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  • 1. Banegas, José R
    et al.
    López-García, Esther
    Dallongeville, Jean
    Guallar, Eliseo
    Halcox, Julian P
    Borghi, Claudio
    Massó-González, Elvira L
    Sazova, Ogün
    Perk, Joep
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Steg, Philippe Gabriel
    De Backer, Guy
    Rodríguez-Artalejo, Fernando
    Achievement of lipoprotein goals among patients with metabolic syndrome at high cardiovascular risk across Europe. The EURIKA study.2013In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 166, no 1, p. 210-214Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To examine for the first time the achievement of lipoprotein treatment goals in patients with metabolic syndrome and lipid abnormalities who are at elevated cardiovascular risk in Europe. METHODS: Cross-sectional study conducted in 2009-2010 in 12 European countries among outpatients aged ≥50years free of clinical cardiovascular disease. We assessed achievement of American Diabetes Association/American College of Cardiology lipid treatment goals in those with metabolic syndrome at highest risk (diabetes plus ≥1 additional major cardiovascular risk factor beyond lipid abnormalities) or high risk (no diabetes but ≥2 additional major cardiovascular risk factors). RESULTS: Among 1431 highest-risk patients, 64.6% (between-country range [BCR] 40-84.5%) were on lipid-lowering medication. Of them, 13.4% (BCR: 2.5-28.6%) had LDL-cholesterol<70mg/dl, non-HDL-cholesterol<100mg/dl, and apolipoprotein B<80mg/dl. Among 832 high-risk patients, 38.7% BCR: 27.5-55.3%) were on lipid-lowering medication. Of them, 20.5% (BCR: 5.5-57.6%) had LDL-cholesterol<100mg/dl, non-HDL-cholesterol<130mg/dl, and apolipoprotein B<90mg/dl. About 96% of highest-risk patients and 94% of high-risk patients were given at least one lifestyle advice (weight reduction, healthy diet, physical activity, no-smoking), but only 1.3% of the former and 4.9% of the latter reached all three lipid goals. CONCLUSION: There is a substantial gap between clinical guidelines and medical practice since only one in 5-7 patients met all treatment targets. Although most patients received lifestyle advice, the effectiveness of counseling was very low. Large between-country differences in outcomes suggest considerable room for improvement.

  • 2.
    Borghi, Claudio
    et al.
    Univ Bologna, Italy.
    Rodriguez-Artalejo, Fernando
    Univ Autonoma Madrid, Spain;Inst Salud Carlos III, Spain;IMDEA, Spain;CEI UAM CSIC, Spain.
    De Backer, Guy
    Univ Ghent, Belgium.
    Dallongeville, Jean
    Univ Lille Nord France, France.
    Medina, Jesus
    AstraZeneca, Spain.
    Nuevo, Javier
    AstraZeneca, Spain.
    Guallar, Eliseo
    Johns Hopkins Bloomberg Sch Publ Hlth, USA.
    Perk, Joep
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Banegas, Jose R.
    Univ Autonoma Madrid, Spain;Inst Salud Carlos III, Spain.
    Tubach, Florence
    Hop La Pitie Salpetriere, France;INSERM, France;Sorbonne Univ, France.
    Roy, Carine
    Hop Bichat Claude Bernard, France.
    Halcox, Julian P.
    Swansea Univ, UK.
    Serum uric acid levels are associated with cardiovascular risk score: A post hoc analysis of the EURIKA study2018In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 253, p. 167-173Article in journal (Refereed)
    Abstract [en]

    Background: Reports are conflicting on whether serum uric acid (sUA) levels are independently associated with increased cardiovascular (CV) death risk. Methods: This post hoc analysis assessed the relationship between sUA levels and CV death risk score in 7531 patients from the cross-sectional, multinational EURIKA study (NCT00882336). Patients had at least one CV risk factor but no clinical CV disease. Ten-year risk of CV death was estimated using SCORE-HDL and SCORE algorithms, categorized as low (<1%), intermediate (1% to <5%), high (>5% to <10%) or very high (>10%). Results: Mean serum sUA levels increased significantly with increasing CV death risk category in the overall population and in subgroups stratified by diuretics use or renal function (all P < 0.0001). Multivariate ordinal logistic regression analyses, adjusted for factors significantly associated with CV death risk in univariate analyses (study country, body mass index, number of CV risk factors and comorbidities, use of lipid lowering therapies, antihypertensives and antidiabetics), showed a significant association between sUA levels and SCORE-HDL category in the overall population (OR: 1.39 [95% CI: 1.34-1.44]) and all subgroups (using diuretics: 1.32 [1.24-1.40]; not using diuretics: 1.46 [1.39-1.53]; estimated glomerular filtration rate [eGFR] < 60 ml/min/1.73 m(2): 1.30 [1.22-1.38]; eGFR >= 60 ml/min/1.73 m(2): 1.44 [1.38-1.51]; all P < 0.0001). Similar results were obtained when using SCORE. Conclusions: Higher sUA levels are associated with progressively higher 10-year CV death risk score in patients with at least one CV risk factor but no CV disease. (c) 2017 Elsevier B.V. All rights reserved.

  • 3.
    Borghi, Claudio
    et al.
    Univ Bologna, Italy.
    Tubach, Florence
    Hop Bichat Claude Bernard, France ; Univ Paris Diderot, France.
    De Backer, Guy
    Univ Ghent, Belgium.
    Dallongeville, Jean
    Univ Lille Nord France, France.
    Guallar, Eliseo
    Johns Hopkins Bloomberg Sch Publ Hlth, USA ; Natl Ctr Cardiovasc Res, Spain.
    Medina, Jesus
    AstraZeneca, Spain.
    Perk, Joep
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Roy, Carine
    Hop Bichat Claude Bernard, France.
    Banegas, Jose R.
    Univ Autonoma Madrid IdiPaz, Spain ; CIBER Epidemiol & Publ Hlth CIBERESP, Spain.
    Rodriguez-Artalejo, Fernando
    Univ Autonoma Madrid IdiPaz, Spain ; CIBER Epidemiol & Publ Hlth CIBERESP, Spain.
    Halcox, Julian P.
    Swansea Univ, UK.
    Lack of control of hypertension in primary cardiovascular disease prevention in Europe: Results from the EURIKA study2016In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 218, p. 83-88Article in journal (Refereed)
    Abstract [en]

    Background: The prevalence of and factors associated with uncontrolled hypertension and apparent resistant hypertension were assessed in the European Study on Cardiovascular Risk Prevention and Management in Usual Daily Practice (EURIKA; NCT00882336). Methods: EURIKA was a cross-sectional observational study including patients being treated for the primary prevention of cardiovascular disease in 12 European countries. Patients were assessed if they were being treated for hypertension (N = 5220). Blood pressure control was defined according to European guidelines, with sensitivity analysis taking account of patients' age and diabetes status. Associated factors were assessed using multivariate analysis. Results: In the primary analysis, a total of 2691 patients (51.6%) had uncontrolled hypertension. Factors significantly associated with an increased risk of having uncontrolled hypertension included female sex (odds ratio [OR]: 2.29; 95% confidence interval [CI]: 1.93-2.73), body mass index (BMI; OR per kg/m(2): 1.03; 95% CI: 1.01-1.04), and geographic location. A total of 749 patients (14.3%) had apparent resistant hypertension. Factors significantly associated with an increased risk of having apparent resistant hypertension included BMI (OR per kg/m(2): 1.06; 95% CI: 1.04-1.08), diabetes (OR: 1.28; 95% CI: 1.06-1.53), use of statins (OR: 1.36; 95% CI: 1.15-1.62), serum uric acid levels (OR: 1.16; 95% CI: 1.09-1.23), and geographic location. Similar results were seen in sensitivity analyses. Conclusions: Over 50% of patients treated for hypertension continued to have uncontrolled blood pressure and 14.3% had apparent resistant hypertension. Positive associations were seen with other cardiovascular risk factors. (C) 2016 Elsevier Ireland Ltd. All rights reserved.

  • 4. Libungan, Berglind
    et al.
    Stensdotter, Lillemor
    Hjalmarson, Agneta
    From Attebring, Mona
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Lindqvist, Jonny
    Back, Maria
    Herlitz, Johan
    Secondary prevention in coronary artery disease. Achieved goals and possibilities for improvements2012In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 161, no 1, p. 18-24Article in journal (Refereed)
    Abstract [en]

    Aim: To describe presence of risk indicators of recurrence 6 months after hospitalisation due to coronary artery disease at a university clinic. Methods: The presence of risk indicators, including tobacco use, lipid levels, blood pressure and glucometabolic status, including 24-hour blood pressure monitoring and an oral glucose-tolerance test, was analysed. Results: Of 1465 patients who were screened, 402 took part in the survey (50% previous myocardial infarction and 50% angina pectoris). Mean age was 64 years (range 40-85 years) and 23% were women. Present medications were: lipid lowering drugs (statins; 94%), beta-blockers (85%), aspirin or warfarin (100%) and ACE-inhibitors or angiotensin II blockers (66%). Values above target levels recommended in guidelines were: a) low density lipoprotein (LDL) in 40%; b) mean blood pressure (day or night) in 38% and c) smoking in 13%. Of all patients, 66% had at least one risk factor (LDL or blood pressure above target levels or current smoking). An abnormal glucose-tolerance test was found in 59% of patients without known diabetes. If no history of diabetes, 85% had either LDL or blood pressure above target levels, current smoking or an abnormal glucose-tolerance test. However, with treatment intensification to patients with elevated risk factors 56% reached target levels for blood pressure and 79% reached target levels for LDL. Conclusion: Six months after hospitalisation due to coronary artery disease, despite the high use of medication aimed at prophylaxis against recurrence, the majority were either above target levels for LDL or blood pressure or continued to smoke. (c) 2011 Elsevier Ireland Ltd. All rights reserved.

  • 5.
    Orrem, Hilde L.
    et al.
    Oslo Univ Hosp, Norway;Univ Oslo, Norway.
    Shetelig, Christian
    Univ Oslo, Norway;Oslo Univ Hosp Ulleval, Norway.
    Ueland, Thor
    Univ Oslo, Norway.;Oslo Univ Hosp, Norway;Univ Tromso, Norway.
    Limalanathan, Shanmuganathan
    Oslo Univ Hosp Ulleval, Norway;Feiring Heart Clin, Norway.
    Nilsson, Per H.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences. Univ Oslo, Norway.
    Husebye, Trygve
    Oslo Univ Hosp Ulleval, Norway;Univ Oslo, Norway.
    Aukrust, Pal
    Univ Oslo, Norway;Oslo Univ Hosp, Norway.
    Seljeflot, Ingebjorg
    Univ Oslo, Norway;Oslo Univ Hosp Ulleval, Norway.
    Hoffmann, Pavel
    Univ Oslo, Norway;Oslo Univ Hosp Ulleval, Norway.
    Eritsland, Jan
    Oslo Univ Hosp Ulleval, Norway.
    Mollnes, Tom E.
    Oslo Univ Hosp, Norway;Univ Tromso, Norway;Univ Oslo, Norway;Nordland Hosp, Norway;Norwegian Univ Sci, Norway.
    Andersen, Geir Oystein
    Oslo Univ Hosp Ulleval, Norway;Univ Oslo, Norway.
    Yndestad, Arne
    Univ Oslo, Norway;Oslo Univ Hosp, Norway.
    Soluble IL-1 receptor 2 is associated with left ventricular remodelling in patients with ST-elevation myocardial infarction2018In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 268, p. 187-192Article in journal (Refereed)
    Abstract [en]

    Background: The inflammatory response following myocardial infarction (MI) is prerequisite for proper healing of infarcted tissue, but can also have detrimental effects on cardiac function. Interleukin (IL)-1 alpha and IL-1 beta are potent inflammatory mediators and their bioactivity is tightly regulated by IL-1 receptor antagonist (IL-1ra) and soluble (s) IL-1 receptors (R). We aimed to examine whether levels of soluble regulators of IL-1 signalling are changed during ST-elevation MI (STEMI) and their associations with parameters of cardiac injury and ventricular remodelling. Methods: Plasma levels of IL-1Ra, sIL-1R1, sIL-1R2 and sIL-1R accessory protein (sIL-1RAcP) were measured by immunoassays in repeated samples from patients with STEMI (n = 255) and compared to healthy controls (n=65). Results: IL-1Ra, sIL-1R1 and sIL-1R2 levels were all significantly elevated after STEMI, while levels of sIL-1RAcP were lower compared to controls. sIL-1R2 levels (at different time points) correlated positively with C-reactive protein, myocardial infarct size and change in indexed left ventricular end-diastolic and end-systolic volume (LVEDVi and LVESVi) measured by cardiac MR acutely and after 4 months, and negatively with LV ejection fraction. Patients with >median levels of sIL-1R2 in the acute phase were more likely to have increased change in LVEDVi and LVESVi. Importantly, sIL-1R2 remained significantly associated with change in LVEDVi and LVESVi also after adjustment for clinical covariates. Conclusion: Levels of sIL-1R2 are independently associated with parameters of LV adverse remodelling following STEMI. (C 18 Elsevier B.V. All rights reserved.

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