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  • 1.
    Behan, Miles W.
    et al.
    Edinburgh Heart Ctr, Edinburgh, Midlothian, Scotland..
    Haude, Michael
    Lukaskrankenhaus GmbH, Stadt Kliniken Neuss, Med Clin 1, Neuss, Germany..
    Oldroyd, Keith G.
    Golden Jubilee Natl Hosp, West Scotland Heart & Lung Ctr, Clydebank, Scotland..
    Lansky, Alexandra J.
    Yale Univ, Sch Med, Div Cardiovasc Med, New Haven, CT USA..
    James, Stefan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    Baumbach, Andreas
    Bristol Heart Inst, Bristol BS2 8HW, Avon, England..
    Will this trial change my practice?: TOTAL a randomised trial of thrombus aspiration in ST-elevation myocardial infarction2015In: EuroIntervention, ISSN 1774-024X, E-ISSN 1969-6213, Vol. 11, no 3, p. 361-363Article in journal (Other academic)
  • 2.
    Buccheri, Sergio
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    Sarno, Giovanna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    Lagerqvist, Bo
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    Olivecrona, Göran
    Hambraeus, Kristina
    Witt, Nils
    Lindholm, Daniel
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Erlinge, David
    Angerås, Oskar
    James, Stefan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    Bioabsorbable polymer everolimus-eluting stents in patients with acute myocardial infarction: a report from the Swedish Coronary Angiography and Angioplasty Registry.2018In: EuroIntervention, ISSN 1774-024X, E-ISSN 1969-6213, article id EIJ-D-18-00392Article in journal (Refereed)
    Abstract [en]

    AIMS: The clinical performance of the SYNERGY drug-eluting stent (DES) in patients with acute myocardial infarction (MI) has not been investigated in detail. We sought to report on the outcomes after SYNERGY DES (Boston Scientific, Marlborough, MA, USA) implantation in patients with MI undergoing percutaneous revascularisation (PCI).

    METHODS AND RESULTS: We included all consecutive patients with MI undergoing PCI with the SYNERGY DES and newer-generation DES (n-DES group) in Sweden. From March 2013 to September 2016, a total of 36,292 patients, of whom 39.7% presented with ST-elevation MI, were included. As compared to patients in the n-DES group (n=31,403), patients in the SYNERGY group (n=4,889) were older and presented more often with left main or three-vessel disease involvement, as well as with restenotic lesions (p<0.001 for all parameters). The Kaplan-Meier estimates of ST at two years in the SYNERGY and n-DES groups were 0.69% and 0.81%, respectively (adjusted HR 1.00, 95% CI: 0.69-1.46; p=0.99). Clinically relevant restenosis was encountered in 1.48% and 1.25% of patients in the SYNERGY and n-DES groups, respectively (adjusted HR 1.05, 95% CI: 0.81-1.37; p=0.72). No differences in the risk of all-cause death and recurrent MI were found between the two groups after adjustment (adjusted HR 1.12, 95% CI: 0.98-1.28; p=0.10, and adjusted HR 0.95, 95% CI: 0.82-1.10; p=0.49, respectively).

    CONCLUSIONS: In a large and unselected cohort of patients with MI undergoing percutaneous revascularisation with the SYNERGY DES, stent performance and clinical outcomes did not differ compared with other n-DES up to two years.

  • 3.
    Byrne, Robert A.
    et al.
    Tech Univ Munich, Deutsch Herzzentrum Munchen, Munich, Germany.;DZHK German Ctr Cardiovasc Res, Partner Site Munich Heart Alliance, Munich, Germany..
    Stefanini, Giulio G.
    Humanitas Res Hosp, Cardio Ctr, Div Cardiol, Milan, Italy..
    Capodanno, Davide
    Univ Catania, Ferrarotto Hosp, Cardiothorac Vasc Dept, Catania, Italy..
    Onuma, Yoshinobu
    Erasmus MC, Dept Intervent Cardiol, Rotterdam, Netherlands..
    Baumbach, Andreas
    St Bartholomews Hosp, William Harvey Res Inst, Dept Cardiol, London, England.;Queen Mary Univ London, London, England..
    Escaned, Javier
    Hosp San Carlos, Intervent Cardiol, Madrid, Spain..
    Haude, Michael
    Lukaskrankenhaus GmbH, Stadtisches Kliniken Neuss, Med Clin 1, Neuss, Germany..
    James, Stefan K
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Joner, Michael
    Tech Univ Munich, Deutsch Herzzentrum Munchen, Munich, Germany.;DZHK German Ctr Cardiovasc Res, Partner Site Munich Heart Alliance, Munich, Germany..
    Jüni, Peter
    Univ Toronto, St Michaels Hosp, Li Ka Shing Knowledge Inst, Appl Hlth Res Ctr, Toronto, ON, Canada..
    Kastrati, Adnan
    Tech Univ Munich, Deutsch Herzzentrum Munchen, Munich, Germany.;DZHK German Ctr Cardiovasc Res, Partner Site Munich Heart Alliance, Munich, Germany..
    Oktay, Semih
    Cardio Med Device Consultants, Baltimore, MD USA..
    Wijns, William
    Saolta Univ, Healthcare Grp, Galway, Ireland.;Natl Univ Ireland, Lambe Inst Translat Med & Curam, Galway, Ireland..
    Serruys, Patrick W.
    Erasmus Univ, Rotterdam, Netherlands.;Imperial Coll London, Natl Heart & Lung Inst, Int Ctr Circulatory Hlth, London, England..
    Windecker, Stephan
    Bern Univ Hosp, Cardiovasc Ctr Bern, Bern, Switzerland..
    Report of an ESC-EAPCI Task Force on the evaluation and use of bioresorbable scaffolds for percutaneous coronary intervention: executive summary2018In: EuroIntervention, ISSN 1774-024X, E-ISSN 1969-6213, Vol. 13, no 13, p. 1574-1586Article in journal (Refereed)
    Abstract [en]

    A previous Task Force of the European Society of Cardiology (ESC) and European Association of Percutaneous Cardiovascular Interventions (EAPCI) provided a report on recommendations for the non-clinical and clinical evaluation of coronary stents. Following dialogue with the European Commission, the Task Force was asked to prepare an additional report on the class of devices known as bioresorbable scaffolds (BRS). Five BRS have CE-mark approval for use in Europe. Only one device - the Absorb bioresorbable vascular scaffold - has published randomized clinical trial data and this data show inferior outcomes to conventional drug-eluting stents (DES) at 2-3 years. For this reason, at present BRS should not be preferred to conventional DES in clinical practice. The Task Force recommends that new BRS devices should undergo systematic non-clinical testing according to standardized criteria prior to evaluation in clinical studies. A clinical evaluation plan should include data from a medium sized, randomized trial against DES powered for a surrogate end point of clinical efficacy. Manufacturers of successful devices receive CE-mark approval for use and must have an approved plan for a large-scale randomized clinical trial with planned long-term follow-up.

  • 4.
    Damman, Peter
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Jernberg, Tomas
    Lindahl, Bertil
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    de Winter, Robbert J
    Jeppsson, Anders
    Johanson, Per
    Held, Claes
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    James, Stefan K
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Invasive strategies and outcomes for non-ST-segment elevation acute coronary syndromes: a twelve-year experience from SWEDEHEART.2016In: EuroIntervention, ISSN 1774-024X, E-ISSN 1969-6213, Vol. 12, no 9, p. 1108-1116Article in journal (Refereed)
    Abstract [en]

    AIMS: Despite recommendations in recent guidelines for a routine invasive strategy for non-ST-segment elevation acute coronary syndrome (NSTE-ACS), long-term data on the implementation of treatment strategies in clinical practice are not available. Our aim was to provide long-term data on the implementation of a routine invasive strategy in NSTE-ACS in clinical practice.

    METHODS AND RESULTS: In the SWEDEHEART registry, data from 204,092 consecutive NSTE-ACS patients admitted between 1996 and 2007 were recorded. The use of the routine invasive strategy, retrospectively defined as coronary angiography (and subsequent revascularisation) within three days after admission, increased from 3.8% in the period 1996-1998 to 37.4% in the period 2005-2007. The largest absolute increase in the use of this strategy was observed in low-risk patients, while a similar relative increase was observed in all risk categories. The use of the selective invasive strategy, defined as coronary angiography later than three days after admission or none at all, decreased from 96.2% in the period 1996-1998 to 62.5% in the period 2005-2007. In the total population, there was a gradual decrease in three-year all-cause mortality, from 29.1% in the period 1996-1998 to 23.9% in the period 2005-2007.

    CONCLUSIONS: There has been an increase in the use of a routine invasive strategy in NSTE-ACS patients over the course of 12 years in Sweden. There was a decrease in three-year mortality over the same time course.

  • 5. De Palma, Rodney
    et al.
    James, Stefan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Jueni, Peter
    Cuisset, Thomas
    Will this trial change my practice?: ACCOAST - early loading with a novel P2Y12 inhibitor in patients with an acute coronary syndrome2014In: EuroIntervention, ISSN 1774-024X, E-ISSN 1969-6213, Vol. 10, no 3, p. 408-410Article in journal (Other academic)
  • 6. Di Mario, C
    et al.
    Syrseloudis, D
    James, Stefan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology. Uppsala Clinical Research Center.
    Viceconte, N
    Wijns, W
    STEMI guidelines: from formulation to implementation2013In: EuroIntervention, ISSN 1774-024X, E-ISSN 1969-6213, Vol. 8, p. 11-17Article in journal (Refereed)
  • 7. Ducrocq, Gregory
    et al.
    Schulte, P J
    Becker, R C
    Cannon, C P
    Harrington, R A
    Held, Claes
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    Himmelmann, A
    Lassila, R
    Storey, R F
    Sorbets, E
    Wallentin, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    Steg, P G
    Association of spontaneous and procedure-related bleeds with short- and long-term mortality after acute coronary syndromes:: an analysis from the PLATO trial2015In: EuroIntervention, ISSN 1774-024X, E-ISSN 1969-6213, Vol. 11, no 7, p. 737-745Article in journal (Refereed)
    Abstract [en]

    Aims: We sought to describe the differential effect of bleeding events in acute coronary syndromes (ACS) on short- and long-term mortality according to their type and severity.

    Methods and results: The PLATO trial randomised 18,624 ACS patients to clopidogrel or ticagrelor. Post-randomisation bleeding events were captured according to bleeding type (spontaneous or procedure-related), with PLATO, TIMI, and GUSTO definitions. The association of bleeding events with subsequent short-term (<30 days) and long-term (>30 days) all-cause mortality was assessed using time-dependent Cox proportional hazard models. A model was fitted to compare major and minor bleeding for mortality prediction. Of 18,624 patients, 2,189 (11.8%) had at least one PLATO major bleed (mean follow-up 272.2±123.5 days). Major bleeding was associated with higher short-term mortality (adjusted hazard ratio [HR] 9.28; 95% confidence interval [CI]: 7.50-11.48) but not with long-term mortality (adjusted HR 1.28; 95% CI: 0.93-1.75). Spontaneous bleeding was associated with short-term (adjusted HR 14.59; 95% CI: 11.14-19.11) and long-term (adjusted HR 3.38; 95% CI: 2.26-5.05) mortality. Procedure-related bleeding was associated with short-term mortality (adjusted HR 5.29; 95% CI: 4.06-6.87): CABG-related and non-coronary-procedure-related bleeding were associated with a higher short-term mortality, whereas PCI or angiography-related bleeding was not associated with either short- or long-term mortality. Similar results were obtained using the GUSTO and TIMI bleeding definitions.

    Conclusions: Major bleeding is associated with high subsequent mortality in ACS. However, this association is much stronger in the first 30 days and is strongest for spontaneous (vs. procedure-related) bleeding.

  • 8. Farooq, Vasim
    et al.
    Girasis, Chrysafios
    Magro, Michael
    Onuma, Yoshinobu
    Morel, Marie Angèle
    Heo, Jung Ho
    Garcia-Garcia, Hector
    Kappetein, Arie Pieter
    van den Brand, Marcel
    Holmes, David R
    Mack, Michael
    Feldman, Ted
    Colombo, Antonio
    Ståhle, Elisabeth
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Thoracic Surgery.
    James, Stefan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Carrié, Didier
    Fournial, Gerard
    van Es, Gerrit-Anne
    Dawkins, Keith D
    Mohr, Friedrich W
    Morice, Marie-Claude
    Serruys, Patrick W
    The CABG SYNTAX Score - an angiographic tool to grade the complexity of coronary disease following coronary artery bypass graft surgery: from the SYNTAX Left Main Angiographic (SYNTAX-LE MANS) substudy2013In: EuroIntervention, ISSN 1774-024X, E-ISSN 1969-6213, Vol. 8, no 11, p. 1277-1285Article in journal (Refereed)
    Abstract [en]

    AIMS: The SYNTAX Score (SXscore) has established itself as an important prognostic tool in patients undergoing percutaneous coronary intervention (PCI). A limitation of the SXscore is the inability to differentiate outcomes in patients who have undergone prior coronary artery bypass graft (CABG) surgery. The CABG SXscore was devised to address this limitation.

    METHODS AND RESULTS: In the SYNTAX-LE MANS substudy 115 patients with unprotected left main coronary artery disease (isolated or associated with one, two or three-vessel disease) treated with CABG were prospectively assigned to undergo a 15-month coronary angiogram. An independent core laboratory analysed the baseline SXscore prior to CABG. The 15-month CABG SXscore was calculated by a panel of three interventional cardiologists. The CABG SXscore was calculated by determining the standard SXscore in the "native" coronary vessels ("native SXscore") and deducting points based on the importance of the diseased coronary artery segment (Leaman score) that have a functioning bypass graft anastomosed distally. Points relating to intrinsic coronary disease, such as bifurcation disease or calcification, remain unaltered. The mean 15-month CABG SXscore was significantly lower compared to the mean baseline SXscore (baseline SXscore 31.6, SD 13.1; 15-month CABG SXscore 21.2, SD 11.1; p<0.001). Reproducibility analyses (kappa [k] statistics) indicated a substantial agreement between CABG SXscore measurements (k=0.70; 95% CI [0.50-0.90], p<0.001), with the points deducted to calculate the CABG SXscore the most reproducible measurement (k=0.74; 95% CI [0.53-0.95], p<0.001). Despite the limited power of the study, four-year outcome data (Kaplan-Meier curves) demonstrated a trend towards reduced all-cause death (9.1% vs. 1.8%, p=0.084) and death/CVA/MI (16.4% vs. 7.0%, p=0.126) in the low compared to the high CABG SXscore group.

    CONCLUSIONS: In this pilot study the calculation of the CABG SXscore appeared feasible, reproducible and may have a long-term prognostic role in patients with complex coronary disease undergoing surgical revascularisation. Validation of this new scoring methodology is required.

  • 9. Farooq, Vasim
    et al.
    Girasis, Chrysafios
    Magro, Michael
    Onuma, Yoshinobu
    Morel, Marie-Angele
    Heo, Jung Ho
    Garcia-Garcia, Hector M.
    Kappetein, Arie Pieter
    van den Brand, Marcel
    Holmes, David R.
    Mack, Michael
    Feldman, Ted
    Colombo, Antonio
    Ståhle, Elisabeth
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Thoracic Surgery.
    James, Stefan K.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Carrie, Didier
    Fournial, Gerard
    van Es, Gerrit Anne
    Dawkins, Keith D.
    Mohr, Friedrich W.
    Morice, Marie-Claude
    Serruys, Patrick W.
    The coronary artery bypass graft SYNTAX Score: final five-year outcomes from the SYNTAX-LE MANS left main angiographic substudy2013In: EuroIntervention, ISSN 1774-024X, E-ISSN 1969-6213, Vol. 9, no 8, p. 1009-1010Article in journal (Refereed)
  • 10.
    Fokkema, Marieke L.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center. Univ Groningen, Univ Med Ctr Groningen, Dept Cardiol, Groningen, Netherlands.
    James, Stefan K.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    Albertsson, Per
    Sahlgrens Univ Hosp, Dept Cardiol, Gothenburg, Sweden.
    Aasa, Mikael
    Soder Sjukhuset, Dept Cardiol, Stockholm, Sweden.
    Åkerblom, Axel
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Calais, Fredrik
    Univ Orebro, Fac Hlth, Dept Cardiol, Orebro, Sweden.
    Eriksson, Peter
    Umea Univ Hosp, Dept Cardiol, Umea, Sweden.
    Jensen, Jens
    Sundsvall Harnosand Cty Hosp, Karolinska Inst, Dept Med, Stockholm, Sweden.
    Schersten, Fredrik
    Lund Univ, Skane Univ Hosp, Dept Cardiol, Lund, Sweden.
    de Smet, Bart J
    Univ Groningen, Univ Med Ctr Groningen, Dept Cardiol, Groningen, Netherlands; Meander Med Ctr, Dept Cardiol, Amersfoort, Netherlands.
    Sjögren, Iwar
    Falun Lasarett, Dept Cardiol, Falun, Sweden.
    Tornvall, Per
    arolinska Univ Hosp, Dept Cardiol, Stockholm, Sweden.
    Lagerqvist, Bo
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    Outcome after percutaneous coronary intervention for different indications: long-term results from the Swedish Coronary Angiography and Angioplasty Registry (SCAAR)2016In: EuroIntervention, ISSN 1774-024X, E-ISSN 1969-6213, Vol. 12, no 3, p. 303-311Article in journal (Refereed)
    Abstract [en]

    Aims: The aim of this study was to evaluate clinical outcome for different indications for PCI in an unselected, nationwide PCI population at short- and long-term follow-up. Methods and results: We evaluated clinical outcome up to six years after PCI in all patients undergoing a PCI procedure for different indications in Sweden between 2006 and 2010. A total of 70,479 patients were treated for stable coronary artery disease (CAD) (21.0%), unstable angina (11.0%), non-ST-elevation myocardial infarction (NSTEMI) (36.6%) and ST-elevation myocardial infarction (STEMI) (31.4%). Mortality was higher in STEMI patients at one year after PCI (9.6%) compared to NSTEMI (4.7%), unstable angina (2.2%) and stable CAD (2.0%). At one year after PCI until the end of follow-up, the adjusted mortality risk (one to six years after PCI) and the risk of myocardial infarction were comparable between NSTEMI and STEMI patients and lower in patients with unstable angina and stable CAD. The adjusted risk of stent thrombosis and heart failure was highest in STEMI patients. Conclusions: The risk of short-term mortality, heart failure and stent thrombosis is highest for STEMI patients after PCI. Therapies to reduce stent thrombosis and heart failure appear to be most important in decreasing mortality in patients with STEMI or NSTEMI undergoing PCI.

  • 11. Gorenek, Bulent
    et al.
    Blomström-Lundqvist, Carina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology-Arrhythmia.
    Brugada Terradellas, Josep
    Camm, A John
    Hindricks, Gerhard
    Huber, Kurt
    Kirchhof, Paulus
    Kuck, Karl-Heinz
    Kudaiberdieva, Gulmira
    Lin, Tina
    Raviele, Antonio
    Santini, Massimo
    Tilz, Roland Richard
    Valgimigli, Marco
    Vos, Marc A
    Vrints, Christian
    Zeymer, Uwe
    Cardiac arrhythmias in acute coronary syndromes: position paper from the joint EHRA, ACCA, and EAPCI task force2014In: EuroIntervention, ISSN 1774-024X, E-ISSN 1969-6213, Vol. 16, p. 1655-1673Article in journal (Refereed)
    Abstract [en]

    It is known that myocardial ischaemia and infarction leads to severe metabolic and electrophysiological changes that induce silent or symptomatic life-threatening arrhythmias. Sudden cardiac death is most often attributed to this pathophysiology, but many patients survive the early stage of an acute coronary syndrome (ACS) reaching a medical facility where the management of ischaemia and infarction must include continuous electrocardiographic (ECG) and hemodynamic monitoring, and a prompt therapeutic response to incident sustained arrhythmias. During the last decade, the hospital locations in which arrhythmias are most relevant have changed to include the cardiac catheterization laboratory, since the preferred management of early acute ACS is generally interventional in nature. However, a large proportion of patients are still managed medically.

    Both atrial and ventricular arrhythmias may occur in the setting of ACS and sustained ventricular tachyarrhythmias (VAs) may be associated with circulatory collapse and require immediate treatment. Atrial fibrillation (AF) may also warrant urgent treatment when a fast ventricular rate is associated with hemodynamic deterioration. The management of other arrhythmias is also based largely on symptoms rather than to avert progression to more serious arrhythmias. Prophylactic antiarrhythmic management strategies have largely been discouraged.

    Although the mainstay of antiarrhythmic therapy used to rely on antiarrhythmic drugs (AADs), particularly sodium channel blockers and amiodarone, their use has now declined, since clinical evidence to support such treatment has never been convincing. Therapy for acute coronary syndrome and arrhythmia management are now based increasingly on invasive approaches. The changes in the clinical approach to arrhythmia management in ACS have been so substantial that the European Heart Rhythm Association, the Acute Cardiovascular Care Association and the European Association of Percutaneous Cardiovascular Interventions established a task force to define the current position.

  • 12.
    Grimfjärd, Per
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology. Västerås Univ, Dept Cardiol, Västerås, Sweden..
    Erlinge, David
    Lund Univ, Skane Univ Hosp, Dept Cardiol, Lund, Sweden..
    Koul, Sasha
    Lund Univ, Skane Univ Hosp, Dept Cardiol, Lund, Sweden..
    Lagerqvist, Bo
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Svennblad, Bodil
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Varenhorst, Christoph
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    James, Stefan K.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Unfractionated heparin versus bivalirudin in patients undergoing primary percutaneous coronary intervention: a SWEDEHEART study2017In: EuroIntervention, ISSN 1774-024X, E-ISSN 1969-6213, Vol. 12, no 16, p. 2009-2017Article in journal (Refereed)
    Abstract [en]

    Aims: The aim of the stud was to compare outcomes in unfractionated heparin (UM) and bivalirudintreated patients undergoing primary percutaneous coronary intervention (PPCI). Methods and results: This observational study contained 20,612 PPCT patients treated with either GM monotherapv or bivalirudin with or without concomitant UFE. Patients with oral anticoagulant or glycoprotein IIb/IIIa inhibitor (GPI) treatment were excluded. The primary outcome measure was definite early stent thrombosis (Si) that occurred at low and similar rates in UNA only and bivalirudin-treated patients: 0.9% vs. 0.8% (adjusted hazard ratio [HR] 1.08, 95% confidence interval [CI]: 0.7-1.65). All-cause death at 30 days occurred in 6.9% vs. 5.4% of patients (adjusted HR 1.23, 95% Cl: 1.05-1.44) and within 365 days in 12.1% vs. 8.9% (adjusted HR 1.34, 95% CI: 1.19-1.52) in the two groups, respectively. The incidence of major bleeding within 30 days was 0.8% vs. 0.6% (adjusted HR 1.54, 95% CI: 0.97-2.45). The incidence of reinfarction within 365 days and stroke within 30 days was similar between groups. Conclusions: In this large, nationwide observational study we found low and similar rates of early ST in UFH only and bivalirudin-treated patients undergoing primary PCI. Mortality was higher in IJFH compared with bivalirudin-treated patients.

  • 13.
    Grimfjärd, Per
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology. Department of Cardiology, Västerås Hospital, Västerås, Sweden.
    James, Stefan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    Persson, Jonas
    Danderyd Hospital, Department of Cardiology, Stockholm, Sweden.
    Angerås, Oskar
    Sahlgrenska University Hospital, Department of Cardiology, Gothenburg, Sweden.
    Koul, Sasha
    Lund University, Skåne University Hospital, Department of Cardiology, Clinical Sciences, Lund, Sweden.
    Omerovic, Elmir
    Sahlgrenska University Hospital, Department of Cardiology, Gothenburg, Sweden.
    Varenhorst, Christoph
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Lagerqvist, Bo
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    Erlinge, David
    Lund University, Skåne University Hospital, Department of Cardiology, Clinical Sciences, Lund, Sweden.
    Outcome of percutaneous coronary intervention with the Absorb bioresorbable scaffold: data from the Swedish Coronary Angiography and Angioplasty Registry (SCAAR)2017In: EuroIntervention, ISSN 1774-024X, E-ISSN 1969-6213, Vol. 13, no 11, p. 1304-1311, article id EIJ-D-17-00458Article in journal (Refereed)
    Abstract [en]

    Aims: Randomised trials indicate higher rates of stent thrombosis (ST) and target lesion failure (TLF) after percutaneous coronary intervention (PCI) with the Absorb bioresorbable scaffold (BRS) compared with modern drug-eluting stents (DES). We aimed to investigate the outcome of all Swedish patients treated with the Absorb BRS.

    Methods and results: The Absorb BRS (n=810) was compared with commonly used modern DES (n=67,909). The main outcome measure was definite ST; mean follow-up was two years. Despite being implanted in a younger, lower-risk population compared with modern DES, the Absorb BRS was associated with a higher crude incidence of definite ST at stent level: 1.5 vs. 0.6%, hazard ratio (HR) 2.38 (95% confidence interval [CI]: 1.34-4.23), adjusted HR 4.34 (95% CI: 2.37-7.94); p<0.001. The patient level adjusted HR was 4.44 (95% CI: 2.25-8.77). Rates of in-stent restenosis were similar for BRS and DES. Non-compliance with dual antiplatelet therapy (DAPT) guidelines was noted in six out of 12 BRS ST events. Three very late ST events occurred with the Absorb BRS.

    Conclusions: In this real-world observational study, the Absorb BRS was associated with a significantly higher risk of definite ST compared with modern DES. Non-compliance with DAPT guideline recommendations was common among Absorb definite ST events.

  • 14.
    Kappetein, Arie Pieter
    et al.
    Erasmus MC, Dept Cardiothorac Surg, Rotterdam, Netherlands..
    Serruys, Patrick W.
    Imperial Coll London, NHLI, Int Ctr Circulatory Hlth, London, England..
    Sabik, Joseph F.
    Cleveland Clin Fdn, Dept Thorac & Cardiovasc Surg, 9500 Euclid Ave, Cleveland, OH 44195 USA..
    Leon, Martin B.
    Columbia Univ, Dept Med, Med Ctr, New York, NY USA.;Cardiovasc Res Fdn, New York, NY USA..
    Taggart, David P.
    John Radcliffe Hosp, Dept Cardiac Surg, Oxford, England..
    Morice, Marie-Claude
    Inst Hosp Jacques Cartier, Dept Cardiol, Massy, France..
    Gersh, Bernard J.
    Mayo Clin, Coll Med, Dept Cardiovasc Dis, Rochester, MN USA..
    Pocock, Stuart J.
    London Sch Hyg & Trop Med, Dept Med Stat, London, England..
    Cohen, David J.
    St Lukes Mid Amer Heart Inst, Kansas City, MO USA..
    Wallentin, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Ben-Yehuda, Ori
    Columbia Univ, Dept Med, Med Ctr, New York, NY USA.;Cardiovasc Res Fdn, New York, NY USA..
    van Es, Gerrit-Anne
    Cardialysis, Rotterdam, Netherlands..
    Simonton, Charles A.
    Abbott Vasc, Santa Clara, CA USA..
    Stone, Gregg W.
    Columbia Univ, Dept Med, Med Ctr, New York, NY USA.;Cardiovasc Res Fdn, New York, NY USA..
    Design and rationale for a randomised comparison of everolimus-eluting stents and coronary artery bypass graft surgery in selected patients with left main coronary artery disease: the EXCEL trial2016In: EuroIntervention, ISSN 1774-024X, E-ISSN 1969-6213, Vol. 12, no 7, p. 861-872Article in journal (Refereed)
    Abstract [en]

    Aims: Coronary artery bypass graft (CABG) surgery is the standard of care for revascularisation of patients with left main coronary artery disease (LMCAD). Recent studies have suggested that percutaneous coronary intervention (PCI) with drug-eluting stents (DES) may provide comparable outcomes in selected patients with LMCAD without extensive CAD. We therefore designed a trial to investigate whether PCI with XIENCE cobalt-chromium everolimus-eluting stents (CoCr-EES) would result in non-inferior or superior clinical outcomes to CABG in selected patients with LMCAD. Methods and results: The Evaluation of XIENCE versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization (EXCEL) trial is a prospective, open-label, multicentre, international study of 1,900 randomised subjects. Patients with significant LMCAD with a SYNTAX score <= 32 and local Heart Team consensus that the subject is appropriate for revascularisation by both PCI and CABG are consented and randomised 1:1 to undergo PCI using CoCr-EES or CABG. All patients undergo follow-up for five years. The primary endpoint is the three-year composite rate of death, stroke or myocardial infarction, assessed at a median follow-up of at least three years (with at least two-year follow-up in all patients), powered for sequential non-inferiority and superiority testing. Conclusions: The EXCEL study will define the contemporary roles of CABG and PCI using XIENCE CoCr-EES in patients with LMCAD disease with low and intermediate SYNTAX scores.

  • 15.
    Perk, Joep
    et al.
    Linnaeus University, Kalmar, Sweden.
    Hambraeus, Kristina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    Burell, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Carlsson, Roland
    Department of Cardiology, Karlstad.
    Johansson, Pelle
    Heart and Lung Patients Association, Stockholm Sweden.
    Lisspers, Jan
    Mid Sweden University, Östersund.
    Study of Patient Information after Percutaneous Coronary Intervention (SPCI): should prevention programmes become more effective?2015In: EuroIntervention, ISSN 1774-024X, E-ISSN 1969-6213, Vol. 10, no 11, p. e1-e7Article in journal (Refereed)
    Abstract [en]

    Aims:

    This cross-sectional observational study was designed to evaluate the uptake and outcome of patient education after percutaneous coronary intervention (PCI).

    Methods and results:

    A questionnaire containing 41 items was handed out to consecutive patients from randomly selected Swedish hospitals after PCI. Questions concerned the patient's attribution of the cause of the cardiac event, perception of the information provided by physicians and nurses, and a self-assessment of changes in lifestyle post PCI regarding tobacco, physical activity, food habits and stress. Replies were obtained from 1,073 patients (reply rate 67%). Non-modifiable risk factors (age, heredity) were attributed a higher rate as the cause of disease compared to modifiable factors (smoking, physical activity, food habits). Most patients (67%) perceived they were cured, and 38% perceived from the given information that there was no need to change their habits. A mere 27% reported that they still had cardiovascular disease and needed behavioural change. After PCI, 16% continued to use tobacco; half of these were offered smoking cessation support. In spite of an 80% referral rate to cardiac rehabilitation, one out of two patients did not enrol. Fewer than half were regularly physically active. Nutritional counselling was provided to 71%, but only 40% changed food habits. Stress management programmes were rarely provided.

    Conclusions:

    Current preventive practice scarcely meets the challenge posed by the progress in modern invasive cardiology. The Study of Patient Information after percutaneous Coronary Intervention (SPICI) motivates an in-depth revision and adaptation of cardiac rehabilitation programmes in order to improve patient understanding of the disease, and to support greater compliance with a cardioprotective lifestyle.

  • 16.
    Sarno, Giovanna
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Garg, Scot
    Gomez-Lara, Josep
    Garcia Garcia, Hector M
    Ligthart, Jurgen
    Bruining, Nico
    Onuma, Yoshinobu
    Witberg, Karen
    van Geuns, Robert-Jan
    de Boer, Sanneke
    Wykrzykowska, Joanna
    Schultz, Carl
    Duckers, Henricus J
    Regar, Evelyn
    de Jaegere, Peter
    de Feyter, Pim
    van Es, Gerrit Anne
    Boersma, Eric
    van der Giessen, Wim
    Serruys, Patrick W
    Intravascular ultrasound radiofrequency analysis after optimal coronary stenting with initial quantitative coronary angiography guidance: an ATHEROREMO sub-study2011In: EuroIntervention, ISSN 1774-024X, E-ISSN 1969-6213, Vol. 6, no 8, p. 977-984Article in journal (Refereed)
    Abstract [en]

    AIMS:

    To investigate whether the use of intravascular ultrasound virtual histology (IVUS-VH) leads to any improvements in stent deployment, when performed in patients considered to have had an optimal percutaneous coronary intervention (PCI) by quantitative coronary angiography (QCA).

    METHODS AND RESULTS:

    After optimal PCI result (residual stenosis by QCA<30%), IVUS-VH was performed in 100 patients by protocol, with the option to use the information left to the discretion of the operators. Patients were categorised as: Group1 (n=54), where the IVUS-VH findings were used to evaluate the need for further optimisation of the stent deployment; and Group2 (n=46), where the IVUS-VH was documentary such that the stenting results were considered optimal according to QCA. Optimal stent deployment on IVUS-VH was defined as: normal stent expansion, absence of stent malapposition, complete lesion coverage as indicated by a plaque burden (PB%) between 30-40% and necrotic core confluent to the lumen<10% or PB%<30% at the 5 mm proximal and distal to the stent. The first IVUS-VH in all patients demonstrated the achievement of optimal stent deployment, incomplete lesion coverage, stent under-expansion and stent-edge dissection in 60%, 31%, 20% and 8% of patients, respectively. There was no stent malapposition. In Group 1, 25 patients had optimal stent deployment and did not require further intervention, whilst in 29 patients further intervention was needed (additional stent, n=18; post-dilatation, n=29). Overall optimal stent deployment was finally achieved in 52/54 patients (96%) in Group 1 and 35/46 (76%) of Group 2, p<0.05.

    CONCLUSIONS:

    IVUS-VH may have a role in facilitating optimal stent implantation and complete lesion coverage.

  • 17. Schwalm, Torsten
    et al.
    Carlsson, Jorg
    Meissner, Axel
    Lagerqvist, Bo
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    James, Stefan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Current treatment and outcome of coronary in-stent restenosis in Sweden: a report from the Swedish Coronary Angiography and Angioplasty Registry (SCAAR)2013In: EuroIntervention, ISSN 1774-024X, E-ISSN 1969-6213, Vol. 9, no 5, p. 564-572Article in journal (Refereed)
    Abstract [en]

    Aims: The aim of this study was to evaluate treatment of coronary in-stent restenosis (ISR). Methods and results: We investigated interventions for ISR and the occurrence of re-restenosis in the Swedish Angiography and Angioplasty Registry (SCAAR). From January 1st 2005 to March 3rd 2012, 212,166 coronary segments were treated and 7,806 restenoses analysed. During seven years of follow-up 1,079 re-restenoses were registered on clinically driven angiography. For BMS-ISR the adjusted risk of re-restenosis was significantly lower with DES (adjusted hazard ratio [BR] 0.71,95% confidence interval [CI]: 0.61-0.82), tended to be lower with DEB (HR 0.84, 95% CI: 0.62-1.16), but higher with BMS (BR 1.24, 95% CI: 1.0-1.55) as compared to balloon angioplasty. For DES-ISR a new DES was associated with a significantly lower adjusted risk of re-restenosis (HR. 0.80, 95% CI: 0.66-0.99), and a similar but non-significant reduction with DEB (BR 0.86, 95% CI: 0.57-1.30) and BMS (BR 0.81, 95% CI: 0.53-1.24) compared to balloon angioplasty. For DES-ISR a DES with a different drug was not more effective than a DES with the same drug. Conclusions: ISR in BMS should be treated with DES or DEB while the optimal treatment of ISR in DES remains to be proven.

  • 18.
    Tzikas, Apostolos
    et al.
    AHEPA Univ Hosp, Thessaloniki, Greece..
    Holmes, David R., Jr.
    Mayo Clin, Rochester, MN USA..
    Gafoor, Sameer
    CardioVasc Ctr Frankfitrt, Frankfurt, Germany..
    Ruiz, Carlos E.
    Hackensack UMC Heart & Vasc Hosp, Hackensack, NJ USA.;Joseph M Sanzari Childrens Hosp, Hackensack, NJ USA..
    Blomström-Lundqvist, Carina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology-Arrhythmia.
    Diener, Hans-Christoph
    Univ Duisburg Essen, Univ Hosp Essen, Dept Neurol, Essen, Germany..
    Cappato, Riccardo
    IRCCS Humanitas Res Hosp, Arrhythmia & Electrophysiol Res Ctr, Milan, Italy.;Humanitas Gavazzeni, Arrhythmia & Electrophysiol Ctr 2, Bergamo, Italy..
    Kar, Saibal
    Cedars Sinai Med Ctr, Los Angeles, CA 90048 USA..
    Lee, Randal J.
    Univ Calif San Francisco, Cardiovasc Res Inst, San Francisco, CA USA.;Univ Calif San Francisco, Dept Med, San Francisco, CA USA..
    Byrne, Robert A.
    Tech Univ Munich, Deutsch Herzzentrum Munchen, Munich, Germany..
    Ibrahim, Reda
    Univ Montreal, Montreal Heart Inst, Montreal, PQ, Canada..
    Lakkireddy, Dhanunjaya
    Univ Kansas Hosp, KU Cardiovasc Res Inst, Bloch Heart Rhythm Ctr, Kansas City, KS USA..
    Soliman, Osama I.
    Erasmus MC, Thoraxctr, Cardialysis, Rotterdam, Netherlands.;Erasmus MC, Thoraxctr, Dept Cardiol, Rotterdam, Netherlands..
    Naebauer, Michael
    Univ Munich, Med Klin & Poliklin 1, Munich, Germany..
    Schneider, Steffen
    Fdn IHF, Stung Inst Herzinfarktforsch, Ludwigshafen, Germany..
    Brachman, Johannes
    Coburg GmbH, Med Hosp Klinikum 2, Coburg, Germany..
    Saver, Jeffrey L.
    Univ Calif Los Angeles, David Geffen Sch Med, Comprehens Stroke Ctr, Los Angeles, CA 90095 USA.;Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurol, Los Angeles, CA 90095 USA..
    Tiemane, Klaus
    Tech Univ Munich, Dept Nucl Med, Munich, Germany..
    Sievert, Horst
    CardioVasc Ctr Frankfitrt, Frankfurt, Germany..
    Camm, A. John
    St Georges Univ London, Cardiovasc, London, England.;St Georges Univ London, Cell Sci Res Inst, London, England..
    Lewalter, Thorsten
    Univ Munich, Med Klin & Poliklin 1, Munich, Germany.;Clin Munich Thalkirchen, Peter Osypka Heart Ctr, Dept Med Cardiol & Intens Care, Munich, Germany..
    Percutaneous left atrial appendage occlusion: the Munich consensus document on definitions, endpoints and data collection requirements for clinical studies2016In: EuroIntervention, ISSN 1774-024X, E-ISSN 1969-6213, Vol. 12, no 1, p. 103-111Article in journal (Refereed)
    Abstract [en]

    The increasing interest in left atrial appendage occlusion (LAAO) for ischaemic stroke prevention in atrial fibrillation (AF) fuels the need for more clinical data on the safety and effectiveness of this therapy. Besides an assessment of the effectiveness of the therapy in specific patient groups, comparisons with pharmacological stroke prophylaxis, surgical approaches and other device-based therapies are warranted. This paper documents the consensus reached among clinical experts in relevant disciplines from Europe and North America, European cardiology professional societies and representatives from the medical device industry regarding defmitions for parameters and endpoints to be assessed in clinical studies. Adherence to these definitions is proposed in order to achieve a consistent approach across clinical studies on LAAO among the involved stakeholders and various clinical disciplines and thereby facilitate continued evaluation of therapeutic strategies available.

  • 19.
    Witt, Nils
    et al.
    Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, and Unit of Cardiology, Södersjukhuset, Stockholm, Sweden.
    Rück, Andreas
    Department of Medicine, Karolinska Institutet, and Department of Cardiology, Karolinska University Hospital, Stockholm.
    James, Stefan K
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology.
    Koul, Sasha
    Department of Cardiology, Skåne University Hospital, Lund University, Lund, Sweden .
    Lagerqvist, Bo
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    Sweden: coronary and structural heart interventions from 2010 to 20152017In: EuroIntervention, ISSN 1774-024X, E-ISSN 1969-6213, Vol. 13, no Z, p. Z70-Z74, article id EIJ-D-16-00830Article in journal (Refereed)
    Abstract [en]

    Sparsely populated and with wide non-urbanised areas, Sweden faces specific challenges in providing publicly financed, high-quality and equal healthcare to all parts of the country. As a result, a decentralised organisation for acute coronary care has been developed with coronary care units and catheterisation laboratories in several small- and medium-sized city areas. In contrast, highly specialised non-emergent interventional procedures are centralised to a few high-volume centres, mainly located at university hospitals in large city areas. Nationwide quality registries with nearly complete coverage facilitate healthcare quality improvement and form a basis for clinical research. In this report, we present an overview of demographics, healthcare organisation, quality registries and procedural data for coronary and structural heart interventions in Sweden over the past six years.

1 - 19 of 19
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