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Accuracy of the ICD-10 discharge diagnosis for syncope.

https://arctichealth.org/en/permalink/ahliterature119178
Source
Europace. 2013 Apr;15(4):595-600
Publication Type
Article
Date
Apr-2013
Author
Martin Huth Ruwald
Morten Lock Hansen
Morten Lamberts
Søren Lund Kristensen
Mads Wissenberg
Anne-Marie Schjerning Olsen
Stefan Bisgaard Christensen
Michael Vinther
Lars Køber
Christian Torp-Pedersen
Jim Hansen
Gunnar Hilmar Gislason
Author Affiliation
Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark. mruwald@hotmail.com
Source
Europace. 2013 Apr;15(4):595-600
Date
Apr-2013
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Chi-Square Distribution
Denmark - epidemiology
Emergency Service, Hospital - statistics & numerical data
Female
Humans
International Classification of Diseases - statistics & numerical data
Male
Middle Aged
Patient Discharge - statistics & numerical data
Predictive value of tests
Reproducibility of Results
Retrospective Studies
Risk factors
Syncope - diagnosis - epidemiology
Abstract
Administrative discharge codes are widely used in epidemiology, but the specificity and sensitivity of this coding is unknown and must be validated. We assessed the validity of the discharge diagnosis of syncope in administrative registers and reviewed the etiology of syncope after workup.
Two samples were investigated. One sample consisted of 5262 randomly selected medical patients. The other sample consisted of 750 patients admitted or seen in the emergency department (ED) for syncope (ICD-10: R55.9) in three hospitals in Denmark. All charts were reviewed for baseline characteristics and to confirm the presence/absence of syncope and to compare with the administrative coding. In a sample of 600 admitted patients 570 (95%) and of 150 patients from ED 140 (93%) had syncope representing the positive predictive values. Median age of the population was 69 years (IQR: ± 14). In the second sample of 5262 randomly selected medical patients, 75 (1.4%) had syncope, of which 47 were coded as R55.9 yielding a sensitivity of 62.7%, a negative predictive value of 99.5%, and a specificity of 99.9%.
ED and hospital discharge diagnostic coding for syncope has a positive predictive value of 95% and a sensitivity of 63%.
PubMed ID
23129545 View in PubMed
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Age-dependent trends in postoperative mortality and preoperative comorbidity in isolated coronary artery bypass surgery: a nationwide study.

https://arctichealth.org/en/permalink/ahliterature277099
Source
Eur J Cardiothorac Surg. 2016 Feb;49(2):391-7
Publication Type
Article
Date
Feb-2016
Author
Kristinn Thorsteinsson
Kirsten Fonager
Charlotte Mérie
Gunnar Gislason
Lars Køber
Christian Torp-Pedersen
Rikke N Mortensen
Jan J Andreasen
Source
Eur J Cardiothorac Surg. 2016 Feb;49(2):391-7
Date
Feb-2016
Language
English
Publication Type
Article
Keywords
Age Distribution
Aged
Aged, 80 and over
Comorbidity
Coronary Artery Bypass - mortality
Coronary Artery Disease - mortality - surgery
Denmark - epidemiology
Elective Surgical Procedures - mortality
Emergency Treatment - mortality
Female
Humans
Kaplan-Meier Estimate
Length of Stay
Male
Middle Aged
Postoperative Complications - mortality
Retrospective Studies
Abstract
An increasing number of octogenarians are being subjected to coronary artery bypass grafting (CABG). The purpose of this study was to examine age-dependent trends in postoperative mortality and preoperative comorbidity over time following CABG.
All patients who underwent isolated CABG surgery between January 1996 and December 2012 in Denmark were included. Patients were identified through nationwide administrative registers. Age was categorized into five different groups and time into three periods to see if mortality and preoperative comorbidity had changed over time. Predictors of 30-day mortality were analysed in a multivariable Cox proportional-hazard models and survival at 1 and 5 years was estimated by Kaplan-Meier curves.
A total of 38 830 patients were included; the median age was 65.4 ± 9.5 years, increasing over time to 66.6 ± 9.5 years. Males comprised 80%. The number of octogenarians was 1488 (4%). The median survival was 14.7 years (60-69 years), 10.7 years (70-74 years), 8.9 years (75-79 years) and 7.2 years (=80 years). The 30-day mortality rate was 3%, increasing with age (1% in patients 80 years), respectively. The proportion of patients >75 years increased from 10 to 20% during the study period as well as the proportion of patients undergoing urgent or emergency surgery. The burden of comorbidities increased over time, e.g. congestive heart failure 13-17%, diabetes 12-21%, stroke 9-11%, in all age groups. Age and emergency surgery were the main predictors of 30-day mortality: age >80 years [hazard ratio (HR): 5.75, 95% confidence interval (CI): 4.41-7.50], emergency surgery (HR: 5.23, 95% CI: 4.38-6.25).
Patients are getting older at the time of surgery and have a heavier burden of comorbidities than before. The proportion of patients undergoing urgent or emergency surgery increased with age and over time. Despite this, the 30-day mortality decreased over time and long-term survival increased, except in octogenarians where it was stable. Octogenarians had substantially higher 30-day mortality compared with younger patients but surgery can be performed with acceptable risks and good long-term outcomes.
Notes
Comment In: Eur J Cardiothorac Surg. 2016 Feb;49(2):397-826242898
PubMed ID
25698155 View in PubMed
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Age-specific performance of the revised cardiac risk index for predicting cardiovascular risk in elective noncardiac surgery.

https://arctichealth.org/en/permalink/ahliterature266490
Source
Circ Cardiovasc Qual Outcomes. 2015 Jan;8(1):103-8
Publication Type
Article
Date
Jan-2015
Author
Charlotte Andersson
Mads Wissenberg
Mads Emil Jørgensen
Mark A Hlatky
Charlotte Mérie
Per Føge Jensen
Gunnar H Gislason
Lars Køber
Christian Torp-Pedersen
Source
Circ Cardiovasc Qual Outcomes. 2015 Jan;8(1):103-8
Date
Jan-2015
Language
English
Publication Type
Article
Keywords
Adult
Age Distribution
Age Factors
Aged
Aged, 80 and over
Brain Ischemia - etiology
Cardiovascular Diseases - diagnosis - etiology - mortality
Comorbidity
Decision Support Techniques
Denmark
Elective Surgical Procedures
Female
Humans
Logistic Models
Male
Middle Aged
Multivariate Analysis
Myocardial Infarction - etiology
Odds Ratio
Registries
Retrospective Studies
Risk assessment
Risk factors
Stroke - etiology
Surgical Procedures, Operative - adverse effects - mortality
Time Factors
Treatment Outcome
Abstract
The revised cardiac risk index (RCRI) holds a central role in preoperative cardiac risk stratification in noncardiac surgery. Its performance in unselected populations, including different age groups, has, however, not been systematically investigated. We assessed the relationship of RCRI with major adverse cardiovascular events in an unselected cohort of patients undergoing elective, noncardiac surgery overall and in different age groups.
We followed up all individuals = 25 years who underwent major elective noncardiac surgery in Denmark (January 1, 2005, to November 30, 2011) for the 30-day risk of major adverse cardiovascular events (ischemic stroke, myocardial infarction, or cardiovascular death). There were 742 of 357,396 (0.2%), 755 of 74.889 (1.0%), 521 of 11,921 (4%), and 257 of 3146 (8%) major adverse cardiovascular events occurring in RCRI classes I, II, III, and IV. Multivariable odds ratio estimates were as follows: ischemic heart disease 3.30 (95% confidence interval, 2.96-3.69), high-risk surgery 2.70 (2.46-2.96), congestive heart failure 2.65 (2.29-3.06), cerebrovascular disease 10.02 (9.08-11.05), insulin therapy 1.62 (1.37-1.93), and kidney disease 1.45 (1.33-1.59). Modeling RCRI classes as a continuous variable, C statistic was highest among age group 56 to 65 years (0.772) and lowest for those aged >85 years (0.683). Sensitivity of RCRI class >I (ie, having = 1 risk factor) for capturing major adverse cardiovascular events was 59%, 71%, 64%, 66%, and 67% in patients aged = 55, 56 to 65, 66 to 75, 76 to 85, and >85 years, respectively; the negative predictive values were >98% across all age groups.
In a nationwide unselected cohort, the performance of the RCRI was similar to that of the original cohort. Having = 1 risk factor was of moderate sensitivity, but high negative predictive value for all ages.
PubMed ID
25587095 View in PubMed
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Age-Specific Trends in Incidence, Mortality, and Comorbidities of Heart Failure in Denmark, 1995 to 2012.

https://arctichealth.org/en/permalink/ahliterature282234
Source
Circulation. 2017 Mar 28;135(13):1214-1223
Publication Type
Article
Date
Mar-28-2017
Author
Mia N Christiansen
Lars Køber
Peter Weeke
Ramachandran S Vasan
Jørgen L Jeppesen
J Gustav Smith
Gunnar H Gislason
Christian Torp-Pedersen
Charlotte Andersson
Source
Circulation. 2017 Mar 28;135(13):1214-1223
Date
Mar-28-2017
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Comorbidity
Denmark - epidemiology
Female
Heart Failure - epidemiology
History, 20th Century
History, 21st Century
Humans
Incidence
Male
Middle Aged
Mortality
Risk factors
Young Adult
Abstract
The cumulative burden and importance of cardiovascular risk factors have changed over the past decades. Specifically, obesity rates have increased among younger people, whereas cardiovascular health has improved in the elderly. Little is known regarding how these changes have impacted the incidence and the mortality rates of heart failure. Therefore, we aimed to investigate the age-specific trends in the incidence and 1-year mortality rates following a first-time diagnosis of heart failure in Denmark between 1995 and 2012.
We included all Danish individuals >18 years of age with a first-time in-hospital diagnosis of heart failure. Data were collected from 3 nationwide Danish registries. Annual incidence rates of heart failure and 1-year standardized mortality rates were calculated under the assumption of a Poisson distribution.
We identified 210?430 individuals with a first-time diagnosis of heart failure between 1995 and 2012; the annual incidence rates per 10?000 person-years declined among older individuals (rates in 1995 versus 2012: 164 versus 115 in individuals >74 years, 63 versus 35 in individuals 65-74 years, and 20 versus 17 in individuals 55-64 years; P50 years of age, and 1.52 (95% confidence interval, 1.33-1.73; P50 years), but increased among younger (=50 years) individuals. These observations may portend a rising burden of heart failure in the community.
PubMed ID
28174193 View in PubMed
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Alcohol consumption and mortality in patients undergoing coronary artery bypass graft (CABG)-a register-based cohort study.

https://arctichealth.org/en/permalink/ahliterature285995
Source
BMC Cardiovasc Disord. 2016 Nov 11;16(1):219
Publication Type
Article
Date
Nov-11-2016
Author
Mads Phillip Kofoed Grabas
Steen Møller Hansen
Christian Torp-Pedersen
Henrik Bøggild
Line Rosenkilde Ullits
Ulrik Deding
Berit Jamie Nielsen
Per Føge Jensen
Charlotte Overgaard
Source
BMC Cardiovasc Disord. 2016 Nov 11;16(1):219
Date
Nov-11-2016
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Alcohol Abstinence
Alcohol Drinking - adverse effects - mortality - prevention & control
Alcoholism - mortality - prevention & control
Chi-Square Distribution
Coronary Artery Bypass - adverse effects - mortality
Coronary Artery Disease - diagnosis - mortality - surgery
Denmark - epidemiology
Female
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Multivariate Analysis
Proportional Hazards Models
Registries
Risk assessment
Risk factors
Time Factors
Treatment Outcome
Abstract
Previous studies have shown that compared with abstinence and heavy drinking, moderate alcohol consumption is associated with a reduced risk of mortality among the general population and patients with heart failure and myocardial infarction. We examined the association between alcohol consumption and mortality in coronary artery bypass graft (CABG) patients.
We studied 1,919 first-time CABG patients using data on alcohol consumption and mortality obtained from Danish national registers from March 2006 to October 2011. Alcohol consumption was divided into the following groups: abstainers (0 units/week), moderate consumers (1-14 units/week), moderate-heavy drinkers (15-21 units/week) and heavy drinkers (>21 units/week). Hazard ratios (HR) of all-cause mortality were calculated using Cox proportional hazard regression analysis.
The median follow-up was 2.2 years [IQR 2.0]. There were 112 deaths, of which 96 (86 %) were classified as cardiovascular. Adjustments for age and sex showed no increased risk of all-cause mortality for the abstainers (HR 1.61, 95 % CI, 1.00-2.58) and moderate-heavy drinkers (HR 1.40, 95 % CI, 0.73-2.67) compared with moderate consumers. However, heavy drinkers had a high risk of all-cause mortality compared with moderate consumers (HR 2.44, 95 % CI, 1.47-4.04). A full adjustment showed no increase in mortality for the abstainers (HR 1.59, 95 % CI, 0.98-2.57) and moderate-heavy drinkers (HR 1.68, 95 % CI, 0.86-3.29), while heavy drinkers were associated with an increased mortality rate (HR 1.88, 95 % CI, 1.10-3.21). There was no increased risk of 30-day mortality for the abstainers (HR 0.74, 95 % CI, 0.23-2.32), moderate-heavy drinkers (HR 0.36, 95 % CI, 0.07-1.93) and heavy drinkers (HR 2.20, 95 % CI, 0.65-7.36).
There was no increased risk of mortality for abstainers (0 units/week) or moderate-heavy drinkers (15-21 units/week) following a CABG. Only heavy drinking (>21 units/week) were significantly associated with an increased mortality rate. These results suggest that only heavy drinking present a risk factor among CABG patients.
Notes
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PubMed ID
27835965 View in PubMed
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Ambulatory blood pressure monitoring and risk of cardiovascular disease: a population based study.

https://arctichealth.org/en/permalink/ahliterature76238
Source
Am J Hypertens. 2006 Mar;19(3):243-50
Publication Type
Article
Date
Mar-2006
Author
Tine Willum Hansen
Jørgen Jeppesen
Susanne Rasmussen
Hans Ibsen
Christian Torp-Pedersen
Author Affiliation
Research Center for Prevention and Health, Copenhagen, Denmark. tw@heart.dk
Source
Am J Hypertens. 2006 Mar;19(3):243-50
Date
Mar-2006
Language
English
Publication Type
Article
Keywords
Adult
Aged
Blood pressure
Blood Pressure Monitoring, Ambulatory
Cardiovascular Diseases - epidemiology - mortality
Circadian Rhythm
Denmark - epidemiology
Female
Humans
Hypertension - diagnosis - epidemiology - mortality
Male
Middle Aged
Morbidity
Prospective Studies
Research Support, Non-U.S. Gov't
Risk factors
Abstract
BACKGROUND: Information on the relationship between ambulatory blood pressure (BP) and cardiovascular disease in the general population is sparse. METHODS: Prospective study of a random sample of 1700 Danish men and women, aged 41 to 72 years, without major cardiovascular diseases. At baseline, ambulatory BP, office BP, and other risk factors were recorded. The end point was a combined end point consisting of cardiovascular mortality, ischemic heart disease, and stroke. RESULTS: After a mean follow-up of 9.5 years, 156 end points were recorded. In multivariate models, the relative risk (95% confidence interval) associated with increments of 10/5 mmHg of systolic/diastolic ambulatory BP were 1.35 (1.21-1.50) and 1.27 (1.16-1.39). The corresponding figures for office BP were 1.18 (1.09-1.29) and 1.11 (1.03-1.19). Compared with normotension (office BP /=140/90 mm Hg; daytime BP /=135/85 mm Hg), and sustained hypertension (office BP >/=140/90 mm Hg; daytime BP >/=135/85 mm Hg) were 0.66 (0.30-1.44), 1.52 (0.91-2.54), and 2.10 (1.45-3.06), respectively. A blunted BP decrease at night was a risk factor (P = .02) in subjects with daytime ambulatory hypertension, but not in subjects with daytime ambulatory normotension (P = .13). CONCLUSIONS: Ambulatory BP provided prognostic information about cardiovascular disease better than office BP. Isolated office hypertension was not a risk factor and isolated ambulatory hypertension tended to be associated with increased risk. A blunted BP decrease at night was a risk factor in subjects with daytime ambulatory hypertension.
PubMed ID
16500508 View in PubMed
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Angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers in patients with abdominal aortic aneurysms: nation-wide cohort study.

https://arctichealth.org/en/permalink/ahliterature271818
Source
Arterioscler Thromb Vasc Biol. 2015 Mar;35(3):733-40
Publication Type
Article
Date
Mar-2015
Author
Karl Emil Kristensen
Christian Torp-Pedersen
Gunnar Hilmar Gislason
Martin Egfjord
Henrik Berg Rasmussen
Peter Riis Hansen
Source
Arterioscler Thromb Vasc Biol. 2015 Mar;35(3):733-40
Date
Mar-2015
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Angiotensin II Type 1 Receptor Blockers - therapeutic use
Angiotensin-Converting Enzyme Inhibitors - therapeutic use
Aortic Aneurysm, Abdominal - diagnosis - drug therapy - mortality - physiopathology
Chi-Square Distribution
Denmark - epidemiology
Female
Humans
Incidence
Male
Middle Aged
Proportional Hazards Models
Registries
Renin-Angiotensin System - drug effects
Time Factors
Treatment Outcome
Vascular Surgical Procedures
Abstract
The renin-angiotensin system is thought to play a pivotal role in the pathogenesis of abdominal aortic aneurysms (AAAs). However, effects of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II type 1 receptor blockers (ARBs) on human AAAs remain unclear. We therefore examined whether treatment with ACEIs or ARBs influenced hard clinical end points in a nation-wide cohort of patients with AAA.
All patients diagnosed with AAA during the period 1995 to 2011 were identified from the Danish nation-wide registries. Subjects were divided according to ACEI and ARB treatment status and followed up for an average of 5 years. Study outcomes were evaluated by time-dependent Cox proportional hazard models. Of 9441 patients with AAA, 12.6% were treated with ACEIs and 5.0% received ARBs. Incidence rates of death from AAA per 100 patient-years were 3.7, 3.6, 4.0, and 4.7 for treatment with ACEIs or ARBs, ACEIs, ARBs, and no ACEI/ARB, respectively. Hazard ratios of death from AAA were 0.64 (95% confidence interval, 0.51-0.80; P
PubMed ID
25633315 View in PubMed
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Antiarrhythmic therapy and risk of death in patients with atrial fibrillation: a nationwide study.

https://arctichealth.org/en/permalink/ahliterature150959
Source
Europace. 2009 Jul;11(7):886-91
Publication Type
Article
Date
Jul-2009
Author
Søren Skøtt Andersen
Morten Lock Hansen
Gunnar H Gislason
Tina Ken Schramm
Fredrik Folke
Emil Fosbøl
Steen Z Abildstrøm
Mette Madsen
Lars Køber
Christian Torp-Pedersen
Author Affiliation
Department of Cardiology, Gentofte University Hospital, Niels Andersens Vej 65, Hellerup, Copenhagen DK-2900, Denmark. ssa@heart.dk
Source
Europace. 2009 Jul;11(7):886-91
Date
Jul-2009
Language
English
Publication Type
Article
Keywords
Aged
Anti-Arrhythmia Agents - therapeutic use
Atrial Fibrillation - drug therapy - mortality
Cohort Studies
Denmark - epidemiology
Female
Humans
Incidence
Male
Middle Aged
Proportional Hazards Models
Registries
Risk assessment
Risk factors
Survival Analysis
Survival Rate
Treatment Outcome
Abstract
To examine the risk of death associated with antiarrhythmic drug (AAD) therapy in a nationwide unselected cohort of patients with atrial fibrillation (AF).
All patients admitted with AF in Denmark from 1995 to 2004 and their subsequent use of AADs were identified by individual-level linkage of nationwide registries. Multivariable Cox proportional-hazard models with time-dependent covariates were used to analyse the risk of death associated with AAD therapy. A total of 141,500 patients were included in the study; of these 3356 (2.4%) patients received treatment with flecainide, 3745 (2.6%) propafenone, 23,346 (16.5%) sotalol, and 10,376 (7.3%) amiodarone. Annualized mortality rates were 2.54, 4.25, 5.29, and 7.42 per year per 100 person years for flecainide, propafenone, sotalol, and amiodarone, respectively. Multivariable Cox proportional-hazard models did not show increased risk of death associated with any of the AADs. Hazard ratio (95% confidence interval) for flecainide 0.38 (0.32-0.44), propafenone 0.65 (0.58-0.71), sotalol 0.65 (0.63-0.67), and amiodarone 0.94 (0.89-1.00).
In an unselected cohort of patients with AF, antiarrhythmic treatment with flecainide, propafenone, sotalol, or amiodarone was not associated with increased risk of death. From a safety perspective, this indicates appropriate selection of patients for AAD therapy.
Notes
Comment In: Europace. 2009 Jul;11(7):840-119546183
Comment In: Europace. 2009 Jul;11(7):837-919546182
PubMed ID
19443433 View in PubMed
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Antidepressants and the risk of hyponatremia: a Danish register-based population study.

https://arctichealth.org/en/permalink/ahliterature287562
Source
BMJ Open. 2016 May 18;6(5):e011200
Publication Type
Article
Date
May-18-2016
Author
Katja Biering Leth-Møller
Annette Højmann Hansen
Maia Torstensson
Stig Ejdrup Andersen
Lars Ødum
Gunnar Gislasson
Christian Torp-Pedersen
Ellen Astrid Holm
Source
BMJ Open. 2016 May 18;6(5):e011200
Date
May-18-2016
Language
English
Publication Type
Article
Keywords
Adult
Aged
Antidepressive Agents, Tricyclic - therapeutic use
Citalopram - therapeutic use
Clomipramine - therapeutic use
Denmark - epidemiology
Duloxetine Hydrochloride - therapeutic use
Female
Humans
Hyponatremia - blood - epidemiology
Incidence
Male
Mianserin - analogs & derivatives - therapeutic use
Middle Aged
Registries
Retrospective Studies
Risk factors
Serotonin Uptake Inhibitors - therapeutic use
Serotonin and Noradrenaline Reuptake Inhibitors - therapeutic use
Sodium - blood
Venlafaxine Hydrochloride - therapeutic use
Abstract
To examine the association between classes of antidepressants and hyponatremia, and between specific antidepressants and hyponatremia.
Retrospective register-based cohort study using nationwide registers from 1998 to 2012.
The North Denmark Region.
In total, 638 352 individuals were included.
Plasma sodium was obtained from the LABKA database. The primary outcome was hyponatremia defined as plasma sodium (p-sodium) below 135 mmol/L and secondary outcome was severe hyponatremia defined as p-sodium below 130 mmol/L. The association between use of specific antidepressants and hyponatremia was analysed using multivariable Poisson regression models.
An event of hyponatremia occurred in 72 509 individuals and 11.36% (n=6476) of these events happened during treatment with antidepressants. Incidence rate ratios and CIs for the association with hyponatremia in the first p-sodium measured after initiation of treatment were for citalopram 7.8 (CI 7.42 to 8.20); clomipramine 4.93 (CI 2.72 to 8.94); duloxetine 2.05 (CI 1.44 to 292); venlafaxine 2.90 (CI 2.43 to 3.46); mirtazapine 2.95 (CI 2.71 to 3.21); and mianserin 0.90 (CI 0.71 to 1.14).
All antidepressants except mianserin are associated with hyponatremia. The association is strongest with citalopram and lowest with duloxetine, venlafaxine and mirtazapine.
Notes
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PubMed ID
27194321 View in PubMed
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Antidepressant use and risk for mortality in 121,252 heart failure patients with or without a diagnosis of clinical depression.

https://arctichealth.org/en/permalink/ahliterature276785
Source
Int J Cardiol. 2016 Jan 15;203:867-73
Publication Type
Article
Date
Jan-15-2016
Author
Corline Brouwers
Stefan B Christensen
Nikki L Damen
Johan Denollet
Christian Torp-Pedersen
Gunnar H Gislason
Susanne S Pedersen
Source
Int J Cardiol. 2016 Jan 15;203:867-73
Date
Jan-15-2016
Language
English
Publication Type
Article
Keywords
Aged - therapeutic use - epidemiology - diagnosis - drug therapy - etiology - complications - mortality - epidemiology - trends
Antidepressive Agents - therapeutic use - epidemiology - diagnosis - drug therapy - etiology - complications - mortality - epidemiology - trends
Denmark - therapeutic use - epidemiology - diagnosis - drug therapy - etiology - complications - mortality - epidemiology - trends
Depression - therapeutic use - epidemiology - diagnosis - drug therapy - etiology - complications - mortality - epidemiology - trends
Female - therapeutic use - epidemiology - diagnosis - drug therapy - etiology - complications - mortality - epidemiology - trends
Follow-Up Studies - therapeutic use - epidemiology - diagnosis - drug therapy - etiology - complications - mortality - epidemiology - trends
Heart Failure - therapeutic use - epidemiology - diagnosis - drug therapy - etiology - complications - mortality - epidemiology - trends
Humans - therapeutic use - epidemiology - diagnosis - drug therapy - etiology - complications - mortality - epidemiology - trends
Male - therapeutic use - epidemiology - diagnosis - drug therapy - etiology - complications - mortality - epidemiology - trends
Netherlands - therapeutic use - epidemiology - diagnosis - drug therapy - etiology - complications - mortality - epidemiology - trends
Retrospective Studies - therapeutic use - epidemiology - diagnosis - drug therapy - etiology - complications - mortality - epidemiology - trends
Risk Factors - therapeutic use - epidemiology - diagnosis - drug therapy - etiology - complications - mortality - epidemiology - trends
Survival Rate - therapeutic use - epidemiology - diagnosis - drug therapy - etiology - complications - mortality - epidemiology - trends
Treatment Outcome - therapeutic use - epidemiology - diagnosis - drug therapy - etiology - complications - mortality - epidemiology - trends
Abstract
Depression is a risk factor for mortality in patients with heart failure (HF), however, treating depression with antidepressant therapy does not seem to improve survival. We examined the prevalence of antidepressant use in HF patients, the correlates of antidepressant use subsequent to hospital discharge and the relation between antidepressant use, clinical depression and mortality in patients with HF.
121,252 HF patients surviving first hospitalization were stratified by antidepressant use and a diagnosis of clinical depression.
In total, 15.6% (19,348) received antidepressants at baseline, of which 86.7% (16,780) had no diagnosis of clinical depression. Female gender, older age, higher socio-economic status, more comorbidities, increased use of statins, spironolactone and aspirin, lower use of beta-blockers and ACE-inhibitors, greater HF severity and a diagnosis of clinical depression were independently associated with antidepressant use. Patients using no antidepressants with clinical depression and patients using antidepressants, with or without clinical depression, had a significantly higher risk for all-cause mortality (HR, 1.25; 95% CI, 1.15-1.36; HR, 1.24; 95% CI, 1.22-1.27; HR, 1.21; 95% CI, 1.16-1.27, respectively) and CV-mortality (HR: 1.17; 95% CI, 1.14-1.20, P
PubMed ID
26599753 View in PubMed
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