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Bates ER. In patients with type 2 diabetes and recent MI, colchicine reduced a composite CV outcome at 23 mo. Ann Intern Med 2024. [PMID: 38710085 DOI: 10.7326/j24-0026] [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: 05/08/2024] Open
Abstract
SOURCE CITATION Roubille F, Bouabdallaoui N, Kouz S, et al. Low-dose colchicine in patients with type 2 diabetes and recent myocardial infarction in the COLchicine Cardiovascular Outcomes Trial (COLCOT). Diabetes Care. 2024;47:467-470. 38181203.
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Affiliation(s)
- Eric R Bates
- University of Michigan, Ann Arbor, Michigan, USA (E.R.B.)
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2
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Redfors B, Stone GW, Alexander JH, Bates ER, Bhatt DL, Biondi-Zoccai G, Caldonazo T, Farkouh M, Rahouma M, Puskas J, Sandner S, Gaudino MFL. Outcomes According to Coronary Revascularization Modality in the ISCHEMIA Trial. J Am Coll Cardiol 2024; 83:549-558. [PMID: 37956961 DOI: 10.1016/j.jacc.2023.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 11/03/2023] [Accepted: 11/07/2023] [Indexed: 11/21/2023]
Abstract
BACKGROUND In the ISCHEMIA (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches) trial, the risk of ischemic events was similar in patients with stable coronary artery disease treated with an invasive (INV) strategy of angiography and percutaneous coronary intervention (PCI) or surgical (coronary artery bypass grafting [CABG]) coronary revascularization and a conservative (CON) strategy of initial medical therapy. OBJECTIVES The authors analyzed separately the outcomes of INV patients treated with PCI or CABG. METHODS Patients without preceding primary outcome events were categorized as INV-PCI or INV-CABG from the time of revascularization. The ISCHEMIA primary outcome (composite of cardiovascular death, protocol-defined myocardial infarction or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest) was used. RESULTS Among INV-CABG patients, primary outcome events occurred in 84 of 512 (16.4%) at a median follow-up of 2.85 years; 48 events (57.1%) occurred within 30 days after CABG, including 40 procedural MIs. Among INV-PCI patients, primary outcome events occurred in 147 of 1,500 (9.8%) at median follow-up of 2.94 years; 31 of which (21.1%) occurred within 30 days after PCI, including 24 procedural MIs. In comparison, 352 of 2,591 CON patients (13.6%) had primary outcome events at a median follow-up of 3.2 years, 22 of which (6.3%) occurred within 30 days of randomization. The adjusted primary outcome risks were higher after both CABG and PCI within 30 days (HR: 16.25 [95% CI: 11.44-23.07] and HR: 2.99 [95% CI: 1.97-4.53]) and lower thereafter (0.63 [95% CI: 0.44-0.89] and 0.66 [95% CI: 0.53-0.82]). CONCLUSIONS In ISCHEMIA, early revascularization by PCI and CABG was associated with higher early risks and lower long-term risks of cardiovascular events compared with CON. The early risk was greatest after CABG, owing to protocol-defined procedural MIs.
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Affiliation(s)
- Bjorn Redfors
- Department of Molecular and Clinical Medicine, Institute of Medicine, Gothenburg University, Gothenburg, Sweden; Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Gothenburg, Sweden; Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, USA
| | - Gregg W Stone
- Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - John H Alexander
- Division of Cardiology and the Duke Clinical Research Institute, Duke University, Durham, North Carolina, USA
| | - Eric R Bates
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Deepak L Bhatt
- Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Giuseppe Biondi-Zoccai
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy; Mediterranea Cardiocentro, Napoli, Italy
| | - Tulio Caldonazo
- Department of Cardiothoracic Surgery, Jena University Hospital, Friedrich-Schiller-University Jena, Germany; Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Michael Farkouh
- Peter Munk Cardiac Centre and the Heart and Stroke Richard Lewar Centre, University of Toronto, Toronto, Ontario, Canada
| | - Mohamed Rahouma
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, New York, USA
| | - John Puskas
- Department of Cardiovascular Surgery, Icahn School of Medicine at Mount Sinai Cardiovascular Institute, New York, New York, USA; Department of Cardiovascular Surgery, Mount Sinai Heart at Mount Sinai Beth Israel, New York, New York, USA
| | - Sigrid Sandner
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, New York, USA; Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
| | - Mario F L Gaudino
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, New York, USA.
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3
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Bates ER. Clinically Significant Differences Between P2Y 12 Inhibitor Monotherapy and Aspirin Monotherapy Have Yet to Be Demonstrated. J Am Coll Cardiol 2024; 83:e9-e10. [PMID: 38171716 DOI: 10.1016/j.jacc.2023.09.833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 09/22/2023] [Indexed: 01/05/2024]
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4
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Gaudino M, Di Franco A, Arbustini E, Bacha E, Bates ER, Cameron DE, Cao D, David TE, De Paulis R, El-Hamamsy I, Farooqi KM, Girardi LN, Gräni C, Kochav JD, Molossi S, Puskas JD, Rao SV, Sandner S, Tatoulis J, Truong QA, Weinsaft JW, Zimpfer D, Mery CM. Management of Adults With Anomalous Aortic Origin of the Coronary Arteries: State-of-the-Art Review. Ann Thorac Surg 2023; 116:1124-1141. [PMID: 37855783 DOI: 10.1016/j.athoracsur.2023.09.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/16/2023] [Indexed: 10/20/2023]
Abstract
As a result of increasing adoption of imaging screening, the number of adult patients with a diagnosis of anomalous aortic origin of the coronary arteries (AAOCA) has grown in recent years. Existing guidelines provide a framework for management and treatment, but patients with AAOCA present with a wide range of anomalies and symptoms that make general recommendations of limited applicability. In particular, a large spectrum of interventions can be used for treatment, and there is no consensus on the optimal approach to be used. In this paper, a multidisciplinary group of clinical and interventional cardiologists and cardiac surgeons performed a systematic review and critical evaluation of the available evidence on the interventional treatment of AAOCA in adult patients. Using a structured Delphi process, the group agreed on expert recommendations that are intended to complement existing clinical practice guidelines.
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Affiliation(s)
- Mario Gaudino
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, New York.
| | - Antonino Di Franco
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, New York
| | - Eloisa Arbustini
- Transplant Research Area and Centre for Inherited Cardiovascular Diseases, Scientific Department, IRCCS and Polyclinic San Matteo Foundation, Pavia, Italy
| | - Emile Bacha
- Division of Cardiac, Thoracic, and Vascular Surgery, Columbia University Medical Center/New York-Presbyterian Hospital, New York, New York
| | - Eric R Bates
- Cardiovascular Center, Michigan Medicine, University of Michigan, Ann Arbor, Michigan
| | - Duke E Cameron
- Division of Cardiac Surgery, Corrigan Minehan Heart Center, Massachusetts General Hospital, Boston, Massachusetts
| | - Davide Cao
- The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Tirone E David
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Ruggero De Paulis
- Department of Cardiac Surgery, European Hospital, Rome, Italy; UniCamillus University, Rome, Italy
| | - Ismail El-Hamamsy
- Department of Cardiovascular Surgery, Mount Sinai Hospital and Icahn School of Medicine at Mount Sinai, New York, New York
| | - Kanwal M Farooqi
- Division of Pediatric Cardiology, New York-Presbyterian, Columbia University Irving Medical Center, New York, New York
| | - Leonard N Girardi
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, New York
| | - Christoph Gräni
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Jonathan D Kochav
- Division of Cardiology, Columbia University Irving Medical Center, New York, New York
| | - Silvana Molossi
- Division of Pediatric Cardiology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas
| | - John D Puskas
- Department of Cardiovascular Surgery, Mount Sinai Hospital and Icahn School of Medicine at Mount Sinai, New York, New York
| | - Sunil V Rao
- Division of Interventional Cardiology, NYU Langone Health, New York, New York
| | - Sigrid Sandner
- Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
| | - James Tatoulis
- Department of Cardiothoracic Surgery, Royal Melbourne Hospital, University of Melbourne, Melbourne, Victoria, Australia
| | - Quynh A Truong
- Department of Radiology, New York Presbyterian, Weill Cornell Medicine, New York, New York
| | - Jonathan W Weinsaft
- Greenberg Cardiology Division, Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Daniel Zimpfer
- Division of Cardiac Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - Carlos M Mery
- Texas Center for Pediatric and Congenital Heart Disease, Dell Medical School at The University of Texas at Austin/Dell Children's Medical Center, Austin, Texas
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5
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Gaudino M, Di Franco A, Arbustini E, Bacha E, Bates ER, Cameron DE, Cao D, David TE, De Paulis R, El-Hamamsy I, Farooqi KM, Girardi LN, Gräni C, Kochav JD, Molossi S, Puskas JD, Rao SV, Sandner S, Tatoulis J, Truong QA, Weinsaft JW, Zimpfer D, Mery CM. Management of Adults With Anomalous Aortic Origin of the Coronary Arteries: State-of-the-Art Review. J Am Coll Cardiol 2023; 82:2034-2053. [PMID: 37855757 DOI: 10.1016/j.jacc.2023.08.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 08/07/2023] [Accepted: 08/16/2023] [Indexed: 10/20/2023]
Abstract
As a result of increasing adoption of imaging screening, the number of adult patients with a diagnosis of anomalous aortic origin of the coronary arteries (AAOCA) has grown in recent years. Existing guidelines provide a framework for management and treatment, but patients with AAOCA present with a wide range of anomalies and symptoms that make general recommendations of limited applicability. In particular, a large spectrum of interventions can be used for treatment, and there is no consensus on the optimal approach to be used. In this paper, a multidisciplinary group of clinical and interventional cardiologists and cardiac surgeons performed a systematic review and critical evaluation of the available evidence on the interventional treatment of AAOCA in adult patients. Using a structured Delphi process, the group agreed on expert recommendations that are intended to complement existing clinical practice guidelines.
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Affiliation(s)
- Mario Gaudino
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, New York, USA.
| | - Antonino Di Franco
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Eloisa Arbustini
- Transplant Research Area and Centre for Inherited Cardiovascular Diseases, Scientific Department, IRCCS and Polyclinic San Matteo Foundation, Pavia, Italy
| | - Emile Bacha
- Division of Cardiac, Thoracic, and Vascular Surgery, Columbia University Medical Center/New York-Presbyterian Hospital, New York, New York, USA
| | - Eric R Bates
- Cardiovascular Center, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Duke E Cameron
- Division of Cardiac Surgery, Corrigan Minehan Heart Center, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Davide Cao
- The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA; Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Tirone E David
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Ruggero De Paulis
- Department of Cardiac Surgery, European Hospital, Rome, Italy; UniCamillus University, Rome, Italy
| | - Ismail El-Hamamsy
- Department of Cardiovascular Surgery, Mount Sinai Hospital and Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Kanwal M Farooqi
- Division of Pediatric Cardiology, New York-Presbyterian, Columbia University Irving Medical Center, New York, New York, USA
| | - Leonard N Girardi
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Christoph Gräni
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Jonathan D Kochav
- Division of Cardiology, Columbia University Irving Medical Center, New York, New York, USA
| | - Silvana Molossi
- Division of Pediatric Cardiology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA
| | - John D Puskas
- Department of Cardiovascular Surgery, Mount Sinai Hospital and Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Sunil V Rao
- Division of Interventional Cardiology, NYU Langone Health, New York, New York, USA
| | - Sigrid Sandner
- Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
| | - James Tatoulis
- Department of Cardiothoracic Surgery, Royal Melbourne Hospital, University of Melbourne, Melbourne, Victoria, Australia
| | - Quynh A Truong
- Department of Radiology, New York Presbyterian, Weill Cornell Medicine, New York, New York, USA
| | - Jonathan W Weinsaft
- Greenberg Cardiology Division, Department of Medicine, Weill Cornell Medical College, New York, New York, USA
| | - Daniel Zimpfer
- Division of Cardiac Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - Carlos M Mery
- Texas Center for Pediatric and Congenital Heart Disease, Dell Medical School at The University of Texas at Austin/Dell Children's Medical Center, Austin, Texas, USA
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6
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Virk HUH, Escobar J, Rodriguez M, Bates ER, Khalid U, Jneid H, Birnbaum Y, Levine GN, Smith SC, Krittanawong C. Dual Antiplatelet Therapy: A Concise Review for Clinicians. Life (Basel) 2023; 13:1580. [PMID: 37511955 PMCID: PMC10381391 DOI: 10.3390/life13071580] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/05/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
Dual antiplatelet therapy (DAPT) combines two antiplatelet agents to decrease the risk of thrombotic complications associated with atherosclerotic cardiovascular diseases. Emerging data about the duration of DAPT is being published continuously. New approaches are trying to balance the time, benefits, and risks for patients taking DAPT for established cardiovascular diseases. Short-term dual DAPT of 3-6 months, or even 1 month in high-bleeding risk patients, is equivalent in terms of efficacy and effectiveness compared to long-term DAPT for patients who experienced percutaneous coronary intervention in an acute coronary syndrome setting. Prolonged DAPT beyond 12 months reduces stent thrombosis, major adverse cardiovascular events, and myocardial infarction rates but increases bleeding risk. Extended DAPT does not significantly benefit stable coronary artery disease patients in reducing stroke, myocardial infarction, or cardiovascular death. Ticagrelor and aspirin reduce cardiovascular events in stable coronary artery disease with diabetes but carry a higher bleeding risk. Antiplatelet therapy duration in atrial fibrillation patients after percutaneous coronary intervention depends on individual characteristics and bleeding risk. Antiplatelet therapy is crucial for post-coronary artery bypass graft and transcatheter aortic valve implantation; Aspirin (ASA) monotherapy is preferred. Antiplatelet therapy duration in peripheral artery disease depends on the scenario. Adding vorapaxar and cilostazol may benefit secondary prevention and claudication, respectively. Carotid artery disease patients with transient ischemic attack or stroke benefit from antiplatelet therapy and combining ASA and clopidogrel is more effective than ASA alone. The optimal duration of DAPT after carotid artery stenting is uncertain. Resistance to ASA and clopidogrel poses an incremental risk of deleterious cardiovascular events and stroke. The selection and duration of antiplatelet therapy in patients with cardiovascular disease requires careful consideration of both efficacy and safety outcomes. The use of combination therapies may provide added benefits but should be weighed against the risk of bleeding. Further research and clinical trials are needed to optimize antiplatelet treatment in different patient populations and clinical scenarios.
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Affiliation(s)
- Hafeez Ul Hassan Virk
- Harrington Heart & Vascular Institute, Case Western Reserve University, University Hospitals Cleveland Medical Center, Cleveland, OH 44101, USA
| | - Johao Escobar
- International Transitional Medical Graduate, American College of Physician, Philadelphia, PA 19106, USA
| | - Mario Rodriguez
- John T Milliken Department of Medicine, Division of Cardiovascular Disease, Section of Advanced Heart Failure and Transplant, Barnes-Jewish Hospital, Washington University, St. Louis School of Medicine, St. Louis, MO 63110, USA
| | - Eric R Bates
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA
| | - Umair Khalid
- Michael E. DeBakey VA Medical Center, Section of Cardiology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Hani Jneid
- Division of Cardiology, University of Texas Medical Branch, Houston, TX 77555, USA
| | - Yochai Birnbaum
- Michael E. DeBakey VA Medical Center, Section of Cardiology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Glenn N Levine
- Michael E. DeBakey VA Medical Center, Section of Cardiology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Sidney C Smith
- Division of Cardiology, McAllister Heart Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Chayakrit Krittanawong
- Cardiology Division, NYU School of Medicine, NYU Langone Health, New York, NY 10016, USA
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7
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Bates ER. P2Y12 inhibitor monotherapy 1 to 3 mo after PCI did not differ from standard DAPT for fatal or ischemic events. Ann Intern Med 2023; 176:JC66. [PMID: 37276597 DOI: 10.7326/j23-0032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/07/2023] Open
Abstract
SOURCE CITATION Gragnano F, Mehran R, Branca M; Single Versus Dual Antiplatelet Therapy (Sidney-2) Collaboration. P2Y12 inhibitor monotherapy or dual antiplatelet therapy after complex percutaneous coronary interventions. J Am Coll Cardiol. 2023;81:537-552. 36754514.
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Affiliation(s)
- Eric R Bates
- University of Michigan, Ann Arbor, Michigan, USA (E.R.B.)
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8
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Bates ER. What Is a Periprocedural Major Adverse Event After PCI and CABG? JACC Cardiovasc Interv 2023; 16:314-316. [PMID: 36792255 DOI: 10.1016/j.jcin.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 11/07/2022] [Indexed: 02/16/2023]
Affiliation(s)
- Eric R Bates
- Cardiovascular Center, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA.
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9
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Grapsa J, Walsh MN, Enriquez-Sarano ML, Sorgente A, Vidovich MI, Fischman DL, Fontes-Carvalho R, Vidal-Pérez R, Taramasso M, Moe TG, Santangeli P, Johar S, Restrepo AJ, Mahadevan V, Bates ER. 2022 Year in Review: Countdown of the Best Manuscripts in 2022. JACC Case Rep 2023; 7:101727. [PMID: 36776795 PMCID: PMC9911924 DOI: 10.1016/j.jaccas.2022.101727] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Julia Grapsa
- Guys and St Thomas NHS Trust, London, United Kingdom,Address for correspondence: Dr Julia Grapsa, Cardiology Department, Guys and St Thomas NHS Hospitals Trust, Westminster Bridge Road, London SE1 7EH, United Kingdom. @JGrapsa
| | | | | | | | | | | | | | | | | | | | | | | | | | - Vaikom Mahadevan
- University of California-San Francisco San Francisco, California, USA
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10
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Fischman DL, Mahadevan VS, Bates ER. The "Evolving" Role of Intravascular Imaging in Myocardial Infarction With Nonobstructive Coronary Arteries. JACC Case Rep 2023; 6:101701. [PMID: 36704053 PMCID: PMC9871201 DOI: 10.1016/j.jaccas.2022.101701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Affiliation(s)
- David L. Fischman
- Department of Internal Medicine, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Vaikom S. Mahadevan
- Division of Cardiology, Department of Internal Medicine, University of California, San Francisco, California, USA
| | - Eric R. Bates
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
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11
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Armstrong PW, Bates ER, Gaudino M. Left main coronary disease: evolving management concepts. Eur Heart J 2022; 43:4635-4643. [PMID: 36173870 DOI: 10.1093/eurheartj/ehac542] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 07/25/2022] [Accepted: 09/16/2022] [Indexed: 01/05/2023] Open
Abstract
Remarkable advances in the management of coronary artery disease have enhanced our approach to left main coronary artery (LMCA) disease. The traditional role of coronary artery bypass graft surgery has been challenged by the less invasive percutaneous coronary interventional approach. Additionally, major strides in optimal medical therapy now provide a rich menu of treatment choices in selected circumstances. Although a LMCA stenosis >70% is an acceptable threshold for revascularization, those patients with a LMCA narrowing between 40 and 69% present a more complex scenario. This review examines the relative merits of the different treatment options, addresses key diagnostic and therapeutic unknowns, and identifies future work likely to advance progress.
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Affiliation(s)
- Paul W Armstrong
- Canadian VIGOUR Centre, University of Alberta, 4-120 Katz Group Centre for Pharmacy and Health Research, Edmonton, AB T6G 2E1, Canada.,Division of Cardiology, Department of Medicine, University of Alberta, 2C2 Cardiology Walter MacKenzie Center, University of Alberta Hospital, 8440-111 St., Edmonton, AB T6G 2B7, Canada
| | - Eric R Bates
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, 1500 E. Medical Center Drive 2139 Cardiovascular Center, Ann Arbor, MI 48109, USA
| | - Mario Gaudino
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, 525 East 68th St, Box 110, New York, NY 10065, USA
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12
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Bates ER. Is CABG Indicated in Patients With Ischemic Cardiomyopathy? JAMA Cardiol 2022; 7:1176-1177. [PMID: 36223111 DOI: 10.1001/jamacardio.2022.3315] [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: 12/15/2022]
Affiliation(s)
- Eric R Bates
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor
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13
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Bates ER. In HFpEF, adding empagliflozin to usual care reduced a composite of CV death or HF hospitalization at a median 26 mo. Ann Intern Med 2022; 175:JC4. [PMID: 34978853 DOI: 10.7326/j21-0006] [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: 11/22/2022] Open
Abstract
Anker SD, Butler J, Filippatos G, et al. Empagliflozin in heart failure with a preserved ejection fraction. N Engl J Med. 2021;385:1451-61. 34449189.
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Affiliation(s)
- Eric R Bates
- University of Michigan, Ann Arbor, Michigan, USA (E.R.B.)
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14
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Jivan A, Bates ER. The Role of Intravascular Imaging in Coronary Thrombosis Assessment and Management. JACC Case Rep 2021; 3:1911-1912. [PMID: 34984351 PMCID: PMC8693258 DOI: 10.1016/j.jaccas.2021.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Arif Jivan
- Bluhm Cardiovascular Institute, Northwestern Medicine, Northwestern Lake Forest Hospital, Lake Forest, Illinois, USA
| | - Eric R. Bates
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
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Lawton JS, Tamis-Holland JE, Bangalore S, Bates ER, Beckie TM, Bischoff JM, Bittl JA, Cohen MG, DiMaio JM, Don CW, Fremes SE, Gaudino MF, Goldberger ZD, Grant MC, Jaswal JB, Kurlansky PA, Mehran R, Metkus TS, Nnacheta LC, Rao SV, Sellke FW, Sharma G, Yong CM, Zwischenberger BA. 2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation 2021; 145:e18-e114. [PMID: 34882435 DOI: 10.1161/cir.0000000000001038] [Citation(s) in RCA: 124] [Impact Index Per Article: 41.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
AIM The guideline for coronary artery revascularization replaces the 2011 coronary artery bypass graft surgery and the 2011 and 2015 percutaneous coronary intervention guidelines, providing a patient-centric approach to guide clinicians in the treatment of patients with significant coronary artery disease undergoing coronary revascularization as well as the supporting documentation to encourage their use. METHODS A comprehensive literature search was conducted from May 2019 to September 2019, encompassing studies, reviews, and other evidence conducted on human subjects that were published in English from PubMed, EMBASE, the Cochrane Collaboration, CINHL Complete, and other relevant databases. Additional relevant studies, published through May 2021, were also considered. Structure: Coronary artery disease remains a leading cause of morbidity and mortality globally. Coronary revascularization is an important therapeutic option when managing patients with coronary artery disease. The 2021 coronary artery revascularization guideline provides recommendations based on contemporary evidence for the treatment of these patients. The recommendations present an evidence-based approach to managing patients with coronary artery disease who are being considered for coronary revascularization, with the intent to improve quality of care and align with patients' interests.
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Lawton JS, Tamis-Holland JE, Bangalore S, Bates ER, Beckie TM, Bischoff JM, Bittl JA, Cohen MG, DiMaio JM, Don CW, Fremes SE, Gaudino MF, Goldberger ZD, Grant MC, Jaswal JB, Kurlansky PA, Mehran R, Metkus TS, Nnacheta LC, Rao SV, Sellke FW, Sharma G, Yong CM, Zwischenberger BA. 2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation 2021; 145:e4-e17. [PMID: 34882436 DOI: 10.1161/cir.0000000000001039] [Citation(s) in RCA: 112] [Impact Index Per Article: 37.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
AIM The executive summary of the American College of Cardiology/American Heart Association/Society for Cardiovascular Angiography and Interventions coronary artery revascularization guideline provides the top 10 items readers should know about the guideline. In the full guideline, the recommendations replace the 2011 coronary artery bypass graft surgery guideline and the 2011 and 2015 percutaneous coronary intervention guidelines. This summary offers a patient-centric approach to guide clinicians in the treatment of patients with significant coronary artery disease undergoing coronary revascularization, as well as the supporting documentation to encourage their use. METHODS A comprehensive literature search was conducted from May 2019 to September 2019, encompassing studies, reviews, and other evidence conducted on human subjects that were published in English from PubMed, EMBASE, the Cochrane Collaboration, CINHL Complete, and other relevant databases. Additional relevant studies, published through May 2021, were also considered. Structure: Recommendations from the earlier percutaneous coronary intervention and coronary artery bypass graft surgery guidelines have been updated with new evidence to guide clinicians in caring for patients undergoing coronary revascularization. This summary includes recommendations, tables, and figures from the full guideline that relate to the top 10 take-home messages. The reader is referred to the full guideline for graphical flow charts, supportive text, and tables with additional details about the rationale for and implementation of each recommendation, and the evidence tables detailing the data considered in the development of this guideline.
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Lawton JS, Tamis-Holland JE, Bangalore S, Bates ER, Beckie TM, Bischoff JM, Bittl JA, Cohen MG, DiMaio JM, Don CW, Fremes SE, Gaudino MF, Goldberger ZD, Grant MC, Jaswal JB, Kurlansky PA, Mehran R, Metkus TS, Nnacheta LC, Rao SV, Sellke FW, Sharma G, Yong CM, Zwischenberger BA. 2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol 2021; 79:e21-e129. [PMID: 34895950 DOI: 10.1016/j.jacc.2021.09.006] [Citation(s) in RCA: 455] [Impact Index Per Article: 151.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
AIM The guideline for coronary artery revascularization replaces the 2011 coronary artery bypass graft surgery and the 2011 and 2015 percutaneous coronary intervention guidelines, providing a patient-centric approach to guide clinicians in the treatment of patients with significant coronary artery disease undergoing coronary revascularization as well as the supporting documentation to encourage their use. METHODS A comprehensive literature search was conducted from May 2019 to September 2019, encompassing studies, reviews, and other evidence conducted on human subjects that were published in English from PubMed, EMBASE, the Cochrane Collaboration, CINHL Complete, and other relevant databases. Additional relevant studies, published through May 2021, were also considered. STRUCTURE Coronary artery disease remains a leading cause of morbidity and mortality globally. Coronary revascularization is an important therapeutic option when managing patients with coronary artery disease. The 2021 coronary artery revascularization guideline provides recommendations based on contemporary evidence for the treatment of these patients. The recommendations present an evidence-based approach to managing patients with coronary artery disease who are being considered for coronary revascularization, with the intent to improve quality of care and align with patients' interests.
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Abstract
Xia M, Yang X, Qian C. Meta-analysis evaluating the utility of colchicine in secondary prevention of coronary artery disease. Am J Cardiol. 2021;140:33-8. 33137319.
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Affiliation(s)
- Eric R Bates
- University of Michigan, Ann Arbor, Michigan, USA (E.R.B.)
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Brindis RG, Bates ER, Henry TD. Value of Registries in ST-Segment-Elevation Myocardial Infarction Care in Both the Pre-Coronavirus Disease 2019 and the Coronavirus Disease 2019 Eras. J Am Heart Assoc 2020; 10:e019958. [PMID: 33345555 PMCID: PMC7955494 DOI: 10.1161/jaha.120.019958] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Ralph G Brindis
- Department of Medicine and the Philip R. Lee Institute for Health Policy Studies University of California, San Francisco CA
| | - Eric R Bates
- Division of Cardiovascular Medicine Department of Internal Medicine University of Michigan Ann Arbor MI
| | - Timothy D Henry
- The Carl and Edyth Lindner Center for Research and Education The Christ Hospital Cincinnati OH
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Affiliation(s)
- Eric R Bates
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor
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Boden WE, Hartigan PM, Mancini J, Teo KK, Chaitman BR, Maron DJ, Kostuk WJ, Hartigan JA, Dada M, Spertus JA, Bates ER, Weintraub WS. Risk Prediction Tool for Assessing the Probability of Death or Myocardial Infarction in Patients With Stable Coronary Artery Disease. Am J Cardiol 2020; 130:1-6. [PMID: 32654755 DOI: 10.1016/j.amjcard.2020.05.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 05/20/2020] [Accepted: 05/25/2020] [Indexed: 11/19/2022]
Abstract
Several risk scores in acute coronary syndromes are available, but few models exist for stable coronary artery disease to guide decision-making and prognosis. A multivariate model was developed using 23 baseline candidate variables from the Clinical Outcomes Utilizing Revascularization and Aggressive Drug Therapy EvaluationTrial (n = 2,287 patients). Discrimination of the model was evaluated by the concordance c-index. The procedure was validated using 100 random half samples. We identified 9 independent predictors of death or myocardial infarction (MI) during a 5-year follow-up. The following predictors and points contributing to the risk score were: heart failure (3), number of diseased coronary arteries (1 for each vessel), diabetes (1), age (1 for each 15 years ≥ age 45), previous revascularization (1), current smoking (1), female (1), previous MI (1), and high-density lipoprotein cholesterol (1: 31 to 40 mg/dL; 2: <30 mg/dL). The risk tool had a potential range from 0 to 15, corresponding to 5-year event rates of 5.8% to 56%. C-indices ranged from 0.67 for the full data set to 0.62 for the validating subsamples. Respective observed versus predicted 5-year event rates for 3 predefined risk strata revealed: 30% had a low-risk score of 0 to 3 (9.3% vs 9.3%, or 1.9%/year); 59% had an intermediate-risk score of 4-6 (18.0% vs 18.1%, or 3.6%/year); and 11% had a high-risk score of 7-11 (36% vs 36.5%, or 7.2%/year). This stable coronary artery disease risk score permitted a prognostic assessment of 5-year probability of death or MI with an approximate 4-fold range in event rates from the lowest (9.3%) to the highest (36%) terciles, thus enabling better clinical practice decisions that allow physicians to tailor the intensity of treatment to the level of risk.
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Affiliation(s)
- William E Boden
- Clinical Trials Network, VA New England Healthcare System, Boston University School of Medicine, Boston, Massachusetts.
| | | | - John Mancini
- University of British Columbia, Vancouver, BC, Canada
| | - Koon K Teo
- McMaster University Medical Center, Hamilton, ON, Canada
| | | | - David J Maron
- Department of Medicine, Stanford University School of Medicine, Stanford, California
| | | | - John A Hartigan
- Department of Statistics, Yale University, New Haven, Connecticut
| | - Marcin Dada
- Baystate Medical Center, Springfield, Massachusetts
| | | | - Eric R Bates
- University of Michigan Medical Center, Ann Arbor, Michigan
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Bates ER. In stable coronary disease with moderate or severe ischemia, initial invasive therapy plus medical therapy did not improve CV outcomes at 3 years. Ann Intern Med 2020; 173:JC14. [PMID: 32805178 DOI: 10.7326/acpj202008180-014] [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: 11/22/2022] Open
Abstract
Maron DJ, Hochman JS, Reynolds HR, et al. Initial invasive or conservative strategy for stable coronary disease. N Engl J Med. 2020;382:1395-1407. 32227755.
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Affiliation(s)
- Eric R Bates
- University of Michigan, Ann Arbor, MI, USA (E.R.B.)
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Bates ER. Invasive therapy improved angina health status in patients with high-risk stable coronary disease and more frequent angina. Ann Intern Med 2020; 173:JC15. [PMID: 32805176 DOI: 10.7326/acpj202008180-015] [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: 11/22/2022] Open
Abstract
Spertus JA, Jones PG, Maron DJ, et al. Health-status outcomes with invasive or conservative care in coronary disease. N Engl J Med. 2020;382:1408-19. 32227753.
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Affiliation(s)
- Eric R Bates
- University of Michigan, Ann Arbor, MI, USA (E.R.B.)
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Affiliation(s)
- Mary Norine Walsh
- Division of Cardiology, St. Vincent Heart Center, Indianapolis, Indiana
| | - Antonio Sorgente
- Cardiovascular Division, EpiCURA Hospital, Division of Cardiology, Hornu, Belgium
| | - David L Fischman
- Division of Cardiology, Department of Internal Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Eric R Bates
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
| | - Julia Grapsa
- Division of Cardiovascular Medicine, Guy's and St. Thomas' NHS Hospitals Trust, London, United Kingdom
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Bates ER. Did "Pistol" Pete Maravich Die From Congenital Coronary Artery Disease or Acquired Myocardial Disease? JACC Case Rep 2020; 2:723-724. [PMID: 34317335 PMCID: PMC8302060 DOI: 10.1016/j.jaccas.2020.03.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Eric R. Bates
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
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Affiliation(s)
- Mladen I Vidovich
- Division of Cardiology, Department of Internal Medicine, University of Illinois at Chicago, Chicago, Illinois.,Division of Cardiology, Jesse Brown VA Medical Center, Chicago, Illinois
| | - David L Fischman
- Division of Cardiology, Department of Internal Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Eric R Bates
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
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Bainey KR, Bates ER, Armstrong PW. ST-Segment-Elevation Myocardial Infarction Care and COVID-19: The Value Proposition of Fibrinolytic Therapy and the Pharmacoinvasive Strategy. Circ Cardiovasc Qual Outcomes 2020; 13:e006834. [PMID: 32339038 DOI: 10.1161/circoutcomes.120.006834] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Kevin R Bainey
- Canadian VIGOUR Center, Division of Cardiology, Department of Medicine, University of Alberta, Edmonton, Canada (K.R.B., P.W.A.)
| | - Eric R Bates
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor (E.R.B.)
| | - Paul W Armstrong
- Canadian VIGOUR Center, Division of Cardiology, Department of Medicine, University of Alberta, Edmonton, Canada (K.R.B., P.W.A.)
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Bates ER. Stent-Centric View of Stable Ischemic Heart Disease. Circ Cardiovasc Interv 2020; 13:e009129. [PMID: 32279568 DOI: 10.1161/circinterventions.120.009129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Eric R Bates
- From the Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor
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Bates ER. Reply: Intravascular Imaging: Too Much or Too Little of a Good Thing? JACC Case Rep 2020; 2:517. [PMID: 34317282 PMCID: PMC8311692 DOI: 10.1016/j.jaccas.2020.02.001] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Eric R. Bates
- University of Michigan Medical Center, Internal Medicine–Cardiology, CVC Cardiovascular Medicine, 1500 E. Medical Center Drive, SPC 5869, Ann Arbor, Michigan 48109-5869
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Granger CB, Bates ER, Jollis JG, Antman EM, Nichol G, O'Connor RE, Gregory T, Roettig ML, Peng SA, Ellrodt G, Henry TD, French WJ, Jacobs AK. Improving Care of STEMI in the United States 2008 to 2012. J Am Heart Assoc 2020; 8:e008096. [PMID: 30596310 PMCID: PMC6405711 DOI: 10.1161/jaha.118.008096] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background We aimed to determine the change in treatment strategies and times to treatment over the first 5 years of the Mission: Lifeline program. Methods and Results We assessed pre‐ and in‐hospital care and outcomes from 2008 to 2012 for patients with ST‐segment–elevation myocardial infarction at US hospitals, using data from the National Cardiovascular Data Registry Acute Coronary Treatment and Intervention Outcomes Network Registry—Get With The Guidelines Registry. In‐hospital adjusted mortality was calculated including and excluding cardiac arrest as a reason for primary percutaneous coronary intervention delay. A total of 147 466 patients from 485 hospitals were analyzed. There was a decrease in the proportion of eligible patients not treated with reperfusion (6.2% versus 3.3%) and treated with fibrinolytic therapy (13.4% versus 7.0%). Median time from symptom onset to first medical contact was unchanged (≈50 minutes). Use of prehospital ECGs increased (45% versus 71%). All major reperfusion times improved: median first medical contact‐to‐device for emergency medical systems transport to percutaneous coronary intervention–capable hospitals (93 to 84 minutes), first door‐to‐device for transfers for primary percutaneous coronary intervention (130 to 112 minutes), and door‐in–door‐out at non–percutaneous coronary intervention–capable hospitals (76 to 62 minutes) (all P<0.001 over 5 years). Rates of cardiogenic shock and cardiac arrest, and overall in‐hospital mortality increased (5.7% to 6.3%). Adjusted mortality excluding patients with known cardiac arrest decreased by 14% at 3 years and 25% at 5 years (P<0.001). Conclusions Quality of care for patients with ST‐segment–elevation myocardial infarction improved over time in Mission: Lifeline, including increased use of reperfusion therapy and faster times‐to‐treatment. In‐hospital mortality improved for patients without cardiac arrest but did not appear to improve overall as the number of these high‐risk patients increased.
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Affiliation(s)
| | - Eric R Bates
- 2 Department of Internal Medicine University of Michigan Ann Arbor MI
| | - James G Jollis
- 1 Division of Cardiology Duke Clinical Research Institute Durham NC
| | | | - Graham Nichol
- 4 University of Washington-Harborview Center for Prehospital Emergency Care University of Washington Seattle WA
| | - Robert E O'Connor
- 5 Department of Emergency Medicine University of Virginia School of Medicine Charlottesville VA
| | | | - Mayme L Roettig
- 1 Division of Cardiology Duke Clinical Research Institute Durham NC
| | | | - Gray Ellrodt
- 8 Department of Medicine Berkshire Medical Center Pittsfield MA
| | | | - William J French
- 10 Department of Medicine Harbor-University of California at Los Angeles Medical Center Torrance CA
| | - Alice K Jacobs
- 11 Department of Medicine Boston University School of Medicine Boston MA
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Affiliation(s)
- Eric R Bates
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
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Bates ER. Achieving Aspirational Goals in Providing Primary Percutaneous Coronary Intervention Care. JACC Cardiovasc Interv 2019; 12:2269-2271. [PMID: 31678082 DOI: 10.1016/j.jcin.2019.08.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 08/06/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Eric R Bates
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan.
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Bates ER. In suspected MI without ST elevation, a risk tool including hs-cTnI or hs-cTnT predicted diagnosis and 30-d outcomes. Ann Intern Med 2019; 171:JC46. [PMID: 31610559 DOI: 10.7326/acpj201910150-046] [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: 11/22/2022] Open
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Bates ER. In patients with suspected AMI and LBBB, algorithms based on ECG and troponin data were tested to rule MI in or out. Ann Intern Med 2019; 171:JC47. [PMID: 31610560 DOI: 10.7326/acpj201910150-047] [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: 11/22/2022] Open
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Affiliation(s)
- Eric R Bates
- From the Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor
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Andersson H, Laustsen LS, Laustsen A, Pedersen F, Bang LE, Bates ER, Nallamothu BK, Blankenberg S, Grande P, Clemmensen P, Holmvang L. P885Cardiovascular events in patients with suspected ST-elevation myocardial infarction and no obstructive coronary artery disease. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0482] [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: 11/14/2022] Open
Abstract
Abstract
Background
Patients with suspected ST-elevation myocardial infarction (STEMI) and no obstructive coronary artery disease (CAD) comprise a heterogeneous group with varying prognoses.
Purpose
To evaluate the prognostic value of cardiac troponin T (cTnT) in patients with suspected STEMI and no obstructive CAD.
Methods
Patients with suspected STEMI and no obstructive (<50% diameter stenosis) CAD were consecutively included from 2009–2014. Patients were classified as having normal cTnT, dynamic cTnT elevation, or stationary cTnT elevation. All patients were followed with respect to major adverse cardiovascular events (MACE), cardiovascular readmission, and repeat coronary procedures, until 1 year after discharge.
Results
The study included 502 patients with suspected STEMI and no obstructive CAD: 165 (33%) had normal cTnT, 293 (58%) had dynamic cTnT elevation and 44 (9%) had stationary cTnT elevation. Within one year after admission, 40 (8%) had MACE, 81 (16%) had cardiovascular readmission, and 8 (2%) underwent repeat coronary procedures. The risk of MACE was elevated in patients with stationary cTnT elevation compared with normal cTnT (OR 13.6, 95% CI 2.3–80.2, p=0.004). There was no statistically significant difference between those with dynamic cTnT elevation and normal cTnT (OR 2.9, 95% CI 0.6–14.0, p=0.189). Adding cTnT pattern to a conventional risk model, area under the receiver operating curve for predicting the 1-year risk of MACE improved significantly (80% vs. 85%, p=0.004, Figure 1).
Figure 1
Conclusion
In patients with suspected STEMI and no obstructive CAD, cTnT pattern during acute hospitalization is associated with the 1-year risk of MACE and improves risk prediction for the individual patient.
Acknowledgement/Funding
The Danish Heart Foundation, the A.P. Møller Foundation, the Foundation of Reinholdt W. Jorck and Wife, Rigshospitalet's Research Foundation
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Affiliation(s)
- H Andersson
- Rigshospitalet - Copenhagen University Hospital, The Heart Centre, Department of Cardiology, Copenhagen, Denmark
| | - L S Laustsen
- Rigshospitalet - Copenhagen University Hospital, The Heart Centre, Department of Cardiology, Copenhagen, Denmark
| | - A Laustsen
- Rigshospitalet - Copenhagen University Hospital, The Heart Centre, Department of Cardiology, Copenhagen, Denmark
| | - F Pedersen
- Rigshospitalet - Copenhagen University Hospital, The Heart Centre, Department of Cardiology, Copenhagen, Denmark
| | - L E Bang
- Rigshospitalet - Copenhagen University Hospital, The Heart Centre, Department of Cardiology, Copenhagen, Denmark
| | - E R Bates
- University of Michigan, Department of Internal Medicine, Division of Cardiovascular Medicine, Ann Arbor, United States of America
| | - B K Nallamothu
- University of Michigan, Department of Internal Medicine, Division of Cardiovascular Medicine, Ann Arbor, United States of America
| | - S Blankenberg
- University Heart Center, Hamburg-Eppendorf, Department of General and Interventional Cardiology, Hamburg, Germany
| | - P Grande
- Nykøbing F Hospital - University of Southern Denmark, Odense, Denmark, Department of Medicine, Nykøbing Falster, Denmark
| | - P Clemmensen
- University Heart Center, Hamburg-Eppendorf, Department of General and Interventional Cardiology, Hamburg, Germany
| | - L Holmvang
- Rigshospitalet - Copenhagen University Hospital, The Heart Centre, Department of Cardiology, Copenhagen, Denmark
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Green JL, Jacobs AK, Holmes D, Chiswell K, Blanco R, Bates ER, French W, Kupas DF, Mears G, Roe M, Nallamothu BK. Taking the Reins on Systems of Care for ST-Segment-Elevation Myocardial Infarction Patients: A Report From the American Heart Association Mission: Lifeline Program. Circ Cardiovasc Interv 2019; 11:e005706. [PMID: 29716933 DOI: 10.1161/circinterventions.117.005706] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 03/12/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND Early success with regionalization of ST-segment-elevation myocardial infarction (STEMI) care has led many states to adopt statewide prehospital STEMI hospital destination policies, allowing emergency medical services to bypass non-percutaneous coronary intervention-capable hospitals. The association between adoption of these policies and patterns of care among STEMI patients is unknown. METHODS AND RESULTS Using data from January 1, 2013, to December 31, 2014, from the National Cardiovascular Data Registry and Acute Coronary Treatment and Intervention Outcomes Network Registry, 6 states with bypass policies (cases included Delaware, Iowa, Maryland, North Carolina, Pennsylvania, and Massachusetts) were matched to 6 states without bypass policies (controls included South Carolina, Minnesota, Virginia, Texas, New York, and Connecticut) a priori on region, hospital density, and percent state participation in the registry. Using the matched sample, logistic regression models were adjusted for patient- and state-level characteristics. Outcomes were receipt of reperfusion and receipt of timely percutaneous coronary intervention. Our study cohort included 19 287 patients at 379 sites across 12 states. Patients from states with hospital destination policies were similar in age, sex, and comorbidities to patients from states without such policies. After adjustment for patient- and state-level characteristics, 57.9% (95% confidence intervals, 53.2%-62.5%) of patients living in states with hospital destination policies when compared with 47.5% (95% confidence intervals, 43.4%-51.7%) living in states without hospital destination policies received primary percutaneous coronary intervention within their relevant guideline-recommended time from first medical contact. CONCLUSIONS Statewide adoption of STEMI hospital destination policies allowing emergency medical services to bypass non-percutaneous coronary intervention-capable facilities is associated with significantly faster treatment times for patients with STEMI.
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Affiliation(s)
- Jacqueline L Green
- From the Department of Internal Medicine, University of Michigan, Ann Arbor (J.L.G., E.R.B., B.K.N.)
| | - Alice K Jacobs
- Department of Internal Medicine, Boston University School of Medicine, Boston University, MA (A.K.J.)
| | - DaJuanicia Holmes
- Department of Internal Medicine, Duke University, Durham, NC (D.H., K.C., R.B., M.R.)
| | - Karen Chiswell
- Department of Internal Medicine, Duke University, Durham, NC (D.H., K.C., R.B., M.R.)
| | - Rosalia Blanco
- Department of Internal Medicine, Duke University, Durham, NC (D.H., K.C., R.B., M.R.)
| | - Eric R Bates
- From the Department of Internal Medicine, University of Michigan, Ann Arbor (J.L.G., E.R.B., B.K.N.)
| | - William French
- Department of Internal Medicine, UCLA Medical Center, Los Angeles, CA (W.F.)
| | - Douglas F Kupas
- Department of Emergency Medicine, Geisinger Medical Center, Mechanicsville, PA (D.F.K.)
| | | | - Matthew Roe
- Department of Internal Medicine, Duke University, Durham, NC (D.H., K.C., R.B., M.R.)
| | - Brahmajee K Nallamothu
- From the Department of Internal Medicine, University of Michigan, Ann Arbor (J.L.G., E.R.B., B.K.N.)
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Bates ER. After an acute coronary syndrome, alirocumab reduced total nonfatal CV events and deaths vs placebo. Ann Intern Med 2019; 170:JC62. [PMID: 31207615 DOI: 10.7326/acpj201906180-062] [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: 11/22/2022] Open
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Affiliation(s)
- Nadia R. Sutton
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor
| | - Eric R. Bates
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor
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Bates ER. Review: In coronary artery disease, PCI reduces 30-day and 5-year risk for stroke compared with CABG. Ann Intern Med 2018; 169:JC55. [PMID: 30452562 DOI: 10.7326/acpjc-2018-169-10-055] [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: 11/22/2022] Open
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Bates ER. In myocardial injury after noncardiac surgery, dabigatran reduced vascular events without increasing major bleeding. Ann Intern Med 2018; 169:JC41. [PMID: 30326085 DOI: 10.7326/acpjc-2018-169-8-041] [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: 11/22/2022] Open
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Affiliation(s)
- John A Bittl
- Interventional Cardiology Section, Munroe Regional Medical Center, Ocala, Florida
| | - Eric R Bates
- Department of Medicine, University of Michigan Medical Center, Ann Arbor
| | - Sanjay Kaul
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California
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Affiliation(s)
- Eric R Bates
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan.
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Bates ER. Guided early deescalation of antiplatelet treatment was noninferior to usual prasugrel care in PCI-treated ACS. Ann Intern Med 2017; 167:JC69. [PMID: 29255859 DOI: 10.7326/acpjc-2017-167-12-069] [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: 11/22/2022] Open
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Bates ER, Bhatt DL, Cao C, Holmes D, Kupfer S, Martinez F, Spaeder J, Weitz JI, Ye Z, Zannad F, Goldstein S. Phase 2 study of TAK-442, an oral factor Xa inhibitor, in patients following acute coronary syndrome. Thromb Haemost 2017; 111:1141-52. [DOI: 10.1160/th13-07-0543] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Accepted: 12/19/2013] [Indexed: 12/26/2022]
Abstract
SummaryTAK-442 is an oral direct factor Xa inhibitor. We sought to determine the dose-dependent effect of TAK-442 on major bleeding when added to standard treatment in stabilised patients with acute coronary syndrome (ACS). In this phase II double-blind study, 2,753 ACS patients were randomised to TAK-442 or placebo in addition to usual care using a three-stage adaptive design. Patients were randomised to placebo in all stages, but doses of TAK-442 escalated from 10 mg BID, 20 mg twice-daily (BID), or 40 mg once-daily (QD) in stage 1; to 40 mg BID, 80 mg QD, or 80 mg BID in stage 2; and to 160 mg QD or 120 mg BID in stage 3. Study drug was started 36 hours after emergent treatment of ACS and within seven days of admission, and continued for 24 weeks. The primary endpoint was incidence of TIMI (thrombolysis in myocardial infarction) major bleeding. TIMI major bleeding incidence was low, but higher with the pooled TAK-442 doses than with placebo (17 [0.9%] vs 4 [0.5%]; p=0.47), although the difference was neither significant nor dose-dependent. However, a dose response was evident when using the modified ISTH scale. The incidence of cardiovascular events was similar among TAK-442 dose groups and placebo. When administered over a wide range of doses after an ACS event, TAK-442 treatment did not result in a dose-dependent increase in TIMI major bleeding, but increased bleeding was observed when a more sensitive bleeding scale was used. There was no evidence for efficacy.
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Bates ER. MY APPROACH to the patient with left main disease. Trends Cardiovasc Med 2017; 28:78. [PMID: 29032934 DOI: 10.1016/j.tcm.2017.09.007] [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] [Received: 09/26/2017] [Accepted: 09/26/2017] [Indexed: 10/18/2022]
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Bates ER. Intravenous beta-blockers in patients with ST-elevation myocardial infarction treated with primary PCI. EUROINTERVENTION 2017; 13:e149-e151. [PMID: 28579557 DOI: 10.4244/eijv13i2a21] [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: 11/23/2022]
Affiliation(s)
- Eric R Bates
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor, MI, USA
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Bates ER. Review: In AF, direct oral anticoagulants reduce all-cause and vascular mortality compared with warfarin. Ann Intern Med 2017; 166:JC28. [PMID: 28320002 DOI: 10.7326/acpjc-2017-166-6-028] [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: 11/22/2022] Open
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