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Prognosis Among Healthy Individuals Discharged With a Primary Diagnosis of Syncope

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@article{857cecfd5b67449a9c12153875fdc008,
title = "Prognosis Among Healthy Individuals Discharged With a Primary Diagnosis of Syncope",
abstract = "OBJECTIVE: This study sought to examine the risk of major cardiac adverse events and death in a nationwide cohort of patients without previous comorbidity admitted for syncope. BACKGROUND: Syncope is a common clinical event, but knowledge of prognosis is not fully elucidated in healthy individuals. METHODS: Patients without previous comorbidity admitted for syncope in Denmark from 2001 to 2009 were identified in nationwide administrative registries and matched by sex and age with 5 control subjects from the Danish population. The risk of death or recurrent syncope, implantation of pacemaker or implantable cardioverter-defibrillator, and cardiovascular hospitalization were analyzed with multivariable Cox proportional hazard models. RESULTS: We identified 37,017 patients with a first-time diagnosis of syncope and 185,085 control subjects; their median age was 47 years (interquartile range, 32 to 63 years) and 47{\%} were male. A total of 3,023 (8.2{\%}) and 14,251 (7.1{\%}) deaths occurred in the syncope and the control population, respectively, yielding an event rate of 14.3 per 1,000 person-years (PY) in the syncope population. Multivariable Cox regression analysis demonstrated a significantly increased risk of all-cause mortality (hazard ratio [HR]: 1.06; 95{\%} confidence interval [CI]: 1.02 to 1.10), cardiovascular hospitalization event rate of 26.5 per 1,000 PY (HR: 1.74; 95{\%} CI: 1.68 to 1.80), recurrent syncope event rate of 45.1 per 1,000, stroke event rate of 6.8 per 1,000 PY (HR: 1.35; 95{\%} CI: 1.27 to 1.44), and pacemaker or implantable cardioverter-defibrillator event rate of 4.2 per 1,000 PY (HR: 5.52; 95{\%} CI: 4.67 to 5.73; p <0.0001). CONCLUSIONS: The first admission for syncope among healthy individuals significantly predicts the risk of all-cause mortality, stroke, cardiovascular hospitalization, device implantation, and recurrent syncope.",
author = "Ruwald, {Martin Huth} and Hansen, {Morten Lock} and Morten Lamberts and Hansen, {Carolina Malta} and H{\o}jgaard, {Michael Vinther} and Lars K{\o}ber and Christian Torp-Pedersen and Jim Hansen and Gislason, {Gunnar Hilmar}",
note = "Copyright {\circledC} 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.",
year = "2013",
month = "1",
day = "22",
doi = "10.1016/j.jacc.2012.08.1024",
language = "English",
volume = "61",
pages = "325--32",
journal = "American College of Cardiology. Journal",
issn = "0735-1097",
publisher = "Elsevier Inc",
number = "3",

}

RIS

TY - JOUR

T1 - Prognosis Among Healthy Individuals Discharged With a Primary Diagnosis of Syncope

AU - Ruwald, Martin Huth

AU - Hansen, Morten Lock

AU - Lamberts, Morten

AU - Hansen, Carolina Malta

AU - Højgaard, Michael Vinther

AU - Køber, Lars

AU - Torp-Pedersen, Christian

AU - Hansen, Jim

AU - Gislason, Gunnar Hilmar

N1 - Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

PY - 2013/1/22

Y1 - 2013/1/22

N2 - OBJECTIVE: This study sought to examine the risk of major cardiac adverse events and death in a nationwide cohort of patients without previous comorbidity admitted for syncope. BACKGROUND: Syncope is a common clinical event, but knowledge of prognosis is not fully elucidated in healthy individuals. METHODS: Patients without previous comorbidity admitted for syncope in Denmark from 2001 to 2009 were identified in nationwide administrative registries and matched by sex and age with 5 control subjects from the Danish population. The risk of death or recurrent syncope, implantation of pacemaker or implantable cardioverter-defibrillator, and cardiovascular hospitalization were analyzed with multivariable Cox proportional hazard models. RESULTS: We identified 37,017 patients with a first-time diagnosis of syncope and 185,085 control subjects; their median age was 47 years (interquartile range, 32 to 63 years) and 47% were male. A total of 3,023 (8.2%) and 14,251 (7.1%) deaths occurred in the syncope and the control population, respectively, yielding an event rate of 14.3 per 1,000 person-years (PY) in the syncope population. Multivariable Cox regression analysis demonstrated a significantly increased risk of all-cause mortality (hazard ratio [HR]: 1.06; 95% confidence interval [CI]: 1.02 to 1.10), cardiovascular hospitalization event rate of 26.5 per 1,000 PY (HR: 1.74; 95% CI: 1.68 to 1.80), recurrent syncope event rate of 45.1 per 1,000, stroke event rate of 6.8 per 1,000 PY (HR: 1.35; 95% CI: 1.27 to 1.44), and pacemaker or implantable cardioverter-defibrillator event rate of 4.2 per 1,000 PY (HR: 5.52; 95% CI: 4.67 to 5.73; p <0.0001). CONCLUSIONS: The first admission for syncope among healthy individuals significantly predicts the risk of all-cause mortality, stroke, cardiovascular hospitalization, device implantation, and recurrent syncope.

AB - OBJECTIVE: This study sought to examine the risk of major cardiac adverse events and death in a nationwide cohort of patients without previous comorbidity admitted for syncope. BACKGROUND: Syncope is a common clinical event, but knowledge of prognosis is not fully elucidated in healthy individuals. METHODS: Patients without previous comorbidity admitted for syncope in Denmark from 2001 to 2009 were identified in nationwide administrative registries and matched by sex and age with 5 control subjects from the Danish population. The risk of death or recurrent syncope, implantation of pacemaker or implantable cardioverter-defibrillator, and cardiovascular hospitalization were analyzed with multivariable Cox proportional hazard models. RESULTS: We identified 37,017 patients with a first-time diagnosis of syncope and 185,085 control subjects; their median age was 47 years (interquartile range, 32 to 63 years) and 47% were male. A total of 3,023 (8.2%) and 14,251 (7.1%) deaths occurred in the syncope and the control population, respectively, yielding an event rate of 14.3 per 1,000 person-years (PY) in the syncope population. Multivariable Cox regression analysis demonstrated a significantly increased risk of all-cause mortality (hazard ratio [HR]: 1.06; 95% confidence interval [CI]: 1.02 to 1.10), cardiovascular hospitalization event rate of 26.5 per 1,000 PY (HR: 1.74; 95% CI: 1.68 to 1.80), recurrent syncope event rate of 45.1 per 1,000, stroke event rate of 6.8 per 1,000 PY (HR: 1.35; 95% CI: 1.27 to 1.44), and pacemaker or implantable cardioverter-defibrillator event rate of 4.2 per 1,000 PY (HR: 5.52; 95% CI: 4.67 to 5.73; p <0.0001). CONCLUSIONS: The first admission for syncope among healthy individuals significantly predicts the risk of all-cause mortality, stroke, cardiovascular hospitalization, device implantation, and recurrent syncope.

U2 - 10.1016/j.jacc.2012.08.1024

DO - 10.1016/j.jacc.2012.08.1024

M3 - Journal article

VL - 61

SP - 325

EP - 332

JO - American College of Cardiology. Journal

JF - American College of Cardiology. Journal

SN - 0735-1097

IS - 3

ER -

ID: 36587721