Prognosis Among Healthy Individuals Discharged With a Primary Diagnosis of Syncope

Martin Huth Ruwald; Morten Lock Hansen; Morten Lamberts; Carolina Malta Hansen; Michael Vinther; Lars Køber; Christian Torp-Pedersen; Jim Hansen; Gunnar Hilmar Gislason

doi:10.1016/j.jacc.2012.08.1024

Prognosis Among Healthy Individuals Discharged With a Primary Diagnosis of Syncope

Martin Huth Ruwald, Morten Lock Hansen, Morten Lamberts, Carolina Malta Hansen, Michael Vinther, Lars Køber, Christian Torp-Pedersen, Jim Hansen, Gunnar Hilmar Gislason

59 Citationer (Scopus)

Abstract

Objectives: 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.

Originalsprog	Engelsk
Tidsskrift	Journal of the American College of Cardiology
ISSN	0735-1097
DOI	https://doi.org/10.1016/j.jacc.2012.08.1024
Status	Udgivet - 22 jan. 2013

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10.1016/j.jacc.2012.08.1024

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@article{3c4962f831a942e596a431ea2c746283,

title = "Prognosis Among Healthy Individuals Discharged With a Primary Diagnosis of Syncope",

abstract = "Objectives: 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 Michael Vinther and Lars K{\o}ber and Christian Torp-Pedersen and Jim Hansen and Gislason, {Gunnar Hilmar}",

year = "2013",

month = jan,

day = "22",

doi = "10.1016/j.jacc.2012.08.1024",

language = "English",

journal = "Journal of the American College of Cardiology",

issn = "0735-1097",

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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 - Vinther, Michael

AU - Køber, Lars

AU - Torp-Pedersen, Christian

AU - Hansen, Jim

AU - Gislason, Gunnar Hilmar

PY - 2013/1/22

Y1 - 2013/1/22

N2 - Objectives: 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 - Objectives: 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

C2 - 23246392

SN - 0735-1097

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

ER -

Prognosis Among Healthy Individuals Discharged With a Primary Diagnosis of Syncope

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