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  • 1. Hedner, J
    et al.
    Caidahl, K
    Sjöland, H
    Karlsson, T
    Herlitz, Johan
    [external].
    Sleep habits and their association with mortality during 5-year follow-up after coronary artery bypass surgery2002In: Acta Cardiologica, ISSN 0001-5385, E-ISSN 1784-973X, Vol. 57, no 5, p. 341-348Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To study various aspects of sleep quality and sleep patterns prior to and after coronary artery bypass surgery and their implications for 5-year survival. METHODS: All patients from western Sweden who underwent coronary artery bypass grafting (CABG) between 1988 and 1991 (n = 2,121) received a questionnaire addressing sleep habits prior to and I year after surgery. Various symptoms and habits related to sleep at the two evaluations were compared. Symptoms and habits related to sleep prior to CABG were then related to 5-year survival. RESULTS: In all, 1,224 patients took part in the evaluation. A highly significant improvement was observed with regard to the following symptoms and habits related to sleep: feeling refreshed upon awakening, feeling tired during daytime, waking up with headache, nightmares, sweating during night time, medication for pain relief at bedtime, involuntarily falling asleep during daytime, apnoea during sleep and mouth dryness during the night. Various symptoms and habits associated with sleep prior to CABG were generally not strongly related to prognosis. Exceptions were feeling refreshed upon awakening and infrequent consumption of pain relief medication at bedtime which both were associated with an improved long-term survival. CONCLUSIONS: A variety of symptoms associated with sleep improve highly significantly after CABG. The occurrence of these symptoms prior to CABG do not generally seem to influence the long-term prognosis.

  • 2.
    Herlitz, Johan
    et al.
    [external].
    Hjalmarson, Å
    Bengtsson, A
    Sillfors, L
    Long-term prognosis in relation to ECG findings in acute myocardial infarction1987In: Acta Cardiologica, ISSN 0001-5385, E-ISSN 1784-973X, Vol. 42, no 2, p. 79-89Article in journal (Refereed)
    Abstract [en]

    In 680 patients with acute myocardial infarction the prognosis during the following 5 years was related to observations made in a standard electrocardiogram (ECG) and 24 precordial chest leads. Patients with a Q-wave infarction (based on a 12-lead standard ECG) had a mortality rate during hospitalization of 10.2% which was much higher than that in patients with a non-Q-wave infarction (1.9%, p less than 0.001). At 5 years' follow-up 33.6% of those with a Q-wave infarction had died versus 28.4% of those with a non-Q-wave infarction (p greater than 0.2). Corresponding mortality rate among patients with no previous infarction (n = 587) was 32.1% and 25.2%, respectively (p = 0.17). In patients with anterior infarction and no previous infarction there was no correlation between Q- and R-wave changes in the 24 chest leads 4 days after admission to hospital and 5-year mortality rate. We thus conclude that patients with a Q-wave infarction had a higher in-hospital mortality compared with non-Q-wave infarction as judged from standard ECG, whereas 5-year mortality was similar. Similarly, there was no correlation between Q- and R-wave changes in an increased number of chest leads and 5-year mortality rate.

  • 3.
    Herlitz, Johan
    et al.
    [external].
    Hjalmarson, Å
    Waldenström, J
    Correlation between electrocardiographically and enzymatically estimated infarct size and its relation to clinical course in inferior myocardial infarction1984In: Acta Cardiologica, ISSN 0001-5385, E-ISSN 1784-973X, Vol. 39, no 6, p. 437-448Article in journal (Refereed)
    Abstract [en]

    In 194 patients with inferior wall acute myocardial infarction (MI) defined from ECG, the initial ST elevation and final Q- and R-wave changes in leads II, III and aVF were related to peak serum enzyme (heat stable lactate dehydrogenase) activity. Positive correlations were observed between initial ST elevation and peak LD (r = 0.54; p less than 0.001) and between peak LD and the final Q- and R-wave changes (r = 0.45; p less than 0.001). Peak LD activity was strongly related to the incidence and severity of congestive heart failure, and to mortality after 90 days and 2 years. A similar relationship could not be demonstrated between ECG findings and clinical outcome.

  • 4.
    Herlitz, Johan
    et al.
    [external].
    Hjalmarson, Å
    Waldenström, J
    Estimated appearance of raised serum enzyme activity in relation to onset of symptoms in acute myocardial infarction1985In: Acta Cardiologica, ISSN 0001-5385, E-ISSN 1784-973X, Vol. 40, no 5, p. 461-476Article in journal (Refereed)
    Abstract [en]

    In 709 patients with definite acute myocardial infarction (MI) the appearance of raised serum enzyme activity was related to onset of symptoms. Heat stable lactate dehydrogenase (LD), creatine kinase (CK) and CK B were analysed. A gradual increase in the incidence of raised enzyme activity in the first blood sample was seen for up to 18 hours after the onset of MI for all 3 enzymes. The incidence of raised enzyme activity in the first blood sample was higher for CK and CK B than for heat stable LD up to 24 hours after onset of MI, but thereafter a similar incidence was found. The median time between onset of symptoms and estimated appearance of raised serum enzyme activity was 6.2 hours for heat stable LD versus 4.3 hours for CK and 4.1 hours for CK B. A wide variation was however found. Infarct localization and chronic treatment with betablockade might affect these results. The clinical course including short- and long-term survival was similar in patients with early and later appearance of enzymes.

  • 5.
    Herlitz, Johan
    et al.
    [external].
    Hjalmarson, Å
    Waldenström, J
    Relationship between different enzymatical estimation of the infarct size1985In: Acta Cardiologica, ISSN 0001-5385, E-ISSN 1784-973X, Vol. 40, no 2, p. 217-228Article in journal (Refereed)
  • 6. Karlson, BW
    et al.
    Kalin, B
    Karlsson, T
    Stensdotter, L
    Zehlertz, E
    Herlitz, Johan
    [external].
    Long-term morbidity in patients with acute chest pain. A comparison between a city university hospital and a county hospital.2003In: Acta Cardiologica, ISSN 0001-5385, E-ISSN 1784-973X, Vol. 58, no 5, p. 397-402Article in journal (Refereed)
    Abstract [en]

    AIM: To compare long-term morbidity after hospital discharge in patients admitted to the emergency department with acute chest pain in a city university hospital and a county hospital. METHODS: Patients with acute chest pain admitted to the emergency department due to acute chest pain at Sahlgrenska University Hospital in Göteborg, Sweden, and at Uddevalla County Hospital in Uddevalla, Sweden, between October 21, 1996, and April 30, 1997, were retrospectively followed for 30 months. RESULTS: The mortality during the subsequent 30 months was similar in the two cohorts (16% in the city university hospital and 15% in the county hospital, respectively). In the city university hospital 1575 patients and in the county hospital 715 patients took part in the evaluation of survivors. Coronary angiography was performed less frequently in patients in the city hospital (14% versus 20%; p = 0.002) but there was no difference with regard to development of myocardial infarction (6% versus 7%), stroke (2% in both cohorts) or requirement of percutaneous transluminal coronary angioplasty (PTCA) or coronary artery bypass grafting (CABG) after hospital discharge. The proportion of patients who were rehospitalized did not differ, but the mean number of days in hospital per patient and per hospitalized patient was higher in the county hospital (10.2 +/- 17.2 versus 6.7 +/- 13.7 (p = 0.0003) and 17.3 +/- 19.5 versus 13.2 +/- 16.8 (p = 0.003), respectively). P-values were adjusted for differences in the patient's characteristics. The proportion of patients rehospitalized due to stable angina pectoris, cardiac arrhythmias and heart investigation was higher in the county hospital. CONCLUSION: In chest pain patients admitted to a city university hospital and a county hospital morbidity differences were found after hospital discharge indicating a higher requirement of rehospitalization for various cardiac reasons and a higher use of coronary angiography in the county hospital after discharge from hospital. The mechanisms behind this observation are not clear at present.

  • 7. Karlson, BW
    et al.
    Kalin, B
    Karlsson, T
    Svensson, L
    Zehlertz, E
    Herlitz, Johan
    [external].
    Subjective symptoms and well-being 30 months after acute chest pain in a county hospital and a city university hospital in Sweden.2003In: Acta Cardiologica, ISSN 0001-5385, E-ISSN 1784-973X, Vol. 58, no 6, p. 547-553Article in journal (Refereed)
    Abstract [en]

    AIM: To compare various health-related aspects of quality of life during long-term follow-up after admission to hospital due to acute chest pain in a city university hospital and a county hospital. METHODS: This was a retrospective survey of all chest pain patients > or = 30 years of age at the Sahlgrenska University Hospital, Göteborg, covering an area with 706 inhabitants per km2 and at Uddevalla County Hospital, Uddevalla, covering an area with 34 inhabitants per km2 over a period of six months. After 30 months all patients alive were approached with a questionnaire in which they were asked about various aspects of health-related quality of life and use of medication. RESULTS: In all, 1,813 patients in the city hospital and 804 patients in the county hospital took part in the survey. The mortality and the overall proportion of patients requiring rehospitalization was similar in the two cohorts. Thirty months after onset of symptoms there was a difference between the two study populations. Patients in the county hospital smoked less frequently (p = 0.004). They tended to have less problems with chest pain at rest (p < 0.05) and dyspnoea at slight physical exercise (p = 0.01). Furthermore, they had less emotional symptoms (p = 0.003) and their state of health caused fewer problems when doing housekeeping (p = 0.008). Differences with regard to emotional symptoms and problems when doing housekeeping were particularly observed among women, whereas smoking habits differed only among men. CONCLUSION: When comparing patients admitted to hospital with acute chest pain in a city university hospital and a county hospital after 30 months some differences appeared. Patients in the county hospital appeared to suffer from less symptoms than patients in the city hospital. This was particularly observed among women. The mechanisms behind these observations are not clear.

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