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Delnoij TSR, Suverein MM, Essers BAB, Hermanides RC, Otterspoor L, Elzo Kraemer CV, Vlaar APJ, van der Heijden JJ, Scholten E, den Uil C, Akin S, de Metz J, van der Horst ICC, Maessen JG, Lorusso R, van de Poll MCG. Cost-effectiveness of ECPR versus CCPR in OHCA; A pre-planned, trial-based economic evaluation. Eur Heart J Acute Cardiovasc Care 2024:zuae050. [PMID: 38652269 DOI: 10.1093/ehjacc/zuae050] [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] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 03/27/2024] [Accepted: 04/19/2024] [Indexed: 04/25/2024]
Abstract
INTRODUCTION When out-of-hospital cardiac arrest (OHCA) becomes refractory, extracorporeal cardiopulmonary resuscitation (ECPR) is a potential option to restore circulation and improve the patient's outcome. However, ECPR requires specific materials and highly skilled personnel, and it is unclear whether increased survival and health-related quality of life (HRQOL) justify these costs. METHODS This cost-effectiveness study was part of the INCEPTION study, a multicenter, pragmatic randomized trial comparing hospital-based ECPR to conventional CPR (CCPR) in patients with refractory OHCA in 10 cardiosurgical centers in the Netherlands. We analyzed healthcare costs in the first year and measured HRQOL using the EQ-5D-5L at 1, 3, 6, and 12 months. Incremental cost-effectiveness ratio's (ICER), cost-effectiveness planes, and acceptability curves were calculated. Sensitivity analyses were performed for per-protocol and as-treated subgroups as well as imputed productivity loss in deceased patients. RESULTS In total 132 patients were enrolled: 62 in the CCPR and 70 in the ECPR group. The difference in mean costs after one year was €5,109 (95%CI -7,264-15,764). Mean QALY after one year was 0.15 in the ECPR group and 0.11 in the CCPR group, resulting in an ICER of €121,643 per additional QALY gained. The acceptability curve shows that at a willingness-to-pay threshold of €80.000, the probability of ECPR being cost-effective compared to CCPR is 36%. Sensitivity analysis showed increasing ICER in the per-protocol and as-treated groups and lower probabilities of acceptance. CONCLUSION Hospital-based ECPR in refractory OHCA has a low probability of being cost-effective in a trial-based economic evaluation.
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Affiliation(s)
- Thijs S R Delnoij
- Department of Intensive Care Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
- Department of Cardiology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Martje M Suverein
- Department of Intensive Care Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Brigitte A B Essers
- Department of Clinical Epidemiology and Medical Technical Assessment, Maastricht University Medical Center, Maastricht, the Netherlands
| | | | - Luuk Otterspoor
- Department of Intensive Care Medicine, Catharina Hospital, Eindhoven, the Netherlands
| | - Carlos V Elzo Kraemer
- Department of Intensive Care Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Alexander P J Vlaar
- Department of Intensive Care Medicine, Amsterdam University Medical Center location AMC, Amsterdam, the Netherlands
- Department of Intensive Care Medicine, Maasstad Hospital, Rotterdam, the Netherlands
| | - Joris J van der Heijden
- Department of Intensive Care Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Erik Scholten
- Department of Intensive Care Medicine, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - Corstiaan den Uil
- Department of Intensive Care Medicine and Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Sakir Akin
- Department of Intensive Care Medicine, HagaZiekenhuis, The Hague, The Netherlands
| | - Jesse de Metz
- Department of Intensive Care Medicine, OLVG, Amsterdam, The Netherlands
| | - Iwan C C van der Horst
- Department of Intensive Care Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
- Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Jos G Maessen
- Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands
- Department of Cardiothoracic Surgery, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Roberto Lorusso
- Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands
- Department of Cardiothoracic Surgery, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Marcel C G van de Poll
- Department of Intensive Care Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
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Suverein MM, Delnoij TSR, Lorusso R, Brandon Bravo Bruinsma GJ, Otterspoor L, Elzo Kraemer CV, Vlaar APJ, van der Heijden JJ, Scholten E, den Uil C, Jansen T, van den Bogaard B, Kuijpers M, Lam KY, Montero Cabezas JM, Driessen AHG, Rittersma SZH, Heijnen BG, Dos Reis Miranda D, Bleeker G, de Metz J, Hermanides RS, Lopez Matta J, Eberl S, Donker DW, van Thiel RJ, Akin S, van Meer O, Henriques J, Bokhoven KC, Mandigers L, Bunge JJH, Bol ME, Winkens B, Essers B, Weerwind PW, Maessen JG, van de Poll MCG. Early Extracorporeal CPR for Refractory Out-of-Hospital Cardiac Arrest. N Engl J Med 2023; 388:299-309. [PMID: 36720132 DOI: 10.1056/nejmoa2204511] [Citation(s) in RCA: 122] [Impact Index Per Article: 122.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND Extracorporeal cardiopulmonary resuscitation (CPR) restores perfusion and oxygenation in a patient who does not have spontaneous circulation. The evidence with regard to the effect of extracorporeal CPR on survival with a favorable neurologic outcome in refractory out-of-hospital cardiac arrest is inconclusive. METHODS In this multicenter, randomized, controlled trial conducted in the Netherlands, we assigned patients with an out-of-hospital cardiac arrest to receive extracorporeal CPR or conventional CPR (standard advanced cardiac life support). Eligible patients were between 18 and 70 years of age, had received bystander CPR, had an initial ventricular arrhythmia, and did not have a return of spontaneous circulation within 15 minutes after CPR had been initiated. The primary outcome was survival with a favorable neurologic outcome, defined as a Cerebral Performance Category score of 1 or 2 (range, 1 to 5, with higher scores indicating more severe disability) at 30 days. Analyses were performed on an intention-to-treat basis. RESULTS Of the 160 patients who underwent randomization, 70 were assigned to receive extracorporeal CPR and 64 to receive conventional CPR; 26 patients who did not meet the inclusion criteria at hospital admission were excluded. At 30 days, 14 patients (20%) in the extracorporeal-CPR group were alive with a favorable neurologic outcome, as compared with 10 patients (16%) in the conventional-CPR group (odds ratio, 1.4; 95% confidence interval, 0.5 to 3.5; P = 0.52). The number of serious adverse events per patient was similar in the two groups. CONCLUSIONS In patients with refractory out-of-hospital cardiac arrest, extracorporeal CPR and conventional CPR had similar effects on survival with a favorable neurologic outcome. (Funded by the Netherlands Organization for Health Research and Development and Maquet Cardiopulmonary [Getinge]; INCEPTION ClinicalTrials.gov number, NCT03101787.).
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Affiliation(s)
- Martje M Suverein
- From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Public Health Research Institute (B.W.), the Cardiovascular Research Institute Maastricht (R.L., J.G.M.), and the School for Nutrition and Translational Research in Metabolism (M.C.G.P.), Maastricht University, Maastricht, the Departments of Cardiothoracic Surgery (G.J.B.B.B.), Intensive Care (M.K.), and Cardiology (R.S.H.), Isala Clinics, Zwolle, the Departments of Intensive Care (L.O.) and Cardiothoracic Surgery (K.Y.L.), Catharina Hospital, Eindhoven, the Departments of Intensive Care (C.V.E.K., J.L.M.), Cardiology (J.M.M.C.), and Emergency Medicine (O.M.), Leiden University Medical Center, Leiden, the Departments of Intensive Care (A.P.J.V.), Cardiothoracic Surgery (A.H.G.D.), Anesthesia (S.E.), and Cardiology (J.H.), Amsterdam University Medical Center, and the Department of Intensive Care, Onze Lieve Vrouwe Gasthuis (B.B., J.M.), Amsterdam, the Departments of Intensive Care (J.J.H., D.W.D.) and Cardiology (S.Z.H.R.), University Medical Center Utrecht, Utrecht, the Department of Intensive Care, St. Antonius Hospital, Nieuwegein (E.S., B.G.H.), the Department of Intensive Care, Erasmus Medical Center (C.U., D.D.R.M., R.J.T., K.C.B., L.M., J.J.H.B.), and the Department of Cardiology, Thorax Center, Erasmus University Medical Center (J.J.H.B.), Rotterdam, the Departments of Intensive Care (T.J., S.A.) and Cardiology (G.B.), Haga Hospital, the Hague, and Cardiovascular and Respiratory Physiology Group, TechMed Center, University of Twente, Enschede (D.W.D.) - all in the Netherlands
| | - Thijs S R Delnoij
- From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Public Health Research Institute (B.W.), the Cardiovascular Research Institute Maastricht (R.L., J.G.M.), and the School for Nutrition and Translational Research in Metabolism (M.C.G.P.), Maastricht University, Maastricht, the Departments of Cardiothoracic Surgery (G.J.B.B.B.), Intensive Care (M.K.), and Cardiology (R.S.H.), Isala Clinics, Zwolle, the Departments of Intensive Care (L.O.) and Cardiothoracic Surgery (K.Y.L.), Catharina Hospital, Eindhoven, the Departments of Intensive Care (C.V.E.K., J.L.M.), Cardiology (J.M.M.C.), and Emergency Medicine (O.M.), Leiden University Medical Center, Leiden, the Departments of Intensive Care (A.P.J.V.), Cardiothoracic Surgery (A.H.G.D.), Anesthesia (S.E.), and Cardiology (J.H.), Amsterdam University Medical Center, and the Department of Intensive Care, Onze Lieve Vrouwe Gasthuis (B.B., J.M.), Amsterdam, the Departments of Intensive Care (J.J.H., D.W.D.) and Cardiology (S.Z.H.R.), University Medical Center Utrecht, Utrecht, the Department of Intensive Care, St. Antonius Hospital, Nieuwegein (E.S., B.G.H.), the Department of Intensive Care, Erasmus Medical Center (C.U., D.D.R.M., R.J.T., K.C.B., L.M., J.J.H.B.), and the Department of Cardiology, Thorax Center, Erasmus University Medical Center (J.J.H.B.), Rotterdam, the Departments of Intensive Care (T.J., S.A.) and Cardiology (G.B.), Haga Hospital, the Hague, and Cardiovascular and Respiratory Physiology Group, TechMed Center, University of Twente, Enschede (D.W.D.) - all in the Netherlands
| | - Roberto Lorusso
- From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Public Health Research Institute (B.W.), the Cardiovascular Research Institute Maastricht (R.L., J.G.M.), and the School for Nutrition and Translational Research in Metabolism (M.C.G.P.), Maastricht University, Maastricht, the Departments of Cardiothoracic Surgery (G.J.B.B.B.), Intensive Care (M.K.), and Cardiology (R.S.H.), Isala Clinics, Zwolle, the Departments of Intensive Care (L.O.) and Cardiothoracic Surgery (K.Y.L.), Catharina Hospital, Eindhoven, the Departments of Intensive Care (C.V.E.K., J.L.M.), Cardiology (J.M.M.C.), and Emergency Medicine (O.M.), Leiden University Medical Center, Leiden, the Departments of Intensive Care (A.P.J.V.), Cardiothoracic Surgery (A.H.G.D.), Anesthesia (S.E.), and Cardiology (J.H.), Amsterdam University Medical Center, and the Department of Intensive Care, Onze Lieve Vrouwe Gasthuis (B.B., J.M.), Amsterdam, the Departments of Intensive Care (J.J.H., D.W.D.) and Cardiology (S.Z.H.R.), University Medical Center Utrecht, Utrecht, the Department of Intensive Care, St. Antonius Hospital, Nieuwegein (E.S., B.G.H.), the Department of Intensive Care, Erasmus Medical Center (C.U., D.D.R.M., R.J.T., K.C.B., L.M., J.J.H.B.), and the Department of Cardiology, Thorax Center, Erasmus University Medical Center (J.J.H.B.), Rotterdam, the Departments of Intensive Care (T.J., S.A.) and Cardiology (G.B.), Haga Hospital, the Hague, and Cardiovascular and Respiratory Physiology Group, TechMed Center, University of Twente, Enschede (D.W.D.) - all in the Netherlands
| | - George J Brandon Bravo Bruinsma
- From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Public Health Research Institute (B.W.), the Cardiovascular Research Institute Maastricht (R.L., J.G.M.), and the School for Nutrition and Translational Research in Metabolism (M.C.G.P.), Maastricht University, Maastricht, the Departments of Cardiothoracic Surgery (G.J.B.B.B.), Intensive Care (M.K.), and Cardiology (R.S.H.), Isala Clinics, Zwolle, the Departments of Intensive Care (L.O.) and Cardiothoracic Surgery (K.Y.L.), Catharina Hospital, Eindhoven, the Departments of Intensive Care (C.V.E.K., J.L.M.), Cardiology (J.M.M.C.), and Emergency Medicine (O.M.), Leiden University Medical Center, Leiden, the Departments of Intensive Care (A.P.J.V.), Cardiothoracic Surgery (A.H.G.D.), Anesthesia (S.E.), and Cardiology (J.H.), Amsterdam University Medical Center, and the Department of Intensive Care, Onze Lieve Vrouwe Gasthuis (B.B., J.M.), Amsterdam, the Departments of Intensive Care (J.J.H., D.W.D.) and Cardiology (S.Z.H.R.), University Medical Center Utrecht, Utrecht, the Department of Intensive Care, St. Antonius Hospital, Nieuwegein (E.S., B.G.H.), the Department of Intensive Care, Erasmus Medical Center (C.U., D.D.R.M., R.J.T., K.C.B., L.M., J.J.H.B.), and the Department of Cardiology, Thorax Center, Erasmus University Medical Center (J.J.H.B.), Rotterdam, the Departments of Intensive Care (T.J., S.A.) and Cardiology (G.B.), Haga Hospital, the Hague, and Cardiovascular and Respiratory Physiology Group, TechMed Center, University of Twente, Enschede (D.W.D.) - all in the Netherlands
| | - Luuk Otterspoor
- From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Public Health Research Institute (B.W.), the Cardiovascular Research Institute Maastricht (R.L., J.G.M.), and the School for Nutrition and Translational Research in Metabolism (M.C.G.P.), Maastricht University, Maastricht, the Departments of Cardiothoracic Surgery (G.J.B.B.B.), Intensive Care (M.K.), and Cardiology (R.S.H.), Isala Clinics, Zwolle, the Departments of Intensive Care (L.O.) and Cardiothoracic Surgery (K.Y.L.), Catharina Hospital, Eindhoven, the Departments of Intensive Care (C.V.E.K., J.L.M.), Cardiology (J.M.M.C.), and Emergency Medicine (O.M.), Leiden University Medical Center, Leiden, the Departments of Intensive Care (A.P.J.V.), Cardiothoracic Surgery (A.H.G.D.), Anesthesia (S.E.), and Cardiology (J.H.), Amsterdam University Medical Center, and the Department of Intensive Care, Onze Lieve Vrouwe Gasthuis (B.B., J.M.), Amsterdam, the Departments of Intensive Care (J.J.H., D.W.D.) and Cardiology (S.Z.H.R.), University Medical Center Utrecht, Utrecht, the Department of Intensive Care, St. Antonius Hospital, Nieuwegein (E.S., B.G.H.), the Department of Intensive Care, Erasmus Medical Center (C.U., D.D.R.M., R.J.T., K.C.B., L.M., J.J.H.B.), and the Department of Cardiology, Thorax Center, Erasmus University Medical Center (J.J.H.B.), Rotterdam, the Departments of Intensive Care (T.J., S.A.) and Cardiology (G.B.), Haga Hospital, the Hague, and Cardiovascular and Respiratory Physiology Group, TechMed Center, University of Twente, Enschede (D.W.D.) - all in the Netherlands
| | - Carlos V Elzo Kraemer
- From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Public Health Research Institute (B.W.), the Cardiovascular Research Institute Maastricht (R.L., J.G.M.), and the School for Nutrition and Translational Research in Metabolism (M.C.G.P.), Maastricht University, Maastricht, the Departments of Cardiothoracic Surgery (G.J.B.B.B.), Intensive Care (M.K.), and Cardiology (R.S.H.), Isala Clinics, Zwolle, the Departments of Intensive Care (L.O.) and Cardiothoracic Surgery (K.Y.L.), Catharina Hospital, Eindhoven, the Departments of Intensive Care (C.V.E.K., J.L.M.), Cardiology (J.M.M.C.), and Emergency Medicine (O.M.), Leiden University Medical Center, Leiden, the Departments of Intensive Care (A.P.J.V.), Cardiothoracic Surgery (A.H.G.D.), Anesthesia (S.E.), and Cardiology (J.H.), Amsterdam University Medical Center, and the Department of Intensive Care, Onze Lieve Vrouwe Gasthuis (B.B., J.M.), Amsterdam, the Departments of Intensive Care (J.J.H., D.W.D.) and Cardiology (S.Z.H.R.), University Medical Center Utrecht, Utrecht, the Department of Intensive Care, St. Antonius Hospital, Nieuwegein (E.S., B.G.H.), the Department of Intensive Care, Erasmus Medical Center (C.U., D.D.R.M., R.J.T., K.C.B., L.M., J.J.H.B.), and the Department of Cardiology, Thorax Center, Erasmus University Medical Center (J.J.H.B.), Rotterdam, the Departments of Intensive Care (T.J., S.A.) and Cardiology (G.B.), Haga Hospital, the Hague, and Cardiovascular and Respiratory Physiology Group, TechMed Center, University of Twente, Enschede (D.W.D.) - all in the Netherlands
| | - Alexander P J Vlaar
- From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Public Health Research Institute (B.W.), the Cardiovascular Research Institute Maastricht (R.L., J.G.M.), and the School for Nutrition and Translational Research in Metabolism (M.C.G.P.), Maastricht University, Maastricht, the Departments of Cardiothoracic Surgery (G.J.B.B.B.), Intensive Care (M.K.), and Cardiology (R.S.H.), Isala Clinics, Zwolle, the Departments of Intensive Care (L.O.) and Cardiothoracic Surgery (K.Y.L.), Catharina Hospital, Eindhoven, the Departments of Intensive Care (C.V.E.K., J.L.M.), Cardiology (J.M.M.C.), and Emergency Medicine (O.M.), Leiden University Medical Center, Leiden, the Departments of Intensive Care (A.P.J.V.), Cardiothoracic Surgery (A.H.G.D.), Anesthesia (S.E.), and Cardiology (J.H.), Amsterdam University Medical Center, and the Department of Intensive Care, Onze Lieve Vrouwe Gasthuis (B.B., J.M.), Amsterdam, the Departments of Intensive Care (J.J.H., D.W.D.) and Cardiology (S.Z.H.R.), University Medical Center Utrecht, Utrecht, the Department of Intensive Care, St. Antonius Hospital, Nieuwegein (E.S., B.G.H.), the Department of Intensive Care, Erasmus Medical Center (C.U., D.D.R.M., R.J.T., K.C.B., L.M., J.J.H.B.), and the Department of Cardiology, Thorax Center, Erasmus University Medical Center (J.J.H.B.), Rotterdam, the Departments of Intensive Care (T.J., S.A.) and Cardiology (G.B.), Haga Hospital, the Hague, and Cardiovascular and Respiratory Physiology Group, TechMed Center, University of Twente, Enschede (D.W.D.) - all in the Netherlands
| | - Joris J van der Heijden
- From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Public Health Research Institute (B.W.), the Cardiovascular Research Institute Maastricht (R.L., J.G.M.), and the School for Nutrition and Translational Research in Metabolism (M.C.G.P.), Maastricht University, Maastricht, the Departments of Cardiothoracic Surgery (G.J.B.B.B.), Intensive Care (M.K.), and Cardiology (R.S.H.), Isala Clinics, Zwolle, the Departments of Intensive Care (L.O.) and Cardiothoracic Surgery (K.Y.L.), Catharina Hospital, Eindhoven, the Departments of Intensive Care (C.V.E.K., J.L.M.), Cardiology (J.M.M.C.), and Emergency Medicine (O.M.), Leiden University Medical Center, Leiden, the Departments of Intensive Care (A.P.J.V.), Cardiothoracic Surgery (A.H.G.D.), Anesthesia (S.E.), and Cardiology (J.H.), Amsterdam University Medical Center, and the Department of Intensive Care, Onze Lieve Vrouwe Gasthuis (B.B., J.M.), Amsterdam, the Departments of Intensive Care (J.J.H., D.W.D.) and Cardiology (S.Z.H.R.), University Medical Center Utrecht, Utrecht, the Department of Intensive Care, St. Antonius Hospital, Nieuwegein (E.S., B.G.H.), the Department of Intensive Care, Erasmus Medical Center (C.U., D.D.R.M., R.J.T., K.C.B., L.M., J.J.H.B.), and the Department of Cardiology, Thorax Center, Erasmus University Medical Center (J.J.H.B.), Rotterdam, the Departments of Intensive Care (T.J., S.A.) and Cardiology (G.B.), Haga Hospital, the Hague, and Cardiovascular and Respiratory Physiology Group, TechMed Center, University of Twente, Enschede (D.W.D.) - all in the Netherlands
| | - Erik Scholten
- From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Public Health Research Institute (B.W.), the Cardiovascular Research Institute Maastricht (R.L., J.G.M.), and the School for Nutrition and Translational Research in Metabolism (M.C.G.P.), Maastricht University, Maastricht, the Departments of Cardiothoracic Surgery (G.J.B.B.B.), Intensive Care (M.K.), and Cardiology (R.S.H.), Isala Clinics, Zwolle, the Departments of Intensive Care (L.O.) and Cardiothoracic Surgery (K.Y.L.), Catharina Hospital, Eindhoven, the Departments of Intensive Care (C.V.E.K., J.L.M.), Cardiology (J.M.M.C.), and Emergency Medicine (O.M.), Leiden University Medical Center, Leiden, the Departments of Intensive Care (A.P.J.V.), Cardiothoracic Surgery (A.H.G.D.), Anesthesia (S.E.), and Cardiology (J.H.), Amsterdam University Medical Center, and the Department of Intensive Care, Onze Lieve Vrouwe Gasthuis (B.B., J.M.), Amsterdam, the Departments of Intensive Care (J.J.H., D.W.D.) and Cardiology (S.Z.H.R.), University Medical Center Utrecht, Utrecht, the Department of Intensive Care, St. Antonius Hospital, Nieuwegein (E.S., B.G.H.), the Department of Intensive Care, Erasmus Medical Center (C.U., D.D.R.M., R.J.T., K.C.B., L.M., J.J.H.B.), and the Department of Cardiology, Thorax Center, Erasmus University Medical Center (J.J.H.B.), Rotterdam, the Departments of Intensive Care (T.J., S.A.) and Cardiology (G.B.), Haga Hospital, the Hague, and Cardiovascular and Respiratory Physiology Group, TechMed Center, University of Twente, Enschede (D.W.D.) - all in the Netherlands
| | - Corstiaan den Uil
- From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Public Health Research Institute (B.W.), the Cardiovascular Research Institute Maastricht (R.L., J.G.M.), and the School for Nutrition and Translational Research in Metabolism (M.C.G.P.), Maastricht University, Maastricht, the Departments of Cardiothoracic Surgery (G.J.B.B.B.), Intensive Care (M.K.), and Cardiology (R.S.H.), Isala Clinics, Zwolle, the Departments of Intensive Care (L.O.) and Cardiothoracic Surgery (K.Y.L.), Catharina Hospital, Eindhoven, the Departments of Intensive Care (C.V.E.K., J.L.M.), Cardiology (J.M.M.C.), and Emergency Medicine (O.M.), Leiden University Medical Center, Leiden, the Departments of Intensive Care (A.P.J.V.), Cardiothoracic Surgery (A.H.G.D.), Anesthesia (S.E.), and Cardiology (J.H.), Amsterdam University Medical Center, and the Department of Intensive Care, Onze Lieve Vrouwe Gasthuis (B.B., J.M.), Amsterdam, the Departments of Intensive Care (J.J.H., D.W.D.) and Cardiology (S.Z.H.R.), University Medical Center Utrecht, Utrecht, the Department of Intensive Care, St. Antonius Hospital, Nieuwegein (E.S., B.G.H.), the Department of Intensive Care, Erasmus Medical Center (C.U., D.D.R.M., R.J.T., K.C.B., L.M., J.J.H.B.), and the Department of Cardiology, Thorax Center, Erasmus University Medical Center (J.J.H.B.), Rotterdam, the Departments of Intensive Care (T.J., S.A.) and Cardiology (G.B.), Haga Hospital, the Hague, and Cardiovascular and Respiratory Physiology Group, TechMed Center, University of Twente, Enschede (D.W.D.) - all in the Netherlands
| | - Tim Jansen
- From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Public Health Research Institute (B.W.), the Cardiovascular Research Institute Maastricht (R.L., J.G.M.), and the School for Nutrition and Translational Research in Metabolism (M.C.G.P.), Maastricht University, Maastricht, the Departments of Cardiothoracic Surgery (G.J.B.B.B.), Intensive Care (M.K.), and Cardiology (R.S.H.), Isala Clinics, Zwolle, the Departments of Intensive Care (L.O.) and Cardiothoracic Surgery (K.Y.L.), Catharina Hospital, Eindhoven, the Departments of Intensive Care (C.V.E.K., J.L.M.), Cardiology (J.M.M.C.), and Emergency Medicine (O.M.), Leiden University Medical Center, Leiden, the Departments of Intensive Care (A.P.J.V.), Cardiothoracic Surgery (A.H.G.D.), Anesthesia (S.E.), and Cardiology (J.H.), Amsterdam University Medical Center, and the Department of Intensive Care, Onze Lieve Vrouwe Gasthuis (B.B., J.M.), Amsterdam, the Departments of Intensive Care (J.J.H., D.W.D.) and Cardiology (S.Z.H.R.), University Medical Center Utrecht, Utrecht, the Department of Intensive Care, St. Antonius Hospital, Nieuwegein (E.S., B.G.H.), the Department of Intensive Care, Erasmus Medical Center (C.U., D.D.R.M., R.J.T., K.C.B., L.M., J.J.H.B.), and the Department of Cardiology, Thorax Center, Erasmus University Medical Center (J.J.H.B.), Rotterdam, the Departments of Intensive Care (T.J., S.A.) and Cardiology (G.B.), Haga Hospital, the Hague, and Cardiovascular and Respiratory Physiology Group, TechMed Center, University of Twente, Enschede (D.W.D.) - all in the Netherlands
| | - Bas van den Bogaard
- From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Public Health Research Institute (B.W.), the Cardiovascular Research Institute Maastricht (R.L., J.G.M.), and the School for Nutrition and Translational Research in Metabolism (M.C.G.P.), Maastricht University, Maastricht, the Departments of Cardiothoracic Surgery (G.J.B.B.B.), Intensive Care (M.K.), and Cardiology (R.S.H.), Isala Clinics, Zwolle, the Departments of Intensive Care (L.O.) and Cardiothoracic Surgery (K.Y.L.), Catharina Hospital, Eindhoven, the Departments of Intensive Care (C.V.E.K., J.L.M.), Cardiology (J.M.M.C.), and Emergency Medicine (O.M.), Leiden University Medical Center, Leiden, the Departments of Intensive Care (A.P.J.V.), Cardiothoracic Surgery (A.H.G.D.), Anesthesia (S.E.), and Cardiology (J.H.), Amsterdam University Medical Center, and the Department of Intensive Care, Onze Lieve Vrouwe Gasthuis (B.B., J.M.), Amsterdam, the Departments of Intensive Care (J.J.H., D.W.D.) and Cardiology (S.Z.H.R.), University Medical Center Utrecht, Utrecht, the Department of Intensive Care, St. Antonius Hospital, Nieuwegein (E.S., B.G.H.), the Department of Intensive Care, Erasmus Medical Center (C.U., D.D.R.M., R.J.T., K.C.B., L.M., J.J.H.B.), and the Department of Cardiology, Thorax Center, Erasmus University Medical Center (J.J.H.B.), Rotterdam, the Departments of Intensive Care (T.J., S.A.) and Cardiology (G.B.), Haga Hospital, the Hague, and Cardiovascular and Respiratory Physiology Group, TechMed Center, University of Twente, Enschede (D.W.D.) - all in the Netherlands
| | - Marijn Kuijpers
- From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Public Health Research Institute (B.W.), the Cardiovascular Research Institute Maastricht (R.L., J.G.M.), and the School for Nutrition and Translational Research in Metabolism (M.C.G.P.), Maastricht University, Maastricht, the Departments of Cardiothoracic Surgery (G.J.B.B.B.), Intensive Care (M.K.), and Cardiology (R.S.H.), Isala Clinics, Zwolle, the Departments of Intensive Care (L.O.) and Cardiothoracic Surgery (K.Y.L.), Catharina Hospital, Eindhoven, the Departments of Intensive Care (C.V.E.K., J.L.M.), Cardiology (J.M.M.C.), and Emergency Medicine (O.M.), Leiden University Medical Center, Leiden, the Departments of Intensive Care (A.P.J.V.), Cardiothoracic Surgery (A.H.G.D.), Anesthesia (S.E.), and Cardiology (J.H.), Amsterdam University Medical Center, and the Department of Intensive Care, Onze Lieve Vrouwe Gasthuis (B.B., J.M.), Amsterdam, the Departments of Intensive Care (J.J.H., D.W.D.) and Cardiology (S.Z.H.R.), University Medical Center Utrecht, Utrecht, the Department of Intensive Care, St. Antonius Hospital, Nieuwegein (E.S., B.G.H.), the Department of Intensive Care, Erasmus Medical Center (C.U., D.D.R.M., R.J.T., K.C.B., L.M., J.J.H.B.), and the Department of Cardiology, Thorax Center, Erasmus University Medical Center (J.J.H.B.), Rotterdam, the Departments of Intensive Care (T.J., S.A.) and Cardiology (G.B.), Haga Hospital, the Hague, and Cardiovascular and Respiratory Physiology Group, TechMed Center, University of Twente, Enschede (D.W.D.) - all in the Netherlands
| | - Ka Yan Lam
- From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Public Health Research Institute (B.W.), the Cardiovascular Research Institute Maastricht (R.L., J.G.M.), and the School for Nutrition and Translational Research in Metabolism (M.C.G.P.), Maastricht University, Maastricht, the Departments of Cardiothoracic Surgery (G.J.B.B.B.), Intensive Care (M.K.), and Cardiology (R.S.H.), Isala Clinics, Zwolle, the Departments of Intensive Care (L.O.) and Cardiothoracic Surgery (K.Y.L.), Catharina Hospital, Eindhoven, the Departments of Intensive Care (C.V.E.K., J.L.M.), Cardiology (J.M.M.C.), and Emergency Medicine (O.M.), Leiden University Medical Center, Leiden, the Departments of Intensive Care (A.P.J.V.), Cardiothoracic Surgery (A.H.G.D.), Anesthesia (S.E.), and Cardiology (J.H.), Amsterdam University Medical Center, and the Department of Intensive Care, Onze Lieve Vrouwe Gasthuis (B.B., J.M.), Amsterdam, the Departments of Intensive Care (J.J.H., D.W.D.) and Cardiology (S.Z.H.R.), University Medical Center Utrecht, Utrecht, the Department of Intensive Care, St. Antonius Hospital, Nieuwegein (E.S., B.G.H.), the Department of Intensive Care, Erasmus Medical Center (C.U., D.D.R.M., R.J.T., K.C.B., L.M., J.J.H.B.), and the Department of Cardiology, Thorax Center, Erasmus University Medical Center (J.J.H.B.), Rotterdam, the Departments of Intensive Care (T.J., S.A.) and Cardiology (G.B.), Haga Hospital, the Hague, and Cardiovascular and Respiratory Physiology Group, TechMed Center, University of Twente, Enschede (D.W.D.) - all in the Netherlands
| | - José M Montero Cabezas
- From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Public Health Research Institute (B.W.), the Cardiovascular Research Institute Maastricht (R.L., J.G.M.), and the School for Nutrition and Translational Research in Metabolism (M.C.G.P.), Maastricht University, Maastricht, the Departments of Cardiothoracic Surgery (G.J.B.B.B.), Intensive Care (M.K.), and Cardiology (R.S.H.), Isala Clinics, Zwolle, the Departments of Intensive Care (L.O.) and Cardiothoracic Surgery (K.Y.L.), Catharina Hospital, Eindhoven, the Departments of Intensive Care (C.V.E.K., J.L.M.), Cardiology (J.M.M.C.), and Emergency Medicine (O.M.), Leiden University Medical Center, Leiden, the Departments of Intensive Care (A.P.J.V.), Cardiothoracic Surgery (A.H.G.D.), Anesthesia (S.E.), and Cardiology (J.H.), Amsterdam University Medical Center, and the Department of Intensive Care, Onze Lieve Vrouwe Gasthuis (B.B., J.M.), Amsterdam, the Departments of Intensive Care (J.J.H., D.W.D.) and Cardiology (S.Z.H.R.), University Medical Center Utrecht, Utrecht, the Department of Intensive Care, St. Antonius Hospital, Nieuwegein (E.S., B.G.H.), the Department of Intensive Care, Erasmus Medical Center (C.U., D.D.R.M., R.J.T., K.C.B., L.M., J.J.H.B.), and the Department of Cardiology, Thorax Center, Erasmus University Medical Center (J.J.H.B.), Rotterdam, the Departments of Intensive Care (T.J., S.A.) and Cardiology (G.B.), Haga Hospital, the Hague, and Cardiovascular and Respiratory Physiology Group, TechMed Center, University of Twente, Enschede (D.W.D.) - all in the Netherlands
| | - Antoine H G Driessen
- From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Public Health Research Institute (B.W.), the Cardiovascular Research Institute Maastricht (R.L., J.G.M.), and the School for Nutrition and Translational Research in Metabolism (M.C.G.P.), Maastricht University, Maastricht, the Departments of Cardiothoracic Surgery (G.J.B.B.B.), Intensive Care (M.K.), and Cardiology (R.S.H.), Isala Clinics, Zwolle, the Departments of Intensive Care (L.O.) and Cardiothoracic Surgery (K.Y.L.), Catharina Hospital, Eindhoven, the Departments of Intensive Care (C.V.E.K., J.L.M.), Cardiology (J.M.M.C.), and Emergency Medicine (O.M.), Leiden University Medical Center, Leiden, the Departments of Intensive Care (A.P.J.V.), Cardiothoracic Surgery (A.H.G.D.), Anesthesia (S.E.), and Cardiology (J.H.), Amsterdam University Medical Center, and the Department of Intensive Care, Onze Lieve Vrouwe Gasthuis (B.B., J.M.), Amsterdam, the Departments of Intensive Care (J.J.H., D.W.D.) and Cardiology (S.Z.H.R.), University Medical Center Utrecht, Utrecht, the Department of Intensive Care, St. Antonius Hospital, Nieuwegein (E.S., B.G.H.), the Department of Intensive Care, Erasmus Medical Center (C.U., D.D.R.M., R.J.T., K.C.B., L.M., J.J.H.B.), and the Department of Cardiology, Thorax Center, Erasmus University Medical Center (J.J.H.B.), Rotterdam, the Departments of Intensive Care (T.J., S.A.) and Cardiology (G.B.), Haga Hospital, the Hague, and Cardiovascular and Respiratory Physiology Group, TechMed Center, University of Twente, Enschede (D.W.D.) - all in the Netherlands
| | - Saskia Z H Rittersma
- From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Public Health Research Institute (B.W.), the Cardiovascular Research Institute Maastricht (R.L., J.G.M.), and the School for Nutrition and Translational Research in Metabolism (M.C.G.P.), Maastricht University, Maastricht, the Departments of Cardiothoracic Surgery (G.J.B.B.B.), Intensive Care (M.K.), and Cardiology (R.S.H.), Isala Clinics, Zwolle, the Departments of Intensive Care (L.O.) and Cardiothoracic Surgery (K.Y.L.), Catharina Hospital, Eindhoven, the Departments of Intensive Care (C.V.E.K., J.L.M.), Cardiology (J.M.M.C.), and Emergency Medicine (O.M.), Leiden University Medical Center, Leiden, the Departments of Intensive Care (A.P.J.V.), Cardiothoracic Surgery (A.H.G.D.), Anesthesia (S.E.), and Cardiology (J.H.), Amsterdam University Medical Center, and the Department of Intensive Care, Onze Lieve Vrouwe Gasthuis (B.B., J.M.), Amsterdam, the Departments of Intensive Care (J.J.H., D.W.D.) and Cardiology (S.Z.H.R.), University Medical Center Utrecht, Utrecht, the Department of Intensive Care, St. Antonius Hospital, Nieuwegein (E.S., B.G.H.), the Department of Intensive Care, Erasmus Medical Center (C.U., D.D.R.M., R.J.T., K.C.B., L.M., J.J.H.B.), and the Department of Cardiology, Thorax Center, Erasmus University Medical Center (J.J.H.B.), Rotterdam, the Departments of Intensive Care (T.J., S.A.) and Cardiology (G.B.), Haga Hospital, the Hague, and Cardiovascular and Respiratory Physiology Group, TechMed Center, University of Twente, Enschede (D.W.D.) - all in the Netherlands
| | - Bram G Heijnen
- From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Public Health Research Institute (B.W.), the Cardiovascular Research Institute Maastricht (R.L., J.G.M.), and the School for Nutrition and Translational Research in Metabolism (M.C.G.P.), Maastricht University, Maastricht, the Departments of Cardiothoracic Surgery (G.J.B.B.B.), Intensive Care (M.K.), and Cardiology (R.S.H.), Isala Clinics, Zwolle, the Departments of Intensive Care (L.O.) and Cardiothoracic Surgery (K.Y.L.), Catharina Hospital, Eindhoven, the Departments of Intensive Care (C.V.E.K., J.L.M.), Cardiology (J.M.M.C.), and Emergency Medicine (O.M.), Leiden University Medical Center, Leiden, the Departments of Intensive Care (A.P.J.V.), Cardiothoracic Surgery (A.H.G.D.), Anesthesia (S.E.), and Cardiology (J.H.), Amsterdam University Medical Center, and the Department of Intensive Care, Onze Lieve Vrouwe Gasthuis (B.B., J.M.), Amsterdam, the Departments of Intensive Care (J.J.H., D.W.D.) and Cardiology (S.Z.H.R.), University Medical Center Utrecht, Utrecht, the Department of Intensive Care, St. Antonius Hospital, Nieuwegein (E.S., B.G.H.), the Department of Intensive Care, Erasmus Medical Center (C.U., D.D.R.M., R.J.T., K.C.B., L.M., J.J.H.B.), and the Department of Cardiology, Thorax Center, Erasmus University Medical Center (J.J.H.B.), Rotterdam, the Departments of Intensive Care (T.J., S.A.) and Cardiology (G.B.), Haga Hospital, the Hague, and Cardiovascular and Respiratory Physiology Group, TechMed Center, University of Twente, Enschede (D.W.D.) - all in the Netherlands
| | - Dinis Dos Reis Miranda
- From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Public Health Research Institute (B.W.), the Cardiovascular Research Institute Maastricht (R.L., J.G.M.), and the School for Nutrition and Translational Research in Metabolism (M.C.G.P.), Maastricht University, Maastricht, the Departments of Cardiothoracic Surgery (G.J.B.B.B.), Intensive Care (M.K.), and Cardiology (R.S.H.), Isala Clinics, Zwolle, the Departments of Intensive Care (L.O.) and Cardiothoracic Surgery (K.Y.L.), Catharina Hospital, Eindhoven, the Departments of Intensive Care (C.V.E.K., J.L.M.), Cardiology (J.M.M.C.), and Emergency Medicine (O.M.), Leiden University Medical Center, Leiden, the Departments of Intensive Care (A.P.J.V.), Cardiothoracic Surgery (A.H.G.D.), Anesthesia (S.E.), and Cardiology (J.H.), Amsterdam University Medical Center, and the Department of Intensive Care, Onze Lieve Vrouwe Gasthuis (B.B., J.M.), Amsterdam, the Departments of Intensive Care (J.J.H., D.W.D.) and Cardiology (S.Z.H.R.), University Medical Center Utrecht, Utrecht, the Department of Intensive Care, St. Antonius Hospital, Nieuwegein (E.S., B.G.H.), the Department of Intensive Care, Erasmus Medical Center (C.U., D.D.R.M., R.J.T., K.C.B., L.M., J.J.H.B.), and the Department of Cardiology, Thorax Center, Erasmus University Medical Center (J.J.H.B.), Rotterdam, the Departments of Intensive Care (T.J., S.A.) and Cardiology (G.B.), Haga Hospital, the Hague, and Cardiovascular and Respiratory Physiology Group, TechMed Center, University of Twente, Enschede (D.W.D.) - all in the Netherlands
| | - Gabe Bleeker
- From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Public Health Research Institute (B.W.), the Cardiovascular Research Institute Maastricht (R.L., J.G.M.), and the School for Nutrition and Translational Research in Metabolism (M.C.G.P.), Maastricht University, Maastricht, the Departments of Cardiothoracic Surgery (G.J.B.B.B.), Intensive Care (M.K.), and Cardiology (R.S.H.), Isala Clinics, Zwolle, the Departments of Intensive Care (L.O.) and Cardiothoracic Surgery (K.Y.L.), Catharina Hospital, Eindhoven, the Departments of Intensive Care (C.V.E.K., J.L.M.), Cardiology (J.M.M.C.), and Emergency Medicine (O.M.), Leiden University Medical Center, Leiden, the Departments of Intensive Care (A.P.J.V.), Cardiothoracic Surgery (A.H.G.D.), Anesthesia (S.E.), and Cardiology (J.H.), Amsterdam University Medical Center, and the Department of Intensive Care, Onze Lieve Vrouwe Gasthuis (B.B., J.M.), Amsterdam, the Departments of Intensive Care (J.J.H., D.W.D.) and Cardiology (S.Z.H.R.), University Medical Center Utrecht, Utrecht, the Department of Intensive Care, St. Antonius Hospital, Nieuwegein (E.S., B.G.H.), the Department of Intensive Care, Erasmus Medical Center (C.U., D.D.R.M., R.J.T., K.C.B., L.M., J.J.H.B.), and the Department of Cardiology, Thorax Center, Erasmus University Medical Center (J.J.H.B.), Rotterdam, the Departments of Intensive Care (T.J., S.A.) and Cardiology (G.B.), Haga Hospital, the Hague, and Cardiovascular and Respiratory Physiology Group, TechMed Center, University of Twente, Enschede (D.W.D.) - all in the Netherlands
| | - Jesse de Metz
- From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Public Health Research Institute (B.W.), the Cardiovascular Research Institute Maastricht (R.L., J.G.M.), and the School for Nutrition and Translational Research in Metabolism (M.C.G.P.), Maastricht University, Maastricht, the Departments of Cardiothoracic Surgery (G.J.B.B.B.), Intensive Care (M.K.), and Cardiology (R.S.H.), Isala Clinics, Zwolle, the Departments of Intensive Care (L.O.) and Cardiothoracic Surgery (K.Y.L.), Catharina Hospital, Eindhoven, the Departments of Intensive Care (C.V.E.K., J.L.M.), Cardiology (J.M.M.C.), and Emergency Medicine (O.M.), Leiden University Medical Center, Leiden, the Departments of Intensive Care (A.P.J.V.), Cardiothoracic Surgery (A.H.G.D.), Anesthesia (S.E.), and Cardiology (J.H.), Amsterdam University Medical Center, and the Department of Intensive Care, Onze Lieve Vrouwe Gasthuis (B.B., J.M.), Amsterdam, the Departments of Intensive Care (J.J.H., D.W.D.) and Cardiology (S.Z.H.R.), University Medical Center Utrecht, Utrecht, the Department of Intensive Care, St. Antonius Hospital, Nieuwegein (E.S., B.G.H.), the Department of Intensive Care, Erasmus Medical Center (C.U., D.D.R.M., R.J.T., K.C.B., L.M., J.J.H.B.), and the Department of Cardiology, Thorax Center, Erasmus University Medical Center (J.J.H.B.), Rotterdam, the Departments of Intensive Care (T.J., S.A.) and Cardiology (G.B.), Haga Hospital, the Hague, and Cardiovascular and Respiratory Physiology Group, TechMed Center, University of Twente, Enschede (D.W.D.) - all in the Netherlands
| | - Renicus S Hermanides
- From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Public Health Research Institute (B.W.), the Cardiovascular Research Institute Maastricht (R.L., J.G.M.), and the School for Nutrition and Translational Research in Metabolism (M.C.G.P.), Maastricht University, Maastricht, the Departments of Cardiothoracic Surgery (G.J.B.B.B.), Intensive Care (M.K.), and Cardiology (R.S.H.), Isala Clinics, Zwolle, the Departments of Intensive Care (L.O.) and Cardiothoracic Surgery (K.Y.L.), Catharina Hospital, Eindhoven, the Departments of Intensive Care (C.V.E.K., J.L.M.), Cardiology (J.M.M.C.), and Emergency Medicine (O.M.), Leiden University Medical Center, Leiden, the Departments of Intensive Care (A.P.J.V.), Cardiothoracic Surgery (A.H.G.D.), Anesthesia (S.E.), and Cardiology (J.H.), Amsterdam University Medical Center, and the Department of Intensive Care, Onze Lieve Vrouwe Gasthuis (B.B., J.M.), Amsterdam, the Departments of Intensive Care (J.J.H., D.W.D.) and Cardiology (S.Z.H.R.), University Medical Center Utrecht, Utrecht, the Department of Intensive Care, St. Antonius Hospital, Nieuwegein (E.S., B.G.H.), the Department of Intensive Care, Erasmus Medical Center (C.U., D.D.R.M., R.J.T., K.C.B., L.M., J.J.H.B.), and the Department of Cardiology, Thorax Center, Erasmus University Medical Center (J.J.H.B.), Rotterdam, the Departments of Intensive Care (T.J., S.A.) and Cardiology (G.B.), Haga Hospital, the Hague, and Cardiovascular and Respiratory Physiology Group, TechMed Center, University of Twente, Enschede (D.W.D.) - all in the Netherlands
| | - Jorge Lopez Matta
- From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Public Health Research Institute (B.W.), the Cardiovascular Research Institute Maastricht (R.L., J.G.M.), and the School for Nutrition and Translational Research in Metabolism (M.C.G.P.), Maastricht University, Maastricht, the Departments of Cardiothoracic Surgery (G.J.B.B.B.), Intensive Care (M.K.), and Cardiology (R.S.H.), Isala Clinics, Zwolle, the Departments of Intensive Care (L.O.) and Cardiothoracic Surgery (K.Y.L.), Catharina Hospital, Eindhoven, the Departments of Intensive Care (C.V.E.K., J.L.M.), Cardiology (J.M.M.C.), and Emergency Medicine (O.M.), Leiden University Medical Center, Leiden, the Departments of Intensive Care (A.P.J.V.), Cardiothoracic Surgery (A.H.G.D.), Anesthesia (S.E.), and Cardiology (J.H.), Amsterdam University Medical Center, and the Department of Intensive Care, Onze Lieve Vrouwe Gasthuis (B.B., J.M.), Amsterdam, the Departments of Intensive Care (J.J.H., D.W.D.) and Cardiology (S.Z.H.R.), University Medical Center Utrecht, Utrecht, the Department of Intensive Care, St. Antonius Hospital, Nieuwegein (E.S., B.G.H.), the Department of Intensive Care, Erasmus Medical Center (C.U., D.D.R.M., R.J.T., K.C.B., L.M., J.J.H.B.), and the Department of Cardiology, Thorax Center, Erasmus University Medical Center (J.J.H.B.), Rotterdam, the Departments of Intensive Care (T.J., S.A.) and Cardiology (G.B.), Haga Hospital, the Hague, and Cardiovascular and Respiratory Physiology Group, TechMed Center, University of Twente, Enschede (D.W.D.) - all in the Netherlands
| | - Susanne Eberl
- From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Public Health Research Institute (B.W.), the Cardiovascular Research Institute Maastricht (R.L., J.G.M.), and the School for Nutrition and Translational Research in Metabolism (M.C.G.P.), Maastricht University, Maastricht, the Departments of Cardiothoracic Surgery (G.J.B.B.B.), Intensive Care (M.K.), and Cardiology (R.S.H.), Isala Clinics, Zwolle, the Departments of Intensive Care (L.O.) and Cardiothoracic Surgery (K.Y.L.), Catharina Hospital, Eindhoven, the Departments of Intensive Care (C.V.E.K., J.L.M.), Cardiology (J.M.M.C.), and Emergency Medicine (O.M.), Leiden University Medical Center, Leiden, the Departments of Intensive Care (A.P.J.V.), Cardiothoracic Surgery (A.H.G.D.), Anesthesia (S.E.), and Cardiology (J.H.), Amsterdam University Medical Center, and the Department of Intensive Care, Onze Lieve Vrouwe Gasthuis (B.B., J.M.), Amsterdam, the Departments of Intensive Care (J.J.H., D.W.D.) and Cardiology (S.Z.H.R.), University Medical Center Utrecht, Utrecht, the Department of Intensive Care, St. Antonius Hospital, Nieuwegein (E.S., B.G.H.), the Department of Intensive Care, Erasmus Medical Center (C.U., D.D.R.M., R.J.T., K.C.B., L.M., J.J.H.B.), and the Department of Cardiology, Thorax Center, Erasmus University Medical Center (J.J.H.B.), Rotterdam, the Departments of Intensive Care (T.J., S.A.) and Cardiology (G.B.), Haga Hospital, the Hague, and Cardiovascular and Respiratory Physiology Group, TechMed Center, University of Twente, Enschede (D.W.D.) - all in the Netherlands
| | - Dirk W Donker
- From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Public Health Research Institute (B.W.), the Cardiovascular Research Institute Maastricht (R.L., J.G.M.), and the School for Nutrition and Translational Research in Metabolism (M.C.G.P.), Maastricht University, Maastricht, the Departments of Cardiothoracic Surgery (G.J.B.B.B.), Intensive Care (M.K.), and Cardiology (R.S.H.), Isala Clinics, Zwolle, the Departments of Intensive Care (L.O.) and Cardiothoracic Surgery (K.Y.L.), Catharina Hospital, Eindhoven, the Departments of Intensive Care (C.V.E.K., J.L.M.), Cardiology (J.M.M.C.), and Emergency Medicine (O.M.), Leiden University Medical Center, Leiden, the Departments of Intensive Care (A.P.J.V.), Cardiothoracic Surgery (A.H.G.D.), Anesthesia (S.E.), and Cardiology (J.H.), Amsterdam University Medical Center, and the Department of Intensive Care, Onze Lieve Vrouwe Gasthuis (B.B., J.M.), Amsterdam, the Departments of Intensive Care (J.J.H., D.W.D.) and Cardiology (S.Z.H.R.), University Medical Center Utrecht, Utrecht, the Department of Intensive Care, St. Antonius Hospital, Nieuwegein (E.S., B.G.H.), the Department of Intensive Care, Erasmus Medical Center (C.U., D.D.R.M., R.J.T., K.C.B., L.M., J.J.H.B.), and the Department of Cardiology, Thorax Center, Erasmus University Medical Center (J.J.H.B.), Rotterdam, the Departments of Intensive Care (T.J., S.A.) and Cardiology (G.B.), Haga Hospital, the Hague, and Cardiovascular and Respiratory Physiology Group, TechMed Center, University of Twente, Enschede (D.W.D.) - all in the Netherlands
| | - Robert J van Thiel
- From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Public Health Research Institute (B.W.), the Cardiovascular Research Institute Maastricht (R.L., J.G.M.), and the School for Nutrition and Translational Research in Metabolism (M.C.G.P.), Maastricht University, Maastricht, the Departments of Cardiothoracic Surgery (G.J.B.B.B.), Intensive Care (M.K.), and Cardiology (R.S.H.), Isala Clinics, Zwolle, the Departments of Intensive Care (L.O.) and Cardiothoracic Surgery (K.Y.L.), Catharina Hospital, Eindhoven, the Departments of Intensive Care (C.V.E.K., J.L.M.), Cardiology (J.M.M.C.), and Emergency Medicine (O.M.), Leiden University Medical Center, Leiden, the Departments of Intensive Care (A.P.J.V.), Cardiothoracic Surgery (A.H.G.D.), Anesthesia (S.E.), and Cardiology (J.H.), Amsterdam University Medical Center, and the Department of Intensive Care, Onze Lieve Vrouwe Gasthuis (B.B., J.M.), Amsterdam, the Departments of Intensive Care (J.J.H., D.W.D.) and Cardiology (S.Z.H.R.), University Medical Center Utrecht, Utrecht, the Department of Intensive Care, St. Antonius Hospital, Nieuwegein (E.S., B.G.H.), the Department of Intensive Care, Erasmus Medical Center (C.U., D.D.R.M., R.J.T., K.C.B., L.M., J.J.H.B.), and the Department of Cardiology, Thorax Center, Erasmus University Medical Center (J.J.H.B.), Rotterdam, the Departments of Intensive Care (T.J., S.A.) and Cardiology (G.B.), Haga Hospital, the Hague, and Cardiovascular and Respiratory Physiology Group, TechMed Center, University of Twente, Enschede (D.W.D.) - all in the Netherlands
| | - Sakir Akin
- From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Public Health Research Institute (B.W.), the Cardiovascular Research Institute Maastricht (R.L., J.G.M.), and the School for Nutrition and Translational Research in Metabolism (M.C.G.P.), Maastricht University, Maastricht, the Departments of Cardiothoracic Surgery (G.J.B.B.B.), Intensive Care (M.K.), and Cardiology (R.S.H.), Isala Clinics, Zwolle, the Departments of Intensive Care (L.O.) and Cardiothoracic Surgery (K.Y.L.), Catharina Hospital, Eindhoven, the Departments of Intensive Care (C.V.E.K., J.L.M.), Cardiology (J.M.M.C.), and Emergency Medicine (O.M.), Leiden University Medical Center, Leiden, the Departments of Intensive Care (A.P.J.V.), Cardiothoracic Surgery (A.H.G.D.), Anesthesia (S.E.), and Cardiology (J.H.), Amsterdam University Medical Center, and the Department of Intensive Care, Onze Lieve Vrouwe Gasthuis (B.B., J.M.), Amsterdam, the Departments of Intensive Care (J.J.H., D.W.D.) and Cardiology (S.Z.H.R.), University Medical Center Utrecht, Utrecht, the Department of Intensive Care, St. Antonius Hospital, Nieuwegein (E.S., B.G.H.), the Department of Intensive Care, Erasmus Medical Center (C.U., D.D.R.M., R.J.T., K.C.B., L.M., J.J.H.B.), and the Department of Cardiology, Thorax Center, Erasmus University Medical Center (J.J.H.B.), Rotterdam, the Departments of Intensive Care (T.J., S.A.) and Cardiology (G.B.), Haga Hospital, the Hague, and Cardiovascular and Respiratory Physiology Group, TechMed Center, University of Twente, Enschede (D.W.D.) - all in the Netherlands
| | - Oene van Meer
- From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Public Health Research Institute (B.W.), the Cardiovascular Research Institute Maastricht (R.L., J.G.M.), and the School for Nutrition and Translational Research in Metabolism (M.C.G.P.), Maastricht University, Maastricht, the Departments of Cardiothoracic Surgery (G.J.B.B.B.), Intensive Care (M.K.), and Cardiology (R.S.H.), Isala Clinics, Zwolle, the Departments of Intensive Care (L.O.) and Cardiothoracic Surgery (K.Y.L.), Catharina Hospital, Eindhoven, the Departments of Intensive Care (C.V.E.K., J.L.M.), Cardiology (J.M.M.C.), and Emergency Medicine (O.M.), Leiden University Medical Center, Leiden, the Departments of Intensive Care (A.P.J.V.), Cardiothoracic Surgery (A.H.G.D.), Anesthesia (S.E.), and Cardiology (J.H.), Amsterdam University Medical Center, and the Department of Intensive Care, Onze Lieve Vrouwe Gasthuis (B.B., J.M.), Amsterdam, the Departments of Intensive Care (J.J.H., D.W.D.) and Cardiology (S.Z.H.R.), University Medical Center Utrecht, Utrecht, the Department of Intensive Care, St. Antonius Hospital, Nieuwegein (E.S., B.G.H.), the Department of Intensive Care, Erasmus Medical Center (C.U., D.D.R.M., R.J.T., K.C.B., L.M., J.J.H.B.), and the Department of Cardiology, Thorax Center, Erasmus University Medical Center (J.J.H.B.), Rotterdam, the Departments of Intensive Care (T.J., S.A.) and Cardiology (G.B.), Haga Hospital, the Hague, and Cardiovascular and Respiratory Physiology Group, TechMed Center, University of Twente, Enschede (D.W.D.) - all in the Netherlands
| | - José Henriques
- From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Public Health Research Institute (B.W.), the Cardiovascular Research Institute Maastricht (R.L., J.G.M.), and the School for Nutrition and Translational Research in Metabolism (M.C.G.P.), Maastricht University, Maastricht, the Departments of Cardiothoracic Surgery (G.J.B.B.B.), Intensive Care (M.K.), and Cardiology (R.S.H.), Isala Clinics, Zwolle, the Departments of Intensive Care (L.O.) and Cardiothoracic Surgery (K.Y.L.), Catharina Hospital, Eindhoven, the Departments of Intensive Care (C.V.E.K., J.L.M.), Cardiology (J.M.M.C.), and Emergency Medicine (O.M.), Leiden University Medical Center, Leiden, the Departments of Intensive Care (A.P.J.V.), Cardiothoracic Surgery (A.H.G.D.), Anesthesia (S.E.), and Cardiology (J.H.), Amsterdam University Medical Center, and the Department of Intensive Care, Onze Lieve Vrouwe Gasthuis (B.B., J.M.), Amsterdam, the Departments of Intensive Care (J.J.H., D.W.D.) and Cardiology (S.Z.H.R.), University Medical Center Utrecht, Utrecht, the Department of Intensive Care, St. Antonius Hospital, Nieuwegein (E.S., B.G.H.), the Department of Intensive Care, Erasmus Medical Center (C.U., D.D.R.M., R.J.T., K.C.B., L.M., J.J.H.B.), and the Department of Cardiology, Thorax Center, Erasmus University Medical Center (J.J.H.B.), Rotterdam, the Departments of Intensive Care (T.J., S.A.) and Cardiology (G.B.), Haga Hospital, the Hague, and Cardiovascular and Respiratory Physiology Group, TechMed Center, University of Twente, Enschede (D.W.D.) - all in the Netherlands
| | - Karen C Bokhoven
- From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Public Health Research Institute (B.W.), the Cardiovascular Research Institute Maastricht (R.L., J.G.M.), and the School for Nutrition and Translational Research in Metabolism (M.C.G.P.), Maastricht University, Maastricht, the Departments of Cardiothoracic Surgery (G.J.B.B.B.), Intensive Care (M.K.), and Cardiology (R.S.H.), Isala Clinics, Zwolle, the Departments of Intensive Care (L.O.) and Cardiothoracic Surgery (K.Y.L.), Catharina Hospital, Eindhoven, the Departments of Intensive Care (C.V.E.K., J.L.M.), Cardiology (J.M.M.C.), and Emergency Medicine (O.M.), Leiden University Medical Center, Leiden, the Departments of Intensive Care (A.P.J.V.), Cardiothoracic Surgery (A.H.G.D.), Anesthesia (S.E.), and Cardiology (J.H.), Amsterdam University Medical Center, and the Department of Intensive Care, Onze Lieve Vrouwe Gasthuis (B.B., J.M.), Amsterdam, the Departments of Intensive Care (J.J.H., D.W.D.) and Cardiology (S.Z.H.R.), University Medical Center Utrecht, Utrecht, the Department of Intensive Care, St. Antonius Hospital, Nieuwegein (E.S., B.G.H.), the Department of Intensive Care, Erasmus Medical Center (C.U., D.D.R.M., R.J.T., K.C.B., L.M., J.J.H.B.), and the Department of Cardiology, Thorax Center, Erasmus University Medical Center (J.J.H.B.), Rotterdam, the Departments of Intensive Care (T.J., S.A.) and Cardiology (G.B.), Haga Hospital, the Hague, and Cardiovascular and Respiratory Physiology Group, TechMed Center, University of Twente, Enschede (D.W.D.) - all in the Netherlands
| | - Loes Mandigers
- From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Public Health Research Institute (B.W.), the Cardiovascular Research Institute Maastricht (R.L., J.G.M.), and the School for Nutrition and Translational Research in Metabolism (M.C.G.P.), Maastricht University, Maastricht, the Departments of Cardiothoracic Surgery (G.J.B.B.B.), Intensive Care (M.K.), and Cardiology (R.S.H.), Isala Clinics, Zwolle, the Departments of Intensive Care (L.O.) and Cardiothoracic Surgery (K.Y.L.), Catharina Hospital, Eindhoven, the Departments of Intensive Care (C.V.E.K., J.L.M.), Cardiology (J.M.M.C.), and Emergency Medicine (O.M.), Leiden University Medical Center, Leiden, the Departments of Intensive Care (A.P.J.V.), Cardiothoracic Surgery (A.H.G.D.), Anesthesia (S.E.), and Cardiology (J.H.), Amsterdam University Medical Center, and the Department of Intensive Care, Onze Lieve Vrouwe Gasthuis (B.B., J.M.), Amsterdam, the Departments of Intensive Care (J.J.H., D.W.D.) and Cardiology (S.Z.H.R.), University Medical Center Utrecht, Utrecht, the Department of Intensive Care, St. Antonius Hospital, Nieuwegein (E.S., B.G.H.), the Department of Intensive Care, Erasmus Medical Center (C.U., D.D.R.M., R.J.T., K.C.B., L.M., J.J.H.B.), and the Department of Cardiology, Thorax Center, Erasmus University Medical Center (J.J.H.B.), Rotterdam, the Departments of Intensive Care (T.J., S.A.) and Cardiology (G.B.), Haga Hospital, the Hague, and Cardiovascular and Respiratory Physiology Group, TechMed Center, University of Twente, Enschede (D.W.D.) - all in the Netherlands
| | - Jeroen J H Bunge
- From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Public Health Research Institute (B.W.), the Cardiovascular Research Institute Maastricht (R.L., J.G.M.), and the School for Nutrition and Translational Research in Metabolism (M.C.G.P.), Maastricht University, Maastricht, the Departments of Cardiothoracic Surgery (G.J.B.B.B.), Intensive Care (M.K.), and Cardiology (R.S.H.), Isala Clinics, Zwolle, the Departments of Intensive Care (L.O.) and Cardiothoracic Surgery (K.Y.L.), Catharina Hospital, Eindhoven, the Departments of Intensive Care (C.V.E.K., J.L.M.), Cardiology (J.M.M.C.), and Emergency Medicine (O.M.), Leiden University Medical Center, Leiden, the Departments of Intensive Care (A.P.J.V.), Cardiothoracic Surgery (A.H.G.D.), Anesthesia (S.E.), and Cardiology (J.H.), Amsterdam University Medical Center, and the Department of Intensive Care, Onze Lieve Vrouwe Gasthuis (B.B., J.M.), Amsterdam, the Departments of Intensive Care (J.J.H., D.W.D.) and Cardiology (S.Z.H.R.), University Medical Center Utrecht, Utrecht, the Department of Intensive Care, St. Antonius Hospital, Nieuwegein (E.S., B.G.H.), the Department of Intensive Care, Erasmus Medical Center (C.U., D.D.R.M., R.J.T., K.C.B., L.M., J.J.H.B.), and the Department of Cardiology, Thorax Center, Erasmus University Medical Center (J.J.H.B.), Rotterdam, the Departments of Intensive Care (T.J., S.A.) and Cardiology (G.B.), Haga Hospital, the Hague, and Cardiovascular and Respiratory Physiology Group, TechMed Center, University of Twente, Enschede (D.W.D.) - all in the Netherlands
| | - Martine E Bol
- From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Public Health Research Institute (B.W.), the Cardiovascular Research Institute Maastricht (R.L., J.G.M.), and the School for Nutrition and Translational Research in Metabolism (M.C.G.P.), Maastricht University, Maastricht, the Departments of Cardiothoracic Surgery (G.J.B.B.B.), Intensive Care (M.K.), and Cardiology (R.S.H.), Isala Clinics, Zwolle, the Departments of Intensive Care (L.O.) and Cardiothoracic Surgery (K.Y.L.), Catharina Hospital, Eindhoven, the Departments of Intensive Care (C.V.E.K., J.L.M.), Cardiology (J.M.M.C.), and Emergency Medicine (O.M.), Leiden University Medical Center, Leiden, the Departments of Intensive Care (A.P.J.V.), Cardiothoracic Surgery (A.H.G.D.), Anesthesia (S.E.), and Cardiology (J.H.), Amsterdam University Medical Center, and the Department of Intensive Care, Onze Lieve Vrouwe Gasthuis (B.B., J.M.), Amsterdam, the Departments of Intensive Care (J.J.H., D.W.D.) and Cardiology (S.Z.H.R.), University Medical Center Utrecht, Utrecht, the Department of Intensive Care, St. Antonius Hospital, Nieuwegein (E.S., B.G.H.), the Department of Intensive Care, Erasmus Medical Center (C.U., D.D.R.M., R.J.T., K.C.B., L.M., J.J.H.B.), and the Department of Cardiology, Thorax Center, Erasmus University Medical Center (J.J.H.B.), Rotterdam, the Departments of Intensive Care (T.J., S.A.) and Cardiology (G.B.), Haga Hospital, the Hague, and Cardiovascular and Respiratory Physiology Group, TechMed Center, University of Twente, Enschede (D.W.D.) - all in the Netherlands
| | - Bjorn Winkens
- From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Public Health Research Institute (B.W.), the Cardiovascular Research Institute Maastricht (R.L., J.G.M.), and the School for Nutrition and Translational Research in Metabolism (M.C.G.P.), Maastricht University, Maastricht, the Departments of Cardiothoracic Surgery (G.J.B.B.B.), Intensive Care (M.K.), and Cardiology (R.S.H.), Isala Clinics, Zwolle, the Departments of Intensive Care (L.O.) and Cardiothoracic Surgery (K.Y.L.), Catharina Hospital, Eindhoven, the Departments of Intensive Care (C.V.E.K., J.L.M.), Cardiology (J.M.M.C.), and Emergency Medicine (O.M.), Leiden University Medical Center, Leiden, the Departments of Intensive Care (A.P.J.V.), Cardiothoracic Surgery (A.H.G.D.), Anesthesia (S.E.), and Cardiology (J.H.), Amsterdam University Medical Center, and the Department of Intensive Care, Onze Lieve Vrouwe Gasthuis (B.B., J.M.), Amsterdam, the Departments of Intensive Care (J.J.H., D.W.D.) and Cardiology (S.Z.H.R.), University Medical Center Utrecht, Utrecht, the Department of Intensive Care, St. Antonius Hospital, Nieuwegein (E.S., B.G.H.), the Department of Intensive Care, Erasmus Medical Center (C.U., D.D.R.M., R.J.T., K.C.B., L.M., J.J.H.B.), and the Department of Cardiology, Thorax Center, Erasmus University Medical Center (J.J.H.B.), Rotterdam, the Departments of Intensive Care (T.J., S.A.) and Cardiology (G.B.), Haga Hospital, the Hague, and Cardiovascular and Respiratory Physiology Group, TechMed Center, University of Twente, Enschede (D.W.D.) - all in the Netherlands
| | - Brigitte Essers
- From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Public Health Research Institute (B.W.), the Cardiovascular Research Institute Maastricht (R.L., J.G.M.), and the School for Nutrition and Translational Research in Metabolism (M.C.G.P.), Maastricht University, Maastricht, the Departments of Cardiothoracic Surgery (G.J.B.B.B.), Intensive Care (M.K.), and Cardiology (R.S.H.), Isala Clinics, Zwolle, the Departments of Intensive Care (L.O.) and Cardiothoracic Surgery (K.Y.L.), Catharina Hospital, Eindhoven, the Departments of Intensive Care (C.V.E.K., J.L.M.), Cardiology (J.M.M.C.), and Emergency Medicine (O.M.), Leiden University Medical Center, Leiden, the Departments of Intensive Care (A.P.J.V.), Cardiothoracic Surgery (A.H.G.D.), Anesthesia (S.E.), and Cardiology (J.H.), Amsterdam University Medical Center, and the Department of Intensive Care, Onze Lieve Vrouwe Gasthuis (B.B., J.M.), Amsterdam, the Departments of Intensive Care (J.J.H., D.W.D.) and Cardiology (S.Z.H.R.), University Medical Center Utrecht, Utrecht, the Department of Intensive Care, St. Antonius Hospital, Nieuwegein (E.S., B.G.H.), the Department of Intensive Care, Erasmus Medical Center (C.U., D.D.R.M., R.J.T., K.C.B., L.M., J.J.H.B.), and the Department of Cardiology, Thorax Center, Erasmus University Medical Center (J.J.H.B.), Rotterdam, the Departments of Intensive Care (T.J., S.A.) and Cardiology (G.B.), Haga Hospital, the Hague, and Cardiovascular and Respiratory Physiology Group, TechMed Center, University of Twente, Enschede (D.W.D.) - all in the Netherlands
| | - Patrick W Weerwind
- From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Public Health Research Institute (B.W.), the Cardiovascular Research Institute Maastricht (R.L., J.G.M.), and the School for Nutrition and Translational Research in Metabolism (M.C.G.P.), Maastricht University, Maastricht, the Departments of Cardiothoracic Surgery (G.J.B.B.B.), Intensive Care (M.K.), and Cardiology (R.S.H.), Isala Clinics, Zwolle, the Departments of Intensive Care (L.O.) and Cardiothoracic Surgery (K.Y.L.), Catharina Hospital, Eindhoven, the Departments of Intensive Care (C.V.E.K., J.L.M.), Cardiology (J.M.M.C.), and Emergency Medicine (O.M.), Leiden University Medical Center, Leiden, the Departments of Intensive Care (A.P.J.V.), Cardiothoracic Surgery (A.H.G.D.), Anesthesia (S.E.), and Cardiology (J.H.), Amsterdam University Medical Center, and the Department of Intensive Care, Onze Lieve Vrouwe Gasthuis (B.B., J.M.), Amsterdam, the Departments of Intensive Care (J.J.H., D.W.D.) and Cardiology (S.Z.H.R.), University Medical Center Utrecht, Utrecht, the Department of Intensive Care, St. Antonius Hospital, Nieuwegein (E.S., B.G.H.), the Department of Intensive Care, Erasmus Medical Center (C.U., D.D.R.M., R.J.T., K.C.B., L.M., J.J.H.B.), and the Department of Cardiology, Thorax Center, Erasmus University Medical Center (J.J.H.B.), Rotterdam, the Departments of Intensive Care (T.J., S.A.) and Cardiology (G.B.), Haga Hospital, the Hague, and Cardiovascular and Respiratory Physiology Group, TechMed Center, University of Twente, Enschede (D.W.D.) - all in the Netherlands
| | - Jos G Maessen
- From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Public Health Research Institute (B.W.), the Cardiovascular Research Institute Maastricht (R.L., J.G.M.), and the School for Nutrition and Translational Research in Metabolism (M.C.G.P.), Maastricht University, Maastricht, the Departments of Cardiothoracic Surgery (G.J.B.B.B.), Intensive Care (M.K.), and Cardiology (R.S.H.), Isala Clinics, Zwolle, the Departments of Intensive Care (L.O.) and Cardiothoracic Surgery (K.Y.L.), Catharina Hospital, Eindhoven, the Departments of Intensive Care (C.V.E.K., J.L.M.), Cardiology (J.M.M.C.), and Emergency Medicine (O.M.), Leiden University Medical Center, Leiden, the Departments of Intensive Care (A.P.J.V.), Cardiothoracic Surgery (A.H.G.D.), Anesthesia (S.E.), and Cardiology (J.H.), Amsterdam University Medical Center, and the Department of Intensive Care, Onze Lieve Vrouwe Gasthuis (B.B., J.M.), Amsterdam, the Departments of Intensive Care (J.J.H., D.W.D.) and Cardiology (S.Z.H.R.), University Medical Center Utrecht, Utrecht, the Department of Intensive Care, St. Antonius Hospital, Nieuwegein (E.S., B.G.H.), the Department of Intensive Care, Erasmus Medical Center (C.U., D.D.R.M., R.J.T., K.C.B., L.M., J.J.H.B.), and the Department of Cardiology, Thorax Center, Erasmus University Medical Center (J.J.H.B.), Rotterdam, the Departments of Intensive Care (T.J., S.A.) and Cardiology (G.B.), Haga Hospital, the Hague, and Cardiovascular and Respiratory Physiology Group, TechMed Center, University of Twente, Enschede (D.W.D.) - all in the Netherlands
| | - Marcel C G van de Poll
- From the Departments of Intensive Care (M.M.S., T.S.R.D., M.E.B., M.C.G.P.), Cardiothoracic Surgery (R.L., P.W.W., J.G.M.), and Clinical Epidemiology and Medical Technical Assessment (B.E.), Maastricht University Medical Center, and the Department of Methodology and Statistics and the Care and Public Health Research Institute (B.W.), the Cardiovascular Research Institute Maastricht (R.L., J.G.M.), and the School for Nutrition and Translational Research in Metabolism (M.C.G.P.), Maastricht University, Maastricht, the Departments of Cardiothoracic Surgery (G.J.B.B.B.), Intensive Care (M.K.), and Cardiology (R.S.H.), Isala Clinics, Zwolle, the Departments of Intensive Care (L.O.) and Cardiothoracic Surgery (K.Y.L.), Catharina Hospital, Eindhoven, the Departments of Intensive Care (C.V.E.K., J.L.M.), Cardiology (J.M.M.C.), and Emergency Medicine (O.M.), Leiden University Medical Center, Leiden, the Departments of Intensive Care (A.P.J.V.), Cardiothoracic Surgery (A.H.G.D.), Anesthesia (S.E.), and Cardiology (J.H.), Amsterdam University Medical Center, and the Department of Intensive Care, Onze Lieve Vrouwe Gasthuis (B.B., J.M.), Amsterdam, the Departments of Intensive Care (J.J.H., D.W.D.) and Cardiology (S.Z.H.R.), University Medical Center Utrecht, Utrecht, the Department of Intensive Care, St. Antonius Hospital, Nieuwegein (E.S., B.G.H.), the Department of Intensive Care, Erasmus Medical Center (C.U., D.D.R.M., R.J.T., K.C.B., L.M., J.J.H.B.), and the Department of Cardiology, Thorax Center, Erasmus University Medical Center (J.J.H.B.), Rotterdam, the Departments of Intensive Care (T.J., S.A.) and Cardiology (G.B.), Haga Hospital, the Hague, and Cardiovascular and Respiratory Physiology Group, TechMed Center, University of Twente, Enschede (D.W.D.) - all in the Netherlands
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3
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Spoormans EM, Lemkes JS, Janssens GN, Soultana O, van der Hoeven NW, Jewbali LSD, Dubois EA, Meuwissen M, Rijpstra TA, Bosker HA, Blans MJ, Bleeker GB, Baak R, Vlachojannis GJ, Eikemans BJW, van der Harst P, van der Horst ICC, Voskuil M, van der Heijden JJ, Beishuizen A, Stoel M, Camaro C, van der Hoeven H, Henriques JP, Vlaar APJ, Vink MA, van den Bogaard B, Heestermans TACM, de Ruijter W, Delnoij TSR, Crijns HJGM, Oemrawsingh PV, Gosselink MTM, Plomp K, Magro M, Elbers PWG, van de Ven PM, van Royen N. Ischaemic electrocardiogram patterns and its association with survival in out-of-hospital cardiac arrest patients without ST-segment elevation myocardial infarction: a COACT trials’ post-hoc subgroup analysis. European Heart Journal. Acute Cardiovascular Care 2022; 11:535-543. [PMID: 35656797 PMCID: PMC9302930 DOI: 10.1093/ehjacc/zuac060] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 05/12/2022] [Accepted: 05/16/2022] [Indexed: 11/25/2022]
Abstract
Aims ST-depression and T-wave inversion are frequently present on the post-resuscitation electrocardiogram (ECG). However, the prognostic value of ischaemic ECG patterns is unknown. Methods and results In this post-hoc subgroup analysis of the Coronary Angiography after Cardiac arrest (COACT) trial, the first in-hospital post-resuscitation ECG in out-of-hospital cardiac arrest patients with a shockable rhythm was analysed for ischaemic ECG patterns. Ischaemia was defined as ST-depression of ≥0.1 mV, T-wave inversion in ≥2 contiguous leads, or both. The primary endpoint was 90-day survival. Secondary endpoints were rate of acute unstable lesions, levels of serum troponin-T, and left ventricular function. Of the 510 out-of-hospital cardiac arrest patients, 340 (66.7%) patients had ischaemic ECG patterns. Patients with ischaemic ECG patterns had a worse 90-day survival compared with those without [hazard ratio 1.51; 95% confidence interval (CI) 1.08–2.12; P = 0.02]. A higher sum of ST-depression was associated with lower survival (log-rank = 0.01). The rate of acute unstable lesions (14.5 vs. 15.8%; odds ratio 0.90; 95% CI 0.51–1.59) did not differ between the groups. In patients with ischaemic ECG patterns, maximum levels of serum troponin-T (μg/L) were higher [0.595 (interquartile range 0.243–1.430) vs. 0.359 (0.159–0.845); ratio of geometric means 1.58; 1.13–2.20] and left ventricular function (%) was worse (44.7 ± 12.5 vs. 49.9 ± 13.3; mean difference −5.13; 95% CI −8.84 to −1.42). Adjusted for age and time to return of spontaneous circulation, ischaemic ECG patterns were no longer associated with survival. Conclusion Post-arrest ischaemic ECG patterns were associated with worse 90-day survival. A higher sum of ST-depression was associated with lower survival. Adjusted for age and time to return of spontaneous circulation, ischaemic ECG patterns were no longer associated with survival.
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Affiliation(s)
- Eva M Spoormans
- Department of Cardiology, Amsterdam University Medical Centre , location VUmc, ZH 5F 19, De Boelelaan 1117, 1081 HV Amsterdam , The Netherlands
| | - Jorrit S Lemkes
- Department of Cardiology, Amsterdam University Medical Centre , location VUmc, ZH 5F 19, De Boelelaan 1117, 1081 HV Amsterdam , The Netherlands
| | - Gladys N Janssens
- Department of Cardiology, Amsterdam University Medical Centre , location VUmc, ZH 5F 19, De Boelelaan 1117, 1081 HV Amsterdam , The Netherlands
| | - Ouissal Soultana
- Department of Cardiology, Amsterdam University Medical Centre , location VUmc, ZH 5F 19, De Boelelaan 1117, 1081 HV Amsterdam , The Netherlands
| | - Nina W van der Hoeven
- Department of Cardiology, Amsterdam University Medical Centre , location VUmc, ZH 5F 19, De Boelelaan 1117, 1081 HV Amsterdam , The Netherlands
| | - Lucia S D Jewbali
- Department of Cardiology, Erasmus Medical Centre , Rotterdam , The Netherlands
| | - Eric A Dubois
- Department of Cardiology, Erasmus Medical Centre , Rotterdam , The Netherlands
- Department of Intensive Care Medicine, Erasmus Medical Centre , Rotterdam , The Netherlands
| | | | - Tom A Rijpstra
- Department of Intensive Care Medicine, Amphia Hospital , Breda , The Netherlands
| | - Hans A Bosker
- Department of Cardiology, Rijnstate Hospital , Arnhem , The Netherlands
| | - Michiel J Blans
- Department of Intensive Care Medicine, Rijnstate Hospital , Arnhem , The Netherlands
| | - Gabe B Bleeker
- Department of Cardiology, HAGA Hospital , Den Haag , The Netherlands
| | - Remon Baak
- Department of Intensive Care Medicine, HAGA Hospital , Den Haag , The Netherlands
| | - Georgios J Vlachojannis
- Department of Cardiology, Maasstad Hospital , Rotterdam , The Netherlands
- Department of Cardiology, University Medical Centre Utrecht , Utrecht , The Netherlands
| | - Bob J W Eikemans
- Department of Intensive Care Medicine, Maasstad Hospital , Rotterdam , The Netherlands
| | - Pim van der Harst
- Department of Cardiology, University Medical Centre Utrecht , Utrecht , The Netherlands
- Department of Cardiology, University of Groningen, University Medical Centre Groningen , Groningen , The Netherlands
| | - Iwan C C van der Horst
- Department of Intensive Care Medicine, University of Groningen, University Medical Centre Groningen , Groningen , The Netherlands
- Department of Intensive Care Medicine, Maastricht University Medical Centre, University Maastricht , Maastricht , The Netherlands
| | - Michiel Voskuil
- Department of Cardiology, University Medical Centre Utrecht , Utrecht , The Netherlands
| | - Joris J van der Heijden
- Department of Intensive Care Medicine, University Medical Centre Utrecht , Utrecht , The Netherlands
| | | | - Martin Stoel
- Department of Cardiology, Medisch Spectrum Twente , Enschede , The Netherlands
| | - Cyril Camaro
- Department of Cardiology, Radboud University Medical Centre , Nijmegen , The Netherlands
| | - Hans van der Hoeven
- Department of Intensive Care Medicine, Radboud University Medical Centre , Nijmegen , The Netherlands
| | - José P Henriques
- Department of Cardiology, Amsterdam University Medical Centre , location AMC, Amsterdam , The Netherlands
| | - Alexander P J Vlaar
- Department of Intensive Care Medicine, Amsterdam University Medical Centre , location AMC, Amsterdam , The Netherlands
| | - Maarten A Vink
- Department of Cardiology, OLVG , Amsterdam , The Netherlands
| | | | | | - Wouter de Ruijter
- Department of Intensive Care Medicine, Noord West Ziekenhuisgroep , Alkmaar , The Netherlands
| | - Thijs S R Delnoij
- Department of Intensive Care Medicine, Maastricht University Medical Centre, University Maastricht , Maastricht , The Netherlands
| | - Harry J G M Crijns
- Department of Cardiology, Maastricht University Medical Centre , Maastricht , The Netherlands
| | | | | | - Koos Plomp
- Department of Cardiology, Tergooi Hospital , Blaricum , The Netherlands
| | - Michael Magro
- Department of Cardiology, Elisabeth-Tweesteden Hospital , Tilburg , The Netherlands
| | - Paul W G Elbers
- Department of Intensive care medicine, Amsterdam University Medical Centre , location VUmc, Amsterdam , The Netherlands
| | - Peter M van de Ven
- Department of Epidemiology and Data Science, Amsterdam University Medical Centre , location VUmc, Amsterdam , The Netherlands
| | - Niels van Royen
- Department of Cardiology, Amsterdam University Medical Centre , location VUmc, ZH 5F 19, De Boelelaan 1117, 1081 HV Amsterdam , The Netherlands
- Department of Cardiology, Radboud University Medical Centre , Nijmegen , The Netherlands
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4
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Camaro C, Bonnes JL, Adang EM, Spoormans EM, Janssens GN, van der Hoeven NW, Jewbali LS, Dubois EA, Meuwissen M, Rijpstra TA, Bosker HA, Blans MJ, Bleeker GB, Baak R, Vlachojannis GJ, Eikemans BJ, van der Harst P, van der Horst IC, Voskuil M, van der Heijden JJ, Beishuizen B, Stoel M, van der Hoeven H, Henriques JP, Vlaar AP, Vink MA, van den Bogaard B, Heestermans TA, de Ruijter W, Delnoij TS, Crijns HJ, Jessurun GA, Oemrawsingh PV, Gosselink MT, Plomp K, Magro M, Elbers PW, van de Ven PM, Lemkes JS, van Royen N. Cost Analysis From a Randomized Comparison of Immediate Versus Delayed Angiography After Cardiac Arrest. J Am Heart Assoc 2022; 11:e022238. [PMID: 35195012 PMCID: PMC9075079 DOI: 10.1161/jaha.121.022238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background In patients with out-of-hospital cardiac arrest without ST-segment elevation, immediate coronary angiography did not improve clinical outcomes when compared with delayed angiography in the COACT (Coronary Angiography After Cardiac Arrest) trial. Whether 1 of the 2 strategies has benefits in terms of health care resource use and costs is currently unknown. We assess the health care resource use and costs in patients with out-of-hospital cardiac arrest. Methods and Results A total of 538 patients were randomly assigned to a strategy of either immediate or delayed coronary angiography. Detailed health care resource use and cost-prices were collected from the initial hospital episode. A generalized linear model and a gamma distribution were performed. Generic quality of life was measured with the RAND-36 and collected at 12-month follow-up. Overall total mean costs were similar between both groups (EUR 33 575±19 612 versus EUR 33 880±21 044; P=0.86). Generalized linear model: (β, 0.991; 95% CI, 0.894-1.099; P=0.86). Mean procedural costs (coronary angiography and percutaneous coronary intervention, coronary artery bypass graft) were higher in the immediate angiography group (EUR 4384±3447 versus EUR 3028±4220; P<0.001). Costs concerning intensive care unit and ward stay did not show any significant difference. The RAND-36 questionnaire did not differ between both groups. Conclusions The mean total costs between patients with out-of-hospital cardiac arrest randomly assigned to an immediate angiography or a delayed invasive strategy were similar during the initial hospital stay. With respect to the higher invasive procedure costs in the immediate group, a strategy awaiting neurological recovery followed by coronary angiography and planned revascularization may be considered. Registration URL: https://trialregister.nl; Unique identifier: NL4857.
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5
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van der Boon RMA, den Dekker WK, Meuwese CL, Lorusso R, von der Thüsen JH, Constantinescu AC, Manintveld OC, Delnoij TSR, van der Heijden JJ, van Mieghem NMDA, den Uil CA. Safety of Endomyocardial Biopsy in New-Onset Acute Heart Failure Requiring Veno-Arterial Extracorporeal Membrane Oxygenation. Circ Heart Fail 2021; 14:e008387. [PMID: 34344163 DOI: 10.1161/circheartfailure.121.008387] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 11/16/2022]
Abstract
BACKGROUND Endomyocardial biopsy (EMB) has an important role in determining the pathogenesis of new-onset acute heart failure (new-AHF) when noninvasive testing is impossible. However, data on safety and histopathologic outcomes in patients requiring veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is lacking. METHODS A retrospective, multicenter cohort of patients undergoing EMB while requiring VA-ECMO for new-AHF between 1990 and 2020 was compared with a cohort of nontransplant related biopsies not requiring VA-ECMO. Primary end point of the study was to determine the safety of EMB. Additionally, we describe the underlying pathogenesis causing new-AHF based on histopathologic examination of the samples obtained. RESULTS A total of 23 patients underwent EMB while requiring VA-ECMO (10.0%), 125 (54.3%) during an unplanned admission, and 82 (35.7%) in elective setting. Major complications occurred in 8.3% of all procedures with a significantly higher rate in patients requiring VA-ECMO (26.1% versus 8.0% versus 3.7%, P=0.003) predominately due to the occurrence of sustained ventricular tachycardia or need of resuscitation (13.0% versus 3.2% versus 1.2%, P=0.02). EMB led to a histopathologic diagnosis in 78.3% of the patients requiring VA-ECMO which consisted primarily of patients with myocarditis (73.9%). CONCLUSIONS EMB in patients requiring VA-ECMO can be performed albeit with a substantial risk of major complications. The risk of the procedure was offset by a histopathologic diagnosis in 78.3% of the patients, which for the majority consisted of patients with myocarditis. The important therapeutic and prognostic implications of establishing an underlying pathogenesis causing new-AHF in this population warrant further refinement to improve procedural safety.
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Affiliation(s)
- Robert M A van der Boon
- Department of Cardiology (R.M.A.v.d.B., W.K.d.D., A.C.C., O.C.M., N.M.D.A.v.M., C.d.U.), Erasmus Medical Center Rotterdam, the Netherlands
| | - Wijnand K den Dekker
- Department of Cardiology (R.M.A.v.d.B., W.K.d.D., A.C.C., O.C.M., N.M.D.A.v.M., C.d.U.), Erasmus Medical Center Rotterdam, the Netherlands
| | - Christiaan L Meuwese
- Department of Intensive Care (C.d.U., C.L.M.), Erasmus Medical Center Rotterdam, the Netherlands.,Department of Cardiology and Intensive Care, Utrecht Medical Center, the Netherlands (C.L.M., J.J.v.d.H.)
| | - Roberto Lorusso
- Department of Cardiology and Intensive Care, Maastricht University Medical Center, the Netherlands (R.L., T.S.R.D.)
| | - Jan H von der Thüsen
- Department of Pathology (J.H.v.d.T.), Erasmus Medical Center Rotterdam, the Netherlands
| | - Alina C Constantinescu
- Department of Cardiology (R.M.A.v.d.B., W.K.d.D., A.C.C., O.C.M., N.M.D.A.v.M., C.d.U.), Erasmus Medical Center Rotterdam, the Netherlands
| | - Olivier C Manintveld
- Department of Cardiology (R.M.A.v.d.B., W.K.d.D., A.C.C., O.C.M., N.M.D.A.v.M., C.d.U.), Erasmus Medical Center Rotterdam, the Netherlands
| | - Thijs S R Delnoij
- Department of Cardiology and Intensive Care, Maastricht University Medical Center, the Netherlands (R.L., T.S.R.D.)
| | - Joris J van der Heijden
- Department of Cardiology and Intensive Care, Utrecht Medical Center, the Netherlands (C.L.M., J.J.v.d.H.)
| | - Nicolas M D A van Mieghem
- Department of Cardiology (R.M.A.v.d.B., W.K.d.D., A.C.C., O.C.M., N.M.D.A.v.M., C.d.U.), Erasmus Medical Center Rotterdam, the Netherlands
| | - Corstiaan A den Uil
- Department of Cardiology (R.M.A.v.d.B., W.K.d.D., A.C.C., O.C.M., N.M.D.A.v.M., C.d.U.), Erasmus Medical Center Rotterdam, the Netherlands.,Department of Intensive Care (C.d.U., C.L.M.), Erasmus Medical Center Rotterdam, the Netherlands.,Department of Intensive Care, Maasstad Hospital, Rotterdam, the Netherlands (C.d.U.)
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6
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Lemkes JS, Spoormans EM, Demirkiran A, Leutscher S, Janssens GN, van der Hoeven NW, Jewbali LSD, Dubois EA, Meuwissen M, Rijpstra TA, Bosker HA, Blans MJ, Bleeker GB, Baak R, Vlachojannis GJ, Eikemans BJW, van der Harst P, van der Horst ICC, Voskuil M, van der Heijden JJ, Beishuizen A, Stoel M, Camaro C, van der Hoeven H, Henriques JP, Vlaar APJ, Vink MA, van den Bogaard B, Heestermans TACM, de Ruijter W, Delnoij TSR, Crijns HJGM, Jessurun GAJ, Oemrawsingh PV, Gosselink MTM, Plomp K, Magro M, Elbers PWG, van de Ven PM, van Loon RB, van Royen N. The effect of immediate coronary angiography after cardiac arrest without ST-segment elevation on left ventricular function. A sub-study of the COACT randomised trial. Resuscitation 2021; 164:93-100. [PMID: 33932485 DOI: 10.1016/j.resuscitation.2021.04.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 01/22/2021] [Revised: 04/09/2021] [Accepted: 04/19/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND The effect of immediate coronary angiography and percutaneous coronary intervention (PCI) in patients who are successfully resuscitated after cardiac arrest in the absence of ST-segment elevation myocardial infarction (STEMI) on left ventricular function is currently unknown. METHODS This prespecified sub-study of a multicentre trial evaluated 552 patients, successfully resuscitated from out-of-hospital cardiac arrest without signs of STEMI. Patients were randomized to either undergo immediate coronary angiography or delayed coronary angiography, after neurologic recovery. All patients underwent PCI if indicated. The main outcomes of this analysis were left ventricular ejection fraction and end-diastolic and systolic volumes assessed by cardiac magnetic resonance imaging or echocardiography. RESULTS Data on left ventricular function was available for 397 patients. The mean (± standard deviation) left ventricular ejection fraction was 45.2% (±12.8) in the immediate angiography group and 48.4% (±13.2) in the delayed angiography group (mean difference: -3.19; 95% confidence interval [CI], -6.75 to 0.37). Median left ventricular end-diastolic volume was 177 ml in the immediate angiography group compared to 169 ml in the delayed angiography group (ratio of geometric means: 1.06; 95% CI, 0.95-1.19). In addition, mean left ventricular end-systolic volume was 90 ml in the immediate angiography group compared to 78 ml in the delayed angiography group (ratio of geometric means: 1.13; 95% CI 0.97-1.32). CONCLUSION In patients successfully resuscitated after out-of-hospital cardiac arrest and without signs of STEMI, immediate coronary angiography was not found to improve left ventricular dimensions or function compared with a delayed angiography strategy. CLINICAL TRIAL REGISTRATION Netherlands Trial Register number, NTR4973.
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Affiliation(s)
- Jorrit S Lemkes
- Department of Cardiology, Amsterdam University Medical Centre, Location VUmc, Amsterdam, The Netherlands.
| | - Eva M Spoormans
- Department of Cardiology, Amsterdam University Medical Centre, Location VUmc, Amsterdam, The Netherlands
| | - Ahmet Demirkiran
- Department of Cardiology, Amsterdam University Medical Centre, Location VUmc, Amsterdam, The Netherlands
| | - Sophie Leutscher
- Department of Cardiology, Amsterdam University Medical Centre, Location VUmc, Amsterdam, The Netherlands
| | - Gladys N Janssens
- Department of Cardiology, Amsterdam University Medical Centre, Location VUmc, Amsterdam, The Netherlands
| | - Nina W van der Hoeven
- Department of Cardiology, Amsterdam University Medical Centre, Location VUmc, Amsterdam, The Netherlands
| | - Lucia S D Jewbali
- Department of Cardiology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Eric A Dubois
- Department of Cardiology, Erasmus Medical Centre, Rotterdam, The Netherlands; Department of Intensive Care Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands
| | | | - Tom A Rijpstra
- Department of Intensive Care Medicine, Amphia Hospital, Breda, The Netherlands
| | - Hans A Bosker
- Department of Cardiology, Rijnstate Hospital, Arnhem, The Netherlands
| | - Michiel J Blans
- Department of Intensive Care Medicine, Rijnstate Hospital, Arnhem, The Netherlands
| | - Gabe B Bleeker
- Department of Cardiology, HAGA Hospital, Den Haag, The Netherlands
| | - Rémon Baak
- Department of Intensive Care Medicine, HAGA Hospital, Den Haag, The Netherlands
| | - Georgios J Vlachojannis
- Department of Cardiology, Maasstad Hospital, Rotterdam, The Netherlands; Department of Cardiology, University Medical Centre Utrecht, The Netherlands
| | - Bob J W Eikemans
- Department of Intensive Care Medicine, Maasstad Hospital, Rotterdam, The Netherlands
| | - Pim van der Harst
- University of Groningen, University Medical Centre Groningen, Department of Cardiology, Groningen, The Netherlands; Department of Cardiology, University Medical Centre Utrecht, The Netherlands
| | - Iwan C C van der Horst
- University of Groningen, University Medical Centre Groningen, Department of Intensive Care Medicine, Groningen, The Netherlands; Department of Intensive Care Medicine, Maastricht University Medical Centre, University Maastricht, Maastricht, The Netherlands
| | - Michiel Voskuil
- Department of Cardiology, University Medical Centre Utrecht, The Netherlands
| | | | - Albertus Beishuizen
- Department of Intensive Care Medicine, Medisch Spectrum Twente, Enschede, The Netherlands
| | - Martin Stoel
- Department of Cardiology, Medisch Spectrum Twente, Enschede, The Netherlands
| | - Cyril Camaro
- Department of Cardiology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Hans van der Hoeven
- Department of Intensive Care Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - José P Henriques
- Department of Cardiology, Amsterdam University Medical Centre, Location AMC, Amsterdam, The Netherlands
| | - Alexander P J Vlaar
- Department of Intensive Care Medicine, Amsterdam University Medical Centre, Location AMC, Amsterdam, The Netherlands
| | - Maarten A Vink
- Department of Cardiology, OLVG, Amsterdam, The Netherlands
| | | | | | - Wouter de Ruijter
- Department of Intensive care medicine, Noord West Ziekenhuisgroep, Alkmaar, The Netherlands
| | - Thijs S R Delnoij
- Department of Intensive Care Medicine, Maastricht University Medical Centre, University Maastricht, Maastricht, The Netherlands
| | - Harry J G M Crijns
- Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | | | | | | | - Koos Plomp
- Department of Cardiology, Ter Gooi Hospital, Blaricum, The Netherlands
| | - Michael Magro
- Department of Cardiology, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands
| | - Paul W G Elbers
- Department of Intensive Care Medicine, Amsterdam University Medical Centre, Location VUmc, Amsterdam, The Netherlands
| | - Peter M van de Ven
- Department of Epidemiology and Data Science, Amsterdam University Medical Centre, Location VUmc, Amsterdam, The Netherlands
| | - Ramon B van Loon
- Department of Cardiology, Amsterdam University Medical Centre, Location VUmc, Amsterdam, The Netherlands
| | - Niels van Royen
- Department of Cardiology, Amsterdam University Medical Centre, Location VUmc, Amsterdam, The Netherlands; Department of Cardiology, Radboud University Medical Centre, Nijmegen, The Netherlands
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7
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Spoormans EM, Lemkes JS, Janssens GN, van der Hoeven NW, Jewbali LSD, Dubois EA, van de Ven PM, Meuwissen M, Rijpstra TA, Bosker HA, Blans MJ, Bleeker GB, Baak R, Vlachojannis GJ, Eikemans BJW, van der Harst P, van der Horst ICC, Voskuil M, van der Heijden JJ, Beishuizen A, Stoel M, Camaro C, van der Hoeven H, Henriques JP, Vlaar APJ, Vink MA, van den Bogaard B, Heestermans TACM, de Ruijter W, Delnoij TSR, Crijns HJGM, Jessurun GAJ, Oemrawsingh PV, Gosselink MTM, Plomp K, Magro M, Elbers PWG, Appelman Y, van Royen N. Data on sex differences in one-year outcomes of out-of-hospital cardiac arrest patients without ST-segment elevation. Data Brief 2020; 33:106521. [PMID: 33294518 PMCID: PMC7691722 DOI: 10.1016/j.dib.2020.106521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 11/09/2020] [Indexed: 11/25/2022] Open
Abstract
Sex differences in out-of-hospital cardiac arrest (OHCA) patients are increasingly recognized. Although it has been found that post-resuscitated women are less likely to have significant coronary artery disease (CAD) than men, data on follow-up in these patients are limited. Data for this data in brief article was obtained as a part of the randomized controlled Coronary Angiography after Cardiac Arrest without ST-segment elevation (COACT) trial. The data supplements the manuscript “Sex differences in out-of-hospital cardiac arrest patients without ST-segment elevation: A COACT trial substudy” were it was found that women were less likely to have significant CAD including chronic total occlusions, and had worse survival when CAD was present. The dataset presented in this paper describes sex differences on interventions, implantable-cardioverter defibrillator (ICD) shocks and hospitalizations due to heart failure during one-year follow-up in patients successfully resuscitated after OHCA. Data was derived through a telephone interview at one year with the patient or general practitioner. Patients in this randomized dataset reflects a homogenous study population, which can be valuable to further build on research regarding long-term sex differences and to further improve cardiac care.
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Affiliation(s)
- Eva M Spoormans
- Department of Cardiology, Amsterdam University Medical Center, location VUmc, Amsterdam, the Netherlands
| | - Jorrit S Lemkes
- Department of Cardiology, Amsterdam University Medical Center, location VUmc, Amsterdam, the Netherlands
| | - Gladys N Janssens
- Department of Cardiology, Amsterdam University Medical Center, location VUmc, Amsterdam, the Netherlands
| | - Nina W van der Hoeven
- Department of Cardiology, Amsterdam University Medical Center, location VUmc, Amsterdam, the Netherlands
| | | | - Eric A Dubois
- Thorax Center, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Peter M van de Ven
- Department of Epidemiology and Data Science, Amsterdam University Medical Center, location VUmc, Amsterdam, the Netherlands
| | | | - Tom A Rijpstra
- Department of Intensive care medicine, Amphia Hospital, Breda, the Netherlands
| | - Hans A Bosker
- Department of Cardiology, Rijnstate Hospital, Arnhem, the Netherlands
| | - Michiel J Blans
- Department of Intensive care medicine, Rijnstate Hospital, Arnhem, the Netherlands
| | - Gabe B Bleeker
- Department of Cardiology, HAGA Hospital, Den Haag, the Netherlands
| | - Remon Baak
- Department of Intensive care medicine, HAGA Hospital, Den Haag, the Netherlands
| | - Georgios J Vlachojannis
- Department of Cardiology, Maasstad Hospital, Rotterdam, the Netherlands.,Department of Cardiology, University Medical Center Utrecht, the Netherlands
| | - Bob J W Eikemans
- Department of Intensive care medicine, Maasstad Hospital, Rotterdam, the Netherlands
| | - Pim van der Harst
- University of Groningen, University Medical Center Groningen, Department of Cardiology, Groningen, the Netherlands.,Department of Intensive care medicine, Medisch Spectrum Twente, Enschede, The Netherlands
| | - Iwan C C van der Horst
- University of Groningen, University Medical Center Groningen, Department of Intensive care medicine, Groningen, the Netherlands.,Department of Intensive care medicine, Maastricht University Medical Center, University Maastricht, Maastricht, the Netherlands
| | - Michiel Voskuil
- Department of Cardiology, University Medical Center Utrecht, the Netherlands
| | | | - Albertus Beishuizen
- Department of Intensive care medicine, Medisch Spectrum Twente, Enschede, The Netherlands
| | - Martin Stoel
- Department of Cardiology, Medisch Spectrum Twente, Enschede, The Netherlands
| | - Cyril Camaro
- Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Hans van der Hoeven
- Department of Intensive care medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - José P Henriques
- Department of Cardiology, Amsterdam University Medical Center, location AMC, Amsterdam, the Netherlands
| | - Alexander P J Vlaar
- Department of Intensive care medicine, Amsterdam University Medical Center, location AMC, Amsterdam, the Netherlands
| | - Maarten A Vink
- Department of Cardiology, OLVG, Amsterdam, the Netherlands
| | | | | | - Wouter de Ruijter
- Department of Intensive care medicine, Noord West Ziekenhuisgroep, Alkmaar, the Netherlands
| | - Thijs S R Delnoij
- Department of Intensive care medicine, Maastricht University Medical Center, University Maastricht, Maastricht, the Netherlands
| | - Harry J G M Crijns
- Department of Cardiology, Maastricht University Medical Center, Maastricht, the Netherlands
| | | | | | | | - Koos Plomp
- Department of Cardiology, Tergooi Hospital, Blaricum, the Netherlands
| | - Michael Magro
- Department of Cardiology, Elisabeth-Tweesteden Hospital, Tilburg, the Netherlands
| | - Paul W G Elbers
- Department of Intensive care medicine, Amsterdam University Medical Center, location VUmc, Amsterdam, the Netherlands
| | - Yolande Appelman
- Department of Cardiology, Amsterdam University Medical Center, location VUmc, Amsterdam, the Netherlands
| | - Niels van Royen
- Department of Cardiology, Amsterdam University Medical Center, location VUmc, Amsterdam, the Netherlands.,Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands
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8
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Lemkes JS, Janssens GN, van der Hoeven NW, Jewbali LSD, Dubois EA, Meuwissen MM, Rijpstra TA, Bosker HA, Blans MJ, Bleeker GB, Baak RR, Vlachojannis GJ, Eikemans BJW, van der Harst P, van der Horst ICC, Voskuil M, van der Heijden JJ, Beishuizen A, Stoel M, Camaro C, van der Hoeven H, Henriques JP, Vlaar APJ, Vink MA, van den Bogaard B, Heestermans TACM, de Ruijter W, Delnoij TSR, Crijns HJGM, Jessurun GAJ, Oemrawsingh PV, Gosselink MTM, Plomp K, Magro M, Elbers PWG, Spoormans EM, van de Ven PM, Oudemans-van Straaten HM, van Royen N. Coronary Angiography After Cardiac Arrest Without ST Segment Elevation: One-Year Outcomes of the COACT Randomized Clinical Trial. JAMA Cardiol 2020; 5:1358-1365. [PMID: 32876654 DOI: 10.1001/jamacardio.2020.3670] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [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: 01/10/2023]
Abstract
Importance Ischemic heart disease is a common cause of cardiac arrest. However, randomized data on long-term clinical outcomes of immediate coronary angiography and percutaneous coronary intervention (PCI) in patients successfully resuscitated from cardiac arrest in the absence of ST segment elevation myocardial infarction (STEMI) are lacking. Objective To determine whether immediate coronary angiography improves clinical outcomes at 1 year in patients after cardiac arrest without signs of STEMI, compared with a delayed coronary angiography strategy. Design, Setting, and Participants A prespecified analysis of a multicenter, open-label, randomized clinical trial evaluated 552 patients who were enrolled in 19 Dutch centers between January 8, 2015, and July 17, 2018. The study included patients who experienced out-of-hospital cardiac arrest with a shockable rhythm who were successfully resuscitated without signs of STEMI. Follow-up was performed at 1 year. Data were analyzed, using the intention-to-treat principle, between August 29 and October 10, 2019. Interventions Immediate coronary angiography and PCI if indicated or coronary angiography and PCI if indicated, delayed until after neurologic recovery. Main Outcomes and Measures Survival, myocardial infarction, revascularization, implantable cardiac defibrillator shock, quality of life, hospitalization for heart failure, and the composite of death or myocardial infarction or revascularization after 1 year. Results At 1 year, data on 522 of 552 patients (94.6%) were available for analysis. Of these patients, 413 were men (79.1%); mean (SD) age was 65.4 (12.3) years. A total of 162 of 264 patients (61.4%) in the immediate angiography group and 165 of 258 patients (64.0%) in the delayed angiography group were alive (odds ratio, 0.90; 95% CI, 0.63-1.28). The composite end point of death, myocardial infarction, or repeated revascularization since the index hospitalization was met in 112 patients (42.9%) in the immediate group and 104 patients (40.6%) in the delayed group (odds ratio, 1.10; 95% CI, 0.77-1.56). No significant differences between the groups were observed for the other outcomes at 1-year follow-up. For example, the rate of ICD shocks was 20.4% in the immediate group and 16.2% in the delayed group (odds ratio, 1.32; 95% CI, 0.66-2.64). Conclusions and Relevance In this trial of patients successfully resuscitated after out-of-hospital cardiac arrest and without signs of STEMI, a strategy of immediate angiography was not found to be superior to a strategy of delayed angiography with respect to clinical outcomes at 1 year. Coronary angiography in this patient group can therefore be delayed until after neurologic recovery without affecting outcomes. Trial Registration trialregister.nl Identifier: NTR4973.
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Affiliation(s)
- Jorrit S Lemkes
- Department of Cardiology, Amsterdam University Medical Center, location VUmc, Amsterdam, the Netherlands
| | - Gladys N Janssens
- Department of Cardiology, Amsterdam University Medical Center, location VUmc, Amsterdam, the Netherlands
| | - Nina W van der Hoeven
- Department of Cardiology, Amsterdam University Medical Center, location VUmc, Amsterdam, the Netherlands
| | | | - Eric A Dubois
- Thorax Center, Erasmus Medical Center, Rotterdam, the Netherlands
| | | | - Topm A Rijpstra
- Department of Intensive Care Medicine, Amphia Hospital, Breda, the Netherlands
| | - Hans A Bosker
- Department of Cardiology, Rijnstate Hospital, Arnhem, the Netherlands
| | - Michiel J Blans
- Department of Intensive Care Medicine, Rijnstate Hospital, Arnhem, the Netherlands
| | - Gabe B Bleeker
- Department of Cardiology, HAGA Hospital, Den Haag, the Netherlands
| | - Remon R Baak
- Department of Intensive care medicine, HAGA Hospital, Den Haag, the Netherlands
| | | | - Bob J W Eikemans
- Department of Intensive Care Medicine, Maasstad Hospital, Rotterdam, the Netherlands
| | - Pim van der Harst
- Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.,Department of Intensive Care Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Iwan C C van der Horst
- Department of Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands.,Department of Intensive Care Medicine, Maastricht University Medical Center, University Maastricht, Maastricht, the Netherlands
| | - Michiel Voskuil
- Department of Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Joris J van der Heijden
- Department of Intensive Care Medicine, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Albertus Beishuizen
- Department of Intensive Care Medicine, Medisch Spectrum Twente, Enschede, the Netherlands
| | - Martin Stoel
- Department of Cardiology, Medisch Spectrum Twente, Enschede, the Netherlands
| | - Cyril Camaro
- Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Hans van der Hoeven
- Department of Intensive Care Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Jose P Henriques
- Department of Cardiology, Amsterdam University Medical Center, location AMC, Amsterdam, the Netherlands
| | - Alexander P J Vlaar
- Department of Intensive Care Medicine, Amsterdam University Medical Center, location AMC, Amsterdam, the Netherlands
| | - Maarten A Vink
- Department of Cardiology, OLVG, Amsterdam, the Netherlands
| | | | | | - Wouter de Ruijter
- Department of Intensive Care Medicine, Noord West Ziekenhuisgroep, Alkmaar, the Netherlands
| | - Thijs S R Delnoij
- Department of Intensive Care Medicine, Maastricht University Medical Center, University Maastricht, Maastricht, the Netherlands
| | - Harry J G M Crijns
- Department of Cardiology, Maastricht University Medical Center, Maastricht, the Netherlands
| | | | | | | | - Koos Plomp
- Department of Cardiology, Ter Gooi Hospital, Blaricum, the Netherlands
| | - Michael Magro
- Department of Cardiology, Elisabeth-Tweesteden Hospital, Tilburg, the Netherlands
| | - Paul W G Elbers
- Department of Intensive Care Medicine, Amsterdam University Medical Center, location VUmc, Amsterdam, the Netherlands
| | - Eva M Spoormans
- Department of Cardiology, Amsterdam University Medical Center, location VUmc, Amsterdam, the Netherlands
| | - Peter M van de Ven
- Department of Epidemiology and Biostatistics, Amsterdam University Medical Center, location VUmc, Amsterdam, the Netherlands
| | | | - Niels van Royen
- Department of Cardiology, Amsterdam University Medical Center, location VUmc, Amsterdam, the Netherlands.,Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands
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9
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Spoormans EM, Lemkes JS, Janssens GN, van der Hoeven NW, Jewbali LSD, Dubois EA, van de Ven PM, Meuwissen M, Rijpstra TA, Bosker HA, Blans MJ, Bleeker GB, Baak R, Vlachojannis GJ, Eikemans BJW, der Harst PV, van der Horst ICC, Voskuil M, van der Heijden JJ, Beishuizen A, Stoel M, Camaro C, van der Hoeven H, Henriques JP, Vlaar APJ, Vink MA, van den Bogaard B, Heestermans TACM, de Ruijter W, Delnoij TSR, Crijns HJGM, Jessurun GAJ, Oemrawsingh PV, Gosselink MTM, Plomp K, Magro M, Elbers PWG, Appelman Y, van Royen N. Sex differences in patients with out-of-hospital cardiac arrest without ST-segment elevation: A COACT trial substudy. Resuscitation 2020; 158:14-22. [PMID: 33189807 DOI: 10.1016/j.resuscitation.2020.10.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 08/24/2020] [Revised: 10/09/2020] [Accepted: 10/16/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Whether sex is associated with outcomes of out-of-hospital cardiac arrest (OHCA) is unclear. OBJECTIVES This study examined sex differences in survival in patients with OHCA without ST-segment elevation myocardial infarction (STEMI). METHODS Using data from the randomized controlled Coronary Angiography after Cardiac Arrest (COACT) trial, the primary point of interest was sex differences in OHCA-related one-year survival. Secondary points of interest included the benefit of immediate coronary angiography compared to delayed angiography until after neurologic recovery, angiographic and clinical outcomes. RESULTS In total, 522 patients (79.1% men) were included. Overall one-year survival was 59.6% in women and 63.4% in men (HR 1.18; 95% CI: 0.76-1.81;p = 0.47). No cardiovascular risk factors were found that modified survival. Women less often had significant coronary artery disease (CAD) (37.0% vs. 71.3%;p < 0.001), but when present, they had a worse prognosis than women without CAD (HR 3.06; 95% CI 1.31-7.19;p = 0.01). This was not the case for men (HR 1.05; 95% CI 0.67-1.65;p = 0.83). In both sexes, immediate coronary angiography did not improve one-year survival compared to delayed angiography (women, odds ratio (OR) 0.87; 95% CI 0.58-1.30;p = 0.49; vs. men, OR 0.97; 95% CI 0.45-2.09;p = 0.93). CONCLUSION In OHCA patients without STEMI, we found no sex differences in overall one-year survival. Women less often had significant CAD, but when CAD was present they had worse survival than women without CAD. This was not the case for men. Both sexes did not benefit from a strategy of immediate coronary angiography as compared to delayed strategy with respect to one-year survival. CLINICAL TRIAL REGISTRATION NUMBER Netherlands trial register (NTR) 4973.
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Affiliation(s)
- Eva M Spoormans
- Department of Cardiology, Amsterdam University Medical Centre, location VUmc, Amsterdam, the Netherlands
| | - Jorrit S Lemkes
- Department of Cardiology, Amsterdam University Medical Centre, location VUmc, Amsterdam, the Netherlands.
| | - Gladys N Janssens
- Department of Cardiology, Amsterdam University Medical Centre, location VUmc, Amsterdam, the Netherlands
| | - Nina W van der Hoeven
- Department of Cardiology, Amsterdam University Medical Centre, location VUmc, Amsterdam, the Netherlands
| | | | - Eric A Dubois
- Thorax Centre, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Peter M van de Ven
- Department of Epidemiology and Data Science, Amsterdam University Medical Centre, location VUmc, Amsterdam, the Netherlands
| | | | - Tom A Rijpstra
- Department of Intensive care medicine, Amphia Hospital, Breda, the Netherlands
| | - Hans A Bosker
- Department of Cardiology, Rijnstate Hospital, Arnhem, the Netherlands
| | - Michiel J Blans
- Department of Intensive care medicine, Rijnstate Hospital, Arnhem, the Netherlands
| | - Gabe B Bleeker
- Department of Cardiology, HAGA Hospital, Den Haag, the Netherlands
| | - Remon Baak
- Department of Intensive care medicine, HAGA Hospital, Den Haag, the Netherlands
| | - Georgios J Vlachojannis
- Department of Cardiology, Maasstad Hospital, Rotterdam, the Netherlands; Department of Cardiology, University Medical Centre Utrecht, the Netherlands
| | - Bob J W Eikemans
- Department of Intensive care medicine, Maasstad Hospital, Rotterdam, the Netherlands
| | - Pim van der Harst
- University of Groningen, University Medical Centre Groningen, Department of Cardiology, Groningen, the Netherlands; Department of Cardiology, University Medical Centre Utrecht, the Netherlands
| | - Iwan C C van der Horst
- University of Groningen, University Medical Centre Groningen, Department of Intensive care medicine, Groningen, the Netherlands; Department of Intensive care medicine, Maastricht University Medical Centre, University Maastricht, Maastricht, the Netherlands
| | - Michiel Voskuil
- Department of Cardiology, University Medical Centre Utrecht, the Netherlands
| | | | - Albertus Beishuizen
- Department of Intensive care medicine, Medisch Spectrum Twente, Enschede, The Netherlands
| | - Martin Stoel
- Department of Cardiology, Medisch Spectrum Twente, Enschede, The Netherlands
| | - Cyril Camaro
- Department of Cardiology, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Hans van der Hoeven
- Department of Intensive care medicine, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - José P Henriques
- Department of Cardiology, Amsterdam University Medical Centre, location AMC, Amsterdam, the Netherlands
| | - Alexander P J Vlaar
- Department of Intensive care medicine, Amsterdam University Medical Centre, location AMC, Amsterdam, the Netherlands
| | - Maarten A Vink
- Department of Cardiology, OLVG, Amsterdam, the Netherlands
| | | | | | - Wouter de Ruijter
- Department of Intensive care medicine, Noord West Ziekenhuisgroep, Alkmaar, the Netherlands
| | - Thijs S R Delnoij
- Department of Intensive care medicine, Maastricht University Medical Centre, University Maastricht, Maastricht, the Netherlands
| | - Harry J G M Crijns
- Department of Cardiology, Maastricht University Medical Centre, Maastricht, the Netherlands
| | | | | | | | - Koos Plomp
- Department of Cardiology, Tergooi Hospital, Blaricum, the Netherlands
| | - Michael Magro
- Department of Cardiology, Elisabeth-Tweesteden Hospital, Tilburg, the Netherlands
| | - Paul W G Elbers
- Department of Intensive care medicine, Amsterdam University Medical Centre, location VUmc, Amsterdam, the Netherlands
| | - Yolande Appelman
- Department of Cardiology, Amsterdam University Medical Centre, location VUmc, Amsterdam, the Netherlands
| | - Niels van Royen
- Department of Cardiology, Amsterdam University Medical Centre, location VUmc, Amsterdam, the Netherlands; Department of Cardiology, Radboud University Medical Centre, Nijmegen, the Netherlands
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Lemkes JS, Janssens GN, van der Hoeven NW, Jewbali LSD, Dubois EA, Meuwissen M, Rijpstra TA, Bosker HA, Blans MJ, Bleeker GB, Baak R, Vlachojannis GJ, Eikemans BJW, van der Harst P, van der Horst ICC, Voskuil M, van der Heijden JJ, Beishuizen A, Stoel M, Camaro C, van der Hoeven H, Henriques JP, Vlaar APJ, Vink MA, van den Bogaard B, Heestermans TACM, de Ruijter W, Delnoij TSR, Crijns HJGM, Jessurun GAJ, Oemrawsingh PV, Gosselink MTM, Plomp K, Magro M, Elbers PWG, van de Ven PM, Oudemans-van Straaten HM, van Royen N. Coronary Angiography after Cardiac Arrest without ST-Segment Elevation. N Engl J Med 2019; 380:1397-1407. [PMID: 30883057 DOI: 10.1056/nejmoa1816897] [Citation(s) in RCA: 322] [Impact Index Per Article: 64.4] [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: 11/19/2022]
Abstract
BACKGROUND Ischemic heart disease is a major cause of out-of-hospital cardiac arrest. The role of immediate coronary angiography and percutaneous coronary intervention (PCI) in the treatment of patients who have been successfully resuscitated after cardiac arrest in the absence of ST-segment elevation myocardial infarction (STEMI) remains uncertain. METHODS In this multicenter trial, we randomly assigned 552 patients who had cardiac arrest without signs of STEMI to undergo immediate coronary angiography or coronary angiography that was delayed until after neurologic recovery. All patients underwent PCI if indicated. The primary end point was survival at 90 days. Secondary end points included survival at 90 days with good cerebral performance or mild or moderate disability, myocardial injury, duration of catecholamine support, markers of shock, recurrence of ventricular tachycardia, duration of mechanical ventilation, major bleeding, occurrence of acute kidney injury, need for renal-replacement therapy, time to target temperature, and neurologic status at discharge from the intensive care unit. RESULTS At 90 days, 176 of 273 patients (64.5%) in the immediate angiography group and 178 of 265 patients (67.2%) in the delayed angiography group were alive (odds ratio, 0.89; 95% confidence interval [CI], 0.62 to 1.27; P = 0.51). The median time to target temperature was 5.4 hours in the immediate angiography group and 4.7 hours in the delayed angiography group (ratio of geometric means, 1.19; 95% CI, 1.04 to 1.36). No significant differences between the groups were found in the remaining secondary end points. CONCLUSIONS Among patients who had been successfully resuscitated after out-of-hospital cardiac arrest and had no signs of STEMI, a strategy of immediate angiography was not found to be better than a strategy of delayed angiography with respect to overall survival at 90 days. (Funded by the Netherlands Heart Institute and others; COACT Netherlands Trial Register number, NTR4973.).
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Affiliation(s)
- Jorrit S Lemkes
- From the Departments of Cardiology (J.S.L., G.N.J., N.W.H., N.R.), Intensive Care Medicine (P.W.G.E., H.M.O.-S.), and Epidemiology and Biostatistics (P.M.V.), Amsterdam University Medical Center VUmc, the Departments of Cardiology (J.P.H.) and Intensive Care Medicine (A.P.J.V.), Amsterdam University Medical Center AMC, and the Departments of Cardiology (M.A.V.) and Intensive Care Medicine (B.B.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Thorax Center, Erasmus Medical Center (L.S.D.J., E.A.D.), and the Departments of Cardiology (G.J.V.) and Intensive Care Medicine (B.J.W.E.), Maasstad Hospital, Rotterdam, the Departments of Cardiology (M. Meuwissen) and Intensive Care Medicine (T.A.R.), Amphia Hospital, Breda, the Departments of Cardiology (H.A.B.) and Intensive Care Medicine (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Cardiology (G.B.B.) and Intensive Care Medicine (R.B.), Haga Hospital, and the Department of Cardiology, Haaglanden Medical Center (P.V.O.), The Hague, the Departments of Cardiology (P.H.) and Intensive Care Medicine (I.C.C.H.), University of Groningen, Groningen, the Departments of Cardiology (M.V.) and Intensive Care Medicine (J.J.H.), University Medical Center Utrecht, Utrecht, the Departments of Intensive Care Medicine (A.B.) and Cardiology (M.S.), Medisch Spectrum Twente, Enschede, the Departments of Cardiology (C.C., N.R.) and Intensive Care Medicine (H.H.), Radboud University Medical Center, Nijmegen, the Departments of Cardiology (T.A.C.M.H.) and Intensive Care Medicine (W.R.), Noordwest Ziekenhuisgroep, Alkmaar, the Departments of Intensive Care Medicine (T.S.R.D.) and Cardiology (H.J.G.M.C.), Maastricht University Medical Center, Maastricht, the Department of Cardiology, Scheper Hospital, Emmen (G.A.J.J.), the Department of Cardiology, Isala Hospital, Zwolle (M.T.M.G.), the Department of Cardiology, Tergooi Hospital, Blaricum (K.P.), and the Department of Cardiology, Elisabeth-Tweesteden Hospital, Tilburg (M. Magro) - all in the Netherlands
| | - Gladys N Janssens
- From the Departments of Cardiology (J.S.L., G.N.J., N.W.H., N.R.), Intensive Care Medicine (P.W.G.E., H.M.O.-S.), and Epidemiology and Biostatistics (P.M.V.), Amsterdam University Medical Center VUmc, the Departments of Cardiology (J.P.H.) and Intensive Care Medicine (A.P.J.V.), Amsterdam University Medical Center AMC, and the Departments of Cardiology (M.A.V.) and Intensive Care Medicine (B.B.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Thorax Center, Erasmus Medical Center (L.S.D.J., E.A.D.), and the Departments of Cardiology (G.J.V.) and Intensive Care Medicine (B.J.W.E.), Maasstad Hospital, Rotterdam, the Departments of Cardiology (M. Meuwissen) and Intensive Care Medicine (T.A.R.), Amphia Hospital, Breda, the Departments of Cardiology (H.A.B.) and Intensive Care Medicine (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Cardiology (G.B.B.) and Intensive Care Medicine (R.B.), Haga Hospital, and the Department of Cardiology, Haaglanden Medical Center (P.V.O.), The Hague, the Departments of Cardiology (P.H.) and Intensive Care Medicine (I.C.C.H.), University of Groningen, Groningen, the Departments of Cardiology (M.V.) and Intensive Care Medicine (J.J.H.), University Medical Center Utrecht, Utrecht, the Departments of Intensive Care Medicine (A.B.) and Cardiology (M.S.), Medisch Spectrum Twente, Enschede, the Departments of Cardiology (C.C., N.R.) and Intensive Care Medicine (H.H.), Radboud University Medical Center, Nijmegen, the Departments of Cardiology (T.A.C.M.H.) and Intensive Care Medicine (W.R.), Noordwest Ziekenhuisgroep, Alkmaar, the Departments of Intensive Care Medicine (T.S.R.D.) and Cardiology (H.J.G.M.C.), Maastricht University Medical Center, Maastricht, the Department of Cardiology, Scheper Hospital, Emmen (G.A.J.J.), the Department of Cardiology, Isala Hospital, Zwolle (M.T.M.G.), the Department of Cardiology, Tergooi Hospital, Blaricum (K.P.), and the Department of Cardiology, Elisabeth-Tweesteden Hospital, Tilburg (M. Magro) - all in the Netherlands
| | - Nina W van der Hoeven
- From the Departments of Cardiology (J.S.L., G.N.J., N.W.H., N.R.), Intensive Care Medicine (P.W.G.E., H.M.O.-S.), and Epidemiology and Biostatistics (P.M.V.), Amsterdam University Medical Center VUmc, the Departments of Cardiology (J.P.H.) and Intensive Care Medicine (A.P.J.V.), Amsterdam University Medical Center AMC, and the Departments of Cardiology (M.A.V.) and Intensive Care Medicine (B.B.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Thorax Center, Erasmus Medical Center (L.S.D.J., E.A.D.), and the Departments of Cardiology (G.J.V.) and Intensive Care Medicine (B.J.W.E.), Maasstad Hospital, Rotterdam, the Departments of Cardiology (M. Meuwissen) and Intensive Care Medicine (T.A.R.), Amphia Hospital, Breda, the Departments of Cardiology (H.A.B.) and Intensive Care Medicine (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Cardiology (G.B.B.) and Intensive Care Medicine (R.B.), Haga Hospital, and the Department of Cardiology, Haaglanden Medical Center (P.V.O.), The Hague, the Departments of Cardiology (P.H.) and Intensive Care Medicine (I.C.C.H.), University of Groningen, Groningen, the Departments of Cardiology (M.V.) and Intensive Care Medicine (J.J.H.), University Medical Center Utrecht, Utrecht, the Departments of Intensive Care Medicine (A.B.) and Cardiology (M.S.), Medisch Spectrum Twente, Enschede, the Departments of Cardiology (C.C., N.R.) and Intensive Care Medicine (H.H.), Radboud University Medical Center, Nijmegen, the Departments of Cardiology (T.A.C.M.H.) and Intensive Care Medicine (W.R.), Noordwest Ziekenhuisgroep, Alkmaar, the Departments of Intensive Care Medicine (T.S.R.D.) and Cardiology (H.J.G.M.C.), Maastricht University Medical Center, Maastricht, the Department of Cardiology, Scheper Hospital, Emmen (G.A.J.J.), the Department of Cardiology, Isala Hospital, Zwolle (M.T.M.G.), the Department of Cardiology, Tergooi Hospital, Blaricum (K.P.), and the Department of Cardiology, Elisabeth-Tweesteden Hospital, Tilburg (M. Magro) - all in the Netherlands
| | - Lucia S D Jewbali
- From the Departments of Cardiology (J.S.L., G.N.J., N.W.H., N.R.), Intensive Care Medicine (P.W.G.E., H.M.O.-S.), and Epidemiology and Biostatistics (P.M.V.), Amsterdam University Medical Center VUmc, the Departments of Cardiology (J.P.H.) and Intensive Care Medicine (A.P.J.V.), Amsterdam University Medical Center AMC, and the Departments of Cardiology (M.A.V.) and Intensive Care Medicine (B.B.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Thorax Center, Erasmus Medical Center (L.S.D.J., E.A.D.), and the Departments of Cardiology (G.J.V.) and Intensive Care Medicine (B.J.W.E.), Maasstad Hospital, Rotterdam, the Departments of Cardiology (M. Meuwissen) and Intensive Care Medicine (T.A.R.), Amphia Hospital, Breda, the Departments of Cardiology (H.A.B.) and Intensive Care Medicine (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Cardiology (G.B.B.) and Intensive Care Medicine (R.B.), Haga Hospital, and the Department of Cardiology, Haaglanden Medical Center (P.V.O.), The Hague, the Departments of Cardiology (P.H.) and Intensive Care Medicine (I.C.C.H.), University of Groningen, Groningen, the Departments of Cardiology (M.V.) and Intensive Care Medicine (J.J.H.), University Medical Center Utrecht, Utrecht, the Departments of Intensive Care Medicine (A.B.) and Cardiology (M.S.), Medisch Spectrum Twente, Enschede, the Departments of Cardiology (C.C., N.R.) and Intensive Care Medicine (H.H.), Radboud University Medical Center, Nijmegen, the Departments of Cardiology (T.A.C.M.H.) and Intensive Care Medicine (W.R.), Noordwest Ziekenhuisgroep, Alkmaar, the Departments of Intensive Care Medicine (T.S.R.D.) and Cardiology (H.J.G.M.C.), Maastricht University Medical Center, Maastricht, the Department of Cardiology, Scheper Hospital, Emmen (G.A.J.J.), the Department of Cardiology, Isala Hospital, Zwolle (M.T.M.G.), the Department of Cardiology, Tergooi Hospital, Blaricum (K.P.), and the Department of Cardiology, Elisabeth-Tweesteden Hospital, Tilburg (M. Magro) - all in the Netherlands
| | - Eric A Dubois
- From the Departments of Cardiology (J.S.L., G.N.J., N.W.H., N.R.), Intensive Care Medicine (P.W.G.E., H.M.O.-S.), and Epidemiology and Biostatistics (P.M.V.), Amsterdam University Medical Center VUmc, the Departments of Cardiology (J.P.H.) and Intensive Care Medicine (A.P.J.V.), Amsterdam University Medical Center AMC, and the Departments of Cardiology (M.A.V.) and Intensive Care Medicine (B.B.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Thorax Center, Erasmus Medical Center (L.S.D.J., E.A.D.), and the Departments of Cardiology (G.J.V.) and Intensive Care Medicine (B.J.W.E.), Maasstad Hospital, Rotterdam, the Departments of Cardiology (M. Meuwissen) and Intensive Care Medicine (T.A.R.), Amphia Hospital, Breda, the Departments of Cardiology (H.A.B.) and Intensive Care Medicine (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Cardiology (G.B.B.) and Intensive Care Medicine (R.B.), Haga Hospital, and the Department of Cardiology, Haaglanden Medical Center (P.V.O.), The Hague, the Departments of Cardiology (P.H.) and Intensive Care Medicine (I.C.C.H.), University of Groningen, Groningen, the Departments of Cardiology (M.V.) and Intensive Care Medicine (J.J.H.), University Medical Center Utrecht, Utrecht, the Departments of Intensive Care Medicine (A.B.) and Cardiology (M.S.), Medisch Spectrum Twente, Enschede, the Departments of Cardiology (C.C., N.R.) and Intensive Care Medicine (H.H.), Radboud University Medical Center, Nijmegen, the Departments of Cardiology (T.A.C.M.H.) and Intensive Care Medicine (W.R.), Noordwest Ziekenhuisgroep, Alkmaar, the Departments of Intensive Care Medicine (T.S.R.D.) and Cardiology (H.J.G.M.C.), Maastricht University Medical Center, Maastricht, the Department of Cardiology, Scheper Hospital, Emmen (G.A.J.J.), the Department of Cardiology, Isala Hospital, Zwolle (M.T.M.G.), the Department of Cardiology, Tergooi Hospital, Blaricum (K.P.), and the Department of Cardiology, Elisabeth-Tweesteden Hospital, Tilburg (M. Magro) - all in the Netherlands
| | - Martijn Meuwissen
- From the Departments of Cardiology (J.S.L., G.N.J., N.W.H., N.R.), Intensive Care Medicine (P.W.G.E., H.M.O.-S.), and Epidemiology and Biostatistics (P.M.V.), Amsterdam University Medical Center VUmc, the Departments of Cardiology (J.P.H.) and Intensive Care Medicine (A.P.J.V.), Amsterdam University Medical Center AMC, and the Departments of Cardiology (M.A.V.) and Intensive Care Medicine (B.B.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Thorax Center, Erasmus Medical Center (L.S.D.J., E.A.D.), and the Departments of Cardiology (G.J.V.) and Intensive Care Medicine (B.J.W.E.), Maasstad Hospital, Rotterdam, the Departments of Cardiology (M. Meuwissen) and Intensive Care Medicine (T.A.R.), Amphia Hospital, Breda, the Departments of Cardiology (H.A.B.) and Intensive Care Medicine (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Cardiology (G.B.B.) and Intensive Care Medicine (R.B.), Haga Hospital, and the Department of Cardiology, Haaglanden Medical Center (P.V.O.), The Hague, the Departments of Cardiology (P.H.) and Intensive Care Medicine (I.C.C.H.), University of Groningen, Groningen, the Departments of Cardiology (M.V.) and Intensive Care Medicine (J.J.H.), University Medical Center Utrecht, Utrecht, the Departments of Intensive Care Medicine (A.B.) and Cardiology (M.S.), Medisch Spectrum Twente, Enschede, the Departments of Cardiology (C.C., N.R.) and Intensive Care Medicine (H.H.), Radboud University Medical Center, Nijmegen, the Departments of Cardiology (T.A.C.M.H.) and Intensive Care Medicine (W.R.), Noordwest Ziekenhuisgroep, Alkmaar, the Departments of Intensive Care Medicine (T.S.R.D.) and Cardiology (H.J.G.M.C.), Maastricht University Medical Center, Maastricht, the Department of Cardiology, Scheper Hospital, Emmen (G.A.J.J.), the Department of Cardiology, Isala Hospital, Zwolle (M.T.M.G.), the Department of Cardiology, Tergooi Hospital, Blaricum (K.P.), and the Department of Cardiology, Elisabeth-Tweesteden Hospital, Tilburg (M. Magro) - all in the Netherlands
| | - Tom A Rijpstra
- From the Departments of Cardiology (J.S.L., G.N.J., N.W.H., N.R.), Intensive Care Medicine (P.W.G.E., H.M.O.-S.), and Epidemiology and Biostatistics (P.M.V.), Amsterdam University Medical Center VUmc, the Departments of Cardiology (J.P.H.) and Intensive Care Medicine (A.P.J.V.), Amsterdam University Medical Center AMC, and the Departments of Cardiology (M.A.V.) and Intensive Care Medicine (B.B.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Thorax Center, Erasmus Medical Center (L.S.D.J., E.A.D.), and the Departments of Cardiology (G.J.V.) and Intensive Care Medicine (B.J.W.E.), Maasstad Hospital, Rotterdam, the Departments of Cardiology (M. Meuwissen) and Intensive Care Medicine (T.A.R.), Amphia Hospital, Breda, the Departments of Cardiology (H.A.B.) and Intensive Care Medicine (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Cardiology (G.B.B.) and Intensive Care Medicine (R.B.), Haga Hospital, and the Department of Cardiology, Haaglanden Medical Center (P.V.O.), The Hague, the Departments of Cardiology (P.H.) and Intensive Care Medicine (I.C.C.H.), University of Groningen, Groningen, the Departments of Cardiology (M.V.) and Intensive Care Medicine (J.J.H.), University Medical Center Utrecht, Utrecht, the Departments of Intensive Care Medicine (A.B.) and Cardiology (M.S.), Medisch Spectrum Twente, Enschede, the Departments of Cardiology (C.C., N.R.) and Intensive Care Medicine (H.H.), Radboud University Medical Center, Nijmegen, the Departments of Cardiology (T.A.C.M.H.) and Intensive Care Medicine (W.R.), Noordwest Ziekenhuisgroep, Alkmaar, the Departments of Intensive Care Medicine (T.S.R.D.) and Cardiology (H.J.G.M.C.), Maastricht University Medical Center, Maastricht, the Department of Cardiology, Scheper Hospital, Emmen (G.A.J.J.), the Department of Cardiology, Isala Hospital, Zwolle (M.T.M.G.), the Department of Cardiology, Tergooi Hospital, Blaricum (K.P.), and the Department of Cardiology, Elisabeth-Tweesteden Hospital, Tilburg (M. Magro) - all in the Netherlands
| | - Hans A Bosker
- From the Departments of Cardiology (J.S.L., G.N.J., N.W.H., N.R.), Intensive Care Medicine (P.W.G.E., H.M.O.-S.), and Epidemiology and Biostatistics (P.M.V.), Amsterdam University Medical Center VUmc, the Departments of Cardiology (J.P.H.) and Intensive Care Medicine (A.P.J.V.), Amsterdam University Medical Center AMC, and the Departments of Cardiology (M.A.V.) and Intensive Care Medicine (B.B.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Thorax Center, Erasmus Medical Center (L.S.D.J., E.A.D.), and the Departments of Cardiology (G.J.V.) and Intensive Care Medicine (B.J.W.E.), Maasstad Hospital, Rotterdam, the Departments of Cardiology (M. Meuwissen) and Intensive Care Medicine (T.A.R.), Amphia Hospital, Breda, the Departments of Cardiology (H.A.B.) and Intensive Care Medicine (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Cardiology (G.B.B.) and Intensive Care Medicine (R.B.), Haga Hospital, and the Department of Cardiology, Haaglanden Medical Center (P.V.O.), The Hague, the Departments of Cardiology (P.H.) and Intensive Care Medicine (I.C.C.H.), University of Groningen, Groningen, the Departments of Cardiology (M.V.) and Intensive Care Medicine (J.J.H.), University Medical Center Utrecht, Utrecht, the Departments of Intensive Care Medicine (A.B.) and Cardiology (M.S.), Medisch Spectrum Twente, Enschede, the Departments of Cardiology (C.C., N.R.) and Intensive Care Medicine (H.H.), Radboud University Medical Center, Nijmegen, the Departments of Cardiology (T.A.C.M.H.) and Intensive Care Medicine (W.R.), Noordwest Ziekenhuisgroep, Alkmaar, the Departments of Intensive Care Medicine (T.S.R.D.) and Cardiology (H.J.G.M.C.), Maastricht University Medical Center, Maastricht, the Department of Cardiology, Scheper Hospital, Emmen (G.A.J.J.), the Department of Cardiology, Isala Hospital, Zwolle (M.T.M.G.), the Department of Cardiology, Tergooi Hospital, Blaricum (K.P.), and the Department of Cardiology, Elisabeth-Tweesteden Hospital, Tilburg (M. Magro) - all in the Netherlands
| | - Michiel J Blans
- From the Departments of Cardiology (J.S.L., G.N.J., N.W.H., N.R.), Intensive Care Medicine (P.W.G.E., H.M.O.-S.), and Epidemiology and Biostatistics (P.M.V.), Amsterdam University Medical Center VUmc, the Departments of Cardiology (J.P.H.) and Intensive Care Medicine (A.P.J.V.), Amsterdam University Medical Center AMC, and the Departments of Cardiology (M.A.V.) and Intensive Care Medicine (B.B.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Thorax Center, Erasmus Medical Center (L.S.D.J., E.A.D.), and the Departments of Cardiology (G.J.V.) and Intensive Care Medicine (B.J.W.E.), Maasstad Hospital, Rotterdam, the Departments of Cardiology (M. Meuwissen) and Intensive Care Medicine (T.A.R.), Amphia Hospital, Breda, the Departments of Cardiology (H.A.B.) and Intensive Care Medicine (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Cardiology (G.B.B.) and Intensive Care Medicine (R.B.), Haga Hospital, and the Department of Cardiology, Haaglanden Medical Center (P.V.O.), The Hague, the Departments of Cardiology (P.H.) and Intensive Care Medicine (I.C.C.H.), University of Groningen, Groningen, the Departments of Cardiology (M.V.) and Intensive Care Medicine (J.J.H.), University Medical Center Utrecht, Utrecht, the Departments of Intensive Care Medicine (A.B.) and Cardiology (M.S.), Medisch Spectrum Twente, Enschede, the Departments of Cardiology (C.C., N.R.) and Intensive Care Medicine (H.H.), Radboud University Medical Center, Nijmegen, the Departments of Cardiology (T.A.C.M.H.) and Intensive Care Medicine (W.R.), Noordwest Ziekenhuisgroep, Alkmaar, the Departments of Intensive Care Medicine (T.S.R.D.) and Cardiology (H.J.G.M.C.), Maastricht University Medical Center, Maastricht, the Department of Cardiology, Scheper Hospital, Emmen (G.A.J.J.), the Department of Cardiology, Isala Hospital, Zwolle (M.T.M.G.), the Department of Cardiology, Tergooi Hospital, Blaricum (K.P.), and the Department of Cardiology, Elisabeth-Tweesteden Hospital, Tilburg (M. Magro) - all in the Netherlands
| | - Gabe B Bleeker
- From the Departments of Cardiology (J.S.L., G.N.J., N.W.H., N.R.), Intensive Care Medicine (P.W.G.E., H.M.O.-S.), and Epidemiology and Biostatistics (P.M.V.), Amsterdam University Medical Center VUmc, the Departments of Cardiology (J.P.H.) and Intensive Care Medicine (A.P.J.V.), Amsterdam University Medical Center AMC, and the Departments of Cardiology (M.A.V.) and Intensive Care Medicine (B.B.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Thorax Center, Erasmus Medical Center (L.S.D.J., E.A.D.), and the Departments of Cardiology (G.J.V.) and Intensive Care Medicine (B.J.W.E.), Maasstad Hospital, Rotterdam, the Departments of Cardiology (M. Meuwissen) and Intensive Care Medicine (T.A.R.), Amphia Hospital, Breda, the Departments of Cardiology (H.A.B.) and Intensive Care Medicine (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Cardiology (G.B.B.) and Intensive Care Medicine (R.B.), Haga Hospital, and the Department of Cardiology, Haaglanden Medical Center (P.V.O.), The Hague, the Departments of Cardiology (P.H.) and Intensive Care Medicine (I.C.C.H.), University of Groningen, Groningen, the Departments of Cardiology (M.V.) and Intensive Care Medicine (J.J.H.), University Medical Center Utrecht, Utrecht, the Departments of Intensive Care Medicine (A.B.) and Cardiology (M.S.), Medisch Spectrum Twente, Enschede, the Departments of Cardiology (C.C., N.R.) and Intensive Care Medicine (H.H.), Radboud University Medical Center, Nijmegen, the Departments of Cardiology (T.A.C.M.H.) and Intensive Care Medicine (W.R.), Noordwest Ziekenhuisgroep, Alkmaar, the Departments of Intensive Care Medicine (T.S.R.D.) and Cardiology (H.J.G.M.C.), Maastricht University Medical Center, Maastricht, the Department of Cardiology, Scheper Hospital, Emmen (G.A.J.J.), the Department of Cardiology, Isala Hospital, Zwolle (M.T.M.G.), the Department of Cardiology, Tergooi Hospital, Blaricum (K.P.), and the Department of Cardiology, Elisabeth-Tweesteden Hospital, Tilburg (M. Magro) - all in the Netherlands
| | - Rémon Baak
- From the Departments of Cardiology (J.S.L., G.N.J., N.W.H., N.R.), Intensive Care Medicine (P.W.G.E., H.M.O.-S.), and Epidemiology and Biostatistics (P.M.V.), Amsterdam University Medical Center VUmc, the Departments of Cardiology (J.P.H.) and Intensive Care Medicine (A.P.J.V.), Amsterdam University Medical Center AMC, and the Departments of Cardiology (M.A.V.) and Intensive Care Medicine (B.B.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Thorax Center, Erasmus Medical Center (L.S.D.J., E.A.D.), and the Departments of Cardiology (G.J.V.) and Intensive Care Medicine (B.J.W.E.), Maasstad Hospital, Rotterdam, the Departments of Cardiology (M. Meuwissen) and Intensive Care Medicine (T.A.R.), Amphia Hospital, Breda, the Departments of Cardiology (H.A.B.) and Intensive Care Medicine (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Cardiology (G.B.B.) and Intensive Care Medicine (R.B.), Haga Hospital, and the Department of Cardiology, Haaglanden Medical Center (P.V.O.), The Hague, the Departments of Cardiology (P.H.) and Intensive Care Medicine (I.C.C.H.), University of Groningen, Groningen, the Departments of Cardiology (M.V.) and Intensive Care Medicine (J.J.H.), University Medical Center Utrecht, Utrecht, the Departments of Intensive Care Medicine (A.B.) and Cardiology (M.S.), Medisch Spectrum Twente, Enschede, the Departments of Cardiology (C.C., N.R.) and Intensive Care Medicine (H.H.), Radboud University Medical Center, Nijmegen, the Departments of Cardiology (T.A.C.M.H.) and Intensive Care Medicine (W.R.), Noordwest Ziekenhuisgroep, Alkmaar, the Departments of Intensive Care Medicine (T.S.R.D.) and Cardiology (H.J.G.M.C.), Maastricht University Medical Center, Maastricht, the Department of Cardiology, Scheper Hospital, Emmen (G.A.J.J.), the Department of Cardiology, Isala Hospital, Zwolle (M.T.M.G.), the Department of Cardiology, Tergooi Hospital, Blaricum (K.P.), and the Department of Cardiology, Elisabeth-Tweesteden Hospital, Tilburg (M. Magro) - all in the Netherlands
| | - Georgios J Vlachojannis
- From the Departments of Cardiology (J.S.L., G.N.J., N.W.H., N.R.), Intensive Care Medicine (P.W.G.E., H.M.O.-S.), and Epidemiology and Biostatistics (P.M.V.), Amsterdam University Medical Center VUmc, the Departments of Cardiology (J.P.H.) and Intensive Care Medicine (A.P.J.V.), Amsterdam University Medical Center AMC, and the Departments of Cardiology (M.A.V.) and Intensive Care Medicine (B.B.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Thorax Center, Erasmus Medical Center (L.S.D.J., E.A.D.), and the Departments of Cardiology (G.J.V.) and Intensive Care Medicine (B.J.W.E.), Maasstad Hospital, Rotterdam, the Departments of Cardiology (M. Meuwissen) and Intensive Care Medicine (T.A.R.), Amphia Hospital, Breda, the Departments of Cardiology (H.A.B.) and Intensive Care Medicine (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Cardiology (G.B.B.) and Intensive Care Medicine (R.B.), Haga Hospital, and the Department of Cardiology, Haaglanden Medical Center (P.V.O.), The Hague, the Departments of Cardiology (P.H.) and Intensive Care Medicine (I.C.C.H.), University of Groningen, Groningen, the Departments of Cardiology (M.V.) and Intensive Care Medicine (J.J.H.), University Medical Center Utrecht, Utrecht, the Departments of Intensive Care Medicine (A.B.) and Cardiology (M.S.), Medisch Spectrum Twente, Enschede, the Departments of Cardiology (C.C., N.R.) and Intensive Care Medicine (H.H.), Radboud University Medical Center, Nijmegen, the Departments of Cardiology (T.A.C.M.H.) and Intensive Care Medicine (W.R.), Noordwest Ziekenhuisgroep, Alkmaar, the Departments of Intensive Care Medicine (T.S.R.D.) and Cardiology (H.J.G.M.C.), Maastricht University Medical Center, Maastricht, the Department of Cardiology, Scheper Hospital, Emmen (G.A.J.J.), the Department of Cardiology, Isala Hospital, Zwolle (M.T.M.G.), the Department of Cardiology, Tergooi Hospital, Blaricum (K.P.), and the Department of Cardiology, Elisabeth-Tweesteden Hospital, Tilburg (M. Magro) - all in the Netherlands
| | - Bob J W Eikemans
- From the Departments of Cardiology (J.S.L., G.N.J., N.W.H., N.R.), Intensive Care Medicine (P.W.G.E., H.M.O.-S.), and Epidemiology and Biostatistics (P.M.V.), Amsterdam University Medical Center VUmc, the Departments of Cardiology (J.P.H.) and Intensive Care Medicine (A.P.J.V.), Amsterdam University Medical Center AMC, and the Departments of Cardiology (M.A.V.) and Intensive Care Medicine (B.B.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Thorax Center, Erasmus Medical Center (L.S.D.J., E.A.D.), and the Departments of Cardiology (G.J.V.) and Intensive Care Medicine (B.J.W.E.), Maasstad Hospital, Rotterdam, the Departments of Cardiology (M. Meuwissen) and Intensive Care Medicine (T.A.R.), Amphia Hospital, Breda, the Departments of Cardiology (H.A.B.) and Intensive Care Medicine (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Cardiology (G.B.B.) and Intensive Care Medicine (R.B.), Haga Hospital, and the Department of Cardiology, Haaglanden Medical Center (P.V.O.), The Hague, the Departments of Cardiology (P.H.) and Intensive Care Medicine (I.C.C.H.), University of Groningen, Groningen, the Departments of Cardiology (M.V.) and Intensive Care Medicine (J.J.H.), University Medical Center Utrecht, Utrecht, the Departments of Intensive Care Medicine (A.B.) and Cardiology (M.S.), Medisch Spectrum Twente, Enschede, the Departments of Cardiology (C.C., N.R.) and Intensive Care Medicine (H.H.), Radboud University Medical Center, Nijmegen, the Departments of Cardiology (T.A.C.M.H.) and Intensive Care Medicine (W.R.), Noordwest Ziekenhuisgroep, Alkmaar, the Departments of Intensive Care Medicine (T.S.R.D.) and Cardiology (H.J.G.M.C.), Maastricht University Medical Center, Maastricht, the Department of Cardiology, Scheper Hospital, Emmen (G.A.J.J.), the Department of Cardiology, Isala Hospital, Zwolle (M.T.M.G.), the Department of Cardiology, Tergooi Hospital, Blaricum (K.P.), and the Department of Cardiology, Elisabeth-Tweesteden Hospital, Tilburg (M. Magro) - all in the Netherlands
| | - Pim van der Harst
- From the Departments of Cardiology (J.S.L., G.N.J., N.W.H., N.R.), Intensive Care Medicine (P.W.G.E., H.M.O.-S.), and Epidemiology and Biostatistics (P.M.V.), Amsterdam University Medical Center VUmc, the Departments of Cardiology (J.P.H.) and Intensive Care Medicine (A.P.J.V.), Amsterdam University Medical Center AMC, and the Departments of Cardiology (M.A.V.) and Intensive Care Medicine (B.B.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Thorax Center, Erasmus Medical Center (L.S.D.J., E.A.D.), and the Departments of Cardiology (G.J.V.) and Intensive Care Medicine (B.J.W.E.), Maasstad Hospital, Rotterdam, the Departments of Cardiology (M. Meuwissen) and Intensive Care Medicine (T.A.R.), Amphia Hospital, Breda, the Departments of Cardiology (H.A.B.) and Intensive Care Medicine (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Cardiology (G.B.B.) and Intensive Care Medicine (R.B.), Haga Hospital, and the Department of Cardiology, Haaglanden Medical Center (P.V.O.), The Hague, the Departments of Cardiology (P.H.) and Intensive Care Medicine (I.C.C.H.), University of Groningen, Groningen, the Departments of Cardiology (M.V.) and Intensive Care Medicine (J.J.H.), University Medical Center Utrecht, Utrecht, the Departments of Intensive Care Medicine (A.B.) and Cardiology (M.S.), Medisch Spectrum Twente, Enschede, the Departments of Cardiology (C.C., N.R.) and Intensive Care Medicine (H.H.), Radboud University Medical Center, Nijmegen, the Departments of Cardiology (T.A.C.M.H.) and Intensive Care Medicine (W.R.), Noordwest Ziekenhuisgroep, Alkmaar, the Departments of Intensive Care Medicine (T.S.R.D.) and Cardiology (H.J.G.M.C.), Maastricht University Medical Center, Maastricht, the Department of Cardiology, Scheper Hospital, Emmen (G.A.J.J.), the Department of Cardiology, Isala Hospital, Zwolle (M.T.M.G.), the Department of Cardiology, Tergooi Hospital, Blaricum (K.P.), and the Department of Cardiology, Elisabeth-Tweesteden Hospital, Tilburg (M. Magro) - all in the Netherlands
| | - Iwan C C van der Horst
- From the Departments of Cardiology (J.S.L., G.N.J., N.W.H., N.R.), Intensive Care Medicine (P.W.G.E., H.M.O.-S.), and Epidemiology and Biostatistics (P.M.V.), Amsterdam University Medical Center VUmc, the Departments of Cardiology (J.P.H.) and Intensive Care Medicine (A.P.J.V.), Amsterdam University Medical Center AMC, and the Departments of Cardiology (M.A.V.) and Intensive Care Medicine (B.B.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Thorax Center, Erasmus Medical Center (L.S.D.J., E.A.D.), and the Departments of Cardiology (G.J.V.) and Intensive Care Medicine (B.J.W.E.), Maasstad Hospital, Rotterdam, the Departments of Cardiology (M. Meuwissen) and Intensive Care Medicine (T.A.R.), Amphia Hospital, Breda, the Departments of Cardiology (H.A.B.) and Intensive Care Medicine (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Cardiology (G.B.B.) and Intensive Care Medicine (R.B.), Haga Hospital, and the Department of Cardiology, Haaglanden Medical Center (P.V.O.), The Hague, the Departments of Cardiology (P.H.) and Intensive Care Medicine (I.C.C.H.), University of Groningen, Groningen, the Departments of Cardiology (M.V.) and Intensive Care Medicine (J.J.H.), University Medical Center Utrecht, Utrecht, the Departments of Intensive Care Medicine (A.B.) and Cardiology (M.S.), Medisch Spectrum Twente, Enschede, the Departments of Cardiology (C.C., N.R.) and Intensive Care Medicine (H.H.), Radboud University Medical Center, Nijmegen, the Departments of Cardiology (T.A.C.M.H.) and Intensive Care Medicine (W.R.), Noordwest Ziekenhuisgroep, Alkmaar, the Departments of Intensive Care Medicine (T.S.R.D.) and Cardiology (H.J.G.M.C.), Maastricht University Medical Center, Maastricht, the Department of Cardiology, Scheper Hospital, Emmen (G.A.J.J.), the Department of Cardiology, Isala Hospital, Zwolle (M.T.M.G.), the Department of Cardiology, Tergooi Hospital, Blaricum (K.P.), and the Department of Cardiology, Elisabeth-Tweesteden Hospital, Tilburg (M. Magro) - all in the Netherlands
| | - Michiel Voskuil
- From the Departments of Cardiology (J.S.L., G.N.J., N.W.H., N.R.), Intensive Care Medicine (P.W.G.E., H.M.O.-S.), and Epidemiology and Biostatistics (P.M.V.), Amsterdam University Medical Center VUmc, the Departments of Cardiology (J.P.H.) and Intensive Care Medicine (A.P.J.V.), Amsterdam University Medical Center AMC, and the Departments of Cardiology (M.A.V.) and Intensive Care Medicine (B.B.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Thorax Center, Erasmus Medical Center (L.S.D.J., E.A.D.), and the Departments of Cardiology (G.J.V.) and Intensive Care Medicine (B.J.W.E.), Maasstad Hospital, Rotterdam, the Departments of Cardiology (M. Meuwissen) and Intensive Care Medicine (T.A.R.), Amphia Hospital, Breda, the Departments of Cardiology (H.A.B.) and Intensive Care Medicine (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Cardiology (G.B.B.) and Intensive Care Medicine (R.B.), Haga Hospital, and the Department of Cardiology, Haaglanden Medical Center (P.V.O.), The Hague, the Departments of Cardiology (P.H.) and Intensive Care Medicine (I.C.C.H.), University of Groningen, Groningen, the Departments of Cardiology (M.V.) and Intensive Care Medicine (J.J.H.), University Medical Center Utrecht, Utrecht, the Departments of Intensive Care Medicine (A.B.) and Cardiology (M.S.), Medisch Spectrum Twente, Enschede, the Departments of Cardiology (C.C., N.R.) and Intensive Care Medicine (H.H.), Radboud University Medical Center, Nijmegen, the Departments of Cardiology (T.A.C.M.H.) and Intensive Care Medicine (W.R.), Noordwest Ziekenhuisgroep, Alkmaar, the Departments of Intensive Care Medicine (T.S.R.D.) and Cardiology (H.J.G.M.C.), Maastricht University Medical Center, Maastricht, the Department of Cardiology, Scheper Hospital, Emmen (G.A.J.J.), the Department of Cardiology, Isala Hospital, Zwolle (M.T.M.G.), the Department of Cardiology, Tergooi Hospital, Blaricum (K.P.), and the Department of Cardiology, Elisabeth-Tweesteden Hospital, Tilburg (M. Magro) - all in the Netherlands
| | - Joris J van der Heijden
- From the Departments of Cardiology (J.S.L., G.N.J., N.W.H., N.R.), Intensive Care Medicine (P.W.G.E., H.M.O.-S.), and Epidemiology and Biostatistics (P.M.V.), Amsterdam University Medical Center VUmc, the Departments of Cardiology (J.P.H.) and Intensive Care Medicine (A.P.J.V.), Amsterdam University Medical Center AMC, and the Departments of Cardiology (M.A.V.) and Intensive Care Medicine (B.B.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Thorax Center, Erasmus Medical Center (L.S.D.J., E.A.D.), and the Departments of Cardiology (G.J.V.) and Intensive Care Medicine (B.J.W.E.), Maasstad Hospital, Rotterdam, the Departments of Cardiology (M. Meuwissen) and Intensive Care Medicine (T.A.R.), Amphia Hospital, Breda, the Departments of Cardiology (H.A.B.) and Intensive Care Medicine (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Cardiology (G.B.B.) and Intensive Care Medicine (R.B.), Haga Hospital, and the Department of Cardiology, Haaglanden Medical Center (P.V.O.), The Hague, the Departments of Cardiology (P.H.) and Intensive Care Medicine (I.C.C.H.), University of Groningen, Groningen, the Departments of Cardiology (M.V.) and Intensive Care Medicine (J.J.H.), University Medical Center Utrecht, Utrecht, the Departments of Intensive Care Medicine (A.B.) and Cardiology (M.S.), Medisch Spectrum Twente, Enschede, the Departments of Cardiology (C.C., N.R.) and Intensive Care Medicine (H.H.), Radboud University Medical Center, Nijmegen, the Departments of Cardiology (T.A.C.M.H.) and Intensive Care Medicine (W.R.), Noordwest Ziekenhuisgroep, Alkmaar, the Departments of Intensive Care Medicine (T.S.R.D.) and Cardiology (H.J.G.M.C.), Maastricht University Medical Center, Maastricht, the Department of Cardiology, Scheper Hospital, Emmen (G.A.J.J.), the Department of Cardiology, Isala Hospital, Zwolle (M.T.M.G.), the Department of Cardiology, Tergooi Hospital, Blaricum (K.P.), and the Department of Cardiology, Elisabeth-Tweesteden Hospital, Tilburg (M. Magro) - all in the Netherlands
| | - Albertus Beishuizen
- From the Departments of Cardiology (J.S.L., G.N.J., N.W.H., N.R.), Intensive Care Medicine (P.W.G.E., H.M.O.-S.), and Epidemiology and Biostatistics (P.M.V.), Amsterdam University Medical Center VUmc, the Departments of Cardiology (J.P.H.) and Intensive Care Medicine (A.P.J.V.), Amsterdam University Medical Center AMC, and the Departments of Cardiology (M.A.V.) and Intensive Care Medicine (B.B.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Thorax Center, Erasmus Medical Center (L.S.D.J., E.A.D.), and the Departments of Cardiology (G.J.V.) and Intensive Care Medicine (B.J.W.E.), Maasstad Hospital, Rotterdam, the Departments of Cardiology (M. Meuwissen) and Intensive Care Medicine (T.A.R.), Amphia Hospital, Breda, the Departments of Cardiology (H.A.B.) and Intensive Care Medicine (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Cardiology (G.B.B.) and Intensive Care Medicine (R.B.), Haga Hospital, and the Department of Cardiology, Haaglanden Medical Center (P.V.O.), The Hague, the Departments of Cardiology (P.H.) and Intensive Care Medicine (I.C.C.H.), University of Groningen, Groningen, the Departments of Cardiology (M.V.) and Intensive Care Medicine (J.J.H.), University Medical Center Utrecht, Utrecht, the Departments of Intensive Care Medicine (A.B.) and Cardiology (M.S.), Medisch Spectrum Twente, Enschede, the Departments of Cardiology (C.C., N.R.) and Intensive Care Medicine (H.H.), Radboud University Medical Center, Nijmegen, the Departments of Cardiology (T.A.C.M.H.) and Intensive Care Medicine (W.R.), Noordwest Ziekenhuisgroep, Alkmaar, the Departments of Intensive Care Medicine (T.S.R.D.) and Cardiology (H.J.G.M.C.), Maastricht University Medical Center, Maastricht, the Department of Cardiology, Scheper Hospital, Emmen (G.A.J.J.), the Department of Cardiology, Isala Hospital, Zwolle (M.T.M.G.), the Department of Cardiology, Tergooi Hospital, Blaricum (K.P.), and the Department of Cardiology, Elisabeth-Tweesteden Hospital, Tilburg (M. Magro) - all in the Netherlands
| | - Martin Stoel
- From the Departments of Cardiology (J.S.L., G.N.J., N.W.H., N.R.), Intensive Care Medicine (P.W.G.E., H.M.O.-S.), and Epidemiology and Biostatistics (P.M.V.), Amsterdam University Medical Center VUmc, the Departments of Cardiology (J.P.H.) and Intensive Care Medicine (A.P.J.V.), Amsterdam University Medical Center AMC, and the Departments of Cardiology (M.A.V.) and Intensive Care Medicine (B.B.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Thorax Center, Erasmus Medical Center (L.S.D.J., E.A.D.), and the Departments of Cardiology (G.J.V.) and Intensive Care Medicine (B.J.W.E.), Maasstad Hospital, Rotterdam, the Departments of Cardiology (M. Meuwissen) and Intensive Care Medicine (T.A.R.), Amphia Hospital, Breda, the Departments of Cardiology (H.A.B.) and Intensive Care Medicine (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Cardiology (G.B.B.) and Intensive Care Medicine (R.B.), Haga Hospital, and the Department of Cardiology, Haaglanden Medical Center (P.V.O.), The Hague, the Departments of Cardiology (P.H.) and Intensive Care Medicine (I.C.C.H.), University of Groningen, Groningen, the Departments of Cardiology (M.V.) and Intensive Care Medicine (J.J.H.), University Medical Center Utrecht, Utrecht, the Departments of Intensive Care Medicine (A.B.) and Cardiology (M.S.), Medisch Spectrum Twente, Enschede, the Departments of Cardiology (C.C., N.R.) and Intensive Care Medicine (H.H.), Radboud University Medical Center, Nijmegen, the Departments of Cardiology (T.A.C.M.H.) and Intensive Care Medicine (W.R.), Noordwest Ziekenhuisgroep, Alkmaar, the Departments of Intensive Care Medicine (T.S.R.D.) and Cardiology (H.J.G.M.C.), Maastricht University Medical Center, Maastricht, the Department of Cardiology, Scheper Hospital, Emmen (G.A.J.J.), the Department of Cardiology, Isala Hospital, Zwolle (M.T.M.G.), the Department of Cardiology, Tergooi Hospital, Blaricum (K.P.), and the Department of Cardiology, Elisabeth-Tweesteden Hospital, Tilburg (M. Magro) - all in the Netherlands
| | - Cyril Camaro
- From the Departments of Cardiology (J.S.L., G.N.J., N.W.H., N.R.), Intensive Care Medicine (P.W.G.E., H.M.O.-S.), and Epidemiology and Biostatistics (P.M.V.), Amsterdam University Medical Center VUmc, the Departments of Cardiology (J.P.H.) and Intensive Care Medicine (A.P.J.V.), Amsterdam University Medical Center AMC, and the Departments of Cardiology (M.A.V.) and Intensive Care Medicine (B.B.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Thorax Center, Erasmus Medical Center (L.S.D.J., E.A.D.), and the Departments of Cardiology (G.J.V.) and Intensive Care Medicine (B.J.W.E.), Maasstad Hospital, Rotterdam, the Departments of Cardiology (M. Meuwissen) and Intensive Care Medicine (T.A.R.), Amphia Hospital, Breda, the Departments of Cardiology (H.A.B.) and Intensive Care Medicine (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Cardiology (G.B.B.) and Intensive Care Medicine (R.B.), Haga Hospital, and the Department of Cardiology, Haaglanden Medical Center (P.V.O.), The Hague, the Departments of Cardiology (P.H.) and Intensive Care Medicine (I.C.C.H.), University of Groningen, Groningen, the Departments of Cardiology (M.V.) and Intensive Care Medicine (J.J.H.), University Medical Center Utrecht, Utrecht, the Departments of Intensive Care Medicine (A.B.) and Cardiology (M.S.), Medisch Spectrum Twente, Enschede, the Departments of Cardiology (C.C., N.R.) and Intensive Care Medicine (H.H.), Radboud University Medical Center, Nijmegen, the Departments of Cardiology (T.A.C.M.H.) and Intensive Care Medicine (W.R.), Noordwest Ziekenhuisgroep, Alkmaar, the Departments of Intensive Care Medicine (T.S.R.D.) and Cardiology (H.J.G.M.C.), Maastricht University Medical Center, Maastricht, the Department of Cardiology, Scheper Hospital, Emmen (G.A.J.J.), the Department of Cardiology, Isala Hospital, Zwolle (M.T.M.G.), the Department of Cardiology, Tergooi Hospital, Blaricum (K.P.), and the Department of Cardiology, Elisabeth-Tweesteden Hospital, Tilburg (M. Magro) - all in the Netherlands
| | - Hans van der Hoeven
- From the Departments of Cardiology (J.S.L., G.N.J., N.W.H., N.R.), Intensive Care Medicine (P.W.G.E., H.M.O.-S.), and Epidemiology and Biostatistics (P.M.V.), Amsterdam University Medical Center VUmc, the Departments of Cardiology (J.P.H.) and Intensive Care Medicine (A.P.J.V.), Amsterdam University Medical Center AMC, and the Departments of Cardiology (M.A.V.) and Intensive Care Medicine (B.B.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Thorax Center, Erasmus Medical Center (L.S.D.J., E.A.D.), and the Departments of Cardiology (G.J.V.) and Intensive Care Medicine (B.J.W.E.), Maasstad Hospital, Rotterdam, the Departments of Cardiology (M. Meuwissen) and Intensive Care Medicine (T.A.R.), Amphia Hospital, Breda, the Departments of Cardiology (H.A.B.) and Intensive Care Medicine (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Cardiology (G.B.B.) and Intensive Care Medicine (R.B.), Haga Hospital, and the Department of Cardiology, Haaglanden Medical Center (P.V.O.), The Hague, the Departments of Cardiology (P.H.) and Intensive Care Medicine (I.C.C.H.), University of Groningen, Groningen, the Departments of Cardiology (M.V.) and Intensive Care Medicine (J.J.H.), University Medical Center Utrecht, Utrecht, the Departments of Intensive Care Medicine (A.B.) and Cardiology (M.S.), Medisch Spectrum Twente, Enschede, the Departments of Cardiology (C.C., N.R.) and Intensive Care Medicine (H.H.), Radboud University Medical Center, Nijmegen, the Departments of Cardiology (T.A.C.M.H.) and Intensive Care Medicine (W.R.), Noordwest Ziekenhuisgroep, Alkmaar, the Departments of Intensive Care Medicine (T.S.R.D.) and Cardiology (H.J.G.M.C.), Maastricht University Medical Center, Maastricht, the Department of Cardiology, Scheper Hospital, Emmen (G.A.J.J.), the Department of Cardiology, Isala Hospital, Zwolle (M.T.M.G.), the Department of Cardiology, Tergooi Hospital, Blaricum (K.P.), and the Department of Cardiology, Elisabeth-Tweesteden Hospital, Tilburg (M. Magro) - all in the Netherlands
| | - José P Henriques
- From the Departments of Cardiology (J.S.L., G.N.J., N.W.H., N.R.), Intensive Care Medicine (P.W.G.E., H.M.O.-S.), and Epidemiology and Biostatistics (P.M.V.), Amsterdam University Medical Center VUmc, the Departments of Cardiology (J.P.H.) and Intensive Care Medicine (A.P.J.V.), Amsterdam University Medical Center AMC, and the Departments of Cardiology (M.A.V.) and Intensive Care Medicine (B.B.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Thorax Center, Erasmus Medical Center (L.S.D.J., E.A.D.), and the Departments of Cardiology (G.J.V.) and Intensive Care Medicine (B.J.W.E.), Maasstad Hospital, Rotterdam, the Departments of Cardiology (M. Meuwissen) and Intensive Care Medicine (T.A.R.), Amphia Hospital, Breda, the Departments of Cardiology (H.A.B.) and Intensive Care Medicine (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Cardiology (G.B.B.) and Intensive Care Medicine (R.B.), Haga Hospital, and the Department of Cardiology, Haaglanden Medical Center (P.V.O.), The Hague, the Departments of Cardiology (P.H.) and Intensive Care Medicine (I.C.C.H.), University of Groningen, Groningen, the Departments of Cardiology (M.V.) and Intensive Care Medicine (J.J.H.), University Medical Center Utrecht, Utrecht, the Departments of Intensive Care Medicine (A.B.) and Cardiology (M.S.), Medisch Spectrum Twente, Enschede, the Departments of Cardiology (C.C., N.R.) and Intensive Care Medicine (H.H.), Radboud University Medical Center, Nijmegen, the Departments of Cardiology (T.A.C.M.H.) and Intensive Care Medicine (W.R.), Noordwest Ziekenhuisgroep, Alkmaar, the Departments of Intensive Care Medicine (T.S.R.D.) and Cardiology (H.J.G.M.C.), Maastricht University Medical Center, Maastricht, the Department of Cardiology, Scheper Hospital, Emmen (G.A.J.J.), the Department of Cardiology, Isala Hospital, Zwolle (M.T.M.G.), the Department of Cardiology, Tergooi Hospital, Blaricum (K.P.), and the Department of Cardiology, Elisabeth-Tweesteden Hospital, Tilburg (M. Magro) - all in the Netherlands
| | - Alexander P J Vlaar
- From the Departments of Cardiology (J.S.L., G.N.J., N.W.H., N.R.), Intensive Care Medicine (P.W.G.E., H.M.O.-S.), and Epidemiology and Biostatistics (P.M.V.), Amsterdam University Medical Center VUmc, the Departments of Cardiology (J.P.H.) and Intensive Care Medicine (A.P.J.V.), Amsterdam University Medical Center AMC, and the Departments of Cardiology (M.A.V.) and Intensive Care Medicine (B.B.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Thorax Center, Erasmus Medical Center (L.S.D.J., E.A.D.), and the Departments of Cardiology (G.J.V.) and Intensive Care Medicine (B.J.W.E.), Maasstad Hospital, Rotterdam, the Departments of Cardiology (M. Meuwissen) and Intensive Care Medicine (T.A.R.), Amphia Hospital, Breda, the Departments of Cardiology (H.A.B.) and Intensive Care Medicine (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Cardiology (G.B.B.) and Intensive Care Medicine (R.B.), Haga Hospital, and the Department of Cardiology, Haaglanden Medical Center (P.V.O.), The Hague, the Departments of Cardiology (P.H.) and Intensive Care Medicine (I.C.C.H.), University of Groningen, Groningen, the Departments of Cardiology (M.V.) and Intensive Care Medicine (J.J.H.), University Medical Center Utrecht, Utrecht, the Departments of Intensive Care Medicine (A.B.) and Cardiology (M.S.), Medisch Spectrum Twente, Enschede, the Departments of Cardiology (C.C., N.R.) and Intensive Care Medicine (H.H.), Radboud University Medical Center, Nijmegen, the Departments of Cardiology (T.A.C.M.H.) and Intensive Care Medicine (W.R.), Noordwest Ziekenhuisgroep, Alkmaar, the Departments of Intensive Care Medicine (T.S.R.D.) and Cardiology (H.J.G.M.C.), Maastricht University Medical Center, Maastricht, the Department of Cardiology, Scheper Hospital, Emmen (G.A.J.J.), the Department of Cardiology, Isala Hospital, Zwolle (M.T.M.G.), the Department of Cardiology, Tergooi Hospital, Blaricum (K.P.), and the Department of Cardiology, Elisabeth-Tweesteden Hospital, Tilburg (M. Magro) - all in the Netherlands
| | - Maarten A Vink
- From the Departments of Cardiology (J.S.L., G.N.J., N.W.H., N.R.), Intensive Care Medicine (P.W.G.E., H.M.O.-S.), and Epidemiology and Biostatistics (P.M.V.), Amsterdam University Medical Center VUmc, the Departments of Cardiology (J.P.H.) and Intensive Care Medicine (A.P.J.V.), Amsterdam University Medical Center AMC, and the Departments of Cardiology (M.A.V.) and Intensive Care Medicine (B.B.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Thorax Center, Erasmus Medical Center (L.S.D.J., E.A.D.), and the Departments of Cardiology (G.J.V.) and Intensive Care Medicine (B.J.W.E.), Maasstad Hospital, Rotterdam, the Departments of Cardiology (M. Meuwissen) and Intensive Care Medicine (T.A.R.), Amphia Hospital, Breda, the Departments of Cardiology (H.A.B.) and Intensive Care Medicine (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Cardiology (G.B.B.) and Intensive Care Medicine (R.B.), Haga Hospital, and the Department of Cardiology, Haaglanden Medical Center (P.V.O.), The Hague, the Departments of Cardiology (P.H.) and Intensive Care Medicine (I.C.C.H.), University of Groningen, Groningen, the Departments of Cardiology (M.V.) and Intensive Care Medicine (J.J.H.), University Medical Center Utrecht, Utrecht, the Departments of Intensive Care Medicine (A.B.) and Cardiology (M.S.), Medisch Spectrum Twente, Enschede, the Departments of Cardiology (C.C., N.R.) and Intensive Care Medicine (H.H.), Radboud University Medical Center, Nijmegen, the Departments of Cardiology (T.A.C.M.H.) and Intensive Care Medicine (W.R.), Noordwest Ziekenhuisgroep, Alkmaar, the Departments of Intensive Care Medicine (T.S.R.D.) and Cardiology (H.J.G.M.C.), Maastricht University Medical Center, Maastricht, the Department of Cardiology, Scheper Hospital, Emmen (G.A.J.J.), the Department of Cardiology, Isala Hospital, Zwolle (M.T.M.G.), the Department of Cardiology, Tergooi Hospital, Blaricum (K.P.), and the Department of Cardiology, Elisabeth-Tweesteden Hospital, Tilburg (M. Magro) - all in the Netherlands
| | - Bas van den Bogaard
- From the Departments of Cardiology (J.S.L., G.N.J., N.W.H., N.R.), Intensive Care Medicine (P.W.G.E., H.M.O.-S.), and Epidemiology and Biostatistics (P.M.V.), Amsterdam University Medical Center VUmc, the Departments of Cardiology (J.P.H.) and Intensive Care Medicine (A.P.J.V.), Amsterdam University Medical Center AMC, and the Departments of Cardiology (M.A.V.) and Intensive Care Medicine (B.B.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Thorax Center, Erasmus Medical Center (L.S.D.J., E.A.D.), and the Departments of Cardiology (G.J.V.) and Intensive Care Medicine (B.J.W.E.), Maasstad Hospital, Rotterdam, the Departments of Cardiology (M. Meuwissen) and Intensive Care Medicine (T.A.R.), Amphia Hospital, Breda, the Departments of Cardiology (H.A.B.) and Intensive Care Medicine (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Cardiology (G.B.B.) and Intensive Care Medicine (R.B.), Haga Hospital, and the Department of Cardiology, Haaglanden Medical Center (P.V.O.), The Hague, the Departments of Cardiology (P.H.) and Intensive Care Medicine (I.C.C.H.), University of Groningen, Groningen, the Departments of Cardiology (M.V.) and Intensive Care Medicine (J.J.H.), University Medical Center Utrecht, Utrecht, the Departments of Intensive Care Medicine (A.B.) and Cardiology (M.S.), Medisch Spectrum Twente, Enschede, the Departments of Cardiology (C.C., N.R.) and Intensive Care Medicine (H.H.), Radboud University Medical Center, Nijmegen, the Departments of Cardiology (T.A.C.M.H.) and Intensive Care Medicine (W.R.), Noordwest Ziekenhuisgroep, Alkmaar, the Departments of Intensive Care Medicine (T.S.R.D.) and Cardiology (H.J.G.M.C.), Maastricht University Medical Center, Maastricht, the Department of Cardiology, Scheper Hospital, Emmen (G.A.J.J.), the Department of Cardiology, Isala Hospital, Zwolle (M.T.M.G.), the Department of Cardiology, Tergooi Hospital, Blaricum (K.P.), and the Department of Cardiology, Elisabeth-Tweesteden Hospital, Tilburg (M. Magro) - all in the Netherlands
| | - Ton A C M Heestermans
- From the Departments of Cardiology (J.S.L., G.N.J., N.W.H., N.R.), Intensive Care Medicine (P.W.G.E., H.M.O.-S.), and Epidemiology and Biostatistics (P.M.V.), Amsterdam University Medical Center VUmc, the Departments of Cardiology (J.P.H.) and Intensive Care Medicine (A.P.J.V.), Amsterdam University Medical Center AMC, and the Departments of Cardiology (M.A.V.) and Intensive Care Medicine (B.B.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Thorax Center, Erasmus Medical Center (L.S.D.J., E.A.D.), and the Departments of Cardiology (G.J.V.) and Intensive Care Medicine (B.J.W.E.), Maasstad Hospital, Rotterdam, the Departments of Cardiology (M. Meuwissen) and Intensive Care Medicine (T.A.R.), Amphia Hospital, Breda, the Departments of Cardiology (H.A.B.) and Intensive Care Medicine (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Cardiology (G.B.B.) and Intensive Care Medicine (R.B.), Haga Hospital, and the Department of Cardiology, Haaglanden Medical Center (P.V.O.), The Hague, the Departments of Cardiology (P.H.) and Intensive Care Medicine (I.C.C.H.), University of Groningen, Groningen, the Departments of Cardiology (M.V.) and Intensive Care Medicine (J.J.H.), University Medical Center Utrecht, Utrecht, the Departments of Intensive Care Medicine (A.B.) and Cardiology (M.S.), Medisch Spectrum Twente, Enschede, the Departments of Cardiology (C.C., N.R.) and Intensive Care Medicine (H.H.), Radboud University Medical Center, Nijmegen, the Departments of Cardiology (T.A.C.M.H.) and Intensive Care Medicine (W.R.), Noordwest Ziekenhuisgroep, Alkmaar, the Departments of Intensive Care Medicine (T.S.R.D.) and Cardiology (H.J.G.M.C.), Maastricht University Medical Center, Maastricht, the Department of Cardiology, Scheper Hospital, Emmen (G.A.J.J.), the Department of Cardiology, Isala Hospital, Zwolle (M.T.M.G.), the Department of Cardiology, Tergooi Hospital, Blaricum (K.P.), and the Department of Cardiology, Elisabeth-Tweesteden Hospital, Tilburg (M. Magro) - all in the Netherlands
| | - Wouter de Ruijter
- From the Departments of Cardiology (J.S.L., G.N.J., N.W.H., N.R.), Intensive Care Medicine (P.W.G.E., H.M.O.-S.), and Epidemiology and Biostatistics (P.M.V.), Amsterdam University Medical Center VUmc, the Departments of Cardiology (J.P.H.) and Intensive Care Medicine (A.P.J.V.), Amsterdam University Medical Center AMC, and the Departments of Cardiology (M.A.V.) and Intensive Care Medicine (B.B.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Thorax Center, Erasmus Medical Center (L.S.D.J., E.A.D.), and the Departments of Cardiology (G.J.V.) and Intensive Care Medicine (B.J.W.E.), Maasstad Hospital, Rotterdam, the Departments of Cardiology (M. Meuwissen) and Intensive Care Medicine (T.A.R.), Amphia Hospital, Breda, the Departments of Cardiology (H.A.B.) and Intensive Care Medicine (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Cardiology (G.B.B.) and Intensive Care Medicine (R.B.), Haga Hospital, and the Department of Cardiology, Haaglanden Medical Center (P.V.O.), The Hague, the Departments of Cardiology (P.H.) and Intensive Care Medicine (I.C.C.H.), University of Groningen, Groningen, the Departments of Cardiology (M.V.) and Intensive Care Medicine (J.J.H.), University Medical Center Utrecht, Utrecht, the Departments of Intensive Care Medicine (A.B.) and Cardiology (M.S.), Medisch Spectrum Twente, Enschede, the Departments of Cardiology (C.C., N.R.) and Intensive Care Medicine (H.H.), Radboud University Medical Center, Nijmegen, the Departments of Cardiology (T.A.C.M.H.) and Intensive Care Medicine (W.R.), Noordwest Ziekenhuisgroep, Alkmaar, the Departments of Intensive Care Medicine (T.S.R.D.) and Cardiology (H.J.G.M.C.), Maastricht University Medical Center, Maastricht, the Department of Cardiology, Scheper Hospital, Emmen (G.A.J.J.), the Department of Cardiology, Isala Hospital, Zwolle (M.T.M.G.), the Department of Cardiology, Tergooi Hospital, Blaricum (K.P.), and the Department of Cardiology, Elisabeth-Tweesteden Hospital, Tilburg (M. Magro) - all in the Netherlands
| | - Thijs S R Delnoij
- From the Departments of Cardiology (J.S.L., G.N.J., N.W.H., N.R.), Intensive Care Medicine (P.W.G.E., H.M.O.-S.), and Epidemiology and Biostatistics (P.M.V.), Amsterdam University Medical Center VUmc, the Departments of Cardiology (J.P.H.) and Intensive Care Medicine (A.P.J.V.), Amsterdam University Medical Center AMC, and the Departments of Cardiology (M.A.V.) and Intensive Care Medicine (B.B.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Thorax Center, Erasmus Medical Center (L.S.D.J., E.A.D.), and the Departments of Cardiology (G.J.V.) and Intensive Care Medicine (B.J.W.E.), Maasstad Hospital, Rotterdam, the Departments of Cardiology (M. Meuwissen) and Intensive Care Medicine (T.A.R.), Amphia Hospital, Breda, the Departments of Cardiology (H.A.B.) and Intensive Care Medicine (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Cardiology (G.B.B.) and Intensive Care Medicine (R.B.), Haga Hospital, and the Department of Cardiology, Haaglanden Medical Center (P.V.O.), The Hague, the Departments of Cardiology (P.H.) and Intensive Care Medicine (I.C.C.H.), University of Groningen, Groningen, the Departments of Cardiology (M.V.) and Intensive Care Medicine (J.J.H.), University Medical Center Utrecht, Utrecht, the Departments of Intensive Care Medicine (A.B.) and Cardiology (M.S.), Medisch Spectrum Twente, Enschede, the Departments of Cardiology (C.C., N.R.) and Intensive Care Medicine (H.H.), Radboud University Medical Center, Nijmegen, the Departments of Cardiology (T.A.C.M.H.) and Intensive Care Medicine (W.R.), Noordwest Ziekenhuisgroep, Alkmaar, the Departments of Intensive Care Medicine (T.S.R.D.) and Cardiology (H.J.G.M.C.), Maastricht University Medical Center, Maastricht, the Department of Cardiology, Scheper Hospital, Emmen (G.A.J.J.), the Department of Cardiology, Isala Hospital, Zwolle (M.T.M.G.), the Department of Cardiology, Tergooi Hospital, Blaricum (K.P.), and the Department of Cardiology, Elisabeth-Tweesteden Hospital, Tilburg (M. Magro) - all in the Netherlands
| | - Harry J G M Crijns
- From the Departments of Cardiology (J.S.L., G.N.J., N.W.H., N.R.), Intensive Care Medicine (P.W.G.E., H.M.O.-S.), and Epidemiology and Biostatistics (P.M.V.), Amsterdam University Medical Center VUmc, the Departments of Cardiology (J.P.H.) and Intensive Care Medicine (A.P.J.V.), Amsterdam University Medical Center AMC, and the Departments of Cardiology (M.A.V.) and Intensive Care Medicine (B.B.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Thorax Center, Erasmus Medical Center (L.S.D.J., E.A.D.), and the Departments of Cardiology (G.J.V.) and Intensive Care Medicine (B.J.W.E.), Maasstad Hospital, Rotterdam, the Departments of Cardiology (M. Meuwissen) and Intensive Care Medicine (T.A.R.), Amphia Hospital, Breda, the Departments of Cardiology (H.A.B.) and Intensive Care Medicine (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Cardiology (G.B.B.) and Intensive Care Medicine (R.B.), Haga Hospital, and the Department of Cardiology, Haaglanden Medical Center (P.V.O.), The Hague, the Departments of Cardiology (P.H.) and Intensive Care Medicine (I.C.C.H.), University of Groningen, Groningen, the Departments of Cardiology (M.V.) and Intensive Care Medicine (J.J.H.), University Medical Center Utrecht, Utrecht, the Departments of Intensive Care Medicine (A.B.) and Cardiology (M.S.), Medisch Spectrum Twente, Enschede, the Departments of Cardiology (C.C., N.R.) and Intensive Care Medicine (H.H.), Radboud University Medical Center, Nijmegen, the Departments of Cardiology (T.A.C.M.H.) and Intensive Care Medicine (W.R.), Noordwest Ziekenhuisgroep, Alkmaar, the Departments of Intensive Care Medicine (T.S.R.D.) and Cardiology (H.J.G.M.C.), Maastricht University Medical Center, Maastricht, the Department of Cardiology, Scheper Hospital, Emmen (G.A.J.J.), the Department of Cardiology, Isala Hospital, Zwolle (M.T.M.G.), the Department of Cardiology, Tergooi Hospital, Blaricum (K.P.), and the Department of Cardiology, Elisabeth-Tweesteden Hospital, Tilburg (M. Magro) - all in the Netherlands
| | - Gillian A J Jessurun
- From the Departments of Cardiology (J.S.L., G.N.J., N.W.H., N.R.), Intensive Care Medicine (P.W.G.E., H.M.O.-S.), and Epidemiology and Biostatistics (P.M.V.), Amsterdam University Medical Center VUmc, the Departments of Cardiology (J.P.H.) and Intensive Care Medicine (A.P.J.V.), Amsterdam University Medical Center AMC, and the Departments of Cardiology (M.A.V.) and Intensive Care Medicine (B.B.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Thorax Center, Erasmus Medical Center (L.S.D.J., E.A.D.), and the Departments of Cardiology (G.J.V.) and Intensive Care Medicine (B.J.W.E.), Maasstad Hospital, Rotterdam, the Departments of Cardiology (M. Meuwissen) and Intensive Care Medicine (T.A.R.), Amphia Hospital, Breda, the Departments of Cardiology (H.A.B.) and Intensive Care Medicine (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Cardiology (G.B.B.) and Intensive Care Medicine (R.B.), Haga Hospital, and the Department of Cardiology, Haaglanden Medical Center (P.V.O.), The Hague, the Departments of Cardiology (P.H.) and Intensive Care Medicine (I.C.C.H.), University of Groningen, Groningen, the Departments of Cardiology (M.V.) and Intensive Care Medicine (J.J.H.), University Medical Center Utrecht, Utrecht, the Departments of Intensive Care Medicine (A.B.) and Cardiology (M.S.), Medisch Spectrum Twente, Enschede, the Departments of Cardiology (C.C., N.R.) and Intensive Care Medicine (H.H.), Radboud University Medical Center, Nijmegen, the Departments of Cardiology (T.A.C.M.H.) and Intensive Care Medicine (W.R.), Noordwest Ziekenhuisgroep, Alkmaar, the Departments of Intensive Care Medicine (T.S.R.D.) and Cardiology (H.J.G.M.C.), Maastricht University Medical Center, Maastricht, the Department of Cardiology, Scheper Hospital, Emmen (G.A.J.J.), the Department of Cardiology, Isala Hospital, Zwolle (M.T.M.G.), the Department of Cardiology, Tergooi Hospital, Blaricum (K.P.), and the Department of Cardiology, Elisabeth-Tweesteden Hospital, Tilburg (M. Magro) - all in the Netherlands
| | - Pranobe V Oemrawsingh
- From the Departments of Cardiology (J.S.L., G.N.J., N.W.H., N.R.), Intensive Care Medicine (P.W.G.E., H.M.O.-S.), and Epidemiology and Biostatistics (P.M.V.), Amsterdam University Medical Center VUmc, the Departments of Cardiology (J.P.H.) and Intensive Care Medicine (A.P.J.V.), Amsterdam University Medical Center AMC, and the Departments of Cardiology (M.A.V.) and Intensive Care Medicine (B.B.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Thorax Center, Erasmus Medical Center (L.S.D.J., E.A.D.), and the Departments of Cardiology (G.J.V.) and Intensive Care Medicine (B.J.W.E.), Maasstad Hospital, Rotterdam, the Departments of Cardiology (M. Meuwissen) and Intensive Care Medicine (T.A.R.), Amphia Hospital, Breda, the Departments of Cardiology (H.A.B.) and Intensive Care Medicine (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Cardiology (G.B.B.) and Intensive Care Medicine (R.B.), Haga Hospital, and the Department of Cardiology, Haaglanden Medical Center (P.V.O.), The Hague, the Departments of Cardiology (P.H.) and Intensive Care Medicine (I.C.C.H.), University of Groningen, Groningen, the Departments of Cardiology (M.V.) and Intensive Care Medicine (J.J.H.), University Medical Center Utrecht, Utrecht, the Departments of Intensive Care Medicine (A.B.) and Cardiology (M.S.), Medisch Spectrum Twente, Enschede, the Departments of Cardiology (C.C., N.R.) and Intensive Care Medicine (H.H.), Radboud University Medical Center, Nijmegen, the Departments of Cardiology (T.A.C.M.H.) and Intensive Care Medicine (W.R.), Noordwest Ziekenhuisgroep, Alkmaar, the Departments of Intensive Care Medicine (T.S.R.D.) and Cardiology (H.J.G.M.C.), Maastricht University Medical Center, Maastricht, the Department of Cardiology, Scheper Hospital, Emmen (G.A.J.J.), the Department of Cardiology, Isala Hospital, Zwolle (M.T.M.G.), the Department of Cardiology, Tergooi Hospital, Blaricum (K.P.), and the Department of Cardiology, Elisabeth-Tweesteden Hospital, Tilburg (M. Magro) - all in the Netherlands
| | - Marcel T M Gosselink
- From the Departments of Cardiology (J.S.L., G.N.J., N.W.H., N.R.), Intensive Care Medicine (P.W.G.E., H.M.O.-S.), and Epidemiology and Biostatistics (P.M.V.), Amsterdam University Medical Center VUmc, the Departments of Cardiology (J.P.H.) and Intensive Care Medicine (A.P.J.V.), Amsterdam University Medical Center AMC, and the Departments of Cardiology (M.A.V.) and Intensive Care Medicine (B.B.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Thorax Center, Erasmus Medical Center (L.S.D.J., E.A.D.), and the Departments of Cardiology (G.J.V.) and Intensive Care Medicine (B.J.W.E.), Maasstad Hospital, Rotterdam, the Departments of Cardiology (M. Meuwissen) and Intensive Care Medicine (T.A.R.), Amphia Hospital, Breda, the Departments of Cardiology (H.A.B.) and Intensive Care Medicine (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Cardiology (G.B.B.) and Intensive Care Medicine (R.B.), Haga Hospital, and the Department of Cardiology, Haaglanden Medical Center (P.V.O.), The Hague, the Departments of Cardiology (P.H.) and Intensive Care Medicine (I.C.C.H.), University of Groningen, Groningen, the Departments of Cardiology (M.V.) and Intensive Care Medicine (J.J.H.), University Medical Center Utrecht, Utrecht, the Departments of Intensive Care Medicine (A.B.) and Cardiology (M.S.), Medisch Spectrum Twente, Enschede, the Departments of Cardiology (C.C., N.R.) and Intensive Care Medicine (H.H.), Radboud University Medical Center, Nijmegen, the Departments of Cardiology (T.A.C.M.H.) and Intensive Care Medicine (W.R.), Noordwest Ziekenhuisgroep, Alkmaar, the Departments of Intensive Care Medicine (T.S.R.D.) and Cardiology (H.J.G.M.C.), Maastricht University Medical Center, Maastricht, the Department of Cardiology, Scheper Hospital, Emmen (G.A.J.J.), the Department of Cardiology, Isala Hospital, Zwolle (M.T.M.G.), the Department of Cardiology, Tergooi Hospital, Blaricum (K.P.), and the Department of Cardiology, Elisabeth-Tweesteden Hospital, Tilburg (M. Magro) - all in the Netherlands
| | - Koos Plomp
- From the Departments of Cardiology (J.S.L., G.N.J., N.W.H., N.R.), Intensive Care Medicine (P.W.G.E., H.M.O.-S.), and Epidemiology and Biostatistics (P.M.V.), Amsterdam University Medical Center VUmc, the Departments of Cardiology (J.P.H.) and Intensive Care Medicine (A.P.J.V.), Amsterdam University Medical Center AMC, and the Departments of Cardiology (M.A.V.) and Intensive Care Medicine (B.B.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Thorax Center, Erasmus Medical Center (L.S.D.J., E.A.D.), and the Departments of Cardiology (G.J.V.) and Intensive Care Medicine (B.J.W.E.), Maasstad Hospital, Rotterdam, the Departments of Cardiology (M. Meuwissen) and Intensive Care Medicine (T.A.R.), Amphia Hospital, Breda, the Departments of Cardiology (H.A.B.) and Intensive Care Medicine (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Cardiology (G.B.B.) and Intensive Care Medicine (R.B.), Haga Hospital, and the Department of Cardiology, Haaglanden Medical Center (P.V.O.), The Hague, the Departments of Cardiology (P.H.) and Intensive Care Medicine (I.C.C.H.), University of Groningen, Groningen, the Departments of Cardiology (M.V.) and Intensive Care Medicine (J.J.H.), University Medical Center Utrecht, Utrecht, the Departments of Intensive Care Medicine (A.B.) and Cardiology (M.S.), Medisch Spectrum Twente, Enschede, the Departments of Cardiology (C.C., N.R.) and Intensive Care Medicine (H.H.), Radboud University Medical Center, Nijmegen, the Departments of Cardiology (T.A.C.M.H.) and Intensive Care Medicine (W.R.), Noordwest Ziekenhuisgroep, Alkmaar, the Departments of Intensive Care Medicine (T.S.R.D.) and Cardiology (H.J.G.M.C.), Maastricht University Medical Center, Maastricht, the Department of Cardiology, Scheper Hospital, Emmen (G.A.J.J.), the Department of Cardiology, Isala Hospital, Zwolle (M.T.M.G.), the Department of Cardiology, Tergooi Hospital, Blaricum (K.P.), and the Department of Cardiology, Elisabeth-Tweesteden Hospital, Tilburg (M. Magro) - all in the Netherlands
| | - Michael Magro
- From the Departments of Cardiology (J.S.L., G.N.J., N.W.H., N.R.), Intensive Care Medicine (P.W.G.E., H.M.O.-S.), and Epidemiology and Biostatistics (P.M.V.), Amsterdam University Medical Center VUmc, the Departments of Cardiology (J.P.H.) and Intensive Care Medicine (A.P.J.V.), Amsterdam University Medical Center AMC, and the Departments of Cardiology (M.A.V.) and Intensive Care Medicine (B.B.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Thorax Center, Erasmus Medical Center (L.S.D.J., E.A.D.), and the Departments of Cardiology (G.J.V.) and Intensive Care Medicine (B.J.W.E.), Maasstad Hospital, Rotterdam, the Departments of Cardiology (M. Meuwissen) and Intensive Care Medicine (T.A.R.), Amphia Hospital, Breda, the Departments of Cardiology (H.A.B.) and Intensive Care Medicine (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Cardiology (G.B.B.) and Intensive Care Medicine (R.B.), Haga Hospital, and the Department of Cardiology, Haaglanden Medical Center (P.V.O.), The Hague, the Departments of Cardiology (P.H.) and Intensive Care Medicine (I.C.C.H.), University of Groningen, Groningen, the Departments of Cardiology (M.V.) and Intensive Care Medicine (J.J.H.), University Medical Center Utrecht, Utrecht, the Departments of Intensive Care Medicine (A.B.) and Cardiology (M.S.), Medisch Spectrum Twente, Enschede, the Departments of Cardiology (C.C., N.R.) and Intensive Care Medicine (H.H.), Radboud University Medical Center, Nijmegen, the Departments of Cardiology (T.A.C.M.H.) and Intensive Care Medicine (W.R.), Noordwest Ziekenhuisgroep, Alkmaar, the Departments of Intensive Care Medicine (T.S.R.D.) and Cardiology (H.J.G.M.C.), Maastricht University Medical Center, Maastricht, the Department of Cardiology, Scheper Hospital, Emmen (G.A.J.J.), the Department of Cardiology, Isala Hospital, Zwolle (M.T.M.G.), the Department of Cardiology, Tergooi Hospital, Blaricum (K.P.), and the Department of Cardiology, Elisabeth-Tweesteden Hospital, Tilburg (M. Magro) - all in the Netherlands
| | - Paul W G Elbers
- From the Departments of Cardiology (J.S.L., G.N.J., N.W.H., N.R.), Intensive Care Medicine (P.W.G.E., H.M.O.-S.), and Epidemiology and Biostatistics (P.M.V.), Amsterdam University Medical Center VUmc, the Departments of Cardiology (J.P.H.) and Intensive Care Medicine (A.P.J.V.), Amsterdam University Medical Center AMC, and the Departments of Cardiology (M.A.V.) and Intensive Care Medicine (B.B.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Thorax Center, Erasmus Medical Center (L.S.D.J., E.A.D.), and the Departments of Cardiology (G.J.V.) and Intensive Care Medicine (B.J.W.E.), Maasstad Hospital, Rotterdam, the Departments of Cardiology (M. Meuwissen) and Intensive Care Medicine (T.A.R.), Amphia Hospital, Breda, the Departments of Cardiology (H.A.B.) and Intensive Care Medicine (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Cardiology (G.B.B.) and Intensive Care Medicine (R.B.), Haga Hospital, and the Department of Cardiology, Haaglanden Medical Center (P.V.O.), The Hague, the Departments of Cardiology (P.H.) and Intensive Care Medicine (I.C.C.H.), University of Groningen, Groningen, the Departments of Cardiology (M.V.) and Intensive Care Medicine (J.J.H.), University Medical Center Utrecht, Utrecht, the Departments of Intensive Care Medicine (A.B.) and Cardiology (M.S.), Medisch Spectrum Twente, Enschede, the Departments of Cardiology (C.C., N.R.) and Intensive Care Medicine (H.H.), Radboud University Medical Center, Nijmegen, the Departments of Cardiology (T.A.C.M.H.) and Intensive Care Medicine (W.R.), Noordwest Ziekenhuisgroep, Alkmaar, the Departments of Intensive Care Medicine (T.S.R.D.) and Cardiology (H.J.G.M.C.), Maastricht University Medical Center, Maastricht, the Department of Cardiology, Scheper Hospital, Emmen (G.A.J.J.), the Department of Cardiology, Isala Hospital, Zwolle (M.T.M.G.), the Department of Cardiology, Tergooi Hospital, Blaricum (K.P.), and the Department of Cardiology, Elisabeth-Tweesteden Hospital, Tilburg (M. Magro) - all in the Netherlands
| | - Peter M van de Ven
- From the Departments of Cardiology (J.S.L., G.N.J., N.W.H., N.R.), Intensive Care Medicine (P.W.G.E., H.M.O.-S.), and Epidemiology and Biostatistics (P.M.V.), Amsterdam University Medical Center VUmc, the Departments of Cardiology (J.P.H.) and Intensive Care Medicine (A.P.J.V.), Amsterdam University Medical Center AMC, and the Departments of Cardiology (M.A.V.) and Intensive Care Medicine (B.B.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Thorax Center, Erasmus Medical Center (L.S.D.J., E.A.D.), and the Departments of Cardiology (G.J.V.) and Intensive Care Medicine (B.J.W.E.), Maasstad Hospital, Rotterdam, the Departments of Cardiology (M. Meuwissen) and Intensive Care Medicine (T.A.R.), Amphia Hospital, Breda, the Departments of Cardiology (H.A.B.) and Intensive Care Medicine (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Cardiology (G.B.B.) and Intensive Care Medicine (R.B.), Haga Hospital, and the Department of Cardiology, Haaglanden Medical Center (P.V.O.), The Hague, the Departments of Cardiology (P.H.) and Intensive Care Medicine (I.C.C.H.), University of Groningen, Groningen, the Departments of Cardiology (M.V.) and Intensive Care Medicine (J.J.H.), University Medical Center Utrecht, Utrecht, the Departments of Intensive Care Medicine (A.B.) and Cardiology (M.S.), Medisch Spectrum Twente, Enschede, the Departments of Cardiology (C.C., N.R.) and Intensive Care Medicine (H.H.), Radboud University Medical Center, Nijmegen, the Departments of Cardiology (T.A.C.M.H.) and Intensive Care Medicine (W.R.), Noordwest Ziekenhuisgroep, Alkmaar, the Departments of Intensive Care Medicine (T.S.R.D.) and Cardiology (H.J.G.M.C.), Maastricht University Medical Center, Maastricht, the Department of Cardiology, Scheper Hospital, Emmen (G.A.J.J.), the Department of Cardiology, Isala Hospital, Zwolle (M.T.M.G.), the Department of Cardiology, Tergooi Hospital, Blaricum (K.P.), and the Department of Cardiology, Elisabeth-Tweesteden Hospital, Tilburg (M. Magro) - all in the Netherlands
| | - Heleen M Oudemans-van Straaten
- From the Departments of Cardiology (J.S.L., G.N.J., N.W.H., N.R.), Intensive Care Medicine (P.W.G.E., H.M.O.-S.), and Epidemiology and Biostatistics (P.M.V.), Amsterdam University Medical Center VUmc, the Departments of Cardiology (J.P.H.) and Intensive Care Medicine (A.P.J.V.), Amsterdam University Medical Center AMC, and the Departments of Cardiology (M.A.V.) and Intensive Care Medicine (B.B.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Thorax Center, Erasmus Medical Center (L.S.D.J., E.A.D.), and the Departments of Cardiology (G.J.V.) and Intensive Care Medicine (B.J.W.E.), Maasstad Hospital, Rotterdam, the Departments of Cardiology (M. Meuwissen) and Intensive Care Medicine (T.A.R.), Amphia Hospital, Breda, the Departments of Cardiology (H.A.B.) and Intensive Care Medicine (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Cardiology (G.B.B.) and Intensive Care Medicine (R.B.), Haga Hospital, and the Department of Cardiology, Haaglanden Medical Center (P.V.O.), The Hague, the Departments of Cardiology (P.H.) and Intensive Care Medicine (I.C.C.H.), University of Groningen, Groningen, the Departments of Cardiology (M.V.) and Intensive Care Medicine (J.J.H.), University Medical Center Utrecht, Utrecht, the Departments of Intensive Care Medicine (A.B.) and Cardiology (M.S.), Medisch Spectrum Twente, Enschede, the Departments of Cardiology (C.C., N.R.) and Intensive Care Medicine (H.H.), Radboud University Medical Center, Nijmegen, the Departments of Cardiology (T.A.C.M.H.) and Intensive Care Medicine (W.R.), Noordwest Ziekenhuisgroep, Alkmaar, the Departments of Intensive Care Medicine (T.S.R.D.) and Cardiology (H.J.G.M.C.), Maastricht University Medical Center, Maastricht, the Department of Cardiology, Scheper Hospital, Emmen (G.A.J.J.), the Department of Cardiology, Isala Hospital, Zwolle (M.T.M.G.), the Department of Cardiology, Tergooi Hospital, Blaricum (K.P.), and the Department of Cardiology, Elisabeth-Tweesteden Hospital, Tilburg (M. Magro) - all in the Netherlands
| | - Niels van Royen
- From the Departments of Cardiology (J.S.L., G.N.J., N.W.H., N.R.), Intensive Care Medicine (P.W.G.E., H.M.O.-S.), and Epidemiology and Biostatistics (P.M.V.), Amsterdam University Medical Center VUmc, the Departments of Cardiology (J.P.H.) and Intensive Care Medicine (A.P.J.V.), Amsterdam University Medical Center AMC, and the Departments of Cardiology (M.A.V.) and Intensive Care Medicine (B.B.), Onze Lieve Vrouwe Gasthuis, Amsterdam, the Thorax Center, Erasmus Medical Center (L.S.D.J., E.A.D.), and the Departments of Cardiology (G.J.V.) and Intensive Care Medicine (B.J.W.E.), Maasstad Hospital, Rotterdam, the Departments of Cardiology (M. Meuwissen) and Intensive Care Medicine (T.A.R.), Amphia Hospital, Breda, the Departments of Cardiology (H.A.B.) and Intensive Care Medicine (M.J.B.), Rijnstate Hospital, Arnhem, the Departments of Cardiology (G.B.B.) and Intensive Care Medicine (R.B.), Haga Hospital, and the Department of Cardiology, Haaglanden Medical Center (P.V.O.), The Hague, the Departments of Cardiology (P.H.) and Intensive Care Medicine (I.C.C.H.), University of Groningen, Groningen, the Departments of Cardiology (M.V.) and Intensive Care Medicine (J.J.H.), University Medical Center Utrecht, Utrecht, the Departments of Intensive Care Medicine (A.B.) and Cardiology (M.S.), Medisch Spectrum Twente, Enschede, the Departments of Cardiology (C.C., N.R.) and Intensive Care Medicine (H.H.), Radboud University Medical Center, Nijmegen, the Departments of Cardiology (T.A.C.M.H.) and Intensive Care Medicine (W.R.), Noordwest Ziekenhuisgroep, Alkmaar, the Departments of Intensive Care Medicine (T.S.R.D.) and Cardiology (H.J.G.M.C.), Maastricht University Medical Center, Maastricht, the Department of Cardiology, Scheper Hospital, Emmen (G.A.J.J.), the Department of Cardiology, Isala Hospital, Zwolle (M.T.M.G.), the Department of Cardiology, Tergooi Hospital, Blaricum (K.P.), and the Department of Cardiology, Elisabeth-Tweesteden Hospital, Tilburg (M. Magro) - all in the Netherlands
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11
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Bol ME, Suverein MM, Lorusso R, Delnoij TS, Brandon Bravo Bruinsma GJ, Otterspoor L, Kuijpers M, Lam KY, Vlaar AP, Elzo Kraemer CV, van der Heijden JJ, Scholten E, Driessen AH, Montero Cabezas JM, Rittersma SZ, Heijnen BG, Taccone FS, Essers B, Delhaas T, Weerwind PW, Roekaerts PM, Maessen JG, van de Poll MC. Early initiation of extracorporeal life support in refractory out-of-hospital cardiac arrest: Design and rationale of the INCEPTION trial. Am Heart J 2019; 210:58-68. [PMID: 30738245 DOI: 10.1016/j.ahj.2018.12.008] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 12/02/2018] [Indexed: 01/14/2023]
Abstract
Return of spontaneous circulation occurs in less than 10% of patients with cardiac arrest undergoing cardiopulmonary resuscitation (CPR) for more than 15 minutes. Studies suggest that extracorporeal life support during cardiopulmonary resuscitation (ECPR) improves survival rate in these patients. These studies, however, are hampered by their non-randomized, observational design and are mostly single-center. A multicenter, randomized controlled trial is urgently warranted to evaluate the effectiveness of ECPR. HYPOTHESIS We hypothesize that early initiation of ECPR in refractory out-of-hospital cardiac arrest (OHCA) improves the survival rate with favorable neurological status. STUDY DESIGN The INCEPTION trial is an investigator-initiated, prospective, multicenter trial that will randomly allocate 110 patients to either continued CPR or ECPR in a 1:1 ratio. Patients eligible for inclusion are adults (≤ 70 years) with witnessed OHCA presenting with an initial rhythm of ventricular fibrillation (VF) or ventricular tachycardia (VT), who received bystander basic life support and who fail to achieve sustained return of spontaneous circulation within 15 minutes of cardiopulmonary resuscitation by emergency medical services. The primary endpoint of the study is 30-day survival rate with favorable neurological status, defined as 1 or 2 on the Cerebral Performance Category score. The secondary endpoints include 3, 6 and 12-month survival rate with favorable neurological status and the cost-effectiveness of ECPR compared to CCPR. SUMMARY The INCEPTION trial aims to determine the clinical benefit for the use of ECPR in patients with refractory OHCA presenting with VF/VT. Additionally, the feasibility and cost-effectiveness of ECPR will be evaluated.
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12
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Donker DW, Meuwese CL, Braithwaite SA, Broomé M, van der Heijden JJ, Hermens JA, Platenkamp M, de Jong M, Janssen JG, Balík M, Bělohlávek J. Echocardiography in extracorporeal life support: A key player in procedural guidance, tailoring and monitoring. Perfusion 2018; 33:31-41. [DOI: 10.1177/0267659118766438] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Extracorporeal life support (ECLS) is a mainstay of current practice in severe respiratory, circulatory or cardiac failure refractory to conventional management. The inherent complexity of different ECLS modes and their influence on the native pulmonary and cardiovascular system require patient-specific tailoring to optimize outcome. Echocardiography plays a key role throughout the ECLS care, including patient selection, adequate placement of cannulas, monitoring, weaning and follow-up after decannulation. For this purpose, echocardiographers require specific ECLS-related knowledge and skills, which are outlined here.
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Affiliation(s)
- Dirk W. Donker
- Department of Intensive Care Medicine, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Christiaan L. Meuwese
- Department of Cardiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Sue A. Braithwaite
- Department of Anaesthesiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Michael Broomé
- ECMO Department, Karolinska University Hospital, Stockholm, Sweden
- Anaesthesiology and Intensive Care, Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden
- School of Technology and Health, Royal Institute of Technology, Stockholm, Sweden
| | - Joris J. van der Heijden
- Department of Intensive Care Medicine, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Jeannine A. Hermens
- Department of Intensive Care Medicine, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Marc Platenkamp
- Department of Intensive Care Medicine, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Michel de Jong
- Department of Cardiothoracic Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Jacqueline G.D. Janssen
- Department of Intensive Care Medicine, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Martin Balík
- Department of Anaesthesiology, Resuscitation and Intensive Medicine, 1st Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Jan Bělohlávek
- 2nd Department of Medicine, Department of Cardiovascular Medicine, 1st Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
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13
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Affiliation(s)
- Rob C.M. van Kruijsdijk
- From the Department of Intensive Care (R.C.M.K., L.C.O.) and the Department of Cardiology (J.J.v.d.H.), University Medical Centre, Utrecht, Utrecht, The Netherlands; and the Department of Cardiology (R.U.), Deventer Hospital, Deventer, The Netherlands
| | - Joris J. van der Heijden
- From the Department of Intensive Care (R.C.M.K., L.C.O.) and the Department of Cardiology (J.J.v.d.H.), University Medical Centre, Utrecht, Utrecht, The Netherlands; and the Department of Cardiology (R.U.), Deventer Hospital, Deventer, The Netherlands
| | - Ruben Uijlings
- From the Department of Intensive Care (R.C.M.K., L.C.O.) and the Department of Cardiology (J.J.v.d.H.), University Medical Centre, Utrecht, Utrecht, The Netherlands; and the Department of Cardiology (R.U.), Deventer Hospital, Deventer, The Netherlands
| | - Luuk C. Otterspoor
- From the Department of Intensive Care (R.C.M.K., L.C.O.) and the Department of Cardiology (J.J.v.d.H.), University Medical Centre, Utrecht, Utrecht, The Netherlands; and the Department of Cardiology (R.U.), Deventer Hospital, Deventer, The Netherlands
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