Christina Gerlach Øgard

Increased Mortality in Patients Hospitalized with Primary Hyperparathyroidism during the Period 1977–1993 in Denmark

The aim of the present study was to determine whether patients with the incident hospital diagnosis of primary hyperparathyroidism (PHPT) in Denmark during the period 1977–1993 had an increased mortality from cardiovascular disease and cancer compared to the rest of the Danish population. In a random sample of half of the Danish population, all patients with an incident hospital diagnosis of PHPT were identified in the National Hospital Patients Register. The mortality in the cohort was analyzed and compared with the background population. A cohort of 1578 patients was identified. Follow-up of 1179 women and 376 men, who did not die in the same month as the incident PHPT diagnosis, was made through 1993. Of these, 312 (20%) died within the follow-up period. The standard mortality ratio (SMR) for women was 1.7 (95% confidence interval [95% CI]: 1.5–1.9). SMR for men was 1.6 (95% CI: 1.3–2.0). In women an increased mortality from ischemic heart disease, cerebrovascular disease, and cancer was found. In men an increased mortality from cerebrovascular disease and cancer was found.

Increased plasma N-terminal pro-B-type natriuretic peptide and markers of inflammation related to atherosclerosis in patients with primary hyperparathyroidism

Objective  Increased risk of cardiovascular disease has been reported in patients with primary hyperparathyroidism (PHPT). The aim of this study was to evaluate novel plasma risk markers of cardiovascular disease in patients with PHPT.

Serum ionised calcium and cardiovascular disease in 45-years old men and women followed for 18 years.

High level of total serum calcium within the normal range has been associated with increased cardiovascular risk. We wanted to evaluate whether the physiological active ionised form of calcium also was a risk factor for cardiovascular disease (CVD). Methods: A total of 974 participants from a health survey in 1981 in Copenhagen had ionised serum calcium and different cardiovascular risk factors measured. The participants were followed until 1999 in The National Hospital Patients Registry and The National Death Registry in Denmark regarding the diagnosis ischemic heart disease (IHD) and a broader definition of CVD. Persons with ionised serum calcium in the highest quintile were compared with persons in the lower four quintiles. Results: In a univariate analysis persons with ionised serum calcium in the highest quintile had increased risk of IHD (p = 0.001) and CVD (p = 0.02) compared to persons in the lower quintiles. The increased risk disappeared when gender and cardiovascular confounders were included in a Cox proportional hazards analysis (p = 0.20 for IHD and p = 0.50 for CVD, respectively). In a separate analysis of men and IHD the result remained insignificant (p = 0.07). Conclusions: Serum ionised calcium in the upper quintile in women and men together did not seem to be a risk factor in development of IHD and CVD, but a non-significant tendency towards increased risk of IHD was observed in men with ionised calcium in the upper quintile compared to men in the lower four quintiles.

Parathyroid scintigraphy during hypocalcaemia in primary hyperparathyroidism.

Background:  Minimally invasive parathyroid surgery in patients with primary hyperparathyroidism (PHPT) demands high imaging accuracy. By increasing blood flow to the parathyroid adenoma before injection of a perfusion marker, we intended to improve the parathyroid scintigraphy. We have named the technique stimulated parathyroid scintigraphy (SPS).