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2-year clinical outcomes after implantation of sirolimus-eluting, paclitaxel-eluting, and bare-metal coronary stents: results from the WDHR (Western Denmark Heart Registry).

https://arctichealth.org/en/permalink/ahliterature89935
Source
J Am Coll Cardiol. 2009 Feb 24;53(8):658-64
Publication Type
Article
Date
Feb-24-2009
Author
Kaltoft Anne
Jensen Lisette Okkels
Maeng Michael
Tilsted Hans Henrik
Thayssen Per
Bøttcher Morten
Lassen Jens Flensted
Krusell Lars Romer
Rasmussen Klaus
Hansen Knud Nørregaard
Pedersen Lars
Johnsen Søren Paaske
Sørensen Henrik Toft
Thuesen Leif
Author Affiliation
Department of Cardiology, Aarhus University Hospital, Skejby, Brendstrupgaardsvej 100, 8200 Aarhus N, Denmark. annekaltoft@stofanet.dk
Source
J Am Coll Cardiol. 2009 Feb 24;53(8):658-64
Date
Feb-24-2009
Language
English
Publication Type
Article
Keywords
Aged
Angioplasty, Transluminal, Percutaneous Coronary
Coronary Disease - mortality - therapy
Drug-Eluting Stents - adverse effects
Female
Humans
Immunosuppressive Agents
Male
Middle Aged
Myocardial Infarction - etiology
Paclitaxel
Sirolimus
Stents - adverse effects
Thrombosis - etiology
Abstract
OBJECTIVES: This registry study assessed the safety and efficacy of the 2 types of drug-eluting stents (DES), sirolimus-eluting stents (SES) and paclitaxel-eluting stents (PES), compared with bare-metal stents (BMS). BACKGROUND: Drug-eluting stents may increase the risk of stent thrombosis (ST), myocardial infarction (MI), and death. METHODS: A total of 12,395 consecutive patients with coronary intervention and stent implantation recorded in the Western Denmark Heart Registry from January 2002 through June 2005 were followed up for 2 years. Data on death and MI were ascertained from national medical databases. We used Cox regression analysis to control for confounding. RESULTS: The 2-year incidence of definite ST was 0.64% in BMS patients, 0.79% in DES patients (adjusted relative risk [RR]: 1.09; 95% confidence interval [CI]: 0.72 to 1.65), 0.50% in SES patients (adjusted RR: 0.63, 95% CI: 0.35 to 1.15), and 1.30% in PES patients (adjusted RR: 1.82, 95% CI: 1.13 to 2.94). The incidence of MI was 3.8% in BMS-treated patients, 4.5% in DES-treated patients (adjusted RR: 1.24, 95% CI: 1.02 to 1.51), 4.1% in SES-treated patients (adjusted RR: 1.15, 95% CI: 0.91 to 1.47), and 5.3% in PES-treated patients (adjusted RR: 1.38, 95% CI: 1.06 to 1.81). Whereas overall 2-year adjusted mortality was similar in the BMS and the 2 DES stent groups, 12- to 24-month mortality was higher in patients treated with PES (RR 1.46, 95% CI: 1.02 to 2.09). Target lesion revascularization was reduced in both DES groups. CONCLUSIONS: During 2 years of follow-up, patients treated with PES had an increased risk of ST and MI compared with those treated with BMS and SES. Mortality after 12 months was also increased in PES patients.
Notes
Comment In: J Am Coll Cardiol. 2009 Feb 24;53(8):665-619232898
PubMed ID
19232897 View in PubMed
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Lost life years attributable to stroke among patients with nonvalvular atrial fibrillation: a nationwide population-based follow-up study.

https://arctichealth.org/en/permalink/ahliterature87754
Source
Neuroepidemiology. 2007;29(1-2):59-65
Publication Type
Article
Date
2007
Author
Frost Lars
Andersen Ljubica Vukelic
Johnsen Søren Paaske
Mortensen Leif Spange
Author Affiliation
Department of Medicine, Silkeborg Hospital and Clinical Institute, Aarhus University Hospital, Aarhus and Aalborg, Denmark. malfr@sc.aaa.dk
Source
Neuroepidemiology. 2007;29(1-2):59-65
Date
2007
Language
English
Publication Type
Article
Keywords
Adult
Age Distribution
Aged
Aged, 80 and over
Atrial Fibrillation - complications - diagnosis - mortality
Cohort Studies
Denmark - epidemiology
Female
Humans
Life expectancy
Male
Middle Aged
Sex Distribution
Stroke - etiology - mortality
Survival Rate
Abstract
AIM: We assessed the number of lost life years attributable to stroke among patients with a hospital diagnosis of nonvalvular atrial fibrillation. METHODS: We identified all patients, aged 40-89 years, with an incident hospital diagnosis of atrial fibrillation or flutter in the Danish National Registry of Patients from calendar year 1980 to 2002, and no previous or concomitant diagnosis of stroke or heart valve disease. All patients were followed in the Danish National Registry of Patients for occurrence of an incident diagnosis of stroke of any type (ischemic and/or hemorrhagic) and in the Danish Civil Registration System for emigration or change in vital status. We used multivariate Cox regression analysis with stroke as a time dependent covariate to estimate excess mortality associated with incident stroke. The baseline hazard function for mortality was computed and used for modeling lost life years by sex, age, and time to incident stroke after diagnosis of atrial fibrillation, adjusted for conditions of comorbidity and calendar year of diagnosis of atrial fibrillation. RESULTS: The mean loss of life years attributable to incident stroke within 20 years after a first diagnosis of atrial fibrillation was most frequently less than 5 years, but a mean of up to 10 years of lost life years was observed. The largest number of lost life years was observed in women, in younger patients, and in those who had a stroke early after the diagnosis of atrial fibrillation. The relative loss of life years was up to 90% of the estimated expected remaining lifetime without stroke within 20 years after the diagnosis of atrial fibrillation, and was highest in the elderly. CONCLUSION: Stroke causes a substantial loss of life years in patients with atrial fibrillation.
PubMed ID
17925595 View in PubMed
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Microalbuminuria and short-term prognosis in patients undergoing cardiac surgery.

https://arctichealth.org/en/permalink/ahliterature95203
Source
Interact Cardiovasc Thorac Surg. 2009 Sep;9(3):484-90
Publication Type
Article
Date
Sep-2009
Author
Mikkelsen Martin Majlund
Andersen Niels Holmark
Christensen Thomas Decker
Hansen Troels Krarup
Eiskjaer Hans
Mogensen Carl Erik
Hjortdal Vibeke Elisabeth
Johnsen Søren Paaske
Author Affiliation
Department of Cardiothoracic and Vascular Surgery T, Aarhus University Hospital, Skejby, Brendstrupgaardsvej 100, 8200 Aarhus N, Denmark. majlund@ki.au.dk
Source
Interact Cardiovasc Thorac Surg. 2009 Sep;9(3):484-90
Date
Sep-2009
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Albumins - metabolism
Albuminuria - complications - mortality - urine
Atrial Fibrillation - etiology
Biological Markers - urine
Cardiac Surgical Procedures - adverse effects - mortality
Creatine - urine
Denmark - epidemiology
Female
Follow-Up Studies
Heart Diseases - complications - mortality - surgery
Humans
Intensive Care
Kaplan-Meiers Estimate
Length of Stay
Male
Middle Aged
Myocardial Infarction - etiology
Odds Ratio
Prospective Studies
Registries
Renal Insufficiency - etiology
Reoperation
Risk assessment
Risk factors
Sepsis - etiology
Stroke - etiology
Surgical Procedures, Elective
Surgical Wound Infection - etiology
Time Factors
Treatment Outcome
Young Adult
Abstract
OBJECTIVES: To examine if preoperative microalbuminuria (MA) is associated with in increased risk of adverse outcomes in patients undergoing elective cardiothoracic surgery, and if adding information on MA could improve the accuracy of the additive EuroSCORE. METHODS: In a follow-up study we included 962 patients undergoing elective cardiothoracic surgery from 1 April 2005 to 30 September 2007 at our department. MA (urine albumin/creatinine ratio between 2.5-25 mg/mmol) was assessed in a morning spot-urine sample. We used population-based medical registries for 30-day follow-up and compared the length of stay and adverse outcomes including (i) all-cause death, myocardial infarction, stroke, or atrial fibrillation, (ii) surgical reintervention, renal insufficiency, sternal wound infection, or septicaemia among patients with and without MA. RESULTS: MA was found in 180 (18.7%) patients. The risk of both combined outcomes (adjusted odds ratios (ORs): 1.00 (95% confidence interval (CI): 0.77-1.30) and 1.18 (95% CI: 0.79-1.75), respectively) and most individual outcomes did not differ between the micro- and normoalbuminuric patients. The patients with MA and an additive EuroSCORE of 5 had a significantly prolonged median length of intensive care unit (ICU) stay (0.15 days [95% CI: 0.04-0.26]) and total hospital stay (0.5 days [95% CI: 0.04-0.96]). Patients with MA had a higher risk of postoperative septicaemia (OR: 12.1 [95% CI: 3.2-45.9]). Area under receiver operating characteristics curves of the EuroSCORE with regard to 30-day mortality was 0.86 both with and without MA. CONCLUSIONS: Preoperative MA in patients undergoing elective cardiothoracic surgery was not associated with most early adverse outcomes. However, risk of septicaemia was higher and patients with MA also had a marginally longer length of ICU and hospital stay. Information on preoperative MA did not improve the accuracy of the additive EuroSCORE.
PubMed ID
19549646 View in PubMed
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Paclitaxel and sirolimus eluting stents versus bare metal stents: long-term risk of stent thrombosis and other outcomes. From the Western Denmark Heart Registry.

https://arctichealth.org/en/permalink/ahliterature99564
Source
EuroIntervention. 2010 Apr;5(8):898-905
Publication Type
Article
Date
Apr-2010
Author
Jensen Lisette Okkels
Tilsted Hans Henrik
Thayssen Per
Kaltoft Anne
Maeng Michael
Lassen Jens Flensted
Hansen Knud Noerregaard
Madsen Morten
Ravkilde Jan
Johnsen Søren Paaske
Sørensen Henrik Toft
Thuesen Leif
Author Affiliation
Department of Cardiology, Odense University Hospital, Denmark. okkels@dadlnet.dk
Source
EuroIntervention. 2010 Apr;5(8):898-905
Date
Apr-2010
Language
English
Publication Type
Article
Keywords
Aged
Angioplasty, Transluminal, Percutaneous Coronary - adverse effects - instrumentation - mortality
Cardiovascular Agents - administration & dosage
Chi-Square Distribution
Coronary Artery Disease - mortality - therapy
Denmark - epidemiology
Drug-Eluting Stents
Female
Follow-Up Studies
Humans
Incidence
Kaplan-Meiers Estimate
Male
Metals
Middle Aged
Myocardial Infarction - etiology
Paclitaxel - administration & dosage
Platelet Aggregation Inhibitors - therapeutic use
Proportional Hazards Models
Prosthesis Design
Registries
Risk assessment
Risk factors
Sirolimus - administration & dosage
Stents
Thrombosis - etiology - mortality
Time Factors
Treatment Outcome
Abstract
AIMS: Stent thrombosis is a serious complication of percutaneous coronary intervention (PCI). We examined the incidence of stent thrombosis and other outcomes in patients treated with PCI and paclitaxeleluting stents (PES), sirolimus-eluting stents (SES) or bare-metal stents (BMS). METHODS AND RESULTS: All patients who underwent PES, SES or BMS implantation from January 2002 to June 2005 were identified in the population-based Western Denmark Heart Registry. All were followed for 36 months. Cox regression analysis was used to estimate relative risk (RR), controlling for covariates. A total of 12,374 patients were treated with stents: 1,298 with PES, 2,202 with SES and 8,847 with BMS. The three-year incidence of definite stent thrombosis was similar in the DES group (1.1%) and in the BMS group (0.7%) (adjusted relative risk [RR]: 1.24; 95% confidence interval [CI]: 0.85-1.81). Very late definite stent thrombosis occurred more frequently in DES-treated patients (adjusted RR: 2.89, 95% CI: 1.48- 5.65). The three-year mortality rate did not differ significantly between the two groups. Target lesion revascularisation (TLR) was lower in DES-treated patients than in BMS-treated patients (adjusted RR: 0.71, 95% CI: 0.63-0.81). CONCLUSIONS: An increased risk of very late definite stent thrombosis was observed in DES-treated patients compared with BMS-treated patients, but a similar mortality was detected. TLR continued to be lower among patients receiving DES.
PubMed ID
20542774 View in PubMed
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Quality of care and length of hospital stay among patients with stroke.

https://arctichealth.org/en/permalink/ahliterature89334
Source
Med Care. 2009 May;47(5):575-82
Publication Type
Article
Date
May-2009
Author
Svendsen Marie Louise
Ehlers Lars Holger
Andersen Grethe
Johnsen Søren Paaske
Author Affiliation
Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Allé 43-45, Aarhus N, Denmark. mls@dce.au.dk
Source
Med Care. 2009 May;47(5):575-82
Date
May-2009
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Denmark
Female
Follow-Up Studies
Humans
Length of Stay - statistics & numerical data
Male
Middle Aged
Quality of Health Care
Stroke - drug therapy - therapy
Abstract
BACKGROUND: The relationship between quality of care and economic outcome measures, including length of stay (LOS), among patients with stroke remains to be clarified. OBJECTIVES: To determine whether quality of care is associated with LOS among patients with stroke. METHODS: In this population-based follow-up study, we included 2636 patients with stroke who had been admitted to dedicated stroke units in Aarhus County, Denmark, from 2003 to 2005. Quality of care was measured as fulfillment of 12 criteria: early admission to a stroke unit, early antiplatelet therapy, early anticoagulant therapy, early computed tomography/magnetic resonance imaging scan, early water swallowing test, early mobilization, early intermittent catheterization, early deep venous thromboembolism prophylaxis, early assessment by a physiotherapist and an occupational therapist, and early assessment of nutritional and constipation risk. Data were analyzed by linear regression clustered at the stroke units by multilevel modeling. RESULTS: Median LOS was 13 days (25th and 75th percentiles: 7, 33). Meeting each quality of care criteria was associated with shorter LOS. Adjusted relative LOS ranged from 0.67 (95% confidence interval (CI): 0.61-0.73) to 0.87 (95% CI: 0.81-0.93). The association between meeting more quality of care criteria and LOS followed a dose-response effect, that is, patients who fulfilled between 75% and 100% of the quality of care criteria were hospitalized about one-half as long as patients who fulfilled between 0% and 24% of the criteria (adjusted relative LOS: 0.53, 95% CI: 0.48-0.59). CONCLUSIONS: Higher quality of care during the early phase of stroke was associated with shorter LOS among patients with stroke.
PubMed ID
19365293 View in PubMed
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Risk of hospitalization for acute pancreatitis associated with conventional and atypical antipsychotics: a population-based case-control study.

https://arctichealth.org/en/permalink/ahliterature84819
Source
Pharmacotherapy. 2008 Jan;28(1):27-34
Publication Type
Article
Date
Jan-2008
Author
Gasse Christiane
Jacobsen Jacob
Pedersen Lars
Mortensen Preben Bo
Nørgaard Mette
Sørensen Henrik Toft
Johnsen Søren Paaske
Author Affiliation
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark. cgas@dce.au.dk
Source
Pharmacotherapy. 2008 Jan;28(1):27-34
Date
Jan-2008
Language
English
Publication Type
Article
Abstract
STUDY OBJECTIVE: To examine the association of atypical and conventional antipsychotics with the risk of hospitalization for acute pancreatitis. DESIGN: Population-based, case-control study. DATA SOURCE: Health care databases of Northern Denmark. PATIENTS: A total of 3083 adults hospitalized with acute pancreatitis (case patients) and 30,830 control subjects. MEASUREMENTS AND MAIN RESULTS: Controls were selected from the general population by using risk-set sampling and were matched to case patients by age and sex. The date of the case patients' admission for acute pancreatitis was used as the index date for the matched control subjects. Conditional logistic regression analysis was used to estimate rate ratios (RRs) for hospitalization due to acute pancreatitis in current users (0-90 days before admission or index date) and former users (> 90 days before admission or index date) of atypical and conventional antipsychotics compared with nonusers of the respective antipsychotics, while controlling for covariates and stratifying by age. Fifteen case patients (0.5%) were current users of atypical antipsychotics, and 128 case patients (4.2%) were current users of conventional antipsychotics. Adjusted RRs for current use and former use of atypical antipsychotics were 0.6 (95% confidence interval [CI] 0.3-1.1) and 0.3 (95% CI 0.1-0.9), respectively. A trend was noted for increasing risk of hospitalization due to acute pancreatitis with decreasing potency of conventional antipsychotics, with adjusted RRs of 1.2 (95% CI 0.7-2.0) for high-potency, 1.5 (95% CI 1.0-2.2) for intermediate-potency, and 2.8 (95% CI 2.0-3.8) for low-potency conventional antipsychotics, which was largely age-modified with an adjusted RR of 5.2 (95% CI 3.2-8.5) in patients younger than 60 years, compared with an adjusted RR of 1.5 (95% CI 0.9-2.5) in older users. Former use of conventional antipsychotics of any kind was associated with an adjusted RR of 1.6 (95% CI 1.4-1.9). CONCLUSIONS: Current use of low-potency conventional, but not atypical, antipsychotics was associated with an increased risk of hospitalization for acute pancreatitis.
PubMed ID
18154471 View in PubMed
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Use of statins and risk of hospitalization with dementia: a Danish population-based case-control study.

https://arctichealth.org/en/permalink/ahliterature92539
Source
Alzheimer Dis Assoc Disord. 2009 Jan-Mar;23(1):18-22
Publication Type
Article
Author
Horsdal Henriette Thisted
Olesen Anne Vingård
Gasse Christiane
Sørensen Henrik Toft
Green Robert C
Johnsen Søren Paaske
Author Affiliation
Department of Clinical Epidemiology section, Unit for Psychiatric Research, Aalborg Psychiatric Hospital , University of Aarhus, Aarhus, Denmark. ht@dce.au.dk
Source
Alzheimer Dis Assoc Disord. 2009 Jan-Mar;23(1):18-22
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Case-Control Studies
Dementia - drug therapy
Denmark
Female
Hospitalization - statistics & numerical data
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
Male
Middle Aged
Risk factors
Abstract
Several epidemiologic studies have indicated reduced risk of dementia among users of statins. We assessed the risk of hospitalization with dementia associated with use of statins in a population-based case-control study in 4 Northern Danish counties in the period 1991 to 2005. We identified 11,039 cases with dementia and 110,340 age- matched and sex-matched population controls using data from the National Patient Registry, the Danish Psychiatric Central Register, and the Civil Registration System. Prescriptions for statins filled before the admission for dementia were identified using population-based prescription databases. We used conditional logistic regression analysis to compute relative risk of hospitalization with dementia associated with use of statins using nonusers as reference group. We found an overall reduced risk of hospitalization with dementia among statin users (adjusted odds ratio: 0.67, 95% confidence intervals: 0.60-0.75). The reduced risk associated with statin use remained robust in various subanalyses, however, we found no clear dose-response pattern between the number of filled prescriptions for statin and the risk of hospitalization with dementia. In conclusion, we found a reduced risk of hospitalization with dementia among users of statins, however, whether this association is causal remains to be clarified.
PubMed ID
18695588 View in PubMed
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7 records – page 1 of 1.