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Jonsson, F., Olofsson, B., Söderberg, S. & Niklasson, J. (2024). Association between the COVID-19 pandemic and mental health in very old people in Sweden. PLOS ONE, 19(4), Article ID e0299098.
Open this publication in new window or tab >>Association between the COVID-19 pandemic and mental health in very old people in Sweden
2024 (English)In: PLOS ONE, E-ISSN 1932-6203, Vol. 19, no 4, article id e0299098Article in journal (Refereed) Published
Abstract [en]

Background: During the COVID-19 pandemic, Sweden implemented social distancing measures to reduce infection rates. However, the recommendation meant to protect individuals particularly at risk may have had negative consequences. The aim of this study was to investigate the impact of the COVID-19 pandemic on very old Swedish peoples' mental health and factors associated with a decline in mental health.

Methods: We conducted a cross-sectional study among previous participants of the SilverMONICA (MONItoring of Trends and Determinants of CArdiovascular disease) study. Of 394 eligible participants, 257 (65.2%) agreed to participate. Of these, 250 individuals reported mental health impact from COVID-19. Structured telephone interviews were carried out during the spring of 2021. Data were analysed using the χ2 test, t-test, and binary logistic regression.

Results: Of 250 individuals (mean age: 85.5 ± 3.3 years, 54.0% women), 75 (30.0%) reported a negative impact on mental health, while 175 (70.0%) reported either a positive impact (n = 4) or no impact at all (n = 171). In the binary logistic regression model, factors associated with a decline in mental health included loneliness (odds ratio [95% confidence interval]) (3.87 [1.83-8.17]) and difficulty adhering to social distancing recommendations (5.10 [1.92-13.53]). High morale was associated with positive or no impact on mental health (0.37 [0.17-0.82]).

Conclusions: A high percentage of very old people reported a negative impact on mental health from the COVID-19 pandemic, primarily from loneliness and difficulty adhering to social distancing measures, while high morale seemed to be a protective factor.

Place, publisher, year, edition, pages
Public Library of Science (PLoS), 2024
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-223268 (URN)10.1371/journal.pone.0299098 (DOI)38564616 (PubMedID)2-s2.0-85189507899 (Scopus ID)
Funder
Umeå University
Available from: 2024-04-17 Created: 2024-04-17 Last updated: 2024-04-17Bibliographically approved
Arnold, N., Blaum, C., Goßling, A., Brunner, F. J., Bay, B., Ferrario, M. M., . . . Waldeyer, C. (2024). C-reactive protein modifies lipoprotein(a)-related risk for coronary heart disease: the BiomarCaRE project. European Heart Journal, 45(12), 1043-1054
Open this publication in new window or tab >>C-reactive protein modifies lipoprotein(a)-related risk for coronary heart disease: the BiomarCaRE project
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2024 (English)In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 45, no 12, p. 1043-1054Article in journal (Refereed) Published
Abstract [en]

Background and Aims: Recent investigations have suggested an interdependence of lipoprotein(a) [Lp(a)]-related risk for cardiovascular disease with background inflammatory burden. The aim the present analysis was to investigate whether high-sensitive C-reactive protein (hsCRP) modulates the association between Lp(a) and coronary heart disease (CHD) in the general population.

Methods: Data from 71 678 participants from 8 European prospective population-based cohort studies were used (65 661 without/6017 with established CHD at baseline; median follow-up 9.8/13.8 years, respectively). Fine and Gray competing risk-adjusted models were calculated according to accompanying hsCRP concentration (<2 and ≥2 mg/L).

Results: Among CHD-free individuals, increased Lp(a) levels were associated with incident CHD irrespective of hsCRP concentration: fully adjusted sub-distribution hazard ratios [sHRs (95% confidence interval)] for the highest vs. lowest fifth of Lp(a) distribution were 1.45 (1.23-1.72) and 1.48 (1.23-1.78) for a hsCRP group of <2 and ≥2 mg/L, respectively, with no interaction found between these two biomarkers on CHD risk (Pinteraction = 0.82). In those with established CHD, similar associations were seen only among individuals with hsCRP ≥ 2 mg/L [1.34 (1.03-1.76)], whereas among participants with a hsCRP concentration <2 mg/L, there was no clear association between Lp(a) and future CHD events [1.29 (0.98-1.71)] (highest vs. lowest fifth, fully adjusted models; Pinteraction = 0.024).

Conclusions: While among CHD-free individuals Lp(a) was significantly associated with incident CHD regardless of hsCRP, in participants with CHD at baseline, Lp(a) was related to recurrent CHD events only in those with residual inflammatory risk. These findings might guide adequate selection of high-risk patients for forthcoming Lp(a)-targeting compounds.

Place, publisher, year, edition, pages
Oxford University Press, 2024
Keywords
Coronary heart disease, Epidemiology, General population, High-sensitive C-reactive protein, Lipoprotein(a)
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-223062 (URN)10.1093/eurheartj/ehad867 (DOI)38240386 (PubMedID)2-s2.0-85189079840 (Scopus ID)
Funder
EU, FP7, Seventh Framework Programme, HEALTH-F2-2011-278913EU, FP7, Seventh Framework Programme, HEALTH-F3-2010-242244EU, FP7, Seventh Framework Programme, HEALTH- F4-2007-201413EU, Horizon 2020, 825903EU, Horizon 2020, 847770EU, Horizon 2020, 648131NIH (National Institutes of Health)Swedish Heart Lung Foundation, 20140799Swedish Heart Lung Foundation, 20120631Swedish Heart Lung Foundation, 20100635Region Västerbotten, VLL-548791Umeå University
Available from: 2024-04-18 Created: 2024-04-18 Last updated: 2024-04-18Bibliographically approved
Law, L., Lindqvist, P., Liv, P., Hellman, U., Lejon, K., Geijer, M., . . . Forsblad-d'Elia, H. (2024). Increased carotid intima-media thickness in patients with radiographic axial spondyloarthritis compared to controls and associations with markers of inflammation. Clinical Rheumatology, 43(5), 1559-1570
Open this publication in new window or tab >>Increased carotid intima-media thickness in patients with radiographic axial spondyloarthritis compared to controls and associations with markers of inflammation
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2024 (English)In: Clinical Rheumatology, ISSN 0770-3198, E-ISSN 1434-9949, Vol. 43, no 5, p. 1559-1570Article in journal (Refereed) Published
Abstract [en]

Objective: There is an increased risk for cardiovascular disease (CVD) in patients with radiographic axial spondyloarthritis (r-axSpA). In this cross-sectional study, we aimed to, overall and stratified by sex, (i) compare ultrasound derived carotid intima media thickness (cIMT), between patients and controls, and (ii) investigate associations between cIMT, clinical disease activity and inflammation-related laboratory markers in patients with r-axSpA.

Method: In total, 155 patients diagnosed with r-axSpA using the modified New York criteria and 400 controls were included. Bilateral carotid ultrasound, laboratory testing, and questionaries were acquired. Disease-specific assessments were carried out for patients. Linear regression analysis was used to assess associations.

Results: Linear regression analyses showed that patients with r-axSpA had increased mean cIMT compared to controls (mean ± SD, 0.8 ± 0.1 mm vs 0.7± 0.1 mm, respectively, unstandardized β (95% CI) -0.076 (-0.10, -0.052), P < 0.001) adjusted for smoking status and age. Linear regression analyses for patients with r-axSpA showed that only males presented significant associations between cIMT and inflammation-related laboratory markers, white blood cell (WBC) count (mean ± SD, 6.8 ± 1.6 109/L) and monocytes (0.6 ± 0.2 109/L); WBC count (unstandardized β (95% CI) 0.019 (0.0065, 0.031), P = 0.003, R2 = 0.57) and monocytes (0.13 (0.0047, 0.26), P = 0.041, R2 = 0.55), adjusted for age, smoking status, body mass index, hypertension, dyslipidemia, diabetes mellitus, ASDAS-CRP, and treatment with DMARDs and glucocorticoids. No significant association was found between cIMT and clinical disease activity assessed by ASDAS-CRP.

Conclusion: Patients with r-axSpA had significantly increased cIMT compared to controls. In male patients, higher WBC and monocyte count were associated with an increase in cIMT suggesting the role of inflammation in the development of atherosclerosis. 

Place, publisher, year, edition, pages
Springer Nature, 2024
Keywords
Cardiovascular disease (CVD), Carotid intima-media thickness (cIMT), Radiographic axial spondyloarthritis (r-axSpA), Ultrasound
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-221778 (URN)10.1007/s10067-024-06913-8 (DOI)001176391500001 ()38443604 (PubMedID)2-s2.0-85186622797 (Scopus ID)
Funder
Swedish Research CouncilRegion VästerbottenStiftelsen Konung Gustaf V:s 80-årsfond
Available from: 2024-03-06 Created: 2024-03-06 Last updated: 2024-04-18Bibliographically approved
Shimanda, P. P., Shumba, T. W., Brunström, M., Iipinge, S. N., Söderberg, S., Lindholm, L. & Norström, F. (2024). Preventive interventions to reduce the burden of rheumatic heart disease in populations at risk: a systematic review. Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, 13(5), Article ID e032442.
Open this publication in new window or tab >>Preventive interventions to reduce the burden of rheumatic heart disease in populations at risk: a systematic review
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2024 (English)In: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, E-ISSN 2047-9980, Vol. 13, no 5, article id e032442Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Rheumatic heart disease (RHD) is a devastating yet preventable condition that disproportionately affects low-middle-income countries and indigenous populations in some high-income countries. Various preventive interventions have been implemented across the globe, but evidence for the effectiveness of these measures in reducing the incidence or prevalence of acute rheumatic fever and RHD is scattered. This systematic review aims to assess the effectiveness of preventive interventions and identify the strategies used to reduce the burden of RHD.

METHODS AND RESULTS: A comprehensive search was conducted to identify relevant studies on RHD prevention interventions including interventions for primordial, primary, and secondary prevention. Effectiveness measures for the interventions were gathered when available. The findings indicate that school-based primary prevention services targeting the early detection and treatment of Group A Streptococcus pharyngitis infection with penicillin have the potential to reduce the incidence of Group A Streptococcus pharyngitis and acute rheumatic fever. Community-based programs using various prevention strategies also reduced the burden of RHD. However, there is limited evidence from low-middle-income countries and a lack of rigorous evaluations reporting the true impact of the interventions. Narrative synthesis was performed, and the methodological quality appraisal was done using the Joanna Briggs Institute critical appraisal tools.

CONCLUSIONS: This systematic review underscores the importance of various preventive interventions in reducing the incidence and burden of Group A Streptococcus pharyngitis, acute rheumatic fever, and RHD. Rigorous evaluations and comprehensive analyses of interventions are necessary for guiding effective strategies and informing public health policies to prevent and reduce the burden of these diseases in diverse populations.

REGISTRATION: URL: https://www.crd.york.ac.uk/prospero/; Unique identifier: CRD42020170503.

Place, publisher, year, edition, pages
American Heart Association, 2024
Keywords
RHD prevention, acute rheumatic fever, rheumatic heart disease, systematic review
National Category
Health Sciences Public Health, Global Health, Social Medicine and Epidemiology
Research subject
cardiovascular disease; Public health; Epidemiology
Identifiers
urn:nbn:se:umu:diva-221473 (URN)10.1161/JAHA.123.032442 (DOI)38390809 (PubMedID)2-s2.0-85187199895 (Scopus ID)
Funder
Familjen Erling-Perssons Stiftelse
Available from: 2024-02-23 Created: 2024-02-23 Last updated: 2024-04-02Bibliographically approved
Engström, G., Lampa, E., Dekkers, K., Lin, Y.-T., Ahlm, K., Ahlström, H., . . . Sundström, J. (2024). Pulmonary function and atherosclerosis in the general population: causal associations and clinical implications. European Journal of Epidemiology, 39(1), 35-49
Open this publication in new window or tab >>Pulmonary function and atherosclerosis in the general population: causal associations and clinical implications
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2024 (English)In: European Journal of Epidemiology, ISSN 0393-2990, E-ISSN 1573-7284, Vol. 39, no 1, p. 35-49Article in journal (Refereed) Published
Abstract [en]

Reduced lung function is associated with cardiovascular mortality, but the relationships with atherosclerosis are unclear. The population-based Swedish CArdioPulmonary BioImage study measured lung function, emphysema, coronary CT angiography, coronary calcium, carotid plaques and ankle-brachial index in 29,593 men and women aged 50–64 years. The results were confirmed using 2-sample Mendelian randomization. Lower lung function and emphysema were associated with more atherosclerosis, but these relationships were attenuated after adjustment for cardiovascular risk factors. Lung function was not associated with coronary atherosclerosis in 14,524 never-smokers. No potentially causal effect of lung function on atherosclerosis, or vice versa, was found in the 2-sample Mendelian randomization analysis. Here we show that reduced lung function and atherosclerosis are correlated in the population, but probably not causally related. Assessing lung function in addition to conventional cardiovascular risk factors to gauge risk of subclinical atherosclerosis is probably not meaningful, but low lung function found by chance should alert for atherosclerosis.

Place, publisher, year, edition, pages
Springer Nature, 2024
Keywords
Atherosclerosis, Coronary heart disease, Emphysema, Spirometry
National Category
Cardiac and Cardiovascular Systems Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-219309 (URN)10.1007/s10654-023-01088-z (DOI)001132630700001 ()38165527 (PubMedID)2-s2.0-85181226926 (Scopus ID)
Funder
EU, European Research Council, ERC-2018-STG-801965Swedish Research Council, 2019-01471Swedish Heart Lung Foundation, 20200173Swedish Heart Lung Foundation, 20190505Göran Gustafsson Foundation for Research in Natural Sciences and MedicineAxel och Signe Lagermans donationsstiftelseKnut and Alice Wallenberg FoundationVinnovaUniversity of GothenburgKarolinska InstituteRegion StockholmLinköpings universitetLund UniversityUmeå UniversityUppsala University
Available from: 2024-01-15 Created: 2024-01-15 Last updated: 2024-05-07Bibliographically approved
Muller, A., Escribano-Subias, P., Fernandes, C. C., Fontana, M., Lange, T. J., Söderberg, S. & Gaine, S. (2024). Real-world management of patients with pulmonary arterial hypertension: insights from EXPOSURE. Advances in Therapy, 41(3), 1103-1119
Open this publication in new window or tab >>Real-world management of patients with pulmonary arterial hypertension: insights from EXPOSURE
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2024 (English)In: Advances in Therapy, ISSN 0741-238X, E-ISSN 1865-8652, Vol. 41, no 3, p. 1103-1119Article in journal (Refereed) Published
Abstract [en]

Introduction: Further insights into real-world management and outcomes of patients with pulmonary arterial hypertension (PAH) are needed. This interim analysis of the ongoing, multicentre, prospective EXPOSURE (EUPAS19085) observational study describes characteristics, treatment patterns and outcomes of patients with PAH initiating a new PAH-specific therapy in Europe/Canada.

Methods and Results: All analyses were descriptive. In total, 1944 patients with follow-up information were included; the majority were female, with World Health Organization functional class II/III symptoms and with idiopathic PAH or connective tissue disease-associated PAH. Most incident patients (N = 1100; diagnosed for ≤ 6 months) initiated treatment as monotherapy (48%) or double therapy (43%). Of those initiating monotherapy, 38% (199/530) escalated to double therapy (median [Q1, Q3] time to escalation 3.4 [1.9, 6.6] months), and of those initiating double therapy, 17% (78/457) escalated to triple therapy (median [Q1, Q3] time to escalation 7.0 [3.4, 12.7] months) during the observation period (median [Q1, Q3]: 17.0 [7.5, 29.9] months). The majority of the 834 prevalent patients (diagnosed > 6 months) entered the study on initiation of combination therapy and most did not change treatment regimen during the observation period (median [Q1, Q3]: 19.6 [10.2, 32.2] months). One-year survival was 88% for incident patients and 90% for prevalent patients.

Conclusions: Results from EXPOSURE suggest a shift towards combination therapy and the alignment of real-world treatment patterns with current guideline recommendations. While survival estimates are encouraging, the extent of monotherapy use at treatment initiation and follow-up highlight an opportunity for further improvements through optimisation of treatment strategies in line with current guidelines.

A graphical abstract is also available with this article.

Trial Registration Number: EUPAS19085.

Place, publisher, year, edition, pages
Springer Nature, 2024
Keywords
Epidemiology, Outcomes, Pulmonary arterial hypertension, Real-world evidence, Survival, Treatment patterns
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-219825 (URN)10.1007/s12325-023-02730-8 (DOI)001142087300001 ()38216826 (PubMedID)2-s2.0-85182202295 (Scopus ID)
Available from: 2024-01-22 Created: 2024-01-22 Last updated: 2024-05-07Bibliographically approved
Reinikainen, J., Kuulasmaa, K., Oskarsson, V., Amouyel, P., Biasch, K., Brenner, H., . . . Niiranen, T. (2024). Regional and temporal differences in the associations between cardiovascular disease and its classic risk factors: an analysis of 49 cohorts from 11 European countries. European Journal of Preventive Cardiology, 31(5), 569-577
Open this publication in new window or tab >>Regional and temporal differences in the associations between cardiovascular disease and its classic risk factors: an analysis of 49 cohorts from 11 European countries
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2024 (English)In: European Journal of Preventive Cardiology, ISSN 2047-4873, E-ISSN 2047-4881, Vol. 31, no 5, p. 569-577Article in journal (Refereed) Published
Abstract [en]

Aims: The regional and temporal differences in the associations between cardiovascular disease (CVD) and its classic risk factors are unknown. The current study examined these associations in different European regions over a 30-year period.

Methods and results: The study sample comprised 553 818 individuals from 49 cohorts in 11 European countries (baseline: 1982-2012) who were followed up for a maximum of 10 years. Risk factors [sex, smoking, diabetes, non-HDL cholesterol, systolic blood pressure (BP), and body mass index (BMI)] and CVD events (coronary heart disease or stroke) were harmonized across cohorts. Risk factor-outcome associations were analysed using multivariable-adjusted Cox regression models, and differences in associations were assessed using meta-regression. The differences in the risk factor-CVD associations between central Europe, northern Europe, southern Europe, and the UK were generally small. Men had a slightly higher hazard ratio (HR) in southern Europe (P = 0.043 for overall difference), and those with diabetes had a slightly lower HR in central Europe (P = 0.022 for overall difference) compared with the other regions. Of the six CVD risk factors, minor HR decreases per decade were observed for non-HDL cholesterol [7% per mmol/L; 95% confidence interval (CI), 3-10%] and systolic BP (4% per 20 mmHg; 95% CI, 1-8%), while a minor HR increase per decade was observed for BMI (7% per 10 kg/m2; 95% CI, 1-13%).

Conclusion: The results demonstrate that all classic CVD risk factors are still relevant in Europe, irrespective of regional area. Preventive strategies should focus on risk factors with the greatest population attributable risk.

Place, publisher, year, edition, pages
Oxford University Press, 2024
Keywords
Cardiovascular disease, Coronary heart disease, Europe, Risk factor, Stroke
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-223090 (URN)10.1093/eurjpc/zwad359 (DOI)001117280000001 ()37976098 (PubMedID)2-s2.0-85186508558 (Scopus ID)
Available from: 2024-04-11 Created: 2024-04-11 Last updated: 2024-04-11Bibliographically approved
Almevall, A., Dahlin Almevall, A., Öhlin, J., Gustafson, Y., Zingmark, K., Niklasson, J., . . . Olofsson, B. (2024). Self-rated health in old age, related factors and survival: A 20-Year longitudinal study within the Silver-MONICA cohort. Archives of gerontology and geriatrics (Print), 122, Article ID 105392.
Open this publication in new window or tab >>Self-rated health in old age, related factors and survival: A 20-Year longitudinal study within the Silver-MONICA cohort
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2024 (English)In: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 122, article id 105392Article in journal (Refereed) Published
Abstract [en]

Introduction: Self-rated health (SRH) offers insights into the evolving health demographics of an ageing population.

Aim: To assess change in SRH from old age to very old age and their associations with health and well-being factors, and to investigate the association between SRH and survival.

Methods: All participants in the MONICA 1999 re-examination born before 1940 (n = 1595) were included in the Silver-MONICA baseline cohort. The Silver-MONICA follow-up started in 2016 included participants in the Silver-MONICA baseline cohort aged 80 years or older. Data on SRH was available for 1561 participants at baseline with 446 of them also participating in the follow-up. The follow-up examination included a wide variety of measurements and tests.

Findings: Most participants rated their health as "Quite good" (54.5 %) at baseline. Over the study period, 42.6 % had stable SRH, 40.6 % had declined, and 16.8 % had improved. Changes in SRH were at follow-up significantly associated with age, pain, nutrition, cognition, walking aid use, self-paced gait speed, lower extremity strength, independence in activities of daily living, weekly physical exercise, outdoor activity, participation in organized activities, visiting others, morale, and depressive symptoms. SRH at baseline was significantly associated with survival (p < 0.05).

Conclusion: This study demonstrates associations between changes in SRH and a multitude of health- and wellbeing-related factors, as well as a relation between survival and SRH, accentuating their relevance within the ageing population.

Place, publisher, year, edition, pages
Elsevier, 2024
Keywords
Aged 80 and over, Aging/psychology, Diagnostic self evaluation, Longitudinal studies, Population characteristics, Self-rated health, Survival analysis
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-222682 (URN)10.1016/j.archger.2024.105392 (DOI)38492492 (PubMedID)2-s2.0-85187986768 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2016-01074Swedish Research Council, K2014-99X-22610-01-6Visare NorrNorrbotten County CouncilRegion VästerbottenSwedish Dementia CentreFoundation for the Memory of Ragnhild and Einar LundströmSwedish Society of MedicineKonung Gustaf V:s och Drottning Victorias Frimurarestiftelse
Available from: 2024-04-09 Created: 2024-04-09 Last updated: 2024-04-09Bibliographically approved
Hansén, N., Ljungberg, J., Bergdahl, I., Hultdin, J., Näslund, U., Johansson, B. & Söderberg, S. (2023). Adipokines are possible risk markers for aortic stenosis requiring surgery. Scandinavian Cardiovascular Journal, 57(1), Article ID 2247193.
Open this publication in new window or tab >>Adipokines are possible risk markers for aortic stenosis requiring surgery
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2023 (English)In: Scandinavian Cardiovascular Journal, ISSN 1401-7431, E-ISSN 1651-2006, Vol. 57, no 1, article id 2247193Article in journal (Refereed) Published
Abstract [en]

Objectives: Aortic stenosis (AS) is the most prevalent valvular heart disease among adults. The adipocyte-derived hormones, leptin and adiponectin, have profound metabolic actions. We examined whether these adipokines are independently associated with future aortic valve replacement (AVR).

Design: In this longitudinal case-control study, we identified 336 cases who had undergone AVR due to AS, and who had previously participated in population-based health surveys. Two referents were matched to each case and leptin and adiponectin concentrations were analysed from stored baseline survey samples. Uni- and multivariable logistic regression analyses were used to estimate the risk of future AVR. An additional cohort was identified for validation including 106 cases with AVR and 212 matched referents.

Results: Median age (interquartile range (IQR)) in years at survey was 59.9 (10.4) and at surgery 68.3 (12.7), and 48% were women. An elevated concentration of leptin was not associated with future AVR (odds ratio [95% confidence interval]) (1.10 [0.92–1.32]), although leptin was associated with a higher risk in patients with coronary artery disease (CAD) having more than 5 years between survey and AVR (1.41 [1.08–1.84]). Adiponectin was not associated with higher risk for future AVR (0.95 [0.82–1.11]), although after stratification for age, higher levels were associated with reduced risk for AVR in persons aged ≥60 years at surgery (0.79 [0.64–0.98]). In the validation study, leptin was associated with future AVR whereas adiponectin was not. None of the associations remained significant after adjustment for body mass index (BMI).

Conclusions: The adipokine leptin may promote the development of AS.

Place, publisher, year, edition, pages
Taylor & Francis, 2023
Keywords
adiponectin, Aortic stenosis, fat mass, leptin, prospective study, risk markers
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-214075 (URN)10.1080/14017431.2023.2247193 (DOI)001050266400001 ()37592808 (PubMedID)2-s2.0-85168287214 (Scopus ID)
Funder
Swedish Heart Lung Foundation, 20100635Swedish Heart Lung Foundation, 20120631Swedish Heart Lung Foundation, 20140799Swedish Heart Lung Foundation, 20130630Region Västerbotten, RV-967561Umeå University, 964731
Available from: 2023-09-04 Created: 2023-09-04 Last updated: 2023-09-04Bibliographically approved
Cederström, S., Lundman, P., Alfredsson, J., Hagström, E., Ravn-Fischer, A., Söderberg, S., . . . Jernberg, T. (2023). Association between high-sensitivity C-reactive protein and coronary atherosclerosis in a general middle-aged population. Scientific Reports, 13(1), Article ID 12171.
Open this publication in new window or tab >>Association between high-sensitivity C-reactive protein and coronary atherosclerosis in a general middle-aged population
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2023 (English)In: Scientific Reports, E-ISSN 2045-2322, Vol. 13, no 1, article id 12171Article in journal (Refereed) Published
Abstract [en]

Despite abundant knowledge about the relationship between inflammation and coronary atherosclerosis, it is still unknown whether systemic inflammation measured as high-sensitivity C-reactive protein (hsCRP) is associated with coronary atherosclerosis in a general population. This study aimed to examine the association between hsCRP and coronary computed tomography angiography (CCTA)-detected coronary atherosclerosis in a population-based cohort. Out of 30,154 randomly invited men and women aged 50 to 64 years in the Swedish Cardiopulmonary Bioimage Study (SCAPIS), 25,408 had a technically acceptable CCTA and analysed hsCRP. Coronary atherosclerosis was defined as presence of plaque of any degree in any of 18 coronary segments. HsCRP values were categorised in four groups. Compared with hsCRP below the detection limit, elevated hsCRP (≥ 2.3 mg/L) was weakly associated with any coronary atherosclerosis (OR 1.15, 95% CI 1.07–1.24), coronary diameter stenosis ≥ 50% (OR 1.27, 95% CI 1.09–1.47), ≥ 4 segments involved (OR 1.13, 95% CI 1.01–1.26 ) and severe atherosclerosis (OR 1.33, 95% CI 1.05–1.69) after adjustment for age, sex and traditional risk factors. The associations were attenuated after further adjustment for body mass index (BMI), although elevated hsCRP still associated with noncalcified plaques (OR 1.16, 95% CI 1.02–1.32), proposed to be more vulnerable. In conclusion, the additional value of hsCRP to traditional risk factors in detection of coronary atherosclerosis is low. The association to high-risk noncalcified plaques, although unlikely through a causal pathway, could explain the relationship between hsCRP and clinical coronary events in numerous studies.

Place, publisher, year, edition, pages
Springer Nature, 2023
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-212742 (URN)10.1038/s41598-023-39051-3 (DOI)37500663 (PubMedID)2-s2.0-85165905600 (Scopus ID)
Funder
Karolinska Institute
Available from: 2023-08-14 Created: 2023-08-14 Last updated: 2023-08-14Bibliographically approved
Projects
Impact of living conditions and health in middle age on active and healthy aging: The Silver MONICA study [2016-01074_Forte]; Umeå University
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-9225-1306

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