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Coronary Artery Disease: HELP
Articles by Eva Swahn
Based on 5 articles published since 2008

Between 2008 and 2019, Eva Swahn wrote the following 5 articles about Coronary Artery Disease.
+ Citations + Abstracts
1 Editorial Stable or not, woman or man: is there a difference? 2012

Swahn, Eva. · ·Eur Heart J · Pubmed #22922506.

ABSTRACT: -- No abstract --

2 Article Computed tomography coronary angiography in patients with acute myocardial infarction and normal invasive coronary angiography. 2016

Panayi, Georgios / Wieringa, Wouter G / Alfredsson, Joakim / Carlsson, Jörg / Karlsson, Jan-Erik / Persson, Anders / Engvall, Jan / Pundziute, Gabija / Swahn, Eva. ·Department of Cardiology and Department of Medical and Health Sciences, Linkoping University, Linkoping, Sweden. georgios.panayi@regionostergotland.se. · Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. · Department of Cardiology and Department of Medical and Health Sciences, Linkoping University, Linkoping, Sweden. · Department of Cardiology, Kalmar County Hospital and Linnæus University, Faculty of Health and Life Sciences, Kalmar, Sweden. · Department of Cardiology, County Hospital Ryhov, Jönköping and Department of Medical and Health Sciences, Linkoping University, Linkoping, Sweden. · Center for Medical Image Science and Visualization (CMIV), Linkoping University, Linkoping, Sweden. · Department of Clinical Physiology and Department of Medical and Health Sciences, Linkoping University, Linkoping, Sweden. ·BMC Cardiovasc Disord · Pubmed #27142217.

ABSTRACT: BACKGROUND: Three to five percent of patients with acute myocardial infarction (AMI) have normal coronary arteries on invasive coronary angiography (ICA). The aim of this study was to assess the presence and characteristics of atherosclerotic plaques on computed tomography coronary angiography (CTCA) and describe the clinical characteristics of this group of patients. METHODS: This was a multicentre, prospective, descriptive study on CTCA evaluation in thirty patients fulfilling criteria for AMI and without visible coronary plaques on ICA. CTCA evaluation was performed head to head in consensus by two experienced observers blinded to baseline patient characteristics and ICA results. Analysis of plaque characteristics and plaque effect on the arterial lumen was performed. Coronary segments were visually scored for the presence of plaque. Seventeen segments were differentiated, according to a modified American Heart Association classification. Echocardiography performed according to routine during the initial hospitalisation was retrieved for analysis of wall motion abnormalities and left ventricular systolic function in most patients. RESULTS: Twenty-five patients presented with non ST-elevation myocardial infarction (NSTEMI) and five with ST-elevation myocardial infarction (STEMI). Mean age was 60.2 years and 23/30 were women. The prevalence of risk factors of coronary artery disease (CAD) was low. In total, 452 coronary segments were analysed. Eighty percent (24/30) had completely normal coronary arteries and twenty percent (6/30) had coronary atherosclerosis on CTCA. In patients with atherosclerotic plaques, the median number of segments with plaque per patient was one. Echocardiography was normal in 4/22 patients based on normal global longitudinal strain (GLS) and normal wall motion score index (WMSI); 4/22 patients had normal GLS with pathological WMSI; 3/22 patients had pathological GLS and normal WMSI; 11/22 patients had pathological GLS and WMSI and among them we could identify 5 patients with a Takotsubo pattern on echo. CONCLUSIONS: Despite a diagnosis of AMI, 80 % of patients with normal ICA showed no coronary plaques on CTCA. The remaining 20 % had only minimal non-obstructive atherosclerosis. Patients fulfilling clinical criteria for AMI but with completely normal ICA need further evaluation, suggestively with magnetic resonance imaging (MRI).

3 Article Neutrophil/Lymphocyte ratio is associated with non-calcified plaque burden in patients with coronary artery disease. 2014

Nilsson, Lennart / Wieringa, Wouter G / Pundziute, Gabija / Gjerde, Marcus / Engvall, Jan / Swahn, Eva / Jonasson, Lena. ·Department of Medical and Health Sciences, Linköping University, Linköping, Sweden; Department of Cardiology, Linköping University, Linköping, Sweden. · University of Groningen, University Medical Center Groningen, Department of Cardiology, Groningen, The Netherlands. · Department of Medical and Health Sciences, Linköping University, Linköping, Sweden; Department of Clinical Physiology, Linköping University, Linköping, Sweden. ·PLoS One · Pubmed #25268632.

ABSTRACT: BACKGROUND: Elevations in soluble markers of inflammation and changes in leukocyte subset distribution are frequently reported in patients with coronary artery disease (CAD). Lately, the neutrophil/lymphocyte ratio has emerged as a potential marker of both CAD severity and cardiovascular prognosis. OBJECTIVES: The aim of the study was to investigate whether neutrophil/lymphocyte ratio and other immune-inflammatory markers were related to plaque burden, as assessed by coronary computed tomography angiography (CCTA), in patients with CAD. METHODS: Twenty patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) and 30 patients with stable angina (SA) underwent CCTA at two occasions, immediately prior to coronary angiography and after three months. Atherosclerotic plaques were classified as calcified, mixed and non-calcified. Blood samples were drawn at both occasions. Leukocyte subsets were analyzed by white blood cell differential counts and flow cytometry. Levels of C-reactive protein (CRP) and interleukin(IL)-6 were measured in plasma. Blood analyses were also performed in 37 healthy controls. RESULTS: Plaque variables did not change over 3 months, total plaque burden being similar in NSTE-ACS and SA. However, non-calcified/total plaque ratio was higher in NSTE-ACS, 0.25(0.09-0.44) vs 0.11(0.00-0.25), p<0.05. At admission, levels of monocytes, neutrophils, neutrophil/lymphocyte ratios, CD4+ T cells, CRP and IL-6 were significantly elevated, while levels of NK cells were reduced, in both patient groups as compared to controls. After 3 months, levels of monocytes, neutrophils, neutrophil/lymphocyte ratios and CD4+ T cells remained elevated in patients. Neutrophil/lymphocyte ratios and neutrophil counts correlated significantly with numbers of non-calcified plaques and also with non-calcified/total plaque ratio (r = 0.403, p = 0.010 and r = 0.382, p = 0.024, respectively), but not with total plaque burden. CONCLUSIONS: Among immune-inflammatory markers in NSTE-ACS and SA patients, neutrophil counts and neutrophil/lymphocyte ratios were significantly correlated with non-calcified plaques. Data suggest that these easily measured biomarkers reflect the burden of vulnerable plaques in CAD.

4 Article Similar outcome with an invasive strategy in men and women with non-ST-elevation acute coronary syndromes: from the Swedish Web-System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies (SWEDEHEART). 2011

Alfredsson, Joakim / Lindbäck, Johan / Wallentin, Lars / Swahn, Eva. ·Division of Cardiovascular Medicine, Department of Medicine and Health Sciences, Faculty of Health Sciences, Linköping University, Linköping, Sweden. joakim.alfredsson@liu.se ·Eur Heart J · Pubmed #21911338.

ABSTRACT: AIMS: To assess gender differences in outcome with an early invasive or non-invasive strategy in patients with non-ST-elevation acute coronary syndromes (NSTE ACS). METHODS AND RESULTS: We included 46,455 patients [14 819 women (32%) and 31,636 men (68%)] from the SWEDEHEART register, with NSTE ACS, between 2000 and 2006, and followed them for 1 year. In the non-invasive strategy arm, the relative risk (RR) of death was (women vs. men) 1.02 [95% confidence interval (CI), 0.94-1.11] and in the invasive strategy arm 1.12 (95% CI, 0.96-1.29). After adjustment for baseline differences between the genders, with propensity score and discharge medication, there was a similar trend towards better outcome among women in both the early non-invasive cohort [RR 0.90 (95% CI, 0.82-0.99)] and the early invasive cohort [RR 0.90 (95% CI, 0.76-1.06)], although it did not reach statistical significance in the early invasive cohort. Results were similar with the combined endpoint death/myocardial infarction. An early invasive treatment was associated with a marked, and similar, mortality reduction in women [RR 0.46 (95% CI, 0.38-0.55)] and men [RR 0.45 (95% CI, 0.40-0.52)], without interaction with gender. CONCLUSION: In this large cohort of patients with NSTE ACS, reflecting real-life management, women and men had similar and better outcome associated with an invasive strategy.

5 Article Sleep, arousal and health-related quality of life in men and women with coronary artery disease. 2011

Johansson, Anna / Svanborg, Eva / Swahn, Eva / Ejdebäck, Jan / Tygesen, Hans / Edell-Gustafsson, Ulla. ·Department of Cardiology, Kärnsjukhuset, Skövde Hospital, Skövde, Sweden. anna.m.johansson@vgregion.se ·J Clin Nurs · Pubmed #21781201.

ABSTRACT: AIM: To evaluate whether there are gender differences in insomnia, sleep quality, sleep efficiency (%), general arousal, disease-specific and health-related quality of life in patients with coronary artery disease, compared with an age- and gender-matched randomly selected group from the general population. BACKGROUND: There are gender difference effects of sleep disturbances in the general population, but this perspective among patients with coronary artery disease has been poorly analysed. DESIGN: In this prospective study, comparative, descriptive and model testing designs were used. METHOD: The patients with coronary artery disease, 556 men and 324 women aged 25-86, were compared with a matched population-based group. Data were collected by validated and reliability-tested questionnaires. RESULTS: The prevalence of severe insomnia varied between 17-44% in all four groups. The severe insomniac coronary artery disease patients displayed a two- or threefold higher presleep arousal, had two hours shorter nocturnal sleep duration/night and were more limited in their physical exercise level than the population-based group. Gender differences in sleep quality, sleep efficiency (%) and general arousal disappeared with increased insomnia severity. CONCLUSIONS: Independent of gender, age and comorbidity, physical exercise, general arousal behaviour and delayed poststress recovery after mental stress were found to have a negative impact on the coronary artery disease patients' sleep quality and sleep efficiency (%), interfering with their health-related quality of life. The variables significantly explained 41% of the sleep quality outcome and 29% of the sleep efficiency (%). RELEVANCE TO CLINICAL PRACTICE: Insomnia because of hyperarousal behaviour can be an important factor in the development of an individual self-care management programme supported by a healthcare team.