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1.  Prevalence of infective endocarditis in patients with Staphylococcus aureus bacteraemia: the value of screening with echocardiography 
Aims
Staphylococcus aureus infective endocarditis (IE) is a critical medical condition associated with a high morbidity and mortality. In the present study, we prospectively evaluated the importance of screening with echocardiography in an unselected S. aureus bacteraemia (SAB) population.
Methods and results
From 1 January 2009 to 31 August 2010, a total of 244 patients with SAB at six Danish hospitals underwent screening echocardiography. The inclusion rate was 73% of all eligible patients (n= 336), and 53 of the 244 included patients (22%; 95% CI: 17–27%) were diagnosed with definite IE. In patients with native heart valves the prevalence was 19% (95% CI: 14–25%) compared with 38% (95% CI: 20–55%) in patients with prosthetic heart valves and/or cardiac rhythm management devices (P= 0.02). No difference was found between Main Regional Hospitals and Tertiary Cardiac Hospitals, 20 vs. 23%, respectively (NS). The prevalence of IE in high-risk patients with one or more predisposing condition or clinical evidence of IE were significantly higher compared with low-risk patients with no additional risk factors (38 vs. 5%; P < 0.001). IE was associated with a higher 6 months mortality, 14(26%) vs. 28(15%) in SAB patients without IE, respectively (P < 0.05).
Conclusion
SAB patients carry a high risk for development of IE, which is associated with a worse prognosis compared with uncomplicated SAB. The presenting symptoms and clinical findings associated with IE are often non-specific and echocardiography should always be considered as part of the initial evaluation of SAB patients.
doi:10.1093/ejechocard/jer023
PMCID: PMC3117467  PMID: 21685200
Infective endocarditis; Echocardiography; Staphylococcus aureus; Screening
2.  Positive predictive value and impact of misdiagnosis of a heart failure diagnosis in administrative registers among patients admitted to a University Hospital cardiac care unit 
Clinical Epidemiology  2010;2:235-239.
Objective
To evaluate the positive predictive value (PPV) of a diagnosis of heart failure (HF) in the Danish National Registry of Patients (NRP) among patients admitted to a University Hospital cardiac care unit, and to evaluate the impact of misdiagnosing HF.
Design
The NRP was used to identify patients with heart failure from July 1, 2005 to June 30, 2007. Heart failure was defined in accordance with European Society of Cardiology (ESC) guidelines. The recorded diagnoses from the NRP were compared with clinical data from the medical records.
Results
We identified 758 patients with a diagnosis of heart failure in the NRP. The PPV of a heart failure discharge diagnosis was 84.0% (95% confidence interval: 81.2–86.6). Patients with a discharge diagnosis of HF in the NRP without fulfilling the ESC criteria for HF had a better survival rate, a lower rate of rehospitalization, none were followed in the outpatient clinic, and they had a lower consumption of anticongestive medicine after discharge.
Conclusion
We found a relatively high PPV of the HF diagnosis in the NRP, and the NRP can therefore be a valuable tool for identification of patients with HF. However, using the NRP alone will not give a true picture of the cost and total burden of the disease.
doi:10.2147/CLEP.S12457
PMCID: PMC2964079  PMID: 21042557
heart failure; diagnosis; positive predictive value; National Registry of Patients
3.  Single-living is associated with increased risk of long-term mortality among employed patients with acute myocardial infarction 
Clinical Epidemiology  2010;2:91-98.
Objective:
There is conflicting evidence about the impact of social support on adverse outcome after acute myocardial infarction (MI). We examined the relation between single-living and long-term all-cause mortality after MI.
Design:
A prospective cohort study of 242 employed patients with MI followed up to 16 years after MI.
Results:
A total of 106 (43.8%) patients died during the follow-up. Single-living nearly doubled the risk of death; after adjusting for potential confounding factors, single-living was an independent predictor of death, with a hazard ratio of 2.55 (95% confidence interval: 1.52–4.30). Other predictors of death were diabetes mellitus, atrial fibrillation, age, and ejection fraction less than 35%.
Conclusion:
Single-living is a prognostic determinant of long-term all-cause mortality after MI.
PMCID: PMC2943193  PMID: 20865108
acute myocardial infarction; social support; single-living; prognosis

Results 1-3 (3)