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Biomedical subjects

A Vedin

Publications and source records attributed to A Vedin.

108 records · Page 6Linked to original sources
PubMed1976

The postinfarction clinic in Göteborg, Sweden. A controlled trial of a therapeutic organization.

Since Jan. 1, 1968, a Postmyocardial Infarction Clinic has been operating in Göteborg, Sweden. The methods used have been presented previously in this journal. The present study compares 96 male postinfarction cases, 57-67-year-old, treated at the Postmyocardial Infarction Clinic and a random sample of 85 patients not treated at the clinic. The mortality did not differ between the groups but there was a significant difference with regard to non-fatal reinfarction. The reasons for this are only partially explained by better control of accepted cardiovascular risk factors in the group treated at the clinic. Cessation of smoking was vigorously recommended but lipid lowering, antiarrhythmic or anticoagulant drugs were never used in this group. The results indicate that formalized management of homogeneous patient groups may achieve a general reduction of recurrences.

Aged↗
PubMed1976

Symptoms, disablement and treatment during two years after myocardial infarction.

Invalidism after myocardial infarction was elucidated by assessing chest pain, dyspnoea, need for cardiac medication, and the extent to which patients returned to work during the first two years after myocardial infarction. The patients in the study were obtained from the Myocardial Infarction Register in Göteborg and were followed at the Post-MI Clinic. Standardized criteria were used for handling of symptoms, signs, risk factors and complications. The prevalence of various symptoms was registered at regular intervals and the findings at 3 months and one year infarction are presented. The prevalence of symptoms was determined by means of questionnaires. Three months and one year after infarction the prevalence of effort-induced chest pain was 53 and 44%, respectively. There was no age correlation. The comparable figues for dyspnoea on exertion were 47 and 41%, respectively. The proportion of patients with dyspnoea tended to rise with increasing age. Dyspnoea on exertion was more prevalent at 3 months than at 12 months after infarction. About 60% of the patients had experienced some of the symptoms before acute infarction and this proportion increased to about 70% during the follow-up period. This rise is caused by an increase of patients with solitary dyspnoea. Only a few patients received treatment with digitalis and diuretics prior to onset of symptoms. Three and 12 months after infarction the prevalence of patients treated with digitalis was 36 and 39%, respectively. The corresponding figures for diuretics were 15 and 20%, respectively. Both digitalis and diuretic therapy were more frequent at 12 months than at 3 months after infarction. Diuretic therapy increased significantly with age. Three months after infarction 17% of the patients were back at work. After 12 and 24 months the corresponding figures were 63 and 70%, respectively. The tendency for resumption of work at all intervals during the follow-up decreased with advancing age. During the first year after myocardial infarction 30% of the patients were readmitted to hospital. The chief reason for readmission to hospital was suspected (but later not verified) reinfarction.

Adult↗
PubMed1975

Deaths and non-fatal reinfarctions during two years' follow-up after myocardial infarction.

Since 1968 special units for registering and following up all myocardial infarction patients have been in operation in Góteborg. The present paper reports on the deaths and non-fatal reinfarctions among 440 men and women below 67 years of age followed for two years after hospitalization for myocardial infarction. Of the 359 men, 299 had their first infarction and 60 a recurrent infarction. During two years 13% of men with a first infarction, and 37% of men with a recurrent infarction died. Deaths were significantly more common during the first than during the second year. There was no significant difference in mortality between men and women. The incidence of non-fatal reinfarctions was of similar magnitude and showed similar time relationships. Two thirds of the deaths were sudden (within 24 hours after onset of new symptoms) and half of the deaths occurred outside hospital. The autopsy rate was 92%. Two thirds of the deaths were caused by a fresh morphological infarct. In one fourth of the deaths where no cause was found at autopsy, death was ascribed to malignant arrhythmias. Heart weights were higher among patients dying after recurrent infarction at entry to the study. No distinctive pattern was found when autopsy findings were correlated to the interval between the onset of symptoms and death. Deaths due to fresh infarction and without an identifiable cause were more common among those who died within 24 hours of onset of symptoms compared to those dying after longer intervals.

Adult↗
PubMedDate not supplied

Serum lipids and apolipoprotein levels in women with acute myocardial infarction.

In this study covering more than 150,000 person-years from women younger than 55 years of age, 61 survived a first acute myocardial infarction (AMI). Of these, 59 were compared with a random sample from the same population regarding serum lipids and apolipoproteins (apo) A-I, A-II, B, and E, as well as several other cardiovascular risk factors. Mean values of serum cholesterol, triglycerides, apo B, and apo E were significantly higher and high density lipoprotein cholesterol and apo A-I were significantly lower among patients with infarction than among controls. Those who sustained and survived an AMI more often had a history of hypertension and of tobacco smoking than did the controls. Cigarette smoking, a history of hypertension, age, high serum triglycerides and apo E, as well as low levels of apo A-I, were independently and significantly associated with infarction. Sixty percent of the cases and 11% of the controls were distributed in the highest quartile of risk. A major contribution to the association with AMI was accounted for by the conventional risk factors, cigarette smoking and hypertension, as well as high serum triglycerides. In this group of relatively young women, high serum triglycerides were strongly associated with infarction, while levels of serum cholesterol were not.

Adult↗