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Zareini B, Sørensen KK, Pedersen‐Bjergaard U, Loldrup Fosbøl E, Køber L, Torp‐Pedersen C. Glucagon-like-peptide-1 receptor agonists versus dipeptidyl peptidase-4 inhibitors and cardiovascular outcomes in diabetes in relation to achieved glycemic control. A Danish nationwide study. J Diabetes 2024; 16:e13560. [PMID: 38751369 PMCID: PMC11096807 DOI: 10.1111/1753-0407.13560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 02/23/2024] [Accepted: 03/10/2024] [Indexed: 05/18/2024] Open
Abstract
AIM To compare the cardiovascular preventive effect associated with glucagon-like-peptide-1 receptor agonists (GLP-1 RA) versus dipeptidyl peptidase-4 inhibitors (DPP-4i) according to the achieved target level of glycated hemoglobin (HbA1c). METHODS We used retrospective Danish registries to include type 2 diabetes patients already in metformin treatment initiating GLP-1 RA or DPP-4i between 2007 and 2021. Patients were included 6 months after GLP-1 RA or DPP-4i initiation. The last available HbA1c measurement before inclusion was collected. The achieved HbA1c level was categorized according to a target level below or above 53 mmol/mol (7%). The primary outcome was a composite of nonfatal myocardial infarction, nonfatal stroke, and all-cause death. We used a multivariable Cox proportional hazard model to estimate the effect of HbA1c levels on the outcome among GLP-1 RA users compared to DPP-4i users. RESULTS The study included 13 634 GLP-1 RA users (median age 56.9, interquartile range [IQR]: 48.5-65.5; 53% males) and 39 839 DPP-4i users (median age 63.4, IQR: 54.6-71.8; 61% males). The number of GLP-1 RA and DPP-4i users according to achieved HbA1c levels were as follows: HbA1c ≤ 53 mmol/mol (≤7.0%): 3026 (22%) versus 4824 (12%); HbA1c > 53 mmol/mol (>7.0%): 6577 (48%) versus 17 508 (44%); missing HbA1c: 4031 (30%) versus 17 507 (44%). During a median follow-up of 5 years (IQR: 2.6-5.0), 954 GLP-1 RA users experienced the primary outcome compared to 7093 DPP-4i users. The 5-year risk (95% confidence interval [CI]) of the outcome associated with GLP1-RA versus DPP-4i according to HbA1c categories was as follows: HbA1c ≤ 53 mmol/mol: 10.3% (8.2-12.3) versus 24.3% (22.7-25.8); HbA1c > 53 mmol/mol: 16.0% (14.3-17.6) versus 21.1% (20.3-21.9); missing HbA1c: 17.1% (15.7-18.5) versus 25.6% (24.9-26.3). The preventive effect associated with GLP-1 RA versus DPP-4i was significantly enhanced when achieving lower HbA1c levels: HbA1c ≤ 53 mmol/mol: 0.65 (0.52-0.80); HbA1c > 53 mmol/mol: 0.92 (0.83-1.03); missing HbA1c: 0.92 (0.84-1.02) (p value for interaction <.001). CONCLUSION GLP-1 RA use was associated with a lower rate of major adverse cardiovascular outcomes. The association was stronger in patients achieving the target glycemic level and weaker in patients not achieving the target glycemic level, suggestive of an interaction between achieved HbA1c level and GLP-1 RA.
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Affiliation(s)
- Bochra Zareini
- Department of CardiologyNorth Zealand University HospitalHillerødDenmark
| | | | - Ulrik Pedersen‐Bjergaard
- Department of Endocrinology and NephrologyNorth Zealand HospitalHillerødDenmark
- Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
| | - Emil Loldrup Fosbøl
- Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
- Department of Cardiology, RigshospitaletUniversity of CopenhagenCopenhagenDenmark
| | - Lars Køber
- Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
- Department of Cardiology, RigshospitaletUniversity of CopenhagenCopenhagenDenmark
| | - Christian Torp‐Pedersen
- Department of CardiologyNorth Zealand University HospitalHillerødDenmark
- Department of Public HealthUniversity of CopenhagenCopenhagenDenmark
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Doi SN, Thune JJ, Nielsen JC, Haarbo J, Videbæk L, Yafasova A, Bruun NE, Gustafsson F, Eiskjær H, Hassager C, Svendsen JH, Høfsten DE, Torp‐Pedersen C, Pehrson S, Køber L, Butt JH. Estimated Glomerular Filtration Rate and Implantable Cardioverter-Defibrillator in Nonischemic Systolic Heart Failure: Extended Follow-Up of DANISH. J Am Heart Assoc 2024; 13:e031977. [PMID: 38293926 PMCID: PMC11056118 DOI: 10.1161/jaha.123.031977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 12/29/2023] [Indexed: 02/01/2024]
Abstract
BACKGROUND Patients with heart failure and chronic kidney disease (CKD) may have an increased risk of death from causes competing with arrhythmic death, which could have implications for the efficacy of implantable cardioverter-defibrillators (ICDs). We examined the long-term effects of primary prophylactic ICD implantation, compared with usual care, according to baseline CKD status in an extended follow-up study of DANISH (Danish Study to Assess the Efficacy of ICDs in Patients With Nonischemic Systolic Heart Failure on Mortality). METHODS AND RESULTS In the DANISH trial, 1116 patients with nonischemic heart failure with reduced ejection fraction were randomized to receive an ICD (N=556) or usual care (N=550). Outcomes were analyzed according to CKD status (estimated glomerular filtration rate ≥/<60 mL/min per 1.73 m2) at baseline. In total, 1113 patients had an available estimated glomerular filtration rate measurement at baseline (median estimated glomerular filtration rate 73 mL/min per 1.73 m2), and 316 (28%) had CKD. During a median follow-up of 9.5 years, ICD implantation, compared with usual care, did not reduce the rate of all-cause mortality (no CKD, HR, 0.82 [95% CI, 0.64-1.04]; CKD, HR, 1.02 [95% CI, 0.75-1.38]; Pinteraction=0.31) or cardiovascular death (no CKD, HR, 0.77 [95% CI, 0.58-1.03]; CKD, HR, 1.05 [95% CI, 0.73-1.51]; Pinteraction=0.20), irrespective of baseline CKD status. Similarly, baseline CKD status did not modify the beneficial effects of ICD implantation on sudden cardiovascular death (no CKD, HR, 0.57 [95% CI, 0.32-1.00]; CKD, HR, 0.65 [95% CI, 0.34-1.24]; Pinteraction=0.70). CONCLUSIONS ICD implantation, compared with usual care, did not reduce the overall mortality rate, but it did reduce the rate of sudden cardiovascular death, regardless of baseline kidney function in patients with nonischemic heart failure with reduced ejection fraction. REGISTRATION URL: https://www.clinicaltrials.gov; Unique identifier: NCT00542945.
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MESH Headings
- Humans
- Defibrillators, Implantable/adverse effects
- Heart Failure, Systolic/complications
- Heart Failure, Systolic/therapy
- Follow-Up Studies
- Risk Factors
- Glomerular Filtration Rate
- Death, Sudden, Cardiac/epidemiology
- Death, Sudden, Cardiac/etiology
- Death, Sudden, Cardiac/prevention & control
- Heart Failure/diagnosis
- Heart Failure/therapy
- Heart Failure/complications
- Renal Insufficiency, Chronic/complications
- Renal Insufficiency, Chronic/diagnosis
- Renal Insufficiency, Chronic/therapy
- Ventricular Dysfunction, Left
- Denmark/epidemiology
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Affiliation(s)
- Seiko N. Doi
- Department of CardiologyCopenhagen University Hospital—RigshospitaletCopenhagenDenmark
| | - Jens Jakob Thune
- Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
- Department of CardiologyCopenhagen University Hospital—Bispebjerg and FrederiksbergCopenhagenDenmark
| | - Jens C. Nielsen
- Department of CardiologyAarhus University HospitalAarhusDenmark
- Department of Clinical MedicineAarhus UniversityAarhusDenmark
| | - Jens Haarbo
- Department of CardiologyCopenhagen University Hospital—Herlev and GentofteHellerupDenmark
| | - Lars Videbæk
- Department of CardiologyOdense University HospitalSvendborgDenmark
| | - Adelina Yafasova
- Department of CardiologyCopenhagen University Hospital—RigshospitaletCopenhagenDenmark
| | - Niels E. Bruun
- Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
- Department of CardiologyAalborg University HospitalAalborgDenmark
- Department of CardiologyZealand University HospitalRoskildeDenmark
| | - Finn Gustafsson
- Department of CardiologyCopenhagen University Hospital—RigshospitaletCopenhagenDenmark
- Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
| | - Hans Eiskjær
- Department of CardiologyAarhus University HospitalAarhusDenmark
| | - Christian Hassager
- Department of CardiologyCopenhagen University Hospital—RigshospitaletCopenhagenDenmark
- Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
| | - Jesper H. Svendsen
- Department of CardiologyCopenhagen University Hospital—RigshospitaletCopenhagenDenmark
- Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
| | - Dan E. Høfsten
- Department of CardiologyCopenhagen University Hospital—RigshospitaletCopenhagenDenmark
- Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
| | - Christian Torp‐Pedersen
- Department of CardiologyNordsjællands HospitalHillerødDenmark
- Department of Public HealthUniversity of CopenhagenCopenhagenDenmark
| | - Steen Pehrson
- Department of CardiologyCopenhagen University Hospital—RigshospitaletCopenhagenDenmark
| | - Lars Køber
- Department of CardiologyCopenhagen University Hospital—RigshospitaletCopenhagenDenmark
- Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
| | - Jawad H. Butt
- Department of CardiologyCopenhagen University Hospital—RigshospitaletCopenhagenDenmark
- Department of CardiologyZealand University HospitalRoskildeDenmark
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Wallace BI, Tsai H, Lin P, Aasbjerg K, Wu AC, Tsai Y, Torp‐Pedersen C, Waljee AK, Yao T. Prevalence and prescribing patterns of oral corticosteroids in the United States, Taiwan, and Denmark, 2009-2018. Clin Transl Sci 2023; 16:2565-2576. [PMID: 37718472 PMCID: PMC10719491 DOI: 10.1111/cts.13649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 09/04/2023] [Accepted: 09/09/2023] [Indexed: 09/19/2023] Open
Abstract
Oral corticosteroids (OCS) are commonly prescribed for acute, self-limited conditions, despite studies demonstrating toxicity. Studies evaluating longitudinal OCS prescribing in the general population are scarce and do not compare use across countries. This study investigated and compared OCS prescription patterns from 2009 to 2018 in the general populations of the United States, Taiwan, and Denmark. This international population-based longitudinal cohort study used nationwide claims databases (United States: Optum Clinformatics Data Mart; de-identified; Taiwan: National Health Insurance Research Database; and Denmark: National Prescription and Patient Registries/Danish National Patient Registry) to evaluate OCS prescribing. We classified annual OCS duration as short-term (1-29 days), medium-term (30-89 days), or long-term (≥90 days). Longitudinal change in annual prevalence of OCS use and physician prescribing patterns were reported. Among 54,630,437 participants, average annual percentage of overall OCS use was 6.8% in the United States, 17.5% in Taiwan, and 2.2% in Denmark during 2009-2018. Prevalence of OCS prescribing increased at an average annual rate of 0.1%-0.17%, mainly driven by short-term prescribing to healthy adults. One-quarter to one-fifth of OCS prescribing was associated with a diagnosis of respiratory infection. Family practice and internal medicine physicians were among the highest OCS prescribers across countries and durations. Age- and sex-stratified trends mirrored unstratified trends. This study provides real-world evidence of an ongoing steady increase in OCS use in the general populations of the United States, Taiwan, and Denmark. This increase is largely driven by short-term OCS prescribing to healthy adults, a practice previously viewed as safe but recently shown to incur substantial population-level risk.
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Affiliation(s)
- Beth I. Wallace
- University of MichiganAnn ArborMichiganUSA
- Center for Clinical Management ResearchLieutenant Colonel Charles S. Kettles VA Medical CenterAnn ArborMichiganUSA
- Institute for Healthcare Policy and InnovationAnn ArborMichiganUSA
| | - Hui‐Ju Tsai
- Institute of Population Health SciencesNational Health Research InstitutesZhunanTaiwan
- National Tsing‐Hua University College of Life ScienceHsinchuTaiwan
| | - Paul Lin
- Institute for Healthcare Policy and InnovationAnn ArborMichiganUSA
| | | | - Ann Chen Wu
- Harvard Medical SchoolBostonMassachusettsUSA
- Department of Pediatrics, Children's HospitalBostonMassachusettsUSA
| | - Yi‐Fen Tsai
- Institute of Population Health SciencesNational Health Research InstitutesZhunanTaiwan
| | - Christian Torp‐Pedersen
- Department of Clinical Investigation and Cardiology, Nordsjaellands HospitalHilleroedDenmark
- Department of Clinical Medicine, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
| | - Akbar K. Waljee
- University of MichiganAnn ArborMichiganUSA
- Center for Clinical Management ResearchLieutenant Colonel Charles S. Kettles VA Medical CenterAnn ArborMichiganUSA
- Institute for Healthcare Policy and InnovationAnn ArborMichiganUSA
| | - Tsung‐Chieh Yao
- Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial HospitalTaoyuanTaiwan
- School of MedicineChang Gung University College of MedicineTaoyuanTaiwan
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Mikkelsen AP, Egerup P, Kolte AM, Westergaard D, Torp‐Pedersen C, Nielsen HS, Lidegaard Ø. Pregnancy Loss and the Risk of Myocardial Infarction, Stroke, and All-Cause Mortality: A Nationwide Partner Comparison Cohort Study. J Am Heart Assoc 2023; 12:e028620. [PMID: 37489734 PMCID: PMC10492966 DOI: 10.1161/jaha.122.028620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 02/07/2023] [Indexed: 07/26/2023]
Abstract
Background Pregnancy loss has been associated with myocardial infarction, stroke, and all-cause mortality in women through unknown mechanisms. The aim of this study was to examine these associations in women and their male partners. Methods and Results In this register-based cohort study, all people born between 1957 and 1997, residing in Denmark between 1977 and 2017, and with a registered partner of the opposite sex were eligible for inclusion. Male partners through cohabitation, marriage, or paternity constituted the male cohort. Exposure to pregnancy loss was categorized as follows: 0, 1, 2, or ≥3 pregnancy losses. The outcomes of interest were myocardial infarction, stroke, and all-cause mortality. The Cox proportional hazards model estimated hazard ratios (HRs), adjusted for age, calendar year, parity, and parental history of myocardial infarction or stroke. During follow-up, 1 112 507 women experienced 4463 events of myocardial infarction compared with 13 838 events among 1 120 029 male partners. With the no pregnancy loss group as reference, the adjusted HRs of myocardial infarction in the female cohort after 1, 2, and ≥3 pregnancy losses were as follows: 1.1 (95% CI, 1.0-1.2), 1.3 (95% CI, 1.1-1.5), and 1.4 (95% CI, 1.1-1.8), respectively. In the male partner cohort, the corresponding estimates were 1.0 (95% CI, 1.0-1.1), 1.1 (95% CI, 1.0-1.2), and 1.0 (95% CI, 0.8-1.2), respectively. The outcome of stroke showed similar results. Pregnancy loss was not significantly associated with increased mortality in either sex. Conclusions Pregnancy loss or stillbirth was significantly associated with myocardial infarction and stroke in women but not their male partners. Pregnancy loss or stillbirth was not significantly associated with all-cause mortality in women or male partners.
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Affiliation(s)
- Anders Pretzmann Mikkelsen
- Department of GynaecologyCopenhagen University Hospital–RigshospitaletCopenhagenDenmark
- Department of Obstetrics and GynaecologyCopenhagen University Hospital HerlevHerlevDenmark
| | - Pia Egerup
- Department of Obstetrics and GynaecologyCopenhagen University Hospital HvidovreHvidovreDenmark
- The Recurrent Pregnancy Loss UnitThe Capital Region, Copenhagen University Hospitals Rigshospitalet and HvidovreHvidovreDenmark
| | - Astrid Marie Kolte
- Department of Obstetrics and GynaecologyCopenhagen University Hospital HvidovreHvidovreDenmark
- The Recurrent Pregnancy Loss UnitThe Capital Region, Copenhagen University Hospitals Rigshospitalet and HvidovreHvidovreDenmark
| | - David Westergaard
- Novo Nordisk Foundation Center for Protein ResearchUniversity of CopenhagenCopenhagenDenmark
- Methods and Analysis, Statistics DenmarkCopenhagenDenmark
| | - Christian Torp‐Pedersen
- Department of Cardiology and Clinical Research, Nordsjaellands HospitalHillerødDenmark
- Department of CardiologyAalborg University HospitalAalborgDenmark
| | - Henriette Svarre Nielsen
- Department of Obstetrics and GynaecologyCopenhagen University Hospital HvidovreHvidovreDenmark
- The Recurrent Pregnancy Loss UnitThe Capital Region, Copenhagen University Hospitals Rigshospitalet and HvidovreHvidovreDenmark
- Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
| | - Øjvind Lidegaard
- Department of GynaecologyCopenhagen University Hospital–RigshospitaletCopenhagenDenmark
- Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
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5
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Horwitz A, Klemp M, Andreasen J, Horwitz H, Freiberg J, Torp‐Pedersen C, Kolko M. Glaucoma and cardioprotective medication. Acta Ophthalmol 2022. [DOI: 10.1111/j.1755-3768.2022.0217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Anna Horwitz
- Rigshospitalet‐Glostrup, Department of Ophthalmology Copenhagen University Hospital Glostrup Denmark
| | - Marc Klemp
- Department of Economics University of Copenhagen Copenhagen Denmark
| | - Jens Andreasen
- Department of Drug Design and Pharmacology University of Copenhagen Copenhagen Denmark
| | - Henrik Horwitz
- Bispebjerg and Frederiksberg Hospital Department of Clinical Pharmacology University of Copenhagen Copenhagen SV Denmark
| | - Josefine Freiberg
- Department of Drug Design and Pharmacology University of Copenhagen Copenhagen Denmark
| | - Christian Torp‐Pedersen
- Department of Clinical Research University of Copenhagen‐ Nordsjællands Hospital Hillerød Denmark
| | - Miriam Kolko
- Department of Drug Design and Pharmacology University of Copenhagen Copenhagen Denmark
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Øvlisen AK, Jakobsen LH, Kragholm KH, Nielsen RE, Nully Brown P, Dahl‐Sørensen RB, Frederiksen H, Mannering N, Josefsson PL, Ludvigsen Al‐Mashhadi A, Jørgensen JM, Dessau‐Arp A, Clausen MR, Pedersen RS, Torp‐Pedersen C, Severinsen MT, El‐Galaly TC. Mental health among patients with non-Hodgkin lymphoma: A Danish nationwide study of psychotropic drug use in 8750 patients and 43 750 matched comparators. Am J Hematol 2022; 97:749-761. [PMID: 35298039 PMCID: PMC9310853 DOI: 10.1002/ajh.26538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 02/21/2022] [Accepted: 03/07/2022] [Indexed: 11/12/2022]
Abstract
Psychological distress following cancer diagnosis may lead to mental health complications including depression and anxiety. Non-Hodgkin lymphomas (NHLs) include indolent and aggressive subtypes for which treatment and prognosis differ widely. Incident use of psychotropic drugs (PDs-antidepressants, antipsychotics, and anxiolytics) and its correlation to lymphoma types can give insights into the psychological distress these patients endure. In this prospective matched cohort study, we used nationwide population-based registries to investigate the cumulative risk of PD use in NHL patients compared to a sex- and age-matched cohort from the Danish background population. In addition, contact patterns to psychiatric departments and incident intentional self-harm or completed suicide were explored. In total, 8750 NHL patients and 43 750 matched comparators were included (median age 68; male:female ratio 1.6). Median follow-up was 7.1 years. Two-year cumulative risk of PD use was higher in NHL patients (16.4%) as compared to the matched comparators (5.1%, p < .01); patients with aggressive NHL subtypes had the highest incidence. Prescription rates were higher in the first years after diagnosis but approached the rate of the matched population 5 years into survivorship in aggressive NHLs, whereas patients with indolent subtypes continued to be at higher risk. NHL patients had a slightly higher two-year risk of suicide/intentional self-harm (0.3%) as compared to the matched comparators (0.2%, p = .01). These results demonstrate that mental health complications among NHL patients are frequent. Routine assessment for symptoms of depression and anxiety should be consider as part of standard follow-up of NHL patients.
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Affiliation(s)
- Andreas Kiesbye Øvlisen
- Department of Hematology Aalborg University Hospital Aalborg Denmark
- Department of Clinical Medicine Aalborg University Aalborg Denmark
| | - Lasse Hjort Jakobsen
- Department of Hematology Aalborg University Hospital Aalborg Denmark
- Department of Clinical Medicine Aalborg University Aalborg Denmark
| | - Kristian Hay Kragholm
- Unit of Epidemiology and Biostatistics Aalborg University Hospital Aalborg Denmark
- Department of Cardiology Aalborg University Hospital Aalborg Denmark
| | - René Ernst Nielsen
- Department of Clinical Medicine Aalborg University Aalborg Denmark
- Department of Psychiatry Aalborg University Hospital Aalborg Denmark
| | - Peter Nully Brown
- Department of Hematology, Rigshospitalet Copenhagen University Hospital Copenhagen Denmark
| | | | | | | | | | | | | | | | | | | | - Christian Torp‐Pedersen
- Unit of Epidemiology and Biostatistics Aalborg University Hospital Aalborg Denmark
- Department of Cardiology and Clinical Research Nordsjællands Hospital Hillerød Denmark
| | - Marianne Tang Severinsen
- Department of Hematology Aalborg University Hospital Aalborg Denmark
- Department of Clinical Medicine Aalborg University Aalborg Denmark
- Clinical Cancer Research Unit Aalborg University Hospital Aalborg Denmark
| | - Tarec Christoffer El‐Galaly
- Department of Hematology Aalborg University Hospital Aalborg Denmark
- Department of Clinical Medicine Aalborg University Aalborg Denmark
- Clinical Cancer Research Unit Aalborg University Hospital Aalborg Denmark
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Gregers MCT, Andelius L, Malta Hansen C, Kragh AR, Torp‐Pedersen C, Christensen HC, Kjoelbye JS, Væggemose U, Frischknecht Christensen E, Folke F. Activation of Citizen Responders to Out‐of‐Hospital Cardiac Arrest During the COVID‐19 Outbreak in Denmark 2020. J Am Heart Assoc 2022; 11:e024140. [PMID: 35253455 PMCID: PMC9075288 DOI: 10.1161/jaha.121.024140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Little is known about how COVID‐19 influenced engagement of citizen responders dispatched to out‐of‐hospital cardiac arrest (OHCA) by a smartphone application. The objective was to describe and analyze the Danish Citizen Responder Program and bystander interventions (both citizen responders and nondispatched bystanders) during the first COVID‐19 lockdown in 2020. Methods and Results All OHCAs from January 1, 2020, to June 30, 2020, with citizen responder activation in 2 regions of Denmark were included. We compared citizen responder engagement for OHCA in the nonlockdown period (January 1, 2020, to March 10, 2020, and April 21, 2020, to June 30, 2020) with the lockdown period (March 11, 2020, to April 20, 2020). Data are displayed in the order lockdown versus nonlockdown period. Bystander cardiopulmonary resuscitation rates did not differ in the 2 periods (99% versus 92%; P=0.07). Bystander defibrillation (9% versus 14%; P=0.4) or return‐of‐spontaneous circulation (23% versus 23%; P=1.0) also did not differ. A similar amount of citizen responders accepted alarms during the lockdown (6 per alarm; interquartile range, 6) compared with the nonlockdown period (5 per alarm; interquartile range, 5) (P=0.05). More citizen responders reported performing chest‐compression‐only cardiopulmonary resuscitation during lockdown compared with nonlockdown (79% versus 59%; P=0.0029), whereas fewer performed standardized cardiopulmonary resuscitation, including ventilations (19% versus 38%; P=0.0061). Finally, during lockdown, more citizen responders reported being not psychologically affected by attending an OHCA compared with nonlockdown period (68% versus 56%; P<0.0001). Likewise, fewer reported being mildly affected during lockdown (26%) compared with nonlockdown (35%) (P=0.003). Conclusions The COVID‐19 lockdown in Denmark was not associated with decreased bystander‐initiated resuscitation in OHCAs attended by citizen responders.
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Affiliation(s)
- Mads Christian Tofte Gregers
- Copenhagen University Hospital–Copenhagen Emergency Medical Services Copenhagen Denmark
- Department of Clinical Medicine University of Copenhagen Copenhagen Denmark
| | - Linn Andelius
- Copenhagen University Hospital–Copenhagen Emergency Medical Services Copenhagen Denmark
| | - Carolina Malta Hansen
- Copenhagen University Hospital–Copenhagen Emergency Medical Services Copenhagen Denmark
- Department of Clinical Medicine University of Copenhagen Copenhagen Denmark
- Department of Cardiology Copenhagen University Hospital–Herlev and Gentofte Copenhagen Denmark
| | - Astrid Rolin Kragh
- Copenhagen University Hospital–Copenhagen Emergency Medical Services Copenhagen Denmark
- Department of Clinical Medicine University of Copenhagen Copenhagen Denmark
| | - Christian Torp‐Pedersen
- Department of Cardiology Copenhagen University Hospital–North Zealand Copenhagen Denmark
- Department of Cardiology Aalborg University Hospital–Aalborg Aalborg Denmark
- Department of Public Health University of Copenhagen Denmark
| | - Helle Collatz Christensen
- Copenhagen University Hospital–Copenhagen Emergency Medical Services Copenhagen Denmark
- Department of Clinical Medicine University of Copenhagen Copenhagen Denmark
| | - Julie Samsoee Kjoelbye
- Copenhagen University Hospital–Copenhagen Emergency Medical Services Copenhagen Denmark
- Department of Clinical Medicine University of Copenhagen Copenhagen Denmark
| | - Ulla Væggemose
- Department of Research and Development Prehospital Emergency Medical ServicesCentral Denmark Region Aarhus Denmark
- Department of Clinical Medicine Aarhus University Aarhus Denmark
| | - Erika Frischknecht Christensen
- Department of Emergency Medicine and Trauma Care Centre for Prehospital and Emergency ResearchAalborg University Hospital Aalborg Denmark
- Department of Clinical Medicine Aalborg University Hospital Aalborg Denmark
- Prehospital Emergency Services North Denmark Region Aalborg Denmark
| | - Fredrik Folke
- Copenhagen University Hospital–Copenhagen Emergency Medical Services Copenhagen Denmark
- Department of Clinical Medicine University of Copenhagen Copenhagen Denmark
- Department of Cardiology Copenhagen University Hospital–Herlev and Gentofte Copenhagen Denmark
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8
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Alhakak A, Butt JH, Gerds TA, Fosbøl EL, Mogensen UM, Krøll J, Pallisgaard JL, Gislason GH, Torp‐Pedersen C, Køber L, Weeke PE. Glycated haemoglobin levels among 3295 hospitalized COVID-19 patients, with and without diabetes, and risk of severe infection, admission to an intensive care unit and all-cause mortality. Diabetes Obes Metab 2022; 24:499-510. [PMID: 34779086 PMCID: PMC8653248 DOI: 10.1111/dom.14604] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 11/05/2021] [Accepted: 11/11/2021] [Indexed: 12/16/2022]
Abstract
AIM To determine the risk of adverse outcomes across the spectrum of glycated haemoglobin (HbA1c) levels among hospitalized COVID-19 patients with and without diabetes. MATERIALS AND METHODS Danish nationwide registries were used to study the association between HbA1c levels and 30-day risk of all-cause mortality and the composite of severe COVID-19 infection, intensive care unit (ICU) admission and all-cause mortality. The study population comprised patients hospitalized with COVID-19 (3 March 2020 to 31 December 2020) with a positive polymerase chain reaction (PCR) test and an available HbA1c ≤ 6 months before the first positive PCR test. All patients had at least 30 days of follow-up. Among patients with diabetes, HbA1c was categorized as <48 mmol/mol, 48 to 53 mmol/mol, 54 to 58 mmol/mol, 59 to 64 mmol/mol (reference) and >64 mmol/mol. Among patients without diabetes, HbA1c was stratified into <31 mmol/mol, 31 to 36 mmol/mol (reference), 37 to 41 mmol/mol and 42 to 47 mmol/mol. Thirty-day standardized absolute risks and standardized absolute risk differences are reported. RESULTS We identified 3295 hospitalized COVID-19 patients with an available HbA1c (56.2% male, median age 73.9 years), of whom 35.8% had diabetes. The median HbA1c was 54 and 37 mmol/mol among patients with and without diabetes, respectively. Among patients with diabetes, the standardized absolute risk difference of the composite outcome was higher with HbA1c < 48 mmol/mol (12.0% [95% confidence interval {CI} 3.3% to 20.8%]) and HbA1c > 64 mmol/mol (15.1% [95% CI 6.2% to 24.0%]), compared with HbA1c 59 to 64 mmol/mol (reference). Among patients without diabetes, the standardized absolute risk difference of the composite outcome was greater with HbA1c < 31 mmol/mol (8.5% [95% CI 0.5% to 16.5%]) and HbA1c 42 to 47 mmol/mol (6.7% [95% CI 1.3% to 12.1%]), compared with HbA1c 31 to 36 mmol/mol (reference). CONCLUSIONS Patients with COVID-19 and HbA1c < 48 mmol/mol or HbA1c > 64 mmol/mol had a higher associated risk of the composite outcome. Similarly, among patients without diabetes, varying HbA1c levels were associated with higher risk of the composite outcome.
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Affiliation(s)
| | - Jawad H. Butt
- Department of Cardiology, RigshospitaletCopenhagen University HospitalCopenhagenDenmark
| | - Thomas A. Gerds
- Department of BiostatisticsUniversity of CopenhagenCopenhagenDenmark
- The Danish Heart FoundationCopenhagenDenmark
| | - Emil L. Fosbøl
- Department of Cardiology, RigshospitaletCopenhagen University HospitalCopenhagenDenmark
| | - Ulrik M. Mogensen
- Department of Cardiology, RigshospitaletCopenhagen University HospitalCopenhagenDenmark
| | - Johanna Krøll
- Department of Cardiology, RigshospitaletCopenhagen University HospitalCopenhagenDenmark
| | - Jannik L. Pallisgaard
- Department of CardiologyHerlev and Gentofte Hospital, University of CopenhagenHellerupDenmark
| | - Gunnar H. Gislason
- The Danish Heart FoundationCopenhagenDenmark
- Department of CardiologyHerlev and Gentofte Hospital, University of CopenhagenHellerupDenmark
- The National Institute of Public HealthUniversity of Southern DenmarkOdenseDenmark
| | - Christian Torp‐Pedersen
- Department of Clinical Research and CardiologyNordsjællands HospitalHillerødDenmark
- Department of CardiologyAalborg University HospitalAalborgDenmark
| | - Lars Køber
- Department of Cardiology, RigshospitaletCopenhagen University HospitalCopenhagenDenmark
| | - Peter E. Weeke
- Department of Cardiology, RigshospitaletCopenhagen University HospitalCopenhagenDenmark
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9
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Vinding NE, Kristensen SL, Rørth R, Butt JH, Østergaard L, Olesen JB, Torp‐Pedersen C, Gislason GH, Køber L, Kruuse C, Johnsen SP, Fosbøl EL. Ischemic Stroke Severity and Mortality in Patients With and Without Atrial Fibrillation. J Am Heart Assoc 2022; 11:e022638. [PMID: 35156393 PMCID: PMC9245802 DOI: 10.1161/jaha.121.022638] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Background Our objective was to investigate stroke severity and subsequent rate of mortality among patients with and without atrial fibrillation (AF). Contemporary data on stroke severity and prognosis in patients with AF are lacking. Methods and Results First‐time ischemic stroke patients from the Danish Stroke Registry (January 2005–December 2016) were included in an observational study. Patients with AF were matched 1:1 by sex, age, calendar year, and CHA2DS2‐VASc score with patients without AF. Stroke severity was determined by the Scandinavian Stroke Scale (0–58 points). The rate of death was estimated by Kaplan‐Meier plots and multivariable Cox regression. Among 86 458 identified patients with stroke, 17 205 had AF. After matching, 14 662 patients with AF and 14 662 patients without AF were included (51.8% women; median age, 79.6 years [25th–75th percentile, 71.8–86.0]). More patients with AF had very severe stroke (0–14 points) than patients without AF (13.7% versus 7.9%, P<0.01). The absolute rates of 30‐day and 1‐year mortality were significantly higher for patients with AF (12.1% and 28.4%, respectively) versus patients without AF (8.7% and 21.8%, respectively). This held true in adjusted models for 30‐day mortality (hazard ratio [HR], 1.40 [95% CI, 1.30–1.51]). However, this association became nonsignificant when additionally adjusting for stroke severity (HR, 1.10 [95% CI, 1.00–1.23]). AF was associated with a higher rate of 1‐year mortality (HR, 1.39 [95% CI, 1.32–1.46]), although it was mediated by stroke severity (HR, 1.15 [95% CI, 1.09–1.23], model including stroke severity). Conclusions In a contemporary nationwide cohort of patients with ischemic stroke, patients with AF had more severe strokes and higher mortality than patients without AF. The difference in mortality was mainly driven by stroke severity.
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Affiliation(s)
- Naja E. Vinding
- Department of Cardiology, Rigshospitalet Copenhagen University Hospital Gentofte Denmark
| | - Søren L. Kristensen
- Department of Cardiology, Rigshospitalet Copenhagen University Hospital Gentofte Denmark
| | - Rasmus Rørth
- Department of Cardiology, Rigshospitalet Copenhagen University Hospital Gentofte Denmark
| | - Jawad H. Butt
- Department of Cardiology, Rigshospitalet Copenhagen University Hospital Gentofte Denmark
| | - Lauge Østergaard
- Department of Cardiology, Rigshospitalet Copenhagen University Hospital Gentofte Denmark
| | - Jonas B. Olesen
- Department of Cardiology, Herlev and Gentofte Hospital Copenhagen University Hospital Gentofte Denmark
| | - Christian Torp‐Pedersen
- Department of Cardiology and Clinical Investigation Nordsjaellands Hospital Hilerød Denmark
- Department of Cardiology Aalborg University Hospital Aalborg Denmark
| | - Gunnar H. Gislason
- Department of Cardiology, Herlev and Gentofte Hospital Copenhagen University Hospital Gentofte Denmark
- The Danish Heart Foundation Copenhagen Denmark
| | - Lars Køber
- Department of Cardiology, Rigshospitalet Copenhagen University Hospital Gentofte Denmark
| | - Christina Kruuse
- Department of Neurology Herlev and Gentofte HospitalCopenhagen University Hospital Gentofte Denmark
- Department of Neurology Herlev and Gentofte HospitalCopenhagen University Hospital Herlev Denmark
| | - Søren P. Johnsen
- Department of Clinical Epidemiology Aarhus University Hospital Aarhus N Denmark
| | - Emil L. Fosbøl
- Department of Cardiology, Rigshospitalet Copenhagen University Hospital Gentofte Denmark
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10
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Holm E, Jacobsen KK, Lony TB, Lembeck M, Pedersen H, Andersson C, Johannsen P, Jørgensen TSH, Torp‐Pedersen C. Frequency of missed or delayed diagnosis in dementia is associated with neighborhood socioeconomic status. A&D Transl Res & Clin Interv 2022; 8:e12271. [PMID: 35356741 PMCID: PMC8943602 DOI: 10.1002/trc2.12271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 01/18/2022] [Accepted: 01/23/2022] [Indexed: 11/12/2022]
Abstract
Introduction Underdetection of dementia in areas with low socioeconomic status (SES) may interfere with findings concerning associations between SES and dementia. Methods Using administrative registers we assessed the associations between age‐ and sex‐adjusted dementia incidence and neighborhood socioeconomic status (nSES) in 94 Danish municipalities. Wealth was divided into income quartiles and other nSES variables were dichotomized into high versus low according to the median. Results High population density (odds ratio [OR] 1.21, 95% confidence interval [CI] 1.18–1.24), higher proportion of inhabitants in higher income quartiles (P for trend < .0001), and high educational level (OR 1.19, 95% CI 1.15–1.22) were associated with higher incidence of dementia. High proportion of residents above 65 years was associated with lower age‐adjusted dementia incidence (OR 0.86, 95% CI 0.84–0.89). Discussion Low nSES municipalities have a lower age‐adjusted incidence of dementia diagnosis. These findings corroborate prior concerns that a large number of dementia diagnoses may be missed in municipalities characterized by low SES.
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Affiliation(s)
- Ellen Holm
- Department of Internal Medicine University Hospital Zealand Køge Denmark
- Department of Clinical Medicine University of Copenhagen Copenhagen Denmark
| | - Katja Kemp Jacobsen
- Department of Technology Faculty of Health and Technology University College Copenhagen Copenhagen Denmark
| | - Thea Bang Lony
- Geriatric Section Department of Internal Medicine Nykøbing Falster Hospital Nykøbing Falster Denmark
| | - Maurice Lembeck
- Geriatric Section Department of Internal Medicine Nykøbing Falster Hospital Nykøbing Falster Denmark
| | - Hanne Pedersen
- Geriatric Section Department of Internal Medicine in Glostrup Amager Hvidovre Hospital Glostrup Denmark
| | - Charlotte Andersson
- Department of Medicine Section of Cardiovascular Medicine Boston University Medical Center Boston Massachusetts USA
| | - Peter Johannsen
- International Medical Vice President, Medical & Science Clinical Drug Development Novo Nordisk Copenhagen Denmark
| | | | - Christian Torp‐Pedersen
- Department of Cardiology and Clinical Research Nordsjaellands Hospital Hillerød Denmark
- Department of Public Health University of Copenhagen Copenhagen Denmark
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11
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Brainin P, Mohr GH, Modin D, Claggett B, Silvestre OM, Shah A, Vestergaard LS, Jensen JUS, Hviid L, Torp‐Pedersen C, Køber L, Solomon S, Schou M, Gislason GH, Biering‐Sørensen T. Heart failure associated with imported malaria: a nationwide Danish cohort study. ESC Heart Fail 2021; 8:3521-3529. [PMID: 34313024 PMCID: PMC8497340 DOI: 10.1002/ehf2.13441] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 04/18/2021] [Accepted: 05/12/2021] [Indexed: 11/29/2022] Open
Abstract
AIMS Despite adequate treatment, recent studies have hypothesized that malaria may affect long-term cardiovascular function. We aimed to investigate the long-term risk of cardiovascular events and death in individuals with a history of imported malaria in Denmark. METHODS Using nationwide Danish registries, we followed individuals with a history of malaria for the risk of incident heart failure (HF), myocardial infarction (MI), cardiovascular death and all-cause death (1 January 1994 to 1 January 2017). The population was age- and sex-matched with individuals without a history of malaria from the Danish population (ratio 1:9). We excluded patients with known HF and ischaemic heart disease at inclusion. RESULTS We identified 3912 cases with a history of malaria (mean age 33 ± 17 years, 57% male, 41% Plasmodium falciparum infections). The median follow-up was 9.8 years (interquartile range 3.9-16.4 years). Event rates per 1000 person-years for individuals with a history vs. no history of malaria were HF: 1.84 vs. 1.32; MI: 1.28 vs. 1.30; cardiovascular death: 1.40 vs. 1.77; and all-cause death: 5.04 vs. 5.28. In Cox proportional hazards models adjusted for cardiovascular risk factors, concomitant pharmacotherapy, region of origin, household income and educational level, malaria was associated with HF (HR: 1.59 [1.21-2.09], P = 0.001), but not MI (HR: 1.00 [0.72-1.39], P = 1.00), cardiovascular death (HR: 1.00 [0.74-1.35], P = 0.98) or all-cause death (HR 1.11 [0.94-1.30], P = 0.21). Specifically, P. falciparum infection was associated with increased risk of HF (HR: 1.64 [1.14-2.36], P = 0.008). CONCLUSION Individuals with a history of imported malaria, specifically P. falciparum, may have an increased risk of incident HF.
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Affiliation(s)
- Philip Brainin
- Department of CardiologyHerlev and Gentofte HospitalHerlevDenmark
- Department of CardiologyFederal University of Acre, Câmpus FlorestaCruzeiro do SulBrazil
| | - Grimur Høgnason Mohr
- Department of CardiologyHerlev and Gentofte HospitalHerlevDenmark
- Centre for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre GlostrupUniversity of CopenhagenGlostrupMADenmark
| | - Daniel Modin
- Department of CardiologyHerlev and Gentofte HospitalHerlevDenmark
| | - Brian Claggett
- Division of Cardiovascular Medicine, Brigham and Women's HospitalHarvard Medical SchoolBostonMAUSA
| | - Odilson M. Silvestre
- Department of CardiologyFederal University of Acre, Câmpus FlorestaCruzeiro do SulBrazil
| | - Amil Shah
- Division of Cardiovascular Medicine, Brigham and Women's HospitalHarvard Medical SchoolBostonMAUSA
| | - Lasse S. Vestergaard
- National Malaria Reference Laboratory, Department of Bacteria, Parasites and FungiStatens Serum InstitutCopenhagenDenmark
| | - Jens Ulrik Stæhr Jensen
- Department of Internal Medicine, Respiratory Medicine SectionCopenhagen UniversityCopenhagenDenmark
- PERSIMUNE, Department of Infectious Diseases, RigshospitaletCopenhagen UniversityCopenhagenDenmark
- Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
| | - Lars Hviid
- Department of Immunology and MicrobiologyCopenhagen UniversityCopenhagenDenmark
- Department of Infectious Diseases, RigshospitaletCopenhagen UniversityCopenhagenDenmark
| | - Christian Torp‐Pedersen
- Department of Cardiology and Clinical ResearchNordsjaellands HospitalHillerødDenmark
- Department of CardiologyAalborg University HospitalAalborgDenmark
| | - Lars Køber
- Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
- Department of Cardiology, RigshospitaletCopenhagen UniversityCopenhagenDenmark
| | - Scott Solomon
- Division of Cardiovascular Medicine, Brigham and Women's HospitalHarvard Medical SchoolBostonMAUSA
| | - Morten Schou
- Department of CardiologyHerlev and Gentofte HospitalHerlevDenmark
- Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
| | - Gunnar H. Gislason
- Department of CardiologyHerlev and Gentofte HospitalHerlevDenmark
- Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
- The Danish Heart FoundationCopenhagenDenmark
| | - Tor Biering‐Sørensen
- Department of CardiologyHerlev and Gentofte HospitalHerlevDenmark
- Department of Biomedical SciencesCopenhagen UniversityCopenhagenDenmark
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12
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Bellinge JW, Dalgaard F, Murray K, Connolly E, Blekkenhorst LC, Bondonno CP, Lewis JR, Sim M, Croft KD, Gislason G, Torp‐Pedersen C, Tjønneland A, Overvad K, Hodgson JM, Schultz C, Bondonno NP. Vitamin K Intake and Atherosclerotic Cardiovascular Disease in the Danish Diet Cancer and Health Study. J Am Heart Assoc 2021; 10:e020551. [PMID: 34369182 PMCID: PMC8475061 DOI: 10.1161/jaha.120.020551] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Background Dietary vitamin K (K1 and K2) may reduce atherosclerotic cardiovascular disease (ASCVD) risk via several mechanisms. However, studies linking vitamin K intake with incident ASCVD are limited. We aimed to determine the relationship between dietary vitamin K intake and ASCVD hospitalizations. Methods and Results In this prospective cohort study, participants from the Danish Diet, Cancer, and Health Study, with no prior ASCVD, completed a food‐frequency questionnaire at baseline and were followed up for hospital admissions of ASCVD; ischemic heart disease, ischemic stroke, or peripheral artery disease. Intakes of vitamin K1 and vitamin K2 were estimated from the food‐frequency questionnaire, and their relationship with ASCVD hospitalizations was determined using Cox proportional hazards models. Among 53 372 Danish citizens with a median (interquartile range) age of 56 (52–60) years, 8726 individuals were hospitalized for any ASCVD during 21 (17–22) years of follow‐up. Compared with participants with the lowest vitamin K1 intakes, participants with the highest intakes had a 21% lower risk of an ASCVD‐related hospitalization (hazard ratio, 0.79; 95% CI: 0.74–0.84), after multivariable adjustments for relevant demographic covariates. Likewise for vitamin K2, the risk of an ASCVD‐related hospitalization for participants with the highest intakes was 14% lower than participants with the lowest vitamin K2 intake (hazard ratio, 0.86; 95% CI, 0.81–0.91). Conclusions Risk of ASCVD was inversely associated with diets high in vitamin K1 or K2. The similar inverse associations with both vitamin K1 and K2, despite very different dietary sources, highlight the potential importance of vitamin K for ASCVD prevention.
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Affiliation(s)
- Jamie W. Bellinge
- School of MedicineUniversity of Western AustraliaPerthAustralia
- Department of CardiologyRoyal Perth HospitalPerthAustralia
| | - Frederik Dalgaard
- Department of CardiologyHerlev & Gentofte University HospitalCopenhagenDenmark
| | - Kevin Murray
- School of Population and Global HealthUniversity of Western AustraliaPerthWAAustralia
| | - Emma Connolly
- Institute for Nutrition ResearchSchool of Medical and Health SciencesEdith Cowan UniversityPerthAustralia
| | - Lauren C. Blekkenhorst
- School of MedicineUniversity of Western AustraliaPerthAustralia
- Institute for Nutrition ResearchSchool of Medical and Health SciencesEdith Cowan UniversityPerthAustralia
| | - Catherine P. Bondonno
- School of MedicineUniversity of Western AustraliaPerthAustralia
- Institute for Nutrition ResearchSchool of Medical and Health SciencesEdith Cowan UniversityPerthAustralia
| | - Joshua R. Lewis
- School of MedicineUniversity of Western AustraliaPerthAustralia
- Institute for Nutrition ResearchSchool of Medical and Health SciencesEdith Cowan UniversityPerthAustralia
- Centre for Kidney ResearchChildren's Hospital at WestmeadSchool of Public HealthSydney Medical SchoolThe University of SydneySydneyNSWAustralia
| | - Marc Sim
- School of MedicineUniversity of Western AustraliaPerthAustralia
- Institute for Nutrition ResearchSchool of Medical and Health SciencesEdith Cowan UniversityPerthAustralia
| | - Kevin D. Croft
- School of Biomedical SciencesUniversity of Western AustraliaRoyal Perth HospitalPerthWAAustralia
| | - Gunnar Gislason
- Department of CardiologyHerlev & Gentofte University HospitalCopenhagenDenmark
- The National Institute of Public HealthUniversity of Southern DenmarkOdenseDenmark
- The Danish Heart FoundationCopenhagenDenmark
| | - Christian Torp‐Pedersen
- Department of Clinical Investigation and CardiologyNordsjælland HospitalHillerødDenmark
- Department of Public HealthAarhus UniversityAarhusDenmark
| | - Anne Tjønneland
- The Danish Cancer Society Research CentreCopenhagenDenmark
- Department of Public HealthUniversity of CopenhagenCopenhagenDenmark
| | - Kim Overvad
- Department of Public HealthAarhus UniversityAarhusDenmark
- Aalborg University HospitalAalborgDenmark
| | - Jonathan M. Hodgson
- School of MedicineUniversity of Western AustraliaPerthAustralia
- Institute for Nutrition ResearchSchool of Medical and Health SciencesEdith Cowan UniversityPerthAustralia
| | - Carl Schultz
- School of MedicineUniversity of Western AustraliaPerthAustralia
- Department of CardiologyRoyal Perth HospitalPerthAustralia
| | - Nicola P. Bondonno
- Institute for Nutrition ResearchSchool of Medical and Health SciencesEdith Cowan UniversityPerthAustralia
- School of Biomedical SciencesUniversity of Western AustraliaRoyal Perth HospitalPerthWAAustralia
- The Danish Cancer Society Research CentreCopenhagenDenmark
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13
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Barcella CA, Polcwiartek C, Mohr GH, Hodges G, Søndergaard K, Niels Bang C, Andersen MP, Fosbøl E, Køber L, Schou M, Torp‐Pedersen C, Kessing LV, Gislason G, Kragholm K. Severe mental illness is associated with increased mortality and severe course of COVID-19. Acta Psychiatr Scand 2021; 144:82-91. [PMID: 33894064 PMCID: PMC8250986 DOI: 10.1111/acps.13309] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 04/12/2021] [Accepted: 04/20/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Psychiatric disorders have been associated with unfavourable outcome following respiratory infections. Whether this also applies to coronavirus disease 2019 (COVID-19) has been scarcely investigated. METHODS Using the Danish administrative databases, we identified all patients with a positive real-time reverse transcription-polymerase chain reaction test for COVID-19 in Denmark up to and including 2 January 2021. Multivariable cox regression was used to calculate 30-day absolute risk and average risk ratio (ARR) for the composite end point of death from any cause and severe COVID-19 associated with psychiatric disorders, defined using both hospital diagnoses and redemption of psychotropic drugs. RESULTS We included 144,321 patients with COVID-19. Compared with patients without psychiatric disorders, the standardized ARR of the composite outcome was significantly increased for patients with severe mental illness including schizophrenia spectrum disorders 2.43 (95% confidence interval [CI], 1.79-3.07), bipolar disorder 2.11 (95% CI, 1.25-2.97), unipolar depression 1.70 (95% CI, 1.38-2.02), and for patients who redeemed psychotropic drugs 1.70 (95% CI, 1.48-1.92). No association was found for patients with other psychiatric disorders 1.13 (95% CI, 0.86-1.38). Similar results were seen with the outcomes of death or severe COVID-19. Among the different psychiatric subgroups, patients with schizophrenia spectrum disorders had the highest 30-day absolute risk for the composite outcome 3.1% (95% CI, 2.3-3.9%), death 1.2% (95% CI, 0.4-2.0%) and severe COVID-19 2.7% (95% CI, 1.9-3.6%). CONCLUSION Schizophrenia spectrum disorders, bipolar disorder, unipolar depression and psychotropic drug redemption are associated with unfavourable outcomes in patients with COVID-19.
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Affiliation(s)
- Carlo Alberto Barcella
- Department of CardiologyCopenhagen University Hospital Herlev and GentofteCopenhagenDenmark
| | | | - Grimur Høgnason Mohr
- Department of CardiologyCopenhagen University Hospital Herlev and GentofteCopenhagenDenmark,Mental Health Centre GlostrupCopenhagen University HospitalCopenhagenDenmark
| | - Gethin Hodges
- Department of CardiologyCopenhagen University Hospital Herlev and GentofteCopenhagenDenmark
| | - Kathrine Søndergaard
- Department of CardiologyCopenhagen University Hospital Herlev and GentofteCopenhagenDenmark
| | - Casper Niels Bang
- Departments of Cardiology, Bispebjerg and Frederiksberg HospitalCopenhagen UniversityCopenhagenDenmark,Department of CardiologyNordsjællands HospitalHillerødDenmark
| | | | - Emil Fosbøl
- Department of CardiologyThe Heart CentreCopenhagen University Hospital RigshospitaletCopenhagenDenmark
| | - Lars Køber
- Department of CardiologyThe Heart CentreCopenhagen University Hospital RigshospitaletCopenhagenDenmark
| | - Morten Schou
- Department of CardiologyCopenhagen University Hospital Herlev and GentofteCopenhagenDenmark
| | - Christian Torp‐Pedersen
- Department of CardiologyAalborg University HospitalAalborgDenmark,Department of CardiologyNordsjællands HospitalHillerødDenmark
| | - Lars Vedel Kessing
- Psychiatric Center CopenhagenCopenhagen University HospitalCopenhagenDenmark,Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
| | - Gunnar Gislason
- Department of CardiologyCopenhagen University Hospital Herlev and GentofteCopenhagenDenmark,The Danish Heart FoundationCopenhagenDenmark
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14
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Gade IL, Kold S, Severinsen MT, Kragholm KH, Torp‐Pedersen C, Kristensen SR, Riddersholm SJ. Venous thromboembolism after lower extremity orthopedic surgery: A population-based nationwide cohort study. Res Pract Thromb Haemost 2021; 5:148-158. [PMID: 33537539 PMCID: PMC7845063 DOI: 10.1002/rth2.12449] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 10/07/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Venous thromboembolism (VTE) causes morbidity and mortality in the general population. Several events occur after lower limb orthopedic surgery, but the contribution from various types of lower limb surgery is not well known. OBJECTIVE To investigate the postoperative incidence of VTE for all types of lower extremity orthopedic surgery compared with the background population. METHODS Individual-level linkage of Danish nationwide register data for all Danish residents with first-time orthopedic surgery of the lower limb (1996-2017) and, for each of these, four controls from the general population matched on age, sex, and history of VTE. Adjusted hazard ratios (HR) compared the postoperative risk of VTE to the matched controls. RESULTS In total 7203 of the 1 012 823 patients with a first orthopedic procedure had a VTE within 180 days after surgery, corresponding to a postoperative cumulative incidence of 0.71% (95% confidence interval [CI], 0.70-0.73). The cumulative incidence of VTE among controls was 0.11% (95% CI, 0.11-0.12). The HR of VTE within the first 30 days after surgery below knee level was 20.5 (95% CI, 17.9-23.5) compared with matched controls. The HRs of VTE after minor distal procedures (eg, meniscectomy and arthroscopies) were 2.9 (95% CI, 1.9-4.4) to 7.1 (95% CI, 6.4-8.0). CONCLUSION All types of lower limb orthopedic surgery including minor distal procedures were associated with higher rates of VTE compared with matched controls, in particular within the first 30 days after surgery.
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Affiliation(s)
- Inger Lise Gade
- Department of Hematology and Clinical Cancer Research CenterAalborg University HospitalAalborgDenmark
- Department of Clinical BiochemistryAalborg University HospitalAalborgDenmark
| | - Søren Kold
- Department of Clinical MedicineAalborg UniversityAalborgDenmark
- Department of Orthopedic SurgeryAalborg University HospitalAalborgDenmark
| | - Marianne T. Severinsen
- Department of Hematology and Clinical Cancer Research CenterAalborg University HospitalAalborgDenmark
- Department of Clinical MedicineAalborg UniversityAalborgDenmark
| | - Kristian H. Kragholm
- Department of CardiologyNorth Denmark Regional HospitalHjørringDenmark
- Unit of Clinical BiostatisticsAalborg University HospitalAalborgDenmark
| | - Christian Torp‐Pedersen
- Department of Clinical MedicineAalborg UniversityAalborgDenmark
- Unit of Clinical BiostatisticsAalborg University HospitalAalborgDenmark
- Department of Cardiology and Clinical InvestigationNorth Zealand HospitalHillerødDenmark
| | - Søren R. Kristensen
- Department of Clinical BiochemistryAalborg University HospitalAalborgDenmark
- Department of Clinical MedicineAalborg UniversityAalborgDenmark
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15
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Ballard C, Nørgaard CH, Friedrich S, Mørch LS, Gerds T, Møller DV, Knudsen LB, Kvist K, Zinman B, Holm E, Torp‐Pedersen C, Hansen CT. Liraglutide and semaglutide: Pooled post hoc analysis to evaluate risk of dementia in patients with type 2 diabetes. Alzheimers Dement 2020. [DOI: 10.1002/alz.042909] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Clive Ballard
- The University of Exeter College of Medicine and Health Exeter United Kingdom
| | | | | | - Lina Steinrud Mørch
- Cancer Surveillance and Pharmacoepidemiology Danish Cancer Society Copenhagen Denmark
| | | | | | | | | | - Bernard Zinman
- Lunenfeld–Tanenbaum Research Institute Mount Sinai Hospital University of Toronto Toronto ON Canada
| | - Ellen Holm
- Nykøbing Falster Hospital Nykøbing Falster Denmark
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16
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Malik ME, Madelaire C, D'Souza M, Blanche P, Kristensen SL, Kistorp C, Gustafsson F, Køber L, Rørth R, McMurray J, Sattar N, Gislason G, Torp‐Pedersen C, Schou M. Risk of heart failure in type 2 diabetes complicated by incident ischaemic heart disease and end‐stage renal disease. Eur J Heart Fail 2020; 22:813-820. [DOI: 10.1002/ejhf.1819] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 02/21/2020] [Accepted: 03/20/2020] [Indexed: 01/14/2023] Open
Affiliation(s)
- Mariam E. Malik
- Department of Cardiology Herlev and Gentofte University Hospital Copenhagen Denmark
| | - Christian Madelaire
- Department of Cardiology Herlev and Gentofte University Hospital Copenhagen Denmark
| | - Maria D'Souza
- Department of Cardiology Herlev and Gentofte University Hospital Copenhagen Denmark
| | - Paul Blanche
- Department of Cardiology Herlev and Gentofte University Hospital Copenhagen Denmark
- The Heart Centre, Rigshospitalet University of Copenhagen Copenhagen Denmark
- Danish Heart Foundation Copenhagen Denmark
| | - Søren L. Kristensen
- The Heart Centre, Rigshospitalet University of Copenhagen Copenhagen Denmark
| | - Caroline Kistorp
- Department of Cardiology Herlev and Gentofte University Hospital Copenhagen Denmark
| | - Finn Gustafsson
- The Heart Centre, Rigshospitalet University of Copenhagen Copenhagen Denmark
| | - Lars Køber
- The Heart Centre, Rigshospitalet University of Copenhagen Copenhagen Denmark
| | - Rasmus Rørth
- Department of Cardiology Herlev and Gentofte University Hospital Copenhagen Denmark
| | - John McMurray
- BHF Cardiovascular Research Centre University of Glasgow Glasgow UK
| | - Naveed Sattar
- BHF Cardiovascular Research Centre University of Glasgow Glasgow UK
| | - Gunnar Gislason
- Department of Cardiology Herlev and Gentofte University Hospital Copenhagen Denmark
- Danish Heart Foundation Copenhagen Denmark
| | | | - Morten Schou
- The Heart Centre, Rigshospitalet University of Copenhagen Copenhagen Denmark
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17
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Butt JH, Fosbøl EL, Gerds TA, Andersson C, McMurray JJ, Petrie MC, Gustafsson F, Madelaire C, Kristensen SL, Gislason GH, Torp‐Pedersen C, Køber L, Schou M. Readmission and death in patients admitted with new‐onset versus worsening of chronic heart failure: insights from a nationwide cohort. Eur J Heart Fail 2020; 22:1777-1785. [DOI: 10.1002/ejhf.1800] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 02/16/2020] [Accepted: 03/02/2020] [Indexed: 12/20/2022] Open
Affiliation(s)
- Jawad H. Butt
- Department of Cardiology Rigshospitalet, Copenhagen University Hospital Copenhagen Denmark
- Department of Cardiology Herlev and Gentofte University Hospital Herlev Denmark
| | - Emil L. Fosbøl
- Department of Cardiology Rigshospitalet, Copenhagen University Hospital Copenhagen Denmark
| | - Thomas A. Gerds
- Department of Biostatistics University of Copenhagen Copenhagen Denmark
- The Danish Heart Foundation Copenhagen Denmark
| | - Charlotte Andersson
- Department of Cardiology Herlev and Gentofte University Hospital Gentofte Denmark
| | | | - Mark C. Petrie
- BHF Cardiovascular Research Centre University of Glasgow Glasgow UK
| | - Finn Gustafsson
- Department of Cardiology Rigshospitalet, Copenhagen University Hospital Copenhagen Denmark
| | - Christian Madelaire
- Department of Cardiology Herlev and Gentofte University Hospital Gentofte Denmark
| | | | - Gunnar H. Gislason
- The Danish Heart Foundation Copenhagen Denmark
- Department of Cardiology Herlev and Gentofte University Hospital Gentofte Denmark
- Department of Clinical Medicine University of Copenhagen Copenhagen Denmark
| | | | - Lars Køber
- Department of Cardiology Rigshospitalet, Copenhagen University Hospital Copenhagen Denmark
- Department of Clinical Medicine University of Copenhagen Copenhagen Denmark
| | - Morten Schou
- Department of Cardiology Herlev and Gentofte University Hospital Herlev Denmark
- Department of Clinical Medicine University of Copenhagen Copenhagen Denmark
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18
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Ravn Jacobsen M, Jabbari R, Glinge C, Kjær Stampe N, Butt JH, Blanche P, Lønborg J, Wendelboe Nielsen O, Køber L, Torp‐Pedersen C, Pedersen F, Tfelt‐Hansen J, Engstrøm T. Potassium Disturbances and Risk of Ventricular Fibrillation Among Patients With ST-Segment-Elevation Myocardial Infarction. J Am Heart Assoc 2020; 9:e014160. [PMID: 32067598 PMCID: PMC7070188 DOI: 10.1161/jaha.119.014160] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Background Potassium disturbances per se increase the risk of ventricular fibrillation (VF). Whether potassium disturbances in the acute phase of ST-segment-elevation myocardial infarction (STEMI) are associated with VF before primary percutaneous coronary intervention (PPCI) is uncertain. Methods and Results All consecutive STEMI patients were identified in the Eastern Danish Heart Registry from 1999 to 2016. Comorbidities and medication use were assessed from Danish nationwide registries. Potassium levels were collected immediately before PPCI start. Multivariate logistic models were performed to determine the association between potassium and VF. The main analysis included 8624 STEMI patients of whom 822 (9.5%) had VF before PPCI. Compared with 6693 (77.6%) patients with normokalemia (3.5-5.0 mmol/L), 1797 (20.8%) patients with hypokalemia (<3.5 mmol/L) were often women with fewer comorbidities, whereas 134 (1.6%) patients with hyperkalemia (>5.0 mmol/L) were older with more comorbidities. After adjustment, patients with hypokalemia and hyperkalemia had a higher risk of VF before PPCI (odds ratio 1.90, 95% CI 1.57-2.30, P<0.001) and (odds ratio 3.36, 95% CI 1.95-5.77, P<0.001) compared with normokalemia, respectively. Since the association may reflect a post-resuscitation phenomenon, a sensitivity analysis was performed including 7929 STEMI patients without VF before PPCI of whom 127 (1.6%) had VF during PPCI. Compared with normokalemia, patients with hypokalemia had a significant association with VF during PPCI (odds ratio 1.68, 95% CI 1.01-2.77, P=0.045) after adjustment. Conclusions Hypokalemia and hyperkalemia are associated with increased risk of VF before PPCI during STEMI. For hypokalemia, the association may be independent of the measurement of potassium before or after VF.
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Affiliation(s)
- Mia Ravn Jacobsen
- Department of Cardiology, RigshospitaletCopenhagen University HospitalCopenhagenDenmark
| | - Reza Jabbari
- Department of Cardiology, RigshospitaletCopenhagen University HospitalCopenhagenDenmark
| | - Charlotte Glinge
- Department of Cardiology, RigshospitaletCopenhagen University HospitalCopenhagenDenmark
| | - Niels Kjær Stampe
- Department of Cardiology, RigshospitaletCopenhagen University HospitalCopenhagenDenmark
| | - Jawad Haider Butt
- Department of Cardiology, RigshospitaletCopenhagen University HospitalCopenhagenDenmark
| | - Paul Blanche
- Department of Cardiology, RigshospitaletCopenhagen University HospitalCopenhagenDenmark
- Department of BiostatisticsUniversity of CopenhagenDenmark
| | - Jacob Lønborg
- Department of Cardiology, RigshospitaletCopenhagen University HospitalCopenhagenDenmark
| | - Olav Wendelboe Nielsen
- Department of CardiologyBispebjerg and Frederiksberg University HospitalCopenhagenDenmark
| | - Lars Køber
- Department of Cardiology, RigshospitaletCopenhagen University HospitalCopenhagenDenmark
| | | | - Frants Pedersen
- Department of Cardiology, RigshospitaletCopenhagen University HospitalCopenhagenDenmark
| | - Jacob Tfelt‐Hansen
- Department of Cardiology, RigshospitaletCopenhagen University HospitalCopenhagenDenmark
- Department of Forensic MedicineFaculty of Medical ScienceUniversity of CopenhagenDenmark
| | - Thomas Engstrøm
- Department of Cardiology, RigshospitaletCopenhagen University HospitalCopenhagenDenmark
- Department of CardiologyUniversity of LundSweden
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19
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Barcella CA, Lamberts M, McGettigan P, Fosbøl EL, Lindhardsen J, Torp‐Pedersen C, Gislason GH, Olsen AS. Differences in cardiovascular safety with non‐steroidal anti‐inflammatory drug therapy—A nationwide study in patients with osteoarthritis. Basic Clin Pharmacol Toxicol 2019; 124:629-641. [DOI: 10.1111/bcpt.13182] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 11/20/2018] [Indexed: 12/11/2022]
Affiliation(s)
- Carlo Alberto Barcella
- Department of Cardiology Copenhagen University Hospital Herlev and Gentofte Copenhagen Denmark
| | - Morten Lamberts
- Department of Cardiology Copenhagen University Hospital Rigshospitalet Copenhagen Denmark
| | - Patricia McGettigan
- William Harvey Research Institute Barts and the London School of Medicine and Dentistry London UK
| | - Emil Loldrup Fosbøl
- William Harvey Research Institute Barts and the London School of Medicine and Dentistry London UK
| | - Jesper Lindhardsen
- Department of Cardiology Copenhagen University Hospital Herlev and Gentofte Copenhagen Denmark
| | - Christian Torp‐Pedersen
- Department of Health Science and Technology Aalborg University Aalborg Denmark
- Department of Cardiology Aalborg University Hospital Aalborg Denmark
| | - Gunnar Hilmar Gislason
- Department of Cardiology Copenhagen University Hospital Herlev and Gentofte Copenhagen Denmark
- The Danish Heart Foundation Copenhagen Denmark
- The National Institute of Public Health University of Southern Denmark Odense Denmark
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20
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Baech J, Hansen SM, Lund PE, Soegaard P, Brown PDN, Haaber J, Jørgensen J, Starklint J, Josefsson P, Poulsen CB, Juul MB, Torp‐Pedersen C, El‐Galaly TC. Cumulative anthracycline exposure and risk of cardiotoxicity; a Danish nationwide cohort study of 2440 lymphoma patients treated with or without anthracyclines. Br J Haematol 2018; 183:717-726. [DOI: 10.1111/bjh.15603] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 08/14/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Joachim Baech
- Department of Haematology Aalborg University Hospital Aalborg Denmark
- Unit of Epidemiology and Biostatistics Aalborg University Hospital Aalborg Denmark
| | - Steen M. Hansen
- Unit of Epidemiology and Biostatistics Aalborg University Hospital Aalborg Denmark
| | - Peter E. Lund
- Unit of Epidemiology and Biostatistics Aalborg University Hospital Aalborg Denmark
| | - Peter Soegaard
- Department of Cardiology Aalborg University Hospital Aalborg Denmark
| | - Peter de Nully Brown
- Department of Haematology Rigshospitalet, Copenhagen University Hospital Copenhagen Denmark
| | - Jacob Haaber
- Department of Haematology Odense University Hospital Odense Denmark
| | - Judit Jørgensen
- Department of Haematology Aarhus University Hospital Aarhus Denmark
| | - Jørn Starklint
- Department of Haematology Holstebro Hospital Holstebro Denmark
| | - Pär Josefsson
- Department of Haematology Herlev Hospital Copenhagen University Hospital Copenhagen Denmark
| | | | - Maja B. Juul
- Department of Haematology Sygehus Lillebaelt Vejle Denmark
| | | | - Tarec C. El‐Galaly
- Department of Haematology Aalborg University Hospital Aalborg Denmark
- Department of Clinical Medicine Aalborg University Hospital Aalborg Denmark
- Clinical Cancer Research Centre Aalborg University Hospital Aalborg Denmark
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21
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Winther‐Jensen M, Hassager C, Lassen JF, Køber L, Torp‐Pedersen C, Hansen SM, Lippert F, Kragholm K, Christensen EF, Kjaergaard J. Neurological prognostication tools in out-of-hospital cardiac arrest patients in Danish intensive care units from 2005 to 2013. Acta Anaesthesiol Scand 2018; 62:1412-1420. [PMID: 29947076 DOI: 10.1111/aas.13177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 05/07/2018] [Accepted: 05/09/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Neurological prognostication is an essential part of post-resuscitation care in out-of-hospital cardiac arrest (OHCA). This study aims to assess the use of computed tomography (CT) and magnetic resonance imaging (MR) of the head, electroencephalography (EEG), and somatosensory evoked potentials (SSEP) in neurological prognostication in resuscitated OHCA patients and factors associated with their use in Danish tertiary and non-tertiary centers from 2005 to 2013 and associations with outcome. METHODS We used the Danish Cardiac Arrest Registry to identify patients ≥18 years of age admitted to intensive care units due to OHCA of presumed cardiac etiology. CT 0-20 days and MR, SSEP, and EEG ≥2-20 days post OHCA were considered related to prognostication. Incidence and factors associated with procedures were assessed by multiple Cox regression with death as competing risk. RESULTS Use of CT, MR, EEG, and SSEP increased during the study period (CT: 51%-67%, HRCT : 1.06, CI: 1.03-1.08, MR: 2%-5%, P = .08, EEG: 6%-33%, HREEG : 1.25, CI: 1.19-1.30, SSEP: 4%-15%, HRSSEP : 1.23, CI: 1.15-1.32). EEG and SSEP were more used in tertiary centers than non-tertiary (HREEG : 1.86, CI: 1.51-2.29, HRSSEP : 4.44, CI: 2.86-6.89). Use of CT, SSEP, and EEG were associated with higher 30-day mortality, and MR was associated with lower (HRCT : 1.15, CI: 1.01-1.30, HRMR : 0.53, CI: 0.37-0.77, HRSSEP : 1.90, CI: 1.57-2.32, HREEG : 1.75, CI: 1.49-2.05). CONCLUSION Use of neurological prognostication procedures increased during the study period. EEG and SSEP were more used in tertiary centers. CT, EEG and SSEP were associated with increased mortality.
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Affiliation(s)
- M. Winther‐Jensen
- Department of Cardiology The Heart Centre Copenhagen University Hospital Rigshospitalet Copenhagen Denmark
| | - C. Hassager
- Department of Cardiology The Heart Centre Copenhagen University Hospital Rigshospitalet Copenhagen Denmark
| | - J. F. Lassen
- Department of Cardiology The Heart Centre Copenhagen University Hospital Rigshospitalet Copenhagen Denmark
| | - L. Køber
- Department of Cardiology The Heart Centre Copenhagen University Hospital Rigshospitalet Copenhagen Denmark
| | - C. Torp‐Pedersen
- Unit of Epidemiology and Biostatistics Aalborg University Hospital Forskningens Hus Aalborg Denmark
| | - S. M. Hansen
- Unit of Epidemiology and Biostatistics Aalborg University Hospital Forskningens Hus Aalborg Denmark
| | - F. Lippert
- Emergency Medical Services Copenhagen University of Copenhagen Copenhagen Denmark
| | - K. Kragholm
- Department of Anesthesiology and Intensive Care Medicine Cardiovascular Research Centre Aalborg Denmark
| | - E. F. Christensen
- Department of Cardiology Aalborg University Hospital Aalborg Denmark
| | - J. Kjaergaard
- Department of Cardiology The Heart Centre Copenhagen University Hospital Rigshospitalet Copenhagen Denmark
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22
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Riemann M, Ngo AT, Holstein‐Rathlou N, Torp‐Pedersen C. Low salt diet intensifies conducted vasoconstriction via an angiotensin II receptor mediated mechanism. FASEB J 2009. [DOI: 10.1096/fasebj.23.1_supplement.952.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Mads Riemann
- Biomedical SciencesUniversity of CopenhagenCopenhagen NDenmark
| | - Anh Thuc Ngo
- Biomedical SciencesUniversity of CopenhagenCopenhagen NDenmark
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23
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Riemann MA, Holstein‐Rathlou N, Torp‐Pedersen C. Muscle vasodilatation caused by hypoxia propagates upstream within the arteriolar wall. FASEB J 2007. [DOI: 10.1096/fasebj.21.5.a494-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Mads Achen Riemann
- Medical PhysiologyPanum Institute CopenhagenBlegdamsvej 3, 10.5.15Copenhagen N2200Denmark
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24
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Ali I, Akman D, Bruun NE, Køber L, Brendorp B, Ottesen M, Møller J, Torp‐Pedersen C. Importance of a history of hypertension for the prognosis after acute myocardial infarction--for the Bucindolol Evaluation in Acute myocardial infarction Trial (BEAT) study group. Clin Cardiol 2004; 27:265-9. [PMID: 15188939 PMCID: PMC6653964 DOI: 10.1002/clc.4960270504] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Arterial hypertension is a major risk factor for cardiovascular events. The prognosis for hypertensive patients after acute myocardial infarction (MI) is uncertain because of the sparse and somewhat contradictionary data. HYPOTHESIS Our study aimed to investigate the importance of hypertension to prognosis after an MI in patients receiving contemporary medical therapy. METHODS We performed a retrospective study using a large register from the Bucindolol Evaluation in Acute myocardial infarction Trial (BEAT). The register comprised 3,326 patients admitted between June 1998 and August 1999 with an enzyme-verified MI to 33 Danish coronary care units. Hypertension was considered present when a previous diagnosis of hypertension was accompanied by relevant medical therapy. Survival information for all patients was obtained in January 2002. RESULTS Of the 3,326 patients studied, 825 were hypertensive. Overall, 28.4% had died by January 2002. The unadjusted hazard ratio associated with hypertension was 1.2 (95% confidence limit [CI] 1.1-1.4, p = 0.004). Hypertensive patients were older, and after adjustment for age the hazard ratio associated with hypertension was 1.04 (CI 0.9-1.2, p = 0.6). Adjustment for further covariates did not change the result. CONCLUSION Our study showed that after an acute MI the survival rate of patients with and without a history of hypertension was identical when they received contemporary medical therapy.
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Affiliation(s)
- Irma Ali
- Department of Cardiology, Gentofte University Hospital, Copenhagen, Denmark
| | - Dilek Akman
- Department of Cardiology, Rigshospitalet Heart Center, Copenhagen, Denmark
| | - Niels Eske Bruun
- Department of Cardiology, Gentofte University Hospital, Copenhagen, Denmark
| | - Lars Køber
- Department of Cardiology, Rigshospitalet Heart Center, Copenhagen, Denmark
| | - Bente Brendorp
- Department of Cardiology, Gentofte University Hospital, Copenhagen, Denmark
| | - Michael Ottesen
- Department of Cardiology, Gentofte University Hospital, Copenhagen, Denmark
| | - Jacob Møller
- Department of Cardiology, Gentofte University Hospital, Copenhagen, Denmark
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