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  • 1. Holmgren, CM
    et al.
    Abdon, NJ
    Bergfeldt, LB
    Edvardsson, NG
    Herlitz, J
    University of Borås, School of Health Science.
    Karlsson, T
    Svensson, LG
    Åstrand, BH
    Changes in medication preceededing out-of hopital cardiac arrest where resuscitation was attempted2014In: Journal of Cardiovascular Pharmacology, ISSN 0160-2446, E-ISSN 1533-4023, Vol. 63, no 6, p. 497-503Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To describe recent changes in medication preceding out-of-hospital cardiac arrest (OHCA) where resuscitation was attempted. METHODS: OHCA victims were identified by the Swedish Cardiac Arrest Register and linked by means of their unique 10-digit personal identification numbers to the Prescribed Drug Register. We identified new claimed prescriptions during a 6-month period before the OHCA compared with those claimed in the period 12 to 18 months before. The 7-digit Anatomical Therapeutical Chemical codes of individual drugs were used. The study period was November 2007-January 2011. RESULTS: OHCA victims with drugs were (1) older than those who did not claim any drugs in any period (70 ± 16 years vs. 54 ± 22 years, P < 0.001), (2) more often women (34% vs. 20%, P < 0.001), and (3) had more often a presumed cardiac etiology (67% vs. 54%, P < 0.001). The OHCA victims were less likely to have ventricular tachycardia/ventricular fibrillation as the first recorded rhythm (26% vs. 33%, P < 0.001) or to survive 1 month (9% vs. 17%, P < 0.0001). New prescriptions were claimed by 5122 (71%) of 7243 OHCA victims. The most frequently claimed new drugs were paracetamol (acetaminophen) 10.3%, furosemide 7.8%, and omeprazole 7.6%. Of drugs known or supposed to cause QT prolongation, ciprofloxacin was the most frequent (3.4%) altogether; 16% had a new claimed prescription of a drug included in the "qtdrugs.org" lists. CONCLUSIONS: Most OHCA victims had new drugs prescribed within 6 months before the event but most often intended for diseases other than cardiac. No claims can be made as to the causality.

  • 2. Holmgren, CM
    et al.
    Abdon, NJ
    Bergfeldt, LB
    Edvardsson, NG
    Herlitz, Johan
    University of Borås, School of Health Science.
    Karlsson, T
    Svensson, LG
    Astrand, BH
    Changes in medication preceding out-of-hospital cardiac arrest where resuscitation was attempted2014In: Journal of Cardiovascular Pharmacology, ISSN 0160-2446, E-ISSN 1533-4023, Vol. 63, no 6, p. 497-503Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE:: To describe recent changes in medication preceding Out-of-Hospital Cardiac Arrest (OHCA) where resuscitation was attempted. METHODS:: OHCA victims were identified by the Swedish Cardiac Arrest Register and linked by means of their unique 10-digit personal identification numbers to the Prescribed Drug Register. We identified new claimed prescriptions during a six month period prior to the OHCA compared with those claimed 12-18 months before. The 7-digit ATC codes of individual drugs were used. The study period was November 2007 to January 2011 RESULTS:: OHCA victims with drugs were older than those who did not claim any drugs in any period (70±16years vs. 54±22 years p<0.001), were more often women (34% vs. 20%, p<0.001) and had more often a presumed cardiac etiology (67% vs. 54% (p<0.001), were less likely to have VT/VF as the first recorded rhythm (26% vs. 33%, p<0.001) or to survive one month (9% vs. 17%, p<0.0001). New prescriptions were claimed by 5122 (71%) of 7243 OHCA victims. The most frequently claimed new drugs were paracetamol (acetaminophen) 10.3%, furosemide 7.8% and omeprazole 7.6%. Of drugs known or supposed to cause QT prolongation, ciprofloxacin was the most frequent (3.4%) altogether; 16% had a new claimed prescription of a drug included in the ¨qtdrugs.org¨ lists. CONCLUSION:: A majority of OHCA victims had new drugs prescribed within six months prior to the event, but most often intended for diseases other than cardiac. No claims can be made as to the causality.

  • 3. Scheiman, JM
    et al.
    Herlitz, J
    University of Borås, School of Health Science.
    Veldhyuzen van Zanten, SJ
    Lanas, A
    Agewall, S
    Naucler, EC
    Svedberg, LE
    Nagy, P
    Esomeprazole for prevention and resolution of upper gastrointestinal symptoms in patients treated with low-dose acetylsalicylic acid for cardiovascular protection: the OBERON trial.2013In: Journal of Cardiovascular Pharmacology, ISSN 0160-2446, E-ISSN 1533-4023, Vol. 61, no 3, p. 250-257Article in journal (Refereed)
    Abstract [en]

    Although low-dose acetylsalicylic acid (ASA) is recommended for prevention of cardiovascular events in at-risk patients, its long-term use can be associated with the risk of peptic ulcer and upper gastrointestinal (GI) symptoms that may impact treatment compliance. This prespecified secondary analysis of the OBERON study (NCT00441727) determined the efficacy of esomeprazole for prevention/resolution of low-dose ASA-associated upper GI symptoms. A post hoc analysis of predictors of symptom prevention/resolution was also conducted. Helicobacter pylori-negative patients taking low-dose ASA (75-325 mg) for cardiovascular protection who had ≥1 upper GI risk factor were eligible. The patients were randomized to once-daily esomeprazole 40 mg, 20 mg, or placebo, for 26 weeks; 2303 patients (mean age 67.6 years; 36% aged >70 years) were evaluable for upper GI symptoms. The proportion of patients with dyspeptic or reflux symptoms (self-reported Reflux Disease Questionnaire) was significantly lower (P < 0.0001) in those treated with esomeprazole versus in those treated with placebo. Treatment with esomeprazole (P < 0.0001), age >70 years (P < 0.01), and the absence of upper GI symptoms at baseline (P < 0.0001) were all factors associated with prevention/resolution of upper GI symptoms. Together, these analyses demonstrate that esomeprazole is effective in preventing and resolving patient-reported upper GI symptoms in low-dose ASA users at increased GI risk.

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