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Cardiac symptoms before sudden cardiac death caused by coronary artery disease: a nationwide study among young Danish people.

https://arctichealth.org/en/permalink/ahliterature114837
Source
Heart. 2013 Jul;99(13):938-43
Publication Type
Article
Date
Jul-2013
Author
Reza Jabbari
Bjarke Risgaard
Anders G Holst
Jonas B Nielsen
Charlotte Glinge
Thomas Engstrøm
Henning Bundgaard
Jesper H Svendsen
Stig Haunsø
Bo Gregers Winkel
Jacob Tfelt-Hansen
Author Affiliation
Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC), University of Copenhagen, Rigshospitalet, Juliane Maries Vej 20, 2100 Copenhagen, Denmark. rezajabbari77@gmail.com
Source
Heart. 2013 Jul;99(13):938-43
Date
Jul-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Angina Pectoris - epidemiology
Autopsy
Chi-Square Distribution
Child
Child, Preschool
Coronary Artery Disease - mortality - therapy
Death, Sudden, Cardiac - epidemiology
Denmark - epidemiology
Dyspnea - epidemiology
Female
Humans
Incidence
Infant
Male
Patient Acceptance of Health Care
Registries
Retrospective Studies
Risk factors
Time Factors
Young Adult
Abstract
The aim of this nationwide case-control study was to identify and characterise symptoms before sudden death of young persons who had died due to coronary artery disease (CAD).
We have previously investigated the incidence of sudden cardiac death (SCD) in young Danish people aged 1-35 years in Denmark during 2000-2006. We included all deaths (n=6629) and identified 314 autopsied cases of SCD, 40 of whom (13%) died from CAD. To compare symptoms before death, the CAD case group was sex- and age-matched 1:2 with a control group randomly sampled from a population of 1497 individuals who had died in accidents. We used data from the National Patient Registry on previous contacts with the healthcare system for all persons and read all available patient records, including death certificates and autopsy reports.
A total of 31 (79%) persons with CAD-SCD had cardiac symptoms such as angina pectoris (n=24, 62%) and dyspnoea during the 12 months before death, and this was significantly higher than in the control group (p
PubMed ID
23574972 View in PubMed
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Cardiac symptoms before sudden cardiac death caused by hypertrophic cardiomyopathy: a nationwide study among the young in Denmark.

https://arctichealth.org/en/permalink/ahliterature285164
Source
Europace. 2016 Dec;18(12):1801-1808
Publication Type
Article
Date
Dec-2016
Author
Thomas Hadberg Lynge
Bjarke Risgaard
Reza Jabbari
Charlotte Glinge
Henning Bundgaard
Barry Maron
Stig Haunsø
Bo Gregers Winkel
Jacob Tfelt-Hansen
Source
Europace. 2016 Dec;18(12):1801-1808
Date
Dec-2016
Language
English
Publication Type
Article
Keywords
Accidents, Traffic - mortality
Adolescent
Adult
Autopsy
Cardiomyopathy, Hypertrophic - complications - mortality
Cause of Death
Chest Pain - epidemiology
Child
Child, Preschool
Coronary Artery Disease - mortality
Death Certificates
Death, Sudden, Cardiac - etiology
Denmark
Echocardiography
Female
Humans
Male
Registries
Retrospective Studies
Risk factors
Sports
Syncope - epidemiology
Young Adult
Abstract
Hypertrophic cardiomyopathy (HCM) is a frequent cause of sudden cardiac death (SCD) among the young (SCDY). The aim of this study was to characterize symptoms before SCDY due to HCM.
Through review of all death certificates, we identified all SCDs in Danes aged 1-35 years in 2000-2009. Nationwide we included all deaths (n = 8756) and identified 431 autopsied SCDYs. All available records from hospitals and general practitioners were retrieved. To compare symptoms, we included a control groups consisting of traffic accident victims (n = 74). In the 10-year study period, 431 autopsied SCDY cases were reviewed and 38 cases (9%) were included, of which 22 (58%) had morphologic findings diagnostic of HCM and 16 (42%) had findings suggestive, but not diagnostic, of HCM ('possible HCM'). Cardiac symptoms >1 h prior to death were reported in 21 (55%) of cases, and 16 (42%) sought medical attention. One (1%) control had cardiac symptoms before death. Consequently, a significantly higher proportion of cases had cardiac symptoms before death and cases more often sought medical attention than controls (P
PubMed ID
26823388 View in PubMed
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Differences in investigations of sudden unexpected deaths in young people in a nationwide setting.

https://arctichealth.org/en/permalink/ahliterature132784
Source
Int J Legal Med. 2012 Mar;126(2):223-9
Publication Type
Article
Date
Mar-2012
Author
Bo Gregers Winkel
Anders Gaarsdal Holst
Juliane Theilade
Ingrid Bayer Kristensen
Jørgen Lange Thomsen
Hans Petter Hougen
Henning Bundgaard
Jesper Hastrup Svendsen
Stig Haunsø
Jacob Tfelt-Hansen
Author Affiliation
The Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC), Copenhagen, Denmark. bowinkel@dadlnet.dk
Source
Int J Legal Med. 2012 Mar;126(2):223-9
Date
Mar-2012
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Autopsy - utilization
Cause of Death
Child
Child, Preschool
Death, Sudden - epidemiology - pathology
Denmark - epidemiology
Female
Humans
Incidence
Infant
Male
Young Adult
Abstract
Inherited disease may be causative in many young sudden unexpected death cases. Autopsy is essential in the counselling of the bereaved, as the family of the victim may be at risk too. In a nationwide setting operating under the same set of laws, we hypothesized that regional differences exist in the investigation of young persons dying suddenly and unexpectedly.
All deaths in persons aged 1-35 years in Denmark in 2000-2006 were included. Death certificates were read independently by two physicians. External examination as well as autopsy status was retrieved. Significant regional differences were found regarding external examinations and autopsy frequencies. Ratios of conducted external examinations varied between 63% and 93% (p?=?0.004). Autopsy ratios varied between 60% and 88% (p?=?0.001). In urban areas, external examinations and autopsies were more often conducted than in rural areas. In East Denmark, there were more external examinations resulting in a forensic autopsy, and there was a higher overall autopsy rate compared to West Denmark.
Despite operating under the same set of laws, we document significant regional differences in forensic investigations of young persons suffering a sudden unexpected death. This is probably not unique for Denmark although no data exist to confirm that. The results are worrying and call for a revision of the way these deaths are handled. Mandatory autopsy in sudden unexpected death in young persons is warranted as a thorough investigation of the death may help the clinician in guidance of the relatives in relation to hereditary diseases.
PubMed ID
21779923 View in PubMed
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Epilepsy and risk of death and sudden unexpected death in the young: a nationwide study.

https://arctichealth.org/en/permalink/ahliterature108385
Source
Epilepsia. 2013 Sep;54(9):1613-20
Publication Type
Article
Date
Sep-2013
Author
Anders Gaarsdal Holst
Bo Gregers Winkel
Bjarke Risgaard
Jonas Bille Nielsen
Peter Vibe Rasmussen
Stig Haunsø
Anne Sabers
Peter Uldall
Jacob Tfelt-Hansen
Author Affiliation
The Danish National Research Foundation Center for Cardiac Arrhythmia (DARC), Copenhagen, Denmark. anders@kanten.dk
Source
Epilepsia. 2013 Sep;54(9):1613-20
Date
Sep-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Cause of Death
Cohort Studies
Death, Sudden - epidemiology - etiology
Denmark - epidemiology
Epilepsy - complications - mortality
Female
Humans
Incidence
Male
Risk
Abstract
Patients with epilepsy are at increased risk of premature death from all causes and likely also from sudden unexplained death (SUD). Many patients with epilepsy have significant comorbidity, and it is unclear how much of the increased risk can be explained by epilepsy itself. We aimed to chart the incidence of sudden unexpected death in epilepsy (SUDEP) and estimate the risk of death from all causes and SUD conferred by epilepsy independently.
We conducted a historical cohort study using data from Danish registries and a complete manual review of all death certificates. The population studied consisted of all Danish residents in the age group 1-35 years, in the period 2000-2006 (inclusive), and the main outcome measures were risk of death and SUD.
We identified 33,022 subjects with epilepsy (median follow-up 3.7 years) and 3,001,952 subjects without (median follow-up 7.0 years). Among 685 deaths in the population with epilepsy, we identified 50 cases of definite and probable SUDEP corresponding to an incidence rate of 41.1 (95% confidence interval [CI] 31.6-54.9) per 100,000 person-years. Incidence rates increased with age from 17.6 (95% CI 9.5-32.8) in the age group 1-18 years to 73.8 (95% CI 52.5-103.8) for the age group 24-35 years. Having epilepsy increased the crude risk of death with a hazard ratio (HR) of 11.9 (95% CI 11.0-12.9). When adjusting for sex and comorbidities often encountered in patients with epilepsy (neurologic disease including cerebral palsy, psychiatric disease including mental retardation, and congenital disorders), as well as the Charlson comorbidity score, the HR fell to 5.4 (95% CI 4.9-6.0). The crude HR for SUD was 27.5 (95% CI 18.1-41.8) and fell to 16.3 (95% CI 9.8-26.9) when adjusted for the same covariates as above.
Epilepsy in and of itself carries a significant risk of premature death and SUD. These findings highlight the potential gains of risk factor modification for the prevention of premature death and SUDEP in patients with epilepsy.
PubMed ID
23895621 View in PubMed
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Gender differences in sudden cardiac death in the young-a nationwide study.

https://arctichealth.org/en/permalink/ahliterature285984
Source
BMC Cardiovasc Disord. 2017 Jan 07;17(1):19
Publication Type
Article
Date
Jan-07-2017
Author
Bo Gregers Winkel
Bjarke Risgaard
Thea Bjune
Reza Jabbari
Thomas Hadberg Lynge
Charlotte Glinge
Henning Bundgaard
Stig Haunsø
Jacob Tfelt-Hansen
Source
BMC Cardiovasc Disord. 2017 Jan 07;17(1):19
Date
Jan-07-2017
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Distribution
Cause of Death
Child
Child, Preschool
Comorbidity
Death, Sudden, Cardiac - epidemiology
Denmark - epidemiology
Female
Humans
Incidence
Infant
Infant, Newborn
Male
Registries
Retrospective Studies
Risk factors
Sex Distribution
Time Factors
Young Adult
Abstract
Hitherto, sudden cardiac death (SCD) in the young has been described with no distinction between genders. SCD occurs more often in men (SCDm) than women (SCDw), but this disparity is not understood and has not been investigated systematically in a nationwide setting. Our objective was to report gender differences in SCD in the young in a nationwide (Denmark) setting.
All deaths in persons aged 1-35 years nationwide in Denmark between 2000 and 2009 were included. Death certificates and autopsy reports were obtained. The extensive health care registries in Denmark were used to investigate any known disease prior to death. SCDw were compared to SCDm.
During the 10-year study period there were a total of 8756 deaths in 23.7 million person-years. In total, 635 deaths were SCD. SCDw constituted 205 deaths (32%). Women had a higher proportion of witnessed deaths (51 vs. 41%, p?=?0.02) and died less often in a public place (16 vs. 26%, p?=?0.01). Age at death, ratios of autopsies and sudden unexplained deaths, and comorbidities, did not differ. Causes of SCD were largely comparable between genders. The incidence rate of SCDw was half of that of SCDm (1.8 vs. 3.6 per 100,000 person-years, incidence rate ratio 2.0 (95% CI 1.7-2.4), p?
Notes
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PubMed ID
28061807 View in PubMed
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Incidence and etiology of sports-related sudden cardiac death in Denmark-Implications for preparticipation screening.

https://arctichealth.org/en/permalink/ahliterature96547
Source
Heart Rhythm. 2010 May 15;
Publication Type
Article
Date
May-15-2010
Author
Anders Gaarsdal Holst
Bo Gregers Winkel
Juliane Theilade
Ingrid Bayer Kristensen
Jørgen Lange Thomsen
Gyda Lolk Ottesen
Jesper Hastrup Svendsen
Stig Haunsø
Eva Prescott
Jacob Tfelt-Hansen
Author Affiliation
Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC), Copenhagen, Denmark; Laboratory of Molecular Cardiology, Department of Cardiology, The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
Source
Heart Rhythm. 2010 May 15;
Date
May-15-2010
Language
English
Publication Type
Article
Abstract
BACKGROUND: Studies on incidences of sports-related sudden cardiac death (SrSCD) are few and data are needed for the discussion of preparticipation screening for cardiac disease. OBJECTIVE: We sought to chart the incidence and etiology of SrSCD in the young in Denmark (population 5.4 million) and to compare this to the incidence of sudden cardiac death (SCD) in the background population. METHODS: All 5,662 death certificates for decedents in the period 2000 to 2006 in the age group 12 to 35 years in Denmark were read independently by 2 physicians to identify cases of SCD. Information from autopsy reports, selected hospital records, and multiple registries was used to identify cases of SCD and SrSCD. SrSCD was defined as SCD occurring during or within 1 hour after exercise in a competitive athlete. The size of the athlete population was estimated from national survey data. RESULTS: Fifteen (range 0 to 5 per year) cases of SrSCD were found, 8 of which had antecedent symptoms. The incidence rate was 1.21 (95% confidence interval [CI]: 0.68 to 2.00) per 100,000 athlete person-years. The most common autopsy findings were arrhythmogenic right ventricular cardiomyopathy (n = 4), sudden unexplained death (n = 4), and coronary artery disease (n = 2). The incidence of SCD in the general population age 12 to 35 was 3.76 (95% CI: 3.42 to 4.14) per 100,000 person-years. CONCLUSION: In Denmark, SrSCD is a rare occurrence and the incidence rate is lower than that of SCD in the general population. This may imply a low value of preparticipation screening of athletes in Denmark.
PubMed ID
20580680 View in PubMed
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Incidence and risk factors of ventricular fibrillation before primary angioplasty in patients with first ST-elevation myocardial infarction: a nationwide study in Denmark.

https://arctichealth.org/en/permalink/ahliterature272098
Source
J Am Heart Assoc. 2015 Jan;4(1):e001399
Publication Type
Article
Date
Jan-2015
Author
Reza Jabbari
Thomas Engstrøm
Charlotte Glinge
Bjarke Risgaard
Javad Jabbari
Bo Gregers Winkel
Christian Juhl Terkelsen
Hans-Henrik Tilsted
Lisette Okkels Jensen
Mikkel Hougaard
Stephanie E Chiuve
Frants Pedersen
Jesper Hastrup Svendsen
Stig Haunsø
Christine M Albert
Jacob Tfelt-Hansen
Source
J Am Heart Assoc. 2015 Jan;4(1):e001399
Date
Jan-2015
Language
English
Publication Type
Article
Keywords
Age Distribution
Aged
Alcohol drinking - epidemiology
Angioplasty, Balloon, Coronary - methods - mortality
Case-Control Studies
Death, Sudden, Cardiac - epidemiology
Denmark
Electrocardiography - methods
Female
Humans
Incidence
Life Style
Logistic Models
Male
Middle Aged
Myocardial Infarction - diagnosis - epidemiology - therapy
Prospective Studies
Risk factors
Severity of Illness Index
Sex Distribution
Smoking - epidemiology
Statistics, nonparametric
Treatment Outcome
Ventricular Fibrillation - diagnosis - epidemiology
Abstract
We aimed to investigate the incidence and risk factors for ventricular fibrillation (VF) before primary percutaneous coronary intervention (PPCI) among patients with ST-segment elevation myocardial infarction (STEMI) in a prospective nationwide setting.
In this case-control study, patients presenting within the first 12 hours of first STEMI who survived to undergo angiography and subsequent PPCI were enrolled. Over 2 years, 219 cases presenting with VF before PPCI and 441 controls without preceding VF were enrolled. Of the 219 case patients, 182 (83%) had STEMI with out-of-hospital cardiac arrest due to VF, and 37 (17%) had cardiac arrest upon arrival to the emergency room. Medical history was collected by standardized interviews and by linkage to national electronic health records. The incidence of VF before PPCI among STEMI patients was 11.6%. Multivariable logistic regression analysis identified novel associations between atrial fibrillation and alcohol consumption with VF. Patients with a history of atrial fibrillation had a 2.80-fold odds of experiencing VF before PPCI (95% CI 1.10 to 7.30). Compared with nondrinkers, patients who consumed 1 to 7 units, 8 to 14 units, or >15 units of alcohol per week had an odds ratio (OR) of 1.30 (95% CI, 0.80 to 2.20), 2.30 (95% CI, 1.20 to 4.20), or 3.30 (95% CI, 1.80 to 5.90), respectively, for VF. Previously reported associations for preinfarction angina (OR 0.46; 95% CI 0.32 to 0.67), age of
Notes
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Erratum In: J Am Heart Assoc. 2015 Jul;4(7). pii: e000738. doi: 10.1161/JAHA.115.00073826178403
PubMed ID
25559012 View in PubMed
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Nationwide study of sudden cardiac death in persons aged 1-35 years.

https://arctichealth.org/en/permalink/ahliterature99934
Source
Eur Heart J. 2010 Dec 2;
Publication Type
Article
Date
Dec-2-2010
Author
Bo Gregers Winkel
Anders Gaarsdal Holst
Juliane Theilade
Ingrid Bayer Kristensen
Jørgen Lange Thomsen
Gyda Lolk Ottesen
Henning Bundgaard
Jesper Hastrup Svendsen
Stig Haunsø
Jacob Tfelt-Hansen
Author Affiliation
The Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC), Copenhagen, Denmark.
Source
Eur Heart J. 2010 Dec 2;
Date
Dec-2-2010
Language
English
Publication Type
Article
Abstract
Aims The aim of this investigation was to study the incidence of sudden cardiac death (SCD) in persons aged 1-35 years in a nationwide setting (5.38 million people) by systematic evaluation of all deaths. Methods and results All deaths in persons aged 1-35 years in Denmark in 2000-06 were included. Death certificates were read independently by two physicians. The National Patient Registry was used to retrieve information on prior medical history. All autopsy reports were read and the cause of death was revised based on autopsy findings. We identified 625 cases of sudden unexpected death (10% of all deaths), of which 156 (25%) were not autopsied. Of the 469 autopsied cases, 314 (67%) were SCD. The most common cardiac cause of death was ischaemic heart disease (13%); 29% of autopsied sudden unexpected death cases were unexplained. In 45% of SCD cases, the death was witnessed; 34% died during sleep; 89% were out-of-hospital deaths. Highest possible incidence rate of SCD in the young was 2.8 per 100 000 person-years including non-autopsied cases of sudden unexpected death. Excluding those, the incidence rate declined to 1.9 per 100 000 person-years. Conclusions A total of 7% of all deaths in the young can be attributed to SCD, when including non-autopsied cases (autopsy ratio 75%). The incidence rate of SCD in the young of 2.8 per 100 000 person-years is higher than previously reported.
PubMed ID
21131293 View in PubMed
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23 records – page 1 of 3.