Biomedical subjects

Stefan Agewall

Publications and source records attributed to Stefan Agewall.

24 records · Page 2Linked to original sources

PubMed2003

Evaluation of point-of-care test systems using the new definition of myocardial infarction.

OBJECTIVES: To examine the proportion of patients admitted to CCU because of chest pain with a negative quantitative troponin t-test (Cardiac reader; Roche), who despite the negative test, would fulfil the new myocardial infarction criteria. A second aim was to evaluate the clinical utility of troponin I. DESIGN AND METHODS: Troponin T (Cardiac reader; Roche) was measured 12 h after the last chest pain episode. If Troponin T was negative the subjects were included in the study. All included subjects were also examined with troponin I (Stratus CS; Dade Behring) and troponin T at the central laboratory (Elecsys 2010) at the same time. 187 patients were included. CKMB was also measured 6 h after the last chest pain (Stratus CS; Dade Behring). RESULTS: Fifteen patients (8.0%) fulfilled the criteria of myocardial infarction, despite a negative Troponin T (Cardiac reader; Roche). CKMB measures did not add useful diagnostic information. The sensitivity and specificity were 100% and 95.3%, respectively for troponin I, when 0.2 microg/L was used as cut off level for myocardial infarction. CONCLUSION: In this low risk group, eight percent of the patients with a negative Troponin T (Cardiac reader; Roche) fulfilled the new criteria of myocardial infarction. Troponin I (Stratus CS; Dade Behring) appeared to be a reliable method in this group.

Aged↗

PubMed2003

Is impaired flow-mediated dilatation of the brachial artery a cardiovascular risk factor?

Endothelial dysfunction is thought to be an important factor in the development of atherosclerosis. Over the past decade, a non-invasive technique has evolved to evaluate flow-mediated vasodilation ([FMD), an endothelium-dependent function, in the brachial artery. FMD decreases with increasing age and subjects with diabetes mellitus, hypercholesterolemia, smokers and hypertension have decreased FMD. There are a few concise studies reporting that FMD predicts cardiovascular events. However, the assumption that focal measurement of brachial artery FMD predicts coronary artery disease deserves further investigation.

Brachial Artery↗

PubMed2002

Lipoprotein(a) was an independent predictor for major coronary events in treated hypertensive men.

BACKGROUND AND HYPOTHESIS: Lipoprotein(a) may play a part in the development of coronary heart disease. The purpose of this prospective study was to evaluate lipoprotein(a) as a predictor of major coronary events (fatal and nonfatal myocardial infarction and sudden death). METHODS: This was a prospective study of 118 men, aged 56 to 77 years, with treated hypertension and at least one additional cardiovascular risk factor (hypercholesterolemia, diabetes mellitus, or smoking) were included in the study. Lipoprotein(a) was measured at entry and major coronary events were followed during follow-up. RESULTS: The mean observation time was 3.0 years. Fourteen patients had a major coronary event during the follow-up period. Subjects with coronary heart disease (previous myocardial infarction, angina pectoris, or major electrocardiographic changes) at entry (n = 27) had significantly higher lipoprotein(a) levels than subjects without (n = 91) known coronary heart disease (p < 0.05). Lipoprotein(a) was a significant predictor for major coronary events (p = 0.033). Furthermore, when coronary disease at entry was included into the Cox regression analysis, lipoprotein(a) was an independent predictor for major coronary events (p = 0.044). CONCLUSIONS: Among treated hypertensive men, lipoprotein(a) was an independent predictor of major coronary events.

Aged↗

PubMed2002

Microalbuminuria and intima-media thickness of the carotid artery in clinically healthy men.

Microalbuminuria has been shown to be an independent predictor of cardiovascular disease in different populations. However, the underlying pathophysiological mechanism behind this observation is not known. The purpose of the present cross-sectional study was to examine the relation of microalbuminuria to intima-media thickness (IMT) of the common carotid artery in a group of 368 clinically healthy 58-year old men. Urinary albumin excretion (UAE) and IMT of the common carotid artery were measured. Body mass index, WHR, systolic and diastolic blood pressure, heart rate, High-density lipoprotein (HDL) cholesterol and common carotid artery IMT were associated with UAE. A stepwise forward multiple regression showed that systolic blood pressure and WHR could explain 10.4% of the variability in log UAE (systolic blood pressure beta-coefficient 0.0047, SE 0.001, P<0.001; WHR beta-coefficient 0.93, SE 0.30, P=0.002). In conclusion, UAE was significantly associated with IMT of the common carotid artery in clinically healthy men. However, after adjustment for systolic blood pressure and WHR this association was not significant. We suggest that microalbuminuria in healthy subjects is not primarily associated with atherosclerosis but rather to blood pressure and abdominal obesity.

Albuminuria↗

PubMed2002

Post-occlusion brachial artery vasodilatation after ischaemic handgrip exercise is nitric oxide mediated.

Flow-mediated vasodilatation (FMD) of the brachial artery is used as a measure to quantify endothelial dysfunction. However, FMD after occlusion only is small in healthy people over middle age, but can be increased after handgrip exercise. The aim of this study was to evaluate whether postocclusion vasodilatation after handgrip exercise is mediated by nitric oxide (NO). High frequency ultrasound was used to measure brachial artery diameter at rest and after reactive hyperaemia with and without handgrip exercise during NaCl or NG-monomethyl-L-arginine (L-NMMA) infusion in healthy 60-year-old men. Postocclusion vasodilation was significantly larger after handgrip exercise compared with occlusion only (P=0.0078). Postocclusion vasodilatation was significantly lower after ischaemic handgrip exercise during intra-arterial infusion of L-NMMA compared with infusion of NaCl (P = 0.039). It may be concluded that the increased postocclusion brachial artery vasodilatation observed after ischaemic handgrip exercise is at least partly NO mediated. This modification of the investigation procedure may improve our ability to quantify FMD in subjects with and without vascular disease.

Arm↗

PubMed2002

Urinary albumin excretion and insulin metabolism in clinically healthy 58-year-old men.

The aim of the present cross-sectional study was to investigate the relationship between urinary albumin excretion and insulin sensitivity, intact insulin and insulin propeptides in 104 clinically healthy 58-year-old men recruited from the general population. Insulin sensitivity (hyperinsulinemic euglycemic clamp) adjusted for lean body mass, fasting plasma insulin, proinsulin, split-proinsulin, C-peptide, and urinary albumin excretion and were determined. Urinary albumin excretion was significantly associated with body mass index (BMI), systolic and diastolic blood pressure, plasma insulin, and C-peptide (P <.05). Insulin sensitivity tended to be associated with urinary albumin excretion (P=.07). In a multiple regression analysis, urinary albumin excretion was independently and significantly associated with systolic blood pressure (P <.05). In conclusion, urinary albumin excretion was associated with insulin and C-peptide in clinically healthy 58-year-old men; however, this relationship became insignificant when blood pressure was taken into account in the regression analysis.

Albuminuria↗