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Clopidogrel discontinuation after myocardial infarction and risk of thrombosis: a nationwide cohort study.

https://arctichealth.org/en/permalink/ahliterature122602
Source
Eur Heart J. 2012 Oct;33(20):2527-34
Publication Type
Article
Date
Oct-2012
Author
Mette Charlot
Lars Hougaard Nielsen
Jesper Lindhardsen
Ole Ahlehoff
Anne-Marie S Olsen
Morten Lock Hansen
Peter Riis Hansen
Jan Kyst Madsen
Lars Køber
Gunnar H Gislason
Christian Torp-Pedersen
Author Affiliation
Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark. mc@heart.dk
Source
Eur Heart J. 2012 Oct;33(20):2527-34
Date
Oct-2012
Language
English
Publication Type
Article
Keywords
Adult
Aged
Denmark - epidemiology
Drug Administration Schedule
Epidemiologic Methods
Female
Graft Occlusion, Vascular - etiology - mortality
Hemorrhage - chemically induced
Humans
Male
Middle Aged
Myocardial Infarction - drug therapy - mortality
Percutaneous Coronary Intervention - methods - mortality
Platelet Aggregation Inhibitors - therapeutic use
Prosthesis Failure
Recurrence
Stents
Thrombosis - etiology
Ticlopidine - analogs & derivatives - therapeutic use
Withholding Treatment
Abstract
The benefit of extending clopidogrel treatment beyond the 12-month period recommended in current guidelines after myocardial infarction (MI) is debated. We analysed the risk of adverse cardiovascular outcomes after discontinuation of 12 months of clopidogrel treatment.
This Danish retrospective nationwide study included all patients treated with clopidogrel after discharge from a first-time MI during 2004-09. The risk of death or recurrent MI after the discontinuation of clopidogrel was studied by multivariable Poisson regression models. Patients treated with and without percutaneous coronary intervention (PCI) were analysed separately. The follow-up was 18 months. Of the 29,268 patients included, 3214 (11.0%) experienced death or recurrent MI. There were 9819 (33.6%) patients treated only medically and 19,449 (66.4%) patients treated with PCI. Twelve months after the index MI, for patients treated only medically, the risk of death or recurrent MI in the first 90-day period of clopidogrel discontinuation was 1.07 (0.65-1.76; P= 0.79) [adjusted incidence rate ratio (IRR) and 95% confidence interval] compared with the next 90-day period of discontinuation. For patients treated with PCI, the corresponding IRR was 1.59 (1.11-2.30; P= 0.013). The risk of recurrent MI yielded an IRR of 0.77 (0.36-1.67; P= 0.51) for patients treated only medically and 1.87 (1.11-3.15; P= 0.019) for PCI-treated patients.
Discontinuation of clopidogrel 12 months after MI is associated with an increased risk of death or recurrent MI in the first 90 days of discontinuation compared with the next 90-day period of discontinuation for patients treated with PCI, but not for patients not treated with PCI.
PubMed ID
22798561 View in PubMed
Less detail

Duration of treatment with nonsteroidal anti-inflammatory drugs and impact on risk of death and recurrent myocardial infarction in patients with prior myocardial infarction: a nationwide cohort study.

https://arctichealth.org/en/permalink/ahliterature134660
Source
Circulation. 2011 May 24;123(20):2226-35
Publication Type
Article
Date
May-24-2011
Author
Anne-Marie Schjerning Olsen
Emil L Fosbøl
Jesper Lindhardsen
Fredrik Folke
Mette Charlot
Christian Selmer
Morten Lamberts
Jonas Bjerring Olesen
Lars Køber
Peter R Hansen
Christian Torp-Pedersen
Gunnar H Gislason
Author Affiliation
Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark. aols0073@geh.regionh.dk
Source
Circulation. 2011 May 24;123(20):2226-35
Date
May-24-2011
Language
English
Publication Type
Article
Keywords
Adrenergic beta-Antagonists - therapeutic use
Aged
Aged, 80 and over
Anti-Inflammatory Agents, Non-Steroidal - adverse effects - contraindications
Cohort Studies
Comorbidity
Cyclooxygenase 2 Inhibitors - therapeutic use
Denmark - epidemiology
Diclofenac - adverse effects - contraindications
Female
Humans
Ibuprofen - adverse effects - contraindications
Incidence
Male
Middle Aged
Myocardial Infarction - drug therapy - mortality
Naproxen - adverse effects - contraindications
Prognosis
Proportional Hazards Models
Recurrence
Registries - statistics & numerical data
Risk factors
Abstract
Despite the fact that nonsteroidal anti-inflammatory drugs (NSAIDs) are contraindicated among patients with established cardiovascular disease, many receive NSAID treatment for a short period of time. However, little is known about the association between NSAID treatment duration and risk of cardiovascular disease. We therefore studied the duration of NSAID treatment and cardiovascular risk in a nationwide cohort of patients with prior myocardial infarction (MI).
Patients =30 years of age who were admitted with first-time MI during 1997 to 2006 and their subsequent NSAID use were identified by individual-level linkage of nationwide registries of hospitalization and drug dispensing from pharmacies in Denmark. Risk of death and recurrent MI according to duration of NSAID treatment was analyzed by multivariable time-stratified Cox proportional-hazard models and by incidence rates per 1000 person-years. Of the 83 677 patients included, 42.3% received NSAIDs during follow-up. There were 35 257 deaths/recurrent MIs. Overall, NSAID treatment was significantly associated with an increased risk of death/recurrent MI (hazard ratio, 1.45; 95% confidence interval, 1.29 to 1.62) at the beginning of the treatment, and the risk persisted throughout the treatment course (hazard ratio, 1.55; 95% confidence interval, 1.46 to 1.64 after 90 days). Analyses of individual NSAIDs showed that the traditional NSAID diclofenac was associated with the highest risk (hazard ratio, 3.26; 95% confidence interval, 2.57 to 3.86 for death/MI at day 1 to 7 of treatment).
Even short-term treatment with most NSAIDs was associated with increased risk of death and recurrent MI in patients with prior MI. Neither short- nor long-term treatment with NSAIDs is advised in this population, and any NSAID use should be limited from a cardiovascular safety point of view.
Notes
Comment In: Circulation. 2011 Nov 22;124(21):e552; author reply e55522105203
Comment In: Circulation. 2011 Nov 22;124(21):e553; author reply e55522105204
Comment In: Evid Based Med. 2012 Apr;17(2):61-221937502
Comment In: Circulation. 2011 Nov 22;124(21):e554; author reply e55522105205
Comment In: Ann Intern Med. 2011 Oct 18;155(8):JC4-1122007070
PubMed ID
21555710 View in PubMed
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Effects of oral glucose-lowering drugs on long term outcomes in patients with diabetes mellitus following myocardial infarction not treated with emergent percutaneous coronary intervention--a retrospective nationwide cohort study.

https://arctichealth.org/en/permalink/ahliterature140790
Source
Cardiovasc Diabetol. 2010;9:54
Publication Type
Article
Date
2010
Author
Casper H Jørgensen
Gunnar H Gislason
Charlotte Andersson
Ole Ahlehoff
Mette Charlot
Tina K Schramm
Allan Vaag
Steen Z Abildstrøm
Christian Torp-Pedersen
Peter R Hansen
Author Affiliation
Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark. cj@heart.dk
Source
Cardiovasc Diabetol. 2010;9:54
Date
2010
Language
English
Publication Type
Article
Keywords
Administration, Oral
Aged
Aged, 80 and over
Angioplasty, Balloon, Coronary - statistics & numerical data
Cohort Studies
Comorbidity
Denmark - epidemiology
Diabetes Mellitus, Type 2 - drug therapy - mortality
Female
Humans
Hypoglycemic agents - therapeutic use
Male
Middle Aged
Myocardial Infarction - mortality - therapy
Proportional Hazards Models
Registries - statistics & numerical data
Retrospective Studies
Risk factors
Abstract
The optimum oral pharmacological treatment of diabetes mellitus to reduce cardiovascular disease and mortality following myocardial infarction has not been established. We therefore set out to investigate the association between individual oral glucose-lowering drugs and cardiovascular outcomes following myocardial infarction in patients with diabetes mellitus not treated with emergent percutaneous coronary intervention.
All patients aged 30 years or older receiving glucose-lowering drugs (GLDs) and admitted with myocardial infarction (MI) not treated with emergent percutaneous coronary intervention in Denmark during 1997-2006 were identified by individual-level linkage of nationwide registries of hospitalizations and drug dispensing from pharmacies. Multivariable Cox regression models adjusted for age, sex, calendar year, comorbidity, and concomitant pharmacotherapy were used to assess differences in the composite endpoint of non-fatal MI and cardiovascular mortality between individual GLDs, using metformin monotherapy as reference.
The study comprised 9876 users of GLDs admitted with MI. The mean age was 72.3 years and 56.5% of patients were men. A total of 3649 received sulfonylureas and 711 received metformin at admission. The average length of follow-up was 2.2 (SD 2.6) years. A total of 6,171 patients experienced the composite study endpoint. The sulfonylureas glibenclamide, glimepiride, glipizide, and tolbutamide were associated with increased risk of cardiovascular mortality and/or nonfatal MI with hazard ratios [HRs] of 1.31 (95% confidence interval [CI] 1.17-1.46), 1.19 (1.06-1.32), 1.25 (1.11-1.42), and 1.18 (1.03-1.34), respectively, compared with metformin. Gliclazide was the only sulfonylurea not associated with increased risk compared with metformin (HR 1.03 [0.88-1.22]).
In patients with diabetes mellitus admitted with MI not treated with emergent percutaneous coronary intervention, monotherapy treatment with the sulfonylureas glibenclamide, glimepiride, glipizide, and tolbutamide was associated with increased cardiovascular risk compared with metformin monotherapy.
Notes
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PubMed ID
20843380 View in PubMed
Less detail

Efficacy of post-operative clopidogrel treatment in patients revascularized with coronary artery bypass grafting after myocardial infarction.

https://arctichealth.org/en/permalink/ahliterature136521
Source
J Am Coll Cardiol. 2011 Mar 8;57(10):1202-9
Publication Type
Article
Date
Mar-8-2011
Author
Rikke Sørensen
Steen Z Abildstrøm
Peter R Hansen
Anders Hvelplund
Charlotte Andersson
Mette Charlot
Emil L Fosbøl
Lars Køber
Jan K Madsen
Gunnar H Gislason
Christian Torp-Pedersen
Author Affiliation
Department of Cardiology, Copenhagen University Hospital Gentofte, Copenhagen, Denmark. rs@heart.dk
Source
J Am Coll Cardiol. 2011 Mar 8;57(10):1202-9
Date
Mar-8-2011
Language
English
Publication Type
Article
Keywords
Aged
Combined Modality Therapy
Comorbidity
Coronary Artery Bypass
Denmark - epidemiology
Female
Hemorrhage - chemically induced - epidemiology
Humans
Male
Middle Aged
Myocardial Infarction - drug therapy - epidemiology - mortality - surgery
Platelet Aggregation Inhibitors - adverse effects - therapeutic use
Postoperative Period
Propensity Score
Proportional Hazards Models
Recurrence - prevention & control
Registries
Ticlopidine - adverse effects - analogs & derivatives - therapeutic use
Abstract
The objective of this study was to examine the clinical efficacy of clopidogrel treatment on death and recurrent myocardial infarction (MI) among MI patients revascularized by coronary artery bypass graft surgery (CABG).
The benefit from post-operative clopidogrel in CABG-treated MI patients is largely unknown.
All patients admitted with first-time MI between 2002 and 2006, treated with CABG within 180 days after admission, were identified by nationwide administrative registers. Clopidogrel treatment was determined by claimed prescriptions after discharge from surgery. Risk of death or recurrent MI, and of a combined end point of the 2, were assessed by cumulative incidence and Cox proportional hazards model. A propensity score-matched subgroup analysis was done.
We included 3,545 patients, and of these, 957 (27.0%) were treated with clopidogrel after CABG. Mean follow-up was 466 ± 144 days. Among patients treated with clopidogrel, 39 (4.1%) died or experienced a recurrent MI, whereas that occurred in 203 (7.8%) patients without clopidogrel (log-rank p = 0.0003). Hazard ratio was 0.59 (95% confidence interval [CI]: 0.42 to 0.85) for patients treated with clopidogrel, with no-clopidogrel as reference. By propensity score, of 945 patients with or without clopidogrel treatment who were matched, death or recurrent MI occurred in 38 (4.0%) patients with clopidogrel and 57 (6.0%) without clopidogrel (log-rank p = 0.05). Corresponding hazard ratio was 0.67 (95% CI: 0.44 to 1.00) for clopidogrel users, with no-clopidogrel as reference.
Among MI patients revascularized by CABG, only 27% received clopidogrel after discharge. Clopidogrel-treated patients had a lower risk of the combined end point of death or recurrent MI. Focus on discharge clopidogrel treatment of these patients should be made.
Notes
Comment In: J Am Coll Cardiol. 2011 Aug 30;58(10):1085; author reply 1085-621867852
Comment In: J Am Coll Cardiol. 2011 Aug 30;58(10):1084-5; author reply 1085-621867851
PubMed ID
21371637 View in PubMed
Less detail

Long-term cardiovascular risk of nonsteroidal anti-inflammatory drug use according to time passed after first-time myocardial infarction: a nationwide cohort study.

https://arctichealth.org/en/permalink/ahliterature120835
Source
Circulation. 2012 Oct 16;126(16):1955-63
Publication Type
Article
Date
Oct-16-2012
Author
Anne-Marie Schjerning Olsen
Emil L Fosbøl
Jesper Lindhardsen
Fredrik Folke
Mette Charlot
Christian Selmer
Jonas Bjerring Olesen
Morten Lamberts
Martin H Ruwald
Lars Køber
Peter R Hansen
Christian Torp-Pedersen
Gunnar H Gislason
Author Affiliation
Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark. amschjerning@gmail.com
Source
Circulation. 2012 Oct 16;126(16):1955-63
Date
Oct-16-2012
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Anti-Inflammatory Agents, Non-Steroidal - administration & dosage - adverse effects - contraindications
Cohort Studies
Comorbidity
Death, Sudden, Cardiac - epidemiology
Denmark - epidemiology
Female
Follow-Up Studies
Hospitalization - statistics & numerical data
Humans
Incidence
Male
Middle Aged
Myocardial Infarction - mortality
Pharmacy - statistics & numerical data
Prognosis
Proportional Hazards Models
Registries - statistics & numerical data
Risk factors
Abstract
The cardiovascular risk after the first myocardial infarction (MI) declines rapidly during the first year. We analyzed whether the cardiovascular risk associated with using nonsteroidal anti-inflammatory drugs (NSAIDs) was associated with the time elapsed following first-time MI.
We identified patients aged 30 years or older admitted with first-time MI in 1997 to 2009 and subsequent NSAID use by individual-level linkage of nationwide registries of hospitalization and drug dispensing from pharmacies in Denmark. We calculated the incidence rates of death and a composite end point of coronary death or nonfatal recurrent MIs associated with NSAID use in 1-year time intervals up to 5 years after inclusion and analyzed risk by using multivariable adjusted time-dependent Cox proportional hazards models. Of the 99 187 patients included, 43 608 (44%) were prescribed NSAIDs after the index MI. There were 36 747 deaths and 28 693 coronary deaths or nonfatal recurrent MIs during the 5 years of follow-up. Relative to noncurrent treatment with NSAIDs, the use of any NSAID in the years following MI was persistently associated with an increased risk of death (hazard ratio 1.59 [95% confidence interval, 1.49-1.69]) after 1 year and hazard ratio 1.63 [95% confidence interval, 1.52-1.74] after 5 years) and coronary death or nonfatal recurrent MI (hazard ratio, 1.30 [95% confidence interval,l 1.22-1.39] and hazard ratio, 1.41 [95% confidence interval, 1.28-1.55]).
The use of NSAIDs is associated with persistently increased coronary risk regardless of time elapsed after first-time MI. We advise long-term caution in the use of NSAIDs for patients after MI.
Notes
Comment In: Ann Intern Med. 2013 Jun 18;158(12):903-623580081
Comment In: Ann Intern Med. 2013 Jan 15;158(2):JC1023318332
PubMed ID
22965337 View in PubMed
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Patient adherence to evidence-based pharmacotherapy in systolic heart failure and the transition of follow-up from specialized heart failure outpatient clinics to primary care.

https://arctichealth.org/en/permalink/ahliterature116451
Source
Eur J Heart Fail. 2013 Jun;15(6):671-8
Publication Type
Article
Date
Jun-2013
Author
Anne Gjesing
Morten Schou
Christian Torp-Pedersen
Lars Køber
Finn Gustafsson
Per Hildebrandt
Lars Videbæk
Henrik Wiggers
Malene Demant
Mette Charlot
Gunnar H Gislason
Author Affiliation
Department of Cardiology, Gentofte University Hospital, post 635, Niels Andersens Vej 65, 2900 Hellerup, Denmark. anne@gjesing.com
Source
Eur J Heart Fail. 2013 Jun;15(6):671-8
Date
Jun-2013
Language
English
Publication Type
Article
Keywords
Adrenergic beta-Antagonists - administration & dosage - therapeutic use
Aged
Aged, 80 and over
Ambulatory Care Facilities - statistics & numerical data
Angiotensin-Converting Enzyme Inhibitors - administration & dosage - therapeutic use
Cohort Studies
Denmark
Diuretics - administration & dosage - therapeutic use
Evidence-Based Medicine
Female
Follow-Up Studies
Heart Failure, Systolic - drug therapy
Humans
Male
Medication Adherence
Middle Aged
Primary Health Care - statistics & numerical data
Spironolactone - administration & dosage - therapeutic use
Abstract
Undertreatment with evidence-based pharmacotherapy for heart failure (HF) is an important problem, and it has been suggested that specialized HF clinics (HFCs) can improve treatment initiation and correct dosing. The objective of this study was to examine long-term adherence to and dosages of evidence-based pharmacotherapy during and after participation in specialized HFCs.
Initiation, dosages, and adherence were studied in patients with systolic HF attending HFCs in Denmark from 2002 to 2009. Information was obtained from an electronic patient file and research database used in the HFCs combined with prescription data from the Danish Registry of Medicinal Product Statistics. A total of 8792 patients were included in the study. The mean age was 68 years; with a mean LVEF of 30%, and 72% were males. Long-term adherence to treatment was high for the patients who initiated renin-angiotensin system (RAS) inhibitors and beta-blockers. Adherence after 1 year was 93% for RAS inhibitors, 92% for beta-blockers, and 86% for spironolactone. After 3 years, it was 90% for RAS inhibitors, 88% for beta-blockers, and 74% for spironolactone. For patients referred back to their general practitioner (GP), adherence 1 year after they left the HFC was 89% for RAS inhibitors, 89% for beta-blockers, and 72% for spironolactone.
In specialized outpatient HFCs, long-term adherence to RAS inhibitors and beta-blockers is close to optimal. Importantly, adherence was maintained after patients were referred back to their GP for continued management. This is likely to provide long-term benefits for the patients.
PubMed ID
23397577 View in PubMed
Less detail

Prognosis after percutaneous coronary intervention in patients with psoriasis: a cohort study using Danish nationwide registries.

https://arctichealth.org/en/permalink/ahliterature120423
Source
BMC Cardiovasc Disord. 2012;12:79
Publication Type
Article
Date
2012
Author
Ole Ahlehoff
Jesper Lindhardsen
Gunnar H Gislason
Jonas B Olesen
Mette Charlot
Lone Skov
Christian Torp-Pedersen
Peter R Hansen
Author Affiliation
Department of Cardiology, Copenhagen University Hospital, Gentofte, Hellerup DK-2900, Denmark. olahha01@geh.regionh.dk
Source
BMC Cardiovasc Disord. 2012;12:79
Date
2012
Language
English
Publication Type
Article
Keywords
Aged
Cohort Studies
Denmark - epidemiology
Female
Humans
Male
Middle Aged
Percutaneous Coronary Intervention - adverse effects - mortality
Prognosis
Proportional Hazards Models
Psoriasis - complications
Registries
Abstract
Psoriasis is an inflammatory disease associated with increased risk of coronary artery disease. However, the potential impact of psoriasis on the prognosis following percutaneous coronary revascularization (PCI) is unknown.
The study comprised the entire Danish population undergoing first-time PCI in the period 2002-09. Cox regression models, controlling for age, gender, socioeconomic status, pharmacological treatment, and comorbidity were used to assess the risk of 1) all-cause mortality and 2) a composite endpoint of death, myocardial infarction, and stroke.
A total of 53,141 patients with first-time PCI in the study period were identified. Of these, 1074 had mild psoriasis and 315 had severe psoriasis. Patients with severe psoriasis, but not those with mild disease had increased risk of both endpoints compared to patients without psoriasis. The incidence rates for all-cause mortality were 30.5 (CI 29.7-31.3), 29.9 (CI 24.7-36.1), and 47.2 (CI 35.0-63.6) per 1000 patient years for patients without psoriasis, with mild psoriasis, and with severe psoriasis, respectively. Hazard ratios were 1.10 (CI 0.91-1.33) and 1.67 (CI 1.24-2.26) for mild and severe psoriasis, respectively. Patients with severe psoriasis were less likely to receive secondary prevention pharmacotherapy with betablockers, statins and platelet inhibitors.
This first study of the prognosis following PCI in patients with psoriasis demonstrated an increased risk of all-cause mortality and of a composite of death, myocardial infarction and stroke, respectively, in patients with severe psoriasis compared to patients without psoriasis. Further studies of this novel association are needed.
Notes
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PubMed ID
23006590 View in PubMed
Less detail

Proton pump inhibitor use and risk of adverse cardiovascular events in aspirin treated patients with first time myocardial infarction: nationwide propensity score matched study.

https://arctichealth.org/en/permalink/ahliterature134590
Source
BMJ. 2011;342:d2690
Publication Type
Article
Date
2011
Author
Mette Charlot
Erik L Grove
Peter Riis Hansen
Jonas B Olesen
Ole Ahlehoff
Christian Selmer
Jesper Lindhardsen
Jan Kyst Madsen
Lars Køber
Christian Torp-Pedersen
Gunnar H Gislason
Author Affiliation
Department of Cardiology, Copenhagen University Hospital Gentofte, Post 635, Niels Andersens Vej 65, 2900 Hellerup, Denmark. mc@heart.dk
Source
BMJ. 2011;342:d2690
Date
2011
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aspirin - adverse effects
Cardiovascular Diseases - chemically induced - mortality
Denmark
Drug Interactions
Humans
Kaplan-Meier Estimate
Middle Aged
Myocardial Infarction - drug therapy
Platelet Aggregation Inhibitors - adverse effects
Prognosis
Propensity Score
Proton Pump Inhibitors - adverse effects
Recurrence
Retrospective Studies
Risk factors
Stroke - chemically induced
Abstract
To examine the effect of proton pump inhibitors on adverse cardiovascular events in aspirin treated patients with first time myocardial infarction.
Retrospective nationwide propensity score matched study based on administrative data. Setting All hospitals in Denmark.
All aspirin treated patients surviving 30 days after a first myocardial infarction from 1997 to 2006, with follow-up for one year. Patients treated with clopidogrel were excluded.
The risk of the combined end point of cardiovascular death, myocardial infarction, or stroke associated with use of proton pump inhibitors was analysed using Kaplan-Meier analysis, Cox proportional hazard models, and propensity score matched Cox proportional hazard models. Results 3366 of 19,925 (16.9%) aspirin treated patients experienced recurrent myocardial infarction, stroke, or cardiovascular death. The hazard ratio for the combined end point in patients receiving proton pump inhibitors based on the time dependent Cox proportional hazard model was 1.46 (1.33 to 1.61; P
Notes
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Comment In: Evid Based Med. 2012 Feb;17(1):33-422108076
PubMed ID
21562004 View in PubMed
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Psoriasis and risk of atrial fibrillation and ischaemic stroke: a Danish Nationwide Cohort Study.

https://arctichealth.org/en/permalink/ahliterature132222
Source
Eur Heart J. 2012 Aug;33(16):2054-64
Publication Type
Article
Date
Aug-2012
Author
Ole Ahlehoff
Gunnar H Gislason
Casper H Jørgensen
Jesper Lindhardsen
Mette Charlot
Jonas B Olesen
Steen Z Abildstrøm
Lone Skov
Christian Torp-Pedersen
Peter Riis Hansen
Author Affiliation
Department of Cardiology, Copenhagen University Hospital Gentofte, DK-2900 Hellerup, Denmark. olahha01@geh.regionh.dk
Source
Eur Heart J. 2012 Aug;33(16):2054-64
Date
Aug-2012
Language
English
Publication Type
Article
Keywords
Adult
Aged
Atrial Fibrillation - etiology
Cohort Studies
Denmark - epidemiology
Female
Humans
Male
Middle Aged
Psoriasis - complications - epidemiology
Risk factors
Stroke - epidemiology - etiology
Abstract
Psoriasis is a chronic inflammatory disease and inflammation contributes to the pathogenesis of atrial fibrillation (AF) and ischaemic stroke. We therefore investigated the risk of these endpoints in patients with psoriasis.
Cohort study of the entire Danish population followed from 1997 to 2006 by individual-level-linkage of nationwide prospectively recorded registers. Multivariable Poisson's regression and sensitivity analyses were used to assess the psoriasis-related risk of AF and ischaemic stroke. A total of 36 765 patients with mild psoriasis and 2793 with severe psoriasis were compared with 4 478 926 individuals, i.e., the reference population. In patients with mild psoriasis, the adjusted rate ratios (RRs) for AF were 1.50 (1.21-1.86) and 1.16 (1.08-1.24) in patients aged
Notes
Comment In: Eur Heart J. 2012 Aug;33(16):1989-9122108835
PubMed ID
21840930 View in PubMed
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Temporal trends in stroke admissions in Denmark 1997-2009.

https://arctichealth.org/en/permalink/ahliterature256956
Source
BMC Neurol. 2013;13:156
Publication Type
Article
Date
2013
Author
Malene Nøhr Demant
Charlotte Andersson
Ole Ahlehoff
Mette Charlot
Jonas Bjerring Olesen
Anne Gjesing
Peter R Hansen
Gunnar H Gislason
Thomas Truelsen
Christian Torp-Pedersen
Author Affiliation
Department of Cardiology, Copenhagen University Hospital Gentofte, Niels Andersens Vej 65, 2900 Hellerup, Denmark. malenedemant@gmail.com.
Source
BMC Neurol. 2013;13:156
Date
2013
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Denmark - epidemiology
Female
Humans
Male
Middle Aged
Patient Admission - trends
Registries
Retrospective Studies
Stroke - diagnosis - epidemiology - therapy
Time Factors
Abstract
The Stroke burden is increasing in many populations where health institutions may experience more patients. We wanted to examine whether incidence rates and absolute number of hospitalized stroke patients remained stable in Denmark during a 13 years period where exposure to major stroke risk factors decreased, changes in stroke treatment was implemented, and the age of the population increased.
The Danish National Patient Register was used to identify all subjects 25 years of age or above admitted with a first time stroke in Denmark from 1997-2009. Incidence rates (IRs) and age-adjusted Poisson regression analyses were used to examine trends in age-, gender- and stroke subtype (ischaemic or unspecified).
During the 13-year observation period there were 53.5 million person-years at risk (PY) and a total of 84,626 male and 84,705 female stroke patients were admitted to Danish hospitals. The IRs of hospitalized strokes per 1000 PY was 3.21 (95% confidence interval [CI] 3.16-3.27) in 1997, 3.85 (95% CI 3.79-3.91) in 2003 and 3.22 (95% CI 3.16-3.28) in 2009, respectively.Incidence rate ratios of hospitalized stroke events adjusted for age in the period 2007-2009 compared to 1997-2000 were 0.89 (95% CI 0.87- 0.91) for men and 0.92 (95% CI 0.90-0.94) for women.The incidence of hospitalized unspecified strokes decreased from 1997 to 2009 whereas there was a steep rise in incidence for hospitalization with specified ischemic stroke during this period.
This study found a constant rate of stroke hospitalization in Denmark from 1997-2009. The overall rate of hospitalized strokes adjusted for age decreased during this period.
Notes
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PubMed ID
24171730 View in PubMed
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