Incidence and Influence of Hospitalization for Recurrent Syncope and Its Effect on Short- and Long-Term All-Cause and Cardiovascular Mortality
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Incidence and Influence of Hospitalization for Recurrent Syncope and Its Effect on Short- and Long-Term All-Cause and Cardiovascular Mortality. / Ruwald, Martin H; Numé, Anna-Karin; Lamberts, Morten; Hansen, Carolina M; Hansen, Morten L; Vinther, Michael; Kober, Lars; Torp-Pedersen, Christian; Hansen, Jim; Gislason, Gunnar Hilmar.
I: American Journal of Cardiology, Bind 113, Nr. 10, 2014, s. 1744-1750.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Incidence and Influence of Hospitalization for Recurrent Syncope and Its Effect on Short- and Long-Term All-Cause and Cardiovascular Mortality
AU - Ruwald, Martin H
AU - Numé, Anna-Karin
AU - Lamberts, Morten
AU - Hansen, Carolina M
AU - Hansen, Morten L
AU - Vinther, Michael
AU - Kober, Lars
AU - Torp-Pedersen, Christian
AU - Hansen, Jim
AU - Gislason, Gunnar Hilmar
N1 - Copyright © 2014 Elsevier Inc. All rights reserved.
PY - 2014
Y1 - 2014
N2 - Recurrence of syncope is a common event, but the influence of recurrent syncope on the risk of death has not previously been investigated on a large scale. We examined the prognostic impact of recurrent syncope in a nationwide cohort of patients with syncope. All patients (n = 70,819) hospitalized from 2001 to 2009 in Denmark with a first-time diagnosis of syncope aged from 15 to 90 years were identified from national registries. Recurrence of syncope was incorporated as a time-dependent variable in multivariable-adjusted Cox models on the outcomes of 30-day, 1-year, and long-term all-cause mortality and cardiovascular death. During a mean follow-up of 3.9 ± 2.6 years, a total of 11,621 patients (16.4%) had at least 1 hospitalization for recurrent syncope, with a median time to recurrence of 251 days (33 to 364). A total of 14,270 patients died, and 3,204 deaths were preceded by a hospitalization for recurrent syncope. The long-term risk of all-cause death was significantly associated with recurrent syncope (hazard ratio 2.64, 95% confidence interval 2.54 to 2.75) compared with those with no recurrence. On 1-year mortality, recurrent syncope was associated with a 3.2-fold increase in risk and on 30-day mortality associated with a threefold increase. The increased mortality risk was consistent over age groups 15 to 39, 40 to 59, and 60 to 89 years, and a similar pattern of increase in both long-term and short-term risk of cardiovascular death was evident. In conclusion, recurrent syncope is independently associated with all-cause and cardiovascular mortality across all age groups exhibiting a high prognostic influence. Increased awareness on high short- and long-term risk of adverse events in subjects with recurrent syncope is warranted for future risk stratification.
AB - Recurrence of syncope is a common event, but the influence of recurrent syncope on the risk of death has not previously been investigated on a large scale. We examined the prognostic impact of recurrent syncope in a nationwide cohort of patients with syncope. All patients (n = 70,819) hospitalized from 2001 to 2009 in Denmark with a first-time diagnosis of syncope aged from 15 to 90 years were identified from national registries. Recurrence of syncope was incorporated as a time-dependent variable in multivariable-adjusted Cox models on the outcomes of 30-day, 1-year, and long-term all-cause mortality and cardiovascular death. During a mean follow-up of 3.9 ± 2.6 years, a total of 11,621 patients (16.4%) had at least 1 hospitalization for recurrent syncope, with a median time to recurrence of 251 days (33 to 364). A total of 14,270 patients died, and 3,204 deaths were preceded by a hospitalization for recurrent syncope. The long-term risk of all-cause death was significantly associated with recurrent syncope (hazard ratio 2.64, 95% confidence interval 2.54 to 2.75) compared with those with no recurrence. On 1-year mortality, recurrent syncope was associated with a 3.2-fold increase in risk and on 30-day mortality associated with a threefold increase. The increased mortality risk was consistent over age groups 15 to 39, 40 to 59, and 60 to 89 years, and a similar pattern of increase in both long-term and short-term risk of cardiovascular death was evident. In conclusion, recurrent syncope is independently associated with all-cause and cardiovascular mortality across all age groups exhibiting a high prognostic influence. Increased awareness on high short- and long-term risk of adverse events in subjects with recurrent syncope is warranted for future risk stratification.
KW - Adolescent
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Cause of Death
KW - Defibrillators, Implantable
KW - Denmark
KW - Electrocardiography
KW - Female
KW - Follow-Up Studies
KW - Hospitalization
KW - Humans
KW - Incidence
KW - Male
KW - Middle Aged
KW - Prognosis
KW - Proportional Hazards Models
KW - Recurrence
KW - Registries
KW - Risk Factors
KW - Survival Rate
KW - Syncope
KW - Time Factors
KW - Young Adult
U2 - 10.1016/j.amjcard.2014.02.035
DO - 10.1016/j.amjcard.2014.02.035
M3 - Journal article
C2 - 24698464
VL - 113
SP - 1744
EP - 1750
JO - Am. J. Cardiol.
JF - Am. J. Cardiol.
SN - 0002-9149
IS - 10
ER -
ID: 138614613