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Background: ECG marker P Terminal Force V1 (PTFV1) is generally perceived as a marker of left atrial pathology and has been associated with atrial fibrillation or flutter (AF).Objective: To determine the association between PTFV1 components (duration and amplitude) and incident AF and stroke/TIA.Methods: We included patients with an ECG recorded in the Copenhagen General Practitioners Laboratory in 2001-2011. PTFV1 of ≥ 4 mV·ms was considered abnormal. Patients with abnormal PTFV1 were stratified into tertiles based on duration (PTDV1) and amplitude (PTAV1) values. Cox regressions adjusted for age, sex and relevant comorbidities were used to investigate associations between abnormal PTFV1 components and AF and stroke/TIA.Results: Of 267,636 patients, 5,803 had AF and 18,176 had stroke/TIA (follow-up time 6.5 years). Abnormal PTFV1 was present in 44,549 (16.7%) subjects and was associated with an increased risk of AF and stroke/TIA. Among patients with abnormal PTFV1, the highest tertile of PTDV1 (78 ms to 97 ms) was associated with the highest risk of AF (hazard ratio (HR) 1.37 (95% CI: 1.23-1.52)) and highest risk of stroke/TIA (HR 1.13 (95% CI: 1.05 -1.20)). For PTAV1, the highest tertile (78 μV to 126 μV) conferred the highest risk of AF and stroke/TIA, with a HR of 1.20 (95% CI: 1.09-1.32) and 1.21 (95% CI:1.14-1.25), respectively.Conclusion: Abnormal PTFV1 was associated with an increased risk of AF and stroke/TIA. Increasing PTDV1 showed a dose-response relationship with the development of AF and stroke/TIA, while the association between PTAV1 and AF was less apparent. [ABSTRACT FROM AUTHOR]

Aim: To investigate trends in the utilization of transcatheter aortic valve replacement (TAVR) and changes in the characteristics of patients undergoing first-time TAVR.Methods: Using Danish nationwide registers, we included all patients undergoing TAVR between 2008 and 2020. To compare patient characteristics, the study population was stratified according to calendar year of procedure: 2008-2010, 2011-2013, 2014-2016, and 2017-2020.Results: We identified 6,097 patients undergoing TAVR with year-by-year increases in TAVR penetration rate. Over time, the age of the patients remained stable (2008-2010: median age 82 year [interquartile range (IQR): 77-86] vs 2017-2020: median age 81 years [IQR: 77-85]). Moreover, there was an increase in male patients (2008-2010: 49.9% vs 2017-2020: 57.4%) and patients with diabetes (2008-2010: 14.2% vs 2017-2020: 19.2%). Conversely, a history of stroke (2008-2010: 15.8% vs 2017-2020: 13.1%), previous myocardial infarction (2008-2010: 22.4% vs 2017-2020: 10.0%), heart failure (2008-2010: 40.5% vs 2017-2020: 25.2%), and peripheral artery disease (2008-2010: 14.8% vs 2017-2020: 10.4) decreased among patients.Conclusions: TAVR utilization increased markedly in the years 2008-2020. Patients undergoing TAVR had less comorbidity over time while age remained stable. Thus, despite expanding to patients at lower surgical risk, TAVR is still offered mainly to older patients. [ABSTRACT FROM AUTHOR]

Socioeconomic factors are well-established determinants of clinical outcomes among patients with acute coronary syndrome (ACS) although quality of care has improved the last decades. This study aims to investigate 20-years temporal trends of socioeconomic disparity in 1-year incidence of major adverse cardiac events (MACE) among ACS patients in Denmark. This population-based cohort study included all incident ACS patients in the Danish National Patient Registry during 1998–2017. Socioeconomic disparity was assessed by income and educational level. Patients were followed 1-year for MACE; defined as all-cause mortality, recurrent ACS, revascularization, stroke, or cardiac arrest. Adjusted MACE incidence rates (aIR) and hazard rate ratios (aHR) were computed with 95 % confidence intervals (CI) for five-year-periods. Changes in trends were examined from interaction analyses between the HR for five-year-periods and income and education, respectively. The study included 220,887 patients with first-time ACS. The incidence of MACE decreased within all income and education levels. In 1998–2002 the MACE aIR among patients with low income was 885[95%CI:863–907] versus 733[711–756]/1000-person-year among those with high income (aHR: 1.19[95%CI:1.15–1.23]). The aIRs decreased to 506[489–522] and 405[388–423]/1000-person-year, respectively, in 2013–2017 (aHR: 1.23[1.17–1.29]). The aIRs of MACE decreased correspondingly within all educational levels from 1998 to 2002 to 2013–2017. However, the socioeconomic disparity according to the interaction analyses persisted both according to income and educational level. Although 1-year clinical outcomes following ACS has improved substantially over the last decades, socioeconomic disparity persisted both according to income and education level. [Display omitted] • 30-days and 1-year clinical outcomes following ACS has improved substantially over the last decades. • Outcomes following ACS has improved among patients within all levels of income and education. • Socioeconomic disparity in severe clinical outcomes after ACS persisted across the 20-years. [ABSTRACT FROM AUTHOR]