12
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Sposito AC, de Lima-Junior JC, Moura FA, Barreto J, Bonilha I, Santana M, Virginio VW, Sun L, Carvalho LSF, Soares AA, Nadruz W, Feinstein SB, Nofer JR, Zanotti I, Kontush A, Remaley AT. Reciprocal Multifaceted Interaction Between HDL (High-Density Lipoprotein) and Myocardial Infarction. Arterioscler Thromb Vasc Biol 2019; 39:1550-1564. [DOI: 10.1161/atvbaha.119.312880] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Despite decades of therapeutic advances, myocardial infarction remains a leading cause of death worldwide. Recent studies have identified HDLs (high-density lipoproteins) as a potential candidate for mitigating coronary ischemia/reperfusion injury via a broad spectrum of signaling pathways. HDL ligands, such as S1P (sphingosine-1-phosphate), Apo (apolipoprotein) A-I, clusterin, and miRNA, may influence the opening of the mitochondrial channel, insulin sensitivity, and production of vascular autacoids, such as NO, prostacyclin, and endothelin-1. In parallel, antioxidant activity and sequestration of oxidized molecules provided by HDL can attenuate the oxidative stress that triggers ischemia/reperfusion. Nevertheless, during myocardial infarction, oxidation and the capture of oxidized and proinflammatory molecules generate large phenotypic and functional changes in HDL, potentially limiting its beneficial properties. In this review, new findings from cellular and animal models, as well as from clinical studies, will be discussed to describe the cardioprotective benefits of HDL on myocardial infarction. Furthermore, mechanisms by which HDL modulates cardiac function and potential strategies to mitigate postmyocardial infarction risk damage by HDL will be detailed throughout the review.
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Affiliation(s)
- Andrei C. Sposito
- From the Atherosclerosis and Vascular Biology Laboratory, Cardiology Department, State University of Campinas, Brazil (A.C.S., J.C.d.L.-J., F.A.M., J.B., I.B., M.S., V.W.V., L.S.F.C., A.A.S.S., W.N.)
| | - José Carlos de Lima-Junior
- From the Atherosclerosis and Vascular Biology Laboratory, Cardiology Department, State University of Campinas, Brazil (A.C.S., J.C.d.L.-J., F.A.M., J.B., I.B., M.S., V.W.V., L.S.F.C., A.A.S.S., W.N.)
| | - Filipe A. Moura
- From the Atherosclerosis and Vascular Biology Laboratory, Cardiology Department, State University of Campinas, Brazil (A.C.S., J.C.d.L.-J., F.A.M., J.B., I.B., M.S., V.W.V., L.S.F.C., A.A.S.S., W.N.)
- Department of Medicine, Weill-Cornell Medical College, New York, NY (F.A.M.)
| | - Joaquim Barreto
- From the Atherosclerosis and Vascular Biology Laboratory, Cardiology Department, State University of Campinas, Brazil (A.C.S., J.C.d.L.-J., F.A.M., J.B., I.B., M.S., V.W.V., L.S.F.C., A.A.S.S., W.N.)
| | - Isabella Bonilha
- From the Atherosclerosis and Vascular Biology Laboratory, Cardiology Department, State University of Campinas, Brazil (A.C.S., J.C.d.L.-J., F.A.M., J.B., I.B., M.S., V.W.V., L.S.F.C., A.A.S.S., W.N.)
| | - Michele Santana
- From the Atherosclerosis and Vascular Biology Laboratory, Cardiology Department, State University of Campinas, Brazil (A.C.S., J.C.d.L.-J., F.A.M., J.B., I.B., M.S., V.W.V., L.S.F.C., A.A.S.S., W.N.)
| | - Vitor W. Virginio
- From the Atherosclerosis and Vascular Biology Laboratory, Cardiology Department, State University of Campinas, Brazil (A.C.S., J.C.d.L.-J., F.A.M., J.B., I.B., M.S., V.W.V., L.S.F.C., A.A.S.S., W.N.)
| | - Lufan Sun
- Lipoprotein Metabolism Section, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (L.S., A.T.R.)
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, Liaoning Province, China (L.S.)
| | - Luiz Sergio F. Carvalho
- From the Atherosclerosis and Vascular Biology Laboratory, Cardiology Department, State University of Campinas, Brazil (A.C.S., J.C.d.L.-J., F.A.M., J.B., I.B., M.S., V.W.V., L.S.F.C., A.A.S.S., W.N.)
| | - Alexandre A.S. Soares
- From the Atherosclerosis and Vascular Biology Laboratory, Cardiology Department, State University of Campinas, Brazil (A.C.S., J.C.d.L.-J., F.A.M., J.B., I.B., M.S., V.W.V., L.S.F.C., A.A.S.S., W.N.)
| | - Wilson Nadruz
- From the Atherosclerosis and Vascular Biology Laboratory, Cardiology Department, State University of Campinas, Brazil (A.C.S., J.C.d.L.-J., F.A.M., J.B., I.B., M.S., V.W.V., L.S.F.C., A.A.S.S., W.N.)
| | - Steve B. Feinstein
- Division of Cardiology, Rush University Medical Center, Chicago, IL (S.B.F.)
| | - Jerzy-Roch Nofer
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center Hamburg-Eppendorf, Germany (J.-R.N.)
| | - Ilaria Zanotti
- Department of Food and Drugs, University of Parma, Italy (I.Z.)
| | - Anatol Kontush
- UMR-ICAN 1166, National Institute for Health and Medical Research (INSERM), Sorbonne University, Paris, France (A.K.)
| | - Alan T. Remaley
- Lipoprotein Metabolism Section, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (L.S., A.T.R.)
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23
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Michael Gibson C, Korjian S, Tricoci P, Daaboul Y, Yee M, Jain P, Alexander JH, Steg PG, Lincoff AM, Kastelein JJP, Mehran R, D'Andrea DM, Deckelbaum LI, Merkely B, Zarebinski M, Ophuis TO, Harrington RA. Safety and Tolerability of CSL112, a Reconstituted, Infusible, Plasma-Derived Apolipoprotein A-I, After Acute Myocardial Infarction: The AEGIS-I Trial (ApoA-I Event Reducing in Ischemic Syndromes I). Circulation 2016; 134:1918-1930. [PMID: 27881559 PMCID: PMC5147036 DOI: 10.1161/circulationaha.116.025687] [Citation(s) in RCA: 126] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 10/22/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND Human or recombinant apolipoprotein A-I (apoA-I) has been shown to increase high-density lipoprotein-mediated cholesterol efflux capacity and to regress atherosclerotic disease in animal and clinical studies. CSL112 is an infusible, plasma-derived apoA-I that has been studied in normal subjects or those with stable coronary artery disease. This study aimed to characterize the safety, tolerability, pharmacokinetics, and pharmacodynamics of CSL112 in patients with a recent acute myocardial infarction. METHODS The AEGIS-I trial (Apo-I Event Reducing in Ischemic Syndromes I) was a multicenter, randomized, double-blind, placebo-controlled, dose-ranging phase 2b trial. Patients with myocardial infarction were stratified by renal function and randomized 1:1:1 to CSL112 (2 g apoA-I per dose) and high-dose CSL112 (6 g apoA-I per dose), or placebo for 4 consecutive weekly infusions. Coprimary safety end points were occurrence of either a hepatic safety event (an increase in alanine transaminase >3 times the upper limit of normal or an increase in total bilirubin >2 times the upper limit of normal) or a renal safety event (an increase in serum creatinine >1.5 times the baseline value or a new requirement for renal replacement therapy). RESULTS A total of 1258 patients were randomized, and 91.2% received all 4 infusions. The difference in incidence rates for an increase in alanine transaminase or total bilirubin between both CSL112 arms and placebo was within the protocol-defined noninferiority margin of 4%. Similarly, the difference in incidence rates for an increase in serum creatinine or a new requirement for renal replacement therapy was within the protocol-defined noninferiority margin of 5%. CSL112 was associated with increases in apoA-I and ex vivo cholesterol efflux similar to that achieved in patients with stable coronary artery disease. In regard to the secondary efficacy end point, the risk for the composite of major adverse cardiovascular events among the groups was similar. CONCLUSIONS Among patients with acute myocardial infarction, 4 weekly infusions of CSL112 are feasible, well tolerated, and not associated with any significant alterations in liver or kidney function or other safety concern. The ability of CSL112 to acutely enhance cholesterol efflux was confirmed. The potential benefit of CSL112 to reduce major adverse cardiovascular events needs to be assessed in an adequately powered phase 3 trial. CLINICAL TRIAL REGISTRATION URL: https://clinicaltrials.gov. Unique identifier: NCT02108262.
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Affiliation(s)
- C Michael Gibson
- From PERFUSE Study Group, Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical, Harvard Medical School, Boston, MA (C.M.G., S.K., Y.D., M.Y., P.J.); Duke Clinical Research Institute, Cardiovascular Division, Department of Medicine, Duke University Health, Durham, NC (P.T., J.H.A.); INSERM-Unité 1148, France Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, France Université Paris-Diderot, Sorbonne- Paris Cité, France National Heart and Lung Institute, Paris, France (P.G.S.); Imperial College London, UK Institute of Cardiovascular Medicine and Science, and Royal Brompton Hospital, London, UK (P.G.S.); Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, OH (A.M.L.); Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands (J.J.P.K.); Cardiovascular Institute, Mount Sinai Medical Center, Icahn School of Medicine at Mount Sinai, New York (R.M.); CSL Behring, LLC, King of Prussia, PA (D.M.D., L.I.D.); Heart and Vascular Center, Semmelweis University, Budapest, Hungary (B.M.); Department of Cardiology, Warsaw Medical University, Warsaw, Poland (M.Z.); Department of Cardiology, Canisius Wilhelmina Ziekenhuis, Nijmegen, the Netherlands (T.O.O.); and Department of Medicine, Stanford University, Stanford, CA (R.A.H.).
| | - Serge Korjian
- From PERFUSE Study Group, Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical, Harvard Medical School, Boston, MA (C.M.G., S.K., Y.D., M.Y., P.J.); Duke Clinical Research Institute, Cardiovascular Division, Department of Medicine, Duke University Health, Durham, NC (P.T., J.H.A.); INSERM-Unité 1148, France Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, France Université Paris-Diderot, Sorbonne- Paris Cité, France National Heart and Lung Institute, Paris, France (P.G.S.); Imperial College London, UK Institute of Cardiovascular Medicine and Science, and Royal Brompton Hospital, London, UK (P.G.S.); Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, OH (A.M.L.); Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands (J.J.P.K.); Cardiovascular Institute, Mount Sinai Medical Center, Icahn School of Medicine at Mount Sinai, New York (R.M.); CSL Behring, LLC, King of Prussia, PA (D.M.D., L.I.D.); Heart and Vascular Center, Semmelweis University, Budapest, Hungary (B.M.); Department of Cardiology, Warsaw Medical University, Warsaw, Poland (M.Z.); Department of Cardiology, Canisius Wilhelmina Ziekenhuis, Nijmegen, the Netherlands (T.O.O.); and Department of Medicine, Stanford University, Stanford, CA (R.A.H.)
| | - Pierluigi Tricoci
- From PERFUSE Study Group, Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical, Harvard Medical School, Boston, MA (C.M.G., S.K., Y.D., M.Y., P.J.); Duke Clinical Research Institute, Cardiovascular Division, Department of Medicine, Duke University Health, Durham, NC (P.T., J.H.A.); INSERM-Unité 1148, France Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, France Université Paris-Diderot, Sorbonne- Paris Cité, France National Heart and Lung Institute, Paris, France (P.G.S.); Imperial College London, UK Institute of Cardiovascular Medicine and Science, and Royal Brompton Hospital, London, UK (P.G.S.); Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, OH (A.M.L.); Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands (J.J.P.K.); Cardiovascular Institute, Mount Sinai Medical Center, Icahn School of Medicine at Mount Sinai, New York (R.M.); CSL Behring, LLC, King of Prussia, PA (D.M.D., L.I.D.); Heart and Vascular Center, Semmelweis University, Budapest, Hungary (B.M.); Department of Cardiology, Warsaw Medical University, Warsaw, Poland (M.Z.); Department of Cardiology, Canisius Wilhelmina Ziekenhuis, Nijmegen, the Netherlands (T.O.O.); and Department of Medicine, Stanford University, Stanford, CA (R.A.H.)
| | - Yazan Daaboul
- From PERFUSE Study Group, Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical, Harvard Medical School, Boston, MA (C.M.G., S.K., Y.D., M.Y., P.J.); Duke Clinical Research Institute, Cardiovascular Division, Department of Medicine, Duke University Health, Durham, NC (P.T., J.H.A.); INSERM-Unité 1148, France Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, France Université Paris-Diderot, Sorbonne- Paris Cité, France National Heart and Lung Institute, Paris, France (P.G.S.); Imperial College London, UK Institute of Cardiovascular Medicine and Science, and Royal Brompton Hospital, London, UK (P.G.S.); Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, OH (A.M.L.); Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands (J.J.P.K.); Cardiovascular Institute, Mount Sinai Medical Center, Icahn School of Medicine at Mount Sinai, New York (R.M.); CSL Behring, LLC, King of Prussia, PA (D.M.D., L.I.D.); Heart and Vascular Center, Semmelweis University, Budapest, Hungary (B.M.); Department of Cardiology, Warsaw Medical University, Warsaw, Poland (M.Z.); Department of Cardiology, Canisius Wilhelmina Ziekenhuis, Nijmegen, the Netherlands (T.O.O.); and Department of Medicine, Stanford University, Stanford, CA (R.A.H.)
| | - Megan Yee
- From PERFUSE Study Group, Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical, Harvard Medical School, Boston, MA (C.M.G., S.K., Y.D., M.Y., P.J.); Duke Clinical Research Institute, Cardiovascular Division, Department of Medicine, Duke University Health, Durham, NC (P.T., J.H.A.); INSERM-Unité 1148, France Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, France Université Paris-Diderot, Sorbonne- Paris Cité, France National Heart and Lung Institute, Paris, France (P.G.S.); Imperial College London, UK Institute of Cardiovascular Medicine and Science, and Royal Brompton Hospital, London, UK (P.G.S.); Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, OH (A.M.L.); Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands (J.J.P.K.); Cardiovascular Institute, Mount Sinai Medical Center, Icahn School of Medicine at Mount Sinai, New York (R.M.); CSL Behring, LLC, King of Prussia, PA (D.M.D., L.I.D.); Heart and Vascular Center, Semmelweis University, Budapest, Hungary (B.M.); Department of Cardiology, Warsaw Medical University, Warsaw, Poland (M.Z.); Department of Cardiology, Canisius Wilhelmina Ziekenhuis, Nijmegen, the Netherlands (T.O.O.); and Department of Medicine, Stanford University, Stanford, CA (R.A.H.)
| | - Purva Jain
- From PERFUSE Study Group, Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical, Harvard Medical School, Boston, MA (C.M.G., S.K., Y.D., M.Y., P.J.); Duke Clinical Research Institute, Cardiovascular Division, Department of Medicine, Duke University Health, Durham, NC (P.T., J.H.A.); INSERM-Unité 1148, France Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, France Université Paris-Diderot, Sorbonne- Paris Cité, France National Heart and Lung Institute, Paris, France (P.G.S.); Imperial College London, UK Institute of Cardiovascular Medicine and Science, and Royal Brompton Hospital, London, UK (P.G.S.); Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, OH (A.M.L.); Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands (J.J.P.K.); Cardiovascular Institute, Mount Sinai Medical Center, Icahn School of Medicine at Mount Sinai, New York (R.M.); CSL Behring, LLC, King of Prussia, PA (D.M.D., L.I.D.); Heart and Vascular Center, Semmelweis University, Budapest, Hungary (B.M.); Department of Cardiology, Warsaw Medical University, Warsaw, Poland (M.Z.); Department of Cardiology, Canisius Wilhelmina Ziekenhuis, Nijmegen, the Netherlands (T.O.O.); and Department of Medicine, Stanford University, Stanford, CA (R.A.H.)
| | - John H Alexander
- From PERFUSE Study Group, Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical, Harvard Medical School, Boston, MA (C.M.G., S.K., Y.D., M.Y., P.J.); Duke Clinical Research Institute, Cardiovascular Division, Department of Medicine, Duke University Health, Durham, NC (P.T., J.H.A.); INSERM-Unité 1148, France Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, France Université Paris-Diderot, Sorbonne- Paris Cité, France National Heart and Lung Institute, Paris, France (P.G.S.); Imperial College London, UK Institute of Cardiovascular Medicine and Science, and Royal Brompton Hospital, London, UK (P.G.S.); Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, OH (A.M.L.); Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands (J.J.P.K.); Cardiovascular Institute, Mount Sinai Medical Center, Icahn School of Medicine at Mount Sinai, New York (R.M.); CSL Behring, LLC, King of Prussia, PA (D.M.D., L.I.D.); Heart and Vascular Center, Semmelweis University, Budapest, Hungary (B.M.); Department of Cardiology, Warsaw Medical University, Warsaw, Poland (M.Z.); Department of Cardiology, Canisius Wilhelmina Ziekenhuis, Nijmegen, the Netherlands (T.O.O.); and Department of Medicine, Stanford University, Stanford, CA (R.A.H.)
| | - P Gabriel Steg
- From PERFUSE Study Group, Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical, Harvard Medical School, Boston, MA (C.M.G., S.K., Y.D., M.Y., P.J.); Duke Clinical Research Institute, Cardiovascular Division, Department of Medicine, Duke University Health, Durham, NC (P.T., J.H.A.); INSERM-Unité 1148, France Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, France Université Paris-Diderot, Sorbonne- Paris Cité, France National Heart and Lung Institute, Paris, France (P.G.S.); Imperial College London, UK Institute of Cardiovascular Medicine and Science, and Royal Brompton Hospital, London, UK (P.G.S.); Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, OH (A.M.L.); Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands (J.J.P.K.); Cardiovascular Institute, Mount Sinai Medical Center, Icahn School of Medicine at Mount Sinai, New York (R.M.); CSL Behring, LLC, King of Prussia, PA (D.M.D., L.I.D.); Heart and Vascular Center, Semmelweis University, Budapest, Hungary (B.M.); Department of Cardiology, Warsaw Medical University, Warsaw, Poland (M.Z.); Department of Cardiology, Canisius Wilhelmina Ziekenhuis, Nijmegen, the Netherlands (T.O.O.); and Department of Medicine, Stanford University, Stanford, CA (R.A.H.)
| | - A Michael Lincoff
- From PERFUSE Study Group, Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical, Harvard Medical School, Boston, MA (C.M.G., S.K., Y.D., M.Y., P.J.); Duke Clinical Research Institute, Cardiovascular Division, Department of Medicine, Duke University Health, Durham, NC (P.T., J.H.A.); INSERM-Unité 1148, France Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, France Université Paris-Diderot, Sorbonne- Paris Cité, France National Heart and Lung Institute, Paris, France (P.G.S.); Imperial College London, UK Institute of Cardiovascular Medicine and Science, and Royal Brompton Hospital, London, UK (P.G.S.); Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, OH (A.M.L.); Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands (J.J.P.K.); Cardiovascular Institute, Mount Sinai Medical Center, Icahn School of Medicine at Mount Sinai, New York (R.M.); CSL Behring, LLC, King of Prussia, PA (D.M.D., L.I.D.); Heart and Vascular Center, Semmelweis University, Budapest, Hungary (B.M.); Department of Cardiology, Warsaw Medical University, Warsaw, Poland (M.Z.); Department of Cardiology, Canisius Wilhelmina Ziekenhuis, Nijmegen, the Netherlands (T.O.O.); and Department of Medicine, Stanford University, Stanford, CA (R.A.H.)
| | - John J P Kastelein
- From PERFUSE Study Group, Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical, Harvard Medical School, Boston, MA (C.M.G., S.K., Y.D., M.Y., P.J.); Duke Clinical Research Institute, Cardiovascular Division, Department of Medicine, Duke University Health, Durham, NC (P.T., J.H.A.); INSERM-Unité 1148, France Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, France Université Paris-Diderot, Sorbonne- Paris Cité, France National Heart and Lung Institute, Paris, France (P.G.S.); Imperial College London, UK Institute of Cardiovascular Medicine and Science, and Royal Brompton Hospital, London, UK (P.G.S.); Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, OH (A.M.L.); Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands (J.J.P.K.); Cardiovascular Institute, Mount Sinai Medical Center, Icahn School of Medicine at Mount Sinai, New York (R.M.); CSL Behring, LLC, King of Prussia, PA (D.M.D., L.I.D.); Heart and Vascular Center, Semmelweis University, Budapest, Hungary (B.M.); Department of Cardiology, Warsaw Medical University, Warsaw, Poland (M.Z.); Department of Cardiology, Canisius Wilhelmina Ziekenhuis, Nijmegen, the Netherlands (T.O.O.); and Department of Medicine, Stanford University, Stanford, CA (R.A.H.)
| | - Roxana Mehran
- From PERFUSE Study Group, Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical, Harvard Medical School, Boston, MA (C.M.G., S.K., Y.D., M.Y., P.J.); Duke Clinical Research Institute, Cardiovascular Division, Department of Medicine, Duke University Health, Durham, NC (P.T., J.H.A.); INSERM-Unité 1148, France Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, France Université Paris-Diderot, Sorbonne- Paris Cité, France National Heart and Lung Institute, Paris, France (P.G.S.); Imperial College London, UK Institute of Cardiovascular Medicine and Science, and Royal Brompton Hospital, London, UK (P.G.S.); Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, OH (A.M.L.); Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands (J.J.P.K.); Cardiovascular Institute, Mount Sinai Medical Center, Icahn School of Medicine at Mount Sinai, New York (R.M.); CSL Behring, LLC, King of Prussia, PA (D.M.D., L.I.D.); Heart and Vascular Center, Semmelweis University, Budapest, Hungary (B.M.); Department of Cardiology, Warsaw Medical University, Warsaw, Poland (M.Z.); Department of Cardiology, Canisius Wilhelmina Ziekenhuis, Nijmegen, the Netherlands (T.O.O.); and Department of Medicine, Stanford University, Stanford, CA (R.A.H.)
| | - Denise M D'Andrea
- From PERFUSE Study Group, Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical, Harvard Medical School, Boston, MA (C.M.G., S.K., Y.D., M.Y., P.J.); Duke Clinical Research Institute, Cardiovascular Division, Department of Medicine, Duke University Health, Durham, NC (P.T., J.H.A.); INSERM-Unité 1148, France Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, France Université Paris-Diderot, Sorbonne- Paris Cité, France National Heart and Lung Institute, Paris, France (P.G.S.); Imperial College London, UK Institute of Cardiovascular Medicine and Science, and Royal Brompton Hospital, London, UK (P.G.S.); Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, OH (A.M.L.); Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands (J.J.P.K.); Cardiovascular Institute, Mount Sinai Medical Center, Icahn School of Medicine at Mount Sinai, New York (R.M.); CSL Behring, LLC, King of Prussia, PA (D.M.D., L.I.D.); Heart and Vascular Center, Semmelweis University, Budapest, Hungary (B.M.); Department of Cardiology, Warsaw Medical University, Warsaw, Poland (M.Z.); Department of Cardiology, Canisius Wilhelmina Ziekenhuis, Nijmegen, the Netherlands (T.O.O.); and Department of Medicine, Stanford University, Stanford, CA (R.A.H.)
| | - Lawrence I Deckelbaum
- From PERFUSE Study Group, Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical, Harvard Medical School, Boston, MA (C.M.G., S.K., Y.D., M.Y., P.J.); Duke Clinical Research Institute, Cardiovascular Division, Department of Medicine, Duke University Health, Durham, NC (P.T., J.H.A.); INSERM-Unité 1148, France Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, France Université Paris-Diderot, Sorbonne- Paris Cité, France National Heart and Lung Institute, Paris, France (P.G.S.); Imperial College London, UK Institute of Cardiovascular Medicine and Science, and Royal Brompton Hospital, London, UK (P.G.S.); Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, OH (A.M.L.); Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands (J.J.P.K.); Cardiovascular Institute, Mount Sinai Medical Center, Icahn School of Medicine at Mount Sinai, New York (R.M.); CSL Behring, LLC, King of Prussia, PA (D.M.D., L.I.D.); Heart and Vascular Center, Semmelweis University, Budapest, Hungary (B.M.); Department of Cardiology, Warsaw Medical University, Warsaw, Poland (M.Z.); Department of Cardiology, Canisius Wilhelmina Ziekenhuis, Nijmegen, the Netherlands (T.O.O.); and Department of Medicine, Stanford University, Stanford, CA (R.A.H.)
| | - Bela Merkely
- From PERFUSE Study Group, Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical, Harvard Medical School, Boston, MA (C.M.G., S.K., Y.D., M.Y., P.J.); Duke Clinical Research Institute, Cardiovascular Division, Department of Medicine, Duke University Health, Durham, NC (P.T., J.H.A.); INSERM-Unité 1148, France Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, France Université Paris-Diderot, Sorbonne- Paris Cité, France National Heart and Lung Institute, Paris, France (P.G.S.); Imperial College London, UK Institute of Cardiovascular Medicine and Science, and Royal Brompton Hospital, London, UK (P.G.S.); Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, OH (A.M.L.); Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands (J.J.P.K.); Cardiovascular Institute, Mount Sinai Medical Center, Icahn School of Medicine at Mount Sinai, New York (R.M.); CSL Behring, LLC, King of Prussia, PA (D.M.D., L.I.D.); Heart and Vascular Center, Semmelweis University, Budapest, Hungary (B.M.); Department of Cardiology, Warsaw Medical University, Warsaw, Poland (M.Z.); Department of Cardiology, Canisius Wilhelmina Ziekenhuis, Nijmegen, the Netherlands (T.O.O.); and Department of Medicine, Stanford University, Stanford, CA (R.A.H.)
| | - Maciej Zarebinski
- From PERFUSE Study Group, Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical, Harvard Medical School, Boston, MA (C.M.G., S.K., Y.D., M.Y., P.J.); Duke Clinical Research Institute, Cardiovascular Division, Department of Medicine, Duke University Health, Durham, NC (P.T., J.H.A.); INSERM-Unité 1148, France Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, France Université Paris-Diderot, Sorbonne- Paris Cité, France National Heart and Lung Institute, Paris, France (P.G.S.); Imperial College London, UK Institute of Cardiovascular Medicine and Science, and Royal Brompton Hospital, London, UK (P.G.S.); Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, OH (A.M.L.); Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands (J.J.P.K.); Cardiovascular Institute, Mount Sinai Medical Center, Icahn School of Medicine at Mount Sinai, New York (R.M.); CSL Behring, LLC, King of Prussia, PA (D.M.D., L.I.D.); Heart and Vascular Center, Semmelweis University, Budapest, Hungary (B.M.); Department of Cardiology, Warsaw Medical University, Warsaw, Poland (M.Z.); Department of Cardiology, Canisius Wilhelmina Ziekenhuis, Nijmegen, the Netherlands (T.O.O.); and Department of Medicine, Stanford University, Stanford, CA (R.A.H.)
| | - Ton Oude Ophuis
- From PERFUSE Study Group, Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical, Harvard Medical School, Boston, MA (C.M.G., S.K., Y.D., M.Y., P.J.); Duke Clinical Research Institute, Cardiovascular Division, Department of Medicine, Duke University Health, Durham, NC (P.T., J.H.A.); INSERM-Unité 1148, France Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, France Université Paris-Diderot, Sorbonne- Paris Cité, France National Heart and Lung Institute, Paris, France (P.G.S.); Imperial College London, UK Institute of Cardiovascular Medicine and Science, and Royal Brompton Hospital, London, UK (P.G.S.); Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, OH (A.M.L.); Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands (J.J.P.K.); Cardiovascular Institute, Mount Sinai Medical Center, Icahn School of Medicine at Mount Sinai, New York (R.M.); CSL Behring, LLC, King of Prussia, PA (D.M.D., L.I.D.); Heart and Vascular Center, Semmelweis University, Budapest, Hungary (B.M.); Department of Cardiology, Warsaw Medical University, Warsaw, Poland (M.Z.); Department of Cardiology, Canisius Wilhelmina Ziekenhuis, Nijmegen, the Netherlands (T.O.O.); and Department of Medicine, Stanford University, Stanford, CA (R.A.H.)
| | - Robert A Harrington
- From PERFUSE Study Group, Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical, Harvard Medical School, Boston, MA (C.M.G., S.K., Y.D., M.Y., P.J.); Duke Clinical Research Institute, Cardiovascular Division, Department of Medicine, Duke University Health, Durham, NC (P.T., J.H.A.); INSERM-Unité 1148, France Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, France Université Paris-Diderot, Sorbonne- Paris Cité, France National Heart and Lung Institute, Paris, France (P.G.S.); Imperial College London, UK Institute of Cardiovascular Medicine and Science, and Royal Brompton Hospital, London, UK (P.G.S.); Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, OH (A.M.L.); Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands (J.J.P.K.); Cardiovascular Institute, Mount Sinai Medical Center, Icahn School of Medicine at Mount Sinai, New York (R.M.); CSL Behring, LLC, King of Prussia, PA (D.M.D., L.I.D.); Heart and Vascular Center, Semmelweis University, Budapest, Hungary (B.M.); Department of Cardiology, Warsaw Medical University, Warsaw, Poland (M.Z.); Department of Cardiology, Canisius Wilhelmina Ziekenhuis, Nijmegen, the Netherlands (T.O.O.); and Department of Medicine, Stanford University, Stanford, CA (R.A.H.)
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