Publications by authors named "Gunnar Gislason"

Background: Sparse information regarding the long-term risk of acute myocardial infarction (MI) following a transient ischemic attack (TIA) emphasizes further research to guide preventive strategies and risk stratification in patients with a TIA.

Methods: We conducted a nationwide cohort study to investigate the 5-year risk of MI and all-cause mortality in patients with a first-time TIA. Patients with a first-time TIA were identified in the Danish Stroke Registry (2013-2020), matched on age, sex, and calendar year (1:4) with the general population and (1:1) with patients with first-time ischemic stroke.

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Background: Chronic kidney disease (CKD) is frequently complicated by arrhythmias, plausibly leading to the increased risk of sudden cardiac death in this population. However, little is known about the association between CKD and third-degree atrioventricular block (3AVB) and need for permanent pacing.

Objectives: This study aimed to investigate the association between CKD and 3AVB.

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Purpose: Bacteremia is a well-known complication to surgery and may result in infective endocarditis (IE). Transurethral resection of the prostate (TUR-P) may give rise to bacteremia, but the associated risk of IE is not well described. We aimed to examine risk of infective endocarditis following TUR-P.

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Background: We aimed to investigate how self-reported physical and cognitive limitations (challenges), self-efficacy, and social support interacted with life satisfaction in adolescents and young adults with congenital heart disease (CHD) or acquired heart disease, among whom life satisfaction may be impaired.

Methods: "Adolescence with Heart Disease" was a cross-sectional, nationwide survey of patients with CHD or early acquired heart disease aged 15-25. Structural equation modeling was used to test the implied latent variable mediation model between the main outcome of interest (life satisfaction) and challenges, social support, and self-efficacy.

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Objective: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) improve cardiovascular outcomes in patients with type 2 diabetes, but few studies have studied the risk of out-of-hospital cardiac arrest (OHCA). We investigated whether GLP-1 RA use reduce OHCA risk in type 2 diabetes when compared to dipeptidyl peptidase-4 inhibitor (DPP-4i) use.

Methods: We identified all patients having a redeemed prescription of a glucose-lowering drug between 1995 and 2019 and excluded patients with a first-time redeemed prescription consisting of insulin.

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Article Synopsis
  • The study focuses on the growing elderly population with atrial fibrillation (AF) and examines the effectiveness of AF ablation as a treatment for this group.
  • It analyzes data from Danish administrative records from 2001 to 2020, showing a significant increase in AF ablation procedures among the elderly, especially those aged 75 and older.
  • Results indicate a decrease in major adverse cardiovascular events (MACE) over time and that age is not a consistent predictor of AF-related complications or the need for further treatment.
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Aims: Iron deficiency (ID) is prevalent in chronic heart failure (HF) but lacks a consensus definition. This study evaluates the prevalence and the prognostic impact of ID using different criteria on all-cause and cardiovascular mortality, as well as first hospitalization for HF in patients with new-onset chronic HF.

Methods: In this nationwide registry-based cohort, we explored four definitions of ID: the current European Society of Cardiology (ESC) guidelines [ferritin <100 ng/mL or ferritin 100-299 ng/mL and transferrin saturation (TSAT) <20%], ferritin level <100 ng/mL, TSAT < 20% and serum iron ≤13 μmol/L.

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  • Pericardial effusion is a serious condition that can happen after doctors put in heart devices, and it might lead to even worse problems like cardiac tamponade.
  • Researchers studied data from over 55,000 patients in Denmark to find out what factors might increase the chances of this happening after getting heart devices like pacemakers.
  • They found that certain things, like being female, having heart failure, or the number of leads in the device, can make it more likely to have a problem called procedural pericardial effusion, even though it's pretty rare.
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  • Heart failure (HF) significantly increases the risk of death and hospitalization compared to the general population, especially evident in patients initiating guideline-directed therapy.
  • In a study of over 35,000 HF patients matched with non-HF individuals, those with HF had a 13% higher risk of death, 17% higher risk of HF-related hospitalization, and 24% higher risk of non-HF hospitalization over five years.
  • The excess risk of death declined with age; for example, a 60-year-old man with HF had a similar five-year death risk to a 75-year-old man without HF, suggesting the need to adjust healthcare resources based on age and comorbidities.
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  • - The study aimed to examine how the timing of influenza vaccinations (morning vs. later in the day) affects the immune response and overall health outcomes, particularly in a large trial comparing high-dose and standard-dose influenza vaccines.
  • - Researchers analyzed data from 12,477 participants and found that earlier vaccinations were linked to fewer hospitalizations for respiratory issues, regardless of the vaccine dosage, with statistically significant results.
  • - Although both high-dose and standard-dose vaccines showed similar effectiveness regardless of vaccination timing, the findings suggest that getting vaccinated earlier in the day could still be beneficial, warranting further investigation.
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Aims: Atrial fibrillation (AF) is a common arrhythmia associated with reduced quality of life that can lead to serious complications such as stroke and heart failure. Ablation is a safe and effective treatment for AF but is not offered equally to all patients. The aim of this study is to identify demographic groups more or less likely to undergo AF ablation.

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  • Influenza poses a significant health risk for patients with heart failure, leading to increased hospitalizations and deaths, though the specific impact at a population level was less understood.
  • This study aimed to quantify the annual excess burden of morbidity and mortality caused by influenza in heart failure patients in Denmark, analyzing data from 2010 to 2018.
  • Findings revealed that influenza activity was linked to an excess of approximately 250 overall deaths and 115 cardiovascular deaths annually among heart failure patients, highlighting the need for preventive measures during flu seasons.
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Background: Despite improved survival, hospitalization is still common among patients with heart failure (HF).

Objective: This study aimed to examine temporal trends in infection-related hospitalization among HF patients and compare it to temporal trends in the risk of HF hospitalization and death.

Methods: Using Danish nationwide registers, we included all patients aged 18 to 100 years, with HF diagnosed between January 1, 1997 and December 31, 2017, resulting in a total population of 147.

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Influenza vaccination reduces the risk of adverse outcomes in patients with cardiovascular disease (CVD). We sought to evaluate whether the presence of CVD modified the relative effectiveness of high-dose (QIV-HD) vs. standard-dose (QIV-SD) quadrivalent influenza vaccine in this prespecified analysis of the DANFLU-1 trial.

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Aims: To assess the level of adherence to glucagon-like peptide-1 receptor agonist (GLP-1RA) treatment using real-world data and to investigate the sociodemographic and clinical factors associated with discontinuation of GLP-1RAs.

Methods: First-time users of GLP-1RAs with type 2 diabetes mellitus (T2DM), aged ≥18 years, in the period 2007 to 2020, were identified using Danish registries, allowing all participants a minimum of 18 months' follow-up. Adherence to GLP-1RA therapy (medication possession ratio >0.

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Article Synopsis
  • - The study explored the relationship between ischemic heart disease (IHD) and the recurrence of atrial fibrillation (AF) after catheter ablation in patients, using data from Danish registries between 2010 and 2020.
  • - It found that while preexisting IHD initially seemed to increase the risk of AF recurrence, this association disappeared after adjusting for other factors; however, new-onset IHD after ablation was linked to a significantly higher risk of AF recurrence.
  • - The conclusion suggests that IHD doesn't hinder the effectiveness of AF ablation, but developing IHD after the procedure may trigger recurrent AF episodes that the ablation didn't fully suppress.
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  • Early percutaneous coronary intervention (PCI) is crucial for treating STEMI, yet the impact of delays in PCI timing has not been thoroughly evaluated.
  • A study in Copenhagen analyzed the effects of delays caused by system factors or hospital distance on outcomes for STEMI patients, finding significant differences based on time from distress call to PCI.
  • Results showed that delays over one hour substantially increased the risk of death, recurrent heart attacks, or heart failure, highlighting the importance of reducing the time from the first contact to PCI for better patient outcomes.
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  • After implantation of an implantable cardioverter defibrillator (ICD), patients face temporary driving restrictions for personal vehicles and permanent prohibitions for professional driving, impacting their job and daily activities.
  • A Danish survey revealed that among active professional drivers, 33% lost their jobs due to these driving restrictions, while 47% of previously employed patients felt restricted in maintaining their work.
  • The study indicated that younger age, higher income, and pre-implantation driving frequency increased the likelihood of significant daily living disruptions due to driving limitations after ICD implantation.
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Objectives: Whether vaginal estradiol use is associated with an increased risk of recurrent venous thromboembolism (VTE) in women with prior VTE is unknown. We sought to evaluate the association between vaginal estradiol use and recurrent VTE in women with prior VTE.

Methods: We performed a nationwide nested case-control study among 44 024 women aged ≥45 years who developed a first VTE without a history of vaginal estrogen use prior to VTE diagnosis.

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Article Synopsis
  • The study investigates the impact of different types of anesthesia (conscious sedation vs. general anesthesia) on recurrence rates of atrial fibrillation (AF) after catheter ablation (CA).
  • Using data from Danish healthcare registries, researchers analyzed nearly 8,000 patients who underwent their first CA for AF from 2010 to 2018, measuring AF recurrence through various medical indicators.
  • Results indicated that patients who received conscious sedation had a higher risk of AF recurrence compared to those who had general anesthesia, suggesting that general anesthesia may lead to better outcomes in CA for AF patients.
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Key Points: Retrospective study of guideline-directed management of myocardial infarction in patients with and without CKD from 2010 to 2022. CKD was associated with lower rate of guideline-directed management and worse prognosis. Uptake of guideline-directed management increased and prognosis improved in both groups during the study period.

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Background: The growing prevalence of obesity is expected to increase the burden of coronary artery disease. This study examined the prevalence of overweight and obesity in patients with a first-time diagnosis of obstructive coronary artery disease in a contemporary population. The association of body-mass-index (BMI) with age, traditional risk factors, and the presence of multivessel disease were explored.

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Aims: Chronic kidney disease (CKD) is a well-established risk factor for heart failure (HF); however, patients with an estimated glomerular filtration rate (eGFR) < 30 mL/min/1.73 m have been systematically excluded from clinical trials. This study investigated the incidence of HF and kidney outcomes in HF patients with and without advanced CKD, that is, eGFR < 30.

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Aims: The treatment of atrial fibrillation (AF) in hypertrophic cardiomyopathy (HCM) can be challenging since AF aggravates symptoms and increases the risk of stroke. Which factors contribute to the development of AF and stroke in HCM remains unknown. The aim of this study was to determine the incidence of AF and stroke in HCM patients and identify the risk factors.

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