32 results on '"Mortensen, Martin B."'
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2. Abstract 13721: Coronary Artery Calcium for Risk Stratification Among Persons With Very-High High-Density Lipoprotein Cholesterol
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Razavi, Alexander C, Mehta, Anurag, Budoff, Matthew J, Gianos, Eugenia, Wong, Nathan, Vaccarino, Viola, Van Assen, Marly, De, Carlo N, Rozanski, Alan, Miedema, Michael, Rumberger, John A, Mortensen, Martin B, Shaw, Leslee J, Nasir, Khurram, Blumenthal, Roger S, Rohatgi, Anand, Quyyumi, Arshed A, Sperling, Laurence, Whelton, Seamus P, Blaha, Michael J, Berman, Daniel, and Dzaye, Omar
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- 2023
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3. Coronary Artery Calcium and the Age-Specific Competing Risk of Cardiovascular Versus Cancer Mortality: The Coronary Artery Calcium Consortium
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Whelton, Seamus P, Rifai, Mahmoud Al, Marshall, Catherine Handy, Dardari, Zeina, Shaw, Leslee J, Al-Mallah, Mouaz H, Rozanski, Alan, Mortensen, Martin B, Dzaye, Omar, Bazzano, Lydia, Kelly, Tanika N, Matsushita, Kunihiro, Rumberger, John A, Berman, Daniel S, Budoff, Matthew J, Miedema, Michael D, Nasir, Khurram, and Blaha, Michael J
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Biomedical and Clinical Sciences ,Epidemiology ,Public Health ,Health Sciences ,Clinical Sciences ,Cardiovascular ,Cancer ,Prevention ,Heart Disease - Coronary Heart Disease ,Aging ,Heart Disease ,Detection ,screening and diagnosis ,4.1 Discovery and preclinical testing of markers and technologies ,Good Health and Well Being ,Adult ,Aged ,Cardiac-Gated Imaging Techniques ,Cardiovascular Diseases ,Cause of Death ,Coronary Artery Disease ,Female ,Humans ,Male ,Middle Aged ,Neoplasms ,Risk Assessment ,Severity of Illness Index ,Tomography ,X-Ray Computed ,Vascular Calcification ,Age ,Competing risk ,Coranary artery calcium ,Risk prediction ,Coronary artery calcium ,Medical and Health Sciences ,General & Internal Medicine ,Biomedical and clinical sciences ,Health sciences - Abstract
BackgroundCoronary artery calcium (CAC) is a guideline recommended cardiovascular disease (CVD) risk stratification tool that increases with age and is associated with non-cardiovascular disease outcomes including cancer. We sought to define the age-specific change in the association between CAC and cause-specific mortality.MethodsThe Coronary Artery Calcium Consortium includes 59,502 asymptomatic patients age 40-75 without known CVD. Age-stratified mortality rates and parametric survival regression modeling was performed to estimate the age-specific CAC score at which CVD and cancer mortality risk were equal.ResultsThe mean age was 54±8 years (67% men) and there were 2,423 deaths over a mean 12±3 years follow-up. Among individuals with CAC = 0, cancer was the leading cause of death, with low CVD mortality rates for both younger (40-54 years) 0.2/1,000 person-years and older participants (65-75 years) 1.3/1,000 person-years. When CAC ≥400, CVD was consistently the leading cause of death among younger (71% of deaths) and older participants (56% of deaths). The CAC score at which CVD overtook cancer as the leading cause of death increased exponentially with age and was approximately 115 at age 50 and 380 at age 65.ConclusionsRegardless of age, when CAC = 0 cancer was the leading cause of death and the cardiovascular disease mortality rate was low. Our age-specific estimate for the CAC score at which CVD overtakes cancer mortality allows for a more precise approach to synergistic prediction and prevention strategies for CVD and cancer.
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- 2020
4. Coronary Artery Calcium as a Synergistic Tool for the Age‐ and Sex‐Specific Risk of Cardiovascular and Cancer Mortality: The Coronary Artery Calcium Consortium
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Dzaye, Omar, Rifai, Mahmoud Al, Dardari, Zeina, Shaw, Leslee J, Al‐Mallah, Mouaz H, Marshall, Catherine Handy, Rozanski, Alan, Mortensen, Martin B, Duebgen, Matthias, Matsushita, Kunihiro, Rumberger, John A, Berman, Daniel S, Budoff, Matthew J, Miedema, Michael D, Nasir, Khurram, Blaha, Michael J, and Whelton, Seamus P
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Aging ,Heart Disease - Coronary Heart Disease ,Cardiovascular ,Heart Disease ,Prevention ,2.4 Surveillance and distribution ,Aetiology ,Good Health and Well Being ,Adult ,Age Factors ,Aged ,Cardiovascular Diseases ,Cause of Death ,Coronary Angiography ,Coronary Artery Disease ,Female ,Humans ,Male ,Middle Aged ,Neoplasms ,Predictive Value of Tests ,Prognosis ,Risk Assessment ,Risk Factors ,Severity of Illness Index ,Sex Factors ,Time Factors ,United States ,Vascular Calcification ,aging ,cardiovascular disease ,competing risk ,coronary artery calcium ,sex differences ,Cardiorespiratory Medicine and Haematology - Abstract
Background Coronary artery calcium (CAC) is a predictor for the development of cardiovascular disease (CVD) and to a lesser extent cancer. The age- and sex-specific relationship of CAC with CVD and cancer mortality is unknown. Methods and Results Asymptomatic patients aged 40 to 75 years old without known CVD were included from the CAC Consortium. We calculated sex-specific mortality rates per 1000 person-years' follow-up. Using parametric survival regression modeling, we determined the age- and sex-specific CAC score at which the risk of death from CVD and cancer were equal. Among the 59 502 patients included in this analysis, the mean age was 54.9 (±8.5) years, 34% were women, and 89% were white. There were 671 deaths attributable to CVD and 954 deaths attributable to cancer over a mean follow-up of 12±3 years. Among patients with CAC=0, cancer was the leading cause of death, the total mortality rate was low (women, 1.8; men, 1.5), and the CVD mortality rate was exceedingly low for women (0.3) and men (0.3). The age-specific CAC score at which the risk of CVD and cancer mortality were equal had a U-shaped relationship for women, while the relationship was exponential for men. Conclusions The age- and sex-specific relationship of CAC with CVD and cancer mortality differed significantly for women and men. Our age- and sex-specific CAC score provides a more precise estimate and further facilitates the use of CAC as a synergistic tool in strategies for the prediction and prevention of CVD and cancer mortality.
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- 2020
5. Primary prevention statin therapy in older adults
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Nanna, Michael G., Abdullah, Ahmed, Mortensen, Martin B., and Navar, Ann Marie
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- 2023
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6. Reduction of Myocardial Infarction and All-Cause Mortality Associated to Statins in Patients Without Obstructive CAD
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Øvrehus, Kristian A., Diederichsen, Axel, Grove, Erik L., Steffensen, Flemming H., Mortensen, Martin B., Jensen, Jesper M., Mickley, Hans, Nielsen, Lene H., Busk, Martin, Sand, Niels Peter R., Lambrechtsen, Jess, Riis, Anders H., Andersen, Ina Trolle, Bøtker, Hans E., and Nørgaard, Bjarne L.
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- 2021
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7. Increased retention of LDL from type 1 diabetic patients in atherosclerosis-prone areas of the murine arterial wall
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Hagensen, Mette K., Mortensen, Martin B., Kjolby, Mads, Palmfeldt, Johan, Bentzon, Jacob F., and Gregersen, Soeren
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- 2019
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8. Abstract 16424: Cardiovascular Risk Factors Among a Nationally Representative Adult Population With Inflammatory Bowel Disease and Without Clinical Atherosclerotic Cardiovascular Disease
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Agrawal, Tanushree, Acquah, Isaac, Dey, Amit, Hassan, Syed Z, Glassner, Kerri, Abraham, Bincy, Quigley, Eamonn, Mehta, Nehal N, Mortensen, Martin B, Virani, Salim S, Blaha, Michael J, Blankstein, Ron, Nasir, Khurram, and Cainzos Achirica, Miguel
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- 2020
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9. Low‐density lipoprotein cholesterol cannot be too low after a myocardial infarction.
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Wulff, Anders B., Mortensen, Martin B., and Nordestgaard, Børge G.
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LDL cholesterol , *MYOCARDIAL infarction - Abstract
Said differently, LDL cholesterol cannot be too low after a myocardial infarction and all patients with a myocardial infarction should receive LDL cholesterol-lowering medication post myocardial infarction irrespective of their LDL cholesterol levels at the time of the infarct. Just as age - these comorbidities increase the risk of dying during follow-up for patients with low LDL cholesterol at myocardial infarction compared with those with high LDL cholesterol at myocardial infarction. Elevated low-density lipoprotein (LDL) cholesterol is a causal risk factor for the development of atherosclerosis and drives an increased risk of both myocardial infarction and early death. [Extracted from the article]
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- 2023
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10. Abstract 20854: A Tale of Self-Fulfilling Prophecies in Out-of-Hospital Cardiac Arrest: Emergency Medical Technicians Deliberately Perform Substandard CPR When Anticipating Poor Prognosis
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Bødtker, Henrik, Klausen, Troels M, Lauridsen, Kasper G, Jæger, Andre’, Mortensen, Martin B, and Løfgren, Bo
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- 2017
11. Diabetes with poor glycaemic control does not promote atherosclerosis in genetically modified hypercholesterolaemic minipigs
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Al-Mashhadi, Rozh H., Bjørklund, Martin M., Mortensen, Martin B., Christoffersen, Christina, Larsen, Torben, Falk, Erling, and Bentzon, Jacob F.
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- 2015
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12. Targeting sortilin in immune cells reduces proinflammatory cytokines and atherosclerosis
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Mortensen, Martin B., Kjolby, Mads, Gunnersen, Stine, Larsen, Jakob V., Palmfeldt, Johan, Falk, Erling, Nykjaer, Anders, and Bentzon, Jacob F.
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Cytokines -- Physiological aspects -- Research ,Cell receptors -- Physiological aspects -- Research ,Atherosclerosis -- Development and progression -- Research ,Health care industry - Abstract
Genome-wide association studies have identified a link between genetic variation at the human chromosomal locus 1p13.3 and coronary artery disease. The gene encoding sortilin (SORT1) has been implicated as the causative gene within the locus, as sortilin regulates hepatic lipoprotein metabolism. Here we demonstrated that sortilin also directly affects atherogenesis, independent of its regulatory role in lipoprotein metabolism. In a mouse model of atherosclerosis, deletion of Sort1 did not alter plasma cholesterol levels, but reduced the development of both early and late atherosclerotic lesions. We determined that sortilin is a high-affinity receptor for the proinflammatory cytokines IL-6 and IFN-γ. Moreover, macrophages and Th1 cells (both of which mediate atherosclerotic plaque formation) lacking sortilin had reduced secretion of IL-6 and IFN- γ, but not of other measured cytokines. Transfer of sortilin-deficient BM into irradiated atherosclerotic mice reduced atherosclerosis and systemic markers of inflammation. Together, these data demonstrate that sortilin influences cytokine secretion and that targeting sortilin in immune cells attenuates inflammation and reduces atherosclerosis., Introduction SNPs at the 1p13.3 locus are associated with coronary artery disease and myocardial infarction in humans (1, 2) as well as with LDL cholesterol levels (3). Recent studies have [...]
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- 2014
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13. Influence of intensive lipid‐lowering on CT derived fractional flow reserve in patients with stable chest pain: Rationale and design of the FLOWPROMOTE study.
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Mortensen, Martin B., Sand, Niels‐Peter, Busk, Martin, Jensen, Jesper M., Grove, Erik L., Dey, Damini, Iraqi, Nadia, Updegrove, Adam, Fonte, Tim, Mathiassen, Ole N., Hosbond, Susanne, Bøtker, Hans E., Leipsic, Jonathon, Narula, Jagat, and Nørgaard, Bjarne L.
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CHEST pain ,CORONARY artery stenosis ,CORONARY artery disease ,CORONARY angiography ,STATINS (Cardiovascular agents) - Abstract
Introduction: Coronary CT angiography (CTA) derived fractional flow reserve (FFRCT) shows high diagnostic performance when compared to invasively measured FFR. Presence and extent of low attenuation plaque density have been shown to be associated with abnormal physiology by measured FFR. Moreover, it is well established that statin therapy reduces the rate of plaque progression and results in morphology alterations underlying atherosclerosis. However, the interplay between lipid lowering treatment, plaque regression, and the coronary physiology has not previously been investigated. Aim: To test whether lipid lowering therapy is associated with significant improvement in FFRCT, and whether there is a dose–response relationship between lipid lowering intensity, plaque regression, and coronary flow recovery. Methods: Investigator driven, prospective, multicenter, randomized study of patients with stable angina, coronary stenosis ≥50% determined by clinically indicated first‐line CTA, and FFRCT ≤ 0.80 in whom coronary revascularization was deferred. Patients are randomized to standard (atorvastatin 40 mg daily) or intensive (rosuvastatin 40 mg + ezetimibe 10 mg daily) lipid lowering therapy for 18 months. Coronary CTA scans with blinded coronary plaque and FFRCT analyses will be repeated after 9 and 18 months. The primary endpoint is the 18‐month difference in FFRCT using (1) the FFRCT value 2 cm distal to stenosis and (2) the lowest distal value in the vessel of interest. A total of 104 patients will be included in the study. Conclusion: The results of this study will provide novel insights into the interplay between lipid lowering, and the pathophysiology in coronary artery disease. [ABSTRACT FROM AUTHOR]
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- 2022
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14. ApoB and Non‐HDL Cholesterol Versus LDL Cholesterol for Ischemic Stroke Risk.
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Johannesen, Camilla D. L., Mortensen, Martin B., Langsted, Anne, and Nordestgaard, Børge G.
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Objective: Conflicting results have been reported on the association between lipids and risk of ischemic stroke. We tested the hypothesis that the burden of ischemic stroke attributable to either elevated apolipoprotein B (apoB) or non‐high‐density lipoprotein (non‐HDL) cholesterol is higher than that attributable to elevated low‐density lipoprotein (LDL) cholesterol. Methods: We included 104,618 individuals from an ongoing cohort study, the Copenhagen General Population Study. The associations of quintiles of apoB, non‐HDL cholesterol, and LDL cholesterol with risk of ischemic stroke were estimated by Cox proportional hazards regressions with 95% confidence intervals. With 1st quintile as reference, the proportion of ischemic stroke attributable to the 2nd, 3rd, 4th, and 5th quintiles of apoB, non‐HDL cholesterol, and LDL cholesterol were estimated by population attributable fractions. Results: Higher quintiles of apoB and non‐HDL cholesterol were associated with increased risk of ischemic stroke (both trends: p < 0.0001), whereas for LDL cholesterol this association was somewhat attenuated (trend: p = 0.0005). A similar pattern was seen for population attributable fraction values. Compared to individuals in the 1st quintile, the combined proportion of ischemic stroke attributable to individuals in the 2nd to 5th quintiles was 16.3% for apoB (levels >82 mg/dL), 14.7% for non‐HDL cholesterol (>3.0 mmol/L; >117 mg/dL), and 6.8% for LDL cholesterol (>2.4 mmol/L; >94 mg/dL). Interpretation: The proportion of ischemic stroke attributable to either elevated apoB or non‐HDL cholesterol was double that attributable to elevated LDL cholesterol. ANN NEUROL 2022;92:379–389 [ABSTRACT FROM AUTHOR]
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- 2022
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15. The high-density lipoprotein-adjusted SCORE model worsens SCORE-based risk classification in a contemporary population of 30 824 Europeans: the Copenhagen General Population Study
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Mortensen, Martin B., Afzal, Shoaib, Nordestgaard, Børge G., and Falk, Erling
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- 2015
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16. PROGNOSTIC IMPLICATION OF THORACIC AORTIC CALCIUM AREA AND DENSITY BEYOND CORONARY ARTERY CALCIUM FOR ATHEROSCLEROTIC CARDIOVASCULAR DISEASE MORTALITY
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Razavi, Alexander C., Berman, Daniel S., Van Assen, Marly, De Cecco, Carlo Nicola, Sperling, Laurence S., Quyyumi, Arshed A., Budoff, Matthew J., Miedema, Michael D., Nasir, Khurram, Rozanski, Alan, Rumberger, John A., Shaw, Leslee J., Mortensen, Martin B⊘dtker, Whelton, Seamus P., Blaha, Michael J., and Dzaye, Omar
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- 2023
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17. Circulating endothelial progenitor cells do not contribute to regeneration of endothelium after murine arterial injury
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Hagensen, Mette K., Raarup, Merete K., Mortensen, Martin B., Thim, Troels, Nyengaard, Jens R., Falk, Erling, and Bentzon, Jacob F.
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- 2012
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18. Clinical outcomes following real-world computed tomography angiography-derived fractional flow reserve testing in chronic coronary syndrome patients with calcification.
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Nørgaard, Bjarne L, Mortensen, Martin B, Parner, Erik, Leipsic, Jonathon, Steffensen, Flemming H, Grove, Erik Lerkevang, Mathiassen, Ole N, Sand, Niels Peter, Pedersen, Kamilla, Riedl, Katharina A, Engholm, Morten, Bøtker, Hans Erik, and Jensen, Jesper M
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CORONARY arterial radiography ,CALCIUM metabolism ,BLOOD vessels ,SCIENTIFIC observation ,CORONARY artery stenosis ,ANGINA pectoris ,MYOCARDIAL infarction ,CORONARY circulation ,TREATMENT effectiveness ,CORONARY artery disease ,HEART function tests ,CALCINOSIS ,HOSPITAL care ,MYOCARDIAL revascularization ,DESCRIPTIVE statistics ,COMPUTED tomography ,CORONARY arteries ,PATIENT safety ,DISEASE risk factors - Abstract
Aims This study sought to investigate outcomes following a normal CT-derived fractional flow reserve (FFR
CT ) result in patients with moderate stenosis and coronary artery calcification, and to describe the relationship between the extent of calcification, stenosis, andFFR CT. Methods and results Data from 975 consecutive patients suspected of chronic coronary syndrome with stenosis (30–70%) determined by computed CT angiography and FFRCT to guide downstream management decisions were reviewed. Median (range) follow-up time was 2.2 (0.5–4.2) years. Coronary artery calcium (CAC) scores were ≥400 in 25%, stenosis ≥50% in 83%, and FFRCT >0.80 in 51% of the patients. There was a lower incidence of the composite endpoint (death, myocardial infarction, hospitalization for unstable angina, and unplanned coronary revascularization) at 4.2 years in patients with any CAC and FFRCT > 0.80 vs. FFRCT ≤ 0.80 (3.9% and 8.7%, P = 0.04), however, in patients with CAC scores ≥400 the risk difference between groups did not reach statistical significance, 4.2% vs. 9.7% (P = 0.24). A negative relationship between CAC scores and FFRCT irrespective of stenosis severity was demonstrated. Conclusion FFRCT shows promise in identifying patients with stenosis and calcification who can be managed without further downstream testing. Moreover, an inverse relationship between CAC levels and FFRCT was demonstrated. Studies are needed to further assess the clinical utility of FFRCT in patients with extensive coronary calcification. [ABSTRACT FROM AUTHOR]- Published
- 2021
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19. Trends in antidiabetic drug utilization and expenditure in Denmark: A 22‐year nationwide study.
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Bang, Camilla, Mortensen, Martin B., Lauridsen, Kasper G., and Bruun, Jens M.
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DRUG utilization , *EXENATIDE , *GLUCAGON-like peptide-1 receptor , *GLUCAGON-like peptide-1 agonists , *TYPE 2 diabetes , *COST accounting , *DRUG prices - Abstract
Aims: To examine the nationwide trends in antidiabetic drug utilization and expenditure in Denmark over the past 22 years. Methods: Data on antidiabetic use and expenditure from 1996 to 2017 were retrieved from the Register of Medicinal Product Statistics. Antidiabetic drug use is reported as defined daily dose (DDD) in total counts and per 1000 inhabitants/d. Expenditure is reported as volume sold in total counts per 1000 inhabitants and as annual mean expenditure. Results: Throughout the study period, the total use of antidiabetic drugs increased from 16.4 to 55.8 DDDs per 1000 inhabitants/d, while total expenditure increased from €59 to €286 m. The introduction of glucagon‐like peptide‐1 receptor agonists (GLP‐1RAs), dipeptidyl peptidase‐4 inhibitors and sodium‐glucose co‐transporter‐2 inhibitors has, since 2005, led to considerable variation in the proportional use of the different drug classes. Use of insulin and insulin analogues accounted for the majority of the cost of antidiabetic drugs, peaking at 75% in 2008; however, its proportional impact on overall antidiabetic drug expenditure decreased to ~44% in 2017. In contrast, a steep increase in GLP‐1RA expenditure was observed from 2010 to 2017, reaching an annual cost of €85 m (~29% of all antidiabetic expenditure). Conclusion: Antidiabetic drug utilization and cost in Denmark has increased considerably over the last 22 years, in accordance with the increased incidence of type 2 diabetes and changes in treatment guidelines. The release of several novel antidiabetic drugs seems to be responsible for the increase in antidiabetic drug expenditure. [ABSTRACT FROM AUTHOR]
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- 2020
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20. Kringle IV Type 2, Not Low Lipoprotein(a), as a Cause of Diabetes: A Novel Genetic Approach Using SNPs Associated Selectively with Lipoprotein(a) Concentrations or with Kringle IV Type 2 Repeats.
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Tolbus, Andra, Mortensen, Martin B., Nielsen, Sune F., Kamstrup, Pia R., Bojesen, Stig E., and Nordestgaard, Børge G.
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- 2017
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21. Primary Prevention With Statins: ACC/AHA Risk-Based Approach Versus Trial-Based Approaches to Guide Statin Therapy.
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Mortensen, Martin B., Afzal, Shoaib, Nordestgaard, Børge G., and Falk, Erling
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STATINS (Cardiovascular agents) , *CARDIOVASCULAR diseases , *CLINICAL trials , *COMPARATIVE studies , *ATHEROSCLEROSIS , *CARDIAC research , *ATHEROSCLEROSIS prevention , *ANTILIPEMIC agents , *DISEASES , *LONGITUDINAL method , *RESEARCH methodology , *MEDICAL cooperation , *MEDICAL protocols , *PREVENTIVE health services , *RESEARCH , *RISK assessment , *EVALUATION research , *RANDOMIZED controlled trials , *TREATMENT effectiveness - Abstract
Background: Guidelines recommend initiating primary prevention for atherosclerotic cardiovascular disease (ASCVD) with statins based on absolute ASCVD risk assessment. Recently, alternative trial-based and hybrid approaches were suggested for statin treatment eligibility.Objectives: This study compared these approaches in a direct head-to-head fashion in a contemporary population.Methods: The study used the CGPS (Copenhagen General Population Study) with 37,892 subjects aged 40 to 75 years recruited in 2003 to 2008, all free of ASCVD, diabetes, and statin use at baseline.Results: Among the population studied, 42% were eligible for statin therapy according to the 2013 American College of Cardiology/American Heart Association (ACC/AHA) risk assessment and cholesterol treatment guidelines approach, versus 56% with the trial-based approach and 21% with the hybrid approach. Among these statin-eligible subjects, the ASCVD event rate per 1,000 person-years was 9.8, 6.8, and 11.2, respectively. The ACC/AHA-recommended absolute risk score was well calibrated around the 7.5% 10-year ASCVD risk treatment threshold and discriminated better than the trial-based or hybrid approaches. Compared with the ACC/AHA risk-based approach, the net reclassification index for eligibility for statin therapy among 40- to 75-year-old subjects from the CGPS was -0.21 for the trial-based approach and -0.13 for the hybrid approach.Conclusions: The clinical performance of the ACC/AHA risk-based approach for primary prevention of ASCVD with statins was superior to the trial-based and hybrid approaches. Our results indicate that the ACC/AHA guidelines will prevent more ASCVD events than the trial-based and hybrid approaches, while treating fewer people compared with the trial-based approach. [ABSTRACT FROM AUTHOR]- Published
- 2015
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22. Real-life evaluation of European and American high-risk strategies for primary prevention of cardiovascular disease in patients with first myocardial infarction.
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Mortensen, Martin B. and Falk, Erling
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Objective: To determine the detection rate (sensitivity) of the high-risk strategy recommended in the European Society of Cardiology (ESC) and National Institute for Health and Care Excellence (NICE/UK) and American College of Cardiology/American Heart Association (ACC/AHA) guidelines on cardiovascular disease (CVD) prevention. In particular, to evaluate the ability to ensure statin therapy to contemporary Europeans destined for a first myocardial infarction (MI). Design: 393 consecutive statin-naïve, CVD-free patients without diabetes hospitalised for a first MI, 247 of whom were 40-75 years of age. We assumed they had undergone a health check the day before their MI and estimated the predicted risk. Primary outcome: Sensitivity of the risk-based eligibility for primary prevention with statins recommended by the guidelines. Results: All recommended risk scores rank-ordered patients similarly, but the sensitivity of the cut point above which statin therapy should be considered differed substantially. In younger patients (age 40-60), 62% of men and 13% of women qualified for statin therapy by ACC/AHA criteria, compared with only 2% of men and no women using the ESC criteria recommended for most non-Eastern European countries. In those 60-75 years of age, the ACC/AHA guidelines captured all men and 85% of women, compared with 12% and 2%, respectively, using the new ESC guideline. This guideline restricted the eligibility for primary prevention with statins substantially by reclassifying many European countries from 'high-risk' to 'low-risk', whereas the eligibility was expanded in the ACC/AHA and the new NICE/UK guidelines by lowering the decision threshold. Conclusions: The 2012 ESC guidelines differ substantially from the 2013 ACC/AHA and 2014 NICE/UK guidelines in ability to secure statin therapy to those destined for a first MI. A great opportunity for primary prevention with statins remains unexploited in Europe. [ABSTRACT FROM AUTHOR]
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- 2014
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23. Familial Hypercholesterolemia and Atherosclerosis in Cloned Minipigs Created by DNA Transposition of a Human PCSK9 Gain-of-Function Mutant.
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Al-Mashhadi, Rozh H., Sørensen, Charlotte B., Kragh, Peter M., Christoffersen, Christina, Mortensen, Martin B., Tolbod, Lars P., Thim, Troels, Yutao Du, Juan Li, Ying Liu, Moldt, Brian, Schmidt, Mette, Vajta, Gabor, Larsen, Torben, Purup, Stig, Bolund, Lars, Nielsen, Lars B., Callesen, Henrik, Falk, Erling, and Mikkelsen, Jacob Giehm
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- 2013
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24. Unique Structural Features Facilitate Lizard Tail Autotomy.
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Sanggaard, Kristian W., Danielsen, Carl Chr., Wogensen, Lise, Vinding, Mads S., Rydtoft, Louise M., Mortensen, Martin B., Karring, Henrik, Nielsen, Niels Chr., Wang, Tobias, Thøgersen, Ida B., and Enghild, Jan J.
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REGENERATION (Biology) ,CONNECTIVE tissues ,STEREOLOGY ,SQUAMATA ,GECKOS - Abstract
Autotomy refers to the voluntary shedding of a body part; a renowned example is tail loss among lizards as a response to attempted predation. Although many aspects of lizard tail autotomy have been studied, the detailed morphology and mechanism remains unclear. In the present study, we showed that tail shedding by the Tokay gecko (Gekko gecko) and the associated extracellular matrix (ECM) rupture were independent of proteolysis. Instead, lizard caudal autotomy relied on biological adhesion facilitated by surface microstructures. Results based on bio-imaging techniques demonstrated that the tail of Gekko gecko was pre-severed at distinct sites and that its structural integrity depended on the adhesion between these segments. [ABSTRACT FROM AUTHOR]
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- 2012
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25. Eligibility for and Preventive Potential of Semaglutide in Overweight and Obese Patients With Myocardial Infarction.
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Hansen, Malene K., Olesen, Kevin K.W., Gyldenkerne, Christine, Thrane, Pernille G., Stødkilde-Jørgensen, Nina, Mortensen, Martin B., and Maeng, Michael
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MYOCARDIAL infarction , *SEMAGLUTIDE , *OBESITY - Published
- 2024
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26. High-Quality Statin Trials Support the 2013 American College of Cardiology/American Heart Association Cholesterol Guidelines After the HOPE-3 Trial (Heart Outcomes Prevention Evaluation-3): MESA (The Multiethnic Study of Atherosclerosis).
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Mortensen, Martin B, Budoff, Matthew J, Li, Dong, Nasir, Khurram, Blaha, Michael J, Sandfort, Veit, Rodriguez, Carlos J, Ouyang, Pamela, Falk, Erling, Mortensen, Martin Bødtker, Budoff, Matthew, and Jose Rodriguez, Carlos
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The 2013 American College of Cardiology/American Heart Association (ACC/AHA) guideline on cholesterol treatment to prevent atherosclerotic cardiovascular disease (ASCVD) has been criticized for lowering the risk thresholds for primary prevention with statin therapy. Although the ≥ 7.5% (class I) and ≥ 5% (class IIa) 10-year ASCVD risk thresholds were identified as new indications for treatment by extrapolating results obtained in randomized controlled trials (RCT) of statin therapy, results from population-based European cohorts indicate that >30% of individuals eligible for statin therapy by class I recommendations do not have RCT data supporting statin efficacy. Further, when the US Preventive Services Task Force published their recommendations (based on review of trial evidence), they restricted the indication for statin therapy compared with the ACC/AHA guideline by recommending a higher treatment threshold (10%) combined with ≥1 ASCVD risk factor. However, the evidence base for statins in primary prevention grew substantially in 2016 with publication of the Heart Outcomes Prevention Evaluation-3 (HOPE-3) trial that enrolled intermediate-risk persons for whom a clear indication for statin therapy was still lacking. The implications of HOPE-3 for the evidence base supporting ACC/AHA risk-based statin allocation remain unknown. Therefore, using MESA (Multiethnic Study of Atherosclerosis, www.mesa-nhlbi.org) - a population-based US cohort - we assessed the extent to which the ACC/AHA recommendations for statin therapy are supported by currently available high-quality RCT evidence: WOSCOPS, AFCAPS/TexCAPS, ASCOT-LLA, CARDS, MEGA, JUPITER and HOPE-3 (ref. 2 and 4 for details). Given the controversy that exists in whom to treat with statins in primary prevention, such information may provide important insights for clinical practice and future updates of guidelines and recommendations. [ABSTRACT FROM AUTHOR]
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- 2017
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27. Completeness of revascularization by FFR CT in stable angina: Association to adverse cardiovascular outcomes.
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Madsen KT, Nørgaard BL, Øvrehus KA, Jensen JM, Parner E, Grove EL, Mortensen MB, Iraqi N, Fairbairn TA, Nieman K, Patel MR, Rogers C, Mullen S, Mickley H, Thomsen KK, Bøtker HE, Leipsic J, and Rønnow Sand NP
- Abstract
Background: The prognostic impact of complete coronary revascularization relative to non-invasive testing methods is unknown., Objectives: To assess the association between completeness of revascularization defined by CTA-derived fractional flow reserve (FFR
CT ) and cardiovascular outcomes in patients with stable angina., Methods: Multicenter 3-year follow-up study of patients with new onset stable angina and ≥ 30% stenosis by CTA. The lesion-specific FFRCT value (two cm-distal-to-stenosis) was registered in all vessels with stenosis and considered abnormal when ≤ 0.80. Patients with FFRCT ≤ 0.80 were categorized as: Completely revascularized (CR-FFRCT ), all vessels with FFRCT ≤ 0.80 revascularized; incompletely revascularized (IR-FFRCT ), ≥ 1 vessels with FFRCT ≤ 0.80 non-revascularized. Early revascularization (< 90 days from index CTA) categorized vessels as revascularized. The primary endpoint comprised cardiovascular death and non-fatal myocardial infarction; the secondary endpoint vessel-specific late revascularization and non-fatal myocardial infarction., Results: Amongst 900 patients and 1759 vessels, FFRCT was ≤ 0.80 in 377 (42%) patients, 536 (30%) vessels; revascularization was performed in 244 (27%) patients, 340 (19%) vessels. Risk of the primary endpoint was higher for IR-FFRCT (15/210 [7.1%]) compared to CR-FFRCT (4/167 [2.4%]), RR: 2.98; 95% CI: 1.01-8.8, p = 0.036, and to normal FFRCT (3/523 [0.6%]), RR: 12.45; 95% CI: 3.6-42.6, p < 0.001. Incidence of the secondary endpoint was higher in non-revascularized vessels with FFRCT ≤ 0.80 (29/250 [12%]) compared to revascularized vessels with FFRCT ≤ 0.80 (5/286 [1.7%]), p = 0.001, and to vessels with FFRCT > 0.80 (10/1223 [0.8%]), p < 0.001., Conclusion: Incomplete revascularization of patients with lesion-specific FFRCT ≤ 0.80 is associated to unfavorable cardiovascular outcomes compared to those with complete revascularization or FFRCT > 0.80., Competing Interests: Declaration of competing interest CR is a full-time employee of HeartFlow, and receives salary and stock options from HeartFlow. ELG has no conflicts related to this manuscript but has received speaker honoraria or consultancy fees from AstraZeneca, Bayer, Boehringer Ingelheim, Bristol-Myers Squibb, Pfizer, Lundbeck Pharma, Novo Nordisk and Organon. He is investigator in clinical studies sponsored by AstraZeneca, Idorsia or Bayer and has received unrestricted research grants from Boehringer Ingelheim. JL is a consultant and holds stock options in Circle CVI and HeartFlow. KN acknowledges support from the NIH and reports unrestricted institutional research support from Siemens Healthineers, Bayer, HeartFlow Inc and Novartis. MP has received research grants from Janssen, Bayer, Heartflow and NIH and is part of the following advisory boards: Janssen, Bayer, Heartflow, Phillips. SM is a full-time employee of HeartFlow, and shareholder of HeartFlow. TF is associated with the HeartFlow speakers bureau. All other authors had no disclosures to declare., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)- Published
- 2024
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28. Clinical outcomes following real-world computed tomography angiography-derived fractional flow reserve testing in chronic coronary syndrome patients with calcification.
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Nørgaard BL, Mortensen MB, Parner E, Leipsic J, Steffensen FH, Grove EL, Mathiassen ON, Sand NP, Pedersen K, Riedl KA, Engholm M, Bøtker HE, and Jensen JM
- Subjects
- Computed Tomography Angiography, Coronary Angiography, Coronary Vessels, Humans, Predictive Value of Tests, Severity of Illness Index, Tomography, X-Ray Computed, Coronary Artery Disease diagnostic imaging, Coronary Stenosis diagnostic imaging, Fractional Flow Reserve, Myocardial
- Abstract
Aims: This study sought to investigate outcomes following a normal CT-derived fractional flow reserve (FFRCT) result in patients with moderate stenosis and coronary artery calcification, and to describe the relationship between the extent of calcification, stenosis, and FFRCT., Methods and Results: Data from 975 consecutive patients suspected of chronic coronary syndrome with stenosis (30-70%) determined by computed CT angiography and FFRCT to guide downstream management decisions were reviewed. Median (range) follow-up time was 2.2 (0.5-4.2) years. Coronary artery calcium (CAC) scores were ≥400 in 25%, stenosis ≥50% in 83%, and FFRCT >0.80 in 51% of the patients. There was a lower incidence of the composite endpoint (death, myocardial infarction, hospitalization for unstable angina, and unplanned coronary revascularization) at 4.2 years in patients with any CAC and FFRCT > 0.80 vs. FFRCT ≤ 0.80 (3.9% and 8.7%, P = 0.04), however, in patients with CAC scores ≥400 the risk difference between groups did not reach statistical significance, 4.2% vs. 9.7% (P = 0.24). A negative relationship between CAC scores and FFRCT irrespective of stenosis severity was demonstrated., Conclusion: FFRCT shows promise in identifying patients with stenosis and calcification who can be managed without further downstream testing. Moreover, an inverse relationship between CAC levels and FFRCT was demonstrated. Studies are needed to further assess the clinical utility of FFRCT in patients with extensive coronary calcification., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissions@oup.com.)
- Published
- 2021
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29. Contemporary lipid clinic and achievements in low-density lipoprotein-cholesterol reductions in very high-risk patients.
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Larsen JV, Martinsen MH, Mortensen MB, Klausen IC, and Hedegaard BS
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- Ambulatory Care Facilities, Cholesterol, LDL, Humans, Retrospective Studies, Risk Factors, Treatment Outcome, Cardiovascular Diseases prevention & control, Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use
- Abstract
Introduction: Numerous studies have shown that lowering of low-density lipoprotein-cholesterol (LDL-C) reduces the risk of cardiovascular disease (CVD). To optimise treatment, some patients are referred to a lipid clinic. The reduction in LDL-C achieved in a lipid clinic in contemporary practice is, however, not well described. The aim of the present study was to assess the LDL-C lowering effect among very high-risk patients with or without statin-associated muscle symptoms (SAMS) after treatment at a specialised lipid clinic endorsing European guidelines., Methods: Medical records from 653 patients referred to our Lipid Clinic from 1 January 2013 to 1 May 2017 were examined retrospectively. Very high-risk patients were defined as either having CVD or diabetes mellitus Type 2 who were active smokers and/or had hypertension. The reduction in LDL-C and the number of patients reaching the LDL-C treatment target were investigated by comparing baseline data with the most recent values recorded., Results: We identified 208 patients at a very high-risk for CVD. They obtained an LDL-C reduction of 23% corresponding to a reduction in LDL-C of 0.7 mmol/l (p less than 0.001). The percentage of patients reaching their LDL-C goal increased from 13% to 32%. In patients who had experienced SAMS, LDL-C was reduced by 26% corresponding to a reduction in LDL-C of 0.9 mmol/l (p less than 0.001), and the percentage of patients reaching their LDL-C goal increased from 8% to 23%., Conclusions: Very high-risk patients with or without SAMS obtained a clinically meaningful reduction in LDL-C of approximately 25% owing to their Lipid Clinic treatment., Funding: none., Trial Registration: not relevant., (Articles published in the DMJ are “open access”. This means that the articles are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.)
- Published
- 2020
30. The high-density lipoprotein-adjusted SCORE model worsens SCORE-based risk classification in a contemporary population of 30,824 Europeans: the Copenhagen General Population Study.
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Mortensen MB, Afzal S, Nordestgaard BG, and Falk E
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- Adult, Aged, Cardiovascular Diseases mortality, Denmark epidemiology, Female, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use, Male, Middle Aged, Myocardial Infarction mortality, Prospective Studies, Risk Assessment methods, Sensitivity and Specificity, Sex Distribution, Stroke mortality, Cardiovascular Diseases prevention & control, Cholesterol, HDL blood
- Abstract
Aims: Recent European guidelines recommend to include high-density lipoprotein (HDL) cholesterol in risk assessment for primary prevention of cardiovascular disease (CVD), using a SCORE-based risk model (SCORE-HDL). We compared the predictive performance of SCORE-HDL with SCORE in an independent, contemporary, 'low-risk' European population, focusing on ability to identify those in need of intensified CVD prevention., Methods and Results: Between 2003 and 2008, 46,092 individuals without CVD, diabetes, or statin use were enrolled in the Copenhagen General Population Study (CGPS). During a mean of 6.8 years of follow-up, 339 individuals died of CVD. In the SCORE target population (age 40-65; n = 30,824), fewer individuals were at baseline categorized as high risk (≥5% 10-year risk of fatal CVD) using SCORE-HDL compared with SCORE (10 vs. 17% in men, 1 vs. 3% in women). SCORE-HDL did not improve discrimination of future fatal CVD, compared with SCORE, but decreased the detection rate (sensitivity) of the 5% high-risk threshold from 42 to 26%, yielding a negative net reclassification index (NRI) of -12%. Importantly, using SCORE-HDL, the sensitivity was zero among women. Both SCORE and SCORE-HDL overestimated risk of fatal CVD. In well-calibrated models developed from the CGPS, HDL did not improve discrimination or NRI. Lowering the decision threshold from 5 to 1% led to progressive gain in NRI for both CVD mortality and morbidity., Conclusion: SCORE-HDL did not improve discrimination compared with SCORE, but deteriorated risk classification based on NRI. Future guidelines should consider lower decision thresholds and prioritize CVD morbidity and people above age 65., (© The Author 2015. Published by Oxford University Press on behalf of the European Society of Cardiology.)
- Published
- 2015
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31. Sortilin and atherosclerosis.
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Mortensen MB, Kjolby M, and Bentzon JF
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- Adaptor Proteins, Vesicular Transport genetics, Animals, Atherosclerosis genetics, Atherosclerosis pathology, Humans, Mice, Adaptor Proteins, Vesicular Transport metabolism, Atherosclerosis metabolism
- Published
- 2015
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32. Traditional SCORE-based health check fails to identify individuals who develop acute myocardial infarction.
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Mortensen MB, Sivesgaard K, Jensen HK, Comuth W, Kanstrup H, Gotzsche O, May O, Bertelsen J, and Falk E
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- Age Factors, Aged, Aged, 80 and over, Blood Pressure, Cholesterol blood, Female, Humans, Male, Middle Aged, Myocardial Infarction etiology, Risk Assessment methods, Risk Factors, Sex Factors, Smoking adverse effects, Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use, Myocardial Infarction prevention & control
- Abstract
Introduction: Atherosclerotic cardiovascular disease (CVD), including acute myocardial infarction (AMI), is caused by well-known risk factors. They constitute important therapeutic targets, but their predictive value is disputed. We evaluated the effectiveness of the risk scoring system (SCORE) and thresholds for pharmacotherapy re-commended in the European guidelines on CVD prevention., Material and Methods: The medical records of 605 consecutive patients hospitalized for a first AMI were reviewed. Patients with pre-existing CVD, diabetes, or incomplete information on risk factors were excluded. Those not treated with statin before AMI were risk stratified based on risk factors. A SCORE ≥ 5% or ≥ 10% was considered to qualify for preventive medication in young adults (age ≤ 60 years) or elderly (age > 60 years), respectively., Results: Before AMI, 40 (9%) used statin. Among non-statin users, only five of the 109 young adults had a SCORE ≥ 5%, and 23 of the 284 elderly had a SCORE ≥ 10%. Among women, only three elderly qualified for treatment. More than four times more patients would have qualified for treatment with the high-risk country chart used in 2011. The incremental value of the novel high-density lipoprotein adjusted SCORE charts was limited., Conclusion: Few patients admitted with a first AMI used statin. Among non-statin users, SCORE and the recommended thresholds for pharmacotherapy identified no women and less than one out of ten men who untreated were destined for an AMI before 61 years of age. The preventive potential of a traditional risk factor-based health check is limited., Funding: not relevant., Trial Registration: not relevant.
- Published
- 2013
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