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  1. AU="Olsson, Marita"
  2. AU="Gevorkyan, Gevork"
  3. AU="Francis, Jill"
  4. AU="Katori, Chiaki"
  5. AU="Anderson, Karly N"
  6. AU=Sheikh Fatima
  7. AU="Machado, Clarissa Maria Goncalves" AU="Machado, Clarissa Maria Goncalves"
  8. AU="Goldfaden, Rebecca F"
  9. AU="Jacques, Simon"
  10. AU="Calatayud, David G"
  11. AU="Yan, Dingfei"
  12. AU="Rippin, Ido"
  13. AU="Krista M. Pullen"
  14. AU="Higo, Tomoya"
  15. AU="Bremadesam Raman, Lakshmi"
  16. AU="Duffner, P K"
  17. AU="Walsh, Jacinta"

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  1. Artikel ; Online: Contemporary risk estimates of three HbA

    Skrtic, Stanko / Cabrera, Claudia / Olsson, Marita / Schnecke, Volker / Lind, Marcus

    Heart (British Cardiac Society)

    2017  Band 103, Heft 5, Seite(n) 353–358

    Abstract: Background: We evaluated the association between glycaemic control and the risk of heart failure (HF) in a contemporary cohort of persons followed after diagnosis of type 2 diabetes (T2D).: Methods and results: Persons with T2D diagnosed between 1998 ...

    Abstract Background: We evaluated the association between glycaemic control and the risk of heart failure (HF) in a contemporary cohort of persons followed after diagnosis of type 2 diabetes (T2D).
    Methods and results: Persons with T2D diagnosed between 1998 and 2012 were retrieved from the Clinical Practice Research Data Link in the UK and followed from diagnosis until the event of HF, mortality, drop out from the database due to any other reason, or the end of the study on 1 July 2015. The association between each of three different haemoglobin A
    Conclusions: Hyperglycaemia is still a risk factor for HF in persons with T2D of similar magnitude as in earlier cohorts. Such a relationship exists for current glycaemic levels, at diagnosis and the overall level but the pattern differs for these variables.
    Mesh-Begriff(e) Aged ; Biomarkers/blood ; Blood Glucose/metabolism ; Databases, Factual ; Diabetes Mellitus, Type 2/blood ; Diabetes Mellitus, Type 2/diagnosis ; Diabetes Mellitus, Type 2/epidemiology ; Electronic Health Records ; Female ; Glycated Hemoglobin A/metabolism ; Heart Failure/diagnosis ; Heart Failure/epidemiology ; Humans ; Linear Models ; Male ; Middle Aged ; Primary Health Care ; Prognosis ; Proportional Hazards Models ; Risk Assessment ; Risk Factors ; Time Factors ; United Kingdom/epidemiology
    Chemische Substanzen Biomarkers ; Blood Glucose ; Glycated Hemoglobin A ; hemoglobin A1c protein, human
    Sprache Englisch
    Erscheinungsdatum 2017-03
    Erscheinungsland England
    Dokumenttyp Comparative Study ; Journal Article ; Observational Study
    ZDB-ID 1303417-0
    ISSN 1468-201X ; 1355-6037
    ISSN (online) 1468-201X
    ISSN 1355-6037
    DOI 10.1136/heartjnl-2016-309806
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  2. Artikel ; Online: Impact of CKD Progression on Cardiovascular Disease Risk in a Contemporary UK Cohort of Individuals With Diabetes.

    Cabrera, Claudia S / Lee, Alison S / Olsson, Marita / Schnecke, Volker / Westman, Klara / Lind, Marcus / Greasley, Peter J / Skrtic, Stanko

    Kidney international reports

    2020  Band 5, Heft 10, Seite(n) 1651–1660

    Abstract: Introduction: It remains unclear whether an increased progression rate of chronic kidney disease (CKD) adds predictive information regarding cardiovascular disease (CVD) risk. The aim of this study was to evaluate the association between CKD progression, ...

    Abstract Introduction: It remains unclear whether an increased progression rate of chronic kidney disease (CKD) adds predictive information regarding cardiovascular disease (CVD) risk. The aim of this study was to evaluate the association between CKD progression, based on estimated glomerular filtration rate (eGFR) slope estimates and the risk for CVD.
    Methods: We compared the updated eGFR slope calculated over multiple overlapping 2-year periods and the updated mean eGFR. Incident CKD subjects were selected from a prevalent population with diabetes (T2DM). Subjects from the UK Clinical Practice Research Data Link GOLD (CPRD) were followed from CKD diagnosis (
    Results: Both the updated eGFR slope and updated mean eGFR were associated with MACE plus and HF. Updated eGFR slope decline of > -3 ml/min/1.73 m
    Conclusions: This study strongly supports current evidence that CKD is an independent risk factor for CVD. From a clinical perspective, both rate of progression and cumulative status of CKD describe distinct aspects of the cardiorenal risk among persons with diabetes. This evidence is essential to enable more timely and improved use of treatments in this population.
    Sprache Englisch
    Erscheinungsdatum 2020-08-07
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ISSN 2468-0249
    ISSN (online) 2468-0249
    DOI 10.1016/j.ekir.2020.07.029
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  3. Artikel ; Online: Contemporary Risk Estimates of Three HbA1c Variables for Myocardial Infarction in 101,799 Patients Following Diagnosis of Type 2 Diabetes.

    Olsson, Marita / Schnecke, Volker / Cabrera, Claudia / Skrtic, Stanko / Lind, Marcus

    Diabetes care

    2015  Band 38, Heft 8, Seite(n) 1481–1486

    Abstract: Objective: This study evaluated the risk of myocardial infarction (MI) by impaired glycemic control in a contemporary large cohort of patients with type 2 diabetes followed from diagnosis.: Research design and methods: Patients with type 2 diabetes ... ...

    Abstract Objective: This study evaluated the risk of myocardial infarction (MI) by impaired glycemic control in a contemporary large cohort of patients with type 2 diabetes followed from diagnosis.
    Research design and methods: Patients with type 2 diabetes diagnosed between 1995 and 2011 were retrieved from the Clinical Practice Research Datalink in the U.K., and followed from diagnosis until event of MI or end of study in 2013. Two subcohorts were defined: an early cohort with those diagnosed from 1997 to 2004 and a recent cohort with those diagnosed from 2004 to 2011. Association between each of three HbA1c metrics and MI was estimated using adjusted proportional hazards models.
    Results: In the overall cohort (n = 101,799), the risk increase for MI per 1% (10 mmol/mol) increase in HbA(1c) was higher for updated latest and updated mean HbA(1c) of 1.11 (95% CI 1.09-1.13) and 1.15 (1.13-1.18) than for baseline HbA(1c) of 1.05 (1.03-1.06). In the early subcohort, the corresponding risk estimates were greater than those in the recent subcohort. When categorized, the updated latest variable showed an increased risk for HbA(1c) <6% (42 mmol/mol), relative category 6-7%, in the recent but not in the early subcohort, with hazard ratios of 1.23 (1.08-1.40) and 1.01 (0.84-1.22), respectively.
    Conclusions: The two time-updated HbA(1c) variables show a stronger relation with MI than baseline HbA(1c). The risk association between HbA(1c) and MI has decreased over time. In recently diagnosed patients with type 2 diabetes, an increased risk of MI exists at a current HbA(1c) of <6.0% (42 mmol/mol).
    Mesh-Begriff(e) Aged ; Blood Glucose/metabolism ; Diabetes Mellitus, Type 2/blood ; Diabetes Mellitus, Type 2/etiology ; Diabetic Angiopathies/blood ; Diabetic Angiopathies/etiology ; Epidemiologic Methods ; Female ; Glycated Hemoglobin A/metabolism ; Humans ; Male ; Middle Aged ; Myocardial Infarction/blood ; Myocardial Infarction/etiology
    Chemische Substanzen Blood Glucose ; Glycated Hemoglobin A
    Sprache Englisch
    Erscheinungsdatum 2015-08
    Erscheinungsland United States
    Dokumenttyp Journal Article ; Observational Study
    ZDB-ID 441231-x
    ISSN 1935-5548 ; 0149-5992
    ISSN (online) 1935-5548
    ISSN 0149-5992
    DOI 10.2337/dc14-2351
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  4. Artikel ; Online: AZD5634, an inhaled ENaC inhibitor, in healthy subjects and patients with cystic fibrosis.

    Kristensson, Cecilia / Åstrand, Annika / Donaldson, Scott / Goldwater, Ron / Abdulai, Raolat / Patel, Naimish / Gardiner, Philip / Tehler, Ulrika / Mercier, Anne-Kristina / Olsson, Marita / Ersdal, Eva / Mäenpää, Jukka / Bramer, Tobias / Malmgren, Anna / Bennett, William / Keen, Christina

    Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society

    2022  Band 21, Heft 4, Seite(n) 684–690

    Abstract: Background: Epithelial sodium channel (ENaC) inhibitors may offer clinical benefit in cystic fibrosis (CF); however, data are limited. We report the outcomes of a Phase I (NCT02679729) and a Phase Ib (NCT02950805) study of AZD5634, a novel inhaled ENaC ... ...

    Abstract Background: Epithelial sodium channel (ENaC) inhibitors may offer clinical benefit in cystic fibrosis (CF); however, data are limited. We report the outcomes of a Phase I (NCT02679729) and a Phase Ib (NCT02950805) study of AZD5634, a novel inhaled ENaC inhibitor.
    Methods: A Phase I, first-in-human, single-blind, placebo-controlled, single ascending dose, sequential dose group study assessed the safety, tolerability, and pharmacokinetics of AZD5634 in healthy subjects (n=53) in part A following inhaled doses up to 1700 µg, and, in part B, following administration of single inhaled (1700 µg) and intravenous (65 µg) doses. A Phase Ib, randomized, double-blind, placebo-controlled, single-dose, 2-way cross-over study assessed the effects of a single dose (600 µg) of inhaled AZD5634 on mucociliary clearance (MCC), pharmacokinetics and safety and tolerability in patients with CF (n=11). Nasal potential difference (NPD) was assessed as an in situ target engagement exploratory biomarker.
    Results: Absolute bioavailability of AZD5634 after inhalation was approximately 3%, indicating minimal distribution into the systemic circulation. Urinary excretion was a minor elimination pathway. Administration of inhaled AZD5634 did not improve MCC in CF patients, but AZD5634 inhibited ENaC in the nasal epithelium, as measured by NPD. AZD5634 was safe and well tolerated in both studies.
    Conclusions: AZD5634 showed favorable pharmacokinetics and safety in healthy subjects and patients with CF. However, despite achieving target engagement, proof of mechanism was not achieved after a single dose in patients with CF. Further evaluation into multiple dose studies is warranted to explore its therapeutic potential.
    Mesh-Begriff(e) Administration, Inhalation ; Cross-Over Studies ; Cystic Fibrosis/diagnosis ; Cystic Fibrosis/drug therapy ; Double-Blind Method ; Healthy Volunteers ; Humans ; Single-Blind Method
    Sprache Englisch
    Erscheinungsdatum 2022-02-26
    Erscheinungsland Netherlands
    Dokumenttyp Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
    ZDB-ID 2084724-5
    ISSN 1873-5010 ; 1569-1993
    ISSN (online) 1873-5010
    ISSN 1569-1993
    DOI 10.1016/j.jcf.2022.02.010
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  5. Artikel ; Online: Eosinophil-derived neurotoxin: A biologically and analytically attractive asthma biomarker.

    Rutten, Bert / Young, Simon / Rhedin, Magdalena / Olsson, Marita / Kurian, Nisha / Syed, Farhat / Beech, Augusta / Fidock, Mark / Newbold, Paul / Singh, Dave / Platt, Adam / Hughes, Glen

    PloS one

    2021  Band 16, Heft 2, Seite(n) e0246627

    Abstract: There is a growing body of evidence for the utility of eosinophil-derived neurotoxin (EDN) as a biomarker in asthma, including association with eosinophilic airway inflammation, assessment of disease severity and potential for predicting pathogenic risks, ...

    Abstract There is a growing body of evidence for the utility of eosinophil-derived neurotoxin (EDN) as a biomarker in asthma, including association with eosinophilic airway inflammation, assessment of disease severity and potential for predicting pathogenic risks, including exacerbations. However, to interpret any biomarker data with confidence, it is first important to understand the preanalytical factors and biological variation that may affect its reliable measurement and results interpretation. In this study we defined the healthy serum EDN reference range for men and women as 1.98 to 26.10 ng/mL, with no significant gender differences. Smoking did not impact the mean EDN levels and no circadian rhythm was identified for EDN, unlike blood eosinophils (EOS) where levels peaked at 00:00h. EDN expression in different cell types was investigated and shown to occur primarily in eosinophils, indicating they are likely to be the main cellular repository for EDN. We also confirm that the quantification of serum EDN is not influenced by the type of storage tube used, and it is stable at ambient temperature or when refrigerated for at least 7 days and for up to one year when frozen at -20°C or -80°C. In summary, EDN is a stable biomarker that may prove useful in precision medicine approaches by enabling the identification of a subpopulation of asthma patients with activated eosinophils and a more severe form of the disease.
    Mesh-Begriff(e) Adult ; Aged ; Asthma/blood ; Asthma/immunology ; Biomarkers/blood ; Eosinophil-Derived Neurotoxin/immunology ; Eosinophils/metabolism ; Female ; Healthy Volunteers ; Humans ; Male ; Middle Aged ; Reference Values ; Severity of Illness Index
    Chemische Substanzen Biomarkers ; Eosinophil-Derived Neurotoxin (EC 3.1.-)
    Sprache Englisch
    Erscheinungsdatum 2021-02-10
    Erscheinungsland United States
    Dokumenttyp Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 1932-6203
    ISSN (online) 1932-6203
    DOI 10.1371/journal.pone.0246627
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  6. Artikel ; Online: Preclinical evaluation of point-of-care prothrombin time as a biomarker test to guide prothrombin replacement therapy in coagulopathic bleeding.

    Balendran, Clare A / Henderson, Neil / Olsson, Marita / Lövgren, Ann / Hansson, Kenny M

    Research and practice in thrombosis and haemostasis

    2017  Band 1, Heft 2, Seite(n) 252–258

    Sprache Englisch
    Erscheinungsdatum 2017-08-02
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ISSN 2475-0379
    ISSN (online) 2475-0379
    DOI 10.1002/rth2.12027
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  7. Artikel ; Online: Variable flip angle 3D ultrashort echo time (UTE) T

    Alamidi, Daniel F / Smailagic, Amir / Bidar, Abdel W / Parker, Nicole S / Olsson, Marita / Hockings, Paul D / Lagerstrand, Kerstin M / Olsson, Lars E

    Journal of magnetic resonance imaging : JMRI

    2018  

    Abstract: Background: Lung T: Purpose: To evaluate the feasibility of regional lung T: Study type: Prospective preclinical animal study.: Population: Eight naive mice and phantoms.: Field strength/sequence: 3D free-breathing radial UTE (8 μs) at 4.7T.! ...

    Abstract Background: Lung T
    Purpose: To evaluate the feasibility of regional lung T
    Study type: Prospective preclinical animal study.
    Population: Eight naive mice and phantoms.
    Field strength/sequence: 3D free-breathing radial UTE (8 μs) at 4.7T.
    Assessment: VFA 3D-UTE T
    Statistical tests: Agreement in T
    Results: Good T
    Data conclusion: VFA 3D-UTE shows promise as a reliable T
    Level of evidence: 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018.
    Sprache Englisch
    Erscheinungsdatum 2018-03-08
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ZDB-ID 1146614-5
    ISSN 1522-2586 ; 1053-1807
    ISSN (online) 1522-2586
    ISSN 1053-1807
    DOI 10.1002/jmri.25999
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  8. Artikel ; Online: Pharmacokinetics, pharmacodynamics and safety of the inverse retinoic acid-related orphan receptor γ agonist AZD0284.

    Asimus, Sara / Palmér, Robert / Albayaty, Muna / Forsman, Henrik / Lundin, Christina / Olsson, Marita / Pehrson, Rikard / Mo, John / Russell, Muir / Carlert, Sara / Close, David / Keeling, David

    British journal of clinical pharmacology

    2020  Band 86, Heft 7, Seite(n) 1398–1405

    Abstract: Aims: Retinoic acid-related orphan receptor γ (RORγ), a master regulator of T-helper 17 (Th17) cell function and differentiation, is an attractive target for treatment of Th17-driven diseases. This first-in-human study aimed to investigate the ... ...

    Abstract Aims: Retinoic acid-related orphan receptor γ (RORγ), a master regulator of T-helper 17 (Th17) cell function and differentiation, is an attractive target for treatment of Th17-driven diseases. This first-in-human study aimed to investigate the pharmacokinetics, pharmacodynamics, safety and tolerability of the inverse RORγ agonist AZD0284.
    Methods: We conducted a phase I, randomized, single-blind, placebo-controlled, two-part, first-in-human study with healthy subjects receiving single (4-238 mg) or multiple (12-100 mg) oral doses of AZD0284 or placebo after overnight fasting. Subjects in the one single dose cohort additionally received a single dose of AZD0284 after a high-calorie meal. AZD0284 plasma concentrations, as well as inhibition of ex vivo-stimulated interleukin (IL)-17A release in whole blood, were frequently measured after both single and multiple dosing.
    Results: Eighty-three men participated in the study. AZD0284 was absorbed rapidly into plasma after oral dosing and exhibited a terminal half-life of 13-16 hours. Both the area under the concentration-time curve (AUC) and maximum concentration (C
    Conclusions: AZD0284 was well tolerated, rapidly and dose-dependently absorbed, and reduced stimulated IL-17A release after single and multiple dosing. The results of this study support further clinical development of AZD0284.
    Mesh-Begriff(e) Administration, Oral ; Area Under Curve ; Dose-Response Relationship, Drug ; Double-Blind Method ; Half-Life ; Humans ; Male ; Single-Blind Method ; Tretinoin
    Chemische Substanzen Tretinoin (5688UTC01R)
    Sprache Englisch
    Erscheinungsdatum 2020-03-03
    Erscheinungsland England
    Dokumenttyp Clinical Trial, Phase I ; Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
    ZDB-ID 188974-6
    ISSN 1365-2125 ; 0306-5251 ; 0264-3774
    ISSN (online) 1365-2125
    ISSN 0306-5251 ; 0264-3774
    DOI 10.1111/bcp.14253
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  9. Artikel ; Online: INEXAS: A Phase 2 Randomized Trial of On-demand Inhaled Interferon Beta-1a in Severe Asthmatics.

    McCrae, Christopher / Olsson, Marita / Gustafson, Per / Malmgren, Anna / Aurell, Malin / Fagerås, Malin / Da Silva, Carla A / Cavallin, Anders / Paraskos, Jonathan / Karlsson, Karin / Wingren, Cecilia / Monk, Phillip / Marsden, Richard / Harrison, Tim

    Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology

    2020  Band 51, Heft 2, Seite(n) 273–283

    Abstract: Background: Upper respiratory tract infections (URTIs) are important triggers for asthma exacerbations. We hypothesized that inhalation of the anti-viral cytokine, interferon (IFN)-β, during URTI, could prevent these exacerbations.: Objective: To ... ...

    Abstract Background: Upper respiratory tract infections (URTIs) are important triggers for asthma exacerbations. We hypothesized that inhalation of the anti-viral cytokine, interferon (IFN)-β, during URTI, could prevent these exacerbations.
    Objective: To evaluate the efficacy of on-demand inhaled IFN-β1a (AZD9412) to prevent severe asthma exacerbations following symptomatic URTI.
    Methods: This was a randomized, double-blind, placebo-controlled trial in which patients with severe asthma (GINA 4-5; n = 121) reporting URTI symptoms were randomized to 14 days of once-daily nebulized AZD9412 or placebo. The primary endpoint was severe exacerbations during treatment. Secondary endpoints included 6-item asthma control questionnaire (ACQ-6) and lung function. Exploratory biomarkers included IFN-response markers in serum and sputum, blood leucocyte counts and serum inflammatory cytokines.
    Results: Following a pre-planned interim analysis, the trial was terminated early due to an unexpectedly low exacerbation rate. Asthma worsenings were generally mild and tended to peak at randomization, possibly contributing to the lack of benefit of AZD9412 on other asthma endpoints. Numerically, AZD9412 did not reduce severe exacerbation rate, ACQ-6, asthma symptom scores or reliever medication use. AZD9412 improved lung function (morning peak expiratory flow; mPEF) by 19.7 L/min. Exploratory post hoc analyses indicated a greater mPEF improvement by AZD9412 in patients with high blood eosinophils (>0.3 × 10
    Conclusions & clinical relevance: Colds did not have the impact on asthma patients that was expected and, due to the low exacerbation rate, the trial was stopped early. On-demand AZD9412 treatment did not numerically reduce the number of exacerbations, but did attenuate URTI-induced worsening of mPEF. Severe asthma patients with high blood eosinophils or low serum interleukin-18 response are potential subgroups for further investigation of inhaled IFN-β1a.
    Mesh-Begriff(e) Administration, Inhalation ; Adult ; Antiviral Agents/therapeutic use ; Asthma/blood ; Asthma/complications ; Asthma/drug therapy ; Asthma/physiopathology ; Cytokines/blood ; Disease Progression ; Double-Blind Method ; Female ; Humans ; Interferon beta-1a/therapeutic use ; Male ; Middle Aged ; Peak Expiratory Flow Rate/physiology ; Respiratory Tract Infections/blood ; Respiratory Tract Infections/complications ; Respiratory Tract Infections/drug therapy ; Respiratory Tract Infections/physiopathology ; Severity of Illness Index
    Chemische Substanzen Antiviral Agents ; Cytokines ; Interferon beta-1a (XRO4566Q4R)
    Sprache Englisch
    Erscheinungsdatum 2020-11-03
    Erscheinungsland England
    Dokumenttyp Clinical Trial, Phase II ; Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
    ZDB-ID 645204-8
    ISSN 1365-2222 ; 0954-7894 ; 0960-2178
    ISSN (online) 1365-2222
    ISSN 0954-7894 ; 0960-2178
    DOI 10.1111/cea.13765
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  10. Artikel ; Online: Prothrombin time is predictive of low plasma prothrombin concentration and clinical outcome in patients with trauma hemorrhage: analyses of prospective observational cohort studies.

    Balendran, Clare A / Lövgren, Ann / Hansson, Kenny M / Nelander, Karin / Olsson, Marita / Johansson, Karin J / Brohi, Karim / Fries, Dietmar / Berggren, Anders

    Scandinavian journal of trauma, resuscitation and emergency medicine

    2017  Band 25, Heft 1, Seite(n) 30

    Abstract: Background: Fibrinogen and prothrombin have been suggested to become rate limiting in trauma associated coagulopathy. Administration of fibrinogen is now recommended, however, the importance of prothrombin to patient outcome is unknown.: Methods: We ... ...

    Abstract Background: Fibrinogen and prothrombin have been suggested to become rate limiting in trauma associated coagulopathy. Administration of fibrinogen is now recommended, however, the importance of prothrombin to patient outcome is unknown.
    Methods: We have utilized two trauma patient databases (database 1 n = 358 and database 2 n = 331) to investigate the relationship of plasma prothrombin concentration on clinical outcome and coagulation status. Database 1 has been used to assess the relationship of plasma prothrombin to administered packed red blood cells (PRBC), clinical outcome and coagulation biomarkers (Prothrombin Time (PT), ROTEM EXTEM Coagulation Time (CT) and Maximum Clot Firmness (MCF)). ROC analyses have been performed to investigate the ability of admission coagulation biomarkers to predict low prothrombin concentration (database 1), massive transfusion and 24 h mortality (database 1 and 2). The importance of prothrombin was further investigated in vitro by PT and ROTEM assays in the presence of a prothrombin neutralizing monoclonal antibody and following step-wise dilution.
    Results: Patients who survived the first 24 h had higher admission prothrombin levels compared to those who died (94 vs.67 IU/dL). Patients with lower transfusion requirements within the first 24 h (≤10 units of PRBCs) also had higher admission prothrombin levels compared to patients with massive transfusion demands (>10 units of PRBCs) (95 vs.62 IU/dL). Admission PT, in comparison to admission ROTEM EXTEM CT and MCF, was found to be a better predictor of prothrombin concentration <60 IU/dL (AUC 0.94 in database 1), of massive transfusion (AUC 0.92 and 0.81 in database 1 and 2 respectively) and 24 h mortality (AUC 0.90 and 0.78 in database 1 and 2, respectively). In vitro experiments supported a critical role for prothrombin in coagulation and demonstrated that PT and ROTEM EXTEM CT are sensitive methods to measure low prothrombin concentration.
    Discussion: Our analyses suggest that prothrombin concentration at admission is predictive of mortality and transfusion and indicates that prothrombin and fibrinogen are rate limiting in coagulopathy.
    Conclusions: Admission PT is predictive of low prothrombin concentration and clinical outcome. PT could therefore be used as a surrogate for prothrombin concentration and further evaluation of point-of-care devices for faster PT analysis is warranted.
    Mesh-Begriff(e) Adult ; Female ; Hemorrhage/therapy ; Humans ; Hypoprothrombinemias/diagnosis ; Male ; Middle Aged ; Plasma ; Predictive Value of Tests ; Prospective Studies ; Prothrombin Time ; Treatment Outcome ; Young Adult
    Sprache Englisch
    Erscheinungsdatum 2017-03-14
    Erscheinungsland England
    Dokumenttyp Journal Article ; Observational Study
    ZDB-ID 2455990-8
    ISSN 1757-7241 ; 1757-7241
    ISSN (online) 1757-7241
    ISSN 1757-7241
    DOI 10.1186/s13049-016-0332-2
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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