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Vester M, Beeres S, Lucas C, van Pol P, Schalij M, Bonten T, van Dijkman P, Tops L. Chronic care for heart failure patients: Who to refer back to the general practitioner?-Experiences of the Dutch integrated heart failure care model. J Eval Clin Pract 2024; 30:209-216. [PMID: 37897173 DOI: 10.1111/jep.13937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 09/08/2023] [Accepted: 09/14/2023] [Indexed: 10/29/2023]
Abstract
OBJECTIVE The number of patients with heart failure (HF) and corresponding burden of the healthcare system will increase significantly. The Dutch integrated model, 'Transmural care of HF Patients' was based on the European Society of Cardiology (ESC) guidelines and initiated to manage the increasing prevalence of HF patients in primary and secondary care and stimulate integrated care. It is unknown how many HF patients are eligible for back-referral to general practitioners (GPs), which is important information for the management of chronic HF care. This study aims to evaluate clinical practice of patients for whom chronic HF care can be referred from the cardiologist to the GP based on the aforementioned chronic HF care model. DESIGN AND METHODS A retrospective case record-based study was conducted, which included all chronic HF patients registered in the cardiology information systems of two different hospitals. Subsequently, 200 patients were randomly selected for evaluation. The following patients were considered eligible for referral to the GP: 1/Stable HF patients with reduced left ventricular ejection fraction (LVEF), 2/Stable HF patients with a recovered LVEF and 3/Stable HF patients with a preserved LVEF, 4/HF, palliative setting. RESULTS Of the 200 patients, 17% was considered eligible for referral to the GP. This group consisted of 5% patients with a reduced LVEF, 10.5% patients with recovered LVEF and 1.5% patients with a preserved LVEF. Main indicators for HF care by cardiologists were active cardiac disease other than HF (39.5%), recent admission for HF (29.5%) or a recent adjustment in HF medication (7.5%). CONCLUSION Applying the chronic HF care model of the 'Transmural care of HF patients' and the ESC-guidelines, results in an important opportunity to further optimise HF integrated care and to deal with the increasing number of HF patients referred to the hospital.
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Affiliation(s)
- Marijke Vester
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Saskia Beeres
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Carolien Lucas
- Department of Cardiology, Alrijne Hospital, Leiderdorp, The Netherlands
| | - Petra van Pol
- Department of Cardiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
| | - Martin Schalij
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Tobias Bonten
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Paul van Dijkman
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Laurens Tops
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
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2
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de Koning E, van der Haas Y, Saguna S, Stoop E, Bosch J, Beeres S, Schalij M, Boogers M. AI Algorithm to Predict Acute Coronary Syndrome in Prehospital Cardiac Care: Retrospective Cohort Study. JMIR Cardio 2023; 7:e51375. [PMID: 37906226 PMCID: PMC10646678 DOI: 10.2196/51375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/29/2023] [Accepted: 09/19/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND Overcrowding of hospitals and emergency departments (EDs) is a growing problem. However, not all ED consultations are necessary. For example, 80% of patients in the ED with chest pain do not have an acute coronary syndrome (ACS). Artificial intelligence (AI) is useful in analyzing (medical) data, and might aid health care workers in prehospital clinical decision-making before patients are presented to the hospital. OBJECTIVE The aim of this study was to develop an AI model which would be able to predict ACS before patients visit the ED. The model retrospectively analyzed prehospital data acquired by emergency medical services' nurse paramedics. METHODS Patients presenting to the emergency medical services with symptoms suggestive of ACS between September 2018 and September 2020 were included. An AI model using a supervised text classification algorithm was developed to analyze data. Data were analyzed for all 7458 patients (mean 68, SD 15 years, 54% men). Specificity, sensitivity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for control and intervention groups. At first, a machine learning (ML) algorithm (or model) was chosen; afterward, the features needed were selected and then the model was tested and improved using iterative evaluation and in a further step through hyperparameter tuning. Finally, a method was selected to explain the final AI model. RESULTS The AI model had a specificity of 11% and a sensitivity of 99.5% whereas usual care had a specificity of 1% and a sensitivity of 99.5%. The PPV of the AI model was 15% and the NPV was 99%. The PPV of usual care was 13% and the NPV was 94%. CONCLUSIONS The AI model was able to predict ACS based on retrospective data from the prehospital setting. It led to an increase in specificity (from 1% to 11%) and NPV (from 94% to 99%) when compared to usual care, with a similar sensitivity. Due to the retrospective nature of this study and the singular focus on ACS it should be seen as a proof-of-concept. Other (possibly life-threatening) diagnoses were not analyzed. Future prospective validation is necessary before implementation.
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Affiliation(s)
- Enrico de Koning
- Cardiology Department, Leiden University Medical Center, Leiden, Netherlands
| | | | | | - Esmee Stoop
- Clinical AI and Research lab, Leiden University Medical Center, Leiden, Netherlands
| | - Jan Bosch
- Research and Development, Regional Ambulance Service Hollands-Midden, Leiden, Netherlands
| | - Saskia Beeres
- Cardiology Department, Leiden University Medical Center, Leiden, Netherlands
| | - Martin Schalij
- Cardiology Department, Leiden University Medical Center, Leiden, Netherlands
| | - Mark Boogers
- Cardiology Department, Leiden University Medical Center, Leiden, Netherlands
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Van Hout MJP, Dekkers IA, Westenberg JJ, Schalij M, de Mutsert R, Rosendaal F, De Roos A, Jukema J, Scholte A, Lamb HJ. MAGNETIC RESONANCE IMAGING BASED AORTIC PULSE WAVE VELOCITY NORMAL AND REFERENCE VALUES IN THE MIDDLE-AGED GENERAL POPULATION. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)02665-6] [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: 11/29/2022]
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de Koning E, Biersteker TE, Beeres S, Bosch J, Backus BE, Kirchhof CJ, Alizadeh Dehnavi R, Silvius HA, Schalij M, Boogers MJ. Prehospital triage of patients with acute cardiac complaints: study protocol of HART-c, a multicentre prospective study. BMJ Open 2021; 11:e041553. [PMID: 33579765 PMCID: PMC7883865 DOI: 10.1136/bmjopen-2020-041553] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 12/27/2022] Open
Abstract
INTRODUCTION Emergency department (ED) overcrowding is a major healthcare problem associated with worse patient outcomes and increased costs. Attempts to reduce ED overcrowding of patients with cardiac complaints have so far focused on in-hospital triage and rapid risk stratification of patients with chest pain at the ED. The Hollands-Midden Acute Regional Triage-Cardiology (HART-c) study aimed to assess the amount of patients left at home in usual ambulance care as compared with the new prehospital triage method. This method combines paramedic assessment and expert cardiologist consultation using live monitoring, hospital data and real-time admission capacity. METHODS AND ANALYSIS Patients visited by the emergency medical services (EMS) for cardiac complaints are included. EMS consultation consists of medical history, physical examination and vital signs, and ECG measurements. All data are transferred to a newly developed platform for the triage cardiologist. Prehospital data, in-hospital medical records and real-time admission capacity are evaluated. Then a shared decision is made whether admission is necessary and, if so, which hospital is most appropriate. To evaluate safety, all patients left at home and their general practitioners (GPs) are contacted for 30-day adverse events. ETHICS AND DISSEMINATION The study is approved by the LUMC's Medical Ethics Committee. Patients are asked for consent for contacting their GPs. The main results of this trial will be disseminated in one paper. DISCUSSION The HART-c study evaluates the efficacy and feasibility of a prehospital triage method that combines prehospital patient assessment and direct consultation of a cardiologist who has access to live-monitored data, hospital data and real-time hospital admission capacity. We expect this triage method to substantially reduce unnecessary ED visits.
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Affiliation(s)
- Enrico de Koning
- Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Tom E Biersteker
- Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Saskia Beeres
- Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jan Bosch
- Research and Development, Regional Ambulance Service Hollands-Midden (RAVHM), Leiden, The Netherlands
| | - Barbra E Backus
- Emergency Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | | | | | - Helen Am Silvius
- Public Health and General Practice, Leiden University Medical Center, Leiden, The Netherlands
| | - Martin Schalij
- Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Mark J Boogers
- Cardiology, Leiden University Medical Center, Leiden, The Netherlands
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Nederend M, Zandstra T, Jongbloed M, Kies P, Vliegen H, Bouma B, Tops L, Schalij M, Egorova A. 12. Sacubitril/valsartan in the treatment of systemic right ventricular failure. International Journal of Cardiology Congenital Heart Disease 2021. [DOI: 10.1016/j.ijcchd.2020.100040] [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: 11/26/2022] Open
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Koppel C, Vliegen H, Bökenkamp R, Harkel DJT, Kiès P, Egorova A, Jukema W, Hazekamp M, Schalij M, Gittenberger-de Groot A, Jongbloed M. 18. The Leiden convention coronary coding system: Translation from the surgical to the universal view. International Journal of Cardiology Congenital Heart Disease 2021. [DOI: 10.1016/j.ijcchd.2020.100046] [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: 11/25/2022] Open
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Zandstra T, Kiès P, Man SC, Maan A, Bootsma M, Vliegen H, Egorova A, Holman E, Schalij M, Jongbloed M. QT interval variability and heart rate turbulence are associated with clinical characteristics in congenital heart disease patients with a systemic right ventricle. J Cardiol 2020; 76:514-520. [PMID: 32665161 DOI: 10.1016/j.jjcc.2020.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 04/09/2020] [Accepted: 05/20/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND QT interval variability (QTV) and heart rate turbulence (HRT) are measures of cardiac autonomic function, which, when abnormal, are correlated with ventricular arrhythmias and worse clinical outcome. This study aims to evaluate QTV and HRT in patients with a systemic right ventricle (RV) and to assess correlations with clinical characteristics. METHODS In a retrospective cohort study, QTV and HRT were derived from 24-h Holter registrations of patients with a systemic RV and healthy controls. QTV and HRT were compared between groups. In patients, the association between QTV, HRT, and clinical characteristics was assessed. RESULTS Holter recordings from 40 patients (mean age 40 years, 16 females) and 37 healthy controls (mean age 42 years, 21 females) were analyzed. Groups were comparable in terms of age and sex. QTV was increased in patients compared with controls (p < 0.001), HRT did not differ significantly between the groups. Increased QTV and decreased HRT correlated with medication use, especially of diuretics, and with clinical events, particularly supraventricular arrhythmias. Increased QTV correlated with reduced systemic RV function. Decreased HRT was independently associated with a larger number of past clinical events (estimate -0.33, 95% CI -0.63 to -0.02, p = 0.037). QTV was higher in women in both patients and controls (p = 0.041 and p = 0.034, respectively). CONCLUSIONS QTV and HRT are associated with clinical factors and events in patients with a systemic RV. Further studies are mandatory to confirm their prognostic value.
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Affiliation(s)
- Tjitske Zandstra
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Philippine Kiès
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Sum-Che Man
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Arie Maan
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Marianne Bootsma
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Hubert Vliegen
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Anastasia Egorova
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Eduard Holman
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Martin Schalij
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Monique Jongbloed
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands; Department of Anatomy & Embryology, Leiden University Medical Center, Leiden, The Netherlands.
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8
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Zandstra T, Kiès P, Maan A, Man SC, Bootsma M, Vliegen H, Egorova A, Mertens B, Holman E, Schalij M, Jongbloed M. Association between reduced heart rate variability components and supraventricular tachyarrhythmias in patients with a systemic right ventricle. Auton Neurosci 2020; 227:102696. [PMID: 32623323 DOI: 10.1016/j.autneu.2020.102696] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 05/24/2020] [Accepted: 06/23/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Patients with a systemic right ventricle are prone to develop heart failure. Abnormal heart rate variability (HRV), a measure of autonomic dysfunction, is associated with morbidity and mortality in patients with left ventricular failure. The association between HRV and supraventricular arrhythmias (SVTs), which are associated with adverse events in this population, was assessed. METHODS 24-Hour Holter recordings of patients with a systemic right ventricle and healthy controls were analysed in a retrospective cohort study. HRV was calculated and compared between groups. Correlation coefficients were determined for HRV variables and clinical characteristics. The relation between HRV and SVTs was investigated with linear regression. RESULTS The patient group included 29 patients (69%) late after Mustard or Senning correction for transposition of the great arteries, and 13 patients with congenitally corrected transposition of the great arteries (31%). The control group included 38 subjects. HRV was significantly lower in patients compared with controls. In the patient group, lower SDANN (standard deviation of the average NN intervals calculated over 5-minute intervals) was independently associated with a higher number of supraventricular arrhythmias (95% CI -0.03 to -0.0004, p = 0.045). In exploratory correlation analysis, several HRV variables correlated with echocardiographic systemic right ventricular function (rho = 0.36, p = 0.02 for SDANN), and exercise capacity (rho = 0.39, p = 0.05 for SDANN). CONCLUSION In patients with a systemic right ventricle, HRV is lower compared with controls and (SDANN) is independently associated with supraventricular arrhythmias.
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Affiliation(s)
- Tjitske Zandstra
- Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands.
| | - Philippine Kiès
- Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands.
| | - Arie Maan
- Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands.
| | - Sum-Che Man
- Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands.
| | - Marianne Bootsma
- Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands.
| | - Hubert Vliegen
- Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands.
| | - Anastasia Egorova
- Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands.
| | - Bart Mertens
- Department of Statistics, Leiden University Medical Center, Leiden, the Netherlands.
| | - Eduard Holman
- Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands.
| | - Martin Schalij
- Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands.
| | - Monique Jongbloed
- Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands; Department of Anatomy & Embryology, Leiden University Medical Center, Leiden, the Netherlands.
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Van Hout MJP, Dekkers IA, Westenberg JJ, Schalij M, Scholte A, Lamb H. ASSOCIATIONS OF VASCULAR AND LEFT VENTRICULAR FUNCTION WITH BRAIN VOLUMES AND WHITE MATTER HYPERINTENSITIES: A CROSS-SECTIONAL MAGNETIC RESONANCE IMAGING STUDY OF THE UK BIOBANK. J Am Coll Cardiol 2020. [DOI: 10.1016/s0735-1097(20)32176-8] [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: 10/24/2022]
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Liu J, Tsonaka R, Mei H, Akerboom B, Schalij M, Pijnappels D, De Vries A. P3503Transcriptome changes in atrial myocytes during the transition from a proliferative into a contractile phenotype and vice versa. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
iAM-1 cells are conditionally immortalized neonatal rat atrial myocytes allowing toggling between proliferative and contractile phenotypes by a single-component change in culture medium composition. In the absence of proliferation stimuli, the cells synchronously differentiate into functional cardiomyocytes. Following re-expression of the immortalization factor, the fully differentiated iAM-1 cells dedifferentiate and start to proliferate again.
Purpose
The aim of our study was to investigate the changes in gene expression profile in iAM-1 cells during one round of cardiac differentiation and dedifferentiation in order to identify potential (new) regulators of atrial myocyte differentiation and proliferation.
Methods
RNA sequencing was performed on iAM-1 cells at 9 time points during one cycle of cardiomyogenic differentiation and dedifferentiation (20 million 150-bp paired-end reads per sample, 4 samples per time point). The resulting sequence data were analysed by EdgeR. Hierarchical clustering and principle component analysis were performed in R. GO category enrichment was determined using DAVID.
Results
Approximately 13,000 genes were extracted from the RNA sequencing analysis. In general, dynamic changes in mRNA levels during the transition from a proliferative into a contractile phenotype opposed those that occurred when differentiated iAM-1 were re-exposed to proliferation stimuli. These inverse trends were most evident for genes involved in cell cycle progression, DNA replication, sarcomere formation and cardiac contraction. Moreover, the RNA-SEQ data allowed us to make a distinction between genes contributing to the early and late phases of cardiomyogenic differentiation and dedifferentiation and to identify similarities and differences in the transcriptional programs underlying the cardiomyogenic differentiation of iAM-1 cells versus those of embryonic stem cells and induced pluripotent stem cells. The transcriptome analysis also unveiled several genes with potentially important and previously unrecognized roles in cardiomyocyte differentiation and proliferation.
iAM-1 differentiation and dedifferention
Conclusions
Due to their ability to homogenously and synchronously differentiate and dedifferentiate, iAM-1 cells offer unique new insights into the transcriptional regulation of cardiomyocyte differentiation and proliferation.
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Affiliation(s)
- J Liu
- Leiden University Medical Center, Department of Cardiology, Leiden, Netherlands (The)
| | - R Tsonaka
- Leiden University Medical Center, Department of Biomedical Data Sciences, Medical Statistics Section, Leiden, Netherlands (The)
| | - H Mei
- Leiden University Medical Center, Department of Medical Data Sciences, Sequencing Analysis Support Core, Leiden, Netherlands (The)
| | - B Akerboom
- Leiden University Medical Center, Department of Cardiology, Leiden, Netherlands (The)
| | - M Schalij
- Leiden University Medical Center, Department of Cardiology, Leiden, Netherlands (The)
| | - D Pijnappels
- Leiden University Medical Center, Department of Cardiology, Leiden, Netherlands (The)
| | - A De Vries
- Leiden University Medical Center, Department of Cardiology, Leiden, Netherlands (The)
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Van Hout MJP, Dekkers IA, Westenberg JJ, Schalij M, Scholte A, Lamb H. THE EFFECT OF ABDOMINAL OBESITY ON CARDIOVASCULAR FUNCTION AND DISEASE: A POPULATION BASED MAGNETIC RESONANCE IMAGING STUDY OF THE UK BIOBANK. J Am Coll Cardiol 2019. [DOI: 10.1016/s0735-1097(19)32066-2] [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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van Dongen IM, Yilmaz D, Elias J, Claessen B, Delewi R, Reinoud Knops, Wilde A, van Erven L, Schalij M, Henriques JPS. TCT-529 Evaluation of the impact of a chronic total coronary occlusion on ventricular arrhythmias and long-term mortality in patients with ischemic cardiomyopathy and an implantable cardioverter-device (the eCTOpy-in-ICD study). J Am Coll Cardiol 2018. [DOI: 10.1016/j.jacc.2018.08.1711] [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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13
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Ebert M, Wijnmaalen AP, De Riva M, Van Tintelen JP, Androulakis A, Trines SA, Schalij M, Zeppenfeld K. 521The impact of genetic mutations on ventricular tachycardia substrate types and ablation outcome in patients with non ischemic cardiomyopathy. Europace 2018. [DOI: 10.1093/europace/euy015.288] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- M Ebert
- Leiden University Medical Center, Cardiology, Leiden, Netherlands
| | - A P Wijnmaalen
- Leiden University Medical Center, Cardiology, Leiden, Netherlands
| | - M De Riva
- Leiden University Medical Center, Cardiology, Leiden, Netherlands
| | - J P Van Tintelen
- Academic Medical Center of Amsterdam, Cardiology, Amsterdam, Netherlands
| | - A Androulakis
- Leiden University Medical Center, Cardiology, Leiden, Netherlands
| | - S A Trines
- Leiden University Medical Center, Cardiology, Leiden, Netherlands
| | - M Schalij
- Leiden University Medical Center, Cardiology, Leiden, Netherlands
| | - K Zeppenfeld
- Leiden University Medical Center, Cardiology, Leiden, Netherlands
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Abou R, Goedemans L, Prihadi E, Schalij M, Marsan NA, Bax JJ, Delgado V. MULTILAYER LEFT VENTRICULAR GLOBAL LONGITUDINAL STRAIN AND LEFT VENTRICULAR REMODELLING IN PATIENTS AFTER ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION. J Am Coll Cardiol 2018. [DOI: 10.1016/s0735-1097(18)32245-9] [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: 11/15/2022]
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Abou R, Goedemans L, Prihadi E, Schalij M, Marsan NA, Bax JJ, Delgado V. PROGNOSTIC VALUE OF MULTILAYER LEFT VENTRICULAR GLOBAL LONGITUDINAL STRAIN IN PATIENTS AFTER ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION WITH PRESERVED LEFT VENTRICULAR EJECTION FRACTION. J Am Coll Cardiol 2018. [DOI: 10.1016/s0735-1097(18)32244-7] [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: 10/17/2022]
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16
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Smit J, Hermans M, Dimitriu-Leen AC, van Rosendael A, Dibbets-Schneider P, de Geus-Oei LF, Mertens B, Schalij M, Bax JJ, Scholte A. LONG-TERM PROGNOSTIC VALUE OF SINGLE-PHOTON EMISSION COMPUTED TOMOGRAPHY MYOCARDIAL PERFUSION IMAGING AFTER PRIMARY PCI FOR STEMI. J Am Coll Cardiol 2018. [DOI: 10.1016/s0735-1097(18)32040-0] [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: 10/17/2022]
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17
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Abou R, Prihadi E, Goedemans L, Van Der Geest R, Schalij M, Marsan NA, Bax JJ, Delgado V. LEFT VENTRICULAR MECHANICAL DISPERSION IN ISCHEMIC CARDIOMYOPATHY: ASSOCIATION WITH MYOCARDIAL SCAR BURDEN AND PROGNOSTIC IMPLICATIONS. J Am Coll Cardiol 2018. [DOI: 10.1016/s0735-1097(18)32103-x] [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: 10/17/2022]
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18
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Montero JM, Abou R, Goedemans L, Schalij M, Marsan NA, Bax JJ, Delgado V. CORONARY ATRIAL BRANCH OCCLUSION DURING PRIMARY PERCUTANEOUS CORONARY INTERVENTION IN ST-ELEVATION MYOCARDIAL INFARCTION AND ASSOCIATION WITH ATRIAL ARRHYTHMIAS AT ONE-YEAR FOLLOW-UP. J Am Coll Cardiol 2018. [DOI: 10.1016/s0735-1097(18)31934-x] [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: 10/17/2022]
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Montero JM, Abou R, Goedemans L, Schalij M, Bax JJ, Delgado V. CORONARY FLOW IMPAIRMENT IN DOMINANT CORONARY ATRIAL BRANCHES IN ST-ELEVATION MYOCARDIAL INFARCTION PATIENTS AND ATRIAL ARRHYTHMIAS AT ONE-YEAR FOLLOW-UP. J Am Coll Cardiol 2018. [DOI: 10.1016/s0735-1097(18)31857-6] [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: 11/29/2022]
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Abou R, Goedemans L, Yilmaz D, Prihadi E, van der Bijl P, Schalij M, Marsan NA, Bax JJ, Delgado V. THE INCREMENTAL PROGNOSTIC VALUE OF LEFT VENTRICULAR MECHANICAL DISPERSION IN PATIENTS AFTER ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION. J Am Coll Cardiol 2018. [DOI: 10.1016/s0735-1097(18)32243-5] [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: 11/29/2022]
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Dirksen MT, Spaulding C, Kelbæk H, Schalij M, Thuesen L, van der Hoeven B, Vink MA, Kaiser C, Musto C, Chechi T, Spaziani G, de la Llera LSD, Pasceri V, Di Lorenzo E, Violini R, Suryapranata H, Stone GW, De Luca G. Time course, predictors and clinical implications of stent thrombosis following primary angioplasty. Thromb Haemost 2017; 110:826-33. [DOI: 10.1160/th13-02-0092] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2013] [Accepted: 05/17/2013] [Indexed: 01/22/2023]
Abstract
summaryPrimary percutaneous coronary intervention (pPCI) has improved survival as compared to thrombolysis. Concerns still remain regarding the risk of stent thrombosis in the setting of STEMI, especially after drugeluting stent (DES) implantation. Therefore, the aim of this study was to report on the timing of stent thrombosis (ST) with both DES and bare metal stents (BMS) and its prognostic significance in patients undergoing pPCI. The Drug-Eluting Stent in Primary Angioplasty (DESERT) cooperation is based on a pooled database including individual data of randomised trials that evaluate the long-term safety and effectiveness of DES as compared to BMS in patients undergoing pPCI for STEMI. Follow-up data were collected for 3–6 years after the procedure. ST was defined as definite or probable, based on the ARC definition. The study population consists of 6,274 STEMI patients undergoing primary angioplasty with BMS or DES. At 1201±440 days, ST occurred in 267 patients (4.25%). Most of the events were acute or subacute (within 30 days) and very late (> 1 years), with different distribution between DES vs BMS. Patients with ST were more often diabetic (21.7% vs 15.1%, p=0.005), more frequently had post-procedural TIMI 0–2 flow (14.0% vs 9.3%, p = 0.01), and were less often treated with dual antiplatelet therapy at one year follow-up. Diabetes (p = 0.036), post-procedural TIMI 0–2 Flow (p = 0.013) and ischaemia time > 6 hours (p = 0.03) were independent predictors of ST. Post-procedural TIMI 0–2 flow (p = 0.001) and ischaemia time > 6 hours (p < 0.001) were independent predictors of early ST, ischaemia time > 6 hours (p=0.05) was independent predictor of late ST, whereas diabetes (p = 0.022) and use of DES (p=0.002) were independent predictors of very late ST. ST was associated with a significantly higher mortality (23.6% vs 6%, p < 0.001). The greatest impact on mortality was observed with subacute (40.4%) and late (20.9%) ST, as compared to acute (12.5%) and very late (9.1%) ST. ST was an independent predictor of mortality (HR [95%CI]=3.73 [2.75–5.07], p < 0.001). In conclusion, ST occurs relatively frequently also beyond the first year for up to six years after pPCI in STEMI, with higher late occurrence rates among patients treated with first generation DES. ST after pPCI is a powerful predictor of mortality, especially subacute ST.
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Naruse Y, De Riva M, Watanabe M, Wijnmaalen A, Venlet J, Schalij M, Zeppenfeld K. P1807The clinical impact of J waves on recurrence of ventricular tachycardia after radiofrequency catheter ablation in patients with myocardial infarction. Europace 2017. [DOI: 10.1093/ehjci/eux161.116] [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: 11/14/2022] Open
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Naruse Y, De Riva M, Wijnmaalen A, Ebert M, Watanabe M, Schalij M, Zeppenfeld K. P1808Myocardial calcification detected by cineangiography is a useful tool to identify patients who may benefit from an epicardial approach in post-infarct ventricular tachycardia ablation. Europace 2017. [DOI: 10.1093/ehjci/eux161.117] [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: 11/13/2022] Open
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Naruse Y, Kece F, De Riva M, Watanabe M, Wijnmaalen A, Alizadeh R, Schalij M, Zeppenfeld K, Trines S. P1715Clinical impact of non-fluoroscopic catheter tracking system on radiation exposure during pulmonary vein isolation. Europace 2017. [DOI: 10.1093/ehjci/eux161.025] [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: 11/14/2022] Open
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Bodde M, Hermans M, Wolterbeek R, van der Laarse A, Schalij M, Jukema J. PLASMA LDL-CHOLESTEROL LEVEL IS INDEPENDENTLY ASSOCIATED WITH INFARCT SIZE IN PATIENTS WITH ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION TREATED WITH PRIMARY PERCUTANEOUS CORONARY INTERVENTION. J Am Coll Cardiol 2017. [DOI: 10.1016/s0735-1097(17)33521-0] [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: 10/20/2022]
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Regeer M, Merkestein L, de Weger A, Kamperidis V, van der Kley F, van Rosendael P, Marsan N, Klautz R, Schalij M, Bax J, Delgado V. Left bundle branch block after sutureless, transcatheter, and stented biological aortic valve replacement for aortic stenosis. EUROINTERVENTION 2017; 12:1660-1666. [DOI: 10.4244/eij-d-15-00256] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [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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Neuzil P, Reddy VY, Sogaard P, Riahi S, Delnoy PP, van Erven L, Schalij M, Butter C, Seifert M, Boersma L. 169-02: Wireless LV endocardial stimulation for CRT: 12m experience from SELECT-LV study. Europace 2016. [DOI: 10.1093/europace/18.suppl_1.i115a] [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: 11/12/2022] Open
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Reddy VY, Neuzil P, Riahi S, Sogaard P, Butter C, Seifert M, Delnoy PP, van Erven L, Schalij M, Boersma L. 109-03: Leadless LV endocardial stimulation for CRT: Final Outcomes of SELECT-LV Study. Europace 2016. [DOI: 10.1093/europace/18.suppl_1.i85c] [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: 11/13/2022] Open
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Yilmaz D, Van Der Heijden A, Thijssen J, Schalij M, van Erven L. 176-55: Implantable Cardioverter Defibrillator Patients Remain at Risk of Painful Shocks at the End of Life. Europace 2016. [DOI: 10.1093/europace/18.suppl_1.i131a] [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: 11/12/2022] Open
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Keçe F, Silva MDR, Naruse Y, Dehnavi RA, Masaya W, Schalij M, Zeppenfeld K, Trines S. 58-03: Posterior Box Lesion Surface Area and Ablation Success in Patients with Atrial Fibrillation. Europace 2016. [DOI: 10.1093/europace/18.suppl_1.i169a] [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: 11/12/2022] Open
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Venlet J, Piers S, Silva MDR, Naruse Y, Barge-Schaapveld D, Schalij M, Zeppenfeld K. 16-80: Non-invasive testing cannot identify a typical substrate for life-threatening re-entry VTs in athletes. Europace 2016. [DOI: 10.1093/europace/18.suppl_1.i21a] [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: 11/13/2022] Open
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Brouwer TF, Yilmaz D, Buiten M, Olde Nordkamp L, Schalij M, van Erven L, Knops R, Wilde AA. 99-02: A Comparison of Clinical Outcomes of Subcutaneous and Transvenous Implantable Defibrillator Therapy. Europace 2016. [DOI: 10.1093/europace/18.suppl_1.i175a] [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: 11/14/2022] Open
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Jangsangthong W, Feola I, Teplenin A, Schalij M, Ypey D, De Vries A, Pijnappels D. 29-03: Optogenetically-induced microfoci of oxidative stress increase pro-arrhythmic risk. Europace 2016. [DOI: 10.1093/europace/18.suppl_1.i27b] [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: 11/12/2022] Open
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Brouwer C, Kapel GF, Silva MDR, Schalij M, Zeppenfeld K. 218-05: The Remaining Substrate for Ventricular Tachycardia in Repaired Tetralogy of Fallot in the Modern Surgical Era. Europace 2016. [DOI: 10.1093/europace/18.suppl_1.i186c] [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: 11/13/2022] Open
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Yilmaz D, Brouwer TF, Knops R, van Erven L, Schalij M. 96-40: The Endocardiac Position of Implantable Cardioverter-Defibrillator Leads Does Not Result in More Appropriate Shocks. Europace 2016. [DOI: 10.1093/europace/18.suppl_1.i71a] [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: 11/12/2022] Open
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Riahi S, Søgaard P, Reddy VY, Neuzil P, Butter C, Seifert M, Delnoy PP, van Erven L, Schalij M, Boersma L. 139-01: Wireless LV endocardial pacing for CRT, SELECT-LV Study: Ischaemic patients. Europace 2016. [DOI: 10.1093/europace/18.suppl_1.i179c] [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: 11/14/2022] Open
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Yilmaz D, Schalij M, van Erven L. 176-53: Patient awareness of Implantable Cardioverter Defibrillator-therapy when the end is near. Europace 2016. [DOI: 10.1093/europace/18.suppl_1.i130c] [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: 11/13/2022] Open
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Brouwer C, Kapel GF, Naruse Y, Silva MDR, Schalij M, Zeppenfeld K. 97-06: Fragmented QRS is Not Associated with Conduction Delay and Ventricular Arrhythmias in Patients with Repaired Tetralogy of Fallot. Europace 2016. [DOI: 10.1093/europace/18.suppl_1.i173] [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: 11/13/2022] Open
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Androulakis A, Vester M, Venlet J, Silva MDR, Schalij M, Khidir M, Verwey H, Tops L, Beeres S, Zeppenfeld K. 177-04: The potential impact of LVADs on the substrate and characteristics of ventricular tachycardia. Europace 2016. [DOI: 10.1093/europace/18.suppl_1.i182] [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: 11/14/2022] Open
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Hermans M, van der Velden D, Huizinga T, Kuiper J, Toes R, Schalij M, Jukema J, van der Woude D. ASSOCIATION BETWEEN ANTI-CITRULLINATED PROTEIN ANTIBODIES AND LONG-TERM MORTALITY IN PATIENTS WITH ST-SEGMENT ELEVATED MYOCARDIAL INFARCTION. J Am Coll Cardiol 2016. [DOI: 10.1016/s0735-1097(16)32323-3] [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: 11/27/2022]
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Yilmaz D, Schalij M, van Erven L. PATIENT AWARENESS OF IMPLANTABLE CARDIOVERTER DEFIBRILLATOR-THERAPY DEACTIVATION WHEN THE END IS NEAR. J Am Coll Cardiol 2016. [DOI: 10.1016/s0735-1097(16)30702-1] [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: 11/27/2022]
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van Vessem M, Palmen M, Couperus L, Mertens B, Tops L, Verwey H, Klautz R, Schalij M, Beeres S. PREOPERATIVE ANEMIA, THYROXINE LEVELS, CREATININE CLEARANCE AND BETA-BLOCKER USE ARE ASSOCIATED WITH THE DEVELOPMENT OF VASOPLEGIA AFTER HEART FAILURE SURGERY. J Am Coll Cardiol 2016. [DOI: 10.1016/s0735-1097(16)31386-9] [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: 10/22/2022]
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Abou R, Leung M, Schalij M, Marsan NA, Bax J, Delgado V. LAYER SPECIFIC LEFT VENTRICULAR STRAIN MECHANICS WITH 2-DIMENSIONAL SPECKLE TRACKING ECHOCARDIOGRAPHY: A REFERENCE IN PATIENTS WITH NO STRUCTURAL HEART DISEASE. J Am Coll Cardiol 2016. [DOI: 10.1016/s0735-1097(16)31642-4] [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: 11/29/2022]
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Gobardhan SN, Dimitriu-Leen AC, van Rosendael AR, van Zwet EW, Schalij M, Scholte A. DIFFERENCES IN ATHEROSCLEROTIC BURDEN BETWEEN SOUTH ASIANS AND CAUCASIANS WITH TYPE 2 DIABETES MELLITUS AND COMPARABLE 10 YEAR PREDICTED CARDIOVASCULAR RISK. J Am Coll Cardiol 2016. [DOI: 10.1016/s0735-1097(16)31766-1] [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: 10/22/2022]
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Yilmaz D, Van Der Heijden A, Thijssen J, Schalij M, van Erven L. TIMELY DEACTIVATION OF IMPLANTABLE CARDIOVERTER DEFIBRILLATOR-THERAPY: WORK IN PROGRESS. J Am Coll Cardiol 2016. [DOI: 10.1016/s0735-1097(16)30864-6] [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: 11/28/2022]
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Couperus L, Henkens I, Vliegen H, Hazekamp M, Schalij M. TAILORED CIRCULATORY INTERVENTION IN ADULTS WITH PULMONARY HYPERTENSION DUE TO CONGENITAL HEART DISEASE. J Am Coll Cardiol 2015. [DOI: 10.1016/s0735-1097(15)60529-0] [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: 11/16/2022]
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Regeer MV, Kamperidis V, Versteegh M, Klautz R, Schalij M, Bax J, Marsan NA, Delgado V. EFFECT OF NATIVE DESCENDING THORACIC AORTA GROWTH AFTER ACUTE AORTIC DISSECTION TYPE A ON EVENT FREE SURVIVAL. J Am Coll Cardiol 2015. [DOI: 10.1016/s0735-1097(15)62099-x] [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: 10/23/2022]
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Van Der Kley F, Katsanos S, Van Rosendael P, Kamperidis V, Bax J, Schalij M, Marsan NA, Delgado V. DURABILITY OF TRANSCATHETER BALLOON-EXPANDABLE AORTIC VALVE: RELATION WITH FRAME DEPLOYMENT ASSESSED WITH MULTIDETECTOR COMPUTED TOMOGRAPHY STUDY. J Am Coll Cardiol 2015. [DOI: 10.1016/s0735-1097(15)61120-2] [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: 10/23/2022]
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De Luca G, Dirksen MT, Spaulding C, Kelbæk H, Schalij M, Thuesen L, van der Hoeven B, Vink MA, Kaiser C, Musto C, Chechi T, Spaziani G, Diaz de la Llera LS, Pasceri V, Di Lorenzo E, Violini R, Suryapranata H, Stone GW. Impact of hypertension on clinical outcome in STEMI patients undergoing primary angioplasty with BMS or DES: insights from the DESERT cooperation. Int J Cardiol 2014; 175:50-4. [PMID: 24852835 DOI: 10.1016/j.ijcard.2014.04.180] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2013] [Revised: 03/30/2014] [Accepted: 04/17/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Hypertension is a well known risk factor for atherosclerosis. However, data on the prognostic impact of hypertension in patients with ST elevation myocardial infarction (STEMI) are inconsistent and mainly related to studies performed in the thrombolytic era, with very few data in patients undergoing primary angioplasty. Therefore, the aim of the current study was to evaluate the impact hypertension on clinical outcome in STEMI patients undergoing primary PCI with BMS or DES. METHODS Our population is represented by 6298 STEMI patients undergoing primary angioplasty included in the DESERT database from 11 randomized trials comparing DES vs BMS for STEMI. RESULTS Hypertension was observed in 2764 patients (43.9%), and associated with ageing (p<0.0001), female gender (p<0.001), diabetes (p<0.0001), hypercholesterolemia (p<0.0001), previous MI (p=0.002), previous revascularization (p=0.002), longer time-to-treatment (p<0.001), preprocedural TIMI 3 flow, and with a lower prevalence of smoking (41% vs 53.9%, p<0.001) and anterior MI (42% vs 45.9%, p=0.002). Hypertension was associated with impaired postprocedural TIMI 0-2 flow (Adjusted OR [95% CI]=1.22 [1.01-1.47], p=0.034). At a follow-up of 1,201 ± 440 days, hypertension was associated with higher mortality (adjusted HR [95% CI]=1.24 [1.01-1.54], p=0.048), reinfarction (adjusted HR [95% CI]=1.31 [1.03-1.66], p=0.027), stent thrombosis (adjusted HR [95% CI]=1.29 [0.98-1.71], p=0.068) and TVR (adjusted HR [95% CI]=1.22 [1.04-1.44], p=0.013). CONCLUSIONS This study showed that among STEMI patients undergoing primary angioplasty with DES or BMS, hypertension is independently associated with impaired epicardial reperfusion, mortality, reinfarction and TVR, and a trend in higher ST.
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Affiliation(s)
- Giuseppe De Luca
- Division of Cardiology, Ospedale "Maggiore della Carità", Eastern Piedmont University, Novara, Italy; Centro di Biotecnologie per la Ricerca Medica Applicata (BRMA), Eastern Piedmont University, Novara, Italy.
| | - Maurits T Dirksen
- Department of Interventional Cardiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
| | - Christian Spaulding
- Assistance Publique-Hopitaux de Paris Cochin Hospital, Paris 5 Medical School Rene Descartes University and INSERM Unite 780 Avenir, Paris, France
| | | | - Martin Schalij
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Leif Thuesen
- Cardiac Department, Skejby Hospital, Skejby, Denmark
| | - Bas van der Hoeven
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Marteen A Vink
- Department of Interventional Cardiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
| | - Christoph Kaiser
- Department of Cardiology, University Hospital Basel, Switzerland
| | - Carmine Musto
- Division of Cardiology, San Camillo Hospital, Rome, Italy
| | - Tania Chechi
- Ospedale Santa Maria Annunziata, Bagno a Ripoli, Florence, Italy
| | - Gaia Spaziani
- Ospedale Santa Maria Annunziata, Bagno a Ripoli, Florence, Italy
| | | | - Vincenzo Pasceri
- Interventional Cardiology Unit, San Filippo Neri Hospital, Rome, Italy
| | | | | | | | - Gregg W Stone
- Columbia University Medical Center, New York City, NY, USA; Cardiovascular Research Foundation, New York City, NY, USA
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De Luca G, Dirksen MT, Spaulding C, Kelbæk H, Schalij M, Thuesen L, van der Hoeven B, Vink MA, Kaiser C, Musto C, Chechi T, Spaziani G, de la Llera LSD, Pasceri V, Di Lorenzo E, Violini R, Suryapranata H, Stone GW. Drug-eluting stents in patients with anterior STEMI undergoing primary angioplasty: a substudy of the DESERT cooperation. Clin Res Cardiol 2014; 103:685-99. [PMID: 24687617 DOI: 10.1007/s00392-014-0702-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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: 02/02/2014] [Accepted: 03/11/2014] [Indexed: 01/28/2023]
Abstract
BACKGROUND Several concerns have emerged on the higher risk of in-stent thrombosis after drug-eluting stent (DES) implantation, especially in the setting of STEMI patients. Few data have even been reported in high-risk patients, such as those with anterior MI. Therefore this represents the aim of the current study. METHODS The literature was scanned by formal searches of electronic databases (MEDLINE and CENTRAL). We examined all completed randomized trials of DES for STEMI. The following key words were used for study selection: randomized trial, myocardial infarction, reperfusion, primary angioplasty, stenting, DES, sirolimus-eluting stent (SES), Cypher, paclitaxel-eluting stent (PES), Taxus. No language restrictions were enforced. RESULTS Individual patient's data were obtained from 11 out of 13 trials, including a total of 2,782 patients with anterior MI [1,739 or 62.5% randomized to DES and 1,043 or 37.5% randomized to bare-metal stent (BMS)]. At long-term follow-up, no significant benefit was observed with DES as compared to BMS in terms of mortality [9.8 vs 10.9%, HR (95% CI) = 0.81 (0.61, 1.07), p = 0.13, p heterogeneity = 0.18], reinfarction [8.8 vs 6.4%, respectively; HR (95% CI) = 1.14 (0.80, 1.61), p = 0.47, p heterogeneity = 0.82], and stent thrombosis [5.6 vs 5%, OR (95% CI) = 0.88 (0.59, 1.30), p = 0.51, p heterogeneity = 0.65], whereas DES was associated with a significant reduction in terms of target-vessel revascularization (TVR) [13.7 vs 23.4%; OR (95% CI) = 0.56 (0.46, 0.69), p < 0.0001, p het = 0.81] that was observed at both early (within 1 year) [7 vs 14.7%, HR (95% CI) = 0.56 (0.46, 0.69), p < 0.0001, p het = 0.81] and late (>1 year) follow-up [7.2 vs 9%, HR (95% CI) = 0.67 (0.47, 0.96), p = 0.03, p het = 0.96]. CONCLUSIONS This study showed that among patients with anterior STEMI undergoing primary angioplasty, SES and PES, as compared to BMS, are associated with a significant reduction in TVR at long-term follow-up. No concerns were found with the use of first-generation DES in terms of mortality.
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Affiliation(s)
- Giuseppe De Luca
- Division of Cardiology, Ospedale "Maggiore della Carità", Eastern Piedmont University, C.so Mazzini, 18, 24100, Novara, Italy,
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