More than 30% of the diagnoses of PAD notified in the Danish National Patient Registry were not valid, stressing the importance of validation when using register information for research purposes. In contrast, diagnoses obtained from the Danish National Vascular Registry had a high validity ready for use without further validation.

n-3 PUFA may exert favourable effects on several processes that may inhibit the atherosclerotic process. However, the role of n-3 PUFA in lowering the risk of atherosclerotic CVD (ASCVD) has been fiercely debated. In the present paper, we summarise the main findings from previous follow-up studies of intake and studies using adipose tissue as an objective biomarker to investigate exposure to n-3 PUFA in relation to ASCVD risk and discuss some perspectives for further research. The majority of previous studies investigating intake of marine- and plant-based n-3 PUFA have focused on CHD while other ASCVD such as ischaemic stroke and peripheral artery disease have been less studied. However, recent data from Danish Diet, Cancer and Health cohort suggest that marine n-3 PUFA may be inversely associated with risk of myocardial infarction, ischaemic stroke and peripheral arterial disease caused by atherosclerosis. The effect of the plant-derived n-3 PUFA α-linolenic acid on ASCVD is less clear and several gaps in the literature remain to be explored.

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This study suggests that substituting red meat with fish and especially fatty fish may be associated with a lower risk of PAD, although not statistically significant. Replacing poultry with fish was not associated with the risk of PAD.

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BACKGROUND: Population-based epidemiologic studies of aortic dissections (ADs) are needed. This study aimed to report clinical characteristics, incidences, and mortality rates for adult patients admitted to Danish hospitals with type A AD (TAAD) or type B AD (TBAD) from 1996 through 2016. METHODS: We conducted a nationwide, population-based register study. All cases of AD registered with International Classification of Diseases, Tenth Revision codes in the Danish National Patient Registry at time of admission to a hospital with available medical records underwent validation. Data were merged between nationwide health registries including the cause of death registry. Patients with validated AD were matched 1:10 on sex and age with patients with hypertension from the general Danish population. RESULTS: Of 5018 registered cases of AD, 4183 cases underwent review and 3023 (60.2%) were confirmed as AD. After exclusions, the distribution of validated TAAD and TBAD was 1620 (60.5%) and 1059 (39.5%; P <0.001), 67.5% and 67.0% of patients were men, and mean ages at dissection were 63.5±12.9 and 67.5±12.2 years ( P <0.001), respectively. The most prevalent comorbidities for TAAD were hypertension (55.2%), thoracic aortic aneurysms (14.6%), and chronic obstructive pulmonary disease (13.1%); for TBAD, the most prevalent comorbidities were hypertension (64.1%), aortic aneurysms at any location (7.5% to 12.0%), and chronic obstructive pulmonary disease (15.7%). The overall mean annual incidence rate was 4.2/100 000 patient-years. Incidence was significantly higher for TAAD (2.2/100 000) compared with TBAD (1.5/100 000; P <0.001). The 30-day mortality rates for validated TAAD and TBAD were 22.0% and 13.9% ( P <0.001), respectively, with no significant changes over time or between sexes. Adjusted 5-year overall mortality rates for TAAD and TBAD were hazard ratio 3.2 (2.9 to 3.5; P <0.001; aortic-related cause of death, 57.0%) and hazard ratio 2.1 (1.9 to 2.4; P <0.001; aortic-related cause of death, 42.8%), respectively, compared with the general hypertensive population. Among patients who survived 30 days from dissection, the adjusted 5-year overall mortality rates were hazard ratio 1.1 (1.0 to 1.3; P =0.12; aortic-related cause of death, 23.2%) and hazard ratio 1.4 (1.2 to 1.6; P <0.001; aortic-related cause of death, 25.6%) for TAAD and TBAD, respectively. CONCLUSIONS: Hypertension, aortic aneurysms, and chronic obstructive pulmonary disease were the most prevalent comorbidities. The 30-day mortality frequencies were consistent over time with no significant differences between sexes. The 5-year mortality rate was higher for TAAD than TBAD. If the patient survived 30 days from dissection, the mortality rate for patients with TAAD was comparable with that of the general hypertensive population, but the mortality rate was significantly higher in patients with TBAD.

Purpose This study evaluated the validity of the ICD-10 diagnostic codes for aortic dissections (ADs) in the Danish National Patient Registry (DNPR) based upon positive predictive values (PPV). Patients and methods Cases registered in the DNPR with the unspecific AD diagnostic code DI710 (unspecified AD) from 1996 to 2016, and the specific AD diagnostic codes DI710A (AD Type A) and DI710B (AD Type B) from 2006 to 2016, were included. Available medical records from all registered cases underwent review. Confirmed cases of AD served as “gold standard” when reporting PPV. PPV estimates were stratified by regional differences, date, age at time of diagnosis, and sex. Results A total of 5018 cases were identified in the DNPR. After merging of data and retrieval of medical records, 3767 cases were eligible for validation. Of these, 2677 cases were verified as AD type A (59.7%), AD type B (38.8%), and unspecified type of AD (1.5%). The average age at diagnosis was 65.1 ±13.0 years (67.3% males). The overall PPV for having an AD when one of the three diagnostic codes were registered from 1996 to 2016 was 71.1% (95% confidence interval (CI): 69.6–72.5) and increased significantly over time. From 2006 to 2016, the PPV for the specific AD diagnostic codes was 89.5% (95% CI: 87.4–91.3), whilst the PPV for the unspecific diagnostic code was 63.5% (95% CI: 61.1–65.9). Conclusion We found the overall PPV for the pooled AD diagnostic codes in the DNPR acceptable. However, the two specific AD diagnostic codes presented remarkably higher PPV compared to the unspecific diagnostic code.

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