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2-year patient-related versus stent-related outcomes: the SORT OUT IV (Scandinavian Organization for Randomized Trials With Clinical Outcome IV) Trial.

https://arctichealth.org/en/permalink/ahliterature120892
Source
J Am Coll Cardiol. 2012 Sep 25;60(13):1140-7
Publication Type
Article
Date
Sep-25-2012
Author
Lisette Okkels Jensen
Per Thayssen
Evald Høj Christiansen
Hans Henrik Tilsted
Michael Maeng
Knud Nørregaard Hansen
Anne Kaltoft
Henrik Steen Hansen
Hans Erik Bøtker
Lars Romer Krusell
Jan Ravkilde
Morten Madsen
Leif Thuesen
Jens Flensted Lassen
Author Affiliation
Department of Cardiology, Odense University Hospital, Odense, Denmark. okkels@dadlnet.dk
Source
J Am Coll Cardiol. 2012 Sep 25;60(13):1140-7
Date
Sep-25-2012
Language
English
Publication Type
Article
Keywords
Aged
Angioplasty, Balloon, Coronary
Coronary Artery Disease - mortality - therapy
Death
Denmark
Drug-Eluting Stents
Female
Follow-Up Studies
Humans
Immunosuppressive Agents - therapeutic use
Male
Middle Aged
Myocardial Infarction - etiology
Myocardial Revascularization - statistics & numerical data
Single-Blind Method
Sirolimus - adverse effects - analogs & derivatives - therapeutic use
Thrombosis - etiology
Treatment Outcome
Abstract
There are limited head-to-head randomized data on patient-related versus stent-related outcomes for everolimus-eluting stents (EES) and sirolimus-eluting stents (SES).
In the SORT OUT IV (Scandinavian Organization for Randomized Trials With Clinical Outcome IV) trial, comparing the EES with the SES in patients with coronary artery disease, the EES was noninferior to the SES at 9 months.
The primary endpoint was a composite: cardiac death, myocardial infarction (MI), definite stent thrombosis, or target vessel revascularization. Safety and efficacy outcomes at 2 years were further assessed with specific focus on patient-related composite (all death, all MI, or any revascularization) and stent-related composite outcomes (cardiac death, target vessel MI, or symptom-driven target lesion revascularization). A total of 1,390 patients were assigned to receive the EES, and 1,384 patients were assigned to receive the SES.
At 2 years, the composite primary endpoint occurred in 8.3% in the EES group and in 8.7% in the SES group (hazard ratio [HR]: 0.94, 95% confidence interval [CI]: 0.73 to 1.22). The patient-related outcome: 15.0% in the EES group versus 15.6% in the SES group, (HR: 0.95, 95% CI: 0.78 to 1.15), and the stent-related outcome: 5.2% in the EES group versus 5.3% in the SES group (HR: 0.97, 95% CI: 0.70 to 1.35) did not differ between groups. Rate of definite stent thrombosis was lower in the EES group (0.2% vs. 0.9%, (HR: 0.23, 95% CI: 0.07 to 0.80).
At 2-year follow-up, the EES was found to be noninferior to the SES with regard to both patient-related and stent-related clinical outcomes.
PubMed ID
22958957 View in PubMed
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A 10-month angiographic and 4-year clinical outcome of everolimus-eluting versus sirolimus-eluting coronary stents in patients with diabetes mellitus (the DiabeDES IV randomized angiography trial).

https://arctichealth.org/en/permalink/ahliterature275976
Source
Catheter Cardiovasc Interv. 2015 Dec 1;86(7):1161-7
Publication Type
Article
Date
Dec-1-2015
Author
Michael Maeng
Arvydas Baranauskas
Evald Høj Christiansen
Anne Kaltoft
Niels Ramsing Holm
Lars Romer Krusell
Jan Ravkilde
Hans-Henrik Tilsted
Per Thayssen
Lisette Okkels Jensen
Source
Catheter Cardiovasc Interv. 2015 Dec 1;86(7):1161-7
Date
Dec-1-2015
Language
English
Publication Type
Article
Keywords
Aged
Cardiovascular Agents - administration & dosage
Coronary Angiography
Coronary Artery Disease - mortality - radiography - therapy
Coronary Restenosis - mortality - radiography
Coronary Stenosis - mortality - radiography - therapy
Coronary Thrombosis - mortality - radiography
Denmark
Diabetic Angiopathies - mortality - radiography - therapy
Drug-Eluting Stents
Everolimus - administration & dosage
Female
Humans
Male
Middle Aged
Myocardial Infarction - mortality - radiography
Percutaneous Coronary Intervention - adverse effects - instrumentation - mortality
Predictive value of tests
Prospective Studies
Prosthesis Design
Risk factors
Sirolimus - administration & dosage
Time Factors
Treatment Outcome
Abstract
We aimed to compare angiographic and clinical outcomes after the implantation of everolimus-eluting (EES) and sirolimus-eluting (SES) stents in patients with diabetes.
There are limited data on long-term outcome after EES vs SES implantation in diabetic patients.
We randomized 213 patients with diabetes and coronary artery disease to EES (n?=?108) or SES (n?=?105) implantation. Angiographic follow-up was performed 10 months after the index procedure and all patients were followed clinically for 4 years. The primary endpoint was angiographic in-stent late luminal loss at 10-month follow-up. Secondary endpoints included angiographic restenosis rate, the need for target lesion revascularization (TLR) and major adverse cardiac events (MACE; defined as cardiac death, myocardial infarction, definite stent thrombosis, or TLR) at 4-year follow-up.
At 10-month angiographic follow-up, in-stent late lumen loss was 0.20?±?0.53 mm and 0.11?±?0.49 mm (P?=?0.28), and angiographic restenosis rate was 3.8% and 5.2% (P?=?0.72) in the EES and SES groups, respectively. At 4-year clinical follow-up, MACE had occurred in 22 (20.4%) patients in the EES group and 25 (23.8%) patients in SES group (HR 0.84, 95% CI 0.47-1.49; P?=?0.55), with TLR performed in 6 (5.6%) and 10 (9.5%) patients in the two groups (HR 0.57, 95% CI 0.21-1-58; P?=?0.28).
EES and SES had comparable 10-month angiographic and 4-year clinical outcomes in patients with diabetes mellitus and coronary artery disease.
PubMed ID
25640050 View in PubMed
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Biochemical diagnosis of myocardial infarction evolves towards ESC/ACC consensus: experiences from the Nordic countries.

https://arctichealth.org/en/permalink/ahliterature53097
Source
Scand Cardiovasc J. 2005 Jul;39(3):159-66
Publication Type
Article
Date
Jul-2005
Author
Søren Hjortshøj
Jan Erik Otterstad
Bertil Lindahl
Ragnar Danielsen
Kari Pulkki
Jan Ravkilde
Author Affiliation
Cardiovascular Research Center and Department of Cardiology, Aalborg Hospital, Denmark.
Source
Scand Cardiovasc J. 2005 Jul;39(3):159-66
Date
Jul-2005
Language
English
Publication Type
Article
Keywords
Biological Markers
Comparative Study
Consensus
Denmark
Emergency Service, Hospital - standards
Finland
Health Care Surveys
Humans
Iceland
Laboratory Techniques and Procedures
Myocardial Infarction - diagnosis - physiopathology
Norway
Practice Guidelines
Questionnaires
Sweden
Abstract
OBJECTIVES: To investigate the diagnostic approach in Nordic hospitals receiving patients suspected of acute myocardial infarction (MI), especially focusing on implementation of the recently proposed criteria by the European Society of Cardiology (ESC) and the American College of Cardiology (ACC) for the definition of MI. DESIGN: A survey with questionnaires of the diagnostic approach was conducted among all relevant departments (220) in the Nordic countries. RESULTS: Seventy-six percent (167) of hospitals responded. Troponins I and T (TnI and TnT) and creatinine kinase monobasic fraction (mass concentration) (CKMB(mass)) covered 93 and 65% of hospitals, respectively. Of troponin users, 34% indicated use of TnI vs 66% using TnT. Sporadic use of AST, CK, LD and myoglobin was reported. There was a tendency to lower cut-off levels in Sweden and Finland. Among troponin assays, there was considerable heterogeneity regarding cut-off levels. CONCLUSIONS: The Nordic countries are approaching ESC/ACC consensus on cardiac markers. Compared with previous national surveys (1995-1999), there is a shift towards the use of troponins. However, differences in cut-off levels of troponin emphasize the need for harmonization of assays.
PubMed ID
16146978 View in PubMed
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Clinical outcome after crush versus culotte stenting of coronary artery bifurcation lesions: the Nordic Stent Technique Study 36-month follow-up results.

https://arctichealth.org/en/permalink/ahliterature106024
Source
JACC Cardiovasc Interv. 2013 Nov;6(11):1160-5
Publication Type
Article
Date
Nov-2013
Author
Kari Kervinen
Matti Niemelä
Hannu Romppanen
Andrejs Erglis
Indulis Kumsars
Michael Maeng
Niels R Holm
Jens F Lassen
Pål Gunnes
Sindre Stavnes
Jan S Jensen
Anders Galløe
Inga Narbute
Dace Sondore
Evald H Christiansen
Jan Ravkilde
Terje K Steigen
Jan Mannsverk
Per Thayssen
Knud Nørregaard Hansen
Steffen Helqvist
Saila Vikman
Rune Wiseth
Jens Aarøe
Jari Jokelainen
Leif Thuesen
Author Affiliation
Division of Cardiology, Department of Medicine, Oulu University Hospital, Oulu, Finland. Electronic address: kari.kervinen@ppshp.fi.
Source
JACC Cardiovasc Interv. 2013 Nov;6(11):1160-5
Date
Nov-2013
Language
English
Publication Type
Article
Keywords
Aged
Cardiovascular Agents - administration & dosage
Coronary Angiography
Coronary Artery Disease - diagnosis - mortality - therapy
Coronary Restenosis - etiology
Coronary Thrombosis - etiology
Drug-Eluting Stents
Female
Finland
Humans
Latvia
Male
Middle Aged
Percutaneous Coronary Intervention - adverse effects - instrumentation - methods - mortality
Prosthesis Design
Risk factors
Scandinavia
Sirolimus - administration & dosage
Time Factors
Treatment Outcome
Abstract
The aim of the study was to compare long-term follow-up results of crush versus culotte stent techniques in coronary bifurcation lesions.
The randomized Nordic Stent Technique Study showed similar 6-month clinical and 8-month angiographic results with the crush and culotte stent techniques of de novo coronary artery bifurcation lesions using sirolimus-eluting stents. Here, we report the 36-month efficacy and safety of the Nordic Stent Technique Study.
A total of 424 patients with a bifurcation lesion were randomized to stenting of both main vessel and side branch with the crush or the culotte technique and followed for 36 months. Major adverse cardiac events-the composite of cardiac death, myocardial infarction, stent thrombosis, or target vessel revascularization-were the primary endpoint.
Follow-up was complete for all patients. At 36 months, the rates of the primary endpoint were 20.6% versus 16.7% (p = 0.32), index lesion restenosis 11.5% versus 6.5% (p = 0.09), and definite stent thrombosis 1.4% versus 4.7% (p = 0.09) in the crush and the culotte groups, respectively.
At 36-month follow-up, the clinical outcomes were similar for patients with coronary bifurcation lesions treated with the culotte or the crush stent technique. (Nordic Bifurcation Study. How to Use Drug Eluting Stents [DES] in Bifurcation Lesions? NCT00376571).
PubMed ID
24262616 View in PubMed
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Comparison of outcomes in patients with versus without diabetes mellitus after revascularization with everolimus- and sirolimus-eluting stents (from the SORT OUT IV trial).

https://arctichealth.org/en/permalink/ahliterature120882
Source
Am J Cardiol. 2012 Dec 1;110(11):1585-91
Publication Type
Article
Date
Dec-1-2012
Author
Lisette Okkels Jensen
Per Thayssen
Anders Junker
Michael Maeng
Hans-Henrik Tilsted
Anne Kaltoft
Knud Nørregaard Hansen
Evald Høj Christiansen
Steen Dalby Kristensen
Jan Ravkilde
Morten Madsen
Henrik Toft Sørensen
Leif Thuesen
Jens Flensted Lassen
Author Affiliation
Department of Cardiology, Odense University Hospital, Odense, Denmark. okkels@dadlnet.dk
Source
Am J Cardiol. 2012 Dec 1;110(11):1585-91
Date
Dec-1-2012
Language
English
Publication Type
Article
Keywords
Angioplasty, Balloon, Coronary - methods
Coronary Artery Disease - complications - mortality - surgery
Denmark - epidemiology
Diabetes Mellitus - mortality
Drug-Eluting Stents
Female
Follow-Up Studies
Humans
Immunosuppressive Agents - pharmacology
Male
Middle Aged
Retrospective Studies
Sirolimus - analogs & derivatives - pharmacology
Survival Rate - trends
Treatment Outcome
Abstract
Diabetes is associated with increased risk of major adverse cardiac events (MACEs) after percutaneous coronary intervention. The purpose of this substudy of the SORT OUT IV trial was to compare clinical outcomes in patients with and without diabetes mellitus treated with everolimus-eluting stents (EESs) or sirolimus-eluting stents (SESs). In total 2,774 patients (390 with diabetes, 14.1%) were randomized to stent implantation with EESs (n = 1,390, diabetes in 14.0%) or SESs (n = 1,384, diabetes in 14.2%). Randomization was stratified by presence/absence of diabetes. The primary end point was MACEs, a composite of cardiac death, myocardial infarction, definite stent thrombosis, or target vessel revascularization within 18 months. MACEs were higher in diabetic than in nondiabetic patients (13.1% vs 6.4%, hazard ratio [HR] 2.08, 95% confidence interval [CI] 1.51 to 2.86). In diabetic patients, MACEs were seen in 10.3% of those treated with EESs and in 15.8% of those treated with SESs (HR 0.63, 95% CI 0.36 to 1.11). In nondiabetic patients, MACEs occurred in 6.6% of EES-treated and in 6.3% SES-treated patients (HR 1.06, 95% CI 0.77 to 1.46). In diabetics, cardiac death occurred in 3.1% of EES-treated and in 4.6% of SES-treated patients (HR 0.67, 95% CI 0.24 to 1.89), myocardial infarction occurred in 0.5% of EES-treated and in 3.6% of SES-treated patients (HR 0.14, 95% CI 0.02 to 1.16), and clinically driven target lesion revascularization was needed in 3.1% of EES-treated and in 7.7% of SES-treated patients (HR 0.40, 95% CI 0.15 to 1.02). No interaction between diabetes status and type of drug-eluting stent was found for the end points. In conclusion, patients with diabetes have higher MACE rates than nondiabetics. No significant differences in safety or efficacy outcomes after EES or SES implantation were present in nondiabetic or diabetic patients.
Notes
Comment In: Expert Rev Cardiovasc Ther. 2013 Feb;11(2):151-423405836
PubMed ID
22959714 View in PubMed
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Comparison of outcomes of patients = 80 years of age having percutaneous coronary intervention according to presentation (stable vs unstable angina pectoris/non-ST-segment elevation myocardial infarction vs ST-segment elevation myocardial infarction).

https://arctichealth.org/en/permalink/ahliterature131661
Source
Am J Cardiol. 2011 Nov 15;108(10):1395-400
Publication Type
Article
Date
Nov-15-2011
Author
Lisbeth Antonsen
Lisette Okkels Jensen
Per Thayssen
Evald Høj Christiansen
Anders Junker
Hans-Henrik Tilsted
Christian Juhl Terkelsen
Anne Kaltoft
Michael Maeng
Knud Noerregaard Hansen
Jan Ravkilde
Jens Flensted Lassen
Morten Madsen
Henrik Toft Sørensen
Leif Thuesen
Author Affiliation
Department of Cardiology, Odense University Hospital, Odense, Denmark. dr_lissie@hotmail.com
Source
Am J Cardiol. 2011 Nov 15;108(10):1395-400
Date
Nov-15-2011
Language
English
Publication Type
Article
Keywords
Aged, 80 and over
Angina, Stable - mortality - therapy
Angina, Unstable - mortality - therapy
Angioplasty, Balloon, Coronary - statistics & numerical data - trends
Arrhythmias, Cardiac - mortality
Cohort Studies
Comorbidity
Coronary Artery Disease - mortality - therapy
Denmark - epidemiology
Female
Follow-Up Studies
Heart Failure - mortality
Humans
Male
Myocardial Infarction - mortality - therapy
Registries
Regression Analysis
Abstract
Patients = 80 years old with coronary artery disease constitute a particular risk group in relation to percutaneous coronary intervention (PCI). From 2002 through 2008 we examined the annual proportion of patients = 80 years old undergoing PCI in western Denmark, their indications for PCI, and prognosis. From 2002 through 2009 all elderly patients treated with PCI were identified in a population of 3.0 million based on the Western Denmark Heart Registry. Cox regression analysis was used to compare mortality rates according to clinical indications controlling for potential confounding. In total 3,792 elderly patients (= 80 years old) were treated with PCI and the annual proportion increased from 224 (5.4%) in 2002 to 588 (10.2%) in 2009. The clinical indication was stable angina pectoris (SAP) in 30.2%, ST-segment elevation myocardial infarction (STEMI) in 35.0%, UAP/non-STEMI in 29.7%, and "ventricular arrhythmia or congestive heart failure" in 5.1%. Overall 30-day and 1-year mortality rates were 9.2% and 18.1%, respectively. Compared to patients with SAP the adjusted 1-year mortality risk was significantly higher for patients presenting with STEMI (hazard ratio 3.86, 95% confidence interval 3.08 to 4.85), UAP/non-STEMI (hazard ratio 1.95, 95% confidence interval 1.53 to 2.50), and ventricular arrhythmia or congestive heart failure (hazard ratio 2.75, 95% confidence interval 1.92 to 3.92). In patients with SAP target vessel revascularization decreased from 7.1% in 2002 to 2.5% in 2008. In conclusion, the proportion of patients = 80 years old treated with PCI increased significantly over an 8-year period. Patients with SAP had the lowest mortality rates and rates of clinically driven target vessel revascularization decreased over time.
PubMed ID
21890087 View in PubMed
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Denmark: coronary and structural heart interventions from 2010 to 2015.

https://arctichealth.org/en/permalink/ahliterature290874
Source
EuroIntervention. 2017 May 15; 13(Z):Z17-Z20
Publication Type
Journal Article
Date
May-15-2017
Author
Hans-Henrik Tilsted
Ole Ahlehoff
Christian J Terkelsen
Frants Pedersen
Cengiz Özcan
Troels H Jørgensen
Jens E Nielsen-Kudsk
Jan Ravkilde
Henrik Nissen
Sune A Pedersen
Ole Havndrup
Jens F Lassen
Author Affiliation
The Heart Centre, Rigshospitalet, Copenhagen, Denmark.
Source
EuroIntervention. 2017 May 15; 13(Z):Z17-Z20
Date
May-15-2017
Language
English
Publication Type
Journal Article
Keywords
Coronary Angiography - methods
Denmark
Drug-Eluting Stents
Humans
Myocardial Infarction - surgery
Percutaneous Coronary Intervention - methods
Registries
Transcatheter Aortic Valve Replacement - methods
Treatment Outcome
Abstract
Interventional cardiology in Denmark has been carried out since the mid 1980s. Interventional cardiology is only performed at a few high-volume centres. Healthcare coverage is universal and is essentially free of charge. Hospitals are mostly publicly owned and financed by fixed budgets and, in part, an activity-based funding system. Approximately 30,000 coronary angiographies (CAG), 10,000 percutaneous coronary interventions (PCIs) of which approximately 25% are primary PCIs, and 500 transcatheter aortic valve implantations (TAVIs) are carried out each year. The numbers of CAG and PCI have reached a plateau in recent years, whereas structural heart interventions, in particular TAVI, are increasing. Around 90% of all patients treated with PCI have a stent implanted, with more than 95% of these being drug-eluting stents. There is a low but increasing use of bioabsorbable scaffolds and drug-eluting balloons.
PubMed ID
28504224 View in PubMed
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Diagnostic value of ischemia-modified albumin in patients with suspected acute coronary syndrome.

https://arctichealth.org/en/permalink/ahliterature98029
Source
Am J Emerg Med. 2010 Feb;28(2):170-6
Publication Type
Article
Date
Feb-2010
Author
Søren Hjortshøj
Søren Risom Kristensen
Jan Ravkilde
Author Affiliation
Department of Cardiology, Cardiovascular Research Centre, Aalborg Hospital, Aarhus University Hospital, DK-9000 Alborg, Denmark. sph@dadlnet.dk
Source
Am J Emerg Med. 2010 Feb;28(2):170-6
Date
Feb-2010
Language
English
Publication Type
Article
Keywords
Acute Coronary Syndrome - diagnosis
Adult
Aged
Aged, 80 and over
Biological Markers - blood
Case-Control Studies
Chest Pain - etiology
Denmark
Humans
Male
Middle Aged
Myocardial Infarction - diagnosis
Myocardial Ischemia - blood - diagnosis
Predictive value of tests
ROC Curve
Reagent kits, diagnostic
Serum Albumin - analysis
Abstract
INTRODUCTION: Ischemia-modified albumin (IMA) has been proposed as a useful rule-out marker for the diagnosis of acute coronary syndrome (ACS) in the emergency department. This study evaluated the ability of IMA to predict the acute myocardial infarction (AMI) diagnosis in a population of chest pain patients. METHODS: The study population comprised 107 subjects (men, 62%; women, 38%) admitted with suspected ACS. None of the patients had ST-segment elevations that qualified for immediate revascularization. Ischemia-modified albumin was determined from serum with albumin cobalt binding test (Inverness Medical Innovations Inc, Stirling, UK). Furthermore, cardiac troponin T, creatinine kinase MB mass, myoglobin, and heart-type fatty acid binding protein (H-FABP) were determined on arrival, after 6 to 9 hours, and after 12 to 24 hours. All patients had at least 2 blood samples taken to exclude/verify the AMI. AMI was defined by a cardiac troponin T level greater than 0.03 microg/L. RESULTS: Thirty-three percent of the patients (n = 35) had a final diagnosis of AMI. The sensitivity of admission IMA for a final diagnosis of ACS was 0.86 (95% confidence interval [95% CI], 0.69-0.95). Specificity was 0.49 (95% CI, 0.36-0.60). Negative predictive value was 0.88 (95% CI, 0.72-0.95). The optimal cutoff threshold derived from the receiver operating characteristics (ROC) curve (ROC analysis) was determined as 91 U/mL. The area under the ROC curve was 0.73. Ischemia-modified albumin did not, at any time, provide superior sensitivity or specificity compared with other biomarkers. We do not find the data supportive of IMA as a standard marker in the emergency department.
PubMed ID
20159386 View in PubMed
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Dimensions of socioeconomic status and clinical outcome after primary percutaneous coronary intervention.

https://arctichealth.org/en/permalink/ahliterature120190
Source
Circ Cardiovasc Interv. 2012 Oct;5(5):641-8
Publication Type
Article
Date
Oct-2012
Author
Lars Jakobsen
Troels Niemann
Niels Thorsgaard
Leif Thuesen
Jens F Lassen
Lisette O Jensen
Per Thayssen
Jan Ravkilde
Hans H Tilsted
Frank Mehnert
Søren P Johnsen
Author Affiliation
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
Source
Circ Cardiovasc Interv. 2012 Oct;5(5):641-8
Date
Oct-2012
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Chi-Square Distribution
Denmark
Educational Status
Employment
Female
Follow-Up Studies
Health Status Disparities
Healthcare Disparities
Humans
Income
Male
Middle Aged
Myocardial Infarction - economics - mortality - therapy
Percutaneous Coronary Intervention - adverse effects - economics - mortality
Proportional Hazards Models
Prospective Studies
Recurrence
Registries
Risk assessment
Risk factors
Socioeconomic Factors
State Medicine
Time Factors
Treatment Outcome
Abstract
The association between low socioeconomic status (SES) and high mortality from coronary heart disease is well-known. However, the role of SES in relation to the clinical outcome after primary percutaneous coronary intervention remains poorly understood.
We studied 7385 patients treated with primary percutaneous coronary intervention. Participants were divided into high-SES and low-SES groups according to income, education, and employment status. The primary outcome was major adverse cardiac events (cardiac death, recurrent myocardial infarction, and target vessel revascularization) at maximum follow-up (mean, 3.7 years). Low-SES patients had more adverse baseline risk profiles than high-SES patients. The cumulative risk of major adverse cardiac events after maximum follow-up was higher among low-income patients and unemployed patients compared with their counterparts (income: hazard ratio, 1.68; 95% CI, 1.47-1.92; employment status: hazard ratio, 1.75; 95% CI, 1.46-2.10). After adjustment for patient characteristics, these differences were substantially attenuated (income: hazard ratio, 1.12; 95% CI, 0.93-1.33; employment status: hazard ratio, 1.27; 95% CI, 1.03-1.56). Further adjustment for admission findings, procedure-related data, and medical treatment during follow-up did not significantly affect the associations. With education as the SES indicator, no between-group differences were observed in the risk of the composite end point.
Even in a tax-financed healthcare system, low-SES patients treated with primary percutaneous coronary intervention face a worse prognosis than high-SES patients. The poor outcome seems to be largely explained by differences in baseline patient characteristics. Employment status and income (but not education level) were associated with clinical outcomes.
PubMed ID
23031837 View in PubMed
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Extra corporeal life support makes advanced radiologic examinations and cardiac interventions possible in patients with cardiac arrest.

https://arctichealth.org/en/permalink/ahliterature136576
Source
Resuscitation. 2011 May;82(5):623-6
Publication Type
Article
Date
May-2011
Author
Benedict Kjærgaard
Anne Frost
Bodil S Rasmussen
Kerstin Krüger
Jan Ravkilde
Author Affiliation
Dept of Cardiothoracic Surgery, Aalborg Hospital, Aarhus University Hospital, Center for Cardiovascular Research, DK-9100 Aalborg, Denmark. benedict@dadlnet.dk
Source
Resuscitation. 2011 May;82(5):623-6
Date
May-2011
Language
English
Publication Type
Article
Keywords
Adult
Aged
Angiography - methods
Denmark - epidemiology
Emergency Medical Services - methods
Extracorporeal Circulation - methods
Female
Follow-Up Studies
Humans
Male
Middle Aged
Out-of-Hospital Cardiac Arrest - mortality - radiography - therapy
Retrospective Studies
Survival Rate - trends
Tomography, X-Ray Computed - methods
Treatment Outcome
Young Adult
Abstract
Extra corporeal life support (ECLS) with a mobile system is an option in the treatment of cardiac arrest often of unknown reason. After commencing ECLS the search for a provoking origin may include advanced radiologic examinations before deciding further treatment.
Fifty-eight patients with circulatory arrest were treated with ECLS. In 15 cases the patient went through CT scans of the cerebrum, thorax and abdomen, pulmonary angiography, and or invasive cardiologic examinations. Two patients were transported in ambulance and helicopter on ECLS before the examinations.
The underlying diagnosis in the 15 patients were: lung embolism (n = 6), accidental hypothermia (n = 2), myocardial infarction (n = 2), WPW syndrome (n = 1), sepsis (n = 1), disseminated intravascular coagulation (n = 2), high voltage accident (n = 1). Only in the last mentioned patient the CT scan was indicative of major brain damage, and further treatment was stopped. Five of the 15 examined patients survived. The diagnoses in the survivors were lung embolism (n = 2), myocardial infarction (n = 1), WPW syndrome (n = 1), and accidental hypothermia (n = 1). The results of the radiologic examinations had great influence on all treatments.
It is possible to make radiological examinations i.e., CT scans, pulmonary and coronary angiography in patients suffering heart arrest of unknown origin with the use of ECLS in order to improve patient treatment in this very high-risk population.
PubMed ID
21367509 View in PubMed
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24 records – page 1 of 3.