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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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Aortic regurgitation after transcatheter aortic valve implantation of the Edwards SAPIEN ™ valve.

https://arctichealth.org/en/permalink/ahliterature120594
Source
Scand Cardiovasc J Suppl. 2013 Feb;47(1):36-41
Publication Type
Article
Date
Feb-2013
Author
Hans Henrik Møller Nielsen
Henrik Egeblad
Henning Rud Andersen
Leif Thuesen
Steen Hvitfeldt Poulsen
Kaj-Erik Klaaborg
Carl-Johan Jakobsen
Vibeke Elisabeth Hjortdal
Author Affiliation
Department of Thoracic and Cardiovascular Surgery, Aarhus University Hospital, Skejby, Denmark. hhmn@kirurgi.org
Source
Scand Cardiovasc J Suppl. 2013 Feb;47(1):36-41
Date
Feb-2013
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Aortic Valve Insufficiency - epidemiology - ultrasonography
Aortic Valve Stenosis - therapy
Cardiac Catheterization - adverse effects - instrumentation
Denmark - epidemiology
Echocardiography, Doppler, Color
Female
Heart Valve Prosthesis
Heart Valve Prosthesis Implantation - adverse effects - instrumentation
Humans
Male
Prevalence
Prosthesis Design
Retrospective Studies
Risk factors
Severity of Illness Index
Time Factors
Treatment Outcome
Abstract
Transcatheter aortic valve implantation (TAVI) is established as an attractive treatment option for high-risk patients with aortic valve stenosis. One concern is the high risk of prosthetic valve regurgitation. This study aimed to examine for potential preoperative risk factors for postprocedural transcatheter heart valve regurgitation and to quantify the risk, degree, and consequences of postprocedural regurgitation.
100 consecutive patients who underwent femoral (n = 22) or transapical (n = 78) TAVI were retrospectively reviewed. Echocardiographic valve regurgitation and clinical parameters were analyzed over the first year after TAVI.
Seventy-five percent of all patients had prosthetic valve regurgitation. It was, however, only mild or absent in 64% of patients and did not require re-intervention in any of the patients in the series. The severity of the regurgitation appeared unchanged over the one-year follow-up period. Moderate to severe regurgitation was associated with significant yet stable dilatation of the left ventricle over one year and lesser NYHA class improvement three months after TAVI. Asymmetrical native valve calcification increased the risk of paravalvular regurgitation non-significantly.
Transcatheter heart valve regurgitation seems to be mild in the majority of cases and unchanged over a 12 months follow-up period. While affecting left ventricular dimensions in moderate or severe cases, we observed no obvious undesirable consequences of the prosthetic valve regurgitation within the first year.
PubMed ID
22989057 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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Clinical outcome after primary percutaneous coronary intervention with drug-eluting and bare metal stents in patients with ST-segment elevation myocardial infarction.

https://arctichealth.org/en/permalink/ahliterature98528
Source
Circ Cardiovasc Interv. 2008 Dec;1(3):176-84
Publication Type
Article
Date
Dec-2008
Author
Lisette Okkels Jensen
Michael Maeng
Per Thayssen
Anne Kaltoft
Hans Henrik Tilsted
Morten Bøttcher
Jens Flensted Lassen
Knud Nørregaard Hansen
Lars Romer Krusell
Klaus Rasmussen
Knud Erik Pedersen
Lars Pedersen
Søren Paaske Johnsen
Henrik Toft Sørensen
Leif Thuesen
Author Affiliation
Department of Cardiology, Odense University Hospital, Sdr. Boulevard 29, Odense, Denmark. okkels@dadlnet.dk
Source
Circ Cardiovasc Interv. 2008 Dec;1(3):176-84
Date
Dec-2008
Language
English
Publication Type
Article
Keywords
Aged
Angioplasty, Transluminal, Percutaneous Coronary
Cohort Studies
Coronary Thrombosis - epidemiology
Diabetes Mellitus - epidemiology
Female
Follow-Up Studies
Humans
Incidence
Male
Middle Aged
Myocardial Infarction - mortality - therapy
Prosthesis Design
Registries
Retreatment - statistics & numerical data
Stents - adverse effects
Abstract
BACKGROUND: The use of drug-eluting stents (DESs) versus bare metal stents (BMSs) in primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction is a matter of debate. Therefore, we examined the risk of target lesion revascularization (TLR), stent thrombosis, myocardial infarction, and death after the implantation of DES or BMS in primary PCI patients in Western Denmark. METHODS AND RESULTS: A total of 3756 consecutive patients with ST-segment elevation myocardial infarction treated with primary PCI and stent implantation, recorded in the Western Denmark Heart Registry from January 2002 through June 2005, were followed up for 2 years. We used Cox regression analysis to control for confounding. The 2-year incidence of definite stent thrombosis was 1.9% in the DES group and 1.1% in the BMS group (adjusted relative risk [RR]=1.53; 95% CI=0.84 to 2.78; P=0.17). Very late definite stent thrombosis (> or =12 months) was seen in 0.4% in the DES group and 0.06% in the BMS group (adjusted RR=6.74; 95% CI=1.23 to 37.00; P=0.03). The 2-year incidence of myocardial infarction was similar in the 2 groups, 5.2% in the DES group versus 6.3% in the BMS group (P=0.28; adjusted RR=1.13; 95% CI=0.81 to 1.59; P=0.47). All-cause 2-year mortality was 7.8% in the DES group and 11.4% in BMS group (P
Notes
RefSource: Circ Cardiovasc Interv. 2008 Dec;1(3):161-3
PubMed ID
20031676 View in PubMed
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Clopidogrel discontinuation within the first year after coronary drug-eluting stent implantation: an observational study.

https://arctichealth.org/en/permalink/ahliterature259840
Source
BMC Cardiovasc Disord. 2014;14:100
Publication Type
Article
Date
2014
Author
Troels Thim
Martin Berg Johansen
Gro Egholm Chisholm
Morten Schmidt
Anne Kaltoft
Henrik Toft Sørensen
Leif Thuesen
Steen Dalby Kristensen
Hans Erik Bøtker
Lars Romer Krusell
Jens Flensted Lassen
Per Thayssen
Lisette Okkels Jensen
Hans-Henrik Tilsted
Michael Maeng
Source
BMC Cardiovasc Disord. 2014;14:100
Date
2014
Language
English
Publication Type
Article
Keywords
Aged
Coronary Thrombosis - etiology - mortality - prevention & control
Denmark
Drug Administration Schedule
Drug Prescriptions
Drug-Eluting Stents
Female
Humans
Male
Medication Adherence
Middle Aged
Myocardial Infarction - etiology - mortality - prevention & control
Percutaneous Coronary Intervention - adverse effects - instrumentation - mortality
Platelet Aggregation Inhibitors - administration & dosage
Registries
Retrospective Studies
Risk assessment
Risk factors
Ticlopidine - administration & dosage - analogs & derivatives
Time Factors
Treatment Outcome
Abstract
The impact of adherence to the recommended duration of dual antiplatelet therapy after first generation drug-eluting stent implantation is difficult to assess in real-world settings and limited data are available.
We followed 4,154 patients treated with coronary drug-eluting stents in Western Denmark for 1 year and obtained data on redeemed clopidogrel prescriptions and major adverse cardiovascular events (MACE, i.e., cardiac death, myocardial infarction, or stent thrombosis) from medical databases.
Discontinuation of clopidogrel within the first 3 months after stent implantation was associated with a significantly increased rate of MACE at 1-year follow-up (hazard ratio (HR) 2.06; 95% confidence interval (CI): 1.08-3.93). Discontinuation 3-6 months (HR 1.29; 95% CI: 0.70-2.41) and 6-12 months (HR 1.29; 95% CI: 0.54-3.07) after stent implantation were associated with smaller, not statistically significant, increases in MACE rates. Among patients who discontinued clopidogrel, MACE rates were highest within the first 2 months after discontinuation.
Discontinuation of clopidogrel was associated with an increased rate of MACE among patients treated with drug-eluting stents. The increase was statistically significant within the first 3 months after drug-eluting stent implantation but not after 3 to 12 months.
Notes
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PubMed ID
25125079 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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Comparison of zotarolimus-eluting and sirolimus-eluting coronary stents: a study from the Western Denmark Heart Registry.

https://arctichealth.org/en/permalink/ahliterature120203
Source
BMC Cardiovasc Disord. 2012;12:84
Publication Type
Article
Date
2012
Author
Michael Maeng
Lisette Okkels Jensen
Anne Kaltoft
Hans-Henrik Tilsted
Evald Høj Christiansen
Per Thayssen
Morten Madsen
Henrik Toft Sørensen
Jens Flensted Lassen
Leif Thuesen
Author Affiliation
Department of Cardiology, Aarhus University Hospital, Skejby, Brendstrupgaardsvej 100, 8200 Aarhus N, Denmark. michael.maeng@ki.au.dk
Source
BMC Cardiovasc Disord. 2012;12:84
Date
2012
Language
English
Publication Type
Article
Keywords
Aged
Angioplasty, Balloon, Coronary
Cohort Studies
Denmark - epidemiology
Drug-Eluting Stents - adverse effects
Female
Humans
Male
Middle Aged
Registries
Sirolimus - administration & dosage - analogs & derivatives
Abstract
We evaluated the effectiveness and safety of a zotarolimus-eluting (ZES) versus a sirolimus-eluting (SES) coronary stent in a large cohort of patients treated with one of these stents in Western Denmark.
A total of 6,122 patients treated with ZES (n=2,282) or SES (n=3,840) were followed for up to 27 months. We ascertained clinical outcomes based on national medical databases.
Incidence of target lesion revascularization (no. per 100 person-years) was 5.3 in the ZES group compared to 1.9 in the SES group (adjusted hazard ratio (HR)=2.19, 95% confidence intervals (CI): 1.39-3.47; p=0.001). All-cause mortality was also higher in the ZES group (ZES: 6.3; SES: 3.3; adjusted HR=1.34, 95% CI: 1.05-1.72; p=0.02), while stent thrombosis (ZES: 1.2; SES: 0.5; adjusted HR=1.98, 95% CI: 0.75-5.23; p=0.14) did not differ significantly.
In agreement with previously published randomised data, this observational study indicated that the ZES was associated with an increased risk of death and TLR in a large cohort of consecutive patients.
Notes
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PubMed ID
23031197 View in PubMed
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Culprit only or multivessel percutaneous coronary interventions in patients with ST-segment elevation myocardial infarction and multivessel disease.

https://arctichealth.org/en/permalink/ahliterature121329
Source
EuroIntervention. 2012 Aug;8(4):456-64
Publication Type
Article
Date
Aug-2012
Author
Lisette Okkels Jensen
Per Thayssen
Dóra Körmendiné Farkas
Mikkel Hougaard
Christian Juhl Terkelsen
Hans-Henrik Tilsted
Michael Maeng
Anders Junker
Jens Flensted Lassen
Erzsébet Horváth-Puhó
Henrik Toft Sørensen
Leif Thuesen
Author Affiliation
Department of Cardiology, Odense University Hospital, Denmark. okkels@dadlnet.dk
Source
EuroIntervention. 2012 Aug;8(4):456-64
Date
Aug-2012
Language
English
Publication Type
Article
Keywords
Aged
Cohort Studies
Denmark
Electrocardiography
Female
Humans
Male
Middle Aged
Myocardial Infarction - mortality - therapy
Percutaneous Coronary Intervention - methods
Registries
Regression Analysis
Retrospective Studies
Time Factors
Treatment Outcome
Vascular Diseases - mortality - therapy
Abstract
In patients with ST-segment elevation myocardial infarction (STEMI), timely reperfusion with primary percutaneous coronary intervention (PPCI) is the preferred treatment. However, it remains unclear whether the optimal strategy is complete revascularisation or culprit vessel PPCI only.
From January 2002 to June 2009 all patients treated with PPCI were identified from the Western Denmark Heart Registry. We examined mortality according to timing of multivessel PCI: acute procedure, staged procedure during the index hospitalisation, or staged procedure performed within 60 days. The hazard ratio (HR) for death was estimated using a time-dependent Cox regression model, with time of PCI for the non-culprit lesion as the time-dependent variable. The study cohort consisted of 5,944 patients, of whom 4,770 (80%) had single-vessel disease and 1,174 (20%) had multivessel PCI within 60 days. Among 354 (30.2%) patients with acute multivessel PCI, 194 (16.5%) patients with multivessel PCI during the index hospitalisation, and 626 (53.3%) patients with multivessel PCI within 60 days after the index hospitalisation, the adjusted HRs for one-year mortality were 1.53 (95% confidence interval (CI): 1.07-2.18), 0.60 (95% CI: 0.28-1.26), and 0.28 (95% CI: 0.14-0.54), respectively, compared to patients with single vessel disease.
Acute multivessel PCI in patients with STEMI was associated with increased mortality.
Notes
Comment In: EuroIntervention. 2012 Aug;8(4):423-522917723
PubMed ID
22917729 View in PubMed
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Diagnosis and outcome in a prehospital cohort of patients with bundle branch block and suspected acute myocardial infarction.

https://arctichealth.org/en/permalink/ahliterature106195
Source
Eur Heart J Acute Cardiovasc Care. 2013 Jun;2(2):176-81
Publication Type
Article
Date
Jun-2013
Author
Jacob Thorsted Sørensen
Carsten Stengaard
Christina Ankjær Sørensen
Kristian Thygesen
Hans Erik Bøtker
Leif Thuesen
Christian Juhl Terkelsen
Author Affiliation
Aarhus University Hospital, Department of Cardiology, Aarhus, Denmark.
Source
Eur Heart J Acute Cardiovasc Care. 2013 Jun;2(2):176-81
Date
Jun-2013
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Bundle-Branch Block - complications - diagnosis - mortality
Denmark
Electrocardiography - methods - mortality
Emergency Medical Services - methods
Female
Humans
Kaplan-Meier Estimate
Male
Myocardial Infarction - complications - diagnosis - mortality
Prognosis
Telemedicine - methods
Abstract
Immediate revascularization is beneficial in patients with presumed new-onset bundle branch block myocardial infarction (BBBMI). In the prehospital setting, it is a challenge to diagnose new-onset BBBMI and triage accordingly.
ECG, final diagnosis, and mortality were assessed in a prehospital cohort of 4905 consecutive patients with suspected acute myocardial infarction (AMI). Bundle branch block (BBB) was defined as QRS duration =120 ms caused by delayed intraventricular conduction. Mortality and angiography data were obtained from the Central Office of Civil Registration and the Western Denmark Heart Registry. Definite diagnosis of AMI and the onset of BBB were determined by expert consensus. Patients were divided into four groups: with or without AMI and with or without BBB. Mortality was evaluated by Kaplan-Meier plots and compared using log-rank statistics.
AMI was diagnosed in 954 patients, of whom 118 had BBB. In 3951 patients without AMI, 436 had BBB. Patients with BBBMI were less often revascularized than patients with AMI without BBB (24 vs. 54%, p
Notes
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PubMed ID
24222828 View in PubMed
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