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Mulari S, Kesävuori R, Stewart JA, Karjalainen P, Holmström M, Lehtinen M, Peltonen J, Laine M, Sinisalo J, Juvonen T, Kupari M, Harjula A, Pätilä T, Kivistö S, Kankuri E, Vento A. Follow-up of intramyocardial bone marrow mononuclear cell transplantation beyond 10 years. Sci Rep 2024; 14:3747. [PMID: 38355940 PMCID: PMC10866866 DOI: 10.1038/s41598-024-53776-9] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 02/05/2024] [Indexed: 02/16/2024] Open
Abstract
Bone marrow mononuclear cells (BMMCs) have been evaluated for their ability to improve cardiac repair and benefit patients with severe ischemic heart disease and heart failure. In our single-center trial in 2006-2011 we demonstrated the safety and efficacy of BMMCs injected intramyocardially in conjunction with coronary artery bypass surgery. The effect persisted in the follow-up study 5 years later. In this study, we investigated the efficacy of BMMC therapy beyond 10 years. A total of 18 patients (46%) died during over 10-years follow-up and 21 were contacted for participation. Late gadolinium enhancement cardiac magnetic resonance imaging (CMRI) and clinical evaluation were performed on 14 patients, seven from each group. CMRIs from the study baseline, 1-year and 5-years follow-ups were re-analyzed to enable comparison. The CMRI demonstrated a 2.1-fold larger reduction in the mass of late gadolinium enhancement values between the preoperative and the over 10-years follow-up, suggesting less scar or fibrosis after BMMC treatment (- 15.1%; 95% CI - 23 to - 6.7% vs. - 7.3%; 95% CI - 16 to 4.5%, p = 0.039), compared to placebo. No differences in mortality or morbidity were observed. Intramyocardially injected BMMCs may exert long-term benefits in patients with ischemic heart failure. This deserves further evaluation in patients who have received BMMCs in international clinical studies over two decades.
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Affiliation(s)
- Severi Mulari
- Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Faculty of Medicine, Department of Pharmacology, University of Helsinki, Haartmaninkatu 8, PO Box 63, 00014, Helsinki, Finland
| | - Risto Kesävuori
- Department of Radiology, HUS Medical Imaging Center and Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Juhani A Stewart
- Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Pasi Karjalainen
- Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Miia Holmström
- Department of Radiology, HUS Medical Imaging Center and Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Miia Lehtinen
- Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Juha Peltonen
- Department of Radiology, HUS Medical Imaging Center and Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Mika Laine
- Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Juha Sinisalo
- Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Tatu Juvonen
- Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Markku Kupari
- Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Ari Harjula
- Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Tommi Pätilä
- Pediatric Cardiac Surgery, Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Sari Kivistö
- Department of Radiology, HUS Medical Imaging Center and Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Esko Kankuri
- Faculty of Medicine, Department of Pharmacology, University of Helsinki, Haartmaninkatu 8, PO Box 63, 00014, Helsinki, Finland.
| | - Antti Vento
- Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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Hindricks G, Theuns DA, Bar-Lev D, Anguera I, Ayala Paredes FA, Arnold M, Geller JC, Merkely B, Dyrda KM, Perings C, Maglia G, Ploux S, Meyhöfer J, Blomström-Lundqvist C, Karjalainen P, Liang Y, Diemberger I, Wranicz JK, Barr C, Quartieri F, Timmel T, Bollmann A. Ability to remotely monitor atrial high-rate episodes using a single-chamber implantable cardioverter-defibrillator with a floating atrial sensing dipole. Europace 2023; 25:euad061. [PMID: 37038759 PMCID: PMC10227664 DOI: 10.1093/europace/euad061] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 12/06/2022] [Indexed: 04/12/2023] Open
Abstract
AIMS To allow timely initiation of anticoagulation therapy for the prevention of stroke, the European guidelines on atrial fibrillation (AF) recommend remote monitoring (RM) of device-detected atrial high-rate episodes (AHREs) and progression of arrhythmia duration along pre-specified strata (6 min…<1 h, 1 h…<24 h, ≥ 24 h). We used the MATRIX registry data to assess the capability of a single-lead implantable cardioverter-defibrillator (ICD) with atrial sensing dipole (DX ICD system) to follow this recommendation in patients with standard indication for single-chamber ICD. METHODS AND RESULTS In 1841 DX ICD patients with daily automatic RM transmissions, electrograms of first device-detected AHREs per patient in each duration stratum were adjudicated, and the corresponding positive predictive values (PPVs) for the detections to be true atrial arrhythmia were calculated. Moreover, the incidence and progression of new-onset AF was assessed in 1451 patients with no AF history. A total of 610 AHREs ≥6 min were adjudicated. The PPV was 95.1% (271 of 285) for episodes 6min…<1 h, 99.6% (253/254) for episodes 1 h…<24 h, 100% (71/71) for episodes ≥24 h, or 97.5% for all episodes (595/610). The incidence of new-onset AF was 8.2% (119/1451), and in 31.1% of them (37/119), new-onset AF progressed to a higher duration stratum. Nearly 80% of new-onset AF patients had high CHA2DS2-VASc stroke risk, and 70% were not on anticoagulation therapy. Age was the only significant predictor of new-onset AF. CONCLUSION A 99.7% detection accuracy for AHRE ≥1 h in patients with DX ICD systems in combination with daily RM allows a reliable guideline-recommended screening for subclinical AF and monitoring of AF-duration progression.
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Affiliation(s)
- Gerhard Hindricks
- Department of Electrophysiology, Heart Centre Leipzig and Leipzig Heart Institute, Strümpellstrasse 39, 04289 Leipzig, Germany
| | - Dominic A Theuns
- Erasmus University Medical Center,‘s-Gravendijkwal 230, 3015 GD Rotterdam, TheNetherlands
| | - David Bar-Lev
- Chaim Sheba Medical Center,52621 Tel Hashomer, Israel
| | - Ignasi Anguera
- Arrhythmia Unit, Heart Diseases Institute, Bellvitge Biomedical Research Institute (IDIBELL), Bellvitge University Hospital, Feixa Llarga, 08907 L'Hospitalet, Barcelona, Spain
| | | | - Martin Arnold
- Department of Cardiology, Friedrich-Alexander-Universität Erlangen-Nuremberg, Ulmenweg 18, 91054 Erlangen, Germany
| | - J Christoph Geller
- Zentralklinik Bad Berka GmbH,Robert-Koch-Allee 9, 99437 Bad Berka, Germany
| | - Béla Merkely
- Semmelweis Medical University, Városmajorutca 68, 1122 Budapest, Hungary
| | - Katia Marjolaine Dyrda
- Montreal Heart Institute affiliated with Université de Montréal, 5000, rue Belanger, H1T 1C8 Montréal, Québec, Canada
| | | | - Giampiero Maglia
- Azienda Ospedaliera Pugliese Ciaccio, Via Vinicio Cortese 25, 88100 Catanzaro, Italia
| | - Sylvain Ploux
- Hôpital Haut Lévêque (CHU), 1 avenue de Magellan, 33600 Pessac Cedex, France
| | - Jürgen Meyhöfer
- Maria Heimsuchung—Caritas-Klinik Pankow,Breite Str. 46/47, 13187 Berlin, Germany
| | - Carina Blomström-Lundqvist
- Department of Cardiology, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, SE-701 82 Örebro, Sweden
- Department of Medical Science and Cardiology, Uppsala University, S-751 85 Uppsala, Sweden
| | - Pasi Karjalainen
- Satakunta Central Hospital, Sydänyksikkö, Sairaalantie 3, 28500 Pori, Finland
| | - Yanchun Liang
- General Hospital of Northern Theater Command, No. 83 Wenhua Road, Shenhe District, 110016 Shenyang, China
| | - Igor Diemberger
- Department of Experimental, Diagnostic and Specialty Medicine, Institute of Cardiology, University of Bologna, Via Massarenti 9, 40138 Bologna, Italia
| | - Jerzy Krzysztof Wranicz
- Department of Electrocardiology, Medical University of Lodz, Ul. Pomorska 251, 92-213 Łódź, Poland
| | - Craig Barr
- Russells Hall Hospital, Pensett Road, DY1 2HQ Dudley, UK
| | - Fabio Quartieri
- Arcispedale Santa Maria Nuova, Viale Risorgimento 80, 42123 Reggio Emilia, Italia
| | - Tobias Timmel
- Biotronik SE & Co. KG,Woermannkehre 1, 12359 Berlin, Germany
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Sabbah M, Veien K, Niemela M, Freeman P, Linder R, Ioanes D, Terkelsen CJ, Kajander OA, Koul S, Savontaus M, Karjalainen P, Erglis A, Minkkinen M, Jørgensen T, Sondergaard L, De Backer O, Engstrøm T, Lønborg J. Routine revascularization with percutaneous coronary intervention in patients with coronary artery disease undergoing transcatheter aortic valve implantation - the third nordic aortic valve intervention trial - NOTION-3. Am Heart J 2023; 255:39-51. [PMID: 36220354 DOI: 10.1016/j.ahj.2022.10.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 08/24/2022] [Accepted: 10/05/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Coronary artery disease (CAD) frequently coexists with severe aortic valve stenosis (AS) in patients planned for transcatheter aortic valve implantation (TAVI). How to manage CAD in this patient population is still an unresolved question. In particular, it is still not known whether fractional flow reserve (FFR) guided revascularization with percutaneous coronary intervention (PCI) is superior to medical treatment for CAD in terms of clinical outcomes. STUDY DESIGN The third Nordic Aortic Valve Intervention (NOTION-3) Trial is an open-label investigator-initiated, multicenter multinational trial planned to randomize 452 patients with severe AS and significant CAD to either FFR-guided PCI or medical treatment, in addition to TAVI. Patients are eligible for the study in the presence of at least 1 significant PCI-eligible coronary stenosis. A significant stenosis is defined as either FFR ≤0.80 and/or diameter stenosis >90%. The primary end point is a composite of first occurring all-cause mortality, myocardial infarction, or urgent revascularization (PCI or coronary artery bypass graft performed during unplanned hospital admission) until the last included patient have been followed for 1 year after the TAVI. SUMMARY NOTION-3 is a multicenter, multinational randomized trial aiming at comparing FFR-guided revascularization vs medical treatment of CAD in patients with severe AS planned for TAVI.
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Affiliation(s)
- Muhammad Sabbah
- Department of Cardiology, Copenhagen University Hospital - Rigshospitalet, Denmark
| | - Karsten Veien
- Department of Cardiology, Odense University Hospital, Odense, Denmark
| | - Matti Niemela
- Department of Cardiology, Oulu University Hospital, University of Oulu, Finland
| | - Phillip Freeman
- Department of Cardiology, Aalborg University Hospital, Denmark
| | - Rickard Linder
- Department of Medicine, Karolinska Institutet, Stockholm, Sweden; Division of Cardiovascular Medicine, Department of Clinical Sciences, Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden
| | - Dan Ioanes
- Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Christian Juhl Terkelsen
- The Danish Heart Foundation; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
| | - Olli A Kajander
- Heart and Lung Center, Helsinki University Hospital and Helsinki University, Helsinki, Finland
| | - Sasha Koul
- Department of Cardiology, Clinical Sciences, Lund University, Skane University Hospital, Lund, Sweden
| | | | - Pasi Karjalainen
- Heart and Lung Center, Helsinki University Hospital and Helsinki University, Helsinki, Finland
| | | | - Mikko Minkkinen
- Heart and Lung Center, Helsinki University Hospital and Helsinki University, Helsinki, Finland
| | - Troels Jørgensen
- Department of Cardiology, Copenhagen University Hospital - Rigshospitalet, Denmark
| | - Lars Sondergaard
- Department of Cardiology, Copenhagen University Hospital - Rigshospitalet, Denmark; Department of Clinical Medicine, University of Copenhagen, Denmark
| | - Ole De Backer
- Department of Cardiology, Copenhagen University Hospital - Rigshospitalet, Denmark
| | - Thomas Engstrøm
- Department of Cardiology, Copenhagen University Hospital - Rigshospitalet, Denmark; Department of Clinical Medicine, University of Copenhagen, Denmark
| | - Jacob Lønborg
- Department of Cardiology, Copenhagen University Hospital - Rigshospitalet, Denmark.
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4
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Sikorski V, Karjalainen P, Blokhina D, Oksaharju K, Khan J, Katayama S, Rajala H, Suihko S, Tuohinen S, Teittinen K, Nummi A, Nykänen A, Eskin A, Stark C, Biancari F, Kiss J, Simpanen J, Ropponen J, Lemström K, Savinainen K, Lalowski M, Kaarne M, Jormalainen M, Elomaa O, Koivisto P, Raivio P, Bäckström P, Dahlbacka S, Syrjälä S, Vainikka T, Vähäsilta T, Tuncbag N, Karelson M, Mervaala E, Juvonen T, Laine M, Laurikka J, Vento A, Kankuri E. Epitranscriptomics of Ischemic Heart Disease-The IHD-EPITRAN Study Design and Objectives. Int J Mol Sci 2021; 22:6630. [PMID: 34205699 PMCID: PMC8235045 DOI: 10.3390/ijms22126630] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 06/10/2021] [Accepted: 06/15/2021] [Indexed: 12/11/2022] Open
Abstract
Epitranscriptomic modifications in RNA can dramatically alter the way our genetic code is deciphered. Cells utilize these modifications not only to maintain physiological processes, but also to respond to extracellular cues and various stressors. Most often, adenosine residues in RNA are targeted, and result in modifications including methylation and deamination. Such modified residues as N-6-methyl-adenosine (m6A) and inosine, respectively, have been associated with cardiovascular diseases, and contribute to disease pathologies. The Ischemic Heart Disease Epitranscriptomics and Biomarkers (IHD-EPITRAN) study aims to provide a more comprehensive understanding to their nature and role in cardiovascular pathology. The study hypothesis is that pathological features of IHD are mirrored in the blood epitranscriptome. The IHD-EPITRAN study focuses on m6A and A-to-I modifications of RNA. Patients are recruited from four cohorts: (I) patients with IHD and myocardial infarction undergoing urgent revascularization; (II) patients with stable IHD undergoing coronary artery bypass grafting; (III) controls without coronary obstructions undergoing valve replacement due to aortic stenosis and (IV) controls with healthy coronaries verified by computed tomography. The abundance and distribution of m6A and A-to-I modifications in blood RNA are charted by quantitative and qualitative methods. Selected other modified nucleosides as well as IHD candidate protein and metabolic biomarkers are measured for reference. The results of the IHD-EPITRAN study can be expected to enable identification of epitranscriptomic IHD biomarker candidates and potential drug targets.
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Affiliation(s)
- Vilbert Sikorski
- Department of Pharmacology, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland; (V.S.); (D.B.); (E.M.)
| | - Pasi Karjalainen
- Heart and Lung Center, Helsinki University Hospital, 00029 Helsinki, Finland; (P.K.); (K.O.); (H.R.); (S.S.); (S.T.); (K.T.); (A.N.); (A.N.); (C.S.); (F.B.); (J.K.); (J.S.); (J.R.); (K.L.); (M.K.); (M.J.); (P.R.); (S.D.); (S.S.); (T.V.); (T.V.); (T.J.); (M.L.); (A.V.)
| | - Daria Blokhina
- Department of Pharmacology, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland; (V.S.); (D.B.); (E.M.)
| | - Kati Oksaharju
- Heart and Lung Center, Helsinki University Hospital, 00029 Helsinki, Finland; (P.K.); (K.O.); (H.R.); (S.S.); (S.T.); (K.T.); (A.N.); (A.N.); (C.S.); (F.B.); (J.K.); (J.S.); (J.R.); (K.L.); (M.K.); (M.J.); (P.R.); (S.D.); (S.S.); (T.V.); (T.V.); (T.J.); (M.L.); (A.V.)
| | - Jahangir Khan
- Tampere Heart Hospital, Tampere University Hospital, 33520 Tampere, Finland; (J.K.); (J.L.)
| | | | - Helena Rajala
- Heart and Lung Center, Helsinki University Hospital, 00029 Helsinki, Finland; (P.K.); (K.O.); (H.R.); (S.S.); (S.T.); (K.T.); (A.N.); (A.N.); (C.S.); (F.B.); (J.K.); (J.S.); (J.R.); (K.L.); (M.K.); (M.J.); (P.R.); (S.D.); (S.S.); (T.V.); (T.V.); (T.J.); (M.L.); (A.V.)
| | - Satu Suihko
- Heart and Lung Center, Helsinki University Hospital, 00029 Helsinki, Finland; (P.K.); (K.O.); (H.R.); (S.S.); (S.T.); (K.T.); (A.N.); (A.N.); (C.S.); (F.B.); (J.K.); (J.S.); (J.R.); (K.L.); (M.K.); (M.J.); (P.R.); (S.D.); (S.S.); (T.V.); (T.V.); (T.J.); (M.L.); (A.V.)
| | - Suvi Tuohinen
- Heart and Lung Center, Helsinki University Hospital, 00029 Helsinki, Finland; (P.K.); (K.O.); (H.R.); (S.S.); (S.T.); (K.T.); (A.N.); (A.N.); (C.S.); (F.B.); (J.K.); (J.S.); (J.R.); (K.L.); (M.K.); (M.J.); (P.R.); (S.D.); (S.S.); (T.V.); (T.V.); (T.J.); (M.L.); (A.V.)
| | - Kari Teittinen
- Heart and Lung Center, Helsinki University Hospital, 00029 Helsinki, Finland; (P.K.); (K.O.); (H.R.); (S.S.); (S.T.); (K.T.); (A.N.); (A.N.); (C.S.); (F.B.); (J.K.); (J.S.); (J.R.); (K.L.); (M.K.); (M.J.); (P.R.); (S.D.); (S.S.); (T.V.); (T.V.); (T.J.); (M.L.); (A.V.)
| | - Annu Nummi
- Heart and Lung Center, Helsinki University Hospital, 00029 Helsinki, Finland; (P.K.); (K.O.); (H.R.); (S.S.); (S.T.); (K.T.); (A.N.); (A.N.); (C.S.); (F.B.); (J.K.); (J.S.); (J.R.); (K.L.); (M.K.); (M.J.); (P.R.); (S.D.); (S.S.); (T.V.); (T.V.); (T.J.); (M.L.); (A.V.)
| | - Antti Nykänen
- Heart and Lung Center, Helsinki University Hospital, 00029 Helsinki, Finland; (P.K.); (K.O.); (H.R.); (S.S.); (S.T.); (K.T.); (A.N.); (A.N.); (C.S.); (F.B.); (J.K.); (J.S.); (J.R.); (K.L.); (M.K.); (M.J.); (P.R.); (S.D.); (S.S.); (T.V.); (T.V.); (T.J.); (M.L.); (A.V.)
| | - Arda Eskin
- Graduate School of Informatics, Department of Health Informatics, Middle East Technical University, 06800 Ankara, Turkey;
| | - Christoffer Stark
- Heart and Lung Center, Helsinki University Hospital, 00029 Helsinki, Finland; (P.K.); (K.O.); (H.R.); (S.S.); (S.T.); (K.T.); (A.N.); (A.N.); (C.S.); (F.B.); (J.K.); (J.S.); (J.R.); (K.L.); (M.K.); (M.J.); (P.R.); (S.D.); (S.S.); (T.V.); (T.V.); (T.J.); (M.L.); (A.V.)
| | - Fausto Biancari
- Heart and Lung Center, Helsinki University Hospital, 00029 Helsinki, Finland; (P.K.); (K.O.); (H.R.); (S.S.); (S.T.); (K.T.); (A.N.); (A.N.); (C.S.); (F.B.); (J.K.); (J.S.); (J.R.); (K.L.); (M.K.); (M.J.); (P.R.); (S.D.); (S.S.); (T.V.); (T.V.); (T.J.); (M.L.); (A.V.)
- Heart Center, Turku University Hospital and Department of Surgery, University of Turku, 20521 Turku, Finland
- Research Unit of Surgery, Anesthesiology and Critical Care, University of Oulu, 90014 Oulu, Finland
| | - Jan Kiss
- Heart and Lung Center, Helsinki University Hospital, 00029 Helsinki, Finland; (P.K.); (K.O.); (H.R.); (S.S.); (S.T.); (K.T.); (A.N.); (A.N.); (C.S.); (F.B.); (J.K.); (J.S.); (J.R.); (K.L.); (M.K.); (M.J.); (P.R.); (S.D.); (S.S.); (T.V.); (T.V.); (T.J.); (M.L.); (A.V.)
| | - Jarmo Simpanen
- Heart and Lung Center, Helsinki University Hospital, 00029 Helsinki, Finland; (P.K.); (K.O.); (H.R.); (S.S.); (S.T.); (K.T.); (A.N.); (A.N.); (C.S.); (F.B.); (J.K.); (J.S.); (J.R.); (K.L.); (M.K.); (M.J.); (P.R.); (S.D.); (S.S.); (T.V.); (T.V.); (T.J.); (M.L.); (A.V.)
| | - Jussi Ropponen
- Heart and Lung Center, Helsinki University Hospital, 00029 Helsinki, Finland; (P.K.); (K.O.); (H.R.); (S.S.); (S.T.); (K.T.); (A.N.); (A.N.); (C.S.); (F.B.); (J.K.); (J.S.); (J.R.); (K.L.); (M.K.); (M.J.); (P.R.); (S.D.); (S.S.); (T.V.); (T.V.); (T.J.); (M.L.); (A.V.)
| | - Karl Lemström
- Heart and Lung Center, Helsinki University Hospital, 00029 Helsinki, Finland; (P.K.); (K.O.); (H.R.); (S.S.); (S.T.); (K.T.); (A.N.); (A.N.); (C.S.); (F.B.); (J.K.); (J.S.); (J.R.); (K.L.); (M.K.); (M.J.); (P.R.); (S.D.); (S.S.); (T.V.); (T.V.); (T.J.); (M.L.); (A.V.)
| | - Kimmo Savinainen
- Clinical Biobank Tampere, Tampere University Hospital, 33520 Tampere, Finland;
| | - Maciej Lalowski
- Helsinki Institute of Life Science (HiLIFE), Meilahti Clinical Proteomics Core Facility, Department of Biochemistry and Developmental Biology, Faculty of Medicine, University of Helsinki, 00290 Helsinki, Finland;
- Institute of Bioorganic Chemistry, Polish Academy of Sciences, Department of Biomedical Proteomics, 61-704 Poznan, Poland
| | - Markku Kaarne
- Heart and Lung Center, Helsinki University Hospital, 00029 Helsinki, Finland; (P.K.); (K.O.); (H.R.); (S.S.); (S.T.); (K.T.); (A.N.); (A.N.); (C.S.); (F.B.); (J.K.); (J.S.); (J.R.); (K.L.); (M.K.); (M.J.); (P.R.); (S.D.); (S.S.); (T.V.); (T.V.); (T.J.); (M.L.); (A.V.)
| | - Mikko Jormalainen
- Heart and Lung Center, Helsinki University Hospital, 00029 Helsinki, Finland; (P.K.); (K.O.); (H.R.); (S.S.); (S.T.); (K.T.); (A.N.); (A.N.); (C.S.); (F.B.); (J.K.); (J.S.); (J.R.); (K.L.); (M.K.); (M.J.); (P.R.); (S.D.); (S.S.); (T.V.); (T.V.); (T.J.); (M.L.); (A.V.)
| | - Outi Elomaa
- Folkhälsan Research Center, 00250 Helsinki, Finland; (S.K.); (O.E.)
| | - Pertti Koivisto
- Chemistry Unit, Finnish Food Authority, 00790 Helsinki, Finland;
| | - Peter Raivio
- Heart and Lung Center, Helsinki University Hospital, 00029 Helsinki, Finland; (P.K.); (K.O.); (H.R.); (S.S.); (S.T.); (K.T.); (A.N.); (A.N.); (C.S.); (F.B.); (J.K.); (J.S.); (J.R.); (K.L.); (M.K.); (M.J.); (P.R.); (S.D.); (S.S.); (T.V.); (T.V.); (T.J.); (M.L.); (A.V.)
| | - Pia Bäckström
- Helsinki Biobank, Hospital District of Helsinki and Uusimaa, 00029 Helsinki, Finland;
| | - Sebastian Dahlbacka
- Heart and Lung Center, Helsinki University Hospital, 00029 Helsinki, Finland; (P.K.); (K.O.); (H.R.); (S.S.); (S.T.); (K.T.); (A.N.); (A.N.); (C.S.); (F.B.); (J.K.); (J.S.); (J.R.); (K.L.); (M.K.); (M.J.); (P.R.); (S.D.); (S.S.); (T.V.); (T.V.); (T.J.); (M.L.); (A.V.)
| | - Simo Syrjälä
- Heart and Lung Center, Helsinki University Hospital, 00029 Helsinki, Finland; (P.K.); (K.O.); (H.R.); (S.S.); (S.T.); (K.T.); (A.N.); (A.N.); (C.S.); (F.B.); (J.K.); (J.S.); (J.R.); (K.L.); (M.K.); (M.J.); (P.R.); (S.D.); (S.S.); (T.V.); (T.V.); (T.J.); (M.L.); (A.V.)
| | - Tiina Vainikka
- Heart and Lung Center, Helsinki University Hospital, 00029 Helsinki, Finland; (P.K.); (K.O.); (H.R.); (S.S.); (S.T.); (K.T.); (A.N.); (A.N.); (C.S.); (F.B.); (J.K.); (J.S.); (J.R.); (K.L.); (M.K.); (M.J.); (P.R.); (S.D.); (S.S.); (T.V.); (T.V.); (T.J.); (M.L.); (A.V.)
| | - Tommi Vähäsilta
- Heart and Lung Center, Helsinki University Hospital, 00029 Helsinki, Finland; (P.K.); (K.O.); (H.R.); (S.S.); (S.T.); (K.T.); (A.N.); (A.N.); (C.S.); (F.B.); (J.K.); (J.S.); (J.R.); (K.L.); (M.K.); (M.J.); (P.R.); (S.D.); (S.S.); (T.V.); (T.V.); (T.J.); (M.L.); (A.V.)
| | - Nurcan Tuncbag
- Department of Chemical and Biological Engineering, College of Engineering, Koç University, 34450 Istanbul, Turkey;
- School of Medicine, Koç University, 34450 Istanbul, Turkey
| | - Mati Karelson
- Institute of Chemistry, University of Tartu, 50411 Tartu, Estonia;
| | - Eero Mervaala
- Department of Pharmacology, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland; (V.S.); (D.B.); (E.M.)
| | - Tatu Juvonen
- Heart and Lung Center, Helsinki University Hospital, 00029 Helsinki, Finland; (P.K.); (K.O.); (H.R.); (S.S.); (S.T.); (K.T.); (A.N.); (A.N.); (C.S.); (F.B.); (J.K.); (J.S.); (J.R.); (K.L.); (M.K.); (M.J.); (P.R.); (S.D.); (S.S.); (T.V.); (T.V.); (T.J.); (M.L.); (A.V.)
- Research Unit of Surgery, Anesthesiology and Critical Care, University of Oulu, 90014 Oulu, Finland
| | - Mika Laine
- Heart and Lung Center, Helsinki University Hospital, 00029 Helsinki, Finland; (P.K.); (K.O.); (H.R.); (S.S.); (S.T.); (K.T.); (A.N.); (A.N.); (C.S.); (F.B.); (J.K.); (J.S.); (J.R.); (K.L.); (M.K.); (M.J.); (P.R.); (S.D.); (S.S.); (T.V.); (T.V.); (T.J.); (M.L.); (A.V.)
| | - Jari Laurikka
- Tampere Heart Hospital, Tampere University Hospital, 33520 Tampere, Finland; (J.K.); (J.L.)
| | - Antti Vento
- Heart and Lung Center, Helsinki University Hospital, 00029 Helsinki, Finland; (P.K.); (K.O.); (H.R.); (S.S.); (S.T.); (K.T.); (A.N.); (A.N.); (C.S.); (F.B.); (J.K.); (J.S.); (J.R.); (K.L.); (M.K.); (M.J.); (P.R.); (S.D.); (S.S.); (T.V.); (T.V.); (T.J.); (M.L.); (A.V.)
| | - Esko Kankuri
- Department of Pharmacology, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland; (V.S.); (D.B.); (E.M.)
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Ulander L, Tolppanen H, Hartman O, Rissanen TT, Paakkanen R, Kuusisto J, Anttonen O, Nieminen T, Yrjölä J, Ryysy R, Drews T, Utriainen S, Karjalainen P, Anttila I, Nurmi K, Silventoinen K, Koskinen M, Kovanen PT, Lehtonen J, Eklund KK, Sinisalo J. Hydroxychloroquine reduces interleukin-6 levels after myocardial infarction: The randomized, double-blind, placebo-controlled OXI pilot trial. Int J Cardiol 2021; 337:21-27. [PMID: 33961943 DOI: 10.1016/j.ijcard.2021.04.062] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [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] [Received: 12/30/2020] [Revised: 04/06/2021] [Accepted: 04/28/2021] [Indexed: 12/27/2022]
Abstract
OBJECTIVES To determine the anti-inflammatory effect and safety of hydroxychloroquine after acute myocardial infarction. METHOD In this multicenter, double-blind, placebo-controlled OXI trial, 125 myocardial infarction patients were randomized at a median of 43 h after hospitalization to receive hydroxychloroquine 300 mg (n = 64) or placebo (n = 61) once daily for 6 months and, followed for an average of 32 months. Laboratory values were measured at baseline, 1, 6, and 12 months. RESULTS The levels of interleukin-6 (IL-6) were comparable at baseline between study groups (p = 0.18). At six months, the IL-6 levels were lower in the hydroxychloroquine group (p = 0.042, between groups), and in the on-treatment analysis, the difference at this time point was even more pronounced (p = 0.019, respectively). The high-sensitivity C-reactive protein levels did not differ significantly between study groups at any time points. Eleven patients in the hydroxychloroquine group and four in the placebo group had adverse events leading to interruption or withdrawal of study medication, none of which was serious (p = 0.10, between groups). CONCLUSIONS In patients with myocardial infarction, hydroxychloroquine reduced IL-6 levels significantly more than did placebo without causing any clinically significant adverse events. A larger randomized clinical trial is warranted to prove the potential ability of hydroxychloroquine to reduce cardiovascular endpoints after myocardial infarction.
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Affiliation(s)
- Lotta Ulander
- Heart and Lung Center, Helsinki University Hospital, Helsinki University, Helsinki, Finland
| | - Heli Tolppanen
- Heart and Lung Center, Helsinki University Hospital, Helsinki University, Helsinki, Finland
| | - Otto Hartman
- Heart and Lung Center, Helsinki University Hospital, Helsinki University, Helsinki, Finland
| | - Tuomas T Rissanen
- Heart Center, North Karelia Central Hospital, Siunsote, Joensuu, Finland
| | - Riitta Paakkanen
- Heart and Lung Center, Helsinki University Hospital, Helsinki University, Helsinki, Finland
| | - Jouni Kuusisto
- Heart and Lung Center, Helsinki University Hospital, Helsinki University, Helsinki, Finland
| | - Olli Anttonen
- Department of Internal Medicine, Päijät-Häme Central Hospital, Lahti, Finland
| | - Tuomo Nieminen
- Department of Internal Medicine, Päijät-Häme Central Hospital, Lahti, Finland
| | - Jaana Yrjölä
- Department of Internal Medicine, Kymenlaakson Central Hospital, Kotka, Finland
| | - Ransu Ryysy
- Department of Internal Medicine, Kymenlaakson Central Hospital, Kotka, Finland
| | - Teemu Drews
- Department of Internal Medicine, South Karelia Central Hospital, Lappeenranta, Finland
| | - Seppo Utriainen
- Department of Internal Medicine, South Karelia Central Hospital, Lappeenranta, Finland
| | - Pasi Karjalainen
- Heart and Lung Center, Helsinki University Hospital, Helsinki University, Helsinki, Finland
| | - Ismo Anttila
- Department of Internal Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland
| | - Katariina Nurmi
- Department of Rheumatology, Helsinki University Hospital, Helsinki University, ORTON Orthopaedic Hospital of the Orton Foundation, Helsinki, Finland
| | - Kristiina Silventoinen
- Department of Rheumatology, Helsinki University Hospital, Helsinki University, ORTON Orthopaedic Hospital of the Orton Foundation, Helsinki, Finland
| | - Miika Koskinen
- Helsinki Biobank, Helsinki University Hospital, Helsinki University, Helsinki, Finland
| | | | - Jukka Lehtonen
- Heart and Lung Center, Helsinki University Hospital, Helsinki University, Helsinki, Finland
| | - Kari K Eklund
- Department of Rheumatology, Helsinki University Hospital, Helsinki University, ORTON Orthopaedic Hospital of the Orton Foundation, Helsinki, Finland
| | - Juha Sinisalo
- Heart and Lung Center, Helsinki University Hospital, Helsinki University, Helsinki, Finland.
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6
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Emmerson S, Mukherjee S, Melendez-Munoz J, Cousins F, Edwards SL, Karjalainen P, Ng M, Tan KS, Darzi S, Bhakoo K, Rosamilia A, Werkmeister JA, Gargett CE. Composite mesh design for delivery of autologous mesenchymal stem cells influences mesh integration, exposure and biocompatibility in an ovine model of pelvic organ prolapse. Biomaterials 2019; 225:119495. [PMID: 31606680 DOI: 10.1016/j.biomaterials.2019.119495] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Revised: 08/20/2019] [Accepted: 09/11/2019] [Indexed: 12/21/2022]
Abstract
The widespread use of synthetic transvaginal polypropylene mesh for treating Pelvic Organ Prolapse (POP) has been curtailed due to serious adverse effects highlighted in 2008 and 2011 FDA warnings and subsequent legal action. We are developing new synthetic mesh to deliver endometrial mesenchymal stem cells (eMSC) to improve mesh biocompatibility and restore strength to prolapsed vaginal tissue. Here we evaluated knitted polyamide (PA) mesh in an ovine multiparous model using transvaginal implantation and matched for the degree of POP. Polyamide mesh dip-coated in gelatin and stabilised with 0.5% glutaraldehyde (PA/G) were used either alone or seeded with autologous ovine eMSC (eMSC/PA/G), which resulted in substantial mesh folding, poor tissue integration and 42% mesh exposure in the ovine model. In contrast, a two-step insertion protocol, whereby the uncoated PA mesh was inserted transvaginally followed by application of autologous eMSC in a gelatin hydrogel onto the mesh and crosslinked with blue light (PA + eMSC/G), integrated well with little folding and no mesh exposure. The autologous ovine eMSC survived 30 days in vivo but had no effect on mesh integration. The stiff PA/G constructs provoked greater myofibroblast and inflammatory responses in the vaginal wall, disrupted the muscularis layer and reduced elastin fibres compared to PA + eMSC/G constructs. This study identified the superiority of a two-step protocol for implanting synthetic mesh in cellular compatible composite constructs and simpler surgical application, providing additional translational value.
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Affiliation(s)
- S Emmerson
- Ritchie Centre, Hudson Institute of Medical Research, 27-31 Wright Street, Clayton, Melbourne, Australia; Department of Obstetrics and Gynaecology, Monash University, Wellington Road, Clayton, Melbourne, Australia
| | - S Mukherjee
- Ritchie Centre, Hudson Institute of Medical Research, 27-31 Wright Street, Clayton, Melbourne, Australia; Department of Obstetrics and Gynaecology, Monash University, Wellington Road, Clayton, Melbourne, Australia
| | | | - F Cousins
- Ritchie Centre, Hudson Institute of Medical Research, 27-31 Wright Street, Clayton, Melbourne, Australia
| | - S L Edwards
- CSIRO Manufacturing, Research Way, Clayton, Melbourne, Australia
| | - P Karjalainen
- Monash Health, Centre Road, Moorabbin, Melbourne, Australia
| | - M Ng
- Singapore Bioimaging Consortium, 1 Agency for Science, Technology and Research (A*STAR), 1 Biopolis Way, Singapore
| | - K S Tan
- Ritchie Centre, Hudson Institute of Medical Research, 27-31 Wright Street, Clayton, Melbourne, Australia
| | - S Darzi
- Ritchie Centre, Hudson Institute of Medical Research, 27-31 Wright Street, Clayton, Melbourne, Australia; Department of Obstetrics and Gynaecology, Monash University, Wellington Road, Clayton, Melbourne, Australia
| | - K Bhakoo
- Singapore Bioimaging Consortium, 1 Agency for Science, Technology and Research (A*STAR), 1 Biopolis Way, Singapore
| | - A Rosamilia
- Department of Obstetrics and Gynaecology, Monash University, Wellington Road, Clayton, Melbourne, Australia; Monash Health, Centre Road, Moorabbin, Melbourne, Australia
| | - J A Werkmeister
- Ritchie Centre, Hudson Institute of Medical Research, 27-31 Wright Street, Clayton, Melbourne, Australia; Department of Obstetrics and Gynaecology, Monash University, Wellington Road, Clayton, Melbourne, Australia
| | - C E Gargett
- Ritchie Centre, Hudson Institute of Medical Research, 27-31 Wright Street, Clayton, Melbourne, Australia; Department of Obstetrics and Gynaecology, Monash University, Wellington Road, Clayton, Melbourne, Australia.
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7
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Kiviniemi T, Lehto J, Nissinen M, Nieminen T, Hartikainen J, Malmberg M, Yannopoulos F, Savolainen J, Karjalainen P, Airaksinen KJ, Rosato S, Biancari F. Performance of CHA2DS2-VASc score for stroke prediction after surgical aortic valve replacement. J Thorac Cardiovasc Surg 2019; 157:896-904. [DOI: 10.1016/j.jtcvs.2018.06.096] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 05/28/2018] [Accepted: 06/27/2018] [Indexed: 10/28/2022]
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8
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Kortelainen P, Huttunen JT, Väisänen T, Mattsson T, Karjalainen P, Martikainen PJ. CH4, CO2 and N2O supersaturation in 12 Finnish lakes before and after ice-melt. ACTA ACUST UNITED AC 2017. [DOI: 10.1080/03680770.1998.11901468] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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9
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Lahtela H, Karjalainen P, Niemelä M, Vikman S, Kervinen K, Ylitalo A, Puurunen M, Porela P, Nyman K, Hinkka-Yli-Salomäki S, Airaksinen KE. Are glycoprotein inhibitors safe during percutaneous coronary intervention in patients on chronic warfarin treatment? Thromb Haemost 2017; 102:1227-33. [DOI: 10.1160/th09-04-0245] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
SummaryThe aim of this study was to evaluate the safety of glycoprotein IIb/IIIa inhibitors (GPIs) during percutaneous coronary intervention (PCI) in patients on chronic warfarin therapy due to atrial fibrillation (AF).We analysed all consecutive AF patients (N = 377, mean age 70 years, male 71%) on warfarin therapy referred for PCI in seven centres. Major bleeding, access site complications and major adverse cardiovascular events were recorded during hospitalisation. A total of 111 patients (29%) received periprocedural GPIs with a wide inter-hospital variation in their use (range 3–68%).The use of GPIs increased with the severity of the disease presentation and 49% of patients with ST-elevation myocardial infarction received GPIs. Mean periprocedural international normalised ratio (INR) of patients who received GPIs was 1.89 (range 1.1–3.3). Major bleeding was more common in the patients treated with GPIs (9.0% vs. 1.5%, p = 0.001) than in those without GPIs, but there was no difference in major adverse cardiovascular events between the groups. In multivariable analysis, use of GPIs (odds ratio [OR]???????????5.1, 95% confidence interval [CI]???????????1.3–20.6, p = 0.02) and old age (OR 1.2, 95% CI 1.0–1.3, p = 0.02) remained as the only independent predictors of major bleeding. Also after adjusting for propensity score, GPIs remained as a significant predictor of major bleeding (OR 3.8, 95% CI 1.03–14.1, p = 0.045). In the GPI group, major bleeding was not predicted by INR level or warfarin pause. GPIs increase the risk of major bleeding events irrespective of periprocedural INR levels and should be used with caution in this fragile patient group.
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10
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Öhman J, Harjola VP, Karjalainen P, Lassus J. Focused echocardiography and lung ultrasound protocol for guiding treatment in acute heart failure. ESC Heart Fail 2017; 5:120-128. [PMID: 28960894 PMCID: PMC5793966 DOI: 10.1002/ehf2.12208] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 07/25/2017] [Accepted: 07/31/2017] [Indexed: 01/06/2023] Open
Abstract
Aims There is little evidence‐based therapy existing for acute heart failure (AHF), hospitalizations are lengthy and expensive, and optimal monitoring of AHF patients during in‐hospital treatment is poorly defined. We evaluated a rapid cardiothoracic ultrasound (CaTUS) protocol, combining focused echocardiographic evaluation of cardiac filling pressures, that is, medial E/e′ and inferior vena cava index, with lung ultrasound (LUS) for guiding treatment in hospitalized AHF patients. Methods and results We enrolled 20 consecutive patients hospitalized for AHF, whose in‐hospital treatment was guided using the CaTUS protocol according to a pre‐specified treatment protocol targeting resolution of pulmonary congestion on LUS and lowering cardiac filling pressures. Treatment results of these 20 patients were compared with those of a standard care sample of 100 patients, enrolled previously for follow‐up purposes. The standard care sample had CaTUS performed daily for follow‐up and received standard in‐hospital treatment without ultrasound guidance. All CaTUS exams were performed by a single experienced sonographer. The CaTUS‐guided therapy resulted in significantly larger decongestion as defined by reduction in symptoms, cardiac filling pressures, natriuretic peptides, cumulative fluid loss, and resolution of pulmonary congestion (P < 0.05 for all) despite a shorter mean length of hospitalization. Congestion parameters were significantly lower also at discharge (P < 0.05 for all), without any significant difference in these parameters on admission. The treatment arm displayed better survival regarding the combined endpoint of 6 month all‐cause death or AHF re‐hospitalization (log rank P = 0.017). No significant difference in adverse events occurred between the groups. Conclusions The CaTUS‐guided therapy for AHF resulted in greater decongestion during shorter hospitalization without increased adverse events in this small pilot study and might be associated with a better post‐discharge prognosis.
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Affiliation(s)
- Jonas Öhman
- Division of Internal Medicine and Cardiology, Turku University Hospital, Turku, Finland
| | - Veli-Pekka Harjola
- Department of Emergency Medicine and Services, Helsinki University Hospital, Turku, Finland
| | - Pasi Karjalainen
- Heart Center, Department of Cardiology, Pori Central Hospital, Turku, Finland
| | - Johan Lassus
- Heart and Lung Center, Helsinki University Hospital, Turku, Finland
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11
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Karjalainen P, Paana T, Ylitalo A, Sia J, Nammas W. Optical coherence tomography follow-up 18 months after titanium-nitride-oxide-coated versus everolimus-eluting stent implantation in patients with acute coronary syndrome. Acta Radiol 2017; 58:1077-1084. [PMID: 28273737 DOI: 10.1177/0284185116683573] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Inadequate neointimal coverage of stent struts is associated with late stent thrombosis. Purpose To demonstrate the extent of neointimal coverage and strut malapposition in titanium-nitride-oxide-coated bioactive stents (BAS) versus everolimus-eluting stents (EES) by optical coherence tomography (OCT) performed at 18-month follow-up. Material and Methods In the BASE-ACS trial, 827 patients presenting with acute coronary syndrome were randomized to receive either BAS or EES. Forty patients (20 BAS, 20 EES) underwent OCT at 18-month follow-up for evaluation of stent strut coverage, malapposition, and neointimal hyperplasia (NIH). Primary endpoint was binary stent strut coverage (ratio of covered struts to all analyzed struts multiplied by 100). Co-primary endpoint was the percentage of malapposed struts. Results We analyzed 3465 struts in 330 cross-sections of BAS and 3327 struts in 316 cross-sections of EES. Binary stent strut coverage, based on strut-level analysis, was higher with BAS versus EES (99.5% versus 94.2%, respectively; P < 0.001), the strut-level percentage of malapposed struts was lower with BAS (0.6% versus 2.5%, respectively; P < 0.001). Yet, the mean NIH thickness was greater with BAS (237 ± 125 versus 108 ± 62 µm, respectively; P < 0.001). Conclusion In the current post-hoc analysis with OCT performed at 18 months, binary strut coverage, based on strut-level analysis, was higher with BAS versus EES; strut-level malapposed struts were fewer with BAS; yet, BAS induced thicker NIH.
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Affiliation(s)
| | - Tuomas Paana
- Heart Center, Satakunta Central Hospital, Pori, Finland
| | - Antti Ylitalo
- Heart Center, Satakunta Central Hospital, Pori, Finland
| | - Jussi Sia
- Heart Center, Kokkola Central Hospital, Kokkola, Finland
| | - Wail Nammas
- Heart Center, Satakunta Central Hospital, Pori, Finland
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12
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Öhman J, Harjola VP, Karjalainen P, Lassus J. Assessment of early treatment response by rapid cardiothoracic ultrasound in acute heart failure: Cardiac filling pressures, pulmonary congestion and mortality. European Heart Journal: Acute Cardiovascular Care 2017; 7:311-320. [DOI: 10.1177/2048872617708974] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: It is unclear how to optimally monitor acute heart failure (AHF) patients. We evaluated the timely interplay of cardiac filling pressures, brain natriuretic peptides (BNPs), lung ultrasound (LUS) and symptoms during AHF treatment. Methods: We enrolled 60 patients who had been hospitalised for AHF. Patients were examined with a rapid cardiothoracic ultrasound (CaTUS) protocol, combining LUS and focused echocardiographic evaluation of cardiac filling pressures (i.e. medial E/e’ and inferior vena cava index [IVCi]). CaTUS was done at 0, 12, 24 and 48 hours (±3 hours) and on the day of discharge, alongside clinical evaluation and laboratory samples. Patients free of congestion (B lines or pleural fluid) on LUS at discharge were categorised as responders, whereas the rest were categorised as non-responders. Improvement in congestion parameters was evaluated separately in these groups. The effect of congestion parameters on prognosis was also analysed. Results: Responders experienced a significantly larger decline in E/e’ (2.58 vs. 0.38, p = 0.037) and dyspnoea visual analogue scale (1–10) score (7.68 vs. 3.57, p = 0.007) during the first 12 hours of treatment, while IVCi and BNPs declined later without no such rapid initial decline. Among patients experiencing a >3 U decline in E/e’ during the first 12 hours of treatment, 18/21 were to become responders ( p < 0.001). LUS response was the only congestion parameter independently predicting both 6-month survival regarding all-cause mortality and the composite endpoint of all-cause mortality or rehospitalisation for AHF. Conclusion: E/e’ seemed like the most useful congestion parameter for monitoring early treatment response, predicting prognostically beneficial resolution of pulmonary congestion.
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Affiliation(s)
- Jonas Öhman
- Division of Internal Medicine and Cardiology, Turku University Hospital, Turku, Finland
| | - Veli-Pekka Harjola
- Emergency Medicine, University of Helsinki, Department of Emergency Medicine and Services, Helsinki University Hospital, Helsinki, Finland
| | - Pasi Karjalainen
- Heart Center. Department of Cardiology. Pori Central Hospital, Pori, Finland
| | - Johan Lassus
- Cardiology, University of Helsinki, Helsinki, Finland
- Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland
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13
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Karjalainen P, Paana T, Sia J, Nammas W. Neointimal Healing Evaluated by Optical Coherence Tomography after Drug-Eluting Absorbable Metal Scaffold Implantation in de novo Native Coronary Lesions: Rationale and Design of the Magmaris-OCT Study. Cardiology 2017; 137:225-230. [DOI: 10.1159/000468979] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 03/07/2017] [Indexed: 11/19/2022]
Abstract
Objectives: We sought to explore neointimal healing assessed by optical coherence tomography (OCT) following implantation of the Magmaris sirolimus-eluting absorbable metal scaffold. Methods: The Magmaris-OCT is a prospective, multicenter, single-arm observational clinical study, intended to enrol 60 consecutive patients with up to 2 de novo native coronary lesions, each located in different major epicardial vessels, with a reference vessel diameter of 2.5-3.5 mm, and a maximum lesion length of 20 mm. Patients will undergo Magmaris scaffold implantation in the target lesion, according to the standard practice. Clinical follow-up will take place at 30 days, and at 3, 6, 9, and 12 months. For invasive-imaging follow-up, patients will be classified into 3 groups: cohort A will be scheduled for follow-up at 3 months, cohort B at 6 months, and cohort C at 12 months. Invasive imaging will include quantitative coronary angiography, OCT evaluation, and coronary flow reserve measurement. The primary end point will be the percentage of uncovered scaffold struts assessed by OCT at the prespecified follow-up. Conclusions: This study will provide insight into the short- and mid-term healing properties following Magmaris scaffold implantation, with special emphasis on the neointimal coverage of scaffold struts.
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14
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Meigal AY, Rissanen SM, Zaripova YR, Miroshnichenko GG, Karjalainen P. [Nonlinear Parameters of the Surface Electromyogram for the Diagnostics of Neuromuscular Disorders and Normal Conditions of the Motor System in Human]. Fiziol Cheloveka 2015; 41:119-127. [PMID: 26859996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The article presents data on new approaches to the application of the surface electromyogram based on the nonlinear dynamics of complex systems. Special focus is placed on applicability of nonlinear parameters for early and differential diagnostics of Parkinson's disease, various kinds of tremor, schizophrenia, as well as for the estimation of normal processes in the motor system, such as musle development, fatigue and ageing.
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15
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Könönen M, Tamsi N, Säisänen L, Kemppainen S, Määttä S, Julkunen P, Jutila L, Äikiä M, Kälviäinen R, Niskanen E, Vanninen R, Karjalainen P, Mervaala E. Non-invasive mapping of bilateral motor speech areas using navigated transcranial magnetic stimulation and functional magnetic resonance imaging. J Neurosci Methods 2015; 248:32-40. [DOI: 10.1016/j.jneumeth.2015.03.030] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2014] [Revised: 03/26/2015] [Accepted: 03/27/2015] [Indexed: 10/23/2022]
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16
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Lehto J, Gunn J, Karjalainen P, Airaksinen J, Kiviniemi T. Incidence and risk factors of postpericardiotomy syndrome requiring medical attention: The Finland postpericardiotomy syndrome study. J Thorac Cardiovasc Surg 2015; 149:1324-9. [DOI: 10.1016/j.jtcvs.2015.01.031] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2014] [Revised: 01/10/2015] [Accepted: 01/18/2015] [Indexed: 10/24/2022]
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17
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Mikkelsson J, Paana T, Lepantalo A, Karjalainen P. PERSONALISED ANTIPLATELET TREATMENT STRATEGY AND OUTCOMES FOLLOWING PRIMARY PCI FOR STEMI (PASTOR STUDY). J Am Coll Cardiol 2015. [DOI: 10.1016/s0735-1097(15)60241-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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18
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Ruonala V, Pekkonen E, Rissanen S, Airaksinen O, Miroshnichenko G, Kankaanpää M, Karjalainen P. Dynamic tension EMG to characterize the effects of DBS treatment of advanced Parkinson's disease. Annu Int Conf IEEE Eng Med Biol Soc 2015; 2014:3248-51. [PMID: 25570683 DOI: 10.1109/embc.2014.6944315] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Deep brain stimulation (DBS) is an effective treatment method for motor symptoms of advanced Parkinson's disease. DBS-electrode is implanted to subthalamic nucleus to give precisely allocated electrical stimuli to brain. The optimal stimulus type has to be adjusted individually. Disease severity, main symptoms and biological factors play a role in correctly setting up the device. Currently there are no objective methods to assess the efficacy of DBS, hence the adjustment is based solely on clinical assessment. In optimal case an objectively measurable feature would point the right settings of DBS. Surface electromyographic and kinematic measurements have been used in Parkinson's disease research. As Parkinson's disease symptoms are known to change the EMG signal properties, these methods could be helpful aid in the clinical adjustment of DBS. In this study, 13 patients with advanced Parkinson's disease who received DBS treatment were measured. The patients were measured with seven different settings of the DBS in clinical range including changes in stimulation amplitude, frequency and pulse width. The EMG analysis was based on parameters that characterize EMG signal morphology. Correlation dimension and recurrence rate made the most significant difference in relation to optimal settings. In conclusion, EMG analysis is able to detect differences between the DBS setups, and can help in finding the correct parameters.
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Kaskinoro K, Maksimow A, Georgiadis S, Långsjö J, Scheinin H, Karjalainen P, Jääskeläinen SK. Electroencephalogram reactivity to verbal command after dexmedetomidine, propofol and sevoflurane-induced unresponsiveness. Anaesthesia 2014; 70:190-204. [DOI: 10.1111/anae.12868] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2014] [Indexed: 12/29/2022]
Affiliation(s)
- K. Kaskinoro
- Department of Perioperative Services; Intensive Care and Pain Medicine; Turku University Hospital; Turku Finland
| | - A. Maksimow
- Department of Perioperative Services; Intensive Care and Pain Medicine; Turku University Hospital; Turku Finland
| | - S. Georgiadis
- Department of Applied Physics; University of Eastern Finland; Kuopio Finland
| | - J. Långsjö
- Turku PET Centre; University of Turku; Turku Finland
- Intensive Care Unit; Tampere University Hospital; Tampere Finland
| | - H. Scheinin
- Turku PET Centre and Department of Pharmacology and Clinical Pharmacology; University of Turku; Turku Finland
| | - P. Karjalainen
- Department of Applied Physics; University of Eastern Finland; Kuopio Finland
| | - S. K. Jääskeläinen
- Departments of Clinical Neurophysiology; Turku University Hospital and Clinical Neurophysiology; University of Turku; Turku Finland
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20
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Lautamäki A, Airaksinen KEJ, Kiviniemi T, Vinco G, Ribichini F, Gunn J, Anttila V, Heikkinen J, Korpilahti K, Karjalainen P, Kajander O, Eskola M, Ilveskoski E, Axelsson T, Gudbjartsson T, Jeppsson A, Biancari F. Prognosis and disease progression in patients under 50 years old undergoing PCI: the CRAGS (Coronary aRtery diseAse in younG adultS) study. Atherosclerosis 2014; 235:483-7. [PMID: 24953487 DOI: 10.1016/j.atherosclerosis.2014.05.953] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Revised: 05/23/2014] [Accepted: 05/28/2014] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Young patients undergoing percutaneous coronary intervention (PCI) are generally considered at low procedural risk, but the potentially aggressive nature of coronary artery disease and long expectancy of life expose them to a high risk of recurrent coronary events. The extent and determinants of disease progression in this patient subset remain largely unknown. The aim of the present study was to evaluate general risk factors for late outcomes among patients ≤50 years old who underwent PCI. METHODS Coronary aRtery diseAse in younG adults (CRAGS) is a multicenter European retrospective registry that enrolled 1617 patients (age ≤50 years) who underwent PCI over the years 2002-2012. The median follow-up was 3.0 years. RESULTS The majority of patients were smokers who were nevertheless prescribed adequate secondary prevention medication, including statins, aspirin, beta blockers and/or ACE inhibitors/AT blockers. At 5 years, survival was 97.8%, while freedom from major adverse cardiac and cerebrovascular events was 74.1%, from repeat revascularization 77.8% and from myocardial infarction 89.9%. Altogether 13.5% of patients exhibited disease progression that indicated a need for repeat revascularization. Other indications for repeat revascularization were restenosis (7.1%) and stent thrombosis (2.1%) at the 5-year follow-up. Independent post-PCI predictors of disease progression were multivessel disease, diabetes and hypertension. CONCLUSION PCI is associated with excellent survival in patients ≤50 years old. Nevertheless, despite guideline-adherent medication, every eighth patient underwent repeat revascularization due to disease progression diagnosed at the median follow-up of three years, underscoring the need for more effective secondary prevention than currently available.
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Affiliation(s)
- Anna Lautamäki
- Heart Center, Turku University Hospital and University of Turku, Turku, Finland
| | | | - Tuomas Kiviniemi
- Heart Center, Turku University Hospital and University of Turku, Turku, Finland
| | - Giulia Vinco
- Division of Cardiology, Department of Medicine, University of Verona, Verona, Italy
| | - Flavio Ribichini
- Division of Cardiology, Department of Medicine, University of Verona, Verona, Italy
| | - Jarmo Gunn
- Heart Center, Turku University Hospital and University of Turku, Turku, Finland
| | - Vesa Anttila
- Department of Surgery, Oulu University Hospital, Oulu, Finland
| | - Jouni Heikkinen
- Department of Surgery, Oulu University Hospital, Oulu, Finland
| | - Kari Korpilahti
- Department of Internal Medicine, Vaasa Central Hospital, Vaasa, Finland
| | | | - Olli Kajander
- Heart Center, Tampere University Hospital, Tampere, Finland
| | - Markku Eskola
- Heart Center, Tampere University Hospital, Tampere, Finland
| | | | - Tomas Axelsson
- Department of Cardiothoracic Surgery, Landspitali University Hospital, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Tomas Gudbjartsson
- Department of Cardiothoracic Surgery, Landspitali University Hospital, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Anders Jeppsson
- Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Göteborg, Sweden
| | - Fausto Biancari
- Department of Surgery, Oulu University Hospital, Oulu, Finland
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21
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Kiviniemi T, Puurunen M, Schlitt A, Rubboli A, Karjalainen P, Vikman S, Niemelä M, Lahtela H, Lip GYH, Airaksinen KEJ. Performance of bleeding risk-prediction scores in patients with atrial fibrillation undergoing percutaneous coronary intervention. Am J Cardiol 2014; 113:1995-2001. [PMID: 24793675 DOI: 10.1016/j.amjcard.2014.03.038] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [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] [Received: 01/12/2014] [Revised: 03/20/2014] [Accepted: 03/20/2014] [Indexed: 11/18/2022]
Abstract
The hypertension, abnormal renal/liver function, stroke, bleeding history or predisposition, labile international normalized ratio, elderly, and drugs/alcohol (HAS-BLED); anticoagulation and risk factors in atrial fibrillation (ATRIA); modified Outpatient Bleeding Risk Index (mOBRI); and reduction of atherothrombosis for continued health (REACH) schemes are validated bleeding risk-prediction tools, but their predictive performance in patients with AF receiving multiple antithrombotic drugs after percutaneous coronary intervention (PCI) is unknown. We sought to compare the predictive performance of bleeding risk-estimation tools in a cohort of patients with atrial fibrillation (AF) undergoing PCI. Management of patients with AF undergoing coronary artery stenting is a multicenter European prospective registry enrolling patients with AF undergoing PCI. We calculated HAS-BLED, ATRIA, mOBRI, and REACH bleeding risk-prediction scores and assessed the rate of bleeding complications as defined by Bleeding Academic Research Consortium at 12 months follow-up in 929 consecutive patients undergoing PCI. Increasing age, femoral access site, and previous peptic ulcer were independent determinants of bleeding. Low bleeding risk scores as determined by HAS-BLED 0 to 2, ATRIA 0 to 3, mOBRI 0, and REACH 0 to 10 were detected in 23.7%, 73.0%, 7.8%, and 5.7% of patients of the cohort, respectively. No significant differences were detected in the rates of any bleeding or major bleeding events for low versus intermediate/high scores with each risk-prediction tool. In conclusion, the performance of ATRIA, HAS-BLED, mOBRI, and REACH scores in predicting bleeding complications in this high-risk patient subset was useless.
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Affiliation(s)
- Tuomas Kiviniemi
- Heart Center, Turku University Hospital and University of Turku, Turku, Finland.
| | - Marja Puurunen
- Hemostasis laboratory, Finnish Red Cross Blood Service, Helsinki, Finland
| | - Axel Schlitt
- Medical Faculty, Martin Luther University Halle-Wittenberg and Paracelsus-Harz-Clinic Bad Suderode, Halle-Wittenberg, Germany
| | - Andrea Rubboli
- Division of Cardiology, Laboratory of Interventional Cardiology, Ospedale Maggiore, Bologna, Italy
| | | | - Saila Vikman
- Heart Center, Tampere University Hospital, Tampere, Finland
| | - Matti Niemelä
- Department of Medicine, Oulu University Hospital, Oulu, Finland
| | - Heli Lahtela
- Heart Center, Turku University Hospital and University of Turku, Turku, Finland
| | - Gregory Y H Lip
- University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, United Kingdom
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22
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Puurunen M, Kiviniemi T, Nammas W, Schlitt A, Rubboli A, Nyman K, Karjalainen P, Kirchhof P, Lip GYH, Airaksinen JKE. Impact of anaemia on clinical outcome in patients with atrial fibrillation undergoing percutaneous coronary intervention: insights from the AFCAS registry. BMJ Open 2014; 4:e004700. [PMID: 24823675 PMCID: PMC4025460 DOI: 10.1136/bmjopen-2013-004700] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [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: 11/04/2022] Open
Abstract
OBJECTIVES Anaemia has an adverse impact on the outcome in the general patient population undergoing percutaneous coronary intervention (PCI). The aim of this study was to analyse the impact of anaemia on the 12-month clinical outcome of patients with atrial fibrillation (AF) undergoing PCI and therefore requiring intense antithrombotic treatment. We hypothesised that anaemia might be associated with a worse outcome and more bleeding in these anticoagulated patients. SETTING Data were collected from 17 secondary care centres in Europe. PARTICIPANTS Consecutive patients with AF undergoing PCI were enrolled in the prospective, multicenter AFCAS (Atrial Fibrillation undergoing Coronary Artery Stenting) registry. Altogether, 929 patients participated in the study. Preprocedural haemoglobin concentration was available for 861 (92.7%; 30% women). The only exclusion criteria were inability or unwillingness to give informed consent. Anaemia was defined as a haemoglobin concentration of <12 g/dL for women and <13 g/dL for men. OUTCOME MEASURES The primary endpoint was occurrence of major adverse cardiac and cerebrovascular events (MACCE) or bleeding events. RESULTS 258/861 (30%) patients had anaemia. Anaemic patients were older, more often had diabetes, higher CHA2DS2-VASc scores, prior history of heart failure, chronic renal impairment and acute coronary syndrome. Anaemic patients had more MACCE than non-anaemic (29.1% vs 19.4%, respectively, p=0.002), and minor bleeding events (7.0% vs 3.3%, respectively, p=0.028), with a trend towards more total bleeding events (25.2% vs 21.7%, respectively, p=0.059). No difference was observed in antithrombotic regimens at discharge. In multivariate analysis, anaemia was an independent predictor of all-cause mortality at 12-month follow-up (hazard ratio 1.62, 95% CI 1.05 to 2.51, p=0.029). CONCLUSIONS Anaemia was a frequent finding in patients with AF referred for PCI. Anaemic patients had a higher all-cause mortality, more thrombotic events and minor bleeding events. Anaemia seems to be an identification of patients at risk for cardiovascular events and death. TRIAL REGISTRATION ClinicalTrials.gov number NCT00596570.
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Affiliation(s)
- Marja Puurunen
- Hemostasis Laboratory, Finnish Red Cross Blood Service, Helsinki, Finland
| | - Tuomas Kiviniemi
- Heart Center, Turku University Hospital and University of Turku, Turku, Finland
| | - Wail Nammas
- Heart Center, Turku University Hospital and University of Turku, Turku, Finland
| | - Axel Schlitt
- Medical Faculty, Martin Luther University Halle-Wittenberg, Halle-Wittenberg, Germany
| | - Andrea Rubboli
- Division of Cardiology, Laboratory of Interventional Cardiology, Ospedale Maggiore, Bologna, Italy
| | - Kai Nyman
- Department of Cardiology, Central Finland Central Hospital, Jyväskylä, Finland
| | | | - Paulus Kirchhof
- Department of Cardiovascular Medicine, Hospital of the University of Münster, Münster, Germany
- University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, UK
| | - Gregory Y H Lip
- Department of Cardiovascular Medicine, Hospital of the University of Münster, Münster, Germany
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23
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Nammas W, Raatikainen MJP, Korkeila P, Lund J, Ylitalo A, Karjalainen P, Virtanen V, Koivisto UM, Utriainen S, Vasankari T, Koistinen J, Airaksinen KEJ. Predictors of pocket hematoma in patients on antithrombotic therapy undergoing cardiac rhythm device implantation: insights from the FinPAC trial. Ann Med 2014; 46:177-81. [PMID: 24785546 DOI: 10.3109/07853890.2014.894285] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [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: 01/22/2023] Open
Abstract
BACKGROUND The FinPAC trial showed that the strategy of uninterrupted oral anticoagulation (OAC) was non-inferior to interrupted OAC for the primary outcome of bleeding and thromboembolic complications in patients undergoing cardiac rhythm management device (CRMD) implantation. METHODS We conducted a post hoc analysis of the FinPAC data to explore the incidence and predictors of significant (> 100 cm(2)) pocket hematoma after CRMD implantation among the study population (n = 447). A total of 213 patients were on OAC, 128 were on aspirin, and 106 on no antithrombotic therapy. RESULTS The incidence of significant pocket hematoma during hospital stay was significantly higher among patients using OAC (5.6%) and aspirin (5.5%) than in those with no antithrombotic medications (0.9%), but only one patient (0.8%) in the aspirin group needed revision of hematoma. Two patients (0.9%) in the OAC group and one (0.8%) in the aspirin group needed blood products. In multivariable regression analysis, no pre- procedural features predicted the significant hematoma in any of the groups. CONCLUSIONS Clinically significant pocket hematoma is a rare complication after CRMD implantation in patients with ongoing therapeutic OAC. The incidence of significant pocket hematoma formation is similar in patients using OAC and those using aspirin.
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Affiliation(s)
- Wail Nammas
- Heart Center, Turku University Hospital and University of Turku , Turku , Finland
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24
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Kiviniemi T, Karjalainen P, Niemelä M, Rubboli A, Lip GY, Schlitt A, Nammas W, Airaksinen KJ. Bivalirudin use during percutaneous coronary intervention in patients on chronic warfarin therapy. Thromb Res 2014; 133:695-6. [DOI: 10.1016/j.thromres.2014.01.038] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Revised: 01/24/2014] [Accepted: 01/28/2014] [Indexed: 11/26/2022]
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25
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Kiviniemi T, Puurunen M, Schlitt A, Rubboli A, Karjalainen P, Nammas W, Kirchhof P, Biancari F, Lip GYH, Airaksinen KEJ. Bare-Metal vs. Drug-Eluting Stents in Patients With Atrial Fibrillation Undergoing Percutaneous Coronary Intervention. Circ J 2014; 78:2674-81. [DOI: 10.1253/circj.cj-14-0792] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | | | - Axel Schlitt
- Medical Faculty, Martin Luther University Halle-Wittenberg and Paracelsus-Harz-Clinic Bad Suderode
| | - Andrea Rubboli
- Division of Cardiology, Laboratory of Interventional Cardiology, Ospedale Maggiore
| | | | - Wail Nammas
- Heart Center, Turku University Hospital and University of Turku
| | - Paulus Kirchhof
- School of Clinical and Experimental Medicine, University of Birmingham
| | | | - Gregory YH Lip
- University of Birmingham Centre for Cardiovascular Sciences, City Hospital
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26
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Muraru D, Addetia K, Veronesi F, Corsi C, Mor-Avi V, Yamat M, Weinert L, Lang R, Badano L, Faita F, Di Lascio N, Bruno R, Bianchini E, Ghiadoni L, Sicari R, Gemignani V, Angelis A, Ageli K, Ioakimidis N, Chrysohoou C, Agelakas A, Felekos I, Vaina S, Aznaourides K, Vlachopoulos C, Stefanadis C, Nemes A, Szolnoky G, Gavaller H, Gonczy A, Kemeny L, Forster T, Ramalho A, Placido R, Marta L, Menezes M, Magalhaes A, Cortez Dias N, Martins S, Almeida A, Pinto F, Nunes Diogo A, Botezatu CD, Enache R, Popescu B, Nastase O, Coman M, Ghiorghiu I, Calin A, Rosca M, Beladan C, Ginghina C, Grapsa J, Cabrita I, Durighel G, O'regan D, Dawson D, Nihoyannopoulos P, Pellicori P, Kallvikbacka-Bennett A, Zhang J, Lukaschuk E, Joseph A, Bourantas C, Loh H, Bragadeesh T, Clark A, Cleland J, Kallvikbacka-Bennett A, Pellicori P, Lomax S, Putzu P, Diercx R, Parsons S, Dicken B, Zhang J, Clark A, Cleland J, Vered Z, Adirevitz L, Dragu R, Blatt A, Karev E, Malca Y, Roytvarf A, Marek D, Sovova E, Berkova M, Cihalik C, Taborsky M, Lindqvist P, Tossavainen E, Soderberg S, Gonzales M, Gustavsson S, Henein M, Sonne C, Bott-Fluegel L, Hauck S, Lesevic H, Hadamitzky M, Wolf P, Kolb C, Bandera F, Pellegrino M, Generati G, Donghi V, Alfonzetti E, Castelvecchio S, Menicanti L, Guazzi M, Buchyte S, Rinkuniene D, Jurkevicius R, Smarz K, Zaborska B, Jaxa-Chamiec T, Maciejewski P, Budaj A, Santoro A, Federico Alvino F, Giovanni Antonelli G, Roberta Molle R, Matteo Bertini M, Stefano Lunghetti S, Sergio Mondillo S, Henri C, Magne J, Dulgheru R, Laaraibi S, Voilliot D, Kou S, Pierard L, Lancellotti P, Szulik M, Stabryla-Deska J, Kalinowski M, Sliwinska A, Szymala M, Lenarczyk R, Kalarus Z, Kukulski T, Yiangou K, Azina C, Yiangou A, Ioannides M, Chimonides S, Baysal S, Pirat B, Okyay K, Bal U, Muderrisoglu H, Popovic D, Ostojic M, Petrovic M, Vujisic-Tesic B, Arandjelovic A, Petrovic I, Banovic M, Popovic B, Vukcevic V, Damjanovic S, Velasco Del Castillo S, Onaindia Gandarias J, Arana Achaga X, Laraudogoitia Zaldumbide E, Rodriguez Sanchez I, Cacicedo De Bobadilla A, Romero Pereiro A, Aguirre Larracoechea U, Salinas T, Subinas A, Elzbieciak M, Wita K, Grabka M, Chmurawa J, Doruchowska A, Turski M, Filipecki A, Wybraniec M, Mizia-Stec K, Varho V, Karjalainen P, Lehtinen T, Airaksinen J, Ylitalo A, Kiviniemi T, Gargiulo P, Galderisi M, D' Amore C, Lo Iudice F, Savarese G, Casaretti L, Pellegrino A, Fabiani I, La Mura L, Perrone Filardi P, Kim JY, Chung W, Yu J, Choi Y, Park C, Youn H, Lee M, Nagy A, Manouras A, Gunyeli E, Gustafsson U, Shahgaldi K, Winter R, Johnsson J, Zagatina A, Krylova L, Zhuravskaya N, Vareldzyan Y, Tyurina T, Clitsenko O, Khalifa EA, Ashour Z, Elnagar W, Jung I, Seo H, Lee S, Lim D, Mizariene V, Verseckaite R, Janenaite J, Jonkaitiene R, Jurkevicius R, Sanchez Espino A, Bonaque Gonzalez J, Merchan Ortega G, Bolivar Herrera N, Ikuta I, Macancela Quinones J, Gomez Recio M, Silva Fazendas Adame PR, Caldeira D, Stuart B, Almeida S, Cruz I, Ferreira A, Freire G, Lopes L, Cotrim C, Pereira H, Mediratta A, Addetia K, Moss J, Nayak H, Yamat M, Weinert L, Mor-Avi V, Lang R, Al Amri I, Debonnaire P, Van Der Kley F, Schalij M, Bax J, Ajmone Marsan N, Delgado V, Schmidt FP, Gniewosz T, Jabs A, Munzel T, Jansen T, Kaempfner D, Hink U, Von Bardeleben R, Jose J, George O, Joseph G, Jose J, Adawi S, Najjar R, Ahronson D, Shiran A, Van Riel A, Boerlage - Van Dijk K, De Bruin - Bon H, Araki M, Meregalli P, Koch K, Vis M, Mulder B, Baan J, Bouma B, Marciniak A, Elton D, Glover K, Campbell I, Sharma R, Batalha S, Lourenco C, Oliveira Da Silva C, Manouras A, Shahgaldi K, Caballero L, Garcia-Lara J, Gonzalez-Carrillo J, Oliva M, Saura D, Garcia-Navarro M, Espinosa M, Pinar E, Valdes M, De La Morena G, Barreiro Perez M, Lopez Perez M, Roy D, Brecker S, Sharma R, Venkateshvaran A, Dash PK, Sola S, Barooah B, Govind SC, Winter R, Shahgaldi K, Brodin LA, Manouras A, Saura Espin D, Caballero Jimenez L, Gonzalez Carrillo J, Oliva Sandoval M, Lopez Ruiz M, Garcia Navarro M, Espinosa Garcia M, Valdes Chavarri M, De La Morena Valenzuela G, Gatti G, Dell'angela L, Pinamonti B, Benussi B, Sinagra G, Pappalardo A, Hernandez V, Saavedra J, Gonzalez A, Iglesias P, Civantos S, Guijarro G, Monereo S, Ikeda M, Toh N, Oe H, Tanabe Y, Watanabe N, Ito H, Ciampi Q, Cortigiani L, Pratali L, Rigo F, Villari B, Picano E, Sicari R, Yoon J, Sohn J, Kim Y, Chang H, Hong G, Kim T, Ha J, Choi B, Rim S, Choi E, Tibazarwa K, Sliwa K, Wonkam A, Mayosi B, Oryshchyn N, Ivaniv Y, Pavlyk S, Lourenco MR, Azevedo O, Moutinho J, Nogueira I, Fernandes M, Pereira V, Quelhas I, Lourenco A, Sunbul M, Tigen K, Karaahmet T, Dundar C, Ozben B, Guler A, Cincin A, Bulut M, Sari I, Basaran Y, Baydar O, Kadriye Kilickesmez K, Ugur Coskun U, Polat Canbolat P, Veysel Oktay V, Umit Yasar Sinan U, Okay Abaci O, Cuneyt Kocas C, Sinan Uner S, Serdar Kucukoglu S, Zaroui A, Mourali M, Ben Said R, Asmi M, Aloui H, Kaabachi N, Mechmeche R, Saberniak J, Hasselberg N, Borgquist R, Platonov P, Holst A, Edvardsen T, Haugaa K, Lourenco MR, Azevedo O, Nogueira I, Moutinho J, Fernandes M, Pereira V, Quelhas I, Lourenco A, Eran A, Yueksel D, Er F, Gassanov N, Rosenkranz S, Baldus S, Guedelhoefer H, Faust M, Caglayan E, Matveeva N, Nartsissova G, Chernjavskij A, Ippolito R, De Palma D, Muscariello R, Santoro C, Raia R, Schiano-Lomoriello V, Gargiulo F, Galderisi M, Lipari P, Bonapace S, Zenari L, Valbusa F, Rossi A, Lanzoni L, Canali G, Molon G, Campopiano E, Barbieri E, Ikonomidis I, Varoudi M, Papadavid E, Theodoropoulos K, Papadakis I, Pavlidis G, Triantafyllidi H, Anastasiou - Nana M, Rigopoulos D, Lekakis J, Sunbul M, Tigen K, Ozen G, Durmus E, Kivrak T, Cincin A, Ozben B, Atas H, Direskeneli H, Basaran Y, Stevanovic A, Dekleva M, Trajic S, Paunovic N, Simic A, Khan S, Mushemi-Blake S, Jouhra F, Dennes W, Monaghan M, Melikian N, Shah A, Maceira Gonzalez AM, Lopez-Lereu M, Monmeneu J, Igual B, Estornell J, Boraita A, Kosmala W, Rojek A, Bialy D, Mysiak A, Przewlocka-Kosmala M, Popescu I, Mancas S, Mornos C, Serbescu I, Ionescu G, Ionac A, Gaudron P, Niemann M, Herrmann S, Hu K, Liu D, Wojciech K, Frantz S, Bijnens B, Ertl G, Weidemann F, Maceira Gonzalez AM, Cosin-Sales J, Ruvira J, Diago J, Aguilar J, Igual B, Lopez-Lereu M, Monmeneu J, Estornell J, Cruz C, Pinho T, Madureira A, Lebreiro A, Dias C, Ramos I, Silva Cardoso J, Julia Maciel M, De Meester P, Van De Bruaene A, Herijgers P, Voigt JU, Budts W, Franzoso F, Voser E, Wohlmut C, Kellenberger C, Valsangiacomo Buechel E, Carrero C, Benger J, Parcerisa M, Falconi M, Oberti P, Granja M, Cagide A, Del Pasqua A, Secinaro A, Antonelli G, Iacomino M, Toscano A, Chinali M, Esposito C, Carotti A, Pongiglione G, Rinelli G, Youssef Moustafa A, Al Murayeh M, Al Masswary A, Al Sheikh K, Moselhy M, Dardir M, Deising J, Butz T, Suermeci G, Liebeton J, Wennemann R, Tzikas S, Van Bracht M, Prull M, Trappe HJ, Martin Hidalgo M, Delgado Ortega M, Ruiz Ortiz M, Mesa Rubio D, Carrasco Avalos F, Seoane Garcia T, Pan Alvarez-Ossorio M, Lopez Aguilera J, Puentes Chiachio M, Suarez De Lezo Cruz Conde J, Petrovic MT, Giga V, Stepanovic J, Tesic M, Jovanovic I, Djordjevic-Dikic A, Generati G, Pellegrino M, Bandera F, Donghi V, Alfonzetti E, Guazzi M, Piatkowski R, Kochanowski J, Scislo P, Opolski G, Zagatina A, Zhuravskaya N, Krylova L, Vareldzhyan Y, Tyurina T, Clitsenko O, Bombardini T, Gherardi S, Leone O, Picano E, Michelotto E, Ciccarone A, Tarantino N, Ostuni V, Rubino M, Genco W, Santoro G, Carretta D, Romito R, Colonna P, Cameli M, Lunghetti S, Lisi M, Curci V, Cameli P, Focardi M, Favilli R, Galderisi M, Mondillo S, Hoffmann R, Barletta G, Von Bardeleben S, Kasprzak J, Greis C, Vanoverschelde J, Becher H, Machida T, Izumo M, Suzuki K, Kaimijima R, Mizukoshi K, Manabe-Uematsu M, Takai M, Harada T, Akashi Y, Martin Garcia A, Arribas-Jimenez A, Cruz-Gonzalez I, Nieto F, Iscar A, Merchan S, Martin-Luengo C, Brecht A, Theres L, Spethmann S, Dreger H, Baumann G, Knebel F, Jasaityte R, Heyde B, Rademakers F, Claus P, D'hooge J, Lervik Nilsen LC, Lund J, Brekke B, Stoylen A, Giraldeau G, Duchateau N, Gabrielli L, Penela D, Evertz R, Mont L, Brugada J, Berruezo A, Bijnens B, Sitges M, Kordybach M, Kowalski M, Hoffman P, Pilichowska E, Zaborska B, Baran J, Kulakowski P, Budaj A, Wahi S, Vollbon W, Leano R, Thomas A, Bricknell K, Holland D, Napier S, Stanton T, Teferici D, Qirko S, Petrela E, Dibra A, Bajraktari G, Bara P, Sanchis Ruiz L, Gabrielli L, Andrea R, Falces C, Duchateau N, Perez-Villa F, Bijnens B, Sitges M, Sulemane S, Panoulas V, Bratsas A, Tam F, Nihoyannopoulos P, Abduch M, Alencar A, Coracin F, Barban A, Saboya R, Dulley F, Mathias W, Vieira M, Buccheri S, Mangiafico S, Arcidiacono A, Bottari V, Leggio S, Tamburino C, Monte IP, Cruz C, Lebreiro A, Pinho T, Dias C, Silva Cardoso J, Julia Maciel M, Spitzer E, Beitzke D, Kaneider A, Pavo N, Gottsauner-Wolf M, Wolf F, Loewe C, Mushtaq S, Andreini D, Pontone G, Bertella E, Conte E, Baggiano A, Annoni A, Cortinovis S, Fiorentini C, Pepi M, Gustafsson M, Alehagen U, Dahlstrom U, Johansson P, Faden G, Faggiano P, Albertini L, Reverberi C, Gaibazzi N, Taylor RJ, Moody W, Umar F, Edwards N, Townend J, Steeds R, Leyva F, Mihaila S, Muraru D, Piasentini E, Peluso D, Casablanca S, Naso P, Puma L, Iliceto S, Vinereanu D, Badano L, Ciciarello FL, Agati L, Cimino S, De Luca L, Petronilli V, Fedele F, Tsverava M. Poster Session Saturday 14 December - AM: 14/12/2013, 08:30-12:30 * Location: Poster area. Eur Heart J Cardiovasc Imaging 2013. [DOI: 10.1093/ehjci/jet207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Airaksinen KJ, Korkeila P, Lund J, Ylitalo A, Karjalainen P, Virtanen V, Raatikainen P, Koivisto UM, Koistinen J. Safety of pacemaker and implantable cardioverter–defibrillator implantation during uninterrupted warfarin treatment — The FinPAC study. Int J Cardiol 2013; 168:3679-82. [DOI: 10.1016/j.ijcard.2013.06.022] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2012] [Revised: 04/04/2013] [Accepted: 06/15/2013] [Indexed: 11/27/2022]
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Karjalainen P. Neointimal coverage and vasodilator response to titanium-nitride-oxide-coated bioactive stents and everolimus-eluting stents in patients with acute coronary syndrome: insights from the BASE-ACS trial. Int J Cardiovasc Imaging 2013; 29:1693-703. [DOI: 10.1007/s10554-013-0285-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Accepted: 08/24/2013] [Indexed: 10/26/2022]
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Kiviniemi T, Karjalainen P, Rubboli A, Schlitt A, Tuomainen P, Niemelä M, Laine M, Biancari F, Lip GYH, Airaksinen KEJ. Thrombocytopenia in patients with atrial fibrillation on oral anticoagulation undergoing percutaneous coronary intervention. Am J Cardiol 2013; 112:493-8. [PMID: 23672991 DOI: 10.1016/j.amjcard.2013.04.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2013] [Revised: 04/03/2013] [Accepted: 04/03/2013] [Indexed: 12/29/2022]
Abstract
Thrombocytopenia is often regarded as a risk factor for bleeding complications in patients undergoing percutaneous coronary intervention (PCI). The risk of mild to moderate baseline and acquired thrombocytopenia on bleeding and thrombotic or thromboembolic complications in patients with atrial fibrillation on oral anticoagulation therapy undergoing PCI, however, remains largely unknown. Management of Patients With Atrial Fibrillation undergoing Coronary Artery Stenting is a multicenter European prospective registry enrolling patients with atrial fibrillation undergoing PCI. We assessed the rate of bleeding complications as defined by Bleeding Academic Research Consortium and a composite of major adverse cardiac and cerebrovascular events (MACCE) including all-cause mortality, myocardial infarction, transient ischemic attack or stroke, stent thrombosis, systemic arterial embolism, or revascularization; and a composite of any harmful event (Bleeding Academic Research Consortium and MACCE) at 12-month follow-up in 861 consecutive patients undergoing PCI. Patients were divided into those with mild to moderate baseline thrombocytopenia (platelet count <150 × 10⁹/L; n = 99) and control group (platelet count >150 × 10⁹/L; n = 762). At hospital discharge, thrombocytopenia had no effect on prescribed antithrombotic treatment, and triple therapy (vitamin K antagonist + aspirin + clopidogrel) was the most common combination in both patient groups (69% vs 73%, p = 0.40). No differences in all-cause mortality (12% vs 11%, p = 0.79), MACCE (23% vs 22%, p = 0.87), or bleeding complications (23% vs 19%, p = 0.26) were detected. Acquired in-hospital thrombocytopenia occurred in 9.7% of patients, and it was associated with similar risk of adverse outcomes compared with control group. In conclusion, mild to moderate baseline thrombocytopenia does not seem to have a clinically significant effect on bleeding or thrombotic or thromboembolic complications after PCI in these frail patients receiving multiple antithrombotic drugs.
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Affiliation(s)
- Tuomas Kiviniemi
- Heart Center, Turku University Hospital, and University of Turku, Turku, Finland
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Puurunen MK, Kiviniemi T, Rubboli A, Schlitt A, Karjalainen P, Tuomainen P, Vikman S, Biancari F, Lip G, Airaksinen J. CHADS2 and CHA2DS2-VASc scores as predictors of outcome in patients with atrial fibrillation undergoing percutaneous coronary intervention. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p4780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Sousa C, Lousada N, Dos Reis RP, Azevedo O, Lourenco M, Machado I, Guardado J, Medeiros R, Pereira A, Quelhas I, Lourenco A, Duman D, Sargin F, Kilicaslan B, Inan A, Ozgunes N, Goktas P, Ikonomidis I, Tzortzis S, Paraskevaidis I, Andreadou I, Katseli C, Katsimbri P, Papadakis I, Pavlidis G, Anastasiou-Nana M, Lekakis J, Charalampopoulos A, Howard L, Davies R, Gin-Sing W, Tzoulaki I, Grapsa I, Gibbs J, Dobson RA, Cuthbertson DJ, Burgess M, Lichodziejewska B, Kurnicka K, Goliszek S, Kostrubiec M, Dzikowska-Diduch O, Ciurzynski M, Krupa M, Grudzka K, Palczewski P, Pruszczyk P, Mansencal N, Marcadet D, Montalvan B, Dubourg O, Matveeva N, Nartsissova G, Chernjavskiy A, Eicher JC, Berthier S, Lorcerie B, Philip JL, Wolf JE, Wiesen P, Ledoux D, Massion P, Piret S, Canivet JL, Cusma-Piccione M, Zito C, Imbalzano E, Saitta A, Donato D, Madaffari A, Luzza G, Pipitone V, Tripodi R, Carerj S, Bombardini T, Gherardi S, Arpesella G, Maccherini M, Serra W, Del Bene R, Sicari R, Picano E, Al-Mallah M, Ananthasubramaniam K, Alam M, Chattahi J, Zweig B, Boedeker S, Song T, Khoo J, Davies J, Ang KL, Galinanes M, Chin D, Papamichael ND, Karassavidou D, Mpougialkli M, Antoniou S, Giannitsi S, Chachalos S, Gouva C, Naka K, Katopodis K, Michalis L, Tsang W, Cui V, Ionasec R, Takeuchi M, Houle H, Weinert L, Roberson D, Lang R, Altman M, Aussoleil A, Bergerot C, Sibellas F, Bonnefoy-Cudraz E, Derumeaux GA, Thibault H, Mohamed A, Omran A, Hussein M, Shahgaldi K, Gunyeli E, Sahlen A, Manouras A, Winter R, Squeri A, Binno S, Ferdenzi E, Reverberi C, Baldelli M, Barbieri A, Iaccarino D, Naldi M, Bosi S, Kalinowski M, Szulik M, Streb W, Stabryla J, Nowak J, Rybus-Kalinowska B, Kukulski T, Kalarus Z, Ouss A, Riezebos R, Nestaas E, Skranes J, Stoylen A, Brunvand L, Fugelseth D, Magalhaes A, Silva Marques J, Martins S, Carrilho Ferreira P, Placido R, Jorge C, Silva D, Goncalves S, Almeida A, Nunes Diogo A, Nagy A, Kovats T, Apor A, Nagy A, Vago H, Toth A, Toth M, Merkely B, Ranjbar S, Karvandi M, Hassantash S, Da Silva SG, Marin C, Rodriguez A, Marcos C, Rodriguez-Ogando A, Maroto E, Medrano C, Del Valle DI, Lopez-Fernandez T, Gemma D, Gomez-Rubin M, De Torres F, Feliu J, Canales M, Buno A, Ramirez E, Lopez-Sendon J, Magalhaes A, Silva Marques J, Martins S, Placido R, Silva D, Jorge C, Calisto C, Goncalves S, Almeida A, Nunes Diogo A, Jorge C, Cortez-Dias N, Goncalves S, Ribeiro S, Santos L, Silva D, Barreiros C, Bernardes A, Carpinteiro L, Sousa J, Kim SH, Choi W, Chidambaram S, Arunkumar R, Venkatesan S, Gnanavelu G, Dhandapani V, Ravi M, Karthikeyan G, Meenakshi K, Muthukumar D, Swaminathan N, Vitarelli A, Barilla F, Capotosto L, Truscelli G, Dettori O, Caranci F, D-Angeli I, De Maio M, De Cicco V, Bruno P, Doesch C, Sueselbeck T, Haghi D, Streitner F, Borggrefe M, Papavassiliu T, Laser K, Schaefer F, Fischer M, Habash S, Degener F, Moysich A, Haas N, Kececioglu D, Burchert W, Koerperich H, Dwivedi G, Al-Shehri H, Dekemp R, Ali I, Alghamdi A, Klein R, Scullion A, Beanlands R, Ruddy T, Chow B, Lipiec P, Szymczyk E, Michalski B, Wozniakowski B, Rotkiewicz A, Stefanczyk L, Szymczyk K, Kasprzak J, Angelov A, Yotov Y, Mircheva L, Kisheva A, Kunchev O, Ikonomidis I, Tsantes A, Triantafyllidi H, Tzortzis S, Dima K, Trivilou P, Papadopoulos C, Travlou A, Anastasiou-Nana M, Lekakis J, Bader R, Agoston-Coldea L, Lupu S, Mocan T, Loegstrup B, Hofsten D, Christophersen T, Moller J, Bjerre M, Flyvbjerg A, Botker H, Egstrup K, Park Y, Choi J, Yun K, Lee S, Han D, Kim J, Kim J, Kim J, Chun K. Poster Session Wednesday 5 December all day Display * Determinants of left ventricular performance. Eur Heart J Cardiovasc Imaging 2012. [DOI: 10.1093/ehjci/jes248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Landmesser U, Wijns W, Barbato E, Karjalainen P, de Winter R, Verheye S, Hill J, Wojakowski W, Ligtenberg E, Rowland S, Bezerra H, Costa M. TCT-282 The REMEDEE OCT study: A prospective randomized study of the early vascular healing of a novel Dual Therapy Stent in comparison with an everolimus eluting stent. J Am Coll Cardiol 2012. [DOI: 10.1016/j.jacc.2012.08.306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Kuusniemi K, Zöllner J, Sjövall S, Huhtala J, Karjalainen P, Kokki M, Lemken J, Oppermann J, Kokki H. Prolonged-release Oxycodone/Naloxone in Postoperative Pain Management: From a Randomized Clinical Trial to Usual Clinical Practice. J Int Med Res 2012. [DOI: 10.1177/030006051204000516] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [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] Open
Abstract
Objective: These studies evaluated the feasibility of using oral prolonged-release oxycodone/naloxone (OXN PR) for the management of acute postoperative pain. Methods: Three studies were undertaken: (i) the analgesic efficacy of OXN PR was compared with prolonged-release oxycodone (OXY PR) in patients with knee arthroplasty in an immediate postoperative period (IPOP) study; (ii) OXN PR treatment was compared with other opioids during rehabilitation after knee arthroplasty in a noninterventional study (NIS); and (iii) surgical patients on other opioids were switched to OXN PR postoperatively during a quality improvement programme (QIP). Results: In the IPOP study, the pain intensity at rest score decreased by a similar amount in the OXN PR and OXY PR groups, indicating similar analgesic efficacies. In the NIS, patient assessments indicated enhanced efficacy and tolerability for OXN PR compared with other opioids. The QIP indicated significant improvements in bowel function and less difficulty passing urine at the end of OXN PR treatment compared with baseline. No safety concerns were raised. Conclusions: The analgesic efficacies of OXN PR and OXY PR were similar in postoperative pain settings. OXN PR reduced the degree of restriction in relation to patients carrying out physio - therapy compared with other opioids, and improved bowel and bladder function.
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Affiliation(s)
- K Kuusniemi
- Department of Anaesthesiology, Intensive Care, Emergency Care and Pain Medicine, Turku University Hospital and University of Turku, Turku, Finland
| | - J Zöllner
- Department of Orthopaedics and Traumatology, SRH Karlsbad-Langensteinbach Hospital, Karlsbad, Germany
| | - S Sjövall
- Department of Surgery and Anaesthesia, Central Hospital of Pori, Pori, Finland
| | - J Huhtala
- Coxa Hospital for Joint Replacement, Tampere, Finland
| | - P Karjalainen
- Department of Surgery and Anaesthesia, Hospital of Oulaskangas, Oulainen, Finland
| | - M Kokki
- Department of Anaesthesia and Operative Services, Kuopio University Hospital, Kuopio, Finland
- Department of Anaesthesiology and Intensive Care, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - J Lemken
- Department of Orthopaedics and Traumatology, SRH Karlsbad-Langensteinbach Hospital, Karlsbad, Germany
| | - J Oppermann
- Department of Orthopaedics and Traumatology, SRH Karlsbad-Langensteinbach Hospital, Karlsbad, Germany
| | - H Kokki
- Department of Anaesthesia and Operative Services, Kuopio University Hospital, Kuopio, Finland
- Department of Anaesthesiology and Intensive Care, School of Medicine, University of Eastern Finland, Kuopio, Finland
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Kiviniemi T, Karjalainen P, Pietilä M, Ylitalo A, Niemelä M, Vikman S, Puurunen M, Biancari F, Airaksinen KEJ. Comparison of additional versus no additional heparin during therapeutic oral anticoagulation in patients undergoing percutaneous coronary intervention. Am J Cardiol 2012; 110:30-5. [PMID: 22464216 DOI: 10.1016/j.amjcard.2012.02.045] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2012] [Revised: 02/13/2012] [Accepted: 02/13/2012] [Indexed: 11/18/2022]
Abstract
Uninterrupted oral anticoagulation (OAC) therapy can be the preferred strategy in patients with atrial fibrillation at moderate to high risk of thromboembolism undergoing percutaneous coronary intervention (PCI). To evaluate the need for additional heparins in addition to therapeutic peri-PCI OAC, we assessed bleeding complications and major adverse cardiac and cerebrovascular events in 414 consecutive patients undergoing PCI during therapeutic (international normalized ratio 2 to 3.5) periprocedural OAC. Patients were divided into those with no (n = 196) and with (n = 218) additional use of periprocedural heparins. No differences in major adverse cardiac and cerebrovascular events (4.1% vs 3.2%, p = 0.79) or major bleeding (1.0% vs 3.7%, p = 0.11) were detected, but access site complications (5.1% vs 11.0%, p = 0.032) were less frequent in those without additional heparins. When adjusted for propensity score, patients with additional heparins had a higher risk of access site complications (odds ratio 2.6, 95% confidence interval 1.1 to 6.1, p = 0.022) without any increased risk of any other adverse event. Analysis of 1-to-1 propensity-matched pairs showed a significantly higher risk of access site complication in patients receiving additional AC (13.1% vs 5.7%, p = 0.049). In conclusion, therapeutic warfarin treatment seems to provide sufficient AC for PCI. Additional heparins are not needed and may increase access site complications.
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Affiliation(s)
- Tuomas Kiviniemi
- Department of Medicine, Turku University Hospital, Turku, Finland
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Kuoppa P, Niskanen E, Karjalainen P, Tarvainen MP. Cerebral cortex and sub-cortex lateralization in cardiovascular regulation: correlations of BOLD fMRI and heart rate variability. Annu Int Conf IEEE Eng Med Biol Soc 2012; 2012:3412-3415. [PMID: 23366659 DOI: 10.1109/embc.2012.6346698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The role of cerebral cortex in cardiovascular regulation has not yet been mapped in detail. Especially the lateralization of different regions that are connected to cardiovascular modulation is still unknown. In this study we used simultaneously measured electrocardiography (ECG) and blood oxygen level dependent (BOLD) fMRI to examine the correlation of cerebral cortex and sub-cortex activation and heart rate variability parameters. Correlations were calculated for 11 subjects. Regions of interest (ROIs) were predefined from observations made in previous studies. Lateralization was studied by forming ratios of left and right hemisphere activations in ROIs and calculating correlations of these to heart rate variability (HRV) parameters. Statistically significant correlations were found in every ROI.
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Affiliation(s)
- P Kuoppa
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.
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Airaksinen KJ, Biancari F, Karjalainen P, Mikkola R, Kuttila K, Porela P, Laitio T, Lip GY. Safety of coronary artery bypass surgery during therapeutic oral anticoagulation. Thromb Res 2011; 128:435-9. [DOI: 10.1016/j.thromres.2011.05.021] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2011] [Revised: 04/03/2011] [Accepted: 05/30/2011] [Indexed: 12/31/2022]
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Karjalainen P, Nammas W. Titanium-nitride-oxide-coated Titan-2 bioactive coronary stent: a new breakthrough in interventional cardiology. Minerva Cardioangiol 2011; 59:447-454. [PMID: 21983305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The introduction of drug-eluting stents (DES) has revolutionized the field of interventional cardiology, since it has reduced the incidence of restenosis by 50% to 70%. However, recent worrisome data from registries and meta-analyses emphasized higher rates of late and very late stent thrombosis associated with DES. The recently introduced titanium-nitride-oxide-coated stent bioactive stent (Titan-2) was manufactured by a proprietary process to coat titanium-nitride-oxide on the surface of the stainless steel stent, based on a plasma technology using the nano-synthesis of gas and metal. This late-breaking stent has demonstrated an excellent biocompatibility, as reflected by lower rates of platelet aggregation and fibrin deposition, and better endothelialization. Preclinical and clinical trials and registries involving real-life unselected populations have shown a low rate of major adverse cardiac events at long-term follow-up. Restenosis rates were comparable with those of DES, with very rare stent thrombosis. Equally favorable results have been obtained in patients at high-risk of in-stent restenosis, such as diabetics and those with small coronary arteries. Results in patients presenting with acute coronary syndrome have been again comparable to those of DES, with tendency to lower rates of myocardial infarction and stent thrombosis. Comparisons with second generation drug-eluting stents have also been promising.
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Affiliation(s)
- P Karjalainen
- Heart Center, Satakunta Central Hospital, Pori, Finland.
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Karjalainen P, Nammas W. Bioactive stents for percutaneous coronary intervention: a new forerunner on the track. Interv Cardiol 2011. [DOI: 10.2217/ica.11.61] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Gang UJO, Jons C, Jorgensen RM, Abildstrom SZ, Messier MD, Haarbo J, Huikuri HV, Thomsen PEB, Raatikainen MJP, Hartikainen J, Virtanen V, Boland J, Anttonen O, Hoest N, Boersma LVA, Platou ES, Becker D, Schrijver G, Robbe H, Mahaux V, Christiansen LK, Huikuri P, Karjalainen P. Risk markers of late high-degree atrioventricular block in patients with left ventricular dysfunction after an acute myocardial infarction: a CARISMA substudy. Europace 2011; 13:1471-7. [DOI: 10.1093/europace/eur165] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
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Niskanen E, Julkunen P, Säisänen L, Vanninen R, Karjalainen P, Könönen M. Group-level variations in motor representation areas of thenar and anterior tibial muscles: Navigated Transcranial Magnetic Stimulation Study. Hum Brain Mapp 2010; 31:1272-80. [PMID: 20082330 DOI: 10.1002/hbm.20942] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Navigated transcranial magnetic stimulation (TMS) can be used to stimulate functional cortical areas at precise anatomical location to induce measurable responses. The stimulation has commonly been focused on anatomically predefined motor areas: TMS of that area elicits a measurable muscle response, the motor evoked potential. In clinical pathologies, however, the well-known homunculus somatotopy theory may not be straightforward, and the representation area of the muscle is not fixed. Traditionally, the anatomical locations of TMS stimulations have not been reported at the group level in standard space. This study describes a methodology for group-level analysis by investigating the normal representation areas of thenar and anterior tibial muscle in the primary motor cortex. The optimal representation area for these muscles was mapped in 59 healthy right-handed subjects using navigated TMS. The coordinates of the optimal stimulation sites were then normalized into standard space to determine the representation areas of these muscles at the group-level in healthy subjects. Furthermore, 95% confidence interval ellipsoids were fitted into the optimal stimulation site clusters to define the variation between subjects in optimal stimulation sites. The variation was found to be highest in the anteroposterior direction along the superior margin of the precentral gyrus. These results provide important normative information for clinical studies assessing changes in the functional cortical areas because of plasticity of the brain. Furthermore, it is proposed that the presented methodology to study TMS locations at the group level on standard space will be a suitable tool for research purposes in population studies.
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Affiliation(s)
- Eini Niskanen
- Department of Clinical Neurophysiology, Kuopio University Hospital, Finland.
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Airaksinen K, Schlitt A, Rubboli A, Karjalainen P, Lip G. How to manage antithrombotic treatment during percutaneous coronary interventions in patients receiving long-term oral anticoagulation: to "bridge" or not to "bridge"? EUROINTERVENTION 2010; 6:520-6. [DOI: 10.4244/eij30v6i4a86] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Valdesuso R, Karjalainen P, García J, Díaz J, Portales JF, Masotti M, Picó F, Serra A, Burgos JM, Insa L, Mauri F, Collado JR, Nammas W. The EXTREME registry: Titanium-nitride-oxide coated stents in small coronary arteries. Catheter Cardiovasc Interv 2010; 76:281-7. [DOI: 10.1002/ccd.22474] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Raúl Valdesuso
- Cardiology Department, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain
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Korkeila P, Mustonen P, Koistinen J, Nyman K, Ylitalo A, Karjalainen P, Lund J, Airaksinen J. Clinical and laboratory risk factors of thrombotic complications after pacemaker implantation: a prospective study. Europace 2010; 12:817-24. [DOI: 10.1093/europace/euq075] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
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Exner DV, Ramza BL, Kutarski A, Malecka B, Zabek A, Goncalves A, Lopes R, Sousa A, Medeiros F, Parada MA, Campos J, Maciel MA}J, Kutarski A, Malecka B, Zabek A, Scott PA, Chow W, Ellis E, Turner NG, Morgan JM, Roberts PR, Korkeila P, Mustonen P, Koistinen J, Nyman K, Ylitalo A, Karjalainen P, Lund J, Airaksinen J, Jais P, Reddy V, Neuzil P, D'avila A, Hallier B, Ritter P, Bordachar P, Haissaguerre M, Nakajima H, Igawa OI, Adachi MA, Marchese P, Delle Donne G, Malavasi V, Casali E, Modena MG, Geller L, Szilagyi SZ, Zima E, Molnar L, Tahin T, Szucs G, Roka A, Merkely B, Gasparini G, Mangino D, Rossillo A, Madalosso M, Polesel E, Raviele A, Toluie K, Mounir M, Hedayati A, Diaz J, Green M, Jetton E, Oza A, Scipione P, Misiani A, Cecchetti P, Rita E, Francioni M, Molini S, Capucci A, Claessens P, Roose I, Crocq C, Mayoux G, Irigoyen J, Bauple JL, Razani M, Dubin K, Luedorff G, Grove R, Wolff E, Kranig W, Thale J, Zanon F, Baracca E, Pastore G, Aggio S, Piergentili C, Conte L, Bortolazzi A, Roncon L. Poster Session 2: Pacing leads. Europace 2009. [DOI: 10.1093/europace/euq208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Rissanen V, Suomalainen O, Karjalainen P, Kettunen K, Kärkkäinen A, Länsimies E, Wiljasalo M. Screening for postoperative pulmonary embolism on the basis of clinical symptomatology, routine electrocardiography and plain chest radiography. Acta Med Scand 2009; 215:13-9. [PMID: 6695561 DOI: 10.1111/j.0954-6820.1984.tb04964.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The incidence of pulmonary embolism (PE) and the usefulness of various screening methods for its detection were studied in 108 patients undergoing elective hip surgery. Twenty patients had PE as shown by perfusion-ventilation lung scintigraphy. Six of them had symptoms of embolism. Clinical symptoms of PE, highly suggestive electrocardiographic (ECG) signs and signs in chest radiographs showed high specificity but low sensitivity with regard to PE. If the non-specific ECG signs and the symptoms and signs of deep vein thrombosis in the calves had also been taken into account, it would have been possible to identify 95% of the patients with PE. The use of all these screening tests revealed a suspicion of PE in two thirds of the patients. The simplest way to screen for postoperative PE seems to be to use a combination of the symptoms and signs of both PE and deep vein thrombosis, and to identify any tachycardia. This method gave a sensitivity of 85%.
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Hoikka V, Alhava EM, Aro A, Karjalainen P, Rehnberg V. Treatment of osteoporosis with 1-alpha-hydroxycholecalciferol and calcium. Acta Med Scand 2009; 207:221-4. [PMID: 6989171 DOI: 10.1111/j.0954-6820.1980.tb09709.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
A double-blind comparative study of 1 alpha-OHD3 and placebo was performed on 37 patients with osteoporotic hip fracture without clinical osteomalacia. 1 alpha-OHD3, in a dose of 1 microgram/day together with 2.5 g CaCO3, did not heal osteoporosis as judged from determinations of bone mineral density and histomorphometric analyses during four months of treatment. However, 1 alpha-OHD3 seemed to have an effect on fracture healing as concluded from the posttreatment alkaline phosphatase level. Hypercalcemia was common, occurring in six out of 19 patients treated with 1 alpha-OHD3. It is concluded that treatment of osteoporosis with 1 alpha-OHD3 and calcium is ineffective and potentially dangerous because it frequently causes hypercalcemia.
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Abstract
Fatigue is a prevalent problem in the workplace and a common symptom of many diseases. However, its relationship with the autonomic nervous system, specifically with sympathetic arousal, needs clarification. The objective of this study was to determine the association between fatigue and heart rate variability (HRV). HRV is regarded as an indicator of the autonomic regulation activity of heart rate, specifically sympathetic and parasympathetic activity. Spectral changes in low-frequency (LF; 0.04–0.15 Hz) and high-frequency (HF; 0.15–0.4 Hz) components of HRV have been reported to be associated with distressing conditions such as hemorrhagic shock, acute myocardial infarction, elevated anxiety, and depressed mood. While HRV changes have been found in persons with chronic fatigue syndrome, its association with fatigue in healthy individuals still needs clarification. HRV was assessed in a total of 50 participants who were asked to perform a task until becoming fatigued. Low-frequency HRV activity increased, while indices of parasympathetic modulation such as RMSSD and pNN50 remained stable as participants experienced fatigue, suggesting that fatigue in healthy individuals may be associated with increased sympathetic arousal. In addition, employing multiple regression analyses, we could positively associate the change in LF/HF HRV ratio from baseline to fatigue with factors such as emotional stability, warmth and tension and negatively associate it with social boldness and self-reported levels of vigor.
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Affiliation(s)
- Yvonne Tran
- Centre in Health Technologies, University of Technology, Sydney, Australia
| | - Nirupama Wijesuriya
- Rehabilitation Studies Unit, Northern Clinical School, Faculty of Medicine, The University of Sydney, Australia
| | | | | | - Ashley Craig
- Rehabilitation Studies Unit, Northern Clinical School, Faculty of Medicine, The University of Sydney, Australia
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Hess OM, Karjalainen P, James S, Wallentin L, de Winter RJ. Why don't we return to bare metal stents? EUROINTERVENTION 2008; 4:36-41. [PMID: 19112775 DOI: 10.4244/eijv4i1a6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Otto M Hess
- Swiss Cardiovascular Center, University Hospital, 3010 Bern, Switzerland.
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Orsila R, Virtanen M, Luukkaala T, Tarvainen M, Karjalainen P, Viik J, Savinainen M, Nygård CH. Perceived mental stress and reactions in heart rate variability--a pilot study among employees of an electronics company. Int J Occup Saf Ergon 2008; 14:275-83. [PMID: 18954537 DOI: 10.1080/10803548.2008.11076767] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
In this study perceived mental stress during occupational work was compared to heart rate variability (HRV) using a traditional questionnaire and a novel wristop heart rate monitor with related software. The aim was to find HRV parameters useful for mental stress detection. We found the highest correlation between perceived mental stress with the differences between the values of triangular interpolation of rhythm-to-rhythm (RR) interval histogram (TINN) and the root mean square of differences of successive RR intervals (RMSSD) obtained in the morning and during the workday (r=-.73 and r=-.60, respectively). The analysis shows that as the RMSSD and TINN value differences increase from night to morning, the stress decreases.
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Affiliation(s)
- Reetta Orsila
- Tampere School of Public Health, University of Tampere, and Tampere University Hospital, Finland.
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