 patients by laser Doppler fluxmetry (LDF) [PU; perfusion unit, median (interquartile range)] measuring resting LDF and peak LDF following a six min heating of the skin to 44 °C at the foot, respectively. All patients with ACS and without previously known diabetes underwent oral glucose tolerance test. Thirty-nine patients with type 2 diabetes mellitus free from coronary artery disease served as controls. Results Peak LDF was significantly (P = 0.03) lower in patients with ACS and diabetes (n = 22; 72 (52)) and diabetes without coronary artery disease (n = 39; 69 (51)) as compared to patients with ACS without diabetes (n = 46; 97 (60)), and patients without ACS (n = 15; 140 (121)), respectively. Patients with ACS (n = 68) had significantly (P = 0.04) lower peak LDF (92 (49)) as compared to patients without ACS (n = 15) (140 (121)). Conclusion Microvascular reactivity is severely impaired in patients with diabetes and ACS. Diabetes has a major influence on microvascular function in patients with coronary artery disease.

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