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  • 1.
    Bajraktari, Artan
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för medicin.
    Bytyci, Ibadete
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för medicin. University College, Bardhosh, Kosovo; Clinic of Cardiology, University Clinical Centre of Kosovo, Prishtina, Kosovo.
    Henein, Michael Y.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för medicin. Molecular and Clinic Research Institute, St George University, London, andBrunel University, United Kingdom.
    High Coronary Wall Shear Stress Worsens Plaque Vulnerability: A Systematic Review and Meta-Analysis2021Ingår i: Angiology, ISSN 0003-3197, E-ISSN 1940-1574, Vol. 72, nr 8, s. 706-714Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Aim: The aim of this meta-analysis is to assess the impact of wall shear stress (WSS) severity on arterial plaque vulnerability.

    Methods: We systematically searched electronic databases and selected studies which assessed the relationship between WSS measured by intravascular ultrasound and coronary artery plaque features. In 7 studies, a total of 615 patients with 28 276 arterial segments (median follow-up: 7.71 months) were identified. At follow-up, the pooled analysis showed high WSS to be associated with regression of plaque fibrous area, weighted mean difference (WMD) −0.11 (95% CI: −0.20 to −0.02, P = .02) and fibrofatty area, WMD −0.09 (95% CI: −0.17 to −0.01, P = .02), reduction in plaque total area, WMD −0.09 (95% CI: −0.14 to −0.04, P = .007) and increased necrotic core area, and WMD 0.04 (95% CI: 0.01-0.09, P = .03) compared with low WSS. Dense calcium deposits remained unchanged in high and low WSS (0.01 vs 0.02 mm2; P > .05). High WSS resulted in profound remodeling (40% vs 18%, P < .05) and with more constructive remodeling than low WSS (78% vs 40%, P < .01).

    Conclusions: High WSS in coronary arteries is associated with worsening plaque vulnerability and more profound arterial wall remodeling compared with low WSS.

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  • 2.
    Bajraktari, Artan
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Kardiologi.
    Bytyci, Ibadete
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Kardiologi. Clinic of Cardiology, University Clinical Centre of Kosovo, Prishtina, Kosovo.
    Henein, Michael Y.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Kardiologi. Institute of Environment & Health and Societies, Brunel University, Middlesex, UK; Molecular and Clinic Research Institute, St George University, London, UK.
    The Relationship between Coronary Artery Wall Shear Strain and Plaque Morphology: A Systematic Review and Meta-Analysis2020Ingår i: Diagnostics (Basel), ISSN 2075-4418, Vol. 10, nr 2, artikel-id 91Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Background and Aim: Arterial wall shear strain (WSS) has been proposed to impact the features of atherosclerotic plaques. The aim of this meta-analysis was to assess the impact of different types of WSS on plaque features in coronary artery disease (CAD).

    Methods: We systematically searched PubMed-Medline, EMBASE, Scopus, Google Scholar, and the Cochrane Central Registry, from 1989 up to January 2020 and selected clinical trials and observational studies which assessed the relationship between WSS, measured by intravascular ultrasound (IVUS), and plaque morphology in patients with CAD.

    Results: In four studies, a total of 72 patients with 13,098 coronary artery segments were recruited, with mean age 57.5 +/- 9.5 years. The pooled analysis showed that low WSS was associated with larger baseline lumen area (WMD 2.55 [1.34 to 3.76, p < 0.001]), smaller plaque area (WMD 1.16 [-1.84 to -0.49, p = 0.0007]), lower plaque burden (WMD -12.7 [-21.4 to -4.01, p = -0.04]), and lower necrotic core area (WMD -0.32 [-0.78 to 0.14, p = 0.04]). Low WSS also had smaller fibrous area (WMD -0.79 [-1.88 to -0.30, p = 0.02]) and smaller fibro-fatty area (WMD 0.22 [-0.57 to 0.13, p = 0.02]), compared with high WSS, but the dense calcium score was similar between the two groups (WMD -0.17 [-0.47 to 0.13, p = 0.26]). No differences were found between intermediate and high WSS.

    Conclusions: High WSS is associated with signs of plaque instability such as higher necrotic core, higher calcium score, and higher plaque burden compared with low WSS. These findings highlight the role of IVUS in assessing plaque vulnerability.

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  • 3.
    Bajraktari, Gani
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin. Clinic of Cardiology, University Clinical Centre of Kosova, Kosovo, Prishtina; Medical Faculty, University of Prishtina, Kosovo, Prishtina.
    Bytyci, Ibadete
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin. Clinic of Cardiology, University Clinical Centre of Kosova, Kosovo, Prishtina; Medical Faculty, University of Prishtina, Kosovo, Prishtina.
    Abdyli, Genc
    Clinic of Cardiology, University Clinical Centre of Kosova, Kosovo, Prishtina; Medical Faculty, University of Prishtina, Kosovo, Prishtina.
    Ibrahimi, Pranvera
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin. Clinic of Cardiology, University Clinical Centre of Kosova, Kosovo, Prishtina.
    Bajraktari, Artan
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin. Clinic of Cardiology, University Clinical Centre of Kosova, Kosovo, Prishtina.
    Karahoda, Rona
    Department of Pharmacology and Toxicology, Faculty of Pharmacy in Hradec Králové, Charles University, Prague, Czech Republic.
    Elezi, Shpend
    Clinic of Cardiology, University Clinical Centre of Kosova, Kosovo, Prishtina; Medical Faculty, University of Prishtina, Kosovo, Prishtina.
    Henein, Michael Y.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
    One-month dual antiplatelet therapy reduces major bleeding compared with longer-term treatment without excess stent thrombosis: a systematic review and meta-analysis of randomized clinical trials2024Ingår i: American Journal of Cardiology, ISSN 0002-9149, E-ISSN 1879-1913, Vol. 227, s. 91-97Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Dual antiplatelet therapy (DAPT) remains the gold standard in patients who underwent percutaneous coronary intervention (PCI). This meta-analysis aims to evaluate the clinical safety of 1-month DAPT followed by aspirin or a P2Y12 receptor inhibitor after PCI with drug-eluting stents (DES). We searched PubMed, MEDLINE, Embase, Scopus, Google Scholar, Cochrane Central Registry, and ClinicalTrials.gov databases and identified 5 randomized controlled trials with 29,831 patients who underwent PCI with DES and compared 1-month versus >1-month DAPT. The primary end point was major bleeding, and the co-primary end point was stent thrombosis. The secondary end point included all-cause mortality, cardiovascular death, myocardial infarction, stroke, and major adverse cardiovascular or cerebrovascular events. Compared with >1-month DAPT, the 1-month DAPT was associated with a lower rate of major bleeding (odds ratio [OR] 0.66, 95% confidence interval [CI] 0.45 to 0.97, p = 0.03, I2 = 71%), whereas stent thrombosis had a similar rate in both study groups (OR 1.08, 95% CI 0.81 to 1.44, p = 0.60, I2 = 0.0%). The study groups had similar risks for all-cause mortality (OR 0.89, 95% CI 0.77 to 1.04, p = 0.14, I2 = 0.0%), cardiovascular death (OR 0.84, 95% CI 0.59 to 1.19, p = 0.32, I2 = 0.0%), myocardial infarction (OR 1.04, 95% CI 0.89 to 1.21, p = 0.62, I2 = 0.0%), and stroke (OR 0.82, 95% CI 0.64 to 1.05, p = 0.11, I2 = 6%). The risk of major adverse cardiovascular or cerebrovascular events was lower (OR 0.86, 95% CI 0.76 to 0.97, p = 0.02, I2 = 25%) in the 1-month DAPT compared with >1-month DAPT. In conclusion, in patients who underwent PCI with DES, 1-month DAPT followed by aspirin or a P2Y12 receptor inhibitor reduced major bleeding with no risk of increased thrombotic risk compared with longer-term DAPT.

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  • 4.
    Bajraktari, Gani
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för medicin. Clinic of Cardiology, University Clinical Centre of Kosova, University of Prishtina, Prishtina, Kosovo.
    Bytyci, Ibadete
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för medicin. Clinic of Cardiology, University Clinical Centre of Kosova, University of Prishtina, Prishtina, Kosovo.
    Bajraktari, Artan
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för medicin. Clinic of Cardiology, University Clinical Centre of Kosova, University of Prishtina, Prishtina, Kosovo.
    Henein, Michael Y.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för medicin.
    Non-inferiority of 1 month versus longer dual antiplatelet therapy in patients undergoing PCI with drug-eluting stents: a systematic review and meta-analysis of randomized clinical trials2022Ingår i: Therapeutic Advances in Chronic Disease, ISSN 2040-6223, Vol. 13Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: The aim of this meta-analysis was to evaluate the safety of 1-month dual antiplatelet therapy (DAPT) followed by aspirin or a P2Y12 receptor inhibitor, after percutaneous coronary intervention (PCI) with drug-eluting stents (DES), based on the available evidence.

    Methods: PubMed, MEDLINE, Embase, Scopus, Google Scholar, CENTRAL, and ClinicalTrials.gov database search identified four RCTs of 26,431 patients who underwent PCI with DES and compared 1-month versus >1-month DAPT. The primary endpoint was major bleeding and co-primary endpoint stent thrombosis, and secondary endpoints included all-cause mortality, cardiovascular death, myocardial infarction (MI), stroke, and major adverse clinical events (MACE).

    Results: Compared with >1-month DAPT, the 1-month DAPT was associated with a similar rate of major bleeding (OR = 0.74, 95%CI: 0.51–1.07, p = 0.11, I2 = 67%), stent thrombosis (OR = 1.10, 95%CI: 0.82–1.47, p = 0.53, I2 = 0.0%), similar risk for all-cause mortality (OR = 0.89, 95%CI: 0.77–1.04, p = 0.14, I2 = 0%), CV death (OR = 0.80, 95% CI: 0.55–1.60, p = 0.24, I2 = 0.0%), MI (OR = 1.02, 95% CI: 0.88–1.19, p = 0.78, I2 = 0.0%), and stroke (OR = 0.76, 95% CI: 0.54–1.08, p = 0.13, I2 = 29%). The risk of MACE was lower (OR = 0.84, 95% CI: 0.73–0.98, p = 0.02, I2 = 39%) in the 1-month DAPT compared with the >1-month DAPT. Only patients with stable CAD had lower risk of MACE with 1-month DAPT (OR = 0.81, 95% CI: 0.67–0.98, p = 0.03, I2 = 21%) compared with >1-month DAPT.

    Conclusion: This meta-analysis proved the non-inferiority of 1-month DAPT followed by aspirin or a P2Y12 receptor inhibitor compared with long-term DAPT in patients undergoing PCI with DES.

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  • 5.
    Bajraktari, Gani
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för medicin. Clinic of Cardiology, University Clinical Centre of Kosova, Prishtina, Kosovo; Medical Faculty, University of Prishtina “Hasan Prishtina”, Prishtina, Kosovo; UBT College, Prishtina, Kosovo.
    Rexhaj, Zarife
    Elezi, Shpend
    Zhubi-Bakija, Fjolla
    Bajraktari, Artan
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för medicin. Clinic of Cardiology, University Clinical Centre of Kosova, Prishtina, Kosovo.
    Bytyci, Ibadete
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för medicin. Clinic of Cardiology, University Clinical Centre of Kosova, Prishtina, Kosovo.
    Batalli, Arlind
    Henein, Michael Y.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för medicin.
    Radial Access for Coronary Angiography Carries Fewer Complications Compared with Femoral Access: A Meta-Analysis of Randomized Controlled Trials2021Ingår i: Journal of Clinical Medicine, E-ISSN 2077-0383, Vol. 10, nr 10, artikel-id 2163Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Background and Aim: In patients undergoing diagnostic coronary angiography (CA) and percutaneous coronary interventions (PCI), the benefits associated with radial access compared with the femoral access approach remain controversial. The aim of this meta-analysis was to compare the short-term evidence-based clinical outcome of the two approaches. Methods: The PubMed, Embase, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov databases were searched for randomized controlled trials (RCTs) comparing radial versus femoral access for CA and PCI. We identified 34 RCTs with 29,352 patients who underwent CA and/or PCI and compared 14,819 patients randomized for radial access with 14,533 who underwent procedures using femoral access. The follow-up period for clinical outcome was 30 days in all studies. Data were pooled by meta-analysis using a fixed-effect or a random-effect model, as appropriate. Risk ratios (RRs) were used for efficacy and safety outcomes.Results: Compared with femoral access, the radial access was associated with significantly lower risk for all-cause mortality (RR: 0.74; 95% confidence interval (CI): 0.61 to 0.88; p = 0.001), major bleeding (RR: 0.53; 95% CI:0.43 to 0.65; p ˂ 0.00001), major adverse cardiovascular events (MACE)(RR: 0.82; 95% CI: 0.74 to 0.91; p = 0.0002), and major vascular complications (RR: 0.37; 95% CI: 0.29 to 0.48; p ˂ 0.00001). These results were consistent irrespective of the clinical presentation of ACS or STEMI. Conclusions: Radial access in patients undergoing CA with or without PCI is associated with lower mortality, MACE, major bleeding and vascular complications, irrespective of clinical presentation, ACS or STEMI, compared with femoral access.

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  • 6.
    Bajraktari, Gani
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Kardiologi. Clinic of Cardiology, University Clinical Centre of Kosova, Prishtina, Kosovo; Medical Faculty, University of Prishtina “Hasan Prishtina”, Prishtina, Kosovo.
    Zhubi-Bakija, Fjolla
    Ndrepepa, Gjin
    Alfonso, Fernando
    Elezi, Shpend
    Rexhaj, Zarife
    Bytyçi, Ibadete
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Kardiologi. Clinic of Cardiology, University Clinical Centre of Kosova, Prishtina, Kosovo.
    Bajraktari, Artan
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Kardiologi.
    Poniku, Afrim
    Henein, Michael Y.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Kardiologi.
    Long-Term Outcomes of Patients with Unprotected Left Main Coronary Artery Disease Treated with Percutaneous Angioplasty versus Bypass Grafting: A Meta-Analysis of Randomized Controlled Trials2020Ingår i: Journal of Clinical Medicine, E-ISSN 2077-0383, Vol. 9, nr 7, artikel-id 2231Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background and Aim: Treatment of patients with left main coronary artery disease (LMCA) with percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) remains controversial. The aim of this meta-analysis was to compare the long-term clinical outcomes of patients with unprotected LMCA treated randomly by PCI or CABG. Methods: PubMed, MEDLINE, Embase, Scopus, Google Scholar, CENTRAL and ClinicalTrials.gov database searches identified five randomized trials (RCTs) including 4499 patients with unprotected LMCA comparing PCI (n= 2249) vs. CABG (n= 2250), with a minimum clinical follow-up of five years. Random effect risk ratios were used for efficacy and safety outcomes. The study was registered in PROSPERO. The primary outcome was major adverse cardiac events (MACE), defined as a composite of death from any cause, myocardial infarction or stroke. Results: Compared to CABG, patients assigned to PCI had a similar rate of MACE (risk ratio (RR): 1.13; 95% CI: 0.94 to 1.36;p= 0.19), myocardial infarction (RR: 1.48; 95% CI: 0.97 to 2.25;p= 0.07) and stroke (RR: 0.87; 95% CI: 0.62 to 1.23;p= 0.42). Additionally, all-cause mortality (RR: 1.07; 95% CI: 0.89 to 1.28;p= 0.48) and cardiovascular (CV) mortality (RR: 1.13; 95% CI: 0.89 to 1.43;p= 0.31) were not different. However, the risk of any repeat revascularization (RR: 1.70; 95% CI: 1.34 to 2.15;p< 0.00001) was higher in patients assigned to PCI. Conclusions: The findings of this meta-analysis suggest that the long-term survival and MACE of patients who underwent PCI for unprotected LMCA stenosis were comparable to those receiving CABG, despite a higher rate of repeat revascularization.

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  • 7.
    Batalli, Arlind
    et al.
    Clinic of Cardiology, University Clinical Centre of Kosova, Prishtina, Kosovo; Medical Faculty, University of Prishtina, Prishtina, Kosovo.
    Henein, Michael Y.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
    Poniku, Afrim
    Clinic of Cardiology, University Clinical Centre of Kosova, Prishtina, Kosovo; Medical Faculty, University of Prishtina, Prishtina, Kosovo.
    Ibrahimi, Pranvera
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin. Clinic of Cardiology, University Clinical Centre of Kosova, Prishtina, Kosovo.
    Pllana-Pruthi, Edita
    Clinic of Cardiology, University Clinical Centre of Kosova, Prishtina, Kosovo.
    Elezi, Shpend
    Clinic of Cardiology, University Clinical Centre of Kosova, Prishtina, Kosovo; Medical Faculty, University of Prishtina, Prishtina, Kosovo.
    Shatri, Faik
    Clinic of Cardiology, University Clinical Centre of Kosova, Prishtina, Kosovo.
    Abdyli, Genc
    Clinic of Cardiology, University Clinical Centre of Kosova, Prishtina, Kosovo; Medical Faculty, University of Prishtina, Prishtina, Kosovo.
    Bajraktari, Artan
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin. Clinic of Cardiology, University Clinical Centre of Kosova, Prishtina, Kosovo.
    Karahoda, Rona
    Research Unit, Heimerer College, 10000, Prishtina, Kosovo.
    Selmani, Hamza
    Clinic of Cardiology, University Clinical Centre of Kosova, Prishtina, Kosovo.
    Bytyci, Ibadete
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin. Clinic of Cardiology, University Clinical Centre of Kosova, Prishtina, Kosovo; Medical Faculty, University of Prishtina, Prishtina, Kosovo.
    Bajraktari, Gani
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin. Clinic of Cardiology, University Clinical Centre of Kosova, Prishtina, Kosovo; Medical Faculty, University of Prishtina, Prishtina, Kosovo.
    Management and clinical outcome of myocardial infarction in Kosovo: a cross-sectional study2024Ingår i: Health Science Reports, E-ISSN 2398-8835, Vol. 7, nr 10, artikel-id e70122Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background and Aims: Myocardial infarction (MI) is a major cause of mortality worldwide, irrespective of its presentation as non-ST-segment elevation MI (NSTEMI) or ST-segment elevation MI (STEMI). The objective of this study was to assess national results of management and clinical outcome of acute MI patients in Kosovo.

    Methods: This cross-sectional descriptive study, conducted at the Clinic of Cardiology of the University Clinical Center of Kosovo, in Prishtina, included all patients hospitalized with acute MI over a period of 7 years (2014-2020). The primary outcome of the study was in-hospital mortality.

    Results: Among 7353 admitted patients with acute MI (mean age 63 ± 12 years, 29% female) and according to the final diagnosis, 4436 (59.4%) patients had STEMI, and 2987 (40.6%) NSTEMI. More patients with STEMI received primary percutaneous intervention (PPCI) than those with NSTEMI (50% vs. 41%, p < 0.001). In-hospital mortality was higher in no PPCI patients compared to PPCI both in NSTEMI (10.7% vs. 2.6%, p < 0.001) and STEMI (20.9% vs. 6.8%, p < 0.001). Age ≥65 years [0.399 (0.267–0.597), p ˂ 0.001], hemoglobin level [0.889 (0.815–0.970), p = 0.008], STEMI [0.491 (0.343–0.704), p ˂ 0.001], lack of PPCI [2.636 (1.798–3.866), p ˂ 0.001], cardiogenic shock [0.002 (0.001–0.006), p < 0.001], reduced left ventricular ejection fraction (LV EF) [0.966 (0.951–0.980), p < 0.001], and heart rate at admission [1.009 (1.000–1.017), p = 0.047], independently predicted mortality. In STEMI, cardiogenic shock (p ˂ 0.001), lack of PPCI (p = 0.006), female gender (p = 0.01), and low LV EF (p = 0.04) predicted mortality but age ≥65 years (p = 0.02), female gender (p = 0.02), low LV EF (p = 0.007), and low hemoglobin (p = 0.04) predicted mortality in NSTEMI.

    Conclusion: Between 2014 and 2020, half of patients with acute MI were not treated with PPCI, who had high mortality, particularly when presenting with STEMI. Age, cardiogenic shock, anemia, low LV EF, STEMI and no PPCI independently predicted mortality. Cardiogenic shock and lack of PPCI independently predicted mortality, only in STEMI.

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  • 8.
    Bytyci, Ibadete
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin. Clinic of Cardiology, Prishtina, Albania.
    Bajraktari, Gani
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin. Clinic of Cardiology, Prishtina, Albania.
    Ibrahimi, Pranvera
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin. Clinic of Cardiology, Prishtina, Albania.
    Lindqvist, Per
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin. Clinic of Cardiology, Prishtina, Albania.
    Henein, Michael
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin. Clinic of Cardiology, Prishtina, Albania.
    The relationship between left atrial measurements and cavity pressure: a systematic review and meta-analysis2018Ingår i: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 71, nr 11, s. 911-911Artikel i tidskrift (Övrigt vetenskapligt)
  • 9.
    Bytyci, Ibadete
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Kardiologi. Clinic of Cardiology, University Clinical Centre of Kosovo, 10000 Prishtina, Kosovo.
    Dini, Frank L.
    Bajraktari, Artan
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Kardiologi.
    Pugliese, Nicola Riccardo
    D'Agostino, Andreina
    Bajraktari, Gani
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Kardiologi. Clinic of Cardiology, University Clinical Centre of Kosovo, 10000 Prishtina, Kosovo.
    Lindqvist, Per
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Klinisk fysiologi. Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Kardiologi.
    Henein, Michael Y.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Klinisk fysiologi. Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Kardiologi.
    Speckle Tracking-Derived Left Atrial Stiffness Predicts Clinical Outcome in Heart Failure Patients with Reduced to Mid-Range Ejection Fraction2020Ingår i: Journal of Clinical Medicine, E-ISSN 2077-0383, Vol. 9, nr 5, artikel-id 1244Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background and Aim: Left atrial stiffness (LASt) is an important marker of cardiac function, especially in patients with heart failure (HF); it explains symptoms on the basis of pressure transfer to the pulmonary circulation. The aim of this study was to evaluate the relationship between LASt and cardiac events (CE) in HF patients with reduced to mid-range ejection fraction.

    Methods: The study included 215 consecutive ambulatory HF patients with ejection fraction (EF) < 50% (162 HF reduced EF and 53 HF mid-range EF) of mean age 66 +/- 11 years and 24.4% females. Peak LA strain (PALS) was measured by speckle tracking echocardiography and E/e' recorded from the apical four-chamber view. Non-invasive LASt was calculated using the equation: LASt = E/e' ratio/PALS. Documented cardiac events (CE) were HF hospitalization and cardiac death.

    Results: During a median follow up of 41 +/- 34 months, 65 patients (30%) had CE. In multivariate analysis model, only raised LV filling pressure (E/e') (OR = 0.292, (95% CI 0.099 to 0.859), p = 0.02), peak pulmonary artery pressure (PAP) (OR = 1.050 (1.009 to 1.094), p = 0.01), PALS (OR = 0.932 (0.873 to 0.994), p = 0.02) and LASt (OR = 3.781 (1.144 to 5.122), p = 0.001) independently predicted CE. LASt >= 0.76% was the most powerful predictor of CE, with 80% sensitivity and 73% specificity (AUC 0.82, CI = 0.73 to 0.87, p < 0.001) followed by PALS <= 16%, with 74% sensitivity and 72% specificity (AUC 0.77, CI = 0.71 to 0.84, p < 0.001). These results were consistent irrespective of EF (p < 0.05).

    Conclusion: In this cohort of ambulatory HFrEF and HFmrEF patients, LASt proved the most powerful predictor of clinical outcome.

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  • 10. Poniku, Afrim
    et al.
    Bajraktari, Gani
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Kardiologi. Clinic of Cardiology, University Clinical Centre of Kosova, Prishtina, Kosovo; Medical Faculty, University of Prishtina, Prishtina, Kosovo.
    Elezi, Shpend
    Ibrahimi, Pranvera
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för medicin. Clinic of Cardiology, University Clinical Centre of Kosova, Prishtina, Kosovo.
    Henein, Michael Y.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Kardiologi.
    Adiponectin correlates with body mass index and to a lesser extent with left ventricular mass in dialysis patients2018Ingår i: Cardiology Journal, ISSN 1897-5593, Vol. 25, nr 4, s. 501-511Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Adiponectin is a serum protein produced by adipose tissue which exerts anti-inflammatory, anti-diabetic and anti-atherosclerotic properties, hence is considered a cardio-protective marker. With the current uncertain role of adiponectin in dialysis patients to the aim of this study was to investigate its relationship with left ventricular (LV) structure and function in these patients.

    Methods: This study included 89 (age 56 +/- 13 years, 43% male) patients treated with regular dialysis for > 6 months, and 55 control subjects with normal renal function. A complete two-dimensional, M- ode and tissue-Doppler echocardiographic study, and biochemical blood analyses, adiponectin and anthropometric parameters were obtainedon the same day.

    Results: Dialysis patients had lower body mass index (BMI) and lower body surface area (BSA) (p < 0.001 for both), lower waist/hips ratio (p = 0.005), higher LV mass index (LVMI, p < 0.001), higher adiponectin level (p < 0.001) and LV end-systolic volume p = 0.003), lower LV ejection fraction (p = 0.006), longer isovolumic relaxation time (p < 0.001), lower mean LV strain (p = 0.002), larger left atrium volume (p = 0.022) and lower left atrium emptying fraction (p = 0.026), compared to controls. In dialysis patients, adiponectin correlated with waist circumference (r = -0.427, p < 0.001), BMI (r = -0.403, p < 0.001) and BSA (r = -0.480, p < 0.001), and to a lesser extent with LVMI (r = 0.296, p = 0.005), waist/hips ratio (r = -0.222, p = 0.037) and total cholesterol (r = -0.292, p = 0.013). But in controls, it correlated only modestly with age (r = 0.304, p = 0.024), hemoglobin (r = 0.371, p = 0.005), high density lipoprotein cholesterol (r = 0.315, p = 0.019) and LVMI (r = 0277, p = 0.043).

    Conclusions: It seems that in dialysis patients, adiponectin modest correlation with anthropometric measurements suggests an ongoing catabolic process rather than a change in ventricular function.

  • 11.
    Poniku, Afrim
    et al.
    Medical Faculty, University of Prishtina, Prishtina, Kosovo; Clinic of Cardiology, University Clinical Centre of Kosova, Prishtina, Kosovo.
    Batalli, Arlind
    Medical Faculty, University of Prishtina, Prishtina, Kosovo; Clinic of Cardiology, University Clinical Centre of Kosova, Prishtina, Kosovo.
    Shita, Dua
    Medical Faculty, University of Prishtina, Prishtina, Kosovo.
    Rexhaj, Zarife
    Clinic of Cardiology, University Clinical Centre of Kosova, Prishtina, Kosovo.
    Ferati, Arlind
    Clinic of Cardiology, University Clinical Centre of Kosova, Prishtina, Kosovo.
    Leka, Rita
    Clinic of Cardiology, University Clinical Centre of Kosova, Prishtina, Kosovo.
    Bajraktari, Artan
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin. Clinic of Cardiology, University Clinical Centre of Kosova, Prishtina, Kosovo.
    Abdyli, Genc
    Medical Faculty, University of Prishtina, Prishtina, Kosovo; Clinic of Cardiology, University Clinical Centre of Kosova, Prishtina, Kosovo.
    Haliti, Edmond
    Medical Faculty, University of Prishtina, Prishtina, Kosovo; Clinic of Cardiology, University Clinical Centre of Kosova, Prishtina, Kosovo.
    Ibrahimi, Pranvera
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin. Clinic of Cardiology, University Clinical Centre of Kosova, Prishtina, Kosovo.
    Karahoda, Rona
    Research Unit, Heimerer College, Prishtina, Kosovo.
    Elezi, Shpend
    Clinic of Cardiology, University Clinical Centre of Kosova, Prishtina, Kosovo.
    Shatri, Faik
    Clinic of Cardiology, University Clinical Centre of Kosova, Prishtina, Kosovo.
    Bytyci, Ibadete
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin. Clinic of Cardiology, University Clinical Centre of Kosova, Prishtina, Kosovo.
    Henein, Michael Y.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
    Bajraktari, Gani
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin. Medical Faculty, University of Prishtina, Prishtina, Kosovo; Clinic of Cardiology, University Clinical Centre of Kosova, Prishtina, Kosovo.
    Smoking and hypertriglyceridemia predict st-segment elevation myocardial infarction in Kosovo patients with acute myocardial infarction2024Ingår i: Clinics and Practice, ISSN 2039-7275, E-ISSN 2039-7283, Vol. 14, nr 3, s. 1149-1158Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Myocardial infarction (MI), presented as ST-segment elevation MI (STEMI) and non-ST-segment elevation MI (NSTEMI), is influenced by atherosclerosis risk factors. Aim: The aim of this study was to assess the patterns of presentation of patients with acute MI in Kosovo. Methods: This was a cross-sectional study conducted at the University Clinical Center of Kosovo, which included all patients hospitalized with acute MI over a period of 7 years. Results: Among the 7353 patients admitted with acute MI (age 63 ± 12 years, 29% female), 59.4% had STEMI and 40.6% had NSTEMI. The patients with NSTEMI patients less (48.3% vs. 54%, p < 0.001), but more of them had diabetes (37.8% vs. 33.6%, p < 0.001), hypertension (69.6% vs. 63%, p < 0.001), frequently had a family history of coronary artery disease (CAD) (40% vs. 38%, p = 0.009), and had more females compared to the patients with STEMI (32% vs. 27%, p < 0.001). The patients with NSTEMI underwent less primary percutaneous interventions compared with the patients with STEMI (43.6% vs. 55.2%, p < 0.001). Smoking [1.277 (1.117–1.459), p ˂ 0.001] and high triglycerides [0.791 (0.714–0.878), p = 0.02] were independent predictors of STEMI. Conclusions: In Kosovo, patients with STEMI are more common than those with NSTEMI, and they were mostly males and more likely to have diabetes, hypertension, and a family history of CAD compared to those with NSTEMI. Smoking and high triglycerides proved to be the strongest predictors of acute STEMI in Kosovo, thus highlighting the urgent need for optimum atherosclerosis risk control and education strategies.

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