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Von Olshausen G, Bourke T, Schwieler J, Drca N, Bastani H, Tapanainen J, Saluveer O, Benson L, Goedel A, Kenneback G, Insulander P, Jensen-Urstad M, Braunschweig F. Long-term outcome of patients with invasive electrophysiology procedure related cardiac tamponade. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Aims
Iatrogenic cardiac tamponades are a rare but dreaded complication of invasive electrophysiology procedures (EPs). Their long-term impact on clinical outcomes is unknown. This study analyzed the risk of death or serious cardiovascular events in patients suffering from EP related cardiac tamponade requiring pericardiocentesis during long-term follow-up.
Methods and results
Out of 19997 invasive EPs at our university hospital between January 1998 and September 2018, all patients with EP related periprocedural cardiac tamponade were identified (n=60) and matched (1:3 ratio) to a control group (n=180). After a follow-up of 5 years, the composite primary end point - death from any cause, acute myocardial infarction, TIA/stroke and hospitalization for heart failure – occurred in significantly more patients in the tamponade than in the control group (12 patients (20.0%) vs 19 patients (10.6%); Hazard ratio (HR) 2.53 (95% CI, 1.15–5.58); p=0.021). This was mainly driven by a higher incidence of TIA/stroke in the tamponade than in the control group (HR 3.75 (95% CI, 1.01–13.97); p=0.049). Death from any cause, acute myocardial infarction and hospitalization for heart failure did not show a significant difference between the groups. Hospitalization for pericarditis occurred in significantly more patients in the tamponade than in the control group (HR 36.0 (95% CI, 4.68–276.86); p=0.001).
Conclusion
Patients with EP related cardiac tamponade are at higher risk for cerebrovascular events during the first two weeks and hospitalization for pericarditis during the first months after index procedure. Despite the increased risk for early complications tamponade patients have a good long-term prognosis without increased risk for mortality or other serious cardiovascular events.
Funding Acknowledgement
Type of funding source: Foundation. Main funding source(s): German Research Foundation
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Affiliation(s)
| | - T Bourke
- Karolinska University Hospital, Stockholm, Sweden
| | - J Schwieler
- Karolinska University Hospital, Stockholm, Sweden
| | - N Drca
- Karolinska University Hospital, Stockholm, Sweden
| | - H Bastani
- Karolinska University Hospital, Stockholm, Sweden
| | - J Tapanainen
- Karolinska University Hospital, Stockholm, Sweden
| | - O Saluveer
- Karolinska University Hospital, Stockholm, Sweden
| | - L Benson
- Karolinska Institutet, Stockholm, Sweden
| | - A Goedel
- Karolinska Institutet, Stockholm, Sweden
| | - G Kenneback
- Karolinska University Hospital, Stockholm, Sweden
| | - P Insulander
- Karolinska University Hospital, Stockholm, Sweden
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Goedel A, Müller S, Schwerdtfeger C, Zink A, Noe S, Bongiovanni D, Haller B, Spinner CD, Bernlochner I. Influence of antiretroviral therapy and cardiovascular disease on the immature platelet fraction in patients living with HIV. Platelets 2019; 31:756-762. [PMID: 31608753 DOI: 10.1080/09537104.2019.1678114] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Cardiovascular disease is an important contributor to morbidity and mortality in people living with HIV . The immature platelet fraction (IPF) is increased in HIV-negative patients with cardiovascular disease and evidence suggests that an enlarged IPF is associated with adverse cardiovascular events. In this multi-center observational study, we aimed to investigate how the IPF in people living with HIV is influenced by antiretroviral therapy and cardiovascular disease. Subjects without cardiovascular disease that received antiretroviral therapy showed a smaller IPF accompanied by lower D-dimer and C-reactive protein (CRP) levels compared to therapy-naïve subjects (mean IPF: 2.9% vs. 3.9%, p = .016; median D-dimer: 252 µg/L vs. 623 µg/L, p < .001; median CRP: 0.2 mg/dL vs. 0.5 mg/dL, p = .004). No significant differences for the IPF, D-dimer or CRP were found between subjects on antiretroviral therapy with documented cardiovascular disease and therapy-naïve subjects. In conclusion, we observed a reduction in the IPF among subjects on therapy only in the absence of cardiovascular disease. In contrast, subjects receiving therapy that had documented cardiovascular disease showed an IPF comparable to therapy-naïve subjects. Future studies are needed to investigate if an enlarged IPF may serve as a biomarker in predicting adverse cardiovascular events in people living with HIV.
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Affiliation(s)
- A Goedel
- Department of Medicine I, Technical University of Munich, School of Medicine, University Hospital Klinikum rechts der Isar , Munich, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance , Munich, Germany
| | - S Müller
- Department of Medicine II, Technical University of Munich, School of Medicine, University Hospital Klinikum rechts der Isar , Munich, Germany
| | - C Schwerdtfeger
- Department of Medicine II, Technical University of Munich, School of Medicine, University Hospital Klinikum rechts der Isar , Munich, Germany.,DZIF (German Center for Infection Research), partner site Munich , Munich, Germany
| | - A Zink
- Department of Dermatology and Allergology, Technical University of Munich, School of Medicine, University Hospital Klinikum rechts der Isar , Munich, Germany
| | - S Noe
- Medizinisches Versorgungszentrum am Karlsplatz, HIV Clinical Care and Research Center , Munich, Germany
| | - D Bongiovanni
- Department of Medicine I, Technical University of Munich, School of Medicine, University Hospital Klinikum rechts der Isar , Munich, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance , Munich, Germany
| | - B Haller
- School of Medicine, Institute for Medical Informatics, Statistics and Epidemiology, Technical University of Munich , Munich, Germany
| | - C D Spinner
- Department of Medicine II, Technical University of Munich, School of Medicine, University Hospital Klinikum rechts der Isar , Munich, Germany.,DZIF (German Center for Infection Research), partner site Munich , Munich, Germany
| | - I Bernlochner
- Department of Medicine I, Technical University of Munich, School of Medicine, University Hospital Klinikum rechts der Isar , Munich, Germany
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My I, Laue S, Dressen M, Schmidt F, Brade T, Dorn T, Goedel A, Lahm H, Lickert H, Krane M, Moretti A, Laugwitz KL. P1848Primary cilium-autophagy-cell cycle axis defects impair cardiac progenitor specification in hypoplastic left heart syndrome. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- I My
- Hospital Rechts der Isar, Molecular Cardiology, first department of medicine, TU, Munich, Germany
| | - S Laue
- Hospital Rechts der Isar, Molecular Cardiology, first department of medicine, TU, Munich, Germany
| | - M Dressen
- Deutsches Herzzentrum Technische Universitat, Department of cardiovascular surgery, division of experimental surgery, Munich, Germany
| | - F Schmidt
- Helmholtz Center Munich - German Research Center for Environment and Health, Institute of diabetes and regeneration research, Munich, Germany
| | - T Brade
- Hospital Rechts der Isar, Molecular Cardiology, first department of medicine, TU, Munich, Germany
| | - T Dorn
- Hospital Rechts der Isar, Molecular Cardiology, first department of medicine, TU, Munich, Germany
| | - A Goedel
- Hospital Rechts der Isar, Molecular Cardiology, first department of medicine, TU, Munich, Germany
| | - H Lahm
- Deutsches Herzzentrum Technische Universitat, Department of cardiovascular surgery, division of experimental surgery, Munich, Germany
| | - H Lickert
- Helmholtz Center Munich - German Research Center for Environment and Health, Institute of diabetes and regeneration research, Munich, Germany
| | - M Krane
- Deutsches Herzzentrum Technische Universitat, Department of cardiovascular surgery, division of experimental surgery, Munich, Germany
| | - A Moretti
- Hospital Rechts der Isar, Molecular Cardiology, first department of medicine, TU, Munich, Germany
| | - K.-L Laugwitz
- Hospital Rechts der Isar, Molecular Cardiology, first department of medicine, TU, Munich, Germany
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Sinnecker D, Chen Z, Goedel A, My I, Dreizehnter L, Moretti A, Laugwitz KL. P2561All-optical imaging of membrane potential and calcium signalling in patient-specific hiPSC-derived cardiomyocytes. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Goedel A, Orban M, Haas J, Gaertner F, Sandrock K, Zieger B, Kurnik K, Moretti A, Laugwitz KL, Massberg S. In vitro generation of hiPSC-derived megakaryocytes and platelets from a patient with Glanzmann thrombasthenia. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht311.5867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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