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Antiarrhythmic therapy and risk of death in patients with atrial fibrillation: a nationwide study.

https://arctichealth.org/en/permalink/ahliterature150959
Source
Europace. 2009 Jul;11(7):886-91
Publication Type
Article
Date
Jul-2009
Author
Søren Skøtt Andersen
Morten Lock Hansen
Gunnar H Gislason
Tina Ken Schramm
Fredrik Folke
Emil Fosbøl
Steen Z Abildstrøm
Mette Madsen
Lars Køber
Christian Torp-Pedersen
Author Affiliation
Department of Cardiology, Gentofte University Hospital, Niels Andersens Vej 65, Hellerup, Copenhagen DK-2900, Denmark. ssa@heart.dk
Source
Europace. 2009 Jul;11(7):886-91
Date
Jul-2009
Language
English
Publication Type
Article
Keywords
Aged
Anti-Arrhythmia Agents - therapeutic use
Atrial Fibrillation - drug therapy - mortality
Cohort Studies
Denmark - epidemiology
Female
Humans
Incidence
Male
Middle Aged
Proportional Hazards Models
Registries
Risk assessment
Risk factors
Survival Analysis
Survival Rate
Treatment Outcome
Abstract
To examine the risk of death associated with antiarrhythmic drug (AAD) therapy in a nationwide unselected cohort of patients with atrial fibrillation (AF).
All patients admitted with AF in Denmark from 1995 to 2004 and their subsequent use of AADs were identified by individual-level linkage of nationwide registries. Multivariable Cox proportional-hazard models with time-dependent covariates were used to analyse the risk of death associated with AAD therapy. A total of 141,500 patients were included in the study; of these 3356 (2.4%) patients received treatment with flecainide, 3745 (2.6%) propafenone, 23,346 (16.5%) sotalol, and 10,376 (7.3%) amiodarone. Annualized mortality rates were 2.54, 4.25, 5.29, and 7.42 per year per 100 person years for flecainide, propafenone, sotalol, and amiodarone, respectively. Multivariable Cox proportional-hazard models did not show increased risk of death associated with any of the AADs. Hazard ratio (95% confidence interval) for flecainide 0.38 (0.32-0.44), propafenone 0.65 (0.58-0.71), sotalol 0.65 (0.63-0.67), and amiodarone 0.94 (0.89-1.00).
In an unselected cohort of patients with AF, antiarrhythmic treatment with flecainide, propafenone, sotalol, or amiodarone was not associated with increased risk of death. From a safety perspective, this indicates appropriate selection of patients for AAD therapy.
Notes
Comment In: Europace. 2009 Jul;11(7):840-119546183
Comment In: Europace. 2009 Jul;11(7):837-919546182
PubMed ID
19443433 View in PubMed
Less detail

Arrhythmic and sudden death in chronic ischemic heart disease--a review of epidemiological data.

https://arctichealth.org/en/permalink/ahliterature190414
Source
Card Electrophysiol Rev. 2002 Feb;6(1-2):5-8
Publication Type
Article
Date
Feb-2002
Author
Steen Z Abildstrom
Christian Torp-Pedersen
Lars Køber
Author Affiliation
National Institute of Public Health, Copenhagen, Denmark. stabil@dadlnet.dk
Source
Card Electrophysiol Rev. 2002 Feb;6(1-2):5-8
Date
Feb-2002
Language
English
Publication Type
Article
Keywords
Arrhythmias, Cardiac - complications
Canada
Chronic Disease
Death, Sudden, Cardiac - epidemiology - etiology
Humans
Incidence
Myocardial Ischemia - complications
United States
PubMed ID
11984007 View in PubMed
Less detail

Association of subcutaneous allergen-specific immunotherapy with incidence of autoimmune disease, ischemic heart disease, and mortality.

https://arctichealth.org/en/permalink/ahliterature130415
Source
J Allergy Clin Immunol. 2012 Feb;129(2):413-9
Publication Type
Article
Date
Feb-2012
Author
Allan Linneberg
Rikke Kart Jacobsen
Lasse Jespersen
Steen Z Abildstrøm
Author Affiliation
Research Centre for Prevention and Health, Glostrup University Hospital, Glostrup, Denmark. alllin01@regionh.dk
Source
J Allergy Clin Immunol. 2012 Feb;129(2):413-9
Date
Feb-2012
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Autoimmune Diseases - epidemiology
Denmark - epidemiology
Desensitization, Immunologic
Female
Histamine Antagonists - therapeutic use
Humans
Hypersensitivity - epidemiology - therapy
Incidence
Injections, Subcutaneous
Male
Middle Aged
Mortality - trends
Myocardial Ischemia - epidemiology
Prospective Studies
Risk
Young Adult
Abstract
Subcutaneous allergen-specific immunotherapy (SCIT) is a well-documented treatment of IgE-mediated allergic disease. Little is known about potential effects of SCIT on the risk of other chronic immune-related diseases. Over the years, a few casuistic reports have caused concern that SCIT might act as a trigger of autoimmune disease.
We aimed to investigate the association of SCIT with the incidence of autoimmune disease and ischemic heart disease (IHD), as well as all-cause mortality.
All Danish citizens without other known diseases were linked and followed through central registries on medications and hospital admissions. Persons receiving SCIT and persons receiving conventional allergy treatment (CAT; nasal steroids or oral antihistamines) were compared with regard to mortality and development of autoimmune diseases, acute myocardial infarction (AMI), and IHD. Cox regression (survival analysis) with age as the underlying time scale was used to estimate relative risks (hazard ratios [HRs] with 95% CIs) associated with SCIT compared with CAT adjusted for age, sex, vocational status, and income.
During the 10-year study period (1997-2006), a total of 18,841 and 428,484 persons were followed in the SCIT and CAT groups, respectively. Receiving SCIT was associated with lower mortality (HR, 0.71; 95% CI, 0.62-0.81) and lower incidence of AMI (HR, 0.70; 95% CI, 0.52-0.93), IHD (HR, 0.88; 95% CI, 0.73-1.05), and autoimmune disease (HR, 0.86; 95% CI, 0.74-0.99).
In this registry-based observational study, receiving SCIT compared with CAT was associated with lower risk of autoimmune disease and AMI, as well as decreased all-cause mortality.
Notes
Comment In: J Allergy Clin Immunol. 2012 Dec;130(6):1438-9; author reply 1439-4023098811
PubMed ID
22004944 View in PubMed
Less detail

Body mass index is closely correlated to incident diabetes in patients with heart failure or myocardial infarction.

https://arctichealth.org/en/permalink/ahliterature135745
Source
Eur J Cardiovasc Prev Rehabil. 2011 Apr;18(2):305-11
Publication Type
Article
Date
Apr-2011
Author
Michelle Schmiegelow
Charlotte Andersson
Jonas B Olesen
Steen Z Abildstrom
Lars Kober
Christian Torp-Pedersen
Author Affiliation
Department of Cardiology, Gentofte University Hospital, Niels Andersens Vej 65, Copenhagen, Denmark. mdschmiegelow@gmail.com
Source
Eur J Cardiovasc Prev Rehabil. 2011 Apr;18(2):305-11
Date
Apr-2011
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Body mass index
Chi-Square Distribution
Denmark - epidemiology
Diabetes Mellitus - epidemiology - mortality
Female
Heart Failure - epidemiology - mortality
Humans
Incidence
Inpatients - statistics & numerical data
Kaplan-Meier Estimate
Male
Middle Aged
Myocardial Infarction - epidemiology - mortality
Obesity - epidemiology - mortality
Prevalence
Prognosis
Proportional Hazards Models
Registries
Retrospective Studies
Risk assessment
Risk factors
Time Factors
Abstract
Diabetes in patients with heart failure or myocardial infarction (MI) increases morbidity and mortality, but little is known about the impact of obesity on the risk of developing diabetes in these populations.
A cohort of patients consecutively hospitalized with heart failure (n?=?3472) or MI (n?=?5723) was followed in the period 1995-2006.
Multivariable Cox proportional-hazard models were used to estimate the risk of developing diabetes according to the World Health Organization body mass index (BMI) classification. Normal weight patients (BMI 18.5-24.9?kg/m(2)) were used as the reference.
In both populations, more than half of the patients with a BMI above 34.9?kg/m(2) developed diabetes. In heart failure patients, a BMI above 24.9?kg/m(2) was associated with an increased risk of diabetes for the three BMI groups, i.e. 25.0-29.9?kg/m(2), 30.9-34.9?kg/m(2), and >34.9?kg/m(2), with adjusted hazard ratios (HRs) of 2.16 (95% confidence interval 1.50-3.12), 3.89 (2.61-5.78), and 6.06 (3.79-9.69), respectively. In MI patients, the adjusted HRs in the three corresponding BMI groups were 1.84 (1.44-2.37), 4.31 (3.26-5.69), and 9.50 (6.70-13.46), respectively. Incident diabetes was associated with increased cardiovascular and all-cause mortality risks with adjusted HRs of greater magnitude than in prevalent diabetes.
BMI was an independent predictor of incident diabetes in patients with either heart failure or MI. More than half of the patients with a BMI above 34.9?kg/m(2) developed diabetes during follow-up. Incident diabetes carries an increased mortality risk.
PubMed ID
21450677 View in PubMed
Less detail

Burden of hospital admission and repeat angiography in angina pectoris patients with and without coronary artery disease: a registry-based cohort study.

https://arctichealth.org/en/permalink/ahliterature263886
Source
PLoS One. 2014;9(4):e93170
Publication Type
Article
Date
2014
Author
Lasse Jespersen
Steen Z Abildstrom
Anders Hvelplund
Jan K Madsen
Soren Galatius
Frants Pedersen
Soren Hojberg
Eva Prescott
Source
PLoS One. 2014;9(4):e93170
Date
2014
Language
English
Publication Type
Article
Keywords
Adult
Aged
Angina Pectoris - complications - economics - epidemiology - radiography
Angiography - economics - utilization
Cohort Studies
Coronary Artery Disease - complications - economics - epidemiology - radiography
Denmark - epidemiology
Female
Health Care Costs - statistics & numerical data
Humans
Length of Stay - economics - statistics & numerical data
Male
Middle Aged
Patient Admission - economics - statistics & numerical data
Recurrence
Registries
Abstract
To evaluate risk of hospitalization due to cardiovascular disease (CVD) and repeat coronary angiography (CAG) in stable angina pectoris (SAP) with no obstructive coronary artery disease (CAD) versus obstructive CAD, and asymptomatic reference individuals.
We followed 11,223 patients with no prior CVD having a first-time CAG in 1998-2009 due to SAP symptoms and 5,695 asymptomatic reference individuals from the Copenhagen City Heart Study through registry linkage for 7.8 years (median). In recurrent event survival analysis, patients with SAP had 3-4-fold higher risk of hospitalization for CVD irrespective of CAG findings and cardiovascular comorbidity. Multivariable adjusted hazard ratios(95%CI) for patients with angiographically normal coronary arteries was 3.0(2.5-3.5), for angiographically diffuse non-obstructive CAD 3.9(3.3-4.6) and for 1-3-vessel disease 3.6-4.1(range)(all P
Notes
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PubMed ID
24705387 View in PubMed
Less detail

Case-fatality rates for myocardial infarction declined in Denmark and Sweden during 1987-1999.

https://arctichealth.org/en/permalink/ahliterature53311
Source
J Clin Epidemiol. 2004 Jun;57(6):638-46
Publication Type
Article
Date
Jun-2004
Author
Søren Rasmussen
Steen Z Abildstrom
Måns Rosén
Mette Madsen
Author Affiliation
National Institute of Public Health, Svanemøllevej 25, DK-2100 Copenhagen, Denmark. sr@niph.dk
Source
J Clin Epidemiol. 2004 Jun;57(6):638-46
Date
Jun-2004
Language
English
Publication Type
Article
Keywords
Adult
Comparative Study
Death, Sudden
Denmark - epidemiology
Female
Humans
Incidence
Logistic Models
Male
Middle Aged
Myocardial Infarction - mortality
Registries
Research Support, Non-U.S. Gov't
Sweden - epidemiology
Abstract
OBJECTIVE: To evaluate trends in prognosis after acute myocardial infarction (AMI) between Denmark and Sweden using routinely collected data and different case-fatality measures. STUDY DESIGN AND SETTING: We compared three case-fatality measures during 1987-1999 using national registries in Denmark and Sweden, and extended these measures with underlying deaths of ischemic heart disease and sudden deaths of unknown cause. RESULTS: Changed coding practice distorted trends of case fatality rates during the day of the event. In general, Denmark had higher case-fatality rates, but trends in hospital-based rates were very similar, except for men 35-64 years old; Denmark declined more steeply. Short- and long-term prognosis improved considerably: the odds ratios for case fatality during days 1-28 for 1999 vs. 1987 were 0.48 among men in Denmark (women 0.58) and 0.53 among men in Sweden (women 0.55) and the odds ratios for case fatality during days 29-365 for 1999 vs. 1987 were 0.56 among men in Denmark (women 0.65) and 0.66 among men in Sweden (women 0.67). CONCLUSION: Short- and long-term prognosis improved considerably during 1987-1999 in Denmark and Sweden. Case fatality during the day of the event is epidemiologically important, but less certain than case-fatality measures defined after the day of the event when comparing countries.
PubMed ID
15246134 View in PubMed
Less detail

Changes in hospitalization rate and mortality after acute myocardial infarction in Denmark after diagnostic criteria and methods changed.

https://arctichealth.org/en/permalink/ahliterature53231
Source
Eur Heart J. 2005 May;26(10):990-5
Publication Type
Article
Date
May-2005
Author
Steen Z Abildstrom
Søren Rasmussen
Mette Madsen
Author Affiliation
National Institute of Public Health, Svanemøllevej 25, DK-2100 Copenhagen O, Denmark. saz@niph.dk
Source
Eur Heart J. 2005 May;26(10):990-5
Date
May-2005
Language
English
Publication Type
Article
Keywords
Adult
Age Distribution
Aged
Biological Markers - blood
Denmark - epidemiology
Female
Hospital Mortality - trends
Hospitalization - statistics & numerical data - trends
Humans
Male
Middle Aged
Mortality - trends
Myocardial Infarction - diagnosis - mortality
Practice Guidelines
Regression Analysis
Research Support, Non-U.S. Gov't
Sex Distribution
Troponin - blood
Abstract
AIMS: To analyse the effect of the change in diagnostic criteria for acute myocardial infarction (AMI) and the use of troponin as a diagnostic marker on the hospitalization rate and mortality of hospitalized AMI patients from 1994 to 2001. METHODS AND RESULTS: Patients (> or =30 years) admitted for their first AMI were identified using the National Patient Registry in Denmark. We registered when each hospital introduced troponin as a diagnostic marker. The reported hospitalization rate decreased until 1998 and then increased substantially from 1999 to 2001 from 3472 to 4163 per million inhabitants (19.9%) for men and from 1648 to 2020 per million inhabitants (22.6%) for women. Troponin use was associated with a significant 14% increase in hospitalization rate in this period [rate ratio 1.14, 95% confidence interval (CI) 1.11-1.18]. The effect of troponin was greatest among patients 70 years and older (rate ratio 1.19, 95% CI 1.14-1.23). The 28 day mortality decreased steadily from 25.9% in 1994 to 17.5% in 2002 (32.4%) and was not affected by troponin use. CONCLUSION: The reported hospitalization rate for AMI increased significantly after the new diagnostic criteria for AMI were introduced. The measurement of cardiac troponins further increased the hospitalization rate. The mortality among hospitalized patients with AMI declined steadily and was not affected by the use of troponins.
PubMed ID
15618048 View in PubMed
Less detail
Source
Scand J Public Health. 2011 Jul;39(7 Suppl):46-9
Publication Type
Article
Date
Jul-2011
Author
Steen Z Abildstrøm
Mette Madsen
Author Affiliation
National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark. stabil@dadlnet.dk
Source
Scand J Public Health. 2011 Jul;39(7 Suppl):46-9
Date
Jul-2011
Language
English
Publication Type
Article
Keywords
Cardiac Imaging Techniques - methods - standards - statistics & numerical data
Cardiac Surgical Procedures - methods - standards - statistics & numerical data
Denmark - epidemiology
Heart Diseases - diagnosis - epidemiology - therapy
Humans
Quality Assurance, Health Care
Registries - standards
Abstract
The Danish Heart Register (DHR) is a clinical database of invasive procedures within cardiology.
All providers of these procedures have been obliged to report to DHR since 2000. DHR is used to monitor the activity and quality of the procedures and serves as a data source for research.
The coverage is high (>95%) but some variables have many missing.
The combination of both cardiological and surgical data in this register is internationally unique and makes it possible to follow the patient from the invasive examination to treatment and by linkage to other registers to follow the prognosis.
PubMed ID
21775351 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
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PubMed ID
20113477 View in PubMed
Less detail

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
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