Pia Lundman

My research focuses on the role of cardiometabolic risk factors (particularly glucose and lipids) in cardiovascular disease and prognosis. I primarily conduct clinical research, complemented by some translational research. My work is based on both prospective and retrospective cohort studies, including data from Swedish cardiovascular registries such as SWEDEHEART and the Atrial Fibrillation Registry, as well as data collected in my own studies.

Glucose Metabolic Disturbances and Prognosis in Cardiovascular Disease

A central part of my research concerns the relationship between disordered glucose metabolism—prediabetes, newly diagnosed diabetes, and established type 2 diabetes—and outcomes in various forms of cardiovascular disease.

In prospective cohort studies and registry-based analyses, we have investigated the prognostic implications of oral glucose tolerance testing (OGTT), fasting glucose, and HbA1c in patients with acute coronary syndromes, and compared the ability of different methods to identify high-risk patients (European Journal of Preventive Cardiology, 2013; Cardiovascular Diabetology, 2021), as well as long-term prognosis in dysglycaemia and acute coronary syndromes (Cardiovascular Diabetology, 2015). I have contributed to a study examining the prevalence and consequences of preoperative dysglycaemia prior to coronary artery bypass surgery (Open Heart, 2020).

Atrial Fibrillation in Diabetes and Prediabetes

We study the prevalence and prognosis of atrial fibrillation in relation to metabolic disease. In a nationwide cohort study, we characterised cardiovascular risk and mortality in atrial fibrillation and diabetes, including analyses stratified by type 1 and type 2 diabetes (European Journal of Preventive Cardiology, 2022; Diabetes & Vascular Disease Research, 2018).

In another study, we found that elevated fasting glucose—even at the prediabetes level—was associated with an increased risk of developing atrial fibrillation and heart failure during 19 years of follow-up in more than 240, 000 individuals (Cardiovascular Diabetology, 2021).

In an ongoing study, partly funded by the Swedish Heart-Lung Foundation, we are investigating the prevalence and clinical significance of modifiable metabolic factors, such as prediabetes and diabetes, for recurrence and complications in atrial fibrillation. Data analysis is currently underway, and long-term follow-up is planned.

Lipid Management and Cardiovascular Prevention

In registry-based analyses, we have studied the extent to which patients with recent myocardial infarction achieve LDL cholesterol targets according to the 2011, 2016, and 2019 ESC/EAS guidelines (European Heart Journal – Quality of Care and Clinical Outcomes, 2021; European Heart Journal, 2020), as well as how SCORE2-based risk assessment affects the estimated treatment burden in an apparently healthy middle-aged population (European Journal of Preventive Cardiology, 2024). We have also analysed discontinuation and reinitiation of secondary preventive pharmacotherapy after myocardial infarction (European Heart Journal – Cardiovascular Pharmacotherapy, 2026), with relevance for interventions aimed at improving medication adherence.

Following my postdoctoral training in Australia, I participated in a research collaboration with, among others, Professor Stephen Nicholls and Professor Philip Barter, conducting a series of analyses within the VOYAGER programme (individual patient data meta-analysis of statin therapy). These studies examined LDL-cholesterol responses to different statins and doses, guideline-based target attainment, and treatment effects in specific patient groups, including patients with diabetes and hypertriglyceridaemia (Atherosclerosis, 2015; American Journal of Cardiology, 2016; European Journal of Preventive Cardiology, 2016; Atherosclerosis, 2017).

Biomarkers and Atherosclerosis

My research interest also covers the development of atherosclerosis and we study, among other aspects, circulating biomarkers and their association with atherosclerotic disease and prognosis. In a cross-sectional study within a population-based cohort of middle-aged individuals (SCAPIS), we investigated the association between high-sensitivity C-reactive protein and coronary atherosclerotic burden (Scientific Reports, 2023). I have also contributed to studies of plasma proteomics associated with coronary atherosclerosis (Atherosclerosis, 2025), as well as inflammatory biomarkers and long-term outcomes in young patients three months after a first myocardial infarction (Cytokine, 2024).

Additionally, I have participated in studies of patients with coronary artery disease and varying degrees of renal function, in which we identified associations between inflammatory and angiogenic proteins and the risk of cardiovascular events and mortality (Clinical Kidney Journal, 2024; International Journal of Cardiology, 2023).