Mari Nordbø Gynnild

• Gynnild, Mari Nordbø; Mecinaj, Albulena; Wethal, Torgeir; Jakobsen, Even Olav; Vinje-Jakobsen, Victoria & Heck, Siri Lagethon [Show all 12 contributors for this article] (2026). Sacubitril/Valsartan and Right Ventricular and Diastolic Function During Breast Cancer Therapy. JACC: CardioOncology. 8(4), p. 436–436. doi: 10.1016/j.jaccao.2026.06.002. Full text in Research Archive
• Holtrop, Joris; Gynnild, Mari Nordbø; Deo, Salil V; Lim, Carl-Emil; Logothetis, Stelios Boulitsakis & Läll, Kristi [Show all 37 contributors for this article] (2026). Predicting lifetime cardiovascular risk and benefits of preventive treatment in patients with established atherosclerotic cardiovascular disease: the SMART-REACH2 model. European Heart Journal. ISSN 0195-668X. doi: 10.1093/eurheartj/ehag400. Full text in Research Archive Show summary

  Abstract Background and Aims The 2021 ESC guidelines on cardiovascular (CV) disease prevention recommend the SMART-REACH lifetime risk model to guide treatment decisions in patients with established atherosclerotic CV disease. The aim was to develop the SMART-REACH2 model for estimating lifetime risk of recurrent CV events and treatment benefits in patients with established atherosclerotic CV disease, with systematic recalibration to the four European and other global risk regions. Methods SMART-REACH2 was derived in 8708 individuals aged 40–90 years with coronary, cerebrovascular, peripheral artery disease and/or abdominal aortic aneurysm from the UCC-SMART cohort. Sex-stratified, cause-specific Cox models for recurrent CV events and non-CV death were fitted using age as timescale and routinely available predictors. Recurrent CV events were defined as a composite of myocardial infarction, stroke, or CV death. Recalibration was based on representative cohorts per risk region. External validation was performed in 2 085 780 patients from 54 countries; model performance was assessed by calibration plots and Harrell's C-statistic. Results In the derivation cohort, 2057 recurrent CV events occurred over a median follow-up of 8.5 years (25th–75th: 4.3–13.0). In external validation, 307 706 events occurred. The pooled C-statistic was 0.68 (95% confidence interval 0.66–0.69) and ranged from 0.66 (0.64–0.69) for European low-risk region up to 0.72 (0.66–0.78) for Latin America, with adequate calibration across risk regions. Performance was consistent across sexes and CV disease subtypes. Using SMART-REACH2, estimated potential gains in CV disease-free life expectancy for a 50-year-old example patient receiving intensified preventive treatment (15 mmHg systolic blood pressure and 1.0 mmol/L low-density lipoprotein cholesterol reduction) ranged from 2 years in the low-risk region to 4.4 years in the very-high-risk region. Conclusions The updated SMART-REACH2 model accounts for geographical and sex-specific variations and allows estimation of short-term and lifetime risk of recurrent CV events and treatment benefits, facilitating shared decision-making as recommended by guidelines.

• Omland, Torbjørn; Heck, Siri Lagethon; Holte, Espen; Gynnild, Mari Nordbø; Gulati, Geeta & Wethal, Torgeir (2026). Response by Omland et al to Letter Regarding Article, “Sacubitril/Valsartan and Prevention of Cardiac Dysfunction During Adjuvant Breast Cancer Therapy: The PRADA II Randomized Clinical Trial”. Circulation. ISSN 0009-7322. 153(22). doi: 10.1161/circulationaha.126.079810. Full text in Research Archive
• Kaptoge, Stephen; Keene, Spencer J; Reitsma, Tessa; Shi, Wen; Lees, Jennifer S & Lõo, Laura [Show all 127 contributors for this article] (2026). Prediction of incident heart failure in individuals without prior cardiovascular disease: the SCORE2-HF risk model. European Heart Journal. ISSN 0195-668X. doi: 10.1093/eurheartj/ehag154. Full text in Research Archive Show summary

  Abstract Background and Aims Heart failure (HF) presents a significant and growing public health challenge. The aim of this study was to develop and validate SCORE2-HF, a model for HF risk estimation in European adults aged over 40-years without previous cardiovascular disease. Methods Using data from 25 prospective cohorts (14 countries, 611 778 individuals, 21 818 incident HF events) the sex-specific, competing risk-adjusted SCORE2-HF models were derived including age, smoking status, systolic blood pressure, antihypertensive treatment, body mass-index (BMI), estimated glomerular filtration rate, and type 2 diabetes mellitus (T2DM), including age at diagnosis and glycated haemoglobin. Using Europe-wide statistics from the World Health Organization and linked health records from five countries (>36 million individuals, 515 466 incident HF events) models were recalibrated to contemporary 10-year and 30-year HF incidence in four European risk regions. SCORE2-HF was validated using data from three further cohorts (three countries; 1 336 824 participants; 36 841 incident HF-events). Results In the three external validation cohorts, C-indices (95% confidence interval) were 0.827 (0.824–0.829), 0.839 (0.827–0.850) and 0.874 (0.863–0.884). SCORE2-HF risks varied importantly by individual’s risk factors, and risk region. For example, in the low-risk region, the average 10-year risk for 70-year-old individuals with zero versus four adverse risk factors (smoking, T2DM, hypertension and BMI >30 kg/m2), was 8% versus 24% in men and 6% versus 20% in women. By contrast, in the very high-risk region, average SCORE2-HF risk with four adverse risk factors was 59% in 70-year-old men or women. Conclusions SCORE2-HF – a model derived, recalibrated and validated to estimate 10-year and 30-year risk of incident HF across European countries – may enhance the identification of individuals at higher risk of developing HF.

• Reitsma, Tessa H; Lim, Carl-Emil; Gynnild, Mari Nordbø; Kaptoge, Stephen; Lõo, Laura & Holtrop, Joris [Show all 59 contributors for this article] (2026). Prediction of incident heart failure in established atherosclerotic cardiovascular disease: the SMART2-HF model. European Heart Journal. ISSN 0195-668X. doi: 10.1093/eurheartj/ehag153. Full text in Research Archive Show summary

  Abstract Background and aims Patients with established atherosclerotic cardiovascular disease (ASCVD) are at high risk of developing heart failure (HF). However, incident HF is not part of the risk assessment of current guideline-recommended models. The aim of this study was to develop and externally validate the SMART2-HF model for prediction of incident HF in patients with ASCVD. Methods SMART2-HF was developed in 7698 individuals with established ASCVD (coronary, cerebrovascular, or peripheral artery disease, or abdominal aortic aneurysm) but without prior HF from the UCC-SMART cohort. Cox proportional hazards models including sex-predictor interactions and with age as the time scale were derived to estimate the 10-year and lifetime risk of incident HF (hospitalization for HF or HF-related death), accounting for competing non-HF mortality. Predictors, limited to routinely available clinical characteristics, were aligned with the SMART2 risk model for recurrent cardiovascular risk in the same population. External validation was performed in 240 741 patients with ASCVD from six data sources: the Clinical Practice Research Datalink, the HUNT3 study, the SWEDEHEART Registry, the ASCVD-Particles cohort, the Estonian Biobank and the international REACH Registry. Results During a median follow-up of 11.2 years (interquartile range 6.1–16.4 years), 1031 incident HF events (13%) occurred in the UCC-SMART cohort. In the external validation data sources, a total of 24 885 incident HF events (10%) occurred. The pooled C-statistic was 0.696 (95% confidence interval 0.674–0.717), with consistent performance in subgroups by sex and type of ASCVD. Predicted risks matched observed incidence in external validation. Conclusions The SMART2-HF model enables the prediction of incident HF in patients with ASCVD. Aligned with the guideline-recommended SMART2 model for recurrent cardiovascular risk, SMART2-HF can be used as a complementary tool in this population.

• Holtrop, Joris; Gynnild, Mari N; Richards, Matthew; Lim, Carl-Emil; Lääperi, Mitja & Deo, Salil V [Show all 43 contributors for this article] (2026). Improving 10-year cardiovascular risk prediction in patients with established cardiovascular disease: flexible addition of risk predictors on top of the SMART2 risk score. European Journal of Preventive Cardiology (EJPC). ISSN 2047-4873. doi: 10.1093/eurjpc/zwag086. Full text in Research Archive Show summary

  Abstract Background Guidelines recommend using the SMART2 model, estimating the risk of recurrent cardiovascular (CV) events, to support treatment decisions in patients with established atherosclerotic CV disease (ASCVD). They further outline that adding biomarkers, comorbidities, anthropometric, and social factors may improve these predictions. Aims To investigate the added predictive value of guideline-outlined factors including biomarkers, comorbidities, anthropometric, and social factors on top of the SMART2 model using an approach enabling their use as add-on predictors. Methods Patients aged 40–80 with ASCVD were included from 11 cohorts (n=179,382 with 25,789 recurrent CV events). Additional factors included biomarkers (troponin I, NT-proBNP, albuminuria), comorbidities (heart failure, atrial fibrillation, coronary multivessel disease), anthropometric measurements (body-mass index, waist and hip circumference), social (employment, education), and other factors (former smoking, parental CV history). Cross-cohort availability of these factors ranged from 2 cohorts for albuminuria to all cohorts for BMI. These factors were assessed as add-on predictors to the SMART2 model using Fine-Gray models with SMART2 coefficients as offset with recurrent CV events as primary outcome (non-fatal myocardial infarction or stroke, or CV death). Added predictive value was assessed through cohort cross validation by change (Δ) in C--statistic, calibration, and net benefit through decision curve analysis. Results Sub distribution hazard ratios for additional factors ranged from 0.77 [95% confidence interval 0.75-0.80] for employment status to 1.69 [1.63-1.76] for heart failure history. ΔC-statistic was largest for NT-proBNP (0.0127 [0.0060-0.0193]) and troponin I (0.0100 [0.0020-0.0181]), with statistically significant but smaller ΔC-statistics for employment, heart failure, and atrial fibrillation. Calibration was adequate before and after integration of additional factors. Decision curve analysis demonstrated added net benefit beyond SMART2 for NT-proBNP, heart failure history, atrial fibrillation, albuminuria, current employment, coronary multivessel disease, and education level across clinically relevant thresholds up to 40% predicted risk. Conclusions The flexible add-on of guideline-outlined factors on top of SMART2 enables more personalised and improved estimation of recurrent CV event risk in patients with established ASCVD.

• Gynnild, Mari Nordbø; Holtrop, Joris; Hageman, Steven H J; Vinje, Victoria; Dorresteijn, Jannick A N & Visseren, Frank L J [Show all 10 contributors for this article] (2025). External validation of the systematic coronary risk evaluation 2 (SCORE2) and SCORE2-older persons in cancer patients. European Journal of Preventive Cardiology (EJPC). ISSN 2047-4873. doi: 10.1093/eurjpc/zwaf356. Full text in Research Archive Show summary

  Aims The 2022 European Society of Cardiology cardio-oncology guidelines recommend cardiovascular disease (CVD) risk stratification for cancer patients and suggest using SCORE2 and SCORE2-OP. However, these models have not been validated or specifically adapted for cancer populations. Our aim was to refine the SCORE2 and SCORE2-OP models to accurately predict 10-year fatal and non-fatal CVD risk in cancer patients. Methods and results We included 1622 patients from the HUNT3 study (2006–08) who were diagnosed with cancer within 4 years after their enrolment and followed until 2023 linked to national registries. The primary outcome was a composite of myocardial infarction (MI), stroke, or CVD mortality. Model performance was assessed using Harrel’s C-statistic and calibration curves. Both models were recalibrated by applying a multiplicative adjustment factor based on expected–observed (E/O) ratios. The most prevalent cancers were gastrointestinal (23%), prostate (17%), and breast (14%). Mean age was 65.2 years, 52% were female. During a median follow-up of 8.8 years [inter-quartile range 1.9–12.6], 252 CVD events (39% MI, 36% stroke, 25% CVD deaths) and 708 non-CVD deaths occurred. SCORE2 initially underestimated CVD risk (E/O ratio for men and women: 0.91 and 0.63, respectively) but showed adequate agreement after recalibration. C-statistics for SCORE2 was 0.693 [95% confidence interval (CI) 0.643–0.743], and 0.730 (95% CI 0.676–0.784) after excluding those not surviving the first 2 years. For SCORE2-OP, the C-statistics were 0.586 (95% CI 0.529–0.643) and 0.648 (95% CI 0.577–0.720). Conclusion SCORE2 underestimated CVD risk in cancer patients. After recalibration, the model may serve as a valuable tool for risk stratification in cancer patients.

• Gynnild, Mari Nordbø; Vinje-Jakobsen, Victoria; Holtrop, Joris; Hageman, Steven H.J.; Holte, Espen & Gulati, Geeta [Show all 14 contributors for this article] (2025). Prognostic Performance of a Modified HFA-ICOS Tool for Prediction of Cardiovascular Complications in Cancer Patients. JACC: Advances. 4(12). doi: 10.1016/j.jacadv.2025.102344. Full text in Research Archive Show summary

  Background The 2022 European Society of Cardiology Cardio-oncology Guidelines recommend the Heart Failure Association and International Cardio-Oncology Society risk stratification tool to predict cardiovascular disease (CVD) risk in cancer patients. Developed from expert consensus rather than mathematical derivation, its quantitative prognostic value in unselected cancer populations remains uncertain. Objectives The objective of the study was to assess the prognostic utility of a modified Heart Failure Association and International Cardio-Oncology Society tool, excluding biomarkers and imaging, in predicting CVD complications in cancer patients, thereby providing a quantitative correlate to an expert consensus-based method. Methods We included 2,290 cancer patients from the third follow-up of the Trøndelag Health study, diagnosed within 4 years of participation, and followed through 2023. Cancer therapy details were obtained from the Norwegian Cancer Registry. The primary outcome was a composite of myocardial infarction, heart failure hospitalization, stroke, or CVD mortality, identified via national registries. Results The mean age was 65.8 years; 48% were female. The most common cancers were gastrointestinal (23%), prostate (19%), and breast (12%). The median follow-up was 6.9 years. The modified tool classified 28% as low-, 35% moderate-, 34% high-, and 3% very high-risk. CVD incidence rose across categories: 7%, 21%, 29%, and 37% (P < 0.001). The C-statistic was 0.696 (95% CI: 0.674-0.718), and 0.746 (95% CI: 0.676-0.812) among anthracycline-treated patients. Within the low-to-moderate group, event rates ranged from 6% to 8% (0-1 points) to 24% to 27% (3-4 points). Conclusions The tool stratifies CVD risk in cancer patients and may guide tailored follow-up and cardioprotection. Heterogeneity within moderate-risk patients highlights the need for refinement to improve individualized assessment.

• Hageman, Steven H J; Kaptoge, Stephen; Gynnild, Mari Nordbø; Holtrop, Joris; Pennells, Lisa & McEvoy, J William [Show all 18 contributors for this article] (2025). Using SCORE2 with a risk chart or online calculator: impact on model performance, treatment eligibility, and cardiovascular disease prevention. European Heart Journal - Quality of Care and Clinical Outcomes. ISSN 2058-5225. doi: 10.1093/ehjqcco/qcaf122. Full text in Research Archive Show summary

  Aims Current European Cardiovascular Disease (CVD) prevention guidelines recommend 10-year risk assessment using the SCORE2 model to identify individuals eligible for preventive treatment. Risk can be estimated using conventional risk charts or online calculators, though these methods may differ in precision and treatment classification. Methods and results Individuals without established CVD or diabetes mellitus were included from CPRD (UK, Europe’s low risk region, n = 977 616) and HAPIEE (Czech Republic and Poland, high risk region and Lithuania, very high risk region, n = 11 739). During median 8.4 years [interquartile range (IQR) 5.0–10.4], 22 898 CVD events occurred. SCORE2 risk was estimated via two methods: an online calculator (unrounded SCORE2 algorithm) and risk charts from the 2021 ESC Prevention Guidelines. Predicted risks were higher with the risk charts than with the online calculator. In the low risk region, the median 10-year risk was 4.0% (IQR 2.0–6.0) with the risk charts vs. 3.7% (IQR 2.3–5.8) with the calculator. In the high/very high-risk region, risk was 9.0% (IQR 5.0–15.0) and 8.4% (IQR 4.5–13.9), respectively. Chart-based risk assessment resulted in higher treatment eligibility (6.3% vs. 4.0% in the low risk region; 51% vs. 43% in high/very high risk region). Discrimination was higher with the online calculator: difference in C-statistic +0.010 [95% confidence interval (CI) 0.008–0.012] in low risk region and +0.008 (95% CI 0.005–0.010) in high/very high risk region. Calibration was adequate for both approaches. Assuming a 50% relative risk reduction for preventive treatment, this corresponded to 53 vs. 46 events prevented per 1000 treated in the low-risk region and 80 vs. 74 in the high/very-high-risk region (calculator vs. risk charts). Conclusion Risk assessment using SCORE2 risk charts yields too high predicted risks and too broad treatment eligibility. By avoiding rounding of risk factors, the online calculator shows better discrimination.

• Holtrop, Joris; Gynnild, Mari Nordbø; Dammen, Toril; Dalen, Håvard; Saltvedt, Ingvild Tina & Ellekjær, Hanne [Show all 11 contributors for this article] (2025). Psychological factors beyond the SMART2 model for predicting recurrent events in atherosclerotic cardiovascular disease patients. European Journal of Preventive Cardiology (EJPC). ISSN 2047-4873. doi: 10.1093/eurjpc/zwaf526. Full text in Research Archive Show summary

  Aims Guidelines recommend using cardiovascular (CV) risk prediction models to support treatment decisions. Psychological factors such as depression, anxiety, and insomnia may affect CV risk. The aim is to evaluate the added value of these psychological factors on top of the SMART2 model for estimating 10-year risk of recurrent CV events in patients with atherosclerotic CV disease. Methods and results Patients aged 40–80 with atherosclerotic CV disease were included from the UCC-SMART, HUNT3, HUNT4, NORCOR, and Nor-COAST cohorts. Potential added value of (self-reported) symptoms, diagnoses, and treatment for depression, anxiety, and insomnia on top of the SMART2 was investigated using Fine and Gray models, with SMART2 coefficients as an offset. Added value was assessed by change (Δ) in C-statistic and calibration. A total of 20 050 patients were eligible, with 2987 experiencing recurrent CV events. Psychological factors were present in 3–9%, 3–45%, and 10–14% of patients for diagnosis, self-reported symptoms, and prescribed treatment, respectively. No psychological factors were significantly associated with recurrent CV events on top of SMART2 and performance in patients with psychological factors was adequate (C-statistics 0.61–0.70). Added value of psychological factors was minimal, with the ΔC-statistic ranging from −0.0003 [95% confidence interval: −0.0005–0.0001] for symptoms of depression, to 0.0011 [0.0011–0.0011] for prescribed treatment with anxiolytics. There was no relevant difference in calibration. Conclusion SMART2 model reliably estimates recurrent CV event risk in patients with psychological factors. Psychological factors have no added value to CV risk prediction when integrated on top of the SMART2 risk score.

• Omland, Torbjørn; Heck, Siri Lagethon; Holte, Espen; Mecinaj, Albulena; Gynnild, Mari Nordbø & Fagerland, Morten [Show all 13 contributors for this article] (2025). Sacubitril/Valsartan and Prevention of Cardiac Dysfunction During Adjuvant Breast Cancer Therapy: The PRADA II Randomized Clinical Trial. Circulation. ISSN 0009-7322. 152(16), p. 1136–1145. doi: 10.1161/circulationaha.125.076616. Full text in Research Archive Show summary

  Background: Anthracycline- and trastuzumab-associated cardiotoxicity may lead to cardiac dysfunction and dose reduction or halt in potentially life-saving adjuvant cancer therapy. Whether angiotensin receptor neprilysin inhibitors can prevent cancer therapy-related cardiac dysfunction and injury remains to be established. Methods: PRADA II was a randomized, parallel-group, placebo-controlled, double-blind multicenter trial conducted at 4 academic medical centers in Norway that evaluated the cardioprotective effect of sacubitril-valsartan vs. placebo administered concomitantly with anthracycline-containing breast cancer therapy and continued for 18 months. The target dose was 97/103 mg b.i.d. The primary outcome was change in left ventricular ejection fraction by cardiovascular magnetic resonance from prior to initiation of chemotherapy to 18 months after. Secondary outcomes included change in echocardiographic global longitudinal strain, circulating cardiac troponins, and N-terminal pro-B-type natriuretic peptide (NT-proBNP). Results: In total, 138 women (mean (±SD) age: 54.0 ± 9.4 years) were randomized. The overall decline in left ventricular ejection fraction from baseline to 18 months was 2.2 percentage points (95% confidence interval [CI], 1.1 to 3.3) in the placebo group and 1.1 percentage points (95% CI, -0.01 to 2.2) in the sacubitril-valsartan group. The between-group difference was 1.1 percentage points (95% CI, -0.4 to 2.7; P=0.16). Left ventricular global longitudinal strain was normal and remained stable in the sacubitril-valsartan group throughout the study (change from baseline to 18 months -0.32 [95% CI, -0.80 to 0.15]). In contrast, there was a progressive decline in the placebo group (change from baseline to 18 months 0.53 [95% CI, 0.05 to 1.00]). The between-group difference was -0.85 (95% CI, -1.52 to -0.18). The mean increases in NT-proBNP and cardiac troponin I concentrations from baseline to 18 months were greater in the placebo than in the sacubitril-valsartan group (log difference 0.303 (95% CI 0.0547 to 0.552) for NT-proBNP and 0.534 (95% CI 0.114 to 0.954) for cardiac troponin I). Conclusions: Anthracycline-based treatment for early breast cancer is associated with a reduction in left ventricular ejection fraction that was not significantly attenuated by sacubitril-valsartan.

• Sande, Ingvild Svorkdal; Helgheim, Kamilla Lind; Saltvedt, Ingvild Tina; Røsstad, Tove Garåsen; Spigset, Olav & Ellekjær, Hanne [Show all 7 contributors for this article] (2025). Follow-Up in Primary Care After Ischemic Stroke - Insights From the Nor-COAST Study. International Journal of General Medicine. doi: 10.2147/IJGM.S508154. Full text in Research Archive
• Fagerli, Erlend; Ellekjær, Hanne; Spigset, Olav; Saltvedt, Ingvild Tina & Gynnild, Mari Nordbø (2025). Three-year adherence to secondary prevention and vascular risk control after ischemic stroke. European Stroke Journal. ISSN 2396-9873. 11(1). doi: 10.1177/23969873251329210. Full text in Research Archive
• Aakerøy, Rachel; Gynnild, Mari Nordbø; Løfblad, Lena; Dyrkorn, Roar; Ellekjær, Hanne & Lydersen, Stian [Show all 8 contributors for this article] (2023). Direct oral anticoagulant concentrations and adherence in stroke patients. Basic & Clinical Pharmacology & Toxicology. ISSN 1742-7835. doi: 10.1111/bcpt.13953. Full text in Research Archive Show summary

  No therapeutic ranges linking drug concentrations of apixaban and rivaroxaban to clinical outcomes have been defined. We investigated whether direct oral anticoagulant (DOAC) concentrations among patients admitted to hospital with symptoms of stroke differed between those later verified to suffer an ischaemic cerebrovascular event (stroke or transient ischaemic attack) and those having other diagnoses (control group). Serum concentrations in 102 patients on DOAC for atrial fibrillation (84%) and thromboembolic disease (16%) were measured within 24 h of the acute event, employing ultra-high performance liquid chromatography with tandem mass spectrometry. We converted all concentrations to standardized trough levels. DOAC concentrations were lower in the 64 patients with verified ischaemic cerebrovascular event than in the 30 controls, 255 ± 155 versus 329 ± 144 nmol/L (p = 0.029), despite no statistically significant difference in self-reported adherence and daily dosages. Calculated concentrations were 5.4–596 nmol/L (median = 229 nmol/L) in the ischaemic stroke group and 41–602 nmol/L (median = 316 nmol/L) in controls. CHA2DS2-VASc score was significantly higher in the ischaemic stroke group than in controls (4.9 ± 1.6 versus 4.1 ± 1.7; p = 0.007). These results may suggest that patients with high cerebrovascular risk might benefit from higher DOAC levels than those with a lower risk.

• Hageman, Steven HJ; McKay, Ailsa; Ueda, Peter; Gunn, Laura; Jernberg, Tomas & Hagström, Emil [Show all 27 contributors for this article] (2022). Estimation of recurrent atherosclerotic cardiovascular event risk in patients with established cardiovascular disease: The updated SMART2 algorithm. European Heart Journal. ISSN 0195-668X. 43(18), p. 1715–1727. doi: 10.1093/eurheartj/ehac056. Full text in Research Archive Show summary

  Aims The 10-year risk of recurrent atherosclerotic cardiovascular disease (ASCVD) events in patients with established ASCVD can be estimated with the Secondary Manifestations of ARTerial disease (SMART) risk score, and may help refine clinical management. To broaden generalizability across regions, we updated the existing tool (SMART2 risk score) and recalibrated it with regional incidence rates and assessed its performance in external populations. Methods and results Individuals with coronary artery disease, cerebrovascular disease, peripheral artery disease, or abdominal aortic aneurysms were included from the Utrecht Cardiovascular Cohort-SMART cohort [n = 8355; 1706 ASCVD events during a median follow-up of 8.2 years (interquartile range 4.2–12.5)] to derive a 10-year risk prediction model for recurrent ASCVD events (non-fatal myocardial infarction, non-fatal stroke, or cardiovascular mortality) using a Fine and Gray competing risk-adjusted model. The model was recalibrated to four regions across Europe, and to Asia (excluding Japan), Japan, Australia, North America, and Latin America using contemporary cohort data from each target region. External validation used data from seven cohorts [Clinical Practice Research Datalink, SWEDEHEART, the international REduction of Atherothrombosis for Continued Health (REACH) Registry, Estonian Biobank, Spanish Biomarkers in Acute Coronary Syndrome and Biomarkers in Acute Myocardial Infarction (BACS/BAMI), the Norwegian COgnitive Impairment After STroke, and Bialystok PLUS/Polaspire] and included 369 044 individuals with established ASCVD of whom 62 807 experienced an ASCVD event. C-statistics ranged from 0.605 [95% confidence interval (CI) 0.547–0.664] in BACS/BAMI to 0.772 (95% CI 0.659–0.886) in REACH Europe high-risk region. The clinical utility of the model was demonstrated across a range of clinically relevant treatment thresholds for intensified treatment options. Conclusion The SMART2 risk score provides an updated, validated tool for the prediction of recurrent ASCVD events in patients with established ASCVD across European and non-European populations. The use of this tool could allow for a more personalized approach to secondary prevention based upon quantitative rather than qualitative estimates of residual risk.

• Gynnild, Mari Nordbø; Hageman, Steven H. J.; Spigset, Olav; Lydersen, Stian; Saltvedt, Ingvild & Dorresteijn, Jannick AN [Show all 8 contributors for this article] (2022). Use of lipid-lowering therapy after ischaemic stroke and expected benefit from intensification of treatment. Open heart. 9(1). doi: 10.1136/openhrt-2022-001972. Full text in Research Archive Show summary

  Objectives: Elevated low-density lipoprotein cholesterol (LDL-C) increases the risk of recurrent cardiovascular disease (CVD) events. We examined use of lipid-lowering therapy (LLT) following ischaemic stroke, and estimated benefits from guideline-based up-titration of LLT. Methods: The Norwegian COgnitive Impairment After STroke (Nor-COAST) study, a multicentre prospective cohort study, collected data on LLT use, dose intensity and LDL-C levels for 462 home-dwelling patients with ischaemic stroke. We used the Secondary Manifestations of Arterial Disease-Reduction of Atherothrombosis for Continued Health (SMART-REACH) model to estimate the expected benefit of up-titrating LLT. Results: At discharge, 92% received LLT (97% statin monotherapy). Patients with prestroke dementia and cardioembolic stroke aetiology were less likely to receive LLT. Older patients (coefficient −3 mg atorvastatin per 10 years, 95% CI −6 to −0.5) and women (coefficient −5.1 mg atorvastatin, 95% CI −9.2 to −0.9) received lower doses, while individuals with higher baseline LDL-C, ischaemic heart disease and large artery stroke aetiology received higher dose intensity. At 3 months, 45% reached LDL-C ≤1.8 mmol/L, and we estimated that 81% could potentially reach the target with statin and ezetimibe, resulting in median 5 (IQR 0–12) months of CVD-free life gain and median 2% 10-year absolute risk reduction (IQR 0–4) with large interindividual variation. Conclusion: Potential for optimisation of conventional LLT use exists in patients with ischaemic stroke. Awareness of groups at risk of undertreatment and objective estimates of the individual patient’s benefit of intensification can help personalise treatment decisions and reduce residual cholesterol risk.

• Gynnild, Mari Nordbø; Hageman, Steven HJ; Dorresteijn, Jannick AN; Spigset, Olav; Lydersen, Stian & Wethal, Torgeir [Show all 9 contributors for this article] (2021). Risk Stratification in Patients with Ischemic Stroke and Residual Cardiovascular Risk with Current Secondary Prevention. Clinical Epidemiology. 13, p. 813–823. doi: 10.2147/CLEP.S322779. Full text in Research Archive Show summary

  Purpose: Suboptimal secondary prevention in patients with stroke causes a remaining cardiovascular risk desirable to reduce. We have validated a prognostic model for secondary preventive settings and estimated future cardiovascular risk and theoretical benefit of reaching guideline recommended risk factor targets. Patients and Methods: The SMART-REACH (Secondary Manifestations of Arterial Disease-Reduction of Atherothrombosis for Continued Health) model for 10-year and lifetime risk of cardiovascular events was applied to 465 patients in the Norwegian Cognitive Impairment After Stroke (Nor-COAST) study, a multicenter observational study with twoyear follow-up by linkage to national registries for cardiovascular disease and mortality. The residual risk when reaching recommended targets for blood pressure, low-density lipoprotein cholesterol, smoking cessation and antithrombotics was estimated. Results: In total, 11.2% had a new event. Calibration plots showed adequate agreement between estimated and observed 2-year prognosis (C-statistics 0.63, 95% confidence interval 0.55–0.71). Median estimated 10-year risk of recurrent cardiovascular events was 42% (Interquartile range (IQR) 32–54%) and could be reduced to 32% by optimal guidelinebased therapy. The corresponding numbers for lifetime risk were 70% (IQR 63–76%) and 61%. We estimated an overall median gain of 1.4 (IQR 0.2–3.4) event-free life years if guideline targets were met. Conclusion: Secondary prevention was suboptimal and residual risk remains elevated even after optimization according to current guidelines. Considerable interindividual variation in risk exists, with a corresponding variation in benefit from intensification of treatment. The SMART-REACH model can be used to identify patients with the largest benefit from more intensive treatment and follow-up.

• Aam, Stina; Gynnild, Mari Nordbø; Munthe-Kaas, Ragnhild; Saltvedt, Ingvild; Lydersen, Stian & Knapskog, Anne Brita [Show all 10 contributors for this article] (2021). The Impact of Vascular Risk Factors on Post-stroke Cognitive Impairment: The Nor-COAST Study. Frontiers in Neurology. 12, p. 1–11. doi: 10.3389/fneur.2021.678794. Full text in Research Archive Show summary

  Introduction: Post-stroke cognitive impairment (PSCI) is common, but evidence on the impact of vascular risk factors is lacking. We explored the association between pre-stroke vascular risk factors and PSCI and studied the course of PSCI. Materials and Methods: Vascular risk factors were collected at baseline in stroke survivors (n = 635). Cognitive assessments of attention, executive function, memory, language, and the Montreal Cognitive Assessment (MoCA) were performed at 3 and/or 18 months post-stroke. Stroke severity was assessed with the National Institutes of Health Stroke Scale (NIHSS). PSCI was measured with global z; MoCA z-score; and z-score of the four assessed cognitive domains. Mixed-effect linear regression was applied with global z, MoCA z-score, and z-scores of the cognitive domains as dependent variables. Independent variables were the vascular risk factors (hypertension, hypercholesterolemia, smoking, diabetes mellitus, atrial fibrillation, coronary heart disease, previous stroke), time, and the interaction between these. The analyses were adjusted for age, education, and sex. There were between 5 and 25% missing data for the variables for PSCI. Results: Mean age was 71.6 years (SD 11.7); 42% were females; and the mean NIHSS score at admittance was 3.8 (SD 4.8). Regardless of vascular risk factors, global z, MoCA, and all the assessed cognitive domains were impaired at 3 and 18 months, with MoCA being the most severely impaired. Atrial fibrillation (AF) was associated with poorer language at 18 months and coronary heart disease (CHD) with poorer MoCA at 18 months (LR = 12.80, p = 0.002, and LR = 8.32, p = 0.004, respectively). Previous stroke was associated with poorer global z and attention at 3 and 18 months (LR = 15.46, p < 0.001, and LR = 16.20, p < 0.001). In patients without AF, attention improved from 3 to 18 months, and in patients without CHD, executive function improved from 3 to 18 months (LR = 10.42, p < 0.001, and LR = 9.33, p = 0.009, respectively). Discussion: Our findings indicate that a focal stroke lesion might be related to pathophysiological processes leading to global cognitive impairment. The poorer prognosis of PSCI in patients with vascular risk factors emphasizes the need for further research on complex vascular risk factor interventions to prevent PSCI.

• Gynnild, Mari Nordbø; Aakerøy, Rachel; Spigset, Olav; Askim, Torunn; Beyer, Mona Kristiansen & Ihle-Hansen, Hege [Show all 15 contributors for this article] (2020). Vascular risk factor control and adherence to secondary preventive medication after ischaemic stroke. Journal of Internal Medicine. ISSN 0954-6820. 289(3), p. 1–14. doi: 10.1111/joim.13161. Full text in Research Archive Show summary

  Background Studies regarding adequacy of secondary stroke prevention are limited. We report medication adherence, risk factor control and factors influencing vascular risk profile following ischaemic stroke. Methods A total of 664 home‐dwelling participants in the Norwegian Cognitive Impairment After Stroke study, a multicenter observational study, were evaluated 3 and 18 months poststroke. We assessed medication adherence by self‐reporting (4‐item Morisky Medication Adherence Scale) and medication persistence (defined as continuation of medication(s) prescribed at discharge), achievement of guideline‐defined targets of blood pressure (BP) (<140/90 mmHg), low‐density lipoprotein cholesterol (LDL‐C) (<2.0 mmol L−1) and haemoglobin A1c (HbA1c) (≤53 mmol mol−1) and determinants of risk factor control. Results At discharge, 97% were prescribed antithrombotics, 88% lipid‐lowering drugs, 68% antihypertensives and 12% antidiabetic drugs. Persistence of users declined to 99%, 88%, 93% and 95%, respectively, at 18 months. After 3 and 18 months, 80% and 73% reported high adherence. After 3 and 18 months, 40.7% and 47.0% gained BP control, 48.4% and 44.6% achieved LDL‐C control, and 69.2% and 69.5% of diabetic patients achieved HbA1c control. Advanced age was associated with increased LDL‐C control (OR 1.03, 95% CI 1.01 to 1.06) and reduced BP control (OR 0.98, 0.96 to 0.99). Women had poorer LDL‐C control (OR 0.60, 0.37 to 0.98). Polypharmacy was associated with increased LDL‐C control (OR 1.29, 1.18 to 1.41) and reduced HbA1c control (OR 0.76, 0.60 to 0.98). Conclusion Risk factor control is suboptimal despite high medication persistence and adherence. Improved understanding of this complex clinical setting is needed for optimization of secondary preventive strategies.

• Anshushaug, Malin; Gynnild, Mari Aas; Kaasa, Stein; Kvikstad, Anne & Grønberg, Bjørn H. (2014). Characterization of patients receiving palliative chemo- and radiotherapy during end of life at a regional cancer center in Norway. Acta Oncologica. ISSN 0284-186X. 54(3), p. 395–402. doi: 10.3109/0284186X.2014.948061. Full text in Research Archive Show summary

  Background. Many cancer patients receive chemotherapy and radiotherapy their last 30 days [end of life (EOL)]. The benefi t is questionable and side effects are common. The aim of this study was to investigate what characterized the patients who received chemo- and radiotherapy during EOL, knowledge that might be used to improve practice. Methods. Patients dead from cancer in 2005 and 2009 were analyzed. Data were collected from hospital medical records. When performance status (PS) was not stated, PS was estimated from other information in the records. A Glasgow Prognostic Score (GPS) of 0, 1 or 2 was assessed from blood values (CRP and albumin). A higher score is associated with a shorter prognosis. Results. In total 616 patients died in 2005; 599 in 2009. Among the 723 analyzed, median age was 71; 42% had metastases at diagnosis (synchronous metastases); 53% had PS 2 and 16% PS 3 – 4 at the start of last cancer therapy. GPS at the start of last cancer therapy was assessable in 70%; of these, 26% had GPS 1 and 35% GPS 2. Overall, 10% received chemotherapy and 8% radiotherapy during EOL. The proportions varied signifi cantly between the different types of cancer. Multivariate analyses revealed that those at age 70 years, GPS 2, no contact with our Palliative Care Unit and synchronous metastases received most chemotherapy the last 30 days. PS 3 – 4, GPS 2 and synchronous metastases were strongest associated with radiotherapy the last 30 days. Conclusion. Ten percent received chemotherapy and 8% radiotherapy the last 30 days of life. GPS 2 and synchronous metastases were most signifi cantly associated with cancer therapy the last 30 days of life, indicating that in general, patients with the shortest survival time after diagnosis of cancer received more chemo- and radiotherapy during EOL than other patients.

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• Vinje-Jakobsen, Victoria; Gynnild, Mari Nordbø; Mecinaj, Albulena; Wisløff, Torbjørn; Holte, Espen & Wethal, Torgeir [Show all 13 contributors for this article] (2026). The effect of sacubitril/valsartan on functional disability and skeletal muscle injury during breast cancer therapy: insights from the PRADA II trial. Full text in Research Archive Show summary

  Background: Anthracycline therapy induces dose-dependent cardiotoxicity and systemic adverse effects, including functional disability. While sacubitril/valsartan attenuates early subclinical myocardial injury during breast cancer therapy, its impact on functional capacity and skeletal muscle injury remains unknown. Purpose: To evaluate whether sacubitril/valsartan attenuates anthracycline-induced decline in functional capacity and skeletal muscle injury compared to placebo. Methods: PRADA II was a randomised, double-blind, placebo-controlled multicentre trial including 138 women with early breast cancer receiving (neo)adjuvant anthracycline therapy±trastuzumab. Participants were randomised prior to anthracycline initiation to sacubitril/valsartan or placebo for 18 months. The predefined primary outcome of this substudy was change in maximal handgrip strength from baseline to 18 months. Secondary outcomes included changes in 6-minute walk distance and circulating creatine kinase (CK) and myoglobin concentrations. Assessments were performed at baseline, post-anthracycline (Visit 2), and at 18 months (Visit 3). Changes were analysed using generalised linear mixed models, and a two-sided alpha level of 0.05 was applied to the primary outcome of this predefined substudy. Results: Maximal handgrip strength declined in both groups from baseline to Visit 2, with partial recovery at Visit 3 in the sacubitril/valsartan group and continued decline in the placebo group. No significant between-group difference was observed in handgrip strength (between-group change from baseline to Visit 3: -0.3 kg, 95% CI -1.5 to 0.8, p=0.57). However, a greater decline from baseline to Visit 2 was observed with sacubitril/valsartan than placebo, corresponding to a between-group difference of -1.8 kg, 95% CI -3.0 to -0.6. 6-minute walk distance increased from baseline to both follow-up timepoints in the sacubitril/valsartan group, and a transient reduction was observed in the placebo group from baseline to Visit 2. Between-group changes did not differ at Visit 2 (8.8 m, 95% CI -19.3 to 36.9) or Visit 3 (13.6 m, 95% CI -13.3 to 40.5). CK and myoglobin were numerically higher in the placebo group from baseline to Visit 3, however, the confidence intervals for between-group differences included the null value (CK geometric mean ratio 1.17, 95% CI 0.94 to 1.45; myoglobin 1.10, 95% CI 0.98 to 1.23). Temporal changes by randomisation group are shown in Figure 1. Conclusions: Sacubitril/valsartan did not significantly attenuate anthracycline-related decline in functional capacity assessed by maximal handgrip strength and 6-minute walk distance or changes in biomarkers of skeletal muscle injury. These findings suggest a neutral effect of sacubitril/valsartan on functional capacity, without challenging its potential cardioprotective role during anthracycline therapy.

• Gynnild, Mari Nordbø; Gulati, Geeta; Mecinaj, Albulena; Wethal, Torgeir; Holte, Espen & Vinje-Jakobsen, Victoria [Show all 11 contributors for this article] (2026). Baseline and early changes in cardiac biomarkers as predictors of global longitudinal strain deterioration during breast cancer therapy: a PRADAII substudy. Full text in Research Archive Show summary

  Background: Cardiac biomarkers are recommended for risk stratification before and during potentially cardiotoxic cancer therapy, but the prognostic value of baseline levels and early changes for subsequent left ventricular (LV) dysfunction remains unclear. Objectives: To evaluate whether baseline and early changes in high-sensitivity cardiac troponins (hs-cTnI, hs-cTnT) and N-terminal pro–B-type natriuretic peptide (NT-proBNP) predict changes in global longitudinal strain (GLS) over 18 months. Methods: In the randomized PRADAII, 138 women treated with anthracyclines (±trastuzumab) received sacubitril/valsartan or placebo and underwent serial biomarker sampling and cardiac imaging at baseline, post-anthracycline, and 18 months. Longitudinal changes in GLS and left ventricular ejection fraction (LVEF) were analyzed using adjusted linear mixed models, including exploratory analyses of combined, persistent, and peak biomarker elevations. Results: Mean age was 54.0±9.4 years. At baseline, no patients had hs-cTnI values above the sex-specific 99th percentile, 6 (4%) had hs-cTnT >99th percentile, and 16 (12%) had NT-proBNP >125 ng/L. Mean baseline GLS was −19.5±2.1% and CMR- and echocardiography-derived LVEF was 60.3±4.8% and 58.3±6.2%, respectively. GLS declined modestly over follow-up, with less deterioration in the sacubitril/valsartan group than in the placebo group (ΔΔ −1.26, 95% CI −2.19 to −0.33). Both hs-cTnI and hs-cTnT increased markedly after anthracycline therapy, with 16.7% and 71.7% exceeding the sex-specific 99th percentile at peak, whereas NT-proBNP showed modest changes with wide inter-individual variability. Transient and persistent troponin elevation occurred in 60.1% and 11.6%, respectively; corresponding NT-proBNP elevations in 5.1% and 7.3%, and combined troponin and NT-proBNP elevation in 9.4%. Baseline biomarker levels were not associated with GLS deterioration, and no biomarker–treatment interactions were observed (all p for interaction >0.27). Early post-anthracycline changes in hs-cTnI, hs-cTnT, or NT-proBNP were not predictive of subsequent GLS decline, nor were peak or persistent elevations (Table 1, Figure 1). No significant associations were observed between baseline or early biomarker levels and changes in LVEF assessed by echocardiography or CMR. Conclusions: In our breast cancer cohort with preserved baseline LV function, baseline levels and early changes in hs-cTnI, hs-cTnT, and NT-proBNP were not associated with subsequent deterioration in GLS over 18 months. Larger studies including higher-risk patients and clinical endpoints are needed to clarify the role of cardiac biomarkers in individualized cardiotoxicity risk stratification.

• Gynnild, Mari Nordbø; Gulati, Geeta; Mecinaj, Albulena; Wethal, Torgeir; Holte, Espen & Vinje-Jakobsen, Victoria [Show all 11 contributors for this article] (2026). Baseline and early changes in cardiac biomarkers as predictors of global longitudinal strain deterioration during breast cancer therapy: a PRADAII substudy. European Heart Journal, Supplement. ISSN 1520-765X. 28(Supplement_8). doi: 10.1093/eurheartjsupp/suag097.089. Full text in Research Archive Show summary

  Abstract Background Cardiac biomarkers are recommended for risk stratification before and during potentially cardiotoxic cancer therapy, but the prognostic value of baseline levels and early changes for subsequent left ventricular (LV) dysfunction remains unclear. Objectives To evaluate wheter baseline and early changes in high-sensitivity cardiac troponins (hs-cTnI, hs-cTnT) and N-terminal pro–B-type natriuretic peptide (NT-proBNP) predict changes in global longitudinal strain (GLS) over 18 months. Methods In the randomized PRADAII, 138 women treated with anthracyclines (±trastuzumab) received sacubitril/valsartan or placebo and underwent serial biomarker sampling and cardiac imaging at baseline, post-anthracycline, and 18 months. Longitudinal changes in GLS and left ventricular ejection fraction (LVEF) were analyzed using adjusted linear mixed models, including exploratory analyses of combined, persistent, and peak biomarker elevations. Results Mean age was 54.0±9.4 years. At baseline, no patients had hs-cTnI values above the sex-specific 99th percentile, 6 (4%) had hs-cTnT &gt;99th percentile, and 16 (12%) had NT-proBNP &gt;125 ng/L. Mean baseline GLS was −19.5±2.1% and CMR- and echocardiography-derived LVEF was 60.3±4.8% and 58.3±6.2%, respectively. GLS declined modestly over follow-up, with less deterioration in the sacubitril/valsartan group than in the placebo group (ΔΔ −1.26, 95% CI −2.19 to −0.33). Both hs-cTnI and hs-cTnT increased markedly after anthracycline therapy, with 16.7% and 71.7% exceeding the sex-specific 99th percentile at peak, whereas NT-proBNP showed modest changes with wide inter-individual variability. Transient and persistent troponin elevation occurred in 60.1% and 11.6%, respectively; corresponding NT-proBNP elevations in 5.1% and 7.3%, and combined troponin and NT-proBNP elevation in 9.4%. Baseline biomarker levels were not associated with GLS deterioration, and no biomarker–treatment interactions were observed (all p for interaction &gt;0.27). Early post-anthracycline changes in hs-cTnI, hs-cTnT, or NT-proBNP were not predictive of subsequent GLS decline, nor were peak or persistent elevations (Table 1, Figure 1). No significant associations were observed between baseline or early biomarker levels and changes in LVEF assessed by echocardiography or CMR. Conclusions In our breast cancer cohort with preserved baseline LV function, baseline levels and early changes in hs-cTnI, hs-cTnT, and NT-proBNP were not associated with subsequent deterioration in GLS over 18 months. Larger studies including higher-risk patients and clinical endpoints are needed to clarify the role of cardiac biomarkers in individualized cardiotoxicity risk stratification.  

• Reitsma, Tessa; Holtrop, Joris; Gynnild, Mari Nordbø; Lim, Carl E; Pennels, Lisa & Keene, Spencer [Show all 14 contributors for this article] (2025). Lifetime prediction of incident heart failure risk in patients with established atherosclerotic cardiovascular disease: the SMART2-HF risk score. Full text in Research Archive
• Gynnild, Mari Nordbø; Hageman, Steven; Holtrop, Joris; Holte, Espen; Dalen, Håvard & Wethal, Torgeir [Show all 7 contributors for this article] (2025). Improved risk stratification with SCORE2 on top of HFA-ICOS in cancer patients without previous cardiovascular disease. European Heart Journal, Supplement. ISSN 1520-765X. doi: 10.1093/eurheartj/ehaf784.4088. Full text in Research Archive
• Gynnild, Mari Nordbø; Hageman, Steven; Holtrop, Joris; Holte, Espen; Dalen, Håvard & Wethal, Torgeir [Show all 7 contributors for this article] (2025). Improved risk stratification with SCORE2 on top of HFA-ICOS in cancer patients without previous cardiovascular disease. Full text in Research Archive
• Hageman, Steven HJ; Kaptoge, Steven; Gynnild, Mari Nordbø; Pennels, Lisa; Pajak, Andrzej & Pikhart, Hynek [Show all 12 contributors for this article] (2025). Assessment of CV risk by SCORE2 with an online calculator estimates CV risk better compared to 2-dimensional risk charts. European Journal of Preventive Cardiology (EJPC). ISSN 2047-4873. doi: 10.1093/eurjpc/zwaf236.190. Full text in Research Archive
• Holtrop, Joris; Gynnild, Mari Nordbø; Dammen, Toril; Dalen, Håvard; Hageman, Steven HJ & Visseren, Frank [Show all 9 contributors for this article] (2025). Integration of psychological risk modifiers on-top the SMART2-risk score for estimation of recurrent cardiovascular events in patients with atherosclerotic cardiovascular disease. European Journal of Preventive Cardiology (EJPC). ISSN 2047-4873. doi: 10.1093/eurjpc/zwaf236.210. Full text in Research Archive
• Gynnild, Mari Nordbø; Holtrop, Joris; Dalen, Håvard; Dorresteijn, Jannick; Visseren, Frank & Holte, Espen [Show all 9 contributors for this article] (2025). Validation of the LIFE-CVD2 model for lifetime cardiovascular risk prediction in cancer survivors. European Journal of Preventive Cardiology (EJPC). ISSN 2047-4873. doi: 10.1093/eurjpc/zwaf236.207. Full text in Research Archive
• Hageman, Steven H. J.; Kaptoge, Stephen; Gynnild, Mari Nordbø; Holtrop, Joris; Pennels, Lisa & McEvoy, John William [Show all 18 contributors for this article] (2025). Using SCORE2 with a risk chart or online calculator: Impact on model performance, treatment eligibility and cardiovascular disease prevention. Full text in Research Archive
• Gynnild, Mari Nordbø; Holtrop, Joris; Dorresteijn, Jannick A. N.; Visseren, F.L.J.; Dalen, Håvard & Holte, Espen [Show all 9 contributors for this article] (2025). Validation of the LIFE-CVD2 model for lifetime cardiovascular risk prediction in cancer survivors. Full text in Research Archive
• Holtrop, Joris; Gynnild, Mari Nordbø; Dalen, Håvard; Dammen, Toril; McEvoy, John William & Hageman, Steven H. J. [Show all 9 contributors for this article] (2025). Integration of guideline-recommended psychosocial risk modifiers on-top the SMART2-risk score for estimation of recurrent cardiovascular events in patients with established cardiovascular disease. Full text in Research Archive
• Gynnild, Mari Nordbø; Holtrop, Joris; Hageman, Steven HJ; Vinje, Victoria; Dorresteijn, Jannick AN & Visseren, Frank [Show all 10 contributors for this article] (2024). External validation of the HFA-ICOS risk stratification tool for prediction of cardiovascular complications after cancer treatment. European Heart Journal, Supplement. ISSN 1520-765X. doi: 10.1093/eurheartj/ehae666.2693. Full text in Research Archive
• Holtrop, Joris; Gynnild, Mari Nordbø; Ueda, Peter; Tuñón, José; Bhat, Deepak & Jernberg, Thomas [Show all 9 contributors for this article] (2024). Estimation of individual lifetime cardiovascular disease risk and treatment benefit in patients with established atherosclerotic cardiovascular disease: the updated SMART-REACH2 model. Full text in Research Archive
• Gynnild, Mari Nordbø; Holtrop, Joris; Hageman, Steven; Vinje, Victoria; Dorresteijn, Jannick & Visseren, Frank [Show all 10 contributors for this article] (2024). External validation of the Systematic COronary Risk Evaluation 2 (SCORE2) model in cancer patients. Full text in Research Archive
• Gynnild, Mari Nordbø; Holtrop, Joris; Hageman, Steven; Vinje, Victoria; Dorresteijn, Jannick A.N. & Visseren, Frank [Show all 10 contributors for this article] (2024). External validation of the HFA-ICOS risk stratification tool for prediction of cardiovascular complications after cancer treatment. Full text in Research Archive
• Gynnild, Mari Nordbø; Holtrop, Joris; Hageman, Steven HJ; Vinje, Victoria; Dorresteijn, Jannick AN & Visseren, Frank [Show all 10 contributors for this article] (2024). External validation of the Systematic COronary Risk Evaluation 2 (SCORE2) model in cancer patients. European Heart Journal, Supplement. ISSN 1520-765X. doi: 10.1093/eurheartj/ehae666.2692. Full text in Research Archive
• Gynnild, Mari Nordbø (2024). Kardiovaskulær risikostratifisering. Hjerteforum. ISSN 0802-1465. Full text in Research Archive
• Holtrop, Joris; Gynnild, Mari Nordbø; Munkhaugen, John; Dalen, Håvard; Lim, Carl-Emil & Ueda, Peter [Show all 14 contributors for this article] (2024). Estimation of individual lifetime cardiovascular disease risk and treatment benefit in patients with established atherosclerotic cardiovascular disease: the updated SMART-REACH2 model. European Heart Journal, Supplement. ISSN 1520-765X. 45(1). doi: 10.1093/eurheartj/ehae666.2695. Full text in Research Archive
• Gynnild, Mari Nordbø (2022). Etterlevelse av forbyggende behandling, er vi sammen gode nok? Full text in Research Archive
• Gynnild, Mari Nordbø (2022). Under halvparten nådde de anbefalte målene for blodtrykk og kolesterol. [Journal]. Dagens Medisin. Full text in Research Archive
• Gynnild, Mari Nordbø (2021). Optimalisert etterlevelse for sekundærprofylaktiske legemidler. Full text in Research Archive
• Gynnild, Mari Nordbø; Aakerøy, Rachel; Spigset, Olav & Ellekjær, Hanne (2020). Adherence to secondary preventive anticoagulation and risk for subsequent stroke and death. Full text in Research Archive
• Gynnild, Mari Nordbø & Ellekjær, Hanne (2018). Adherence to secondary prevention after stroke. Full text in Research Archive
• Gynnild, Mari Nordbø; Ellekjær, Hanne; Spigset, Olav; Røsstad, Tove & Næss, Halvor (2022). RESIDUAL CARDIOVASCULAR RISK AFTER ISCHEMIC STROKE Risk factors, medication adherence and risk-benefit considerations. Norges teknisk-naturvitenskapelige universitet. ISSN 9788232651818. Full text in Research Archive

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