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Biomedical subjects

J F Hansen

Publications and source records attributed to J F Hansen.

At least 37 records · Page 2Linked to original sources
PubMed1999

Verapamil and risk of cancer in patients with coronary artery disease. DAVIT Study Group. Danish Verapamil Infarction Trial.

The risk of cancer in users of verapamil was assessed in a long-term follow-up of 1,775 patients who were randomized to verapamil or matching placebo in the Danish Verapamil Infarction Trial-II in the years 1985 to 1987. During 10,474 patient-years, no increased risk of cancer was observed for the verapamil-treated men or women compared with the age- and sex-matched background population.

Aged↗
PubMed1999

Nonsteroidal anti-inflammatory drugs after acute myocardial infarction. DAVIT Study Group. Danish Verapamil Infarction Trial.

The effect of nonsteroid anti-inflammatory drugs (NSAIDs) after acute myocardial infarction was studied in a retrospective study of 88 patients who were receiving regular NSAID treatment at randomization in the Danish Verapamil Infarction Trial II. There were no significant differences in mortality or major events between NSAID-treated patients versus controls (1,687); however, in a multivariate analysis a nonsignificant beneficial trend in favor of NSAIDs was observed.

Aged↗
PubMed1999

[Predictors of sudden death and death from heart failure in patients with heart insufficiency are different].

The purpose was to identify risk factors for the two most common modes of death in chronic congestive heart failure (CHF) in 190 consecutive patients discharged with CHF. They were examined with clinical evaluation, blood chemistry, chest X-ray, exercise testing, echocardiography, isotope ventriculography and Holter monitoring. Mortality after one year was 21%, after two years 32%. Of 60 deaths, 33% were sudden and 49% due to pump failure. Multivariate analyses identified totally different risk factors for sudden death: ventricular tachycardia, S-sodium < or = 137 mmol/l, S-magnesium < or = 0.80 mmol/l, S-creatinine > 121 mumol/l, and maximal change in heart rate during exercise < or = 35/min. For death from progressive pump failure: New York Heart Association class 3 + 4, delta heart rate over 24 h < or = 50/min, low ejection fraction, high resting P-noradrenaline, S-urea > 7.6 mmol/l, S-potassium < 3.5 mmol/l, and maximal exercise duration < or = 4 min.

Adult↗
PubMed1998

Prognostic implications of ventricular ectopy one week, one month, and sixteen months after an acute myocardial infarction. Danish Study Group on Verapamil in Myocardial Infarction.

BACKGROUND: Ventricular ectopy early after an acute myocardial infarction (AMI) has previously been demonstrated to predict mortality. Less information is available about the prognostic implications of ventricular ectopy occurring late after an AMI, and no information is available about the prognostic implication of the development of ventricular ectopy during the first year after an AMI. HYPOTHESIS: The purpose of the present prospectively conducted trial, a part of the Danish Verapamil Infarction Trial II (DAVIT II), was to evaluate the prognostic implication of (1) ventricular premature complexes (VPCs) recorded by 24-h Holter monitoring 1 week, 1 month, and 16 months after an AMI; and (2) development of > 10 VPCs/h or of any complex ventricular ectopy, that is, pairs, more than two types of VPCs, ventricular tachycardia, or > 10 VPCs/h during follow-up after an AMI. METHODS: Patients were monitored 1 week (n = 250), 1 month (n = 210), and 16 months (n = 201) after AMI. RESULTS: Multivariate analyses based on history, clinical findings, and ventricular ectopy showed the following results: After 1 week, > 10 VPCs/h (p = 0.0006) and heart failure (p < 0.007); after 1 month, > 10 VPCs/h (p = 0.003) and resting heart rate (p < 0.02); and after 16 months, ventricular tachycardia (p = 0.002) independently predicted long-term mortality. Mortality was significantly predicted by the development of > 10 VPCs/h from 1 week to 1 month (p = 0.003) and 16 months (p = 0.03), and from 1 to 16 months (p = 0.007) after AMI, as well as by the development of any complex ventricular ectopy from 1 week to 1 month (p = 0.02) and 16 months (p = 0.01), and from 1 to 16 months (p = 0.04) after AMI. CONCLUSION: The present study demonstrated that 1 week and 1 month after an AMI the quantity of VPCs, that is, > 10 VPCs/h, predicted mortality, whereas 16 months after an AMI the quality of VPCs, that is, ventricular tachycardia, predicted mortality.

Aged↗
PubMed1998

Comparison of the prognosis after early versus late recurrent nonfatal myocardial infarction. DAVIT Study Group. Danish Verapamil Infarction Trial.

BACKGROUND: Recurrent nonfatal myocardial infarction (RNMI) is the most significant risk factor for later outcome after an index infarction. However, little is known about the prognosis after RNMIs that occur beyond the first year after the index infarction. METHODS AND RESULTS: In 3867 nonselected patients <76 years old with an acute myocardial infarction, we studied the rate of and prognosis after a first RNMI, depending on the year of its occurrence after the index infarction. Mortality rate was estimated by the method of Kaplan-Meier, and the differences were evaluated by means of the Tarone-Ware test. Four hundred ninety-three (13.6%) patients had a first RNMI in the first, 151 (5.4%) in the second, 105 (4.2%) in the third, and 71 (3.8%) in the fourth year after the index infarction (groups 1 through 4). One-year mortality rate after RNMI was 23.7% in the first group, 24.1% in the second group, 17.5% in the third group, and 22.8 in the fourth group. When all the groups were compared with each other, no significant difference was found between the mortality rates (p = 0.12) or standardized mortality rates. CONCLUSIONS: Late RNMIs have almost the same grave prognosis as do early RNMIs.

Aged↗
PubMed1998

Comparison of the effects of fish oil and olive oil on blood lipids and aortic atherosclerosis in Watanabe heritable hyperlipidaemic rabbits.

To compare the effects of fish oil and olive oil on the development of atherosclerosis in Watanabe heritable hyperlipidaemic (WHHL) rabbits, 6-week-old animals were given a daily dose (1.5 ml/kg body weight) of fish oil (n 10) or olive oil (n 10) by oral administration for 16 weeks. Plasma cholesterol and triacylglycerols were measured once monthly, and their concentrations in lipoproteins, together with susceptibility of LDL to oxidation were measured in vitro at the termination of the experiment. Aortic atherosclerosis was quantified biochemically and microscopically. After 4 weeks of treatment, and throughout the study thereafter, blood lipids were significantly (P < 0.05) lower in the fish-oil group than in the olive-oil group (cholesterol: 17.0 v. 30.3 mmol/l, triacylglycerols 2.97 v. 6.25 mmol/l, at termination). In the fish-oil group cholesterol was significantly lower in intermediate-density lipoproteins (2.69 v. 6.76 mmol/l) and VLDL (3.36 v. 11.51 mmol/l). Triacylglycerol levels of intermediate-density lipoproteins and VLDL in the fish-oil group were also significantly lower when compared with the olive-oil group (0.54 v 1.36 mmol/l and 0.92 v. 2.87 mmol/l respectively). No group differences were recorded for LDL- and HDL-cholesterol or triacylglycerol levels. A significantly higher oxidation of LDL was recorded 1 h after exposure to CuSO4 in the fish-oil group when compared with the olive-oil group (0.465 v. 0.202, arbitrary units). The following indicators of atherosclerosis development were significantly lower in the fish-oil group than in the olive-oil group: the cholesterol content (mg/g tissue) in the ascending aorta (29.8 v. 48.9), the intima:media value (4.81 v. 18.24) and the area of intima (0.10 v. 0.57 mm2) in the thoracic aorta. It was concluded that fish-oil treatment decreased blood lipids and the development of aortic atherosclerosis in WHHL rabbits when compared with olive-oil treatment.

Animals↗
PubMed1998

Temporal pattern of the effect of verapamil on myocardial reinfarction. DAVIT Study Group. Danish Verapamil Infarction Trial.

The purpose of this study was to compare the effects of verapamil on early versus late reinfarction after an index myocardial infarction. A total of 1775 consecutive patients < 76 years of age, with acute myocardial infarction, included in the Danish Verapamil Infarction Trial II, were followed for 18 months. Reinfarctions during the observation period were retrospectively divided into the 50% earliest occurring and the 50% latest occurring (early and late reinfarction, respectively). Cox regression analysis was applied to assess the significance of clinical baseline variables and treatment group (verapamil vs. placebo) on early, late, and total reinfarction. One hundred and ninety-one reinfarctions were registered during the 18-month observation: 96 in the first 5 months (early) and 95 in the last 13 months (late). On univariate analysis verapamil significantly reduced the rate of total reinfarction (P = 0.04, hazard ratio [HR] = 0.77; 95% confidence Interval [CI] 0.58-1.03) and early reinfarction (P = 0.007, HR 0.56; 95% CI 0.37-0.86), but not late reinfarction (P = 0.99, HR = 1.05; 95% CI 0.70-1.56). In a multivariate model, only the rate of early reinfarction was reduced by verapamil (P = 0.012, HR = 0.59, 95% CI 0.39-0.90). Additionally, predictors of early and late reinfarction were quite different in this model. After an index myocardial infarction verapamil reduces the rate of early but not late reinfarction.

Aged↗
PubMed1998

5993 survivors of suspected myocardial infarction. 10 year incidence of later myocardial infarction and subsequent mortality.

AIMS: To evaluate the 10-year incidence of later infarction and subsequent mortality, as well as predictors of later infarction, in patients with suspected myocardial infarction and alive on day 15 after admission. METHODS AND RESULTS: 5993 patients admitted with suspected myocardial infarction and alive on day 15 after admission were registered in The First Danish Verapamil Infarction Trial database in 1979-81. 2586 had definite infarction, 402 probable infarction and 3005 no infarction as they fulfilled 3, 2 and 1 criteria for infarction. They were followed for 10 years with respect to later infarction and death, i.e., including death after later infarction. The 10 year infarction rate after index admission was 48.8% in definite, 47.3% in probable and 24.6% in no infarction patients (P < 0.0001). The subsequent 10-year mortality was 82.3% in primary definite, 74.7% in primary probable, and 77.9% in primary no infarction patients (ns), Cox regression analysis with sex, age group, and definite, probable or no infarction as independent variables showed that females aged < 50 years without a primary infarction had the lowest hazard ratio (0.13 relative to males, aged 50-65 years with definite/probable infarction at index admission) for a later infarction, in contrast to the highest hazard ratio (1.17) for males aged > 65 years with definite or probable infarction. CONCLUSION: The 10-year infarction rate in patients with suspected myocardial infarction in whom the diagnosis is ruled out is lower than in those with definite or probable infarction, but the mortality after a later infarction is similar in all three groups.

Adult↗
PubMed1998

Improvement in long-term prognosis of elderly patients with acute myocardial infarction after the introduction of intravenous thrombolytic therapy.

Survival rate from a "thrombolytic" period of 351 patients above 66 years of age with acute myocardial infarction (AMI) was compared with that of 289 patients from a "prethrombolytic" period. The two groups were comparable regarding sex, age, previous AMI, cerebrovascular events, morbidity and mortality during admission. Survival rates after four years were 45.0% in the "thrombolytic" group and 38.4% in the "prethrombolytic" group (p = 0.047, log rank test). Using the Cox proportional hazard analysis, thrombolytic therapy was shown to be an independent prognostic predictor in "the thrombolytic population" with a relative risk of death from day 30 to end of follow-up of 0.4 (95% confidence interval 0.2-0.8). No interaction was found between age and thrombolysis. Although only one-fifth of the patients with AMI were eligible for thrombolysis, this treatment may have contributed to the improved long-term survival.

Aged↗
PubMed1998

Congestive heart failure and ischaemic heart disease treated with trandolapril and verapamil. DAVIT Study Group. Danish Verapamil Infarction Trial.

CLINICAL TRIALS WITH VERAPAMIL AND TRANDOLAPRIL: In the Danish Verapamil Infarction Trial II, verapamil improved survival in patients without heart failure but had no effect in patients with heart failure who were receiving diuretic treatment. In the Acute Infarction Ramipril Efficacy study ramipril improved survival in patients receiving diuretic treatment but had no effect in patients not receiving diuretics. COMBINATION WITH THERAPY WITH VERAPAMIL AND TRANDOLAPRIL: By combining verapamil with trandolapril we hypothesized that we could obtain an improvement in left ventricular function and prevent cardiac events. In an open study of 14 patients with angina pectoris and left ventricular ejection fraction below 40%, treatment with trandolapril-verapamil significantly improved left ventricular function. In a double-blind randomized study of 100 postinfarct patients with congestive heart failure the cardiac event rate was significantly lower in verapamil-trandolapril-treated than in the trandolapril-treated patients. These results indicate that the combined treatment with verapamil and trandolapril might be beneficial in patients with ischaemic heart disease and congestive heart failure.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1997

[Prognosis after AMI--are there gender differences?].

To examine the prevailing hypothesis that females fare worse than males after acute myocardial infarction, we compared short-term (15 days) and long-term (ten year) prognosis after acute myocardial infarction for the two sexes. Three thousand and seventy-three consecutive patients with acute myocardial infarction were followed for 10 years after a first registration in the Danish Verapamil Infarction Trial database in 1979-81. Early mortality increased significantly with age (p < 0.0001), but was not significantly related to sex, with a 15 days mortality of 17% in females and 16% in males. Ten year mortality in patients alive day 15 was 58.8%. Hazard ratio for females versus males after adjustment for age was 0.90 (0.80-1.01). Ten year reinfarction rate was 48.8% with age adjusted hazard ratio for females versus males of 0.90 (0.78-1.04) and ten year mortality after reinfarction was 82.3%, with age adjusted hazard ratio in females versus males of 0.98 (0.82-1.16). No difference in cause of death was found between the two sexes. We conclude that sex by itself is not a risk indicator after acute myocardial infarction.

Adult↗
PubMed1997

Cardiac event rates after acute myocardial infarction in patients treated with verapamil and trandolapril versus trandolapril alone. Danish Verapamil Infarction Trial (DAVIT) Study Group.

Angiotensin-converting enzyme (ACE) inhibitors improve survival in patients with congestive heart failure (CHF) after an acute myocardial infarction (AMI), but mortality may be as high as 10% to 15% after 1 year. Verapamil prevents cardiac events after an AMI in patients without CHF. We hypothesized that in postinfarct patients with CHF already prescribed diuretics and an ACE inhibitor, additional treatment with verapamil may reduce cardiac event rate. In this multicenter, double-blind study, patients with CHF receiving diuretic treatment were consecutively randomized to treatment with trandolapril 1 mg/day for 1 month and 2 mg/day the following 2 months (n = 49), or to trandolapril as mentioned plus verapamil 240 mg/day for 1 month and 360 mg/day for 2 months (n = 51). Trial medication started 3 to 10 days after AMI. All patients were followed for 3 months. End points in the trandolapril/trandolapril-verapamil groups were death 1/1, reinfarction 7/1, unstable angina 9/3, and readmission for CHF 6/2. The 3-month first cardiac event rate was 35% in trandolapril-treated patients and 14% in trandolapril-verapamil-treated patients (hazard ratio 0.35, 95% confidence interval 0.15 to 0.85, p = 0.015). These data suggest that verapamil reduces cardiac event rates in post-AMI patients with CHF when added to an ACE inhibitor and a diuretic.

Aged↗
PubMed1997

Predictors of sudden death and death from pump failure in congestive heart failure are different. Analysis of 24 h Holter monitoring, clinical variables, blood chemistry, exercise test and radionuclide angiography.

One hundred and ninety consecutive patients discharged with congestive heart failure were examined with clinical evaluation, blood chemistry, 24 h Holter monitoring, exercise test and radionuclide angiography. Median left ventricular ejection fraction was 0.30, 46% were in New York Heart Association class II and 44% in III. Total mortality after 1 year was 21%, after 2 years 32%. Of 60 deaths, 33% were sudden and 49% due to pump failure. Multivariate analyses identified totally different risk factors for sudden death: ventricular tachycardia, s-sodium < or = 137 mmol/l, s-magnesium < or = 0.80 mmol/l, s-creatinine > 121 mumol/l, and maximal change in heart rate during exercise < or = 35 min-1, and for death from progressive pump failure: New York Heart Association class III + IV, delta heart rate over 24 h < or = 50 min-1, low ejection fraction, high resting p-noradrenaline, s-urea > 7.6 mmol/l, s-potassium < 3.5 mmol/l, and maximal exercise duration < or = 4 min. In conclusion, this study demonstrated different risk factors for sudden death and for death from progressive pump failure.

Adult↗