12 results on '"Kristensen, Søren L."'
Search Results
2. SGLT2 Inhibitors in Patients With Heart Failure and Chronic Kidney Disease: Jigsaw Falling Into Place.
- Author
-
Kristensen, Søren L., Jensen, Jesper, and Schou, Morten
- Subjects
- *
CHRONIC kidney failure , *SODIUM-glucose cotransporter 2 inhibitors , *HEART failure patients - Abstract
[Display omitted] [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
3. Long-term prognosis following hospitalization for acute myocarditis – a matched nationwide cohort study.
- Author
-
Ghanizada, Muzhda, Kristensen, Søren L., Bundgaard, Henning, Rossing, Kasper, Sigvardt, Flora, Madelaire, Christian, Gislason, Gunnar H., Schou, Morten, Hansen, Morten L., and Gustafsson, Finn
- Subjects
- *
HEART failure , *PROGNOSIS , *MYOCARDITIS , *MORTALITY , *COHORT analysis , *VENTRICULAR ejection fraction - Abstract
The aim of this study was to examine the long-term risk of heart failure (HF) and all-cause mortality, in patients discharged alive following hospitalization for myocarditis. Background. Prognosis in patients with apparently uncomplicated myocarditis is in general perceived as good, but data on long-term outcomes are sparse. Methods. From nationwide Danish registries we included patients without prior cardiac disease, discharged alive with a first-time diagnosis of myocarditis 1996–2016. Patients were matched 1:10 by age- and sex, with controls from the general population. Risk of HF hospitalization and death in cases and controls was compared by use of adjusted Cox regression analyses. Results. We identified 1557 patients with a first-time diagnosis of myocarditis, 72% men, median age 39 years. Patients with myocarditis had more hypertension, diabetes, and cancer, and received more pharmacotherapy prior to hospitalization compared to matched controls. During a mean follow-up of 8.5 years, the event rate of HF hospitalization was 8.7 vs. 2.2 per 1000 patient-years (py) in cases and controls; HR 4.59 (95% CI; 3.58–5.88) and for all-cause mortality, event rate 21.9 vs 11.2 per 1000 py; HR 2.10 (95% CI; 1.82–2.43). Among 784 patients with no events or HF medication one year after diagnosis, risk of HF hospitalization (HR 2.15; 95% CI; 1.18–3.92), and all-cause mortality (HR 1.62; 95% CI; 1.21–2.16) remained elevated compared to matched controls. Conclusion. Myocarditis in younger patients without prior cardiac disease was associated with a long-term excess risk of HF hospitalization, and death, even in patients free of events and HF medication 1 year after discharge. Myocarditis ranges from chest discomfort to severe heart failure. In most patients, left ventricular ejection fraction recovers but the long-term adverse cardiac risk is unknown. Patients with myocarditis and no prior cardiac disease were at higher risk of death and heart failure Routine follow-up may be warranted following an episode of acute myocarditis. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
4. Sacubitril/valsartan reduces serum uric acid concentration, an independent predictor of adverse outcomes in PARADIGM-HF
- Author
-
Mogensen, Ulrik M., Køber, Lars, Jhund, Pardeep S., Desai, Akshay S., Senni, Michele, Kristensen, Søren L., Dukát, Andrej, Chen, Chen-Huan, Ramires, Felix, Lefkowitz, Martin P., Prescott, Margaret F., Shi, Victor C., Rouleau, Jean L., Solomon, Scott D., Swedberg, Karl, Packer, Milton, McMurray, John J.V., Mogensen, U, Køber, L, Jhund, P, Desai, A, Senni, M, Kristensen, S, Dukát, A, Chen, C, Ramires, F, Lefkowitz, M, Prescott, M, Shi, V, Rouleau, J, Solomon, S, Swedberg, K, Packer, M, and Mcmurray, J
- Subjects
Male ,Tetrazoles ,Heart failure ,Angiotensin Receptor Antagonists ,Angiotensin ,Double-Blind Method ,Humans ,Mortality ,Heart Failure ,Aminobutyrates ,Biphenyl Compounds ,Stroke Volume ,Focus on Clinical Trials ,Middle Aged ,Prognosis ,Uric Acid ,Drug Combinations ,Treatment Outcome ,Valsartan ,Female ,Neprilysin ,Co‐morbidities in Clinical Trials ,Uric acid ,Biomarkers ,Follow-Up Studies ,Glomerular Filtration Rate ,Research Article - Abstract
Aims Elevated serum uric acid concentration (SUA) has been associated with an increased risk of cardiovascular disease, but this may be due to unmeasured confounders. We examined the association between SUA and outcomes as well as the effect of sacubitril/valsartan on SUA in patients with heart failure with reduced ejection fraction (HFrEF) in PARADIGM-HF. ..................................................................................................................................................................... Methods and results The association between SUA and the primary composite outcome of cardiovascular death or heart failure (HF) hospitalization, its components, and all-cause mortality was examined using Cox regression analyses among 8213 patients using quintiles (Q1–Q5) of SUA adjusted for baseline prognostic variables including estimated glomerular filtration rate (eGFR), diuretic dose, and log N-terminal pro-brain natriuretic peptide. Change in SUA from baseline over 12 months was also evaluated in each treatment group. Patients in Q5 (SUA ≥8.6 mg/dL) compared with Q1 ( < 5.4 mg/dL) were younger (62.8 vs. 64.2 years), more often male (88.7% vs. 63.1%), had lower systolic blood pressure (119 vs. 123 mmHg), lower eGFR (57.4 vs. 76.6 mL/min/1.73 m2), and greater diuretic use. Higher SUA was associated with a higher risk of the primary outcome (adjusted hazard ratios) Q5 vs. Q1=1.28 [95% confidence intervals (1.09–1.50), P =0.003], cardiovascular death [1.44 (1.11–1.77), P =0.001], HF hospitalization [1.37 (1.11–1.70), P =0.004], and all-cause mortality [1.36 (1.13–1.64), P =0.001]. Compared with enalapril, sacubitril/valsartan reduced SUA by 0.24 (0.17–0.32) mg/dL over 12 months (P < 0.0001). Sacubitril/valsartan improved outcomes, irrespective of SUA concentration. ..................................................................................................................................................................... Conclusion Serum uric acid concentration was an independent predictor of worse outcomes after multivariable adjustment in patients with HFrEF. Compared with enalapril, sacubitril/valsartan reduced SUA and improved outcomes irrespective of SUA.
- Published
- 2018
5. The prognostic value of troponin T and N-terminal pro B-type natriuretic peptide, alone and in combination, in heart failure patients with and without diabetes.
- Author
-
Rørth, Rasmus, Jhund, Pardeep S., Kristensen, Søren L., Desai, Akshay S., Køber, Lars, Rouleau, Jean L., Solomon, Scott D., Swedberg, Karl, Zile, Michael R., Packer, Milton, and McMurray, John J.V.
- Subjects
BRAIN natriuretic factor ,HEART failure ,HEART ,TYPE 2 diabetes complications ,DISEASES ,LONGITUDINAL method ,TYPE 2 diabetes ,PEPTIDE hormones ,PEPTIDES ,PROGNOSIS ,TROPONIN ,STROKE volume (Cardiac output) ,DISEASE complications - Abstract
Aims: We examined the prognostic importance of N-terminal pro B-type natriuretic peptide (NT-proBNP) and troponin T (TnT) in heart failure patients with and without diabetes.Methods and Results: We measured NT-proBNP and TnT in the biomarker substudy of the Prospective Comparison of ARNI With ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure trial (PARADIGM-HF). Of 1907 patients, 759 (40%) had diabetes. Median TnT in patients with diabetes was 18 (interquartile range 11-27) ng/L and 13 (9-21) ng/L in those without (P < 0.001). The TnT frequency-distribution curve was shifted to the right in patients with diabetes, compared to those without diabetes. By contrast, NT-proBNP did not differ between patients with and without diabetes. Diabetes and each biomarker were predictive of worse outcomes. Thus, patients with diabetes, an elevated TnT and a NT-proBNP level in the highest tertile (9% of all patients) had an absolute risk of cardiovascular death or heart failure hospitalization of 265 per 1000 person-years, compared to a rate of 42 per 1000 person-years in those without diabetes, a TnT < 18 ng/L and a NT-proBNP in the lowest tertile (16% of all patients). TnT remained an independent predictor of adverse outcomes in multivariable analyses including NT-proBNP.Conclusion: TnT is elevated to a greater extent in heart failure patients with diabetes compared to those without (whereas NT-proBNP is not). TnT and NT-proBNP are additive in predicting risk and when combined help identify diabetes patients at extremely high absolute risk. [ABSTRACT FROM AUTHOR]- Published
- 2019
- Full Text
- View/download PDF
6. Microvascular complications in diabetes patients with heart failure and reduced ejection fraction-insights from the Beta-blocker Evaluation of Survival Trial.
- Author
-
Kristensen, Søren L., Rørth, Rasmus, Jhund, Pardeep S., Shen, Li, Lee, Matthew M. Y., Petrie, Mark C., Køber, Lars, McMurray, John J.V., and BEST Investigators
- Subjects
- *
PEOPLE with diabetes , *HEART failure patients , *ADRENERGIC beta blockers , *MICROCIRCULATION disorders , *CAUSES of death , *COMPARATIVE studies , *DIABETIC angiopathies , *HEART failure , *LONGITUDINAL method , *RESEARCH methodology , *MEDICAL cooperation , *PROGNOSIS , *RESEARCH , *SURVIVAL , *TIME , *EVALUATION research , *RANDOMIZED controlled trials , *DISEASE incidence , *BLIND experiment , *RETROSPECTIVE studies , *STROKE volume (Cardiac output) , *DISEASE complications - Abstract
Aims: The role of microvascular complications in the risk conferred by diabetes in heart failure with reduced ejection fraction (HFrEF) is unknown.Methods and Results: We studied 2707 HFrEF patients in the Beta-blocker Evaluation of Survival Trial (BEST), stratified into three groups: no diabetes and diabetes without or with microvascular complications (neuropathy, nephropathy, or retinopathy). The risks of the composite of cardiovascular death or heart failure hospitalization, and all-cause death, were studied using Cox regression analyses adjusted for other prognostic variables. Overall, 964 (36%) patients had diabetes, of which 313 (32%) had microvascular complications. Patients with microvascular complications had more severe symptoms (New York Heart Association class IV 12% vs. 9% diabetes with no complications and 7% no diabetes), and worse quality of life (Minnesota Living with Heart Failure median score 60 vs. 54 and 51 points). In patients with diabetes and complications, the rate of the composite outcome was 50 per 100 person-years of follow-up (compared with 34 and 29 in those with diabetes and no microvascular complications and participants without diabetes, respectively). Compared to patients without diabetes, the adjusted hazard ratio (HR) for the composite outcome was 1.44 [95% confidence interval (CI) 1.22-1.70] and 1.18 (95% CI 1.03-1.35) for patients with diabetes with and without complications, respectively. The risk of all-cause mortality was similarly elevated: adjusted HR 1.42 (95% CI 1.16-1.74) and 1.20 (95% CI 1.01-1.42), respectively.Conclusion: In HFrEF, diabetes with microvascular complications is associated with worse symptoms and outcomes than diabetes without microvascular complications. Prevention of microvascular complications has the potential to improve HFrEF outcomes. [ABSTRACT FROM AUTHOR]- Published
- 2018
- Full Text
- View/download PDF
7. Risk Related to Pre--Diabetes Mellitus and Diabetes Mellitus in Heart Failure With Reduced Ejection Fraction.
- Author
-
Kristensen, Søren L., Preiss, David, Jhund, Pardeep S., Squire, Iain, Cardoso, José Silva, Merkely, Bela, Martinez, Felipe, Starling, Randall C., Desai, Akshay S., Lefkowitz, Martin P., Rizkala, Adel R., Rouleau, Jean L., Shi, Victor C., Solomon, Scott D., Swedberg, Karl, Zile, Michael R., McMurray, John J. V., and Packer, Milton
- Abstract
Background--The prevalence of pre-diabetes mellitus and its consequences in patients with heart failure and reduced ejection fraction are not known. We investigated these in the Prospective Comparison of ARNI With ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure (PARADIGM-HF) trial. Methods and Results--We examined clinical outcomes in 8399 patients with heart failure and reduced ejection fraction according to history of diabetes mellitus and glycemic status (baseline hemoglobin A1c [HbA1c]: <6.0% [<42 mmol/ mol], 6.0%-6.4% [42-A7 mmol/mol; pre-diabetes mellitus], and ≥6.5% [≥48 mmol/mol; diabetes mellitus]), in Cox regression models adjusted for known predictors of poor outcome. Patients with a history of diabetes mellitus (n=2907 [35%]) had a higher risk of the primary composite outcome of heart failure hospitalization or cardiovascular mortality compared with those without a history of diabetes mellitus: adjusted hazard ratio, 1.38; 95% confidence interval, 1.25 to 1.52; P<0.001. HbA1c measurement showed that an additional 1106 (13% of total) patients had undiagnosed diabetes mellitus and 2103 (25%) had pre-diabetes mellitus. The hazard ratio for patients with undiagnosed diabetes mellitus (HbA1c, >6.5%) and known diabetes mellitus compared with those with HbA1c<6.0% was 1.39 (1.17-1.64); P<0.001 and 1.64 (1.43-1.87); P<0.001, respectively. Patients with pre-diabetes mellitus were also at higher risk (hazard ratio, 1.27 [1.10-1.47]; P<0.001) compared with those with HbA1c<6.0%. The benefit of LCZ696 (sacubitril/valsartan) compared with enalapril was consistent across the range of HbA1c in the trial. Conclusions--In patients with heart failure and reduced ejection fraction, dysglycemia is common and pre-diabetes mellitus is associated with a higher risk of adverse cardiovascular outcomes (compared with patients with no diabetes mellitus and HbA1c <6.0%). LCZ696 was beneficial compared with enalapril, irrespective of glycemic status. Clinical Trial Registration--URL: http://www.clinicaltrials.gov. Unique identifier: NCT01035255. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
8. Comparison of outcomes after hospitalization for worsening heart failure, myocardial infarction, and stroke in patients with heart failure and reduced and preserved ejection fraction.
- Author
-
Kristensen, Søren L., Jhund, Pardeep S., Køber, Lars, Preiss, David, Kjekshus, John, McKelvie, Robert S., Zile, Michael R., Anand, Inder S., Wikstrand, John, Wedel, Hans, Komajda, Michel, Carson, Peter E., Cleland, John G.F., and McMurray, John J.V.
- Subjects
- *
HOSPITAL patients , *HEART failure patients , *MYOCARDIAL infarction , *STROKE , *HEART failure , *HEART disease related mortality , *HEALTH outcome assessment , *HOSPITAL care , *PROGNOSIS - Abstract
Aims To investigate the prognostic significance of hospitalization for worsening heart failure ( WHF), myocardial infarction ( MI), and stroke in patients with chronic heart failure ( HF). Methods and results We studied 5011 patients with HF and reduced EF ( HF-REF) in the CORONA trial and 4128 patients with HF and preserved EF ( HF-PEF) in the I-Preserve trial. Adjusted hazard ratios ( HRs) for death were estimated for 0-30 days and ≥31 days after first post-randomization WHF, MI, or stroke used as a time-dependent variable, compared with patients with none of these events. In CORONA, 1616 patients (32%) had post-randomization first events (1223 WHF, 216 MI, 177 stroke), and the adjusted HR for mortality ≤30 days after an event was: WHF 7.21 [95% confidence interval ( CI) 2.05-25.40], MI 23.08 (95% CI 6.44-82.71), and stroke 32.15 (95% CI 8.93-115.83). The HR for mortality at >30 days was: WHF 3.62 (95% CI 3.11-4.21), MI 4.41 (95% CI 3.23-6.02), and stroke 3.19 (95% CI 2.21-4.61). In I-Preserve, 896 patients (22%) experienced a post-randomization event (638 WHF, 111 MI, 147 stroke). The HR for mortality ≤30 days was WHF 31.77 (95% CI 7.60-132.81), MI 154.77 (95% CI 34.21-700.17), and stroke 223.30 (95% CI 51.42-969.78); for >30 days it was WHF 3.36 (95% CI 2.79-4.05), MI 3.29 (95% CI 2.14-5.06), and stroke 5.13 (95% CI 3.61-7.29). Conclusions In patients with both HF-REF and HF-PEF, hospitalization for WHF was associated with high early and late mortality. The early relative risk of death was not as great as following MI or stroke, but the longer term relative risk of death was similar following all three types of event. Numerically, more deaths occurred following WHF because it was a much more common event. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
9. Risk Factors for Morbidity and Mortality Following Hospitalization for Pericarditis.
- Author
-
Sigvardt, Flora L., Hansen, Morten L., Kristensen, Søren L., Gustafsson, Finn, Ghanizada, Muzhda, Schou, Morten, Køber, Lars, Torp-Pedersen, Christian, Gislason, Gunnar H., and Madelaire, Christian
- Subjects
- *
PROPORTIONAL hazards models , *DISEASES - Abstract
Background: Viral or idiopathic pericarditis is a frequent condition, often considered benign, although prior studies have suggested that pericarditis is associated with both cardiovascular and noncardiovascular disease, for example, malignancy.Objectives: This study sought to assess mortality risk and morbidity patterns in patients with incident viral or idiopathic pericarditis.Methods: In nationwide Danish registries, we identified patients discharged with a first-time diagnosis of pericarditis from 1996 to 2016. Patients with a severe underlying heart condition were excluded. The patients were matched 1:10 with individuals from the general population by sex and year of birth. We assessed 5-year mortality using Kaplan-Meier and Cox proportional hazards models adjusted for baseline comorbidities and identified subsequent hospital admissions.Results: We identified 7,988 patients with pericarditis and 79,880 matched control individuals. The absolute 5-year survival probability was 92.9% and 95.8% in the pericarditis and control groups, respectively (adjusted hazard ratio: 1.31; 95% confidence interval: 1.13 to 1.52). The greatest difference in mortality was seen the first year, and it was primarily driven by the female part of the population. The incidence rate per 1,000 person-years of new-onset, admission-required diagnosis was higher in the pericarditis group both for cardiovascular and noncardiovascular diseases.Conclusions: We observed a higher mortality risk over 5 years in the pericarditis group, especially among the female patients, compared to matched control individuals. Furthermore, we observed a higher frequency of both cardiovascular and noncardiovascular hospital admissions, highlighting the need for focus on underlying morbidity in patients presenting with apparent viral or idiopathic pericarditis. [ABSTRACT FROM AUTHOR]- Published
- 2020
- Full Text
- View/download PDF
10. Return to the Workforce After First Hospitalization for Heart Failure: A Danish Nationwide Cohort Study.
- Author
-
Rørth, Rasmus, Fosbøl, Emil L., Køber, Lars, Mogensen, Ulrik M., Kristensen, Søren L., Chih Wong, Petrie, Mark C., Jhund, Pardeep S., McMurray, John J. V., Kragholm, Kristian, Lamberts, Morten, Gislason, Gunnar H., Gerds, Thomas A., Torp-Pedersen, Christian, and Wong, Chih
- Subjects
- *
EPIDEMIOLOGY , *HEART diseases , *THERAPEUTICS , *PROGNOSIS , *QUALITY of life , *PHYSIOLOGICAL aspects of work , *HEALTH outcome assessment , *PSYCHOLOGY , *CHARTS, diagrams, etc. , *PHYSIOLOGY , *OBSTRUCTIVE lung disease diagnosis , *HEART failure , *HOSPITAL care , *LONGITUDINAL method , *OBSTRUCTIVE lung diseases , *TIME , *COMORBIDITY , *ACQUISITION of data , *DISEASE complications , *DIAGNOSIS - Abstract
Background: Return to work is important financially, as a marker of functional status and for self-esteem in patients developing chronic illness. We examined return to work after first heart failure (HF) hospitalization.Methods: By individual-level linkage of nationwide Danish registries, we identified 21 455 patients of working age (18-60 years) with a first HF hospitalization in the period from 1997 to 2012. Of these patients, 11 880 (55%) were in the workforce before HF hospitalization and comprised the study population. We applied logistic regression to estimate odds ratios for associations between age, sex, length of hospital stay, level of education, income, comorbidity, and return to work.Results: One year after first HF hospitalization, 8040 (67.7%) returned to the workforce, 2981 (25.1%) did not, 805 (6.7%) died, and 54 (0.5%) emigrated. Predictors of return to work included younger age (18-30 versus 51-60 years; odds ratio [OR], 3.12; 95% confidence interval [CI], 2.42-4.03), male sex (OR, 1.22; 95% CI, 1.12-1.34), and level of education (long-higher versus basic school; OR, 2.06; 95% CI, 1.63-2.60). Conversely, hospital stay >7 days (OR, 0.56; 95% CI, 0.51-0.62) and comorbidity including history of stroke (OR, 0.55; 95% CI, 0.45-0.69), chronic kidney disease (OR, 0.46; 95% CI, 0.36-0.59), chronic obstructive pulmonary disease (OR, 0.62; 95% CI, 0.52-0.75), diabetes mellitus (OR 0.76; 95% CI, 0.68-0.85), and cancer (OR, 0.49; 95% CI, 0.40-0.61) were all significantly associated with lower chance of return to work.Conclusions: Patients in the workforce before HF hospitalization had low mortality but high risk of detachment from the workforce 1 year later. Young age, male sex, and a higher level of education were predictors of return to work. [ABSTRACT FROM AUTHOR]- Published
- 2016
- Full Text
- View/download PDF
11. Antithrombotic Treatment in Patients With Heart Failure and Associated Atrial Fibrillation and Vascular Disease: A Nationwide Cohort Study.
- Author
-
Lamberts, Morten, Lip, Gregory Y.H., Ruwald, Martin H., Hansen, Morten Lock, Özcan, Cengiz, Kristensen, Søren L., Køber, Lars, Torp-Pedersen, Christian, and Gislason, Gunnar H.
- Subjects
- *
HEART failure patients , *HEART failure , *HEART failure treatment , *FIBRINOLYTIC agents , *ATRIAL fibrillation , *HOSPITAL admission & discharge , *COHORT analysis , *PROGNOSIS ,TREATMENT of vascular diseases - Abstract
Objectives: The aim of this study was to investigate the impact of atrial fibrillation (AF) and antithrombotic treatment on the prognosis in patients with heart failure (HF) as well as vascular disease. Background: HF, vascular disease, and AF are pathophysiologically related, and understanding antithrombotic treatment for these conditions is crucial. Methods: In hospitalized patients with HF and coexisting vascular disease (coronary artery disease or peripheral arterial disease) followed from 1997 to 2009, AF status was categorized as prevalent AF, incident AF, or no AF. Risk of thromboembolism (TE), myocardial infarction (MI), and serious bleeding was assessed by Cox regression models (hazard ratio [HR] with 95% confidence interval [CI]) with antithrombotic therapy and AF as time-dependent variables. Results: A total of 37,464 patients were included (age, 74.5 ± 10.7 years; 36.3% females) with a mean follow-up of 3 years during which 20.7% were categorized as prevalent AF and 17.2% as incident AF. Compared with vitamin K antagonist (VKA) in prevalent AF, VKA plus antiplatelet was not associated with a decreased risk of TE (HR: 0.91; 95% CI: 0.73 to 1.12) or MI (HR: 1.11; 95% CI: 0.96 to 1.28), whereas bleeding risk was significantly increased (HR: 1.31; 95% CI: 1.09 to 1.57). Corresponding estimates for incident AF were HRs of 0.77 (95% CI: 0.56 to 1.06), 1.07 (95% CI: 0.89 to 1.28), and 2.71 (95% CI: 1.33 to 2.21) for TE, MI, and bleeding, respectively. In no AF patients, no statistical differences were seen between antithrombotic therapies in TE or MI risk, whereas bleeding risk was significantly increased for VKA with and without single-antiplatelet therapy. Conclusions: In AF patients with coexisting HF and vascular disease, adding single-antiplatelet therapy to VKA therapy is not associated with additional benefit in thromboembolic or coronary risk, but notably increased bleeding risk. [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
- View/download PDF
12. Ongoing treatment with non-steroidal anti-inflammatory drugs at time of admission is associated with poorer prognosis in patients with first-time acute myocardial infarction.
- Author
-
Lamberts, Morten, Fosbøl, Emil L., Olsen, Anne-Marie S., Hansen, Morten L., Folke, Frederik, Kristensen, Søren L., Olesen, Jonas B., Hansen, Peter R., Køber, Lars, Torp-Pedersen, Christian, and Gislason, Gunnar H.
- Subjects
- *
MYOCARDIAL infarction , *MORTALITY , *ROFECOXIB , *CELECOXIB , *NAPROXEN , *CYCLOOXYGENASE 2 inhibitors , *PATIENTS , *THERAPEUTICS - Abstract
Abstract: Background: Use of non-steroidal anti-inflammatory drugs (NSAIDs) has been associated with increased cardiovascular morbidity and mortality. The purpose of this study was to examine the effect of ongoing NSAID treatment at time of admission for myocardial infarction (MI) on prognosis. Methods: All patients admitted with first-time MI in 1997–2006 were included by use of individual-level linkage of nationwide registries. By claimed prescription of NSAIDs, availability of tablets was estimated within 14days prior to inclusion and defined ongoing use. Risk of death within 30days and risk of death or MI within 1year was analyzed by logistic regression and Cox proportional-hazard models, respectively. Results: A total of 97,458 patients were included (mean age 69.9 [SD 13.2] years and 62% males); the 30day and 1year mortality rates were 18.1% and 27.7%, respectively. Ongoing NSAID treatment was identified in 12,156 (12.5%) patients and 30-day mortality was significantly increased in patients receiving rofecoxib (odds ratio [OR] 1.43; 95% confidence interval [CI] 1.22–1.68) and celecoxib (OR 1.23; CI 1.03–1.47) relative to no use of NSAIDs. Correspondingly, the 1-year rate of death or recurrent MI was significantly increased in patients receiving rofecoxib (hazard ratio [HR] 1.15; CI 1.04–1.27), celecoxib (HR 1.13; CI 1.01–1.26), diclofenac (HR 1.12; CI 1.04–1.20) or any NSAID use (HR 1.05; CI 1.02–1.09). No association was found for naproxen or ibuprofen. Conclusion: Ongoing treatment with NSAIDs and in particular the cyclooxygenase-2-selective inhibitors rofecoxib, celecoxib, and diclofenac is associated with worsened prognosis in patients admitted with first-time MI. [Copyright &y& Elsevier]
- Published
- 2013
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.