oalib

Publish in OALib Journal

ISSN: 2333-9721

APC: Only $99

Submit

Any time

2020 ( 2 )

2019 ( 237 )

2018 ( 291 )

2017 ( 319 )

Custom range...

Search Results: 1 - 10 of 142930 matches for " Lars K?ber "
All listed articles are free for downloading (OA Articles)
Page 1 /142930
Display every page Item
Impact of dronedarone in atrial fibrillation and flutter on stroke reduction
Christine Benn Christiansen, Christian Torp-Pedersen, Lars K ber
Clinical Interventions in Aging , 2010, DOI: http://dx.doi.org/10.2147/CIA.S8883
Abstract: ct of dronedarone in atrial fibrillation and flutter on stroke reduction Review (6199) Total Article Views Authors: Christine Benn Christiansen, Christian Torp-Pedersen, Lars K ber Published Date March 2010 Volume 2010:5 Pages 63 - 69 DOI: http://dx.doi.org/10.2147/CIA.S8883 Christine Benn Christiansen1, Christian Torp-Pedersen1, Lars K ber2 1Department of Cardiology, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; 2Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark Background: Dronedarone has been developed for treatment of atrial fibrillation (AF) or atrial flutter (AFL). It is an amiodarone analogue but noniodinized and without the same adverse effects as amiodarone. Objective and methods: This is a review of 7 studies (DAFNE, ADONIS, EURIDIS, ATHENA, ANDROMEDA, ERATO and DIONYSOS) on dronedarone focusing on efficacy, safety and prevention of stroke. There was a dose-finding study (DAFNE), 3 studies focusing on maintenance of sinus rhythm (ADONIS, EURIDIS and DIONYSOS), 1 study focusing on rate control (ERATO) and 2 studies investigating mortality and morbidity (ANDROMEDA and ATHENA). Results: The target dose for dronedarone was established in the DAFNE study to be 400 mg twice daily. Both EURIDIS and ADONIS studies demonstrated that dronedarone was superior to placebo for maintaining sinus rhythm. However, DIONYSOS found that dronedarone is less efficient at maintaining sinus rhythm than amiodarone. ERATO concluded that dronedarone reduces ventricular rate in patients with chronic AF. The ANDROMEDA study in patients with severe heart failure was discontinued because of increased mortality in dronedarone group. Dronedarone reduced cardiovascular hospitalizations and mortality in patients with AF or AFL in the ATHENA trial. Secondly, according to a post hoc analysis a significant reduction in stroke was observed (annual rate 1.2% on dronedarone vs 1.8% on placebo, respectively [hazard ratio 0.66, confidence interval 0.46 to 0.96, P = 0.027]). In total, 54 cases of stroke occurred in 3439 patients (crude rate 1.6%) receiving dronedarone compared to 76 strokes in 3048 patients on placebo (crude rate 2.5%), respectively. Conclusion: Dronedarone can be used for maintenance of sinus rhythm and can reduce stroke in patients with AF who receive usual care, which includes antithrombotic therapy and heart rate control.
Diabetes is an independent predictor of survival 17 years after myocardial infarction: follow-up of the TRACE registry
Thomas Kümler, Gunnar H Gislason, Lars Kber, Christian Torp-Pedersen
Cardiovascular Diabetology , 2010, DOI: 10.1186/1475-2840-9-22
Abstract: The aim of this study was to systematically evaluate the development of diabetes as an independent long-term prognostic factor after myocardial infarction.Prospective follow-up of 6676 consecutive MI patients screened for entry in the Trandolapril Cardiac Evaluation (TRACE) study. The patients were analysed by Kaplan-Meier survival analysis, landmark analysis and Cox proportional hazard models and outcome measure was all-cause mortality.The mortality in patients with diabetes was 82,7% at 10 years of follow-up and 91,1% at 15 years of follow-up, while patients without diabetes had a mortality of 60,2% at 10 years of follow-up and 72,9% at 15 years of follow-up (p < 0.0001). Landmark analysis continued to show prognostic significance of diabetes throughout the duration of follow-up. Multivariable Cox proportional-hazards model showed that the hazard ratio for death in patients with diabetes overall was 1.47 (95% confidence intervals (CI) 1.35-1.61) and varied between 1.19 (CI 1.04-1.37) and 2.13 (CI 1.33-3.42) in the 2-year periods of follow-up.Diabetes is an important independent long-term prognostic factor after MI and continues to predict mortality even 17 years after index MI.This underscores the importance of aggressive diagnostic and therapeutic approach in diabetes patients with MI.Disturbances in glucose metabolism are frequent in patients with ischemic heart disease, and abnormal glucose tolerance in MI patients is almost twice as common as hypertension and dyslipidemia [1]. The Glucose Metabolism in Patients with Acute Myocardial Infarction (GAMI) study documented a high prevalence of diabetes and abnormal glucose tolerance in patients MI and no known diabetes [2]. Diabetes increases long-term mortality following MI [3,4], and patients requiring glucose-lowering therapy exhibit a cardiovascular risk of the same magnitude as patients without diabetes with a prior myocardial infarction, regardless of gender and diabetes type [5]. As a result, patients with di
Impact of dronedarone in atrial fibrillation and flutter on stroke reduction
Christine Benn Christiansen,Christian Torp-Pedersen,Lars Køber
Clinical Interventions in Aging , 2010,
Abstract: Christine Benn Christiansen1, Christian Torp-Pedersen1, Lars K ber21Department of Cardiology, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; 2Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, DenmarkBackground: Dronedarone has been developed for treatment of atrial fibrillation (AF) or atrial flutter (AFL). It is an amiodarone analogue but noniodinized and without the same adverse effects as amiodarone.Objective and methods: This is a review of 7 studies (DAFNE, ADONIS, EURIDIS, ATHENA, ANDROMEDA, ERATO and DIONYSOS) on dronedarone focusing on efficacy, safety and prevention of stroke. There was a dose-finding study (DAFNE), 3 studies focusing on maintenance of sinus rhythm (ADONIS, EURIDIS and DIONYSOS), 1 study focusing on rate control (ERATO) and 2 studies investigating mortality and morbidity (ANDROMEDA and ATHENA).Results: The target dose for dronedarone was established in the DAFNE study to be 400 mg twice daily. Both EURIDIS and ADONIS studies demonstrated that dronedarone was superior to placebo for maintaining sinus rhythm. However, DIONYSOS found that dronedarone is less efficient at maintaining sinus rhythm than amiodarone. ERATO concluded that dronedarone reduces ventricular rate in patients with chronic AF. The ANDROMEDA study in patients with severe heart failure was discontinued because of increased mortality in dronedarone group. Dronedarone reduced cardiovascular hospitalizations and mortality in patients with AF or AFL in the ATHENA trial. Secondly, according to a post hoc analysis a significant reduction in stroke was observed (annual rate 1.2% on dronedarone vs 1.8% on placebo, respectively [hazard ratio 0.66, confidence interval 0.46 to 0.96, P = 0.027]). In total, 54 cases of stroke occurred in 3439 patients (crude rate 1.6%) receiving dronedarone compared to 76 strokes in 3048 patients on placebo (crude rate 2.5%), respectively.Conclusion: Dronedarone can be used for maintenance of sinus rhythm and can reduce stroke in patients with AF who receive usual care, which includes antithrombotic therapy and heart rate control.Keywords: atrial fibrillation, stroke, dronedarone
Predictors of right ventricular function as measured by tricuspid annular plane systolic excursion in heart failure
Jesper Kjaergaard, Kasper K Iversen, Dilek Akkan, Jacob M?ller, Lars V Kber, Christian Torp-Pedersen, Christian Hassager
Cardiovascular Ultrasound , 2009, DOI: 10.1186/1476-7120-7-51
Abstract: TAPSE were correlated with global and regional measures of longitudinal LV function, segmental wall motion scores and measures of diastolic LV function as measured from transthoracic echocardiography.LV ejection fraction, wall motion index scores, atrio-ventricular annular plane systolic excursion of the mitral annulus were significantly related to TAPSE. Septal and posterior mitral annular plane systolic excursion (β = 0.56, p < 0.0001 and β = 0.35, p = 0.0002 per mm, respectively) and non-ischemic etiology of heart failure (β = 1.3, p = 0.002) were independent predictors of TAPSE, R2 = 0.28, p < 0.0001. The prognostic importance of TAPSE was not dependent of heart failure etiology or any of the other clinical factors analyzed, pinteraction = NS.TAPSE is reduced with left ventricular dysfunction in heart failure patients, in particular with reduced septal longitudinal motion. TAPSE is decreased in patients with heart failure of ischemic etiology. However, the absolute reduction in TAPSE is small and seems to be of minor importance in the clinical utilization of TAPSE whether applied as a measure of right ventricular systolic function or as a prognostic factor.Right ventricular (RV) dysfunction is an important entity in heart failure as patients with reduced RV ejection fraction have poorer exercise tolerance and prognosis than patients with preserved RV function regardless of left ventricular (LV) function and degree of pulmonary hypertension [1]. Tricuspid annular plane systolic excursion (TAPSE) has been proposed as a simple and reproducible parameter for quantitative assessment of RV ejection fraction [2]. The prognostic importance of TAPSE in the evaluation of RV function in patients with severe heart failure has been well-described [3], and the parementer has been recommended in the most recent joint American European guidelines for echocardiographic quantification of right ventricular function [4]. Later studies showed the prognostic information in a mixed he
Incidence of Atrial Fibrillation in Patients with either Heart Failure or Acute Myocardial Infarction and Left Ventricular Dysfunction: A Cohort Study
Michelle D Schmiegelow, Ole D Pedersen, Lars Kber, Marie Seib?k, Steen Z Abildstr?m, Christian Torp-Pedersen
BMC Cardiovascular Disorders , 2011, DOI: 10.1186/1471-2261-11-19
Abstract: The Danish Investigations of Arrhythmia and Mortality ON Dofetilide (DIAMOND) studies included 2627 patients without atrial fibrillation at baseline, who were randomised to treatment with either dofetilide or placebo.The competing risk analyses estimated the cumulative incidences of atrial fibrillation during the 42 months of follow-up to be 9.6% in the placebo-treated heart failure-group, and 2.9% in the placebo-treated myocardial infarction-group.Cox proportional hazard regression found a 42% significant reduction in the incidence of new-onset AF when assigned to dofetilide compared to placebo (hazard ratio 0.58, 95% confidence interval 0.40-0.82) and there was no interaction with study (p = 0.89).In the heart failure-group, the incidence of atrial fibrillation was significantly reduced to 5.6% in the dofetilide-treated patients (hazard ratio 0.57, 95% confidence interval 0.38-0.86).In the myocardial infarction-group the incidence of atrial fibrillation was reduced to 1.7% with the administration of dofetilide. This reduction was however not significant (hazard ratio 0.61, 95% confidence interval 0.30-1.24).In patients with left ventricular dysfunction the incidence of AF in 42 months was 9.6% in patients with heart failure and 2.9% in patients with a recent MI. Dofetilide significantly reduced the risk of developing atrial fibrillation compared to placebo in the entire study group and in the subgroup of patients with heart failure. The reduction in the subgroup with recent MI was not statistically significant, but the hazard ratio was similar to the hazard ratio for the heart failure patients, and there was no difference between the effect in the two studies (p = 0.89 for interaction).Recent studies have indicated that particularly new-onset atrial fibrillation (AF) following hospitalization for heart failure or myocardial infarction (MI) is associated with a greater risk of death and stroke than permanent/persistent AF [1,2]. Although a number of studies have fo
The Minaret of the Great Mosque in Algiers, a Structural Challenge  [PDF]
Dan Constantinescu, Dietlinde Kber
Open Journal of Civil Engineering (OJCE) , 2013, DOI: 10.4236/ojce.2013.32A004
Abstract:

The Great Mosque in Algiers will be the third largest mosque in the world and its minaret the highest. The region has a high seismic risk. The project designed by a German team of architects and engineers is under construction and will be finished by 2016. Due to the minaret slenderness and to the special composite structure chosen to withstand lateral loading, the structural design faced some challenging aspects. The paper presents the design philosophy, some significant structural features and details of the minaret structure.

Temporal trends in the initiation of glucose-lowering medications after a first-time myocardial infarction - a nationwide study between 1997 and 2006
Mette L Norgaard, Charlotte Andersson, Peter Hansen, S?ren S Andersen, Allan Vaag, Tina K Schramm, Fredrik Folke, Lars Kber, Christian Torp-Pedersen, Gunnar H Gislason
Cardiovascular Diabetology , 2011, DOI: 10.1186/1475-2840-10-5
Abstract: All Danish residents aged ≥ 30 years without prior diabetes hospitalized with first-time MI between 1997 and 2006 were identified by individual-level-linkage of nationwide registers. Initiation of GLM during follow-up was assessed by claimed prescriptions from pharmacies. Temporal trends in initiation of GLM were assessed by incidence rate calculations in the MI population as in the general population. Multivariable Cox proportional-hazard models were used to investigate the likelihood of initiating GLM within a year post-MI.The population comprised 66,788 patients. Among these patients 3962 patients initiated GLM, of whom 1567 started within one year post-MI. An increase in incidence rates of GLM initiation in the MI population from 19.6 per 1000 person years in 1997 to approximately 27.6 in 2001 was demonstrated. After 2001 the incidence rates stabilized. A similar trend was observed in the general population where the incidence rates increased from 2.8 in 1997 to 4.0 in 2004 and then stabilized.Our study demonstrated an increase in incidence rates of GLM initiation within the first year post- MI. A similar trend was observed in the general population suggesting that the increase in GLM among MI patients was primarily the effect of a general increased awareness of diabetes. From a public heath perspective, this study underscores a continuous need for diagnostic and therapeutic improvement in the care of MI patients that develop diabetes.Type 2 diabetes is a well-established risk factor for cardiovascular disease and is common among patients with acute myocardial infarction (MI), where the prevalence is as high as 20%[1]. Previous studies have shown that abnormal glucose metabolism is more common than normal glucose tolerance among patients with MI and that abnormal glucose tolerance is an important predictor of impaired long-term outcome in these patients[2-4]. Thus, among patients with MI without known diabetes up to 65% exhibit abnormal glucose regulation when c
Metoprolol compared to carvedilol deteriorates insulin-stimulated endothelial function in patients with type 2 diabetes - a randomized study
Britt Kveiborg, Thomas S Hermann, Atheline Major-Pedersen, Buris Christiansen, Christian Rask-Madsen, Jakob Rauns?, Lars Kber, Christian Torp-Pedersen, Helena Dominguez
Cardiovascular Diabetology , 2010, DOI: 10.1186/1475-2840-9-21
Abstract: 24 patients with type 2 diabetes were randomized to receive either 200 mg metoprolol succinate or 50 mg carvedilol daily. Endothelium-dependent vasodilation was assessed by using venous occlusion plethysmography with increasing doses of intra-arterial infusions of the agonist serotonin. Insulin-stimulated endothelial function was assessed after co-infusion of insulin for sixty minutes. Vaso-reactivity studies were done before and after the two-month treatment period.Insulin-stimulated endothelial function was deteriorated after treatment with metoprolol, the percentage change in forearm blood-flow was 60.19% ± 17.89 (at the highest serotonin dosages) before treatment and -33.80% ± 23.38 after treatment (p = 0.007). Treatment with carvedilol did not change insulin-stimulated endothelial function. Endothelium-dependent vasodilation without insulin was not changed in either of the two treatment groups.This study shows that vascular insulin sensitivity was preserved during treatment with carvedilol while blunted during treatment with metoprolol in patients with type 2 diabetes.Current Controlled Trials NCT00497003Type 2 diabetes is associated with a high risk of cardiovascular complications [1]. Beta-blockers are generally considered to worsen metabolic control in patients with diabetes, but the GEMINI (The Glycemic Effects in Diabetes Mellitus: Carvedilol-Metoprolol Comparison in Hypertensives) study demonstrated improved metabolic control in patients with type 2 diabetes and hypertension treated with carvedilol as compared with metoprolol [2]. Further, in the presence of heart failure, carvedilol was shown to be associated with improved survival (The Carvedilol or Metoprolol European Trial [COMET]) and with fewer cases of new onset diabetes compared to metoprolol tartrate [3,4].These results lead us to hypothesize that carvedilol and metoprolol might have different vascular effects related to insulin sensitivity. Endothelial dysfunction is thought to be one of the ear
Endothelial function is unaffected by changing between carvedilol and metoprolol in patients with heart failure-a randomized study
Britt Falskov, Thomas Hermann, Jakob Rauns?, Buris Christiansen, Christian Rask-Madsen, Atheline Major-Pedersen, Lars Kber, Christian Torp-Pedersen, Helena Dominguez
Cardiovascular Diabetology , 2011, DOI: 10.1186/1475-2840-10-91
Abstract: Twenty-seven patients with mild HF, all initially treated with carvedilol, were randomized to a two-month treatment with carvedilol, metoprolol tartrate or metoprolol succinate. Venous occlusion plethysmography, 24-hour blood pressure and heart rate measurements were done before and after a two-month treatment period.Endothelium-dependent vasodilatation was not affected by changing from carvedilol to either metoprolol tartrate or metoprolol succinate. The relative forearm blood flow at the highest dose of serotonin was 2.42 ± 0.33 in the carvedilol group at baseline and 2.14 ± 0.24 after two months continuation of carvedilol (P = 0.34); 2.57 ± 0.33 before metoprolol tartrate treatment and 2.42 ± 0.55 after treatment (p = 0.74) and in the metoprolol succinate group 1.82 ± 0.29 and 2.10 ± 0.37 before and after treatment, respectively (p = 0.27). Diurnal blood pressures as well as heart rate were also unchanged by changing from carvedilol to metoprolol tartrate or metoprolol succinate.Endothelial function remained unchanged when switching the beta blocker treatment from carvedilol to either metoprolol tartrate or metoprolol succinate in this study, where blood pressure and heart rate also remained unchanged in patients with mild HF.Current Controlled Trials NCT00497003Beta blocker treatment is a well-established therapy for heart failure (HF), but the drugs tested have different profiles of possible clinical consequence. In the Carvedilol Or Metoprolol European Trial (COMET) treatment with carvedilol was found superior in patients with chronic heart failure when compared to metoprolol tartrate [1].Patients with heart failure are characterized by having an impaired endothelial function regardless of the etiology of heart failure [2]. An impaired endothelial function in patients with heart failure is associated with a poor prognosis [3,4] and the severity of endothelial function in HF is proportional to the New York Heart Association heart failure classification (NYHA) i
The prognostic importance of a history of hypertension in patients with symptomatic heart failure is substantially worsened by a short mitral inflow deceleration time
Charlotte Andersson, Gunnar H Gislason, Peter Weeke, Jesper Kjaergaard, Christian Hassager, Dilek Akkan, Jacob E M?ller, Lars Kber, Christian Torp-Pedersen
BMC Cardiovascular Disorders , 2012, DOI: 10.1186/1471-2261-12-30
Abstract: 3078 consecutively hospitalized heart failure patients (NYHA classes II-IV) were screened for the EchoCardiography and Heart Outcome Study (ECHOS). The left ventricular ejection fraction (LVEF) was estimated by 2 dimensional transthoracic echocardiography in all patients and a subgroup of 878 patients had additional data on pulsed wave Doppler assessment of transmitral flow available. A restrictive filling (RF) was defined as a mitral inflow deceleration time ≤140?ms. Patients were followed for a median of 6.8 (Inter Quartile Range 6.6-7.0) years and multivariable Cox regression models were used to assess the risk of all-cause mortality associated with hypertension.The study population had a mean age of 73?±?11?years. 39% were female, 27% had a history of hypertension and 48% had a RF. Over the study period, 64% of the population died. Hypertension was not associated with increased risk of mortality, hazard ratio (HR) 0.95 (0.85-1.05). LVEF did not modify this relationship (p for interaction?=?0.7), but RF pattern substantially influenced the outcomes associated with hypertension (p for interaction?<?0.001); HR 0.75 (0.57-0.99) and 1.41 (1.08-1.84) in patients without and with RF, respectively.In patients with symptomatic heart failure, a history of hypertension is associated with a substantially increased relative risk of mortality among patients with a restrictive transmitral filling pattern.
Page 1 /142930
Display every page Item


Home
Copyright © 2008-2017 Open Access Library. All rights reserved.