Publications by authors named "Jan Kyst Madsen"
Background: Based on evident sex-related differences in the invasive management of patients presenting with acute myocardial infarction (AMI), we sought to identify predictors of diagnostic coronary angiography (DCA) and to investigate reasons for opting out an invasive strategy in women and men.
Methods: The study was designed as a matched cohort study. We randomly selected 250 female cases from a source population of 4000 patients hospitalized with a first AMI in a geographically confined region of Denmark from January 2010 to November 2011.
Background: Randomized clinical trials have found that early invasive strategies reduce mortality, myocardial infarction (MI), and rehospitalization compared with a conservative invasive approach in acute coronary syndromes (ACSs), but the effectiveness of such strategies in real-world settings is unknown.
Objective: To investigate adverse cardiovascular outcomes of an early versus a conservative invasive strategy in a national cohort of patients with ACSs.
Design: Retrospective cohort study.
Objectives: The purpose of this study was to investigate if systolic myocardial function is reduced in all patients with type 1 diabetes (T1DM) or only in patients with albuminuria.
Background: Heart failure is a common cause of mortality in T1DM, and a specific diabetic cardiomyopathy has been suggested. It is not known whether myocardial dysfunction is a feature of T1DM per se or primarily associated with diabetes with albuminuria.
Background: Guidelines recommend an early invasive strategy for patients with diabetes with acute coronary syndromes (ACS). We investigated if patients with diabetes with ACS are offered coronary angiography (CAG) and revascularisation to the same extent as patients without diabetes.
Methods And Results: The study is a nationwide cohort study linking Danish national registries containing information on healthcare.
Background: Bleeding complications are associated with an adverse outcome after a percutaneous coronary intervention (PCI) is performed. Traditional risk factors for bleeding complications are age, gender, underweight, hypertension, and renal impairment. The aim of our study was to identify the independent predictors of bleeding complications in patients undergoing a PCI with concomitant treatment with bivalirudin.
View Article and Find Full Text PDFBackground: Less invasive treatment and poorer outcomes have been shown among patients admitted with acute myocardial infarction (AMI) on weekends compared to weekdays.
Objectives: To investigate the 'weekend-effect' on mortality in patients with AMI.
Methods: Using nationwide registers we identified 92,164 patients aged 30-90 years who were admitted to a Danish hospital with a first AMI from 1997 to 2009.
Recently, research interests are focussed on biomarkers to predict the outcome in patients with coronary artery disease (CAD). We examined whether the levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP) could predict outcome in patients who underwent elective or acute coronary angiography (CAG). A total of 337 patients with suspected CAD who underwent elective or acute CAG were followed up for a mean period of 6.
View Article and Find Full Text PDFObjectives: The purpose of this study was to examine the effect of primary percutaneous coronary intervention (PCI) compared to fibrinolysis in smokers and non-smokers with ST-segment elevation myocardial infarction (STEMI). Smokers seem to have less atherosclerosis but are more prone to thrombotic disease. Compared to non-smokers, they have higher rates of early, complete reperfusion when treated with fibrinolysis for MI.
View Article and Find Full Text PDFAims: The benefit of extending clopidogrel treatment beyond the 12-month period recommended in current guidelines after myocardial infarction (MI) is debated. We analysed the risk of adverse cardiovascular outcomes after discontinuation of 12 months of clopidogrel treatment.
Methods And Results: This Danish retrospective nationwide study included all patients treated with clopidogrel after discharge from a first-time MI during 2004-09.
Objective: To describe gender-specific long-term outcome and initiation of secondary preventive medication among patients with acute myocardial infarction (AMI).
Design: Observational cohort study.
Setting: Nationwide registries.
Objective: To investigate possible gender differences in patients with acute myocardial infarction (AMI) and without significant stenoses on coronary angiography (CAG) regarding prognosis and use of secondary preventive medication.
Design: Nationwide register-based cohort study.
Patients: By compiling data from Danish registries, we identified 20,800 patients hospitalized with AMI during 2005-2007.
Aims: To test the safety of immediate mobilisation of patients undergoing coronary angiography and percutaneous coronary intervention (PCI) closed with Angio-Seal™ -a femoral vascular closure device.
Methods And Results: First, a randomised controlled trial of immediate mobilisation vs. delayed ambulation was performed followed by a prospective validation registry to test the obtained results in a real-world situation.
Objective: To examine the effect of proton pump inhibitors on adverse cardiovascular events in aspirin treated patients with first time myocardial infarction.
Design: Retrospective nationwide propensity score matched study based on administrative data. Setting All hospitals in Denmark.
Sudden cardiac death in competing athletes is usually caused by unsuspected heart disease, and pre-participation screening may reduce the incidence of this tragic event. Although the cost-effectiveness of screening programs is unclear, international sports associations are currently implementing mandatory screening of elite athletes. During the first year of screening in the top Danish soccer league, all athletes were found to be eligible for continued participation in the game, suggesting that concern about false positive screening results may be exaggerated.
View Article and Find Full Text PDFObjective: To investigate whether distance from a patient's home to the nearest invasive centre influenced the invasive treatment strategy in acute coronary syndrome (ACS).
Methods: This was an observational cohort study using nationwide registries involving 24,910 patients admitted with ACS (median age 67, range 30-90 years). All persons were grouped in tertiles according to the distance from their residence to the invasive centre.
Background: Controversy remains on whether the dual use of clopidogrel and proton-pump inhibitors (PPIs) affects clinical efficacy of clopidogrel.
Objective: To examine the risk for adverse cardiovascular outcomes related to concomitant use of PPIs and clopidogrel compared with that of PPIs alone in adults hospitalized for myocardial infarction.
Design: A nationwide cohort study based on linked administrative registry data.
Unlabelled: Aim To determine how the left ventricular wall motion assessed by echocardiographic Tissue Doppler Imaging (TDI) is affected by increasing severity of coronary artery disease (CAD) among patients with stable angina pectoris and preserved ejection fraction.
Methods And Results: This study comprises 82 patients with suspected angina pectoris, no previous cardiac history, and a normal ejection fraction, who were all examined with colour TDI prior to coronary angiography. Patients without significant stenoses (n = 35) constituted the control group and patients with significant stenoses (n = 47) were divided into three groups according to significant one-, two-, or three-vessel disease (n = 18, n = 14, and n = 15, respectively).
Background: We sought to describe the long-term prognosis after routine primary percutaneous coronary intervention (pPCI) in a contemporary consecutive population of patients with presumed ST-segment elevation myocardial infarction, compare it with similar results from the landmark DANAMI-2 trial, and to identify a possible impact of time of presentation and referral pattern.
Methods And Results: Long-term prognosis in 1019 presumed ST-segment elevation myocardial infarction patients, treated according to modern routine pPCI during the year 2004, was analyzed and compared with similar data from the DANAMI-2 trial. Furthermore, we analyzed the impact of patient presentation to the angioplasty center during "off hours" (4 pm to 8 am plus weekends and holidays) and the impact of being referred from noninvasive hospitals.
Aims: To investigate if gender bias is present in today's setting of an early invasive strategy for patients with acute coronary syndrome in Denmark (population 5 million).
Methods And Results: We identified all patients admitted to Danish hospitals with acute coronary syndrome in 2005-07 (9561 women and 16 406 men). Cox proportional hazard models were used to estimate the gender differences in coronary angiography (CAG) rate and subsequent revascularization rate within 60 days of admission.
Background: The positive effect of reperfusion after ST-elevation myocardial infarction (STEMI) can be reduced by ischemic/reperfusion (I/R) injury.Mannose-binding-lectin (MBL) and soluble C5b-9 (membrane-attack-complex) are involved in complement-driven cell lysis and may play a role in human myocardial I/R injury. We evaluated the potential association between MBL and sC5b-9 in plasma and subsequent cardiac dysfunction in patients with STEMI treated with primary percutaneous coronary intervention (pPCI).
View Article and Find Full Text PDFAims: The European ImproveR registry aimed to characterise the patient population undergoing percutaneous coronary intervention (PCI) with bivalirudin treatment in a routine clinical setting and to evaluate associated ischaemic and bleeding events.
Methods And Results: A total of 3,799 evaluable patients, aged > 18 years, were enrolled in 102 centres across 12 European countries from January 2005 to June 2006. The population was elderly (median age, 67.
Introduction: The Danish Heart Registry (DHR) keeps track of all coronary angiographies (CATH), percutaneous coronary interventions (PCI), coronary artery bypass grafting (CABG), and adult heart valve surgery performed in Denmark. DHR is a clinical database established in order to follow the activity and quality of the procedures mentioned.
Materials And Methods: Information concerning each procedure, age, gender, and co-morbidity of the patient was collected.
Background: Routine use of ACE inhibitors (ACE-I) as secondary preventive therapy for all patients with coronary artery disease (CAD) is challenged by the PEACE trial. Currently it is unclear to what extent ACE-I should be used in CAD populations.
Purpose: To analyze the prevalence of left ventricular systolic dysfunction, diabetes, myocardial infarction and hypertension in an unselected and consecutive population of patients with documented CAD and evaluate the potential need for ACE-I treatment in a real-life scenario.
Aim: Analyze clinical, temporal and procedural characteristics from 7,528 consecutive percutaneous coronary intervention (PCI) patients in one of the largest published contemporary European PCI-database during a 6-year period.
Method: Retrospective study design.
Period: 1998-2004.