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Return to the workforce following infective endocarditis-A nationwide cohort study.

https://arctichealth.org/en/permalink/ahliterature287600
Source
Am Heart J. 2018 Jan;195:130-138
Publication Type
Article
Date
Jan-2018
Author
Jawad H Butt
Kristian Kragholm
Michael Dalager-Pedersen
Rasmus Rørth
Søren L Kristensen
Mavish S Chaudry
Nana Valeur
Lauge Østergaard
Christian Torp-Pedersen
Gunnar H Gislason
Lars Køber
Emil L Fosbøl
Source
Am Heart J. 2018 Jan;195:130-138
Date
Jan-2018
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Denmark - epidemiology
Endocarditis, Bacterial - epidemiology - rehabilitation
Female
Follow-Up Studies
Humans
Incidence
Male
Middle Aged
Population Surveillance
Return to Work - statistics & numerical data
Risk factors
Sick Leave - trends
Social Class
Young Adult
Abstract
The ability to return to work after infective endocarditis (IE) holds important socioeconomic consequences for both patients and society, yet data on this issue are sparse. We examined return to the workforce and associated factors in IE patients of working age.
Using Danish nationwide registries, we identified 1,065 patients aged 18-60 years with a first-time diagnosis of IE (1996-2013) who were part of the workforce prior to admission and alive at discharge.
One year after discharge, 765 (71.8%) patients had returned to the workforce, 130 (12.2%) were on paid sick leave, 76 (7.1%) received disability pension, 23 (2.2%) were on early retirement, 65 (6.1%) had died, and 6 (0.6%) had emigrated. Factors associated with return to the workforce were identified using multivariable logistic regression. Younger age (18-40 vs 56-60 years; odds ratio, 2.85; 95% CI, 1.71-4.76) and higher level of education (higher educational level vs basic school; 5.47, 2.05-14.6) and income (highest quartile vs lowest; 3.17, 1.85-5.46) were associated with return to the workforce. Longer length of hospital stay (>90 vs 14-30 days; 0.16, 0.07-0.38); stroke during IE admission (0.38, 0.21-0.71); and a history of chronic kidney disease (0.29, 0.11-0.75), chronic obstructive pulmonary disease (0.31, 0.13-0.71), and malignancy (0.39, 0.22-0.69) were associated with a lower likelihood of returning to the workforce.
Seven of 10 patients who were part of the workforce prior to IE and alive at discharge were part of the workforce 1 year later. Younger age, higher socioeconomic status, and absence of major comorbidities were associated with return to the workforce.
PubMed ID
29224640 View in PubMed
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ß-Blocker-Associated Risks in Patients With Uncomplicated Hypertension Undergoing Noncardiac Surgery.

https://arctichealth.org/en/permalink/ahliterature271714
Source
JAMA Intern Med. 2015 Dec;175(12):1923-31
Publication Type
Article
Date
Dec-2015
Author
Mads E Jørgensen
Mark A Hlatky
Lars Køber
Robert D Sanders
Christian Torp-Pedersen
Gunnar H Gislason
Per Føge Jensen
Charlotte Andersson
Source
JAMA Intern Med. 2015 Dec;175(12):1923-31
Date
Dec-2015
Language
English
Publication Type
Article
Keywords
Adrenergic beta-Antagonists - adverse effects - therapeutic use
Adult
Aged
Cause of Death - trends
Denmark - epidemiology
Female
Follow-Up Studies
General Surgery
Humans
Hypertension - complications - drug therapy
Incidence
Male
Middle Aged
Myocardial Infarction - chemically induced - epidemiology
Preoperative Period
Prognosis
Propensity Score
Registries
Retrospective Studies
Risk factors
Stroke - chemically induced - epidemiology
Young Adult
Abstract
Perioperative ß-blocker strategies are important to reduce risks of adverse events. Effectiveness and safety may differ according to patients' baseline risk.
To determine the risk of major adverse cardiovascular events (MACEs) associated with long-term ß-blocker therapy in patients with uncomplicated hypertension undergoing noncardiac surgery.
Association study based on in-hospital records and out-of-hospital pharmacotherapy use using a Danish nationwide cohort of patients with uncomplicated hypertension treated with at least 2 antihypertensive drugs (ß-blockers, thiazides, calcium antagonists, or renin-angiotensin system [RAS] inhibitors) undergoing noncardiac surgery between 2005 and 2011.
Various antihypertensive treatment regimens, chosen as part of usual care.
Thirty-day risk of MACEs?(cardiovascular death, nonfatal ischemic stroke, nonfatal myocardial infarction) and all-cause mortality, assessed using multivariable logistic regression models and adjusted numbers needed to harm (NNH).
The baseline characteristics of the 14,644 patients who received ß-blockers (65% female, mean [SD] age, 66.1 [12.0] years) were similar to those of the 40,676 patients who received other antihypertensive drugs (57% female, mean [SD] age, 65.9 [11.8] years). Thirty-day MACEs occurred in 1.3% of patients treated with ß-blockers compared with 0.8% of patients not treated with ß-blockers (P?
Notes
Comment In: BMJ. 2015;351:h534926447201
PubMed ID
26436291 View in PubMed
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Sulfonylurea in combination with insulin is associated with increased mortality compared with a combination of insulin and metformin in a retrospective Danish nationwide study.

https://arctichealth.org/en/permalink/ahliterature271849
Source
Diabetologia. 2015 Jan;58(1):50-8
Publication Type
Article
Date
Jan-2015
Author
Ulrik M Mogensen
Charlotte Andersson
Emil L Fosbøl
Tina K Schramm
Allan Vaag
Nikolai M Scheller
Christian Torp-Pedersen
Gunnar Gislason
Lars Køber
Source
Diabetologia. 2015 Jan;58(1):50-8
Date
Jan-2015
Language
English
Publication Type
Article
Keywords
Adult
Aged
Denmark - epidemiology
Diabetes Mellitus, Type 2 - complications - drug therapy - mortality
Diabetic Angiopathies - mortality
Drug Therapy, Combination
Female
Humans
Hypoglycemic Agents - administration & dosage
Insulin - administration & dosage
Male
Metformin - administration & dosage
Middle Aged
Myocardial Infarction - complications - mortality
Registries
Retrospective Studies
Sulfonylurea Compounds - administration & dosage
Abstract
Individual sulfonylureas (SUs) and metformin have, in some studies, been associated with unequal hypoglycaemic, cardiovascular and mortality risks when used as monotherapy in type 2 diabetes. We investigated the outcomes in patients treated with different combinations of SUs and insulin vs a combination of metformin and insulin in a retrospective nationwide study.
All Danish individuals using dual therapy with SU?+?insulin or metformin?+?insulin without prior myocardial infarction (MI) or stroke were followed from 1 January 1997 to 31 December 2009 in nationwide registries. Risks of all-cause mortality, cardiovascular death, hypoglycaemia and a composite endpoint of MI, stroke and cardiovascular death were compared. Rate ratios (RR) [95% CIs] were calculated using time-dependent multivariable Poisson regression analysis.
A total of 11,081 patients used SU?+?insulin and 16,910 used metformin?+?insulin. Patients receiving metformin?+?insulin were younger and had less comorbidity and a longer history of glucose-lowering treatment. SU?+?insulin was associated with higher mortality rates compared with metformin?+?insulin (76-126 vs 23 per 1,000 person-years). In adjusted analyses, SU?+?insulin was associated with increased all-cause mortality (RR 1.81 [1.63, 2.01]), cardiovascular death (RR 1.35 [1.14, 1.60]) and the composite endpoint (RR 1.25 [1.09, 1.42]) compared with metformin?+?insulin. Hypoglycaemia was more frequent with SU?+?insulin than with metformin?+?insulin (17-23 vs six events per 1,000 person-years) and was associated with increased mortality (RR 2.13 [1.97, 2.37]). There were no significant differences in risk between individual SUs in combination with insulin.
In combination with insulin, the use of SUs was associated with increased mortality compared with metformin. There were no significant risk differences between SUs.
Notes
Comment In: Diabetologia. 2015 Jan;58(1):1-325322844
PubMed ID
25205223 View in PubMed
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Prognostic value of reduced discrimination and oedema on cerebral computed tomography in a daily clinical cohort of out-of-hospital cardiac arrest patients.

https://arctichealth.org/en/permalink/ahliterature272284
Source
Resuscitation. 2015 Jul;92:141-7
Publication Type
Article
Date
Jul-2015
Author
Sandra Langkjær
Christian Hassager
Jesper Kjaergaard
Idrees Salam
Jakob Hartvig Thomsen
Freddy K Lippert
Michael Wanscher
Lars Køber
Niklas Nielsen
Helle Søholm
Source
Resuscitation. 2015 Jul;92:141-7
Date
Jul-2015
Language
English
Publication Type
Article
Keywords
Aged
Brain Edema - etiology - mortality - radiography
Cardiopulmonary Resuscitation - methods
Denmark - epidemiology
Female
Follow-Up Studies
Humans
Male
Middle Aged
Out-of-Hospital Cardiac Arrest - complications - mortality - therapy
Prognosis
Survival Rate - trends
Tomography, X-Ray Computed - methods
Abstract
Assessment of prognosis after out-of-hospital cardiac arrest (OHCA) is challenging. Cerebral computed tomography (cCT) scans are widely available, but the use in prognostication of comatose OHCA-patients is unclear. We evaluated the prognostic value of cCT in a clinical cohort of OHCA-patients.
A total of 1120 consecutive OHCA-patients with cardiac aetiology and successful or on-going resuscitation at hospital arrival were included (2002-2011). Utstein-criteria for registration of pre-hospital data and review of patient-charts for post-resuscitation care including cCT results were used. The primary endpoint was 30-day mortality analysed by log-rank and multivariate Cox-regression analyses.
A cCT scan was performed in 341(30%) of the clinical OHCA-cohort, and an early CT (
Notes
Comment In: Resuscitation. 2015 Jul;92:A125959981
PubMed ID
25882783 View in PubMed
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Patient adherence to evidence-based pharmacotherapy in systolic heart failure and the transition of follow-up from specialized heart failure outpatient clinics to primary care.

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

https://arctichealth.org/en/permalink/ahliterature117093
Source
Heart. 2013 May;99(9):655-60
Publication Type
Article
Date
May-2013
Author
Aziza Azimi
Mette Gitz Charlot
Christian Torp-Pedersen
Gunnar H Gislason
Lars Køber
Lisette Okkels Jensen
Per Thayssen
Jan Ravkilde
Hans-Henrik Tilsted
Jens Flensted Lassen
Leif Thuesen
Author Affiliation
Department of Cardiology, Gentofte Hospital, post 635, Niels Andersens Vej 65, Hellerup 2900, Denmark. Aziza.Azimi@regionh.dk
Source
Heart. 2013 May;99(9):655-60
Date
May-2013
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Body mass index
Cohort Studies
Coronary Angiography
Coronary Artery Disease - complications - mortality
Denmark - epidemiology
Female
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Obesity - complications - mortality
Overweight - complications - mortality
Proportional Hazards Models
Registries
Retrospective Studies
Abstract
Obesity is paradoxically associated with enhanced survival in patients with established cardiovascular disease. We explored this paradox further by examining the influence of obesity on survival in patients with verified atherosclerotic heart disease.
This retrospective registry based cohort study included all patients from the Western Denmark Heart Registry with coronary atherosclerosis confirmed by coronary angiography from January 2000 to December 2010. Patients were divided into eight groups according to body mass index (BMI) based on WHO BMI classification.
Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark.
The study included 37 573 patients (70.7% men) with a mean age of (66.3 ± 11.1) years. During the 11 years of follow-up, 5866 (15.6%) patients died. Multivariable analysis confirmed that the risk of death was the lowest among the preobese patients (27.5 = BMI
Notes
Comment In: Heart. 2013 May;99(9):596-823470341
PubMed ID
23335496 View in PubMed
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Sudden cardiovascular death following myocardial infarction: the importance of left ventricular systolic dysfunction and congestive heart failure.

https://arctichealth.org/en/permalink/ahliterature76254
Source
Int J Cardiol. 2005 Sep 30;104(2):184-9
Publication Type
Article
Date
Sep-30-2005
Author
Steen Z Abildstrom
Michael M Ottesen
Christian Rask-Madsen
Per K Andersen
Susanne Rosthøj
Christian Torp-Pedersen
Lars Køber
Author Affiliation
National Institute of Public Health, Øster Farimagsgade 5, DK-1399 Copenhagen, Denmark. stabil@dadlnet.dk
Source
Int J Cardiol. 2005 Sep 30;104(2):184-9
Date
Sep-30-2005
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Antihypertensive Agents - therapeutic use
Death, Sudden, Cardiac - epidemiology - etiology
Denmark - epidemiology
Echocardiography
Female
Follow-Up Studies
Heart Failure, Congestive - mortality - physiopathology - prevention & control
Humans
Indoles - therapeutic use
Male
Middle Aged
Multivariate Analysis
Myocardial Infarction - drug therapy - mortality - physiopathology
Odds Ratio
Proportional Hazards Models
Randomized Controlled Trials
Registries
Research Support, Non-U.S. Gov't
Risk factors
Systole
Ventricular Dysfunction, Left - mortality - physiopathology - prevention & control
Abstract
BACKGROUND: To study the prognostic information of congestive heart failure (CHF) and left ventricular systolic dysfunction regarding sudden and non-sudden cardiovascular death (SCD and non-SCD) in patients with acute myocardial infarction (MI), as this may indicate the potential benefit of implantable defibrillators. METHODS: Data from consecutive patients with acute MI screened in 1990-92 for the TRAndolapril Cardiac Evaluation (TRACE) study were entered into a registry. A total of 5502 patients were alive 30 days after the MI and were followed for up to 4 years with respect to cause of death. SCD was defined as cardiovascular death within 1 h of onset of symptoms. An echocardiography was performed 1-6 days after the admission and evaluated centrally using the wall motion index (WMI). RESULTS: Half of the patients had CHF and 17% of the patients had WMI
PubMed ID
16168812 View in PubMed
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Targeted temperature management at 33°C versus 36°C and impact on systemic vascular resistance and myocardial function after out-of-hospital cardiac arrest: a sub-study of the Target Temperature Management Trial.

https://arctichealth.org/en/permalink/ahliterature264654
Source
Circ Cardiovasc Interv. 2014 Oct;7(5):663-72
Publication Type
Article
Date
Oct-2014
Author
John Bro-Jeppesen
Christian Hassager
Michael Wanscher
Morten Østergaard
Niklas Nielsen
David Erlinge
Hans Friberg
Lars Køber
Jesper Kjaergaard
Source
Circ Cardiovasc Interv. 2014 Oct;7(5):663-72
Date
Oct-2014
Language
English
Publication Type
Article
Keywords
Aged
Cold Temperature - adverse effects
Denmark
Echocardiography
Female
Heart rate
Hemodynamics
Humans
Hypothermia, Induced - methods
Male
Middle Aged
Myocardium - chemistry - metabolism
Out-of-Hospital Cardiac Arrest - physiopathology - therapy
Stroke Volume
Vascular Resistance
Abstract
Cardiovascular dysfunction is common after out-of-hospital cardiac arrest as part of the postcardiac arrest syndrome, and hypothermia may pose additional impact on hemodynamics. The aim was to investigate systemic vascular resistance index (SVRI), cardiac index, and myocardial performance at a targeted temperature management of 33°C (TTM33) versus 36°C (TTM36).
Single-center substudy of 171 patients included in the Target Temperature Management Trial (TTM Trial) randomly assigned to TTM33 or TTM36 for 24 hours after out-of-hospital cardiac arrest. Mean arterial pressure =65 mm Hg and central venous pressure of 10 to 15 mm Hg were hemodynamic treatment goals. Hemodynamic evaluation was performed by serial right heart catheterization and transthoracic echocardiography. Primary end point was SVRI after 24 hours of cooling and secondary end points included mean SVRI, cardiac index, systolic function, and lactate levels. The TTM33 group had a significant increase in SVRI compared with TTM36 (2595; 95% confidence interval, 2422-2767) versus 1960 (95% confidence interval, 1787-2134) dynes m(2)/s per cm(5); P
PubMed ID
25270900 View in PubMed
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Noncardiac surgery in patients with aortic stenosis: a contemporary study on outcomes in a matched sample from the Danish health care system.

https://arctichealth.org/en/permalink/ahliterature264669
Source
Clin Cardiol. 2014 Nov;37(11):680-6
Publication Type
Article
Date
Nov-2014
Author
Charlotte Andersson
Mads Emil Jørgensen
Andreas Martinsson
Peter Waede Hansen
J. Gustav Smith
Per Føge Jensen
Gunnar H Gislason
Lars Køber
Christian Torp-Pedersen
Source
Clin Cardiol. 2014 Nov;37(11):680-6
Date
Nov-2014
Language
English
Publication Type
Article
Keywords
Aged
Aortic Valve Stenosis - mortality
Denmark - epidemiology
Elective Surgical Procedures - mortality
Emergencies
Female
Humans
Male
Matched-Pair Analysis
Myocardial Infarction - epidemiology
Registries
Stroke - epidemiology
Surgical Procedures, Operative - mortality
Abstract
Past research has identified aortic stenosis (AS) as a major risk factor for adverse outcomes in noncardiac surgery; however, more contemporary studies have questioned the grave prognosis. To further our understanding of this, the risks of a 30-day major adverse cardiovascular event (MACE) and all-cause mortality were investigated in a contemporary Danish cohort.
AS is not an independent risk factor for adverse outcomes in noncardiac surgery.
All patients with and without diagnosed AS who underwent noncardiac surgery in 2005 to 2011 were identified through nationwide administrative registers. AS patients (n = 2823; mean age, 75.5 years, 53% female) were matched with patients without AS (n = 2823) on propensity score for AS and surgery type.
In elective surgery, MACE (ie, nonfatal myocardial infarction, ischemic stroke, or cardiovascular death) occurred in 66/1772 (3.7%) of patients with AS and 52/1772 (2.9%) of controls (P = 0.19), whereas mortality occurred in 67/1772 (3.8%) AS patients and 51/1772 (2.9%) controls (P = 0.13). In emergency surgery, 163/1051 (15.5%) AS patients and 120/1051 (11.4%) controls had a MACE (P = 0.006), whereas 225/1051 (21.4%) vs 179/1051 (17.0%) AS patients and controls died, respectively (P = 0.01). Event rates were higher for those with symptoms (defined as use of nitrates, congestive heart failure, or use of loop diuretics), compared with those without symptoms (P
PubMed ID
25224044 View in PubMed
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161 records – page 1 of 17.