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5. External validation of the simple NULL-PLEASE clinical score in predicting outcomes of out-of-hospital cardiac arrest in the Danish population – A nationwide registry-based study

Author

Byrne, Christina, Barcella, Carlo A., Krogager, Maria Lukacs, Pareek, Manan, Ringgren, Kristian Bundgaard, Andersen, Mikkel Porsborg, Mills, Elisabeth Helen Anna, Wissenberg, Mads, Folke, Fredrik, Gislason, Gunnar, Køber, Lars, Lippert, Freddy, Kjærgaard, Jesper, Hassager, Christian, Torp-Pedersen, Christian, Kragholm, Kristian, and Lip, Gregory Y.H.

Published
2022
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7. Increased 5-year risk of stroke, atrial fibrillation, acute coronary syndrome, and heart failure in out-of-hospital cardiac arrest survivors compared with population controls: A nationwide registry-based study

Author

Byrne, Christina, Pareek, Manan, Krogager, Maria Lukacs, Ringgren, Kristian B., Wissenberg, Mads, Folke, Fredrik, Lippert, Freddy, Gislason, Gunnar, Køber, Lars, Søgaard, Peter, Lip, Gregory Y.H., Torp-Pedersen, Christian, and Kragholm, Kristian

Published
2021
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10. To ventilate or not to ventilate during bystander CPR — A EuReCa TWO analysis

Author

Moertl, Maximilian, Mols, Pierre, Alihodžić, Hajriz, Hadžibegović, Irzal, Ioannides, Marios, Truhlář, Anatolij, Wissenberg, Mads, Salo, Ari, Escutnaire, Josephine, Nikolaou, Nikolaos, Nagy, Eniko, Jonsson, Bergthor Steinn, Wright, Peter, Semeraro, Federico, Clarens, Carlo, Beesems, Steffie, Cebula, Grzegorz, Correia, Vitor H., Cimpoesu, Diana, Raffay, Violetta, Trenkler, Stefan, Markota, Andrej, Strömsöe, Anneli, Burkart, Roman, Booth, Scott, Baubin, Michael, Schinnerl, Adolf, Prause, Gerhard, Tschoellitsch, Thomas, Trimmel, Helmut, Belz, Rene, Fleischmann, Wolfgang, Bartiaux, Magali, Monsieurs, Koenraad, Wilmin, Stephan, Faniel, Mathias, Vanhove, Marie, Lievens, Pascale, Biarent, Dominique, Van Nuffelen, Marc, Hubloue, Ives, Jacques, Jean-Marie, Yerna, Michèle, Leach, Robert, Jeanmaire, Mathieu, Denoël, Paule, Van Trimpont, Frank, Desmet, Francis, Delhaye, Louise, Van Belleghem, Vincent, Dewitte, Ken, Abbasi, Musa, Scheyltjens, Simon, Vermylen, Olivier, de Longueville, Diane, Debaize, Stéphane, Antičević, Silvija Hunyadi, Keleuva, Slobodanka, Lazarević, Milan, Ujević, Radmila Majhen, Šego, Gordana Antić, Bardak, Branka, Mišković, Domagoj, Praunová, Monika, Franěk, Ondřej, Kratochvíl, Jaroslav, Přikryl, Jan, Sýkora, Roman, Vaňatka, Tomáš, Vašák, Marek, Jaššo, Petr, Šmejkal, Petr, Kušička, Otomar, Šín, Robin, Smržová, Eva, Pfeifer, Dorián, Harve-Rytsälä, Heini, Hiltunen, Pamela, Holmström, Peter, Iirola, Timo, Jokela, Katja, Kirves, Hetti, Korvenoja, Pekka, Kuisma, Markku, Laine, Jukka, Lyyra, Markus, Länkimäki, Sami, Portaankorva, Petra, Raatiniemi, Lasse, Sainio, Marko, Setälä, Piritta, Toivonen, Tuukka, Uotinen, Jan, Vaahersalo, Jukka, Väyrynen, Taneli, Hamdan, David, Agostinucci, Jean-Marc, Branche, Fabienne, Revaux, François, Jonquet, Sébastien, Loubert, Richard, Boursier, Marion, Simonnet, Bruno, Morel, Jean-Charles, Lagadec, Steven, Avondo, Aurélie, Gelin, Emilie, Morel-Maréchal, Emanuel, Ursat, Cécile, Villain-Coquet, Laurent, Fournier, Marc, Tabary, Romain, Le Pimpec, Philippe, Hugenschmitt, Delphine, Abarrategui, Diego, Blondet, Romain, Arnaud, Aurélie, Sadoune, Sonia, Segard, Julien, Narcisse, Sophie, Laot, Mélanie, Pernot, Thomas, Courcoux, Hubert, Chassin, Coralie, Jardel, Benoît, Picart, Jeanne, Brèche, Franck Garden, Guenier, Pierre-Alban, Getti, Renaud, Jeziorny, Alexandre, Leroy, Antoine, Vanderstraeten, Carine, Dussoulier, Sébastien, Haja, Attila, Németh, Dániel, Válint, Andrea, Csató, Gábor, Lóczi, Gerda, Vörös, Péter, Németh, Zsuzsanna, Molnár, Ferenc, Nagy, Ferenc, Kádár, Henrietta, Duda, Julia, Tęczar, Justyna, Dul, Sylwia, Świtacz, Grażyna, Raczynski, Andrzej, Fiser, Zlatko, Babic, Zlatko, Opacic, Aleksandra, Horvat, Kornelija Jaksic, Vukelic, Snezana, Tijanic, Jelena, Milenkovic, Dusan, Milic, Sasa, Babinski, Deze, Boskovic, Cedomir, Koprivica, Jovanka, Terek, Erika, Provci, Goran, Zvijer, Dragana Jovic, Bajerovská, Ľubica, Chabroň, Miroslav, Pražienková, Danka, Kratochvílová, Renáta, Burian, Radoslav, Dobrík, Martin, Patráš, Juraj, Šteflík, Vladimír, Androvič, Peter, Mičáň, František, Horáňová, Božena, Pavčo, Július, Grochová, Monika, Bulíková, Táňa, Maček, Rok, Furman, Matej Rubelli, Podhostnik, Samo, Oman, Miha, Lipovšek, Klemen, Baznik, Špela, Ferenčina, Jurica, Strnad, Matej, Žižek, Edith, Kodela, Miha, Košat, Alenka Antolinc, Lotrič, Nina, Lindqvist, Jonny, Stieglis, Remy, Radstok, Anja, Wnent, Jan, Tjelmeland, Ingvild, Lefering, Rolf, Koster, Rudolph W., Maurer, Holger, Masterson, Siobhán, Herlitz, Johan, Böttiger, Bernd W., Ortiz, Fernando Rosell, Perkins, Gavin D., Bossaert, Leo, Baert, Valentine, and Gräsner, Jan-Thorsten

Published
2021
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14. Survival after out-of-hospital cardiac arrest in Europe - Results of the EuReCa TWO study

Author

Gräsner, Jan-Thorsten, Wnent, Jan, Herlitz, Johan, Perkins, Gavin D., Lefering, Rolf, Tjelmeland, Ingvild, Koster, Rudolph W., Masterson, Siobhán, Rossell-Ortiz, Fernando, Maurer, Holger, Böttiger, Bernd W., Moertl, Maximilian, Mols, Pierre, Alihodžić, Hajriz, Hadžibegović, Irzal, Ioannides, Marios, Truhlář, Anatolij, Wissenberg, Mads, Salo, Ari, Escutnaire, Josephine, Nikolaou, Nikolaos, Nagy, Eniko, Jonsson, Bergthor Steinn, Wright, Peter, Semeraro, Federico, Clarens, Carlo, Beesems, Steffie, Cebula, Grzegorz, Correia, Vitor H, Cimpoesu, Diana, Raffay, Violetta, Trenkler, Stefan, Markota, Andrej, Strömsöe, Anneli, Burkart, Roman, Booth, Scott, and Bossaert, Leo

Published
2020
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30. EuReCa ONE⿿27 Nations, ONE Europe, ONE Registry: A prospective one month analysis of out-of-hospital cardiac arrest outcomes in 27 countries in Europe

Author

Kaufmann, Marc, Thaler, Markus, Maier, Martin, Prause, Gerhard, Trimmel, Helmut, de Longueville, Diane, Preseau, Thierry, Biarent, Dominique, Melot, Christian, Mpotos, Nicolas, Monsieurs, Koen, Van de Voorde, Patrick, Vanhove, Marie, Lievens, Pascale, Faniel, Mathias, Keleuva, Slobodanka, Lazarevic, Milan, Ujevic, Radmila Majhen, Devcic, Mato, Bardak, Branka, Barisic, Fabijan, Anticevic, Silvija Hunyadi, Georgiou, Marios, Truhláſ, Anatolij, Knor, Jiſí, Smržová, Eva, Sviták, Roman, Šín, Robin, Mokrejš, Petr, Lippert, Freddy K., Hallikainen, Juhana, Hoikka, Marko, Iirola, Timo, Jama, Timo, Jäntti, Helena, Jokisalo, Raimo, Jousi, Milla, Kirves, Hetti, Kuisma, Markku, Laine, Jukka, Länkimäki, Sami, Loikas, Petri, Lund, Vesa, Määttä, Teuvo, Nal, Heini, Niemelä, Heimo, Portaankorva, Petra, Pylkkänen, Marko, Sainio, Marko, Setälä, Piritta, Tervo, Jerry, Väyrynen, Taneli, Murgue, Davy, Champenois, Anne, Fournier, Marc, Meyran, Daniel, Tabary, Romain, Avondo, Aurélie, Gelin, Gelin, Simonnet, Bruno, Joly, Marc, Megy-Michoux, Isabelle, Paringaux, Xavier, Duffait, Yves, Vial, Michael, Segard, Julien, Narcisse, Sophie, Hamban, David, Hennache, Jonathan, Thiriez, Sylvain, Doukhan, Mathieu, Vanderstraeten, Carine, Morel, Jean-Charles, Majour, Gilles, Michenet, Corinne, Tritsch, Laurent, Dubesset, Marc, Peguet, Olivier, Pinero, David, Guillaumee, Fréderic, Fuster, Patrick, Ciacala, Jean-François, Jardel, Benoît, Letarnec, Jean-Yves, Goes, Frank, Gosset, Pierre, Vergne, Muriel, Bar, Christian, Branche, Fabienne, Prineau, Stevens, Lagadec, Steven, Cornaglia, Carole, Ursat, Cécile, Bertrand, Philippe, Agostinucci, Jean-Marc, Nadiras, Pierre, de Linares, Géraldine Gonzales, Jacob, Line, Revaux, François, Pernot, Thomas, Roudiak, Nathalie, Ricard-Hibon, Agnès, Villain-Coquet, Laurent, Beckers, Stefan, Hanff, Thomas, Strickmann, Bernd, Wiegand, Nicolai, Wilke, Petra, Sues, Harald, Bogatzki, Stefan, Baumeier, Wolfgang, Pohl, Kai, Werner, Bert, Fischer, Hans, Zeng, Torsten, Popp, Erik, Günther, Andreas, Hochberg, Andreas, Lechleuthner, Alex, Schewe, Jens-Christian, Lemke, Hans, Wranze-Bielefeld, Erich, Bohn, Andreas, Roessler, Markus, Naujoks, Frank, Sensen, Frank, Esser, Torben, Fischer, Matthias, Messelken, Martin, Rose, Christopher, Schlüter, Gabriele, Lotz, Wolfgang, Corzilius, Michael, Muth, Claus-Martin, Diepenseifen, Christian, Tauchmann, Björn, Birkholz, Torsten, Flemming, Andreas, Herrmann, Stefanie, Kreimeier, Uwe, Kill, Clemens, Marx, Frank, Schröder, Ralph, Lenz, Wolfgang, Botini, Glykeria, Grigorios, Barakos, Giannakoudakis, Nikolaos, Zervopoulos, Michail, Papangelis, Dimitrios, Petropoulou-Papanastasiou, Sofia, Liaskos, Themistoklis, Papanikolaou, Spyridon, Karabinis, Andreas, Zentay, Attila, ÿorsteinsson, Hólmgeir, Gilsdóttir, Anna, Birgisson, Svavar A., Guðmundsson, Fjölnir Freyr, Hreiðarsson, Hallgrímur, ÿrnason, Björgvin, Hermannsson, Hermann, Björnsson, Gísli, Friðriksson, Brynjar ÿór, Baldursson, Gunnar, Höskuldsson, ÿrmann, Valgarðsdottir, Jórunn, ÿsmundardóttir, Matthildur, Guðmundsson, Guðmundur, Kristjánsson, Hjörtur, ÿórarinsson, Eyþór Rúnar, Guðlaugsson, Jón, Skarphéðinsson, Sigurður, Peratoner, Alberto, Santarelli, Andrea, Sabetta, Cesare, Gordini, Giovanni, Sesana, Giovanni, Giudici, Riccardo, Savastano, Simone, Pellis, Tommaso, Beissel, Jean, Uhrig, Jean, Manderscheid, Tom, Klop, Marco, Stammet, Pascal, Koch, Marc, Welter, Philippe, Schuman, Robert, Bruins, Wendy, Amin, Hesam, Braa, Nina, Bratland, Staale, Buanes, Eirik Alnes, Draegni, Tomas, Johnsen, Knut Roar, Mathisen, Wenche Torunn, Oedegaarden, Terje, Oppedal, Marie, Reksten, Alf Stolt-Nielsen, Roedsand, Mats Eirik, Steen-Hansen, Jon Erik, Dyrda, Marta, Frejlich, Anna, MaciĿg, Sſawomir, Osadnik, Sonia, Weryk, Ireneusz, Mendonça, Eugénio, Freitas, Carlos, Cruz, Pinto, Caldeira, Carmo, Barros, José, Vale, Luis, Brazão, António, Jardim, Nuno, Rocha, Fernanda, Duarte, Ricardo, Fernandes, Nicodemos, Ramos, Pedro, Jardim, Margarida, Reis, Miguel, Ribeiro, Romulo, Zenha, Sérgio, Fernandes, Jorge, Francisco, Juan, Assis, David, Abreu, Fernanda, Freitas, Dinarte, Ribeiro, Leonardo, Azevedo, Paulo, Calafatinho, Débora, Jardim, Rui, Pestana, Aleixo, Faria, Rui, Oprita, Bogdan, Grasu, Alis, Nedelea, Paul, Sovar, Sorina, Agapi, Florin, KliĿkoviĿ, Aleksandar, LaziĿ, Aleksandra, NikoliĿ, Bogdan, Zivanovic, Bogdan, MartinoviĿ, Branislav, MilenkoviĿ, Dušan, Damir, HuseinoviĿ, Koprivica, Jovanka, JakšiĿ, Kornelija Horvat, Pajor, Margit, MiliĿ, Saša, VidoviĿ, Mirko, Glamoclija, Radojka Petrovic, Andjelic, Sladjana, Sladjana, Vlajovic, BabiĿ, Zlatko, Fišer, Zlatko, Androvic, Peter, Bajerovska, Lubica, Chabron, Miroslav, Dobias, Viliam, Havlikova, Eva, Horanova, Bozena, Kratochvilova, Renata, Kubova, Dana, Murgas, Jan, Patras, Juraj, Simak, Ladislav, Snarskij, Vladimir, Zaviaticova, Zuzana, Zuffova, Marcela, Roig, Francesc Escalada, Santos, Luis Sánchez, Sucunza, Alfredo Echarri, Cordero Torres, Juan A., Muñoz, Guadalupe Inza, del Valle, Marta Martínez, Rozalen, Isabel Ceniceros, Sánchez, Enrique Martín, Berlanga, María Victoria Raúl Canabal, Olalde, Karlos Ibarguren, Ruiz Azpiazu, José I., García-Ochoa, María José, López-Navarro, Rafael Zoyo, Adsuar Quesada, José M., Cortés Ramas, José A., Mellado Vergel, Francisco J., López Messa, Juan B., del Valle, Patricia Fernández, Anselmi, Luciano, Benvenuti, Breganzona Claudio, Batey, Nigel, Ambulance, Yorkshire, Booth, Scott, Bucher, Patricia, Deakin, Charles D., Duckett, Jay, Ji, Chen, Loughlin, Nancy, Lumley-Holmes, Jenny, Lynde, Jessica, Mersom, Frank, Ramsey, Carly, Robinson, Clare, Spaight, Robert, Dosanjh, Sukhdeep, Virdi, Gurkamal, Whittington, Andrew, Gräsner, Jan-Thorsten, Lefering, Rolf, Koster, Rudolph W., Masterson, Siobhán, Böttiger, Bernd W., Herlitz, Johan, Wnent, Jan, Tjelmeland, Ingvild B.M., Ortiz, Fernando Rosell, Maurer, Holger, Baubin, Michael, Mols, Pierre, HadžibegoviĿ, Irzal, Ioannides, Marios, Škulec, Roman, Wissenberg, Mads, Salo, Ari, Hubert, Hervé, Nikolaou, Nikolaos I., Lóczi, Gerda, Svavarsdóttir, Hildigunnur, Semeraro, Federico, Wright, Peter J., Clarens, Carlo, Pijls, Ruud, Cebula, Grzegorz, Correia, Vitor Gouveia, Cimpoesu, Diana, Raffay, Violetta, Trenkler, Stefan, Markota, Andrej, Strömsöe, Anneli, Burkart, Roman, Perkins, Gavin D., and Bossaert, Leo L.

Published
2016
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33. Performance of 8- vs 16 ECG-gated reconstructions in assessing myocardial function using Rubidium-82 myocardial perfusion imaging:Findings in a young, healthy population

Author

Lassen, Martin Lyngby, Wissenberg, Mads, Byrne, Christina, Kjaer, Andreas, Hasbak, Philip, Lassen, Martin Lyngby, Wissenberg, Mads, Byrne, Christina, Kjaer, Andreas, and Hasbak, Philip

Abstract

Background: Current imaging guidelines recommend using at least 16 ECG gates when performing MUGA and cardiac SPECT to assess left ventricular ejection fraction (LVEF). However, for Rubidium-82 (82Rb) PET, 8 ECG-gated reconstructions have been a mainstay. This study investigated the implications of quantitative assessments when employing 16 gate, instead of 8 gate, reconstructions for 82Rb myocardial perfusion imaging (MPI). Methods: The study comprised 25 healthy volunteers (median age 23 years) who underwent repeat MPI sessions employing 82Rb PET/CT. We report LVEF, its reserve (stress LVEF – rest LVEF), and their repeatability measures (RMS method) obtained for 8- and 16 ECG-gated reconstructions. Results: Similar LVEF and LVEF reserve estimates were found for the 8- and 16-gated reconstructions ([%] LVEF (8/16 gates): rest = 61 ± 6/64 ± 6, stress = 68 ± 7/71 ± 6, LVEF reserve (8/16 gates): 8 ± 3/6 ± 4, and all P ≥ 0.13). Similar test–retest repeatability measures were observed for rest and stress LVEF and their reserves [LVEF (8/16 gates); Rest = 4.5/4.6 (P = 0.81), Stress = 3.5/3.2 (P = 0.33), LVEF reserve = 46.7/49.3 (P = 0.13)]. Conclusion: In healthy subjects, 8 and 16 ECG gates can be used interchangeably if only volumetric assessments are desired. However, if filling and emptying rates are of interest, a minimum of 16 ECG gates should be employed.

Published
2023

37. Diurnal variations in incidence and outcome of out-of-hospital cardiac arrest including prior comorbidity and pharmacotherapy: A nationwide study in Denmark

Author

Karlsson, Lena I.M., Wissenberg, Mads, Fosbøl, Emil L., Hansen, Carolina Malta, Lippert, Freddy K., Bagai, Akshay, McNally, Bryan, Granger, Christopher B., Christensen, Erika Frischknecht, Folke, Fredrik, Rajan, Shahzleen, Weeke, Peter, Nielsen, Søren L., Køber, Lars, Gislason, Gunnar H., and Torp-Pedersen, Christian

Published
2014
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44. Duration of resuscitation and long-term outcome after in-hospital cardiac arrest:A nationwide observational study

Author

Yonis, Harman, Andersen, Mikkel Porsborg, Mills, Elisabeth Helen Anna, Winkel, Bo Gregers, Wissenberg, Mads, Køber, Lars, Gislason, Gunnar, Folke, Fredrik, Larsen, Jacob Moesgaard, Søgaard, Peter, Torp-Pedersen, Christian, Kragholm, Kristian Hay, Yonis, Harman, Andersen, Mikkel Porsborg, Mills, Elisabeth Helen Anna, Winkel, Bo Gregers, Wissenberg, Mads, Køber, Lars, Gislason, Gunnar, Folke, Fredrik, Larsen, Jacob Moesgaard, Søgaard, Peter, Torp-Pedersen, Christian, and Kragholm, Kristian Hay

Abstract

Prior studies have investigated the association between duration of resuscitation and short-term outcomes following in-hospital cardiac arrest (IHCA). However, it remains unknown whether there is an association between duration of resuscitation and long-term survival and functional outcomes, Background: Prior studies have investigated the association between duration of resuscitation and short-term outcomes following in-hospital cardiac arrest (IHCA). However, it remains unknown whether there is an association between duration of resuscitation and long-term survival and functional outcomes. Method: We linked data from the Danish in-hospital cardiac arrest registry with nationwide registries and identified 8,727 patients between 2013 and 2019. Patients were stratified into four groups (A–D) according to quartiles of duration of resuscitation. Standardized average probability of outcomes was estimated using logistic regression. Results: Of 8,727 patients, 53.1% (n = 4,604) achieved return of spontaneous circulation. Median age was 74 (1st–3rd quartile [Q1–Q3] 65–81 years) and 63.1% were men. Among all IHCA patients the standardized 30-day survival was 62.0% (95% CI 59.8–64.2%) for group A (<5 minutes), 32.7% (30.8–34.6%) for group B (5–11 minutes), 14.4% (12.9–15.9%) for group C (12–20 minutes) and 8.1% (7.0–9.1%) for group D (21 minutes or more). Similarly, 1-year survival was also highest for group A (50.4%; 48.2–52.6%) gradually decreasing to 6.6% (5.6–7.6%) in group D. Among 30-day survivors, survival without anoxic brain damage or nursing home admission within one-year post-arrest was highest for group A (80.4%; 78.2–82.6%), decreasing to 73.3% (70.0–76.6%) in group B, 67.2% (61.7–72.6%) in group C and 73.3% (66.9–79.7%) in group D. Conclusion: Shorter duration of resuscitation attempt during an IHCA is associated with higher 30-day and 1-year survival. Furthermore, we found that the majority of 30-day survivors were still alive 1-year post-arrest without anoxic brain damage or nursing home admission despite prolonged resuscitation.

Published
2022

45. Optimization of the left ventricle ejection fraction estimate obtained during cardiac adenosine stress 82Rubidium-PET scanning:impact of different reconstruction protocols

Author

Lassen, Martin Lyngby, Wissenberg, Mads, Byrne, Christina, Kjaer, Andreas, Hasbak, Philip, Lassen, Martin Lyngby, Wissenberg, Mads, Byrne, Christina, Kjaer, Andreas, and Hasbak, Philip

Abstract

Background: Left ventricular ejection fraction (LVEF) estimation using adenosine stress myocardial perfusion imaging (MPI) can be challenging. The short half-life of adenosine and the guideline-recommended adenosine infusion stop during Rubidium-82 acquisition protocol may affect the accuracy and repeatability of the LVEF measures. Methods: This study comprised 25 healthy volunteers (median age 23 years) who underwent repeat myocardial perfusion imaging (MPI) sessions employing Rubidium-82 PET/CT. A guideline-recommended reconstruction protocol was used for both rest and adenosine stress MPI (150-360 s post-radiotracer injection, standardrecon). For the stress MPI protocol, two additional reconstruction protocols were considered; one was employing 60 seconds data (150-210 seconds, shortfixed) and the other a dynamic frame window based on the bolus arrival of Rubidium-82 in the heart until 210 seconds (x-210 seconds, shortindividual). We report rest and stress LVEF, the LVEF reserve, and the LVEF reserve repeatability. Results: Differences in the LVEF assessments were observed between the guideline recommended and alternative reconstruction protocol (LVEF stress MPI: standardrecon = 68 ± 7%, shortfixed = 71 ± 7% (P =.08), shortindividual = 72 ± 7% (P =.04)), and the LVEF reserve was reduced for the guideline-recommended protocol (standardrecon = 7.8 ± 3.5, shortfixed = 10.1 ± 3.7, shortindividual = 10.5 ± 3.6, all P <.001). The best repeatability measures were obtained for the shortindividual protocol (repeatability: standardrecon = 45.3%, shortfixed = 41.2%, shortindividual = 31.7%). Conclusion: We recommend using the shortindividual reconstruction protocol for improved LVEF repeatability and reserve assessment. Alternatively, in centers with limited technical support we recommend the use of the shortfix

Published
2022

46. Out-of-hospital cardiac arrest and differential risk of cardiac and non-cardiac QT-prolonging drugs in 37 000 cases

Author

Eroglu, Talip E., Barcella, Carlo A., Blom, Marieke T., Mohr, Grimur H., Souverein, Patrick C, Torp-Pedersen, Christian, Folke, Fredrik, Wissenberg, Mads, de Boer, Anthonius, Schwartz, Peter J, Gislason, Gunnar H., Tan, Hanno L, Eroglu, Talip E., Barcella, Carlo A., Blom, Marieke T., Mohr, Grimur H., Souverein, Patrick C, Torp-Pedersen, Christian, Folke, Fredrik, Wissenberg, Mads, de Boer, Anthonius, Schwartz, Peter J, Gislason, Gunnar H., and Tan, Hanno L

Abstract

Aims: Drugs that prolong the QT interval, either by design (cardiac QT-prolonging drugs: anti-arrhythmics) or as off-target effect (non-cardiac QT-prolonging drugs), may increase the risk of ventricular arrhythmias and out-of-hospital cardiac arrest (OHCA). Risk mitigation measures were instituted, in particular, surrounding prescription of cardiac QT-prolonging drugs. We studied OHCA risk of both drug types in current clinical practice. Methods: Using data from large population-based OHCA registries in the Netherlands and Denmark, we conducted two independent case–control studies. OHCA cases with presumed cardiac causes were matched on age/sex/index date with up to five non-OHCA controls. We calculated odds ratios (ORs) for the association of cardiac or non-cardiac QT-prolonging drugs with OHCA risk using conditional logistic regression analyses. Results: We identified 2503 OHCA cases and 10 543 non-OHCA controls in the Netherlands, and 35 017 OHCA cases and 175 085 non-OHCA controls in Denmark. Compared to no use of QT-prolonging drugs, use of non-cardiac QT-prolonging drugs (Netherlands: cases: 3.0%, controls: 1.9%; Denmark: cases: 14.9%, controls: 7.5%) was associated with increased OHCA risk (Netherlands: OR 1.37 [95% CI: 1.03–1.81]; Denmark: OR 1.63 [95% CI: 1.57–1.70]). The association between cardiac QT-prolonging drugs (Netherlands: cases: 4.0%, controls: 2.5%; Denmark: cases: 2.1%, controls: 0.9%) and OHCA was weaker (Netherlands: OR 1.17 [95% CI: 0.92–1.50]; Denmark: OR 1.21 [95% CI: 1.09–1.33]), although users of cardiac QT-prolonging drugs had more medication use and comorbidities associated with OHCA risk than users of non-cardiac QT-prolonging drugs. Conclusion: In clinical practice, cardiac QT-prolonging drugs confer lower OHCA risk than non-cardiac QT-prolonging drugs, although users of the former have higher a priori risk. This is likely due to risk mitigation measures surrounding prescription of cardiac QT-prolonging drugs.

Published
2022

47. Opioid use is associated with increased out-of-hospital cardiac arrest risk among 40 000-cases across two countries

Author

Eroglu, Talip E., Barcella, Carlo A., Blom, Marieke T., Souverein, Patrick C., Mohr, Grimur H., Torp-Pedersen, Christian, Folke, Fredrik, Wissenberg, Mads, de Boer, Anthonius, Gislason, Gunnar H., Tan, Hanno L., Eroglu, Talip E., Barcella, Carlo A., Blom, Marieke T., Souverein, Patrick C., Mohr, Grimur H., Torp-Pedersen, Christian, Folke, Fredrik, Wissenberg, Mads, de Boer, Anthonius, Gislason, Gunnar H., and Tan, Hanno L.

Abstract

Aims: Opioid use has substantially increased in the last decade and is associated with overdose mortality, but also with increased mortality from cardiovascular causes. This finding may partly reflect an association between opioids and out-of-hospital cardiac arrest (OHCA). Therefore, we aimed to investigate OHCA-risk of opioids in the community. Methods: We conducted 2 population-based case–control studies separately in the Netherlands (2009–2018) and Denmark (2001–2015). Cases were individuals who experienced OHCA of presumed cardiac cause. Each case was matched with up to 5 non-OHCA-controls according to age, sex and OHCA-date. Conditional logistic regression analysis was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Results: We included 5473 OHCA-cases matched with 21 866 non-OHCA-controls in the Netherlands, and 35 017 OHCA-cases matched with 175 085 non-OHCA-controls in Denmark. We found that use of opioids (the Netherlands: cases: 5.4%, controls: 1.8%; Denmark: cases: 11.9%, controls: 4.4%) was associated with increased OHCA-risk in both regions (the Netherlands: OR 2.1 [95% CI 1.8–2.5]; Denmark: OR 1.8 [95% CI 1.5–2.1]). The association was observed in both sexes, and in individuals with cardiovascular disease (the Netherlands: OR 1.8 [95% CI 1.5–2.1]; Denmark: OR 1.6 [95% CI 1.5–1.7]) or without (the Netherlands: OR 3.4 [95% CI: 2.4–4.8], Pinteraction <.0001; Denmark: OR 2.3 [95% CI: 2.0–2.5], Pinteraction <.0001). Conclusion: Use of opioids is associated with increased OHCA-risk in both sexes, independently of concomitant cardiovascular disease. These findings should be considered when evaluating the harms and benefits of treatment with opioids.

Published
2022

48. Risk of out-of-hospital cardiac arrest in antidepressant drug users

Author

Eroglu, Talip E., Barcella, Carlo A., Gerds, Thomas A., Kessing, Lars Vedel, Zylyftari, Nertila, Mohr, Grimur H., Kragholm, Kristian, Polcwiartek, Christoffer, Wissenberg, Mads, Folke, Fredrik, Tan, Hanno L., Torp-Pedersen, Christian, Gislason, Gunnar H., Eroglu, Talip E., Barcella, Carlo A., Gerds, Thomas A., Kessing, Lars Vedel, Zylyftari, Nertila, Mohr, Grimur H., Kragholm, Kristian, Polcwiartek, Christoffer, Wissenberg, Mads, Folke, Fredrik, Tan, Hanno L., Torp-Pedersen, Christian, and Gislason, Gunnar H.

Abstract

Conflicting results have been reported regarding the association between antidepressant use and out-of-hospital cardiac arrest (OHCA) risk. We investigated whether the use of antidepressants is associated with OHCA. Methods We conducted a nationwide nested case-control study to assess the association of individual antidepressant drugs within drug classes with the hazard of OHCA. Cases were defined as OHCA from presumed cardiac causes. Cox regression with time-dependent exposure and time-dependent covariates was conducted to calculate hazard ratios (HR) and 95% confidence intervals (95% CIs) overall and in subgroups defined by established cardiac disease and cardiovascular risk factors. Also, we studied antidepressants with and without sodium channel blocking or potassium channel blocking properties separately. Results During the study period from 2001 to 2015 we observed 10 987 OHCA cases, and found increased OHCA rate for high-dose citalopram (>20 mg) and high-dose escitalopram (>10 mg; HR:1.46 [95% CI:1.27-1.69], HR:1.43 [95% CI:1.16-1.75], respectively) among selective serotonin reuptake inhibitors (reference drug sertraline), and for high-dose mirtazapine (>30; HR:1.59 [95% CI:1.18-2.14]) among the serotonin-norepinephrine reuptake inhibitors or noradrenergic and specific serotonergic antidepressants (reference drug duloxetine). Among tricyclic antidepressants (reference drug amitriptyline), no drug was associated with significantly increased OHCA rate. Increased OHCA rate was found for antidepressants with known potassium channel blocking properties (HR:1.14 [95% CI:1.05-1.23]), but for not those with sodium channel blocking properties. Citalopram, although not statistically significant, and mirtazapine were associated with increased OHCA rate in patients without cardiac disease and cardiovascular risk factors. Conclusion Our findings indicate that careful titration of citalopram, escitalopram and mirtazapine dose may have to be considered due to dr

Published
2022

49. Sex differences and caffeine impact in adenosine-induced hyperemia

Author

Lassen, Martin Lyngby, Byrne, Christina, Sheykhzade, Majid, Wissenberg, Mads, Hurry, Preetee Kapisha, Schmedes, Anne Vibeke, Kjaer, Andreas, Hasbak, Philip, Lassen, Martin Lyngby, Byrne, Christina, Sheykhzade, Majid, Wissenberg, Mads, Hurry, Preetee Kapisha, Schmedes, Anne Vibeke, Kjaer, Andreas, and Hasbak, Philip

Abstract

Caffeine consumption before adenosine stress myocardial perfusion imaging (MPI) is known to affect the hemodynamic response and, thus, reduce the stress myocardial blood flow (MBF) and myocardial flow reserve (MFR) assessments. However, it is not clear if any sex-specific differences in the hemodynamic response after caffeine consumption exist. This study aimed to evaluate if such differences exist and, if so, their impact on MBF and MFR assessments. Methods: This study comprised 40 healthy volunteers (19 women). All volunteers underwent 4 serial rest/stress MPI sessions using 82Rb; 2 sessions were acquired without controlled caffeine consumption, and 2 sessions after oral ingestion of either 100 and 300 mg of caffeine or 200 and 400 mg of caffeine. For the caffeine imaging sessions, caffeine was ingested orally 1 h before the MPI scan. Results: Increase in plasma caffeine concentration (PCC) (mg/L) after consumption of caffeine was larger in women (MPI session without caffeine vs. MPI session with caffeine: women = 0.3 ± 0.2 vs. 5.4 ± 5.1, men = 0.1 ± 0.2 vs. 2.7 ± 2.6, both P < 0.001). Caffeine consumption led to reduced stress MBF and MFR assessments for men whereas no changes were reported for women (women [PCC < 1 mg/L vs. PCC ≥ 1 mg/L]: stress MBF = 3.3 ± 0.6 vs. 3.0 ± 0.8 mL/g/min, P = 0.07; MFR = 3.7 ± 0.6 vs. 3.5 ± 1.0, P = 0.35; men [PCC < 1 mg/L vs. PCC ≥ 1 mg/L]: stress MBF = 2.7 ± 0.7 vs. 2.1 ± 1.0 mL/g/min, P = 0.005; MFR = 3.8 ± 1.0 vs. 3.1 ± 1.4, P = 0.018). Significant differences in the stress MBF were observed for the 2 sexes (both P ≤ 0.001), whereas similar MFR was reported (both P ≥ 0.12). Conclusion: Associations between increases in PCC and reductions in stress MBF and MFR were observed for men, whereas women did not have the same hemodynamic response. Stress MBF was affected at lower PCCs in men than women.

Published
2022

50. Out-of-hospital cardiac arrest and differential risk of cardiac and non-cardiac QT-prolonging drugs in 37 000 cases

Author

Eroglu, Talip E., Barcella, Carlo A., Blom, Marieke T., Mohr, Grimur H., Souverein, Patrick C., Torp-Pedersen, Christian, Folke, Fredrik, Wissenberg, Mads, de Boer, Anthonius, Schwartz, Peter J., Gislason, Gunnar H., and Tan, Hanno L.

Abstract

Aims Drugs that prolong the QT interval, either by design (cardiac QT-prolonging drugs: anti-arrhythmics) or as off-target effect (non-cardiac QT-prolonging drugs), may increase the risk of ventricular arrhythmias and out-of-hospital cardiac arrest (OHCA). Risk mitigation measures were instituted, in particular, surrounding prescription of cardiac QT-prolonging drugs. We studied OHCA risk of both drug types in current clinical practice. Methods Using data from large population-based OHCA registries in the Netherlands and Denmark, we conducted two independent case–control studies. OHCA cases with presumed cardiac causes were matched on age/sex/index date with up to five non-OHCA controls. We calculated odds ratios (ORs) for the association of cardiac or non-cardiac QT-prolonging drugs with OHCA risk using conditional logistic regression analyses. Results We identified 2503 OHCA cases and 10 543 non-OHCA controls in the Netherlands, and 35 017 OHCA cases and 175 085 non-OHCA controls in Denmark. Compared to no use of QT-prolonging drugs, use of non-cardiac QT-prolonging drugs (Netherlands: cases: 3.0%, controls: 1.9%; Denmark: cases: 14.9%, controls: 7.5%) was associated with increased OHCA risk (Netherlands: OR 1.37 [95% CI: 1.03–1.81]; Denmark: OR 1.63 [95% CI: 1.57–1.70]). The association between cardiac QT-prolonging drugs (Netherlands: cases: 4.0%, controls: 2.5%; Denmark: cases: 2.1%, controls: 0.9%) and OHCA was weaker (Netherlands: OR 1.17 [95% CI: 0.92–1.50]; Denmark: OR 1.21 [95% CI: 1.09–1.33]), although users of cardiac QT-prolonging drugs had more medication use and comorbidities associated with OHCA risk than users of non-cardiac QT-prolonging drugs. Conclusion In clinical practice, cardiac QT-prolonging drugs confer lower OHCA risk than non-cardiac QT-prolonging drugs, although users of the former have higher a priori risk. This is likely due to risk mitigation measures surrounding prescription of cardiac QT-prolonging drugs.

Published
2021

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