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30-year mortality after venous thromboembolism: a population-based cohort study.

https://arctichealth.org/en/permalink/ahliterature257922
Source
Circulation. 2014 Sep 2;130(10):829-36
Publication Type
Article
Date
Sep-2-2014
Author
Kirstine Kobberøe Søgaard
Morten Schmidt
Lars Pedersen
Erzsébet Horváth-Puhó
Henrik Toft Sørensen
Author Affiliation
From the Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark. kks@clin.au.dk.
Source
Circulation. 2014 Sep 2;130(10):829-36
Date
Sep-2-2014
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Cohort Studies
Databases as Topic - statistics & numerical data
Denmark - epidemiology
Female
Humans
Longitudinal Studies
Male
Middle Aged
Regression Analysis
Retrospective Studies
Risk factors
Survival Rate
Venous Thromboembolism - epidemiology - mortality
Abstract
Studies on long-term mortality after venous thromboembolism (VTE) are sparse.
Using Danish medical databases, we conducted a 30-year nationwide population-based cohort study of 128 223 patients with first-time VTE (1980-2011) and a comparison cohort of 640 760 people from the general population (without VTE) randomly matched by sex, year of birth, and calendar period. The mortality risks for patients with deep venous thrombosis (DVT) and pulmonary embolism (PE) were markedly higher than for the comparison cohort during the first year, especially within the first 30 days (3.0% and 31% versus 0.4%). Using Cox regression, we assessed mortality rate ratios (MRRs) with 95% confidence intervals (CIs). The overall 30-year MRR was 1.55 (95% CI, 1.53-1.57) for DVT and 2.77 (95% CI, 2.74-2.81) for PE. The 30-day MRR was 5.38 (95% CI, 5.00-5.80) for DVT and 80.87 (95% CI, 76.02-86.02) for PE. Over time, the 30-day MRR was consistently 5- to 6-fold increased for DVT, whereas it improved for PE from 138 (95% CI, 125-153) in 1980 to 1989 to 36.08 (95% CI, 32.65-39.87) in 2000 to 2011. The 1- to 10-year and 11- to 30-year MRRs remained 25% to 40% increased after both DVT and PE but were 3- to 5-fold increased after DVT and 6- to 11-fold increased after PE when VTE was considered the immediate cause of death.
Patients with VTE are at increased risk of dying, especially within the first year after diagnosis, but also during the entire 30 years of follow-up, with VTE as an important cause of death. Although 30-day mortality after DVT remained fairly constant over the last 3 decades, it improved markedly for PE.
Notes
Comment In: Nat Rev Cardiol. 2014 Sep;11(9):49625027484
Comment In: Nat Rev Cardiol. 2014 Sep;11(9):49725027486
PubMed ID
24970783 View in PubMed
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30-year nationwide trends in incidence of atrial fibrillation in Denmark and associated 5-year risk of heart failure, stroke, and death.

https://arctichealth.org/en/permalink/ahliterature286741
Source
Int J Cardiol. 2016 Dec 15;225:30-36
Publication Type
Article
Date
Dec-15-2016
Author
Morten Schmidt
Sinna Pilgaard Ulrichsen
Lars Pedersen
Hans Erik Bøtker
Jens Cosedis Nielsen
Henrik Toft Sørensen
Source
Int J Cardiol. 2016 Dec 15;225:30-36
Date
Dec-15-2016
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Atrial Fibrillation - epidemiology - mortality - therapy
Cohort Studies
Death
Denmark - epidemiology
Female
Follow-Up Studies
Heart Failure - epidemiology - mortality - therapy
Hospitalization - trends
Humans
Incidence
Male
Middle Aged
Population Surveillance - methods
Registries
Risk factors
Stroke - epidemiology - mortality - therapy
Time Factors
Abstract
Long-term nationwide trends in atrial fibrillation (AF) incidence and 5-year outcomes are rare.
We conducted a population-based cohort study using the Danish National Patient Registry covering all Danish hospitals. We computed standardized incidence rates during 1983-2012. We used Cox regression to estimate hazard ratios (HRs) of heart failure, stroke, and death within 5years, comparing 5-year calendar periods with the earliest period (1983-1987) as reference.
We identified 312,420 patients with first-time hospital-diagnosed AF. The incidence rate per 100,000person-years increased from 98 in 1983 to 307 in 2012. The mean annual increase during the 30-year study period was 4%, with a 6% increase annually until 2000 and a 1.4% increase annually thereafter. The incidence trends were most pronounced among men and persons above 70years. Among high-risk subgroups, AF incidence was consistently highest in patients with valvular heart disease or heart failure. The rate of heart failure following AF declined by 50% over the entire study period (HR: 0.49, 95% confidence interval (CI): 0.48-0.51) and the mortality rate declined by 40% (HR: 0.62, 95% CI: 0.61-0.63). Within the last two decades, the rate for ischemic stroke declined by 20% (HR 0.81, 95% CI: 0.78-0.84), but increased almost as much for haemorrhagic stroke (HR: 1.14, 95% CI: 1.01-1.29).
The long-term risk of heart failure, ischemic stroke, and death following onset of AF has decreased remarkably over the last three decades. Still, the threefold increased incidence of hospital-diagnosed AF during the same period is a major public health concern.
PubMed ID
27705839 View in PubMed
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Adult height and risk of ischemic heart disease, atrial fibrillation, stroke, venous thromboembolism, and premature death: a population based 36-year follow-up study.

https://arctichealth.org/en/permalink/ahliterature105680
Source
Eur J Epidemiol. 2014 Feb;29(2):111-8
Publication Type
Article
Date
Feb-2014
Author
Morten Schmidt
Hans Erik Bøtker
Lars Pedersen
Henrik Toft Sørensen
Author Affiliation
Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Allé 43-45, 8200, Aarhus, Denmark, morten.schmidt@dadlnet.dk.
Source
Eur J Epidemiol. 2014 Feb;29(2):111-8
Date
Feb-2014
Language
English
Publication Type
Article
Keywords
Adult
Atrial Fibrillation - complications - diagnosis - epidemiology
Body Height
Body mass index
Denmark - epidemiology
Follow-Up Studies
Humans
Incidence
Life expectancy
Male
Middle Aged
Mortality, Premature
Myocardial Ischemia - complications - diagnosis - mortality
Population Surveillance
Proportional Hazards Models
Risk factors
Stroke - complications - diagnosis - epidemiology
Venous Thromboembolism - complications - diagnosis - epidemiology
Abstract
Few studies have associated height with cardiovascular diseases other than myocardial infarction. We conducted a population-based 36-year cohort study of 12,859 men born in 1955 or 1965 whose fitness for military service was assessed by Draft Boards in Northern Denmark. Hospital diagnoses for ischemic heart diseases, atrial fibrillation, stroke, and venous thromboembolism were obtained from the Danish National Patient Registry, covering all Danish hospitals since 1977. Mortality data were obtained from the Danish Civil Registration System. We began follow-up on the 22nd birthday of each subject and continued until occurrence of an outcome, emigration, death, or 31 December 2012, whichever came first. We used Cox regression to compute hazard ratios (HRs) with 95 % confidence intervals (CIs). Compared with short stature, the education-adjusted HR among tall men was 0.67 (95 % CI 0.54-0.84) for ischemic heart disease (similar for myocardial infarction, angina pectoris, and heart failure), 1.60 (95 % CI 1.11-2.33) for atrial fibrillation, 1.05 (95 % CI 0.75-1.46) for stroke, 1.04 (95 % CI 0.67-1.64) for venous thromboembolism, and 0.70 (95 % CI 0.58-0.86) for death. In conclusion, short stature was a risk factor for ischemic heart disease and premature death, but a protective factor for atrial fibrillation. Stature was not substantially associated with stroke or venous thromboembolism.
PubMed ID
24337942 View in PubMed
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Comparison of the frequency of atrial fibrillation in young obese versus young nonobese men undergoing examination for fitness for military service.

https://arctichealth.org/en/permalink/ahliterature105358
Source
Am J Cardiol. 2014 Mar 1;113(5):822-6
Publication Type
Article
Date
Mar-1-2014
Author
Morten Schmidt
Hans Erik Bøtker
Lars Pedersen
Henrik Toft Sørensen
Author Affiliation
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark. Electronic address: morten.schmidt@dadlnet.dk.
Source
Am J Cardiol. 2014 Mar 1;113(5):822-6
Date
Mar-1-2014
Language
English
Publication Type
Article
Keywords
Atrial Fibrillation - epidemiology - physiopathology
Body mass index
Cohort Studies
Denmark - epidemiology
Diabetic Angiopathies - epidemiology
Female
Heart Failure - epidemiology
Humans
Hypertension - epidemiology
Male
Military Personnel
Myocardial Infarction - epidemiology
Obesity - epidemiology - physiopathology
Physical Examination
Proportional Hazards Models
Risk factors
Sleep Apnea Syndromes - epidemiology
Abstract
The association between body mass index (BMI) in young adulthood and long-term risk of atrial fibrillation (AF) has not yet been examined for men. We conducted a population-based 36-year cohort study to examine the BMI-associated risk of AF in 12,850 young men who had BMI measured at their examination of fitness for military service. AF was identified from the Danish National Registry of Patients, covering all Danish hospitals since 1977. We began follow-up on the twenty-second birthday of each subject and continued until the occurrence of AF, emigration, death, or December 31, 2012. We used Cox regression to compute hazard ratios (HRs) with 95% confidence intervals (CIs), adjusting for education and height. The cohort contributed a total of 375,888 person-years of follow-up and the median follow-up time was 26 years (mean 29 years). The incidence of AF per 100,000 person-years was 53 for men of normal weight (BMI: 18.5 to 24.9 kg/m(2)), 54 for underweight men (BMI
PubMed ID
24406109 View in PubMed
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The Danish Civil Registration System as a tool in epidemiology.

https://arctichealth.org/en/permalink/ahliterature257550
Source
Eur J Epidemiol. 2014 Aug;29(8):541-9
Publication Type
Article
Date
Aug-2014
Author
Morten Schmidt
Lars Pedersen
Henrik Toft Sørensen
Author Affiliation
Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Allé 43-45, 8200, Aarhus N, Denmark, morten.schmidt@dce.au.dk.
Source
Eur J Epidemiol. 2014 Aug;29(8):541-9
Date
Aug-2014
Language
English
Publication Type
Article
Keywords
Demography
Denmark - epidemiology - ethnology
Emigrants and Immigrants
Epidemiologic Studies
Female
Humans
Male
Population Surveillance
Registries
Abstract
The methodological advances in epidemiology have facilitated the use of the Danish Civil Registration System (CRS) in ways not previously described systematically. We reviewed the CRS and its use as a research tool in epidemiology. We obtained information from the Danish Law on Civil Registration and the Central Office of Civil Registration, and used existing literature to provide illustrative examples of its use. The CRS is an administrative register established on April 2, 1968. It contains individual-level information on all persons residing in Denmark (and Greenland as of May 1, 1972). By January 2014, the CRS had cumulatively registered 9.5 million individuals and more than 400 million person-years of follow-up. A unique ten-digit Civil Personal Register number assigned to all persons in the CRS allows for technically easy, cost-effective, and unambiguous individual-level record linkage of Danish registers. Daily updated information on migration and vital status allows for nationwide cohort studies with virtually complete long-term follow-up on emigration and death. The CRS facilitates sampling of general population comparison cohorts, controls in case-control studies, family cohorts, and target groups in population surveys. The data in the CRS are virtually complete, have high accuracy, and can be retrieved for research purposes while protecting the anonymity of Danish residents. In conclusion, the CRS is a key tool for epidemiological research in Denmark.
PubMed ID
24965263 View in PubMed
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Impact of preadmission treatment with calcium channel blockers or beta blockers on short-term mortality after stroke: a nationwide cohort study.

https://arctichealth.org/en/permalink/ahliterature271794
Source
BMC Neurol. 2015;15:24
Publication Type
Article
Date
2015
Author
Jens Sundbøll
Morten Schmidt
Erzsébet Horváth-Puhó
Christian F Christiansen
Lars Pedersen
Hans Erik Bøtker
Henrik T Sørensen
Source
BMC Neurol. 2015;15:24
Date
2015
Language
English
Publication Type
Article
Keywords
Adrenergic beta-Antagonists - therapeutic use
Aged
Aged, 80 and over
Calcium Channel Blockers - therapeutic use
Cardiovascular Diseases - drug therapy - epidemiology
Cerebral Hemorrhage - epidemiology - mortality
Cohort Studies
Comorbidity
Denmark - epidemiology
Female
Humans
Male
Middle Aged
Prognosis
Proportional Hazards Models
Registries
Risk factors
Stroke - epidemiology - mortality
Subarachnoid Hemorrhage - epidemiology - mortality
Abstract
The prognostic impact of preadmission use of calcium channel blockers (CCBs) and beta blockers (BBs) on stroke mortality remains unclear. We aimed to examine whether preadmission use of CCBs or BBs was associated with improved short-term mortality following ischemic stroke, intracerebral hemorrhage (ICH), or subarachnoid hemorrhage (SAH).
We conducted a nationwide population-based cohort study using Danish medical registries. We identified all patients with a first-time inpatient diagnosis of stroke between 2004 and 2012 and their comorbidities. We defined CCB/BB use as current use, former use, or non-use. Current use was further classified as new or long-term use. We used Cox regression modeling to compute 30-day mortality rate ratios (MRRs) with 95% confidence intervals (CIs), controlling for potential confounders.
We identified 100,043 patients with a first-time stroke. Of these, 83,736 (83.7%) patients had ischemic stroke, 11,779 (11.8%) had ICH, and 4,528 (4.5%) had SAH. Comparing current users of CCBs or BBs with non-users, we found no association with mortality for ischemic stroke [adjusted 30-day MRR?=?0.99 (95% CI: 0.94-1.05) for CCBs and 1.01 (95% CI: 0.96-1.07) for BBs], ICH [adjusted 30-day MRR?=?1.05 (95% CI: 0.95-1.16) for CCBs and 0.95 (95% CI: 0.87-1.04) for BBs], or SAH [adjusted 30-day MRR?=?1.05 (95% CI: 0.85-1.29) for CCBs and 0.89 (95% CI: 0.72-1.11) for BBs]. Former use of CCBs or BBs was not associated with mortality.
Preadmission use of CCBs or BBs was not associated with 30-day mortality following ischemic stroke, ICH, or SAH.
Notes
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Cites: Eur J Neurol. 2012 Feb;19(2):234-4021777353
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Cites: Lancet. 2002 Dec 14;360(9349):1903-1312493255
Cites: Am J Epidemiol. 2003 Nov 1;158(9):915-2014585769
Cites: J Intern Med. 2004 Feb;255(2):257-6514746563
Cites: Stroke. 1994 Nov;25(11):2215-97974548
Cites: Stroke. 1996 Oct;27(10):1817-208841337
Cites: Dan Med Bull. 1999 Jun;46(3):263-810421985
Cites: Eur J Neurol. 2006 Jun;13(6):581-9816796582
Cites: Neurology. 2007 Feb 13;68(7):509-1417296916
Cites: Neuroepidemiology. 2007;28(3):150-417478969
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Cites: World Neurosurg. 2011 Dec;76(6 Suppl):S85-9022182277
PubMed ID
25884780 View in PubMed
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Long-Term Risk of Stroke in Myocardial Infarction Survivors: Thirty-Year Population-Based Cohort Study.

https://arctichealth.org/en/permalink/ahliterature282669
Source
Stroke. 2016 Jul;47(7):1727-33
Publication Type
Article
Date
Jul-2016
Author
Jens Sundbøll
Erzsébet Horváth-Puhó
Morten Schmidt
Lars Pedersen
Victor W Henderson
Hans Erik Bøtker
Henrik Toft Sørensen
Source
Stroke. 2016 Jul;47(7):1727-33
Date
Jul-2016
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Brain Ischemia - epidemiology - etiology
Cohort Studies
Denmark - epidemiology
Female
Follow-Up Studies
Humans
Incidence
Male
Middle Aged
Myocardial Infarction - complications
Registries
Risk
Stroke - epidemiology - etiology
Abstract
Improved survival after myocardial infarction (MI) has increased the number of patients at risk of post-MI stroke. We examined risks of ischemic stroke, intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH) in patients with MI compared with the general population.
We conducted a nationwide population-based cohort study using Danish medical registries. During 1980 to 2009, we identified all patients with a first-time inpatient diagnosis of MI and formed a sex- and age-matched comparison cohort. We computed cumulative stroke risks and adjusted stroke rate ratios with 95% confidence intervals (CIs).
We identified 258?806 patients with an MI and 1?244?773 individuals from the general population. For patients with MI, the cumulative stroke risks after 1 to 30 years were 12.6% for ischemic stroke, 1.2% for ICH, and 0.24% for SAH. During the first 30 days after MI, the adjusted stroke rate ratio was 30-fold increased for ischemic stroke (31.9; 95% CI, 28.4-35.8), 20-fold for ICH (21.8; 95% CI, 16.6-28.5), and 15-fold for SAH (16.6; 95% CI, 8.7-32.0). The adjusted stroke rate ratio remained increased during 31 to 365 days (3-fold for ischemic stroke, 2-fold for ICH, and 1.5-fold for SAH). During the ensuing 1 to 30 years, the risks remained increased for ischemic stroke (1.6; 95% CI, 1.6-1.6) but decreased to near unity for ICH (1.1; 95% CI, 1.0-1.2) and SAH (1.1; 95% CI, 0.94-1.2).
MI was a risk factor for all stroke subtypes during the first year of follow-up, but only for ischemic stroke thereafter.
PubMed ID
27301935 View in PubMed
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Long-Term Survival Among Patients With Myocardial Infarction Before Age 50 Compared With the General Population: A Danish Nationwide Cohort Study.

https://arctichealth.org/en/permalink/ahliterature287049
Source
Circ Cardiovasc Qual Outcomes. 2016 Sep;9(5):523-31
Publication Type
Article
Date
Sep-2016
Author
Morten Schmidt
Szimonetta Szépligeti
Erzsébet Horváth-Puhó
Lars Pedersen
Hans Erik Bøtker
Henrik Toft Sørensen
Source
Circ Cardiovasc Qual Outcomes. 2016 Sep;9(5):523-31
Date
Sep-2016
Language
English
Publication Type
Article
Keywords
Adult
Age of Onset
Cause of Death
Comorbidity
Denmark - epidemiology
Female
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Myocardial Infarction - diagnosis - epidemiology - mortality
Proportional Hazards Models
Prospective Studies
Risk assessment
Risk factors
Sex Factors
Survivors
Time Factors
Abstract
The long-term prognosis for young myocardial infarction (MI) survivors remains poorly understood.
We conducted a nationwide population-based cohort study using prospectively collected medical data from all hospitals in Denmark during 1980 to 2009. We examined 30-year cause-specific death rates among 21?693 MI patients
PubMed ID
27576336 View in PubMed
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Nonsteroidal antiinflammatory drug use and cardiovascular risks after coronary stent implantation.

https://arctichealth.org/en/permalink/ahliterature131226
Source
Pharmacotherapy. 2011 May;31(5):458-68
Publication Type
Article
Date
May-2011
Author
Morten Schmidt
Lars Pedersen
Michael Maeng
Jens F Lassen
Timothy L Lash
Torsten T Nielsen
Henrik T Sørensen
Author Affiliation
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark. morten.schmidt@dce.au.dk
Source
Pharmacotherapy. 2011 May;31(5):458-68
Date
May-2011
Language
English
Publication Type
Article
Keywords
Aged
Anti-Inflammatory Agents, Non-Steroidal - adverse effects - therapeutic use
Cardiovascular Diseases - etiology - mortality - prevention & control - therapy
Cohort Studies
Cyclooxygenase 2 Inhibitors - adverse effects - therapeutic use
Databases, Factual
Denmark - epidemiology
Drug Prescriptions - statistics & numerical data
Female
Humans
Male
Middle Aged
Platelet Aggregation Inhibitors - adverse effects - therapeutic use
Proportional Hazards Models
Registries
Retrospective Studies
Risk
Severity of Illness Index
Stents - adverse effects
Abstract
To determine whether use of nonselective nonsteroidal antiinflammatory drugs (NSAIDs) or cyclooxygenase-2 (COX-2)-selective inhibitors in patients with coronary stents increased the 3-year rate of major adverse cardiovascular events (MACE).
Population-based cohort study.
The Danish National Patient Registry, the Western Denmark Heart Registry, the Danish Nationwide Prescription Database, the Danish Civil Registration System, and the National Registry of Causes of Deaths.
A total of 13,001 patients who underwent first-ever percutaneous coronary intervention with stent implantation between January 1, 2002, and June 30, 2005.
All patients were followed for 3 years after stent implantation for MACE, defined as the first occurrence of myocardial infarction, stent thrombosis, target-lesion revascularization, or cardiac death. Patients' comorbidities were identified from the hospital registries; time-varying use of NSAIDs and concomitant drugs was determined from the Danish Nationwide Prescription Database. For each clinical outcome (MACE), the 3-year risk was computed. We used Cox proportional-hazards regression analysis to compute hazard ratios (HRs) as a measure of relative risk, controlling for potential confounders. During the follow-up period, 5407 patients (41.6%) redeemed at least one NSAID prescription. There were 686 hospitalizations for myocardial infarction (5.3% of patients), 146 for stent thrombosis (1.1%), and 1091 for target-lesion revascularization (8.4%). A total of 1220 patients (9.4%) died during the follow-up period; 637 (4.9%) died of cardiac causes. Compared with no NSAID use, the adjusted HR for MACE was 1.04 (95% confidence interval [CI] 0.83-1.31) for nonselective NSAID use and 1.00 (95% CI 0.81-1.25) for COX-2 inhibitor use.
Use of nonselective NSAIDs or COX-2 inhibitors was not associated with an increased rate of MACE in patients with coronary stents. However, we cannot rule out small risks associated with individual NSAIDs.
PubMed ID
21923427 View in PubMed
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14 records – page 1 of 2.