Skip header and navigation

Refine By

30 records – page 1 of 3.

Association of national initiatives to improve cardiac arrest management with rates of bystander intervention and patient survival after out-of-hospital cardiac arrest.

https://arctichealth.org/en/permalink/ahliterature106936
Source
JAMA. 2013 Oct 2;310(13):1377-84
Publication Type
Article
Date
Oct-2-2013
Author
Mads Wissenberg
Freddy K Lippert
Fredrik Folke
Peter Weeke
Carolina Malta Hansen
Erika Frischknecht Christensen
Henning Jans
Poul Anders Hansen
Torsten Lang-Jensen
Jonas Bjerring Olesen
Jesper Lindhardsen
Emil L Fosbol
Søren L Nielsen
Gunnar H Gislason
Lars Kober
Christian Torp-Pedersen
Author Affiliation
Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark. mads.wissenberg.joergensen@regionh.dk
Source
JAMA. 2013 Oct 2;310(13):1377-84
Date
Oct-2-2013
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Cardiopulmonary Resuscitation
Causality
Denmark - epidemiology
Female
Government Programs
Humans
Male
Middle Aged
Out-of-Hospital Cardiac Arrest - mortality - therapy
Registries - statistics & numerical data
Survival Analysis
Time Factors
Abstract
Out-of-hospital cardiac arrest is a major health problem associated with poor outcomes. Early recognition and intervention are critical for patient survival. Bystander cardiopulmonary resuscitation (CPR) is one factor among many associated with improved survival.
To examine temporal changes in bystander resuscitation attempts and survival during a 10-year period in which several national initiatives were taken to increase rates of bystander resuscitation and improve advanced care.
Patients with out-of-hospital cardiac arrest for which resuscitation was attempted were identified between 2001 and 2010 in the nationwide Danish Cardiac Arrest Registry. Of 29,111 patients with cardiac arrest, we excluded those with presumed noncardiac cause of arrest (n?=?7390) and those with cardiac arrests witnessed by emergency medical services personnel (n?=?2253), leaving a study population of 19,468 patients.
Temporal trends in bystander CPR, bystander defibrillation, 30-day survival, and 1-year survival.
The median age of patients was 72 years; 67.4% were men. Bystander CPR increased significantly during the study period, from 21.1% (95% CI, 18.8%-23.4%) in 2001 to 44.9% (95% CI, 42.6%-47.1%) in 2010 (P?
PubMed ID
24084923 View in PubMed
Less detail

Calcium-channel blockers do not alter the clinical efficacy of clopidogrel after myocardial infarction: a nationwide cohort study.

https://arctichealth.org/en/permalink/ahliterature137753
Source
J Am Coll Cardiol. 2011 Jan 25;57(4):409-17
Publication Type
Article
Date
Jan-25-2011
Author
Jonas B Olesen
Gunnar H Gislason
Mette G Charlot
Emil L Fosbøl
Charlotte Andersson
Peter Weeke
Ole Ahlehoff
Christian Selmer
Christian Torp-Pedersen
Peter R Hansen
Author Affiliation
Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark. jo@heart.dk
Source
J Am Coll Cardiol. 2011 Jan 25;57(4):409-17
Date
Jan-25-2011
Language
English
Publication Type
Article
Keywords
Aged
Calcium Channel Blockers - adverse effects - therapeutic use
Cause of Death
Cohort Studies
Confidence Intervals
Denmark
Dose-Response Relationship, Drug
Drug Administration Schedule
Drug Interactions
Drug Therapy, Combination
Female
Follow-Up Studies
Humans
Male
Middle Aged
Multivariate Analysis
Myocardial Infarction - diagnosis - drug therapy - mortality
Proportional Hazards Models
Registries
Retrospective Studies
Survival Analysis
Ticlopidine - adverse effects - analogs & derivatives - therapeutic use
Time Factors
Treatment Outcome
Abstract
The purpose of this study was to determine the risk of adverse cardiovascular events associated with concomitant use of clopidogrel and calcium-channel blockers (CCBs) in patients with myocardial infarction (MI).
CCBs inhibit a variety of cytochrome P-450 enzymes, some of which contribute to clopidogrel metabolic activation. This interaction may diminish the efficacy of clopidogrel.
All patients surviving 30 days after a first-time MI in the period 2000 to 2006 in Denmark were identified by individual-level linkage of nationwide administrative registers. The cohort was divided into patients treated with and without clopidogrel and followed for 1 year after discharge. The risk of a composite of cardiovascular death, MI, or stroke and the risk of the individual components of the composite end point and all-cause death associated with CCBs were analyzed with multivariable Cox proportional hazard models and in univariate propensity score-matched models.
A total of 56,800 patients were included, of whom 24,923 were treated with clopidogrel and 13,380 with CCBs. In the Cox analyses, the risk of the composite end point associated with CCBs was increased in both patients treated and not treated with clopidogrel, with a hazard ratio of 1.15 (95% confidence interval [CI]: 1.07 to 1.24) and 1.05 (95% CI: 1.01 to 1.11), respectively. The increased risk was independent of clopidogrel use; the hazard rate ratio was 1.08 (95% CI: 0.99 to 1.18). Analyses of all additional adverse end points and propensity score-matched models provided similar results.
The clinical efficacy of clopidogrel in patients with a recent MI is not modified by concomitant CCB treatment. This potential drug interaction is unlikely to have clinical significance.
PubMed ID
21251580 View in PubMed
Less detail

Cause-specific cardiovascular risk associated with nonsteroidal anti-inflammatory drugs among myocardial infarction patients--a nationwide study.

https://arctichealth.org/en/permalink/ahliterature116575
Source
PLoS One. 2013;8(1):e54309
Publication Type
Article
Date
2013
Author
Anne-Marie Schjerning Olsen
Emil L Fosbøl
Jesper Lindhardsen
Charlotte Andersson
Fredrik Folke
Mia B Nielsen
Lars Køber
Peter R Hansen
Christian Torp-Pedersen
Gunnar H Gislason
Author Affiliation
Department of Cardiology, Copenhagen University Hospital, Hellerup, Denmark. amschjerning@gmail.com
Source
PLoS One. 2013;8(1):e54309
Date
2013
Language
English
Publication Type
Article
Keywords
Aged
Anti-Inflammatory Agents, Non-Steroidal - administration & dosage - adverse effects
Denmark
Diclofenac - administration & dosage - adverse effects
Female
Follow-Up Studies
Hospitalization
Humans
Lactones - administration & dosage - adverse effects
Male
Middle Aged
Myocardial Infarction - drug therapy - mortality - pathology
Proportional Hazards Models
Registries
Risk factors
Sulfones - administration & dosage - adverse effects
Abstract
Non steroidal anti-inflammatory drugs (NSAIDs) increase mortality and morbidity after myocardial infarction (MI). We examined cause-specific mortality and morbidity associated with NSAIDs in a nationwide cohort of MI patients.
By individual-level linkage of nationwide registries of hospitalization and drug dispensing from pharmacies in Denmark, patients aged >30 years admitted with first-time MI during 1997-2009 and their subsequent NSAID use were identified. The risk of three cardiovascular specific endpoints: cardiovascular death, the composite of coronary death and nonfatal MI, and the composite of fatal and nonfatal stroke, associated with NSAID use was analyzed by Cox proportional hazard analyses. Of 97,698 patients included 44.0% received NSAIDs during follow-up. Overall use of NSAIDs was associated with an increased risk of cardiovascular death (hazard ratio [HR] 1.42, 95% confidence interval [CI] 1.36-1.49). In particular use of the nonselective NSAID diclofenac and the selective cyclooxygenase-2 inhibitor rofecoxib was associated with increased risk of cardiovascular death (HR 1.96 [1.79-2.15] and HR1.66 [1.44-1.91], respectively) with a dose dependent increase in risk. Use of ibuprofen was associated with increased risk of cardiovascular death (HR 1.34[1.26-1.44]), whereas naproxen was associated with the lowest risk of (e.g., HR 1.27[1.01-1.59].
Use of individual NSAIDs is associated with different cause-specific cardiovascular risk and in particular rofecoxib and diclofenac were associated with increased cardiovascular morbidity and mortality. These results support caution with use of all NSAIDs in patients with prior MI.
Notes
Cites: J Am Coll Cardiol. 2001 Mar 15;37(4):992-711263626
Cites: Circulation. 2011 May 24;123(20):2226-3521555710
Cites: J Clin Epidemiol. 2003 Feb;56(2):124-3012654406
Cites: N Engl J Med. 1985 Nov 14;313(20):1263-94058507
Cites: Circulation. 1997 Aug 5;96(3):748-559264478
Cites: Dan Med Bull. 1997 Sep;44(4):445-89377907
Cites: Eur J Epidemiol. 1999 Feb;15(2):155-6010204645
Cites: Dan Med Bull. 1999 Jun;46(3):263-810421985
Cites: Eur J Cardiovasc Prev Rehabil. 2005 Apr;12(2):132-715785298
Cites: BMJ. 2005 Jun 11;330(7504):136615947398
Cites: Circulation. 2005 Aug 2;112(5):759-7016061757
Cites: Med Care. 2005 Oct;43(10):970-816166866
Cites: J Clin Invest. 2006 Jan;116(1):4-1516395396
Cites: Circulation. 2006 Jun 27;113(25):2906-1316785336
Cites: N Engl J Med. 2007 Jan 25;356(4):328-3017251528
Cites: Circulation. 2007 Mar 27;115(12):1634-4217325246
Cites: Neuroepidemiology. 2007;28(3):150-417478969
Cites: Circulation. 2008 Apr 15;117(15):1945-5418378618
Cites: Arch Neurol. 2008 Jul;65(7):896-90518474729
Cites: Pharmacoepidemiol Drug Saf. 2008 Aug;17(8):822-3318383428
Cites: J Am Coll Cardiol. 2008 Nov 11;52(20):1628-3618992652
Cites: J Am Coll Cardiol. 2008 Nov 11;52(20):1637-918992653
Cites: Arch Intern Med. 2009 Jan 26;169(2):141-919171810
Cites: Circ Cardiovasc Qual Outcomes. 2009 May;2(3):155-6320031832
Cites: Circ Cardiovasc Qual Outcomes. 2010 Jul;3(4):395-40520530789
Cites: Arch Intern Med. 2010 Dec 13;170(22):2035-621149763
Cites: BMJ. 2011;342:c708621224324
Cites: JAMA. 2001 Aug 22-29;286(8):954-911509060
PubMed ID
23382889 View in PubMed
Less detail

Comparative cardiovascular safety of dementia medications: a cross-national study.

https://arctichealth.org/en/permalink/ahliterature118717
Source
J Am Geriatr Soc. 2012 Dec;60(12):2283-9
Publication Type
Article
Date
Dec-2012
Author
Emil L Fosbøl
Eric D Peterson
Ellen Holm
Gunnar H Gislason
Yinghong Zhang
Lesley H Curtis
Lars Køber
Isao Iwata
Christian Torp-Pedersen
Soko Setoguchi
Author Affiliation
Duke Clinical Research Institute, School of Medicine, Duke University, Durham, North Carolina 27705, USA. emil.fosbol@duke.edu
Source
J Am Geriatr Soc. 2012 Dec;60(12):2283-9
Date
Dec-2012
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Cholinesterase Inhibitors - adverse effects - therapeutic use
Cohort Studies
Dementia - drug therapy
Denmark
Female
Heart Failure - chemically induced
Humans
Indans - adverse effects - therapeutic use
Male
Medicare
Memantine - adverse effects - therapeutic use
Myocardial Infarction - chemically induced
Nootropic Agents - adverse effects - therapeutic use
Piperidines - adverse effects - therapeutic use
Receptors, N-Methyl-D-Aspartate - antagonists & inhibitors
United States
Abstract
To compare the cardiovascular safety of currently marketed dementia medications in new users in the United States and Denmark.
Retrospective cohort study.
Nationally representative sample of Medicare beneficiaries from 2006 through 2009 and nationwide Danish administrative registries from 1997 through 2007.
Individuals treated with a dementia medication aged 65 and older.
Hospitalizations for myocardial infarction (MI), heart failure, and syncope or atrioventricular block in both cohorts; fatal or nonfatal MI and cardiac death in the Danish cohort; and all-cause mortality in sensitivity analyses.
In 46,737 Medicare beneficiaries and 29,496 Danish participants, donepezil was the most frequently used medication. There were no substantial differences in the risk of MI or heart failure between participants using donepezil and those using other cholinesterase inhibitors (all hazard ratios (HR) crossing 1). In the Danish cohort, memantine was associated with fatal or nonfatal MI (HR = 1.33, 95% confidence interval (CI) = 1.08-1.63), cardiac death (HR = 1.31, 95% CI = 1.12-1.53), and a trend toward higher rates of hospitalization for MI (HR = 1.31, 95% CI = 0.98-1.76). Memantine was also associated with greater risk of all-cause mortality in the Medicare (HR = 1.20, 95% CI = 1.13-1.28) and Danish (HR = 1.83, 95% CI = 1.73-1.94) cohorts, suggesting that sicker individuals were selected for memantine therapy.
Cholinesterase inhibitors have similar cardiovascular risk profiles. Associations between memantine and fatal outcomes in Denmark may be related, in part, to selection of sicker individuals for memantine therapy.
PubMed ID
23176182 View in PubMed
Less detail

Differences between out-of-hospital cardiac arrest in residential and public locations and implications for public-access defibrillation.

https://arctichealth.org/en/permalink/ahliterature141913
Source
Circulation. 2010 Aug 10;122(6):623-30
Publication Type
Article
Date
Aug-10-2010
Author
Fredrik Folke
Gunnar H Gislason
Freddy K Lippert
Søren L Nielsen
Peter Weeke
Morten L Hansen
Emil L Fosbøl
Søren S Andersen
Søren Rasmussen
Tina K Schramm
Lars Køber
Christian Torp-Pedersen
Author Affiliation
Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark. FF@heart.dk
Source
Circulation. 2010 Aug 10;122(6):623-30
Date
Aug-10-2010
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Cardiopulmonary Resuscitation - instrumentation - utilization
Defibrillators - utilization
Denmark - epidemiology
Emergency Medical Services - manpower - trends
Female
Heart Arrest - epidemiology - therapy
Hospitalization
Humans
Male
Middle Aged
Mobile Health Units - manpower - trends
Population Surveillance
Public Facilities
Risk factors
Abstract
The majority of out-of-hospital cardiac arrests (OHCAs) occur in residential locations, but knowledge about strategic placement of automated external defibrillators in residential areas is lacking. We examined whether residential OHCA areas suitable for placement of automated external defibrillators could be identified on the basis of demographic characteristics and characterized individuals with OHCA in residential locations.
We studied 4828 OHCAs in Copenhagen between 1994 and 2005. The incidence and characteristics of OHCA were examined in every 100 x 100-m (109.4 x 109.4-yd) residential area according to its underlying demographic characteristics. By combining > or =2 demographic characteristics, it was possible to identify 100 x 100-m (109.4 x 109.4-yd) areas with at least 1 arrest every 5.6 years (characterized by >300 persons per area and lowest income) to 1 arrest every 4.3 years (characterized by >300 persons per area, lowest income, low education, and highest age). These areas covered 9.0% and 0.8% of all residential OHCAs, respectively. Individuals with OHCA in residential locations differed from public ones in that the patients were older (70.6 versus 60.6 years; P
Notes
Comment In: Circulation. 2010 Aug 10;122(6):567-920660801
PubMed ID
20660807 View in PubMed
Less detail

Diurnal variations in incidence and outcome of out-of-hospital cardiac arrest including prior comorbidity and pharmacotherapy: a nationwide study in Denmark.

https://arctichealth.org/en/permalink/ahliterature267618
Source
Resuscitation. 2014 Sep;85(9):1161-8
Publication Type
Article
Date
Sep-2014
Author
Lena I M Karlsson
Mads Wissenberg
Emil L Fosbøl
Carolina Malta Hansen
Freddy K Lippert
Akshay Bagai
Bryan McNally
Christopher B Granger
Erika Frischknecht Christensen
Fredrik Folke
Shahzleen Rajan
Peter Weeke
Søren L Nielsen
Lars Køber
Gunnar H Gislason
Christian Torp-Pedersen
Source
Resuscitation. 2014 Sep;85(9):1161-8
Date
Sep-2014
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Circadian Rhythm
Denmark
Drug Therapy
Female
Humans
Incidence
Male
Middle Aged
Out-of-Hospital Cardiac Arrest - complications - epidemiology
Time Factors
Abstract
To investigate diurnal variations in incidence and outcomes following out-of-hospital cardiac arrest (OHCA).
OHCA of presumed cardiac etiology were identified through the nationwide Danish Cardiac Arrest Registry (2001-2010). Time of day was divided into three time periods: daytime 07.00-14.59; evening 15.00-22.59; and nighttime 23.00-06.59.
We identified 18,929 OHCA patients, aged =18 years. The median age was 72 years (IQR 62-80) and the majority were male (67.5%). OHCA occurrence varied across time periods, with 43.9%, 35.7% and 20.6% occurring during daytime, evening and nighttime, respectively. Nighttime patients were more likely to have: severe comorbidity (i.e. COPD), arrest in private home (87.2% vs. 69.0% and 73.0% daytime and evening, respectively), non-witnessed arrest (51.2% vs. 48.4% and 43.7%), no bystander CPR (75.9% vs. 68.4% and 66.1%), longer time interval from recognition of OHCA to rhythm analysis (12 min vs. 11 min and 11 min), and non-shockable heart rhythm (80.1% vs. 70.3% and 69.4%), all p
PubMed ID
24971509 View in PubMed
Less detail

Duration of clopidogrel treatment and risk of mortality and recurrent myocardial infarction among 11 680 patients with myocardial infarction treated with percutaneous coronary intervention: a cohort study.

https://arctichealth.org/en/permalink/ahliterature145748
Source
BMC Cardiovasc Disord. 2010;10:6
Publication Type
Article
Date
2010
Author
Rikke Sørensen
Steen Z Abildstrom
Peter Weeke
Emil L Fosbøl
Fredrik Folke
Morten L Hansen
Peter R Hansen
Jan K Madsen
Ulrik Abildgaard
Lars Køber
Henrik E Poulsen
Christian Torp-Pedersen
Gunnar H Gislason
Author Affiliation
Department of Cardiology, Copenhagen University Hospital Gentofte, Niels Andersens Vej 65, 2900 Hellerup, Denmark. rs@heart.dk
Source
BMC Cardiovasc Disord. 2010;10:6
Date
2010
Language
English
Publication Type
Article
Keywords
Aged
Angioplasty, Balloon, Coronary - mortality - trends
Cohort Studies
Denmark - epidemiology
Female
Follow-Up Studies
Humans
Male
Middle Aged
Myocardial Infarction - drug therapy - mortality - prevention & control
Recurrence - prevention & control
Registries
Retrospective Studies
Risk factors
Ticlopidine - administration & dosage - analogs & derivatives
Time Factors
Treatment Outcome
Abstract
The optimal duration of clopidogrel treatment after percutaneous coronary intervention (PCI) is unclear. We studied the risk of death or recurrent myocardial infarction (MI) in relation to 6- and 12-months clopidogrel treatment among MI patients treated with PCI.
Using nationwide registers of hospitalizations and drug dispensing from pharmacies we identified 11 680 patients admitted with MI, treated with PCI and clopidogrel. Clopidogrel treatment was categorized in a 6-months and a 12-months regimen. Rates of death, recurrent MI or a combination of both were analyzed by the Kaplan Meier method and Cox proportional hazards models. Bleedings were compared between treatment regimens.
The Kaplan Meier analysis indicated no benefit of the 12-months regimen compared with the 6-months in all endpoints. The Cox proportional hazards analysis confirmed these findings with hazard ratios for the 12-months regimen (the 6-months regimen used as reference) for the composite endpoint of 1.01 (confidence intervals 0.81-1.26) and 1.24 (confidence intervals 0.95-1.62) for Day 0-179 and Day 180-540 after discharge. Bleedings occurred in 3.5% and 4.1% of the patients in the 6-months and 12-months regimen (p = 0.06).
We found comparable rates of death and recurrent MI in patients treated with 6- and 12-months' clopidogrel. The potential benefit of prolonged clopidogrel treatment in a real-life setting remains uncertain.
Notes
Cites: JAMA. 2002 Nov 20;288(19):2411-2012435254
Cites: J Thromb Thrombolysis. 2009 May;27(4):365-7818498003
Cites: J Clin Epidemiol. 2003 Feb;56(2):124-3012654406
Cites: N Engl J Med. 2003 Aug 21;349(8):733-4212930925
Cites: Dan Med Bull. 1997 Sep;44(4):445-89377907
Cites: Eur Heart J. 2005 Apr;26(8):804-4715769784
Cites: JAMA. 2005 Sep 14;294(10):1224-3216143698
Cites: JAMA. 2006 Apr 5;295(13):1531-816533938
Cites: N Engl J Med. 2006 Apr 20;354(16):1706-1716531616
Cites: Eur Heart J. 2006 May;27(10):1153-816399775
Cites: Am J Cardiol. 2006 Aug 1;98(3):352-616860022
Cites: JAMA. 2007 Jan 10;297(2):159-6817148711
Cites: J Am Coll Cardiol. 2001 Mar 15;37(4):992-711263626
Cites: N Engl J Med. 2001 Aug 16;345(7):494-50211519503
Cites: Lancet. 2001 Aug 18;358(9281):527-3311520521
Cites: N Engl J Med. 2007 Mar 8;356(10):1009-1917296822
Cites: Eur Heart J. 2007 Jul;28(13):1598-66017569677
Cites: J Am Coll Cardiol. 2007 Jul 31;50(5):463-7017662400
Cites: Circulation. 2007 Aug 14;116(7):e148-30417679616
Cites: JAMA. 2008 Feb 6;299(5):532-918252883
Cites: Eur J Heart Fail. 2008 Jul;10(7):658-6018539522
Cites: Cardiology. 2008;111(1):41-618239391
Cites: Br J Clin Pharmacol. 2008 Dec;66(6):875-8418823305
Cites: Circulation. 2003 Feb 25;107(7):966-7212600908
PubMed ID
20113477 View in PubMed
Less detail

Duration of treatment with nonsteroidal anti-inflammatory drugs and impact on risk of death and recurrent myocardial infarction in patients with prior myocardial infarction: a nationwide cohort study.

https://arctichealth.org/en/permalink/ahliterature134660
Source
Circulation. 2011 May 24;123(20):2226-35
Publication Type
Article
Date
May-24-2011
Author
Anne-Marie Schjerning Olsen
Emil L Fosbøl
Jesper Lindhardsen
Fredrik Folke
Mette Charlot
Christian Selmer
Morten Lamberts
Jonas Bjerring Olesen
Lars Køber
Peter R Hansen
Christian Torp-Pedersen
Gunnar H Gislason
Author Affiliation
Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark. aols0073@geh.regionh.dk
Source
Circulation. 2011 May 24;123(20):2226-35
Date
May-24-2011
Language
English
Publication Type
Article
Keywords
Adrenergic beta-Antagonists - therapeutic use
Aged
Aged, 80 and over
Anti-Inflammatory Agents, Non-Steroidal - adverse effects - contraindications
Cohort Studies
Comorbidity
Cyclooxygenase 2 Inhibitors - therapeutic use
Denmark - epidemiology
Diclofenac - adverse effects - contraindications
Female
Humans
Ibuprofen - adverse effects - contraindications
Incidence
Male
Middle Aged
Myocardial Infarction - drug therapy - mortality
Naproxen - adverse effects - contraindications
Prognosis
Proportional Hazards Models
Recurrence
Registries - statistics & numerical data
Risk factors
Abstract
Despite the fact that nonsteroidal anti-inflammatory drugs (NSAIDs) are contraindicated among patients with established cardiovascular disease, many receive NSAID treatment for a short period of time. However, little is known about the association between NSAID treatment duration and risk of cardiovascular disease. We therefore studied the duration of NSAID treatment and cardiovascular risk in a nationwide cohort of patients with prior myocardial infarction (MI).
Patients =30 years of age who were admitted with first-time MI during 1997 to 2006 and their subsequent NSAID use were identified by individual-level linkage of nationwide registries of hospitalization and drug dispensing from pharmacies in Denmark. Risk of death and recurrent MI according to duration of NSAID treatment was analyzed by multivariable time-stratified Cox proportional-hazard models and by incidence rates per 1000 person-years. Of the 83 677 patients included, 42.3% received NSAIDs during follow-up. There were 35 257 deaths/recurrent MIs. Overall, NSAID treatment was significantly associated with an increased risk of death/recurrent MI (hazard ratio, 1.45; 95% confidence interval, 1.29 to 1.62) at the beginning of the treatment, and the risk persisted throughout the treatment course (hazard ratio, 1.55; 95% confidence interval, 1.46 to 1.64 after 90 days). Analyses of individual NSAIDs showed that the traditional NSAID diclofenac was associated with the highest risk (hazard ratio, 3.26; 95% confidence interval, 2.57 to 3.86 for death/MI at day 1 to 7 of treatment).
Even short-term treatment with most NSAIDs was associated with increased risk of death and recurrent MI in patients with prior MI. Neither short- nor long-term treatment with NSAIDs is advised in this population, and any NSAID use should be limited from a cardiovascular safety point of view.
Notes
Comment In: Circulation. 2011 Nov 22;124(21):e552; author reply e55522105203
Comment In: Circulation. 2011 Nov 22;124(21):e553; author reply e55522105204
Comment In: Evid Based Med. 2012 Apr;17(2):61-221937502
Comment In: Circulation. 2011 Nov 22;124(21):e554; author reply e55522105205
Comment In: Ann Intern Med. 2011 Oct 18;155(8):JC4-1122007070
PubMed ID
21555710 View in PubMed
Less detail

Efficacy of post-operative clopidogrel treatment in patients revascularized with coronary artery bypass grafting after myocardial infarction.

https://arctichealth.org/en/permalink/ahliterature136521
Source
J Am Coll Cardiol. 2011 Mar 8;57(10):1202-9
Publication Type
Article
Date
Mar-8-2011
Author
Rikke Sørensen
Steen Z Abildstrøm
Peter R Hansen
Anders Hvelplund
Charlotte Andersson
Mette Charlot
Emil L Fosbøl
Lars Køber
Jan K Madsen
Gunnar H Gislason
Christian Torp-Pedersen
Author Affiliation
Department of Cardiology, Copenhagen University Hospital Gentofte, Copenhagen, Denmark. rs@heart.dk
Source
J Am Coll Cardiol. 2011 Mar 8;57(10):1202-9
Date
Mar-8-2011
Language
English
Publication Type
Article
Keywords
Aged
Combined Modality Therapy
Comorbidity
Coronary Artery Bypass
Denmark - epidemiology
Female
Hemorrhage - chemically induced - epidemiology
Humans
Male
Middle Aged
Myocardial Infarction - drug therapy - epidemiology - mortality - surgery
Platelet Aggregation Inhibitors - adverse effects - therapeutic use
Postoperative Period
Propensity Score
Proportional Hazards Models
Recurrence - prevention & control
Registries
Ticlopidine - adverse effects - analogs & derivatives - therapeutic use
Abstract
The objective of this study was to examine the clinical efficacy of clopidogrel treatment on death and recurrent myocardial infarction (MI) among MI patients revascularized by coronary artery bypass graft surgery (CABG).
The benefit from post-operative clopidogrel in CABG-treated MI patients is largely unknown.
All patients admitted with first-time MI between 2002 and 2006, treated with CABG within 180 days after admission, were identified by nationwide administrative registers. Clopidogrel treatment was determined by claimed prescriptions after discharge from surgery. Risk of death or recurrent MI, and of a combined end point of the 2, were assessed by cumulative incidence and Cox proportional hazards model. A propensity score-matched subgroup analysis was done.
We included 3,545 patients, and of these, 957 (27.0%) were treated with clopidogrel after CABG. Mean follow-up was 466 ± 144 days. Among patients treated with clopidogrel, 39 (4.1%) died or experienced a recurrent MI, whereas that occurred in 203 (7.8%) patients without clopidogrel (log-rank p = 0.0003). Hazard ratio was 0.59 (95% confidence interval [CI]: 0.42 to 0.85) for patients treated with clopidogrel, with no-clopidogrel as reference. By propensity score, of 945 patients with or without clopidogrel treatment who were matched, death or recurrent MI occurred in 38 (4.0%) patients with clopidogrel and 57 (6.0%) without clopidogrel (log-rank p = 0.05). Corresponding hazard ratio was 0.67 (95% CI: 0.44 to 1.00) for clopidogrel users, with no-clopidogrel as reference.
Among MI patients revascularized by CABG, only 27% received clopidogrel after discharge. Clopidogrel-treated patients had a lower risk of the combined end point of death or recurrent MI. Focus on discharge clopidogrel treatment of these patients should be made.
Notes
Comment In: J Am Coll Cardiol. 2011 Aug 30;58(10):1085; author reply 1085-621867852
Comment In: J Am Coll Cardiol. 2011 Aug 30;58(10):1084-5; author reply 1085-621867851
PubMed ID
21371637 View in PubMed
Less detail

Factors Associated With and Outcomes After Ventricular Fibrillation Before and During Primary Angioplasty in Patients With ST-Segment Elevation Myocardial Infarction.

https://arctichealth.org/en/permalink/ahliterature267755
Source
Am J Cardiol. 2015 Sep 1;116(5):678-85
Publication Type
Article
Date
Sep-1-2015
Author
Reza Jabbari
Bjarke Risgaard
Emil L Fosbøl
Thomas Scheike
Berit T Philbert
Bo G Winkel
Christine M Albert
Charlotte Glinge
Kiril A Ahtarovski
Stig Haunsø
Lars Køber
Erik Jørgensen
Frants Pedersen
Jacob Tfelt-Hansen
Thomas Engstrøm
Source
Am J Cardiol. 2015 Sep 1;116(5):678-85
Date
Sep-1-2015
Language
English
Publication Type
Article
Keywords
Aged
Angioplasty, Balloon, Coronary
Cause of Death - trends
Denmark - epidemiology
Electrocardiography
Female
Follow-Up Studies
Humans
Intraoperative Period
Male
Middle Aged
Myocardial Infarction - complications - diagnosis - surgery
Preoperative Period
Prognosis
Retrospective Studies
Survival Rate - trends
Time Factors
Treatment Outcome
Ventricular Fibrillation - etiology - mortality - physiopathology
Abstract
We aimed to assess the risk factors and outcome of ventricular fibrillation (VF) before and during primary percutaneous coronary intervention (PPCI) in patients with ST-segment elevation myocardial infarction. From 1999 to 2012, we consecutively enrolled 5,373 patients with ST-segment elevation myocardial infarction. In total, 410 of the patients had VF before and 88 had VF during PPCI. During a mean follow-up of 4.2 years, 1,196 subjects died. A logistic regression model identified younger age, anterior infarct, Killip class >I at admission, and a preprocedural Thrombolysis In Myocardial Infarction flow grade of 0 to I to be significantly associated with VF before PPCI, whereas inferior infarct, a preprocedural Thrombolysis In Myocardial Infarction flow grade of 0 to I, and Killip class >I at admission were significantly associated with VF during PPCI. All-cause mortality was evaluated using the Cox regression model. Compared with the patients without VF, those with VF before or during PPCI had a significantly increased 30-day mortality, with an adjusted hazard ratio = 3.40 (95% confidence interval 1.70 to 6.70) and 4.20 (95% confidence interval 1.30 to 13.30), respectively. Importantly, there was no tendency of 30-day mortality difference between VF before and during PPCI (p = 0.170). In patients with VF before or during PPCI who survived for at least 30 days, there was no increase in the long-term mortality. In conclusion, our data suggest that 30-day mortality is the same for patients with VF before PPCI compared with VF during PPCI, and the occurrence of VF before or during PPCI was associated with increased 30-day mortality but not with long-term mortality.
PubMed ID
26150175 View in PubMed
Less detail

30 records – page 1 of 3.