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All-cause mortality and cardiovascular effects associated with the DPP-IV inhibitor sitagliptin compared with metformin, a retrospective cohort study on the Danish population.

https://arctichealth.org/en/permalink/ahliterature258352
Source
Diabetes Obes Metab. 2014 Mar;16(3):231-6
Publication Type
Article
Date
Mar-2014
Author
N M Scheller
U M Mogensen
C. Andersson
A. Vaag
C. Torp-Pedersen
Author Affiliation
Institute of Health, Science and Technology, Aalborg University, Aalborg, Denmark.
Source
Diabetes Obes Metab. 2014 Mar;16(3):231-6
Date
Mar-2014
Language
English
Publication Type
Article
Keywords
Denmark - epidemiology
Diabetes Mellitus, Type 2 - blood - drug therapy - mortality
Diabetic Angiopathies - blood - mortality
Dipeptidyl-Peptidase IV Inhibitors - adverse effects - therapeutic use
Female
Humans
Hypoglycemic Agents - adverse effects - therapeutic use
Male
Metformin - adverse effects - therapeutic use
Middle Aged
Myocardial Infarction - blood - mortality
Proportional Hazards Models
Pyrazines - adverse effects - therapeutic use
Retrospective Studies
Stroke - blood - mortality
Treatment Outcome
Triazoles - adverse effects - therapeutic use
Abstract
We performed a retrospective cohort study, investigating the clinical outcomes including mortality and cardiovascular disease of sitagliptin compared with metformin monotherapies.
All patients receiving monotherapy with the dipeptidyl peptidase-IV inhibitors (DPP-IV) inhibitor sitagliptin between 1 January 2007 and 31 December 2011 were identified. All-cause mortality and a composite endpoint of stroke, acute myocardial infarction (AMI) and all-cause mortality associated with sitagliptin monotherapy were compared with metformin monotherapy. In addition, as an indicator of efficacy we analysed the hazard ratio of changing treatment.
A total of 84?756 patients were included in the analysis, 1228 (1.4%) received sitagliptin monotherapy whereas the remaining 83?528 (98.6%) patients received metformin monotherapy. Patients using metformin were younger than patients using sitagliptin (59.0?±?15.2 vs. 62.5?±?13.1) were less often male (51.6 vs. 54.2%) and had longer treatment duration with monotherapy (1.8?±?1.3 vs. 0.9?±?1.1?years). Compared with patients receiving metformin, patients using sitagliptin showed no statistically significant excess risks of all-cause mortality [hazard ratio, 1.25; 95% confidence interval (CI), 0.92-1.71; p?=?0.153] or the composite endpoint (hazard ratio, 1.22; 95% CI, 0.92-1.61; p?=?0.164). However, the use of sitagliptin monotherapy was associated with an increased likelihood of changing treatment (hazard ratio, 4.88; 95% CI, 4.46-5.35; p?
PubMed ID
24020750 View in PubMed
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[An increased risk of death from ischemic heart disease in men with low blood concentrations of total cholesterol and low-density lipoprotein cholesterol].

https://arctichealth.org/en/permalink/ahliterature222417
Source
Ter Arkh. 1993;65(4):27-32
Publication Type
Article
Date
1993
Author
A M Kalinina
L V Chazova
N V Perova
L I Pavlova
V V Shchepkin
Source
Ter Arkh. 1993;65(4):27-32
Date
1993
Language
Russian
Publication Type
Article
Keywords
Adult
Cholesterol - blood
Cholesterol, LDL - blood
Humans
Male
Middle Aged
Moscow - epidemiology
Myocardial Infarction - blood - mortality
Myocardial Ischemia - blood - mortality
Prognosis
Prospective Studies
Risk factors
Sex Distribution
Urban Population - statistics & numerical data
Abstract
A number of epidemiological surveys have recently established that in populations with the lowest levels of total cholesterol (TC) and LDL cholesterol (LDLC) death rates grow due to both malignant and cardiovascular diseases. The results of a detailed study on multifactor prevention of coronary heart disease (CHD) in an open population of Moscow males aged 40-59 to elucidate the relations between TC, HDL cholesterol, LDLC and CHD mortality demonstrated that low levels of TC are markers, but not a factor of CHD and sudden death risk in low-educated subjects free of CHD symptoms. When planning mass measures to primarily prevent CHD, subjects with low cholesterol levels should be given a special care as well as those with hypercholesterolemia.
PubMed ID
8059402 View in PubMed
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Association between increased levels of reverse triiodothyronine and mortality after acute myocardial infarction.

https://arctichealth.org/en/permalink/ahliterature53826
Source
Am J Med. 2001 Dec 15;111(9):699-703
Publication Type
Article
Date
Dec-15-2001
Author
L. Friberg
V. Drvota
A H Bjelak
G. Eggertsen
S. Ahnve
Author Affiliation
Department of Cardiology, Karolinska Institutet at Huddinge University Hospital, Stockholm, Sweden.
Source
Am J Med. 2001 Dec 15;111(9):699-703
Date
Dec-15-2001
Language
English
Publication Type
Article
Keywords
Aged
Biological Markers
Female
Humans
Male
Multivariate Analysis
Myocardial Infarction - blood - mortality
Prognosis
Proportional Hazards Models
Research Support, Non-U.S. Gov't
Survival Analysis
Sweden - epidemiology
Triiodothyronine, Reverse - blood
Abstract
PURPOSE: The thyroid hormone system may be downregulated temporarily in patients who are severely ill. This "euthyroid sick syndrome" may be an adaptive response to conserve energy. However, thyroid hormone also has beneficial effects on the cardiovascular system, such as improving cardiac function, reducing systemic vascular resistance, and lowering serum cholesterol levels. We investigated whether thyroid hormone levels obtained at the time of myocardial infarction are associated with subsequent mortality. PATIENTS AND METHODS: Serum levels of thyroid hormones (triiodothyronine [T3], reverse T3, free thyroxine [T4], and thyroid-stimulating hormone) were measured in 331 consecutive patients with acute myocardial infarction (mean age [+/- SD], 68 +/- 12 years), from samples obtained at the time of admission. RESULTS: Fifty-three patients (16%) died within 1 year. Ten percent (16 of 165) of patients with reverse T3 levels (an inactive metabolite) >0.41 nmol/L (the median value) died within the first week after myocardial infarction, compared with none of the 166 patients with lower levels (P 0.41 nmol/L were associated with an increased risk of 1-year mortality (hazard ratio = 3.0; 95% confidence interval: 1.4 to 6.3; P = 0.005), independent of age, previous myocardial infarction, prior angina, heart failure, serum creatinine level, and peak serum creatine kinase-MB fraction levels. CONCLUSION: Determination of reverse T3 levels may be a valuable and simple aid to improve identification of patients with myocardial infarction who are at high risk of subsequent mortality.
PubMed ID
11747849 View in PubMed
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Associations of serum lipid concentrations and obesity with mortality in women: 20 year follow up of participants in prospective population study in Gothenburg, Sweden.

https://arctichealth.org/en/permalink/ahliterature54968
Source
BMJ. 1993 Nov 27;307(6916):1385-8
Publication Type
Article
Date
Nov-27-1993
Author
C. Bengtsson
C. Björkelund
L. Lapidus
L. Lissner
Author Affiliation
Department of Primary Health Care, University of Gothenburg, Sweden.
Source
BMJ. 1993 Nov 27;307(6916):1385-8
Date
Nov-27-1993
Language
English
Publication Type
Article
Keywords
Adult
Body mass index
Cholesterol - blood
Cohort Studies
Female
Humans
Middle Aged
Myocardial Infarction - blood - mortality
Obesity - blood - mortality
Prospective Studies
Random Allocation
Research Support, Non-U.S. Gov't
Risk factors
Sweden - epidemiology
Triglycerides - blood
Abstract
OBJECTIVE--To examine association of different measures of serum lipid concentration and obesity with mortality in women. DESIGN--Prospective observational study initiated in 1968-9, follow up examination after 12 years, and follow up study based on death certificates after 20 years. SETTING--Gothenburg, Sweden. SUBJECTS--1462 randomly selected women aged 38-60 at start of study. MAIN OUTCOME MEASURES--Total mortality and death from myocardial infarction as predicted by serum cholesterol and triglyceride concentrations, body mass index, and ratio of circumference of waist to circumference of hips. RESULTS--170 women died during follow up, 26 from myocardial infarction. Serum triglyceride concentration and waist:hip ratio were significantly associated with both end points (relative risk of total mortality for highest quarter of triglyceride concentration v lower three quarters 1.86 (95% confidence interval 1.30 to 2.67); relative risk for waist:hip ratio 1.67 (1.18 to 2.36)). These associations remained after adjustment for background variables. Serum cholesterol concentration and body mass index were initially associated with death from myocardial infarction, but association was lost after adjustment for background variables. Serum triglyceride concentration and waist:hip ratio were independently predictive of both end points (logistic regression coefficient for total mortality for triglyceride 0.514 (SE 0.150), p = 0.0006; coefficient for waist:hip ratio 7.130 (1.92), p = 0.0002) whereas the other two risk factors were not (coefficient for total mortality for cholesterol concentration -0.102 (0.079), p = 0.20; coefficient for body mass index -0.051 (0.027), p = 0.05). CONCLUSIONS--Lipid risk profile appears to be different in men and women given that serum triglyceride concentration was an independent risk factor for mortality while serum cholesterol concentration was not. Consistent with previous observations in men, localisation of adipose tissue was more important than obesity per se as risk factor in women.
Notes
Comment In: ACP J Club. 1994 May-Jun;120 Suppl 3:79
PubMed ID
8274890 View in PubMed
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Clinical Characteristics and Outcomes of Patients with Myocardial Infarction, Myocardial Injury, and Nonelevated Troponins.

https://arctichealth.org/en/permalink/ahliterature275003
Source
Am J Med. 2016 Apr;129(4):446.e5-446.e21
Publication Type
Article
Date
Apr-2016
Author
Laura Sarkisian
Lotte Saaby
Tina S Poulsen
Oke Gerke
Nikolaj Jangaard
Susanne Hosbond
Axel C P Diederichsen
Kristian Thygesen
Hans Mickley
Source
Am J Med. 2016 Apr;129(4):446.e5-446.e21
Date
Apr-2016
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Denmark - epidemiology
Female
Humans
Male
Middle Aged
Myocardial Infarction - blood - mortality
Prospective Studies
Troponin T - blood
Abstract
Cardiac troponins have emerged as the preferred biomarkers for detecting myocardial necrosis and diagnosing myocardial infarction. However, current cardiac troponin assays do not discriminate between ischemic and nonischemic causes of myocardial cell death. Thus, when an increased troponin value is encountered in the absence of obvious myocardial ischemia, a careful search for other clinical conditions is crucial.
In 2010 to 2011, we prospectively studied hospitalized patients who had cardiac troponin I measured on clinical indication. An acute myocardial infarction was diagnosed in cases of a cardiac troponin I increase or decrease pattern with at least 1 value >30 ng/L (99th percentile) together with myocardial ischemia. Myocardial injury was defined as cardiac troponin I values >30 ng/L, but without signs or symptoms indicating overt cardiac ischemia. Patients with peak values =30 ng/L were classified as nonelevated cardiac troponin I. Follow-up was at least 3 years with all-cause mortality as the sole clinical end point.
A total of 3762 patients were included. Of these, 488 (13%) had acute myocardial infarction, 1089 (29%) had myocardial injury, and 2185 (58%) had nonelevated cardiac troponin I values. Patients with myocardial injury frequently presented with dyspnea, were older, and had more comorbidity than patients in the 2 other groups. During a median follow-up of 3.2 years, 1342 patients died. Mortality differed significantly between groups: 39% in those with myocardial infarction, 59% in those with myocardial injury, and 23% in those with nonelevated cardiac troponin I (log-rank test; P
PubMed ID
26593739 View in PubMed
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[Diet changes and the rise and fall of cardiovascular disease mortality in Norway]

https://arctichealth.org/en/permalink/ahliterature53329
Source
Tidsskr Nor Laegeforen. 2004 Jun 3;124(11):1532-6
Publication Type
Article
Date
Jun-3-2004
Author
Jan I Pedersen
Aage Tverdal
Bente Kirkhus
Author Affiliation
Institutt for medisinske basalfag Avdeling for ernaeringsvitenskap, Universitetet i Oslo, Postboks 1046 Blindern, 0316 Oslo. j.i.pedersen@basalmed.uio.no
Source
Tidsskr Nor Laegeforen. 2004 Jun 3;124(11):1532-6
Date
Jun-3-2004
Language
Norwegian
Publication Type
Article
Keywords
Adult
Aged
Cardiovascular Diseases - blood - mortality - prevention & control
Cause of Death
Cerebrovascular Disorders - mortality - prevention & control
Cholesterol - blood
Death, Sudden, Cardiac
Diet
Diet Surveys
Dietary Fats - administration & dosage
English Abstract
Female
Food Habits
Humans
Male
Middle Aged
Myocardial Infarction - blood - mortality
Myocardial Ischemia - blood - mortality
Norway - epidemiology
Abstract
BACKGROUND: Cardiovascular disease mortality in Norway during the last 50 years has been analysed and related to changes in dietary habits and serum cholesterol in the population. MATERIAL AND METHODS: Mortality and dietary data have been collected from official statistics. Changes in serum cholesterol have been estimated from changes in intake of fatty acids based on published regression equations. Data on changes in serum cholesterol and blood pressure are from the former National Health Screening Service. RESULTS: Mortality from ischemic heart disease (IHD) peaked in 1966-70 when it was 100% higher than in 1951-55 for men and 50% higher for women. For age group 40-69 years mortality has been reduced by more than one half during the last 30 years. For the period 1996-2000 and for all age groups, 30,903 fewer deaths occurred than expected, had the mortality remained the same as during 1971-75, that is 6180 per year. Mortality from sudden death has followed the same pattern as for IHD. Cerebrovascular disease mortality has shown a declining tendency during the entire period. Since 1960 the proportion of total fat in the diet has been reduced from 41 to 34% of energy and the proportion of unsaturated to saturated plus trans fatty acids has increased. Cholesterol in the diet has been reduced by almost one half. Based on changes in consumption in milk fat, fat from meat and margarine, and taken into consideration the change from boiled to filtered coffee the estimated reduction in serum cholesterol in the population is in the order of 0.8 mmol/l. This corresponds closely to the observed 0.5 to 1 mmol/l. Most of the reduction is due to changes in milk fat and margarine consumption and composition. INTERPRETATION: Based on the established relation between serum cholesterol and risk of IHD we conclude that reduction in serum cholesterol may explain most of the decline in mortality since 1970. Other factors that may have contributed are reduced smoking (in men), a small reduction in blood pressure, increased consumption of fruit, vegetables, cod liver - and fish oil and better means of treatment.
Notes
Comment In: Tidsskr Nor Laegeforen. 2004 Aug 26;124(16):2153; author reply 215315334142
Comment In: Tidsskr Nor Laegeforen. 2004 Oct 7;124(19):251715477904
Comment In: Tidsskr Nor Laegeforen. 2005 Feb 17;125(4):47015742038
PubMed ID
15195160 View in PubMed
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Do cardiac troponins provide prognostic insight in hemodialysis patients?

https://arctichealth.org/en/permalink/ahliterature184366
Source
Can J Cardiol. 2003 Jul;19(8):907-11
Publication Type
Article
Date
Jul-2003
Author
Jonathan B Choy
Paul W Armstrong
Raymond A Ulan
Patricia M Campbell
Sita Gourishankar
Connie I Prosser
Wayne J Tymchak
Author Affiliation
Division of Cardiology, University of Alberta Hospital, Edmonton, Canada.
Source
Can J Cardiol. 2003 Jul;19(8):907-11
Date
Jul-2003
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Alberta - epidemiology
Biological Markers - blood
Cohort Studies
Disease-Free Survival
Endpoint Determination
Female
Follow-Up Studies
Heart Failure - blood - mortality - therapy
Humans
Incidence
Kidney Failure, Chronic - blood - mortality - therapy
Male
Middle Aged
Multivariate Analysis
Myocardial Infarction - blood - mortality - therapy
Predictive value of tests
Prognosis
Prospective Studies
Renal Dialysis
Serum Albumin - metabolism
Treatment Outcome
Troponin I - blood - diagnostic use
Troponin T - blood - diagnostic use
Abstract
The diagnosis of myocardial necrosis in patients with chronic renal failure is often difficult because biochemical markers of cardiac damage such as creatine kinase MB (CKMB) and cardiac troponin T (cTnT) may be spuriously elevated. Recent small studies also report unexplained elevations in cardiac troponin I (cTnI) in chronic renal failure patients undergoing hemodialysis. The relative incidence of elevated cardiac troponins in this population and their relationship to clinical events remain unknown.
To determine the incidence and prognostic significance of asymptomatic elevations of cTnT and cTnI in patients undergoing hemodialysis for chronic renal failure.
Prospective cohort study.
University tertiary care teaching hospital.
One hundred thirteen patients over 21 years of age undergoing onsite hemodialysis were enrolled between December 1997 and February 1998.
All-cause and cardiovascular mortality, hospitalization for acute myocardial infarction, unstable angina or congestive heart failure, new onset sustained arrhythmia or need for unscheduled emergency hemodialysis due to volume overload at 30 days and six months.
The incidence of abnormal results for cTnT, cTnI and CKMB were 42%, 15% and 4%, respectively. Independent predictors of mortality at six months were median age greater than 63 years (odds ratio 14.3, 95% CI 1.5 to 130.3, P=0.019) and positive cTnT (odds ratio 13.6, 95% CI 2.5 to 73.2, P=0.002). Diabetics were more likely to have positive cTnI and cTnT results than nondiabetics (P
Notes
Comment In: Can J Cardiol. 2003 Dec;19(13):1545-6; author reply 154614763460
PubMed ID
12876611 View in PubMed
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Echocardiographic algorithms for admission and predischarge prediction of mortality in acute myocardial infarction.

https://arctichealth.org/en/permalink/ahliterature55124
Source
Am J Cardiol. 1992 Jun 15;69(19):1538-44
Publication Type
Article
Date
Jun-15-1992
Author
J. Berning
J. Launbjerg
M. Appleyard
Author Affiliation
Medical Department C, Glostrup Hospital, Copenhagen, Denmark.
Source
Am J Cardiol. 1992 Jun 15;69(19):1538-44
Date
Jun-15-1992
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Algorithms
Creatine Kinase - blood
Denmark - epidemiology
Echocardiography - statistics & numerical data
Female
Follow-Up Studies
Heart Arrest - epidemiology - physiopathology
Heart Failure, Congestive - epidemiology - physiopathology
Hospital Mortality
Humans
Isoenzymes
Male
Middle Aged
Myocardial Infarction - blood - mortality - physiopathology
Probability
Prognosis
Proportional Hazards Models
Prospective Studies
Recurrence
Research Support, Non-U.S. Gov't
Survival Rate
Tachycardia - epidemiology - physiopathology
Tachycardia, Supraventricular - epidemiology - physiopathology
Ventricular Fibrillation - epidemiology - physiopathology
Ventricular Function, Left - physiology
Abstract
To develop improved prognostic algorithms for routine bedside use in acute myocardial infarction (AMI), the prognostic value concerning 2- and 12-month mortality of an early (within 72 hours after AMI) resting echocardiogram was defined in 201 consecutive patients. The relation between (1) the clinical variables (age, sex, prior and repeat AMI, arrhythmias, cardiac arrest, early [less than 72 hours after AMI] and late heart failure, early and maximal in-hospital Killip class, and maximal creatine kinase-MB isoenzyme), (2) early myocardial performance by echocardiography, and (3) mortality was characterized by Kaplan-Meier survival curves and receiver-operating characteristic curves based on Cox regression model. Only age and clinical heart failure in terms of the maximal in-hospital Killip class had independent predictive value of death (p less than 0.05) when an early echocardiographic estimate of left ventricular ejection fraction (LVEF) was included in the multivariate statistical models. The following 2 optimized algorithms for admission and predischarge calculation of risk of mortality at 2 and 12 months were developed based on the Cox model, using combinations of age, maximal Killip class and early echocardiographic LVEF: mortality at 2 months = 1 - exp - [0.051 x exp [0.044 x (age -60) - (0.117 x (LVEF - 40)]]; and mortality at 1 year = 1 - exp - [0.101 x exp [0.408 x (maxKillip - 1) - (0.061 x (LVEF - 40)]]. Discriminative power for prediction of mortality of the predischarge algorithm in an independent population of 195 patients 5 days after AMI compared favorably with that obtained in the original population, confirming the validity of the proposed method of prognostication.
PubMed ID
1598866 View in PubMed
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The effect of correcting for troponins on trends in coronary heart disease events in Finland during 1993-2002: the FINAMI study.

https://arctichealth.org/en/permalink/ahliterature168487
Source
Eur Heart J. 2006 Oct;27(20):2394-9
Publication Type
Article
Date
Oct-2006
Author
Veikko Salomaa
Matti Ketonen
Heli Koukkunen
Pirjo Immonen-Räihä
Aapo Lehtonen
Jorma Torppa
Kari Kuulasmaa
Y Antero Kesäniemi
Kalevi Pyörälä
Author Affiliation
KTL-National Public Health Institute, Mannerheimintie 166, FI-00300 Helsinki, Finland. veikko.salomaa@ktl.fi
Source
Eur Heart J. 2006 Oct;27(20):2394-9
Date
Oct-2006
Language
English
Publication Type
Article
Keywords
Adult
Age Distribution
Aged
Biological Markers - blood
Cost of Illness
Electrocardiography
Female
Finland - epidemiology
Humans
Incidence
Male
Middle Aged
Mortality - trends
Myocardial Infarction - blood - mortality
Regression Analysis
Troponin - blood
Abstract
The object of this study is to analyse the trends in coronary events in Finland during 1993-2002, correcting for the effect of troponins.
A population-based myocardial infarction register recorded all coronary events (n=14 782) in four geographical areas of Finland during 1993-2002. Correction coefficients for the effect of troponins were calculated on the basis of 4359 coronary events, with simultaneous determination of troponins and the 'old' enzymatic markers of myocardial injury. Coronary mortality declined steeply, except in women aged > or = 75 years. The incidence of first coronary events declined 2.0% (95% confidence interval -3.0, -0.9%) per year among men and 1.0% (-2.7, 0.6%) per year among women aged 35-74 years. After correcting for the effect of troponins, also the decline among women became statistically significant: 2.7% (-4.5, -0.8%) per year. The effect of troponins tended to be stronger in women and older individuals than in men and younger individuals. The 28-day case fatality declined among men, but not among women. The effect of troponins on case fatality trends was weak.
Declining trends in the incidence of coronary events in Finland during 1993-2002 were partly hidden by the effect of troponins. Both incidence and case fatality declines have contributed to the decline in mortality.
Notes
Comment In: Eur Heart J. 2006 Oct;27(20):2373-517000625
PubMed ID
16818460 View in PubMed
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Hard drinking water and ischemic heart disease: calcium, bloodlipids, and acute myocardial infarcts.

https://arctichealth.org/en/permalink/ahliterature54993
Source
J Med Syst. 1993 Aug;17(3-4):277-81
Publication Type
Article
Date
Aug-1993

35 records – page 1 of 4.