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Coronary Artery Disease: HELP
Articles by Per Hostrup Nielsen
Based on 4 articles published since 2010
(Why 4 articles?)
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Between 2010 and 2020, Per H. Nielsen wrote the following 4 articles about Coronary Artery Disease.
 
+ Citations + Abstracts
1 Clinical Trial One-year clinical and angiographic results of hybrid coronary revascularization. 2015

Modrau, Ivy S / Holm, Niels R / Mæng, Michael / Bøtker, Hans E / Christiansen, Evald H / Kristensen, Steen D / Lassen, Jens F / Thuesen, Leif / Nielsen, Per H / Anonymous5220844. ·Department of Cardiothoracic Surgery, Aarhus University Hospital, Aarhus, Denmark. Electronic address: modrau@mail1.stofanet.dk. · Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark. · Department of Cardiothoracic Surgery, Aarhus University Hospital, Aarhus, Denmark. ·J Thorac Cardiovasc Surg · Pubmed #26432721.

ABSTRACT: OBJECTIVE: To evaluate 1-year clinical and angiographic results after hybrid coronary revascularization (HCR) combining off-pump left internal mammary artery (LIMA) grafting through an inferior J-hemisternotomy with percutaneous coronary intervention (PCI). METHODS: Prospective, single-arm clinical feasibility study including 100 consecutive patients with multivessel disease undergoing staged HCR. The primary endpoint was the major adverse cardiac and cerebrovascular event rate at 1 year. Secondary endpoints included 1-year all-cause death, stroke, myocardial infarction, repeat revascularization, and angiographic graft and stent patency. RESULTS: One-year clinical follow-up data were available in all patients. The primary endpoint was met by 20 patients (20%). Individual endpoints were as follows: 1 death due to heart failure; 1 stroke, 2 procedure-related myocardial infarctions; and 1 spontaneous myocardial infarction during follow-up. A total of 16 patients underwent repeat revascularization: 5 surgical reinterventions during the index hospitalization for angiographically suspected internal mammary artery graft dysfunction, and 3 repeat PCIs. Only 1 patient had evidence of ischemia. After discharge, PCI was performed in 6 patients who had recurrent angina, and in 2 asymptomatic patients who had angiographic restenosis. At the 1-year angiographic follow-up, 87 of 89 (98%) patients had patent internal mammary artery grafts. Angiographic restenosis was present in 10 of 100 lesions treated by PCI. CONCLUSIONS: Angiographically controlled HCR was associated with a high repeat revascularization rate. The 1-year 98% LIMA-graft patency rate, and low risk of death and stroke, seem promising for the long-term outcome. Non-left anterior descending coronary artery lesion revascularization remains a challenge.

2 Article Thirty-Year Mortality After Coronary Artery Bypass Graft Surgery: A Danish Nationwide Population-Based Cohort Study. 2017

Adelborg, Kasper / Horváth-Puhó, Erzsébet / Schmidt, Morten / Munch, Troels / Pedersen, Lars / Nielsen, Per Hostrup / Bøtker, Hans Erik / Toft Sørensen, Henrik. ·From the Department of Clinical Epidemiology (K.A., E.H.-P., M.S., T.M., L.P., H.T.S.), Department of Cardiology (K.A., H.E.B.), and Department of Cardiothoracic Surgery (P.H.N.), Aarhus University Hospital, Skejby, Denmark. kade@clin.au.dk. · From the Department of Clinical Epidemiology (K.A., E.H.-P., M.S., T.M., L.P., H.T.S.), Department of Cardiology (K.A., H.E.B.), and Department of Cardiothoracic Surgery (P.H.N.), Aarhus University Hospital, Skejby, Denmark. ·Circ Cardiovasc Qual Outcomes · Pubmed #28500223.

ABSTRACT: BACKGROUND: Data are sparse on long-term mortality after coronary artery bypass graft (CABG) surgery. We examined short-term and long-term mortality of patients undergoing CABG surgery and a general population comparison cohort. METHODS AND RESULTS: Linking data from Danish registries, we conducted a nationwide, population-based cohort study on 51 307 CABG patients and 513 070 individuals from the general population matched on age, sex, and calendar year (1980-2009). The mortality risk was higher in patients having isolated CABG surgery than in the general population, particularly during 0 to 30 days (3.2% versus 0.2%), 11 to 20 years (51.1% versus 35.6%), and 21 to 30 years (62.4% versus 44.8%), but not substantially higher during 31 to 364 days (2.9% versus 2.4%) or 1 to 10 years (30.7% versus 25.8%). The 30-day adjusted mortality rate ratio for isolated CABG surgery was 13.51 (95% confidence interval [CI], 12.59-14.49). Between 31 to 364 days and 1 to 10 years, the isolated CABG surgery cohort had a slightly higher mortality rate than the general population comparison cohort, adjusted mortality rate ratios of 1.15 (95% CI, 1.09-1.21) and 1.09 (95% CI, 1.08-1.11), respectively. Between 11 to 20 years and 21 to 30 years, the adjusted mortality rate ratios were 1.62 (95% CI, 1.58-1.66) and 1.76 (95% CI, 1.62-1.91). Within 30 days, CABG patients had a 25-fold, a 26-fold, and a 18-fold higher risk of dying from myocardial infarction, heart failure, or stroke, respectively, than members of the general population comparison cohort. We found substantial heterogeneity in absolute mortality rates according to baseline risk groups. CONCLUSIONS: The isolated CABG cohort had a higher mortality rate than the general population comparison cohort, especially within 30 days of and 10 years after surgery.

3 Article Percutaneous coronary angioplasty versus coronary artery bypass grafting in treatment of unprotected left main stenosis (NOBLE): a prospective, randomised, open-label, non-inferiority trial. 2016

Mäkikallio, Timo / Holm, Niels R / Lindsay, Mitchell / Spence, Mark S / Erglis, Andrejs / Menown, Ian B A / Trovik, Thor / Eskola, Markku / Romppanen, Hannu / Kellerth, Thomas / Ravkilde, Jan / Jensen, Lisette O / Kalinauskas, Gintaras / Linder, Rikard B A / Pentikainen, Markku / Hervold, Anders / Banning, Adrian / Zaman, Azfar / Cotton, Jamen / Eriksen, Erlend / Margus, Sulev / Sørensen, Henrik T / Nielsen, Per H / Niemelä, Matti / Kervinen, Kari / Lassen, Jens F / Maeng, Michael / Oldroyd, Keith / Berg, Geoff / Walsh, Simon J / Hanratty, Colm G / Kumsars, Indulis / Stradins, Peteris / Steigen, Terje K / Fröbert, Ole / Graham, Alastair N J / Endresen, Petter C / Corbascio, Matthias / Kajander, Olli / Trivedi, Uday / Hartikainen, Juha / Anttila, Vesa / Hildick-Smith, David / Thuesen, Leif / Christiansen, Evald H / Anonymous3940886. ·Department of Cardiology, Oulu University Hospital, Oulu, Finland. · Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus, Denmark. · Department of Cardiology, Golden Jubilee National Hospital, Clydebank, Scotland. · Belfast Heart Centre, Belfast Trust, Belfast, Northern Ireland. · Latvia Centre of Cardiology, Paul Stradins Clinical Hospital, Riga, Latvia. · Craigavon Cardiac Centre, Craigavon, Northern Ireland. · Department of Cardiology, University of Northern Norway, Tromsø, Norway. · Heart Hospital, Tampere University Hospital, Tampere, Finland. · Heart Center, Kuopio University Hospital, Kuopio, Finland. · Department of Cardiology, Örebro University Hospital, Örebro, Sweden. · Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark. · Department of Cardiology, Odense University Hospital, Odense, Denmark. · Department of Cardiology, Vilnius University Hospital, Vilnius, Lithuania. · Department of Cardiology, Danderyd Hospital, Stockholm, Sweden. · Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland. · Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway. · Oxford Heart Centre, Oxford, UK. · Department of Cardiology, Freeman Hospital and Institute of Cellular Medicine, Newcastle, UK. · Heart and Lung Centre, New Cross Hospital, Wolverhampton, UK. · Department of Cardiology, Haukeland University Hospital, Bergen, Norway. · Department of Cardiology, East Tallinn Hospital, Tallinn, Estonia. · Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; Department of Health Research and Policy (Epidemiology), Stanford University, Stanford, CA, USA. · Department of Cardiac Surgery, Aarhus University Hospital, Skejby, Aarhus, Denmark. · Department of Cardiovascular Surgery, University of Northern Norway, Tromsø, Norway. · Department of Cardiology, Karolinska University Hospital, Huddinge, Stockholm, Sweden. · Sussex Cardiac Centre, Brighton and Sussex University Hospital, Brighton, UK. · Department of Cardiac Surgery, Oulu University Hospital, Finland. · Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus, Denmark. Electronic address: evald.christiansen@dadlnet.dk. ·Lancet · Pubmed #27810312.

ABSTRACT: BACKGROUND: Coronary artery bypass grafting (CABG) is the standard treatment for revascularisation in patients with left main coronary artery disease, but use of percutaneous coronary intervention (PCI) for this indication is increasing. We aimed to compare PCI and CABG for treatment of left main coronary artery disease. METHODS: In this prospective, randomised, open-label, non-inferiority trial, patients with left main coronary artery disease were enrolled in 36 centres in northern Europe and randomised 1:1 to treatment with PCI or CABG. Eligible patients had stable angina pectoris, unstable angina pectoris, or non-ST-elevation myocardial infarction. Exclusion criteria were ST-elevation myocardial infarction within 24 h, being considered too high risk for CABG or PCI, or expected survival of less than 1 year. The primary endpoint was major adverse cardiac or cerebrovascular events (MACCE), a composite of all-cause mortality, non-procedural myocardial infarction, any repeat coronary revascularisation, and stroke. Non-inferiority of PCI to CABG required the lower end of the 95% CI not to exceed a hazard ratio (HR) of 1·35 after up to 5 years of follow-up. The intention-to-treat principle was used in the analysis if not specified otherwise. This trial is registered with ClinicalTrials.gov identifier, number NCT01496651. FINDINGS: Between Dec 9, 2008, and Jan 21, 2015, 1201 patients were randomly assigned, 598 to PCI and 603 to CABG, and 592 in each group entered analysis by intention to treat. Kaplan-Meier 5 year estimates of MACCE were 29% for PCI (121 events) and 19% for CABG (81 events), HR 1·48 (95% CI 1·11-1·96), exceeding the limit for non-inferiority, and CABG was significantly better than PCI (p=0·0066). As-treated estimates were 28% versus 19% (1·55, 1·18-2·04, p=0·0015). Comparing PCI with CABG, 5 year estimates were 12% versus 9% (1·07, 0·67-1·72, p=0·77) for all-cause mortality, 7% versus 2% (2·88, 1·40-5·90, p=0·0040) for non-procedural myocardial infarction, 16% versus 10% (1·50, 1·04-2·17, p=0·032) for any revascularisation, and 5% versus 2% (2·25, 0·93-5·48, p=0·073) for stroke. INTERPRETATION: The findings of this study suggest that CABG might be better than PCI for treatment of left main stem coronary artery disease. FUNDING: Biosensors, Aarhus University Hospital, and participating sites.

4 Article Feasibility and early safety of hybrid coronary revascularisation combining off-pump coronary surgery through J-hemisternotomy with percutaneous coronary intervention. 2015

Modrau, Ivy S / Nielsen, Per H / Bøtker, Hans E / Christiansen, Evald H / Krusell, Lars R / Kaltoft, Anne K / Mæng, Michael / Terkelsen, Christian J / Kristensen, Steen D / Lassen, Jens F / Thuesen, Leif. ·Department of Cardiothoracic Surgery, Aarhus University Hospital, Skejby, Aarhus, Denmark. ·EuroIntervention · Pubmed #24103704.

ABSTRACT: AIMS: To assess the procedural feasibility and early safety of hybrid coronary revascularisation, combining off-pump left internal mammary artery grafting to the left descending coronary artery (LAD) through an inferior J-hemisternotomy (JOPCAB) with percutaneous coronary intervention (PCI) of non-LAD lesions. METHODS AND RESULTS: A total of 100 patients with multivessel coronary artery disease involving LAD were included in this prospective registry. Hybrid revascularisation was performed by JOPCAB, either prior to PCI (89%) or following PCI (11%). In 96% of the cases, the procedure was carried out according to the preoperative strategy and without perioperative (24 hours) major adverse cardiac or cerebral events. At one month, we observed no deaths, one stroke and two procedure-related myocardial infarctions. Five patients underwent reoperation for graft dysfunction, four of whom were identified by angiography without prior signs of ischaemia. Reoperation due to bleeding was necessary in six patients, and nine patients received red blood cell transfusion. CONCLUSIONS: Our prospective registry documented promising procedural feasibility and early safety of coronary hybrid revascularisation combining JOPCAB with PCI. ClinicalTrials.gov identifier: NCT01496664.