Publications by authors named "Niels E Bruun"
Article Synopsis
- * A study utilizing Danish registries analyzed 4,748 patients with infective endocarditis before and after the POET trial publication, examining changes in hospital length of stay (LOS) and outcomes like mortality and relapse of bacteremia.
- * Results showed a significant decrease in median LOS by 8 days post-POET publication, with no significant change in mortality rates but a notable reduction in relapse of bacteremia from 3.5% to 1.6%.
Article Synopsis
- Bacteremia (SAB) is a serious condition that can lead to high rates of illness and death, especially in patients with cardiac implantable electronic devices (CIEDs), prompting researchers to study its incidence in first-time CIED carriers in Denmark over a 10-year period.
- The study involved 87,257 patients from a national registry who had their first CIED implanted from 2000 to 2020, with a focus on identifying the occurrence of SAB after the procedure and understanding risk factors that contribute to it.
- Results showed that 1.6% of patients developed SAB, with higher risks associated with specific device types and factors such as hemodialysis, previous SAB, liver disease, and demographic
Article Synopsis
- This study compares the prognostic value of different body measurement indices, like BMI and waist-to-height ratio, in predicting mortality in patients with non-ischaemic heart failure with reduced ejection fraction (HFrEF).
- It finds that higher BMI is linked to increased risks of all-cause and cardiovascular death, particularly in patients with a BMI of 35 or more.
- The research suggests that greater waist-to-height ratios also indicate higher mortality risk, highlighting the importance of fat location and distribution beyond just body weight.
Article Synopsis
- The Heart Failure Collaboratory (HFC) score evaluates pharmacotherapy for heart failure patients, and this study analyzed its impact in 1116 Danish patients with nonischemic heart failure with reduced ejection fraction (HFrEF).
- A lower modified HFC (mHFC) score was linked to increased all-cause mortality, while an mHFC score of 3-4 had better outcomes compared to scores of 1-2.
- Despite these findings, implanting cardioverter-defibrillators (ICDs) did not improve overall or cardiovascular survival rates in these patients, although it did reduce sudden cardiovascular deaths.
Article Synopsis
- Current guidelines recommend implantable cardioverter-defibrillator (ICD) therapy for patients with heart failure and left ventricular ejection fraction ≤35%, but the benefits of ICDs in patients with NYHA class III remain uncertain.
- The DANISH trial studied 1116 patients and found that those in NYHA class III/IV had higher long-term all-cause and cardiovascular mortality rates compared to those in NYHA class II.
- Despite these findings, ICD implantation did not significantly reduce all-cause or cardiovascular mortality rates in either NYHA class, indicating a limited benefit of ICD therapy for this patient population.
In this case, an unusual presentation of () endocarditis and clinical signs of wrist and forearm infection are reported. Before the patient was diagnosed with E.faecalis endocarditis, the patient managed to be treated with both prednisolone, various antibiotics, and colchicine on suspicion of gout, erysipelas, and deep tissue infection.
View Article and Find Full Text PDFStep-down oral antibiotic therapy is associated with a non-inferior long-term outcome compared with continued intravenous antibiotic therapy in the treatment of left-sided infective endocarditis. We aimed to analyze whether step-down oral therapy compared with continued intravenous antibiotic therapy is also associated with a non-inferior outcome in patients with large vegetations (vegetation length ≥ 10 mm) or among patients who underwent surgery before step-down oral therapy. We included patients without presence of aortic root abscess at diagnosis from the POET (Partial Oral Antibiotic Endocarditis Treatment) study.
View Article and Find Full Text PDFBackground: Cardiac troponins are the preferred biomarkers for the diagnosis of acute myocardial infarction. Although sex-specific 99th percentile thresholds of troponins are recommended in international guidelines, the clinical effect of their use is poorly investigated. The DANSPOT Study (The Danish Study of Sex- and Population-Specific 99th percentile upper reference limits of Troponin) aims to evaluate the clinical effect of a prospective implementation of population- and sex-specific diagnostic thresholds of troponins into clinical practice.
View Article and Find Full Text PDFCarotid intima-media thickness (CIMT) is a surrogate indicator for atherosclerosis and has been shown to predict cardiovascular risk in multiple large studies. Identification of molecular markers for carotid atheroma plaque formation can be critical for early intervention and prevention of atherosclerosis. This study performed transcription factor (TF) network analysis of global gene expression data focusing on two TF genes, and , whose polymorphisms have been recently reported to show association with CIMT.
View Article and Find Full Text PDFArticle Synopsis
- A study examined the long-term impacts of implantable cardioverter-defibrillators (ICDs) on patients with heart failure and chronic kidney disease (CKD), comparing ICD outcomes to usual care.* -
- The study included 1116 patients, with findings showing that ICD implantation did not significantly lower overall mortality or cardiovascular death rates, regardless of CKD status.* -
- However, ICDs were effective in reducing sudden cardiovascular deaths in both patients with and without CKD over a median follow-up of 9.5 years.*
Aims: The NatIonal Danish endocarditis stUdieS (NIDUS) registry aims to investigate the mechanisms contributing to the increasing incidence of infective endocarditis (IE) and to discover risk factors associated to the course, treatment and clinical outcomes of the disease.
Methods: The NIDUS registry was created to investigate a nationwide unselected group of patients hospitalized for IE. The National Danish healthcare registries have been queried for validated IE diagnosis codes (International Classification of Disease, 10 edition [ICD-10]: DI33, DI38, and DI398).
Background And Aims: In the Partial Oral Treatment of Endocarditis (POET) trial, stabilized patients with left-sided infective endocarditis (IE) were randomized to oral step-down antibiotic therapy (PO) or conventional continued intravenous antibiotic treatment (IV), showing non-inferiority after 6 months. In this study, the first guideline-driven clinical implementation of the oral step-down POET regimen was examined.
Methods: Patients with IE, caused by Staphylococcus aureus, Enterococcus faecalis, Streptococcus spp.
Background: Linezolid in combination with rifampicin has been used in treatment of infective endocarditis especially for patients infected with staphylococci.
Objectives: Because rifampicin has been reported to reduce the plasma concentration of linezolid, the present study aimed to characterize the population pharmacokinetics of linezolid for the purpose of quantifying an effect of rifampicin cotreatment. In addition, the possibility of compensation by dosage adjustments was evaluated.
Aims/hypothesis: We aimed to examine whether individuals with initial omission of glucose-lowering drug treatment (GLDT), including those achieving initial remission of type 2 diabetes, may experience a higher risk of major adverse cardiovascular events (MACE) compared with well-controlled individuals on GLDT after a new type 2 diabetes diagnosis in real-world clinical practice. Furthermore, we examined whether a higher risk could be related to lower initiation of statins and renin-angiotensin system inhibitors (RASi).
Methods: In this cohort study, we used Danish registers to identify individuals with a first measured HbA between 48 and 57 mmol/mol (6.
Aims: Identifying clinical and echocardiographic parameters associated with improvement in systolic function in outpatients with heart failure with reduced ejection fraction (HFrEF) could lead to more targeted treatment improving systolic function and outcome.
Methods: In a retrospective cohort study, echocardiographic examinations from the first and final visit of 686 patients with HFrEF at the heart failure clinic at Gentofte Hospital were retrieved and analysed. Parameters associated with left ventricular ejection fraction (LVEF) improvement and survival according to LVEF improvement were assessed using linear regression and Cox regression, respectively.
Purpose: In patients surviving infective endocarditis (IE) recurrence of bacteremia or IE is feared. However, knowledge is sparse on the incidence and risk factors for the recurrence of bacteremia or IE.
Methods: Using Danish nationwide registries (2010-2020), we identified patients with first-time IE which were categorized by bacterial species (Staphylococcus aureus, Enterococcus spp.
Background: Patients with Philadelphia-negative myeloproliferative neoplasms (MPNs) have a higher burden of cardiac calcifications compared to the general population. It is not known whether the JAK2V617F mutation is associated with increased cardiac calcification.
Aim: To investigate if a higher JAK2V617F variant allele frequency (VAF) is associated with severe coronary atherosclerosis and the presence of aortic valve calcification (AVC).
Background: Patients with chronic renal failure on hemodialysis carry a significant risk of infective endocarditis (IE), but data on whether these patients differ from other patients with IE in terms of comorbidity, microbiology, rates of surgery and mortality are sparse.
Methods: Using Danish nationwide registries, all patients with IE diagnosed between February 1, 2010, and May 14, 2018 were identified and categorized into a "hemodialysis group" and a "non-hemodialysis group." Patient groups were compared by comorbidities, microbiological etiology, cardiac surgery, and mortality.
Objective: The incidence of infective endocarditis (IE) is increasing, as is the insertion of prosthetic heart valves. We aimed to examine nationwide temporal trends in the incidence of IE in patients with a prosthetic heart valve in Denmark from 1999 to 2018.
Methods: Using the Danish nationwide registries, we identified patients who underwent heart valve implantation (for other reasons than IE) between 1999 and 2018.
Purpose: Streptococcal bloodstream infections (BSIs) are common, yet prognostic factors are poorly investigated. We aimed to investigate the mortality according to streptococcal species and seasonal variation.
Methods: Patients with streptococcal BSIs from 2008 to 2017 in the Capital Region of Denmark were investigated, and data were crosslinked with nationwide registers for the identification of comorbidities.
Background: In the POET (Partial Oral Endocarditis Treatment) trial, oral step-down therapy was noninferior to full-length intravenous antibiotic administration. The aim of the present study was to perform pharmacokinetic/pharmacodynamic analyses for oral treatments of infective endocarditis to assess the probabilities of target attainment (PTAs).
Methods: Plasma concentrations of oral antibiotics were measured at day 1 and 5.
Escape: Evaluation of a patient-centred biopsychosocial blended collaborative care pathway for the treatment of multimorbid elderly patients.
Therapeutic Area: Healthcare interventions for the management of older patients with multiple morbidities.
Aims: Multi-morbidity treatment is an increasing challenge for healthcare systems in ageing societies.