Skip header and navigation

Refine By

49 records – page 1 of 5.

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
Less detail

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
Less detail

Association of Psoriatic Disease With Uveitis: A Danish Nationwide Cohort Study.

https://arctichealth.org/en/permalink/ahliterature270433
Source
JAMA Dermatol. 2015 Nov;151(11):1200-5
Publication Type
Article
Date
Nov-2015
Author
Alexander Egeberg
Usman Khalid
Gunnar Hilmar Gislason
Lotus Mallbris
Lone Skov
Peter Riis Hansen
Source
JAMA Dermatol. 2015 Nov;151(11):1200-5
Date
Nov-2015
Language
English
Publication Type
Article
Keywords
Adult
Arthritis, Psoriatic - complications - pathology
Cohort Studies
Denmark - epidemiology
Female
Humans
Incidence
Male
Middle Aged
Psoriasis - complications - pathology
Risk
Severity of Illness Index
Uveitis - epidemiology - etiology
Young Adult
Abstract
Psoriasis, psoriatic arthritis, and uveitis are inflammatory disorders with significant overlap in their inflammatory pathways. Limited evidence is available about the relationship between psoriatic disease and uveitis.
To investigate the potential bidirectional relationship between psoriatic disease, including psoriasis and psoriatic arthritis, and uveitis.
We performed a nationwide cohort study of the Danish population from January 1, 1997, through December 31, 2011. We included 74,129 Danish patients with psoriasis who were 18 years or older during the study period. Patients were identified through administrative registries, and information on age, sex, socioeconomic status, medication, and comorbidity was obtained using individual-level linkage of administrative registers. We performed data analysis from January 27 through March 4, 2015.
Diagnosis of mild or severe psoriasis or psoriatic arthritis for uveitis risk and diagnosis of uveitis for the risk for psoriasis or psoriatic arthritis.
Diagnosis of uveitis, mild psoriasis, severe psoriasis, or psoriatic arthritis. We calculated incidence rates (IRs) and estimated IR ratios adjusted for potential confounders using Poisson regression.
We identified 74,129 cases of psoriasis and psoriatic arthritis and 13,114 cases of uveitis. The IRs (95% CIs) for uveitis were 2.02 (1.99-2.06), 2.88 (2.33-3.56), 4.23 (2.40-7.45), and 5.49 (3.36-8.96) for the reference population and those with mild psoriasis, severe psoriasis, and psoriatic arthritis, respectively. In the reference population, these IRs (95% CIs) were 9.37 (9.30-9.45), 1.12 (1.10-1.15), and 1.04 (1.01-1.06), and in patients with uveitis, these statistics were 15.51 (12.92-18.62), 2.66 (1.72-4.13), and 4.25 (3.00-6.01) for mild psoriasis, severe psoriasis, and psoriatic arthritis, respectively. Adjusted IR ratios (95% CIs) for uveitis were 1.38 (1.11-1.70 [P?=?.02]), 1.40 (0.70-2.81 [P?=?.34]), and 2.50 (1.53-4.08 [P?
PubMed ID
26222707 View in PubMed
Less detail

Automated external defibrillators inaccessible to more than half of nearby cardiac arrests in public locations during evening, nighttime, and weekends.

https://arctichealth.org/en/permalink/ahliterature107254
Source
Circulation. 2013 Nov 12;128(20):2224-31
Publication Type
Article
Date
Nov-12-2013
Author
Carolina Malta Hansen
Mads Wissenberg
Peter Weeke
Martin Huth Ruwald
Morten Lamberts
Freddy Knudsen Lippert
Gunnar Hilmar Gislason
Søren Loumann Nielsen
Lars Køber
Christian Torp-Pedersen
Fredrik Folke
Author Affiliation
Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup (C.M.H., M.W., P.W., M.H.R., M.L., G.H.G., F.F.); Emergency Medical Services, Copenhagen, Capital Region of Denmark and Copenhagen University (F.K.L., S.L.N.); National Institute of Public Health, University of Southern Denmark, Copenhagen (G.H.G.); The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen (L.K.); and Institute of Health, Science and Technology, Aalborg University, Aalborg (C.T.-P.), Denmark.
Source
Circulation. 2013 Nov 12;128(20):2224-31
Date
Nov-12-2013
Language
English
Publication Type
Article
Keywords
Adult
After-Hours Care - statistics & numerical data
Aged
Aged, 80 and over
Cardiopulmonary Resuscitation - mortality
Cities - statistics & numerical data
Defibrillators - statistics & numerical data
Denmark - epidemiology
Female
Health Services Accessibility - statistics & numerical data
Humans
Male
Middle Aged
Out-of-Hospital Cardiac Arrest - mortality - therapy
Residence Characteristics
Abstract
Despite wide dissemination, use of automated external defibrillators (AEDs) in community settings is limited. We assessed how AED accessibility affected coverage of cardiac arrests in public locations.
We identified cardiac arrests in public locations (1994-2011) in terms of location and time and viewed them in relation to the location and accessibility of all AEDs linked to the emergency dispatch center as of December 31, 2011, in Copenhagen, Denmark. AED coverage of cardiac arrests was defined as cardiac arrests within 100 m (109.4 yd) of an AED and further categorized according to AED accessibility at the time of cardiac arrest. Daytime, evening, and nighttime were defined as 8 am to 3:59 pm, 4 to 11:59 pm, and midnight to 7:59 am, respectively. Of 1864 cardiac arrests in public locations, 61.8% (n=1152) occurred during the evening, nighttime, or weekends. Of 552 registered AEDs, 9.1% (n=50) were accessible at all hours, and 96.4% (n=532) were accessible during the daytime on all weekdays. Regardless of AED accessibility, 28.8% (537 of 1864) of all cardiac arrests were covered by an AED. Limited AED accessibility decreased coverage of cardiac arrests by 4.1% (9 of 217) during the daytime on weekdays and by 53.4% (171 of 320) during the evening, nighttime, and weekends.
Limited AED accessibility at the time of cardiac arrest decreased AED coverage by 53.4% during the evening, nighttime, and weekends, which is when 61.8% of all cardiac arrests in public locations occurred. Thus, not only strategic placement but also uninterrupted AED accessibility warrant attention if public-access defibrillation is to improve survival after out-of-hospital cardiac arrest.
PubMed ID
24036607 View in PubMed
Less detail

Bleeding after initiation of multiple antithrombotic drugs, including triple therapy, in atrial fibrillation patients following myocardial infarction and coronary intervention: a nationwide cohort study.

https://arctichealth.org/en/permalink/ahliterature121881
Source
Circulation. 2012 Sep 4;126(10):1185-93
Publication Type
Article
Date
Sep-4-2012
Author
Morten Lamberts
Jonas Bjerring Olesen
Martin Huth Ruwald
Carolina Malta Hansen
Deniz Karasoy
Søren Lund Kristensen
Lars Køber
Christian Torp-Pedersen
Gunnar Hilmar Gislason
Morten Lock Hansen
Author Affiliation
Department of Cardiology, Post 635, Copenhagen University Hospital Gentofte, Niels Andersens Vej 65, 2900 Hellerup, Denmark. mortenlamberts@gmail.com
Source
Circulation. 2012 Sep 4;126(10):1185-93
Date
Sep-4-2012
Language
English
Publication Type
Article
Keywords
Acute Coronary Syndrome - drug therapy - mortality
Aged
Aged, 80 and over
Angioplasty, Balloon, Coronary
Aspirin - administration & dosage - adverse effects
Atrial Fibrillation - drug therapy - mortality
Cohort Studies
Comorbidity
Denmark - epidemiology
Drug Therapy, Combination - adverse effects
Female
Fibrinolytic Agents - administration & dosage - adverse effects
Hemorrhage - chemically induced - mortality - prevention & control
Humans
Male
Middle Aged
Myocardial Infarction - mortality - therapy
Platelet Aggregation Inhibitors - administration & dosage - adverse effects
Registries - statistics & numerical data
Risk factors
Stroke - mortality
Ticlopidine - administration & dosage - adverse effects - analogs & derivatives
Vitamin K - antagonists & inhibitors
Abstract
Uncertainty remains over optimal antithrombotic treatment of patients with atrial fibrillation presenting with myocardial infarction and/or undergoing percutaneous coronary intervention. We investigated the risk and time frame for bleeding following myocardial infarction/percutaneous coronary intervention in patients with atrial fibrillation according to antithrombotic treatment.
Patients with atrial fibrillation and admitted with myocardial infarction or for percutaneous coronary intervention between 2000 and 2009 (11 480 subjects, mean age 75.6 years [SD ±10.3], males 60.9%) were identified by individual level linkage of nationwide registries in Denmark. Fatal or nonfatal (requiring hospitalization) bleeding was determined according to antithrombotic treatment regimen: triple therapy (TT) with vitamin K antagonist (VKA)+aspirin+clopidogrel, VKA+antiplatelet, and dual antiplatelet therapy with aspirin+clopidogrel. We calculated crude incidence rates and adjusted hazard ratios by Cox regression models. Within 1 year, 728 bleeding events were recorded (6.3%); 79 were fatal (0.7%). Within 30 days, rates were 22.6, 20.3, and 14.3 bleeding events per 100 person-years for TT, VKA+antiplatelet, and dual antiplatelet therapy, respectively. Both early (within 90 days) and delayed (90-360 days) bleeding risk with TT exposure in relation to VKA+antiplatelet was increased; hazard ratio 1.47 (1.04;2.08) and 1.36 (0.95;1.95), respectively. No significant difference in thromboembolic risk was observed for TT versus VKA+antiplatelet; hazard ratio, 1.15 (0.95;1.40).
High risk of bleeding is immediately evident with TT after myocardial infarction/percutaneous coronary intervention in patients with atrial fibrillation. A continually elevated risk associated with TT indicates no safe therapeutic window, and TT should only be prescribed after thorough bleeding risk assessment of patients.
Notes
Comment In: Circulation. 2013 Apr 30;127(17):e58523762910
Comment In: Circulation. 2012 Sep 4;126(10):1176-822869840
Comment In: Circulation. 2013 Apr 30;127(17):e58423630091
PubMed ID
22869839 View in PubMed
Less detail

Cardioversion and Risk of Adverse Events with Dabigatran versus Warfarin-A Nationwide Cohort Study.

https://arctichealth.org/en/permalink/ahliterature274069
Source
PLoS One. 2015;10(10):e0141377
Publication Type
Article
Date
2015
Author
Jannik Langtved Pallisgaard
Tommi Bo Lindhardt
Morten Lock Hansen
Anne-Marie Schjerning
Jonas Bjerring Olesen
Laila Staerk
Christian Torp-Pedersen
Gunnar Hilmar Gislason
Source
PLoS One. 2015;10(10):e0141377
Date
2015
Language
English
Publication Type
Article
Keywords
Anticoagulants - adverse effects - therapeutic use
Antithrombins - adverse effects - therapeutic use
Atrial Fibrillation - complications - epidemiology
Cohort Studies
Dabigatran - adverse effects - therapeutic use
Denmark - epidemiology
Female
Follow-Up Studies
Hospital Administration
Humans
Incidence
Male
Registries
Risk
Thromboembolism - epidemiology - etiology - prevention & control
Time Factors
Warfarin - adverse effects - therapeutic use
Abstract
Cardioversion can rapidly and effectively restore sinus rhythm in patients with persistent atrial fibrillation. Since 2011 dabigatran has been available as an alternative to warfarin to prevent thromboembolic events in patients with non-valvular atrial fibrillation undergoing cardioversion. We studied time to cardioversion, risk of adverse events, and risk of readmission with atrial fibrillation after cardioversion according to anticoagulation therapy.
Through the nationwide Danish registries we included 1,230 oral anticoagulation naïve patients with first time non-valvular atrial fibrillation and first time cardioversion from 2011 to 2012; 37% in the dabigatran group (n = 456), and 63% in the warfarin group (n = 774). Median time to cardioversion was 4.0 (interquartile range [IQR] 2.9 to 6.5) and 6.9 (IQR 3.9 to 12.1) weeks in the dabigatran and warfarin groups respectively, and the adjusted odds ratio of cardioversion within the first 4 weeks was 2.3 (95% confidence interval [CI] 1.7 to 3.1) in favor of dabigatran. The cumulative incidence of composite endpoint of stroke, bleeding or death were 2.0% and 1.0% at 30 weeks in the warfarin and dabigatran groups respectively, with an adjusted hazard ratio of 1.33 (95% CI 0.33 to 5.42). Cumulative incidence of readmission with atrial fibrillation after 30 weeks were 9% and 11% in the warfarin and dabigatran groups, respectively, and an adjusted hazard ratio of 0.66 (95% CI 0.41 to 1.08).
Anticoagulation treatment with dabigatran allows shorter time to cardioversion for atrial fibrillation than warfarin, and appears to be an effective and safe alternative treatment strategy to warfarin.
Notes
Cites: Cleve Clin J Med. 2002 Sep;69(9):713-812222975
Cites: Circulation. 2011 Jan 18;123(2):131-621200007
Cites: Am J Cardiol. 1969 Feb;23(2):208-164180019
Cites: BMJ. 2011;342:d12421282258
Cites: Scand J Public Health. 2011 Jul;39(7 Suppl):38-4121775349
Cites: Europace. 2012 Oct;14(10):1385-41322923145
Cites: Circulation. 2014 Mar 4;129(9):961-7024323795
Cites: J Am Coll Cardiol. 2014 Mar 25;63(11):1082-724211508
Cites: J Am Coll Cardiol. 2014 Dec 2;64(21):e1-7624685669
Cites: Circulation. 2004 Mar 2;109(8):997-100314967716
Cites: J Am Coll Cardiol. 1992 Mar 15;19(4):851-51545081
Cites: Circulation. 1995 Oct 1;92(7):1954-687671380
Cites: Dan Med Bull. 1999 Jun;46(3):263-810421985
Cites: Am Heart J. 2006 Feb;151(2):380-916442904
Cites: Eur Heart J. 2014 Dec 14;35(47):3346-5525182247
PubMed ID
26513589 View in PubMed
Less detail

Clustering of autoimmune diseases in patients with rosacea.

https://arctichealth.org/en/permalink/ahliterature275377
Source
J Am Acad Dermatol. 2016 Apr;74(4):667-72.e1
Publication Type
Article
Date
Apr-2016
Author
Alexander Egeberg
Peter Riis Hansen
Gunnar Hilmar Gislason
Jacob Pontoppidan Thyssen
Source
J Am Acad Dermatol. 2016 Apr;74(4):667-72.e1
Date
Apr-2016
Language
English
Publication Type
Article
Keywords
Adult
Age Distribution
Autoimmune Diseases - epidemiology - genetics - immunology
Case-Control Studies
Celiac Disease - epidemiology - genetics - immunology
Cluster analysis
Comorbidity
Confidence Intervals
Databases, Factual
Denmark - epidemiology
Diabetes Mellitus, Type 1 - epidemiology - genetics - immunology
Female
Genome-Wide Association Study
Humans
Incidence
Logistic Models
Male
Middle Aged
Odds Ratio
Retrospective Studies
Rheumatic Fever - epidemiology - genetics - immunology
Risk assessment
Rosacea - epidemiology - genetics - immunology
Sex Distribution
Young Adult
Abstract
Rosacea is a common inflammatory skin condition that shares genetic risk loci with autoimmune diseases such as type 1 diabetes mellitus (T1DM) and celiac disease. A recent genomewide association study identified 90 genetic regions associated with T1DM, celiac disease, multiple sclerosis, and/or rheumatoid arthritis, respectively. However, a possible association with rosacea was not investigated.
We evaluated the association between rosacea and T1DM, celiac disease, multiple sclerosis, and rheumatoid arthritis, respectively.
We performed a population-based case-control study. A total of 6759 patients with rosacea were identified and matched with 33,795 control subjects on age, sex, and calendar time. We used conditional logistic regression to calculate crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs).
After adjustment for smoking and socioeconomic status, patients with rosacea had significantly increased ORs for T1DM (OR 2.59, 95% CI 1.41-4.73), celiac disease (OR 2.03, 95% CI 1.35-3.07), multiple sclerosis (OR 1.65, 95% CI 1.20-2.28), and rheumatoid arthritis (OR 2.14, 95% CI 1.82-2.52). The association was mainly observed in women.
We were unable to distinguish between the different subtypes and severities of rosacea.
Rosacea is associated with T1DM, celiac disease, multiple sclerosis, and rheumatoid arthritis, respectively, in women, whereas the association in men only reached statistical significance for rheumatoid arthritis.
PubMed ID
26830864 View in PubMed
Less detail

Comparison of incidence, predictors, and the impact of co-morbidity and polypharmacy on the risk of recurrent syncope in patients <85 versus =85 years of age.

https://arctichealth.org/en/permalink/ahliterature107262
Source
Am J Cardiol. 2013 Nov 15;112(10):1610-5
Publication Type
Article
Date
Nov-15-2013
Author
Martin Huth Ruwald
Morten Lock Hansen
Morten Lamberts
Carolina Malta Hansen
Anna-Karin Numé
Michael Vinther
Lars Køber
Christian Torp-Pedersen
Jim Hansen
Gunnar Hilmar Gislason
Author Affiliation
Department of Cardiology, Gentofte Hospital, Hellerup, Denmark; Division of Cardiology, Heart Research Follow-up Program, University of Rochester Medical Center, Rochester, New York. Electronic address: mruwald@hotmail.com.
Source
Am J Cardiol. 2013 Nov 15;112(10):1610-5
Date
Nov-15-2013
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Cardiovascular Agents - therapeutic use
Comorbidity
Denmark - epidemiology
Female
Humans
Male
Middle Aged
Polypharmacy
Prevalence
Proportional Hazards Models
Registries
Risk Assessment - methods
Risk factors
Survival Rate - trends
Syncope - drug therapy - epidemiology - physiopathology
Abstract
Recurrent syncope is a major cause of hospitalizations and may be associated with cardiovascular co-morbidities. Despite this, prognostic factors and the clinical characteristics among patients are not well described. Therefore, we identified and analyzed data on all patients >50 years of age discharged after a first-time episode of syncope in the period 2001 to 2009 through nationwide administrative registries. We identified the clinical characteristics of 5,141 patients =85 years of age and 23,454 patients
PubMed ID
24035171 View in PubMed
Less detail

Coronary artery disease severity and long-term cardiovascular risk in patients with myocardial infarction: a Danish nationwide register-based cohort study.

https://arctichealth.org/en/permalink/ahliterature298150
Source
Eur Heart J Cardiovasc Pharmacother. 2018 01 01; 4(1):25-35
Publication Type
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Date
01-01-2018
Author
Cengiz Özcan
Anna Deleskog
Anne-Marie Schjerning Olsen
Helene Nordahl Christensen
Morten Lock Hansen
Gunnar Hilmar Gislason
Author Affiliation
Department of Cardiology, Copenhagen University Hospital Gentofte, Kildegårdsvej 28, 2900 Hellerup, Denmark.
Source
Eur Heart J Cardiovasc Pharmacother. 2018 01 01; 4(1):25-35
Date
01-01-2018
Language
English
Publication Type
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Keywords
Aged
Aged, 80 and over
Coronary Artery Disease - complications - diagnosis - epidemiology
Denmark - epidemiology
Female
Follow-Up Studies
Humans
Male
Middle Aged
Morbidity - trends
Myocardial Infarction - diagnosis - epidemiology - etiology
Prognosis
Registries
Retrospective Studies
Risk Assessment - methods
Risk factors
Severity of Illness Index
Survival Rate - trends
Time Factors
Abstract
Long-term prognostic impact of coronary artery disease (CAD) severity in stable post-myocardial infarction (MI) patients is not well known. We examined the impact of CAD severity and co-morbidity on the long-term (1 year and beyond) risk of cardiovascular events post-MI.
From nationwide administrative and clinical registers, we identified 55?747?MI patients, during 2004-2010, who had not experienced subsequent MI, stroke, or death within 7 days post-discharge. The risk for primary composite endpoint (MI, stroke, or cardiovascular death) was estimated for the first 365 days after MI (index MI) and from day 366 to study completion (stable post-MI population), corresponding to a mean follow-up of 3.6 (2.2) years. Risk was assessed using cumulative incidence, multivariable adjusted logistic regression and Cox proportional-hazards models. The 1-year cumulative incidence for primary endpoint was 20.0% [95% confidence interval (CI), (19.6-20.3)]. Correspondingly, the 4-year cumulative incidence for primary endpoint was 21.0% (95% CI, 20.6-21.4) in patients without events on the first year. In multivariable models with no significant stenosis as reference, CAD severity was the most important risk factor for cardiovascular events the first 365 days [left main stenosis (LMS): odds ratio and 95% CI, 4.37, 3.69-5.17; 3-vessel disease (VD), 4.18, 3.66-4.77; 2-VD, 3.23, 2.81-3.72; 1-VD, 2.12,-1.85-2.43] and remained from day 366 to study completion [LMS: hazard ratio and 95% CI, 1.91, 1.64-2.22; 3-VD, 1.85,1.65-2.07; 2-VD, 1.55, 1.38-1.74; 1-VD, 1.30, 1.16-1.45].
Despite contemporary treatment at baseline, stable post-MI patients' 4-year outcome was similar to 1-year outcome after MI, and CAD severity remained a critical risk factor the first year and thereafter.
PubMed ID
28444162 View in PubMed
Less detail

Discontinuation of hormone replacement therapy after myocardial infarction and short term risk of adverse cardiovascular events: nationwide cohort study.

https://arctichealth.org/en/permalink/ahliterature125794
Source
BMJ. 2012;344:e1802
Publication Type
Article
Date
2012
Author
Ditte-Marie Bretler
Peter Riis Hansen
Rikke Sørensen
Jesper Lindhardsen
Ole Ahlehoff
Charlotte Andersson
Steen Zabell Abildstrøm
Christian Torp-Pedersen
Gunnar Hilmar Gislason
Author Affiliation
Department of Cardiology, Copenhagen University Hospital Gentofte, Copenhagen, Denmark. dimabr01@geh.regionh.dk
Source
BMJ. 2012;344:e1802
Date
2012
Language
English
Publication Type
Article
Keywords
Adult
Aged
Cause of Death - trends
Denmark - epidemiology
Female
Follow-Up Studies
Hormone Replacement Therapy - adverse effects
Humans
Incidence
Middle Aged
Myocardial Infarction - complications - epidemiology - prevention & control
Postmenopause
Prognosis
Recurrence
Retrospective Studies
Risk factors
Survival Rate - trends
Time Factors
Withholding Treatment
Abstract
To assess the risk of adverse cardiovascular events in women who discontinue hormone replacement therapy after myocardial infarction compared with those who continue.
Nationwide register based cohort study.
All hospitals in Denmark.
All 3322 women aged 40 years or over who survived 30 days after a myocardial infarction and were prescribed hormone replacement therapy at the time of myocardial infarction in the period 1997 to 2008.
Reinfarction, cardiovascular mortality, and all cause mortality 30 to 360 days after discharge.:
A total of 282 (8.5%) women had a reinfarction, 218 (6.6%) died of cardiovascular causes, and 357 (10.7%) died of any cause during follow-up. Women who discontinued overall hormone replacement therapy in the first year after myocardial infarction did not have a significantly different risk of reinfarction (hazard ratio 0.90, 95% confidence interval 0.68 to 1.19), cardiovascular mortality (1.21, 0.90 to 1.62), or all cause mortality (1.22, 0.97 to 1.53) than women who continued use. However, discontinuation of vaginal oestrogen was associated with a lower risk of reinfarction (hazard ratio 0.54, 0.34 to 0.86).
No certain conclusions can be drawn regarding increased or decreased risk of adverse cardiovascular events with continuing hormone replacement therapy after myocardial infarction. The results rule out neither a modest benefit nor a worrisome increase in risk. These figures may be valuable when a possible cardiovascular risk of hormone replacement therapy needs to be balanced with menopausal symptoms for the individual patient.
Notes
Cites: Prev Med. 1991 Jan;20(1):47-631826173
Cites: Circulation. 2004 Oct 5;110(14):1926-3215451794
Cites: Dan Med Bull. 1997 Sep;44(4):445-89377907
Cites: Annu Rev Public Health. 1998;19:55-729611612
Cites: JAMA. 1998 Aug 19;280(7):605-139718051
Cites: Circulation. 1999 Feb 23;99(7):855-6010027805
Cites: Am J Cardiol. 1999 Jan 15;83(2):247-9, A510073827
Cites: N Engl J Med. 1999 Jun 10;340(23):1801-1110362825
Cites: Climacteric. 2004 Dec;7(4):333-715799604
Cites: Am J Med. 2005 Dec 19;118 Suppl 12B:163-516414343
Cites: Eur J Obstet Gynecol Reprod Biol. 2006 Apr 1;125(2):217-2016337074
Cites: Pharmacoepidemiol Drug Saf. 2006 May;15(5):291-30316447304
Cites: Eur Heart J. 2006 May;27(10):1153-816399775
Cites: BMJ. 2006 Jul 1;333(7557):1516790458
Cites: Hum Reprod. 2006 Sep;21(9):2450-416731546
Cites: Climacteric. 2006 Dec;9(6):459-6317085379
Cites: Heart. 2007 Feb;93(2):210-516940389
Cites: Circulation. 2007 Mar 20;115(11):1481-50117309915
Cites: Am J Prev Med. 2007 Jun;32(6):483-917533063
Cites: J Clin Epidemiol. 2007 Sep;60(9):971-417689814
Cites: Circulation. 2007 Aug 14;116(7):e148-30417679616
Cites: Lancet. 2007 Oct 20;370(9596):1453-718064739
Cites: Eur J Heart Fail. 2008 Jul;10(7):658-6018539522
Cites: Metabolism. 2008 Aug;57(8):1088-9218640386
Cites: BMJ. 2008;337:a119018719013
Cites: Eur Heart J. 2008 Nov;29(21):2660-818826989
Cites: Menopause. 2008 Nov-Dec;15(6):1060-418521047
Cites: Menopause. 2009 Jan-Feb;16(1):30-618820592
Cites: Arch Cardiovasc Dis. 2009 Jun-Jul;102(6-7):485-9619664568
Cites: Menopause. 2010 May-Jun;17(3):443-420142788
Cites: Br J Clin Pharmacol. 2011 Jan;71(1):105-1521143506
Cites: Pharmacoepidemiol Drug Saf. 2011 Feb;20(2):146-5321254285
Cites: Eur Heart J. 2012 Aug;33(15):1886-9222199117
Cites: Am J Cardiol. 2000 Aug 1;86(3):330-310922445
Cites: Circulation. 2000 Nov 28;102(22):2687-9311094033
Cites: J Am Coll Cardiol. 2001 Mar 15;37(4):992-711263626
Cites: Thromb Haemost. 2001 Apr;85(4):619-2511341495
Cites: Circulation. 2001 Nov 6;104(19):2300-411696469
Cites: N Engl J Med. 2002 Jul 4;347(1):5-1212097534
Cites: JAMA. 2002 Jul 17;288(3):321-3312117397
Cites: J Clin Epidemiol. 2003 Feb;56(2):124-3012654406
Cites: J Am Coll Cardiol. 2003 Apr 16;41(8):1358-6312706932
Cites: Circulation. 2004 Feb 10;109(5):672-9314761900
Cites: Ann Intern Med. 1992 Dec 15;117(12):1038-411443972
PubMed ID
22453184 View in PubMed
Less detail

49 records – page 1 of 5.