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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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Acromegaly incidence, prevalence, complications and long-term prognosis: a nationwide cohort study.

https://arctichealth.org/en/permalink/ahliterature280006
Source
Eur J Endocrinol. 2016 Sep;175(3):181-90
Publication Type
Article
Date
Sep-2016
Author
Jakob Dal
Ulla Feldt-Rasmussen
Marianne Andersen
Lars Ø Kristensen
Peter Laurberg
Lars Pedersen
Olaf M Dekkers
Henrik Toft Sørensen
Jens Otto L Jørgensen
Source
Eur J Endocrinol. 2016 Sep;175(3):181-90
Date
Sep-2016
Language
English
Publication Type
Article
Keywords
Acromegaly - diagnosis - epidemiology
Adult
Aged
Cohort Studies
Comorbidity
Denmark - epidemiology
Diabetes Mellitus - epidemiology
Female
Heart Failure - epidemiology
Humans
Incidence
Male
Middle Aged
Myocardial Infarction - epidemiology
Prevalence
Prognosis
Registries
Stroke - epidemiology
Abstract
Valid data on acromegaly incidence, complications and mortality are scarce. The Danish Health Care System enables nationwide studies with complete follow-up and linkage among health-related databases to assess acromegaly incidence, prevalence, complications and mortality in a population-based cohort study.
All incident cases of acromegaly in Denmark (1991-2010) were identified from health registries and validated by chart review. We estimated the annual incidence rate of acromegaly per 10(6) person-years (py) with 95% confidence intervals (95% CIs). For every patient, 10 persons were sampled from the general population as a comparison cohort. Cox regression and hazard ratios (HRs) with 95% confidence intervals (95% CIs) were used.
Mean age at diagnosis (48.7 years (CI: 95%: 47.2-50.1)) and annual incidence rate (3.8 cases/10(6) persons (95% CI: 3.6-4.1)) among the 405 cases remained stable. The prevalence in 2010 was 85 cases/10(6) persons. The patients were at increased risk of diabetes mellitus (HR: 4.0 (95% CI: 2.7-5.8)), heart failure (HR: 2.5 (95% CI: 1.4-4.5)), venous thromboembolism (HR: 2.3 (95% CI: 1.1-5.0)), sleep apnoea (HR: 11.7 (95% CI: 7.0-19.4)) and arthropathy (HR: 2.1 (95% CI: 1.6-2.6)). The complication risk was also increased before the diagnosis of acromegaly. Overall mortality risk was elevated (HR: 1.3 (95% CI: 1.0-1.7)) but uninfluenced by treatment modality.
(i) The incidence rate and age at diagnosis of acromegaly have been stable over decades, and the prevalence is higher than previously reported. (ii) The risk of complications is very high even before the diagnosis. (iii) Mortality risk remains elevated but uninfluenced by mode of treatment.
PubMed ID
27280374 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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Age and colorectal cancer with focus on the elderly: trends in relative survival and initial treatment from a Danish population-based study.

https://arctichealth.org/en/permalink/ahliterature16932
Source
Dis Colon Rectum. 2005 Sep;48(9):1755-63
Publication Type
Article
Date
Sep-2005
Author
Lene H Iversen
Lars Pedersen
Anders Riis
Søren Friis
Søren Laurberg
Henrik T Sørensen
Author Affiliation
Department of Surgery L, Aarhus University Hospital, Denmark.
Source
Dis Colon Rectum. 2005 Sep;48(9):1755-63
Date
Sep-2005
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Child
Child, Preschool
Colorectal Neoplasms - mortality - therapy
Comparative Study
Denmark - epidemiology
Female
Humans
Infant
Male
Middle Aged
Registries
Research Support, Non-U.S. Gov't
Survival Analysis
Survival Rate
Abstract
PURPOSE: Elderly patients with colorectal cancer undergo surgery with curative intent less frequently than younger patients, and survival declines with increasing age. We compared relative survival of colorectal cancer among patients older than 75 years with that of younger patients in Denmark during the period 1977 to 1999. We also examined trends in choice of initial treatment. METHODS: From the files of the nationwide population-based Danish Cancer Registry, we identified all cases of colorectal cancer diagnosed between 1977 and 1999. We then linked this data to information on survival obtained from the Danish Register of Causes of Death and from the Central Population Register. RESULTS: During the entire study period, short-term and long-term relative survival improved for patients of all ages, but the improvement was more pronounced among elderly patients (>75 years). Radical resection was increasingly chosen as the initial treatment for elderly patients; during the 1995 to 1999 period it was performed on approximately 50 percent of such patients, almost as frequently as among younger patients. CONCLUSIONS: Relative survival of elderly colorectal cancer patients (>75 years) improved in Denmark between 1977 and 1999. In the most recent period studied, 1995 to 1997, only minor differences in five-year relative survival were observed among younger, middle-aged, and elderly patients. A simultaneous increase in the rate of radical resection among elderly patients, reflecting more effective treatment, may underlie this finding.
PubMed ID
15981072 View in PubMed
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Application for disability pension and change in use of prescribed drugs. A regional Danish cohort study.

https://arctichealth.org/en/permalink/ahliterature151831
Source
Scand J Public Health. 2009 Jun;37(4):380-6
Publication Type
Article
Date
Jun-2009
Author
Thomas T Petersen
Kirsten Fonager
Henrik Bøggild
Lars Pedersen
Jens T Mortensen
Author Affiliation
Department of Social Medicine, Aalborg Hospital, Aarhus University Hospital, DK-9000 Aalborg, Denmark. thtp@rn.dk
Source
Scand J Public Health. 2009 Jun;37(4):380-6
Date
Jun-2009
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Analgesics - administration & dosage
Cohort Studies
Denmark - epidemiology
Disability Evaluation
Disabled Persons - classification - rehabilitation
Drug Prescriptions - statistics & numerical data
Female
Follow-Up Studies
Humans
Male
Middle Aged
Musculoskeletal Diseases - diagnosis - drug therapy - epidemiology
Pensions
Registries
Young Adult
Abstract
To investigate if a pending application for disability pension had an influence on the applicant's purchase of medical drugs, with a particular focus on musculoskeletal disorders and the use of painkillers.
We performed a registry-based follow-up study including 12,020 applicants for disability pension in a Danish county from 1995 to 2000 and linked this information to a database of drug prescriptions. Purchase of drug was calculated for the 6-month period just before the decision and for the 6-month period 2 years later. Changes in a 2-year time period were estimated by differences in purchase rates. Furthermore, the proportion of applicants with an increased purchase of drugs and the proportion of applicants who ceased buying drugs were estimated. The results were stratified by diagnosis and result of application (awarded/rejected). The analyses were furthermore restricted to musculoskeletal disorders and the use of painkillers.
At baseline 81% had a purchase and after the 2-year time period 11% ceased buying prescribed drugs. Half of all applicants increased the purchase of drugs. For musculoskeletal disorders one third had an increased purchase rate of painkillers while one fourth ceased purchase of drugs with variations in different diagnostic subgroups. The major changes of drug purchase after a pending application for disability pension are probably ascribed to characteristics of the diseases underlying the disability.
PubMed ID
19324925 View in PubMed
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Aspirin and other nonsteroidal anti-inflammatory drugs in relation to Hodgkin lymphoma risk in northern Denmark.

https://arctichealth.org/en/permalink/ahliterature98435
Source
Cancer Epidemiol Biomarkers Prev. 2010 Jan;19(1):59-64
Publication Type
Article
Date
Jan-2010
Author
Ellen T Chang
Deirdre P Cronin-Fenton
Søren Friis
Henrik Hjalgrim
Henrik Toft Sørensen
Lars Pedersen
Author Affiliation
Northern California Cancer Center, 2201 Walnut Avenue, Suite 300, Fremont, CA 94538, USA. ellen@nccc.org
Source
Cancer Epidemiol Biomarkers Prev. 2010 Jan;19(1):59-64
Date
Jan-2010
Language
English
Publication Type
Article
Keywords
Adult
Aged
Anti-Inflammatory Agents, Non-Steroidal - administration & dosage
Aspirin - administration & dosage
Case-Control Studies
Denmark - epidemiology
Dose-Response Relationship, Drug
Female
Hodgkin Disease - epidemiology
Humans
Male
Middle Aged
Odds Ratio
Registries
Risk factors
Young Adult
Abstract
There are few known modifiable risk factors for Hodgkin lymphoma, but the recent finding of an inverse association between routine regular-strength aspirin use and Hodgkin lymphoma risk suggests that aspirin may protect against Hodgkin lymphoma development. To further investigate this association using prospectively collected data, we conducted a population-based case-control study in northern Denmark. A total of 478 incident Hodgkin lymphoma cases were identified in nationwide health-care databases from 1991 to 2008. Ten population controls were matched to each case on age, sex, and county using risk-set sampling. Use of aspirin, selective cyclooxygenase-2 inhibitors, and other nonsteroidal anti-inflammatory drugs (NSAIDs) from 1989 to 2007 was ascertained by linkage to a population-based prescription database. Conditional logistic regression was used to estimate odds ratios for associations between medication use and risk of Hodgkin lymphoma. The odds ratio (95% confidence interval) for ever use (>2 prescriptions) compared with never/rare use (2 prescriptions in the 1-2 years before the index date), short-term use ( or =25% of duration of use covered by prescription) of selective cyclooxygenase-2 inhibitors or other NSAIDs was associated with increased Hodgkin lymphoma risk possibly due to prodromal symptoms among cases. In conclusion, our results provide some evidence of a protective effect of low-dose aspirin, but not other NSAIDs, against Hodgkin lymphoma development.
PubMed ID
20056623 View in PubMed
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Association Between the Birth of an Infant With Major Congenital Anomalies and Subsequent Risk of Mortality in Their Mothers.

https://arctichealth.org/en/permalink/ahliterature280786
Source
JAMA. 2016 12 20;316(23):2515-2524
Publication Type
Article
Date
12-20-2016
Author
Eyal Cohen
Erzsébet Horváth-Puhó
Joel G Ray
Lars Pedersen
Nancy Adler
Anne Gulbech Ording
Paul H Wise
Arnold Milstein
Henrik Toft Sørensen
Source
JAMA. 2016 12 20;316(23):2515-2524
Date
12-20-2016
Language
English
Publication Type
Article
Keywords
Adult
Cause of Death
Cohort Studies
Congenital Abnormalities - epidemiology
Denmark - epidemiology
Female
Humans
Infant
Middle Aged
Mortality - trends
Mothers - statistics & numerical data
Pregnancy
Registries
Risk
Abstract
Giving birth to a child with a major birth defect is a serious life event for a woman, yet little is known about the long-term health consequences for the mother.
To assess whether birth of an infant born with a major congenital anomaly was associated with higher maternal risk of mortality.
This population-based cohort study (n?=?455?250 women) used individual-level linked Danish registry data for mothers who gave birth to an infant with a major congenital anomaly (41?508) between 1979 and 2010, with follow-up until December 31, 2014. A comparison cohort (413?742) was constructed by randomly sampling, for each mother with an affected infant, up to 10 mothers matched on maternal age, parity, and year of infant's birth.
Live birth of an infant with a major congenital anomaly as defined by the European Surveillance of Congenital Anomalies classification system.
Primary outcome was all-cause mortality. Secondary outcomes included cause-specific mortality. Hazard ratios (HRs) were adjusted for marital status, immigration status, income quartile (since 1980), educational level (since 1981), diabetes mellitus, modified Charlson comorbidity index score, hypertension, depression, history of alcohol-related disease, previous spontaneous abortion, pregnancy complications, smoking (since 1991), and body mass index (since 2004).
Mothers in both groups were a mean (SD) age of 28.9 (5.1) years at delivery. After a median (IQR) follow-up of 21 (12-28) years, there were 1275 deaths (1.60 per 1000 person-years) among 41?508 mothers of a child with a major congenital anomaly vs 10?112 deaths (1.27 per 1000 person-years) among 413?742 mothers in the comparison cohort, corresponding to an absolute mortality rate difference of 0.33 per 1000 person-years (95% CI, 0.24-0.42), an unadjusted HR of 1.27 (95% CI, 1.20-1.35), and an adjusted HR of 1.22 (95% CI, 1.15-1.29). Mothers with affected infants were more likely to die of cardiovascular disease (rate difference, 0.05 per 1000 person-years [95% CI, 0.02-0.08]; adjusted HR, 1.26 [95% CI, 1.04-1.53]), respiratory disease (rate difference, 0.02 per 1000 person-years [95% CI, 0.00-0.04]; adjusted HR, 1.45 [95% CI, 1.01-2.08]), and other natural causes (rate difference, 0.11 per 1000 person-years [95% CI, 0.07-0.15]; adjusted HR, 1.50 [95% CI, 1.27-1.76]).
In Denmark, having a child with a major congenital anomaly was associated with a small but statistically significantly increased mortality risk in the mother compared with women without an affected child. However, the clinical importance of this association is uncertain.
PubMed ID
27997654 View in PubMed
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The association between vitamin K antagonist therapy and site-specific cancer incidence estimated by using heart valve replacement as an instrumental variable.

https://arctichealth.org/en/permalink/ahliterature129963
Source
Am J Epidemiol. 2011 Dec 15;174(12):1382-90
Publication Type
Article
Date
Dec-15-2011
Author
Thomas P Ahern
Lars Pedersen
Claus Sværke
Kenneth J Rothman
Henrik Toft Sørensen
Timothy L Lash
Author Affiliation
Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA. nhtpa@channing.harvard.edu
Source
Am J Epidemiol. 2011 Dec 15;174(12):1382-90
Date
Dec-15-2011
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Cohort Studies
Denmark - epidemiology
Female
Heart Valve Prosthesis Implantation - statistics & numerical data
Humans
Incidence
Male
Middle Aged
Neoplasms - epidemiology - etiology
Vitamin K - antagonists & inhibitors
Young Adult
Abstract
Earlier studies suggest a protective association between vitamin K antagonist (VKA) anticoagulants and the incidence of cancer. The authors examined the associations between VKA therapy and incidence of 24 site-specific cancers with a Danish population-based cohort study, using heart valve replacement as an instrumental variable. The authors enrolled 9,727 Danish residents who received a replacement heart valve between 1989 and 2006. The heart valve recipients were matched with 95,481 unexposed individuals on age and sex. The authors used the heart valve replacement instrument to estimate rate ratios associating VKA therapy with incidence of the 24 site-specific cancers using Poisson regression models. Direct associations between VKA therapy and incidence of the 24 cancers were estimated in a prescription validation subset. The instrumental variable associations were plotted according to the inverse normal of rank percentile and subjected to semi-Bayes shrinkage adjustment for multiple comparisons. The pattern of associations was consistent with a null-centered Gaussian distribution. No individual cancer site showed a substantial positive or negative association with VKA therapy in the prescription validation subset, the instrumental variable analysis, or the analysis with semi-Bayes adjustment. These results do not support the existing hypothesis that VKA therapy is associated with reduced cancer risk.
Notes
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PubMed ID
22047822 View in PubMed
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Blood and urinary concentrations of salbutamol in asthmatic subjects.

https://arctichealth.org/en/permalink/ahliterature98725
Source
Med Sci Sports Exerc. 2010 Feb;42(2):244-9
Publication Type
Article
Date
Feb-2010
Author
Jimmi Elers
Lars Pedersen
John Henninge
Thomas K Lund
Peter Hemmersbach
Kim Dalhoff
Vibeke Backer
Author Affiliation
Respiratory and Allergy Research Unit, Bispebjerg Hospital, Copenhagen, Denmark. jele0004@bbh.regionh.dk
Source
Med Sci Sports Exerc. 2010 Feb;42(2):244-9
Date
Feb-2010
Language
English
Publication Type
Article
Keywords
Administration, Inhalation
Administration, Oral
Adolescent
Adult
Albuterol - administration & dosage - blood - pharmacokinetics - urine
Asthma - drug therapy
Bronchodilator Agents - administration & dosage - blood - urine
Cross-Over Studies
Denmark
Doping in Sports
Humans
Male
Middle Aged
Questionnaires
Respiratory Function Tests
Young Adult
Abstract
PURPOSE: Data on blood and urinary concentrations of salbutamol after inhalation and oral administration in healthy subjects are scarce. Accordingly, we examined the pharmacokinetics of inhaled and oral salbutamol in asthmatic subjects. METHODS: We enrolled 10 men aged 18-45 yr in an open-label study in which 0.8 mg of inhaled or 8 mg of systemic salbutamol was administered in a crossover design. All subjects had doctor-diagnosed asthma, used beta2 agonist when needed, and abstained from any medicine, beta2 agonist inclusive, for 14 d before visit. Urine was collected from all subjects (0-4, 4-8, and 8-12 h), and blood samples were taken at 0, 0.5, 1, 2, 3, 4, and 6 h after salbutamol administration. RESULTS: Maximum urine concentration was reached during the first 4 h after administration of both inhaled and oral salbutamol. We found differences in median urinary concentrations (Cmax) of 260.9 and 2422.2 ng x mL(-1), respectively (P
PubMed ID
19927035 View in PubMed
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64 records – page 1 of 7.