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Association of Rosacea With Risk for Glioma in a Danish Nationwide Cohort Study.

https://arctichealth.org/en/permalink/ahliterature282351
Source
JAMA Dermatol. 2016 May 01;152(5):541-5
Publication Type
Article
Date
May-01-2016
Author
Alexander Egeberg
Peter R Hansen
Gunnar H Gislason
Jacob P Thyssen
Source
JAMA Dermatol. 2016 May 01;152(5):541-5
Date
May-01-2016
Language
English
Publication Type
Article
Keywords
Adult
Brain Neoplasms - enzymology - epidemiology - pathology
Cohort Studies
Denmark
Female
Follow-Up Studies
Glioma - enzymology - epidemiology - pathology
Humans
Incidence
Male
Matrix Metalloproteinases - metabolism
Middle Aged
Poisson Distribution
Registries
Risk factors
Rosacea - enzymology - epidemiology - pathology
Up-Regulation
Young Adult
Abstract
Rosacea, a common facial skin disorder, has a poorly understood pathogenesis in which increased matrix metalloproteinase activity might play an important role. Glioma accounts for 80% of all primary malignant tumors in the central nervous system, and these tumors also show upregulation of certain matrix metalloproteinases.
To investigate the association between rosacea and the risk for glioma.
Nationwide cohort study of the Danish population from individual-level linkage of administrative registers. All Danish citizens 18 years or older from January 1, 1997, to December 31, 2011, were eligible for inclusion. A total of 5 484 910 individuals were eligible for analysis; of these, 68 372 had rosacea and 5 416 538 constituted the reference population. Data were analyzed from July 14 to August 10, 2015.
The outcome of interest was a diagnosis of glioma. Incidence rates per 10?000 person-years were calculated, and incidence rate ratios adjusted for age, sex, and socioeconomic status were estimated by Poisson regression distribution models.
Of the 5?484?910 individuals in the study population, 21?118 individuals developed glioma during the study period, including 20 934 of the 5 416 538 individuals in the reference population (50.4% women; mean [SD] age, 40.8 [19.7] years) and 184 of the 68?372 patients with rosacea (67.3% women; mean [SD] age, 42.2 [16.5] years). The incidence rate (95% CI) of glioma was 3.34 (3.30-3.39) in the reference population and 4.99 (4.32-5.76) in patients with rosacea. The adjusted incidence rate ratio (95% CI) of glioma in patients with rosacea was 1.36 (1.18-1.58) in our primary analysis. When analyses were limited to patients with a primary diagnosis of rosacea by a hospital dermatologist (n?=?5964), the adjusted incidence rate ratio was 1.82 (1.16-2.86).
Rosacea was associated with a significantly increased risk for glioma in a nationwide cohort. This association may be mediated, in part, by mechanisms dependent on matrix metalloproteinases. Increased focus on neurologic symptoms in patients with rosacea may be warranted.
PubMed ID
26818473 View in PubMed
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Calcium-channel blockers do not alter the clinical efficacy of clopidogrel after myocardial infarction: a nationwide cohort study.

https://arctichealth.org/en/permalink/ahliterature137753
Source
J Am Coll Cardiol. 2011 Jan 25;57(4):409-17
Publication Type
Article
Date
Jan-25-2011
Author
Jonas B Olesen
Gunnar H Gislason
Mette G Charlot
Emil L Fosbøl
Charlotte Andersson
Peter Weeke
Ole Ahlehoff
Christian Selmer
Christian Torp-Pedersen
Peter R Hansen
Author Affiliation
Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark. jo@heart.dk
Source
J Am Coll Cardiol. 2011 Jan 25;57(4):409-17
Date
Jan-25-2011
Language
English
Publication Type
Article
Keywords
Aged
Calcium Channel Blockers - adverse effects - therapeutic use
Cause of Death
Cohort Studies
Confidence Intervals
Denmark
Dose-Response Relationship, Drug
Drug Administration Schedule
Drug Interactions
Drug Therapy, Combination
Female
Follow-Up Studies
Humans
Male
Middle Aged
Multivariate Analysis
Myocardial Infarction - diagnosis - drug therapy - mortality
Proportional Hazards Models
Registries
Retrospective Studies
Survival Analysis
Ticlopidine - adverse effects - analogs & derivatives - therapeutic use
Time Factors
Treatment Outcome
Abstract
The purpose of this study was to determine the risk of adverse cardiovascular events associated with concomitant use of clopidogrel and calcium-channel blockers (CCBs) in patients with myocardial infarction (MI).
CCBs inhibit a variety of cytochrome P-450 enzymes, some of which contribute to clopidogrel metabolic activation. This interaction may diminish the efficacy of clopidogrel.
All patients surviving 30 days after a first-time MI in the period 2000 to 2006 in Denmark were identified by individual-level linkage of nationwide administrative registers. The cohort was divided into patients treated with and without clopidogrel and followed for 1 year after discharge. The risk of a composite of cardiovascular death, MI, or stroke and the risk of the individual components of the composite end point and all-cause death associated with CCBs were analyzed with multivariable Cox proportional hazard models and in univariate propensity score-matched models.
A total of 56,800 patients were included, of whom 24,923 were treated with clopidogrel and 13,380 with CCBs. In the Cox analyses, the risk of the composite end point associated with CCBs was increased in both patients treated and not treated with clopidogrel, with a hazard ratio of 1.15 (95% confidence interval [CI]: 1.07 to 1.24) and 1.05 (95% CI: 1.01 to 1.11), respectively. The increased risk was independent of clopidogrel use; the hazard rate ratio was 1.08 (95% CI: 0.99 to 1.18). Analyses of all additional adverse end points and propensity score-matched models provided similar results.
The clinical efficacy of clopidogrel in patients with a recent MI is not modified by concomitant CCB treatment. This potential drug interaction is unlikely to have clinical significance.
PubMed ID
21251580 View in PubMed
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Cardiovascular risk factors in subjects with psoriasis: a cross-sectional general population study.

https://arctichealth.org/en/permalink/ahliterature125146
Source
Int J Dermatol. 2013 Jun;52(6):681-3
Publication Type
Article
Date
Jun-2013
Author
Peter Jensen
Jacob P Thyssen
Claus Zachariae
Peter R Hansen
Allan Linneberg
Lone Skov
Author Affiliation
Department of Dermato-Allergology Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark. peterj01@geh.regionh.dk
Source
Int J Dermatol. 2013 Jun;52(6):681-3
Date
Jun-2013
Language
English
Publication Type
Article
Keywords
Adult
Cardiovascular Diseases - epidemiology
Cross-Sectional Studies
Denmark - epidemiology
Female
Humans
Male
Middle Aged
Prevalence
Psoriasis - epidemiology
Risk factors
Severity of Illness Index
Urban Population - statistics & numerical data
Abstract
Epidemiological data have established an association between cardiovascular disease and psoriasis. Only one general population study has so far compared prevalences of cardiovascular risk factors among subjects with psoriasis and control subjects. We aimed to determine the prevalence of cardiovascular risk factors in subjects with and without psoriasis in the general population.
During 2006-2008, a cross-sectional study was performed in the general population in Copenhagen, Denmark. A total of 3471 subjects participated in a general health examination that included assessment of current smoking status, weight, height, waist and hip circumferences, systolic and diastolic blood pressures, resting heart rate, and plasma lipids, hemoglobin A1c, fasting glucose, and insulin levels.
Physician-diagnosed psoriasis was reported by 238 (7.1%) of 3374 participants. There were no differences between subjects with and without psoriasis with regard to traditional cardiovascular risk factors.
Our results contrast with the hitherto-reported increased prevalence of metabolic syndrome in subjects with psoriasis in the general U.S. population. However, our results agree with those of other previous studies in which the association between mild psoriasis and cardiovascular risk factors is often non-significant. Further controlled research is needed to describe the prevalence of cardiovascular risk factors in subjects with mainly mild to moderate psoriasis in the general population.
PubMed ID
22512330 View in PubMed
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Cardiovascular risk prediction in the general population with use of suPAR, CRP, and Framingham Risk Score.

https://arctichealth.org/en/permalink/ahliterature121415
Source
Int J Cardiol. 2013 Sep 10;167(6):2904-11
Publication Type
Article
Date
Sep-10-2013
Author
Stig Lyngbæk
Jacob L Marott
Thomas Sehestedt
Tine W Hansen
Michael H Olsen
Ove Andersen
Allan Linneberg
Steen B Haugaard
Jesper Eugen-Olsen
Peter R Hansen
Jørgen Jeppesen
Author Affiliation
Department of Cardiology, Copenhagen University Hospital Gentofte, Denmark. stiglyngbaek@gmail.com
Source
Int J Cardiol. 2013 Sep 10;167(6):2904-11
Date
Sep-10-2013
Language
English
Publication Type
Article
Keywords
Adult
Aged
Biological Markers - blood
C-Reactive Protein - metabolism
Cardiovascular Diseases - blood - diagnosis - epidemiology
Denmark - epidemiology
Disease-Free Survival
Female
Follow-Up Studies
Humans
Male
Middle Aged
Population Surveillance - methods
Predictive value of tests
Receptors, Urokinase Plasminogen Activator - blood
Risk Assessment - methods
Risk factors
Abstract
The inflammatory biomarkers soluble urokinase plasminogen activator receptor (suPAR) and C-reactive protein (CRP) independently predict cardiovascular disease (CVD). The prognostic implications of suPAR and CRP combined with Framingham Risk Score (FRS) have not been determined.
From 1993 to 1994, baseline levels of suPAR and CRP were obtained from 2315 generally healthy Danish individuals (mean [SD] age: 53.9 [10.6] years) who were followed for the composite outcome of ischemic heart disease, stroke and CVD mortality.
During a median follow-up of 12.7 years, 302 events were recorded. After adjusting for FRS, women with suPAR levels in the highest tertile had a 1.74-fold (95% confidence interval [CI]: 1.08-2.81, p=0.027) and men a 2.09-fold (95% CI: 1.37-3.18, p20%) risk categories, respectively. This was reflected in a significant improvement of C statistics for men (p=0.034) and borderline significant for women (p=0.054), while the integrated discrimination improvement was highly significant (P=0.001) for both genders.
suPAR provides prognostic information of CVD risk beyond FRS and improves risk prediction substantially when combined with CRP in this setting.
PubMed ID
22909410 View in PubMed
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Cause-specific cardiovascular risk associated with nonsteroidal anti-inflammatory drugs among myocardial infarction patients--a nationwide study.

https://arctichealth.org/en/permalink/ahliterature116575
Source
PLoS One. 2013;8(1):e54309
Publication Type
Article
Date
2013
Author
Anne-Marie Schjerning Olsen
Emil L Fosbøl
Jesper Lindhardsen
Charlotte Andersson
Fredrik Folke
Mia B Nielsen
Lars Køber
Peter R Hansen
Christian Torp-Pedersen
Gunnar H Gislason
Author Affiliation
Department of Cardiology, Copenhagen University Hospital, Hellerup, Denmark. amschjerning@gmail.com
Source
PLoS One. 2013;8(1):e54309
Date
2013
Language
English
Publication Type
Article
Keywords
Aged
Anti-Inflammatory Agents, Non-Steroidal - administration & dosage - adverse effects
Denmark
Diclofenac - administration & dosage - adverse effects
Female
Follow-Up Studies
Hospitalization
Humans
Lactones - administration & dosage - adverse effects
Male
Middle Aged
Myocardial Infarction - drug therapy - mortality - pathology
Proportional Hazards Models
Registries
Risk factors
Sulfones - administration & dosage - adverse effects
Abstract
Non steroidal anti-inflammatory drugs (NSAIDs) increase mortality and morbidity after myocardial infarction (MI). We examined cause-specific mortality and morbidity associated with NSAIDs in a nationwide cohort of MI patients.
By individual-level linkage of nationwide registries of hospitalization and drug dispensing from pharmacies in Denmark, patients aged >30 years admitted with first-time MI during 1997-2009 and their subsequent NSAID use were identified. The risk of three cardiovascular specific endpoints: cardiovascular death, the composite of coronary death and nonfatal MI, and the composite of fatal and nonfatal stroke, associated with NSAID use was analyzed by Cox proportional hazard analyses. Of 97,698 patients included 44.0% received NSAIDs during follow-up. Overall use of NSAIDs was associated with an increased risk of cardiovascular death (hazard ratio [HR] 1.42, 95% confidence interval [CI] 1.36-1.49). In particular use of the nonselective NSAID diclofenac and the selective cyclooxygenase-2 inhibitor rofecoxib was associated with increased risk of cardiovascular death (HR 1.96 [1.79-2.15] and HR1.66 [1.44-1.91], respectively) with a dose dependent increase in risk. Use of ibuprofen was associated with increased risk of cardiovascular death (HR 1.34[1.26-1.44]), whereas naproxen was associated with the lowest risk of (e.g., HR 1.27[1.01-1.59].
Use of individual NSAIDs is associated with different cause-specific cardiovascular risk and in particular rofecoxib and diclofenac were associated with increased cardiovascular morbidity and mortality. These results support caution with use of all NSAIDs in patients with prior MI.
Notes
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PubMed ID
23382889 View in PubMed
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Duration of clopidogrel treatment and risk of mortality and recurrent myocardial infarction among 11 680 patients with myocardial infarction treated with percutaneous coronary intervention: a cohort study.

https://arctichealth.org/en/permalink/ahliterature145748
Source
BMC Cardiovasc Disord. 2010;10:6
Publication Type
Article
Date
2010
Author
Rikke Sørensen
Steen Z Abildstrom
Peter Weeke
Emil L Fosbøl
Fredrik Folke
Morten L Hansen
Peter R Hansen
Jan K Madsen
Ulrik Abildgaard
Lars Køber
Henrik E Poulsen
Christian Torp-Pedersen
Gunnar H Gislason
Author Affiliation
Department of Cardiology, Copenhagen University Hospital Gentofte, Niels Andersens Vej 65, 2900 Hellerup, Denmark. rs@heart.dk
Source
BMC Cardiovasc Disord. 2010;10:6
Date
2010
Language
English
Publication Type
Article
Keywords
Aged
Angioplasty, Balloon, Coronary - mortality - trends
Cohort Studies
Denmark - epidemiology
Female
Follow-Up Studies
Humans
Male
Middle Aged
Myocardial Infarction - drug therapy - mortality - prevention & control
Recurrence - prevention & control
Registries
Retrospective Studies
Risk factors
Ticlopidine - administration & dosage - analogs & derivatives
Time Factors
Treatment Outcome
Abstract
The optimal duration of clopidogrel treatment after percutaneous coronary intervention (PCI) is unclear. We studied the risk of death or recurrent myocardial infarction (MI) in relation to 6- and 12-months clopidogrel treatment among MI patients treated with PCI.
Using nationwide registers of hospitalizations and drug dispensing from pharmacies we identified 11 680 patients admitted with MI, treated with PCI and clopidogrel. Clopidogrel treatment was categorized in a 6-months and a 12-months regimen. Rates of death, recurrent MI or a combination of both were analyzed by the Kaplan Meier method and Cox proportional hazards models. Bleedings were compared between treatment regimens.
The Kaplan Meier analysis indicated no benefit of the 12-months regimen compared with the 6-months in all endpoints. The Cox proportional hazards analysis confirmed these findings with hazard ratios for the 12-months regimen (the 6-months regimen used as reference) for the composite endpoint of 1.01 (confidence intervals 0.81-1.26) and 1.24 (confidence intervals 0.95-1.62) for Day 0-179 and Day 180-540 after discharge. Bleedings occurred in 3.5% and 4.1% of the patients in the 6-months and 12-months regimen (p = 0.06).
We found comparable rates of death and recurrent MI in patients treated with 6- and 12-months' clopidogrel. The potential benefit of prolonged clopidogrel treatment in a real-life setting remains uncertain.
Notes
Cites: JAMA. 2002 Nov 20;288(19):2411-2012435254
Cites: J Thromb Thrombolysis. 2009 May;27(4):365-7818498003
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PubMed ID
20113477 View in PubMed
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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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Effect of weight loss on the cardiovascular risk profile of obese patients with psoriasis.

https://arctichealth.org/en/permalink/ahliterature264506
Source
Acta Derm Venereol. 2014 Nov;94(6):691-4
Publication Type
Article
Date
Nov-2014
Author
Peter Jensen
Claus Zachariae
Robin Christensen
Nina R W Geiker
Bente K Schaadt
Steen Stender
Arne Astrup
Peter R Hansen
Lone Skov
Source
Acta Derm Venereol. 2014 Nov;94(6):691-4
Date
Nov-2014
Language
English
Publication Type
Article
Keywords
Biological Markers - blood
Blood Glucose - metabolism
Blood pressure
Caloric Restriction
Cardiovascular Diseases - blood - diagnosis - epidemiology - physiopathology - prevention & control
Comorbidity
Denmark - epidemiology
Endothelium, Vascular - metabolism - physiopathology
Heart rate
Hemoglobin A, Glycosylated - metabolism
Humans
Lipids - blood
Manometry
Microvessels - metabolism - physiopathology
Obesity - blood - diagnosis - diet therapy - epidemiology - physiopathology
Plasminogen Activator Inhibitor 1 - blood
Protective factors
Psoriasis - diagnosis - epidemiology
Risk factors
Time Factors
Treatment Outcome
Weight Loss
Abstract
Psoriasis is associated with obesity and other cardiovascular risk factors including endothelial dysfunction. We aimed to investigate the effects of weight loss on the cardiovascular risk profile of obese patients with psoriasis. A randomised controlled study was conducted in which we measured the microvascular endothelial function with peripheral arterial tonometry (PAT), selected plasma markers of endothelial function, and traditional cardiovascular risk factors in 60 obese patients with psoriasis. The participants were randomised to either low-energy diet (n?=?30) providing 800-1,000 kcal/day for 8 weeks followed by 8 weeks of reduced food intake reaching 1,200 kcal/day or normal healthy foods (n?=?30) for 16 weeks. The intervention group lost significantly more weight than controls, which resulted in significant reductions of diastolic blood pressure, resting heart rate, total cholesterol, VLDL cholesterol, triglyceride, plasma glucose, glycated haemoglobin, and tissue plasminogen activator inhibitor. Microvascular endothelial function assessed by PAT remained unchanged. We conclude that certain components of the cardiovascular risk profile of obese patients with psoriasis can be significantly improved by weight reduction.
PubMed ID
24556829 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
Cites: Dan Med Bull. 1997 Sep;44(4):445-89377907
Cites: Int J Cardiol. 2011 Nov 3;152(3):327-3120797803
Cites: Diabetes. 1998 Sep;47(9):1412-89726229
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PubMed ID
20843380 View in PubMed
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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
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