PMID- 42861503 OWN - NLM STAT- Publisher LR - 20261012 IS - 1941-7632 (Electronic) IS - 1941-7640 (Linking) DP - 2026 Oct 12 TI - High-Potency P2Y12 Inhibitors Among Patients With Chronic Coronary Syndrome Undergoing PCI: An Analysis From the NCDR CathPCI Registry. PG - e016658 LID - 10.1161/CIRCINTERVENTIONS.126.016658 [doi] AB - BACKGROUND: Clinical practice guidelines recommend the use of clopidogrel among patients with chronic coronary syndrome undergoing percutaneous coronary intervention. The frequency of high-potency P2Y12 inhibitors, such as ticagrelor or prasugrel, in this setting is not well known. METHODS: Using the National Cardiovascular Data Registry CathPCI registry, we analyzed patients with chronic coronary syndrome undergoing percutaneous coronary intervention from April 2018 to June 2024, excluding those discharged on oral anticoagulants. Temporal trends in high-potency P2Y12 inhibitor prescription were examined. A mixed-effects multivariable logistic regression model with a random intercept for hospital was used to identify patient-, procedural-, and institutional-level factors associated with high-potency P2Y12 inhibitor prescription while accounting for within-hospital clustering. Between-hospital variation was quantified using the median odds ratio. RESULTS: Among 783 977 patients across 1815 hospitals, 35% were prescribed a high-potency P2Y12 inhibitor at discharge. The use of high-potency P2Y12 inhibitors declined from 35% in 2018 to 31% in 2024 (P-trend=0.019), driven by a reduction in ticagrelor (from 29% to 23%, P-trend <0.001) despite a modest increase in prasugrel use (from 6.2% to 8%, P-trend=0.10). Male sex, prior myocardial infarction, and markers of procedural complexity (high-complexity/type C lesions, left main coronary artery, proximal left anterior descending artery, or use of mechanical circulatory support) were associated with higher odds of high-potency P2Y12 inhibitor prescription. In contrast, older age (>/=75 years), prior stroke/transient ischemic attack, prior coronary artery bypass graft, severe renal dysfunction, and chronic total occlusion were associated with lower odds. University hospitals had lower odds of prescribing high-potency P2Y12 inhibitors, with considerable variability in prescription patterns among institutions (median odds ratio, 2.59). CONCLUSIONS: Nearly one-third of chronic coronary syndrome patients undergoing percutaneous coronary intervention were discharged on high-potency P2Y12 inhibitors, with decreasing trends over time. Practice patterns reflected perceived ischemic versus bleeding risk and significant institutional variation, underscoring opportunities for quality improvement and guideline alignment. FAU - Fath, Ayman R AU - Fath AR AUID- ORCID: 0000-0002-0063-1692 AD - Allina Health Minneapolis Heart Institute, Abbott Northwestern Hospital, and Center for Coronary Artery Disease, Minneapolis Heart Institute Foundation (A.R.F., Y.S., E.B.). FAU - Rymer, Jennifer AU - Rymer J AUID- ORCID: 0000-0001-9841-2393 AD - Division of Cardiology, Department of Medicine, Duke University School of Medicine, Durham, NC (J.R.). AD - Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (J.R., A.M., D.W.). FAU - Marks, Angel AU - Marks A AUID- ORCID: 0009-0003-6133-0820 AD - Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (J.R., A.M., D.W.). FAU - Wojdyla, Daniel AU - Wojdyla D AUID- ORCID: 0009-0009-3431-2014 AD - Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (J.R., A.M., D.W.). FAU - Gilchrist, Ian C AU - Gilchrist IC AUID- ORCID: 0000-0001-8525-8454 AD - Geisel School of Medicine at Dartmouth, Section of Cardiovascular Medicine, Heart and Vascular Center, Dartmouth Hitchcock Medical Center, Hanover, NH (I.C.G.). FAU - Sandoval, Yader AU - Sandoval Y AUID- ORCID: 0000-0003-4800-2972 AD - Allina Health Minneapolis Heart Institute, Abbott Northwestern Hospital, and Center for Coronary Artery Disease, Minneapolis Heart Institute Foundation (A.R.F., Y.S., E.B.). FAU - Shah, Binita AU - Shah B AUID- ORCID: 0000-0001-8872-8001 AD - Division of Cardiology, Department of Medicine, NYU Grossman School of Medicine (B.S., S.V.R.). FAU - Brilakis, Emmanouil AU - Brilakis E AUID- ORCID: 0000-0001-9416-9701 AD - Allina Health Minneapolis Heart Institute, Abbott Northwestern Hospital, and Center for Coronary Artery Disease, Minneapolis Heart Institute Foundation (A.R.F., Y.S., E.B.). FAU - Rao, Sunil V AU - Rao SV AUID- ORCID: 0000-0003-2914-0894 AD - Division of Cardiology, Department of Medicine, NYU Grossman School of Medicine (B.S., S.V.R.). FAU - Elgendy, Islam Y AU - Elgendy IY AUID- ORCID: 0000-0001-9853-7591 AD - Division of Cardiovascular Medicine, Gill Heart and Vascular Institute, University of Kentucky, Lexington (I.Y.E.). LA - eng PT - Journal Article DEP - 20261012 PL - United States TA - Circ Cardiovasc Interv JT - Circulation. Cardiovascular interventions JID - 101499602 SB - IM OTO - NOTNLM OT - clopidogrel OT - coronary artery bypass OT - myocardial infarction OT - percutaneous coronary intervention OT - ticagrelor EDAT- 2026/10/12 11:41 MHDA- 2026/10/12 11:41 CRDT- 2026/10/12 05:03 PHST- 2026/10/12 11:41 [medline] PHST- 2026/10/12 11:41 [pubmed] PHST- 2026/10/12 05:03 [entrez] AID - 10.1161/CIRCINTERVENTIONS.126.016658 [doi] PST - aheadofprint SO - Circ Cardiovasc Interv. 2026 Oct 12:e016658. doi: 10.1161/CIRCINTERVENTIONS.126.016658. PMID- 42858262 OWN - NLM STAT- Publisher LR - 20261010 IS - 1784-973X (Electronic) IS - 0001-5385 (Linking) DP - 2026 Oct 10 TI - Effect of a single high-concentration sodium bicarbonate bolus on contrast-induced nephropathy in STEMI patients undergoing Primary PCI: a prospective randomized study. PG - 1-8 LID - 10.1080/00015385.2026.2747423 [doi] AB - BACKGROUND: Contrast-induced nephropathy (CIN) remains an important complication following primary percutaneous coronary intervention (PPCI) in patients with ST-segment elevation myocardial infarction (STEMI). In emergency settings, preventive strategies must be rapid and compatible with timely reperfusion. This study evaluated whether a single preprocedural bolus of high-concentration sodium bicarbonate was associated with a lower incidence of CIN. METHODS: In this prospective randomised study, 110 STEMI patients undergoing PPCI at two tertiary centres were enrolled. All patients received standard care, including isotonic saline hydration. Participants were assigned to saline hydration alone or saline plus a single intravenous bolus of 20 mEq of 8.4% sodium bicarbonate administered 5-10 min before contrast exposure. The primary endpoint was CIN within 48 +/- 12 h, defined as an increase in serum creatinine >/=0.5 mg/dL or >/=25% from baseline. RESULTS: Baseline characteristics were generally comparable, although baseline blood urea nitrogen was higher and estimated glomerular filtration rate lower in the control group. CIN occurred more frequently in controls than in the sodium bicarbonate group (16.4% vs. 1.8%; p = 0.008). Renal function trajectories also favoured sodium bicarbonate. However, sodium bicarbonate did not remain an independent predictor of CIN after multivariable adjustment (OR 0.061, 95% CI 0.003-1.205; p = 0.066). CONCLUSIONS: Sodium bicarbonate administration was associated with a lower unadjusted incidence of CIN. These findings should be considered hypothesis-generating and require confirmation in larger multicentre studies. FAU - Zahid, Basant AU - Zahid B AUID- ORCID: 0000-0002-2773-4659 AD - Department of Cardiology, Faculty of Medicine, Benha University, Benha, Egypt. FAU - Bendary, Ahmed AU - Bendary A AUID- ORCID: 0000-0002-0161-3779 AD - Department of Cardiology, Faculty of Medicine, Benha University, Benha, Egypt. FAU - AbdelHay, Mahmoud AU - AbdelHay M AUID- ORCID: 0009-0007-6434-9307 AD - Department of Cardiology, Faculty of medicine, Mansoura university, Egypt. FAU - Hamadto, Mona AU - Hamadto M AUID- ORCID: 0000-0002-2316-0109 AD - Department of Cardiology, Faculty of Medicine, Benha University, Benha, Egypt. LA - eng PT - Journal Article DEP - 20261010 PL - England TA - Acta Cardiol JT - Acta cardiologica JID - 0370570 SB - IM OTO - NOTNLM OT - Contrast-induced nephropathy OT - ST-segment elevation myocardial infarction OT - primary percutaneous coronary intervention OT - renal function OT - sodium bicarbonate EDAT- 2026/10/11 04:08 MHDA- 2026/10/11 04:08 CRDT- 2026/10/10 19:01 PHST- 2026/10/11 04:08 [medline] PHST- 2026/10/11 04:08 [pubmed] PHST- 2026/10/10 19:01 [entrez] AID - 10.1080/00015385.2026.2747423 [doi] PST - aheadofprint SO - Acta Cardiol. 2026 Oct 10:1-8. doi: 10.1080/00015385.2026.2747423. PMID- 42828419 OWN - NLM STAT- Publisher LR - 20261003 IS - 2048-8734 (Electronic) IS - 2048-8726 (Linking) DP - 2026 Oct 3 TI - Inflammation, Infarct Size and 10-Year Mortality in STEMI Patients Stratified by the ORBI Risk Score: A DANAMI-3 Sub-study. LID - zuag126 [pii] LID - 10.1093/ehjacc/zuag126 [doi] AB - BACKGROUND: The ORBI Risk Score predicts in-hospital cardiogenic shock after primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI). Whether high-risk patients also have more systemic inflammation, larger infarcts and higher long-term mortality is not known. METHODS: In a DANAMI-3 sub-study, 1,574 STEMI patients without cardiogenic shock were classified as high (ORBI >/=8, n = 273) or low risk (n = 1,301). Inflammation was assessed by routine C-reactive protein (CRP), leukocyte count and neutrophil-to-lymphocyte ratio (NLR) within 72 hours of PCI, and admission mid-regional pro-adrenomedullin (MR-proADM). Infarct size was measured by cardiac magnetic resonance. Ten-year all-cause mortality was obtained from the Danish Civil Registration System. Cox models were adjusted for age, sex, comorbidity, kidney function and randomised allocation. RESULTS: High-risk patients had higher peak CRP (72 vs. 11 mg/L), leukocyte count (12.8 vs. 10.4 x 109/L), NLR (6.2 vs. 3.5) and MR-proADM (0.73 vs. 0.62 nmol/L; all p < 0.001), and larger infarcts (final infarct size 15.7% vs. 10.1% of left ventricular mass). Ten-year mortality was 41% vs. 20% (hazard ratio 2.56, 95% CI 2.05-3.20; adjusted 1.47, 1.16-1.85). The adjusted hazard ratio was 4.79 within 30 days and 1.27 after the first year. The score discriminated 10-year mortality less well than age alone (area under the curve 0.67 vs. 0.79). CONCLUSIONS: The ORBI Risk Score identifies STEMI patients with more inflammation, larger infarcts and higher mortality, especially in the first year. Beyond the first year the association was largely explained by age. Whether anti-inflammatory treatment benefits these patients is a question for randomised trials. CI - (c) The Author(s) 2026. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site-for further information please contact journals.permissions@oup.com. FAU - Kunkel, Joakim Bo AU - Kunkel JB AUID- ORCID: 0000-0002-0793-4557 AD - Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark. FAU - Lonborg, Jacob AU - Lonborg J AUID- ORCID: 0000-0002-4693-8980 AD - Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark. FAU - Frydland, Martin AU - Frydland M AUID- ORCID: 0000-0003-1543-8948 AD - Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark. AD - Zealand University Hospital, Department of Cardiology, Roskilde, Denmark. FAU - Ozbek, Burcu Tas AU - Ozbek BT AUID- ORCID: 0000-0002-7279-970X AD - Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark. FAU - Nepper-Christensen, Lars AU - Nepper-Christensen L AD - Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark. FAU - Vejlstrup, Niels AU - Vejlstrup N AUID- ORCID: 0000-0002-5362-8593 AD - Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark. FAU - Ahtarovski, Kiril AU - Ahtarovski K AD - Zealand University Hospital, Department of Cardiology, Roskilde, Denmark. FAU - Kober, Lars AU - Kober L AUID- ORCID: 0000-0002-6635-1466 AD - Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark. FAU - Hofsten, Dan Eik AU - Hofsten DE AD - Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark. FAU - Marquard, Jasmine Melissa AU - Marquard JM AUID- ORCID: 0000-0003-2299-7377 AD - Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark. FAU - Islam, Utsho AU - Islam U AUID- ORCID: 0009-0003-3692-4491 AD - Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark. FAU - Duus Holle, Sarah Louise AU - Duus Holle SL AUID- ORCID: 0000-0001-8426-617X AD - Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark. FAU - Zhou, Yan AU - Zhou Y AUID- ORCID: 0000-0001-5094-4809 AD - Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark. FAU - Holmvang, Lene AU - Holmvang L AUID- ORCID: 0000-0002-0941-378X AD - Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark. FAU - Hassager, Christian AU - Hassager C AUID- ORCID: 0000-0002-1199-0981 AD - Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark. AD - University of Copenhagen, Department of Clinical Medicine, Copenhagen, Denmark. FAU - Engstrom, Thomas AU - Engstrom T AUID- ORCID: 0000-0001-5436-9194 AD - Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark. AD - University of Copenhagen, Department of Clinical Medicine, Copenhagen, Denmark. FAU - Soholm, Helle AU - Soholm H AUID- ORCID: 0000-0002-0662-0898 AD - Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark. AD - Skanes University Hospital, Department of Cardiology, Lund, Sweden. LA - eng PT - Journal Article DEP - 20261003 PL - England TA - Eur Heart J Acute Cardiovasc Care JT - European heart journal. Acute cardiovascular care JID - 101591369 SB - IM OTO - NOTNLM OT - ORBI Risk Score OT - ST-segment elevation myocardial infarction OT - long-term mortality OT - myocardial infarct size OT - risk stratification OT - systemic inflammation EDAT- 2026/10/04 00:33 MHDA- 2026/10/04 00:33 CRDT- 2026/10/03 06:56 PHST- 2026/07/17 00:00 [received] PHST- 2026/09/24 00:00 [revised] PHST- 2026/10/04 00:33 [medline] PHST- 2026/10/04 00:33 [pubmed] PHST- 2026/10/03 06:56 [entrez] AID - 8860181 [pii] AID - 10.1093/ehjacc/zuag126 [doi] PST - aheadofprint SO - Eur Heart J Acute Cardiovasc Care. 2026 Oct 3:zuag126. doi: 10.1093/ehjacc/zuag126. PMID- 42783015 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260924 LR - 20260928 IS - 2308-3425 (Electronic) IS - 2308-3425 (Linking) VI - 13 IP - 9 DP - 2026 Aug 24 TI - Liver Disease, Liver Fibrosis, and the Invasive-Management Gap in Acute Myocardial Infarction: A Single-Center Cohort with Dual ICD and FIB-4 Stratification. LID - 10.3390/jcdd13090408 [doi] LID - 408 AB - Patients with chronic liver disease are systematically excluded from acute myocardial infarction (AMI) trials, and prior real-world data rely on administrative coding alone. Whether ICD-coded liver disease and laboratory-defined liver fibrosis identify the same patients, and whether they predict the same outcomes, is unknown. We conducted a single-center retrospective cohort study of 1037 consecutive adults admitted with AMI (ICD-10 I21.x) to a tertiary New York center between November 2022 and December 2024. The primary exposure was ICD-defined advanced liver disease (cirrhosis, hepatic failure, or portal hypertension/decompensation; n = 102). The secondary, lab-based exposure was the Fibrosis-4 (FIB-4) index calculated from earliest admission AST, ALT, and platelet count (computable in 1031 patients, 99.4%), stratified as low (<1.45), indeterminate (1.45-3.25), or advanced (>3.25). Co-primary outcomes were invasive management (diagnostic angiography, percutaneous coronary intervention, or coronary artery bypass grafting) and in-hospital mortality. Multivariable logistic regression adjusted for age, sex, diabetes, chronic kidney disease, heart failure, and ST-elevation; the trend across FIB-4 tiers was assessed with the Cochran-Armitage test. Denominators throughout (including the 168/909 occult-fibrosis estimate) use the full exposure group as denominator under a missing-as-not-exposed convention; the four no-LD and two advanced-LD patients with missing FIB-4 are counted as non-advanced fibrosis for this calculation. Patients with ICD-defined advanced liver disease received invasive management less often (12.7% vs. 50.4%; adjusted odds ratio [aOR] 0.17, 95% CI 0.09-0.32) and died in hospital more often (43.1% vs. 7.9%; aOR 8.22, 95% CI 5.02-13.46) than patients without coded liver disease. Outcomes worsened monotonically across FIB-4 tiers (mortality 4.4% --> 9.2% --> 27.5%; invasive management 55.2% --> 45.6% --> 33.5%; both p < 0.001 by Cochran-Armitage trend test). Critically, 168 of 909 patients with no coded liver disease (18.5%) had FIB-4 > 3.25, representing a substantial population of unrecognized advanced fibrosis missed by clinical coding. Coded liver disease identifies a small, severely affected subgroup with markedly lower rates of invasive management and 6- to 8-fold higher mortality after AMI. Routine FIB-4 calculation, a free, three-variable lab score, identifies a much larger population with occult advanced fibrosis and graded excess risk that ICD codes miss entirely. Pending prospective validation, FIB-4 may serve as a low-cost adjunct to bedside risk stratification in AMI care. FAU - Pradeep, Arun Gajan AU - Pradeep AG AD - Department of Medicine, Staten Island University Hospital, Northwell Health, Staten Island, NY 10305, USA. FAU - Butt, Muhammad Abdurrahman AU - Butt MA AD - Department of Medicine, Staten Island University Hospital, Northwell Health, Staten Island, NY 10305, USA. FAU - Jia, Kaiyu AU - Jia K AUID- ORCID: 0009-0002-8976-0411 AD - Department of Medicine, Staten Island University Hospital, Northwell Health, Staten Island, NY 10305, USA. FAU - Beshay, Bishoy AU - Beshay B AUID- ORCID: 0000-0002-9301-8669 AD - Department of Medicine, Staten Island University Hospital, Northwell Health, Staten Island, NY 10305, USA. FAU - Meng, Jessica AU - Meng J AD - Department of Medicine, Staten Island University Hospital, Northwell Health, Staten Island, NY 10305, USA. FAU - Yasin, Saif AU - Yasin S AD - Department of Medicine, Staten Island University Hospital, Northwell Health, Staten Island, NY 10305, USA. FAU - Pearce, Esther AU - Pearce E AD - Department of Medicine, Staten Island University Hospital, Northwell Health, Staten Island, NY 10305, USA. FAU - Gut, Thomas AU - Gut T AUID- ORCID: 0000-0002-5704-3410 AD - Department of Medicine, Staten Island University Hospital, Northwell Health, Staten Island, NY 10305, USA. LA - eng PT - Journal Article DEP - 20260824 PL - Switzerland TA - J Cardiovasc Dev Dis JT - Journal of cardiovascular development and disease JID - 101651414 PMC - PMC13607740 OTO - NOTNLM OT - FIB-4 OT - acute myocardial infarction OT - cirrhosis OT - invasive management OT - liver fibrosis OT - outcomes COIS- The authors declare no conflicts of interest. EDAT- 2026/09/24 23:52 MHDA- 2026/09/24 23:53 PMCR- 2026/08/24 CRDT- 2026/09/24 18:11 PHST- 2026/06/08 00:00 [received] PHST- 2026/07/20 00:00 [revised] PHST- 2026/07/27 00:00 [accepted] PHST- 2026/09/24 23:53 [medline] PHST- 2026/09/24 23:52 [pubmed] PHST- 2026/09/24 18:11 [entrez] PHST- 2026/08/24 00:00 [pmc-release] AID - jcdd13090408 [pii] AID - jcdd-13-00408 [pii] AID - 10.3390/jcdd13090408 [doi] PST - epublish SO - J Cardiovasc Dev Dis. 2026 Aug 24;13(9):408. doi: 10.3390/jcdd13090408. PMID- 42762209 OWN - NLM STAT- Publisher LR - 20260919 IS - 2772-3747 (Electronic) IS - 2772-3747 (Linking) DP - 2026 Sep 17 TI - Impact of Renal Dysfunction on FFR- or IVUS-Guided PCI for Intermediate Coronary Stenosis. LID - S2772-3747(26)00704-0 [pii] LID - 10.1016/j.jacasi.2026.07.044 [doi] AB - BACKGROUND: A previous FLAVOUR (Fractional Flow Reserve or Intravascular Ultrasonography to Guide PCI) trial reported that percutaneous coronary intervention (PCI) guided by fractional flow reserve (FFR) was noninferior to intravascular ultrasound (IVUS)-guided strategies in terms of the composite outcome of death, myocardial infarction, or revascularization at 24 months (patient-oriented composite outcome [POCO]). OBJECTIVES: This post hoc secondary analysis of the FLAVOUR trial evaluated the impact of renal dysfunction on lesion characteristics, treatment patterns, and clinical outcomes according to FFR- or IVUS-guided strategies in patients with intermediate coronary stenosis. METHODS: Patients were classified according to renal function as chronic kidney disease (CKD) or non-CKD. The primary endpoint was POCO. RESULTS: Among 1,617 patients, 101 (6.2%) had CKD. Compared with non-CKD patients, CKD patients had greater anatomic disease burden on IVUS but similar pre-PCI FFR. CKD patients underwent PCI more frequently (60.4% vs 46.9%; P = 0.009), mainly in the IVUS-guided group, and had a higher POCO rate (17.8% vs 7.8%; P = 0.001). These differences were more evident in PCI-treated patients, whereas deferred lesions showed broadly similar outcomes. No statistically significant differences in outcomes were detected between FFR- and IVUS-guided strategies within renal function strata. Formal interaction analyses showed no significant effect modification by renal function for POCO or any individual endpoint (all P for interaction >0.05). CONCLUSIONS: CKD was associated with higher PCI and POCO rates, whereas no significant renal function-by-strategy interaction was detected. These exploratory findings require prospective validation. (Fractional Flow Reserve and Intravascular Ultrasound for Clinical Outcomes in Patients with Intermediate Stenosis; NCT02673424). CI - Copyright (c) 2026 The Authors. Published by Elsevier Inc. All rights reserved. FAU - He, Wenming AU - He W AD - Department of Cardiology, The First Affiliated Hospital of Ningbo University, Ningbo, China. FAU - Tang, Wenbin AU - Tang W AD - Department of Cardiology, The First Affiliated Hospital of Ningbo University, Ningbo, China. FAU - Zhang, Jinlong AU - Zhang J AD - Department of Cardiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China. FAU - Wu, Xianpeng AU - Wu X AD - Department of Cardiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China. FAU - Lu, Haoxuan AU - Lu H AD - Department of Cardiology, The First Affiliated Hospital of Ningbo University, Ningbo, China. FAU - Xie, Yanqing AU - Xie Y AD - Department of Cardiology, The First Affiliated Hospital of Ningbo University, Ningbo, China. FAU - Chen, Xiaomin AU - Chen X AD - Department of Cardiology, The First Affiliated Hospital of Ningbo University, Ningbo, China. FAU - Sun, Yong AU - Sun Y AD - Department of Cardiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China. FAU - Li, Changling AU - Li C AD - Department of Cardiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China. FAU - Zhu, Lingjun AU - Zhu L AD - Department of Cardiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China. FAU - Gao, Feng AU - Gao F AD - Department of Cardiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China. FAU - Dong, Liang AU - Dong L AD - Department of Cardiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China. FAU - Liu, Yabin AU - Liu Y AD - Department of Cardiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China. FAU - Shen, Jian AU - Shen J AD - Department of Cardiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China. FAU - Ni, Cheng AU - Ni C AD - Department of Cardiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China. FAU - Wang, Kan AU - Wang K AD - Department of Cardiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China. FAU - Chen, Zexin AU - Chen Z AD - Department of Cardiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China. FAU - Chen, Haibo AU - Chen H AD - Department of Cardiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China. FAU - Li, Shiqiang AU - Li S AD - Department of Cardiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China. FAU - Yang, Seokhun AU - Yang S AD - Seoul National University Hospital, Seoul, Republic of Korea. FAU - Kang, Jeehoon AU - Kang J AD - Seoul National University Hospital, Seoul, Republic of Korea. FAU - Hwang, Doyeon AU - Hwang D AD - Seoul National University Hospital, Seoul, Republic of Korea. FAU - Hahn, Joo-Yong AU - Hahn JY AD - Samsung Medical Center, Seoul, Republic of Korea. FAU - Nam, Chang-Wook AU - Nam CW AD - Keimyung University Dongsan Medical Center, Daegu, Republic of Korea. FAU - Doh, Joon-Hyung AU - Doh JH AD - Inje University Ilsan Paik Hospital, Goyang, Republic of Korea. FAU - Lee, Bong-Ki AU - Lee BK AD - Kangwon National University Hospital, Chuncheon, Gangwon-Do, Republic of Korea. FAU - Kim, Weon AU - Kim W AD - KyungHee University Hospital, Seoul, Republic of Korea. FAU - Huang, Jinyu AU - Huang J AD - Hangzhou First People's Hospital, Hangzhou, China. FAU - Jiang, Fan AU - Jiang F AD - Hangzhou Normal University Affiliated Hospital, Hangzhou, China. FAU - Zhou, Hao AU - Zhou H AD - The 1st Affiliated Hospital of Wenzhou Medical University, Wenzhou, China. FAU - Chen, Peng AU - Chen P AD - The 2nd Affiliated Hospital of Wenzhou Medical University, Wenzhou, China. FAU - Tang, Lijiang AU - Tang L AD - Zhejiang Hospital, Hangzhou, China. FAU - Jiang, Wenbing AU - Jiang W AD - The Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou, China. FAU - Ahn, Sung Gyun AU - Ahn SG AD - Wonju Severance Christian Hospital, Wonju, Gangwon-Do, Republic of Korea. FAU - Yoon, Myeong-Ho AU - Yoon MH AD - Ajou University Hospital, Suwon, Republic of Korea. FAU - Kim, Ung AU - Kim U AD - Yeungnam University Medical Center, Daegu, Republic of Korea. FAU - Lee, Joo Myung AU - Lee JM AD - Samsung Medical Center, Seoul, Republic of Korea. FAU - Ki, You-Jeong AU - Ki YJ AD - Uijeongbu Eulji Medical Center, Uijeongbu, Gyeonggi-Do, Republic of Korea. FAU - Shin, Eun-Seok AU - Shin ES AD - Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea. FAU - Tahk, Seung-Jea AU - Tahk SJ AD - Ajou University Hospital, Suwon, Republic of Korea. FAU - Koo, Bon-Kwon AU - Koo BK AD - Seoul National University Hospital, Seoul, Republic of Korea. FAU - Jiang, Jun AU - Jiang J AD - Department of Cardiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China. Electronic address: jiang-jun@zju.edu.cn. FAU - Hu, Xinyang AU - Hu X AD - Department of Cardiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China. FAU - Wang, Jian'an AU - Wang J AD - Department of Cardiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China. Electronic address: wangjianan111@zju.edu.cn. LA - eng SI - ClinicalTrials.gov/NCT02673424 PT - Journal Article DEP - 20260917 PL - United States TA - JACC Asia JT - JACC. Asia JID - 9918452380106676 OTO - NOTNLM OT - chronic kidney disease OT - fractional flow reserve OT - intermediate stenosis OT - intravascular ultrasound OT - outcome OT - percutaneous coronary intervention COIS- Funding Support and Author Disclosures The FLAVOUR trial was funded by Boston Scientific. The funder had no role in study design, data collection, analysis, interpretation, or writing of the manuscript. The study has also received funding from International Sci-tech Cooperation Projects under the "Innovation Yongjiang 2035" Program (2024H010) and Project for the Establishment of the Coronary Intervention Center of Cixi Integrated Traditional Chinese and Western Medicine Healthcare Group (H2024000472). Dr Hahn received research grants from Abbott Korea, Biosensors International Group, Biotronik, Boston Scientific Corporation, and Medtronic. Dr Koo received an institutional research grant from Abbott Vascular, Boston Scientific Corporation, and Philips. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2026/09/19 23:52 MHDA- 2026/09/19 23:52 CRDT- 2026/09/19 10:28 PHST- 2026/01/29 00:00 [received] PHST- 2026/06/24 00:00 [revised] PHST- 2026/07/20 00:00 [accepted] PHST- 2026/09/19 23:52 [medline] PHST- 2026/09/19 23:52 [pubmed] PHST- 2026/09/19 10:28 [entrez] AID - S2772-3747(26)00704-0 [pii] AID - 10.1016/j.jacasi.2026.07.044 [doi] PST - aheadofprint SO - JACC Asia. 2026 Sep 17:S2772-3747(26)00704-0. doi: 10.1016/j.jacasi.2026.07.044. PMID- 42751771 OWN - NLM STAT- Publisher LR - 20260917 IS - 1941-7632 (Electronic) IS - 1941-7640 (Linking) DP - 2026 Sep 17 TI - Influence of Chronic Kidney Disease on Outcomes After Paclitaxel-Coated Balloon Angioplasty for Coronary In-Stent Restenosis. PG - e016978 LID - 10.1161/CIRCINTERVENTIONS.126.016978 [doi] AB - BACKGROUND: Drug-coated balloons (DCB) are superior to conventional balloon angioplasty in coronary in-stent restenosis. The influence of chronic kidney disease (CKD) on outcomes after DCB for in-stent restenosis is not well described. METHODS: A post hoc analysis of the AGENT IDE trial was performed to compare the efficacy and safety of DCB versus balloon angioplasty in patients with CKD (estimated glomerular filtration rate <60 mL/min per 1.73 m(2)) and those without renal impairment. The primary outcome was target lesion failure, a composite of ischemia-driven target lesion revascularization (TLR), target vessel myocardial infarction, or cardiac death. The 2 cohorts were compared using time-to-first-event and recurrent event methods through 2 years. RESULTS: Of the 406 patients randomized to DCB, 149 (25%) had CKD (mean estimated glomerular filtration rate 47.3+/-9.2). They were older and had greater multivessel disease and congestive heart failure than those without CKD. There were no differences in clinical presentation, Mehran in-stent restenosis patterns or technical success. The effect of DCB versus balloon angioplasty on 2-year target lesion failure was similar in patients with CKD (23.6% versus 30.0%; hazard ratio, 0.70 [95% CI, 0.35-1.39]) compared with those without CKD (28.1% versus 34.9%; hazard ratio, 0.74 [95% CI, 0.52-1.05]; P(Int)=0.90). Similarly, the effect of DCB on outcomes in the recurrent events analysis was not influenced by baseline renal function. CONCLUSIONS: Among patients undergoing intervention for in-stent restenosis, the benefit of DCB versus balloon angioplasty was consistent irrespective of baseline CKD status. Baseline renal function also did not influence outcomes in the recurrent event analysis. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT04647253. FAU - Tehrani, Behnam N AU - Tehrani BN AUID- ORCID: 0000-0002-8037-7021 AD - Inova Schar Heart and Vascular, Inova Health System, Falls Church, VA (B.N.T., I.V., W. Batchelor). RINGGOLD: 237248 FAU - Vavilin, Ilan AU - Vavilin I AD - Inova Schar Heart and Vascular, Inova Health System, Falls Church, VA (B.N.T., I.V., W. Batchelor). RINGGOLD: 237248 FAU - Shlofmitz, Richard AU - Shlofmitz R AUID- ORCID: 0000-0002-9422-048X AD - St. Francis Hospital, Roslyn, NY (R. Shlofmitz, J.M.). FAU - Moses, Jeffrey AU - Moses J AUID- ORCID: 0000-0002-8842-7919 AD - St. Francis Hospital, Roslyn, NY (R. Shlofmitz, J.M.). FAU - Bachinsky, William AU - Bachinsky W AD - University of Pittsburgh Medical Center, Central PA, Harrisburg (W. Bachinsky). FAU - Dohad, Suhail AU - Dohad S AUID- ORCID: 0000-0003-2297-8475 AD - Cedars-Sinai Medical Center, Los Angeles, CA (S.D.). FAU - Rudick, Steven AU - Rudick S AD - Lindner Center for Research and Education at Christ Hospital, Cincinnati, OH (S.R.). FAU - Stoler, Robert AU - Stoler R AUID- ORCID: 0000-0002-8946-0163 AD - Baylor Heart & Vascular Hospital, Dallas, TX (R. Stoler). FAU - Jefferson, Brian K AU - Jefferson BK AUID- ORCID: 0009-0008-9709-2234 AD - HCA Tristar Centennial Medical Center, Nashville, TN (B.K.J.). FAU - Nicholson, William AU - Nicholson W AUID- ORCID: 0000-0001-7586-4258 AD - Emory University Hospital, Atlanta, GA (W.N.). FAU - Altman, John AU - Altman J AD - St. Anthony Hospital, Denver, CO (J.A.). FAU - Bateman, Cinthia AU - Bateman C AD - South Denver Cardiology, Littleton, CO (C.B.). FAU - Tremmel, Jennifer A AU - Tremmel JA AUID- ORCID: 0000-0001-6620-9139 AD - Stanford University Medical Center, CA (J.A.T.). FAU - Abbott, J Dawn AU - Abbott JD AUID- ORCID: 0000-0002-2560-0155 AD - Brown University Health Cardiovascular Institute, Rhode Island Hospital, Providence (J.D.A.). FAU - Batchelor, Wayne AU - Batchelor W AUID- ORCID: 0000-0002-3016-1150 AD - Inova Schar Heart and Vascular, Inova Health System, Falls Church, VA (B.N.T., I.V., W. Batchelor). RINGGOLD: 237248 FAU - Cavalcante, Rafael AU - Cavalcante R AD - Boston Scientific Corporation, Marlborough, MA (R.C.). RINGGOLD: 5724 FAU - Yeh, Robert W AU - Yeh RW AUID- ORCID: 0000-0002-0564-4468 AD - Beth Israel Deaconess Medical Center, Boston, MA (R.W.Y.). FAU - Kirtane, Ajay J AU - Kirtane AJ AUID- ORCID: 0000-0003-0061-1058 AD - Columbia University Irving Medical Center/New York-Presbyterian Hospital and the Cardiovascular Research Foundation (A.J.K.). LA - eng SI - ClinicalTrials.gov/NCT04647253 PT - Journal Article DEP - 20260917 PL - United States TA - Circ Cardiovasc Interv JT - Circulation. Cardiovascular interventions JID - 101499602 SB - IM OTO - NOTNLM OT - angioplasty, balloon OT - ischemia OT - kidney diseases OT - myocardial infarction OT - stents EDAT- 2026/09/17 15:37 MHDA- 2026/09/17 15:37 CRDT- 2026/09/17 07:22 PHST- 2026/09/17 15:37 [medline] PHST- 2026/09/17 15:37 [pubmed] PHST- 2026/09/17 07:22 [entrez] AID - 10.1161/CIRCINTERVENTIONS.126.016978 [doi] PST - aheadofprint SO - Circ Cardiovasc Interv. 2026 Sep 17:e016978. doi: 10.1161/CIRCINTERVENTIONS.126.016978. PMID- 42745232 OWN - NLM STAT- Publisher LR - 20260916 IS - 1538-4683 (Electronic) IS - 1061-5377 (Linking) DP - 2026 Sep 16 TI - The Ischemia-Plaque Paradox: A Mechanistic Framework for Chronic Coronary Syndromes. LID - 10.1097/CRD.0000000000001461 [doi] AB - Percutaneous coronary intervention relieves angina in chronic coronary syndromes, yet contemporary randomized trials have not shown that relieving ischemia reduces death or myocardial infarction when added to optimal medical therapy. This discordance requires a mechanistic reevaluation. Inducible ischemia identifies obstructive coronary disease and the likelihood of angina but does not reliably identify plaques that will rupture. Fractional flow reserve-guided percutaneous intervention reduces urgent revascularization without reducing death or infarction. Most spontaneous infarctions arise from lesions that were not severely obstructive before rupture. Coronary artery bypass grafting reduces spontaneous infarction in complex multivessel and left main disease, plausibly through more complete revascularization and through placement of grafts distal to long diseased segments that preserve perfusion if proximal plaque rupture occurs. Advances in intracoronary imaging and coronary computed tomography angiography can identify high-risk plaque features, but trials of focal treatment of non-flow-limiting vulnerable plaques have not shown benefit. Modern medical therapy with high-intensity lipid lowering, icosapent ethyl in selected patients, anti-inflammatory approaches, and therapies for diabetes and chronic kidney disease has lowered overall event rates. Chronic coronary syndromes comprise 2 overlapping but distinct pathophysiological mechanisms. Flow-limiting stenoses cause angina and are effectively treated by percutaneous coronary intervention. Plaque instability causes infarction and is modified by systemic therapy. Bypass surgery in selected patients with complex coronary anatomy addresses both mechanisms by relieving flow limitation and protecting myocardium against future plaque events. CI - Copyright (c) 2026 Wolters Kluwer Health, LLC. All rights reserved. FAU - Klein, Lloyd W AU - Klein LW AD - From the Department of Medicine, University of California, San Francisco, San Francisco, CA. LA - eng PT - Journal Article DEP - 20260916 PL - United States TA - Cardiol Rev JT - Cardiology in review JID - 9304686 SB - IM OTO - NOTNLM OT - chronic coronary syndromes OT - coronary artery bypass grafting OT - guideline-directed medical therapy OT - percutaneous coronary intervention OT - vulnerable plaque COIS- Disclosure: The authors have no conflicts of interest to report. EDAT- 2026/09/16 05:36 MHDA- 2026/09/16 05:36 CRDT- 2026/09/16 03:00 PHST- 2026/09/16 05:36 [medline] PHST- 2026/09/16 05:36 [pubmed] PHST- 2026/09/16 03:00 [entrez] AID - 00045415-990000000-01023 [pii] AID - 10.1097/CRD.0000000000001461 [doi] PST - aheadofprint SO - Cardiol Rev. 2026 Sep 16. doi: 10.1097/CRD.0000000000001461. PMID- 42735033 OWN - NLM STAT- Publisher LR - 20261026 IS - 1555-905X (Electronic) IS - 1555-9041 (Linking) DP - 2026 Sep 14 TI - Atherosclerotic Cardiovascular Disease in CKD: Contemporary Insights into Pathogenesis, Diagnosis, and Management. LID - 10.2215/CJN.0000001199 [doi] AB - Patients with CKD have a disproportionate burden of cardiovascular (CV) disease, and the majority die from CV causes before ever reaching kidney failure. Atherosclerotic cardiovascular disease (ASCVD), which includes coronary artery disease, cerebrovascular disease, and peripheral arterial disease, develops in CKD through the convergence of traditional risk factors and a distinct group of CKD-related, nontraditional mechanisms, including mineral and bone disorder with vascular calcification, chronic inflammation and oxidative stress, uremic toxicity, and an atherogenic dyslipidemia. CV and kidney disease interact in a bidirectional manner in which each accelerates the other. Reflecting this unique pathophysiology, the burden of ASCVD rises steeply as kidney function declines, reaching a several-fold higher risk of myocardial infarction, stroke, and peripheral arterial disease at the lowest eGFR and highest albuminuria. Nonetheless, ASCVD in CKD remains under-recognized and undertreated, owing partly to atypical clinical presentations, conventional risk-prediction tools that underestimate risk, and to the exclusion of patients with advanced CKD from most landmark CV trials. In this review, which focuses primarily on coronary artery disease in non-dialysis-dependent CKD, we examine the epidemiology and key pathogenic mechanisms of ASCVD in this setting and appraise diagnostic and risk-prediction approaches together with their limitations, including contemporary CKD-adapted risk equations, cardiac biomarkers, and noninvasive imaging. We also summarize the current evidence for management, spanning lipid-lowering, antiplatelet, and BP therapies, newer cardiometabolic agents (including sodium-glucose cotransporter 2 inhibitors, glucagon-like peptide-1 receptor agonists, and nonsteroidal mineralocorticoid receptor antagonists), coronary revascularization, and lifestyle modification. Throughout, we highlight where high-quality, CKD-specific evidence is lacking, and we outline priority research gaps and emerging therapies directed at CKD-relevant pathways, such as inflammation. Recognizing and aggressively modifying CV risk in CKD, across both traditional and CKD-specific pathways, represents a substantial, and currently underrealized, opportunity to reduce morbidity and mortality in this high-risk population. CI - Copyright (c) 2026 by the American Society of Nephrology. FAU - Correa, Simon AU - Correa S AUID- ORCID: 0000-0001-9157-3987 AD - Renal Division, Brigham and Women's Hospital, Boston, Massachusetts. AD - Harvard Medical School, Boston, Massachusetts. FAU - Cunningham, Jonathan W AU - Cunningham JW AUID- ORCID: 0000-0003-4481-7867 AD - Harvard Medical School, Boston, Massachusetts. AD - Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, Massachusetts. AD - Cardiovascular Disease Initiative, Broad Institute of Harvard University and the Massachusetts Institute of Technology, Cambridge, Massachusetts. FAU - Mc Causland, Finnian R AU - Mc Causland FR AUID- ORCID: 0000-0002-0299-0533 AD - Renal Division, Brigham and Women's Hospital, Boston, Massachusetts. AD - Harvard Medical School, Boston, Massachusetts. LA - eng GR - DK/NIDDK NIH HHS/United States PT - Journal Article DEP - 20260914 PL - United States TA - Clin J Am Soc Nephrol JT - Clinical journal of the American Society of Nephrology : CJASN JID - 101271570 SB - IM OTO - NOTNLM OT - CKD OT - cardiorenal syndrome OT - cardiovascular-kidney-metabolic (CKM) syndrome OT - heart failure OT - hemodialysis EDAT- 2026/09/14 17:40 MHDA- 2026/09/14 17:40 CRDT- 2026/09/14 12:03 PHST- 2026/09/14 17:40 [pubmed] PHST- 2026/09/14 17:40 [medline] PHST- 2026/09/14 12:03 [entrez] AID - 01277230-990000000-01049 [pii] AID - 10.2215/CJN.0000001199 [doi] PST - aheadofprint SO - Clin J Am Soc Nephrol. 2026 Sep 14. doi: 10.2215/CJN.0000001199. PMID- 42732086 OWN - NLM STAT- MEDLINE DCOM- 20260913 LR - 20260919 IS - 1643-3750 (Electronic) IS - 1234-1010 (Print) IS - 1234-1010 (Linking) VI - 32 DP - 2026 Sep 13 TI - Protective Effect of Sodium-Glucose Cotransporter 2 Inhibitors (SGLT2i) on Liver Function: Results From MELD Analysis in Surgical Revascularization-A Preliminary Study. PG - e953130 LID - 10.12659/MSM.953130 [doi] LID - e953130 AB - BACKGROUND Coronary artery disease is associated with long-term systemic inflammation and perioperative multiorgan vulnerability, including transient hepato-renal dysfunction after cardiac surgery. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) provide cardiorenal protection beyond glucose lowering via anti-inflammatory, metabolic, and endothelial effects, but their effect on perioperative liver-related risk markers, including the Model for End-Stage Liver Disease (MELD) score, in off-pump coronary artery bypass grafting (OPCAB) remains uncertain. MATERIAL AND METHODS We retrospectively studied 111 consecutive patients undergoing elective OPCAB in 2024 (chronic hepatic or renal disease excluded). Patients were stratified by long-term preoperative SGLT2i therapy (>/=3 months): no SGLT2i (n = 85) vs SGLT2i (n = 26). MELD score, bilirubin, international normalized ratio , and creatinine were assessed preoperatively and on postoperative days 1 and 6. Between-group comparisons used the Mann-Whitney U test; within-group changes were analyzed using the Friedman test, Kendall's W, and Bonferroni post hoc testing RESULTS Baseline MELD and components were comparable. On postoperative day 1, SGLT2i group exhibited lower bilirubin (P < 0.001), INR (P = 0.04), and MELD score (P = 0.03), but higher creatinine (P = 0.002). By day 6, differences attenuated. Within-group analysis showed significant time effects for MELD, INR, and creatinine in both groups, with large effect sizes (W = 0.48-0.88). Total bilirubin changed over time in the control but not the SGLT2i group. CONCLUSIONS Long-term preoperative SGLT2i therapy was associated with distinct perioperative MELD dynamics in OPCAB, with relative preservation of bilirubin and INR despite creatinine changes, suggesting the potential modulation of hepatic function during perioperative stress. Given the observational design and possible confounding, results are hypothesis-generating and warrant prospective confirmation.. FAU - Urbanowicz, Tomasz AU - Urbanowicz T AUID- ORCID: 0000-0001-8080-2764 AD - Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznan, Poland. FAU - Bajsert, Monika AU - Bajsert M AUID- ORCID: 0009-0006-7401-5645 AD - Cardiac Surgery Students' Research Group, Poznan University of Medical Sciences, Poznan, Poland. FAU - Kowalczyk, Monika Lucja AU - Kowalczyk ML AUID- ORCID: 0009-0006-4050-4934 AD - Cardiac Surgery Students' Research Group, Poznan University of Medical Sciences, Poznan, Poland. FAU - Marcinkowska, Zuzanna AU - Marcinkowska Z AUID- ORCID: 0009-0006-8684-5603 AD - Cardiac Surgery Students' Research Group, Poznan University of Medical Sciences, Poznan, Poland. FAU - Wisniewska, Oksana AU - Wisniewska O AUID- ORCID: 0009-0005-9597-8486 AD - Cardiac Surgery Students' Research Group, Poznan University of Medical Sciences, Poznan, Poland. FAU - Krasinska-Plachta, Aleksandra AU - Krasinska-Plachta A AUID- ORCID: 0000-0001-8934-2506 AD - Department of Ophthalmology, Poznan University of Medical Sciences, Poznan, Poland. FAU - Krasinska, Beata AU - Krasinska B AUID- ORCID: 0000-0002-3464-1645 AD - Department of Hypertensiology, Angiology, and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland. FAU - Spasenenko, Eugeniusz AU - Spasenenko E AD - Department of Hypertensiology, Angiology, and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland. FAU - Krasinski, Zbigniew AU - Krasinski Z AUID- ORCID: 0000-0002-2798-1959 AD - Department of Vascular, Endovascular Surgery, Angiology and Phlebology, Poznan University of Medical Science, Poznan, Poland. FAU - Filipiak, Krzysztof J AU - Filipiak KJ AUID- ORCID: 0000-0002-6563-0877 AD - The Centre of Postgraduate Medical Education, Warsaw, Poland. FAU - Mertowska, Paulina AU - Mertowska P AUID- ORCID: 0000-0001-9530-6659 AD - Department of Experimental Immunology, Medical University of Lublin, Lublin, Poland. FAU - Grywalska, Ewelina AU - Grywalska E AUID- ORCID: 0000-0002-0451-4741 AD - Department of Experimental Immunology, Medical University of Lublin, Lublin, Poland. FAU - Bartus, Krzysztof AU - Bartus K AUID- ORCID: 0000-0002-3457-6978 AD - Department of Cardiovascular Surgery and Transplantology, Jagiellonian University Medical College, Cracow, Poland. FAU - Jemielity, Marek AU - Jemielity M AUID- ORCID: 0000-0003-2442-4644 AD - Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznan, Poland. LA - eng PT - Journal Article DEP - 20260913 PL - United States TA - Med Sci Monit JT - Medical science monitor : international medical journal of experimental and clinical research JID - 9609063 RN - 0 (Sodium-Glucose Transporter 2 Inhibitors) RN - RFM9X3LJ49 (Bilirubin) SB - IM MH - Humans MH - Male MH - Female MH - Retrospective Studies MH - Middle Aged MH - *Sodium-Glucose Transporter 2 Inhibitors/pharmacology/therapeutic use MH - Aged MH - *Liver/drug effects MH - *End Stage Liver Disease MH - Coronary Artery Bypass, Off-Pump/adverse effects/methods MH - Coronary Artery Disease/surgery MH - Liver Function Tests MH - Bilirubin/blood PMC - PMC13584803 COIS- Conflict of interest: None declared EDAT- 2026/09/13 05:41 MHDA- 2026/09/13 05:42 PMCR- 2026/09/13 CRDT- 2026/09/13 01:22 PHST- 2026/09/13 05:42 [medline] PHST- 2026/09/13 05:41 [pubmed] PHST- 2026/09/13 01:22 [entrez] PHST- 2026/09/13 00:00 [pmc-release] AID - 953130 [pii] AID - 10.12659/MSM.953130 [doi] PST - epublish SO - Med Sci Monit. 2026 Sep 13;32:e953130. doi: 10.12659/MSM.953130. PMID- 42649013 OWN - NLM STAT- Publisher LR - 20260826 IS - 1878-0938 (Electronic) IS - 1878-0938 (Linking) DP - 2026 Aug 19 TI - Timing of non-culprit revascularization in STEMI with multivessel disease: A contemporary meta-analysis of immediate and staged strategies. LID - S1553-8389(26)00368-4 [pii] LID - 10.1016/j.carrev.2026.08.009 [doi] AB - BACKGROUND: Complete revascularization improves outcomes in ST-segment elevation myocardial infarction (STEMI) with multivessel coronary artery disease, but the optimal timing of non-culprit intervention-immediate, early-staged (same hospitalization), or delayed (post-discharge)-remains uncertain. OBJECTIVES: To evaluate the effect of timing of non-culprit revascularization in STEMI. METHODS: We performed a systematic review and meta-analysis of randomized trials comparing immediate, early-staged, and delayed-staged non-culprit revascularization in STEMI. DerSimonian-Laird random-effects models pooled risk ratios (RR) with 95% confidence intervals (CI); fixed-effect and REML sensitivity analyses and parallel hard-endpoint (death plus myocardial infarction) analyses were performed. RESULTS: Five randomized trials contributed to the pooled timing comparisons. Versus early-staged revascularization, immediate complete PCI was not associated with improved outcomes (three trials; RR 1.25, 95% CI 0.92-1.70; I(2) = 0%). Versus delayed-staged strategies, immediate PCI showed a numerical event reduction (RR 0.73, 95% CI 0.37-1.45) with substantial heterogeneity (I(2) approximately 88%), driven by discordant results between MULTISTARS AMI and iMODERN, the latter a hybrid strategy-plus-timing (physiology- versus imaging-guided) rather than a pure timing comparison. Hard-endpoint analyses showed no significant difference; where reported, contrast-induced nephropathy and major bleeding did not differ. CONCLUSIONS: Immediate complete revascularization showed no clear difference in outcomes versus staged revascularization during the same hospitalization; as most trials were not powered for non-inferiority, this should not be read as equivalence. These findings support an individualized approach emphasizing timely completion rather than routine immediate multivessel PCI in stable STEMI, with staged PCI favored when lesions are complex, renal function is impaired, or physiology-guided assessment is preferred. CONDENSED ABSTRACT: In this meta-analysis of direct-timing randomized trials, immediate multivessel PCI showed no benefit versus in-hospital staged revascularization and only inconsistent benefit versus delayed strategies. These data support immediate non-culprit PCI in the hemodynamically stable patient with a non-complex culprit intervention and anticipated non-complex non-culprit PCI, and staged in-hospital PCI as an equally pragmatic default, in stable STEMI with multivessel disease. Because the potential downside of brief post-discharge deferral (within 30-45 days) appears small, selected patients-such as those with significant acute kidney injury after index PCI or functionally vulnerable elderly patients who would benefit from earlier discharge-may reasonably undergo planned outpatient non-culprit revascularization. CI - Copyright (c) 2026 Elsevier Inc. All rights reserved. FAU - Ali, Rubiya AU - Ali R AD - Memorial Healthcare System, Pembroke Pines, FL, USA. Electronic address: ruali@mhs.net. FAU - Naeem, Muniba AU - Naeem M AD - Memorial Healthcare System, Pembroke Pines, FL, USA. Electronic address: MNaeem@mhs.net. FAU - Harrisingh, Kamahl AU - Harrisingh K AD - Memorial Healthcare System, Pembroke Pines, FL, USA. Electronic address: KHarrisingh@mhs.net. FAU - Arteaga, Edgar Morales AU - Arteaga EM AD - Memorial Healthcare System, Pembroke Pines, FL, USA. Electronic address: EMoralesArteaga@mhs.net. FAU - Gaines, Holly AU - Gaines H AD - Memorial Healthcare System, Pembroke Pines, FL, USA. Electronic address: HGaines@mhs.net. FAU - Roberts, Jonathan S AU - Roberts JS AD - Memorial Healthcare System, Pembroke Pines, FL, USA. Electronic address: JonathanRoberts@mhs.net. LA - eng PT - Journal Article DEP - 20260819 PL - United States TA - Cardiovasc Revasc Med JT - Cardiovascular revascularization medicine : including molecular interventions JID - 101238551 SB - IM OTO - NOTNLM OT - Complete revascularization OT - Immediate PCI OT - Multivessel coronary artery disease OT - Percutaneous coronary intervention OT - STEMI OT - Staged PCI OT - Timing strategy COIS- Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2026/08/26 23:35 MHDA- 2026/08/26 23:35 CRDT- 2026/08/26 21:53 PHST- 2026/07/09 00:00 [received] PHST- 2026/08/05 00:00 [revised] PHST- 2026/08/12 00:00 [accepted] PHST- 2026/08/26 23:35 [medline] PHST- 2026/08/26 23:35 [pubmed] PHST- 2026/08/26 21:53 [entrez] AID - S1553-8389(26)00368-4 [pii] AID - 10.1016/j.carrev.2026.08.009 [doi] PST - aheadofprint SO - Cardiovasc Revasc Med. 2026 Aug 19:S1553-8389(26)00368-4. doi: 10.1016/j.carrev.2026.08.009. PMID- 42647034 OWN - NLM STAT- Publisher LR - 20260826 IS - 2168-6238 (Electronic) IS - 2168-622X (Linking) DP - 2026 Aug 26 TI - Glucagon-Like Peptide 1 Receptor Agonists, Mortality, and Cardiovascular Outcomes in Serious Mental Illness. LID - 10.1001/jamapsychiatry.2026.2574 [doi] AB - IMPORTANCE: Bipolar disorder, major depressive disorder, and schizophrenia are associated with substantial excess mortality, principally from cardiovascular disease. Identifying strategies to reduce this burden is a critical psychiatric priority. OBJECTIVE: To evaluate associations between initiation of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) vs sodium-glucose cotransporter-2 (SGLT2) inhibitors and all-cause mortality and major adverse cardiovascular events (MACEs) among adults with and without serious mental illness (SMI). DESIGN, SETTING, AND PARTICIPANTS: This was a retrospective target trial emulation within the TriNetX Analytics Network, a multinational federated electronic health record network. Adults initiating GLP-1 RAs or SGLT2 inhibitors were included using a new-user, active-comparator design with propensity score matching and separate psychiatric and nonpsychiatric cohorts. The study included all available data in the TriNetX network through the most recent database refresh. Data were queried and analyzed in March 2026, with prespecified follow-up intervals of 1, 4, and 10 years. Additional subgroup analyses were conducted following peer review in May 2026. EXPOSURE: First-recorded GLP-1 RA vs SGLT2 inhibitor prescription. MAIN OUTCOMES AND MEASURES: The primary outcome was 4-year all-cause mortality; the key secondary outcome, 1-year mortality. Additional outcomes included 3- and 5-point MACEs and individual cardiovascular end points. Sensitivity analyses included diabetes stratification, exclusion of baseline heart failure and chronic kidney disease, and censoring at crossover. Exploratory analyses examined SMI subgroups, agent-specific effects, and combination therapy. RESULTS: For the primary 4-year analysis, 1 528 230 adults were propensity score matched (764 115 pairs; 195 184 pairs with serious mental illness [SMI] and 568 931 pairs without SMI). The mean [SD] age in the GLP-1RA and SGLT2 inhibitor groups was 60.5 [12.0] and 60.2 [13.3] years, respectively, in the SMI cohort and 60.9 [12.2] and 60.6 [13.0] years, respectively, in the non-SMI cohort; 112 911 [57.8%], 113 488 [58.1%], 251 679 [44.2%], and 260 480 [45.8%] were female, respectively. Among participants with SMI, mortality was lower with GLP-1RA initiation than with SGLT2 inhibitor initiation (9585 of 195 184 [4.91%] vs 12 584 of 195 184 [6.45%]; hazard ratio [HR], 0.76; 95% CI, 0.74-0.78; absolute risk difference [ARD], -1.54 percentage points; 95% CI, -1.68 to -1.39; P < .001). Among participants with SMI and type 2 diabetes, semaglutide initiation, compared with SGLT2 inhibitor initiation, was associated with lower risks of 3-point MACE (HR, 0.77; 95% CI, 0.76-0.79), 5-point MACE, myocardial infarction, stroke, heart failure, and coronary artery bypass grafting. In a separately matched 1-year SMI cohort, mortality was lower with GLP-1RA initiation than with SGLT2 inhibitor initiation (2898 of 198 065; 1.46% vs 5624 of 198 065; 2.84%; RR, 0.52; 95% CI, 0.49-0.54; ARD, -1.38 percentage points; 95% CI, -1.47 to -1.29; P < .001). In 10-year exploratory analyses among participants with type 2 diabetes, semaglutide initiation, compared with SGLT2 inhibitor initiation, was associated with lower mortality in the major depressive disorder (RR, 0.55; 95% CI, 0.53-0.56), bipolar disorder (RR, 0.57; 95% CI, 0.51-0.63), and schizophrenia (RR, 0.67; 95% CI, 0.59-0.75) groups (all P < .001). The primary mortality association persisted across prespecified sensitivity analyses. CONCLUSIONS AND RELEVANCE: In this study, GLP-1 RA initiation was associated with lower mortality and cardiovascular events compared to SGLT2 inhibitor initiation, with greater absolute reductions in SMI. Benefits were evident within 1 year, consistent across SMI subgroups, and driven by semaglutide and tirzepatide. Prospective randomized trials are warranted. FAU - McIntyre, Roger S AU - McIntyre RS AD - Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada. AD - Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada. AD - Brain and Cognition Discovery Foundation, Toronto, Ontario, Canada. FAU - Zhang-James, Yanli AU - Zhang-James Y AD - Department of Psychiatry and Behavioral Sciences, Norton College of Medicine at State University of New York, Upstate Medical University, Syracuse. FAU - Kwan, Angela T H AU - Kwan ATH AD - Brain and Cognition Discovery Foundation, Toronto, Ontario, Canada. AD - Department of Internal Medicine, University of Toronto, Toronto, Ontario, Canada. LA - eng PT - Journal Article DEP - 20260826 PL - United States TA - JAMA Psychiatry JT - JAMA psychiatry JID - 101589550 SB - IM EDAT- 2026/08/26 17:37 MHDA- 2026/08/26 17:37 CRDT- 2026/08/26 11:38 PHST- 2026/08/26 17:37 [medline] PHST- 2026/08/26 17:37 [pubmed] PHST- 2026/08/26 11:38 [entrez] AID - 2852856 [pii] AID - 10.1001/jamapsychiatry.2026.2574 [doi] PST - aheadofprint SO - JAMA Psychiatry. 2026 Aug 26. doi: 10.1001/jamapsychiatry.2026.2574. PMID- 42645145 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260826 LR - 20260828 IS - 2039-7275 (Print) IS - 2039-7283 (Electronic) IS - 2039-7275 (Linking) VI - 16 IP - 8 DP - 2026 Aug 14 TI - Development and Preliminary Assessment of a Mortality Risk Score in Patients with Coronary Artery Disease Receiving Dual Antiplatelet Therapy After Percutaneous Coronary Intervention. LID - 10.3390/clinpract16080149 [doi] LID - 149 AB - Background: Patients with coronary artery disease (CAD) receiving dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) remain at risk of early adverse outcomes, including in-hospital mortality. Simple risk stratification based on routinely available variables may help identify higher-risk patients, but a limited number of outcome events constrains robust prediction-model development and validation. Aim: This exploratory study aimed to derive a preliminary, interpretable clinical score based on routinely available variables for risk stratification of all-cause in-hospital mortality in CAD patients receiving DAPT after PCI. In the clopidogrel-dominant practice setting of the participating centers, the score was conceived as a hypothesis-generating risk-enrichment framework rather than a validated treatment-selection tool or a surrogate measure of platelet reactivity. Methods: We analyzed a retrospective cohort of 1600 adults with CAD admitted between 2022 and 2024; 36 in-hospital deaths occurred. Twenty demographic, clinical, laboratory, and instrumental variables were evaluated. The primary outcome was all-cause in-hospital mortality during the index hospitalization. For exploratory score derivation, the dataset was randomly divided into a derivation subset (75%; n = 1200) and a hold-out assessment subset (25%; n = 400). Predictors were explored using univariable and multivariable logistic regression with stepwise selection. Continuous variables were categorized using Weight of Evidence binning, and an integer point score was derived. Performance was summarized using ROC analysis, AUC, sensitivity, specificity, and accuracy. Given the small number of deaths and the data-driven modelling workflow, all performance estimates were considered preliminary rather than definitive internal validation. Results: The exploratory six-variable score included age >/= 57 years, estimated glomerular filtration rate < 45 mL/min/1.73 m(2), body mass index >/= 25 kg/m(2), troponin I >/= 100, prior myocardial infarction, and current smoking. In the derivation subset, each additional point was associated with higher odds of mortality (OR 1.39; 95% CI 1.29-1.51; p < 0.001), and the AUC was 0.654. A Youden-index threshold of approximately 6 points yielded sensitivity of 0.41, specificity of 0.80, and accuracy of 0.72. In the hold-out assessment subset, sensitivity was 0.53, specificity was 0.70, accuracy was 0.70, and AUC was 0.61. These estimates indicate modest discrimination and should be interpreted cautiously because only 36 outcome events were available. Conclusions: This exploratory clinical score showed modest discrimination for all-cause in-hospital mortality and should be regarded as a preliminary, hypothesis-generating risk-stratification approach. It is not sufficiently validated for routine prognostic classification, platelet-reactivity triage, or antiplatelet treatment selection. Model redevelopment using event-efficient methods, resampling-based internal validation, and subsequent external validation are required before clinical implementation. FAU - Nurmukhammad, Friba AU - Nurmukhammad F AUID- ORCID: 0000-0002-6312-4479 AD - Faculty of Postgraduate Medical Education, Khoja Akhmet Yassawi International Kazakh-Turkish University, Turkestan 161200, Kazakhstan. FAU - Zhangelova, Sholpan AU - Zhangelova S AUID- ORCID: 0000-0003-3702-5642 AD - Department of Internal Diseases, School of General Medicine, Asfendiyarov Kazakh National Medical University, Almaty 050012, Kazakhstan. FAU - Sugraliyev, Akhmetzhan AU - Sugraliyev A AUID- ORCID: 0000-0002-8255-4159 AD - Department of Internal Diseases, School of General Medicine, Asfendiyarov Kazakh National Medical University, Almaty 050012, Kazakhstan. FAU - Arutyunov, Alexander AU - Arutyunov A AUID- ORCID: 0000-0003-1180-3549 AD - Department of Internal Diseases, School of General Medicine, Asfendiyarov Kazakh National Medical University, Almaty 050012, Kazakhstan. FAU - Kuatbayev, Yermagambet AU - Kuatbayev Y AD - City Cardiology Center, Almaty 050012, Kazakhstan. FAU - Mukanova, Zhanetta AU - Mukanova Z AUID- ORCID: 0000-0001-5272-1190 AD - Department of Internal Diseases, School of General Medicine, Asfendiyarov Kazakh National Medical University, Almaty 050012, Kazakhstan. FAU - Kapsultanova, Dina AU - Kapsultanova D AUID- ORCID: 0000-0003-1449-4438 AD - Department of Internal Diseases, School of General Medicine, Asfendiyarov Kazakh National Medical University, Almaty 050012, Kazakhstan. LA - eng PT - Journal Article DEP - 20260814 PL - Switzerland TA - Clin Pract JT - Clinics and practice JID - 101563282 PMC - PMC13511506 OTO - NOTNLM OT - clinical risk stratification OT - clopidogrel OT - coronary artery disease OT - dual antiplatelet therapy OT - exploratory risk score OT - in-hospital mortality OT - percutaneous coronary intervention COIS- The authors declare no conflicts of interest. EDAT- 2026/08/26 17:36 MHDA- 2026/08/26 17:37 PMCR- 2026/08/14 CRDT- 2026/08/26 11:08 PHST- 2026/07/01 00:00 [received] PHST- 2026/08/03 00:00 [revised] PHST- 2026/08/12 00:00 [accepted] PHST- 2026/08/26 17:37 [medline] PHST- 2026/08/26 17:36 [pubmed] PHST- 2026/08/26 11:08 [entrez] PHST- 2026/08/14 00:00 [pmc-release] AID - clinpract16080149 [pii] AID - clinpract-16-00149 [pii] AID - 10.3390/clinpract16080149 [doi] PST - epublish SO - Clin Pract. 2026 Aug 14;16(8):149. doi: 10.3390/clinpract16080149. PMID- 42595519 OWN - NLM STAT- MEDLINE DCOM- 20260813 LR - 20260814 IS - 0253-3758 (Print) IS - 0253-3758 (Linking) VI - 54 IP - 8 DP - 2026 Aug 24 TI - [Development and validation of a prediction score for gastrointestinal bleeding following percutaneous coronary intervention in East Asian patients with acute coronary syndrome]. PG - 933-941 LID - 10.3760/cma.j.cn112148-20260105-00010 [doi] AB - Objective: To develop and validate a risk scoring system for post-percutaneous coronary intervention (PCI) gastrointestinal bleeding in East Asian patients with acute coronary syndrome (ACS) based on the Fine-Gray model. Methods: This post-hoc analysis was performed on the BleeMACS international multicenter registry study. Patients with ACS undergoing PCI from 15 hospitals across 10 countries between November 2003 and June 2014 were enrolled and stratified into the East Asian group (China and Japan) and the non-East Asian group (other countries). The Fine-Gray model was used to screen predictors and construct an integer-based risk scoring system, with LASSO competing-risk regression for sensitivity analysis. The primary endpoint was gastrointestinal bleeding within 1 year after discharge, with death treated as a competing risk event. Bootstrap resampling was applied for internal validation. Calibration performance was assessed using calibration slope, intercept, and expected-to-observed (E/O) risk ratio. Risk stratification was performed using the Aalen-Johansen cumulative incidence function curve and Gray's test. The temporal distribution of bleeding events was analyzed, and subgroup analyses were conducted according to sex, diabetes mellitus, chronic kidney disease, and dual antiplatelet therapy (DAPT) status. Results: A total of 15 401 ACS patients were enrolled, with an age of (63.6+/-12.7) years and 3 592 females (23.32%). There were 2 332 patients in the East Asian group and 13 069 in the non-East Asian group. The final model incorporated seven predictors: admission hemoglobin (subdistribution hazard ratio (SHR)=0.82, 95%CI 0.74-0.90), age (SHR=1.02, 95%CI 1.01-1.04), hypertension (SHR=1.57, 95%CI 1.10-2.25), history of heart failure (SHR=1.97, 95%CI 1.08-3.57), peptic ulcer (SHR=3.25, 95%CI 1.41-7.52), proton-pump inhibitor use (SHR=1.54, 95%CI 1.12-2.12), and bleeding history (SHR=1.65, 95%CI 0.98-2.78). The bootstrap-corrected C-index was 0.693 (95%CI 0.652-0.738), with a calibration slope of 0.969 and an E/O ratio of 0.99, indicating favorable overall calibration performance. Risk stratification showed that the bleeding risk in the high-risk group was 3.93 times that in the low-risk group in the overall cohort. For the East Asian group, Gray's test P=0.116, with no significant difference among risk strata. The trend of bleeding risk was consistent with that of the overall cohort, and the ratio of cumulative bleeding risk between the high-and low-risk subgroups was 2.72 in the East Asian group. During the 1-year follow-up, 160 cases of post-PCI gastrointestinal bleeding occurred. The cumulative incidence was higher in East Asian patients than in non-East Asian patients (34 cases (1.46%) vs. 126 cases (0.96%)), with a higher proportion of late bleeding events (181-365 days) (14 cases (41.2%) vs. 41 cases (32.5%)). Subgroup analyses demonstrated stable risk stratification and good calibration performance across clinical subgroups. Conclusions: The gastrointestinal bleeding risk scoring system established in this study exhibits acceptable discrimination and excellent calibration, with stable performance in East Asian populations and various clinical subgroups. East Asian ACS patients have a higher incidence of post-PCI gastrointestinal bleeding with persistent late risk, indicating the need for prolonged monitoring and individualized antithrombotic therapy strategies. FAU - Zheng, W AU - Zheng W AD - Center for Coronary Artery Disease, Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China. FAU - Gong, Z T AU - Gong ZT AD - Center for Coronary Artery Disease, Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China. FAU - Li, X AU - Li X AD - Center for Coronary Artery Disease, Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China. FAU - Yan, H Y AU - Yan HY AD - Center for Coronary Artery Disease, Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China. FAU - Yan, Y AU - Yan Y AD - Research Ward, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China. FAU - Qian, H Y AU - Qian HY AD - Center for Coronary Artery Disease, Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China. LA - chi GR - 2024AZB1004, 2025AZB5003/High-level Research Special Project of the National Clinical Research Center for Cardiovascular Diseases of Beijing Anzhen Hospital/ GR - PX2025020/Beijing Municipal Administration of Hospitals Incubating Program/ GR - BRWEP2024W012060111/Beijing Research-Oriented Ward Excellence Clinical Research Program/ GR - 26G10379, 7264260/Natural Science Foundation of Beijing Municipality/ PT - English Abstract PT - Journal Article PT - Validation Study PL - China TA - Zhonghua Xin Xue Guan Bing Za Zhi JT - Zhonghua xin xue guan bing za zhi JID - 7910682 SB - IM MH - Aged MH - Female MH - Humans MH - Male MH - *Acute Coronary Syndrome/surgery MH - East Asian People MH - *Gastrointestinal Hemorrhage/etiology MH - *Percutaneous Coronary Intervention/adverse effects MH - Risk Assessment MH - Risk Factors COIS- 所有作者声明无利益冲突 EDAT- 2026/08/13 23:36 MHDA- 2026/08/13 23:37 CRDT- 2026/08/13 21:53 PHST- 2026/08/13 23:37 [medline] PHST- 2026/08/13 23:36 [pubmed] PHST- 2026/08/13 21:53 [entrez] AID - 10.3760/cma.j.cn112148-20260105-00010 [doi] PST - ppublish SO - Zhonghua Xin Xue Guan Bing Za Zhi. 2026 Aug 24;54(8):933-941. doi: 10.3760/cma.j.cn112148-20260105-00010. PMID- 42524114 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260729 LR - 20260813 IS - 1011-6842 (Print) IS - 1011-6842 (Linking) VI - 42 IP - 4 DP - 2026 Jul TI - Clinical Outcomes of Intravascular Lithotripsy for Severely Calcified Coronary Lesions: A Single-Center Study. PG - 551-561 LID - 10.6515/ACS.202607_42(4).20251124E [doi] AB - BACKGROUND: Intravascular lithotripsy (IVL) is an emerging calcium modification technique designed to optimize stent expansion in patients with severely calcified coronary artery disease. While clinical trials support its efficacy, real-world data from Asia remain limited. OBJECTIVES: To evaluate the procedural success, safety, and 1-year clinical outcomes of IVL in a single-center Taiwanese cohort. METHODS: This retrospective single-center cohort study enrolled patients undergoing IVL for complex calcified coronary lesions between November 2022 and October 2024. RESULTS: The 1-year MACE rate was 13.6% (raw proportion), driven by cardiac death (1.5%), myocardial infarction (4.5%), ischemia-driven target vessel revascularization (7.6%), and prior in-stent restenosis requiring repeat revascularization (3.0%). The Kaplan-Meier-estimated 1-year cumulative incidence of MACEs was 14.9%. Subgroup analyses showed significantly higher MACE and revascularization rates in patients with end-stage renal disease (ESRD) (p = 0.004, 0.012) and in non-bifurcation lesions (p = 0.014). Multivariable analysis identified ESRD as an independent predictor of MACEs (hazard ratio [HR]: 5.790, p = 0.004) and revascularization (HR: 7.233, p = 0.015); stent under-expansion was also independently associated with revascularization (HR: 7.030, p = 0.010). These findings highlight the clinical performance of IVL and key predictors of adverse outcomes. CONCLUSIONS: IVL appears to be safe and effective for managing complex calcified coronary lesions. Outcomes in this study were influenced by renal dysfunction and stent expansion. FAU - Huang, Chien-Po AU - Huang CP AD - Heart Center, Cheng Hsin General Hospital. FAU - Tsao, Tien-Ping AU - Tsao TP AD - Heart Center, Cheng Hsin General Hospital. AD - Faculty of Medicine, National Defense Medical Center, Taipei, Taiwan. FAU - Fu, Hao-Neng AU - Fu HN AD - Heart Center, Cheng Hsin General Hospital. FAU - Teng, Hsin-I AU - Teng HI AD - Heart Center, Cheng Hsin General Hospital. AD - Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University. FAU - Kao, Yu-Cheng AU - Kao YC AD - Heart Center, Cheng Hsin General Hospital. FAU - Jen, Hsu-Lung AU - Jen HL AD - Heart Center, Cheng Hsin General Hospital. FAU - Yin, Wei-Hsian AU - Yin WH AD - Heart Center, Cheng Hsin General Hospital. AD - Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University. LA - eng PT - Journal Article PL - China (Republic : 1949- ) TA - Acta Cardiol Sin JT - Acta Cardiologica Sinica JID - 101687085 PMC - PMC13409420 OTO - NOTNLM OT - Calcium modification OT - Coronary artery disease OT - Intravascular lithotripsy OT - Major adverse cardiovascular events OT - Stent expansion COIS- All the authors declare no conflict of interest. EDAT- 2026/07/29 13:54 MHDA- 2026/07/29 13:55 PMCR- 2026/07/01 CRDT- 2026/07/29 10:26 PHST- 2025/04/20 00:00 [received] PHST- 2025/11/24 00:00 [accepted] PHST- 2026/07/29 13:55 [medline] PHST- 2026/07/29 13:54 [pubmed] PHST- 2026/07/29 10:26 [entrez] PHST- 2026/07/01 00:00 [pmc-release] AID - 10.6515/ACS.202607_42(4).20251124E [doi] PST - ppublish SO - Acta Cardiol Sin. 2026 Jul;42(4):551-561. doi: 10.6515/ACS.202607_42(4).20251124E. PMID- 42516021 OWN - NLM STAT- MEDLINE DCOM- 20261014 LR - 20261016 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 108 IP - 4 DP - 2026 Oct TI - One-Year Outcomes of High-Risk Percutaneous Coronary Interventions With Versus Without Mechanical Circulatory Support: Propensity Score-Matched Analysis. PG - 1268-1275 LID - 10.1002/ccd.70749 [doi] AB - BACKGROUND: Impella is increasingly used as mechanical circulatory support (MCS) during high-risk percutaneous coronary interventions (HR-PCI). Registry-based data provide insights into the efficacy and safety of Impella-assisted HR-PCI. AIMS: We aimed to evaluate 1-year outcomes of Impella-assisted HR-PCI compared to HR-PCI without MCS. METHODS: One hundred and thirty-eight patients undergoing Impella-assisted PCI, included in the IMPELLA-PL registry, were propensity score-matched with controls from the retrospective CardioSilesia registry who underwent HR-PCI without MCS. Study endpoints included 1-year post-discharge all-cause mortality, myocardial infarction (MI), stroke, rehospitalization for heart failure (HF), and repeat coronary revascularization. RESULTS: Clinical and angiographic characteristics were comparable in both groups, with higher rates of dyslipidemia (78.3% vs. 37.7%, p < 0.001), chronic kidney disease (39.9% vs. 16.7%, p < 0.001), and peripheral artery disease (34.1% vs. 8.0%, p < 0.001) in the IMPELLA-PL cohort. Intravascular ultrasound was more frequently used in the Impella-supported patients (44.2% vs. 25.4%, p = 0.002), while staged revascularization was more common among controls (30.4% vs. 15.9%, p = 0.007). At 1 year, rates of post-discharge all-cause mortality, stroke, and repeat coronary revascularization were similar in both groups. MI was less frequent in the IMPELLA-PL cohort (1.4% vs. 10.9%, p = 0.003), alongside a trend toward lower incidence of rehospitalizations for HF (9.4% vs. 18.1%, p = 0.055). CONCLUSIONS: Despite an unfavorable cardiovascular risk profile, patients who underwent Impella-assisted HR-PCI had similar 1-year post-discharge survival, with a lower rate of MI, compared to propensity score-matched controls who underwent HR-PCI without MCS. Impella may improve HR-PCI outcomes in selected patients, but further randomized controlled trials are required to confirm this finding. CI - (c) 2026 Wiley Periodicals LLC. FAU - Gasecka, Aleksandra AU - Gasecka A AD - 1st Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland. FAU - Pietrasik, Arkadiusz AU - Pietrasik A AD - 1st Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland. FAU - Pawlowski, Tomasz AU - Pawlowski T AD - National Medical Institute of the Ministry of the Interior and Administration, Warsaw, Poland. FAU - Zimodro, Jakub Michal AU - Zimodro JM AUID- ORCID: 0000-0002-2405-8982 AD - 1st Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland. FAU - Ciesla, Daniel AU - Ciesla D AD - Department of Science and New Technologies, Silesian Center for Heart Diseases, Zabrze, Poland. FAU - Sacha, Jerzy AU - Sacha J AUID- ORCID: 0000-0001-7504-7506 AD - Department of Cardiology, University Hospital in Opole, Opole, Poland. AD - Faculty of Physical Education and Physiotherapy, Opole University of Technology, Opole, Poland. FAU - Grygier, Marek AU - Grygier M AD - 1st Department of Cardiology, Poznan University of Medical Sciences, Poznan, Poland. FAU - Kochman, Janusz AU - Kochman J AD - 1st Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland. FAU - Tajstra, Mateusz AU - Tajstra M AD - 3rd Department of Cardiology, School of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland. FAU - Dyrbus, Krzysztof AU - Dyrbus K AD - 3rd Department of Cardiology, School of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland. FAU - Wojakowski, Wojciech AU - Wojakowski W AD - Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland. FAU - Mizia-Stec, Katarzyna AU - Mizia-Stec K AUID- ORCID: 0000-0001-6907-2799 AD - 1st Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland. FAU - Swiatkowski, Andrzej AU - Swiatkowski A AD - Department of Cardiology, Congenital Heart Disease and Electrotherapy, Silesian Center for Heart Diseases, Medical University of Silesia, Zabrze, Poland. FAU - Francuz, Pawel AU - Francuz P AD - Department of Cardiology, Congenital Heart Disease and Electrotherapy, Silesian Center for Heart Diseases, Medical University of Silesia, Zabrze, Poland. FAU - Kalarus, Zbigniew AU - Kalarus Z AD - Department of Cardiology, Congenital Heart Disease and Electrotherapy, Silesian Center for Heart Diseases, Medical University of Silesia, Zabrze, Poland. FAU - Smolka, Grzegorz AU - Smolka G AUID- ORCID: 0000-0003-2031-822X AD - Department of Cardiology, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland. FAU - Gasior, Mariusz AU - Gasior M AD - 3rd Department of Cardiology, School of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland. LA - eng GR - 69829335/Abiomed, Aachen, Germany/ PT - Comparative Study PT - Journal Article PT - Observational Study DEP - 20260728 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Humans MH - Female MH - Male MH - *Heart-Assist Devices MH - Treatment Outcome MH - Time Factors MH - Registries MH - Aged MH - *Percutaneous Coronary Intervention/adverse effects/mortality/instrumentation MH - Risk Factors MH - Retrospective Studies MH - Risk Assessment MH - *Coronary Artery Disease/therapy/mortality/diagnostic imaging/physiopathology MH - Propensity Score MH - Middle Aged MH - Patient Readmission MH - Heart Failure/therapy/mortality/physiopathology MH - Myocardial Infarction/mortality/etiology MH - Stroke/etiology/mortality MH - Aged, 80 and over OTO - NOTNLM OT - Impella OT - high-risk percutaneous coronary intervention OT - mechanical circulatory support EDAT- 2026/07/28 06:37 MHDA- 2026/10/14 18:14 CRDT- 2026/07/28 03:22 PHST- 2026/05/27 00:00 [revised] PHST- 2025/10/13 00:00 [received] PHST- 2026/07/09 00:00 [accepted] PHST- 2026/10/14 18:14 [medline] PHST- 2026/07/28 06:37 [pubmed] PHST- 2026/07/28 03:22 [entrez] AID - 10.1002/ccd.70749 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2026 Oct;108(4):1268-1275. doi: 10.1002/ccd.70749. Epub 2026 Jul 28. PMID- 42500622 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260725 LR - 20260813 IS - 2491-0929 (Electronic) IS - 2426-3958 (Print) IS - 2426-3958 (Linking) VI - 12 IP - 2 DP - 2026 Jul TI - ACEF score and its predictive performance in coronary artery disease patients undergoing PCI: a systematic review and meta-analysis of the C-statistic. PG - e146-e155 LID - 10.4244/AIJ-D-25-00031 [doi] AB - BACKGROUND: Despite being minimally invasive, percutaneous coronary intervention (PCI) presents challenges, especially regarding major adverse cardiovascular events (MACE), which typically occur within the first year after intervention. Furthermore, many existing MACE prediction models are complex and challenging to apply in clinical practice. AIMS: This study evaluated the simple Age, Creatinine, Ejection Fraction (ACEF) score for predicting outcomes in coronary artery disease patients undergoing PCI. METHODS: A meta-analysis of randomised controlled trials (RCTs) and cohort studies was conducted using six prominent databases. Predictive performance was assessed with the C-statistic, with MACE as the primary endpoint and mortality and ACEF modifications as secondary endpoints. Outcomes reported in at least two studies were included. RESULTS: Twenty studies involving 41,255 patients were analysed, including three RCTs and eight multicentre studies. Key findings include the following: (1) the ACEF score showed good discrimination for <=30-day MACE (area under the curve [AUC] 0.71), (2) it demonstrated stronger predictive ability for both cardiac mortality (AUC 0.75 at 2 years) and all-cause mortality (AUC 0.82 at <=30 days), and (3) its performance was comparable to more complex scores, such as the modified ACEF (mACEF), the Age, Glomerular filtration rate, Ejection Fraction (AGEF), and the clinical SYNTAX scores. CONCLUSIONS: Adhering to the law of parsimony, the ACEF score is a straightforward tool based on objectively measured variables. The ACEF score effectively predicts MACE and mortality at <=30 days in PCI patients. Its simplicity and accessibility highlight its value as a practical tool for clinical risk stratification. (PROSPERO Identifier CRD42024558580). FAU - Rasti, Shinta Dewi AU - Rasti SD AD - Department of Cardiology and Vascular Medicine, Dr. Soetomo General Hospital, Faculty of Medicine, University of Airlangga, Surabaya, Indonesia. FAU - Fagi, Rosi Amrilla AU - Fagi RA AD - Department of Cardiology and Vascular Medicine, Dr. Soetomo General Hospital, Faculty of Medicine, University of Airlangga, Surabaya, Indonesia. FAU - Arvianti, Militanisa Zamzara AU - Arvianti MZ AD - Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia. FAU - Sugiarto, Adra Achirultan Ramainaldo AU - Sugiarto AAR AD - Faculty of Medicine, University of Airlangga, Surabaya, Indonesia. FAU - Nuryandi, Audia Putri Amalia AU - Nuryandi APA AD - Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia. FAU - Istifarina, Rizky AU - Istifarina R AD - Department of Cardiology and Vascular Medicine, Dr. Soetomo General Hospital, Faculty of Medicine, University of Airlangga, Surabaya, Indonesia. FAU - Pragitara, Chiquita Febby AU - Pragitara CF AD - Faculty of Medicine, University of Airlangga, Surabaya, Indonesia. FAU - Yomara, Romadhana Trisnha AU - Yomara RT AD - Department of Cardiology and Vascular Medicine, Dr. Soetomo General Hospital, Faculty of Medicine, University of Airlangga, Surabaya, Indonesia. FAU - Oktaviono, Yudi Her AU - Oktaviono YH AD - Department of Cardiology and Vascular Medicine, Dr. Soetomo General Hospital, Faculty of Medicine, University of Airlangga, Surabaya, Indonesia. LA - eng PT - Journal Article DEP - 20260730 PL - France TA - AsiaIntervention JT - AsiaIntervention JID - 101697313 PMC - PMC13397422 COIS- The authors have no conflicts of interest to declare regarding the contents herein. EDAT- 2026/07/25 06:36 MHDA- 2026/07/25 06:37 PMCR- 2026/07/30 CRDT- 2026/07/25 05:05 PHST- 2025/06/06 00:00 [received] PHST- 2026/03/12 00:00 [accepted] PHST- 2026/07/25 06:37 [medline] PHST- 2026/07/25 06:36 [pubmed] PHST- 2026/07/25 05:05 [entrez] PHST- 2026/07/30 00:00 [pmc-release] AID - 10.4244/AIJ-D-25-00031 [doi] PST - epublish SO - AsiaIntervention. 2026 Jul 30;12(2):e146-e155. doi: 10.4244/AIJ-D-25-00031. eCollection 2026 Jul. PMID- 42462211 OWN - NLM STAT- MEDLINE DCOM- 20260717 LR - 20260813 IS - 1438-8871 (Electronic) IS - 1439-4456 (Print) IS - 1438-8871 (Linking) VI - 28 DP - 2026 Jul 16 TI - Machine Learning Analysis of Sex Differences in Cardiovascular-Kidney-Metabolic Risk Factors and Prognosis Among Patients With Moderate-to-Severe Coronary Artery Calcification: Prospective Cohort Study. PG - e82742 LID - 10.2196/82742 [doi] LID - e82742 AB - BACKGROUND: Patients with coronary artery calcification exhibit notable sex differences in clinical presentation, particularly concerning the role of cardiovascular-kidney-metabolic (CKM) risk factors and their impact on prognoses. However, the precise nature of these sex-specific differences remains incompletely understood. OBJECTIVE: This study aimed to investigate sex disparities in CKM risk factors among patients with moderate-to-severe coronary artery calcification (MSCAC) and elucidate their association with adverse clinical outcomes. METHODS: A total of 2418 patients with MSCAC undergoing their first percutaneous coronary intervention were included. Hazard ratios (HRs) were computed to evaluate sex differences in the prognostic significance of various CKM risk factors, including chronic kidney disease (CKD), diabetes mellitus (DM), obesity, hypertension, and hypertriglyceridemia. Four machine learning models-logistic regression, extreme gradient boosting (XGBoost), random forest, and support vector machine-were constructed to predict adverse events. The best-performing model was interpreted using Shapley additive explanations (SHAP) values to identify the relative importance of CKM risk factors and clarify potential sex disparities. Major adverse cardiovascular events (MACEs) were defined as all-cause mortality, nonfatal myocardial infarction, and unplanned repeat revascularization. RESULTS: Among the participants, 86.9% (2101/2418) had >/=1 CKM risk factor, while 3.1% (74/2418) had >/=4 risk factors. CKD was independently associated with the occurrence of MACEs in both female patients (HR 2.65, 95% CI 1.50-4.69) and male patients (HR 1.53, 95% CI 1.02-2.60). Notably, the association was stronger in female patients, with a female-to-male multivariate-adjusted HR ratio for CKD of 1.68 (95% CI 1.04-2.97). DM was also associated with MACEs in both sexes, with adjusted HRs of 1.20 (95% CI 1.02-1.92) in female patients and 1.59 (95% CI 1.19-2.12) in male patients. Among the models evaluated, XGBoost demonstrated the highest predictive performance in the test set (area under the curve 0.92; average precision 0.92; F(1)-score=0.86). XGBoost maintained good predictive performance in the external validation cohort (area under the curve 0.86; average precision 0.71; F(1)-score=0.68). Baseline DM was identified as the CKM risk factor with the highest feature importance for MACEs, with SHAP values of 0.17 in female patients and 0.23 in male patients. Conversely, CKD emerged as the most important CKM risk factor in female patients (SHAP value 0.18), while DM ranked highest in male participants. CONCLUSIONS: This study confirmed that CKM risk factors and their influence on prognosis in patients with MSCAC exhibit significant sex differences. The application of machine learning, particularly XGBoost, facilitates a deeper understanding of these disparities and provides a basis for personalized, sex-specific risk assessment and targeted interventions for patients with MSCAC. CI - (c)Zixiang Ye, Enmin Xie, Zhangyu Lin, Chenxi Song, Rui Zhang, Hao-Yu Wang, Shanshan Shi, Zhiyong Zhao, Hao Wang, Lei Feng, Kefei Dou. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 16.07.2026. FAU - Ye, Zixiang AU - Ye Z AUID- ORCID: 0000-0003-2500-6807 AD - Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. AD - State Key Laboratory of Cardiovascular Disease, Beijing, China. AD - Cardiometabolic Medicine Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Xie, Enmin AU - Xie E AUID- ORCID: 0000-0002-0767-7407 AD - Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. AD - State Key Laboratory of Cardiovascular Disease, Beijing, China. AD - Cardiometabolic Medicine Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Lin, Zhangyu AU - Lin Z AUID- ORCID: 0000-0001-9240-9724 AD - Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. AD - State Key Laboratory of Cardiovascular Disease, Beijing, China. AD - Cardiometabolic Medicine Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Song, Chenxi AU - Song C AUID- ORCID: 0009-0008-1367-4561 AD - Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. AD - State Key Laboratory of Cardiovascular Disease, Beijing, China. AD - Cardiometabolic Medicine Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Zhang, Rui AU - Zhang R AUID- ORCID: 0000-0003-2593-1664 AD - Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. AD - State Key Laboratory of Cardiovascular Disease, Beijing, China. AD - Cardiometabolic Medicine Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Wang, Hao-Yu AU - Wang HY AUID- ORCID: 0000-0002-5634-0966 AD - Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. AD - State Key Laboratory of Cardiovascular Disease, Beijing, China. AD - Cardiometabolic Medicine Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Shi, Shanshan AU - Shi S AUID- ORCID: 0000-0003-4970-3615 AD - Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. AD - State Key Laboratory of Cardiovascular Disease, Beijing, China. AD - Cardiometabolic Medicine Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Zhao, Zhiyong AU - Zhao Z AUID- ORCID: 0000-0002-7633-0036 AD - Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. AD - State Key Laboratory of Cardiovascular Disease, Beijing, China. AD - Cardiometabolic Medicine Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Wang, Hao AU - Wang H AUID- ORCID: 0009-0005-2087-755X AD - Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. AD - State Key Laboratory of Cardiovascular Disease, Beijing, China. AD - Cardiometabolic Medicine Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Feng, Lei AU - Feng L AUID- ORCID: 0009-0007-8931-3781 AD - Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. AD - State Key Laboratory of Cardiovascular Disease, Beijing, China. AD - Cardiometabolic Medicine Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Dou, Kefei AU - Dou K AUID- ORCID: 0000-0002-8372-6338 AD - Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. AD - State Key Laboratory of Cardiovascular Disease, Beijing, China. AD - Cardiometabolic Medicine Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. LA - eng PT - Journal Article DEP - 20260716 PL - Canada TA - J Med Internet Res JT - Journal of medical Internet research JID - 100959882 SB - IM MH - Humans MH - Male MH - Female MH - Prognosis MH - *Machine Learning MH - Risk Factors MH - Prospective Studies MH - *Coronary Artery Disease MH - Middle Aged MH - Sex Factors MH - Aged MH - Boosting Machine Learning Algorithms MH - Sex Characteristics MH - *Vascular Calcification MH - Renal Insufficiency, Chronic MH - Random Forest PMC - PMC13424754 OTO - NOTNLM OT - cardiovascular-kidney-metabolic risk factors OT - coronary artery calcification OT - extreme gradient boosting OT - prognosis OT - sex difference COIS- Conflicts of Interest: None declared. EDAT- 2026/07/16 18:46 MHDA- 2026/07/17 12:41 PMCR- 2026/07/16 CRDT- 2026/07/16 16:53 PHST- 2025/08/21 00:00 [received] PHST- 2026/06/24 00:00 [accepted] PHST- 2026/05/26 00:00 [revised] PHST- 2026/07/17 12:41 [medline] PHST- 2026/07/16 18:46 [pubmed] PHST- 2026/07/16 16:53 [entrez] PHST- 2026/07/16 00:00 [pmc-release] AID - v28i1e82742 [pii] AID - 10.2196/82742 [doi] PST - epublish SO - J Med Internet Res. 2026 Jul 16;28:e82742. doi: 10.2196/82742. PMID- 42420851 OWN - NLM STAT- MEDLINE DCOM- 20261001 LR - 20261003 IS - 1471-2261 (Electronic) IS - 1471-2261 (Linking) VI - 26 IP - 1 DP - 2026 Jul 8 TI - Impact of below-the-knee runoff in patients undergoing drug-coated balloon angioplasty for femoropopliteal disease: a propensity score-matched analysis. LID - 10.1186/s12872-026-06193-x [doi] LID - 860 AB - BACKGROUND: In a real-world setting, the impact of below-the-knee (BTK) runoff status on outcomes following drug-coated balloon (DCB) treatment for femoropopliteal (FP) lesions remains insufficiently studied, and robust evidence is still lacking. METHODS: Between 2021 and 2024, a total of 1,574 patients undergoing drug-coated balloon (DCB) treatment for femoropopliteal arterial occlusive disease were retrospectively identified from 9 centers in China. Propensity score matching was applied to minimize baseline imbalances, resulting in 155 matched pairs for subsequent analysis. Outcome measures included 12-month amputation-free survival (AFS), freedom from clinically driven target lesion revascularization (CD-TLR), all-cause mortality, major adverse event rate, and amputation rate. Predictors of 12-month AFS were also analyzed. RESULTS: The mean age was 69.82 +/- 9.16 years, and 78.06% of patients were male. Hypertension (71.61%), diabetes mellitus (65.48%), and hyperlipidemia (27.10%) were the predominant comorbid conditions observed in the study population. The incidence of coronary artery disease and chronic kidney disease (CKD) was 22.58% and 17.10%, respectively. The mean lesion length was 19.12 +/- 11.19 cm, with 56.77% being chronic total occlusions. Kaplan-Meier analysis revealed that the 12-month AFS was 93.67% in the group with 2-3 patent BTK arteries versus 84.93% in the group with 1 patent BTK artery, a statistically significant difference (log-rank test P = 0.028). In the overall cohort, univariable analysis indicated that renal insufficiency, chronic limb-threatening ischemia (CLTI), lesion length, concomitant BTK intervention, and preprocedural BTK runoff status were significantly associated with AFS. In the multivariable model, renal insufficiency, CLTI, and preprocedural BTK runoff status remained independent predictors of AFS. CONCLUSION: In this multicenter real-world study, preprocedural BTK runoff status was associated with amputation-free survival after DCB treatment for femoropopliteal lesions. Compared with patients with a single patent BTK vessel, those with two or three patent BTK runoff vessels showed a lower event risk across different clinical and anatomical subgroups. These findings suggest that preprocedural BTK runoff status may serve as an important reference for risk stratification and prognostic assessment after DCB treatment. TRIAL REGISTRATION: ClinicalTrials.gov, NCT04826705. CI - (c) 2026. The Author(s). FAU - Li, Chunbo AU - Li C AUID- ORCID: 0009-0000-1858-1593 AD - Wound Repair Center, Hubei Provincial Clinical Research Center for Chronic Wound and Diabetic Foot, Liyuan Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. FAU - Zhu, Youpeng AU - Zhu Y AUID- ORCID: 0009-0001-6202-8071 AD - Wound Repair Center, Hubei Provincial Clinical Research Center for Chronic Wound and Diabetic Foot, Liyuan Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. FAU - Yang, Wenbo AU - Yang W AUID- ORCID: 0009-0002-5004-5226 AD - Wound Repair Center, Hubei Provincial Clinical Research Center for Chronic Wound and Diabetic Foot, Liyuan Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. FAU - Du, Ye AU - Du Y AUID- ORCID: 0009-0008-2821-615X AD - Wound Repair Center, Hubei Provincial Clinical Research Center for Chronic Wound and Diabetic Foot, Liyuan Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. FAU - Song, Qiong AU - Song Q AUID- ORCID: 0009-0004-7375-3561 AD - Wound Repair Center, Hubei Provincial Clinical Research Center for Chronic Wound and Diabetic Foot, Liyuan Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. FAU - Wang, Tingyu AU - Wang T AUID- ORCID: 0009-0006-7491-6152 AD - Wound Repair Center, Hubei Provincial Clinical Research Center for Chronic Wound and Diabetic Foot, Liyuan Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. FAU - Wang, Xinyuan AU - Wang X AUID- ORCID: 0009-0006-1492-2710 AD - Wound Repair Center, Hubei Provincial Clinical Research Center for Chronic Wound and Diabetic Foot, Liyuan Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. FAU - Li, Leixin AU - Li L AUID- ORCID: 0009-0005-0369-2705 AD - Wound Repair Center, Hubei Provincial Clinical Research Center for Chronic Wound and Diabetic Foot, Liyuan Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. FAU - Feng, Zibo AU - Feng Z AUID- ORCID: 0000-0002-3944-3605 AD - Wound Repair Center, Hubei Provincial Clinical Research Center for Chronic Wound and Diabetic Foot, Liyuan Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. fengzibo@hust.edu.cn. LA - eng SI - ClinicalTrials.gov/NCT04826705 GR - No. 2023LYYYKYPT0001/Research Fund of Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology/ PT - Journal Article PT - Multicenter Study PT - Observational Study DEP - 20260708 PL - England TA - BMC Cardiovasc Disord JT - BMC cardiovascular disorders JID - 100968539 RN - 0 (Coated Materials, Biocompatible) RN - 0 (Cardiovascular Agents) SB - IM MH - Humans MH - *Peripheral Arterial Disease/physiopathology/therapy/diagnostic imaging/mortality MH - *Popliteal Artery/physiopathology/diagnostic imaging MH - *Femoral Artery/physiopathology/diagnostic imaging MH - Male MH - *Coated Materials, Biocompatible MH - Risk Factors MH - Female MH - Time Factors MH - *Angioplasty, Balloon/adverse effects/instrumentation/mortality MH - Retrospective Studies MH - Aged MH - Risk Assessment MH - Propensity Score MH - *Cardiovascular Agents/administration & dosage/adverse effects MH - Progression-Free Survival MH - *Vascular Access Devices MH - Amputation, Surgical MH - Middle Aged MH - China MH - Vascular Patency MH - Limb Salvage MH - Treatment Outcome MH - Aged, 80 and over PMC - PMC13628843 OTO - NOTNLM OT - Below-the-knee OT - Drug-coated balloon OT - Femoropopliteal occlusive disease OT - Peripheral artery disease OT - Propensity score matching OT - Real-world study COIS- Declarations. Ethics approval and consent to participate: The PROMISING registry protocol was conducted in accordance with the Declaration of Helsinki and approved by the Medical Ethics Committee of Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology (protocol code: 2021IEC-YJ002, approval date: 11 January 2024). Written informed consent was obtained from all participants, and ethical approval was granted by the local ethics committees of each participating center. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests. EDAT- 2026/07/09 06:32 MHDA- 2026/10/01 05:30 PMCR- 2026/07/08 CRDT- 2026/07/09 00:14 PHST- 2026/04/25 00:00 [received] PHST- 2026/06/25 00:00 [accepted] PHST- 2026/10/01 05:30 [medline] PHST- 2026/07/09 06:32 [pubmed] PHST- 2026/07/09 00:14 [entrez] PHST- 2026/07/08 00:00 [pmc-release] AID - 10.1186/s12872-026-06193-x [pii] AID - 6193 [pii] AID - 10.1186/s12872-026-06193-x [doi] PST - epublish SO - BMC Cardiovasc Disord. 2026 Jul 8;26(1):860. doi: 10.1186/s12872-026-06193-x. PMID- 42368850 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260629 LR - 20260813 IS - 2297-055X (Print) IS - 2297-055X (Electronic) IS - 2297-055X (Linking) VI - 13 DP - 2026 TI - Effect of remote ischemic preconditioning on the risk of contrast-induced acute kidney injury in patients with coronary heart disease undergoing percutaneous coronary intervention. PG - 1870596 LID - 10.3389/fcvm.2026.1870596 [doi] LID - 1870596 AB - Contrast-induced acute kidney injury (CIAKI) is a frequent and clinically important complication after percutaneous coronary intervention (PCI). Despite standard preventive strategies including adequate hydration and the use of low- or iso-osmolar contrast media, the residual risk of CIAKI remains substantial. Remote ischemic preconditioning (RIPC), a non-invasive method involving brief cycles of ischemia and reperfusion applied to a limb, has been proposed as a potential strategy to mitigate ischemia-reperfusion injury, including in the kidneys. However, the impact of RIPC on the incidence of CIAKI after PCI in patients with CHD remains unclear. This study aim is to investigate the impact of RIPC on the incidence of CIAKI in patients with CHD undergoing PCI. A total of 484 patients who underwent elective PCI were enrolled and randomly assigned to either the RIPC or control group. The RIPC group received preconditioning twice daily for two days prior to PCI and once again two hours before the procedure. Renal function was assessed at baseline, 48 h, and one week post-PCI. The primary endpoint was the incidence of CIAKI, and the secondary endpoint was the occurrence of major adverse cardiac events (MACE) during the 90-day follow-up. Results showed that the incidence of CIAKI was significantly lower in the RIPC group compared to the control group (6.2% vs. 12.0%, P = 0.039), with multivariate analysis indicating RIPC as an independent protective factor for reducing CIAKI (OR = 0.338, 95% CI: 0.159-0.717, P = 0.005). However, there was no significant difference in the incidence of MACE between the two groups during the follow-up period (Log-rank chi(2) = 1.665, P = 0.126).In conclusion, RIPC appears to reduce the risk of CIAKI in patients with CHD after PCI, offering a simple, cost-effective, and non-pharmacological preventive strategy. CI - (c) 2026 Wu, Zhang and Liu. FAU - Wu, Yanmin AU - Wu Y AD - Department of Cardiology, Affiliated Hospital of Hebei University, Baoding, Hebei Province, China. FAU - Zhang, Xinxin AU - Zhang X AD - Department of Cardiology, Affiliated Hospital of Hebei University, Baoding, Hebei Province, China. FAU - Liu, Peng AU - Liu P AD - Department of Cardiology, Affiliated Hospital of Hebei University, Baoding, Hebei Province, China. LA - eng PT - Journal Article DEP - 20260612 PL - Switzerland TA - Front Cardiovasc Med JT - Frontiers in cardiovascular medicine JID - 101653388 PMC - PMC13303137 OTO - NOTNLM OT - contrast-induced acute kidney injury OT - coronary heart disease OT - percutaneous coronary intervention OT - remote ischemic preconditioning OT - risk COIS- The author(s) declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2026/06/29 12:33 MHDA- 2026/06/29 12:34 PMCR- 2026/06/12 CRDT- 2026/06/29 06:51 PHST- 2026/05/01 00:00 [received] PHST- 2026/05/24 00:00 [revised] PHST- 2026/05/27 00:00 [accepted] PHST- 2026/06/29 12:34 [medline] PHST- 2026/06/29 12:33 [pubmed] PHST- 2026/06/29 06:51 [entrez] PHST- 2026/06/12 00:00 [pmc-release] AID - 10.3389/fcvm.2026.1870596 [doi] PST - epublish SO - Front Cardiovasc Med. 2026 Jun 12;13:1870596. doi: 10.3389/fcvm.2026.1870596. eCollection 2026. PMID- 42285186 OWN - NLM STAT- MEDLINE DCOM- 20260909 LR - 20260915 IS - 1097-6809 (Electronic) IS - 0741-5214 (Linking) VI - 84 IP - 4 DP - 2026 Oct TI - A score system to determine the 5-year survival in patients with asymptomatic carotid stenosis under best medical therapy: Results from the Carotid Asymptomatic Stenosis study. PG - 912-918.e2 LID - S0741-5214(26)01217-6 [pii] LID - 10.1016/j.jvs.2026.06.003 [doi] AB - BACKGROUND: Current international guidelines do not recommend carotid revascularization in patients with asymptomatic carotid artery stenosis (ACAS) with a life expectancy less than 5 years or high-risk clinical conditions. However, improvements in medical therapy leading to a reduction of cerebral ischemic events risk may improve long-term survival. After a previous report of 5-year cerebral ischemic event outcomes in a prospective observational study of patients with ACAS treated with best medical therapy (BMT), the long-term survival in the same population was evaluated. METHODS: This was a prospective (NCT04825080; Carotid Asymptomatic Stenosis Study) observational cohort study including patients with ACAS > 60% (North American Symptomatic Carotid Endarterectomy Trial criteria) started in 2019 and ended in 2025. Patients were not considered for carotid revascularization due to high surgical risk or the absence of plaque vulnerability features. BMT was defined as regular intake of antiplatelet therapy and statins, blood pressure control, and cessation/absence of smoking. Follow-up included annual clinical visits and 6-month telephone interviews. The primary endpoint was overall survival, stratified by age (85 years). Secondary analyses aimed to identify independent predictors of mortality and to develop a mortality risk score. RESULTS: A total of 307 patients were included (mean age, 80 +/- 7 years; 55% male). Contralateral carotid stenosis > 60% was present in 61 patients (20%). At the end of follow-up, 86% of patients were under BMT. The overall transient ischemic attack /stroke rate was 1.3% per year, with higher risk for contralateral stenosis (1.9%) and plaque progression (1.8%). The overall 5-year survival rate was 80 +/- 2%, with age-related differences: 90 +/- 2% in patients 85 years (P < .001). Multivariable Cox regression identified diabetes mellitus [hazard ratio (HR), 2.2; 95% confidence interval (CI), 1.5-3.3; P < .001), chronic kidney disease (HR, 2.2; 95% CI, 1.3-3.8; P < .001), coronary artery disease (HR, 2.0; 95% CI, 1.3-3.0; P < .001), age 81 to 85 years (HR, 2.5; 95% CI, 1.5-4.1; P < .001), and age >85 years (HR, 3.5; 95% CI, 2.1-5.8; P < .001) as independent predictors of mortality. Based on these variables, a mortality score was developed: one point each for diabetes mellitus, chronic kidney disease, coronary artery disease, and age 81 to 85 years, and two points for age >85 years. Receiver-operating characteristic curve analysis identified a score >/= 3 as highly specific for patients at high risk (area under the curve, 75%). Patients with a score > 3 had significantly lower 5-year survival (52%) compared with those with a score /=60 [HGFR] mL/min). Bleeding Academic Research Consortium (BARC)-defined outcomes, Major Adverse Cardiac Events (MACEs), Intraprocedural Thrombotic Events (IPTEs), and other safety parameters were assessed in the two subgroups. RESULTS: Of 770 patients included in this post-hoc analysis, 136 (17.7%) had LGFR. These patients had a higher frequency of comorbidities, including diabetes (34.6% vs. 20.0%, p = 0.0004) and atrial fibrillation (10.3% vs. 2.4%, p = 0.0001) than those HGFR. A higher rate of LGFR patients had NSTEMI (54.4% vs. 44.5%) (p = 0.0350) and a multi-vessel coronary artery disease (67.6%) than HGFR ones (48.3%, p < 0.0001). While rates of bleeding, IPTE, and MACEs were similarly low in LGFR and HGFR patients during the 30-day observation period, a higher proportion of LGFR patients (2.2%) experienced BARC type 3-5 (moderate-severe) bleeding compared to HGFR patients (0.2%; p = 0.0188). The type and frequency of MACEs and adverse events in this fragile population were similar to those observed in the overall patients treated with cangrelor. CONCLUSIONS: These data suggest that the transition from cangrelor to any oral P2Y12 inhibitor is a safe and effective treatment in patients with acute coronary syndrome and reduced renal function undergoing PCI in the setting of routine clinical practice. CI - Copyright (c) 2026 The Authors. Published by Elsevier B.V. All rights reserved. FAU - Capranzano, Piera AU - Capranzano P AD - Cardiology Division, Policlinico Hospital, University of Catania, Catania, Italy. Electronic address: pcapranzano@gmail.com. FAU - Calabro, Paolo AU - Calabro P AD - UOC Cardiologia Clinica con UTIC. A.O.R.N. Sant'Anna e San Sebastiano, Caserta, Italy. Electronic address: paolo.calabro@unicampania.it. FAU - Musumeci, Giuseppe AU - Musumeci G AD - S.C. Cardiologia A.O. Mauriziano, Torino, Italy. Electronic address: giuseppe.musumeci@gmail.com. FAU - Di Mario, Carlo AU - Di Mario C AD - Interventistica Cardiologica Strutturale A.O.U. Careggi, Firenze, Italy. Electronic address: dimarioc@aou-careggi.toscana.it. FAU - Nicolini, Elisa AU - Nicolini E AD - UO Cardiologia Interventistica, strutturale e pediatrica, Ospedali Riuniti Ancona (AN), Italy. Electronic address: Elisa.Nicolini@ospedaliriuniti.marche.it. FAU - Mauro, Ciro AU - Mauro C AD - Cardiologia UTIC con emodinamica AORN Cardarelli Napoli (NA), Italy. Electronic address: ciro.mauro1957@gmail.com. FAU - Trani, Carlo AU - Trani C AD - UOC Interventistica Cardiologica e diagnostica invasiva Fondazione Policlinico Universitario A. Gemelli, IRCCS (RM), Italy. Electronic address: carlo.trani@policlinicogemelli.it. FAU - Versaci, Francesco AU - Versaci F AD - Department of Cardiology, Santa Maria Goretti Hospital, Italy. Electronic address: segreteriaversaci@gmail.com. FAU - Tomai, Fabrizio AU - Tomai F AD - UOC di Cardiologia, Aurelia Hospital, Rome, Italy. Electronic address: fabriziotomai@gmail.com. FAU - Pepe, Martino AU - Pepe M AD - Cardiovascular Diseases Section, Interdisciplinary Department of Medicine (DIM), University of Bari Aldo Moro, Bari, Italy. Electronic address: martino.pepe@uniba.it. FAU - Berti, Sergio AU - Berti S AD - Fondazione C.N.R. Reg. Toscana G. Monasterio Pisa (MS), Italy. Electronic address: sergio.berti@ftgm.it. FAU - Cernetti, Carlo AU - Cernetti C AD - Cardiologia Ospedale Ca' Foncello, Treviso, Italy. Electronic address: carlocernetti@yahoo.it. FAU - Cirillo, Plinio AU - Cirillo P AD - Dipartimento di Scienze Biomediche Avanzate, Cardiologia, AOUP "Federico II" (NA), Italy. Electronic address: pcirillo@unina.it. FAU - De Luca, Leonardo AU - De Luca L AD - Unita di Cardiologia IRCCS Policlinico San Matteo, Pavia, Italy. Electronic address: leo.deluca@libero.it. LA - eng PT - Journal Article PT - Multicenter Study PT - Observational Study DEP - 20260603 PL - Netherlands TA - Int J Cardiol JT - International journal of cardiology JID - 8200291 RN - 415SHH325A (Adenosine Monophosphate) RN - 6AQ1Y404U7 (cangrelor) RN - 0 (Platelet Aggregation Inhibitors) RN - 0 (Purinergic P2Y Receptor Antagonists) SB - IM MH - Aged MH - Female MH - Humans MH - Male MH - Middle Aged MH - *Acute Coronary Syndrome/drug therapy/surgery/physiopathology MH - *Adenosine Monophosphate/analogs & derivatives/administration & dosage/adverse effects/therapeutic use/analogs & derivatives MH - *Glomerular Filtration Rate/physiology/drug effects MH - Hemorrhage/chemically induced/epidemiology MH - Italy/epidemiology MH - *Percutaneous Coronary Intervention/adverse effects MH - Platelet Aggregation Inhibitors/administration & dosage MH - Prospective Studies MH - *Purinergic P2Y Receptor Antagonists/administration & dosage/adverse effects/therapeutic use MH - *Renal Insufficiency MH - Treatment Outcome OTO - NOTNLM OT - Acute coronary syndrome OT - Bleeding OT - Cangrelor OT - MACEs OT - Renal insufficiency COIS- Declaration of competing interest The study was fully sponsored by Chiesi Farmaceutici S.p.A. Prof. P. Capranzano has received personal speaker fees from Daiichi-Sankyo and Chiesi. Prof. C. Di Mario has received research or educational grants from Abbott, Amgen, Asahi Intecc., AstraZeneca, Boston Scientific, Cardinal Health, CSL Behring, Chiesi, Daiichi Sankyo, Edwards, Medtronic, Menarini, Pfizer, Sanofi, Shockwave, Teleflex, and Volcano/Philips. L. De Luca declares that he has received consulting fees or honoraria from Amgen, Aspen, AstraZeneca, Bayer, Boehringer Ingelheim, Chiesi, Daiichi Sankyo, Eli Lilly, Menarini, Pfizer/Bristol-Myers Squibb, Sanofi, Servier, and The Medicines Company, outside the present work. Prof. P. Calabro, Prof. G. Musumeci, Dr. F. Chirillo, Dr. C. Rolfo, Dr. A. Menozzi, Prof. M. Menichelli, Dr. D. Maffeo, Dr. G. Salanas, Dr. M. Ferlini, Dr. M. Contarini, and Dr. V. Lanzillotti declare no conflicts of interest. EDAT- 2026/06/05 00:34 MHDA- 2026/07/02 04:10 CRDT- 2026/06/04 19:33 PHST- 2026/02/19 00:00 [received] PHST- 2026/05/19 00:00 [revised] PHST- 2026/06/02 00:00 [accepted] PHST- 2026/07/02 04:10 [medline] PHST- 2026/06/05 00:34 [pubmed] PHST- 2026/06/04 19:33 [entrez] AID - S0167-5273(26)00450-X [pii] AID - 10.1016/j.ijcard.2026.134601 [doi] PST - ppublish SO - Int J Cardiol. 2026 Oct 1;460:134601. doi: 10.1016/j.ijcard.2026.134601. Epub 2026 Jun 3. PMID- 42194767 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260527 LR - 20260813 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 15 IP - 10 DP - 2026 May 15 TI - What Drives Anticoagulant Selection in Patients Aged >/=85 Years with Atrial Fibrillation? Insights from the CRAFT Registry. LID - 10.3390/jcm15103806 [doi] LID - 3806 AB - Background: Anticoagulation management in very elderly patients with atrial fibrillation (AF) is particularly challenging due to the coexistence of high thromboembolic and bleeding risks, often compounded by multiple comorbidities. Randomized clinical trials rarely include patients aged >/=85 years, leaving important gaps in our understanding of how anticoagulant therapies are selected in this growing population. Methods: We analyzed data from the CRAFT registry, including 2914 patients hospitalized with AF. Patients were stratified into two age groups: <85 years (n = 2322) and >/=85 years (n = 592). Baseline clinical characteristics, comorbidities, and laboratory parameters were compared between groups. Separate multivariable logistic regression analyses were performed for each age group to identify independent predictors of anticoagulant therapy selection. Results: Patients aged >/=85 years exhibited a distinct clinical profile, characterized by higher thromboembolic risk and a greater prevalence of heart failure, renal dysfunction, anemia, and structural heart disease. Renal function was significantly impaired (median eGFR 47.6 vs. 60.0 mL/min; p < 0.001), while NT-proBNP levels were higher and hemoglobin levels lower in this group. Multivariable analysis revealed clear age-related differences in determinants of treatment selection. In patients < 85 years, anticoagulant choice was influenced by multiple clinical factors, including CHA(2)DS(2)-VA score, renal function, bleeding risk, coronary artery disease, and prior revascularization. In contrast, in patients >/= 85 years, only two independent predictors remained significant: thromboembolic risk (CHA(2)DS(2)-VA score; OR 1.34, 95% CI 1.11-1.64) and renal function (eGFR; OR 0.64, 95% CI 0.47-0.89). Anticoagulation in this group was predominantly based on reduced-dose DOACs, with apixaban used most frequently. Conclusions: Very elderly patients with AF represent a clinically distinct, high-risk population. While anticoagulant selection in younger elderly patients reflects a multifactorial decision process, treatment in those aged >/=85 years appears to rely primarily on thromboembolic risk and renal function, suggesting a more streamlined-and potentially oversimplified-approach. FAU - Bednarski, Janusz AU - Bednarski J AUID- ORCID: 0000-0001-6359-0202 AD - Department of Cardiology, St. John Paul II Western Hospital, 05-825 Grodzisk Mazowiecki, Poland. AD - Clinic of Cardiology, Lazarski University, Swieradowska Str. 43, 02-662 Warsaw, Poland. FAU - Szewczak, Monika AU - Szewczak M AD - Department of Cardiology, St. John Paul II Western Hospital, 05-825 Grodzisk Mazowiecki, Poland. AD - Clinic of Cardiology, Lazarski University, Swieradowska Str. 43, 02-662 Warsaw, Poland. FAU - Grzesiak, Marta AU - Grzesiak M AD - Department of Cardiology, St. John Paul II Western Hospital, 05-825 Grodzisk Mazowiecki, Poland. AD - Clinic of Cardiology, Lazarski University, Swieradowska Str. 43, 02-662 Warsaw, Poland. FAU - Kaminska, Emilia AU - Kaminska E AD - Department of Cardiology, St. John Paul II Western Hospital, 05-825 Grodzisk Mazowiecki, Poland. AD - Clinic of Cardiology, Lazarski University, Swieradowska Str. 43, 02-662 Warsaw, Poland. FAU - Karczewski, Maciej AU - Karczewski M AD - Department of Cardiology, St. John Paul II Western Hospital, 05-825 Grodzisk Mazowiecki, Poland. AD - Clinic of Cardiology, Lazarski University, Swieradowska Str. 43, 02-662 Warsaw, Poland. FAU - Wlasiuk, Karolina AU - Wlasiuk K AD - Department of Cardiology, St. John Paul II Western Hospital, 05-825 Grodzisk Mazowiecki, Poland. AD - Clinic of Cardiology, Lazarski University, Swieradowska Str. 43, 02-662 Warsaw, Poland. FAU - Wojewodzki, Michal AU - Wojewodzki M AUID- ORCID: 0000-0002-1082-3831 AD - Department of Cardiology, St. John Paul II Western Hospital, 05-825 Grodzisk Mazowiecki, Poland. AD - Clinic of Cardiology, Lazarski University, Swieradowska Str. 43, 02-662 Warsaw, Poland. LA - eng PT - Journal Article DEP - 20260515 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC13207535 OTO - NOTNLM OT - anticoagulation OT - atrial fibrillation OT - direct oral anticoagulants OT - elderly OT - registry OT - renal function OT - stroke prevention COIS- The authors declare no conflicts of interest. EDAT- 2026/05/27 06:42 MHDA- 2026/05/27 06:43 PMCR- 2026/05/15 CRDT- 2026/05/27 01:11 PHST- 2026/04/19 00:00 [received] PHST- 2026/05/10 00:00 [revised] PHST- 2026/05/13 00:00 [accepted] PHST- 2026/05/27 06:43 [medline] PHST- 2026/05/27 06:42 [pubmed] PHST- 2026/05/27 01:11 [entrez] PHST- 2026/05/15 00:00 [pmc-release] AID - jcm15103806 [pii] AID - jcm-15-03806 [pii] AID - 10.3390/jcm15103806 [doi] PST - epublish SO - J Clin Med. 2026 May 15;15(10):3806. doi: 10.3390/jcm15103806. PMID- 42175583 OWN - NLM STAT- Publisher LR - 20260523 IS - 1879-0844 (Electronic) IS - 1388-9842 (Linking) DP - 2026 May 22 TI - Cardiovascular events after acute myocardial infarction complicated by low ejection fraction and/or congestion: a landmark analysis of the PARADISE-MI trial. LID - xuag176 [pii] LID - 10.1093/ejhf/xuag176 [doi] AB - AIMS: Despite improvements in post-acute myocardial infarction (AMI) care, the risk of subsequent cardiovascular (CV) events remains substantial, particularly heart failure (HF) in patients with left ventricular systolic dysfunction (LVSD) and/or pulmonary congestion. METHODS: The PARADISE-MI trial randomized 5661 patients with AMI complicated by LVSD and/or pulmonary congestion to sacubitril/valsartan (97/103 mg bid) or ramipril (5 mg bid) at a mean of 4 days post-AMI. This post hoc analysis described the timing and distribution of CV events, and compared treatment effects in early ( 3 months) post-AMI periods. RESULTS: Post-AMI, CV events peaked early; HF was the most frequent (16.2/100 patient-years (py)), followed by CV death (11.6/100 py) and recurrent MI (10.9/100 py). Later, HF remained predominant (3.2/100 py vs. 2.6/100 py for MI, p=0.008; CV death 2.1/100 py). Early post-AMI, patients with HF or recurrent MI shared similar profiles. Later, HF patients were predominantly older and female, with greater pulmonary congestion and lower eGFR; recurrent MI patients had more frequent history of coronary revascularization. Only sacubitril/valsartan showed a favorable influence late post-AMI (HR 0.76, 95% CI 0.60-1.00, p=0.05) and expanded CV composite outcome (CV death, HF events, recurrent MI, hospitalization for angina, or post-randomization coronary revascularization) benefit over the trial (HR=0.87, 95% CI 0.77-0.97, p=0.012). CONCLUSIONS: Post-AMI, HF predominates both early and late among CV events. Compared with ramipril, sacubitril/valsartan was associated with a possible late reduction in recurrent MI and a modest decrease in an expanded CV composite outcome that merits further investigation. CI - (c) The Author(s) 2026. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site-for further information please contact journals.permissions@oup.com. FAU - Boulet, Jacinthe AU - Boulet J AD - Montreal Heart Institute, Department of Medicine, Division of Cardiology, Universite de Montreal, Montreal, Canada. FAU - Rouleau, Jean-Lucien AU - Rouleau JL AD - Montreal Heart Institute, Department of Medicine, Division of Cardiology, Universite de Montreal, Montreal, Canada. FAU - Petrie, Mark AU - Petrie M AD - British Heart Foundation Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom. FAU - Claggett, Brian AU - Claggett B AD - Cardiovascular Division, Brigham and Women's Hospital, and Harvard Medical School Boston, MA, USA. FAU - Lewis, Eldrin F AU - Lewis EF AD - Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford University, Palo Alto, CA, USA. FAU - Pfeffer, Marc A AU - Pfeffer MA AD - Cardiovascular Division, Brigham and Women's Hospital, and Harvard Medical School Boston, MA, USA. FAU - Kulac, Ian AU - Kulac I AD - Cardiovascular Division, Brigham and Women's Hospital, and Harvard Medical School Boston, MA, USA. FAU - Morais, Joao AU - Morais J AD - Polytechnic Institute of Leiria, ciTechCare - Center for Innovative Care and Health Technology, Leiria, Portugal. FAU - Petrov, Ivo AU - Petrov I AUID- ORCID: 0000-0002-9989-0730 AD - Head of Cardiology, Angiology and Electrophysiology Department, Acibadem City Clinic; Sofia, Bulgaria. FAU - Senni, Michele AU - Senni M AUID- ORCID: 0000-0001-5502-7882 AD - Cardiology Division, Cardiovascular Department, Hospital Papa Giovanni XXIII, Bergamo, Italy. FAU - Tanguay, Jean-Francois AU - Tanguay JF AD - Montreal Heart Institute, Department of Medicine, Division of Cardiology, Universite de Montreal, Montreal, Canada. FAU - Widimsky, Petr AU - Widimsky P AUID- ORCID: 0000-0001-5686-7752 AD - Cardiocenter, Charles University, Prague, Czech Republic. FAU - Braunwald, Eugene AU - Braunwald E AUID- ORCID: 0000-0002-3472-626X AD - TIMI Study Group, Cardiovascular Division, Brigham and Women's Hospital, and Harvard Medical School Boston, MA, USA. LA - eng PT - Journal Article DEP - 20260522 PL - England TA - Eur J Heart Fail JT - European journal of heart failure JID - 100887595 SB - IM OTO - NOTNLM OT - Acute myocardial infarction OT - Death OT - Heart failure OT - Hospitalization OT - PARADISE-MI OT - Sacubitril/Valsartan EDAT- 2026/05/23 06:31 MHDA- 2026/05/23 06:31 CRDT- 2026/05/23 01:53 PHST- 2025/12/16 00:00 [received] PHST- 2026/03/10 00:00 [revised] PHST- 2026/03/23 00:00 [accepted] PHST- 2026/05/23 06:31 [medline] PHST- 2026/05/23 06:31 [pubmed] PHST- 2026/05/23 01:53 [entrez] AID - 8691120 [pii] AID - 10.1093/ejhf/xuag176 [doi] PST - aheadofprint SO - Eur J Heart Fail. 2026 May 22:xuag176. doi: 10.1093/ejhf/xuag176. PMID- 42088959 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260506 LR - 20260813 IS - 1734-9338 (Print) IS - 1897-4295 (Electronic) IS - 1734-9338 (Linking) VI - 22 IP - 1 DP - 2026 Mar TI - Guideline-directed medical therapy in Polish patients with chronic coronary syndrome and advanced chronic kidney disease: insights from the ISCHEMIA-CKD trial. PG - 1-7 LID - 10.5114/aic.2026.160027 [doi] AB - INTRODUCTION: The ISCHEMIA-CKD trial showed similar outcomes with an initial conservative vs invasive approach to chronic coronary syndrome in patients with advanced chronic kidney disease. Guideline-directed medical therapy (GDMT) was recommended regardless of the randomized strategy assignment. AIM: To describe GDMT attainment in ISCHEMIA-CKD participants in Poland compared to other world regions. MATERIAL AND METHODS: Among 777 trial participants, 105 were randomized in Poland. Patients were followed for a median of 2.2 years with the following GDMT recommendations: not smoking, systolic blood pressure (SBP) < 140/ diastolic blood pressure (DBP) < 90 mm Hg, high/moderate-intensity statin, antiplatelet/anticoagulant, angiotensin-converting-enzyme inhibitors (ACE-I)/angiotensin receptor blockers (ARB) and b-blocker therapy, glycated hemoglobin (HbA1c) < 8% when indicated. RESULTS: Participants in Poland vs other regions of the world (age 67 [60, 76] vs. 63 [55, 70] years, p < 0.001, 32% vs. 31% females, p = 0.86) had higher incidence of prior myocardial infarction (25% vs. 16%, p = 0.04), peripheral vascular disease (12% vs. 5%, p = 0.009), atrial fibrillation (23% vs. 7%, p < 0.001), and less frequently diabetes (44% vs. 59%, p = 0.004). At baseline, Polish participants were more often on antiplatelets/anticoagulants (91% vs. 83%, p = 0.04), b-blockers (95% vs. 72%, p < 0.001), and ACE-I/ARBs (62% vs. 45%, p = 0.002), with better attainment of SBP < 140 (73% vs. 53%, p < 0.001), and HbA1c < 8% (86% vs. 56%, p = 0.003) and similar smoking and high-/moderate-intensity statin treatment frequencies. This degree of GDMT goal attainment was maintained at the last follow-up visit. CONCLUSIONS: In Polish patients with advanced kidney disease, high GDMT goal attainment was observed and maintained until the last follow-up visit under trial-specific, strict medical surveillance. The impact of GDMT on long-term outcomes remains to be studied in this patient population. CI - Copyright: (c) 2026 Termedia Sp. z o. o. FAU - Pracon, Radoslaw AU - Pracon R AD - Coronary and Structural Heart Diseases Department, National Institute of Cardiology, Warsaw, Poland. FAU - Anthopolos, Rebecca AU - Anthopolos R AD - Division of Biostatistics, Department of Population Health, NYU Grossman School of Medicine, New York, USA. FAU - Lu, Ying AU - Lu Y AD - Division of Biostatistics, Department of Population Health, NYU Grossman School of Medicine, New York, USA. FAU - Demkow, Marcin AU - Demkow M AD - Coronary and Structural Heart Diseases Department, National Institute of Cardiology, Warsaw, Poland. FAU - Mazurek, Tomasz AU - Mazurek T AD - 1 Chair and Department of Cardiology, Medical University of Warsaw, Poland. FAU - Drozdz, Jaroslaw AU - Drozdz J AD - Department of Cardiology, Medical University of Lodz, Poland. FAU - Pruszczyk, Piotr AU - Pruszczyk P AD - Department of Internal Medicine and Cardiology, Medical University of Warsaw, Poland. FAU - Roik, Marek AU - Roik M AD - Department of Internal Medicine and Cardiology, Medical University of Warsaw, Poland. FAU - Kryczka, Karolina AU - Kryczka K AD - Coronary and Structural Heart Diseases Department, National Institute of Cardiology, Warsaw, Poland. FAU - Henzel, Jan AU - Henzel J AD - Coronary and Structural Heart Diseases Department, National Institute of Cardiology, Warsaw, Poland. FAU - Kaczmarska-Dyrda, Edyta AU - Kaczmarska-Dyrda E AD - Coronary and Structural Heart Diseases Department, National Institute of Cardiology, Warsaw, Poland. FAU - Malecki, Robert AU - Malecki R AD - Nephrology Department, Miedzyleski Szpital Specjalistyczny, Warsaw, Poland. AD - First Department of Internal Medicine, Collegium Medicum, Cardinal Stefan Wyszynski University, Warsaw, Poland. FAU - Teresinska, Anna AU - Teresinska A AD - National Institute of Cardiology, Warsaw, Poland. FAU - Szwed, Hanna AU - Szwed H AD - National Institute of Cardiology, Warsaw, Poland. FAU - Ruzyllo, Witold AU - Ruzyllo W AD - National Institute of Cardiology, Warsaw, Poland. LA - eng PT - Journal Article DEP - 20260309 PL - Poland TA - Postepy Kardiol Interwencyjnej JT - Postepy w kardiologii interwencyjnej = Advances in interventional cardiology JID - 101272671 PMC - PMC13137105 OTO - NOTNLM OT - advanced chronic kidney disease OT - chronic coronary syndrome OT - coronary revascularization OT - optimal medical therapy COIS- The authors declare no conflict of interest. EDAT- 2026/05/06 06:39 MHDA- 2026/05/06 06:40 PMCR- 2026/03/09 CRDT- 2026/05/06 05:07 PHST- 2025/11/20 00:00 [received] PHST- 2025/12/29 00:00 [accepted] PHST- 2026/05/06 06:40 [medline] PHST- 2026/05/06 06:39 [pubmed] PHST- 2026/05/06 05:07 [entrez] PHST- 2026/03/09 00:00 [pmc-release] AID - 57683 [pii] AID - 10.5114/aic.2026.160027 [doi] PST - epublish SO - Postepy Kardiol Interwencyjnej. 2026 Mar 9;22(1):1-7. doi: 10.5114/aic.2026.160027. eCollection 2026 Mar. PMID- 42075656 OWN - NLM STAT- MEDLINE DCOM- 20260716 LR - 20260827 IS - 1648-9144 (Electronic) IS - 1010-660X (Print) IS - 1010-660X (Linking) VI - 62 IP - 4 DP - 2026 Apr 19 TI - Determinants of In-Stent Restenosis in ST-Elevation Myocardial Infarction: Insights from a Single-Center Retrospective Analysis. LID - 10.3390/medicina62040785 [doi] LID - 785 AB - Background and Objectives: Percutaneous coronary intervention (PCI) has markedly improved outcomes in coronary artery disease through the implantation of bare-metal stents (BMS) or drug-eluting stents (DES). However, in-stent restenosis (ISR) remains a significant complication, often necessitating repeat interventions. This study aimed to identify risk factors associated with ISR in patients with ST-elevation myocardial infarction (STEMI) who underwent PCI. Materials and Methods: We conducted a retrospective, non-randomized observational study of 107 STEMI patients treated with PCI between January 2016 and December 2019 who subsequently underwent clinically indicated (predominantly symptom-driven) follow-up coronary angiography within 12 months. ISR was defined as >/=50% luminal narrowing at follow-up angiography. Time-to-event analysis was performed using Cox regression models, incorporating clinical, biochemical, and angiographic variables. Results: In this selected cohort of patients undergoing follow-up angiography, ISR of any degree was identified in 87% of patients, and 52% had restenosis >70%. Advanced age, prior cardiovascular events, diabetes mellitus, chronic kidney disease, and history of stroke significantly increased the hazard of ISR. Smoking, dyslipidemia, and hypertension were prevalent in patients with severe ISR. Women presented with more severe clinical profiles (higher Killip class and troponin levels). DES showed slightly better TIMI flow than BMS, but stent type, dimensions, and number did not significantly impact restenosis risk. Thrombolytic therapy was associated with a significantly reduced ISR hazard. Mortality was 6% in patients with severe ISR. The highest restenosis incidence occurred in the LAD and RCA territories. Conclusions: ISR is a multifactorial process influenced by demographic, clinical, and procedural factors. Despite technological advances, ISR remains a prevalent issue, particularly in high-risk groups undergoing clinically indicated follow-up angiography. Secondary prevention strategies, optimized stent deployment, and targeted therapies addressing inflammation and vascular remodeling are essential to improving long-term PCI outcomes. FAU - Munteanu, Alice Elena AU - Munteanu AE AUID- ORCID: 0000-0002-6122-7781 AD - Department of Medical-Surgical and Prophylactical Disciplines, Faculty of Medicine, "Titu Maiorescu" University, 031593 Bucharest, Romania. AD - "Carol Davila" Emergency Hospital, 88 M. Vulcanescu Street, 010825 Bucharest, Romania. FAU - Badea, Alexandru Andrei AU - Badea AA AD - Doctoral School, Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania. FAU - Stanciu, Silviu Marcel AU - Stanciu SM AD - "Carol Davila" Emergency Hospital, 88 M. Vulcanescu Street, 010825 Bucharest, Romania. AD - Department No. 5-Internal Medicine, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania. FAU - Popescu, Alexandru Mihai AU - Popescu AM AUID- ORCID: 0009-0002-6395-3389 AD - Doctoral School, Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania. FAU - Plesa, Florentina Cristina AU - Plesa FC AD - Department No. 6-Clinical Neurosciences, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania. FAU - Constantin, Ciprian AU - Constantin C AUID- ORCID: 0000-0003-3355-5048 AD - "Carol Davila" Emergency Hospital, 88 M. Vulcanescu Street, 010825 Bucharest, Romania. AD - Research Metabolism Center, Faculty of Medicine, Titu Maiorescu University, 76 Al I Cuza Blvd, 011053 Bucharest, Romania. LA - eng GR - Publish not perish/Carol Davila University of Medicine and Pharmacy/ PT - Journal Article PT - Observational Study DEP - 20260419 PL - Switzerland TA - Medicina (Kaunas) JT - Medicina (Kaunas, Lithuania) JID - 9425208 SB - IM MH - Humans MH - Female MH - Retrospective Studies MH - *ST Elevation Myocardial Infarction/surgery/complications MH - Middle Aged MH - Aged MH - Male MH - *Coronary Restenosis/epidemiology/etiology MH - Risk Factors MH - Coronary Angiography/methods MH - *Stents/adverse effects MH - *Percutaneous Coronary Intervention/adverse effects/methods MH - Drug-Eluting Stents/adverse effects MH - Proportional Hazards Models PMC - PMC13117846 OTO - NOTNLM OT - PCI OT - STEMI OT - diabetes OT - inflammation OT - restenosis OT - stenting OT - thrombolytic COIS- The authors declare no conflicts of interest. EDAT- 2026/05/04 06:33 MHDA- 2026/05/04 06:34 PMCR- 2026/04/19 CRDT- 2026/05/04 01:19 PHST- 2026/02/03 00:00 [received] PHST- 2026/04/02 00:00 [revised] PHST- 2026/04/13 00:00 [accepted] PHST- 2026/05/04 06:34 [medline] PHST- 2026/05/04 06:33 [pubmed] PHST- 2026/05/04 01:19 [entrez] PHST- 2026/04/19 00:00 [pmc-release] AID - medicina62040785 [pii] AID - medicina-62-00785 [pii] AID - 10.3390/medicina62040785 [doi] PST - epublish SO - Medicina (Kaunas). 2026 Apr 19;62(4):785. doi: 10.3390/medicina62040785. PMID- 42074969 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260504 LR - 20260813 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 15 IP - 8 DP - 2026 Apr 21 TI - Real-World Antiplatelet Use and Clinical Outcomes in Patients with Advanced Chronic Kidney Disease Following Acute Coronary Syndrome: A Descriptive Cohort Study. LID - 10.3390/jcm15083167 [doi] LID - 3167 AB - Background: Patients with advanced chronic kidney disease (CKD) experience disproportionately high ischemic and bleeding risks following acute coronary syndrome (ACS), yet remain markedly underrepresented in randomized trials of antiplatelet therapy. Consequently, real-world data describing antiplatelet prescribing patterns and clinical outcomes in this population are limited. Objectives: To describe real-world antiplatelet use and 12-month clinical outcomes in patients with advanced CKD and end-stage renal disease (ESRD) following ACS. Methods: We conducted a single-center, retrospective cohort study including adults with advanced CKD (stage 4-5) or dialysis-dependent ESRD hospitalized with ACS and discharged on dual antiplatelet therapy. Baseline characteristics, revascularization strategies, and clinical outcomes were collected. Outcomes of interest included all-cause mortality, recurrent ischemic events (recurrent myocardial infarction, stroke or transient ischemic attack, or repeat revascularization), and bleeding events defined by Thrombolysis in Myocardial Infarction (TIMI) criteria over 12 months. All analyses were descriptive in nature. Results: A total of 222 patients were included; clopidogrel was prescribed in 96.0% of patients and ticagrelor in 4.0%. The cohort was elderly, highly comorbid, and predominantly dialysis-dependent. At 12 months, all-cause mortality occurred in approximately one-third of patients, recurrent ischemic events were frequent, and bleeding complications were common. Most bleeding events occurred in dialysis-dependent individuals. Outcomes among ticagrelor-treated patients are reported descriptively only due to the very small sample size. Conclusions: In this real-world cohort of patients with advanced CKD and ESRD following ACS, a substantial burden of mortality, recurrent ischemic events, and bleeding complications was observed, underscoring the narrow therapeutic window in this high-risk population. These findings are descriptive and hypothesis-generating, supporting the need for individualized antiplatelet strategies and prospective studies specifically enrolling patients with advanced CKD. FAU - Alfehaid, Lama AU - Alfehaid L AUID- ORCID: 0000-0002-1549-0941 AD - Department of Pharmacy Practice, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, P.O. Box 3660, Riyadh 11481, Saudi Arabia. AD - Pharmaceutical Care Department, King Abdulaziz Medical City, P.O. Box 22490, Riyadh 11426, Saudi Arabia. AD - King Abdullah International Medical Research Center, P.O. Box 3660, Riyadh 11481, Saudi Arabia. FAU - Alzahrani, Eman AU - Alzahrani E AD - Pharmaceutical Care Department, King Abdulaziz Medical City, P.O. Box 22490, Riyadh 11426, Saudi Arabia. FAU - Alsubaie, Amani AU - Alsubaie A AD - Department of Pharmacy Practice, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, P.O. Box 3660, Riyadh 11481, Saudi Arabia. FAU - Almutairi, Majed AU - Almutairi M AUID- ORCID: 0000-0002-0365-1103 AD - Pharmaceutical Care Department, King Abdulaziz Medical City, P.O. Box 22490, Riyadh 11426, Saudi Arabia. AD - King Abdullah International Medical Research Center, P.O. Box 3660, Riyadh 11481, Saudi Arabia. FAU - Alomran, Mansour AU - Alomran M AUID- ORCID: 0009-0008-4656-2478 AD - King Abdullah International Medical Research Center, P.O. Box 3660, Riyadh 11481, Saudi Arabia. AD - College of Medicine, King Saud bin Abdulaziz University for Health Sciences, P.O. Box 3660, Riyadh 11481, Saudi Arabia. AD - King Abdulaziz Cardiac Center, King Abdulaziz Medical City, P.O. Box 22490, Riyadh 11426, Saudi Arabia. FAU - Alghadeer, Saleh AU - Alghadeer S AD - King Abdullah International Medical Research Center, P.O. Box 3660, Riyadh 11481, Saudi Arabia. AD - College of Medicine, King Saud bin Abdulaziz University for Health Sciences, P.O. Box 3660, Riyadh 11481, Saudi Arabia. AD - King Abdulaziz Cardiac Center, King Abdulaziz Medical City, P.O. Box 22490, Riyadh 11426, Saudi Arabia. LA - eng PT - Journal Article DEP - 20260421 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC13118201 OTO - NOTNLM OT - acute coronary syndrome OT - bleeding risk OT - chronic kidney disease OT - clopidogrel OT - dual antiplatelet therapy OT - ticagrelor COIS- The authors declare no conflicts of interest. EDAT- 2026/05/04 06:33 MHDA- 2026/05/04 06:34 PMCR- 2026/04/21 CRDT- 2026/05/04 01:16 PHST- 2026/03/05 00:00 [received] PHST- 2026/04/05 00:00 [revised] PHST- 2026/04/10 00:00 [accepted] PHST- 2026/05/04 06:34 [medline] PHST- 2026/05/04 06:33 [pubmed] PHST- 2026/05/04 01:16 [entrez] PHST- 2026/04/21 00:00 [pmc-release] AID - jcm15083167 [pii] AID - jcm-15-03167 [pii] AID - 10.3390/jcm15083167 [doi] PST - epublish SO - J Clin Med. 2026 Apr 21;15(8):3167. doi: 10.3390/jcm15083167. PMID- 42045855 OWN - NLM STAT- MEDLINE DCOM- 20260710 LR - 20260818 IS - 1471-2261 (Electronic) IS - 1471-2261 (Linking) VI - 26 IP - 1 DP - 2026 Apr 27 TI - Long-term outcomes of stepwise provisional versus upfront two-stent strategies for true distal left main bifurcation lesions: a single-center registry study. LID - 10.1186/s12872-026-05896-5 [doi] LID - 588 AB - BACKGROUND: Randomized trials in true distal left main (LM) bifurcation PCI have shown broadly comparable outcomes between stepwise provisional and planned two-stent strategies. We evaluated long-term clinical outcomes and procedural patterns in a contemporary real-world cohort. METHODS: We analyzed a single-center registry of patients with true distal LM bifurcation lesions (Medina 1,1,1; 1,0,1; or 0,1,1) treated with either a stepwise provisional or an upfront two-stent strategy. The primary endpoint was major adverse cardiovascular events (MACE), defined as all-cause death, myocardial infarction, or target lesion revascularization (TLR). Stabilized inverse probability of treatment weighting (IPTW) was used as a sensitivity analysis for the primary strategy comparison. To address the nonrandomized use of intravascular imaging, we also performed a post hoc propensity score-weighted analysis for imaging guidance including age, sex, diabetes, chronic kidney disease, left ventricular ejection fraction, SYNTAX score, ACS presentation, and initial stent strategy. RESULTS: Among 214 patients (provisional n = 106; two-stent n = 108) with a median follow-up of 25 months (IQR 8-50), upfront two-stent cases more frequently used intravascular imaging and kissing balloon inflation (both p < 0.001). MACE occurred in 17.9% versus 16.7% of patients in the provisional and two-stent groups, respectively (RR 1.08, 95% CI 0.60-1.93; p = 0.86). All-cause mortality was similar (13.2% vs. 12.0%; p = 0.79). Findings were consistent after IPTW adjustment (adjusted RR 1.19, 95% CI 0.58-2.44; p = 0.63). In crude exploratory analyses, imaging-guided PCI was associated with lower MACE and TLR than angiography-guided PCI alone; however, this association was attenuated after propensity score weighting (weighted RR for MACE 0.74, 95% CI 0.39-1.42; weighted RR for TLR 0.23, 95% CI 0.04-1.48). CONCLUSIONS: In this real-world cohort of true distal LM bifurcation PCI, stepwise provisional and upfront two-stent strategies were associated with similar long-term outcomes. These data support anatomy-driven strategy selection and meticulous procedural optimization. The crude association between imaging guidance and lower adverse events was attenuated after adjustment and should be interpreted as hypothesis-generating. CI - (c) 2026. The Author(s). FAU - Kumar, Prathap AU - Kumar P AD - Meditrina Hospital, Kollam, Kerala, India. FAU - Toukami, Youness AU - Toukami Y AD - Meditrina Hospital, Kollam, Kerala, India. younesstoukami@gmail.com. AD - CHU Ibn Rochd, Casablanca, Morocco. younesstoukami@gmail.com. FAU - Rajendran, Manu AU - Rajendran M AD - Meditrina Hospital, Kollam, Kerala, India. FAU - Katragadda, Abhiram AU - Katragadda A AD - Meditrina Hospital, Kollam, Kerala, India. FAU - Hussein, Thaha Mohamed AU - Hussein TM AD - Meditrina Hospital, Kollam, Kerala, India. FAU - Ghimire, Roshan AU - Ghimire R AD - Meditrina Hospital, Kollam, Kerala, India. FAU - Jino, Blessvin AU - Jino B AD - Meditrina Hospital, Kollam, Kerala, India. LA - eng PT - Comparative Study PT - Journal Article PT - Observational Study DEP - 20260427 PL - England TA - BMC Cardiovasc Disord JT - BMC cardiovascular disorders JID - 100968539 SB - IM MH - Humans MH - Female MH - Registries MH - Male MH - *Coronary Artery Disease/diagnostic imaging/mortality/therapy MH - Time Factors MH - Aged MH - Treatment Outcome MH - Risk Factors MH - *Stents MH - Middle Aged MH - *Percutaneous Coronary Intervention/adverse effects/instrumentation/mortality MH - Myocardial Infarction/etiology MH - Coronary Angiography MH - Drug-Eluting Stents PMC - PMC13348094 OTO - NOTNLM OT - Bifurcation OT - Bifurcation lesions OT - Clinical outcomes OT - PCILeft main coronary artery OT - Percutaneous coronary intervention OT - Provisional OT - Provisional stenting OT - Two-stent technique COIS- Declarations. Ethics approval and consent to participate: The study was conducted in accordance with the Declaration of Helsinki and approved by the institutional ethics committee of Meditrina Hospital. Written informed consent was obtained from all patients prior to inclusion in the institutional registry. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests. EDAT- 2026/04/28 00:34 MHDA- 2026/07/10 13:18 PMCR- 2026/04/27 CRDT- 2026/04/27 23:54 PHST- 2026/03/11 00:00 [received] PHST- 2026/04/20 00:00 [accepted] PHST- 2026/07/10 13:18 [medline] PHST- 2026/04/28 00:34 [pubmed] PHST- 2026/04/27 23:54 [entrez] PHST- 2026/04/27 00:00 [pmc-release] AID - 10.1186/s12872-026-05896-5 [pii] AID - 5896 [pii] AID - 10.1186/s12872-026-05896-5 [doi] PST - epublish SO - BMC Cardiovasc Disord. 2026 Apr 27;26(1):588. doi: 10.1186/s12872-026-05896-5. PMID- 42003300 OWN - NLM STAT- MEDLINE DCOM- 20260715 LR - 20260810 IS - 1969-6213 (Electronic) IS - 1774-024X (Print) IS - 1774-024X (Linking) VI - 22 IP - 8 DP - 2026 Apr 20 TI - Impact of renal function on edoxaban antithrombotic therapy in patients with atrial fibrillation and stable coronary artery disease: a prespecified analysis of the EPIC-CAD trial. PG - e432-e443 LID - EIJ-D-25-01274 [pii] LID - 10.4244/EIJ-D-25-01274 [doi] AB - BACKGROUND: Renal function is a critical factor of ischaemic and bleeding risks in patients with atrial fibrillation (AF) receiving antithrombotic therapy. AIMS: This study aimed to evaluate the impact of renal dysfunction in patients with AF and stable coronary artery disease (CAD) undergoing antithrombotic therapy. METHODS: The Edoxaban Versus Edoxaban With antiPlatelet Agent In Patients With Atrial Fibrillation and Chronic Stable Coronary Artery Disease (EPIC-CAD) trial randomised patients to edoxaban monotherapy or dual antithrombotic therapy (edoxaban plus a single antiplatelet agent). In this prespecified analysis, patients were stratified by creatinine clearance into low (<50 mL/min) or high (>/=50 mL/min) groups according to edoxaban dose-reduction criteria. The primary endpoint was net adverse clinical events (NACE: death from any cause, myocardial infarction, stroke, systemic embolism, urgent revascularisation, or major/clinically relevant non-major bleeding) at 12 months. RESULTS: Of 1,040 randomised patients, 252 (24.2%) had low creatinine clearance; these patients were older and had more comorbidities compared with the 788 patients (75.8%) with high creatinine clearance. Patients with low creatinine clearance experienced higher risks of NACE (hazard ratio [HR] 1.72, 95% confidence interval [CI]: 1.19-2.49; p=0.004), ischaemic events (HR 2.70, 95% CI: 1.09-6.70; p=0.032), and bleeding (HR 1.54, 95% CI: 1.01-2.34; p=0.046). At 12 months, edoxaban monotherapy reduced NACE compared with dual therapy in both the low (12.1% vs 21.7%, HR 0.52, 95% CI: 0.28-0.98; p=0.042) and high creatinine clearance groups (5.2% vs 14.5%, HR 0.40, 95% CI: 0.25-0.65; p<0.001), with no interaction (p for interaction=0.53). CONCLUSIONS: In patients with AF and stable CAD, edoxaban monotherapy led to a lower risk of primary NACE than dual antithrombotic therapy, regardless of renal function. (ClinicalTrials.gov: NCT03718559). FAU - Lee, Joong Min AU - Lee JM AD - Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. FAU - Cho, Min Soo AU - Cho MS AD - Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. FAU - Kang, Do-Yoon AU - Kang DY AD - Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. FAU - Ahn, Jung-Min AU - Ahn JM AD - Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. FAU - Oh, Yong-Seog AU - Oh YS AD - Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea. FAU - Lee, Chang Hoon AU - Lee CH AD - Department of Cardiology, Veterans Health Service Medical Center, Seoul, South Korea. FAU - Choi, Eue-Keun AU - Choi EK AD - Department of Internal Medicine, Seoul National University College of Medicine and Seoul National University Hospital, Seoul, South Korea. FAU - Lee, Ji Hyun AU - Lee JH AD - Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, South Korea and National University College of Medicine, Seongnam, South Korea. FAU - Kwon, Chang Hee AU - Kwon CH AD - Division of Cardiology, Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, South Korea. FAU - Park, Gyung-Min AU - Park GM AD - Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea. FAU - Choi, Hyung Oh AU - Choi HO AD - Department of Cardiology, Soon Chun Hyang University Hospital Bucheon, Bucheon, South Korea. FAU - Park, Kyoung-Ha AU - Park KH AD - Department of Cardiology, Hallym University Medical Center, Anyang, South Korea. FAU - Park, Kyoung-Min AU - Park KM AD - Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. FAU - Hwang, Jongmin AU - Hwang J AD - Department of Cardiology, Keimyung University Dongsan Hospital, Daegu, South Korea. FAU - Yoo, Ki-Dong AU - Yoo KD AD - Department of Cardiology, St. Vincent's Hospital, College of Medicine, Catholic University of Korea, Suwon, South Korea. FAU - Cho, Young-Rak AU - Cho YR AD - Department of Cardiology, Dong-A University Hospital, Dong-A University College of Medicine, Busan, South Korea. FAU - Kim, Ji Hyun AU - Kim JH AD - Department of Cardiology, Dongguk University Ilsan Hospital, Goyang, South Korea. FAU - Hwang, Ki Won AU - Hwang KW AD - Department of Cardiology, Pusan National University Yangsan Hospital, Pusan National University of Medicine, Yangsan, South Korea. FAU - Jin, Eun-Sun AU - Jin ES AD - Department of Cardiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University Medical College, Seoul, South Korea. FAU - Kwon, Osung AU - Kwon O AD - Division of Cardiology, Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea. FAU - Kim, Ki-Hun AU - Kim KH AD - Department of Cardiology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea. FAU - Park, Seung-Jung AU - Park SJ AD - Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. FAU - Nam, Gi-Byoung AU - Nam GB AD - Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. FAU - Park, Duk-Woo AU - Park DW AD - Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. LA - eng SI - ClinicalTrials.gov/NCT03718559 PT - Clinical Trial, Phase IV PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20260420 PL - France TA - EuroIntervention JT - EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology JID - 101251040 RN - NDU3J18APO (edoxaban) RN - 0 (Factor Xa Inhibitors) RN - 0 (Fibrinolytic Agents) RN - 0 (Platelet Aggregation Inhibitors) RN - 0 (Pyridines) RN - 0 (Thiazoles) SB - IM MH - Aged MH - Female MH - Humans MH - Male MH - Middle Aged MH - *Atrial Fibrillation/drug therapy/complications MH - *Coronary Artery Disease/drug therapy/complications MH - *Factor Xa Inhibitors/therapeutic use/adverse effects MH - *Fibrinolytic Agents/therapeutic use/adverse effects MH - Hemorrhage/chemically induced MH - *Kidney/physiopathology MH - *Platelet Aggregation Inhibitors/therapeutic use MH - *Pyridines/therapeutic use/adverse effects MH - *Thiazoles/therapeutic use/adverse effects MH - Treatment Outcome PMC - PMC13080388 COIS- D.-W. Park has received research grants from the Cardiovascular Research Foundation, Daewoong Pharmaceutical, and Daiichi Sankyo. G.-B. Nam has received research grants from the Cardiovascular Research Foundation, Daewoong Pharmaceutical, and Daiichi Sankyo. The other authors have no conflicts of interest to declare. EDAT- 2026/04/20 13:10 MHDA- 2026/04/20 13:11 PMCR- 2027/04/20 CRDT- 2026/04/20 03:23 PHST- 2026/04/20 13:11 [medline] PHST- 2026/04/20 13:10 [pubmed] PHST- 2026/04/20 03:23 [entrez] PHST- 2027/04/20 00:00 [pmc-release] AID - EIJ-D-25-01274 [pii] AID - 10.4244/EIJ-D-25-01274 [doi] PST - epublish SO - EuroIntervention. 2026 Apr 20;22(8):e432-e443. doi: 10.4244/EIJ-D-25-01274. PMID- 41988281 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260416 LR - 20260813 IS - 2072-1439 (Print) IS - 2077-6624 (Electronic) IS - 2072-1439 (Linking) VI - 18 IP - 3 DP - 2026 Mar 31 TI - Machine learning-based prediction of 1-year mortality risk after off-pump coronary artery bypass grafting. PG - 212 LID - 10.21037/jtd-2025-aw-2271 [doi] LID - 212 AB - BACKGROUND: Coronary heart disease (CHD) has gradually become one of the main causes of death among patients worldwide. Off-pump coronary artery bypass grafting (OPCABG) has been increasingly applied due to its avoidance of cardiopulmonary bypass. However, there is currently no study that predicts the postoperative mortality risk for patients undergoing OPCABG. To fill this gap, we identified the independent risk factors associated with poor 1-year survival outcomes in patients undergoing OPCABG and developed an effective machine learning (ML) model for prediction. METHODS: Patient data were extracted from the Medical Information Mart for Intensive Care (MIMIC)-IV database. Multivariate Cox regression analysis was performed to identify independent risk factors for adverse postoperative survival outcomes in patients undergoing OPCABG. Based on these features, five survival ML models were developed, including Gradient Boosting Machine (GBM), least absolute shrinkage and selection operator-Cox regression (Lasso-Cox), Cox Boosting (CoxBoost), eXtreme Gradient Boosting (XGBoost), and partial least squares regression-Cox (PLSRCox). Model performance was assessed at 3 months, 6 months, and 1 year after surgery across the training, testing, and validation cohorts, respectively. The optimal model was further interpreted using Shapley Additive Explanations (SHAP) visualization. RESULTS: A total of 2,280 patients who underwent OPCABG were identified from the MIMIC-IV database and randomly divided into training and testing sets in a 7:3 ratio. In the training cohort, multivariate Cox regression analysis identified creatine kinase (CK), red cell distribution width (RDW), total bilirubin (TBIL), alanine aminotransferase (ALT), chronic kidney disease (CKD), anion gap, and aspartate aminotransferase (AST) as independent risk factors for adverse postoperative survival outcomes. Among the five developed survival ML models, the CoxBoost model achieved areas under the receiver operating characteristic curve (AUCs) of 0.955, 0.958, and 0.961 at 3, 6, and 12 months, respectively, in the training set. The time-dependent concordance index (C-index) and AUC indicated strong model performance. In the testing and validation cohorts, CoxBoost also demonstrated excellent predictive capability across all time points. CONCLUSIONS: The CoxBoost model, constructed using CK, RDW, TBIL, ALT, CKD, anion gap, and AST as key predictors, effectively predicts the risk of adverse 1-year survival outcomes in patients undergoing OPCABG. However, this study has an imbalance in the sample size. Although the survival Synthetic Minority Oversampling Technique (SMOTE) was adopted to address this issue, it may still have an impact on the model's performance. We look forward to more research in the future to further explore this problem. CI - (c) AME Publishing Company. FAU - Ma, Yunyun AU - Ma Y AD - Department of Cardiothoracic Surgery, Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, China. FAU - Shi, Yuqing AU - Shi Y AD - The First Clinical Medical College of Lanzhou University, Lanzhou, China. FAU - Yin, Rui AU - Yin R AD - Department of Cardiothoracic Surgery, Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, China. LA - eng PT - Journal Article DEP - 20260324 PL - China TA - J Thorac Dis JT - Journal of thoracic disease JID - 101533916 PMC - PMC13077357 OTO - NOTNLM OT - Off-pump coronary artery bypass grafting (OPCABG) OT - machine learning (ML) OT - risk prediction OT - survival COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jtd.amegroups.com/article/view/10.21037/jtd-2025-aw-2271/coif). The authors have no conflicts of interest to declare. EDAT- 2026/04/16 13:09 MHDA- 2026/04/16 13:10 PMCR- 2026/03/31 CRDT- 2026/04/16 04:28 PHST- 2025/11/04 00:00 [received] PHST- 2026/01/26 00:00 [accepted] PHST- 2026/04/16 13:10 [medline] PHST- 2026/04/16 13:09 [pubmed] PHST- 2026/04/16 04:28 [entrez] PHST- 2026/03/31 00:00 [pmc-release] AID - jtd-18-03-212 [pii] AID - 10.21037/jtd-2025-aw-2271 [doi] PST - ppublish SO - J Thorac Dis. 2026 Mar 31;18(3):212. doi: 10.21037/jtd-2025-aw-2271. Epub 2026 Mar 24. PMID- 41987274 OWN - NLM STAT- MEDLINE DCOM- 20260627 LR - 20260813 IS - 1749-8090 (Electronic) IS - 1749-8090 (Linking) VI - 21 IP - 1 DP - 2026 Apr 15 TI - Determinants of the renal function after the coronary artery bypass grafting in chronic kidney disease patients: a prospective cohort study. LID - 10.1186/s13019-026-04028-6 [doi] LID - 283 AB - BACKGROUND: This study aims to evaluate renal outcomes and identify key factors influencing estimated glomerular filtration rate (eGFR) in patients with chronic kidney disease(CKD) undergoing coronary artery bypass grafting (CABG). METHODS: In a prospective cohort of 100 patients with CKD (mean age 65.5 years; 77% male; most in CKD stage 2 or 3), eGFR was measured at baseline, three months, and six months postoperatively. Generalized Estimating Equations (GEE) were applied to assess longitudinal changes in eGFR and associated predictors. Statistical analyses were performed using Stata 17. RESULTS: Approximately 19% of patients experienced a > 30% decline in eGFR, while over 40% demonstrated improvement at six months. Advanced CKD stage, higher preoperative heart ejection fraction (EF), and longer anesthesia time were associated with greater eGFR decline. Conversely, higher preoperative hemoglobin (Hb) levels, elective surgery, and a history of cerebrovascular accident were associated with improved estimated eGFR trends. CONCLUSION: Several clinical and procedural factors influence postoperative renal function in CKD patients undergoing CABG. These findings support the development of targeted perioperative strategies to mitigate renal decline. CLINICAL TRIAL REGISTRATION: This study does not meet the criteria of a clinical trial and, therefore, was not registered in a clinical trial registry. FAU - Nooralishahi, Behrang AU - Nooralishahi B AUID- ORCID: 0000-0003-1550-153X AD - Cardiovascular Diseases Research Institute, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. FAU - Rahmanian, Mohammad AU - Rahmanian M AUID- ORCID: 0000-0002-0024-1934 AD - Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. FAU - Samavat, Shiva AU - Samavat S AUID- ORCID: 0000-0001-6707-7844 AD - Chronic Kidney Disease Research Center, Research Institute for Urology and Nephrology, Shahid Beheshti University of Medical Sciences, Tehran, Iran. FAU - Jafari, Kasra AU - Jafari K AUID- ORCID: 0009-0002-1029-1000 AD - Research Development Center, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran. AD - Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran. FAU - Nafar, Mohsen AU - Nafar M AUID- ORCID: 0000-0001-5636-2666 AD - Chronic Kidney Disease Research Center, Research Institute for Urology and Nephrology, Shahid Beheshti University of Medical Sciences, Tehran, Iran. FAU - Dalili, Nooshin AU - Dalili N AUID- ORCID: 0000-0002-1618-0937 AD - Chronic Kidney Disease Research Center, Research Institute for Urology and Nephrology, Shahid Beheshti University of Medical Sciences, Tehran, Iran. FAU - Baratali, Bahareh Haji AU - Baratali BH AUID- ORCID: 0000-0002-2138-2007 AD - Department of Cardiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran. FAU - Khademi, Reza AU - Khademi R AUID- ORCID: 0009-0001-5857-8003 AD - Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. AD - Department of Cardiovascular Diseases, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. FAU - Jafari, Mohammadsadegh AU - Jafari M AUID- ORCID: 0009-0001-5623-6165 AD - Universal Scientific Education and Research Network (USERN), Tehran, Iran. FAU - Ghotbein, Reza AU - Ghotbein R AUID- ORCID: 0009-0003-7384-3682 AD - Chronic Kidney Disease Research Center, Research Institute for Urology and Nephrology, Shahid Beheshti University of Medical Sciences, Tehran, Iran. reghotbein@yahoo.com. LA - eng PT - Journal Article DEP - 20260415 PL - England TA - J Cardiothorac Surg JT - Journal of cardiothoracic surgery JID - 101265113 SB - IM MH - Humans MH - Male MH - *Coronary Artery Bypass/adverse effects MH - *Glomerular Filtration Rate/physiology MH - Prospective Studies MH - *Renal Insufficiency, Chronic/physiopathology/complications MH - Female MH - Aged MH - *Coronary Artery Disease/surgery/complications MH - Middle Aged PMC - PMC13214396 OTO - NOTNLM OT - Chronic OT - Coronary Artery Bypass OT - Glomerular Filtration Rate OT - Renal Insufficiency OT - Risk Factors COIS- Declarations. Ethics approval and consent to participate: The study, written informed consent forms, recruitment materials, and all participant materials were approved by the Research Ethics Committee of the Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences (Approval ID: IR.SBMU.UNRC.REC.1400.015, Approval Date: 2022/01/22). All participants provided written informed consent before participation. The study was conducted in accordance with the Declaration of Helsinki. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests. EDAT- 2026/04/16 13:09 MHDA- 2026/06/27 18:36 PMCR- 2026/04/15 CRDT- 2026/04/16 01:15 PHST- 2025/08/17 00:00 [received] PHST- 2026/04/06 00:00 [accepted] PHST- 2026/06/27 18:36 [medline] PHST- 2026/04/16 13:09 [pubmed] PHST- 2026/04/16 01:15 [entrez] PHST- 2026/04/15 00:00 [pmc-release] AID - 10.1186/s13019-026-04028-6 [pii] AID - 4028 [pii] AID - 10.1186/s13019-026-04028-6 [doi] PST - epublish SO - J Cardiothorac Surg. 2026 Apr 15;21(1):283. doi: 10.1186/s13019-026-04028-6. PMID- 41986123 OWN - NLM STAT- MEDLINE DCOM- 20260715 LR - 20260715 IS - 0376-2491 (Print) IS - 0376-2491 (Linking) VI - 106 IP - 15 DP - 2026 Apr 21 TI - [Analysis of risk factors and construction of a predictive model for the occurrence of heart failure with preserved ejection fraction in patients with type 2 diabetes mellitus complicated by coronary heart disease after percutaneous coronary intervention]. PG - 1457-1464 LID - 10.3760/cma.j.cn112137-20251110-02932 [doi] AB - Objective: To explore the risk factors and construct a prediction model for heart failure with preserved ejection fraction (HFpEF) after percutaneous coronary intervention (PCI) in patients with type 2 diabetes mellitus (T2DM) and coronary heart disease(CHD). Methods: A retrospective analysis was conducted on the clinical data of 210 patients with T2DM complicated with CHD who underwent PCI at Tianjin Medical University Chu Hsien-I Memorial Hospital from January 2021 to June 2024. Among them, 136 were males and 74 were females, with the age of (66.4+/-9.1) years. Patients were divided into a training set and a validation set at a ratio of 7ratio3 using the random number generator built into R software. Based on the occurrence of HFpEF within 12 months after PCI, patients in the training set were further categorized into the HFpEF group and the non-HFpEF group. Differences between the two groups were compared. The least absolute shrinkage and selection operator (LASSO) regression analysis and multivariate logistic regression models were used to screen variables, and a nomogram of the prediction model was plotted. The area under the receiver operating characteristic curve (AUC), calibration curve, and decision curve analysis (DCA) were adopted to evaluate the predictive ability, calibration degree, and clinical applicability of the model. Results: The training set included 147 patients, with 38 in the HFpEF group and 109 in the non-HFpEF group. In the training set, patients in the HFpEF group had higher values than those in the non-HFpEF group in terms of age, body mass index (BMI), duration of diabetes, fasting blood glucose, glycosylated hemoglobin (HbA1c), triglyceride levels, triglyceride-glucose (TyG) index, N-terminal pro-B-type natriuretic peptide (NT-proBNP), and the ratio of mitral early diastolic flow velocity(E) to mitral annular early diastolic velocity(e'). Conversely, they exhibited lower values in estimated glomerular filtration rate (eGFR), left ventricular ejection fraction (LVEF), the proportion of complete revascularization, and the proportion of sodium-glucose cotransporter 2 inhibitor usage (all P<0.05). LASSO regression analysis screened out 8 variables, including age, BMI, TyG index, HbA1c, Ln(NT-proBNP), LVEF, E/e' ratio, and eGFR. Multivariate logistic regression analysis showed that advanced age (OR=1.070, 95%CI: 1.011-1.133), elevated TyG index (OR=8.560, 95%CI: 2.581-28.391), elevated Ln(NT-proBNP) (OR=3.880, 95%CI: 1.959-7.684), and elevated E/e' ratio (OR=1.480, 95%CI: 1.181-1.854) were risk factors for HFpEF after PCI in patients with T2DM complicated with CHD. A nomogram was constructed using the above parameters. In the training set, the AUC of the prediction model for HFpEF after PCI in patients with T2DM complicated with CHD was 0.886 (95%CI: 0.831-0.941), with a sensitivity of 84.2% and a specificity of 82.6%. In the validation set, the AUC was 0.871 (95%CI: 0.782-0.960), with the sensitivity of 81.3% and the specificity of 80.9%. The Hosmer-Lemeshow goodness-of-fit test indicated good calibration in both the training cohort (chi(2)=6.832, P=0.554) and the validation set (chi(2)=5.127, P=0.744). DCA demonstrated that the model achieved a high clinical net benefit when the threshold probability ranged from 10% to 90%. Conclusions: Advanced age, elevated TyG index, elevated Ln(NT-proBNP), and elevated E/e' ratio are risk factors for HFpEF in patients with T2DM complicated by CHD after PCI. The nomogram of the prediction model constructed based on these factors can intuitively evaluate the risk of HFpEF in patients with T2DM complicated by CHD after PCI. FAU - Yao, W J AU - Yao WJ AD - NHC Key Lab of Hormones and Development and Tianjin Key Lab of Metabolic Diseases, Tianjin Medical University Chu Hsien-I Memorial Hospital & Institute of Endocrinology, Tianjin 300134, China. FAU - Zhou, Q N AU - Zhou QN AD - NHC Key Lab of Hormones and Development and Tianjin Key Lab of Metabolic Diseases, Tianjin Medical University Chu Hsien-I Memorial Hospital & Institute of Endocrinology, Tianjin 300134, China. FAU - Song, H N AU - Song HN AD - NHC Key Lab of Hormones and Development and Tianjin Key Lab of Metabolic Diseases, Tianjin Medical University Chu Hsien-I Memorial Hospital & Institute of Endocrinology, Tianjin 300134, China. FAU - Zhang, H B AU - Zhang HB AD - NHC Key Lab of Hormones and Development and Tianjin Key Lab of Metabolic Diseases, Tianjin Medical University Chu Hsien-I Memorial Hospital & Institute of Endocrinology, Tianjin 300134, China. LA - chi GR - TJYXZDXK-3-007B/Tianjin Key Medical Discipline Construction Project/ GR - TJWJ2025QN035/Tianjin Health Research Project/ PT - English Abstract PT - Journal Article PL - China TA - Zhonghua Yi Xue Za Zhi JT - Zhonghua yi xue za zhi JID - 7511141 SB - IM MH - Humans MH - *Diabetes Mellitus, Type 2/complications MH - Risk Factors MH - *Heart Failure MH - Retrospective Studies MH - Percutaneous Coronary Intervention MH - Female MH - *Coronary Disease/complications MH - Male MH - Stroke Volume MH - Aged MH - Logistic Models EDAT- 2026/04/16 13:09 MHDA- 2026/04/16 13:10 CRDT- 2026/04/15 21:38 PHST- 2026/04/16 13:10 [medline] PHST- 2026/04/16 13:09 [pubmed] PHST- 2026/04/15 21:38 [entrez] AID - 10.3760/cma.j.cn112137-20251110-02932 [doi] PST - ppublish SO - Zhonghua Yi Xue Za Zhi. 2026 Apr 21;106(15):1457-1464. doi: 10.3760/cma.j.cn112137-20251110-02932. PMID- 41985625 OWN - NLM STAT- MEDLINE DCOM- 20261005 LR - 20261008 IS - 1916-7075 (Electronic) IS - 0828-282X (Linking) VI - 42 IP - 10 DP - 2026 Oct TI - High Kidney Function in Myocardial Infarction Patients Who Underwent Coronary Intervention: Acute Kidney Injury Risk and Long-term Prognosis. PG - 2372-2379 LID - S0828-282X(26)00354-5 [pii] LID - 10.1016/j.cjca.2026.04.001 [doi] AB - BACKGROUND: Acute kidney injury (AKI) is a critical complication in ST-segment elevation myocardial infarction (STEMI) patients who undergo percutaneous coronary intervention (PCI). The effect of high preoperative estimated glomerular filtration rate (eGFR; >/= 105 mL/min/1.73 m(2)) on AKI and long-term adverse outcomes remains poorly understood. METHODS: In this multicentre, prospective cohort study we enrolled 4536 STEMI consecutive patients who underwent emergency PCI in China. Logistic regression was used to assess the association between preoperative eGFR and AKI, and Cox regression was used to evaluate the effect of preoperative eGFR and AKI on 2-year adverse outcomes. RESULTS: Among 4536 patients, 820 (18.1%) had high eGFR, 1806 (39.8%) normal eGFR (90-105 mL/min/1.73 m(2)), 1547 (34.1%) mild reduction of eGFR (60-90 mL/min/1.73 m(2)), and 363 (8.0%) had low eGFR (< 60 mL/min/1.73 m(2)). Mean age was 62 years; 23.2% were female. Low and high eGFR levels were independently associated with increased AKI risk (adjusted odds ratio, 1.818 [95% confidence interval (CI), 1.268-2.608] and 2.143 [95% CI, 1.517-3.025]). Two-year major adverse cardiovascular events incidence increased progressively with declining eGFR: 4.0% (high), 5.5% (normal), 11.3% (mild), and 22.3% (low). Among patients with normal-to-high eGFR, those with AKI had higher risks of major adverse cardiovascular events (hazard ratio, 2.418 [95% CI, 1.579-3.704]) and all-cause mortality (hazard ratio, 2.380 [95% CI, 1.407-4.025]). CONCLUSIONS: This study confirmed a U-shaped relationship between preoperative eGFR and AKI, highlighting that high eGFR is an under-recognized risk factor for AKI and long-term adverse outcomes in STEMI patients. These findings underscore the need for enhanced clinical vigilance and tailored management strategies for PCI patients with high preoperative eGFR. CLINICAL TRIAL REGISTRATION: NCT03510832. CI - Copyright (c) 2026. Published by Elsevier Inc. FAU - Wu, Shuo AU - Wu S AD - Department of Emergency Medicine, Qilu Hospital of Shandong University, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, Medical and Pharmaceutical Basic Research Innovation Center of Emergency and Critical Care Medicine, China's Ministry of Education, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong Province, Qilu Hospital of Shandong University, Jinan, China. FAU - Wang, Shikun AU - Wang S AD - Department of Emergency Medicine, Qilu Hospital of Shandong University, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, Medical and Pharmaceutical Basic Research Innovation Center of Emergency and Critical Care Medicine, China's Ministry of Education, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong Province, Qilu Hospital of Shandong University, Jinan, China. FAU - Xu, Feng AU - Xu F AD - Department of Emergency Medicine, Qilu Hospital of Shandong University, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, Medical and Pharmaceutical Basic Research Innovation Center of Emergency and Critical Care Medicine, China's Ministry of Education, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong Province, Qilu Hospital of Shandong University, Jinan, China. FAU - Pang, Jiaojiao AU - Pang J AD - Department of Emergency Medicine, Qilu Hospital of Shandong University, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, Medical and Pharmaceutical Basic Research Innovation Center of Emergency and Critical Care Medicine, China's Ministry of Education, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong Province, Qilu Hospital of Shandong University, Jinan, China. Electronic address: jiaojiaopang@email.sdu.edu.cn. FAU - Chen, Yuguo AU - Chen Y AD - Department of Emergency Medicine, Qilu Hospital of Shandong University, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, Medical and Pharmaceutical Basic Research Innovation Center of Emergency and Critical Care Medicine, China's Ministry of Education, Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine, Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong Province, Qilu Hospital of Shandong University, Jinan, China. Electronic address: chen919085@sdu.edu.cn. LA - eng SI - ClinicalTrials.gov/NCT03510832 PT - Journal Article PT - Multicenter Study DEP - 20260413 PL - England TA - Can J Cardiol JT - The Canadian journal of cardiology JID - 8510280 SB - IM MH - Humans MH - Female MH - *Acute Kidney Injury/epidemiology/etiology MH - *Percutaneous Coronary Intervention/adverse effects MH - Male MH - *Glomerular Filtration Rate MH - Prognosis MH - *ST Elevation Myocardial Infarction/surgery/complications MH - Prospective Studies MH - China/epidemiology MH - Middle Aged MH - Risk Factors MH - Risk Assessment/methods MH - Follow-Up Studies MH - Time Factors MH - Aged OTO - NOTNLM OT - Percutaneous coronary intervention OT - ST-segment elevation myocardial infarction OT - acute kidney injury OT - estimated glomerular filtration rate OT - mortality EDAT- 2026/04/16 13:09 MHDA- 2026/10/05 23:29 CRDT- 2026/04/15 19:38 PHST- 2026/02/02 00:00 [received] PHST- 2026/03/31 00:00 [revised] PHST- 2026/04/03 00:00 [accepted] PHST- 2026/10/05 23:29 [medline] PHST- 2026/04/16 13:09 [pubmed] PHST- 2026/04/15 19:38 [entrez] AID - S0828-282X(26)00354-5 [pii] AID - 10.1016/j.cjca.2026.04.001 [doi] PST - ppublish SO - Can J Cardiol. 2026 Oct;42(10):2372-2379. doi: 10.1016/j.cjca.2026.04.001. Epub 2026 Apr 13. PMID- 41969682 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260413 LR - 20260813 IS - 2297-055X (Print) IS - 2297-055X (Electronic) IS - 2297-055X (Linking) VI - 13 DP - 2026 TI - The prognostic value of albumin-corrected anion gap for major adverse cardiac events in chronic kidney disease patients undergoing percutaneous coronary intervention. PG - 1675923 LID - 10.3389/fcvm.2026.1675923 [doi] LID - 1675923 AB - BACKGROUND: Cardiovascular disease currently holds the highest morbidity and mortality rates globally. The survival of patients with coronary artery disease (CAD) complicated by chronic kidney disease (CKD) remains a significant threat, posing challenges in management and timely treatment. This study aims to explore the relationship between the Albumin-Corrected Anion Gap (ACAG) and the prognosis of patients with CKD Receiving Percutaneous Coronary Intervention. METHODS: This was a single-center, retrospective study including 973 patients who underwent percutaneous coronary intervention (PCI) at Tianjin Medical University Second Hospital from January 2019 to June 2023, all with an estimated glomerular filtration rate (eGFR) of less than or equal to 60 mL/min/1.73 m(2). Follow-up was completed in June 2023. The primary efficacy endpoint was the time-to-first occurrence of major adverse cardiovascular events (MACE), defined as the composite of cardiovascular death, recurrent myocardial infarction (MI), or non-fatal stroke. The key secondary endpoint was all-cause mortality, Additional secondary endpoints included (1) the individual components of the primary composite, (2) recurrent MACE (i.e., events after the first occurrence), and (3) any repeat revascularization. RESULTS: After a follow-up of 918.0 +/- 364.7 days, 205 MACEs were recorded. Receiver Operating Characteristic (ROC) curve analysis identified the optimal cutoff value for trial subjects. Compared to the low-ACAG group, the high-ACAG group exhibited a higher incidence of MACEs (29.65% vs. 15.78%, P < 0.001) and all-cause mortality (29.92% vs. 11.96%, P < 0.001). The Kaplan-Meier survival curve indicated that the low-ACAG group had a higher survival rate. Restricted cubic spline (RCS) analysis suggested that ACAG was positively correlated with MACE events. Univariate and multivariate Cox regression analysis indicated that a high ACAG level (HR: 1.820;95%CI: 1.300-2.546, P < 0.001) and the use of diuretics during hospitalization (HR: 1.653;95%CI: 1.195-2.286, P = 0.002) were independently associated with the occurrence of MACEs in patients with CAD and CKD. After adding ACAG and eGFR to the traditional risk model, Decision Curve Analysis (DCA) pointed out that DCA could improve the clinical net benefit within a certain range. CONCLUSIONS: Among patients undergoing PCI treatment for chronic kidney disease, elevated ACAG levels are closely related to the patient's cardiac mortality and all-cause mortality rates. Additionally, the use of diuretics in patients with CAD and CKD requires caution and should optimize treatment strategies. CI - (c) 2026 Guo, Zhang, Lu and Chen. FAU - Guo, Ziqiang AU - Guo Z AD - Department of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China. FAU - Zhang, Xue AU - Zhang X AD - Department of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China. FAU - Lu, Yahui AU - Lu Y AD - Department of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China. FAU - Chen, Kangyin AU - Chen K AD - Department of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China. AD - Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, The Second Hospital of Tianjin Medical University, Tianjin, China. LA - eng PT - Journal Article DEP - 20260327 PL - Switzerland TA - Front Cardiovasc Med JT - Frontiers in cardiovascular medicine JID - 101653388 PMC - PMC13065508 OTO - NOTNLM OT - acidosis and oxidative stress OT - albumin-corrected anion gap (ACAG) OT - chronic kidney disease OT - coronary artery disease OT - percutaneous coronary intervention COIS- The author(s) declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2026/04/13 18:17 MHDA- 2026/04/13 18:18 PMCR- 2026/03/27 CRDT- 2026/04/13 06:28 PHST- 2025/07/29 00:00 [received] PHST- 2026/02/16 00:00 [revised] PHST- 2026/02/25 00:00 [accepted] PHST- 2026/04/13 18:18 [medline] PHST- 2026/04/13 18:17 [pubmed] PHST- 2026/04/13 06:28 [entrez] PHST- 2026/03/27 00:00 [pmc-release] AID - 10.3389/fcvm.2026.1675923 [doi] PST - epublish SO - Front Cardiovasc Med. 2026 Mar 27;13:1675923. doi: 10.3389/fcvm.2026.1675923. eCollection 2026. PMID- 41932602 OWN - NLM STAT- MEDLINE DCOM- 20260613 LR - 20260617 IS - 1615-5947 (Electronic) IS - 0890-5096 (Linking) VI - 129 DP - 2026 Aug TI - Effects of Remote Ischemic Preconditioning in Patients with Acute Lower Extremity Ischemia. PG - 147-159 LID - S0890-5096(26)00219-0 [pii] LID - 10.1016/j.avsg.2026.03.049 [doi] AB - BACKGROUND: Acute limb ischemia (ALI) requires urgent revascularization but this can cause ischemia/reperfusion injury. Remote ischemic preconditioning (RIPC) has shown benefit in reducing infarct size and improving endothelial function in acute myocardial ischemia. We hypothesized that RIPC may mitigate adverse outcomes in ALI following revascularization. METHODS: In a triple-blinded, randomized controlled trial, 28 ALI patients (Rutherford Classes 1-2b) scheduled for surgical revascularization were assigned to RIPC or control groups. The primary outcome was changes in kidney function; secondary outcomes included oxidative stress, mitochondrial function in peripheral blood mononuclear cells (PBMCs), and clinical outcomes. RESULTS: Fourteen patients were in each group, and baseline characteristics were similar. Changes in kidney function (creatinine clearance, neutrophil gelatinase-associated lipocalin) did not differ between groups. No significant differences were found in hospital stay, local complications (compartment syndrome, muscle necrosis), or systemic complications (heart failure, pulmonary edema, 30-day amputation/mortality). At the cellular level, RIPC reduced mitochondrial oxidative stress in PBMCs at 24 hours postrevascularization (P < 0.05) but had no effect on overall cellular oxidative stress. Mitochondrial function was decreased 24 hours postoperation in both groups; RIPC did not modify this effect. CONCLUSION: RIPC did not significantly affect renal function, clinical outcomes, or cellular changes in ALI patients, though it transiently reduced mitochondrial oxidative stress. These results suggest limited clinical benefit of RIPC in this setting. Larger studies are needed to further explore the protective mechanisms of RIPC in ALI. CI - Copyright (c) 2026 Elsevier Inc. All rights reserved. FAU - Apichartpiyakul, Poon AU - Apichartpiyakul P AD - Vascular Surgery Unit, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. FAU - Apaijai, Nattayaporn AU - Apaijai N AD - Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand; Cardiac Electrophysiology Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. FAU - Chansakaow, Chayatorn AU - Chansakaow C AD - Vascular Surgery Unit, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. FAU - Chattipakorn, Siriporn C AU - Chattipakorn SC AD - Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand; Department of Oral Biology and Diagnostic Sciences, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand. FAU - Chattipakorn, Nipon AU - Chattipakorn N AD - Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand; Cardiac Electrophysiology Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; The Academy of Science, The Royal Society of Thailand, Bangkok, Thailand. Electronic address: nchattip@gmail.com. LA - eng PT - Journal Article PT - Randomized Controlled Trial DEP - 20260401 PL - Netherlands TA - Ann Vasc Surg JT - Annals of vascular surgery JID - 8703941 RN - 0 (Biomarkers) SB - IM MH - Humans MH - *Ischemic Preconditioning/adverse effects/methods MH - Male MH - Treatment Outcome MH - Female MH - *Lower Extremity/blood supply MH - Oxidative Stress MH - Time Factors MH - *Ischemia/physiopathology/diagnosis/surgery/therapy MH - Aged MH - Acute Disease MH - Middle Aged MH - Mitochondria/metabolism MH - Leukocytes, Mononuclear/metabolism MH - *Peripheral Arterial Disease/physiopathology/surgery/diagnosis/therapy MH - Regional Blood Flow MH - Kidney/physiopathology MH - *Vascular Surgical Procedures/adverse effects MH - Biomarkers/blood MH - Risk Factors EDAT- 2026/04/04 00:36 MHDA- 2026/06/13 06:39 CRDT- 2026/04/03 19:14 PHST- 2025/11/26 00:00 [received] PHST- 2026/03/22 00:00 [revised] PHST- 2026/03/25 00:00 [accepted] PHST- 2026/06/13 06:39 [medline] PHST- 2026/04/04 00:36 [pubmed] PHST- 2026/04/03 19:14 [entrez] AID - S0890-5096(26)00219-0 [pii] AID - 10.1016/j.avsg.2026.03.049 [doi] PST - ppublish SO - Ann Vasc Surg. 2026 Aug;129:147-159. doi: 10.1016/j.avsg.2026.03.049. Epub 2026 Apr 1. PMID- 41932491 OWN - NLM STAT- MEDLINE DCOM- 20260714 LR - 20260720 IS - 1097-6744 (Electronic) IS - 0002-8703 (Linking) VI - 298 DP - 2026 Aug TI - Optimal antiplatelet strategy in patients with advanced chronic kidney disease undergoing drug-eluting stent implantation: Design and rationale of the randomized ADAPT-CKD trial. PG - 107437 LID - S0002-8703(26)00099-2 [pii] LID - 10.1016/j.ahj.2026.107437 [doi] AB - BACKGROUND: Although shortened dual antiplatelet therapy (DAPT) strategies have demonstrated favorable outcomes in the general percutaneous coronary intervention (PCI) population, patients with advanced chronic kidney disease (CKD) have been underrepresented in randomized clinical trials. The optimal duration of DAPT after PCI remains uncertain in patients with CKD, who are at increased risk for both ischemic and bleeding events. METHODS: The ADAPT-CKD trial is an investigator-initiated, multicenter, open-label, randomized, superiority study designed to compare an abbreviated vs a standard DAPT strategy in patients with advanced CKD undergoing PCI with contemporary drug-eluting stents. A total of 900 patients with an estimated glomerular filtration rate <45 mL/min/1.73 m(2) will be randomly assigned in a 1:1 ratio to abbreviated DAPT (<3 months of DAPT after PCI) or standard DAPT (>/=6 months). The primary endpoint is net adverse clinical events at 1 year, defined as a composite of all-cause death, myocardial infarction, stent thrombosis, stroke, or major bleeding according to the Bleeding Academic Research Consortium criteria. The primary hypothesis is that abbreviated DAPT is superior to standard DAPT in reducing net adverse clinical events at 1 year after randomization. CONCLUSIONS: The ADAPT-CKD trial will provide randomized evidence on the efficacy and safety of an abbreviated DAPT strategy compared with a standard DAPT strategy in patients with advanced CKD undergoing PCI. The results are expected to inform clinical decision-making regarding optimal antiplatelet therapy in this high-risk population. CLINICAL TRIAL REGISTRATION: https://www. CLINICALTRIALS: gov. Unique identifier: NCT04708587. CI - Copyright (c) 2026 Elsevier Inc. All rights reserved. FAU - Jin, In Tae AU - Jin IT AD - Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: jinintae@yuhs.ac. FAU - Lee, Sang-Hyup AU - Lee SH AD - Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: shlee0917@yuhs.ac. FAU - Yun, Kyeong Ho AU - Yun KH AD - Wonkwang University Hospital, Iksan, Republic of Korea. Electronic address: dryunkh@gmail.com. FAU - Kim, Weon AU - Kim W AD - Kyung Hee University Hospital, Kyung Hee University, Seoul, Republic of Korea. Electronic address: mylovekw@hanmail.net. FAU - Shin, Sanghoon AU - Shin S AD - Ewha Womans University Seoul Hospital, Seoul, Republic of Korea. Electronic address: nephilla99@gmail.com. FAU - Jang, Ji-Yong AU - Jang JY AD - National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea. Electronic address: dogkkoma@gmail.com. FAU - Cho, Deok-Kyu AU - Cho DK AD - Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea. Electronic address: chodk123@yuhs.ac. FAU - Cha, Jung-Joon AU - Cha JJ AD - Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea. Electronic address: joonletter@hanmail.net. FAU - Kang, Tae Soo AU - Kang TS AD - Dankook University Hospital, Cheonan, Republic of Korea. Electronic address: neosoo70@dankook.ac.kr. FAU - Lee, Ji Hyun AU - Lee JH AD - Myongji Hospital, Hanyang University College of Medicine, Goyang, Republic of Korea. Electronic address: jihyun.cardio@gmail.com. FAU - Cho, Yun-Kyeong AU - Cho YK AD - Keimyung University Dongsan Medical Center, Daegu, Republic of Korea. Electronic address: ds010042@gmail.com. FAU - Heo, Jung Ho AU - Heo JH AD - Kosin University Gospel Hospital, Busan, Republic of Korea. Electronic address: duggymdc@gmail.com. FAU - Ahn, Sung Gyun AU - Ahn SG AD - Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea. Electronic address: sgahn@yonsei.ac.kr. FAU - Lee, Jaeoh AU - Lee J AD - Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; Ajou University School of Medicine, Suwon, Republic of Korea. Electronic address: jaeo0816@yuhs.ac. FAU - Lee, Yong-Joon AU - Lee YJ AD - Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: alpha10000@yuhs.ac. FAU - Lee, Seung-Jun AU - Lee SJ AD - Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: sjunlee@yuhs.ac. FAU - Hong, Sung-Jin AU - Hong SJ AD - Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: hongs@yuhs.ac. FAU - Ahn, Chul-Min AU - Ahn CM AD - Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: drcello@yuhs.ac. FAU - Kim, Byeong-Keuk AU - Kim BK AD - Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: kimbk@yuhs.ac. FAU - Ko, Young-Guk AU - Ko YG AD - Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: ygko@yuhs.ac. FAU - Choi, Donghoon AU - Choi D AD - Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: cdhlyj@yuhs.ac. FAU - Hong, Myeong-Ki AU - Hong MK AD - Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: mkhong61@yuhs.ac. FAU - Jang, Yangsoo AU - Jang Y AD - Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: jangys1212@yuhs.ac. FAU - Kim, Jung-Sun AU - Kim JS AD - Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: KJS1218@yuhs.ac. LA - eng SI - ClinicalTrials.gov/NCT04708587 PT - Clinical Trial Protocol PT - Journal Article DEP - 20260401 PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 RN - 0 (Platelet Aggregation Inhibitors) SB - IM MH - Humans MH - *Drug-Eluting Stents MH - *Renal Insufficiency, Chronic/complications MH - *Percutaneous Coronary Intervention/methods/adverse effects MH - *Platelet Aggregation Inhibitors/administration & dosage/therapeutic use MH - *Coronary Artery Disease/complications/surgery MH - Multicenter Studies as Topic MH - Hemorrhage/chemically induced/epidemiology MH - Equivalence Trials as Topic MH - *Dual Anti-Platelet Therapy/methods MH - Female MH - Randomized Controlled Trials as Topic MH - Male MH - Stroke/epidemiology MH - Glomerular Filtration Rate COIS- Conflict of interest J-S Kim has received research grants from Yuhan Pharmaceutical, Daiichi-Sankyo, Biosensors, Dio Medical, and Qualitech Korea, has received proctoring fees from Abbott Vascular, and has a financial interest in Raywatt through stock ownership. The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this article. EDAT- 2026/04/04 00:36 MHDA- 2026/05/18 00:30 CRDT- 2026/04/03 19:13 PHST- 2026/01/28 00:00 [received] PHST- 2026/03/09 00:00 [revised] PHST- 2026/03/28 00:00 [accepted] PHST- 2026/05/18 00:30 [medline] PHST- 2026/04/04 00:36 [pubmed] PHST- 2026/04/03 19:13 [entrez] AID - S0002-8703(26)00099-2 [pii] AID - 10.1016/j.ahj.2026.107437 [doi] PST - ppublish SO - Am Heart J. 2026 Aug;298:107437. doi: 10.1016/j.ahj.2026.107437. Epub 2026 Apr 1. PMID- 41848042 OWN - NLM STAT- MEDLINE DCOM- 20260711 LR - 20260915 IS - 2047-9980 (Electronic) IS - 2047-9980 (Linking) VI - 15 IP - 7 DP - 2026 Apr 7 TI - Contemporary Trends in High-Potency P2Y12 Receptor Inhibitor Use Among Patients With Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention. PG - e047683 LID - 10.1161/JAHA.125.047683 [doi] AB - BACKGROUND: High-potency P2Y12 receptor inhibitors (ticagrelor and prasugrel) reduce ischemic outcomes compared with clopidogrel among patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI). This study aims to examine contemporary trends and identify predictors of their use among patients with AMI undergoing PCI in the United States. METHODS: This observational study used electronic health records from >95 US-based health care organizations. Adults with AMI who underwent PCI between 2016 and 2023 were included. The primary outcome was the prescription of high-potency P2Y12 receptor inhibitors versus clopidogrel. Multivariable logistic regression was used to identify independent predictors of P2Y12 inhibitor selection. RESULTS: Among 182 986 patients with AMI who underwent PCI, clopidogrel was the most prescribed P2Y12 receptor inhibitor (101 136 patients, 55.2%), followed by ticagrelor (68 350, 37.4%) and prasugrel (13 500, 7.4%). Clopidogrel use declined from 66.2% in 2016 to 51.4% in 2023 (P(trend)=0.002), whereas ticagrelor use increased from 27.8% to 39.4% (P(trend)=0.022), and prasugrel use increased from 6.0% to 9.2% (P(trend)=0.008), predominantly after 2019. High-potency P2Y12 receptor inhibitors were more frequently used in younger patients (<60 years), those with prior PCI, prior MI, chronic kidney disease, and morbid obesity. CONCLUSIONS: Among patients with AMI undergoing PCI, the use of high-potency agents continues to rise. Prasugrel use increased notably after 2019, following the ISAR-REACT 5 (Prospective, Randomized Trial of Ticagrelor Versus Prasugrel in Patients With Acute Coronary Syndrome) trial and the European guideline updates. These findings reflect an evolving prescribing landscape of P2Y12 receptor inhibitors in contemporary practice. FAU - Fath, Ayman R AU - Fath AR AUID- ORCID: 0000-0002-0063-1692 AD - Division of Cardiology University of Texas Health Science Center San Antonio TX USA. AD - Center for Coronary Artery Disease Allina Health Minneapolis Heart Institute, Abbott Northwestern Hospital, Minneapolis Heart Institute Foundation Minneapolis MN USA. FAU - Qureshi, Binish AU - Qureshi B AD - Division of Cardiology University of Texas Health Science Center San Antonio TX USA. FAU - Aglan, Amro AU - Aglan A AUID- ORCID: 0009-0007-0902-3021 AD - Department of Cardiology, Westchester Medical Center New York Medical College Valhalla NY USA. FAU - Altaee, Osamah AU - Altaee O AD - Division of Cardiology University of Texas Health Science Center San Antonio TX USA. FAU - Mansoor, Hend AU - Mansoor H AUID- ORCID: 0000-0002-3940-4155 AD - Department of Pharmacy Practice and Science University of Kentucky Lexington KY USA. FAU - Almomani, Ahmed AU - Almomani A AUID- ORCID: 0000-0002-1302-7590 AD - Division of Cardiology University of Texas Health Science Center San Antonio TX USA. FAU - Al-Azizi, Karim AU - Al-Azizi K AUID- ORCID: 0000-0003-0195-4984 AD - Baylor Scott & White Health-The Heart Hospital Plano TX USA. FAU - Saad, Marwan AU - Saad M AD - Brown University Health Cardiovascular Institute Providence RI USA. AD - Department of Cardiology Warren Alpert Medical School of Brown University Providence RI USA. FAU - Goldsweig, Andrew M AU - Goldsweig AM AUID- ORCID: 0000-0003-2952-7837 AD - Department of Cardiovascular Medicine, Baystate Medical Center and Division of Cardiovascular Medicine University of Massachusetts-Baystate Springfield MA USA. FAU - Jneid, Hani AU - Jneid H AUID- ORCID: 0000-0002-8754-358X AD - Division of Cardiology University of Texas Medical Branch Galveston TX USA. FAU - Elgendy, Islam Y AU - Elgendy IY AUID- ORCID: 0000-0001-9853-7591 AD - Division of Cardiovascular Medicine, Gill Heart and Vascular Institute University of Kentucky Lexington KY USA. LA - eng PT - Journal Article PT - Observational Study PT - Research Support, Non-U.S. Gov't DEP - 20260318 PL - England TA - J Am Heart Assoc JT - Journal of the American Heart Association JID - 101580524 RN - 0 (Purinergic P2Y Receptor Antagonists) RN - G89JQ59I13 (Prasugrel Hydrochloride) RN - GLH0314RVC (Ticagrelor) RN - A74586SNO7 (Clopidogrel) RN - 0 (Platelet Aggregation Inhibitors) SB - IM MH - Humans MH - *Purinergic P2Y Receptor Antagonists/therapeutic use MH - *Percutaneous Coronary Intervention MH - Female MH - Middle Aged MH - *Prasugrel Hydrochloride/therapeutic use MH - *Ticagrelor/therapeutic use MH - *Clopidogrel/therapeutic use MH - Male MH - Aged MH - *Myocardial Infarction/therapy MH - Platelet Aggregation Inhibitors/therapeutic use MH - United States/epidemiology MH - Treatment Outcome OTO - NOTNLM OT - P2Y12 inhibitors OT - acute myocardial infarction OT - percutaneous coronary intervention OT - prasugrel OT - ticagrelor EDAT- 2026/03/18 12:53 MHDA- 2026/04/07 12:33 CRDT- 2026/03/18 07:13 PHST- 2026/04/07 12:33 [medline] PHST- 2026/03/18 12:53 [pubmed] PHST- 2026/03/18 07:13 [entrez] AID - 10.1161/JAHA.125.047683 [doi] PST - ppublish SO - J Am Heart Assoc. 2026 Apr 7;15(7):e047683. doi: 10.1161/JAHA.125.047683. Epub 2026 Mar 18. PMID- 41847669 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260318 LR - 20260813 IS - 1016-7315 (Print) IS - 2212-5043 (Electronic) IS - 1016-7315 (Linking) VI - 37 IP - 4 DP - 2025 TI - Early Dapagliflozin in Non-diabetic Acute Myocardial Infarction Patients Post-PCI: Effects on Cardiovascular Outcomes and Left Ventricular Remodeling (EARLY DAPA-AMI). PG - 9 LID - 10.37616/2212-5043.1464 [doi] LID - 9 AB - BACKGROUND: Early initiation of dapagliflozin, a sodium-glucose co-transporter-2 (SGLT2) inhibitor, may improve cardiovascular outcomes in acute myocardial infarction (AMI) by mitigating adverse remodeling and enhancing cardiac function. OBJECTIVES: To assess dapagliflozin's impact on major adverse cardiovascular events (MACE) and left ventricular (LV) recovery in non-diabetic AMI patients using speckle-tracking echocardiography (STE). METHODS: This prospective, single-blinded randomized controlled trial (RCT) enrolled 200 non-diabetic patients with a first episode of AMI, including both ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI), following successful percutaneous coronary intervention (PCI). Participants received guideline-directed therapy and were randomized to dapagliflozin + standard care (Group I, n = 100) or standard care alone (Group II, n = 100). Echocardiographic parameters, including left ventricular ejection fraction (LVEF), global longitudinal strain (GLS), LV end-diastolic volume (EDV), and LV end-systolic volume (ESV), were measured at baseline (1-3 days after acute myocardial infarction [AMI]) and at 6-month follow-up. Primary endpoint: 6-month MACE; secondary endpoints: cardiac function changes. RESULTS: MACE rates showed no significant difference (Group I: 4 % vs. Group II: 9 %; p = 0.152). Group I demonstrated superior cardiac improvement: higher LVEF (52.24 % vs. 47.66 %; p = 0.025), greater ESV reduction (-7.41 +/- 13.20 mL vs. -2.52 +/- 9.17 mL; p = 0.003), and improved GLS (-14.50 +/- 3.27 % vs. -13.48 +/- 3.77 %; p = 0.043). GLS change was significantly greater in Group I (Delta-1.467 +/- 3.023 % vs. Delta-0.475 +/- 2.252%; p = 0.009). Hypertensive and chronic kidney disease (CKD) subgroups showed enhanced myocardial recovery with dapagliflozin. CONCLUSION: Early dapagliflozin in non-diabetic AMI patients did not reduce 6-month MACE but significantly improved LV function and remodeling, suggesting cardioprotective benefits beyond glycemic control, especially in high-risk subgroups. CI - (c) 2025 Saudi Heart Association. FAU - Salem, Hazem S E AU - Salem HSE AD - Department of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt. FAU - El-Mawardy, Ramzy M AU - El-Mawardy RM AD - Department of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt. FAU - Zahran, Mohamed E AU - Zahran ME AD - Department of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt. FAU - Bastawy, Islam M AU - Bastawy IM AD - Department of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt. FAU - Aziz, Mina F AU - Aziz MF AD - Department of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt. FAU - Attia, Abdelrahman E AU - Attia AE AD - Department of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt. LA - eng PT - Journal Article DEP - 20251031 PL - Saudi Arabia TA - J Saudi Heart Assoc JT - Journal of the Saudi Heart Association JID - 9887261 PMC - PMC12991818 OTO - NOTNLM OT - Acute myocardial infarction OT - Dapagliflozin OT - Diabetes mellitus OT - Global longitudinal strain OT - Major adverse cardiovascular events OT - SGLT2 inhibitors COIS- Conflict of interest: The authors declare that there are no conflicts of interest. EDAT- 2026/03/18 07:26 MHDA- 2026/03/18 07:27 PMCR- 2025/10/31 CRDT- 2026/03/18 04:43 PHST- 2025/07/08 00:00 [received] PHST- 2025/09/27 00:00 [revised] PHST- 2025/10/06 00:00 [accepted] PHST- 2026/03/18 07:27 [medline] PHST- 2026/03/18 07:26 [pubmed] PHST- 2026/03/18 04:43 [entrez] PHST- 2025/10/31 00:00 [pmc-release] AID - sha49 [pii] AID - 10.37616/2212-5043.1464 [doi] PST - epublish SO - J Saudi Heart Assoc. 2025 Oct 31;37(4):9. doi: 10.37616/2212-5043.1464. eCollection 2025. PMID- 41812133 OWN - NLM STAT- Publisher LR - 20260805 IS - 2047-4881 (Electronic) IS - 2047-4873 (Linking) DP - 2026 Mar 11 TI - Mortality score in chronic coronary syndrome: prediction model from the ISCHEMIA trial. LID - zwag116 [pii] LID - 10.1093/eurjpc/zwag116 [doi] AB - AIMS: Accurate stratification of mortality risk is essential for management of chronic coronary syndromes (CCS), but existing models focus primarily on short-term outcomes and acute settings. We aimed to develop and validate a machine learning model (ISCHEMIA-PREDICT) for cardiovascular and all-cause death risk in CCS patients. METHODS AND RESULTS: Machine learning analysis of the ISCHEMIA randomized controlled trial (median follow-up 3.2 years) with trial and registry validation. The development cohort comprised 5179 CCS patients; external validation used a 23 303 patient multicentre registry (median follow-up 7.4 years). ISCHEMIA-PREDICT combined the glomerular filtration rate, exercise-induced ST-segment depression, exercise duration, systolic blood pressure, multivessel CAD, and invasive- vs. conservative-treatment strategy. Model discrimination was high for both cardiovascular [area under the curve (AUC) 0.94; 95% CI 0.92-0.96] and all-cause (AUC 0.94; 0.91-0.96) mortality and remained robust in registry-based external validation for all-cause mortality (AUC 0.82; 0.81-0.84). Cardiovascular mortality differed by 6.0% between highest and lowest quartiles (7.10 vs. 1.10%; hazard ratio 6.65; 3.15-14.03). CONCLUSION: The ISCHEMIA-PREDICT score provides a practical tool to stratify cardiovascular and all-cause mortality among CCS patients, enabling risk-guided clinical decision-making. REGISTRATION: ISCHEMIA ClinicalTrials.gov number, NCT01471522. LAY SUMMARY: We created and validated ISCHEMIA-PREDICT, a machine learning-based score using six routine clinical measures to estimate the risk of cardiovascular and all-cause death in people with chronic coronary syndrome. KEY FINDINGS: What we did and found: Using the randomized ISCHEMIA trial (5179 patients), we built a risk score from routinely available data-glomerular filtration rate, ST-segment depression and exercise duration on a stress test, systolic blood pressure, multivessel coronary disease, and initial treatment strategy (invasive vs. conservative). The score clearly separated lower- from higher-risk patients and showed strong discrimination. Its performance for all-cause death was confirmed in an independent, contemporary multicentre registry of over 23 000 patients with long-term follow-up. Why it matters for patients and clinicians: Because it relies on familiar information collected in everyday practice, ISCHEMIA-PREDICT can help clinicians quickly gauge mortality risk in chronic coronary syndrome patients and tailor care accordingly-supporting intensified medical therapy and consideration of invasive management in those at highest risk. A web calculator enables point-of-care use and risk-guided decision-making. CI - (c) The Author(s) 2026. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site-for further information please contact journals.permissions@oup.com. FAU - Navarese, Eliano P AU - Navarese EP AUID- ORCID: 0000-0002-2355-4589 AD - Department of Life and Health Sciences, Link Campus University, Via del Casale di San Pio V, 44, Rome 00165, Italy. AD - SIRIO MEDICINE Research Network, Department of Cardiology and Internal Medicine, ul. Marii Sklodowskiej Curie 9, 85-094 Bydgoszcz, Poland. FAU - Talanas, Giuseppe AU - Talanas G AD - Department of Cardiology, University of Sassari, Sassari, Italy. FAU - Kereiakes, Dean J AU - Kereiakes DJ AD - The Christ Hospital and Lindner Research Center, Cincinnati, OH 45219, USA. AD - The Carl and Edyth Lindner Center for Research and Education, The Christ Hospital, Cincinnati, OH, USA. FAU - Henry, Timothy D AU - Henry TD AD - The Christ Hospital and Lindner Research Center, Cincinnati, OH 45219, USA. AD - The Carl and Edyth Lindner Center for Research and Education, The Christ Hospital, Cincinnati, OH, USA. FAU - Gasior, Mariusz AU - Gasior M AD - Department of Cardiology, Silesian Center for Heart Disease, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland. FAU - Kalarus, Zbigniewem AU - Kalarus Z AD - Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland. FAU - Uminska, Julia AU - Uminska J AD - Department of Cardiology and Internal Medicine, L. Rydygier Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland. FAU - Burzotta, Francesco AU - Burzotta F AD - CardioThoracic Department, Catholic University Medical School, Largo Vito 1, Rome 00168, Italy. AD - Cardiovascular Science Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Gemelli 8, Rome 00168, Italy. FAU - Buffon, Antonio AU - Buffon A AD - CardioThoracic Department, Catholic University Medical School, Largo Vito 1, Rome 00168, Italy. AD - Cardiovascular Science Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Gemelli 8, Rome 00168, Italy. FAU - Van Belle, Eric AU - Van Belle E AUID- ORCID: 0000-0001-6509-443X AD - Department of Cardiology, Institut Coeur et Poumon, CHU Lille, Lille, France. FAU - Wojakowski, Wojciech AU - Wojakowski W AUID- ORCID: 0000-0002-3681-5207 AD - Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland. FAU - Mizia-Stec, Katarzyna AU - Mizia-Stec K AD - Department of Cardiology, Medical University of Silesia, Katowice, Poland. FAU - Smolka, Grzegorz AU - Smolka G AD - Department of Cardiology, School of Health Sciences (SHS), Medical University of Silesia, Katowice, Poland. FAU - Hudzik, Bartosz AU - Hudzik B AD - Department of Metabolic Disease Prevention, Faculty of Public Health in Bytom, Medical University of Silesia, Bytom, Poland. FAU - Ciesla, Daniel AU - Ciesla D AD - Department of Science and New Technologies, Silesian Center for Heart Diseases, Zabrze, Poland. FAU - Waksman, Ron AU - Waksman R AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington DC, USA. FAU - Kubica, Jacek AU - Kubica J AD - Department of Cardiology and Internal Medicine, L. Rydygier Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland. FAU - Sangiorgi, Giuseppe M AU - Sangiorgi GM AD - Division of Cardiology, Policlinico Tor Vergata, Rome, Italy. FAU - Farkouh, Michael E AU - Farkouh ME AD - Departments of Academic Affairs and Cardiology, Cedars-Sinai Health System, Los Angeles, CA, USA. FAU - Stone, Gregg W AU - Stone GW AD - Department of Cardiology, Icahn School of Medicine at Mount Sinai, NewYork, NY, USA. FAU - Andreotti, Felicita AU - Andreotti F AD - CardioThoracic Department, Catholic University Medical School, Largo Vito 1, Rome 00168, Italy. AD - Cardiovascular Science Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Gemelli 8, Rome 00168, Italy. LA - eng SI - ClinicalTrials.gov/NCT01471522 PT - Journal Article DEP - 20260311 PL - England TA - Eur J Prev Cardiol JT - European journal of preventive cardiology JID - 101564430 SB - IM CIN - Eur J Prev Cardiol. 2026 May 24:zwag284. doi: 10.1093/eurjpc/zwag284. PMID: 42177041 EIN - Eur J Prev Cardiol. 2026 Aug 05:zwag407. doi: 10.1093/eurjpc/zwag407. PMID: 42555101 OTO - NOTNLM OT - ISCHEMIA trial OT - Mortality OT - Prediction model COIS- Conflict of interest: E.P.N. reports research grants from Abbott, Amgen, and lecture fees/honoraria from Amgen, AstraZeneca, Bayer, Pfizer, and Sanofi-Regeneron, outside the submitted work. D.J.K. reports personal fees from SINO Medical Sciences Technologies, Inc.; Boston Scientific Corporation; Elixir Medical, Inc.; Svelte Medical Systems, Inc.; Caliber Therapeutics/Orchestra Biomed; and Shockwave, others from Ablative Solutions, Inc., outside the submitted work. F.B. reports speaker fees from Abiomed, Abbott, Medtronic, and Terumo. G.W.S. reports speaker honoraria from Medtronic, Pulnovo, Abiomed, Amgen, and Boehringer Ingelheim; has served as a consultant to Abbott, Daiichi Sankyo, Ablative Solutions, CorFlow, Cardiomech, Robocath, Miracor, Vectorious, Apollo Therapeutics, Elucid Bio, Cardiac Success, Valfix, TherOx, HeartFlow, Neovasc, Ancora, Occlutech, Impulse Dynamics, Adona Medical, Millennia Biopharma, Oxitope, HighLife, Elixir, Remote Cardiac Enablement, and Aria; and has equity/options in Cardiac Success, Ancora, Cagent, Applied Therapeutics, Biostar family of funds, SpectraWave, Orchestra Biomed, Aria, Valfix, and Xenter. In addition, G.W.S.'s employer, Mount Sinai Hospital, receives research grants from Shockwave, Abbott, Abiomed, Bioventrix, Cardiovascular Systems Inc, Phillips, Biosense-Webster, Vascular Dynamics, Pulnovo, and V-Wave. F.A. reports lecture/consultancy fees from Amgen, Daiichi Sankyo, Menarini, Novo Nordisk, and Servier. The other authors have no conflicts to declare. EDAT- 2026/03/11 19:00 MHDA- 2026/03/11 19:00 CRDT- 2026/03/11 16:22 PHST- 2025/09/24 00:00 [received] PHST- 2025/11/14 00:00 [revised] PHST- 2026/01/08 00:00 [accepted] PHST- 2026/03/11 19:00 [medline] PHST- 2026/03/11 19:00 [pubmed] PHST- 2026/03/11 16:22 [entrez] AID - 8514457 [pii] AID - 10.1093/eurjpc/zwag116 [doi] PST - aheadofprint SO - Eur J Prev Cardiol. 2026 Mar 11:zwag116. doi: 10.1093/eurjpc/zwag116. PMID- 41802529 OWN - NLM STAT- MEDLINE DCOM- 20260710 LR - 20260805 IS - 1097-6744 (Electronic) IS - 0002-8703 (Linking) VI - 297 DP - 2026 Jul TI - Design and rationale of the clinical trial to obtain the highest efficacy of dual antiplatelet therapy after carotid artery stenting in high bleeding risk patients (CHET): A multicenter, randomized, open-label, superiority trial. PG - 107418 LID - S0002-8703(26)00080-3 [pii] LID - 10.1016/j.ahj.2026.107418 [doi] AB - RATIONALE: Abbreviated dual antiplatelet therapy (DAPT) strategies effective in percutaneous coronary intervention among patients with high bleeding risk (HBR) may not be applicable to carotid artery stenting (CAS) owing to anatomical and procedural differences. PRIMARY HYPOTHESIS: Among patients with HBR undergoing CAS, abbreviated DAPT followed by SAPT will reduce clinically significant bleeding compared to prolonged DAPT, while maintaining noninferiority in net clinical outcomes, including ischemic and major bleeding events. DESIGN: CHET trial is a multicenter, randomized, open-label, superiority trial in HBR patients undergoing CAS. Assuming a 38% relative reduction in bleeding (10.4%-6.45%), 1,524 participants (762 per group) provide 80% power with a two-sided alpha of 0.05; the final target is 1,556 (778 per group), allowing 2% dropout. Key HBR criteria include age >/=75 years, ischemic stroke within 6 months, renal insufficiency, anemia, and thrombocytopenia. All patients will receive aspirin and clopidogrel for 30 days after CAS (enrichment period). Event-free patients on day 30 were randomized 1:1 to receive SAPT (aspirin 100 mg daily or clopidogrel 75 mg daily, at the treating physician's discretion) or continued DAPT for 11 months. The primary safety endpoint is clinically significant bleeding (BARC 2, 3, or 5) from day 30 to 12 months post-CAS. The secondary efficacy endpoint is a composite of nonfatal stroke, nonfatal myocardial infarction, cardiovascular death, and major bleeding (BARC 3 or 5). ENROLLMENT DATES AND CURRENT STATUS: CHET began enrollment on July 15, 2024. As of February 5, 2026, the trial is currently enrolling, with 328 participants enrolled. Enrollment is expected to be completed by November 2029, and follow-up by December 2030. CONCLUSIONS: CHET trial is the first randomized controlled trial to define optimal DAPT duration in HBR patients after CAS. TRIAL REGISTRATION: www. CLINICALTRIALS: gov (NCT06276374). CI - Copyright (c) 2026 Elsevier Inc. All rights reserved. FAU - Kim, Hyung Jun AU - Kim HJ AD - Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. FAU - Song, Tae-Jin AU - Song TJ AD - Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Republic of Korea. FAU - Park, Moo-Seok AU - Park MS AD - Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea. FAU - Baek, Jang-Hyun AU - Baek JH AD - Department of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. FAU - Kim, Yong-Won AU - Kim YW AD - Department of Neurology, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Republic of Korea. FAU - Eun, Mi-Yeon AU - Eun MY AD - Department of Neurology, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Republic of Korea. FAU - Woo, Ho Geol AU - Woo HG AD - Department of Neurology, Kyung Hee University College of Medicine, Seoul, Republic of Korea. FAU - Jeong, Darda AU - Jeong D AD - Department of Neurology, Korea University Anam Hospital, Korea University College of Medicine, Ansan, Republic of Korea. FAU - Park, Hyungjong AU - Park H AD - Department of Neurology, Keimyung University School of Medicine, Daegu, Republic of Korea. FAU - Jung, Jin-Man AU - Jung JM AD - Department of Neurology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea. FAU - Kim, Jun Yup AU - Kim JY AD - Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. FAU - Kim, Bum Joon AU - Kim BJ AD - Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. FAU - Kim, Young-Dae AU - Kim YD AD - Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea. FAU - Park, Hee-Kwon AU - Park HK AD - Department of Neurology, Inha University Hospital, Incheon, Republic of Korea. FAU - Choi, Kang-Ho AU - Choi KH AD - Department of Neurology, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea. FAU - Kim, Joong-Goo AU - Kim JG AD - Department of Neurology, Jeju National University Hospital, Jeju, Republic of Korea. FAU - Cho, Han-Jin AU - Cho HJ AD - Department of Neurology, Pusan National University Hospital, Busan, Republic of Korea. FAU - Joon An, Sang AU - Joon An S AD - Department of Neurology, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea. FAU - Lee, Seok-Yoon AU - Lee SY AD - Department of Neurology, Inje University Busan Paik Hospital, Busan, Republic of Korea. FAU - Lee, Seung-Jae AU - Lee SJ AD - Department of Neurology, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea. FAU - Lee, Seong-Joon AU - Lee SJ AD - Department of Neurology, School of Medicine, Ajou University, Suwon, Republic of Korea. FAU - Lee, Jun AU - Lee J AD - Department of Neurology, Yeongnam University Hospital, Daegu, Republic of Korea. FAU - Yoo, Joonsang AU - Yoo J AD - Department of Neurology, Yonsei University College of Medicine, Yongin Severance Hospital, Yongin, Republic of Korea. FAU - Shin, Dong-Woo AU - Shin DW AD - Department of Neurology, Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea. FAU - Kang, Hyun Goo AU - Kang HG AD - Department of Neurology, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea. FAU - Seo, Jung-Hwa AU - Seo JH AD - Department of Neurology, Dong-Ah University Hospital, Busan, Republic of Korea. FAU - Bang, Oh Young AU - Bang OY AD - Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. FAU - Seo, Woo-Keun AU - Seo WK AD - Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Electronic address: mcastenosis@gmail.com. CN - CHET Investigators LA - eng SI - ClinicalTrials.gov/NCT06276374 PT - Clinical Trial Protocol PT - Journal Article DEP - 20260307 PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 RN - 0 (Platelet Aggregation Inhibitors) RN - A74586SNO7 (Clopidogrel) RN - R16CO5Y76E (Aspirin) SB - IM MH - Humans MH - Equivalence Trials as Topic MH - *Dual Anti-Platelet Therapy/methods/adverse effects MH - *Platelet Aggregation Inhibitors/administration & dosage/adverse effects/therapeutic use MH - *Clopidogrel/adverse effects/administration & dosage/therapeutic use MH - *Aspirin/administration & dosage/adverse effects/therapeutic use MH - *Stents MH - Multicenter Studies as Topic MH - *Hemorrhage/chemically induced/prevention & control MH - Female MH - Aged MH - *Carotid Stenosis/surgery MH - Male MH - Randomized Controlled Trials as Topic MH - Drug Therapy, Combination MH - Treatment Outcome COIS- Declaration of competing interest Dr Seo reports other grants from Dong-A Pharmaceutical Co, Ltd and JLK INSPECTION outside of the submitted work. The other authors declare no conflicts of interest. EDAT- 2026/03/10 01:06 MHDA- 2026/05/03 05:27 CRDT- 2026/03/09 20:12 PHST- 2025/10/10 00:00 [received] PHST- 2026/02/15 00:00 [revised] PHST- 2026/03/02 00:00 [accepted] PHST- 2026/05/03 05:27 [medline] PHST- 2026/03/10 01:06 [pubmed] PHST- 2026/03/09 20:12 [entrez] AID - S0002-8703(26)00080-3 [pii] AID - 10.1016/j.ahj.2026.107418 [doi] PST - ppublish SO - Am Heart J. 2026 Jul;297:107418. doi: 10.1016/j.ahj.2026.107418. Epub 2026 Mar 7. PMID- 41801439 OWN - NLM STAT- MEDLINE DCOM- 20260910 LR - 20261022 IS - 1861-0692 (Electronic) IS - 1861-0684 (Print) IS - 1861-0684 (Linking) VI - 115 IP - 10 DP - 2026 Oct TI - Impact of renal dysfunction on immediate versus staged revascularization of non-culprit lesions in patients with ST segment elevation myocardial infarction: a pre-specified subgroup analysis of the randomized MULTISTARS AMI trial. PG - 1831-1844 LID - 10.1007/s00392-026-02875-w [doi] AB - BACKGROUND: Renal dysfunction might affect outcomes in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel coronary artery disease (MVD) undergoing percutaneous coronary intervention (PCI). METHODS: In MULTISTARS AMI, patients with STEMI and MVD were randomized to immediate or staged PCI of non-culprit lesions. In this pre-specified analysis, patients were stratified according to the presence of renal dysfunction at baseline, defined at an estimated glomerular filtration rate (eGFR) of 60 ml/min/1.73 m(2). Patients with an eGFR < 30 ml/min/1.73 m(2) were excluded from the trial. The primary endpoint was a composite of death, non-fatal myocardial infarction, stroke, unplanned revascularization, or hospitalization for heart failure at 1 year. RESULTS: In MULTISTARS AMI, 108 (13%) of 832 patients had renal dysfunction. The primary endpoint occurred more frequently in patients with renal dysfunction (19.4% vs. 11.2%, unadjusted HR 1.82, 95% CI 1.13-2.94), primarily driven by higher rates of death. Among patients with renal dysfunction, the rates of the primary end point were 14.5% and 24.5% in the immediate and staged PCI groups (unadjusted HR 0.55, 95% CI 0.23-1.33). There was no interaction between renal dysfunction and the randomized treatment assignment with respect to the primary end point (adjusted HR 1.30, 95% CI 0.8-2.20, p(int) 0.82). The occurrence of acute renal insufficiency was statistically similar in patients with renal dysfunction who underwent immediate and staged PCI (10.9% vs. 18.9%, unadjusted HR 0.61, 95% CI 0.22-1.72, p(int) 0.09). Renal dysfunction at baseline emerged as a strong risk factor for the development of acute renal insufficiency (adjusted HR 5.0, 95% CI 2.30-10.70, p < 0.01). CONCLUSIONS: Outcomes with immediate compared to staged multivessel PCI did not appear significantly altered by the presence of renal dysfunction at baseline. (Supported by Boston Scientific; MULTISTARS AMI ClinicalTrials.gov number, NCT03135275). CI - (c) 2026. Springer-Verlag GmbH Germany, part of Springer Nature. FAU - Rohla, Miklos AU - Rohla M AUID- ORCID: 0000-0002-8967-0806 AD - Department of Cardiology, Bern University Hospital, University of Bern, Bern, Switzerland. FAU - Huber, Kurt AU - Huber K AD - Austrian Heart Foundation, Vienna, Austria. AD - Medical Private University Burgenland (GmbH), Pinkafeld, Austria. FAU - Varbella, Ferdinando AU - Varbella F AD - Interventional Cardiology Unit, Degli Infermi Hospital, Rivoli, Turin, Italy. FAU - Linke, Axel AU - Linke A AD - Department of Internal Medicine and Cardiology, Technische Universitat Dresden, University Clinic, Herzzentrum Dresden, Dresden, Germany. FAU - Schwarz, Bettina AU - Schwarz B AD - Heart Center, Segeberger Kliniken GmbH, Academic Teaching Hospital for the Universities of Kiel, Lubeck and Hamburg, Bad Segeberg, Germany. FAU - Felix, Stephan B AU - Felix SB AD - Department of Internal Medicine B, DZHK (German Centre for Cardiovascular Research), University Medicine Greifswald, Partner Site Greifswald, Greifswald, Germany. FAU - Seiffert, Moritz AU - Seiffert M AD - BG University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany. FAU - Kesterke, Rahel AU - Kesterke R AD - Department of Cardiology, Center for Translational and Experimental Cardiology (CTEC), University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland. FAU - Nordbeck, Peter AU - Nordbeck P AD - Department of Internal Medicine I, University Hospital Wurzburg, Wurzburg, Germany. FAU - Witzenbichler, Bernhard AU - Witzenbichler B AD - Department of Cardiology and Pneumology, Helios Amper-Klinikum, Dachau, Germany. FAU - Lang, Irene M AU - Lang IM AD - Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria. FAU - Kessler, Mirjam AU - Kessler M AD - Department of Cardiology, Ulm University Heart Center, Ulm, Germany. FAU - Valina, Christian AU - Valina C AD - Department of Cardiology and Angiology, Medical Center, University of Freiburg, Freiburg, Germany. AD - Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Dibra, Alban AU - Dibra A AD - Department of Cardiovascular Diseases, University of Medicine, Tirana University Hospital "Mother Teresa", Tirana, Albania. FAU - Jakob, Philipp AU - Jakob P AD - Department of Cardiology, Center for Translational and Experimental Cardiology (CTEC), University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland. FAU - Moccetti, Marco AU - Moccetti M AD - Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland. FAU - Vercellino, Matteo AU - Vercellino M AD - Cardiovascular Disease and Cardiology Unit, IRCCS, Policlinico San Martino University Hospital, Genoa, Italy. FAU - Gaede, Luise AU - Gaede L AD - Klinikum Herrsching, Starnberger-Kliniken, Herrsching, Germany. FAU - Bott-Flugel, Lorenz AU - Bott-Flugel L AD - Cardiology and Pneumology, Klinikum Landkreis Erding, Erding, Germany. FAU - Stehli, Julia AU - Stehli J AD - Department of Cardiology, Center for Translational and Experimental Cardiology (CTEC), University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland. FAU - Candreva, Alessandro AU - Candreva A AD - Department of Cardiology, Center for Translational and Experimental Cardiology (CTEC), University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland. FAU - Paneni, Francesco AU - Paneni F AD - Department of Cardiology, Center for Translational and Experimental Cardiology (CTEC), University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland. FAU - Templin, Christian AU - Templin C AD - Department of Cardiology, Center for Translational and Experimental Cardiology (CTEC), University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland. FAU - Schindler, Matthias AU - Schindler M AD - Department of Cardiology, Center for Translational and Experimental Cardiology (CTEC), University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland. FAU - Wischnewsky, Manfred AU - Wischnewsky M AD - FB Mathematics and Computer Science, University of Bremen, Bremen, Germany. FAU - Zanda, Greca AU - Zanda G AD - Interventional Cardiology Unit, Degli Infermi Hospital, Rivoli, Turin, Italy. FAU - Quadri, Giorgio AU - Quadri G AD - Interventional Cardiology Unit, Degli Infermi Hospital, Rivoli, Turin, Italy. FAU - Mangner, Norman AU - Mangner N AD - Department of Internal Medicine and Cardiology, Technische Universitat Dresden, University Clinic, Herzzentrum Dresden, Dresden, Germany. FAU - Toma, Aurel AU - Toma A AD - Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria. FAU - Magnani, Giulia AU - Magnani G AD - Division of Cardiology, Parma University Hospital, Parma, Italy. FAU - Clemmensen, Peter AU - Clemmensen P AD - Department of Cardiology, Center for Population Health Innovation (POINT), University Heart and Vascular Center HamburgUniversity Clinic Hamburg-Eppendorf (UKE), andDZHK (German Centre for Cardiovascular Research) Partner Site Hamburg/Kiel/Lubeck, Hamburg, Germany. FAU - Luscher, Thomas F AU - Luscher TF AD - Heart Division, Royal Brompton &, Harefield Hospitals and National Heart and Lung Institute, Imperial College London, London, UK. FAU - Munzel, Thomas AU - Munzel T AD - Department of Cardiology, Center for Cardiovascular Research, University Medical Center Mainz, Johannes Gutenberg University, Partner Site Rhine Main, Mainz, Germany. FAU - Schulze, P Christian AU - Schulze PC AD - Department of Internal Medicine I, Division of Cardiology, Pneumology, Angiology and Intensive Medical Care, University Hospital Jena, Friedrich-Schiller-University Jena, Jena, Germany. FAU - Laugitz, Karl-Ludwig AU - Laugitz KL AD - Clinic and Policlinic Internal Medicine I (Cardiology and Angiology), DZHK (German Center for Cardiovascular Research), Technische Universitat Munchenand, Partner Site Munich Heart Alliance, Klinikum Rechts Der Isar, Munich, Germany. FAU - Rottbauer, Wolfgang AU - Rottbauer W AD - Department of Cardiology, Ulm University Heart Center, Ulm, Germany. FAU - Neumann, Franz-Josef AU - Neumann FJ AD - Department of Cardiology and Angiology, Medical Center, University of Freiburg, Freiburg, Germany. AD - Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Schneider, Steffen AU - Schneider S AD - Institut Fur Herzinfarktforschung (Foundation IHF), Ludwigshafen, Germany. FAU - Riemer, Thomas AU - Riemer T AD - Institut Fur Herzinfarktforschung (Foundation IHF), Ludwigshafen, Germany. FAU - Weidinger, Franz AU - Weidinger F AD - Medical Department With Cardiology and Intensive Care Medicine, Hospital Landstrasse, Vienna, Austria. FAU - Achenbach, Stephan AU - Achenbach S AD - Klinikum Herrsching, Starnberger-Kliniken, Herrsching, Germany. FAU - Richardt, Gert AU - Richardt G AD - Heart Center, Segeberger Kliniken GmbH, Academic Teaching Hospital for the Universities of Kiel, Lubeck and Hamburg, Bad Segeberg, Germany. FAU - Kastrati, Adnan AU - Kastrati A AD - Klinik Fur Herz Und Kreislauferkrankungen, DZHK (German Center for Cardiovascular Research), Deutsches Herzzentrum Munchen, Technische Universitat Munchenand, Partner Site Munich Heart Alliance , Munich, Germany. FAU - Ford, Ian AU - Ford I AD - Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK. FAU - Ruschitzka, Frank AU - Ruschitzka F AD - Department of Cardiology, Center for Translational and Experimental Cardiology (CTEC), University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland. FAU - Stahli, Barbara E AU - Stahli BE AD - Department of Cardiology, Center for Translational and Experimental Cardiology (CTEC), University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland. barbara.staehli@usz.ch. CN - MULTISTARS AMI Investigators LA - eng SI - ClinicalTrials.gov/NCT03135275 GR - ISROTH10277/Boston Scientific Corporation/ PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20260309 PL - Germany TA - Clin Res Cardiol JT - Clinical research in cardiology : official journal of the German Cardiac Society JID - 101264123 SB - IM MH - Humans MH - Female MH - Male MH - *Percutaneous Coronary Intervention/methods/adverse effects MH - *ST Elevation Myocardial Infarction/surgery/complications/mortality MH - Glomerular Filtration Rate MH - Treatment Outcome MH - Middle Aged MH - Aged MH - Risk Factors MH - Time Factors MH - *Coronary Artery Disease/complications/surgery MH - *Renal Insufficiency PMC - PMC13680518 OTO - NOTNLM OT - Acute coronary syndrome myocardial infarction OT - Acute kidney injury OT - Chronic kidney disease OT - Contrast-induced nephropathy, Renal failure OT - Percutaneous coronary intervention COIS- Declarations. Conflict of interests: Miklos Rohla has received advisory fees from Medtronic, Daiichi Sankyo, Sanofi Aventis, COR2ED and Novartis, and lecturing fees from Daiichi Sankyo, Biotronik and Takeda Pharma, all outside of the submitted work. Kurt Huber did not report conflicts of interest with respect to the submitted work. Ferdinando Varbella did not report conflicts of interest with respect to the submitted work. Axel Linke did not report conflicts of interest with respect to the submitted work. Bettina Schwarz did not report conflicts of interest with respect to the submitted work. Stephan B. Felix did not report conflicts of interest with respect to the submitted work. Moritz Seiffert reports personal fees and non-financial support from Abbott Vascular, personal fees from Abiomed, personal fees from AstraZeneca, grants, personal fees and non-financial support from Boston Scientific, personal fees from Bristol-Myers Squibb, personal fees and non-financial support from Edwards Lifesciences, grants and personal fees from Philips, personal fees from Medtronic, personal fees from Amgen, personal fees from Shockwave Medical, personal fees from Daichii Sankyo, personal fees from Pfizer, personal fees from Siemens Healthineers, and personal fees from Inari Medical, outside the submitted work. Rahel Kesterke did not report conflicts of interest with respect to the submitted work. Peter Nordbeck did not report conflicts of interest with respect to the submitted work. Bernhard Witzenbichler did not report conflicts of interest with respect to the submitted work. Irene M. Lang has relationships with drug companies including AOP-Health, Actelion-Janssen, MSD, United Therapeutics, Pulnovo, Medtronic, Neutrolis and Sanofi. In addition to being investigator in trials involving these companies, relationships include consultancy service, research grants, and membership of scientific advisory boards. Mirjam Kessler did not report conflicts of interest with respect to the submitted work. Christian Valina did not report conflicts of interest with respect to the submitted work. Alban Dibra did not report conflicts of interest with respect to the submitted work. Philipp Jakob did not report conflicts of interest with respect to the submitted work. Marco Moccetti did not report conflicts of interest with respect to the submitted work. Matteo Vercellino did not report conflicts of interest with respect to the submitted work. Luise Gaede reports consultant/lecture fees for Abiomed, Astra Zeneca, Abbott vascular, Boston Scientific, Edwards Lifesciences, SMT, and Shock Wave. Lorenz Bott-Flugel did not report conflicts of interest with respect to the submitted work. Julia Stehli did not report conflicts of interest with respect to the submitted work. Alessandro Candreva did not report conflicts of interest with respect to the submitted work. Francesco Paneni has received advisory fees from Novo Nordisk, all outside of the submitted work. Christian Templin did not report conflicts of interest with respect to the submitted work. Matthias Schindler did not report conflicts of interest with respect to the submitted work. Manfred Wischnewsky did not report conflicts of interest with respect to the submitted work. Greca Zanda did not report conflicts of interest with respect to the submitted work. Giorgio Quadri did not report conflicts of interest with respect to the submitted work. Norman Mangner received a research and an educational grant from Abiomed to his institution, outside the submitted work; an educational grant from BostonScientific to his institution, outside the submitted work; received personal fees from Abbott, Abiomed, Amgen, AstraZeneca, B. Braun, Biotronik, Boston Scientific, Edwards Lifesciences, Inari, Medtronic, Pfizer/BMS, and Shockwave, outside the submitted work. Aurel Toma did not report conflicts of interest with respect to the submitted work. Giulia Magnani did not report conflicts of interest with respect to the submitted work. Peter Clemmensen reports previous or current involvement in research contracts, consulting, speakers bureau or received research and educational grants from: Abbott, Abiomed, AliveCor Inc. AstraZeneca, Aventis, Bayer, Boehringer Ingelheim, Bristol Myers Squibb, CeleCor, Daiichi Sankyo, Eli-Lilly, Evolva, Fibrex, Idorsia, IQVIA, Janssen, Merck, Myogen, Medtronic, Mitsubishi Pharma, The Medicines Company, Nycomed, Organon, Pfizer, Pharmacia, Philips, Regado, Sanofi, Searle, Servier, and ViFor Pharma. Thomas F. Luscher does no longer accept any honoraria from industry but has received. research and educational grants. Professor Luscher has outside this work received research and educational grants to the institution from Abbott, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Daiichi Sankyo, Eli Lilly, Novartis, Novo Nordisk, Roche Diagnostics, Sanofi, and Vifor. Thomas Munzel did not report conflicts of interest with respect to the submitted work. Christian Schulze did not report conflicts of interest with respect to the submitted work. Karl-Ludwig Laugwitz did not report conflicts of interest with respect to the submitted work. Wolfgang Rottbauer did not report conflicts of interest with respect to the submitted work. Franz-Josef Neumann reports the following potential conflicts of interest: Novartis: DSMB. Meril: Consultancy fees, DSMB. Daichi-Sankyo: Speaker honoraria. Amgen: Speaker honoraria. Steffen Schneider did not report conflicts of interest with respect to the submitted work. Thomas Riemer did not report conflicts of interest with respect to the submitted work. Franz Weidinger did not report conflicts of interest with respect to the submitted work. Stephan Achenbach did not report conflicts of interest with respect to the submitted work. Gert Richardt did not report conflicts of interest with respect to the submitted work. Adnan Kastrati did not report conflicts of interest with respect to the submitted work. Ian Ford did not report conflicts of interest with respect to the submitted work. Frank Ruschitzka has not received personal payments by pharmaceutical companies or device manufacturers in the last 3 years (remuneration for the time spent in activities, such as participation as steering committee member of clinical trials and member of the Pfizer Research Award selection committee in Switzerland, were made directly to the University of Zurich). The Department of Cardiology (University Hospital of Zurich/University of Zurich) reports research-, educational- and/or travel grants from Abbott, Abiomed, Alnylam, Amarin, Amgen, Astra Zeneca, At the Limits Ltd., Bayer, Biotronik, BMS, Boehringer Ingelheim, Boston Scientific, Bracco, CM Microport, Concept Medical, CTI, Daiichi Sankyo, Davos Congress, Edwards Lifesciences, FomF GmbH, Hamilton Health Sciences, Holcim, IHF, Innosuisse, IumiraDX, Kantar, LabPoint, MedAlliance, Medcon International, Medical Education Global Solutions, Medtronic, MicroPort, Monocle, Novartis, Novo Nordisk, OM Pharma, Pfizer, Quintiles Switzerland Sarl, RecorMedical, Roche Diagnostics, Roche Pharma, Sahajanand IN, Sanofi, Sarstedt AG, Servier, Sorin SRM SAS, SSS Int., Terumo Deutschland, Trama Solutions, V- Wave, Vifor, and ZOLL. These grants do not impact on Prof. Ruschitzka;s personal remuneration. Barbara E. Stahli is supported by the H.H. Sheikh Khalifa bin Hamad Al-Thani Research Programme, and has received research grants to the institution from Boston Scientific, the B. Braun Foundation, the German Center for Cardiovascular Research (DZHK), the German Heart Research Foundation, Edwards Lifesciences, the Iten-Kohaut Foundation, and the OPO Foundation. B. S. has received consulting and speaker fees from Abbott Vascular, Abiomed, and Boston Scientific. EDAT- 2026/03/09 19:00 MHDA- 2026/09/10 17:42 PMCR- 2026/03/09 CRDT- 2026/03/09 12:16 PHST- 2025/12/22 00:00 [received] PHST- 2026/02/03 00:00 [accepted] PHST- 2026/09/10 17:42 [medline] PHST- 2026/03/09 19:00 [pubmed] PHST- 2026/03/09 12:16 [entrez] PHST- 2026/03/09 00:00 [pmc-release] AID - 10.1007/s00392-026-02875-w [pii] AID - 2875 [pii] AID - 10.1007/s00392-026-02875-w [doi] PST - ppublish SO - Clin Res Cardiol. 2026 Oct;115(10):1831-1844. doi: 10.1007/s00392-026-02875-w. Epub 2026 Mar 9. PMID- 41795301 OWN - NLM STAT- MEDLINE DCOM- 20260710 LR - 20260728 IS - 1618-095X (Electronic) IS - 0944-7113 (Linking) VI - 154 DP - 2026 May TI - Shexiang Baoxin pill in patients with stable coronary artery disease and reduced eGFR: Subgroup analysis of phase IV randomized trial. PG - 157946 LID - S0944-7113(26)00184-4 [pii] LID - 10.1016/j.phymed.2026.157946 [doi] AB - BACKGROUND: Shexiang Baoxin pill (MUSKARDIA) is a well-known traditional Chinese medicine that has demonstrated protective effects in coronary artery disease (CAD). PURPOSE: To evaluate MUSKARDIA in patients with stable CAD and reduced estimated glomerular filtration rate (eGFR). STUDY DESIGN: This was a subgroup analysis of the multicenter, double‑blind, placebo‑controlled phase IV randomized clinical trial (MUST, ChiCTR-TRC-12,003,513). The MUST trial randomly assigned patients with stable CAD to MUSKARDIA or placebo group in a 1:1 ratio. The primary composite efficacy endpoint was the incidence of major adverse cardiovascular events. The secondary composite efficacy endpoint included all‑cause mortality, non‑fatal MI, non‑fatal stroke, hospitalization for unstable angina or heart failure, and coronary revascularization. METHODS: This subgroup analysis included patients with reduced baseline eGFR (< 90 ml/min/1.73m(2)). RESULTS: Among the 1354 participants with reduced baseline eGFR, there were numerical advantages with MUSKARDIA in improving the primary (hazard ratio=0.713; 95% CI: 0.379-1.342; p = 0.292) and secondary (hazard ratio=0.840; 95% CI: 0.608-1.161; p = 0.290) composite efficacy endpoints. Multivariable adjustment confirmed these benefits. The primary composite efficacy endpoint showed a trend toward a protective effect of MUSKARDIA after 12 months. MUSKARDIA significantly improved the secondary composite efficacy endpoint after 14 months. The profiles of adverse events were comparable between groups. There were no clinically meaningful differences in liver and kidney function indicators. CONCLUSION: Long-term MUSKARDIA shows a protective trend against cardiovascular events in patients with stable CAD and reduced eGFR, and may be a consideration for clinical management. CI - Copyright (c) 2026. Published by Elsevier GmbH. FAU - Zhou, Jingmin AU - Zhou J AD - Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China. Electronic address: zhou.jingmin@zs-hospital.sh.cn. FAU - Chen, Yanqiu AU - Chen Y AD - Shanghai Innovative Engineering Technology Research Center for Traditional Chinese Medicine Solid Preparations, Shanghai, China. FAU - Shi, Haiming AU - Shi H AD - Department of Cardiology, Huashan Hospital, Fudan University, Shanghai, China. FAU - Jin, Yuanzhe AU - Jin Y AD - Department of Cardiology, The Fourth Affiliated Hospital of China Medical University, Shenyang, China. FAU - Li, Xinli AU - Li X AD - Department of Cardiology, Jiangsu Province Hospital, Nanjing, China. FAU - Wu, Jianguang AU - Wu J AD - Department of Cardiology, The Affiliated Hospital of Jiangxi University of Chinese Medicine, Nanchang, China. FAU - Pan, Chaoxin AU - Pan C AD - Department of Cardiology, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, China. FAU - Qian, Jun AU - Qian J AD - Department of Cardiology, Maanshan General Hospital of Ranger-duree Healthcare, Maanshan, China. FAU - Wu, Yang AU - Wu Y AD - Department of Cardiology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China. FAU - Wang, Xiaolong AU - Wang X AD - Department of Cardiology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China. FAU - Wang, Yan AU - Wang Y AD - Department of Cardiology, Xiamen Cardiovascular Hospital, Xiamen University, Xiamen, China. FAU - Lu, Feng AU - Lu F AD - Department of Cardiology, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China. FAU - Ge, Junbo AU - Ge J AD - Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China. LA - eng PT - Clinical Trial, Phase IV PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20260209 PL - Germany TA - Phytomedicine JT - Phytomedicine : international journal of phytotherapy and phytopharmacology JID - 9438794 RN - 0 (Drugs, Chinese Herbal) RN - 0 (shexiang baoxin) SB - IM MH - Humans MH - Female MH - *Coronary Artery Disease/drug therapy MH - *Drugs, Chinese Herbal/therapeutic use/pharmacology MH - Male MH - *Glomerular Filtration Rate/drug effects MH - Double-Blind Method MH - Middle Aged MH - Aged MH - *Phytotherapy MH - Treatment Outcome OTO - NOTNLM OT - Chronic kidney diseases OT - Coronary artery disease OT - Estimated glomerular filtration rate OT - MUSKARDIA OT - Shexiang Baoxin pill COIS- Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2026/03/08 06:37 MHDA- 2026/03/23 06:31 CRDT- 2026/03/08 05:53 PHST- 2025/10/27 00:00 [received] PHST- 2026/02/05 00:00 [revised] PHST- 2026/02/07 00:00 [accepted] PHST- 2026/03/23 06:31 [medline] PHST- 2026/03/08 06:37 [pubmed] PHST- 2026/03/08 05:53 [entrez] AID - S0944-7113(26)00184-4 [pii] AID - 10.1016/j.phymed.2026.157946 [doi] PST - ppublish SO - Phytomedicine. 2026 May;154:157946. doi: 10.1016/j.phymed.2026.157946. Epub 2026 Feb 9. PMID- 41762182 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260506 LR - 20260813 IS - 2772-3747 (Electronic) IS - 2772-3747 (Linking) VI - 6 IP - 5 DP - 2026 May TI - Sex-Based Differences in Clinical Outcomes With Edoxaban Therapy: A Prespecified Analysis of the EPIC-CAD Trial. PG - 587-598 LID - S2772-3747(26)00047-5 [pii] LID - 10.1016/j.jacasi.2025.12.022 [doi] AB - BACKGROUND: Sex-based differences exist in the characteristics and prognosis of patients with atrial fibrillation (AF) and coronary artery disease (CAD). It is still unknown whether optimal antithrombotic therapy differs by sex. OBJECTIVES: This study aimed to evaluate the efficacy and safety of edoxaban therapy in AF with stable CAD, according to sex category. METHODS: This prespecified substudy of the EPIC-CAD (Edoxaban Versus Edoxaban With Antiplatelet Agent in Patients With Atrial Fibrillation and Chronic Stable Coronary Artery Disease [EPIC-CAD]) trial compared edoxaban monotherapy with dual antithrombotic therapy (edoxaban plus a single antiplatelet agent). The primary outcome was net adverse clinical events (a composite of death, myocardial infarction, stroke, unplanned revascularization, or clinically relevant bleeding) at 12 months. Median follow-up was 12.0 months (IQR: 11.6-12.9). RESULTS: Of 1,040 randomized patients, 238 (22.9%) were women; in the dual-therapy group (n = 516), 110 (21.3%) were women and in the monotherapy group (n = 524), 128 (24.4%) were women. Women were older, had lower body weight, lower creatinine clearance, and more frequently met the edoxaban dose-reduction criteria. The risk of primary outcome was similar between women and men (adjusted HR [aHR]: 1.15; 95% CI: 0.71-1.87; P = 0.559). Edoxaban monotherapy significantly reduced primary events in men compared with dual therapy (aHR: 0.36; 95% CI: 0.23-0.57; P < 0.001), but not in women (aHR: 0.74; 95% CI: 0.33-1.64; P = 0.455). No significant interaction between the randomized treatment and sex was observed (P for interaction = 0.09). CONCLUSIONS: Edoxaban monotherapy reduced primary net adverse events at 12 months in men but not in women. No significant interaction with sex was observed. Further research is needed to identify sex-specific antithrombotic strategies for patients with AF and CAD. (Edoxaban Versus Edoxaban With Antiplatelet Agent in Patients With Atrial Fibrillation and Chronic Stable Coronary Artery Disease [EPIC-CAD]; NCT03718559). CI - Copyright (c) 2026 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Kim, Gi-Hwan AU - Kim GH AD - Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. FAU - Cho, MinSoo AU - Cho M AD - Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. FAU - Kim, Seonok AU - Kim S AD - Division of Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. FAU - Kang, Do-Yoon AU - Kang DY AD - Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. FAU - Ahn, Jung-Min AU - Ahn JM AD - Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. FAU - Oh, Yong-Seog AU - Oh YS AD - Department of Cardiology, Seoul St Mary's Hospital, Seoul, Korea. FAU - Lee, Chang Hoon AU - Lee CH AD - Department of Cardiology, Veterans Health Service Medical Center, Seoul, Korea. FAU - Choi, Eue-Keun AU - Choi EK AD - Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea. FAU - Lee, Ji Hyun AU - Lee JH AD - Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea. FAU - Kwon, Chang Hee AU - Kwon CH AD - Division of Cardiology, Konkuk University Medical Center, Seoul, Korea. FAU - Park, Gyung-Min AU - Park GM AD - Department of Cardiology, Ulsan University Hospital, Ulsan, Korea. FAU - Choi, Hyung Oh AU - Choi HO AD - Department of Cardiology, Soon Chung Hyang University Hospital Bucheon, Bucheon, Korea. FAU - Park, Kyung-Ha AU - Park KH AD - Department of Cardiology, Hallym University Medical Center, Anyang, Korea. FAU - Park, Kyoung-Min AU - Park KM AD - Division of Cardiology, Samsung Medical Center, Seoul, Korea. FAU - Hwang, Jongmin AU - Hwang J AD - Department of Cardiology, Keimyung University Dongsan Hospital, Daegu, Korea. FAU - Yoo, Ki-Dong AU - Yoo KD AD - Department of Cardiology, St Vincent's Hospital, Suwon, Korea. FAU - Cho, Young-Rak AU - Cho YR AD - Department of Cardiology, Dong-A University Hospital, Busan, Korea. FAU - Kim, Ji Hyun AU - Kim JH AD - Department of Cardiology, Dongguk University Ilsan Hospital, Goyang, Korea. FAU - Hwang, Ki Won AU - Hwang KW AD - Department of Cardiology, Pusan National University Yangsan Hospital, Yangsan, Korea. FAU - Jin, Eun-Sun AU - Jin ES AD - Department of Cardiology, Kyung Hee University Hospital at Gangdong, Seoul, Korea. FAU - Kwon, Osung AU - Kwon O AD - Division of Cardiology, Eunpyeong St Mary's Hospital, Seoul, Korea. FAU - Kim, Ki-Hun AU - Kim KH AD - Department of Cardiology, Haeundae Paik Hospital, Busan, Korea. FAU - Park, Seung-Jung AU - Park SJ AD - Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. FAU - Nam, Gi-Byoung AU - Nam GB AD - Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. FAU - Park, Duk-Woo AU - Park DW AD - Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. Electronic address: dwpark@amc.seoul.kr. CN - EPIC-CAD Investigators LA - eng SI - ClinicalTrials.gov/NCT03718559 PT - Journal Article DEP - 20260228 PL - United States TA - JACC Asia JT - JACC. Asia JID - 9918452380106676 PMC - PMC13153895 OTO - NOTNLM OT - anticoagulation OT - atrial fibrillation OT - coronary artery disease OT - sex difference COIS- Funding Support and Author Disclosures This work was supported by grants from the Cardiovascular Research Foundation (Seoul, Korea), Daiichi-Sankyo, and Daewoong Pharmaceutical (Seoul, Korea). Dr S.-J. Park has received research grants from Daewoong Pharm and the Cardiovascular Research Foundation related to this work, as well as lecture fees from Daiichi-Sankyo, Abbott Vascular, Boston Scientific, Medtronic, and Edwards outside the submitted work. Dr Nam received research grants from Daiichi-Sankyo and Daewoong Pharm. Dr D.-W. Park has received research grants from Daiichi-Sankyo, Daewoong Pharm, and the Cardiovascular Research Foundation related to this work, along with lecture fees from Daiichi-Sankyo, Abbott Vascular, Boston Scientific, Medtronic, and Edwards outside the submitted work. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2026/02/28 12:53 MHDA- 2026/02/28 12:54 PMCR- 2026/02/28 CRDT- 2026/02/28 10:27 PHST- 2025/10/03 00:00 [received] PHST- 2025/12/14 00:00 [revised] PHST- 2025/12/31 00:00 [accepted] PHST- 2026/02/28 12:54 [medline] PHST- 2026/02/28 12:53 [pubmed] PHST- 2026/02/28 10:27 [entrez] PHST- 2026/02/28 00:00 [pmc-release] AID - S2772-3747(26)00047-5 [pii] AID - 10.1016/j.jacasi.2025.12.022 [doi] PST - ppublish SO - JACC Asia. 2026 May;6(5):587-598. doi: 10.1016/j.jacasi.2025.12.022. Epub 2026 Feb 28. PMID- 41717861 OWN - NLM STAT- MEDLINE DCOM- 20260708 LR - 20260904 IS - 2047-9980 (Electronic) IS - 2047-9980 (Linking) VI - 15 IP - 5 DP - 2026 Mar 3 TI - Biodegradable Polymer Versus Polymer-Free Ultrathin Sirolimus-Eluting Stents in Complex Percutaneous Coronary Intervention: Post Hoc Analysis of the Stent Arm Registry From the HOST-IDEA Randomized Trial. PG - e043441 LID - 10.1161/JAHA.125.043441 [doi] LID - e043441 AB - BACKGROUND: The performance of third-generation drug-eluting stents with ultrathin struts and advanced polymer technology in complex percutaneous coronary intervention (PCI) remains unclear. This study compared the clinical outcomes of Coroflex ISAR polymer-free sirolimus-eluting stent (SES) and Orsiro biodegradable polymer SES, 2 third-generation drug-eluting stents, based on PCI complexity. METHODS: A post hoc analysis of the HOST-IDEA (Harmonizing Optimal Strategy for Treatment of Coronary Artery Stenosis-Coronary Intervention With Next-Generation Drug-Eluting Stent Platforms and Abbreviated Dual Antiplatelet Therapy) trial, which randomized 2013 patients undergoing PCI with Coroflex ISAR or Orsiro SES based on the duration of dual antiplatelet therapy (3 versus 12 months), was conducted herein. The baseline characteristics were balanced through propensity score matching. Complex PCI satisfied >/=1 of the following criteria: >/=3 stents implanted, >/=3 lesions or vessels treated, bifurcation PCI, total stent length of >/=60 mm, left main PCI, or heavy calcification. Target lesion failure (TLF) at 1 year, a composite of cardiac death, target vessel myocardial infarction, and clinically driven target lesion revascularization, was the primary end point. RESULTS: Each stent group comprised 546 patients after propensity score matching. In total, 336 and 756 patients underwent complex PCI and noncomplex PCI, respectively. Complex PCI exhibited a significant association with a higher risk of TLF compared with noncomplex PCI (5.7% versus 1.3%, P<0.01). In the complex PCI group, the TLF rate in the Coroflex ISAR SES group was significantly higher than that in the Orsiro SES group (8.9% versus 2.4%; hazard ratio [HR], 3.74 [95% CI, 1.24-11.26]; P=0.02). However, the TLF rates in the 2 stent groups in the noncomplex PCI group were comparable (1.1% versus 1.6%; HR, 0.66 [95% CI, 0.19-2.35]; P=0.53; P for interaction=0.04). Multivariable analysis identified Coroflex ISAR SES and chronic kidney disease as independent predictors of TLF. CONCLUSIONS: Orsiro SES was associated with significantly better TLF outcomes than the Coroflex ISAR SES in complex PCI; however, no significant difference was observed in noncomplex PCI. FAU - Park, Sang-Hyeon AU - Park SH AUID- ORCID: 0000-0001-8453-4146 AD - Cardiovascular Center Seoul National University Hospital Seoul Republic of Korea. FAU - Han, Jung-Kyu AU - Han JK AUID- ORCID: 0000-0002-0016-0747 AD - Cardiovascular Center Seoul National University Hospital Seoul Republic of Korea. AD - Department of Internal Medicine, College of Medicine Seoul National University Seoul Republic of Korea. FAU - Yang, Seokhun AU - Yang S AUID- ORCID: 0000-0003-2078-3930 AD - Cardiovascular Center Seoul National University Hospital Seoul Republic of Korea. FAU - Hwang, Doyeon AU - Hwang D AD - Cardiovascular Center Seoul National University Hospital Seoul Republic of Korea. FAU - Kang, Jeehoon AU - Kang J AD - Cardiovascular Center Seoul National University Hospital Seoul Republic of Korea. FAU - Yang, Han-Mo AU - Yang HM AUID- ORCID: 0000-0002-1548-2351 AD - Cardiovascular Center Seoul National University Hospital Seoul Republic of Korea. AD - Department of Internal Medicine, College of Medicine Seoul National University Seoul Republic of Korea. FAU - Park, Kyung Woo AU - Park KW AUID- ORCID: 0000-0003-2432-4432 AD - Cardiovascular Center Seoul National University Hospital Seoul Republic of Korea. AD - Department of Internal Medicine, College of Medicine Seoul National University Seoul Republic of Korea. FAU - Kang, Hyun-Jae AU - Kang HJ AUID- ORCID: 0000-0002-3500-1746 AD - Cardiovascular Center Seoul National University Hospital Seoul Republic of Korea. AD - Department of Internal Medicine, College of Medicine Seoul National University Seoul Republic of Korea. FAU - Koo, Bon-Kwon AU - Koo BK AUID- ORCID: 0000-0002-8188-3348 AD - Cardiovascular Center Seoul National University Hospital Seoul Republic of Korea. AD - Department of Internal Medicine, College of Medicine Seoul National University Seoul Republic of Korea. FAU - Cho, Jin-Man AU - Cho JM AD - Cardiovascular Center Kyung Hee University Hospital at Gangdong Seoul Republic of Korea. FAU - Cho, Janghyun AU - Cho J AUID- ORCID: 0000-0003-3696-3557 AD - Department of Cardiology, Heart Center Saint Carollo Hospital Sun-cheon Republic of Korea. FAU - Bang, Duk Won AU - Bang DW AUID- ORCID: 0000-0002-6691-7546 AD - Division of Cardiology, Department of Internal Medicine, Soonchunhyang University Seoul Hospital Soonchunhyang University College of Medicine Seoul Republic of Korea. FAU - Lee, Jae-Hwan AU - Lee JH AUID- ORCID: 0000-0002-6561-7760 AD - Division of Cardiology, Department of Internal Medicine, Chungnam National University Sejong Hospital Chungnam National University School of Medicine Sejong Republic of Korea. FAU - Lee, Han Cheol AU - Lee HC AUID- ORCID: 0000-0002-7236-4204 AD - Division of Cardiology, Department of Internal Medicine Pusan National University Hospital Busan Republic of Korea. FAU - Kim, Kyung-Jin AU - Kim KJ AUID- ORCID: 0000-0002-5796-3284 AD - Department of Internal Medicine, Ewha Womans University Medical Center Ewha Womans University School of Medicine Seoul Republic of Korea. FAU - Chun, Woo Jung AU - Chun WJ AUID- ORCID: 0000-0001-7637-906X AD - Department of Cardiology, Samsung Changwon Hospital Sungkyunkwan University School of Medicine Changwon Republic of Korea. FAU - Seo, Won-Woo AU - Seo WW AD - Departments of Internal Medicine, Kangdong Sacred Heart Hospital Hallym University College of Medicine Seoul South Korea. FAU - Park, Woo-Jung AU - Park WJ AD - Division of Cardiology, Department of Internal Medicine Hallym University Pyeongchon Sacred Heart Hospital Anyang Republic of Korea. FAU - Park, Sang Min AU - Park SM AUID- ORCID: 0000-0001-6521-303X AD - Division of Cardiology, Nowon Eulji Medical Center Eulji University School of Medicine Seoul Republic of Korea. FAU - Kim, Yong Hoon AU - Kim YH AUID- ORCID: 0000-0002-9669-3598 AD - Department of Internal Medicine Kangwon National University School of Medicine Chuncheon Republic of Korea. FAU - Kim, Hyo-Soo AU - Kim HS AUID- ORCID: 0000-0003-0847-5329 AD - Cardiovascular Center Seoul National University Hospital Seoul Republic of Korea. AD - Department of Internal Medicine, College of Medicine Seoul National University Seoul Republic of Korea. LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20260220 PL - England TA - J Am Heart Assoc JT - Journal of the American Heart Association JID - 101580524 RN - W36ZG6FT64 (Sirolimus) RN - 0 (Polymers) SB - IM MH - Humans MH - *Drug-Eluting Stents MH - *Sirolimus/administration & dosage/pharmacology MH - *Percutaneous Coronary Intervention/instrumentation/adverse effects MH - Female MH - Prosthesis Design MH - *Absorbable Implants MH - Male MH - Registries MH - *Polymers MH - Middle Aged MH - Aged MH - *Coronary Artery Disease/surgery/diagnostic imaging/therapy MH - Treatment Outcome MH - Time Factors MH - *Coronary Stenosis/surgery/diagnostic imaging PMC - PMC13055759 OTO - NOTNLM OT - complex percutaneous coronary intervention OT - third-generation drug-eluting stents OT - ultrathin strut COIS- Dr Han reports grants from ChongKunDang and HanMi outside the submitted work. Dr Park reports speaker fees from Daiichi Sankyo, AstraZeneca, Sanofi, Bristol-Myers Squibb, Bayer, and Pfizer outside the submitted work. Dr Kim reports grants or speaker fees from Daiichi Sankyo, Boston Scientific, Terumo, Biotronik, Dio, Medtronic, Abbott Vascular, Edwards Lifesciences, Amgen, and Behringer Ingelheim outside of the submitted work. All other authors declare no competing interests. The sponsors had no role in the design and conduct of this study; the collection, analysis, and interpretation of data; the writing and approval of the article; or the decision to submit the article for publication. EDAT- 2026/02/20 16:08 MHDA- 2026/03/06 09:06 PMCR- 2026/02/20 CRDT- 2026/02/20 06:43 PHST- 2026/03/06 09:06 [medline] PHST- 2026/02/20 16:08 [pubmed] PHST- 2026/02/20 06:43 [entrez] PHST- 2026/02/20 00:00 [pmc-release] AID - JAH370123 [pii] AID - 10.1161/JAHA.125.043441 [doi] PST - ppublish SO - J Am Heart Assoc. 2026 Mar 3;15(5):e043441. doi: 10.1161/JAHA.125.043441. Epub 2026 Feb 20. PMID- 41684415 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260213 LR - 20260215 IS - 2767-7206 (Electronic) IS - 2767-7206 (Linking) VI - 5 IP - 1 DP - 2026 Feb TI - Clinical implications and feasibility of cerebral autoregulation-based precision blood pressure monitoring in major noncardiac surgery: A protocol for AUTOREGULATE-NONCARDIAC, a multicentre prospective cohort study and peri-operative precision medicine platform. PG - e0093 LID - 10.1097/EA9.0000000000000093 [doi] AB - BACKGROUND: Peri-operative hypotension is strongly associated with organ injury following noncardiac surgery, however hypotension avoidance trials have not shown meaningful improvements in cardiovascular outcomes and only inconsistent improvements in renal and neurological outcomes. The true haemodynamic drivers of peri-operative organ injury are probably falls in BP below individual autoregulatory boundaries and not below population-based harm thresholds. Novel methods of personalising peri-operative blood pressure (BP) management are needed. Cerebral autoregulation (cAR)-guided precision BP monitoring is an established paradigm that uses near-infrared spectroscopy (NIRS) to noninvasively estimate the safe BP range for the brain and potentially other vital organs. We aim to assess the feasibility and clinical implications of cAR-based precision BP monitoring in major noncardiac surgery. OBJECTIVES: To investigate the association of intra-operative BP excursions below the lower level of cerebral autoregulation, and other measures of disturbed cerebral autoregulatory function, with the primary and secondary outcomes, to determine the feasibility of cAR-based precision BP monitoring in noncardiac surgery. DESIGN: Multicentre, prospective cohort study. SETTING: 3 Swiss tertiary care centres. PATIENTS: Inclusion criteria: Adults >/=45 years of age, at cardiovascular risk, undergoing elective major noncardiac surgery with invasive BP monitoring, surgical time >/=90 min, postoperative hospital stay >/=1 night. Exclusion criteria include pregnancy, emergency or urological surgery, glomerular filtration rate <30 ml min(-1), dialysis. PRIMARY OUTCOME MEASURES: Composite of peri-operative myocardial injury and/or peri-operative acute kidney injury on postoperative days 1 to 3. SECONDARY OUTCOMES: Composite of major cardiovascular, renal and neurological complications up to 1 year following surgery: acute coronary syndrome, acute congestive heart failure, coronary revascularisation, stroke, new or progressive chronic kidney disease, new need for renal replacement therapy, all-cause mortality, cardiovascular mortality. RESULTS: N/A. CONCLUSIONS: N/A. TRIAL REGISTRATION: Association of Intraoperative Blood Pressure Excursions Below Cerebral Autoregulatory Boundaries With Organ Injury Following Major Noncardiac Surgery (AUTOREGULATE-NONCARDIAC), Clinicaltrials.gov NCT05336864. registered 13/04/2022. CI - Copyright (c) 2025 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the European Society of Anaesthesiology and Intensive Care. FAU - Wanner, Patrick M AU - Wanner PM AD - From the Anaesthesiology, University Hospital Basel, Basel, Switzerland (PMW, AJMW, ES, ND, LAS), Department of Clinical Research, University of Basel, Basel, Switzerland (PMW, AJMW, LAS), Swiss Tropical and Public Health Institute, Basel, Switzerland (CS), Brain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK (EB, PS), Department of Anesthesiology, Bluhm Cardiovascular Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA (CWH), Department of Anesthesiology, Perioperative, and Pain Medicine; Division of Cardiac Anesthesia; Stanford University, Stanford, California, USA (CHB), Department of Anaesthesiology and Pain Medicine, Seoul National University, College of Medicine, Seoul, South Korea (YJ), Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland (CP), Department of Anaesthesiology, Rescue and Pain Medicine, HOCH Health Ostschweiz St. Gallen, St. Gallen, Switzerland (TY), Centre for Laboratory Medicine, St. Gallen, Switzerland (JB, WK), Division of Peri-operative Intensive Care Medicine, HOCH Health Ostschweiz St. Gallen, St. Gallen, Switzerland (CK, UP, MF), Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (APV). FAU - Schindler, Christian AU - Schindler C AD - From the Anaesthesiology, University Hospital Basel, Basel, Switzerland (PMW, AJMW, ES, ND, LAS), Department of Clinical Research, University of Basel, Basel, Switzerland (PMW, AJMW, LAS), Swiss Tropical and Public Health Institute, Basel, Switzerland (CS), Brain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK (EB, PS), Department of Anesthesiology, Bluhm Cardiovascular Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA (CWH), Department of Anesthesiology, Perioperative, and Pain Medicine; Division of Cardiac Anesthesia; Stanford University, Stanford, California, USA (CHB), Department of Anaesthesiology and Pain Medicine, Seoul National University, College of Medicine, Seoul, South Korea (YJ), Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland (CP), Department of Anaesthesiology, Rescue and Pain Medicine, HOCH Health Ostschweiz St. Gallen, St. Gallen, Switzerland (TY), Centre for Laboratory Medicine, St. Gallen, Switzerland (JB, WK), Division of Peri-operative Intensive Care Medicine, HOCH Health Ostschweiz St. Gallen, St. Gallen, Switzerland (CK, UP, MF), Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (APV). FAU - Beqiri, Erta AU - Beqiri E AD - From the Anaesthesiology, University Hospital Basel, Basel, Switzerland (PMW, AJMW, ES, ND, LAS), Department of Clinical Research, University of Basel, Basel, Switzerland (PMW, AJMW, LAS), Swiss Tropical and Public Health Institute, Basel, Switzerland (CS), Brain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK (EB, PS), Department of Anesthesiology, Bluhm Cardiovascular Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA (CWH), Department of Anesthesiology, Perioperative, and Pain Medicine; Division of Cardiac Anesthesia; Stanford University, Stanford, California, USA (CHB), Department of Anaesthesiology and Pain Medicine, Seoul National University, College of Medicine, Seoul, South Korea (YJ), Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland (CP), Department of Anaesthesiology, Rescue and Pain Medicine, HOCH Health Ostschweiz St. Gallen, St. Gallen, Switzerland (TY), Centre for Laboratory Medicine, St. Gallen, Switzerland (JB, WK), Division of Peri-operative Intensive Care Medicine, HOCH Health Ostschweiz St. Gallen, St. Gallen, Switzerland (CK, UP, MF), Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (APV). FAU - Smielewski, Peter AU - Smielewski P AD - From the Anaesthesiology, University Hospital Basel, Basel, Switzerland (PMW, AJMW, ES, ND, LAS), Department of Clinical Research, University of Basel, Basel, Switzerland (PMW, AJMW, LAS), Swiss Tropical and Public Health Institute, Basel, Switzerland (CS), Brain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK (EB, PS), Department of Anesthesiology, Bluhm Cardiovascular Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA (CWH), Department of Anesthesiology, Perioperative, and Pain Medicine; Division of Cardiac Anesthesia; Stanford University, Stanford, California, USA (CHB), Department of Anaesthesiology and Pain Medicine, Seoul National University, College of Medicine, Seoul, South Korea (YJ), Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland (CP), Department of Anaesthesiology, Rescue and Pain Medicine, HOCH Health Ostschweiz St. Gallen, St. Gallen, Switzerland (TY), Centre for Laboratory Medicine, St. Gallen, Switzerland (JB, WK), Division of Peri-operative Intensive Care Medicine, HOCH Health Ostschweiz St. Gallen, St. Gallen, Switzerland (CK, UP, MF), Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (APV). FAU - Hogue, Charles W AU - Hogue CW AD - From the Anaesthesiology, University Hospital Basel, Basel, Switzerland (PMW, AJMW, ES, ND, LAS), Department of Clinical Research, University of Basel, Basel, Switzerland (PMW, AJMW, LAS), Swiss Tropical and Public Health Institute, Basel, Switzerland (CS), Brain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK (EB, PS), Department of Anesthesiology, Bluhm Cardiovascular Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA (CWH), Department of Anesthesiology, Perioperative, and Pain Medicine; Division of Cardiac Anesthesia; Stanford University, Stanford, California, USA (CHB), Department of Anaesthesiology and Pain Medicine, Seoul National University, College of Medicine, Seoul, South Korea (YJ), Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland (CP), Department of Anaesthesiology, Rescue and Pain Medicine, HOCH Health Ostschweiz St. Gallen, St. Gallen, Switzerland (TY), Centre for Laboratory Medicine, St. Gallen, Switzerland (JB, WK), Division of Peri-operative Intensive Care Medicine, HOCH Health Ostschweiz St. Gallen, St. Gallen, Switzerland (CK, UP, MF), Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (APV). FAU - Brown, Charles H 4th AU - Brown CH 4th AD - From the Anaesthesiology, University Hospital Basel, Basel, Switzerland (PMW, AJMW, ES, ND, LAS), Department of Clinical Research, University of Basel, Basel, Switzerland (PMW, AJMW, LAS), Swiss Tropical and Public Health Institute, Basel, Switzerland (CS), Brain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK (EB, PS), Department of Anesthesiology, Bluhm Cardiovascular Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA (CWH), Department of Anesthesiology, Perioperative, and Pain Medicine; Division of Cardiac Anesthesia; Stanford University, Stanford, California, USA (CHB), Department of Anaesthesiology and Pain Medicine, Seoul National University, College of Medicine, Seoul, South Korea (YJ), Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland (CP), Department of Anaesthesiology, Rescue and Pain Medicine, HOCH Health Ostschweiz St. Gallen, St. Gallen, Switzerland (TY), Centre for Laboratory Medicine, St. Gallen, Switzerland (JB, WK), Division of Peri-operative Intensive Care Medicine, HOCH Health Ostschweiz St. Gallen, St. Gallen, Switzerland (CK, UP, MF), Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (APV). FAU - Jeon, Yunseok AU - Jeon Y AD - From the Anaesthesiology, University Hospital Basel, Basel, Switzerland (PMW, AJMW, ES, ND, LAS), Department of Clinical Research, University of Basel, Basel, Switzerland (PMW, AJMW, LAS), Swiss Tropical and Public Health Institute, Basel, Switzerland (CS), Brain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK (EB, PS), Department of Anesthesiology, Bluhm Cardiovascular Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA (CWH), Department of Anesthesiology, Perioperative, and Pain Medicine; Division of Cardiac Anesthesia; Stanford University, Stanford, California, USA (CHB), Department of Anaesthesiology and Pain Medicine, Seoul National University, College of Medicine, Seoul, South Korea (YJ), Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland (CP), Department of Anaesthesiology, Rescue and Pain Medicine, HOCH Health Ostschweiz St. Gallen, St. Gallen, Switzerland (TY), Centre for Laboratory Medicine, St. Gallen, Switzerland (JB, WK), Division of Peri-operative Intensive Care Medicine, HOCH Health Ostschweiz St. Gallen, St. Gallen, Switzerland (CK, UP, MF), Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (APV). FAU - Puelacher, Christian AU - Puelacher C AD - From the Anaesthesiology, University Hospital Basel, Basel, Switzerland (PMW, AJMW, ES, ND, LAS), Department of Clinical Research, University of Basel, Basel, Switzerland (PMW, AJMW, LAS), Swiss Tropical and Public Health Institute, Basel, Switzerland (CS), Brain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK (EB, PS), Department of Anesthesiology, Bluhm Cardiovascular Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA (CWH), Department of Anesthesiology, Perioperative, and Pain Medicine; Division of Cardiac Anesthesia; Stanford University, Stanford, California, USA (CHB), Department of Anaesthesiology and Pain Medicine, Seoul National University, College of Medicine, Seoul, South Korea (YJ), Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland (CP), Department of Anaesthesiology, Rescue and Pain Medicine, HOCH Health Ostschweiz St. Gallen, St. Gallen, Switzerland (TY), Centre for Laboratory Medicine, St. Gallen, Switzerland (JB, WK), Division of Peri-operative Intensive Care Medicine, HOCH Health Ostschweiz St. Gallen, St. Gallen, Switzerland (CK, UP, MF), Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (APV). FAU - Murgatroyd Wiles, Angus J AU - Murgatroyd Wiles AJ AD - From the Anaesthesiology, University Hospital Basel, Basel, Switzerland (PMW, AJMW, ES, ND, LAS), Department of Clinical Research, University of Basel, Basel, Switzerland (PMW, AJMW, LAS), Swiss Tropical and Public Health Institute, Basel, Switzerland (CS), Brain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK (EB, PS), Department of Anesthesiology, Bluhm Cardiovascular Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA (CWH), Department of Anesthesiology, Perioperative, and Pain Medicine; Division of Cardiac Anesthesia; Stanford University, Stanford, California, USA (CHB), Department of Anaesthesiology and Pain Medicine, Seoul National University, College of Medicine, Seoul, South Korea (YJ), Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland (CP), Department of Anaesthesiology, Rescue and Pain Medicine, HOCH Health Ostschweiz St. Gallen, St. Gallen, Switzerland (TY), Centre for Laboratory Medicine, St. Gallen, Switzerland (JB, WK), Division of Peri-operative Intensive Care Medicine, HOCH Health Ostschweiz St. Gallen, St. Gallen, Switzerland (CK, UP, MF), Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (APV). FAU - Yurttas, Timur AU - Yurttas T AD - From the Anaesthesiology, University Hospital Basel, Basel, Switzerland (PMW, AJMW, ES, ND, LAS), Department of Clinical Research, University of Basel, Basel, Switzerland (PMW, AJMW, LAS), Swiss Tropical and Public Health Institute, Basel, Switzerland (CS), Brain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK (EB, PS), Department of Anesthesiology, Bluhm Cardiovascular Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA (CWH), Department of Anesthesiology, Perioperative, and Pain Medicine; Division of Cardiac Anesthesia; Stanford University, Stanford, California, USA (CHB), Department of Anaesthesiology and Pain Medicine, Seoul National University, College of Medicine, Seoul, South Korea (YJ), Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland (CP), Department of Anaesthesiology, Rescue and Pain Medicine, HOCH Health Ostschweiz St. Gallen, St. Gallen, Switzerland (TY), Centre for Laboratory Medicine, St. Gallen, Switzerland (JB, WK), Division of Peri-operative Intensive Care Medicine, HOCH Health Ostschweiz St. Gallen, St. Gallen, Switzerland (CK, UP, MF), Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (APV). FAU - Burgi, Justus AU - Burgi J AD - From the Anaesthesiology, University Hospital Basel, Basel, Switzerland (PMW, AJMW, ES, ND, LAS), Department of Clinical Research, University of Basel, Basel, Switzerland (PMW, AJMW, LAS), Swiss Tropical and Public Health Institute, Basel, Switzerland (CS), Brain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK (EB, PS), Department of Anesthesiology, Bluhm Cardiovascular Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA (CWH), Department of Anesthesiology, Perioperative, and Pain Medicine; Division of Cardiac Anesthesia; Stanford University, Stanford, California, USA (CHB), Department of Anaesthesiology and Pain Medicine, Seoul National University, College of Medicine, Seoul, South Korea (YJ), Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland (CP), Department of Anaesthesiology, Rescue and Pain Medicine, HOCH Health Ostschweiz St. Gallen, St. Gallen, Switzerland (TY), Centre for Laboratory Medicine, St. Gallen, Switzerland (JB, WK), Division of Peri-operative Intensive Care Medicine, HOCH Health Ostschweiz St. Gallen, St. Gallen, Switzerland (CK, UP, MF), Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (APV). FAU - Seeberger, Esther AU - Seeberger E AD - From the Anaesthesiology, University Hospital Basel, Basel, Switzerland (PMW, AJMW, ES, ND, LAS), Department of Clinical Research, University of Basel, Basel, Switzerland (PMW, AJMW, LAS), Swiss Tropical and Public Health Institute, Basel, Switzerland (CS), Brain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK (EB, PS), Department of Anesthesiology, Bluhm Cardiovascular Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA (CWH), Department of Anesthesiology, Perioperative, and Pain Medicine; Division of Cardiac Anesthesia; Stanford University, Stanford, California, USA (CHB), Department of Anaesthesiology and Pain Medicine, Seoul National University, College of Medicine, Seoul, South Korea (YJ), Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland (CP), Department of Anaesthesiology, Rescue and Pain Medicine, HOCH Health Ostschweiz St. Gallen, St. Gallen, Switzerland (TY), Centre for Laboratory Medicine, St. Gallen, Switzerland (JB, WK), Division of Peri-operative Intensive Care Medicine, HOCH Health Ostschweiz St. Gallen, St. Gallen, Switzerland (CK, UP, MF), Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (APV). FAU - Doyle, Nadine AU - Doyle N AD - From the Anaesthesiology, University Hospital Basel, Basel, Switzerland (PMW, AJMW, ES, ND, LAS), Department of Clinical Research, University of Basel, Basel, Switzerland (PMW, AJMW, LAS), Swiss Tropical and Public Health Institute, Basel, Switzerland (CS), Brain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK (EB, PS), Department of Anesthesiology, Bluhm Cardiovascular Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA (CWH), Department of Anesthesiology, Perioperative, and Pain Medicine; Division of Cardiac Anesthesia; Stanford University, Stanford, California, USA (CHB), Department of Anaesthesiology and Pain Medicine, Seoul National University, College of Medicine, Seoul, South Korea (YJ), Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland (CP), Department of Anaesthesiology, Rescue and Pain Medicine, HOCH Health Ostschweiz St. Gallen, St. Gallen, Switzerland (TY), Centre for Laboratory Medicine, St. Gallen, Switzerland (JB, WK), Division of Peri-operative Intensive Care Medicine, HOCH Health Ostschweiz St. Gallen, St. Gallen, Switzerland (CK, UP, MF), Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (APV). FAU - Klein, Carsten AU - Klein C AD - From the Anaesthesiology, University Hospital Basel, Basel, Switzerland (PMW, AJMW, ES, ND, LAS), Department of Clinical Research, University of Basel, Basel, Switzerland (PMW, AJMW, LAS), Swiss Tropical and Public Health Institute, Basel, Switzerland (CS), Brain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK (EB, PS), Department of Anesthesiology, Bluhm Cardiovascular Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA (CWH), Department of Anesthesiology, Perioperative, and Pain Medicine; Division of Cardiac Anesthesia; Stanford University, Stanford, California, USA (CHB), Department of Anaesthesiology and Pain Medicine, Seoul National University, College of Medicine, Seoul, South Korea (YJ), Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland (CP), Department of Anaesthesiology, Rescue and Pain Medicine, HOCH Health Ostschweiz St. Gallen, St. Gallen, Switzerland (TY), Centre for Laboratory Medicine, St. Gallen, Switzerland (JB, WK), Division of Peri-operative Intensive Care Medicine, HOCH Health Ostschweiz St. Gallen, St. Gallen, Switzerland (CK, UP, MF), Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (APV). FAU - Korte, Wolfgang AU - Korte W AD - From the Anaesthesiology, University Hospital Basel, Basel, Switzerland (PMW, AJMW, ES, ND, LAS), Department of Clinical Research, University of Basel, Basel, Switzerland (PMW, AJMW, LAS), Swiss Tropical and Public Health Institute, Basel, Switzerland (CS), Brain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK (EB, PS), Department of Anesthesiology, Bluhm Cardiovascular Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA (CWH), Department of Anesthesiology, Perioperative, and Pain Medicine; Division of Cardiac Anesthesia; Stanford University, Stanford, California, USA (CHB), Department of Anaesthesiology and Pain Medicine, Seoul National University, College of Medicine, Seoul, South Korea (YJ), Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland (CP), Department of Anaesthesiology, Rescue and Pain Medicine, HOCH Health Ostschweiz St. Gallen, St. Gallen, Switzerland (TY), Centre for Laboratory Medicine, St. Gallen, Switzerland (JB, WK), Division of Peri-operative Intensive Care Medicine, HOCH Health Ostschweiz St. Gallen, St. Gallen, Switzerland (CK, UP, MF), Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (APV). FAU - Pietsch, Urs AU - Pietsch U AD - From the Anaesthesiology, University Hospital Basel, Basel, Switzerland (PMW, AJMW, ES, ND, LAS), Department of Clinical Research, University of Basel, Basel, Switzerland (PMW, AJMW, LAS), Swiss Tropical and Public Health Institute, Basel, Switzerland (CS), Brain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK (EB, PS), Department of Anesthesiology, Bluhm Cardiovascular Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA (CWH), Department of Anesthesiology, Perioperative, and Pain Medicine; Division of Cardiac Anesthesia; Stanford University, Stanford, California, USA (CHB), Department of Anaesthesiology and Pain Medicine, Seoul National University, College of Medicine, Seoul, South Korea (YJ), Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland (CP), Department of Anaesthesiology, Rescue and Pain Medicine, HOCH Health Ostschweiz St. Gallen, St. Gallen, Switzerland (TY), Centre for Laboratory Medicine, St. Gallen, Switzerland (JB, WK), Division of Peri-operative Intensive Care Medicine, HOCH Health Ostschweiz St. Gallen, St. Gallen, Switzerland (CK, UP, MF), Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (APV). FAU - Vogt, Andreas P AU - Vogt AP AD - From the Anaesthesiology, University Hospital Basel, Basel, Switzerland (PMW, AJMW, ES, ND, LAS), Department of Clinical Research, University of Basel, Basel, Switzerland (PMW, AJMW, LAS), Swiss Tropical and Public Health Institute, Basel, Switzerland (CS), Brain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK (EB, PS), Department of Anesthesiology, Bluhm Cardiovascular Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA (CWH), Department of Anesthesiology, Perioperative, and Pain Medicine; Division of Cardiac Anesthesia; Stanford University, Stanford, California, USA (CHB), Department of Anaesthesiology and Pain Medicine, Seoul National University, College of Medicine, Seoul, South Korea (YJ), Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland (CP), Department of Anaesthesiology, Rescue and Pain Medicine, HOCH Health Ostschweiz St. Gallen, St. Gallen, Switzerland (TY), Centre for Laboratory Medicine, St. Gallen, Switzerland (JB, WK), Division of Peri-operative Intensive Care Medicine, HOCH Health Ostschweiz St. Gallen, St. Gallen, Switzerland (CK, UP, MF), Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (APV). FAU - Filipovic, Miodrag AU - Filipovic M AD - From the Anaesthesiology, University Hospital Basel, Basel, Switzerland (PMW, AJMW, ES, ND, LAS), Department of Clinical Research, University of Basel, Basel, Switzerland (PMW, AJMW, LAS), Swiss Tropical and Public Health Institute, Basel, Switzerland (CS), Brain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK (EB, PS), Department of Anesthesiology, Bluhm Cardiovascular Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA (CWH), Department of Anesthesiology, Perioperative, and Pain Medicine; Division of Cardiac Anesthesia; Stanford University, Stanford, California, USA (CHB), Department of Anaesthesiology and Pain Medicine, Seoul National University, College of Medicine, Seoul, South Korea (YJ), Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland (CP), Department of Anaesthesiology, Rescue and Pain Medicine, HOCH Health Ostschweiz St. Gallen, St. Gallen, Switzerland (TY), Centre for Laboratory Medicine, St. Gallen, Switzerland (JB, WK), Division of Peri-operative Intensive Care Medicine, HOCH Health Ostschweiz St. Gallen, St. Gallen, Switzerland (CK, UP, MF), Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (APV). FAU - Steiner, Luzius A AU - Steiner LA AD - From the Anaesthesiology, University Hospital Basel, Basel, Switzerland (PMW, AJMW, ES, ND, LAS), Department of Clinical Research, University of Basel, Basel, Switzerland (PMW, AJMW, LAS), Swiss Tropical and Public Health Institute, Basel, Switzerland (CS), Brain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK (EB, PS), Department of Anesthesiology, Bluhm Cardiovascular Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA (CWH), Department of Anesthesiology, Perioperative, and Pain Medicine; Division of Cardiac Anesthesia; Stanford University, Stanford, California, USA (CHB), Department of Anaesthesiology and Pain Medicine, Seoul National University, College of Medicine, Seoul, South Korea (YJ), Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland (CP), Department of Anaesthesiology, Rescue and Pain Medicine, HOCH Health Ostschweiz St. Gallen, St. Gallen, Switzerland (TY), Centre for Laboratory Medicine, St. Gallen, Switzerland (JB, WK), Division of Peri-operative Intensive Care Medicine, HOCH Health Ostschweiz St. Gallen, St. Gallen, Switzerland (CK, UP, MF), Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (APV). LA - eng SI - ClinicalTrials.gov/NCT05336864 PT - Journal Article DEP - 20251205 PL - United States TA - Eur J Anaesthesiol Intensive Care JT - European journal of anaesthesiology and intensive care JID - 9918917745206676 PMC - PMC12893411 COIS- Conflicts of interest: PMW is collaborating with Covidien/Medtronic in the context of a planned subanalysis of AUTOREGULATE-NONCARDIAC aiming to independently evaluate the Covidien/Medtronic Cotrending algorithm in major noncardiac surgery. EDAT- 2026/02/13 06:33 MHDA- 2026/02/13 06:34 PMCR- 2025/12/05 CRDT- 2026/02/13 04:24 PHST- 2025/07/10 00:00 [received] PHST- 2025/09/29 00:00 [accepted] PHST- 2026/02/13 06:34 [medline] PHST- 2026/02/13 06:33 [pubmed] PHST- 2026/02/13 04:24 [entrez] PHST- 2025/12/05 00:00 [pmc-release] AID - EJAIC-D-25-00046 [pii] AID - 10.1097/EA9.0000000000000093 [doi] PST - epublish SO - Eur J Anaesthesiol Intensive Care. 2025 Dec 5;5(1):e0093. doi: 10.1097/EA9.0000000000000093. eCollection 2026 Feb. PMID- 41638385 OWN - NLM STAT- MEDLINE DCOM- 20260706 LR - 20260723 IS - 1097-6744 (Electronic) IS - 0002-8703 (Linking) VI - 296 DP - 2026 Jun TI - Study design for an emulated trial of a 2 arm, parallel, stratified, adaptive, RCT of CABG versus PCI in people requiring myocardial revascularization at high risk (High-Risk REVASC). PG - 107368 LID - S0002-8703(26)00030-X [pii] LID - 10.1016/j.ahj.2026.107368 [doi] AB - AIM: This study aims to use routinely collected health data and trial emulation methodology to inform the design of a pragmatic randomized controlled trial (RCT) in people requiring multivessel coronary revascularization with severe symptomatic multivessel disease and high-risk characteristics, typically underrepresented in previous RCTs. METHODS: Hospital episode statistics (HES) linked to Office for National Statistics will be the main data source. The study population is patients who require multivessel myocardial revascularization with at least one of the following high-risk characteristics: age >75 years, female, diagnosed with acute coronary syndrome, heart failure, chronic kidney disease, peripheral vascular disease, or intermediate frailty risk. The intervention procedure is coronary artery bypass grafting (CABG) and the control (reference) is percutaneous coronary intervention (PCI). Outcomes include all-cause and cardiovascular (CV) death, CV hospitalization, major adverse cardiovascular events, and major vascular complications or bleeding within 5 years of the index procedure. This study includes 3 stages of statistical analyses: (1) latent class analysis (LCA) to identify mutually exclusive patient clusters (latent classes) representing different clinical phenotypes, (2) instrumental variable analysis (IVA) to estimate the average treatment effect (ATE) in the whole population and each patient cluster; and (3) repeating stage 2 in an emulated trial population obtained by matching the HES population with individual participant data from an RCT. We will then co-design the protocol for a definitive clinical trial in partnership with patients, public, and stakeholders. DISCUSSION: This study introduces a novel, stepwise data science framework that integrates machine learning (unsupervised learning through LCA), causal inference, and trial emulation methods applied in big data, to design a future stratified and adaptive RCT of CABG versus PCI in high-risk patients. Our proposed approach fosters new collaborations among data scientists, trial methodologists, clinicians, and patient and public representatives in complex trial designs for diverse, high-risk populations. This study represents a new framework for co-production in trials of cardiovascular interventions, which offers a scalable model and has the potential to transfer to other disease areas. CLINICAL TRIAL REGISTRATION: URL: https://www. CLINICALTRIALS: gov/study/NCT05853536. Unique identifier: NCT05853536. CI - Copyright (c) 2026 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Liao, Weiqi AU - Liao W AD - Division of Cardiovascular Sciences, School of Medical Sciences, University of Leicester, Leicester, UK. Electronic address: weiqi.liao@leicester.ac.uk. FAU - Rashid, Muhammad AU - Rashid M AD - Division of Cardiovascular Sciences, School of Medical Sciences, University of Leicester, Leicester, UK. FAU - Brookes, Cassandra L AU - Brookes CL AD - Leicester Clinical Trials Unit, University of Leicester, Leicester, UK. FAU - Barber, Shaun AU - Barber S AD - Leicester Clinical Trials Unit, University of Leicester, Leicester, UK. FAU - Turner, Rebecca M AU - Turner RM AD - Medical Research Council Clinical Trials Unit at UCL, UK. FAU - Gravel, Guillaume Marquis AU - Gravel GM AD - Montreal Heart Institute, Universite de Montreal, Montreal, Quebec, Canada. FAU - Petrie, Mark C AU - Petrie MC AD - School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK. FAU - Lipsic, Erik AU - Lipsic E AD - Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. FAU - Doenst, Torsten AU - Doenst T AD - Jena University Hospital, Friedrich-Schiller-University of Jena, Jena, Germany. FAU - Fremes, Stephen AU - Fremes S AD - Department of Surgery, University of Toronto for Fremes,Toronto, Canada. FAU - Murphy, Gavin J AU - Murphy GJ AD - Division of Cardiovascular Sciences, School of Medical Sciences, University of Leicester, Leicester, UK; Leicester Clinical Trials Unit, University of Leicester, Leicester, UK. CN - High-Risk REVASC consortium LA - eng SI - ClinicalTrials.gov/NCT05853536 PT - Journal Article DEP - 20260202 PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 SB - IM MH - Humans MH - *Coronary Artery Bypass/methods MH - Female MH - *Percutaneous Coronary Intervention/methods MH - Research Design MH - *Coronary Artery Disease/surgery MH - Aged MH - Male MH - Risk Assessment MH - Adaptive Clinical Trials as Topic MH - Myocardial Revascularization/methods MH - Acute Coronary Syndrome/surgery COIS- Conflict of interest GMG is a Junior 2 research scholar from the Fonds de Recherche du Quebec - Sante (grant # 367177), received speaker honoraria or in advisory boards of Novartis, JAMP Pharma, KYE, HLS Therapeutics, Bayer, Pharmascience, Cardiovascular Systems inc., Metapharm, Amgen, and Novo Nordisk. GJM has received funding unrelated to the current work from Pharmacosmos. Other authors have no conflicts of interest to declare. FIR - White, Ian IR - White I FIR - Redfors, Bjorn IR - Redfors B FIR - Rouleau, Jean IR - Rouleau J FIR - Omerovic, Elmir IR - Omerovic E FIR - Cooke, Angela IR - Cooke A FIR - Murray, Sarah IR - Murray S EDAT- 2026/02/05 00:30 MHDA- 2026/03/12 13:56 CRDT- 2026/02/04 19:12 PHST- 2025/09/12 00:00 [received] PHST- 2026/01/28 00:00 [revised] PHST- 2026/01/31 00:00 [accepted] PHST- 2026/03/12 13:56 [medline] PHST- 2026/02/05 00:30 [pubmed] PHST- 2026/02/04 19:12 [entrez] AID - S0002-8703(26)00030-X [pii] AID - 10.1016/j.ahj.2026.107368 [doi] PST - ppublish SO - Am Heart J. 2026 Jun;296:107368. doi: 10.1016/j.ahj.2026.107368. Epub 2026 Feb 2. PMID- 41615170 OWN - NLM STAT- MEDLINE DCOM- 20260701 LR - 20260813 IS - 1678-4170 (Electronic) IS - 0066-782X (Print) IS - 0066-782X (Linking) VI - 122 IP - 12 DP - 2025 Dec TI - Impact of Contrast Volume Used After Percutaneous Coronary Procedures in Patients at Risk for Contrast-Induced Nephropathy. PG - e20250270 LID - S0066-782X2025001200302 [pii] LID - 10.36660/abc.20250270 [doi] LID - e20250270 AB - BACKGROUND: Contrast-induced nephropathy (CIN) is a common complication following angiographic procedures, potentially related to the volume of contrast agent administered. However, it is unclear whether the type of contrast also influences its occurrence. OBJECTIVE: To evaluate the interaction between contrast volume and contrast type (iso-osmolar vs low-osmolar) in the development of CIN. METHODS: A post hoc subanalysis was performed on patients undergoing diagnostic or therapeutic coronary procedures who were randomized 1:1 to receive low-osmolar or iso-osmolar contrast media. The overall sample (n = 2,268) was stratified by contrast volume: Group I (< 150 mL; n = 1,985) and Group II (>/= 150 mL; n = 283), and groups were compared by contrast type. The primary endpoint was CIN at 48- and 96-hours post-procedure. CIN was defined as a >/= 25% or >/= 0.5 mg/dL increase in serum creatinine from baseline at 48 hours. The effects of contrast type and volume were tested with logistic regression including an interaction term, adjusted for acute coronary syndrome, ventricular dysfunction, baseline creatinine, sex, and age (p < 0.05). RESULTS: We included 2,268 consecutive patients; two-thirds were male; hypertension was present in 85%, diabetes in 52%, and chronic kidney disease in 31%. Mean contrast volume was 75.3 +/- 28.0 mL in Group I and 188.6 +/- 46.9 mL in Group II. The incidence of CIN was higher with greater volume (14.8% vs 17.7%) but not statistically significant (adjusted odds ratio = 1.25; 95% CI = 0.89-1.73; p = 0.191). The model with the interaction term showed no evidence of an interaction between the type of contrast and volume (p > 0.999). CONCLUSION: The type of contrast was not associated with CIN, even among patients exposed to higher contrast volumes. FAU - Freitas, Rafaela Andrade Penalva AU - Freitas RAP AUID- ORCID: 0000-0002-6401-6170 AD - Instituto Dante Pazzanese de Cardiologia, Sao Paulo, SP - Brasil. FAU - Tanajura, Luiz Fernando Leite AU - Tanajura LFL AUID- ORCID: 0000-0002-7620-1752 AD - Instituto Dante Pazzanese de Cardiologia, Sao Paulo, SP - Brasil. FAU - Sousa, Amanda Guerra M R AU - Sousa AGMR AD - Instituto Dante Pazzanese de Cardiologia, Sao Paulo, SP - Brasil. FAU - Feres, Fausto AU - Feres F AD - Instituto Dante Pazzanese de Cardiologia, Sao Paulo, SP - Brasil. FAU - Costa, Jose Ribamar AU - Costa JR AD - Instituto Dante Pazzanese de Cardiologia, Sao Paulo, SP - Brasil. AD - Hospital Sao Domingos, Sao Luis, MA - Brasil. LA - eng LA - por PT - Journal Article PT - Randomized Controlled Trial TT - Impacto do Volume de Contraste Utilizado Apos Procedimentos Coronarios Percutaneos em Pacientes Predispostos a Nefropatia Induzida por Contraste. PL - Brazil TA - Arq Bras Cardiol JT - Arquivos brasileiros de cardiologia JID - 0421031 RN - 0 (Contrast Media) RN - AYI8EX34EU (Creatinine) SB - IM MH - Humans MH - *Contrast Media/adverse effects/administration & dosage/chemistry MH - Male MH - Female MH - Middle Aged MH - Creatinine/blood MH - Risk Factors MH - *Coronary Angiography/adverse effects/methods MH - Aged MH - *Percutaneous Coronary Intervention/adverse effects MH - *Kidney Diseases/chemically induced MH - Time Factors PMC - PMC12978361 OAB - BACKGROUND: Contrast-induced nephropathy (CIN) is a common complication following angiographic procedures, potentially related to the volume of contrast agent administered. However, it is unclear whether the type of contrast also influences its occurrence. OBJECTIVE: To evaluate the interaction between contrast volume and contrast type (iso-osmolar vs low-osmolar) in the development of CIN. METHODS: A post hoc subanalysis was performed on patients undergoing diagnostic or therapeutic coronary procedures who were randomized 1:1 to receive low-osmolar or iso-osmolar contrast media. The overall sample (n = 2,268) was stratified by contrast volume: Group I (< 150 mL; n = 1,985) and Group II (>/= 150 mL; n = 283), and groups were compared by contrast type. The primary endpoint was CIN at 48- and 96-hours post-procedure. CIN was defined as a >/= 25% or >/= 0.5 mg/dL increase in serum creatinine from baseline at 48 hours. The effects of contrast type and volume were tested with logistic regression including an interaction term, adjusted for acute coronary syndrome, ventricular dysfunction, baseline creatinine, sex, and age (p < 0.05). RESULTS: We included 2,268 consecutive patients; two-thirds were male; hypertension was present in 85%, diabetes in 52%, and chronic kidney disease in 31%. Mean contrast volume was 75.3 +/- 28.0 mL in Group I and 188.6 +/- 46.9 mL in Group II. The incidence of CIN was higher with greater volume (14.8% vs 17.7%) but not statistically significant (adjusted odds ratio = 1.25; 95% CI = 0.89-1.73; p = 0.191). The model with the interaction term showed no evidence of an interaction between the type of contrast and volume (p > 0.999). CONCLUSION: The type of contrast was not associated with CIN, even among patients exposed to higher contrast volumes. OABL- eng OAB - OABL- eng COIS- Potencial conflito de interesse: Nao ha conflito com o presente artigo EDAT- 2026/01/30 13:12 MHDA- 2026/01/30 13:13 PMCR- 2025/12/23 CRDT- 2026/01/30 09:04 PHST- 2025/04/15 00:00 [received] PHST- 2025/09/04 00:00 [accepted] PHST- 2026/01/30 13:13 [medline] PHST- 2026/01/30 13:12 [pubmed] PHST- 2026/01/30 09:04 [entrez] PHST- 2025/12/23 00:00 [pmc-release] AID - S0066-782X2025001200302 [pii] AID - 10.36660/abc.20250270 [doi] PST - ppublish SO - Arq Bras Cardiol. 2025 Dec;122(12):e20250270. doi: 10.36660/abc.20250270. PMID- 41590862 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260127 LR - 20260131 IS - 2308-3425 (Electronic) IS - 2308-3425 (Linking) VI - 13 IP - 1 DP - 2026 Jan 8 TI - Protocol for the CABG-PRIME Study (Coronary Artery Bypass Graft-Platelet Response and Improvement in Medicine Efficacy)-An Exploratory Study to Review the Role of Platelet Function Testing in Improving Patient Outcomes Post-CABG Surgery. LID - 10.3390/jcdd13010035 [doi] LID - 35 AB - BACKGROUND: Coronary artery bypass grafting (CABG) is a well-established revascularization strategy for patients with multivessel coronary artery disease. The effectiveness of CABG is significantly influenced by antiplatelet therapy aimed at maintaining graft patency and reducing thrombotic complications. However, substantial inter-individual variability exists in platelet function responses to standard therapies such as aspirin and clopidogrel, leading to antiplatelet resistance. This variability has been linked to increased risks of myocardial infarction, stroke, and early graft failure. Platelet function testing (PFT) offers a potential strategy to identify resistance and guide more personalized antiplatelet therapy. This study aims to evaluate the association between perioperative platelet function test results and clinical outcomes following CABG. By assessing platelet responsiveness at multiple timepoints and correlating findings with postoperative events, the study seeks to determine whether PFT can stratify risk and improve patient management. METHODS: This is a prospective, single-centre, observational cohort study conducted at a tertiary NHS cardiac surgery centre. Patients having elective or urgent isolated CABG will be enrolled and undergo perioperative PFT using the TEG6s system. Clinical outcomes will be monitored for 12 months postoperatively, with primary endpoints assessing the correlation between platelet function results and major adverse cardiovascular and cerebrovascular events (MACCE). Secondary endpoints will include the prevalence of antiplatelet resistance, demographic predictors, and the feasibility of integrating PFT into clinical workflows. RESULTS: This study will report the prevalence of aspirin and clopidogrel resistance in CABG patients based on TEG6s PFT, as well as the correlation between platelet function results and MACCE, postoperative bleeding, and the need for surgical re-exploration. Additionally, it will examine the associations between demographic and clinical factors-such as diabetes status, renal function, BMI, and surgical technique-and variability in platelet responsiveness. The feasibility of incorporating PFT into perioperative workflows will also be evaluated, assessing whether results could support personalized antiplatelet management in future clinical trials. CONCLUSIONS: Findings from this study will provide real-world evidence regarding platelet function variability in CABG patients and suggest that PFT may identify those at increased risk of thrombotic complications. This exploratory analysis supports the need for larger interventional trials aimed at optimizing individualized postoperative antiplatelet therapy to improve surgical outcomes. FAU - Comanici, Maria AU - Comanici M AUID- ORCID: 0000-0002-7160-9230 AD - Department of Cardiac Surgery, Harefield Hospital, Royal Brompton and Harefield Hospitals, Part of Guy's and St Thomas NHS Trust, London UB9 6JH, UK. FAU - Das, Anonna AU - Das A AD - Department of Cardiac Surgery, Harefield Hospital, Royal Brompton and Harefield Hospitals, Part of Guy's and St Thomas NHS Trust, London UB9 6JH, UK. FAU - Camangon, Charlene AU - Camangon C AD - Department of Cardiac Surgery, Harefield Hospital, Royal Brompton and Harefield Hospitals, Part of Guy's and St Thomas NHS Trust, London UB9 6JH, UK. FAU - Kanchirassery, Kavya AU - Kanchirassery K AD - Department of Cardiac Surgery, Harefield Hospital, Royal Brompton and Harefield Hospitals, Part of Guy's and St Thomas NHS Trust, London UB9 6JH, UK. FAU - Singh, Harsimran AU - Singh H AD - Department of Cardiac Surgery, Harefield Hospital, Royal Brompton and Harefield Hospitals, Part of Guy's and St Thomas NHS Trust, London UB9 6JH, UK. FAU - Lees, Nicholas James AU - Lees NJ AD - Department of Anaesthesia and Critical Care, Harefield Hospital, Royal Brompton and Harefield Hospitals, Part of Guy's and St Thomas NHS Trust, London UB9 6JH, UK. FAU - Gorog, Diana AU - Gorog D AD - Department of Cardiology, Royal Brompton and Harefield Hospitals, Part of Guy's and St Thomas NHS Trust, London SW3 6NP, UK. AD - Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London SW7 2AZ, UK. FAU - Marczin, Nandor AU - Marczin N AD - Department of Anaesthesia and Critical Care, Harefield Hospital, Royal Brompton and Harefield Hospitals, Part of Guy's and St Thomas NHS Trust, London UB9 6JH, UK. AD - Division of Anaesthesia, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Imperial College London, London SW7 2BX, UK. AD - Department of Anaesthesia and Intensive Care, Semmelweis University, 1082 Budapest, Hungary. FAU - Raja, Shahzad G AU - Raja SG AUID- ORCID: 0000-0003-1325-0490 AD - Department of Cardiac Surgery, Harefield Hospital, Royal Brompton and Harefield Hospitals, Part of Guy's and St Thomas NHS Trust, London UB9 6JH, UK. LA - eng GR - C0118: RFSG-16/24/Royal Brompton and Harefield Hospitals Charity/ PT - Journal Article DEP - 20260108 PL - Switzerland TA - J Cardiovasc Dev Dis JT - Journal of cardiovascular development and disease JID - 101651414 PMC - PMC12842188 OTO - NOTNLM OT - antiplatelets OT - coronary artery bypass grafting OT - personalised medicine COIS- We declare no competing interests. EDAT- 2026/01/27 12:59 MHDA- 2026/01/27 13:00 PMCR- 2026/01/08 CRDT- 2026/01/27 09:34 PHST- 2025/11/27 00:00 [received] PHST- 2026/01/05 00:00 [revised] PHST- 2026/01/06 00:00 [accepted] PHST- 2026/01/27 13:00 [medline] PHST- 2026/01/27 12:59 [pubmed] PHST- 2026/01/27 09:34 [entrez] PHST- 2026/01/08 00:00 [pmc-release] AID - jcdd13010035 [pii] AID - jcdd-13-00035 [pii] AID - 10.3390/jcdd13010035 [doi] PST - epublish SO - J Cardiovasc Dev Dis. 2026 Jan 8;13(1):35. doi: 10.3390/jcdd13010035. PMID- 41514308 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20260214 LR - 20260215 IS - 1758-5996 (Print) IS - 1758-5996 (Electronic) IS - 1758-5996 (Linking) VI - 18 IP - 1 DP - 2026 Jan 9 TI - Cardiovascular and renal outcomes of sodium-glucose cotransporter-2 versus dipeptidyl peptidase-4 inhibitors in patients with type 2 diabetes post-PCI: a meta-analysis of 14,511 patients. PG - 63 LID - 10.1186/s13098-025-02080-1 [doi] LID - 63 AB - BACKGROUND: Patients with type 2 diabetes mellitus (T2DM) undergoing percutaneous coronary intervention (PCI) are at high risk of adverse cardiovascular and renal outcomes. While both sodium-glucose cotransporter-2 inhibitors (SGLT-2i) and dipeptidyl peptidase-4 inhibitors (DPP-4i) are widely used in this population, direct evidence comparing their long-term efficacy and safety after PCI remains scarce. This meta-analysis aimed to compare cardiovascular and renal outcomes between SGLT-2i and DPP-4i in patients with T2DM post-PCI. METHODS: PubMed, Web of Science, Scopus, and Cochrane CENTRAL were searched through June 2025. Primary outcomes were all-cause mortality, worsening renal function, and heart failure. We included primary studies and assessed the quality of studies using Newcastle Ottawa Scale. RevMan software was used to calculate hazard ratios (HR) estimates and 95% confidence intervals (CI) using the random-effects model. RESULTS: We analyzed the outcomes between SGLT-2i (n = 7,025 patients) and DPP-4i (n = 7,459 patients). The mean age was 62.7 years, and 77.4% were males. SGLT-2i significantly reduced all-cause mortality (HR = 0.65; 95% CI: 0.54-0.79; P < 0.001) and the risk of worsening renal function (HR = 0.15; 95% CI: 0.09-0.26; P < 0.001). They also demonstrated a significant reduction in heart failure events (HR = 0.59; 95% CI: 0.48-0.74; P < 0.001). For myocardial infarction, a non-significant trend toward risk reduction with SGLT-2i was observed (HR = 0.85; 95% CI: 0.72-1.02; P = 0.08). For cerebrovascular accidents and the need for repeat revascularization (PCI/CABG), no significant difference was observed. CONCLUSION: SGLT-2i demonstrates more clinical benefits, and current evidence supports its initiation over DPP-4i in T2DM patients after PCI. CI - (c) 2026. The Author(s). FAU - Badran, Ahmed Samy AU - Badran AS AD - Faculty of Medicine, Ain Shams University, Cairo, Egypt. FAU - Gbreel, Mohamed Ibrahim AU - Gbreel MI AD - Faculty of Medicine, October 6 University, Giza, Egypt. FAU - Tawfik, Abdelrahman M AU - Tawfik AM AD - Faculty of Medicine, Alexandria University, Alexandria, Egypt. FAU - Balata, Mahmoud AU - Balata M AUID- ORCID: 0000-0003-4744-1703 AD - Department of Cardiology, University Hospital Rostock, Ernst- Heydemann-Strasse 6, 18057, Rostock, Germany. dr.mahmoud.balata@gmail.com. LA - eng PT - Journal Article DEP - 20260109 PL - England TA - Diabetol Metab Syndr JT - Diabetology & metabolic syndrome JID - 101488958 PMC - PMC12903319 OTO - NOTNLM OT - DPP-4 inhibitors OT - Meta-analysis OT - Percutaneous coronary intervention OT - SGLT-2 inhibitors OT - Type 2 diabetes mellitus COIS- Declarations. Ethics approval and consent to participate: Not applicable. Competing interests: The authors declare no competing interests. Trial registry number: This meta-analysis was registered on PROSPERO. Registration Number: CRD420251077885. EDAT- 2026/01/10 00:34 MHDA- 2026/01/10 00:35 PMCR- 2026/01/09 CRDT- 2026/01/09 23:56 PHST- 2025/08/21 00:00 [received] PHST- 2025/12/26 00:00 [accepted] PHST- 2026/01/10 00:35 [medline] PHST- 2026/01/10 00:34 [pubmed] PHST- 2026/01/09 23:56 [entrez] PHST- 2026/01/09 00:00 [pmc-release] AID - 10.1186/s13098-025-02080-1 [pii] AID - 2080 [pii] AID - 10.1186/s13098-025-02080-1 [doi] PST - epublish SO - Diabetol Metab Syndr. 2026 Jan 9;18(1):63. doi: 10.1186/s13098-025-02080-1. PMID- 41453443 OWN - NLM STAT- MEDLINE DCOM- 20260624 LR - 20260625 IS - 1916-7075 (Electronic) IS - 0828-282X (Linking) VI - 42 IP - 6 DP - 2026 Jun TI - Long-term Clopidogrel vs Aspirin Monotherapy in Coronary Artery Disease Patients With High Ischemic Risk: HOST-EXAM Extended Study Post hoc Analysis. PG - 1129-1139 LID - S0828-282X(25)01576-4 [pii] LID - 10.1016/j.cjca.2025.11.051 [doi] AB - BACKGROUND: An optimal antiplatelet monotherapy agent for stable coronary artery disease (CAD) patients with high ischemic risk (HIR) is lacking. We analyzed the long-term outcomes between aspirin and clopidogrel monotherapy in a population of patients with CAD. METHODS: The current study is a post hoc analysis of the HOST-EXAM Extended Study. HIR was defined as having a history of diabetes or chronic kidney disease, combined with at least 1 of the following: left main percutaneous coronary intervention, a bifurcation lesion treated with stents, a total stent length > 60 mm, at least 3 stents implanted, at least 3 lesions treated, or the presence of chronic total occlusion lesions. The primary endpoint was a composite of all-cause death, nonfatal myocardial infarction, stroke, readmission due to acute coronary syndrome, and major bleeding complications. RESULTS: Of 4558 patients, the HIR arm included 803 patients and the non-HIR arm included 3755 patients. The primary endpoint was higher in the HIR arm compared with the non-HIR arm (19.4% vs 13.9%, hazard ratio [HR] 1.52, 95% confidence interval [CI] 1.37-1.68, P < 0.001). Clopidogrel monotherapy was associated with a lower risk of the primary endpoint in the HIR arm (16.4% vs 23.2%, HR 0.67, 95% CI 0.49-0.92, P = 0.014) and in the non-HIR arm (12.1% vs 15.7%, HR 0.74, 95% CI 0.64-0.87, P < 0.001). There was no significant interaction between HIR status and antiplatelet strategy (P for interaction = 0.53). CONCLUSIONS: In this long-term follow-up of stable CAD patients, clopidogrel monotherapy demonstrated significant advantages over aspirin in reducing adverse clinical outcomes, regardless of HIR status. CLINICAL TRIAL REGISTRATION: NCT02044250. CI - Copyright (c) 2025 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved. FAU - Song, Jin-Eun AU - Song JE AD - Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea. Electronic address: https://x.com/Doctor_Ssong. FAU - Yang, Han-Mo AU - Yang HM AD - Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea. FAU - Kang, Jeehoon AU - Kang J AD - Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Department of Critical Care Medicine, Seoul National University Hospital, Seoul, Republic of Korea. Electronic address: medikang@gmail.com. FAU - Hwang, Doyeon AU - Hwang D AD - Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea. FAU - Han, Jung-Kyu AU - Han JK AD - Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea. FAU - Park, Kyung Woo AU - Park KW AD - Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea. FAU - Kang, Hyun-Jae AU - Kang HJ AD - Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea. FAU - Koo, Bon-Kwon AU - Koo BK AD - Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea. FAU - Kim, Hyo-Soo AU - Kim HS AD - Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea. LA - eng SI - ClinicalTrials.gov/NCT02044250 PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20251224 PL - England TA - Can J Cardiol JT - The Canadian journal of cardiology JID - 8510280 RN - A74586SNO7 (Clopidogrel) RN - R16CO5Y76E (Aspirin) RN - 0 (Platelet Aggregation Inhibitors) RN - OM90ZUW7M1 (Ticlopidine) SB - IM MH - Humans MH - *Clopidogrel MH - *Aspirin/administration & dosage/therapeutic use/adverse effects MH - Male MH - *Coronary Artery Disease/drug therapy/complications/therapy MH - Female MH - Platelet Aggregation Inhibitors/administration & dosage/therapeutic use MH - *Ticlopidine/analogs & derivatives/administration & dosage MH - Treatment Outcome MH - Aged MH - Middle Aged MH - Follow-Up Studies MH - Percutaneous Coronary Intervention MH - Time Factors MH - Risk Factors MH - Hemorrhage/chemically induced/epidemiology OTO - NOTNLM OT - aspirin OT - bleeding OT - clopidogrel OT - drug-eluting stent OT - high ischemic risk OT - ischemic OT - percutaneous coronary intervention OT - thrombotic EDAT- 2025/12/27 00:54 MHDA- 2026/06/25 00:34 CRDT- 2025/12/26 19:31 PHST- 2025/06/17 00:00 [received] PHST- 2025/11/13 00:00 [revised] PHST- 2025/11/30 00:00 [accepted] PHST- 2026/06/25 00:34 [medline] PHST- 2025/12/27 00:54 [pubmed] PHST- 2025/12/26 19:31 [entrez] AID - S0828-282X(25)01576-4 [pii] AID - 10.1016/j.cjca.2025.11.051 [doi] PST - ppublish SO - Can J Cardiol. 2026 Jun;42(6):1129-1139. doi: 10.1016/j.cjca.2025.11.051. Epub 2025 Dec 24. PMID- 41444908 OWN - NLM STAT- MEDLINE DCOM- 20260128 LR - 20260131 IS - 1749-8090 (Electronic) IS - 1749-8090 (Linking) VI - 21 IP - 1 DP - 2025 Dec 24 TI - Impact of surgical urgency on outcomes after minimally invasive coronary artery bypass surgery: a retrospective cohort study. PG - 43 LID - 10.1186/s13019-025-03768-1 [doi] LID - 43 AB - BACKGROUND: Surgical urgency in minimally invasive coronary artery bypass grafting (MICS-CABG) is associated with increased perioperative risk. This study evaluates the impact of surgical urgency on early postoperative outcomes in patients undergoing isolated MICS-CABG. METHODS: A retrospective cohort study was conducted at Shar Hospital, Erbil, Iraq, including 311 patients who underwent isolated MICS-CABG between September 2021 and December 2024. Patients were classified as elective group (n = 285) and urgent group (n = 26) according to Society of Thoracic Surgeons criteria. Baseline demographics, intraoperative variables, and early postoperative outcomes were compared using appropriate statistical tests with a significance level of p < 0.05. RESULTS: Baseline characteristics, including, gender, and body mass index, showed no significant differences between elective and urgent groups. However, the urgent group had significantly lower preoperative left ventricular ejection fraction (49.2% +/- 12.0 vs. 53.8% +/- 10.0, p = 0.032) and higher preoperative serum creatinine levels (1.59 +/- 1.58 vs. 1.19 +/- 1.94 mg/dL, p = 0.008). Intraoperatively, urgent patients required more vasopressor support (adrenaline: 26.9% vs. 10.2%, p = 0.020; noradrenaline: 73.1% vs. 40.7%, p = 0.001). Postoperatively, urgent cases had higher serum creatinine (1.86 +/- 1.79 vs. 1.14 +/- 0.58 mg/dL, p = 0.037) and more frequent incidence of acute respiratory failure in urgent group (39.1% vs. 17.5%, p = 0.023). CONCLUSIONS: Urgent MICS-CABG was associated with increased vasopressor use, renal dysfunction, and respiratory complications. TRIAL REGISTRATION: Not applicable. CI - (c) 2025. The Author(s). FAU - Abdullah, Hemn Abdulrahman AU - Abdullah HA AD - Department of Cardiovascular and Thoracic Surgery, Ministry of Health, Erbil, Iraq. FAU - Saeed, Darya Nadir AU - Saeed DN AD - Department of Cardiovascular and Thoracic Surgery, Ministry of Health, Erbil, Iraq. FAU - Flaih, Abdullah Hayder AU - Flaih AH AD - Department of Biology, College of sciences, Salahaddin University-Erbil, Erbil, Iraq. abdullahaider2988@gmail.com. FAU - Barzani, Marwan Abdullah AU - Barzani MA AD - Hawler Teaching Hospital, Ministry of Health, Erbil, Iraq. marwanahb1999@gmail.com. LA - eng PT - Journal Article DEP - 20251224 PL - England TA - J Cardiothorac Surg JT - Journal of cardiothoracic surgery JID - 101265113 SB - IM MH - Humans MH - Retrospective Studies MH - Male MH - Female MH - *Coronary Artery Bypass/methods/adverse effects MH - *Minimally Invasive Surgical Procedures/methods/adverse effects MH - Middle Aged MH - *Postoperative Complications/epidemiology MH - Treatment Outcome MH - *Coronary Artery Disease/surgery MH - Aged MH - Iraq/epidemiology PMC - PMC12849472 OTO - NOTNLM OT - Acute respiratory failure. OT - Coronary artery bypass grafting OT - Minimally invasive cardiac surgery OT - Postoperative outcomes OT - Renal dysfunction OT - Surgical urgency OT - Vasopressor support COIS- Declarations. Ethics approval and consent to participate: This retrospective study was conducted in accordance with institutional and national ethical guidelines and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. Ethical approval was granted by the Research Ethics Committee of Shar Hospital (Approval No.: 15, Date: 12/12/2024). Given the retrospective design, the requirement for informed consent was waived by the committee. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests. EDAT- 2025/12/25 07:40 MHDA- 2026/01/28 19:20 PMCR- 2025/12/24 CRDT- 2025/12/25 00:01 PHST- 2025/01/05 00:00 [received] PHST- 2025/11/19 00:00 [accepted] PHST- 2026/01/28 19:20 [medline] PHST- 2025/12/25 07:40 [pubmed] PHST- 2025/12/25 00:01 [entrez] PHST- 2025/12/24 00:00 [pmc-release] AID - 10.1186/s13019-025-03768-1 [pii] AID - 3768 [pii] AID - 10.1186/s13019-025-03768-1 [doi] PST - epublish SO - J Cardiothorac Surg. 2025 Dec 24;21(1):43. doi: 10.1186/s13019-025-03768-1. PMID- 41392024 OWN - NLM STAT- MEDLINE DCOM- 20260526 LR - 20260526 IS - 1365-2125 (Electronic) IS - 0306-5251 (Linking) VI - 92 IP - 6 DP - 2026 Jun TI - Cardiovascular benefits of early sodium-glucose cotransporter 2 inhibitor use for diabetics with acute myocardial infarction: A nationwide cohort study. PG - 1584-1594 LID - 10.1002/bcp.70416 [doi] AB - AIMS: Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have well-documented cardiovascular benefits. However, the cardiovascular benefits of early SGLT2i use in diabetics experiencing acute myocardial infarction (MI) remain unclear. METHODS: To evaluate the cardiovascular effects of early initiation of SGLT2i in diabetics experiencing acute MI, this study emulated a target trial using data from Taiwan's Health Research Data Integration Service of the National Health Insurance Administration. This study analysed cardiovascular composite outcomes, including hospitalization for heart failure (HHF), MI re-hospitalization, ischaemic stroke, cardiovascular mortality, and individual outcomes. Adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using Cox proportional hazard models. RESULTS: Among 36,103 diabetic patients experiencing acute MI, SGLT2i administration within 14 days after acute MI (N = 2,149) reduced cardiovascular composite risks relative to dipeptidyl peptidase-4 inhibitors (DPP4i) (N = 10,802, HR = 0.89, 95% CI: 0.82-0.96, p = 0.0017). Compared to DPP4i, SGLT2i significantly reduced HHF (HR = 0.86, 0.79-0.95), MI re-hospitalization (HR = 0.70, 0.62-0.80), and cardiovascular mortality (HR = 0.65, 0.54-0.79) risks, but not ischaemic stroke. Sensitivity analysis confirmed the robust therapeutic efficacy of SGLT2i, and Subgroup analyses suggested that the therapeutic efficacy of SGLT2i may be affected by chronic kidney disease, age, and percutaneous coronary intervention. The cardiovascular benefits were consistent across patients without heart failure and new SGLT2i users. Exploratory analyses revealed comparable results between SGLT2i and glucagon-like peptide-1 receptor agonists. CONCLUSIONS: Early SGLT2i use in diabetics experiencing acute MI reduced cardiovascular risk, supporting its potential therapeutic use. CI - (c) 2025 British Pharmacological Society. FAU - Wang, Sheng-Fan AU - Wang SF AUID- ORCID: 0000-0002-6467-7366 AD - Department of Pharmacy, Taipei Veterans General Hospital, Taipei, Taiwan. AD - Department of Clinical Pharmacy, School of Pharmacy, Taipei Medical University, Taipei, Taiwan. AD - Department and Institute of Pharmacology, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. AD - Institute of Biopharmaceutical Sciences, College of Pharmaceutical Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan. FAU - Chan, Tzu-Kuan AU - Chan TK AD - College of Pharmaceutical Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan. FAU - Lee, Yu-Hsuan AU - Lee YH AD - Division of Faculty Development, Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan. FAU - Wang, Yu-Shiuan AU - Wang YS AD - College of Pharmaceutical Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan. FAU - Chou, Chian-Ying AU - Chou CY AD - Department of Pharmacy, Taipei Veterans General Hospital, Taipei, Taiwan. AD - College of Pharmaceutical Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan. FAU - Chang, Yuh-Lih AU - Chang YL AD - Department of Pharmacy, Taipei Veterans General Hospital, Taipei, Taiwan. AD - Department and Institute of Pharmacology, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. AD - College of Pharmaceutical Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan. FAU - Tsai, Hui-Ju AU - Tsai HJ AD - Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan. AD - Department of Medical Science, National Tsing-Hua University, Hsinchu, Taiwan. FAU - Lee, Hsin-Chen AU - Lee HC AD - Department and Institute of Pharmacology, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. AD - College of Pharmaceutical Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan. AD - Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan. FAU - Lip, Gregory Y H AU - Lip GYH AD - Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK. AD - Department of Clinical Medicine, Aalborg University, Aalborg, Denmark. FAU - Chiang, Chern-En AU - Chiang CE AD - General Clinical Research Center, Taipei Veterans General Hospital, Taipei, Taiwan. AD - ReShining Clinic, Taipei, Taiwan. FAU - Chen, Chen-Huan AU - Chen CH AD - School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. AD - Institute of Public Health and Community Medicine Research Center, National Yang Ming Chiao Tung University School of Medicine, Taipei, Taiwan. FAU - Cheng, Hao-Min AU - Cheng HM AUID- ORCID: 0000-0002-3885-6600 AD - Division of Faculty Development, Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan. AD - ReShining Clinic, Taipei, Taiwan. AD - Institute of Public Health and Community Medicine Research Center, National Yang Ming Chiao Tung University School of Medicine, Taipei, Taiwan. AD - Ph.D. Program of Interdisciplinary Medicine (PIM), National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan. LA - eng GR - E107F-M01-0501/National Yang Ming Chiao Tung University/ GR - Yin Yen-Liang Foundation/ GR - Melissa Lee Cancer Foundation/ GR - MOHW104-TDU-B-211-113-003/Ministry of Health and Welfare/ GR - MOHW106-TDU-B-211-113001/Ministry of Health and Welfare/ GR - Ministry of Education/ GR - Dr. Morris Chang Foundation/ GR - V113C-030/Taipei Veterans General Hospital/ GR - V114C-232/Taipei Veterans General Hospital/ GR - 106-2314-B-075-051-MY3/National Science and Technology Council, Taiwan/ GR - 109-2314-B-010-061/National Science and Technology Council, Taiwan/ GR - 113-2320-B-075-002/National Science and Technology Council, Taiwan/ GR - Yin Yen-Liang Foundation Development and Construction Plan of the School of Medicine, National Yang-Ming Chiao-Tung University/ GR - Interdisciplinary Research Center for Healthy Longevity, National Yang-Ming Chiao-Tung University/ PT - Journal Article DEP - 20251214 PL - England TA - Br J Clin Pharmacol JT - British journal of clinical pharmacology JID - 7503323 RN - 0 (Sodium-Glucose Transporter 2 Inhibitors) RN - 0 (Dipeptidyl-Peptidase IV Inhibitors) SB - IM MH - Humans MH - *Sodium-Glucose Transporter 2 Inhibitors/therapeutic use/administration & dosage MH - Male MH - Female MH - Aged MH - *Myocardial Infarction/drug therapy/epidemiology/mortality/complications MH - Middle Aged MH - Taiwan/epidemiology MH - *Diabetes Mellitus, Type 2/drug therapy/complications MH - Dipeptidyl-Peptidase IV Inhibitors/therapeutic use/administration & dosage MH - Hospitalization/statistics & numerical data MH - Cohort Studies MH - Heart Failure/epidemiology/prevention & control MH - Ischemic Stroke/epidemiology/prevention & control OTO - NOTNLM OT - diabetes OT - dipeptidyl peptidase 4 inhibitor OT - glucagon-like peptide-1 receptor agonist OT - myocardial infarction OT - sodium-glucose cotransporter 2 inhibitor EDAT- 2025/12/15 00:28 MHDA- 2026/05/26 06:31 CRDT- 2025/12/14 22:53 PHST- 2025/10/20 00:00 [revised] PHST- 2025/06/19 00:00 [received] PHST- 2025/11/27 00:00 [accepted] PHST- 2026/05/26 06:31 [medline] PHST- 2025/12/15 00:28 [pubmed] PHST- 2025/12/14 22:53 [entrez] AID - 10.1002/bcp.70416 [doi] PST - ppublish SO - Br J Clin Pharmacol. 2026 Jun;92(6):1584-1594. doi: 10.1002/bcp.70416. Epub 2025 Dec 14. PMID- 41383808 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20251212 LR - 20251214 IS - 2008-6164 (Print) IS - 2008-6172 (Electronic) IS - 2008-6164 (Linking) VI - 16 IP - 4 DP - 2025 Fall TI - One-year survival prediction models following ST-elevation myocardial infarction: A comparative analysis of the Cox Frailty Model and machine learning. PG - 775-790 LID - 10.22088/cjim.16.4.775 [doi] AB - BACKGROUND: The aim of this study was developing and comparative analyzing prediction models using a Cox proportional hazards model with and without frailty, random survival forests (RSF) and survival support vector regression (SVR). METHODS: In this study, 2800 patients with STEMI have been used and two machine learning methods for survival analysis have been applied: RSF and SVR, then the Cox model with and without frailty has been employed. The main outcome was 1-year mortality after STEMI. In this study, 16 variables have missing data. After applying four multiple imputation via chained equations methods, the "Sample" algorithm was selected as the appropriate model with complete data and the modeling process was continued with this data and Hazard Ratio (HR) were calculated. RESULTS: Overall, 1628 (58.1%) patients received primary percutaneous coronary intervention and 737 (26.3%) received thrombolytic therapy. Based on the experimental results, between all the models, the Cox with frailty model performed the best, with the highest overall C-index (0.891) and time-dependent area under the curve (0.9134) and the least Brier score (0.0458). Ever smoking (HR= 1.46), systolic blood pressure (HR= 0.98), left ventricular ejection fraction (HR= 0.96), glomerular filtration rate (HR= 0.96), and reperfusion therapy (No reperfusion HR= 2.71) independently associated with 1-year mortality of STEMI patients. CONCLUSION: The findings suggest that there are advantages in developing frailty models further than the fundamental Cox proportional hazards regression for estimating the likelihood of survival for STEMI patients to account for the unobserved heterogeneity in grouped observations. CI - (c) The Author(s). FAU - Rezaei, Mansour AU - Rezaei M AD - Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran. FAU - Montaseri, Maryam AU - Montaseri M AD - School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran. FAU - Mostafaei, Shayan AU - Mostafaei S AD - Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden. FAU - Khayati, Armin AU - Khayati A AD - Department of Computer Science and Engineering, School of Electrical and Computer Engineering, Shiraz University, Shiraz, Iran. FAU - Taheri, Mohammad AU - Taheri M AD - Department of Computer Science and Engineering, School of Electrical and Computer Engineering, Shiraz University, Shiraz, Iran. LA - eng PT - Journal Article DEP - 20251019 PL - Iran TA - Caspian J Intern Med JT - Caspian journal of internal medicine JID - 101523876 PMC - PMC12694771 OTO - NOTNLM OT - Frailty model OT - Machine-learning OT - Myocardial Infarction OT - Survival analysis COIS- None declared. EDAT- 2025/12/12 07:20 MHDA- 2025/12/12 07:21 PMCR- 2025/10/19 CRDT- 2025/12/12 04:32 PHST- 2024/11/27 00:00 [received] PHST- 2025/01/18 00:00 [accepted] PHST- 2025/12/12 07:21 [medline] PHST- 2025/12/12 07:20 [pubmed] PHST- 2025/12/12 04:32 [entrez] PHST- 2025/10/19 00:00 [pmc-release] AID - 10.22088/cjim.16.4.775 [doi] PST - epublish SO - Caspian J Intern Med. 2025 Oct 19;16(4):775-790. doi: 10.22088/cjim.16.4.775. eCollection 2025 Fall. PMID- 41369941 OWN - NLM STAT- MEDLINE DCOM- 20260114 LR - 20260915 IS - 2380-6591 (Electronic) VI - 11 IP - 1 DP - 2026 Jan 1 TI - Rationale, Design, and Baseline Clinical Characteristics of the Ziltivekimab Cardiovascular Outcomes Trial: Interleukin-6 Inhibition and Atherosclerotic Event Rate Reduction. PG - 89-97 LID - 10.1001/jamacardio.2025.4491 [doi] AB - IMPORTANCE: Cardiovascular inflammation is a major determinant of atherosclerotic disease, and inhibition of the central signaling cytokine, interleukin 6 (IL-6), is a promising target for intervention. Patients with chronic kidney disease (CKD) commonly have plasma elevations of inflammatory biomarkers, such as high-sensitivity C-reactive protein (hsCRP) and IL-6, and are at high risk for life-threatening atherosclerotic events as well as loss of kidney function and might therefore benefit from IL-6 inhibition. OBSERVATIONS: The Ziltivekimab Cardiovascular Outcomes Trial (ZEUS; NCT05021835) will determine the safety and efficacy of IL-6 inhibition with ziltivekimab among patients with atherosclerotic cardiovascular disease (ASCVD), CKD, and systemic inflammation. ZEUS is a multinational, double-blind, placebo-controlled, event-driven, randomized clinical trial inclusive of 6376 participants with ASCVD, CKD, and an hsCRP level greater than or equal to 2 mg/L who were randomized in a 1:1 fashion to receive either ziltivekimab, 15 mg, administered subcutaneously every month or matching placebo. At randomization, mean age was 69.5 years, 27.5% were female, 92.0% had hypertension, 65.7% had diabetes, and 41.3% had heart failure. At baseline, the mean estimated glomerular filtration rate (eGFR) was 44.5 mL/min/1.73 m2, mean low-density lipoprotein cholesterol level was 77.7 mg/dL, median hsCRP level was 4.5 mg/L, and median IL-6 level was 4.9 pg/mL. At enrollment, sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists were being used by 36.8% and 11.3% of the cohort, respectively. The primary outcome is 3-point major adverse cardiovascular events. Secondary cardiovascular outcomes include (1) an expanded major adverse cardiovascular event outcome including hospitalization for unstable angina requiring urgent coronary revascularization, (2) hospitalizations for heart failure or urgent heart failure visits or cardiovascular death, and (3) all-cause mortality. The secondary kidney outcome is a composite of greater than 40% decline in eGFR, eGFR less than 15 mL/min/1.73 m2, dialysis, kidney transplant, death from kidney disease, or cardiovascular death. CONCLUSIONS AND RELEVANCE: The ZEUS randomized clinical trial will formally test the hypothesis that IL-6 inhibition with ziltivekimab will lower incident cardiovascular event rates and potentially slow kidney decline among participants with known ASCVD, CKD, and elevated hsCRP. If successful, the ZEUS trial would provide a fully novel approach for prevention of myocardial infarction, stroke, cardiovascular death, and kidney function decline among high-risk patients with CKD. FAU - Ridker, Paul M AU - Ridker PM AD - Center for Cardiovascular Disease Prevention, Brigham and Women's Hospital, Boston, Massachusetts. AD - Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, Massachusetts. FAU - Baeres, Florian M M AU - Baeres FMM AD - Novo Nordisk, Copenhagen, Denmark. FAU - Hveplund, Anders AU - Hveplund A AD - Novo Nordisk, Copenhagen, Denmark. FAU - Engelmann, Mads M D AU - Engelmann MMD AD - Novo Nordisk, Copenhagen, Denmark. FAU - Hovingh, G Kees AU - Hovingh GK AD - Novo Nordisk, Copenhagen, Denmark. FAU - Lincoff, A Michael AU - Lincoff AM AD - Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio. FAU - Marx, Nikolaus AU - Marx N AD - Department of Internal Medicine I, University Hospital RWTH Aachen, Aachen, Germany. FAU - Navar, Ann Marie AU - Navar AM AD - Department of Medicine, UT Southwestern Medical Center, Dallas, Texas. AD - Deputy Editor, JAMA Cardiology. FAU - Sattar, Naveed AU - Sattar N AD - School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom. FAU - Tuttle, Katherine AU - Tuttle K AD - Providence Medical Research Center, Providence Inland Northwest Health, Spokane, Washington. FAU - Perkovic, Vlado AU - Perkovic V AD - University of New South Wales Sydney, Sydney, New South Wales, Australia. LA - eng PT - Clinical Trial Protocol PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - United States TA - JAMA Cardiol JT - JAMA cardiology JID - 101676033 RN - 0 (Antibodies, Monoclonal, Humanized) RN - 0 (Biomarkers) RN - 9007-41-4 (C-Reactive Protein) RN - 0 (Interleukin-6) RN - 0 (Interleukin-6 Inhibitors) SB - IM EIN - JAMA Cardiol. 2026 Jun 1;11(6):611. doi: 10.1001/jamacardio.2026.1448. PMID: 42054010 MH - Aged MH - Female MH - Humans MH - Male MH - Middle Aged MH - *Antibodies, Monoclonal, Humanized/therapeutic use MH - *Atherosclerosis/drug therapy/complications MH - Biomarkers/blood MH - C-Reactive Protein/metabolism MH - Double-Blind Method MH - Glomerular Filtration Rate MH - Inflammation/drug therapy MH - *Interleukin-6/blood MH - *Interleukin-6 Inhibitors MH - Randomized Controlled Trials as Topic MH - *Renal Insufficiency, Chronic/complications/drug therapy MH - Multicenter Studies as Topic EDAT- 2025/12/10 13:53 MHDA- 2026/01/14 12:31 CRDT- 2025/12/10 11:33 PHST- 2026/01/14 12:31 [medline] PHST- 2025/12/10 13:53 [pubmed] PHST- 2025/12/10 11:33 [entrez] AID - 2842746 [pii] AID - 10.1001/jamacardio.2025.4491 [doi] PST - ppublish SO - JAMA Cardiol. 2026 Jan 1;11(1):89-97. doi: 10.1001/jamacardio.2025.4491. PMID- 41351610 OWN - NLM STAT- MEDLINE DCOM- 20260306 LR - 20260813 IS - 1876-7591 (Electronic) IS - 1936-878X (Print) IS - 1876-7591 (Linking) VI - 19 IP - 3 DP - 2026 Mar TI - Stress Cardiac Magnetic Resonance Ischemia Burden and Cardiovascular Events: Post-Hoc Analysis From the ISCHEMIA Trial. PG - 326-341 LID - S1936-878X(25)00597-2 [pii] LID - 10.1016/j.jcmg.2025.10.015 [doi] AB - BACKGROUND: Research comparing the prognostic value of stress cardiac magnetic resonance (CMR) to other stress modalities in patients with coronary disease is limited. OBJECTIVES: The authors compared the prognostic value of stress CMR vs alternative testing by either single-photon emission computed tomography or stress echocardiography (SPECT/echo) in the ISCHEMIA (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches) trial. METHODS: CMR vs SPECT/echo was compared in 3,909 patients randomized in ISCHEMIA after sites' interpretation of moderate to severe ischemia. Ischemia and infarct extent, measured by either CMR or SPECT/echo, were each associated with the trial's primary outcome of cardiovascular death, nonfatal myocardial infarction (MI), or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest, at a median follow-up of 3.37 years (Q1-Q3: 2.20-4.56 years). RESULTS: Compared with SPECT/echo (n = 5,627), CMR participants (n = 313) were not different in key demographic factors but were more likely to have severe ischemia (57% vs 38%; P < 0.001) and to be randomized (n = 257, 82%, vs n = 3,652, 65%; P < 0.001). Ischemia severity (no/mild, moderate, severe) by CMR core laboratory was associated with cumulative 4-year event rates of all trial-specific endpoints, including the primary outcome (P = 0.042), cardiovascular death/MI (P = 0.041), and nonfatal MI (P = 0.03), but SPECT/echo ischemia severity was not. No/mild, moderate, and severe ischemia by CMR were associated with 0%, 14%, and 23% 4-year primary outcome rates, respectively, compared with 18%, 15%, and 16%, by SPECT/echo. After adjustment for age, estimated glomerular filtration rate, and diabetes, the association between ischemia extent and the primary endpoint differed by imaging modality, with each additional ischemic segment on CMR associated with a 13% increase in hazard (interaction P = 0.02). In participants assigned to initial conservative management who had no/mild ischemia on imaging, 4-year rates of invasive referral and coronary revascularization were lower in the CMR than SPECT/echo group (16.7% and 0%, respectively, for CMR; and 31% and 13.3%, respectively, for SPECT/echo). CONCLUSIONS: Ischemia severity by CMR had a stronger association with all ISCHEMIA trial endpoints compared with SPECT/echo. (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches [ISCHEMIA]; NCT01471522). CI - Copyright (c) 2026 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Kwong, Raymond Y AU - Kwong RY AD - Department of Medicine, Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. Electronic address: rykwong@bwh.harvard.edu. FAU - Heydari, Bobby AU - Heydari B AD - Department of Medicine, Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. FAU - Abbasi, Siddique AU - Abbasi S AD - Amegen, Thousand Oaks, California, USA. FAU - Mongeon, Francois-Pierre AU - Mongeon FP AD - Department of Specialized Medicine, Division of Non-Invasive Cardiology, Montreal Heart Institute, Montreal, Quebec, Canada. FAU - Marcotte, Francois AU - Marcotte F AD - Mayo Clinic, Phoenix, Arizona, USA. FAU - Friedrich, Matthias AU - Friedrich M AD - Department of Specialized Medicine, Division of Non-Invasive Cardiology, Montreal Heart Institute, Universite de Montreal, Montreal, Quebec, Canada. FAU - Shaw, Leslee J AU - Shaw LJ AD - Icahn School of Medicine at Mount Sinai, New York, New York, USA. FAU - Xu, Yifan AU - Xu Y AD - NYU Grossman School of Medicine, New York, New York, USA. FAU - Anthopolos, Rebecca AU - Anthopolos R AD - NYU Grossman School of Medicine, New York, New York, USA. FAU - Bekeredjian, Raffi AU - Bekeredjian R AD - Robert Bosch Medical Center, Stuttgart, Germany. FAU - Monti, Lorenzo AU - Monti L AD - Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy. FAU - Selvanayagam, Joseph AU - Selvanayagam J AD - Flinders Medical Centre, Adelaide, South Australia, Australia. FAU - Lesiak, Maciej AU - Lesiak M AD - University Hospital of the Lords Transfiguration, Poznan, Poland. FAU - Picard, Michael H AU - Picard MH AD - Department of Medicine, Cardiovascular Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA. FAU - Berman, Daniel S AU - Berman DS AD - Cedars Sinai Medical Center, Los Angeles, California, USA. FAU - Bangalore, Sripal AU - Bangalore S AD - Duke Clinical Research Institute, Durham, North Carolina, USA. FAU - Spertus, John A AU - Spertus JA AD - Saint Luke's Mid America Heart Institute, Kansas City, Missouri, USA; University of Missouri-Kansas City's Healthcare Institute for Innovations in Quality, Kansas City, Missouri, USA. FAU - Stone, Gregg W AU - Stone GW AD - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA. FAU - Boden, William E AU - Boden WE AD - VA New England Healthcare System, Bedford, Massachusetts, USA. FAU - Min, James AU - Min J AD - Cleerly Inc, New York, New York, USA. FAU - Mancini, G B John AU - Mancini GBJ AD - University of British Columbia, Vancouver, British Columbia, Canada. FAU - Leipsic, Jonathan AU - Leipsic J AD - University of British Columbia, Vancouver, British Columbia, Canada. FAU - Budoff, Matthew AU - Budoff M AD - Lundquist Institute, Harbor-UCLA Medical Center, Torrance, California, USA. FAU - Hague, Cameron AU - Hague C AD - Cleerly Inc, New York, New York, USA. FAU - Hochman, Judith S AU - Hochman JS AD - Cardiovascular Clinical Research Center, Leon H. Charney Division of Cardiology, Department of Medicine, NYU Grossman School of Medicine, New York, New York, USA. FAU - Maron, David J AU - Maron DJ AD - Department of Medicine, Stanford University School of Medicine, Stanford, California, USA. FAU - Reynolds, Harmony R AU - Reynolds HR AD - Cardiovascular Clinical Research Center, Leon H. Charney Division of Cardiology, Department of Medicine, NYU Grossman School of Medicine, New York, New York, USA. CN - ISCHEMIA Research Group LA - eng SI - ClinicalTrials.gov/NCT01471522 GR - U01 HL105462/HL/NHLBI NIH HHS/United States GR - U01 HL105561/HL/NHLBI NIH HHS/United States GR - U01 HL105565/HL/NHLBI NIH HHS/United States GR - U01 HL105907/HL/NHLBI NIH HHS/United States PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20251205 PL - United States TA - JACC Cardiovasc Imaging JT - JACC. Cardiovascular imaging JID - 101467978 SB - IM MH - Humans MH - Male MH - Female MH - Middle Aged MH - Predictive Value of Tests MH - *Tomography, Emission-Computed, Single-Photon MH - Aged MH - Time Factors MH - *Myocardial Ischemia/mortality/therapy/diagnostic imaging/diagnosis/complications MH - Severity of Illness Index MH - Risk Factors MH - Prognosis MH - *Echocardiography, Stress MH - Myocardial Infarction/mortality/etiology/therapy MH - *Magnetic Resonance Imaging MH - Angina, Unstable/etiology/mortality MH - Heart Failure/etiology/mortality MH - Hospitalization MH - *Magnetic Resonance Imaging, Cine MH - Risk Assessment PMC - PMC13155462 MID - NIHMS2141543 OTO - NOTNLM OT - ISCHEMIA trial OT - cardiovascular events OT - stress cardiac magnetic resonance imaging COIS- Funding Support and Author Disclosures This study was funded by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health (grant numbers U01HL105907, U01HL105462, U01HL105561, U01HL105565). Dr Kwong has received grants from the NHLBI during the conduct of the trial. Dr Abbasi is an employee and shareholder of Amegen. Dr Shaw has received grants from the NHLBI during the conduct of the trial and currently. Dr Anthopolos, Mr Xu, and Dr Selvanayagam have received grants from the NHLBI during the conduct of the study. Dr Lesiak has received personal fees from AstraZeneca, Pfizer, and Terumo outside of the submitted work. Dr Picard has received grants from the NHLBI during the conduct of the trial. Dr Berman has received software royalties from Cedars-Sinai Medical Center outside of the submitted work; and grants from the NHLBI during the conduct of the trial. Dr Bangalore has received grants from the NHLBI during the conduct of the study; grants and personal fees from Abbott Vascular; and personal fees from Biotronik, Pfizer, Amgen, and Reata outside of the submitted work. Dr Spertus has received grants from the NHLBI during the conduct of the study and the American College of Cardiology; personal fees from Bayer, Novartis, AstraZeneca, Amgen, Janssen, United Healthcare, and Blue Cross Blue Shield of Kansas City outside of the submitted work; and has a patent copyright to Seattle Angina Questionnaire with royalties paid and Equity in Health Outcomes Sciences. Dr Stone has received grants and personal fees from the NHLBI during the conduct of the study; speaker honoraria from Medtronic, Pulnovo, Infraredx, Abiomed, Amgen, and Boehringer Ingelheim; consulting fees from Abbott, Daiichi-Sankyo, Ablative Solutions, CorFlow, Apollo Therapeutics, Cardiomech, Gore, Robocath, Miracor, Vectorious, Abiomed, Valfix, TherOx, HeartFlow, Neovasc, Ancora, Elucid Bio, Occlutech, Impulse Dynamics, Adona Medical, Millennia Biopharma, Oxitope, Cardiac Success, and HighLife; has equity/options from Ancora, Cagent, Applied Therapeutics, Biostar family of funds, SpectraWave, Orchestra Biomed, Aria, Cardiac Success, Valfix, and Xenter; his employer, Mount Sinai Hospital, has received research grants from Abbott, Abiomed, Bioventrix, Cardiovascular Systems Inc, Phillips, Biosense-Webster, Shockwave, Vascular Dynamics, Pulnovo, and V-wave; and his daughter is an employee at IQVIA. Dr Boden has received grants from the NHLBI during the conduct of the study; grants from Abbvie, Amarin, and Amgen; and personal fees from Amgen, Cleveland Clinic Clinical Coordinating Center, and Janssen, outside of the submitted work. Dr Min is an employee of Cleerly, Inc and retains equity. Dr Mancini has received grants from the NHLBI during the conduct of the study; grants and personal fees from Amgen, Sanofi, Boehringer Ingelheim, AstraZeneca, Bayer, Janssen, Novo Nordisk, and HLS Therapeutics; and grants from Novartis, outside of the submitted work. Dr Leipsic has received consulting fees and has stock options with HeartFlow and Circle CVI; and a research grant from GE HealthCare outside of the submitted work. Dr Budoff has received grant support from General Electric outside of the submitted work. Dr Hochman has been the primary investigator for the ISCHEMIA trial for which, in addition to support by the NHLBI grant, devices and medications were provided by Abbott Vascular, Medtronic Inc, Abbott Laboratories (formerly St Jude Medical, Inc), Royal Philips NV (formerly Volcano Corporation), Arbor Pharmaceuticals, LLC, AstraZeneca Pharmaceuticals, LP, Merck Sharp & Dohme Corp, and Omron Healthcare, Inc; and has received financial donations from Arbor Pharmaceuticals LLC and AstraZeneca Pharmaceuticals LP; and she is primary investigator for ISCHEMIA-EXTEND. Dr Maron has received grants from the NHLBI during the conduct of the study; independent contractor fees from Abiomed; has stock in Ablative Solutions; has received research funding from Cleerly; and has received consulting fees from Regeneron. Dr Reynolds has received grants from the NHLBI during the conduct of the study; consulting fees from HeartFlow; and support from Abbott Vascular (donation of optical coherence tomography catheters for an unrelated research study) and Biotelemetry Inc (donation of telemetry monitors for an unrelated research study). All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2025/12/06 12:51 MHDA- 2026/03/07 01:37 PMCR- 2026/05/08 CRDT- 2025/12/06 10:38 PHST- 2024/09/24 00:00 [received] PHST- 2025/09/17 00:00 [revised] PHST- 2025/10/16 00:00 [accepted] PHST- 2026/03/07 01:37 [medline] PHST- 2025/12/06 12:51 [pubmed] PHST- 2025/12/06 10:38 [entrez] PHST- 2026/05/08 00:00 [pmc-release] AID - S1936-878X(25)00597-2 [pii] AID - 10.1016/j.jcmg.2025.10.015 [doi] PST - ppublish SO - JACC Cardiovasc Imaging. 2026 Mar;19(3):326-341. doi: 10.1016/j.jcmg.2025.10.015. Epub 2025 Dec 5. PMID- 41342080 OWN - NLM STAT- MEDLINE DCOM- 20251204 LR - 20251226 IS - 1969-6213 (Electronic) IS - 1774-024X (Print) IS - 1774-024X (Linking) VI - 21 IP - 23 DP - 2025 Dec 1 TI - Abbreviated or standard antiplatelet therapy after PCI in HBR patients with chronic kidney disease: a prespecified analysis from the MASTER DAPT trial. PG - e1445-e1455 LID - EIJ-D-25-00566 [pii] LID - 10.4244/EIJ-D-25-00566 [doi] AB - BACKGROUND: Abbreviated antiplatelet therapy (APT) can reduce bleeding without increasing ischaemic harm in high bleeding risk (HBR) patients undergoing percutaneous coronary intervention (PCI). The impact of chronic kidney disease (CKD) on the safety and effectiveness of abbreviated APT remains unknown. AIMS: We aimed to investigate the comparative effectiveness of abbreviated (1 month) versus standard (>/=3 months) APT in HBR patients with and without CKD. METHODS: This was a prespecified analysis from the MASTER DAPT trial, which randomised 4,579 HBR patients (1,428 [31%] with CKD) to abbreviated or standard APT. CKD was defined as an estimated glomerular filtration rate <60 mL/min/1.73 m(2). Co-primary outcomes were net adverse clinical events (NACE; a composite of all-cause death, myocardial infarction [MI], stroke, and major bleeding), major adverse cardiac or cerebral events (MACCE; all-cause death, MI and stroke), and Bleeding Academic Research Consortium (BARC) 2, 3, or 5 bleeding at 11 months. RESULTS: NACE did not significantly differ with abbreviated and standard APT among CKD patients (hazard ratio [HR] 0.91, 95% confidence interval [CI]: 0.66-1.24) and non-CKD patients (HR 0.96, 95% CI: 0.73-1.27; pinteraction=0.78). Similarly, MACCE did not differ in CKD patients (HR 0.91, 95% CI: 0.64-1.27) and non-CKD patients (HR 1.09, 95% CI: 0.78-1.51; pinteraction=0.45). Abbreviated APT was associated with consistently lower BARC 2, 3, or 5 bleeding in both patients with CKD (HR 0.74, 95% CI: 0.52-1.07) and without it (HR 0.66, 95% CI: 0.51-0.85; pinteraction=0.59). CONCLUSIONS: Abbreviated APT was associated with similar NACE and MACCE rates and reduced bleeding compared with standard APT in HBR patients undergoing PCI, regardless of the presence or absence of CKD. (ClinicalTrials.gov: NCT03023020). FAU - Landi, Antonio AU - Landi A AD - Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland. AD - The Faculty of Biomedical Sciences, University of Italian Switzerland, Lugano, Switzerland. FAU - Mahfoud, Felix AU - Mahfoud F AD - The Cardiovascular Research Institute Basel (CRIB), Basel, Switzerland and University Heart Center, University Hospital Basel, Basel, Switzerland. FAU - Frigoli, Enrico AU - Frigoli E AD - Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland. FAU - Chalkou, Konstantina AU - Chalkou K AD - The Department of Clinical Research, University of Bern, Bern, Switzerland. FAU - Heg, Dik AU - Heg D AD - The Department of Clinical Research, University of Bern, Bern, Switzerland. FAU - Abhaichand, Rajpal K AU - Abhaichand RK AD - The G. Kuppuswamy Naidu Memorial Hospital, Coimbatore, India. FAU - Abhyankar, Atul Damodar AU - Abhyankar AD AD - Mahavir Heart Institute, Surat, India. FAU - Barbato, Emanuele AU - Barbato E AD - Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy. FAU - Beygui, Farzin AU - Beygui F AD - The Cardiology Department, Caen University Hospital, Caen, France and INSERM UMRS 1237, Caen, France. FAU - Danse, Peter W AU - Danse PW AD - Department of Cardiology, Rijnstate Hospital, Arnhem, the Netherlands. FAU - Garachemani, Ali AU - Garachemani A AD - Lindenhof Hospital, Bern, Switzerland. FAU - Del Blanco, Bruno Garcia AU - Del Blanco BG AD - Cardiology Department, University Hospital Vall d'Hebron, Barcelona, Spain. FAU - Huber, Kurt AU - Huber K AD - 3rd Medical Department, Cardiology and Intensive Care Medicine, Wilhelminen Hospital, Vienna, Austria. FAU - Koning, Rene AU - Koning R AD - Clinique Saint-Hilaire, Rouen, France. FAU - Kukreja, Neville AU - Kukreja N AD - Department of Cardiology, East and North Hertfordshire NHS Trust, Stevenage, United Kingdom. FAU - Piot, Christophe AU - Piot C AD - Departement de Cardiologie Interventionnelle, Clinique du Millenaire, Universite de Montpellier, CNRS, INSERM, Montpellier, France. FAU - Quang, Nguyen Ngoc AU - Quang NN AD - Vietnam National Heart Institute, Bach Mai Hospital, Hanoi, Vietnam. FAU - Tirouvanziam, Ashok AU - Tirouvanziam A AD - Cardiology Department, Hopital Prive le Confluent, Nantes, France. FAU - Valla, Mathieu AU - Valla M AD - Cardiology Department, Mercy Hospital, CHR Metz-Thionville, Metz, France. FAU - Smits, Pieter C AU - Smits PC AD - Department of Cardiology, Maasstad Hospital, Rotterdam, the Netherlands. FAU - Valgimigli, Marco AU - Valgimigli M AD - Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland. AD - The Faculty of Biomedical Sciences, University of Italian Switzerland, Lugano, Switzerland. AD - University of Bern, Bern, Switzerland. FAU - Master Dapt Investigators, On Behalf Of The AU - Master Dapt Investigators OBOT LA - eng SI - ClinicalTrials.gov/NCT03023020 PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20251201 PL - France TA - EuroIntervention JT - EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology JID - 101251040 RN - 0 (Platelet Aggregation Inhibitors) SB - IM MH - Humans MH - *Percutaneous Coronary Intervention/methods/adverse effects MH - *Renal Insufficiency, Chronic/complications MH - Female MH - *Platelet Aggregation Inhibitors/administration & dosage/adverse effects/therapeutic use MH - Male MH - Aged MH - *Hemorrhage/chemically induced MH - Middle Aged MH - Treatment Outcome MH - *Coronary Artery Disease/complications/surgery MH - Risk Factors PMC - PMC12641549 COIS- A. Landi declares that he has received consulting fees from Terumo, outside the submitted work. F. Mahfoud has been supported by Deutsche Forschungsgemeinschaft (SFB TRR219, Project-ID 322900939), and Deutsche Herzstiftung; Saarland University has received scientific support from Ablative Solutions, Medtronic, and Recor Medical; up to May 2024, he received speaker honoraria/consulting fees from Ablative Solutions, AstraZeneca, Inari, Medtronic, Merck & Co, Novartis, Philips, and Recor Medical. D. Heg and K. Chalkou are employed by the Department of Clinical Research (DCR), University of Bern, which has a staff policy of not accepting honoraria or consultancy fees; however, the DCR is involved in the design, conduct, and analysis of clinical studies funded by not-for-profit and for-profit organisations. In particular, pharmaceutical and medical device companies provide direct funding to some of these studies. For an up-to-date list of our conflicts of interest see https://dcr.unibe.ch/services/declaration_of_interest/index_eng.html. E. Barbato declares grants or contracts from Pfizer; honoraria from Abbott, Boston Scientific, and Insight Lifetech; and participation on advisory boards for Novo Nordisk and Abbott, outside the submitted work. N. Kukreja has received grants from DalCor Pharma, the Population Health Research Institute, the European Cardiovascular Research Institute, and Daiichi Sankyo; and has received personal fees from AstraZeneca and Pfizer, outside the submitted work. A. Tirouvanziam reports receiving consultant and proctor (TAVI) fees from Edwards Lifesciences, outside the submitted work. P.C. Smits reports personal consulting or speaker fees from Terumo, Abiomed, and OpSense; grants and personal consulting fees from Abbott, MicroPort, and Daiichi Sankyo; and grants from SMT, outside the submitted work. M. Valgimigli reports grants and/or personal fees from AstraZeneca, Terumo, Alvimedica/CID, Abbott, Daiichi Sankyo, Bayer, CoreFlow, Idorsia Pharmaceuticals, Universitat Basel Department Klinische Forschung, Vifor, Bristol-Myers Squibb SA, Biotronik, Boston Scientific, Medtronic, Vesalio, Novartis, Chiesi, and PhaseBio, outside the submitted work. The other authors have no conflicts of interest relevant to the contents of this paper to declare. EDAT- 2025/12/04 06:27 MHDA- 2025/12/04 06:28 PMCR- 2026/12/01 CRDT- 2025/12/04 05:01 PHST- 2025/12/04 06:28 [medline] PHST- 2025/12/04 06:27 [pubmed] PHST- 2025/12/04 05:01 [entrez] PHST- 2026/12/01 00:00 [pmc-release] AID - EIJ-D-25-00566 [pii] AID - 10.4244/EIJ-D-25-00566 [doi] PST - epublish SO - EuroIntervention. 2025 Dec 1;21(23):e1445-e1455. doi: 10.4244/EIJ-D-25-00566. PMID- 41318078 OWN - NLM STAT- MEDLINE DCOM- 20260111 LR - 20260116 IS - 1097-6744 (Electronic) IS - 0002-8703 (Linking) VI - 293 DP - 2026 Mar TI - Efficacy and safety of postoperative autologous blood transfusion in cardiac surgery (RESCUE): Rationale, design, and study protocol of a multicenter randomized controlled trial. PG - 107313 LID - S0002-8703(25)00375-8 [pii] LID - 10.1016/j.ahj.2025.107313 [doi] AB - BACKGROUND: Postoperative bleeding is a major concern in cardiac surgery, often leading to significant transfusion requirements. Despite this high transfusion demand, the use of postoperative autologous blood transfusion (PABT) remains underexplored. METHODS AND RESULTS: This large-scale, single-blind randomized controlled trial with a 30-day follow-up enrolls patients undergoing elective on- or off-pump coronary artery bypass grafting. Patients with shed mediastinal blood volumes over 500 mL within the first 6 hours postoperatively are randomly assigned 1:1 to either the PABT group or the standard care group. The PABT group receives postoperative autotransfusion and additional allogeneic RBC transfusions if needed, while the standard care group receives allogeneic RBC transfusions only when clinically necessary, without postoperative autotransfusion. The primary efficacy endpoint is the postoperative allogeneic RBC transfusion volume, defined as the cumulative amount transfused from the day of surgery to discharge. Secondary efficacy endpoints include postoperative allogeneic RBC and non-RBC transfusion rates, perioperative hematologic recovery, drainage volume, mechanical ventilation duration, ICU and hospital length of stay. The primary safety endpoint is the incidence of a composite of postoperative infections (pneumonia, bloodstream infections, and surgical site infections). Secondary safety endpoints include a composite of other postoperative complications (renal dysfunction, myocardial infarction, stroke, deep vein thrombosis, and all-cause mortality), individual components of these composites, and 30-day mortality and morbidity. The estimated sample size is 1,232 participants. Patient recruitment is planned from January 2026 to December 2029 and is currently in the preparatory phase. The study is registered at the Chinese Clinical Trial Registry (ChiCTR2500103269, https://www.chictr.org.cn/) and was registered on May 27, 2025. CONCLUSIONS: The study is designed to identify the efficacy and safety of PABT after cardiac surgery. We hypothesize that PABT has superior efficacy and noninferior safety to the standard care. CI - Copyright (c) 2025 The Author(s). Published by Elsevier Inc. All rights reserved. FAU - Shan, Jiachen AU - Shan J AD - Department of Anesthesiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Gao, Jie AU - Gao J AD - Department of Anesthesiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Chen, Yuye AU - Chen Y AD - Department of Anesthesiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Ji, Hongwen AU - Ji H AD - Department of Anesthesiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Department of Anesthesiology, Chinese Academy of Medical Sciences Fuwai Hospital Shenzhen Hospital, Guangdong, China. Electronic address: 13701229553@163.com. LA - eng PT - Clinical Trial Protocol PT - Journal Article DEP - 20251127 PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 SB - IM MH - Humans MH - *Blood Transfusion, Autologous/methods MH - Single-Blind Method MH - Randomized Controlled Trials as Topic MH - *Postoperative Hemorrhage/therapy MH - Multicenter Studies as Topic MH - *Cardiac Surgical Procedures/adverse effects MH - *Postoperative Care/methods MH - *Coronary Artery Bypass/adverse effects MH - Female MH - Male MH - Erythrocyte Transfusion COIS- Declaration of competing interest None reported. EDAT- 2025/11/30 00:30 MHDA- 2026/01/12 00:37 CRDT- 2025/11/29 19:15 PHST- 2025/06/08 00:00 [received] PHST- 2025/11/19 00:00 [revised] PHST- 2025/11/20 00:00 [accepted] PHST- 2026/01/12 00:37 [medline] PHST- 2025/11/30 00:30 [pubmed] PHST- 2025/11/29 19:15 [entrez] AID - S0002-8703(25)00375-8 [pii] AID - 10.1016/j.ahj.2025.107313 [doi] PST - ppublish SO - Am Heart J. 2026 Mar;293:107313. doi: 10.1016/j.ahj.2025.107313. Epub 2025 Nov 27. PMID- 41311568 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20251128 LR - 20251130 IS - 1011-6842 (Print) IS - 1011-6842 (Linking) VI - 41 IP - 6 DP - 2025 Nov TI - Association of Blood Pressure Variability with Contrast Nephropathy in STEMI Patients Undergoing Primary PCI. PG - 703-711 LID - 10.6515/ACS.202511_41(6).20250428E [doi] AB - BACKGROUND: Cardiovascular disease, particularly ST-segment elevation myocardial infarction (STEMI), continues to be a leading cause of death worldwide despite advances in treatment options. Contrast-induced nephropathy (CIN) increases the risk of morbidity and mortality after percutaneous coronary intervention (PCI) in STEMI patients. Blood pressure variability (BPV), defined as fluctuations in blood pressure (BP) over time, has been associated with cardiovascular events, stroke, target organ damage and renal dysfunction independently of BP levels. The relationship between BPV and CIN is unknown. METHODS: This prospective study investigated the relationship between invasively measured short-term BPV and CIN in haemodynamically stable STEMI patients undergoing PCI. In 220 patients, BP was monitored through the femoral sheath for six hours after PCI, and systolic and diastolic standard deviation (SD), average real variability (ARV) and delta parameters were calculated using universal formulae. RESULTS: The results indicated a significant association between short-term BPV, especially systolic BPV, and the development of CIN (p < 0.01). In particular, systolic SD [odds ratio (OR): 1.055, 95% confidence interval (CI) 1.003-1.110, p = 0.04] and systolic ARV (OR: 1.084, 95% CI 1.011-1.162, p = 0,02) emerged as independent predictors of CIN. CONCLUSIONS: Our study demonstrated that intra-arterially measured short-term BPV was associated with the development of CIN in STEMI patients. Notably, systolic SD and systolic ARV were independent predictors of CIN, which may be of clinical importance for early diagnosis and prevention. These results suggest that BPV may be an indicator of CIN risk, and further large-scale randomised trials are warranted to clarify this relationship. FAU - Coskun, Cahit AU - Coskun C AD - Ministry of Health Demirci State Hospital, Cardiology Dr. Mehmet Akarsu Street Demirci, Manisa. FAU - Eren, Semih AU - Eren S AD - Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey. FAU - Mollaalioglu, Feyza AU - Mollaalioglu F AD - Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey. FAU - Ayata, Alihan AU - Ayata A AD - Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey. FAU - Karatas, Mehmet Baran AU - Karatas MB AD - Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey. LA - eng PT - Journal Article PL - China (Republic : 1949- ) TA - Acta Cardiol Sin JT - Acta Cardiologica Sinica JID - 101687085 PMC - PMC12648249 OTO - NOTNLM OT - Blood pressure variability OT - Contrast induced nephropathy OT - ST elevation myocardial infarction COIS- All the authors declare no conflict of interest. EDAT- 2025/11/28 06:28 MHDA- 2025/11/28 06:29 PMCR- 2025/11/01 CRDT- 2025/11/28 04:36 PHST- 2024/11/17 00:00 [received] PHST- 2025/04/28 00:00 [accepted] PHST- 2025/11/28 06:29 [medline] PHST- 2025/11/28 06:28 [pubmed] PHST- 2025/11/28 04:36 [entrez] PHST- 2025/11/01 00:00 [pmc-release] AID - 10.6515/ACS.202511_41(6).20250428E [doi] PST - ppublish SO - Acta Cardiol Sin. 2025 Nov;41(6):703-711. doi: 10.6515/ACS.202511_41(6).20250428E. PMID- 41285658 OWN - NLM STAT- MEDLINE DCOM- 20260707 LR - 20260728 IS - 1878-0938 (Electronic) IS - 1878-0938 (Linking) VI - 88 DP - 2026 Jul TI - A randomized prospective study investigating the relationship between post-PCI wall shear stress and 12-month neointimal healing: The SHEAR-STENT study. PG - 57-65 LID - S1553-8389(25)00569-X [pii] LID - 10.1016/j.carrev.2025.11.001 [doi] AB - BACKGROUND: While disturbed wall shear stress (WSS) is associated with coronary plaque progression and vulnerability, its influence on stent neointimal healing is not well characterized. We designed a prospective, randomized trial to investigate the influence of WSS on neointimal healing in angulated arteries undergoing percutaneous coronary intervention (PCI). METHODS: Eighty-six patients were randomized to Xience Xpedition(R) (X-EES) or Resolute(R) Integrity/Onyx (R-ZES) drug-eluting stents. Patients underwent serial OCT imaging post PCI and at 12-months. Angiography was combined with OCT to generate post-stent vessel reconstructions. WSS was calculated using computational fluid dynamics. Post-stent WSS was related to strut, frame and patient level neointimal thickness (NIT) at 12-months. RESULTS: Sixty patients met inclusion criteria and had adequate OCT image quality for analysis. Mean age was 62.7 years, 78 % were men, and 37 % had diabetes. NIT at 12-months was 0.09 mm (0.05-0.15). There was no difference in frame level NIT (p = 0.08) or post-stent WSS (p = 0.75) between X-EES or R-ZES. Patient level analysis demonstrated correlation coefficients between WSS and NIT ranging from -0.78 to 0.67. Of these, 33 % were significantly positive, indicating an association between high WSS and increased NIT, while 31.6 % were significantly negative signifying an association between low WSS and increased NIT. Age, gender, hyperlipidemia, diabetes, renal insufficiency or prior MI was not associated with the distribution of correlation coefficients. CONCLUSIONS: The SHEAR-STENT study demonstrated no significant differences in WSS or NIT at 12 months between R-ZES and X-EES. A wide range of patient level correlation coefficients between WSS and NIT were observed, with some patients showing increased NIT was associated with low WSS and others associated with high WSS. REGISTRATION: URL: https://www. CLINICALTRIALS: gov; Unique identifier: NCT02098876. CI - Copyright (c) 2025 Elsevier Inc. All rights reserved. FAU - Molony, David S AU - Molony DS AD - Georgia Heart Institute, Northeast Georgia Health System, Gainesville, GA, USA. FAU - Hung, Olivia AU - Hung O AD - Division of Cardiology, Emory University, Atlanta, GA, USA. FAU - Corban, Michel AU - Corban M AD - Division of Cardiology, Emory University, Atlanta, GA, USA. FAU - Gogas, Bill AU - Gogas B AD - Division of Cardiology, Emory University, Atlanta, GA, USA. FAU - Lefieux, Adrien AU - Lefieux A AD - Georgia Heart Institute, Northeast Georgia Health System, Gainesville, GA, USA. FAU - Shah, Imran AU - Shah I AD - Department of Biomedical Engineering, Georgia Institute of Technology, GA, USA; Department of Mathematics and Computer Science, Emory University, Atlanta, GA, USA. FAU - Komilian, Keyana AU - Komilian K AD - Georgia Heart Institute, Northeast Georgia Health System, Gainesville, GA, USA. FAU - Adams, Alex AU - Adams A AD - Georgia Heart Institute, Northeast Georgia Health System, Gainesville, GA, USA. FAU - Sykalo, Christine AU - Sykalo C AD - Georgia Heart Institute, Northeast Georgia Health System, Gainesville, GA, USA. FAU - Dodoo, Sheriff AU - Dodoo S AD - Georgia Heart Institute, Northeast Georgia Health System, Gainesville, GA, USA. FAU - Kumar, Arnav AU - Kumar A AD - Division of Cardiology, Emory University, Atlanta, GA, USA. FAU - Kumar, Sonali AU - Kumar S AD - Division of Cardiology, Emory University, Atlanta, GA, USA. FAU - Azarnoosh, Jimmy AU - Azarnoosh J AD - Georgia Heart Institute, Northeast Georgia Health System, Gainesville, GA, USA. FAU - Piccinelli, Marina AU - Piccinelli M AD - Division of Cardiology, Emory University, Atlanta, GA, USA. FAU - McDaniel, Michael C AU - McDaniel MC AD - Division of Cardiology, Emory University, Atlanta, GA, USA. FAU - King, Spencer B AU - King SB AD - Division of Cardiology, Emory University, Atlanta, GA, USA. FAU - Maynard, Charles AU - Maynard C AD - Department of Health Services, University of Washington, Seattle, USA. FAU - Chatzizisis, Yiannis S AU - Chatzizisis YS AD - Division of Cardiovascular Medicine, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, USA. FAU - Chen, Shao-Liang AU - Chen SL AD - Nanjing First Hospital, Nanjing Medical University, China. FAU - Shin, Eun-Seok AU - Shin ES AD - Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea. FAU - Stankovic, Goran AU - Stankovic G AD - Department of Cardiology, University Clinical Center of Serbia, Belgrade, Serbia. FAU - Milasinovic, Dejan AU - Milasinovic D AD - Department of Cardiology, University Clinical Center of Serbia, Belgrade, Serbia. FAU - Erglis, Andrejs AU - Erglis A AD - Pauls Stradins Clinical University Hospital, University of Latvia, Riga, Latvia. FAU - Otake, Hiromasa AU - Otake H AD - Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan. FAU - Akasaka, Takashi AU - Akasaka T AD - Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan. FAU - Escaned, Javier AU - Escaned J AD - Department of Cardiology, Hospital Clinico San Carlos, Madrid, Spain. FAU - Kwon-Koo, Bon AU - Kwon-Koo B AD - Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea. FAU - Wook-Nam, Chang AU - Wook-Nam C AD - Department of Cardiology, Chung-Ang University Gwangmyeong Medical Center, Chung-Ang University College of Medicine, Gwangmyeong, Republic of Korea. FAU - Won, Ki-Bum AU - Won KB AD - Department of Cardiology, Chung-Ang University Gwangmyeong Medical Center, Chung-Ang University College of Medicine, Gwangmyeong, Republic of Korea. FAU - Murasato, Yoshinobu AU - Murasato Y AD - Department of Cardiology and Clinical Research Center, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan. FAU - Lee, Won Yik AU - Lee WY AD - Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju, Republic of Korea. FAU - Lee, Seung Hun AU - Lee SH AD - Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. FAU - Hahn, Joo-Yong AU - Hahn JY AD - Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. FAU - Lee, Joo Myung AU - Lee JM AD - Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. FAU - Giddens, Don P AU - Giddens DP AD - Department of Biomedical Engineering, Georgia Institute of Technology, GA, USA. FAU - Veneziani, Alessandro AU - Veneziani A AD - Department of Mathematics and Computer Science, Emory University, Atlanta, GA, USA. FAU - Samady, Habib AU - Samady H AD - Division of Cardiology, Emory University, Atlanta, GA, USA. Electronic address: habib.samady@gmail.com. LA - eng SI - ClinicalTrials.gov/NCT02098876 PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20251115 PL - United States TA - Cardiovasc Revasc Med JT - Cardiovascular revascularization medicine : including molecular interventions JID - 101238551 SB - IM MH - Humans MH - Male MH - Female MH - Prospective Studies MH - Middle Aged MH - *Neointima MH - Stress, Mechanical MH - Time Factors MH - Aged MH - Tomography, Optical Coherence MH - Treatment Outcome MH - *Drug-Eluting Stents MH - *Coronary Artery Disease/diagnostic imaging/therapy/physiopathology MH - Coronary Angiography MH - *Percutaneous Coronary Intervention/adverse effects/instrumentation MH - *Coronary Vessels/diagnostic imaging/physiopathology/pathology MH - Prosthesis Design MH - *Wound Healing OTO - NOTNLM OT - Coronary OT - Neointima OT - Stent OT - Wall shear stress COIS- Declaration of competing interest Dr. Samady has the following relationships with industry to disclose: advisory board of Phillips Volcano, institutional research grants with Philips Volcano, Medtronic and Abbott Vascular, equity ownership and co-founder of Covanos Inc. Dr. Molony has equity ownership in Covanos Inc. Dr. J.M. Lee has received research grants from Abbott and Philips. Dr. Koo has received institutional research grants from Abbott Vascular and Philips Volcano. Dr. Chatzizisis has received speaker honoraria, advisory board fees, and research grants from Boston Scientific; advisory board fees and research grants from Medtronic Inc. Dr. Escaned has received speaker and/or advisory board member fees from Abbott Vascular, Boston Scientific, Medis, and Philips. Dr. Stankovic has received speaker honoraria from Abbott Vascular, Boston Scientific and Medtronic. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2025/11/25 00:27 MHDA- 2026/07/08 01:11 CRDT- 2025/11/24 21:55 PHST- 2025/11/04 00:00 [received] PHST- 2025/11/04 00:00 [accepted] PHST- 2026/07/08 01:11 [medline] PHST- 2025/11/25 00:27 [pubmed] PHST- 2025/11/24 21:55 [entrez] AID - S1553-8389(25)00569-X [pii] AID - 10.1016/j.carrev.2025.11.001 [doi] PST - ppublish SO - Cardiovasc Revasc Med. 2026 Jul;88:57-65. doi: 10.1016/j.carrev.2025.11.001. Epub 2025 Nov 15. PMID- 41282377 OWN - NLM STAT- MEDLINE DCOM- 20251124 LR - 20251126 IS - 1178-1998 (Electronic) IS - 1176-9092 (Print) IS - 1176-9092 (Linking) VI - 20 DP - 2025 TI - Machine Learning Based Prediction of Postoperative Acute Kidney Injury Risk in Coronary Artery Bypass Grafting Patients. PG - 2033-2048 LID - 10.2147/CIA.S543303 [doi] AB - BACKGROUND: Coronary artery bypass grafting (CABG) is key for severe coronary artery disease, but postoperative acute kidney injury (AKI) may increase mortality and prolong hospital stays. Reliable models for early prediction of post-CABG AKI remain lacking. METHODS: Data of 520 CABG patients (September 2021-December 2024) from the Affiliated Hospital of Xuzhou Medical University were collected, and the patients were divided into a training group (70%, for model building) and a validation group (30%). Key variables were screened through Least Absolute Shrinkage and Selection Operator (LASSO) regression, followed by the construction of six machine learning models: Random Forest (RF), eXtreme Gradient Boosting (XGBoost), Logistic Regression (LR), Light Gradient Boosting Machine (LightGBM), Softmax Regression, and Support Vector Machine (SVM). The SHapley Additive exPlanations (SHAP) was used to quantify feature importance. RESULTS: The incidence of post-CABG AKI was 25.96%, and the median age of patients in the AKI group was significantly higher than that in the non-AKI group (66.09 +/- 8.15 vs 64.32 +/- 7.76, p = 0.025). In the training group, the XGBoost model using the top 5 important variables outperformed other models (Area Under the Curve [AUC] = 0.89, 95% Confidence Interval [CI]: 0.86-0.91), followed by the LightGBM model using the top 5 important variables and the RF model using the top 5 important variables (both had an AUC of 0.88; 95% CI: 0.85-0.90 and 0.85-0.91, respectively). In the validation group, the LR model using the top 15 important variables and the Softmax Regression model using the top 15 important variables maintained the highest stability (both had an AUC of 0.86, 95% CI: 0.79-0.92). SHAP analysis confirmed that estimated glomerular filtration rate (eGFR), intraoperative epinephrine use and calcium levels were the top three predictive factors. CONCLUSION: The machine learning models constructed in this study can effectively predict post-CABG AKI, facilitating early identification of high-risk patients. CI - (c) 2025 Zhang et al. FAU - Zhang, Yang AU - Zhang Y AD - Department of Cardiovascular Surgery, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, People's Republic of China. FAU - Cai, Dabei AU - Cai D AUID- ORCID: 0000-0001-6898-0664 AD - Department of Cardiology, The Third Affiliated Hospital of Nanjing Medical University, Changzhou, Jiangsu, 213000, People's Republic of China. FAU - Deng, Ye AU - Deng Y AD - Department of Cardiology, The Third Affiliated Hospital of Nanjing Medical University, Changzhou, Jiangsu, 213000, People's Republic of China. FAU - Wang, Zhu AU - Wang Z AD - Department of Cardiovascular Surgery, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, People's Republic of China. FAU - Zhang, Zhihan AU - Zhang Z AD - Department of Cardiovascular Surgery, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, People's Republic of China. FAU - Zhang, Hu AU - Zhang H AD - Department of Cardiovascular Surgery, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, People's Republic of China. FAU - Wang, Qingjie AU - Wang Q AUID- ORCID: 0000-0002-7944-8128 AD - Department of Cardiology, The Third Affiliated Hospital of Nanjing Medical University, Changzhou, Jiangsu, 213000, People's Republic of China. FAU - Feng, Shoujie AU - Feng S AD - Department of Cardiovascular Surgery, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, People's Republic of China. FAU - Sun, Ling AU - Sun L AUID- ORCID: 0000-0001-6444-9470 AD - Department of Cardiology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, 214023, People's Republic of China. FAU - Wei, Jun AU - Wei J AD - Department of Cardiovascular Surgery, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, People's Republic of China. LA - eng PT - Journal Article DEP - 20251115 PL - New Zealand TA - Clin Interv Aging JT - Clinical interventions in aging JID - 101273480 SB - IM MH - Humans MH - *Acute Kidney Injury/epidemiology/etiology/diagnosis MH - *Machine Learning MH - Male MH - Female MH - *Coronary Artery Bypass/adverse effects MH - Aged MH - Middle Aged MH - *Postoperative Complications/epidemiology/etiology MH - Risk Factors MH - Risk Assessment/methods MH - Incidence MH - Coronary Artery Disease/surgery PMC - PMC12631032 OTO - NOTNLM OT - acute kidney injury OT - area under the receiver operating characteristic curve OT - coronary artery bypass grafting OT - machine learning OT - prediction model COIS- The authors report no conflicts of interest in this work. EDAT- 2025/11/24 18:21 MHDA- 2025/11/24 18:38 PMCR- 2025/11/15 CRDT- 2025/11/24 09:12 PHST- 2025/06/11 00:00 [received] PHST- 2025/11/06 00:00 [accepted] PHST- 2025/11/24 18:38 [medline] PHST- 2025/11/24 18:21 [pubmed] PHST- 2025/11/24 09:12 [entrez] PHST- 2025/11/15 00:00 [pmc-release] AID - 543303 [pii] AID - 10.2147/CIA.S543303 [doi] PST - epublish SO - Clin Interv Aging. 2025 Nov 15;20:2033-2048. doi: 10.2147/CIA.S543303. eCollection 2025. PMID- 41277381 OWN - NLM STAT- MEDLINE DCOM- 20260107 LR - 20260115 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 107 IP - 1 DP - 2026 Jan TI - Coronary Rotational ATherectomy Elective Versus Bailout in Patients With Severely Calcified Lesions and Chronic Renal Failure: Long-Term Outcomes of CRATER Trial. PG - 431-438 LID - 10.1002/ccd.70353 [doi] AB - BACKGROUND: Although rotational atherectomy (RA) has been proven to be a useful tool for severely calcified lesions in patients with chronic kidney disease (CKD), there is a paucity of data comparing an elective RA (E-RA) versus a bailout RA (B-RA) strategy. AIMS: To compare the long-term outcomes between E-RA versus B-RA in patients with CKD. METHODS: This prospective, multicentre, randomized study compared E-RA versus B-RA in severely calcified lesions in patients with CKD. Participants were randomized 1:1 and clinically followed. The primary endpoint was major cardiovascular events (MACE) defined as cardiovascular death, myocardial infarction (MI), target vessel revascularization (TVR), target lesion revascularization (TLR) or stent thrombosis. RESULTS: 124 patients (62 per group) were enrolled and followed up for a median of 4.2 [3.4-5.3] years. Mean age was 77.3 +/- 8.3 years; 69.4% were male. There were no baseline differences between groups. There were no differences in MACE (B-RA: 23.3% vs E-RA: 21.3%; log-rank p = 0.97), death (B-RA: 36.7% vs E-RA: 41.0%; log-rank p = 0.53), cardiovascular death (B-RA: 8.3% vs E-RA: 9.8%; log-rank p = 0.71) and MI during long-term follow-up between E-RA and B-RA strategies. There was a non-significant trend toward fewer TVR events (HR: 0.69; 95% CI: 0.19-2.44; p = 0.56) and TLR events (HR: 0.51; 95% CI: 0.13-2.06; p = 0.35) in the E-RA group. CONCLUSIONS: Both E-RA and B-RA showed a high rate of clinical events in the long-term follow-up, consistent with a high-risk population. A non-significant trend toward lower rates of TVR and TLR was observed in E-RA group. CI - (c) 2025 Wiley Periodicals LLC. FAU - Zubiaur, Jon AU - Zubiaur J AUID- ORCID: 0000-0003-4744-4306 AD - Cardiology Department, La Paz University Hospital, Madrid, Spain. AD - Fundacion de Investigacion IDIPAZ, Madrid, Spain. FAU - Galeote, Guillermo AU - Galeote G AD - Cardiology Department, La Paz University Hospital, Madrid, Spain. AD - Fundacion de Investigacion IDIPAZ, Madrid, Spain. FAU - Jurado-Roman, Alfonso AU - Jurado-Roman A AUID- ORCID: 0000-0001-6362-7618 AD - Cardiology Department, La Paz University Hospital, Madrid, Spain. AD - Fundacion de Investigacion IDIPAZ, Madrid, Spain. AD - Centro de Investigacion Biomedica en Red de Enfermedades Cardiovasculares (CIBERCV), Espana, Spain. FAU - Fernandez-Portales, Javier AU - Fernandez-Portales J AUID- ORCID: 0000-0003-3193-0035 AD - Cardiology Department, San Pedro de Alcantara Hospital, Caceres, Spain. FAU - Romani, Sebastian AU - Romani S AUID- ORCID: 0009-0003-4563-0209 AD - Cardiology Department, Clinico San Carlos University Hospital, Madrid, Spain. FAU - Salinas, Pablo AU - Salinas P AUID- ORCID: 0000-0003-4040-4029 AD - Cardiology Department, October Twelve University Hospital, Madrid, Spain. FAU - Garcia-Tejada, Julio AU - Garcia-Tejada J AD - Cardiology Department, October Twelve University Hospital, Madrid, Spain. FAU - Subinas, Asier AU - Subinas A AD - Cardiology Department, Galdakao-Usansolo University Hospital, Basque country, Spain. FAU - Rodriguez, Marcos AU - Rodriguez M AD - Cardiology Department, Nuestra Senora de Candelaria University Hospital, Canary Islands, Spain. FAU - Palazuelos-Molinero, Jorge AU - Palazuelos-Molinero J AUID- ORCID: 0000-0003-2864-9832 AD - Cardiology Department, La Luz University Hospital, Madrid, Spain. FAU - Flores, Xacobe AU - Flores X AD - Cardiology Department, University Hospital Complex of A Coruna, Galicia, Spain. FAU - Lopez, Manuel AU - Lopez M AD - Cardiology Department, Clinico San Cecilio University Hospital, Granada, Spain. FAU - Planas, Ana AU - Planas A AD - Cardiology Department, General University Hospital of Castellon, Castellon, Spain. FAU - Arroyo, Eduardo AU - Arroyo E AUID- ORCID: 0000-0002-0695-9381 AD - Cardiology Department, Hospital Universitario de Torrevieja, Alicante, Spain. FAU - Bastos, Guillermo AU - Bastos G AUID- ORCID: 0000-0002-0882-2573 AD - Cardiology Department, University Hospital Complex of Vigo, Galicia, Spain. FAU - Vera-Vera, Silvio AU - Vera-Vera S AD - Cardiology Department, La Paz University Hospital, Madrid, Spain. FAU - Jimenez-Valero, Santiago AU - Jimenez-Valero S AD - Cardiology Department, La Paz University Hospital, Madrid, Spain. AD - Fundacion de Investigacion IDIPAZ, Madrid, Spain. FAU - Santana, Borja Rivero AU - Santana BR AD - Cardiology Department, La Paz University Hospital, Madrid, Spain. AD - Fundacion de Investigacion IDIPAZ, Madrid, Spain. FAU - Tebar, Daniel AU - Tebar D AD - Cardiology Department, La Paz University Hospital, Madrid, Spain. AD - Fundacion de Investigacion IDIPAZ, Madrid, Spain. FAU - Basile, Mattia AU - Basile M AD - Cardiology Department, La Paz University Hospital, Madrid, Spain. AD - Fundacion de Investigacion IDIPAZ, Madrid, Spain. FAU - Gonzalvez, Ariana AU - Gonzalvez A AUID- ORCID: 0000-0001-5200-4650 AD - Cardiology Department, La Paz University Hospital, Madrid, Spain. AD - Fundacion de Investigacion IDIPAZ, Madrid, Spain. FAU - Moreno, Raul AU - Moreno R AD - Cardiology Department, La Paz University Hospital, Madrid, Spain. AD - Fundacion de Investigacion IDIPAZ, Madrid, Spain. AD - Centro de Investigacion Biomedica en Red de Enfermedades Cardiovasculares (CIBERCV), Espana, Spain. LA - eng GR - The CRATER trial was supported by a non-restricted grant from Boston Scientific. The Spanish Society of Cardiology was the promoter of the study./ PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20251124 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Humans MH - Male MH - Female MH - *Atherectomy, Coronary/adverse effects/mortality/methods MH - Aged MH - Time Factors MH - *Vascular Calcification/mortality/diagnostic imaging/therapy/surgery MH - *Coronary Artery Disease/mortality/diagnostic imaging/therapy/complications/surgery MH - Prospective Studies MH - Treatment Outcome MH - Severity of Illness Index MH - Risk Factors MH - Aged, 80 and over MH - *Kidney Failure, Chronic/mortality/diagnosis/complications MH - *Percutaneous Coronary Intervention/adverse effects/instrumentation/mortality MH - Elective Surgical Procedures OTO - NOTNLM OT - chronic kidney disease OT - percutaneous coronary intervention OT - rotational atherectomy OT - severely calcified coronary lesions EDAT- 2025/11/24 06:27 MHDA- 2026/01/07 06:30 CRDT- 2025/11/24 04:33 PHST- 2025/11/04 00:00 [revised] PHST- 2025/09/01 00:00 [received] PHST- 2025/11/11 00:00 [accepted] PHST- 2026/01/07 06:30 [medline] PHST- 2025/11/24 06:27 [pubmed] PHST- 2025/11/24 04:33 [entrez] AID - 10.1002/ccd.70353 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2026 Jan;107(1):431-438. doi: 10.1002/ccd.70353. Epub 2025 Nov 24. PMID- 41264778 OWN - NLM STAT- MEDLINE DCOM- 20260107 LR - 20260115 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 107 IP - 1 DP - 2026 Jan TI - Impact of Chronic Kidney Disease on Outcomes With Drug-Coated Balloons Versus Drug-Eluting Stents: Insights From the REC-CAGEFREE I Trial. PG - 304-314 LID - 10.1002/ccd.70348 [doi] AB - BACKGROUND: Data regarding the efficacy and safety of drug-coated balloons (DCBs) versus drug-eluting stents (DES) in patients with chronic kidney disease (CKD) remains limited. AIMS: To assess the prognosis of DCB versus DES in patients with and without CKD. METHODS: REC-CAGEFREE I was an investigator-initiated, non-inferiority trial conducted at 43 sites in China, which randomized 2272 patients to paclitaxel-coated balloons with the option of rescue stenting (DCB group) or second-generation sirolimus-eluting stents (DES group) for treating de novo lesions, regardless of vessel diameter. In this pre-specified subgroup analysis, patients were stratified based on the presence of CKD (kidney damage or estimated glomerular filtration rate < 60 mL/min per 1.73 m(2)) at baseline. The primary outcome was the device-oriented composite endpoint (DoCE; including cardiovascular death, target vessel myocardial infarction, and clinically and physiologically-indicated target lesion revascularization) at 2 years. RESULTS: Of 2272 patients enrolled, 203 (8.9%) had CKD, with 95 and 108 treated with DCB and DES, respectively. At 2 years, the risk of DoCE was significantly higher in CKD versus non-CKD patients (22/203 [10.9%] vs. 88/2069 [4.3%], HR(IPTW): 2.14, 95% CI: 1.13-4.07, p = 0.022). There was no significant interaction between CKD and treatment allocation (p(interaction) = 0.352). Among CKD patients, DoCE occurred in 12/95 (12.7%) and 10/108 (9.3%) patients in the DCB and DES groups (HR(IPTW): 1.57, 95% CI: 0.66-3.71, p = 0.317), respectively. Among non-CKD patients, DoCE occurred in 60/1038 (5.8%) versus 28/1031 (2.7%) patients in the DCB and DES groups (HR(IPTW): 2.27, 95% CI: 1.38-3.72, p = 0.002), respectively. CONCLUSION: Patients with CKD had worse outcomes compared to those without. DCBs were associated with a higher risk of DoCE than DES, irrespective of CKD status. TRIAL REGISTRATION: Unique Identifier: NCT04561739; URL: https://www. CLINICALTRIALS: gov. CI - (c) 2025 Wiley Periodicals LLC. FAU - Bai, Xiongwei AU - Bai X AUID- ORCID: 0009-0005-1080-3514 AD - Department of Cardiology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China. FAU - Gao, Haokao AU - Gao H AD - Department of Cardiology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China. FAU - Lv, Yuehao AU - Lv Y AD - Department of Cardiology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China. FAU - Sun, Dongdong AU - Sun D AD - Department of Cardiology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China. FAU - Wang, Qiong AU - Wang Q AD - Department of Cardiology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China. FAU - Yin, Zhiyong AU - Yin Z AD - Department of Cardiology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China. FAU - Wen, Shangyu AU - Wen S AD - Department of Cardiology, Tianjin Fourth Central Hospital, Tianjin, China. FAU - Jin, Yuanzhe AU - Jin Y AD - Department of Cardiology, The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning, China. FAU - Chen, Hui AU - Chen H AUID- ORCID: 0000-0002-6634-7635 AD - Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China. FAU - Yuan, Ming AU - Yuan M AD - Department of Cardiology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China. FAU - Zhong, Lin AU - Zhong L AD - Department of Cardiology, Yantai Yuhuangding Hospital, Yantai, China. FAU - Hu, Sigan AU - Hu S AD - Department of Cardiology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China. FAU - Lian, Zhexun AU - Lian Z AUID- ORCID: 0000-0002-0887-017X AD - Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao, China. FAU - Zeng, Hesong AU - Zeng H AUID- ORCID: 0000-0001-5160-4427 AD - Department of Cardiology, Tongji Hospital, Tongji Medical College of HUST, Wuhan, China. FAU - Pan, Hongwei AU - Pan H AD - Department of Cardiology, Hunan Provincial People's Hospital, Changsha, China. FAU - Liu, Jianzheng AU - Liu J AD - Department of Cardiology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China. FAU - Fu, Guotao AU - Fu G AD - Department of Cardiology, Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, China. FAU - Zhang, Ruining AU - Zhang R AD - Department of Cardiology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China. FAU - He, Xingqiang AU - He X AUID- ORCID: 0000-0001-9449-6470 AD - Department of Cardiology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China. FAU - Capodanno, Davide AU - Capodanno D AD - Department of Cardiology, Azienda Ospedaliero-Universitaria Policlinico "G. Rodolico-San Marco", University of Catania, Catania, Italy. FAU - Garg, Scot AU - Garg S AD - Department of Cardiology, Royal Blackburn Hospital, Blackburn, UK. AD - School of Medicine, University of Lancashire, Preston, UK. FAU - Onuma, Yoshinobu AU - Onuma Y AD - Department of Cardiology, University of Galway, Galway, Ireland. FAU - Wang, Duolao AU - Wang D AD - Biostatistics Unit, Liverpool School of Tropical Medicine, Liverpool, UK. FAU - Serruys, Patrick W AU - Serruys PW AUID- ORCID: 0000-0002-9636-1104 AD - Department of Cardiology, University of Galway, Galway, Ireland. FAU - Gao, Chao AU - Gao C AD - Department of Cardiology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China. AD - Department of Cardiology, Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, China. FAU - Tao, Ling AU - Tao L AD - Department of Cardiology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China. LA - eng SI - ClinicalTrials.gov/NCT04561739 GR - This trial is an investigator-initiated trial sponsored by Xijing Hospital. The study obtained grant support from Xijing Hospital (Xi'an, China; Grant Number XJZT24LY36), Noncommunicable Chronic Diseases-National Science and Technology Major Project (2023ZD0503905), and unrestricted grant support from Shenqi Medical (Shanghai, China). An independent research organization (Medisets, Hefei, China), which was funded by the sponsor, participated in site management and safety reporting./ PT - Equivalence Trial PT - Journal Article PT - Multicenter Study DEP - 20251120 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 RN - 0 (Cardiovascular Agents) RN - 0 (Coated Materials, Biocompatible) RN - P88XT4IS4D (Paclitaxel) RN - W36ZG6FT64 (Sirolimus) SB - IM MH - Aged MH - Female MH - Humans MH - Male MH - Middle Aged MH - *Angioplasty, Balloon, Coronary/instrumentation/adverse effects/mortality MH - Cardiac Catheters MH - *Cardiovascular Agents/administration & dosage/adverse effects MH - China MH - Coated Materials, Biocompatible MH - *Coronary Artery Disease/therapy/mortality/complications/diagnostic imaging/diagnosis MH - *Drug-Eluting Stents MH - Glomerular Filtration Rate MH - Kidney/physiopathology MH - *Paclitaxel/administration & dosage/adverse effects MH - Percutaneous Coronary Intervention/instrumentation/adverse effects/mortality MH - Prosthesis Design MH - *Renal Insufficiency, Chronic/diagnosis/mortality/physiopathology/complications MH - Risk Factors MH - *Sirolimus/administration & dosage/adverse effects MH - Time Factors MH - Treatment Outcome OTO - NOTNLM OT - chronic kidney disease OT - drug-coated balloon OT - drug-eluting stent EDAT- 2025/11/20 18:28 MHDA- 2026/01/07 06:31 CRDT- 2025/11/20 14:32 PHST- 2025/11/06 00:00 [revised] PHST- 2025/09/08 00:00 [received] PHST- 2025/11/11 00:00 [accepted] PHST- 2026/01/07 06:31 [medline] PHST- 2025/11/20 18:28 [pubmed] PHST- 2025/11/20 14:32 [entrez] AID - 10.1002/ccd.70348 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2026 Jan;107(1):304-314. doi: 10.1002/ccd.70348. Epub 2025 Nov 20. PMID- 41246025 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20251117 LR - 20251120 IS - 2297-055X (Print) IS - 2297-055X (Electronic) IS - 2297-055X (Linking) VI - 12 DP - 2025 TI - Early outcomes of hybrid coronary revascularization in multivessel coronary artery disease with low ejection fraction. PG - 1641223 LID - 10.3389/fcvm.2025.1641223 [doi] LID - 1641223 AB - BACKGROUND: Hybrid coronary revascularization (HCR), combining left internal mammary artery (LIMA) grafting to the left anterior descending artery (LAD) with percutaneous coronary intervention (PCI) for non-LAD lesions, has emerged as a potential strategy in patients with multivessel coronary artery disease (CAD) and severely reduced left ventricular ejection fraction (EF). However, data regarding its outcomes in this high-risk group remain limited. OBJECTIVES: To evaluate the early-term safety, feasibility, and clinical outcomes of HCR in patients with multivessel CAD and left ventricular dysfunction (EF 20%-35%). METHODS: This retrospective, single-center study included 50 consecutive patients with multivessel CAD and EF between 20% and 35% who underwent HCR between January 2022 and December 2024. HCR was performed with PCI for non-LAD lesions, followed by off-pump LIMA-to-LAD grafting. The primary endpoints were 30-day all-cause mortality and major adverse cardiac events (MACE). Secondary endpoints included hospital length of stay, perioperative complications, and 12-month outcomes. RESULTS: The mean patient age was 65.4 +/- 8.2 years, with 58% being male. Technical success was achieved in 96% of cases. The 30-day mortality rate was 2%, and the 30-day MACE rate was 8%, including myocardial infarction (4%), repeat revascularization (2%), and ischemic stroke (2%). New-onset atrial fibrillation occurred in 18% of patients, transient renal dysfunction in 10%, and prolonged ventilation (>24 h) in 4%. The mean hospital stay was 7.3 +/- 2.1 days. At 12 months, the MACE-free survival rate was 88%, with a LIMA-LAD graft patency of 100% and saphenous vein graft patency of 92%. There was a modest improvement in EF from 28.6 +/- 4.1% to 30.1 +/- 4.5% (p = 0.12). Follow-up coronary angiography was performed in 48 patients (96%) at one year. CONCLUSIONS: HCR appears to be a feasible and relatively safe revascularization strategy for patients with multivessel CAD and severely reduced EF, offering acceptable early mortality and MACE rates. The excellent graft patency and low perioperative complication rates suggest that HCR may be a valuable alternative in this high-risk population, although larger multicenter trials are needed to confirm these findings. CI - (c) 2025 Guz, Avsar, Kirat, Onsel, Yorgancilar and Ateseal. FAU - Guz, Goksel AU - Guz G AD - Department of Cardiology, Medicana International Istanbul Hospital, Istanbul, Turkiye. FAU - Avsar, Mustafa Kemal AU - Avsar MK AD - Department of Cardiovascular Surgery, Faculty of Medicine, Cukurova University, Adana, Turkiye. FAU - Kirat, Baris AU - Kirat B AD - Department of Anesthesiology, Medicana International Istanbul Hospital, Istanbul, Turkiye. FAU - Onsel, Ibrahim Ozgur AU - Onsel IO AD - Department of Anesthesiology, Medicana International Istanbul Hospital, Istanbul, Turkiye. FAU - Yorgancilar, Deniz AU - Yorgancilar D AD - Department of Thoracic Surgery, Medicana International Istanbul Hospital, Istanbul, Turkiye. FAU - Ateseal, Sabahattin AU - Ateseal S AD - Department of Cardiology, Medicana International Istanbul Hospital, Istanbul, Turkiye. LA - eng PT - Journal Article DEP - 20251031 PL - Switzerland TA - Front Cardiovasc Med JT - Frontiers in cardiovascular medicine JID - 101653388 PMC - PMC12615366 OTO - NOTNLM OT - LIMA grafting OT - PCI OT - hybrid coronary revascularization OT - low ejection fraction OT - multivessel coronary artery disease OT - off-pump CABG COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2025/11/17 17:29 MHDA- 2025/11/17 17:30 PMCR- 2025/10/31 CRDT- 2025/11/17 06:24 PHST- 2025/06/04 00:00 [received] PHST- 2025/10/01 00:00 [accepted] PHST- 2025/11/17 17:30 [medline] PHST- 2025/11/17 17:29 [pubmed] PHST- 2025/11/17 06:24 [entrez] PHST- 2025/10/31 00:00 [pmc-release] AID - 10.3389/fcvm.2025.1641223 [doi] PST - epublish SO - Front Cardiovasc Med. 2025 Oct 31;12:1641223. doi: 10.3389/fcvm.2025.1641223. eCollection 2025. PMID- 41224599 OWN - NLM STAT- MEDLINE DCOM- 20260104 LR - 20260615 IS - 1532-8422 (Electronic) IS - 1053-0770 (Linking) VI - 40 IP - 1 DP - 2026 Jan TI - Center-mediated Differences in Postoperative Acute Kidney Injury Rates: A Post Hoc Analysis of the PROTECTION Trial. PG - 179-186 LID - S1053-0770(25)01054-7 [pii] LID - 10.1053/j.jvca.2025.10.022 [doi] AB - OBJECTIVES: The recently published PROTECTION trial (Intravenous Amino Acid Therapy for Kidney Protection in Cardiac Surgery) demonstrated that, in adult cardiac surgery patients, preoperative amino acid (AA) administration has a protective effect on renal function. However, large differences were observed within the participating centers. We aimed to investigate whether such center effects would remove the impact of AA on the prevention of cardiac surgery-associated acute kidney injury (CSA-AKI). DESIGN: A post hoc analysis of data from the PROTECTION trial was performed. SETTING: Multi-institutional data from centers that participated in the PROTECTION trial. PARTICIPANTS: Adult patients undergoing cardiac surgery enrolled in the PROTECTION trial. INTERVENTIONS: Two centers showed a significantly lower rate of CSA-AKI with respect to the pooled rate in all centers (low-rate centers) and 3 centers had a significantly higher rate (high-rate centers [HR-C]). These centers were compared for preoperative and intraoperative variables. RESULTS: Patients in the HR-C were significantly (p = 0.001) older, with lower left ventricular ejection fraction and hemoglobin values, a higher rate of class III and IV New York Heart Association functional class, arterial hypertension, previous myocardial infarction, diabetes, peripheral vascular disease, and more frequently received myocardial revascularization. During surgery, patients in the HR-C group had a longer aortic cross-clamp time, higher temperature on cardiopulmonary bypass, and received diuretics and hemofiltration at a lower rate. Additionally, a greater number of patients in the HR-C group required norepinephrine. However, once corrected for such a center effect, AA remained significantly independently associated with a reduction in CSA-AKI (relative risk, 0.79). CONCLUSIONS: HR-Cs treated patients with greater severity (unmodifiable risk factors) and received different operative and perioperative management. Taking into account such center effects, however, AA therapy remained independently associated with CSA-AKI prevention. CI - Copyright (c) 2025 Elsevier Inc. All rights reserved. FAU - Ranucci, Marco AU - Ranucci M AD - Department of Cardiovascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy. FAU - Monaco, Fabrizio AU - Monaco F AD - Division of Cardiacthoracic and Vascular Anesthesia, IRCCS Azienda Ospedaliero-Universitaria di Bologna, S. Orsola Hospital, University of Bologna, Bologna, Italy; Department of Medical and Surgical Sciences, DIMEC, University of Bologna, Bologna, Italy. Electronic address: fabrizio.monaco4@unibo.it. FAU - Bradic, Nikola AU - Bradic N AD - Clinic of Anesthesiology, Resuscitation and Intensive Medicine, University Hospital Dubrava, Zagreb, Croatia; University North, Department of Nursing, Varazdin, Croatia. FAU - Venditto, Maria AU - Venditto M AD - Cardiac Anesthesia and ICU, AORN "Dei Colli," Monaldi Hospital, Naples, Italy. FAU - Neri, Giuseppe AU - Neri G AD - Anesthesia and Intensive care, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy. FAU - Barucco, Gaia AU - Barucco G AD - Clinic of Anesthesiology, Resuscitation and Intensive Medicine, University Hospital Dubrava, Zagreb, Croatia. FAU - Ti, Lian Kah AU - Ti LK AD - Department of Anaesthesia, National University Hospital, Singapore. FAU - Porta, Sabrina AU - Porta S AD - S.C. Anestesia e Rianimazione Cardiovascolare, A.O. Ordine Maurizio Umberto I di Torino, Turin, Italy. FAU - Baryshnikova, Ekaterina AU - Baryshnikova E AD - Department of Cardiovascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy. FAU - Pontillo, Domenico AU - Pontillo D AD - Clinic of Anesthesiology, Resuscitation and Intensive Medicine, University Hospital Dubrava, Zagreb, Croatia. FAU - Silvetti, Simona AU - Silvetti S AD - Department of Cardiac Anesthesia and Intensive Care, Ospedale Policlinico San Martino IRCCS - IRCCS Cardiovascular Network, Genova, Italy. FAU - Federici, Francesco AU - Federici F AD - UOC Anestesia e Rianimazione, Azienda Ospedaliero-Universitaria Sant'Andrea, Rome, Italy. FAU - Crescenzi, Giuseppe AU - Crescenzi G AD - IRCCS Humanitas Research Hospital, Anestesia e Terapia Intensiva Cardiochirurgica (TIC), Rozzano, Milan, Italy. FAU - Cortegiani, Andrea AU - Cortegiani A AD - Department of Precision Medicine in Medical, Surgical and Critical Care Area (Me.Pre.C.C.), University of Palermo, Palermo, Italy; Department of Anesthesia Analgesia Intensive Care and Emergency, University Hospital Policlinico 'Paolo Giaccone', Palermo, Italy. FAU - Guarracino, Fabio AU - Guarracino F AD - Azienda Ospedaliero Universitaria Pisana, Department of Cardiothoracic Anaesthesia and Intensive Care, Pisa, Italy. FAU - Bove, Tiziana AU - Bove T AD - Department of Medicine, University of Udine, Udine, Italy; Azienda Sanitaria Universitaria Friuli Centrale, Department of Emergency "Santa Maria Della Misericordia", University Hospital of Udine, Italy. FAU - Paternoster, Gianluca AU - Paternoster G AD - Department of Health Science School of Medicine, University of Basilicata, Italy; Anesthesia and ICU San Carlo Hospital, Potenza, Italy. FAU - Anguissola, Martina AU - Anguissola M AD - Department of Cardiovascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy. CN - PROTECTION Study Group Collaborators LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20251022 PL - United States TA - J Cardiothorac Vasc Anesth JT - Journal of cardiothoracic and vascular anesthesia JID - 9110208 SB - IM MH - Humans MH - *Acute Kidney Injury/epidemiology/prevention & control/etiology/diagnosis MH - Male MH - Female MH - *Cardiac Surgical Procedures/adverse effects/trends MH - Aged MH - Middle Aged MH - *Postoperative Complications/epidemiology/prevention & control/diagnosis OTO - NOTNLM OT - acute kidney injury OT - amino acids OT - cardiac surgery OT - cardiopulmonary bypass OT - perioperative care COIS- Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. FIR - D'Amico, Filippo IR - D'Amico F IRAD- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy. FIR - D'Andria Ursoleo, Jacopo IR - D'Andria Ursoleo J IRAD- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy. FIR - Losiggio, Rosario IR - Losiggio R IRAD- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy. FIR - Barbaria, Alessandro IR - Barbaria A IRAD- Department of Cardiovascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy. FIR - Landi, Giovanna IR - Landi G IRAD- Department of Cardiovascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy. FIR - Ranaldi, Claudia IR - Ranaldi C IRAD- Department of Cardiovascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy. FIR - Ferri, Camilla IR - Ferri C IRAD- Hospital Pharmacy, IRCCS San Raffaele Scientific Institute, Milano, Italy. FIR - Tomasi, Enrico IR - Tomasi E IRAD- Hospital Pharmacy, IRCCS San Raffaele Scientific Institute, Milano, Italy. FIR - Rocco, Monica IR - Rocco M IRAD- UOC Anestesia e Rianimazione, Azienda Ospedaliero-Universitaria Sant'Andrea, Rome, Italy. FIR - Cavalieri D'Oro, Laura IR - Cavalieri D'Oro L IRAD- Department of Cardiovascular Anesthesia and ICU, San Carlo Hospital, Potenza, Italy. FIR - Ferrod, Federica IR - Ferrod F IRAD- S.C. Anestesia e Rianimazione Cardiovascolare, A.O. Ordine Maurizio Umberto I di Torino, Turin, Italy. FIR - Amitrano, Daniele IR - Amitrano D IRAD- Azienda Ospedaliero Universitaria Pisana, Department of Cardiothoracic Anaesthesia and Intensive Care, Pisa, Italy. FIR - Fraja, Diana Di IR - Fraja DD IRAD- Cardiac Anesthesia and ICU, AORN "Dei Colli," Monaldi Hospital, Naples, Italy. FIR - Guerriero, Giuseppe IR - Guerriero G IRAD- Anesthesia and Intensive Care, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy. FIR - Persec, Jasminka IR - Persec J IRAD- Clinic of Anesthesiology, Resuscitation and Intensive Care, University Hospital Dubrava, Zagreb, Croatia; University of Zagreb School of Dental Medicine, Zagreb, Croatia. FIR - Salsano, Antonio IR - Salsano A IRAD- Division of Cardiac Surgery, Ospedale Policlinico San Martino, Genoa, Italy; Department of Integrated Surgical And Diagnostic Sciences, University of Genova, Italy. FIR - Re, Maria Rosaria IR - Re MR IRAD- Department of Anesthesia Analgesia Intensive Care and Emergency, University Hospital Policlinico 'Paolo Giaccone', Palermo, Italy. FIR - Meroi, Francesco IR - Meroi F IRAD- Azienda Sanitaria Universitaria Friuli Centrale, Department of Emergency "Santa Maria Della Misericordia," University Hospital of Udine, Italy. FIR - Arangino, Cristina IR - Arangino C IRAD- Dipartimento di Chirurgia Cardiovascolare, Unita Operativa di Anestesia e Terapia Intensiva, IRCCS Centro Cadiologico Monzino, Italy. FIR - Haxhiademi, Dorela IR - Haxhiademi D IRAD- Ospedale del Cuore, Fondazione Toscana Gabriele Monasterio, Massa, Italy. FIR - Tripodi, Vincenzo Francesco IR - Tripodi VF IRAD- Cardiothoracic Vascular Department, "Bianchi-Melacrino-Morelli" Hospital, Reggio Calabria, Italy; Human Pathology Department, University Hospital of Messina, Italy. EDAT- 2025/11/13 00:31 MHDA- 2026/01/05 00:49 CRDT- 2025/11/12 21:59 PHST- 2025/06/06 00:00 [received] PHST- 2025/09/30 00:00 [revised] PHST- 2025/10/15 00:00 [accepted] PHST- 2026/01/05 00:49 [medline] PHST- 2025/11/13 00:31 [pubmed] PHST- 2025/11/12 21:59 [entrez] AID - S1053-0770(25)01054-7 [pii] AID - 10.1053/j.jvca.2025.10.022 [doi] PST - ppublish SO - J Cardiothorac Vasc Anesth. 2026 Jan;40(1):179-186. doi: 10.1053/j.jvca.2025.10.022. Epub 2025 Oct 22. PMID- 41212864 OWN - NLM STAT- MEDLINE DCOM- 20251113 LR - 20251210 IS - 1932-6203 (Electronic) IS - 1932-6203 (Linking) VI - 20 IP - 11 DP - 2025 TI - Efficacy and safety of polymer-free amphilimus-eluting stent in patients with and without diabetes mellitus: A prospective, multicenter observational study. PG - e0336017 LID - 10.1371/journal.pone.0336017 [doi] LID - e0336017 AB - BACKGROUND: Patients with diabetes mellitus (DM) undergoing percutaneous coronary intervention face higher risks of restenosis and adverse cardiovascular outcomes compared to those without DM. This study compared the real-world safety and effectiveness of the Cre8/Cre8 EVO stents in patients with and without diabetes. METHODS: We performed an investigator-initiated, prospective, single-arm observational trial at 28 sites in South Korea. The primary endpoint was a composite of cardiac death, target vessel-related myocardial infarction (MI), and any clinically driven repeat revascularization at 12 months. All-cause mortality was a key secondary endpoint. The adjusted outcomes of DM and non-DM groups were compared using 1:1 propensity score (PS) matching. RESULTS: A total of 2,043 patients (66.0 +/- 11.5 years of age; 76.2% male) were analyzed. Diabetic patients (n = 773; HbA1c 7.3 +/- 1.4%) were more likely to be older, female, and have hypertension, dyslipidemia, or chronic kidney disease. Among these, 20.2% (156 patients) were using insulin. There were 54 cases of primary endpoint, 22 (cumulative incidence, 3.4%) in the DM group and 32 (3.0%) in the non-DM group (p = 0.61). The DM group exhibited a higher all-cause mortality rate compared to the non-DM group (2.1% vs. 1.3%; p = 0.19). The adjusted risk of 1-year primary endpoint was similar between the DM and non-DM groups (hazard ratio, 1.20; 95% confidence interval, 0.63-2.30), with comparable safety profiles. CONCLUSION: In this real-world study, the DM group treated with amphilimus-eluting stents demonstrated sufficient safety and effectiveness at 12 months, with a similar occurrence of cardiovascular events compared to the non-DM group. CI - Copyright: (c) 2025 Lim et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. FAU - Lim, Subin AU - Lim S AD - Department of Cardiology, Cardiovascular Center, Ewha Womans University Seoul Hospital, Seoul, Republic of Korea. AD - Department of Cardiology, Cardiovascular Center, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea. FAU - Kim, Ju Hyeon AU - Kim JH AD - Department of Cardiology, Cardiovascular Center, Asan Medical Center, Seoul, Republic of Korea. FAU - Hong, Soon Jun AU - Hong SJ AUID- ORCID: 0000-0003-4832-6678 AD - Department of Cardiology, Cardiovascular Center, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea. FAU - Cha, Jung-Joon AU - Cha JJ AD - Department of Cardiology, Cardiovascular Center, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea. FAU - Joo, Hyung Joon AU - Joo HJ AD - Department of Cardiology, Cardiovascular Center, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea. FAU - Park, Jae Hyoung AU - Park JH AD - Department of Cardiology, Cardiovascular Center, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea. FAU - Yu, Cheol Woong AU - Yu CW AD - Department of Cardiology, Cardiovascular Center, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea. FAU - Lim, Do-Sun AU - Lim DS AD - Department of Cardiology, Cardiovascular Center, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea. FAU - Moon, Jae-Youn AU - Moon JY AD - Department of Cardiology, CHA Bundang Medical Center, CHA University, Gyeonggi-do, Republic of Korea. FAU - Suh, Soon Yong AU - Suh SY AD - Department of Cardiology, Gachon University Gil Medical Center, Incheon, Republic of Korea. FAU - Cho, Jin Man AU - Cho JM AD - Cardiovascular Center, Kyunghee University Hospital at Gangdong, Seoul, Republic of Korea. LA - eng PT - Journal Article PT - Multicenter Study PT - Observational Study DEP - 20251110 PL - United States TA - PLoS One JT - PloS one JID - 101285081 SB - IM MH - Humans MH - Female MH - Male MH - *Drug-Eluting Stents/adverse effects MH - Aged MH - Prospective Studies MH - Middle Aged MH - *Percutaneous Coronary Intervention/adverse effects MH - *Diabetes Mellitus MH - Republic of Korea MH - Treatment Outcome MH - Myocardial Infarction PMC - PMC12599944 COIS- The authors have declared that no competing interests exist. EDAT- 2025/11/10 18:23 MHDA- 2025/11/13 12:30 PMCR- 2025/11/10 CRDT- 2025/11/10 13:33 PHST- 2025/07/03 00:00 [received] PHST- 2025/10/20 00:00 [accepted] PHST- 2025/11/13 12:30 [medline] PHST- 2025/11/10 18:23 [pubmed] PHST- 2025/11/10 13:33 [entrez] PHST- 2025/11/10 00:00 [pmc-release] AID - PONE-D-25-28364 [pii] AID - 10.1371/journal.pone.0336017 [doi] PST - epublish SO - PLoS One. 2025 Nov 10;20(11):e0336017. doi: 10.1371/journal.pone.0336017. eCollection 2025. PMID- 41211128 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20251112 LR - 20251112 IS - 2666-6022 (Electronic) IS - 2666-6022 (Linking) VI - 60 DP - 2025 Dec TI - Impact of intracoronary adenosine on the no-reflow phenomenon: A randomized, triple-blind, placebo-controlled clinical trial. PG - 100650 LID - 10.1016/j.ahjo.2025.100650 [doi] LID - 100650 AB - INTRODUCTION: The no-reflow phenomenon occurs in 5 % to 50 % of patients with ST-elevation myocardial infarction (STEMI) during primary percutaneous coronary intervention (PPCI), leading to suboptimal myocardial reperfusion and poor outcomes. Although intracoronary adenosine has shown benefits in studies, its use remains controversial. This analysis aims to evaluate the impact of intracoronary adenosine administration on preventing NRP during PPCI. METHODS: In this randomized, triple-blind, placebo-controlled trial, 240 STEMI patients undergoing PPCI were divided into two cohorts, one receiving a bolus dose of intracoronary adenosine and the other receiving 5 cc of saline as a placebo before stenting. The primary endpoint was the incidence of NRP measured by Thrombolysis in Myocardial Infarction flow grade and frame count. Secondary endpoints included ST-segment resolution after 90 min, left ventricular ejection fraction, and major adverse cardiac events after 40 days. RESULTS: Among 240 STEMI patients, adenosine did not significantly reduce angiographic no-reflow compared with placebo (TIMI flow grade 3 (P for association = 0.023, 0.013, and 0.049, respectively). CONCLUSION: Lower mBMI is associated with an increased risk of in-hospital mortality and multiple adverse outcomes in patients undergoing OPCABG, particularly among females and those with renal impairment or systemic comorbidities.Trial registration: Chinese Clinical Trial Registry: Chictr2400085741. CI - (c) 2025 The Authors. Published by Elsevier B.V. FAU - Wang, Shipan AU - Wang S AD - Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. AD - Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China. FAU - Li, Yilin AU - Li Y AD - Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. AD - Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China. FAU - Han, Hao AU - Han H AD - Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. AD - Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China. FAU - Han, Tianxu AU - Han T AD - Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. AD - Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China. FAU - Yang, Zhiran AU - Yang Z AD - Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. AD - Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China. FAU - Li, Youjin AU - Li Y AD - Department of Cardiac Macrovascular Surgery, People's Hospital of Ningxia Hui Autonomous Region Affiliated to Ningxia Medical University, Yinchuan, Ningxia, China. FAU - Yang, Haiping AU - Yang H AD - Department of Cardiac Surgery, Beijing LUHE Hospital, Capital Medical University, Beijing, China. FAU - Li, Hongli AU - Li H AD - Department of Cardiac Surgery, Xuanwu Hospital of Capital Medical University, Beijing, China. FAU - Liu, Gang AU - Liu G AD - Heart Centre of The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China. FAU - Zhu, Minjia AU - Zhu M AD - Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin, China. FAU - Huang, Jian AU - Huang J AD - Department of Cardiovascular Surgery of the First Affiliated Hospital of Xiamen University, Xiamen, Fujian, China. FAU - Zhao, Qingwu AU - Zhao Q AD - Department of Cardiothoracic Surgery, Guangdong Provincial Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China. FAU - Liu, Jihong AU - Liu J AD - Department of Cardiovascular Surgery of the Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning, China. FAU - Li, Haibin AU - Li H AD - Department of Cardiac Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China. FAU - Zhang, Shuaitong AU - Zhang S AD - School of Medical Technology, Beijing Institute of Technology, Beijing, China. FAU - Xue, Yuan AU - Xue Y AD - Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. AD - Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China. FAU - Zhang, Hongjia AU - Zhang H AD - Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. AD - Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China. FAU - Li, Haiyang AU - Li H AD - Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. AD - Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China. LA - eng PT - Journal Article DEP - 20251015 PL - Ireland TA - Int J Cardiol Heart Vasc JT - International journal of cardiology. Heart & vasculature JID - 101649525 PMC - PMC12553022 OTO - NOTNLM OT - Malnutrition OT - Modified body mass index OT - Off-pump coronary artery bypass grafting OT - Perioperative complications OT - Risk factor COIS- The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2025/10/27 15:18 MHDA- 2025/10/27 15:19 PMCR- 2025/10/15 CRDT- 2025/10/27 07:06 PHST- 2025/07/08 00:00 [received] PHST- 2025/10/05 00:00 [revised] PHST- 2025/10/07 00:00 [accepted] PHST- 2025/10/27 15:19 [medline] PHST- 2025/10/27 15:18 [pubmed] PHST- 2025/10/27 07:06 [entrez] PHST- 2025/10/15 00:00 [pmc-release] AID - S2352-9067(25)00226-X [pii] AID - 101823 [pii] AID - 10.1016/j.ijcha.2025.101823 [doi] PST - epublish SO - Int J Cardiol Heart Vasc. 2025 Oct 15;61:101823. doi: 10.1016/j.ijcha.2025.101823. eCollection 2025 Dec. PMID- 41137841 OWN - NLM STAT- MEDLINE DCOM- 20251211 LR - 20260724 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 18 IP - 23 DP - 2025 Dec 8 TI - Renal Function-Stratified Comparison of Complete vs Culprit-Only Revascularization in Older Patients With Myocardial Infarction and Multivessel Disease. PG - 2849-2859 LID - S1936-8798(25)02464-1 [pii] LID - 10.1016/j.jcin.2025.09.019 [doi] AB - BACKGROUND: Chronic kidney disease is a major risk factor for cardiovascular events and complicates revascularization decisions in patients with myocardial infarction (MI). However, data on optimal strategies in this population remain limited. OBJECTIVES: The authors sought to determine whether the benefits of physiology-guided complete revascularization are consistent across subpopulations of older MI patients stratified by renal function. METHODS: In the FIRE (Functional Assessment in Elderly MI Patients with Multivessel Disease (FIRE) trial, 1,445 patients aged >/=75 years with MI and multivessel disease were randomized to receive physiology-guided complete or culprit-only revascularization. Patients were stratified based on baseline estimated glomerular filtration rate (eGFR) (>/=60 vs <60 mL/min/1.73 m(2)). The primary outcome was a 3-year composite of death, MI, stroke, or ischemia-driven revascularization. RESULTS: A total of 662 patients (45.8 %) had eGFR <60 mL/min/1.73 m(2). The primary endpoint occurred in 222 patients (33.5%) with eGFR <60 vs 159 patients (20.3%) with eGFR >/=60 mL/min/1.73 m(2). Lower eGFR was independently associated with higher risk of the primary endpoint (adjusted HR: 1.42; 95% CI: 1.15-1.76; P < 0.001). Complete revascularization reduced the primary endpoint in both subgroups (HR: 0.68; 95% CI: 0.52-0.89 for patients with eGFR <60 mL/min/1.73 m(2); HR: 0.80; 95% CI: 0.59-1.10 for those with eGFR >/=60 mL/min/1.73 m(2)) without significant interaction (P > 0.42). HR for complete vs culprit-only revascularization remained stable across the continuous eGFR range. Contrast-associated acute kidney injury occurred in 245 patients (17%), increased progressively across Kidney Disease: Improving Global Outcomes (KDIGO) stages (P < 0.001), and was similar between treatment arms (HR: 1.11; 95% CI: 0.87-1.43). CONCLUSIONS: Kidney function remains a strong prognostic factor in older MI patients. Physiology-guided complete revascularization is effective regardless of renal function and may provide greater absolute clinical benefit in patients with chronic kidney disease due to their elevated baseline risk. CI - Copyright (c) 2025. Published by Elsevier Inc. FAU - Cantone, Anna AU - Cantone A AD - Cardiology Unit, Azienda Ospedaliero Universitaria di Ferrara, Ferrara, Italy. FAU - Verardi, Filippo Maria AU - Verardi FM AD - Cardiology Unit, Azienda Ospedaliero Universitaria di Ferrara, Ferrara, Italy. FAU - Vadala, Giuseppe AU - Vadala G AD - Azienda Ospedaliero Universitaria Policlinico Paolo Giaccone, Palermo, Italy. FAU - Guiducci, Vincenzo AU - Guiducci V AD - Cardiology Unit, Azienda USL-IRCCS Reggio Emilia, S. Maria Nuova Hospital, Reggio Emilia, Italy. FAU - Casella, Gianni AU - Casella G AD - Cardiology Unit, Ospedale Maggiore, Bologna, Italy. FAU - Cavazza, Caterina AU - Cavazza C AD - Cardiovascular Department, Infermi Hospital, Rimini, Italy. FAU - Cerrato, Enrico AU - Cerrato E AD - Interventional Cardiology Unit, San Luigi Gonzaga University Hospital, Orbassano, and Rivoli Infermi Hospital ASLTO3, Rivoli, Turin, Italy. FAU - Sacchetta, Giorgio AU - Sacchetta G AD - Cardiology Unit, Umberto I Hospital, ASP Siracusa, Siracusa, Italy. FAU - Moreno, Raul AU - Moreno R AD - Centro de Investigacion Biomedica en Red en Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain, Instituto de Investigacion Hospital La Paz (IDIPAZ), University Hospital La Paz, Madrid, Spain. FAU - Serenelli, Matteo AU - Serenelli M AD - Cardiology Unit, Azienda Ospedaliero Universitaria di Ferrara, Ferrara, Italy. FAU - Amat Santos, Ignacio AU - Amat Santos I AD - Centro de Investigacion Biomedica en Red en Enfermedades Cardiovasculares (CIBERCV), Cardiology Department, Hospital Clinico Universitario, Valladolid, Spain. Electronic address: https://twitter.com/ignamatsant. FAU - Diez Gil, Jose Luis AU - Diez Gil JL AD - Centro de Investigation Biomedica end Red en Enfermedades Cardiovasculares, Cardiology Department, H. Universitario y Politecnico La Fe, Valencia, Spain. FAU - Scarsini, Roberto AU - Scarsini R AD - Azienda Ospedaliero Universitaria Integrata di Verona, Verona, Italy. Electronic address: https://twitter.com/MdScarsini. FAU - Picchi, Andrea AU - Picchi A AD - Cardiovascular Department, Azienda Unita Sanitaria Locale (AUSL) Toscana Sud-Est, Misericordia Hospital, Grosseto, Italy. FAU - Cocco, Marta AU - Cocco M AD - Cardiology Unit, Azienda Ospedaliero Universitaria di Ferrara, Ferrara, Italy. FAU - Colaiori, Iginio AU - Colaiori I AD - Cardiology Unit, Ospedale Santa Maria Goretti, Latina, Italy. FAU - Barbierato, Marco AU - Barbierato M AD - Interventional Cardiology, Department of Cardio-Thoracic and Vascular Sciences, Ospedale dell'Angelo, Mestre (Venice), Italy. FAU - Arioti, Manfredi AU - Arioti M AD - Ospedale Santa Maria delle Croci, AUSL Romagna, Ravenna, Italy. Electronic address: https://twitter.com/AriotiManfredi. FAU - Marchini, Federico AU - Marchini F AD - Cardiology Unit, Azienda Ospedaliero Universitaria di Ferrara, Ferrara, Italy. FAU - Pavasini, Rita AU - Pavasini R AD - Cardiology Unit, Azienda Ospedaliero Universitaria di Ferrara, Ferrara, Italy. FAU - Caglioni, Serena AU - Caglioni S AD - Cardiology Unit, Azienda Ospedaliero Universitaria di Ferrara, Ferrara, Italy. FAU - Lanzilotti, Valerio AU - Lanzilotti V AD - Cardiology Unit, Ospedale Maggiore, Bologna, Italy. FAU - Menozzi, Mila AU - Menozzi M AD - Cardiovascular Department, Infermi Hospital, Rimini, Italy. FAU - Erriquez, Andrea AU - Erriquez A AD - Cardiology Unit, Azienda Ospedaliero Universitaria di Ferrara, Ferrara, Italy. FAU - Campo, Gianluca AU - Campo G AD - Cardiology Unit, Azienda Ospedaliero Universitaria di Ferrara, Ferrara, Italy. Electronic address: https://twitter.com/GianlucaCampo78. FAU - Biscaglia, Simone AU - Biscaglia S AD - Cardiology Unit, Azienda Ospedaliero Universitaria di Ferrara, Ferrara, Italy. Electronic address: bscsmn@unife.it. LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20251025 PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 SB - IM MH - Humans MH - *Glomerular Filtration Rate MH - Aged MH - Male MH - Female MH - Risk Factors MH - Treatment Outcome MH - *Kidney/physiopathology MH - *Coronary Artery Disease/mortality/therapy/physiopathology/diagnostic imaging/diagnosis/complications MH - Time Factors MH - Age Factors MH - *Renal Insufficiency, Chronic/physiopathology/diagnosis/mortality/complications MH - Aged, 80 and over MH - *Percutaneous Coronary Intervention/adverse effects/mortality MH - Risk Assessment MH - *Non-ST Elevated Myocardial Infarction/mortality/therapy/physiopathology/diagnostic imaging MH - *Myocardial Infarction/mortality/therapy/physiopathology MH - *Myocardial Revascularization/adverse effects/mortality MH - *ST Elevation Myocardial Infarction/mortality/therapy/diagnostic imaging/physiopathology OTO - NOTNLM OT - coronary physiology OT - myocardial infarction OT - older patients OT - renal function COIS- Funding Support and Author Disclosures Sahajanand Medical Technologies Ltd. (SMT), Medis Medical Imaging Systems, Eukon S.r.l., Siemens Healthineers, General Electric (GE) Healthcare, and Insight Lifetech provided unrestricted funding to the study sponsor for the conduction of the trial. These companies had no involvement in the trial design, data collection, analysis, interpretation, or writing of the manuscript. Dr Biscaglia received funding from the Italian Health Minister (Ricerca Finalizzata 2021, GR-2021-12372516) for the conduction of the Functional Coronary Angiography Guided Revascularization in STEMI trial. Dr Moreno has received speaker/consulting fees from Abbott Vascular, AMGEN, AstraZeneca, Biosensors, Biotronik, Boston Scientific, Daiichi-Sankyo, Edwards Lifesciences, Medtronic, and Philips, outside the submitted work. Dr Campo has received research grants and personal fees from Abbott Vascular, GADA, Menarini, Amgen, Daiichi-Sankyo, and Sanofi, outside the submitted work. Dr Biscaglia has received personal fees from Abbott Vascular and Siemens Healthcare, outside the submitted work. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2025/10/25 12:29 MHDA- 2025/12/11 07:42 CRDT- 2025/10/25 10:32 PHST- 2025/08/28 00:00 [received] PHST- 2025/09/18 00:00 [revised] PHST- 2025/09/18 00:00 [accepted] PHST- 2025/12/11 07:42 [medline] PHST- 2025/10/25 12:29 [pubmed] PHST- 2025/10/25 10:32 [entrez] AID - S1936-8798(25)02464-1 [pii] AID - 10.1016/j.jcin.2025.09.019 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2025 Dec 8;18(23):2849-2859. doi: 10.1016/j.jcin.2025.09.019. Epub 2025 Oct 25. PMID- 41024656 OWN - NLM STAT- Publisher LR - 20251101 IS - 1969-6213 (Electronic) IS - 1774-024X (Print) IS - 1774-024X (Linking) VI - 21 IP - 21 DP - 2025 Sep 30 TI - Mechanical circulatory support in high-risk elective PCI: rationale and design of the PROTECT IV trial. PG - e1244-58 LID - EIJ-D-25-00486 [pii] LID - 10.4244/EIJ-D-25-00486 [doi] AB - Coronary artery disease (CAD) is the leading cause of heart failure with reduced ejection fraction (HFrEF). Coronary artery bypass grafting (CABG) improves long-term mortality in HFrEF. Percutaneous coronary intervention (PCI) is often performed as an alternative to CABG in patients at high surgical risk. However, in patients with HFrEF and limited myocardial reserve, PCI may result in haemodynamic instability, increasing risk and precluding optimal revascularisation. Mechanical circulatory support (MCS) during high-risk PCI may enhance haemodynamic stability during the procedure and enable complete revascularisation. We thus performed the PROTECT IV trial to determine whether PCI with routine use of the Impella CP microaxial flow pump improves early and late outcomes in patients with HFrEF and complex CAD compared with PCI with or without use of an intra-aortic balloon pump (IABP). PROTECT IV is a prospective, multicentre, randomised, parallel-controlled, open-label, superiority trial with an adaptive design. Patients with complex CAD and left ventricular ejection fraction 65 years (p = 0.007), previous acute myocardial infarction (p = 0.02), CKD stage-3 (p = 0.01) and avoidance of OT use (p = 0.02). OTG had a favourable serum creatinine trend (p = 0.05). Absolute risk reduction of CA-AKI with OT was 8.7%, and the number needed to treat was 12. Interventional complications were zero. CONCLUSION: Oxygen supplementation and saline hydration effectively prevented CA-AKI in CKD stages 3-5 patients undergoing elective CAG +/- R. Hence, oxygen therapy should be a standard CA-AKI protective strategy during CAG +/- R and radiocontrast-related procedures. CI - (c) 2025 Asian Pacific Society of Nephrology. FAU - Bhatia, Inderpreet Singh AU - Bhatia IS AD - Department of Medicine, Armed Forces Medical College, Pune, India. FAU - Murari, Tomala AU - Murari T AD - Department of Medicine, Armed Forces Medical College, Pune, India. FAU - Dogra, Pavitra Manu AU - Dogra PM AUID- ORCID: 0000-0002-0582-3845 AD - Department of Nephrology, Army Hospital (R&R), Delhi, India. FAU - Ananthakrishnan, Ramamoorthy AU - Ananthakrishnan R AD - Department of Cardiology, Army Institute of Cardiothoracic Sciences, Pune, India. FAU - Dhillon, Gurmanbir Singh AU - Dhillon GS AD - Department of Community Medicine, Armed Forces Medical College, Pune, India. FAU - Hasvi, Jayaraj AU - Hasvi J AUID- ORCID: 0000-0002-0998-0776 AD - Department of Medicine, Armed Forces Medical College, Pune, India. LA - eng PT - Equivalence Trial PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PL - Australia TA - Nephrology (Carlton) JT - Nephrology (Carlton, Vic.) JID - 9615568 RN - 0 (Contrast Media) SB - IM MH - Humans MH - Female MH - Male MH - *Acute Kidney Injury/chemically induced/prevention & control/diagnosis/epidemiology/mortality MH - *Contrast Media/adverse effects MH - Aged MH - *Renal Insufficiency, Chronic/complications/diagnosis/therapy/mortality MH - *Coronary Angiography/adverse effects MH - Middle Aged MH - Treatment Outcome MH - *Coronary Artery Disease/diagnostic imaging/therapy/complications/mortality/surgery MH - Incidence MH - *Oxygen Inhalation Therapy/adverse effects MH - Time Factors MH - Risk Factors MH - *Myocardial Revascularization/adverse effects OTO - NOTNLM OT - acute kidney injury OT - contrast agents OT - contrast nephropathy OT - coronary angiography OT - oxygenation EDAT- 2025/09/23 06:35 MHDA- 2025/09/23 06:36 CRDT- 2025/09/23 03:33 PHST- 2025/08/22 00:00 [revised] PHST- 2025/06/16 00:00 [received] PHST- 2025/09/01 00:00 [accepted] PHST- 2025/09/23 06:36 [medline] PHST- 2025/09/23 06:35 [pubmed] PHST- 2025/09/23 03:33 [entrez] AID - 10.1111/nep.70122 [doi] PST - ppublish SO - Nephrology (Carlton). 2025 Sep;30(9):e70122. doi: 10.1111/nep.70122. PMID- 40948992 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20250915 LR - 20250917 IS - 2666-6022 (Electronic) IS - 2666-6022 (Linking) VI - 58 DP - 2025 Oct TI - Real-world effectiveness of early revascularization in stable coronary artery disease with moderate or severe ischemia. PG - 100596 LID - 10.1016/j.ahjo.2025.100596 [doi] LID - 100596 AB - BACKGROUND: Comparative effectiveness studies may provide insights into generalizability of the ISCHEMIA trial to real-world patients. We evaluated the long-term effectiveness of revascularization within 90 days after detecting moderate or severe ischemia on myocardial perfusion imaging (MPI) in stable coronary artery disease. METHODS: All consecutive patients with moderate or severe ischemia (summed difference score >/=7) on single photon emission computed tomography MPI at a tertiary academic medical center were included (January 2003 to March 2020). Early revascularization (defined as percutaneous coronary intervention or coronary artery bypass grafting within 90 days) after MPI, was compared to those patients treated without early revascularization, excluding those with left main disease, severe chronic kidney disease, severe left ventricular dysfunction, recent acute coronary syndrome or heart failure hospitalization. Primary outcomes were cardiovascular death or the composite of cardiovascular hospitalization or cardiovascular death, and were tracked throughout the provincial healthcare system. RESULTS: 1530 patients (mean age: 65 years; 70 % male) were followed for a median of 9.9 years. After inverse-probability treatment weighting, early revascularization was associated with lower risks of cardiovascular death (3.76 % vs 8.93 %; HR 0.54, 95 % CI: 0.31-0.91, p = 0.022) and a reduction in the composite endpoint (33.73 % vs 43.94 %; HR 0.67, 95 % CI: 0.49-0.92, p = 0.013) compared to those treated without early revascularization. CONCLUSIONS: Patients with stable coronary artery disease treated with early revascularization after MPI showing moderate or severe ischemia experienced lower risks of cardiovascular death and composite of cardiovascular hospitalization or cardiovascular death compared to those treated without early revascularization. CI - (c) 2025 The Authors. Published by Elsevier Inc. FAU - Gerodias, Ferdinand Jr AU - Gerodias FJ AD - Robert J. Burns Nuclear Cardiology Laboratory and the Joint Department of Medical Imaging of University Health Network, University of Toronto, Toronto, Canada. AD - Division of Cardiology, Peter Munk Cardiac Centre and Ted Rogers Centre for Heart Research, University Health Network, Toronto, Canada. FAU - Iwanochko, Robert M AU - Iwanochko RM AD - Robert J. Burns Nuclear Cardiology Laboratory and the Joint Department of Medical Imaging of University Health Network, University of Toronto, Toronto, Canada. AD - Division of Cardiology, Peter Munk Cardiac Centre and Ted Rogers Centre for Heart Research, University Health Network, Toronto, Canada. FAU - Austin, Peter C AU - Austin PC AD - ICES, University of Toronto, Toronto, Canada. FAU - Wang, Xuesong AU - Wang X AD - ICES, University of Toronto, Toronto, Canada. FAU - Dzavik, Vladimir AU - Dzavik V AD - Division of Cardiology, Peter Munk Cardiac Centre and Ted Rogers Centre for Heart Research, University Health Network, Toronto, Canada. FAU - Goodman, Shaun G AU - Goodman SG AD - Division of Cardiology, Peter Munk Cardiac Centre and Ted Rogers Centre for Heart Research, University Health Network, Toronto, Canada. AD - Division of Cardiology, St. Michael's Hospital, Unity Health Toronto, Toronto, Canada. FAU - Udell, Jacob A AU - Udell JA AD - Division of Cardiology, Peter Munk Cardiac Centre and Ted Rogers Centre for Heart Research, University Health Network, Toronto, Canada. AD - Division of Cardiology, Department of Medicine, Women's College Hospital, Toronto, Canada. AD - ICES, University of Toronto, Toronto, Canada. FAU - Ouzounian, Maral AU - Ouzounian M AD - Division of Cardiac Surgery, University of Toronto, Toronto, Canada. FAU - Ross, Heather J AU - Ross HJ AD - Division of Cardiology, Peter Munk Cardiac Centre and Ted Rogers Centre for Heart Research, University Health Network, Toronto, Canada. FAU - Godoy, Lucas C AU - Godoy LC AD - Robert J. Burns Nuclear Cardiology Laboratory and the Joint Department of Medical Imaging of University Health Network, University of Toronto, Toronto, Canada. AD - Division of Cardiology, Peter Munk Cardiac Centre and Ted Rogers Centre for Heart Research, University Health Network, Toronto, Canada. AD - ICES, University of Toronto, Toronto, Canada. FAU - Amad, Hani AU - Amad H AD - Robert J. Burns Nuclear Cardiology Laboratory and the Joint Department of Medical Imaging of University Health Network, University of Toronto, Toronto, Canada. AD - Division of Cardiology, Peter Munk Cardiac Centre and Ted Rogers Centre for Heart Research, University Health Network, Toronto, Canada. FAU - Husain, Mansoor AU - Husain M AD - Robert J. Burns Nuclear Cardiology Laboratory and the Joint Department of Medical Imaging of University Health Network, University of Toronto, Toronto, Canada. AD - Division of Cardiology, Peter Munk Cardiac Centre and Ted Rogers Centre for Heart Research, University Health Network, Toronto, Canada. FAU - Lee, Douglas S AU - Lee DS AD - Robert J. Burns Nuclear Cardiology Laboratory and the Joint Department of Medical Imaging of University Health Network, University of Toronto, Toronto, Canada. AD - Division of Cardiology, Peter Munk Cardiac Centre and Ted Rogers Centre for Heart Research, University Health Network, Toronto, Canada. AD - ICES, University of Toronto, Toronto, Canada. LA - eng PT - Journal Article DEP - 20250824 PL - United States TA - Am Heart J Plus JT - American heart journal plus : cardiology research and practice JID - 101779333 PMC - PMC12424251 OTO - NOTNLM OT - Cardiovascular outcomes OT - Early revascularization OT - Ischemia OT - Stable coronary artery disease COIS- The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Dr. Goodman reports research grant support (e.g., steering committee or data and safety monitoring committee) and/or speaker/consulting honoraria (e.g., advisory boards) from: Alnylam, Amgen, Anthos Therapeutics, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol Myers Squibb, CSL Behring, CYTE Ltd., Daiichi-Sankyo/American Regent, Eli Lilly, Esperion, Ferring Pharmaceuticals, HLS Therapeutics, Idorsia, JAMP Pharma, Merck, Novartis, Novo Nordisk A/C, Pendopharm/Pharmascience, Pfizer, Regeneron, Roche, Sanofi, Servier, Tolmar Pharmaceuticals, Valeo Pharma; and salary support/honoraria from the Canadian Heart Failure Society, Canadian Heart Research Centre and MD Primer, Canadian VIGOUR Centre, Cleveland Clinic Coordinating Centre for Clinical Research, Duke Clinical Research Institute, Jewish General Hospital\ CIUSSS Centre-Ouest-de-l'Ile-de-Montreal, New York University Clinical Coordinating Centre, PERFUSE Research Institute, Peter Munk Cardiac Centre Clinical Trials and Translation Unit, Ted Rogers Centre for Heart Research, TIMI Study Group (Brigham Health). Dr. Ross is the Loretta Rogers Chair in Heart Function. Dr. Lee is supported by the Ted Rogers Chair in Heart Function Outcomes, University Health Network, University of Toronto. EDAT- 2025/09/15 12:33 MHDA- 2025/09/15 12:34 PMCR- 2025/08/24 CRDT- 2025/09/15 07:38 PHST- 2025/04/15 00:00 [received] PHST- 2025/08/12 00:00 [revised] PHST- 2025/08/18 00:00 [accepted] PHST- 2025/09/15 12:34 [medline] PHST- 2025/09/15 12:33 [pubmed] PHST- 2025/09/15 07:38 [entrez] PHST- 2025/08/24 00:00 [pmc-release] AID - S2666-6022(25)00099-0 [pii] AID - 100596 [pii] AID - 10.1016/j.ahjo.2025.100596 [doi] PST - epublish SO - Am Heart J Plus. 2025 Aug 24;58:100596. doi: 10.1016/j.ahjo.2025.100596. eCollection 2025 Oct. PMID- 40928512 OWN - NLM STAT- Publisher LR - 20250910 IS - 1861-0692 (Electronic) IS - 1861-0684 (Linking) DP - 2025 Sep 10 TI - Impact of diabetes on outcomes of patients with ST-segment elevation myocardial infarction and multivessel coronary artery disease undergoing percutaneous coronary intervention. LID - 10.1007/s00392-025-02745-x [doi] AB - BACKGROUND: Diabetic patients with ST-segment elevation myocardial infarction (STEMI) are at an increased risk of cardiovascular events as compared to non-diabetic patients. This analysis investigated outcomes of diabetic patients presenting with multivessel disease (MVD) and STEMI in a contemporary trial and the relevance of an immediate versus staged multivessel PCI strategy in this high-risk population. METHODS: Patients enrolled in the MULTISTARS AMI trial were stratified according to the presence/absence of diabetes. Baseline characteristics and outcomes of diabetic and non-diabetic patients were compared. The primary end point was a composite of all-cause death, non-fatal myocardial infarction, stroke, unplanned ischemia-driven revascularization, or hospitalization for heart failure at 1 year. RESULTS: In the MULTISTARS AMI trial, out of a total of 840 patients, 131 (15.6%) patients had diabetes. Patients with diabetes had a higher cardiovascular risk profile and worse kidney function. The occurrence of the primary end point was similar between patients with and without diabetes (HR, 1.14 (95% CI, 0.69-1.90), p-value = 0.60). Rates of non-cardiovascular death (HR, 6.53 (95% CI, 2.00-21.33)) and acute renal failure (HR, 3.23 (95% CI, 1.49-7.04)) were higher in diabetic patients as compared to non-diabetic patients. Comparing an immediate with a staged PCI strategy in diabetic patients, a numerically lower number of patients in the immediate PCI group experienced a primary end point event (10.6% vs. 16.9%, HR, 0.60 (95% CI, 0.23-1.53), p-value = 0.28). CONCLUSION: Among diabetic patients with STEMI and MVD, a strategy of immediate multivessel PCI may be safe and comparable to a strategy of staged multivessel PCI. TRIAL REGISTRATION: Supported by Boston Scientific; MULTISTARS AMI ClinicalTrials.gov number, NCT03135275. CI - (c) 2025. The Author(s). FAU - Jakob, Philipp AU - Jakob P AD - Department of Cardiology, University Heart Center, University Hospital Zurich, Center for Translational and Experimental Cardiology (CTEC), University of Zurich, Ramistrasse 100, 8091, Zurich, Switzerland. FAU - Varbella, Ferdinando AU - Varbella F AD - Interventional Cardiology Unit, Degli Infermi Hospital, Rivoli, Turin, Italy. FAU - Linke, Axel AU - Linke A AD - Department of Internal Medicine and Cardiology, Technische Universitat Dresden, Herzzentrum Dresden, University Clinic, Dresden, Germany. FAU - Schwarz, Bettina AU - Schwarz B AD - Heart Center, Segeberger Kliniken GmbH, Academic Teaching Hospital for the Universities of Kiel, Lubeck and Hamburg, Bad Segeberg, Germany. FAU - Felix, Stephan B AU - Felix SB AD - Department of Internal Medicine B, University Medicine Greifswald, Greifswald, and DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Bochum, Germany. FAU - Seiffert, Moritz AU - Seiffert M AD - BG University Hospital Bergmannsheil, Ruhr-University Bochum, Bochum, Germany. FAU - Kesterke, Rahel AU - Kesterke R AD - Department of Cardiology, University Heart Center, University Hospital Zurich, Center for Translational and Experimental Cardiology (CTEC), University of Zurich, Ramistrasse 100, 8091, Zurich, Switzerland. FAU - Nordbeck, Peter AU - Nordbeck P AD - Department of Internal Medicine I, University Hospital Wurzburg, Wurzburg, Germany. FAU - Witzenbichler, Bernhard AU - Witzenbichler B AD - Department of Cardiology and Pneumology, Helios Amper-Klinikum, Dachau, Germany. FAU - Lang, Irene M AU - Lang IM AD - Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria. FAU - Kessler, Mirjam AU - Kessler M AD - Department of Cardiology, Ulm University Heart Center, Ulm, Germany. FAU - Valina, Christian AU - Valina C AD - Department of Cardiology and Angiology, Medical Center - University of Freiburg, Germany and Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Dibra, Alban AU - Dibra A AD - Department of Cardiovascular Diseases, University of Medicine, Tirana University Hospital "Mother Teresa", Tirana, Albania. FAU - Rohla, Miklos AU - Rohla M AD - 3rd Department of Medicine, Cardiology and Intensive Care Medicine, Medical School, Clinic Ottakring (Former Wilhelminenhospital) and Sigmund Freud University, Vienna, Austria. AD - Department of Cardiology, Bern University Hospital, University of Bern, Bern, Switzerland. FAU - Moccetti, Marco AU - Moccetti M AD - Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland. FAU - Vercellino, Matteo AU - Vercellino M AD - Department of Internal Medicine, Santi Antonio E Biagio E Cesare Arrigo Hospital, Alessandria, Italy. FAU - Gaede, Luise AU - Gaede L AD - Department of Cardiology, Friedrich-Alexander-University Erlangen-Nurnberg (FAU), Erlangen, Germany. FAU - Bott-Flugel, Lorenz AU - Bott-Flugel L AD - Cardiology and Pneumology, Klinikum Landkreis Erding, Erding, Germany. FAU - Stehli, Julia AU - Stehli J AD - Department of Cardiology, University Heart Center, University Hospital Zurich, Center for Translational and Experimental Cardiology (CTEC), University of Zurich, Ramistrasse 100, 8091, Zurich, Switzerland. FAU - Candreva, Alessandro AU - Candreva A AD - Department of Cardiology, University Heart Center, University Hospital Zurich, Center for Translational and Experimental Cardiology (CTEC), University of Zurich, Ramistrasse 100, 8091, Zurich, Switzerland. FAU - Paneni, Francesco AU - Paneni F AD - Department of Cardiology, University Heart Center, University Hospital Zurich, Center for Translational and Experimental Cardiology (CTEC), University of Zurich, Ramistrasse 100, 8091, Zurich, Switzerland. FAU - Templin, Christian AU - Templin C AD - Department of Cardiology, University Heart Center, University Hospital Zurich, Center for Translational and Experimental Cardiology (CTEC), University of Zurich, Ramistrasse 100, 8091, Zurich, Switzerland. FAU - Schindler, Matthias AU - Schindler M AD - Department of Cardiology, University Heart Center, University Hospital Zurich, Center for Translational and Experimental Cardiology (CTEC), University of Zurich, Ramistrasse 100, 8091, Zurich, Switzerland. FAU - Wischnewsky, Manfred AU - Wischnewsky M AD - FB Mathematics and Computer Science, University of Bremen, Bremen, Germany. FAU - Zanda, Greca AU - Zanda G AD - Interventional Cardiology Unit, Degli Infermi Hospital, Rivoli, Turin, Italy. FAU - Quadri, Giorgio AU - Quadri G AD - Interventional Cardiology Unit, Degli Infermi Hospital, Rivoli, Turin, Italy. FAU - Mangner, Norman AU - Mangner N AD - Department of Internal Medicine and Cardiology, Technische Universitat Dresden, Herzzentrum Dresden, University Clinic, Dresden, Germany. FAU - Toma, Aurel AU - Toma A AD - Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria. FAU - Magnani, Giulia AU - Magnani G AD - Division of Cardiology, Parma University Hospital, Parma, Italy. FAU - Clemmensen, Peter AU - Clemmensen P AD - Department of Cardiology, University Heart and Vascular Center Hamburg, Center for Population Health Innovation (POINT), University Clinic Hamburg-Eppendorf (UKE), and DZHK (German Centre for Cardiovascular Research) Partner Site Hamburg/Kiel/Lubeck, Hamburg, Germany. FAU - Luscher, Thomas F AU - Luscher TF AD - Heart Division, Royal Brompton & Harefield Hospitals and National Heart and Lung Institute, Imperial College London, London, UK. FAU - Munzel, Thomas AU - Munzel T AD - Department of Cardiology, University Medical Center Mainz, Johannes Gutenberg University, Center for Cardiovascular Research, Partner Site Rhine Main, Mainz, Germany. FAU - Schulze, P Christian AU - Schulze PC AD - Division of Cardiology, Pneumology, Angiology and Intensive Medical Care, Department of Internal Medicine I, University Hospital Jena, Friedrich-Schiller-University Jena, Jena, Germany. FAU - Laugwitz, Karl-Ludwig AU - Laugwitz KL AD - Clinic and Policlinic Internal Medicine I (Cardiology and Angiology), Klinikum Rechts Der Isar, Technische Universitat Munchen and DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany. FAU - Rottbauer, Wolfgang AU - Rottbauer W AD - Department of Cardiology, Ulm University Heart Center, Ulm, Germany. FAU - Huber, Kurt AU - Huber K AD - 3rd Department of Medicine, Cardiology and Intensive Care Medicine, Medical School, Clinic Ottakring (Former Wilhelminenhospital) and Sigmund Freud University, Vienna, Austria. FAU - Neumann, Franz-Josef AU - Neumann FJ AD - Department of Cardiology and Angiology, Medical Center - University of Freiburg, Germany and Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Schneider, Steffen AU - Schneider S AD - Stiftung Institut Fur Herzinfarktforschung (Foundation IHF), Ludwigshafen, Germany. FAU - Riemer, Thomas AU - Riemer T AD - Stiftung Institut Fur Herzinfarktforschung (Foundation IHF), Ludwigshafen, Germany. FAU - Weidinger, Franz AU - Weidinger F AD - 2nd Medical Department With Cardiology and Intensive Care Medicine, Hospital Landstrasse, Vienna, Austria. FAU - Achenbach, Stephan AU - Achenbach S AD - Department of Cardiology, Friedrich-Alexander-University Erlangen-Nurnberg (FAU), Erlangen, Germany. FAU - Richardt, Gert AU - Richardt G AD - Heart Center, Segeberger Kliniken GmbH, Academic Teaching Hospital for the Universities of Kiel, Lubeck and Hamburg, Bad Segeberg, Germany. FAU - Kastrati, Adnan AU - Kastrati A AD - Klinik Fur Herz Und Kreislauferkrankungen, Deutsches Herzzentrum Munchen, Technische Universitat Munchen and DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany. FAU - Ford, Ian AU - Ford I AD - Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK. FAU - Ruschitzka, Frank AU - Ruschitzka F AD - Department of Cardiology, University Heart Center, University Hospital Zurich, Center for Translational and Experimental Cardiology (CTEC), University of Zurich, Ramistrasse 100, 8091, Zurich, Switzerland. FAU - Stahli, Barbara E AU - Stahli BE AD - Department of Cardiology, University Heart Center, University Hospital Zurich, Center for Translational and Experimental Cardiology (CTEC), University of Zurich, Ramistrasse 100, 8091, Zurich, Switzerland. barbara.staehli@usz.ch. CN - MULTISTARS A. M. I. Investigators LA - eng SI - ClinicalTrials.gov/NCT03135275 PT - Journal Article DEP - 20250910 PL - Germany TA - Clin Res Cardiol JT - Clinical research in cardiology : official journal of the German Cardiac Society JID - 101264123 SB - IM OTO - NOTNLM OT - Acute coronary syndrome OT - Coronary artery disease OT - Diabetes OT - Ischemia OT - Myocardial infarction OT - Percutaneous coronary intervention COIS- Declarations. Ethics approval: The protocol was approved by the ethics committees at all the trial sites. The study has been performed in accordance with the ethical standards laid down in the Declaration of Helsinki and its later amendments. Consent to participate: All participants received a clear explanation of the study and provided their written informed consent. Consent for publication: All authors gave final approval to the manuscript and agreed to publish the manuscript. Conflict of interest: B.E.S. is supported by the H.H. Sheikh Khalifa bin Hamad Al-Thani Research Program and has received research grants to the institution from Boston Scientific, the B. Braun Foundation, the German Center for Cardiovascular Research (DZHK), the German Heart Research Foundation, Edwards Lifesciences, the Iten-Kohaut Foundation, and the OPO Foundation. B.E.S. has received consulting and speaker fees from Abbott Vascular, Abiomed, and Boston Scientific. C.T. receives consulting and speaker honoraria from Biotronik, Medtronic, Microport, Philips, AstraZeneca, Boehringer Ingelheim, Novartis, and payment for expert testimony from Microport. F.J.N. serves as Data and Safety Monitoring Board (DSMB) member for Novartis and Meril and receives speaker honoraria from Daiichi Sankyo and Amgen and consultancy fees from Meril. F.P. has received research grants to the institution from Novo Nordisk, including speaker or consultant fees. F.R. has not received personal payments from pharmaceutical companies or device manufacturers in the last 3 years (remuneration for the time spent in activities, such as participation as steering committee member of clinical trials and member of the Pfizer Research Award selection committee in Switzerland, were made directly to the University of Zurich). F.R. reports research, educational, and/or travel grants to the institution (University Hospital of Zurich/University of Zurich) from Abbott, Abiomed, Alnylam, Amarin, Amgen, AstraZeneca, At the Limits Ltd., Bayer, Biotronik, BMS, Boehringer Ingelheim, Boston Scientific, Bracco, CM Microport, Concept Medical, CTI, Daiichi Sankyo, Davos Congress, Edwards Lifesciences, FomF GmbH, Hamilton Health Sciences, Holcim, IHF, Innosuisse, IumiraDX, Kantar, LabPoint, MedAlliance, Medcon International, Medical Education Global Solutions, Medtronic, MicroPort, Monocle, Novartis, Novo Nordisk, OM Pharma, Pfizer, Quintiles Switzerland Sarl, RecorMedical, Roche Diagnostics, Roche Pharma, Sahajanand IN, Sanofi, Sarstedt AG, Servier, Sorin SRM SAS, SSS Int., Terumo Deutschland, Trama Solutions, V-Wave, Vifor, and ZOLL. These grants do not impact F.R.'s personal remuneration. I.M.L. has relationships with drug companies including AOP-Health, Actelion-Janssen, MSD, United Therapeutics, Pulnovo, Medtronic, Neutrolis, and Sanofi. In addition to being an investigator in trials involving these companies, relationships include consultancy services, research grants, and membership on scientific advisory boards. L.G. receives consultant and lecture fees from Abiomed, AstraZeneca, Abbott Vascular, Boston Scientific, Edwards Lifesciences, SMT, and Shockwave. M.R. has received advisory fees from Daiichi Sankyo, Sanofi Aventis, COR2ED, and Novartis and lecturing fees from Daiichi Sankyo, Biotronik, and Takeda Pharma, all outside the submitted work. M.S. reports personal fees and non-financial support from Abbott Vascular, personal fees from Abiomed, personal fees from AstraZeneca, grants, personal fees and non-financial support from Boston Scientific, personal fees from Bristol-Myers Squibb, personal fees and non-financial support from Edwards Lifesciences, grants and personal fees from Philips, personal fees from Medtronic, personal fees from Amgen, personal fees from Shockwave Medical, personal fees from Daiichi Sankyo, personal fees from Pfizer, personal fees from Siemens Healthineers, personal fees from Inari Medical, outside the submitted work. N.M. received research and an educational grant from Abiomed to his institution, outside the submitted work, and an educational grant from Boston Scientific to his institution, outside the submitted work. N.M. received personal fees from Abbott, Abiomed, Amgen, AstraZeneca, B. Braun, Biotronik, BMS/Pfizer, Boston Scientific, Daiichi Sankyo, Edwards Lifesciences, Medtronic, Novartis, Sanofi Genzyme, and Shockwave, outside the submitted work. P.C. reports previous or current involvement in research contracts, consulting, and speakers bureau and received research and educational grants from Abbott, Abiomed, AliveCor Inc., AstraZeneca, Aventis, Bayer, Boehringer Ingelheim, Bristol Myers Squibb, CeleCor, Daiichi Sankyo, Eli-Lilly, Evolva, Fibrex, Idorsia, IQVIA, Janssen, Merck, Myogen, Medtronic, Mitsubishi Pharma, The Medicines Company, Nycomed, Organon, Pfizer, Pharmacia, Philips, Regado, Sanofi, Searle, Servier, and ViFor Pharma. P.J. reports research grants to the institution from the Swiss Heart Foundation and research or travel grants to the institution without personal remuneration from Abbott, Bayer, and Sanofi-Aventis. T.F.L. does no longer accept any honoraria from industry but has received research and educational grants. T.F.L. has outside this work received research and educational grants to the institution from Abbott, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Daiichi Sankyo, Eli Lilly, Novartis, Novo Nordisk, Roche Diagnostics, Sanofi, and Vifor. EDAT- 2025/09/10 12:32 MHDA- 2025/09/10 12:32 CRDT- 2025/09/10 11:03 PHST- 2025/06/05 00:00 [received] PHST- 2025/08/15 00:00 [accepted] PHST- 2025/09/10 12:32 [medline] PHST- 2025/09/10 12:32 [pubmed] PHST- 2025/09/10 11:03 [entrez] AID - 10.1007/s00392-025-02745-x [pii] AID - 10.1007/s00392-025-02745-x [doi] PST - aheadofprint SO - Clin Res Cardiol. 2025 Sep 10. doi: 10.1007/s00392-025-02745-x. PMID- 40868251 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20250914 LR - 20250914 IS - 2227-9059 (Print) IS - 2227-9059 (Electronic) IS - 2227-9059 (Linking) VI - 13 IP - 8 DP - 2025 Aug 17 TI - A Combined Approach to the Prevention of Postoperative Atrial Fibrillation in Cardiac Surgery. LID - 10.3390/biomedicines13081999 [doi] LID - 1999 AB - Background: Postoperative atrial fibrillation (POAF) is a common complication after cardiac surgery with cardiopulmonary bypass (CPB) affecting between 5% and 40% of patients, which leads to hemodynamic instability, an increased risk of thromboembolism, decompensated heart failure, prolonged hospitalization, and higher treatment costs. Currently, there are no universally accepted guidelines for preventing POAF. Methods: A single-center, prospective, randomized controlled trial, "The Effect of Colchicine on the Occurrence of Atrial Fibrillation after Cardiac Surgery" (CAFE), ClinicalTrials.gov ID: NCT06798714, was conducted. The study included 140 patients with coronary artery disease randomized into two groups of 70 patients each. Group 1 (control group) received standard postoperative care. Group 2 (intervention group) received colchicine (Colchicum-Dispert at a dose of 500 mcg 4 h before coronary artery bypass grafting (CABG) with CPB and at a dose of 500 mcg twice daily for 10 days postoperatively) and underwent intraoperative pericardial fenestration using an original technique. Results: Perioperative colchicine administration combined with intraoperative pericardial fenestration reduced POAF incidence to 2.9% compared to the control group with POAF incidence of 12.9% (p < 0.05). This management strategy was not associated with an increased incidence of infectious complications, gastrointestinal disorders, or elevated levels of alanine aminotransferase, aspartate aminotransferase, or creatinine. Conclusions: Perioperative colchicine administration combined with pericardial fenestration during CABG with CPB is associated with a reduced POAF incidence, good tolerability, and does not contribute to an increased incidence of infectious complications or impaired liver and renal function. FAU - Diakova, Mariia L AU - Diakova ML AUID- ORCID: 0000-0001-9353-7234 AD - Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, 634012 Tomsk, Russia. FAU - Kuznetsov, Mikhail S AU - Kuznetsov MS AUID- ORCID: 0000-0002-1975-043X AD - Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, 634012 Tomsk, Russia. FAU - Vechersky, Yuri Yu AU - Vechersky YY AUID- ORCID: 0000-0002-7175-4526 AD - Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, 634012 Tomsk, Russia. FAU - Kim, Elena B AU - Kim EB AUID- ORCID: 0009-0001-5610-3506 AD - Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, 634012 Tomsk, Russia. FAU - Zyryanov, Stepan V AU - Zyryanov SV AUID- ORCID: 0000-0002-1352-6517 AD - Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, 634012 Tomsk, Russia. FAU - Petlin, Konstantin A AU - Petlin KA AUID- ORCID: 0000-0001-9906-9945 AD - Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, 634012 Tomsk, Russia. FAU - Kozlov, Boris N AU - Kozlov BN AUID- ORCID: 0000-0002-0217-7737 AD - Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, 634012 Tomsk, Russia. LA - eng SI - ClinicalTrials.gov/NCT06798714 GR - theme no. 123051500130-9/the Ministry of Science and Higher Education of the Russian Federation in the framework of the state assignment for applied scientific research/ PT - Journal Article DEP - 20250817 PL - Switzerland TA - Biomedicines JT - Biomedicines JID - 101691304 PMC - PMC12383744 OTO - NOTNLM OT - cardiac surgery OT - cardiopulmonary bypass OT - colchicine OT - pericardial drainage OT - pericardial fenestration OT - postoperative atrial fibrillation COIS- The authors declare no conflicts of interest. EDAT- 2025/08/30 04:46 MHDA- 2025/08/30 04:47 PMCR- 2025/08/17 CRDT- 2025/08/28 01:07 PHST- 2025/07/24 00:00 [received] PHST- 2025/08/14 00:00 [revised] PHST- 2025/08/15 00:00 [accepted] PHST- 2025/08/30 04:47 [medline] PHST- 2025/08/30 04:46 [pubmed] PHST- 2025/08/28 01:07 [entrez] PHST- 2025/08/17 00:00 [pmc-release] AID - biomedicines13081999 [pii] AID - biomedicines-13-01999 [pii] AID - 10.3390/biomedicines13081999 [doi] PST - epublish SO - Biomedicines. 2025 Aug 17;13(8):1999. doi: 10.3390/biomedicines13081999. PMID- 40878356 OWN - NLM STAT- MEDLINE DCOM- 20260115 LR - 20260830 IS - 1522-9645 (Electronic) IS - 0195-668X (Print) IS - 0195-668X (Linking) VI - 47 IP - 3 DP - 2026 Jan 16 TI - C-reactive protein and cardiovascular risk among women with no standard modifiable risk factors: evaluating the 'SMuRF-less but inflamed'. PG - 306-314 LID - 10.1093/eurheartj/ehaf658 [doi] AB - BACKGROUND AND AIMS: Interventions in preventive cardiology traditionally focus on four standard modifiable cardiovascular risk factors (SMuRFs): hypertension, dyslipidaemia, diabetes mellitus, and smoking. Yet, a substantial proportion of incident cardiovascular events accrues for individuals with none of these factors, particularly among women for whom cardiovascular disease remains under-detected and under-treated. The utility of the inflammatory biomarker high-sensitivity C-reactive protein (hsCRP) was evaluated to detect cardiovascular risk in SMuRF-less women participating in the prospective NIH-funded Women's Health Study. METHODS: High-sensitivity C-reactive protein was measured at baseline among 12 530 initially healthy American women with no standard modifiable risk factors who were followed over 30 years for first major adverse cardiovascular events (myocardial infarction, coronary revascularization, ischaemic stroke, or cardiovascular death). Hazard ratios (HRs) and 95% confidence intervals (95% CI) for incident coronary heart disease (CHD), ischaemic stroke, and total cardiovascular events were calculated across quintiles of hsCRP, along with 30-year cumulative incidence curves. Hazard ratios were also computed according to common clinical thresholds of hsCRP, according to standard deviation change in hsCRP, and as a continuous variable in penalized spline regression models. RESULTS: During 30-year follow-up, 973 first major cardiovascular events accrued. Median baseline hsCRP was significantly higher among SMuRF-less women who subsequently suffered a cardiovascular event when compared with those who did not (median hsCRP 2.22 vs 1.50 mg/L, P < .0001). In age-adjusted analyses, the HRs for the primary endpoint of incident CHD from lowest (referent) to highest levels of hsCRP at study entry were 1.0 (referent), 1.24, 1.41, 1.57, and 2.23 (P-trend < .0001) such that CHD risk over 30 years increased 21% for each increasing quintile of hsCRP (age-adjusted HR 1.21, 95% CI 1.13-1.29, P < .0001). Corresponding HRs for the top vs bottom quintile of hsCRP were 1.69 (95% CI 1.16-2.47) for ischaemic stroke and 1.74 (95% CI 1.42-2.14) for total cardiovascular disease events. Using common clinical hsCRP thresholds, SMuRF-less women with hsCRP > 3 mg/L had a 77% higher risk of CHD events, a 39% higher risk of ischaemic stroke events, and a 52% higher risk of total cardiovascular disease events when compared with those with hsCRP < 1 mg/L. Spline analyses demonstrated linear association with risk across the spectrum of hsCRP values. Hazards were moderately attenuated after additional adjustment for body mass index and estimated glomerular filtration rate [covariate-adjusted CHD HR 1.86 (95% CI 1.35-2.58, P = .0002) for comparison of the top vs bottom quintile of hsCRP and 1.52 (95% CI 1.20-1.92, P = .0006) for comparison of those with hsCRP > 3 mg/L to those < 1 mg/L]. CONCLUSIONS: Over a 30-year horizon, cardiovascular events commonly occur among 'SMuRF-less but inflamed' women who are otherwise missed by current screening algorithms, a clinically important observation given recent trial data demonstrating that statin therapy reduces risk by 38% among such individuals. CI - (c) The Author(s) 2025. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site-for further information please contact journals.permissions@oup.com. FAU - Ridker, Paul M AU - Ridker PM AUID- ORCID: 0000-0003-1249-4522 AD - Center for Cardiovascular Disease Prevention, Divisions of Preventive Medicine and Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, 900 Commonwealth Avenue, Boston, MA 02215, USA. FAU - Figtree, Gemma A AU - Figtree GA AD - Royal North Shore Hospital, University of Sydney, Australia. FAU - Moorthy, M Vinayaga AU - Moorthy MV AD - Center for Cardiovascular Disease Prevention, Divisions of Preventive Medicine and Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, 900 Commonwealth Avenue, Boston, MA 02215, USA. FAU - Mora, Samia AU - Mora S AD - Center for Cardiovascular Disease Prevention, Divisions of Preventive Medicine and Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, 900 Commonwealth Avenue, Boston, MA 02215, USA. FAU - Buring, Julie E AU - Buring JE AD - Center for Cardiovascular Disease Prevention, Divisions of Preventive Medicine and Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, 900 Commonwealth Avenue, Boston, MA 02215, USA. LA - eng GR - National Heart, Lung and Blood Institute/ PT - Journal Article PL - England TA - Eur Heart J JT - European heart journal JID - 8006263 RN - 9007-41-4 (C-Reactive Protein) RN - 0 (Biomarkers) SB - IM CIN - doi: 10.1093/eurheartj/ehaf653 MH - Humans MH - Female MH - *C-Reactive Protein/metabolism MH - Middle Aged MH - *Cardiovascular Diseases/epidemiology/blood MH - Biomarkers/metabolism/blood MH - Heart Disease Risk Factors MH - Prospective Studies MH - Adult MH - Risk Factors MH - Inflammation MH - Aged PMC - PMC12807569 OTO - NOTNLM OT - Atherosclerotic disease OT - C-reactive protein OT - Inflammation OT - Risk factors OT - Women EDAT- 2025/08/29 08:45 MHDA- 2026/01/16 04:07 PMCR- 2026/08/29 CRDT- 2025/08/29 02:52 PHST- 2025/07/12 00:00 [received] PHST- 2025/07/28 00:00 [revised] PHST- 2025/08/14 00:00 [accepted] PHST- 2026/01/16 04:07 [medline] PHST- 2025/08/29 08:45 [pubmed] PHST- 2025/08/29 02:52 [entrez] PHST- 2026/08/29 00:00 [pmc-release] AID - 8242429 [pii] AID - ehaf658 [pii] AID - 10.1093/eurheartj/ehaf658 [doi] PST - ppublish SO - Eur Heart J. 2026 Jan 16;47(3):306-314. doi: 10.1093/eurheartj/ehaf658. PMID- 40876528 OWN - NLM STAT- MEDLINE DCOM- 20251208 LR - 20260112 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 258 DP - 2026 Jan 1 TI - Radial Versus Femoral Access for Percutaneous Coronary Intervention in Patients With Chronic Coronary Disease. PG - 63-68 LID - S0002-9149(25)00504-1 [pii] LID - 10.1016/j.amjcard.2025.08.038 [doi] AB - Guidelines recommend trans-radial access (TRA) for all percutaneous coronary intervention (PCI). However, no randomized trials have shown a lower mortality when compared to the femoral approach in chronic coronary disease and femoral access may be preferred in certain situations. Consecutive eligible patients in a multi-center registry between 2014 - 2020 were included. Clinical characteristics and outcomes were compared between those who underwent radial versus femoral access. The main outcomes were major bleeding and 5-year mortality. Of the 6,158 patients included, 3,784 (61.4%) had TRA and 2,374 (38.6%) femoral access. TRA predominated from 2016. The femoral group had higher rates of diabetes mellitus, renal dysfunction and prior stroke. Trans-femoral procedures were more complex with higher rates of ACC/AHA type B2/C lesions, chronic total occlusions, left main PCI, use of adjuvants including rotational atherectomy, and lower procedural success rates. Major bleeding was higher in the femoral group (radial 0.4% vs femoral 0.8%, p = 0.039), however femoral access did not predict major bleeding (OR 1.68, 95% CI 0.74 to 3.82). There was no difference in 5-year mortality (radial 20.3% vs femoral 21%, p = 0.65). In conclusion, TRA predominates in contemporary PCI for CCD. The femoral group had higher procedural complexity and risk with a higher incidence of peri‑procedural major bleeding. Nonetheless, femoral access did not predict major bleeding and there was no difference in 5-year mortality as compared to TRA. In the absence of a contemporary randomized trial, the femoral approach appears reasonable if clinically preferred in patients with chronic coronary disease undergoing PCI. CI - Copyright (c) 2025 The Author(s). Published by Elsevier Inc. All rights reserved. FAU - Hamilton, Garry W AU - Hamilton GW AD - Department of Cardiology, Austin Health, Melbourne, Australia; Department of Medicine, University of Melbourne, Melbourne, Australia. Electronic address: garry.hamilton@austin.org.au. FAU - Dinh, Diem T AU - Dinh DT AD - School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia. FAU - Yeoh, Julian AU - Yeoh J AD - Department of Cardiology, Austin Health, Melbourne, Australia. FAU - Brennan, Angela L AU - Brennan AL AD - School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia. FAU - Yudi, Matias B AU - Yudi MB AD - Department of Cardiology, Austin Health, Melbourne, Australia; Department of Medicine, University of Melbourne, Melbourne, Australia. FAU - Reid, Christopher M AU - Reid CM AD - School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; School of Population Health, Curtin University, Perth, Western Australia, Australia. FAU - Stub, Dion AU - Stub D AD - School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; Department of Cardiovascular Medicine, Alfred Hospital, Melbourne, Australia. FAU - Chan, William AU - Chan W AD - Department of Medicine, University of Melbourne, Melbourne, Australia; Department of Cardiovascular Medicine, Alfred Hospital, Melbourne, Australia. FAU - Freeman, Melanie AU - Freeman M AD - Department of Cardiology, Box Hill Hospital, Melbourne Australia. FAU - Ajani, Andrew AU - Ajani A AD - School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; Department of Cardiology, Royal Melbourne Hospital, Melbourne, Australia. FAU - Farouque, Omar AU - Farouque O AD - Department of Cardiology, Austin Health, Melbourne, Australia; Department of Medicine, University of Melbourne, Melbourne, Australia. FAU - Clark, David J AU - Clark DJ AD - Department of Cardiology, Austin Health, Melbourne, Australia; Department of Medicine, University of Melbourne, Melbourne, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia. CN - Melbourne Interventional Group Registry LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study DEP - 20250826 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM MH - Humans MH - *Percutaneous Coronary Intervention/methods MH - *Radial Artery MH - *Femoral Artery MH - Male MH - Female MH - Aged MH - Middle Aged MH - Registries MH - Chronic Disease MH - *Coronary Disease/surgery MH - *Coronary Artery Disease/surgery MH - *Catheterization, Peripheral/methods OTO - NOTNLM OT - access OT - chronic coronary disease OT - coronary angiography OT - femoral OT - percutaneous coronary intervention OT - radial artery OT - stable ischemic heart disease OT - trans-radial COIS- Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2025/08/29 00:45 MHDA- 2025/12/09 00:32 CRDT- 2025/08/28 19:13 PHST- 2025/07/09 00:00 [received] PHST- 2025/08/09 00:00 [revised] PHST- 2025/08/23 00:00 [accepted] PHST- 2025/12/09 00:32 [medline] PHST- 2025/08/29 00:45 [pubmed] PHST- 2025/08/28 19:13 [entrez] AID - S0002-9149(25)00504-1 [pii] AID - 10.1016/j.amjcard.2025.08.038 [doi] PST - ppublish SO - Am J Cardiol. 2026 Jan 1;258:63-68. doi: 10.1016/j.amjcard.2025.08.038. Epub 2025 Aug 26. PMID- 40838370 OWN - NLM STAT- MEDLINE DCOM- 20251001 LR - 20260909 IS - 1473-5598 (Electronic) IS - 0263-6352 (Print) IS - 0263-6352 (Linking) VI - 43 IP - 11 DP - 2025 Nov 1 TI - Long-term safety and efficacy of renal sympathetic denervation in comparison to a population-based cohort: a propensity-matching approach. PG - 1832-1840 LID - 10.1097/HJH.0000000000004117 [doi] AB - OBJECTIVE: To evaluate the long-term changes in risk of cardiovascular outcomes and blood pressure (BP) in hypertensive patients treated with renal sympathetic denervation (RDN) as compared to hypertensive controls from a population-based cohort. METHODS: This prospective cohort study included patients with office systolic blood pressure (SBP) at least 140 mmHg and/or diastolic BP at least 90 mmHg. Patients treated with RDN were matched to hypertensive controls from the population-based Rotterdam Study using one-to-many variable-ratio propensity score matching. The primary safety outcome was a composite endpoint of myocardial infarction, coronary revascularization, stroke, renal failure and mortality. The primary efficacy outcome was the 5-year change in office SBP. RESULTS: A total of 53 RDN patients were matched to 238 population-based controls. Median age [25th-75th percentile] was 60.5 [56.5-68.4] years (46% female). Baseline BP +/-SD was 166.1/95.5 +/- 20.6/10.9 mmHg. Patients were prescribed 2.8 [1.5-4.5] defined daily dosages of antihypertensive drugs. The incidence of the primary safety outcome was similar among the RDN group and the control group at 5 years [13 vs. 18%; hazard ratio 0.93; 95% confidence interval (CI) 0.36-2.38; P = 0.87]. The 5-year change in SBP was -12.0 [-18.0, -6.0] mmHg in the RDN group ( P < 0.001) and -14.9 [-22.5 to -7.3] mmHg in the control group ( P < 0.001), with no significant between-group difference [2.9 (-6.6 to 12.4) mmHg; P = 0.55]. CONCLUSION: Patients with uncontrolled hypertension undergoing RDN did not have a significantly lower risk for future adverse cardiovascular events as compared to hypertensive controls from a population-based study. No difference in office BP was observed at 5 years. While real-world observational data could provide valuable insights, randomized trials are needed to confirm the role of RDN in improving long-term outcomes. CI - Copyright (c) 2025 The Author(s). Published by Wolters Kluwer Health, Inc. FAU - Zeijen, Victor J M AU - Zeijen VJM AD - Department of Cardiology, Thorax Center. FAU - Tilly, Martijn J AU - Tilly MJ AD - Department of Cardiology, Thorax Center. AD - Department of Epidemiology. FAU - Saville, Kari A AU - Saville KA AD - Department of Cardiology, Thorax Center. FAU - Stricker, Bruno H C AU - Stricker BHC AD - Department of Epidemiology. FAU - Kardys, Isabella AU - Kardys I AD - Department of Cardiology, Thorax Center. FAU - Ikram, M Kamran AU - Ikram MK AD - Department of Epidemiology. AD - Department of Neurology, Erasmus University Medical Center, Rotterdam, the Netherlands. FAU - Kavousi, Maryam AU - Kavousi M AD - Department of Epidemiology. FAU - Daemen, Joost AU - Daemen J AD - Department of Cardiology, Thorax Center. LA - eng PT - Comparative Study PT - Journal Article DEP - 20250811 PL - Netherlands TA - J Hypertens JT - Journal of hypertension JID - 8306882 RN - 0 (Antihypertensive Agents) SB - IM MH - Humans MH - Female MH - Male MH - Middle Aged MH - Aged MH - *Hypertension/surgery/physiopathology MH - *Sympathectomy/adverse effects/methods MH - Propensity Score MH - Prospective Studies MH - *Kidney/innervation/surgery MH - Blood Pressure MH - Treatment Outcome MH - Cohort Studies MH - Antihypertensive Agents/therapeutic use PMC - PMC12517731 OTO - NOTNLM OT - blood pressure OT - cohort studies OT - glomerular filtration rate OT - hypertension OT - kidney OT - sympathectomy COIS- J.D. received institutional grant/research support from Abbott Vascular, Boston Scientific, ACIST Medical, Medtronic, Pie Medical, and ReCor medical, and consultancy and speaker fees from Abbott Vascular, Abiomed, ACIST medical, Boston Scientific, Cardialysis BV, CardiacBooster, Kaminari Medical, ReCor Medical, PulseCath, Pie Medical, Sanofi, Siemens Healthcare and Medtronic. All other authors declare no relevant interests to disclose. EDAT- 2025/08/21 12:47 MHDA- 2025/10/01 06:30 PMCR- 2025/10/13 CRDT- 2025/08/21 06:06 PHST- 2025/03/22 00:00 [received] PHST- 2025/07/24 00:00 [accepted] PHST- 2025/10/01 06:30 [medline] PHST- 2025/08/21 12:47 [pubmed] PHST- 2025/08/21 06:06 [entrez] PHST- 2025/10/13 00:00 [pmc-release] AID - 00004872-202511000-00012 [pii] AID - JH-D-25-00338 [pii] AID - 10.1097/HJH.0000000000004117 [doi] PST - ppublish SO - J Hypertens. 2025 Nov 1;43(11):1832-1840. doi: 10.1097/HJH.0000000000004117. Epub 2025 Aug 11. PMID- 40835906 OWN - NLM STAT- MEDLINE DCOM- 20250821 LR - 20260427 IS - 1471-2261 (Electronic) IS - 1471-2261 (Linking) VI - 25 IP - 1 DP - 2025 Aug 20 TI - Comparative analysis of third-generation dual-energy CT and IVUS for in-stent restenosis detection. PG - 614 LID - 10.1186/s12872-025-04836-z [doi] LID - 614 AB - PURPOSE: Prior studies have assessed in-stent diameter restenosis (ISDR) in coronary arteries using 64-slice multidetector computed tomography coronary angiography (MDCT-CA) compared to invasive coronary angiography (ICA), which is the gold standard. This study aimed to compare the diagnostic accuracy of monoenergetic reconstruction using third-generation dual-source dual-energy CT (DSDECT) to that of ICA reconstruction via adjunctive intravascular ultrasonography (IVUS) for evaluating the ISDR. METHODS: A total of 95 patients with previously stented coronary arteries (involving 110 stents) underwent DSDECT followed by ICA and IVUS within a 24-h timeframe. The specificities, sensitivities, negative predictive values (NPVs), and positive predictive values (PPVs) of the DSDECT and ICA were compared for confirming or excluding the ISDR using in-stent area restenosis (ISAR) and a minimal luminal area (MLA) 0.1 for each) and had comparable area at risk by CMR and FAPI-PET. SSO(2) patients showed lower FIS determined by CMR (SSO(2): 20% vs non-SSO(2): 32%; p<0.001) and SPECT (SSO(2): 16% vs non-SSO(2): 29%; p=0.014). Myocardial salvage was higher in SSO(2) patients (50% vs 28%; p=0.002). MVO occurred less often and was less extreme under SSO(2) therapy. CONCLUSIONS: SSO(2) therapy was associated with significantly reduced microvascular obstruction and FIS in patients with anterior AMI in clinical routine practice. FAU - Konig, Tobias AU - Konig T AD - Department of Cardiology and Angiology, Hannover Medical School, Hanover, Germany. FAU - Berliner, Dominik AU - Berliner D AD - Department of Cardiology and Angiology, Hannover Medical School, Hanover, Germany. FAU - Diekmann, Johanna AU - Diekmann J AD - Department of Nuclear Medicine, Hannover Medical School, Hanover, Germany. FAU - Akin, Muharrem AU - Akin M AD - Department of Cardiology and Angiology, Hannover Medical School, Hanover, Germany. FAU - Pfeffer, Tobias AU - Pfeffer T AD - Department of Cardiology and Angiology, Hannover Medical School, Hanover, Germany. FAU - Sanchez Martinez, Carolina AU - Sanchez Martinez C AD - Department of Cardiology and Angiology, Hannover Medical School, Hanover, Germany. FAU - Garcheva, Vera AU - Garcheva V AD - Department of Cardiology and Angiology, Hannover Medical School, Hanover, Germany. FAU - Bengel, Frank M AU - Bengel FM AD - Department of Nuclear Medicine, Hannover Medical School, Hanover, Germany. FAU - Bauersachs, Johann AU - Bauersachs J AD - Department of Cardiology and Angiology, Hannover Medical School, Hanover, Germany. FAU - Schafer, Andreas AU - Schafer A AD - Department of Cardiology and Angiology, Hannover Medical School, Hanover, Germany. LA - eng PT - Journal Article DEP - 20250721 PL - France TA - EuroIntervention JT - EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology JID - 101251040 RN - S88TT14065 (Oxygen) SB - IM MH - Humans MH - Male MH - Female MH - Middle Aged MH - Aged MH - Percutaneous Coronary Intervention/methods MH - Treatment Outcome MH - *Anterior Wall Myocardial Infarction/therapy/pathology/diagnostic imaging MH - *Oxygen/administration & dosage/therapeutic use MH - Microcirculation MH - Tomography, Emission-Computed, Single-Photon MH - *Myocardial Infarction/therapy MH - *Oxygen Inhalation Therapy/methods PMC - PMC12285395 COIS- A. Schafer received lecture fees and honoraria from Abiomed, Amgen, AstraZeneca, Daiichi Sankyo, Boehringer Ingelheim, BMS, Novartis, Pfizer, and ZOLL; as well as research support from Abiomed and Daiichi Sankyo. J. Bauersachs received lecture fees and honoraria from Novartis, Vifor, Bayer, Pfizer, Boehringer Ingelheim, AstraZeneca, Cardior, CVRx, BMS, Amgen, and Corvia; as well as research support from ZOLL, CVRx, and Abiomed. D. Berliner received honoraria for lectures/consulting from Abbott, AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb, Daiichi Sankyo, Edwards Lifesciences, and Pfizer. The other authors have no conflicts of interest to declare. EDAT- 2025/07/25 06:38 MHDA- 2025/07/25 06:39 PMCR- 2026/07/21 CRDT- 2025/07/25 02:13 PHST- 2025/07/25 06:39 [medline] PHST- 2025/07/25 06:38 [pubmed] PHST- 2025/07/25 02:13 [entrez] PHST- 2026/07/21 00:00 [pmc-release] AID - EIJ-D-25-00034 [pii] AID - 10.4244/EIJ-D-25-00034 [doi] PST - epublish SO - EuroIntervention. 2025 Jul 21;21(14):e810-e819. doi: 10.4244/EIJ-D-25-00034. PMID- 40700541 OWN - NLM STAT- MEDLINE DCOM- 20251106 LR - 20251210 IS - 1557-2501 (Electronic) IS - 1042-3931 (Linking) VI - 37 IP - 11 DP - 2025 Nov TI - Prognostic implications over time of platelet FcɣRIIa expression in patients with myocardial infarction: a secondary analysis. LID - 10.25270/jic/25.00102 [doi] AB - OBJECTIVES: In patients with myocardial infarction (MI), quantifying platelet FcɣRIIa (pFCG) stratifies the risk of subsequent MI, stroke, and death. The authors conducted a secondary analysis to assess the prognostic implications of the pFCG test over the course of 1 year after MI. METHODS: Patients (n = 764) hospitalized for type 1 MI (ST elevation and non-ST elevation) were enrolled in a prospective non-interventional trial. Inclusion criteria included at least 2 of the following: age 65 years or older, multi-vessel coronary artery disease, prior MI, chronic kidney disease, and diabetes mellitus. Flow cytometry was used to quantify pFCG at a core laboratory. High and low pFCG were defined by a prespecified threshold. The primary endpoint (n = 98) was the composite of MI, stroke, and death. RESULTS: The time-to-first-event analysis demonstrated that the pFCG test had the greatest prognostic power early after MI. The hazard ratio (HR) for the primary composite endpoint in all subjects was greatest during the first month (3.84, P = .0009), and the HR for the first 6 months was 2.90 (P = .00005). Similar trends were apparent for patients treated with percutaneous coronary intervention and those treated with medical therapy alone. Analysis of components of the primary endpoint, the composite of MI and death, as well as MI alone, showed similar trends. CONCLUSIONS: The pFCG test is a powerful prognostic marker of ischemic risk during the first 6 months after MI. The prognostic information provided by the pFCG test should be useful to clinicians as they balance risk of ischemic events with that of bleeding to define a treatment strategy. FAU - Schneider, David J AU - Schneider DJ AD - Department of Medicine, Cardiovascular Research Institute, The University of Vermont, Burlington, Vermont. Email: David.Schneider@med.uvm.edu. FAU - McMahon, Sean R AU - McMahon SR AD - Department of Medicine, Hartford Hospital, Hartford, Connecticut. FAU - Angiolillo, Dominick J AU - Angiolillo DJ AD - Department of Medicine, Division of Cardiology, University of Florida, Jacksonville, Florida. FAU - Fanaroff, Alexander C AU - Fanaroff AC AD - Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania. FAU - Ibrahim, Homam AU - Ibrahim H AD - Adventist Healthcare White Oak, Silver Spring, Maryland. FAU - Hohl, Patrick K AU - Hohl PK AD - Division of Cardiovascular Medicine, Maine Medical Center, Portland, Maine. FAU - Wanamaker, Brett L AU - Wanamaker BL AD - Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan. FAU - Effron, Mark B AU - Effron MB AD - John Ochsner Heart and Vascular Institute, University of Queensland Ochsner Clinical School, New Orleans, Louisiana. FAU - DiBattiste, Peter M AU - DiBattiste PM AD - Prolocor, Inc, Philadelphia, Pennsylvania. CN - investigators LA - eng PT - Journal Article PT - Multicenter Study PT - Observational Study PL - United States TA - J Invasive Cardiol JT - The Journal of invasive cardiology JID - 8917477 RN - 0 (Biomarkers) RN - 0 (Receptors, IgG) SB - IM MH - Aged MH - Female MH - Humans MH - Male MH - Middle Aged MH - Biomarkers/blood MH - *Blood Platelets/metabolism MH - Flow Cytometry MH - Follow-Up Studies MH - *Myocardial Infarction/blood/diagnosis/mortality MH - Prognosis MH - Prospective Studies MH - *Receptors, IgG/blood MH - Risk Assessment/methods MH - Risk Factors MH - Time Factors OTO - NOTNLM OT - biomarker OT - myocardial infarction OT - platelets EDAT- 2025/07/23 18:28 MHDA- 2025/11/06 18:26 CRDT- 2025/07/23 14:12 PHST- 2025/11/06 18:26 [medline] PHST- 2025/07/23 18:28 [pubmed] PHST- 2025/07/23 14:12 [entrez] AID - 10.25270/jic/25.00102 [doi] PST - ppublish SO - J Invasive Cardiol. 2025 Nov;37(11). doi: 10.25270/jic/25.00102. PMID- 40695135 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20250913 LR - 20251227 IS - 2772-963X (Electronic) IS - 2772-963X (Linking) VI - 4 IP - 8 DP - 2025 Aug TI - Prediction of 1-Year Major Adverse Cardiovascular Events in Chronic Limb Threatening Ischemia. PG - 101959 LID - S2772-963X(25)00381-3 [pii] LID - 10.1016/j.jacadv.2025.101959 [doi] LID - 101959 AB - BACKGROUND: Patients with chronic limb threatening ischemia (CLTI) are at risk for major adverse cardiovascular events (MACE), yet few tools exist for risk stratification. OBJECTIVES: The purpose of this study was to derive and validate a CLTI MACE risk prediction model. METHODS: Participants in the BEST-CLI (Best Endovascular vs. Best Surgical Therapy for Patients with Critical Limb Ischemia) trial were randomly split 80%/20% into derivation and validation cohorts. A parsimonious multivariable model to predict 1-year MACE was developed. External validation was performed in the observational BEST Registry with 1-year outcomes conducted at a subset of 40 BEST-CLI trial sites. RESULTS: Among 1,780 patients, the average age was 67.2 years, 28.3% were female, and 20.2% were Black. Hypertension (87.1%), hyperlipidemia (73.9%), diabetes (69.2%), and coronary artery disease (44.9%) were prevalent. The 1-year cumulative incidence of MACE was 17.33% (95% CI: 15.59%-19.24%). Overall model discrimination (C-statistic = 0.669) and calibration (calibration slope = 0.884) were good. Model performance was driven by nonmodifiable risk factors: prior coronary artery disease (HR: 2.22 [95% CI: 1.72-2.89]; P < 0.0001), congestive heart failure (HR: 1.93 [95% CI: 1.35-2.75]; P = 0.0003), stage 3 or greater chronic kidney disease (HR: 1.46 [95% CI: 1.14-1.87]; P = 0.0025). Statin use was protective (HR: 0.7 [95% CI: 0.54-0.91]; P = 0.007) but mode of revascularization was not. External validation in the BEST Registry yielded a C-statistic of 0.66 and a calibration slope of 0.78. CONCLUSIONS: The BEST-CLI MACE model predicts 1-year MACE in CLTI, is not influenced by mode of revascularization, and highlights the importance of statin therapy. Further work is needed to determine if this model may be helpful in guiding therapeutic decision-making in CLTI patients. CI - Copyright (c) 2025 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Vemulapalli, Sreekanth AU - Vemulapalli S AD - Division of Cardiology, Duke University Medical Center, Durham, North Carolina, USA; Duke Clinical Research Institute, Durham, North Carolina, USA. Electronic address: Sreekanth.vemulapalli@duke.edu. FAU - Doros, Gheorghe AU - Doros G AD - Boston University School of Publich Health, Boston, Massachusetts, USA. FAU - Weissler, E Hope AU - Weissler EH AD - Division of Cardiology, Duke University Medical Center, Durham, North Carolina, USA; Division of Vascular Surgery, Duke University Medical Center, Durham, North Carolina, USA. FAU - Jones, W Schuyler AU - Jones WS AD - Division of Cardiology, Duke University Medical Center, Durham, North Carolina, USA; Duke Clinical Research Institute, Durham, North Carolina, USA. FAU - Li, Shuang AU - Li S AD - Duke Clinical Research Institute, Durham, North Carolina, USA. FAU - Obrien, Sean M AU - Obrien SM AD - Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina, USA. FAU - Beckman, Joshua A AU - Beckman JA AD - Vascular Medicine, Department of Medicine, UT Southwestern Medical Center, Dallas, Texas, USA. FAU - Hamburg, Naomi M AU - Hamburg NM AD - Boston University Chobanian and Avedesian School of Medicine, Boston, Massachusetts, USA. FAU - Jaff, Michael R AU - Jaff MR AD - The Harvard Medical School (Retired), Boston, Massachusetts, USA. FAU - Strong, Michael B AU - Strong MB AD - The Division of Vascular and Endovascular Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. FAU - Rosenfield, Kenneth AU - Rosenfield K AD - The Section of Vascular Medicine and Intervention, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA. FAU - Menard, Matthew T AU - Menard MT AD - The Division of Vascular and Endovascular Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. FAU - Farber, Alik AU - Farber A AD - The Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, USA. FAU - Patel, Manesh R AU - Patel MR AD - Division of Cardiology, Duke University Medical Center, Durham, North Carolina, USA; Duke Clinical Research Institute, Durham, North Carolina, USA. LA - eng PT - Journal Article DEP - 20250721 PL - United States TA - JACC Adv JT - JACC. Advances JID - 9918419284106676 PMC - PMC12296431 OTO - NOTNLM OT - chronic limb threatening ischemia OT - major adverse cardiovascular events OT - revascularization OT - risk model OT - statin COIS- Funding support and author disclosures BEST-CLI was supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health under Award Numbers U01HL107407, U01HL107352, and U01HL115662. The following entities also provided funding to the BEST-CLI trial during the follow-up period (2019-2021). These include Physician Societies: Vascular InterVentional Advances (VIVA), Society for Vascular Surgery, New England Society for Vascular Surgery, Western Vascular Society, Eastern Vascular Society, Midwest Vascular Surgery Society, Southern Association of Vascular Surgeons, Canadian Society for Vascular Surgery, Society for Clinical Vascular Surgery, Society of Interventional Radiology, Vascular and Endovascular Surgery Society, Society for Vascular Medicine; and Industry sources: Janssen, W. L. Gore & Associates, Becton Dickinson and Company, Medtronic, Cook, Boston Scientific, Abbott, Cordis, Cardiovascular Systems Inc. As of September 1, 2022, ongoing BEST-CLI research is funded primarily by the Novo Nordisk Foundation. Dr Vemulapalli has received grants/contracts from the American College of Cardiology, National Institutes of Health (R01 and UG3), Cytokinetics, Food and Drug Administration, Abbott Vascular, and Edwards Lifesciences; and is on the advisory board/consulting for Veralox Therapeutics, Medtronic, AstraZeneca, Boehringer Ingelheim, HeartFlow, Total CME, Icon, Edwards Lifesciences, and Cytokinetics. Dr Jones has a relationship with Bayer Pharmaceuticals, Bristol Myers Squibb, Janssen, and Boehringer Ingelheim. Dr Beckman has done consulting for Janssen, JanOne, and Novartis; and has received grants/contracts from Bristol Myers Squibb. Dr Hamburg has done consulting for Sanifit, Boston Scientific, and Novo Nordisk. Dr Strong has a relationship with NIA/NIH. Dr Jaff is a part-time employee of Boston Scientific. Dr Rosenfield has received income as a consultant or member of a scientific advisory board for Abbott Vascular, Althea Medical, Angiodynamics, Auxetics, Becton-Dickinson, Boston Scientific, Contego, Crossliner, Innova Vascular, Inspire MD, Janssen/Johnson and Johnson, Magneto, Mayo Clinic, MedAlliance, Medtronic, Neptune Medical, Penumbra, Philips, Surmodics, Terumo, Thrombolex, Truvic, Vasorum, and Vumedi; owns equity or stock options in Access Vascular, Aerami, Althea Medical, Auxetics, Contego, Crossliner, Cruzar Systems, Endospan, Imperative Care/Truvic, Innova Vascular, InspireMD, JanaCare, Magneto, MedAlliance, Neptune Medical, Orchestra, Prosomnus, Shockwave, Skydance, Summa Therapeutics, Thrombolex, Vasorum, and Vumedi; or his institution (on his behalf) has received research grants from NIH, Abiomed, Boston Scientific, Novo Nordisk Foundation, Penumbra, and Gettinge-Atrium; and has served as a member of the Board of Directors of the National PERT Consortium. Dr Menard is an advisor for Janssen. Dr Farber has done consulting for Sanifit, LeMaitre, BioGenCell; and is on the advisory board for iThera and DialysisX. Dr Patel has received grants/contracts from NIH (R01 and URG3) Bayer, Novartis, and Janssen; and is on the advisory board/consulting for Bayer, Janssen, Esperion, and Medscape. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2025/07/23 11:27 MHDA- 2025/07/23 11:28 PMCR- 2025/07/21 CRDT- 2025/07/22 18:06 PHST- 2024/09/24 00:00 [received] PHST- 2025/05/12 00:00 [revised] PHST- 2025/05/20 00:00 [accepted] PHST- 2025/07/23 11:28 [medline] PHST- 2025/07/23 11:27 [pubmed] PHST- 2025/07/22 18:06 [entrez] PHST- 2025/07/21 00:00 [pmc-release] AID - S2772-963X(25)00381-3 [pii] AID - 101959 [pii] AID - 10.1016/j.jacadv.2025.101959 [doi] PST - ppublish SO - JACC Adv. 2025 Aug;4(8):101959. doi: 10.1016/j.jacadv.2025.101959. Epub 2025 Jul 21. PMID- 40649164 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20250714 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 14 IP - 13 DP - 2025 Jul 7 TI - Effect of Complete Revascularization in STEMI: Ischemia-Driven Rehospitalization and Cardiovascular Mortality. LID - 10.3390/jcm14134793 [doi] LID - 4793 AB - Background: Patients with ST-elevation myocardial infarction (STEMI) and multivessel coronary artery disease (MVD) who undergo complete revascularization (CR) have a more favorable prognosis than those who receive incomplete revascularization (IR), as evidenced by recent randomized controlled trials. Despite the absence of a survival benefit associated with CR in these trials, positive outcomes were ascribed to combined endpoints, such as repeat revascularization, myocardial infarction, or ischemia-driven rehospitalization. In light of the significant burden that rehospitalization from STEMI imposes on healthcare systems, we examined the long-term effects of CR on ischemia-driven rehospitalization and cardiovascular (CV) mortality in STEMI patients with MVD. Methods: In our retrospective study, we included patients with STEMI and MVD who underwent successful primary percutaneous coronary intervention (PCI) at the University Medical Centre Ljubljana between 1 January 2009, and 11 April 2011. The combined endpoint was ischemia-driven rehospitalization and CV mortality, with a minimum follow-up period of six years. Results: We included 235 participants who underwent CR (N = 70) or IR (N = 165) at index hospitalization, with a median follow-up time of 7 years (interquartile range 6.0-8.2). The primary endpoint was significantly higher in the IR group than in the CR group (47.3% vs. 32.9%, log-rank p = 0.025), driven by CV mortality (23.6% vs. 12.9%, log-rank p = 0.047), as there was no difference in ischemia-driven rehospitalization rate (log-rank p = 0.206). Ischemia-driven rehospitalization did not influence CV mortality in the CR group (p = 0.49), while it significantly impacted CV mortality in the IR group (p = 0.03). After adjusting for confounders, there were no differences in CV mortality between CR and IR groups (p = 0.622). Predictors of the combined endpoint included age (p = 0.014), diabetes (p = 0.006), chronic kidney disease (CKD) (p = 0.001), cardiogenic shock at presentation (p = 0.003), chronic total occlusion (CTO) (p = 0.046), and ischemia-driven rehospitalization (p = 0.0001). Significant risk factors for the combined endpoint were cardiogenic shock at presentation (p < 0.001), stage 4 kidney failure (p = 0.001), age over 70 years (p = 0.004), female gender (p = 0.008), and residual SYNTAX I score > 5.5 (p = 0.017). Conclusions: Patients with STEMI and MVD who underwent CR had a lower combined endpoint of ischemia-driven rehospitalizations and CV mortality than IR patients, but after adjustments for confounders, the true determinants of the combined endpoint and risk factors for the combined endpoint were independent of the revascularization method. FAU - Sustersic, Miha AU - Sustersic M AD - Department of Cardiology, University Medical Centre Ljubljana, Zaloska 7, 1000 Ljubljana, Slovenia. FAU - Bunc, Matjaz AU - Bunc M AUID- ORCID: 0000-0001-7269-8944 AD - Department of Cardiology, University Medical Centre Ljubljana, Zaloska 7, 1000 Ljubljana, Slovenia. AD - Institute of Pathological Physiology, Medical Faculty, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia. LA - eng PT - Journal Article DEP - 20250707 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC12250939 OTO - NOTNLM OT - ST-elevation myocardial infarction OT - cardiovascular mortality OT - complete percutaneous revascularization OT - ischemia-driven rehospitalization OT - multivessel coronary artery disease COIS- The authors declare no conflicts of interest. EDAT- 2025/07/13 03:36 MHDA- 2025/07/13 03:37 PMCR- 2025/07/07 CRDT- 2025/07/12 01:16 PHST- 2025/04/02 00:00 [received] PHST- 2025/06/10 00:00 [revised] PHST- 2025/06/13 00:00 [accepted] PHST- 2025/07/13 03:37 [medline] PHST- 2025/07/13 03:36 [pubmed] PHST- 2025/07/12 01:16 [entrez] PHST- 2025/07/07 00:00 [pmc-release] AID - jcm14134793 [pii] AID - jcm-14-04793 [pii] AID - 10.3390/jcm14134793 [doi] PST - epublish SO - J Clin Med. 2025 Jul 7;14(13):4793. doi: 10.3390/jcm14134793. PMID- 40600268 OWN - NLM STAT- MEDLINE DCOM- 20250905 LR - 20260818 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 106 IP - 3 DP - 2025 Sep TI - Coronary Rotational Atherectomy Elective Versus Bailout in Patients With Severely Calcified Lesions and Chronic Renal Failure (CRATER) Trial. PG - 1702-1712 LID - 10.1002/ccd.31730 [doi] AB - BACKGROUND: Plaque modification is crucial for successful stent expansion in calcified coronary lesions. Although rotational atherectomy (RA) improves initial procedural success compared to balloon predilatation, data comparing elective versus bailout RA, particularly in chronic kidney disease (CKD) patients, are scarce. AIMS: To perform a cost analysis of elective RA (E-RA) versus bailout RA (B-RA) to treat severely calcified lesions in patients with CKD, comparing procedural material cost and total healthcare cost. METHODS: This prospective, multicentre, randomized study compared the costs, safety, and efficacy of E-RA versus B-RA in severely calcified lesions in CKD patients. Participants were randomized 1:1. The primary endpoint was total healthcare cost at 30 days; secondary endpoints included procedural success, stent expansion, and in-hospital complications. RESULTS: One hundred and twenty-four patients were enrolled (62 per group). The mean age was 77.3 +/- 8.3 years; 69.4% were male. There were no baseline clinical differences between both treatment arms. Procedural success was similar (B-RA: 95.2% vs. E-RA: 93.6%; p = 0.69), but crossover was higher in B-RA (20.9% vs. 4.8%; p = 0.014). Procedural complications were more frequent in the elective group (6.5% vs. 22.5%; p = 0.04). The B-RA group tended to higher balloon cost (2100.3 vs. 1485.1euro; p = 0.06), while E-RA had higher burr costs (374.2 vs. 1408.8euro; p < 0.01) and tended toward higher stent costs (2396.7 vs. 2836.1euro; p = 0.06). Overall, procedural material costs were higher in E-RA (6676.9 vs. 7683.3euro; p = 0.02), but total healthcare costs were not significantly different (12569.1 vs. 14879.1euro; p = 0.09). CONCLUSIONS: Total healthcare costs were comparable between B-RA and E-RA. A substantial number of patients with CKD and severe CAC required crossover from B-RA, highlighting the potential benefit of E-RA. Besides, the high number of complications underscores the need for expert operators. CI - (c) 2025 Wiley Periodicals LLC. FAU - Galeote, Guillermo AU - Galeote G AD - Cardiology Department, La Paz University Hospital, Madrid, Spain. AD - Fundacion de Investigacion IDIPAZ, Centro de Investigacion Biomedica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain. FAU - Zubiaur, Jon AU - Zubiaur J AUID- ORCID: 0000-0003-4744-4306 AD - Cardiology Department, La Paz University Hospital, Madrid, Spain. AD - Fundacion de Investigacion IDIPAZ, Centro de Investigacion Biomedica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain. FAU - Jurado-Roman, Alfonso AU - Jurado-Roman A AUID- ORCID: 0000-0001-6362-7618 AD - Cardiology Department, La Paz University Hospital, Madrid, Spain. AD - Fundacion de Investigacion IDIPAZ, Centro de Investigacion Biomedica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain. FAU - Fernandez-Portales, Javier AU - Fernandez-Portales J AUID- ORCID: 0000-0003-3193-0035 AD - Cardiology Department, San Pedro de Alcantara Hospital, Caceres, Spain. FAU - Romani, Sebastian AU - Romani S AUID- ORCID: 0009-0003-4563-0209 AD - Cardiology Department, Clinico San Carlos University Hospital, Madrid, Spain. FAU - Salinas, Pablo AU - Salinas P AUID- ORCID: 0000-0003-4040-4029 AD - Cardiology Department, Clinico San Carlos University Hospital, Madrid, Spain. FAU - Garcia-Tejada, Julio AU - Garcia-Tejada J AD - Cardiology Department, October Twelve University Hospital, Madrid, Spain. FAU - Subinas, Asier AU - Subinas A AD - Cardiology Department, Galdakao-Usansolo University Hospital, Basque country, Spain. FAU - Rodriguez, Marcos AU - Rodriguez M AD - Cardiology Department, Nuestra Senora de Candelaria University Hospital, Canary Islands, Spain. FAU - Palazuelos-Molinero, Jorge AU - Palazuelos-Molinero J AUID- ORCID: 0000-0003-2864-9832 AD - Cardiology Department, La Luz University Hospital, Madrid, Spain. FAU - Flores, Xacobe AU - Flores X AD - Cardiology Department, University Hospital Complex of A Coruna, Galicia, Spain. FAU - Lopez, Manuel AU - Lopez M AD - Cardiology Department, Clinico San Cecilio University Hospital, Granada, Spain. FAU - Planas, Ana AU - Planas A AD - Cardiology Department, General University Hospital of Castellon, Castellon, Spain. FAU - Arroyo, Eduardo AU - Arroyo E AUID- ORCID: 0000-0002-0695-9381 AD - Cardiology Department, Hospital Universitario de Torrevieja, Alicante, Spain. FAU - Bastos, Guillermo AU - Bastos G AUID- ORCID: 0000-0002-0882-2573 AD - Cardiology Department, University Hospital Complex of Vigo, Galicia, Spain. FAU - Vera-Vera, Silvio AU - Vera-Vera S AD - Cardiology Department, La Paz University Hospital, Madrid, Spain. AD - Fundacion de Investigacion IDIPAZ, Centro de Investigacion Biomedica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain. FAU - Jimenez-Valero, Santiago AU - Jimenez-Valero S AD - Cardiology Department, La Paz University Hospital, Madrid, Spain. AD - Fundacion de Investigacion IDIPAZ, Centro de Investigacion Biomedica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain. FAU - Rivero Santana, Borja AU - Rivero Santana B AD - Cardiology Department, La Paz University Hospital, Madrid, Spain. AD - Fundacion de Investigacion IDIPAZ, Centro de Investigacion Biomedica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain. FAU - Tebar, Daniel AU - Tebar D AD - Cardiology Department, La Paz University Hospital, Madrid, Spain. AD - Fundacion de Investigacion IDIPAZ, Centro de Investigacion Biomedica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain. FAU - Gonzalvez, Ariana AU - Gonzalvez A AUID- ORCID: 0000-0001-5200-4650 AD - Cardiology Department, La Paz University Hospital, Madrid, Spain. AD - Fundacion de Investigacion IDIPAZ, Centro de Investigacion Biomedica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain. FAU - Moreno, Raul AU - Moreno R AD - Cardiology Department, La Paz University Hospital, Madrid, Spain. AD - Fundacion de Investigacion IDIPAZ, Centro de Investigacion Biomedica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain. LA - eng SI - ClinicalTrials.gov/NCT05353946 GR - The CRATER trial was supported by a nonrestricted grant from Boston Scientific. The Spanish Society of Cardiology was the promoter of the study./ PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20250702 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Humans MH - Male MH - *Atherectomy, Coronary/economics/adverse effects/methods MH - Female MH - Aged MH - *Coronary Artery Disease/economics/diagnostic imaging/therapy/complications MH - *Vascular Calcification/economics/diagnostic imaging/therapy MH - Treatment Outcome MH - Prospective Studies MH - Severity of Illness Index MH - Aged, 80 and over MH - Time Factors MH - Hospital Costs MH - Cost-Benefit Analysis MH - Elective Surgical Procedures MH - *Kidney Failure, Chronic/diagnosis/complications/economics MH - Risk Factors MH - Stents/economics MH - *Renal Insufficiency, Chronic/diagnosis/complications/economics OTO - NOTNLM OT - chronic kidney disease OT - intravascular ultrasound OT - percutaneous coronary intervention OT - rotational atherectomy OT - severely calcified coronary lesions EDAT- 2025/07/02 06:29 MHDA- 2025/09/05 12:40 CRDT- 2025/07/02 05:32 PHST- 2025/06/11 00:00 [revised] PHST- 2025/06/01 00:00 [received] PHST- 2025/06/20 00:00 [accepted] PHST- 2025/09/05 12:40 [medline] PHST- 2025/07/02 06:29 [pubmed] PHST- 2025/07/02 05:32 [entrez] AID - 10.1002/ccd.31730 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2025 Sep;106(3):1702-1712. doi: 10.1002/ccd.31730. Epub 2025 Jul 2. PMID- 40541479 OWN - NLM STAT- MEDLINE DCOM- 20251212 LR - 20260521 IS - 1878-0938 (Electronic) IS - 1878-0938 (Linking) VI - 81 DP - 2025 Dec TI - Novel risk score for patients undergoing Impella-assisted high-risk percutaneous coronary intervention. PG - 86-94 LID - S1553-8389(25)00284-2 [pii] LID - 10.1016/j.carrev.2025.05.031 [doi] AB - BACKGROUND: High-risk percutaneous coronary intervention (HRPCI) procedures supported by percutaneous left ventricular assist devices (pLVAD) are increasingly common, but existing PCI risk scores were developed in patients across the risk spectrum, including few pLVAD-assisted patients. OBJECTIVES: Assess the performance of existing PCI risk scores in patients receiving pLVAD-assisted HRPCI and create a novel risk score specific to this group. METHODS: Patients in the PROTECT III multicenter, observational (46 US centers) study undergoing pLVAD-assisted HRPCI were assessed. The National Cardiovascular Data Registry (NCDR) bedside risk score and the Complex High-Risk Indicated PCI (CHIP-PCI) risk score were calculated for each patient, and their accuracy in predicting in-hospital events was assessed. A novel risk score for in-hospital mortality was created using pre-procedural variables which were significant in univariable and multivariable regressions. RESULTS: Among 1237 patients, the NCDR bedside risk score showed modest discrimination (C-index 0.71) but poor goodness of fit (R(2) = 0.30). The CHIP-PCI score had poor discrimination (C-index 0.61) and reasonable goodness of fit (R(2) = 0.62). Five independent predictors of in-hospital mortality were identified: age >80 years, eGFR <30, left main disease, acute myocardial infarction, and left ventricular ejection fraction <30 %. These formed the "HRPCI" risk score (C-index 0.75), which correlated with 30-day mortality (5.4 % vs. 17.0 %, p<0.0001). CONCLUSIONS: Existing PCI risk scores perform poorly in patients undergoing pLVAD-assisted HRPCI. A novel easily, calculable HRPCI risk score can assist in clinical decision making once validated. CLINICAL TRIAL INFORMATION: Trial Name: The Global cVAD Study (cVAD). URL: https://clinicaltrials.gov/ct2/show/NCT04136392?term=cvad&draw=2&rank=2 ClinicalTrial.gov Identifier: NCT04136392. CI - Copyright (c) 2025. Published by Elsevier Inc. FAU - Lemor, Alejandro AU - Lemor A AD - Department of Cardiology, University of Mississippi Medical Center, Jackson, MS, USA. FAU - Shah, Tayyab AU - Shah T AD - Division of Cardiovascular Medicine, Penn Medicine: University of Pennsylvania Health System, Philadelphia, PA, USA; Division of Cardiology, Yale School of Medicine, New Haven, CT, USA. FAU - Thompson, Julia B AU - Thompson JB AD - Clinical Trials Center, Cardiovascular Research Foundation, NY, New York, USA. FAU - Protty, Majd B AU - Protty MB AD - Systems Immunity University Research Institute, Cardiff University, Cardiff, UK. FAU - Mamas, Mamas A AU - Mamas MA AD - National Institute for Health Research School for Primary Care Research, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele University, Keele, UK; Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, UK. FAU - Kinnaird, Tim AU - Kinnaird T AD - Department of Cardiology, University Hospital of Wales, Cardiff, UK. FAU - Bharadwaj, Aditya S AU - Bharadwaj AS AD - Division of Cardiology, Loma Linda University Medical Center, Loma Linda, CA, USA. FAU - Truesdell, Alexander G AU - Truesdell AG AD - Virginia Heart / Inova Schar Heart and Vascular, Falls Church, VA, USA. FAU - Schonning, Michael J AU - Schonning MJ AD - Clinical Trials Center, Cardiovascular Research Foundation, NY, New York, USA. FAU - Zhang, Yiran AU - Zhang Y AD - Clinical Trials Center, Cardiovascular Research Foundation, NY, New York, USA. FAU - Hussain, Yasin AU - Hussain Y AD - Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA; Veterans Affairs Connecticut Healthcare System, West Haven, CA, USA. FAU - Falah, Batla AU - Falah B AD - Clinical Trials Center, Cardiovascular Research Foundation, NY, New York, USA. FAU - Cohen, David J AU - Cohen DJ AD - Clinical Trials Center, Cardiovascular Research Foundation, NY, New York, USA; Department of Cardiology, St. Francis Hospital, Roslyn, NY, USA. FAU - Redfors, Bjorn AU - Redfors B AD - Clinical Trials Center, Cardiovascular Research Foundation, NY, New York, USA; Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA; Department of Molecular and Clinical Medicine, Gothenburg University, Gothenburg, Sweden; Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden. FAU - Baron, Suzanne J AU - Baron SJ AD - Massachusetts General Hospital, Boston, MA, USA; Baim Institute for Clinical Research, Boston, MA, USA. FAU - Witzke, Christian F AU - Witzke CF AD - Department of Medicine, Jefferson Einstein Hospital, Philadelphia, PA, USA; Department of Cardiology, Jefferson Einstein Hospital, Philadelphia, PA, USA. FAU - Dixon, Simon R AU - Dixon SR AD - Department of Cardiovascular Medicine, William Beaumont University Hospital, Royal Oak, MI, USA. FAU - Basir, Mir B AU - Basir MB AD - Center for Structural Heart Disease, Division of Cardiology, Henry Ford Health System, Detroit, MI, USA. FAU - Lansky, Alexandra J AU - Lansky AJ AD - Division of Cardiology, Yale School of Medicine, New Haven, CT, USA; Barts Heart Centre, London and Queen Mary University of London, London, United Kingdom. FAU - O'Neill, William W AU - O'Neill WW AD - Center for Structural Heart Disease, Division of Cardiology, Henry Ford Health System, Detroit, MI, USA. Electronic address: woneill1@hfhs.org. LA - eng SI - ClinicalTrials.gov/NCT04136392 PT - Journal Article PT - Multicenter Study PT - Observational Study PT - Research Support, Non-U.S. Gov't DEP - 20250530 PL - United States TA - Cardiovasc Revasc Med JT - Cardiovascular revascularization medicine : including molecular interventions JID - 101238551 SB - IM MH - Humans MH - *Heart-Assist Devices MH - *Percutaneous Coronary Intervention/adverse effects/mortality MH - Risk Assessment MH - Male MH - Female MH - Aged MH - Middle Aged MH - Hospital Mortality MH - United States MH - *Ventricular Function, Left MH - Treatment Outcome MH - Predictive Value of Tests MH - Registries MH - *Decision Support Techniques MH - Risk Factors MH - Time Factors MH - *Coronary Artery Disease/mortality/therapy/physiopathology/diagnostic imaging MH - *Heart Failure/mortality/therapy/physiopathology/diagnosis MH - *Prosthesis Implantation/instrumentation/adverse effects/mortality MH - Clinical Decision-Making OTO - NOTNLM OT - CHIP risk score OT - HRPCI risk score OT - High-risk percutaneous coronary intervention OT - In hospital mortality OT - NCDR risk score COIS- Declaration of competing interest Dr. Lemor reports speaker fees from Abiomed. Dr. Shah has received speaking honorariums from Abiomed. Dr. Mamas reports holding unrestricted educational grants from Boston Scientific, Terumo, and Abbott. Dr. Bharadwaj reports consulting and speaker fees from Abiomed, Shockwave Medical, and Cardiovascular Systems, Inc. Dr. Truesdell reports speaking/consultant fees from Abiomed, Getinge, Shockwave, Zoll. Dr. Cohen has received research grant support from Edwards Lifesciences, Abbott, Boston Scientific, Corvia Medical, Philips, Brain-Q, Saranas, Zoll Medical, CathWorks, and ANCORA, and has received consultant fees from Medtronic, Edwards Lifesciences, Abbott, AngioInsight, and HeartBeam. Dr. Redfors has received consultant fees from Pfizer and Boehringer Ingelheim. Dr. Baron reports receiving institutional research support from Boston Scientific Corporation, Acarix and Abiomed; speaker fees from Medtronic, Edwards LifeSciences, Shockwave and Zoll Medical; and consulting fees/advisory board membership from Medtronic, Boston Scientific Corporation, Zoll Medical and Abiomed. All other coauthors have no other relevant disclosures. Dr. Basir reports consultant fees from Abiomed, Boston Scientific, Chiesi, Saranas and Zoll. Dr. Lansky has received speaker fees from Keystone Heart. Dr. O'Neill reports grant/research support from St. Jude Medical, Edwards Life Sciences, and Biomed; consulting fees/honoraria from Medtronic and Abiomed; and major stock shareholder/equity in Synecor, Accumed, Neovasc, Tendyne, and Mitral Align. All other coauthors have no other relevant disclosures. EDAT- 2025/06/21 00:32 MHDA- 2025/12/13 00:32 CRDT- 2025/06/20 21:52 PHST- 2025/03/18 00:00 [received] PHST- 2025/05/28 00:00 [revised] PHST- 2025/05/29 00:00 [accepted] PHST- 2025/12/13 00:32 [medline] PHST- 2025/06/21 00:32 [pubmed] PHST- 2025/06/20 21:52 [entrez] AID - S1553-8389(25)00284-2 [pii] AID - 10.1016/j.carrev.2025.05.031 [doi] PST - ppublish SO - Cardiovasc Revasc Med. 2025 Dec;81:86-94. doi: 10.1016/j.carrev.2025.05.031. Epub 2025 May 30. PMID- 40535226 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20260813 IS - 0970-9134 (Print) IS - 0973-7723 (Electronic) IS - 0970-9134 (Linking) VI - 41 IP - 7 DP - 2025 Jul TI - Short-term outcomes of off-pump vs. on-pump coronary artery bypass grafting in left main coronary artery disease: a systematic review and meta-analysis. PG - 852-862 LID - 10.1007/s12055-025-01907-w [doi] AB - BACKGROUND: The efficacy and safety of off-pump relative to on-pump coronary artery bypass grafting (CABG) in patients with left main coronary artery disease (LMCAD) remain unclear. OBJECTIVES: Conduct a meta-analysis assessing the outcomes following CABG comparing off-pump CABG vs. on-pump CABG. METHODS: MEDLINE, Cochrane, and Embase were examined for randomized controlled trials (RCTs) and observational studies that communicated outcomes after off-pump vs. on-pump CABG in patients with LMCAD. Odds ratios (OR) with 95% confidence intervals (CI) were pooled with a random-effects model. Cochrane recommendations for quality assessment and risk of bias were performed. This study was registered in the PROSPERO platform, ID: CRD42023451467. RESULTS: One RCT and 17 observational studies with 16,848 patients were included, 6735 (40.0%) of whom underwent off-pump CABG. In patients with LMCAD undergoing CABG, off-pump CABG was associated with a lower incidence of all-cause mortality (OR 0.52, 95% CI 0.38-0.71; p < 0.001), acute renal dysfunction (OR 0.40; 95% CI 0.27-0.59; p < 0.001), postoperative use of intra-aortic balloon pump (IABP) (OR 0.38; 95% CI 0.22-0.64; p < 0.01), and wound infection (OR 0.66; 95% CI 0.48-0.9; p = 0.01). There was no difference between the groups for myocardial infarction (OR 0.81; 95% CI 0.59-1.11; p = 0.193), stroke, or transitional ischemic attack (TIA) (OR 0.64; 95% CI 0.38-1.06; p = 0.085). The number of grafts per patient was also lower in the off-pump CABG group (mean deviation (MD) -0.32; 95% CI -0.50 to -0.14; p < 0.001). After a mean follow-up of 38.1 months, no significant difference in all-cause mortality incidence was observed between the two techniques (OR 0.72; 95% CI 0.30-1.74; p = 0.47). This underscores that the reduction in mortality rates was primarily driven by short-term outcomes. CONCLUSION: In this meta-analysis with 16,848 patients with LMCAD undergoing CABG, off-pump CABG was associated with lower rates of all-cause mortality, acute renal dysfunction, IABP use, and wound infection compared with on-pump CABG. GRAPHICAL ABSTRACT: On-pump versus off-pump CABG in patients with LMCAD. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12055-025-01907-w. CI - (c) Indian Association of Cardiovascular-Thoracic Surgeons 2025. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. FAU - Pansani, Lucas Nogueira AU - Pansani LN AUID- ORCID: 0009-0001-4499-3441 AD - Department of Cardiovascular Surgery of Funfarme/Famerp, Avenue Brigadeiro Faria Lima, Sao Jose do Rio Preto, SP Postal Code 15090-000 Brazil. FAU - de Paula Carvalho, Pedro Emanuel AU - de Paula Carvalho PE AD - Department of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil. ROR: https://ror.org/0176yjw32. GRID: grid.8430.f. ISNI: 0000 0001 2181 4888 FAU - Gewehr, Douglas AU - Gewehr D AD - Curitiba Heart Institute, Curitiba, Brazil. FAU - Taramasso, Maurizio AU - Taramasso M AD - Heart Center Hirslanden Hirslanden, Zurich, Switzerland. FAU - Burkhardt, Giullia AU - Burkhardt G AD - Department of Medicine, Petropolis Medical School, Petropolis, Brazil. FAU - Almeidinha, Lara AU - Almeidinha L AD - Department of Internal Medicine, General Hospital Rochester, Rochester, USA. ROR: https://ror.org/01jk6xr82. GRID: grid.416016.4. ISNI: 0000 0004 0456 3003 FAU - Ayala, Rafael AU - Ayala R AD - Department of Cardiovascular Surgery, Robert Bosch Hospital, Stuttgart, Germany. ROR: https://ror.org/034nkkr84. GRID: grid.416008.b. ISNI: 0000 0004 0603 4965 FAU - Grapow, Martin Tobias Robert AU - Grapow MTR AD - Heart Center Hirslanden Hirslanden, Zurich, Switzerland. LA - eng PT - Journal Article DEP - 20250306 PL - India TA - Indian J Thorac Cardiovasc Surg JT - Indian journal of thoracic and cardiovascular surgery JID - 8700105 PMC - PMC12170468 OTO - NOTNLM OT - Cardiopulmonary bypass surgery OT - Left main coronary artery disease OT - Off-pump coronary artery bypass graft surgery OT - On-pump coronary artery bypass graft surgery COIS- Conflict of interest All authors declare that they have no conflicts of interest. They are responsible for ensuring the data's reliability and unbiased interpretation. All authors declare no relationships that could be perceived as a conflict of interest. All authors report no relationships that could be construed as a conflict of interest. All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation. EDAT- 2025/06/19 07:53 MHDA- 2025/06/19 07:54 PMCR- 2026/07/01 CRDT- 2025/06/19 05:22 PHST- 2024/04/03 00:00 [received] PHST- 2024/12/28 00:00 [revised] PHST- 2025/01/13 00:00 [accepted] PHST- 2025/06/19 07:54 [medline] PHST- 2025/06/19 07:53 [pubmed] PHST- 2025/06/19 05:22 [entrez] PHST- 2026/07/01 00:00 [pmc-release] AID - 1907 [pii] AID - 10.1007/s12055-025-01907-w [doi] PST - ppublish SO - Indian J Thorac Cardiovasc Surg. 2025 Jul;41(7):852-862. doi: 10.1007/s12055-025-01907-w. Epub 2025 Mar 6. PMID- 40480618 OWN - NLM STAT- MEDLINE DCOM- 20250918 LR - 20260422 IS - 1097-6809 (Electronic) IS - 0741-5214 (Linking) VI - 82 IP - 4 DP - 2025 Oct TI - Validation of BASIL-2 among patients undergoing primary bypass or angioplasty with or without stenting for chronic limb-threatening ischemia. PG - 1334-1342.e2 LID - S0741-5214(25)01036-5 [pii] LID - 10.1016/j.jvs.2025.05.009 [doi] AB - OBJECTIVE: BASIL-2 demonstrated the superiority of an endovascular-first approach in patients with chronic limb-threatening ischemia (CLTI) for the primary endpoint of amputation-free survival (AFS); however, the generalizability of these data are unknown. Thus, we aimed to externally validate these findings by comparing open surgical bypass (BPG) to angioplasty +/- stenting (PTA/S), using the BASIL-2 inclusion and randomization criteria. METHODS: All patients undergoing a first-time lower extremity infrapopliteal revascularization for CLTI at our institution from 2005 to 2022 were retrospectively reviewed. To approximate BASIL-2, one-to-one propensity matching was performed. The primary outcome was AFS; secondary outcomes included perioperative complications, major reintervention, major amputation, and major adverse limb events (MALE). A sensitivity analysis was performed assessing the same PTA/S cohort vs BPG with only single-segment great saphenous vein (ssGSV) conduits. Outcomes in the matched cohorts were evaluated using chi(2), Kaplan-Meier, and Cox regression analyses. RESULTS: Of 1184 limbs undergoing a first-time infrapopliteal intervention for CLTI between 2005 and 2022, 490 underwent BPG, and 694 underwent PTA/S. After matching, 620 patients (310 BPG and 310 PTA/S) fit our criteria, with no baseline differences noted between groups. Between BPG and PTA/S, the mean age was 71.0 years in both groups, with similar rates of male sex (64% vs 66%), White race (74% vs 75%), coronary artery disease (49% vs 52%), diabetes (75% vs 77%), chronic kidney disease (27% vs 34%), dialysis dependence (17% vs 19%), and smoking history (65% vs 66%). There were no differences in perioperative mortality (4.5% vs 3.9%), stroke (1.0% vs 0.0%), myocardial infarction (2.9% vs 1.3%), or acute kidney injury (12% vs 16%) (all P > .05). BPG, as compared with PTA/S, did not demonstrate any difference in AFS (at 5 years, 36% vs 39%), major reintervention (15% vs 19%), major amputation (24% vs 22%), or MALE (32% vs 36%) (all P > .05). When limiting the BPG group to only ssGSV conduits (n = 267), despite no difference seen in AFS (32% vs 36%), we noted significantly lower rates of major reintervention (12% vs 19%) and MALE (29% vs 36%), demonstrating a 48% and 30% risk reduction, respectively (hazard ratio, 0.52; 95% confidence interval, 0.30-0.89 and 0.69; 95% confidence interval, 0.49-0.98). CONCLUSIONS: Among patients undergoing infrapopliteal revascularization for CLTI, BPG and PTA/S do not differ in regard to AFS, raising concerns regarding the generalizability of BASIL-2. Importantly, infrapopliteal interventions following ssGSV BPG, as compared with PTA/S, do demonstrate significantly lower rates of major reintervention and MALE, reinforcing the benefits of this conduit in patients with CLTI. CI - Copyright (c) 2025. Published by Elsevier Inc. FAU - Darling, Jeremy D AU - Darling JD AD - Division of Vascular and Endovascular Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. FAU - Guetter, Camila R AU - Guetter CR AD - Division of Vascular and Endovascular Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. FAU - Caron, Elisa AU - Caron E AD - Division of Vascular and Endovascular Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. FAU - van Galen, Isa AU - van Galen I AD - Division of Vascular and Endovascular Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. FAU - Park, Jemin AU - Park J AD - Division of Vascular and Endovascular Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. FAU - Marcaccio, Christina AU - Marcaccio C AD - Division of Vascular and Endovascular Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. FAU - Liang, Patric AU - Liang P AD - Division of Vascular and Endovascular Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. FAU - Lee, Andy AU - Lee A AD - Division of Vascular and Endovascular Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. FAU - Wyers, Mark C AU - Wyers MC AD - Division of Vascular and Endovascular Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. FAU - Hamdan, Allen D AU - Hamdan AD AD - Division of Vascular and Endovascular Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. FAU - Schermerhorn, Marc L AU - Schermerhorn ML AD - Division of Vascular and Endovascular Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. FAU - Stangenberg, Lars AU - Stangenberg L AD - Division of Vascular and Endovascular Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. Electronic address: lstangen@bidmc.harvard.edu. LA - eng PT - Comparative Study PT - Journal Article PT - Validation Study DEP - 20250604 PL - United States TA - J Vasc Surg JT - Journal of vascular surgery JID - 8407742 SB - IM MH - Humans MH - Male MH - Female MH - Retrospective Studies MH - Aged MH - Limb Salvage MH - Amputation, Surgical MH - *Peripheral Arterial Disease/mortality/therapy/physiopathology/surgery/diagnostic imaging MH - *Stents MH - Middle Aged MH - *Ischemia/mortality/surgery/physiopathology/diagnostic imaging/therapy MH - Risk Factors MH - Time Factors MH - *Angioplasty/adverse effects/instrumentation/mortality MH - Risk Assessment MH - Aged, 80 and over MH - Treatment Outcome MH - *Chronic Limb-Threatening Ischemia/mortality/surgery/therapy/diagnostic imaging MH - *Vascular Grafting/adverse effects/mortality MH - Saphenous Vein/transplantation MH - *Lower Extremity/blood supply MH - Postoperative Complications/etiology OTO - NOTNLM OT - Angioplasty OT - BASIL-2 OT - Bypass OT - CLTI OT - Outcome research OT - Peripheral arterial disease COIS- Disclosures None. EDAT- 2025/06/07 16:44 MHDA- 2025/09/19 00:36 CRDT- 2025/06/06 19:42 PHST- 2025/04/07 00:00 [received] PHST- 2025/05/06 00:00 [revised] PHST- 2025/05/06 00:00 [accepted] PHST- 2025/09/19 00:36 [medline] PHST- 2025/06/07 16:44 [pubmed] PHST- 2025/06/06 19:42 [entrez] AID - S0741-5214(25)01036-5 [pii] AID - 10.1016/j.jvs.2025.05.009 [doi] PST - ppublish SO - J Vasc Surg. 2025 Oct;82(4):1334-1342.e2. doi: 10.1016/j.jvs.2025.05.009. Epub 2025 Jun 4. PMID- 40464262 OWN - NLM STAT- MEDLINE DCOM- 20250717 LR - 20250719 IS - 1525-1594 (Electronic) IS - 0160-564X (Print) IS - 0160-564X (Linking) VI - 49 IP - 8 DP - 2025 Aug TI - Coronary Artery Bypass Grafting on Microaxial Flow Pump Support in Patients With Severely Reduced Left Ventricular Ejection Fraction. PG - 1346-1355 LID - 10.1111/aor.15038 [doi] AB - INTRODUCTION: Patients with coronary artery disease (CAD) and severely reduced left ventricular ejection fraction (LVEF) face high perioperative risks during surgical revascularization. This case series examines outcomes in CAD patients with LVEF 270 degrees visualization along > 70% of the lesion's length, as evaluated by an independent core laboratory). A total of 632 patients (mean age: 68.4 years; 80.2% male) were enrolled in the study. OCT-guided PCI was performed in 503 patients, whereas OCT guidance was avoided in 129 patients for patient's condition. Successful image acquisition was achieved in all but seven patients who underwent OCT. The primary endpoint was achieved in 78.5% (496/632) of patients. No procedural complications were associated with OCT. Patients with left main disease (adjusted odds ratio, 4.1; 95% confidence interval, 1.2-14.7; p = 0.024), estimated glomerular filtration rate (mL/min/1.73 m(2)) < 30 (3.7; 1.6-8.3; p = 0.002), and Killip IV (2.5; 1.3-4.6; p = 0.003) were significantly avoided for OCT guidance. OCT guidance was feasible in four-fifths of all-comers with STEMI. Further studies are warranted to evaluate the efficacy of OCT-guided PCI in selected patient populations based on the findings of this trial (UMIN000048590). CI - (c) 2025. The Author(s) under exclusive licence to Japanese Association of Cardiovascular Intervention and Therapeutics. FAU - Wakabayashi, Kohei AU - Wakabayashi K AD - Division of Cardiology, Cardiovascular Center, Showa University Koto-Toyosu Hospital, Tokyo, Japan. FAU - Yonetsu, Taishi AU - Yonetsu T AD - Department of Cardiovascular Medicine, Institute of Science Tokyo, Tokyo, Japan. FAU - Mizukami, Takuya AU - Mizukami T AD - Division of Clinical Pharmacology, Department of Pharmacology, Showa University School of Medicine, Tokyo, Japan. FAU - Yamamoto, Myong Hwa AU - Yamamoto MH AD - Clinical Research Institute for Clinical Pharmacology and Therapeutics, Showa University School of Medicine, Tokyo, Japan. FAU - Yasuhara, Sakiko AU - Yasuhara S AD - Division of Clinical Pharmacology, Department of Pharmacology, Showa University School of Medicine, Tokyo, Japan. FAU - Shishido, Koki AU - Shishido K AD - Division of Cardiology, Cardiovascular Center, Shonan Kamakura General Hospital, Kamakura, Japan. FAU - Saito, Shigeru AU - Saito S AD - Division of Cardiology, Cardiovascular Center, Shonan Kamakura General Hospital, Kamakura, Japan. FAU - Kobayashi, Nobuaki AU - Kobayashi N AD - Department of Cardiology, Nippon Medical School Chiba Hokusoh Hospital, Inzai, Japan. FAU - Takano, Masamichi AU - Takano M AD - Department of Cardiology, Nippon Medical School Chiba Hokusoh Hospital, Inzai, Japan. FAU - Usui, Eisuke AU - Usui E AD - Division of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Tsuchiura, Japan. FAU - Kakuta, Tsunekazu AU - Kakuta T AD - Division of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Tsuchiura, Japan. FAU - Oishi, Yosuke AU - Oishi Y AD - Division of Cardiology, Department of Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan. FAU - Kondo, Seita AU - Kondo S AD - Division of Cardiology, Department of Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan. FAU - Nishikura, Tenjin AU - Nishikura T AD - Division of Cardiology, Cardiovascular Center, Showa University Koto-Toyosu Hospital, Tokyo, Japan. FAU - Minami, Yoshiyasu AU - Minami Y AD - Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan. FAU - Ako, Junya AU - Ako J AD - Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan. FAU - Okabe, Toshitaka AU - Okabe T AD - Division of Cardiology, Showa University Northern Yokohama Hospital, Yokohama, Japan. FAU - Naganuma, Toru AU - Naganuma T AD - Department of Cardiology, New Tokyo Hospital, Matsudo, Japan. FAU - Mitomo, Satoru AU - Mitomo S AD - Division of Cardiology, Cardiovascular Center, Kawasaki Saiwai Hospital, Kawasaki, Japan. FAU - Nakamura, Sunao AU - Nakamura S AD - Division of Cardiology, Cardiovascular Center, Kawasaki Saiwai Hospital, Kawasaki, Japan. FAU - Higuma, Takumi AU - Higuma T AD - Division of Cardiology, Department of Internal Medicine, Kawasaki Municipal Tama Hospital, Kawasaki, Japan. FAU - Shite, Junya AU - Shite J AD - Division of Cardiology, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan. FAU - Kozuki, Amane AU - Kozuki A AD - Division of Cardiology, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan. FAU - Suwa, Satoru AU - Suwa S AD - Department of Cardiology, Juntendo University Shizuoka Hospital, Izunokuni, Japan. FAU - Kume, Teruyoshi AU - Kume T AD - Department of Cardiology, Kawasaki Medical School, Kurashiki, Japan. FAU - Uemura, Shiro AU - Uemura S AD - Department of Cardiology, Kawasaki Medical School, Kurashiki, Japan. FAU - Naruse, Genki AU - Naruse G AD - Department of Cardiology, Gifu University Graduate School of Medicine, Gifu, Japan. FAU - Okura, Hiroyuki AU - Okura H AD - Department of Cardiology, Gifu University Graduate School of Medicine, Gifu, Japan. FAU - Yamakami, Yosuke AU - Yamakami Y AD - Department of Cardiology, Yokohama Minami Kyosai Hospital, Yokohama, Japan. FAU - Fujii, Hiroyuki AU - Fujii H AD - Department of Cardiology, Yokohama Minami Kyosai Hospital, Yokohama, Japan. FAU - Kimura, Shigeki AU - Kimura S AD - Cardiovascular Center, International University of Health and Welfare Mita Hospital, Tokyo, Japan. FAU - Iwasaki, Masamichi AU - Iwasaki M AD - Department of Cardiology, Hyogo Prefectural Awaji Medical Center, Sumoto, Japan. FAU - Araki, Makoto AU - Araki M AD - Department of Cardiovascular Medicine, Institute of Science Tokyo, Tokyo, Japan. FAU - Sugiyama, Tomoyo AU - Sugiyama T AD - Department of Cardiovascular Medicine, Institute of Science Tokyo, Tokyo, Japan. FAU - Nanasato, Mamoru AU - Nanasato M AD - Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan. FAU - Dohi, Tomotaka AU - Dohi T AD - Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan. FAU - Ashikaga, Takashi AU - Ashikaga T AD - Department of Cardiology, Japanese Red Cross Musashino Hospital, Tokyo, Japan. FAU - Mori, Hiroyoshi AU - Mori H AD - Division of Cardiology, Showa University Fujigaoka Hospital, Yokohama, Japan. FAU - Sekimoto, Teruo AU - Sekimoto T AD - CVPath Institute, Inc, Gaithersburg, USA. FAU - Sugizaki, Yoichiro AU - Sugizaki Y AD - Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan. FAU - Otake, Hiromasa AU - Otake H AD - Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan. FAU - Shinke, Toshiro AU - Shinke T AD - Division of Cardiology, Department of Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan. shinke@med.showa-u.ac.jp. CN - ATLAS-OCT Investigators LA - eng PT - Journal Article PT - Multicenter Study PT - Observational Study DEP - 20250530 PL - Japan TA - Cardiovasc Interv Ther JT - Cardiovascular intervention and therapeutics JID - 101522043 SB - IM MH - Aged MH - Female MH - Humans MH - Male MH - Middle Aged MH - *Coronary Vessels/diagnostic imaging/surgery MH - Feasibility Studies MH - *Percutaneous Coronary Intervention/methods MH - Prospective Studies MH - *ST Elevation Myocardial Infarction/surgery/diagnostic imaging MH - *Surgery, Computer-Assisted/methods MH - *Tomography, Optical Coherence/methods OTO - NOTNLM OT - All-comers study OT - Optical coherence tomography OT - Percutaneous coronary intervention OT - ST-segment elevation myocardial infarction COIS- Declarations. Conflict of interest: Dr. Taishi Yonetsu received a research grant from CANON Medical Systems. Dr. Takuya Mizukami received consultancy fees from Zeon Medical Inc., research grants from Boston Scientific, and speaker fees from Abbott Vascular, Cathworks, and Boston Scientific. Dr. Koki Shishido received remuneration for lecture from Abbott Medical Japan LLC. Dr. Yoshiyasu Minami received remuneration for lecture and consultant fee from Abbott Medical Japan LLC. Dr. Takumi Higuma received scholarship funds from Abbott Medical Japan LLC. Dr. Satoru Suwa received personal fees from Abbott Medical Japan and Daiichi Sankyo LLC. Junya Ako received a speaking honorarium from Abbott Medical Japan LLC. Teruyoshi Kume received a speaking honorarium from Abbott Vascular Japan LLC. Dr. Shiro Uemura received a speaking honorarium and research grant from Abbott Vascular Japan LLC. Dr. Hiroyuki Okura received scholarship funds from Abbott Medical Japan LLC. Dr. Mamoru Nanasato received remuneration for lecture from Abbott Medical Japan LLC. Dr. Hiromasa Otake received research grants from Abbott Medical Japan LLC. Dr. Toshiro Shinke received personal fees and research grants from Abbott Medical Japan LLC. The remaining authors have no disclosures to report. EDAT- 2025/05/30 17:56 MHDA- 2025/06/14 17:09 CRDT- 2025/05/30 11:21 PHST- 2025/02/22 00:00 [received] PHST- 2025/04/30 00:00 [accepted] PHST- 2025/06/14 17:09 [medline] PHST- 2025/05/30 17:56 [pubmed] PHST- 2025/05/30 11:21 [entrez] AID - 10.1007/s12928-025-01137-2 [pii] AID - 10.1007/s12928-025-01137-2 [doi] PST - ppublish SO - Cardiovasc Interv Ther. 2025 Jul;40(3):576-587. doi: 10.1007/s12928-025-01137-2. Epub 2025 May 30. PMID- 40401600 OWN - NLM STAT- MEDLINE DCOM- 20250603 LR - 20260824 IS - 2047-9980 (Electronic) IS - 2047-9980 (Linking) VI - 14 IP - 11 DP - 2025 Jun 3 TI - Association of Lipoprotein(a) With Major Adverse Limb Events and All-Cause Mortality Following Revascularization for Chronic Limb-Threatening Ischemia: A Substudy of the BEST-CLI Trial. PG - e041177 LID - 10.1161/JAHA.125.041177 [doi] LID - e041177 AB - BACKGROUND: The BEST-CLI (Best Endovascular Versus Best Surgical Therapy in Patients With Critical Limb Ischemia) trial tested the optimal initial revascularization strategy in patients with chronic limb-threatening ischemia. Little is known about the prognostic relevance of Lp(a) (lipoprotein[a]) and its modification by renal function in patients with chronic limb-threatening ischemia. We investigated the relationship between Lp(a) and prespecified cardiovascular outcomes. METHODS: A subgroup of patients from the BEST-CLI trial (as part of the TIDE [The Impact of Diabetes on Revascularization] study) underwent blinded, core-laboratory assessment of Lp(a) levels and were included in this analysis. The primary end point was major adverse limb events or death from any cause. Secondary end points were the components of the primary end point, major amputation, major reintervention, and major adverse cardiac events (myocardial infarction, ischemic stroke, or death from any cause). The association of Lp(a) with end points was assessed using Cox proportional hazard models adjusting for traditional risk factors and then also for renal function and statin use, which increase Lp(a) levels. RESULTS: A total of 189 patients (median [interquartile range] age 67.3 [61.6-74.1] years) were included and followed for a median of 2.1 (1.2-2.9) years. Median Lp(a) for the total study population was 27.3 (10.4-65.8) mg/dL, and 62 (32.8%) patients had elevated values (>/=50 mg/dL). The 1-year event rate of the primary outcome was 33.3 (95% CI, 23.7-42.8) per 100 person-years. There was no association between Lp(a) and the primary outcome (hazard ratio [HR], 1.00 [95% CI, 0.99-1.00]; P=0.186). In secondary analyses controlling for renal function, elevated Lp(a) was associated with increased risk for all-cause death (HR, 1.03 [95% CI, 1.01-1.05]; P=0.009). Results were similar regardless of peripheral revascularization strategy. CONCLUSIONS: Elevated Lp(a) level was not associated with major adverse limb events or death but was associated with all-cause death after controlling for renal function. Lp(a) may be an important therapeutic target in the patient population with high-risk chronic limb-threatening ischemia. REGISTRATION: https://clinicaltrials.gov/study/NCT03085524; Unique identifier: NCT03085524. FAU - Sullivan, Alexander E AU - Sullivan AE AUID- ORCID: 0000-0002-1755-0055 AD - Division of Cardiovascular Medicine, Department of Medicine Vanderbilt University Medical Center Nashville TN USA. FAU - Huang, Shi AU - Huang S AD - Department of Biostatistics Vanderbilt University School of Medicine Nashville TN USA. FAU - Kundu, Suman AU - Kundu S AUID- ORCID: 0000-0002-6305-2559 AD - Division of Cardiovascular Medicine, Department of Medicine Vanderbilt University Medical Center Nashville TN USA. AD - Vanderbilt Translational and Clinical Cardiovascular Research Center, Division of Cardiovascular Medicine Vanderbilt University Medical Center Nashville TN USA. FAU - Thomas, Victoria E AU - Thomas VE AUID- ORCID: 0000-0001-7814-8361 AD - Division of Cardiovascular Medicine, Department of Medicine Vanderbilt University Medical Center Nashville TN USA. FAU - Clair, Daniel G AU - Clair DG AUID- ORCID: 0000-0002-6269-260X AD - Department of Vascular Surgery Vanderbilt University Medical Center Nashville TN USA. FAU - Aday, Aaron W AU - Aday AW AUID- ORCID: 0000-0001-6243-3432 AD - Division of Cardiovascular Medicine, Department of Medicine Vanderbilt University Medical Center Nashville TN USA. AD - Vanderbilt Translational and Clinical Cardiovascular Research Center, Division of Cardiovascular Medicine Vanderbilt University Medical Center Nashville TN USA. FAU - Menard, Matthew T AU - Menard MT AUID- ORCID: 0000-0003-2470-7978 AD - Division of Vascular and Endovascular Surgery, Brigham and Women's Hospital Harvard Medical School Boston MA USA. FAU - Farber, Alik AU - Farber A AUID- ORCID: 0000-0001-7231-4189 AD - Department of Surgery, Division of Vascular and Endovascular Surgery, Boston Medical Center Boston University Chobanian & Avedisian School of Medicine Boston MA USA. FAU - Rosenfield, Kenneth AU - Rosenfield K AUID- ORCID: 0000-0002-5633-6983 AD - Section of Vascular Medicine and Intervention, Massachusetts General Hospital Harvard Medical School Boston MA USA. FAU - Newman, Jonathan D AU - Newman JD AUID- ORCID: 0000-0001-6855-7305 AD - Department of Medicine NYU Grossman School of Medicine New York NY USA. FAU - Berger, Jeffrey S AU - Berger JS AUID- ORCID: 0000-0001-8216-4647 AD - Department of Medicine NYU Grossman School of Medicine New York NY USA. FAU - Wells, Quinn S AU - Wells QS AUID- ORCID: 0000-0003-3899-0313 AD - Division of Cardiovascular Medicine, Department of Medicine Vanderbilt University Medical Center Nashville TN USA. AD - Vanderbilt Translational and Clinical Cardiovascular Research Center, Division of Cardiovascular Medicine Vanderbilt University Medical Center Nashville TN USA. FAU - Freiberg, Matthew S AU - Freiberg MS AUID- ORCID: 0000-0002-3699-4022 AD - Division of Cardiovascular Medicine, Department of Medicine Vanderbilt University Medical Center Nashville TN USA. AD - Vanderbilt Translational and Clinical Cardiovascular Research Center, Division of Cardiovascular Medicine Vanderbilt University Medical Center Nashville TN USA. FAU - Linton, MacRae F AU - Linton MF AUID- ORCID: 0000-0002-9277-0453 AD - Division of Cardiovascular Medicine, Department of Medicine Vanderbilt University Medical Center Nashville TN USA. FAU - Beckman, Joshua A AU - Beckman JA AUID- ORCID: 0000-0001-8332-8439 AD - Division of Vascular Medicine, Department of Medicine University of Texas Southwestern Dallas TX USA. LA - eng SI - ClinicalTrials.gov/NCT03085524 GR - P01 HL116263/HL/NHLBI NIH HHS/United States GR - R01 HL131977/HL/NHLBI NIH HHS/United States GR - R01 HL165208/HL/NHLBI NIH HHS/United States GR - T32 GM007569/GM/NIGMS NIH HHS/United States PT - Equivalence Trial PT - Journal Article PT - Multicenter Study PT - Pragmatic Clinical Trial PT - Randomized Controlled Trial PT - Research Support, N.I.H., Extramural DEP - 20250522 PL - England TA - J Am Heart Assoc JT - Journal of the American Heart Association JID - 101580524 RN - 0 (Biomarkers) RN - 0 (Lipoprotein(a)) RN - 0 (LPA protein, human) SB - IM MH - Aged MH - Female MH - Humans MH - Male MH - Middle Aged MH - Amputation, Surgical MH - Biomarkers/blood MH - Cause of Death MH - Chronic Disease MH - *Chronic Limb-Threatening Ischemia/mortality/blood/surgery MH - *Endovascular Procedures/adverse effects/mortality MH - *Ischemia/mortality/blood/surgery MH - Limb Salvage MH - *Lipoprotein(a)/blood MH - *Peripheral Arterial Disease/mortality/blood/surgery/therapy/diagnosis MH - Risk Assessment MH - Risk Factors MH - Time Factors MH - Treatment Outcome MH - *Vascular Surgical Procedures/adverse effects/mortality PMC - PMC12229200 OTO - NOTNLM OT - chronic limb-threatening ischemia OT - lipids OT - lipoprotein(a) OT - mortality OT - peripheral artery disease COIS- Dr Aday reports serving on the Clinical Endpoint Committee for Janssen. Dr Farber reports consulting fees from Sanifit, BiogenCell, and Lemaitre and serves on the advisory board for iThera and DialysisX. Dr Linton reports consulting fees from Merck, Amgen, Regenxbio, and Ionis and receives research support from Novartis, Sanofi Aventis, Ionis, Regeneron, Regenxbio, and FH Foundation. Dr Beckman reports consulting fees from JanOne, Merck, and MingSight and serves on the Data and Safety Monitoring Committee for Janssen and Novartis. All other authors have no financial disclosures. EDAT- 2025/05/22 12:32 MHDA- 2025/06/03 12:32 PMCR- 2025/05/22 CRDT- 2025/05/22 06:42 PHST- 2025/06/03 12:32 [medline] PHST- 2025/05/22 12:32 [pubmed] PHST- 2025/05/22 06:42 [entrez] PHST- 2025/05/22 00:00 [pmc-release] AID - JAH310979 [pii] AID - 10.1161/JAHA.125.041177 [doi] PST - ppublish SO - J Am Heart Assoc. 2025 Jun 3;14(11):e041177. doi: 10.1161/JAHA.125.041177. Epub 2025 May 22. PMID- 40392554 OWN - NLM STAT- MEDLINE DCOM- 20250520 LR - 20260518 IS - 2574-3805 (Electronic) IS - 2574-3805 (Linking) VI - 8 IP - 5 DP - 2025 May 1 TI - Deescalation From Ticagrelor to Clopidogrel for Myocardial Infarction With Chronic Kidney Disease: A Secondary Analysis of a Randomized Clinical Trial. PG - e2511297 LID - 10.1001/jamanetworkopen.2025.11297 [doi] LID - e2511297 AB - IMPORTANCE: Chronic kidney disease (CKD) is a significant risk factor for both ischemic and bleeding complications following percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI). Optimizing dual antiplatelet therapy (DAPT) is essential for improving clinical outcomes. OBJECTIVE: To evaluate whether an 11-month, unguided deescalation strategy from ticagrelor to clopidogrel was associated with reduced bleeding without an increase in ischemic events in stabilized patients with CKD after AMI. DESIGN, SETTING, AND PARTICIPANTS: This was a post hoc secondary analysis of the multicenter, open-label, Ticagrelor vs Clopidogrel in Stabilized Patients With Acute Myocardial Infarction (TALOS-AMI) randomized clinical trial conducted at 32 major cardiac centers in South Korea. Patients with biomarker-positive AMI who tolerated 1 month of ticagrelor-based DAPT after PCI were included in the trial. Patient enrollment occurred from February 2014 to December 2018, with follow-up at 30 days and 3, 6, and 12 months after PCI. The present analysis focused on the subgroup of patients with CKD (estimated glomerular filtration rate [eGFR]<60 mL/min/1.73 m2). Data analyses were performed from July 2023 to October 2024. INTERVENTIONS: In the TALOS-AMI trial, patients were randomized 1:1 to continue ticagrelor (active control group) or switch to clopidogrel (deescalation group) for 11 months after PCI. MAIN OUTCOMES AND MEASURES: The primary end point was a composite of death from cardiovascular disease, myocardial infarction, stroke, and bleeding (Bleeding Academic Research Consortium [BARC] types 2, 3, or 5). RESULTS: Of 2646 patients included in the trial, 305 had CKD (11.5%; mean [SD] age, 67.2 [11.4] years; 223 males [73.1%]; mean [SD] eGFR, 49.7 [9.5] mL/min/1.73 m2) and 2341 did not have CKD (1975 male [84.4%]; mean [SD] age, 59.0 [11.0] years). Patients with CKD had an increased risk of ischemic events compared with patients without CKD (hazard ratio [HR], 2.47; 95% CI, 1.38-4.42; P = .002), but there was no difference in bleeding risk (HR, 1.36; 95% CI, 0.80-2.31; P = .26). Among patients with CKD, deescalation (n = 160) vs active control (n = 145) was associated with reduced risks of the primary end point (10 patients [6.2%] vs 19 [13.1%]; HR, 0.45 [95% CI, 0.21-0.98]; P = .04) and BARC 2, 3, or 5 bleeding (4 patients [2.5%] vs 12 [8.3%]; HR, 0.29 [95% CI, 0.09-0.89]; P = .03). No increased risk of ischemic events was observed following deescalation (7 patients [4.4%] vs 8 [5.5%]; HR, 0.78 [95% CI, 0.28-2.16]; P = .64). CONCLUSIONS AND RELEVANCE: In this secondary analysis of a randomized clinical trial, deescalation from ticagrelor to clopidogrel at 1 month after PCI for AMI was associated with significant reduction in bleeding without increased risk of ischemic events among study-eligible patients with CKD. Further adequately powered studies are needed to validate these findings. FAU - Kim, Sang Hyun AU - Kim SH AD - Division of Cardiology, Department of Internal Medicine, Seoul St Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea. AD - Division of Cardiology, Department of Internal Medicine, The Armed Forces Capital Hospital, Seongnam, Republic of Korea. FAU - Lee, Kwan Yong AU - Lee KY AD - Division of Cardiology, Department of Internal Medicine, Seoul St Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea. AD - Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. FAU - Byeon, Jaeho AU - Byeon J AD - Division of Cardiology, Department of Internal Medicine, Incheon St Mary's Hospital, The Catholic University of Korea, Incheon, Republic of Korea. FAU - Sa, Young Kyoung AU - Sa YK AD - Division of Cardiology, Department of Internal Medicine, Yeouido St Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea. FAU - Hwang, Byung-Hee AU - Hwang BH AD - Division of Cardiology, Department of Internal Medicine, Seoul St Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea. AD - Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. FAU - Kim, Chan Joon AU - Kim CJ AD - Division of Cardiology, Department of Internal Medicine, Uijeongbu St Mary's Hospital, The Catholic University of Korea, Uijeongbu, Republic of Korea. FAU - Choo, Eun-Ho AU - Choo EH AD - Division of Cardiology, Department of Internal Medicine, Seoul St Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea. FAU - Lim, Sungmin AU - Lim S AD - Division of Cardiology, Department of Internal Medicine, Uijeongbu St Mary's Hospital, The Catholic University of Korea, Uijeongbu, Republic of Korea. FAU - Choi, Ik Jun AU - Choi IJ AD - Division of Cardiology, Department of Internal Medicine, Incheon St Mary's Hospital, The Catholic University of Korea, Incheon, Republic of Korea. FAU - Choi, Yun Seok AU - Choi YS AD - Division of Cardiology, Department of Internal Medicine, Seoul St Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea. FAU - Park, Chul Soo AU - Park CS AD - Division of Cardiology, Department of Internal Medicine, Yeouido St Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea. FAU - Park, Mahn-Won AU - Park MW AD - Division of Cardiology, Department of Internal Medicine, Daejeon St Mary's Hospital, The Catholic University of Korea, Daejeon, Republic of Korea. FAU - Her, Sung-Ho AU - Her SH AD - Division of Cardiology, Department of Internal Medicine, St Vincent's Hospital, The Catholic University of Korea, Suwon, Republic of Korea. FAU - Lee, Myunhee AU - Lee M AD - School of Public Health, San Diego State University, San Diego, California. FAU - Chang, Kiyuk AU - Chang K AD - Division of Cardiology, Department of Internal Medicine, Seoul St Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea. AD - Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. CN - TALOS-AMI Investigators LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20250501 PL - United States TA - JAMA Netw Open JT - JAMA network open JID - 101729235 RN - A74586SNO7 (Clopidogrel) RN - 0 (Platelet Aggregation Inhibitors) RN - GLH0314RVC (Ticagrelor) SB - IM MH - Aged MH - Female MH - Humans MH - Male MH - Middle Aged MH - *Clopidogrel/administration & dosage/adverse effects MH - Hemorrhage/chemically induced MH - *Myocardial Infarction/drug therapy/complications MH - Percutaneous Coronary Intervention/adverse effects MH - *Platelet Aggregation Inhibitors/administration & dosage/adverse effects MH - *Renal Insufficiency, Chronic/complications MH - Republic of Korea MH - *Ticagrelor/administration & dosage/adverse effects MH - Secondary Data Analysis PMC - PMC12093190 COIS- Conflict of Interest Disclosures: None reported. FIR - Jeong, Myung Ho IR - Jeong MH FIR - Park, Chul-Soo IR - Park CS FIR - Shin, Woo Seung IR - Shin WS FIR - Kim, Dong Bin IR - Kim DB FIR - Jung, Sang Shik IR - Jung SS FIR - Cho, Byung Ryeol IR - Cho BR FIR - Ko, Jin Shin IR - Ko JS FIR - Kim, Won IR - Kim W FIR - Huh, Seung Ho IR - Huh SH FIR - Kim, Ki Sik IR - Kim KS FIR - Kim, Sang Hyeon IR - Kim SH FIR - Cho, Chang Hyeon IR - Cho CH FIR - Park, Sang Ho IR - Park SH FIR - Yoon, Myung Ho IR - Yoon MH FIR - Park, Jong Sun IR - Park JS FIR - Park, Kyung Min IR - Park KM FIR - Lee, Seoung Hwan IR - Lee SH FIR - Chung, Kyung Tae IR - Chung KT FIR - Do, Joon Hyeong IR - Do JH FIR - Kim, Sang Wook IR - Kim SW FIR - Baek, Joo Yeol IR - Baek JY FIR - Shim, Byung Joo IR - Shim BJ FIR - Sung, Ki Chul IR - Sung KC FIR - Oh, Ju Hyun IR - Oh JH FIR - Cha, Kwang Soo IR - Cha KS FIR - Cho, Young Hoon IR - Cho YH FIR - Jang, Jae Sik IR - Jang JS FIR - Cho, Jin Man IR - Cho JM FIR - Lee, Jang Hoon IR - Lee JH EDAT- 2025/05/20 17:07 MHDA- 2025/05/20 17:08 PMCR- 2025/05/20 CRDT- 2025/05/20 11:33 PHST- 2025/05/20 17:08 [medline] PHST- 2025/05/20 17:07 [pubmed] PHST- 2025/05/20 11:33 [entrez] PHST- 2025/05/20 00:00 [pmc-release] AID - 2834261 [pii] AID - zoi250387 [pii] AID - 10.1001/jamanetworkopen.2025.11297 [doi] PST - epublish SO - JAMA Netw Open. 2025 May 1;8(5):e2511297. doi: 10.1001/jamanetworkopen.2025.11297. PMID- 40365856 OWN - NLM STAT- MEDLINE DCOM- 20250829 LR - 20260704 IS - 1532-5415 (Electronic) IS - 0002-8614 (Linking) VI - 73 IP - 8 DP - 2025 Aug TI - Frailty Burden and Efficacy of Initial Invasive Strategy in Chronic Coronary Disease: The ISCHEMIA Trials. PG - 2376-2385 LID - 10.1111/jgs.19508 [doi] AB - BACKGROUND: Frailty is common among patients with chronic coronary disease and is associated with worse outcomes. METHODS: A pooled, post hoc analysis of the ISCHEMIA and ISCHEMIA-CKD trials was conducted. Baseline frailty was assessed using a Frailty Index (FI), and participants were categorized into data-derived tertiles. Multivariable Cox models with multiplicative interaction terms (frailty x treatment arm) were constructed to evaluate whether baseline frailty status modified the treatment effect of the initial invasive (vs conservative) strategy on a composite outcome of cardiovascular death, myocardial infarction, hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest and the secondary outcome of HRQoL (Seattle Angina Questionnaire [SAQ]). RESULTS: Among 5322 participants (mean 64 years, 24% female), a high frailty burden (tertile 3 vs. tertile 1) was associated with lower baseline SAQ scores and increased risk of adverse clinical outcomes on follow-up. Baseline frailty burden did not significantly modify the effect of the initial invasive strategy on the primary composite outcome (P (interaction)frailty x intervention arm = 0.30). However, frailty significantly modified the effect of the initial invasive strategy on HRQoL, with higher baseline frailty burden associated with greater improvement in SAQ scores at 1 year with initial invasive (vs. conservative) treatment (P (interaction)frailty x intervention arm < 0.001). The treatment effect of an initial invasive vs. conservative strategy on 12-month SAQ score change was most pronounced in individuals with lower baseline SAQ scores in both higher and lower frailty burden groups. CONCLUSION: Patients with chronic coronary disease with a higher frailty burden are more likely to experience greater improvements in HRQoL with initial invasive management without a higher risk of adverse clinical events. Lower baseline SAQ scores predicted greater improvement in HRQoL with initial invasive management, independent of frailty burden. CI - (c) 2025 The American Geriatrics Society. FAU - Patel, Lajjaben AU - Patel L AUID- ORCID: 0000-0002-9037-318X AD - Division of Cardiology, Department of Medicine, UT Southwestern Medical Center, Dallas, Texas, USA. FAU - Segar, Matthew W AU - Segar MW AUID- ORCID: 0000-0001-6100-0897 AD - Division of Cardiology, Texas Heart Institute, Houston, Texas, USA. FAU - Usman, Muhammad S AU - Usman MS AUID- ORCID: 0000-0001-9747-8892 AD - Division of Cardiology, Department of Medicine, UT Southwestern Medical Center, Dallas, Texas, USA. FAU - Dhruve, Ritika AU - Dhruve R AUID- ORCID: 0009-0007-9894-3910 AD - Division of Cardiology, Department of Medicine, UT Southwestern Medical Center, Dallas, Texas, USA. FAU - Keshvani, Neil AU - Keshvani N AUID- ORCID: 0000-0001-6890-8670 AD - Division of Cardiology, Department of Medicine, UT Southwestern Medical Center, Dallas, Texas, USA. FAU - Postalian, Alexander AU - Postalian A AUID- ORCID: 0000-0002-8491-7638 AD - Division of Cardiology, Texas Heart Institute, Houston, Texas, USA. FAU - Mentias, Amgad AU - Mentias A AUID- ORCID: 0000-0001-6555-2517 AD - Department of Cardiology, Cleveland Clinic, Cleveland, Ohio, USA. FAU - Rubin, Craig D AU - Rubin CD AUID- ORCID: 0000-0003-0267-8774 AD - Division of Geriatric Medicine, Department of Medicine, UT Southwestern Medical Center, Dallas, Texas, USA. FAU - Patel, Kershaw V AU - Patel KV AUID- ORCID: 0000-0003-2002-4096 AD - Department of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas, USA. FAU - Kumbhani, Dharam J AU - Kumbhani DJ AUID- ORCID: 0000-0003-4321-4538 AD - Division of Cardiology, Department of Medicine, UT Southwestern Medical Center, Dallas, Texas, USA. FAU - Banerjee, Subhash AU - Banerjee S AUID- ORCID: 0000-0003-0863-7914 AD - Baylor University Medical Center, Dallas, Texas, USA. FAU - Pandey, Ambarish AU - Pandey A AUID- ORCID: 0000-0001-9651-3836 AD - Division of Cardiology, Department of Medicine, UT Southwestern Medical Center, Dallas, Texas, USA. LA - eng GR - Gilead Sciences Research Scholar Program/ GR - Texas Health Resources Clinical Scholarship/ GR - 5T32HL125247-09/HL/NHLBI NIH HHS/United States GR - 23DSG1154425/American Heart Association/ GR - Myovista Research/ GR - R01MD017529/MD/NIMHD NIH HHS/United States GR - 1R03AG067960-01/AG/NIA NIH HHS/United States GR - Applied Therapeutics/ GR - 5T32HL125247-09/HL/NHLBI NIH HHS/United States GR - R01MD017529/MD/NIMHD NIH HHS/United States GR - 1R03AG067960-01/AG/NIA NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't DEP - 20250514 PL - United States TA - J Am Geriatr Soc JT - Journal of the American Geriatrics Society JID - 7503062 SB - IM MH - Humans MH - Female MH - Male MH - *Frailty/complications/epidemiology MH - Middle Aged MH - Aged MH - Chronic Disease MH - *Coronary Disease/therapy/complications MH - Quality of Life MH - Treatment Outcome OTO - NOTNLM OT - chronic coronary disease OT - frailty OT - invasive treatment OT - quality of life EDAT- 2025/05/14 12:39 MHDA- 2025/09/08 07:58 CRDT- 2025/05/14 06:43 PHST- 2025/04/03 00:00 [revised] PHST- 2024/11/08 00:00 [received] PHST- 2025/04/10 00:00 [accepted] PHST- 2025/09/08 07:58 [medline] PHST- 2025/05/14 12:39 [pubmed] PHST- 2025/05/14 06:43 [entrez] AID - 10.1111/jgs.19508 [doi] PST - ppublish SO - J Am Geriatr Soc. 2025 Aug;73(8):2376-2385. doi: 10.1111/jgs.19508. Epub 2025 May 14. PMID- 40263680 OWN - NLM STAT- MEDLINE DCOM- 20250423 LR - 20250425 IS - 2338-2732 (Electronic) IS - 0125-9326 (Linking) VI - 57 IP - 1 DP - 2025 Jan TI - Role of Colchicine in Reducing Reperfusion Injury in STEMI Patients Who Undergo Primary Percutaneous Coronary Intervention: A Randomized Clinical Trial. PG - 11-17 AB - BACKGROUND: Inflammation plays a role in ST-segment elevation myocardial infarction (STEMI), especially in reperfusion injury (RI). Colchicine, an anti-inflammatory drug, can suppress inflammation during RI. We assessed the effectiveness of administering colchicine to STEMI patients undergoing primary percutaneous coronary intervention (PPCI) in suppressing RI events. METHODS: This study was a randomized, double-blind, placebo-controlled clinical trial conducted in a multicenter manner at two hospitals in Jakarta with IKPP facilities from December 2022 to April 2023. STEMI patients that underwent PPCI received 2 mg of colchicine as a loading dose and a maintenance dose of 0.5 mg every 12 hours for two days or amylum at a similar dose. Patients were observed for RI events (low-flow thrombolysis in myocardial infarction (0-2) during angiography procedure, reperfusion arrhythmia, cardiogenic shock, or persistent chest pain). RESULTS: Seventy-seven STEMI patients with a mean age of 55.2 +/- 9.9 years underwent PPCI. Of these patients, 37 received colchicine, and 40 received a placebo. Most subjects were male (77.5%), suffered three-vessel disease (44.15%), and occlusion in left anterior descending coronary artery (53.24%). Colchicine was found to fail to reduce the incidence of ischemia-RI (51.5% vs. 42.4%; p = 0.437). Analysis of comorbidities (hypertension, chronic kidney disease, diabetes mellitus, and obesity) and angiography results (vessel disease, lesion diameter, and culprit artery) failed to demonstrate a statistical difference in RI. Side effects were similar in the colchicine and placebo groups (21.6% vs. 15%). CONCLUSION: Colchicine administration in STEMI patients undergoing PPCI failed to reduce RI. FAU - Karim, Birry AU - Karim B AD - 1. Doctoral Program in Medical Sciences, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia. 2. Division of Cardiology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia.. drbirrykarim@yahoo.co.id. FAU - Alwi, Idrus AU - Alwi I FAU - Yamin, Mohammad AU - Yamin M FAU - Pasaribu, Merci Monica AU - Pasaribu MM FAU - Harimurti, Kuntjoro AU - Harimurti K FAU - Nafrialdi, Nafrialdi AU - Nafrialdi N FAU - Indrajaya, Taufik AU - Indrajaya T FAU - Rivaldo, Rivaldo AU - Rivaldo R LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PL - Indonesia TA - Acta Med Indones JT - Acta medica Indonesiana JID - 7901042 RN - SML2Y3J35T (Colchicine) RN - 0 (Anti-Inflammatory Agents) SB - IM MH - Humans MH - *Colchicine/therapeutic use/administration & dosage MH - Male MH - *Percutaneous Coronary Intervention/adverse effects MH - *ST Elevation Myocardial Infarction/surgery MH - Female MH - Middle Aged MH - Double-Blind Method MH - Aged MH - *Myocardial Reperfusion Injury/prevention & control/etiology MH - *Anti-Inflammatory Agents/therapeutic use/administration & dosage MH - Treatment Outcome OTO - NOTNLM OT - Colchicine OT - PPCI OT - STEMI OT - inflammation OT - reperfusion injury EDAT- 2025/04/23 00:31 MHDA- 2025/04/23 12:28 CRDT- 2025/04/22 23:53 PHST- 2025/04/23 12:28 [medline] PHST- 2025/04/23 00:31 [pubmed] PHST- 2025/04/22 23:53 [entrez] PST - ppublish SO - Acta Med Indones. 2025 Jan;57(1):11-17. PMID- 40259359 OWN - NLM STAT- MEDLINE DCOM- 20250421 LR - 20260802 IS - 1475-2840 (Electronic) IS - 1475-2840 (Linking) VI - 24 IP - 1 DP - 2025 Apr 21 TI - Long-term impact of diabetes on mortality in patients undergoing unprotected left main PCI: a propensity score-matched analysis from the BIA-LM registry. PG - 175 LID - 10.1186/s12933-025-02733-5 [doi] LID - 175 AB - BACKGROUND: There is modest data on long-term impact of diabetes on left main coronary artery (LMCA) percutaneous coronary intervention (PCI). This observational study, based on the largest single-center registry of LMCA PCI in Poland, evaluated the impact of diabetes on long-term survival following PCI in a real-world setting. METHODS: We retrospectively analyzed 998 patients who underwent LMCA PCI between December 27, 2007, and February 21, 2022. Diabetes and insulin dependence were defined based on medical history, prior records, and prescribed treatment. The endpoint was all-cause mortality at the longest available follow-up (mean 4.2 years). Survival analysis was conducted in the overall cohort and a one-to-one propensity score-matched (PSM) population. Moderation effects and differences between subgroups were analysed in predefined groups of PSM cohort. RESULTS: The median age was 71 (63-79) years; 212 (28.2%) were women, and 250 (33.2%) had diabetes. In the overall cohort, diabetes was associated with a worse prognosis (HR 1.35, 95% CI 1.03-1.76, P = 0.03). PSM resulted in 214 well-balanced pairs (median age 73 years (66-79)), with no significant difference in all-cause mortality between groups (adjusted HR 1.27, 95% CI 0.91-1.77, P = 0.16). After PSM subgroup analysis showed worse outcomes for patients with diabetes undergoing two-stent angioplasty (HR 3.70, 95% CI 1.64-8.34, P = 0.002) and elective PCI (HR 2.07, 95% CI 1.29-3.31, P = 0.003). Conversely, among patients presenting with myocardial infarction (MI), people with diabetes had better survival than the control group (HR 0.56, 95% CI 0.35-0.90, P = 0.02). No significant differences in outcomes were observed in patients with heart failure (HR 1.29, 95% CI 0.88-1.89, P = 0.19), chronic kidney disease (HR 1.08, 95% CI 0.69-1.71, P = 0.19), intravascular imaging use (HR 1.38, 95% CI 0.70-2.71, P = 0.35), or concomitant multivessel disease (HR 1.14, 95% CI 0.75-1.73, P = 0.53). CONCLUSIONS: No significant association was observed between diabetes and overall mortality following LMCA PCI. Sensitivity analyses showed worse survival outcomes in diabetic patients treated with two-stent techniques and undergoing non-emergency PCI. These findings suggest the overall safety of PCI for LMCA in people with diabetes and highlight the need for randomized trials, especially investigating indicated high-risk subgroups. CI - (c) 2025. The Author(s). FAU - Kralisz, Pawel AU - Kralisz P AD - Department of Invasive Cardiology, Medical University of Bialystok, 1 Kilinskiego St., 15-089, Bialystok, Poland. FAU - Dabrowski, Emil Julian AU - Dabrowski EJ AUID- ORCID: 0000-0001-7598-1913 AD - Department of Invasive Cardiology, Medical University of Bialystok, 1 Kilinskiego St., 15-089, Bialystok, Poland. e.j.dabrowski@gmail.com. FAU - Dobrzycki, Slawomir AU - Dobrzycki S AD - Department of Invasive Cardiology, Medical University of Bialystok, 1 Kilinskiego St., 15-089, Bialystok, Poland. FAU - Kozlowska, Wiktoria Urszula AU - Kozlowska WU AD - Department of Invasive Cardiology, Medical University of Bialystok, 1 Kilinskiego St., 15-089, Bialystok, Poland. FAU - Lipska, Patrycja Oliwia AU - Lipska PO AD - Department of Invasive Cardiology, Medical University of Bialystok, 1 Kilinskiego St., 15-089, Bialystok, Poland. FAU - Nowak, Konrad AU - Nowak K AD - Department of Invasive Cardiology, Medical University of Bialystok, 1 Kilinskiego St., 15-089, Bialystok, Poland. FAU - Gugala, Kamil AU - Gugala K AD - Department of Invasive Cardiology, Medical University of Bialystok, 1 Kilinskiego St., 15-089, Bialystok, Poland. FAU - Prokopczuk, Przemyslaw AU - Prokopczuk P AD - Department of Invasive Cardiology, Medical University of Bialystok, 1 Kilinskiego St., 15-089, Bialystok, Poland. FAU - Mezynski, Grzegorz AU - Mezynski G AD - Department of Invasive Cardiology, Medical University of Bialystok, 1 Kilinskiego St., 15-089, Bialystok, Poland. FAU - Swieczkowski, Michal AU - Swieczkowski M AD - Department of Invasive Cardiology, Medical University of Bialystok, 1 Kilinskiego St., 15-089, Bialystok, Poland. FAU - Kozuch, Marcin AU - Kozuch M AD - Department of Invasive Cardiology, Medical University of Bialystok, 1 Kilinskiego St., 15-089, Bialystok, Poland. LA - eng GR - B.SUB.25.504/Uniwersytet Medyczny w Bialymstoku/ GR - B.SUB.25.535/Uniwersytet Medyczny w Bialymstoku/ PT - Journal Article PT - Observational Study PT - Research Support, Non-U.S. Gov't DEP - 20250421 PL - England TA - Cardiovasc Diabetol JT - Cardiovascular diabetology JID - 101147637 SB - IM MH - Humans MH - Female MH - Male MH - Aged MH - Registries MH - *Percutaneous Coronary Intervention/mortality/adverse effects/instrumentation MH - Retrospective Studies MH - Middle Aged MH - Time Factors MH - Treatment Outcome MH - *Diabetes Mellitus/mortality/diagnosis/drug therapy MH - *Coronary Artery Disease/mortality/diagnostic imaging/therapy MH - Risk Factors MH - Risk Assessment MH - Poland/epidemiology MH - Propensity Score PMC - PMC12013000 OTO - NOTNLM OT - CAD OT - Coronary artery disease OT - Diabetes OT - Left main OT - PCI OT - Propensity score matching OT - Registry COIS- Declarations. Competing interests: The authors declare no competing interests. EDAT- 2025/04/22 00:26 MHDA- 2025/04/22 00:27 PMCR- 2025/04/21 CRDT- 2025/04/21 23:38 PHST- 2025/02/21 00:00 [received] PHST- 2025/04/07 00:00 [accepted] PHST- 2025/04/22 00:27 [medline] PHST- 2025/04/22 00:26 [pubmed] PHST- 2025/04/21 23:38 [entrez] PHST- 2025/04/21 00:00 [pmc-release] AID - 10.1186/s12933-025-02733-5 [pii] AID - 2733 [pii] AID - 10.1186/s12933-025-02733-5 [doi] PST - epublish SO - Cardiovasc Diabetol. 2025 Apr 21;24(1):175. doi: 10.1186/s12933-025-02733-5. PMID- 40240978 OWN - NLM STAT- MEDLINE DCOM- 20250507 LR - 20260811 IS - 2047-9980 (Electronic) IS - 2047-9980 (Linking) VI - 14 IP - 9 DP - 2025 May 6 TI - Characteristics and Outcomes of Older Patients Undergoing Protected Percutaneous Coronary Intervention With Impella. PG - e038509 LID - 10.1161/JAHA.124.038509 [doi] LID - e038509 AB - BACKGROUND: In patients undergoing high-risk percutaneous coronary intervention, Impella has become an important adjunctive tool to support revascularization. The impact of age on the outcomes of patients undergoing high-risk percutaneous coronary intervention is limited. The aim of this study is to describe the characteristics and outcomes of patients >/=75 years of age undergoing Impella-supported high-risk percutaneous coronary intervention. METHODS AND RESULTS: Baseline characteristics and outcomes of patients >/=75 years of age versus those of patients <75 years of age in patients enrolled in the cVAD PROTECT III (Catheter-Based Ventricular Assist Device Prospective, Multi-Center, Randomized Controlled Trial of the IMPELLA RECOVER LP 2.5 System Versus Intra Aortic Balloon Pump in Patients Undergoing Non Emergent High Risk Percutaneous Coronary Intervention) study (NCT04136392). Major adverse cardiovascular and cerebral events (composite of all-cause death, nonfatal myocardial infarction, stroke/transient ischemic attack, and repeat revascularization) were assessed at 30 and 90 days and all-cause death at 1 year. Out of 1237 patients, 493 (39.9%) patients were >/=75 years of age. Patients >/=75 years of age had less diabetes and prior myocardial infarction, more hypertension and dyslipidemia, worse renal function, more severe valvular heart disease, but higher left ventricular ejection fraction (P<0.05 for all comparisons). Baseline Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery scores were similar between groups. Older patients underwent more left main percutaneous coronary intervention (58% versus 39%; P<0.0001), atherectomy (32% versus 22%; P<0.0001), and femoral access (87% versus 79%, P=0.0003) as compared with younger patients. In-hospital vascular complications did not differ, but rates of respiratory failure, pericardial tamponade, and cardiogenic shock were higher in older patients. Rates of all-cause death and major adverse cardiovascular and cerebral events did not differ between groups at 30 and 90 days. Rates of all-cause death at 1 year were higher in patients >/=75 years (adjusted hazard ratio, 1.99 [95% CI, 1.24-3.18], P=0.004). CONCLUSIONS: Impella-supported high-risk percutaneous coronary intervention in older patients is feasible with an acceptable safety profile. However, age >/=75 years remained a statistically significant predictor for all-cause death at 1 year. REGISTRATION: URL: https://clinicaltrials.gov; Unique Identifier: NCT04136392. FAU - Jakob, Philipp AU - Jakob P AUID- ORCID: 0000-0002-2443-6090 AD - Department of Cardiology, University Heart Center, University Hospital Zurich and the Center for Translational and Experimental Cardiology (CTEC) University of Zurich Zurich Switzerland. FAU - Lansky, Alexandra J AU - Lansky AJ AUID- ORCID: 0000-0001-8002-7497 AD - Department of Cardiology Yale University School of Medicine New Haven CT USA. FAU - Basir, Mir B AU - Basir MB AUID- ORCID: 0000-0003-3486-6753 AD - Center for Structural Heart Disease, Division of Cardiology Henry Ford Health System Detroit MI USA. FAU - Schonning, Michael J AU - Schonning MJ AUID- ORCID: 0000-0002-0624-3332 AD - Clinical Trials Center Cardiovascular Research Foundation New York NY USA. FAU - Falah, Batla AU - Falah B AUID- ORCID: 0009-0002-6709-0840 AD - Clinical Trials Center Cardiovascular Research Foundation New York NY USA. FAU - Zhou, Zhipeng AU - Zhou Z AD - Clinical Trials Center Cardiovascular Research Foundation New York NY USA. FAU - Batchelor, Wayne B AU - Batchelor WB AUID- ORCID: 0000-0002-3016-1150 AD - Inova Center of Outcomes Research Inova Heart and Vascular Institute Falls Church VA USA. FAU - Abu-Much, Arsalan AU - Abu-Much A AUID- ORCID: 0000-0002-0626-6649 AD - Clinical Trials Center Cardiovascular Research Foundation New York NY USA. FAU - Grines, Cindy L AU - Grines CL AUID- ORCID: 0000-0003-1653-6443 AD - Department of Cardiology Northside Hospital Cardiovascular Institute Atlanta GA USA. FAU - O'Neill, William W AU - O'Neill WW AUID- ORCID: 0009-0000-5896-728X AD - Center for Structural Heart Disease, Division of Cardiology Henry Ford Health System Detroit MI USA. FAU - Stahli, Barbara E AU - Stahli BE AUID- ORCID: 0000-0002-3058-6407 AD - Department of Cardiology, University Heart Center, University Hospital Zurich and the Center for Translational and Experimental Cardiology (CTEC) University of Zurich Zurich Switzerland. LA - eng SI - ClinicalTrials.gov/NCT04136392 PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20250416 PL - England TA - J Am Heart Assoc JT - Journal of the American Heart Association JID - 101580524 SB - IM CIN - J Am Heart Assoc. 2025 May 6;14(9):e042149. doi: 10.1161/JAHA.125.042149. PMID: 40332139 MH - Humans MH - Aged MH - *Percutaneous Coronary Intervention/adverse effects/mortality MH - Male MH - Female MH - *Heart-Assist Devices MH - Treatment Outcome MH - Age Factors MH - Prospective Studies MH - Middle Aged MH - Risk Factors MH - Aged, 80 and over MH - *Coronary Artery Disease/mortality/surgery/therapy MH - Time Factors MH - Intra-Aortic Balloon Pumping/mortality MH - Ventricular Function, Left PMC - PMC12184249 OTO - NOTNLM OT - PROTECT III OT - age differences OT - all-cause mortality OT - high-risk percutaneous coronary intervention OT - major adverse cardiovascular and cerebrovascular events COIS- Dr Lansky has received speaker fees from Abiomed. Dr Basir reports consultant/speaker fees from Abiomed, Boston Scientific, Chiesi, Saranas, and Zoll. Dr Batchelor has received speaker honoraria from Boston Scientific, Abbott Medical, and Medtronic. Dr Grines reports participation on the advisory boards for Philips and Abiomed. Dr O'Neill reports grant/research support from St Jude Medical, Edwards Life Sciences, and Biomed; consulting fees/honoraria from Medtronic and Abiomed; and major stock shareholder/equity in Synecor, Accumed, Neovasc, Tendyne, and Mitralign. Dr Stahli and her research has been supported by a donation of H.H. Sheikh Khalifa bin Hamad Al-Thani to the University of Zurich, Switzerland; investigator sponsored research received at the University of Zurich from Boston Scientific and Edwards Lifesciences; research grant support received at the University of Zurich from the OPO Foundation, the Iten-Kohaut Foundation, the German Center for Cardiovascular Research, the German Heart Research Foundation, and the B. Braun Foundation; speaker fees from Boston Scientific, Abbott Vascular, and MedAlliance; and is a Steering Committee Member of the Cruz Senior study (SMT). All other coauthors have no relevant disclosures. EDAT- 2025/04/17 00:24 MHDA- 2025/05/07 12:32 PMCR- 2025/04/16 CRDT- 2025/04/16 23:45 PHST- 2025/05/07 12:32 [medline] PHST- 2025/04/17 00:24 [pubmed] PHST- 2025/04/16 23:45 [entrez] PHST- 2025/04/16 00:00 [pmc-release] AID - JAH310795 [pii] AID - 10.1161/JAHA.124.038509 [doi] PST - ppublish SO - J Am Heart Assoc. 2025 May 6;14(9):e038509. doi: 10.1161/JAHA.124.038509. Epub 2025 Apr 16. PMID- 40233024 OWN - NLM STAT- MEDLINE DCOM- 20250521 LR - 20260108 IS - 1935-5548 (Electronic) IS - 0149-5992 (Linking) VI - 48 IP - 6 DP - 2025 Jun 1 TI - Empagliflozin in Patients With Type 2 Diabetes Undergoing On-Pump CABG: The POST-CABGDM Randomized Clinical Trial. PG - 988-995 LID - 10.2337/dc24-2807 [doi] AB - OBJECTIVE: To evaluate the efficacy and safety of empagliflozin in patients with type 2 diabetes mellitus (T2DM) undergoing elective on-pump coronary artery bypass grafting (CABG). RESEARCH DESIGN AND METHODS: Investigator-initiated, pragmatic, single-center, randomized, open-label trial with blinded outcome adjudication conducted in Brazil. A total of 145 patients with T2DM scheduled for elective on-pump CABG were randomized to receive empagliflozin 25 mg daily plus standard care (n = 71) for at least 3 months, which was discontinued 72 h before surgery, or to received standard care alone (n = 74). The primary outcome was postoperative acute kidney injury (AKI) within 7 days of surgery, defined by creatinine-based criteria (namely, Acute Kidney Injury Network; Risk, Injury, Failure, Loss of Kidney Function, and End-Stage Kidney Disease; or Kidney Disease: Improving Global Outcomes). Secondary outcomes included 30-day postoperative atrial fibrillation and type 5 myocardial infarction (MI). Safety outcomes were ketoacidosis, urinary tract infection, hospital-acquired pneumonia, and wound infection within 30 days after CABG. RESULTS: AKI occurred in 22.5% of the empagliflozin group vs. 39.1% in the control group (relative risk [RR] 0.57 [95% CI 0.34-0.96]; P = 0.03). Rates of atrial fibrillation (15.4% vs. 13.5%; RR 1.15 [95% CI 0.52-2.53]; P = 0.73) and type 5 MI (1.4% vs. 4.1%; RR 0.35 [95% CI 0.04-3.26]; P = 0.62) were similar between groups. No statistically significant differences between groups were observed for safety events. Three deaths occurred, all in the control group. CONCLUSIONS: Empagliflozin use before on-pump CABG in patients with T2DM was associated with a reduced incidence of postoperative AKI without an increase in safety events. These findings warrant confirmation in larger clinical trials. CI - (c) 2025 by the American Diabetes Association. FAU - Pitta, Fabio Grunspun AU - Pitta FG AUID- ORCID: 0000-0001-7574-757X AD - Instituto do coracao, Hospital das Clinicas Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil. AD - Hospital Israelita Albert Einstein, Sao Paulo, Brazil. FAU - Lima, Eduardo Gomes AU - Lima EG AD - Instituto do coracao, Hospital das Clinicas Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil. AD - Hospital Nove de Julho, Sao Paulo, Brazil. FAU - Tavares, Caio Assis Moura AU - Tavares CAM AD - Instituto do coracao, Hospital das Clinicas Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil. AD - Hospital Israelita Albert Einstein, Sao Paulo, Brazil. FAU - Martins, Eduardo Bello AU - Martins EB AD - Instituto do coracao, Hospital das Clinicas Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil. AD - Hospital Israelita Albert Einstein, Sao Paulo, Brazil. FAU - Rached, Fabiana Hanna AU - Rached FH AD - Instituto do coracao, Hospital das Clinicas Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil. AD - Hospital Israelita Albert Einstein, Sao Paulo, Brazil. FAU - Moreira, Eduardo Martelli AU - Moreira EM AD - Instituto do coracao, Hospital das Clinicas Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil. FAU - Mioto, Bruno Mahler AU - Mioto BM AD - Instituto do coracao, Hospital das Clinicas Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil. AD - Hospital Israelita Albert Einstein, Sao Paulo, Brazil. FAU - Lottenberg, Simao Augusto AU - Lottenberg SA AD - Hospital Israelita Albert Einstein, Sao Paulo, Brazil. AD - Servico de endocrinologia e metabolismo, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil. FAU - Bolta, Paula Mathias Paulino AU - Bolta PMP AD - Instituto do coracao, Hospital das Clinicas Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil. FAU - Justino, Larissa Goncalves AU - Justino LG AD - Instituto do coracao, Hospital das Clinicas Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil. FAU - Favarato, Desiderio AU - Favarato D AD - Instituto do coracao, Hospital das Clinicas Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil. FAU - Carvalho, Leticia Neves Solon AU - Carvalho LNS AD - Instituto do coracao, Hospital das Clinicas Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil. FAU - Pinesi, Henrique Trombini AU - Pinesi HT AD - Instituto do coracao, Hospital das Clinicas Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil. AD - Hospital Israelita Albert Einstein, Sao Paulo, Brazil. FAU - Barbosa, Camila Talita Machado AU - Barbosa CTM AD - Instituto do coracao, Hospital das Clinicas Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil. AD - Hospital Israelita Albert Einstein, Sao Paulo, Brazil. FAU - Dallan, Luis Alberto Oliveira AU - Dallan LAO AD - Instituto do coracao, Hospital das Clinicas Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil. FAU - Dallan, Luis Roberto Palma AU - Dallan LRP AD - Instituto do coracao, Hospital das Clinicas Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil. FAU - Barbosa, Marcelo Henrique Moreira AU - Barbosa MHM AD - Instituto do coracao, Hospital das Clinicas Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil. AD - Hospital Israelita Albert Einstein, Sao Paulo, Brazil. FAU - Kalil Filho, Roberto AU - Kalil Filho R AD - Instituto do coracao, Hospital das Clinicas Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil. FAU - de Lemos, James A AU - de Lemos JA AD - Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX. FAU - Serrano, Carlos Vicente Jr AU - Serrano CV Jr AD - Instituto do coracao, Hospital das Clinicas Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil. AD - Hospital Israelita Albert Einstein, Sao Paulo, Brazil. LA - eng PT - Journal Article PT - Pragmatic Clinical Trial PT - Randomized Controlled Trial PL - United States TA - Diabetes Care JT - Diabetes care JID - 7805975 RN - HDC1R2M35U (empagliflozin) RN - 0 (Glucosides) RN - 0 (Benzhydryl Compounds) SB - IM MH - Humans MH - *Glucosides/therapeutic use MH - *Benzhydryl Compounds/therapeutic use/adverse effects MH - *Diabetes Mellitus, Type 2/drug therapy/surgery MH - Female MH - Male MH - Middle Aged MH - Aged MH - *Coronary Artery Bypass/adverse effects MH - Acute Kidney Injury/epidemiology/prevention & control MH - Postoperative Complications EDAT- 2025/04/15 18:24 MHDA- 2025/05/21 18:29 CRDT- 2025/04/15 13:23 PHST- 2024/12/18 00:00 [received] PHST- 2025/03/21 00:00 [accepted] PHST- 2025/05/21 18:29 [medline] PHST- 2025/04/15 18:24 [pubmed] PHST- 2025/04/15 13:23 [entrez] AID - 158108 [pii] AID - 10.2337/dc24-2807 [doi] PST - ppublish SO - Diabetes Care. 2025 Jun 1;48(6):988-995. doi: 10.2337/dc24-2807. PMID- 40228852 OWN - NLM STAT- MEDLINE DCOM- 20250414 LR - 20250417 IS - 2044-6055 (Electronic) IS - 2044-6055 (Linking) VI - 15 IP - 4 DP - 2025 Apr 14 TI - Design of a randomised, placebo-controlled, double-blind multicentre study assessing the effect of colchicine on the incidence of knee or hip replacements in symptomatic knee or hip osteoarthritis: the ECHO trial. PG - e098096 LID - 10.1136/bmjopen-2024-098096 [doi] LID - e098096 AB - INTRODUCTION: Osteoarthritis (OA) is a multifactorial disease in which low-grade inflammation is considered to play a pivotal role. Although colchicine is a widely used anti-inflammatory drug in the treatment of gout, its effect in OA is still disputed due to inconsistent results of short-term clinical trials. Therefore, we aim to evaluate the effect of long-term colchicine 0.5 mg once daily on the incidence of knee or hip replacements in patients with knee or hip OA. METHODS AND ANALYSIS: The ECHO trial is a prospective, multicentre, randomised, double-blind, placebo-controlled, phase III trial in which 1200 participants with knee or hip OA tolerant to colchicine during a 30-day run-in period will be 1:1 randomised to colchicine 0.5 mg once daily or matching placebo using concealed allocation. The primary endpoint is the time from randomisation to the first knee or hip replacement assessed up to 4.5 years. Secondary endpoints include course of pain, physical function, joint space narrowing, low-grade inflammation, quality of life, clinical or radiological onset of OA in a new joint group other than present at baseline, number of participants using pain medication during the study, onset of new cardiovascular events (ie, myocardial infarction, ischaemia-driven coronary revascularisation, ischaemic stroke, peripheral artery disease or cardiovascular death) and direct and indirect costs related to treatment and disease burden due to OA. Harm-related endpoints include the number of (serious) adverse events, the number of withdrawals due to (serious) adverse events and changes in laboratory data (ie, serum creatinine, estimated glomerular filtration rate and alanine transferase) throughout the study. The primary analysis will be performed according to the intention-to-treat principle. ETHICS AND DISSEMINATION: This trial has been approved by the Medical Ethics Review Committee East-Netherlands. Findings will be presented at scientific meetings and published in a peer-reviewed scientific journal. TRIAL REGISTRATION NUMBER: NCT06578182. CI - (c) Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY. Published by BMJ Group. FAU - Heijman, Michelle W J AU - Heijman MWJ AUID- ORCID: 0000-0003-2148-7375 AD - Department of Research, Sint Maartenskliniek, Nijmegen, Netherlands m.heijman@maartenskliniek.nl. AD - Department of Rheumatology, Radboud University Medical Center, Nijmegen, Netherlands. FAU - van den Ende, Cornelia H M AU - van den Ende CHM AUID- ORCID: 0000-0002-4352-2824 AD - Department of Research, Sint Maartenskliniek, Nijmegen, Netherlands. AD - Department of Rheumatology, Radboud University Medical Center, Nijmegen, Netherlands. FAU - Cornel, Jan H AU - Cornel JH AUID- ORCID: 0000-0002-1006-2112 AD - Department of Cardiology, Radboud University Medical Center, Nijmegen, Netherlands. AD - Department of Cardiology, Northwest Clinics, Alkmaar, Netherlands. AD - Dutch Network for Cardiovascular Research (WCN), Utrecht, Netherlands. FAU - Smolders, Jose M H AU - Smolders JMH AD - Department of Orthopedics, Sint Maartenskliniek, Nijmegen, Netherlands. FAU - Schers, Henk J AU - Schers HJ AUID- ORCID: 0000-0002-9362-9451 AD - Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, Netherlands. FAU - Kievit, Wietske AU - Kievit W AD - Department of Health Evidence, Radboud University Medical Center, Nijmegen, Netherlands. FAU - Koeter, Sander AU - Koeter S AD - Department of Orthopedics, Canisius Wilhelmina Hospital, Nijmegen, Netherlands. FAU - van den Bemt, Bart J F AU - van den Bemt BJF AD - Department of Pharmacy, Sint Maartenskliniek, Nijmegen, Netherlands. AD - Department of Pharmacy, Radboud University Medical Center, Nijmegen, Netherlands. FAU - Popa, Calin D AU - Popa CD AD - Department of Rheumatology, Radboud University Medical Center, Nijmegen, Netherlands. AD - Department of Rheumatology, Sint Maartenskliniek, Nijmegen, Netherlands. LA - eng SI - ClinicalTrials.gov/NCT06578182 PT - Clinical Trial Protocol PT - Journal Article DEP - 20250414 PL - England TA - BMJ Open JT - BMJ open JID - 101552874 RN - SML2Y3J35T (Colchicine) SB - IM MH - Aged MH - Female MH - Humans MH - Male MH - Middle Aged MH - *Arthroplasty, Replacement, Hip/statistics & numerical data MH - *Arthroplasty, Replacement, Knee/statistics & numerical data MH - Clinical Trials, Phase III as Topic MH - *Colchicine/therapeutic use/administration & dosage MH - Double-Blind Method MH - Incidence MH - Multicenter Studies as Topic MH - *Osteoarthritis, Hip/surgery/drug therapy MH - *Osteoarthritis, Knee/surgery/drug therapy MH - Prospective Studies MH - Randomized Controlled Trials as Topic PMC - PMC11997832 OTO - NOTNLM OT - Drug Therapy OT - Hip OT - Inflammation OT - Knee OT - RHEUMATOLOGY OT - Randomized Controlled Trial COIS- Competing interests: JHC received consulting fees from Amgen and Novo Nordisk, participated on a Data Safety Monitoring Board or Advisory Board in the EDIT-CAS study and BioNTech malaria vaccine program and has a leadership or fiduciary role in the executive committee LIBREXIA AF and Chair Event Adjudication committee REDEFINE/REIMAGINE. JMHS received consulting fees from Smith & Nephew consultancy. SK has a leadership or fiduciary role in the Board Dutch Knee Society, President Commission on Quality Royal Dutch Orthopaedic Society and is chairman of Department Orthopaedic Surgery CWZ. All other authors have no competing interest to declare. EDAT- 2025/04/15 00:24 MHDA- 2025/04/15 00:25 PMCR- 2025/04/14 CRDT- 2025/04/14 20:43 PHST- 2025/04/15 00:25 [medline] PHST- 2025/04/15 00:24 [pubmed] PHST- 2025/04/14 20:43 [entrez] PHST- 2025/04/14 00:00 [pmc-release] AID - bmjopen-2024-098096 [pii] AID - 10.1136/bmjopen-2024-098096 [doi] PST - epublish SO - BMJ Open. 2025 Apr 14;15(4):e098096. doi: 10.1136/bmjopen-2024-098096. PMID- 40135363 OWN - NLM STAT- MEDLINE DCOM- 20250415 LR - 20260518 IS - 1941-7632 (Electronic) IS - 1941-7640 (Linking) VI - 18 IP - 4 DP - 2025 Apr TI - Predictive Value of Platelet FcgammaRIIa in Patients Treated With PCI Compared With Medical Therapy Alone After Myocardial Infarction. PG - e014939 LID - 10.1161/CIRCINTERVENTIONS.124.014939 [doi] AB - BACKGROUND: In patients with myocardial infarction (MI), quantifying platelet FcɣRIIa (pFCG) stratifies the risk of subsequent MI, stroke, and death. This report is a subgroup analysis of outcomes in patients treated with percutaneous coronary intervention (PCI) or medical management alone in an 800-patient, 25-center trial. METHODS: Patients were enrolled in a prospective, noninterventional trial during hospitalization for type 1 MI (ST-segment-elevation and non-ST-segment-elevation). Inclusion criteria included at least 2 of the following: aged >/=65 years, multivessel coronary artery disease, prior MI, chronic kidney disease, or diabetes. Flow cytometry was used to quantify pFCG at a core laboratory. High and low pFCG were defined by a prespecified threshold. The primary end point was the composite of MI, stroke, and death. RESULTS: Patients treated with medical therapy alone (n=151) had a greater occurrence of the primary end point (23.8%) than those treated with PCI (n=490, 8.8%). The pFCG test discriminated to a similar extent the risk of the primary end point in both the medical treatment group (hazard ratio, 2.29 [95% CI, 1.18-4.41]; P=0.014) and the PCI group (hazard ratio, 2.57 [95% CI, 1.41-4.69]; P=0.002). There was no significant association between pFCG and clinically relevant bleeding in the medical treatment group (hazard ratio, 1.22 [95% CI, 0.29-5.10]) or the PCI group (hazard ratio, 1.56 [95% CI, 0.67-3.61]). CONCLUSIONS: Quantifying pFCG discerned the risk of subsequent cardiovascular events among patients treated with medical therapy alone or PCI. This prognostic information will be useful for clinical decisions that balance ischemic and bleeding risk. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT05175261. FAU - Schneider, David J AU - Schneider DJ AUID- ORCID: 0000-0002-2751-6870 AD - Department of Medicine, Cardiovascular Research Institute, The University of Vermont, Burlington (D.J.S.). FAU - McMahon, Sean R AU - McMahon SR AD - Department of Medicine, Hartford Hospital, CT (S.R.M.M.). FAU - Angiolillo, Dominick J AU - Angiolillo DJ AUID- ORCID: 0000-0001-8451-2131 AD - Division of Cardiology, Department of Medicine, University of Florida, Jacksonville (D.J.A.). FAU - Fanaroff, Alexander C AU - Fanaroff AC AUID- ORCID: 0000-0002-9060-5307 AD - Department of Medicine, University of Pennsylvania, Philadelphia (A.C.F.). FAU - Ibrahim, Homam AU - Ibrahim H AD - Adventist Healthcare White Oak, Silver Spring, MD (H.I.). FAU - Hohl, Patrick K AU - Hohl PK AUID- ORCID: 0009-0000-1557-7484 AD - Division of Cardiovascular Medicine, Maine Medical Center, Portland, ME (P.K.H.). FAU - Wanamaker, Brett L AU - Wanamaker BL AD - Division of Cardiovascular Medicine, University of Michigan, Ann Arbor (B.L.W.). FAU - Effron, Mark B AU - Effron MB AUID- ORCID: 0000-0003-4050-5030 AD - John Ochsner Heart and Vascular Institute, University of Queensland Ochsner Clinical School, New Orleans, LA (M.B.E.). FAU - DiBattiste, Peter M AU - DiBattiste PM AD - Prolocor, Inc, Philadelphia, PA (P.M.D.B.). CN - Investigators LA - eng SI - ClinicalTrials.gov/NCT05175261 PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Observational Study DEP - 20250326 PL - United States TA - Circ Cardiovasc Interv JT - Circulation. Cardiovascular interventions JID - 101499602 RN - 0 (Biomarkers) RN - 0 (Platelet Aggregation Inhibitors) RN - 0 (Receptors, IgG) SB - IM CIN - Circ Cardiovasc Interv. 2025 Apr;18(4):e015282. doi: 10.1161/CIRCINTERVENTIONS.125.015282. PMID: 40135345 MH - Aged MH - Female MH - Humans MH - Male MH - Middle Aged MH - Biomarkers/blood MH - *Blood Platelets/metabolism/immunology/drug effects MH - *Non-ST Elevated Myocardial Infarction/therapy/blood/mortality/diagnosis MH - *Percutaneous Coronary Intervention/adverse effects/mortality MH - *Platelet Aggregation Inhibitors/adverse effects/therapeutic use MH - Predictive Value of Tests MH - Prospective Studies MH - *Receptors, IgG/blood MH - Risk Assessment MH - Risk Factors MH - *ST Elevation Myocardial Infarction/therapy/blood/mortality/diagnosis MH - Stroke/mortality/blood/etiology MH - Time Factors MH - Treatment Outcome OTO - NOTNLM OT - coronary artery disease OT - flow cytometry OT - myocardial infarction OT - percutaneous coronary intervention OT - prognosis COIS- Dr Schneider is the named inventor on patents (US 10 502 737, US 11 747 335 B2) related to the use of FcgammaRIIa for assaying platelet reactivity and treatment selection. Drs Schneider and DiBattiste are cofounders of Prolocor. Dr Angiolillo declares that he has received consulting fees or honoraria from Abbott, Amgen, AstraZeneca, Bayer, Biosensors, Boehringer Ingelheim, Bristol-Myers Squibb, Chiesi, CSL Behring, Daiichi-Sankyo, Eli Lilly, Faraday, Haemonetics, Janssen, Merck, Novartis, Novo Nordisk, PhaseBio, PLx Pharma, Pfizer, Sanofi, and Vectura, outside of the present work; Dr Angiolillo also declares that his institution has received research grants from Amgen, AstraZeneca, Bayer, Biosensors, CeloNova, CSL Behring, Daiichi-Sankyo, Eisai, Eli Lilly, Faraday, Gilead, Janssen, Matsutani Chemical Industry Co., Merck, Novartis, Osprey Medical, Renal Guard Solutions, and the Scott R. MacKenzie Foundation. Dr Effron discloses that he receives a pension from, and has equity in Eli Lilly and Company. The other authors report no conflicts. FIR - Schneider, D J IR - Schneider DJ FIR - McMahon, S R IR - McMahon SR FIR - Fanaroff, A IR - Fanaroff A FIR - Serrano-Gomez, Claudia IR - Serrano-Gomez C FIR - Hohl, P K IR - Hohl PK FIR - Angiolillo, D J IR - Angiolillo DJ FIR - Ball, K M IR - Ball KM FIR - Wanamaker, B L IR - Wanamaker BL FIR - Effron, M IR - Effron M FIR - Shapiro, T A IR - Shapiro TA FIR - Nolan, B IR - Nolan B FIR - Hassan, A IR - Hassan A FIR - Cohen, M IR - Cohen M FIR - Rodriguez, D IR - Rodriguez D FIR - Amin, R IR - Amin R FIR - Gurbel, P A IR - Gurbel PA FIR - French, W J IR - French WJ FIR - Paul, T IR - Paul T FIR - Shutt, R IR - Shutt R FIR - Pudusseri, J IR - Pudusseri J FIR - Shaheem, W IR - Shaheem W FIR - Mojares, B IR - Mojares B EDAT- 2025/03/26 13:06 MHDA- 2025/04/15 18:24 CRDT- 2025/03/26 05:04 PHST- 2025/04/15 18:24 [medline] PHST- 2025/03/26 13:06 [pubmed] PHST- 2025/03/26 05:04 [entrez] AID - 10.1161/CIRCINTERVENTIONS.124.014939 [doi] PST - ppublish SO - Circ Cardiovasc Interv. 2025 Apr;18(4):e014939. doi: 10.1161/CIRCINTERVENTIONS.124.014939. Epub 2025 Mar 26. PMID- 40132104 OWN - NLM STAT- MEDLINE DCOM- 20250703 LR - 20250822 IS - 2048-8734 (Electronic) IS - 2048-8726 (Print) IS - 2048-8726 (Linking) VI - 14 IP - 6 DP - 2025 Jul 3 TI - Development and validation of a risk score in acute myocardial infarction-related cardiogenic shock. PG - 327-341 LID - 10.1093/ehjacc/zuaf043 [doi] AB - AIMS: Mortality in patients with acute myocardial infarction-related cardiogenic shock (AMICS) is high, but a widely accepted tool for individual risk assessment is lacking. A reliable prediction model could assist in clinical decision-making, patient selection for clinical trials, and comparison of AMICS populations. Therefore, the aim of this study was to develop and externally validate a prediction model for 30-day mortality in AMICS patients. METHODS AND RESULTS: This retrospective cohort study included patients from 2017 to 2021 (development cohort) and 2010-2017 (validation cohort). Patients with AMICS undergoing percutaneous coronary intervention in The Netherlands were identified using the Netherlands Heart Registration. International validation was performed in the Danish Retroshock registry. The main outcome was 30-day mortality. Among 2261 patients, the median age was 67 years [interquartile range (IQR) 58-75], and 1649 (73%) were male. The mortality rate at 30 days was 39% (n = 886). Significant predictors for mortality were: initial lactate, glucose, renal function, haemoglobin, age, blood pressure, heart rate, intubation prior to PCI, intervention in the left main coronary artery, and successful revascularization. The AUC of the initial model was 0.81 (0.79-0.83). The external validation cohort included 1393 patients with 1050 (75%) male and a median age of 67 years (IQR 59-75). The 30-day mortality rate was 49% (n = 680). The model showed good performance on the external validation with an AUC of 0.73 (0.70-0.76). CONCLUSION: A prediction model was developed and externally validated using data from two large national registries. The model demonstrated good performance and is suitable for clinical decision-making and quality purposes in AMICS. CI - (c) The Author(s) 2025. Published by Oxford University Press on behalf of the European Society of Cardiology. FAU - Peters, Elma J AU - Peters EJ AUID- ORCID: 0000-0003-4851-1320 AD - Department of Cardiology, Heart Center, Amsterdam University Medical Center, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands. FAU - Kunkel, Joakim B AU - Kunkel JB AD - Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. FAU - Bogerd, Margriet AU - Bogerd M AUID- ORCID: 0009-0002-2554-6352 AD - Department of Cardiology, Heart Center, Amsterdam University Medical Center, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands. FAU - Ten Berg, Sanne AU - Ten Berg S AUID- ORCID: 0009-0008-0029-4391 AD - Department of Cardiology, Heart Center, Amsterdam University Medical Center, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands. FAU - Timmermans, Marijke J C AU - Timmermans MJC AD - Netherlands Heart Registration, Utrecht, The Netherlands. FAU - Helgestad, Ole K L AU - Helgestad OKL AD - Department of Cardiology, Odense University Hospital, Odense, Denmark. FAU - Ravn, Hanne B AU - Ravn HB AD - Department of Cardiothoracic Anesthesia, Odense University Hospital, Odense, Denmark. FAU - Kraaijeveld, Adriaan O AU - Kraaijeveld AO AD - Department of Cardiology, Utrecht University Medical Center, Utrecht, The Netherlands. FAU - Otterspoor, Luuk C AU - Otterspoor LC AUID- ORCID: 0000-0002-8510-8648 AD - Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands. AD - Department of Intensive Care, Catharina Hospital, Eindhoven, The Netherlands. FAU - Sjauw, Krischan D AU - Sjauw KD AD - Department of Cardiology, Medical Center Leeuwarden, Leeuwarden, The Netherlands. AD - Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands. FAU - Lipsic, Erik AU - Lipsic E AD - Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands. FAU - Engstrom, Annemarie E AU - Engstrom AE AD - Department of Intensive Care, Amsterdam University Medical Centers, Amsterdam, The Netherlands. FAU - Vlaar, Alexander P J AU - Vlaar APJ AUID- ORCID: 0000-0002-3453-7186 AD - Department of Intensive Care, Amsterdam University Medical Centers, Amsterdam, The Netherlands. FAU - Hassager, Christian AU - Hassager C AD - Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. FAU - Moller, Jacob E AU - Moller JE AD - Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. AD - Department of Cardiology, Odense University Hospital, Odense, Denmark. FAU - Henriques, Jose P S AU - Henriques JPS AUID- ORCID: 0000-0002-8969-7929 AD - Department of Cardiology, Heart Center, Amsterdam University Medical Center, Meibergdreef 9, Amsterdam 1105 AZ, The Netherlands. LA - eng PT - Journal Article PT - Multicenter Study PT - Validation Study PL - England TA - Eur Heart J Acute Cardiovasc Care JT - European heart journal. Acute cardiovascular care JID - 101591369 SB - IM MH - Humans MH - *Shock, Cardiogenic/etiology/mortality MH - Male MH - Female MH - Aged MH - Retrospective Studies MH - Risk Assessment/methods MH - Middle Aged MH - *Myocardial Infarction/complications/mortality/surgery MH - Percutaneous Coronary Intervention MH - Netherlands/epidemiology MH - *Registries MH - Risk Factors MH - Survival Rate/trends MH - Prognosis PMC - PMC12365599 OTO - NOTNLM OT - Acute myocardial infarction OT - Cardiogenic shock OT - Mortality OT - Prediction model OT - Risk prediction COIS- Conflict of interest: All authors have completed the ICMJE uniform disclosure form at http://www.icmje.org/disclosure-of-interest/ and declare: no support from any organization for the submitted work; O.K.L.H. has received a consultant fee from Abiomed, H.B.R. has received honoraria from Abiomed, A.O.K. declares an institutional research grant from Xenios AG, institutional lecture fees from Novartis and Inari, and travel support from Edwards, E.L. has received an educational institutional grant from Abbott Medical Nederland and a consulting fee from Dekra Certification BV and is a board member of the Interventional Cardiology Working group of the NVVC (Nederlandse Vereniging Voor Cardiologie), J.E.M. has received speakers fees from Abbott Vascular, Orion Corporation, and Boehringer Ingelheim and declares institutional research fees from Abiomed and Roche, J.P.S.H. reports receiving research grants from Health approximately Holland, B. Braun, Infraredx/Nipro, ZonMw, Astra Zeneca, and Abbott Vascular and is a board member of the NVVC; no other relationships or activities that could appear to have influenced the submitted work. EDAT- 2025/03/25 18:28 MHDA- 2025/07/03 12:30 PMCR- 2025/03/25 CRDT- 2025/03/25 15:03 PHST- 2025/02/13 00:00 [received] PHST- 2025/03/07 00:00 [revised] PHST- 2025/03/18 00:00 [accepted] PHST- 2025/07/03 12:30 [medline] PHST- 2025/03/25 18:28 [pubmed] PHST- 2025/03/25 15:03 [entrez] PHST- 2025/03/25 00:00 [pmc-release] AID - 8093447 [pii] AID - zuaf043 [pii] AID - 10.1093/ehjacc/zuaf043 [doi] PST - ppublish SO - Eur Heart J Acute Cardiovasc Care. 2025 Jul 3;14(6):327-341. doi: 10.1093/ehjacc/zuaf043. PMID- 39969197 OWN - NLM STAT- MEDLINE DCOM- 20250507 LR - 20250629 IS - 1522-726X (Electronic) IS - 1522-1946 (Print) IS - 1522-1946 (Linking) VI - 105 IP - 6 DP - 2025 May TI - Myocardial Infarction and All-Cause Mortality Following Percutaneous Coronary Intervention Versus Conservative Treatment of Chronic Total Occlusions: A West Denmark Heart Registry Study. PG - 1296-1303 LID - 10.1002/ccd.31454 [doi] AB - BACKGROUND: Chronic coronary total occlusions (CTO) represent a therapeutic challenge, and results of randomized clinical trials and observational studies comparing conservative treatment versus percutaneous coronary intervention (PCI) are underpowered. AIMS: To assess myocardial infarction (MI) and all-cause mortality in consecutive patients with CTO lesions. METHODS: Using data from the West Denmark Heart Registry, patients with chronic coronary syndrome and a 100% occluded vessel by invasive coronary angiography (ICA) were identified. Patients were stratified according to PCI within 90 days. Five-year risk of MI and all-cause mortality was calculated using cause-specific Cox-models and g-formula methods. Subsequently, models were stratified on sex, diabetes, estimated glomerular filtration rate above 60 mL/min, procedure before 2012, and history of cardiac surgery. The risk was calculated for patients who did not experience MI or death within 30 days of the initial ICA. RESULTS: A total of 7675 patients were included in the study, of whom 3129 patients underwent PCI, and 4546 patients were treated conservatively. PCI- and conservatively treated patients had comparable risks of MI (13.1% [95% confidence interval [CI] 12.0%-14.3%] for patients who underwent PCI vs. 13.4% [95% CI 12.4%-13.4%] for patients who received conservative treatment). For all-cause mortality, results were 14.4% (95% CI 13.3%-15.5%) versus 18.9% (95% CI 17.8%-20.0%), respectively. Results were consistent across subgroups. However, CTO-PCI-treated patients with previous heart surgery were at higher risk of MI. CONCLUSIONS: Patients who underwent CTO-PCI had a comparable 5-year risk of MI and lower all-cause mortality as compared to conservatively treated patients. CI - (c) 2025 The Author(s). Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC. FAU - Sondergaard, Marc Meller AU - Sondergaard MM AUID- ORCID: 0000-0001-6059-4478 AD - Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark. FAU - Gunnarstein, Sanna AU - Gunnarstein S AD - Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark. FAU - Christensen, Martin Kirk AU - Christensen MK AD - Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark. FAU - Christiansen, Evald Hoj AU - Christiansen EH AD - Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark. FAU - Jensen, Lisette Okkels AU - Jensen LO AD - Department of Cardiology, Odense University Hospital, Odense, Denmark. FAU - Veien, Karsten Tange AU - Veien KT AD - Department of Cardiology, Odense University Hospital, Odense, Denmark. FAU - Holck, Emil Nielsen AU - Holck EN AUID- ORCID: 0009-0009-6697-1073 AD - Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark. FAU - Kragholm, Kristian AU - Kragholm K AD - Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark. FAU - Thuesen, Leif AU - Thuesen L AD - Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark. FAU - Eftekhari, Ashkan AU - Eftekhari A AD - Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark. LA - eng GR - This study was supported by Novo Nordisk Fonden./ PT - Comparative Study PT - Journal Article PT - Observational Study PT - Research Support, Non-U.S. Gov't DEP - 20250219 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Humans MH - *Percutaneous Coronary Intervention/mortality/adverse effects MH - Registries MH - Denmark/epidemiology MH - Male MH - Female MH - *Coronary Occlusion/mortality/therapy/diagnostic imaging MH - Aged MH - *Conservative Treatment/mortality/adverse effects MH - Chronic Disease MH - Middle Aged MH - *Myocardial Infarction/mortality/etiology/diagnosis MH - Treatment Outcome MH - Risk Factors MH - Time Factors MH - Coronary Angiography MH - Risk Assessment MH - Cause of Death MH - Proportional Hazards Models PMC - PMC12057301 OTO - NOTNLM OT - acute myocardial infarction OT - all-cause mortality OT - chronic total occlusions OT - percutaneous coronary intervention COIS- The authors declare no conflicts of interest. EDAT- 2025/02/19 12:24 MHDA- 2025/05/07 12:32 PMCR- 2025/05/07 CRDT- 2025/02/19 09:12 PHST- 2025/01/30 00:00 [revised] PHST- 2025/01/02 00:00 [received] PHST- 2025/02/05 00:00 [accepted] PHST- 2025/05/07 12:32 [medline] PHST- 2025/02/19 12:24 [pubmed] PHST- 2025/02/19 09:12 [entrez] PHST- 2025/05/07 00:00 [pmc-release] AID - CCD31454 [pii] AID - 10.1002/ccd.31454 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2025 May;105(6):1296-1303. doi: 10.1002/ccd.31454. Epub 2025 Feb 19. PMID- 39961315 OWN - NLM STAT- MEDLINE DCOM- 20250327 LR - 20250522 IS - 2213-8595 (Electronic) IS - 2213-8587 (Linking) VI - 13 IP - 4 DP - 2025 Apr TI - Effect of sotagliflozin on major adverse cardiovascular events: a prespecified secondary analysis of the SCORED randomised trial. PG - 321-332 LID - S2213-8587(24)00362-0 [pii] LID - 10.1016/S2213-8587(24)00362-0 [doi] AB - BACKGROUND: Sodium-glucose co-transporter (SGLT)-2 inhibitors have shown consistent benefit in improving heart failure-related outcomes but not ischaemic cardiovascular events such as myocardial infarction or stroke. We assessed if the dual SGLT1/2 inhibitor sotagliflozin improves ischaemic outcomes. METHODS: We did a prespecified secondary analysis of the SCORED trial, which was a double-blind, placebo-controlled, randomised clinical trial enrolling patients (aged >/=18 years) with type 2 diabetes, chronic kidney disease (estimated glomerular filtration rate [eGFR] 25-60 mL/min per 1.73 m(2)), and additional cardiovascular risk factors. Patients at 750 sites in 44 countries were randomly assigned (1:1) to oral sotagliflozin or placebo via an interactive response technology system (block size of four; stratified by heart failure-related criteria and geographical region), with participants, investigators, and study staff, including those who assessed outcomes, masked to group assignment. Sotagliflozin treatment was prescribed at 200 mg once a day, with the dose increased to 400 mg once a day within the first 6 months if tolerated. Matching placebo was prescribed at the same treatment frequency as the intervention regimen. A prespecified secondary outcome was total major adverse cardiovascular events (MACE), which was defined as a composite of cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke, assessed as first and subsequent events. Other outcomes included total myocardial infarction and total stroke (fatal and non-fatal events) as individual post-hoc endpoints. Outcomes were assessed by intention to treat with competing-risk proportional hazard models in the overall population, and, for total MACE, in prespecified subgroups stratified by baseline demographic and clinical features (sex, age, geographical region, heart failure-related criteria, eGFR, urine albumin-creatinine ratio, and cardiovascular disease history). The SCORED trial was registered at ClinicalTrials.gov, NCT03315143, and was ended early due to loss of funding. FINDINGS: 10 584 patients were enrolled and randomly assigned to sotagliflozin (n=5292 [50.0%]) or placebo (n=5292 [50.0%]) between Dec 8, 2017 and Jan 20, 2020 (median age 69 years [IQR 63-74]; 4754 [44.9%] female patients and 5830 [55.1%] male patients). 5144 (48.6%) patients had a history of cardiovascular disease, of whom 2108 (19.9% of the total population) had a history of myocardial infarction, 946 (8.9%) had a history of stroke, and 2375 (22.4%) had a history of coronary revascularisation. Patients in the sotagliflozin group had a significantly lower rate of total MACE than those in the placebo group (4.8 events per 100 person-years vs 6.3 events per 100 person-years; hazard ratio [HR] 0.77 [95% CI 0.65-0.91]; p=0.0020). Interaction analyses suggested a consistent effect of sotagliflozin on total MACE among stratified subgroups without evidence of heterogeneity. Additionally, sotagliflozin significantly reduced the rate of myocardial infarction (1.8 events per 100 person-years vs 2.7 events per 100 person-years; HR 0.68 [0.52-0.89]; p=0.0041) and stroke (1.2 events per 100 person-years vs 1.8 events per 100 person-years; HR 0.66 [0.48-0.91]; p=0.012) compared with placebo. INTERPRETATION: Sotagliflozin reduced MACE, with independent reductions in myocardial infarction and stroke, among patients with type 2 diabetes, chronic kidney disease, and additional cardiovascular risk. The ischaemic benefit on both myocardial infarction and stroke has not been previously observed with other SGLT inhibitors and warrants investigation of combined SGLT1 and SGLT2 inhibition as a possible underlying mechanism. FUNDING: Lexicon Pharmaceuticals. CI - Copyright (c) 2025 Elsevier Ltd. All rights reserved, including those for text and data mining, AI training, and similar technologies. FAU - Aggarwal, Rahul AU - Aggarwal R AD - Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston, MA, USA. FAU - Bhatt, Deepak L AU - Bhatt DL AD - Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA. Electronic address: dlbhattmd@post.harvard.edu. FAU - Szarek, Michael AU - Szarek M AD - Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA; CPC Clinical Research and University of Colorado Anschutz Medical Campus, Aurora, CO, USA; State University of New York Downstate School of Public Health, Brooklyn, NY, USA. FAU - Cannon, Christopher P AU - Cannon CP AD - Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston, MA, USA. FAU - Leiter, Lawrence A AU - Leiter LA AD - Li Ka Shing Knowledge Institute, St Michael's Hospital, University of Toronto, Toronto, ON, Canada. FAU - Inzucchi, Silvio E AU - Inzucchi SE AD - Yale School of Medicine, New Haven, CT, USA. FAU - Lopes, Renato D AU - Lopes RD AD - Duke University School of Medicine, Durham, NC, USA. FAU - McGuire, Darren K AU - McGuire DK AD - University of Texas Southwestern Medical Center and Parkland Health, Dallas, Texas, USA. FAU - Lewis, Julia B AU - Lewis JB AD - Vanderbilt University Medical Center, Nashville, Tennessee, USA. FAU - Riddle, Matthew C AU - Riddle MC AD - Oregon Health and Science University, Portland, OR, USA. FAU - Davies, Michael J AU - Davies MJ AD - Lexicon Pharmaceuticals, The Woodlands, TX, USA. FAU - Banks, Phillip AU - Banks P AD - Lexicon Pharmaceuticals, The Woodlands, TX, USA. FAU - Carroll, Amy K AU - Carroll AK AD - Lexicon Pharmaceuticals, The Woodlands, TX, USA. FAU - Scirica, Benjamin M AU - Scirica BM AD - TIMI Study Group, Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. FAU - Ray, Kausik K AU - Ray KK AD - Department of Primary Care and Public Health, Imperial College London, London, UK. FAU - Kosiborod, Mikhail N AU - Kosiborod MN AD - Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City, Kansas City, MO, USA. FAU - Cherney, David Z I AU - Cherney DZI AD - University Health Network, Toronto General Hospital Research Institute, University of Toronto, Toronto, ON, Canada. FAU - Udell, Jacob A AU - Udell JA AD - Women's College Hospital and Peter Munk Cardiac Centre, Toronto General Hospital, University of Toronto, ON, Canada. FAU - Verma, Subodh AU - Verma S AD - Li Ka Shing Knowledge Institute, St Michael's Hospital, University of Toronto, Toronto, ON, Canada. FAU - Mason, R Preston AU - Mason RP AD - Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston, MA, USA; Elucida Research, Beverly, MA, USA. FAU - Pitt, Bertram AU - Pitt B AD - University of Michigan, Ann Arbor, MI, USA. FAU - Steg, Ph Gabriel AU - Steg PG AD - Universite Paris-Cite, INSERM U1148 and AP-HP Hopital Bichat, Paris, France; French Alliance for Cardiovascular Trials, Paris, France. LA - eng SI - ClinicalTrials.gov/NCT03315143 PT - Clinical Trial, Phase III PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20250214 PL - England TA - Lancet Diabetes Endocrinol JT - The lancet. Diabetes & endocrinology JID - 101618821 RN - 6B4ZBS263Y ((2S,3R,4R,5S,6R)-2-(4-chloro-3-(4-ethoxybenzyl)phenyl)-6-(methylthio)tetrahydro-2H-pyran-3,4,5-triol) RN - 0 (Glycosides) RN - 0 (Sodium-Glucose Transporter 2 Inhibitors) SB - IM CIN - Lancet Diabetes Endocrinol. 2025 Apr;13(4):268-270. doi: 10.1016/S2213-8587(25)00001-4. PMID: 39961316 MH - Aged MH - Female MH - Humans MH - Male MH - Middle Aged MH - *Cardiovascular Diseases/epidemiology/prevention & control/chemically induced MH - *Diabetes Mellitus, Type 2/drug therapy/complications MH - Double-Blind Method MH - *Glycosides/therapeutic use MH - *Renal Insufficiency, Chronic/drug therapy/complications MH - *Sodium-Glucose Transporter 2 Inhibitors/therapeutic use COIS- Declaration of interests RA is involved in research funded by the Bristol Myers Squibb-Pfizer alliance, Novartis, Amarin, and Lexicon Pharmaceuticals. He has previously served as a consultant for Lexicon. DLB receives research funding from Lexicon Pharmaceuticals paid to the Icahn School of Medicine at Mount Sinai for his role as Chair of the SCORED trial and discloses the following relationships: advisory board membership for Angiowave, Bayer, Boehringer Ingelheim, CellProthera, Cereno Scientific, Elsevier Practice Update Cardiology, E-Star Biotech, High Enroll, Janssen, Level Ex, McKinsey, Medscape Cardiology, Merck, MyoKardia, NirvaMed, Novo Nordisk, PhaseBio, PLx Pharma, Stasys; Board of Directors membership for the American Heart Association New York City, Angiowave, Bristol Myers Squibb, DRS.LINQ, and High Enroll (and holds stock or stock options with Angiowave, Bristol Myers Squibb, DRS.LINQ, and High Enroll); consulting for Broadview Ventures, GlaxoSmithKline, Hims, SFJ, and Youngene; data monitoring committee participation for Acesion Pharma, Assistance Publique-Hopitaux de Paris, Baim Institute for Clinical Research (formerly Harvard Clinical Research Institute, for the PORTICO trial, funded by St Jude Medical, now Abbott), Boston Scientific (Chair, PEITHO trial), Cleveland Clinic, Contego Medical (Chair, PERFORMANCE 2 trial), Duke Clinical Research Institute, Mayo Clinic, Icahn School of Medicine at Mount Sinai (for the ENVISAGE trial, funded by Daiichi Sankyo; for the ABILITY-DM trial, funded by Concept Medical; and for the ALLAY-HF trial, funded by Alleviant Medical), Novartis, Population Health Research Institute, and Rutgers University (for the MINT trial, funded by the US National Institutes of Health [NIH]); honoraria from the American College of Cardiology (Senior Associate Editor, Clinical Trials and News, ACC.org; and Chair, American College of Cardiology Accreditation Oversight Committee), Arnold and Porter law firm (work related to Sanofi/Bristol Myers Squibb clopidogrel litigation), Baim Institute for Clinical Research (formerly Harvard Clinical Research Institute; for RE-DUAL PCI Clinical Trial Steering Committee membership funded by Boehringer Ingelheim; for AEGIS-II Executive Committee membership funded by CSL Behring), Belvoir Publications (Editor in Chief, Harvard Heart Letter), the Canadian Medical and Surgical Knowledge Translation Research Group (clinical trial steering committees), CSL Behring (American Heart Association lecture), Cowen and Company, Duke Clinical Research Institute (clinical trial steering committees, including for the PRONOUNCE trial, funded by Ferring Pharmaceuticals), HMP Global (Editor in Chief, Journal of Invasive Cardiology), Journal of the American College of Cardiology (Guest Editor, Associate Editor), K2P (Co-Chair, interdisciplinary curriculum), Level Ex, Medtelligence/ReachMD (continuing medical education steering committees), MJH Life Sciences, Oakstone CME (Course Director, Comprehensive Review of Interventional Cardiology), Piper Sandler, the Population Health Research Institute (for the COMPASS Operations Committee, Publications Committee, Steering Committee, and US National Co-Leader, funded by Bayer), WebMD (continuing medical education steering committees), and Wiley (steering committee); other support from Clinical Cardiology (Deputy Editor); a patent for sotagliflozin (named on a patent for sotagliflozin assigned to Brigham and Women's Hospital who assigned the patent to Lexicon Pharmaceuticals; neither DLB nor Brigham and Women's Hospital receive any income from this patent); research funding from Abbott, Acesion Pharma, Afimmune, Aker Biomarine, Alnylam, Amarin, Amgen, AstraZeneca, Bayer, Beren, Boehringer Ingelheim, Boston Scientific, Bristol Myers Squibb, Cardax, CellProthera, Cereno Scientific, Chiesi, CinCor, Cleerly, CSL Behring, Eisai, Ethicon, Faraday Pharmaceuticals, Ferring Pharmaceuticals, Forest Laboratories, Fractyl, Garmin, HLS Therapeutics, Idorsia, Ironwood, Ischemix, Janssen, Javelin, Lexicon Pharmaceuticals, Eli Lilly, Medtronic, Merck, Moderna, MyoKardia, NirvaMed, Novartis, Novo Nordisk, Otsuka, Owkin, Pfizer, PhaseBio, PLx Pharma, Recardio, Regeneron, Reid Hoffman Foundation, Roche, Sanofi, Stasys, Synaptic, The Medicines Company, Youngene, and 89Bio; royalties from Elsevier (Editor, Braunwald's Heart Disease); a role as site co-investigator for Abbott, Biotronik, Boston Scientific, CSI, Endotronix, St Jude Medical (now Abbott), Philips, SpectraWAVE, Svelte, and Vascular Solutions; a role as Trustee of the American College of Cardiology; and unfunded research with FlowCo. MS serves as a consultant for and/or has received research support from Lexicon Pharmaceuticals, Amarin, NewAmsterdam, Silence, Sanofi, Regeneron, and Tourmaline. MS also receives salary support from CPC, a non-profit academic research organisation affiliated with the University of Colorado, that receives or has received research grant or consulting funding between July, 2021 and July, 2024 from the following organisations: Abbott Laboratories, Agios Pharmaceuticals, Alexion Pharma Godo Kaisha, Amgen, Anthos Therapeutics, ARCA biopharma, Arrowhead Pharmaceuticals, AstraZeneca Pharma India, AstraZeneca UK, Bayer, Bayer Aktiengesellschaft, Bayer Pharma, Beth Israel Deaconess Medical Center, Better Therapeutics, Boston Clinical Research Institute, Bristol Myers Squibb, Cleerly, Colorado Department of Public Health and Environment, Congress, Cook Regentec, CSL Behring, Eidos Therapeutics, EPG Communication Holdings, Esperion Therapeutics, Faraday Pharmaceuticals, HeartFlow, Insmed, Ionis Pharmaceuticals, IQVIA, Janssen Pharmaceuticals, Janssen Research & Development, Janssen Scientific Affairs, Lexicon Pharmaceuticals, Medpace, Medscape, Merck Sharp & Dohme, Nectero Medical, Novartis Pharmaceuticals, Novo Nordisk, Pfizer, PPD Development, Prothena Biosciences, Regeneron, Regents of the University of Colorado (University of Colorado Denver), Sanifit Therapeutics, Sanofi, Silence Therapeutics, Stanford University, Stealth BioTherapeutics, Brigham and Women's Hospital, Thrombosis Research Institute, Tourmaline Bio, University of Colorado, University of Colorado Denver, University of Pittsburgh, VarmX, Verve Therapeutics, and WraSer. CPC has received research grants from Amgen, Better Therapeutics, Boehringer Ingelheim, Bristol Myers Squibb, Daiichi-Sankyo, Merck, Novo Nordisk, and Pfizer; has received consulting fees from Alnylam, Amarin, Amgen, Applied Therapeutics, Ascendia, Boehringer Ingelheim, Bristol Myers Squibb, Chiesi, Eli Lilly, Janssen, Lexicon Pharmaceuticals, Merck, Pfizer, Rhoshan, and Sanofi; and has served on data and safety monitoring boards for Applied Therapeutics and Novo Nordisk. LAL has received research funding from, has provided continuing medical education on behalf of, and/or has acted an adviser to Amarin, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Eli Lilly, Esperion, HLS Therapeutics, Lexicon Pharmaceuticals, Merck, Novartis, Novo Nordisk, Pfizer, and Sanofi. SEI has served as a consultant and member of clinical trial steering committees for Boehringer Ingelheim, AstraZeneca, Novo Nordisk, Merck, Pfizer, and Bayer; and has delivered lectures sponsored by Boehringer Ingelheim and AstraZeneca. RDL has received research grants or contracts from Amgen, Bristol Myers Squibb, GlaxoSmithKline, Medtronic, Pfizer, and Sanofi; has received funding for educational activities or lectures from Pfizer, Bristol Myers Squibb, Novo Nordisk, and AstraZeneca; and has received funding for consulting from Bayer, Boehringer Ingelheim, Bristol Myers Squibb, Novo Nordisk, and AstraZeneca. DKM has received research support for clinical trials leadership from Boehringer Ingelheim, Merck, Pfizer, AstraZeneca, Novo Nordisk, Esperion, Eli Lilly, Lexicon Pharmaceuticals, CSL Behring, and NewAmsterdam Pharma; and has received honoraria for consultancy from Eli Lilly, Boehringer Ingelheim, Merck, Novo Nordisk, Applied Therapeutics, Altimmune, CSL Behring, Bayer, GlaxoSmithKline, and Intercept. JBL has received consultant fees from Sanofi. MCR has received honoraria for consulting from Adocia, Anji, Xeris, DalCor, and Theracos. MJD, AKC, and PB are employees of Lexicon Pharmaceuticals, and may hold stocks or stock options in the company. BAS reports institutional research grants to Brigham and Women's Hospital from Better Therapeutics, Merck, Novo Nordisk, and Pfizer; consulting fees from Allergan, Boehringer Ingelheim, Better Therapeutics, Elsevier Practice Update Cardiology, Esperion Therapeutics, Hanmi Pharmaceutical, Lexicon Pharmaceuticals, and Novo Nordisk; and equity in Health at Scale and Doximity. DZIC has received honoraria from Boehringer Ingelheim-Eli Lilly, Merck, AstraZeneca, Sanofi, Mitsubishi Tanabe, AbbVie, Janssen, Amgen, Bayer, Prometic, Bristol Myers Squibb, Maze, Gilead, CSL Behring, Otsuka, Novartis, Youngene, Lexicon Pharmaceuticals, Inversago, GlaxoSmithKline, and Novo Nordisk, and has received operational funding for clinical trials from Boehringer Ingelheim-Eli Lilly, Merck, Janssen, Sanofi, AstraZeneca, CSL Behring, Novo Nordisk, and Bayer. SV holds a Tier 1 Canada Research Chair in Cardiovascular Surgery; and reports receiving grants and/or research support and/or speaking honoraria from Amarin, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, the Canadian Medical and Surgical Knowledge Translation Research Group, Eli Lilly, HLS Therapeutics, Humber River Health, Janssen, Merck, Novartis, Novo Nordisk, Pfizer, PhaseBio, S & L Solutions Event Management, and Sanofi. JAU discloses advisory board roles for Boehringer Ingelheim, Novavax, Novo Nordisk, and Sanofi; speaker honoraria from Amgen, AstraZeneca, Boehringer Ingelheim, and Eli Lilly; and research funding to his institution from Amgen, Bayer, Boehringer Ingelheim, and Novartis. RPM has received research funding or consulting fees from Amarin, Lexicon Pharmaceuticals, Esperion, and HLS Therapeutics. BP has received consulting fees from Lexicon Pharmaceuticals, Bayer, AstraZeneca, Boehringer Ingelheim, Merck, and Phasebio; has received consulting fees from and/or holds stock options from Viror, KBP Biosciences, Cereno Scientific, Tricida, scPharmaceuticals, SQ Innovation, G-3 Pharmaceuticals, Protonintel, and Brainstorm Medical; and holds a US patent (number 9931412) on site-specific delivery of eplerenone to the myocardium and US patent, pending (number 63/045,783) on histone-modulating agents for the protection and treatment of organ damage. PGS has received research grants from Amarin, Bayer, Sanofi, and Servier; has received speaker or consultant fees from Amarin, Amgen, AstraZeneca, Bayer, Bristol Myers Squibb, Janssen, Kowa, Idorsia, Lexicon Pharmaceuticals, Merck, Novartis, Novo Nordisk, PhaseBio, Pfizer, Regeneron, Sanofi, and Servier; and is a Senior Associate Editor of Circulation. All other authors declare no competing interests. EDAT- 2025/02/18 00:22 MHDA- 2025/03/28 00:24 CRDT- 2025/02/17 18:53 PHST- 2024/09/17 00:00 [received] PHST- 2024/11/14 00:00 [revised] PHST- 2024/11/14 00:00 [accepted] PHST- 2025/03/28 00:24 [medline] PHST- 2025/02/18 00:22 [pubmed] PHST- 2025/02/17 18:53 [entrez] AID - S2213-8587(24)00362-0 [pii] AID - 10.1016/S2213-8587(24)00362-0 [doi] PST - ppublish SO - Lancet Diabetes Endocrinol. 2025 Apr;13(4):321-332. doi: 10.1016/S2213-8587(24)00362-0. Epub 2025 Feb 14. PMID- 39955553 OWN - NLM STAT- MEDLINE DCOM- 20250215 LR - 20260721 IS - 1475-2840 (Electronic) IS - 1475-2840 (Linking) VI - 24 IP - 1 DP - 2025 Feb 15 TI - Predicting major adverse cardiac events in diabetes and chronic kidney disease: a machine learning study from the Silesia Diabetes-Heart Project. PG - 76 LID - 10.1186/s12933-025-02615-w [doi] LID - 76 AB - BACKGROUND: People living with diabetes mellitus (DM) and chronic kidney disease (CKD) are at significantly high risk of cardiovascular events (CVEs), however the predictive performance of traditional risk prediction methods are limited. METHODS: We utilised machine learning (ML) model to predict CVEs in persons with DM and CKD from the Silesia Diabetes-Heart Project, a routine standard of care dataset. CVEs were defined as composite of nonfatal myocardial infarction, new onset heart failure, nonfatal stroke, incident atrial fibrillation, undergoing percutaneous coronary intervention or coronary artery bypass grafting, hospitalisation or death due to cardiovascular disease. Five ML models (Logistic regression [LR], Random forest [RF], Support vector classification [SVC], Light gradient boosting machine [LGBM], and eXtreme gradient boosting machine [XGBM]) were constructed. The predictive performance of the five ML models was compared and the model interpretability were evaluated by Shapley Additive exPlanations (SHAP). RESULTS: A total of 1,116 people with DM and CKD out of 3,056 with DM were included (median age 67 [IQR 57-76] years; 57% men). The incidence of CVEs was 14.1% (157/1,116) during a median of 3.1 years follow-up period. Ten important features were identified through univariate Logistic regression, Boruta, and Least Absolute Shrinkage and Selection Operator [LASSO] regression. Among the five ML models based on these features, LGBM had the highest area under curve [AUC] (AUC = 0.740, 95% Confidence Interval [CI] 0.738-0.743), followed by LR (AUC = 0.621, 95% CI 0.618-0.623), RF (AUC = 0.707, 95% CI 0.704-0.709), SVC (AUC = 0.707, 95% CI 0.704-0.710), and XGBM (AUC = 0.710, 95% CI 0.707-0.713). Meanwhile, LGBM had relatively higher Recall (0.739), F1-score (0.820), and G-mean (0.826). The SHAP plot of LGBM revealed that estimated glomerular filtration rate (eGFR), age, and triglyceride glucose index were the three most important features for predicting CVEs. CONCLUSION: Ten features-based ML models, especially the LGBM model, had acceptable performance in predicting CVEs in persons with DM and CKD. A decrease in eGFR, aging, and elevated inflammatory markers significantly enhanced the predictive capability of the model. Future external validation of our model is required prior to implementation in a clinical environment. CI - (c) 2025. The Author(s). FAU - Kwiendacz, Hanna AU - Kwiendacz H AD - Department of Internal Medicine, Diabetology and Nephrology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055, Katowice, Poland. FAU - Huang, Bi AU - Huang B AD - Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital, Liverpool, UK. AD - Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China. FAU - Chen, Yang AU - Chen Y AD - Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital, Liverpool, UK. FAU - Janota, Oliwia AU - Janota O AD - Department of Internal Medicine, Diabetology and Nephrology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055, Katowice, Poland. AD - Doctoral School, Department of Internal Medicine, Diabetology and Nephrology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland. FAU - Irlik, Krzysztof AU - Irlik K AD - Department of Internal Medicine, Diabetology and Nephrology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055, Katowice, Poland. AD - Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital, Liverpool, UK. FAU - Liu, Yang AU - Liu Y AD - Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital, Liverpool, UK. AD - Department of Cardiovascular Medicine, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China. FAU - Mantovani, Marta AU - Mantovani M AD - Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital, Liverpool, UK. AD - Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy. FAU - Zheng, Yalin AU - Zheng Y AD - Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital, Liverpool, UK. AD - Department of Eye and Vision Sciences, University of Liverpool, Liverpool, UK. FAU - Hendel, Mirela AU - Hendel M AD - Student's Scientific Association at the Department of Internal Medicine, Diabetology and Nephrology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland. FAU - Piasnik, Julia AU - Piasnik J AD - Student's Scientific Association at the Department of Internal Medicine, Diabetology and Nephrology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland. FAU - Wojcik, Wiktoria AU - Wojcik W AD - Student's Scientific Association at the Department of Internal Medicine, Diabetology and Nephrology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland. FAU - Alam, Uazman AU - Alam U AD - Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital, Liverpool, UK. AD - Department of Medicine, University Hospital Aintree, Liverpool University Hospitals NHS Foundation Trust, Aintree Hospital, Liverpool, UK. FAU - Gumprecht, Janusz AU - Gumprecht J AD - Department of Internal Medicine, Diabetology and Nephrology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055, Katowice, Poland. FAU - Lip, Gregory Y H AU - Lip GYH AD - Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital, Liverpool, UK. AD - Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark. FAU - Nabrdalik, Katarzyna AU - Nabrdalik K AD - Department of Internal Medicine, Diabetology and Nephrology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055, Katowice, Poland. knabrdalik@sum.edu.pl. AD - Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital, Liverpool, UK. knabrdalik@sum.edu.pl. LA - eng PT - Comparative Study PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20250215 PL - England TA - Cardiovasc Diabetol JT - Cardiovascular diabetology JID - 101147637 SB - IM MH - Humans MH - Male MH - *Renal Insufficiency, Chronic/diagnosis/mortality/epidemiology/therapy MH - Female MH - Middle Aged MH - Risk Assessment MH - Aged MH - Predictive Value of Tests MH - *Machine Learning MH - *Diabetes Mellitus/diagnosis/mortality/epidemiology/therapy MH - Prognosis MH - Incidence MH - Time Factors MH - *Decision Support Techniques MH - Databases, Factual MH - Heart Disease Risk Factors PMC - PMC11829423 OTO - NOTNLM OT - Cardiovascular events OT - Chronic kidney disease OT - Diabetes mellitus OT - Machine learning COIS- Declarations. Ethics approval and consent to participate: Based on the decision of the Bioethics Committee of the Medical University of Silesia in Katowice, the need for ethical approval was waived (decision no. PCN/0022/KB/126/20). Consent for publication: All authors gave consent for the publication of the article. Consent to participate: Not applicable. Competing interests: G.L. is a consultant and speaker for BMS/Pfizer, Boehringer Ingelheim, Anthos and Daiichi-Sankyo. No fees are received personally. G.L. is a NIHR Senior Investigator and co-PI of the AFFIRMO project on multimorbidity in AF (grant agreement No 899871), TARGET project on digital twins for personalised management of atrial fibrillation and stroke (grant agreement No 101136244) and ARISTOTELES project on artificial intelligence for management of chronic long term conditions (grant agreement No 101080189), which are all funded by the EU's Horizon Europe Research & Innovation program. U.A. has received investigator-led funding form Proctor & Gamble. U.A. has received honoraria from Viatris, Grunenthal, Eli Lilly, Procter & Gamble, and Sanofi for educational meetings. U.A. has received funding for attendance to an international medical conference from Diiachi Sankyo. U.A. is member of the Royal Society of Medicine's Vascular, Lipid & Metabolic Medicine Section (Unpaid). K.N. received remunerations/fees for activities on behalf of Sanofi Aventis, Eli Lilly, Novo Nordisk, Astra-Zeneca, Boehringer-Ingelheim and received support for attending meetings and/or travel from Sanofi Aventis. H.K. received remunerations/fees for activities on behalf of Sanofi Aventis, Eli Lilly, Novo Nordisk, Astra-Zeneca, Boehringer-Ingelheim and received support for attending meetings and/or travel from Sanofi Aventis. Others declared none conflict of interest. EDAT- 2025/02/16 01:32 MHDA- 2025/02/16 01:33 PMCR- 2025/02/15 CRDT- 2025/02/15 23:36 PHST- 2024/10/20 00:00 [received] PHST- 2025/01/26 00:00 [accepted] PHST- 2025/02/16 01:33 [medline] PHST- 2025/02/16 01:32 [pubmed] PHST- 2025/02/15 23:36 [entrez] PHST- 2025/02/15 00:00 [pmc-release] AID - 10.1186/s12933-025-02615-w [pii] AID - 2615 [pii] AID - 10.1186/s12933-025-02615-w [doi] PST - epublish SO - Cardiovasc Diabetol. 2025 Feb 15;24(1):76. doi: 10.1186/s12933-025-02615-w. PMID- 39923225 OWN - NLM STAT- MEDLINE DCOM- 20250209 LR - 20250512 IS - 1899-1505 (Electronic) IS - 0867-5910 (Linking) VI - 75 IP - 6 DP - 2024 Dec TI - The efficacy and long-term impact of different doses of statins in patients with acute coronary syndrome. LID - 10.26402/jpp.2024.6.02 [doi] AB - We aimed to evaluate the clinical efficacy of different doses of atorvastatin in patients with acute coronary syndrome (ACS) following percutaneous coronary intervention (PCI). In this prospective, randomized controlled study, we enrolled 147 patients with ACS who underwent PCI at our hospital between April 2020 and June 2021. Participants were randomly assigned to three groups based on their post-PCI atorvastatin dose: low-dose (20 mg/day, n=49), medium-dose (40 mg/day, n=49), and high-dose (80 mg/day, n=49). We assessed clinical parameters including blood lipid profiles, inflammatory marker levels, creatine kinase (CK) levels and liver and kidney function before and after atorvastatin treatment. Adverse reactions were monitored to evaluate the safety and efficacy of the different atorvastatin doses. The mean follow-up duration was 13.76+/-1.27 months (range 12-15 months). No significant differences in baseline blood lipid levels, CK levels and inflammatory markers were observed among the groups (all P>0.05). Post-treatment, the high-dose atorvastatin group showed a more pronounced reduction in blood lipid levels and higher CK levels compared to the medium-dose and low-dose groups. Similarly, the medium-dose group had better outcomes than the low-dose group, with these differences being statistically significant (P<0.05). The high-dose group also exhibited significantly lower levels of inflammatory markers than both the medium-dose and low-dose groups after treatment (P<0.05). Adverse reactions were relatively infrequent across all groups: 4.08% in the low-dose group (1 case of nausea, 1 case of insomnia), 8.16% in the medium-dose group (1 case of insomnia, 1 case of dyspnea, 1 case of nausea, and 1 case of muscular soreness ), and 16.33% in the high-dose group (2 cases of nausea, 1 case of dyspnea, 2 cases of insomnia, and 3 cases of muscular soreness). There was no statistically significant difference in the incidence of adverse reactions among the groups (chi(2)=4.421, P=0.110). To sum up the results, high-dose atorvastatin significantly improved blood lipid profiles and reduced inflammatory markers in ACS patients following PCI, without adversely affecting liver or kidney function. Furthermore, the high-dose regimen demonstrated a favorable safety profile, suggesting its potential benefit in managing these patients population. FAU - Chen, H AU - Chen H AD - Department of Cardiology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China. chenhuidr@163.com. FAU - Hao, Y M AU - Hao YM AD - Department of Cardiology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China. LA - eng PT - Journal Article PT - Randomized Controlled Trial DEP - 20250203 PL - Poland TA - J Physiol Pharmacol JT - Journal of physiology and pharmacology : an official journal of the Polish Physiological Society JID - 9114501 RN - A0JWA85V8F (Atorvastatin) RN - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors) RN - 0 (Lipids) RN - EC 2.7.3.2 (Creatine Kinase) RN - 0 (Biomarkers) SB - IM MH - Humans MH - *Acute Coronary Syndrome/drug therapy/blood/surgery MH - Male MH - *Atorvastatin/administration & dosage/adverse effects/therapeutic use MH - Female MH - Middle Aged MH - *Hydroxymethylglutaryl-CoA Reductase Inhibitors/administration & dosage/adverse effects/therapeutic use MH - Aged MH - Percutaneous Coronary Intervention MH - Prospective Studies MH - Treatment Outcome MH - Dose-Response Relationship, Drug MH - Lipids/blood MH - Creatine Kinase/blood MH - Biomarkers/blood EDAT- 2025/02/09 12:48 MHDA- 2025/02/09 18:20 CRDT- 2025/02/09 11:52 PHST- 2024/05/09 00:00 [received] PHST- 2024/12/31 00:00 [accepted] PHST- 2025/02/09 18:20 [medline] PHST- 2025/02/09 12:48 [pubmed] PHST- 2025/02/09 11:52 [entrez] AID - 10.26402/jpp.2024.6.02 [doi] PST - ppublish SO - J Physiol Pharmacol. 2024 Dec;75(6). doi: 10.26402/jpp.2024.6.02. Epub 2025 Feb 3. PMID- 39907871 OWN - NLM STAT- MEDLINE DCOM- 20260204 LR - 20260517 IS - 1573-7241 (Electronic) IS - 0920-3206 (Linking) VI - 40 IP - 1 DP - 2026 Feb TI - Safety Analysis of Spironolactone Use in Patients Undergoing Percutaneous Coronary Intervention with High Bleeding Risk: A Propensity Score-Matched Study. PG - 191-200 LID - 10.1007/s10557-025-07676-3 [doi] AB - PURPOSE: Spironolactone has been reported to increase the risk of upper gastrointestinal bleeding in patients. We aimed to validate this perspective in a population of patients undergoing percutaneous coronary intervention with high bleeding risk (PCI-HBR). METHODS: We prospectively included a total of 1616 PCI-HBR patients who were treated at West China Hospital of Sichuan University from May 2022 to July 2024. These patients were divided into a spironolactone treatment group (n = 301) and a non-spironolactone treatment group (n = 1315). A propensity score matching was performed at a 1:4 ratio, and Cox regression analysis was conducted on the matched data. Additionally, Kaplan-Meier curves were plotted to evaluate the direct correlation between spironolactone use and gastrointestinal bleeding. And the subgroup analysis is used to assess the robustness of the results. RESULTS: In this study, after propensity score matching, a total of 927 patients were included in the outcome analysis, with 259 in the spironolactone group and 668 in the non-spironolactone group. Throughout the follow-up period, 14 (5.4%) and 42 (6.3%) patients experienced BARC 2-5 gastrointestinal bleeding events in the spironolactone and non-spironolactone groups, respectively, while 6 (2.3%) and 24 (3.6%) patients experienced BARC 3-5 gastrointestinal bleeding. The incidence of BARC 2-5 gastrointestinal bleeding was comparable between the groups (14/259 [5.4%] vs. 42/668 [6.3%]; HR 0.88 [0.48-1.62], p = 0.689), as was the incidence of BARC 3-5 gastrointestinal bleeding (6/259 [2.3%] vs. 24/668 [3.6%]; HR 0.69 [0.28-1.68], p = 0.410). No statistically significant interactions were found between spironolactone use and clinical variables such as acute coronary syndrome, diabetes, and chronic kidney disease concerning the risk of gastrointestinal bleeding. CONCLUSIONS: In summary, our prospective cohort study, which used propensity score matching, represents the first comprehensive investigation of spironolactone usage in PCI-HBR patients. Our results underscore that cardiologists need not routinely consider the risk of spironolactone-induced bleeding when making decisions about its use in patients. Larger randomized trials or analyses from existing randomized trials on spironolactone are warranted to draw definitive conclusions about the potential association between spironolactone and bleeding. CI - (c) 2025. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature. FAU - Zhang, Junyan AU - Zhang J AUID- ORCID: 0000-0002-2448-9598 AD - Department of Cardiology, West China Hospital of Sichuan University, 37 Guo Xue Xiang, Chengdu, China. FAU - Yan, Ting AU - Yan T AD - Department of Cardiology, West China Hospital of Sichuan University, 37 Guo Xue Xiang, Chengdu, China. AD - West China School of Nursing, Sichuan University, Chengdu, China. FAU - Liu, Ran AU - Liu R AD - Information Center of West China Hospital, Sichuan University, Chengdu, China. FAU - Li, Yuxiao AU - Li Y AD - Department of Cardiology, West China Hospital of Sichuan University, 37 Guo Xue Xiang, Chengdu, China. AD - West China School of Nursing, Sichuan University, Chengdu, China. FAU - Zhou, Minggang AU - Zhou M AD - Department of Cardiology, West China Hospital of Sichuan University, 37 Guo Xue Xiang, Chengdu, China. FAU - Wang, Hua AU - Wang H AD - Department of Cardiology, West China Hospital of Sichuan University, 37 Guo Xue Xiang, Chengdu, China. FAU - Li, Chen AU - Li C AD - Department of Cardiology, West China Hospital of Sichuan University, 37 Guo Xue Xiang, Chengdu, China. FAU - Rao, Li AU - Rao L AD - Department of Cardiology, West China Hospital of Sichuan University, 37 Guo Xue Xiang, Chengdu, China. FAU - Chen, Zhongxiu AU - Chen Z AD - Department of Cardiology, West China Hospital of Sichuan University, 37 Guo Xue Xiang, Chengdu, China. 619087296@qq.com. FAU - He, Yong AU - He Y AD - Department of Cardiology, West China Hospital of Sichuan University, 37 Guo Xue Xiang, Chengdu, China. heyongmd@wchscu.cn. LA - eng SI - ClinicalTrials.gov/NCT05369442 GR - 82100282/the Natural Science Foundation of China/ GR - 2021HXFH021/1.3.5 project for disciplines of excellence-Clinical Research Incubation Project, West China Hospital, Sichuan University/ GR - 2022YFS0357/The Science & Technology Pillar Program of Sichuan Province/ PT - Journal Article PT - Observational Study PT - Research Support, Non-U.S. Gov't DEP - 20250205 PL - United States TA - Cardiovasc Drugs Ther JT - Cardiovascular drugs and therapy JID - 8712220 RN - 27O7W4T232 (Spironolactone) RN - 0 (Mineralocorticoid Receptor Antagonists) SB - IM MH - Humans MH - *Spironolactone/adverse effects/administration & dosage MH - Female MH - Male MH - Propensity Score MH - *Percutaneous Coronary Intervention/adverse effects MH - Middle Aged MH - *Gastrointestinal Hemorrhage/chemically induced/epidemiology MH - Aged MH - Prospective Studies MH - *Mineralocorticoid Receptor Antagonists/adverse effects MH - Risk Factors MH - Risk Assessment MH - China/epidemiology MH - Treatment Outcome OTO - NOTNLM OT - High bleeding risk OT - Percutaneous coronary intervention OT - Propensity score matching OT - Spironolactone COIS- Declarations. Ethical Approval: The Ethics Committee of West China Hospital (No. 2022-269) and all patients provided informed consent for the procedure as well as the subsequent data collection and analysis for research. Consent to Participate: Written informed consent was obtained from all participating patients. Consent for Publication: All authors have read and approved the final manuscript for publication. Competing Interests: The authors declare no competing interests. EDAT- 2025/02/05 12:24 MHDA- 2026/02/04 15:12 CRDT- 2025/02/05 11:20 PHST- 2025/01/19 00:00 [accepted] PHST- 2026/02/04 15:12 [medline] PHST- 2025/02/05 12:24 [pubmed] PHST- 2025/02/05 11:20 [entrez] AID - 10.1007/s10557-025-07676-3 [pii] AID - 10.1007/s10557-025-07676-3 [doi] PST - ppublish SO - Cardiovasc Drugs Ther. 2026 Feb;40(1):191-200. doi: 10.1007/s10557-025-07676-3. Epub 2025 Feb 5. PMID- 39867174 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20250130 IS - 2153-8174 (Electronic) IS - 1530-6550 (Print) IS - 1530-6550 (Linking) VI - 26 IP - 1 DP - 2025 Jan TI - Development and Validation of a Nomogram for Predicting Long-Term Net Adverse Clinical Events in High Bleeding Risk Patients Undergoing Percutaneous Coronary Intervention. PG - 25352 LID - 10.31083/RCM25352 [doi] LID - 25352 AB - BACKGROUND: Patients with a high risk of bleeding undergoing percutaneous coronary intervention (PCI-HBR) were provided consensus-based criteria by the Academic Research Consortium for High Bleeding Risk (ARC-HBR). However, the prognostic predictors in this group of patients have yet to be fully explored. Thus, an effective prognostic prediction model for PCI-HBR patients is required. METHODS: We prospectively enrolled PCI-HBR patients from May 2022 to April 2024 at West China Hospital of Sichuan University. The cohort was randomly divided into training and internal validation sets in a ratio of 7:3. The least absolute shrinkage and selection operator (LASSO) regression algorithm was employed to select variables in the training set. Subsequently, a prediction model for 1-year net adverse clinical events (NACEs)-free survival was developed using a multivariable Cox regression model, and a nomogram was constructed. The outcome of the NACEs is defined as a composite endpoint that includes death, myocardial infarction, ischemic stroke, and Bleeding Academic Research Consortium (BARC) grade 3-5 major bleeding. Validation was conducted exclusively using the internal validation cohort, assessing the discrimination, calibration, and clinical utility of the nomogram. RESULTS: This study included 1512 patients with PCI-HBR, including 1058 in the derivation cohort and 454 in the validation cohort. We revealed five risk factors after LASSO regression, Cox regression, and clinical significance screening. These were then utilized to construct a prognostic prediction nomogram, including chronic kidney disease, left main stem lesion, multivessel disease, triglycerides (TG), and creatine kinase-myocardial band (CK-MB). The nomogram exhibited strong predictive ability (the area under the curve (AUC) to predict 1-year NACE-free survival was 0.728), displaying favorable levels of accuracy, discrimination, and clinical usefulness in the internal validation cohort. CONCLUSIONS: This study presents a nomogram to predict 1-year NACE outcomes in PCI-HBR patients. Internal validation showed strong predictive capability and clinical utility. Future research should validate the nomogram in diverse populations and explore new predictors for improved accuracy. CLINICAL TRIAL REGISTRATION: The data for this study were obtained from the PPP-PCI registry, NCT05369442 (https://clinicaltrials.gov/study/NCT05369442). CI - Copyright: (c) 2025 The Author(s). Published by IMR Press. FAU - Zhang, Junyan AU - Zhang J AD - Department of Cardiology, West China Hospital of Sichuan University, 610041 Chengdu, Sichuan, China. FAU - Chen, Zhongxiu AU - Chen Z AD - Department of Cardiology, West China Hospital of Sichuan University, 610041 Chengdu, Sichuan, China. FAU - Liu, Ran AU - Liu R AD - Information Center of West China Hospital, Sichuan University, 610041 Chengdu, Sichuan, China. FAU - Li, Yuxiao AU - Li Y AD - Department of Cardiology, West China Hospital of Sichuan University, 610041 Chengdu, Sichuan, China. AD - Department of Nursing, West China Hospital of Sichuan University, 610041 Chengdu, Sichuan, China. FAU - Zhao, Hongsen AU - Zhao H AD - Information Center of West China Hospital, Sichuan University, 610041 Chengdu, Sichuan, China. FAU - Li, Yanning AU - Li Y AD - Information Center of West China Hospital, Sichuan University, 610041 Chengdu, Sichuan, China. FAU - Zhou, Minggang AU - Zhou M AD - Department of Cardiology, West China Hospital of Sichuan University, 610041 Chengdu, Sichuan, China. FAU - Wang, Hua AU - Wang H AD - Department of Cardiology, West China Hospital of Sichuan University, 610041 Chengdu, Sichuan, China. FAU - Li, Chen AU - Li C AD - Department of Cardiology, West China Hospital of Sichuan University, 610041 Chengdu, Sichuan, China. FAU - Rao, Li AU - Rao L AD - Department of Cardiology, West China Hospital of Sichuan University, 610041 Chengdu, Sichuan, China. FAU - He, Yong AU - He Y AUID- ORCID: 0009-0009-5057-1147 AD - Department of Cardiology, West China Hospital of Sichuan University, 610041 Chengdu, Sichuan, China. LA - eng SI - ClinicalTrials.gov/NCT05369442 PT - Journal Article DEP - 20250117 PL - Singapore TA - Rev Cardiovasc Med JT - Reviews in cardiovascular medicine JID - 100960007 PMC - PMC11760544 OTO - NOTNLM OT - high bleeding risk OT - internal validation OT - nomogram OT - percutaneous coronary intervention OT - prediction model OT - prognosis COIS- The authors declare no conflict of interest. EDAT- 2025/01/27 06:20 MHDA- 2025/01/27 06:21 PMCR- 2025/01/17 CRDT- 2025/01/27 05:48 PHST- 2024/06/23 00:00 [received] PHST- 2024/10/04 00:00 [revised] PHST- 2024/10/16 00:00 [accepted] PHST- 2025/01/27 06:21 [medline] PHST- 2025/01/27 06:20 [pubmed] PHST- 2025/01/27 05:48 [entrez] PHST- 2025/01/17 00:00 [pmc-release] AID - S1530-6550(24)01635-1 [pii] AID - 10.31083/RCM25352 [doi] PST - epublish SO - Rev Cardiovasc Med. 2025 Jan 17;26(1):25352. doi: 10.31083/RCM25352. eCollection 2025 Jan. PMID- 39824667 OWN - NLM STAT- MEDLINE DCOM- 20250502 LR - 20250522 IS - 1444-2892 (Electronic) IS - 1443-9506 (Linking) VI - 34 IP - 2 DP - 2025 Feb TI - The Clinical Significance of PCI-Related Myocardial Infarction in Stable Ischaemic Heart Disease Patients in the Era of hs-Troponin. PG - 190-196 LID - S1443-9506(24)01838-9 [pii] LID - 10.1016/j.hlc.2024.09.011 [doi] AB - BACKGROUND & AIM: The definition and clinical relevance of percutaneous coronary intervention (PCI)-related myocardial infarction (MI) has been a topic of significant debate and controversy. It has particularly garnered widespread attention recently due to a contemporary trend of including it as a component of primary end points in major trials. The study aimed to assess the clinical relevance of PCI-related MI (PMI) according to the Fourth Universal Definition of MI using a high-sensitivity troponin (hs-Tn) assay in a real-world setting. METHODS: This was a single centre, retrospective registry analysis of consecutive patients who underwent elective PCI for stable ischaemic heart disease between January 2014 to December 2018. The primary end point was major adverse cardiovascular events (MACEs)-the composite of death, spontaneous MI, stent thrombosis and the need for repeat revascularisation within 12 months from the index procedure. RESULTS: We treated 858 patients with a mean age of 67.6 years and 78.3% were men. The incidence of PMI in our cohort was 12.8%. On univariable analysis, contrast volume >150 mL, prior coronary artery bypass graft, final thrombolysis in MI flow 0-2, total stent length and stent length >20 mm were significantly associated with increased risk of PMI. There were 46 (5.4%) MACE in total with seven (6.4%) in the PMI group and 39 (5.2%) in the non-PMI group (p=0.6). Kaplan-Meier survival curves were used to estimate 1-year MACE-free survival for the patients with PMI versus non-PMI and there was no significant difference. On multivariable Cox proportional hazards analysis, contrast volume >150 mL, prior coronary artery bypass graft and estimated glomerular filtration rate <60 (mL/min/1.73 m(2)) were independent predictors of MACE during 1-year follow-up, whereas PMI was not an independent predictor. CONCLUSIONS: PMI defined according to the Fourth Universal Definition of MI and using hs-Tn was common, occurring in 12.8% of patients, but not independently predictive of MACE in 1 year. As PMIs are increasingly used as a component of composite primary end points in major, practice-changing trials, establishing a clinically relevant definition of PMI is of utmost importance. CI - Copyright (c) 2024 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved. FAU - Das, Souvik Kumar AU - Das SK AD - Department of Cardiology, The Canberra Hospital, Canberra, ACT, Australia; Department of Cardiology, Royal Melbourne Hospital, Melbourne, VIC, Australia. Electronic address: souvik.das@mh.org.au. FAU - Itty, Charles AU - Itty C AD - Department of Cardiology, The Canberra Hospital, Canberra, ACT, Australia. FAU - Tran, Quan AU - Tran Q AD - Department of Cardiology, The Canberra Hospital, Canberra, ACT, Australia. FAU - Das, Avik Kumar AU - Das AK AD - Department of Cardiology, The Canberra Hospital, Canberra, ACT, Australia. FAU - Farshid, Ahmad AU - Farshid A AD - Australian National University, Canberra, ACT, Australia; National Capital Private Hospital, Canberra, ACT, Australia. LA - eng PT - Journal Article DEP - 20250116 PL - Australia TA - Heart Lung Circ JT - Heart, lung & circulation JID - 100963739 RN - 0 (Troponin) RN - 0 (Biomarkers) SB - IM MH - Humans MH - Male MH - Female MH - *Percutaneous Coronary Intervention/adverse effects MH - Aged MH - Retrospective Studies MH - *Myocardial Infarction/blood/etiology/epidemiology MH - *Myocardial Ischemia/surgery/blood MH - *Registries MH - *Troponin/blood MH - Follow-Up Studies MH - Biomarkers/blood MH - Middle Aged MH - Incidence MH - Risk Factors MH - Clinical Relevance OTO - NOTNLM OT - Elective PCI OT - High-sensitivity troponin OT - Percutaneous coronary interventions OT - Periprocedural myocardial infarctions COIS- Declaration of Competing Interests There are no conflicts of interest to disclose. EDAT- 2025/01/18 15:10 MHDA- 2025/02/04 00:20 CRDT- 2025/01/17 21:52 PHST- 2024/01/03 00:00 [received] PHST- 2024/07/23 00:00 [revised] PHST- 2024/09/24 00:00 [accepted] PHST- 2025/02/04 00:20 [medline] PHST- 2025/01/18 15:10 [pubmed] PHST- 2025/01/17 21:52 [entrez] AID - S1443-9506(24)01838-9 [pii] AID - 10.1016/j.hlc.2024.09.011 [doi] PST - ppublish SO - Heart Lung Circ. 2025 Feb;34(2):190-196. doi: 10.1016/j.hlc.2024.09.011. Epub 2025 Jan 16. PMID- 39818975 OWN - NLM STAT- MEDLINE DCOM- 20250122 LR - 20260918 IS - 2047-9980 (Electronic) IS - 2047-9980 (Linking) VI - 14 IP - 2 DP - 2025 Jan 21 TI - Influence of Worsening Renal Function and Baseline Chronic Kidney Disease on Clinical Outcomes in Patients With Chronic Coronary Syndromes: Insights From the REAL-CAD Study. PG - e034627 LID - 10.1161/JAHA.124.034627 [doi] LID - e034627 AB - BACKGROUND: The effect of worsening renal function and baseline chronic kidney disease (CKD) on outcomes in patients with chronic coronary syndrome in the setting of optimal medical therapy remains unknown. METHODS AND RESULTS: The REAL-CAD (Randomized Evaluation of Aggressive or Moderate Lipid Lowering Therapy With Pitavastatin in Coronary Artery Disease) study is a prospective, multicenter, randomized trial of high-dose (pitavastatin 4 mg/day) or low-dose (pitavastatin 1 mg/day) statin therapy in 12 118 patients with chronic coronary syndrome. The primary end point was a composite of cardiovascular death, nonfatal myocardial infarction, stroke, or unstable angina requiring hospitalization (major adverse cardiac and cerebral events [MACCE]). CKD was defined as an estimated glomerular filtration rate [eGFR] <60 mL/min per 1.73 m(2). WRF was defined as a decrease in eGFR >/=20% in the initial year; borderline renal function was an annual decrease of 0%/=18 years at 784 sites in the National Cardiovascular Data Registry Chest Pain-MI Registry were used to develop a risk-standardized model to predict in-hospital mortality. The sample was randomly divided into 70% development (n=220 014) and 30% validation (n=93 811) samples, and 23 separate registry-based patient characteristics at presentation were considered for model inclusion using stepwise logistic regression with 1000 bootstrapped samples. A simplified risk score was also developed for individual risk stratification. RESULTS: The mean age of the study cohort was 65.3 (SD 13.1) years, and 33.6% were women. The overall in-hospital mortality rate was 5.0% (n=15 822 deaths). The final model included 14 variables, with out-of-hospital cardiac arrest, cardiogenic shock, and ST-segment elevation MI as the strongest independent predictors of mortality. The model also included age, comorbidities (dyslipidemia, diabetes, prior percutaneous coronary intervention, cerebrovascular disease, and peripheral artery disease), heart failure on admission, heart rate, systolic blood pressure, glomerular filtration rate, and hemoglobin. The model demonstrated excellent discrimination (C-statistic, 0.868 [95% CI 0.865-0.871]) and good calibration, with similar performance across subgroups based on MI type, periods before and during the COVID-19 pandemic, and hospital volume. The simplified risk score included values from 0 to 25, with mortality risk ranging from 0.3% with a score of 0 to 1 up to 49.4% with a score >11. CONCLUSIONS: This contemporary risk model accurately predicts in-hospital mortality for patients with acute MI and can be used for risk standardization across hospitals and at the bedside for patient prognostication. FAU - Faridi, Kamil F AU - Faridi KF AUID- ORCID: 0000-0002-9276-9110 AD - Section of Cardiovascular Medicine, Department of Medicine, Yale School of Medicine, New Haven, CT (K.F.F., Y.W., K.E.M., R.L.M.N., J.P.C.). AD - Center for Outcomes Research and Evaluation, Yale New Haven Health, New Haven, CT (K.F.F., Y.W., K.E.M., R.L.M.N., L.P., J.P.C.). FAU - Wang, Yongfei AU - Wang Y AUID- ORCID: 0000-0001-5764-2213 AD - Section of Cardiovascular Medicine, Department of Medicine, Yale School of Medicine, New Haven, CT (K.F.F., Y.W., K.E.M., R.L.M.N., J.P.C.). AD - Center for Outcomes Research and Evaluation, Yale New Haven Health, New Haven, CT (K.F.F., Y.W., K.E.M., R.L.M.N., L.P., J.P.C.). FAU - Minges, Karl E AU - Minges KE AUID- ORCID: 0000-0002-9063-8272 AD - Section of Cardiovascular Medicine, Department of Medicine, Yale School of Medicine, New Haven, CT (K.F.F., Y.W., K.E.M., R.L.M.N., J.P.C.). AD - Center for Outcomes Research and Evaluation, Yale New Haven Health, New Haven, CT (K.F.F., Y.W., K.E.M., R.L.M.N., L.P., J.P.C.). FAU - Smilowitz, Nathaniel R AU - Smilowitz NR AUID- ORCID: 0000-0002-6823-2815 AD - Division of Cardiology, Department of Medicine, NYU Grossman School of Medicine, New York, NY (N.R.S.). FAU - McNamara, Robert L AU - McNamara RL AUID- ORCID: 0000-0002-1364-7749 AD - Section of Cardiovascular Medicine, Department of Medicine, Yale School of Medicine, New Haven, CT (K.F.F., Y.W., K.E.M., R.L.M.N., J.P.C.). AD - Center for Outcomes Research and Evaluation, Yale New Haven Health, New Haven, CT (K.F.F., Y.W., K.E.M., R.L.M.N., L.P., J.P.C.). FAU - Kontos, Michael C AU - Kontos MC AD - Division of Cardiology, Department of Medicine, Virginia Commonwealth University, Richmond, VA (M.C.K.). FAU - Wang, Tracy Y AU - Wang TY AD - Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (T.Y.W.). FAU - Connors, Annie C AU - Connors AC AD - Division of Cardiology, Tufts Medical Center, Boston, MA (A.C.C.). FAU - Clary, Julie M AU - Clary JM AD - Division of Cardiology, Indiana University School of Medicine, Indianapolis (J.M.C.). FAU - Osborne, Anwar D AU - Osborne AD AUID- ORCID: 0000-0001-8235-2330 AD - Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA (A.D.O.). FAU - Pereira, Lucy AU - Pereira L AD - Center for Outcomes Research and Evaluation, Yale New Haven Health, New Haven, CT (K.F.F., Y.W., K.E.M., R.L.M.N., L.P., J.P.C.). FAU - Curtis, Jeptha P AU - Curtis JP AUID- ORCID: 0000-0002-6872-0501 AD - Section of Cardiovascular Medicine, Department of Medicine, Yale School of Medicine, New Haven, CT (K.F.F., Y.W., K.E.M., R.L.M.N., J.P.C.). AD - Center for Outcomes Research and Evaluation, Yale New Haven Health, New Haven, CT (K.F.F., Y.W., K.E.M., R.L.M.N., L.P., J.P.C.). FAU - Blankinship, Kristina AU - Blankinship K AUID- ORCID: 0009-0007-8355-0882 AD - American College of Cardiology, Washington DC (K.B., J.M.). FAU - Mayfield, Jarrott AU - Mayfield J AD - American College of Cardiology, Washington DC (K.B., J.M.). FAU - Abbott, J Dawn AU - Abbott JD AUID- ORCID: 0000-0002-2560-0155 AD - Division of Cardiology Lifespan Cardiovascular Institute, Warren Alpert Medical School of Brown University, Providence, RI (J.D.A.). LA - eng GR - K23 HL150315/HL/NHLBI NIH HHS/United States GR - K23 HL161424/HL/NHLBI NIH HHS/United States PT - Journal Article PT - Multicenter Study DEP - 20250113 PL - United States TA - Circ Cardiovasc Qual Outcomes JT - Circulation. Cardiovascular quality and outcomes JID - 101489148 SB - IM MH - Humans MH - Female MH - *Hospital Mortality MH - Male MH - Registries MH - Aged MH - Middle Aged MH - Risk Assessment MH - *Myocardial Infarction/mortality/diagnosis/therapy MH - United States/epidemiology MH - Risk Factors MH - Prognosis MH - *Hospitalization MH - Time Factors MH - Predictive Value of Tests MH - Aged, 80 and over MH - *Decision Support Techniques MH - Reproducibility of Results PMC - PMC11919567 MID - NIHMS2042885 OTO - NOTNLM OT - mortality risk OT - myocardial infarction OT - quality of health care COIS- Dr Faridi receives research funding from the NIH/NHLBI (K23HL161424). Y. Wang reports compensation for performing data analytic services for the American College of Cardiology. Dr Minges reports compensation for performing data analytic services for the American College of Cardiology. Dr Smilowitz receives research funding from the National Institutes of Health/National Heart, Lung and Blood Institute (K23HL150315) and serves as a consultant for Abbott Vascular. L. Pereira reports compensation for performing data analytic services for the American College of Cardiology. Dr Curtis has a contract with the American College of Cardiology (ACC) for his role as Chief Scientific Advisor of the ACC's National Cardiovascular Data Registry. He holds equity interest in Medtronic. Dr Abbott reports consulting with Abbott, Medtronic, and Penumbra, and research with Recor, Boston Scientific, Shockwave, and Med Alliance. The other authors report no conflicts. EDAT- 2025/01/13 06:16 MHDA- 2025/03/18 18:22 PMCR- 2026/03/01 CRDT- 2025/01/13 05:03 PHST- 2025/03/18 18:22 [medline] PHST- 2025/01/13 06:16 [pubmed] PHST- 2025/01/13 05:03 [entrez] PHST- 2026/03/01 00:00 [pmc-release] AID - 10.1161/CIRCOUTCOMES.124.011259 [doi] PST - ppublish SO - Circ Cardiovasc Qual Outcomes. 2025 Mar;18(3):e011259. doi: 10.1161/CIRCOUTCOMES.124.011259. Epub 2025 Jan 13. PMID- 39763313 OWN - NLM STAT- MEDLINE DCOM- 20250930 LR - 20250930 IS - 2149-2271 (Electronic) IS - 2149-2263 (Print) IS - 2149-2263 (Linking) VI - 29 IP - 2 DP - 2025 Feb 1 TI - Comparison of 1-Year Clinical Outcomes Between Ticagrelor Versus Clopidogrel in Type 2 Diabetes Patients After Implantation of Small Diameter Stents. PG - 95-103 LID - 10.14744/AnatolJCardiol.2024.4603 [doi] AB - BACKGROUND: Type 2 diabetes mellitus (T2DM) patients with small-diameter stents (SDS), that are equal to or less than 2.5 mm in diameter, face increased risks of restenosis and complications. This study aimed to evaluate the 1-year follow-up to assess the rate of major adverse cardiac events (MACE) and bleeding risk between ticagrelor and clopidogrel in T2DM patients after SDS implantation. METHODS: The study was a single-center, prospective controlled registry trial, which included 332 T2DM patients who underwent percutaneous coronary intervention with SDS implantation. Follow-up was conducted for 1 year. RESULTS: Following propensity score matching, the 1-year analysis revealed no significant difference in the risk of the composite MACE between clopidogrel and ticagrelor groups (P = .295). Male gender, history of ischemic heart disease, ejection fraction (EF), coronary lesion type, and chronic kidney disease (CKD) were identified as potential predictors for the composite endpoint. In a subanalysis of CKD patients, the 12-month rates of composites of cardiac death (CD), myocardial infarction (MI), stroke, and target vessel revascularization (TVR) were lower in the ticagrelor group than in the clopidogrel group (P = .024). However, the ticagrelor group was associated with a higher rate of bleeding compared to the clopidogrel group (20% vs. 9%) (P = .041). CONCLUSION: Our study demonstrated that ticagrelor did not show improvement in the composite of CD, MI, stroke, TVR, or the risk of bleeding events defined by the BARC criteria in patients with T2DM and SDS compared with clopidogrel emphasizing the importance of individualized treatment decisions based on patient characteristics. However, the results may not be representative of the entire population. FAU - Algazzar, Alaa S AU - Algazzar AS AD - Department of Cardiology, Ahmed Maher Teaching Hospital, Cairo, Egypt. FAU - Aljondi, Raghad M AU - Aljondi RM AD - Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia. FAU - Metwalli, Eilaf Majdi AU - Metwalli EM AD - Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia. FAU - Dhaher, Ghazal Y AU - Dhaher GY AD - Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia. FAU - Mushaeb, Hanan H AU - Mushaeb HH AD - Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia. FAU - Aljadani, Renad H AU - Aljadani RH AD - Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia. FAU - Balahmar, Rahaf S AU - Balahmar RS AD - Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia. FAU - Hafiz, Awatif AU - Hafiz A AD - Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia. FAU - Qutub, Mohamed A AU - Qutub MA AD - Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia. LA - eng PT - Comparative Study PT - Journal Article DEP - 20250107 PL - Turkey TA - Anatol J Cardiol JT - Anatolian journal of cardiology JID - 101652981 RN - GLH0314RVC (Ticagrelor) RN - A74586SNO7 (Clopidogrel) RN - 0 (Platelet Aggregation Inhibitors) SB - IM MH - Humans MH - *Ticagrelor/therapeutic use MH - Male MH - *Clopidogrel/therapeutic use MH - Female MH - *Diabetes Mellitus, Type 2/complications MH - Middle Aged MH - *Platelet Aggregation Inhibitors/therapeutic use MH - Prospective Studies MH - Treatment Outcome MH - *Stents MH - Percutaneous Coronary Intervention MH - Aged MH - Registries MH - Follow-Up Studies PMC - PMC11793804 COIS- Declaration of Interests: The authors have no conflict of interests to declare. EDAT- 2025/01/07 06:22 MHDA- 2025/09/30 06:36 PMCR- 2025/02/01 CRDT- 2025/01/07 02:53 PHST- 2025/09/30 06:36 [medline] PHST- 2025/01/07 06:22 [pubmed] PHST- 2025/01/07 02:53 [entrez] PHST- 2025/02/01 00:00 [pmc-release] AID - ajc-29-2-95 [pii] AID - 10.14744/AnatolJCardiol.2024.4603 [doi] PST - ppublish SO - Anatol J Cardiol. 2025 Feb 1;29(2):95-103. doi: 10.14744/AnatolJCardiol.2024.4603. Epub 2025 Jan 7. PMID- 39756819 OWN - NLM STAT- MEDLINE DCOM- 20250106 LR - 20250129 IS - 2053-3624 (Print) IS - 2053-3624 (Electronic) IS - 2053-3624 (Linking) VI - 12 IP - 1 DP - 2025 Jan 4 TI - Sex differences in ST-segment elevation myocardial infarction patients treated by primary percutaneous intervention. LID - 10.1136/openhrt-2024-002831 [doi] LID - e002831 AB - INTRODUCTION: The impact of sex on coronary artery disease prognosis is debated. It has been postulated that women receive less prompt treatment compared with men, potentially adversely affecting their prognosis by significantly increasing the risk of morbidity and mortality. We aim to investigate the influence of sex on the timing and clinical outcomes of ST-segment elevation myocardial infarction (STEMI) patients using a controlled Swiss registry. METHODS AND RESULTS: Based on the Fribourg STEMI Fast Track Registry, 1177 patients (288 women, 889 men) with >12 months clinical follow-up were selected. Women had longer first medical contact to reperfusion times (1.31 (1.14-2.00) vs 1.27 (1.09-1.54) hours, p=0.035) but similar total ischaemic times (3.04 (2.15-4.50) vs 2.56 (2.07-4.38) hours, p=0.064). Men had higher rates of diabetes, smoking and dyslipidaemia, while women had higher hypertension and renal insufficiency rates. No significant sex differences in clinical outcomes were observed at 1-year and 5-year follow-ups. DISCUSSION: The study found sex differences in patient profiles and minor treatment delays for women, which did not significantly affect outcomes. Efforts to improve sex equity in STEMI care are effective, as no significant outcome differences were observed. Disparities are more related to patient characteristics than sex. CONCLUSION: Despite slight delays and different risk profiles for women with STEMI, clinical outcomes are similar between sexes. Ongoing efforts are needed to ensure sex equity in acute coronary syndrome management. TRIAL REGISTRATION NUMBER: NCT04185285. CI - (c) Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY. Published by BMJ Group. FAU - Cook, Selma T AU - Cook ST AD - Cardiology, University Hospital Fribourg, Fribourg, Switzerland. FAU - Allemann, Laure AU - Allemann L AD - Cardiology, University Hospital Fribourg, Fribourg, Switzerland. FAU - Cook, Malica AU - Cook M AD - Cardiology, University Hospital Fribourg, Fribourg, Switzerland. FAU - Arroyo, Diego A AU - Arroyo DA AD - Cardiology, University Hospital Fribourg, Fribourg, Switzerland. FAU - Pittet, Thais AU - Pittet T AD - Cardiology, University Hospital Fribourg, Fribourg, Switzerland. FAU - Meier, Pascal AU - Meier P AD - Cardiology, University Hospital Fribourg, Fribourg, Switzerland. FAU - Togni, Mario AU - Togni M AD - Cardiology, University Hospital Fribourg, Fribourg, Switzerland. FAU - Brahim-Mathiron, Amel AU - Brahim-Mathiron A AD - Cardiology, University Hospital Fribourg, Fribourg, Switzerland. FAU - Puricel, Serban AU - Puricel S AD - Cardiology, University Hospital Fribourg, Fribourg, Switzerland. FAU - Cook, Stephane AU - Cook S AUID- ORCID: 0000-0003-1221-2978 AD - Cardiology, University Hospital Fribourg, Fribourg, Switzerland stephane.cook@unifr.ch. LA - eng SI - ClinicalTrials.gov/NCT04185285 PT - Comparative Study PT - Journal Article PT - Multicenter Study DEP - 20250104 PL - England TA - Open Heart JT - Open heart JID - 101631219 SB - IM MH - Aged MH - Female MH - Humans MH - Male MH - Middle Aged MH - Follow-Up Studies MH - Health Status Disparities MH - Healthcare Disparities MH - *Percutaneous Coronary Intervention/methods MH - Registries MH - Risk Assessment/methods MH - Risk Factors MH - Sex Factors MH - *ST Elevation Myocardial Infarction/diagnosis/epidemiology/therapy MH - Switzerland/epidemiology MH - Time Factors MH - Time-to-Treatment MH - Treatment Outcome PMC - PMC11751907 OTO - NOTNLM OT - Acute Coronary Syndrome OT - Atherosclerosis OT - Clinical Competence COIS- Competing interests: None declared. EDAT- 2025/01/06 10:07 MHDA- 2025/01/07 00:21 PMCR- 2025/01/04 CRDT- 2025/01/05 20:42 PHST- 2024/07/11 00:00 [received] PHST- 2024/12/12 00:00 [accepted] PHST- 2025/01/07 00:21 [medline] PHST- 2025/01/06 10:07 [pubmed] PHST- 2025/01/05 20:42 [entrez] PHST- 2025/01/04 00:00 [pmc-release] AID - openhrt-2024-002831 [pii] AID - 10.1136/openhrt-2024-002831 [doi] PST - epublish SO - Open Heart. 2025 Jan 4;12(1):e002831. doi: 10.1136/openhrt-2024-002831. PMID- 39735867 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20250104 IS - 2297-055X (Print) IS - 2297-055X (Electronic) IS - 2297-055X (Linking) VI - 11 DP - 2024 TI - Prediction of postoperative stroke in patients experienced coronary artery bypass grafting surgery: a machine learning approach. PG - 1448740 LID - 10.3389/fcvm.2024.1448740 [doi] LID - 1448740 AB - BACKGROUND: Coronary artery bypass grafting (CABG) surgery has been a widely accepted method for treating coronary artery disease. However, its postoperative complications can have a significant effect on long-term patient outcomes. A retrospective study was conducted to identify before and after surgery that contribute to postoperative stroke in patients undergoing CABG, and to develop predictive models and recommendations for single-factor thresholds. MATERIALS AND METHODS: We utilized data from 1,200 patients who undergone CABG surgery at the Wuhan Union Hospital from 2016 to 2022, which was divided into a training group (n = 841) and a test group (n = 359). 33 preoperative clinical features and 4 postoperative complications were collected in each group. LASSO is a regression analysis method that performs both variable selection and regularization to enhance model prediction accuracy and interpretability. The LASSO method was used to verify the collected features, and the SHAP value was used to explain the machine model prediction. Six machine learning models were employed, and the performance of the models was evaluated by area under the curve (AUC) and decision curve analysis (DCA). AUC, or area under the receiver operating characteristic curve, quantifies the ability of a model to distinguish between positive and negative outcomes. Finally, this study provided a convenient online tool for predicting CABG patient post-operative stroke. RESULTS: The study included a combined total of 1,200 patients in both the development and validation cohorts. The average age of the participants in the study was 60.26 years. 910 (75.8%) of the patients were men, and 153 (12.8%) patients were in NYHA class III and IV. Subsequently, LASSO model was used to identify 11 important features, which were mechanical ventilation time, preoperative creatinine value, preoperative renal insufficiency, diabetes, the use of an intra-aortic balloon pump (IABP), age, Cardiopulmonary bypass time, Aortic cross-clamp time, Chronic Obstructive Pulmonary Disease (COPD) history, preoperative arrhythmia and Renal artery stenosis in descending order of importance according to the SHAP value. According to the analysis of receiver operating characteristic (ROC) curve, AUC, DCA and sensitivity, all seven machine learning models perform well and random forest (RF) machine model was found to perform best (AUC-ROC = 0.9008, Accuracy: 0.9008, Precision: 0.6905; Recall: 0.7532, F1: 0.7205). Finally, an online tool was established to predict the occurrence of stroke after CABG based on the 11 selected features. CONCLUSION: Mechanical ventilation time, preoperative creatinine value, preoperative renal insufficiency, diabetes, the use of an intra-aortic balloon pump (IABP), age, Cardiopulmonary bypass time, Aortic cross-clamp time, Chronic Obstructive Pulmonary Disease (COPD) history, preoperative arrhythmia and Renal artery stenosis in the preoperative and intraoperative period was associated with significant postoperative stroke risk, and these factors can be identified and modeled to assist in implementing proactive measures to protect the brain in high-risk patients after surgery. CI - (c) 2024 Chen, Wang, Wang, Fan, Yan, Wang, Liu, Shi, Guo and Dong. FAU - Chen, Shiqi AU - Chen S AD - Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China. FAU - Wang, Kan AU - Wang K AD - Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China. FAU - Wang, Chen AU - Wang C AD - Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China. FAU - Fan, Zhengfeng AU - Fan Z AD - Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China. FAU - Yan, Lizhao AU - Yan L AD - Department of Hand Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China. FAU - Wang, Yixuan AU - Wang Y AD - Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China. FAU - Liu, Fayuan AU - Liu F AD - Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China. FAU - Shi, JiaWei AU - Shi J AD - Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China. FAU - Guo, QianNan AU - Guo Q AD - Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China. FAU - Dong, NianGuo AU - Dong N AD - Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China. LA - eng PT - Journal Article DEP - 20241213 PL - Switzerland TA - Front Cardiovasc Med JT - Frontiers in cardiovascular medicine JID - 101653388 PMC - PMC11671478 OTO - NOTNLM OT - coronary artery bypass grafting (CABG) OT - machine learning (ML) OT - postoperative complications OT - preoperative clinical features OT - random forest OT - stroke COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2024/12/30 06:19 MHDA- 2024/12/30 06:20 PMCR- 2024/01/01 CRDT- 2024/12/30 05:38 PHST- 2024/06/13 00:00 [received] PHST- 2024/11/30 00:00 [accepted] PHST- 2024/12/30 06:20 [medline] PHST- 2024/12/30 06:19 [pubmed] PHST- 2024/12/30 05:38 [entrez] PHST- 2024/01/01 00:00 [pmc-release] AID - 10.3389/fcvm.2024.1448740 [doi] PST - epublish SO - Front Cardiovasc Med. 2024 Dec 13;11:1448740. doi: 10.3389/fcvm.2024.1448740. eCollection 2024. PMID- 39701404 OWN - NLM STAT- MEDLINE DCOM- 20250222 LR - 20250605 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 239 DP - 2025 Mar 15 TI - Optimal Intravascular Ultrasound-Guided Percutaneous Coronary Intervention in Patients With Multivessel Disease and Chronic Kidney Disease. PG - 20-27 LID - S0002-9149(24)00873-7 [pii] LID - 10.1016/j.amjcard.2024.12.020 [doi] AB - There is a scarcity of data on clinical outcomes after intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) in patients with multivessel disease and chronic kidney disease (CKD). The Optimal Intravascular Ultrasound (OPTIVUS)-Complex PCI study multivessel cohort was a prospective multicenter single-arm trial enrolling 1,015 patients who underwent multivessel IVUS-guided PCI including left anterior descending coronary artery target with an intention to meet the prespecified OPTIVUS criteria for optimal stent expansion. We compared the clinical outcomes between patients with and without CKD. The primary end point was a composite of death, myocardial infarction, stroke, or any coronary revascularization. There were 528 patients (52.0%) without CKD (estimated glomerular filtration rate [eGFR] >/=60 ml/min/1.73 m(2)), 391 patients (38.5%) with moderate CKD (60 >eGFR >/=30 ml/min/1.73 m(2)), and 96 patients (9.5%) with severe CKD (eGFR <30 ml/min/1.73 m(2) or hemodialysis). The rate of meeting OPTIVUS criteria was not different across the 3 groups. The cumulative 1-year incidence of the primary end point was 9.1%, 9.0%, and 22.1% in patients without CKD, with moderate CKD, and with severe CKD, respectively (log-rank p <0.001). After adjusting confounders, the higher risk of severe CKD relative to no CKD remained significant for the primary end point (hazard ratio 2.42, 95% confidence interval 1.30 to 4.25, p = 0.01), whereas the risk of moderate CKD relative to no CKD was not significant for the primary end point (hazard ratio 0.97, 95% confidence interval 0.61 to 1.53, p = 0.88). In conclusion, in patients who underwent multivessel IVUS-guided PCI, and were managed with contemporary clinical practice, 1-year clinical outcomes were worse in patients with severe CKD, whereas 1-year clinical outcomes were not different between patients without CKD and with moderate CKD. CI - Copyright (c) 2024 Elsevier Inc. All rights reserved. FAU - Yamamoto, Ko AU - Yamamoto K AD - Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan. FAU - Shiomi, Hiroki AU - Shiomi H AD - Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan. FAU - Nishikawa, Ryusuke AU - Nishikawa R AD - Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan. FAU - Morimoto, Takeshi AU - Morimoto T AD - Department of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya, Japan. FAU - Miyazawa, Akiyoshi AU - Miyazawa A AD - Cardiocore Japan, Tokyo, Japan. FAU - Naganuma, Toru AU - Naganuma T AD - Department of Cardiovascular Medicine, New Tokyo Hospital, Matsudo, Japan. FAU - Suwa, Satoru AU - Suwa S AD - Department of Cardiology, Juntendo University Shizuoka Hospital, Izunokuni, Japan. FAU - Fujita, Takanari AU - Fujita T AD - Department of Cardiology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan. FAU - Domei, Takenori AU - Domei T AD - Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan. FAU - Tatsushima, Shojiro AU - Tatsushima S AD - Department of Cardiology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan. FAU - Hamaguchi, Yukihiro AU - Hamaguchi Y AD - Department of Cardiology, Shizuoka General Hospital, Shizuoka, Japan. FAU - Nishimoto, Yuji AU - Nishimoto Y AD - Department of Cardiology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan. FAU - Matsuda, Kensho AU - Matsuda K AD - Department of Cardiology, Ehime Prefectural Central Hospital, Matsuyama, Japan. FAU - Takayama, Yohei AU - Takayama Y AD - Department of Cardiology, Hamamatsu Medical Center, Hamamatsu, Japan. FAU - Kuribara, Jun AU - Kuribara J AD - Department of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Japan. FAU - Kirigaya, Hidekuni AU - Kirigaya H AD - Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan. FAU - Yoneda, Kohei AU - Yoneda K AD - Department of Cardiology, Tokushima Red Cross Hospital, Tokushima, Japan. FAU - Shigetoshi, Masataka AU - Shigetoshi M AD - Department of Cardiology, National Hospital Organization Okayama Medical Center, Okayama, Japan. FAU - Yokomatsu, Takafumi AU - Yokomatsu T AD - Department of Cardiology, Mitsubishi Kyoto Hospital, Kyoto, Japan. FAU - Kadota, Kazushige AU - Kadota K AD - Department of Cardiology, Kurashiki Central Hospital, Kurashiki, Japan. FAU - Ando, Kenji AU - Ando K AD - Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan. FAU - Hibi, Kiyoshi AU - Hibi K AD - Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan. FAU - Ono, Koh AU - Ono K AD - Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan. FAU - Kimura, Takeshi AU - Kimura T AD - Department of Cardiology, Hirakata Kohsai Hospital, Hirakata, Japan. Electronic address: taketaka@kuhp.kyoto-u.ac.jp. CN - OPTIVUS-Complex PCI investigators LA - eng PT - Journal Article PT - Multicenter Study DEP - 20241217 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM MH - Humans MH - Female MH - Male MH - *Percutaneous Coronary Intervention/methods MH - *Renal Insufficiency, Chronic/complications MH - *Ultrasonography, Interventional/methods MH - *Coronary Artery Disease/surgery/complications/diagnostic imaging MH - Prospective Studies MH - Aged MH - Middle Aged MH - Treatment Outcome MH - Glomerular Filtration Rate MH - Follow-Up Studies MH - Coronary Angiography OTO - NOTNLM OT - chronic kidney disease OT - drug-eluting stent OT - intravascular ultrasound OT - percutaneous coronary intervention COIS- Declaration of competing interest Dr Yamamoto reports honoraria from Abbott Medical and Boston Scientific. Dr Morimoto reports lecturer's fees from Abbott, AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb, Daiichi Sankyo, Japan Lifeline, Pfizer (New York, NY), Tsumura and UCB; manuscript fee from Pfizer; advisory board for GlaxoSmithKline, Novartis, and Teijin. Dr Kimura reports research grant from Abbott Medical, and Boston Scientific; honoraria from Abbott Medical, Boston Scientific, Daiichi Sankyo, Sanofi, and Terumo; participation on advisory board from Abbott Medical, Boston Scientific, and Sanofi. The remaining authors have no competing interests to declare. EDAT- 2024/12/20 00:23 MHDA- 2025/02/23 00:42 CRDT- 2024/12/19 19:17 PHST- 2024/10/24 00:00 [received] PHST- 2024/12/06 00:00 [revised] PHST- 2024/12/12 00:00 [accepted] PHST- 2025/02/23 00:42 [medline] PHST- 2024/12/20 00:23 [pubmed] PHST- 2024/12/19 19:17 [entrez] AID - S0002-9149(24)00873-7 [pii] AID - 10.1016/j.amjcard.2024.12.020 [doi] PST - ppublish SO - Am J Cardiol. 2025 Mar 15;239:20-27. doi: 10.1016/j.amjcard.2024.12.020. Epub 2024 Dec 17. PMID- 39698011 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20250104 IS - 1923-2829 (Print) IS - 1923-2837 (Electronic) IS - 1923-2829 (Linking) VI - 15 IP - 6 DP - 2024 Dec TI - Does Chronic Kidney Disease Influence Revascularization Strategy After Acute Coronary Syndrome? A Systematic Review and Meta-Analysis. PG - 425-438 LID - 10.14740/cr1731 [doi] AB - BACKGROUND: Coronary artery bypass grafting (CABG) provides superior long-term outcomes to percutaneous coronary intervention (PCI) for complex multivessel coronary artery disease (CAD). People with chronic kidney disease (CKD) have increased prevalence of multivessel CAD, but also increased surgical risk. We investigated whether CKD predicted real-world use of CABG, versus PCI, in patients revascularized for acute coronary syndrome (ACS). METHODS: Embase, MEDLINE, Scopus and CENTRAL were searched to identify articles referring to ACS and invasive coronary intervention in high-income countries (2012 - 2023). Articles were included if CABG rates were reported in ACS patients with and without CKD receiving revascularization. CKD was defined as an estimated glomerular filtration rate < 60 mL/min/1.73 m(2); proxy definitions were accepted. Random effect meta-analyses were used to determine the average effect of CKD on odds of CABG, stratified by ACS type and dialysis use. RESULTS: Searches generated 15,138 articles, of which 13 observational studies were included (n = 1,682,207). Amongst revascularized ACS patients, those with CKD were more likely to receive CABG than those without (pooled odds ratio (OR) = 1.50 (95% confidence interval (CI) = 1.30 - 1.72). This association was stronger following ST-elevation myocardial infarction (STEMI) than non-ST-elevation ACS (NSTE-ACS) (OR: 1.54 (95% CI: 1.23 - 1.93)) versus 1.16 (1.10 - 1.23), respectively). CONCLUSIONS: In high-income countries, revascularized ACS patients with CKD receive CABG (versus PCI) more frequently than those without kidney disease. However, accounting for lower use of coronary angiography in the CKD population removed this association following NSTE-ACS. Greater use of invasive angiography in those with NSTE-ACS and CKD might therefore increase access to revascularization, and thereby improve outcomes. CI - Copyright 2024, Scott et al. FAU - Scott, Jemima K AU - Scott JK AD - Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK. AD - Richard Bright Renal Service, North Bristol NHS Trust, Southmead Hospital, Bristol, UK. FAU - Letts, Matthew AU - Letts M AD - Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK. AD - Richard Bright Renal Service, North Bristol NHS Trust, Southmead Hospital, Bristol, UK. FAU - Hajee-Adam, Wafaa AU - Hajee-Adam W AD - Royal London Hospital, Whitechapel, London, UK. FAU - Chau, Hoi Man AU - Chau HM AD - Royal United Hospital, Bath, UK. FAU - Selman, Lucy E AU - Selman LE AD - Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK. FAU - Caskey, Fergus J AU - Caskey FJ AD - Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK. AD - Richard Bright Renal Service, North Bristol NHS Trust, Southmead Hospital, Bristol, UK. FAU - Bailey, Pippa K AU - Bailey PK AD - Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK. AD - Richard Bright Renal Service, North Bristol NHS Trust, Southmead Hospital, Bristol, UK. FAU - Ascione, Raimondo AU - Ascione R AD - Translational Health Sciences, University of Bristol, Bristol, UK. AD - Bristol Heart Institute, University Hospitals Bristol and Weston, Bristol, UK. FAU - Johnson, Tom AU - Johnson T AD - Translational Health Sciences, University of Bristol, Bristol, UK. AD - Bristol Heart Institute, University Hospitals Bristol and Weston, Bristol, UK. FAU - Ben-Shlomo, Yoav AU - Ben-Shlomo Y AD - Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK. AD - Cardio-CKD Working Group. LA - eng PT - Journal Article DEP - 20241203 PL - Canada TA - Cardiol Res JT - Cardiology research JID - 101557543 PMC - PMC11650572 OTO - NOTNLM OT - Chronic kidney disease OT - Meta-analysis OT - Revascularization COIS- The authors declare that there is no conflict of interest. EDAT- 2024/12/19 06:22 MHDA- 2024/12/19 06:23 PMCR- 2024/12/03 CRDT- 2024/12/19 05:17 PHST- 2024/09/11 00:00 [received] PHST- 2024/11/18 00:00 [accepted] PHST- 2024/12/19 06:23 [medline] PHST- 2024/12/19 06:22 [pubmed] PHST- 2024/12/19 05:17 [entrez] PHST- 2024/12/03 00:00 [pmc-release] AID - 10.14740/cr1731 [doi] PST - ppublish SO - Cardiol Res. 2024 Dec;15(6):425-438. doi: 10.14740/cr1731. Epub 2024 Dec 3. PMID- 39697471 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20250104 IS - 1319-0164 (Print) IS - 2213-7475 (Electronic) IS - 1319-0164 (Linking) VI - 32 IP - 12 DP - 2024 Dec TI - Real-World safety and effectiveness of evolocumab in primary hypercholesterolemia and mixed dyslipidemia in Saudi Arabia. PG - 102203 LID - 10.1016/j.jsps.2024.102203 [doi] LID - 102203 AB - INTRODUCTION: Evolocumab's short-term efficacy and safety were proven in phase-3 clinical trial, but its long-term safety and effectiveness in the Saudi population are yet to be studied. The aim of this study was to assess the long-term safety and effectiveness of evolocumab in Saudi patients with primary hypercholesterolemia or mixed dyslipidemia. METHOD: A retrospective cohort study evaluated adult patients who had newly been prescribed evolocumab for hypercholesterolemia or mixed dyslipidemia. Safety events included myocardial infarction, unstable angina, stroke, transient ischemic attack, heart failure, rhabdomyolysis, renal dysfunction, and myalgia. Effectiveness outcomes included changes in lipid profiles from baseline, assessed at 6-, 12-, 18-, and 24-month. RESULTS: The study sample were 469 who newly prescribed evolocumab, from which 69.1 % being male, were included. The most prevalent comorbidities were coronary artery disease, diabetes, and hypertension. Statin was the most commonly used therapy. The most common adverse events at 6-month follow-up, based on the incidence rate per 1000 person-years, were coronary revascularization (63.20), myalgia (44.96), myocardial infarction (31.53), unstable angina (31.49), heart failure (26.94), rhabdomyolysis without renal dysfunction (8.93), transient ischemic attack (4.46), and rhabdomyolysis with renal dysfunction (4.46). Stroke incidence increased with follow-up length, from 8.87 per 1000 person-years at 6 months to 12.84 per 1000 person-years at 24 months. Evolocumab use significantly reduced LDL and total cholesterol levels at 6, 12, 18, and 24 months follow-up, while having no significant effect on HDL or triglycerides levels. CONCLUSION: Evolocumab appeared to be safe and effective therapeutic option for patients with primary hypercholesterolemia or mixed dyslipidemia to potentially reduce LDL levels to therapeutic levels when statins are insufficient. CI - (c) 2024 The Author(s). FAU - Almutairi, Abdulaali R AU - Almutairi AR AD - Drug Sector, Saudi Food and Drug Authority, Riyadh, Saudi Arabia. FAU - Alshahrani, Walaa A AU - Alshahrani WA AD - Department of Pharmacy Practice, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Pharmacy Practice, Riyadh, Saudi Arabia. FAU - Alhathlol, Ghaida K AU - Alhathlol GK AD - Department of Pharmacy Practice, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Pharmacy Practice, Riyadh, Saudi Arabia. FAU - Alsheikh, Fatimah AU - Alsheikh F AD - Department of Pharmacy Practice, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Pharmacy Practice, Riyadh, Saudi Arabia. FAU - Alakeel, Abdulaziz AU - Alakeel A AD - Drug Sector, Saudi Food and Drug Authority, Riyadh, Saudi Arabia. FAU - Al Yami, Majed S AU - Al Yami MS AD - Department of Pharmacy Practice, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Pharmacy Practice, Riyadh, Saudi Arabia. FAU - Fouda, Mohammad AU - Fouda M AD - Drug Sector, Saudi Food and Drug Authority, Riyadh, Saudi Arabia. FAU - Almohammed, Omar A AU - Almohammed OA AD - Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia. AD - Pharmacoeconomics Research Unit, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia. FAU - Alhamed, Meshal S AU - Alhamed MS AD - College of Medicine, King Saud University, Riyadh, Saudi Arabia. FAU - Hafiz, Awatif AU - Hafiz A AD - Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia. FAU - Kutbi, Hussam AU - Kutbi H AD - Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia. FAU - Bagalagel, Alaa AU - Bagalagel A AD - Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia. FAU - Alharbi, Aisha AU - Alharbi A AD - Pharmaceutical Care Department, King Abdulaziz Medical City, Jeddah, Saudi Arabia. FAU - Alaboud, Mashael AU - Alaboud M AD - Pharmaceutical Care Department, King Abdulaziz Medical City, Jeddah, Saudi Arabia. FAU - Aljohani, Sarah AU - Aljohani S AD - Department of Clinical Pharmacy, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia. FAU - Ashram, Waddah AU - Ashram W AD - Department of medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia. AD - King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia. LA - eng PT - Journal Article DEP - 20241104 PL - Netherlands TA - Saudi Pharm J JT - Saudi pharmaceutical journal : SPJ : the official publication of the Saudi Pharmaceutical Society JID - 9705695 PMC - PMC11653656 COIS- The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2024/12/19 06:22 MHDA- 2024/12/19 06:23 PMCR- 2024/11/04 CRDT- 2024/12/19 05:09 PHST- 2024/05/02 00:00 [received] PHST- 2024/11/03 00:00 [accepted] PHST- 2024/12/19 06:23 [medline] PHST- 2024/12/19 06:22 [pubmed] PHST- 2024/12/19 05:09 [entrez] PHST- 2024/11/04 00:00 [pmc-release] AID - S1319-0164(24)00254-8 [pii] AID - 102203 [pii] AID - 10.1016/j.jsps.2024.102203 [doi] PST - ppublish SO - Saudi Pharm J. 2024 Dec;32(12):102203. doi: 10.1016/j.jsps.2024.102203. Epub 2024 Nov 4. PMID- 39686662 OWN - NLM STAT- MEDLINE DCOM- 20241217 LR - 20250205 IS - 1938-2723 (Electronic) IS - 1076-0296 (Print) IS - 1076-0296 (Linking) VI - 30 DP - 2024 Jan-Dec TI - Comparison of the Effects of Indobufen and Aspirin in Older Patients with Coronary Artery Disease After Coronary Drug-Eluting Stent Implantation: A Prospective Randomized Single-Center Study. PG - 10760296241309633 LID - 10.1177/10760296241309633 [doi] LID - 10760296241309633 AB - After coronary drug-eluting stent (DES) implantation, dual antiplatelet therapy (DAPT, usually aspirin in combination with a P2Y12 inhibitor) is necessary. However, older patients are prone to aspirin intolerance or resistance. Indobufen has been reported as an ideal alternative to aspirin. To evaluate the clinical efficacy and safety of indobufen-based DAPT in this population, a total of 251 older patients (aged >/=65 years) undergoing coronary DES implantation in a tertiary healthcare facility in Quzhou, China, were enrolled, of which 110 received indobufen-based DAPT and 141 received aspirin-based DAPT. Baseline data, adverse reactions, adverse events, angina attacks, and repeated revascularization during 1-year follow-up were collected. At 1-year follow-up, creatinine, and left ventricular ejection fraction levels in the indobufen group were higher than those in the aspirin group, whereas estimated glomerular filtration rate levels were lower than those in the aspirin group. No significant difference in the incidence of adverse reactions or adverse events was found between the two groups. At 1-year follow-up, the incidence of angina in the indobufen group was significantly lower than that in the aspirin group, and the repeated revascularization rate was lower than that in the aspirin group. Indobufen-based DAPT was beneficial in avoiding repeated revascularizations (odds ratio 0.433, 95% CI 0.229-0.821, P = 0.010). These findings highlight that, for older patients who underwent coronary DES implantation, indobufen-based DAPT may be a better choice, which can effectively improve patients' symptoms and prognosis. However, application to older patients with potential renal insufficiency requires caution. FAU - Wu, Yeshun AU - Wu Y AD - Department of Cardiology, the Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, China. RINGGOLD: 91619 FAU - Gao, Zhenyan AU - Gao Z AD - Department of Cardiology, the Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, China. RINGGOLD: 91619 FAU - Jin, Qizhi AU - Jin Q AD - Department of Cardiology, the Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, China. RINGGOLD: 91619 FAU - Zheng, Jiasheng AU - Zheng J AD - Department of Cardiology, the Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, China. RINGGOLD: 91619 FAU - Xu, Hongqing AU - Xu H AD - Department of Cardiology, the Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, China. RINGGOLD: 91619 FAU - Tu, Xiaoming AU - Tu X AUID- ORCID: 0000-0003-1148-9641 AD - Department of Cardiology, the Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, China. RINGGOLD: 91619 LA - eng PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial PL - United States TA - Clin Appl Thromb Hemost JT - Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis JID - 9508125 RN - R16CO5Y76E (Aspirin) RN - 0 (Platelet Aggregation Inhibitors) SB - IM MH - Humans MH - *Drug-Eluting Stents/adverse effects MH - Aged MH - *Aspirin/therapeutic use/administration & dosage MH - Female MH - Male MH - *Coronary Artery Disease/therapy MH - Prospective Studies MH - Platelet Aggregation Inhibitors/therapeutic use MH - Percutaneous Coronary Intervention/methods PMC - PMC11788808 OTO - NOTNLM OT - clinical efficacy OT - coronary artery disease OT - coronary drug-eluting stent implantation OT - dual antiplatelet therapy OT - indobufen COIS- Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. EDAT- 2024/12/17 11:49 MHDA- 2024/12/17 11:50 PMCR- 2024/12/16 CRDT- 2024/12/17 02:52 PHST- 2024/12/17 11:50 [medline] PHST- 2024/12/17 11:49 [pubmed] PHST- 2024/12/17 02:52 [entrez] PHST- 2024/12/16 00:00 [pmc-release] AID - 10.1177_10760296241309633 [pii] AID - 10.1177/10760296241309633 [doi] PST - ppublish SO - Clin Appl Thromb Hemost. 2024 Jan-Dec;30:10760296241309633. doi: 10.1177/10760296241309633. PMID- 39643207 OWN - NLM STAT- MEDLINE DCOM- 20250528 LR - 20250625 IS - 1885-5857 (Electronic) IS - 1885-5857 (Linking) VI - 78 IP - 6 DP - 2025 Jun TI - Prognostic impact of intravascular imaging in percutaneous coronary intervention according to atherothrombotic risk: a post hoc analysis of a randomized clinical trial. PG - 542-552 LID - S1885-5857(24)00352-9 [pii] LID - 10.1016/j.rec.2024.11.007 [doi] AB - INTRODUCTION AND OBJECTIVES: Recent randomized controlled trials support the use of intravascular imaging-guided percutaneous coronary intervention (PCI) to improve patient prognosis. However, the subsequent risk of clinical events in patients with coronary artery disease is not determined solely by lesion characteristics or how these lesions are treated. The current study investigated whether the effects of intravascular imaging in complex PCI vary according to atherothrombotic risks. METHODS: This study was a post hoc analysis of the RENOVATE-COMPLEX-PCI trial, which compared intravascular imaging-guided PCI with angiography-guided PCI in patients with complex coronary artery lesions. The study population was stratified by atherothrombotic risk, assessed using the Thrombolysis in Myocardial Infarction risk score for secondary prevention (TRS-2P). TRS-2P is calculated based on the presence of the following factors: age >/= 75 years, diabetes mellitus, hypertension, smoking, peripheral arterial disease, stroke, coronary artery bypass grafting, heart failure, and renal dysfunction. Patients were categorized into low-risk (TRS-2P <3) or high-risk (TRS-2P >/= 3) groups. The primary endpoint was target vessel failure, a composite of cardiac death, target vessel-related myocardial infarction, or clinically driven target vessel revascularization. RESULTS: Among the total study population, 1247 patients were categorized as low-risk, and 392 as high-risk. The risk of target vessel failure was significantly higher in the high-risk group than in the low-risk group (15.5% vs 7.2%; HR, 2.13; 95%CI, 1.51-3.00; P <.001). The benefits of intravascular imaging-guided PCI over angiography-guided PCI did not differ between the low-risk group (5.6% vs 10.4%; HR, 0.56; 95%CI, 0.36-0.86) and the high-risk group (14.1% vs 18.5%; HR, 0.71; 95%CI, 0.41-1.24), with no significant interaction (interaction P=.496). CONCLUSIONS: In this hypothesis-generating post hoc analysis of the RENOVATE-COMPLEX-PCI trial, patients with high atherothrombotic risk had significantly worse clinical outcomes than those with low atherothrombotic risk. Nevertheless, the prognostic impact of intravascular imaging-guided PCI compared with angiography-guided PCI was similarly observed in both low- and high-risk groups. RENOVATE-COMPLEX-PCI clinical trial register number: NCT03381872. CI - Copyright (c) 2024 Sociedad Espanola de Cardiologia. Published by Elsevier Espana, S.L.U. All rights reserved. FAU - Hong, David AU - Hong D AD - Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. FAU - Ha, Junho AU - Ha J AD - Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. FAU - Choi, Ki Hong AU - Choi KH AD - Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. FAU - Lee, Seung Hun AU - Lee SH AD - Department of Internal Medicine and Cardiovascular Center, Chonnam National University Hospital, Gwangju, Korea. FAU - Shin, Doosup AU - Shin D AD - Department of Cardiology, St Francis Hospital and Heart Center, Roslyn, New York, United States. FAU - Lee, Jong-Young AU - Lee JY AD - Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea. FAU - Lee, Seung-Jae AU - Lee SJ AD - Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea. FAU - Lee, Sang Yeub AU - Lee SY AD - Division of Cardiology, Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea; Division of Cardiology, Department of Internal Medicine, Chung-Ang University College of Medicine, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, Korea. FAU - Kim, Sang Min AU - Kim SM AD - Division of Cardiology, Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea. FAU - Yun, Kyeong Ho AU - Yun KH AD - Division of Cardiology, Department of Internal Medicine, Wonkwang University Hospital, Iksan, Korea. FAU - Cho, Jae Young AU - Cho JY AD - Division of Cardiology, Department of Internal Medicine, Wonkwang University Hospital, Iksan, Korea. FAU - Kim, Chan Joon AU - Kim CJ AD - Division of Cardiology, Department of Internal Medicine, The Catholic University of Korea, Uijeongbu St. Mary's Hospital, Seoul, Korea. FAU - Ahn, Hyo-Suk AU - Ahn HS AD - Division of Cardiology, Department of Internal Medicine, The Catholic University of Korea, Uijeongbu St. Mary's Hospital, Seoul, Korea. FAU - Nam, Chang-Wook AU - Nam CW AD - Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Hospital, Daegu, Korea. FAU - Yoon, Hyuck-Jun AU - Yoon HJ AD - Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Hospital, Daegu, Korea. FAU - Park, Yong Hwan AU - Park YH AD - Department of Cardiology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea. FAU - Lee, Wang Soo AU - Lee WS AD - Division of Cardiology, Department of Internal Medicine, Chung-Ang University College of Medicine, Chung-Ang University Hospital, Seoul, Korea. FAU - Yang, Jeong Hoon AU - Yang JH AD - Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. FAU - Choi, Seung-Hyuk AU - Choi SH AD - Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. FAU - Gwon, Hyeon-Cheol AU - Gwon HC AD - Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. FAU - Song, Young Bin AU - Song YB AD - Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. FAU - Hahn, Joo-Yong AU - Hahn JY AD - Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. FAU - Park, Taek Kyu AU - Park TK AD - Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. Electronic address: taekkyu.park@samsung.com. FAU - Lee, Joo Myung AU - Lee JM AD - Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. Electronic address: drone80@hanmail.net. CN - RENOVATE-COMPLEX-PCI Investigators LA - eng LA - spa SI - ClinicalTrials.gov/NCT03381872 PT - Journal Article PT - Randomized Controlled Trial DEP - 20241204 PL - Spain TA - Rev Esp Cardiol (Engl Ed) JT - Revista espanola de cardiologia (English ed.) JID - 101587954 SB - IM MH - Aged MH - Female MH - Humans MH - Male MH - Middle Aged MH - *Coronary Angiography/methods MH - *Coronary Artery Disease/surgery/diagnosis MH - *Coronary Vessels/diagnostic imaging/surgery MH - Follow-Up Studies MH - *Percutaneous Coronary Intervention/methods MH - Prognosis MH - Risk Assessment/methods MH - Risk Factors MH - *Ultrasonography, Interventional/methods OTO - NOTNLM OT - Coronary artery disease OT - Ecografia intravascular OT - Enfermedad arterial coronaria OT - Intervencion coronaria percutanea OT - Intravascular ultrasound OT - Ischemic risks OT - Optical coherence tomography OT - Percutaneous coronary intervention OT - Riesgos isquemicos OT - Tomografia de coherencia optica EDAT- 2024/12/07 14:46 MHDA- 2025/05/29 00:27 CRDT- 2024/12/06 20:41 PHST- 2024/09/12 00:00 [received] PHST- 2024/11/20 00:00 [accepted] PHST- 2025/05/29 00:27 [medline] PHST- 2024/12/07 14:46 [pubmed] PHST- 2024/12/06 20:41 [entrez] AID - S1885-5857(24)00352-9 [pii] AID - 10.1016/j.rec.2024.11.007 [doi] PST - ppublish SO - Rev Esp Cardiol (Engl Ed). 2025 Jun;78(6):542-552. doi: 10.1016/j.rec.2024.11.007. Epub 2024 Dec 4. PMID- 39619631 OWN - NLM STAT- MEDLINE DCOM- 20241202 LR - 20241202 IS - 1178-1998 (Electronic) IS - 1176-9092 (Print) IS - 1176-9092 (Linking) VI - 19 DP - 2024 TI - Construction and Validation of a Predictive Model for Long-Term Major Adverse Cardiovascular Events in Patients with Acute Myocardial Infarction. PG - 1965-1977 LID - 10.2147/CIA.S486839 [doi] AB - PURPOSE: Current scoring systems used to predict major adverse cardiovascular events (MACE) in patients with acute myocardial infarction (AMI) lack some key components and their predictive ability needs improvement. This study aimed to develop a more effective scoring system for predicting 3-year MACE in patients with AMI. PATIENTS AND METHODS: Our statistical analyses included data for 461 patients with AMI. Eighty percent of patients (n=369) were randomly assigned to the training set and the remaining patients (n=92) to the validation set. Independent risk factors for MACE were identified in univariate and multifactorial logistic regression analyses. A nomogram was used to create the scoring system, the predictive ability of which was assessed using calibration curve, decision curve analysis, receiver-operating characteristic curve, and survival analysis. RESULTS: The nomogram model included the following seven variables: age, diabetes, prior myocardial infarction, Killip class, chronic kidney disease, lipoprotein(a), and percutaneous coronary intervention during hospitalization. The predicted and observed values for the nomogram model were in good agreement based on the calibration curves. Decision curve analysis showed that the clinical nomogram model had good predictive ability. The area under the curve (AUC) for the scoring system was 0.775 (95% confidence interval [CI] 0.728-0.823) in the training set and 0.789 (95% CI 0.693-0.886) in the validation set. Risk stratification based on the scoring system found that the risk of MACE was 4.51-fold higher (95% CI 3.24-6.28) in the high-risk group than in the low-risk group. Notably, this scoring system demonstrated better predictive ability than the GRACE risk score (AUC 0.776 vs 0.731; P=0.007). CONCLUSION: The scoring system developed from the nomogram in this study showed favorable performance in prediction of MACE and risk stratification of patients with AMI. CI - (c) 2024 Yang et al. FAU - Yang, Peng AU - Yang P AUID- ORCID: 0009-0007-7487-6661 AD - Department of Geriatric Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People's Republic of China. FAU - Duan, Jieying AU - Duan J AD - Department of Cardiology, Henan Provincial Chest Hospital, Zhengzhou, Henan, People's Republic of China. AD - Department of Cardiology, Chest Hospital of Zhengzhou University, Zhengzhou, Henan, People's Republic of China. FAU - Li, Mingxuan AU - Li M AD - Department of Cardiology, Henan Provincial Chest Hospital, Zhengzhou, Henan, People's Republic of China. AD - Department of Cardiology, Chest Hospital of Zhengzhou University, Zhengzhou, Henan, People's Republic of China. FAU - Tan, Rui AU - Tan R AD - Department of Geriatric Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People's Republic of China. FAU - Li, Yuan AU - Li Y AD - Department of Geriatric Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People's Republic of China. FAU - Zhang, Zeqing AU - Zhang Z AD - Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People's Republic of China. FAU - Wang, Ying AU - Wang Y AUID- ORCID: 0000-0003-3535-6966 AD - Department of Geriatric Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People's Republic of China. LA - eng PT - Journal Article PT - Validation Study DEP - 20241126 PL - New Zealand TA - Clin Interv Aging JT - Clinical interventions in aging JID - 101273480 SB - IM MH - Humans MH - Male MH - Female MH - *Myocardial Infarction MH - *Nomograms MH - Aged MH - Middle Aged MH - Risk Assessment/methods MH - Risk Factors MH - *ROC Curve MH - Percutaneous Coronary Intervention MH - Logistic Models MH - Area Under Curve MH - Prognosis MH - Renal Insufficiency, Chronic/complications PMC - PMC11608036 OTO - NOTNLM OT - MACE OT - acute myocardial infarction OT - long-term outcome OT - nomogram OT - risk prediction model COIS- The authors report no conflicts of interest in this work. EDAT- 2024/12/02 06:27 MHDA- 2024/12/02 12:32 PMCR- 2024/11/26 CRDT- 2024/12/02 05:22 PHST- 2024/09/06 00:00 [received] PHST- 2024/11/12 00:00 [accepted] PHST- 2024/12/02 12:32 [medline] PHST- 2024/12/02 06:27 [pubmed] PHST- 2024/12/02 05:22 [entrez] PHST- 2024/11/26 00:00 [pmc-release] AID - 486839 [pii] AID - 10.2147/CIA.S486839 [doi] PST - epublish SO - Clin Interv Aging. 2024 Nov 26;19:1965-1977. doi: 10.2147/CIA.S486839. eCollection 2024. PMID- 39569316 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20241130 IS - 2048-8505 (Print) IS - 2048-8513 (Electronic) IS - 2048-8505 (Linking) VI - 17 IP - 11 DP - 2024 Nov TI - Integrated, person-centred care for patients with complex cardiovascular disease, diabetes mellitus and chronic kidney disease: a randomized trial. PG - sfae331 LID - 10.1093/ckj/sfae331 [doi] LID - sfae331 AB - BACKGROUND: Patients with cardiovascular disease (CVD), diabetes mellitus (DM) and chronic kidney disease (CKD) often experience fragmented care, which negatively impacts outcomes and health-related quality of life (HRQoL). This study assessed whether multidisciplinary, person-centred care at an integrated clinic improves clinical outcomes and HRQoL. METHODS: This prospective, open, blinded-endpoint trial (CareHND; NCT03362983) included 131 patients with CVD, DM and CKD stages 3-4, most of whom were enrolled during or shortly after acute hospitalization. The intervention group received person-centred care from cardiologists, nephrologists, endocrinologists and specialist nurses at an integrated clinic; the control group received traditional care from separate specialists. Primary disease progression outcome was the composite of major adverse renal and cardiovascular events (MARCE) including death, heart failure (HF) readmission, myocardial infarction, percutaneous coronary intervention/coronary artery bypass graft, acute or end-stage kidney failure, or transient ischaemic attack/stroke at 2 years. Co-primary person-centred outcomes was self-reported HRQoL by RAND-36. RESULTS: In a pre-specified interim analysis, patients randomized to integrated care had lower estimated glomerular filtration rate and higher NT-proBNP (N-terminal pro brain natriuretic peptide) than traditional care. Follow-up ranged from 2.0 to 5.7 years. Kaplan-Meier analysis showed no difference in MARCE between groups. Cox-regression adjusting for baseline differences, indicated a trend towards reduced HF hospitalizations for integrated care (hazard ratio 0.53; confidence interval 0.28-1.01; P = .054). Integrated care improved role physical and social function scores, and self-rated health (P = .021, P = .019 and P = .011, respectively). CONCLUSIONS: Integrated care improved several dimensions of HRQoL but did not improve MARCE compared with traditional care in this small trial. We observed a trend towards reduced HF hospitalizations. Overall, integrated care presents a promising alternative. CI - (c) The Author(s) 2024. Published by Oxford University Press on behalf of the ERA. FAU - Even, Gudrun AU - Even G AUID- ORCID: 0000-0001-5816-2633 AD - Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Stockholm, Sweden. FAU - Stenfors, Terese AU - Stenfors T AD - Karolinska Institutet, Department of Learning, Informatics, Management and Ethics - LIME. FAU - Jacobson, Stefan H AU - Jacobson SH AD - Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Stockholm, Sweden. FAU - Jernberg, Tomas AU - Jernberg T AD - Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Stockholm, Sweden. FAU - Franzen-Dahlin, Asa AU - Franzen-Dahlin A AD - Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Stockholm, Sweden. FAU - Jaghult, Susanna AU - Jaghult S AD - Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Stockholm, Sweden. AD - Department of Clinical Science and Education, Sodersjukhuset. FAU - Kahan, Thomas AU - Kahan T AUID- ORCID: 0000-0001-9909-4956 AD - Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Stockholm, Sweden. FAU - Spaak, Jonas AU - Spaak J AUID- ORCID: 0000-0002-2135-1294 AD - Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Stockholm, Sweden. LA - eng PT - Journal Article DEP - 20241029 PL - England TA - Clin Kidney J JT - Clinical kidney journal JID - 101579321 PMC - PMC11577277 OTO - NOTNLM OT - heart failure OT - kidney failure OT - multimorbidity OT - patient-centered OT - person-centered COIS- J.S. declares speaker honoraria from Boehringer Ingelheim, Sanofi, Bayer, AstraZeneca and Novo Nordisk, and shares in Beat Vascular Health AB. S.J. also declares speaker fee from Takeda, Eli Lilly, Mediahuset, Bristol Myers Squibb and ViforPharma. S.H.J. declares speaker and advisory board honoraria from AstraZeneca, Boehringer Ingelheim, Baxter, GlaxoSmithKline GSK and Otsuka. EDAT- 2024/11/21 06:21 MHDA- 2024/11/21 06:22 PMCR- 2024/10/29 CRDT- 2024/11/21 04:48 PHST- 2024/07/22 00:00 [received] PHST- 2024/11/21 06:22 [medline] PHST- 2024/11/21 06:21 [pubmed] PHST- 2024/11/21 04:48 [entrez] PHST- 2024/10/29 00:00 [pmc-release] AID - sfae331 [pii] AID - 10.1093/ckj/sfae331 [doi] PST - epublish SO - Clin Kidney J. 2024 Oct 29;17(11):sfae331. doi: 10.1093/ckj/sfae331. eCollection 2024 Nov. PMID- 39537270 OWN - NLM STAT- MEDLINE DCOM- 20241113 LR - 20260708 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 17 IP - 21 DP - 2024 Nov 11 TI - Surgical vs Transcatheter Treatment in Patients With Coronary Artery Disease and Severe Aortic Stenosis. PG - 2472-2485 LID - S1936-8798(24)01170-1 [pii] LID - 10.1016/j.jcin.2024.09.003 [doi] AB - BACKGROUND: Severe aortic stenosis (AS) coexists with coronary artery disease (CAD) in approximately 50% of patients. The preferred treatment is combined surgical aortic valve replacement (SAVR) and coronary artery bypass grafting (CABG). However, transcatheter aortic valve replacement (TAVR) along with percutaneous coronary intervention (PCI) has emerged as a viable alternative. OBJECTIVES: This study sought to compare the outcomes of PCI + TAVR vs CABG + SAVR. METHODS: This national multicenter retrospective study in Spain involved patients with severe AS and CAD treated between 2018 and 2021. Patients underwent either PCI + TAVR or CABG + SAVR and were compared. The primary endpoint was all-cause mortality and stroke at 1 year. Propensity score analysis was performed to mitigate baseline differences. RESULTS: Of the 1,342 included patients, 625 (46.6%) underwent PCI + TAVR, and 713 (53.1%) underwent CABG + SAVR. Patients in the percutaneous arm were older (age 81.6 +/- 5.8 years vs 72.1 +/- 7 years; P < 0.001), had a higher prevalence of chronic kidney disease (40.6% vs 14.9%; P < 0.001), and had higher Society of Thoracic Surgeons risk scores (4.3% [interquartile range (Q1-Q3): 2.8-6.4] vs 2.2% [Q1-Q3: 1.4-3.3]; P < 0.001). Technical success rates were 96% for PCI + TAVR and 98.4% for CABG + SAVR (P = 0.008), with similar periprocedural mortality (0.8% vs 0.7%; P = 0.999). However, the mortality + stroke rate at 30 days was higher in the CABG + SAVR group compared with PCI + TAVR, both in the unmatched (12.2% vs 4.7%; P = 0.005) and matched cohorts (8.8% vs 4.5%; P = 0.002), persisting at the 1-year follow-up. CONCLUSIONS: Despite a lower baseline risk, CABG + SAVR in patients with severe AS and CAD was associated with a higher rate of death and stroke compared with PCI + TAVR, highlighting the necessity for a large, randomized analysis. CI - Copyright (c) 2024 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Amat-Santos, Ignacio J AU - Amat-Santos IJ AD - Cardiology Department, Hospital Clinico Universitario, Valladolid, Spain; Centro de Investigacion Biomedica en Red-Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain. Electronic address: ijamat@gmail.com. FAU - Garcia-Gomez, Mario AU - Garcia-Gomez M AD - Cardiology Department, Hospital Clinico Universitario, Valladolid, Spain. FAU - Avanzas, Pablo AU - Avanzas P AD - Centro de Investigacion Biomedica en Red-Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain; Area Del Corazon, Hospital Universitario Central Asturias, Oviedo, Spain; Instituto de Investigacion Sanitaria Del Principado de Asturia, Oviedo, Spain; Departamento de Medicina, Universidad de Oviedo, Oviedo, Spain. FAU - Jimenez-Diaz, Victor AU - Jimenez-Diaz V AD - Centro de Investigacion Biomedica en Red-Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain; Cardiology Department, Hospital Alvaro Cunqueiro, Vigo, Spain. FAU - Alonso-Briales, Juan H AU - Alonso-Briales JH AD - Centro de Investigacion Biomedica en Red-Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain; Cardiology Department, Hospital Virgen de la Victoria, Malaga, Spain. FAU - de la Torre Hernandez, Jose M AU - de la Torre Hernandez JM AD - Cardiology Department, Hospital Universitario Marques de Valdecilla, IDIVAL, Santander, Spain. FAU - Sanz-Sanchez, Jorge AU - Sanz-Sanchez J AD - Centro de Investigacion Biomedica en Red-Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain; Cardiology Department, Hospital Universitario La Fe, Valencia, Spain. FAU - Diarte-de Miguel, Jose Antonio AU - Diarte-de Miguel JA AD - Cardiology Department, Hospital Universitario Miguel Servet, Zaragoza, Spain. FAU - Sanchez-Recalde, Angel AU - Sanchez-Recalde A AD - Cardiology Department, Hospital Ramon y Cajal, Madrid, Spain. FAU - Nombela-Franco, Luis AU - Nombela-Franco L AD - Cardiovascular Institute, Hospital Clinico San Carlos, IdISSC, Madrid, Spain. FAU - Jimenez-Mazuecos, Jesus AU - Jimenez-Mazuecos J AD - Cardiology Department, Hospital Universitario de Albacete, Albacete, Spain. FAU - Serra, Vicenc AU - Serra V AD - Cardiology Department, Hospital Universitario Vall d'Hebron, Barcelona, Spain. FAU - Nogales-Asensio, Juan Manuel AU - Nogales-Asensio JM AD - Cardiology Department, Hospital Universitario de Badajoz, Badajoz, Spain. FAU - Garcia-Blas, Sergio AU - Garcia-Blas S AD - Cardiology Department, Hospital Clinico Universitario de Valencia, Valencia, Spain. FAU - Gomez-Menchero, Antonio AU - Gomez-Menchero A AD - Cardiology Department, Hospital Juan Ramon Jimenez, Huelva, Spain. FAU - Del Valle, Raquel AU - Del Valle R AD - Centro de Investigacion Biomedica en Red-Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain; Area Del Corazon, Hospital Universitario Central Asturias, Oviedo, Spain; Instituto de Investigacion Sanitaria Del Principado de Asturia, Oviedo, Spain; Departamento de Medicina, Universidad de Oviedo, Oviedo, Spain. FAU - Mayor Deniz, Carolina AU - Mayor Deniz C AD - Cardiology Department, Hospital Alvaro Cunqueiro, Vigo, Spain. FAU - Al Houssaini, Walid AU - Al Houssaini W AD - Cardiology Department, Hospital Virgen de la Victoria, Malaga, Spain. FAU - Veiga-Fernandez, Gabriela AU - Veiga-Fernandez G AD - Cardiology Department, Hospital Universitario Marques de Valdecilla, IDIVAL, Santander, Spain. FAU - Diez-Gil, Jose Luis AU - Diez-Gil JL AD - Centro de Investigacion Biomedica en Red-Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain; Cardiology Department, Hospital Universitario La Fe, Valencia, Spain. FAU - Jimeno Sanchez, Javier AU - Jimeno Sanchez J AD - Cardiology Department, Hospital Universitario Miguel Servet, Zaragoza, Spain. FAU - Lopez Menendez, Jose AU - Lopez Menendez J AD - Cardiac Surgery Department, Hospital Ramon y Cajal, Madrid, Spain. FAU - Fernandez-Cordon, Clara AU - Fernandez-Cordon C AD - Cardiology Department, Hospital Clinico Universitario, Valladolid, Spain. FAU - Gomez-Salvador, Itziar AU - Gomez-Salvador I AD - Cardiology Department, Hospital Clinico Universitario, Valladolid, Spain; Centro de Investigacion Biomedica en Red-Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain. FAU - Bustamante-Munguira, Juan AU - Bustamante-Munguira J AD - Cardiac Surgery Department, Hospital Clinico Universitario, Valladolid, Spain. FAU - Kedhi, Elvin AU - Kedhi E AD - Cardiology Department, McGill University Hospital, Montreal, Canada. FAU - San Roman, J Alberto AU - San Roman JA AD - Cardiology Department, Hospital Clinico Universitario, Valladolid, Spain; Centro de Investigacion Biomedica en Red-Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain. LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 SB - IM CIN - JACC Cardiovasc Interv. 2024 Nov 11;17(21):2486-2487. doi: 10.1016/j.jcin.2024.09.060. PMID: 39537271 MH - Aged MH - Aged, 80 and over MH - Female MH - Humans MH - Male MH - Aortic Valve/surgery/diagnostic imaging/physiopathology MH - *Aortic Valve Stenosis/surgery/mortality/diagnostic imaging/physiopathology MH - Coronary Artery Bypass/adverse effects/mortality MH - *Coronary Artery Disease/diagnostic imaging/mortality/surgery/therapy MH - Heart Valve Prosthesis Implantation/adverse effects/mortality/instrumentation MH - Percutaneous Coronary Intervention/mortality/adverse effects MH - Retrospective Studies MH - Risk Assessment MH - Risk Factors MH - *Severity of Illness Index MH - Spain MH - Stroke/mortality/etiology MH - Time Factors MH - *Transcatheter Aortic Valve Replacement/mortality/adverse effects MH - Treatment Outcome OTO - NOTNLM OT - coronary artery bypass grafting OT - percutaneous coronary intervention OT - surgical aortic valve replacement OT - transcatheter aortic valve replacement COIS- Funding Support and Author Disclosures Dr Amat-Santos is a proctor for Medtronic, Meril Life, and Boston Scientific. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2024/11/14 03:58 MHDA- 2024/11/14 03:59 CRDT- 2024/11/13 21:02 PHST- 2024/05/04 00:00 [received] PHST- 2024/08/14 00:00 [revised] PHST- 2024/09/03 00:00 [accepted] PHST- 2024/11/14 03:59 [medline] PHST- 2024/11/14 03:58 [pubmed] PHST- 2024/11/13 21:02 [entrez] AID - S1936-8798(24)01170-1 [pii] AID - 10.1016/j.jcin.2024.09.003 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2024 Nov 11;17(21):2472-2485. doi: 10.1016/j.jcin.2024.09.003. PMID- 39506892 OWN - NLM STAT- In-Process LR - 20260520 IS - 1555-905X (Electronic) IS - 1555-9041 (Print) IS - 1555-9041 (Linking) VI - 19 IP - 12 DP - 2024 Dec 1 TI - Benefits and Harms of Coronary Revascularization in Non-Dialysis-Dependent Chronic Kidney Disease and Ischemic Heart Disease: A Systematic Review and Meta-Analysis. PG - 1562-1573 LID - 10.2215/CJN.0000000000000549 [doi] AB - KEY POINTS: In people with non-dialysis-dependent CKD, revascularization may lower all-cause mortality and risk of cardiovascular events. Adverse kidney events, which are often cited as a reason to avoid revascularization, were uncommon. Additional research on the effect of revascularization on patient-reported outcomes in people with non-dialysis-dependent CKD is needed. BACKGROUND: Cardiovascular disease is the leading cause of death in people with CKD. Coronary revascularization can improve cardiac function and prognosis in people with ischemic heart disease; however, in people with CKD, there is concern that potential harms could outweigh benefits of revascularization. Evidence on the balance of these risks and benefits, specifically in people with non-dialysis-dependent CKD, is lacking. METHODS: We conducted a systematic review of randomized controlled trials to assess the risks and benefits of revascularization, compared with medical management, among adults or children with ischemic heart disease and CKD not requiring KRT (dialysis or transplantation). We searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials through December 12, 2023. Two people independently screened titles and abstracts followed by full-text review, serially extracted data using standardized forms, independently assessed risk of bias, and graded the certainty of evidence (COE). RESULTS: Evaluating data from nine randomized controlled trials, we found that people with CKD and ischemic heart disease treated with revascularization may experience lower all-cause mortality compared with people receiving medical management (risk ratio [RR], 0.80; 95% confidence interval [CI], 0.64 to 0.98; COE, low). Revascularization may reduce incidence of myocardial infarction (RR, 0.81; 95% CI, 0.64 to 1.04; COE, low) and heart failure (RR, 0.80; 95% CI, 0.52 to 1.23; COE, low). The effect on cardiovascular mortality is uncertain (hazard ratio, 0.67; 95% CI, 0.37 to 1.20; COE, very low). Evidence was insufficient for patient-reported outcomes and adverse kidney events. Data were limited by heterogeneity of patient populations and the limited number of trials. CONCLUSIONS: In people with non-dialysis-dependent CKD, revascularization may be associated with lower all-cause mortality compared with medical management and may also lower the risk of cardiovascular events. Additional data surrounding kidney and patient-reported outcomes are needed to comprehensively engage in shared decision making and determine optimal treatment strategies for people with CKD and ischemic heart disease. CLINICAL TRIAL REGISTRY NAME AND REGISTRATION NUMBER: CRD42022349820 (PROSPERO). FAU - Patel, Dipal M AU - Patel DM AUID- ORCID: 0000-0002-8502-839 AD - Division of Nephrology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland. FAU - Wilson, Lisa M AU - Wilson LM AUID- ORCID: 0000-0001-5882-342 AD - Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. FAU - Wilson, Renee F AU - Wilson RF AD - Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. FAU - Yang, Xuhao AU - Yang X AUID- ORCID: 0000-0002-3790-3524 AD - Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. FAU - Gharibani, Troy AU - Gharibani T AUID- ORCID: 0009-0009-4880-3623 AD - Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. FAU - Robinson, Karen A AU - Robinson KA AUID- ORCID: 0000-0003-1021-7820 AD - Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. AD - Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland. AD - Department of Epidemiology, Johns Hopkins University School of Medicine, Baltimore, Maryland. LA - eng GR - KDIGO/ PT - Journal Article DEP - 20241108 PL - United States TA - Clin J Am Soc Nephrol JT - Clinical journal of the American Society of Nephrology : CJASN JID - 101271570 SB - IM PMC - PMC11637693 COIS- Disclosure forms, as provided by each author, are available with the online version of the article at http://links.lww.com/CJN/C43. EDAT- 2024/11/12 04:44 MHDA- 2024/11/12 04:44 PMCR- 2025/12/01 CRDT- 2024/11/07 04:22 PHST- 2024/03/22 00:00 [received] PHST- 2024/09/30 00:00 [accepted] PHST- 2024/11/12 04:44 [pubmed] PHST- 2024/11/12 04:44 [medline] PHST- 2024/11/07 04:22 [entrez] PHST- 2025/12/01 00:00 [pmc-release] AID - 01277230-202412000-00009 [pii] AID - CJASN-2024-000435 [pii] AID - 10.2215/CJN.0000000000000549 [doi] PST - ppublish SO - Clin J Am Soc Nephrol. 2024 Dec 1;19(12):1562-1573. doi: 10.2215/CJN.0000000000000549. Epub 2024 Nov 8. PMID- 39469391 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20241030 IS - 2168-8184 (Print) IS - 2168-8184 (Electronic) IS - 2168-8184 (Linking) VI - 16 IP - 9 DP - 2024 Sep TI - Association Between Febuxostat Use and the Incidence of Cardiovascular Events, Mortality, and Kidney Events in Patients With Chronic Kidney Disease Compared to Allopurinol: A Study Using a Japanese Nationwide Database. PG - e70351 LID - 10.7759/cureus.70351 [doi] LID - e70351 AB - Background Patients with chronic kidney disease (CKD) were excluded in most trials that investigated the effects of urate-lowering agents, such as febuxostat and allopurinol, in hyperuricemic patients. This exclusion leads to uncertainty regarding the efficacy of febuxostat in patients with CKD. Due to the high prevalence of hyperuricemia in patients with CKD, we aimed to assess the effect of febuxostat on improving patient outcomes concerning cardiovascular events and survival compared with those treated with allopurinol among patients with CKD. Methods We conducted a retrospective cohort study using Japanese nationwide administrative data from Jan 1, 2013, to Sep 30, 2020. Patients aged over 60 years diagnosed with CKD were included in this study if they were prescribed either febuxostat or allopurinol. The primary outcome was the occurrence of cardiovascular events including myocardial infarction, stroke, unstable angina requiring urgent revascularization, and all-cause deaths. We estimated hazard ratios (HR) and 95% CI using a Cox proportional hazard regression model adjusted for comorbidities, medications, and laboratory data. We also assessed defined starting kidney replacement therapy as a secondary endpoint treating death as a competing risk using the Fine & Gray regression model. Results A total of 21,015 patients included those with febuxostat (n=17,796) and those with allopurinol (n=3,219). The association between the type of drug and the occurrence of cardiovascular events did not show a significant difference (0.107 vs. 0.116 events per patient-year; adjusted HR 0.953, 95% CI: 0.854 to 1.062, P=0.381). Similar results were seen for all-cause deaths (0.060 vs. 0.068 events per patient-year; adjusted HR 0.877, 95% CI: 0.760 to 1.012, P=0.073). Regarding the secondary endpoint, the association between the type of drug and the timing of starting kidney replacement therapy did not show a significant difference (0.118 vs. 0.097 events per patient-year; adjusted HR 0.953, 95% CI: 0.854 to 1.062, P=0.425). Conclusion The use of febuxostat was neither associated with a decreased risk of cardiovascular events or deaths nor with the timing of starting kidney replacement therapy compared to the use of allopurinol in patients with CKD. CI - Copyright (c) 2024, Otani et al. FAU - Otani, Miho AU - Otani M AD - Medical Statistics, Osaka Metropolitan University, Osaka, JPN. FAU - Nonomiya, Yuta AU - Nonomiya Y AD - Medical Statistics, Osaka Metropolitan University, Osaka, JPN. FAU - Ihara, Yasutaka AU - Ihara Y AD - Medical Statistics, Osaka Metropolitan University, Osaka, JPN. FAU - Kawai, Ryota AU - Kawai R AD - Medical Statistics, Osaka Metropolitan University, Osaka, JPN. FAU - Taniuchi, Satsuki AU - Taniuchi S AD - Medical Statistics, Osaka Metropolitan University, Osaka, JPN. FAU - Yoshida, Hisako AU - Yoshida H AD - Medical Statistics, Osaka Metropolitan University, Osaka, JPN. FAU - Tsuruya, Kazuhiko AU - Tsuruya K AD - Nephrology, Nara Medical University, Kashihara, JPN. FAU - Shintani, Ayumi AU - Shintani A AD - Medical Statistics, Osaka Metropolitan University, Osaka, JPN. LA - eng PT - Journal Article DEP - 20240927 PL - United States TA - Cureus JT - Cureus JID - 101596737 PMC - PMC11513208 OTO - NOTNLM OT - cardiovascular events OT - chronic kidney disease OT - database OT - hyperuricemia OT - kidney prognosis OT - kidney replacement therapy OT - mortality OT - renal prognosis OT - urate-lowering agent OT - uric acid COIS- Human subjects: Consent was obtained or waived by all participants in this study. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: Ayumi Shintani is compensated by Kyowa Kirin, and the payment is made to the institution. Financial relationships: Ayumi Shintani declare(s) personal fees from Daiichi Sankyo. Payment was made to her. Ayumi Shintani declare(s) personal fees from Eisai. Payment was made to her. Ayumi Shintani declare(s) personal fees from Maruho. Payment was made to her. Ayumi Shintani declare(s) personal fees from Novo Nordisk Pharma. Payment was made to her. Ayumi Shintani declare(s) personal fees from Pfizer. Payment was made to her. Ayumi Shintani declare(s) personal fees from Taisho Pharmaceutical. Payment was made to her. Ayumi Shintani declare(s) personal fees from Torii Pharmaceutical. Payment was made to her. Ayumi Shintani declare(s) personal fees from Janssen Pharmaceutical. Payment was made to her. Ayumi Shintani declare(s) personal fees from Kisei Pharmaceutical. Payment was made to her. Ayumi Shintani declare(s) personal fees from Mallinckrodt Pharmaceuticals. Payment was made to her. Ayumi Shintani declare(s) personal fees from Mitsubishi Tanabe Pharma Corporation. Payment was made to her. Ayumi Shintani declare(s) personal fees from Nippon Shinyaku. Payment was made to her. Ayumi Shintani declare(s) personal fees from Ono Pharmaceutical Company Limited. Payment was made to her. Ayumi Shintani declare(s) personal fees from Takeda Pharmaceutical Company Limited. Payment was made to her. Ayumi Shintani declare(s) personal fees from Taisho Pharmaceutical. Payment was made to her. Ayumi Shintani declare(s) personal fees from Kyowa Kirin. Payment was made to her. Ayumi Shintani declare(s) personal fees from Merck Biopharma. Payment was made to her. Ayumi Shintani declare(s) personal fees from Nipro Corporation. Payment was made to her. Yuta Nonomiya declare(s) a grant from Osaka Metropolitan University. An annual fellowship of 3.9 million yen is paid to the author. Yasutaka Ihara declare(s) employment from Daiichi Sankyo. Yasutaka Ihara is an employee of Daiichi Sankyo. Kazuhiko Tsuruya declare(s) a grant from Teijin. Kazuhiko Tsuruya declare(s) a grant from Mochida. Kazuhiko Tsuruya declare(s) personal fees from Teijin. Kazuhiko Tsuruya declare(s) personal fees from Mochida. Kazuhiko Tsuruya declare(s) personal fees from Sanwa Chemical. Kazuhiko Tsuruya declare(s) personal fees from Fuji. Ayumi Shintani declare(s) personal fees from Chugai Pharmaceutical. Payment was made to the institution. Ayumi Shintani declare(s) personal fees from Daiichi Sankyo. Payment was made to the institution. Ayumi Shintani declare(s) personal fees from Kyowa Kirin. Payment was made to the institution and to her. Ayumi Shintani declare(s) personal fees from Takeda Pharmaceutical Company Limited. Payment was made to the institution. Ayumi Shintani declare(s) personal fees from Shionogi Pharma. Payment was made to her. Ayumi Shintani declare(s) personal fees from Abbvie. Payment was made to her. Ayumi Shintani declare(s) personal fees from Asahi Kasei Corporation. Payment was made to her. Ayumi Shintani declare(s) personal fees from AstraZeneca plc. Payment was made to her. Ayumi Shintani declare(s) personal fees from Astellas Pharma. Payment was made to her. Ayumi Shintani declare(s) personal fees from Bayer Yakuhin. Payment was made to her. Ayumi Shintani declare(s) personal fees from Bristol Myers Squibb. Payment was made to her. Ayumi Shintani declare(s) personal fees from Chugai Pharmaceutical. Payment was made to her. Ayumi Shintani declare(s) personal fees from Sanofi K.K. Payment was made to her. Ayumi Shintani declare(s) personal fees from Nippon Kayaku. Payment was made to her. Ayumi Shintani declare(s) personal fees from JCR Pharmaceuticals Co. Payment was made to her. Ayumi Shintani declare(s) personal fees from MSD. Payment was made to her. Hisako Yoshida declare(s) personal fees from Organization for Clinical Medicine Promotion. Other relationships: Febuxostat is sold by the following companies, which I declared in the COI: Teijin, DAIICHI SANKYO ESPHA CO., LTD., and NIPRO CORPORATION. Allopurinol is sold by the following companies, which I declared in the COI: NIPRO ES PHARMA and Shionogi Pharma Co. . EDAT- 2024/10/29 06:23 MHDA- 2024/10/29 06:24 PMCR- 2024/09/27 CRDT- 2024/10/29 04:41 PHST- 2024/09/20 00:00 [accepted] PHST- 2024/10/29 06:24 [medline] PHST- 2024/10/29 06:23 [pubmed] PHST- 2024/10/29 04:41 [entrez] PHST- 2024/09/27 00:00 [pmc-release] AID - 10.7759/cureus.70351 [doi] PST - epublish SO - Cureus. 2024 Sep 27;16(9):e70351. doi: 10.7759/cureus.70351. eCollection 2024 Sep. PMID- 39462482 OWN - NLM STAT- MEDLINE DCOM- 20250210 LR - 20250630 IS - 1524-4539 (Electronic) IS - 0009-7322 (Linking) VI - 151 IP - 6 DP - 2025 Feb 11 TI - Derivation and Validation of the PRECISE-HBR Score to Predict Bleeding After Percutaneous Coronary Intervention. PG - 343-355 LID - 10.1161/CIRCULATIONAHA.124.072009 [doi] AB - BACKGROUND: Accurate bleeding risk stratification after percutaneous coronary intervention is important for treatment individualization. However, there is still an unmet need for a more precise and standardized identification of patients at high bleeding risk. We derived and validated a novel bleeding risk score by augmenting the Predicting Bleeding Complications in Patients Undergoing Stent Implantation and Subsequent Dual Antiplatelet Therapy (PRECISE-DAPT) score with the Academic Research Consortium for High Bleeding Risk (ARC-HBR) criteria. METHODS: The derivation cohort comprised 29 188 patients undergoing percutaneous coronary intervention, of whom 1136 (3.9%) had Bleeding Academic Research Consortium (BARC) 3 or 5 bleeding at 1 year, from 4 contemporary real-world registries and the XIENCE V USA trial. The PRECISE-DAPT score was refitted with a Fine-Gray model in the derivation cohort and extended with the ARC-HBR criteria. The primary outcome was BARC 3 or 5 bleeding within 1 year. Independent predictors of BARC 3 or 5 bleeding were selected at multivariable analysis (P<0.01). The discrimination of the score was internally assessed with apparent validation and cross-validation. The score was externally validated in 4578 patients from the MASTER DAPT trial (Management of High Bleeding Risk Patients Post Bioresorbable Polymer Coated Stent Implantation With an Abbreviated Versus Prolonged DAPT Regimen) and 5970 patients from the STOPDAPT-2 (Short and Optimal Duration of Dual Antiplatelet Therapy-2) total cohort. RESULTS: The PRECISE-HBR score (age, estimated glomerular filtration rate, hemoglobin, white blood cell count, previous bleeding, oral anticoagulation, and ARC-HBR criteria) showed an area under the curve (AUC) for 1-year BARC 3 or 5 bleeding of 0.73 (95% CI, 0.71-0.74) at apparent validation, 0.72 (95% CI, 0.70-0.73) at cross-validation, 0.74 (95% CI, 0.68-0.80) in MASTER DAPT, and 0.73 (95% CI, 0.66-0.79) in STOPDAPT-2, with superior discrimination compared with PRECISE-DAPT (cross-validation: DeltaAUC, 0.01; P=0.02; MASTER DAPT: DeltaAUC, 0.05; P=0.004; STOPDAPT-2: DeltaAUC, 0.02; P=0.20) and other risk scores. In the derivation cohort, a cutoff of 23 points identified 11 414 patients (39.1%) with a 1-year BARC 3 or 5 bleeding risk >/=4%. An alternative version of the score, including acute myocardial infarction on admission instead of white blood cell count, showed similar predictive ability. CONCLUSIONS: The PRECISE-HBR score is a contemporary, simple 7-item risk score to predict bleeding after percutaneous coronary intervention, offering a moderate improvement in discrimination over multiple existing scores. Further evaluation is required to assess its impact on clinical practice. FAU - Gragnano, Felice AU - Gragnano F AUID- ORCID: 0000-0002-6943-278X AD - Department of Translational Medical Sciences, University of Campania Luigi Vanvitelli, Caserta, Italy (F.G., P.C.). AD - Division of Cardiology, Sant'Anna and San Sebastiano Hospital, Caserta, Italy (F.G., P.C.). FAU - van Klaveren, David AU - van Klaveren D AUID- ORCID: 0000-0002-2096-606X AD - Department of Public Health, Erasmus MC University Medical Center, Rotterdam, the Netherlands (D.v.K.). FAU - Heg, Dik AU - Heg D AUID- ORCID: 0000-0002-8766-7945 AD - Department of Clinical Research (D.H.), University of Bern, Switzerland. FAU - Raber, Lorenz AU - Raber L AUID- ORCID: 0000-0003-0824-3026 AD - Department of Cardiology, Bern University Hospital (L.R., N.C., A.S., S.B., R.K., S.W., M.V.), University of Bern, Switzerland. FAU - Krucoff, Mitchell W AU - Krucoff MW AD - Duke University Medical Center-Duke Clinical Research Institute, Durham, NC (M.W.K.). FAU - Raposeiras-Roubin, Sergio AU - Raposeiras-Roubin S AUID- ORCID: 0000-0002-6462-4715 AD - Servicio de Cardiologia, Hospital Alvaro Cunqueiro, Vigo, Pontevedra, Spain (S.R.-R., E.A.-A.). FAU - Ten Berg, Jurrien M AU - Ten Berg JM AUID- ORCID: 0000-0001-5192-886X AD - Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands (J.M.t.B., D.C.P.Y., J.A.). FAU - Leonardi, Sergio AU - Leonardi S AUID- ORCID: 0000-0002-4800-6132 AD - Department of Molecular Medicine, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Italy (S.L., M.G.). FAU - Kimura, Takeshi AU - Kimura T AUID- ORCID: 0000-0002-5665-4076 AD - Department of Cardiology, Hirakata Kohsai Hospital, Japan (T.K., H.W.). FAU - Corpataux, Noe AU - Corpataux N AUID- ORCID: 0000-0001-9514-6835 AD - Department of Cardiology, Bern University Hospital (L.R., N.C., A.S., S.B., R.K., S.W., M.V.), University of Bern, Switzerland. FAU - Spirito, Alessandro AU - Spirito A AUID- ORCID: 0000-0002-7473-6577 AD - Department of Cardiology, Bern University Hospital (L.R., N.C., A.S., S.B., R.K., S.W., M.V.), University of Bern, Switzerland. FAU - Hermiller, James B AU - Hermiller JB AD - Department of Cardiology, Ascension St. Vincent's Heart Center of Indiana, Indianapolis (J.B.H.). FAU - Abu-Assi, Emad AU - Abu-Assi E AD - Servicio de Cardiologia, Hospital Alvaro Cunqueiro, Vigo, Pontevedra, Spain (S.R.-R., E.A.-A.). FAU - Chan Pin Yin, Dean AU - Chan Pin Yin D AD - Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands (J.M.t.B., D.C.P.Y., J.A.). FAU - Azzahhafi, Jaouad AU - Azzahhafi J AUID- ORCID: 0000-0003-4727-0481 AD - Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands (J.M.t.B., D.C.P.Y., J.A.). FAU - Montalto, Claudio AU - Montalto C AUID- ORCID: 0000-0002-8721-0515 AD - Interventional Cardiology, De Gasperis Cardio Center, Niguarda Hospital, Milan, Italy (C.M.). AD - School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy (C.M.). FAU - Galazzi, Marco AU - Galazzi M AD - Department of Molecular Medicine, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Italy (S.L., M.G.). FAU - Bar, Sarah AU - Bar S AUID- ORCID: 0000-0003-0045-6596 AD - Department of Cardiology, Bern University Hospital (L.R., N.C., A.S., S.B., R.K., S.W., M.V.), University of Bern, Switzerland. FAU - Kavaliauskaite, Raminta AU - Kavaliauskaite R AUID- ORCID: 0000-0002-4044-4154 AD - Department of Cardiology, Bern University Hospital (L.R., N.C., A.S., S.B., R.K., S.W., M.V.), University of Bern, Switzerland. FAU - D'Ascenzo, Fabrizio AU - D'Ascenzo F AUID- ORCID: 0000-0002-6646-9317 AD - Azienda Ospedaliero Universitaria Citta della Salute e della Scienza, Turin, Italy (F.D., G.M.D.F.). FAU - De Ferrari, Gaetano M AU - De Ferrari GM AD - Azienda Ospedaliero Universitaria Citta della Salute e della Scienza, Turin, Italy (F.D., G.M.D.F.). FAU - Watanabe, Hirotoshi AU - Watanabe H AUID- ORCID: 0000-0002-9443-5915 AD - Department of Cardiology, Hirakata Kohsai Hospital, Japan (T.K., H.W.). FAU - Steg, Philippe Gabriel AU - Steg PG AUID- ORCID: 0000-0001-6896-2941 AD - Universite Paris-Cite, French Alliance for Cardiovascular Trials, Assistance Publique-Hopitaux de Paris, Hopital Bichat, France (P.G.S.). FAU - Bhatt, Deepak L AU - Bhatt DL AUID- ORCID: 0000-0002-1278-6245 AD - Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, New York, NY (D.L.B., R.M.). FAU - Calabro, Paolo AU - Calabro P AUID- ORCID: 0000-0002-5018-830X AD - Department of Translational Medical Sciences, University of Campania Luigi Vanvitelli, Caserta, Italy (F.G., P.C.). AD - Division of Cardiology, Sant'Anna and San Sebastiano Hospital, Caserta, Italy (F.G., P.C.). FAU - Mehran, Roxana AU - Mehran R AUID- ORCID: 0000-0002-5546-262X AD - Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, New York, NY (D.L.B., R.M.). FAU - Urban, Philip AU - Urban P AD - Hopital de la Tour, Geneva, Switzerland (P.U.). FAU - Pocock, Stuart AU - Pocock S AUID- ORCID: 0000-0003-2212-4007 AD - Department of Medical Statistics, London School of Hygiene and Tropical Medicine, UK (S.P.). FAU - Windecker, Stephan AU - Windecker S AUID- ORCID: 0000-0003-2653-6762 AD - Department of Cardiology, Bern University Hospital (L.R., N.C., A.S., S.B., R.K., S.W., M.V.), University of Bern, Switzerland. FAU - Valgimigli, Marco AU - Valgimigli M AUID- ORCID: 0000-0002-4353-7110 AD - Department of Cardiology, Bern University Hospital (L.R., N.C., A.S., S.B., R.K., S.W., M.V.), University of Bern, Switzerland. AD - Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland (M.V.). LA - eng PT - Journal Article PT - Multicenter Study PT - Validation Study DEP - 20241027 PL - United States TA - Circulation JT - Circulation JID - 0147763 RN - 0 (Platelet Aggregation Inhibitors) SB - IM MH - Humans MH - *Percutaneous Coronary Intervention/adverse effects MH - Male MH - Female MH - Aged MH - Middle Aged MH - Risk Assessment MH - *Platelet Aggregation Inhibitors/adverse effects/administration & dosage MH - *Hemorrhage/diagnosis/chemically induced MH - Risk Factors MH - Dual Anti-Platelet Therapy/adverse effects MH - Registries MH - Predictive Value of Tests MH - Reproducibility of Results OTO - NOTNLM OT - anticoagulants OT - dual anti-platelet therapy OT - hemorrhage OT - percutaneous coronary intervention OT - risk OT - stents COIS- Dr Valgimigli reports grants and personal fees from Terumo and personal fees from AstraZeneca, Alvimedica/CID, Abbott Vascular, Daiichi Sankyo, Bayer, CoreFLOW, IDORSIA PHARMACEUTICALS LTD, Universitat Basel, Department Klinische Forschung, Bristol Myers Squib SA, Medscape, Biotronik, and Novartis, outside the submitted work. Dr Gragnano reports personal fees from SANOFI for advisory board outside the submitted work. Dr Heg is affiliated with the Department of Clinical Research (DCR), University of Bern, which has a staff policy of not accepting honoraria or consultancy fees. DCR Bern is involved in the design, conduct, or analysis of clinical studies funded by not-for-profit and for-profit organizations. Pharmaceutical and medical device companies provide direct funding to some of these studies. Dr Raber reports grants or contracts from Abbott, Biotronik, BostonScientific, Heartfolow, Sanofi, and Regeneron; consulting fees from Canon; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Abbott, Amgen, Sanofi, and Occlutech; and participation on a data safety monitoring board or advisory board for Abbott, Amgen, NovoNordisk, Medtronic, and Sanofi outside the submitted work. Dr ten Berg reports support by an institutional research grant from AstraZeneca for the present article. Dr Bar reports grants or contracts from Medis Medical Imaging Systems, Abbott, Bangerter-Rhyner Stiftung, and Swiss National Science Foundation, outside the submitted work. Dr Kimura reports research grants from Abbott and Boston Scientific, outside the submitted work. Dr Leonardi reports grants from AstraZeneca and consulting fees from AstraZeneca, Daiichi Sankyo, Bayer, Pfizer/BMS, ICON, Chiesi, and Novo Nordisk, outside the submitted work. Dr Bhatt reports the following relationships outside the submitted work: Advisory Board: Angiowave, Bayer, Boehringer Ingelheim, CellProthera, Cereno Scientific, Elsevier Practice Update Cardiology, High Enroll, Janssen, Level Ex, McKinsey, Medscape Cardiology, Merck, MyoKardia, NirvaMed, Novo Nordisk, PhaseBio, PLx Pharma, and Stasys; board of directors: American Heart Association, New York City, Angiowave (stock options), Bristol Myers Squibb (stock), DRS.LINQ (stock options), and High Enroll (stock); consultant: Broadview Ventures, GlaxoSmithKline, Hims, SFJ, and Youngene; data monitoring committee: Acesion Pharma, Assistance Publique-Hopitaux de Paris, Baim Institute for Clinical Research (formerly Harvard Clinical Research Institute, for the PORTICO trial, funded by St. Jude Medical, now Abbott), Boston Scientific (chair, PEITHO trial), Cleveland Clinic, Contego Medical (chair, PERFORMANCE 2), Duke Clinical Research Institute, Mayo Clinic, Mount Sinai School of Medicine (for the ENVISAGE trial, funded by Daiichi Sankyo; for the ABILITY-DM trial, funded by Concept Medical; for ALLAY-HF, funded by Alleviant Medical), Novartis, Population Health Research Institute, and Rutgers University (for the National Institutes of Health-funded MINT Trial); honoraria: American College of Cardiology (senior associate editor, Clinical Trials and News, ACC.org; chair, ACC accreditation oversight committee), Arnold and Porter law firm (work related to Sanofi/Bristol-Myers Squibb clopidogrel litigation), Baim Institute for Clinical Research (formerly Harvard Clinical Research Institute; RE-DUAL PCI clinical trial steering committee funded by Boehringer Ingelheim; AEGIS-II executive committee funded by CSL Behring), Belvoir Publications (editor in chief, Harvard Heart Letter), Canadian Medical and Surgical Knowledge Translation Research Group (clinical trial steering committees), CSL Behring (American Heart Association lecture), Cowen and Company, Duke Clinical Research Institute (clinical trial steering committees, including for the PRONOUNCE trial, funded by Ferring Pharmaceuticals), HMP Global (editor in chief, Journal of Invasive Cardiology), Journal of the American College of Cardiology (guest editor; associate editor), K2P (co-chair, interdisciplinary curriculum), Level Ex, Medtelligence/ReachMD (CME steering committees), MJH Life Sciences, Oakstone CME (course director, Comprehensive Review of Interventional Cardiology), Piper Sandler, Population Health Research Institute (for the COMPASS operations committee, publications committee, steering committee, and US national co-leader, funded by Bayer), WebMD (CME steering committees), Wiley (steering committee); other: Clinical Cardiology (deputy editor); patent: Sotagliflozin (named on a patent for sotagliflozin assigned to Brigham and Women's Hospital, which assigned to Lexicon; neither Dr Bhatt nor Brigham and Women's Hospital receives any income from this patent); research funding: Abbott, Acesion Pharma, Afimmune, Aker Biomarine, Alnylam, Amarin, Amgen, AstraZeneca, Bayer, Beren, Boehringer Ingelheim, Boston Scientific, Bristol-Myers Squibb, Cardax, CellProthera, Cereno Scientific, Chiesi, CinCor, Cleerly, CSL Behring, Eisai, Ethicon, Faraday Pharmaceuticals, Ferring Pharmaceuticals, Forest Laboratories, Fractyl, Garmin, HLS Therapeutics, Idorsia, Ironwood, Ischemix, Janssen, Javelin, Lexicon, Lilly, Medtronic, Merck, Moderna, MyoKardia, NirvaMed, Novartis, Novo Nordisk, Otsuka, Owkin, Pfizer, PhaseBio, PLx Pharma, Recardio, Regeneron, Reid Hoffman Foundation, Roche, Sanofi, Stasys, Synaptic, The Medicines Company, Youngene, and 89Bio; royalties: Elsevier (editor, Braunwald's Heart Disease); site co-investigator: Abbott, Biotronik, Boston Scientific, CSI, Endotronix, St. Jude Medical (now Abbott), Philips, SpectraWAVE, Svelte, and Vascular Solutions; trustee: American College of Cardiology; and unfunded research: FlowCo. Dr Urban reports consulting fees from Biosensors and MedAlliance; support for attending meetings and/or travel from MedAlliance; and stock or stock options for MedAlliance and CERC, outside the submitted work. Dr Windecker reports research, travel, or educational grants to the institution from Abbott, Abiomed, Amgen, Astra Zeneca, Bayer, Biotronik, Boehringer Ingelheim, Boston Scientific, Bristol Myers Squibb, Cardinal Health, CardioValve, Corflow Therapeutics, CSL Behring, Daiichi Sankyo, Edwards Lifesciences, Guerbet, InfraRedx, Janssen-Cilag, Johnson & Johnson, Medicure, Medtronic, Merck Sharp & Dohm, Miracor Medical, Novartis, Novo Nordisk, Organon, OrPha Suisse, Pfizer, Polares, Regeneron, Sanofi-Aventis, Servier, Sinomed, Terumo, Vifor, and V-Wave. He serves as Advisory Board member and/or member of the steering/executive group of trials funded by Abbott, Abiomed, Amgen, AstraZeneca, Bayer, Boston Scientific, Biotronik, Bristol Myers Squibb, Edwards Lifesciences, Janssen, MedAlliance, Medtronic, Novartis, Polares, Recardio, Sinomed, Terumo, V-Wave, and Xeltis, with payments to the institution but no personal payments. He is also member of the steering/executive committee group of several investigator-initiated trials that receive funding by industry without impact on his personal remuneration. The other authors report no conflicts. EDAT- 2024/10/27 18:21 MHDA- 2025/02/10 18:16 CRDT- 2024/10/27 17:32 PHST- 2025/02/10 18:16 [medline] PHST- 2024/10/27 18:21 [pubmed] PHST- 2024/10/27 17:32 [entrez] AID - 10.1161/CIRCULATIONAHA.124.072009 [doi] PST - ppublish SO - Circulation. 2025 Feb 11;151(6):343-355. doi: 10.1161/CIRCULATIONAHA.124.072009. Epub 2024 Oct 27. PMID- 39438608 OWN - NLM STAT- MEDLINE DCOM- 20241023 LR - 20241025 IS - 2045-2322 (Electronic) IS - 2045-2322 (Linking) VI - 14 IP - 1 DP - 2024 Oct 22 TI - Precision phenotyping from routine laboratory parameters for out of hospital survival prediction in an all comers prospective PCI registry. PG - 24837 LID - 10.1038/s41598-024-76936-3 [doi] LID - 24837 AB - Out-of-hospital mortality in coronary artery disease (CAD) is particularly high and established adverse event prediction tools are yet to be available. Our study aimed to investigate whether precision phenotyping can be performed using routine laboratory parameters for the prediction of out-of-hospital survival in a CAD population treated by percutaneous coronary intervention (PCI). All patients treated by PCI and discharged alive in a tertiary center between January 2016 - December 2022 that have been included prospectively in the local registry were analyzed. 115 parameters from the PCI registry and 266 parameters derived from routine laboratory testing were used. An extreme gradient-boosted decision tree machine learning (ML) algorithm was trained and used to predict all-cause and cardiovascular-cause survival. A total of 4027 patients with 4981 PCI hospitalizations were randomly included in the 70% training dataset and 1729 patients with 2160 PCI hospitalizations were randomly included in the 30% validation dataset. All-cause and cardiovascular cause mortality was 17.5% and 12.2%. The integrated area under the receiver operator characteristic curve for prediction of all-cause and cardiovascular cause mortality by the ML on the validation dataset was 0.844 and 0.837, respectively (all p < 0.001). Parameters reflecting renal function (first and maximum serum creatinine), hematologic function (mean corpuscular hemoglobin concentration, platelet distribution width), and inflammatory status (lymphocyte per monocyte ratio) were among the most important predictors. Accurate out-of-hospital survival prediction in CAD can be achieved using routine laboratory parameters. ML outperformed clinical risk scores in predicting out-of-hospital mortality in a prospective all-comers PCI population and has the potential to precisely phenotype patients. CI - (c) 2024. The Author(s). FAU - Calburean, Paul-Adrian AU - Calburean PA AD - George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Gheorghe Marinescu Str., no. 38, Targu Mures, Targu Mures, Romania. calbureanpaul@gmail.com. AD - Emergency Institute for Cardiovascular Diseases and Transplantation Targu Mures, Targu Mures, Romania. calbureanpaul@gmail.com. FAU - Harpa, Marius AU - Harpa M AD - George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Gheorghe Marinescu Str., no. 38, Targu Mures, Targu Mures, Romania. AD - Emergency Institute for Cardiovascular Diseases and Transplantation Targu Mures, Targu Mures, Romania. FAU - Scurtu, Anda-Cristina AU - Scurtu AC AD - George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Gheorghe Marinescu Str., no. 38, Targu Mures, Targu Mures, Romania. AD - Emergency Institute for Cardiovascular Diseases and Transplantation Targu Mures, Targu Mures, Romania. FAU - Grebenisan, Paul AU - Grebenisan P AD - Emergency Institute for Cardiovascular Diseases and Transplantation Targu Mures, Targu Mures, Romania. FAU - Nistor, Ioana-Andreea AU - Nistor IA AD - Emergency Institute for Cardiovascular Diseases and Transplantation Targu Mures, Targu Mures, Romania. FAU - Vacariu, Victor AU - Vacariu V AD - Emergency Institute for Cardiovascular Diseases and Transplantation Targu Mures, Targu Mures, Romania. FAU - Drincal, Reka-Katalin AU - Drincal RK AD - George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Gheorghe Marinescu Str., no. 38, Targu Mures, Targu Mures, Romania. AD - Emergency Institute for Cardiovascular Diseases and Transplantation Targu Mures, Targu Mures, Romania. FAU - Sulea, Ioana Paula AU - Sulea IP AD - George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Gheorghe Marinescu Str., no. 38, Targu Mures, Targu Mures, Romania. FAU - Oltean, Tiberiu AU - Oltean T AD - Emergency Institute for Cardiovascular Diseases and Transplantation Targu Mures, Targu Mures, Romania. FAU - Mesaros, Petru-Vasile AU - Mesaros PV AD - George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Gheorghe Marinescu Str., no. 38, Targu Mures, Targu Mures, Romania. AD - Emergency Institute for Cardiovascular Diseases and Transplantation Targu Mures, Targu Mures, Romania. FAU - Hadadi, Laszlo AU - Hadadi L AD - Emergency Institute for Cardiovascular Diseases and Transplantation Targu Mures, Targu Mures, Romania. LA - eng PT - Journal Article DEP - 20241022 PL - England TA - Sci Rep JT - Scientific reports JID - 101563288 SB - IM MH - Humans MH - *Percutaneous Coronary Intervention MH - Female MH - Male MH - Aged MH - *Registries MH - *Coronary Artery Disease/mortality/blood MH - Middle Aged MH - Prospective Studies MH - *Phenotype MH - Machine Learning MH - ROC Curve PMC - PMC11496522 OTO - NOTNLM OT - Coronary artery disease OT - Machine learning OT - Percutaneous coronary intervention OT - Survival analysis COIS- The authors have nothing to disclose. EDAT- 2024/10/23 00:21 MHDA- 2024/10/23 10:18 PMCR- 2024/10/22 CRDT- 2024/10/22 23:42 PHST- 2024/08/09 00:00 [received] PHST- 2024/10/17 00:00 [accepted] PHST- 2024/10/23 10:18 [medline] PHST- 2024/10/23 00:21 [pubmed] PHST- 2024/10/22 23:42 [entrez] PHST- 2024/10/22 00:00 [pmc-release] AID - 10.1038/s41598-024-76936-3 [pii] AID - 76936 [pii] AID - 10.1038/s41598-024-76936-3 [doi] PST - epublish SO - Sci Rep. 2024 Oct 22;14(1):24837. doi: 10.1038/s41598-024-76936-3. PMID- 39401917 OWN - NLM STAT- MEDLINE DCOM- 20250224 LR - 20260704 IS - 1347-4820 (Electronic) IS - 1346-9843 (Linking) VI - 89 IP - 3 DP - 2025 Feb 25 TI - Renal Function-Stratified Comparison of Short- and Long-Term Dual Antiplatelet Therapy in Patients Undergoing Percutaneous Coronary Intervention With Third-Generation Drug-Eluting Stents　- Post Hoc Analysis From the HOST-IDEA Randomized Clinical Trial. PG - 281-291 LID - 10.1253/circj.CJ-24-0481 [doi] AB - BACKGROUND: The optimal duration of dual antiplatelet therapy (DAPT) in patients with chronic kidney disease undergoing percutaneous coronary intervention (PCI), especially with third-generation drug-eluting stents (DES), remains unknown. METHODS AND RESULTS: We conducted a prespecified post hoc analysis of the HOST-IDEA trial, randomizing patients undergoing PCI with third-generation DES to 3- to 6-month or 12-month DAPT. In all, 1,997 patients were grouped by their estimated glomerular filtration rate (eGFR): high (>90 mL/min/1.73 m(2)), intermediate (60-90 mL/min/1.73 m(2)), and low (<60 mL/min/1.73 m(2)). The primary outcome was net adverse clinical events (NACE), a composite of cardiac death, target vessel myocardial infarction, clinically driven target lesion revascularization, stent thrombosis, or major bleeding (Bleeding Academic Research Consortium Type 3 or 5) at 12 months. Secondary outcomes were target lesion failure (TLF) and major bleeding. The low eGFR group had the highest rates of NACE, TLF, and major bleeding compared with the other 2 groups (P<0.001). Rates of NACE were similar in the 3- to 6-month and 12-month DAPT in the high (2.9% vs. 3.2%; P=0.84), intermediate (2.1% vs. 2.8%, P=0.51), and low (8.9% vs. 9.1%; hazard ratio 0.99; P=0.97; P(interaction)=0.88) eGFR groups. TLF and major bleeding events showed similar trends. CONCLUSIONS: In patients undergoing PCI with third-generation DES, 3- to 6-month DAPT was comparable to 12-month DAPT for clinical outcomes regardless of renal function. FAU - Han, Jung-Kyu AU - Han JK AD - Cardiovascular Center, Seoul National University Hospital. AD - Department of Internal Medicine, College of Medicine, Seoul National University. FAU - Lee, Seung Do AU - Lee SD AD - Cardiovascular Center, Seoul National University Hospital. FAU - Hwang, Doyeon AU - Hwang D AD - Cardiovascular Center, Seoul National University Hospital. FAU - Park, Sang-Hyeon AU - Park SH AD - Cardiovascular Center, Seoul National University Hospital. FAU - Kang, Jeehoon AU - Kang J AD - Cardiovascular Center, Seoul National University Hospital. FAU - Yang, Han-Mo AU - Yang HM AD - Cardiovascular Center, Seoul National University Hospital. AD - Department of Internal Medicine, College of Medicine, Seoul National University. FAU - Park, Kyung Woo AU - Park KW AD - Cardiovascular Center, Seoul National University Hospital. AD - Department of Internal Medicine, College of Medicine, Seoul National University. FAU - Kang, Hyun-Jae AU - Kang HJ AD - Cardiovascular Center, Seoul National University Hospital. AD - Department of Internal Medicine, College of Medicine, Seoul National University. FAU - Koo, Bon-Kwon AU - Koo BK AD - Cardiovascular Center, Seoul National University Hospital. AD - Department of Internal Medicine, College of Medicine, Seoul National University. FAU - Cho, Jin-Man AU - Cho JM AD - Cardiovascular Center, Kyung Hee University Hospital at Gangdong. FAU - Cho, Janghyun AU - Cho J AD - Department of Cardiology, Heart Center, Saint Carollo Hospital. FAU - Bang, Duk Won AU - Bang DW AD - Division of Cardiology, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine. FAU - Lee, Jae-Hwan AU - Lee JH AD - Division of Cardiology, Department of Internal Medicine, Chungnam National University Sejong Hospital, Chungnam National University School of Medicine. FAU - Lee, Han Cheol AU - Lee HC AD - Division of Cardiology, Department of Internal Medicine, Pusan National University Hospital. FAU - Kim, Kyung-Jin AU - Kim KJ AD - Department of Internal Medicine, Ewha Womans University Medical Center, Ewha Womans University School of Medicine. FAU - Chun, Woojung AU - Chun W AD - Department of Cardiology, Seoul Medical Center. FAU - Seo, Won-Woo AU - Seo WW AD - Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine. FAU - Park, Woo-Jung AU - Park WJ AD - Division of Cardiology, Department of Internal Medicine, Hallym University Pyeongchon Sacred Heart Hospital. FAU - Park, Sang Min AU - Park SM AD - Division of Cardiology, Nowon Eulji Medical Center, Eulji University School of Medicine. FAU - Lee, Seung Jin AU - Lee SJ AD - Department of Internal Medicine and Division of Cardiology, Chungnam Regional Cardiocerebrovascular Center, Soonchunhyang University Hospital Cheonan. FAU - Kim, Hyo-Soo AU - Kim HS AD - Cardiovascular Center, Seoul National University Hospital. AD - Department of Internal Medicine, College of Medicine, Seoul National University. LA - eng GR - Biotronik Korea/ GR - B. Braun Korea/ PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20241012 PL - Japan TA - Circ J JT - Circulation journal : official journal of the Japanese Circulation Society JID - 101137683 RN - 0 (Platelet Aggregation Inhibitors) SB - IM MH - Humans MH - *Percutaneous Coronary Intervention/adverse effects/instrumentation MH - *Drug-Eluting Stents MH - Male MH - Female MH - Aged MH - Middle Aged MH - *Platelet Aggregation Inhibitors/administration & dosage/adverse effects MH - *Glomerular Filtration Rate MH - *Renal Insufficiency, Chronic/physiopathology/complications MH - *Dual Anti-Platelet Therapy/adverse effects MH - *Coronary Artery Disease/therapy/complications/mortality MH - Hemorrhage/chemically induced MH - Time Factors MH - Treatment Outcome MH - *Kidney/physiopathology OTO - NOTNLM OT - Chronic kidney disease OT - Dual anti-platelet therapy OT - Percutaneous coronary intervention OT - Renal function OT - Third-generation drug-eluting stent EDAT- 2024/10/15 00:20 MHDA- 2025/02/25 00:22 CRDT- 2024/10/14 21:13 PHST- 2025/02/25 00:22 [medline] PHST- 2024/10/15 00:20 [pubmed] PHST- 2024/10/14 21:13 [entrez] AID - 10.1253/circj.CJ-24-0481 [doi] PST - ppublish SO - Circ J. 2025 Feb 25;89(3):281-291. doi: 10.1253/circj.CJ-24-0481. Epub 2024 Oct 12. PMID- 39398430 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20241015 IS - 2667-0895 (Electronic) IS - 2667-0909 (Print) IS - 2667-0895 (Linking) VI - 58 DP - 2024 Dec TI - Coronary artery calcification score and 19 biomarkers on cardiovascular events; a 10-year follow-up DanRisk substudy. PG - 9-15 LID - 10.1016/j.athplu.2024.09.003 [doi] AB - AIM: The SCORE2 algorithm is recommended to estimate risk of cardiovascular disease (CVD). Coronary artery calcification (CAC) score is expensive but improves the risk prediction. This study aims to determine and compare the additive value of CAC-score and 19 biomarkers in risk prediction. METHODS: Traditional cardiovascular (CV) risk factors, CAC-score, and a wide range of biomarkers (including lipids, calcium-phosphate metabolism, troponin, inflammation, kidney function and ankle brachial index (ABI)) were collected from 1211 randomly selected middle-aged men and women in this multicenter prospective cohort in 2009-2010. 10-year follow-up data on CV-events were obtained via the Danish Health Registries. CV-event was defined as stroke, myocardial infarction, hospitalization for heart failure, coronary artery revascularization or death from CVD. The association between SCORE2, CAC-score, biomarkers, and CV-events was assessed using cox proportional hazard rates (HR) and compared using AUC-calculation of ROC-curves. Finally, net reclassification improvement (NRI) was calculated. RESULTS: 92 participants had CV-events. Adjusted for risk factors, CAC-score was significantly associated with events (adjusted HR 1.9 (95%CI:1.1; 3.3), 3.6 (95%CI:1.9; 6.8), and 5. (95%CI:2.6; 10.3) for CAC-score 1-99, CAC-score 100-399 and CAC-score >/=400, respectively. HR for the highest quartile of CRP was 2.3 (95%CI:1.2; 4.5), while none of the remaining biomarkers improved HR. Adjusted for SCORE2, the CAC-score improved AUC (AUC(CAC): 0.72, AUC(SCORE2): 0.67, p<0.01). A combination of selected biomarkers (total cholesterol, low-density lipoprotein, phosphate, troponin, CRP, and creatinine) borderline improved AUC (AUC(Biomarkers + SCORE2): 0.71, AUC(SCORE2): 0.67, p=0.06). NRI for CAC score was 63 % (p<0.0001). CONCLUSION: CAC-score improved prediction of CV-events, however the selected biomarkers did not. CI - (c) 2024 The Authors. Published by Elsevier B.V. FAU - Schaeffer, Mie AU - Schaeffer M AD - Department of Cardiology, Odense University Hospital, Denmark. FAU - Rasmussen, Jeppe Holm AU - Rasmussen JH AD - Department of Cardiology, Odense University Hospital, Denmark. FAU - Fredgart, Maise Hoigaard AU - Fredgart MH AD - Department of Cardiology, Odense University Hospital, Denmark. FAU - Hasific, Selma AU - Hasific S AD - Department of Cardiology, Odense University Hospital, Denmark. FAU - Jakobsen, Frederikke Norregaard AU - Jakobsen FN AD - Department of Cardiology, Odense University Hospital, Denmark. FAU - Steffensen, Flemming Hald AU - Steffensen FH AD - Department of Cardiology, Sygehus Lillebaelt Vejle, Vejle, Denmark. FAU - Lambrechtsen, Jess AU - Lambrechtsen J AD - Department of Cardiology, Svendborg Hospital, Svendborg, Denmark. FAU - Ronnow Sand, Niels Peter AU - Ronnow Sand NP AD - Department of Cardiology, University Hospital of Southern Denmark, Esbjerg, Denmark. AD - Department of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark. FAU - Rasmussen, Lars Melholt AU - Rasmussen LM AD - Centre for Individualized Medicine in Arterial Diseases, Odense University Hospital, Odense, Denmark. AD - Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark. AD - Cardiovascular Centre of Excellence, University of Southern Denmark, Odense, Denmark. FAU - Diederichsen, Axel Cp AU - Diederichsen AC AD - Department of Cardiology, Odense University Hospital, Denmark. AD - Centre for Individualized Medicine in Arterial Diseases, Odense University Hospital, Odense, Denmark. AD - Cardiovascular Centre of Excellence, University of Southern Denmark, Odense, Denmark. LA - eng PT - Journal Article DEP - 20240924 PL - Netherlands TA - Atheroscler Plus JT - Atherosclerosis plus JID - 9918249514806676 PMC - PMC11470180 OTO - NOTNLM OT - Biomarkers OT - Cardiovascular disease OT - Coronary artery calcification score OT - European HeartScore OT - Risk assessment OT - Risk prediction COIS- The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2024/10/14 16:18 MHDA- 2024/10/14 16:19 PMCR- 2024/09/24 CRDT- 2024/10/14 06:49 PHST- 2024/07/26 00:00 [received] PHST- 2024/09/19 00:00 [accepted] PHST- 2024/10/14 16:19 [medline] PHST- 2024/10/14 16:18 [pubmed] PHST- 2024/10/14 06:49 [entrez] PHST- 2024/09/24 00:00 [pmc-release] AID - S2667-0895(24)00044-0 [pii] AID - 10.1016/j.athplu.2024.09.003 [doi] PST - epublish SO - Atheroscler Plus. 2024 Sep 24;58:9-15. doi: 10.1016/j.athplu.2024.09.003. eCollection 2024 Dec. PMID- 39384342 OWN - NLM STAT- MEDLINE DCOM- 20241009 LR - 20260430 IS - 2053-3624 (Print) IS - 2053-3624 (Electronic) IS - 2053-3624 (Linking) VI - 11 IP - 2 DP - 2024 Oct 9 TI - Association between kidney function, frailty and receipt of invasive management after acute coronary syndrome. LID - 10.1136/openhrt-2024-002875 [doi] LID - e002875 AB - BACKGROUND: Reduced estimated glomerular filtration rate (eGFR) is associated with lower use of invasive management and increased mortality after acute coronary syndrome (ACS). The reasons for this are unclear. METHODS: A retrospective clinical cohort study was performed using data from the English National Institute for Health Research Health Informatics Collaborative (2010-2017). Multivariable logistic regression was used to investigate whether eGFR<90 mL/min/1.73 m(2) was associated with conservative ACS management and test whether (a) differences in care could be related to frailty and (b) associations between eGFR and mortality could be related to variation in revascularisation rates. RESULTS: Among 10 205 people with ACS, an eGFR of <60 mL/min/1.73m(2) was found in 25%. Strong inverse linear associations were found between worsening eGFR category and receipt of invasive management, on a relative and absolute scale. People with an eGFR <30 mL compared with >/=90 mL/min/1.73 m(2) were half as likely to receive coronary angiography (OR 0.50, 95% CI 0.40 to 0.64) after non-ST-elevation (NSTE)-ACS and one-third as likely after STEMI (OR 0.30, 95% CI 0.19 to 0.46), resulting in 15 and 17 per 100 fewer procedures, respectively. Following multivariable adjustment, the ORs for receipt of angiography following NSTE-ACS were 1.05 (95% CI 0.88 to 1.27), 0.98 (95% CI 0.77 to 1.26), 0.76 (95% CI 0.57 to 1.01) and 0.58 (95% CI 0.44 to 0.77) in eGFR categories 60-89, 45-59, 30-44 and <30, respectively. After STEMI, the respective ORs were 1.20 (95% CI 0.84 to 1.71), 0.77 (95% CI 0.47 to 1.24), 0.33 (95% CI 0.20 to 0.56) and 0.28 (95% CI 0.16 to 0.48) (p<0.001 for linear trends). ORs were unchanged following adjustment for frailty. A positive association between the worse eGFR category and 30-day mortality was found (test for trend p<0.001), which was unaffected by adjustment for frailty. CONCLUSIONS: In people with ACS, lower eGFR was associated with reduced receipt of invasive coronary management and increased mortality. Adjustment for frailty failed to change these observations. Further research is required to explain these disparities and determine whether treatment variation reflects optimal care for people with low eGFR. TRIAL REGISTRATION NUMBER: NCT03507309. CI - (c) Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ. FAU - Scott, Jemima Kate AU - Scott JK AUID- ORCID: 0000-0001-5180-5464 AD - Population Health Sciences, University of Bristol, Bristol, UK jemima.scott@bristol.ac.uk. AD - Richard Bright Renal Service, North Bristol NHS Trust, Westbury on Trym, UK. FAU - Johnson, Thomas AU - Johnson T AD - NIHR Bristol Biomedical Research Centre, Bristol, UK. AD - Translational Health Sciences, University of Bristol, Bristol, UK. FAU - Caskey, Fergus John AU - Caskey FJ AD - Population Health Sciences, University of Bristol, Bristol, UK. AD - Richard Bright Renal Service, North Bristol NHS Trust, Bristol, UK. FAU - Bailey, Pippa AU - Bailey P AD - Population Health Sciences, University of Bristol, Bristol, UK. AD - Richard Bright Renal Service, North Bristol NHS Trust, Bristol, UK. FAU - Selman, Lucy Ellen AU - Selman LE AD - Population Health Sciences, University of Bristol, Bristol, UK. FAU - Mulla, Abdulrahim AU - Mulla A AD - NIHR Imperial Biomedical Research Centre, London, UK. FAU - Glampson, Ben AU - Glampson B AD - NIHR Imperial Biomedical Research Centre, London, UK. FAU - Davies, Jim AU - Davies J AD - NIHR Oxford Biomedical Research Centre, Oxford, UK. FAU - Papdimitriou, Dimitri AU - Papdimitriou D AD - NIHR Imperial Biomedical Research Centre, London, UK. FAU - Woods, Kerrie AU - Woods K AD - NIHR Oxford Biomedical Research Centre, Oxford, UK. FAU - O'Gallagher, Kevin AU - O'Gallagher K AD - NIHR Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust and King's College, London, UK. FAU - Williams, Bryan AU - Williams B AD - NIHR University College London Hospitals Biomedical Research Centre, London, UK. AD - UCL Institute of Health Informatics, London, UK. FAU - Asselbergs, Folkert W AU - Asselbergs FW AD - NIHR University College London Hospitals Biomedical Research Centre, London, UK. AD - University College London Institute of Health Informatics, London, UK. FAU - Mayer, Erik K AU - Mayer EK AD - NIHR Imperial Biomedical Research Centre, London, UK. FAU - Lee, Richard AU - Lee R AD - Royal Marsden Hospital NHS Trust, London, UK. FAU - Herbert, Christopher AU - Herbert C AD - Leeds Biomedical Research Centre, Leeds, UK. FAU - Grant, Stuart W AU - Grant SW AD - Department of Cardiothoracic Surgery, NIHR Manchester Biomedical Research Centre, Manchester, UK. FAU - Curzen, Nick AU - Curzen N AD - NIHR Southampton Clinical Research Facility, Southampton, UK. FAU - Squire, Iain AU - Squire I AD - Department of Cardiovascular Sciences, University of Leicester, Leicester, UK. AD - Glenfield Hospital, Leicester, UK. FAU - Kharbanda, Rajesh AU - Kharbanda R AD - NIHR Oxford Biomedical Research Centre, Oxford, UK. FAU - Shah, Ajay AU - Shah A AD - Cardiology, NIHR Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust and King's College, London, UK. FAU - Perera, Divaka AU - Perera D AUID- ORCID: 0000-0001-6362-1291 AD - Cardiology, NIHR Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust and King's College, London, UK. FAU - Patel, Riyaz S AU - Patel RS AD - Epidemiology and Public Health, NIHR University College London Hospitals Biomedical Research Centre, London, UK. FAU - Channon, Keith AU - Channon K AD - Department of Cardiovascular Medicine, NIHR Oxford Biomedical Research Centre, Oxford, UK. FAU - Mayet, Jamil AU - Mayet J AD - NIHR Imperial Biomedical Research Centre, London, UK. FAU - Kaura, Amit AU - Kaura A AD - NIHR Imperial Biomedical Research Centre, London, UK. FAU - Ben-Shlomo, Yoav AU - Ben-Shlomo Y AD - Population Health Sciences, University of Bristol, Bristol, UK. LA - eng SI - ClinicalTrials.gov/NCT03507309 GR - FS/20/18/34972/BHF_/British Heart Foundation/United Kingdom GR - FS/CRA/22/23036/BHF_/British Heart Foundation/United Kingdom PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't DEP - 20241009 PL - England TA - Open Heart JT - Open heart JID - 101631219 SB - IM MH - Humans MH - *Acute Coronary Syndrome/therapy/physiopathology/mortality/diagnosis/epidemiology MH - Male MH - Female MH - Retrospective Studies MH - *Glomerular Filtration Rate MH - Aged MH - *Frailty/diagnosis/epidemiology/physiopathology/complications MH - Middle Aged MH - *Kidney/physiopathology MH - Risk Factors MH - Coronary Angiography MH - Aged, 80 and over MH - Percutaneous Coronary Intervention MH - Risk Assessment/methods MH - England/epidemiology MH - Myocardial Revascularization/methods/statistics & numerical data MH - Follow-Up Studies PMC - PMC11474759 OTO - NOTNLM OT - Acute Coronary Syndrome OT - Coronary Angiography OT - Percutaneous Coronary Intervention COIS- Competing interests: YB-S is partly funded as the Data Science co-lead by the National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) and University of Bristol. RL reports funding unrelated to this work from the Royal Marsden Cancer charity, Cancer Research UK, Innovate UK (co-funded by Roche), RM Partners Cancer Alliance, the NIHR and NHS England and consulting fees from Royal Marsden Private Care for personal private practice and is NHS England Joint National Clinical Lead for the Targeted Lung Health Check Programme and NIHR Clinical Research Network National Specialty Lead for Screening, Prevention and Early Detection. EDAT- 2024/10/10 04:18 MHDA- 2024/10/10 04:19 PMCR- 2024/10/09 CRDT- 2024/10/09 21:23 PHST- 2024/08/01 00:00 [received] PHST- 2024/09/27 00:00 [accepted] PHST- 2024/10/10 04:19 [medline] PHST- 2024/10/10 04:18 [pubmed] PHST- 2024/10/09 21:23 [entrez] PHST- 2024/10/09 00:00 [pmc-release] AID - openhrt-2024-002875 [pii] AID - 10.1136/openhrt-2024-002875 [doi] PST - epublish SO - Open Heart. 2024 Oct 9;11(2):e002875. doi: 10.1136/openhrt-2024-002875. PMID- 39372595 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20241008 IS - 1178-7031 (Print) IS - 1178-7031 (Electronic) IS - 1178-7031 (Linking) VI - 17 DP - 2024 TI - The Predictive Value of SII Combined with UHR for Contrast-Induced Acute Kidney Injury in Patients with Acute Myocardial Infarction After Percutaneous Coronary Intervention. PG - 7005-7016 LID - 10.2147/JIR.S482977 [doi] AB - BACKGROUND: Contrast-induced acute kidney injury (CI-AKI) refers to the acute renal dysfunction caused by the injection of contrast agents. CI-AKI is currently a common complication after percutaneous coronary intervention (PCI). OBJECTIVE: To investigate the predictive value of the combined systemic inflammatory index (SII) and urate/high-density lipoprotein cholesterol ratio (UHR) for CI-AKI after PCI in patients with AMI. METHODS: A total of 1222 patients with AMI who underwent PCI were randomly divided into a training group and a validation group in an 8:2 ratio. According to the definition of CI-AKI diagnostic criteria, the training group was divided into CI-AKI group and non-CI-AKI group. Collect patient's blood and biochemical data, then calculate SII and UHR. The risk factors for CI-AKI were identified using LASSO and multivariate logistic regression analyses. A predictive column was created by using R language.Evaluate the predictive value of SII, UHR and their combination for CI-AKI after PCI using the area under the ROC curve (AUC). RESULTS: Diabetes, Cystatin C, Diuretics, UHR, and LnSII were independent risk factors for CI-AKI in AMI patients after PCI. The ROC curve showed that the AUC of UHR and SII combined for predicting CI-AKI in AMI patients after PCI was 0.761 (95% CI: 0.709-0.812), with a sensitivity of 65.20% and a specificity of 76.70%, which was better than the prediction by either factor alone. CONCLUSION: High SII and high UHR are risk factors for AMI, and their combination can improve the accuracy of predicting CI-AKI in AMI patients after PCI.The prognosis of CI-AKI in AMI patients is worse than in the general population. CI - (c) 2024 Wang et al. FAU - Wang, Linsheng AU - Wang L AUID- ORCID: 0009-0007-8198-7263 AD - Institute of Cardiovascular Diseases, Xuzhou Medical University, Xuzhou, Jiangsu, People's Republic of China. FAU - Xu, Yang AU - Xu Y AUID- ORCID: 0009-0000-8316-1202 AD - Department of Cardiology, Xuzhou Central Hospital, Xuzhou, Jiangsu, People's Republic of China. FAU - Zhang, Xudong AU - Zhang X AUID- ORCID: 0009-0003-3079-0007 AD - Institute of Cardiovascular Diseases, Xuzhou Medical University, Xuzhou, Jiangsu, People's Republic of China. FAU - Ding, Jiahui AU - Ding J AD - Institute of Cardiovascular Diseases, Xuzhou Medical University, Xuzhou, Jiangsu, People's Republic of China. FAU - Jin, Jingkun AU - Jin J AD - Institute of Cardiovascular Diseases, Xuzhou Medical University, Xuzhou, Jiangsu, People's Republic of China. FAU - Zong, Jing AU - Zong J AD - Institute of Cardiovascular Diseases, Xuzhou Medical University, Xuzhou, Jiangsu, People's Republic of China. FAU - Li, Fangfang AU - Li F AD - Institute of Cardiovascular Diseases, Xuzhou Medical University, Xuzhou, Jiangsu, People's Republic of China. FAU - Qian, Weidong AU - Qian W AD - Department of Cardiology, Wujin Affiliated Hospital of Nanjing University of Chinese Medicine, Changzhou, Jiangsu, People's Republic of China. FAU - Li, Wenhua AU - Li W AD - Institute of Cardiovascular Diseases, Xuzhou Medical University, Xuzhou, Jiangsu, People's Republic of China. AD - Department of Cardiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, People's Republic of China. LA - eng PT - Journal Article DEP - 20241002 PL - New Zealand TA - J Inflamm Res JT - Journal of inflammation research JID - 101512684 PMC - PMC11456302 OTO - NOTNLM OT - contrast-induced acute kidney injury OT - high-density lipoprotein cholesterol OT - lymphocytes OT - neutrophils OT - serum uric acid OT - systemic immune-inflammatory index COIS- The authors report no conflict of interest in this work. EDAT- 2024/10/07 11:22 MHDA- 2024/10/07 11:23 PMCR- 2024/10/02 CRDT- 2024/10/07 05:59 PHST- 2024/06/16 00:00 [received] PHST- 2024/09/25 00:00 [accepted] PHST- 2024/10/07 11:23 [medline] PHST- 2024/10/07 11:22 [pubmed] PHST- 2024/10/07 05:59 [entrez] PHST- 2024/10/02 00:00 [pmc-release] AID - 482977 [pii] AID - 10.2147/JIR.S482977 [doi] PST - epublish SO - J Inflamm Res. 2024 Oct 2;17:7005-7016. doi: 10.2147/JIR.S482977. eCollection 2024. PMID- 39359172 OWN - NLM STAT- MEDLINE DCOM- 20241112 LR - 20250508 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 104 IP - 6 DP - 2024 Nov TI - One-month DAPT after biodegradable-polymer everolimus-eluting stent implantation in women at high-bleeding risk: Insights from the POEM trial. PG - 1129-1138 LID - 10.1002/ccd.31255 [doi] AB - AIMS: We conducted a prespecified subanalysis of the POEM trial to assess the association between sex and clinical outcomes following a short 1-month dual-antiplatelet-therapy (DAPT) period after percutaneous coronary intervention (PCI) with bioresorbable polymer everolimus-eluting stent (BP-EES) among patients at high bleeding risk (HBR). BACKGROUND: Shortening the DAPT period after PCI is an effective bleeding avoidance strategy with contemporary drug-eluting stents. Whether sex affects the risk of adverse events following PCI is still debated. METHODS: Patients at HBR undergoing PCI with BP-EES were enrolled and treated with 1-month DAPT. If anticoagulation was needed, study participants received an oral anticoagulant (OAC) in addition to a P2Y(12) inhibitor for 1 month, followed by OAC only thereafter. The primary endpoint was a composite of cardiac death, myocardial infarction, or definite/probable stent thrombosis at 12 months. We report sex-based outcomes of patients included in the POEM study. RESULTS: We enrolled 129 (29.1%) women and 314 (70.9%) men. Women were older, with lower hemoglobin levels, and worse renal function. Accordingly, they had a trend for a greater number of HBR criteria fulfilled and a higher PARIS bleeding score. However, they were not at a significantly higher risk for the primary endpoint (men vs. women: 5.17% vs. 3.94%; HR 1.30; 95% CI: 0.48-3.54, p = 0.61), or any of the hemorrhagic and ischemic secondary endpoints. CONCLUSIONS: This prespecified subanalysis of the POEM trial suggests that 1-month DAPT following PCI with BP-EES may be a safe and effective therapeutic strategy for women at HBR. CI - (c) 2024 The Author(s). Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC. FAU - Maurina, Matteo AU - Maurina M AUID- ORCID: 0000-0003-3761-7605 AD - Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, Milan, Italy. FAU - Pivato, Carlo Andrea AU - Pivato CA AUID- ORCID: 0000-0001-5195-8815 AD - Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, Milan, Italy. AD - Cardio Center, IRCCS Humanitas Research Hospital, via Manzoni 56, Rozzano, Milan, Italy. FAU - Kunadian, Vijay AU - Kunadian V AD - Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University Medical School, Newcastle upon Tyne, UK. AD - Cardiothoracic Centre, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK. FAU - Testa, Luca AU - Testa L AUID- ORCID: 0000-0003-4687-3686 AD - IRCCS Policlinico San Donato, Milan, Italy. FAU - Briguori, Carlo AU - Briguori C AUID- ORCID: 0000-0002-2105-8186 AD - Mediterranea Cardiocentro, Naples, Italy. FAU - Pacchioni, Andrea AU - Pacchioni A AUID- ORCID: 0000-0002-6561-7832 AD - Mirano Hospital, Mirano, Italy. FAU - Latini, Alessia Chiara AU - Latini AC AD - Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, Milan, Italy. AD - Cardio Center, IRCCS Humanitas Research Hospital, via Manzoni 56, Rozzano, Milan, Italy. FAU - Cesani, Nicola AU - Cesani N AD - Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, Milan, Italy. AD - Cardio Center, IRCCS Humanitas Research Hospital, via Manzoni 56, Rozzano, Milan, Italy. FAU - Piccolo, Raffale AU - Piccolo R AUID- ORCID: 0000-0002-3124-9912 AD - Department of Advanced Biomedical Sciences, "Federico II" University of Naples, Naples, Italy. FAU - Musto, Carmine AU - Musto C AD - Department of Cardiosciences A.O. San Camillo-Forlanini Hospital, Rome, Italy. FAU - Sardella, Gennaro AU - Sardella G AD - Policlinico Umberto I University, Rome, Italy. FAU - Indolfi, Ciro AU - Indolfi C AD - Department of Medical and Surgical Sciences, "Magna Graecia" University, Catanzaro, Italy. FAU - Regazzoli, Damiano AU - Regazzoli D AD - Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, Milan, Italy. FAU - Paradies, Valeria AU - Paradies V AD - Department of Cardiology Maasstad Hospital Rotterdam, Rotterdam, The Netherlands. FAU - Stefanini, Giulio AU - Stefanini G AUID- ORCID: 0000-0002-3558-6967 AD - Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, Milan, Italy. AD - Cardio Center, IRCCS Humanitas Research Hospital, via Manzoni 56, Rozzano, Milan, Italy. LA - eng SI - ClinicalTrials.gov/NCT03112707 SI - EudraCT/2016-004510-99 GR - Boston Scientific Corporation/ PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't DEP - 20241003 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 RN - 9HW64Q8G6G (Everolimus) RN - 0 (Platelet Aggregation Inhibitors) RN - 0 (Purinergic P2Y Receptor Antagonists) RN - 0 (Anticoagulants) SB - IM MH - Humans MH - Female MH - *Percutaneous Coronary Intervention/adverse effects/instrumentation/mortality MH - *Drug-Eluting Stents MH - *Everolimus/administration & dosage/adverse effects MH - Male MH - Aged MH - Time Factors MH - Risk Factors MH - Middle Aged MH - *Absorbable Implants MH - *Prosthesis Design MH - *Dual Anti-Platelet Therapy MH - *Hemorrhage/chemically induced MH - Treatment Outcome MH - *Platelet Aggregation Inhibitors/administration & dosage/adverse effects MH - Risk Assessment MH - *Coronary Artery Disease/therapy/diagnostic imaging/mortality MH - Sex Factors MH - *Drug Administration Schedule MH - Coronary Thrombosis/etiology/prevention & control MH - Purinergic P2Y Receptor Antagonists/administration & dosage/adverse effects MH - Anticoagulants/adverse effects/administration & dosage MH - Prospective Studies MH - Administration, Oral OTO - NOTNLM OT - biodegradable polymer OT - high bleeding risk OT - percutaneous coronary intervention OT - sex OT - short DAPT OT - women EDAT- 2024/10/03 06:58 MHDA- 2024/11/13 13:53 CRDT- 2024/10/03 03:52 PHST- 2024/08/27 00:00 [revised] PHST- 2024/05/11 00:00 [received] PHST- 2024/09/23 00:00 [accepted] PHST- 2024/11/13 13:53 [medline] PHST- 2024/10/03 06:58 [pubmed] PHST- 2024/10/03 03:52 [entrez] AID - 10.1002/ccd.31255 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2024 Nov;104(6):1129-1138. doi: 10.1002/ccd.31255. Epub 2024 Oct 3. PMID- 39294033 OWN - NLM STAT- MEDLINE DCOM- 20241204 LR - 20260824 IS - 1879-0828 (Electronic) IS - 0953-6205 (Linking) VI - 130 DP - 2024 Dec TI - Carotid plaque offsets sex-related differences in cardiovascular risk of young hypertensive patients. PG - 137-143 LID - S0953-6205(24)00385-6 [pii] LID - 10.1016/j.ejim.2024.09.007 [doi] AB - BACKGROUND: Women have a lower risk for cardiovascular (CV) disease compared to men. Whether this difference is influenced by the presence of hypertension-mediated organ damage is unknown. OBJECTIVE: To assess whether the presence of carotid plaque (CP) impacts the sex difference in risk for CV events in treated hypertensive patients. METHODS: From the Campania Salute Network Registry 2419 women and men <51 years of age with treated hypertension and free from prevalent CV disease were included. The presence of CP was identified by Doppler ultrasound (intima-media thickness>/=1.5 mm). The primary outcome was a composite of fatal and non-fatal stroke or myocardial infarction, sudden death, TIA, myocardial revascularization, de novo angina, and atrial fibrillation. RESULTS: Among patients without CP at baseline (n = 1807), women were older, with higher systolic blood pressure, serum cholesterol level and prevalence of LVH but lower serum triglycerides and eGFR, compared to men (all p < 0.001). Among patients with CP (n = 612), women were older, used higher number of antihypertensive drugs, had higher serum cholesterol level and prevalence of left ventricular hypertrophy (LVH), but had lower serum triglycerides and eGFR compared to men (all p < 0.001). During follow-up, women without CP had a lower risk for CV disease than men (hazard ratio, HR, 0.51, 95 % confidence intervals, CI, 0.27-0.99, p = 0.04) after accounting for cardiovascular risk factors, LVH, and antihypertensive treatment. In contrast, among patients with CP, women had similar risk for CV disease compared with men (HR 1.3, 95 % CI, 0.59-2.9, p = 0.48). CONCLUSIONS: Our findings suggest that the presence of CP in young patients with treated hypertension offsets the CV disease protection in women. TRIAL REGISTRATION: NCT02211365. CI - Copyright (c) 2024 The Author(s). Published by Elsevier B.V. All rights reserved. FAU - Mancusi, Costantino AU - Mancusi C AD - Hypertension Research Center and Department of Advanced Biomedical Science, Federico II University, Naples, Italy. FAU - Basile, Christian AU - Basile C AD - Hypertension Research Center and Department of Advanced Biomedical Science, Federico II University, Naples, Italy; Division of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden. FAU - Gerdts, Eva AU - Gerdts E AD - Department of Clinical Science, University of Bergen, Bergen, Norway. FAU - Fucile, Ilaria AU - Fucile I AD - Hypertension Research Center and Department of Advanced Biomedical Science, Federico II University, Naples, Italy. FAU - Manzi, Maria Virginia AU - Manzi MV AD - Hypertension Research Center and Department of Advanced Biomedical Science, Federico II University, Naples, Italy. FAU - Lembo, Maria AU - Lembo M AD - Hypertension Research Center and Department of Advanced Biomedical Science, Federico II University, Naples, Italy. FAU - Pacella, Daniela AU - Pacella D AD - Department of Public Health, Federico II University, Naples, Italy. FAU - Giugliano, Giuseppe AU - Giugliano G AD - Hypertension Research Center and Department of Advanced Biomedical Science, Federico II University, Naples, Italy. FAU - Canciello, Grazia AU - Canciello G AD - Hypertension Research Center and Department of Advanced Biomedical Science, Federico II University, Naples, Italy. FAU - Piccolo, Raffaele AU - Piccolo R AD - Hypertension Research Center and Department of Advanced Biomedical Science, Federico II University, Naples, Italy. FAU - Spinelli, Alessandra AU - Spinelli A AD - Hypertension Research Center and Department of Advanced Biomedical Science, Federico II University, Naples, Italy. FAU - Morisco, Carmine AU - Morisco C AD - Hypertension Research Center and Department of Advanced Biomedical Science, Federico II University, Naples, Italy. FAU - De Luca, Nicola AU - De Luca N AD - Hypertension Research Center and Department of Advanced Biomedical Science, Federico II University, Naples, Italy. FAU - Trimarco, Bruno AU - Trimarco B AD - Hypertension Research Center and Department of Advanced Biomedical Science, Federico II University, Naples, Italy. FAU - de Simone, Giovanni AU - de Simone G AD - Hypertension Research Center and Department of Advanced Biomedical Science, Federico II University, Naples, Italy. FAU - Bossone, Eduardo AU - Bossone E AD - Department of Clinical Science, University of Bergen, Bergen, Norway. FAU - Izzo, Raffaele AU - Izzo R AD - Hypertension Research Center and Department of Advanced Biomedical Science, Federico II University, Naples, Italy. FAU - Losi, Maria Angela AU - Losi MA AD - Hypertension Research Center and Department of Advanced Biomedical Science, Federico II University, Naples, Italy. Electronic address: losi@unina.it. FAU - Esposito, Giovanni AU - Esposito G AD - Hypertension Research Center and Department of Advanced Biomedical Science, Federico II University, Naples, Italy. LA - eng SI - ClinicalTrials.gov/NCT02211365 PT - Journal Article PT - Observational Study DEP - 20240917 PL - Netherlands TA - Eur J Intern Med JT - European journal of internal medicine JID - 9003220 RN - 0 (Antihypertensive Agents) SB - IM MH - Adult MH - Female MH - Humans MH - Male MH - Middle Aged MH - Antihypertensive Agents/therapeutic use MH - Cardiovascular Diseases/epidemiology/etiology MH - Carotid Artery Diseases/epidemiology MH - *Carotid Intima-Media Thickness MH - Heart Disease Risk Factors MH - *Hypertension/epidemiology/complications MH - Hypertrophy, Left Ventricular/epidemiology MH - Italy/epidemiology MH - *Plaque, Atherosclerotic/diagnostic imaging MH - Proportional Hazards Models MH - Registries MH - Risk Factors MH - Sex Factors OTO - NOTNLM OT - Cardiovascular risk OT - Carotid atherosclerosis OT - Hypertensive mediated target organ damage OT - Sex difference COIS- Conflict of interest The authors reported no conflict of interest with the present manuscript. EDAT- 2024/09/19 00:49 MHDA- 2024/12/05 05:31 CRDT- 2024/09/18 21:59 PHST- 2024/05/22 00:00 [received] PHST- 2024/08/24 00:00 [revised] PHST- 2024/09/11 00:00 [accepted] PHST- 2024/12/05 05:31 [medline] PHST- 2024/09/19 00:49 [pubmed] PHST- 2024/09/18 21:59 [entrez] AID - S0953-6205(24)00385-6 [pii] AID - 10.1016/j.ejim.2024.09.007 [doi] PST - ppublish SO - Eur J Intern Med. 2024 Dec;130:137-143. doi: 10.1016/j.ejim.2024.09.007. Epub 2024 Sep 17. PMID- 39248265 OWN - NLM STAT- MEDLINE DCOM- 20240917 LR - 20260713 IS - 2047-9980 (Electronic) IS - 2047-9980 (Linking) VI - 13 IP - 18 DP - 2024 Sep 17 TI - Clopidogrel Versus Aspirin as Chronic Maintenance Antiplatelet Monotherapy in Patients After Percutaneous Coronary Intervention With Chronic Kidney Disease: A Post Hoc Analysis of the HOST-EXAM Trial. PG - e035269 LID - 10.1161/JAHA.124.035269 [doi] LID - e035269 AB - BACKGROUND: Clopidogrel monotherapy improved clinical outcomes compared with aspirin monotherapy during a chronic maintenance period in patients who underwent coronary stenting in the HOST-EXAM (Harmonizing Optimal Strategy for Treatment of Coronary Artery Stenosis-Extended Antiplatelet Monotherapy) trial. However, it is uncertain whether the beneficial effect of clopidogrel over aspirin is different according to the renal function. METHODS AND RESULTS: We conducted a post hoc analysis of the HOST-EXAM trial. Chronic kidney disease (CKD) was defined as baseline estimated glomerular filtration rate <60 mL/min per 1.73 m(2). The primary end point was a composite of all-cause death, nonfatal myocardial infarction, stroke, readmission due to acute coronary syndrome, and Bleeding Academic Research Consortium bleeding type >/=3, during the 2-year follow up. Among the 5438 patients enrolled in the HOST-EXAM trial, 4844 patients (mean age, 63.3+/-10.6 years; 74.9% men) with a baseline creatinine value were analyzed in this study. A total of 508 (10.5%) patients had CKD, who were at higher risk of the primary end point compared with those without CKD (hazard ratio [HR], 2.01 [95% CI, 1.51-2.67]). Clopidogrel monotherapy was associated with a lower rate of the primary end point in both patients with CKD (HR, 0.74 [95% CI, 0.44-1.25]) and patients without CKD (HR, 0.71 [95% CI, 0.56-0.91]). No significant interaction was observed between the treatment effect and CKD status (P for interaction=0.889). CONCLUSIONS: During the chronic maintenance period after coronary stenting, the risk of thrombotic and bleeding events was significantly higher in patients with CKD compared with those without CKD. There was no statistical difference in the treatment effect of clopidogrel monotherapy in those with versus without CKD. FAU - Kang, Jeehoon AU - Kang J AUID- ORCID: 0000-0002-9078-2231 AD - Department of Internal Medicine, Cardiovascular Center Seoul National University Hospital Seoul South Korea. FAU - Park, Sang-Hyeon AU - Park SH AUID- ORCID: 0000-0001-8453-4146 AD - Department of Internal Medicine, Cardiovascular Center Seoul National University Hospital Seoul South Korea. FAU - Park, Kyung Woo AU - Park KW AUID- ORCID: 0000-0003-2432-4432 AD - Department of Internal Medicine, Cardiovascular Center Seoul National University Hospital Seoul South Korea. FAU - Koo, Bon-Kwon AU - Koo BK AUID- ORCID: 0000-0002-8188-3348 AD - Department of Internal Medicine, Cardiovascular Center Seoul National University Hospital Seoul South Korea. FAU - Lee, Huijin AU - Lee H AUID- ORCID: 0009-0004-5930-2705 AD - Department of Internal Medicine, Cardiovascular Center Seoul National University Hospital Seoul South Korea. FAU - Han, Minju AU - Han M AUID- ORCID: 0000-0002-0748-287X AD - Department of Internal Medicine, Cardiovascular Center Seoul National University Hospital Seoul South Korea. FAU - Hwang, Doyeon AU - Hwang D AD - Department of Internal Medicine, Cardiovascular Center Seoul National University Hospital Seoul South Korea. FAU - Yang, Han-Mo AU - Yang HM AUID- ORCID: 0000-0002-1548-2351 AD - Department of Internal Medicine, Cardiovascular Center Seoul National University Hospital Seoul South Korea. FAU - Chae, In-Ho AU - Chae IH AUID- ORCID: 0000-0003-1644-2105 AD - Department of Internal Medicine Seoul National University Bundang Hospital Seongnam South Korea. FAU - Shin, Won-Yong AU - Shin WY AUID- ORCID: 0000-0002-1517-7189 AD - Department of Internal Medicine Soonchunhyang University Cheonan Hospital Cheonan South Korea. FAU - Oh, Ju Hyeon AU - Oh JH AD - Department of Cardiology, Samsung Changwon Hospital Sungkyunkwan University School of Medicine Changwon South Korea. FAU - Kim, Yong Hoon AU - Kim YH AUID- ORCID: 0000-0002-9669-3598 AD - Department of Internal Medicine Kangwon National University School of Medicine Chuncheon South Korea. FAU - Park, Tae-Ho AU - Park TH AD - Department of Internal Medicine Dong-A University Hospital Busan South Korea. FAU - Kim, Bum Soo AU - Kim BS AD - Department of Internal Medicine, Kangbuk Samsung Hospital Sungkyunkwan University Seoul South Korea. FAU - Han, Jung-Kyu AU - Han JK AUID- ORCID: 0000-0002-0016-0747 AD - Department of Internal Medicine, Cardiovascular Center Seoul National University Hospital Seoul South Korea. FAU - Shin, Eun-Seok AU - Shin ES AUID- ORCID: 0000-0002-9169-6968 AD - Department of Internal Medicine Ulsan University Hospital Ulsan South Korea. FAU - Kim, Hyo-Soo AU - Kim HS AUID- ORCID: 0000-0003-0847-5329 AD - Department of Internal Medicine, Cardiovascular Center Seoul National University Hospital Seoul South Korea. LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20240909 PL - England TA - J Am Heart Assoc JT - Journal of the American Heart Association JID - 101580524 RN - A74586SNO7 (Clopidogrel) RN - 0 (Platelet Aggregation Inhibitors) RN - R16CO5Y76E (Aspirin) SB - IM MH - Humans MH - *Clopidogrel/therapeutic use/adverse effects/administration & dosage MH - Male MH - Female MH - *Platelet Aggregation Inhibitors/adverse effects/therapeutic use/administration & dosage MH - *Renal Insufficiency, Chronic/complications/diagnosis/physiopathology/therapy MH - Middle Aged MH - *Percutaneous Coronary Intervention/adverse effects MH - *Aspirin/administration & dosage/therapeutic use/adverse effects MH - Aged MH - Hemorrhage/chemically induced MH - Treatment Outcome MH - Glomerular Filtration Rate MH - Coronary Artery Disease/diagnosis/therapy/complications/mortality MH - Stents MH - Time Factors PMC - PMC11935617 OTO - NOTNLM OT - aspirin OT - chronic kidney disease OT - clopidogrel OT - percutaneous coronary intervention EDAT- 2024/09/09 12:44 MHDA- 2024/09/17 21:46 PMCR- 2024/09/17 CRDT- 2024/09/09 07:23 PHST- 2024/09/17 21:46 [medline] PHST- 2024/09/09 12:44 [pubmed] PHST- 2024/09/09 07:23 [entrez] PHST- 2024/09/17 00:00 [pmc-release] AID - JAH310075 [pii] AID - 10.1161/JAHA.124.035269 [doi] PST - ppublish SO - J Am Heart Assoc. 2024 Sep 17;13(18):e035269. doi: 10.1161/JAHA.124.035269. Epub 2024 Sep 9. PMID- 39228664 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240906 IS - 2297-055X (Print) IS - 2297-055X (Electronic) IS - 2297-055X (Linking) VI - 11 DP - 2024 TI - Evaluation of preprocedural statin loading on clinical outcomes in patients undergoing elective percutaneous coronary intervention. PG - 1435989 LID - 10.3389/fcvm.2024.1435989 [doi] LID - 1435989 AB - BACKGROUND AND AIM: High-dose statin therapy before percutaneous coronary intervention (PCI) is thought to reduce the occurrence of Peri-procedural Myocardial Infarction (PPMI), which is associated with increased mortality and prolonged hospitalization, especially in statin naive patients. This study aims to investigate the effect of rosuvastatin loading dose on PPMI and major adverse cardiac and cerebrovascular events (MACCE) in patients undergoing elective PCI, considering their statin use. METHODS: One hundred sixty-five patients with stable coronary artery disease (CAD) without heart failure (HF) or chronic kidney disease (CKD) were included in the study. They were divided into two groups: patients already on statin treatment (n:126) and statin naive patients (n:39). Both groups were randomly assigned to high-dose (40 mg) rosuvastatin (n:86) or a non- loading dose group (n:79). The primary endpoint was the incidence of PPMI, and the secondary endpoint was MACCE. RESULTS: The mean age of study population was 59 +/- 9.4 years with 77% being male (n = 127). The median follow-up (FU) time was 368 day. Thirty patients were diagnosed with PPMI after PCI (19 in the high-dose group and 11 in the no-loading-dose group). Meanwhile, less than half of study population (77 patients, 46.7%) had complex lesion type (B2, C) and 88 of those (53.3%) had simple lesion type (A, B1). PPMI was observed more frequently in statin-naive patients (23%) than in statin users (17%), although the difference was not statistically significant. Only two patients (1.2%) experienced MACCE during the FU period. One of these patients, who had a type C lesion, belonged to group A2 and underwent Target Vessel Revascularization (TVR) on the 391st day. The other patient, with a type B1 lesion, was in group A1 and was hospitalized due to Acute Coronary Syndrome (ACS) on the 40th day of FU. CONCLUSIONS: Pre-procedural administration of high dose rosuvastatin in patients with stable coronary artery disease did not decrease PPMI, independent of chronic statin use. CI - (c) 2024 Sinan, Keskin Meric, Bursa, Moumin, Kaya and Arat Ozkan. FAU - Sinan, Umit Yasar AU - Sinan UY AD - Department of Cardiology, Istanbul University-Cerrahpasa Institute of Cardiology, Istanbul, Turkiye. FAU - Keskin Meric, Bengisu AU - Keskin Meric B AD - Department of Cardiology, Istanbul University-Cerrahpasa Institute of Cardiology, Istanbul, Turkiye. FAU - Bursa, Nurbanu AU - Bursa N AD - Department of Statistics, Faculty of Science, Hacettepe University, Ankara, Turkiye. FAU - Moumin, Gkiozde AU - Moumin G AD - Department of Cardiology, Istanbul University-Cerrahpasa Institute of Cardiology, Istanbul, Turkiye. FAU - Kaya, Aysem AU - Kaya A AD - Department of Biochemistry, Istanbul University-Cerrahpasa Institute of Cardiology, Istanbul, Turkiye. FAU - Arat Ozkan, Alev AU - Arat Ozkan A AD - Department of Cardiology, Istanbul University-Cerrahpasa Institute of Cardiology, Istanbul, Turkiye. LA - eng PT - Journal Article DEP - 20240820 PL - Switzerland TA - Front Cardiovasc Med JT - Frontiers in cardiovascular medicine JID - 101653388 PMC - PMC11368834 OTO - NOTNLM OT - Peri-procedural Myocardial Infarction OT - elective coronary angioplasty OT - myocardial necrosis OT - prevention OT - rosuvastatin COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2024/09/04 06:42 MHDA- 2024/09/04 06:43 PMCR- 2024/01/01 CRDT- 2024/09/04 04:26 PHST- 2024/05/21 00:00 [received] PHST- 2024/08/01 00:00 [accepted] PHST- 2024/09/04 06:43 [medline] PHST- 2024/09/04 06:42 [pubmed] PHST- 2024/09/04 04:26 [entrez] PHST- 2024/01/01 00:00 [pmc-release] AID - 10.3389/fcvm.2024.1435989 [doi] PST - epublish SO - Front Cardiovasc Med. 2024 Aug 20;11:1435989. doi: 10.3389/fcvm.2024.1435989. eCollection 2024. PMID- 39168566 OWN - NLM STAT- MEDLINE DCOM- 20240821 LR - 20250114 IS - 1558-3597 (Electronic) IS - 0735-1097 (Linking) VI - 84 IP - 9 DP - 2024 Aug 27 TI - Low-Dose Rivaroxaban Plus Aspirin in Fragile Patients After Lower Extremity Revascularization. PG - 801-811 LID - S0735-1097(24)07674-5 [pii] LID - 10.1016/j.jacc.2024.05.060 [doi] AB - BACKGROUND: Rivaroxaban 2.5 mg plus aspirin reduced limb and cardiovascular events and increased bleeding in patients with symptomatic peripheral artery disease (PAD) after lower extremity revascularization in the VOYAGER PAD (Efficacy and Safety of Rivaroxaban in Reducing the Risk of Major Thrombotic Vascular Events in Subjects With Symptomatic Peripheral Artery Disease Undergoing Peripheral Revascularization Procedures of the Lower Extremities) study. Fragile patients are at heightened risk for ischemic and bleeding events. OBJECTIVES: The purpose of this study was to investigate the safety and efficacy of rivaroxaban 2.5 mg in fragile patients from VOYAGER PAD. METHODS: Patients were categorized as fragile based on prespecified criteria (age >75 years, weight /=130 mmHg, mean daily diastolic BP >/=80 mmHg). The data were collected from 2018 through 2020. A total of 75 patients was included and distributed by simple randomization into two groups: group 1 (main, n=37) received azilsartan medoxomil as an antihypertensive drug at a dose of 40 mg/day (previously prescribed angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers (ARB) were discontinued); group 2 (control, n=38) continued on their previous antihypertensive therapy. The follow-up period was 6 months. During each of 5 consecutive follow-up visits, the patient was examined, 24-BPM was recorded, and urinary markers of renal dysfunction (glomerular filtration rate, GFR; neutrophil gelatinase-associated lipocalin, NGAL; urine albumin-creatinine ratio, UACR; kidney injury molecule, KIM-1; and interleukin-18, IL-18) were measured. RESULTS: During the azilsartan treatment, GFR decreased by 7.4%, while in the control group, it decreased by 18.9% (p<0.001). For 6 months of follow-up, no changes in the NGAL concentration were found in the main group, while the NGAL concentration in the control group increased by 12.9%. With azilsartan, there was a decrease in the urinary concentration of IL-18 (16.9%), while in patients of the control group, IL-18 increased (7.14%). Proteinuria progressed in both groups, which was expectable given the presence of DM; however, in patients receiving azilsartan, the UACR value increased by 37.5%, while in patients of the control group, it increased by 96.15%. These differences were statistically significant. No statistically significant differences were found in the concentrations of cystatin C and KIM-1. CONCLUSION: This study demonstrated two important facts: the possibility for diagnosing contrast-induced acute kidney injury (CI-AKI) using new, more sensitive markers of kidney damage, which is important for assessing the effectiveness of prevention, and the possibility of using ARBs, in particular azilsartan, for the prevention of CI-AKI in patients with IHD in combination with AH and DM. FAU - Kochergina, A M AU - Kochergina AM AD - Research Institute for Complex Problems of Cardiovascular Diseases, Kemerovo. FAU - Barbarash, O L AU - Barbarash OL AD - Research Institute for Complex Problems of Cardiovascular Diseases, Kemerovo. LA - rus LA - eng PT - Journal Article PT - Randomized Controlled Trial DEP - 20240731 PL - Russia (Federation) TA - Kardiologiia JT - Kardiologiia JID - 0376351 RN - 0 (Oxadiazoles) RN - 0 (Benzimidazoles) RN - LL0G25K7I2 (azilsartan medoxomil) RN - 0 (Antihypertensive Agents) SB - IM MH - Humans MH - *Diabetes Mellitus, Type 2/complications MH - Male MH - Female MH - *Oxadiazoles/adverse effects/administration & dosage MH - Middle Aged MH - *Benzimidazoles/adverse effects/administration & dosage MH - *Percutaneous Coronary Intervention/methods MH - *Hypertension MH - Aged MH - Antihypertensive Agents/therapeutic use MH - Preoperative Care/methods MH - Myocardial Ischemia EDAT- 2024/08/05 18:43 MHDA- 2024/08/05 18:44 CRDT- 2024/08/05 15:23 PHST- 2024/03/29 00:00 [received] PHST- 2024/06/10 00:00 [accepted] PHST- 2024/08/05 18:44 [medline] PHST- 2024/08/05 18:43 [pubmed] PHST- 2024/08/05 15:23 [entrez] AID - 10.18087/cardio.2024.7.n2671 [doi] PST - epublish SO - Kardiologiia. 2024 Jul 31;64(7):48-55. doi: 10.18087/cardio.2024.7.n2671. PMID- 39055837 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240727 IS - 2405-8440 (Print) IS - 2405-8440 (Electronic) IS - 2405-8440 (Linking) VI - 10 IP - 13 DP - 2024 Jul 15 TI - A risk score for predicting in-stent restenosis in patients with premature acute myocardial infarction undergoing percutaneous coronary intervention with drug-eluting stent. PG - e34077 LID - 10.1016/j.heliyon.2024.e34077 [doi] LID - e34077 AB - BACKGROUND: This study aimed at developing and validating a risk score to predict in-stent restenosis (ISR) in patients with premature acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI) with drug-eluting stent (DES). METHODS: This was a two-center retrospective study. A total of 2185 patients firstly diagnosed with premature AMI (age >/=18 years and <55 years in men, <65 years in women) from Xinjiang cohort were retrospectively analyzed. After filtering by exclusion criteria, patients were randomly divided into training cohort (n = 434) and internal validation cohort (n = 186) at a 7:3 ratio. Several candidate variables associated with ISR in the training cohort were assessed by the least absolute shrinkage and selection operator and logistic regression analysis. The ISR risk nomogram score based on the superior predictors was finally developed, and then validated in the internal validation cohort and in an independent Chengdu external validation cohort (n = 192). The higher total nomogram score, the greater the ISR risk. RESULTS: The eight variables in the final risk nomogram score, cardiovascular-kidney-metabolic (CKM) score included age, diabetes mellitus (DM), body mass index (BMI), systolic blood pressure (SBP), low-density lipoprotein cholesterol (LDLC), estimated glomerular filtration rate (eGFR), stent in left anterior descending coronary artery, minimum stent diameter <3 mm. The areas under the curve (AUC) and C-statistics [training cohort: 0.834 (95%CI: 0.787 to 0.882); internal validation cohort: 0.852 (95%CI: 0.784 to 0.921); Chengdu external validation cohort: 0.787 (95%CI: 0.692 to 0.882), respectively)] demonstrated the good discrimination of the CKM score. The Hosmer-Lemeshow test (chi(2) = 7.86, P = 0.448; chi(2) = 5.17, P = 0.740; chi(2) = 6.35, P = 0.608, respectively) and the calibration curve confirmed the good calibration of the CKM score. Decision curve analysis (DCA) testified the clinical net benefit of the CKM score in the training and validation cohort. CONCLUSION: This study provided a well-developed and validated risk nomogram score, the CKM score to predict ISR in patients with premature AMI undergoing PCI with DES. Given that these variables are readily available and practical, the CKM score should be widely adopted for individualized assessment and management of premature AMI. CI - (c) 2024 The Authors. Published by Elsevier Ltd. FAU - Liu, Sen AU - Liu S AD - Heart Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang, China. FAU - Yang, Hong AU - Yang H AD - Heart Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang, China. FAU - Liu, Cheng AU - Liu C AD - Heart Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang, China. FAU - Liu, Ziyang AU - Liu Z AD - Heart Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang, China. FAU - Hou, Jixin AU - Hou J AD - Department of Cardiology, The First Affiliated Hospital, Chengdu Medical College, Chengdu, 610500, Sichuan, China. FAU - Wei, Mengwei AU - Wei M AD - Heart Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang, China. FAU - Luo, Sifu AU - Luo S AD - Heart Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang, China. FAU - Zhou, Yaqi AU - Zhou Y AD - Heart Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang, China. FAU - Wang, Peijian AU - Wang P AD - Department of Cardiology, The First Affiliated Hospital, Chengdu Medical College, Chengdu, 610500, Sichuan, China. FAU - Fu, Zhenyan AU - Fu Z AD - Heart Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang, China. LA - eng PT - Journal Article DEP - 20240704 PL - England TA - Heliyon JT - Heliyon JID - 101672560 PMC - PMC11269898 OTO - NOTNLM OT - In-stent restenosis OT - Nomogram OT - Percutaneous coronary intervention OT - Predicting model OT - Premature acute myocardial infarction OT - Risk score COIS- The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2024/07/26 12:46 MHDA- 2024/07/26 12:47 PMCR- 2024/07/04 CRDT- 2024/07/26 04:36 PHST- 2024/03/27 00:00 [received] PHST- 2024/06/24 00:00 [revised] PHST- 2024/07/03 00:00 [accepted] PHST- 2024/07/26 12:47 [medline] PHST- 2024/07/26 12:46 [pubmed] PHST- 2024/07/26 04:36 [entrez] PHST- 2024/07/04 00:00 [pmc-release] AID - S2405-8440(24)10108-9 [pii] AID - e34077 [pii] AID - 10.1016/j.heliyon.2024.e34077 [doi] PST - epublish SO - Heliyon. 2024 Jul 4;10(13):e34077. doi: 10.1016/j.heliyon.2024.e34077. eCollection 2024 Jul 15. PMID- 39050427 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240726 IS - 2405-8440 (Print) IS - 2405-8440 (Electronic) IS - 2405-8440 (Linking) VI - 10 IP - 13 DP - 2024 Jul 15 TI - Effect of the combined use of ivabradine and metoprolol in patients with acute myocardial infarction early after percutaneous coronary intervention: A randomized controlled study. PG - e33779 LID - 10.1016/j.heliyon.2024.e33779 [doi] LID - e33779 AB - OBJECTIVE: To investigate the effect and safety of the combined use of ivabradine and metoprolol in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI). METHODS: Eighty patients with AMI were randomly divided into the ivabradine group and the control group. The ivabradine group was treated with ivabradine combined with metoprolol after PCI, while the control group was treated with metoprolol only. Both groups were treated continuously for 1 year. Echocardiography-derived parameters, heart rate, cardiopulmonary exercise testing (CPET) data, major adverse cardiac events (MACE) and myocardial markers were analyzed. The primary endpoint was the left ventricular ejection fraction (LVEF). The safety outcomes were blood pressure, liver and kidney function. RESULTS: The LVEF was significantly higher in the ivabradine group than in the control group at 1 week, 3 months and 1 year after PCI. The heart rate of the ivabradine group was significantly lower than that of the control group at 1 week and 1month after PCI. The VO2max, metabolic equivalents, anaerobic threshold heart rate, peak heart rate, and heart rate recovery at 8 min of the ivabradine group were significantly higher than those of the control group at 1 year after PCI. Kaplan-Meier analysis demonstrated the one-year total incidence of MACE in the ivabradine group was significantly lower than that in the control group. The B-type natriuretic peptide of the ivabradine group was significantly lower than that of the control group on Day 2 and Day 3 after PCI. The high-sensitivity cardiac troponin I level of the ivabradine group was significantly lower than that of the control group on Day 5 after PCI. CONCLUSION: Early use of ivabradine in patients with AMI after PCI can achieve effective heart rate control, reduce myocardial injury, improve cardiac function and exercise tolerance, and may reduce the incidence of major adverse cardiac events. (Clinical research registration number: ChiCTR2000032731). CI - (c) 2024 Published by Elsevier Ltd. FAU - He, Ruiqing AU - He R AD - Department of Cardiology, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China. FAU - Li, Lingyan AU - Li L AD - Department of Cardiology, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China. FAU - Han, Chao AU - Han C AD - Department of Cardiology, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China. AD - Institute of Translational Cardiovascular Medicine, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China. FAU - An, Wen AU - An W AD - Department of Cardiology, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China. AD - Institute of Translational Cardiovascular Medicine, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China. FAU - Liu, Zongjun AU - Liu Z AD - Department of Cardiology, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China. AD - Institute of Translational Cardiovascular Medicine, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China. FAU - Gao, Junqing AU - Gao J AD - Department of Cardiology, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China. AD - Institute of Translational Cardiovascular Medicine, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China. LA - eng PT - Journal Article DEP - 20240627 PL - England TA - Heliyon JT - Heliyon JID - 101672560 PMC - PMC11268166 OTO - NOTNLM OT - Acute myocardial infarction OT - Cardiac function OT - ivabradine OT - major adverse cardiac events COIS- The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Junqing Gao reports financial support was provided by The Shanghai Medical Innovation Research Project of Scientific and Technological Innovation Action Plan. Zongjun Liu reports financial support was provided by The Shanghai Medical Innovation Research Project of Scientific and Technological Innovation Action Plan. Zongjun Liu reports financial support was provided by Clinical Advantage Discipline of Health System of Putuo District in Shanghai. Junqing Gao reports financial support was provided by Scientific Research Hundred Personnel Plan of Shanghai Putuo District Central Hospital. Ruiqing He reports financial support was provided by Shanghai Municipal Health and Health Commission Health Industry Clinical Research Project. Lingyan Li reports financial support was provided by Budget Project of 10.13039/501100010876Shanghai University of Traditional Chinese Medicine. Lingyan Li reports financial support was provided by Shanghai Putuo District Health System Science and Technology Innovation Project. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2024/07/26 12:47 MHDA- 2024/07/26 12:48 PMCR- 2024/06/27 CRDT- 2024/07/25 04:51 PHST- 2023/07/15 00:00 [received] PHST- 2024/06/17 00:00 [revised] PHST- 2024/06/26 00:00 [accepted] PHST- 2024/07/26 12:48 [medline] PHST- 2024/07/26 12:47 [pubmed] PHST- 2024/07/25 04:51 [entrez] PHST- 2024/06/27 00:00 [pmc-release] AID - S2405-8440(24)09810-4 [pii] AID - e33779 [pii] AID - 10.1016/j.heliyon.2024.e33779 [doi] PST - epublish SO - Heliyon. 2024 Jun 27;10(13):e33779. doi: 10.1016/j.heliyon.2024.e33779. eCollection 2024 Jul 15. PMID- 39038562 OWN - NLM STAT- MEDLINE DCOM- 20241116 LR - 20260919 IS - 1557-3117 (Electronic) IS - 1053-2498 (Linking) VI - 43 IP - 12 DP - 2024 Dec TI - Long-term follow-up of the randomized, prospective Scandinavian heart transplant everolimus de novo study with early calcineurin inhibitors avoidance (SCHEDULE) trial. PG - 1948-1959 LID - S1053-2498(24)01732-7 [pii] LID - 10.1016/j.healun.2024.07.002 [doi] AB - BACKGROUND: Early substitution of calcineurin inhibitor (CNI) with mammalian target of rapamycin inhibitors has been shown to improve kidney function and reduce intimal hyperplasia in heart transplant (HTx) recipients but data on long-term outcome of such a regime are still sparse. METHODS: In the SCHEDULE trial, 115 de novo HTx recipients were randomized to (1) everolimus with reduced exposure of CNI followed by CNI withdrawal at week 7-11 post-transplant or (2) standard-exposure with CNI. Both groups received mycophenolate mofetil and corticosteroids. Herein we report on the 10-12-year long-term follow-up of the study. RESULTS: A total of 78 patients attended the follow-up visit at a median time of 11 years post-transplant. In the everolimus intention to treat (ITT) group 87.5% (35/40 patients) still received everolimus and in the CNI ITT group 86.8% (33/38) still received CNI. Estimated glomerular filtration rate (eGFR) (least square mean (95% CI)) at the 10-12 years visit was 82.7 (74.2-91.1) ml/min/1.73 m(2) and 61.0 (52.3-69.7) ml/min/1.73 m(2) in the everolimus and CNI group, respectively (p < 0.001). Graft function measured by ejection fraction, ECG, NT-proBNP and drug safety were comparable between groups. During the study period there was a total of 28 deaths, but there was no difference in survival between the everolimus and the CNI group (aHR 0.61 (95% CI 0.29-1.30) p = 0.20). For the composite endpoint of death, re-transplantation, myocardial infarction, PCI, dialysis, kidney transplantation or cancer no between group differences were found (aHR 1.0 (95% CI 0.57-1.77) p = 0.99). CONCLUSIONS: De novo HTx patients randomized to everolimus and low dose CNI followed by CNI free therapy sustained significantly better long-term kidney function than patients randomized to standard therapy. The graft function at 10-12 years was similar in both groups and there was no difference in survival. CI - Copyright (c) 2024 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Bollano, Entela AU - Bollano E AD - Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Transplantation, Sahlgrenska University Hospital, Gothenburg, Sweden; Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Electronic address: entela.bollano@vgregion.se. FAU - Andreassen, Arne K AU - Andreassen AK AD - Department of Cardiology, Oslo University Hospital Rikshospitalet, Oslo, Norway. FAU - Eiskjaer, Hans AU - Eiskjaer H AD - Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark. FAU - Gustafsson, Finn AU - Gustafsson F AD - Department of Cardiology, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. FAU - Radegran, Goran AU - Radegran G AD - Section for Heart Failure and Valvular Disease, Skane University Hospital and Department of Clinical Sciences, Cardiology, Lund University, Lund, Sweden. FAU - Gude, Einar AU - Gude E AD - Department of Cardiology, Oslo University Hospital Rikshospitalet, Oslo, Norway. FAU - Gullestad, Lars AU - Gullestad L AD - Department of Cardiology, Oslo University Hospital Rikshospitalet, Oslo, Norway; KG Jebsen Center for Cardiac Research, University of Oslo, Oslo, Norway. FAU - Broch, Kaspar AU - Broch K AD - Department of Cardiology, Oslo University Hospital Rikshospitalet, Oslo, Norway; KG Jebsen Center for Cardiac Research, University of Oslo, Oslo, Norway. FAU - Halden, Thea A S AU - Halden TAS AD - Department of Immunology, Novartis Norge AS, Oslo, Norway. FAU - Karason, Kristjan AU - Karason K AD - Department of Transplantation, Sahlgrenska University Hospital, Gothenburg, Sweden; Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. FAU - Bartfay, Sven-Erik AU - Bartfay SE AD - Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Transplantation, Sahlgrenska University Hospital, Gothenburg, Sweden; Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. FAU - Bergh, Niklas AU - Bergh N AD - Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. CN - SCHEDULE (Scandinavian heart transplant everolimus de novo study with early calcineurin inhibitors avoidance) investigators LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20240720 PL - United States TA - J Heart Lung Transplant JT - The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation JID - 9102703 RN - 9HW64Q8G6G (Everolimus) RN - 0 (Calcineurin Inhibitors) RN - 0 (Immunosuppressive Agents) RN - HU9DX48N0T (Mycophenolic Acid) SB - IM MH - Humans MH - *Everolimus/administration & dosage/therapeutic use MH - Male MH - Female MH - *Heart Transplantation MH - *Calcineurin Inhibitors/administration & dosage/therapeutic use MH - Middle Aged MH - Follow-Up Studies MH - *Immunosuppressive Agents/therapeutic use/administration & dosage MH - Prospective Studies MH - Adult MH - Glomerular Filtration Rate MH - Graft Rejection/prevention & control MH - Scandinavian and Nordic Countries MH - Time Factors MH - Graft Survival/drug effects MH - Mycophenolic Acid/therapeutic use/administration & dosage MH - Treatment Outcome MH - Aged OTO - NOTNLM OT - calcineurin inhibitor OT - everolimus OT - graft function OT - heart transplantation OT - survival EDAT- 2024/07/23 00:42 MHDA- 2024/11/17 04:19 CRDT- 2024/07/22 19:21 PHST- 2023/12/12 00:00 [received] PHST- 2024/05/08 00:00 [revised] PHST- 2024/07/03 00:00 [accepted] PHST- 2024/11/17 04:19 [medline] PHST- 2024/07/23 00:42 [pubmed] PHST- 2024/07/22 19:21 [entrez] AID - S1053-2498(24)01732-7 [pii] AID - 10.1016/j.healun.2024.07.002 [doi] PST - ppublish SO - J Heart Lung Transplant. 2024 Dec;43(12):1948-1959. doi: 10.1016/j.healun.2024.07.002. Epub 2024 Jul 20. PMID- 38957330 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240704 IS - 2297-055X (Print) IS - 2297-055X (Electronic) IS - 2297-055X (Linking) VI - 11 DP - 2024 TI - Electroacupuncture for slow flow/no-reflow phenomenon in patients with acute myocardial infarction undergoing percutaneous coronary intervention: protocol for a pilot randomized controlled trial. PG - 1401269 LID - 10.3389/fcvm.2024.1401269 [doi] LID - 1401269 AB - BACKGROUND: Slow flow/no-reflow (SF-NR) during percutaneous coronary intervention (PCI) is associated with poor prognosis of patients with acute myocardial infarction (AMI). Currently, effective treatment is not available for SF-NR. Electroacupuncture (EA) has shown significant efficacy as an adjuvant therapy for many cardiovascular diseases by improving microcirculation and reducing ischemia-reperfusion injury. However, its effects on SF-NR in the AMI patients during PCI are not clear. This pilot trial aims to determine the efficacy of intraoperative EA in alleviating SF-NR in AMI patients undergoing PCI. METHODS: This prospective, single-center, randomized controlled, pilot trial will recruit 60 AMI patients scheduled for PCI at the Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, China. The patients will be randomized in a 1:1 ratio into the EA or the control groups. Patients in the control group will undergo standard PCI. Patients in the EA group will undergo intraoperative electroacupuncture while undergoing standard PCI. Incidence of SF-NR is the primary outcome for this study. This study will also assess secondary outcomes including cardiac biomarkers, inflammatory biomarkers, pain and anxiety scores, electrocardiography parameters, traditional Chinese medicine (TCM) symptom score, and major adverse cardiovascular and cerebrovascular events (MACCE). All the included patients will undergo laboratory tests including routine blood tests, levels of electrolytes, as well as liver and renal function tests. Patients will be followed up for 1 month after the procedure. DISCUSSION: This pilot trial will provide evidence for the potential benefits of intraoperative EA in improving microvascular perfusion and preventing or alleviating SF-NR during PCI in patients with AMI. If proven effective, intraoperative EA will provide a new and effective strategy against SF-NR and provide evidence for subsequent multicenter trials. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, identifier (ChiCTR2300072265). Registered on 8 June 2023. CI - (c) 2024 Peng, Wei, Wu, Fan, Wang and Zhou. FAU - Peng, Yanbin AU - Peng Y AD - Acupuncture Anesthesia Clinical Research Institute, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China. FAU - Wei, Xuqiang AU - Wei X AD - Acupuncture Anesthesia Clinical Research Institute, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China. FAU - Wu, Feng AU - Wu F AD - Department of Cardiovascular Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China. FAU - Fan, Min AU - Fan M AD - Department of Cardiovascular Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China. FAU - Wang, Ke AU - Wang K AD - Acupuncture Anesthesia Clinical Research Institute, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China. FAU - Zhou, Jia AU - Zhou J AD - Acupuncture Anesthesia Clinical Research Institute, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China. LA - eng PT - Journal Article DEP - 20240618 PL - Switzerland TA - Front Cardiovasc Med JT - Frontiers in cardiovascular medicine JID - 101653388 PMC - PMC11218819 OTO - NOTNLM OT - BMI OT - acute myocardial infarction OT - electroacupuncture OT - gender OT - protocol OT - randomized controlled trial (RCT) including age OT - slow flow/no-reflow OT - smoking history COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2024/07/03 06:42 MHDA- 2024/07/03 06:43 PMCR- 2024/01/01 CRDT- 2024/07/03 04:06 PHST- 2024/03/15 00:00 [received] PHST- 2024/06/05 00:00 [accepted] PHST- 2024/07/03 06:43 [medline] PHST- 2024/07/03 06:42 [pubmed] PHST- 2024/07/03 04:06 [entrez] PHST- 2024/01/01 00:00 [pmc-release] AID - 10.3389/fcvm.2024.1401269 [doi] PST - epublish SO - Front Cardiovasc Med. 2024 Jun 18;11:1401269. doi: 10.3389/fcvm.2024.1401269. eCollection 2024. PMID- 38914608 OWN - NLM STAT- MEDLINE DCOM- 20240624 LR - 20260518 IS - 2045-2322 (Electronic) IS - 2045-2322 (Linking) VI - 14 IP - 1 DP - 2024 Jun 24 TI - Low platelet count at admission has an adverse impact on outcome in patients with acute coronary syndromes: from the START Antiplatelet registry. PG - 14516 LID - 10.1038/s41598-024-64113-5 [doi] LID - 14516 AB - Some previous observations suggest that a low platelet count is associated with an increased risk of adverse outcomes in patients with acute coronary syndromes (ACS). However, most of the data come from post-hoc analyses of randomized controlled trials and from studies including thrombocytopenia developed during hospital stay. Our aim was to assess the impact of low platelet count at admission on cardiovascular outcomes and treatment approach in patients hospitalized for ACS in a current real-life setting in Italy. Patients admitted to Italian coronary care units for ACS were enrolled in the START-ANTIPLATELET registry. Baseline clinical characteristics and treatment at discharge were recorded. Patients were followed-up at 6 months, 1 year and yearly thereafter. Low platelet count was defined as a count at admission < 150 > 100 k/microl or < 100 k/microL. Among 1894 enrolled patients, 157 (8.3%) had a platelet count < 150 > 100 k/microl and 30 (1.6%) < 100 k/microl. The median follow-up was 12.3 months (0.4-50.1). patients with low platelets were older (72 +/- 10.4 vs 66 +/- 12.4 years, p = 0.006), more frequently males (82.9 vs 72.1%, p = 0.001), hypertensive (90.0% vs 70.4%, p = 0.03), with non-valvular atrial fibrillation (NVAF) (17.1 vs 8.6%, p = 0.02), and peripheral arterial disease (11.5 vs 6.2% p = 0.01) and/or had a previous myocardial infarction (40 vs 18.7%, p = 0.008) and/or a PCI (14.6 vs 7.8%, p = 0.001) than patients with normal platelets. A slightly, but significantly, lower percentage of thrombocytopenic patients were treated with primary PCI (78.1 vs 84.4%, p = 0.04) and they were more frequently discharged on aspirin plus clopidogrel rather than aspirin plus newer P2Y(12) antagonists (51.9 vs 65.4%, p = 0.01). MACE-free survival was significantly shorter in thrombocytopenic patients compared to patients with normal platelets (< 150 > 100 k/microl: 37.6 vs 41.8 months, p = 0.002; HR = 2.7, 95% CIs 1.4-5.2; < 100 k/microl: 31.7 vs 41.8 months, p = 0.01; HR = 6.5, 95% CIs 1.5-29.1). At multivariate analysis, low platelet count, age at enrollment, low glomerular filtration rate, low ejection fraction, a previous ischemic stroke and NVAF were independent predictors of MACE. A low platelet count at admission identifies a subgroup of ACS patients with a significantly increased risk of MACE and these patients should be managed with special care to prevent excess adverse outcomes. CI - (c) 2024. The Author(s). FAU - Gresele, Paolo AU - Gresele P AD - Department of Medicine and Surgery, Section of Internal and Cardiovascular Medicine, University of Perugia, Strada Vicinale Via Delle Corse, S. Andrea Delle Fratte, 06132, Perugia, Italy. paolo.gresele@unipg.it. FAU - Guglielmini, Giuseppe AU - Guglielmini G AD - Department of Medicine and Surgery, Section of Internal and Cardiovascular Medicine, University of Perugia, Strada Vicinale Via Delle Corse, S. Andrea Delle Fratte, 06132, Perugia, Italy. FAU - Del Pinto, Maurizio AU - Del Pinto M AD - Division of Cardiology, Perugia Hospital, Perugia, Italy. FAU - Calabro, Paolo AU - Calabro P AD - Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy. FAU - Pignatelli, Pasquale AU - Pignatelli P AD - Department of Clinical, Internistic, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy. FAU - Patti, Giuseppe AU - Patti G AD - Department of Translational Medicine, University of Eastern Piedmont, Maggiore della Carita Hospital, Novara, Italy. FAU - Pengo, Vittorio AU - Pengo V AD - Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padua, Italy. FAU - Antonucci, Emilia AU - Antonucci E AD - Arianna Anticoagulazione Foundation, Bologna, Italy. FAU - Cirillo, Plinio AU - Cirillo P AD - Division of Cardiology, Department of Advanced Biomedical Sciences, "Federico II" University, Naples, Italy. FAU - Fierro, Tiziana AU - Fierro T AD - Department of Medicine and Surgery, Section of Internal and Cardiovascular Medicine, University of Perugia, Strada Vicinale Via Delle Corse, S. Andrea Delle Fratte, 06132, Perugia, Italy. FAU - Palareti, Gualtiero AU - Palareti G AD - Arianna Anticoagulazione Foundation, Bologna, Italy. FAU - Marcucci, Rossella AU - Marcucci R AD - Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy. CN - START Antiplatelet Registry Group LA - eng PT - Journal Article DEP - 20240624 PL - England TA - Sci Rep JT - Scientific reports JID - 101563288 RN - 0 (Platelet Aggregation Inhibitors) SB - IM MH - Humans MH - *Acute Coronary Syndrome/drug therapy/blood MH - Male MH - Female MH - Aged MH - Platelet Count MH - *Registries MH - *Platelet Aggregation Inhibitors/therapeutic use/adverse effects MH - Middle Aged MH - Aged, 80 and over MH - Treatment Outcome MH - Italy/epidemiology MH - Patient Admission PMC - PMC11196263 COIS- P. Gresele declares to be speaker, consultant, member of advisory board for Roche, Sanofi, Viatris, Werfen, STAGO, Kedrion. G. Patti declares to be speaker, consultant, member of advisory board for Amgen, Sanofi, Bayer, Bohering-Ingelheim, BMS-Pfizer, Daiichi Sanyo, Astra Zeneca, Sigma-Tau, Malesci, PIAM and MDS. R. Marcucci declares to be speaker, consultant, member of advisory board for Sanofi, Novartis, Bayer, Amgen, Werfen, Astra Zeneca, Servier. All the other authors declare no conflict of interest. FIR - Riccini, C IR - Riccini C FIR - Cesaro, A IR - Cesaro A FIR - Gragnano, F IR - Gragnano F FIR - Menichelli, D IR - Menichelli D FIR - Pastori, D IR - Pastori D FIR - Cavallari, I IR - Cavallari I FIR - Denas, G IR - Denas G FIR - Zoppellaro, G IR - Zoppellaro G FIR - Di Serafino, L IR - Di Serafino L FIR - De Rosa, G IR - De Rosa G FIR - Grossi, G IR - Grossi G FIR - Piazzai, C IR - Piazzai C EDAT- 2024/06/25 00:43 MHDA- 2024/06/25 00:44 PMCR- 2024/06/24 CRDT- 2024/06/24 23:18 PHST- 2023/12/22 00:00 [received] PHST- 2024/06/05 00:00 [accepted] PHST- 2024/06/25 00:44 [medline] PHST- 2024/06/25 00:43 [pubmed] PHST- 2024/06/24 23:18 [entrez] PHST- 2024/06/24 00:00 [pmc-release] AID - 10.1038/s41598-024-64113-5 [pii] AID - 64113 [pii] AID - 10.1038/s41598-024-64113-5 [doi] PST - epublish SO - Sci Rep. 2024 Jun 24;14(1):14516. doi: 10.1038/s41598-024-64113-5. PMID- 38879458 OWN - NLM STAT- MEDLINE DCOM- 20240618 LR - 20260712 IS - 2047-9980 (Electronic) IS - 2047-9980 (Linking) VI - 13 IP - 12 DP - 2024 Jun 18 TI - Comparison of Endovascular Therapy and Open Surgical Revascularization in Patients With Acute Superior Mesenteric Artery Occlusion: A Large-Scale Analysis Based on the JROAD-DPC Database. PG - e035017 LID - 10.1161/JAHA.124.035017 [doi] LID - e035017 AB - BACKGROUND: Acute mesenteric ischemia is rare, and few large-scale trials have evaluated endovascular therapy (EVT) and open surgical revascularization (OS). This study aimed to assess clinical outcomes after EVT or OS for acute superior mesenteric artery occlusion and identify predictors of mortality and bowel resection. METHODS AND RESULTS: Data from the Japanese Registry of All Cardiac and Vascular Diseases-Diagnosis Procedure Combination (JROAD-DPC) database from April 2012 to March 2020 were retrospectively analyzed. Overall, 746 patients with acute superior mesenteric artery occlusion who underwent revascularization were classified into 2 groups: EVT (n=475) or OS (n=271). The primary clinical outcome was in-hospital mortality. The secondary outcomes were bowel resection, bleeding complications (transfusion or endoscopic hemostasis), major adverse cardiovascular events, hospitalization duration, and cost. The in-hospital death or bowel resection rate was approximately 30%. In-hospital mortality (22.5% versus 21.4%, P=0.72), bowel resection (8.2% versus 8.5%, P=0.90), and major adverse cardiovascular events (11.6% versus 9.2%, P=0.32) were comparable between the EVT and OS groups. Hospitalization duration in the EVT group was 6 days shorter than that in the OS group, and total hospitalization cost was 0.88 million yen lower. Interaction analyses revealed that EVT and OS had no significant difference in terms of in-hospital death in patients with thromboembolic and atherothrombotic characteristics. Advanced age, decreased activities of daily living, chronic kidney disease, and old myocardial infarction were significant predictive factors for in-hospital mortality. Diabetes was a predictor of bowel resection after revascularization. CONCLUSIONS: EVT was comparable to OS in terms of clinical outcomes in patients with acute superior mesenteric artery occlusion. Some predictive factors for mortality or bowel resection were obtained. REGISTRATION: URL: www.umin.ac.jp/ctr/; Unique Identifier: UMIN000045240. FAU - Goto, Daiki AU - Goto D AD - Department of Cardiovascular Medicine, Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto Japan. FAU - Yanishi, Kenji AU - Yanishi K AUID- ORCID: 0000-0002-6158-9395 AD - Department of Cardiovascular Medicine, Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto Japan. FAU - Ozawa, Takaaki AU - Ozawa T AUID- ORCID: 0009-0003-7658-1163 AD - Department of Cardiovascular Medicine, Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto Japan. FAU - Yoshimura, Jun AU - Yoshimura J AD - Department of Cardiovascular Medicine, Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto Japan. FAU - Kawamata, Hirofumi AU - Kawamata H AUID- ORCID: 0000-0002-5404-7432 AD - Department of Cardiovascular Medicine, Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto Japan. FAU - Fujioka, Ayumu AU - Fujioka A AUID- ORCID: 0009-0006-2453-3372 AD - Department of Cardiovascular Medicine, Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto Japan. FAU - Seki, Tomotsugu AU - Seki T AUID- ORCID: 0000-0002-3387-9774 AD - Department of Cardiovascular Medicine, Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto Japan. FAU - Zen, Kan AU - Zen K AD - Department of Cardiovascular Medicine, Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto Japan. FAU - Matoba, Satoaki AU - Matoba S AUID- ORCID: 0000-0002-9373-4331 AD - Department of Cardiovascular Medicine, Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto Japan. LA - eng PT - Comparative Study PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20240615 PL - England TA - J Am Heart Assoc JT - Journal of the American Heart Association JID - 101580524 SB - IM MH - Humans MH - Male MH - Female MH - *Endovascular Procedures/adverse effects/methods MH - Aged MH - *Mesenteric Vascular Occlusion/surgery/mortality/complications MH - *Mesenteric Artery, Superior/surgery MH - *Hospital Mortality MH - Retrospective Studies MH - *Registries MH - Japan/epidemiology MH - Middle Aged MH - Treatment Outcome MH - Acute Disease MH - Databases, Factual MH - Vascular Surgical Procedures/adverse effects/methods MH - Aged, 80 and over MH - Risk Factors PMC - PMC11255773 OTO - NOTNLM OT - acute superior mesenteric artery occlusion OT - bowel resection OT - endovascular therapy OT - in-hospital mortality OT - open surgical revascularization EDAT- 2024/06/16 11:58 MHDA- 2024/06/18 17:42 PMCR- 2024/06/18 CRDT- 2024/06/15 23:02 PHST- 2024/06/18 17:42 [medline] PHST- 2024/06/16 11:58 [pubmed] PHST- 2024/06/15 23:02 [entrez] PHST- 2024/06/18 00:00 [pmc-release] AID - JAH39796 [pii] AID - 10.1161/JAHA.124.035017 [doi] PST - ppublish SO - J Am Heart Assoc. 2024 Jun 18;13(12):e035017. doi: 10.1161/JAHA.124.035017. Epub 2024 Jun 15. PMID- 38876778 OWN - NLM STAT- MEDLINE DCOM- 20250806 LR - 20250806 IS - 1708-539X (Electronic) IS - 1708-5381 (Linking) VI - 33 IP - 4 DP - 2025 Aug TI - Optimal medical therapy is lacking in patients undergoing intervention for symptomatic carotid artery stenosis and protects against larger areas of cerebral infarction. PG - 870-878 LID - 10.1177/17085381241262927 [doi] AB - ObjectivesCarotid interventions are indicated for both patients with symptomatic and a subset of patients with severe asymptomatic carotid artery stenosis (CAS). Symptomatic CAS accounts for up to 12%-25% of overall carotid interventions, but predictors of symptomatic presentation remain poorly defined. The aim of this study was to identify factors associated with symptomatic CAS in our patient population.MethodsBetween January 2015 and February 2022, an institutional retrospective cohort study of prospectively collected data on patients undergoing interventions for CAS was performed. Procedures included carotid endarterectomy (CEA), transcarotid artery revascularization (TCAR), and transfemoral carotid artery stenting (TF-CAS). Demographic data, comorbidities, procedural details, and anatomic features from various imaging modalities were collected. Comparisons were made between symptomatic (symptoms within the prior 6 months) and asymptomatic patients.ResultsDuring the study period, 279 patients who underwent intervention for symptomatic CAS were paired with a randomly selected cohort of 300 patients who underwent intervention for asymptomatic CAS from a total patient cohort of 1143 patients undergoing interventions for asymptomatic CAS. Demographic data did not differ between groups. Patients with symptomatic CAS more frequently had prior TIA/stroke (>6 months remote to the current event), but less frequently had coronary artery disease or chronic kidney disease and were less likely to receive adequate medical management including antihypertensive agents, lipid-lowering agents, and anti-platelet therapy. On multivariate analysis, remote prior TIA/stroke and lack of anti-platelet therapy remained significant. Among symptomatic patients presenting with stroke, lack of anti-platelet therapy was associated with an overall larger area of parenchymal involvement. No difference was observed with single versus dual anti-platelet therapy. Furthermore, symptomatic patients were more likely to have ulcerated plaques (30.9% vs 18%, p < .001), and symptomatic patients with ulcerated plaques more frequently had less than 50% compared to moderate/severe CAS. Nine patients who presented with symptoms had mild CAS and underwent intervention.ConclusionsSymptomatic CAS was associated with a history of remote prior symptoms and lack of anti-platelet therapy at time of presentation. Furthermore, symptomatic patients not on anti-platelet agents were more likely to have a greater area of parenchymal involvement when presenting with stroke and symptomatic patients with ulcerated plaques were more likely to have mild CAS, suggesting the role of plaque instability in symptomatic presentation. These findings underscore the importance of appropriate medical management and adherence in all patients with CAS and perhaps a role for more frequent surveillance in those with potentially unstable plaque morphology. FAU - Teter, Katherine AU - Teter K AUID- ORCID: 0000-0002-8807-1553 AD - NYU Langone Health, New York, NY, USA. RINGGOLD: 12297 FAU - Willems, Loes AU - Willems L AD - Radbound University Medical Center, Nijmegen, The Netherlands. RINGGOLD: 6034 FAU - Harish, Keerthi AU - Harish K AD - NYU Langone Health, New York, NY, USA. RINGGOLD: 12297 FAU - Negash, Bruck AU - Negash B AD - NYU Langone Health, New York, NY, USA. RINGGOLD: 12297 FAU - Warle, Michiel AU - Warle M AD - Radbound University Medical Center, Nijmegen, The Netherlands. RINGGOLD: 6034 FAU - Rockman, Caron AU - Rockman C AD - NYU Langone Health, New York, NY, USA. RINGGOLD: 12297 FAU - Torres, Jose AU - Torres J AD - NYU Langone Health, New York, NY, USA. RINGGOLD: 12297 FAU - Ishida, Koto AU - Ishida K AD - NYU Langone Health, New York, NY, USA. RINGGOLD: 12297 FAU - Jacobowitz, Glenn AU - Jacobowitz G AD - NYU Langone Health, New York, NY, USA. RINGGOLD: 12297 FAU - Garg, Karan AU - Garg K AUID- ORCID: 0000-0002-6535-864X AD - NYU Langone Health, New York, NY, USA. RINGGOLD: 12297 FAU - Maldonado, Thomas AU - Maldonado T AD - NYU Langone Health, New York, NY, USA. RINGGOLD: 12297 LA - eng PT - Comparative Study PT - Journal Article DEP - 20240614 PL - England TA - Vascular JT - Vascular JID - 101196722 RN - 0 (Cardiovascular Agents) RN - 0 (Platelet Aggregation Inhibitors) SB - IM MH - Humans MH - *Carotid Stenosis/therapy/diagnostic imaging/complications MH - Male MH - Female MH - Retrospective Studies MH - Aged MH - Risk Factors MH - Treatment Outcome MH - *Endovascular Procedures/adverse effects/instrumentation MH - Middle Aged MH - Time Factors MH - Stents MH - Risk Assessment MH - *Endarterectomy, Carotid/adverse effects MH - *Cerebral Infarction/prevention & control/etiology/diagnostic imaging MH - Aged, 80 and over MH - Asymptomatic Diseases MH - *Cardiovascular Agents/therapeutic use/adverse effects MH - *Platelet Aggregation Inhibitors/therapeutic use MH - Protective Factors OTO - NOTNLM OT - Carotid artery stenosis OT - anti-platelet therapy OT - extracranial atherosclerotic disease COIS- Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. EDAT- 2024/06/15 10:44 MHDA- 2025/08/06 06:28 CRDT- 2024/06/14 21:13 PHST- 2025/08/06 06:28 [medline] PHST- 2024/06/15 10:44 [pubmed] PHST- 2024/06/14 21:13 [entrez] AID - 10.1177/17085381241262927 [doi] PST - ppublish SO - Vascular. 2025 Aug;33(4):870-878. doi: 10.1177/17085381241262927. Epub 2024 Jun 14. PMID- 38740165 OWN - NLM STAT- MEDLINE DCOM- 20240630 LR - 20260424 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 223 DP - 2024 Jul 15 TI - Optimal Intravascular Ultrasound-Guided Percutaneous Coronary Intervention in Patients With Multivessel Disease and Diabetes. PG - 18-28 LID - S0002-9149(24)00335-7 [pii] LID - 10.1016/j.amjcard.2024.04.054 [doi] AB - There is a scarcity of data on clinical outcomes after intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) in patients with multivessel disease and diabetes. The Optimal Intravascular Ultrasound Guided Complex Percutaneous Coronary Intervention study multivessel cohort was a prospective, multicenter, single-arm trial enrolling 1,021 patients who underwent multivessel PCI, including left anterior descending coronary artery using IVUS, aiming to meet the prespecified OPTIVUS criteria for optimal stent expansion. We compared the clinical outcomes between those patients with and without diabetes. The primary end point was a composite of death, myocardial infarction, stroke, or any coronary revascularization. There were 560 patients (54.8%) with diabetes and 461 patients (45.2%) without diabetes. The mean age was not different between the 2 groups (70.9 +/- 9.7 vs 71.7 +/- 10.4 years, p = 0.17). Patients with diabetes more often had chronic kidney disease and complex coronary artery disease, as indicated by the greater total number of stents and longer total stent length. The rate of meeting the OPTIVUS criteria was not different between the 2 groups (61.2% vs 60.7%, p = 0.83). The cumulative 1-year incidence of the primary end point was not different between the 2 groups (10.8% vs 9.8%, log-rank p = 0.65). After adjusting for confounders, the risk of diabetes relative to nondiabetes remained insignificant for the primary end point (hazard ratio 0.97, 95% confidence interval 0.65 to 1.44, p = 0.88). In conclusion, in patients who underwent multivessel IVUS-guided PCI and were managed with contemporary clinical practice, patients with diabetes had similar 1-year outcomes to patients without diabetes. CI - Copyright (c) 2024 Elsevier Inc. All rights reserved. FAU - Yamamoto, Ko AU - Yamamoto K AD - Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan. FAU - Shiomi, Hiroki AU - Shiomi H AD - Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan. FAU - Morimoto, Takeshi AU - Morimoto T AD - Department of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya, Japan. FAU - Miyazawa, Akiyoshi AU - Miyazawa A AD - Cardiocore Japan, Tokyo, Japan. FAU - Nakamura, Sunao AU - Nakamura S AD - Department of Cardiovascular Medicine, New Tokyo Hospital, Matsudo, Japan. FAU - Suwa, Satoru AU - Suwa S AD - Department of Cardiology, Juntendo University Shizuoka Hospital, Izunokuni, Japan. FAU - Fujita, Takanari AU - Fujita T AD - Department of Cardiology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan. FAU - Kurita, Tairo AU - Kurita T AD - Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Japan. FAU - Sugawara, Shigeo AU - Sugawara S AD - Department of Cardiology, Nihonkai General Hospital, Yamagata Japan. FAU - Fujii, Kenji AU - Fujii K AD - Department of Cardiology, Sakurabashi Watanabe Hospital, Osaka, Japan. FAU - Suematsu, Nobuhiro AU - Suematsu N AD - Division of Cardiology, Saiseikai Fukuoka General Hospital, Fukuoka, Japan. FAU - Isawa, Tsuyoshi AU - Isawa T AD - Department of Cardiology, Sendai Kousei Hospital, Sendai, Japan. FAU - Matsuo, Hitoshi AU - Matsuo H AD - Division of Cardiology, Gifu Heart Center, Gifu, Japan. FAU - Tanaka, Hiroyuki AU - Tanaka H AD - Department of Cariology, Tokyo Metropolitan Tama Medical Center, Japan. FAU - Shirota, Kinya AU - Shirota K AD - Division of Cardiology, Matsue Red Cross Hospital, Matsue, Japan. FAU - Hibi, Kiyoshi AU - Hibi K AD - Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan. FAU - Kadota, Kazushige AU - Kadota K AD - Department of Cardiology, Kurashiki Central Hospital, Kurashiki, Japan. FAU - Ando, Kenji AU - Ando K AD - Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan. FAU - Ono, Koh AU - Ono K AD - Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan. FAU - Kimura, Takeshi AU - Kimura T AD - Department of Cardiology, Hirakata Kohsai Hospital, Hirakata, Japan. Electronic address: taketaka@kuhp.kyoto-u.ac.jp. CN - OPTIVUS-Complex PCI investigators LA - eng PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't DEP - 20240511 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM CIN - Am J Cardiol. 2024 Aug 15;225:1-3. doi: 10.1016/j.amjcard.2024.05.024. PMID: 38788823 MH - Humans MH - *Ultrasonography, Interventional/methods MH - *Percutaneous Coronary Intervention/methods MH - Male MH - Female MH - Aged MH - *Coronary Artery Disease/surgery MH - Prospective Studies MH - Coronary Angiography/methods MH - Treatment Outcome MH - Middle Aged MH - Diabetes Mellitus/epidemiology MH - Surgery, Computer-Assisted/methods MH - Stents MH - Coronary Vessels/diagnostic imaging/surgery MH - Follow-Up Studies OTO - NOTNLM OT - diabetes OT - drug-eluting stent OT - intravascular ultrasound OT - percutaneous coronary intervention COIS- Declaration of competing interest Dr. Morimoto receives lecturer fees from AstraZeneca, Bristol-Myers Squibb, Daiichi Sankyo, Japan Lifeline, Kowa, Pfizer (New York, New York), and Tsumura; receives manuscript fees from Bristol-Myers Squibb and Pfizer; is part of the advisory board for Novartis and Teijin. Dr. Matsuo receives lecturer fees from Abbott Medical, Boston Scientific, Philips, Zeon Medical, Kaneka, and Amgen. Dr. Kimura receives research grant from Abbott Medical, and Boston Scientific; receives honoraria from Abbott Medical, Boston Scientific, Daiichi Sankyo, Sanofi, and Terumo; is on the advisory board of Abbott Medical, Boston Scientific, and Sanofi. The remaining authors have no competing interests to declare. EDAT- 2024/05/14 00:43 MHDA- 2024/07/01 00:42 CRDT- 2024/05/13 19:22 PHST- 2024/03/17 00:00 [received] PHST- 2024/04/14 00:00 [revised] PHST- 2024/04/27 00:00 [accepted] PHST- 2024/07/01 00:42 [medline] PHST- 2024/05/14 00:43 [pubmed] PHST- 2024/05/13 19:22 [entrez] AID - S0002-9149(24)00335-7 [pii] AID - 10.1016/j.amjcard.2024.04.054 [doi] PST - ppublish SO - Am J Cardiol. 2024 Jul 15;223:18-28. doi: 10.1016/j.amjcard.2024.04.054. Epub 2024 May 11. PMID- 38708609 OWN - NLM STAT- MEDLINE DCOM- 20240716 LR - 20260527 IS - 1941-7632 (Electronic) IS - 1941-7640 (Print) IS - 1941-7640 (Linking) VI - 17 IP - 7 DP - 2024 Jul TI - Angiographic Characteristics and Clinical Outcomes in Patients With Chronic Kidney Disease Undergoing Impella-Supported High-Risk Percutaneous Coronary Intervention: Insights From the cVAD PROTECT III Study. PG - e013503 LID - 10.1161/CIRCINTERVENTIONS.123.013503 [doi] AB - BACKGROUND: Prior studies have found that patients with chronic kidney disease (CKD) have worse outcomes following percutaneous coronary intervention (PCI). There are no data about patients with advanced CKD undergoing Impella-supported high-risk PCI. We, therefore, aimed to evaluate angiographic characteristics and clinical outcomes in patients with CKD who received Impella-supported high-risk PCI as part of the catheter-based ventricular assist device PROTECT III study (A Prospective, Multi-Center, Randomized Controlled Trial of the IMPELLA RECOVER LP 2.5 System Versus Intra Aortic Balloon Pump [IABP] in Patients Undergoing Non Emergent High Risk PCI). METHODS: Patients enrolled in the PROTECT III study were analyzed according to their baseline estimated glomerular filtration rate (eGFR). The primary outcome was 90-day major adverse cardiovascular and cerebrovascular events (the composite of all-cause death, myocardial infarction, stroke/transient ischemic attack, and repeat revascularization). RESULTS: Of 1237 enrolled patients, 1052 patients with complete eGFR baseline assessment were evaluated: 586 with eGFR >/=60 mL/min per 1.73 m(2), 190 with eGFR >/=45 to <60, 105 with eGFR >/=30 to <45, and 171 with eGFR <30 or on dialysis. Patients with lower eGFR (all groups with eGFR <60) were more frequently females and had a higher prevalence of hypertension, diabetes, anemia, and peripheral artery disease. The baseline Synergy Between PCI With Taxus and Cardiac Surgery score was similar between groups (28.2+/-12.6 for all groups). Patients with lower eGFR were more likely to have severe coronary calcifications and higher usage of atherectomy. There were no differences in individual PCI-related coronary complications between groups, but the rates of overall PCI complications were less frequent among patients with lower eGFR. Major adverse cardiovascular and cerebrovascular events at 90 days and 1-year mortality were significantly higher among patients with eGFR <30 mL/min per 1.73 m(2) or on dialysis. CONCLUSIONS: Patients with advanced CKD undergoing Impella-assisted high-risk PCI tend to have higher baseline comorbidities, severe coronary calcification, and higher atherectomy usage, yet CKD was not associated with a higher rate of immediate PCI-related complications. However, 90-day major adverse cardiovascular and cerebrovascular events and 1-year mortality were significantly higher among patients with eGFR<30 mL/min per 1.73 m(2) or on dialysis. Future studies of strategies to improve intermediate and long-term outcomes of these high-risk patients are warranted. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT04136392. FAU - Bharadwaj, Aditya S AU - Bharadwaj AS AUID- ORCID: 0000-0002-3911-0579 AD - Division of Cardiology, Loma Linda University Medical Center, CA (A.S.B.). FAU - Abu-Much, Arsalan AU - Abu-Much A AUID- ORCID: 0000-0002-0626-6649 AD - Clinical Trials Center, Cardiovascular Research Foundation, New York, NY (A.A.-M., A.S.M., Z.Z., Y.L., B.R.). FAU - Maini, Aneel S AU - Maini AS AD - Clinical Trials Center, Cardiovascular Research Foundation, New York, NY (A.A.-M., A.S.M., Z.Z., Y.L., B.R.). FAU - Zhou, Zhipeng AU - Zhou Z AD - Clinical Trials Center, Cardiovascular Research Foundation, New York, NY (A.A.-M., A.S.M., Z.Z., Y.L., B.R.). FAU - Li, Yanru AU - Li Y AUID- ORCID: 0000-0001-8440-9337 AD - Clinical Trials Center, Cardiovascular Research Foundation, New York, NY (A.A.-M., A.S.M., Z.Z., Y.L., B.R.). FAU - Batchelor, Wayne B AU - Batchelor WB AD - Inova Center of Outcomes Research, Inova Heart and Vascular Institute, Falls Church, VA (W.B.B.). FAU - Grines, Cindy L AU - Grines CL AUID- ORCID: 0000-0003-1653-6443 AD - Department of Cardiology, Northside Hospital Cardiovascular Institute, Atlanta, GA (C.L.G.). FAU - Baron, Suzanne J AU - Baron SJ AUID- ORCID: 0000-0002-8319-5637 AD - Massachusetts General Hospital, Boston (S.J.B.). AD - Baim Institute for Clinical Research, Boston, MA (S.J.B.). FAU - Redfors, Bjorn AU - Redfors B AUID- ORCID: 0000-0002-4155-4451 AD - Clinical Trials Center, Cardiovascular Research Foundation, New York, NY (A.A.-M., A.S.M., Z.Z., Y.L., B.R.). AD - Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden (B.R.). FAU - Lansky, Alexandra J AU - Lansky AJ AUID- ORCID: 0000-0001-8002-7497 AD - Yale University School of Medicine, New Haven, CT (A.J.L.). AD - Barts Heart Centre, Queen Mary University of London, United Kingdom (A.J.L.). FAU - Basir, Mir B AU - Basir MB AUID- ORCID: 0000-0003-3486-6753 AD - Division of Cardiology, Center for Structural Heart Disease, Henry Ford Health System, Detroit, MI (M.B.B., W.W.O.). FAU - O'Neill, William W AU - O'Neill WW AUID- ORCID: 0009-0000-5896-728X AD - Division of Cardiology, Center for Structural Heart Disease, Henry Ford Health System, Detroit, MI (M.B.B., W.W.O.). LA - eng SI - ClinicalTrials.gov/NCT04136392 GR - UL1 TR001863/TR/NCATS NIH HHS/United States PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20240506 PL - United States TA - Circ Cardiovasc Interv JT - Circulation. Cardiovascular interventions JID - 101499602 SB - IM MH - Humans MH - *Percutaneous Coronary Intervention/adverse effects/mortality MH - Male MH - Female MH - Aged MH - *Heart-Assist Devices MH - *Renal Insufficiency, Chronic/mortality/physiopathology/diagnosis/therapy MH - Prospective Studies MH - Treatment Outcome MH - Middle Aged MH - Risk Factors MH - *Glomerular Filtration Rate MH - *Coronary Artery Disease/mortality/diagnostic imaging/therapy/physiopathology MH - Risk Assessment MH - Time Factors MH - *Coronary Angiography MH - Predictive Value of Tests MH - Intra-Aortic Balloon Pumping/adverse effects/mortality MH - Kidney/physiopathology MH - United States MH - Prosthesis Design PMC - PMC11239095 OTO - NOTNLM OT - coronary artery disease OT - glomerular filtration rate OT - hypertension OT - percutaneous coronary intervention OT - renal insufficiency, chronic COIS- Dr Bharadwaj reports consulting and speaker fees from Abiomed, Shockwave Medical, and Cardiovascular Systems, Inc. Dr Batchelor reports consulting for Abbott, Medtronic, and Boston Scientific. Dr Grines reports participation on the advisory boards for Philips and Abiomed. Dr Baron reports receiving institutional research support from Boston Scientific Corporation, Acarix, and Abiomed; speaker fees from Medtronic, Edwards Lifesciences, Shockwave, and Zoll Medical; and consulting fees/advisory board membership from Medtronic, Boston Scientific Corporation, Zoll Medical, and Abiomed. Dr Redfors reports consultant fees from Pfizer and Boehringer Ingelheim. Dr Lansky received speaker fees from Abiomed. M.B. Basir has been a consultant/speaker for Abiomed, Boston Scientific, Chiesi, Saranas, and Zoll. Dr O'Neill reports grant/research support from St. Jude Medical, Edwards Life Sciences, and Biomed; consulting fees/honoraria from Medtronic and Abiomed; and major stock shareholder/equity in Synecor, Accumed, Neovasc, Tendyne, and Mitral Align. The other authors report no conflicts. EDAT- 2024/05/06 06:44 MHDA- 2024/07/16 18:42 PMCR- 2024/07/11 CRDT- 2024/05/06 05:06 PHST- 2024/07/16 18:42 [medline] PHST- 2024/05/06 06:44 [pubmed] PHST- 2024/05/06 05:06 [entrez] PHST- 2024/07/11 00:00 [pmc-release] AID - CIRCCVINT2023013503-T [pii] AID - 10.1161/CIRCINTERVENTIONS.123.013503 [doi] PST - ppublish SO - Circ Cardiovasc Interv. 2024 Jul;17(7):e013503. doi: 10.1161/CIRCINTERVENTIONS.123.013503. Epub 2024 May 6. PMID- 38649992 OWN - NLM STAT- MEDLINE DCOM- 20240425 LR - 20241115 IS - 1741-7015 (Electronic) IS - 1741-7015 (Linking) VI - 22 IP - 1 DP - 2024 Apr 23 TI - Impact of perioperative low-molecular-weight heparin therapy on clinical events of elderly patients with prior coronary stents implanted > 12 months undergoing non-cardiac surgery: a randomized, placebo-controlled trial. PG - 171 LID - 10.1186/s12916-024-03391-2 [doi] LID - 171 AB - BACKGROUND: Little is known about the safety and efficacy of discontinuing antiplatelet therapy via LMWH bridging therapy in elderly patients with coronary stents implanted for > 12 months undergoing non-cardiac surgery. This randomized trial was designed to compare the clinical benefits and risks of antiplatelet drug discontinuation via LMWH bridging therapy. METHODS: Patients were randomized 1:1 to receive subcutaneous injections of either dalteparin sodium or placebo. The primary efficacy endpoint was cardiac or cerebrovascular events. The primary safety endpoint was major bleeding. RESULTS: Among 2476 randomized patients, the variables (sex, age, body mass index, comorbidities, medications, and procedural characteristics) and percutaneous coronary intervention information were not significantly different between the bridging and non-bridging groups. During the follow-up period, the rate of the combined endpoint in the bridging group was significantly lower than in the non-bridging group (5.79% vs. 8.42%, p = 0.012). The incidence of myocardial injury in the bridging group was significantly lower than in the non-bridging group (3.14% vs. 5.19%, p = 0.011). Deep vein thrombosis occurred more frequently in the non-bridging group (1.21% vs. 0.4%, p = 0.024), and there was a trend toward a higher rate of pulmonary embolism (0.32% vs. 0.08%, p = 0.177). There was no significant difference between the groups in the rates of acute myocardial infarction (0.81% vs. 1.38%), cardiac death (0.24% vs. 0.41%), stroke (0.16% vs. 0.24%), or major bleeding (1.22% vs. 1.45%). Multivariable analysis showed that LMWH bridging, creatinine clearance < 30 mL/min, preoperative hemoglobin < 10 g/dL, and diabetes mellitus were independent predictors of ischemic events. LMWH bridging and a preoperative platelet count of < 70 x 10(9)/L were independent predictors of minor bleeding events. CONCLUSIONS: This study showed the safety and efficacy of perioperative LMWH bridging therapy in elderly patients with coronary stents implanted > 12 months undergoing non-cardiac surgery. An alternative approach might be the use of bridging therapy with half-dose LMWH. TRIAL REGISTRATION: ISRCTN65203415. CI - (c) 2024. The Author(s). FAU - Wang, Bin AU - Wang B AD - Department of Comprehensive Surgery, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100853, China. FAU - Su, Yanhui AU - Su Y AD - Department of Comprehensive Surgery, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100853, China. FAU - Ma, Cong AU - Ma C AD - Health Management Institute, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China. FAU - Xu, Lining AU - Xu L AD - Department of Comprehensive Surgery, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100853, China. FAU - Mao, Qunxia AU - Mao Q AD - National Research Institute for Family Planning, Beijing, China. FAU - Cheng, Wenjia AU - Cheng W AD - Department of Comprehensive Surgery, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100853, China. FAU - Lu, Qingming AU - Lu Q AD - Department of Comprehensive Surgery, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100853, China. FAU - Zhang, Ying AU - Zhang Y AD - Department of Comprehensive Surgery, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100853, China. FAU - Wang, Rong AU - Wang R AD - Department of Comprehensive Surgery, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100853, China. FAU - Lu, Yan AU - Lu Y AD - Department of Comprehensive Surgery, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100853, China. FAU - He, Jing AU - He J AD - Department of Comprehensive Surgery, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100853, China. FAU - Chen, Shihao AU - Chen S AD - Department of Comprehensive Surgery, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100853, China. FAU - Chen, Lei AU - Chen L AD - Department of Thoracic Surgery of The First Medical Center, General Hospital of Chinese People's Liberation Army, Beijing, 100853, China. chenleighcpl@163.com. FAU - Li, Tianzhi AU - Li T AD - Department of Comprehensive Surgery, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100853, China. litianzhi301@sina.com. FAU - Gao, Linggen AU - Gao L AD - Department of Comprehensive Surgery, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100853, China. gaolinggen@163.com. LA - eng SI - ISRCTN/ISRCTN65203415 GR - NCRCG-PLAGH-2023003/IP/NCIRD CDC HHS/United States PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20240423 PL - England TA - BMC Med JT - BMC medicine JID - 101190723 RN - 0 (Anticoagulants) RN - 0 (Platelet Aggregation Inhibitors) RN - 0 (Heparin, Low-Molecular-Weight) RN - S79O08V79F (Dalteparin) RN - 0 (Placebos) SB - IM MH - Humans MH - Male MH - Female MH - Aged MH - *Stents MH - Aged, 80 and over MH - Anticoagulants/administration & dosage/adverse effects/therapeutic use MH - Platelet Aggregation Inhibitors/administration & dosage/therapeutic use/adverse effects MH - Heparin, Low-Molecular-Weight/administration & dosage/therapeutic use/adverse effects MH - Dalteparin/administration & dosage/therapeutic use/adverse effects MH - Treatment Outcome MH - Surgical Procedures, Operative/adverse effects MH - Hemorrhage/chemically induced MH - Placebos/administration & dosage MH - Perioperative Care/methods PMC - PMC11036782 OTO - NOTNLM OT - Bridging therapy OT - Clinical event OT - Low-molecular-weight heparin OT - Percutaneous coronary intervention OT - Perioperative COIS- The authors declare that they have no competing interests. EDAT- 2024/04/23 15:04 MHDA- 2024/04/25 06:49 PMCR- 2024/04/23 CRDT- 2024/04/22 23:54 PHST- 2023/12/12 00:00 [received] PHST- 2024/04/15 00:00 [accepted] PHST- 2024/04/25 06:49 [medline] PHST- 2024/04/23 15:04 [pubmed] PHST- 2024/04/22 23:54 [entrez] PHST- 2024/04/23 00:00 [pmc-release] AID - 10.1186/s12916-024-03391-2 [pii] AID - 3391 [pii] AID - 10.1186/s12916-024-03391-2 [doi] PST - epublish SO - BMC Med. 2024 Apr 23;22(1):171. doi: 10.1186/s12916-024-03391-2. PMID- 38635062 OWN - NLM STAT- MEDLINE DCOM- 20240721 LR - 20261010 IS - 1615-2573 (Electronic) IS - 0910-8327 (Linking) VI - 39 IP - 8 DP - 2024 Aug TI - Efficacy of early administration of sacubitril/valsartan after coronary artery revascularization in patients with acute myocardial infarction complicated by moderate-to-severe mitral regurgitation: a randomized controlled trial. PG - 673-686 LID - 10.1007/s00380-024-02398-2 [doi] AB - Effects of angiotensin receptor/neprilysin inhibitors (ARNI) on ventricular remodeling in patients with heart failure, especially heart failure with reduced ejection fraction (HFrEF), are better than those of angiotensin-converting enzyme inhibitors (ACEI). Acute myocardial infarction (AMI) complicated by mitral regurgitation exacerbates ventricular remodeling and increases the risk of heart failure. There is limited evidence on the effects of early administration of ARNI in patients with AMI complicated by mitral regurgitation. The aim of this trial was to examine the effectiveness and the safety of early administration of sacubitril/valsartan after coronary artery revascularization in patients with AMI complicated by moderate-to-severe mitral regurgitation. This was a randomized, single-blind, parallel-group, controlled trial. From June 2021 to June 2022, we enrolled 142 consecutive patients with AMI complicated by moderate-to-severe mitral regurgitation and followed them for 12 months. The patients received standard treatment for AMI and were randomly assigned to receive ARNI or benazepril. The primary efficacy end points were the differences in mitral regurgitant jet area (MRJA), mitral regurgitant volume (MRV), concentration of n-terminal pro-brain natriuretic peptide (NT-proBNP), left ventricular ejection fraction (LVEF), and left ventricular end-diastolic volume and end-systolic volume (LVEDV and LVESV) between groups and within groups at baseline, 1, 3, 6, and 12 months. Secondary end points included the rates of heart failure hospitalization, all-cause mortality, refractory angina, malignant arrhythmias, recurrent myocardial infarction, and stroke. Safety end points included the rates of hyperkalemia, renal dysfunction, hypotension, angioedema, and cough. The ARNI group had significantly lower NT-proBNP levels than the benazepril group at 1 month and later (P < 0.001). MRJA and MRV significantly improved in the ARNI group compared with the benazepril group at 12 months (MRJA: - 3.21 +/- 2.18 cm(2) vs. - 1.83 +/- 2.81 cm(2), P < 0.05; MRV: - 27.22 +/- 15.22 mL vs. - 13.67 +/- 21.02 mL, P < 0.001). The ARNI group also showed significant reductions in LVEDV and LVESV (P < 0.05) and improvement in LVEF (P < 0.05). Secondary end point analysis showed a significantly higher rate of heart failure hospitalization in the benazepril group compared with the ARNI group (HR = 2.03, 95% CI 1.12-3.68, P = 0.021). Safety end point analysis showed a higher rate of hypotension in the ARNI group (P < 0.05). Early use of sacubitril/valsartan after coronary artery revascularization in patients with AMI complicated by moderate-to-severe mitral regurgitation can significantly reduce mitral regurgitation, improve ventricular remodeling, and decrease heart failure hospitalization. Nevertheless, caution is needed to avoid hypotension. Chinese Clinical Trial Registry (ChiCTR2100054255) registered on December 11, 2021. CI - (c) 2024. Springer Nature Japan KK, part of Springer Nature. FAU - Yin, Hongtao AU - Yin H AD - Tianjin Medical University, Tianjin, 300000, People's Republic of China. AD - Department of Cardiology, The First Hospital of Qinhuangdao, Qinhuangdao, Hebei, 066000, People's Republic of China. FAU - Ma, Lixiang AU - Ma L AD - Department of Cardiology, The First Hospital of Qinhuangdao, Qinhuangdao, Hebei, 066000, People's Republic of China. FAU - Zhou, Yanqing AU - Zhou Y AD - The First Hospital of Qinhuangdao, Qinhuangdao, Hebei, 066000, People's Republic of China. FAU - Tang, Xiuying AU - Tang X AD - Department of Cardiology, The First Hospital of Qinhuangdao, Qinhuangdao, Hebei, 066000, People's Republic of China. FAU - Li, Runjun AU - Li R AD - Department of Critical Care Medicine, People's Hospital of Yangjiang, Yangjiang, Guangdong, 529500, People's Republic of China. FAU - Zhou, Yingjun AU - Zhou Y AD - Department of Cardiology, The First Hospital of Qinhuangdao, Qinhuangdao, Hebei, 066000, People's Republic of China. FAU - Shi, Jiaxiu AU - Shi J AD - The First Hospital of Qinhuangdao, Qinhuangdao, Hebei, 066000, People's Republic of China. FAU - Zhang, Jun AU - Zhang J AD - Tianjin Medical University, Tianjin, 300000, People's Republic of China. dr_zhangj@sina.com. AD - Depatment of Cardiology, Cangzhou Central Hospital, Tianjin Medical University Teaching Hospital, Cangzhou, Hebei, 061000, People's Republic of China. dr_zhangj@sina.com. LA - eng GR - 20231885/Hebei Medical Science Research Project Plan/ PT - Journal Article PT - Randomized Controlled Trial DEP - 20240418 PL - Japan TA - Heart Vessels JT - Heart and vessels JID - 8511258 RN - 80M03YXJ7I (Valsartan) RN - WB8FT61183 (sacubitril and valsartan sodium hydrate drug combination) RN - 0 (Aminobutyrates) RN - 0 (Drug Combinations) RN - 0 (Biphenyl Compounds) RN - 0 (Angiotensin Receptor Antagonists) SB - IM MH - Humans MH - *Valsartan/administration & dosage/adverse effects MH - Male MH - Female MH - *Aminobutyrates/administration & dosage/adverse effects/therapeutic use MH - *Drug Combinations MH - *Mitral Valve Insufficiency/physiopathology/diagnosis/complications/surgery MH - Middle Aged MH - *Biphenyl Compounds MH - Treatment Outcome MH - *Myocardial Infarction/complications MH - Single-Blind Method MH - Aged MH - *Percutaneous Coronary Intervention/methods MH - Angiotensin Receptor Antagonists/administration & dosage/therapeutic use MH - Stroke Volume/physiology MH - Ventricular Remodeling/drug effects/physiology MH - Ventricular Function, Left/physiology/drug effects MH - Severity of Illness Index MH - Time Factors OTO - NOTNLM OT - Acute myocardial infarction OT - Angiotensin receptor/neprilysin inhibitors OT - Mitral regurgitation OT - Sacubitril/valsartan OT - Ventricular remodeling EDAT- 2024/04/18 12:43 MHDA- 2024/07/22 00:42 CRDT- 2024/04/18 11:14 PHST- 2023/10/22 00:00 [received] PHST- 2024/03/13 00:00 [accepted] PHST- 2024/07/22 00:42 [medline] PHST- 2024/04/18 12:43 [pubmed] PHST- 2024/04/18 11:14 [entrez] AID - 10.1007/s00380-024-02398-2 [pii] AID - 10.1007/s00380-024-02398-2 [doi] PST - ppublish SO - Heart Vessels. 2024 Aug;39(8):673-686. doi: 10.1007/s00380-024-02398-2. Epub 2024 Apr 18. PMID- 38586173 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240409 IS - 2297-055X (Print) IS - 2297-055X (Electronic) IS - 2297-055X (Linking) VI - 11 DP - 2024 TI - Sex-based outcomes on unguided de-escalation from ticagrelor to clopidogrel in stabilized patients with acute myocardial infarction undergoing percutaneous coronary intervention: a post-hoc analysis of the TALOS-AMI. PG - 1358657 LID - 10.3389/fcvm.2024.1358657 [doi] LID - 1358657 AB - BACKGROUND: The TALOS-AMI study highlighted the effectiveness of a de-escalation strategy shifting from ticagrelor to clopidogrel 1 month after percutaneous coronary intervention (PCI), resulting in significant reduction in clinical events, primarily attributed to a substantial decrease in bleeding events. Nevertheless, the impact of this strategy on outcomes based on sex remains unclear. METHODS: This was a post-hoc analysis of the TALOS-AMI study. At 1 month after PCI, patients who remained adherent to aspirin and ticagrelor without experiencing major adverse events were randomized into either the de-escalation group (clopidogrel plus aspirin) or the active control group (ticagrelor plus aspirin) for an additional 12 months. The primary endpoint encompassed a composite of cardiovascular death, myocardial infarction, stroke, and Bleeding Academic Research Consortium bleeding type 2 or greater at 12 months after randomization. RESULTS: Among the 2,697 patients included in this study, 454 (16.8%) were women. Women, characterized by older age and a higher prevalence of hypertension, diabetes, impaired renal function, and non-ST-segment myocardial infarction, exhibited a lower primary endpoint at 12 months compared to men [adjusted hazards ratio (HR), 0.60; 95% confidence interval (CI), 0.37-0.95; P = 0.03]. Compare to the active control group, the de-escalation group demonstrated a reduced risk of the primary endpoint in both women (adjusted HR, 0.38; 95% CI, 0.15-0.95; P = 0.039) and men (adjusted HR, 0.56; 95% CI, 0.40-0.79; P = 0.001) (interaction P = 0.46). CONCLUSIONS: In stabilized patients post-PCI with drug-eluting stents for acute myocardial infarction, the primary endpoint was lower among women compared to men. In this cohort, the benefits of an unguided de-escalation strategy from ticagrelor to clopidogrel were comparable in women and men. CI - (c) 2024 Shin, Jun, Kim, Kim, Park, Choo, Hwang, Lee, Oh, Kim, Yim, Ahn and Chang. FAU - Shin, Eun-Seok AU - Shin ES AD - Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea. FAU - Jun, Eun Jung AU - Jun EJ AD - Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea. FAU - Kim, Bitna AU - Kim B AD - Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea. FAU - Kim, Chan Joon AU - Kim CJ AD - Division of Cardiology, Department of Internal Medicine, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Republic of Korea. FAU - Park, Mahn-Won AU - Park MW AD - Division of Cardiology, Department of Internal Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon, Republic of Korea. FAU - Choo, Eun-Ho AU - Choo EH AD - Department of Internal Medicine, Division of Cardiology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea. FAU - Hwang, Byung-Hee AU - Hwang BH AD - Department of Internal Medicine, Division of Cardiology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea. FAU - Lee, Kwan Yong AU - Lee KY AD - Department of Internal Medicine, Division of Cardiology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea. FAU - Oh, Gyu-Chul AU - Oh GC AD - Department of Internal Medicine, Division of Cardiology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea. FAU - Kim, Min Chul AU - Kim MC AD - Department of Cardiology, Chonnam National University Hospital, Chonnam National University Medical School, Chonnam, Republic of Korea. FAU - Yim, Hyeon Woo AU - Yim HW AD - Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. FAU - Ahn, Youngkeun AU - Ahn Y AD - Department of Cardiology, Chonnam National University Hospital, Chonnam National University Medical School, Chonnam, Republic of Korea. FAU - Chang, Kiyuk AU - Chang K AD - Department of Internal Medicine, Division of Cardiology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea. LA - eng PT - Journal Article DEP - 20240321 PL - Switzerland TA - Front Cardiovasc Med JT - Frontiers in cardiovascular medicine JID - 101653388 PMC - PMC10996367 OTO - NOTNLM OT - acute myocardial infarction OT - clopidogrel OT - drug-eluting stent OT - percutaneous coronary intervention OT - sex OT - ticagrelor COIS- KC has received research grants from ChongKunDang Pharm, Medtronic, Abbott, and Boston Scientific. CK has received research grants and speaker's fees from ChongKunDang Pharm. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2024/04/08 06:43 MHDA- 2024/04/08 06:44 PMCR- 2024/01/01 CRDT- 2024/04/08 04:41 PHST- 2023/12/20 00:00 [received] PHST- 2024/02/27 00:00 [accepted] PHST- 2024/04/08 06:44 [medline] PHST- 2024/04/08 06:43 [pubmed] PHST- 2024/04/08 04:41 [entrez] PHST- 2024/01/01 00:00 [pmc-release] AID - 10.3389/fcvm.2024.1358657 [doi] PST - epublish SO - Front Cardiovasc Med. 2024 Mar 21;11:1358657. doi: 10.3389/fcvm.2024.1358657. eCollection 2024. PMID- 38503613 OWN - NLM STAT- MEDLINE DCOM- 20240906 LR - 20260622 IS - 1878-7541 (Electronic) IS - 1550-8307 (Linking) VI - 20 IP - 5 DP - 2024 Sep-Oct TI - Efficacy and safety of Tongxin formula after stent implantation for acute coronary syndrome: A multicenter, double-blind, placebo-controlled randomized trial. PG - 102992 LID - S1550-8307(24)00055-7 [pii] LID - 10.1016/j.explore.2024.02.010 [doi] AB - OBJECTIVE: The aim of this study is to comprehensively evaluate both the efficacy and safety profile of integrating the Tongxin formula with optimal medical therapy (OMT) for patients experiencing acute coronary syndromes subsequent to coronary stenting, over the course of one year. METHODS: We enrolled 150 patients diagnosed with acute coronary syndromes who had received stent placement within one month and exhibited a TCM syndrome characterized by Qi deficiency and blood stasis. This group comprised patients with unstable angina, non-ST-segment elevation myocardial infarction, and ST-segment elevation myocardial infarction. The participants were divided equally, allocating 75 to the Tongxin formula group and 75 to a placebo-controlled group. After undergoing percutaneous coronary intervention (PCI) surgery, both groups received conventional Western medical care, including dual antiplatelet therapy and lipid-lowering medications. The placebo-controlled group received a placebo, while the Tongxin formula group were administered Tongxin formula granules orally. Both study cohorts were monitored for a duration of 6 months. The primary endpoints included the occurrence of major adverse cardiovascular events and the rate of lumen diameter reduction post-treatment in both groups, with the Seattle Angina Scale serving as a secondary assessment tool. Safety evaluations encompassed the measurement of liver and kidney function, coagulation parameters, and other relevant indicators. RESULTS: The rate of adverse cardiovascular events in the placebo-controlled group was 42.46 % within a year of surgery, whereas it was 16.90 % in the Tongxin formula group (P < 0.05). Comparing the Tongxin formula group to the placebo-controlled group, there was a decrease in the frequency of unstable angina and readmission due to cardiovascular events (P < 0.05). Coronary angiography performed 6 months after surgery revealed that the Tongxin formula group had considerably less lumen loss than the placebo-controlled group in a number of segments, including the entire segment, within the stent, at the proximal end, and at the distal end (P < 0.05). Six months after surgery, the Seattle angina score was higher in the Tongxin formula group than in the placebo-controlled group (P < 0.05). There were no significant changes in indicators such as liver and renal function as well as coagulation indexes in both groups within the first 12 months after surgery (P > 0.05). CONCLUSION: Tongxin formula has been shown to lower the occurrence of major adverse cardiovascular events, minimize narrowing of blood vessel lumen, enhance clinical symptoms, and enhance the quality of life of patients following PCI surgery, all while maintaining a good safety profile. CI - Copyright (c) 2024. Published by Elsevier Inc. FAU - Zhu, Wen AU - Zhu W AD - Department of Cardiology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Zhijiang Middle Road Jing 'an District, Shanghai 200071, China. FAU - Wang, Su AU - Wang S AD - Department of Cardiology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Zhijiang Middle Road Jing 'an District, Shanghai 200071, China. FAU - Zhang, Lei AU - Zhang L AD - Department of Cardiology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Zhijiang Middle Road Jing 'an District, Shanghai 200071, China. FAU - Xie, Feng-Qun AU - Xie FQ AD - Department of Cardiology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Zhijiang Middle Road Jing 'an District, Shanghai 200071, China. FAU - Cheng, Jie AU - Cheng J AD - Department of Cardiology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Zhijiang Middle Road Jing 'an District, Shanghai 200071, China. FAU - Li, Xian-Kai AU - Li XK AD - Department of Cardiology, Tenth People's Hospital, Tongji University, Shanghai 200072, China. FAU - Chen, Wei AU - Chen W AD - Department of Cardiology, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China. FAU - Yan, Shi-Yun AU - Yan SY AD - Institute of Science, Technology and Humanities, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China. FAU - Feng, Qi-Mao AU - Feng QM AD - Department of Cardiology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Zhijiang Middle Road Jing 'an District, Shanghai 200071, China. Electronic address: fengqimao6287@126.com. LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20240301 PL - United States TA - Explore (NY) JT - Explore (New York, N.Y.) JID - 101233160 RN - 0 (Drugs, Chinese Herbal) RN - 0 (Platelet Aggregation Inhibitors) SB - IM MH - Humans MH - Male MH - Female MH - Middle Aged MH - *Drugs, Chinese Herbal/therapeutic use MH - *Percutaneous Coronary Intervention/methods MH - Double-Blind Method MH - *Acute Coronary Syndrome/drug therapy/surgery/therapy MH - Aged MH - *Stents/adverse effects MH - Treatment Outcome MH - Angina, Unstable/surgery/drug therapy MH - Medicine, Chinese Traditional/methods MH - Platelet Aggregation Inhibitors/therapeutic use OTO - NOTNLM OT - Tongxin formula OT - acute coronary syndrome OT - clinical trial OT - percutaneous coronary intervention OT - randomized control EDAT- 2024/03/20 00:42 MHDA- 2024/09/07 14:42 CRDT- 2024/03/19 22:59 PHST- 2023/12/26 00:00 [received] PHST- 2024/02/25 00:00 [revised] PHST- 2024/02/29 00:00 [accepted] PHST- 2024/09/07 14:42 [medline] PHST- 2024/03/20 00:42 [pubmed] PHST- 2024/03/19 22:59 [entrez] AID - S1550-8307(24)00055-7 [pii] AID - 10.1016/j.explore.2024.02.010 [doi] PST - ppublish SO - Explore (NY). 2024 Sep-Oct;20(5):102992. doi: 10.1016/j.explore.2024.02.010. Epub 2024 Mar 1. PMID- 38479953 OWN - NLM STAT- MEDLINE DCOM- 20240315 LR - 20260616 IS - 1558-3597 (Electronic) IS - 0735-1097 (Linking) VI - 83 IP - 11 DP - 2024 Mar 19 TI - Kidney Injury After Minimal Radiographic Contrast Administration in Patients With Acute Coronary Syndromes. PG - 1059-1069 LID - S0735-1097(24)00152-9 [pii] LID - 10.1016/j.jacc.2024.01.016 [doi] AB - BACKGROUND: Acute kidney injury (AKI) is common in patients with acute coronary syndromes (ACS) treated by percutaneous coronary intervention. OBJECTIVES: Contrast media (CM) volume minimization has been advocated for prevention of AKI. The DyeVert CM diversion system (Osprey Medical, Inc) is designed to reduce CM volume during coronary procedures. METHODS: In this randomized, single-blind, investigator-driven clinical trial conducted in 4 Italian centers from February 4, 2020 to September 13, 2022, 550 participants with ACS were randomly assigned in a 1:1 ratio to the following: 1) the contrast volume reduction (CVR) group (n = 276), in which CM injection was handled by the CM diversion system; and 2) the control group (n = 274), in which a conventional manual or automatic injection syringe was used. The primary endpoint was the rate of AKI, defined as a serum creatinine (sCr) increase >/=0.3 mg/dL within 48 hours after CM exposure. RESULTS: There were 412 of 550 (74.5%) participants with ST-segment elevation myocardial infarction (211 of 276 [76.4%] in the CVR group and 201 of 274 [73.3%] in the control group). The CM volume was lower in the CVR group (95 +/- 30 mL vs 160 +/- 23 mL; P < 0.001). Seven participants (1 in the CVR group and 6 in the control group) did not have postprocedural sCr values. AKI occurred in 44 of 275 (16%) participants in the CVR group and in 65 of 268 (24.3%) participants in the control group (relative risk: 0.66; 95% CI: 0.47-0.93; P = 0.018). CONCLUSIONS: CM volume reduction obtained using the CM diversion system is effective for prevention of AKI in patients with ACS undergoing invasive procedures. (REnal Insufficiency Following Contrast MEDIA Administration TriaL IV [REMEDIALIV]: NCT04714736). CI - Copyright (c) 2024 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Briguori, Carlo AU - Briguori C AD - Interventional Cardiology Unit, Mediterranea Cardiocentre, Naples, Italy. Electronic address: carlobriguori@clinicamediterranea.it. FAU - Quintavalle, Cristina AU - Quintavalle C AD - Center for Experimental Endocrinology and Oncology (IEOS), National Research Council (CNR), Naples, Italy. FAU - Mariano, Enrica AU - Mariano E AD - Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy. FAU - D'Agostino, Alessandro AU - D'Agostino A AD - Division of Cardiology, Paolo Giaccone University Hospital, Palermo, Italy. FAU - Scarpelli, Mario AU - Scarpelli M AD - Interventional Cardiology Unit, Mediterranea Cardiocentre, Naples, Italy. FAU - Focaccio, Amelia AU - Focaccio A AD - Interventional Cardiology Unit, Mediterranea Cardiocentre, Naples, Italy. FAU - Zoccai, Giuseppe Biondi AU - Zoccai GB AD - Interventional Cardiology Unit, Mediterranea Cardiocentre, Naples, Italy; Center for Experimental Endocrinology and Oncology (IEOS), National Research Council (CNR), Naples, Italy; Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy; Division of Cardiology, Paolo Giaccone University Hospital, Palermo, Italy; Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy. FAU - Evola, Salvatore AU - Evola S AD - Division of Cardiology, Paolo Giaccone University Hospital, Palermo, Italy. FAU - Esposito, Giovanni AU - Esposito G AD - Department of Advanced Biomedical Science, Division of Cardiology, Federico II University of Naples, Naples, Italy. FAU - Sangiorgi, Giuseppe Massimo AU - Sangiorgi GM AD - Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy. FAU - Condorelli, Gerolama AU - Condorelli G AD - Department of Molecular Medicine and Medical Biotechnology, Federico II University, Naples, Italy; Scientific Institute for Research, Hospitalization, and Health Care-Mediterranean Neurological Institute (IRCCS Neuromed), Pozzilli, Italy. LA - eng SI - ClinicalTrials.gov/NCT04714736 PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PL - United States TA - J Am Coll Cardiol JT - Journal of the American College of Cardiology JID - 8301365 RN - 0 (Contrast Media) RN - AYI8EX34EU (Creatinine) SB - IM MH - Humans MH - *Acute Coronary Syndrome/diagnostic imaging MH - *Acute Kidney Injury/chemically induced/epidemiology MH - Contrast Media/adverse effects MH - Creatinine MH - Kidney MH - *Percutaneous Coronary Intervention/adverse effects MH - Risk Factors MH - Single-Blind Method OTO - NOTNLM OT - contrast media OT - myocardial infarction OT - percutaneous coronary intervention COIS- Funding Support and Author Disclosures The authors have reported that they have no relationships relevant to the contents of this paper to disclose. The company providing the DyeVert system (Osprey Medical, Inc) was not involved in the trial design and conduction. EDAT- 2024/03/14 00:43 MHDA- 2024/03/15 06:43 CRDT- 2024/03/13 21:58 PHST- 2023/12/21 00:00 [received] PHST- 2024/01/09 00:00 [accepted] PHST- 2024/03/15 06:43 [medline] PHST- 2024/03/14 00:43 [pubmed] PHST- 2024/03/13 21:58 [entrez] AID - S0735-1097(24)00152-9 [pii] AID - 10.1016/j.jacc.2024.01.016 [doi] PST - ppublish SO - J Am Coll Cardiol. 2024 Mar 19;83(11):1059-1069. doi: 10.1016/j.jacc.2024.01.016. PMID- 38411168 OWN - NLM STAT- MEDLINE DCOM- 20240327 LR - 20260611 IS - 1473-5830 (Electronic) IS - 0954-6928 (Linking) VI - 35 IP - 3 DP - 2024 May 1 TI - Efficacy of nicorandil and ranolazine in prevention of contrast-induced nephropathy in patients with mild-to-moderate renal dysfunction: a randomized controlled trial. PG - 186-192 LID - 10.1097/MCA.0000000000001347 [doi] AB - INTRODUCTION: Contrast-induced nephropathy (CIN) is a common complication after percutaneous coronary intervention (PCI). There is conflicting evidence regarding efficacy of nicorandil in CIN prevention. With respect to ranolazine, there is physiological possibility as well as data in animal study regarding its protective effect against CIN; there is, however, no human data till date. AIM AND OBJECTIVES: To assess the efficacy of nicorandil and ranolazine in preventing CIN. The secondary endpoint was to measure difference in postprocedure acute kidney injury (AKI) incidence across groups. Also, patients were followed up till 6 months for major adverse events. MATERIAL AND METHODS: This single-center randomized controlled study included 315 patients of coronary artery disease with mild-to-moderate renal dysfunction undergoing elective PCI. Eligible patients were assigned to either nicorandil (n = 105), ranolazine (n = 105) or control group (n = 105) in 1 : 1 : 1 ratio by block randomization. All enrolled patients were given intravenous sodium chloride at rate of 1.0 mL/kg/h (0.5 mL/kg/h for patients with left ventricular ejection fraction <45%) from 6 h before procedure till 12 h after procedure. Iso-osmolar contrast agent (iodixanol) was used for all patients. In addition to hydration, patients in nicorandil group received oral nicorandil (10 mg, 3 times/d) and those in ranolazine group received oral ranolazine (1000 mg, 2 times/d) 1 day before procedure and for 2 days after PCI. Patients in control group received only hydration. RESULTS: Total number of CIN was 34 (10.7%), which included 19 (18.1%) in control, 8 (7.6%) in nicorandil and 7 (6.6%) in ranolazine group. There was significant association of CIN reduction across groups ( P = 0.012). On pairwise comparison also, there was significant benefit across control and ranolazine as well as control and nicorandil ( P < 0.025). There was numerically higher incidence of AKI in controls; the difference, however, did not reach statistical significance after applying Bonferroni correction ( P = 0.044). Over 6-month follow-up, adverse events were similar across groups. CONCLUSION: While this study adds to existing literature that supports role for nicorandil in CIN prevention, the efficacy of ranolazine in protecting against CIN has been demonstrated in humans for the first time. CI - Copyright (c) 2024 Wolters Kluwer Health, Inc. All rights reserved. FAU - Yusuf, Jamal AU - Yusuf J AD - Department of Cardiology, Maulana Azad Medical College and GB Pant Institute of Postgraduate Medical Education and Research, New Delhi, India. FAU - Prakash, Gyan AU - Prakash G FAU - Safal, Safal AU - Safal S FAU - Mehta, Vimal AU - Mehta V FAU - Mukhopadhyay, Saibal AU - Mukhopadhyay S LA - eng PT - Journal Article PT - Randomized Controlled Trial DEP - 20240220 PL - England TA - Coron Artery Dis JT - Coronary artery disease JID - 9011445 RN - 260456HAM0 (Nicorandil) RN - A6IEZ5M406 (Ranolazine) RN - 0 (Contrast Media) SB - IM MH - Humans MH - Nicorandil/therapeutic use MH - Ranolazine/therapeutic use MH - Coronary Angiography/adverse effects/methods MH - *Percutaneous Coronary Intervention/adverse effects/methods MH - Stroke Volume MH - Ventricular Function, Left MH - Contrast Media/adverse effects MH - *Acute Kidney Injury/chemically induced/prevention & control EDAT- 2024/02/27 12:45 MHDA- 2024/03/27 06:44 CRDT- 2024/02/27 09:15 PHST- 2024/03/27 06:44 [medline] PHST- 2024/02/27 12:45 [pubmed] PHST- 2024/02/27 09:15 [entrez] AID - 00019501-202405000-00003 [pii] AID - 10.1097/MCA.0000000000001347 [doi] PST - ppublish SO - Coron Artery Dis. 2024 May 1;35(3):186-192. doi: 10.1097/MCA.0000000000001347. Epub 2024 Feb 20. PMID- 38378459 OWN - NLM STAT- MEDLINE DCOM- 20240222 LR - 20240318 IS - 0035-9351 (Print) IS - 0035-9351 (Linking) VI - 102 IP - 12 DP - 2023 TI - The significance of glycocalyx in surgery. PG - 453-458 LID - 10.33699/PIS.2023.102.12.453-458 [doi] AB - INTRODUCTION: Surgical treatment is associated with an unwanted response of the organism to the so-called surgical trauma. This response is called surgical stress. Ischaemia-reperfusion injury is one of essential causes of tissue damage. It comprises functional and structural changes in tissue that occur after the restoration of circulation, after an episode of ischaemia. Necrosis of irreversibly changed cells and endothelial and mitochondrial-induced tissue swelling occur. METHODS: Physiology, pathophysiology of endothelial glycocalyx: Endothelial glycocalyx is a 0.2 to 5 micrometres thin heteropolysaccharide layer that covers the endothelium on its intraluminal side. Backbone molecules of the glycocalyx include proteoglycans, glycoproteins, and glycosaminoglycans. Damage of the endothelial glycocalyx was described in trauma patients, in patients with septic shock, in ischemia and reperfusion injury, and during extensive surgical procedures. Approaches to prevent endothelial glycocalyx damage: Remote ischemic preconditioning was tested as a method of ischemia and reperfusion injury prevention during and after surgery. Nevertheless, the expected effect was not confirmed in performed meta-analyses. Endothelial glycocalyx damage can be prevented pharmacologically with a broad spectrum of substances, such as antithrombin III, doxycycline, hydrocortisone, etanercept, or nitric oxide donors. Hydrogen inhalation or albumin affects glycocalyx positively. Sulodexide provides a positive effect on the protection and reparation of endothelial glycocalyx. This proteoglycan with antithrombotic, fibrinolytic, hypofibrinogenemic, and lipolytic function is used for the treatment of venous diseases, ischaemic heart disease, and peripheral arterial disease. A positive effect of sulodexide on renal dysfunction was documented in a model of ischaemia and reperfusion injury. Equally, a positive effect of sulodexide was described on endothelium repair after its mechanical damage. CONCLUSION: Further research needs to be performed to evaluate the effect of endothelium-protectives on glycocalyx damage prevention and repair in ischaemia and reperfusion models involving large laboratory animals or in clinical trials in patients undergoing surgical revascularisation procedures. FAU - Hana, L AU - Hana L FAU - Koci, J AU - Koci J FAU - Pohnan, R AU - Pohnan R FAU - Rehak, D AU - Rehak D FAU - Astapenko, D AU - Astapenko D LA - eng PT - Journal Article TT - Vyznam glykokalyxu v chirurgii. PL - Czech Republic TA - Rozhl Chir JT - Rozhledy v chirurgii : mesicnik Ceskoslovenske chirurgicke spolecnosti JID - 9815441 SB - IM MH - Animals MH - Humans MH - *Glycocalyx/physiology MH - *Reperfusion Injury MH - Ischemia MH - Endothelium, Vascular EDAT- 2024/02/21 11:14 MHDA- 2024/02/22 06:43 CRDT- 2024/02/20 23:32 PHST- 2024/02/22 06:43 [medline] PHST- 2024/02/21 11:14 [pubmed] PHST- 2024/02/20 23:32 [entrez] AID - 136561 [pii] AID - 10.33699/PIS.2023.102.12.453-458 [doi] PST - ppublish SO - Rozhl Chir. 2023;102(12):453-458. doi: 10.33699/PIS.2023.102.12.453-458. PMID- 38345584 OWN - NLM STAT- MEDLINE DCOM- 20240215 LR - 20240215 IS - 1319-2442 (Print) IS - 1319-2442 (Linking) VI - 34 IP - 4 DP - 2023 Jul 1 TI - Acute Kidney Injury in Acute Myocardial Infarction and Its Outcome at 3 and 6 Months. PG - 297-304 LID - 10.4103/1319-2442.395445 [doi] AB - Epidemiological data on the prevalence of acute kidney injury (AKI) in acute coronary syndrome are sparse, with most studies having been conducted retrospectively. This study prospectively analyzed the incidence of AKI in patients with acute myocardial infarction (AMI) and to identify the risk factors for AKI and their renal outcome at 3 and 6 months. This was a prospective and observational study, which enrolled 120 patients presenting with their first episode of AMI to our hospital and consented to the study. Renal function tests were performed at admission, at 48 h, and at follow-up at 3 and 6 months. The majority of the patients underwent a percutaneous coronary intervention (59.2%), 21.7% received thrombolytic therapy, and 19.2% were managed conservatively. At 48 h, 11 patients had AKI. At 3 months, 8 patients had died, and renal dysfunctions were seen in 9 out of 112 patients. At 6 months, 12 patients out of 112 had renal dysfunction. There was no difference in the incidence of AKI in patients with an estimated glomerular filtration rate above and below 60 mL/min/1.73 m2. Killip Class 4 and diabetes mellitus were associated with an increased incidence of renal dysfunction in AMI patients. The type of treatment and the use of a contrast agent in the coronary intervention did not affect the development of AKI. According to this study, if indicated, a percutaneous coronary intervention should not be denied to patients for fear of developing AKI. This needs to be examined in larger randomized trials. CI - Copyright (c) 2023 Copyright: (c) 2023 Saudi Journal of Kidney Diseases and Transplantation. FAU - Kaur, Jaspreet AU - Kaur J AD - Department of General Medicine, Government Medical College and Hospital, Chandigarh, India. FAU - Bhardwaj, Nidhi AU - Bhardwaj N AD - Department of General Medicine, Government Medical College and Hospital, Chandigarh, India. FAU - Reddy, Sreenivas AU - Reddy S AD - Department of Cardiology, Government Medical College and Hospital, Chandigarh, India. FAU - D'Cruz, Sanjay AU - D'Cruz S AD - Department of General Medicine, Government Medical College and Hospital, Chandigarh, India. LA - eng PT - Journal Article PT - Observational Study DEP - 20240212 PL - Saudi Arabia TA - Saudi J Kidney Dis Transpl JT - Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia JID - 9436968 RN - 0 (Contrast Media) SB - IM MH - Humans MH - *Acute Kidney Injury/diagnosis/epidemiology/therapy MH - Contrast Media/adverse effects MH - Kidney MH - *Myocardial Infarction/complications/epidemiology/therapy MH - Prospective Studies MH - Risk Factors EDAT- 2024/02/12 15:44 MHDA- 2024/02/12 15:45 CRDT- 2024/02/12 10:43 PHST- 2024/02/12 15:45 [medline] PHST- 2024/02/12 15:44 [pubmed] PHST- 2024/02/12 10:43 [entrez] AID - 00936703-202334040-00003 [pii] AID - 10.4103/1319-2442.395445 [doi] PST - ppublish SO - Saudi J Kidney Dis Transpl. 2023 Jul 1;34(4):297-304. doi: 10.4103/1319-2442.395445. Epub 2024 Feb 12. PMID- 38343370 OWN - NLM STAT- MEDLINE DCOM- 20240214 LR - 20250206 IS - 1969-6213 (Electronic) IS - 1774-024X (Print) IS - 1774-024X (Linking) VI - 20 IP - 3 DP - 2024 Feb 5 TI - Dynamic Coronary Roadmap versus standard angiography for percutaneous coronary intervention: the randomised, multicentre DCR4Contrast trial. PG - e198-e206 LID - EIJ-D-23-00460 [pii] LID - 10.4244/EIJ-D-23-00460 [doi] AB - BACKGROUND: Decreasing the amount of iodinated contrast is an important safety aspect of percutaneous coronary interventions (PCI), particularly in patients with a high risk of contrast-induced acute kidney injury (CI-AKI). Dynamic Coronary Roadmap (DCR) is a PCI navigation support tool projecting a motion-compensated virtual coronary roadmap overlay on fluoroscopy, potentially limiting the need for contrast during PCI. AIMS: This study investigates the contrast-sparing potential of DCR in PCI, compared to standard angiographic guidance. METHODS: The Dynamic Coronary Roadmap for Contrast Reduction (DCR4Contrast) trial is a multicentre, international, prospective, unblinded, stratified 1:1 randomised controlled trial. Patients were randomised to either DCR-guided PCI or to conventional angiography-guided PCI. The primary endpoint was the total volume of iodinated contrast administered, and the secondary endpoint was the number of cineangiography runs during PCI. RESULTS: The study population included 356 randomised patients (179 in DCR and 177 in control groups, respectively). There were no differences in patient demographics, angiographic characteristics or estimated glomerular filtration rate (eGFR) between the two groups. The total contrast volume used during PCI was significantly lower with DCR guidance compared with conventional angiographic guidance (64.6+/-44.4 ml vs 90.8+/-55.4 ml, respectively; p<0.001). The total number of cineangiography runs was also significantly reduced in the DCR group (8.7+/-4.7 vs 11.7+/-7.6 in the control group; p<0.001). CONCLUSIONS: Compared to conventional angiography-guided PCI, DCR guidance was associated with a significant reduction in both contrast volume and the number of cineangiography runs during PCI. (ClinicalTrials.gov: NCT04085614). FAU - Hennessey, Breda AU - Hennessey B AD - Hospital Clinico San Carlos IdISSC, Complutense University of Madrid, Madrid, Spain. AD - Department of Cardiology, Blackrock Clinic, Dublin, Ireland. FAU - Danenberg, Haim AU - Danenberg H AD - Heart Institute, Hadassah Hebrew University Medical Center, Jerusalem, Israel. AD - Interventional Cardiology Division, Wolfson Medical Center, Holon, Israel. FAU - De Vroey, Frederic AU - De Vroey F AD - Department of Cardiology, Grand Hopital de Charleroi, Charleroi, Belgium. FAU - Kirtane, Ajay J AU - Kirtane AJ AD - Division of Cardiology, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, NY, USA and the Cardiovascular Research Foundation, New York, NY, USA. FAU - Parikh, Manish AU - Parikh M AD - Division of Cardiology, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, NY, USA and the Cardiovascular Research Foundation, New York, NY, USA. AD - Division of Cardiology, NewYork-Presbyterian Brooklyn Methodist Hospital, New York, NY, USA. FAU - Karmpaliotis, Dimitrios AU - Karmpaliotis D AD - Division of Cardiology, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, NY, USA and the Cardiovascular Research Foundation, New York, NY, USA. AD - Division of Cardiology, Morristown Medical Center, Morristown, NJ, USA. FAU - Messenger, John C AU - Messenger JC AD - Department of Medicine, Division of Cardiology, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, USA. FAU - Strobel, Aaron AU - Strobel A AD - Department of Medicine, Division of Cardiology, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, USA. AD - Division of Cardiology, Baptist Health Heart Institute, Little Rock, AK, USA. FAU - Curcio, Alejandro AU - Curcio A AD - Department of Cardiology, Hospital de Fuenlabrada, Madrid, Spain. FAU - van Mourik, Martijn S AU - van Mourik MS AD - Philips Medical Systems, Best, the Netherlands. FAU - Eshuis, Peter AU - Eshuis P AD - Philips Medical Systems, Best, the Netherlands. FAU - Escaned, Javier AU - Escaned J AD - Hospital Clinico San Carlos IdISSC, Complutense University of Madrid, Madrid, Spain. LA - eng SI - ClinicalTrials.gov/NCT04085614 PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20240205 PL - France TA - EuroIntervention JT - EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology JID - 101251040 RN - 0 (Contrast Media) SB - IM MH - Humans MH - *Coronary Artery Disease/diagnostic imaging/surgery MH - Coronary Angiography/adverse effects/methods MH - *Percutaneous Coronary Intervention/adverse effects MH - Prospective Studies MH - Treatment Outcome MH - Contrast Media/adverse effects PMC - PMC10851082 COIS- B. Hennessey is a speaker at educational events for Philips. H. Danenberg is a proctor for Medtronic and Edwards Lifesciences; and has received an institutional grant from Abbott. F. De Vroey is a speaker at educational events for Abbott. A.J. Kirtane has received institutional funding to Columbia University and/or Cardiovascular Research Foundation from Medtronic, Boston Scientific, Abbott, Amgen, CSI, Philips, ReCor Medical, Neurotronic, Biotronik, Chiesi, Bolt Medical, Magenta Medical, Canon, SoniVie, Shockwave Medical, and Merck; is a consultant for IMDS; and received travel expenses/meals from Amgen, Medtronic, Biotronik, Boston Scientific, Abbott, CathWorks, Edwards Lifesciences, CSI, Novartis, Philips, Abiomed, Merck, ReCor Medical, Chiesi, Zoll, Shockwave Medical, and Regeneron in addition to research grants, institutional funding received includes fees paid to Columbia University and/or Cardiovascular Research Foundation for consulting and/or speaking engagements in which Dr Kirtane controlled the content. M. Parikh has served on advisory boards for Medtronic, Boston Scientific, and Abbott. D. Karmpaliotis has received honoraria from Boston Scientific, Abbott, Teleflex, and Abiomed; and has equity in Saranas, Soundbite, Traverse Vascular, and Nanowear. J.C. Messenger has received institutional grant support from Philips Medical Systems. M.S. van Mourik is an employee of Philips Medical Systems. P. Eshuis is an employee of Philips Medical Systems. J. Escaned is an advisory board member and speaker at educational events for Philips. The other authors have no conflicts of interest to declare. EDAT- 2024/02/12 15:42 MHDA- 2024/02/12 15:43 PMCR- 2025/02/05 CRDT- 2024/02/12 03:53 PHST- 2024/02/12 15:43 [medline] PHST- 2024/02/12 15:42 [pubmed] PHST- 2024/02/12 03:53 [entrez] PHST- 2025/02/05 00:00 [pmc-release] AID - EIJ-D-23-00460 [pii] AID - 10.4244/EIJ-D-23-00460 [doi] PST - epublish SO - EuroIntervention. 2024 Feb 5;20(3):e198-e206. doi: 10.4244/EIJ-D-23-00460. PMID- 38238027 OWN - NLM STAT- MEDLINE DCOM- 20240122 LR - 20260501 IS - 2053-3624 (Print) IS - 2053-3624 (Electronic) IS - 2053-3624 (Linking) VI - 11 IP - 1 DP - 2024 Jan 18 TI - Use of sacubitril/valsartan early after CABG. LID - 10.1136/openhrt-2023-002492 [doi] LID - e002492 AB - BACKGROUND: Heart failure (HF) remains a major public health problem with a high mortality and morbidity worldwide. Currently, there is no optimal revascularisation strategy for patients with ischaemic cardiomyopathy despite suggestions that coronary artery bypass graft (CABG) may be superior to medical therapy in improving survival. However, CABG may be associated with substantial risk in HF subjects. We therefore aimed to evaluate the safety and efficacy of the early initiation of sacubitril/valsartan in haemodynamically stabilised patients with HF with reduced ejection fraction (HFrEF) after early CABG. METHODS: This was an open-label study in which ~80 patients after CABG were randomised either to the early or late initiation of the sacubitril-valsartan. The study included patients >40 years with left ventricular ejection fraction <45% and New York Heart Association (NYHA) class II-IV at the early stage after CABG. Patients underwent intervention, the starting dose of sacubitril/valsartan (24/26 mg or 49/51 mg two times per day). The follow-up took place every 4 weeks except the first visit, which took place in 2 weeks after initiation. The primary endpoint assessed the key safety outcomes, the secondary endpoints were: the quality of life measured, the N-terminal pro-B-type natriuretic peptide (NT-proBNP) changes and 6 min walk test (6MWT). RESULTS: In total, 83 patients were screened and 77 patients were enrolled. The majority of patients (84.4%) were in the NYHA class III at randomisation. The number of patients who discontinued the study was low in both groups (2.5%, 5.2%), and renal function, hyperkalaemia and symptomatic hypotension rarely seen in both groups did not differ significantly. The improvement in quality of life and distance at the 6MWT in both groups was significant (p<0.001). The NT-proBNP concentration decreased in both groups, the significant reduction was in the early group (p<0.001) versus the postdischarge group. CONCLUSIONS: The early initiation of sacubitril/valsartan in patients after CABG with HFrEF is safe and effective. Adverse events and permanent discontinuation were low. The NT-proBNP concentration reduced significantly with the early in-hospital initiation. CI - (c) Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. FAU - Nurzhanova, Madina AU - Nurzhanova M AUID- ORCID: 0000-0003-2561-8707 AD - Scientific Research Institute of Cardiology and Internal Diseases, Almaty, Kazakhstan. AD - Kazakhstan Medical University 'Graduate School of Public Health', Almaty, Kazakhstan. FAU - Musagaliyeva, Aisulu AU - Musagaliyeva A AD - Scientific Research Institute of Cardiology and Internal Diseases, Almaty, Kazakhstan. FAU - Zhakypova, Raushan AU - Zhakypova R AD - Scientific Research Institute of Cardiology and Internal Diseases, Almaty, Kazakhstan. FAU - Senkibayeva, Daniya AU - Senkibayeva D AD - Scientific Research Institute of Cardiology and Internal Diseases, Almaty, Kazakhstan. FAU - Rakisheva, Amina AU - Rakisheva A AUID- ORCID: 0000-0001-9842-962X AD - Scientific Research Institute of Cardiology and Internal Diseases, Almaty, Kazakhstan amina.grakisheva@gmail.com. LA - eng PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20240118 PL - England TA - Open Heart JT - Open heart JID - 101631219 RN - WB8FT61183 (sacubitril and valsartan sodium hydrate drug combination) RN - 17ERJ0MKGI (sacubitril) RN - 0 (Tetrazoles) RN - 80M03YXJ7I (Valsartan) RN - 0 (Aminobutyrates) RN - 0 (Biphenyl Compounds) RN - 0 (Drug Combinations) SB - IM MH - Humans MH - *Heart Failure/diagnosis/drug therapy MH - Stroke Volume MH - Quality of Life MH - Aftercare MH - Tetrazoles/adverse effects MH - Ventricular Function, Left MH - Patient Discharge MH - Valsartan/adverse effects MH - Coronary Artery Bypass/adverse effects MH - *Aminobutyrates MH - *Biphenyl Compounds MH - Drug Combinations PMC - PMC10806467 OTO - NOTNLM OT - Coronary Artery Bypass OT - Coronary Artery Disease OT - Heart Failure OT - Pharmacology, Clinical COIS- Competing interests: AR received a speaker honorarium from AstraZeneca, Novartis and Roche. EDAT- 2024/01/19 00:42 MHDA- 2024/01/22 06:41 PMCR- 2024/01/18 CRDT- 2024/01/18 21:13 PHST- 2023/09/25 00:00 [received] PHST- 2024/01/03 00:00 [accepted] PHST- 2024/01/22 06:41 [medline] PHST- 2024/01/19 00:42 [pubmed] PHST- 2024/01/18 21:13 [entrez] PHST- 2024/01/18 00:00 [pmc-release] AID - openhrt-2023-002492 [pii] AID - 10.1136/openhrt-2023-002492 [doi] PST - epublish SO - Open Heart. 2024 Jan 18;11(1):e002492. doi: 10.1136/openhrt-2023-002492. PMID- 38163943 OWN - NLM STAT- MEDLINE DCOM- 20240103 LR - 20250104 IS - 1550-9397 (Electronic) IS - 1550-9389 (Print) IS - 1550-9389 (Linking) VI - 20 IP - 1 DP - 2024 Jan 1 TI - Obstructive sleep apnea and temporal changes in cardiac repolarization in patients undergoing coronary artery bypass grafting. PG - 49-55 LID - 10.5664/jcsm.10786 [doi] AB - STUDY OBJECTIVES: In coronary artery bypass grafting (CABG), abnormal cardiac repolarization is associated with adverse cardiovascular events that can be measured via the QTc interval. We investigated the impact of obstructive sleep apnea on the change in repolarization after CABG and the association of change in repolarization with the occurrence of major adverse cardiac and cerebrovascular events. METHODS: A total of 1,007 patients from 4 hospitals underwent an overnight sleep study prior to a nonemergent CABG. Electrocardiograms of 954 patients (median age: 62 years; male: 86%; mean follow-up: 2.1 years) were acquired prospectively within 48 hours before CABG (T1) and within 24 hours after CABG (T2). QTc intervals were measured using the BRAVO algorithm by Analyzing Medical Parameters for Solutions LLC. The change in T2 from T1 for QTc (DeltaQTc) was derived, and Cox regression was performed. RESULTS: Compared with those without, patients who developed major adverse cardiac and cerebrovascular events (n = 115) were older and had (1) a higher prevalence of smoking, hypertension, diabetes mellitus, and chronic kidney disease; (2) a higher apnea-hypopnea index and oxygen desaturation index; and (3) a smaller DeltaQTc. Cox regression analysis demonstrated a smaller DeltaQTc to be an independent risk factor for major adverse cardiac and cerebrovascular events (hazard ratio: 0.997; P = .032). In the multivariable regression model, a higher oxygen desaturation index was independently associated with a smaller DeltaQTc (correlation coefficient: -0.58; P < .001). CONCLUSIONS: A higher preoperative oxygen desaturation index was an independent predictor of a smaller DeltaQTc. DeltaQTc within 24 hours after CABG could be a novel predictor of occurrence of major adverse cardiac and cerebrovascular events at medium-term follow-up. CLINICAL TRIAL REGISTRATION: Registry: ClinicalTrials.gov; Name: Undiagnosed Sleep Apnea and Bypass OperaTion (SABOT); URL: https://classic.clinicaltrials.gov/ct2/show/NCT02701504; Identifier: NCT02701504. CITATION: Teo YH, Yong CL, Ou YH, et al. Obstructive sleep apnea and temporal changes in cardiac repolarization in patients undergoing coronary artery bypass grafting. J Clin Sleep Med. 2024;20(1):49-55. CI - (c) 2024 American Academy of Sleep Medicine. FAU - Teo, Yao Hao AU - Teo YH AD - Yong Loo Lin School of Medicine, National University of Singapore, Singapore. FAU - Yong, Cai Ling AU - Yong CL AD - Yong Loo Lin School of Medicine, National University of Singapore, Singapore. FAU - Ou, Yi Hui AU - Ou YH AD - Yong Loo Lin School of Medicine, National University of Singapore, Singapore. FAU - Tam, Wilson W AU - Tam WW AD - Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore. FAU - Teo, Yao Neng AU - Teo YN FAU - Koo, Chieh-Yang AU - Koo CY AD - Department of Cardiology, National University Heart Centre Singapore, Singapore. FAU - Kojodjojo, Pipin AU - Kojodjojo P AD - Asian Heart and Vascular Centre (AHVC), Singapore. FAU - Lee, Chi-Hang AU - Lee CH AD - Yong Loo Lin School of Medicine, National University of Singapore, Singapore. AD - Department of Cardiology, National University Heart Centre Singapore, Singapore. AD - Cardiovascular Research Institute, National University of Singapore, Singapore. LA - eng SI - ClinicalTrials.gov/NCT02701504 PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - Switzerland TA - J Clin Sleep Med JT - Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine JID - 101231977 RN - S88TT14065 (Oxygen) SB - IM CIN - J Clin Sleep Med. 2024 Jan 1;20(1):3-5. doi: 10.5664/jcsm.10904. PMID: 37909086 MH - Humans MH - Male MH - Middle Aged MH - Coronary Artery Bypass/adverse effects MH - *Sleep Apnea, Obstructive/diagnosis MH - *Sleep Apnea Syndromes/complications MH - Risk Factors MH - Oxygen PMC - PMC10758550 OTO - NOTNLM OT - cardiac procedures OT - cardiac procedures and therapy OT - cardiac risk factors OT - cardiac surgery OT - coronary artery disease surgery OT - prevention COIS- All authors approved the final version for submission. Work for this study was supported by a Transition Award and Clinician Scientist Award from the National Medical Research Council of Singapore (award numbers: NMRC/TA/012/2012; NMRC/CSA-INV/002/2015) and the Junior Research Award, National University Health System. Easmed Pte. Ltd. provided support for the overnight sleep studies but had no role in the study design, data interpretation, or manuscript writing. The authors report no conflicts of interest. EDAT- 2024/01/02 11:43 MHDA- 2024/01/03 09:43 PMCR- 2025/01/01 CRDT- 2024/01/02 01:12 PHST- 2024/01/03 09:43 [medline] PHST- 2024/01/02 11:43 [pubmed] PHST- 2024/01/02 01:12 [entrez] PHST- 2025/01/01 00:00 [pmc-release] AID - jcsm.10786 [pii] AID - JC2300099 [pii] AID - 10.5664/jcsm.10786 [doi] PST - ppublish SO - J Clin Sleep Med. 2024 Jan 1;20(1):49-55. doi: 10.5664/jcsm.10786. PMID- 38163579 OWN - NLM STAT- MEDLINE DCOM- 20240226 LR - 20240719 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 214 DP - 2024 Mar 1 TI - Complete Revascularization Strategies in Women and Men With Acute Coronary Syndrome and Multivessel Disease. PG - 25-32 LID - S0002-9149(23)01431-5 [pii] LID - 10.1016/j.amjcard.2023.12.044 [doi] AB - This prespecified substudy of the randomized Percutaneous Complete Revascularization Strategies Using Sirolimus Eluting Biodegradable Polymer Coated Stents in Patients Presenting With Acute Coronary Syndromes and Multivessel Disease (BIOVASC) trial aimed to compare immediate complete revascularization (ICR) and staged complete revascularization (SCR) in patients with acute coronary syndrome and multivessel disease, stratified by gender. The primary end point consisted of a composite of all-cause mortality, myocardial infarction, unplanned ischemia-driven revascularization, and cerebrovascular events at 1-year follow-up. The secondary end points included the individual components of the primary composite and major bleedings. We used Cox regression models to relate randomized treatment with study end points. We evaluated the multiplicative and additive interactions between gender and randomized treatment. The BIOVASC trial enrolled 338 women and 1,187 men. Women were older than men (median age 71.6 vs 63.7 years, p <0.001) and had a higher prevalence of chronic obstructive pulmonary disease (10.1% vs 5.6%, p = 0.003), renal insufficiency (7.7% vs 4.4%, p = 0.015), and hypertension (60.4% vs 51.7%, p = 0.005). In women, the composite primary outcome occurred in 7.3% versus 12.9% (hazard ratio 0.53, 95% confidence interval 0.26 to 1.08) in patients randomly allocated to ICR and SCR, respectively, and in men in 7.7% versus 8.4% (hazard ratio 0.89, 95% confidence interval 0.60 to 1.34), with no evidence of a differential effect (interaction p(multiplicative) = 0.20, p(additive) = 0.87). No evidence of heterogeneity between women and men was found when comparing ICR with SCR in terms of the secondary outcomes. In conclusion, no differential treatment effect was found when comparing ICR versus SCR in women or men presenting with acute coronary syndrome and multivessel disease. CI - Copyright (c) 2024 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Elscot, Jacob J AU - Elscot JJ AD - Erasmus MC Cardiovascular Institute, Thorax Center, Department of Cardiology, Rotterdam, The Netherlands. FAU - Kakar, Hala AU - Kakar H AD - Erasmus MC Cardiovascular Institute, Thorax Center, Department of Cardiology, Rotterdam, The Netherlands. FAU - Dekker, Wijnand K den AU - Dekker WKD AD - Erasmus MC Cardiovascular Institute, Thorax Center, Department of Cardiology, Rotterdam, The Netherlands. FAU - Bennett, Johan AU - Bennett J AD - Department of Cardiovascular Medicine, University Hospital Leuven, Leuven, Belgium. FAU - Sabate, Manel AU - Sabate M AD - Interventional Cardiology Department, Cardiovascular Institute, Hospital Clinic, Barcelona, Spain. FAU - Esposito, Giovanni AU - Esposito G AD - Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy. FAU - Daemen, Joost AU - Daemen J AD - Erasmus MC Cardiovascular Institute, Thorax Center, Department of Cardiology, Rotterdam, The Netherlands. FAU - Boersma, Eric AU - Boersma E AD - Erasmus MC Cardiovascular Institute, Thorax Center, Department of Cardiology, Rotterdam, The Netherlands. FAU - Van Mieghem, Nicolas M AU - Van Mieghem NM AD - Erasmus MC Cardiovascular Institute, Thorax Center, Department of Cardiology, Rotterdam, The Netherlands. FAU - Diletti, Roberto AU - Diletti R AD - Erasmus MC Cardiovascular Institute, Thorax Center, Department of Cardiology, Rotterdam, The Netherlands. Electronic address: r.diletti@erasmusmc.nl. CN - BIOVASC investigators LA - eng PT - Journal Article DEP - 20231230 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM CIN - Am J Cardiol. 2024 Apr 15;217:153-155. doi: 10.1016/j.amjcard.2024.02.008. PMID: 38417652 MH - Male MH - Humans MH - Female MH - Aged MH - *Acute Coronary Syndrome/surgery MH - *Coronary Artery Disease/surgery MH - *Percutaneous Coronary Intervention MH - *Myocardial Infarction/therapy MH - Stents MH - Treatment Outcome OTO - NOTNLM OT - acute coronary syndrome OT - gender OT - multivessel PCI COIS- Declaration of competing interest Dr. Diletti has received institutional research grants from Biotronik, Medtronic, ACIST Medical Systems, and Boston Scientific. Dr. den Dekker has received institutional research grants from Biotronik. Dr. Van Mieghem has received institutional research grants from Biotronik, Abbott, Medtronic, Edwards Lifesciences, PulseCath, Abiomed, and Daiichi Sankyo; speaker fees from Abiomed and Amgen; and a travel grant from JenaValve. Dr. Bennett has received institutional grants from Biotronik, Abbott Vascular, and Shockwave Medical. Dr. Daemen has received institutional grant/research support from Abbott Vascular, Boston Scientific, ACIST Medical, Medtronic, MicroPort, Pie Medical, and ReCor medical and consultancy and speaker fees from Abbott Vascular, Abiomed, ACIST medical, Boston Scientific, Cardialysis BV, CardiacBooster, Kaminari Medical, ReCor Medical, PulseCath, Pie Medical, Sanofi, Siemens Health Care, and Medtronic. Dr. Sabate has received consultancy fees from Abbott Vascular and iVascular. The remaining authors have no competing interest to declare. EDAT- 2024/01/02 11:43 MHDA- 2024/02/26 06:44 CRDT- 2024/01/01 19:14 PHST- 2023/10/16 00:00 [received] PHST- 2023/12/05 00:00 [revised] PHST- 2023/12/17 00:00 [accepted] PHST- 2024/02/26 06:44 [medline] PHST- 2024/01/02 11:43 [pubmed] PHST- 2024/01/01 19:14 [entrez] AID - S0002-9149(23)01431-5 [pii] AID - 10.1016/j.amjcard.2023.12.044 [doi] PST - ppublish SO - Am J Cardiol. 2024 Mar 1;214:25-32. doi: 10.1016/j.amjcard.2023.12.044. Epub 2023 Dec 30. PMID- 38134060 OWN - NLM STAT- MEDLINE DCOM- 20231225 LR - 20250503 IS - 1536-5964 (Electronic) IS - 0025-7974 (Print) IS - 0025-7974 (Linking) VI - 102 IP - 51 DP - 2023 Dec 22 TI - The clinical efficacy of Shenxiang Suhe Pill administration in posterior circulation ischemic vertigo: A randomized controlled trial. PG - e36604 LID - 10.1097/MD.0000000000036604 [doi] LID - e36604 AB - BACKGROUND: Shenxiang Suhe Pill (SXSHP) is a traditional Chinese medicine (TCM) widely used to treat coronary heart disease. The present study aims to investigate the effect of SXSHP on posterior circulation ischemic (PCI) vertigo. METHODS: One hundred and twenty patients with PCI vertigo were randomly divided into the control, low-dose, and high-dose groups with 40 patients in each group. The control group was treated with basic Western medicine. The low-dose and high-dose groups were treated with 0.7 g SXSHP once a day in the morning and twice a day in the morning and evening, respectively. The assessments were performed on days 14 and 28. The traditional Chinese medicine symptom score, average blood flow velocity of vertebral artery and basilar artery, blood viscosity, blood lipids, serum C-reactive protein level (CRP), blood routine test, and liver and kidney function were compared before and after treatment among the 3 groups. RESULTS: In the evaluation of the traditional Chinese medicine symptom score, both low-dose and high-dose SXSHP treatments showed higher efficacy than the control group (P = .013). The average blood flow velocity of vertebral artery and basilar artery in the 3 groups showed an upward trend from baseline (P < .05). The blood viscosity and levels of fibrinogen, hematocrit, and CRP in the 3 groups showed a downward trend from baseline level (P < .05). The levels of total cholesterol, triglycerides, low-density lipoprotein, and CRP in the low-dose group and high-dose group were lower than those in the control group on day 28 (P < .05). There were no significant differences in the routine blood test and liver and kidney function between the low-dose and high-dose groups compared with the baseline values (P > .05). CONCLUSION: SXSHP effectively improved PCI vertigo by inhibiting blood viscosity, regulating blood lipid levels, anti-inflammation, and improving cerebrovascular blood flow without affecting liver and kidney functions. CI - Copyright (c) 2023 the Author(s). Published by Wolters Kluwer Health, Inc. FAU - Zhang, Yongjian AU - Zhang Y AD - Department of Cardiology, Haiyan Traditional Chinese Medicine Hospital, Haiyan, Zhejiang Province, China. FAU - Xu, Lin AU - Xu L AUID- ORCID: 0009-0000-8388-681 AD - Department of Cardiology, Zhejiang Tongde Hospital, Hangzhou, Zhejiang Province, China. FAU - Wang, Xiaoping AU - Wang X AD - Department of Cardiology, Haiyan Traditional Chinese Medicine Hospital, Haiyan, Zhejiang Province, China. FAU - Ma, Jianjun AU - Ma J AD - Department of Cardiology, Haiyan Traditional Chinese Medicine Hospital, Haiyan, Zhejiang Province, China. FAU - Song, Xiaping AU - Song X AD - Department of Cardiology, Haiyan Traditional Chinese Medicine Hospital, Haiyan, Zhejiang Province, China. FAU - Lv, Heng AU - Lv H AD - Department of Cardiology, Zhejiang Tongde Hospital, Hangzhou, Zhejiang Province, China. FAU - Jin, Luyao AU - Jin L AD - Department of Cardiology, Haiyan Traditional Chinese Medicine Hospital, Haiyan, Zhejiang Province, China. LA - eng PT - Journal Article PT - Randomized Controlled Trial PL - United States TA - Medicine (Baltimore) JT - Medicine JID - 2985248R RN - 0 (Drugs, Chinese Herbal) SB - IM MH - Humans MH - *Percutaneous Coronary Intervention MH - Vertigo/drug therapy MH - Treatment Outcome MH - Medicine, Chinese Traditional MH - *Coronary Disease/drug therapy MH - Ischemia/drug therapy MH - *Drugs, Chinese Herbal/therapeutic use PMC - PMC10735062 COIS- The authors have no conflicts of interest to disclose. EDAT- 2023/12/22 19:43 MHDA- 2023/12/25 06:42 PMCR- 2023/12/22 CRDT- 2023/12/22 13:43 PHST- 2023/12/25 06:42 [medline] PHST- 2023/12/22 19:43 [pubmed] PHST- 2023/12/22 13:43 [entrez] PHST- 2023/12/22 00:00 [pmc-release] AID - 00005792-202312220-00009 [pii] AID - 10.1097/MD.0000000000036604 [doi] PST - ppublish SO - Medicine (Baltimore). 2023 Dec 22;102(51):e36604. doi: 10.1097/MD.0000000000036604. PMID- 38117483 OWN - NLM STAT- MEDLINE DCOM- 20240215 LR - 20260711 IS - 2380-6591 (Electronic) IS - 2380-6583 (Print) VI - 9 IP - 2 DP - 2024 Feb 1 TI - Dual Antiplatelet Therapy De-Escalation in Stabilized Myocardial Infarction With High Ischemic Risk: Post Hoc Analysis of the TALOS-AMI Randomized Clinical Trial. PG - 125-133 LID - 10.1001/jamacardio.2023.4587 [doi] AB - IMPORTANCE: In patients with acute myocardial infarction (AMI) who have high ischemic risk, data on the efficacy and safety of the de-escalation strategy of switching from ticagrelor to clopidogrel are lacking. OBJECTIVE: To evaluate the outcomes of the de-escalation strategy compared with dual antiplatelet therapy (DAPT) with ticagrelor in stabilized patients with AMI and high ischemic risk following percutaneous coronary intervention (PCI). DESIGN, SETTING, AND PARTICIPANTS: This was a post hoc analysis of the Ticagrelor vs Clopidogrel in Stabilized Patients With Acute Myocardial Infarction (TALOS-AMI) trial, an open-label, assessor-blinded, multicenter, randomized clinical trial. Patients with AMI who had no event during 1 month of ticagrelor-based DAPT after PCI were included. High ischemic risk was defined as having a history of diabetes or chronic kidney disease, multivessel PCI, at least 3 lesions treated, total stent length greater than 60 mm, at least 3 stents implanted, left main PCI, or bifurcation PCI with at least 2 stents. Data were collected from February 14, 2014, to January 21, 2021, and analyzed from December 1, 2021, to June 30, 2022. INTERVENTION: Patients were randomly assigned to either de-escalation from ticagrelor to clopidogrel or ticagrelor-based DAPT. MAIN OUTCOMES AND MEASURES: Ischemic outcomes (composite of cardiovascular death, myocardial infarction, ischemic stroke, ischemia-driven revascularization, or stent thrombosis) and bleeding outcomes (Bleeding Academic Research Consortium type 2, 3, or 5 bleeding) were evaluated. RESULTS: Of 2697 patients with AMI (mean [SD] age, 60.0 [11.4] years; 454 [16.8%] female), 1371 (50.8%; 684 assigned to de-escalation and 687 assigned to ticagrelor-based DAPT) had high ischemic risk features and a significantly higher risk of ischemic outcomes than those without high ischemic risk (1326 patients [49.2%], including 665 assigned to de-escalation and 661 assigned to ticagrelor-based DAPT) (hazard ratio [HR], 1.74; 95% CI, 1.15-2.63; P = .01). De-escalation to clopidogrel, compared with ticagrelor-based DAPT, showed no significant difference in ischemic risk across the high ischemic risk group (HR, 0.88; 95% CI, 0.54-1.45; P = .62) and the non-high ischemic risk group (HR, 0.65; 95% CI, 0.33-1.28; P = .21), without heterogeneity (P for interaction = .47). The bleeding risk of the de-escalation group was consistent in both the high ischemic risk group (HR, 0.64; 95% CI, 0.37-1.11; P = .11) and the non-high ischemic risk group (HR, 0.42; 95% CI, 0.24-0.75; P = .003), without heterogeneity (P for interaction = .32). CONCLUSIONS AND RELEVANCE: In stabilized patients with AMI, the ischemic and bleeding outcomes of an unguided de-escalation strategy with clopidogrel compared with a ticagrelor-based DAPT strategy were consistent without significant interaction, regardless of the presence of high ischemic risk. FAU - Lee, Myunhee AU - Lee M AD - Division of Cardiology, Department of Internal Medicine, Daejeon St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. FAU - Byun, Sungwook AU - Byun S AD - Division of Cardiology, Department of Internal Medicine, Bucheon St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. FAU - Lim, Sungmin AU - Lim S AD - Division of Cardiology, Department of Internal Medicine, Uijeongbu St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. AD - Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. FAU - Choo, Eun Ho AU - Choo EH AD - Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. AD - Division of Cardiology, Department of Internal Medicine, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. FAU - Lee, Kwan Yong AU - Lee KY AD - Division of Cardiology, Department of Internal Medicine, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. FAU - Moon, Donggyu AU - Moon D AD - Division of Cardiology, Department of Internal Medicine, St Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. FAU - Choi, Ik Jun AU - Choi IJ AD - Division of Cardiology, Department of Internal Medicine, Incheon St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. FAU - Hwang, Byung-Hee AU - Hwang BH AD - Division of Cardiology, Department of Internal Medicine, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. FAU - Kim, Chan Joon AU - Kim CJ AD - Division of Cardiology, Department of Internal Medicine, Uijeongbu St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. FAU - Park, Mahn-Won AU - Park MW AD - Division of Cardiology, Department of Internal Medicine, Daejeon St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. FAU - Choi, Yun Seok AU - Choi YS AD - Division of Cardiology, Department of Internal Medicine, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. FAU - Kim, Hee-Yeol AU - Kim HY AD - Division of Cardiology, Department of Internal Medicine, Bucheon St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. FAU - Yoo, Ki-Dong AU - Yoo KD AD - Division of Cardiology, Department of Internal Medicine, St Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. FAU - Jeon, Doo-Soo AU - Jeon DS AD - Division of Cardiology, Department of Internal Medicine, Incheon St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. FAU - Yim, Hyeon Woo AU - Yim HW AD - Department of Preventive Medicine, Clinical Research Coordinating Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. FAU - Chang, Kiyuk AU - Chang K AD - Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. AD - Division of Cardiology, Department of Internal Medicine, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. CN - TALOS-AMI Investigators LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PL - United States TA - JAMA Cardiol JT - JAMA cardiology JID - 101676033 RN - 0 (Platelet Aggregation Inhibitors) RN - GLH0314RVC (Ticagrelor) RN - A74586SNO7 (Clopidogrel) SB - IM MH - Humans MH - Female MH - Middle Aged MH - Male MH - Platelet Aggregation Inhibitors/therapeutic use MH - Ticagrelor/therapeutic use MH - Clopidogrel/therapeutic use MH - *Percutaneous Coronary Intervention/adverse effects MH - *Myocardial Infarction/drug therapy MH - Hemorrhage/chemically induced/epidemiology PMC - PMC10733848 COIS- Conflict of Interest Disclosures: Dr Chang reported receiving grants from Chongkundang Pharm, Medtronic, Abbott, and Boston Scientific. No other disclosures were reported. FIR - Jeong, Myung Ho IR - Jeong MH FIR - Park, Chul-Soo IR - Park CS FIR - Shin, Woo Seung IR - Shin WS FIR - Kim, Dong Bin IR - Kim DB FIR - Jung, Sang Shik IR - Jung SS FIR - Cho, Byung Ryeol IR - Cho BR FIR - Ko, Jin Shin IR - Ko JS FIR - Kim, Won IR - Kim W FIR - Huh, Seung Ho IR - Huh SH FIR - Kim, Ki Sik IR - Kim KS FIR - Kim, Sang Hyeon IR - Kim SH FIR - Cho, Chang Hyeon IR - Cho CH FIR - Park, Sang Ho IR - Park SH FIR - Yoon, Myung Ho IR - Yoon MH FIR - Park, Jong Sun IR - Park JS FIR - Park, Kyung Min IR - Park KM FIR - Lee, Seoung Hwan IR - Lee SH FIR - Chung, Kyung Tae IR - Chung KT FIR - Do, Joon Hyeong IR - Do JH FIR - Kim, Sang Wook IR - Kim SW FIR - Baek, Joo Yeol IR - Baek JY FIR - Shim, Byung Joo IR - Shim BJ FIR - Sung, Ki Chul IR - Sung KC FIR - Oh, Ju Hyun IR - Oh JH FIR - Cha, Kwang Soo IR - Cha KS FIR - Cho, Young Hoon IR - Cho YH FIR - Jang, Jae Sik IR - Jang JS FIR - Cho, Jin Man IR - Cho JM FIR - Lee, Jang Hoon IR - Lee JH EDAT- 2023/12/20 12:42 MHDA- 2024/02/15 06:43 PMCR- 2024/12/20 CRDT- 2023/12/20 11:33 PHST- 2024/02/15 06:43 [medline] PHST- 2023/12/20 12:42 [pubmed] PHST- 2023/12/20 11:33 [entrez] PHST- 2024/12/20 00:00 [pmc-release] AID - 2813198 [pii] AID - hoi230064 [pii] AID - 10.1001/jamacardio.2023.4587 [doi] PST - ppublish SO - JAMA Cardiol. 2024 Feb 1;9(2):125-133. doi: 10.1001/jamacardio.2023.4587. PMID- 38084483 OWN - NLM STAT- MEDLINE DCOM- 20240327 LR - 20260608 IS - 1879-0844 (Electronic) IS - 1388-9842 (Linking) VI - 26 IP - 2 DP - 2024 Feb TI - Impact of anaemia and iron deficiency on outcomes in cardiogenic shock complicating acute myocardial infarction. PG - 448-457 LID - 10.1002/ejhf.3099 [doi] AB - AIMS: Anaemia and iron deficiency (ID) are common comorbidities in cardiovascular patients and are associated with a poor clinical status, as well as a worse outcome in patients with heart failure and acute myocardial infarction (AMI). Nevertheless, data concerning the impact of anaemia and ID on clinical outcomes in patients with cardiogenic shock (CS) are scarce. This study aimed to assess the impact of anaemia and ID on clinical outcomes in patients with CS complicating AMI. METHODS AND RESULTS: The presence of anaemia (haemoglobin <13 g/dl in men and <12 g/dl in women) or ID (ferritin <100 ng/ml or transferrin saturation <20%) was determined in patients with CS due to AMI from the CULPRIT-SHOCK trial. Blood samples were collected in the catheterization laboratory during initial percutaneous coronary intervention. Clinical outcomes were compared in four groups of patients having neither anaemia nor ID, against patients with anaemia with or without ID and patients with ID only. A total of 427 CS patients were included in this analysis. Anaemia without ID was diagnosed in 93 (21.7%), anaemia with ID in 54 study participants (12.6%), ID without anaemia in 72 patients (16.8%), whereas in 208 patients neither anaemia nor ID was present (48.9%). CS patients with anaemia without ID were older (73 +/- 10 years, p = 0.001), had more frequently a history of arterial hypertension (72.8%, p = 0.01), diabetes mellitus (47.8%, p = 0.001), as well as chronic kidney disease (14.1%, p = 0.004) compared to CS patients in other groups. Anaemic CS patients without ID presence were at higher risk to develop a composite from all-cause death or renal replacement therapy at 30-day follow-up (odds ratio [OR] 3.83, 95% confidence interval [CI] 2.23-6.62, p < 0.001) than CS patients without anaemia/ID. The presence of ID in CS patients, with and without concomitant anaemia, did not increase the risk for the primary outcome (OR 1.17, 95% CI 0.64-2.13, p = 0.64; and OR 1.01, 95% CI 0.59-1.73, p = 0.54; respectively) within 30 days of follow-up. In time-to-event Kaplan-Meier analysis, anaemic CS patients without ID had a significantly higher hazard ratio (HR) for the primary outcome (HR 2.11, 95% CI 1.52-2.89, p < 0.001), as well as for death from any cause (HR 1.90, 95% CI 1.36-2.65, p < 0.001) and renal replacement therapy during 30-day follow-up (HR 2.99, 95% CI 1.69-5.31, p < 0.001). CONCLUSION: Concomitant anaemia without ID presence in patients with CS at hospital presentation is associated with higher risk for death from any cause or renal replacement therapy and the individual components of this composite endpoint within 30 days after hospitalization. ID has no relevant impact on clinical outcomes in patients with CS. CI - (c) 2023 The Authors. European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology. FAU - Obradovic, Danilo AU - Obradovic D AD - Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig, Germany. FAU - Loncar, Goran AU - Loncar G AD - Institute for Cardiovascular Diseases 'Dedinje', University of Belgrade, Belgrade, Serbia. AD - Faculty of Medicine, University of Belgrade, Belgrade, Serbia. FAU - Zeymer, Uwe AU - Zeymer U AD - Klinikum der Stadt Ludwigshafen and Institut fur Herzinfarktforschung, Ludwigshafen am Rhein, Germany. FAU - Poss, Janine AU - Poss J AD - Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig, Germany. FAU - Feistritzer, Hans-Josef AU - Feistritzer HJ AD - Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig, Germany. FAU - Freund, Anne AU - Freund A AD - Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig, Germany. FAU - Jobs, Alexander AU - Jobs A AD - Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig, Germany. FAU - Fuernau, Georg AU - Fuernau G AD - Clinic for Internal Medicine II, Dessau-Rosslau, Germany. FAU - Desch, Steffen AU - Desch S AD - Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig, Germany. FAU - Ceglarek, Uta AU - Ceglarek U AD - Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, Leipzig University Hospital, Leipzig, Germany. FAU - Isermann, Berend AU - Isermann B AD - Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, Leipzig University Hospital, Leipzig, Germany. FAU - von Haehling, Stephan AU - von Haehling S AD - Department of Cardiology and Pneumology, University Medicine Gottingen (UMG), Gottingen, Germany. FAU - Anker, Stefan D AU - Anker SD AD - Department of Cardiology (CVK), Berlin Institute of Health Center for Regenerative Therapies (BCRT), German Centre for Cardiovascular Research (DZHK) Partner Site Berlin, Charite Universitatsmedizin, Berlin, Germany. FAU - Buttner, Petra AU - Buttner P AD - Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig, Germany. FAU - Thiele, Holger AU - Thiele H AD - Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig, Germany. LA - eng GR - Funding from institutional sources, no specific grant/ PT - Journal Article DEP - 20240101 PL - England TA - Eur J Heart Fail JT - European journal of heart failure JID - 100887595 SB - IM MH - Male MH - Humans MH - Female MH - Shock, Cardiogenic/etiology/therapy/diagnosis MH - *Heart Failure/complications MH - Treatment Outcome MH - *Myocardial Infarction/complications/therapy MH - *Anemia/complications MH - *Anemia, Iron-Deficiency/etiology MH - *Percutaneous Coronary Intervention/adverse effects OTO - NOTNLM OT - Acute myocardial infarction OT - Anaemia OT - Cardiogenic shock OT - Iron deficiency EDAT- 2023/12/12 06:42 MHDA- 2024/03/27 06:43 CRDT- 2023/12/12 04:23 PHST- 2023/11/13 00:00 [revised] PHST- 2023/07/21 00:00 [received] PHST- 2023/11/26 00:00 [accepted] PHST- 2024/03/27 06:43 [medline] PHST- 2023/12/12 06:42 [pubmed] PHST- 2023/12/12 04:23 [entrez] AID - 10.1002/ejhf.3099 [doi] PST - ppublish SO - Eur J Heart Fail. 2024 Feb;26(2):448-457. doi: 10.1002/ejhf.3099. Epub 2024 Jan 1. PMID- 38055276 OWN - NLM STAT- MEDLINE DCOM- 20231207 LR - 20260726 IS - 2574-3805 (Electronic) IS - 2574-3805 (Linking) VI - 6 IP - 12 DP - 2023 Dec 1 TI - Statins, Mortality, and Major Adverse Cardiovascular Events Among US Veterans With Chronic Kidney Disease. PG - e2346373 LID - 10.1001/jamanetworkopen.2023.46373 [doi] LID - e2346373 AB - IMPORTANCE: There are limited data for the utility of statins for primary prevention of atherosclerotic cardiovascular disease (ASCVD) and death in adults with chronic kidney disease (CKD). OBJECTIVE: To evaluate the association of statin use with all-cause mortality and major adverse cardiovascular events (MACE) among US veterans older than 65 years with CKD stages 3 to 4. DESIGN, SETTING, AND PARTICIPANTS: This cohort study used a target trial emulation design for statin initiation among veterans with moderate CKD (stages 3 or 4) using nested trials with a propensity weighting approach. Linked Veterans Affairs (VA) Healthcare System, Medicare, and Medicaid data were used. This study considered veterans newly diagnosed with moderate CKD between 2005 and 2015 in the VA, with follow-up through December 31, 2017. Veterans were older than 65 years, within 5 years of CKD diagnosis, had no prior ASCVD or statin use, and had at least 1 clinical visit in the year prior to trial baseline. Eligibility criteria were assessed for each nested trial, and Cox proportional hazards models with bootstrapping were run. Analysis was conducted from July 2021 to October 2023. EXPOSURE: Statin initiation vs none. MAIN OUTCOMES AND MEASURES: Primary outcome was all-cause mortality; secondary outcome was time to first MACE (myocardial infarction, transient ischemic attack, stroke, revascularization, or mortality). RESULTS: Included in the analysis were 14 828 veterans. Mean (SD) age at CKD diagnosis was 76.9 (8.2) years, 14 616 (99%) were men, 10 539 (72%) White, and 2568 (17%) Black. After expanding to person-trials and assessing eligibility at each baseline, there were 151 243 person-trials (14 685 individuals) of nonstatin initiators and 2924 person-trials (2924 individuals) of statin initiators included. Propensity score adjustment via overlap weighting with nonparametric bootstrapping resulted in covariate balance, with mean (SD) follow-up of 3.6 (2.7) years. The hazard ratio for all-cause mortality was 0.91 (95% CI, 0.85-0.97) comparing statin initiators to noninitiators. The hazard ratio for MACE was 0.96 (95% CI, 0.91-1.02). Results remained consistent in prespecified subgroup analyses. CONCLUSIONS AND RELEVANCE: In this target trial emulation of statin initiation in US veterans older than 65 years with CKD stages 3 to 4 and no prior ASCVD, statin initiation was significantly associated with a lower risk of all-cause mortality but not MACE. Results should be confirmed in a randomized clinical trial. FAU - Barayev, Odeya AU - Barayev O AD - Ben Gurion University of the Negev, Be'er Sheva, Israel. FAU - Hawley, Chelsea E AU - Hawley CE AD - New England Geriatric Research Education and Clinical Center, Bedford and Boston, Massachusetts. FAU - Wellman, Helen AU - Wellman H AD - Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston. FAU - Gerlovin, Hanna AU - Gerlovin H AD - Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston. FAU - Hsu, Whitney AU - Hsu W AD - VA Boston Healthcare System, Department of Pharmacy, Boston, Massachusetts. FAU - Paik, Julie M AU - Paik JM AD - New England Geriatric Research Education and Clinical Center, Bedford and Boston, Massachusetts. AD - Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. AD - Division of Renal Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. FAU - Mandel, Ernest I AU - Mandel EI AD - Division of Renal Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. FAU - Liu, Christine K AU - Liu CK AD - Section of Geriatrics, Department of Medicine, Stanford University School of Medicine, Stanford, California. AD - Geriatric Research Education and Clinical Center, Palo Alto VA Medical Center, Palo Alto, California. FAU - Djousse, Luc AU - Djousse L AD - Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston. AD - Division of Aging, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. FAU - Gaziano, J Michael AU - Gaziano JM AD - Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston. AD - Division of Aging, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. FAU - Gagnon, David R AU - Gagnon DR AD - Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston. AD - Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts. FAU - Orkaby, Ariela R AU - Orkaby AR AD - New England Geriatric Research Education and Clinical Center, Bedford and Boston, Massachusetts. AD - Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston. AD - Division of Aging, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. LA - eng GR - IK2 CX001800/CX/CSRD VA/United States GR - R01 DK133509/DK/NIDDK NIH HHS/United States GR - K23 AG057813/AG/NIA NIH HHS/United States GR - R03 AG060169/AG/NIA NIH HHS/United States PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't PT - Research Support, U.S. Gov't, Non-P.H.S. DEP - 20231201 PL - United States TA - JAMA Netw Open JT - JAMA network open JID - 101729235 RN - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors) SB - IM MH - United States/epidemiology MH - Adult MH - Male MH - Aged MH - Humans MH - Female MH - *Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use MH - Cohort Studies MH - *Veterans MH - Medicare MH - *Atherosclerosis/drug therapy MH - *Renal Insufficiency, Chronic/epidemiology PMC - PMC10701610 COIS- Conflict of Interest Disclosures: Dr Wellman reported receiving personal fees from Novartis Inc outside the submitted work. Dr Djousse reported receiving grants from Novartis during the conduct of the study. Dr Gaziano reported receiving grants from Novartis outside the submitted work. Dr Orkaby reported receiving grants from the National Institutes of Health and the Department of Veterans Affairs (VA) as well as personal fees from Anthos Therapeutics during the conduct of the study. No other disclosures were reported. EDAT- 2023/12/06 12:42 MHDA- 2023/12/07 12:42 PMCR- 2023/12/06 CRDT- 2023/12/06 11:34 PHST- 2023/12/07 12:42 [medline] PHST- 2023/12/06 12:42 [pubmed] PHST- 2023/12/06 11:34 [entrez] PHST- 2023/12/06 00:00 [pmc-release] AID - 2812582 [pii] AID - zoi231355 [pii] AID - 10.1001/jamanetworkopen.2023.46373 [doi] PST - epublish SO - JAMA Netw Open. 2023 Dec 1;6(12):e2346373. doi: 10.1001/jamanetworkopen.2023.46373. PMID- 38055177 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240301 IS - 2193-8261 (Print) IS - 2193-6544 (Electronic) IS - 2193-6544 (Linking) VI - 13 IP - 1 DP - 2024 Mar TI - Impact of Access Site on Periprocedural Bleeding and Cerebral and Coronary Events in High-Bleeding-Risk Percutaneous Coronary Intervention: Findings from the RIVA-PCI Trial. PG - 89-101 LID - 10.1007/s40119-023-00343-4 [doi] AB - INTRODUCTION: The preference for using transradial access (TRA) over transfemoral access (TFA) in patients requiring percutaneous coronary intervention (PCI) is based on evidence suggesting that TRA is associated with less bleeding and fewer vascular complications, shorter hospital stays, improved quality of life, and a potential beneficial effect on mortality. We have limited study data comparing the two access routes in a patient population with atrial fibrillation (AF) undergoing PCI, who have a particular increased risk of bleeding, while AF itself is associated with an increased risk of thromboembolism. METHODS: Using data from the RIVA-PCI registry, which includes patients with AF undergoing PCI, we analyzed a high-bleeding-risk (HBR) cohort. These patients were predominantly on oral anticoagulants (OAC) for AF, and the PCI was performed via radial or femoral access. Endpoints examined were in-hospital bleeding (BARC 2-5), cerebral events (TIA, hemorrhagic or ischemic stroke) and coronary events (stent thrombosis and myocardial infarction). RESULTS: Out of 1636 patients, 854 (52.2%) underwent TFA, while 782 (47.8%) underwent the procedure via TRA, including nine patients with brachial artery puncture. The mean age was 75.5 years. Groups were similar in terms of age, sex distribution, AF type, cardiovascular history, risk factors, and comorbidities, except for a higher incidence of previous bypass surgeries, heart failure, hyperlipidemia, and chronic kidney disease (CKD) with a glomerular filtration rate (GFR) < 60 ml/min in the TFA group. No clinically relevant differences in antithrombotic therapy and combinations were present at the time of PCI. However, upon discharge, transradial PCI patients had a higher rate of triple therapy, while dual therapy was preferred after transfemoral procedures. Radial access was more frequently chosen for non-ST-segment elevation myocardial infarction (NSTEMI) and unstable angina pectoris (UAP) cases (NSTEMI 26.6% vs. 17.0%, p < 0.0001; UAP 21.5% vs. 14.5%, p < 0.001), while femoral access was more common for elective PCI (60.3% vs. 44.1%, p < 0.0001). No differences were observed for ST-segment elevation myocardial infarction (STEMI). Both groups had similar rates of cerebral events (TFA 0.2% vs. TRA 0.3%, p = 0.93), but the TFA group had a higher incidence of bleeding (BARC 2-5) (4.2% vs. 1.5%, p < 0.01), mainly driven by BARC 3 bleeding (1.5% vs. 0.4%, p < 0.05). No significant differences were found for stent thrombosis and myocardial infarction (TFA 0.2% vs. TRA 0.3%, p = 0.93; TFA 0.4% vs. TRA 0.1%, p = 0.36). CONCLUSIONS: In HBR patients with AF undergoing PCI for acute or chronic coronary syndrome, the use of TRA might be associated with a decrease in in-hospital bleeding, while not increasing the risk of embolic or ischemic events compared to femoral access. Further studies are required to confirm these preliminary findings. CI - (c) 2023. The Author(s). FAU - Borlich, Martin AU - Borlich M AUID- ORCID: 0000-0002-1608-4152 AD - Herz- und Gefasszentrum, Segeberger Kliniken GmbH, Am Kurpark 1, Bad Segeberg, Schleswig-Holstein, 23795, Bad Segeberg, Germany. martin.borlich@segebergerkliniken.de. FAU - Zeymer, Uwe AU - Zeymer U AD - Medizinische Klinik B, Klinikum Ludwigshafen, Ludwigshafen, Germany. AD - Institut fur Herzinfarktforschung Ludwigshafen, Ludwigshafen, Germany. FAU - Wienbergen, Harm AU - Wienbergen H AD - Klinikum Links der Weser Bremen, Bremen, Germany. FAU - Hobbach, Hans-Peter AU - Hobbach HP AD - Kreisklinikum Siegen, Siegen, Germany. FAU - Cuneo, Alessandro AU - Cuneo A AD - Krankenhaus und MVZ Maria-Hilf Stadtlohn, Stadtlohn, Germany. FAU - Bekeredjian, Raffi AU - Bekeredjian R AD - Robert-Bosch-Klinikum, Stuttgart, Germany. FAU - Ritter, Oliver AU - Ritter O AD - Klinikum Brandenburg Havel, Brandenburg, Germany. FAU - Hailer, Birgit AU - Hailer B AD - Katholische Kliniken Essen-Nord-West gGmbH, Essen, Germany. FAU - Hertting, Klaus AU - Hertting K AD - Krankenhaus Buchholz und Winsen GmbH, Buchholz, Germany. FAU - Hennersdorf, Marcus AU - Hennersdorf M AD - SLK-Kliniken Heilbronn GmbH, Heilbronn, Germany. FAU - Scholtz, Werner AU - Scholtz W AD - Herz-und Diabeteszentrum, Bad Oeynhausen, Germany. FAU - Lanzer, Peter AU - Lanzer P AD - Gesundheitszentrum Bitterfeld Wolfen, Bitterfeld, Germany. FAU - Mudra, Harald AU - Mudra H AD - Stadtisches Krankenhaus Neuperlach-Munchen, Munich, Germany. FAU - Schwefer, Markus AU - Schwefer M AD - Elblandklinikum Riesa, Riesa, Germany. FAU - Schwimmbeck, Peter-Lothar AU - Schwimmbeck PL AD - Klinikum Leverkusen, Leverkusen, Germany. FAU - Liebetrau, Christoph AU - Liebetrau C AD - Kerckhoff-Klinik GmbH, Bad Nauheim, Germany. FAU - Thiele, Holger AU - Thiele H AD - Herzzentrum Leipzig der Universitat Leipzig, Leipzig, Germany. FAU - Claas, Christoph AU - Claas C AD - Institut fur Herzinfarktforschung Ludwigshafen, Ludwigshafen, Germany. FAU - Riemer, Thomas AU - Riemer T AD - Institut fur Herzinfarktforschung Ludwigshafen, Ludwigshafen, Germany. FAU - Zahn, Ralf AU - Zahn R AD - Medizinische Klinik B, Klinikum Ludwigshafen, Ludwigshafen, Germany. FAU - Iden, Leon AU - Iden L AD - Herz- und Gefasszentrum, Segeberger Kliniken GmbH, Am Kurpark 1, Bad Segeberg, Schleswig-Holstein, 23795, Bad Segeberg, Germany. FAU - Richardt, Gert AU - Richardt G AD - Herz- und Gefasszentrum, Segeberger Kliniken GmbH, Am Kurpark 1, Bad Segeberg, Schleswig-Holstein, 23795, Bad Segeberg, Germany. FAU - Toelg, Ralph AU - Toelg R AD - Herz- und Gefasszentrum, Segeberger Kliniken GmbH, Am Kurpark 1, Bad Segeberg, Schleswig-Holstein, 23795, Bad Segeberg, Germany. AD - Medizinische Fakultat der Christian-Albrechts-Universitat zu Kiel, Kiel, Germany. LA - eng PT - Journal Article DEP - 20231206 PL - England TA - Cardiol Ther JT - Cardiology and therapy JID - 101634495 PMC - PMC10899132 OTO - NOTNLM OT - Access site OT - Dual therapy OT - High-bleeding-risk OT - In-hospital bleeding OT - Percutaneous coronary intervention OT - RIVA PCI OT - Radial access COIS- The article is original, with no portion under simultaneous consideration for publication elsewhere or previously published. All authors have read and approved the submission. Martin Borlich, Uwe Zeymer, Harm Wienbergen, Hans-Peter Hobbach, Alessandro Cuneo, Raffi Bekeredjian, Oliver Ritter, Birgit Hailer, Klaus Hertting, Marcus Hennersdorf, Werner Scholtz, Peter Lanzer, Harald Mudra, Markus Schwefer, Peter-Lothar Schwimmbeck, Christoph Liebetrau, Holger Thiele, Christoph Claas, Thomas Riemer, Ralf Zahn, Leon Iden, Gert Richardt and Ralph Toelg declare no conflicts of interest. EDAT- 2023/12/06 12:42 MHDA- 2023/12/06 12:43 PMCR- 2023/12/06 CRDT- 2023/12/06 11:13 PHST- 2023/09/30 00:00 [received] PHST- 2023/11/14 00:00 [accepted] PHST- 2023/12/06 12:43 [medline] PHST- 2023/12/06 12:42 [pubmed] PHST- 2023/12/06 11:13 [entrez] PHST- 2023/12/06 00:00 [pmc-release] AID - 10.1007/s40119-023-00343-4 [pii] AID - 343 [pii] AID - 10.1007/s40119-023-00343-4 [doi] PST - ppublish SO - Cardiol Ther. 2024 Mar;13(1):89-101. doi: 10.1007/s40119-023-00343-4. Epub 2023 Dec 6. PMID- 38022428 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20231201 IS - 1011-6842 (Print) IS - 1011-6842 (Linking) VI - 39 IP - 6 DP - 2023 Nov TI - Renal Impact of Culprit-Only versus Multi-Vessel Revascularization for Cardiogenic Shock Complicating Acute Myocardial Infarction: Systematic Review and Meta-Analysis. PG - 817-830 LID - 10.6515/ACS.202311_39(6).20230307A [doi] AB - BACKGROUND: The optimal strategy of percutaneous coronary intervention (PCI) for acute myocardial infarction (MI) complicated with cardiogenic shock (CS) remains controversial. We aimed to elucidate the renal and cardiovascular impact of culprit-only (C) revascularization versus additional interventions on non-infarct-related arteries. METHODS: PubMed, Embase, MEDLINE, and Cochrane Library were searched for relevant literature. A total of 96,812 subjects [C-PCI: 69,986; multi-vessel (MV)-PCI: 26,826] in nine studies (one randomized control trial; eight observational cohort studies) were enrolled. RESULTS: MV-PCI was associated with a higher kidney event rate [relative risk (RR): 1.29, 95% confidence interval (CI): 1.12-1.49; p < 0.001]. However, the all-cause mortality rate was comparable both during admission (RR: 1.07, 95% CI: 0.94-1.22; p = 0.30) and at one year (RR: 0.96, 95% CI: 0.79-1.16; p = 0.65). MV-PCI was associated with a greater risk of stroke (RR: 1.19, 95% CI: 1.08-1.32; p < 0.001) and bleeding events (RR: 1.27, 95% CI: 1.07-1.51; p = 0.006), but reduced risk of recurrent MI (RR: 0.89, 95% CI: 0.82-0.97; p = 0.009) and repeat revascularization (RR: 0.34, 95% CI: 0.16-0.71; p = 0.004). No increased risk of coronary artery bypass grafting was present (RR: 1.09, 95% CI: 0.38-3.17; p = 0.87). CONCLUSIONS: C-PCI was associated with a lower rate of renal dysfunction but not all-cause mortality in patients with CS complicating acute MI. FAU - Kao, Ting-Wei AU - Kao TW AD - Department of Internal Medicine, National Taiwan University Hospital. FAU - Huang, Ching-Chang AU - Huang CC AD - Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, Cardiovascular Center, National Taiwan University Hospital. FAU - Tsai, Cheng-Hsuan AU - Tsai CH AD - Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, National Taiwan University Hospital, Taipei. FAU - Chen, Jui-Yi AU - Chen JY AD - Division of Nephrology, Department of Internal Medicine, Chi Mei Medical Center. AD - Department of Health and Nutrition, Chia Nan University of Pharmacy and Science, Tainan. FAU - Huang, Tao-Min AU - Huang TM AD - Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University. AD - NSARF: National Taiwan University Hospital Study Group on Acute Renal Failure, Taipei, Taiwan. FAU - Lin, Ting-Tse AU - Lin TT AD - Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, Cardiovascular Center, National Taiwan University Hospital. FAU - Hung, Chi-Sheng AU - Hung CS AD - Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, Cardiovascular Center, National Taiwan University Hospital. FAU - Wu, Vin-Cent AU - Wu VC AD - Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University. AD - NSARF: National Taiwan University Hospital Study Group on Acute Renal Failure, Taipei, Taiwan. FAU - Kao, Hsien-Li AU - Kao HL AD - Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, Cardiovascular Center, National Taiwan University Hospital. FAU - Chen, Wen-Jone AU - Chen WJ AD - Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, Cardiovascular Center, National Taiwan University Hospital. FAU - Lin, Yen-Hung AU - Lin YH AD - Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, Cardiovascular Center, National Taiwan University Hospital. LA - eng PT - Journal Article PL - China (Republic : 1949- ) TA - Acta Cardiol Sin JT - Acta Cardiologica Sinica JID - 101687085 PMC - PMC10646599 OTO - NOTNLM OT - Angiography OT - Cardiogenic shock OT - Meta-analysis OT - Myocardial infarction OT - Percutaneous coronary revascularization COIS- All the authors declare that they have no conflicts of interest. EDAT- 2023/11/29 18:42 MHDA- 2023/11/29 18:43 PMCR- 2023/11/01 CRDT- 2023/11/29 15:23 PHST- 2022/12/15 00:00 [received] PHST- 2023/03/07 00:00 [accepted] PHST- 2023/11/29 18:43 [medline] PHST- 2023/11/29 18:42 [pubmed] PHST- 2023/11/29 15:23 [entrez] PHST- 2023/11/01 00:00 [pmc-release] AID - 10.6515/ACS.202311_39(6).20230307A [doi] PST - ppublish SO - Acta Cardiol Sin. 2023 Nov;39(6):817-830. doi: 10.6515/ACS.202311_39(6).20230307A. PMID- 38019512 OWN - NLM STAT- MEDLINE DCOM- 20231201 LR - 20260518 IS - 2574-3805 (Electronic) IS - 2574-3805 (Linking) VI - 6 IP - 11 DP - 2023 Nov 1 TI - Intravascular Imaging in Patients With Complex Coronary Lesions and Chronic Kidney Disease. PG - e2345554 LID - 10.1001/jamanetworkopen.2023.45554 [doi] LID - e2345554 AB - IMPORTANCE: As patients with chronic kidney disease (CKD) are more likely to have complex coronary lesions, intravascular imaging guidance in percutaneous coronary intervention (PCI) for this population could be potentially beneficial. OBJECTIVES: To investigate whether the outcomes of intravascular imaging-guided procedural optimization would be different according to the presence of CKD. DESIGN, SETTING, AND PARTICIPANTS: This was a prespecified substudy of RENOVATE-COMPLEX-PCI, a recently published multicenter randomized clinical trial in Korea studying the benefits of intravascular imaging for complex coronary lesions. Patients with complex coronary lesions, with or without CKD, were enrolled between May 2018 and May 2021. Data were analyzed from January to June 2023. INTERVENTIONS: PCI in each group was done either under the guidance of intravascular imaging or angiography alone. MAIN OUTCOMES AND MEASURES: The primary end point was target vessel failure (TVF) at the 3-year point, defined as a composite of cardiac death, target vessel-related myocardial infarction, or clinically driven target vessel revascularization. RESULTS: A total of 1639 patients (1300 male [79.3%]) treated with PCI for complex coronary lesions were stratified into CKD (296 participants) and non-CKD (1343 participants) groups. The mean (SD) age of each group was 70.3 (9.4) and 64.5 (10.1) years, and mean (SD) estimated serum creatinine was 2.9 (5.3) and 0.8 (0.2) mg/dL for CKD and non-CKD groups, respectively. Intravascular imaging-guided revascularization was associated with significantly lower incidence of the primary end point compared with angiography-guided revascularization in both CKD (13.3% vs 23.3%; hazard ratio [HR], 0.51; 95% CI, 0.27-0.93; P = .03) and non-CKD (6.4% vs 9.9%; HR, 0.66; 95% CI, 0.44-0.99; P = .05) groups. The significantly lower incidence of the primary end point was mainly associated with the lower risk of cardiac death or target vessel-related myocardial infarction (9.4% vs 22.2%; HR, 0.39; 95% CI, 0.20-0.76; P = .006) in the CKD group and by target vessel revascularization (3.0% vs 5.5%; HR, 0.55; 95% CI, 0.30-0.99; P = .05) in the non-CKD group. Those with a glomerular filtration rate of at least 30 mL/min/1.73m2 and less than 60 ml/kg/1.73m2 showed the greatest benefit from imaging-guided complex PCI (8.8% vs 21.2%; HR, 0.28; 95% CI, 0.11-0.68; P = .02). CONCLUSIONS AND RELEVANCE: In this prespecified cohort substudy of the Randomized Controlled Trial of Intravascular Imaging Guidance versus Angiography-Guidance on Clinical Outcomes After Complex Percutaneous Coronary Intervention trial, intravascular imaging guidance showed clinical benefit over angiography guidance in reducing the risk of TVF, regardless of the presence of CKD. The greatest benefits of imaging-guided complex PCI were observed in stage 3 CKD. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03381872. FAU - Kwon, Woochan AU - Kwon W AD - Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. FAU - Choi, Ki Hong AU - Choi KH AD - Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. FAU - Song, Young Bin AU - Song YB AD - Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. FAU - Park, Yong Hwan AU - Park YH AD - Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea. FAU - Lee, Joo Myung AU - Lee JM AD - Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. FAU - Lee, Jong-Young AU - Lee JY AD - Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea. FAU - Lee, Seung-Jae AU - Lee SJ AD - Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea. FAU - Lee, Sang Yeub AU - Lee SY AD - Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea. AD - Chung-Ang University College of Medicine, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, Korea. FAU - Kim, Sang Min AU - Kim SM AD - Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea. FAU - Yun, Kyeong Ho AU - Yun KH AD - Wonkwang University Hospital, Iksan, Korea. FAU - Cho, Jae Young AU - Cho JY AD - Wonkwang University Hospital, Iksan, Korea. FAU - Kim, Chan Joon AU - Kim CJ AD - The Catholic University of Korea, Uijeongbu St Mary's Hospital, Seoul, Korea. FAU - Ahn, Hyo-Suk AU - Ahn HS AD - The Catholic University of Korea, Uijeongbu St Mary's Hospital, Seoul, Korea. FAU - Nam, Chang-Wook AU - Nam CW AD - Keimyung University Dongsan Hospital, Daegu, Korea. FAU - Yoon, Hyuck-Jun AU - Yoon HJ AD - Keimyung University Dongsan Hospital, Daegu, Korea. FAU - Lee, Wang Soo AU - Lee WS AD - Chung-Ang University College of Medicine, Chung-Ang University Hospital, Seoul, Korea. FAU - Jeong, Jin-Ok AU - Jeong JO AD - Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea. FAU - Song, Pil Sang AU - Song PS AD - Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea. FAU - Doh, Joon-Hyung AU - Doh JH AD - Inje University Ilsan Paik Hospital, Goyang, Korea. FAU - Jo, Sang-Ho AU - Jo SH AD - Cardiovascular Center, Hallym University Sacred Heart Hospital, Anyang, Korea. FAU - Yoon, Chang-Hwan AU - Yoon CH AD - Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Korea. FAU - Hong, David AU - Hong D AD - Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. FAU - Park, Taek Kyu AU - Park TK AD - Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. FAU - Yang, Jeong Hoon AU - Yang JH AD - Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. FAU - Choi, Seung-Hyuk AU - Choi SH AD - Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. FAU - Gwon, Hyeon-Cheol AU - Gwon HC AD - Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. FAU - Hahn, Joo-Yong AU - Hahn JY AD - Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. CN - RENOVATE COMPLEX-PCI Investigators LA - eng SI - ClinicalTrials.gov/NCT03381872 PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20231101 PL - United States TA - JAMA Netw Open JT - JAMA network open JID - 101729235 SB - IM MH - Aged MH - Female MH - Humans MH - Male MH - Middle Aged MH - Death MH - Diagnostic Imaging MH - *Myocardial Infarction MH - *Percutaneous Coronary Intervention MH - *Renal Insufficiency, Chronic/epidemiology/therapy PMC - PMC10687657 COIS- Conflict of Interest Disclosures: Dr Nam reported receiving grants from Abbott and Genoss during the conduct of the study. Dr Hahn reported receiving grants from Abbott Vascular and Boston Scientific during the conduct of the study; from National Evidence-based Healthcare Collaborating Agency, the Ministry of Health and Welfare, Korea; from Biosensors; from Biotronik; from Daiichi Sankyo; from Donga-ST; from Hanmi Pharmaceutical; and from Medtronic outside the submitted work. No other disclosures were reported. FIR - Lee, Hyun-Jong IR - Lee HJ FIR - Ryu, Dong R IR - Ryu DR FIR - Park, Kyu T IR - Park KT FIR - Chang, Kiyuk IR - Chang K FIR - Kim, Seonwoo IR - Kim S FIR - Kim, Dong-Yeon IR - Kim DY FIR - Shin, Suyoun IR - Shin S FIR - Kim, Jinshil IR - Kim J FIR - Park, Jaeyoung IR - Park J FIR - Lee, Seunghyun IR - Lee S FIR - Kim, Euna IR - Kim E FIR - Kang, Hyein IR - Kang H FIR - Hwang, Su J IR - Hwang SJ FIR - Lee, Yeonhui IR - Lee Y FIR - Joh, Hyun S IR - Joh HS FIR - Im, Se Y IR - Im SY EDAT- 2023/11/29 12:42 MHDA- 2023/11/30 06:42 PMCR- 2023/11/29 CRDT- 2023/11/29 11:34 PHST- 2023/11/30 06:42 [medline] PHST- 2023/11/29 12:42 [pubmed] PHST- 2023/11/29 11:34 [entrez] PHST- 2023/11/29 00:00 [pmc-release] AID - 2812357 [pii] AID - zoi231327 [pii] AID - 10.1001/jamanetworkopen.2023.45554 [doi] PST - epublish SO - JAMA Netw Open. 2023 Nov 1;6(11):e2345554. doi: 10.1001/jamanetworkopen.2023.45554. PMID- 37890004 OWN - NLM STAT- MEDLINE DCOM- 20231117 LR - 20231121 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 102 IP - 6 DP - 2023 Nov TI - Intravascular lithotripsy compared to rotational atherectomy for the treatment of calcified distal left main coronary artery disease: A single center experience. PG - 997-1003 LID - 10.1002/ccd.30855 [doi] AB - BACKGROUND: The safety and efficacy of intravascular lithotripsy (IVL) for the treatment of calcified distal left main (LM) disease remains unclear, especially compared to rotational atherectomy (RA). METHODS: We retrospectively analyzed the baseline clinical, angiographic, intravascular ultrasound (IVUS) characteristics and procedural outcomes of 107 patients who underwent distal LM percutaneous coronary intervention (PCI) with IVL (with or without adjunct atherectomy) versus RA alone for plaque modification before stenting at a single center between 2020 and 2022. RESULTS: A total of 50 patients underwent calcium modification with IVL with or without adjunct atherectomy and 57 with RA only. The mean age was 73 years and with a high prevalence of diabetes (58.9%), chronic kidney disease (42.1%), prior revascularization (coronary artery bypass graft surgery [36.4%] or prior PCI [32.7%]). Acute coronary syndrome was the primary indication for PCI in over 50% of the patients in both groups. Medina 1-1-1 LM bifurcation disease was identified in 64% and 60% of the IVL and RA groups (p = 0.64) respectively. Final minimum stent area in distal LM (>8.2 mm(2) ), ostial LAD (>6.3 mm(2) ) and ostial LCX (>5.0 mm(2) ) were achieved in 96%, 85% and 89% of cases treated with IVL respectively and 93%, 93% and 100% of cases treated with RA respectively (LM p = 1.00; LAD p = 0.62; LCX; p = 1.00 for difference between the two groups). Procedural success (technical success without in-hospital major adverse events) was achieved in 98% of the IVL group and 86% of the RA-only group (p = 0.04). There were eight procedural complications (flow-limiting dissection, perforation, or slow/no-reflow) in the RA group compared to four in the IVL group (NS), and one patient in the RA required salvaged mechanical support compared to none in the IVL group. CONCLUSION: Plaque modification with coronary IVL appears to be efficacious and safe for the treatment of severely calcified distal LM lesions compared to RA only. Larger randomized studies are needed to confirm these findings. CI - (c) 2023 Wiley Periodicals LLC. FAU - Sandesara, Pratik B AU - Sandesara PB AUID- ORCID: 0000-0002-2809-8789 AD - Department of Medicine, Division of Cardiology, Emory University School of Medicine, Emory Heart and Vascular Center, Atlanta, Georgia, USA. FAU - Elhage Hassan, Malika AU - Elhage Hassan M AUID- ORCID: 0000-0003-1829-9322 AD - Department of Medicine, Division of Cardiology, Emory University School of Medicine, Emory Heart and Vascular Center, Atlanta, Georgia, USA. FAU - Shekiladze, Nikoloz AU - Shekiladze N AD - Department of Medicine, Division of Cardiology, Emory University School of Medicine, Emory Heart and Vascular Center, Atlanta, Georgia, USA. FAU - Turk, Ahmad Al AU - Turk AA AUID- ORCID: 0000-0002-4510-5936 AD - Department of Medicine, Division of Cardiology, Emory University School of Medicine, Emory Heart and Vascular Center, Atlanta, Georgia, USA. FAU - Montrivade, Sakolwat AU - Montrivade S AD - Department of Medicine, Division of Cardiology, Emory University School of Medicine, Emory Heart and Vascular Center, Atlanta, Georgia, USA. FAU - Gold, Daniel AU - Gold D AD - Department of Medicine, Division of Cardiology, Emory University School of Medicine, Emory Heart and Vascular Center, Atlanta, Georgia, USA. FAU - Kindya, Bryan AU - Kindya B AUID- ORCID: 0000-0002-3144-2114 AD - Department of Medicine, Division of Cardiology, Emory University School of Medicine, Emory Heart and Vascular Center, Atlanta, Georgia, USA. FAU - Rinfret, Stephane AU - Rinfret S AD - Department of Medicine, Division of Cardiology, Emory University School of Medicine, Emory Heart and Vascular Center, Atlanta, Georgia, USA. FAU - Nicholson, William J AU - Nicholson WJ AD - Department of Medicine, Division of Cardiology, Emory University School of Medicine, Emory Heart and Vascular Center, Atlanta, Georgia, USA. FAU - Jaber, Wissam A AU - Jaber WA AUID- ORCID: 0000-0003-1059-2436 AD - Department of Medicine, Division of Cardiology, Emory University School of Medicine, Emory Heart and Vascular Center, Atlanta, Georgia, USA. LA - eng PT - Journal Article DEP - 20231027 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Humans MH - Aged MH - *Coronary Artery Disease/diagnostic imaging/therapy/etiology MH - *Atherectomy, Coronary/adverse effects MH - *Percutaneous Coronary Intervention/adverse effects MH - Retrospective Studies MH - Coronary Angiography MH - Treatment Outcome MH - *Vascular Calcification/diagnostic imaging/therapy/etiology MH - *Lithotripsy/adverse effects MH - *Plaque, Atherosclerotic OTO - NOTNLM OT - intravascular lithotripsy OT - left main coronary artery OT - percutaneous coronary intervention OT - rotational atherectomy EDAT- 2023/10/27 18:42 MHDA- 2023/11/17 15:29 CRDT- 2023/10/27 14:23 PHST- 2023/08/15 00:00 [revised] PHST- 2023/03/25 00:00 [received] PHST- 2023/10/06 00:00 [accepted] PHST- 2023/11/17 15:29 [medline] PHST- 2023/10/27 18:42 [pubmed] PHST- 2023/10/27 14:23 [entrez] AID - 10.1002/ccd.30855 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2023 Nov;102(6):997-1003. doi: 10.1002/ccd.30855. Epub 2023 Oct 27. PMID- 37870080 OWN - NLM STAT- MEDLINE DCOM- 20231216 LR - 20240321 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 102 IP - 7 DP - 2023 Dec TI - Proportional troponin changes and risk for outcomes with intervention strategies in non-ST-elevation acute coronary syndrome across kidney function. PG - 1162-1176 LID - 10.1002/ccd.30863 [doi] AB - AIMS: This analysis evaluates whether proportional serial cardiac troponin (cTn) change predicts benefit from an early versus delayed invasive, or conservative treatment strategies across kidney function in non-ST-elevation acute coronary syndrome (NSTE-ACS). METHODS: Patients diagnosed with NSTE-ACS in the Veterans Health Administration between 1999 and 2022 were categorized into terciles (<20%, 20 to 80%) of proportional change in serial cTn. Primary outcome included mortality or rehospitalization for myocardial infarction at 6 and 12 months, in survivors of index admission. Adjusted hazard ratio (HR) with 95% confidence Intervals (95% confidence interval [CI]) were calculated for the primary outcome for an early invasive (24 h of index admission to 90-days postdischarge), or a conservative management. RESULTS: Chronic kidney disease (CKD) was more prevalent (45.3%) in the lowest versus 42.2% and 43% in middle and highest terciles, respectively (p < 0.001). Primary outcome is more likely for conservative versus early invasive strategy at 6 (HR: 1.44, 95% CI: 1.37-1.50) and 12 months (HR: 1.44, 95% CI: 1.39-1.50). A >80% proportional change demonstrated HR (95% CI): 0.90 (0.83-0.97) and 0.93 (0.88-1.00; p = 0.041) for primary outcome at 6 and 12 months, respectively, when an early versus delayed invasive strategy was used, across CKD stages. CONCLUSIONS: Overall, the invasive strategy was safe and associated with improved outcomes across kidney function in NSTE-ACS. Additionally, >80% proportional change in serial troponin in NSTE-ACS is associated with benefit from an early versus a delayed invasive strategy regardless of kidney function. These findings deserve confirmation in randomized controlled trials. CI - (c) 2023 The Authors. Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC. FAU - Mathew, Roy O AU - Mathew RO AUID- ORCID: 0000-0002-5582-3165 AD - Division of Nephrology, Department of Medicine, Loma Linda VA Healthcare System, Loma Linda, California, USA. AD - Division of Nephrology, Department of Medicine, Loma Linda University School of Medicine, Loma Linda, California, USA. FAU - Rangaswami, Janani AU - Rangaswami J AD - Division of Nephrology, Department of Medicine, Washington DC VA Medical Center, Washington, District of Columbia, USA. AD - Department of Medicine, George Washington University School of Medicine, Washington, District of Columbia, USA. FAU - Abramov, Dmitry AU - Abramov D AD - Division of Cardiology, Department of Medicine, Loma Linda University School of Medicine, Loma Linda, California, USA. FAU - Mahalwar, Gauranga AU - Mahalwar G AD - Department of Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA. FAU - Vellanki, Shaitalya AU - Vellanki S AD - Department of Medicine, George Washington University School of Medicine, Washington, District of Columbia, USA. FAU - Abuazzam, Farah AU - Abuazzam F AD - Division of Nephrology, Department of Medicine, Loma Linda University School of Medicine, Loma Linda, California, USA. FAU - Fraser, Gary E AU - Fraser GE AD - Division of Cardiology, Department of Medicine, Loma Linda University School of Medicine, Loma Linda, California, USA. AD - Center for Nutrition, Healthy Lifestyle, and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, California, USA. AD - Adventist Health Study, Loma Linda University, Loma Linda, California, USA. AD - Department of Preventive Medicine, School of Medicine, Loma Linda University, Loma Linda, California, USA. FAU - Butler, Fayth Miles AU - Butler FM AD - Center for Nutrition, Healthy Lifestyle, and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, California, USA. AD - Adventist Health Study, Loma Linda University, Loma Linda, California, USA. AD - Department of Preventive Medicine, School of Medicine, Loma Linda University, Loma Linda, California, USA. FAU - Lo, Kevin Bryan AU - Lo KB AD - Department of Medicine, Einstein Medical Center, Philadelphia, Pennsylvania, USA. AD - Department of Medicine, Sydney Kimmel College of Thomas Jefferson University, Philadelphia, Pennsylvania, USA. FAU - Herzog, Charles A AU - Herzog CA AD - Cardiology Division, Department of Internal Medicine, Hennepin Healthcare, University of Minnesota, Minneapolis, Minnesota, USA. FAU - Shroff, Gautam R AU - Shroff GR AUID- ORCID: 0000-0002-7614-9560 AD - Cardiology Division, Department of Internal Medicine, Hennepin Healthcare, University of Minnesota, Minneapolis, Minnesota, USA. FAU - Sidhu, Mandeep S AU - Sidhu MS AD - Division of Cardiology, Department of Medicine, Albany Medical College, Albany, New York, USA. FAU - Bangalore, Sripal AU - Bangalore S AUID- ORCID: 0000-0001-9485-0652 AD - Division of Cardiology, New York University Grossman School of Medicine, New York City, New York, USA. LA - eng PT - Journal Article DEP - 20231023 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 RN - 0 (Troponin) SB - IM MH - Humans MH - *Acute Coronary Syndrome/diagnosis/therapy MH - Troponin MH - Aftercare MH - Treatment Outcome MH - Patient Discharge MH - *Renal Insufficiency, Chronic/diagnosis/therapy MH - Kidney MH - *Percutaneous Coronary Intervention/adverse effects MH - Coronary Angiography OTO - NOTNLM OT - acute coronary syndrome OT - cardiac troponin OT - chronic kidney disease OT - coronary artery bypass grafting OT - non-ST-elevation myocardial infarction OT - percutaneous coronary intervention EDAT- 2023/10/23 12:43 MHDA- 2023/12/17 09:42 CRDT- 2023/10/23 06:54 PHST- 2023/08/17 00:00 [revised] PHST- 2023/06/21 00:00 [received] PHST- 2023/10/05 00:00 [accepted] PHST- 2023/12/17 09:42 [medline] PHST- 2023/10/23 12:43 [pubmed] PHST- 2023/10/23 06:54 [entrez] AID - 10.1002/ccd.30863 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2023 Dec;102(7):1162-1176. doi: 10.1002/ccd.30863. Epub 2023 Oct 23. PMID- 37821166 OWN - NLM STAT- MEDLINE DCOM- 20231013 LR - 20231102 IS - 1558-3597 (Electronic) IS - 0735-1097 (Linking) VI - 82 IP - 16 DP - 2023 Oct 17 TI - Comparison of Antiplatelet Monotherapies After Percutaneous Coronary Intervention According to Clinical, Ischemic, and Bleeding Risks. PG - 1565-1578 LID - S0735-1097(23)06463-X [pii] LID - 10.1016/j.jacc.2023.07.031 [doi] AB - BACKGROUND: Clopidogrel was superior to aspirin monotherapy in secondary prevention after percutaneous coronary intervention (PCI). OBJECTIVES: The purpose of this study was to evaluate the benefits of clopidogrel across high-risk subgroups METHODS: This was a post hoc analysis of the HOST-EXAM (Harmonizing Optimal Strategy for Treatment of coronary artery diseases-EXtended Antiplatelet Monotherapy) trial that randomly assigned patients who were event free for 6 to 18 months post-PCI on dual antiplatelet therapy (DAPT) to clopidogrel or aspirin monotherapy. Two clinical risk scores were used for risk stratification: the DAPT score and the Thrombolysis In Myocardial Infarction Risk Score for Secondary Prevention (TRS 2 degrees P) (the sum of age >/=75 years, diabetes, hypertension, current smoking, peripheral artery disease, stroke, coronary artery bypass grafting, heart failure, and renal dysfunction). The primary composite endpoint was a composite of all-cause death, nonfatal myocardial infarction, stroke, readmission because of acute coronary syndrome, and major bleeding (Bleeding Academic Research Consortium type >/=3) at 2 years after randomization. RESULTS: Among 5,403 patients, clopidogrel monotherapy showed a lower rate of the primary composite endpoint than aspirin monotherapy (HR: 0.73; 95% CI: 0.59-0.90). The benefit of clopidogrel over aspirin was consistent regardless of TRS 2 degrees P (high TRS 2 degrees P [>/=3] group: HR: 0.65 [95% CI: 0.44-0.96]; and low TRS 2 degrees P [<3] group: HR: 0.77 [95% CI: 0.60-0.99]) (P for interaction = 0.454) and regardless of DAPT score (high DAPT score [>/=2] group: HR: 0.68 [95% CI: 0.46-1.00]; and low DAPT score [<2] group: HR: 0.75 [95% CI: 0.59-0.96]) (P for interaction = 0.662). The association was similar for the individual outcomes. CONCLUSIONS: The beneficial effect of clopidogrel over aspirin monotherapy was consistent regardless of clinical risk or relative ischemic and bleeding risks compared with aspirin monotherapy. (Harmonizing Optimal Strategy for Treatment of Coronary Artery Stenosis- EXtended Antiplatelet Monotherapy [HOST-EXAM]; NCT02044250). CI - Copyright (c) 2023 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Yang, Seokhun AU - Yang S AD - Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea. FAU - Kang, Jeehoon AU - Kang J AD - Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea. FAU - Park, Kyung Woo AU - Park KW AD - Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea. Electronic address: kwparkmd@snu.ac.kr. FAU - Hur, Seung-Ho AU - Hur SH AD - Keimyung University Dongsan Hospital, Daegu, Republic of Korea. Electronic address: shur@dsmc.or.kr. FAU - Lee, Nam Ho AU - Lee NH AD - Kangnam Sacred Heart Hospital, Hallym University, Seoul, Republic of Korea. FAU - Hwang, Doyeon AU - Hwang D AD - Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea. FAU - Yang, Han-Mo AU - Yang HM AD - Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea. FAU - Ahn, Hyo-Suk AU - Ahn HS AD - Uijeongbu St Mary's Hospital, Uijeongbu, Republic of Korea. FAU - Cha, Kwang Soo AU - Cha KS AD - Pusan National University Hospital, Busan, Republic of Korea. FAU - Jo, Sang-Ho AU - Jo SH AD - Hallym University Sacred Heart Hospital, Anyang, Republic of Korea. FAU - Ryu, Jae Kean AU - Ryu JK AD - Daegu Catholic University Medical Center, Daegu, Republic of Korea. FAU - Suh, Il-Woo AU - Suh IW AD - Anyang SAM Medical Center, Anyang, Republic of Korea. FAU - Choi, Hyun-Hee AU - Choi HH AD - Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Republic of Korea. FAU - Woo, Seong-Ill AU - Woo SI AD - Inha University Hospital, Inha University, Incheon, Republic of Korea. FAU - Han, Jung-Kyu AU - Han JK AD - Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea. FAU - Shin, Eun-Seok AU - Shin ES AD - Ulsan University Hospital, Ulsan, Republic of Korea. FAU - Koo, Bon-Kwon AU - Koo BK AD - Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea. FAU - Kim, Hyo-Soo AU - Kim HS AD - Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea. LA - eng SI - ClinicalTrials.gov/NCT02044250 PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - United States TA - J Am Coll Cardiol JT - Journal of the American College of Cardiology JID - 8301365 RN - A74586SNO7 (Clopidogrel) RN - 0 (Platelet Aggregation Inhibitors) RN - R16CO5Y76E (Aspirin) SB - IM CIN - J Am Coll Cardiol. 2023 Oct 17;82(16):1579-1582. doi: 10.1016/j.jacc.2023.08.035. PMID: 37821167 MH - Humans MH - Aged MH - Clopidogrel/adverse effects MH - Platelet Aggregation Inhibitors MH - *Percutaneous Coronary Intervention/adverse effects MH - Drug Therapy, Combination MH - Aspirin/adverse effects MH - *Myocardial Infarction/complications MH - Hemorrhage/chemically induced/epidemiology/complications MH - *Stroke/prevention & control MH - Treatment Outcome OTO - NOTNLM OT - aspirin OT - bleeding OT - clopidogrel OT - ischemic events OT - percutaneous coronary intervention COIS- Funding Support and Author Disclosures This work was supported by grants from the Patient-Centered Clinical Research Coordinating Center (grant number: HC19C0305). This research was partially supported by a grant from Seoul National University Hospital (Research ID: 30-2021-0030). The study funders had no role in trial design; data collection, analysis, interpretation, writing of the manuscript, or decision to submit the paper for publication. Dr Kim has received research grants or speaker fees from Daiichi-Sankyo, Boston Scientific, Terumo, Biotronik, Dio, Medtronic, Abbott Vascular, Edwards Lifesciences, Amgen, and Boehringer Ingelheim outside of the submitted work. Dr Park has received speaker fees from Daiichi-Sankyo, InnoN Pharmaceutical, and DaeWoong Pharmaceutical outside of the submitted work. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2023/10/12 00:43 MHDA- 2023/10/13 06:46 CRDT- 2023/10/11 21:04 PHST- 2023/06/07 00:00 [received] PHST- 2023/07/25 00:00 [revised] PHST- 2023/07/28 00:00 [accepted] PHST- 2023/10/13 06:46 [medline] PHST- 2023/10/12 00:43 [pubmed] PHST- 2023/10/11 21:04 [entrez] AID - S0735-1097(23)06463-X [pii] AID - 10.1016/j.jacc.2023.07.031 [doi] PST - ppublish SO - J Am Coll Cardiol. 2023 Oct 17;82(16):1565-1578. doi: 10.1016/j.jacc.2023.07.031. PMID- 37734293 OWN - NLM STAT- MEDLINE DCOM- 20231221 LR - 20240719 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 206 DP - 2023 Nov 1 TI - Forecasting the Risk of Heart Failure Hospitalization After Acute Coronary Syndromes: the CORALYS HF Score. PG - 320-329 LID - S0002-9149(23)00766-X [pii] LID - 10.1016/j.amjcard.2023.08.010 [doi] AB - The present study aimed to identify patients at a higher risk of hospitalization for heart failure (HF) in a population of patients with acute coronary syndrome (ACS) treated with percutaneous coronary revascularization without a history of HF or reduced left ventricular (LV) ejection fraction before the index admission. We performed a Cox regression multivariable analysis with competitive risk and machine learning models on the incideNce and predictOrs of heaRt fAiLure After Acute coronarY Syndrome (CORALYS) registry (NCT04895176), an international and multicenter study including consecutive patients admitted for ACS in 16 European Centers from 2015 to 2020. Of 14,699 patients, 593 (4.0%) were admitted for the development of HF up to 1 year after the index ACS presentation. A total of 2 different data sets were randomly created, 1 for the derivative cohort including 11,626 patients (80%) and 1 for the validation cohort including 3,073 patients (20%). On the Cox regression multivariable analysis, several variables were associated with the risk of HF hospitalization, with reduced renal function, complete revascularization, and LV ejection fraction as the most relevant ones. The area under the curve at 1 year was 0.75 (0.72 to 0.78) in the derivative cohort, whereas on validation, it was 0.72 (0.67 to 0.77). The machine learning analysis showed a slightly inferior performance. In conclusion, in a large cohort of patients with ACS without a history of HF or LV dysfunction before the index event, the CORALYS HF score identified patients at a higher risk of hospitalization for HF using variables easily accessible at discharge. Further approaches to tackle HF development in this high-risk subset of patients are needed. CI - Copyright (c) 2023 Elsevier Inc. All rights reserved. FAU - D'Ascenzo, Fabrizio AU - D'Ascenzo F AD - Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza, Turin, Italy. Electronic address: fabrizio.dascenzo@unito.it. FAU - Fabris, Enrico AU - Fabris E AD - Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, University of Trieste, Trieste, Italy. FAU - DeGregorio, Caterina AU - DeGregorio C AD - Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, University of Trieste, Trieste, Italy. FAU - Mittone, Gianluca AU - Mittone G AD - Cardiovascular Institute, Hospital Clinico San Carlos, Madrid, Spain. FAU - De Filippo, Ovidio AU - De Filippo O AD - Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza, Turin, Italy. FAU - Wanha, Wojciech AU - Wanha W AD - Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland. FAU - Leonardi, Sergio AU - Leonardi S AD - Coronary Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. FAU - Roubin, Sergio Raposeiras AU - Roubin SR AD - Hospital Universitario Alvaro Cunqueiro, Vigo, Spain. FAU - Chinaglia, Alessandra AU - Chinaglia A AD - Division of Cardiology, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy. FAU - Truffa, Alessandra AU - Truffa A AD - Division of Cardiology, Ospedale Cardinal G. Massaia, Asti, Italy. FAU - Huczek, Zenon AU - Huczek Z AD - 1st Department of Cardiology, Medical University of Warsaw, Warszawa, Poland. FAU - Gaibazzi, Nicola AU - Gaibazzi N AD - Cardiology Department, Parma University Hospital, Parma, Italy. FAU - Ielasi, Alfonso AU - Ielasi A AD - U.O. di Cardiologia Clinica ed Interventistica, Istituto Clinico Sant'Ambrogio, Milan, Italy. FAU - Cortese, Bernardo AU - Cortese B AD - Cardiovascular Research Team, San Carlo Clinic, Milano, Italy; Fondazione Ricerca e Innovazione Cardiovascolare, Milano, Italy. FAU - Borin, Andrea AU - Borin A AD - Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza, Turin, Italy. FAU - Pagliaro, Beniamino AU - Pagliaro B AD - Division of Cardiology, Humanitas, Milan, Italy. FAU - Nunez-Gil, Ivan J AU - Nunez-Gil IJ AD - Cardiovascular Institute, Hospital Clinico San Carlos, Madrid, Spain. FAU - Ugo, Fabrizio AU - Ugo F AD - Division of Cardiology, Ospedale Sant'Andrea di Vercelli, Vercelli, Italy. FAU - Marengo, Giorgio AU - Marengo G AD - Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza, Turin, Italy; Departement of Informatica, University of Turin, Turin, Italy. FAU - Barbieri, Lucia AU - Barbieri L AD - Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza, Turin, Italy; Division of Cardiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; University of Milan, Milan, Italy. FAU - Marchini, Federico AU - Marchini F AD - Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Cona, Italy. FAU - Desperak, Piotr AU - Desperak P AD - Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland. FAU - Melendo-Viu, Maria AU - Melendo-Viu M AD - Hospital Universitario Alvaro Cunqueiro, Vigo, Spain. FAU - Montalto, Claudio AU - Montalto C AD - Coronary Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. FAU - Bianco, Matteo AU - Bianco M AD - Division of Cardiology, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy. FAU - Bruno, Francesco AU - Bruno F AD - Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza, Turin, Italy. FAU - Mancone, Massimo AU - Mancone M AD - Department of Clinical Sciences and Community Health, Universita degli Studi di Milano, Milan, Italy. FAU - Ferrandez-Escarabajal, Marcos AU - Ferrandez-Escarabajal M AD - Cardiovascular Institute, Hospital Clinico San Carlos, Madrid, Spain. FAU - Morici, Nuccia AU - Morici N AD - Department of Clinical Sciences and Community Health, Universita degli Studi di Milano, Milan, Italy; ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy. FAU - Scaglione, Marco AU - Scaglione M AD - Division of Cardiology, Ospedale Cardinal G. Massaia, Asti, Italy. FAU - Tuttolomondo, Domenico AU - Tuttolomondo D AD - Cardiology Department, Parma University Hospital, Parma, Italy. FAU - Gasior, Mariusz AU - Gasior M AD - Departement of Informatica, University of Turin, Turin, Italy. FAU - Mazurek, Maciej AU - Mazurek M AD - 1st Department of Cardiology, Medical University of Warsaw, Warszawa, Poland. FAU - Gallone, Guglielmo AU - Gallone G AD - Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza, Turin, Italy. FAU - Campo, Gianluca AU - Campo G AD - Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Cona, Italy. FAU - Wojakowski, Wojciech AU - Wojakowski W AD - Departement of Informatica, University of Turin, Turin, Italy. FAU - Abu Assi, Emad AU - Abu Assi E AD - Hospital Universitario Alvaro Cunqueiro, Vigo, Spain. FAU - Stefanini, Giulio AU - Stefanini G AD - Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy. FAU - Sinagra, Gianfranco AU - Sinagra G AD - Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, University of Trieste, Trieste, Italy. FAU - de Ferrari, Gaetano Maria AU - de Ferrari GM AD - Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza, Turin, Italy. LA - eng SI - ClinicalTrials.gov/NCT04895176 PT - Journal Article PT - Multicenter Study DEP - 20230919 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM EIN - Am J Cardiol. 2024 Aug 1;224:55. doi: 10.1016/j.amjcard.2023.12.011. PMID: 38114059 MH - Humans MH - *Acute Coronary Syndrome/epidemiology/therapy/complications MH - *Heart Failure/epidemiology/therapy/etiology MH - Hospitalization MH - Patient Discharge MH - Ventricular Function, Left OTO - NOTNLM OT - acute coronary syndrome OT - heart failure OT - percutaneous coronary intervention COIS- Declaration of Competing Interest The authors have no competing interests to declare. EDAT- 2023/09/22 00:42 MHDA- 2023/12/21 06:42 CRDT- 2023/09/21 18:09 PHST- 2023/04/15 00:00 [received] PHST- 2023/07/31 00:00 [revised] PHST- 2023/08/05 00:00 [accepted] PHST- 2023/12/21 06:42 [medline] PHST- 2023/09/22 00:42 [pubmed] PHST- 2023/09/21 18:09 [entrez] AID - S0002-9149(23)00766-X [pii] AID - 10.1016/j.amjcard.2023.08.010 [doi] PST - ppublish SO - Am J Cardiol. 2023 Nov 1;206:320-329. doi: 10.1016/j.amjcard.2023.08.010. Epub 2023 Sep 19. PMID- 37692042 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240924 IS - 2297-055X (Print) IS - 2297-055X (Electronic) IS - 2297-055X (Linking) VI - 10 DP - 2023 TI - Influence and risk factors of postoperative infection after surgery for ischemic cardiomyopathy. PG - 1231556 LID - 10.3389/fcvm.2023.1231556 [doi] LID - 1231556 AB - BACKGROUND: Studies on postoperative infection (POI) after surgery for ischemic cardiomyopathy are still lacking. This study aimed to investigate the risk factors of POI and its influence on clinical outcomes in patients undergoing ischemic cardiomyopathy surgery. METHODS: The Surgical Treatment for Ischemic Heart Failure (STICH) trial randomized patients with ischemic cardiomyopathy [coronary artery disease (CAD) with left ventricular ejection fraction /=0.3 mg/dL at 48 h. RESULTS: Patients in the DyeVert group were treated with a significant lower CM volume (median: 47.5 vs. 84.0 mL, p < 0.001). The trend in creatinine increase was lower (p = 0.004) and the Delta of creatinine (0-48 h) showed a higher drop (-0.18 vs. -0.10 mg/dL, p = 0.036) in the DyeVert group. The risk of CA-AKI was significantly lower in DyeVert group compared to control group (5.1% vs. 16.8%; odds ratio 0.27, 95% confidence interval [0.12-0.61]). CONCLUSIONS: CM volume reduction with the DyeVert(TM) system seems to be superior to conventional strategies in reducing the occurrence of CA-AKI. CI - (c) 2023 Wiley Periodicals LLC. FAU - Paolucci, Luca AU - Paolucci L AUID- ORCID: 0009-0000-3290-4053 AD - Interventional Cardiology Unit, Mediterranea Cardiocentro, Naples, Italy. FAU - De Micco, Francesca AU - De Micco F AD - Interventional Cardiology Unit, Mediterranea Cardiocentro, Naples, Italy. FAU - Bezzeccheri, Andrea AU - Bezzeccheri A AUID- ORCID: 0000-0002-7207-8953 AD - Interventional Cardiology Unit, Mediterranea Cardiocentro, Naples, Italy. FAU - Scarpelli, Mario AU - Scarpelli M AD - Interventional Cardiology Unit, Mediterranea Cardiocentro, Naples, Italy. FAU - Esposito, Giovanni AU - Esposito G AD - Department of Advanced Biomedical Science, Division of Cardiology, "Federico II", University of Naples, Naples, Italy. FAU - Airoldi, Flavio AU - Airoldi F AD - Interventional Cardiology Unit, Istituto di Ricerca a Carattere Scientifico Multimedica MultiMedica, Sesto San Giovanni, Milan, Italy. FAU - Focaccio, Amelia AU - Focaccio A AUID- ORCID: 0000-0002-3326-5932 AD - Interventional Cardiology Unit, Mediterranea Cardiocentro, Naples, Italy. FAU - Briguori, Carlo AU - Briguori C AD - Interventional Cardiology Unit, Mediterranea Cardiocentro, Naples, Italy. LA - eng PT - Journal Article DEP - 20230905 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 RN - 0 (Contrast Media) RN - AYI8EX34EU (Creatinine) SB - IM MH - Humans MH - Contrast Media/adverse effects MH - Creatinine MH - Treatment Outcome MH - *Acute Kidney Injury/chemically induced/diagnosis MH - *Coronary Artery Disease/diagnostic imaging/therapy/chemically induced MH - *Percutaneous Coronary Intervention/adverse effects MH - Risk Factors MH - Coronary Angiography/adverse effects OTO - NOTNLM OT - acute kidney injury OT - coronary artery disease OT - percutaneous coronary intervention EDAT- 2023/09/05 12:42 MHDA- 2023/10/06 06:43 CRDT- 2023/09/05 06:41 PHST- 2023/06/20 00:00 [revised] PHST- 2023/04/30 00:00 [received] PHST- 2023/08/15 00:00 [accepted] PHST- 2023/10/06 06:43 [medline] PHST- 2023/09/05 12:42 [pubmed] PHST- 2023/09/05 06:41 [entrez] AID - 10.1002/ccd.30809 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2023 Oct;102(4):655-662. doi: 10.1002/ccd.30809. Epub 2023 Sep 5. PMID- 37641636 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230829 IS - 2752-4191 (Electronic) IS - 2752-4191 (Linking) VI - 3 IP - 4 DP - 2023 Jul TI - Cardiovascular outcomes in patients with coronary artery disease and elevated lipoprotein(a): implications for the OCEAN(a)-outcomes trial population. PG - oead077 LID - 10.1093/ehjopen/oead077 [doi] LID - oead077 AB - AIMS: The ongoing Olpasiran Trials of Cardiovascular Events and Lipoprotein(a) Reduction [OCEAN(a)]-Outcomes trial is evaluating whether Lp(a) lowering can reduce the incidence of cardiovascular events among patients with prior myocardial infarction (MI) or percutaneous coronary intervention (PCI) and elevated Lp(a) (>/=200 nmol/L). The purpose of this study is to evaluate the association of elevated Lp(a) with cardiovascular outcomes in an observational cohort resembling the OCEAN(a)-Outcomes trial main enrolment criteria. METHODS AND RESULTS: This study included patients aged 18-85 years with Lp(a) measured as part of their clinical care between 2000 and 2019. While patients were required to have a history of MI, or PCI, those with severe kidney dysfunction or a malignant neoplasm were excluded. Elevated Lp(a) was defined as >/=200 nmol/L consistent with the OCEAN(a)-Outcomes trial. The primary outcome was a composite of coronary heart disease death, MI, or coronary revascularization. Natural language processing algorithms, billing and ICD codes, and laboratory data were employed to identify outcomes and covariates. A total of 3142 patients met the eligibility criteria, the median age was 61 (IQR: 52-73) years, 28.6% were women, and 12.3% had elevated Lp(a). Over a median follow-up of 12.2 years (IQR: 6.2-14.3), the primary composite outcome occurred more frequently in patients with versus without elevated Lp(a) [46.0 vs. 38.0%, unadjHR = 1.30 (95% CI: 1.09-1.53), P = 0.003]. Following adjustment for measured confounders, elevated Lp(a) remained independently associated with the primary outcome [adjHR = 1.33 (95% CI: 1.12-1.58), P = 0.001]. CONCLUSION: In an observational cohort resembling the main OCEAN(a)-Outcomes Trial enrolment criteria, patients with an Lp(a) >/=200 nmol/L had a higher risk of cardiovascular outcomes. CI - (c) The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. FAU - Shiyovich, Arthur AU - Shiyovich A AUID- ORCID: 0000-0001-7316-1882 AD - Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. FAU - Berman, Adam N AU - Berman AN AUID- ORCID: 0000-0002-0724-9779 AD - Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. FAU - Besser, Stephanie A AU - Besser SA AD - Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. FAU - Biery, David W AU - Biery DW AD - Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. FAU - Huck, Daniel M AU - Huck DM AD - Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. AD - Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. FAU - Weber, Brittany AU - Weber B AUID- ORCID: 0000-0002-0177-2091 AD - Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. FAU - Cannon, Christopher AU - Cannon C AD - Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. FAU - Januzzi, James L AU - Januzzi JL AD - Cardiology Division, Massachusetts General Hospital, Harvard Medical School, and Baim Institute for Clinical Research, Boston, MA 02115, USA. FAU - Booth, John N 3rd AU - Booth JN 3rd AD - Center for Observational Research, Amgen Inc., Thousand Oaks, CA 91320, USA. FAU - Nasir, Khurram AU - Nasir K AUID- ORCID: 0000-0001-5376-2269 AD - Department of Cardiovascular Medicine, Division of Cardiovascular Prevention and Wellness, Houston Methodist DeBakey Heart and Vascular Center, Houston, TX 77030, USA. FAU - Di Carli, Marcelo F AU - Di Carli MF AD - Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. AD - Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. FAU - Lopez, J Antonio G AU - Lopez JAG AD - Global Development, Amgen Inc., Thousand Oaks, CA 91320, USA. FAU - Kent, Shia T AU - Kent ST AD - Center for Observational Research, Amgen Inc., Thousand Oaks, CA 91320, USA. FAU - Bhatt, Deepak L AU - Bhatt DL AUID- ORCID: 0000-0002-1278-6245 AD - Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. AD - Mount Sinai Heart, Icahn School of Medicine at Mount Sinai Health System, New York, NY 10029, USA. FAU - Blankstein, Ron AU - Blankstein R AD - Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. AD - Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. LA - eng PT - Journal Article DEP - 20230827 PL - England TA - Eur Heart J Open JT - European heart journal open JID - 9918282081406676 PMC - PMC10460541 OTO - NOTNLM OT - Cardiovascular outcomes OT - Coronary artery disease OT - Lipoprotein(a) OT - Olpasiran COIS- Conflict of interest: J.N.B., J.A.G.L., and S.T.K.: employees and stockholders of Amgen Inc. B.W.: Scientific Advisory Board: Kiniksa, Horizon Therapeutics, and Novo Nordisk. C.C. reports in calendar years 2021-23: Research grants from: Amgen, Better Therapeutics, Boehringer-Ingelheim (BI), Daiichi Sankyo, Merck, Novo Nordisk, and Pfizer. Consulting fees from Amryt/Chiesi, Alnylam, Amarin, Amgen, Applied Therapeutics, Ascendia, Biogen, BI, BMS, CSL Behring, Eli Lilly, Janssen, Lexicon, Merck, Milestone, Pfizer, Rhoshan, SanofiI serve on Data and Safety Monitoring Boards for the Applied Therapeutics, Areteia, and Novo Nordisk. J.L.J. is a trustee of the American College of Cardiology; is a board member of Imbria Pharmaceuticals; is a director at Jana Care; has received grant support from Abbott, Applied Therapeutics, HeartFlow, Innolife, and Roche Diagnostics; has received consulting income from Abbott, Beckman, Boehringer Ingelheim, Bristol Myers Squibb, Janssen, Merck, Novartis, Pfizer, Roche Diagnostics, and Siemens; and participates in clinical endpoint committees/Data Safety Monitoring Boards for Abbott, AbbVie, CVRx, Intercept, and Takeda. M.F.D.C.: grant support from Amgen. D.L.B. discloses the following relationships-Advisory Board: Angiowave, Bayer, Boehringer Ingelheim, CellProthera, Cereno Scientific, Elsevier Practice Update Cardiology, High Enroll, Janssen, Level Ex, McKinsey, Medscape Cardiology, Merck, MyoKardia, NirvaMed, Novo Nordisk, PhaseBio, PLx Pharma, Stasys; Board of Directors: American Heart Association New York City, Angiowave (stock options), Bristol Myers Squibb (stock), DRS.LINQ (stock options), High Enroll (stock); consultant: Broadview Ventures, Hims, SFJ, Youngene; Data Monitoring Committees: Acesion Pharma, Assistance Publique-Hopitaux de Paris, Baim Institute for Clinical Research (formerly Harvard Clinical Research Institute, for the PORTICO trial, funded by St. Jude Medical, now Abbott), Boston Scientific (Chair, PEITHO trial), Cleveland Clinic, Contego Medical (Chair, PERFORMANCE 2), Duke Clinical Research Institute, Mayo Clinic, Mount Sinai School of Medicine (for the ENVISAGE trial, funded by Daiichi Sankyo; for the ABILITY-DM trial, funded by Concept Medical; for ALLAY-HF, funded by Alleviant Medical), Novartis, Population Health Research Institute; Rutgers University (for the NIH-funded MINT Trial); Honoraria: American College of Cardiology (Senior Associate Editor, Clinical Trials and News, ACC.org; Chair, ACC Accreditation Oversight Committee), Arnold and Porter law firm (work related to Sanofi/Bristol-Myers Squibb clopidogrel litigation), Baim Institute for Clinical Research (formerly Harvard Clinical Research Institute; RE-DUAL PCI clinical trial steering committee funded by Boehringer Ingelheim; AEGIS-II executive committee funded by CSL Behring), Belvoir Publications (Editor in Chief, Harvard Heart Letter), Canadian Medical and Surgical Knowledge Translation Research Group (clinical trial steering committees), CSL Behring (AHA lecture), Cowen and Company, Duke Clinical Research Institute (clinical trial steering committees, including for the PRONOUNCE trial, funded by Ferring Pharmaceuticals), HMP Global (Editor in Chief, Journal of Invasive Cardiology), Journal of the American College of Cardiology (Guest Editor; Associate Editor), K2P (Co-Chair, interdisciplinary curriculum), Level Ex, Medtelligence/ReachMD (CME steering committees), MJH Life Sciences, Oakstone CME (Course Director, Comprehensive Review of Interventional Cardiology), Piper Sandler, Population Health Research Institute (for the COMPASS operations committee, publications committee, steering committee, and USA national co-leader, funded by Bayer), WebMD (CME steering committees), Wiley (steering committee); Other: Clinical Cardiology (Deputy Editor); Patent: Sotagliflozin (named on a patent for sotagliflozin assigned to Brigham and Women's Hospital who assigned to Lexicon; neither I nor Brigham and Women's Hospital receive any income from this patent); Research Funding: Abbott, Acesion Pharma, Afimmune, Aker Biomarine, Alnylam, Amarin, Amgen, AstraZeneca, Bayer, Beren, Boehringer Ingelheim, Boston Scientific, Bristol-Myers Squibb, Cardax, CellProthera, Cereno Scientific, Chiesi, CinCor, Cleerly, CSL Behring, Eisai, Ethicon, Faraday Pharmaceuticals, Ferring Pharmaceuticals, Forest Laboratories, Fractyl, Garmin, HLS Therapeutics, Idorsia, Ironwood, Ischemix, Janssen, Javelin, Lexicon, Lilly, Medtronic, Merck, Moderna, MyoKardia, NirvaMed, Novartis, Novo Nordisk, Otsuka, Owkin, Pfizer, PhaseBio, PLx Pharma, Recardio, Regeneron, Reid Hoffman Foundation, Roche, Sanofi, Stasys, Synaptic, The Medicines Company, Youngene, 89Bio; Royalties: Elsevier (Editor, Braunwald's Heart Disease); Site Co-Investigator: Abbott, Biotronik, Boston Scientific, CSI, Endotronix, St. Jude Medical (now Abbott), Philips, SpectraWAVE, Svelte, Vascular Solutions; Trustee: American College of Cardiology; Unfunded Research: FlowCo. R.B. has received research support from Amgen Inc., Novartis Inc., and Beren Therapeutics, and has served as a consultant/advisory board for Caristo Inc., Elucid Inc., HeartFlow Inc., Nanox AI, and Beren Therapeutics. A.S., A.N.B., S.A.B., D.W.B., D.M.H., and K.N.: none. EDAT- 2023/08/29 06:42 MHDA- 2023/08/29 06:43 PMCR- 2023/08/27 CRDT- 2023/08/29 03:37 PHST- 2023/07/10 00:00 [received] PHST- 2023/07/19 00:00 [revised] PHST- 2023/08/09 00:00 [accepted] PHST- 2023/08/29 06:43 [medline] PHST- 2023/08/29 06:42 [pubmed] PHST- 2023/08/29 03:37 [entrez] PHST- 2023/08/27 00:00 [pmc-release] AID - oead077 [pii] AID - 10.1093/ehjopen/oead077 [doi] PST - epublish SO - Eur Heart J Open. 2023 Aug 27;3(4):oead077. doi: 10.1093/ehjopen/oead077. eCollection 2023 Jul. PMID- 37605710 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230823 IS - 2168-8184 (Print) IS - 2168-8184 (Electronic) IS - 2168-8184 (Linking) VI - 15 IP - 7 DP - 2023 Jul TI - Predicting Determinants for Conversion of Off-Pump Coronary Revascularization to On-Pump Surgery: A Retrospective Analysis. PG - e42258 LID - 10.7759/cureus.42258 [doi] LID - e42258 AB - A global consensus has not yet been reached regarding the preference for off-pump versus on-pump coronary revascularization. Although the coronary trial indicates that the secondary endpoint outcomes favor on-pump surgery, the cost-effectiveness and significantly lower immediate and early complications in off-pump surgery make it favorable for the Indian population. To analyze patients who underwent coronary revascularization, specifically coronary artery bypass grafting (CABG), a retrospective five-year study was conducted. During the given duration, a total of 652 patients underwent CABG. The study revealed a positive correlation between diabetes, high body surface area (BSA), and preexisting renal dysfunction as strong predictors for converting off-pump coronary artery bypass surgery (OPCABG) to on-pump surgery coronary artery bypass surgery (ONCABG). Preoperative electrocardiographic (ECG) changes and the use of intra-aortic balloon pulsation (IABP) as a mechanical assist device were strongly associated with the incidence of conversion from OPCABG to ONCABG. Tight left main disease and ostial coronary disease indicate a progressive dysfunction during off-pump surgery, necessitating early conversion to on-pump surgery to avoid complications. The on-pump group had more adverse outcomes in regard to renal and neurological dysfunction, which can be attributed to pump-induced dysfunction. In such scenarios, a surgeon's preparedness to convert an OPCABG to an ONCABG can be swift and efficient. In anticipation of increased pump-related complications in the ONCABG group, a measured approach can be implemented to avoid adverse postoperative outcomes in high-risk patients. CI - Copyright (c) 2023, Kumar et al. FAU - Kumar, Chandranshu AU - Kumar C AD - Cardiothoracic Surgery, Dr. Ram Manohar Lohia Hospital, New Delhi, IND. FAU - K, Sridartha AU - K S AD - Cardiothoracic Surgery, Dr. Ram Manohar Lohia Hospital, New Delhi, IND. FAU - Bhushan, Rahul AU - Bhushan R AD - Cardiothoracic Surgery, Dr. Ram Manohar Lohia Hospital, New Delhi, IND. FAU - Grover, Vijay AU - Grover V AD - Cardiothoracic Surgery, Dr. Ram Manohar Lohia Hospital, New Delhi, IND. FAU - Jhajhria, Narender S AU - Jhajhria NS AD - Cardiothoracic Surgery, Dr. Ram Manohar Lohia Hospital, New Delhi, IND. FAU - Aiyer, Palash V AU - Aiyer PV AD - Cardiothoracic Surgery, Dr. Ram Manohar Lohia Hospital, New Delhi, IND. LA - eng PT - Journal Article DEP - 20230721 PL - United States TA - Cureus JT - Cureus JID - 101596737 PMC - PMC10440067 OTO - NOTNLM OT - adult coronary surgery on and off pump OT - cabg surgery OT - coronary artery bypass grafting (cabg) OT - off-pump coronary artery bypass grafting (opcabg) OT - off-pump to on-pump conversion COIS- The authors have declared that no competing interests exist. EDAT- 2023/08/22 06:42 MHDA- 2023/08/22 06:43 PMCR- 2023/07/21 CRDT- 2023/08/22 03:39 PHST- 2023/07/21 00:00 [accepted] PHST- 2023/08/22 06:43 [medline] PHST- 2023/08/22 06:42 [pubmed] PHST- 2023/08/22 03:39 [entrez] PHST- 2023/07/21 00:00 [pmc-release] AID - 10.7759/cureus.42258 [doi] PST - epublish SO - Cureus. 2023 Jul 21;15(7):e42258. doi: 10.7759/cureus.42258. eCollection 2023 Jul. PMID- 37524929 OWN - NLM STAT- MEDLINE DCOM- 20230918 LR - 20261010 IS - 1432-1041 (Electronic) IS - 0031-6970 (Linking) VI - 79 IP - 10 DP - 2023 Oct TI - Prevention of contrast induced-acute kidney injury using coenzyme Q10 in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. PG - 1341-1356 LID - 10.1007/s00228-023-03546-9 [doi] AB - PURPOSE: We assessed the potential effect of CoQ10 administration for the prevention of contrast induced-acute kidney injury (CI-AKI) in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). METHODS: One hundred fifty STEMI patients who were candidates for primary PCI, along with intravenous saline hydration, randomly received a placebo or CoQ10. CoQ10 was administrated orally, 400 mg before the procedure and 200 mg twice daily after the procedure for three consecutive days. Serum creatinine concentration and corresponding creatinine clearance (estimated by the CKD Epidemiology Collaboration (CKD-EPI) creatinine equation) were measured at baseline and 24, 48, and 72 h after primary PCI. Furthermore, the serum level of superoxide dismutase (SOD), total antioxidant capacity (TAC), and malondialdehyde (MDA) was measured before and 72 h after primary PCI. RESULTS: The mean serum creatinine concentration before contrast administration was similar in the two groups (0.98 +/- 0.08 versus 0.99 +/- 0.09 mg/dL). While in both study groups, compared to baseline, the mean serum creatinine concentration increased at 48 and 72 h after contrast exposure, the CoQ10 group showed a lower serum creatinine concentration than the placebo group (P-value = 0.017 and 0.004, respectively). However, comparing the mean values of creatinine clearance between the groups at the study time points did not demonstrate a statistically significant difference. CI-AKI, defined as a > 25% or 0.5 mg/dL increase in baseline serum creatinine concentration, occurred in 8.00% of the cases in the CoQ10 group versus 20.00% in the placebo group (P-value = 0.034). Furthermore, at 72 h, the CoQ10-treated group exhibited higher serum levels of SOD and TAC and a lower MDA level than the placebo-treated group. CONCLUSIONS: Our research's findings proposed CoQ10 supplementation as an adjuvant to saline hydration as a preventive approach against CI-AKI. TRIAL REGISTRATION: The trial was registered at Iranian Registry of Clinical Trials ( https://www.irct.ir/trial/60435 , identifier code: IRCT20120215009014N414). Registration date: 2021-12-29. CI - (c) 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature. FAU - Ahmadimoghaddam, Davoud AU - Ahmadimoghaddam D AD - Department of Pharmacology and Toxicology, School of Pharmacy, Hamadan University of Medical Sciences, Hamadan, Iran. FAU - Talebi, Seyed Saman AU - Talebi SS AD - Department of Internal Medicine, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran. FAU - Rahmani, Ayesheh AU - Rahmani A AD - Department of Clinical Pharmacy, School of Pharmacy, Medicinal Plants and Natural Products Research Center, Hamadan University of Medical Sciences, Shahid Fahmideh Ave, Hamadan, 6517838678, Iran. FAU - Zamanirafe, Maryam AU - Zamanirafe M AD - Medical Faculty, Hamadan University of Medical Science, Hamadan, Iran. FAU - Parvaneh, Erfan AU - Parvaneh E AD - Department of Cardiology, School of Medicine, Clinical Research Development Unit of Farshchian Hospital, Hamadan University of Medical Sciences, Hamadan, Iran. FAU - Ranjbar, Akram AU - Ranjbar A AD - Department of Pharmacology and Toxicology, School of Pharmacy, Hamadan University of Medical Sciences, Hamadan, Iran. FAU - Poorolajal, Jalal AU - Poorolajal J AD - Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran. FAU - Mehrpooya, Maryam AU - Mehrpooya M AUID- ORCID: 0000-0003-4119-1600 AD - Department of Clinical Pharmacy, School of Pharmacy, Medicinal Plants and Natural Products Research Center, Hamadan University of Medical Sciences, Shahid Fahmideh Ave, Hamadan, 6517838678, Iran. m_mehrpooya2003@yahoo.com. LA - eng GR - 140011199720/Vice-chancellor for research and technology, Hamadan University of Medical Sciences/ PT - Journal Article DEP - 20230801 PL - Germany TA - Eur J Clin Pharmacol JT - European journal of clinical pharmacology JID - 1256165 RN - AYI8EX34EU (Creatinine) RN - 0 (Contrast Media) RN - EJ27X76M46 (coenzyme Q10) RN - 1339-63-5 (Ubiquinone) SB - IM MH - Humans MH - *ST Elevation Myocardial Infarction/drug therapy/surgery MH - *Percutaneous Coronary Intervention/adverse effects/methods MH - Creatinine MH - Contrast Media MH - Iran MH - *Acute Kidney Injury/chemically induced/prevention & control MH - *Renal Insufficiency, Chronic MH - Risk Factors MH - Ubiquinone/analogs & derivatives OTO - NOTNLM OT - Coenzyme Q10 OT - Contrast induced-acute kidney injury OT - Primary percutaneous coronary intervention OT - ST-segment elevation myocardial infarction EDAT- 2023/08/01 01:08 MHDA- 2023/09/18 12:42 CRDT- 2023/07/31 23:29 PHST- 2023/06/14 00:00 [received] PHST- 2023/07/25 00:00 [accepted] PHST- 2023/09/18 12:42 [medline] PHST- 2023/08/01 01:08 [pubmed] PHST- 2023/07/31 23:29 [entrez] AID - 10.1007/s00228-023-03546-9 [pii] AID - 10.1007/s00228-023-03546-9 [doi] PST - ppublish SO - Eur J Clin Pharmacol. 2023 Oct;79(10):1341-1356. doi: 10.1007/s00228-023-03546-9. Epub 2023 Aug 1. PMID- 37495797 OWN - NLM STAT- MEDLINE DCOM- 20240702 LR - 20260120 IS - 1861-0692 (Electronic) IS - 1861-0684 (Print) IS - 1861-0684 (Linking) VI - 113 IP - 7 DP - 2024 Jul TI - Sex-specific inequalities in the use of drug-coated balloons for small coronary artery disease: a report from the BASKET-SMALL 2 trial. PG - 959-966 LID - 10.1007/s00392-023-02249-6 [doi] AB - BACKGROUND AND OBJECTIVES: Recent data have established non-inferiority of drug-coated balloons (DCB) compared to drug-eluting stents (DES) for treatment of small-vessel coronary artery disease. Since coronary vessels in women might have anatomical and pathophysiological particularities, the safety of the DCB strategy among women compared to men needs to be assessed in more detail. METHODS: In BASKET-SMALL 2, patients with de novo lesions in coronary vessels < 3 mm and an indication for percutaneous coronary intervention were randomly allocated (1:1) to DCB vs. DES after successful lesion preparation. The primary objective of the randomized trial was to establish non-inferiority of DCB vs. DES regarding major adverse cardiac events (MACE; i.e., cardiac death, non-fatal myocardial infarction, and target vessel revascularization) after 12 months. The aim of the current sub-analysis is to evaluate whether the DCB strategy is equally safe among women and men after 12 and 36 months. RESULTS: Among 758 randomized patients, 382 were assigned to DCB (23% women) and 376 to DES (30% women). In general, women were older, had more often diabetes mellitus and renal insufficiency, and presented more often with an acute coronary syndrome, whereas men were more often smokers, had multivessel disease and a previous history of acute myocardial infarction, and received a treatment with a statin. After 3 years, the primary clinical end point was not significantly different between groups (13% women vs. 16% men, HR 0.82; 95% CI 0.52-1.30; p = 0.40). There was no interaction between sex and coronary intervention strategy regarding MACE at 36 months (10% women vs. 16% men in DCB, 16% women vs. 15% men in DES; p(interaction) = 0.31). CONCLUSION: In small native coronary artery disease, there was no statistically significant effect of sex on the difference between DCB and DES regarding MACE up to 36 months. CLINICAL TRIAL REGISTRATION: URL: http://www. CLINICALTRIALS: gov . Unique identifier: NCT01574534. CI - (c) 2023. The Author(s). FAU - Rubini Gimenez, Maria AU - Rubini Gimenez M AUID- ORCID: 0000-0003-2384-8250 AD - Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel and University of Basel, Basel, Switzerland. AD - Department of Internal Medicine/Cardiology, Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig, Germany. FAU - Scheller, Bruno AU - Scheller B AD - Clinical and Experimental Interventional Cardiology, Saarland University, Homburg/Saar, Germany. FAU - Farah, Ahmed AU - Farah A AD - Department of Cardiology Central Clinic Bad Berka, Bad Berka, Germany. FAU - Ohlow, Marc-Alexander AU - Ohlow MA AD - Department of Cardiology Central Clinic Bad Berka, Bad Berka, Germany. FAU - Mangner, Norman AU - Mangner N AD - Department of Internal Medicine and Cardiology, Herzzentrum Dresden, Technische Universitaet Dresden, Dresden, Germany. FAU - Weilenmann, Daniel AU - Weilenmann D AD - Department of Cardiology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland. FAU - Wohrle, Jochen AU - Wohrle J AD - Department of Cardiology, University Hospital Ulm, Ulm, Germany. FAU - Cuculi, Florim AU - Cuculi F AD - Department of Cardiology, Cantonal Hospital Luzern, Luzern, Switzerland. FAU - Leibundgut, Gregor AU - Leibundgut G AD - Department of Cardiology, Cantonal Hospital Baselland, Liestal, Switzerland. FAU - Mobius-Winkler, Sven AU - Mobius-Winkler S AD - Department of Cardiology, Friedrich-Schiller-University of Jena, Jena, Germany. FAU - Cattaneo, Marco AU - Cattaneo M AD - Department of Clinical Research, University Hospital Basel, Basel, Switzerland. FAU - Gilgen, Nicole AU - Gilgen N AD - Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel and University of Basel, Basel, Switzerland. FAU - Kaiser, Christoph AU - Kaiser C AD - Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel and University of Basel, Basel, Switzerland. FAU - Jeger, Raban V AU - Jeger RV AD - Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel and University of Basel, Basel, Switzerland. raban.jeger@stadtspital.ch. AD - Department of Cardiology, Triemli Hospital, Zurich, Switzerland. raban.jeger@stadtspital.ch. LA - eng SI - ClinicalTrials.gov/NCT01574534 PT - Equivalence Trial PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20230726 PL - Germany TA - Clin Res Cardiol JT - Clinical research in cardiology : official journal of the German Cardiac Society JID - 101264123 RN - 0 (Coated Materials, Biocompatible) SB - IM MH - Humans MH - Female MH - Male MH - *Coronary Artery Disease/therapy MH - Aged MH - Sex Factors MH - *Drug-Eluting Stents MH - Middle Aged MH - Treatment Outcome MH - Angioplasty, Balloon, Coronary/methods/instrumentation MH - Coated Materials, Biocompatible MH - Risk Factors PMC - PMC11219376 OTO - NOTNLM OT - Drug-coated balloon OT - Sex inequalities OT - Small coronary artery disease COIS- Dr. Rubini Gimenez reports research grants from the Swiss Heart Foundation and Swiss National Foundation (P400PM_180828) and speakers' honoraria from Roche, Ortho Clinical Diagnostics, Quidel and Siemens (outside the submitted work). Prof. Jeger has received lecture honoraria and travel support from B Braun and lecture honoraria from Cardionovum and Nipro. Norman Mangner reports personal fees from Edwards Lifesciences, Medtronic, Biotronik, Novartis, Sanofi Genzyme, AstraZeneca, Pfizer, Bayer, Abbott, Abiomed, and Boston Scientific, outside the submitted work. Bruno Scheller is a shareholder of InnoRa GmbH and was named as coinventor on patent applications submitted by Charite University Hospital, Berlin, Germany. EDAT- 2023/07/27 01:09 MHDA- 2024/07/02 14:43 PMCR- 2023/07/26 CRDT- 2023/07/26 23:30 PHST- 2022/11/04 00:00 [received] PHST- 2023/06/19 00:00 [accepted] PHST- 2024/07/02 14:43 [medline] PHST- 2023/07/27 01:09 [pubmed] PHST- 2023/07/26 23:30 [entrez] PHST- 2023/07/26 00:00 [pmc-release] AID - 10.1007/s00392-023-02249-6 [pii] AID - 2249 [pii] AID - 10.1007/s00392-023-02249-6 [doi] PST - ppublish SO - Clin Res Cardiol. 2024 Jul;113(7):959-966. doi: 10.1007/s00392-023-02249-6. Epub 2023 Jul 26. PMID- 37365618 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230701 IS - 1758-5996 (Print) IS - 1758-5996 (Electronic) IS - 1758-5996 (Linking) VI - 15 IP - 1 DP - 2023 Jun 26 TI - The safety of SGLT-2 inhibitors in diabetic patients submitted to elective percutaneous coronary intervention regarding kidney function: SAFE-PCI pilot study. PG - 138 LID - 10.1186/s13098-023-01107-9 [doi] LID - 138 AB - BACKGROUND: Percutaneous coronary intervention (PCI) is one of the most performed well-succeeded therapeutic procedures worldwide, reducing symptoms and improving quality of life. Neutrophil Gelatinase-associated Lipocalin (NGAL) is a biomarker of acute kidney injury (AKI) produced early after an ischemic renal insult. Osmotic diuresis and the vasoconstriction of the afferent arteriole promoted by Sodium-glucose Cotransporter-2 Inhibitors (SGLT2i) generate a concern regarding the possibility of dehydration and consequent AKI. There is no consensus on the maintenance or discontinuation of SGTL2i in patients who will undergo PCI. This study aimed to evaluate the safety of empagliflozin in diabetic patients submitted to elective PCI regarding kidney function. METHODS: SAFE-PCI trial is a prospective, open-label, randomized (1:1), single-center pilot study and a follow-up of 30 days. The SGLT2i empagliflozin 25 mg daily was initiated at least 15 days before PCI in the intervention group and maintained until the end of the follow-up period. Serum NGAL was collected 6 h after PCI and creatinine before PCI, 24 h, and 48 h after the procedure. As per protocol, both groups received optimal medical treatment and standard protocol of nephroprotection. RESULTS: A total of 42 patients were randomized (22 patients in the iSGLT-2 group and 20 patients in the control group). There was no difference between-group baseline data. The primary outcome (NGAL and creatinine values post PCI) did not differ in both groups: the mean NGAL value was 199 ng/dL in the empagliflozin group and 150 ng/dL in the control group (p = 0.249). Although there was an initial increase in creatinine in the SGLT-2i group compared to the control group between baseline creatinine and pre-PCI and 24 h post-PCI creatinine, no difference was detected in creatinine 48 h post-PCI (p = 0.065). The incidence of CI-AKI, determined by KDIGO criteria, in the iSGLT2-group was 13.6% and 10.0% in the control group without statistical difference. CONCLUSION: The present study showed that the use of empagliflozin is safe regarding kidney function during elective PCI in patients with T2D when compared with no use of SGLT2i. Trial registration Our clinical study is registered on ClinicalTrials.gov with the following number: NCT05037695. CI - (c) 2023. The Author(s). FAU - Feitosa, Mateus Paiva Marques AU - Feitosa MPM AD - Instituto Do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil. mateusfeitosa@gmail.com. AD - Av. Dr. Eneas de Carvalho Aguiar 44, Departamento de Aterosclerose, 2nd Floor, Cerqueira Cesar, Sao Paulo, SP, 05403-000, Brazil. mateusfeitosa@gmail.com. FAU - Lima, Eduardo Gomes AU - Lima EG AD - Instituto Do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil. FAU - Abizaid, Alexandre Antonio Cunha AU - Abizaid AAC AD - Instituto Do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil. FAU - Mehran, Roxana AU - Mehran R AD - Icahn School of Medicine at Mount Sinai, New York, USA. FAU - Lopes, Neuza Helena Moreira AU - Lopes NHM AD - Instituto Do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil. FAU - de Assis Fischer Ramos, Thiago AU - de Assis Fischer Ramos T AD - Instituto Do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil. FAU - Hideo-Kajita, Alexandre AU - Hideo-Kajita A AD - Instituto Do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil. FAU - Filho, Roberto Kalil AU - Filho RK AD - Instituto Do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil. FAU - Junior, Carlos Vicente Serrano AU - Junior CVS AD - Instituto Do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil. LA - eng SI - ClinicalTrials.gov/NCT05037695 PT - Journal Article DEP - 20230626 PL - England TA - Diabetol Metab Syndr JT - Diabetology & metabolic syndrome JID - 101488958 PMC - PMC10291785 OTO - NOTNLM OT - Acute kidney injury OT - Contrast-induced nephropathy OT - Coronary artery disease OT - Percutaneous coronary intervention OT - SGLT2 inhibitors COIS- The authors declare that they have no competing interests. EDAT- 2023/06/27 01:06 MHDA- 2023/06/27 01:07 PMCR- 2023/06/26 CRDT- 2023/06/26 23:41 PHST- 2023/04/18 00:00 [received] PHST- 2023/06/08 00:00 [accepted] PHST- 2023/06/27 01:07 [medline] PHST- 2023/06/27 01:06 [pubmed] PHST- 2023/06/26 23:41 [entrez] PHST- 2023/06/26 00:00 [pmc-release] AID - 10.1186/s13098-023-01107-9 [pii] AID - 1107 [pii] AID - 10.1186/s13098-023-01107-9 [doi] PST - epublish SO - Diabetol Metab Syndr. 2023 Jun 26;15(1):138. doi: 10.1186/s13098-023-01107-9. PMID- 37331888 OWN - NLM STAT- MEDLINE DCOM- 20231127 LR - 20231127 IS - 1878-0938 (Electronic) IS - 1878-0938 (Linking) VI - 56 DP - 2023 Nov TI - In-hospital outcomes of PCI in patients who have ESRD vs non-ESRD patients, a retrospective study involving a National Inpatient Sample (NIS) database. PG - 43-49 LID - S1553-8389(23)00207-5 [pii] LID - 10.1016/j.carrev.2023.05.016 [doi] AB - BACKGROUND: Cardiovascular disease is the leading cause of death for patients with end-stage renal disease (ESRD). ESRD is known to affect a large portion of the American population. Previous data for patients undergoing percutaneous coronary intervention (PCI) in the setting of ESRD for Acute Coronary Syndrome (ACS) and non-ACS etiologies have shown to have an increase in in-hospital mortality, and prolonged hospitalization among other complications. METHODS: The national inpatient sample (NIS) was used to identify patients who underwent PCI between the years 2016-2019. Patients were then grouped into those with ESRD on renal replacement therapy (RRT). Logistic regression models were employed to assess the primary outcome of in-hospital mortality, while linear regression models were utilized to evaluate secondary outcomes, including hospitalization cost and length of stay. RESULTS: A total of 21,366 unweighted observations were initially included, consisting of 50 % ESRD patients and 50 % randomly selected patients without ESRD who underwent PCI. These observations were weighted to represent a national estimate of 106,830 patients. The mean age of the study population was 65 years, and 63 % of the patients were male. The ESRD group had a greater representation of minority groups compared to the control group. The in-hospital mortality rate was significantly higher in the ESRD group compared to the control group, with an odds ratio of 1.803 (95 % CI: 1.502 to 2.164; p-value of 0.0002). Additionally, the ESRD group had significantly higher healthcare costs and longer length of stay, with a mean difference of $47,618 (95 % CI: $42,701 to $52,534, p-value <0.0001) and 2.933 days (95 % CI, 2.729 to 3.138 days, p-value <0.0001), respectively. CONCLUSION: In-hospital mortality, cost, and length of stay for patients undergoing PCI were found to be significantly greater in the ESRD group. CI - Copyright (c) 2023 Elsevier Inc. All rights reserved. FAU - Abdullahi, Abdullah H AU - Abdullahi AH AD - University of Central Florida College of Medicine, Graduate Medical Education, United States of America; HCA Florida North Florida Hospital, Internal Medicine Residency Program, 6500 W Newberry Rd, Gainesville, FL 32605, United States of America. FAU - Ismail, Zeeshan AU - Ismail Z AD - University of Central Florida College of Medicine, Graduate Medical Education, United States of America; HCA Florida North Florida Hospital, Internal Medicine Residency Program, 6500 W Newberry Rd, Gainesville, FL 32605, United States of America. FAU - Obeidat, Omar AU - Obeidat O AD - University of Central Florida College of Medicine, Graduate Medical Education, United States of America; HCA Florida North Florida Hospital, Internal Medicine Residency Program, 6500 W Newberry Rd, Gainesville, FL 32605, United States of America. Electronic address: Omb19971@gmail.com. FAU - Alzghoul, Hamza AU - Alzghoul H AD - University of Central Florida College of Medicine, Graduate Medical Education, United States of America; HCA Florida North Florida Hospital, Internal Medicine Residency Program, 6500 W Newberry Rd, Gainesville, FL 32605, United States of America. Electronic address: hamzehzghoolmd96@gmail.com. FAU - Hurlock, Natalie P AU - Hurlock NP AD - Graduate Medical Education, Physician Services Group, HCA Research, United States of America. FAU - Tarawneh, Mohammad AU - Tarawneh M AD - University of Central Florida College of Medicine, Graduate Medical Education, United States of America; HCA Florida North Florida Hospital, Internal Medicine Residency Program, 6500 W Newberry Rd, Gainesville, FL 32605, United States of America. FAU - Elsadek, Rabab AU - Elsadek R AD - University of Central Florida College of Medicine, Graduate Medical Education, United States of America; HCA Florida North Florida Hospital, Internal Medicine Residency Program, 6500 W Newberry Rd, Gainesville, FL 32605, United States of America. FAU - Ismail, Mohamed F AU - Ismail MF AD - University of Central Florida College of Medicine, Graduate Medical Education, United States of America; HCA Florida North Florida Hospital, Internal Medicine Residency Program, 6500 W Newberry Rd, Gainesville, FL 32605, United States of America. FAU - Smock, Andrew L AU - Smock AL AD - University of Central Florida College of Medicine, Graduate Medical Education, United States of America; HCA Florida North Florida Hospital, Internal Medicine Residency Program, 6500 W Newberry Rd, Gainesville, FL 32605, United States of America. LA - eng PT - Journal Article DEP - 20230526 PL - United States TA - Cardiovasc Revasc Med JT - Cardiovascular revascularization medicine : including molecular interventions JID - 101238551 SB - IM MH - Humans MH - Male MH - United States MH - Aged MH - Female MH - Retrospective Studies MH - Inpatients MH - *Percutaneous Coronary Intervention/adverse effects MH - *Kidney Failure, Chronic/diagnosis/therapy/complications MH - *Acute Coronary Syndrome/diagnosis/therapy/complications MH - Hospitals MH - Hospital Mortality MH - Treatment Outcome OTO - NOTNLM OT - ESRD OT - NIS OT - PCI COIS- Declaration of competing interest The authors declare that they have no conflicts of interest to disclose. They have no financial, personal or professional relationships with any individual or organization that could influence, or be perceived to influence, the content of the article. EDAT- 2023/06/19 00:42 MHDA- 2023/11/27 12:45 CRDT- 2023/06/18 21:55 PHST- 2023/01/24 00:00 [received] PHST- 2023/05/08 00:00 [revised] PHST- 2023/05/23 00:00 [accepted] PHST- 2023/11/27 12:45 [medline] PHST- 2023/06/19 00:42 [pubmed] PHST- 2023/06/18 21:55 [entrez] AID - S1553-8389(23)00207-5 [pii] AID - 10.1016/j.carrev.2023.05.016 [doi] PST - ppublish SO - Cardiovasc Revasc Med. 2023 Nov;56:43-49. doi: 10.1016/j.carrev.2023.05.016. Epub 2023 May 26. PMID- 37274374 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230606 IS - 1949-8462 (Print) IS - 1949-8462 (Electronic) VI - 15 IP - 5 DP - 2023 May 26 TI - Pharmacoepidemiologic study of association between apparent treatment resistant hypertension, cardiovascular disease and interaction effect by sex and age. PG - 262-272 LID - 10.4330/wjc.v15.i5.262 [doi] AB - BACKGROUND: A limited number of studies have been conducted to test the magnitudes of the association between apparent treatment resistant hypertension (aTRH) and risk of cardiovascular disease (CVD). AIM: To investigate the association between aTRH and risk of CVD and examine whether sex and age modify this association. METHODS: We applied an observational analysis study design using data from the United States Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). ALLHAT recruited participants (n = 25516) from 625 primary care settings throughout the United States, Canada, Puerto Rico, and United States Virgin Islands, aged 55 and older with hypertension and at least one additional risk factor for heart disease. aTRH was assessed from the year 2 visit. CVD event was defined as one of the following from the year 2 follow-up visit: Fatal or non-fatal myocardial infarction, coronary revascularization, angina, stroke, heart failure, or peripheral artery disease. Cox proportional hazards regression was used to examine the effect of aTRH on CVD risk. Potential modifications of sex and age on this association were examined on the multiplicative scale by interaction term and additive scale by joint effects and relative excess risk for interaction. RESULTS: Of the total study participants (n = 25516), 5030 experienced a CVD event during a mean of 4.7 years follow-up. aTRH was associated with a 30% increase in risk of CVD compared to non-aTRH [hazards ratio (HR) = 1.3, 95%CI: 1.19-1.42]. Sex and age modified this relationship on both multiplicative and additive scales independently. Stratified by sex, aTRH was associated with a 64% increase in risk of CVD (HR = 1.64, 95%CI: 1.43-1.88) in women, and a 13% increase in risk of CVD (HR = 1.13, 95%CI: 1.01-1.27) in men. Stratified by age, aTRH had a stronger impact on the risk of CVD in participants aged < 65 (HR = 1.53, 95%CI: 1.32-1.77) than it did in those aged >/= 65 (HR = 1.18, 95%CI: 1.05-1.32). Significant two-way interactions of sex and aTRH, and age and aTRH on risk of CVD were observed (P < 0.05). The observed joint effect of aTRH and ages >/= 65 years (HR = 1.85, 95%CI: 1.22-2.48) in males was less than what was expected for both additive and multiplicative models (HR = 4.10, 95%CI: 3.63-4.57 and 4.88, 95%CI: 3.66-6.31), although three-way interaction of sex, age, and aTRH on the risk of CVD and coronary heart disease did not reach a statistical significance (P > 0.05). CONCLUSION: aTRH was significantly associated with an increased risk of CVD and this association was modified by both sex and age. Further studies are warranted to test these mechanisms. CI - (c)The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved. FAU - Nelson, Julianne Theresa AU - Nelson JT AD - Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA 19104, United States. FAU - Liu, Longjian AU - Liu L AD - Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA 19104, United States. ll85@drexel.edu. LA - eng PT - Journal Article PL - United States TA - World J Cardiol JT - World journal of cardiology JID - 101537090 PMC - PMC10237003 OTO - NOTNLM OT - Age OT - Apparent treatment resistant hypertension OT - Cardiovascular disease outcomes OT - Chronic kidney disease OT - Sex COIS- Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article. EDAT- 2023/06/05 13:04 MHDA- 2023/06/05 13:05 PMCR- 2023/05/26 CRDT- 2023/06/05 12:01 PHST- 2022/12/18 00:00 [received] PHST- 2023/03/31 00:00 [revised] PHST- 2023/04/18 00:00 [accepted] PHST- 2023/06/05 13:05 [medline] PHST- 2023/06/05 13:04 [pubmed] PHST- 2023/06/05 12:01 [entrez] PHST- 2023/05/26 00:00 [pmc-release] AID - 10.4330/wjc.v15.i5.262 [doi] PST - ppublish SO - World J Cardiol. 2023 May 26;15(5):262-272. doi: 10.4330/wjc.v15.i5.262. PMID- 37273882 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230928 IS - 2297-055X (Print) IS - 2297-055X (Electronic) IS - 2297-055X (Linking) VI - 10 DP - 2023 TI - Integrated Chinese and Western medicine for stable angina pectoris of coronary heart disease: a real-world study including 690 patients. PG - 1194082 LID - 10.3389/fcvm.2023.1194082 [doi] LID - 1194082 AB - OBJECTIVE: We aimed to evaluate the effects of integrated Chinese and Western medical therapeutic modalities on clinical prognosis in a population with stable angina pectoris (SAP) of coronary heart disease (CHD). METHODS: In a prospective cohort study, 732 patients with SAP of CHD hospitalized in the Integrated Cardiology Unit of the China-Japan Friendship Hospital From October 2020 to October 2021 were included. The patients were divided into integrated treatment and conventional treatment groups according to whether they had been taking Chinese medicine for more than 6 months per year. The occurrence of composite cardiovascular events (CVEs), including cardiac death, non-fatal myocardial infarction, revascularization, stroke, all-cause death, and readmission due to angina attack, heart failure, or malignant arrhythmia, was recorded during follow-up. The effects of different treatment modalities on prognosis were evaluated using univariate and multifactorial logistic regression. Logistic regression models were evaluated using receiver operating characteristic (ROC) curves. In sensitivity analysis, the correlation between treatment modality and outcome events was corrected by rematching the two groups of patients using the propensity score matching (PSM) method. RESULTS: The data from 690 patients were included in the analysis, with 327 patients in the integrated treatment group and 363 patients in the conventional treatment group. CVEs occurred in 19 patients (5.8%) in the integrated treatment group and 37 patients (10.2%) in the conventional treatment group. The proportion of outcome events was significantly lower in the combination treatment group than in the conventional treatment group (P = 0.037). Covariate correction by multimodal multifactorial logistic regression revealed a lower risk of CVEs in patients receiving integrated therapy compared with conventional therapy (OR = 0.246, 95% CI = 0.097-0.622, P = 0.003). Moreover, a history of renal insufficiency (OR = 3.991, 95% CI = 1.164-13.684, P = 0.028) and a higher Gensini score (OR = 1.039, 95% CI = 1.028-1.050, P < 0.001) were risk factors for the development of CVEs. Model evaluation showed that C-statistic = 0.955 and area under the ROC curve (AUC) = 0.955. After PSM correction, the results still showed that integrated Chinese and Western medical treatment reduced the occurrence of CVEs in patients compared with Western treatment alone (OR = 0.339, 95% CI = 0.131-0.874, P = 0.025). CONCLUSION: Integrated treatment based on Chinese and Western medicine might improve the prognosis and reduce the risk of CVEs in this disease population. TRIAL REGISTRATION: China Clinical Trials Registry, ChiCTR1800017891, Registered 20 August 2018, http://www.chictr.org.cn/showproj.aspx?proj = 30170. CI - (c) 2023 Yu, Wang, Xu, Liu, Li, Wang, Lu and Xu. FAU - Yu, Linghua AU - Yu L AD - Graduate School, Beijing University of Chinese Medicine, Beijing, China. FAU - Wang, Zihan AU - Wang Z AD - Graduate School, Beijing University of Chinese Medicine, Beijing, China. FAU - Xu, Chenxi AU - Xu C AD - Graduate School, Beijing University of Chinese Medicine, Beijing, China. FAU - Liu, Anxiang AU - Liu A AD - Graduate School, Beijing University of Chinese Medicine, Beijing, China. FAU - Li, Tong AU - Li T AD - Graduate School, Beijing University of Chinese Medicine, Beijing, China. FAU - Wang, Yubi AU - Wang Y AD - Graduate School, Beijing University of Chinese Medicine, Beijing, China. FAU - Lu, Xiaoyan AU - Lu X AD - Department of Integrative Cardiology, China-Japan Friendship Hospital, Beijing, China. FAU - Xu, Hao AU - Xu H AD - Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China. AD - National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China. LA - eng PT - Journal Article DEP - 20230519 PL - Switzerland TA - Front Cardiovasc Med JT - Frontiers in cardiovascular medicine JID - 101653388 PMC - PMC10235782 OTO - NOTNLM OT - cardiovascular risk OT - coronary heart disease OT - integrated treatment OT - logistic models OT - propensity score matching OT - stable angina pectoris COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2023/06/05 13:04 MHDA- 2023/06/05 13:05 PMCR- 2023/01/01 CRDT- 2023/06/05 11:53 PHST- 2023/03/26 00:00 [received] PHST- 2023/05/05 00:00 [accepted] PHST- 2023/06/05 13:05 [medline] PHST- 2023/06/05 13:04 [pubmed] PHST- 2023/06/05 11:53 [entrez] PHST- 2023/01/01 00:00 [pmc-release] AID - 10.3389/fcvm.2023.1194082 [doi] PST - epublish SO - Front Cardiovasc Med. 2023 May 19;10:1194082. doi: 10.3389/fcvm.2023.1194082. eCollection 2023. PMID- 37269688 OWN - NLM STAT- MEDLINE DCOM- 20230710 LR - 20231118 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 200 DP - 2023 Aug 1 TI - Outcomes of Non-ST-Segment Myocardial Infarction During Chronic Heart Failure and End-Stage Renal Disease. PG - 1-7 LID - S0002-9149(23)00283-7 [pii] LID - 10.1016/j.amjcard.2023.05.007 [doi] AB - Non-ST-segment myocardial infarction (NSTEMI) occurs frequently in a growing population of patients with chronic heart failure (HF) and end-stage renal disease (ESRD) but outcomes with invasive management approaches are unknown. We sought to determine in-hospital outcomes with percutaneous coronary intervention (PCI) in comparison with medical management only. The National Inpatient Sample was used to capture hospitalizations in the United States from 2006 to 2019. Admissions for NSTEMI in patients with chronic HF and ESRD were identified by International Classification of Diseases codes. The cohort was divided into those that received PCI or medical management only. In-hospital outcomes were compared by multivariable logistic regression and propensity matching. In 27,433 hospitalizations, 8,004 patients (29%) underwent PCI, and 19,429 (71%) were managed with medications only. PCI was associated with lower adjusted odds of death during hospitalization (adjusted odds ratio 0.59, 95% confidence interval 0.52 to 0.66, p <0.01). This association remained consistent after propensity matching (adjusted odds ratio 0.56, 95% confidence interval 0.49 to 0.64, p <0.01) and was apparent across all subtypes of HF. Patients with PCI had greater duration (5, 3, to 9 vs, 5, 3 to 8 days, p <0.01) and cost of hospitalization ($107,942, 70,230 to $173,182 vs, $44,156, 24,409 to $80,810, p <0.01). In conclusion, patients with HF and ESRD admitted for NSTEMI experienced lower in-hospital mortality with PCI in comparison with medical therapy only. Invasive percutaneous revascularization may be reasonable for appropriately selected patients with HF and ESRD but randomized controlled trials are needed to determine its safety and efficacy in this high-risk population. CI - Copyright (c) 2023 Elsevier Inc. All rights reserved. FAU - Alhuarrat, Majd Al Deen AU - Alhuarrat MAD AD - Division of Internal Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, New York. FAU - Alhuarrat, Mohammed Rasoul AU - Alhuarrat MR AD - Hashemite University College of Medicine, Zarqa, Jordan. FAU - Varrias, Dimitrios AU - Varrias D AD - Division of Internal Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, New York. FAU - Patel, Snehal R AU - Patel SR AD - Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York. FAU - Sims, Daniel B AU - Sims DB AD - Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York. FAU - Latib, Azeem AU - Latib A AD - Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York. FAU - Jorde, Ulrich P AU - Jorde UP AD - Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York. FAU - Saeed, Omar AU - Saeed O AD - Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York. Electronic address: osaeed@montefiore.org. LA - eng GR - K23 HL145140/HL/NHLBI NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural DEP - 20230601 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM CIN - Am J Cardiol. 2023 Aug 15;201:364-366. doi: 10.1016/j.amjcard.2023.06.035. PMID: 37407389 MH - Humans MH - United States/epidemiology MH - *Non-ST Elevated Myocardial Infarction/complications/epidemiology/therapy MH - *Percutaneous Coronary Intervention MH - Treatment Outcome MH - *Myocardial Infarction/complications/epidemiology/therapy MH - *Heart Failure/complications/epidemiology/therapy MH - Chronic Disease MH - *Kidney Failure, Chronic/complications/epidemiology/therapy MH - Risk Factors COIS- Declaration of Competing Interest The authors have no conflicts of interest to declare. EDAT- 2023/06/04 01:08 MHDA- 2023/07/10 06:42 CRDT- 2023/06/03 18:05 PHST- 2023/03/09 00:00 [received] PHST- 2023/04/24 00:00 [revised] PHST- 2023/05/07 00:00 [accepted] PHST- 2023/07/10 06:42 [medline] PHST- 2023/06/04 01:08 [pubmed] PHST- 2023/06/03 18:05 [entrez] AID - S0002-9149(23)00283-7 [pii] AID - 10.1016/j.amjcard.2023.05.007 [doi] PST - ppublish SO - Am J Cardiol. 2023 Aug 1;200:1-7. doi: 10.1016/j.amjcard.2023.05.007. Epub 2023 Jun 1. PMID- 37230805 OWN - NLM STAT- MEDLINE DCOM- 20230908 LR - 20230910 IS - 1444-2892 (Electronic) IS - 1443-9506 (Linking) VI - 32 IP - 8 DP - 2023 Aug TI - Invasive Management and Outcomes in Acute Coronary Syndromes and Chronic Kidney Disease (ANZACS-QI 70). PG - 968-977 LID - S1443-9506(23)00471-7 [pii] LID - 10.1016/j.hlc.2023.04.294 [doi] AB - AIMS: Guidelines recommend management with an invasive coronary angiogram in acute coronary syndromes (ACS), but most studies excluded patients with advanced chronic kidney disease (CKD). Our aims were to describe, in a comprehensive ACS cohort, the incidence of CKD, coronary angiography utilisation and outcomes, according to CKD stage. METHODS: National datasets were used to identify hospitalised ACS patients (2013 to 2018) in the Northern region of New Zealand. CKD stage was obtained from a linked laboratory dataset. Outcomes included all-cause and cause-specific mortality, and non-fatal myocardial infarction, heart failure and stroke. RESULTS: Thirty-eight percent (38%) of the 23,432 ACS patients had CKD stage 3 or higher: 2,403 (10%) had stages 4/5 CKD. Overall 61% received coronary angiography. Compared with normal renal function the adjusted rate of coronary angiography was lower in CKD stage 3b (RR 0.75, 95% confidence intervals [CIs] 0.69, 0.82) and stages 4/5 without dialysis (RR 0.41, 95% CIs 0.36, 0.46), but similar for those on dialysis (RR 0.89, 95% CIs 0.77, 1.02). All-cause mortality (mean follow-up 3.2 years) increased with CKD stage from 8% (normal kidney function) to 69% (stages 4/5 CKD without dialysis). Compared with coronary angiography, the adjusted all-cause and CVD mortality risks were higher in those without coronary angiography, except for those on dialysis, where these risks converged. CONCLUSIONS: Invasive management fell below an eGFR of 45 mL/min (70 years, diabetes mellitus, non-dialytic chronic kidney disease, chronic heart failure, cardiogenic shock, and acute coronary syndrome (ACS). The primary endpoint was the occurrence of CIN, defined as a >25% relative increase and/or >0.5 mg/dL absolute increase in creatinine (Cr) levels compared with baseline between the 2nd and 5th day after contrast media administration. RESULTS: A total of 2,268 patients were enrolled. Mean age was 67 years. Diabetes mellitus (53%), non-dialytic chronic kidney disease (31%), and ACS (39%) were highly prevalent. The mean volume of contrast media was 89 ml +/- 48.6. CIN occurred in 15% of all patients, with no significant difference regarding the type of contrast used (iso = 15.2% vs. low = 15.1%, P>.99). Differences were not observed in specific subgroups such as diabetics, elderly, and ACS patients. At 30-day follow-up, 13 patients in the iso-osmolarity group and 11 in low-osmolarity group required dialysis (P =.8). There were 37 (3.3%) deaths in the iso-osmolarity cohort vs. 29 (2.6%) in the low-osmolarity group (P =.4). CONCLUSION: Among patients at high risk for CIN, the incidence of this complication was 15%, and independent of the use of low- or iso-osmolar contrast. FAU - Freitas, Rafaela Andrade Penalva AU - Freitas RAP FAU - Tanajura, Luis Fernando AU - Tanajura LF FAU - Mehran, Roxana AU - Mehran R FAU - Chamie, Daniel AU - Chamie D FAU - Chaves, Aurea AU - Chaves A FAU - Centemero, Marinella AU - Centemero M FAU - Braga, Sergio AU - Braga S FAU - Costa, Ricardo AU - Costa R FAU - Cao, Davide AU - Cao D FAU - Sousa, Amanda AU - Sousa A FAU - Feres, Fausto AU - Feres F FAU - Costa, J Ribamar Jr AU - Costa JR Jr AD - Instituto Dante Pazzanese de Cardiologia, Av. Dr Dante Pazzaensse, 500, Ibirapuera, Sao Paulo - SP, Brazil. rmvcosta@uol.com.br. LA - eng SI - ClinicalTrials.gov/NCT02991742 PT - Journal Article PT - Randomized Controlled Trial DEP - 20230516 PL - United States TA - J Invasive Cardiol JT - The Journal of invasive cardiology JID - 8917477 RN - 0 (Contrast Media) RN - AYI8EX34EU (Creatinine) RN - HW8W27HTXX (iodixanol) RN - Z40X7EI2AF (Ioxaglic Acid) RN - 0 (Triiodobenzoic Acids) SB - IM MH - Aged MH - Humans MH - Contrast Media/adverse effects MH - Coronary Angiography/adverse effects/methods MH - Creatinine MH - *Ioxaglic Acid/adverse effects MH - *Kidney Diseases/chemically induced MH - Risk Factors MH - Triiodobenzoic Acids/adverse effects OTO - NOTNLM OT - contrast media OT - nephropathy OT - osmolarity OT - percutaneous coronary intervention EDAT- 2023/05/23 19:09 MHDA- 2023/07/10 06:42 CRDT- 2023/05/23 17:24 PHST- 2023/07/10 06:42 [medline] PHST- 2023/05/23 19:09 [pubmed] PHST- 2023/05/23 17:24 [entrez] AID - JIC20230516-2 [pii] AID - 10.25270/jic/21.00249 [doi] PST - ppublish SO - J Invasive Cardiol. 2023 Jun;35(6):E281-E290. doi: 10.25270/jic/21.00249. Epub 2023 May 16. PMID- 39131657 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240813 IS - 2772-9303 (Electronic) IS - 2772-9303 (Linking) VI - 2 IP - 4 DP - 2023 Jul-Aug TI - Contrast Media Volume Control and Acute Kidney Injury in Acute Coronary Syndrome: Rationale and Design of the REMEDIAL IV Trial. PG - 100980 LID - 10.1016/j.jscai.2023.100980 [doi] LID - 100980 AB - BACKGROUND: Although the pathogenesis of acute kidney injury (AKI) in patients with acute coronary syndrome (ACS) undergoing invasive treatment is multifactorial, the role of iodinated contrast media (CM) has been well established. The DyeVert system (Osprey Medical) is designed to reduce the CM volume during invasive coronary procedures while maintaining fluoroscopic image quality. OBJECTIVE: The aim of the Renal Insufficiency Following Contrast Media Administration Trial IV (REMEDIAL IV) is to test whether the use of the DyeVert system is effective in reducing contrast-associated acute kidney injury (CA-AKI) rate in patients with ACS undergoing urgent invasive procedures. TRIAL DESIGN: Patients with ACS treated by urgent invasive approach will be enrolled. Participants will be randomly assigned into one of the following groups: (1) DyeVert group and (2) control group. In participants enrolled in the DyeVert group, CM injection will be handled by the DyeVert system. On the contrary, in the control group, CM injection will be performed by a conventional manual or automatic injection syringe. In all cases, iobitridol (a low-osmolar, nonionic CM) will be administered. Participants will receive intravenous 0.9% sodium chloride as soon as moved to the catheterization laboratory. The primary end points are CM volume administration and CA-AKI rate (ie, an increase in serum creatinine concentration of >/=0.3 mg/dL within 48 hours after CM exposure). A sample size of at least 522 randomized participants (261 in each group) is needed to demonstrate an 8.5% difference in the CA-AKI rate between the groups (that is, from 19% in the control group to 10.5% in the DyeVert group), with a 2-sided 95% confidence interval and 80% power (P < .05). CI - (c) 2023 The Author(s). FAU - Briguori, Carlo AU - Briguori C AD - Interventional Cardiology Unit, Mediterranea Cardiocentro, Naples, Italy. FAU - Mariano, Enrica AU - Mariano E AD - Dipartimento di Biomedicina e Prevenzione, Universita Tor Vergata, Rome, Italy. FAU - D'Agostino, Alessandro AU - D'Agostino A AD - Division of Cardiology, Paolo Giaccone University Hospital, Palermo, Italy. FAU - Scarpelli, Mario AU - Scarpelli M AD - Interventional Cardiology Unit, Mediterranea Cardiocentro, Naples, Italy. FAU - Focaccio, Amelia AU - Focaccio A AD - Interventional Cardiology Unit, Mediterranea Cardiocentro, Naples, Italy. FAU - Evola, Salvatore AU - Evola S AD - Division of Cardiology, Paolo Giaccone University Hospital, Palermo, Italy. FAU - Esposito, Giovanni AU - Esposito G AD - Division of Cardiology, Department of Advanced Biomedical Science, "Federico II" University of Naples, Naples, Italy. FAU - Sangiorgi, Giuseppe Massimo AU - Sangiorgi GM AD - Dipartimento di Biomedicina e Prevenzione, Universita Tor Vergata, Rome, Italy. LA - eng PT - Journal Article DEP - 20230428 PL - United States TA - J Soc Cardiovasc Angiogr Interv JT - Journal of the Society for Cardiovascular Angiography & Interventions JID - 9918419271306676 PMC - PMC11307588 OTO - NOTNLM OT - acute coronary syndrome OT - acute kidney injury OT - contrast media EDAT- 2023/04/28 00:00 MHDA- 2023/04/28 00:01 PMCR- 2023/04/28 CRDT- 2024/08/12 06:14 PHST- 2023/02/22 00:00 [received] PHST- 2023/03/21 00:00 [revised] PHST- 2023/04/04 00:00 [accepted] PHST- 2023/04/28 00:01 [medline] PHST- 2023/04/28 00:00 [pubmed] PHST- 2024/08/12 06:14 [entrez] PHST- 2023/04/28 00:00 [pmc-release] AID - S2772-9303(23)00415-5 [pii] AID - 100980 [pii] AID - 10.1016/j.jscai.2023.100980 [doi] PST - epublish SO - J Soc Cardiovasc Angiogr Interv. 2023 Apr 28;2(4):100980. doi: 10.1016/j.jscai.2023.100980. eCollection 2023 Jul-Aug. PMID- 39076740 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240731 IS - 2153-8174 (Electronic) IS - 2153-8174 (Print) IS - 1530-6550 (Linking) VI - 24 IP - 5 DP - 2023 May TI - Prognostic Impact of Percutaneous Coronary Intervention in Chronic Dialysis Patients with Acute Myocardial Infarction: Findings from the Lombardy Health Database. PG - 135 LID - 10.31083/j.rcm2405135 [doi] LID - 135 AB - BACKGROUND: Patients on chronic dialysis are less likely to be treated with percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI). This is due to the lack of evidence from randomized trials, concerns about possible PCI-related side effects, and multimorbidity. Therefore, routine use of PCI for treatment of dialysis patients with AMI remains an unresolved issue. METHODS: We analyzed data of patients on chronic dialysis hospitalized with AMI from 2003 to 2018, by using the administrative Lombardy Health Database (Italy). Patients were grouped according to whether they underwent or not PCI during index hospitalization. The primary outcome was in-hospital mortality, 1-year mortality was the secondary endpoint. RESULTS: During the study period, 265,048 patients were hospitalized with AMI. Of them, 3206 (1.2%) were on chronic dialysis (age 71 +/- 11; 72% males). Among dialysis patients, 44% underwent PCI, while 54% underwent PCI among non-dialysis patients (p < 0.0001). Dialysis was an independent predictor of treatment with medical therapy only (OR 0.75 [95% CI 0.70-0.81]). In-hospital mortality in the dialysis cohort was 15%, significantly lower in patients treated with PCI than in those not treated with PCI (11% vs. 19%; p < 0.0001). One-year mortality was 47% and it was lower in PCI-treated patients (33% vs. 52%; p < 0.0001). The adjusted risk of the study endpoints was significantly lower in dialysis patients undergoing PCI: OR 0.62 (95% CI 0.50-0.76) for in-hospital mortality; HR 0.63 (95% CI 0.56-0.71) for 1-year mortality. CONCLUSIONS: This study showed that in AMI patients on chronic dialysis, PCI is associated with a significant in-hospital and 1-year survival benefit. Yet, they underwent PCI less frequently than patients with preserved renal function. CI - Copyright: (c) 2023 The Author(s). Published by IMR Press. FAU - Cosentino, Nicola AU - Cosentino N AD - Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy. FAU - Genovesi, Simonetta AU - Genovesi S AUID- ORCID: 0000-0002-4699-4149 AD - School of Medicine and Surgery, Nephrology Clinic, Milano-Bicocca University, 20900 Monza, Italy. AD - Istituto Auxologico Italiano, IRCCS, 20133 Milan, Italy. FAU - Bonomi, Alice AU - Bonomi A AD - Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy. FAU - Trombara, Filippo AU - Trombara F AD - Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy. FAU - Ludergnani, Monica AU - Ludergnani M AD - Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy. FAU - Leoni, Olivia AU - Leoni O AD - Regional Epidemiological Observatory, Lombardy Region, 20100 Milan, Italy. FAU - Bortolan, Francesco AU - Bortolan F AD - Regional Epidemiological Observatory, Lombardy Region, 20100 Milan, Italy. FAU - Agostoni, Piergiuseppe AU - Agostoni P AD - Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy. AD - Cardiovascular Section, Department of Clinical Sciences and Community Health, University of Milan, 20159 Milan, Italy. FAU - Marenzi, Giancarlo AU - Marenzi G AD - Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy. LA - eng PT - Journal Article DEP - 20230428 PL - Singapore TA - Rev Cardiovasc Med JT - Reviews in cardiovascular medicine JID - 100960007 PMC - PMC11273045 OTO - NOTNLM OT - acute myocardial infarction OT - administrative database OT - chronic dialysis OT - mortality OT - percutaneous coronary intervention COIS- The authors declare no conflict of interest. Simonetta Genovesi is serving as Guest Editor of this journal. We declare that Simonetta Genovesi had no involvement in the peer review of this article and has no access to information regarding its peer review. Full responsibility for the editorial process for this article was delegated to Gary David Lopaschuk. EDAT- 2023/04/28 00:00 MHDA- 2023/04/28 00:01 PMCR- 2023/04/28 CRDT- 2024/07/30 04:59 PHST- 2023/01/02 00:00 [received] PHST- 2023/04/01 00:00 [revised] PHST- 2023/04/10 00:00 [accepted] PHST- 2023/04/28 00:01 [medline] PHST- 2023/04/28 00:00 [pubmed] PHST- 2024/07/30 04:59 [entrez] PHST- 2023/04/28 00:00 [pmc-release] AID - S1530-6550(23)00979-1 [pii] AID - 10.31083/j.rcm2405135 [doi] PST - epublish SO - Rev Cardiovasc Med. 2023 Apr 28;24(5):135. doi: 10.31083/j.rcm2405135. eCollection 2023 May. PMID- 37066675 OWN - NLM STAT- MEDLINE DCOM- 20230418 LR - 20230421 IS - 1651-2006 (Electronic) IS - 1401-7431 (Linking) VI - 57 IP - 1 DP - 2023 Dec TI - Survival after PCI or CABG for left main stem coronary stenosis. A single institution registry from the NOBLE study period. PG - 2197184 LID - 10.1080/14017431.2023.2197184 [doi] AB - Objective. To analyze 10 years mortality in an all-comers registry of patients with left main coronary artery stenoses treated with either PCI or CABG. Design. Patients with left main coronary stenoses treated with either PCI or CABG in the period of the NOBLE trial (2010-2015) were all included in an institutional database and registry (University Hospital North Norway). Fifty-six of totally 429 patients were included in the randomized, multicenter and international NOBLE trail; 426 eligible patients from the trial and registry were analyzed for mortality on 20 October 2020. The longest observation time on this date was 3611 days (9.9 years); 205 patients were treated with PCI and 221 with CABG. The patients treated with PCI were 74 +/- 10 years vs 68 +/- 10 years (CABG). Also, on average the PCI patients had more comorbidities (lower ejection fraction, more peripheral artery disease, more often acute presentation). Results. Survival at the last observation date was 80% for CABG patients vs 48% for PCI. A Cox proportional hazards analysis found PCI to be the strongest independent predictor for mortality (HR = 2.5, 95% CI 1.7-3.7). Also, COPD, chronic kidney disease, age, peripheral vascular disease, cerebrovascular incidents and acute presentation were factor predicting increased 10 years mortality. Conclusion. These data indicate that life expectancy in the overall patient population is shorter for patient treated for left main disease with PCI than with CABG. FAU - Myrmel, Truls AU - Myrmel T AD - Department of Cardiothoracic and Vascular Surgery, University Hospital North Norway, Tromso, Norway. FAU - Lamoy Bjoru, Anders AU - Lamoy Bjoru A AD - Department of Medicine, Finnmarkssykehuset HF, Hammerfest, Norway. FAU - Cappelen Endresen, Petter AU - Cappelen Endresen P AD - Department of Cardiothoracic and Vascular Surgery, University Hospital North Norway, Tromso, Norway. LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PL - England TA - Scand Cardiovasc J JT - Scandinavian cardiovascular journal : SCJ JID - 9708377 SB - IM MH - Humans MH - Child MH - Coronary Artery Bypass/adverse effects MH - *Percutaneous Coronary Intervention MH - *Stroke/epidemiology MH - *Coronary Artery Disease/diagnostic imaging/surgery MH - *Coronary Stenosis/diagnostic imaging/surgery MH - Registries MH - Treatment Outcome OTO - NOTNLM OT - CABG OT - Left main coronary artery stenoses OT - PCI OT - observational study OT - survival EDAT- 2023/04/18 06:00 MHDA- 2023/04/18 10:16 CRDT- 2023/04/17 04:23 PHST- 2023/04/18 10:16 [medline] PHST- 2023/04/17 04:23 [entrez] PHST- 2023/04/18 06:00 [pubmed] AID - 10.1080/14017431.2023.2197184 [doi] PST - ppublish SO - Scand Cardiovasc J. 2023 Dec;57(1):2197184. doi: 10.1080/14017431.2023.2197184. PMID- 37021576 OWN - NLM STAT- MEDLINE DCOM- 20230526 LR - 20230528 IS - 1524-4636 (Electronic) IS - 1079-5642 (Linking) VI - 43 IP - 6 DP - 2023 Jun TI - Sex Differences in Outcomes of Ticagrelor Therapy With or Without Aspirin After Percutaneous Coronary Intervention in Patients With Acute Coronary Syndrome: A Post Hoc Secondary Analysis of the TICO Randomized Clinical Trial. PG - e218-e226 LID - 10.1161/ATVBAHA.122.318725 [doi] AB - BACKGROUND: We sought to explore the sex differences in clinical outcomes among patients with acute coronary syndrome treated with ticagrelor monotherapy after ticagrelor-based 3-month versus 12-month dual-antiplatelet therapy. METHODS: This was a post hoc analysis of the TICO trial (Ticagrelor Monotherapy After 3 Months in the Patients Treated With New Generation Sirolimus-Eluting Stent for Acute Coronary Syndrome; n=3056)-a randomized controlled trial for patients with acute coronary syndrome treated with drug-eluting stent. The primary outcome was a net adverse clinical event (composite of major bleeding, death, myocardial infarction, stent thrombosis, stroke, or target-vessel revascularization) 1 year after drug-eluting stent implantation. Secondary outcomes included major bleeding and major adverse cardiac and cerebrovascular events. RESULTS: There were 27.3% (n=628) women in the TICO trial; they were older with lower body mass index and higher prevalence of hypertension, diabetes, or chronic kidney disease than men. Compared with men, women had higher risk of net adverse clinical events (hazard ratio [HR], 1.89 [95% CI, 1.34-2.67]), major adverse cardiac and cerebrovascular events (HR, 1.69 [95% CI, 1.07-2.68]), and major bleeding (HR, 2.04 [95% CI, 1.25-3.35]). Among the groups stratified by sex and dual-antiplatelet therapy strategy, the incidences of primary and secondary outcomes were significantly different and the highest in women with ticagrelor-based 12-month dual-antiplatelet therapy (P<0.001). There was no significant heterogeneity in the impact of treatment strategy on the risks of primary and secondary outcomes between both sexes. Ticagrelor monotherapy was associated with a lower risk of the primary outcome in women (HR, 0.47 [95% CI, 0.26-0.85]; P=0.02) and comparable in men (HR, 0.77 [95% CI, 0.52-1.14]; P=0.19) without significant interaction (P for interaction, 0.18). CONCLUSIONS: After percutaneous coronary intervention for acute coronary syndrome, women demonstrated worse clinical outcomes than men. Ticagrelor monotherapy after 3-month dual-antiplatelet therapy was associated with significantly lower risk of net adverse clinical events in women without sex interaction. FAU - Lee, Bom AU - Lee B AD - Division of Cardiology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University College of Medicine, Seongnam, South Korea (B.L., Y.J.). FAU - Lee, Seung-Jun AU - Lee SJ AUID- ORCID: 0000-0002-9201-4818 AD - Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South Korea (S.-J.L., B.-K.K., Y.-J.L., S.-J.H., C.-M.A., J.-S.K., Y.-G.K., D.C., M.-K.H.). FAU - Kim, Byeong-Keuk AU - Kim BK AUID- ORCID: 0000-0003-2493-066X AD - Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South Korea (S.-J.L., B.-K.K., Y.-J.L., S.-J.H., C.-M.A., J.-S.K., Y.-G.K., D.C., M.-K.H.). FAU - Lee, Yong-Joon AU - Lee YJ AUID- ORCID: 0000-0003-4526-6120 AD - Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South Korea (S.-J.L., B.-K.K., Y.-J.L., S.-J.H., C.-M.A., J.-S.K., Y.-G.K., D.C., M.-K.H.). FAU - Hong, Sung-Jin AU - Hong SJ AUID- ORCID: 0000-0003-4893-039X AD - Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South Korea (S.-J.L., B.-K.K., Y.-J.L., S.-J.H., C.-M.A., J.-S.K., Y.-G.K., D.C., M.-K.H.). FAU - Ahn, Chul-Min AU - Ahn CM AUID- ORCID: 0000-0002-7071-4370 AD - Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South Korea (S.-J.L., B.-K.K., Y.-J.L., S.-J.H., C.-M.A., J.-S.K., Y.-G.K., D.C., M.-K.H.). FAU - Kim, Jung-Sun AU - Kim JS AUID- ORCID: 0000-0003-2263-3274 AD - Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South Korea (S.-J.L., B.-K.K., Y.-J.L., S.-J.H., C.-M.A., J.-S.K., Y.-G.K., D.C., M.-K.H.). FAU - Ko, Young-Guk AU - Ko YG AUID- ORCID: 0000-0001-7748-5788 AD - Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South Korea (S.-J.L., B.-K.K., Y.-J.L., S.-J.H., C.-M.A., J.-S.K., Y.-G.K., D.C., M.-K.H.). FAU - Choi, Donghoon AU - Choi D AUID- ORCID: 0000-0002-2009-9760 AD - Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South Korea (S.-J.L., B.-K.K., Y.-J.L., S.-J.H., C.-M.A., J.-S.K., Y.-G.K., D.C., M.-K.H.). FAU - Hong, Meyong-Ki AU - Hong MK AUID- ORCID: 0000-0002-2090-2031 AD - Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South Korea (S.-J.L., B.-K.K., Y.-J.L., S.-J.H., C.-M.A., J.-S.K., Y.-G.K., D.C., M.-K.H.). FAU - Jang, Yangsoo AU - Jang Y AUID- ORCID: 0000-0002-2169-3112 AD - Division of Cardiology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University College of Medicine, Seongnam, South Korea (B.L., Y.J.). LA - eng PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20230406 PL - United States TA - Arterioscler Thromb Vasc Biol JT - Arteriosclerosis, thrombosis, and vascular biology JID - 9505803 RN - R16CO5Y76E (Aspirin) RN - GLH0314RVC (Ticagrelor) RN - 0 (Platelet Aggregation Inhibitors) SB - IM MH - Humans MH - Female MH - Male MH - Aspirin/adverse effects MH - Ticagrelor/adverse effects MH - Platelet Aggregation Inhibitors/adverse effects MH - *Acute Coronary Syndrome/drug therapy MH - *Drug-Eluting Stents/adverse effects MH - Sex Characteristics MH - Hemorrhage/epidemiology MH - *Percutaneous Coronary Intervention/adverse effects OTO - NOTNLM OT - drug- OT - eluting stents OT - incidence OT - sex OT - thrombosis OT - ticagrelor COIS- Disclosures None. EDAT- 2023/04/07 06:00 MHDA- 2023/05/26 06:42 CRDT- 2023/04/06 05:03 PHST- 2023/05/26 06:42 [medline] PHST- 2023/04/07 06:00 [pubmed] PHST- 2023/04/06 05:03 [entrez] AID - 10.1161/ATVBAHA.122.318725 [doi] PST - ppublish SO - Arterioscler Thromb Vasc Biol. 2023 Jun;43(6):e218-e226. doi: 10.1161/ATVBAHA.122.318725. Epub 2023 Apr 6. PMID- 36990493 OWN - NLM STAT- MEDLINE DCOM- 20230331 LR - 20230408 IS - 2044-6055 (Electronic) IS - 2044-6055 (Linking) VI - 13 IP - 3 DP - 2023 Mar 29 TI - Development and validation of dynamic models to predict postdischarge mortality risk in patients with acute myocardial infarction: results from China Acute Myocardial Infarction Registry. PG - e069505 LID - 10.1136/bmjopen-2022-069505 [doi] LID - e069505 AB - OBJECTIVES: The risk of adverse events and prognostic factors are changing in different time phases after acute myocardial infarction (AMI). The incidence of adverse events is considerable in the early period after AMI hospitalisation. Therefore, dynamic risk prediction is needed to guide postdischarge management of AMI. This study aimed to develop a dynamic risk prediction instrument for patients following AMI. DESIGN: A retrospective analysis of a prospective cohort. SETTING: 108 hospitals in China. PARTICIPANTS: A total of 23 887 patients after AMI in the China Acute Myocardial Infarction Registry were included in this analysis. PRIMARY OUTCOME MEASURES: All-cause mortality. RESULTS: In multivariable analyses, age, prior stroke, heart rate, Killip class, left ventricular ejection fraction (LVEF), in-hospital percutaneous coronary intervention (PCI), recurrent myocardial ischaemia, recurrent myocardial infarction, heart failure (HF) during hospitalisation, antiplatelet therapy and statins at discharge were independently associated with 30-day mortality. Variables related to mortality between 30 days and 2 years included age, prior renal dysfunction, history of HF, AMI classification, heart rate, Killip class, haemoglobin, LVEF, in-hospital PCI, HF during hospitalisation, HF worsening within 30 days after discharge, antiplatelet therapy, beta blocker and statin use within 30 days after discharge. The inclusion of adverse events and medications significantly improved the predictive performance of models without these indexes (likelihood ratio test p<0.0001). These two sets of predictors were used to establish dynamic prognostic nomograms for predicting mortality in patients with AMI. The C indexes of 30-day and 2-year prognostic nomograms were 0.85 (95% CI 0.83-0.88) and 0.83 (95% CI 0.81-0.84) in derivation cohort, and 0.79 (95% CI 0.71-0.86) and 0.81 (95% CI 0.79-0.84) in validation cohort, with satisfactory calibration. CONCLUSIONS: We established dynamic risk prediction models incorporating adverse event and medications. The nomograms may be useful instruments to help prospective risk assessment and management of AMI. TRIAL REGISTRATION NUMBER: NCT01874691. CI - (c) Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. FAU - Lv, Junxing AU - Lv J AUID- ORCID: 0000-0003-1480-2015 AD - Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Wang, Chuangshi AU - Wang C AD - Medical Research and Biometrics Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Gao, Xiaojin AU - Gao X AUID- ORCID: 0000-0002-8158-484X AD - Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Yang, Jingang AU - Yang J AD - Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Zhang, Xuan AU - Zhang X AD - Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Ye, Yunqing AU - Ye Y AD - Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Dong, Qiuting AU - Dong Q AD - Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Fu, Rui AU - Fu R AD - Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Sun, Hui AU - Sun H AD - Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Yan, Xinxin AU - Yan X AD - Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Zhao, Yanyan AU - Zhao Y AD - Medical Research and Biometrics Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Wang, Yang AU - Wang Y AUID- ORCID: 0000-0002-5040-2492 AD - Medical Research and Biometrics Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Xu, Haiyan AU - Xu H AD - Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China xuhaiyan@fuwaihospital.org yangyjfw@126.com. FAU - Yang, Yuejin AU - Yang Y AUID- ORCID: 0000-0002-1800-4566 AD - Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China xuhaiyan@fuwaihospital.org yangyjfw@126.com. CN - China Acute Myocardial Infarction Registry study group LA - eng SI - ClinicalTrials.gov/NCT01874691 PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20230329 PL - England TA - BMJ Open JT - BMJ open JID - 101552874 RN - 0 (Platelet Aggregation Inhibitors) SB - IM MH - Humans MH - Infant MH - Retrospective Studies MH - *Percutaneous Coronary Intervention/adverse effects MH - Patient Discharge MH - Prospective Studies MH - Stroke Volume/physiology MH - Aftercare MH - Platelet Aggregation Inhibitors MH - Ventricular Function, Left MH - *Myocardial Infarction MH - *Heart Failure/complications MH - Registries MH - Risk Factors PMC - PMC10069604 OTO - NOTNLM OT - coronary heart disease OT - coronary intervention OT - myocardial infarction OT - prognosis COIS- Competing interests: None declared. EDAT- 2023/03/30 06:00 MHDA- 2023/03/31 06:42 PMCR- 2023/03/28 CRDT- 2023/03/29 20:43 PHST- 2023/03/31 06:42 [medline] PHST- 2023/03/29 20:43 [entrez] PHST- 2023/03/30 06:00 [pubmed] PHST- 2023/03/28 00:00 [pmc-release] AID - bmjopen-2022-069505 [pii] AID - 10.1136/bmjopen-2022-069505 [doi] PST - epublish SO - BMJ Open. 2023 Mar 29;13(3):e069505. doi: 10.1136/bmjopen-2022-069505. PMID- 36959121 OWN - NLM STAT- MEDLINE DCOM- 20230623 LR - 20230915 IS - 1534-6080 (Electronic) IS - 0041-1337 (Linking) VI - 107 IP - 7 DP - 2023 Jul 1 TI - Cardiovascular Outcomes in De Novo Kidney Transplant Recipients Receiving Everolimus and Reduced Calcineurin Inhibitor or Standard Triple Therapy: 24-month Post Hoc Analysis From TRANSFORM Study. PG - 1593-1604 LID - 10.1097/TP.0000000000004555 [doi] AB - BACKGROUND: The comparative impact of everolimus (EVR)-based regimens versus standard of care (mycophenolic acid+standard calcineurin inhibitor [MPA+sCNI]) on cardiovascular outcomes in de novo kidney transplant recipients (KTRs) is poorly understood. The incidence of major adverse cardiac events (MACEs) in KTRs receiving EVR+reduced CNI (rCNI) or MPA+sCNI from the TRANSplant eFficacy and safety Outcomes with an eveRolimus-based regiMen study was evaluated. METHODS: The incidence of MACE was determined for all randomized patients receiving at least 1 dose of the study drug. Factors associated with MACEs were determined by logistic regression. Risk of MACE out to 3 y post-study was calculated using the Patient Outcome in Renal Transplantation equation. RESULTS: MACE occurred in 81 of 1014 (8.0%; EVR+rCNI) versus 89 of 1012 (8.8%; MPA+sCNI) KTRs (risk ratio, 0.91 [95% confidence interval [CI], 0.68-1.21]). The incidence of circulatory death, myocardial infarction, revascularization, or angina was similar between the arms. Incidence of MACE was similar between EVR+rCNI and MPA+sCNI arms with a higher incidence in prespecified risk groups: older age, pretransplant diabetes (15.1% versus 15.9%), statin use (8.5% versus 10.8%), and low estimated glomerular filtration rate (Month 2 estimated glomerular filtration rate <30 versus >60 mL/min/1.73 m 2 ; odds ratio, 2.23 [95% CI, 1.02-4.86]; P = 0.044), respectively. Predicted risk of MACE within 3 y of follow-up did not differ between the treatment arms. CONCLUSIONS: Cardiovascular morbidity and mortality were similar between de novo KTRs receiving EVR+rCNI and MPA+sCNI. EVR+rCNI is a viable alternative to the current standard of care in KTRs. CI - Copyright (c) 2023 The Author(s). Published by Wolters Kluwer Health, Inc. FAU - Sommerer, Claudia AU - Sommerer C AD - Department of Nephrology, Heidelberg University Hospital, Heidelberg, Germany. FAU - Legendre, Christophe AU - Legendre C AD - Department of Adult Kidney Transplantation, Hopital Necker, Universite de Paris, Paris, France. FAU - Citterio, Franco AU - Citterio F AD - Agostino Gemelli University Polyclinic Foundation, Catholic University of the Sacred Heart, Rome, Italy. FAU - Watarai, Yoshihiko AU - Watarai Y AD - Department of Transplant Surgery, Nagoya Daini Red Cross Hospital, Nagoya-City, Aichi, Japan. FAU - Oberbauer, Rainer AU - Oberbauer R AD - Department of Nephrology and Dialysis, University Clinic for Internal Medicine III, Medical University Vienna, Vienna, Austria. FAU - Basic-Jukic, Nikolina AU - Basic-Jukic N AD - University Hospital Centre Zagreb, Zagreb, Croatia. FAU - Han, Jackie AU - Han J AD - Novartis Pharmaceuticals, East Hanover, NJ. FAU - Gawai, Apurva AU - Gawai A AD - Novartis Healthcare Pvt Ltd, Mumbai, India. FAU - Bernhardt, Peter AU - Bernhardt P AD - Novartis Pharma AG, Basel, Switzerland. FAU - Chadban, Steve AU - Chadban S AD - Department of Renal Medicine, Royal Prince Alfred Hospital, Sydney Local Health District, NSW, Australia. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20230620 PL - United States TA - Transplantation JT - Transplantation JID - 0132144 RN - 9HW64Q8G6G (Everolimus) RN - 0 (Calcineurin Inhibitors) RN - 0 (Immunosuppressive Agents) RN - HU9DX48N0T (Mycophenolic Acid) RN - WM0HAQ4WNM (Tacrolimus) SB - IM MH - Humans MH - *Everolimus/adverse effects MH - Calcineurin Inhibitors/adverse effects MH - Immunosuppressive Agents/adverse effects MH - *Kidney Transplantation/adverse effects MH - Standard of Care MH - Mycophenolic Acid/therapeutic use MH - Glomerular Filtration Rate MH - Graft Rejection/etiology MH - Tacrolimus/adverse effects COIS- C.S. declares no personal conflicts; the hospital received patients' fees and research grants from Novartis. F.C. received consulting honoraria and travel grants from Novartis. J.H. is an employee of Novartis Pharmaceuticals. A.G. is an employee of Novartis Healthcare Pvt. Ltd. P.B. is an employee of Novartis Pharma AG. S.C. received funding from Novartis, Astra Zeneca, Bayer, and CSL for research, travel, or speakers' honoraria. The other authors declare no conflicts of interest. EDAT- 2023/03/25 06:00 MHDA- 2023/06/23 06:42 CRDT- 2023/03/24 00:02 PHST- 2023/06/23 06:42 [medline] PHST- 2023/03/25 06:00 [pubmed] PHST- 2023/03/24 00:02 [entrez] AID - 00007890-202307000-00025 [pii] AID - 10.1097/TP.0000000000004555 [doi] PST - ppublish SO - Transplantation. 2023 Jul 1;107(7):1593-1604. doi: 10.1097/TP.0000000000004555. Epub 2023 Jun 20. PMID- 36949408 OWN - NLM STAT- MEDLINE DCOM- 20230324 LR - 20230328 IS - 1471-2369 (Electronic) IS - 1471-2369 (Linking) VI - 24 IP - 1 DP - 2023 Mar 22 TI - Renoprotective effect of febuxostat on contrast-induced acute kidney injury in chronic kidney disease patients stage 3: randomized controlled trial. PG - 65 LID - 10.1186/s12882-023-03114-4 [doi] LID - 65 AB - INTRODUCTION: Contrast-induced acute kidney injury (CI-AKI) is known to be a complication of using intravascular contrast injection. Unfortunately, it is associated with adverse outcomes such as prolonged length of hospitalization and increased burden of health care costs. So, we aimed to determine the efficacy of febuxostat in the prevention of contrast-induced acute kidney injury among patients with chronic kidney disease Stage 3 performing percutaneous coronary intervention (PCI). METHODS: In a randomized controlled trial we enrolled 120 CKD stage 3 Patients with acute coronary syndrome referred to the cardiology department Ain-Shams University hospital for performing PCI and stenting. Patients were randomly assigned to two arms: Group I (study group): Included 60 patients who received Febuxostat added to the traditional treatment (IV hydration and N-acetylcysteine). The patients received Feburic 80 mg within 6-18 h before and within 6-18 h after the coronary intervention (a time gap of 24 h between two doses). Group II (control group): included 60 patients who received only traditional treatment. RESULTS: The incidence of AKI was higher in the control group with a statistically significant difference. We found that Independent Significant risk factors that led to AKI were febuxostate avoidance, DM, high urea level, high creatinine level, CKD stage 3B, high Mehran score and high AKI risk. CONCLUSION: We demonstrated that febuxostat has a Reno protective effect and it can help to reduce the incidence CI-AKI in CKD patients stage 3 performing PCI. CI - (c) 2023. The Author(s). FAU - Sarhan, Iman Ibrahim AU - Sarhan II AD - Department of Internal Medicine and Nephrology, Faculty of Medicine, Ain Shams University, Ramses Street 38, Abbasia, Cairo, 11566, Egypt. FAU - Abdellatif, Yasser A AU - Abdellatif YA AUID- ORCID: 0000-0001-7042-5686 AD - Department of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt. FAU - Saad, Rania Elsayed AU - Saad RE AD - Department of Nephrology, Elsahel teaching hospital, Cairo, Egypt. FAU - Teama, Nahla Mohamed AU - Teama NM AUID- ORCID: 0000-0003-0095-8721 AD - Department of Internal Medicine and Nephrology, Faculty of Medicine, Ain Shams University, Ramses Street 38, Abbasia, Cairo, 11566, Egypt. nahlateama@med.asu.edu.eg. LA - eng PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20230322 PL - England TA - BMC Nephrol JT - BMC nephrology JID - 100967793 RN - 101V0R1N2E (Febuxostat) RN - 0 (Contrast Media) SB - IM MH - Humans MH - Febuxostat/therapeutic use MH - Contrast Media/adverse effects MH - *Percutaneous Coronary Intervention/adverse effects MH - *Renal Insufficiency, Chronic/complications MH - *Acute Kidney Injury/chemically induced/epidemiology/prevention & control MH - Risk Factors MH - Coronary Angiography/adverse effects PMC - PMC10035112 OTO - NOTNLM OT - Contrast OT - Contrast induced acute kidney injury OT - Febuxostat OT - Percutaneous coronary intervention COIS- Authors have no conflicts of interest to declare. EDAT- 2023/03/24 06:00 MHDA- 2023/03/25 06:00 PMCR- 2023/03/22 CRDT- 2023/03/23 00:31 PHST- 2022/09/16 00:00 [received] PHST- 2023/03/09 00:00 [accepted] PHST- 2023/03/23 00:31 [entrez] PHST- 2023/03/24 06:00 [pubmed] PHST- 2023/03/25 06:00 [medline] PHST- 2023/03/22 00:00 [pmc-release] AID - 10.1186/s12882-023-03114-4 [pii] AID - 3114 [pii] AID - 10.1186/s12882-023-03114-4 [doi] PST - epublish SO - BMC Nephrol. 2023 Mar 22;24(1):65. doi: 10.1186/s12882-023-03114-4. PMID- 36948733 OWN - NLM STAT- MEDLINE DCOM- 20230329 LR - 20240208 IS - 1558-3597 (Electronic) IS - 0735-1097 (Linking) VI - 81 IP - 12 DP - 2023 Mar 28 TI - Influence of Culprit Lesion Intervention on Outcomes in Infarct-Related Cardiogenic Shock With Cardiac Arrest. PG - 1165-1176 LID - S0735-1097(23)00203-6 [pii] LID - 10.1016/j.jacc.2023.01.029 [doi] AB - BACKGROUND: Cardiac arrest (CA) is common in patients with infarct-related cardiogenic shock (CS). OBJECTIVES: The goal of this study was to identify the characteristics and outcomes of culprit lesion percutaneous coronary intervention (PCI) of patients with infarct-related CS stratified according to CA in the CULPRIT-SHOCK (Culprit Lesion Only PCI Versus Multivessel PCI in Cardiogenic Shock) randomized trial and registry. METHODS: Patients with CS with and without CA from the CULPRIT-SHOCK study were analyzed. All-cause death or severe renal failure leading to renal replacement therapy within 30 days and 1-year death were assessed. RESULTS: Among 1,015 patients, 550 (54.2%) had CA. Patients with CA were younger, more frequently male, had lower rates of peripheral artery disease, a glomerular filtration rate <30 mL/min, and left main disease, and they presented more often with clinical signs of impaired organ perfusion. The composite of all-cause death or severe renal failure within 30 days occurred in 51.2% of patients with CA vs 48.5% in non-CA patients (P = 0.39) and 1-year death in 53.8% vs 50.4% (P = 0.29), respectively. In a multivariate analysis, CA was an independent predictor of 1-year mortality (HR: 1.27; 95% CI: 1.01-1.59). In the randomized trial, culprit lesion-only PCI was superior to immediate multivessel PCI in patients both with and without CA (P for interaction = 0.6). CONCLUSIONS: More than 50% of patients with infarct-related CS had CA. These patients with CA were younger and had fewer comorbidities, but CA was an independent predictor of 1-year mortality. Culprit lesion-only PCI is the preferred strategy, both in patients with and without CA. (Culprit Lesion Only PCI Versus Multivessel PCI in Cardiogenic Shock [CULPRIT-SHOCK]; NCT01927549). CI - Copyright (c) 2023 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Zeymer, Uwe AU - Zeymer U AD - Klinikum Ludwigshafen, Ludwigshafen, Germany; Institut fur Herzinfarktforschung Ludwigshafen, Ludwigshafen, Germany. Electronic address: Uwe.Zeymer@t-online.de. FAU - Alushi, Brunilda AU - Alushi B AD - Department of Cardiology, Charite-Universitatsmedizin Berlin, Berlin, Germany; Deutsches Zentrum fur Herz-Kreislauf-Forschung (DZHK), Standort Berlin, Germany. FAU - Noc, Marko AU - Noc M AD - University Medical Center Ljubljana, Ljubljana, Slovenia. FAU - Mamas, Mamas A AU - Mamas MA AD - Keele University, Keele, United Kingdom. FAU - Montalescot, Gilles AU - Montalescot G AD - Sorbonne Universite Paris 6, ACTION study group, Centre Hospitalier Universitaire Pitie-Salpetriere (AP-HP), Paris, France. FAU - Fuernau, Georg AU - Fuernau G AD - Stadtisches Klinikum Dessau, Dessau-Rosslau, Germany. FAU - Huber, Kurt AU - Huber K AD - Department of Cardiology, Wilhelminenspital and Sigmund Freud University, Medical School, Vienna, Austria. FAU - Poess, Janine AU - Poess J AD - Heart Center Leipzig, University Hospital, Leipzig, Germany. FAU - de Waha-Thiele, Suzanne AU - de Waha-Thiele S AD - Heart Center Leipzig, University Hospital, Leipzig, Germany. FAU - Schneider, Steffen AU - Schneider S AD - Institut fur Herzinfarktforschung Ludwigshafen, Ludwigshafen, Germany. FAU - Ouarrak, Taoufik AU - Ouarrak T AD - Institut fur Herzinfarktforschung Ludwigshafen, Ludwigshafen, Germany. FAU - Desch, Steffen AU - Desch S AD - Heart Center Leipzig, University Hospital, Leipzig, Germany. FAU - Lauten, Alexander AU - Lauten A AD - Helios-Klinikum Erfurt, Erfurt, Germany. FAU - Thiele, Holger AU - Thiele H AD - Heart Center Leipzig, University Hospital, Leipzig, Germany. LA - eng SI - ClinicalTrials.gov/NCT01927549 PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - United States TA - J Am Coll Cardiol JT - Journal of the American College of Cardiology JID - 8301365 SB - IM CIN - J Am Coll Cardiol. 2023 Mar 28;81(12):1177-1180. doi: 10.1016/j.jacc.2023.02.001. PMID: 36948734 CIN - J Am Coll Cardiol. 2023 Sep 5;82(10):e85. doi: 10.1016/j.jacc.2023.04.062. PMID: 37648360 MH - Humans MH - Male MH - *Coronary Artery Disease/complications/diagnosis/surgery MH - *Heart Arrest/therapy/complications MH - *Myocardial Infarction/diagnosis MH - *Percutaneous Coronary Intervention/adverse effects MH - *Renal Insufficiency/etiology MH - Shock, Cardiogenic/etiology/therapy MH - Treatment Outcome OTO - NOTNLM OT - acute myocardial infarction OT - cardiac arrest OT - cardiogenic shock OT - culprit lesion PCI COIS- Funding Support and Author Disclosures This study was supported by a grant agreement (602202) from the European Union Seventh Framework Program and by the German Heart Research Foundation and the German Cardiac Society. It was also supported by the German Center for Cardiovascular Research (DZHK). Dr Zeymer has received grants from the European Union within the study; has received grants and personal fees from AstraZeneca, Bayer, BMS, Daiichi-Sankyo, and Novartis; and has received personal fees from Boehringer Ingelheim, The Medicines Company, Sanofi, and Ferrer, outside the submitted work. Dr Montalescot has received research grants to the institution or consulting/lecture fees from Abbott, Amgen, Actelion, American College of Cardiology Foundation, AstraZeneca, Axis-Sante, Bayer, Boston Scientific, Boehringer Ingelheim, Bristol Myers Squibb, Beth Israel Deaconess Medical, Brigham Women's Hospital, China Heart House, Daiichi-Sankyo, Idorsia, Elsevier, Europa, Federation Francaise de Cardiologie, ICAN, Lead-Up, Medtronic, Menarini, MSD, Novo Nordisk, Partners, Pfizer, Quantum Genomics, Sanofi, Servier, and WebMD. Dr Desch has received grants from the European Union during the conduct of the study. Dr Thiele has received grants to the institution from the European Union, German Cardiac Society, and German Heart Research Foundation during the conduct of the study. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2023/03/23 06:00 MHDA- 2023/03/25 06:00 CRDT- 2023/03/22 22:00 PHST- 2022/11/07 00:00 [received] PHST- 2023/01/10 00:00 [revised] PHST- 2023/01/17 00:00 [accepted] PHST- 2023/03/22 22:00 [entrez] PHST- 2023/03/23 06:00 [pubmed] PHST- 2023/03/25 06:00 [medline] AID - S0735-1097(23)00203-6 [pii] AID - 10.1016/j.jacc.2023.01.029 [doi] PST - ppublish SO - J Am Coll Cardiol. 2023 Mar 28;81(12):1165-1176. doi: 10.1016/j.jacc.2023.01.029. PMID- 36873753 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230307 IS - 2772-3747 (Electronic) IS - 2772-3747 (Linking) VI - 3 IP - 1 DP - 2023 Feb TI - Prasugrel-Based De-Escalation in Patients With Acute Coronary Syndrome According to Renal Function. PG - 51-61 LID - 10.1016/j.jacasi.2022.09.013 [doi] AB - BACKGROUND: Patients with coronary artery disease and impaired renal function are at higher risk for both bleeding and ischemic adverse events after percutaneous coronary intervention (PCI). OBJECTIVES: This study assessed the efficacy and safety of a prasugrel-based de-escalation strategy in patients with impaired renal function. METHODS: We conducted a post hoc analysis of the HOST-REDUCE-POLYTECH-ACS study. Patients with available estimated glomerular filtration rate (eGFR) (n = 2,311) were categorized into 3 groups. (high eGFR: >90 mL/min; intermediate eGFR: 60 to 90 mL/min; and low eGFR: <60 mL/min). The end points were bleeding outcomes (Bleeding Academic Research Consortium type 2 or higher), ischemic outcomes (cardiovascular death, myocardial infarction, stent thrombosis, repeated revascularization, and ischemic stroke), and net adverse clinical event (including any clinical event) at 1-year follow-up. RESULTS: Prasugrel de-escalation was beneficial regardless of baseline renal function (P for interaction = 0.508). The relative reduction in bleeding risk from prasugrel de-escalation was higher in the low eGFR group than in both the intermediate and high eGFR groups (relative reductions, respectively: 64% (HR: 0.36; 95% CI: 0.15-0.83) vs 50% (HR: 0.50; 95% CI: 0.28-0.90) and 52% (HR: 0.48; 95% CI: 0.21-1.13) (P for interaction = 0.646). Ischemic risk from prasgurel de-escalation was not significant in all eGFR groups (HR: 1.18 [95% CI: 0.47-2.98], HR: 0.95 [95% CI: 0.53-1.69], and HR: 0.61 [95% CI: 0.26-1.39]) (P for interaction = 0.119). CONCLUSIONS: In patients with acute coronary syndrome receiving PCI, prasugrel dose de-escalation was beneficial regardless of the baseline renal function. CI - (c) 2023 The Authors. FAU - Yun, Jun Pil AU - Yun JP AD - Seoul National University Hospital, Seoul, Republic of Korea. FAU - Kang, Jeehoon AU - Kang J AD - Seoul National University Hospital, Seoul, Republic of Korea. FAU - Park, Kyung Woo AU - Park KW AD - Seoul National University Hospital, Seoul, Republic of Korea. FAU - Park, Kyungil AU - Park K AD - Dong-A University Hospital, Busan, Republic of Korea. FAU - Hwang, Doyeon AU - Hwang D AD - Seoul National University Hospital, Seoul, Republic of Korea. FAU - Han, Jung-Kyu AU - Han JK AD - Seoul National University Hospital, Seoul, Republic of Korea. FAU - Yang, Han-Mo AU - Yang HM AD - Seoul National University Hospital, Seoul, Republic of Korea. FAU - Kang, Hyun-Jae AU - Kang HJ AD - Seoul National University Hospital, Seoul, Republic of Korea. FAU - Koo, Bon-Kwon AU - Koo BK AD - Seoul National University Hospital, Seoul, Republic of Korea. FAU - Chae, In-Ho AU - Chae IH AD - Seoul National University Bundang Hospital, Seongnam, Republic of Korea. FAU - Moon, Keon-Woong AU - Moon KW AD - St Vincent's Hospital, Suwon, Republic of Korea. FAU - Park, Hyun Woong AU - Park HW AD - Chungnam National University Sejong Hospital, Sejong, Republic of Korea. FAU - Won, Ki-Bum AU - Won KB AD - Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, South Korea. FAU - Jeon, Dong Woon AU - Jeon DW AD - National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea. FAU - Han, Kyoo-Rok AU - Han KR AD - Kangdong Sacred Heart Hospital, Seoul, Republic of Korea. FAU - Choi, Si Wan AU - Choi SW AD - Chungnam National University Hospital, Daejeon, Republic of Korea. FAU - Ryu, Jae Kean AU - Ryu JK AD - Daegu Catholic University Medical Center, Daegu, Republic of Korea. FAU - Jeong, Myung Ho AU - Jeong MH AD - Cheonnam University Hospital, Gwangju, Republic of Korea. FAU - Kim, Hyo-Soo AU - Kim HS AD - Seoul National University Hospital, Seoul, Republic of Korea. LA - eng PT - Journal Article DEP - 20230110 PL - United States TA - JACC Asia JT - JACC. Asia JID - 9918452380106676 PMC - PMC9982221 OTO - NOTNLM OT - ACS, acute coronary syndrome OT - BARC, bleeding Academic Research Consortium OT - CKD, chronic kidney disease OT - MI, myocardial infarction OT - NACE, net adverse clinical event(s) OT - PCI, percutaneous coronary intervention OT - acute coronary syndrome OT - chronic kidney disease OT - eGFR, estimated glomerular filtration rate OT - prasugrel COIS- This post hoc analysis was supported by research grants from the GENESIS registry (research ID: 620102880) and from Seoul National University Hospital (research ID: 03-2021-0030). Dr Kyung Woo Park has received speaker fees from Daiichi Sankyo, Sanofi, Bristol Myers Squibb, Bayer, Pfizer, InnoN Pharmaceutical, DaeWoong Pharmaceutical, and JW Pharmaceutical outside of the submitted work. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2023/03/07 06:00 MHDA- 2023/03/07 06:01 PMCR- 2023/01/10 CRDT- 2023/03/06 03:45 PHST- 2022/06/06 00:00 [received] PHST- 2022/08/22 00:00 [revised] PHST- 2022/09/16 00:00 [accepted] PHST- 2023/03/06 03:45 [entrez] PHST- 2023/03/07 06:00 [pubmed] PHST- 2023/03/07 06:01 [medline] PHST- 2023/01/10 00:00 [pmc-release] AID - S2772-3747(22)00305-2 [pii] AID - 10.1016/j.jacasi.2022.09.013 [doi] PST - epublish SO - JACC Asia. 2023 Jan 10;3(1):51-61. doi: 10.1016/j.jacasi.2022.09.013. eCollection 2023 Feb. PMID- 36840760 OWN - NLM STAT- MEDLINE DCOM- 20230228 LR - 20240121 IS - 1435-2451 (Electronic) IS - 1435-2443 (Print) IS - 1435-2443 (Linking) VI - 408 IP - 1 DP - 2023 Feb 25 TI - Kidney transplantation following iliac revascularization in severe atherosclerosis: a comparative study. PG - 105 LID - 10.1007/s00423-023-02838-z [doi] LID - 105 AB - BACKGROUND: Kidney transplantation (KT) has become the standard of care for patients with end-stage renal disease. However, as atherosclerosis progresses with time on dialysis, it causes increasing difficulties in implanting the graft. This is a comparative study analyzing complications and graft survival of recipients with iliac revascularization before transplantation. METHODS: Between January 2006 and December 2015, 1691 kidney transplants were performed at our institution. We retrospectively analyzed eighteen patients with peripheral arterial disease (PAD) with the necessity of vascular revascularization before kidney transplantation to protect the inflow to the renal graft and to optimizing blood supply to the extremities. The primary endpoint included patient survival and graft survival. The secondary endpoints evaluate perioperative and early postoperative complication rates after kidney transplantation. RESULTS: All patients enrolled in this study underwent two consecutive surgical procedures. No patient reported limb loss, and there was no additional perioperative morbidity or mortality related to the vascular procedure. Primary endpoints such as graft survival without dialysis and overall patient survival show 1-month survival of 100%, 1-year survival of 94.1%, and 5-year survival of 84.70%, respectively. One graft failure occurred 8 months after transplantation due to acute rejection, and there were two deaths over follow-up period due to myocardial infarction. CONCLUSIONS: Vascular repair before kidney transplantation is safe, and results are suggestive that it prolongs graft survival. These promising results should encourage other centers to address vascular repair before the transplantation to optimize blood supply to the extremity and the future graft. Although, the interpretation of our results must be cautiously because of the small and heterogeneous sample size, and the limitations of retrospective study design. Prospective trials with larger study populations are needed to confirm the results of this study and to identify significant differences. CI - (c) 2023. The Author(s). FAU - Cyrek, Anna E AU - Cyrek AE AD - Division of Vascular and Endovascular Surgery, Department of General, Visceral and Transplant Surgery, University Hospital Essen, University Duisburg-Essen, Essen, Germany. anna.cyrek@uk-essen.de. FAU - Flogel, Lena AU - Flogel L AD - Department of Urology, Evangelical Hospital Witten gGmbH, Witten, Germany. FAU - Pacha, Arkadius AU - Pacha A AD - Institute of Pharmacology and Toxicology, Ruhr-University Bochum, Bochum, Germany. FAU - Kaths, Moritz AU - Kaths M AD - Department of General, Visceral and Transplant Surgery, University Hospital Essen, University Duisburg-Essen, Essen, Germany. FAU - Treckmann, Jurgen AU - Treckmann J AD - Department of General, Visceral and Transplant Surgery, University Hospital Essen, University Duisburg-Essen, Essen, Germany. FAU - Paul, Andreas AU - Paul A AD - Department of General, Visceral and Transplant Surgery, University Hospital Essen, University Duisburg-Essen, Essen, Germany. FAU - Schulze, Maren AU - Schulze M AD - Department of General, Visceral and Transplant Surgery, University Hospital Essen, University Duisburg-Essen, Essen, Germany. LA - eng PT - Journal Article DEP - 20230225 PL - Germany TA - Langenbecks Arch Surg JT - Langenbeck's archives of surgery JID - 9808285 SB - IM MH - Humans MH - *Kidney Transplantation/methods MH - Retrospective Studies MH - Prospective Studies MH - *Atherosclerosis MH - *Kidney Failure, Chronic/surgery MH - Graft Survival MH - Treatment Outcome PMC - PMC9968260 OTO - NOTNLM OT - Graft survival OT - Iliac revascularization OT - Kidney transplantation OT - Outcome COIS- The authors declare no competing interests. The authors declare no competing interests. EDAT- 2023/02/26 06:00 MHDA- 2023/03/03 06:00 PMCR- 2023/02/25 CRDT- 2023/02/25 11:14 PHST- 2022/06/13 00:00 [received] PHST- 2023/02/13 00:00 [accepted] PHST- 2023/02/25 11:14 [entrez] PHST- 2023/02/26 06:00 [pubmed] PHST- 2023/03/03 06:00 [medline] PHST- 2023/02/25 00:00 [pmc-release] AID - 10.1007/s00423-023-02838-z [pii] AID - 2838 [pii] AID - 10.1007/s00423-023-02838-z [doi] PST - epublish SO - Langenbecks Arch Surg. 2023 Feb 25;408(1):105. doi: 10.1007/s00423-023-02838-z. PMID- 36802715 OWN - NLM STAT- MEDLINE DCOM- 20230329 LR - 20260127 IS - 1524-4539 (Electronic) IS - 0009-7322 (Linking) VI - 147 IP - 13 DP - 2023 Mar 28 TI - Exploring the Relationship Between Efpeglenatide Dose and Cardiovascular Outcomes in Type 2 Diabetes: Insights From the AMPLITUDE-O Trial. PG - 1004-1013 LID - 10.1161/CIRCULATIONAHA.122.063716 [doi] AB - BACKGROUND: In the AMPLITUDE-O (Effect of Efpeglenatide on Cardiovascular Outcomes) cardiovascular outcomes trial, adding either 4 mg or 6 mg weekly of the glucagon-like peptide-1 receptor agonist efpeglenatide to usual care reduced major adverse cardiovascular events (MACE) in people with type 2 diabetes at high cardiovascular risk. Whether these benefits are dose related remains uncertain. METHODS: Participants were randomly assigned in a 1:1:1 ratio to placebo, 4 mg or 6 mg of efpeglenatide. The effect of 6 mg versus placebo and of 4 mg versus placebo on MACE (a nonfatal myocardial infarction, nonfatal stroke, or death from cardiovascular or unknown causes) and on all the secondary composite cardiovascular and kidney outcomes was assessed. A dose-response relationship was assessed using the log-rank test and chi(2) statistic for trend. RESULTS: During a median follow-up of 1.8 years, MACE occurred in 125 (9.2%) participants assigned to placebo, 84 (6.2%) participants assigned to 6 mg of efpeglenatide (hazard ratio [HR], 0.65 [95% CI, 0.5-0.86]; P=0.0027), and 105 (7.7%) assigned to 4 mg of efpeglenatide (HR, 0.82 [95% CI, 0.63-1.06]; P=0.14). Participants receiving high-dose efpeglenatide also experienced fewer secondary outcomes, including the composite of MACE, coronary revascularization, or hospitalization for unstable angina (HR, 0.73 for 6 mg, P=0.011; HR, 0.85 for 4 mg, P=0.17), a kidney composite outcome comprising sustained new macroalbuminuria, a >/=40% decline in estimated glomerular filtration rate or renal failure (HR, 0.63 for 6 mg, P<0.0001; HR, 0.73 for 4 mg, P=0.0009), MACE or any death (HR, 0.67 for 6 mg, P=0.0021; HR, 0.81 for 4 mg, P=0.08), a kidney function outcome comprising a sustained >/=40% decline in estimated glomerular filtration rate, renal failure, or death (HR, 0.61 for 6 mg, P=0.0072; HR, 0.97 for 4 mg, P=0.83), and the composite of MACE, any death, heart failure hospitalization, or the kidney function outcome (HR, 0.63 for 6 mg, P=0.0002; HR, 0.81 for 4 mg, P=0.067). A clear dose-response was noted for all primary and secondary outcomes (all P for trend 0.5 mg/dL or a relative >25% increase in creatinine) at discharge, respectively. Thirty-day coprimary outcomes were the out-of-hospital composite of death, myocardial infarction, or stroke (major adverse cardiovascular events [MACE]) and net adverse cardiovascular events (NACE), defined as the composite of MACE or Bleeding Academic Research Consortium type 3 or 5 bleeding. RESULTS: Persistent and transient AKI occurred in 750 (9.1%) and 587 (7.2%) subjects, respectively. After multivariable adjustment, compared with patients without AKI, the risk for 30-day coprimary outcomes was higher in patients with persistent AKI (MACE: adjusted HR: 2.32; 95% CI: 1.48-3.64; P < 0.001; NACE: adjusted HR: 2.29; 95% CI: 1.48-3.52; P < 0.001), driven mainly by all-cause mortality (adjusted HR: 3.43; 95% CI: 2.03-5.82; P < 0.001), whereas transient AKI was not associated with higher rates of MACE or NACE. Results remained consistent when implementing the KDIGO (Kidney Disease Improving Global Outcomes) criteria. CONCLUSIONS: Among patients with ACS undergoing invasive management, in-hospital persistent but not transient AKI was associated with higher risk for 30-day MACE and NACE. (Minimizing Adverse Haemorrhagic Events by Transradial Access Site and Systemic Implementation of Angiox [MATRIX]; NCT01433627). CI - Copyright (c) 2023 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Landi, Antonio AU - Landi A AD - Division of Cardiology, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland. FAU - Branca, Mattia AU - Branca M AD - CTU Bern, University of Bern, Switzerland. FAU - Leonardi, Sergio AU - Leonardi S AD - University of Pavia and Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. FAU - Frigoli, Enrico AU - Frigoli E AD - Division of Cardiology, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland; CTU Bern, University of Bern, Switzerland. FAU - Vranckx, Pascal AU - Vranckx P AD - Department of Cardiology and Critical Care Medicine, Hartcentrum Hasselt, Jessa Ziekenhuis, Hasselt, Belgium; Faculty of Medicine and Life Sciences, University of Hasselt, Hasselt, Belgium. FAU - Tebaldi, Matteo AU - Tebaldi M AD - Cardiology Unit, Azienda Ospedaliero Universitaria di Ferrara, Cona, Italy. FAU - Varbella, Ferdinando AU - Varbella F AD - Cardiology Unit, Ospedali Riuniti di Rivoli, ASL Torino 3, Turin, Italy; Cardiology Unit, Azienda Ospedaliera Universitaria San Luigi Gonzaga Orbassano, Turin, Italy. FAU - Calabro, Paolo AU - Calabro P AD - Division of Cardiology, "Sant'Anna e San Sebastiano" Hospital, Caserta, Italy; Department of Translational Medicine, University of Campania "Luigi Vanvitelli," Caserta, Italy. FAU - Esposito, Giovanni AU - Esposito G AD - Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy. FAU - Sardella, Gennaro AU - Sardella G AD - Department of Cardiovascular Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy. FAU - Garducci, Stefano AU - Garducci S AD - Vimercate Hospital, ASST della Brianza, Italy. FAU - Ando, Giuseppe AU - Ando G AD - Azienda Ospedaliera Universitaria Policlinico "Gaetano Martino," University of Messina, Messina, Italy. FAU - Limbruno, Ugo AU - Limbruno U AD - Cardiology Department, Misericordia Hospital, Grosseto, Italy. FAU - Sganzerla, Paolo AU - Sganzerla P AD - IRCCS Istituto Auxologico Italiano, Ospedale San Luca, Milano. FAU - Santarelli, Andrea AU - Santarelli A AD - Cardiology Unit, Infermi Hospital, Rimini, Italy. FAU - Briguori, Carlo AU - Briguori C AD - Interventional Cardiology Unit, Mediterranea Cardiocentro, Naples, Italy. FAU - Colangelo, Salvatore AU - Colangelo S AD - Cardiovascular Intervention Unit, San Giovanni Bosco Hospital, Turin, Italy. FAU - Brugaletta, Salvatore AU - Brugaletta S AD - Hospital Clinic, Cardiovascular Clinic Institute, Institut d'Investigacions Biomediques August Pi i Sunyer, University of Barcelona, Barcelona, Spain. FAU - Adamo, Marianna AU - Adamo M AD - Cardiac Catheterization Laboratory and Cardiology, ASST Spedali Civili di Brescia, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy. FAU - Omerovic, Elmir AU - Omerovic E AD - Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden; Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. FAU - Heg, Dik AU - Heg D AD - CTU Bern, University of Bern, Switzerland. FAU - Windecker, Stephan AU - Windecker S AD - Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland. FAU - Valgimigli, Marco AU - Valgimigli M AD - Division of Cardiology, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland; Department of Biomedical Sciences, University of Italian Switzerland, Lugano, Switzerland. Electronic address: marco.valgimigli@eoc.ch. CN - MATRIX Investigators LA - eng SI - ClinicalTrials.gov/NCT01433627 PT - Clinical Trial PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20221228 PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 SB - IM CIN - JACC Cardiovasc Interv. 2023 Jan 23;16(2):206-208. doi: 10.1016/j.jcin.2022.10.052. PMID: 36697157 MH - Humans MH - *Acute Coronary Syndrome/diagnostic imaging/therapy MH - *Acute Kidney Injury/diagnosis/epidemiology/etiology MH - Hemorrhage/chemically induced MH - *Myocardial Infarction/etiology MH - *Percutaneous Coronary Intervention MH - Risk Factors MH - Treatment Outcome OTO - NOTNLM OT - acute coronary syndrome OT - percutaneous coronary intervention OT - persistent acute kidney injury OT - transient acute kidney injury COIS- Funding Support and Author Disclosures The trial was sponsored by Societa Italiana di Cardiologia Invasiva (a nonprofit organization), which received grant support from The Medicines Company and Terumo. This substudy did not receive any direct or indirect funding. Prof Leonardi has received grants and personal fees from AstraZeneca; and has received personal fees from Daiichi Sankyo, Bayer, Pfizer/Bristol Myers Squibb, ICON, Chiesi, and Novo Nordisk (all outside the submitted work). Prof Vranckx has received personal fees from Bayer, Daiichi Sankyo, and CLS Behring (all outside the submitted work). Dr Tebaldi has received research grants from GADA and Abbott Vascular; and has received personal fees from Abbott (all outside the submitted work). Prof Ando has received personal fees and nonfinancial support from Daiichi Sankyo, Boeringer Ingelheim, and Amgen; and has received personal fees from AstraZeneca, Chiesi, and Biosensors (all outside the submitted work). Dr Brugaletta has received a research grant to the institution from AstraZeneca; has received personal fees from Abbott Vascular (outside the submitted work); and has served as an advisory board member for Boston Scientific, iVascular, and Teleflex. Dr Adamo has received speaker fees from Abbott Vascular and Medtronic (all outside the submitted work). Prof Windecker has received research and educational grants to the institution from Abbott, Amgen, AstraZeneca, Bristol Myers Squibb, Bayer, Biotronik, Boston Scientific, Cardinal Health, Cardiovalve, CSL Behring, Daiichi Sankyo, Edwards Lifesciences, Guerbet, Infraredx, Johnson & Johnson, Medicure, Medtronic, Novartis, Polares, OrPha Suisse, Pfizer, Regeneron, Sanofi, Sinomed, Terumo, and V-Wave; has served as an unpaid advisory board member and/or unpaid member of the steering or executive groups of trials funded by Abbott, Abiomed, Amgen, AstraZeneca, Bayer, Bristol Myers Squibb, Boston Scientific, Biotronik, Cardiovalve, Edwards Lifesciences, MedAlliance, Medtronic, Novartis, Polares, Sinomed, Terumo, V-Wave, and Xeltis (but has not received personal payments from pharmaceutical companies or device manufacturers); and is a member of the steering or executive committee groups of several investigator-initiated trials that receive funding from industry without impact on his personal remuneration. Prof Valgimigli has received grants and personal fees from Abbott, Terumo, and AstraZeneca; has received personal fees from Chiesi, Bayer, Daiichi Sankyo, Amgen, Alvimedica, Biosensors, and Idorsia; and has received grants from Medicure (outside the submitted work). All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2023/01/26 06:00 MHDA- 2023/01/28 06:00 CRDT- 2023/01/25 20:59 PHST- 2022/07/22 00:00 [received] PHST- 2022/09/27 00:00 [revised] PHST- 2022/10/02 00:00 [accepted] PHST- 2023/01/25 20:59 [entrez] PHST- 2023/01/26 06:00 [pubmed] PHST- 2023/01/28 06:00 [medline] AID - S1936-8798(22)01897-0 [pii] AID - 10.1016/j.jcin.2022.10.009 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2023 Jan 23;16(2):193-205. doi: 10.1016/j.jcin.2022.10.009. Epub 2022 Dec 28. PMID- 36620646 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230111 IS - 2297-055X (Print) IS - 2297-055X (Electronic) IS - 2297-055X (Linking) VI - 9 DP - 2022 TI - Bifurcation strategies using second-generation drug-eluting stents on clinical outcomes in diabetic patients. PG - 1018802 LID - 10.3389/fcvm.2022.1018802 [doi] LID - 1018802 AB - BACKGROUND: Diabetes mellitus (DM) is a critical risk factor for the pathogenesis and progression of coronary artery disease, with a higher prevalence of complex coronary artery disease, including bifurcation lesions. This study aimed to elucidate the optimal stenting strategy for coronary bifurcation lesions in patients with DM. METHODS: A total of 905 patients with DM and bifurcation lesions treated with second-generation drug-eluting stents (DES) from a multicenter retrospective patient cohort were analyzed. The primary outcome was the 5-year incidence of target lesion failure (TLF), which was defined as a composite of cardiac death, target vessel myocardial infarction, and target lesion revascularization. RESULTS: Among all patients with DM with significant bifurcation lesions, 729 (80.6%) and 176 (19.4%) were treated with one- and two-stent strategies, respectively. TLF incidence differed according to the stenting strategy during the mean follow-up of 42 +/- 20 months. Among the stent strategies, T- and V-stents were associated with a higher TLF incidence than one-stent strategy (24.0 vs. 7.3%, p < 0.001), whereas no difference was observed in TLF between the one-stent strategy and crush or culotte technique (7.3 vs. 5.9%, p = 0.645). The T- or V-stent technique was an independent predictor of TLF in multivariate analysis (hazard ratio, 3.592; 95% confidence interval, 2.117-6.095; p < 0.001). Chronic kidney disease, reduced left ventricular ejection fraction, and left main bifurcation were independent predictors of TLF in patients with DM. CONCLUSION: T- or V-stenting in patients with DM resulted in increased cardiovascular events after second-generation DES implantation. CLINICAL TRIAL REGISTRATION: https://clinicaltrials.gov/ct2/show/NCT03068494?term=03068494&draw=2&rank=1, identifier: NCT03068494. CI - Copyright (c) 2022 Cha, Hong, Kim, Lim, Joo, Park, Yu, Kang, Kim, Gwon, Chun, Hur, Han, Rha, Chae, Jeong, Heo, Yoon, Park, Hong, Doh, Cha, Kim, Lee, Chang, Hwang, Choi, Jeong, Song, Choi, Nam, Koo and Lim. FAU - Cha, Jung-Joon AU - Cha JJ AD - Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, South Korea. FAU - Hong, Soon Jun AU - Hong SJ AD - Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, South Korea. FAU - Kim, Ju Hyeon AU - Kim JH AD - Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, South Korea. FAU - Lim, Subin AU - Lim S AD - Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, South Korea. FAU - Joo, Hyung Joon AU - Joo HJ AD - Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, South Korea. FAU - Park, Jae Hyoung AU - Park JH AD - Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, South Korea. FAU - Yu, Cheol Woong AU - Yu CW AD - Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, South Korea. FAU - Kang, Jeehoon AU - Kang J AD - Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, South Korea. FAU - Kim, Hyo-Soo AU - Kim HS AD - Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, South Korea. FAU - Gwon, Hyeon-Cheol AU - Gwon HC AD - Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. FAU - Chun, Woo Jung AU - Chun WJ AD - Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea. FAU - Hur, Seung-Ho AU - Hur SH AD - Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, South Korea. FAU - Han, Seung Hwan AU - Han SH AD - Department of Internal Medicine, Gachon University Gil Hospital, Incheon, South Korea. FAU - Rha, Seung-Woon AU - Rha SW AD - Department of Internal Medicine, Korea University Guro Hospital, Seoul, South Korea. FAU - Chae, In-Ho AU - Chae IH AD - Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea. FAU - Jeong, Jin-Ok AU - Jeong JO AD - Department of Medicine, Chungnam National University Hospital, Daejeon, South Korea. FAU - Heo, Jung Ho AU - Heo JH AD - Department of Internal Medicine, Kosin University Gospel Hospital, Kosin University College of Medicine, Pusan, South Korea. FAU - Yoon, Junghan AU - Yoon J AD - Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, South Korea. FAU - Park, Jong-Seon AU - Park JS AD - Department of Internal Medicine, Yeungnam University Medical Center, Daegu, South Korea. FAU - Hong, Myeong-Ki AU - Hong MK AD - Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South Korea. FAU - Doh, Joon-Hyung AU - Doh JH AD - Department of Internal Medicine, Inje University Ilsan Paik Hospital, Ilsan, South Korea. FAU - Cha, Kwang Soo AU - Cha KS AD - Department of Internal Medicine, Pusan National University Hospital, Pusan, South Korea. FAU - Kim, Doo-Il AU - Kim DI AD - Department of Internal Medicine, Inje University Haeundae Paik Hospital, Pusan, South Korea. FAU - Lee, Sang Yeub AU - Lee SY AD - Department of Cardiology, Chung-Ang University, College of Medicine Heart and Brain Hospital, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, South Korea. FAU - Chang, Kiyuk AU - Chang K AD - Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea. FAU - Hwang, Byung-Hee AU - Hwang BH AD - Department of Internal Medicine, St. Paul's Hospital, The Catholic University of Korea, Seoul, South Korea. FAU - Choi, So-Yeon AU - Choi SY AD - Department of Internal Medicine, Ajou University Hospital, Suwon, South Korea. FAU - Jeong, Myung Ho AU - Jeong MH AD - Department of Internal Medicine, Chonnam National University Hospital, Gwangju, South Korea. FAU - Song, Young Bin AU - Song YB AD - Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. FAU - Choi, Ki Hong AU - Choi KH AD - Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. FAU - Nam, Chang-Wook AU - Nam CW AD - Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, South Korea. FAU - Koo, Bon-Kwon AU - Koo BK AD - Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, South Korea. FAU - Lim, Do-Sun AU - Lim DS AD - Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, South Korea. LA - eng SI - ClinicalTrials.gov/NCT03068494 PT - Journal Article DEP - 20221221 PL - Switzerland TA - Front Cardiovasc Med JT - Frontiers in cardiovascular medicine JID - 101653388 PMC - PMC9811589 OTO - NOTNLM OT - clinical outcome OT - coronary bifurcation angioplasty OT - diabetes mellitus OT - percutaneous coronary intervention (complex PCI) OT - second-generation drug-eluting stent OT - stent strategy COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2023/01/10 06:00 MHDA- 2023/01/10 06:01 PMCR- 2022/01/01 CRDT- 2023/01/09 04:16 PHST- 2022/08/14 00:00 [received] PHST- 2022/12/01 00:00 [accepted] PHST- 2023/01/09 04:16 [entrez] PHST- 2023/01/10 06:00 [pubmed] PHST- 2023/01/10 06:01 [medline] PHST- 2022/01/01 00:00 [pmc-release] AID - 10.3389/fcvm.2022.1018802 [doi] PST - epublish SO - Front Cardiovasc Med. 2022 Dec 21;9:1018802. doi: 10.3389/fcvm.2022.1018802. eCollection 2022. PMID- 36617393 OWN - NLM STAT- Publisher LR - 20240216 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) DP - 2023 Jan 8 TI - Intravascular lithotripsy in the treatment of coronary artery calcification in a high-risk real world population. LID - 10.1002/ccd.30546 [doi] AB - BACKGROUND: The DISRUPT-CAD study series demonstrated feasibility and safety of intravascular lithotripsy (IVL) in selected patients, but applicability across a broad range of clinical scenarios remains unclear. AIMS: This study aims to evaluate the procedural and clinical outcomes of IVL in a high-risk real-world cohort, compared to a regulatory approval cohort. METHODS: Consecutive patients treated with IVL and percutaneous coronary intervention at our center from May 2016 to April 2020 were included. Comparison was made between those enrolled in the DISRUPT-CAD series of studies to those with calcified lesions but an exclusion criteria. RESULTS: Among 177 patients treated with IVL, 142 were excluded from regulatory trials due to acute coronary syndrome presentation (47.2%), left ventricular ejection fraction <40% (22.5%), chronic renal failure (12.0%), or use of mechanical circulatory support (8.5%). This clinical cohort had a higher SYNTAX score (22.6 +/- 12.1 vs. 17.4 +/- 9.9, p = 0.019), and more treated ACC/AHA C lesions (56.3% vs. 37.1%, p = 0.042). Rates of device success (93.7% vs. 100.0%, p = 0.208), procedural success (96.5% vs. 100.0%, p = 0.585), and minimal lumen area gain (221.2 +/- 93.7% vs. 198.6 +/- 152.0%, p = 0.807) were similar in both groups. The DISRUPT-CAD cohort had no in-hospital mortality, 30-day major adverse cardiac events (MACE), or 30-day target vessel revascularization (TVR). The clinical cohort had an in-hospital mortality of 4.2%, 30-day MACE of 7.8%, and 30-day TVR of 1.5%. There was no difference in 12-month TVR (2.9% vs. 2.2%; p = 0.825). Twelve-month MACE was higher in the clinical cohort (21.1% vs. 8.6%, p = 0.03). CONCLUSION: IVL use remains associated with high clinical efficacy, procedural success, and low complication rates in a real-world population previously excluded from regulatory approving trials. CI - (c) 2023 Wiley Periodicals LLC. FAU - Yeoh, Julian AU - Yeoh J AUID- ORCID: 0000-0003-4957-186X AD - King's College Hospital NHS Foundation Trust, London, UK. AD - Department of Medicine, The University of Melbourne, Melbourne, Australia. FAU - Kanyal, Ritesh AU - Kanyal R AUID- ORCID: 0000-0003-4079-2578 AD - King's College Hospital NHS Foundation Trust, London, UK. FAU - Pareek, Nilesh AU - Pareek N AUID- ORCID: 0000-0002-2720-2134 AD - King's College Hospital NHS Foundation Trust, London, UK. FAU - Macaya, Fernando AU - Macaya F AD - King's College Hospital NHS Foundation Trust, London, UK. FAU - Cannata, Stefano AU - Cannata S AUID- ORCID: 0000-0002-0559-7833 AD - King's College Hospital NHS Foundation Trust, London, UK. FAU - Tzalamouras, Vasileos AU - Tzalamouras V AD - King's College Hospital NHS Foundation Trust, London, UK. FAU - Webb, Ian AU - Webb I AD - King's College Hospital NHS Foundation Trust, London, UK. FAU - Dworakowski, Rafal AU - Dworakowski R AD - King's College Hospital NHS Foundation Trust, London, UK. FAU - Melikian, Narbeh AU - Melikian N AD - King's College Hospital NHS Foundation Trust, London, UK. FAU - Shah, Ajay M AU - Shah AM AD - King's College Hospital NHS Foundation Trust, London, UK. FAU - MacCarthy, Philip AU - MacCarthy P AD - King's College Hospital NHS Foundation Trust, London, UK. FAU - Hill, Jonathan AU - Hill J AD - Royal Brompton and Harefield NHS Foundation Trust, London, UK. FAU - Byrne, Jonathan AU - Byrne J AD - King's College Hospital NHS Foundation Trust, London, UK. LA - eng PT - Journal Article DEP - 20230108 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM OTO - NOTNLM OT - calcification OT - intravascular lithotripsy OT - percutaneous coronary intervention EDAT- 2023/01/09 06:00 MHDA- 2023/01/09 06:00 CRDT- 2023/01/08 14:37 PHST- 2022/12/03 00:00 [revised] PHST- 2022/08/28 00:00 [received] PHST- 2022/12/26 00:00 [accepted] PHST- 2023/01/08 14:37 [entrez] PHST- 2023/01/09 06:00 [pubmed] PHST- 2023/01/09 06:00 [medline] AID - 10.1002/ccd.30546 [doi] PST - aheadofprint SO - Catheter Cardiovasc Interv. 2023 Jan 8. doi: 10.1002/ccd.30546. PMID- 36601884 OWN - NLM STAT- MEDLINE DCOM- 20230106 LR - 20230418 IS - 1897-4279 (Electronic) IS - 0022-9032 (Linking) VI - 80 IP - 12 DP - 2022 TI - Dual pathway inhibition for atherosclerotic cardiovascular disease: Recent advances. PG - 1200-1210 LID - 10.33963/KP.a2022.0283 [doi] AB - Atherosclerotic cardiovascular disease (ASCVD), which includes coronary artery disease (CAD), cerebrovascular disease, and peripheral arterial disease (PAD) is associated with significant morbidity, mortality, and healthcare costs. Antiplatelet therapy has long been the mainstay of antithrombotic therapy for the prevention of first-ever and recurrent ASCVD events. More recently, however, randomized trials have demonstrated the benefits and cost-effectiveness of a dual pathway inhibition (DPI) strategy in acute and chronic ASCVD. When used in combination, aspirin and low-dose rivaroxaban work synergistically to inhibit platelet activation and thrombin generation, thereby preventing thrombus formation. Among patients with recent acute coronary syndrome (ACS), those with positive cardiac biomarkers or ST-segment elevation myocardial infarction, or a history of heart failure derive the greatest absolute benefits. Among patients with chronic ASCVD, those with involvement of two or more vascular beds, heart failure, chronic kidney disease, or diabetes derive the greatest absolute benefits. Additional trials are underway to assess the impact of DPI therapy in other populations of interest, including patients with ACS at high risk of left ventricular thrombus formation, intracranial atherosclerotic disease with recent transient ischemic attack or stroke, peripheral arterial disease with limiting claudication or post lower extremity revascularization, and advanced chronic kidney disease with ASCVD or risk factors for ASCVD. Further work is required to assess the possible added benefit of combining rivaroxaban with clopidogrel or ticagrelor instead of aspirin. FAU - Carlin, Stephanie AU - Carlin S AD - Thrombosis Service, Hamilton General Hospital, Hamilton, Ontario, Canada. carlins@hhsc.ca. FAU - de Vries, Tim A C AU - de Vries TAC AD - Heart Center, Department of Clinical and Experimental Cardiology and Cardiothoracic Surgery, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands. AD - Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias, Amsterdam, the Netherlands. AD - Department of Cardiology, Rijnstate Hospital, Arnhem, the Netherlands. FAU - Budaj, Andrzej AU - Budaj A AD - Department of Cardiology, Center of Postgraduate Medical Education, Grochowski Hospital, Warszawa, Poland. FAU - Eikelboom, John AU - Eikelboom J AD - Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Canada. LA - eng PT - Journal Article PL - Poland TA - Kardiol Pol JT - Kardiologia polska JID - 0376352 RN - 0 (Platelet Aggregation Inhibitors) RN - 9NDF7JZ4M3 (Rivaroxaban) RN - R16CO5Y76E (Aspirin) SB - IM MH - Humans MH - Platelet Aggregation Inhibitors/therapeutic use MH - Rivaroxaban/therapeutic use MH - *Cardiovascular Diseases/complications MH - *Atherosclerosis/drug therapy/complications MH - Aspirin/therapeutic use MH - *Peripheral Arterial Disease/drug therapy/complications MH - *Acute Coronary Syndrome/complications MH - *Thrombosis/etiology MH - *Heart Failure/complications MH - *Renal Insufficiency, Chronic/complications MH - Drug Therapy, Combination OTO - NOTNLM OT - atherosclerosis OT - cerebrovascular disease OT - coronary artery disease OT - peripheral arterial disease OT - rivaroxaban EDAT- 2023/01/06 06:00 MHDA- 2023/01/07 06:00 CRDT- 2023/01/05 04:43 PHST- 2022/12/12 00:00 [received] PHST- 2022/12/30 00:00 [accepted] PHST- 2023/01/05 04:43 [entrez] PHST- 2023/01/06 06:00 [pubmed] PHST- 2023/01/07 06:00 [medline] AID - VM/OJS/J/93164 [pii] AID - 10.33963/KP.a2022.0283 [doi] PST - ppublish SO - Kardiol Pol. 2022;80(12):1200-1210. doi: 10.33963/KP.a2022.0283. PMID- 36563712 OWN - NLM STAT- MEDLINE DCOM- 20230324 LR - 20230405 IS - 1097-6809 (Electronic) IS - 0741-5214 (Linking) VI - 77 IP - 4 DP - 2023 Apr TI - Physiologic risk factors increase risk of myocardial infarction with transcarotid artery revascularization in prospective trials. PG - 1192-1198 LID - S0741-5214(22)02634-9 [pii] LID - 10.1016/j.jvs.2022.12.013 [doi] AB - OBJECTIVE: Patients can be considered at high risk for carotid endarterectomy (CEA) because of either anatomic or physiologic factors and will often undergo transcarotid artery revascularization (TCAR). Patients with physiologic criteria will be considered to have a higher overall surgical risk because of more significant comorbidities. Our aim was to study the incidence of stroke, myocardial infarction (MI), death, and combined end points for patients who had undergone TCAR stratified by the risk factors (anatomic vs physiologic). METHODS: An analysis of prospectively collected data from the ROADSTER (pivotal; safety and efficacy study for reverse flow used during carotid artery stenting procedure), ROADSTER 2 (Food and Drug Administration indicated postmarket trial; postapproval study of transcarotid artery revascularization in patients with significant carotid artery disease), and ROADSTER extended access TCAR trials was performed. All 851 patients were considered to be at high risk for CEA and were included and stratified using high-risk anatomic criteria (ie, contralateral occlusion, tandem stenosis, high cervical artery stenosis, restenosis after previous endarterectomy, bilateral carotid stenting, hostile neck anatomy with previous neck irradiation, neck dissection, cervical spine immobility) or high-risk physiologic criteria (ie, age >75 years, multivessel coronary artery disease, history of angina, congestive heart failure New York Heart Association class III/IV, left ventricular ejection fraction <30%, recent MI, severe chronic obstructive pulmonary disease, permanent contralateral cranial nerve injury, chronic renal insufficiency). For trial inclusion, asymptomatic patients were required to have had >/=80% carotid stenosis and symptomatic patients to have had >/=50% stenosis. The primary outcome measures were stroke, death, and MI at 30 days. The data were statistically analyzed using the chi(2) test, as appropriate. RESULTS: A total of 851 high surgical risk patients were categorized into two groups: those with anatomic-only risk factors (n = 372) or at least one physiologic risk factor present (n = 479). Of the 851 patients, 74.5% of those in the anatomic subset were asymptomatic, and 76.6% in the physiologic subset were asymptomatic. General anesthesia was used similarly in both groups (67.7% anatomic vs 68.1% physiologic). MI had occurred in eight patients in the physiologic group (1.7%), all of whom had been asymptomatic and in none of the anatomic patients (P = .01). The combined stroke, death, and MI rate was 2.1% in the anatomic cohort and 4.2% in the physiologic cohort (P = .10). Stratification of each group into asymptomatic and symptomatic patients did not yield any further differences. CONCLUSIONS: The patients who had undergone TCAR in the present prospective, neurologically adjudicated trial because of high-risk physiologic factors had had a higher rate of MI compared with the patients who had qualified for TCAR using anatomic criteria only. These patients had experienced comparable rates of combined stroke, death, and MI rates. The anatomic patients represented a healthier and younger subset of patients, with notably low overall event rates. CI - Copyright (c) 2022 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved. FAU - Chung, Jane AU - Chung J AD - Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Harrington Heart and Vascular Institute, University Hospitals, Case Western Reserve University, Cleveland, OH. FAU - Kumins, Norman H AU - Kumins NH AD - Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Harrington Heart and Vascular Institute, University Hospitals, Case Western Reserve University, Cleveland, OH. FAU - Smith, Justin AU - Smith J AD - Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Harrington Heart and Vascular Institute, University Hospitals, Case Western Reserve University, Cleveland, OH. FAU - Motaganahalli, Raghu L AU - Motaganahalli RL AD - Division of Vascular Surgery, Department of Surgery, Indiana University School of Medicine, Indianapolis, IN. FAU - Schneider, Peter A AU - Schneider PA AD - Division of Vascular and Endovascular Surgery, Department of Surgery, University of California, San Francisco, San Francisco, CA. FAU - Kwolek, Christopher J AU - Kwolek CJ AD - Division of Vascular and Endovascular Surgery, Department of General Surgical Services, Massachusetts General Hospital, Boston, MA. FAU - Kashyap, Vikram S AU - Kashyap VS AD - Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Harrington Heart and Vascular Institute, University Hospitals, Case Western Reserve University, Cleveland, OH. Electronic address: Vikram.kashyap@spectrumhealth.org. CN - ROADSTER Investigators LA - eng SI - ClinicalTrials.gov/NCT01685567 SI - ClinicalTrials.gov/NCT02536378 PT - Journal Article DEP - 20221220 PL - United States TA - J Vasc Surg JT - Journal of vascular surgery JID - 8407742 SB - IM MH - Humans MH - Aged MH - *Carotid Stenosis/complications/diagnostic imaging/surgery MH - Constriction, Pathologic/etiology MH - Prospective Studies MH - Stroke Volume MH - *Endovascular Procedures/adverse effects MH - Treatment Outcome MH - Stents/adverse effects MH - Ventricular Function, Left MH - Risk Factors MH - *Stroke/epidemiology/etiology MH - *Endarterectomy, Carotid/adverse effects MH - *Myocardial Infarction/epidemiology/etiology MH - Arteries MH - Retrospective Studies OTO - NOTNLM OT - Carotid artery revascularization OT - TCAR EDAT- 2022/12/24 06:00 MHDA- 2023/03/25 06:00 CRDT- 2022/12/23 19:12 PHST- 2022/08/10 00:00 [received] PHST- 2022/11/18 00:00 [revised] PHST- 2022/12/01 00:00 [accepted] PHST- 2022/12/24 06:00 [pubmed] PHST- 2023/03/25 06:00 [medline] PHST- 2022/12/23 19:12 [entrez] AID - S0741-5214(22)02634-9 [pii] AID - 10.1016/j.jvs.2022.12.013 [doi] PST - ppublish SO - J Vasc Surg. 2023 Apr;77(4):1192-1198. doi: 10.1016/j.jvs.2022.12.013. Epub 2022 Dec 20. PMID- 36530841 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20221222 IS - 2434-0790 (Electronic) IS - 2434-0790 (Linking) VI - 4 IP - 12 DP - 2022 Dec 9 TI - Rationale and Design of Rivaroxaban Estimation With Warfarin in Atrial Fibrillation Patients With Coronary Stent Implantation (REWRAPS). PG - 604-608 LID - 10.1253/circrep.CR-22-0096 [doi] AB - Background: Recent major randomized trials revealed the superiority of non-vitamin K antagonist oral anticoagulants (NOACs) over vitamin K antagonists (VKAs) from 6 months to 2 years after percutaneous coronary intervention (PCI). However, whether NOAC monotherapy superiority over warfarin continues in real-world patients with a history of atrial fibrillation (AF), coronary stenting, and underlying chronic kidney disease (CKD) >1 year after PCI (e.g., at 5 years) has not been established. Methods and Results: In the Rivaroxaban Estimation with Warfarin in Atrial Fibrillation Patients with Coronary Stent Implantation (REWRAPS) study (NCT02024230), a multicenter, prospective, non-randomized, open-label, physician-initiated efficacy and safety study in Japan, 493 patients received either rivaroxaban or warfarin. The primary efficacy endpoint was major adverse cardiac and cerebrovascular events (MACCE), consisting of cardiac and stroke death, non-fatal myocardial infarction, non-fatal stroke, systemic embolism, and coronary revascularization. The primary safety endpoint was major bleeding (Bleeding Academic Research Consortium 3 and 5). The primary composite endpoint was net adverse clinical events (NACE), defined as a combination of all-cause death and major bleeding. Conclusions: Completion of REWRAPS will provide, for the first time, evidence as to whether rivaroxaban is superior or non-inferior to warfarin with regard to the primary efficacy (MACCE), safety (major bleeding), or combined (all-cause death, major bleeding) endpoints in real-world patients with AF, coronary stenting, and underlying CKD an average of 5 years after PCI. CI - Copyright (c) 2022, THE JAPANESE CIRCULATION SOCIETY. FAU - Ozaki, Yukio AU - Ozaki Y AD - Department of Cardiology, Fujita Health University (FHU) School of Medicine Toyoake Japan. FAU - Kawai, Hideki AU - Kawai H AD - Department of Cardiology, Fujita Health University (FHU) School of Medicine Toyoake Japan. FAU - Muramatsu, Takashi AU - Muramatsu T AD - Department of Cardiology, Fujita Health University (FHU) School of Medicine Toyoake Japan. FAU - Harada, Masahide AU - Harada M AD - Department of Cardiology, Fujita Health University (FHU) School of Medicine Toyoake Japan. FAU - Takahashi, Hiroshi AU - Takahashi H AD - Division of Medical Statistics, FHU Toyoake Japan. FAU - Ishii, Hideki AU - Ishii H AD - Department of Cardiovascular Medicine, Gunma University Maebashi Japan. FAU - Maekawa, Yuichiro AU - Maekawa Y AD - Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine Hamamatsu Japan. FAU - Ismail, Tevfik F AU - Ismail TF AD - Department of Cardiology, Fujita Health University (FHU) School of Medicine Toyoake Japan. AD - King's College & Guy's and St Thomas' Hospital NHS Foundation London UK. FAU - Amano, Tetsuya AU - Amano T AD - Department of Cardiology, Aichi Medical University Hospital Nagakute Japan. FAU - Izawa, Hideo AU - Izawa H AD - Department of Cardiology, Fujita Health University (FHU) School of Medicine Toyoake Japan. FAU - Murohara, Toyoaki AU - Murohara T AD - Department of Cardiology, Nagoya University Graduate School of Medicine Nagoya Japan. LA - eng PT - Journal Article DEP - 20221112 PL - Japan TA - Circ Rep JT - Circulation reports JID - 101746642 PMC - PMC9726694 OTO - NOTNLM OT - Atrial fibrillation OT - Chronic kidney disease OT - Coronary stent OT - Rivaroxaban OT - Warfarin COIS- Y.O., H. Ishii, H. Izawa, and T. Murohara are members of Circulation Reports' Editorial Team. Y.O. received research grant supports from Terumo Co. Ltd., Takeda Pharmaceutical Co. Ltd., Daiichi Sankyo Co. Ltd., and Otsuka Pharmaceutical Co., Ltd. M.H. received lecture fees from Boehringer Ingelheim Japan, Bristol-Myers Squibb Inc., Daiichi-Sankyo Pharma Inc. H. Ishii received lecture fees from AstraZeneca Inc., Bayer Pharmaceutical Co., Ltd., Boehringer Ingelheim Japan, Bristol-Myers Squibb Inc., Daiichi-Sankyo Pharma Inc., MSD K. K., Mitsubishi Tanabe Pharma Co., Ltd., Mochida Pharmaceutical Co., Ltd., Novartis Japan, and Pfizer Japan Inc. as well as got scholarship funds or Donations from Boehringer Ingelheim Japan, Bristol-Myers Squibb Inc. Y.M. received scholarship funds or donation scholarship funds from Abbott Medical Japan LLC, Medtronic Japan Co., Ltd, and BIOTRONIK JAPAN. T.A. received lecture fees from Astellas Pharma, AstraZeneca, Bayer, Daiichi Sankyo, and Bristol-Myers Squibb. H. Izawa received grant support through his institution from Daiichi-Sankyo, Dainihon-Sumitomo, Kowa, Ono, Otsuka, Takeda, and Fuji Film Toyama Kagaku, and honoraria for lectures from Bayer, Otsuka, Novartis, and Daiichi-Sankyo. T. Murohara received lecture fees from AstraZeneca, Bayer Yakuhin, Boehringer Ingelheim Japan, Novartis Pharma Japan, and Kowa. No other potential conflict of interest relevant to this article was reported. EDAT- 2022/12/20 06:00 MHDA- 2022/12/20 06:01 PMCR- 2022/11/12 CRDT- 2022/12/19 03:38 PHST- 2022/09/06 00:00 [received] PHST- 2022/09/25 00:00 [revised] PHST- 2022/10/02 00:00 [accepted] PHST- 2022/12/19 03:38 [entrez] PHST- 2022/12/20 06:00 [pubmed] PHST- 2022/12/20 06:01 [medline] PHST- 2022/11/12 00:00 [pmc-release] AID - 10.1253/circrep.CR-22-0096 [doi] PST - epublish SO - Circ Rep. 2022 Nov 12;4(12):604-608. doi: 10.1253/circrep.CR-22-0096. eCollection 2022 Dec 9. PMID- 36483837 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20221210 IS - 2307-8960 (Print) IS - 2307-8960 (Electronic) IS - 2307-8960 (Linking) VI - 10 IP - 33 DP - 2022 Nov 26 TI - Protective effect of recombinant human brain natriuretic peptide against contrast-induced nephropathy in elderly acute myocardial infarction patients: A randomized controlled trial. PG - 12221-12229 LID - 10.12998/wjcc.v10.i33.12221 [doi] AB - BACKGROUND: Increasing reports have demonstrated that recombinant human brain natriuretic peptide (rhBNP) can improve acute myocardial infarction (AMI) and heart failure. However, whether it can improve renal function and decrease the risk of contrast-induced nephropathy (CIN) in elderly AMI patients is still unclear. AIM: To explore the effect of rhBNP on CIN in elderly AMI patients after percutaneous coronary intervention (PCI). METHODS: One hundred and thirty-one elderly AMI patients underwent PCI from January 2017 to July 2021. Patients were either given 1 mL of 0.9% normal saline/(kg/h) for 72 h after PCI (control group, n = 66) and or intravenous rhBNP [1.5 mg/kg followed by 0.0075 mg/(kg/min)] for 72 h (rhBNP treatment group, n = 65). Serum creatinine and cystatin C levels, creatinine clearance rate, and eGFR were measured at 24 h, 48 h, and 72 h after PCI. Research nurses collected data on handwritten forms, and then stored them in password-protected electronic databases. RESULTS: The creatinine clearance rate and eGFR were increased, while the creatinine and cystatin C levels were decreased significantly in the rhBNP treatment group compared to the control group at 48 h and 72 h. The incidence of CIN (P = 0.028) and acute heart failure (P = 0.017) also significantly decreased in the rhBNP group. No significant difference was noted between the two groups in cardiac death and recurrent AMI. CONCLUSION: Early application of rhBNP could protect renal function and decrease the incidence of CIN after primary PCI and acute heart failure. CI - (c)The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved. FAU - Zhang, Yi-Jing AU - Zhang YJ AD - Department of Imaging, 904Hospital of Joint Logistic Support Force of PLA, Wuxi 214044, Jiangsu Province, China. FAU - Yin, Lin AU - Yin L AD - Department of Imaging, 904Hospital of Joint Logistic Support Force of PLA, Wuxi 214044, Jiangsu Province, China. FAU - Li, Jun AU - Li J AD - Department of Imaging, 904Hospital of Joint Logistic Support Force of PLA, Wuxi 214044, Jiangsu Province, China. sm2008@21cn.com. LA - eng PT - Journal Article PL - United States TA - World J Clin Cases JT - World journal of clinical cases JID - 101618806 PMC - PMC9724537 OTO - NOTNLM OT - Acute myocardial infarction OT - Contrast media OT - Myocardial infarction OT - Natriuretic peptide OT - Percutaneous coronary intervention COIS- Conflict-of-interest statement: The authors declare that there are no conflicting interests to disclose. EDAT- 2022/12/10 06:00 MHDA- 2022/12/10 06:01 PMCR- 2022/11/26 CRDT- 2022/12/09 04:12 PHST- 2022/07/17 00:00 [received] PHST- 2022/09/21 00:00 [revised] PHST- 2022/10/31 00:00 [accepted] PHST- 2022/12/09 04:12 [entrez] PHST- 2022/12/10 06:00 [pubmed] PHST- 2022/12/10 06:01 [medline] PHST- 2022/11/26 00:00 [pmc-release] AID - 10.12998/wjcc.v10.i33.12221 [doi] PST - ppublish SO - World J Clin Cases. 2022 Nov 26;10(33):12221-12229. doi: 10.12998/wjcc.v10.i33.12221. PMID- 36473121 OWN - NLM STAT- MEDLINE DCOM- 20221229 LR - 20260105 IS - 1558-2035 (Electronic) IS - 1558-2027 (Linking) VI - 24 IP - 1 DP - 2023 Jan 1 TI - Rationale and design of COLchicine On-admission to Reduce inflammation in Acute Coronary Syndrome (COLOR-ACS) study. PG - 52-58 LID - 10.2459/JCM.0000000000001389 [doi] AB - AIMS: The aim of the colchicine on-admission to reduce inflammation in acute coronary syndrome (COLOR-ACS) study is to evaluate the effects of the addition of short-term, low-dose colchicine to high-dose atorvastatin in limiting levels of inflammatory markers, such as high-sensitivity C-reactive protein (hs-CRP), in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS). METHODS: The COLOR-ACS study is a multicenter, randomized, open-label, two-arm trial. Statin-naive patients with NSTE-ACS, scheduled for an early invasive strategy, are randomized on admission to receive standard treatment of atorvastatin 80 mg or standard treatment plus colchicine (1 mg loading dose followed by 0.5 mg/day until discharge). The main exclusion criteria are prior statin and/or colchicine treatment, current treatment with potent inhibitors of CYP3A4, P-glycoprotein or immunosuppressive drugs, known active malignancy, severe kidney, cardiac, liver disease. There is clinical and biochemical follow-up at 30 days after discharge and telephone interview at 6 months. The primary end point is the change in hs-CRP from admission to discharge. Secondary end points include: incidence of acute kidney injury; MB fraction of creatine kinase peak value; glomerular filtration rate change from baseline to 30 days; persistence of hs-CRP >/=2 mg/dl at 30 days; adverse clinical events within 30 days; tolerance to colchicine. CONCLUSION: The COLOR-ACS study will provide evidence on the efficacy of early short-term treatment with colchicine in addition to high-dose atorvastatin compared to atorvastatin alone in ACS patients. The potential anti-inflammatory action of colchicine plus atorvastatin is expected to limit hs-CRP increase with resultant clinical benefits. TRIAL REGISTRATION: ClinicalTrials.gov; NCT05250596. CI - Copyright (c) 2022 Italian Federation of Cardiology - I.F.C. All rights reserved. FAU - Toso, Anna AU - Toso A AD - Cardiology Division of Santo Stefano Hospital, Prato. FAU - Leoncini, Mario AU - Leoncini M AD - Cardiology Division of Santo Stefano Hospital, Prato. FAU - Magnaghi, Gaia AU - Magnaghi G AD - Cardiology Division of Santi Cosma e Damiano Hospital, Pescia. FAU - Biagini, Francesco AU - Biagini F AD - Cardiology Division of San Jacopo Hospital, Pistoia. FAU - Martini, Olimpia AU - Martini O AD - Cardiology Division of Santo Stefano Hospital, Prato. FAU - Maioli, Mauro AU - Maioli M AD - Cardiology Division of Santo Stefano Hospital, Prato. FAU - Villani, Simona AU - Villani S AD - Section of Biostatistics and Clinical Epidemiology, Department of Public Health, Neurosciences, Experimental and Forensic Medicine, Pavia University, Pavia, Italy. FAU - Comeglio, Marco AU - Comeglio M AD - Cardiology Division of Santi Cosma e Damiano Hospital, Pescia. AD - Cardiology Division of San Jacopo Hospital, Pistoia. FAU - Bellandi, Francesco AU - Bellandi F AD - Cardiology Division of Santo Stefano Hospital, Prato. LA - eng SI - ClinicalTrials.gov/NCT05250596 PT - Clinical Trial Protocol PT - Journal Article DEP - 20221129 PL - United States TA - J Cardiovasc Med (Hagerstown) JT - Journal of cardiovascular medicine (Hagerstown, Md.) JID - 101259752 RN - A0JWA85V8F (Atorvastatin) RN - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors) RN - 9007-41-4 (C-Reactive Protein) RN - SML2Y3J35T (Colchicine) SB - IM MH - Humans MH - Atorvastatin/adverse effects MH - *Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use MH - *Acute Coronary Syndrome/therapy MH - C-Reactive Protein/metabolism MH - Colchicine/adverse effects MH - Treatment Outcome MH - Inflammation/drug therapy MH - Multicenter Studies as Topic MH - Randomized Controlled Trials as Topic EDAT- 2022/12/07 06:00 MHDA- 2022/12/30 06:00 CRDT- 2022/12/06 15:52 PHST- 2022/12/07 06:00 [pubmed] PHST- 2022/12/30 06:00 [medline] PHST- 2022/12/06 15:52 [entrez] AID - 01244665-202301000-00007 [pii] AID - 10.2459/JCM.0000000000001389 [doi] PST - ppublish SO - J Cardiovasc Med (Hagerstown). 2023 Jan 1;24(1):52-58. doi: 10.2459/JCM.0000000000001389. Epub 2022 Nov 29. PMID- 36445624 OWN - NLM STAT- MEDLINE DCOM- 20240517 LR - 20260510 IS - 1573-7241 (Electronic) IS - 0920-3206 (Print) IS - 0920-3206 (Linking) VI - 38 IP - 3 DP - 2024 Jun TI - Safety and Efficacy of CYP2C19 Genotype-Guided Escalation of P2Y(12) Inhibitor Therapy After Percutaneous Coronary Intervention in Chronic Kidney Disease: a Post Hoc Analysis of the TAILOR-PCI Study. PG - 447-457 LID - 10.1007/s10557-022-07392-2 [doi] AB - PURPOSE: Chronic kidney disease (CKD) is a risk factor for ischemic and bleeding events with dual antiplatelet therapy after percutaneous coronary intervention (PCI). Whether the presence of CYP2C19 loss of function (LOF) alleles modifies this risk, and whether a genotype-guided (GG) escalation of P2Y(12) inhibitor therapy post PCI is safe in this population is unclear. METHODS: This was a post hoc analysis of randomized patients in TAILOR PCI. Patients were divided into two groups based on estimated glomerular filtration rate (eGFR) threshold of < 60 ml/min/1.73 m(2) for CKD (n = 539) and non-CKD (n = 4276). The aggregate of cardiovascular death, stroke, myocardial infarction, stent thrombosis, and severe recurrent coronary ischemia at 12-months post-PCI was assessed as the primary endpoint. Secondary endpoint was major or minor bleeding. RESULTS: Mean (standard deviation) eGFR among patients with CKD was 49.5 (8.4) ml/min/1.72 m(2). Among all patients, there was no significant interaction between randomized strategy and CKD status for any endpoint. Among LOF carriers, the interaction between randomized strategy and CKD status on composite ischemic outcome was not significant (p = 0.2). GG strategy was not associated with an increased risk of bleeding in either CKD group. CONCLUSIONS: In this exploratory analysis, escalation of P2Y(12) inhibitor therapy following a GG strategy did not reduce the primary outcome in CKD. However, P2Y(12) inhibitor escalation following a GG strategy was not associated with increased bleeding risk in CKD. Larger studies in CKD are needed. CLINICAL TRIAL REGISTRATION: https://clinicaltrials.gov/ct2/show/NCT01742117?term=TAILOR-PCI&draw=2&rank=1 . NCT01742117. CI - (c) 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature. FAU - Mathew, Roy O AU - Mathew RO AD - Department of Medicine, Loma Linda VA Health Care System, 11201 Benton Street, Loma Linda, CA, 92357, USA. Roy.mathew@va.gov. FAU - Sidhu, Mandeep S AU - Sidhu MS AUID- ORCID: 0000-0001-6440-8492 AD - Department of Medicine, Albany Medical College, 43 New Scotland Avenue Albany, Schenectady, NY, 12208, USA. mssidhu@yahoo.com. FAU - Rihal, Charanjit S AU - Rihal CS AD - Department of Medicine, Mayo Clinic, Rochester, MN, USA. FAU - Lennon, Ryan AU - Lennon R AD - Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA. FAU - El-Hajjar, Mohammed AU - El-Hajjar M AD - Department of Medicine, Albany Medical College, 43 New Scotland Avenue Albany, Schenectady, NY, 12208, USA. FAU - Yager, Neil AU - Yager N AD - Department of Medicine, Albany Medical College, 43 New Scotland Avenue Albany, Schenectady, NY, 12208, USA. FAU - Lyubarova, Radmila AU - Lyubarova R AD - Department of Medicine, Albany Medical College, 43 New Scotland Avenue Albany, Schenectady, NY, 12208, USA. FAU - Abdul-Nour, Khaled AU - Abdul-Nour K AD - Henry Ford Health System, Detroit, MI, USA. FAU - Weitz, Steven AU - Weitz S AD - Cardiology Associates of Schenectady, Schenectady, NY, USA. FAU - O'Cochlain, D Fearghas AU - O'Cochlain DF AD - Department of Medicine, May Clinic Health System, Eau Claire, WI, USA. FAU - Murthy, Vishakantha AU - Murthy V AD - Department of Endocrine and Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA. FAU - Levisay, Justin AU - Levisay J AD - Department of Medicine, North Shore University Health System, Evanston, IL, USA. FAU - Marzo, Kevin AU - Marzo K AD - Department of Medicine, Winthrop University Hospital, Mineola, NY, USA. FAU - Graham, John AU - Graham J AD - Department of Medicine, St. Michael's Hospital, Toronto, ON, Canada. FAU - Dzavik, Vlad AU - Dzavik V AD - Department of Medicine, University Health Network-Toronto General Hospital, Toronto, ON, Canada. FAU - So, Derek AU - So D AD - Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada. FAU - Goodman, Shaun AU - Goodman S AD - Department of Medicine, St. Michael's Hospital, Toronto, ON, Canada. FAU - Rosenberg, Yves D AU - Rosenberg YD AD - National Heart Lung and Blood Institute, Bethesda, MD, USA. FAU - Pereira, Naveen AU - Pereira N AD - Department of Medicine, Mayo Clinic, Rochester, MN, USA. FAU - Farkouh, Michael E AU - Farkouh ME AD - Department of Medicine, University Health Network-Toronto General Hospital, Toronto, ON, Canada. LA - eng SI - ClinicalTrials.gov/NCT01742117 GR - U01 HL128606/HL/NHLBI NIH HHS/United States GR - U01 HL128626/HL/NHLBI NIH HHS/United States GR - U01HL128626/HL/NHLBI NIH HHS/United States GR - U01HL128606/HL/NHLBI NIH HHS/United States GR - U01HL128606/HL/NHLBI NIH HHS/United States GR - U01HL128626/HL/NHLBI NIH HHS/United States PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, N.I.H., Extramural DEP - 20221129 PL - United States TA - Cardiovasc Drugs Ther JT - Cardiovascular drugs and therapy JID - 8712220 RN - EC 1.14.14.1 (Cytochrome P-450 CYP2C19) RN - 0 (Purinergic P2Y Receptor Antagonists) RN - 0 (Platelet Aggregation Inhibitors) RN - EC 1.14.14.1 (CYP2C19 protein, human) SB - IM MH - Humans MH - *Percutaneous Coronary Intervention/adverse effects MH - *Renal Insufficiency, Chronic/physiopathology/diagnosis MH - *Cytochrome P-450 CYP2C19/genetics MH - Male MH - Female MH - *Purinergic P2Y Receptor Antagonists/adverse effects/therapeutic use/administration & dosage MH - Aged MH - Middle Aged MH - *Glomerular Filtration Rate/drug effects MH - *Platelet Aggregation Inhibitors/adverse effects/therapeutic use/administration & dosage MH - Treatment Outcome MH - Hemorrhage/chemically induced MH - Coronary Artery Disease MH - Pharmacogenomic Variants MH - Time Factors MH - Risk Factors MH - Risk Assessment MH - Kidney/physiopathology/drug effects MH - Pharmacogenomic Testing MH - Dual Anti-Platelet Therapy/adverse effects MH - Genotype PMC - PMC10225474 MID - NIHMS1866592 OTO - NOTNLM OT - CYP2C19 OT - Antiplatelet therapy OT - Chronic kidney disease OT - Coronary artery disease OT - Percutaneous coronary intervention OT - Pharmacogenomics COIS- Roy O. Mathew, MD: No relevant disclosures. Mandeep S. Sidhu, MD, MBA: Astra Zeneca 2019 SAB, Sanofi-Regeneron 2019 SAB. Michael E. Farkouh, MD: research support from Amen, Novartis and Novo Nordisk. Charanjit S. Rihal, MD: No disclosures. Ryan Lennon, MS: No disclosures. Mohammad El-Hajjar, MD: No disclosures. Neil Yager, DO: No Disclosures.... Radmila Lyubarova, MD: No disclosures. Yves Rosenberg, MD: No disclosures Khaled Abdul-Nour, MD: No disclosures. Steven Weitz, MD: No disclosures. D. Fearghas O'Cochlain, MD: No disclosures. Vishu Murthy, MD: No disclosures. Justin Levisay, MD: Previous Proctoring relationship with Boston Scientific which has ceased with the Lotus valve being pulled from the Market. Kevin Marzo, MD: No disclosures. John J. Graham, MD: Honoraria: Astra Zeneca, Teleflex Medical, Boston Scientific. Vladimir Dzavik, MD: No relevant disclosures. Derek So, MD: has received unrestricted grant support (physician-initiated grant) from Eli Lilly Canada; is a member of the advisory board and has received honoraria from AstraZeneca Canada; is a member of the advisory board for Bayer Canada; has received unrestricted grant support (physician-initiated grant) from Spartan Biosciences; has received unrestricted grant support (physician-initiated grant) from Aggredyne; and has received unrestricted grant support (physician-initiated grant) from Diapharma/Roche Diagnostics. Shaun Goodman, MD: Shaun G. Goodman reports research grant support (e.g., steering committee or data and safety monitoring committee) and/or speaker/consulting honoraria (e.g., advisory boards) from: Amgen, Anthos Therapeutics, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol Myers Squibb, CSL Behring, Daiichi-Sankyo/American Regent, Eli Lilly, Esperion, Ferring Pharmaceuticals, HLS Therapeutics, JAMP Pharma, Merck, Novartis, Novo Nordisk A/C, Pendopharm/Pharmascience, Pfizer, Regeneron, Sanofi, Servier, Valeo Pharma; and salary support/honoraria from the Heart and Stroke Foundation of Ontario/University of Toronto (Polo) Chair, Canadian Heart Research Centre and MD Primer, Canadian VIGOUR Centre, Cleveland Clinic Coordinating Centre for Clinical Research, Duke Clinical Research Institute, New York University Clinical Coordinating Centre, PERFUSE Research Institute, TIMI Study Group (Brigham Health). Naveen Pereira, MD: Funding for this research was provided by the NIH (grants U01HL128606 and U01HL128626). EDAT- 2022/11/30 06:00 MHDA- 2024/05/17 12:44 PMCR- 2024/12/01 CRDT- 2022/11/29 11:24 PHST- 2022/10/11 00:00 [accepted] PHST- 2024/05/17 12:44 [medline] PHST- 2022/11/30 06:00 [pubmed] PHST- 2022/11/29 11:24 [entrez] PHST- 2024/12/01 00:00 [pmc-release] AID - 10.1007/s10557-022-07392-2 [pii] AID - 10.1007/s10557-022-07392-2 [doi] PST - ppublish SO - Cardiovasc Drugs Ther. 2024 Jun;38(3):447-457. doi: 10.1007/s10557-022-07392-2. Epub 2022 Nov 29. PMID- 36423254 OWN - NLM STAT- MEDLINE DCOM- 20230105 LR - 20230111 IS - 1540-8191 (Electronic) IS - 0886-0440 (Linking) VI - 37 IP - 12 DP - 2022 Dec TI - Health-related quality of life impacts upon 5-year survival after coronary artery bypass surgery. PG - 4899-4905 LID - 10.1111/jocs.17165 [doi] AB - BACKGROUND: Poor preoperative health-related quality of life (HRQoL) has been associated with reduced short-term survival after coronary artery bypass graft (CABG) surgery; however, its impact on long-term mortality is unknown. This study's objective was to determine if baseline HRQoL status predicts 5-year post-CABG mortality. METHODS: This prespecified, randomized on/off bypass follow-up study (ROOBY-FS) subanalysis compared baseline patient characteristics and HRQoL scores, obtained from the Seattle Angina Questionnaire (SAQ) and Veterans RAND Short Form-36 (VR-36), between 5-year post-CABG survivors and nonsurvivors. Standardized subscores were calculated for each questionnaire. Multivariable logistic regression assessed whether HRQoL survey subcomponents independently predicted 5-year mortality (p /=2% variant allele frequency were detected in 29% (n = 129), most commonly in the DNMT3A or TET2 genes, which harbored 47% and 36% of all mutations, respectively. Compared to non-CHIP patients, CHIP carriers were older and had decreased renal function and increased levels of N-terminal pro-B-type natriuretic peptide and inflammatory biomarkers. CHIP carriers had worse short-term outcomes measured either as mortality or as the combined clinical endpoint of mortality or severe renal failure within 30 days. Association of CHIP with the combined endpoint was independent of age and biomarkers reflecting kidney function, heart failure severity, and inflammation (OR: 1.83; 95% CI: 1.05-3.21; P = 0.03) but not significant regarding all-cause mortality (OR: 1.67; 95% CI: 0.96-2.90; P = 0.069). CONCLUSIONS: CHIP is frequent among AMI and CS patients and is associated with impaired clinical outcome. CHIP assessment may facilitate risk stratification in patients with CS and imply novel treatment targets. (Culprit Lesion Only vs Multivessel Percutaneous Coronary Intervention in Cardiogenic Shock [CULPRIT-SHOCK]; NCT01927549). CI - Copyright (c) 2022 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Bohme, Matthias AU - Bohme M AD - Medical Clinic and Policlinic 1, Hematology, Cellular Therapy and Hemostaseology, Leipzig University Hospital, Leipzig, Germany. FAU - Desch, Steffen AU - Desch S AD - Heart Center Leipzig at University of Leipzig, Department of Internal Medicine/Cardiology and Leipzig Heart Institute, Leipzig, Germany. FAU - Rosolowski, Maciej AU - Rosolowski M AD - Institute of Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany. FAU - Scholz, Markus AU - Scholz M AD - Institute of Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany. FAU - Krohn, Knut AU - Krohn K AD - Medical Clinic and Policlinic 1, Hematology, Cellular Therapy and Hemostaseology, Leipzig University Hospital, Leipzig, Germany. FAU - Buttner, Petra AU - Buttner P AD - Heart Center Leipzig at University of Leipzig, Department of Internal Medicine/Cardiology and Leipzig Heart Institute, Leipzig, Germany. FAU - Cross, Michael AU - Cross M AD - Medical Clinic and Policlinic 1, Hematology, Cellular Therapy and Hemostaseology, Leipzig University Hospital, Leipzig, Germany. FAU - Kirchberg, Janine AU - Kirchberg J AD - Medical Clinic and Policlinic 1, Hematology, Cellular Therapy and Hemostaseology, Leipzig University Hospital, Leipzig, Germany. FAU - Rommel, Karl-Philipp AU - Rommel KP AD - Heart Center Leipzig at University of Leipzig, Department of Internal Medicine/Cardiology and Leipzig Heart Institute, Leipzig, Germany. FAU - Poss, Janine AU - Poss J AD - Heart Center Leipzig at University of Leipzig, Department of Internal Medicine/Cardiology and Leipzig Heart Institute, Leipzig, Germany. FAU - Freund, Anne AU - Freund A AD - Heart Center Leipzig at University of Leipzig, Department of Internal Medicine/Cardiology and Leipzig Heart Institute, Leipzig, Germany. FAU - Baber, Ronny AU - Baber R AD - Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, Leipzig University Hospital, Leipzig, Germany. FAU - Isermann, Berend AU - Isermann B AD - Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, Leipzig University Hospital, Leipzig, Germany. FAU - Ceglarek, Uta AU - Ceglarek U AD - Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, Leipzig University Hospital, Leipzig, Germany. FAU - Metzeler, Klaus H AU - Metzeler KH AD - Medical Clinic and Policlinic 1, Hematology, Cellular Therapy and Hemostaseology, Leipzig University Hospital, Leipzig, Germany. FAU - Platzbecker, Uwe AU - Platzbecker U AD - Medical Clinic and Policlinic 1, Hematology, Cellular Therapy and Hemostaseology, Leipzig University Hospital, Leipzig, Germany. Electronic address: uwe.platzbecker@medizin.uni-leipzig.de. FAU - Thiele, Holger AU - Thiele H AD - Heart Center Leipzig at University of Leipzig, Department of Internal Medicine/Cardiology and Leipzig Heart Institute, Leipzig, Germany. Electronic address: holger.thiele@medizin.uni-leipzig.de. LA - eng SI - ClinicalTrials.gov/NCT01927549 PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - United States TA - J Am Coll Cardiol JT - Journal of the American College of Cardiology JID - 8301365 RN - 114471-18-0 (Natriuretic Peptide, Brain) SB - IM CIN - J Am Coll Cardiol. 2022 Oct 18;80(16):1557-1559. doi: 10.1016/j.jacc.2022.09.002. PMID: 36229092 MH - Aged MH - Clonal Hematopoiesis MH - Humans MH - *Myocardial Infarction/complications/genetics MH - Natriuretic Peptide, Brain MH - *Percutaneous Coronary Intervention/adverse effects MH - Shock, Cardiogenic/genetics MH - Treatment Outcome OTO - NOTNLM OT - acute myocardial infarction OT - cardiogenic shock OT - clonal hematopoiesis of indeterminate potential OT - percutaneous coronary intervention COIS- Funding Support and Author Disclosures This work was supported by Helios Research Funding at the University of Leipzig and the German Federal Ministry of Education and Research within the framework of the e:Med research and funding concept (project SYMPATH, grant number 01ZX1906B). The authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2022/10/14 06:00 MHDA- 2022/10/18 06:00 CRDT- 2022/10/13 21:03 PHST- 2022/04/11 00:00 [received] PHST- 2022/07/13 00:00 [revised] PHST- 2022/08/03 00:00 [accepted] PHST- 2022/10/13 21:03 [entrez] PHST- 2022/10/14 06:00 [pubmed] PHST- 2022/10/18 06:00 [medline] AID - S0735-1097(22)06564-0 [pii] AID - 10.1016/j.jacc.2022.08.740 [doi] PST - ppublish SO - J Am Coll Cardiol. 2022 Oct 18;80(16):1545-1556. doi: 10.1016/j.jacc.2022.08.740. PMID- 36206950 OWN - NLM STAT- MEDLINE DCOM- 20221216 LR - 20251229 IS - 1097-6744 (Electronic) IS - 0002-8703 (Print) IS - 0002-8703 (Linking) VI - 254 DP - 2022 Dec TI - ISCHEMIA-EXTEND studies: Rationale and design. PG - 228-233 LID - S0002-8703(22)00194-6 [pii] LID - 10.1016/j.ahj.2022.09.009 [doi] AB - BACKGROUND: The ISCHEMIA and the ISCHEMIA-CKD trials found no statistical difference in the primary clinical endpoint between initial invasive management and initial conservative management of patients with chronic coronary disease and moderate to severe ischemia on stress testing without or with advanced chronic kidney disease (CKD). In ISCHEMIA, there was numerically lower cardiovascular mortality but higher non-cardiovascular mortality with no significant difference in all-cause death with an initial invasive strategy when compared with a conservative strategy. However, an invasive strategy increased peri-procedural myocardial infarction (MI) but decreased spontaneous MI with continued separation of curves over time, which potentially may lead to reduced risk of cardiovascular and all-cause mortality. Thus, the long-term effect of invasive management strategy on mortality remains unclear. In ISCHEMIA-CKD, the treatment and cause-specific mortality rates were similar during follow-up. METHODS: Funded by the National Heart, Lung, and Blood Institute, the ISCHEMIA-EXTEND observational study is the long-term follow-up of surviving participants (projected median of 10 years) with chronic coronary disease from the ISCHEMIA trial. In the ISCHEMIA trial, 5,179 participants with moderate or severe stress-induced ischemia were randomized to initial invasive management with angiography, revascularization when feasible, and guideline-directed medical therapy (GDMT), or initial conservative management with GDMT alone and angiography reserved for failure of medical therapy. ISCHEMIA-CKD EXTEND is the long-term follow-up of surviving participants (projected median of 9 years) from the ISCHEMIA-CKD trial, a companion trial that included 777 patients with advanced CKD. Ascertainment of death will be conducted via direct participant contact, medical record review, and/or vital status registry search. The overarching objective of long-term follow-up is to assess whether there are between-group differences in long-term all-cause, cardiovascular, and non-cardiovascular mortality, and increase precision around the treatment effect estimates for risk of all-cause, cardiovascular, and non-cardiovascular mortality. We will conduct Bayesian survival modeling to take advantage of rich inferences using the posterior distribution of the treatment effect. CONCLUSIONS: The long-term effect of an initial invasive versus conservative strategy on all-cause, cardiovascular, and non-cardiovascular mortality will be assessed. The findings of ISCHEMIA-EXTEND and ISCHEMIA-CKD EXTEND will inform patients, practitioners, practice guidelines, and health policy. CI - Copyright (c) 2022 Elsevier Inc. All rights reserved. FAU - Anthopolos, Rebecca AU - Anthopolos R AD - NYU Grossman School of Medicine, New York, NY. Electronic address: rebecca.anthopolos@nyulangone.org. FAU - Maron, David J AU - Maron DJ AD - Stanford University Department of Medicine, Stanford, CA. FAU - Bangalore, Sripal AU - Bangalore S AD - NYU Grossman School of Medicine, New York, NY. FAU - Reynolds, Harmony R AU - Reynolds HR AD - NYU Grossman School of Medicine, New York, NY. FAU - Xu, Yifan AU - Xu Y AD - NYU Grossman School of Medicine, New York, NY. FAU - O'Brien, Sean M AU - O'Brien SM AD - Duke Clinical Research Institute, Durham, NC. FAU - Troxel, Andrea B AU - Troxel AB AD - NYU Grossman School of Medicine, New York, NY. FAU - Mavromichalis, Stavroula AU - Mavromichalis S AD - NYU Grossman School of Medicine, New York, NY. FAU - Chang, Michelle AU - Chang M AD - NYU Grossman School of Medicine, New York, NY. FAU - Contreras, Aira AU - Contreras A AD - NYU Grossman School of Medicine, New York, NY. FAU - Hochman, Judith S AU - Hochman JS AD - NYU Grossman School of Medicine, New York, NY. CN - ISCHEMIA-EXTEND Research Group LA - eng GR - R01 HL149888/HL/NHLBI NIH HHS/United States GR - UL1 TR001445/TR/NCATS NIH HHS/United States PT - Clinical Trial Protocol PT - Journal Article DEP - 20221004 PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 SB - IM MH - Humans MH - Bayes Theorem MH - *Coronary Disease MH - Exercise Test MH - *Myocardial Infarction/therapy MH - Observational Studies as Topic MH - *Renal Insufficiency, Chronic/therapy MH - Randomized Controlled Trials as Topic PMC - PMC9880872 MID - NIHMS1867087 EDAT- 2022/10/08 06:00 MHDA- 2022/12/15 06:00 PMCR- 2023/12/01 CRDT- 2022/10/07 19:15 PHST- 2022/09/22 00:00 [received] PHST- 2022/09/27 00:00 [revised] PHST- 2022/09/28 00:00 [accepted] PHST- 2022/10/08 06:00 [pubmed] PHST- 2022/12/15 06:00 [medline] PHST- 2022/10/07 19:15 [entrez] PHST- 2023/12/01 00:00 [pmc-release] AID - S0002-8703(22)00194-6 [pii] AID - 10.1016/j.ahj.2022.09.009 [doi] PST - ppublish SO - Am Heart J. 2022 Dec;254:228-233. doi: 10.1016/j.ahj.2022.09.009. Epub 2022 Oct 4. PMID- 36202565 OWN - NLM STAT- MEDLINE DCOM- 20221010 LR - 20221030 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 15 IP - 19 DP - 2022 Oct 10 TI - Early Invasive Strategy and Outcome of Non-ST-Segment Elevation Myocardial Infarction Patients With Chronic Kidney Disease. PG - 1977-1988 LID - S1936-8798(22)01551-5 [pii] LID - 10.1016/j.jcin.2022.08.008 [doi] AB - BACKGROUND: Current guidelines suggest that an early invasive strategy should be considered for the treatment of non-ST-segment elevation myocardial infarction (NSTEMI). Although chronic kidney disease (CKD) is common among NSTEMI patients, these patients are under-represented in clinical trials, and data regarding their management are limited. OBJECTIVES: The authors sought to evaluate the association between early invasive strategy and long-term survival among patients with NSTEMI and CKD. METHODS: This was a retrospective analysis of 7,107 consecutive NSTEMI patients between 2008 and 2021. Patients were dichotomized into early (40% glomerular filtration rate decrease, initiation of dialysis, and/or kidney transplant. Outcomes were compared using Cox proportional hazards regression analysis, and the results were further adjusted by multivariable analyses and inverse probability weighting. RESULTS: Among the study population (n = 798), 443 (55.5%) patients received CABG and 355 (44.5%) patients received PCI. Compared with the CABG group, the PCI group had similar risk of the primary endpoint (CABG vs. PCI, 19.3% vs. 24.0%, HR: 1.28, 95% CI: 0.95-1.73, p = 0.11) and a lower risk of the renal composite outcome (36.6% vs. 31.2%, HR: 0.74, 95% CI 0.58-0.94, p = 0.03). In addition, PCI-IR was associated with a significantly higher risk of the primary endpoint than CABG (HR: 1.54, 95% CI: 1.11-2.13, p = 0.009) or PCI-CR (HR: 1.78, 95% CI: 1.09-2.89, p = 0.02). However, PCI-CR had a comparable 5-year death, MI, or stroke rate to CABG (HR: 0.86, 95% CI 0.54-1.38, p = 0.54). CONCLUSION: Coronary artery bypass grafting showed an incidence of death, MI, or stroke similar to PCI but was associated with a higher risk of renal injury. PCI-CR had a prognosis comparable with that of CABG, while PCI-IR had worse prognosis. If PCI is chosen for revascularization in patients with CKD, achieving CR should be attempted to ensure favorable outcomes. CLINICAL TRIAL REGISTRATION: [clinicaltrials.gov], identifier [NCT03870815]. CI - Copyright (c) 2022 Kwon, Choi, Jeong, Lee, Lee, Park, Yang, Hahn, Choi, Chung, Cho, Sung, Kim, Gwon, Lee and Song. FAU - Kwon, Woochan AU - Kwon W AD - Division of Cardiology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Heart Vascular Stroke Institute, Seoul, South Korea. FAU - Choi, Ki Hong AU - Choi KH AD - Division of Cardiology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Heart Vascular Stroke Institute, Seoul, South Korea. FAU - Jeong, Dong Seop AU - Jeong DS AD - Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Heart Vascular Stroke Institute, Seoul, South Korea. FAU - Lee, Sang Yoon AU - Lee SY AD - Division of Cardiology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Heart Vascular Stroke Institute, Seoul, South Korea. FAU - Lee, Joo Myung AU - Lee JM AD - Division of Cardiology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Heart Vascular Stroke Institute, Seoul, South Korea. FAU - Park, Taek Kyu AU - Park TK AD - Division of Cardiology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Heart Vascular Stroke Institute, Seoul, South Korea. FAU - Yang, Jeong Hoon AU - Yang JH AD - Division of Cardiology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Heart Vascular Stroke Institute, Seoul, South Korea. FAU - Hahn, Joo-Yong AU - Hahn JY AD - Division of Cardiology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Heart Vascular Stroke Institute, Seoul, South Korea. FAU - Choi, Seung-Hyuk AU - Choi SH AD - Division of Cardiology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Heart Vascular Stroke Institute, Seoul, South Korea. FAU - Chung, Su Ryeun AU - Chung SR AD - Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Heart Vascular Stroke Institute, Seoul, South Korea. FAU - Cho, Yang Hyun AU - Cho YH AD - Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Heart Vascular Stroke Institute, Seoul, South Korea. FAU - Sung, Kiick AU - Sung K AD - Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Heart Vascular Stroke Institute, Seoul, South Korea. FAU - Kim, Wook Sung AU - Kim WS AD - Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Heart Vascular Stroke Institute, Seoul, South Korea. FAU - Gwon, Hyeon-Cheol AU - Gwon HC AD - Division of Cardiology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Heart Vascular Stroke Institute, Seoul, South Korea. FAU - Lee, Young Tak AU - Lee YT AD - Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Heart Vascular Stroke Institute, Seoul, South Korea. FAU - Song, Young Bin AU - Song YB AD - Division of Cardiology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Heart Vascular Stroke Institute, Seoul, South Korea. LA - eng SI - ClinicalTrials.gov/NCT03870815 PT - Journal Article DEP - 20220912 PL - Switzerland TA - Front Cardiovasc Med JT - Frontiers in cardiovascular medicine JID - 101653388 PMC - PMC9510652 OTO - NOTNLM OT - chronic renal insufficiency OT - clinical outcomes OT - coronary artery bypass grafting OT - coronary artery disease OT - percutaneous coronary intervention COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2022/09/30 06:00 MHDA- 2022/09/30 06:01 PMCR- 2022/01/01 CRDT- 2022/09/29 02:22 PHST- 2022/05/23 00:00 [received] PHST- 2022/08/19 00:00 [accepted] PHST- 2022/09/29 02:22 [entrez] PHST- 2022/09/30 06:00 [pubmed] PHST- 2022/09/30 06:01 [medline] PHST- 2022/01/01 00:00 [pmc-release] AID - 10.3389/fcvm.2022.951113 [doi] PST - epublish SO - Front Cardiovasc Med. 2022 Sep 12;9:951113. doi: 10.3389/fcvm.2022.951113. eCollection 2022. PMID- 36128415 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20220922 IS - 1923-2829 (Print) IS - 1923-2837 (Electronic) IS - 1923-2829 (Linking) VI - 13 IP - 4 DP - 2022 Aug TI - Atrial Fibrillation as a Prognostic Indicator in Patients With Orthostatic Hypotension: Nationwide Inpatient Sample Analysis. PG - 228-235 LID - 10.14740/cr1405 [doi] AB - BACKGROUND: Orthostatic hypotension and atrial fibrillation have common etiology and a bidirectional relationship with several cardiovascular conditions. Despite both conditions being highly prevalent in hospitalized patients, prior research has primarily evaluated adverse outcomes due to orthostatic hypotension and atrial fibrillation independent of each other. In this study, we aim to assess if the presence of atrial fibrillation exacerbates in-hospital outcomes of patients with orthostatic hypotension. METHODS: Adult patients hospitalized in 2019 with a primary diagnosis of orthostatic hypotension with or without pre-existing atrial fibrillation were identified using the International Classification of Diseases, Tenth Revision (ICD-10) code. The primary outcome of interest was in-patient mortality and cardiac arrest. Secondary outcomes of interest were the length of stay and total hospital charges. Adjusted and unadjusted analysis was performed on appropriate variables of interest. RESULTS: Among 10,630 hospitalizations with orthostatic hypotension, 2,987 (median (interquartile range (IQR)) age: 78.5 (68.5 - 88.5) years; 1,197 women (40.1%)) comprised the atrial fibrillation cohort. Mean Charlson comorbidity index was noted to be significantly higher in orthostatic hypotension and atrial fibrillation patients (mean (standard deviation (SD)): 3.1 (2.1) vs. 2.5 (2.1), P < 0.001).Compared to orthostatic hypotension patients without atrial fibrillation, the prevalence of congestive heart failure (1,263 (42.3%) vs. 1,367 (17.9%)), coronary artery disease (1,432 (47.9%) vs. 2,481 (32.5%)), history of percutaneous coronary intervention or graft (443 (14.83%) vs. 860 (11.3%)), chronic obstructive pulmonary disease (644 (21.6%) vs. 1,131 (14.8%)) , chronic kidney disease (1,182 (39.6%) vs. 2,216 (29.0%)), and hyperlipidemia (1,828 (61.2%) vs. 4,087 (53.5%); all P < 0.05), were significantly higher in orthostatic hypotension patients with atrial fibrillation. Following multivariable analysis of orthostatic hypotension patients, atrial fibrillation was associated with 5.0 times greater odds for cardiac arrest (adjusted odds ratio (aOR) = 5.0 (95% confidence interval (CI): 1.4 - 18.2), P = 0.014), without increased risk of in-hospital mortality (aOR = 2.1 (95% CI: 0.9 - 5.0), P = 0.090). CONCLUSIONS: Atrial fibrillation is an independent predictor for cardiac arrest but not in-hospital mortality in patients with orthostatic hypotension. The short- and long-term prognostic value of atrial fibrillation in orthostatic hypotension patients must be confirmed in future prospective trials to improve patient outcomes. CI - Copyright 2022, Brgdar et al. FAU - Brgdar, Ahmed AU - Brgdar A AD - Department of Medicine, Howard University Hospital, Washington, DC, USA. FAU - Gharbin, John AU - Gharbin J AD - Department of Medicine, Howard University Hospital, Washington, DC, USA. FAU - Awan, Ahmad AU - Awan A AD - Cardiovascular Disease, Montefiore Medical Center, Bronx, NY, USA. FAU - Ogunti, Richard AU - Ogunti R AD - Department of Medicine, Mayo Clinic Health System, Mankato, Minnesota, USA. FAU - Khurshid, Qasim AU - Khurshid Q AD - Department of Medicine, Howard University Hospital, Washington, DC, USA. FAU - Hamad, Mayar AU - Hamad M AD - Faculty of Science, University of Calgary, Calgary, AB, Canada. FAU - Mehrotra, Prafulla AU - Mehrotra P AD - Cardiovascular Disease, Howard University Hospital, Washington, DC, USA. LA - eng PT - Journal Article DEP - 20220815 PL - Canada TA - Cardiol Res JT - Cardiology research JID - 101557543 PMC - PMC9451585 OTO - NOTNLM OT - Atrial fibrillation OT - Cardiovascular OT - Hypertension OT - Orthostatic hypotension COIS- None to declare. EDAT- 2022/09/22 06:00 MHDA- 2022/09/22 06:01 PMCR- 2022/08/15 CRDT- 2022/09/21 02:00 PHST- 2022/06/12 00:00 [received] PHST- 2022/07/29 00:00 [accepted] PHST- 2022/09/21 02:00 [entrez] PHST- 2022/09/22 06:00 [pubmed] PHST- 2022/09/22 06:01 [medline] PHST- 2022/08/15 00:00 [pmc-release] AID - 10.14740/cr1405 [doi] PST - ppublish SO - Cardiol Res. 2022 Aug;13(4):228-235. doi: 10.14740/cr1405. Epub 2022 Aug 15. PMID- 36007555 OWN - NLM STAT- MEDLINE DCOM- 20221110 LR - 20221116 IS - 2213-3763 (Electronic) IS - 0019-4832 (Print) IS - 0019-4832 (Linking) VI - 74 IP - 5 DP - 2022 Sep-Oct TI - Ultra-low CONtraSt PCI vs conVEntional PCI in patients of ACS with increased risk of CI-AKI (CONSaVE-AKI). PG - 363-368 LID - S0019-4832(22)00128-6 [pii] LID - 10.1016/j.ihj.2022.08.004 [doi] AB - OBJECTIVES: This prospective, randomized study assessed short-term outcomes and safety of ultra-low contrast percutaneous coronary intervention(ULC-PCI) vs conventional PCI in high risk for contrast induced acute kidney injury(CI-AKI) patients presenting with acute coronary syndrome(ACS). BACKGROUND: Patients at an increased risk of developing CI-AKI can be identified prior to PCI based on their pre-procedural risk scores. ULC-PCI is a novel contrast conservation strategy in such high risk patients for prevention of CI-AKI. METHODS: 82 patients undergoing PCI for ACS were enrolled having estimated glomerular filtration rate(eGFR) < 60 ml/min/1.73 m(2) and moderate to very high pre-procedural risk of developing CI-AKI as calculated by Maioli risk calculator. They were randomized into two groups of 41 patients each of ULC-PCI (contrast volume /=20% in quintile 5 (score >33). CONCLUSIONS: The DM-CURE model and score were useful for population risk stratification of incident HHF among patients with T2DM and can be easily applied in clinical practice. CI - (c) 2022 John Wiley & Sons Ltd. FAU - Lin, Yilu AU - Lin Y AUID- ORCID: 0000-0001-7040-4287 AD - Department of Health Policy and Management, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, United States. FAU - Shao, Hui AU - Shao H AUID- ORCID: 0000-0002-4088-546X AD - Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, Florida, United States. FAU - Shi, Lizheng AU - Shi L AUID- ORCID: 0000-0002-7827-6766 AD - Department of Health Policy and Management, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, United States. FAU - Anderson, Amanda H AU - Anderson AH AD - Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, United States. FAU - Fonseca, Vivian AU - Fonseca V AUID- ORCID: 0000-0002-3381-7151 AD - Department of Medicine and Pharmacology, School of Medicine, Tulane University, New Orleans, Louisiana, United States. LA - eng GR - U54 GM104940/GM/NIGMS NIH HHS/United States PT - Journal Article DEP - 20220808 PL - England TA - Diabetes Obes Metab JT - Diabetes, obesity & metabolism JID - 100883645 RN - 0 (Albumins) RN - AYI8EX34EU (Creatinine) RN - 0 (Glycated Hemoglobin) RN - 0 (Lipoproteins, HDL) SB - IM MH - Albumins MH - Child, Preschool MH - Creatinine MH - *Diabetes Mellitus, Type 2/complications/drug therapy/epidemiology MH - Glycated Hemoglobin/metabolism MH - *Heart Failure/diagnosis/epidemiology/etiology MH - Humans MH - Lipoproteins, HDL/therapeutic use MH - Risk Assessment/methods MH - Risk Factors PMC - PMC10201412 MID - NIHMS1893812 OTO - NOTNLM OT - cardiovascular OT - diabetes complications OT - disease OT - heart failure OT - type 2 diabetes EDAT- 2022/07/09 06:00 MHDA- 2022/10/05 06:00 PMCR- 2023/05/22 CRDT- 2022/07/08 03:32 PHST- 2022/06/20 00:00 [revised] PHST- 2022/04/11 00:00 [received] PHST- 2022/07/01 00:00 [accepted] PHST- 2022/07/09 06:00 [pubmed] PHST- 2022/10/05 06:00 [medline] PHST- 2022/07/08 03:32 [entrez] PHST- 2023/05/22 00:00 [pmc-release] AID - 10.1111/dom.14806 [doi] PST - ppublish SO - Diabetes Obes Metab. 2022 Nov;24(11):2203-2211. doi: 10.1111/dom.14806. Epub 2022 Aug 8. PMID- 35767253 OWN - NLM STAT- MEDLINE DCOM- 20220812 LR - 20250728 IS - 2380-6591 (Electronic) IS - 2380-6583 (Print) VI - 7 IP - 8 DP - 2022 Aug 1 TI - Clinical and Quality-of-Life Outcomes Following Invasive vs Conservative Treatment of Patients With Chronic Coronary Disease Across the Spectrum of Kidney Function. PG - 825-835 LID - 10.1001/jamacardio.2022.1763 [doi] AB - IMPORTANCE: Prior trials of invasive vs conservative management of chronic coronary disease (CCD) have not enrolled patients with severe chronic kidney disease (CKD). As such, outcomes across kidney function are not well characterized. OBJECTIVES: To evaluate clinical and quality-of-life (QoL) outcomes across the spectrum of CKD following conservative and invasive treatment strategies. DESIGN, SETTING, AND PARTICIPANTS: Participants from the International Study of Comparative Health Effectiveness With Medical and Invasive Approaches (ISCHEMIA) and ISCHEMIA-Chronic Kidney Disease (CKD) trials were categorized by CKD stage: stage 1 (estimated glomerular filtration rate [eGFR] 90 mL/min/1.73m2 or greater), stage 2 (eGFR 60-89 mL/min/1.73m2), stage 3 (eGFR 30-59 mL/min/1.73m2), stage 4 (eGFR 15-29 mL/min/1.73m2), or stage 5 (eGFR less than 15 mL/min/1.73m2 or receiving dialysis). Enrollment took place from July 26, 2012, through January 31, 2018, with a median follow-up of 3.1 years. Data were analyzed from January 2020 to May 2021. INTERVENTIONS: Initial invasive management of coronary angiography and revascularization with guideline-directed medical therapy (GDMT) vs initial conservative management of GDMT alone. MAIN OUTCOMES AND MEASURES: The primary clinical outcome was a composite of death or nonfatal myocardial infarction (MI). The primary QoL outcome was the Seattle Angina Questionnaire (SAQ) summary score. RESULTS: Among the 5956 participants included in this analysis (mean [SD] age, 64 [10] years; 1410 [24%] female and 4546 [76%] male), 1889 (32%), 2551 (43%), 738 (12%), 311 (5%), and 467 (8%) were in CKD stages 1, 2, 3, 4, and 5, respectively. By self-report, 18 participants (<1%) were American Indian or Alaska Native; 1676 (29%), Asian; 267 (5%), Black; 861 (16%), Hispanic or Latino; 18 (<1%), Native Hawaiian or Other Pacific Islander; 3884 (66%), White; and 13 (<1%), multiple races or ethnicities. There was a monotonic increase in risk of the primary composite end point (3-year rates, 9.52%, 10.72%, 18.42%, 34.21%, and 38.01% respectively), death, cardiovascular death, MI, and stroke in individuals with higher CKD stages. Invasive management was associated with an increase in stroke (3-year event rate difference, 1%; 95% CI, 0.3 to 1.7) and procedural MI (1.6%; 95% CI, 0.9 to 2.3) and a decrease in spontaneous MI (-2.5%; 95% CI, -3.9 to -1.1) with no difference in other outcomes; the effect was similar across CKD stages. There was heterogeneity of treatment effect for QoL outcomes such that invasive management was associated with an improvement in angina-related QoL in individuals with CKD stages 1 to 3 and not in those with CKD stages 4 to 5. CONCLUSIONS AND RELEVANCE: Among participants with CCD, event rates were inversely proportional to kidney function. Invasive management was associated with an increase in stroke and procedural MI and a reduced risk in spontaneous MI, and the effect was similar across CKD stages with no difference in other outcomes, including death. The benefit for QoL with invasive management was not observed in individuals with poorer kidney function. FAU - Bangalore, Sripal AU - Bangalore S AD - New York University Grossman School of Medicine, New York. FAU - Hochman, Judith S AU - Hochman JS AD - New York University Grossman School of Medicine, New York. FAU - Stevens, Susanna R AU - Stevens SR AD - Duke Clinical Research Institute, Durham, North Carolina. FAU - Jones, Philip G AU - Jones PG AD - Saint Luke's Mid America Heart Institute/University of Missouri, Kansas City. FAU - Spertus, John A AU - Spertus JA AD - Saint Luke's Mid America Heart Institute/University of Missouri, Kansas City. FAU - O'Brien, Sean M AU - O'Brien SM AD - Duke Clinical Research Institute, Durham, North Carolina. FAU - Reynolds, Harmony R AU - Reynolds HR AD - New York University Grossman School of Medicine, New York. FAU - Boden, William E AU - Boden WE AD - Veterans Affairs New England Healthcare System, Boston, Massachusetts. FAU - Fleg, Jerome L AU - Fleg JL AD - National Heart, Lung, and Blood Institute, Bethesda, Maryland. FAU - Williams, David O AU - Williams DO AD - Brigham and Women's Hospital, Boston, Massachusetts. FAU - Stone, Gregg W AU - Stone GW AD - Icahn School of Medicine at Mount Sinai, Cardiovascular Research Foundation, New York, New York. FAU - Sidhu, Mandeep S AU - Sidhu MS AD - Albany Medical College, Albany, New York. FAU - Mathew, Roy O AU - Mathew RO AD - Columbia Veterans Affairs Health Care System, Columbia, South Carolina. FAU - Chertow, Glenn M AU - Chertow GM AD - Department of Medicine, Stanford University, Stanford, California. FAU - Maron, David J AU - Maron DJ AD - Department of Medicine, Stanford University, Stanford, California. LA - eng GR - U01 HL105907/HL/NHLBI NIH HHS/United States GR - U01 HL117905/HL/NHLBI NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't PL - United States TA - JAMA Cardiol JT - JAMA cardiology JID - 101676033 SB - IM MH - Chronic Disease MH - Conservative Treatment MH - *Coronary Disease/complications MH - Female MH - Humans MH - Kidney MH - Male MH - Middle Aged MH - *Myocardial Infarction/complications MH - Quality of Life MH - *Renal Insufficiency, Chronic/complications/epidemiology/therapy MH - *Stroke/complications PMC - PMC9244774 COIS- Conflict of Interest Disclosures: Dr Bangalore reports grants from National Heart, Lung, and Blood Institute during the conduct of the study and grants and personal fees from Abbott Vascular and personal fees from Biotronik, Pfizer, Amgen, and Reata outside the submitted work. Dr Hochman is principal investigator for the International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) trial for which, in addition to support by National Heart, Lung, and Blood Institute grant, devices and medications were provided by Abbott Vascular, Medtronic, St Jude Medical, Volcano Corporation, Arbor Pharmaceuticals, AstraZeneca Pharmaceuticals, Merck Sharp & Dohme Corp, and Omron Healthcare, as well as financial donations from Arbor Pharmaceuticals and AstraZeneca Pharmaceuticals. Ms Stevens reports grants from National Heart, Lung, and Blood Institute during the conduct of the study. Mr Jones reports employment by the National Heart, Lung, and Blood Institute during the conduct of the study. Dr Spertus reports grants from National Heart, Lung, and Blood Institute during the conduct of the study and personal fees from Bayer, Novartis, AstraZeneca, Amgen, Janssen, United Healthcare, and Blue Cross Blue Shield of Kansas City and grants from American College of Cardiology outside the submitted work; in addition, Dr Spertus has a patent copyright to Seattle Angina Questionnaire with royalties paid and equity in Health Outcomes Sciences. Dr O'Brien reports grants from National Heart, Lung, and Blood Institute during the conduct of the study. Dr Reynolds reports grants from National Heart, Lung, and Blood Institute during the conduct of the study and nonfinancial support from Abbott Vascular, Siemens, and BioTelemetry outside the submitted work. Dr Boden reports grants from National Heart, Lung, and Blood Institute during the conduct of the study and grants from AbbVie, Amarin, and Amgen and personal fees from Amgen, Cleveland Clinic Clinical Coordinating Center, and Janssen outside the submitted work. Dr Fleg reports employment by the National Heart, Lung, and Blood Institute during the conduct of the study. Dr David O. Williams reports grants from National Heart, Lung, and Blood Institute during the conduct of the study. Dr Gregg W. Stone reports grants and personal fees from the National Heart, Lung, and Blood Institute during the conduct of the study and personal fees from Terumo, Amaranth, Shockwave, Valfix; TherOx, Revascularization, Vascular Dynamics, Robocath, HeartFlow, Gore, Ablative Solutions, Matrizyme, Miracor, Neovasc, V-wave, Abiomed, Claret, Sirtex, Ancora, Qool Therapeutics, SpectraWave, MAIA Pharmaceuticals, Orchestra Biomed, and Vectorious and other from Cagent, Applied Therapeutics, Biostar, MedFocus, Aria, and Cardiac Success outside the submitted work. Dr Sidhu reports grants from National Heart, Lung, and Blood Institute during the conduct of the study and personal fees from Astra Zeneca and Sanofi-Regeneron outside the submitted work. Dr Mathew reports grants from National Heart, Lung, and Blood Institute during the conduct of the study. Dr Chertow reports grants from National Heart, Lung, and Blood Institute during the conduct of the study and grants from National Institute of Diabetes and Digestive and Kidney Diseases and Amgen; personal fees from Akebia, Ardelyx, AstraZeneca, Baxter, Cricket, DiaMedica, Gilead, Reata, Sanifit, Vertex, Satellite Healthcare, Angion, Bayer, and ReCor; and other from CloudCath, Durect, and Outset outside the submitted work. Dr Maron reports grants from National Heart, Lung, and Blood Institute during the conduct of the study. No other disclosures were reported. EDAT- 2022/06/30 06:00 MHDA- 2022/08/13 06:00 PMCR- 2023/06/29 CRDT- 2022/06/29 11:33 PHST- 2022/06/30 06:00 [pubmed] PHST- 2022/08/13 06:00 [medline] PHST- 2022/06/29 11:33 [entrez] PHST- 2023/06/29 00:00 [pmc-release] AID - 2793852 [pii] AID - hoi220029 [pii] AID - 10.1001/jamacardio.2022.1763 [doi] PST - ppublish SO - JAMA Cardiol. 2022 Aug 1;7(8):825-835. doi: 10.1001/jamacardio.2022.1763. PMID- 35697255 OWN - NLM STAT- MEDLINE DCOM- 20220830 LR - 20251031 IS - 2567-689X (Electronic) IS - 0340-6245 (Print) IS - 0340-6245 (Linking) VI - 122 IP - 9 DP - 2022 Sep TI - Rivaroxaban Underdose for Atrial Fibrillation with Stable Coronary Disease: The AFIRE Trial Findings. PG - 1584-1593 LID - 10.1055/s-0042-1744543 [doi] AB - BACKGROUND: Rivaroxaban monotherapy was noninferior to combination therapy (rivaroxaban plus antiplatelet therapy) in efficacy but superior in safety in the Atrial Fibrillation and Ischemic Events with Rivaroxaban in Patients with Stable Coronary Artery Disease (AFIRE) trial. Among 2,215 patients with atrial fibrillation (AF) and stable coronary artery disease (CAD), 1,378 had baseline creatinine clearance (CrCl) >/=50 mL/min and received 10 (underdose) or 15 mg/d (standard-dose) rivaroxaban. We aimed to assess the effects of rivaroxaban underdose on clinical outcomes. METHODS: We assessed efficacy endpoint (a composite of stroke, systemic embolism, myocardial infarction, unstable angina requiring revascularization, and death from any cause) and major bleeding in the subgroup of patients with preserved renal function in the AFIRE trial. RESULTS: Age >/=75 years, female sex, lower CrCl, heart failure, and percutaneous coronary intervention history were associated with the underdose prescription. The underdose group had a similar incidence of the efficacy endpoint (3.62 vs. 3.51% per patient-year; p = 0.871) and significantly lower incidence of major bleeding (0.82 vs. 2.17% per patient-year; p = 0.022) than the standard-dose group. In patients receiving monotherapy, the incidences of efficacy endpoint and major bleeding were similar between the groups, whereas in those receiving combination therapy, the incidence of major bleeding was significantly lower in the underdose group than that in the standard-dose group. CONCLUSION: In patients with AF, stable CAD, and preserved renal function, rivaroxaban underdose was associated with similar rates of thrombotic events but a lower incidence of hemorrhagic events than the standard dose. CLINICAL TRIAL REGISTRATION: AFIRE UMIN Clinical Trials Registry (https://www.umin.ac.jp/ctr/), number UMIN000016612, and ClinicalTrials.gov, number NCT02642419. CI - The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/). FAU - Arashi, Hiroyuki AU - Arashi H AD - Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan. FAU - Yamaguchi, Junichi AU - Yamaguchi J AD - Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan. FAU - Hagiwara, Nobuhisa AU - Hagiwara N AD - Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan. FAU - Yasuda, Satoshi AU - Yasuda S AD - Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Miyagi, Japan. AD - National Cerebral and Cardiovascular Center, Osaka, Japan. FAU - Kaikita, Koichi AU - Kaikita K AD - Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan. AD - Division of Cardiovascular Medicine and Nephrology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan. FAU - Akao, Masaharu AU - Akao M AD - Department of Cardiology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan. FAU - Ako, Junya AU - Ako J AD - Department of Cardiovascular Medicine, Kitasato University School of Medicine, Kanagawa, Japan. FAU - Matoba, Tetsuya AU - Matoba T AD - Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan. FAU - Nakamura, Masato AU - Nakamura M AD - Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan. FAU - Miyauchi, Katsumi AU - Miyauchi K AD - Department of Cardiovascular Medicine, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan. FAU - Kimura, Kazuo AU - Kimura K AD - Cardiovascular Center, Yokohama City University Medical Center, Kanagawa, Japan. FAU - Hirayama, Atsushi AU - Hirayama A AD - Department of Cardiology, Osaka Police Hospital, Osaka, Japan. FAU - Matsui, Kunihiko AU - Matsui K AD - Department of General Medicine and Primary Care, Kumamoto University Hospital, Kumamoto, Japan. FAU - Ogawa, Hisao AU - Ogawa H AD - Kumamoto University, Kumamoto, Japan. CN - AFIRE investigators LA - eng SI - ClinicalTrials.gov/NCT02642419 PT - Clinical Trial PT - Journal Article DEP - 20220613 PL - Germany TA - Thromb Haemost JT - Thrombosis and haemostasis JID - 7608063 RN - 0 (Anticoagulants) RN - 0 (Factor Xa Inhibitors) RN - 0 (Platelet Aggregation Inhibitors) RN - 9NDF7JZ4M3 (Rivaroxaban) SB - IM MH - Aged MH - Anticoagulants MH - *Atrial Fibrillation MH - *Coronary Artery Disease MH - Factor Xa Inhibitors MH - Female MH - Hemorrhage MH - Humans MH - Male MH - Platelet Aggregation Inhibitors MH - Rivaroxaban MH - *Stroke MH - Treatment Outcome PMC - PMC9420554 COIS- H.A. reports personal fees from Takeda Pharmaceutical, Terumo, Abbott, Otsuka Pharmaceutical, and Bayer Yakuhin. J.Y. reports grants and personal fees from Abbott and Terumo, grants from Boston Scientific and Medtronic, and personal fees from Bristol Myers Squibb and Daiichi-Sankyo. S.Y. reports grants from Takeda Pharmaceutical, Abbott, and Boston Scientific, and personal fees from Daiichi-Sankyo and Bristol Myers Squibb. K.K. reports grants from Grants-in-Aid for Scientific Research (20K08451) from the Ministry of Education, Culture, Sports, Science, and Technology of Japan and grants and personal fees from Bayer Yakuhin and Daiichi-Sankyo. T.M. reports grants from the Japan Cardiovascular Research Foundation and personal fees from Nippon Boehringer Ingelheim, Daiichi-Sankyo, AstraZeneca, and Bayer Yakuhin. M.A. reports grants from the Japan Agency for Medical Research and Development (AMED), personal fees from Bristol Myers Squibb and Nippon Boehringer Ingelheim, and grants and personal fees from Bayer Yakuhin and Daiichi-Sankyo. J.A. reports personal fees from Bayer Yakuhin and Sanofi and grants and personal fees from Daiichi-Sankyo. M.N. reports grants and personal fees from Bayer Yakuhin, Daiichi-Sankyo, and Sanofi, and personal fees from Bristol Myers Squibb and Nippon Boehringer Ingelheim. K.M. reports personal fees from Amgen Astellas BioPharma, Astellas Pharma, MSD, Bayer Yakuhin, Sanofi, Takeda Pharmaceutical, Daiichi-Sankyo, Nippon Boehringer Ingelheim, and Bristol Myers Squibb. N.H. reports grants and personal fees from Bayer Yakuhin, grants from Nippon Boehringer Ingelheim, and personal fees from Bristol Myers Squibb. Kimura reports grants from the Japan Cardiovascular Research Foundation, grants and personal fees from Bayer Yakuhin, Daiichi-Sankyo, Sanofi, MSD, and AstraZeneca, and personal fees from Bristol Myers Squibb and Nippon Boehringer Ingelheim. A.H. reports grants and personal fees from Boston Scientific Japan, Otsuka Pharmaceutical, Sanofi, Astellas Pharma, Bristol Myers Squibb, Daiichi-Sankyo, and Bayer Yakuhin, grants from Fukuda Denshi, Abbott Japan, Japan Lifeline, Takeda Pharmaceutical, and Sumitomo Dainippon Pharma, and personal fees from Toa Eiyo, Nippon Boehringer Ingelheim, Amgen Astellas BioPharma, and AstraZeneca. H.O. reports personal fees from Towa Pharmaceutical, Bristol Myers Squibb, Pfizer, Toa Eiyo, Bayer Yakuhin, and Novartis Pharma. The other authors declare that there are no conflicts of interest for this study. EDAT- 2022/06/14 06:00 MHDA- 2022/08/31 06:00 PMCR- 2022/06/01 CRDT- 2022/06/13 19:26 PHST- 2022/06/14 06:00 [pubmed] PHST- 2022/08/31 06:00 [medline] PHST- 2022/06/13 19:26 [entrez] PHST- 2022/06/01 00:00 [pmc-release] AID - 210616 [pii] AID - 10.1055/s-0042-1744543 [doi] PST - ppublish SO - Thromb Haemost. 2022 Sep;122(9):1584-1593. doi: 10.1055/s-0042-1744543. Epub 2022 Jun 13. PMID- 35606172 OWN - NLM STAT- MEDLINE DCOM- 20220622 LR - 20220629 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 176 DP - 2022 Aug 1 TI - One-Year Ischemic and Bleeding Events According to Renal Function in Patients With Non-ST-Segment Elevation Acute Coronary Syndromes Treated With Percutaneous Coronary Intervention and Third-Generation Antiplatelet Drugs. PG - 15-23 LID - S0002-9149(22)00426-X [pii] LID - 10.1016/j.amjcard.2022.04.040 [doi] AB - The optimal antiplatelet therapy of patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS) and chronic kidney disease (CKD) remains unknown. This study included 2,364 patients with NSTE-ACS undergoing predominantly percutaneous coronary intervention (PCI), who were randomized to ticagrelor or prasugrel in the ISAR-REACT 5 trial. Estimated glomerular filtration rate (eGFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation. The primary end point was 1-year mortality. Overall, there were 85 deaths (3.6%): 6 deaths (17.1%) in patients with eGFR <30, 31 deaths (6.9%) in patients with eGFR 30 to <60, 34 deaths (3.0%) in patients with eGFR 60 to <90, and 14 deaths (2.0%) in patients with eGFR >/=90 ml/min/1.73 m(2); adjusted hazard ratio (HR)=1.15, 95% confidence interval (CI) 1.01 to 1.31; p = 0.033 for 10 ml/min/1.73 m(2) decrement in the eGFR. Bleeding occurred in 129 patients (5.5%): 7 bleeds (20.2%) in patients with eGFR <30, 36 bleeds (8.0%) in patients with eGFR 30 to <60, 64 bleeds (5.6%) in patients with eGFR 60 to <90, and 22 bleeds (3.1%) in patients with eGFR >/=90 ml/min/1.73 m(2); adjusted HR=1.11 (1.01 to 1.23); p = 0.045 for 10 ml/min/1.73 m(2) decrement in the eGFR. One-year mortality and bleeding did not differ significantly between ticagrelor and prasugrel in all categories of impaired renal function. In conclusion, in patients with NSTE-ACS undergoing PCI with drug-eluting stents and third-generation antiplatelet drugs, impaired renal function was independently associated with higher risk of 1-year mortality and bleeding. The ischemic and bleeding risks appear to differ little between ticagrelor and prasugrel in all categories of impaired renal function. CI - Copyright (c) 2022 Elsevier Inc. All rights reserved. FAU - Ndrepepa, Gjin AU - Ndrepepa G AD - German Heart Center Munich, Technical University of Munich, Germany. Electronic address: ndrepepa@dhm.mhn.de. FAU - Lahu, Shqipdona AU - Lahu S AD - German Heart Center Munich, Technical University of Munich, Germany. FAU - Aytekin, Alp AU - Aytekin A AD - German Heart Center Munich, Technical University of Munich, Germany. FAU - Scalamogna, Maria AU - Scalamogna M AD - German Heart Center Munich, Technical University of Munich, Germany. FAU - Coughlan, John Joseph AU - Coughlan JJ AD - German Heart Center Munich, Technical University of Munich, Germany. FAU - Gewalt, Senta AU - Gewalt S AD - German Heart Center Munich, Technical University of Munich, Germany. FAU - Pellegrini, Costanza AU - Pellegrini C AD - German Heart Center Munich, Technical University of Munich, Germany. FAU - Mayer, Katharina AU - Mayer K AD - German Heart Center Munich, Technical University of Munich, Germany. FAU - Kastrati, Adnan AU - Kastrati A AD - German Heart Center Munich, Technical University of Munich, Germany; German Center for Cardiovascular Research, Partner Site Munich Heart Alliance, Germany. LA - eng PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20220521 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 RN - 0 (Platelet Aggregation Inhibitors) RN - G89JQ59I13 (Prasugrel Hydrochloride) RN - GLH0314RVC (Ticagrelor) SB - IM MH - *Acute Coronary Syndrome/drug therapy/surgery MH - Hemorrhage/chemically induced/epidemiology MH - Humans MH - Ischemia MH - Kidney/physiology MH - *Percutaneous Coronary Intervention/adverse effects MH - Platelet Aggregation Inhibitors MH - Prasugrel Hydrochloride/therapeutic use MH - *Renal Insufficiency, Chronic/complications/epidemiology MH - Ticagrelor/therapeutic use MH - Treatment Outcome COIS- Disclosures The authors have no conflicts of interest to declare. EDAT- 2022/05/24 06:00 MHDA- 2022/06/23 06:00 CRDT- 2022/05/23 22:03 PHST- 2022/02/04 00:00 [received] PHST- 2022/03/28 00:00 [revised] PHST- 2022/04/05 00:00 [accepted] PHST- 2022/05/24 06:00 [pubmed] PHST- 2022/06/23 06:00 [medline] PHST- 2022/05/23 22:03 [entrez] AID - S0002-9149(22)00426-X [pii] AID - 10.1016/j.amjcard.2022.04.040 [doi] PST - ppublish SO - Am J Cardiol. 2022 Aug 1;176:15-23. doi: 10.1016/j.amjcard.2022.04.040. Epub 2022 May 21. PMID- 35548446 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20220716 IS - 2297-055X (Print) IS - 2297-055X (Electronic) IS - 2297-055X (Linking) VI - 9 DP - 2022 TI - Efficacy and Safety of the Reduced Bivalirudin in Patients Undergoing Coronary Angiography or Percutaneous Coronary Intervention Stratified by Renal Function (REDUCE BOLUS): A Single-Blind, Stratified Randomized, Non-inferiority Trial. PG - 864048 LID - 10.3389/fcvm.2022.864048 [doi] LID - 864048 AB - BACKGROUND: In clinical practice, some cases indicated that the loading dose of bivalirudin increased the bleeding risk, particularly in patients with renal insufficiency. Therefore, this study aimed to assess the efficacy and safety of the low-dose (80%) bolus injection of bivalirudin in patients undergoing cardiac catheterization stratified by renal function. METHODS: A total of 204 individuals in the REDUCE BOLUS trial were stratified 1:1 to the estimated glomerular filtration rate (eGFR) >/= 60 ml/min cohort or eGFR < 60 ml/min cohort, then randomized 1:1 to the reduced bolus bivalirudin group (i.e., the experimental group) or normal bolus bivalirudin group (i.e., the control group), respectively. The primary end point was to compare the differences of the area under the curve of activated clotting time (ACT) between the two groups. The secondary end points were the postoperative net adverse clinical events (NACEs) before discharge, defined as the all-cause mortality, recurrent myocardial infarction, ischemia-driven target vessel revascularization, stroke, and bleeding events. RESULTS: Between January 3, 2020, and March 26, 2021, 204 patients undergoing coronary angiography were randomly assigned, including 102 (i.e., 51 in the control group and 51 in the experimental group) with normal eGFR and 102 (i.e., 51 control and 51 experimental) with abnormal eGFR. No difference was observed in the curve of ACT between the control group and the experimental group (0.55 +/- 0.09 vs. 0.56 +/- 0.08, P = 0.542 and 0.55 +/- 0.06 vs. 0.57 +/- 0.05, P = 0.075, respectively, for normal eGFR cohort and abnormal eGFR cohort). The one-sided 97.5% lower confidence bound for the difference in the area under the ACT curve was -0.017 and 0.0015 in eGFR >/= 60 ml/min and eGFR<60 ml/min cohort, respectively, both above the preset non-inferiority criterion of -0.07, establishing the non-inferiority. There was no incidence of NACE and stent thrombosis before discharge in each group. CONCLUSION: In patients undergoing cardiac catheterization, the efficacy and safety of the reduced bolus of bivalirudin were non-inferior to the normal one, even in patients without chronic kidney disease. CLINICAL TRIAL REGISTRATION: [www.ClinicalTrials.gov], identifier [NCT03588611]. CI - Copyright (c) 2022 Hu, Han, Zhou, Wang and Zhang. FAU - Hu, Qiang AU - Hu Q AD - Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, China. AD - Department of Cardiology, Xijing Hospital, Air Force Medical University, Xi'an, China. FAU - Han, Ya-Ling AU - Han YL AD - Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, China. FAU - Zhou, Tie-Nan AU - Zhou TN AD - Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, China. FAU - Wang, Xiao-Zeng AU - Wang XZ AD - Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, China. FAU - Zhang, Quan-Yu AU - Zhang QY AD - Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, China. LA - eng SI - ClinicalTrials.gov/NCT03588611 PT - Journal Article DEP - 20220425 PL - Switzerland TA - Front Cardiovasc Med JT - Frontiers in cardiovascular medicine JID - 101653388 PMC - PMC9081606 OTO - NOTNLM OT - activated clotting time OT - bivalirudin OT - bleeding OT - loading dose OT - percutaneous coronary intervention COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2022/05/14 06:00 MHDA- 2022/05/14 06:01 PMCR- 2022/01/01 CRDT- 2022/05/13 11:25 PHST- 2022/02/01 00:00 [received] PHST- 2022/03/08 00:00 [accepted] PHST- 2022/05/13 11:25 [entrez] PHST- 2022/05/14 06:00 [pubmed] PHST- 2022/05/14 06:01 [medline] PHST- 2022/01/01 00:00 [pmc-release] AID - 10.3389/fcvm.2022.864048 [doi] PST - epublish SO - Front Cardiovasc Med. 2022 Apr 25;9:864048. doi: 10.3389/fcvm.2022.864048. eCollection 2022. PMID- 35482154 OWN - NLM STAT- MEDLINE DCOM- 20220811 LR - 20250728 IS - 1573-742X (Electronic) IS - 0929-5305 (Print) IS - 0929-5305 (Linking) VI - 54 IP - 2 DP - 2022 Aug TI - Pharmacosimulation of delays and interruptions during administration of tirofiban: a systematic comparison between EU and US dosage regimens. PG - 301-308 LID - 10.1007/s11239-022-02654-0 [doi] AB - Tirofiban is a glycoproteine (GP) IIb/IIIa receptor antagonist, which inhibits platelet-platelet aggregation and is a potential adjunctive antithrombotic treatment in patients with acute coronary syndromes (ACS) or high-risk percutaneous coronary interventions (PCI). It is administered intravenously as a bolus followed by continuous infusion. However, the dosage recommendations in the United States (US) and European Union (EU) differ considerably. Furthermore, in routine clinical practice, deviations from the recommendations may occur. The objective of the present study was to investigate the impact of different alterations on tirofiban plasma concentrations in US and EU administration regimens and to give suggestions for delay management in clinical practice. We therefore mathematically simulated the effects of different bolus-infusion delays and infusion interruptions in different scenarios according to the renal function. Here, we provide a systematic assessment of concentration patterns of tirofiban in the US versus EU dosage regimens. We show that differences between the two regimens have important effects on plasma drug levels. Furthermore, we demonstrate that deviations from the proper administration mode affect the concentration of tirofiban. Additionally, we calculated the optimal dosage of a second bolus to rapidly restore the initial concentration without causing overdosage. In conclusion, differences in tirofiban dosing regimens between the U.S and EU and potential infusion interruptions have important effects on drug levels that may impact on degrees of platelet inhibition and thus antithrombotic effects. Thus, the findings of our modelling studies may help to explain differences in clinical outcomes observed in previous clinical trials on tirofiban. CI - (c) 2022. The Author(s). FAU - Heramvand, Nadia AU - Heramvand N AD - Department of Medicine, Division of Cardiology, Pulmonary Diseases and Vascular Medicine, University Hospital Dusseldorf, Moorenstrasse 5, 40225, Dusseldorf, Germany. FAU - Masyuk, Maryna AU - Masyuk M AUID- ORCID: 0000-0003-2856-6893 AD - Department of Medicine, Division of Cardiology, Pulmonary Diseases and Vascular Medicine, University Hospital Dusseldorf, Moorenstrasse 5, 40225, Dusseldorf, Germany. maryna.masyuk@med.uni-duesseldorf.de. FAU - Muessig, Johanna M AU - Muessig JM AD - Department of Medicine, Division of Cardiology, Pulmonary Diseases and Vascular Medicine, University Hospital Dusseldorf, Moorenstrasse 5, 40225, Dusseldorf, Germany. FAU - Nia, Amir M AU - Nia AM AD - Department of Medicine, Division of Cardiology, Pulmonary Diseases and Vascular Medicine, University Hospital Dusseldorf, Moorenstrasse 5, 40225, Dusseldorf, Germany. FAU - Karathanos, Athanasios AU - Karathanos A AD - Department of Medicine, Division of Cardiology, Pulmonary Diseases and Vascular Medicine, University Hospital Dusseldorf, Moorenstrasse 5, 40225, Dusseldorf, Germany. FAU - Polzin, Amin AU - Polzin A AD - Department of Medicine, Division of Cardiology, Pulmonary Diseases and Vascular Medicine, University Hospital Dusseldorf, Moorenstrasse 5, 40225, Dusseldorf, Germany. FAU - Valgimigli, Marco AU - Valgimigli M AD - Cardiocentro Ticino, Lugano and University of Bern, Bern, Switzerland. FAU - Gurbel, Paul A AU - Gurbel PA AD - Sinai Center for Thrombosis Research and Drug Development, Sinai Hospital of Baltimore, Baltimore, MD, USA. FAU - Tantry, Udaya S AU - Tantry US AD - Sinai Center for Thrombosis Research and Drug Development, Sinai Hospital of Baltimore, Baltimore, MD, USA. FAU - Kelm, Malte AU - Kelm M AD - Department of Medicine, Division of Cardiology, Pulmonary Diseases and Vascular Medicine, University Hospital Dusseldorf, Moorenstrasse 5, 40225, Dusseldorf, Germany. AD - CARID: Cardiovascular Research Institute Dusseldorf, Dusseldorf, Germany. FAU - Jung, Christian AU - Jung C AD - Department of Medicine, Division of Cardiology, Pulmonary Diseases and Vascular Medicine, University Hospital Dusseldorf, Moorenstrasse 5, 40225, Dusseldorf, Germany. LA - eng GR - Sonderforschungsbereich 1116/Deutsche Forschungsgemeinschaft/ PT - Journal Article DEP - 20220428 PL - Netherlands TA - J Thromb Thrombolysis JT - Journal of thrombosis and thrombolysis JID - 9502018 RN - 0 (Fibrinolytic Agents) RN - 0 (Platelet Aggregation Inhibitors) RN - 0 (Platelet Glycoprotein GPIIb-IIIa Complex) RN - 42HK56048U (Tyrosine) RN - GGX234SI5H (Tirofiban) SB - IM MH - European Union MH - Fibrinolytic Agents/therapeutic use MH - Humans MH - *Percutaneous Coronary Intervention MH - Platelet Aggregation Inhibitors MH - *Platelet Glycoprotein GPIIb-IIIa Complex MH - Tirofiban MH - Tyrosine/pharmacology/therapeutic use PMC - PMC9363357 OTO - NOTNLM OT - GP IIb/IIIa inhibitor OT - Pharmacokinetics OT - Pharmacosimulation OT - Tirofiban COIS- Paul A. Gurbel reports grants and personal fees from Bayer HealthCare LLC, Otitopic Inc, Amgen, Janssen, Medicure, and US WorldMeds LLC; grants from Instrumentation Laboratory, Haemonetics, Medicure Inc, Idorsia Pharmaceuticals, and Hikari Dx; personal fees from UpToDate. Paul A. Gurbel is a relator and expert witness in litigation involving clopidogrel. In addition, Paul A. Gurbel holds two patents, Detection of restenosis risk in patients and Assessment of cardiac health and thrombotic risk in a patient. Nadia Heramvand reports a grant from Medicure Inc. Marco Valgimigli reports research grants to the Inselspital from Medicure Inc. for the conduct of the FABOLUS FASTER Trial. EDAT- 2022/04/29 06:00 MHDA- 2022/08/12 06:00 PMCR- 2022/04/28 CRDT- 2022/04/28 11:18 PHST- 2022/04/05 00:00 [accepted] PHST- 2022/04/29 06:00 [pubmed] PHST- 2022/08/12 06:00 [medline] PHST- 2022/04/28 11:18 [entrez] PHST- 2022/04/28 00:00 [pmc-release] AID - 10.1007/s11239-022-02654-0 [pii] AID - 2654 [pii] AID - 10.1007/s11239-022-02654-0 [doi] PST - ppublish SO - J Thromb Thrombolysis. 2022 Aug;54(2):301-308. doi: 10.1007/s11239-022-02654-0. Epub 2022 Apr 28. PMID- 35475802 OWN - NLM STAT- MEDLINE DCOM- 20220429 LR - 20230103 IS - 1536-5964 (Electronic) IS - 0025-7974 (Print) IS - 0025-7974 (Linking) VI - 101 IP - 15 DP - 2022 Apr 15 TI - Safety and efficacy of auricular acupuncture in patients with depression after percutaneous coronary intervention: A protocol for systematic review and meta-analysis. PG - e29173 LID - 10.1097/MD.0000000000029173 [doi] LID - e29173 AB - BACKGROUND: With the advantages of miniature damage and optimal effectiveness, percutaneous coronary intervention (PCI) has been performed in a large number of coronary artery disease patients. However, recent studies have indicated a higher incidence of depression on post-PCI patients. Acupuncture therapy is effective for depression. As a form of acupuncture, the auricular acupuncture has been used to relieve symptoms in patients with post-PCI depression, but its effectiveness and safety have not yet reached a definitive conclusion. Therefore, this systematic review and meta-analysis protocol is planned to evaluate the efficacy and safety of auricular acupuncture for depression in post-PCI patients. METHODS: Six English databases (PubMed, Web of Science, MEDLINE, EMBASE, Springer Cochrane Library, and WHO International Clinical Trials Registry Platform) and 4 Chinese databases (Wan Fang Database, Chinese Scientific Journal Database, China National Knowledge Infrastructure Database, and Chinese Biomedical Literature Database) will be searched normatively according to the rule of each database from the inception to February 1, 2022. Two reviewers will independently conduct article selection, data collection, and risk of bias evaluation. Any disagreement will be resolved by discussion with the third reviewer. Either the fixed-effects or random-effects model will be used for data synthesis based on the heterogeneity test. The change in the scores on the Hamilton Depression Scale and the Self-rating Depression Scale will be used as the main outcome measure. All-cause mortality, cardiac mortality, major adverse cardiovascular events, rehospitalisation rate, and Quality of Life Scale as the secondary outcome. Treatment Emergent Symptom Scale, general physical examination (temperature, pulse, respiration, blood pressure), routine examination of blood, urine and stool, electrocardiogram, liver and kidney function examination as the security indexes. RevMan 5.3.5 will be used for meta-analysis. RESULTS: This study will provide high-quality evidence to assess the efficacy and safety of auricular acupuncture for depression in post-PCI patients. CONCLUSION: This systematic review will explore whether auricular acupuncture is an effective and safe intervention for depression in post-PCI patients. INPLASY REGISTRATION NUMBER: INPLASY202230003. CI - Copyright (c) 2022 the Author(s). Published by Wolters Kluwer Health, Inc. FAU - Lu, Ruozhu AU - Lu R AD - School of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China. FAU - Shi, Rui AU - Shi R AD - Branch of National Clinical Research Center for Chinese Medicine Cardiology, Hospital of Affiliated Changchun University of Chinese Medicine, Changchun, China. FAU - Zhang, Miao AU - Zhang M AD - School of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China. FAU - Shao, Xiao AU - Shao X AD - School of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China. FAU - Xue, Wen AU - Xue W AD - School of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China. FAU - Guo, Qian AU - Guo Q AD - School of Basic Medicine, Changchun University of Chinese Medicine, Changchun, China. FAU - Wang, Cheng AU - Wang C AD - School of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China. FAU - Deng, Yue AU - Deng Y AUID- ORCID: 0000-0003-3522-6088 AD - Branch of National Clinical Research Center for Chinese Medicine Cardiology, Hospital of Affiliated Changchun University of Chinese Medicine, Changchun, China. LA - eng GR - 82174350/National Natural Science Foundation of China/ PT - Journal Article DEP - 20220415 PL - United States TA - Medicine (Baltimore) JT - Medicine JID - 2985248R SB - IM MH - *Acupuncture, Ear MH - Depression/etiology/therapy MH - Humans MH - Meta-Analysis as Topic MH - *Percutaneous Coronary Intervention/adverse effects MH - Quality of Life MH - Systematic Reviews as Topic PMC - PMC9276093 COIS- The authors have no conflicts of interest to disclose. EDAT- 2022/04/28 06:00 MHDA- 2022/04/30 06:00 PMCR- 2022/04/15 CRDT- 2022/04/27 12:09 PHST- 2022/03/07 00:00 [received] PHST- 2022/03/08 00:00 [accepted] PHST- 2022/04/27 12:09 [entrez] PHST- 2022/04/28 06:00 [pubmed] PHST- 2022/04/30 06:00 [medline] PHST- 2022/04/15 00:00 [pmc-release] AID - 00005792-202204150-00010 [pii] AID - MD-D-22-01560 [pii] AID - 10.1097/MD.0000000000029173 [doi] PST - epublish SO - Medicine (Baltimore). 2022 Apr 15;101(15):e29173. doi: 10.1097/MD.0000000000029173. PMID- 35387881 OWN - NLM STAT- MEDLINE DCOM- 20220609 LR - 20260728 IS - 1555-905X (Electronic) IS - 1555-9041 (Print) IS - 1555-9041 (Linking) VI - 17 IP - 6 DP - 2022 Jun TI - PCSK9 and Cardiovascular Disease in Individuals with Moderately Decreased Kidney Function. PG - 809-818 LID - 10.2215/CJN.01230122 [doi] AB - BACKGROUND AND OBJECTIVES: Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a key regulator of lipid homeostasis. Studies investigating the association between PCSK9 and cardiovascular disease in large cohorts of patients with CKD are limited. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The association of PCSK9 concentrations with prevalent and incident cardiovascular disease was investigated in 5138 White participants of the German Chronic Kidney Disease study with a median follow-up of 6.5 years. Inclusion criteria were eGFR of 30-60 or >60 ml/min per 1.73 m(2) in the presence of overt proteinuria (urine albumin-creatinine ratio >300 mg/g or equivalent). Prevalent cardiovascular disease was defined as a history of nonfatal myocardial infarction, coronary artery bypass grafting, percutaneous transluminal coronary angioplasty, carotid arteries interventions, and stroke. Incident major adverse cardiovascular disease events included death from cardiovascular causes, acute nonfatal myocardial infarction, and nonfatal stroke. RESULTS: Median PCSK9 concentration in the cohort was 285 ng/ml (interquartile range, 231-346 ng/ml). There was no association between PCSK9 concentrations and baseline eGFR and albuminuria. With each 100-ng/ml increment of PCSK9, the odds for prevalent cardiovascular disease (n=1284) were 1.22-fold (95% confidence interval, 1.12 to 1.34; P<0.001) higher in a model with extended adjustment for major confounders. This association was stronger in nonstatin than statin users (P value for interaction =0.009). During follow-up, 474 individuals experienced a major adverse cardiovascular disease event, and participants in PCSK9 quartiles 2-4 had a 32%-47% higher risk compared with those in quartile 1 (P<0.05). Subgroup analysis revealed that this association was restricted to those participants who already had cardiovascular disease at baseline (all hazard ratios >1.75; P=0.01). In addition, PCSK9 showed a valuable gain in classification accuracy for both prevalent cardiovascular disease (net reclassification index =0.27; 95% confidence interval, 0.20 to 0.33) and incident major adverse cardiovascular disease events during follow-up (net reclassification index =0.10; 95% confidence interval, 0.01 to 0.21) when added to an extended adjustment model. CONCLUSIONS: Our findings reveal no relation of PCSK9 with baseline eGFR and albuminuria but a significant association between higher PCSK9 concentrations and risk of cardiovascular disease independent of traditional risk factors, including LDL cholesterol levels.Clinical Trial registry name and registration number: German Chronic Kidney Disease Study (GCKD), DRKS 00003971. CI - Copyright (c) 2022 by the American Society of Nephrology. FAU - Kheirkhah, Azin AU - Kheirkhah A AD - Institute of Genetic Epidemiology, Medical University of Innsbruck, Innsbruck, Austria. FAU - Lamina, Claudia AU - Lamina C AD - Institute of Genetic Epidemiology, Medical University of Innsbruck, Innsbruck, Austria. FAU - Kollerits, Barbara AU - Kollerits B AD - Institute of Genetic Epidemiology, Medical University of Innsbruck, Innsbruck, Austria. FAU - Schachtl-Riess, Johanna F AU - Schachtl-Riess JF AD - Institute of Genetic Epidemiology, Medical University of Innsbruck, Innsbruck, Austria. FAU - Schultheiss, Ulla T AU - Schultheiss UT AUID- ORCID: 0000-0002-7541-5310 AD - Institute of Genetic Epidemiology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany. AD - Department of Medicine IV- Nephrology and Primary Care, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany. FAU - Forer, Lukas AU - Forer L AD - Institute of Genetic Epidemiology, Medical University of Innsbruck, Innsbruck, Austria. FAU - Sekula, Peggy AU - Sekula P AUID- ORCID: 0000-0003-2263-447 AD - Institute of Genetic Epidemiology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany. FAU - Kotsis, Fruzsina AU - Kotsis F AD - Institute of Genetic Epidemiology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany. AD - Department of Medicine IV- Nephrology and Primary Care, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany. FAU - Eckardt, Kai-Uwe AU - Eckardt KU AUID- ORCID: 0000-0003-3823-0920 AD - Department of Nephrology and Hypertension, University Hospital Erlangen, Friedrich Alexander Universitat Erlangen-Nurnberg, Erlangen, Germany. AD - Department of Nephrology and Medical Intensive Care, Charite- Universitatsmedizin Berlin, Berlin, Germany. FAU - Kronenberg, Florian AU - Kronenberg F AUID- ORCID: 0000-0003-2229-1120 AD - Institute of Genetic Epidemiology, Medical University of Innsbruck, Innsbruck, Austria. CN - GCKD Investigators LA - eng SI - DRKS/DRKS 00003971 GR - W 1253/FWF_/Austrian Science Fund FWF/Austria PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20220406 PL - United States TA - Clin J Am Soc Nephrol JT - Clinical journal of the American Society of Nephrology : CJASN JID - 101271570 RN - 0 (Biomarkers) RN - EC 3.4.21.- (PCSK9 protein, human) RN - EC 3.4.21.- (Proprotein Convertase 9) SB - IM MH - Albuminuria/complications MH - Biomarkers MH - *Cardiovascular Diseases/epidemiology/etiology MH - Humans MH - Kidney MH - *Myocardial Infarction MH - Proprotein Convertase 9 MH - *Renal Insufficiency, Chronic/complications/therapy MH - Risk Factors MH - *Stroke/etiology PMC - PMC9269648 OTO - NOTNLM OT - PCSK9 OT - cardiovascular disease OT - chronic kidney disease OT - prospective FIR - Eckardt, Kai-Uwe IR - Eckardt KU FIR - Meiselbach, Heike IR - Meiselbach H FIR - Schneider, Markus P IR - Schneider MP FIR - Schiffer, Mario IR - Schiffer M FIR - Prokosch, Hans-Ulrich IR - Prokosch HU FIR - Barthlein, Barbara IR - Barthlein B FIR - Beck, Andreas IR - Beck A FIR - Reis, Andre IR - Reis A FIR - Ekici, Arif B IR - Ekici AB FIR - Becker, Susanne IR - Becker S FIR - Becker-Grosspitsch, Dinah IR - Becker-Grosspitsch D FIR - Alberth-Schmidt, Ulrike IR - Alberth-Schmidt U FIR - Hausknecht, Birgit IR - Hausknecht B FIR - Weigel, Anke IR - Weigel A FIR - Walz, Gerd IR - Walz G FIR - Kottgen, Anna IR - Kottgen A FIR - Schultheiss, Ulla T IR - Schultheiss UT FIR - Kotsis, Fruzsina IR - Kotsis F FIR - Meder, Simone IR - Meder S FIR - Mitsch, Erna IR - Mitsch E FIR - Reinhard, Ursula IR - Reinhard U FIR - Floege, Jurgen IR - Floege J FIR - Saritas, Turgay IR - Saritas T FIR - Schaeffner, Elke IR - Schaeffner E FIR - Baid-Agrawal, Seema IR - Baid-Agrawal S FIR - Theisen, Kerstin IR - Theisen K FIR - Haller, Hermann IR - Haller H FIR - Menne, Jan IR - Menne J FIR - Zeier, Martin IR - Zeier M FIR - Sommerer, Claudia IR - Sommerer C FIR - Theilinger, Johanna IR - Theilinger J FIR - Wolf, Gunter IR - Wolf G FIR - Busch, Martin IR - Busch M FIR - Paul, Rainer IR - Paul R FIR - Sitter, Thomas IR - Sitter T FIR - Wanner, Christoph IR - Wanner C FIR - Krane, Vera IR - Krane V FIR - Borner-Klein, Antje IR - Borner-Klein A FIR - Bauer, Britta IR - Bauer B FIR - Kronenberg, Florian IR - Kronenberg F FIR - Raschenberger, Julia IR - Raschenberger J FIR - Kollerits, Barbara IR - Kollerits B FIR - Forer, Lukas IR - Forer L FIR - Schonherr, Sebastian IR - Schonherr S FIR - Weissensteiner, Hansi IR - Weissensteiner H FIR - Oefner, Peter IR - Oefner P FIR - Gronwald, Wolfram IR - Gronwald W FIR - Schmid, Matthias IR - Schmid M FIR - Nadal, Jennifer IR - Nadal J EDAT- 2022/04/08 06:00 MHDA- 2022/06/10 06:00 PMCR- 2023/06/01 CRDT- 2022/04/07 05:28 PHST- 2022/01/28 00:00 [received] PHST- 2022/04/01 00:00 [accepted] PHST- 2022/04/08 06:00 [pubmed] PHST- 2022/06/10 06:00 [medline] PHST- 2022/04/07 05:28 [entrez] PHST- 2023/06/01 00:00 [pmc-release] AID - 01277230-202206000-00010 [pii] AID - 01230122 [pii] AID - 10.2215/CJN.01230122 [doi] PST - ppublish SO - Clin J Am Soc Nephrol. 2022 Jun;17(6):809-818. doi: 10.2215/CJN.01230122. Epub 2022 Apr 6. PMID- 35365074 OWN - NLM STAT- MEDLINE DCOM- 20220405 LR - 20220510 IS - 1471-2261 (Electronic) IS - 1471-2261 (Linking) VI - 22 IP - 1 DP - 2022 Apr 1 TI - Temporal trends in treatment strategies and clinical outcomes among patients with advanced chronic kidney disease and ST-elevation myocardial infarctions: results from the Bremen STEMI registry. PG - 142 LID - 10.1186/s12872-022-02573-1 [doi] LID - 142 AB - BACKGROUND: Although the detrimental effects of advanced chronic kidney disease (CKD) on prognosis in coronary artery disease is known, there are few data on the efficacy and safety of modern interventional therapies and medications in patients with advanced CKD, because this special patient cohort is often excluded or underrepresented in randomized trials. METHODS: In the present study all patients admitted with ST-elevation myocardial infarctions (STEMI) from the region of Bremen/Germany treated between 2006 and 2019 were analyzed. Advanced CKD was defined as glomerular filtration rate < 45 ml/min. RESULTS: Of 9605 STEMI-patients, 1018 (10.6%) had advanced CKD with a serum creatinine of 2.22 +/- 4.2 mg/dl at admission and with lower rates of primary percutaneous coronary intervention (pPCI) (84.1 vs. 94.1%, p < 0.01) and higher all-cause-mortality (44.4 vs. 3.6%, p < 0.01). Over time, advanced CKD-patients were more likely to be treated with pPCI (2015-2019: 90.3% vs. 2006-2010:75.8%, p < 0.01) and with ticagrelor/prasugrel (59.6% vs. 1.7%, p < 0.01) and drug eluting stents (90.7% vs. 1.3%, p < 0.01). During the study period a decline in adverse ischemic events (OR 0.3, 95% CI 0.1-0.7) and an increase in bleedings (OR 2.2, 95% CI 1.3-3.8) within 1 year after the index event could be observed in patients with advanced CKD while 1-year-mortality (OR 1.0, 95% CI 0.7-1.4) and rates of acute kidney injury (OR 1.2, 95% CI 0.8-1.7) did not change in a multivariate model. Both, ticagrelor/prasugrel (OR 0.48, 95% CI 0.2-0.98) and DES (OR 0.38, 95% CI 0.2-0.8) were associated with a decrease in ischemic events at 1 year. CONCLUSIONS: During the observed time period STEMI-patients with advanced CKD were more likely to be treated with primary PCI, ticagrelor or prasugrel and DE-stents. These changes probably have contributed to the decline in ischemic events and the increase in bleedings within 1 year after STEMI while overall mortality at 1-year remained unchanged for this high-risk patient group. CI - (c) 2022. The Author(s). FAU - Schmucker, Johannes AU - Schmucker J AD - From the Bremen Institute for Heart and Circulation Research, am Klinikum Links der Weser, Senator-Wessling-Str. 1, 28277, Bremen, Germany. Johannes.Schmucker@klinikum-bremen-ldw.de. AD - Medical Clinic III, Department of Nephrology and Cardiology, Klinikum Bremen Mitte, Bremen, Germany. Johannes.Schmucker@klinikum-bremen-ldw.de. FAU - Fach, Andreas AU - Fach A AD - From the Bremen Institute for Heart and Circulation Research, am Klinikum Links der Weser, Senator-Wessling-Str. 1, 28277, Bremen, Germany. FAU - Osteresch, Rico AU - Osteresch R AD - From the Bremen Institute for Heart and Circulation Research, am Klinikum Links der Weser, Senator-Wessling-Str. 1, 28277, Bremen, Germany. FAU - Mata Marin, Luis Alberto AU - Mata Marin LA AD - From the Bremen Institute for Heart and Circulation Research, am Klinikum Links der Weser, Senator-Wessling-Str. 1, 28277, Bremen, Germany. FAU - Retzlaff, Tina AU - Retzlaff T AD - From the Bremen Institute for Heart and Circulation Research, am Klinikum Links der Weser, Senator-Wessling-Str. 1, 28277, Bremen, Germany. FAU - Ruhle, Stephan AU - Ruhle S AD - From the Bremen Institute for Heart and Circulation Research, am Klinikum Links der Weser, Senator-Wessling-Str. 1, 28277, Bremen, Germany. FAU - Garstka, Daniela AU - Garstka D AD - From the Bremen Institute for Heart and Circulation Research, am Klinikum Links der Weser, Senator-Wessling-Str. 1, 28277, Bremen, Germany. FAU - Kuhlmann, Uwe AU - Kuhlmann U AD - Medical Clinic III, Department of Nephrology and Cardiology, Klinikum Bremen Mitte, Bremen, Germany. FAU - Eitel, Ingo AU - Eitel I AD - Medical Clinic II, University Heart Center, Lubeck, Germany. FAU - Hambrecht, Rainer AU - Hambrecht R AD - From the Bremen Institute for Heart and Circulation Research, am Klinikum Links der Weser, Senator-Wessling-Str. 1, 28277, Bremen, Germany. FAU - Wienbergen, Harm AU - Wienbergen H AD - From the Bremen Institute for Heart and Circulation Research, am Klinikum Links der Weser, Senator-Wessling-Str. 1, 28277, Bremen, Germany. AD - Medical Clinic II, University Heart Center, Lubeck, Germany. LA - eng PT - Journal Article DEP - 20220401 PL - England TA - BMC Cardiovasc Disord JT - BMC cardiovascular disorders JID - 100968539 RN - 0 (Platelet Aggregation Inhibitors) SB - IM MH - Humans MH - *Percutaneous Coronary Intervention/adverse effects MH - Platelet Aggregation Inhibitors/adverse effects MH - Registries MH - *Renal Insufficiency, Chronic/diagnosis/epidemiology/therapy MH - *ST Elevation Myocardial Infarction/diagnosis/etiology/therapy MH - Treatment Outcome PMC - PMC8976374 OTO - NOTNLM OT - Acute kidney injury OT - Chronic kidney disease OT - Percutaneous coronary intervention OT - ST-elevation myocardial infarction COIS- The authors declare that they have no competing interests. EDAT- 2022/04/03 06:00 MHDA- 2022/04/06 06:00 PMCR- 2022/04/01 CRDT- 2022/04/02 05:21 PHST- 2021/11/30 00:00 [received] PHST- 2022/03/11 00:00 [accepted] PHST- 2022/04/02 05:21 [entrez] PHST- 2022/04/03 06:00 [pubmed] PHST- 2022/04/06 06:00 [medline] PHST- 2022/04/01 00:00 [pmc-release] AID - 10.1186/s12872-022-02573-1 [pii] AID - 2573 [pii] AID - 10.1186/s12872-022-02573-1 [doi] PST - epublish SO - BMC Cardiovasc Disord. 2022 Apr 1;22(1):142. doi: 10.1186/s12872-022-02573-1. PMID- 35356803 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240825 IS - 2398-8835 (Electronic) IS - 2398-8835 (Linking) VI - 5 IP - 2 DP - 2022 Mar TI - Prospective randomized comparison of effect on coronary endothelial and renal function between febuxostat and benzbromarone in hyperuricemic patients with coronary artery disease: EFEF study. PG - e563 LID - 10.1002/hsr2.563 [doi] LID - e563 AB - BACKGROUND AND AIMS: There are two types of serum uric acid-lowering agents, the xanthine oxidoreductase (XO) inhibitor and non-XO inhibitor. We investigated whether febuxostat, XO inhibitor, could produce more favorable effects on coronary endothelial function (CEF) and renal function than benzbromarone, non-XO inhibitor, in hyperuricemic coronary artery disease (CAD) patients. METHODS: We divided 21 hyperuricemic patients with stenting for left anterior descending (LAD) or left circumflex (LCX) artery into patients started on febuxostat (F group) and those on benzbromarone (B group). After 8 months, all patients underwent CEF evaluations (acetylcholine provocation test) and optical coherence tomography (OCT) for non-culprit vessels (e.g. if patients received LAD stenting, we evaluated LCX). We compared the diameter ratio induced by acetylcholine and baseline (CEF ratio), thin-cap fibroatheroma and calcified plaque by OCT, uric acid, oxidative stress biomarkers, and renal function including estimated glomerular filtration rate (eGFR) between F and B groups. Creatinine 2 days after stenting was measured to evaluate contrast-induced nephropathy (CIN). RESULTS: Change of eGFR was significantly lower in F group (n= 11) than B group over 8 months while the other parameters including CEF ratio were similar. F group showed favorable effects for CIN. CONCLUSION: In conclusion, 8-months of febuxostat, XO inhibitor, does not significantly protect CEF but can protect the renal function including CIN in hyperuricemic patients with CAD compared to benzbromarone, non-XO inhibitor. CI - (c) 2022 The Authors. Health Science Reports published by Wiley Periodicals LLC. FAU - Nishino, Masami AU - Nishino M AUID- ORCID: 0000-0003-0309-7023 AD - Division of Cardiology Osaka Rosai Hospital Osaka Japan. FAU - Egami, Yasuyuki AU - Egami Y AD - Division of Cardiology Osaka Rosai Hospital Osaka Japan. FAU - Nakamura, Hitoshi AU - Nakamura H AD - Division of Cardiology Osaka Rosai Hospital Osaka Japan. FAU - Ukita, Kohei AU - Ukita K AD - Division of Cardiology Osaka Rosai Hospital Osaka Japan. FAU - Kawamura, Akito AU - Kawamura A AD - Division of Cardiology Osaka Rosai Hospital Osaka Japan. FAU - Matsuhiro, Yutaka AU - Matsuhiro Y AD - Division of Cardiology Osaka Rosai Hospital Osaka Japan. FAU - Yasumoto, Koji AU - Yasumoto K AD - Division of Cardiology Osaka Rosai Hospital Osaka Japan. FAU - Tsuda, Masaki AU - Tsuda M AD - Division of Cardiology Osaka Rosai Hospital Osaka Japan. FAU - Tanaka, Akihiro AU - Tanaka A AD - Division of Cardiology Osaka Rosai Hospital Osaka Japan. FAU - Okamoto, Naotaka AU - Okamoto N AD - Division of Cardiology Osaka Rosai Hospital Osaka Japan. FAU - Matsunaga-Lee, Yasuharu AU - Matsunaga-Lee Y AD - Division of Cardiology Osaka Rosai Hospital Osaka Japan. FAU - Yano, Masamichi AU - Yano M AD - Division of Cardiology Osaka Rosai Hospital Osaka Japan. FAU - Shutta, Ryu AU - Shutta R AD - Division of Cardiology Osaka Rosai Hospital Osaka Japan. FAU - Tanouchi, Jun AU - Tanouchi J AD - Division of Cardiology Osaka Rosai Hospital Osaka Japan. LA - eng PT - Journal Article DEP - 20220322 PL - United States TA - Health Sci Rep JT - Health science reports JID - 101728855 PMC - PMC8939499 OTO - NOTNLM OT - coronary artery disease OT - endothelial function OT - febuxostat OT - renal function OT - uric acid COIS- The authors declare no conflict of interest. EDAT- 2022/04/01 06:00 MHDA- 2022/04/01 06:01 PMCR- 2022/03/22 CRDT- 2022/03/31 05:37 PHST- 2021/08/23 00:00 [received] PHST- 2022/02/01 00:00 [revised] PHST- 2022/02/06 00:00 [accepted] PHST- 2022/03/31 05:37 [entrez] PHST- 2022/04/01 06:00 [pubmed] PHST- 2022/04/01 06:01 [medline] PHST- 2022/03/22 00:00 [pmc-release] AID - HSR2563 [pii] AID - 10.1002/hsr2.563 [doi] PST - epublish SO - Health Sci Rep. 2022 Mar 22;5(2):e563. doi: 10.1002/hsr2.563. eCollection 2022 Mar. PMID- 35331554 OWN - NLM STAT- MEDLINE DCOM- 20231216 LR - 20240207 IS - 1097-685X (Electronic) IS - 0022-5223 (Linking) VI - 167 IP - 1 DP - 2024 Jan TI - The Clinical SYNTAX score predicts survival better than the SYNTAX score in coronary revascularization. PG - 164-173.e4 LID - S0022-5223(22)00217-3 [pii] LID - 10.1016/j.jtcvs.2022.02.030 [doi] AB - BACKGROUND: The Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery (SYNTAX) trial showed that the SYNTAX score (SS) is a useful tool for customizing revascularization treatment for patients with multivessel coronary disease. In the past decade, the Clinical SS (CSS) has emerged as a comprehensive tool. This novel tool considers the SS as well as patient clinical parameters such as age, creatinine clearance, and ejection fraction, which were shown to be relevant for patient prognosis. Thus, in the current work we set out to compare the survival predictive values of the SS versus the CSS and their future application in real-world implementation of the revascularization guidelines. METHODS: This study was a subanalysis of data collected in a prospective national registry in Israel that enrolled consecutive patients with left main and/or 2- to 3-vessel coronary artery disease involving the proximal or mid-left anterior descending artery; the MULTI-vessel Coronary Artery Disease (MULTICAD). The revascularization method was chosen by the physicians taking care of the patients at each hospital and the patients were followed for 5 years. Patients were categorized according to their SS, the CSS, and their revascularization method (primary coronary intervention [PCI] vs coronary artery bypass grafting [CABG]) and patient survival were compared. RESULTS: A total of 585 patients were enrolled in the study and were followed for 5 years. The median CSS was 27, with 288 patients showing a CSS >/=27, with a mean CSS of 47.85 and a mean SS of 29.05. At 3 and 5 years post-treatment, the CSS >/=27 group had a lower survival probability, CSS >/=27 was associated with a lower survival probability among patients who underwent PCI compared with those who underwent CABG. More specifically, the high-CSS CABG group had a 5-year mortality rate of 16.8%, whereas the high-CSS PCI group had a 5-year mortality rate of 32.2%. In a comparison of SS with CSS for the 5-year mortality outcome prediction, CSS was superior to SS with a higher area under the curve. CONCLUSIONS: This prospective registry of real-world revascularization strategies in patients with multivessel disease showed that CSS is a better predictive tool of postrevascularization survival than SS. Moreover, it showed that surgical revascularization in patients with CSS >/=27 is associated with better all-cause mortality outcome after CABG as compared with after PCI. This attests to the need for a score that considers clinical parameters in a real-world scenario. CI - Copyright (c) 2022 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved. FAU - Barac, Yaron D AU - Barac YD AD - Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Rabin Medical Center, Petach-Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: yaronbar@icloud.com. FAU - Witberg, Guy AU - Witberg G AD - Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Division of Cardiology, Rabin Medical Center, Petach-Tikva, Israel. FAU - Assali, Abid AU - Assali A AD - Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Division of Cardiology, Meir Medical Center, Cefar Sava, Israel. FAU - Klempfner, Robert AU - Klempfner R AD - Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; The Leviev Heart Center, Sheba Medical Center, Ramat-Gan, Israel. FAU - Krutzwald-Josefson, Efrat AU - Krutzwald-Josefson E AD - Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Rabin Medical Center, Petach-Tikva, Israel. FAU - Rubchevsky, Victor AU - Rubchevsky V AD - Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Rabin Medical Center, Petach-Tikva, Israel. FAU - Abergel, Eytan AU - Abergel E AD - Division of Cardiology, Rambam Medical Center, Haifa, Israel. FAU - Kornowski, Ran AU - Kornowski R AD - Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Division of Cardiology, Rabin Medical Center, Petach-Tikva, Israel. FAU - Aravot, Dan AU - Aravot D AD - Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Rabin Medical Center, Petach-Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. LA - eng PT - Journal Article DEP - 20220224 PL - United States TA - J Thorac Cardiovasc Surg JT - The Journal of thoracic and cardiovascular surgery JID - 0376343 SB - IM CIN - J Thorac Cardiovasc Surg. 2024 Jan;167(1):174-175. doi: 10.1016/j.jtcvs.2022.02.040. PMID: 35321799 MH - Humans MH - *Coronary Artery Disease/diagnostic imaging/surgery MH - Coronary Angiography MH - *Percutaneous Coronary Intervention MH - Treatment Outcome MH - Risk Factors OTO - NOTNLM OT - CSS OT - MULTICAD OT - revascularization EDAT- 2022/03/26 06:00 MHDA- 2023/12/17 09:41 CRDT- 2022/03/25 05:33 PHST- 2021/05/07 00:00 [received] PHST- 2022/01/30 00:00 [revised] PHST- 2022/02/08 00:00 [accepted] PHST- 2023/12/17 09:41 [medline] PHST- 2022/03/26 06:00 [pubmed] PHST- 2022/03/25 05:33 [entrez] AID - S0022-5223(22)00217-3 [pii] AID - 10.1016/j.jtcvs.2022.02.030 [doi] PST - ppublish SO - J Thorac Cardiovasc Surg. 2024 Jan;167(1):164-173.e4. doi: 10.1016/j.jtcvs.2022.02.030. Epub 2022 Feb 24. PMID- 35330098 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20220329 IS - 2075-1729 (Print) IS - 2075-1729 (Electronic) IS - 2075-1729 (Linking) VI - 12 IP - 3 DP - 2022 Feb 27 TI - Percutaneous Coronary Intervention versus Coronary Artery Bypass Grafting for Non-Protected Left Main Coronary Artery Disease: 1-Year Outcomes in a High Volume Single Center Study. LID - 10.3390/life12030347 [doi] LID - 347 AB - INTRODUCTION: There is clear evidence of a significant reduction in all major cardiovascular adverse events (MACE) by coronary artery bypass grafting (CABG) in left main coronary artery stenosis (LMCS), but revascularization by percutaneous coronary artery intervention (PCI) shows an increasingly important role as an alternative to CABG. Several recent trials aiming to test the difference in mortality between the two types of revascularization found conflicting data. The aim of this study is to determine whether PCI is non-inferior to CABG with respect to the occurrence of MACE at 1 year in patients with significant LMCS. MATERIAL AND METHODS: We prospectively enrolled 296 patients with chronic or acute coronary syndromes and significant LM stenosis. The angiography that recommended the revascularization procedure was used for the calculation of the Syntax II score, in order to classify the patients as low-, intermediate- or high-risk. Low- and high-risk patients were revascularized with either PCI or CABG, according to current guidelines, and were included in the subgroup S1. The second subgroup (S0) included intermediate-risk patients (Syntax II score 23-32), in whom the type of revascularization was chosen depending on the decision of the heart team or the patient preference. Patients were monitored according to the chosen mode of revascularization-PCI or CABG. LM revascularization was performed in all the patients. Clinical endpoints included cardiac death, myocardial infarction, need for revascularization and stroke. Patients were evaluated at 1 year after revascularization. Event rates were estimated using the Kaplan-Meier analysis in time to the first event. RESULTS: At 1-year follow-up, a primary endpoint occurred in 35/95 patients in the CABG group and 37/201 in the PCI group. There were no significant differences between the 2 treatment strategies in the 1-year components of the end-point. However, a tendency to higher occurrence of cardiac death (HR = 1.48 CI (0.55-3.9), p = 0.43), necessity of repeat revascularization (HR = 1.7, CI (0.81-3.6), p = 0.16) and stroke (HR = 1.52, CI (1.15-2.93), p = 0.58) were present after CABG. Contrariwise, although without statistical significance, MI was more frequent after PCI (HR = 2, CI (0.78-5.2), p = 0.14). The Kaplan-Meier estimates in subgroups demonstrated the same tendency to higher rates for cardiac death, repeat revascularization and stroke after CABG, and higher rates of MI after PCI. Although without statistical significance, patients with an intermediate-risk showed a slightly lower risk of MACE after PCI than CABG. With the exception of dyslipidemia and gender, other cardiovascular risk factors were in favor of CABG (CKD, obesity). CONCLUSION: In patients with LMCS, PCI with drug-eluting stents was non-inferior to CABG with respect to the composite of cardiac death, myocardial infarction, repeat revascularization and stroke at 1 year, even in patients with intermediate Syntax II risk score. FAU - Mot, Stefan Dan Cezar AU - Mot SDC AD - Cardiology Department, Heart Institute "N. Stancioiu", 400001 Cluj-Napoca, Romania. AD - 5th Department of Internal Medicine, Faculty of Medicine, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania. FAU - Serban, Adela Mihaela AU - Serban AM AD - Cardiology Department, Heart Institute "N. Stancioiu", 400001 Cluj-Napoca, Romania. AD - 5th Department of Internal Medicine, Faculty of Medicine, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania. FAU - Beyer, Ruxandra Stefana AU - Beyer RS AD - Cardiology Department, Heart Institute "N. Stancioiu", 400001 Cluj-Napoca, Romania. FAU - Cocoi, Mihai AU - Cocoi M AD - Cardiology Department, Heart Institute "N. Stancioiu", 400001 Cluj-Napoca, Romania. FAU - Iuga, Horia AU - Iuga H AD - Cardiology Department, Heart Institute "N. Stancioiu", 400001 Cluj-Napoca, Romania. FAU - Muresan, Ioana Danuta AU - Muresan ID AD - 5th Department of Internal Medicine, Faculty of Medicine, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania. AD - Department of Cardiology, Ares Hospital, 400015 Cluj-Napoca, Romania. FAU - Cozma, Simona AU - Cozma S AD - Department of Cardiology, Ares Hospital, 400015 Cluj-Napoca, Romania. FAU - Dadarlat-Pop, Alexandra AU - Dadarlat-Pop A AUID- ORCID: 0000-0003-3964-6995 AD - Cardiology Department, Heart Institute "N. Stancioiu", 400001 Cluj-Napoca, Romania. AD - 5th Department of Internal Medicine, Faculty of Medicine, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania. FAU - Tomoaia, Raluca AU - Tomoaia R AUID- ORCID: 0000-0002-1944-4088 AD - Cardiology Department, Heart Institute "N. Stancioiu", 400001 Cluj-Napoca, Romania. AD - 5th Department of Internal Medicine, Faculty of Medicine, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania. FAU - Pop, Dana AU - Pop D AD - 5th Department of Internal Medicine, Faculty of Medicine, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania. AD - Department of Cardiology, Clinical Rehabilitation Hospital, 400347 Cluj-Napoca, Romania. LA - eng PT - Journal Article DEP - 20220227 PL - Switzerland TA - Life (Basel) JT - Life (Basel, Switzerland) JID - 101580444 PMC - PMC8953531 OTO - NOTNLM OT - coronary artery bypass grafting OT - left main OT - mortality OT - percutaneous coronary intervention COIS- The authors declare no conflict of interest. EDAT- 2022/03/26 06:00 MHDA- 2022/03/26 06:01 PMCR- 2022/02/27 CRDT- 2022/03/25 01:12 PHST- 2022/01/27 00:00 [received] PHST- 2022/02/23 00:00 [revised] PHST- 2022/02/25 00:00 [accepted] PHST- 2022/03/25 01:12 [entrez] PHST- 2022/03/26 06:00 [pubmed] PHST- 2022/03/26 06:01 [medline] PHST- 2022/02/27 00:00 [pmc-release] AID - life12030347 [pii] AID - life-12-00347 [pii] AID - 10.3390/life12030347 [doi] PST - epublish SO - Life (Basel). 2022 Feb 27;12(3):347. doi: 10.3390/life12030347. PMID- 35325085 OWN - NLM STAT- MEDLINE DCOM- 20220930 LR - 20221108 IS - 2055-6845 (Electronic) VI - 8 IP - 7 DP - 2022 Sep 29 TI - Ticagrelor monotherapy after PCI in patients with concomitant diabetes mellitus and chronic kidney disease: TWILIGHT DM-CKD. PG - 707-716 LID - 10.1093/ehjcvp/pvac016 [doi] AB - AIMS: We aimed to evaluate the treatment effects of ticagrelor monotherapy in the very high risk cohort of patients with concomitant diabetes mellitus (DM) and chronic kidney disease (CKD) undergoing percutaneous coronary intervention (PCI). METHODS AND RESULTS: In the TWILIGHT (Ticagrelor with Aspirin or Alone in High-Risk Patients after Coronary Intervention) trial, after 3-month dual antiplatelet therapy with ticagrelor and aspirin post-PCI, event-free patients were randomized to either aspirin or placebo in addition to ticagrelor for 12 months. Those with available information on DM and CKD status were included in this subanalysis and were stratified by the presence or absence of either condition: 3391 (54.1%) had neither DM nor CKD (DM-/CKD-), 1822 (29.0%) had DM only (DM+/CKD-), 561 (8.9%) had CKD only (DM-/CKD+), and 8.0% had both DM and CKD (DM+/CKD+). The incidence of the primary endpoint of Bleeding Academic Research Consortium (BARC) type 2, 3, or 5 bleeding did not differ according to DM/CKD status (P-trend = 0.13), but there was a significant increase in BARC 3 or 5 bleeding (P-trend < 0.001) as well as the key secondary endpoint of death, myocardial infarction, or stroke (P-trend < 0.001). Ticagrelor plus placebo reduced bleeding events compared with ticagrelor plus aspirin across all four groups, including DM+/CKD+ patients with respect to BARC 2-5 [4.5% vs. 8.7%; hazard ratio (HR) 0.49, 95% confidence interval (CI) 0.24-1.01] as well as BARC 3-5 (0.8% vs. 5.3%; HR 0.15, 95% CI 0.03-0.53) bleeding, with no evidence of heterogeneity. The risk of death, myocardial infarction, or stroke was similar between treatment arms across all groups. CONCLUSION: Irrespective of the presence of DM, CKD, and their combination, ticagrelor monotherapy reduced the risk of bleeding without a significant increase in ischaemic events compared with ticagrelor plus aspirin. CI - (c) The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology. FAU - Dehghani, Payam AU - Dehghani P AD - Department of Cardiology, Prairie Vascular Research, Regina, Saskatchewan, Canada. FAU - Cao, Davide AU - Cao D AD - Center for Interventional Cardiovascular Research and Clinical Trials, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029-6574, USA. AD - Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Italy. FAU - Baber, Usman AU - Baber U AUID- ORCID: 0000-0003-1614-5987 AD - Department of Cardiology, the University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA. FAU - Nicolas, Johny AU - Nicolas J AUID- ORCID: 0000-0002-3015-3361 AD - Center for Interventional Cardiovascular Research and Clinical Trials, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029-6574, USA. FAU - Sartori, Samantha AU - Sartori S AUID- ORCID: 0000-0003-0618-9409 AD - Center for Interventional Cardiovascular Research and Clinical Trials, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029-6574, USA. FAU - Pivato, Carlo A AU - Pivato CA AD - Center for Interventional Cardiovascular Research and Clinical Trials, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029-6574, USA. AD - Cardio Center, IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy. FAU - Zhang, Zhongjie AU - Zhang Z AUID- ORCID: 0000-0002-9615-0518 AD - Center for Interventional Cardiovascular Research and Clinical Trials, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029-6574, USA. FAU - Dangas, George AU - Dangas G AD - Center for Interventional Cardiovascular Research and Clinical Trials, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029-6574, USA. FAU - Angiolillo, Dominick J AU - Angiolillo DJ AD - Division of Cardiology, University of Florida College of Medicine, Jacksonville, FL, USA. FAU - Briguori, Carlo AU - Briguori C AUID- ORCID: 0000-0002-2105-8186 AD - Department of Cardiology, Mediterranea Cardiocentro, Naples, Italy. FAU - Cohen, David J AU - Cohen DJ AD - Cardiovascular Research Foundation, New York, NY, USA. AD - Department of Cardiology, St. Francis Hospital, Roslyn, NY, USA. FAU - Collier, Timothy AU - Collier T AUID- ORCID: 0000-0002-3095-277X AD - Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK. FAU - Dudek, Dariusz AU - Dudek D AD - Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland. FAU - Gibson, Michael AU - Gibson M AD - Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA. FAU - Gil, Robert AU - Gil R AUID- ORCID: 0000-0002-9041-3313 AD - Center of Postgraduate Medical Education, Central Clinical Hospital of the Ministry of Interior and Administration, Warsaw, Poland. FAU - Huber, Kurt AU - Huber K AUID- ORCID: 0000-0002-7934-5524 AD - 3rd Department of Medicine, Cardiology and Intensive Care Medicine, Wilhelminen Hospital, and Medical Faculty, Sigmund Freud University, Vienna, Austria. FAU - Kaul, Upendra AU - Kaul U AD - Heart Centre, Batra Hospital and Medical Research Centre, New Delhi, India. FAU - Kornowski, Ran AU - Kornowski R AD - Department of Cardiology, Rabin Medical Center, Petach Tikva, Israel. FAU - Krucoff, Mitchell W AU - Krucoff MW AD - Duke University Medical Center, Duke Clinical Research Institute, Durham, NC, USA. FAU - Kunadian, Vijay AU - Kunadian V AUID- ORCID: 0000-0003-2975-6971 AD - Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University and Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK. FAU - Mehta, Shamir AU - Mehta S AD - Population Health Research Institute, Hamilton Health Sciences, Hamilton, ON, Canada. FAU - Moliterno, David J AU - Moliterno DJ AD - Division of Cardiovascular Medicine, Gill Heart Institute, University of Kentucky, Lexington, KY, USA. FAU - Ohman, E Magnus AU - Ohman EM AD - Duke University Medical Center, Duke Clinical Research Institute, Durham, NC, USA. FAU - Escaned, Javier AU - Escaned J AUID- ORCID: 0000-0003-4932-0112 AD - Department of Cardiology, Hospital Clinico San Carlos IDISCC, Complutense University of Madrid, Madrid, Spain. FAU - Sardella, Gennaro AU - Sardella G AD - Department of Cardiology, Policlinico Umberto I University, Roma, Italy. FAU - Sharma, Samin K AU - Sharma SK AD - Center for Interventional Cardiovascular Research and Clinical Trials, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029-6574, USA. FAU - Shlofmitz, Richard AU - Shlofmitz R AUID- ORCID: 0000-0002-9422-048X AD - Department of Cardiology, St. Francis Hospital, Roslyn, NY, USA. FAU - Weisz, Giora AU - Weisz G AD - Division of Cardiology, NewYork Presbyterian Hospital, Columbia University Medical Center, New York, NY, USA. FAU - Witzenbichler, Bernhard AU - Witzenbichler B AUID- ORCID: 0000-0001-9322-1926 AD - Department of Cardiology and Pneumology, Helios Amper-Klinikum, Dachau, Germany. FAU - Pocock, Stuart AU - Pocock S AD - Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK. FAU - Mehran, Roxana AU - Mehran R AUID- ORCID: 0000-0002-5546-262X AD - Center for Interventional Cardiovascular Research and Clinical Trials, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029-6574, USA. LA - eng PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - England TA - Eur Heart J Cardiovasc Pharmacother JT - European heart journal. Cardiovascular pharmacotherapy JID - 101669491 RN - 0 (Platelet Aggregation Inhibitors) RN - GLH0314RVC (Ticagrelor) RN - R16CO5Y76E (Aspirin) SB - IM MH - Aspirin/adverse effects MH - *Diabetes Mellitus/drug therapy MH - Drug Therapy, Combination MH - Hemorrhage/chemically induced/epidemiology MH - Humans MH - Myocardial Infarction/epidemiology MH - *Percutaneous Coronary Intervention/adverse effects/methods MH - *Platelet Aggregation Inhibitors/adverse effects MH - *Renal Insufficiency, Chronic/complications/diagnosis/therapy MH - Stroke/epidemiology MH - *Ticagrelor/adverse effects OTO - NOTNLM OT - Aspirin OT - Chronic kidney disease OT - Diabetes OT - PCI OT - Ticagrelor monotherapy EDAT- 2022/03/25 06:00 MHDA- 2022/10/01 06:00 CRDT- 2022/03/24 17:25 PHST- 2022/01/07 00:00 [received] PHST- 2022/02/17 00:00 [revised] PHST- 2022/03/25 06:00 [pubmed] PHST- 2022/10/01 06:00 [medline] PHST- 2022/03/24 17:25 [entrez] AID - 6552954 [pii] AID - 10.1093/ehjcvp/pvac016 [doi] PST - ppublish SO - Eur Heart J Cardiovasc Pharmacother. 2022 Sep 29;8(7):707-716. doi: 10.1093/ehjcvp/pvac016. PMID- 35282662 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20220315 IS - 2223-3652 (Print) IS - 2223-3660 (Electronic) IS - 2223-3652 (Linking) VI - 12 IP - 1 DP - 2022 Feb TI - Comparing the efficacy of angiotensin receptor-neprilysin inhibitor and enalapril in acute anterior STEMI patients after primary percutaneous coronary intervention: a prospective randomized trial. PG - 42-54 LID - 10.21037/cdt-21-386 [doi] AB - BACKGROUND: For patients with heart failure (HF), the effect of angiotensin receptor-neprilysin inhibitors (ARNIs, sacubitril/valsartan) on cardiac remodeling has been found to be superior to angiotensin-converting enzyme inhibitors (ACEI). However, little data have described the impact of early-initiation ARNI in patients with acute anterior ST-segment elevation myocardial infarction (STEMI). METHODS: In this prospective, randomized, double-blind, parallel-group trial, we enrolled 131 anterior STEMI patients who were treated with primary percutaneous coronary intervention (PCI) between February 2019 and December 2019. All patients received standard STEMI management and were divided into 2 groups (ARNI/enalapril). Primary efficacy outcomes were the between-group difference in change (from baseline to 4-, 12-, and 24-week) in N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentration, left ventricular ejection fraction (LVEF), and left ventricular end-systolic volumes and end-diastolic volumes (LVESV and LVEDV). Secondary outcomes were determined by a composite of death, reinfarction, outpatient HF or HF hospitalization, malignant arrhythmia, and stroke. Safety outcomes included worsening renal function, hypotension, hyperkalemia, angioedema and cough. RESULTS: We found that NT-proBNP concentration decreased more in the ARNI group than in the enalapril group [4 weeks: ratio of ARNI vs. enalapril 0.36, 95% confidence interval (CI): 0.24 to 0.52, P<0.001; 12 weeks: 0.54, 95% CI: 0.35 to 0.79, P<0.001; 24 weeks: 0.53, 95% CI: 0.32 to 0.83, P<0.001). When compared to the enalapril group, the ARNI group patients had a significant reduction in LVEDV (P<0.001) and LVESV (P<0.001), and an improvement in LVEF (P=0.011) at 24 weeks. Secondary outcomes occurred in 13 participants (20.3%) in the ARNI group and 22 participants (34.4%) in the enalapril group [hazard ratio (HR), 0.56; 95% CI: 0.28 to 1.12; P=0.102]. The incidence of outpatient HF or HF hospitalization in the ARNI group was significantly lower than that in the enalapril group (HR, 0.36; 95% CI: 0.14 to 0.94; P=0.037). There were no significant differences in the safety between the 2 groups. CONCLUSIONS: For patients with acute anterior STEMI undergoing primary PCI, early initiation of ARNI provided significant clinical benefits. TRIAL REGISTRATION: Chinese Clinical Trial Registry (ChiCTR2100042944) registered on February 1, 2021. CI - 2022 Cardiovascular Diagnosis and Therapy. All rights reserved. FAU - Dong, Youzheng AU - Dong Y AD - Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China. FAU - Xu, Yan AU - Xu Y AD - Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China. FAU - Ding, Congcong AU - Ding C AD - Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China. AD - Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, China. FAU - Yu, Zuozhong AU - Yu Z AD - Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China. FAU - Yu, Zhide AU - Yu Z AD - Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China. FAU - Xia, Xin AU - Xia X AD - Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China. FAU - Chen, Yang AU - Chen Y AD - Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China. FAU - Jiang, Xinghua AU - Jiang X AD - Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China. LA - eng PT - Journal Article PL - China TA - Cardiovasc Diagn Ther JT - Cardiovascular diagnosis and therapy JID - 101601613 PMC - PMC8898690 OTO - NOTNLM OT - Angiotensin receptor-neprilysin inhibitor (ARNI) OT - cardiac remodeling OT - enalapril OT - sacubitril/valsartan OT - segment elevation myocardial infarction (STEMI) COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://cdt.amegroups.com/article/view/10.21037/cdt-21-386/coif). The authors have no conflicts of interest to declare. EDAT- 2022/03/15 06:00 MHDA- 2022/03/15 06:01 PMCR- 2022/02/01 CRDT- 2022/03/14 05:37 PHST- 2021/06/24 00:00 [received] PHST- 2021/11/23 00:00 [accepted] PHST- 2022/03/14 05:37 [entrez] PHST- 2022/03/15 06:00 [pubmed] PHST- 2022/03/15 06:01 [medline] PHST- 2022/02/01 00:00 [pmc-release] AID - cdt-12-01-42 [pii] AID - 10.21037/cdt-21-386 [doi] PST - ppublish SO - Cardiovasc Diagn Ther. 2022 Feb;12(1):42-54. doi: 10.21037/cdt-21-386. PMID- 35271932 OWN - NLM STAT- MEDLINE DCOM- 20220627 LR - 20260518 IS - 1523-1755 (Electronic) IS - 0085-2538 (Linking) VI - 102 IP - 1 DP - 2022 Jul TI - High-sensitivity cardiac troponin and the diagnosis of myocardial infarction in patients with kidney impairment. PG - 149-159 LID - S0085-2538(22)00178-8 [pii] LID - 10.1016/j.kint.2022.02.019 [doi] AB - The benefit and utility of high-sensitivity cardiac troponin (hs-cTn) in the diagnosis of myocardial infarction in patients with kidney impairment is unclear. Here, we describe implementation of hs-cTnI testing on the diagnosis, management, and outcomes of myocardial infarction in patients with and without kidney impairment. Consecutive patients with suspected acute coronary syndrome enrolled in a stepped-wedge, cluster-randomized controlled trial were included in this pre-specified secondary analysis. Kidney impairment was defined as an eGFR under 60mL/min/1.73m(2). The index diagnosis and primary outcome of type 1 and type 4b myocardial infarction or cardiovascular death at one year were compared in patients with and without kidney impairment following implementation of hs-cTnI assay with 99th centile sex-specific diagnostic thresholds. Serum creatinine concentrations were available in 46,927 patients (mean age 61 years; 47% women), of whom 9,080 (19%) had kidney impairment. hs-cTnIs were over 99th centile in 46% and 16% of patients with and without kidney impairment. Implementation increased the diagnosis of type 1 infarction from 12.4% to 17.8%, and from 7.5% to 9.4% in patients with and without kidney impairment (both significant). Patients with kidney impairment and type 1 myocardial infarction were less likely to undergo coronary revascularization (26% versus 53%) or receive dual anti-platelets (40% versus 68%) than those without kidney impairment, and this did not change post-implementation. In patients with hs-cTnI above the 99th centile, the primary outcome occurred twice as often in those with kidney impairment compared to those without (24% versus 12%, hazard ratio 1.53, 95% confidence interval 1.31 to 1.78). Thus, hs-cTnI testing increased the identification of myocardial injury and infarction but failed to address disparities in management and outcomes between those with and without kidney impairment. CI - Copyright (c) 2022 International Society of Nephrology. Published by Elsevier Inc. All rights reserved. FAU - Gallacher, Peter J AU - Gallacher PJ AD - British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK. FAU - Miller-Hodges, Eve AU - Miller-Hodges E AD - British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK; Department of Renal Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK. FAU - Shah, Anoop S V AU - Shah ASV AD - British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK. FAU - Farrah, Tariq E AU - Farrah TE AD - British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK; Department of Renal Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK. FAU - Halbesma, Nynke AU - Halbesma N AD - Usher Institute, University of Edinburgh, Edinburgh, UK. FAU - Blackmur, James P AU - Blackmur JP AD - British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK. FAU - Chapman, Andrew R AU - Chapman AR AD - British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK. FAU - Adamson, Philip D AU - Adamson PD AD - British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK; Christchurch Heart Institute, University of Otago, Christchurch, New Zealand, Australia. FAU - Anand, Atul AU - Anand A AD - British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK. FAU - Strachan, Fiona E AU - Strachan FE AD - British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK. FAU - Ferry, Amy V AU - Ferry AV AD - British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK. FAU - Lee, Kuan Ken AU - Lee KK AD - British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK. FAU - Berry, Colin AU - Berry C AD - Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK. FAU - Findlay, Iain AU - Findlay I AD - Department of Cardiology, Royal Alexandra Hospital, Paisley, UK. FAU - Cruickshank, Anne AU - Cruickshank A AD - Department of Biochemistry, Queen Elizabeth University Hospital, Glasgow, UK. FAU - Reid, Alan AU - Reid A AD - Department of Biochemistry, Queen Elizabeth University Hospital, Glasgow, UK. FAU - Gray, Alasdair AU - Gray A AD - Emergency Medicine Research Group Edinburgh, Royal Infirmary of Edinburgh, Edinburgh, UK. FAU - Collinson, Paul O AU - Collinson PO AD - Departments of Clinical Blood Sciences and Cardiology, St. George's, University Hospitals National Health Service Trust and St. George's University of London, London, UK. FAU - Apple, Fred S AU - Apple FS AD - Department of Laboratory Medicine and Pathology, Hennepin Healthcare/Hennepin County Medical Center, Minneapolis, Minnesota, USA; University of Minnesota, Minneapolis, Minnesota, USA. FAU - McAllister, David A AU - McAllister DA AD - Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK. FAU - Maguire, Donogh AU - Maguire D AD - Emergency Medicine Department, Glasgow Royal Infirmary, Glasgow, UK. FAU - Fox, Keith A A AU - Fox KAA AD - British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK. FAU - Keerie, Catriona AU - Keerie C AD - Usher Institute, University of Edinburgh, Edinburgh, UK; Edinburgh Clinical Trials Unit, University of Edinburgh, Edinburgh, UK. FAU - Weir, Christopher J AU - Weir CJ AD - Usher Institute, University of Edinburgh, Edinburgh, UK; Edinburgh Clinical Trials Unit, University of Edinburgh, Edinburgh, UK. FAU - Newby, David E AU - Newby DE AD - British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK. FAU - Mills, Nicholas L AU - Mills NL AD - British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK; Usher Institute, University of Edinburgh, Edinburgh, UK. FAU - Dhaun, Neeraj AU - Dhaun N AD - British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK; Department of Renal Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK. Electronic address: bean.dhaun@ed.ac.uk. CN - High-STEACS Investigators LA - eng GR - CH/F/21/90010/BHF_/British Heart Foundation/United Kingdom GR - SP/12/10/29922/BHF_/British Heart Foundation/United Kingdom GR - FS/CRTF/20/24079/BHF_/British Heart Foundation/United Kingdom GR - FS/16/36/32205/BHF_/British Heart Foundation/United Kingdom GR - CH/09/002/26360/BHF_/British Heart Foundation/United Kingdom PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20220307 PL - United States TA - Kidney Int JT - Kidney international JID - 0323470 RN - 0 (Biomarkers) RN - 0 (Troponin I) RN - 0 (Troponin T) RN - AYI8EX34EU (Creatinine) SB - IM CIN - Kidney Int. 2022 Jul;102(1):20-22. doi: 10.1016/j.kint.2022.04.017. PMID: 35738829 MH - *Acute Coronary Syndrome MH - Biomarkers MH - Creatinine MH - Female MH - Humans MH - Kidney MH - Male MH - Middle Aged MH - *Myocardial Infarction/blood/complications/diagnosis/therapy MH - *Renal Insufficiency/blood/complications/diagnosis MH - *Troponin I/blood MH - Troponin T OTO - NOTNLM OT - cardiac troponin OT - cardiovascular disease OT - chronic kidney disease FIR - Mills, Nicholas L IR - Mills NL FIR - Strachan, Fiona E IR - Strachan FE FIR - Tuck, Christopher IR - Tuck C FIR - Shah, Anoop S V IR - Shah ASV FIR - Strachan, Fiona E IR - Strachan FE FIR - Anand, Atul IR - Anand A FIR - Bularga, Anda IR - Bularga A FIR - Wereski, Ryan IR - Wereski R FIR - Lowry, Matthew T H IR - Lowry MTH FIR - Taggart, Caelan IR - Taggart C FIR - Ferry, Amy V IR - Ferry AV FIR - Lee, Kuan Ken IR - Lee KK FIR - Chapman, Andrew R IR - Chapman AR FIR - Sandeman, Dennis IR - Sandeman D FIR - Adamson, Philip D IR - Adamson PD FIR - Stables, Catherine L IR - Stables CL FIR - Vallejos, Catalina A IR - Vallejos CA FIR - Tsanas, Athanasios IR - Tsanas A FIR - Marshall, Lucy IR - Marshall L FIR - Stewart, Stacey D IR - Stewart SD FIR - Fujisawa, Takeshi IR - Fujisawa T FIR - McPherson, Jean IR - McPherson J FIR - McKinlay, Lynn IR - McKinlay L FIR - Mills, Nicholas L IR - Mills NL FIR - Newby, David E IR - Newby DE FIR - Fox, Keith A A IR - Fox KAA FIR - Berry, Colin IR - Berry C FIR - Walker, Simon IR - Walker S FIR - Weir, Christopher J IR - Weir CJ FIR - Ford, Ian IR - Ford I FIR - Mills, Nicholas L IR - Mills NL FIR - Newby, David E IR - Newby DE FIR - Gray, Alasdair IR - Gray A FIR - Fox, Keith A A IR - Fox KAA FIR - Berry, Colin IR - Berry C FIR - Walker, Simon IR - Walker S FIR - Collinson, Paul O IR - Collinson PO FIR - Apple, Fred S IR - Apple FS FIR - Reid, Alan IR - Reid A FIR - Cruikshank, Anne IR - Cruikshank A FIR - Findlay, Iain IR - Findlay I FIR - Amoils, Shannon IR - Amoils S FIR - McAllister, David A IR - McAllister DA FIR - Maguire, Donogh IR - Maguire D FIR - Stevens, Jennifer IR - Stevens J FIR - Norrie, John IR - Norrie J FIR - Weir, Christopher J IR - Weir CJ FIR - Shah, Anoop S V IR - Shah ASV FIR - Anand, Atul IR - Anand A FIR - Chapman, Andrew R IR - Chapman AR FIR - Lee, Kuan Ken IR - Lee KK FIR - Andrews, Jack P M IR - Andrews JPM FIR - Adamson, Philip D IR - Adamson PD FIR - Moss, Alastair IR - Moss A FIR - Anwar, Mohamed S IR - Anwar MS FIR - Hung, John IR - Hung J FIR - Mills, Nicholas L IR - Mills NL FIR - Walker, Simon IR - Walker S FIR - Malo, Jonathan IR - Malo J FIR - Reid, Alan IR - Reid A FIR - Cruikshank, Anne IR - Cruikshank A FIR - Collinson, Paul O IR - Collinson PO FIR - Fischbacher, Colin M IR - Fischbacher CM FIR - Croal, Bernard L IR - Croal BL FIR - Leslie, Stephen J IR - Leslie SJ FIR - Keerie, Catriona IR - Keerie C FIR - Parker, Richard A IR - Parker RA FIR - Walker, Allan IR - Walker A FIR - Harkess, Ronnie IR - Harkess R FIR - Tuck, Christopher IR - Tuck C FIR - Wackett, Tony IR - Wackett T FIR - Weir, Christopher IR - Weir C FIR - Armstrong, Roma IR - Armstrong R FIR - Stirling, Laura IR - Stirling L FIR - MacDonald, Claire IR - MacDonald C FIR - Sadat, Imran IR - Sadat I FIR - Finlay, Frank IR - Finlay F FIR - Charles, Heather IR - Charles H FIR - Linksted, Pamela IR - Linksted P FIR - Young, Stephen IR - Young S FIR - Alexander, Bill IR - Alexander B FIR - Duncan, Chris IR - Duncan C EDAT- 2022/03/11 06:00 MHDA- 2022/06/28 06:00 CRDT- 2022/03/10 20:12 PHST- 2021/10/29 00:00 [received] PHST- 2022/01/25 00:00 [revised] PHST- 2022/02/08 00:00 [accepted] PHST- 2022/03/11 06:00 [pubmed] PHST- 2022/06/28 06:00 [medline] PHST- 2022/03/10 20:12 [entrez] AID - S0085-2538(22)00178-8 [pii] AID - 10.1016/j.kint.2022.02.019 [doi] PST - ppublish SO - Kidney Int. 2022 Jul;102(1):149-159. doi: 10.1016/j.kint.2022.02.019. Epub 2022 Mar 7. PMID- 35261290 OWN - NLM STAT- MEDLINE DCOM- 20220408 LR - 20260726 IS - 2047-9980 (Electronic) IS - 2047-9980 (Linking) VI - 11 IP - 6 DP - 2022 Mar 15 TI - Dialysis Initiation in Patients With Chronic Coronary Disease and Advanced Chronic Kidney Disease in ISCHEMIA-CKD. PG - e022003 LID - 10.1161/JAHA.121.022003 [doi] LID - e022003 AB - Background In participants with concomitant chronic coronary disease and advanced chronic kidney disease (CKD), the effect of treatment strategies on the timing of dialysis initiation is not well characterized. Methods and Results In ISCHEMIA-CKD (International Study of Comparative Health Effectiveness With Medical and Invasive Approaches-Chronic Kidney Disease), 777 participants with advanced CKD and moderate or severe ischemia were randomized to either an initial invasive or conservative management strategy. Herein, we compare the proportion of randomized participants with non-dialysis-requiring CKD at baseline (n=362) who initiated dialysis and compare the time to dialysis initiation between invasive versus conservative management arms. Using multivariable Cox regression analysis, we also sought to identify the effect of invasive versus conservative chronic coronary disease management strategies on dialysis initiation. At a median follow-up of 23 months (25th-75th interquartile range, 14-32 months), dialysis was initiated in 18.9% of participants (36/190) in the invasive strategy and 16.9% of participants (29/172) in the conservative strategy (P=0.22). The median time to dialysis initiation was 6.0 months (interquartile range, 3.0-16.0 months) in the invasive group and 18.2 months (interquartile range, 12.2-25.0 months) in the conservative group (P=0.004), with no difference in procedural acute kidney injury rates between the groups (7.8% versus 5.4%; P=0.26). Baseline clinical factors associated with earlier dialysis initiation were lower baseline estimated glomerular filtration rate (hazard ratio [HR] associated with 5-unit decrease, 2.08 [95% CI, 1.72-2.56]; P<0.001), diabetes (HR, 2.30 [95% CI, 1.28-4.13]; P=0.005), hypertension (HR, 7.97 [95% CI, 1.09-58.21]; P=0.041), and Hispanic ethnicity (HR, 2.34 [95% CI, 1.22-4.47]; P=0.010). Conclusions In participants with non-dialysis-requiring CKD in ISCHEMIA-CKD, randomization to an invasive chronic coronary disease management strategy (relative to a conservative chronic coronary disease management strategy) is associated with an accelerated time to initiation of maintenance dialysis for kidney failure. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT01985360. FAU - Briguori, Carlo AU - Briguori C AUID- ORCID: 0000-0002-2105-8186 AD - Mediterranea Cardiocentro Naples Italy. FAU - Mathew, Roy O AU - Mathew RO AUID- ORCID: 0000-0002-5582-3165 AD - Loma Linda VA Health Care System Loma Linda CA. FAU - Huang, Zhen AU - Huang Z AD - Duke Clinical Research Institute Duke University Medical Center Durham NC. FAU - Mavromatis, Kreton AU - Mavromatis K AD - Atlanta VA Healthcare System and Emory University School of Medicine Atlanta GA. FAU - Hickson, LaTonya J AU - Hickson LJ AUID- ORCID: 0000-0002-7485-336X AD - Mayo Clinic Jacksonville FL. FAU - Lau, Wei Ling AU - Lau WL AD - Division of Nephrology Department of Medicine University of California-Irvine Irvine CA. FAU - Mathew, Anoop AU - Mathew A AUID- ORCID: 0000-0002-0302-1419 AD - University of Alberta Hospital Edmonton Alberta Canada. FAU - Mahajan, Sandeep AU - Mahajan S AD - All India Institute of Medical Sciences Delhi India. FAU - Wheeler, David C AU - Wheeler DC AUID- ORCID: 0000-0003-0745-3478 AD - University College London London United Kingdom. FAU - Claes, Kathleen J AU - Claes KJ AD - Department of Nephrology University Hospitals Leuven Leuven Belgium. FAU - Chen, Gang AU - Chen G AD - Peking Union Medical College Hospital Beijing China. FAU - Nolasco, Fernando E B AU - Nolasco FEB AD - Centro Hospitalar Lisboa Central Lisbon Portugal. FAU - Stone, Gregg W AU - Stone GW AUID- ORCID: 0000-0002-3416-8210 AD - Icahn School of Medicine at Mount Sinai New York NY. AD - Cardiovascular Research Foundation New York NY. FAU - Fleg, Jerome L AU - Fleg JL AD - National Heart, Lung, and Blood Institute Bethesda MD. FAU - Sidhu, Mandeep S AU - Sidhu MS AD - Albany Medical College Albany NY. FAU - Rockhold, Frank W AU - Rockhold FW AUID- ORCID: 0000-0003-3732-4765 AD - Duke Clinical Research Institute Duke University Medical Center Durham NC. FAU - Chertow, Glenn M AU - Chertow GM AD - Stanford University School of Medicine Stanford CA. FAU - Hochman, Judith S AU - Hochman JS AUID- ORCID: 0000-0002-5889-5981 AD - NYU Grossman School of Medicine New York NY. FAU - Maron, David J AU - Maron DJ AD - Stanford University School of Medicine Stanford CA. FAU - Bangalore, Sripal AU - Bangalore S AUID- ORCID: 0000-0001-9485-0652 AD - NYU Grossman School of Medicine New York NY. LA - eng SI - ClinicalTrials.gov/NCT01985360 GR - U01 HL105907/HL/NHLBI NIH HHS/United States GR - U01 HL117904/HL/NHLBI NIH HHS/United States GR - U01 HL117905/HL/NHLBI NIH HHS/United States PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't DEP - 20220309 PL - England TA - J Am Heart Assoc JT - Journal of the American Heart Association JID - 101580524 SB - IM MH - *Coronary Disease/complications MH - Glomerular Filtration Rate MH - *Heart Diseases/complications MH - Humans MH - Ischemia/complications MH - Renal Dialysis/methods MH - *Renal Insufficiency, Chronic/complications/diagnosis/epidemiology PMC - PMC9075321 OTO - NOTNLM OT - chronic coronary disease OT - chronic kidney disease OT - dialysis OT - guideline-directed medical therapy EDAT- 2022/03/10 06:00 MHDA- 2022/04/09 06:00 PMCR- 2022/03/15 CRDT- 2022/03/09 08:42 PHST- 2022/03/10 06:00 [pubmed] PHST- 2022/04/09 06:00 [medline] PHST- 2022/03/09 08:42 [entrez] PHST- 2022/03/15 00:00 [pmc-release] AID - JAH37142 [pii] AID - 10.1161/JAHA.121.022003 [doi] PST - ppublish SO - J Am Heart Assoc. 2022 Mar 15;11(6):e022003. doi: 10.1161/JAHA.121.022003. Epub 2022 Mar 9. PMID- 35239245 OWN - NLM STAT- MEDLINE DCOM- 20220523 LR - 20250728 IS - 1879-0844 (Electronic) IS - 1388-9842 (Linking) VI - 24 IP - 5 DP - 2022 May TI - Vericiguat in patients with coronary artery disease and heart failure with reduced ejection fraction. PG - 782-790 LID - 10.1002/ejhf.2468 [doi] AB - AIMS: Coronary artery disease (CAD) portends worse outcomes in heart failure (HF). We aimed to characterize patients with CAD and worsening HF with reduced ejection fraction (HFrEF) and evaluate post hoc whether vericiguat treatment effect varied according to CAD. METHODS AND RESULTS: Cox proportional hazards were generated for the primary endpoint of cardiovascular death or HF hospitalization (CVD/HFH). CAD was defined as previous myocardial infarction, percutaneous coronary intervention, or coronary artery bypass grafting. Of 5048 patients in VICTORIA with available data on CAD status, 2704 had CAD and were older, were more frequently male, diabetic, and had a lower glomerular filtration rate than those without CAD (all p <0.0001). Use of implantable cardioverter defibrillators and cardiac resynchronization therapy (CRT) was higher in patients with versus without CAD (33.5% vs. 21.1%; p <0.0001 and 16.3% vs. 12.8%; p = 0.0006). The primary endpoint of CVD/HFH was higher in those with versus without CAD (40.6 vs. 30.1/100 patient-years; adjusted hazard ratio [HR] 1.23; p <0.001) as was all-cause mortality (17.9% vs. 12.7%; adjusted HR 1.32; p <0.001). The primary outcome of CVD/HFH associated with vericiguat in patients with or without CAD was 38.8 versus 27.6 per 100 patient-years and for placebo was 42.6 versus 32.7 per 100 patient-years (interaction p = 0.78). CONCLUSION: In this post hoc study, CAD was associated with more CVD and HFH in patients with HFrEF and worsening HF. Vericiguat was beneficial and safe regardless of concomitant CAD. CI - (c) 2022 European Society of Cardiology. FAU - Saldarriaga, Clara AU - Saldarriaga C AD - Department of Cardiology, University of Antioquia, CardioVID Clinic, Medellin, Colombia. FAU - Atar, Dan AU - Atar D AD - Department of Cardiology, Oslo University Hospital Ulleval, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway. FAU - Stebbins, Amanda AU - Stebbins A AD - Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA. FAU - Lewis, Basil S AU - Lewis BS AD - Lady Davis Carmel Medical Center, Haifa, Israel. FAU - Abidin, Imran Zainal AU - Abidin IZ AD - UM Specialist Centre, Kuala Lumpur, Malaysia. FAU - Blaustein, Robert O AU - Blaustein RO AD - Merck & Co. Inc., Kenilworth, NJ, USA. FAU - Butler, Javed AU - Butler J AD - University of Mississippi Medical Center, Jackson, MS, USA. FAU - Ezekowitz, Justin A AU - Ezekowitz JA AD - Canadian VIGOUR Centre, University of Alberta, Edmonton, Canada. FAU - Hernandez, Adrian F AU - Hernandez AF AD - Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA. FAU - Lam, Carolyn S P AU - Lam CSP AD - National Heart Centre Singapore & Duke-National University of Singapore, Singapore. FAU - O'Connor, Christopher M AU - O'Connor CM AD - Inova Heart and Vascular Institute, Falls Church, VA, USA. FAU - Pieske, Burkert AU - Pieske B AD - Charite University Medicine, German Heart Center, Berlin, Germany. FAU - Ponikowski, Piotr AU - Ponikowski P AD - Wroclaw Medical University, Wroclaw, Poland. FAU - Roessig, Lothar AU - Roessig L AD - Bayer AG, Wuppertal, Germany. FAU - Voors, Adriaan A AU - Voors AA AD - University of Groningen, Groningen, The Netherlands. FAU - Anstrom, Kevin J AU - Anstrom KJ AD - Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA. FAU - Armstrong, Paul W AU - Armstrong PW AD - Canadian VIGOUR Centre, University of Alberta, Edmonton, Canada. CN - VICTORIA Study Group LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20220320 PL - England TA - Eur J Heart Fail JT - European journal of heart failure JID - 100887595 RN - 0 (Heterocyclic Compounds, 2-Ring) RN - 0 (Pyrimidines) RN - LV66ADM269 (vericiguat) SB - IM CIN - Eur J Heart Fail. 2022 May;24(5):791-793. doi: 10.1002/ejhf.2511. PMID: 35445790 EIN - Eur J Heart Fail. 2022 Oct;24(10):1996. doi: 10.1002/ejhf.2676. PMID: 36098209 MH - *Coronary Artery Disease/complications/drug therapy MH - *Heart Failure/complications/epidemiology/therapy MH - *Heterocyclic Compounds, 2-Ring/therapeutic use MH - Humans MH - Male MH - Pyrimidines MH - Stroke Volume MH - *Ventricular Dysfunction, Left/drug therapy OTO - NOTNLM OT - Cardiovascular death OT - Comorbidity OT - Coronary artery disease OT - Heart failure OT - Heart failure hospitalization OT - Vericiguat EDAT- 2022/03/04 06:00 MHDA- 2022/05/24 06:00 CRDT- 2022/03/03 12:20 PHST- 2021/12/02 00:00 [received] PHST- 2022/03/01 00:00 [accepted] PHST- 2022/03/04 06:00 [pubmed] PHST- 2022/05/24 06:00 [medline] PHST- 2022/03/03 12:20 [entrez] AID - 10.1002/ejhf.2468 [doi] PST - ppublish SO - Eur J Heart Fail. 2022 May;24(5):782-790. doi: 10.1002/ejhf.2468. Epub 2022 Mar 20. PMID- 35220449 OWN - NLM STAT- MEDLINE DCOM- 20220701 LR - 20240830 IS - 1861-0692 (Electronic) IS - 1861-0684 (Print) IS - 1861-0684 (Linking) VI - 111 IP - 7 DP - 2022 Jul TI - Drug-coated balloons for small coronary artery disease in patients with chronic kidney disease: a pre-specified analysis of the BASKET-SMALL 2 trial. PG - 806-815 LID - 10.1007/s00392-022-01995-3 [doi] AB - BACKGROUND: Data on the safety and efficacy of drug-coated balloon (DCB) compared to drug-eluting stent (DES) in patients with chronic kidney disease (CKD) are scarce, particularly at long term. This pre-specified analysis aimed to investigate the 3-year efficacy and safety of DCB versus DES for small coronary artery disease (< 3 mm) according to renal function at baseline. METHODS: BASKET-SMALL-2 was a large multi-center, randomized, controlled trial that tested the efficacy and safety of DCBs (n = 382) against DESs (n = 376) in small vessel disease. CKD was defined as eGFR < 60 ml/min/1.73m(2). The primary endpoint was the composite of cardiac death, non-fatal myocardial infarction, and target vessel revascularization (MACE) during 3 years. RESULTS: A total of 174/758 (23%) patients had CKD, out of which 91 were randomized to DCB and 83 to DES implantation. The primary efficacy outcome during 3 years was similar in both, DCB and DES patients (HR 0.98; 95%-CI 0.67-1.44; p = 0.937) and patients with and without CKD (HR 1.18; 95%-CI 0.76-1.83; p = 0.462), respectively. Rates of cardiac death and all-cause death were significantly higher among patients with CKD but not affected by treatment with DCB or DES. Major bleeding events were lower in the DCB when compared to the DES group (12 vs. 3, HR 0.26; 95%-CI 0.07-0.92; p = 0.037) and not influenced by presence of CKD. CONCLUSIONS: The long-term efficacy and safety of DCB was similar in patients with and without CKD. The use of DCB was associated with significantly fewer major bleeding events (NCT01574534). Central Illustration. Drug-coated balloon versus drug-eluting stents in small coronary artery disease with and without chronic kidney disease, a prespecified subgroup analysis of the BASKET-SMALL 2 trial. CI - (c) 2022. The Author(s). FAU - Mahfoud, Felix AU - Mahfoud F AUID- ORCID: 0000-0002-4425-549X AD - Universitatsklinikum des Saarlandes, Saarland University, Kirrberger Str. 1, IMED, Geb. 41.1, 66421, Homburg, Saar, Germany. Felix.Mahfoud@uks.eu. FAU - Farah, Ahmed AU - Farah A AD - Knappschaftskrankenhaus, Klinikum Westfalen, Dortmund, Germany. FAU - Ohlow, Marc-Alexander AU - Ohlow MA AD - SRH Wald-Klinikum, Gera, Germany. FAU - Mangner, Norman AU - Mangner N AD - Herzzentrum Dresden, Technische Universitat Dresden, Dresden, Germany. FAU - Wohrle, Jochen AU - Wohrle J AD - Department of Cardiology and Intensive Care, Medical Campus Lake Constance, Friedrichshafen, Germany. FAU - Mobius-Winkler, Sven AU - Mobius-Winkler S AD - University Hospital Jena, Jena, Germany. FAU - Weilenmann, Daniel AU - Weilenmann D AD - Cantonal Hospital St Gallen, St Gallen, Switzerland. FAU - Leibundgut, Gregor AU - Leibundgut G AD - Cantonal Hospital Baselland, Liestal, Switzerland. FAU - Cuculi, Florim AU - Cuculi F AD - Cantonal Hospital Luzern, Luzern, Switzerland. FAU - Gilgen, Nicole AU - Gilgen N AD - University Hospital Basel, University of Basel, Basel, Switzerland. FAU - Kaiser, Christoph AU - Kaiser C AD - University Hospital Basel, University of Basel, Basel, Switzerland. FAU - Cattaneo, Marco AU - Cattaneo M AD - University Hospital Basel, University of Basel, Basel, Switzerland. FAU - Scheller, Bruno AU - Scheller B AD - Universitatsklinikum des Saarlandes, Saarland University, Kirrberger Str. 1, IMED, Geb. 41.1, 66421, Homburg, Saar, Germany. FAU - Jeger, Raban V AU - Jeger RV AD - University Hospital Basel, University of Basel, Basel, Switzerland. LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20220227 PL - Germany TA - Clin Res Cardiol JT - Clinical research in cardiology : official journal of the German Cardiac Society JID - 101264123 RN - 0 (Coated Materials, Biocompatible) SB - IM MH - *Angioplasty, Balloon, Coronary/adverse effects MH - Coated Materials, Biocompatible MH - *Coronary Artery Disease/complications/diagnosis/surgery MH - Death MH - *Drug-Eluting Stents MH - Humans MH - *Percutaneous Coronary Intervention/adverse effects MH - *Renal Insufficiency, Chronic/complications/diagnosis MH - Treatment Outcome PMC - PMC9242956 OTO - NOTNLM OT - Drug-coated balloon OT - Renal insufficiency OT - Revascularization strategies COIS- FM is supported by Deutsche Gesellschaft fur Kardiologie (DGK), and Deutsche Forschungsgemeinschaft (SFB TRR219) and has received scientific support and speaker honoraria from Astra-Zeneca, Bayer, Boehringer Ingelheim, Medtronic, Merck and ReCor Medical. NM reports personal fees from Edwards Lifesciences, Medtronic, Biotronik, Novartis, Sanofi Genzyme, AstraZeneca, Pfizer, Bayer, Abbott, Abiomed, and Boston Scientific outside the submitted work. BS is a shareholder of InnoRa GmbH and was named as co-inventor on patent applications submitted by Charite University Hospital, Berlin, Germany. RVJ received research support from B.Braun Melsungen AG, and received honoraria and consultation fees from B. Braun Melsungen AG, Cardionovum and Nipro. EDAT- 2022/02/28 06:00 MHDA- 2022/07/02 06:00 PMCR- 2022/02/27 CRDT- 2022/02/27 20:38 PHST- 2022/01/28 00:00 [received] PHST- 2022/02/15 00:00 [accepted] PHST- 2022/02/28 06:00 [pubmed] PHST- 2022/07/02 06:00 [medline] PHST- 2022/02/27 20:38 [entrez] PHST- 2022/02/27 00:00 [pmc-release] AID - 10.1007/s00392-022-01995-3 [pii] AID - 1995 [pii] AID - 10.1007/s00392-022-01995-3 [doi] PST - ppublish SO - Clin Res Cardiol. 2022 Jul;111(7):806-815. doi: 10.1007/s00392-022-01995-3. Epub 2022 Feb 27. PMID- 35154627 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240822 IS - 2040-6223 (Print) IS - 2040-6231 (Electronic) IS - 2040-6223 (Linking) VI - 12 DP - 2021 TI - Coronary artery bypass graft surgery versus stenting for patients with chronic kidney disease and complex coronary artery disease: a systematic review and meta-analysis. PG - 2040622321990273 LID - 10.1177/2040622321990273 [doi] LID - 2040622321990273 AB - BACKGROUND: The relative role of coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) with stent implantation in patients with chronic kidney disease (CKD) and complex coronary artery disease (CAD) remains debatable due to the lack of randomized controlled trials (RCTs). We therefore performed this meta-analysis to compare the outcomes of the two strategies in CKD patients with multivessel and/or left main disease. METHODS: Electronic databases including PubMed, EMBASE and Cochrane Library were comprehensively searched to identify the eligible subgroup analysis of RCTs and propensity-matched registries. The primary endpoint was all-cause mortality during the longest follow-up. RESULTS: Five subgroup analyses of RCTs and six propensity-matched registries involving 26,441 patients were analyzed. Overall, the strategy of CABG was associated with lower risks of long-term mortality [odds ratio (OR) 0.83, 95% confidence interval (CI) 0.74-0.93], myocardial infarction (OR, 0.41; 95% CI, 0.27-0.62), and repeat revascularization (OR, 0.25; 95% CI, 0.16-0.39) compared with PCI in CKD patients with complex CAD. However, CABG was slightly associated with higher risk of stroke than PCI (OR, 1.33; 95% CI, 1.00-1.77). Nonetheless, the higher stroke risk in the CABG group no longer existed during long-term follow-up (OR, 0.92; 95% CI, 0.37-2.25) (>3 years). CONCLUSION: This meta-analysis supports the current guideline advising CABG for patients with CKD and complex CAD. At the expense of slightly increased risk of stroke, CABG reduces the incidences of long-term all-cause death, myocardial infarction and repeat revascularization compared with PCI. CI - (c) The Author(s), 2021. FAU - Cui, Kongyong AU - Cui K AUID- ORCID: 0000-0002-2313-5368 AD - Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Liu, Hong AU - Liu H AD - Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University and Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China. FAU - Yuan, Fei AU - Yuan F AD - Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University and Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China. FAU - Xu, Feng AU - Xu F AD - Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University and Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China. FAU - Zhang, Min AU - Zhang M AD - Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University and Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China. FAU - Zhang, Mingduo AU - Zhang M AD - Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University and Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China. FAU - Wang, Wei AU - Wang W AD - Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University and Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China. FAU - Zhang, Dongfeng AU - Zhang D AD - Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University and Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China. FAU - Tian, Jinfan AU - Tian J AD - Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University and Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China. FAU - Lyu, Shuzheng AU - Lyu S AUID- ORCID: 0000-0002-4243-2341 AD - Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University and Beijing Institute of Heart, Lung and Blood Vessel Diseases, 2 Anzhen Road, Chaoyang District, Beijing 100029, China. FAU - Dou, Kefei AU - Dou K AD - Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167, Beilishi Road, Xicheng District, Beijing 100037, China. LA - eng PT - Journal Article DEP - 20210323 PL - United States TA - Ther Adv Chronic Dis JT - Therapeutic advances in chronic disease JID - 101532140 PMC - PMC8832329 OTO - NOTNLM OT - chronic kidney disease OT - complex coronary artery disease OT - coronary artery bypass grafting OT - outcome OT - percutaneous coronary intervention COIS- Conflict of interest statement: The authors declare that there is no conflict of interest. EDAT- 2022/02/15 06:00 MHDA- 2022/02/15 06:01 PMCR- 2021/03/23 CRDT- 2022/02/14 05:32 PHST- 2020/04/16 00:00 [received] PHST- 2021/01/05 00:00 [accepted] PHST- 2022/02/14 05:32 [entrez] PHST- 2022/02/15 06:00 [pubmed] PHST- 2022/02/15 06:01 [medline] PHST- 2021/03/23 00:00 [pmc-release] AID - 10.1177_2040622321990273 [pii] AID - 10.1177/2040622321990273 [doi] PST - epublish SO - Ther Adv Chronic Dis. 2021 Mar 23;12:2040622321990273. doi: 10.1177/2040622321990273. eCollection 2021. PMID- 35154363 OWN - NLM STAT- MEDLINE DCOM- 20220314 LR - 20240822 IS - 1748-6718 (Electronic) IS - 1748-670X (Print) IS - 1748-670X (Linking) VI - 2022 DP - 2022 TI - Risk Factor Analysis and Construction of a Prognostic Model after Percutaneous Coronary Intervention in Patients with Chronic Total Occlusion. PG - 9902380 LID - 10.1155/2022/9902380 [doi] LID - 9902380 AB - METHODS: The clinical data of 82 patients with CTO who underwent PCI in Lianshui County People's Hospital were collected in this study. The patients were divided into training set (n = 54) and validation set (n = 28) by random sampling method. Statistical difference test was performed for clinical features of patients. Univariate and multivariate Cox regression analyses were performed to determine the risk factors affecting progression of CTO. Nomogram was used to construct a prediction model for disease progression. C-index was calculated, and the accuracy of the model was tested by calibration curve. RESULTS: No statistically significant differences were incorporated in baseline characteristics of included patients (p > 0.05). There were 25 patients with adverse cardiac events during follow-up in the training set and 13 in the validation set. The results of multivariate Cox regression analysis demonstrated that the important factors affecting postoperative disease progression mainly came down to age, BMI, diabetes, creatinine clearance rate, and left ventricular fraction < 40%. A nomogram was constructed and C-index was calculated. The calibration curve was then used to evaluate and predict risk model of disease progression. The result showed an internal validation C-index of 0.6219 and an external validation C-index of 0.6453, which indicated the good prediction performance of the model. CONCLUSION: The risk of disease progression in CTO patients treated with PCI can be effectively predicted by the risk model constructed in this study, which opens up a great possibility for enriching the means of predicting the prognosis of these patients in clinical practice. CI - Copyright (c) 2022 Xia Zhao et al. FAU - Zhao, Xia AU - Zhao X AUID- ORCID: 0000-0003-0207-6677 AD - Department of Cardiovascular Medicine, The Second Affiliated Hospital of Jiaxing University, Jiaxing 314000, China. FAU - Yuan, Xian AU - Yuan X AUID- ORCID: 0000-0002-8794-4885 AD - Department of Cardiology, The Affiliated Huai'an Hospital of Xuzhou Medical University, The Second People's Hospital of Huai'an, Huaihai, Jiangsu Province 223001, China. FAU - Zhong, Yi AU - Zhong Y AUID- ORCID: 0000-0003-3551-2180 AD - Intensive Care Unit, The Affiliated Huai'an Hospital of Xuzhou Medical University, The Second People's Hospital of Huai'an, Huaihai, 223001 Jiangsu Province, China. FAU - Wang, Gang AU - Wang G AUID- ORCID: 0000-0003-1427-7038 AD - Geriatrics Department, Lianshui County People's Hospital, Lianshui County, Huai'an, Jiangsu Province 223400, China. LA - eng PT - Journal Article DEP - 20220201 PL - United States TA - Comput Math Methods Med JT - Computational and mathematical methods in medicine JID - 101277751 SB - IM MH - Adult MH - Aged MH - China MH - Computational Biology MH - Coronary Occlusion/*surgery MH - Disease Progression MH - Female MH - Follow-Up Studies MH - Heart Disease Risk Factors MH - Humans MH - Male MH - Middle Aged MH - Multivariate Analysis MH - Nomograms MH - *Percutaneous Coronary Intervention/adverse effects/statistics & numerical data MH - Postoperative Complications/etiology MH - Prognosis MH - Proportional Hazards Models MH - Risk Factors PMC - PMC8825273 COIS- No potential conflict of interest was reported by the authors. EDAT- 2022/02/15 06:00 MHDA- 2022/03/15 06:00 PMCR- 2022/02/01 CRDT- 2022/02/14 05:31 PHST- 2021/11/03 00:00 [received] PHST- 2021/12/23 00:00 [revised] PHST- 2022/01/05 00:00 [accepted] PHST- 2022/02/14 05:31 [entrez] PHST- 2022/02/15 06:00 [pubmed] PHST- 2022/03/15 06:00 [medline] PHST- 2022/02/01 00:00 [pmc-release] AID - 10.1155/2022/9902380 [doi] PST - epublish SO - Comput Math Methods Med. 2022 Feb 1;2022:9902380. doi: 10.1155/2022/9902380. eCollection 2022. PMID- 35138360 OWN - NLM STAT- MEDLINE DCOM- 20220602 LR - 20250530 IS - 1873-734X (Electronic) IS - 1010-7940 (Print) IS - 1010-7940 (Linking) VI - 61 IP - 6 DP - 2022 May 27 TI - Prognostic factors of 10-year mortality after coronary artery bypass graft surgery: a secondary analysis of the arterial revascularization trial. PG - 1414-1420 LID - 10.1093/ejcts/ezac043 [doi] AB - OBJECTIVES: The objective of this investigation was to determine the preoperative prognostic factors of long-term (10-year) mortality in patients treated with isolated coronary artery bypass graft surgery in the arterial revascularization trial (ART). METHODS: A post hoc analysis of the ART was conducted. Cumulative 10-year mortality was estimated using the Kaplan-Meier method. Prospectively collected preoperative data were used to determine the prognostic factors of 10-year all-cause mortality in patients who participated in the ART (Cox proportional hazards model). RESULTS: A total of 3102 patients who participated in the ART were included in the analysis. Ten-year follow-up was completed in 3040 patients (98%). A total of 644 patients (20.8%) had died by 10 years. Preoperative factors that were identified as statistically significant predictors of 10-year mortality in the multivariable analysis (all P /=10 points) or low (<10) ABCD-GENE scores, respectively. At 12 months, both the primary (5.2% versus 2.6%, P<0.001) and secondary outcomes (7.7% versus 4.6%, P=0.001) were significantly increased in patients with high ABCD-GENE score. Among 4714 patients allocated to genotype-guided or conventional therapy, the former did not significantly reduce the 12-month risk of the primary and secondary outcomes in both the high and low ABCD-GENE score groups (p(interaction)=0.48 and 0.27, respectively). Conclusions Among patients with percutaneous coronary intervention on clopidogrel, the ABCD-GENE score was helpful in identifying those at higher risk. The ABCD-GENE score may potentially enhance the precision of tailored selection of P2Y(12) inhibitors, which needs to be confirmed in prospective investigations. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique Identifier: NCT01742117. FAU - Capodanno, Davide AU - Capodanno D AUID- ORCID: 0000-0002-5156-7723 AD - Division of Cardiology Azienda Ospedaliero Universitaria Policlinico "G. Rodolico-San Marco"University of Catania Catania Italy. FAU - Angiolillo, Dominick J AU - Angiolillo DJ AUID- ORCID: 0000-0001-8451-2131 AD - Division of Cardiology University of Florida College of Medicine Jacksonville Florida. FAU - Lennon, Ryan J AU - Lennon RJ AUID- ORCID: 0000-0002-8366-8422 AD - Department of Health Sciences Research Mayo Clinic Rochester Minnesota. FAU - Goodman, Shaun G AU - Goodman SG AUID- ORCID: 0000-0001-8068-2440 AD - St. Michael's HospitalUniversity of Toronto Toronto Ontario Canada. AD - Canadian VIGOUR Centre University of Alberta Edmonton Alberta Canada. FAU - Kim, Sang-Wook AU - Kim SW AUID- ORCID: 0000-0002-7208-8596 AD - Chung-Ang University Hospital Seoul Korea. FAU - O'Cochlain, Fearghas AU - O'Cochlain F AD - Mayo Clinic Health System - Eau Claire Eau Claire Wisconsin. FAU - So, Derek Y AU - So DY AUID- ORCID: 0000-0002-3909-5698 AD - University of Ottawa Heart Institute Ottawa Ontario Canada. FAU - Sweeney, John AU - Sweeney J AD - Mayo Clinic Arizona Scottsdale Arizona. FAU - Rihal, Charanjit S AU - Rihal CS AUID- ORCID: 0000-0003-2044-4664 AD - Department of Cardiovascular Medicine Mayo Clinic Rochester Minnesota. FAU - Farkouh, Michael AU - Farkouh M AD - St. Michael's HospitalUniversity of Toronto Toronto Ontario Canada. AD - Canadian VIGOUR Centre University of Alberta Edmonton Alberta Canada. FAU - Pereira, Naveen L AU - Pereira NL AUID- ORCID: 0000-0003-3813-3469 AD - Department of Cardiovascular Medicine Mayo Clinic Rochester Minnesota. LA - eng SI - ClinicalTrials.gov/NCT01742117 GR - U01 HL128606/HL/NHLBI NIH HHS/United States GR - U01 HL128626/HL/NHLBI NIH HHS/United States PT - Clinical Trial PT - Journal Article PT - Research Support, N.I.H., Extramural DEP - 20220208 PL - England TA - J Am Heart Assoc JT - Journal of the American Heart Association JID - 101580524 RN - 0 (Platelet Aggregation Inhibitors) RN - A74586SNO7 (Clopidogrel) SB - IM MH - *Acute Coronary Syndrome/drug therapy MH - Clopidogrel/therapeutic use MH - Humans MH - *Myocardial Infarction/etiology MH - *Percutaneous Coronary Intervention/adverse effects MH - Platelet Aggregation Inhibitors/therapeutic use MH - *Stroke/etiology MH - Treatment Outcome PMC - PMC9245815 OTO - NOTNLM OT - antiplatelet therapy OT - genetic testing OT - ischemia OT - percutaneous coronary intervention EDAT- 2022/02/09 06:00 MHDA- 2022/04/09 06:00 PMCR- 2022/02/15 CRDT- 2022/02/08 08:39 PHST- 2022/02/09 06:00 [pubmed] PHST- 2022/04/09 06:00 [medline] PHST- 2022/02/08 08:39 [entrez] PHST- 2022/02/15 00:00 [pmc-release] AID - JAH37180 [pii] AID - 10.1161/JAHA.121.024156 [doi] PST - ppublish SO - J Am Heart Assoc. 2022 Feb 15;11(4):e024156. doi: 10.1161/JAHA.121.024156. Epub 2022 Feb 8. PMID- 35089380 OWN - NLM STAT- MEDLINE DCOM- 20220630 LR - 20261028 IS - 1615-2573 (Electronic) IS - 0910-8327 (Linking) VI - 37 IP - 8 DP - 2022 Aug TI - Use and outcomes of dual antiplatelet therapy for acute coronary syndrome in patients with chronic kidney disease: insights from the Canadian Observational Antiplatelet Study (COAPT). PG - 1291-1298 LID - 10.1007/s00380-022-02029-8 [doi] AB - Chronic kidney disease (CKD) increases the risk of adverse outcomes in acute coronary syndrome (ACS). The optimal regimen of dual antiplatelet therapy (DAPT) post-percutaneous coronary intervention (PCI) in CKD poses a challenge due to the increased bleeding and clotting tendencies, particularly since patients with CKD were underrepresented in randomized controlled trials. We examined the practice patterns of DAPT prescription stratified by the presence of CKD. The multicentre prospective Canadian Observational Antiplatelet Study (COAPT) enrolled patients with ACS between December 2011 and May 2013. The present study is a subgroup analysis comparing type and duration of DAPT and associated outcomes among patients with and without CKD (eGFR < 60 ml/min/1.73 m(2), calculated by CKD-EPI). Patients with CKD (275/1921, 14.3%) were prescribed prasugrel/ticagrelor less (18.5% vs 25.8%, p = 0.01) and had a shorter duration of DAPT therapy versus patients without CKD (median 382 vs 402 days, p = 0.003). CKD was associated with major adverse cardiovascular events (MACE) at 12 months (p < 0.001) but not bleeding when compared to patients without CKD. CKD was associated with MACE in both patients on prasugrel/ticagrelor (p = 0.017) and those on clopidogrel (p < 0.001) (p for heterogeneity = 0.70). CKD was associated with increased bleeding only among patients receiving prasugrel/ticagrelor (p = 0.007), but not among those receiving clopidogrel (p = 0.64) (p for heterogeneity = 0.036). Patients with CKD had a shorter DAPT duration and were less frequently prescribed potent P2Y(12) inhibitors than patients without CKD. Overall, compared with patients without CKD, patients with CKD had higher rates of MACE and similar bleeding rates. However, among those prescribed more potent P2Y(12) inhibitors, CKD was associated with more bleeding than those without CKD. Further studies are needed to better define the benefit/risk evaluation, and establish a more tailored and evidence-based DAPT regimen for this high-risk patient group. CI - (c) 2022. Springer Japan KK, part of Springer Nature. FAU - Graham, Carol Anne AU - Graham CA AD - University of Toronto, Toronto, Canada. FAU - Tan, Mary K AU - Tan MK AD - Canadian Heart Research Centre, Toronto, Canada. FAU - Chew, Derek P AU - Chew DP AD - College of Medicine & Public Health, Flinders University, Adelaide, Australia. FAU - Gale, Christopher P AU - Gale CP AD - University of Leeds, Leeds, UK. FAU - Fox, Keith A A AU - Fox KAA AD - Center for Cardiovascular Science, University of Edinburgh, Edinburgh, UK. FAU - Bagai, Akshay AU - Bagai A AD - University of Toronto, Toronto, Canada. AD - St Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada. FAU - Henderson, Mark A AU - Henderson MA AD - Health Sciences North, Sudbury, Canada. FAU - Quraishi, Ata Ur Rehman AU - Quraishi AUR AD - Queen Elizabeth II Health Sciences Centre, Dalhousie University, Halifax, Canada. FAU - Dery, Jean-Pierre AU - Dery JP AD - Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Laval University, Quebec, Canada. FAU - Cheema, Asim N AU - Cheema AN AD - Southlake Regional Health Centre, Newmarket, Canada. FAU - Fisher, Harold AU - Fisher H AD - University of Toronto, Toronto, Canada. AD - Medcan Clinic, Toronto, Canada. FAU - Brieger, David AU - Brieger D AD - Concord Hospital, University of Sydney, Sydney, Australia. FAU - Lutchmedial, Sohrab R AU - Lutchmedial SR AD - New Brunswick Heart Centre, Dalhousie University, Saint John, Canada. FAU - Lavi, Shahar AU - Lavi S AD - London Health Sciences Centre, Western University, London, Canada. FAU - Wong, Brian Y L AU - Wong BYL AD - Health Sciences North, Northern Ontario School of Medicine, Sudbury, Canada. FAU - Cieza, Tomas AU - Cieza T AD - Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Laval University, Quebec, Canada. FAU - Mehta, Shamir R AU - Mehta SR AD - Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Canada. FAU - Brass, Neil AU - Brass N AD - Royal Alexandra Hospital, Edmonton, Canada. FAU - Goodman, Shaun G AU - Goodman SG AD - University of Toronto, Toronto, Canada. AD - Canadian Heart Research Centre, Toronto, Canada. AD - St Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada. FAU - Yan, Andrew T AU - Yan AT AUID- ORCID: 0000-0002-2063-7485 AD - University of Toronto, Toronto, Canada. Andrew.Yan@unityhealth.to. AD - St Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada. Andrew.Yan@unityhealth.to. LA - eng PT - Journal Article DEP - 20220128 PL - Japan TA - Heart Vessels JT - Heart and vessels JID - 8511258 RN - 0 (Platelet Aggregation Inhibitors) RN - A74586SNO7 (Clopidogrel) RN - G89JQ59I13 (Prasugrel Hydrochloride) RN - GLH0314RVC (Ticagrelor) SB - IM MH - *Acute Coronary Syndrome/complications/drug therapy MH - Canada/epidemiology MH - Clopidogrel/adverse effects MH - Hemorrhage/chemically induced/epidemiology MH - Humans MH - *Percutaneous Coronary Intervention/adverse effects MH - Platelet Aggregation Inhibitors/adverse effects MH - Prasugrel Hydrochloride/adverse effects MH - Prospective Studies MH - *Renal Insufficiency, Chronic/complications/diagnosis/epidemiology MH - Ticagrelor MH - Treatment Outcome OTO - NOTNLM OT - Acute coronary syndrome OT - Antiplatelet therapy OT - Chronic kidney disease EDAT- 2022/01/29 06:00 MHDA- 2022/07/01 06:00 CRDT- 2022/01/28 12:12 PHST- 2021/07/18 00:00 [received] PHST- 2022/01/14 00:00 [accepted] PHST- 2022/01/29 06:00 [pubmed] PHST- 2022/07/01 06:00 [medline] PHST- 2022/01/28 12:12 [entrez] AID - 10.1007/s00380-022-02029-8 [pii] AID - 10.1007/s00380-022-02029-8 [doi] PST - ppublish SO - Heart Vessels. 2022 Aug;37(8):1291-1298. doi: 10.1007/s00380-022-02029-8. Epub 2022 Jan 28. PMID- 35089218 OWN - NLM STAT- MEDLINE DCOM- 20220307 LR - 20230103 IS - 1536-5964 (Electronic) IS - 0025-7974 (Print) IS - 0025-7974 (Linking) VI - 101 IP - 4 DP - 2022 Jan 28 TI - Febuxostat combined with hydration for the prevention of contrast-induced nephropathy in hyperuricemia patients undergoing percutaneous coronary intervention: A CONSORT-compliant randomized controlled trial. PG - e28683 LID - 10.1097/MD.0000000000028683 [doi] LID - e28683 AB - BACKGROUND: To assess the efficacy of febuxostat combined with hydration on contrast-induced nephropathy (CIN) in coronary heart disease patients with hyperuricemia undergoing percutaneous coronary intervention (PCI). METHODS: Patients with hyperuricemia who underwent PCI were randomly assigned to 2 groups. The control group was given hydration only, and the febuxostat group received febuxostat 40 mg daily before administration of contrast agent and hydration. The primary endpoint of the study was the incidence of CIN, defined as an increase in baseline serum creatinine concentration by 25% at 2 days after contrast media administration, and variations in the serum levels of creatinine, neutrophil gelatinase-associated lipocalin, uric acid, and estimated glomerular filtration rate were compared. RESULTS: A total of 202 patients with hyperuricemia were randomly assigned to either the febuxostat group (n = 100) or the control group (n = 102). The baseline characteristics of the 2 groups were similar. The incidence of CIN was 6.0% (6/100) in the febuxostat group and 14.71% (15/102) in the control group.The levels of neutrophil gelatinase-associated lipocalin at 6-hour and serum creatinine and uric acid at 48-hour in the febuxostat combined hydration group were lower than those in the control group after surgery, and the level of estimated glomerular filtration rate was higher than that in the control group (all P < .05). Multivariate logistic regression analysis revealed that febuxostat was an independent predictor of CIN. CONCLUSION: Our study demonstrated that prophylactic treatment with febuxostat combined with hydration can reduce the incidence of CIN in patients with coronary heart disease and hyperuricemia after PCI. CI - Copyright (c) 2022 the Author(s). Published by Wolters Kluwer Health, Inc. FAU - Ma, Guang AU - Ma G AD - Department of Cardiology, The First Affiliated Hospital of Henan University, Kaifeng, Henan, China. FAU - Li, Min AU - Li M FAU - Teng, Wei AU - Teng W FAU - He, Zhaohui AU - He Z FAU - Zhai, Xiaojv AU - Zhai X FAU - Xia, Zhenhua AU - Xia Z LA - eng PT - Journal Article PT - Randomized Controlled Trial PL - United States TA - Medicine (Baltimore) JT - Medicine JID - 2985248R RN - 0 (Contrast Media) RN - 0 (Gout Suppressants) RN - 0 (Lipocalin-2) RN - 101V0R1N2E (Febuxostat) RN - 268B43MJ25 (Uric Acid) RN - AYI8EX34EU (Creatinine) SB - IM MH - Combined Modality Therapy MH - Contrast Media/administration & dosage/*adverse effects MH - Coronary Angiography MH - Coronary Disease MH - Creatinine MH - Febuxostat/*therapeutic use MH - Fluid Therapy/*methods MH - Glomerular Filtration Rate MH - Gout Suppressants/*therapeutic use MH - Humans MH - Hyperuricemia/blood/complications MH - Kidney Diseases/*chemically induced MH - Lipocalin-2 MH - *Percutaneous Coronary Intervention/adverse effects MH - Treatment Outcome MH - Uric Acid/blood PMC - PMC8797528 COIS- The authors have no conflicts of interest to disclose. EDAT- 2022/01/29 06:00 MHDA- 2022/03/08 06:00 PMCR- 2022/01/28 CRDT- 2022/01/28 12:12 PHST- 2021/08/02 00:00 [received] PHST- 2022/01/03 00:00 [accepted] PHST- 2022/01/28 12:12 [entrez] PHST- 2022/01/29 06:00 [pubmed] PHST- 2022/03/08 06:00 [medline] PHST- 2022/01/28 00:00 [pmc-release] AID - 00005792-202201280-00033 [pii] AID - MD-D-21-05425 [pii] AID - 10.1097/MD.0000000000028683 [doi] PST - ppublish SO - Medicine (Baltimore). 2022 Jan 28;101(4):e28683. doi: 10.1097/MD.0000000000028683. PMID- 35035421 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20220430 IS - 1682-024X (Print) IS - 1681-715X (Electronic) IS - 1681-715X (Linking) VI - 38 IP - 1 DP - 2022 Jan-Feb TI - Application of tirofiban in patients with acute myocardial infarction complicated with diabetes and undergoing emergency interventional therapy. PG - 172-178 LID - 10.12669/pjms.38.1.4545 [doi] AB - OBJECTIVES: To investigate the application of tirofiban in patients with acute myocardial infarction complicated with diabetes and undergoing emergency interventional therapy. METHODS: Two hundred patients with acute ST-segment elevation myocardial infarction (STEMI) complicated with diabetes who underwent percutaneous coronary intervention (PCI) and found to have high thrombus burden in coronary artery admitted to our hospital from September 2018 to September 2020 were selected as subjects, and were divided into two groups according to the randomization method: the intravenous tirofiban bolus group and the intracoronary tirofiban bolus group, with 100 cases in each group. The levels of LVEF, LVESD and LVEDD were detected immediately after admission and 15 days after therapy, and the enzyme-linked immunosorbent assay was utilized to detect the levels of CK-MB, MMP-9 and hs-CRP. Furthermore, the levels of BNP, TNI, CR and UREA of the patients were analyzed, and the levels of ESR and FIB were detected with an automatic blood rheology analyzer to analyze the TIMI classification and the incidence of MACE in the two groups. RESULTS: Significant differences were seen between the two groups in the levels of various indicators after therapy. Fifteen days after therapy, the levels of LVEF and LVEDD were higher and the level of LVESD was lower in the intracoronary tirofiban bolus group than in the intravenous tirofiban bolus group (p<0.05); 3d after therapy, the levels of CK-MB, MMP-9 and BNP in the intracoronary tirofiban bolus group were lower than those in the intravenous tirofiban bolus group (p<0.05); 3d after therapy, the levels of TNI (p<0.05), CR and UREA in the intracoronary tirofiban bolus group were lower than those in the intravenous tirofiban bolus group, with no statistical difference (p>0.05); Similarly, 3d after therapy, the levels of TNI, Cr and Urea, as well as ESR, FIB and hs-CRP were lower in the intracoronary tirofiban bolus group than in the intravenous tirofiban bolus group (p<0.05). Compared with the intravenous tirofiban bolus group, the intracoronary tirofiban bolus group had a lower number of patients with Grade-0 and Grade-1, but a higher number of patients with Grade-2 and Grade-3 (p<0.05); Moreover, the incidence of MACE in the intracoronary tirofiban bolus group was lower than that in the intravenous tirofiban bolus group (p<0.05). CONCLUSION: In patients with STEMI complicated with diabetes who underwent PCI and found to have high thrombus burden in coronary artery, intracoronary bolus of tirofiban boasts superior therapeutic efficacy over intravenous bolus of tirofiban in significantly improving cardiac function, reducing myocardial cell damage, and improving renal function and myocardial inflammation of patients. CI - Copyright: (c) Pakistan Journal of Medical Sciences. FAU - Tang, Xiuying AU - Tang X AD - Xiuying Tang, Department of Cardiology, The First Hospital of Qinhuangdao, Qinhuangdao, 066000, Hebei, China. FAU - Li, Runjun AU - Li R AD - Runjun Li, Department of Critical Care Medicine, People's Hospital of Yangjiang, Yangjiang, 529500, Guangdong, China. FAU - Ma, Lixiang AU - Ma L AD - Lixiang Ma, Department of Cardiology, The First Hospital of Qinhuangdao, Qinhuangdao, 066000, Hebei, China. FAU - Zhang, Ting AU - Zhang T AD - Ting Zhang, Geriatrics Department, Baoding First Central Hospital, Baoding, 071000, Hebei, China. LA - eng PT - Journal Article PL - Pakistan TA - Pak J Med Sci JT - Pakistan journal of medical sciences JID - 100913117 PMC - PMC8713192 OTO - NOTNLM OT - Acute ST-segment elevation myocardial infarction OT - Cardiac function OT - Diabetes OT - Percutaneous coronary intervention COIS- Conflicts of interest: None. EDAT- 2022/01/18 06:00 MHDA- 2022/01/18 06:01 PMCR- 2022/01/01 CRDT- 2022/01/17 05:54 PHST- 2021/04/11 00:00 [received] PHST- 2021/08/03 00:00 [revised] PHST- 2021/08/26 00:00 [accepted] PHST- 2022/01/17 05:54 [entrez] PHST- 2022/01/18 06:00 [pubmed] PHST- 2022/01/18 06:01 [medline] PHST- 2022/01/01 00:00 [pmc-release] AID - PJMS-38-172 [pii] AID - 10.12669/pjms.38.1.4545 [doi] PST - ppublish SO - Pak J Med Sci. 2022 Jan-Feb;38(1):172-178. doi: 10.12669/pjms.38.1.4545. PMID- 34924173 OWN - NLM STAT- MEDLINE DCOM- 20220321 LR - 20220321 IS - 1879-1484 (Electronic) IS - 0021-9150 (Linking) VI - 344 DP - 2022 Mar TI - Outcome of early versus delayed invasive strategy in patients with non-ST-segment elevation myocardial infarction and chronic kidney disease not on dialysis. PG - 60-70 LID - S0021-9150(21)01463-5 [pii] LID - 10.1016/j.atherosclerosis.2021.11.024 [doi] AB - BACKGROUND AND AIMS: Because of paucity of published data, we evaluated the 2-year major clinical outcomes between early invasive (EI) and delayed invasive (DI) strategies according to the stage of chronic kidney disease (CKD) in patients with non-ST-segment elevation myocardial infarction (NSTEMI), who underwent a successful newer-generation drug-eluting stent (DES) implantation. METHODS: A total of 8241 NSTEMI patients were recruited from the Korea Acute Myocardial Infarction Registry (KAMIR). Based on baseline estimated glomerular filtration rate (eGFR; >/=90, 60-89, 30-59, and <30 mL/min/1.73 m(2)), the patients were classified into groups A (n = 3498), B (n = 3109), C (n = 1178), and D (n = 1178). Thereafter, these 4 groups were sub-classified into the EI and DI groups. Major adverse cardiac events (MACE), defined as all-cause death, recurrent MI (re-MI), and any repeat revascularization, were evaluated. RESULTS: After multivariable-adjusted and propensity score-adjusted analyses, the cumulative incidence of MACE (group A, p = 0.139 and p = 0.103, respectively; group B, p = 0.968 and p = 0.608, respectively; group C, p = 0.111 and p = 0.196, respectively; group D, p = 0.882 and p = 0.571, respectively), all-cause death, re-MI, and any repeat revascularization was similar between the EI and DI groups in the 4 different renal function groups. CONCLUSIONS: In the era of newer-generation DES, EI and DI strategies showed comparable major clinical outcomes in patients with NSTEMI and CKD during a 2-year follow-up period. However, to confirm these results, further randomized, large-scale, long-term follow-up studies are needed. CI - Copyright (c) 2021 Elsevier B.V. All rights reserved. FAU - Kim, Yong Hoon AU - Kim YH AD - Division of Cardiology, Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Republic of Korea. Electronic address: yhkim02@kangwon.ac.kr. FAU - Her, Ae-Young AU - Her AY AD - Division of Cardiology, Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Republic of Korea. FAU - Jeong, Myung Ho AU - Jeong MH AD - Department of Cardiology, Cardiovascular Center, Chonnam National University Hospital, Gwangju, Republic of Korea. FAU - Kim, Byeong-Keuk AU - Kim BK AD - Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. FAU - Hong, Sung-Jin AU - Hong SJ AD - Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. FAU - Lee, Seung-Jun AU - Lee SJ AD - Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. FAU - Ahn, Chul-Min AU - Ahn CM AD - Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. FAU - Kim, Jung-Sun AU - Kim JS AD - Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. FAU - Ko, Young-Guk AU - Ko YG AD - Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. FAU - Choi, Donghoon AU - Choi D AD - Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. FAU - Hong, Myeong-Ki AU - Hong MK AD - Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. FAU - Jang, Yangsoo AU - Jang Y AD - Department of Cardiology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea. CN - KAMIR investigators LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20211201 PL - Ireland TA - Atherosclerosis JT - Atherosclerosis JID - 0242543 SB - IM MH - *Drug-Eluting Stents MH - Humans MH - *Myocardial Infarction/etiology/therapy MH - *Non-ST Elevated Myocardial Infarction/diagnosis/therapy MH - *Percutaneous Coronary Intervention/adverse effects/methods MH - Renal Dialysis MH - *Renal Insufficiency, Chronic/diagnosis/therapy MH - Treatment Outcome OTO - NOTNLM OT - Drug-eluting stent OT - Non-ST-segment elevation myocardial infarction OT - Reperfusion EDAT- 2021/12/21 06:00 MHDA- 2022/03/22 06:00 CRDT- 2021/12/20 05:39 PHST- 2021/08/09 00:00 [received] PHST- 2021/10/13 00:00 [revised] PHST- 2021/11/24 00:00 [accepted] PHST- 2021/12/21 06:00 [pubmed] PHST- 2022/03/22 06:00 [medline] PHST- 2021/12/20 05:39 [entrez] AID - S0021-9150(21)01463-5 [pii] AID - 10.1016/j.atherosclerosis.2021.11.024 [doi] PST - ppublish SO - Atherosclerosis. 2022 Mar;344:60-70. doi: 10.1016/j.atherosclerosis.2021.11.024. Epub 2021 Dec 1. PMID- 34913631 OWN - NLM STAT- MEDLINE DCOM- 20220223 LR - 20220223 IS - 1827-1839 (Electronic) IS - 0392-9590 (Linking) VI - 41 IP - 1 DP - 2022 Feb TI - Prevalence of VOYAGER PAD trial exclusion criteria in unselected patients undergoing lower limb revascularization. PG - 56-62 LID - 10.23736/S0392-9590.21.04816-1 [doi] AB - BACKGROUND: The VOYAGER PAD trial investigated data on dual pathway inhibition after lower limb revascularization for peripheral arterial disease (PAD). Multiple exclusion criteria were applied. However, neither data on the prevalence of exclusion criteria nor on the total number of patients screened for inclusion was discussed. METHODS: We performed a single-center prospective observational study in unselected PAD patients undergoing lower limb revascularization. Demographic and disease-specific data was collected. RESULTS: One hundred fifty patients were included with only 29 patients (19.3%) as potential candidates for the VOYAGER PAD study medication. Poorly controlled diabetes or severe uncontrolled hypertension (33.3%), major tissue loss (18.7%), acute limb ischaemia within prior 2 weeks (17.3%) and a history of intracranial hemorrhage, stroke or TIA (16%) were amongst the exclusion criteria most frequently met. Compared to VOYAGER PAD study patients, significant differences regarding sex (36.7% female vs. 25.8%), renal insufficiency (29.0% vs. 20.1%), previous myocardial infarction (16.7% vs. 11.1%) and known carotid artery disease (18.7% vs. 8.6%) revealed. Patients presented significantly more frequently with critical limb ischemia (56.7% vs. 30.4%) and a history of previous peripheral revascularization (72.0% vs. 35.9%). Fewer endovascular interventions (52% vs. 65.5%) and more surgeries (58% vs. 34.5%) were performed. CONCLUSIONS: In unselected patients undergoing revascularization for peripheral arterial disease, the majority presents with characteristics that, at present, preclude prescription of rivaroxaban in addition to aspirin. This patient cohort represents a population with higher rates of comorbidities and more complex vascular interventions, but might also benefit from dual pathway inhibition strategy. FAU - Moll, Maria A AU - Moll MA AD - Department of Vascular Surgery, Medical University of Innsbruck, Innsbruck, Austria. FAU - Zwerger, Daniela AU - Zwerger D AD - Department of Vascular Surgery, Medical University of Innsbruck, Innsbruck, Austria. FAU - Grassl, Kristina J AU - Grassl KJ AD - Department of Vascular Surgery, Medical University of Innsbruck, Innsbruck, Austria. FAU - Westreicher, Werner AU - Westreicher W AD - Department of Vascular Surgery, Medical University of Innsbruck, Innsbruck, Austria. FAU - Neururer, Sabrina B AU - Neururer SB AD - Department of Clinical Epidemiology, Tyrolean Federal Institute for Integrated Care, Tirol Kliniken GmbH, Innsbruck, Austria. FAU - Moll, Clemens W AU - Moll CW AD - Department of Vascular Surgery, Medical University of Innsbruck, Innsbruck, Austria. FAU - Wipper, Sabine H AU - Wipper SH AD - Department of Vascular Surgery, Medical University of Innsbruck, Innsbruck, Austria. FAU - Klocker, Josef AU - Klocker J AD - Department of Vascular Surgery, Medical University of Innsbruck, Innsbruck, Austria - josef.klocker@i-med.ac.at. LA - eng PT - Journal Article PT - Observational Study DEP - 20211216 PL - Italy TA - Int Angiol JT - International angiology : a journal of the International Union of Angiology JID - 8402693 RN - 9NDF7JZ4M3 (Rivaroxaban) RN - R16CO5Y76E (Aspirin) SB - IM MH - Aspirin/therapeutic use MH - Female MH - Humans MH - Lower Extremity/blood supply MH - Male MH - *Peripheral Arterial Disease/diagnosis/epidemiology/surgery MH - Prevalence MH - Risk Factors MH - Rivaroxaban/therapeutic use MH - Treatment Outcome EDAT- 2021/12/17 06:00 MHDA- 2022/02/24 06:00 CRDT- 2021/12/16 09:58 PHST- 2021/12/17 06:00 [pubmed] PHST- 2022/02/24 06:00 [medline] PHST- 2021/12/16 09:58 [entrez] AID - S0392-9590.21.04816-1 [pii] AID - 10.23736/S0392-9590.21.04816-1 [doi] PST - ppublish SO - Int Angiol. 2022 Feb;41(1):56-62. doi: 10.23736/S0392-9590.21.04816-1. Epub 2021 Dec 16. PMID- 34801614 OWN - NLM STAT- MEDLINE DCOM- 20220126 LR - 20220126 IS - 1874-1754 (Electronic) IS - 0167-5273 (Linking) VI - 346 DP - 2022 Jan 1 TI - Simple risk-score model for in-hospital major bleeding based on multiple blood variables in patients with acute myocardial infarction. PG - 1-7 LID - S0167-5273(21)01862-3 [pii] LID - 10.1016/j.ijcard.2021.11.046 [doi] AB - BACKGROUND: In-hospital bleeding is associated with poor prognosis in patients with acute myocardial infarction (AMI). We sought to investigate whether a combination of pre-procedural blood tests could predict the incidence of in-hospital major bleeding in patients with AMI. METHODS AND RESULTS: A total of 1684 consecutive AMI patients who underwent primary percutaneous coronary intervention (PCI) were recruited and randomly divided into derivation (n = 1010) and validation (n = 674) cohorts. A risk-score model was created based on a combination of parameters assessed on routine blood tests on admission. In the derivation cohort, multivariate analysis revealed that the following 5 variables were significantly associated with in-hospital major bleeding: hemoglobin level < 12 g/dL (odds ratio [OR], 3.32), white blood cell count >10,000/muL (OR, 2.58), platelet count <150,000/muL (OR, 2.51), albumin level < 3.8 mg/dL (OR, 2.51), and estimated glomerular filtration rate < 60 mL/min/1.73 m(2) (OR, 2.31). Zero to five points were given according to the number of these factors each patient had. Incremental risk scores were significantly associated with a higher incidence of in-hospital major bleeding in both cohorts (P < 0.001). Receiver operating characteristic curve analysis of risk models showed adequate discrimination between patients with and without in-hospital major bleeding (derivation cohort: area under the curve [AUC], 0.807; 95% confidence interval [CI], 0.759-0.848; validation cohort: AUC, 0.793; 95% CI, 0.725-0.847). CONCLUSIONS: Our novel laboratory-based bleeding risk model could be useful for simple and objective prediction of in-hospital major bleeding events in patients with AMI. CI - Copyright (c) 2021 Elsevier B.V. All rights reserved. FAU - Goriki, Yuhei AU - Goriki Y AD - Department of Cardiovascular Medicine, National Hospital Organization Ureshino Medical Center, Saga, Japan; Department of Cardiovascular Medicine, Saga University, Saga, Japan. FAU - Yoshioka, Goro AU - Yoshioka G AD - Department of Cardiovascular Medicine, Saga University, Saga, Japan. FAU - Natsuaki, Masahiro AU - Natsuaki M AD - Department of Cardiovascular Medicine, Saga University, Saga, Japan. Electronic address: natsuakm@cc.saga-u.ac.jp. FAU - Shinzato, Kodai AU - Shinzato K AD - Department of Cardiovascular Medicine, Saga University, Saga, Japan. FAU - Nishihira, Kensaku AU - Nishihira K AD - Miyazaki Medical Association Hospital Cardiovascular Center, Miyazaki, Japan. FAU - Kuriyama, Nehiro AU - Kuriyama N AD - Miyazaki Medical Association Hospital Cardiovascular Center, Miyazaki, Japan. FAU - Shimomura, Mitsuhiro AU - Shimomura M AD - Department of Cardiovascular Medicine, National Hospital Organization Ureshino Medical Center, Saga, Japan. FAU - Inoue, Yohei AU - Inoue Y AD - Cardiovascular Center, Saga Medical Center, Koseikan, Saga, Japan. FAU - Nishikido, Toshiyuki AU - Nishikido T AD - Cardiovascular Center, Saga Medical Center, Koseikan, Saga, Japan. FAU - Kaneko, Tetsuya AU - Kaneko T AD - Department of Cardiovascular Medicine, Saga University, Saga, Japan. FAU - Yokoi, Kensuke AU - Yokoi K AD - Department of Cardiovascular Medicine, Saga University, Saga, Japan. FAU - Yajima, Ayumu AU - Yajima A AD - Department of Cardiovascular Medicine, Saga University, Saga, Japan. FAU - Sakamoto, Yoshiko AU - Sakamoto Y AD - Department of Cardiovascular Medicine, Saga University, Saga, Japan. FAU - Tago, Motoko AU - Tago M AD - Department of Cardiovascular Medicine, Saga University, Saga, Japan. FAU - Kawaguchi, Atsushi AU - Kawaguchi A AD - Center for Comprehensive Community Medicine, Saga University, Saga, Japan. FAU - Yamamoto, Fumi AU - Yamamoto F AD - Department of Cardiology, Karatsu Red-cross Hospital, Saga, Japan. FAU - Tanaka, Atsushi AU - Tanaka A AD - Department of Cardiovascular Medicine, Saga University, Saga, Japan. FAU - Yamaguchi, Takanori AU - Yamaguchi T AD - Department of Cardiovascular Medicine, Saga University, Saga, Japan. FAU - Shiraki, Aya AU - Shiraki A AD - Department of Cardiovascular Medicine, Saga University, Saga, Japan. FAU - Asaka, Machiko AU - Asaka M AD - Department of Cardiovascular Medicine, Saga University, Saga, Japan. FAU - Kotooka, Norihiko AU - Kotooka N AD - Department of Cardiovascular Medicine, Saga University, Saga, Japan. FAU - Sonoda, Shinjo AU - Sonoda S AD - Department of Cardiovascular Medicine, Saga University, Saga, Japan. FAU - Hikichi, Yutaka AU - Hikichi Y AD - Cardiovascular Center, Saga Medical Center, Koseikan, Saga, Japan. FAU - Shibata, Yoshisato AU - Shibata Y AD - Miyazaki Medical Association Hospital Cardiovascular Center, Miyazaki, Japan. FAU - Node, Koichi AU - Node K AD - Department of Cardiovascular Medicine, Saga University, Saga, Japan. LA - eng PT - Journal Article DEP - 20211119 PL - Netherlands TA - Int J Cardiol JT - International journal of cardiology JID - 8200291 SB - IM MH - Hemorrhage/diagnosis/epidemiology MH - Hospitals MH - Humans MH - *Myocardial Infarction/diagnosis/epidemiology/therapy MH - *Percutaneous Coronary Intervention/adverse effects MH - Risk Assessment MH - Risk Factors OTO - NOTNLM OT - Acute myocardial infarction OT - Biomarker OT - Bleeding EDAT- 2021/11/22 06:00 MHDA- 2022/01/27 06:00 CRDT- 2021/11/21 20:40 PHST- 2021/09/25 00:00 [received] PHST- 2021/10/30 00:00 [revised] PHST- 2021/11/16 00:00 [accepted] PHST- 2021/11/22 06:00 [pubmed] PHST- 2022/01/27 06:00 [medline] PHST- 2021/11/21 20:40 [entrez] AID - S0167-5273(21)01862-3 [pii] AID - 10.1016/j.ijcard.2021.11.046 [doi] PST - ppublish SO - Int J Cardiol. 2022 Jan 1;346:1-7. doi: 10.1016/j.ijcard.2021.11.046. Epub 2021 Nov 19. PMID- 34798205 OWN - NLM STAT- MEDLINE DCOM- 20220126 LR - 20220924 IS - 1874-1754 (Electronic) IS - 0167-5273 (Linking) VI - 346 DP - 2022 Jan 1 TI - Relationship betweeen the amount and location of macrophages and clinical outcome: subanalysis of the CLIMA-study. PG - 8-12 LID - S0167-5273(21)01858-1 [pii] LID - 10.1016/j.ijcard.2021.11.042 [doi] AB - BACKGROUND: The ability of optical coherence tomography (OCT) to recognize intraplaque macrophage infiltration is now well acknowledged. This post-hoc analysis of the CLIMA study aimed to address the clinical impact of the circumferential extension of OCT-defined macrophages and their location at one year follow-up. METHODS: The multicentre CLIMA study enrolled 1003 patients undergoing OCT evaluation of the untreated proximal left anterior descending (LAD) coronary artery. Measurements of circumferential extension of macrophages and measurements of the distance from intima-lumen contour to macrophages string were performed at the plaque cross-section judged as containing the greatest amount of macrophages. The main study endpoint was a composite of cardiac death, myocardial infarction (MI) and/or target vessel revascularization (TVR). RESULTS: Patients with large macrophage arc (p = 0.001) and superficial macrophage arc (p < 0.001) showed a higher one-year incidence of the main one-year composite endpoint. Consistently hypertension (p = 0.018), family history of CAD (p = 0.046), diabetes mellitus (p = 0.036), lower ejection fraction (p = 0.009) and chronic kidney disease (p = 0.019) were more frequently found in patients experiencing the main composite endpoint. At multivariate Cox regression analysis, fibrous cap thickness < 75 mum (HR 2.51, 95% 1.46-4.32), presence of large (HR 1.97, 95%CI 1.16-3.35, p = 0.012) and superficial (HR 1.72, 95%CI 1.02-2.90; p = 0.040) macrophage arc remained independent predictors of the main composite endpoint. Large macrophage arc was associated with target LAD related MI. CONCLUSION: The present post-hoc analysis of the CLIMA showed that the circumferential extension of macrophages and their location are related to a composite endpoint of cardiac death, MI and/or TVR. CI - Copyright (c) 2021. Published by Elsevier B.V. FAU - Gatto, Laura AU - Gatto L AD - Cardiovascular Sciences Department, San Giovanni Addolorata Hospital, Rome, Italy; Centro per la Lotta Contro L'Infarto - CLI Foundation, Rome, Italy. FAU - Alfonso, Fernando AU - Alfonso F AD - Department of Cardiology, Hospital Universitario de La Princesa, Madrid, Spain. FAU - Paoletti, Giulia AU - Paoletti G AD - Centro per la Lotta Contro L'Infarto - CLI Foundation, Rome, Italy; Department of Cardiology, Hospital Universitario de La Princesa, Madrid, Spain; UniCamillus - Saint Camillus International University of Health Sciences, Rome, Italy. FAU - Burzotta, Francesco AU - Burzotta F AD - Department of Cardiovascular and Thoracic Sciences, Universita Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy. FAU - La Manna, Alessio AU - La Manna A AD - Cardio-Thoracic Vascular Department, Azienda ospedaliero-Universitaria "Policlinico Vittorio-Emanuele", University of Catania, Catania, Italy. FAU - Budassi, Simone AU - Budassi S AD - Cardiovascular Sciences Department, San Giovanni Addolorata Hospital, Rome, Italy; Centro per la Lotta Contro L'Infarto - CLI Foundation, Rome, Italy. FAU - Biccire, Flavio Giuseppe AU - Biccire FG AD - Cardiovascular Sciences Department, San Giovanni Addolorata Hospital, Rome, Italy; Centro per la Lotta Contro L'Infarto - CLI Foundation, Rome, Italy; Sapienza University of Rome, Rome, Italy. FAU - Fineschi, Massimo AU - Fineschi M AD - Department of Cardiovascular Diseases, Azienda Ospedaliera Universitaria Senese, Siena, Italy. FAU - Marco, Valeria AU - Marco V AD - Centro per la Lotta Contro L'Infarto - CLI Foundation, Rome, Italy. FAU - Fabbiocchi, Franco AU - Fabbiocchi F AD - Centro Cardiologico Monzino, IRCCS, Milan, Italy. FAU - Vergallo, Rocco AU - Vergallo R AD - Department of Cardiovascular and Thoracic Sciences, Universita Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy. FAU - Boi, Alberto AU - Boi A AD - Interventional Cardiology Unit, Ospedale Brotzu, Cagliari, Italy. FAU - Ruscica, Giovanni AU - Ruscica G AD - Centro per la Lotta Contro L'Infarto - CLI Foundation, Rome, Italy. FAU - Versaci, Francesco AU - Versaci F AD - Cardiology Department, Santa Maria Goretti Hospital, Latina, Italy. FAU - Taglieri, Nevio AU - Taglieri N AD - Cardio-Thoracic Vascular Department, University Hospital of Bologna, Bologna, Italy. FAU - Calligaris, Giuseppe AU - Calligaris G AD - Centro Cardiologico Monzino, IRCCS, Milan, Italy. FAU - Albertucci, Mario AU - Albertucci M AD - Centro per la Lotta Contro L'Infarto - CLI Foundation, Rome, Italy. FAU - Romagnoli, Enrico AU - Romagnoli E AD - Department of Cardiovascular and Thoracic Sciences, Universita Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy. FAU - Ramazzotti, Vito AU - Ramazzotti V AD - Cardiovascular Sciences Department, San Giovanni Addolorata Hospital, Rome, Italy. FAU - Tamburino, Corrado AU - Tamburino C AD - Cardio-Thoracic Vascular Department, Azienda ospedaliero-Universitaria "Policlinico Vittorio-Emanuele", University of Catania, Catania, Italy. FAU - Crea, Filippo AU - Crea F AD - Department of Cardiovascular and Thoracic Sciences, Universita Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy. FAU - Ozaki, Yukio AU - Ozaki Y AD - Department of Cardiology, Fujita Health University Hospital, Toyoake, Japan. FAU - Arbustini, Eloisa AU - Arbustini E AD - Centre for Inherited Cardiovascular Diseases, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy. FAU - Prati, Francesco AU - Prati F AD - Cardiovascular Sciences Department, San Giovanni Addolorata Hospital, Rome, Italy; Centro per la Lotta Contro L'Infarto - CLI Foundation, Rome, Italy; Department of Cardiology, Hospital Universitario de La Princesa, Madrid, Spain; UniCamillus - Saint Camillus International University of Health Sciences, Rome, Italy. Electronic address: fprati@hsangiovanni.roma.it. LA - eng PT - Journal Article PT - Multicenter Study DEP - 20211117 PL - Netherlands TA - Int J Cardiol JT - International journal of cardiology JID - 8200291 SB - IM CIN - Int J Cardiol. 2022 Sep 1;362:24-25. doi: 10.1016/j.ijcard.2022.05.059. PMID: 35662557 MH - *Coronary Artery Disease/diagnostic imaging MH - Coronary Vessels MH - Humans MH - Macrophages MH - *Percutaneous Coronary Intervention MH - *Plaque, Atherosclerotic MH - Predictive Value of Tests MH - Risk Factors MH - Tomography, Optical Coherence MH - Treatment Outcome OTO - NOTNLM OT - Macrophages OT - Myocardial infarction OT - Optical coherence tomography OT - Outcomes OT - Vulnerable plaque EDAT- 2021/11/20 06:00 MHDA- 2022/01/27 06:00 CRDT- 2021/11/19 20:17 PHST- 2021/06/02 00:00 [received] PHST- 2021/10/30 00:00 [revised] PHST- 2021/11/15 00:00 [accepted] PHST- 2021/11/20 06:00 [pubmed] PHST- 2022/01/27 06:00 [medline] PHST- 2021/11/19 20:17 [entrez] AID - S0167-5273(21)01858-1 [pii] AID - 10.1016/j.ijcard.2021.11.042 [doi] PST - ppublish SO - Int J Cardiol. 2022 Jan 1;346:8-12. doi: 10.1016/j.ijcard.2021.11.042. Epub 2021 Nov 17. PMID- 34797346 OWN - NLM STAT- MEDLINE DCOM- 20220214 LR - 20260225 IS - 1536-5964 (Electronic) IS - 0025-7974 (Print) IS - 0025-7974 (Linking) VI - 100 IP - 46 DP - 2021 Nov 19 TI - Effectiveness and safety of Xinkeshu on coronary artery disease patients combined with anxiety and depression symptoms after percutaneous coronary intervention: A protocol for systematic review and meta-analysis. PG - e27912 LID - 10.1097/MD.0000000000027912 [doi] LID - e27912 AB - BACKGROUND: It's known that coronary heart disease (CHD) patients after percutaneous coronary intervention (PCI) was significantly associated with anxiety and depression symptoms. Several studies have showed that Xinkeshu tablet (XKS), a kind of Chinese herbal medicine, could effectively improve post-PCI postoperative mood disorders in CHD patients. However, the intensity of evidence has been poor, limiting the further clinical application of XKS to patients above. This systematic review and meta-analysis will assess the effectiveness and safety of studies of XKS in CHD patients with anxiety and depression symptoms after PCI. METHODS: A systematic literature search for articles up to December 2021 will be performed in following electronic databases: PubMed, Embase, the Cochrane Library, China National Knowledge Infrastructure, Chinese Scientific Journals Database Database, Chinese Biomedical Database, Chinese Biomedical Literature Service System, and Wanfang Database. Inclusion criteria are randomized controlled trials of XKS applied on patients with CHD and depression. The primary outcome measures will be CHD-related clinical evaluation (frequency of acute attack angina, severity of angina pectoris, electrocardiographic changes, amount of nitroglycerin) and the scores or reducing fractions of depressive and anxiety measuring scales (the Hospital Anxiety/Depression Scale or other widely used anxiety/depression scale). The safety outcome measures will be adverse events, liver and kidney function. RevMan 5.3 software will be used for data synthesis, sensitivity analysis, subgroup analysis, and risk of bias assessment. A funnel plot will be developed to evaluate reporting bias. Stata 12.0 will be used for meta-regression and Egger tests. We will use the Grading of Recommendations Assessment, Development and Evaluation system to assess the quality of evidence. DISCUSSION: This study will provide a high-quality synthesis of the effects and safety of XKS for CHD patients with anxiety and depression symptoms after PCI. ETHICS AND DISSEMINATION: This systematic review does not require ethics approval and will be submitted to a peer-reviewed journal.Trial registration number PROSPERO CRD42019131346. CI - Copyright (c) 2021 the Author(s). Published by Wolters Kluwer Health, Inc. FAU - Chen, Mingtai AU - Chen M AUID- ORCID: 0000-0003-4579-5559 AD - Department of Cardiovascular Disease, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China. FAU - Zhong, Guofu AU - Zhong G AD - Intensive Care Unit, Shenzhen Traditional Chinese Medicine Hospital, Guangzhou University of Chinese Medicine, Shenzhen, China. FAU - Men, Ling AU - Men L AD - Nephrology Department, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China. FAU - Liu, Qiang AU - Liu Q AD - Department of Cardiovascular Disease, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China. FAU - Luan, Jienan AU - Luan J AD - Department of Cardiovascular Disease, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China. LA - eng GR - JCYJ20210324111213038/Shenzhen Science and Technology Program/ GR - SZSM201612033/Sanming Project of Medicine in Shenzhen/ PT - Journal Article PL - United States TA - Medicine (Baltimore) JT - Medicine JID - 2985248R RN - 0 (Drugs, Chinese Herbal) RN - 0 (xinkeshu) SB - IM MH - Humans MH - *Anxiety/etiology MH - *Coronary Artery Disease/complications/therapy MH - *Depression/etiology MH - *Drugs, Chinese Herbal/administration & dosage/adverse effects MH - Meta-Analysis as Topic MH - *Percutaneous Coronary Intervention/adverse effects/psychology MH - Research Design MH - Systematic Reviews as Topic MH - Randomized Controlled Trials as Topic PMC - PMC8601293 COIS- The authors have no conflicts of interest to disclose. EDAT- 2021/11/20 06:00 MHDA- 2022/02/15 06:00 PMCR- 2021/11/19 CRDT- 2021/11/19 12:15 PHST- 2021/11/04 00:00 [received] PHST- 2021/11/08 00:00 [accepted] PHST- 2021/11/19 12:15 [entrez] PHST- 2021/11/20 06:00 [pubmed] PHST- 2022/02/15 06:00 [medline] PHST- 2021/11/19 00:00 [pmc-release] AID - 00005792-202111190-00076 [pii] AID - MD-D-21-07366 [pii] AID - 10.1097/MD.0000000000027912 [doi] PST - ppublish SO - Medicine (Baltimore). 2021 Nov 19;100(46):e27912. doi: 10.1097/MD.0000000000027912. PMID- 34772347 OWN - NLM STAT- MEDLINE DCOM- 20220128 LR - 20240818 IS - 1471-2261 (Electronic) IS - 1471-2261 (Linking) VI - 21 IP - 1 DP - 2021 Nov 12 TI - Clinical outcomes in 2481 unselected real-world patients treated with a polymer-free sirolimus-eluting stent: 3 years results from the NANO multicenter Registry. PG - 537 LID - 10.1186/s12872-021-02356-0 [doi] LID - 537 AB - OBJECTIVES: To evaluate the 3-year clinical outcomes of a polymer-free sirolimus-eluting, Nano plus stent for the treatment of coronary artery disease in the NANO multicenter Registry. BACKGROUND: The long-term clinical data evaluating the safety and efficacy of the novel polymer-free sirolimus-eluting Nano plus stent (Lepu Medical, Beijing, China) is limited. METHODS: The NANO all-comers Registry trial was a prospective, multicenter clinical registry conducted in 26 centers in China between August 2016 and January 2017. A total of 2481 consecutive patients were exclusively treated with the Nano plus stent. The primary clinical endpoint, target lesion failure (TLF, defined as cardiac death, target vessel nonfatal myocardial infarction, and clinically driven target lesion revascularization [CD-TLR]), was analyzed at 3 years. RESULTS: At 3 years, 2295 patients (92.5%) were followed. The incidence of TLF was 6.8% (168/2481). The rate of cardiac death was 3.8% (94/2481), target vessel nonfatal myocardial infarction 0.7% (18/2481), and CD-TLR 2.9% (68/2481). The rate of definite/probable stent thrombosis was 0.5% (13/2481). The risk factors of diabetes mellitus, acute myocardial infarction, age, chronic renal failure, in-stent restenosis, chronic total occlusion, and left ventricular ejection fraction < 40% were the independent predictors of 3-year TLF. CONCLUSIONS: At three years, the rate of TLF was relatively low in patients treated with the polymer-free Nano plus stent. The polymer-free Nano plus stent showed a favorable safety and efficacy profile in real-world patients. Clinical trial registration URL: https://www.clinicaltrials.gov/ . Unique identifier: NCT02929030. CI - (c) 2021. The Author(s). FAU - Dai, Yi AU - Dai Y AD - Medical School of Nankai University, Tianjin, China. FAU - Wang, Rutao AU - Wang R AD - Department of Cardiology, The First Affiliated Hospital of The Fourth Military Medical University, Xi'an, Shaanxi, China. FAU - Chen, Fengying AU - Chen F AD - Department of Cardiology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China. FAU - Zhang, Yaojun AU - Zhang Y AD - Department of Cardiology, Xuzhou Third People's Hospital, Xuzhou Medical University, Xuzhou, China. FAU - Liu, Yi AU - Liu Y AD - Department of Cardiology, The First Affiliated Hospital of The Fourth Military Medical University, Xi'an, Shaanxi, China. FAU - Huang, He AU - Huang H AD - Department of Cardiology, Xiangtan Central Hospital, Xiangtan, China. FAU - Yang, Ping AU - Yang P AD - Department of Cardiology, China Japan Union Hospital of Jilin University, Changchun, China. FAU - Zhang, Ruining AU - Zhang R AD - Department of Cardiology, The First Affiliated Hospital of The Fourth Military Medical University, Xi'an, Shaanxi, China. FAU - Zheng, Bo AU - Zheng B AD - Department of Cardiology, The First Affiliated Hospital of The Fourth Military Medical University, Xi'an, Shaanxi, China. FAU - Gao, Chao AU - Gao C AD - Department of Cardiology, The First Affiliated Hospital of The Fourth Military Medical University, Xi'an, Shaanxi, China. woshigaochao@gmail.com. AD - Xijing Hospital, 127 Changle west road, Xi'an, 710032, China. woshigaochao@gmail.com. FAU - Chen, Yundai AU - Chen Y AD - Medical School of Nankai University, Tianjin, China. cyundai@vip.163.com. AD - Department of Cardiology, The Chinese PLA General Hospital, 28 Fu xing road, Beijing, 100853, China. cyundai@vip.163.com. FAU - Tao, Ling AU - Tao L AD - Department of Cardiology, The First Affiliated Hospital of The Fourth Military Medical University, Xi'an, Shaanxi, China. lingtaofmmu@qq.com. AD - Xijing Hospital, 127 Changle west road, Xi'an, 710032, China. lingtaofmmu@qq.com. LA - eng SI - ClinicalTrials.gov/NCT02929030 PT - Journal Article PT - Multicenter Study DEP - 20211112 PL - England TA - BMC Cardiovasc Disord JT - BMC cardiovascular disorders JID - 100968539 RN - 0 (Polymers) SB - IM MH - Aged MH - China MH - Coronary Artery Disease/complications/mortality/*surgery MH - *Drug-Eluting Stents/adverse effects MH - Female MH - Humans MH - Male MH - Middle Aged MH - Myocardial Infarction/etiology MH - *Percutaneous Coronary Intervention MH - Polymers MH - Prospective Studies MH - Prosthesis Failure MH - Registries MH - Treatment Failure PMC - PMC8588634 OTO - NOTNLM OT - Percutaneous coronary interventions OT - Polymer-free drug-eluting stent OT - Real-world population OT - Target lesion failure COIS- All the authors declare no conflicts of interest. EDAT- 2021/11/14 06:00 MHDA- 2022/01/29 06:00 PMCR- 2021/11/12 CRDT- 2021/11/13 05:24 PHST- 2021/05/21 00:00 [received] PHST- 2021/10/28 00:00 [accepted] PHST- 2021/11/13 05:24 [entrez] PHST- 2021/11/14 06:00 [pubmed] PHST- 2022/01/29 06:00 [medline] PHST- 2021/11/12 00:00 [pmc-release] AID - 10.1186/s12872-021-02356-0 [pii] AID - 2356 [pii] AID - 10.1186/s12872-021-02356-0 [doi] PST - epublish SO - BMC Cardiovasc Disord. 2021 Nov 12;21(1):537. doi: 10.1186/s12872-021-02356-0. PMID- 34740932 OWN - NLM STAT- MEDLINE DCOM- 20211206 LR - 20211214 IS - 2044-6055 (Electronic) IS - 2044-6055 (Linking) VI - 11 IP - 11 DP - 2021 Nov 5 TI - Efficacy of a glucagon-like peptide-1 agonist and restrictive versus liberal oxygen supply in patients undergoing coronary artery bypass grafting or aortic valve replacement: study protocol for a 2-by-2 factorial designed, randomised clinical trial. PG - e052340 LID - 10.1136/bmjopen-2021-052340 [doi] LID - e052340 AB - INTRODUCTION: Coronary artery bypass grafting (CABG) and/or aortic valve replacement (AVR) are associated with risk of death, as well as brain, heart and kidney injury. Glucagon-like peptide-1 (GLP-1) analogues are approved for treatment of type 2 diabetes, and GLP-1 analogues have been suggested to have potential organ-protective and anti-inflammatory effects. During cardiopulmonary bypass (CPB), consensus on the optimal fraction of oxygen is lacking. The objective of this study is to determine the efficacy of the GLP-1-analogue exenatide versus placebo and restrictive oxygenation (50% fractional inspired oxygen, FiO2) versus liberal oxygenation (100% FiO2) in patients undergoing open heart surgery. METHODS AND ANALYSIS: A randomised, placebo-controlled, double blind (for the exenatide intervention)/single blind (for the oxygenation strategy), 2x2 factorial designed single-centre trial on adult patients undergoing elective or subacute CABG and/or surgical AVR. Patients will be randomised in a 1:1 and 1:1 ratio to a 6-hour and 15 min infusion of 17.4 microg of exenatide or placebo during CPB and to a FiO2 of 50% or 100% during and after weaning from CPB. Patients will be followed until 12 months after inclusion of the last participant. The primary composite endpoint consists of time to first event of death, renal failure requiring renal replacement therapy, hospitalisation for stroke or heart failure. In addition, the trial will include predefined sub-studies applying more advanced measures of cardiac- and pulmonary dysfunction, renal dysfunction and cerebral dysfunction. The trial is event driven and aims at 323 primary endpoints with a projected inclusion of 1400 patients. ETHICS AND DISSEMINATION: Eligible patients will provide informed, written consent prior to randomisation. The trial is approved by the local ethics committee and is conducted in accordance with Danish legislation and the Declaration of Helsinki. The results will be presented in peer-reviewed journals. TRIAL REGISTRATION NUMBER: NCT02673931. CI - (c) Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. FAU - Wiberg, Sebastian AU - Wiberg S AUID- ORCID: 0000-0002-7062-7189 AD - Department of Cardiology, Rigshospitalet, Copenhagen, Denmark Sebastian.christoph.wiberg@regionh.dk. FAU - Kjaergaard, Jesper AU - Kjaergaard J AD - Department of Cardiology, Rigshospitalet, Copenhagen, Denmark. FAU - Mogelvang, Rasmus AU - Mogelvang R AD - Department of Cardiology, Rigshospitalet, Copenhagen, Denmark. FAU - Moller, Christian Holdflod AU - Moller CH AD - Department of Cardiothoracic Surgery, Rigshospitalet, Copenhagen, Denmark. FAU - Kandler, Kristian AU - Kandler K AD - Department of Cardiothoracic Surgery, Rigshospitalet, Copenhagen, Denmark. FAU - Ravn, Hanne AU - Ravn H AUID- ORCID: 0000-0003-4702-5195 AD - Department of Cardiothoracic Anesthesiology, Rigshospitalet, Copenhagen, Denmark. FAU - Hassager, Christian AU - Hassager C AUID- ORCID: 0000-0002-1199-0981 AD - Department of Cardiology, Rigshospitalet, Copenhagen, Denmark. FAU - Kober, Lars AU - Kober L AD - Department of Cardiology, Rigshospitalet, Copenhagen, Denmark. FAU - Nilsson, Jens Christian AU - Nilsson JC AD - Department of Cardiothoracic Anesthesiology, Rigshospitalet, Copenhagen, Denmark. LA - eng SI - ClinicalTrials.gov/NCT02673931 PT - Clinical Trial Protocol PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20211105 PL - England TA - BMJ Open JT - BMJ open JID - 101552874 RN - 89750-14-1 (Glucagon-Like Peptide 1) RN - S88TT14065 (Oxygen) SB - IM MH - Adult MH - Aortic Valve MH - Coronary Artery Bypass MH - *Diabetes Mellitus, Type 2 MH - Double-Blind Method MH - *Glucagon-Like Peptide 1 MH - Humans MH - Oxygen MH - Randomized Controlled Trials as Topic MH - Single-Blind Method MH - Treatment Outcome PMC - PMC8573662 OTO - NOTNLM OT - anaesthesia in cardiology OT - cardiac surgery OT - cardiothoracic surgery OT - ischaemic heart disease OT - valvular heart disease COIS- Competing interests: None declared. EDAT- 2021/11/07 06:00 MHDA- 2021/12/15 06:00 PMCR- 2021/11/05 CRDT- 2021/11/06 05:37 PHST- 2021/11/06 05:37 [entrez] PHST- 2021/11/07 06:00 [pubmed] PHST- 2021/12/15 06:00 [medline] PHST- 2021/11/05 00:00 [pmc-release] AID - bmjopen-2021-052340 [pii] AID - 10.1136/bmjopen-2021-052340 [doi] PST - epublish SO - BMJ Open. 2021 Nov 5;11(11):e052340. doi: 10.1136/bmjopen-2021-052340. PMID- 34706555 OWN - NLM STAT- MEDLINE DCOM- 20220107 LR - 20220107 IS - 1524-4539 (Electronic) IS - 0009-7322 (Print) IS - 0009-7322 (Linking) VI - 144 IP - 22 DP - 2021 Nov 30 TI - Benefits of Icosapent Ethyl Across the Range of Kidney Function in Patients With Established Cardiovascular Disease or Diabetes: REDUCE-IT RENAL. PG - 1750-1759 LID - 10.1161/CIRCULATIONAHA.121.055560 [doi] AB - BACKGROUND: Chronic kidney disease is associated with adverse outcomes among patients with established cardiovascular disease (CVD) or diabetes. Commonly used medications to treat CVD are less effective among patients with reduced kidney function. METHODS: REDUCE-IT (Reduction of Cardiovascular Events with Icosapent Ethyl-Intervention Trial) was a multicenter, double-blind, placebo-controlled trial that randomly assigned statin-treated patients with elevated triglycerides (135-499 mg/dL) who had CVD or diabetes and 1 additional risk factor to treatment with icosapent ethyl (4 g daily) or placebo. Patients from REDUCE-IT were categorized by prespecified estimated glomerular filtration rate (eGFR) categories to analyze the effect of icosapent ethyl on the primary end point (composite of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, coronary revascularization, or unstable angina) and key secondary end point (a composite of cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke). RESULTS: Among the 8179 REDUCE-IT patients, median baseline eGFR was 75 mL.min(-1).1.73 m(-2) (range, 17-123 mL.min(-1).1.73 m(-2)). There were no meaningful changes in median eGFR for icosapent ethyl versus placebo across study visits. Treatment with icosapent ethyl led to consistent reduction in both the primary and key secondary composite end points across baseline eGFR categories. Patients with eGFR <60 mL.min(-1).1.73 m(-2) treated with icosapent ethyl had the largest absolute and similar relative risk reduction for the primary composite end point (icosapent ethyl versus placebo, 21.8% versus 28.9%; hazard ratio [HR], 0.71 [95% CI, 0.59-0.85]; P=0.0002) and key secondary composite end point (16.8% versus 22.5%; HR 0.71 [95% CI, 0.57-0.88]; P=0.001). The numeric reduction in cardiovascular death was greatest in the eGFR <60 mL.min(-1).1.73 m(-2) group (icosapent ethyl: 7.6%; placebo: 10.6%; HR, 0.70 [95% CI, 0.51-0.95]; P=0.02). Although patients with eGFR <60 mL.min(-1).1.73 m(-2) treated with icosapent ethyl had the highest numeric rates of atrial fibrillation/flutter (icosapent ethyl: 4.2%; placebo 3.0%; HR 1.42 [95% CI, 0.86-2.32]; P=0.17) and serious bleeding (icosapent ethyl: 5.4%; placebo 3.6%; HR, 1.40 [95% CI, 0.90-2.18]; P=0.13), HRs for atrial fibrillation/flutter and serious bleeding were similar across eGFR categories (P-interaction for atrial fibrillation/flutter=0.92; P-interaction for serious bleeding=0.76). CONCLUSIONS: In REDUCE-IT, icosapent ethyl reduced fatal and nonfatal ischemic events across the broad range of baseline eGFR categories. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01492361. FAU - Majithia, Arjun AU - Majithia A AD - Division of Cardiovascular Medicine, Lahey Hospital and Medical Center, Burlington, MA (A.M.). FAU - Bhatt, Deepak L AU - Bhatt DL AUID- ORCID: 0000-0002-1278-6245 AD - Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (D.L.B., R.P.M.). FAU - Friedman, Allon N AU - Friedman AN AD - Department of Medicine, Indiana University School of Medicine, Indianapolis (A.N.F.). FAU - Miller, Michael AU - Miller M AUID- ORCID: 0000-0002-1679-2095 AD - Department of Medicine, University of Maryland School of Medicine, Baltimore (M.M.). FAU - Steg, Ph Gabriel AU - Steg PG AUID- ORCID: 0000-0001-6896-2941 AD - Universite de Paris, FACT (French Alliance for Cardiovascular Trials), Assistance Publique-Hopitaux de Paris, Hopital Bichat, INSERM Unite 1148, France (P.G.S.). FAU - Brinton, Eliot A AU - Brinton EA AUID- ORCID: 0000-0002-9807-4010 AD - Utah Lipid Center, Salt Lake City (E.A.B.). FAU - Jacobson, Terry A AU - Jacobson TA AD - Office of Health Promotion and Disease Prevention, Department of Medicine, Emory University School of Medicine, Atlanta, GA (T.A.J.). FAU - Ketchum, Steven B AU - Ketchum SB AD - Amarin Pharma, Inc., Bridgewater, NJ (S.B.K., R.A.J., L.J., R.T.D., C.G.). FAU - Juliano, Rebecca A AU - Juliano RA AUID- ORCID: 0000-0002-3714-6084 AD - Amarin Pharma, Inc., Bridgewater, NJ (S.B.K., R.A.J., L.J., R.T.D., C.G.). FAU - Jiao, Lixia AU - Jiao L AD - Amarin Pharma, Inc., Bridgewater, NJ (S.B.K., R.A.J., L.J., R.T.D., C.G.). FAU - Doyle, Ralph T Jr AU - Doyle RT Jr AUID- ORCID: 0000-0003-4068-7778 AD - Amarin Pharma, Inc., Bridgewater, NJ (S.B.K., R.A.J., L.J., R.T.D., C.G.). FAU - Granowitz, Craig AU - Granowitz C AD - Amarin Pharma, Inc., Bridgewater, NJ (S.B.K., R.A.J., L.J., R.T.D., C.G.). FAU - Budoff, Matthew AU - Budoff M AUID- ORCID: 0000-0002-9616-1946 AD - Division of Cardiology, Harbor UCLA Medical Center, Torrance, CA (M.B.). FAU - Preston Mason, R AU - Preston Mason R AUID- ORCID: 0000-0001-5483-1852 AD - Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (D.L.B., R.P.M.). FAU - Tardif, Jean-Claude AU - Tardif JC AUID- ORCID: 0000-0002-8200-8983 AD - Montreal Heart Institute, Universite de Montreal, Canada (J.-C.T.). FAU - Boden, William E AU - Boden WE AD - Division of Cardiovascular Medicine, Boston Medical Center, MA (W.E.B.). FAU - Ballantyne, Christie M AU - Ballantyne CM AUID- ORCID: 0000-0002-6432-1730 AD - Department of Medicine, Baylor College of Medicine, and Center for Cardiovascular Disease Prevention, Methodist DeBakey Heart and Vascular Center, Houston, TX (C.M.B.). LA - eng SI - ClinicalTrials.gov/NCT01492361 PT - Clinical Trial, Phase III PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20211028 PL - United States TA - Circulation JT - Circulation JID - 0147763 RN - 6GC8A4PAYH (eicosapentaenoic acid ethyl ester) RN - AAN7QOV9EA (Eicosapentaenoic Acid) SB - IM MH - Aged MH - *Cardiovascular Diseases/complications/drug therapy/physiopathology MH - Double-Blind Method MH - Eicosapentaenoic Acid/administration & dosage/adverse effects/*analogs & derivatives MH - Female MH - Glomerular Filtration Rate/*drug effects MH - Humans MH - Male MH - Middle Aged MH - *Renal Insufficiency, Chronic/etiology/physiopathology/prevention & control PMC - PMC8614567 OTO - NOTNLM OT - eicosapentaenoic acid ethyl ester OT - fatty acids OT - fatty acids, omega-3 OT - lipids OT - prevention and control OT - renal insufficiency, chronic OT - triglycerides EDAT- 2021/10/29 06:00 MHDA- 2022/01/08 06:00 PMCR- 2021/11/25 CRDT- 2021/10/28 05:24 PHST- 2021/10/29 06:00 [pubmed] PHST- 2022/01/08 06:00 [medline] PHST- 2021/10/28 05:24 [entrez] PHST- 2021/11/25 00:00 [pmc-release] AID - 10.1161/CIRCULATIONAHA.121.055560 [doi] PST - ppublish SO - Circulation. 2021 Nov 30;144(22):1750-1759. doi: 10.1161/CIRCULATIONAHA.121.055560. Epub 2021 Oct 28. PMID- 34682752 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20211026 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 10 IP - 20 DP - 2021 Oct 9 TI - Outcomes of Different Reperfusion Strategies of Multivessel Disease Undergoing Newer-Generation Drug-Eluting Stent Implantation in Patients with Non-ST-Elevation Myocardial Infarction and Chronic Kidney Disease. LID - 10.3390/jcm10204629 [doi] LID - 4629 AB - Because available data are limited, we compared the 2-year clinical outcomes among different reperfusion strategies (culprit-only percutaneous coronary intervention (C-PCI), multivessel PCI (M-PCI), complete revascularization (CR) and incomplete revascularization (IR)) of multivessel disease (MVD) undergoing newer-generation drug-eluting stent implantation in patients with non-ST-elevation myocardial infarction (NSTEMI) and chronic kidney disease (CKD). In this nonrandomized, multicenter, retrospective cohort study, a total of 1042 patients (C-PCI, n = 470; M-PCI, n = 572; CR, n = 432; IR, n = 140) were recruited from the Korea Acute Myocardial Infarction Registry (KAMIR) and evaluated. The primary outcome was the occurrence of major adverse cardiac events, defined as all-cause death, recurrent myocardial infarction and any repeat coronary revascularization. The secondary outcome was probable or definite stent thrombosis. During the 2-year follow-up period, the cumulative incidences of the primary (C-PCI vs. M-PCI, adjusted hazard ratio (aHR), 1.020; p = 0.924; CR vs. IR, aHR, 1.012; p = 0.967; C-PCI vs. CR, aHR, 1.042; p = 0.863; or C-PCI vs. IR, aHR, 1.060; p = 0.844) and secondary outcomes were statistically insignificant in the four comparison groups. In the contemporary newer-generation DES era, C-PCI may be a better reperfusion option for patients with NSTEMI with MVD and CKD rather than M-PCI, including CR and IR, with regard to the procedure time and the risk of contrast-induced nephropathy. However, further well-designed, large-scale randomized studies are warranted to confirm these results. FAU - Kim, Yong Hoon AU - Kim YH AUID- ORCID: 0000-0002-9669-3598 AD - Division of Cardiology, Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon 24289, Korea. FAU - Her, Ae-Young AU - Her AY AUID- ORCID: 0000-0002-9990-6843 AD - Division of Cardiology, Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon 24289, Korea. FAU - Jeong, Myung Ho AU - Jeong MH AD - Department of Cardiology, Cardiovascular Center, Chonnam National University Hospital, Gwangju 61469, Korea. FAU - Kim, Byeong-Keuk AU - Kim BK AD - Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul 03722, Korea. FAU - Hong, Sung-Jin AU - Hong SJ AUID- ORCID: 0000-0003-4893-039X AD - Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul 03722, Korea. FAU - Lee, Seung-Jun AU - Lee SJ AD - Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul 03722, Korea. FAU - Ahn, Chul-Min AU - Ahn CM AD - Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul 03722, Korea. FAU - Kim, Jung-Sun AU - Kim JS AD - Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul 03722, Korea. FAU - Ko, Young-Guk AU - Ko YG AD - Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul 03722, Korea. FAU - Choi, Donghoon AU - Choi D AD - Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul 03722, Korea. FAU - Hong, Myeong-Ki AU - Hong MK AD - Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul 03722, Korea. FAU - Jang, Yangsoo AU - Jang Y AUID- ORCID: 0000-0002-2169-3112 AD - Department of Cardiology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam 13496, Korea. LA - eng GR - 2016-ER6304-02/Korea Disease Control and Prevention Agency/ PT - Journal Article DEP - 20211009 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC8539165 OTO - NOTNLM OT - angioplasty OT - drug-eluting stents OT - multivessel disease OT - non-ST-elevation myocardial infarction COIS- The authors declared they do not have anything to disclose regarding conflict of interest with respect to this manuscript. EDAT- 2021/10/24 06:00 MHDA- 2021/10/24 06:01 PMCR- 2021/10/09 CRDT- 2021/10/23 01:12 PHST- 2021/09/08 00:00 [received] PHST- 2021/10/02 00:00 [revised] PHST- 2021/10/05 00:00 [accepted] PHST- 2021/10/23 01:12 [entrez] PHST- 2021/10/24 06:00 [pubmed] PHST- 2021/10/24 06:01 [medline] PHST- 2021/10/09 00:00 [pmc-release] AID - jcm10204629 [pii] AID - jcm-10-04629 [pii] AID - 10.3390/jcm10204629 [doi] PST - epublish SO - J Clin Med. 2021 Oct 9;10(20):4629. doi: 10.3390/jcm10204629. PMID- 34669586 OWN - NLM STAT- MEDLINE DCOM- 20220425 LR - 20260127 IS - 1969-6213 (Electronic) IS - 1774-024X (Print) IS - 1774-024X (Linking) VI - 17 IP - 18 DP - 2022 Apr 22 TI - Impact of preprocedural biological markers on 10-year mortality in the SYNTAXES trial. PG - 1477-1487 LID - EIJ-D-21-00415 [pii] LID - 10.4244/EIJ-D-21-00415 [doi] AB - BACKGROUND: Creatinine clearance (CrCl) is an independent determinant of mortality in predictive models of revascularisation outcomes for complex coronary artery disease. AIMS: This study aimed to investigate the impact of preprocedural biological markers on 10-year mortality following coronary revascularisation. METHODS: The SYNTAX Extended Survival (SYNTAXES) study evaluated the 10-year vital status follow-up of 1,800 patients with de novo three-vessel (3VD) and/or left main coronary artery disease (LMCAD) randomised to include percutaneous or surgical coronary revascularisation. The associations between mortality and preprocedural C-reactive protein (CRP), haemoglobin, HbA1c, CrCl, fasting triglycerides, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol were analysed. RESULTS: Out of 1,800 patients, 460 patients died before the 10-year follow-up. CRP, HbA1c and CrCl with threshold values of >/=2 mg/L, >/=6% (42 mmol/mol) and <60 ml/min, respectively, were associated with 10-year all-cause death (adjusted hazard ratio [95% confidence interval]: 1.35 [1.01-1.82], 1.51 [1.16-1.95], and 1.46 [1.07-2.00], respectively). There was no significant interaction between the biological markers on all-cause mortality and the type of revascularisation. Preprocedural lipid markers were not significantly associated with 10-year all-cause death, but the non-use of statins was a determinant factor of worse prognosis (adjusted hazard ratio [95% confidence interval]: 1.68 [1.26-2.25]). CONCLUSIONS: Preprocedural biomarkers, such as CRP and HbA1c, are associated with long-term mortality post revascularisation, regardless of the revascularisation technique. Conventional lipidic biomarkers associated with high-risk of cardiovascular events seem to be effectively mitigated by the long-term use of statins, whereas the non-use of statins was a factor of a worse prognosis, emphasising the importance of pharmacological treatment. TRIAL REGISTRATION: SYNTAXES ClinicalTrials.gov: NCT03417050. SYNTAX ClinicalTrials.gov: NCT00114972. FAU - Hara, Hironori AU - Hara H AD - Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands. AD - Department of Cardiology, National University of Ireland, Galway (NUIG), Galway, Ireland. FAU - Kawashima, Hideyuki AU - Kawashima H AD - Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands. AD - Department of Cardiology, National University of Ireland, Galway (NUIG), Galway, Ireland. FAU - Ono, Masafumi AU - Ono M AD - Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands. AD - Department of Cardiology, National University of Ireland, Galway (NUIG), Galway, Ireland. FAU - Takahashi, Kuniaki AU - Takahashi K AD - Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands. FAU - Mack, Michael J AU - Mack MJ AD - Department of Cardiothoracic Surgery, Baylor Scott & White Health, Dallas, TX, USA. FAU - Holmes, David R Jr AU - Holmes DR Jr AD - Department of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, MN, USA. FAU - Morice, Marie-Claude AU - Morice MC AD - Unite de Cardiologie, Hopital Prive Jacques Cartier, Generale de Sante Massy, Massy, France. FAU - Davierwala, Piroze M AU - Davierwala PM AD - University Department of Cardiac Surgery, Heart Centre Leipzig, Leipzig, Germany. FAU - Mohr, Friedrich W AU - Mohr FW AD - University Department of Cardiac Surgery, Heart Centre Leipzig, Leipzig, Germany. FAU - Thuijs, Daniel J F M AU - Thuijs DJFM AD - Department of Cardiothoracic Surgery, Erasmus University Medical Centre, Rotterdam, the Netherlands. FAU - Kappetein, Arie Pieter AU - Kappetein AP AD - Department of Cardiology, National University of Ireland, Galway (NUIG), Galway, Ireland. FAU - O'Leary, Neil AU - O'Leary N AD - Health Research Board Clinical Research Facility, Department of Medicine, NUIG, Galway, Ireland. FAU - van Klaveren, David AU - van Klaveren D AD - Department of Public Health, Center for Medical Decision Making, Erasmus MC, Rotterdam, the Netherlands. AD - Predictive Analytics and Comparative Effectiveness Center, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA. FAU - Onuma, Yoshinobu AU - Onuma Y AD - Department of Cardiology, National University of Ireland, Galway (NUIG), Galway, Ireland. FAU - Serruys, Patrick W AU - Serruys PW AD - Department of Cardiology, National University of Ireland, Galway (NUIG), Galway, Ireland. AD - NHLI, Imperial College London, London, United Kingdom. LA - eng SI - ClinicalTrials.gov/NCT03417050 SI - ClinicalTrials.gov/NCT00114972 PT - Journal Article PT - Randomized Controlled Trial PL - France TA - EuroIntervention JT - EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology JID - 101251040 RN - 0 (Biomarkers) RN - 97C5T2UQ7J (Cholesterol) RN - 0 (Glycated Hemoglobin) RN - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors) SB - IM MH - Biomarkers MH - Cholesterol MH - Coronary Artery Bypass/methods MH - *Coronary Artery Disease/complications/surgery MH - Glycated Hemoglobin MH - Humans MH - *Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use MH - *Percutaneous Coronary Intervention/methods MH - Treatment Outcome PMC - PMC9896405 COIS- H. Hara reports a grant for studying overseas from the Japanese Circulation Society and a grant from the Fukada Foundation for Medical Technology. M.C. Morice is CEO and shareholder of CERC, a CRO not involved in this trial, and is a minor shareholder of ELECTRODUCER. A. Kappetein reports working as an employee of Medtronic, outside the submitted work. P.W. Serruys reports personal fees from Biosensors, Micel Technologies, Sinomedical Sciences Technology, Philips/Volcano, Xeltis, HeartFlow, and SMT outside the submitted work. The other authors have no conflicts of interest to declare. EDAT- 2021/10/21 06:00 MHDA- 2022/04/26 06:00 PMCR- 2023/04/22 CRDT- 2021/10/20 17:21 PHST- 2021/10/21 06:00 [pubmed] PHST- 2022/04/26 06:00 [medline] PHST- 2021/10/20 17:21 [entrez] PHST- 2023/04/22 00:00 [pmc-release] AID - EIJ-D-21-00415 [pii] AID - 10.4244/EIJ-D-21-00415 [doi] PST - ppublish SO - EuroIntervention. 2022 Apr 22;17(18):1477-1487. doi: 10.4244/EIJ-D-21-00415. PMID- 34632982 OWN - NLM STAT- MEDLINE DCOM- 20220216 LR - 20230817 IS - 1558-2035 (Electronic) IS - 1558-2027 (Linking) VI - 23 IP - 2 DP - 2022 Feb 1 TI - Polymer-free biolimus-A9-eluting stent performance according to renal impairment: insights from the RUDI-FREE registry. PG - 127-134 LID - 10.2459/JCM.0000000000001269 [doi] AB - AIMS: Patients with chronic kidney disease (CKD) are at increased risk of cardiovascular disease and have a worse prognosis after percutaneous coronary interventions (PCI). The BioFreedom polymer-free biolimus-A9-eluting stent (PF-BES) has shown promising results in patients at high bleeding risk; however, its performance in CKD patients has yet to be analyzed. METHODS: The all-comers RUDI-FREE registry documented patients undergoing PCI with PF-BES in routine clinical practice. Patients were stratified into three groups according to their estimated glomerular filtration rate (eGFR): preserved renal function, mild renal insufficiency (RI), and with moderate to severe RI (eGFR >/= 90, between 90 and 45, and <45 ml/min/1.73 m2, respectively). The primary safety end point was a patient-oriented composite end point of cardiovascular death, myocardial infarction (MI), and definite or probable stent thrombosis (ST). The primary efficacy end point was target lesion revascularization (TLR). RESULTS: The registry documented 1,104 consecutive patients treated with PF-BES: 258 (23.4%) with preserved renal function, whereas 712 (64.7%) and 131 (11.9%) had mild and moderate to severe RI, respectively. At 1 year, the primary safety end point was significantly higher in patients with moderate to severe RI (3.5% vs. 2.8% vs. 11.5%; P < 0.001). Conversely, TLR proved similar among groups (0.4% vs. 1.8% vs. 0.8%; P = 0.235). CONCLUSIONS: Patients with worse renal function had increased risk of the composite of cardiovascular deaths, MI, and definite or probable ST. However, the PF-BES showed similar efficacy despite differences in renal function. These findings need to be confirmed in large-scale randomized trials. CI - Copyright (c) 2021 Italian Federation of Cardiology - I.F.C. All rights reserved. FAU - Chiarito, Mauro AU - Chiarito M AD - Humanitas Clinical and Research Hospital IRCCS. AD - Department of Biomedical Sciences, Humanitas University, Milan. FAU - Sturla, Matteo AU - Sturla M AD - Humanitas Clinical and Research Hospital IRCCS. AD - Department of Biomedical Sciences, Humanitas University, Milan. FAU - Briguori, Carlo AU - Briguori C AD - Clinica Mediterranea, Laboratory of Interventional Cardiology and Department of Cardiology, Naples, Italy. FAU - Mancone, Massimo AU - Mancone M AD - Policlinico Umberto I, Department of Cardiovascular Sciences, Rome. FAU - Tamburino, Corrado AU - Tamburino C AD - Ferrarotto Hospital, Department of Cardiology, Catania. FAU - Fabbiocchi, Franco AU - Fabbiocchi F AD - Centro Cardiologico Monzino, Milan. FAU - Trabattoni, Daniela AU - Trabattoni D AD - Centro Cardiologico Monzino, Milan. FAU - Tomai, Fabrizio AU - Tomai F AD - European Hospital, Laboratory of Interventional Cardiology and Department of Cardiology, Rome. FAU - Paggi, Anita AU - Paggi A AD - S. Anna Hospital, Laboratory of Interventional Cardiology and Department of Cardiology, Como. FAU - Gioffre, Gaetano AU - Gioffre G AD - S. Eugenio Hospital, Laboratory of Interventional Cardiology and Department of Cardiology, Rome. FAU - Sclafani, Rocco AU - Sclafani R AD - Azienda Ospedaliera di Perugia, Perugia. FAU - Giordano, Arturo AU - Giordano A AD - Clinica Pineta Grande, Laboratory of Interventional Cardiology and Department of Cardiology, Castel Volturno, Italy. FAU - Stefanini, Giulio G AU - Stefanini GG AD - Humanitas Clinical and Research Hospital IRCCS. AD - Department of Biomedical Sciences, Humanitas University, Milan. FAU - Sardella, Gennaro AU - Sardella G AD - Policlinico Umberto I, Department of Cardiovascular Sciences, Rome. LA - eng PT - Journal Article PT - Multicenter Study PT - Observational Study PL - United States TA - J Cardiovasc Med (Hagerstown) JT - Journal of cardiovascular medicine (Hagerstown, Md.) JID - 101259752 RN - U36PGF65JH (umirolimus) RN - W36ZG6FT64 (Sirolimus) SB - IM MH - Aged MH - Cardiovascular Diseases/mortality MH - *Drug-Eluting Stents/adverse effects MH - Female MH - Humans MH - Male MH - Middle Aged MH - Myocardial Infarction/epidemiology MH - *Percutaneous Coronary Intervention MH - Prospective Studies MH - Registries MH - Renal Insufficiency, Chronic/*epidemiology MH - Sirolimus/*analogs & derivatives MH - Thrombosis/epidemiology EDAT- 2021/10/12 06:00 MHDA- 2022/02/17 06:00 CRDT- 2021/10/11 08:51 PHST- 2021/10/12 06:00 [pubmed] PHST- 2022/02/17 06:00 [medline] PHST- 2021/10/11 08:51 [entrez] AID - 01244665-202202000-00010 [pii] AID - 10.2459/JCM.0000000000001269 [doi] PST - ppublish SO - J Cardiovasc Med (Hagerstown). 2022 Feb 1;23(2):127-134. doi: 10.2459/JCM.0000000000001269. PMID- 34582775 OWN - NLM STAT- MEDLINE DCOM- 20220407 LR - 20231107 IS - 1097-6744 (Electronic) IS - 0002-8703 (Print) IS - 0002-8703 (Linking) VI - 243 DP - 2022 Jan TI - Predictors of outcome in the ISCHEMIA-CKD trial: Anatomy versus ischemia. PG - 187-200 LID - S0002-8703(21)00237-4 [pii] LID - 10.1016/j.ahj.2021.09.008 [doi] AB - BACKGROUND: The ISCHEMIA-CKD (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches-Chronic Kidney Disease) trial found no advantage to an invasive strategy compared to conservative management in reducing all-cause death or myocardial infarction (D/MI). However, the prognostic influence of angiographic coronary artery disease (CAD) burden and ischemia severity remains unknown in this population. We compared the relative impact of CAD extent and severity of myocardial ischemia on D/MI in patients with advanced chronic kidney disease (CKD). METHODS: Participants randomized to invasive management with available data on coronary angiography and stress testing were included. Extent of CAD was defined by the number of major epicardial vessels with >/=50% diameter stenosis by quantitative coronary angiography. Ischemia severity was assessed by site investigators as moderate or severe using trial definitions. The primary endpoint was D/MI. RESULTS: Of the 388 participants, 307 (79.1%) had complete coronary angiography and stress testing data. D/MI occurred in 104/307 participants (33.9%). Extent of CAD was associated with an increased risk of D/MI (P < .001), while ischemia severity was not (P = .249). These relationships persisted following multivariable adjustment. Using 0-vessel disease (VD) as reference, the adjusted hazard ratio (HR) for 1VD was 1.86, 95% confidence interval (CI) 0.94 to 3.68, P = .073; 2VD: HR 2.13, 95% CI 1.10 to 4.12, P = .025; 3VD: HR 4.00, 95% CI 2.06 to 7.76, P < .001. Using moderate ischemia as the reference, the HR for severe ischemia was 0.84, 95% CI 0.54 to 1.30, P = .427. CONCLUSION: Among ISCHEMIA-CKD participants randomized to the invasive strategy, extent of CAD predicted D/MI whereas severity of ischemia did not. CI - Copyright (c) 2021 Elsevier Inc. All rights reserved. FAU - Bainey, Kevin R AU - Bainey KR AD - Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada. Electronic address: kevin.bainey@albertahealthservices.ca. FAU - Fleg, Jerome L AU - Fleg JL AD - National Heart Lung and Blood Institute, Bethesda, MD. FAU - Hochman, Judith S AU - Hochman JS AD - NYU Grossman School of Medicine, New York, NY. FAU - Kunichoff, Dennis F AU - Kunichoff DF AD - NYU Grossman School of Medicine, New York, NY. FAU - Anthopolos, Rebecca AU - Anthopolos R AD - NYU Grossman School of Medicine, New York, NY. FAU - Chernyavskiy, Alexander M AU - Chernyavskiy AM AD - E.Meshalkin National Medical Research Center of the Ministry of Health of the Russian Federation (E.Meshalkin NMRC), Novosibirsk, Russia. FAU - Demkow, Marcin AU - Demkow M AD - Department of Coronary and Structural Heart Diseases, National Institute of Cardiology, Warsaw, Poland. FAU - Lopez-Quijano, Juan-Manuel AU - Lopez-Quijano JM AD - Hospital Central Dr. Ignacio Morones Prieto, San Luis Potosi, Mexico. FAU - Escobedo, Jorge AU - Escobedo J AD - Instituto Mexicano del Seguro Social, Mexico City, Mexico. FAU - Poh, Kian Keong AU - Poh KK AD - National University Heart Center Singapore and Yong Loo Lin School of Medicine, National University of Singapore, Singapore. FAU - Ramos, Ruben B AU - Ramos RB AD - Hospital de Santa Marta, Lisboa, Portugal. FAU - Lima, Eduardo G AU - Lima EG AD - Heart Institute, InCor-HCFMUSP, Sao Paulo, Brazil. FAU - Schuchlenz, Herwig AU - Schuchlenz H AD - oLKH Graz II, Department fuer Kardiologie und Intensivmedizin, Graz, Austria. FAU - Ali, Ziad A AU - Ali ZA AD - Cardiovascular Research Foundation, New York, NY; Columbia University Medical Center/New York-Presbyterian Hospital, New York, NY; St Francis Hospital, Roslyn, NY. FAU - Stone, Gregg W AU - Stone GW AD - Icahn School of Medicine at Mount Sinai, New York, NY. FAU - Maron, David J AU - Maron DJ AD - Stanford University School of Medicine, Stanford, CA. FAU - O'Brien, Sean M AU - O'Brien SM AD - Duke Clinical Research Institute and Duke University, Durham, NC. FAU - Spertus, John A AU - Spertus JA AD - Saint Luke's Mid America Heart Institute/University of Missouri - Kansas City (UMKC), Kansas City, MO. FAU - Bangalore, Sripal AU - Bangalore S AD - NYU Grossman School of Medicine, New York, NY. LA - eng GR - U01 HL105907/HL/NHLBI NIH HHS/United States GR - U01 HL117904/HL/NHLBI NIH HHS/United States GR - U01 HL117905/HL/NHLBI NIH HHS/United States PT - Journal Article PT - Randomized Controlled Trial DEP - 20210925 PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 SB - IM MH - Coronary Angiography MH - *Coronary Artery Disease/complications/diagnosis/epidemiology MH - Humans MH - Ischemia/complications MH - *Myocardial Ischemia/complications/epidemiology MH - *Renal Insufficiency, Chronic/complications/epidemiology MH - Risk Factors PMC - PMC10627379 MID - NIHMS1896340 EDAT- 2021/09/29 06:00 MHDA- 2022/04/08 06:00 PMCR- 2023/11/06 CRDT- 2021/09/28 20:13 PHST- 2021/06/02 00:00 [received] PHST- 2021/09/14 00:00 [accepted] PHST- 2021/09/29 06:00 [pubmed] PHST- 2022/04/08 06:00 [medline] PHST- 2021/09/28 20:13 [entrez] PHST- 2023/11/06 00:00 [pmc-release] AID - S0002-8703(21)00237-4 [pii] AID - 10.1016/j.ahj.2021.09.008 [doi] PST - ppublish SO - Am Heart J. 2022 Jan;243:187-200. doi: 10.1016/j.ahj.2021.09.008. Epub 2021 Sep 25. PMID- 34532348 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20210918 IS - 2297-055X (Print) IS - 2297-055X (Electronic) IS - 2297-055X (Linking) VI - 8 DP - 2021 TI - Coronary Artery Disease: Optimal Lipoprotein(a) for Survival-Lower Is Better? A Large Cohort With 43,647 Patients. PG - 670859 LID - 10.3389/fcvm.2021.670859 [doi] LID - 670859 AB - Background: A high level of lipoprotein(a) can lead to a high risk of cardiovascular events or mortality. However, the association of moderately elevated lipoprotein(a) levels (>/=15 mg/dL) with long-term prognosis among patients with coronary artery disease (CAD) is still uncertain. Hence, we aim to systematically analyzed the relevance of baseline plasma lipoprotein(a) levels to long-term mortality in a large cohort of CAD patients. Methods: We obtained data from 43,647 patients who were diagnosed with CAD and had follow-up information from January 2007 to December 2018. The patients were divided into two groups (<15 and >/=15 mg/dL). The primary endpoint was long-term all-cause death. Kaplan-Meier curve analysis and Cox proportional hazards models were used to investigate the association between moderately elevated baseline lipoprotein(a) levels (>/=15 mg/dL) and long-term all-cause mortality. Results: During a median follow-up of 5.04 years, 3,941 (18.1%) patients died. We observed a linear association between lipoprotein(a) levels and long-term all-cause mortality. Compared with lipoprotein(a) concentrations <15 mg/dL, lipoprotein(a) >/=15 mg/dL was associated with a significantly higher risk of all-cause mortality [adjusted hazard ratio (aHR) 1.10, 95%CI: 1.04-1.16, P-values = 0.001). Similar results were found for the subgroup analysis of non-acute myocardial infarction, non-percutaneous coronary intervention, chronic heart failure, diabetes mellitus, or non-chronic kidney diseases. Conclusion: Moderately elevated baseline plasma lipoprotein(a) levels (>/=15 mg/dL) are significantly associated with higher all-cause mortality in patients with CAD. Our finding provides a rationale for testing the lipoprotein(a)-reducing hypothesis with lower targets (even <15 mg/dL) in CAD outcome trials. CI - Copyright (c) 2021 Liu, Liu, Wang, Chen, Liu, Liang, Huang, Li, Lun, Ying, Chen, Huang, Xu, Yan, Zhu, Tadesse, Tan, Chen and Liu. FAU - Liu, Jin AU - Liu J AD - Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China. FAU - Liu, Liwei AU - Liu L AD - Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China. AD - Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, United States. FAU - Wang, Bo AU - Wang B AD - Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China. FAU - Chen, Shiqun AU - Chen S AD - Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China. FAU - Liu, Buyun AU - Liu B AD - Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, United States. FAU - Liang, Jingjing AU - Liang J AD - The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China. FAU - Huang, Haozhang AU - Huang H AD - The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China. FAU - Li, Qiang AU - Li Q AD - Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China. FAU - Lun, Zhubin AU - Lun Z AD - Department of Cardiology, Dongguan TCM Hospital, Dongguan, China. FAU - Ying, Ming AU - Ying M AD - Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China. FAU - Chen, Guanzhong AU - Chen G AD - Guangdong Provincial People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China. FAU - Huang, Zhidong AU - Huang Z AD - Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China. FAU - Xu, Danyuan AU - Xu D AD - Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China. FAU - Yan, Xiaoming AU - Yan X AD - Department of Information Technology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China. FAU - Zhu, Tingting AU - Zhu T AD - Department of Engineering Science, Institute of Biomedical Engineering, University of Oxford, Oxford, United Kingdom. FAU - Tadesse, Girmaw Abebe AU - Tadesse GA AD - Department of Engineering Science, Institute of Biomedical Engineering, University of Oxford, Oxford, United Kingdom. FAU - Tan, Ning AU - Tan N AD - Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China. AD - The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China. AD - Guangdong Provincial People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China. FAU - Chen, Jiyan AU - Chen J AD - Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China. AD - The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China. AD - Guangdong Provincial People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China. FAU - Liu, Yong AU - Liu Y AD - Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China. AD - The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China. AD - Guangdong Provincial People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China. LA - eng PT - Journal Article DEP - 20210831 PL - Switzerland TA - Front Cardiovasc Med JT - Frontiers in cardiovascular medicine JID - 101653388 PMC - PMC8438333 OTO - NOTNLM OT - baseline lipoprotein(a) OT - coronary angiography OT - coronary artery disease OT - long-term all-cause mortality OT - percutaneous coronary intervention COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2021/09/18 06:00 MHDA- 2021/09/18 06:01 PMCR- 2021/01/01 CRDT- 2021/09/17 07:19 PHST- 2021/02/22 00:00 [received] PHST- 2021/06/09 00:00 [accepted] PHST- 2021/09/17 07:19 [entrez] PHST- 2021/09/18 06:00 [pubmed] PHST- 2021/09/18 06:01 [medline] PHST- 2021/01/01 00:00 [pmc-release] AID - 10.3389/fcvm.2021.670859 [doi] PST - epublish SO - Front Cardiovasc Med. 2021 Aug 31;8:670859. doi: 10.3389/fcvm.2021.670859. eCollection 2021. PMID- 34521746 OWN - NLM STAT- MEDLINE DCOM- 20211221 LR - 20250719 IS - 2053-3624 (Print) IS - 2053-3624 (Electronic) IS - 2053-3624 (Linking) VI - 8 IP - 2 DP - 2021 Sep TI - Using genetics to detangle the relationships between red cell distribution width and cardiovascular diseases: a unique role for body mass index. LID - 10.1136/openhrt-2021-001713 [doi] LID - e001713 AB - OBJECTIVE: Red cell distribution width (RDW) is an enigmatic biomarker associated with the presence and severity of multiple cardiovascular diseases (CVDs). It is unclear whether elevated RDW contributes to, results from, or is pleiotropically related to CVDs. We used contemporary genetic techniques to probe for evidence of aetiological associations between RDW, CVDs, and CVD risk factors. METHODS: Using an electronic health record (EHR)-based cohort, we built and deployed a genetic risk score (GRS) for RDW to test for shared genetic architecture between RDW and the cardiovascular phenome. We also created GRSs for common CVDs (coronary artery disease, heart failure, atrial fibrillation, peripheral arterial disease, venous thromboembolism) and CVD risk factors (body mass index (BMI), low-density lipoprotein, high-density lipoprotein, systolic blood pressure, diastolic blood pressure, serum triglycerides, estimated glomerular filtration rate, diabetes mellitus) to test each for association with RDW. Significant GRS associations were further interrogated by two-sample Mendelian randomisation (MR). In a separate EHR-based cohort, RDW values from 1-year pre-gastric bypass surgery and 1-2 years post-gastric bypass surgery were compared. RESULTS: In a cohort of 17 937 subjects, there were no significant associations between the RDW GRS and CVDs. Of the CVDs and CVD risk factors, only genetically predicted BMI was associated with RDW. In subsequent analyses, BMI was associated with RDW by multiple MR methods. In subjects undergoing bariatric surgery, RDW decreased postsurgery and followed a linear relationship with BMI change. CONCLUSIONS: RDW is unlikely to be aetiologically upstream or downstream of CVDs or CVD risk factors except for BMI. Genetic and clinical association analyses support an aetiological relationship between BMI and RDW. CI - (c) Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. FAU - Thayer, Timothy E AU - Thayer TE AUID- ORCID: 0000-0001-5317-6171 AD - Department of Medicine, Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA timothy.thayer@vumc.org. FAU - Huang, Shi AU - Huang S AD - Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA. FAU - Farber-Eger, Eric AU - Farber-Eger E AUID- ORCID: 0000-0003-0281-3796 AD - VICTR, Vanderbilt University Medical Center, Nashville, Tennessee, USA. FAU - Beckman, Joshua A AU - Beckman JA AD - Department of Medicine, Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA. FAU - Brittain, Evan L AU - Brittain EL AD - Department of Medicine, Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA. FAU - Mosley, Jonathan D AU - Mosley JD AD - Department of Medicine, Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA. AD - Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA. FAU - Wells, Quinn S AU - Wells QS AD - Department of Medicine, Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA. LA - eng GR - R01 HL140074/HL/NHLBI NIH HHS/United States PT - Journal Article PT - Multicenter Study PT - Research Support, N.I.H., Extramural PL - England TA - Open Heart JT - Open heart JID - 101631219 RN - 0 (Biomarkers) RN - 0 (Genetic Markers) SB - IM MH - Biomarkers/blood MH - *Body Mass Index MH - Cardiovascular Diseases/blood/ethnology/*genetics MH - Erythrocyte Indices MH - *Ethnicity MH - Female MH - Genetic Markers/*genetics MH - Humans MH - Incidence MH - Male MH - Mendelian Randomization Analysis/*methods MH - Middle Aged MH - Phenomics/*methods MH - Risk Assessment/*methods MH - United States/epidemiology PMC - PMC8442102 OTO - NOTNLM OT - biomarkers OT - coronary artery disease OT - epidemiology OT - genetic association studies OT - obesity COIS- Competing interests: None declared. EDAT- 2021/09/16 06:00 MHDA- 2021/12/22 06:00 PMCR- 2021/09/14 CRDT- 2021/09/15 06:14 PHST- 2021/05/05 00:00 [received] PHST- 2021/08/27 00:00 [accepted] PHST- 2021/09/15 06:14 [entrez] PHST- 2021/09/16 06:00 [pubmed] PHST- 2021/12/22 06:00 [medline] PHST- 2021/09/14 00:00 [pmc-release] AID - openhrt-2021-001713 [pii] AID - 10.1136/openhrt-2021-001713 [doi] PST - ppublish SO - Open Heart. 2021 Sep;8(2):e001713. doi: 10.1136/openhrt-2021-001713. PMID- 34521217 OWN - NLM STAT- MEDLINE DCOM- 20211229 LR - 20240817 IS - 1524-4539 (Electronic) IS - 0009-7322 (Print) IS - 0009-7322 (Linking) VI - 144 IP - 17 DP - 2021 Oct 26 TI - Outcomes of Participants With Diabetes in the ISCHEMIA Trials. PG - 1380-1395 LID - 10.1161/CIRCULATIONAHA.121.054439 [doi] AB - BACKGROUND: Among patients with diabetes and chronic coronary disease, it is unclear if invasive management improves outcomes when added to medical therapy. METHODS: The ISCHEMIA (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches) trials (ie, ISCHEMIA and ISCHEMIA-Chronic Kidney Disease) randomized chronic coronary disease patients to an invasive (medical therapy + angiography and revascularization if feasible) or a conservative approach (medical therapy alone with revascularization if medical therapy failed). Cohorts were combined after no trial-specific effects were observed. Diabetes was defined by history, hemoglobin A1c >/=6.5%, or use of glucose-lowering medication. The primary outcome was all-cause death or myocardial infarction (MI). Heterogeneity of effect of invasive management on death or MI was evaluated using a Bayesian approach to protect against random high or low estimates of treatment effect for patients with versus without diabetes and for diabetes subgroups of clinical (female sex and insulin use) and anatomic features (coronary artery disease severity or left ventricular function). RESULTS: Of 5900 participants with complete baseline data, the median age was 64 years (interquartile range, 57-70), 24% were female, and the median estimated glomerular filtration was 80 mL.min(-1).1.73(-2) (interquartile range, 64-95). Among the 2553 (43%) of participants with diabetes, the median percent hemoglobin A1c was 7% (interquartile range, 7-8), and 30% were insulin-treated. Participants with diabetes had a 49% increased hazard of death or MI (hazard ratio, 1.49 [95% CI, 1.31-1.70]; P<0.001). At median 3.1-year follow-up the adjusted event-free survival was 0.54 (95% bootstrapped CI, 0.48-0.60) and 0.66 (95% bootstrapped CI, 0.61-0.71) for patients with diabetes versus without diabetes, respectively, with a 12% (95% bootstrapped CI, 4%-20%) absolute decrease in event-free survival among participants with diabetes. Female and male patients with insulin-treated diabetes had an adjusted event-free survival of 0.52 (95% bootstrapped CI, 0.42-0.56) and 0.49 (95% bootstrapped CI, 0.42-0.56), respectively. There was no difference in death or MI between strategies for patients with diabetes versus without diabetes, or for clinical (female sex or insulin use) or anatomic features (coronary artery disease severity or left ventricular function) of patients with diabetes. CONCLUSIONS: Despite higher risk for death or MI, chronic coronary disease patients with diabetes did not derive incremental benefit from routine invasive management compared with initial medical therapy alone. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01471522. FAU - Newman, Jonathan D AU - Newman JD AUID- ORCID: 0000-0001-6855-7305 AD - New York University Grossman School of Medicine (J.D.N., R.A., S.B., H.R.R., D.F.K., J.S.H.). FAU - Anthopolos, Rebecca AU - Anthopolos R AD - New York University Grossman School of Medicine (J.D.N., R.A., S.B., H.R.R., D.F.K., J.S.H.). FAU - Mancini, G B John AU - Mancini GBJ AD - Center for Cardiovascular Innovation, University of British Columbia, Vancouver, Canada (G.B.J.M.). FAU - Bangalore, Sripal AU - Bangalore S AUID- ORCID: 0000-0001-9485-0652 AD - New York University Grossman School of Medicine (J.D.N., R.A., S.B., H.R.R., D.F.K., J.S.H.). FAU - Reynolds, Harmony R AU - Reynolds HR AUID- ORCID: 0000-0003-0284-0655 AD - New York University Grossman School of Medicine (J.D.N., R.A., S.B., H.R.R., D.F.K., J.S.H.). FAU - Kunichoff, Dennis F AU - Kunichoff DF AD - New York University Grossman School of Medicine (J.D.N., R.A., S.B., H.R.R., D.F.K., J.S.H.). FAU - Senior, Roxy AU - Senior R AUID- ORCID: 0000-0001-6579-7039 AD - Northwick Park Hospital-Royal Brompton Hospital, London, UK (R.S.). FAU - Peteiro, Jesus AU - Peteiro J AUID- ORCID: 0000-0002-8457-6351 AD - Complejo Hospitalario Universitario de A Coruna (CHUAC), Centro de Investigacion Biomedica en Red de Enfermedades Cardiovasculares (CIBERCV), Universidad de A Coruna, A Coruna, Spain (J.P.). FAU - Bhargava, Balram AU - Bhargava B AD - All India Institute of Medical Sciences, Delhi (B.B., S.M.). FAU - Garg, Pallav AU - Garg P AD - London Health Sciences Center, Western University, Ontario, Canada (P.G.). FAU - Escobedo, Jorge AU - Escobedo J AUID- ORCID: 0000-0003-1942-7402 AD - Instituto Mexicano del Seguro Social, Mexico City (J.E.). FAU - Doerr, Rolf AU - Doerr R AUID- ORCID: 0000-0002-6599-2958 AD - Praxisklinik Herz und Gefaesse, Dresden, Germany (R.D.). FAU - Mazurek, Tomasz AU - Mazurek T AUID- ORCID: 0000-0002-3693-8741 AD - Medical University of Warsaw, Poland (T.M.). FAU - Gonzalez-Juanatey, Jose AU - Gonzalez-Juanatey J AD - Cardiology Department, Hospital Clinico Universitario, Instituto de Investigacion Sanitaria de Santiago de Compostela (IDIS), Centro de Investigacion Biomedica en Red de Enfermedades Cardiovasculares Institution, Spain (J.G-J.). FAU - Gajos, Grzegorz AU - Gajos G AD - Department of Coronary Disease and Heart Failure, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland (G.G.). FAU - Briguori, Carlo AU - Briguori C AUID- ORCID: 0000-0002-2105-8186 AD - Laboratory of Interventional Cardiology and Department of Cardiology, Mediterranea Cardiocentro, Naples, Italy (C.B.). FAU - Cheng, Hong AU - Cheng H AD - Beijing Anzhen Hospital, Capital Medical University, China (H.C.). FAU - Vertes, Andras AU - Vertes A AD - Del-pesti Centrumkohaz Hospital, National Institute of Hematology and Infectious Disease, Cardiovascular Department, Budapest, Hungary (A.V.). FAU - Mahajan, Sandeep AU - Mahajan S AD - All India Institute of Medical Sciences, Delhi (B.B., S.M.). FAU - Guzman, Luis A AU - Guzman LA AD - Instituto Medico Docencia Asistencia Medica e Investigacion Clinica, Cordoba, Argentina (L.A.G.). FAU - Keltai, Matyas AU - Keltai M AD - Semmelweis University, Budapest, Hungary (M.K.). FAU - Maggioni, Aldo P AU - Maggioni AP AUID- ORCID: 0000-0003-2764-6779 AD - Associazione Nazionale Medici Cardiologi Ospedalieri Research Center, Florence, Italy (A.P.M.). FAU - Stone, Gregg W AU - Stone GW AUID- ORCID: 0000-0002-3416-8210 AD - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, Cardiovascular Research Foundation, New York (G.W.S.). FAU - Berger, Jeffrey S AU - Berger JS AUID- ORCID: 0000-0001-8216-4647 AD - New York University Grossman School of Medicine (J.D.N., R.A., S.B., H.R.R., D.F.K., J.S.H.). FAU - Rosenberg, Yves D AU - Rosenberg YD AD - National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (Y.D.R., J.L.F.). FAU - Boden, William E AU - Boden WE AD - Veterans Affairs New England Healthcare System, Boston University School of Medicine, MA (W.E.B.). FAU - Chaitman, Bernard R AU - Chaitman BR AUID- ORCID: 0000-0002-9216-5317 AD - St Louis University School of Medicine Center for Comprehensive Cardiovascular Care, MO (B.R.C.). FAU - Fleg, Jerome L AU - Fleg JL AD - National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (Y.D.R., J.L.F.). FAU - Hochman, Judith S AU - Hochman JS AUID- ORCID: 0000-0002-5889-5981 FAU - Maron, David J AU - Maron DJ AD - Department of Medicine, Stanford University, CA (D.J.M.). LA - eng SI - ClinicalTrials.gov/NCT01471522 GR - UL1 TR001445/TR/NCATS NIH HHS/United States GR - U01 HL105462/HL/NHLBI NIH HHS/United States GR - U01 HL105561/HL/NHLBI NIH HHS/United States GR - U01 HL105907/HL/NHLBI NIH HHS/United States GR - UL1 TR002243/TR/NCATS NIH HHS/United States GR - U01 HL105565/HL/NHLBI NIH HHS/United States GR - K23 HL125991/HL/NHLBI NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't DEP - 20210915 PL - United States TA - Circulation JT - Circulation JID - 0147763 SB - IM MH - Aged MH - Diabetes Mellitus/*drug therapy MH - Female MH - Humans MH - Male MH - Middle Aged MH - Treatment Outcome PMC - PMC8545918 MID - NIHMS1739854 OTO - NOTNLM OT - Bayes theorem OT - coronary artery disease OT - diabetes mellitus OT - insulin OT - progression-free survival OT - renal insufficiency, chronic OT - ventricular function, left EDAT- 2021/09/16 06:00 MHDA- 2021/12/30 06:00 PMCR- 2022/10/26 CRDT- 2021/09/15 05:36 PHST- 2021/09/16 06:00 [pubmed] PHST- 2021/12/30 06:00 [medline] PHST- 2021/09/15 05:36 [entrez] PHST- 2022/10/26 00:00 [pmc-release] AID - 10.1161/CIRCULATIONAHA.121.054439 [doi] PST - ppublish SO - Circulation. 2021 Oct 26;144(17):1380-1395. doi: 10.1161/CIRCULATIONAHA.121.054439. Epub 2021 Sep 15. PMID- 34454808 OWN - NLM STAT- MEDLINE DCOM- 20220107 LR - 20220107 IS - 1876-4738 (Electronic) IS - 0914-5087 (Linking) VI - 78 IP - 6 DP - 2021 Dec TI - Impact of chronic kidney disease on long-term outcomes for coronary in-stent restenosis after drug-coated balloon angioplasty. PG - 564-570 LID - S0914-5087(21)00206-9 [pii] LID - 10.1016/j.jjcc.2021.08.010 [doi] AB - BACKGROUND: Patients with chronic kidney disease (CKD) and coronary instent restenosis (ISR) treated with drug-coated balloon (DCB) angioplasty have been excluded from randomized controlled trials. We aimed to investigate the clinical impact of CKD stratified by severity, on clinical outcomes for patients with ISR treated with DCB angioplasty. METHODS: This cohort study enrolled 1,376 patients treated with DCB angioplasty; 639 CKD patients defined as having an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 and 737 patients with preserved renal function were identified. Risks of target vessel failure (TVF), all-cause mortality, and any repeated revascularization were analyzed. RESULTS: The CKD group had a significantly higher risk of TVF [adjusted hazard ratio (HR): 1.337; 95% confidence interval (CI): 1.125-1.590; p = 0.0010], all-cause mortality (adjusted HR: 2.553; 95% CI: 1.494-4.361; p = 0.0006), and any repeated revascularization (adjusted HR: 1.447; 95% CI: 1.087-1.927; p = 0.0114) compared with the non-CKD group. After multivariable adjustment, patients with severe CKD (eGFR = 15-29 mL/min/1.73 m2) and end-stage renal disease (ESRD) (eGFR <15 mL/min/1.73 m2) had a significantly higher risk of adverse events comparable to that in patients with preserved renal function. CONCLUSIONS: In this cohort study, patients with CKD and ISR undergoing DCB angioplasty had a significantly higher risk of adverse events compared with patients with preserved renal function, whereas subgroups with mild to moderate CKD did not display this difference. Different revascularization strategies may be considered for patients with severe CKD or ESRD with ISR. CI - Copyright (c) 2021. Published by Elsevier Ltd. FAU - Lee, Hsin-Fu AU - Lee HF AD - Division of Cardiology, Department of Internal Medicine, New Taipei City Municipal Tucheng Hospital, New Taipei City, Taiwan; The Cardiovascular Department, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan. FAU - Cheng, Yu-Wen AU - Cheng YW AD - The Cardiovascular Department, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan. FAU - Peng, Jian-Rong AU - Peng JR AD - Division of Cardiology, Department of Internal Medicine, New Taipei City Municipal Tucheng Hospital, New Taipei City, Taiwan; The Cardiovascular Department, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan. FAU - Hsu, Chiu-Yi AU - Hsu CY AD - Center for Big Data Analytics and Statistics, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan. FAU - Yang, Chia-Hung AU - Yang CH AD - Division of Cardiology, Department of Internal Medicine, New Taipei City Municipal Tucheng Hospital, New Taipei City, Taiwan; The Cardiovascular Department, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan. FAU - Chan, Yi-Hsin AU - Chan YH AD - The Cardiovascular Department, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Microscopy Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan. Electronic address: s851047@hotmail.com. FAU - Chu, Pao-Hsien AU - Chu PH AD - The Cardiovascular Department, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan. Electronic address: taipei.chu@gmail.com. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20210826 PL - Netherlands TA - J Cardiol JT - Journal of cardiology JID - 8804703 RN - 0 (Pharmaceutical Preparations) SB - IM MH - *Angioplasty, Balloon MH - Cohort Studies MH - *Coronary Artery Disease MH - *Coronary Restenosis/etiology MH - *Drug-Eluting Stents MH - Humans MH - *Percutaneous Coronary Intervention/adverse effects MH - *Pharmaceutical Preparations MH - *Renal Insufficiency, Chronic/complications MH - Risk Factors MH - Treatment Outcome OTO - NOTNLM OT - Angioplasty OT - Chronic kidney disease OT - Drug-coated balloon OT - Percutaneous coronary intervention EDAT- 2021/08/30 06:00 MHDA- 2022/01/08 06:00 CRDT- 2021/08/29 20:39 PHST- 2021/05/23 00:00 [received] PHST- 2021/07/07 00:00 [revised] PHST- 2021/07/26 00:00 [accepted] PHST- 2021/08/30 06:00 [pubmed] PHST- 2022/01/08 06:00 [medline] PHST- 2021/08/29 20:39 [entrez] AID - S0914-5087(21)00206-9 [pii] AID - 10.1016/j.jjcc.2021.08.010 [doi] PST - ppublish SO - J Cardiol. 2021 Dec;78(6):564-570. doi: 10.1016/j.jjcc.2021.08.010. Epub 2021 Aug 26. PMID- 34446390 OWN - NLM STAT- MEDLINE DCOM- 20211101 LR - 20220531 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 14 IP - 17 DP - 2021 Sep 13 TI - Ticagrelor or Prasugrel in Patients With Acute Coronary Syndrome in Relation to Estimated Glomerular Filtration Rate. PG - 1857-1866 LID - S1936-8798(21)01219-X [pii] LID - 10.1016/j.jcin.2021.06.028 [doi] AB - OBJECTIVES: The aim of this study was to assess the safety and efficacy of ticagrelor versus prasugrel for patients with acute coronary syndrome (ACS) according to their estimated glomerular filtration rates (eGFRs). BACKGROUND: The outcomes of ticagrelor versus prasugrel in patients with ACS according to eGFR have not been defined. METHODS: Patients (n = 4,012) were categorized into 3 groups: low eGFR (<60 mL/min/1.73 m(2)), intermediate eGFR (>/=60 and <90 mL/min/1.73 m(2)), and high eGFR (>/=90 mL/min/1.73 m(2)). The primary endpoint was a composite of all-cause death, myocardial infarction, and stroke; the secondary safety endpoint was Bleeding Academic Research Consortium types 3 to 5 bleeding, both at 1 year. RESULTS: Patients with low eGFRs had a higher risk for the primary endpoint compared with patients with intermediate eGFRs (adjusted HR: 1.89; 95% CI: 1.46-2.46]) and those with high eGFRs (adjusted HR: 2.33; 95% CI: 1.57-3.46). A risk excess for low eGFR was also observed for bleeding (adjusted HR: 1.55 [95% CI: 1.12-2.13] vs intermediate eGFR; adjusted HR: 1.59 [95% CI: 1.01-2.50] vs high eGFR). However, eGFR did not affect the relative efficacy and safety of ticagrelor versus prasugrel. In patients with low eGFR, the primary endpoint occurred in 20.5% with ticagrelor and in 14.7% with prasugrel (HR: 1.47; 95% CI: 1.04-2.08; P = 0.029); there was no significant difference in bleeding. CONCLUSIONS: These results show that among patients with ACS, reduction of eGFR is associated with increased risk for ischemic and bleeding events but has no significant impact on the relative efficacy and safety of ticagrelor versus prasugrel. (Prospective, Randomized Trial of Ticagrelor Versus Prasugrel in Patients With Acute Coronary Syndrome [ISAR-REACT 5]; NCT01944800). CI - Copyright (c) 2021 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Wohrle, Jochen AU - Wohrle J AD - Department of Cardiology and Intensive Care, Medical Campus Lake Constance, Friedrichshafen, Germany. Electronic address: jochen.wohrle@t-online.de. FAU - Seeger, Julia AU - Seeger J AD - Department of Cardiology and Intensive Care, Medical Campus Lake Constance, Friedrichshafen, Germany. FAU - Lahu, Shqipdona AU - Lahu S AD - Deutsches Herzzentrum Munchen, Cardiology, and Technische Universitat Munchen, Munich, Germany. FAU - Mayer, Katharina AU - Mayer K AD - Deutsches Herzzentrum Munchen, Cardiology, and Technische Universitat Munchen, Munich, Germany. FAU - Bernlochner, Isabell AU - Bernlochner I AD - Medizinische Klinik und Poliklinik Innere Medizin I (Kardiologie, Angiologie, Pneumologie), Klinikum rechts der Isar, Munich, Germany; German Center for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, Germany. FAU - Gewalt, Senta AU - Gewalt S AD - Deutsches Herzzentrum Munchen, Cardiology, and Technische Universitat Munchen, Munich, Germany. FAU - Menichelli, Maurizio AU - Menichelli M AD - Ospedale Fabrizio Spaziani, Cardiology, Frosinone, Italy. FAU - Witzenbichler, Bernhard AU - Witzenbichler B AD - Helios Amper-Klinikum Dachau, Cardiology & Pneumology, Dachau, Germany. FAU - Hochholzer, Willibald AU - Hochholzer W AD - Department of Cardiology and Angiology II, University Heart Center Freiburg Bad Krozingen, Bad Krozingen, Germany. FAU - Sibbing, Dirk AU - Sibbing D AD - German Center for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, Germany; Klinik der Universitat Munchen, Ludwig-Maximilians-University, Cardiology, Munich, Germany. FAU - Cassese, Salvatore AU - Cassese S AD - Deutsches Herzzentrum Munchen, Cardiology, and Technische Universitat Munchen, Munich, Germany. FAU - Angiolillo, Dominick J AU - Angiolillo DJ AD - Division of Cardiology, University of Florida College of Medicine, Jacksonville, Florida, USA. FAU - Hemetsberger, Rayyan AU - Hemetsberger R AD - Heart Center Bad Segeberg, Bad Segeberg, Germany. FAU - Valina, Christian AU - Valina C AD - Department of Cardiology and Angiology II, University Heart Center Freiburg Bad Krozingen, Bad Krozingen, Germany. FAU - Kufner, Sebastian AU - Kufner S AD - Deutsches Herzzentrum Munchen, Cardiology, and Technische Universitat Munchen, Munich, Germany. FAU - Xhepa, Erion AU - Xhepa E AD - Deutsches Herzzentrum Munchen, Cardiology, and Technische Universitat Munchen, Munich, Germany. FAU - Hapfelmeier, Alexander AU - Hapfelmeier A AD - Technical University of Munich, School of Medicine, Institute of General Practice and Health Services Research, Munich, Germany. FAU - Sager, Hendrik B AU - Sager HB AD - Deutsches Herzzentrum Munchen, Cardiology, and Technische Universitat Munchen, Munich, Germany; German Center for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, Germany. FAU - Joner, Michael AU - Joner M AD - Deutsches Herzzentrum Munchen, Cardiology, and Technische Universitat Munchen, Munich, Germany; German Center for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, Germany. FAU - Richardt, Gert AU - Richardt G AD - Heart Center Bad Segeberg, Bad Segeberg, Germany. FAU - Laugwitz, Karl-Ludwig AU - Laugwitz KL AD - Medizinische Klinik und Poliklinik Innere Medizin I (Kardiologie, Angiologie, Pneumologie), Klinikum rechts der Isar, Munich, Germany; German Center for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, Germany. FAU - Neumann, Franz Josef AU - Neumann FJ AD - Department of Cardiology and Angiology II, University Heart Center Freiburg Bad Krozingen, Bad Krozingen, Germany. FAU - Schunkert, Heribert AU - Schunkert H AD - Deutsches Herzzentrum Munchen, Cardiology, and Technische Universitat Munchen, Munich, Germany; German Center for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, Germany. FAU - Schupke, Stefanie AU - Schupke S AD - Deutsches Herzzentrum Munchen, Cardiology, and Technische Universitat Munchen, Munich, Germany; German Center for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, Germany. FAU - Kastrati, Adnan AU - Kastrati A AD - Deutsches Herzzentrum Munchen, Cardiology, and Technische Universitat Munchen, Munich, Germany; German Center for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, Germany. FAU - Ndrepepa, Gjin AU - Ndrepepa G AD - Deutsches Herzzentrum Munchen, Cardiology, and Technische Universitat Munchen, Munich, Germany. LA - eng SI - ClinicalTrials.gov/NCT01944800 PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20210823 PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 RN - 0 (Platelet Aggregation Inhibitors) RN - G89JQ59I13 (Prasugrel Hydrochloride) RN - GLH0314RVC (Ticagrelor) SB - IM CIN - JACC Cardiovasc Interv. 2021 Sep 13;14(17):1867-1869. doi: 10.1016/j.jcin.2021.07.026. PMID: 34446391 MH - *Acute Coronary Syndrome/diagnostic imaging/drug therapy MH - Glomerular Filtration Rate MH - Humans MH - *Percutaneous Coronary Intervention/adverse effects MH - Platelet Aggregation Inhibitors/adverse effects MH - Prasugrel Hydrochloride/adverse effects MH - Prospective Studies MH - Ticagrelor/adverse effects MH - Treatment Outcome OTO - NOTNLM OT - acute coronary syndrome OT - glomerular filtration rate OT - percutaneous coronary intervention OT - prasugrel OT - ticagrelor COIS- Funding Support and Author Disclosures This research was supported by a grant (FKZ 81X1600501) from the German Center for Cardiovascular Research and Deutsches Herzzentrum Munchen. Dr Angiolillo has received grants and personal fees from Amgen, Aralez, AstraZeneca, Bayer, Biosensors, Boehringer Ingelheim, Bristol Myers Squibb, Chiesi, Daiichi-Sankyo, Eli Lilly, Janssen, Merck, Sanofi, and CeloNova; has received personal fees from Haemonetics, PhaseBio, PLx Pharma, Pfizer, The Medicines Company, and St. Jude Medical; and has received grants from CSL Behring, Eisai, Gilead, Idorsia Pharmaceuticals, Matsutani Chemical Industry, Novartis, Osprey Medical, Renal Guard Solutions, and the Scott R. MacKenzie Foundation. Dr Hochholzer has received personal fees from Bayer Vital, Boehringer Ingelheim, Bristol Myers Squibb, Daiichi-Sankyo, Novartis, AstraZeneca, and The Medicines Company. Dr Kufner has received personal fees from Bristol Myers Squibb, AstraZeneca, and Translumina. Dr Sager has received grants from the European Research Council, Else-Kroner-Fresenius-Stiftung, Deutsche Herzstiftung, and Deutsche Forschungsgemeinschaft. Dr Neumann has received personal fees from Amgen, Boehringer Ingelheim, Daiichi-Sankyo, Novartis, and Ferrer; has received grants and personal fees from Pfizer, Biotronik, Edwards Lifesciences, Bayer Healthcare, and Boston Scientific; and has received grants from Medtronic and GlaxoSmithKline outside the submitted work. Dr Schupke has received the Else Kroner memorial grant from Else Kroner-Fresenius Stiftung; has received financial support from the German Center for Cardiovascular Research; has received consulting fees from Bayer Vital; and has received lecture fees from Daiichi-Sankyo and Biopas Laboratories. Dr Sibbing has received personal fees from Daichi-Sankyo, Sanofi, AstraZeneca, Bayer, Pfizer, and Servier. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. EDAT- 2021/08/28 06:00 MHDA- 2021/11/03 06:00 CRDT- 2021/08/27 05:53 PHST- 2021/04/09 00:00 [received] PHST- 2021/06/21 00:00 [revised] PHST- 2021/06/23 00:00 [accepted] PHST- 2021/08/28 06:00 [pubmed] PHST- 2021/11/03 06:00 [medline] PHST- 2021/08/27 05:53 [entrez] AID - S1936-8798(21)01219-X [pii] AID - 10.1016/j.jcin.2021.06.028 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2021 Sep 13;14(17):1857-1866. doi: 10.1016/j.jcin.2021.06.028. Epub 2021 Aug 23. PMID- 34423374 OWN - NLM STAT- MEDLINE DCOM- 20211209 LR - 20211214 IS - 1522-9645 (Electronic) IS - 0195-668X (Linking) VI - 42 IP - 45 DP - 2021 Dec 1 TI - Ticagrelor monotherapy in patients with chronic kidney disease undergoing percutaneous coronary intervention: TWILIGHT-CKD. PG - 4683-4693 LID - 10.1093/eurheartj/ehab533 [doi] AB - AIMS: The aim of this study was to assess the impact of chronic kidney disease (CKD) on the safety and efficacy of ticagrelor monotherapy among patients undergoing percutaneous coronary intervention (PCI). METHODS AND RESULTS: In this prespecified subanalysis of the TWILIGHT trial, we evaluated the treatment effects of ticagrelor with or without aspirin according to renal function. The trial enrolled patients undergoing drug-eluting stent implantation who fulfilled at least one clinical and one angiographic high-risk criterion. Chronic kidney disease, defined as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2, was a clinical study entry criterion. Following a 3-month period of ticagrelor plus aspirin, event-free patients were randomly assigned to aspirin or placebo on top of ticagrelor for an additional 12 months. Of the 6835 patients randomized and with available eGFR at baseline, 1111 (16.3%) had CKD. Ticagrelor plus placebo reduced the primary endpoint of Bleeding Academic Research Consortium (BARC) type 2, 3, or 5 bleeding as compared with ticagrelor plus aspirin in both patients with [4.6% vs. 9.0%; hazard ratio (HR) 0.50, 95% confidence interval (CI) 0.31-0.80] and without (4.0% vs. 6.7%; HR 0.59, 95% CI 0.47-0.75; Pinteraction = 0.508) CKD, but the absolute risk reduction was greater in the former group. Rates of death, myocardial infarction, or stroke were not significantly different between the two randomized groups irrespective of the presence (7.9% vs. 5.7%; HR 1.40, 95% CI 0.88-2.22) or absence of (3.2% vs. 3.6%; HR 0.90, 95% CI 0.68-1.20; Pinteraction = 0.111) CKD. CONCLUSION: Among CKD patients undergoing PCI, ticagrelor monotherapy reduced the risk of bleeding without a significant increase in ischaemic events as compared with ticagrelor plus aspirin. CI - Published on behalf of the European Society of Cardiology. All rights reserved. (c) The Author(s) 2021. For permissions, please email: journals.permissions@oup.com. FAU - Stefanini, Giulio G AU - Stefanini GG AUID- ORCID: 0000-0002-3558-6967 AD - Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan 20090, Italy. AD - IRCCS Humanitas Research Hospital, Rozzano, Milan 20089, Italy. FAU - Briguori, Carlo AU - Briguori C AUID- ORCID: 0000-0002-2105-8186 AD - Mediterranea Cardiocentro, Napoli 80122, Italy. FAU - Cao, Davide AU - Cao D AUID- ORCID: 0000-0001-7755-4069 AD - The Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai Hospital, One Gustave L. Levy Place, Box 1030, New York, NY 10029-6574, USA. FAU - Baber, Usman AU - Baber U AUID- ORCID: 0000-0003-1614-5987 AD - The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA. FAU - Sartori, Samantha AU - Sartori S AUID- ORCID: 0000-0003-0618-9409 AD - Mediterranea Cardiocentro, Napoli 80122, Italy. FAU - Zhang, Zhongjie AU - Zhang Z AUID- ORCID: 0000-0002-9615-0518 AD - Mediterranea Cardiocentro, Napoli 80122, Italy. FAU - Dangas, George AU - Dangas G AD - The Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai Hospital, One Gustave L. Levy Place, Box 1030, New York, NY 10029-6574, USA. FAU - Angiolillo, Dominick J AU - Angiolillo DJ AD - University of Florida College of Medicine, Jacksonville, FL 32209, USA. FAU - Mehta, Shamir AU - Mehta S AD - Hamilton Health Sciences, Hamilton, ON L8N 3Z5, Canada. FAU - Cohen, David J AU - Cohen DJ AUID- ORCID: 0000-0001-9163-724X AD - Cardiovascular Research Foundation, New York, NY 10019, USA. AD - St. Francis Hospital, Roslyn, NY 11576, USA. FAU - Collier, Timothy AU - Collier T AUID- ORCID: 0000-0002-3095-277X AD - London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK. FAU - Dudek, Dariusz AU - Dudek D AD - Jagiellonian University Medical College, Krakow 31-008, Poland. FAU - Escaned, Javier AU - Escaned J AUID- ORCID: 0000-0003-4932-0112 AD - Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos and Complutense University, Madrid 28040, Spain. FAU - Gibson, C Michael AU - Gibson CM AUID- ORCID: 0000-0002-4857-9125 AD - Beth Israel Deaconess Medical Center, Boston, MA 02215, USA. FAU - Gil, Robert AU - Gil R AUID- ORCID: 0000-0002-9041-3313 AD - Center of Postgraduate Medical Education, Central Clinical Hospital of the Ministry of Interior and Administration, Warsaw 02-507, Poland. FAU - Huber, Kurt AU - Huber K AUID- ORCID: 0000-0002-7934-5524 AD - Wilhelminenhospital, Wien 1160, Austria. FAU - Kaul, Upendra AU - Kaul U AD - Batra Hospital and Medical Research Centre, New Delhi 110062, India. FAU - Kornowski, Ran AU - Kornowski R AD - Rabin Medical Center, Petah Tikva 49100, Israel. FAU - Krucoff, Mitchell W AU - Krucoff MW AD - Duke University Medical Center-Duke Clinical Research Institute, Durham, NC 27710, USA. FAU - Kunadian, Vijay AU - Kunadian V AD - Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University and Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE7 7DN, UK. FAU - Moliterno, David J AU - Moliterno DJ AUID- ORCID: 0000-0002-6699-0639 AD - University of Kentucky, Lexington, KY 40506, USA. FAU - Ohman, E Magnus AU - Ohman EM AUID- ORCID: 0000-0002-6249-4988 AD - Duke University Medical Center-Duke Clinical Research Institute, Durham, NC 27710, USA. FAU - Oldroyd, Keith G AU - Oldroyd KG AD - The West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank G81 4DY, UK. FAU - Sardella, Gennaro AU - Sardella G AD - Policlinico Umberto I University, Roma 00161, Italy. FAU - Sharma, Samin K AU - Sharma SK AUID- ORCID: 0000-0002-1888-0793 AD - The Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai Hospital, One Gustave L. Levy Place, Box 1030, New York, NY 10029-6574, USA. FAU - Shlofmitz, Richard AU - Shlofmitz R AUID- ORCID: 0000-0002-9422-048X AD - St. Francis Hospital, Roslyn, NY 11576, USA. FAU - Weisz, Giora AU - Weisz G AD - New York Presbyterian Hospital, Columbia University Medical Center, New York, NY 10032, USA. FAU - Witzenbichler, Bernhard AU - Witzenbichler B AUID- ORCID: 0000-0001-9322-1926 AD - Helios Amper-Klinikum, Dachau 85221, Germany. FAU - Pocock, Stuart AU - Pocock S AUID- ORCID: 0000-0003-2212-4007 AD - London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK. FAU - Mehran, Roxana AU - Mehran R AUID- ORCID: 0000-0002-5546-262X AD - The Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai Hospital, One Gustave L. Levy Place, Box 1030, New York, NY 10029-6574, USA. LA - eng PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - England TA - Eur Heart J JT - European heart journal JID - 8006263 RN - 0 (Platelet Aggregation Inhibitors) RN - GLH0314RVC (Ticagrelor) SB - IM CIN - Eur Heart J. 2021 Dec 1;42(45):4694-4696. doi: 10.1093/eurheartj/ehab607. PMID: 34480540 MH - Drug Therapy, Combination MH - *Drug-Eluting Stents MH - Humans MH - *Percutaneous Coronary Intervention MH - Platelet Aggregation Inhibitors/therapeutic use MH - *Renal Insufficiency, Chronic/complications/drug therapy MH - Ticagrelor/therapeutic use MH - Treatment Outcome OTO - NOTNLM OT - Aspirin OT - Bleeding OT - Chronic kidney disease OT - PCI OT - Thrombosis OT - Ticagrelor monotherapy EDAT- 2021/08/24 06:00 MHDA- 2021/12/15 06:00 CRDT- 2021/08/23 06:46 PHST- 2021/04/13 00:00 [received] PHST- 2021/06/07 00:00 [revised] PHST- 2021/07/26 00:00 [accepted] PHST- 2021/08/24 06:00 [pubmed] PHST- 2021/12/15 06:00 [medline] PHST- 2021/08/23 06:46 [entrez] AID - 6356261 [pii] AID - 10.1093/eurheartj/ehab533 [doi] PST - ppublish SO - Eur Heart J. 2021 Dec 1;42(45):4683-4693. doi: 10.1093/eurheartj/ehab533. PMID- 34339469 OWN - NLM STAT- MEDLINE DCOM- 20240725 LR - 20240725 IS - 1932-6203 (Electronic) IS - 1932-6203 (Linking) VI - 16 IP - 8 DP - 2021 TI - Variability of discharge medical therapy for secondary prevention among patients with myocardial infarction with non-obstructive coronary arteries (MINOCA) in the United States. PG - e0255462 LID - 10.1371/journal.pone.0255462 [doi] LID - e0255462 AB - BACKGROUND: Optimal medical therapy after myocardial infarction with nonobstructive coronary arteries (MINOCA; <50% stenosis) is uncertain. We evaluated variability in discharge prescription of angiotensin-converting enzyme inhibitors / angiotensin receptor blockers (ACEI/ARB) and beta-blockers (BB) to MINOCA patients between hospitals to assess physician equipoise about secondary prevention. METHODS: Patients with MINOCA between 2007-2014 were identified in the NCDR Chest Pain-MI Registry. Those with prior revascularization or missing demographic, angiographic, or medication data were excluded. Analysis was limited to high-volume hospitals with >/=20 MINOCA total discharges. Discharge prescriptions for ACEI/ARB and BB after MINOCA were analyzed for each hospital. Clinical data on left ventricular ejection fraction (LVEF), glomerular filtration rate (GFR), and diabetes mellitus status were extracted to identify other indications for ACEI/ARB or BB. RESULTS: Clinical data were available for 17,849 MINOCA patients, of whom 8,752 (49%) had LVEF <40%, GFR /= 75 years included in the ANTARCTIC randomized trial, data on Bleeding Academic Research Consortium (BARC) bleeding complications and major adverse cardiovascular events (MACE), defined as the composite of cardiovascular death, myocardial infarction, and stroke, were collected over 1 year. RESULTS: Clinically relevant bleeding events (BARC types 2, 3, or 5) were observed in 20.6% of patients (n = 181) at 1 year, of which, one third occurred in the first month. Anemia (adjusted hazard ratio [adj.HR] 3.98, 95% confidence interval [CI] 1.41-11.22; p = 0.009), severe chronic renal failure (adj.HR 1.83, 95% CI 1.12-2.98; p = 0.015), and femoral access (adj.HR 2.54, 95% CI 1.71-3.77; p < 0.001) were independently associated with clinically relevant bleeding events, while age > 85 years (adj.HR 2.22, 95% CI 1.14-4.30; p = 0.018) was independently associated with major bleeding events (BARC types 3 or 5). Patients with a clinically relevant bleeding event had a higher rate of MACE at 1 year (adj.HR 2.04, 95% CI 1.24-3.38; p = 0.005), with a particularly strong effect on stroke (adj.HR 5.55, 95% CI 2.04-15.06; p < 0.001). CONCLUSIONS: Clinically relevant bleeding events were observed in one out of five elderly patients undergoing stenting for an ACS and were strongly associated with further stroke occurrence. Rather than the antiplatelet therapy, comorbidities and an age > 85 years predicted bleeding outcomes in this elderly population. CLINICAL TRIAL REGISTRATION: Clinicaltrials.gov identifier: NCT01538446. https://www.clinicaltrials.gov . CI - (c) 2021. The Author(s), under exclusive licence to Springer Nature Switzerland AG part of Springer Nature. FAU - Lattuca, Benoit AU - Lattuca B AD - ACTION Study Group, INSERM UMRS 1166, Cardiology Institute, Pitie-Salpetriere (AP-HP) University Hospital, Sorbonne University, 47-83 bld de l'Hopital, 75013, Paris, France. AD - ACTION Study Group, Cardiology Department, Nimes University Hospital, Montpellier University, Nimes, France. FAU - Cayla, Guillaume AU - Cayla G AD - ACTION Study Group, Cardiology Department, Nimes University Hospital, Montpellier University, Nimes, France. FAU - Silvain, Johanne AU - Silvain J AD - ACTION Study Group, INSERM UMRS 1166, Cardiology Institute, Pitie-Salpetriere (AP-HP) University Hospital, Sorbonne University, 47-83 bld de l'Hopital, 75013, Paris, France. FAU - Cuisset, Thomas AU - Cuisset T AD - ACTION Study Group, Cardiology Department, INSERM UMR1062, INRA UMR1260, Centre Hospitalier Universitaire La Timone, Aix-Marseille University, Marseille, France. FAU - Leclercq, Florence AU - Leclercq F AD - Cardiology Department, Centre Hospitalier Universitaire de Montpellier, Montpellier University, Montpellier, France. FAU - Manzo-Silberman, Stephane AU - Manzo-Silberman S AD - Cardiology Department, Centre Hospitalier Universitaire Lariboisiere (AP-HP), INSERM UMRS 942, Paris, France. FAU - Saint-Etienne, Christophe AU - Saint-Etienne C AD - Cardiology Department, Centre Hospitalier Universitaire de Tours, Tours, France. FAU - Delarche, Nicolas AU - Delarche N AD - Cardiology Department, Hopital Francois Mitterrand, Pau, France. FAU - El Mahmoud, Rami AU - El Mahmoud R AD - Cardiology Department, Hopital Ambroise Pare, Boulogne-Billancourt, France. FAU - Carrie, Didier AU - Carrie D AD - Cardiology Department, Centre Hospitalier Universitaire Rangueil, Universite Paul Sabatier Toulouse 3, Toulouse, France. FAU - Souteyrand, Geraud AU - Souteyrand G AD - Cardiology Department, Centre Hospitalier Universitaire Gabriel Montpied, Clermont-Ferrand, France. FAU - Kerneis, Mathieu AU - Kerneis M AD - ACTION Study Group, INSERM UMRS 1166, Cardiology Institute, Pitie-Salpetriere (AP-HP) University Hospital, Sorbonne University, 47-83 bld de l'Hopital, 75013, Paris, France. FAU - Hauguel-Moreau, Marie AU - Hauguel-Moreau M AD - ACTION Study Group, INSERM UMRS 1166, Cardiology Institute, Pitie-Salpetriere (AP-HP) University Hospital, Sorbonne University, 47-83 bld de l'Hopital, 75013, Paris, France. FAU - Zeitouni, Michel AU - Zeitouni M AD - ACTION Study Group, INSERM UMRS 1166, Cardiology Institute, Pitie-Salpetriere (AP-HP) University Hospital, Sorbonne University, 47-83 bld de l'Hopital, 75013, Paris, France. FAU - Guedeney, Paul AU - Guedeney P AD - ACTION Study Group, INSERM UMRS 1166, Cardiology Institute, Pitie-Salpetriere (AP-HP) University Hospital, Sorbonne University, 47-83 bld de l'Hopital, 75013, Paris, France. FAU - Diallo, Abdourahmane AU - Diallo A AD - ACTION Study Group, Epidemiology and Clinic Research Unit, Lariboisiere University Hospital, Paris, France. FAU - Collet, Jean-Philippe AU - Collet JP AD - ACTION Study Group, INSERM UMRS 1166, Cardiology Institute, Pitie-Salpetriere (AP-HP) University Hospital, Sorbonne University, 47-83 bld de l'Hopital, 75013, Paris, France. FAU - Vicaut, Eric AU - Vicaut E AD - ACTION Study Group, Epidemiology and Clinic Research Unit, Lariboisiere University Hospital, Paris, France. FAU - Montalescot, Gilles AU - Montalescot G AD - ACTION Study Group, INSERM UMRS 1166, Cardiology Institute, Pitie-Salpetriere (AP-HP) University Hospital, Sorbonne University, 47-83 bld de l'Hopital, 75013, Paris, France. gilles.montalescot@aphp.fr. CN - ACTION Study Group LA - eng SI - ClinicalTrials.gov/NCT01538446 PT - Journal Article PT - Randomized Controlled Trial DEP - 20210630 PL - New Zealand TA - Am J Cardiovasc Drugs JT - American journal of cardiovascular drugs : drugs, devices, and other interventions JID - 100967755 SB - IM MH - Acute Coronary Syndrome/therapy MH - Aged MH - Aged, 80 and over MH - *Hemorrhage/epidemiology MH - Humans MH - Risk Factors MH - Treatment Outcome EDAT- 2021/07/01 06:00 MHDA- 2021/12/24 06:00 CRDT- 2021/06/30 12:37 PHST- 2021/02/07 00:00 [accepted] PHST- 2021/07/01 06:00 [pubmed] PHST- 2021/12/24 06:00 [medline] PHST- 2021/06/30 12:37 [entrez] AID - 10.1007/s40256-021-00468-8 [pii] AID - 10.1007/s40256-021-00468-8 [doi] PST - ppublish SO - Am J Cardiovasc Drugs. 2021 Nov;21(6):681-691. doi: 10.1007/s40256-021-00468-8. Epub 2021 Jun 30. PMID- 34183067 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20260407 IS - 2047-0525 (Print) IS - 2047-0525 (Electronic) IS - 2047-0525 (Linking) VI - 10 IP - 1 DP - 2021 Jun 29 TI - Meta-analysis of AKI to CKD transition in perioperative patients. PG - 24 LID - 10.1186/s13741-021-00192-6 [doi] LID - 24 AB - BACKGROUND: Recent research shows AKI increases the risk of incident CKD. We hypothesized that perioperative AKI may confer increased risk of subsequent CKD compared to nonperioperative AKI. METHODS: A MEDLINE search was performed for "AKI, CKD, chronic renal insufficiency, surgery, and perioperative" and related terms yielded 5209 articles. One thousand sixty-five relevant studies were reviewed. One thousand six were excluded because they were review, animal, or pediatric studies. Fifty-nine studies underwent full manuscript review by two independent evaluators. Seventeen met all inclusion criteria and underwent analysis. Two-by-two tables were constructed from AKI +/- and CKD +/- data. The R package metafor was employed to determine odds ratio (OR), and a random-effects model was used to calculate weighted ORs. Leave-1-out, funnel analysis, and structured analysis were used to estimate effects of study heterogeneity and bias. RESULTS: Nonperioperative studies included studies of oncology, percutaneous coronary intervention, and myocardial infarction patients. Perioperative studies comprised patients from cardiac surgery, vascular surgery, and burns. There was significant heterogeneity, but risk of bias was overall assessed as low. The OR for AKI versus non-AKI patients developing CKD in all studies was 4.31 (95% CI 3.01-6.17; p < 0.01). Nonperioperative subjects demonstrated OR 3.32 for developing CKD compared to non-AKI patients (95% CI 2.06-5.34; p < 0.01) while perioperative patients demonstrated OR 5.20 (95% CI 3.12-8.66; p < 0.01) for the same event. CONCLUSIONS: We conclude that studies conducted in perioperative and nonperioperative patient populations suggest similar risk of development of CKD after AKI. FAU - Abdala, Pedro M AU - Abdala PM AUID- ORCID: 0000-0003-0931-0729 AD - Anesthesiology & Perioperative Medicine, Oregon Health & Science University, Portland, OR, USA. pabdala777@gmail.com. FAU - Swanson, Elizabeth A AU - Swanson EA AD - Medical Scientist Training Program, Oregon Health & Science University, Portland, OR, USA. FAU - Hutchens, Michael P AU - Hutchens MP AD - Anesthesiology & Perioperative Medicine, Oregon Health & Science University, Portland, OR, USA. AD - Portland Veterans Affairs Medical Center, Operative Care Division, 3710 SW US Veterans Hospital Road, Portland, OR, 97239, USA. LA - eng GR - F30 DK114980/DK/NIDDK NIH HHS/United States GR - I01 BX004288/BX/BLRD VA/United States GR - 1I01BX004288/U.S. Department of Veterans Affairs/ GR - F30 DK114980-03/DK/NIDDK NIH HHS/United States PT - Journal Article DEP - 20210629 PL - England TA - Perioper Med (Lond) JT - Perioperative medicine (London, England) JID - 101609072 PMC - PMC8240318 OTO - NOTNLM OT - Chronic kidney disease OT - Long-term outcomes of surgery OT - Perioperative OT - Surgery OT - acute kidney injury COIS- The authors declare that they have no competing interests. EDAT- 2021/06/30 06:00 MHDA- 2021/06/30 06:01 PMCR- 2021/06/29 CRDT- 2021/06/29 05:42 PHST- 2020/03/30 00:00 [received] PHST- 2021/04/26 00:00 [accepted] PHST- 2021/06/29 05:42 [entrez] PHST- 2021/06/30 06:00 [pubmed] PHST- 2021/06/30 06:01 [medline] PHST- 2021/06/29 00:00 [pmc-release] AID - 10.1186/s13741-021-00192-6 [pii] AID - 192 [pii] AID - 10.1186/s13741-021-00192-6 [doi] PST - epublish SO - Perioper Med (Lond). 2021 Jun 29;10(1):24. doi: 10.1186/s13741-021-00192-6. PMID- 34152561 OWN - NLM STAT- MEDLINE DCOM- 20220412 LR - 20220612 IS - 1724-6059 (Electronic) IS - 1121-8428 (Print) IS - 1121-8428 (Linking) VI - 35 IP - 3 DP - 2022 Apr TI - Urinary metabolic profile and stone composition in kidney stone formers with and without heart disease. PG - 851-857 LID - 10.1007/s40620-021-01096-w [doi] AB - OBJECTIVE: Kidney stone disease seems to be associated with an increased risk of incident cardiovascular outcomes; the aim of this study is to identify differences in 24-h urine excretory profiles and stone composition among stone formers with and without cardiovascular disease (CVD). METHODS: Data from patients attending the Department of Renal Medicine's metabolic stone clinic from 1995 to 2012 were reviewed. The sample was divided according to the presence or absence of CVD (myocardial infarction, angina, coronary revascularization, or surgery for calcified heart valves). Univariable and multivariable regression models, adjusted for age, sex, BMI, hypertension, diabetes, eGFR, plasma bicarbonate and potential renal acid load of foods were used to investigate differences across groups. RESULTS: 1826 patients had available data for 24-h urine analysis. Among these, 108 (5.9%) had a history of CVD. Those with CVD were older, have higher prevalence of hypertension and diabetes and lower eGFR. Univariable analysis showed that patients with CVD had significantly lower 24-h urinary excretions for citrate (2.4 vs 2.6 mmol/24 h, p = 0.04), magnesium (3.9 vs 4.2 mmol/24 h, p = 0.03) and urinary pH (6.1 vs 6.2, p = 0.02). After adjustment for confounders, differences in urinary citrate and magnesium excretions remained significant. No differences in the probability of stone formation or stone compositions were found. CONCLUSIONS: Stone formers with CVD have lower renal alkali excretion, possibly suggesting higher acid retention in stone formers with cardiovascular comorbidities. Randomized clinical trials including medications and a controlled diet design are needed to confirm the results presented here. CI - (c) 2021. The Author(s). FAU - Bargagli, Matteo AU - Bargagli M AD - U.O.S. Terapia Conservativa della Malattia Renale Cronica, U.O.C. Nefrologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Universita Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00168, Rome, Italy. FAU - Moochhala, Shabbir AU - Moochhala S AD - Department of Renal Medicine, Royal Free Campus Medical School, University College Hospital, London, UK. FAU - Robertson, William G AU - Robertson WG AD - Department of Renal Medicine, Royal Free Campus Medical School, University College Hospital, London, UK. AD - Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK. FAU - Gambaro, Giovanni AU - Gambaro G AD - Renal Unit, Division of Nephrology and Dialysis, Department of Medicine, University of Verona, Verona, Italy. FAU - Lombardi, Gianmarco AU - Lombardi G AD - Renal Unit, Division of Nephrology and Dialysis, Department of Medicine, University of Verona, Verona, Italy. FAU - Unwin, Robert J AU - Unwin RJ AD - Department of Renal Medicine, Royal Free Campus Medical School, University College Hospital, London, UK. FAU - Ferraro, Pietro Manuel AU - Ferraro PM AUID- ORCID: 0000-0002-1379-022X AD - U.O.S. Terapia Conservativa della Malattia Renale Cronica, U.O.C. Nefrologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Universita Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00168, Rome, Italy. pietromanuel.ferraro@unicatt.it. AD - Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Universita Cattolica del Sacro Cuore, Rome, Italy. pietromanuel.ferraro@unicatt.it. LA - eng PT - Journal Article DEP - 20210621 PL - England TA - J Nephrol JT - Journal of nephrology JID - 9012268 RN - 0 (Citrates) RN - 2968PHW8QP (Citric Acid) RN - I38ZP9992A (Magnesium) RN - SY7Q814VUP (Calcium) SB - IM MH - Calcium/metabolism MH - Citrates MH - Citric Acid MH - *Diabetes Mellitus MH - *Heart Diseases MH - Humans MH - *Hypertension MH - *Kidney Calculi/epidemiology/metabolism MH - Magnesium MH - Metabolome PMC - PMC8995244 OTO - NOTNLM OT - Cardiovascular risk OT - Citrate OT - Kidney stones OT - Magnesium COIS- PMF received consultant fees/grant support from Allena Pharmaceuticals, Alnylam, AstraZeneca, BioHealth Italia, Vifor Fresenius and author royalties from UpToDate; RJU is currently employed by AstraZeneca BioPharmaceuticals R&D, Early CVRM (Cardiovascular, Renal and Metabolism), Cambridge UK and Gothenburg Sweden; MB and PMF are members of the European Reference Network for Rare Kidney Diseases (ERKNet)-Project ID No 739,532; all the other authors have no disclosures. EDAT- 2021/06/22 06:00 MHDA- 2022/04/13 06:00 PMCR- 2021/06/21 CRDT- 2021/06/21 12:27 PHST- 2021/03/09 00:00 [received] PHST- 2021/06/09 00:00 [accepted] PHST- 2021/06/22 06:00 [pubmed] PHST- 2022/04/13 06:00 [medline] PHST- 2021/06/21 12:27 [entrez] PHST- 2021/06/21 00:00 [pmc-release] AID - 10.1007/s40620-021-01096-w [pii] AID - 1096 [pii] AID - 10.1007/s40620-021-01096-w [doi] PST - ppublish SO - J Nephrol. 2022 Apr;35(3):851-857. doi: 10.1007/s40620-021-01096-w. Epub 2021 Jun 21. PMID- 34132753 OWN - NLM STAT- MEDLINE DCOM- 20220428 LR - 20260518 IS - 2380-6591 (Electronic) IS - 2380-6583 (Print) VI - 6 IP - 9 DP - 2021 Sep 1 TI - Skeletonized vs Pedicled Internal Mammary Artery Graft Harvesting in Coronary Artery Bypass Surgery: A Post Hoc Analysis From the COMPASS Trial. PG - 1042-1049 LID - 10.1001/jamacardio.2021.1686 [doi] AB - IMPORTANCE: The relative safety and patency of skeletonized vs pedicled internal mammary artery grafts in patients undergoing coronary artery bypass graft (CABG) surgery are unknown. OBJECTIVE: To investigate the association of skeletonized vs pedicled harvesting with internal mammary artery graft patency and clinical outcomes 1 year after CABG surgery. DESIGN, SETTING, AND PARTICIPANTS: This study was a post hoc analysis of the multicenter, randomized, double-blind, placebo-controlled Cardiovascular Outcomes for People Using Anticoagulation Strategies (COMPASS) clinical trial, which enrolled 27 395 patients from 602 centers in 33 countries from March 2013 through May 2016. Eligibility criteria for the trial included CABG surgery for coronary artery disease with at least 2 grafts implanted and an estimated glomerular filtration rate of at least 30 mL/min. A total of 1002 of 1448 patients were randomized to the CABG arm of the COMPASS trial and underwent skeletonized (282 [28.1%]) or pedicled (720 [71.9%]) internal mammary artery harvesting. The patients had evaluable angiography results 1 year after surgery. Data were analyzed from October 11, 2019, to May 14, 2020. INTERVENTIONS: Patients underwent graft harvesting with either the pedicled technique or skeletonized technique. MAIN OUTCOMES AND MEASURES: The primary outcome was graft occlusion 1 year after CABG surgery, as assessed by computed tomography angiography. RESULTS: A total of 1002 patients underwent skeletonized (282 [28.1%]; mean [SD] age, 65.9 [8.1] years; 229 men [81.2%]; 194 White patients [68.8%]) or pedicled (720 [71.9%]; mean [SD] age, 64.8 [7.6] years; 603 men [83.8%]; 455 White patients [63.2%]) internal mammary artery harvesting. Rates of internal mammary artery graft occlusion 1 year after CABG surgery were higher in the skeletonized group than in the pedicled group (33 of 344 [9.6%] vs 30 of 764 [3.9%]; graft-level adjusted odds ratio, 2.41; 95% CI, 1.39-4.20; P = .002), including the left internal mammary artery to left anterior descending artery (21 of 289 [7.3%] vs 25 of 725 [3.4%]; graft-level adjusted odds ratio, 2.10; 95% CI, 1.14-3.88, P = .02). After a mean follow-up of 23 months, skeletonized graft harvesting was also associated with a higher rate of major adverse cardiovascular events (20 [7.1%] vs 15 [2.1%]; adjusted hazard ratio, 3.19; 95% CI, 1.53-6.67; P = .002) and repeated revascularization (14 [5.0%] vs 10 [1.4%]; adjusted hazard ratio, 2.75; 95% CI, 1.10-6.88; P = .03). CONCLUSIONS AND RELEVANCE: This post hoc analysis of the COMPASS randomized clinical trial found that harvesting of the internal mammary artery during CABG surgery using a skeletonized technique was associated with a higher rate of graft occlusion and worse clinical outcomes than the traditional pedicled technique. Future randomized clinical trials are needed to establish the safety and patency of the skeletonized technique. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01776424. FAU - Lamy, Andre AU - Lamy A AD - Population Health Research Institute, Hamilton Health Sciences, Hamilton, Ontario, Canada. AD - Department of Surgery, McMaster University, Hamilton, Ontario, Canada. AD - Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada. FAU - Browne, Austin AU - Browne A AD - Population Health Research Institute, Hamilton Health Sciences, Hamilton, Ontario, Canada. FAU - Sheth, Tej AU - Sheth T AD - Population Health Research Institute, Hamilton Health Sciences, Hamilton, Ontario, Canada. AD - Department of Medicine, McMaster University, Hamilton, Ontario, Canada. FAU - Zheng, Zhe AU - Zheng Z AD - Department of Cardiovascular Surgery, Fuwai Hospital, Beijing, China. FAU - Dagenais, Francois AU - Dagenais F AD - Department of Cardiac Surgery, Quebec Heart and Lung Institute affiliated with Laval University, Quebec City, Quebec, Canada. FAU - Noiseux, Nicolas AU - Noiseux N AD - Department of Cardiac Surgery, Centre Hospitalier de l'Universite de Montreal, Montreal, Quebec, Canada. FAU - Chen, Xin AU - Chen X AD - Department of Thoracic and Cardiovascular Surgery, Nanjing First Hospital affiliated with Nanjing Medical University, Nanjing, China. FAU - Bakaeen, Faisal G AU - Bakaeen FG AD - Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio. FAU - Brtko, Miroslav AU - Brtko M AD - Department of Cardiac Surgery, Fakultni Nemocnice Hradec Kralove, Hradec Kralove, Kralovehradecky, Czech Republic. FAU - Stevens, Louis-Mathieu AU - Stevens LM AD - Department of Cardiac Surgery, Centre Hospitalier de l'Universite de Montreal, Montreal, Quebec, Canada. FAU - Alboom, Mariam AU - Alboom M AD - Department of Surgery, McMaster University, Hamilton, Ontario, Canada. FAU - Lee, Shun Fu AU - Lee SF AD - Population Health Research Institute, Hamilton Health Sciences, Hamilton, Ontario, Canada. AD - Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada. FAU - Copland, Ingrid AU - Copland I AD - Population Health Research Institute, Hamilton Health Sciences, Hamilton, Ontario, Canada. FAU - Salim, Yusuf AU - Salim Y AD - Population Health Research Institute, Hamilton Health Sciences, Hamilton, Ontario, Canada. AD - Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada. AD - Department of Medicine, McMaster University, Hamilton, Ontario, Canada. FAU - Eikelboom, John AU - Eikelboom J AD - Population Health Research Institute, Hamilton Health Sciences, Hamilton, Ontario, Canada. AD - Department of Medicine, McMaster University, Hamilton, Ontario, Canada. CN - COMPASS Investigators LA - eng SI - ClinicalTrials.gov/NCT01776424 PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PL - United States TA - JAMA Cardiol JT - JAMA cardiology JID - 101676033 SB - IM EIN - JAMA Cardiol. 2021 Oct 1;6(10):1223. doi: 10.1001/jamacardio.2021.3351. PMID: 34406323 CIN - JAMA Cardiol. 2022 Sep 1;7(9):987-988. doi: 10.1001/jamacardio.2022.1945. PMID: 35830168 CIN - JAMA Cardiol. 2022 Sep 1;7(9):988-989. doi: 10.1001/jamacardio.2022.1948. PMID: 35830191 MH - Aged MH - Coronary Artery Bypass/methods MH - *Coronary Artery Disease/etiology/surgery MH - Female MH - Humans MH - Male MH - *Mammary Arteries/transplantation MH - Middle Aged MH - Treatment Outcome MH - Vascular Patency PMC - PMC8209583 COIS- Conflict of Interest Disclosures: Dr Eikelboom reported receiving grants and personal fees from Bayer, Boehringer Ingelheim, Bristol Myers Squibb, Pfizer, Daiichi Sankyo, Janssen, AstraZeneca, Eli Lilly, GlaxoSmithKline, and Sanofi-Aventis and personal fees from Servier outside the submitted work. Dr Salim reported receiving grants and personal fees from Bayer, Boehringer Ingelheim, AstraZeneca, Bristol Myers Squibb, and Cadila Pharmaceuticals and reported receiving consultant and speaker fees and travel expenses from Bayer. No other disclosures were reported. FIR - Diaz, Rafael IR - Diaz R FIR - Tonkin, Andrew M IR - Tonkin AM FIR - Varigos, John D IR - Varigos JD FIR - Verhamme, Peter B IR - Verhamme PB FIR - Avezum, Alvaro IR - Avezum A FIR - Piegas, Leopoldo S IR - Piegas LS FIR - Dagenais, Gilles R IR - Dagenais GR FIR - Lonn, Eva M IR - Lonn EM FIR - Lanas, Fernando IR - Lanas F FIR - Zhu, Jun IR - Zhu J FIR - Liu, Lisheng IR - Liu L FIR - Liang, Yan IR - Liang Y FIR - Lopez-Jaramillo, Patricio IR - Lopez-Jaramillo P FIR - Widimsky, Petr IR - Widimsky P FIR - Torp-Pedersen, Christian IR - Torp-Pedersen C FIR - Felix, Camilo IR - Felix C FIR - Metsarinne, Kaj P IR - Metsarinne KP FIR - Steg, Philippe Gabriel IR - Steg PG FIR - Aboyans, Victor IR - Aboyans V FIR - Ertl, Georg IR - Ertl G FIR - Stoerk, Stefan IR - Stoerk S FIR - Keltai, Katalin IR - Keltai K FIR - Keltai, Matyas IR - Keltai M FIR - O'Donnell, Martin IR - O'Donnell M FIR - Fox, Keith A IR - Fox KA FIR - Kakkar, Ajay IR - Kakkar A FIR - Lewis, Basil S IR - Lewis BS FIR - Maggioni, Aldo P IR - Maggioni AP FIR - Hori, Masatsugu IR - Hori M FIR - Yusoff, Khalid IR - Yusoff K FIR - Alings, Marco IR - Alings M FIR - Dans, Antonio L IR - Dans AL FIR - Guzik, Tomasz J IR - Guzik TJ FIR - Vinereanu, Dragos IR - Vinereanu D FIR - Pogosova, Nana Goar IR - Pogosova NG FIR - Commerford, Patrick J IR - Commerford PJ FIR - Kim, Jae-Hyung IR - Kim JH FIR - Ryden, Lars IR - Ryden L FIR - Parkhomenko, Alexander N IR - Parkhomenko AN FIR - Bhatt, Deepak L IR - Bhatt DL FIR - Branch, Kelley R H IR - Branch KRH FIR - Probstfield, Jeffrey L IR - Probstfield JL FIR - Anand, Sonia IR - Anand S FIR - Bosch, Jackie IR - Bosch J FIR - Connolly, Stuart IR - Connolly S FIR - Eikelboom, John W IR - Eikelboom JW FIR - Hart, Robert IR - Hart R FIR - Lamy, Andre IR - Lamy A FIR - Moayeddi, Paul IR - Moayeddi P FIR - Sharma, Mike IR - Sharma M FIR - Yusuf, Salim IR - Yusuf S FIR - Berkowitz, Scott IR - Berkowitz S FIR - Muehlhofer, Eva IR - Muehlhofer E EDAT- 2021/06/17 06:00 MHDA- 2022/04/29 06:00 PMCR- 2022/06/16 CRDT- 2021/06/16 12:22 PHST- 2021/06/17 06:00 [pubmed] PHST- 2022/04/29 06:00 [medline] PHST- 2021/06/16 12:22 [entrez] PHST- 2022/06/16 00:00 [pmc-release] AID - 2780714 [pii] AID - hoi210036 [pii] AID - 10.1001/jamacardio.2021.1686 [doi] PST - ppublish SO - JAMA Cardiol. 2021 Sep 1;6(9):1042-1049. doi: 10.1001/jamacardio.2021.1686. PMID- 34108090 OWN - NLM STAT- MEDLINE DCOM- 20210913 LR - 20210913 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 152 DP - 2021 Aug 1 TI - Triglyceride-Rich Lipoproteins, Apolipoproteins, and Atherosclerotic Cardiovascular Events Among Patients with Diabetes Mellitus and End-Stage Renal Disease on Hemodialysis. PG - 63-68 LID - S0002-9149(21)00399-4 [pii] LID - 10.1016/j.amjcard.2021.04.023 [doi] AB - Hypertriglyceridemia may be implicated in the high atherosclerotic cardiovascular disease (ASCVD) risk experienced by patients with end-stage renal disease (ESRD). In this post-hoc analysis of the "Die Deutsche Diabetes Dialyse Studie (4D)" clinical trial, we examined incident ASCVD events, defined as myocardial infarction, ischemic stroke, or a coronary revascularization procedure, among 1255 participants with type 2 diabetes and ESRD treated with hemodialysis. Cox-regression methods were used to evaluate the association of triglycerides, very-low density lipoprotein cholesterol (VLDL-C), and apolipoproteins B (Apo B) and C-III (Apo C-III) with ASCVD. During a median follow-up time of 2.3 years, 340 (27%) participants experienced an ASCVD event. Higher concentrations of triglycerides were not associated with ASCVD risk: Hazard ratio (HR) 0.95; 95% CI (0.83, 1.10) per doubling concentration. Similarly, VLDL-C HR 1.01; 95% CI (0.90, 1.13); Apo B HR 1.04; 95% CI (0.93, 1.16); and Apo C-III HR 0.97; 95% CI (0.86, 1.09) (per one standard deviation higher concentrations), were not associated with ASCVD events. These associations did not differ by allocation to treatment to atorvastatin or by concentrations of markers of inflammation or malnutrition. In conclusion, we found no evidence that triglycerides, triglyceride-rich lipoproteins, or apolipoproteins B or C-III were associated with risk of ASCVD events among patients with type 2 diabetes and ESRD on hemodialysis. These results suggest that lowering triglycerides may not decrease atherosclerotic cardiovascular risk in this population. CI - Copyright (c) 2021 Elsevier Inc. All rights reserved. FAU - Lamprea-Montealegre, Julio A AU - Lamprea-Montealegre JA AD - Division of Cardiology and Kidney Health Research Collaborative, University of California, San Francisco, California. Electronic address: julio.lampreamontealegre@ucsf.edu. FAU - Katz, Ronit AU - Katz R AD - Kidney Research Institute, University of Washington, Seattle, Washington. FAU - Scharnagl, Hubert AU - Scharnagl H AD - Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria. FAU - Silbernagel, Gunther AU - Silbernagel G AD - Division of Angiology, Department of Internal Medicine, Medical University of Graz, Graz, Austria; Department of Cardiology, Charite Berlin (CBF), Berlin Institute of Health (BIH), And DZHK (German Research Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany. FAU - Marz, Winfried AU - Marz W AD - Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria; Synlab Academy, Synlab Holding Germany GmbH, Mannheim, Germany; Department of Internal Medicine 5, Mannheim Medical Faculty, University of Heidelberg, Mannheim, Germany. FAU - Drechsler, Christiane AU - Drechsler C AD - Department of Nephrology, University of Wurzburg, Wurzburg, Germany. FAU - Wanner, Cristoph AU - Wanner C AD - Department of Nephrology, University of Wurzburg, Wurzburg, Germany. FAU - de Boer, Ian H AU - de Boer IH AD - Kidney Research Institute, University of Washington, Seattle, Washington. LA - eng PT - Journal Article DEP - 20210606 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 RN - 0 (Apolipoprotein C-III) RN - 0 (Apolipoproteins B) RN - 0 (Cholesterol, VLDL) RN - 0 (Triglycerides) SB - IM MH - Aged MH - Apolipoprotein C-III/*blood MH - Apolipoproteins B/*blood MH - Atherosclerosis/epidemiology MH - Cholesterol, VLDL/*blood MH - Diabetes Mellitus, Type 2/*blood/complications MH - Female MH - Humans MH - Ischemic Stroke/*epidemiology MH - Kidney Failure, Chronic/*blood/complications/therapy MH - Male MH - Middle Aged MH - Myocardial Infarction/*epidemiology MH - Myocardial Revascularization/statistics & numerical data MH - Proportional Hazards Models MH - Renal Dialysis MH - Triglycerides/*blood EDAT- 2021/06/11 06:00 MHDA- 2021/09/14 06:00 CRDT- 2021/06/10 05:48 PHST- 2020/12/21 00:00 [received] PHST- 2021/04/12 00:00 [revised] PHST- 2021/04/16 00:00 [accepted] PHST- 2021/06/11 06:00 [pubmed] PHST- 2021/09/14 06:00 [medline] PHST- 2021/06/10 05:48 [entrez] AID - S0002-9149(21)00399-4 [pii] AID - 10.1016/j.amjcard.2021.04.023 [doi] PST - ppublish SO - Am J Cardiol. 2021 Aug 1;152:63-68. doi: 10.1016/j.amjcard.2021.04.023. Epub 2021 Jun 6. PMID- 34098771 OWN - NLM STAT- MEDLINE DCOM- 20220210 LR - 20220210 IS - 1940-1574 (Electronic) IS - 0003-3197 (Linking) VI - 73 IP - 1 DP - 2022 Jan TI - The Preventive Effect of Alprostadil on the Contrast-Induced Nephropathy of Coronary Heart Disease Treated by Percutaneous Coronary Intervention in Moderate and High-Risk Population Stratified by Mehran Score. PG - 33-41 LID - 10.1177/00033197211015540 [doi] AB - The Mehran risk score (MRS) was used to classify patients with coronary heart disease and evaluate the preventive effect of alprostadil on contrast-induced nephropathy (CIN) after percutaneous coronary intervention. The patients (n = 1146) were randomized into an alprostadil and control group and then divided into 3 groups on the basis of the MRS: low-risk, moderate-risk, and high-risk groups. The primary end point was the occurrence of CIN (alprostadil + hydration vs simple hydration treatment); secondary end points included serum creatinine, blood urea nitrogen, creatinine clearance rate, cystatin C, interleukin-6, C-reactive protein, proteinuria, and differences in the incidence of major adverse events. In the low-risk, moderate-risk, and high-risk groups, the incidence of CIN in the control and alprostadil group was 2.9 versus 2.6% (P = .832), 11.4 versus 4.9% (P = .030), 19.1 versus 7.7% (P = .041), respectively. Multivariate logistic regression analysis showed that alprostadil treatment was a favorable protective factor for moderate-risk and high-risk CIN patients (OR = 0.343, 95% CI: 0.124-0.951, P = .040). Alprostadil can be used as a preventive treatment for moderate- and high-risk CIN patients classified by the MRS. The reduction of CIN by alprostadil may be related to an anti-inflammatory effect. FAU - Liu, Xiaogang AU - Liu X AUID- ORCID: 0000-0003-4099-6693 AD - Department of Cardiology, Tianjin Chest Hospital, Tianjin, China. FAU - Zhang, Peng AU - Zhang P AUID- ORCID: 0000-0003-2039-9373 AD - Department of Cardiology, Tianjin Chest Hospital, Tianjin, China. FAU - Zhang, Jing AU - Zhang J AD - Department of Cardiology, Tianjin Chest Hospital, Tianjin, China. FAU - Zhang, Xue AU - Zhang X AD - Graduate School of Tianjin Medical University, Tianjin, China. FAU - Yang, Shicheng AU - Yang S AUID- ORCID: 0000-0002-9083-5575 AD - Department of Cardiology, Tianjin Chest Hospital, Tianjin, China. FAU - Fu, Naikuan AU - Fu N AD - Department of Cardiology, Tianjin Chest Hospital, Tianjin, China. LA - eng PT - Journal Article PT - Randomized Controlled Trial DEP - 20210608 PL - United States TA - Angiology JT - Angiology JID - 0203706 RN - 0 (Contrast Media) RN - AYI8EX34EU (Creatinine) RN - F5TD010360 (Alprostadil) SB - IM MH - Alprostadil/therapeutic use MH - Contrast Media/adverse effects MH - Coronary Angiography MH - *Coronary Disease MH - Creatinine MH - Humans MH - *Kidney Diseases/chemically induced/prevention & control MH - *Percutaneous Coronary Intervention/adverse effects MH - Risk Factors OTO - NOTNLM OT - Mehran risk score OT - alprostadil OT - contrast-induced nephropathy OT - moderate-risk OT - percutaneous coronary intervention EDAT- 2021/06/09 06:00 MHDA- 2022/02/11 06:00 CRDT- 2021/06/08 05:28 PHST- 2021/06/09 06:00 [pubmed] PHST- 2022/02/11 06:00 [medline] PHST- 2021/06/08 05:28 [entrez] AID - 10.1177/00033197211015540 [doi] PST - ppublish SO - Angiology. 2022 Jan;73(1):33-41. doi: 10.1177/00033197211015540. Epub 2021 Jun 8. PMID- 34082620 OWN - NLM STAT- MEDLINE DCOM- 20220310 LR - 20220311 IS - 1477-0377 (Electronic) IS - 1358-863X (Linking) VI - 26 IP - 6 DP - 2021 Dec TI - Impact of chronic kidney disease on hemoglobin among patients with peripheral artery disease treated with P2Y(12) inhibitors: Insights from the EUCLID trial. PG - 608-612 LID - 10.1177/1358863X211017641 [doi] AB - Patients with chronic kidney disease may develop new or more severe anemia when treated with antiplatelet agents due to blood loss in conjunction with impaired erythropoiesis. Because anemia independently predicts limb amputation and mortality among patients with peripheral artery disease (PAD), we evaluated the relationship between estimated glomerular filtration rate (eGFR) and hemoglobin (Hb) levels in the EUCLID trial in which patients with symptomatic PAD were randomized to ticagrelor or clopidogrel. At baseline, 9025, 1870, and 1000 patients had eGFR ⩾ 60, 45-59, and < 45 mL/min/1.73 m(2), respectively. The mean fall in Hb during the trial was 0.46 +/- 1.68 g/dL and did not differ by baseline eGFR category, although Hb fall ⩾ 10% was more frequent among patients with lower eGFR (p for trend < 0.0001). On-study treatment with iron, erythropoiesis-stimulating agents, and/or red blood cell transfusion was reported for 479 (5.3%), 165 (8.8%), and 129 (12.9%) patients in the three eGFR categories, respectively (p for trend < 0.0001). After adjustment for baseline and post-randomization effects, those not receiving anemia treatment had a smaller reduction in Hb from baseline than those receiving anemia treatment (p < 0.0001). Other determinants of Hb reduction included absence of on-study myocardial infarction, coronary or peripheral revascularization, residence outside North America, male sex, and baseline eGFR. We conclude that among patients with PAD treated with P2Y(12) inhibitors, lower baseline eGFR was associated with a greater reduction in Hb. ClinicalTrials.gov Identifier: NCT01732822. FAU - Hsia, Judith AU - Hsia J AUID- ORCID: 0000-0002-3413-7836 AD - CPC Clinical Research, Aurora, CO, USA. AD - Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA. FAU - Kavanagh, Sarah T AU - Kavanagh ST AD - CPC Clinical Research, Aurora, CO, USA. FAU - Hopley, Charles W AU - Hopley CW AD - Department of Medicine, Geisel School of Medicine at Dartmouth, Dartmouth Hitchcock Medical Center, Hanover, NH, USA. FAU - Baumgartner, Iris AU - Baumgartner I AD - Department of Angiology, Inselspital, Bern, Switzerland. FAU - Berger, Jeffrey S AU - Berger JS AD - Departments of Medicine and Surgery, New York University School of Medicine, New York, NY, USA. FAU - Fowkes, Gerry R AU - Fowkes GR AD - Centre for Population Health Sciences, University of Edinburgh, Edinburgh, Scotland. FAU - Jones, W Schuyler AU - Jones WS AD - Duke Clinical Research Institute, Duke University, Durham, NC, USA. FAU - Mahaffey, Kenneth W AU - Mahaffey KW AD - Stanford University School of Medicine, Palo Alto, CA, USA. FAU - Norgren, Lars AU - Norgren L AUID- ORCID: 0000-0003-2071-7132 AD - Faculty of Medicine and Health, Orebro University Hospital, Orebro, Sweden. FAU - Patel, Manesh R AU - Patel MR AD - Duke Clinical Research Institute, Duke University, Durham, NC, USA. FAU - Rockhold, Frank AU - Rockhold F AUID- ORCID: 0000-0003-3732-4765 AD - Duke Clinical Research Institute, Duke University, Durham, NC, USA. FAU - Blomster, Juuso AU - Blomster J AD - AstraZeneca LP, Gothenburg, Sweden; Gaithersburg, MD, USA. FAU - Katona, Brian G AU - Katona BG AD - AstraZeneca LP, Gothenburg, Sweden; Gaithersburg, MD, USA. FAU - Hiatt, William R AU - Hiatt WR AD - CPC Clinical Research, Aurora, CO, USA. AD - Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA. FAU - Bonaca, Marc P AU - Bonaca MP AD - CPC Clinical Research, Aurora, CO, USA. AD - Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA. LA - eng SI - ClinicalTrials.gov/NCT01732822 PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20210603 PL - England TA - Vasc Med JT - Vascular medicine (London, England) JID - 9610930 RN - 0 (Hemoglobins) RN - GLH0314RVC (Ticagrelor) SB - IM MH - Hemoglobins MH - Humans MH - Male MH - *Peripheral Arterial Disease/complications/diagnosis/drug therapy MH - *Renal Insufficiency, Chronic/diagnosis/drug therapy MH - Ticagrelor/adverse effects MH - Treatment Outcome OTO - NOTNLM OT - anemia therapy OT - antiplatelet therapy OT - chronic kidney disease (CKD) OT - peripheral artery disease (PAD) EDAT- 2021/06/05 06:00 MHDA- 2022/03/11 06:00 CRDT- 2021/06/04 05:33 PHST- 2021/06/05 06:00 [pubmed] PHST- 2022/03/11 06:00 [medline] PHST- 2021/06/04 05:33 [entrez] AID - 10.1177/1358863X211017641 [doi] PST - ppublish SO - Vasc Med. 2021 Dec;26(6):608-612. doi: 10.1177/1358863X211017641. Epub 2021 Jun 3. PMID- 34041060 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20220423 IS - 2249-4863 (Print) IS - 2278-7135 (Electronic) IS - 2249-4863 (Linking) VI - 10 IP - 2 DP - 2021 Feb TI - An investigation of the effectiveness of oral cyclosporine on perioperative myocardial injury (PMI) in patients who undergo the surgical procedure of coronary artery bypass graft (CABG): A Randomized Controlled Clinical Trial. PG - 675-680 LID - 10.4103/jfmpc.jfmpc_1598_20 [doi] AB - BACKGROUND: Routine clinical strategies for the prevention of myocardial infarction (MI) during the surgical procedure of CABG include cross-clamp fibrillation and cardioplegia have failed to decrease the risk of perioperative myocardial injury (PMI). Cyclosporine-A (CsA) might be able to prevent mitochondrial dysfunction and PMI. METHODS: In the present clinical trial, patients were divided into two groups (Case receive 2.5 mg/kg CsA and Control receive a placebo) randomly. Moreover, patients were controlled by placebo through a double-blind, single-center trial 4-12 h before anesthesia. Perioperative blood tests include bilirubin, complete blood count, the amount of hemoglobin in whole blood, liver transaminases, and glomerular filtration rate (GFR). Blood samples were taken before surgery and at 24, 48, and 72 h after surgery and serum Troponin-I and CK-MB levels were determined in all blood samples using ELISA. RESULTS: There were no significant differences between the two groups in the results of routine pre-operative blood results, intraoperative variables, and baseline characteristics (P > 0.05). There are significant correlations between cross clamp time and cTnI and CKMB levels in patients taking CsA. In patients with both diabetes and hypertension, postsurgical cTnI and CKMB levels decrease significantly in CsA compared to placebo group on 24, 48, and 72 h (P < 0.05). Moreover, patients with old MI, both postsurgical cTnI and CKMB levels decrease significantly in CsA compared to placebo group on 24 h and 48 h (P < 0.05). CONCLUSIONS: In patients with a long cross-clamping period, using an oral CSA single dose before conducting CABG surgery, the risk of PMI could be decreased. Also, oral CsA has protective effect for CABG in diabetic patients with hypertension. CI - Copyright: (c) 2021 Journal of Family Medicine and Primary Care. FAU - Hassan Adel, Seyed Mohammad AU - Hassan Adel SM AD - Department of Cardiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. FAU - Sheikhi, Mohammad Ali AU - Sheikhi MA AD - Department of Cardiac Surgery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. FAU - Dorra, Marziyeh AU - Dorra M AD - Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. LA - eng PT - Journal Article DEP - 20210227 PL - India TA - J Family Med Prim Care JT - Journal of family medicine and primary care JID - 101610082 PMC - PMC8138422 OTO - NOTNLM OT - CABG OT - Cyclosporine A OT - clinical trial OT - perioperative myocardial injury COIS- There are no conflicts of interest. EDAT- 2021/05/28 06:00 MHDA- 2021/05/28 06:01 PMCR- 2021/02/01 CRDT- 2021/05/27 06:47 PHST- 2020/08/05 00:00 [received] PHST- 2020/10/29 00:00 [revised] PHST- 2020/12/26 00:00 [accepted] PHST- 2021/05/27 06:47 [entrez] PHST- 2021/05/28 06:00 [pubmed] PHST- 2021/05/28 06:01 [medline] PHST- 2021/02/01 00:00 [pmc-release] AID - JFMPC-10-675 [pii] AID - 10.4103/jfmpc.jfmpc_1598_20 [doi] PST - ppublish SO - J Family Med Prim Care. 2021 Feb;10(2):675-680. doi: 10.4103/jfmpc.jfmpc_1598_20. Epub 2021 Feb 27. PMID- 34017563 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20210523 IS - 1943-8141 (Print) IS - 1943-8141 (Electronic) IS - 1943-8141 (Linking) VI - 13 IP - 4 DP - 2021 TI - The prophylactic effect of alprostadil on contrast-induced nephropathy in renal insufficiency patients after percutaneous coronary intervention. PG - 3766-3772 AB - OBJECTIVES: This study explored and analyzed the prophylactic effect of Alprostadil on contrast-induced nephropathy (CIN) after percutaneous coronary intervention (PCI) in patients with renal insufficiency. METHODS: From June 2014 to June 2017, 156 patients with coronary artery disease and renal insufficiency who electively underwent PCI in our hospital were enrolled and randomly divided into Alprostadil group (n=77) and placebo control group (n=79) by random number table. The control group was given hydration and placebo, while the observation group received hydration and Alprostadil. The alprostadil and placebo were infused intravenously 30-90 minutes before operation until four hours after surgery. The changes of biochemical indicators, serum creatinine (Scr), glomerular filtration rate (GFR), the level of neutrophil gelatinase-associated lipocalin (NGAL) in urinary neutrophils, and the incidence of CIN were compared between the two groups of patients before and after PCI surgery. RESULTS: The difference of SCr and GFR between the two groups of patients was statistical insignificant before and after PCI surgery (P>0.05), while the level of NGAL in both groups 12 h and 24 h after operation were critically higher than those prior-operation (P<0.05), and the increase in the control group was more obvious (P<0.05). The serum CysC, Hcy, and hs-CRP levels of the two groups 24 h after surgery were remarkably higher than those before surgery (P<0.05), and the indicators in observation group were superior to those in control group after surgery (P<0.05). The difference between the two groups of patients in incidence of CIN primary endpoint was statistically insignificant (P>0.05), while the incidence of secondary endpoint of CIN >/= 0.3 mg/dL in Alprostadil group was significantly lower than that in control group (P<0.05). CONCLUSION: For renal insufficiency patients undergoing PCI, the associative usage of Alpromazil with routine treatment can effectively prevent CIN and is worthy of clinical promotion. CI - AJTR Copyright (c) 2021. FAU - Liu, Dongling AU - Liu D AD - Department of Cardiology, Civil Aviation General Hospital Beijing 100123, China. FAU - Gao, Feng AU - Gao F AD - Department of Cardiology, Civil Aviation General Hospital Beijing 100123, China. FAU - Li, Li AU - Li L AD - Department of Cardiology, Civil Aviation General Hospital Beijing 100123, China. FAU - Jian, Xinwen AU - Jian X AD - Department of Cardiology, Civil Aviation General Hospital Beijing 100123, China. FAU - Xiao, Bing AU - Xiao B AD - Department of Cardiology, Civil Aviation General Hospital Beijing 100123, China. LA - eng PT - Journal Article DEP - 20210415 PL - United States TA - Am J Transl Res JT - American journal of translational research JID - 101493030 PMC - PMC8129369 OTO - NOTNLM OT - Alprostadil OT - contrast-induced nephropathy (CIN) OT - percutaneous coronary intervention (PCI) OT - prevention OT - renal insufficiency COIS- None. EDAT- 2021/05/22 06:00 MHDA- 2021/05/22 06:01 PMCR- 2021/04/15 CRDT- 2021/05/21 06:32 PHST- 2020/11/25 00:00 [received] PHST- 2021/01/27 00:00 [accepted] PHST- 2021/05/21 06:32 [entrez] PHST- 2021/05/22 06:00 [pubmed] PHST- 2021/05/22 06:01 [medline] PHST- 2021/04/15 00:00 [pmc-release] PST - epublish SO - Am J Transl Res. 2021 Apr 15;13(4):3766-3772. eCollection 2021. PMID- 34017517 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20231111 IS - 1943-8141 (Print) IS - 1943-8141 (Electronic) IS - 1943-8141 (Linking) VI - 13 IP - 4 DP - 2021 TI - Timing of continuous renal replacement therapy in patients with acute non-ST-segment elevation myocardial infarction complicated with cardiac and renal insufficiency. PG - 3418-3426 AB - OBJECTIVE: To explore the efficacy of different timing options for continuous renal replacement therapy (CRRT) in patients with acute non-ST-segment elevation myocardial infarction (NSTEMI) and cardiac and renal insufficiency. METHODS: Eighty-eight patients with acute NSTEMI complicated with cardiac and renal insufficiency received PCI treatment after achieving a stable condition and were randomly divided into the control group (n = 44) and the research group (n = 44). The control group was given CRRT after percutaneous coronary intervention (PCI), and the research group was treated with CRRT before and after PCI. The clinical treatment efficacy, cardiac function indexes (left ventricular ejection fraction (LVEF), cardiac output (CO), and left ventricular end diastolic diameter (LVEDD)), renal function indexes (creatinine (Cr), glomerular filtration rate (GFR), neutrophil gelatinase-associated lipocalin (NGAL)), quality of life (QoL) and incidence of major adverse cardiovascular events were compared between the two groups. RESULTS: After treatment, the overall effective rate in the research group was higher than that in the control group (P < 0.05); LVEF, CO, GFR and QoL score were higher, while LVEDD value, creatinine level, NGAL level and the incidence of major adverse cardiovascular events were lower in the research group than in the control group (P < 0.05). CONCLUSION: For patients with acute NSTEMI complicated with cardiac and renal insufficiency, the use of CRRT before and after PCI can effectively ameliorate cardiac and renal function, and significantly improve quality of life with a good prognosis. CI - AJTR Copyright (c) 2021. FAU - Qu, Guomei AU - Qu G AD - Department of Hemodialysis Center, The First Affiliated Hospital of Soochow University Suzhou, Jiangsu Province, China. FAU - Chen, Fengling AU - Chen F AD - Department of Hemodialysis Center, The First Affiliated Hospital of Soochow University Suzhou, Jiangsu Province, China. FAU - Xu, Qinjuan AU - Xu Q AD - Department of Hemodialysis Center, The First Affiliated Hospital of Soochow University Suzhou, Jiangsu Province, China. FAU - He, Zhisong AU - He Z AD - Department of Cardiology, The First Affiliated Hospital of Soochow University Suzhou, Jiangsu Province, China. LA - eng PT - Journal Article DEP - 20210415 PL - United States TA - Am J Transl Res JT - American journal of translational research JID - 101493030 PMC - PMC8129374 OTO - NOTNLM OT - Percutaneous coronary intervention OT - acute non-ST-segment elevation myocardial infarction OT - cardiac and renal insufficiency OT - continuous renal replacement therapy COIS- None. EDAT- 2021/05/22 06:00 MHDA- 2021/05/22 06:01 PMCR- 2021/04/15 CRDT- 2021/05/21 06:32 PHST- 2020/12/02 00:00 [received] PHST- 2021/01/07 00:00 [accepted] PHST- 2021/05/21 06:32 [entrez] PHST- 2021/05/22 06:00 [pubmed] PHST- 2021/05/22 06:01 [medline] PHST- 2021/04/15 00:00 [pmc-release] PST - epublish SO - Am J Transl Res. 2021 Apr 15;13(4):3418-3426. eCollection 2021. PMID- 33991416 OWN - NLM STAT- MEDLINE DCOM- 20220113 LR - 20220516 IS - 2380-6591 (Electronic) IS - 2380-6583 (Print) VI - 6 IP - 9 DP - 2021 Sep 1 TI - Sex Differences Among Patients With High Risk Receiving Ticagrelor With or Without Aspirin After Percutaneous Coronary Intervention: A Subgroup Analysis of the TWILIGHT Randomized Clinical Trial. PG - 1032-1041 LID - 10.1001/jamacardio.2021.1720 [doi] AB - IMPORTANCE: Shortened dual antiplatelet therapy followed by potent P2Y12 receptor inhibitor monotherapy reduces bleeding without increasing ischemic events after percutaneous coronary intervention (PCI). OBJECTIVE: To explore sex differences and evaluate the association of sex with outcomes among patients treated with ticagrelor monotherapy vs ticagrelor plus aspirin. DESIGN, SETTING, AND PARTICIPANTS: This was a prespecified secondary analysis of TWILIGHT, an investigator-initiated, placebo-controlled randomized clinical trial conducted at 187 sites across 11 countries. Study participants included patients who underwent successful PCI with drug-eluting stents, were planned for discharge with ticagrelor plus aspirin, and who had at least 1 clinical and at least 1 angiographic feature associated with high risk of ischemic or bleeding events. Data were analyzed from May to July 2020. INTERVENTIONS: At 3 months after PCI, patients adherent to ticagrelor and aspirin without major adverse event were randomized to either aspirin or placebo for an additional 12 months along with ticagrelor. MAIN OUTCOMES AND MEASURES: The primary end point was Bleeding Academic Research Consortium (BARC) type 2, 3, or 5 bleeding at 12 months after randomization. The primary ischemic end point was a composite of death, myocardial infarction, or stroke. RESULTS: Of 9006 enrolled patients, 7119 underwent randomization (mean [SD] age, 63.9 [10.2] years; 5421 [76.1%] men). Women were older (mean [SD] age, 65.5 [9.6] years in women vs 63.4 [10.3] years in men) with higher prevalence of chronic kidney disease (347 women [21.2%] vs 764 men [14.7%]). The primary bleeding end point occurred more often in women than men (hazard ratio [HR], 1.32; 95% CI, 1.06-1.64; P = .01). After multivariate adjustment, incremental bleeding risk associated with female sex was no longer significant (adjusted HR, 1.20; 95% CI, 0.95-1.52; P = .12). Ischemic end points were similar between sexes. Ticagrelor plus placebo vs ticagrelor plus aspirin was associated with lower risk of BARC type 2, 3, or 5 bleeding in women (adjusted HR, 0.62; 95% CI, 0.42-0.92; P = .02) and men (adjusted HR, 0.57; 95% CI, 0.44-0.73; P < .001; P for interaction = .69). Ischemic end points were similar between treatment groups in both sexes. CONCLUSIONS AND RELEVANCE: These findings suggest that the higher bleeding risk in women compared with men was mostly attributable to baseline differences, whereas ischemic events were similar between sexes. In this high-risk PCI population, the benefits of early aspirin withdrawal with continuation of ticagrelor were generally comparable in women and men. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02270242. FAU - Vogel, Birgit AU - Vogel B AD - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York. FAU - Baber, Usman AU - Baber U AD - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York. AD - Department of Cardiology, The University of Oklahoma Health Sciences Center, Oklahoma City. FAU - Cohen, David J AU - Cohen DJ AD - St Francis Hospital, Roslyn, New York. AD - Cardiovascular Research Foundation, New York, New York. FAU - Sartori, Samantha AU - Sartori S AD - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York. FAU - Sharma, Samin K AU - Sharma SK AD - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York. FAU - Angiolillo, Dominick J AU - Angiolillo DJ AD - Division of Cardiology, University of Florida College of Medicine, Jacksonville. FAU - Farhan, Serdar AU - Farhan S AD - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York. FAU - Goel, Ridhima AU - Goel R AD - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York. FAU - Zhang, Zhongjie AU - Zhang Z AD - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York. FAU - Briguori, Carlo AU - Briguori C AD - Mediterranea Cardiocentro, Naples, Italy. FAU - Collier, Timothy AU - Collier T AD - Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom. FAU - Dangas, George AU - Dangas G AD - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York. FAU - Dudek, Dariusz AU - Dudek D AD - Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland. AD - Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy. FAU - Escaned, Javier AU - Escaned J AD - Department of Cardiology, Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos and Complutense University, Calle del Prof Martin Lagos, Madrid, Spain. FAU - Gil, Robert AU - Gil R AD - Department of Invasive Cardiology, Center of Postgraduate Medical Education, Central Clinical Hospital of the Ministry of Interior and Administration, Warsaw, Poland. FAU - Han, Ya-Ling AU - Han YL AD - Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, Liaoning Sheng, China. FAU - Kaul, Upendra AU - Kaul U AD - Department of Cardiology, Batra Hospital and Medical Research Centre, New Delhi, India. FAU - Kornowski, Ran AU - Kornowski R AD - Department of Cardiology, Rabin Medical Center, Petach Tikva, Israel. FAU - Krucoff, Mitchell W AU - Krucoff MW AD - Department of Cardiology, Duke University Medical Center-Duke Clinical Research Institute, Durham, North Carolina. FAU - Kunadian, Vijay AU - Kunadian V AD - Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University and Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom. FAU - Mehta, Shamir R AU - Mehta SR AD - Department of Cardiology, Hamilton Health Sciences, Hamilton, Canada. FAU - Moliterno, David AU - Moliterno D AD - Department of Cardiology, University of Kentucky, Lexington. FAU - Ohman, E Magnus AU - Ohman EM AD - Department of Cardiology, Duke University Medical Center-Duke Clinical Research Institute, Durham, North Carolina. FAU - Sardella, Gennaro AU - Sardella G AD - Department of Cardiology, Policlinico Umberto I University, Roma, Italy. FAU - Witzenbichler, Bernhard AU - Witzenbichler B AD - Department of Cardiology, Helios Amper-Klinikum, Dachau, Germany. FAU - Gibson, C Michael AU - Gibson CM AD - Department of Cardiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts. FAU - Pocock, Stuart AU - Pocock S AD - Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom. FAU - Huber, Kurt AU - Huber K AD - Department of Cardiology, Wilhelminenhospital, Vienna, Austria. AD - Sigmund Freud University, Medical Faculty, Vienna, Austria. FAU - Mehran, Roxana AU - Mehran R AD - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York. LA - eng SI - ClinicalTrials.gov/NCT02270242 PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - United States TA - JAMA Cardiol JT - JAMA cardiology JID - 101676033 RN - 0 (Platelet Aggregation Inhibitors) RN - GLH0314RVC (Ticagrelor) RN - R16CO5Y76E (Aspirin) SB - IM CIN - JAMA Cardiol. 2022 Mar 1;7(3):360-361. doi: 10.1001/jamacardio.2021.5402. PMID: 34985499 MH - Aged MH - Aspirin/*therapeutic use MH - Coronary Angiography MH - Coronary Artery Disease/*surgery MH - Drug Therapy, Combination MH - Female MH - Global Health MH - Humans MH - Incidence MH - Male MH - Middle Aged MH - *Percutaneous Coronary Intervention MH - Platelet Aggregation Inhibitors/therapeutic use MH - Postoperative Care/*methods MH - Postoperative Hemorrhage/*epidemiology MH - Sex Distribution MH - Sex Factors MH - Survival Rate/trends MH - Ticagrelor/*therapeutic use MH - Withholding Treatment PMC - PMC8124295 COIS- Conflict of Interest Disclosures: Dr Baber reported receiving personal fees from Amgen, AstraZeneca, and Boston Scientific during the conduct of the study. Dr Cohen reported receiving grants and personal fees from AstraZeneca, Medtronic, and Abbott Vascular and grants from Boston Scientific outside the submitted work. Dr Sharma reported receiving personal fees from Abbott Vascular, Boston Scientific, and Cardiovascular Systems and serving on an advisory board for Boston Scientific outside the submitted work. Dr Angiolillo reported receiving grants and personal fees from Abbott, Amgen, Aralez, AstraZeneca, Bayer, Biosensors, Boehringer Ingelheim, Bristol Myers Squibb, CeloNova, Chiesi, Daiichi-Sankyo, Eli Lilly, Haemonetics, Janssen, Merck, PhaseBio, PLx Pharma, Pfizer, Sanofi, and The Medicines Company; personal fees from St Jude Medical; and grants (paid to his institution) from Amgen, AstraZeneca, Bayer, Biosensors, CeloNova, CSL Behring, Daiichi-Sankyo, Eisai, Eli Lilly, Gilead, Idorsia, Janssen, Matsutani Chemical Industry, Merck, Novartis, Osprey Medical, Renal Guard Solutions, and the Scott R. MacKenzie Foundation. Dr Briguori reported receiving grants from Mount Sinai during the conduct of the study. Dr Collier reported serving on data monitoring committees sponsored by AstraZeneca, Boston Scientific, Daiichi-Sankyo, Devax, Infraredx, Medtronic, Pfizer, and Zoll. Dr Dangas reported receiving grants from AstraZeneca, personal fees from AstraZeneca and Biosensors, and owning stock in Medtronic outside the submitted work. Dr Escaned reported receiving personal fees from Abbott, Philips, Boston Scientific, Medtronic, Abiomed, Terumo, and Biosensors. Dr Krucoff reported receiving grants and personal fees from Abbott Vascular, Biosensors, Boston Scientific, Celonova, Medtronic, OrbusNeich. Dr Kunadian reports receiving personal fees/honoraria from Bayer, AstraZeneca, Abbott, Amgen, Daichii Sankyo. Dr Mehta reported receiving grants from AstraZeneca during the conduct of the study. Dr Moliterno reported receiving grants from AstraZeneca during the conduct of the study. Dr Ohman reported receiving grants from Chiesi and Portola and personal fees from Cytokinetics, Abiomed, Pfizer, 3D Communications, ACI Clinical, Biotie, Cara Therapeutics, Cardinal Health, Faculty Connection, Imbria, Impulse Medical, Janssen Pharmaceuticals, Medscape, Milestone Pharmaceuticals, XyloCor, and Otsuka outside the submitted work. Dr Witzenbichler reported personal fees from Mount Sinai Hospital during the conduct of the study. Dr Gibson reported receiving grants and personal fees from Angel Medical, Bayer, CSL Behring, Johnson & Johnson, Janssen, AstraZeneca, Portola Pharmaceuticals, personal fees from the Medicines Company, Eli Lilly, Gilead Sciences, Novo Nordisk, WebMD, UpToDate Cardiovascular Medicine, Amarin Pharma, Amgen, Boehringer Ingelheim, Chiesi, Merck, PharmaMar, Sanofi, Somahlution, Verreseon Corporation, Boston Scientific, Impact Bio, MedImmume, Medtelligence, MicroPort, PERT Consortium, and GE Healthcare; owning stock in nference; serving as chief executive officer of Baim Institute, and receiving grants (paid to Baim Institute) from Bristol Myers Squibb. Dr Pocock reported receiving grants and personal fees from AstraZeneca outside the submitted work. Dr Huber reported receiving personal fees from AstraZeneca and Bayer. Dr Mehran reported receiving grants and personal fees (paid to the institution) from Abbott, Abiomed, Bayer, Beth Israel Deaconess, Bristol Myers Squibb, Chiesi, Concept Medical Research, Medtronic, Novartis and DSI Research; grants from Applied Therapeutics, AstraZeneca, Cerecor, CSL Behring, OrbusNeich, and Zoll; personal fees from Boston Scientific, California Institute for Regenerative Medicine, Cine-Med Research, Janssen Scientific Affairs, American College of Cardiology, and WebMD; personal fees paid to the institution from CardiaWave, Duke University, and Idorsia Pharmaceuticals; serving as a consultant or committee or advisory board member for Society for Cardiovascular Angiography and Interventions, the American Medical Association, and Regeneron Pharmaceuticals; and owning stock in ControlRad, Elixir Medical, and STEL outside the submitted work. No other disclosures were reported. EDAT- 2021/05/16 06:00 MHDA- 2022/01/14 06:00 PMCR- 2022/05/15 CRDT- 2021/05/15 17:03 PHST- 2021/05/16 06:00 [pubmed] PHST- 2022/01/14 06:00 [medline] PHST- 2021/05/15 17:03 [entrez] PHST- 2022/05/15 00:00 [pmc-release] AID - 2779977 [pii] AID - hoi210037 [pii] AID - 10.1001/jamacardio.2021.1720 [doi] PST - ppublish SO - JAMA Cardiol. 2021 Sep 1;6(9):1032-1041. doi: 10.1001/jamacardio.2021.1720. PMID- 33989711 OWN - NLM STAT- MEDLINE DCOM- 20211208 LR - 20240403 IS - 1558-3597 (Electronic) IS - 0735-1097 (Print) IS - 0735-1097 (Linking) VI - 78 IP - 4 DP - 2021 Jul 27 TI - Kidney Transplant List Status and Outcomes in the ISCHEMIA-CKD Trial. PG - 348-361 LID - S0735-1097(21)04965-2 [pii] LID - 10.1016/j.jacc.2021.05.001 [doi] AB - BACKGROUND: Patients with chronic kidney disease (CKD) and coronary artery disease frequently undergo preemptive revascularization before kidney transplant listing. OBJECTIVES: In this post hoc analysis from ISCHEMIA-CKD (International Study of Comparative Health Effectiveness of Medical and Invasive Approaches-Chronic Kidney Disease), we compared outcomes of patients not listed versus those listed according to management strategy. METHODS: In the ISCHEMIA-CKD trial (n = 777), 194 patients (25%) with chronic coronary syndromes and at least moderate ischemia were listed for transplant. The primary (all-cause mortality or nonfatal myocardial infarction) and secondary (death, nonfatal myocardial infarction, hospitalization for unstable angina, heart failure, resuscitated cardiac arrest, or stroke) outcomes were analyzed using Cox multivariable modeling. Heterogeneity of randomized treatment effect between listed versus not listed groups was assessed. RESULTS: Compared with those not listed, listed patients were younger (60 years vs 65 years), were less likely to be of Asian race (15% vs 29%), were more likely to be on dialysis (83% vs 44%), had fewer anginal symptoms, and were more likely to have coronary angiography and coronary revascularization irrespective of treatment assignment. Among patients assigned to an invasive strategy versus conservative strategy, the adjusted hazard ratios for the primary outcome were 0.91 (95% confidence interval [CI]: 0.54-1.54) and 1.03 (95% CI: 0.78-1.37) for those listed and not listed, respectively (p(interaction)= 0.68). Adjusted hazard ratios for secondary outcomes were 0.89 (95% CI: 0.55-1.46) in listed and 1.17 (95% CI: 0.89-1.53) in those not listed (p(interaction) = 0.35). CONCLUSIONS: In ISCHEMIA-CKD, an invasive strategy in kidney transplant candidates did not improve outcomes compared with conservative management. These data do not support routine coronary angiography or revascularization in patients with advanced CKD and chronic coronary syndromes listed for transplant. (ISCHEMIA-Chronic Kidney Disease Trial [ISCHEMIA-CKD]; NCT01985360). CI - Copyright (c) 2021 American College of Cardiology Foundation. All rights reserved. FAU - Herzog, Charles A AU - Herzog CA AD - Department of Medicine, Hennepin Healthcare, Minneapolis, Minnesota, USA; University of Minnesota, Minneapolis, Minnesota, USA. Electronic address: cherzog@cdrg.org. FAU - Simegn, Mengistu A AU - Simegn MA AD - Department of Medicine, Hennepin Healthcare, Minneapolis, Minnesota, USA; University of Minnesota, Minneapolis, Minnesota, USA. FAU - Xu, Yifan AU - Xu Y AD - NYU Grossman School of Medicine, New York, New York, USA. FAU - Costa, Salvatore P AU - Costa SP AD - Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA. FAU - Mathew, Roy O AU - Mathew RO AD - Columbia V.A. Health Care System, Columbia, South Carolina, USA. FAU - El-Hajjar, Mohammad C AU - El-Hajjar MC AD - Albany Medical College and Albany Medical Center, Albany, New York, USA. FAU - Gulati, Sanjeev AU - Gulati S AD - Fortis Flt Lt Rajan Dhall Hospital, New Delhi, Delhi, India. FAU - Maldonado, Rafael A AU - Maldonado RA AD - Velez Sarsfield Clinic, Cordoba, Argentina. FAU - Daugas, Eric AU - Daugas E AD - Department of Nephrology, Bichat, Assistance Publique-Hopitaux, Paris, France. FAU - Madero, Magdelena AU - Madero M AD - Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico. FAU - Fleg, Jerome L AU - Fleg JL AD - National Heart, Lung, and Blood Institute, Bethesda, Maryland, USA. FAU - Anthopolos, Rebecca AU - Anthopolos R AD - NYU Grossman School of Medicine, New York, New York, USA. FAU - Stone, Gregg W AU - Stone GW AD - Icahn School of Medicine at Mount Sinai, Cardiovascular Research Foundation, New York, New York, USA. FAU - Sidhu, Mandeep S AU - Sidhu MS AD - Albany Medical College and Albany Medical Center, Albany, New York, USA. FAU - Maron, David J AU - Maron DJ AD - Department of Medicine, Stanford University, Stanford, California, USA. FAU - Hochman, Judith S AU - Hochman JS AD - NYU Grossman School of Medicine, New York, New York, USA. FAU - Bangalore, Sripal AU - Bangalore S AD - NYU Grossman School of Medicine, New York, New York, USA. Electronic address: https://twitter.com/sripalbangalore. LA - eng SI - ClinicalTrials.gov/NCT01985360 GR - U01 HL105907/HL/NHLBI NIH HHS/United States GR - U01 HL117904/HL/NHLBI NIH HHS/United States GR - U01 HL117905/HL/NHLBI NIH HHS/United States PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't DEP - 20210511 PL - United States TA - J Am Coll Cardiol JT - Journal of the American College of Cardiology JID - 8301365 SB - IM CIN - J Am Coll Cardiol. 2021 Jul 27;78(4):362-364. doi: 10.1016/j.jacc.2021.05.033. PMID: 34294271 MH - Aged MH - Comorbidity MH - Conservative Treatment/*methods MH - Coronary Artery Disease/*epidemiology/therapy MH - Female MH - Humans MH - Kidney Transplantation/*statistics & numerical data MH - Male MH - Middle Aged MH - Myocardial Revascularization MH - Renal Dialysis/methods MH - Renal Insufficiency, Chronic/*epidemiology/therapy MH - Survival Rate/trends MH - United States/epidemiology MH - *Waiting Lists PMC - PMC8319110 MID - NIHMS1700545 OTO - NOTNLM OT - chronic kidney disease OT - coronary angiography OT - coronary revascularization OT - ischemic heart disease OT - kidney transplantation OT - medical therapy COIS- Funding Support and Author Disclosures This work was funded by the National Institutes of Health (NIH) (grants U01HL117904 and U01HL117905). This project was supported by grants from Arbor Pharmaceuticals and AstraZeneca Pharmaceuticals. Devices or medications were provided by Abbott Vascular (previously St. Jude Medical), Medtronic, Phillips (previously Volcano Corporation), and Omron Healthcare. Medications provided by Arbor Pharmaceuticals, AstraZeneca Pharmaceuticals, Espero Pharmaceuticals, Merck Sharp & Dohme Corp., and Sunivion Pharmaceuticals. The contents are solely the responsibility of the authors and do not necessarily represent official views of the National Heart, Lung, and Blood Institute, the National Institutes of Health, or the Department of Health and Human Services. Dr Herzog has received personal fees from the National Heart, Lung, and Blood Institute (NHLBI)/NIH during the conduct of the study; has received research grants from Amgen, Relypsa, Bristol Myers Squibb, National Institute of Diabetes and Digestive and Kidney Diseases/NIH, University of British Columbia; and has received other support from Abbvie, Amgen, AstraZeneca, Corvidia, Diamedica, FibroGen, Janssen, NxStage, Pfizer, Relypsa, Sanifit, University of Oxford, Bristol Myers Squibb, UpToDate, Boston Scientific, General Electric, Johnson & Johnson, Merck, and Hennepin Healthcare. Drs. Simegn, Costa, Mathew, El-Hajjar, Gulati, Maldonao, Madero, Anthopolos, Maron, and Mr. Xu has received research grants from the National Heart, Lung, and Blood Institute during the conduct of the study. Dr Daugas has received personal fees from Amgen, GlaxoSmithKline, and AstraZeneca; has received grants from Agence Nationale pour la Recherche/ Direction Generale de l'Offre de Soins; and has received nonfinancial support from Amgen. Dr Fleg was an employee of the NHLBI during the conduct of the study. Dr Stone has received speaker or other honoraria from Cook and Terumo; has served as a consultant to Valfix, TherOx, Vascular Dynamics, Robocath, HeartFlow, Gore, Ablative Solutions, Miracor, Neovasc, V-Wave, Abiomed, Ancora, MAIA Pharmaceuticals, Vectorious, Reva, Matrizyme, Cardiomech, Elucid Bio, and Occlutech; and has equity/options from Ancora, Cagent, Applied Therapeutics, Biostar family of funds, SpectraWave, Orchestra Biomed, Aria, Cardiac Success, MedFocus family of funds, and Valfix. Dr Sidhu has received research grants from the NHLBI during the conduct of the study; and has received personal fees from AstraZeneca and Sanofi-Regeneron. Dr. Hochman served as Principal Investigator for ISCHEMIA trial for which, in addition to support by NHLBI, devices and medications were provided by Abbott Vascular, Medtronic., St. Jude Medical, Volcano Corporation, Arbor Pharmaceuticals, AstraZeneca Pharmaceuticals, Merck Sharp & Dohme, and Omron Healthcare; and has received financial donations from Arbor Pharmaceuticals LLC and AstraZeneca Pharmaceuticals LP. Dr Bangalore has received research grants from the NHLBI during the conduct of the study; has received research grants from Abbott Vascular; and has received personal fees from Abbott Vascular, Biotronik, Pfizer, Amgen, and Reata. EDAT- 2021/05/15 06:00 MHDA- 2021/12/15 06:00 PMCR- 2022/07/27 CRDT- 2021/05/14 20:11 PHST- 2021/03/16 00:00 [received] PHST- 2021/04/26 00:00 [revised] PHST- 2021/05/03 00:00 [accepted] PHST- 2021/05/15 06:00 [pubmed] PHST- 2021/12/15 06:00 [medline] PHST- 2021/05/14 20:11 [entrez] PHST- 2022/07/27 00:00 [pmc-release] AID - S0735-1097(21)04965-2 [pii] AID - 10.1016/j.jacc.2021.05.001 [doi] PST - ppublish SO - J Am Coll Cardiol. 2021 Jul 27;78(4):348-361. doi: 10.1016/j.jacc.2021.05.001. Epub 2021 May 11. PMID- 33980605 OWN - NLM STAT- MEDLINE DCOM- 20211203 LR - 20240817 IS - 1935-5548 (Electronic) IS - 0149-5992 (Print) IS - 0149-5992 (Linking) VI - 44 IP - 7 DP - 2021 Jul TI - Associations of Microvascular Complications With the Risk of Cardiovascular Disease in Type 1 Diabetes. PG - 1499-1505 LID - 10.2337/dc20-3104 [doi] AB - OBJECTIVE: We examined whether the presence of microvascular complications was associated with increased subsequent risk of cardiovascular disease (CVD) among participants with type 1 diabetes in the Diabetes Control and Complications Trial and Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study followed for >35 years. RESEARCH DESIGN AND METHODS: Standardized longitudinal data collection included: 1) stereoscopic seven-field retinal fundus photography centrally graded for retinopathy stage and clinically significant macular edema; 2) urinary albumin excretion rate (AER) and estimated glomerular filtration rate (eGFR); 3) cardiovascular autonomic neuropathy (CAN) reflex testing; and 4) adjudicated CVD events, including death from CVD, nonfatal myocardial infarction, stroke, subclinical myocardial infarction on electrocardiogram, confirmed angina, or coronary artery revascularization. Cox proportional hazards models assessed the association of microvascular complications with subsequent risk of CVD. RESULTS: A total of 239 participants developed CVD, including 120 participants who suffered major adverse cardiovascular events (MACE) defined as nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. The presence of microvascular disease (diabetic retinopathy, kidney disease, or CAN) was associated with increased risk of subsequent CVD and MACE (hazard ratios 1.86 to 3.18 and 2.09 to 3.63, respectively), associations that remained significant after adjusting for age and HbA(1c). After adjustment for traditional CVD risk factors, however, only sustained AER >/=30 mg/24 h occurring alone and/or with eGFR <60 mL/min/1.73 m(2) and the presence of both retinal and kidney disease remained associated with CVD. CONCLUSIONS: Advanced microvascular disease, especially moderate to severe albuminuria or eGFR <60 mL/min/1.73 m(2), conveyed an increased risk of subsequent cardiovascular disease in the DCCT/EDIC cohort. CI - (c) 2021 by the American Diabetes Association. FAU - Gubitosi-Klug, Rose AU - Gubitosi-Klug R AUID- ORCID: 0000-0002-7376-6870 AD - Pediatric Endocrinology, UH Rainbow Babies and Children's Hospital, Cleveland, OH. FAU - Gao, Xiaoyu AU - Gao X AD - Biostatistics Center, Milken Institute School of Public Health, The George Washington University, Rockville, MD. FAU - Pop-Busui, Rodica AU - Pop-Busui R AUID- ORCID: 0000-0002-2042-1350 AD - Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, University of Michigan, Ann Arbor, MI. FAU - de Boer, Ian H AU - de Boer IH AUID- ORCID: 0000-0003-1571-7592 AD - Division of Nephrology, University of Washington, Seattle, WA. FAU - White, Neill AU - White N AD - Department of Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, MO. FAU - Aiello, Lloyd P AU - Aiello LP AD - Joslin Diabetes Center, Boston, MA. FAU - Miller, Ryan AU - Miller R AD - Division of Pediatric Endocrinology, University of Maryland, Baltimore, MD. FAU - Palmer, Jerry AU - Palmer J AD - Division of Metabolism, Endocrinology and Nutrition, University of Washington, Seattle, WA. FAU - Tamborlane, William AU - Tamborlane W AD - Department of Pediatrics and Endocrinology, Yale School of Medicine, New Haven, CT. FAU - Wallia, Amisha AU - Wallia A AUID- ORCID: 0000-0002-3183-4062 AD - Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL. FAU - Kosiborod, Mikhail AU - Kosiborod M AUID- ORCID: 0000-0002-3750-9789 AD - Saint Luke's Mid America Heart Institute, Kansas City, MO. FAU - Lachin, John M AU - Lachin JM AUID- ORCID: 0000-0001-9838-2841 AD - Biostatistics Center, Milken Institute School of Public Health, The George Washington University, Rockville, MD. FAU - Bebu, Ionut AU - Bebu I AUID- ORCID: 0000-0002-4944-7968 AD - Biostatistics Center, Milken Institute School of Public Health, The George Washington University, Rockville, MD ibebu@bsc.gwu.edu. CN - DCCT/EDIC Research Group LA - eng SI - ClinicalTrials.gov/NCT00360893 SI - ClinicalTrials.gov/NCT00360815 SI - figshare/10.2337/figshare.14356943 GR - U01 DK094176/DK/NIDDK NIH HHS/United States GR - UL1 TR001863/TR/NCATS NIH HHS/United States GR - P30 DK045735/DK/NIDDK NIH HHS/United States GR - U01 DK094157/DK/NIDDK NIH HHS/United States GR - P30 DK020572/DK/NIDDK NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural DEP - 20210512 PL - United States TA - Diabetes Care JT - Diabetes care JID - 7805975 SB - IM MH - *Cardiovascular Diseases/epidemiology/etiology MH - *Cardiovascular System MH - *Diabetes Complications MH - *Diabetes Mellitus, Type 1/complications/epidemiology MH - Humans MH - Risk Factors PMC - PMC8323173 EDAT- 2021/05/14 06:00 MHDA- 2021/12/15 06:00 PMCR- 2022/07/01 CRDT- 2021/05/13 05:43 PHST- 2020/12/21 00:00 [received] PHST- 2021/03/26 00:00 [accepted] PHST- 2021/05/14 06:00 [pubmed] PHST- 2021/12/15 06:00 [medline] PHST- 2021/05/13 05:43 [entrez] PHST- 2022/07/01 00:00 [pmc-release] AID - dc20-3104 [pii] AID - 203104 [pii] AID - 10.2337/dc20-3104 [doi] PST - ppublish SO - Diabetes Care. 2021 Jul;44(7):1499-1505. doi: 10.2337/dc20-3104. Epub 2021 May 12. PMID- 33896704 OWN - NLM STAT- MEDLINE DCOM- 20210929 LR - 20210929 IS - 1444-2892 (Electronic) IS - 1443-9506 (Linking) VI - 30 IP - 9 DP - 2021 Sep TI - Very Elderly Patients With Acute Coronary Syndromes Treated With Percutaneous Coronary Intervention. PG - 1337-1342 LID - S1443-9506(21)00387-5 [pii] LID - 10.1016/j.hlc.2021.03.275 [doi] AB - BACKGROUND: The rates of very elderly patients (>/=85 years old) undergoing percutaneous coronary intervention (PCI) for acute coronary syndromes (ACS) are rapidly increasing. They are under-represented in clinical trials, and those who are included may not reflect the real-world population. We aim to review the clinical characteristics of very elderly patients undergoing PCI for ACS and identify factors associated with adverse outcomes. METHOD: All very elderly patients undergoing PCI for ACS in the Auckland region between January 2014 to December 2016 were included. Baseline clinical and procedural details were obtained, and the primary endpoint was all-cause mortality measured up to a maximum of 4 years. Secondary endpoints include recurrent myocardial infarction, unplanned revascularisation, stroke and major bleeding. RESULTS: A total of 186 patients were included for analysis (mean age 87.6+/-2.8 years, 51.6% male). Indications for PCI were ST-elevation myocardial infarction (STEMI) in 74 (39.8%), non-ST elevation myocardial infarction (NSTEMI) in 97 (52.2%) and unstable angina in 15 patients (8.1%). Successful PCI was completed in 180 patients. At a maximal follow-up of 4 years (mean 23.4 mo), the rates of all-cause mortality and recurrent myocardial infarction were 22.0% and 14.0% respectively. The risk of mortality was increased by the presence of diabetes (44.8% vs 17.8%, HR=3.0, 95%CI: 1.6-5.9, p=0.001), STEMI (33.8% vs 13.5%, HR=3.1, 95%CI: 1.6-5.9, p=0.001), and reduced eGFR (every -10 mL/min/1.73m(2), HR=1.7, 95%CI: 1.3-2.1, p<0.0001). Major bleeding events while on dual antiplatelet therapy as defined by Bleeding Academic Research Consortium score >/=3 occurred in 14 patients (7.5%; 8 on ticagrelor, 6 on clopidogrel). CONCLUSION: Very elderly patients who undergo PCI for ACS have acceptable survival outcomes. STEMI, diabetes and impaired renal function were predictive of mortality in this elderly cohort. CI - Copyright (c) 2021 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved. FAU - Wong, Bernard AU - Wong B AD - Department of Cardiology, Waitemata District Health Board, Auckland, New Zealand. Electronic address: bernardwong@hotmail.co.nz. FAU - Lee, Kyu-Hyun AU - Lee KH AD - Department of Cardiology, Waitemata District Health Board, Auckland, New Zealand. FAU - El-Jack, Seif AU - El-Jack S AD - Department of Cardiology, Waitemata District Health Board, Auckland, New Zealand. LA - eng PT - Journal Article DEP - 20210423 PL - Australia TA - Heart Lung Circ JT - Heart, lung & circulation JID - 100963739 RN - 0 (Platelet Aggregation Inhibitors) RN - GLH0314RVC (Ticagrelor) SB - IM MH - *Acute Coronary Syndrome/surgery MH - Aged MH - Aged, 80 and over MH - Female MH - Humans MH - Male MH - *Percutaneous Coronary Intervention MH - Platelet Aggregation Inhibitors MH - *ST Elevation Myocardial Infarction MH - Ticagrelor MH - Treatment Outcome OTO - NOTNLM OT - Acute coronary syndrome OT - Elderly OT - Percutaneous coronary intervention EDAT- 2021/04/27 06:00 MHDA- 2021/09/30 06:00 CRDT- 2021/04/26 05:37 PHST- 2020/05/10 00:00 [received] PHST- 2021/02/24 00:00 [revised] PHST- 2021/03/22 00:00 [accepted] PHST- 2021/04/27 06:00 [pubmed] PHST- 2021/09/30 06:00 [medline] PHST- 2021/04/26 05:37 [entrez] AID - S1443-9506(21)00387-5 [pii] AID - 10.1016/j.hlc.2021.03.275 [doi] PST - ppublish SO - Heart Lung Circ. 2021 Sep;30(9):1337-1342. doi: 10.1016/j.hlc.2021.03.275. Epub 2021 Apr 23. PMID- 33847047 OWN - NLM STAT- MEDLINE DCOM- 20210810 LR - 20260109 IS - 1879-0844 (Electronic) IS - 1388-9842 (Linking) VI - 23 IP - 6 DP - 2021 Jun TI - Prospective ARNI vs. ACE inhibitor trial to DetermIne Superiority in reducing heart failure Events after Myocardial Infarction (PARADISE-MI): design and baseline characteristics. PG - 1040-1048 LID - 10.1002/ejhf.2191 [doi] AB - AIMS: Patients surviving an acute myocardial infarction (AMI) are at risk of developing symptomatic heart failure (HF) or premature death. We hypothesized that sacubitril/valsartan, effective in the treatment of chronic HF, prevents development of HF and reduces cardiovascular death following high-risk AMI compared to a proven angiotensin-converting enzyme (ACE) inhibitor. This paper describes the study design and baseline characteristics of patients enrolled in the Prospective ARNI vs. ACE inhibitor trial to DetermIne Superiority in reducing heart failure Events after Myocardial Infarction (PARADISE-MI) trial. METHODS AND RESULTS: PARADISE-MI, a multinational (41 countries), double-blind, active-controlled trial, randomized patients within 0.5-7 days of presentation with index AMI to sacubitril/valsartan or ramipril. Transient pulmonary congestion and/or left ventricular ejection fraction (LVEF) /=70 years, estimated glomerular filtration rate <60 mL/min/1.73 m(2) , diabetes, prior myocardial infarction, atrial fibrillation, LVEF <30%, Killip class >/=III, ST-elevation myocardial infarction without reperfusion) were required for inclusion. PARADISE-MI was event-driven targeting 708 primary endpoints (cardiovascular death, HF hospitalization or outpatient development of HF). Randomization of 5669 patients occurred 4.3 +/- 1.8 days from presentation with index AMI. The mean age was 64 +/- 12 years, 24% were women. The majority (76%) qualified with ST-segment elevation myocardial infarction; acute percutaneous coronary intervention was performed in 88% and thrombolysis in 6%. LVEF was 37 +/- 9% and 58% were in Killip class >/=II. CONCLUSIONS: Baseline therapies in PARADISE-MI reflect advances in contemporary evidence-based care. With enrollment complete PARADISE-MI is poised to determine whether sacubitril/valsartan is more effective than a proven ACE inhibitor in preventing development of HF and cardiovascular death following AMI. CI - (c) 2021 European Society of Cardiology. FAU - Jering, Karola S AU - Jering KS AD - Cardiovascular Division, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA. FAU - Claggett, Brian AU - Claggett B AD - Cardiovascular Division, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA. FAU - Pfeffer, Marc A AU - Pfeffer MA AD - Cardiovascular Division, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA. FAU - Granger, Christopher AU - Granger C AD - Duke University Medical Center, Durham, NC, USA. FAU - Kober, Lars AU - Kober L AD - Rigshospitalet, Copenhagen, Denmark. FAU - Lewis, Eldrin F AU - Lewis EF AD - Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford University, Palo Alto, CA, USA. FAU - Maggioni, Aldo P AU - Maggioni AP AD - ANMCO Research Center, Florence, Italy. FAU - Mann, Douglas AU - Mann D AD - Washington University Medical Center, St Louis, MO, USA. FAU - McMurray, John J V AU - McMurray JJV AD - British Heart Foundation Cardiovascular Research Centre, University of Glasgow, Glasgow, UK. FAU - Rouleau, Jean-Lucien AU - Rouleau JL AD - Montreal Heart Institute, University of Montreal, Montreal, Canada. FAU - Solomon, Scott D AU - Solomon SD AD - Cardiovascular Division, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA. FAU - Steg, Philippe G AU - Steg PG AD - Universite de Paris, AP-HP (Assistance Publique-Hopitaux de Paris), FACT (French Alliance for Cardiovascular Trials) and INSERM U-1148, Paris, France. FAU - van der Meer, Peter AU - van der Meer P AD - Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. FAU - Wernsing, Margaret AU - Wernsing M AD - Novartis Pharmaceutical Corporation, East Hanover, NJ, USA. FAU - Carter, Katherine AU - Carter K AD - Novartis Pharmaceutical Corporation, East Hanover, NJ, USA. FAU - Guo, Weinong AU - Guo W AD - Novartis Pharmaceutical Corporation, East Hanover, NJ, USA. FAU - Zhou, Yinong AU - Zhou Y AD - Novartis Pharmaceutical Corporation, East Hanover, NJ, USA. FAU - Lefkowitz, Martin AU - Lefkowitz M AD - Novartis Pharmaceutical Corporation, East Hanover, NJ, USA. FAU - Gong, Jianjian AU - Gong J AD - Novartis Pharmaceutical Corporation, East Hanover, NJ, USA. FAU - Wang, Yi AU - Wang Y AD - Novartis Pharmaceutical Corporation, East Hanover, NJ, USA. FAU - Merkely, Bela AU - Merkely B AD - Semmelweis University, Heart and Vascular Center, Budapest, Hungary. FAU - Macin, Stella M AU - Macin SM AD - Instituto de Cardiologia JF Cabral Corrientes, Corrientes, Argentina. FAU - Shah, Urmil AU - Shah U AD - Care Institute of Medical Sciences, Ahmedabad, India. FAU - Nicolau, Jose C AU - Nicolau JC AD - Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil. FAU - Braunwald, Eugene AU - Braunwald E AD - TIMI Study Group, Cardiovascular Division, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA. LA - eng GR - T32 HL007604/HL/NHLBI NIH HHS/United States PT - Clinical Trial Protocol PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't DEP - 20210422 PL - England TA - Eur J Heart Fail JT - European journal of heart failure JID - 100887595 RN - 0 (Aminobutyrates) RN - 0 (Angiotensin Receptor Antagonists) RN - 0 (Angiotensin-Converting Enzyme Inhibitors) RN - 0 (Drug Combinations) RN - 0 (Tetrazoles) SB - IM CIN - Turk Kardiyol Dern Ars. 2021 Jul;49(5):353-356. doi: 10.5543/tkda.2021.21145. PMID: 34308868 CIN - Eur J Heart Fail. 2022 Jul;24(7):1324. doi: 10.1002/ejhf.2444. PMID: 35118775 MH - Aged MH - Aminobutyrates/therapeutic use MH - Angiotensin Receptor Antagonists/therapeutic use MH - Angiotensin-Converting Enzyme Inhibitors/therapeutic use MH - Drug Combinations MH - Female MH - *Heart Failure/drug therapy/epidemiology MH - Humans MH - Middle Aged MH - *Myocardial Infarction/drug therapy/epidemiology MH - Prospective Studies MH - Stroke Volume MH - Tetrazoles/therapeutic use MH - Ventricular Function, Left MH - Equivalence Trials as Topic OTO - NOTNLM OT - Acute myocardial infarction OT - Angiotensin receptor-neprilysin inhibitor OT - Angiotensin-converting enzyme inhibitor OT - Heart failure OT - Sacubitril/valsartan EDAT- 2021/04/14 06:00 MHDA- 2021/08/11 06:00 CRDT- 2021/04/13 06:45 PHST- 2021/03/29 00:00 [revised] PHST- 2021/03/10 00:00 [received] PHST- 2021/04/08 00:00 [accepted] PHST- 2021/04/14 06:00 [pubmed] PHST- 2021/08/11 06:00 [medline] PHST- 2021/04/13 06:45 [entrez] AID - 10.1002/ejhf.2191 [doi] PST - ppublish SO - Eur J Heart Fail. 2021 Jun;23(6):1040-1048. doi: 10.1002/ejhf.2191. Epub 2021 Apr 22. PMID- 33819474 OWN - NLM STAT- MEDLINE DCOM- 20220203 LR - 20220203 IS - 1552-6259 (Electronic) IS - 0003-4975 (Linking) VI - 113 IP - 2 DP - 2022 Feb TI - Ticagrelor or Aspirin After Coronary Artery Bypass in Patients With Chronic Kidney Disease. PG - 554-562 LID - S0003-4975(21)00590-7 [pii] LID - 10.1016/j.athoracsur.2021.03.061 [doi] AB - BACKGROUND: The optimal antiplatelet therapy for patients with chronic kidney disease (CKD) undergoing coronary artery bypass graft surgery remains unknown. METHODS: This post hoc analysis of the Ticagrelor in Coronary Artery Bypass (TiCAB) trial examined the efficacy and safety of ticagrelor vs aspirin in patients with and patients without CKD. The primary endpoint was major adverse cardiac and cerebrovascular events (MACCE), namely, the composite of cardiovascular death, stroke, myocardial infarction, or revascularization at 1 year after coronary artery bypass graft surgery. Secondary endpoints included individual components of the primary endpoint, all-cause death, and major bleeding. RESULTS: Chronic kidney disease was present in 276 of 1843 randomized patients (15%). Patients with CKD vs patients without CKD had higher 1-year rates of MACCE (13% vs 8.3%, hazard ratio [HR] 1.63; 95% confidence interval [CI], 1.12 to 2.39; P = .01) and major bleeding (5.6% vs 3.1%, HR 1.84; 95% CI, 1.03 to 3.28; P = .04). The 1-year rate of MACCE was increased with ticagrelor vs aspirin in patients with CKD (18.2% vs 8.9%, HR 2.15; 95% CI, 1.08 to 4.30; P = .03), but not in patients without CKD (8.5% vs 8.1%, HR 1.05; 95% CI, 0.74 to 1.49; P = .79; P(interaction) = .067). There was no difference in the 1-year rate of major bleeding with ticagrelor vs aspirin in patients with CKD (6.6% vs 4.7%, HR 1.44; 95% CI, 0.52 to 3.97; P = .48) and patients without CKD (3.3% vs 2.9%, HR 1.14; 95% CI, 0.64 to 2.01; P = .65). CONCLUSIONS: Among patients with CKD and coronary artery bypass graft surgery, those who received ticagrelor had a higher incidence of MACCE but a similar incidence of major bleeding compared with those who received aspirin. CI - Copyright (c) 2022 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved. FAU - Sandner, Sigrid E AU - Sandner SE AD - Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria. Electronic address: sigrid.sandner@meduniwien.ac.at. FAU - Schunkert, Heribert AU - Schunkert H AD - German Heart Center Munich, Technical University of Munich, Munich, Germany; German Center for Cardiovascular Research, Munich Heart Alliance, Munich, Germany. FAU - Kastrati, Adnan AU - Kastrati A AD - German Heart Center Munich, Technical University of Munich, Munich, Germany; German Center for Cardiovascular Research, Munich Heart Alliance, Munich, Germany. FAU - Milojevic, Milan AU - Milojevic M AD - Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, Netherlands; Department of Cardiac Surgery and Cardiovascular Research, Dedinje Cardiovascular Institute, Belgrade, Serbia. FAU - Boning, Andreas AU - Boning A AD - Department of Cardiovascular Surgery, University Hospital Giessen, Giessen, Germany. FAU - Zimpfer, Daniel AU - Zimpfer D AD - Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria. FAU - Zellmer, Stephan AU - Zellmer S AD - German Heart Center Munich, Technical University of Munich, Munich, Germany; German Center for Cardiovascular Research, Munich Heart Alliance, Munich, Germany. FAU - Wiedemann, Dominik AU - Wiedemann D AD - Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria. FAU - Laufer, Gunther AU - Laufer G AD - Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria. FAU - von Scheidt, Moritz AU - von Scheidt M AD - German Heart Center Munich, Technical University of Munich, Munich, Germany; German Center for Cardiovascular Research, Munich Heart Alliance, Munich, Germany. CN - TiCAB Investigators LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20210402 PL - Netherlands TA - Ann Thorac Surg JT - The Annals of thoracic surgery JID - 15030100R RN - 0 (Platelet Aggregation Inhibitors) RN - GLH0314RVC (Ticagrelor) RN - R16CO5Y76E (Aspirin) SB - IM CIN - Ann Thorac Surg. 2022 Feb;113(2):562. doi: 10.1016/j.athoracsur.2021.04.088. PMID: 34022214 MH - Aged MH - Aged, 80 and over MH - Aspirin/*therapeutic use MH - Coronary Artery Bypass/*methods MH - Coronary Artery Disease/complications/*therapy MH - Double-Blind Method MH - Female MH - Humans MH - Male MH - Middle Aged MH - Platelet Aggregation Inhibitors/therapeutic use MH - Postoperative Care/*methods MH - Renal Insufficiency, Chronic/*complications MH - Stroke/etiology/*prevention & control MH - Ticagrelor/*therapeutic use MH - Treatment Outcome EDAT- 2021/04/06 06:00 MHDA- 2022/02/04 06:00 CRDT- 2021/04/05 20:08 PHST- 2020/11/06 00:00 [received] PHST- 2021/01/19 00:00 [revised] PHST- 2021/03/22 00:00 [accepted] PHST- 2021/04/06 06:00 [pubmed] PHST- 2022/02/04 06:00 [medline] PHST- 2021/04/05 20:08 [entrez] AID - S0003-4975(21)00590-7 [pii] AID - 10.1016/j.athoracsur.2021.03.061 [doi] PST - ppublish SO - Ann Thorac Surg. 2022 Feb;113(2):554-562. doi: 10.1016/j.athoracsur.2021.03.061. Epub 2021 Apr 2. PMID- 33764198 OWN - NLM STAT- MEDLINE DCOM- 20220114 LR - 20240327 IS - 1940-4034 (Electronic) IS - 1074-2484 (Print) IS - 1074-2484 (Linking) VI - 26 IP - 4 DP - 2021 Jul TI - NITRATE-CIN Study: Protocol of a Randomized (1:1) Single-Center, UK, Double-Blind Placebo-Controlled Trial Testing the Effect of Inorganic Nitrate on Contrast-Induced Nephropathy in Patients Undergoing Coronary Angiography for Acute Coronary Syndromes. PG - 303-309 LID - 10.1177/1074248421000520 [doi] AB - BACKGROUND: Contrast-induced nephropathy (CIN), an acute kidney injury resulting from the administration of intravascular iodinated contrast media, is a significant cause of morbidity/mortality following coronary angiographic procedures in high-risk patients. Despite preventative measures intended to mitigate the risk of CIN, there remains a need for novel effective treatments. Evidence suggests that delivery of nitric oxide (NO) through chemical reduction of inorganic nitrate to NO may offer a novel therapeutic strategy to reduce CIN and thus preserve long term renal function. DESIGN: The NITRATE-CIN trial is a single-center, randomized, double-blind placebo-controlled trial, which plans to recruit 640 patients presenting with acute coronary syndromes (ACS) who are at risk of CIN. Patients will be randomized to either inorganic nitrate therapy (capsules containing 12 mmol KNO(3)) or placebo capsules containing potassium chloride (KCl) daily for 5 days. The primary endpoint is development of CIN using the Kidney Disease Improving Global Outcomes (KDIGO) criteria. A key secondary endpoint is renal function over a 3-month follow-up period. Additional secondary endpoints include serum renal biomarkers (e.g. neutrophil gelatinase-associated lipocalin) at 6 h, 48 h and 3 months following administration of contrast. Cost-effectiveness of inorganic nitrate therapy will also be evaluated. SUMMARY: This study is designed to investigate the hypothesis that inorganic nitrate treatment decreases the rate of CIN as part of semi-emergent coronary angiography for ACS. Inorganic nitrate is a simple and easy to administer intervention that may prove useful in prevention of CIN in at-risk patients undergoing coronary angiographic procedures. FAU - Beirne, Anne-Marie AU - Beirne AM AUID- ORCID: 0000-0002-6817-3747 AD - Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, 560754Queen Mary University of London, United Kingdom. AD - Barts Interventional Group, Barts Heart Centre, Barts Health NHS Trust, London, United Kingdom. FAU - Mitchelmore, Oliver AU - Mitchelmore O AD - Barts Interventional Group, Barts Heart Centre, Barts Health NHS Trust, London, United Kingdom. FAU - Palma, Susana AU - Palma S AD - Barts Interventional Group, Barts Heart Centre, Barts Health NHS Trust, London, United Kingdom. FAU - Andiapen, Mervyn AU - Andiapen M AD - Barts Interventional Group, Barts Heart Centre, Barts Health NHS Trust, London, United Kingdom. FAU - Rathod, Krishnaraj S AU - Rathod KS AD - Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, 560754Queen Mary University of London, United Kingdom. AD - Barts Interventional Group, Barts Heart Centre, Barts Health NHS Trust, London, United Kingdom. FAU - Hammond, Victoria AU - Hammond V AD - Barts Cardiovascular Clinical Trials Unit, 560754Queen Mary University of London, London, United Kingdom. FAU - Bellin, Anna AU - Bellin A AD - Barts Cardiovascular Clinical Trials Unit, 560754Queen Mary University of London, London, United Kingdom. FAU - Cooper, Jackie AU - Cooper J AD - Barts Cardiovascular Clinical Trials Unit, 560754Queen Mary University of London, London, United Kingdom. FAU - Wright, Paul AU - Wright P AD - Department of Pharmacy, 560754Barts Heart Centre, London, United Kingdom. FAU - Antoniou, Sotiris AU - Antoniou S AD - Department of Pharmacy, 560754Barts Heart Centre, London, United Kingdom. FAU - Yaqoob, Muhammad Magdi AU - Yaqoob MM AD - Department of Nephrology, 9744Barts Health NHS Trust, London, United Kingdom. FAU - Naci, Huseyin AU - Naci H AD - Department of Health Policy, 4905London School of Economics, London, United Kingdom. FAU - Mathur, Anthony AU - Mathur A AD - Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, 560754Queen Mary University of London, United Kingdom. AD - Barts Interventional Group, Barts Heart Centre, Barts Health NHS Trust, London, United Kingdom. FAU - Ahluwalia, Amrita AU - Ahluwalia A AD - Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, 560754Queen Mary University of London, United Kingdom. AD - Barts Cardiovascular Clinical Trials Unit, 560754Queen Mary University of London, London, United Kingdom. FAU - Jones, Daniel A AU - Jones DA AD - Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, 560754Queen Mary University of London, United Kingdom. AD - Barts Interventional Group, Barts Heart Centre, Barts Health NHS Trust, London, United Kingdom. AD - Barts Cardiovascular Clinical Trials Unit, 560754Queen Mary University of London, London, United Kingdom. LA - eng SI - ClinicalTrials.gov/NCT03627130 GR - DH_/Department of Health/United Kingdom PT - Clinical Trial Protocol PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20210325 PL - United States TA - J Cardiovasc Pharmacol Ther JT - Journal of cardiovascular pharmacology and therapeutics JID - 9602617 RN - 0 (Contrast Media) RN - 0 (Lipocalin-2) RN - 0 (Nitrates) RN - 0 (Potassium Compounds) RN - RU45X2JN0Z (potassium nitrate) SB - IM MH - Acute Coronary Syndrome/diagnostic imaging MH - Acute Kidney Injury/*chemically induced/*prevention & control MH - Contrast Media/*adverse effects MH - Coronary Angiography/adverse effects/methods MH - Double-Blind Method MH - Humans MH - Kidney Function Tests MH - Lipocalin-2/blood MH - Nitrates/*administration & dosage/adverse effects/economics MH - Potassium Compounds/*administration & dosage/adverse effects/economics MH - Research Design MH - United Kingdom MH - Randomized Controlled Trials as Topic PMC - PMC8132002 OTO - NOTNLM OT - acute coronary syndrome OT - contrast-induced nephropathy OT - inorganic nitrate OT - percutaneous coronary intervention OT - renal biomarkers COIS- Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Professor Ahluwalia is a director of Heartbeet Ltd. EDAT- 2021/03/26 06:00 MHDA- 2022/01/15 06:00 PMCR- 2021/05/19 CRDT- 2021/03/25 12:22 PHST- 2021/03/26 06:00 [pubmed] PHST- 2022/01/15 06:00 [medline] PHST- 2021/03/25 12:22 [entrez] PHST- 2021/05/19 00:00 [pmc-release] AID - 10.1177_1074248421000520 [pii] AID - 10.1177/1074248421000520 [doi] PST - ppublish SO - J Cardiovasc Pharmacol Ther. 2021 Jul;26(4):303-309. doi: 10.1177/1074248421000520. Epub 2021 Mar 25. PMID- 33739127 OWN - NLM STAT- MEDLINE DCOM- 20211021 LR - 20211021 IS - 2047-9980 (Electronic) IS - 2047-9980 (Linking) VI - 10 IP - 7 DP - 2021 Apr 6 TI - Factors Related to Major Bleeding After Ticagrelor Therapy: Results from the TICO Trial. PG - e019630 LID - 10.1161/JAHA.120.019630 [doi] LID - e019630 AB - Background There is a lack of data on factors that are related to clinically relevant bleeding after ticagrelor treatment. We investigated the clinical and procedural factors related to major bleeding in patients with acute coronary syndrome treated with ticagrelor after coronary stent implantation. Methods and Results From the TICO (Ticagrelor Monotherapy After 3 Months in Patients Treated With New Generation Sirolimus-Eluting Stent for Acute Coronary Syndrome) randomized trial, a total of 2660 patients were included for the present study. Patients with major bleeding, defined by TIMI (Thrombolysis in Myocardial Infarction) major or Bleeding Academic Research Consortium type 3 or 5, were compared with those without major bleeding. On the basis of multivariable and receiver operating characteristic curve analyses, weight 80 years). A myocardial infarction (MI) or PCI during follow-up increased the risk of major bleeding (HR = 1.67, 95% CI 1-29-2.15). CONCLUSIONS: The 12-month cumulative incidence of major bleeding in NORSTENT was higher than reported in previous, explanatory trials. This analysis strengthens the role of chronic kidney disease, advanced age, and low bodyweight as risk factors for major bleeding among patients receiving DAPT after PCI. The presence of diabetes mellitus or recurrent MI among patients is furthermore a signal of increased bleeding risk. CLINICAL TRIAL REGISTRATION: Unique identifier NCT00811772; http://www.clinicaltrial.gov. FAU - Samuelsen, Per-Jostein AU - Samuelsen PJ AUID- ORCID: 0000-0002-7484-7488 AD - Regional Medicines Information and Pharmacovigilance Centre (RELIS), University Hospital of North Norway, Tromso, Norway. AD - Department of Community Medicine, UiT The Arctic University of Norway, Tromso, Norway. FAU - Eggen, Anne Elise AU - Eggen AE AD - Department of Community Medicine, UiT The Arctic University of Norway, Tromso, Norway. FAU - Steigen, Terje AU - Steigen T AD - Department of Cardiology, University Hospital of North Norway, Tromso, Norway. AD - Cardiovascular Diseases Research Group, UiT The Arctic University of Norway, Tromso, Norway. FAU - Wilsgaard, Tom AU - Wilsgaard T AD - Department of Community Medicine, UiT The Arctic University of Norway, Tromso, Norway. FAU - Kristensen, Andreas AU - Kristensen A AD - Department of Cardiology, University Hospital of North Norway, Tromso, Norway. FAU - Skogsholm, Anne AU - Skogsholm A AD - Department of Cardiology, University Hospital of North Norway, Tromso, Norway. FAU - Holme, Elizabeth AU - Holme E AD - Department of Cardiology, University Hospital of North Norway, Tromso, Norway. FAU - van den Heuvel, Christian AU - van den Heuvel C AD - Department of Cardiology, University Hospital of North Norway, Tromso, Norway. FAU - Nordrehaug, Jan Erik AU - Nordrehaug JE AD - Department of Clinical Science, University of Bergen, Bergen, Norway. FAU - Bendz, Bjorn AU - Bendz B AD - Department of Cardiology, Rikshospitalet, Oslo University Hospital, Oslo, Norway. AD - Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway. FAU - Nilsen, Dennis W T AU - Nilsen DWT AD - Department of Clinical Science, University of Bergen, Bergen, Norway. AD - Department of Cardiology, Stavanger University Hospital, Stavanger, Norway. FAU - Bonaa, Kaare Harald AU - Bonaa KH AUID- ORCID: 0000-0001-6675-3724 AD - Clinic for Heart Disease, St. Olav's University Hospital, Trondheim, Norway. AD - Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway. LA - eng SI - ClinicalTrials.gov/NCT00811772 PT - Journal Article PT - Multicenter Study PT - Pragmatic Clinical Trial PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20210304 PL - United States TA - PLoS One JT - PloS one JID - 101285081 RN - 0 (Platelet Aggregation Inhibitors) SB - IM MH - Age Factors MH - Aged MH - Aged, 80 and over MH - Drug-Eluting Stents/*adverse effects MH - Female MH - Humans MH - Incidence MH - Male MH - Middle Aged MH - *Myocardial Infarction/blood/epidemiology/surgery MH - Percutaneous Coronary Intervention/*adverse effects MH - Platelet Aggregation Inhibitors/administration & dosage/*adverse effects MH - *Postoperative Hemorrhage/blood/epidemiology/etiology MH - Risk Factors PMC - PMC7932162 COIS- The authors have declared that no competing interests exist. EDAT- 2021/03/05 06:00 MHDA- 2021/08/31 06:00 PMCR- 2021/03/04 CRDT- 2021/03/04 17:13 PHST- 2020/05/13 00:00 [received] PHST- 2021/02/03 00:00 [accepted] PHST- 2021/03/04 17:13 [entrez] PHST- 2021/03/05 06:00 [pubmed] PHST- 2021/08/31 06:00 [medline] PHST- 2021/03/04 00:00 [pmc-release] AID - PONE-D-20-14185 [pii] AID - 10.1371/journal.pone.0247358 [doi] PST - epublish SO - PLoS One. 2021 Mar 4;16(3):e0247358. doi: 10.1371/journal.pone.0247358. eCollection 2021. PMID- 33661913 OWN - NLM STAT- MEDLINE DCOM- 20210830 LR - 20231111 IS - 1932-6203 (Electronic) IS - 1932-6203 (Linking) VI - 16 IP - 3 DP - 2021 TI - Independent predictors of acute kidney injury in patients with acute coronary syndrome after percutaneous coronary intervention. PG - e0247304 LID - 10.1371/journal.pone.0247304 [doi] LID - e0247304 AB - INTRODUCTION: High residual platelet reactivity (RPR) in patients after percutaneous coronary intervention (PCI) receiving antiplatelet agents has been associated with a high risk of developing acute kidney injury (AKI). STUDY AIM: This study aimed at identification of independent prognostic predictors of AKI risk in patients with acute coronary syndrome (ACS) after PCI. STUDY DESIGN, SETTING AND PATIENTS: This was a prospective single-center clinical trial that included 155 patients (n = 119 without AKI, n = 36 with AKI, mean age 64.0+/-10.6 years, of whom 74.2% were males), who underwent PCI with stenting. We prospectively evaluated RPR using optical aggregometry. Development of AKI was the primary endpoint. RESULTS: Acute renal dysfunction was observed in 36 patients (23.2%) after PCI, the risk factors of which according to univariate regression analysis were: age (p = 0.040), low diastolic blood pressure (DBP) (p = 0.001), having severe heart failure (HF) according to Killip (p<0.001), low level of hemoglobin (p = 0.026) and erythrocytes (p = 0.005), increased creatinine (p<0.001), low baseline glomerular filtration rate (GFR) (p<0.001), low left ventricular ejection fraction (LV EF) (p = 0.003), high residual platelet reactivity (RPR) (p<0.001) and platelet aggregation area under the curve (AUC) with 10 mug/mL ADP (p<0.001), as well as dose of X-ray contrast medium (XCM) (p = 0.008). As a result of multivariate regression analysis the following independent predictors of AKI were established with the inclusion of the above factors: baseline creatinine level [OR 1.033 at 95% CI from 1.017 to 1.049; p<0.001], RPR with 10 mug/mL ADP [OR 1.060 at 95% CI from 1.027 to 1.094; p = 0.001], dose of an XCM [capital O, CyrillicR 1.005 at 95% CI from 1.001 to 1.008; small er, Cyrillic = 0.014], diastolic blood pressure (DBP) [OR 0.926 at 95% CI from 0.888 to 0.965; p<0.001]. CONCLUSION: ADP-induced high residual platelet reactivity, baseline creatinine level, X-ray contrast medium, low diastolic blood pressure were independent predictors of AKI in patients with ACS after PCI. FAU - Zhunuspekova, Aisulu AU - Zhunuspekova A AD - Department of Cardiology and Interventional Arrhythmology, Semey Medical University, Semey, Kazakhstan. FAU - Mansurova, Jamilya AU - Mansurova J AUID- ORCID: 0000-0003-2439-2056 AD - Head Office, Semey Medical University, Semey, Kazakhstan. FAU - Karazhanova, Lyudmila AU - Karazhanova L AD - Department of Cardiology and Interventional Arrhythmology, Semey Medical University, Semey, Kazakhstan. LA - eng PT - Clinical Trial PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20210304 PL - United States TA - PLoS One JT - PloS one JID - 101285081 SB - IM MH - *Acute Coronary Syndrome/blood/epidemiology/physiopathology/surgery MH - *Acute Kidney Injury/blood/epidemiology/etiology/physiopathology MH - Aged MH - Blood Platelets/*metabolism MH - *Blood Pressure MH - Female MH - Humans MH - Male MH - Middle Aged MH - *Percutaneous Coronary Intervention MH - Platelet Function Tests MH - *Postoperative Complications/blood/epidemiology/physiopathology MH - Predictive Value of Tests MH - Prospective Studies PMC - PMC7932092 COIS- NO authors have competing interests EDAT- 2021/03/05 06:00 MHDA- 2021/08/31 06:00 PMCR- 2021/03/04 CRDT- 2021/03/04 17:13 PHST- 2020/06/16 00:00 [received] PHST- 2021/02/04 00:00 [accepted] PHST- 2021/03/04 17:13 [entrez] PHST- 2021/03/05 06:00 [pubmed] PHST- 2021/08/31 06:00 [medline] PHST- 2021/03/04 00:00 [pmc-release] AID - PONE-D-20-18410 [pii] AID - 10.1371/journal.pone.0247304 [doi] PST - epublish SO - PLoS One. 2021 Mar 4;16(3):e0247304. doi: 10.1371/journal.pone.0247304. eCollection 2021. PMID- 33638801 OWN - NLM STAT- MEDLINE DCOM- 20210419 LR - 20260109 IS - 1865-8652 (Electronic) IS - 0741-238X (Linking) VI - 38 IP - 4 DP - 2021 Apr TI - Safety and Efficacy of Perioperative Use of Evolocumab in Myocardial Infarction Patients: Study Protocol for a Multicentre Randomized Controlled Trial. PG - 1801-1810 LID - 10.1007/s12325-021-01662-5 [doi] AB - INTRODUCTION: The SECURE-PCI study supports a perioperative loading dose of statins, although whether an intensive lipid-lowering strategy prior to percutaneous coronary intervention further benefits acute coronary syndrome patients remains controversial. Evolocumab, a proprotein-converting enzyme subtilisin/kexin type 9 (PCSK9) inhibitor, acts more quickly and effectively than statins and reduces the risk of cardiovascular events in post-myocardial infarction (MI) patients. Nonetheless, whether it can be safely used in perioperative MI patients and whether perioperative application can benefit patients are still unknown. This study aims to evaluate the safety and efficacy of this treatment regimen. METHODS: A multicentre, prospective, randomized, controlled superiority trial will be conducted in 530 statin-naive MI patients. All eligible patients will be randomized to the evolocumab group (140 mg subcutaneously injected once before revascularization + 14 days after the first dose) or the control group (no evolocumab injection). Evolocumab will then be administered depending on the patient's lipid profile. Both groups will be treated simultaneously with standardized secondary preventive medications. The primary end points are major adverse cardiovascular events (a composite of death, recurrent MI, unanticipated revascularization, stroke and any rehospitalization for ischaemic causes) within 12 months. The secondary end point is post-infarction angina after pain relief. The safety end points include myopathy, impaired liver or renal function, and other adverse events during the follow-up period. OUTCOMES: This is the first trial to evaluate the safety and efficacy of evolocumab pre-treatment on prognosis in MI patients. Perioperative evolocumab injection may be a new, safe way to improve prognosis. TRIAL REGISTRATION: Chinese Clinical Trial Registry ( http://www.chictr.org.cn ; ChiCTR1900024526). Registered on 13 July 2019 and updated on 31 May 2020. The study is currently recruiting patients. FAU - Luan, Yi AU - Luan Y AD - Department of Cardiology, Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 3 East Qingchun Road, Hangzhou, Zhejiang, 310016, People's Republic of China. ryan1218@zju.edu.cn. FAU - Wang, Min AU - Wang M AD - Department of Cardiology, Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 3 East Qingchun Road, Hangzhou, Zhejiang, 310016, People's Republic of China. FAU - Zhao, Liding AU - Zhao L AD - Department of Cardiology, Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 3 East Qingchun Road, Hangzhou, Zhejiang, 310016, People's Republic of China. FAU - Xu, Tian AU - Xu T AD - Department of Cardiology, Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 3 East Qingchun Road, Hangzhou, Zhejiang, 310016, People's Republic of China. FAU - Fu, Guosheng AU - Fu G AD - Department of Cardiology, Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 3 East Qingchun Road, Hangzhou, Zhejiang, 310016, People's Republic of China. fugs@zju.edu.cn. FAU - Zhang, Wenbin AU - Zhang W AD - Department of Cardiology, Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 3 East Qingchun Road, Hangzhou, Zhejiang, 310016, People's Republic of China. 3313011@zju.edu.cn. LA - eng PT - Clinical Trial Protocol PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20210227 PL - United States TA - Adv Ther JT - Advances in therapy JID - 8611864 RN - 0 (Antibodies, Monoclonal) RN - 0 (Antibodies, Monoclonal, Humanized) RN - 0 (Anticholesteremic Agents) RN - EC 3.4.21.- (PCSK9 protein, human) RN - EC 3.4.21.- (Proprotein Convertase 9) RN - LKC0U3A8NJ (evolocumab) MH - Antibodies, Monoclonal/therapeutic use MH - Antibodies, Monoclonal, Humanized MH - *Anticholesteremic Agents/therapeutic use MH - Humans MH - Multicenter Studies as Topic MH - *Myocardial Infarction MH - *Percutaneous Coronary Intervention MH - Proprotein Convertase 9 MH - Prospective Studies MH - Randomized Controlled Trials as Topic MH - Treatment Outcome MH - Equivalence Trials as Topic OTO - NOTNLM OT - Evolocumab OT - Myocardial infarction OT - Perioperative EDAT- 2021/02/28 06:00 MHDA- 2021/04/20 06:00 CRDT- 2021/02/27 12:08 PHST- 2021/01/05 00:00 [received] PHST- 2021/02/10 00:00 [accepted] PHST- 2021/02/28 06:00 [pubmed] PHST- 2021/04/20 06:00 [medline] PHST- 2021/02/27 12:08 [entrez] AID - 10.1007/s12325-021-01662-5 [pii] AID - 10.1007/s12325-021-01662-5 [doi] PST - ppublish SO - Adv Ther. 2021 Apr;38(4):1801-1810. doi: 10.1007/s12325-021-01662-5. Epub 2021 Feb 27. PMID- 33637568 OWN - NLM STAT- MEDLINE DCOM- 20210922 LR - 20250530 IS - 2053-3624 (Print) IS - 2053-3624 (Electronic) IS - 2053-3624 (Linking) VI - 8 IP - 1 DP - 2021 Feb TI - Invasive versus medically managed acute coronary syndromes with prior bypass (CABG-ACS): insights into the registry versus randomised trial populations. LID - 10.1136/openhrt-2020-001453 [doi] LID - e001453 AB - BACKGROUND: Coronary artery bypass graft (CABG) patients are under-represented in acute coronary syndrome (ACS) trials. We compared characteristics and outcomes for patients who did and did not participate in a randomised trial of invasive versus non-invasive management (CABG-ACS). METHODS: ACS patients with prior CABG in four hospitals were randomised to invasive or non-invasive management. Non-randomised patients entered a registry. Primary efficacy (composite of all-cause mortality, rehospitalisation for refractory ischaemia/angina, myocardial infarction (MI), heart failure) and safety outcomes (composite of bleeding, stroke, procedure-related MI, worsening renal function) were independently adjudicated. RESULTS: Of 217 patients screened, 84 (39%) screenfailed, of whom 24 (29%) did not consent and 60 (71%) were ineligible. Of 133 (61%) eligible, 60 (mean+/-SD age, 71+/-9 years, 72% male) entered the trial and 73 (age, 72+/-10 years, 73% male) entered a registry (preferences: physician (79%), patient (38%), both (21%)).Compared with trial participants, registry patients had more valve disease, lower haemoglobin, worse New York Heart Association class and higher frailty.At baseline, invasive management was performed in 52% and 49% trial and registry patients, respectively, of whom 32% and 36% had percutaneous coronary intervention at baseline, respectively (p=0.800). After 2 years follow-up (694 (median, IQR 558-841) days), primary efficacy (43% trial vs 49% registry (HR 1.14, 95% CI 0.69 to 1.89)) and safety outcomes (28% trial vs 22% registry (HR 0.74, 95% CI 0.37 to 1.46)) were similar. EuroQol was lower in registry patients at 1 year. CONCLUSIONS: Compared with trial participants, registry participants had excess morbidity, but longer-term outcomes were similar. TRIAL REGISTRATION NUMBER: NCT01895751. CI - (c) Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ. FAU - Lee, Matthew M Y AU - Lee MMY AUID- ORCID: 0000-0001-9213-2067 AD - Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK. AD - West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, UK. AD - Cardiology, Glasgow Royal Infirmary, Glasgow, UK. AD - Cardiology, Western Infirmary, Glasgow, UK. AD - Cardiology, Royal Alexandra Hospital, Paisley, UK. FAU - Petrie, Mark C AU - Petrie MC AUID- ORCID: 0000-0003-1350-1544 AD - Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK. AD - West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, UK. AD - Cardiology, Glasgow Royal Infirmary, Glasgow, UK. FAU - Rocchiccioli, Paul AU - Rocchiccioli P AUID- ORCID: 0000-0003-1350-1544 AD - West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, UK. AD - Cardiology, Glasgow Royal Infirmary, Glasgow, UK. FAU - Simpson, Joanne AU - Simpson J AD - Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK. AD - West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, UK. FAU - Jackson, Colette E AU - Jackson CE AD - Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK. AD - West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, UK. AD - Cardiology, Western Infirmary, Glasgow, UK. FAU - Corcoran, David S AU - Corcoran DS AUID- ORCID: 0000-0001-5047-0885 AD - Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK. AD - West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, UK. FAU - Mangion, Kenneth AU - Mangion K AUID- ORCID: 0000-0002-3505-7440 AD - Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK. AD - West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, UK. FAU - Brown, Ammani AU - Brown A AD - Cardiology, Western Infirmary, Glasgow, UK. FAU - Cialdella, Pio AU - Cialdella P AD - West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, UK. FAU - Sidik, Novalia P AU - Sidik NP AD - Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK. AD - West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, UK. FAU - McEntegart, Margaret B AU - McEntegart MB AD - Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK. AD - West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, UK. AD - Cardiology, Western Infirmary, Glasgow, UK. FAU - Shaukat, Aadil AU - Shaukat A AD - West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, UK. AD - Cardiology, Glasgow Royal Infirmary, Glasgow, UK. FAU - Rae, Alan P AU - Rae AP AD - Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK. AD - Cardiology, Glasgow Royal Infirmary, Glasgow, UK. FAU - Hood, Stuart H M AU - Hood SHM AD - Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK. AD - West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, UK. AD - Cardiology, Royal Alexandra Hospital, Paisley, UK. FAU - Peat, Eileen E AU - Peat EE AD - West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, UK. AD - Cardiology, Royal Alexandra Hospital, Paisley, UK. FAU - Findlay, Iain N AU - Findlay IN AD - Cardiology, Royal Alexandra Hospital, Paisley, UK. FAU - Murphy, Clare L AU - Murphy CL AD - Cardiology, Royal Alexandra Hospital, Paisley, UK. FAU - Cormack, Alistair J AU - Cormack AJ AD - Cardiology, Royal Alexandra Hospital, Paisley, UK. FAU - Bukov, Nikolay B AU - Bukov NB AD - Cardiology, Royal Blackburn Hospital, Blackburn, UK. FAU - Balachandran, Kanarath P AU - Balachandran KP AD - Cardiology, Royal Blackburn Hospital, Blackburn, UK. FAU - Ford, Ian AU - Ford I AUID- ORCID: 0000-0001-5927-1823 AD - Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK. FAU - Wu, Olivia AU - Wu O AUID- ORCID: 0000-0002-0570-6016 AD - Health Economics and Health Technology Assessment, University of Glasgow, Glasgow, UK. FAU - McConnachie, Alex AU - McConnachie A AUID- ORCID: 0000-0002-7262-7000 AD - Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK. FAU - Barry, Sarah J E AU - Barry SJE AUID- ORCID: 0000-0003-3039-8729 AD - Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK. FAU - Berry, Colin AU - Berry C AUID- ORCID: 0000-0002-4547-8636 AD - Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK colin.berry@glasgow.ac.uk. AD - West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, UK. AD - Cardiology, Western Infirmary, Glasgow, UK. CN - CABG-ACS Investigators LA - eng SI - ClinicalTrials.gov/NCT01895751 GR - RE/18/6134217/BHF_/British Heart Foundation/United Kingdom GR - MR/S005714/1/MRC_/Medical Research Council/United Kingdom GR - MR/S018905/1/MRC_/Medical Research Council/United Kingdom GR - PG/17/2532884/BHF_/British Heart Foundation/United Kingdom GR - FS/15/54/31639/BHF_/British Heart Foundation/United Kingdom GR - FS/17/26/32744/BHF_/British Heart Foundation/United Kingdom PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - England TA - Open Heart JT - Open heart JID - 101631219 RN - 0 (Fibrinolytic Agents) SB - IM MH - Acute Coronary Syndrome/*therapy MH - Aged MH - Coronary Artery Bypass/*methods MH - Female MH - Fibrinolytic Agents/*therapeutic use MH - Humans MH - Male MH - Preoperative Care/*methods MH - *Registries MH - Thrombolytic Therapy/*methods MH - Treatment Outcome PMC - PMC7919592 OTO - NOTNLM OT - acute coronary syndrome OT - coronary angiography OT - coronary artery bypass OT - health care OT - myocardial infarction OT - outcome assessment COIS- Competing interests: CB is employed by the University of Glasgow, which holds consultancy and/or research agreements with companies that have commercial interests in the diagnosis and treatment of ischaemic heart disease, including Abbott Vascular, AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, HeartFlow, Menarini Farmaceutica, Opsens, Philips and Siemens Healthcare. There are no other relevant personal disclosures. EDAT- 2021/02/28 06:00 MHDA- 2021/09/23 06:00 PMCR- 2021/02/26 CRDT- 2021/02/27 05:32 PHST- 2020/09/17 00:00 [received] PHST- 2020/11/23 00:00 [revised] PHST- 2021/01/22 00:00 [accepted] PHST- 2021/02/27 05:32 [entrez] PHST- 2021/02/28 06:00 [pubmed] PHST- 2021/09/23 06:00 [medline] PHST- 2021/02/26 00:00 [pmc-release] AID - openhrt-2020-001453 [pii] AID - 10.1136/openhrt-2020-001453 [doi] PST - ppublish SO - Open Heart. 2021 Feb;8(1):e001453. doi: 10.1136/openhrt-2020-001453. PMID- 33624028 OWN - NLM STAT- MEDLINE DCOM- 20211124 LR - 20220423 IS - 2048-8734 (Electronic) IS - 2048-8726 (Linking) VI - 10 IP - 4 DP - 2021 May 25 TI - Prognostic value of inflammatory biomarkers and GRACE score for cardiac death and acute kidney injury after acute coronary syndromes. PG - 445-452 LID - 10.1093/ehjacc/zuab003 [doi] AB - AIMS: The aim of this study was to analyse the role of inflammation and established clinical scores in predicting acute kidney injury (AKI) after acute coronary syndromes (ACS). METHODS AND RESULTS: In a prospective multicentre cohort including 2034 patients with ACS undergoing percutaneous coronary intervention, high-sensitivity C-reactive protein (hsCRP), neutrophil count, neutrophil-to-lymphocyte ratio (NL-ratio), and creatinine were measured at the index procedure. AKI (n = 39, defined according to RIFLE criteria) and major cardiovascular and cerebrovascular events were adjudicated after 1 year. Associations between inflammation, AKI, and cardiac death (CD) were assessed by C-statistics and Cox proportional hazard models with log-rank test to compare survival. Patients with ACS with elevated neutrophil count >7.8 x 109/L, NL-ratio >5, combined neutrophil-count/creatinine, or NL-ratio/creatinine at baseline showed a higher incidence of AKI (all P < 0.05) and CD (all P < 0.001). The risk of AKI, CD, and their combination was increased in patients with higher neutrophil count/creatinine (heart rate (HR) = 3.7, 95% cardiac index (CI) 1.9-7.1; HR = 2.7, 95% CI 1.6-4.6; HR = 3.2, 95% CI 2.1-4.9); NL-ratio/creatinine (HR = 2.1, 95% CI 1.6-4.1; HR = 2.2, 95% CI 1.3-3.8; HR = 2.3, 95% CI 1.5-3.5); and hsCRP (HR = 1.8, 95% CI 0.9-3.5; HR = 2.2, 95% CI 1.3-3.6; HR = 1.9, 95% CI 1.2-2.8) after adjustment for age, diabetes, hypertension, previous heart failure, kidney function, haemodynamic instability at admission, statin, and renin-angiotensin-aldosterone antagonists use. Subjects with higher GRACE score 1.0/NL-ratio had higher rate of AKI, CD, and both (HR = 1.4, 95% CI 0.5-4.2; HR = 2.7, 95% CI 1.3-5.9; HR = 2.1, 95% CI 1-4.3). CONCLUSIONS: Inflammation markers may predict AKI after correction for renal function at the index procedure. hsCRP performed better than the NL-ratio. However, the integration of inflammation markers to traditional risk factors or scores does not add prognostic information. TRIAL REGISTRATION: ClinicalTrials.gov, NCT01000701. CI - Published on behalf of the European Society of Cardiology. All rights reserved. (c) The Author(s) 2021. For permissions, please email: journals.permissions@oup.com. FAU - Rossi, Valentina A AU - Rossi VA AUID- ORCID: 0000-0001-9235-6597 AD - Department of Cardiology, University Heart Center, University Hospital Zurich, Ramistrasse 100, 8091 Zurich, Switzerland. FAU - Denegri, Andrea AU - Denegri A AUID- ORCID: 0000-0001-5095-1523 AD - Department of Cardiology, University Heart Center, University Hospital Zurich, Ramistrasse 100, 8091 Zurich, Switzerland. AD - Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Via Universita 4, 41125 Modena, Italy. FAU - Candreva, Alessandro AU - Candreva A AD - Department of Cardiology, University Heart Center, University Hospital Zurich, Ramistrasse 100, 8091 Zurich, Switzerland. FAU - Klingenberg, Roland AU - Klingenberg R AD - Department of Cardiology, University Heart Center, University Hospital Zurich, Ramistrasse 100, 8091 Zurich, Switzerland. AD - Department of Cardiology, Kerckhoff Heart and Thorax Center, Benekestr. 2-8, 61231 Bad Nauheim, Germany. FAU - Obeid, Slayman AU - Obeid S AD - Department of Cardiology, University Heart Center, University Hospital Zurich, Ramistrasse 100, 8091 Zurich, Switzerland. FAU - Raber, Lorenz AU - Raber L AD - Department of Cardiology, Cardiovascular Center, University Hospital Bern, Freiburgstrasse 4, 3010 Bern, Switzerland. FAU - Gencer, Baris AU - Gencer B AD - Department of Cardiology, Cardiovascular Center, University Hospital Geneva, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland. FAU - Mach, Francois AU - Mach F AD - Department of Cardiology, Cardiovascular Center, University Hospital Geneva, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland. FAU - Nanchen, David AU - Nanchen D AD - Department of Ambulatory Care and Community Medicine, University Hospital of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland. FAU - Rodondi, Nicolas AU - Rodondi N AD - Department of General Internal Medicine, University Hospital Bern, Freiburgstrasse 4, 3010 Bern, Switzerland. AD - Bern Institute of Primary Health Care (BIHAM), University of Bern, Hochschulstrasse 6, 3012 Bern, Switzerland. FAU - Heg, Dik AU - Heg D AD - Department of Cardiology, Cardiovascular Center, University Hospital Bern, Freiburgstrasse 4, 3010 Bern, Switzerland. AD - Institute of Social and Preventive Medicine, (ISPM) University of Bern, Hochschulstrasse 6, 3012 Bern, Switzerland. FAU - Windecker, Stephan AU - Windecker S AUID- ORCID: 0000-0003-2653-6762 AD - Department of Clinical Research, Clinical Trials Unit, ISPM, University of Bern, Hochschulstrasse 6, 3012 Bern, Switzerland. FAU - Buhmann, Joachim AU - Buhmann J AD - Institute of Neuroinformatics, University of Zurich and ETH Zurich, Winterthurerstrasse 190, 8057 Zurich, Switzerland. FAU - Ruschitzka, Frank AU - Ruschitzka F AUID- ORCID: 0000-0001-5972-0596 AD - Department of Cardiology, University Heart Center, University Hospital Zurich, Ramistrasse 100, 8091 Zurich, Switzerland. FAU - Luscher, Thomas F AU - Luscher TF AD - Department of Cardiology, Royal Brompton and Harefield Hospitals and Imperial College, Sydney St, Chelsea, London SW3 6NP, UK. AD - Center for Molecular Cardiology, University of Zurich, Wagistrasse 12, 8952 Schlieren, Switzerland. FAU - Matter, Christian M AU - Matter CM AD - Department of Cardiology, University Heart Center, University Hospital Zurich, Ramistrasse 100, 8091 Zurich, Switzerland. AD - Center for Molecular Cardiology, University of Zurich, Wagistrasse 12, 8952 Schlieren, Switzerland. LA - eng SI - ClinicalTrials.gov/NCT01000701 PT - Journal Article PL - England TA - Eur Heart J Acute Cardiovasc Care JT - European heart journal. Acute cardiovascular care JID - 101591369 RN - 0 (Biomarkers) SB - IM MH - *Acute Coronary Syndrome/complications/diagnosis MH - *Acute Kidney Injury/diagnosis/epidemiology/etiology MH - Biomarkers MH - Death MH - Humans MH - Prognosis MH - Prospective Studies OTO - NOTNLM OT - Acute kidney injury OT - GRACE score OT - Inflammation OT - Neutrophil-to-lymphocyte ratio OT - hsCRP OT - Acute coronary syndromes EDAT- 2021/02/25 06:00 MHDA- 2021/11/25 06:00 CRDT- 2021/02/24 05:45 PHST- 2019/05/28 00:00 [received] PHST- 2019/07/29 00:00 [revised] PHST- 2021/01/12 00:00 [accepted] PHST- 2021/02/25 06:00 [pubmed] PHST- 2021/11/25 06:00 [medline] PHST- 2021/02/24 05:45 [entrez] AID - 6148891 [pii] AID - 10.1093/ehjacc/zuab003 [doi] PST - ppublish SO - Eur Heart J Acute Cardiovasc Care. 2021 May 25;10(4):445-452. doi: 10.1093/ehjacc/zuab003. PMID- 33623999 OWN - NLM STAT- MEDLINE DCOM- 20220405 LR - 20220405 IS - 2047-4881 (Electronic) IS - 2047-4873 (Linking) VI - 29 IP - 2 DP - 2022 Mar 11 TI - Prediction of recurrent event in patients with coronary heart disease: the EUROASPIRE Risk Model. PG - 328-339 LID - 10.1093/eurjpc/zwaa128 [doi] AB - AIMS: Most patients with established atherosclerotic cardiovascular disease (CVD) are at very high risk for developing recurrent events. Since this risk varies a lot between patients there is a need to identify those in whom an even more intensive secondary prevention strategy should be envisaged. Using data from the EUROASPIRE IV and V cohorts of coronary heart disease (CHD) patients from 27 European countries, we aimed at developing and internally and externally validating a risk model predicting recurrent CVD events in patients aged < 75 years. METHODS AND RESULTS: Prospective data were available for 12 484 patients after a median follow-up time of 1.7 years. The primary endpoint, a composite of fatal CVD or new hospitalizations for non-fatal myocardial infarction (MI), stroke, heart failure, coronary artery bypass graft, or percutaneous coronary intervention (PCI), occurred in 1424 patients. The model was developed based on data from 8000 randomly selected patients in whom the association between potential risk factors and the incidence of the primary endpoint was investigated. This model was then validated in the remaining 4484 patients. The final multivariate model revealed a higher risk for the primary endpoint with increasing age, a previous hospitalization for stroke, heart failure or PCI, a previous diagnosis of peripheral artery disease, self-reported diabetes and its glycaemic control, higher non-high-density lipoprotein cholesterol, reduced renal function, symptoms of depression and anxiety and living in a higher risk country. The model demonstrated excellent internal validity and proved very adequate in the validation cohort. Regarding external validity, the model demonstrated good discriminative ability in 20 148 MI patients participating in the SWEDEHEART register. Finally, we developed a risk calculator to estimate risks at 1 and 2 years for patients with stable CHD. CONCLUSION: In patients with CHD, fatal and non-fatal rates of recurrent CVD events are high. However, there are still opportunities to optimize their management in order to prevent further disease or death. The EUROASPIRE Risk Calculator may be of help to reach this goal. CI - Published on behalf of the European Society of Cardiology. All rights reserved. (c) The Author(s) 2020. For permissions, please email: journals.permissions@oup.com. FAU - De Bacquer, Dirk AU - De Bacquer D AD - Department of Public Health and Primary Care, Ghent University, C. Heymanslaan 10, 9000 Gent, Belgium. FAU - Ueda, Peter AU - Ueda P AD - Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden. AD - Department of Internal Medicine, University Hospital Center Zagreb, School of Medicine, University of Zagreb, Zagreb, Croatia. FAU - Reiner, Zeljko AU - Reiner Z AD - Department of Internal Medicine, University Hospital Center Zagreb, School of Medicine, University of Zagreb, Zagreb, Croatia. FAU - De Sutter, Johan AU - De Sutter J AD - Department of Internal Medicine and Paediatrics, Ghent University, Ghent, Belgium. AD - Department of Cardiology, AZ Maria Middelares Ghent, Ghent, Belgium. FAU - De Smedt, Delphine AU - De Smedt D AD - Department of Public Health and Primary Care, Ghent University, C. Heymanslaan 10, 9000 Gent, Belgium. FAU - Lovic, Dragan AU - Lovic D AD - Cardiology Department, School of Medicine, Clinic for Internal Disease Intermedica, Hypertensive Centre, Singidunum University, Nis, Serbia. FAU - Gotcheva, Nina AU - Gotcheva N AD - Department of Cardiology, National Heart Hospital, Sofia, Bulgaria. FAU - Fras, Zlatko AU - Fras Z AD - Department of Vascular Medicine, Division of Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia. AD - Medical Faculty, University of Ljubljana, Ljubljana, Slovenia. FAU - Pogosova, Nana AU - Pogosova N AD - National Medical Research Centre of Cardiology of the Ministry of Healthcare of the Russian Federation, Moscow, Russia. FAU - Mirrakhimov, Erkin AU - Mirrakhimov E AD - Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan. AD - National Centre of Cardiology and Internal Medicine named after academician Mirrakhimov MM, Bishkek, Kyrgyzstan. FAU - Lehto, Seppo AU - Lehto S AD - Varkaus Hospital, Varkaus, Finland. FAU - Jernberg, Tomas AU - Jernberg T AD - Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden. FAU - Kotseva, Kornelia AU - Kotseva K AD - National Heart and Lung Institute, Imperial College London, London, UK. AD - National University of Ireland, Galway, Ireland. FAU - Ryden, Lars AU - Ryden L AD - Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden. FAU - Wood, David AU - Wood D AD - National Heart and Lung Institute, Imperial College London, London, UK. AD - National University of Ireland, Galway, Ireland. FAU - De Backer, Guy AU - De Backer G AD - Department of Public Health and Primary Care, Ghent University, C. Heymanslaan 10, 9000 Gent, Belgium. CN - EUROASPIRE IV and V National Coordinators LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - England TA - Eur J Prev Cardiol JT - European journal of preventive cardiology JID - 101564430 SB - IM CIN - Eur J Prev Cardiol. 2022 Mar 25;29(3):e139-e140. doi: 10.1093/eurjpc/zwab033. PMID: 33792666 CIN - Eur J Prev Cardiol. 2022 Mar 25;29(3):e138. doi: 10.1093/eurjpc/zwab027. PMID: 33885747 MH - Aged MH - Coronary Artery Bypass/adverse effects MH - *Coronary Disease/diagnosis/epidemiology/etiology MH - Humans MH - *Percutaneous Coronary Intervention/adverse effects MH - Prospective Studies MH - Risk Factors OTO - NOTNLM OT - Coronary heart disease OT - Patient management OT - Recurrent events OT - Risk EDAT- 2021/02/25 06:00 MHDA- 2022/04/06 06:00 CRDT- 2021/02/24 05:45 PHST- 2020/09/19 00:00 [received] PHST- 2020/11/04 00:00 [revised] PHST- 2020/11/10 00:00 [accepted] PHST- 2021/02/25 06:00 [pubmed] PHST- 2022/04/06 06:00 [medline] PHST- 2021/02/24 05:45 [entrez] AID - 6055091 [pii] AID - 10.1093/eurjpc/zwaa128 [doi] PST - ppublish SO - Eur J Prev Cardiol. 2022 Mar 11;29(2):328-339. doi: 10.1093/eurjpc/zwaa128. PMID- 33611899 OWN - NLM STAT- MEDLINE DCOM- 20210223 LR - 20210223 IS - 0253-3758 (Print) IS - 0253-3758 (Linking) VI - 49 IP - 2 DP - 2021 Feb 24 TI - [Long-term outcomes of intravascular ultrasound-guided drug-eluting stent implantation in patients with chronic kidney disease: ULTIMATE CKD subgroup analysis]. PG - 136-142 LID - 10.3760/cma.j.cn112148-20201106-00886 [doi] AB - Objective: To explore the long-term effect of intravascular ultrasound (IVUS) guidance on patients with chronic kidney disease (CKD) undergoing drug-eluting stent (DES) implantation. Methods: Data used in this study derived from ULTIMATE trial, which was a prospective, multicenter, randomized study. From August 2014 to May 2017, 1 448 patients with coronary heart disease undergoing DES implantation were selected from 8 domestic centers and randomly divided into two groups in the ratio of 1ratio1 (IVUS or coronary angiography guided stent implantation). A total of 1 443 patients with the baseline serum creatine available were enrolled. The patients were divided into CKD group and non CKD group. CKD was defined as the estimated glomerular filtration rate (eGFR) derived from Cockcroft Gault (CG) formula< 60 ml.min(-1).1.73 m(-2) for at least 3 months. Primary endpoint of this study was target vessel failure (TVF) at 3 years, including cardiac death, target vessel myocardial infarction, and clinically-driven target vessel revascularization. Kaplan Meier method was used for survival analysis, and log rank test was used to compare the occurrence of end-point events in each group. Cox proportional hazards model was used to calculate HR and 95%CI, and interaction was tested. Multivariate Cox regression was used to analyze the independent influencing factors of TVF. Results: A total of 1 443 patients with coronary heart disease were enrolled in this study, including 349 (24.2%) patients in CKD group and 1 094 patients in non CKD group. In CKD group, IVUS was used to guide stent implantation in 180 cases and angiography was used in 169 cases; in non CKD group, IVUS was used to guide stent implantation in 543 cases and angiography was used in 551 cases. Three-year clinical follow-up was available in 1 418 patients (98.3%). The incidence of TVF in CKD group was 12.0% (42/349), which was higher than that in non CKD group (7.4% (81/1 094) (P = 0.01). The difference was mainly due to the higher cardiac mortality in CKD group (4.6% (16/349) vs. 1.5% (16/1094), P<0.001). In CKD group, the incidence of TVF in patients who underwent IVUS guided stent implantation was lower than that in angiography guided stent implantation (8.3% (15/180) vs. 16.0% (27/169), P = 0.03). There was no significant difference in the incidence of TVF between IVUS guided stent implantation and angiography guided stent implantation in non CKD group (5.9% (32/543) vs. 8.9% (49/551), P = 0.06), and there was no interaction (P = 0.47). Multivariate Cox regression analysis showed that IVUS guidance (HR = 0.56, 95%CI 0.39-0.81, P = 0.002), CKD (HR = 1.83, 95%CI 1.17-2.87, P = 0.010) and stent length (every 10 mm increase) (HR = 1.11, 95%CI 1.04-1.19, P = 0.002) were independent risk factors for TVF within 3 years after DES implantation. Conclusions: CKD patients undergoing DES implantation are associated with a higher risk of 3-year TVF. More importantly, the risk of TVF could be significantly decreased through IVUS guidance in comparison with angiography guidance in patients with CKD. FAU - Gao, X F AU - Gao XF AD - Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China. FAU - Lu, S AU - Lu S AD - Department of Cardiology, First People's Hospital of Taicang, Taicang 215400, China. FAU - Han, L AU - Han L AD - Department of Cardiology, Changshu No. 1 People's Hospital, Changshu 215500, China. FAU - Qian, X S AU - Qian XS AD - Department of Cardiology, First People's Hospital of Zhangjiagang, Zhangjiagang 215600, China. FAU - Ge, Z AU - Ge Z AD - Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China. FAU - Kong, X Q AU - Kong XQ AD - Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China. FAU - Kan, J AU - Kan J AD - Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China. FAU - Zhang, J J AU - Zhang JJ AD - Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China. FAU - Chen, S L AU - Chen SL AD - Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China. LA - chi GR - 81970307/National Natural Science Foundation of China/ GR - BE2019616/Social Development Project of Jiangsu Province/ PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PL - China TA - Zhonghua Xin Xue Guan Bing Za Zhi JT - Zhonghua xin xue guan bing za zhi JID - 7910682 SB - IM MH - Coronary Angiography MH - *Coronary Artery Disease/diagnostic imaging/surgery MH - *Drug-Eluting Stents MH - Humans MH - *Percutaneous Coronary Intervention MH - Prospective Studies MH - *Renal Insufficiency, Chronic MH - Treatment Outcome MH - Ultrasonography, Interventional EDAT- 2021/02/23 06:00 MHDA- 2021/02/24 06:00 CRDT- 2021/02/22 03:41 PHST- 2021/02/22 03:41 [entrez] PHST- 2021/02/23 06:00 [pubmed] PHST- 2021/02/24 06:00 [medline] AID - 10.3760/cma.j.cn112148-20201106-00886 [doi] PST - ppublish SO - Zhonghua Xin Xue Guan Bing Za Zhi. 2021 Feb 24;49(2):136-142. doi: 10.3760/cma.j.cn112148-20201106-00886. PMID- 33591821 OWN - NLM STAT- MEDLINE DCOM- 20210928 LR - 20250530 IS - 1941-7632 (Electronic) IS - 1941-7640 (Linking) VI - 14 IP - 2 DP - 2021 Feb TI - Risk Stratification Guided by the Index of Microcirculatory Resistance and Left Ventricular End-Diastolic Pressure in Acute Myocardial Infarction. PG - e009529 LID - 10.1161/CIRCINTERVENTIONS.120.009529 [doi] AB - BACKGROUND: The index of microcirculatory resistance (IMR) of the infarct-related artery and left ventricular end-diastolic pressure (LVEDP) are acute, prognostic biomarkers in patients undergoing primary percutaneous coronary intervention. The clinical significance of IMR and LVEDP in combination is unknown. METHODS: IMR and LVEDP were prospectively measured in a prespecified substudy of the T-TIME clinical trial (Trial of Low Dose Adjunctive Alteplase During Primary PCI). IMR was measured using a pressure- and temperature-sensing guidewire following percutaneous coronary intervention. Prognostically established thresholds for IMR (>32) and LVEDP (>18 mm Hg) were predefined. Contrast-enhanced cardiovascular magnetic resonance imaging (1.5 Tesla) was acquired 2 to 7 days and 3 months postmyocardial infarction. The primary end point was major adverse cardiac events, defined as cardiac death/nonfatal myocardial infarction/heart failure hospitalization at 1 year. RESULTS: IMR and LVEDP were both measured in 131 patients (mean age 59+/-10.7 years, 103 [78.6%] male, 48 [36.6%] with anterior myocardial infarction). The median IMR was 29 (interquartile range, 17-55), the median LVEDP was 17 mm Hg (interquartile range, 12-21), and the correlation between them was not statistically significant (r=0.15; P=0.087). Fifty-three patients (40%) had low IMR (18 and IMR>32 combined was associated with major adverse cardiac events, independent of age, estimated glomerular filtration rate, and infarct-related artery (odds ratio, 5.80 [95% CI, 1.60-21.22] P=0.008). The net reclassification improvement for detecting major adverse cardiac events was 50.6% (95% CI, 2.7-98.2; P=0.033) when LVEDP>18 was added to IMR>32. CONCLUSIONS: IMR and LVEDP in combination have incremental value for risk stratification following primary percutaneous coronary intervention. Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT02257294. FAU - Maznyczka, Annette M AU - Maznyczka AM AD - British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences (A.M.M., P.J.M., K.G.O., M.M., H.E., D.C., C.B.), University of Glasgow, United Kingdom. AD - West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, Glasgow, United Kingdom (A.M.M., P.J.M., K.G.O., M.L., M.M., H.E., J.P.R., R.G., A.S., K.R., S.H., S.W., D.C., T.J.F., C.B.). FAU - McCartney, Peter J AU - McCartney PJ AD - British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences (A.M.M., P.J.M., K.G.O., M.M., H.E., D.C., C.B.), University of Glasgow, United Kingdom. AD - West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, Glasgow, United Kingdom (A.M.M., P.J.M., K.G.O., M.L., M.M., H.E., J.P.R., R.G., A.S., K.R., S.H., S.W., D.C., T.J.F., C.B.). FAU - Oldroyd, Keith G AU - Oldroyd KG AD - British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences (A.M.M., P.J.M., K.G.O., M.M., H.E., D.C., C.B.), University of Glasgow, United Kingdom. AD - West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, Glasgow, United Kingdom (A.M.M., P.J.M., K.G.O., M.L., M.M., H.E., J.P.R., R.G., A.S., K.R., S.H., S.W., D.C., T.J.F., C.B.). FAU - Lindsay, Mitchell AU - Lindsay M AD - West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, Glasgow, United Kingdom (A.M.M., P.J.M., K.G.O., M.L., M.M., H.E., J.P.R., R.G., A.S., K.R., S.H., S.W., D.C., T.J.F., C.B.). FAU - McEntegart, Margaret AU - McEntegart M AD - British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences (A.M.M., P.J.M., K.G.O., M.M., H.E., D.C., C.B.), University of Glasgow, United Kingdom. AD - West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, Glasgow, United Kingdom (A.M.M., P.J.M., K.G.O., M.L., M.M., H.E., J.P.R., R.G., A.S., K.R., S.H., S.W., D.C., T.J.F., C.B.). FAU - Eteiba, Hany AU - Eteiba H AD - British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences (A.M.M., P.J.M., K.G.O., M.M., H.E., D.C., C.B.), University of Glasgow, United Kingdom. AD - West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, Glasgow, United Kingdom (A.M.M., P.J.M., K.G.O., M.L., M.M., H.E., J.P.R., R.G., A.S., K.R., S.H., S.W., D.C., T.J.F., C.B.). FAU - Rocchiccioli, J Paul AU - Rocchiccioli JP AD - West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, Glasgow, United Kingdom (A.M.M., P.J.M., K.G.O., M.L., M.M., H.E., J.P.R., R.G., A.S., K.R., S.H., S.W., D.C., T.J.F., C.B.). FAU - Good, Richard AU - Good R AD - West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, Glasgow, United Kingdom (A.M.M., P.J.M., K.G.O., M.L., M.M., H.E., J.P.R., R.G., A.S., K.R., S.H., S.W., D.C., T.J.F., C.B.). FAU - Shaukat, Aadil AU - Shaukat A AD - West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, Glasgow, United Kingdom (A.M.M., P.J.M., K.G.O., M.L., M.M., H.E., J.P.R., R.G., A.S., K.R., S.H., S.W., D.C., T.J.F., C.B.). FAU - Robertson, Keith AU - Robertson K AD - West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, Glasgow, United Kingdom (A.M.M., P.J.M., K.G.O., M.L., M.M., H.E., J.P.R., R.G., A.S., K.R., S.H., S.W., D.C., T.J.F., C.B.). FAU - Malkin, Christopher J AU - Malkin CJ AD - Leeds University and Leeds Teaching Hospitals NHS Trust, United Kingdom (C.J.M., J.P.G.). FAU - Greenwood, John P AU - Greenwood JP AD - Leeds University and Leeds Teaching Hospitals NHS Trust, United Kingdom (C.J.M., J.P.G.). FAU - Cotton, James M AU - Cotton JM AD - Wolverhampton University Hospital NHS Trust, United Kingdom (J.M.C.). FAU - Hood, Stuart AU - Hood S AD - West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, Glasgow, United Kingdom (A.M.M., P.J.M., K.G.O., M.L., M.M., H.E., J.P.R., R.G., A.S., K.R., S.H., S.W., D.C., T.J.F., C.B.). FAU - Watkins, Stuart AU - Watkins S AD - West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, Glasgow, United Kingdom (A.M.M., P.J.M., K.G.O., M.L., M.M., H.E., J.P.R., R.G., A.S., K.R., S.H., S.W., D.C., T.J.F., C.B.). FAU - Collison, Damien AU - Collison D AD - British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences (A.M.M., P.J.M., K.G.O., M.M., H.E., D.C., C.B.), University of Glasgow, United Kingdom. AD - West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, Glasgow, United Kingdom (A.M.M., P.J.M., K.G.O., M.L., M.M., H.E., J.P.R., R.G., A.S., K.R., S.H., S.W., D.C., T.J.F., C.B.). FAU - Gillespie, Lynsey AU - Gillespie L AD - Project Management Unit, Greater Glasgow and Clyde Health Board, United Kingdom (L.G.). FAU - Ford, Thomas J AU - Ford TJ AD - Faculty of Medicine, University of Newcastle, Callaghan NSW, Australia (T.J.F.). AD - West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, Glasgow, United Kingdom (A.M.M., P.J.M., K.G.O., M.L., M.M., H.E., J.P.R., R.G., A.S., K.R., S.H., S.W., D.C., T.J.F., C.B.). FAU - Weir, Robin A P AU - Weir RAP AD - University Hospital Hairmyres, East Kilbride, United Kingdom (R.A.P.W.). FAU - McConnachie, Alex AU - McConnachie A AD - Robertson Centre for Biostatistics (A.M.), University of Glasgow, United Kingdom. FAU - Berry, Colin AU - Berry C AD - British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences (A.M.M., P.J.M., K.G.O., M.M., H.E., D.C., C.B.), University of Glasgow, United Kingdom. AD - West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, Glasgow, United Kingdom (A.M.M., P.J.M., K.G.O., M.L., M.M., H.E., J.P.R., R.G., A.S., K.R., S.H., S.W., D.C., T.J.F., C.B.). LA - eng SI - ClinicalTrials.gov/NCT02257294 GR - FS/16/74/32573/BHF_/British Heart Foundation/United Kingdom GR - RE/18/6/34217/BHF_/British Heart Foundation/United Kingdom GR - MC_PC_15113/MRC_/Medical Research Council/United Kingdom GR - MC_PC_12037/MRC_/Medical Research Council/United Kingdom GR - FS/16/74/32573/BHF_/British Heart Foundation/United Kingdom PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20210216 PL - United States TA - Circ Cardiovasc Interv JT - Circulation. Cardiovascular interventions JID - 101499602 SB - IM MH - Aged MH - Blood Pressure MH - Female MH - Humans MH - Male MH - Microcirculation MH - Middle Aged MH - *Myocardial Infarction/therapy MH - Percutaneous Coronary Intervention/adverse effects MH - Prospective Studies MH - Risk Assessment MH - Treatment Outcome MH - Ventricular Function, Left OTO - NOTNLM OT - index of microcirculatory resistance OT - left ventricular end diastolic pressure OT - myocardial infarction OT - percutaneous coronary intervention OT - risk stratification EDAT- 2021/02/17 06:00 MHDA- 2021/09/29 06:00 CRDT- 2021/02/16 17:09 PHST- 2021/02/16 17:09 [entrez] PHST- 2021/02/17 06:00 [pubmed] PHST- 2021/09/29 06:00 [medline] AID - 10.1161/CIRCINTERVENTIONS.120.009529 [doi] PST - ppublish SO - Circ Cardiovasc Interv. 2021 Feb;14(2):e009529. doi: 10.1161/CIRCINTERVENTIONS.120.009529. Epub 2021 Feb 16. PMID- 33591006 OWN - NLM STAT- MEDLINE DCOM- 20210916 LR - 20230812 IS - 1530-0293 (Electronic) IS - 0090-3493 (Print) IS - 0090-3493 (Linking) VI - 49 IP - 5 DP - 2021 May 1 TI - Safety and Efficacy of Human Chorionic Gonadotropin Hormone-Derivative EA-230 in Cardiac Surgery Patients: A Randomized Double-Blind Placebo-Controlled Study. PG - 790-803 LID - 10.1097/CCM.0000000000004847 [doi] AB - OBJECTIVES: To determine the safety and efficacy of human chorionic gonadotropin hormone-derivative EA-230 in cardiac surgery patients. Cardiac surgery induces systemic inflammation and may impair renal function, affecting patient outcome. EA-230 exerted immunomodulatory and renoprotective effects in preclinical models and was safe and showed efficacy in phase I and II human studies. DESIGN: Double-blinded, placebo-controlled, randomized study. SETTING: Collaboration of the Cardiothoracic Surgery, Anesthesiology, and the Intensive Care departments of a tertiary hospital in the Netherlands. PATIENTS: One hundred eighty patients undergoing an on-pump coronary artery bypass procedure with or without concomitant valve surgery. INTERVENTIONS: Ninety mg/kg/hr EA-230 or placebo administered during surgery. MEASUREMENTS AND MAIN RESULTS: During the study, no safety concerns emerged. EA-230 did not modulate interleukin-6 plasma concentrations (area under the curve 2,730 pg/mL x hr [1,968-3,760] vs 2,680 pg/mL x hr [2,090-3,570] for EA-230 and placebo group, respectively; p = 0.80). Glomerular filtration rate increased following surgery (mean +/- sem increase in the EA-230 vs placebo groups: glomerular filtration rateiohexol measured using iohexol plasma clearance: 19 +/- 2 vs 16 +/- 2 mL/min/1.73 m2; p = 0.13 and estimated glomerular filtration rate with the Modification of Diet in Renal Disease equation using creatinine: 6 +/- 1 vs 2 +/- 1 mL/min/1.73 m2; p = 0.01). The "injury" stage of the Risk, Injury, Failure, Loss of kidney function, and End-stage kidney disease criteria for acute kidney injury was 7% in the EA-230 group versus 18% in the placebo group (p = 0.07). In addition, EA-230-treated patients had a less positive fluid balance compared with placebo-treated patients (217 +/- 108 vs 605 +/- 103 mL; p = 0.01), while the use of vasoactive agents was similar in both groups (p = 0.39). Finally, hospital length of stay was shorter in EA-230 treated patients (8 d [7-11] vs 10 d [8-12]; p = 0.001). Efficacy results were more pronounced in patients that had longer duration of surgery and thus longer duration of study drug infusion. CONCLUSIONS: EA-230 was safe in patients undergoing on-pump cardiac surgery. It did not modulate interleukin-6 plasma concentrations but appeared to exert beneficial renal and cardiovascular effects and shortened in-hospital length of stay. CI - Copyright (c) 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. FAU - van Groenendael, Roger AU - van Groenendael R AD - Department of Intensive Care Medicine, Radboud University Medical Center, Nijmegen, The Netherlands. AD - Radboud Center for Infectious Diseases (RCI), Radboud University Medical Center, Nijmegen, The Netherlands. AD - Radboud Institute for Molecular Life Sciences (RIMLS), Radboud University Medical Center, Nijmegen, The Netherlands. AD - Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, The Netherlands. AD - Department of Cardiothoracic Surgery, Radboud University Medical Center, Nijmegen, The Netherlands. AD - Exponential Biotherapies, Inc. (EBI), The Hague, The Netherlands. FAU - Beunders, Remi AU - Beunders R AD - Department of Intensive Care Medicine, Radboud University Medical Center, Nijmegen, The Netherlands. AD - Radboud Center for Infectious Diseases (RCI), Radboud University Medical Center, Nijmegen, The Netherlands. AD - Radboud Institute for Molecular Life Sciences (RIMLS), Radboud University Medical Center, Nijmegen, The Netherlands. AD - Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, The Netherlands. AD - Department of Cardiothoracic Surgery, Radboud University Medical Center, Nijmegen, The Netherlands. AD - Exponential Biotherapies, Inc. (EBI), The Hague, The Netherlands. FAU - Hemelaar, Pleun AU - Hemelaar P AD - Department of Intensive Care Medicine, Radboud University Medical Center, Nijmegen, The Netherlands. AD - Radboud Center for Infectious Diseases (RCI), Radboud University Medical Center, Nijmegen, The Netherlands. FAU - Hofland, Jan AU - Hofland J AD - Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, The Netherlands. FAU - Morshuis, Wim J AU - Morshuis WJ AD - Department of Cardiothoracic Surgery, Radboud University Medical Center, Nijmegen, The Netherlands. FAU - van der Hoeven, Johannes G AU - van der Hoeven JG AD - Department of Intensive Care Medicine, Radboud University Medical Center, Nijmegen, The Netherlands. AD - Radboud Center for Infectious Diseases (RCI), Radboud University Medical Center, Nijmegen, The Netherlands. AD - Radboud Institute for Molecular Life Sciences (RIMLS), Radboud University Medical Center, Nijmegen, The Netherlands. AD - Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, The Netherlands. AD - Department of Cardiothoracic Surgery, Radboud University Medical Center, Nijmegen, The Netherlands. AD - Exponential Biotherapies, Inc. (EBI), The Hague, The Netherlands. FAU - Gerretsen, Jelle AU - Gerretsen J AD - Department of Intensive Care Medicine, Radboud University Medical Center, Nijmegen, The Netherlands. AD - Radboud Center for Infectious Diseases (RCI), Radboud University Medical Center, Nijmegen, The Netherlands. FAU - Wensvoort, Gert AU - Wensvoort G AD - Exponential Biotherapies, Inc. (EBI), The Hague, The Netherlands. FAU - Kooistra, Emma J AU - Kooistra EJ AD - Department of Intensive Care Medicine, Radboud University Medical Center, Nijmegen, The Netherlands. AD - Radboud Center for Infectious Diseases (RCI), Radboud University Medical Center, Nijmegen, The Netherlands. AD - Radboud Institute for Molecular Life Sciences (RIMLS), Radboud University Medical Center, Nijmegen, The Netherlands. AD - Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, The Netherlands. AD - Department of Cardiothoracic Surgery, Radboud University Medical Center, Nijmegen, The Netherlands. AD - Exponential Biotherapies, Inc. (EBI), The Hague, The Netherlands. FAU - Claassen, Wout J AU - Claassen WJ AD - Department of Intensive Care Medicine, Radboud University Medical Center, Nijmegen, The Netherlands. FAU - Waanders, Denise AU - Waanders D AD - Department of Intensive Care Medicine, Radboud University Medical Center, Nijmegen, The Netherlands. FAU - Lamberts, Maud G A AU - Lamberts MGA AD - Department of Intensive Care Medicine, Radboud University Medical Center, Nijmegen, The Netherlands. FAU - Buijsse, Leonie S E AU - Buijsse LSE AD - Department of Intensive Care Medicine, Radboud University Medical Center, Nijmegen, The Netherlands. FAU - Kox, Matthijs AU - Kox M AD - Department of Intensive Care Medicine, Radboud University Medical Center, Nijmegen, The Netherlands. AD - Radboud Center for Infectious Diseases (RCI), Radboud University Medical Center, Nijmegen, The Netherlands. AD - Radboud Institute for Molecular Life Sciences (RIMLS), Radboud University Medical Center, Nijmegen, The Netherlands. AD - Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, The Netherlands. AD - Department of Cardiothoracic Surgery, Radboud University Medical Center, Nijmegen, The Netherlands. AD - Exponential Biotherapies, Inc. (EBI), The Hague, The Netherlands. FAU - van Eijk, Lucas T AU - van Eijk LT AD - Department of Intensive Care Medicine, Radboud University Medical Center, Nijmegen, The Netherlands. AD - Radboud Center for Infectious Diseases (RCI), Radboud University Medical Center, Nijmegen, The Netherlands. AD - Radboud Institute for Molecular Life Sciences (RIMLS), Radboud University Medical Center, Nijmegen, The Netherlands. AD - Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, The Netherlands. AD - Department of Cardiothoracic Surgery, Radboud University Medical Center, Nijmegen, The Netherlands. AD - Exponential Biotherapies, Inc. (EBI), The Hague, The Netherlands. FAU - Pickkers, Peter AU - Pickkers P AD - Department of Intensive Care Medicine, Radboud University Medical Center, Nijmegen, The Netherlands. AD - Radboud Center for Infectious Diseases (RCI), Radboud University Medical Center, Nijmegen, The Netherlands. AD - Radboud Institute for Molecular Life Sciences (RIMLS), Radboud University Medical Center, Nijmegen, The Netherlands. AD - Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, The Netherlands. AD - Department of Cardiothoracic Surgery, Radboud University Medical Center, Nijmegen, The Netherlands. AD - Exponential Biotherapies, Inc. (EBI), The Hague, The Netherlands. LA - eng SI - ClinicalTrials.gov/NCT03145220 PT - Journal Article PT - Randomized Controlled Trial PL - United States TA - Crit Care Med JT - Critical care medicine JID - 0355501 RN - 0 (Cardiotonic Agents) RN - 0 (Oligopeptides) RN - 0 (alanyl-glutaminyl-glycyl-valine) SB - IM MH - Aged MH - Cardiotonic Agents/*therapeutic use MH - Coronary Artery Bypass/*methods MH - Coronary Artery Disease/*drug therapy/*surgery MH - Double-Blind Method MH - Humans MH - Male MH - Middle Aged MH - Netherlands MH - Oligopeptides/*therapeutic use PMC - PMC8043513 COIS- The sponsor had no role in the study design, data collection, analysis, or reporting. Dr. Pickkers received consulting fees and travel reimbursements from EBI. Dr. Wensvoort received consulting fees and travel reimbursements from EBI and owned shares in EBI, and he disclosed work for hire. The remaining authors have disclosed that they do not have any potential conflicts of interest. EDAT- 2021/02/17 06:00 MHDA- 2021/09/18 06:00 PMCR- 2021/04/13 CRDT- 2021/02/16 09:47 PHST- 2021/02/17 06:00 [pubmed] PHST- 2021/09/18 06:00 [medline] PHST- 2021/02/16 09:47 [entrez] PHST- 2021/04/13 00:00 [pmc-release] AID - 00003246-202105000-00008 [pii] AID - 10.1097/CCM.0000000000004847 [doi] PST - ppublish SO - Crit Care Med. 2021 May 1;49(5):790-803. doi: 10.1097/CCM.0000000000004847. PMID- 33587363 OWN - NLM STAT- MEDLINE DCOM- 20220202 LR - 20220309 IS - 1473-5830 (Electronic) IS - 0954-6928 (Linking) VI - 32 IP - 8 DP - 2021 Dec 1 TI - One-year clinical outcome and predictors of ischemic and hemorrhagic events after percutaneous coronary intervention in elderly and very elderly patients. PG - 689-697 LID - 10.1097/MCA.0000000000001028 [doi] AB - BACKGROUND: Elderly constitute a high-risk subset of patients but are under-represented in clinical revascularization trials. Our aim was to investigate clinical outcomes and prognosis predictors after percutaneous coronary intervention (PCI) in this population. METHODS: Unrestricted consecutive patients with >/=75 years who underwent PCI from 2012 to 2015 were enrolled. The primary ischemic endpoint was the composite of 1-year myocardial infarction, definite/probable stent thrombosis and target vessel revascularization. The primary bleeding endpoint was defined according to the Bleeding Academic Research Consortium (BARC) classification as BARC >/= 2. RESULTS: We enrolled 708 patients (mean age 80 +/- 4): 14% were very elderly patients (>/=85 years), 27% of patients were diabetic, 23% had chronic kidney disease (CKD), 17% atrial fibrillation and 37% presented acute coronary syndrome. The primary ischemic endpoint was reported in 67 patients (12%): 29 had myocardial infarction (5%), 25 had definite/probable stent thrombosis (4.4%) and 44 had target vessel revascularization (8%). BARC >/= 2 bleeding was reported in 43 patients (8%). No differences were found in terms of both ischemic and bleeding events between patients with <85 and >/=85 years. Three-vessel disease and use of bare metal stent were independent predictors of the primary ischemic endpoint. Triple antithrombotic therapy and CKD were the only independent predictors of BARC >/= 2 bleedings. CONCLUSIONS: In our experience, elderly patients reported reassuring efficacy and safety outcomes after PCI, even if ischemic and bleeding events were frequent. Three-vessel disease and the use of bare metal stent were the only predictors of primary ischemic endpoint. Triple antithrombotic therapy and CKD were the only predictors of BARC >/= 2 bleedings. CI - Copyright (c) 2021 Wolters Kluwer Health, Inc. All rights reserved. FAU - Monello, Alberto AU - Monello A AD - Cardio-Thoracic-Vascular Department, San Raffaele Institute, Milan. AD - Interventional Cardiology, "G. da Saliceto" Hospital, Piacenza. FAU - Chiarito, Mauro AU - Chiarito M AD - Cardio-Thoracic-Vascular Department, San Raffaele Institute, Milan. AD - Humanitas Clinical and Research Center, Clinical and Interventional Cardiology, Rozzano. FAU - Pivato, Carlo Andrea AU - Pivato CA AD - Cardio-Thoracic-Vascular Department, San Raffaele Institute, Milan. AD - Humanitas Clinical and Research Center, Clinical and Interventional Cardiology, Rozzano. FAU - Scotti, Andrea AU - Scotti A AD - Cardio-Thoracic-Vascular Department, San Raffaele Institute, Milan. FAU - Melillo, Francesco AU - Melillo F AD - Cardio-Thoracic-Vascular Department, San Raffaele Institute, Milan. FAU - Munafo, Andrea AU - Munafo A AD - Cardio-Thoracic-Vascular Department, San Raffaele Institute, Milan. FAU - Montorfano, Matteo AU - Montorfano M AD - Cardio-Thoracic-Vascular Department, San Raffaele Institute, Milan. FAU - Margonato, Alberto AU - Margonato A AD - Cardio-Thoracic-Vascular Department, San Raffaele Institute, Milan. FAU - Colombo, Antonio AU - Colombo A AD - Cardio-Thoracic-Vascular Department, San Raffaele Institute, Milan. AD - Emo-GVM Centro Cuore Columbus, Milan. AD - Interventional Cardiology Unit, Maria Cecilia Hospital, Cotignola, Italy. FAU - Godino, Cosmo AU - Godino C AD - Cardio-Thoracic-Vascular Department, San Raffaele Institute, Milan. LA - eng PT - Journal Article PL - England TA - Coron Artery Dis JT - Coronary artery disease JID - 9011445 SB - IM MH - Aged MH - Aged, 80 and over MH - Female MH - Hemorrhage/epidemiology/etiology/*mortality MH - Humans MH - Ischemia/epidemiology/etiology/*mortality MH - Male MH - Percutaneous Coronary Intervention/methods/*standards/statistics & numerical data MH - Risk Assessment/methods/statistics & numerical data MH - *Time Factors MH - Treatment Outcome EDAT- 2021/02/16 06:00 MHDA- 2022/02/03 06:00 CRDT- 2021/02/15 13:18 PHST- 2021/02/16 06:00 [pubmed] PHST- 2022/02/03 06:00 [medline] PHST- 2021/02/15 13:18 [entrez] AID - 00019501-202112000-00003 [pii] AID - 10.1097/MCA.0000000000001028 [doi] PST - ppublish SO - Coron Artery Dis. 2021 Dec 1;32(8):689-697. doi: 10.1097/MCA.0000000000001028. PMID- 33552527 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240806 IS - 2054-3581 (Print) IS - 2054-3581 (Electronic) IS - 2054-3581 (Linking) VI - 8 DP - 2021 TI - Treatment Preferences for Cardiac Procedures of Patients With Chronic Kidney Disease in Acute Coronary Syndrome: Design and Pilot Testing of a Discrete Choice Experiment. PG - 2054358120985375 LID - 10.1177/2054358120985375 [doi] LID - 2054358120985375 AB - BACKGROUND: Chronic kidney disease is associated with a high incidence of acute coronary syndrome and related morbidity and mortality. Treatment choices for patients with chronic kidney disease involve trade-offs in the potential benefits and harms of invasive management options. OBJECTIVE: The objective was to quantify preferences of patients with chronic kidney disease toward invasive heart procedures. DESIGN: Design and pilot a discrete choice experiment. SETTING: We piloted the discrete choice experiment in 2 multidisciplinary chronic kidney disease clinics in Calgary, Alberta, using an 8-question survey. PATIENTS: Eligible patients included those aged 18 years and older, an estimated glomerular filtration rate < 45 mL/min/1.73 m(2), not currently receiving dialysis, and able to communicate in English. MEASUREMENTS: Quantification of the average importances of key attributes of invasive heart procedures. METHODS: We identified attributes most important to patients and physicians concerning invasive versus conservative management for acute coronary syndrome, using semi-structured qualitative interviews. Levels for each attribute were derived from analysis of early invasive versus conservative acute coronary syndrome management clinical trials and cohort studies, where subgroups of patients with chronic kidney disease were reported. We designed the pilot study with patient partners with relevant lived experience and considered statistical efficiency to estimate main effects and interactions, as well as response efficiency. Hierarchical Bayesian estimation was used to quantify average importances of attributes. RESULTS: We recruited 43 patients with chronic kidney disease, mean (SD) age 67 (14) years, 67% male, and 35% with a history of cardiovascular disease, of whom 39 completed the survey within 2 weeks of enrollment. The results of the pilot revealed acute kidney injury requiring dialysis and permanent kidney replacement therapy, as well as death within 1 year were the most important attributes. Measures of internal validity for the pilot discrete choice experiment were comparable to those for other published discrete choice experiments. LIMITATIONS: Discrete choice experiments are complex instruments and often cognitively demanding for patients. This survey included multiple risk attributes which may have been challenging for some patients to understand. CONCLUSIONS: This pilot study demonstrates the feasibility of a discrete choice experiment to quantify preferences of patients with chronic kidney disease toward the benefits and trade-offs related to invasive versus conservative management for acute coronary syndrome. These preliminary findings suggest that patients with chronic kidney disease may be on average similarly risk averse toward kidney replacement therapy and death. This pilot information will be used to inform a larger discrete choice experiment that will refine these estimates of patient preferences and characterize subgroups with distinct treatment preferences, which should provide new knowledge that can facilitate shared decision-making between patients with chronic kidney disease and their care providers in the setting of acute coronary syndrome. CI - (c) The Author(s) 2021. FAU - Wilson, T AU - Wilson T AD - Department of Community Health Sciences, University of Calgary, AB, Canada. FAU - Javaheri, P AU - Javaheri P AD - Department of Medicine, University of Calgary, AB, Canada. FAU - Finlay, J AU - Finlay J AD - Department of Medicine, University of Calgary, AB, Canada. FAU - Hazlewood, G AU - Hazlewood G AD - Department of Medicine, University of Calgary, AB, Canada. FAU - Wilton, S B AU - Wilton SB AD - Department of Cardiac Sciences, University of Calgary, AB, Canada. FAU - Sajobi, T AU - Sajobi T AD - Department of Community Health Sciences, University of Calgary, AB, Canada. FAU - Levin, A AU - Levin A AD - Division of Nephrology, The University of British Columbia, Vancouver, Canada. FAU - Pearson, W AU - Pearson W AD - Patient and Community Engagement Research Program, O'Brien Institute of Public Health, University of Calgary, AB, Canada. FAU - Connolly, C AU - Connolly C AD - Department of Cardiac Sciences, University of Calgary, AB, Canada. FAU - James, M T AU - James MT AUID- ORCID: 0000-0002-1876-3917 AD - Department of Medicine, Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, AB, Canada. LA - eng PT - Journal Article DEP - 20210127 PL - England TA - Can J Kidney Health Dis JT - Canadian journal of kidney health and disease JID - 101640242 PMC - PMC7844446 OTO - NOTNLM OT - acute coronary syndrome OT - chronic kidney disease OT - discrete choice experiment OT - patient preferences OT - shared decision-making COIS- Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. EDAT- 2021/02/09 06:00 MHDA- 2021/02/09 06:01 PMCR- 2021/01/27 CRDT- 2021/02/08 05:38 PHST- 2020/09/25 00:00 [received] PHST- 2020/11/27 00:00 [accepted] PHST- 2021/02/08 05:38 [entrez] PHST- 2021/02/09 06:00 [pubmed] PHST- 2021/02/09 06:01 [medline] PHST- 2021/01/27 00:00 [pmc-release] AID - 10.1177_2054358120985375 [pii] AID - 10.1177/2054358120985375 [doi] PST - epublish SO - Can J Kidney Health Dis. 2021 Jan 27;8:2054358120985375. doi: 10.1177/2054358120985375. eCollection 2021. PMID- 33526728 OWN - NLM STAT- MEDLINE DCOM- 20210203 LR - 20210203 IS - 1512-0112 (Print) IS - 1512-0112 (Linking) IP - 309 DP - 2020 Dec TI - CARDIOVASCULAR EVENT ASSESSMENT IN PATIENTS WITH NONOBSTRUCTIVE CORONARY ARTERY DISEASE UNDERGOING DUAL ANTIPLATELET TREATMENT. PG - 43-46 AB - The aim of our study was to learn the differences in baseline presentation between NObCAD and obstructive coronary artery disease (ObCAD) subjects, to compare the likelihood of several clinical outcomes and the rate of primary endpoints between this groups. Out study included 165 patients: 115 patients with NObCAD ACS, 50 - with ObCAD ACS. Inclusion criteria: age >18 year; Presence of any atherosclerotic stenosis greater than 20% but less than 50% in the left main coronary artery, and greater than 20% but less than 70% in any other major epicardial coronary artery. capital ER, Cyrillicatients with NObCAD ACS were randomly assign in an 1:1 ratio in 2 group: Group A (n=55) received dual antiplatelet treatment with aspirin 100-160 mg once daily and clopidogrel 75 mg once daily for three months. Group B (n=60) received only aspirin 100-160 mg once daily for three months. 50 patients with ObCAD ACS entered in group C - controlled group, patients were treated according appropriate treatment guidelines. Clinical, demographic and treatment data were investigated. Demographic variables included age and gender. Comorbidities included smoking, diabetes, hyperlipidemia, hypertension, obesity, and prior history of heart disease (angina, heart failure, myocardial infarction, coronary artery bypass grafting, and percutaneous coronary intervention), renal and liver disease. ECG changes and initial laboratory data were recorded. Laboratory analyses: CBC, urine test, serum lipid profile, fasting blood glucose and HbA1C, creatinine and eGFR, liver enzymes were provided. All patients underwent coronary angiography. Data describing patient management included use of beta-blockers, aspirin, ACE inhibitors or angiotensin receptor blockers, lipid-lowering agents. We categorized each patient by CAD extent. To accomplish this, we categorized each patient by CAD severity in a single, double, or triple-vessel distribution. Follow-up evaluations were performed at one, two and three months and 1 year. At these visits was assessed primary endpoints - MACE (Major adverse cardiac events): 1year hospitalization for Myocardial infarction or other cardiovascular causes after index angiography, cardiovascular death, revascularization, survival. We studied type and frequency of bleeding during treatment and follow up period. After data assessment we can tell, that the combination of clopidogrel and aspirin was not significantly more effective than aspirin alone in reducing the rate of myocardial infarction, but there was significant difference between groups regarding the CVD event rates, revascularization frequency and bleeding rate. FAU - Sikharulidze, I AU - Sikharulidze I AD - 1M. Tsinamdzgvrishvili Centre of Cardiology, Georgia. FAU - Chelidze, K AU - Chelidze K AD - 2The First University Clinic of Tbilisi State Medical University, Georgia. FAU - Mamatsashvili, I AU - Mamatsashvili I AD - 2The First University Clinic of Tbilisi State Medical University, Georgia. LA - eng PT - Journal Article PL - Georgia (Republic) TA - Georgian Med News JT - Georgian medical news JID - 101218222 RN - 0 (Platelet Aggregation Inhibitors) RN - A74586SNO7 (Clopidogrel) RN - R16CO5Y76E (Aspirin) SB - IM MH - Aspirin/therapeutic use MH - Clopidogrel MH - *Coronary Artery Disease/drug therapy MH - Humans MH - *Myocardial Infarction MH - *Percutaneous Coronary Intervention MH - Platelet Aggregation Inhibitors/therapeutic use MH - Treatment Outcome EDAT- 2021/02/03 06:00 MHDA- 2021/02/04 06:00 CRDT- 2021/02/02 06:03 PHST- 2021/02/02 06:03 [entrez] PHST- 2021/02/03 06:00 [pubmed] PHST- 2021/02/04 06:00 [medline] PST - ppublish SO - Georgian Med News. 2020 Dec;(309):43-46. PMID- 33517534 OWN - NLM STAT- MEDLINE DCOM- 20220127 LR - 20240320 IS - 1861-0692 (Electronic) IS - 1861-0684 (Print) IS - 1861-0684 (Linking) VI - 110 IP - 10 DP - 2021 Oct TI - Ten-year all-cause death following percutaneous or surgical revascularization in patients with prior cerebrovascular disease: insights from the SYNTAX Extended Survival study. PG - 1543-1553 LID - 10.1007/s00392-020-01802-x [doi] AB - BACKGROUND: Coronary bypass artery grafting (CABG) has a higher procedural risk of stroke than percutaneous coronary intervention (PCI), but may offer better long-term survival. The optimal revascularization strategy for patients with prior cerebrovascular disease (CEVD) remains unclear. METHODS AND RESULTS: The SYNTAXES study assessed the vital status out to 10 year of patients with three-vessel disease and/or left main coronary artery disease enrolled in the SYNTAX trial. The relative efficacy of PCI vs. CABG in terms of 10 year all-cause death was assessed according to prior CEVD. The primary endpoint was 10 year all-cause death. The status of prior CEVD was available in 1791 (99.5%) patients, of whom 253 patients had prior CEVD. Patients with prior CEVD were older and had more comorbidities (medically treated diabetes, insulin-dependent diabetes, metabolic syndrome, peripheral vascular disease, chronic obstructive pulmonary disease, impaired renal function, and congestive heart failure), compared with those without prior CEVD. Prior CEVD was an independent predictor of 10 year all-cause death (adjusted HR: 1.35; 95% CI: 1.04-1.73; p = 0.021). Patients with prior CEVD had a significantly higher risk of 10 year all-cause death (41.1 vs. 24.1%; HR: 1.92; 95% CI: 1.54-2.40; p < 0.001). The risk of 10 year all-cause death was similar between patients receiving PCI or CABG irrespective of the presence of prior CEVD (p(-interaction) = 0.624). CONCLUSION: Prior CEVD was associated with a significantly increased risk of 10 year all-cause death which was similar in patients treated with PCI or CABG. These results do not support preferential referral for PCI rather than CABG in patients with prior CEVD. TRIAL REGISTRATION: SYNTAX: ClinicalTrials.gov reference: NCT00114972. SYNTAX Extended Survival: ClinicalTrials.gov reference: NCT03417050. CI - (c) 2021. The Author(s). FAU - Wang, Rutao AU - Wang R AD - Department of Cardiology, Xijing Hospital, Xi'an, China. AD - Department of Cardiology, National University of Ireland Galway, University Road, Galway, H91 TK33, Ireland. AD - Department of Cardiology, Radboud UMC, Nijmegen, The Netherlands. FAU - Takahashi, Kuniaki AU - Takahashi K AD - Department of Cardiology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands. FAU - Garg, Scot AU - Garg S AD - East Lancashire Hospitals NHS Trust, Blackburn, Lancashire, UK. FAU - Thuijs, Daniel J F M AU - Thuijs DJFM AD - Department of Cardiothoracic Surgery, Erasmus University Medical Centre, Rotterdam, The Netherlands. FAU - Kappetein, Arie Pieter AU - Kappetein AP AD - Department of Cardiothoracic Surgery, Erasmus University Medical Centre, Rotterdam, The Netherlands. FAU - Mack, Michael J AU - Mack MJ AD - Department of Cardiothoracic Surgery, Baylor University Medical Center, Dallas, TX, USA. FAU - Morice, Marie-Claude AU - Morice MC AD - Departement of Cardiologie, Hopital Prive Jacques Cartier, Generale de Sante Massy, Massy, France. FAU - Mohr, Friedrich-Wilhelm AU - Mohr FW AD - University Department of Cardiac Surgery, Heart Centre Leipzig, Leipzig, Germany. FAU - Curzen, Nick AU - Curzen N AD - Cardiology Department, University Hospital Southampton, Southampton, UK. FAU - Davierwala, Piroze AU - Davierwala P AD - University Department of Cardiac Surgery, Heart Centre Leipzig, Leipzig, Germany. FAU - Milojevic, Milan AU - Milojevic M AD - Department of Cardiothoracic Surgery, Erasmus University Medical Centre, Rotterdam, The Netherlands. AD - Department of Cardiac Surgery and Cardiovascular Research, Dedinje Cardiovascular Institute, Belgrade, Serbia. FAU - van Geuns, Robert Jan AU - van Geuns RJ AD - Department of Cardiology, Radboud UMC, Nijmegen, The Netherlands. FAU - Head, Stuart J AU - Head SJ AD - Department of Cardiothoracic Surgery, Erasmus University Medical Centre, Rotterdam, The Netherlands. FAU - Onuma, Yoshinobu AU - Onuma Y AD - Department of Cardiology, National University of Ireland Galway, University Road, Galway, H91 TK33, Ireland. FAU - Holmes, David R Jr AU - Holmes DR Jr AD - Department of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, MN, USA. FAU - Serruys, Patrick W AU - Serruys PW AUID- ORCID: 0000-0002-9636-1104 AD - Department of Cardiology, National University of Ireland Galway, University Road, Galway, H91 TK33, Ireland. patrick.w.j.c.serruys@gmail.com. AD - NHLI, Imperial College London, London, UK. patrick.w.j.c.serruys@gmail.com. LA - eng SI - ClinicalTrials.gov/NCT03417050 SI - ClinicalTrials.gov/NCT00114972 PT - Controlled Clinical Trial PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20210130 PL - Germany TA - Clin Res Cardiol JT - Clinical research in cardiology : official journal of the German Cardiac Society JID - 101264123 SB - IM MH - Aged MH - Cause of Death MH - Cerebrovascular Disorders/complications/*mortality MH - Coronary Artery Bypass/*methods MH - Coronary Artery Disease/*mortality/surgery MH - Female MH - Follow-Up Studies MH - Humans MH - Male MH - Middle Aged MH - Myocardial Revascularization/methods MH - Percutaneous Coronary Intervention/*methods MH - Risk Factors PMC - PMC8484131 OTO - NOTNLM OT - CABG OT - Cerebrovascular disease OT - Left main coronary artery disease OT - PCI OT - Three-vessel disease COIS- Dr. Serruys reports personal fees from Biosensors, Micel Technologies, Sinomedical Sciences Technology, Philips/Volcano, Xeltis, and HeartFlow, outside the submitted work. Dr. Kappetein reports to work as an employee of Medtronic, outside the submitted work. Dr. Head reports to work as a full-time employee of Medtronic outside the scope of this work. Dr. Morice reports to work as the CEO of CERC, a CRO which was never involved in the SYNTAX trial at any level, except that submitted the 10 years additional follow-up (for free) to French authorities to get approval. Dr. van Geuns reports personal fees from Abbott vascular, grants and personal fees from AstraZeneca, grants and personal fees from Amgen, grants and personal fees from Boston Scientific, personal fees from Sanofi, outside the submitted work. All other authors have no disclosures. EDAT- 2021/02/01 06:00 MHDA- 2022/01/28 06:00 PMCR- 2021/01/30 CRDT- 2021/01/31 20:40 PHST- 2020/10/23 00:00 [received] PHST- 2020/12/29 00:00 [accepted] PHST- 2021/02/01 06:00 [pubmed] PHST- 2022/01/28 06:00 [medline] PHST- 2021/01/31 20:40 [entrez] PHST- 2021/01/30 00:00 [pmc-release] AID - 10.1007/s00392-020-01802-x [pii] AID - 1802 [pii] AID - 10.1007/s00392-020-01802-x [doi] PST - ppublish SO - Clin Res Cardiol. 2021 Oct;110(10):1543-1553. doi: 10.1007/s00392-020-01802-x. Epub 2021 Jan 30. PMID- 33468068 OWN - NLM STAT- MEDLINE DCOM- 20210614 LR - 20240330 IS - 1471-2261 (Electronic) IS - 1471-2261 (Linking) VI - 21 IP - 1 DP - 2021 Jan 19 TI - Evaluation of a novel Cardiac Peri-Operative Transfusion Trigger Scoring system in patients with coronary artery disease. PG - 40 LID - 10.1186/s12872-021-01854-5 [doi] LID - 40 AB - BACKGROUND: A simple and accurate scoring system to guide perioperative blood transfusion in patients with coronary artery disease (CAD) undergoing cardiac surgery is lacking. The trigger point for blood transfusions for these patients may be different from existing transfusion guidelines. This study aimed to evaluate the safety and efficacy of a new scoring strategy for use in guiding transfusion decisions in patients with CAD. METHODS: A multicenter randomized controlled trial was conducted at three third-level grade-A hospitals from January 2015 to May 2018. Data of 254 patients in a Cardiac Peri-Operative Transfusion Trigger Score (cPOTTS) group and 246 patients in a group receiving conventional evaluation of the need for transfusion (conventional group) were analysed. The requirements for transfusion and the per capita consumption of red blood cells (RBCs) were compared between groups. RESULTS: Baseline characteristics of the two groups were comparable. Logistic regression analyses revealed no significant differences between the two groups in primary outcomes (1-year mortality and perioperative ischemic cardiac events), secondary outcomes (shock, infections, and renal impairment), ICU admission, and ICU stay duration. However, patients in the cPOTTS group had significantly shorter hospital stays, lower hospital costs, lower utilization rate and lower per capita consumption of transfused RBCs than controls. Stratified analyses revealed no significant differences between groups in associations between baseline characteristics and perioperative ischemic cardiac events, except for hemofiltration or dialysis and NYHA class in I. CONCLUSIONS: This novel scoring system offered a practical and straightforward guideline of perioperative blood transfusion in patients with CAD. Trial registration chiCTR1800016561(2017/7/19). FAU - Ma, Hai-Ping AU - Ma HP AD - Department of Anesthesiology, The First Affiliated Hospital of Xinjiang Medical University, 37 Liyushan South Road, Xinshi District, Urumqi, 830054, Xinjiang, China. FAU - Zhang, Lei AU - Zhang L AD - Department of Anesthesiology, The First Affiliated Hospital of Xinjiang Medical University, 37 Liyushan South Road, Xinshi District, Urumqi, 830054, Xinjiang, China. FAU - Chen, Chun-Ling AU - Chen CL AD - Department of Anesthesiology, The First Affiliated Hospital of Xinjiang Medical University, 37 Liyushan South Road, Xinshi District, Urumqi, 830054, Xinjiang, China. FAU - Li, Jin AU - Li J AD - Department of Anesthesiology, The First Affiliated Hospital of Xinjiang Medical University, 37 Liyushan South Road, Xinshi District, Urumqi, 830054, Xinjiang, China. FAU - Ma, Zhi Tong AU - Ma ZT AD - Department of Anesthesiology, The First Affiliated Hospital of Xinjiang Medical University, 37 Liyushan South Road, Xinshi District, Urumqi, 830054, Xinjiang, China. FAU - Jiang, Qiao Qiao AU - Jiang QQ AD - Department of Anesthesiology, The First Affiliated Hospital of Xinjiang Medical University, 37 Liyushan South Road, Xinshi District, Urumqi, 830054, Xinjiang, China. FAU - Liang, Yuan Yuan AU - Liang YY AD - Department of Anesthesiology, The First Affiliated Hospital of Xinjiang Medical University, 37 Liyushan South Road, Xinshi District, Urumqi, 830054, Xinjiang, China. FAU - Li, Shan Shan AU - Li SS AD - Department of Anesthesiology, The First Affiliated Hospital of Xinjiang Medical University, 37 Liyushan South Road, Xinshi District, Urumqi, 830054, Xinjiang, China. FAU - Long, Fei AU - Long F AD - Department of Anesthesiology, The First Affiliated Hospital of Xinjiang Medical University, 37 Liyushan South Road, Xinshi District, Urumqi, 830054, Xinjiang, China. FAU - Zheng, Hong AU - Zheng H AUID- ORCID: 0000-0002-7209-9674 AD - Department of Anesthesiology, The First Affiliated Hospital of Xinjiang Medical University, 37 Liyushan South Road, Xinshi District, Urumqi, 830054, Xinjiang, China. hongzheng4w@gzsbm.cn. LA - eng GR - (No. 31760327)/the China National Natural Science Foundation Regional Science Fund Project/ PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20210119 PL - England TA - BMC Cardiovasc Disord JT - BMC cardiovascular disorders JID - 100968539 SB - IM MH - Adolescent MH - Adult MH - Aged MH - Anemia/etiology/mortality/*therapy MH - Blood Loss, Surgical/mortality/*prevention & control MH - China MH - *Clinical Decision Rules MH - Clinical Decision-Making MH - *Coronary Artery Bypass/adverse effects/mortality MH - Coronary Artery Disease/diagnosis/mortality/*surgery MH - *Erythrocyte Transfusion/adverse effects/mortality MH - Female MH - Humans MH - Male MH - Middle Aged MH - Perioperative Care MH - Postoperative Hemorrhage/etiology/mortality/*therapy MH - Predictive Value of Tests MH - Risk Assessment MH - Risk Factors MH - Time Factors MH - Treatment Outcome MH - Young Adult PMC - PMC7814977 OTO - NOTNLM OT - Cardiac surgery OT - Coronary artery disease OT - Red blood cells OT - Transfusion guidelines OT - Transfusion trigger score COIS- The authors declare that they have no competing interests. EDAT- 2021/01/21 06:00 MHDA- 2021/06/16 06:00 PMCR- 2021/01/19 CRDT- 2021/01/20 05:36 PHST- 2020/09/10 00:00 [received] PHST- 2021/01/05 00:00 [accepted] PHST- 2021/01/20 05:36 [entrez] PHST- 2021/01/21 06:00 [pubmed] PHST- 2021/06/16 06:00 [medline] PHST- 2021/01/19 00:00 [pmc-release] AID - 10.1186/s12872-021-01854-5 [pii] AID - 1854 [pii] AID - 10.1186/s12872-021-01854-5 [doi] PST - epublish SO - BMC Cardiovasc Disord. 2021 Jan 19;21(1):40. doi: 10.1186/s12872-021-01854-5. PMID- 33465135 OWN - NLM STAT- MEDLINE DCOM- 20210610 LR - 20230919 IS - 1932-6203 (Electronic) IS - 1932-6203 (Linking) VI - 16 IP - 1 DP - 2021 TI - Chronic kidney disease and the outcomes of fibrinolysis for ST-segment elevation myocardial infarction: A real-world study. PG - e0245576 LID - 10.1371/journal.pone.0245576 [doi] LID - e0245576 AB - BACKGROUND: In low-resource regions, fibrinolytic therapy is often the only option for ST-elevation myocardial infarction (STEMI) patients as primary percutaneous coronary intervention (PCI) is often not available and patients are hardly transferred to a medical center with PCI capacity within the first 120 minutes. Chronic kidney disease (CKD) is one of the most frequently encountered complications of STEMI. However, the evidence for the efficacy of fibrinolytic therapy in STEMI patients with CKD is still limited. The aim of this study is to test whether CKD modifies the association between fibrinolytic therapy and short-term major adverse cardiovascular events (MACEs) among patients with STEMI. METHODS AND FINDINGS: This is a real-world study analyzing the data from 9508 STEMI patients (mean age: 64.0+/-12.4 years; male: 70.1%) in the third phase of Clinical Pathways in Acute Coronary Syndromes program (CPACS-3), which is a large study of the management of acute coronary syndromes (ACS) in 101 county hospitals without PCI capacity in China. CKD was defined as an estimated glomerular filtration rate of less than 60 mL/min per 1.73 m2 at the admission. The primary outcome is short-term MACEs, including all-cause death, recurrent myocardial infarction, or nonfatal stroke. Patients were recruited consecutively between October 2011 and November 2014. Out of them, 1282 patients (13.5%) were classified as having CKD. Compared with non-CKD patients, CKD patients were less likely to receive fibrinolytic therapy than non-CKD patients (26.4% vs. 38.9%, P<0.001), more likely to experience a failed fibrinolytic therapy (32.8% vs. 16.9%), and had a higher risk of short-term MACEs (19.7% vs. 5.6%). After full adjustment, use of fibrinolytic therapy was associated with a significantly lower risk of short-term MACEs in non-CKD patients (relative risk [RR] = 0.87, 95% confidence interval [CI]: 0.76-0.99), but not in CKD patients (P for interaction = 0.026). Further analysis stratified by the success of fibrinolysis showed that compared with patients who did not receive fibrinolytic therapy, patients with successful fibrinolysis had a lower risk of short-term MACEs that was similar between patients with (RR = 0.71, 95% CI: 0.55-0.82) and without CKD (RR = 0.67, 95% CI: 0.55-0.92), while patients with unsuccessful fibrinolysis had a similarly higher risk in CKD patients (RR = 1.25, 95% CI: 1.09-1.43) and non-CKD patients (RR = 1.30, 95% CI: 1.13-1.50). CONCLUSIONS: CKD reduced the likelihood of successful fibrinolysis and increased the risk of short-term MACEs in patients with STEMI. Attention should be paid to how to improve the success rate of fibrinolytic therapy for STEMI patients with CKD. TRIAL REGISTRATION: The CPACS-3 study was registered on www.clinicaltrials.gov (NCT01398228). FAU - Xie, Wuxiang AU - Xie W AUID- ORCID: 0000-0001-7527-1022 AD - Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China. FAU - Patel, Anushka AU - Patel A AD - The George Institute for Global Health, University of New South Wales, Sydney, Australia. FAU - Boersma, Eric AU - Boersma E AD - Department of Cardiology, Erasmus Medical College, Rotterdam, The Netherlands. FAU - Feng, Lin AU - Feng L AD - Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China. AD - The George Institute for Global Health at Peking University Health Science Center, Beijing, China. FAU - Li, Min AU - Li M AD - Clinical Epidemiology and EBM Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China. FAU - Gao, Runlin AU - Gao R AD - Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Wu, Yangfeng AU - Wu Y AUID- ORCID: 0000-0002-4451-1932 AD - Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China. AD - The George Institute for Global Health at Peking University Health Science Center, Beijing, China. AD - Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China. LA - eng SI - ClinicalTrials.gov/NCT01398228 PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20210119 PL - United States TA - PLoS One JT - PloS one JID - 101285081 SB - IM MH - Aged MH - Female MH - Humans MH - Male MH - Middle Aged MH - Renal Insufficiency, Chronic/*complications MH - ST Elevation Myocardial Infarction/*complications/*therapy MH - *Thrombolytic Therapy MH - Treatment Outcome PMC - PMC7815111 COIS- The authors declare no competing interests. There are no other relevant declarations relating to employment, consultancy, patents, products in development or marketed products etc. to be made by Sanofi, China. This does not alter our adherence to PLOS ONE policies on sharing data and materials. EDAT- 2021/01/20 06:00 MHDA- 2021/06/11 06:00 PMCR- 2021/01/19 CRDT- 2021/01/19 17:12 PHST- 2020/07/07 00:00 [received] PHST- 2021/01/05 00:00 [accepted] PHST- 2021/01/19 17:12 [entrez] PHST- 2021/01/20 06:00 [pubmed] PHST- 2021/06/11 06:00 [medline] PHST- 2021/01/19 00:00 [pmc-release] AID - PONE-D-20-21065 [pii] AID - 10.1371/journal.pone.0245576 [doi] PST - epublish SO - PLoS One. 2021 Jan 19;16(1):e0245576. doi: 10.1371/journal.pone.0245576. eCollection 2021. PMID- 33461308 OWN - NLM STAT- MEDLINE DCOM- 20211223 LR - 20211223 IS - 1524-4539 (Electronic) IS - 0009-7322 (Linking) VI - 143 IP - 12 DP - 2021 Mar 23 TI - Apixaban or Vitamin K Antagonists and Aspirin or Placebo According to Kidney Function in Patients With Atrial Fibrillation After Acute Coronary Syndrome or Percutaneous Coronary Intervention: Insights From the AUGUSTUS Trial. PG - 1215-1223 LID - 10.1161/CIRCULATIONAHA.120.051020 [doi] AB - BACKGROUND: In the AUGUSTUS trial (An Open-Label, 2x2 Factorial, Randomized Controlled, Clinical Trial to Evaluate the Safety of Apixaban Versus Vitamin K Antagonist and Aspirin Versus Aspirin Placebo in Patients With Atrial Fibrillation and Acute Coronary Syndrome or Percutaneous Coronary Intervention), apixaban resulted in less bleeding and fewer hospitalizations than vitamin K antagonists, and aspirin caused more bleeding than placebo in patients with atrial fibrillation and acute coronary syndrome or percutaneous coronary intervention treated with a P2Y(12) inhibitor. We evaluated the risk-benefit balance of antithrombotic therapy according to kidney function. METHODS: In 4456 patients, the CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) formula was used to calculate baseline estimated glomerular filtration rate (eGFR). The effect of apixaban versus vitamin K antagonists and aspirin versus placebo was assessed across kidney function categories by using Cox models. The primary outcome was International Society on Thrombosis and Haemostasis major or clinically relevant nonmajor bleeding. Secondary outcomes included death or hospitalization and ischemic events (death, stroke, myocardial infarction, stent thrombosis [definite or probable], or urgent revascularization). Creatinine clearance <30 mL/min was an exclusion criterion in the AUGUSTUS trial. RESULTS: Overall, 30%, 52%, and 19% had an eGFR of >80, >50 to 80, and 30 to 50 mL.min(-1).1.73 m(-2), respectively. At the 6-month follow-up, a total of 543 primary outcomes of bleeding, 1125 death or hospitalizations, and 282 ischemic events occurred. Compared with vitamin K antagonists, patients assigned apixaban had lower rates for all 3 outcomes across most eGFR categories without significant interaction. The absolute risk reduction with apixaban was most pronounced in those with an eGFR of 30 to 50 mL.min(-1).1.73 m(-2) for bleeding events with rates of 13.1% versus 21.3% (hazard ratio, 0.59; 95% CI, 0.41-0.84). Patients assigned aspirin had a higher risk of bleeding in all eGFR categories with an even greater increase among those with eGFR >80 mL.min(-1).1.73 m(-2): 16.6% versus 5.6% (hazard ratio, 3.22; 95% CI, 2.19-4.74; P for interaction=0.007). The risk of death or hospitalization and ischemic events were comparable to aspirin and placebo across eGFR categories with hazard ratios ranging from 0.97 (95% CI, 0.76-1.23) to 1.28 (95% CI, 1.02-1.59) and from 0.75 (95% CI, 0.48-1.17) to 1.34 (95% CI, 0.81-2.22), respectively. CONCLUSIONS: The safety and efficacy of apixaban was consistent irrespective of kidney function, compared with warfarin, and in accordance with the overall trial results. The risk of bleeding with aspirin was consistently higher across all kidney function categories. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02415400. FAU - Hijazi, Ziad AU - Hijazi Z AD - Department of Medical Sciences, Cardiology and Uppsala Clinical Research Center, Uppsala University, Sweden (Z.H.). FAU - Alexander, John H AU - Alexander JH AD - Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (J.H.A., Z.L., D.M.W., C.B.G., R.D.L.). FAU - Li, Zhuokai AU - Li Z AD - Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (J.H.A., Z.L., D.M.W., C.B.G., R.D.L.). FAU - Wojdyla, Daniel M AU - Wojdyla DM AD - Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (J.H.A., Z.L., D.M.W., C.B.G., R.D.L.). FAU - Mehran, Roxana AU - Mehran R AD - Zena and Michael A. Weiner Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, and Cardiovascular Research Foundation, New York, NY (R.M.). FAU - Granger, Christopher B AU - Granger CB AD - Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (J.H.A., Z.L., D.M.W., C.B.G., R.D.L.). FAU - Parkhomenko, Alexander AU - Parkhomenko A AD - NSC Institute of Cardiology, Kyiv, Ukraine (A.P.). FAU - Bahit, M Cecilia AU - Bahit MC AD - Instituto de Neurologia Cognitiva (INECO) Neurociencias Orono, Fundacion INECO, Rosario, Argentina (M.C.B.). FAU - Windecker, Stephan AU - Windecker S AD - Bern University Hospital, Inselspital, University of Bern, Switzerland (S.W.). FAU - Aronson, Ronald AU - Aronson R AD - Bristol-Myers Squibb, Lawrenceville, NJ (R.A.). FAU - Berwanger, Otavio AU - Berwanger O AD - Hospital Israelita Albert Einstein, Sao Paulo, Brazil (O.B.). FAU - Halvorsen, Sigrun AU - Halvorsen S AD - Oslo University Hospital Ulleval, Norway (S.H.). FAU - de Waha-Thiele, Suzanne AU - de Waha-Thiele S AD - University Heart Centre Lubeck, University Hospital Schleswig-Holstein, Germany (S.dW.-T.). AD - German Center for Cardiovascular Research (DZHK), Lubeck (S.dW.-T.). FAU - Sinnaeve, Peter AU - Sinnaeve P AD - University Hospitals Leuven, University of Leuven, Belgium (P.S.). FAU - Darius, Harald AU - Darius H AD - Vivantes Neukoelln Medical Center, Berlin, Germany (H.D.). FAU - Storey, Robert F AU - Storey RF AD - Department of Infection, Immunity, and Cardiovascular Disease, University of Sheffield, United Kingdom (R.F.S.). FAU - Lopes, Renato D AU - Lopes RD AD - Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (J.H.A., Z.L., D.M.W., C.B.G., R.D.L.). LA - eng SI - ClinicalTrials.gov/NCT02415400 PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20210119 PL - United States TA - Circulation JT - Circulation JID - 0147763 RN - 0 (Anti-Inflammatory Agents, Non-Steroidal) RN - 0 (Factor Xa Inhibitors) RN - 0 (Pyrazoles) RN - 0 (Pyridones) RN - 12001-79-5 (Vitamin K) RN - 3Z9Y7UWC1J (apixaban) RN - R16CO5Y76E (Aspirin) SB - IM MH - Acute Coronary Syndrome/*drug therapy MH - Aged MH - Aged, 80 and over MH - Anti-Inflammatory Agents, Non-Steroidal/pharmacology/*therapeutic use MH - Aspirin/pharmacology/*therapeutic use MH - Atrial Fibrillation/*drug therapy MH - Factor Xa Inhibitors/pharmacology/*therapeutic use MH - Female MH - Humans MH - Kidney/*pathology MH - Male MH - Middle Aged MH - Percutaneous Coronary Intervention/*methods MH - Pyrazoles/pharmacology/*therapeutic use MH - Pyridones/pharmacology/*therapeutic use MH - Vitamin K/*antagonists & inhibitors OTO - NOTNLM OT - acute coronary syndrome OT - anticoagulant OT - atrial fibrillation OT - fibrinolytic agents OT - kidney function tests EDAT- 2021/01/20 06:00 MHDA- 2021/12/24 06:00 CRDT- 2021/01/19 05:35 PHST- 2021/01/20 06:00 [pubmed] PHST- 2021/12/24 06:00 [medline] PHST- 2021/01/19 05:35 [entrez] AID - 10.1161/CIRCULATIONAHA.120.051020 [doi] PST - ppublish SO - Circulation. 2021 Mar 23;143(12):1215-1223. doi: 10.1161/CIRCULATIONAHA.120.051020. Epub 2021 Jan 19. PMID- 33452152 OWN - NLM STAT- MEDLINE DCOM- 20211122 LR - 20211122 IS - 1469-0756 (Electronic) IS - 0032-5473 (Linking) VI - 97 IP - 1147 DP - 2021 May TI - Impact of statin on long-term outcome among patients with end-stage renal disease with acute myocardial infarction (AMI): a nationwide case-control study. PG - 299-305 LID - 10.1136/postgradmedj-2019-137292 [doi] AB - BACKGROUND: Use of statin has been associated with reduced risk of cardiovascular diseases events and mortality. However, in patients with end-stage renal disease (ESRD), the protective effects of statin are controversial. To evaluate the impact of chronic statin use on clinical outcomes of patients with acute myocardial infarction (AMI) with ESRD. METHODS: We enrolled 8056 patients with ESRD who were initially diagnosed and admitted for first AMI from Taiwan's National Health Insurance Research Database. Of which, 2134 patients underwent statin therapy. We randomly selected and use age, sex, hypertension, diabetes mellitus (DM), peripheral vascular diseases (PVD), heart failure (HF), cerebrovascular accidents (CVA), chronic obstructive pulmonary disease, matched with the study group as controls (non-stain user). We compared the effects of statin use in term of all-cause death among patients with AMI with ESRD. RESULTS: Statin use resulted in a significantly higher survival rate in patients ith AMI with ESRD compared with non-statin users. After adjusted the comorbidities the male patients and patients with DM, PVD, HF and CVA had lower long-term survival rate (all p<0.001). Patients who underwent percutaneous coronary intervention (p<0.001), ACE inhibitors/angiotensin II receptor blockers (p<0.001), beta receptor blockers (p<0.001) and statin therapy (p=0.007) had better long-term survival rate. Patients with AMI with ESRD on statin therapy exhibited a significantly lower risk of mortality compared with non-statin users (p<0.0001). CONCLUSION: Among patients with ESRD with AMI, statin therapy was associated with reduced all-cause mortality. CI - (c) Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ. FAU - Kuo, Feng-You AU - Kuo FY AUID- ORCID: 0000-0002-9254-7753 FAU - Huang, Wei-Chun AU - Huang WC AD - Critical Care Center and Cardiovascular Medical Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan. FAU - Tang, Pei-Ling AU - Tang PL AD - Critical Care Center and Cardiovascular Medical Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan. FAU - Cheng, Chin-Chang AU - Cheng CC AD - Critical Care Center and Cardiovascular Medical Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan. FAU - Chiang, Cheng-Hung AU - Chiang CH AD - Critical Care Center and Cardiovascular Medical Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan. FAU - Lin, Hsiao-Chin AU - Lin HC AD - Critical Care Center and Cardiovascular Medical Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan. FAU - Chuang, Tzu-Jung AU - Chuang TJ AD - Critical Care Center and Cardiovascular Medical Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan. FAU - Wann, Shue-Ren AU - Wann SR AD - Critical Care Center and Cardiovascular Medical Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan. FAU - Mar, Guang-Yuan AU - Mar GY AD - Critical Care Center and Cardiovascular Medical Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan. FAU - Liu, Chun-Peng AU - Liu CP AD - Critical Care Center and Cardiovascular Medical Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan mcwu@mail.npust.edu.tw cpliu@vghks.gov.tw. FAU - Cheng, Juei-Tang AU - Cheng JT AD - Department of Food Science, National Pingtung University of Science and Technology, Pingtung, Taiwan. FAU - Wu, Ming-Chang AU - Wu MC AD - Department of Food Science, National Pingtung University of Science and Technology, Pingtung, Taiwan mcwu@mail.npust.edu.tw cpliu@vghks.gov.tw. CN - whole study team LA - eng PT - Journal Article DEP - 20210115 PL - England TA - Postgrad Med J JT - Postgraduate medical journal JID - 0234135 RN - 0 (Cardiovascular Agents) RN - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors) RN - 0 (Protective Agents) SB - IM MH - Cardiovascular Agents/therapeutic use MH - Cardiovascular Diseases/epidemiology/prevention & control MH - Case-Control Studies MH - Cause of Death MH - Comorbidity MH - Female MH - Humans MH - Hydroxymethylglutaryl-CoA Reductase Inhibitors/*therapeutic use MH - *Kidney Failure, Chronic/epidemiology/therapy MH - Male MH - Middle Aged MH - Mortality MH - *Myocardial Infarction/diagnosis/mortality MH - Protective Agents/therapeutic use MH - Sex Factors MH - Survival Rate MH - Taiwan/epidemiology MH - Time OTO - NOTNLM OT - clinical audit OT - nephrology COIS- Competing interests: None declared. EDAT- 2021/01/17 06:00 MHDA- 2021/11/23 06:00 CRDT- 2021/01/16 05:32 PHST- 2019/11/04 00:00 [received] PHST- 2020/03/07 00:00 [revised] PHST- 2020/03/28 00:00 [accepted] PHST- 2021/01/17 06:00 [pubmed] PHST- 2021/11/23 06:00 [medline] PHST- 2021/01/16 05:32 [entrez] AID - postgradmedj-2019-137292 [pii] AID - 10.1136/postgradmedj-2019-137292 [doi] PST - ppublish SO - Postgrad Med J. 2021 May;97(1147):299-305. doi: 10.1136/postgradmedj-2019-137292. Epub 2021 Jan 15. PMID- 33426008 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20210112 IS - 2297-055X (Print) IS - 2297-055X (Electronic) IS - 2297-055X (Linking) VI - 7 DP - 2020 TI - Trimethylamine N-Oxide Was Not Associated With 30-Day Left Ventricular Systolic Dysfunction in Patients With a First Anterior ST-Segment Elevation Myocardial Infarction After Primary Revascularization: A Sub-analysis From an Optical Coherence Tomography Registry. PG - 613684 LID - 10.3389/fcvm.2020.613684 [doi] LID - 613684 AB - Objective: Left ventricular systolic dysfunction (LVSD) after ST-segment elevation myocardial infarction (STEMI) is associated with poor outcome. Trimethylamine N-oxide (TMAO), a gut metabolite, is linked to cardiovascular diseases but its relationship with LVSD after STEMI remains unclear. The present study therefore aimed to investigate the relationship between TMAO and LVSD at 30 days after a first anterior STEMI. Methods: This was a sub-study from the OCTAMI (Optical Coherence Tomography Examination in Acute Myocardial Infarction) registry. Eligible patients were included in current study if they: (1) presented with a first anterior STEMI; (2) had available baseline TMAO concentration; (3) completed a cardiovascular magnetic resonance examination at 30 days after STEMI. LVSD was defined as left ventricular ejection fraction < 50%. Associations between TMAO and left ventricular ejection fraction, infarct size and left ventricular global strain were examined. Results: In total, 78 patients were included in final analysis. Overall, TMAO was moderately associated with peak cTnI (r = 0.27, p = 0.01), age (r = 0.34, p < 0.01), and estimated glomerular filtration rate (r = -0.30, p < 0.01). At 30-day follow-up, 41 patients were in the LVSD group and 37 in the non-LVSD group. Baseline TMAO levels were not significantly different between the two groups (LVSD vs. non-LVSD: median 1.9 muM, 25-75th percentiles 1.5-3.3 muM vs. median 1.9 muM, 25-75th percentiles 1.5-2.7 muM; p = 0.46). Linear regression analyses showed that TMAO was not associated with left ventricular ejection fraction, infarct size or left ventricular global strain at 30 days (all p > 0.05). Conclusions: TMAO was not significantly correlated with 30-day LVSD in patients with a first anterior STEMI after primary revascularization. Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT03593928. CI - Copyright (c) 2020 Zhou, Yu, Tan, Zhou, Liu, Sheng, Li, Chen, Zhao and Yan. FAU - Zhou, Jinying AU - Zhou J AD - Department of Coronary Heart Disease, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Yu, Shiqin AU - Yu S AD - Magnetic Resonance Centre, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Centre for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Tan, Yu AU - Tan Y AD - Department of Coronary Heart Disease, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. AD - Xiamen Cardiovascular Hospital, Xiamen University, Fujian, China. FAU - Zhou, Peng AU - Zhou P AD - Department of Coronary Heart Disease, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Liu, Chen AU - Liu C AD - Department of Coronary Heart Disease, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Sheng, Zhaoxue AU - Sheng Z AD - Department of Coronary Heart Disease, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Li, Jiannan AU - Li J AD - Department of Coronary Heart Disease, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Chen, Runzhen AU - Chen R AD - Department of Coronary Heart Disease, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Zhao, Shihua AU - Zhao S AD - Magnetic Resonance Centre, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Centre for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Yan, Hongbing AU - Yan H AD - Department of Coronary Heart Disease, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. AD - Fuwai Hospital, Chinese Academy of Medical Sciences, Shenzhen, China. LA - eng SI - ClinicalTrials.gov/NCT03593928 PT - Journal Article DEP - 20201223 PL - Switzerland TA - Front Cardiovasc Med JT - Frontiers in cardiovascular medicine JID - 101653388 PMC - PMC7786017 OTO - NOTNLM OT - ST-segment elevation myocardial infarction OT - cardiovascular magnetic resonance OT - gut metabolite OT - left ventricular systolic dysfunction OT - trimethylamine N-oxide COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2021/01/12 06:00 MHDA- 2021/01/12 06:01 PMCR- 2020/01/01 CRDT- 2021/01/11 05:42 PHST- 2020/10/03 00:00 [received] PHST- 2020/11/30 00:00 [accepted] PHST- 2021/01/11 05:42 [entrez] PHST- 2021/01/12 06:00 [pubmed] PHST- 2021/01/12 06:01 [medline] PHST- 2020/01/01 00:00 [pmc-release] AID - 10.3389/fcvm.2020.613684 [doi] PST - epublish SO - Front Cardiovasc Med. 2020 Dec 23;7:613684. doi: 10.3389/fcvm.2020.613684. eCollection 2020. PMID- 33327293 OWN - NLM STAT- MEDLINE DCOM- 20210105 LR - 20240229 IS - 1536-5964 (Electronic) IS - 0025-7974 (Print) IS - 0025-7974 (Linking) VI - 99 IP - 50 DP - 2020 Dec 11 TI - The efficacy and safety of acupuncture for patients with post-percutaneous coronary intervention depression: A protocol for systematic review and meta analysis. PG - e23510 LID - 10.1097/MD.0000000000023510 [doi] LID - e23510 AB - BACKGROUND: Percutaneous coronary intervention (PCI) has been increasingly applied as an effective revascularization strategy in patients with coronary artery disease (CAD). However, recent studies had indicated a higher incidence of depression on post-PCI patients. Acupuncture therapy is effective for depression. However, the treatment effect of depression on post-PCI patients is still not clear. Therefore, this systematic review and meta-analysis protocol is planned to evaluate the efficacy and safety of acupuncture for depression in post-PCI patients. METHODS: Six English databases (PubMed, Web of science, Medline, EMBASE, Springer Cochrane Library and WHO International Clinical Trials Registry Platform) and 4 Chinese databases (Wan fang Database, Chinese Scientific Journal Database, China National Knowledge Infrastructure Database (CNKI) and Chinese Biomedical Literature Database) will be searched normatively according to the rule of each database from the inception to August 1, 2020. Two reviewers will independently conduct article selection, data collection, and risk of bias evaluation. Any disagreement will be resolved by discussion with the third reviewer. Either the fixed-effects or random-effects model will be used for data synthesis based on the heterogeneity test. The change in the scores on the Hamilton depression scale (HAMD) and the Self-rating depression scale (SDS) will be used as the main outcome measure. All-cause mortality, cardiac mortality, Major Adverse Cardiovascular Events (MACEs), rehospitalisation rate and Quality of Life Scale (SF-36) as the secondary outcome. Treatment Emergent Symptom Scale (TESS), General physical examination (temperature, pulse, respiration, blood pressure), Routine examination of blood, urine and stool, Electrocardiogram, Liver and kidney function examination as the security indexs. RevMan5.3.5 will be used for meta-analysis. RESULTS: This study will provide high-quality evidence to assess the efficacy and safety of acupuncture for depression in post-PCI patients. CONCLUSION: This systematic review will explore whether acupuncture is an effective and safe intervention for depression in post-PCI patients. FAU - Liu, Yong AU - Liu Y AD - Department of Cardiology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing. FAU - Dai, Disha AU - Dai D AD - Department of Cardiology, People's Hospital of Wuhan University, Wuhan, Hubei. FAU - Huang, Kailin AU - Huang K AD - Department of Cardiology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing. FAU - Zhuang, Rui AU - Zhuang R AD - Department of Cardiology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China. FAU - Ma, Liyong AU - Ma L AD - Department of Cardiology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing. FAU - Liu, Birong AU - Liu B AD - Department of Cardiology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing. FAU - Pan, Yi AU - Pan Y AD - Department of Cardiology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing. FAU - Zhang, Lijing AU - Zhang L AUID- ORCID: 0000-0002-4717-5348 AD - Department of Cardiology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing. LA - eng PT - Journal Article PL - United States TA - Medicine (Baltimore) JT - Medicine JID - 2985248R SB - IM MH - Humans MH - *Acupuncture Therapy MH - *Depressive Disorder/therapy MH - *Percutaneous Coronary Intervention MH - Postoperative Complications/therapy MH - Systematic Reviews as Topic MH - Meta-Analysis as Topic PMC - PMC7738083 COIS- The authors have no conflicts of interest to disclose. EDAT- 2020/12/18 06:00 MHDA- 2021/01/05 06:00 PMCR- 2020/12/11 CRDT- 2020/12/17 01:02 PHST- 2020/12/17 01:02 [entrez] PHST- 2020/12/18 06:00 [pubmed] PHST- 2021/01/05 06:00 [medline] PHST- 2020/12/11 00:00 [pmc-release] AID - 00005792-202012110-00074 [pii] AID - MD-D-20-10536 [pii] AID - 10.1097/MD.0000000000023510 [doi] PST - ppublish SO - Medicine (Baltimore). 2020 Dec 11;99(50):e23510. doi: 10.1097/MD.0000000000023510. PMID- 33279481 OWN - NLM STAT- MEDLINE DCOM- 20210312 LR - 20210312 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 142 DP - 2021 Mar 1 TI - Role of Ischemic Heart Disease in Major Adverse Renal and Cardiac Events Among Individuals With Heart Failure With Preserved Ejection Fraction (from the TOPCAT Trial). PG - 91-96 LID - S0002-9149(20)31296-0 [pii] LID - 10.1016/j.amjcard.2020.11.034 [doi] AB - Despite improvements in the prognosis of patients with heart failure with reduced ejection fraction (HFrEF), established therapy for heart failure patients with preserved ejection fraction (HFpEF) is lacking. Additionally, ischemic heart disease adversely impacts the clinical course of HFrEF patients; however, its role in HFpEF is not fully understood. We conducted a post hoc analysis of propensity score matched patients from the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist trial to compare HFpEF patients with versus without myocardial ischemia in terms of major adverse renal and/or cardiac events (MARCE). Of 3,445 participants, the prevalence of ischemia was 59%. For this analysis, we included 1,747 ischemic patients and 1,207 propensity matched nonischemic patients. Ischemia was associated with a 20% increased risk (HR = 1.20, 95% confidence interval [CI] = 1.042 to 1.382, p value = 0.0112) of major adverse renal and/or cardiac events (MARCE) in adjusted analyses. Other important predictors of MARCE were diabetes (hazard ratio [HR] = 1.60, 95% CI = 1.38 to 1.87, p <0.0001), dyslipidemia (HR = 1.30, 95% CI = 1.10 to 1.52, p = 0.001) and smoking (HR = 1.33, 95% CI = 1.04 to 1.69, p = 0.0197). Revascularization was not significantly associated with MARCE in the subgroup of ischemic HFpEF patients. Future work is warranted to develop tailored interventions for patients with both HFpEF and ischemic heart disease to mitigate the risk of MARCE . CI - Copyright (c) 2020 Elsevier Inc. All rights reserved. FAU - Rahimi, Gelareh AU - Rahimi G AD - Baylor Heart and Vascular Institute, Dallas, Texas. Electronic address: Gelareh.Rahimighazikalayeh@BSWHealth.org. FAU - Tecson, Kristen M AU - Tecson KM AD - Baylor Heart and Vascular Institute, Dallas, Texas; Texas A&M College of Medicine Health Science Center, Dallas, Texas. FAU - Elsaid, Osama AU - Elsaid O AD - Baylor Heart and Vascular Institute, Dallas, Texas. FAU - McCullough, Peter A AU - McCullough PA AD - Baylor Heart and Vascular Institute, Dallas, Texas; Texas A&M College of Medicine Health Science Center, Dallas, Texas; Baylor University Medical Center, Dallas, Texas; Baylor Heart and Vascular Hospital, Dallas, Texas. LA - eng PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20201203 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 RN - 0 (Mineralocorticoid Receptor Antagonists) RN - 27O7W4T232 (Spironolactone) RN - AYI8EX34EU (Creatinine) SB - IM MH - Aged MH - Cardiovascular Diseases/mortality MH - Case-Control Studies MH - Creatinine/metabolism MH - Diabetes Mellitus/epidemiology MH - Disease Progression MH - Dyslipidemias/epidemiology MH - Female MH - Heart Arrest/*epidemiology MH - Heart Failure/complications/*drug therapy/physiopathology MH - Humans MH - Male MH - Middle Aged MH - Mineralocorticoid Receptor Antagonists/*therapeutic use MH - Mortality MH - Myocardial Infarction/*epidemiology MH - Myocardial Ischemia/*complications MH - Prognosis MH - Proportional Hazards Models MH - Renal Insufficiency/*epidemiology/metabolism MH - Risk Factors MH - Spironolactone/*therapeutic use MH - Stroke/*epidemiology MH - *Stroke Volume EDAT- 2020/12/07 06:00 MHDA- 2021/03/13 06:00 CRDT- 2020/12/06 20:43 PHST- 2020/07/20 00:00 [received] PHST- 2020/11/09 00:00 [revised] PHST- 2020/11/10 00:00 [accepted] PHST- 2020/12/07 06:00 [pubmed] PHST- 2021/03/13 06:00 [medline] PHST- 2020/12/06 20:43 [entrez] AID - S0002-9149(20)31296-0 [pii] AID - 10.1016/j.amjcard.2020.11.034 [doi] PST - ppublish SO - Am J Cardiol. 2021 Mar 1;142:91-96. doi: 10.1016/j.amjcard.2020.11.034. Epub 2020 Dec 3. PMID- 33277301 OWN - NLM STAT- MEDLINE DCOM- 20210820 LR - 20250115 IS - 1935-5548 (Electronic) IS - 0149-5992 (Print) IS - 0149-5992 (Linking) VI - 44 IP - 2 DP - 2021 Feb TI - Patient Health Utility Equations for a Type 2 Diabetes Model. PG - 381-389 LID - 10.2337/dc20-1207 [doi] AB - OBJECTIVE: To estimate the health utility impact of diabetes-related complications in a large, longitudinal U.S. sample of people with type 2 diabetes. RESEARCH DESIGN AND METHODS: We combined Health Utilities Index Mark 3 data on patients with type 2 diabetes from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) and Look AHEAD (Action for Health in Diabetes) trials and their follow-on studies. Complications were classified as events if they occurred in the year preceding the utility measurement; otherwise, they were classified as a history of the complication. We estimated utility decrements associated with complications using a fixed-effects regression model. RESULTS: Our sample included 15,252 persons with an average follow-up of 8.2 years and a total of 128,873 person-visit observations. The largest, statistically significant (P < 0.05) health utility decrements were for stroke (event, -0.109; history, -0.051), amputation (event, -0.092; history, -0.150), congestive heart failure (event, -0.051; history, -0.041), dialysis (event, -0.039), estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m(2) (event, -0.043; history, -0.025), angina (history, -0.028), and myocardial infarction (MI) (event, -0.028). There were smaller effects for laser photocoagulation and eGFR <60 mL/min/1.73 m(2). Decrements for dialysis history, angina event, MI history, revascularization event, revascularization history, laser photocoagulation event, and hypoglycemia were not significant (P >/= 0.05). CONCLUSIONS: With use of a large study sample and a longitudinal design, our estimated health utility scores are expected to be largely unbiased. Estimates can be used to describe the health utility impact of diabetes complications, improve cost-effectiveness models, and inform diabetes policies. CI - (c) 2020 by the American Diabetes Association. FAU - Neuwahl, Simon J AU - Neuwahl SJ AUID- ORCID: 0000-0003-3512-7397 AD - RTI International, Durham, NC sneuwahl@rti.org. FAU - Zhang, Ping AU - Zhang P AUID- ORCID: 0000-0001-8429-6301 AD - Centers for Disease Control and Prevention, Atlanta, GA. FAU - Chen, Haiying AU - Chen H AUID- ORCID: 0000-0002-9712-5963 AD - Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC. FAU - Shao, Hui AU - Shao H AD - Centers for Disease Control and Prevention, Atlanta, GA. AD - Department of Pharmaceutical Outcomes and Policy, University of Florida College of Pharmacy, Gainesville, Florida. FAU - Laxy, Michael AU - Laxy M AUID- ORCID: 0000-0001-8775-7417 AD - Centers for Disease Control and Prevention, Atlanta, GA. AD - Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany. AD - German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany. AD - Institute of Health Economics and Health Care Management, Helmholtz Zentrum Munchen, Neuherberg, Germany. FAU - Anderson, Andrea M AU - Anderson AM AD - Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC. FAU - Craven, Timothy E AU - Craven TE AD - Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC. FAU - Hoerger, Thomas J AU - Hoerger TJ AD - RTI International, Durham, NC. CN - Look AHEAD Research Group LA - eng SI - figshare/10.2337/figshare.13166159 GR - U01 DK057151/DK/NIDDK NIH HHS/United States GR - U01 DK057219/DK/NIDDK NIH HHS/United States GR - U01 DK057154/DK/NIDDK NIH HHS/United States GR - U01 DK057182/DK/NIDDK NIH HHS/United States GR - U01 DK057078/DK/NIDDK NIH HHS/United States GR - U01 DK057131/DK/NIDDK NIH HHS/United States GR - U01 DK057008/DK/NIDDK NIH HHS/United States PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20201204 PL - United States TA - Diabetes Care JT - Diabetes care JID - 7805975 SB - IM MH - *Diabetes Complications MH - *Diabetes Mellitus, Type 2/complications/epidemiology MH - Humans MH - *Hypoglycemia MH - *Myocardial Infarction MH - *Stroke/epidemiology/etiology PMC - PMC7818320 EDAT- 2020/12/06 06:00 MHDA- 2021/08/21 06:00 PMCR- 2022/02/01 CRDT- 2020/12/05 05:26 PHST- 2020/05/20 00:00 [received] PHST- 2020/10/29 00:00 [accepted] PHST- 2020/12/06 06:00 [pubmed] PHST- 2021/08/21 06:00 [medline] PHST- 2020/12/05 05:26 [entrez] PHST- 2022/02/01 00:00 [pmc-release] AID - dc20-1207 [pii] AID - 201207 [pii] AID - 10.2337/dc20-1207 [doi] PST - ppublish SO - Diabetes Care. 2021 Feb;44(2):381-389. doi: 10.2337/dc20-1207. Epub 2020 Dec 4. PMID- 33214022 OWN - NLM STAT- MEDLINE DCOM- 20210830 LR - 20210830 IS - 1532-8171 (Electronic) IS - 0735-6757 (Linking) VI - 46 DP - 2021 Aug TI - Development and verification of a predictive nomogram to evaluate the risk of complicating ventricular tachyarrhythmia after acute myocardial infarction during hospitalization: A retrospective analysis. PG - 462-468 LID - S0735-6757(20)30948-7 [pii] LID - 10.1016/j.ajem.2020.10.052 [doi] AB - PURPOSE: The purpose of this study was to establish a nomogram to predict the risk of complicating ventricular tachyarrhythmia (VTA) in patients with acute myocardial infarction (AMI) during hospitalization and to verify the accuracy of the model. CLINICAL INFORMATION AND METHOD: The authors enrolled the information of 503 patients who were diagnosed as AMI from January 2017 to December 2019. The cohort was randomly divided into a training set and a testing set at a ratio of 70%:30%. A total of 13 clinical indicators were screened by the least absolute shrinkage and selection operator (LASSO) regression and Boruta arithmetic independently in order to figure out the optimal feature variables. Multivariable logistic regression analysis was applied to establish the prediction model represented by a nomogram incorporating the selected feature variables. The performance of the nomogram was assessed by discrimination, calibration and clinical usefulness. C-Statistics with the area under the receiver operating characteristic curve (AUC), calibration curve and decision curve analysis were used to evaluate the identification ability, calibration and clinical practicability respectively. The prediction model was verified on the testing set to ensure its accuracy. RESULTS: Five feature variables as percutaneous coronary intervention (PCI) timing after hospitalization, ejection fraction (EF), high-sensitive troponin T (hsTnT) score, infection and estimated glomerular filtration rate (eGFR) were selected by both LASSO regression and Boruta arithmetic. C-statistics with AUC was 0.764 (95% confidence interval: 0.690-0.838) in the training set while a slight increasing to 0.804 (95% confidence interval: 0.673-0.935) in the testing set. Calibration curve illustrated that the predicted and actually diagnosis of VTA probabilities were satisfactory on both training set and testing validation. Decision curve analysis indicated that the nomogram can be used in clinical settings as it has a threshold of between 4% to 90% along with a net benefit. CONCLUSION: The nomogram with five variables is practical to clinicians in estimating the risk of complicating VTA after AMI during hospitalization. CI - Copyright (c) 2020 Elsevier Inc. All rights reserved. FAU - Zheng, Xifeng AU - Zheng X AD - Guangxi Medical University, People's Republic of China; Affiliated Hospital of Guangdong Medical University, People's Republic of China. FAU - Huang, Ruina AU - Huang R AD - Affiliated Hospital of Guangdong Medical University, People's Republic of China. FAU - Liu, Guangyan AU - Liu G AD - Affiliated Hospital of Guangdong Medical University, People's Republic of China. FAU - Jia, Zhen AU - Jia Z AD - Affiliated Hospital of Guangdong Medical University, People's Republic of China. FAU - Chen, Kai AU - Chen K AD - Affiliated Hospital of Guangdong Medical University, People's Republic of China. FAU - He, Yan AU - He Y AD - The First Affiliated Hospital of Guangxi Medical University, People's Republic of China. Electronic address: hygxmu@163.com. LA - eng PT - Journal Article DEP - 20201027 PL - United States TA - Am J Emerg Med JT - The American journal of emergency medicine JID - 8309942 RN - 0 (Peptide Fragments) RN - 0 (Troponin T) RN - 0 (pro-brain natriuretic peptide (1-76)) RN - 114471-18-0 (Natriuretic Peptide, Brain) SB - IM MH - Aged MH - Diabetes Mellitus/epidemiology MH - Female MH - Glomerular Filtration Rate MH - Humans MH - Hypertension/epidemiology MH - Hypokalemia/epidemiology MH - Infections/epidemiology MH - Logistic Models MH - Male MH - Middle Aged MH - Multivariate Analysis MH - Myocardial Infarction/blood/physiopathology/*therapy MH - Natriuretic Peptide, Brain/blood MH - *Nomograms MH - Peptide Fragments/blood MH - Percutaneous Coronary Intervention MH - Reproducibility of Results MH - Retrospective Studies MH - *Risk Assessment MH - Stroke Volume MH - Tachycardia, Ventricular/*epidemiology MH - Troponin T/blood MH - Ventricular Fibrillation/*epidemiology OTO - NOTNLM OT - Acute myocardial infarction OT - Nomogram OT - Ventricular tachyarrhythmia COIS- Declaration of Competing Interest The authors declared that they have no conflicts of interests to this work. We declare that we do not have any commercial or associative interests that represents a conflict of interests in connection with the work submitted. EDAT- 2020/11/21 06:00 MHDA- 2021/08/31 06:00 CRDT- 2020/11/20 05:35 PHST- 2020/07/22 00:00 [received] PHST- 2020/10/07 00:00 [revised] PHST- 2020/10/25 00:00 [accepted] PHST- 2020/11/21 06:00 [pubmed] PHST- 2021/08/31 06:00 [medline] PHST- 2020/11/20 05:35 [entrez] AID - S0735-6757(20)30948-7 [pii] AID - 10.1016/j.ajem.2020.10.052 [doi] PST - ppublish SO - Am J Emerg Med. 2021 Aug;46:462-468. doi: 10.1016/j.ajem.2020.10.052. Epub 2020 Oct 27. PMID- 33195457 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240802 IS - 2297-055X (Print) IS - 2297-055X (Electronic) IS - 2297-055X (Linking) VI - 7 DP - 2020 TI - Sex Differences and Long-Term Outcome in Patients With Pacemakers. PG - 569060 LID - 10.3389/fcvm.2020.569060 [doi] LID - 569060 AB - Introduction: Evidence of sex-related differences in patients with pacemakers regarding comorbidities is insufficiently investigated. The aim of this study was to determine the relationship of cardiovascular comorbidities and sex category with properties of pacemaker implantation, pacemaker follow-up, and long-term survival. Methods: This retrospective, single-center cohort study consisted of 6,362 pacemaker-patients (39.7% female) enrolled between May 2000 and April 2015. Functional pacemaker parameters were registered at regular pacemaker controls. Survival status and cause of death were analyzed in relation to comorbidities, implanted pacing devices, and echocardiography. Survival analyses were plotted for a 10-year follow-up. Results: Patients with hypertension or hyperlipidemia had higher rates of implantations due to sick sinus syndrome (28.6 vs. 25.5% without hypertension, P < 0.001; 30.7 vs. 25.7% without hyperlipidemia, P < 0.001), while endocarditis was associated with higher rates of implantations due to AV block (46.7 vs. 33.4%, P < 0.001). Patients with valvular heart disease had higher rates of pacemaker implantation due to bradycardic atrial fibrillation (24.9 vs. 21.0% without valvular heart disease, P < 0.001). Ventricular pacing threshold increased in both sexes during the follow-up and was higher in women in the final follow-up (0.94 vs. 0.91 V in men, P = 0.002). During the 10-years follow-up, 6.1% of women and 8.6% of men underwent lead replacement (P = 0.054). Device and lead replacement rates were increased if the comorbidities coronary artery disease, heart failure, hypertension, hyperlipidemia, valvular heart disease, previous stroke/TIA, atrial arrhythmias, chronic kidney disease, or endocarditis were present. Diabetes and previous CABG increase the rates of device replacement, but not the rate of lead replacement. Severe tricuspid regurgitation after implantation of pacemaker was present in more men than women (14.4 vs. 6.1%, P < 0.001). In a multivariate COX regression, the following variables were associated with independent decrease of 10-year survival: hypertension (HR 1.34, 95% CI 1.09-1.64), chronic kidney disease (HR 1.83, 95% CI 1.53-2.19), tricuspid regurgitation after pacemaker implantation (HR 1.48, 95% CI 1.26-1.74). Survival was independently increased in female sex (HR 0.83, 95% CI 0.70-0.99) and hyperlipidemia (HR 0.81, 95% CI 0.67-0.97). Conclusions: Cardiovascular comorbidities influenced significantly pacemaker implantations and long-term outcome. Trial Registration: ClinicalTrials.gov Unique identifier: NCT03388281. CI - Copyright (c) 2020 Riesenhuber, Spannbauer, Rauscha, Schmidinger, Boszotta, Pezawas, Schukro, Gwechenberger, Stix, Anvari, Wrba, Khazen, Andreas, Laufer, Hengstenberg and Gyongyosi. FAU - Riesenhuber, Martin AU - Riesenhuber M AD - Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria. FAU - Spannbauer, Andreas AU - Spannbauer A AD - Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria. FAU - Rauscha, Friedrich AU - Rauscha F AD - Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria. FAU - Schmidinger, Herwig AU - Schmidinger H AD - Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria. FAU - Boszotta, Adelinde AU - Boszotta A AD - Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria. FAU - Pezawas, Thomas AU - Pezawas T AD - Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria. FAU - Schukro, Christoph AU - Schukro C AD - Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria. FAU - Gwechenberger, Marianne AU - Gwechenberger M AD - Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria. FAU - Stix, Gunter AU - Stix G AD - Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria. FAU - Anvari, Anahit AU - Anvari A AD - Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria. FAU - Wrba, Thomas AU - Wrba T AD - IT Systems and Communications, Medical University of Vienna, Vienna, Austria. FAU - Khazen, Cesar AU - Khazen C AD - Division of Cardiac Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria. FAU - Andreas, Martin AU - Andreas M AD - Division of Cardiac Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria. FAU - Laufer, Gunther AU - Laufer G AD - Division of Cardiac Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria. FAU - Hengstenberg, Christian AU - Hengstenberg C AD - Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria. FAU - Gyongyosi, Mariann AU - Gyongyosi M AD - Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria. LA - eng SI - ClinicalTrials.gov/NCT03388281 PT - Journal Article DEP - 20200922 PL - Switzerland TA - Front Cardiovasc Med JT - Frontiers in cardiovascular medicine JID - 101653388 PMC - PMC7536343 OTO - NOTNLM OT - brady arrhythmia OT - comorbidities OT - outcome OT - pacemaker (PM) OT - survival EDAT- 2020/11/17 06:00 MHDA- 2020/11/17 06:01 PMCR- 2020/01/01 CRDT- 2020/11/16 08:54 PHST- 2020/07/13 00:00 [received] PHST- 2020/08/24 00:00 [accepted] PHST- 2020/11/16 08:54 [entrez] PHST- 2020/11/17 06:00 [pubmed] PHST- 2020/11/17 06:01 [medline] PHST- 2020/01/01 00:00 [pmc-release] AID - 10.3389/fcvm.2020.569060 [doi] PST - epublish SO - Front Cardiovasc Med. 2020 Sep 22;7:569060. doi: 10.3389/fcvm.2020.569060. eCollection 2020. PMID- 33125004 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20220417 IS - 2048-8505 (Print) IS - 2048-8513 (Electronic) IS - 2048-8505 (Linking) VI - 13 IP - 5 DP - 2020 Oct TI - Clinical outcomes of prolonged dual antiplatelet therapy after coronary drug-eluting stent implantation in dialysis patients. PG - 803-812 LID - 10.1093/ckj/sfaa037 [doi] AB - BACKGROUND: End-stage renal disease yields susceptibility to both ischemia and bleeding. The optimal duration of dual antiplatelet therapy (DAPT) after drug-eluting stent (DES) implantation is not established in dialysis patients, who are usually excluded from randomized studies. Since recent studies implied the benefits of prolonged DAPT >12 months in chronic kidney disease, we investigated the effectiveness and safety of prolonged DAPT in dialysis patients with higher cardiovascular risks. METHODS: In this nationwide population-based study, we analyzed dialysis patients who underwent DES implantation from 2008 to 2015. Continued DAPT was compared with discontinued DAPT using landmark analyses, including free-of-event participants at 12 (n = 2246), 15 (n = 1925) and 18 months (n = 1692) after DES implantation. The primary outcome was major adverse cardiovascular events (MACEs): a composite of mortality, nonfatal myocardial infarction, coronary revascularization and stroke. Major bleeding was a safety outcome. Inverse probability of treatment weighting Cox regression was performed. RESULTS: Mean follow-up periods were 278.3-292.4 days, depending on landmarks. Overall, incidences of major bleeding were far lower than those of MACE. Continued DAPT groups showed lower incidences of MACE and higher incidences of major bleeding, compared with discontinued DAPT groups. In Cox analyses, continued DAPT reduced the hazards of MACE at the 12- [hazard ratio (HR) = 0.74, 95% confidence interval (CI) 0.61-0.90; P = 0.003], 15- (HR = 0.78, 95% CI 0.64-0.96; P = 0.019) and 18-month landmarks (HR = 0.79, 95% CI 0.63-0.99; P = 0.041), but without a significant increase in major bleeding at 12 (HR = 1.39, 95% CI 0.90-2.16; P = 0.14), 15 (HR = 1.13, 95% CI 0.75-1.70; P = 0.55) or 18 months (HR = 1.27, 95% CI 0.83-1.95; P = 0.27). CONCLUSIONS: Prolonged DAPT reduced MACE without significantly increasing major bleeding in patients who were event-free at 12 months after DES implantation. In deciding on DAPT duration, prolonged DAPT should be considered in dialysis patients. CI - (c) The Author(s) 2020. Published by Oxford University Press on behalf of ERA-EDTA. FAU - Park, Seokwoo AU - Park S AD - Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. AD - Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea. AD - Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea. FAU - Kim, Yaerim AU - Kim Y AD - Division of Nephrology, Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea. FAU - Jo, Hyung Ah AU - Jo HA AD - Department of Internal Medicine, Inje University Ilsan Paik Hospital, Ilsan, Korea. FAU - Lee, Soojin AU - Lee S AD - Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. AD - Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea. FAU - Kim, Mi-Sook AU - Kim MS AD - Division of Clinical Epidemiology, Medical Research Collaborating Center, Biomedical Research Institution, Seoul National University Hospital, Seoul, Korea. FAU - Yang, Bo Ram AU - Yang BR AD - Division of Clinical Epidemiology, Medical Research Collaborating Center, Biomedical Research Institution, Seoul National University Hospital, Seoul, Korea. FAU - Lee, Joongyub AU - Lee J AD - Department of Prevention and Management, Inha University Hospital, Incheon, Korea. FAU - Han, Seung Seok AU - Han SS AUID- ORCID: 0000-0003-0137-5261 AD - Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. AD - Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea. FAU - Lee, Hajeong AU - Lee H AD - Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. AD - Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea. FAU - Lee, Jung Pyo AU - Lee JP AD - Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. AD - Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Korea. FAU - Joo, Kwon Wook AU - Joo KW AD - Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. AD - Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea. FAU - Lim, Chun Soo AU - Lim CS AD - Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. AD - Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Korea. FAU - Kim, Yon Su AU - Kim YS AD - Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. AD - Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea. AD - Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea. FAU - Kim, Dong Ki AU - Kim DK AD - Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. AD - Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea. LA - eng PT - Journal Article DEP - 20200503 PL - England TA - Clin Kidney J JT - Clinical kidney journal JID - 101579321 CIN - doi: 10.1093/ckj/sfaa040 PMC - PMC7577762 OTO - NOTNLM OT - cardiovascular OT - chronic hemodialysis OT - coronary artery disease OT - dialysis OT - myocardial infarction OT - peritoneal dialysis OT - stroke EDAT- 2020/10/31 06:00 MHDA- 2020/10/31 06:01 PMCR- 2020/05/03 CRDT- 2020/10/30 12:09 PHST- 2019/07/24 00:00 [received] PHST- 2020/02/25 00:00 [accepted] PHST- 2020/10/30 12:09 [entrez] PHST- 2020/10/31 06:00 [pubmed] PHST- 2020/10/31 06:01 [medline] PHST- 2020/05/03 00:00 [pmc-release] AID - sfaa037 [pii] AID - 10.1093/ckj/sfaa037 [doi] PST - epublish SO - Clin Kidney J. 2020 May 3;13(5):803-812. doi: 10.1093/ckj/sfaa037. eCollection 2020 Oct. PMID- 33100632 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20211102 IS - 0970-9134 (Print) IS - 0973-7723 (Electronic) IS - 0970-9134 (Linking) VI - 36 IP - 6 DP - 2020 Nov TI - International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) trial and the appropriateness of revascularization. PG - 664-667 LID - 10.1007/s12055-020-00961-w [doi] AB - The recently published ISCHEMIA trial which is a prospective randomized multi-centre trial has concluded that there was no evidence that an initial invasive strategy of revascularisation in patients with stable angina reduced the risk of ischaemic cardiovascular events or death from any cause. The trial has confirmed that patients with stable angina do not greatly benefit from revascularisation and optimal medical treatment (OMT) is an acceptable alternative. The trial has also confirmed that in patients with stable angina and end-stage renal impairment, OMT is once again an equally effective initial strategy. While the ISCHEMIA trial is one of the most rigorously and meticulously conducted trial, exclusion of symptomatic patients, recruitment of patients who are not known to derive significant benefit from revascularisation and those who were at low risk of clinical events, along with a short follow-up period, may all have contributed to the lack of difference seen between the groups. The fact that the ISCHEMIA trial does not represent the entire cohort of real-life patients requiring revascularisation should be borne in mind, and care should be taken in extrapolating these results to the wider group of patients requiring revascularisation for coronary artery disease. CI - (c) Indian Association of Cardiovascular-Thoracic Surgeons 2020. FAU - Narayan, Pradeep AU - Narayan P AUID- ORCID: 0000-0002-3843-1338 AD - Department of Cardiac Surgery, NH Rabindranath Tagore International Institute of Cardiac Sciences, 124, EM Bypass, Mukundapur, Kolkata, 700099 India. GRID: grid.496646.f. ISNI: 0000 0004 1806 0407 LA - eng PT - Journal Article DEP - 20200701 PL - India TA - Indian J Thorac Cardiovasc Surg JT - Indian journal of thoracic and cardiovascular surgery JID - 8700105 PMC - PMC7572914 OTO - NOTNLM OT - CABG OT - ISCHEMIA OT - Stable angina OT - Stable coronary artery disease OT - Stable ischaemic heart disease COIS- Conflict of interestNone. EDAT- 2020/10/27 06:00 MHDA- 2020/10/27 06:01 PMCR- 2021/11/01 CRDT- 2020/10/26 05:19 PHST- 2020/04/22 00:00 [received] PHST- 2020/04/30 00:00 [revised] PHST- 2020/05/08 00:00 [accepted] PHST- 2020/10/26 05:19 [entrez] PHST- 2020/10/27 06:00 [pubmed] PHST- 2020/10/27 06:01 [medline] PHST- 2021/11/01 00:00 [pmc-release] AID - 961 [pii] AID - 10.1007/s12055-020-00961-w [doi] PST - ppublish SO - Indian J Thorac Cardiovasc Surg. 2020 Nov;36(6):664-667. doi: 10.1007/s12055-020-00961-w. Epub 2020 Jul 1. PMID- 33066794 OWN - NLM STAT- MEDLINE DCOM- 20210607 LR - 20210607 IS - 1475-2840 (Electronic) IS - 1475-2840 (Linking) VI - 19 IP - 1 DP - 2020 Oct 16 TI - Ticagrelor monotherapy in patients with concomitant diabetes mellitus and chronic kidney disease: a post hoc analysis of the GLOBAL LEADERS trial. PG - 179 LID - 10.1186/s12933-020-01153-x [doi] LID - 179 AB - BACKGROUND: Patients with both diabetes mellitus (DM) and chronic kidney disease (CKD) are a subpopulation characterized by ultrahigh ischemic and bleeding risk after percutaneous coronary intervention. There are limited data on the impact of ticagrelor monotherapy among these patients. METHODS: In this post hoc analysis of the GLOBAL-LEADERS trial, the treatment effects of the experimental (one-month dual-antiplatelet therapy [DAPT] followed by 23-month ticagrelor monotherapy) versus the reference regimen (12-month DAPT followed by 12-month aspirin alone) were analyzed according to DM/CKD status. The primary endpoint was a composite endpoint of all-cause death or new Q-wave myocardial infarction at 2-years. The patient-oriented composite endpoint (POCE) was defined as the composite of all-cause death, any stroke, site-reported MI and any revascularization, whereas net adverse clinical events (NACE) combined POCE with BARC type 3 or 5 bleeding events. RESULTS: At 2 years, the DM + /CKD + patients had significantly higher incidences of the primary endpoint (9.5% versus 3.1%, adjusted HR 2.16; 95% CI [1.66-2.80], p < 0.001), BARC type 3 or 5 bleeding events, stroke, site-reported myocardial infraction, all revascularization, POCE, and NACE, compared with the DM-/CKD- patients. Among the DM + /CKD + patients, after adjustment, there were no significant differences in the primary endpoints between the experimental and reference regimen; however, the experimental regimen was associated with lower rates of POCE (20.6% versus 25.9%, HR 0.74; 95% CI [0.55-0.99], p = 0.043, p(interaction) = 0.155) and NACE (22.7% versus 28.3%, HR 0.75; 95% CI [0.56-0.99], p = 0.044, p(interaction) = 0.310), which was mainly driven by a lower rate of all revascularization, as compared with the reference regimen. The landmark analysis showed that while the experimental and reference regimen had similar rates of all the clinical endpoints during the first year, the experimental regimen was associated with significantly lower rates of POCE (5.8% versus 11.0%, HR 0.49; 95% CI [0.29-0.82], p = 0.007, p(interaction) = 0.040) and NACE (5.8% versus 11.2%, HR 0.48; 95% CI [0.29-0.82], p = 0.007, p(interaction) = 0.013) in the second year. CONCLUSION: Among patients with both DM and CKD, ticagrelor monotherapy was not associated with lower rates of all-cause death or new Q-wave, or major bleeding complications; however, it was associated with lower rates of POCE and NACE. These findings should be interpreted as hypothesis-generating. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov (NCT01813435). FAU - Gao, Chao AU - Gao C AD - Department of Cardiology, Xijing hospital, Xi'an, China. AD - Department of Cardiology, Radboud University, Nijmegen, The Netherlands. AD - Department of Cardiology, National University of Ireland Galway, Galway, Ireland. FAU - Tomaniak, Mariusz AU - Tomaniak M AD - First Department of Cardiology, Medical University of Warsaw, Warsaw, Poland. AD - Erasmus Medical Center, Erasmus University, Rotterdam, The Netherlands. FAU - Takahashi, Kuniaki AU - Takahashi K AD - Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. FAU - Kawashima, Hideyuki AU - Kawashima H AD - Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. AD - Department of Cardiology, National University of Ireland Galway, Galway, Ireland. FAU - Wang, Rutao AU - Wang R AD - Department of Cardiology, Xijing hospital, Xi'an, China. AD - Department of Cardiology, Radboud University, Nijmegen, The Netherlands. AD - Department of Cardiology, National University of Ireland Galway, Galway, Ireland. FAU - Hara, Hironori AU - Hara H AD - Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. AD - Department of Cardiology, National University of Ireland Galway, Galway, Ireland. FAU - Ono, Masafumi AU - Ono M AD - Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. AD - Department of Cardiology, National University of Ireland Galway, Galway, Ireland. FAU - Montalescot, Gilles AU - Montalescot G AD - Sorbonne University, ACTION Study Group, Institute of Cardiology, Pitie-Salpetriere Hospital, Paris, France. FAU - Garg, Scot AU - Garg S AD - Department of Cardiology, Royal Blackburn Hospital, Blackburn, UK. FAU - Haude, Michael AU - Haude M AD - Department of Cardiology, Rheinland Klinikum Neuss, Lukaskrankenhaus, Neuss, Germany. FAU - Slagboom, Ton AU - Slagboom T AD - OLVG, Amsterdam, Netherlands. FAU - Vranckx, Pascal AU - Vranckx P AD - Department of Cardiology and Critical Care Medicine, Hartcentrum Hasselt, Jessa Ziekenhuis, Hasselt, Belgium. FAU - Valgimigli, Marco AU - Valgimigli M AD - Department of Cardiology, Bern University Hospital, Bern, Switzerland. FAU - Windecker, Stephan AU - Windecker S AD - Department of Cardiology, Bern University Hospital, Bern, Switzerland. FAU - van Geuns, Robert-Jan AU - van Geuns RJ AD - Department of Cardiology, Radboud University, Nijmegen, The Netherlands. FAU - Hamm, Christian AU - Hamm C AD - Kerckhoff Heart Center, Bad Nauheim, Germany. FAU - Steg, Philippe Gabriel AU - Steg PG AD - FACT, French Alliance for Cardiovascular Trials, Paris, France. AD - Hopital Bichat, AP-HP, Paris, France. FAU - Onuma, Yoshinobu AU - Onuma Y AD - Department of Cardiology, National University of Ireland Galway, Galway, Ireland. FAU - Angiolillo, Dominick J AU - Angiolillo DJ AD - Division of Cardiology, University of Florida College of Medicine, Jacksonville, FL, USA. FAU - Serruys, Patrick W AU - Serruys PW AUID- ORCID: 0000-0002-0390-8060 AD - Department of Cardiology, National University of Ireland Galway, Galway, Ireland. patrick.w.j.c.serruys@gmail.com. AD - NHLI, Imperial College London, London, UK. patrick.w.j.c.serruys@gmail.com. AD - Interventional Medicine and Innovation, National University of Ireland Galway, P.O. University Road, Galway, H91 TK33, Ireland. patrick.w.j.c.serruys@gmail.com. LA - eng SI - ClinicalTrials.gov/NCT01813435 PT - Journal Article PT - Multicenter Study PT - Observational Study PT - Research Support, Non-U.S. Gov't DEP - 20201016 PL - England TA - Cardiovasc Diabetol JT - Cardiovascular diabetology JID - 101147637 RN - 0 (Platelet Aggregation Inhibitors) RN - GLH0314RVC (Ticagrelor) SB - IM MH - Aged MH - Aged, 80 and over MH - Asia MH - Australia MH - Brazil MH - Canada MH - Coronary Artery Disease/diagnosis/mortality/*therapy MH - *Diabetes Mellitus/diagnosis/mortality MH - Drug-Eluting Stents MH - Europe MH - Female MH - Hemorrhage/chemically induced/mortality MH - Humans MH - Incidence MH - Male MH - Middle Aged MH - Myocardial Infarction/diagnosis/mortality/*therapy MH - *Percutaneous Coronary Intervention/adverse effects/instrumentation/mortality MH - Platelet Aggregation Inhibitors/adverse effects/*therapeutic use MH - Prevalence MH - Randomized Controlled Trials as Topic MH - Recurrence MH - *Renal Insufficiency, Chronic/diagnosis/mortality MH - Risk Assessment MH - Risk Factors MH - Secondary Prevention MH - Stroke/mortality/prevention & control MH - Ticagrelor/adverse effects/*therapeutic use MH - Time Factors MH - Treatment Outcome PMC - PMC7568378 OTO - NOTNLM OT - Aspirin-free antiplatelet strategies OT - Chronic kidney disease OT - DAPT OT - Diabetes mellitus OT - Percutaneous coronary intervention OT - Ticagrelor COIS- Dr. Steg received grants and personal fees from Bayer/Janssen, grants and personal fees from Merck, grants and personal fees from Sanofi, grants and personal fees from Amarin, personal fees from Amgen, personal fees from Bristol Myers Squibb, personal fees from Boehringer-Ingelheim, personal fees from Pfizer, personal fees from Novartis, personal fees from Regeneron, personal fees from Lilly, personal fees from AstraZeneca, grants, personal fees and non-financial support from Servier, outside the submitted work. Dr. Hamm received advisory Board fees from AstraZeneca. Dr. van Geuns received speakers fee from Abbott Vascular and Boston Scientific. Dr. Onuma reports being a member of advisory board of Abbott vascular. Dr. Serruys reports personal fees from Biosensors, personal fees from Cardialysis, personal fees from Medtronic, personal fees from Micel Technologies, personal fees from Sinomedical Sciences Technology, personal fees from Philips/Volcano, personal fees from Xeltis, personal fees from HeartFlow, outside the submitted work. Dr. Angiolillo has received payment as an individual for: reports receiving payments as an individual for: a) Consulting fee or honorarium from Amgen, Aralez, AstraZeneca, Bayer, Biosensors, Boehringer Ingelheim, Bristol-Myers Squibb, Chiesi, Daiichi-Sankyo, Eli Lilly, Haemonetics, Janssen, Merck, PhaseBio, PLx Pharma, Pfizer, Sanofi, and The Medicines Company; b) Participation in review activities from CeloNova and St. Jude Medical. Institutional payments for grants from Amgen, AstraZeneca, Bayer, Biosensors, CeloNova, CSL Behring, Daiichi-Sankyo, Eisai, Eli-Lilly, Gilead, Idorsia, Janssen, Matsutani Chemical Industry Co., Merck, Novartis, Osprey Medical, and Renal Guard Solutions. EDAT- 2020/10/18 06:00 MHDA- 2021/06/08 06:00 PMCR- 2020/10/16 CRDT- 2020/10/17 05:19 PHST- 2020/07/05 00:00 [received] PHST- 2020/10/05 00:00 [accepted] PHST- 2020/10/17 05:19 [entrez] PHST- 2020/10/18 06:00 [pubmed] PHST- 2021/06/08 06:00 [medline] PHST- 2020/10/16 00:00 [pmc-release] AID - 10.1186/s12933-020-01153-x [pii] AID - 1153 [pii] AID - 10.1186/s12933-020-01153-x [doi] PST - epublish SO - Cardiovasc Diabetol. 2020 Oct 16;19(1):179. doi: 10.1186/s12933-020-01153-x. PMID- 33060531 OWN - NLM STAT- MEDLINE DCOM- 20220114 LR - 20220114 IS - 1473-5830 (Electronic) IS - 0954-6928 (Linking) VI - 32 IP - 5 DP - 2021 Aug 1 TI - Avoiding the emergence of contrast-induced acute kidney injury in acute coronary syndrome: routine hydration treatment. PG - 397-402 LID - 10.1097/MCA.0000000000000966 [doi] AB - BACKGROUND: Patients with acute coronary syndrome (ACS) have about a three-fold risk for developing contrast-induced acute kidney injury(CI-AKI). Investigating studies on routine hydration therapy have frequently included patients with stable coronary artery disease and high risk of CI-AKI [estimated glomerular filtration rate (eGFR) < 60 ml/min]. However, data on routine hydration treatment in non-ST segment elevation myocardial infarction (NSTEMI) patients with eGFR >/=60 ml/min are insufficient. We aimed to investigate the association between routine hydration therapy and CI-AKI development in NSTEMI patients at low risk for nephropathy. METHODS AND RESULTS: We randomly assigned a total of 401 NSTEMI patients to two groups: the routine hydration group (198 patients) and the nonhydration group (control group) (203 patients). Intravenous hydration with isotonic saline (1 ml/kg/h, 0.9% sodium chloride) was given for 3-12 h before and 24 h after contrast exposure to the hydration group. CI-AKI was defined as the increase in serum creatinine values 0.5 mg/dl or 25% between 48 and 72 h after the invasive procedures. In our study, the incidence of CI-AKI development in the routine hydration group (7.1%) was significantly lower than in the nonhydration group (14.1%) (P: 0.02). This study revealed that older age, amount of contrast media, and routine hydration were independent risk factors for developing CI-AKI (P < 0.01, P: 0.04, P < 0.01, respectively). CONCLUSION: We found that preprocedural and postprocedural intravenous hydration therapy reduces the development of CI-AKI in patients with NSTEMI at low risk for CI-AKI. We suggest administering routine hydration therapy in all ACS patients regardless of eGFR values. CI - Copyright (c) 2020 Wolters Kluwer Health, Inc. All rights reserved. FAU - Arslan, Sukru AU - Arslan S AD - Department of Cardiology, Cardiology Institute of Istanbul University-Cerrahpasa, Istanbul. FAU - Yildiz, Ahmet AU - Yildiz A AD - Department of Cardiology, Cardiology Institute of Istanbul University-Cerrahpasa, Istanbul. FAU - Dalgic, Yalcin AU - Dalgic Y AD - Department of Cardiology, Health Sciences University Derince Training and Research Hospital, Kocaeli. FAU - Batit, Servet AU - Batit S AD - Department of Cardiology, Kilis State Hospital, Kilis. FAU - Kilicarslan, Onur AU - Kilicarslan O AD - Department of Cardiology, Hakkari Yuksekova State Hospital, Hakkari. FAU - Ser, Ozgur Selim AU - Ser OS AD - Department of Cardiology, Health Sciences University Sisli Hamidiye Etfal Training and Research Hospital. FAU - Dalgic, Sadiye Nur AU - Dalgic SN AD - Department of Cardiology, Istanbul, Izmit Seka State Hospital, Kocaeli, Turkey. FAU - Kocas, Cuneyt AU - Kocas C AD - Department of Cardiology, Cardiology Institute of Istanbul University-Cerrahpasa, Istanbul. FAU - Abaci, Okay AU - Abaci O AD - Department of Cardiology, Cardiology Institute of Istanbul University-Cerrahpasa, Istanbul. LA - eng PT - Journal Article PT - Randomized Controlled Trial PL - England TA - Coron Artery Dis JT - Coronary artery disease JID - 9011445 RN - 0 (Contrast Media) RN - AYI8EX34EU (Creatinine) SB - IM MH - *Acute Kidney Injury/blood/chemically induced/diagnosis/prevention & control MH - Aged MH - Contrast Media/*adverse effects MH - Coronary Angiography/adverse effects/methods MH - Creatinine/blood MH - Female MH - Fluid Therapy/*methods MH - Glomerular Filtration Rate MH - Humans MH - Incidence MH - Male MH - Percutaneous Coronary Intervention/adverse effects/methods MH - *Postoperative Complications/blood/chemically induced/diagnosis/prevention & control MH - Risk Adjustment/*methods MH - Risk Factors MH - Treatment Outcome EDAT- 2020/10/17 06:00 MHDA- 2022/01/15 06:00 CRDT- 2020/10/16 05:41 PHST- 2020/10/17 06:00 [pubmed] PHST- 2022/01/15 06:00 [medline] PHST- 2020/10/16 05:41 [entrez] AID - 00019501-202108000-00007 [pii] AID - 10.1097/MCA.0000000000000966 [doi] PST - ppublish SO - Coron Artery Dis. 2021 Aug 1;32(5):397-402. doi: 10.1097/MCA.0000000000000966. PMID- 33046070 OWN - NLM STAT- MEDLINE DCOM- 20210517 LR - 20260127 IS - 1475-2840 (Electronic) IS - 1475-2840 (Linking) VI - 19 IP - 1 DP - 2020 Oct 12 TI - Blood pressure and mortality in patients with type 2 diabetes and a recent coronary event in the ELIXA trial. PG - 175 LID - 10.1186/s12933-020-01150-0 [doi] LID - 175 AB - BACKGROUND: The relationship between blood pressure and mortality in type 2 diabetes (T2DM) is controversial, with concern for increased risk associated with excessively lowered blood pressure. METHODS: We evaluated whether prior cardiovascular disease (CVD) altered the relationship between baseline blood pressure and all-cause mortality in 5852 patients with T2DM and a recent acute coronary syndrome (ACS) who participated in the ELIXA (Evaluation of Lixisenatide in Acute Coronary Syndrome) trial. Risk of death was assessed in Cox models adjusted for age, sex, race, heart rate, BMI, smoking, diabetes duration, insulin use, HbA1c, eGFR, brain natriuretic peptide (BNP), urine albumin/creatinine ratio, treatment allocation and prior coronary revascularization. RESULTS: Although overall there was no significant association between systolic blood pressure (SBP) and mortality (hazard ratio per 10 mmHg lower SBP 1.05 (95% CI 0.99-1.12) P = 0.10), lower SBP was significantly associated with higher risk of death (hazard ratio per 10 mmHg lower SBP 1.13 (95% CI 1.04-1.22) P = 0.002) in 2325 patients with additional CVD (index ACS+ at least one of the following prior to randomization: myocardial infarction other than the index ACS, stroke or heart failure). In 3527 patients with only the index ACS no significant association was observed (hazard ratio per 10 mmHg lower SBP 0.95 (0.86-1.04) P = 0.26; P for interaction 0.005). CONCLUSIONS: The association between blood pressure and mortality was modified by additional CVD history in patients with type 2 diabetes and a recent coronary event. When blood pressures measured after an acute coronary event are used to assess the risk of death in patients with type 2 diabetes, the cardiovascular history needs to be taken into consideration. Trial registration ClinicalTrials.gov number NCT01147250, first posted June 22, 2010. FAU - Wijkman, Magnus O AU - Wijkman MO AUID- ORCID: 0000-0002-4757-9051 AD - Cardiovascular Division, Brigham & Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA. mwijkman@bwh.harvard.edu. AD - Department of Internal Medicine and Department of Health, Medicine and Caring Sciences, Linkoping University, Norrkoping, Sweden. mwijkman@bwh.harvard.edu. FAU - Claggett, Brian AU - Claggett B AD - Cardiovascular Division, Brigham & Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA. FAU - Diaz, Rafael AU - Diaz R AD - Estudios Clinicos Latinoamerica, Instituto Cardiovascular de Rosario, Rosario, Argentina. FAU - Gerstein, Hertzel C AU - Gerstein HC AD - The Population Health Research Institute and the Department of Medicine, McMaster University and Hamilton Health Sciences, Hamilton, Canada. FAU - Kober, Lars AU - Kober L AD - Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark. FAU - Lewis, Eldrin AU - Lewis E AD - Stanford University Medical Center, Stanford, USA. FAU - Maggioni, Aldo P AU - Maggioni AP AD - Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy. AD - Research Center of the Italian Association of Hospital Cardiologists, Florence, Italy. FAU - Wolsk, Emil AU - Wolsk E AD - Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark. FAU - Aguilar, David AU - Aguilar D AD - McGovern Medical School, University of Texas, Houston, USA. FAU - Bentley-Lewis, Rhonda AU - Bentley-Lewis R AD - Massachusetts General Hospital, Harvard Medical School, Boston, USA. FAU - McMurray, John J AU - McMurray JJ AD - British Heart Foundation Cardiovascular Research Centre, University of Glasgow, Glasgow, UK. FAU - Probstfield, Jeffrey AU - Probstfield J AD - University of Washington Medical Center, Seattle, USA. FAU - Riddle, Matthew AU - Riddle M AD - Oregon Health and Science University, Portland, USA. FAU - Tardif, Jean-Claude AU - Tardif JC AD - Montreal Heart Institute, Universite de Montreal, Montreal, Canada. FAU - Solomon, Scott D AU - Solomon SD AD - Cardiovascular Division, Brigham & Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA. FAU - Pfeffer, Marc A AU - Pfeffer MA AD - Cardiovascular Division, Brigham & Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA. LA - eng SI - ClinicalTrials.gov/NCT01147250 PT - Journal Article PT - Multicenter Study PT - Observational Study PT - Research Support, Non-U.S. Gov't DEP - 20201012 PL - England TA - Cardiovasc Diabetol JT - Cardiovascular diabetology JID - 101147637 RN - 0 (Hypoglycemic Agents) RN - 0 (Peptides) RN - 74O62BB01U (lixisenatide) RN - 0 (Glucagon-Like Peptide-2 Receptor) SB - IM MH - Acute Coronary Syndrome/diagnosis/*mortality/physiopathology MH - Aged MH - *Blood Pressure MH - Diabetes Mellitus, Type 2/diagnosis/*drug therapy/mortality/physiopathology MH - Female MH - Humans MH - Hypoglycemic Agents/adverse effects/*therapeutic use MH - Male MH - Middle Aged MH - Peptides/adverse effects/*therapeutic use MH - Randomized Controlled Trials as Topic MH - Risk Assessment MH - Risk Factors MH - Time Factors MH - Treatment Outcome MH - Glucagon-Like Peptide-2 Receptor PMC - PMC7552471 OTO - NOTNLM OT - Blood pressure OT - Coronary artery disease OT - Diabetes mellitus COIS- MOW has served on advisory boards or lectured for MSD, Lilly, Novo Nordisk and Sanofi, and has organized a professional regional meeting sponsored by Lilly, Rubin Medical, Sanofi, Novartis and Novo Nordisk. BC has received consulting fees for Amgen, Biogen, Corvia, Myokardia, and Novartis. RD has received speaker fees from Sanofi, Astra Zeneca and Eli Lilly. HG holds the McMaster-Sanofi Population Health Institute Chair in Diabetes Research and Care and reports research grants from Eli Lilly, AstraZeneca, Merck, Novo Nordisk and Sanofi; honoraria for speaking from AstraZeneca, Boehringer Ingelheim, Eli Lilly, Novo Nordisk, and Sanofi; and consulting fees from Abbott, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Merck, Novo Nordisk, Janssen, Sanofi, and Kowa. LK has received speaker s honorarium (personal fee) from AstraZeneca, Novartis and Boehringer, unrelated to this manuscript. EL has received institutional funding for research grant support from Sanofi and Akebia. APM has received personal fees from Bayer, Fresenius, Novartis for participating in study committees outside the present work. EW has received speaker fees from Orion Pharma, Novartis Healthcare, Boehringer-Ingelheim, Merck. MR has received research funding through Oregon Health & Science University: Eli Lilly, Novo Nordisk, AstraZeneca, and honoraria for consulting: Adocia, AstraZeneca, Eli Lilly, GlaxoSmithKline, Intercept, Novo Nordisk, Sanofi, Theracos. JCT has received research grants from Amarin, Astra-Zeneca, DalCor, Esperion, Ionis, RegenXBio, Sanofi and Servier; honoraria from DalCor, Sanofi and Servier; holds minor equity interest in DalCor; and is an author of a patent on pharmacogenomics-guided CETP inhibition. SDS has received research grants from Alnylam, Amgen, AstraZeneca, Bellerophon, Bayer, BMS, Celladon, Cytokinetics, Eidos, Gilead, GSK, Ionis, Lone Star Heart, Mesoblast, MyoKardia, NIH/NHLBI, Neurotronik, Novartis, Respicardia, Sanofi Pasteur, Theracos, and has consulted for Akros, Alnylam, Amgen, Arena, AstraZeneca, Bayer, BMS, Cardior, Cardurion, Corvia, Cytokinetics, Daiichi-Sankyo, Gilead, GSK, Ironwood, Merck, Myokardia, Novartis, Roche, Takeda, Theracos, Quantum Genetics, Cardurion, AoBiome, Janssen, Cardiac Dimensions, Tenaya, Sanofi-Pasteur, Dinaqor, Tremeau. MAP receives research support from Novartis, serves as a consultant for AstraZeneca, Corvidia, DalCor, GlaxoSmithKline, Novartis, Novo Nordisk, Pharmascience and Sanofi, and has equity in DalCor. EDAT- 2020/10/14 06:00 MHDA- 2021/05/18 06:00 PMCR- 2020/10/12 CRDT- 2020/10/13 05:27 PHST- 2020/07/23 00:00 [received] PHST- 2020/10/01 00:00 [accepted] PHST- 2020/10/13 05:27 [entrez] PHST- 2020/10/14 06:00 [pubmed] PHST- 2021/05/18 06:00 [medline] PHST- 2020/10/12 00:00 [pmc-release] AID - 10.1186/s12933-020-01150-0 [pii] AID - 1150 [pii] AID - 10.1186/s12933-020-01150-0 [doi] PST - epublish SO - Cardiovasc Diabetol. 2020 Oct 12;19(1):175. doi: 10.1186/s12933-020-01150-0. PMID- 33032714 OWN - NLM STAT- MEDLINE DCOM- 20210727 LR - 20210727 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 13 IP - 19 DP - 2020 Oct 12 TI - Long-Term Prognostic Impact of Restenosis of the Unprotected Left Main Coronary Artery Requiring Repeat Revascularization. PG - 2266-2274 LID - S1936-8798(20)31560-0 [pii] LID - 10.1016/j.jcin.2020.07.017 [doi] AB - OBJECTIVES: The aim of this study was to evaluate the prognostic impact of target lesion revascularization (TLR) of the unprotected left main coronary artery (ULMCA) after stent failure. BACKGROUND: Although drug-eluting stents are safe and effective for treatment of the ULMCA, increased rates of repeat revascularization have been observed. METHODS: This is a patient-level pooled analysis of the randomized ISAR-LEFT-MAIN (Drug-Eluting-Stents for Unprotected Left Main Stem Disease) and ISAR-LEFT-MAIN-2 (Drug-Eluting Stents to Treat Unprotected Coronary Left Main Disease) trials, in which patients underwent stenting of the ULMCA. The present analysis includes patients who underwent angiography during follow-up. Patients with TLR were compared with those without. Additional long-term clinical follow-up after TLR was conducted, and its influence on mortality was evaluated. Mortality was calculated using the Kaplan-Meier method. Predictors of mortality were assessed in a multivariate analysis. RESULTS: A total of 1,001 patients were eligible, of whom 166 experienced TLR. The 5-year mortality rate was 30.2% in patients with TLR compared with 17.3% in those without TLR (p < 0.001). In the multivariate analysis, glomerular filtration rate (-30 ml/min; hazard ratio [HR]: 2.25; 95% confidence interval [CI]: 1.54 to 3.27; p < 0.001), chronic obstructive pulmonary disease (HR: 4.95; 95% CI: 1.33 to 18.42; p = 0.02), and body mass index (+5 kg/m(2); HR: 1.61; 95% CI: 1.12 to 2.32; p = 0.01) were independent predictors of mortality after TLR due to left main stent failure. The type of repeat revascularization and the underlying stent did not influence the mortality after TLR of the ULMCA. CONCLUSIONS: Mortality after TLR for left main stent failure is high. Patient-related factors seem to have a greater impact on mortality after TLR than other variables. CI - Copyright (c) 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Wiebe, Jens AU - Wiebe J AD - Deutsches Herzzentrum Munchen, Department of Cardiology, Technische Universitat, Munich, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany. Electronic address: wiebe@dhm.mhn.de. FAU - Kuna, Constantin AU - Kuna C AD - Deutsches Herzzentrum Munchen, Department of Cardiology, Technische Universitat, Munich, Germany. FAU - Ibrahim, Tareq AU - Ibrahim T AD - 1. Med. Klinik, Klinikum Rechts der Isar, Technische Universitat, Munich, Germany. FAU - Losl, Martin AU - Losl M AD - Deutsches Herzzentrum Munchen, Department of Cardiology, Technische Universitat, Munich, Germany. FAU - Cassese, Salvatore AU - Cassese S AD - Deutsches Herzzentrum Munchen, Department of Cardiology, Technische Universitat, Munich, Germany. FAU - Kufner, Sebastian AU - Kufner S AD - Deutsches Herzzentrum Munchen, Department of Cardiology, Technische Universitat, Munich, Germany. FAU - Schunkert, Heribert AU - Schunkert H AD - Deutsches Herzzentrum Munchen, Department of Cardiology, Technische Universitat, Munich, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany. FAU - Byrne, Robert A AU - Byrne RA AD - Mater Private Hospital, Department of Cardiology, Dublin, Ireland; Royal College of Surgeons, Dublin, Ireland. FAU - Laugwitz, Karl-Ludwig AU - Laugwitz KL AD - DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany; 1. Med. Klinik, Klinikum Rechts der Isar, Technische Universitat, Munich, Germany. FAU - Valgimigli, Marco AU - Valgimigli M AD - Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland. FAU - Richardt, Gert AU - Richardt G AD - Heart Centre Segeberger Kliniken, Bad Segeberg, Germany. FAU - Mehilli, Julinda AU - Mehilli J AD - DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany; Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen, Ludwig-Maximilians-Universitat, Munich, Germany. FAU - Kastrati, Adnan AU - Kastrati A AD - Deutsches Herzzentrum Munchen, Department of Cardiology, Technische Universitat, Munich, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany. LA - eng PT - Journal Article PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 SB - IM CIN - JACC Cardiovasc Interv. 2020 Oct 12;13(19):2275-2276. doi: 10.1016/j.jcin.2020.08.028. PMID: 33032715 MH - Coronary Angiography MH - *Coronary Artery Disease MH - *Coronary Restenosis MH - Coronary Vessels MH - Drug-Eluting Stents MH - Humans MH - Kaplan-Meier Estimate MH - Prognosis MH - Risk Factors MH - Treatment Outcome OTO - NOTNLM OT - coronary artery disease OT - in-stent restenosis OT - repeat revascularization OT - stent failure OT - unprotected left main stenosis EDAT- 2020/10/10 06:00 MHDA- 2021/07/28 06:00 CRDT- 2020/10/09 05:26 PHST- 2020/04/06 00:00 [received] PHST- 2020/06/18 00:00 [revised] PHST- 2020/07/14 00:00 [accepted] PHST- 2020/10/09 05:26 [entrez] PHST- 2020/10/10 06:00 [pubmed] PHST- 2021/07/28 06:00 [medline] AID - S1936-8798(20)31560-0 [pii] AID - 10.1016/j.jcin.2020.07.017 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2020 Oct 12;13(19):2266-2274. doi: 10.1016/j.jcin.2020.07.017. PMID- 32997098 OWN - NLM STAT- MEDLINE DCOM- 20220112 LR - 20221207 IS - 2380-6591 (Electronic) IS - 2380-6583 (Print) VI - 6 IP - 1 DP - 2021 Jan 1 TI - Rivaroxaban and Aspirin in Patients With Symptomatic Lower Extremity Peripheral Artery Disease: A Subanalysis of the COMPASS Randomized Clinical Trial. PG - 21-29 LID - 10.1001/jamacardio.2020.4390 [doi] AB - IMPORTANCE: Patients with symptomatic lower extremity peripheral artery disease (LE-PAD) experience an increased risk of major vascular events. There is limited information on what clinical features of symptomatic LE-PAD prognosticate major vascular events and whether patients at high risk have a greater absolute benefit from low-dose rivaroxaban and aspirin. OBJECTIVE: To quantify the risk of major vascular events and investigate the response to treatment with low-dose rivaroxaban and aspirin among patients with symptomatic LE-PAD based on clinical presentation and comorbidities. DESIGN, SETTING, AND PARTICIPANTS: This is a subanalysis of a previously reported subgroup of patients with symptomatic LE-PAD who were enrolled in a large, double-blind, placebo-controlled randomized clinical trial (Cardiovascular Outcomes for People Using Anticoagulation Strategies [COMPASS]) in 602 centers in 33 countries from March 2013 to January 2020. Data analysis was completed from May 2016 to June 2020. INTERVENTIONS: A combination of low-dose rivaroxaban and aspirin compared with aspirin alone. MAIN OUTCOMES AND MEASURES: Thirty-month incidence risk of myocardial infarction, stroke and cardiovascular death (MACE), major adverse limb events (MALE) including major vascular amputation, and bleeding. RESULTS: The COMPASS trial enrolled 4129 patients with symptomatic LE-PAD (mean [SD] age, 66.8 [8.8] years; 2932 men [71.0%]). The 30-month Kaplan-Meier incidence risk of MACE or MALE, including major amputation, was 22.6% in those with prior amputation (this outcome was observed in 54 patients), 17.6% (n = 15) in those with Fontaine III or IV symptoms, and 11.8% (n = 142) in those with previous peripheral artery revascularization, classifying these features as high-risk limb presentations. The 30-month incidence risk of MACE or MALE, including major amputation, was 14.1% (n = 118) in those with kidney dysfunction, 13.5% (n = 67) in those with heart failure, 13.4% (n = 199) in those with diabetes, and 12.8% (n = 222) in those with polyvascular disease, classifying these features as high-risk comorbidities. Among patients with either high-risk limb presentations or high-risk comorbidities, treatment with rivaroxaban and aspirin compared with aspirin alone was associated with an estimated 4.2% (95% CI, 1.9%-6.2%) absolute risk reduction for MACE or MALE, including major amputation, at 30 months. Although the estimated absolute risk increase of major bleeding was higher with rivaroxaban and aspirin in combination than aspirin alone (2.0% [95% CI, 0.5%-3.9%]) for patients with either high-risk limb presentation or high-risk comorbidity, the estimated absolute risk increase of fatal or critical organ bleeding was low in this high-risk group (0.4% [95% CI, 0.2%-1.8%]), such that the net clinical benefit was estimated to be 3.2% (95% CI, 0.6%-5.3%). CONCLUSIONS AND RELEVANCE: Patients with LE-PAD with high-risk limb presentations or high-risk comorbidities had a high incidence of major vascular events. For these patients, treatment with rivaroxaban and aspirin in combination compared with aspirin alone led to a large absolute reduction in vascular risk. FAU - Kaplovitch, Eric AU - Kaplovitch E AD - Population Health Research Institute, McMaster University, Hamilton Health Sciences, Hamilton, Ontario, Canada. AD - Department of Medicine, University of Toronto, Toronto, Ontario, Canada. FAU - Eikelboom, John W AU - Eikelboom JW AD - Population Health Research Institute, McMaster University, Hamilton Health Sciences, Hamilton, Ontario, Canada. AD - Department of Medicine, McMaster University, Hamilton, Ontario, Canada. FAU - Dyal, Leanne AU - Dyal L AD - Population Health Research Institute, McMaster University, Hamilton Health Sciences, Hamilton, Ontario, Canada. FAU - Aboyans, Victor AU - Aboyans V AD - Department of Cardiology, Dupuytren University Hospital, Limoges, France. AD - Institut National de la Sante et de la Recherche Medicale, Unite 1094, Limoges University, Limoges, France. FAU - Abola, Maria Teresa AU - Abola MT AD - College of Medicine, University of the Philippines/Philippine Heart Center, Manila, Philippines. FAU - Verhamme, Peter AU - Verhamme P AD - Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium. FAU - Avezum, Alvaro AU - Avezum A AD - International Research Center, Hospital Alemao Oswaldo Cruz, Sao Paulo, Brazil. FAU - Fox, Keith A A AU - Fox KAA AD - Department of Cardiology, University of Edinburgh, Edinburgh, United Kingdom. FAU - Berkowitz, Scott D AU - Berkowitz SD AD - Clinical Development, Thrombosis & Vascular Medicine, Bayer US LLC, Whippany, New Jersey. FAU - Bangdiwala, Shrikant I AU - Bangdiwala SI AD - Population Health Research Institute, McMaster University, Hamilton Health Sciences, Hamilton, Ontario, Canada. AD - Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada. FAU - Yusuf, Salim AU - Yusuf S AD - Population Health Research Institute, McMaster University, Hamilton Health Sciences, Hamilton, Ontario, Canada. AD - Department of Medicine, McMaster University, Hamilton, Ontario, Canada. FAU - Anand, Sonia S AU - Anand SS AD - Population Health Research Institute, McMaster University, Hamilton Health Sciences, Hamilton, Ontario, Canada. AD - Department of Medicine, McMaster University, Hamilton, Ontario, Canada. AD - Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada. LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - United States TA - JAMA Cardiol JT - JAMA cardiology JID - 101676033 RN - 0 (Factor Xa Inhibitors) RN - 0 (Platelet Aggregation Inhibitors) RN - 9NDF7JZ4M3 (Rivaroxaban) RN - R16CO5Y76E (Aspirin) SB - IM EIN - JAMA Cardiol. 2021 Feb 1;6(2):246. doi: 10.1001/jamacardio.2020.6442. PMID: 33263744 MH - Aged MH - Amputation, Surgical/statistics & numerical data MH - Aspirin/*therapeutic use MH - Cardiovascular Diseases/*mortality MH - Comorbidity MH - Diabetes Mellitus/epidemiology MH - Double-Blind Method MH - Factor Xa Inhibitors/*therapeutic use MH - Female MH - Heart Failure/epidemiology MH - Hemorrhage/chemically induced MH - Humans MH - Male MH - Middle Aged MH - Myocardial Infarction/*epidemiology MH - Peripheral Arterial Disease/*drug therapy/epidemiology/physiopathology MH - Platelet Aggregation Inhibitors/*therapeutic use MH - Prognosis MH - Renal Insufficiency/epidemiology MH - Rivaroxaban/*therapeutic use MH - Severity of Illness Index MH - Stroke/*epidemiology PMC - PMC7527938 COIS- Conflict of Interest Disclosures: Dr Eikelboom reports grants and personal fees from Bayer, Boehringer Ingelheim, Bristol Myers Squibb/Pfizer, Daiichi Sankyo, Eli Lilly, GlaxoSmithKline, Janssen, Sanofi Aventis, and Servier during the conduct of the study; grants and personal fees from Bayer, Boehringer Ingelheim, Bristol Myers Squibb/Pfizer, Daiichi Sankyo, Janssen, AstraZeneca, Eli Lilly, GlaxoSmithKline, Pfizer, Janssen, and Sanofi Aventis outside the submitted work; and personal fees from Servier outside the submitted work. Dr Aboyans reports grants and/or honoraria for speaking and consulting from Bayer, Bristol Myers Squibb, Novartis, and Pfizer and personal fees from Boehringer Ingelheim, Amgen, and Bristol Myers Squibb/Pfizer Alliance during the conduct of the study. Dr Abola reported personal fees and nonfinancial support from Bayer during the conduct of the study and personal fees and nonfinancial support from Bayer and AstraZeneca outside the submitted work; Dr Abola has also received speaker fees from Pfizer. Dr Verhamme reported grants from Bayer during the conduct of the study; grants and personal fees from Bayer, Boehringer Ingelheim, Bristol Myers Squibb, Pfizer, Portola, and Daiichi Sankyo; and personal fees from AbbVie and Anthos outside the submitted work. Dr Avezum has received honoraria and consulting fees from Boehringer Ingelheim and Pfizer and personal fees from Bayer and Daichii Sankyo outside the submitted work. Dr Fox has received grants and personal fees from AstraZeneca and Bayer/Janssen, as well as personal fees from Lilly and Sanofi/Regeneron. Dr Fox reported grants from Bayer/Janssen during the conduct of the study; grants from AstraZeneca, personal fees from Sanofi/Regeneron, and personal fees from Verseon outside the submitted work. Dr Berkowitz is employed as a clinical research physician by Bayer US LLC. Dr Yusuf reported grants and personal fees from Bayer during the conduct of the study; Dr Yusuf has received research grants and honoraria and travel reimbursement for speaking from Bayer, Boehringer Ingelheim, Bristol Myers Squibb, AstraZeneca, Cadila Pharmaceuticals, and Sanofi Aventis from outside the submitted work. Dr Anand has received speaking honoraria and consulting fees from Bayer and speaking fees from Janssen. No other disclosures were reported. EDAT- 2020/10/01 06:00 MHDA- 2022/01/13 06:00 PMCR- 2021/09/30 CRDT- 2020/09/30 12:16 PHST- 2020/10/01 06:00 [pubmed] PHST- 2022/01/13 06:00 [medline] PHST- 2020/09/30 12:16 [entrez] PHST- 2021/09/30 00:00 [pmc-release] AID - 2771002 [pii] AID - hoi200066 [pii] AID - 10.1001/jamacardio.2020.4390 [doi] PST - ppublish SO - JAMA Cardiol. 2021 Jan 1;6(1):21-29. doi: 10.1001/jamacardio.2020.4390. PMID- 32991776 OWN - NLM STAT- MEDLINE DCOM- 20210727 LR - 20210727 IS - 1742-7843 (Electronic) IS - 1742-7835 (Linking) VI - 128 IP - 2 DP - 2021 Feb TI - A novel risk assessment model of contrast-induced nephropathy after percutaneous coronary intervention in patients with diabetes. PG - 305-314 LID - 10.1111/bcpt.13501 [doi] AB - The purpose of our study was to develop a simple clinical pre-procedure risk model based on clinical characteristics for the prediction of contrast-induced nephropathy (CIN) and major adverse cardiac events (MACEs) after percutaneous coronary intervention (PCI) in patients with diabetes. A total of 1113 patients with diabetes who underwent PCI with contrast exposure were randomized into a development group (n = 742) and a validation group (n = 371) in a 2:1 ratio. CIN was defined as an increase of either 25% or 0.5 mg/dL (44.2 mumol/L) in serum creatinine within 72 hours after contrast infusion. A simple CIN risk score based on independent predictors was established. Four variables were identified for our risk score model: LVEF < 40%, acute coronary syndrome (ACS), eGFR < 60, and contrast volume > 300 mL. Based on this new CIN risk score, the incidence of CIN had a significant trend with increased predicting score values of 5.9%, 32.9% and 60.0%, corresponding to low-, moderate- and high-risk groups, respectively. The novel risk assessment exhibited moderate discrimination ability for predicting CIN, with an AUC of 0.759 [95% CI 0.668-0.852, P = .001] in the validation cohort. It also had similar prognostic values for one-year follow-up MACE (C-statistic: 0.705 and 0.606 for new risk score and Mehran score, respectively). This novel risk prediction model could be effective for preventing nephropathy in diabetic patients receiving contrast media during surgical procedures. CI - (c) 2020 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society). FAU - Yao, Zhi-Feng AU - Yao ZF AUID- ORCID: 0000-0001-8686-3728 AD - Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China. AD - Shanghai Institute of Cardiovascular Diseases, Shanghai, China. FAU - Shen, Hong AU - Shen H AD - Department of Emergency Medicine, Zhongshan Hospital, Fudan University, Shanghai, China. FAU - Tang, Min-Na AU - Tang MN AD - Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China. AD - Shanghai Institute of Cardiovascular Diseases, Shanghai, China. FAU - Yan, Yan AU - Yan Y AD - Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China. AD - Shanghai Institute of Cardiovascular Diseases, Shanghai, China. FAU - Ge, Jun-Bo AU - Ge JB AD - Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China. AD - Shanghai Institute of Cardiovascular Diseases, Shanghai, China. LA - eng PT - Journal Article PT - Validation Study DEP - 20201015 PL - England TA - Basic Clin Pharmacol Toxicol JT - Basic & clinical pharmacology & toxicology JID - 101208422 RN - 0 (Contrast Media) SB - IM MH - Acute Coronary Syndrome/diagnostic imaging/epidemiology/physiopathology/*therapy MH - Aged MH - Contrast Media/*adverse effects MH - Coronary Artery Disease/diagnostic imaging/epidemiology/physiopathology/*therapy MH - Databases, Factual MH - *Decision Support Techniques MH - *Diabetes Mellitus/diagnosis/epidemiology MH - Female MH - Humans MH - Incidence MH - Kidney Diseases/*chemically induced/diagnosis/epidemiology MH - Male MH - Middle Aged MH - Percutaneous Coronary Intervention/*adverse effects MH - Predictive Value of Tests MH - Random Allocation MH - Reproducibility of Results MH - Retrospective Studies MH - Risk Assessment MH - Risk Factors MH - Stroke Volume MH - Treatment Outcome MH - Ventricular Function, Left OTO - NOTNLM OT - contrast-induced nephropathy OT - major adverse cardiovascular events OT - percutaneous coronary intervention OT - risk scores EDAT- 2020/09/30 06:00 MHDA- 2021/07/28 06:00 CRDT- 2020/09/29 17:15 PHST- 2020/06/29 00:00 [received] PHST- 2020/09/16 00:00 [revised] PHST- 2020/09/17 00:00 [accepted] PHST- 2020/09/30 06:00 [pubmed] PHST- 2021/07/28 06:00 [medline] PHST- 2020/09/29 17:15 [entrez] AID - 10.1111/bcpt.13501 [doi] PST - ppublish SO - Basic Clin Pharmacol Toxicol. 2021 Feb;128(2):305-314. doi: 10.1111/bcpt.13501. Epub 2020 Oct 15. PMID- 32985249 OWN - NLM STAT- MEDLINE DCOM- 20211011 LR - 20211011 IS - 1524-4539 (Electronic) IS - 0009-7322 (Linking) VI - 142 IP - 21 DP - 2020 Nov 24 TI - Randomized Pilot Clinical Trial of Early Coronary Angiography Versus No Early Coronary Angiography After Cardiac Arrest Without ST-Segment Elevation: The PEARL Study. PG - 2002-2012 LID - 10.1161/CIRCULATIONAHA.120.049569 [doi] AB - BACKGROUND: The benefit of emergency coronary angiography after resuscitation from out-of-hospital cardiac arrest is uncertain for patients without ST-segment elevation. The aim of this randomized trial was to evaluate the efficacy and safety of early coronary angiography and to determine the prevalence of acute coronary occlusion in resuscitated patients with out-of-hospital cardiac arrest without ST-segment elevation. METHODS: Adult (>18 years) comatose survivors without ST-segment elevation after resuscitation from out-of-hospital cardiac arrest were prospectively randomized in a 1:1 fashion under exception to informed consent regulations to early coronary angiography versus no early coronary angiography in this multicenter study. Early angiography was defined as 50%, and a normal regional wall motion score of 16 within 24 hours of admission. Adverse events included rearrest, pulmonary edema on chest x-ray, acute renal dysfunction, bleeding requiring transfusion or intervention, hypotension (systolic arterial pressure /=0.3 mg/dL or 50% in serum creatinine (SCr) compared to baseline in the 48 to 72 h after CAG/PCI. A prediction model was established with independent predictors according to stepwise logistic regression, showing as a nomogram. The discrimination of the new model was evaluated by the area under the curve (AUC) and was compared to the classic Mehran CA-AKI model. The Hosmer-Lemeshow test was conducted to assess the calibration of our model. RESULTS: Overall, 8.4% (71/848) patients of the development group and 11.2% (48/424) patients of the validation group experienced CA-AKI. A new nomogram included estimated glomerular filtration rate (eGFR), serum albumin (ALB), age and the use of intra-aortic balloon pump (IABP); showed better predictive ability than the Mehran score (C-index 0.756 vs. 0.693, p = 0.02); and had good calibration (Hosmer-Lemeshow test p = 0.187). CONCLUSIONS: We developed a simple model for predicting CA-AKI among patients with hypoalbuminemia undergoing CAG/PCI, but our findings need validating externally. TRIAL REGISTRATION: http://www.ClinicalTrials.gov NCT01400295 , retrospectively registered 21 July 2011. FAU - Liu, Liwei AU - Liu L AD - The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, Guangdong, China. AD - Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China. FAU - Liu, Jin AU - Liu J AD - Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China. FAU - Lei, Li AU - Lei L AD - The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, Guangdong, China. AD - Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China. FAU - Wang, Bo AU - Wang B AD - Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China. FAU - Sun, Guoli AU - Sun G AD - Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China. FAU - Guo, Zhaodong AU - Guo Z AD - Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China. FAU - He, Yibo AU - He Y AD - Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China. FAU - Song, Feier AU - Song F AD - Department of Emergency and Critical Care Medicine, Guangdong Provincial People's Hospital and Guangdong Academy of Medical Sciences, Guangzhou, 510080, People's Republic of China. FAU - Lun, Zhubin AU - Lun Z AD - Department of Cardiology, Dongguan People's Hospital, Dongguan, 523059, China. FAU - Liu, Bowen AU - Liu B AD - Guangdong Provincial People's Hospital, School of Medicine, South China University of Technology, Guangzhou, 510100, China. FAU - Chen, Guanzhong AU - Chen G AD - Guangdong Provincial People's Hospital, School of Medicine, South China University of Technology, Guangzhou, 510100, China. FAU - Chen, Shiqun AU - Chen S AD - Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China. FAU - Yang, Yongquan AU - Yang Y AD - Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China. AD - Guangdong Provincial People's Hospital, School of Medicine, South China University of Technology, Guangzhou, 510100, China. FAU - Liu, Yong AU - Liu Y AUID- ORCID: 0000-0003-2224-4885 AD - The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, Guangdong, China. liuyong2099@126.com. AD - Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China. liuyong2099@126.com. AD - Guangdong Provincial People's Hospital, School of Medicine, South China University of Technology, Guangzhou, 510100, China. liuyong2099@126.com. FAU - Chen, Jiyan AU - Chen J AD - The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, Guangdong, China. chenjiyandr@126.com. AD - Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China. chenjiyandr@126.com. AD - Guangdong Provincial People's Hospital, School of Medicine, South China University of Technology, Guangzhou, 510100, China. chenjiyandr@126.com. LA - eng SI - ClinicalTrials.gov/NCT01400295 GR - LHJJ201612127/Beijing Lisheng Cardiovascular Pilot Foundation/International GR - 81670339/National Natural Science Foundation of China/International PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Validation Study DEP - 20200831 PL - England TA - BMC Cardiovasc Disord JT - BMC cardiovascular disorders JID - 100968539 RN - 0 (ALB protein, human) RN - 0 (Biomarkers) RN - 0 (Contrast Media) RN - ZIF514RVZR (Serum Albumin, Human) SB - IM MH - Acute Kidney Injury/*chemically induced/diagnosis MH - Aged MH - Biomarkers/blood MH - *Clinical Decision Rules MH - Contrast Media/*adverse effects MH - Coronary Angiography/*adverse effects MH - Coronary Artery Disease/complications/*diagnostic imaging/therapy MH - Female MH - Humans MH - Hypoalbuminemia/blood/*complications/diagnosis MH - Male MH - Middle Aged MH - *Nomograms MH - Percutaneous Coronary Intervention/adverse effects MH - Predictive Value of Tests MH - Prospective Studies MH - Random Allocation MH - Reproducibility of Results MH - Risk Assessment MH - Risk Factors MH - Serum Albumin, Human/*deficiency MH - Treatment Outcome PMC - PMC7460778 OTO - NOTNLM OT - Contrast-associated kidney injury OT - Coronary angiography OT - Hypoalbuminemia OT - Nomogram OT - Percutaneous coronary intervention COIS- All authors declare that they have no competing interests. EDAT- 2020/09/02 06:00 MHDA- 2021/01/12 06:00 PMCR- 2020/08/31 CRDT- 2020/09/02 06:00 PHST- 2020/06/06 00:00 [received] PHST- 2020/08/26 00:00 [accepted] PHST- 2020/09/02 06:00 [entrez] PHST- 2020/09/02 06:00 [pubmed] PHST- 2021/01/12 06:00 [medline] PHST- 2020/08/31 00:00 [pmc-release] AID - 10.1186/s12872-020-01689-6 [pii] AID - 1689 [pii] AID - 10.1186/s12872-020-01689-6 [doi] PST - epublish SO - BMC Cardiovasc Disord. 2020 Aug 31;20(1):399. doi: 10.1186/s12872-020-01689-6. PMID- 32838661 OWN - NLM STAT- MEDLINE DCOM- 20211124 LR - 20220424 IS - 1477-111X (Electronic) IS - 0267-6591 (Linking) VI - 36 IP - 5 DP - 2021 Jul TI - Preventive effect of trimetazidine on contrast-induced nephropathy undergoing percutaneous coronary intervention in elderly moderate and high risk diabetics stratified by mehran score. PG - 491-500 LID - 10.1177/0267659120952057 [doi] AB - BACKGROUND: The aim of this research was to use the Mehran risk score to classify elderly diabetics with coronary heart disease to assess the preventive effect of trimetazidine on contrast-induced nephropathy (CIN) after percutaneous coronary intervention (PCI) in different risk population. METHODS: An uncompromised of 760 elderly diabetics that went through PCI were included in this research. The patients were first divided into three groups in the light of MRS: low-risk, moderate-risk, and high-risk group, then randomized into trimetazidine group and the control group respectively. The first endpoint was the amount of CIN, which is described as a rise in serum creatinine levels by ⩾44.2 mumol/L or ⩾25% ratio within 48 or 72 hours after medication. Second endpoint included differences in creatinine clearance rate (CrCl), blood urea nitrogen (BUN), serum creatinine (Scr), cystatin-C (Cys-C), and the incidence of major adverse events after administration. RESULTS: In the three groups, the incidence of CIN in trimetazidine and control group was 5.0% versus 4.9%(chi(2) = 0.005, p > 0.05), 8.0% versus 18.0% (chi(2) = 7.685, p < 0.05), 10.4% versus 27.1% (chi(2) = 4.376, p < 0.05), respectively. The multivariable logistic regression result demonstrated that trimetazidine intervention was a profitable element of CIN in moderate and high-risk groups (OR = 0.294, 95% CI 0.094-0.920, p = 0.035). CONCLUSION: Our study confirmed that trimetazidine can be considered for preventive treatment of CIN occurrence in elderly diabetics with moderate and high-risk population, while there is no obvious advantage compared with hydration therapy in low-risk patients. FAU - Zhang, Xue AU - Zhang X AUID- ORCID: 0000-0001-5540-3702 AD - Graduate School of Tianjin Medical University, Tianjin, China. FAU - Zhang, Peng AU - Zhang P AUID- ORCID: 0000-0003-2039-9373 AD - Department of Cardiology, Tianjin Chest Hospital, Tianjin, China. FAU - Yang, Shicheng AU - Yang S AD - Department of Cardiology, Tianjin Chest Hospital, Tianjin, China. FAU - Li, Wenyuan AU - Li W AD - Department of Cardiology, Tianjin Chest Hospital, Tianjin, China. FAU - Men, Xiuzhen AU - Men X AD - Department of Catheter lab, Dongying Second People's Hospital, Shandong,China. FAU - Fu, Naikuan AU - Fu N AUID- ORCID: 0000-0002-4639-3810 AD - Department of Cardiology, Tianjin Chest Hospital, Tianjin, China. LA - eng PT - Journal Article PT - Randomized Controlled Trial DEP - 20200824 PL - England TA - Perfusion JT - Perfusion JID - 8700166 RN - 0 (Contrast Media) RN - AYI8EX34EU (Creatinine) RN - N9A0A0R9S8 (Trimetazidine) SB - IM MH - Aged MH - Contrast Media/adverse effects MH - Coronary Angiography MH - Creatinine MH - *Diabetes Mellitus MH - Humans MH - *Kidney Diseases MH - *Percutaneous Coronary Intervention/adverse effects MH - Risk Factors MH - *Trimetazidine/therapeutic use OTO - NOTNLM OT - Mehran risk score OT - contrast-induced nephropathy OT - diabetics OT - elderly OT - trimetazidine EDAT- 2020/08/26 06:00 MHDA- 2021/11/25 06:00 CRDT- 2020/08/26 06:00 PHST- 2020/08/26 06:00 [pubmed] PHST- 2021/11/25 06:00 [medline] PHST- 2020/08/26 06:00 [entrez] AID - 10.1177/0267659120952057 [doi] PST - ppublish SO - Perfusion. 2021 Jul;36(5):491-500. doi: 10.1177/0267659120952057. Epub 2020 Aug 24. PMID- 32810549 OWN - NLM STAT- MEDLINE DCOM- 20210527 LR - 20210527 IS - 1874-1754 (Electronic) IS - 0167-5273 (Linking) VI - 323 DP - 2021 Jan 15 TI - Association of renal insufficiency with treatments and outcomes in patients with acute coronary syndrome in China. PG - 7-12 LID - S0167-5273(20)33549-X [pii] LID - 10.1016/j.ijcard.2020.08.022 [doi] AB - BACKGROUND: We aimed to analyze the association of estimated glomerular filtration rate (eGFR) levels of hospitalized patients with treatment decisions and clinical outcomes in Chinese patients with acute coronary syndrome (ACS). METHODS: This was a secondary analysis study from CPACS-2 Program which was a trial of a quality improvement intervention in China and recruited 15,141 patients from 75 hospitals between October 2007 and August 2010. All patients were divided into three groups by the eGFR level on admission. The primary outcomes were several key performance indicators (KPIs) reflecting the management of ACS and the secondary outcomes were clinical outcomes. RESULTS: A total of 14,437 ACS patients were enrolled in this analysis. Among patients with reduced eGFR levels, fewer patients received appropriate medical therapy (p for trend <0.001) and fewer high-risk patients received coronary angiography (p for trend <0.001) compared to patients with a normal eGFR. Furthermore, 436 cases of death, 357 cases of cardiac death, 686 cases of major adverse cardiovascular events, and 198 cases of major bleeding episodes were reported. Patients with a worse eGFR level had significantly higher rates of death (p for trend <0.001), cardiac death (p for trend <0.001), major adverse cardiovascular events (p for trend <0.001) and major bleeding episodes (p for trend <0.001). CONCLUSION: Among Chinese ACS patients, those with renal insufficiency have a lower percentage of adherence to guideline-recommended treatments and worse clinical prognosis. Renal insufficiency is an important factor affecting guideline implementation in Chinese ACS patients. CLINICAL TRIAL REGISTRATION: http://www.anzctr.org.au/default.aspx. Unique identifier: ACTRN12609000491268. CI - Copyright (c) 2020 Elsevier B.V. All rights reserved. FAU - Peng, Yong AU - Peng Y AD - Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China; The George Institute for Global Health, University of New South Wales, Sydney, Australia. FAU - Du, Xin AU - Du X AD - The George Institute for Global Health at Peking University Health Science Center, Beijing, China; Beijing Anzhen Hospital, Capital Medical University, Beijing, China. FAU - Li, Xian AU - Li X AD - The George Institute for Global Health at Peking University Health Science Center, Beijing, China. FAU - Ji, Jiachao AU - Ji J AD - The George Institute for Global Health at Peking University Health Science Center, Beijing, China. FAU - Wu, Yangfeng AU - Wu Y AD - The George Institute for Global Health at Peking University Health Science Center, Beijing, China; Clinical Research Institute, Peking University Health Science Center, Beijing, China. FAU - Gao, Runlin AU - Gao R AD - The Department of Cardiology, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Patel, Anushka AU - Patel A AD - The George Institute for Global Health, University of New South Wales, Sydney, Australia. Electronic address: apatel@georgeinstitute.org. CN - Clinical Pathways for Acute Coronary Syndromes in China (CPACS) Investigators LA - eng PT - Journal Article DEP - 20200815 PL - Netherlands TA - Int J Cardiol JT - International journal of cardiology JID - 8200291 SB - IM CIN - Int J Cardiol. 2021 Mar 15;327:36. doi: 10.1016/j.ijcard.2020.11.054. PMID: 33259873 CIN - Int J Cardiol. 2021 Apr 15;329:49. doi: 10.1016/j.ijcard.2020.12.069. PMID: 33388400 MH - *Acute Coronary Syndrome/diagnosis/epidemiology/therapy MH - China/epidemiology MH - Humans MH - *Percutaneous Coronary Intervention MH - *Renal Insufficiency/diagnosis/epidemiology/therapy MH - Treatment Outcome OTO - NOTNLM OT - Acute coronary syndrome OT - Clinical pathways OT - Key performance indicators OT - Renal insufficiency EDAT- 2020/08/19 06:00 MHDA- 2021/05/28 06:00 CRDT- 2020/08/19 06:00 PHST- 2020/02/11 00:00 [received] PHST- 2020/07/01 00:00 [revised] PHST- 2020/08/07 00:00 [accepted] PHST- 2020/08/19 06:00 [pubmed] PHST- 2021/05/28 06:00 [medline] PHST- 2020/08/19 06:00 [entrez] AID - S0167-5273(20)33549-X [pii] AID - 10.1016/j.ijcard.2020.08.022 [doi] PST - ppublish SO - Int J Cardiol. 2021 Jan 15;323:7-12. doi: 10.1016/j.ijcard.2020.08.022. Epub 2020 Aug 15. PMID- 32773223 OWN - NLM STAT- MEDLINE DCOM- 20201110 LR - 20201110 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 132 DP - 2020 Oct 1 TI - Association Between Triglycerides and Residual Cardiovascular Risk in Patients With Type 2 Diabetes Mellitus and Established Cardiovascular Disease (From the Bypass Angioplasty Revascularization Investigation 2 Diabetes [BARI 2D] Trial). PG - 36-43 LID - S0002-9149(20)30673-1 [pii] LID - 10.1016/j.amjcard.2020.07.005 [doi] AB - Triglyceride (TG) levels encompass several lipoproteins that have been implicated in atherogenic pathways. Whether TG levels independently associate with cardiovascular disease both overall and, in particular among patients with established coronary artery disease (CAD) and type 2 diabetes (T2DM), remains controversial. Data from the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) trial was used to evaluate patients with T2DM and CAD. Cox proportional hazards models were used to determine the association between TG levels and outcomes. Stepwise adjustment was performed for demographics, clinical factors, lipid profile and statin treatment. The primary composite outcome was time to CV death, myocardial infarction (MI), or stroke and secondary outcome was CV death. Among 2,307 patients with T2DM and CAD, the mean (+/-SD) TG levels were 181 (+/-136) with a median (Q1-Q3) 148mg/dL (104-219). Overall, 51% of patients had TG <150 mg/dL, 18% 150-199 mg/dL, 28% 200-499 mg/dL and 3% >/=500 mg/dL. Participants with elevated TG levels (>/=150 mg/dL) were younger (61 vs 63 years, p <0.001), had higher BMI (32 vs 30 kg/m(2), p <0.001), more likely to have had prior MI (34.2 vs 30.1%, p = 0.033) and revascularization (25.8 vs 21.4%, p = 0.013), had lower HDL-C (34 vs 39 mg/dL, p <0.001) and higher HbA1c (8 vs 7%, p <0.001). In unadjusted analyses, baseline TG levels were linearly associated with both the primary composite and secondary outcomes. In fully adjusted analyses, every 50 mg/dL increase in TG level was associated with a 3.8% (HR 1.038, 95%CI 1.004-1.072, p <0.001) increase in the primary composite outcome and a 6.4% (HR 1.064 95%CI 1.018-1.113, p <0.001) increase in the secondary outcome. There was no interaction between TG and outcomes within key subgroups including female sex, additional non-coronary atherosclerotic disease, CKD or low LDL (<100 mg/dL). In conclusion, among patients with T2DM and CAD, elevated TG were independently associated with adverse cardiovascular outcomes, even after adjustment for clinical and simple biochemical covariates. CI - Copyright (c) 2020 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Nelson, Adam J AU - Nelson AJ AD - Duke Clinical Research Institute, Duke University, Durham, North Carolina. FAU - Navar, Ann Marie AU - Navar AM AD - Duke Clinical Research Institute, Duke University, Durham, North Carolina. FAU - Mulder, Hillary AU - Mulder H AD - Duke Clinical Research Institute, Duke University, Durham, North Carolina. FAU - Wojdyla, Daniel AU - Wojdyla D AD - Duke Clinical Research Institute, Duke University, Durham, North Carolina. FAU - Philip, Sephy AU - Philip S AD - Amarin Pharma Inc., Bridgewater, New Jersey. FAU - Granowitz, Craig AU - Granowitz C AD - Amarin Pharma Inc., Bridgewater, New Jersey. FAU - Peterson, Eric D AU - Peterson ED AD - Duke Clinical Research Institute, Duke University, Durham, North Carolina. FAU - Pagidipati, Neha J AU - Pagidipati NJ AD - Duke Clinical Research Institute, Duke University, Durham, North Carolina. Electronic address: Neha.pagidipati@duke.edu. LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20200712 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 RN - 0 (Biomarkers) RN - 0 (Triglycerides) SB - IM MH - Aged MH - Biomarkers/blood MH - Cardiovascular Diseases/*epidemiology/etiology/surgery MH - *Coronary Angiography MH - Diabetes Mellitus, Type 2/blood/*complications/epidemiology MH - Humans MH - Incidence MH - Male MH - Middle Aged MH - Prognosis MH - Risk Assessment/*methods MH - Risk Factors MH - Survival Rate/trends MH - Triglycerides/*blood MH - United States/epidemiology EDAT- 2020/08/11 06:00 MHDA- 2020/11/11 06:00 CRDT- 2020/08/11 06:00 PHST- 2020/04/26 00:00 [received] PHST- 2020/07/01 00:00 [revised] PHST- 2020/07/03 00:00 [accepted] PHST- 2020/08/11 06:00 [pubmed] PHST- 2020/11/11 06:00 [medline] PHST- 2020/08/11 06:00 [entrez] AID - S0002-9149(20)30673-1 [pii] AID - 10.1016/j.amjcard.2020.07.005 [doi] PST - ppublish SO - Am J Cardiol. 2020 Oct 1;132:36-43. doi: 10.1016/j.amjcard.2020.07.005. Epub 2020 Jul 12. PMID- 32773222 OWN - NLM STAT- MEDLINE DCOM- 20201110 LR - 20201110 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 132 DP - 2020 Oct 1 TI - Effects of Atrial Fibrillation and Chronic Kidney Disease on Major Adverse Cardiovascular Events. PG - 72-78 LID - S0002-9149(20)30672-X [pii] LID - 10.1016/j.amjcard.2020.07.004 [doi] AB - Atrial fibrillation (AF) is strongly linked to chronic kidney disease (CKD) and both of these conditions contribute to poor cardiovascular outcomes. We evaluated the impact of renal failure on major adverse cardiovascular events (MACE) in AF, and predictive value of the 2MACE score in this post-hoc analysis of the AMADEUS trial. The primary endpoint was MACE (composite of myocardial infarction, cardiac revascularisation and cardiovascular mortality). Secondary endpoints included the composite of stroke, major bleeding and non-cardiovascular mortality, and each of the specific outcomes separately. Of the 4,554 patients, 1,526 (33.5%) were females and the median age was 71 (IQR 64 to 77) years. There were 3,838 (84.3%) non-CKD and 716 (15.7%) CKD patients. The incidence of cardiovascular and non-cardiovascular mortality were 1.41% and 2.44% per 100 patient-years, respectively. There was no significant difference in crude study endpoints between the groups. Multivariable regression analysis found no association between CKD and MACE (HR 1.03 [95% CI, 0.45 to 2.34]). The c-index of the 2MACE score for MACE was 0.65 (95% CI, 0.59 to 0.71, p <0.001). In the presence of CKD, each additional point of the 2MACE score contributed to a greater risk of MACE (HR 3.17 [95% CI, 1.28 to 7.85] vs 1.48 [95% CI, 1.17 to 1.87] in the non-CKD group). In conclusion, the 2MACE score may be a useful tool for clinical risk stratification of high-risk AF patients with CKD and those at high MACE risk could be targeted for more intensive cardiovascular prevention strategies. The presence of CKD was not found to be independently associated with MACE in AF patients. CI - Copyright (c) 2020 Elsevier Inc. All rights reserved. FAU - Ding, Wern Yew AU - Ding WY AD - Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom (WYD, GYHL, AS). FAU - Lip, Gregory Y H AU - Lip GYH AD - Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom (WYD, GYHL, AS); Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark (GYHL). Electronic address: gregory.lip@liverpool.ac.uk. FAU - Pastori, Daniele AU - Pastori D AD - Department of Clinical, Internal Medicine, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy (DP). FAU - Shantsila, Alena AU - Shantsila A AD - Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom (WYD, GYHL, AS). LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20200711 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM MH - Aged MH - Atrial Fibrillation/*complications MH - Europe/epidemiology MH - Female MH - Follow-Up Studies MH - Humans MH - Incidence MH - Male MH - Middle Aged MH - Renal Insufficiency, Chronic/*epidemiology/etiology MH - Risk Assessment/*methods MH - Risk Factors MH - Survival Rate/trends EDAT- 2020/08/11 06:00 MHDA- 2020/11/11 06:00 CRDT- 2020/08/11 06:00 PHST- 2020/06/03 00:00 [received] PHST- 2020/07/04 00:00 [revised] PHST- 2020/07/08 00:00 [accepted] PHST- 2020/08/11 06:00 [pubmed] PHST- 2020/11/11 06:00 [medline] PHST- 2020/08/11 06:00 [entrez] AID - S0002-9149(20)30672-X [pii] AID - 10.1016/j.amjcard.2020.07.004 [doi] PST - ppublish SO - Am J Cardiol. 2020 Oct 1;132:72-78. doi: 10.1016/j.amjcard.2020.07.004. Epub 2020 Jul 11. PMID- 32770957 OWN - NLM STAT- MEDLINE DCOM- 20211018 LR - 20211018 IS - 1471-2369 (Electronic) IS - 1471-2369 (Linking) VI - 21 IP - 1 DP - 2020 Aug 8 TI - Hospital costs and prognosis in end-stage renal disease patients receiving coronary artery bypass grafting. PG - 333 LID - 10.1186/s12882-020-01972-w [doi] LID - 333 AB - BACKGROUND: Coronary artery disease is common in patients with end-stage renal disease (ESRD). Patients with ESRD are a high-risk group for cardiac surgery and have increased morbidity and mortality. Most studies comparing ESRD patients receiving coronary artery bypass grafting (CABG) or percutaneous coronary intervention have found that the long-term survival is good in ESRD patients after CABG. The aim of our study was to compare ESRD patients who underwent CABG with the general population who underwent CABG, in terms of prognosis and hospital costs. METHODS: This study analyzed data from the National Health Insurance Research Database in Taiwan for patients who were diagnosed with ESRD and received CABG (ICD-9-CM codes 585 or 586) between January 1, 2004, and December 31, 2009. The ESRD patients included in this study all received catastrophic illness cards with the major illness listed as ESRD from the Ministry of Health and Welfare in Taiwan. The control subjects were randomly selected patients without ESRD after propensity score matching with ESRD patients according to age, gender, and comorbidities at a 2:1 ratio from the same dataset. RESULTS: A total of 48 ESRD patients received CABG, and their mean age was 62.04 +/- 10.04 years. Of these patients, 29.2% were aged >/=70 years, and 66.7% were male. ESRD patients had marginally higher intensive care unit (ICU) stays (11.06 vs 7.24 days) and significantly higher ICU costs (28,750 vs 17,990 New Taiwan Dollars (NTD)) than non-ESRD patients. Similarly, ESRD patients had significantly higher surgical costs (565,200 vs. 421,890 NTD), a higher perioperative mortality proportion (10.4% vs 2.1%) and a higher postoperative mortality proportion (33.3% vs 11.5%) than non-ESRD patients. CONCLUSIONS: After CABG, ESRD patients had a higher risk of mortality than non-ESRD patients, and ICU and surgery costs were also higher among the ESRD patients than among patients without ESRD. FAU - Liao, Kuang-Ming AU - Liao KM AD - Department of Internal Medicine, Chi Mei Medical Center, Chiali, Taiwan. FAU - Kuo, Lu-Ting AU - Kuo LT AD - Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan. FAU - Lu, Hsueh-Yi AU - Lu HY AD - Department of Industrial Engineering and Management, National Yunlin University of Science and Technology, Yunlin, Taiwan. hylu@yuntech.edu.tw. LA - eng GR - CCFHR10701/Chi Mei Medical Center/International PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20200808 PL - England TA - BMC Nephrol JT - BMC nephrology JID - 100967793 SB - IM MH - Adult MH - Aged MH - Case-Control Studies MH - Coronary Artery Bypass/*economics MH - Coronary Artery Disease/complications/economics/*surgery MH - Female MH - Health Expenditures MH - *Hospital Costs MH - Humans MH - Intensive Care Units/economics MH - Kidney Failure, Chronic/complications/*therapy MH - Length of Stay/economics MH - Male MH - Middle Aged MH - Prognosis MH - Respiration, Artificial/economics PMC - PMC7414285 OTO - NOTNLM OT - Coronary artery bypass grafting OT - End-stage renal disease OT - Hospital costs OT - Prognosis COIS- The authors declare that they have no competing interests. EDAT- 2020/08/11 06:00 MHDA- 2021/10/21 06:00 PMCR- 2020/08/08 CRDT- 2020/08/11 06:00 PHST- 2019/02/23 00:00 [received] PHST- 2020/07/21 00:00 [accepted] PHST- 2020/08/11 06:00 [entrez] PHST- 2020/08/11 06:00 [pubmed] PHST- 2021/10/21 06:00 [medline] PHST- 2020/08/08 00:00 [pmc-release] AID - 10.1186/s12882-020-01972-w [pii] AID - 1972 [pii] AID - 10.1186/s12882-020-01972-w [doi] PST - epublish SO - BMC Nephrol. 2020 Aug 8;21(1):333. doi: 10.1186/s12882-020-01972-w. PMID- 32726228 OWN - NLM STAT- MEDLINE DCOM- 20210316 LR - 20210316 IS - 1522-6662 (Electronic) IS - 1098-3511 (Linking) VI - 23 IP - 4 DP - 2020 Jun 12 TI - Investigation of the Effect of Pulsatile and Nonpulsatile Flow on Kidney in Coronary Surgery With NIRS. PG - E401-E406 LID - 10.1532/hsf.2341 [doi] AB - BACKGROUND: Acute renal insufficiency is a significant cause of morbidity and mortality after coronary artery bypass grafting performed with cardiopulmonary bypass. Functional near-infrared spectroscopy (fNIRS) is an emerging brain-imaging technique that can be used to detect organ perfusions in adults. This study aims to determine the effects of pulsatile and nonpulsatile flow on renal circulation by using functional near-infrared spectroscopy and biochemical markers. METHODS: Forty patients, who had undergone isolated CABG between March 2014 and July 2014 in the authors' clinic, were included in the study. Patients were divided in the pulsatile and nonpulsatile groups by simple randomization. RESULTS: Urine outputs statistically were higher in the pulsatile group, during CPB (P = .045). Renal perfusion measurements via fNIRS intra-operatively statistically were parallel between the groups. When we compared biochemical markers within the groups, in the nonpulsatile group, creatinin statistically is higher on the postoperative first day (P = .003), and BUN statistically is higher on the postoperative first (P = .015), second (P = .001), and fifth (P = .020) days, according to preoperative value. In the pulsatile group, only the postoperative second day BUN is higher (P = .007). CONCLUSION: fNIRS is being used to track cerebral functions. During operation, it also provides a correct observation for blood feeding of somatic organs, such as the kidneys, but it requires more clinical study to be accepted as routine. FAU - Borulu, Ferhat AU - Borulu F AD - Department of Cardiovascular Surgery, Ataturk University Faculty of Medicine, Erzurum, Turkey. fborulu@gmail.com. FAU - Hanedan, Muhammet Onur AU - Hanedan MO AD - Department of Cardiovascular Surgery, University of Health Sciences Ahi Evren Education and Researches Hospital, Trabzon, Turkey. ohanedan@hotmail.com. FAU - Coskun, Ceyhun AU - Coskun C AD - Department of Cardiovascular Surgery, Yalvac Public Hospital, Isparta, Turkey. dr.ceyhuncoskun@hotmail.com. FAU - Emir, Izzet AU - Emir I AD - Department of Cardiovascular Surgery, Erzincan University, Faculty of Medicine, Erzincan, Turkey. dr.izzetemir@hotmail.com. FAU - Mataraci, Ilker AU - Mataraci I AD - Department of Cardiovascular Surgery, University of Health Sciences Ahi Evren Education and Researches Hospital, Trabzon, Turkey. imataraci@gmail.com. LA - eng PT - Journal Article DEP - 20200612 PL - United States TA - Heart Surg Forum JT - The heart surgery forum JID - 100891112 SB - IM MH - Acute Kidney Injury/diagnosis/etiology/*physiopathology MH - Coronary Artery Bypass/*adverse effects MH - Coronary Artery Disease/*surgery MH - Female MH - Follow-Up Studies MH - Humans MH - Kidney/*blood supply/diagnostic imaging MH - Male MH - Middle Aged MH - Postoperative Period MH - Pulsatile Flow/*physiology MH - Retrospective Studies MH - Spectroscopy, Near-Infrared/*methods MH - Ultrasonography, Doppler/methods EDAT- 2020/07/30 06:00 MHDA- 2021/03/17 06:00 CRDT- 2020/07/30 06:00 PHST- 2018/12/03 00:00 [received] PHST- 2020/03/30 00:00 [accepted] PHST- 2020/07/30 06:00 [entrez] PHST- 2020/07/30 06:00 [pubmed] PHST- 2021/03/17 06:00 [medline] AID - 10.1532/hsf.2341 [doi] PST - epublish SO - Heart Surg Forum. 2020 Jun 12;23(4):E401-E406. doi: 10.1532/hsf.2341. PMID- 32720618 OWN - NLM STAT- MEDLINE DCOM- 20200730 LR - 20260127 IS - 0022-9040 (Print) IS - 0022-9040 (Linking) VI - 60 IP - 6 DP - 2020 Jul 7 TI - [Effect of empagliflosin on renal filtration in patients with coronary heart disease undergoing percutaneous coronary intervention]. PG - 825 LID - 10.18087/cardio.2020.6.n825 [doi] AB - Aim To evaluate the effect of empagliflozin on glycemia and renal filtration function in patients with stable ischemic heart disease (IHD) and type 2 diabetes mellitus (DM2) who underwent a percutaneous coronary intervention (PCI).Materials and methods This study included 40 patients with stable IHD and DM2 (age, 63 (58; 65) years; DM2 duration, 7 (4; 15) years) who had indications for an elective PCI. At baseline in the total sample, the level of glycated hemoglobin was 7.2 (6.5; 8.3)%; 48.7 % failed to achieve glycemic goals. A decrease in glomerular filtration rate (GFR) to below 60 ml/min/1.73 m2 was observed in 10.3 % of patients. All patients were divided into two group by simple randomization with successively assigned numbers. The main group consisted of 20 patients who received empagliflozin 10 mg/day in addition to their previous hypoglycemic therapy irrespective of their baseline glycemic control. Patients of the comparison group (n=20) continued on their previous hypoglycemic therapy as prescribed by their endocrinologist. The follow-up duration was 6 months. Statistical analysis was performed with the Statistica 10.0 software.Results The empagliflozin treatment improved the glycemic control; in the comparison group, no significant changes in glycemic control were observed. In both groups, GFR significantly decreased during the follow-up period; median decreases in GFR were -6.0 (-16.0; 4.0) and -8.4 (-26.5; 2.5) ml/min / 1.73 m2 in the main and comparison groups, respectively (p = 0.646). No significant changes in 24-h proteinuria were observed for patients taking empagliflozin. In the control group, the 24-h urinary protein excretion significantly progressed (p=0.011) during the follow-up period.Conclusion In patients with DM2 and stable IHD who underwent a PCI, addition of empagliflozin 10 mg/day to their current hypoglycemic therapy was associated with a significant improvement of glycemic control. The decrease in GFR during the empagliflozin treatment did not significantly differ from the value for patient receiving the other hypoglycemic therapy. FAU - Khorlampenko, A A AU - Khorlampenko AA AD - Federal State Budgetary Institution of Higher Professional Education Kemerovo State Medical University of the Ministry of Healthcare of the Russian Federation, Kemerovo, Russia. FAU - Karetnikova, V N AU - Karetnikova VN AD - Federal State Budgetary Institution of Higher Professional Education Kemerovo State Medical University of the Ministry of Healthcare of the Russian Federation, Kemerovo, Russia. FAU - Kochergina, A M AU - Kochergina AM AD - Federal State Budgetary Institution of Higher Professional Education Kemerovo State Medical University of the Ministry of Healthcare of the Russian Federation, Kemerovo, Russia. FAU - Ignatova, J S AU - Ignatova JS AD - Federal State Budgetary Institution of Higher Professional Education Kemerovo State Medical University of the Ministry of Healthcare of the Russian Federation, Kemerovo, Russia. FAU - Dyleva, J A AU - Dyleva JA AD - Federal State Budgetary Institution Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russia. FAU - Gruzdeva, O V AU - Gruzdeva OV AD - Federal State Budgetary Institution Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russia. FAU - Barbarash, O L AU - Barbarash OL AD - Federal State Budgetary Institution Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russia. LA - rus PT - Journal Article PT - Randomized Controlled Trial DEP - 20200707 PL - Russia (Federation) TA - Kardiologiia JT - Kardiologiia JID - 0376351 RN - 0 (Glycated Hemoglobin) RN - 0 (Hypoglycemic Agents) SB - IM MH - Aged MH - *Coronary Disease MH - Diabetes Mellitus, Type 2 MH - Glomerular Filtration Rate MH - Glycated Hemoglobin MH - Humans MH - Hypoglycemic Agents MH - Middle Aged MH - *Percutaneous Coronary Intervention EDAT- 2020/07/29 06:00 MHDA- 2020/07/31 06:00 CRDT- 2020/07/29 06:00 PHST- 2019/09/17 00:00 [received] PHST- 2020/04/19 00:00 [accepted] PHST- 2020/04/14 00:00 [revised] PHST- 2020/07/29 06:00 [entrez] PHST- 2020/07/29 06:00 [pubmed] PHST- 2020/07/31 06:00 [medline] AID - 10.18087/cardio.2020.6.n825 [doi] PST - epublish SO - Kardiologiia. 2020 Jul 7;60(6):825. doi: 10.18087/cardio.2020.6.n825. PMID- 32720602 OWN - NLM STAT- MEDLINE DCOM- 20220105 LR - 20220105 IS - 1875-6212 (Electronic) IS - 1570-1611 (Linking) VI - 19 IP - 5 DP - 2021 TI - Have We Learnt all from IMPROVE-IT? Part I. Core Results and Subanalyses on the Effects of Ezetimibe Added to Statin Therapy Related to Age, Gender and Selected Chronic Diseases (Kidney Disease, Diabetes Mellitus and Non-Alcoholic Fatty Liver Disease). PG - 451-468 LID - 10.2174/1570161118999200727224946 [doi] AB - IMPROVE-IT (IMProved Reduction of Outcomes: Vytorin Efficacy International Trial) was a randomized clinical trial (including 18,144 patients) that evaluated the efficacy of the combination of ezetimibe with simvastatin vs. simvastatin monotherapy in patients with acute coronary syndrome (ACS) and moderately increased low-density lipoprotein cholesterol (LDL-C) levels (of up to 2.6-3.2 mmol/L; 100-120 mg/dL). After 7 years of follow-up, combination therapy resulted in an additional LDL-C decrease [to 1.8 mmol/L, or 70 mg/dL, within the simvastatin (40 mg/day) monotherapy arm and to 1.4 mmol/L, or 53 mg/dL for simvastatin (40 mg/day) + ezetimibe (10 mg/day)] and showed an incremental clinical benefit [composite of cardiovascular death, nonfatal myocardial infarction, unstable angina requiring rehospitalization, coronary revascularization (>/=30 days after randomization), or nonfatal stroke; hazard ratio (HR) of 0.936, and 95% CI 0.887-0.996, p=0.016]. Therefore, for very high cardiovascular risk patients "even lower is even better" regarding LDL-C, independently of the LDL-C reducing strategy. These findings confirm ezetimibe as an option to treat very-high-risk patients who cannot achieve LDL-C targets with statin monotherapy. Additional analyses of the IMPROVE-IT (both prespecified and post-hoc) include specific very-high-risk subgroups of patients (those with previous acute events and/or coronary revascularization, older than 75 years, as well as patients with diabetes mellitus, chronic kidney disease or non-alcoholic fatty liver disease). The data from IMPROVE-IT also provide reassurance regarding longer-term safety and efficacy of the intensification of lipid-lowering therapy in very-high-risk patients resulting in very low LDL-C levels. We comment on the results of several (sub) analyses of IMPROVE-IT. CI - Copyright(c) Bentham Science Publishers; For any queries, please email at epub@benthamscience.net. FAU - Fras, Zlatko AU - Fras Z AD - Centre for Preventive Cardiology, Department of Vascular Medicine, Division of Medicine, University Medical Centre, Ljubljana, Slovenia. FAU - Mikhailidis, Dimitri P AU - Mikhailidis DP AD - Department of Clinical Biochemistry, Royal Free Hospital Campus, University College Medical School, University College London, London, United Kingdom. LA - eng PT - Journal Article PT - Randomized Controlled Trial PL - United Arab Emirates TA - Curr Vasc Pharmacol JT - Current vascular pharmacology JID - 101157208 RN - 0 (Anticholesteremic Agents) RN - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors) RN - AGG2FN16EV (Simvastatin) RN - EOR26LQQ24 (Ezetimibe) SB - IM MH - Aged MH - Anticholesteremic Agents/adverse effects MH - *Chronic Disease/drug therapy MH - Diabetes Mellitus/drug therapy MH - Drug Therapy, Combination/adverse effects MH - *Ezetimibe/adverse effects MH - Female MH - Humans MH - *Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects MH - Kidney Diseases/drug therapy MH - Male MH - Non-alcoholic Fatty Liver Disease/drug therapy MH - Simvastatin/adverse effects MH - Treatment Outcome OTO - NOTNLM OT - Acute coronary syndrome OT - IMPROVE-IT Trial. OT - combination therapy OT - ezetimibe OT - low-density lipoprotein cholesterol-lowering OT - secondary prevention OT - simvastatin EDAT- 2020/07/29 06:00 MHDA- 2022/01/06 06:00 CRDT- 2020/07/29 06:00 PHST- 2020/06/07 00:00 [received] PHST- 2020/06/23 00:00 [revised] PHST- 2020/07/03 00:00 [accepted] PHST- 2020/07/29 06:00 [pubmed] PHST- 2022/01/06 06:00 [medline] PHST- 2020/07/29 06:00 [entrez] AID - CVP-EPUB-108545 [pii] AID - 10.2174/1570161118999200727224946 [doi] PST - ppublish SO - Curr Vasc Pharmacol. 2021;19(5):451-468. doi: 10.2174/1570161118999200727224946. PMID- 32702903 OWN - NLM STAT- MEDLINE DCOM- 20200803 LR - 20240731 IS - 1536-5964 (Electronic) IS - 0025-7974 (Print) IS - 0025-7974 (Linking) VI - 99 IP - 29 DP - 2020 Jul 17 TI - Clinical outcomes following polymer-free sirolimus-eluting stent implantations in unselected patients: A descriptive subgroup analysis in patients with renal impairment. PG - e21244 LID - 10.1097/MD.0000000000021244 [doi] LID - e21244 AB - Patients with chronic kidney disease (CKD are frequently excluded from coronary artery disease trials. The aim of this assessment was to study the clinical outcomes of polymer-free sirolimus-eluting stent implantations in patients with impaired renal function.Large-scale, international, single-armed, multicenter, 'all comers' observational studies (ClinicalTrials.gov Identifier: NCT02629575 and NCT02905214) were used for this post-hoc subgroup analysis to compare the clinical outcomes in patients with normal renal function (NRF) to those with renal insufficiency (CKD, dialysis dependence). The accumulated target lesion revascularization rate was the primary endpoint at 9 to 12 months whereas the accumulated major adverse cardiac event, stent thrombosis (ST) and procedural success rates were part of the secondary endpoints.There were 6791 patients with NRF, whereas 369 patients had CKD and 83 patients were dialysis dependent. The target lesion revascularization rate at 9 to 12 months was significantly higher in dialysis patients (2.1% vs 3.3% vs 6.7%, P = .011). The accumulated major adverse cardiac events rates in the dialysis and in the CKD group were significantly higher as compared to patients with NRF (13.3% vs 4.0%, P < .001; 6.5% vs 4.0%, P = .024). Finally, ST rates (NRF: 0.7%, CKD: 0.6%, dialysis: 1.3%) were not statistically different between subgroups (P = .768). All-cause cumulative mortality rates were 3.3% (CKD) and 4.0% (dialysis) respectively.Percutaneous coronary interventions with polymer-free, ultra-thin strut sirolimus-eluting stents have comparable revascularization rates in CKD and dialysis dependent patients as compared to percutaneous coronary interventions with other 2nd generation drug-eluting stents. ST and all-cause mortality rates were low as compared to available literature references. FAU - Krackhardt, Florian AU - Krackhardt F AUID- ORCID: 0000-0001-5965-8817 AD - Charite Universitatsmedizin, Internal Medicine and Cardiology, Campus Virchow. FAU - Waliszewski, Matthias W AU - Waliszewski MW AUID- ORCID: 0000-0002-8689-4505 AD - Charite Universitatsmedizin, Internal Medicine and Cardiology, Campus Virchow. AD - Department of Medical Scientific Affairs, Vascular Systems, Aesculap, B. Braun Melsungen AG, Berlin. FAU - Kherad, Behrouz AU - Kherad B AD - Charite Universitatsmedizin, Internal Medicine and Cardiology, Campus Virchow. FAU - Barth, Claudia AU - Barth C AD - Department of Medical Scientific Affairs, Avitum, B.Braun Melsungen AG, Melsungen, Germany. FAU - Marcelli, Daniele AU - Marcelli D AUID- ORCID: 0000-0002-7650-8578 AD - Department of Medical Scientific Affairs, Avitum, B.Braun Melsungen AG, Melsungen, Germany. LA - eng SI - ClinicalTrials.gov/NCT02905214 SI - ClinicalTrials.gov/NCT02629575 PT - Journal Article PT - Multicenter Study PT - Observational Study PL - United States TA - Medicine (Baltimore) JT - Medicine JID - 2985248R RN - W36ZG6FT64 (Sirolimus) SB - IM MH - Aged MH - Asia MH - Coronary Artery Disease/mortality/*surgery MH - *Drug-Eluting Stents MH - Europe MH - Female MH - Humans MH - Male MH - Prosthesis Design MH - *Renal Insufficiency MH - *Sirolimus MH - Treatment Outcome PMC - PMC7373567 COIS- FK received lecture fees from B.Braun and AstraZeneca, MW, CB, and DM are employees of Medical Scientific Affairs B.Braun Melsungen AG. BK has no conflicts of interest EDAT- 2020/07/25 06:00 MHDA- 2020/08/04 06:00 PMCR- 2020/07/17 CRDT- 2020/07/25 06:00 PHST- 2020/07/25 06:00 [entrez] PHST- 2020/07/25 06:00 [pubmed] PHST- 2020/08/04 06:00 [medline] PHST- 2020/07/17 00:00 [pmc-release] AID - 00005792-202007170-00098 [pii] AID - MD-D-19-09559 [pii] AID - 10.1097/MD.0000000000021244 [doi] PST - ppublish SO - Medicine (Baltimore). 2020 Jul 17;99(29):e21244. doi: 10.1097/MD.0000000000021244. PMID- 32624464 OWN - NLM STAT- MEDLINE DCOM- 20210223 LR - 20230222 IS - 1969-6213 (Electronic) IS - 1774-024X (Print) IS - 1774-024X (Linking) VI - 16 IP - 14 DP - 2021 Feb 19 TI - High bleeding risk and clinical outcomes in East Asian patients undergoing percutaneous coronary intervention: the PENDULUM registry. PG - 1154-1162 LID - EIJ-D-20-00345 [pii] LID - 10.4244/EIJ-D-20-00345 [doi] AB - AIMS: We aimed to evaluate the validity of the Academic Research Consortium for High Bleeding Risk (ARC-HBR) criteria for East Asian patients undergoing contemporary percutaneous coronary intervention (PCI) from the PENDULUM registry. METHODS AND RESULTS: This post hoc analysis included 6,267 Japanese patients undergoing PCI between December 2015 and June 2017 enrolled in PENDULUM. The primary endpoint was the incidence of major bleeding at 12 months post index PCI. In total, 3,185 (50.8%) and 3,082 (49.2%) patients were stratified to the ARC-HBR and non-ARC-HBR groups, respectively, and almost all patients had overlapping criteria. Incidence of major bleeding was 4.2% versus 1.4% in the ARC-HBR group versus the non-ARC-HBR group (hazard ratio 3.00 [95% confidence interval: 2.11-4.27]; p<0.001). As the number of overlapping ARC-HBR criteria increased, the incidence of major bleeding also increased. In contrast, the incidence of major bleeding was 4.2% for one major criterion, 2.1% for two minor criteria. Multivariate analysis suggested that severe CKD, anticoagulant use, acute coronary syndrome, low body weight and heart failure were independent predictors of major bleeding. CONCLUSIONS: Half of the Japanese patients who underwent PCI in the PENDULUM registry met the ARC-HBR criteria, and many patients had overlapping criteria. ARC-HBR criteria are applicable to Japanese patients undergoing contemporary PCI. FAU - Nakamura, Masato AU - Nakamura M AD - Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan. FAU - Kadota, Kazushige AU - Kadota K FAU - Nakao, Koichi AU - Nakao K FAU - Nakagawa, Yoshihisa AU - Nakagawa Y FAU - Shite, Junya AU - Shite J FAU - Yokoi, Hiroyoshi AU - Yokoi H FAU - Kozuma, Ken AU - Kozuma K FAU - Tanabe, Kengo AU - Tanabe K FAU - Iijima, Raisuke AU - Iijima R FAU - Harada, Atsushi AU - Harada A FAU - Kuroda, Takeshi AU - Kuroda T FAU - Murakami, Yoshitaka AU - Murakami Y LA - eng PT - Journal Article PL - France TA - EuroIntervention JT - EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology JID - 101251040 RN - 0 (Platelet Aggregation Inhibitors) SB - IM MH - Hemorrhage/epidemiology MH - Humans MH - *Percutaneous Coronary Intervention/adverse effects MH - Platelet Aggregation Inhibitors MH - Registries MH - Risk Assessment MH - Risk Factors MH - Treatment Outcome PMC - PMC9725071 COIS- M. Nakamura has received grants from Daiichi Sankyo Co., Ltd., Sanofi K.K., and Bayer K.K., and other fees from Daiichi Sankyo Co., Ltd., Sanofi K.K., Terumo Corporation, and Bristol Myers Squibb K.K. K. Kadota has received personal fees from Daiichi Sankyo Co., Ltd., and Sanofi K.K. K. Nakao has received personal fees from Daiichi Sankyo Co., Ltd. Y. Nakagawa has received personal fees from Bristol Myers Squibb K.K. and Kowa Pharmaceutical Co., Ltd., and grants and personal fees from Daiichi Sankyo Co., Ltd., Bayer Yakuhin, Ltd., Sanofi K.K., Boston Scientific Corporation, and Abbott Vascular Japan Co., Ltd. J. Shite has received personal fees from Daiichi Sankyo Co., Ltd., Nipro, Abbott, and Terumo Corporation. H. Yokoi has received personal fees from Daiichi Sankyo Co., Ltd., Bayer K.K., and Sanofi K.K. K. Kozuma has received grants and personal fees from Daiichi Sankyo Co., Ltd. K. Tanabe has received personal fees from Daiichi Sankyo Co., Ltd., Sanofi K.K., AstraZeneca, Abbott Vascular Japan, Co., Ltd., Boston Scientific Corporation, and Terumo Corporation. R. Iijima has received personal fees from Daiichi Sankyo Co., Ltd. A. Harada and T. Kuroda are employees of Daiichi Sankyo Co., Ltd. Y. Murakami has received personal fees from Daiichi Sankyo Co., Ltd., SRD Co., Ltd., and Sanofi K.K. EDAT- 2020/07/07 06:00 MHDA- 2021/02/24 06:00 PMCR- 2022/02/19 CRDT- 2020/07/07 06:00 PHST- 2020/07/07 06:00 [pubmed] PHST- 2021/02/24 06:00 [medline] PHST- 2020/07/07 06:00 [entrez] PHST- 2022/02/19 00:00 [pmc-release] AID - EIJ-D-20-00345 [pii] AID - 10.4244/EIJ-D-20-00345 [doi] PST - ppublish SO - EuroIntervention. 2021 Feb 19;16(14):1154-1162. doi: 10.4244/EIJ-D-20-00345. PMID- 32622913 OWN - NLM STAT- MEDLINE DCOM- 20210714 LR - 20210714 IS - 1444-2892 (Electronic) IS - 1443-9506 (Linking) VI - 30 IP - 2 DP - 2021 Feb TI - Clinical Outcomes in Older Patients Undergoing Percutaneous Coronary Intervention for Non-ST-Elevation Acute Coronary Syndromes. PG - 275-281 LID - S1443-9506(20)30273-0 [pii] LID - 10.1016/j.hlc.2020.05.102 [doi] AB - BACKGROUND: Distinguishing the subgroup of older, comorbid patients presenting with non-ST-elevation acute coronary syndromes (NSTEACS) who will benefit from percutaneous coronary intervention (PCI) remains challenging. Identifying risk factors for major adverse cardiac or cerebrovascular events (MACCE) post PCI may help define this cohort. The objective of this study was to describe contemporary outcomes of older patients with NSTEACS undergoing PCI and identify pre-procedural risk factors for MACCE. METHODS: We retrospectively reviewed data for 1,875 patients aged >/=80 years entered in the Victorian Cardiac Outcomes Registry (VCOR) who underwent PCI for NSTEACS between 1 January 2013 and 31 December 2017. MACCE was a composite outcome comprising 30-day mortality, myocardial infarction, stroke, major bleeding, target lesion revascularisation or target vessel revascularisation; in-hospital cardiogenic shock or stent thrombosis; and new requirement for dialysis. Patient demographic data and pre-procedural comorbidities were compared between the groups with and without a MACCE. RESULTS: The rate of MACCE at 30 days was 8.0% (n=150). Thirty-day (30-day) mortality was 3.0% (n=57). Pre-procedural left ventricular ejection fraction (LVEF)<45% (OR 2.32; 95% CI 1.47-3.68; p<0.001) and eGFR/=3b CKD are eligible if the diagnosis of ACS is made and invasive strategy scheduled. Patients are randomized 1:1 between a control group with a 600-mg loading dose of clopidogrel followed by a 75-mg/d maintenance dose for 1 year and an experimental group with a 180-mg loading dose of ticagrelor followed by a 90-mg twice daily maintenance dose for the same duration. The primary end point is defined by the rate of major adverse cardiovascular events, including death, myocardial infarction, urgent revascularization, and stroke at 1 year. Safety will be evaluated by the bleeding rate (Bleeding Academic Research Consortium). To demonstrate the superiority of ticagrelor on major adverse cardiovascular events, we calculated that 508 patients are required. The aim of the TROUPER trial is to compare the efficacy of ticagrelor and clopidogrel in stage >3b CKD patients presenting with ACS and scheduled for an invasive strategy. RCT# NCT03357874. CI - Copyright (c) 2020 Elsevier Inc. All rights reserved. FAU - Laine, Marc AU - Laine M AD - Aix-Marseille Univ, Intensive cardiac care unit, Assistance Publique-Hopitaux de Marseille, Hopital Nord, Marseille, France; Mediterranean Association for Research and Studies in Cardiology (MARS Cardio), Marseille, France; Aix Marseille Univ, INSERM, INRA, C2VN, Marseille, France. Electronic address: marc.laine@ap-hm.fr. FAU - Lemesle, Gilles AU - Lemesle G AD - Institut Coeur et Poumon, CHRU de Lille, Faculte de Medecine de l'Universite de Lille, Unite INSERM UMR 1011, Lille, France. FAU - Burtey, Stephane AU - Burtey S AD - Aix Marseille Univ, INSERM, INRA, C2VN, Marseille, France; Service de Nephrologie, Hopital de la Conception, Assistance Publique des Hopitaux de Marseille, Aix Marseille Universite, Marseille, France. FAU - Cayla, Guillaume AU - Cayla G AD - Departement de Cardiologie, CHU Nimes, Nimes, France. FAU - Range, Gregoire AU - Range G AD - Departement de Cardiologie, CHU Chartres, Chartres, France. FAU - Quaino, Gonzalo AU - Quaino G AD - Service de Cardiologie, Centre Hospitalier Toulon, Toulon, France. FAU - Canault, Matthias AU - Canault M AD - Aix Marseille Univ, INSERM, INRA, C2VN, Marseille, France. FAU - Pankert, Mathieu AU - Pankert M AD - Service de Cardiologie, Centre Hospitalier d'Avignon, Avignon, France. FAU - Paganelli, Franck AU - Paganelli F AD - Aix-Marseille Univ, Intensive cardiac care unit, Assistance Publique-Hopitaux de Marseille, Hopital Nord, Marseille, France; Mediterranean Association for Research and Studies in Cardiology (MARS Cardio), Marseille, France. FAU - Puymirat, Etienne AU - Puymirat E AD - Departement de Cardiologie, Hopital Europeen Georges Pompidou, Assistance Publique des Hopitaux de Paris, Universite Paris Descartes, INSERM U-970, Paris, France. FAU - Bonello, Laurent AU - Bonello L AD - Aix-Marseille Univ, Intensive cardiac care unit, Assistance Publique-Hopitaux de Marseille, Hopital Nord, Marseille, France; Mediterranean Association for Research and Studies in Cardiology (MARS Cardio), Marseille, France; Aix Marseille Univ, INSERM, INRA, C2VN, Marseille, France. LA - eng SI - ClinicalTrials.gov/NCT03357874 PT - Clinical Trial Protocol PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20200430 PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 RN - A74586SNO7 (Clopidogrel) RN - 0 (Platelet Aggregation Inhibitors) RN - GLH0314RVC (Ticagrelor) SB - IM MH - Adolescent MH - Adult MH - Aged MH - Female MH - Humans MH - Male MH - Middle Aged MH - Young Adult MH - *Acute Coronary Syndrome/complications/prevention & control/therapy MH - *Clopidogrel/adverse effects/therapeutic use MH - Hemorrhage/chemically induced MH - *Percutaneous Coronary Intervention MH - *Platelet Aggregation Inhibitors/adverse effects/therapeutic use MH - *Renal Insufficiency, Chronic/complications MH - Secondary Prevention MH - Thrombosis/prevention & control MH - *Ticagrelor/adverse effects/therapeutic use MH - Multicenter Studies as Topic MH - Prospective Studies MH - Randomized Controlled Trials as Topic EDAT- 2020/05/31 06:00 MHDA- 2020/07/17 06:00 CRDT- 2020/05/31 06:00 PHST- 2019/11/13 00:00 [received] PHST- 2020/04/20 00:00 [accepted] PHST- 2020/05/31 06:00 [pubmed] PHST- 2020/07/17 06:00 [medline] PHST- 2020/05/31 06:00 [entrez] AID - S0002-8703(20)30121-6 [pii] AID - 10.1016/j.ahj.2020.04.013 [doi] PST - ppublish SO - Am Heart J. 2020 Jul;225:19-26. doi: 10.1016/j.ahj.2020.04.013. Epub 2020 Apr 30. PMID- 32454863 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20220414 IS - 1741-427X (Print) IS - 1741-4288 (Electronic) IS - 1741-427X (Linking) VI - 2020 DP - 2020 TI - The Role of Xuefu Zhuyu Decoction in Prevention of Contrast-Induced Nephropathy after Percutaneous Coronary Intervention. PG - 5419016 LID - 10.1155/2020/5419016 [doi] LID - 5419016 AB - OBJECTIVE: This study aimed to investigate the effect of Xuefu Zhuyu decoction on preventing contrast-induced nephropathy (CIN) after percutaneous coronary intervention (PCI). METHODS: A total of 256 patients undergoing selective PCI for coronary artery disease were consecutively enrolled and randomly divided into two groups: Group A (n = 126) and Group B (n = 130). Before and after PCI, all patients routinely received antiplatelet aggregation therapy, antilipidemic therapy, and hydration therapy. Besides routine therapy, patients in Group B received Xuefu Zhuyu decoction from 3 days before PCI to 3 days after PCI. Serum creatinine (Scr), estimated glomerular filtration rate (eGFR), superoxide dismutase (SOD), and malondialdehyde (MDA) were measured, respectively, at baseline (72 h before PCI) and at 24, 48, and 72 h after PCI. RESULTS: Compared with Group A, Group B presented a lower fluctuation of SCr and eGFR (P < 0.01). The incidence of CIN was less in Group B. According to the definition, CIN occurred in 5 patients (2.0%) in the intervention group and 5 (4.0%) in the control group (P=0.167). In terms of oxidative stress, Group B had a lower MDA (P < 0.05), but a higher SOD (P < 0.05). CONCLUSIONS: Compared with the control group, Xuefu Zhuyu decoction intervention therapy increased the level of SOD and reduced MDA. The Xuefu Zhuyu decoction intervention group presented a higher level of eGFR at 24, 48, and 72 h after PCI in patients with coronary heart disease and a lower level of Scr. The results are propitious to prove that Xuefu Zhuyu decoction might play an antioxidative stress role in the prevention of CIN after PCI. CI - Copyright (c) 2020 Jingjing Zhao et al. FAU - Zhao, Jingjing AU - Zhao J AUID- ORCID: 0000-0003-4371-5009 AD - Department of Cardiology, Shaoxing People's Hospital, Shaoxing Hospital of Zhejiang University, Shaoxing, Zhejiang 312000, China. AD - Zhejiang University School of Medicine, Hangzhou, Zhejiang 310000, China. FAU - Liu, Huahua AU - Liu H AD - Department of Cardiology, Shaoxing People's Hospital, Shaoxing Hospital of Zhejiang University, Shaoxing, Zhejiang 312000, China. AD - Zhejiang University School of Medicine, Hangzhou, Zhejiang 310000, China. FAU - Xu, Buyun AU - Xu B AD - Department of Cardiology, Shaoxing People's Hospital, Shaoxing Hospital of Zhejiang University, Shaoxing, Zhejiang 312000, China. FAU - Peng, Jiahao AU - Peng J AUID- ORCID: 0000-0002-4028-383X AD - Loma Linda University School of Public Health, 24951 Circle Dr, Loma Linda, CA 92354, USA. FAU - Xing, Yangbo AU - Xing Y AD - Department of Cardiology, Shaoxing People's Hospital, Shaoxing Hospital of Zhejiang University, Shaoxing, Zhejiang 312000, China. FAU - Tang, Weiliang AU - Tang W AUID- ORCID: 0000-0002-6809-5056 AD - Department of Cardiology, Shaoxing People's Hospital, Shaoxing Hospital of Zhejiang University, Shaoxing, Zhejiang 312000, China. FAU - Peng, Fang AU - Peng F AUID- ORCID: 0000-0002-3826-5632 AD - Department of Cardiology, Shaoxing People's Hospital, Shaoxing Hospital of Zhejiang University, Shaoxing, Zhejiang 312000, China. LA - eng PT - Journal Article DEP - 20200427 PL - United States TA - Evid Based Complement Alternat Med JT - Evidence-based complementary and alternative medicine : eCAM JID - 101215021 PMC - PMC7212314 COIS- The authors declare that they have no conflicts of interest. EDAT- 2020/05/27 06:00 MHDA- 2020/05/27 06:01 PMCR- 2020/04/27 CRDT- 2020/05/27 06:00 PHST- 2019/10/03 00:00 [received] PHST- 2020/02/08 00:00 [revised] PHST- 2020/02/11 00:00 [accepted] PHST- 2020/05/27 06:00 [entrez] PHST- 2020/05/27 06:00 [pubmed] PHST- 2020/05/27 06:01 [medline] PHST- 2020/04/27 00:00 [pmc-release] AID - 10.1155/2020/5419016 [doi] PST - epublish SO - Evid Based Complement Alternat Med. 2020 Apr 27;2020:5419016. doi: 10.1155/2020/5419016. eCollection 2020. PMID- 32438990 OWN - NLM STAT- MEDLINE DCOM- 20201209 LR - 20201214 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 13 IP - 10 DP - 2020 May 25 TI - Prognostic Value of SYNTAX Score in Patients With Infarct-Related Cardiogenic Shock: Insights From the CULPRIT-SHOCK Trial. PG - 1198-1206 LID - S1936-8798(20)30876-1 [pii] LID - 10.1016/j.jcin.2020.04.003 [doi] AB - OBJECTIVES: This study sought to evaluate the prognostic value of the SYNTAX (SYNergy between PCI with TAXUS and Cardiac Surgery) scores in patients undergoing percutaneous coronary intervention (PCI) for multivessel coronary disease with infarct-related cardiogenic shock (CS). BACKGROUND: The prognostic value of the SYNTAX score in this high-risk setting remains unclear. METHODS: The CULPRIT-SHOCK (Culprit Lesion Only PCI versus Multivessel PCI in Cardiogenic Shock) trial was an international, open-label trial, where patients presenting with infarct-related CS and multivessel disease were randomized to a culprit-lesion-only or an immediate multivessel PCI strategy. Baseline SYNTAX score was assessed by a central core laboratory and categorized as low SYNTAX score (SS 32). Adjudicated endpoints of interest were the 30-day risk of death or renal replacement therapy (RRT) and 1-year death. Associations between baseline SYNTAX score and outcomes were assessed using multivariate logistic regression. RESULTS: Pre-PCI SYNTAX score was available in 624 patients, of whom 263 (42.1%), 207 (33.2%) and 154 (24.7%) presented with low, intermediate and high SYNTAX score, respectively. A stepwise increase in the incidence of adverse events was observed from low to intermediate and high SYNTAX score for the 30-day risk of death or RRT and the 1-year risk of death (p < 0.001, for all). After multiple adjustments, intermediate and high SYNTAX score remained strongly associated with 30-day risk of death or renal replacement therapy and 1-year risk of all-cause death. There was no significant interaction between SYNTAX score and the coronary revascularization strategy for any outcomes. CONCLUSIONS: In patients presenting with multivessel disease and infarct-related CS, the SYNTAX score was strongly associated with 30-day death or RRT and 1-year mortality. CI - Copyright (c) 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Guedeney, Paul AU - Guedeney P AD - ACTION Study Group, INSERM UMRS_1166, Institut de cardiologie, Assistance Publique-Hopitaux de Paris, Sorbonne Universite, Paris, France. FAU - Barthelemy, Olivier AU - Barthelemy O AD - ACTION Study Group, INSERM UMRS_1166, Institut de cardiologie, Assistance Publique-Hopitaux de Paris, Sorbonne Universite, Paris, France. FAU - Zeitouni, Michel AU - Zeitouni M AD - ACTION Study Group, INSERM UMRS_1166, Institut de cardiologie, Assistance Publique-Hopitaux de Paris, Sorbonne Universite, Paris, France. FAU - Hauguel-Moreau, Marie AU - Hauguel-Moreau M AD - ACTION Study Group, INSERM UMRS_1166, Institut de cardiologie, Assistance Publique-Hopitaux de Paris, Sorbonne Universite, Paris, France. FAU - Hage, Georges AU - Hage G AD - ACTION Study Group, INSERM UMRS_1166, Institut de cardiologie, Assistance Publique-Hopitaux de Paris, Sorbonne Universite, Paris, France. FAU - Kerneis, Mathieu AU - Kerneis M AD - ACTION Study Group, INSERM UMRS_1166, Institut de cardiologie, Assistance Publique-Hopitaux de Paris, Sorbonne Universite, Paris, France. FAU - Lattuca, Benoit AU - Lattuca B AD - ACTION Study Group, INSERM UMRS_1166, Institut de cardiologie, Assistance Publique-Hopitaux de Paris, Sorbonne Universite, Paris, France. FAU - Overtchouk, Pavel AU - Overtchouk P AD - ACTION Study Group, INSERM UMRS_1166, Institut de cardiologie, Assistance Publique-Hopitaux de Paris, Sorbonne Universite, Paris, France. FAU - Rouanet, Stephanie AU - Rouanet S AD - ACTION Study Group, Statistician Unit, StatEthic, Levallois-Perret, France. FAU - Fuernau, Georg AU - Fuernau G AD - University Heart Center Lubeck, Lubeck, Germany. FAU - de Waha-Thiele, Suzanne AU - de Waha-Thiele S AD - University Heart Center Lubeck, Lubeck, Germany. FAU - Zeymer, Uwe AU - Zeymer U AD - Klinikum Ludwigshafen, Institut fur Herzinfarktforschung, Ludwigshafen, Germany. FAU - Sandri, Marcus AU - Sandri M AD - Heart Center Leipzig, Leipzig Heart Institute, University of Leipzig, Leipzig, Germany. FAU - Akin, Ibrahim AU - Akin I AD - First Department of Medicine-Cardiology, University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany. FAU - Desch, Steffen AU - Desch S AD - Heart Center Leipzig, Leipzig Heart Institute, University of Leipzig, Leipzig, Germany. FAU - Thiele, Holger AU - Thiele H AD - Heart Center Leipzig, Leipzig Heart Institute, University of Leipzig, Leipzig, Germany. FAU - Montalescot, Gilles AU - Montalescot G AD - ACTION Study Group, INSERM UMRS_1166, Institut de cardiologie, Assistance Publique-Hopitaux de Paris, Sorbonne Universite, Paris, France. Electronic address: gilles.montalescot@aphp.fr. LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 SB - IM CIN - JACC Cardiovasc Interv. 2020 May 25;13(10):1207-1210. doi: 10.1016/j.jcin.2020.03.040. PMID: 32438991 MH - Aged MH - *Clinical Decision Rules MH - Coronary Artery Disease/complications/diagnostic imaging/mortality/*therapy MH - Drug-Eluting Stents MH - Female MH - Humans MH - Male MH - Middle Aged MH - Myocardial Infarction/diagnostic imaging/etiology/mortality/*therapy MH - *Percutaneous Coronary Intervention/adverse effects/instrumentation/mortality MH - Predictive Value of Tests MH - Recurrence MH - Renal Insufficiency/etiology/mortality/therapy MH - Renal Replacement Therapy MH - Risk Assessment MH - Risk Factors MH - Shock, Cardiogenic/diagnosis/*etiology/mortality MH - Stroke/etiology/mortality MH - Time Factors MH - Treatment Outcome OTO - NOTNLM OT - SYNTAX score OT - cardiogenic shock OT - percutaneous coronary intervention EDAT- 2020/05/23 06:00 MHDA- 2020/12/15 06:00 CRDT- 2020/05/23 06:00 PHST- 2019/12/28 00:00 [received] PHST- 2020/03/12 00:00 [revised] PHST- 2020/04/02 00:00 [accepted] PHST- 2020/05/23 06:00 [entrez] PHST- 2020/05/23 06:00 [pubmed] PHST- 2020/12/15 06:00 [medline] AID - S1936-8798(20)30876-1 [pii] AID - 10.1016/j.jcin.2020.04.003 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2020 May 25;13(10):1198-1206. doi: 10.1016/j.jcin.2020.04.003. PMID- 32434204 OWN - NLM STAT- MEDLINE DCOM- 20210810 LR - 20260120 IS - 1664-5502 (Electronic) IS - 1664-5502 (Linking) VI - 10 IP - 5 DP - 2020 TI - A Prospective, Randomized, Open-Label Trial of Atorvastatin versus Rosuvastatin in the Prevention of Contrast-Induced Acute Kidney Injury, Worsened Renal Function at 30 Days, and Clinical Events After Acute Coronary Angiography: the PRATO-ACS-2 Study. PG - 288-301 LID - 10.1159/000506857 [doi] AB - BACKGROUND/AIMS: Both high-dose atorvastatin and rosuvastatin have been shown to reduce contrast-induced acute kidney injury (AKI) occurrence and improve clinical outcomes in high-risk coronary patients undergoing angiographic procedures. However, there is a lack of head-to-head comparative studies on the effects of atorvastatin or rosuvastatin administered upon hospital admission in statin-naive patients with non-ST segment elevation acute coronary syndrome (NSTE-ACS). METHODS: In this open-label, noninferiority study, we compared changes in renal function in 709 NSTE-ACS patients randomized to atorvastatin (80 mg upon admission followed by 40 mg/day) or rosuvastatin (40 mg upon admission followed by 20 mg/day). The primary end point was AKI (increase in serum creatinine >/=0.5 mg/dL or >/=25% above baseline within 72 h). Worsening renal function (WRF) (decrease of >/=25% in the glomerular filtration rate from baseline to 30 days), 30-day major adverse cardiovascular events, and 12-month myocardial infarction (MI) or death were also evaluated. RESULTS: The AKI incidence was similar in the 2 groups (i.e., 8.2% with rosuvastatin and 7.6% with atorvastatin; absolute risk difference = 0.54; 90% CI -3.9 to 2.8), satisfying the noninferiority criteria. WRF occurred in 53 (7.5%) patients, 19 (34%) of whom had developed AKI. The rates of WRF and adverse events at 30 days and at 12 months did not differ significantly between the 2 groups. Both AKI and WRF were found to be closely associated with the 12-month cardiovascular outcome irrespectively of statin choice. CONCLUSIONS: High-dose rosuvastatin or atorvastatin started upon hospital admission led to similar rates of AKI, 30-day renal function changes, and 12-month death or MI in NSTE-ACS patients who underwent an early invasive strategy (clinical trial registration: https://www.clinicaltrials.gov; unique identifier: NCT01870804). CI - (c) 2020 S. Karger AG, Basel. FAU - Toso, Anna AU - Toso A AD - Division of Cardiology, Santo Stefano Hospital, Prato, Italy, anna.toso@libero.it. FAU - Leoncini, Mario AU - Leoncini M AD - Division of Cardiology, Santo Stefano Hospital, Prato, Italy. FAU - Maioli, Mauro AU - Maioli M AD - Division of Cardiology, Santo Stefano Hospital, Prato, Italy. FAU - Tropeano, Francesco AU - Tropeano F AD - Division of Cardiology, Santo Stefano Hospital, Prato, Italy. FAU - Villani, Simona AU - Villani S AD - Section of Biostatistics and Clinical Epidemiology, Department of Public Health, Neurosciences, Experimental and Forensic Medicine, Pavia University, Pavia, Italy. FAU - Bellandi, Francesco AU - Bellandi F AD - Division of Cardiology, Santo Stefano Hospital, Prato, Italy. LA - eng SI - ClinicalTrials.gov/NCT01870804 PT - Equivalence Trial PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20200520 PL - Switzerland TA - Cardiorenal Med JT - Cardiorenal medicine JID - 101554863 RN - 0 (Contrast Media) RN - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors) RN - 83MVU38M7Q (Rosuvastatin Calcium) RN - A0JWA85V8F (Atorvastatin) SB - IM MH - *Acute Kidney Injury/prevention & control MH - *Atorvastatin/therapeutic use MH - *Contrast Media MH - *Coronary Angiography/adverse effects MH - Humans MH - *Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use MH - Prospective Studies MH - Rosuvastatin Calcium OTO - NOTNLM OT - Acute coronary syndrome OT - Acute kidney injury OT - Atorvastatin OT - Rosuvastatin EDAT- 2020/05/21 06:00 MHDA- 2021/08/11 06:00 CRDT- 2020/05/21 06:00 PHST- 2020/01/05 00:00 [received] PHST- 2020/02/28 00:00 [accepted] PHST- 2020/05/21 06:00 [pubmed] PHST- 2021/08/11 06:00 [medline] PHST- 2020/05/21 06:00 [entrez] AID - 000506857 [pii] AID - 10.1159/000506857 [doi] PST - ppublish SO - Cardiorenal Med. 2020;10(5):288-301. doi: 10.1159/000506857. Epub 2020 May 20. PMID- 32423904 OWN - NLM STAT- MEDLINE DCOM- 20210628 LR - 20210628 IS - 1468-201X (Electronic) IS - 1355-6037 (Print) IS - 1355-6037 (Linking) VI - 106 IP - 19 DP - 2020 Oct TI - Sleep apnoea and cardiovascular outcomes after coronary artery bypass grafting. PG - 1495-1502 LID - 10.1136/heartjnl-2019-316118 [doi] AB - OBJECTIVE: Patients with advanced coronary artery disease are referred for coronary artery bypass grafting (CABG) and it remains unknown if sleep apnoea is a risk marker. We evaluated the association between sleep apnoea and major adverse cardiac and cerebrovascular events (MACCE) in patients undergoing non-emergent CABG. METHODS: This was a prospective cohort study conducted between November 2013 and December 2018. Patients from four public hospitals referred to a tertiary cardiac centre for non-emergent CABG were recruited for an overnight sleep study using a wrist-worn Watch-PAT 200 device prior to CABG. RESULTS: Among the 1007 patients who completed the study, sleep apnoea (defined as apnoea-hypopnoea index >/=15 events per hour) was diagnosed in 513 patients (50.9%). Over a mean follow-up period of 2.1 years, 124 patients experienced the four-component MACCE (2-year cumulative incidence estimate, 11.3%). There was a total of 33 cardiac deaths (2.5%), 42 non-fatal myocardial infarctions (3.7%), 50 non-fatal strokes (4.9%) and 36 unplanned revascularisations (3.2%). The crude incidence of MACCE was higher in the sleep apnoea group than the non-sleep apnoea group (2-year estimate, 14.7% vs 7.8%; p=0.002). Sleep apnoea predicted the incidence of MACCE in unadjusted Cox regression analysis (HR 1.69; 95% CI 1.18 to 2.43), and remained statistically significant (adjusted HR 1.57; 95% CI 1.09 to 2.25), after adjustment for age, sex, body mass index, left ventricular ejection fraction, diabetes mellitus, hypertension, chronic kidney disease and excessive daytime sleepiness. CONCLUSION: Sleep apnoea is independently associated with increased MACCE in patients undergoing CABG. TRIAL REGISTRATION NUMBER: NCT02701504. CI - (c) Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. FAU - Koo, Chieh Yang AU - Koo CY AUID- ORCID: 0000-0002-6051-3807 AD - Department of Cardiology, National University Heart Centre, Singapore christopher_koo@nuhs.edu.sg. FAU - Aung, Aye-Thandar AU - Aung AT AD - Department of Cardiology, National University Heart Centre, Singapore. FAU - Chen, Zhengfeng AU - Chen Z AD - Department of Cardiology, National University Heart Centre, Singapore. FAU - Kristanto, William AU - Kristanto W AD - Department of Cardiology, Ng Teng Fong General Hospital, Singapore. FAU - Sim, Hui-Wen AU - Sim HW AD - Department of Cardiology, National University Heart Centre, Singapore. FAU - Tam, Wilson W AU - Tam WW AD - Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore. FAU - Gochuico, Carlo F AU - Gochuico CF AD - Department of Cardiology, National University Heart Centre, Singapore. FAU - Tan, Kent Anthony AU - Tan KA AD - Department of Cardiology, National University Heart Centre, Singapore. FAU - Kang, Giap-Swee AU - Kang GS AD - Department of Cardiac, Thoracic, and Vascular Surgery, National University Heart Centre, Singapore. FAU - Sorokin, Vitaly AU - Sorokin V AD - Department of Cardiac, Thoracic, and Vascular Surgery, National University Heart Centre, Singapore. FAU - Ong, Paul Jau Lueng AU - Ong PJL AD - Department of Cardiology, Tan Tock Seng Hospital, Singapore. FAU - Kojodjojo, Pipin AU - Kojodjojo P AD - Department of Cardiology, National University Heart Centre, Singapore. AD - Department of Cardiology, Ng Teng Fong General Hospital, Singapore. FAU - Richards, Arthur Mark AU - Richards AM AD - Department of Cardiology, National University Heart Centre, Singapore. AD - Yong Loo Lin School of Medicine, National University of Singapore, Singapore. AD - Cardiovascular Research Institute, National University of Singapore, Singapore. FAU - Tan, Huay-Cheem AU - Tan HC AD - Department of Cardiology, National University Heart Centre, Singapore. FAU - Kofidis, Theodoros AU - Kofidis T AD - Department of Cardiac, Thoracic, and Vascular Surgery, National University Heart Centre, Singapore. AD - Yong Loo Lin School of Medicine, National University of Singapore, Singapore. AD - Cardiovascular Research Institute, National University of Singapore, Singapore. FAU - Lee, Chi-Hang AU - Lee CH AD - Department of Cardiology, National University Heart Centre, Singapore. AD - Yong Loo Lin School of Medicine, National University of Singapore, Singapore. AD - Cardiovascular Research Institute, National University of Singapore, Singapore. LA - eng SI - ClinicalTrials.gov/NCT02701504 PT - Journal Article PT - Observational Study PT - Research Support, Non-U.S. Gov't DEP - 20200518 PL - England TA - Heart JT - Heart (British Cardiac Society) JID - 9602087 SB - IM MH - Adolescent MH - Adult MH - Aged MH - Aged, 80 and over MH - Cerebrovascular Disorders/etiology MH - Comorbidity MH - *Coronary Artery Bypass/adverse effects MH - Coronary Artery Disease/complications/diagnostic imaging/physiopathology/*surgery MH - Female MH - Humans MH - Male MH - Middle Aged MH - Prospective Studies MH - Risk Assessment MH - Risk Factors MH - Sleep Apnea Syndromes/*complications/diagnosis/physiopathology MH - Time Factors MH - Treatment Outcome MH - Young Adult PMC - PMC7509387 OTO - NOTNLM OT - cardiac risk factors and prevention OT - cardiac surgery OT - chronic coronary disease OT - coronary artery disease surgery OT - heart failure COIS- Competing interests: None declared. EDAT- 2020/05/20 06:00 MHDA- 2021/06/29 06:00 PMCR- 2020/09/23 CRDT- 2020/05/20 06:00 PHST- 2019/10/16 00:00 [received] PHST- 2020/02/13 00:00 [revised] PHST- 2020/02/20 00:00 [accepted] PHST- 2020/05/20 06:00 [pubmed] PHST- 2021/06/29 06:00 [medline] PHST- 2020/05/20 06:00 [entrez] PHST- 2020/09/23 00:00 [pmc-release] AID - heartjnl-2019-316118 [pii] AID - 10.1136/heartjnl-2019-316118 [doi] PST - ppublish SO - Heart. 2020 Oct;106(19):1495-1502. doi: 10.1136/heartjnl-2019-316118. Epub 2020 May 18. PMID- 32386761 OWN - NLM STAT- MEDLINE DCOM- 20220131 LR - 20260518 IS - 1097-685X (Electronic) IS - 0022-5223 (Print) IS - 0022-5223 (Linking) VI - 163 IP - 2 DP - 2022 Feb TI - Renal function and coronary bypass surgery in patients with ischemic heart failure. PG - 663-672.e3 LID - S0022-5223(20)30742-X [pii] LID - 10.1016/j.jtcvs.2020.02.136 [doi] AB - OBJECTIVE: Chronic kidney disease is a known risk factor in cardiovascular disease, but its influence on treatment effect of bypass surgery remains unclear. We assessed the influence of chronic kidney disease on 10-year mortality and cardiovascular outcomes in patients with ischemic heart failure treated with medical therapy (medical treatment) with or without coronary artery bypass grafting. METHODS: We calculated the baseline estimated glomerular filtration rate (Chronic Kidney Disease Epidemiology Collaboration formula, chronic kidney disease stages 1-5) from 1209 patients randomized to medical treatment or coronary artery bypass grafting in the Surgical Treatment for IsChemic Heart failure trial and assessed its effect on outcome. RESULTS: In the overall Surgical Treatment for IsChemic Heart failure cohort, patients with chronic kidney disease stages 3 to 5 were older than those with stages 1 and 2 (66-71 years vs 54-59 years) and had more comorbidities. Multivariable modeling revealed an inverse association between estimated glomerular filtration rate and risk of death, cardiovascular death, or cardiovascular rehospitalization (all P < .001, but not for stroke, P = .697). Baseline characteristics of the 2 treatment arms were equal for each chronic kidney disease stage. There were significant improvements in death or cardiovascular rehospitalization with coronary artery bypass grafting (stage 1: hazard ratio, 0.71; confidence interval, 0.53-0.96, P = .02; stage 2: hazard ratio, 0.71; confidence interval, 0.59-0.84, P < .0001; stage 3: hazard ratio, 0.76; confidence interval, 0.53-0.96, P = .03). These data were inconclusive in stages 4 and 5 for insufficient patient numbers (N = 28). There was no significant interaction of estimated glomerular filtration rate with the treatment effect of coronary artery bypass grafting (P = .25 for death and P = .54 for death or cardiovascular rehospitalization). CONCLUSIONS: Chronic kidney disease is an independent risk factor for mortality in patients with ischemic heart failure with or without coronary artery bypass grafting. However, mild to moderate chronic kidney disease does not appear to influence long-term treatment effects of coronary artery bypass grafting. CI - Copyright (c) 2020 The American Association for Thoracic Surgery. All rights reserved. FAU - Doenst, Torsten AU - Doenst T AD - Department of Cardiothoracic Surgery, Jena University Hospital, Friedrich-Schiller-University of Jena, Jena, Germany. Electronic address: doenst@med.uni-jena.de. FAU - Haddad, Haissam AU - Haddad H AD - Department of Medicine, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada. FAU - Stebbins, Amanda AU - Stebbins A AD - Duke Clinical Research Institute, Durham, NC. FAU - Hill, James A AU - Hill JA AD - Division of Cardiovascular Medicine, Department of Medicine, University of Florida, Malcom Randal VAMC, Gainesville, Fla. FAU - Velazquez, Eric J AU - Velazquez EJ AD - Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Conn. FAU - Lee, Kerry L AU - Lee KL AD - Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Duke Clinical Research Institute, Durham, NC. FAU - Rouleau, Jean L AU - Rouleau JL AD - Montreal Heart Institute, University of Montreal, Montreal, Quebec, Canada. FAU - Sopko, George AU - Sopko G AD - Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Md. FAU - Farsky, Pedro S AU - Farsky PS AD - Department of Cardiology, Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil; Department of Cardiology, Hospital Israelita Albert Einstein, Sao Paulo, Brazil. FAU - Al-Khalidi, Hussein R AU - Al-Khalidi HR AD - Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Duke Clinical Research Institute, Durham, NC. CN - Working Group and Surgical Treatment for IsChemic Heart failure Trial Investigators LA - eng GR - R01 HL105853/HL/NHLBI NIH HHS/United States GR - U01 HL069013/HL/NHLBI NIH HHS/United States GR - U01 HL069015/HL/NHLBI NIH HHS/United States PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, N.I.H., Extramural PT - Video-Audio Media DEP - 20200403 PL - United States TA - J Thorac Cardiovasc Surg JT - The Journal of thoracic and cardiovascular surgery JID - 0376343 RN - 0 (Cardiovascular Agents) SB - IM CIN - J Thorac Cardiovasc Surg. 2022 Feb;163(2):673. doi: 10.1016/j.jtcvs.2020.02.067. PMID: 32171487 CIN - J Thorac Cardiovasc Surg. 2022 Feb;163(2):674-675. doi: 10.1016/j.jtcvs.2020.03.051. PMID: 32340811 MH - Aged MH - Cardiovascular Agents/adverse effects/*therapeutic use MH - *Coronary Artery Bypass/adverse effects/mortality MH - Female MH - *Glomerular Filtration Rate MH - Heart Failure/diagnostic imaging/*drug therapy/mortality/physiopathology MH - Humans MH - Kidney/*physiopathology MH - Male MH - Middle Aged MH - Myocardial Ischemia/diagnostic imaging/mortality/physiopathology/*surgery MH - Prospective Studies MH - Renal Insufficiency, Chronic/diagnosis/mortality/*physiopathology MH - Risk Assessment MH - Risk Factors MH - Time Factors MH - Treatment Outcome PMC - PMC7541611 MID - NIHMS1581813 OTO - NOTNLM OT - CABG treatment effect OT - chronic kidney disease OT - coronary artery bypass grafting OT - medical therapy OT - survival COIS- Conflicts of interest: E.J.V. received Research Grants (significant) from Novartis, Amgen, NHLBI, Pfizer and Alnylam and is Consultant/Advisory Board member (modest) for Novartis, Amgen and Philips. J.L.R. reports personal fees from Duke Clinical uresearch Institute and consultation fees from Novartis and AstraZeneca. All other authors report no disclosures. FIR - Jeemon, Panniyammakal IR - Jeemon P IRAD- Epidemiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Kerala, India. FIR - Szwed, Hanna IR - Szwed H IRAD- Department of Coronary Artery Disease, Institute of Cardiology, Warsaw, Poland. FIR - Tan, Ru-San IR - Tan RS IRAD- Department of Cardiology, National Heart Centre Singapore, Singapore. FIR - Bigalli, Daniel R IR - Bigalli DR IRAD- Department of Cardiac Surgery, CICU, Montevideo, Uruguay. FIR - Kosevic, Dragana IR - Kosevic D IRAD- Department of Cardiology, Dedinje Cardiovascular Institute, Belgrade, Serbia. FIR - Benke, Kalman IR - Benke K IRAD- Heart and Vascular Centre, Semmelweis University, Budapest, Hungary. FIR - Kalil, Renato A K IR - Kalil RAK IRAD- Postgraduate Program, Instituto de Cardiologia/FUC and UFCSPA, Porto Alegre, Brazil. FIR - Jasinski, Marek IR - Jasinski M IRAD- Department of Cardiac Surgery, Wroclaw Medical University, Wroclaw, Poland. FIR - Smith, Peter K IR - Smith PK IRAD- Department of Surgery (Cardiothoracic), Duke University School of Medicine, Duke Clinical Research Institute, Durham, NC. FIR - Chua, Yeow Leng IR - Chua YL IRAD- Department of Cardiothoracic Surgery, National Heart Centre Singapore, Singapore. EDAT- 2020/05/11 06:00 MHDA- 2022/02/01 06:00 PMCR- 2023/02/01 CRDT- 2020/05/11 06:00 PHST- 2019/07/15 00:00 [received] PHST- 2020/01/24 00:00 [revised] PHST- 2020/02/13 00:00 [accepted] PHST- 2020/05/11 06:00 [pubmed] PHST- 2022/02/01 06:00 [medline] PHST- 2020/05/11 06:00 [entrez] PHST- 2023/02/01 00:00 [pmc-release] AID - S0022-5223(20)30742-X [pii] AID - 10.1016/j.jtcvs.2020.02.136 [doi] PST - ppublish SO - J Thorac Cardiovasc Surg. 2022 Feb;163(2):663-672.e3. doi: 10.1016/j.jtcvs.2020.02.136. Epub 2020 Apr 3. PMID- 32273094 OWN - NLM STAT- MEDLINE DCOM- 20201102 LR - 20260518 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 13 IP - 7 DP - 2020 Apr 13 TI - 1-Year Clinical Outcomes of All Comers Treated With 2 Bioresorbable Polymer-Coated Sirolimus-Eluting Stents: Propensity Score-Matched Comparison of the COMBO and Ultrathin-Strut Orsiro Stents. PG - 820-830 LID - S1936-8798(19)32460-4 [pii] LID - 10.1016/j.jcin.2019.11.023 [doi] AB - OBJECTIVES: The aim of this study was to determine 1-year safety and efficacy after treatment with the COMBO and Orsiro stents. BACKGROUND: The COMBO stainless-steel stent has an anti-CD34(+) antibody coating to capture endothelial progenitor cells, thereby promoting faster endothelialization. The Orsiro is an ultrathin-strut cobalt-chromium stent, covered by an extremely thin layer of amorphous silicon carbide to minimize ion leakage. Both devices elute sirolimus from biodegradable polymers. METHODS: For this analysis we included European patients from the COMBO collaboration, a patient-level pooling of 2 prospective all-comers registries of COMBO stent implantation (n = 2,775), and all patients randomized to the Orsiro stent (n = 1,169) from the Dutch BIO-RESORT (Comparison of Biodegradable Polymer and Durable Polymer Drug-Eluting Stents in an All Comers Population) randomized trial. The main outcome of interest was 1-year target lesion failure, a composite of cardiac death, target vessel myocardial infarction, and clinically driven target lesion revascularization evaluated using propensity score-matched analysis. RESULTS: At baseline, COMBO patients were older and had more insulin-treated diabetes, renal insufficiency, and other comorbidities. However, Orsiro patients included more current smokers and more acute coronary syndrome presentations. Orsiro patients also received longer stents and had more complex target lesions. After propensity score-matched analysis (n = 862/arm), 1-year target lesion failure occurred in 4.1% of COMBO-treated and 2.7% of Orsiro-treated patients (hazard ratio: 1.55; 95% confidence interval: 0.92 to 2.62; p = 0.10). Definite stent thrombosis occurred in 0.5% of COMBO-treated and 0.5% of Orsiro-treated patients (p = 0.99). CONCLUSIONS: A propensity score-matched comparison of all comers treated with the COMBO or Orsiro stent showed no statistically significant differences. Stent thrombosis risk was low and similar between the stents. (Comparison of Biodegradable Polymer and Durable Polymer Drug-Eluting Stents in an All Comers Population [BIO-RESORT], NCT01674803; MASCOT-Post Marketing Registry [MASCOT], NCT02183454; Prospective Registry to Assess the Long-term Safety and Performance of the Combo Stent [REMEDEE Reg], NCT01874002). CI - Copyright (c) 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Chandrasekhar, Jaya AU - Chandrasekhar J AD - Icahn School of Medicine at Mount Sinai Hospital, New York, New York; Amsterdam UMC, Heart Center, and Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands. FAU - Kok, Marlies M AU - Kok MM AD - Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, the Netherlands. FAU - Kalkman, Deborah N AU - Kalkman DN AD - Icahn School of Medicine at Mount Sinai Hospital, New York, New York; Amsterdam UMC, Heart Center, and Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands. FAU - Aquino, Melissa B AU - Aquino MB AD - Icahn School of Medicine at Mount Sinai Hospital, New York, New York. FAU - Zocca, Paolo AU - Zocca P AD - Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, the Netherlands. FAU - Woudstra, Pier AU - Woudstra P AD - Amsterdam UMC, Heart Center, and Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands. FAU - Beijk, Marcel A AU - Beijk MA AD - Amsterdam UMC, Heart Center, and Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands. FAU - Kerkmeijer, Laura S AU - Kerkmeijer LS AD - Amsterdam UMC, Heart Center, and Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands. FAU - Sartori, Samantha AU - Sartori S AD - Icahn School of Medicine at Mount Sinai Hospital, New York, New York. FAU - Baber, Usman AU - Baber U AD - Icahn School of Medicine at Mount Sinai Hospital, New York, New York. FAU - Tijssen, Jan G AU - Tijssen JG AD - Amsterdam UMC, Heart Center, and Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands. FAU - Koch, Karel T AU - Koch KT AD - Amsterdam UMC, Heart Center, and Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands. FAU - Dangas, George D AU - Dangas GD AD - Icahn School of Medicine at Mount Sinai Hospital, New York, New York. FAU - Colombo, Antonio AU - Colombo A AD - San Raffaele Hospital, Milan, Italy. FAU - Pocock, Stuart AU - Pocock S AD - London School of Hygiene and Tropical Medicine, London, United Kingdom. FAU - von Birgelen, Clemens AU - von Birgelen C AD - Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, the Netherlands. FAU - Mehran, Roxana AU - Mehran R AD - Icahn School of Medicine at Mount Sinai Hospital, New York, New York. Electronic address: roxana.mehran@mountsinai.org. FAU - de Winter, Robbert J AU - de Winter RJ AD - Amsterdam UMC, Heart Center, and Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands. CN - COMBO Collaborators and BIO-RESORT Investigators LA - eng SI - ClinicalTrials.gov/NCT01874002 PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 RN - 0 (Cardiovascular Agents) RN - 0 (Polymers) RN - W36ZG6FT64 (Sirolimus) SB - IM CIN - JACC Cardiovasc Interv. 2020 Apr 13;13(7):831-832. doi: 10.1016/j.jcin.2019.12.015. PMID: 32273095 MH - *Absorbable Implants MH - Aged MH - Cardiovascular Agents/*administration & dosage/adverse effects MH - Coronary Artery Disease/diagnostic imaging/mortality/*therapy MH - Coronary Thrombosis/etiology MH - Databases, Factual MH - *Drug-Eluting Stents MH - Europe MH - Female MH - Humans MH - Male MH - Middle Aged MH - Percutaneous Coronary Intervention/adverse effects/*instrumentation/mortality MH - Polymers/*chemistry MH - Propensity Score MH - Prosthesis Design MH - Randomized Controlled Trials as Topic MH - Registries MH - Risk Assessment MH - Risk Factors MH - Sirolimus/*administration & dosage/adverse effects MH - Time Factors MH - Treatment Outcome OTO - NOTNLM OT - COMBO dual-therapy stent OT - anti-CD34(+) antibody coating OT - endothelial progenitor cell capture OT - percutaneous coronary intervention OT - ultrathin-strut Orsiro stent FIR - von Birgelen, Clemens IR - von Birgelen C FIR - Kok, Marlies M IR - Kok MM FIR - van der Heijden, Liefke C IR - van der Heijden LC FIR - Danse, Peter W IR - Danse PW FIR - Schotborgh, Carl E IR - Schotborgh CE FIR - Scholte, Martijn IR - Scholte M FIR - Joe Gin, Melvin Tjon IR - Joe Gin MT FIR - Somi, Samer IR - Somi S FIR - van Houwelingen, K Gert IR - van Houwelingen KG FIR - Stoel, Martin G IR - Stoel MG FIR - de Man, Frits H A F IR - de Man FHAF FIR - Louwerenburg, J Hans W IR - Louwerenburg JHW FIR - Hartmann, Marc IR - Hartmann M FIR - Zocca, Paolo IR - Zocca P FIR - Linssen, Gerard C M IR - Linssen GCM FIR - van der Palen, Job IR - van der Palen J FIR - Doggen, Carine J M IR - Doggen CJM FIR - Lowik, Marije M IR - Lowik MM EDAT- 2020/04/11 06:00 MHDA- 2020/11/03 06:00 CRDT- 2020/04/11 06:00 PHST- 2019/06/06 00:00 [received] PHST- 2019/11/10 00:00 [revised] PHST- 2019/11/20 00:00 [accepted] PHST- 2020/04/11 06:00 [entrez] PHST- 2020/04/11 06:00 [pubmed] PHST- 2020/11/03 06:00 [medline] AID - S1936-8798(19)32460-4 [pii] AID - 10.1016/j.jcin.2019.11.023 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2020 Apr 13;13(7):820-830. doi: 10.1016/j.jcin.2019.11.023. PMID- 32227756 OWN - NLM STAT- MEDLINE DCOM- 20200428 LR - 20260518 IS - 1533-4406 (Electronic) IS - 0028-4793 (Print) IS - 0028-4793 (Linking) VI - 382 IP - 17 DP - 2020 Apr 23 TI - Management of Coronary Disease in Patients with Advanced Kidney Disease. PG - 1608-1618 LID - 10.1056/NEJMoa1915925 [doi] AB - BACKGROUND: Clinical trials that have assessed the effect of revascularization in patients with stable coronary disease have routinely excluded those with advanced chronic kidney disease. METHODS: We randomly assigned 777 patients with advanced kidney disease and moderate or severe ischemia on stress testing to be treated with an initial invasive strategy consisting of coronary angiography and revascularization (if appropriate) added to medical therapy or an initial conservative strategy consisting of medical therapy alone and angiography reserved for those in whom medical therapy had failed. The primary outcome was a composite of death or nonfatal myocardial infarction. A key secondary outcome was a composite of death, nonfatal myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest. RESULTS: At a median follow-up of 2.2 years, a primary outcome event had occurred in 123 patients in the invasive-strategy group and in 129 patients in the conservative-strategy group (estimated 3-year event rate, 36.4% vs. 36.7%; adjusted hazard ratio, 1.01; 95% confidence interval [CI], 0.79 to 1.29; P = 0.95). Results for the key secondary outcome were similar (38.5% vs. 39.7%; hazard ratio, 1.01; 95% CI, 0.79 to 1.29). The invasive strategy was associated with a higher incidence of stroke than the conservative strategy (hazard ratio, 3.76; 95% CI, 1.52 to 9.32; P = 0.004) and with a higher incidence of death or initiation of dialysis (hazard ratio, 1.48; 95% CI, 1.04 to 2.11; P = 0.03). CONCLUSIONS: Among patients with stable coronary disease, advanced chronic kidney disease, and moderate or severe ischemia, we did not find evidence that an initial invasive strategy, as compared with an initial conservative strategy, reduced the risk of death or nonfatal myocardial infarction. (Funded by the National Heart, Lung, and Blood Institute and others; ISCHEMIA-CKD ClinicalTrials.gov number, NCT01985360.). CI - Copyright (c) 2020 Massachusetts Medical Society. FAU - Bangalore, Sripal AU - Bangalore S AD - From the New York University Grossman School of Medicine (S. Bangalore, H.R.R., J.S.B., J.D.N., J.S.H.), Mount Sinai Hospital (G.W.S.), the Cardiovascular Research Foundation (G.W.S., Z.A.A.), and Columbia University Irving Medical Center/New York Presbyterian Hospital (Z.A.A.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; the Department of Medicine, Stanford University School of Medicine, Stanford, CA (D.J.M., G.M.C.); Duke Clinical Research Institute, Durham, NC (S.M.O., S. Broderick, Z.H., D.B.M., K.P.A.); the National, Heart, Lung and Blood Institute, Bethesda, MD (J.L.F.); E.N. Meshalkin National Medical Research Center, Novosibirsk (E.I.K.), and Bakulev National Medical Research Center for Cardiovascular Surgery, Moscow (O.B.) - both in Russia; Mediterranea Cardiocentro, Naples, Italy (C.B.); Batra Hospital and Medical Research Centre, New Delhi, India (U.K.); Medical University of Warsaw (T.M.) and the Department of Coronary and Structural Heart Diseases, Institute of Cardiology (R.P.) - both in Warsaw, Poland; Columbia Veterans Affairs (VA) Health Care System, Columbia, SC (R.O.M.); Hennepin Healthcare, University of Minnesota, Minneapolis (C.A.H.); VA New England Healthcare System and Boston University School of Medicine, Boston (W.E.B.); and Saint Luke's Mid America Heart Institute/University of Missouri-Kansas City (J.A.S.) and St. Louis University School of Medicine Center for Comprehensive Cardiovascular Care, St. Louis (B.R.C.). FAU - Maron, David J AU - Maron DJ AD - From the New York University Grossman School of Medicine (S. Bangalore, H.R.R., J.S.B., J.D.N., J.S.H.), Mount Sinai Hospital (G.W.S.), the Cardiovascular Research Foundation (G.W.S., Z.A.A.), and Columbia University Irving Medical Center/New York Presbyterian Hospital (Z.A.A.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; the Department of Medicine, Stanford University School of Medicine, Stanford, CA (D.J.M., G.M.C.); Duke Clinical Research Institute, Durham, NC (S.M.O., S. Broderick, Z.H., D.B.M., K.P.A.); the National, Heart, Lung and Blood Institute, Bethesda, MD (J.L.F.); E.N. Meshalkin National Medical Research Center, Novosibirsk (E.I.K.), and Bakulev National Medical Research Center for Cardiovascular Surgery, Moscow (O.B.) - both in Russia; Mediterranea Cardiocentro, Naples, Italy (C.B.); Batra Hospital and Medical Research Centre, New Delhi, India (U.K.); Medical University of Warsaw (T.M.) and the Department of Coronary and Structural Heart Diseases, Institute of Cardiology (R.P.) - both in Warsaw, Poland; Columbia Veterans Affairs (VA) Health Care System, Columbia, SC (R.O.M.); Hennepin Healthcare, University of Minnesota, Minneapolis (C.A.H.); VA New England Healthcare System and Boston University School of Medicine, Boston (W.E.B.); and Saint Luke's Mid America Heart Institute/University of Missouri-Kansas City (J.A.S.) and St. Louis University School of Medicine Center for Comprehensive Cardiovascular Care, St. Louis (B.R.C.). FAU - O'Brien, Sean M AU - O'Brien SM AD - From the New York University Grossman School of Medicine (S. Bangalore, H.R.R., J.S.B., J.D.N., J.S.H.), Mount Sinai Hospital (G.W.S.), the Cardiovascular Research Foundation (G.W.S., Z.A.A.), and Columbia University Irving Medical Center/New York Presbyterian Hospital (Z.A.A.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; the Department of Medicine, Stanford University School of Medicine, Stanford, CA (D.J.M., G.M.C.); Duke Clinical Research Institute, Durham, NC (S.M.O., S. Broderick, Z.H., D.B.M., K.P.A.); the National, Heart, Lung and Blood Institute, Bethesda, MD (J.L.F.); E.N. Meshalkin National Medical Research Center, Novosibirsk (E.I.K.), and Bakulev National Medical Research Center for Cardiovascular Surgery, Moscow (O.B.) - both in Russia; Mediterranea Cardiocentro, Naples, Italy (C.B.); Batra Hospital and Medical Research Centre, New Delhi, India (U.K.); Medical University of Warsaw (T.M.) and the Department of Coronary and Structural Heart Diseases, Institute of Cardiology (R.P.) - both in Warsaw, Poland; Columbia Veterans Affairs (VA) Health Care System, Columbia, SC (R.O.M.); Hennepin Healthcare, University of Minnesota, Minneapolis (C.A.H.); VA New England Healthcare System and Boston University School of Medicine, Boston (W.E.B.); and Saint Luke's Mid America Heart Institute/University of Missouri-Kansas City (J.A.S.) and St. Louis University School of Medicine Center for Comprehensive Cardiovascular Care, St. Louis (B.R.C.). FAU - Fleg, Jerome L AU - Fleg JL AD - From the New York University Grossman School of Medicine (S. Bangalore, H.R.R., J.S.B., J.D.N., J.S.H.), Mount Sinai Hospital (G.W.S.), the Cardiovascular Research Foundation (G.W.S., Z.A.A.), and Columbia University Irving Medical Center/New York Presbyterian Hospital (Z.A.A.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; the Department of Medicine, Stanford University School of Medicine, Stanford, CA (D.J.M., G.M.C.); Duke Clinical Research Institute, Durham, NC (S.M.O., S. Broderick, Z.H., D.B.M., K.P.A.); the National, Heart, Lung and Blood Institute, Bethesda, MD (J.L.F.); E.N. Meshalkin National Medical Research Center, Novosibirsk (E.I.K.), and Bakulev National Medical Research Center for Cardiovascular Surgery, Moscow (O.B.) - both in Russia; Mediterranea Cardiocentro, Naples, Italy (C.B.); Batra Hospital and Medical Research Centre, New Delhi, India (U.K.); Medical University of Warsaw (T.M.) and the Department of Coronary and Structural Heart Diseases, Institute of Cardiology (R.P.) - both in Warsaw, Poland; Columbia Veterans Affairs (VA) Health Care System, Columbia, SC (R.O.M.); Hennepin Healthcare, University of Minnesota, Minneapolis (C.A.H.); VA New England Healthcare System and Boston University School of Medicine, Boston (W.E.B.); and Saint Luke's Mid America Heart Institute/University of Missouri-Kansas City (J.A.S.) and St. Louis University School of Medicine Center for Comprehensive Cardiovascular Care, St. Louis (B.R.C.). FAU - Kretov, Evgeny I AU - Kretov EI AD - From the New York University Grossman School of Medicine (S. Bangalore, H.R.R., J.S.B., J.D.N., J.S.H.), Mount Sinai Hospital (G.W.S.), the Cardiovascular Research Foundation (G.W.S., Z.A.A.), and Columbia University Irving Medical Center/New York Presbyterian Hospital (Z.A.A.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; the Department of Medicine, Stanford University School of Medicine, Stanford, CA (D.J.M., G.M.C.); Duke Clinical Research Institute, Durham, NC (S.M.O., S. Broderick, Z.H., D.B.M., K.P.A.); the National, Heart, Lung and Blood Institute, Bethesda, MD (J.L.F.); E.N. Meshalkin National Medical Research Center, Novosibirsk (E.I.K.), and Bakulev National Medical Research Center for Cardiovascular Surgery, Moscow (O.B.) - both in Russia; Mediterranea Cardiocentro, Naples, Italy (C.B.); Batra Hospital and Medical Research Centre, New Delhi, India (U.K.); Medical University of Warsaw (T.M.) and the Department of Coronary and Structural Heart Diseases, Institute of Cardiology (R.P.) - both in Warsaw, Poland; Columbia Veterans Affairs (VA) Health Care System, Columbia, SC (R.O.M.); Hennepin Healthcare, University of Minnesota, Minneapolis (C.A.H.); VA New England Healthcare System and Boston University School of Medicine, Boston (W.E.B.); and Saint Luke's Mid America Heart Institute/University of Missouri-Kansas City (J.A.S.) and St. Louis University School of Medicine Center for Comprehensive Cardiovascular Care, St. Louis (B.R.C.). FAU - Briguori, Carlo AU - Briguori C AD - From the New York University Grossman School of Medicine (S. Bangalore, H.R.R., J.S.B., J.D.N., J.S.H.), Mount Sinai Hospital (G.W.S.), the Cardiovascular Research Foundation (G.W.S., Z.A.A.), and Columbia University Irving Medical Center/New York Presbyterian Hospital (Z.A.A.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; the Department of Medicine, Stanford University School of Medicine, Stanford, CA (D.J.M., G.M.C.); Duke Clinical Research Institute, Durham, NC (S.M.O., S. Broderick, Z.H., D.B.M., K.P.A.); the National, Heart, Lung and Blood Institute, Bethesda, MD (J.L.F.); E.N. Meshalkin National Medical Research Center, Novosibirsk (E.I.K.), and Bakulev National Medical Research Center for Cardiovascular Surgery, Moscow (O.B.) - both in Russia; Mediterranea Cardiocentro, Naples, Italy (C.B.); Batra Hospital and Medical Research Centre, New Delhi, India (U.K.); Medical University of Warsaw (T.M.) and the Department of Coronary and Structural Heart Diseases, Institute of Cardiology (R.P.) - both in Warsaw, Poland; Columbia Veterans Affairs (VA) Health Care System, Columbia, SC (R.O.M.); Hennepin Healthcare, University of Minnesota, Minneapolis (C.A.H.); VA New England Healthcare System and Boston University School of Medicine, Boston (W.E.B.); and Saint Luke's Mid America Heart Institute/University of Missouri-Kansas City (J.A.S.) and St. Louis University School of Medicine Center for Comprehensive Cardiovascular Care, St. Louis (B.R.C.). FAU - Kaul, Upendra AU - Kaul U AD - From the New York University Grossman School of Medicine (S. Bangalore, H.R.R., J.S.B., J.D.N., J.S.H.), Mount Sinai Hospital (G.W.S.), the Cardiovascular Research Foundation (G.W.S., Z.A.A.), and Columbia University Irving Medical Center/New York Presbyterian Hospital (Z.A.A.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; the Department of Medicine, Stanford University School of Medicine, Stanford, CA (D.J.M., G.M.C.); Duke Clinical Research Institute, Durham, NC (S.M.O., S. Broderick, Z.H., D.B.M., K.P.A.); the National, Heart, Lung and Blood Institute, Bethesda, MD (J.L.F.); E.N. Meshalkin National Medical Research Center, Novosibirsk (E.I.K.), and Bakulev National Medical Research Center for Cardiovascular Surgery, Moscow (O.B.) - both in Russia; Mediterranea Cardiocentro, Naples, Italy (C.B.); Batra Hospital and Medical Research Centre, New Delhi, India (U.K.); Medical University of Warsaw (T.M.) and the Department of Coronary and Structural Heart Diseases, Institute of Cardiology (R.P.) - both in Warsaw, Poland; Columbia Veterans Affairs (VA) Health Care System, Columbia, SC (R.O.M.); Hennepin Healthcare, University of Minnesota, Minneapolis (C.A.H.); VA New England Healthcare System and Boston University School of Medicine, Boston (W.E.B.); and Saint Luke's Mid America Heart Institute/University of Missouri-Kansas City (J.A.S.) and St. Louis University School of Medicine Center for Comprehensive Cardiovascular Care, St. Louis (B.R.C.). FAU - Reynolds, Harmony R AU - Reynolds HR AD - From the New York University Grossman School of Medicine (S. Bangalore, H.R.R., J.S.B., J.D.N., J.S.H.), Mount Sinai Hospital (G.W.S.), the Cardiovascular Research Foundation (G.W.S., Z.A.A.), and Columbia University Irving Medical Center/New York Presbyterian Hospital (Z.A.A.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; the Department of Medicine, Stanford University School of Medicine, Stanford, CA (D.J.M., G.M.C.); Duke Clinical Research Institute, Durham, NC (S.M.O., S. Broderick, Z.H., D.B.M., K.P.A.); the National, Heart, Lung and Blood Institute, Bethesda, MD (J.L.F.); E.N. Meshalkin National Medical Research Center, Novosibirsk (E.I.K.), and Bakulev National Medical Research Center for Cardiovascular Surgery, Moscow (O.B.) - both in Russia; Mediterranea Cardiocentro, Naples, Italy (C.B.); Batra Hospital and Medical Research Centre, New Delhi, India (U.K.); Medical University of Warsaw (T.M.) and the Department of Coronary and Structural Heart Diseases, Institute of Cardiology (R.P.) - both in Warsaw, Poland; Columbia Veterans Affairs (VA) Health Care System, Columbia, SC (R.O.M.); Hennepin Healthcare, University of Minnesota, Minneapolis (C.A.H.); VA New England Healthcare System and Boston University School of Medicine, Boston (W.E.B.); and Saint Luke's Mid America Heart Institute/University of Missouri-Kansas City (J.A.S.) and St. Louis University School of Medicine Center for Comprehensive Cardiovascular Care, St. Louis (B.R.C.). FAU - Mazurek, Tomasz AU - Mazurek T AD - From the New York University Grossman School of Medicine (S. Bangalore, H.R.R., J.S.B., J.D.N., J.S.H.), Mount Sinai Hospital (G.W.S.), the Cardiovascular Research Foundation (G.W.S., Z.A.A.), and Columbia University Irving Medical Center/New York Presbyterian Hospital (Z.A.A.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; the Department of Medicine, Stanford University School of Medicine, Stanford, CA (D.J.M., G.M.C.); Duke Clinical Research Institute, Durham, NC (S.M.O., S. Broderick, Z.H., D.B.M., K.P.A.); the National, Heart, Lung and Blood Institute, Bethesda, MD (J.L.F.); E.N. Meshalkin National Medical Research Center, Novosibirsk (E.I.K.), and Bakulev National Medical Research Center for Cardiovascular Surgery, Moscow (O.B.) - both in Russia; Mediterranea Cardiocentro, Naples, Italy (C.B.); Batra Hospital and Medical Research Centre, New Delhi, India (U.K.); Medical University of Warsaw (T.M.) and the Department of Coronary and Structural Heart Diseases, Institute of Cardiology (R.P.) - both in Warsaw, Poland; Columbia Veterans Affairs (VA) Health Care System, Columbia, SC (R.O.M.); Hennepin Healthcare, University of Minnesota, Minneapolis (C.A.H.); VA New England Healthcare System and Boston University School of Medicine, Boston (W.E.B.); and Saint Luke's Mid America Heart Institute/University of Missouri-Kansas City (J.A.S.) and St. Louis University School of Medicine Center for Comprehensive Cardiovascular Care, St. Louis (B.R.C.). FAU - Sidhu, Mandeep S AU - Sidhu MS AD - From the New York University Grossman School of Medicine (S. Bangalore, H.R.R., J.S.B., J.D.N., J.S.H.), Mount Sinai Hospital (G.W.S.), the Cardiovascular Research Foundation (G.W.S., Z.A.A.), and Columbia University Irving Medical Center/New York Presbyterian Hospital (Z.A.A.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; the Department of Medicine, Stanford University School of Medicine, Stanford, CA (D.J.M., G.M.C.); Duke Clinical Research Institute, Durham, NC (S.M.O., S. Broderick, Z.H., D.B.M., K.P.A.); the National, Heart, Lung and Blood Institute, Bethesda, MD (J.L.F.); E.N. Meshalkin National Medical Research Center, Novosibirsk (E.I.K.), and Bakulev National Medical Research Center for Cardiovascular Surgery, Moscow (O.B.) - both in Russia; Mediterranea Cardiocentro, Naples, Italy (C.B.); Batra Hospital and Medical Research Centre, New Delhi, India (U.K.); Medical University of Warsaw (T.M.) and the Department of Coronary and Structural Heart Diseases, Institute of Cardiology (R.P.) - both in Warsaw, Poland; Columbia Veterans Affairs (VA) Health Care System, Columbia, SC (R.O.M.); Hennepin Healthcare, University of Minnesota, Minneapolis (C.A.H.); VA New England Healthcare System and Boston University School of Medicine, Boston (W.E.B.); and Saint Luke's Mid America Heart Institute/University of Missouri-Kansas City (J.A.S.) and St. Louis University School of Medicine Center for Comprehensive Cardiovascular Care, St. Louis (B.R.C.). FAU - Berger, Jeffrey S AU - Berger JS AD - From the New York University Grossman School of Medicine (S. Bangalore, H.R.R., J.S.B., J.D.N., J.S.H.), Mount Sinai Hospital (G.W.S.), the Cardiovascular Research Foundation (G.W.S., Z.A.A.), and Columbia University Irving Medical Center/New York Presbyterian Hospital (Z.A.A.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; the Department of Medicine, Stanford University School of Medicine, Stanford, CA (D.J.M., G.M.C.); Duke Clinical Research Institute, Durham, NC (S.M.O., S. Broderick, Z.H., D.B.M., K.P.A.); the National, Heart, Lung and Blood Institute, Bethesda, MD (J.L.F.); E.N. Meshalkin National Medical Research Center, Novosibirsk (E.I.K.), and Bakulev National Medical Research Center for Cardiovascular Surgery, Moscow (O.B.) - both in Russia; Mediterranea Cardiocentro, Naples, Italy (C.B.); Batra Hospital and Medical Research Centre, New Delhi, India (U.K.); Medical University of Warsaw (T.M.) and the Department of Coronary and Structural Heart Diseases, Institute of Cardiology (R.P.) - both in Warsaw, Poland; Columbia Veterans Affairs (VA) Health Care System, Columbia, SC (R.O.M.); Hennepin Healthcare, University of Minnesota, Minneapolis (C.A.H.); VA New England Healthcare System and Boston University School of Medicine, Boston (W.E.B.); and Saint Luke's Mid America Heart Institute/University of Missouri-Kansas City (J.A.S.) and St. Louis University School of Medicine Center for Comprehensive Cardiovascular Care, St. Louis (B.R.C.). FAU - Mathew, Roy O AU - Mathew RO AD - From the New York University Grossman School of Medicine (S. Bangalore, H.R.R., J.S.B., J.D.N., J.S.H.), Mount Sinai Hospital (G.W.S.), the Cardiovascular Research Foundation (G.W.S., Z.A.A.), and Columbia University Irving Medical Center/New York Presbyterian Hospital (Z.A.A.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; the Department of Medicine, Stanford University School of Medicine, Stanford, CA (D.J.M., G.M.C.); Duke Clinical Research Institute, Durham, NC (S.M.O., S. Broderick, Z.H., D.B.M., K.P.A.); the National, Heart, Lung and Blood Institute, Bethesda, MD (J.L.F.); E.N. Meshalkin National Medical Research Center, Novosibirsk (E.I.K.), and Bakulev National Medical Research Center for Cardiovascular Surgery, Moscow (O.B.) - both in Russia; Mediterranea Cardiocentro, Naples, Italy (C.B.); Batra Hospital and Medical Research Centre, New Delhi, India (U.K.); Medical University of Warsaw (T.M.) and the Department of Coronary and Structural Heart Diseases, Institute of Cardiology (R.P.) - both in Warsaw, Poland; Columbia Veterans Affairs (VA) Health Care System, Columbia, SC (R.O.M.); Hennepin Healthcare, University of Minnesota, Minneapolis (C.A.H.); VA New England Healthcare System and Boston University School of Medicine, Boston (W.E.B.); and Saint Luke's Mid America Heart Institute/University of Missouri-Kansas City (J.A.S.) and St. Louis University School of Medicine Center for Comprehensive Cardiovascular Care, St. Louis (B.R.C.). FAU - Bockeria, Olga AU - Bockeria O AD - From the New York University Grossman School of Medicine (S. Bangalore, H.R.R., J.S.B., J.D.N., J.S.H.), Mount Sinai Hospital (G.W.S.), the Cardiovascular Research Foundation (G.W.S., Z.A.A.), and Columbia University Irving Medical Center/New York Presbyterian Hospital (Z.A.A.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; the Department of Medicine, Stanford University School of Medicine, Stanford, CA (D.J.M., G.M.C.); Duke Clinical Research Institute, Durham, NC (S.M.O., S. Broderick, Z.H., D.B.M., K.P.A.); the National, Heart, Lung and Blood Institute, Bethesda, MD (J.L.F.); E.N. Meshalkin National Medical Research Center, Novosibirsk (E.I.K.), and Bakulev National Medical Research Center for Cardiovascular Surgery, Moscow (O.B.) - both in Russia; Mediterranea Cardiocentro, Naples, Italy (C.B.); Batra Hospital and Medical Research Centre, New Delhi, India (U.K.); Medical University of Warsaw (T.M.) and the Department of Coronary and Structural Heart Diseases, Institute of Cardiology (R.P.) - both in Warsaw, Poland; Columbia Veterans Affairs (VA) Health Care System, Columbia, SC (R.O.M.); Hennepin Healthcare, University of Minnesota, Minneapolis (C.A.H.); VA New England Healthcare System and Boston University School of Medicine, Boston (W.E.B.); and Saint Luke's Mid America Heart Institute/University of Missouri-Kansas City (J.A.S.) and St. Louis University School of Medicine Center for Comprehensive Cardiovascular Care, St. Louis (B.R.C.). FAU - Broderick, Samuel AU - Broderick S AD - From the New York University Grossman School of Medicine (S. Bangalore, H.R.R., J.S.B., J.D.N., J.S.H.), Mount Sinai Hospital (G.W.S.), the Cardiovascular Research Foundation (G.W.S., Z.A.A.), and Columbia University Irving Medical Center/New York Presbyterian Hospital (Z.A.A.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; the Department of Medicine, Stanford University School of Medicine, Stanford, CA (D.J.M., G.M.C.); Duke Clinical Research Institute, Durham, NC (S.M.O., S. Broderick, Z.H., D.B.M., K.P.A.); the National, Heart, Lung and Blood Institute, Bethesda, MD (J.L.F.); E.N. Meshalkin National Medical Research Center, Novosibirsk (E.I.K.), and Bakulev National Medical Research Center for Cardiovascular Surgery, Moscow (O.B.) - both in Russia; Mediterranea Cardiocentro, Naples, Italy (C.B.); Batra Hospital and Medical Research Centre, New Delhi, India (U.K.); Medical University of Warsaw (T.M.) and the Department of Coronary and Structural Heart Diseases, Institute of Cardiology (R.P.) - both in Warsaw, Poland; Columbia Veterans Affairs (VA) Health Care System, Columbia, SC (R.O.M.); Hennepin Healthcare, University of Minnesota, Minneapolis (C.A.H.); VA New England Healthcare System and Boston University School of Medicine, Boston (W.E.B.); and Saint Luke's Mid America Heart Institute/University of Missouri-Kansas City (J.A.S.) and St. Louis University School of Medicine Center for Comprehensive Cardiovascular Care, St. Louis (B.R.C.). FAU - Pracon, Radoslaw AU - Pracon R AUID- ORCID: 0000-0001-7519-0003 AD - From the New York University Grossman School of Medicine (S. Bangalore, H.R.R., J.S.B., J.D.N., J.S.H.), Mount Sinai Hospital (G.W.S.), the Cardiovascular Research Foundation (G.W.S., Z.A.A.), and Columbia University Irving Medical Center/New York Presbyterian Hospital (Z.A.A.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; the Department of Medicine, Stanford University School of Medicine, Stanford, CA (D.J.M., G.M.C.); Duke Clinical Research Institute, Durham, NC (S.M.O., S. Broderick, Z.H., D.B.M., K.P.A.); the National, Heart, Lung and Blood Institute, Bethesda, MD (J.L.F.); E.N. Meshalkin National Medical Research Center, Novosibirsk (E.I.K.), and Bakulev National Medical Research Center for Cardiovascular Surgery, Moscow (O.B.) - both in Russia; Mediterranea Cardiocentro, Naples, Italy (C.B.); Batra Hospital and Medical Research Centre, New Delhi, India (U.K.); Medical University of Warsaw (T.M.) and the Department of Coronary and Structural Heart Diseases, Institute of Cardiology (R.P.) - both in Warsaw, Poland; Columbia Veterans Affairs (VA) Health Care System, Columbia, SC (R.O.M.); Hennepin Healthcare, University of Minnesota, Minneapolis (C.A.H.); VA New England Healthcare System and Boston University School of Medicine, Boston (W.E.B.); and Saint Luke's Mid America Heart Institute/University of Missouri-Kansas City (J.A.S.) and St. Louis University School of Medicine Center for Comprehensive Cardiovascular Care, St. Louis (B.R.C.). FAU - Herzog, Charles A AU - Herzog CA AD - From the New York University Grossman School of Medicine (S. Bangalore, H.R.R., J.S.B., J.D.N., J.S.H.), Mount Sinai Hospital (G.W.S.), the Cardiovascular Research Foundation (G.W.S., Z.A.A.), and Columbia University Irving Medical Center/New York Presbyterian Hospital (Z.A.A.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; the Department of Medicine, Stanford University School of Medicine, Stanford, CA (D.J.M., G.M.C.); Duke Clinical Research Institute, Durham, NC (S.M.O., S. Broderick, Z.H., D.B.M., K.P.A.); the National, Heart, Lung and Blood Institute, Bethesda, MD (J.L.F.); E.N. Meshalkin National Medical Research Center, Novosibirsk (E.I.K.), and Bakulev National Medical Research Center for Cardiovascular Surgery, Moscow (O.B.) - both in Russia; Mediterranea Cardiocentro, Naples, Italy (C.B.); Batra Hospital and Medical Research Centre, New Delhi, India (U.K.); Medical University of Warsaw (T.M.) and the Department of Coronary and Structural Heart Diseases, Institute of Cardiology (R.P.) - both in Warsaw, Poland; Columbia Veterans Affairs (VA) Health Care System, Columbia, SC (R.O.M.); Hennepin Healthcare, University of Minnesota, Minneapolis (C.A.H.); VA New England Healthcare System and Boston University School of Medicine, Boston (W.E.B.); and Saint Luke's Mid America Heart Institute/University of Missouri-Kansas City (J.A.S.) and St. Louis University School of Medicine Center for Comprehensive Cardiovascular Care, St. Louis (B.R.C.). FAU - Huang, Zhen AU - Huang Z AD - From the New York University Grossman School of Medicine (S. Bangalore, H.R.R., J.S.B., J.D.N., J.S.H.), Mount Sinai Hospital (G.W.S.), the Cardiovascular Research Foundation (G.W.S., Z.A.A.), and Columbia University Irving Medical Center/New York Presbyterian Hospital (Z.A.A.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; the Department of Medicine, Stanford University School of Medicine, Stanford, CA (D.J.M., G.M.C.); Duke Clinical Research Institute, Durham, NC (S.M.O., S. Broderick, Z.H., D.B.M., K.P.A.); the National, Heart, Lung and Blood Institute, Bethesda, MD (J.L.F.); E.N. Meshalkin National Medical Research Center, Novosibirsk (E.I.K.), and Bakulev National Medical Research Center for Cardiovascular Surgery, Moscow (O.B.) - both in Russia; Mediterranea Cardiocentro, Naples, Italy (C.B.); Batra Hospital and Medical Research Centre, New Delhi, India (U.K.); Medical University of Warsaw (T.M.) and the Department of Coronary and Structural Heart Diseases, Institute of Cardiology (R.P.) - both in Warsaw, Poland; Columbia Veterans Affairs (VA) Health Care System, Columbia, SC (R.O.M.); Hennepin Healthcare, University of Minnesota, Minneapolis (C.A.H.); VA New England Healthcare System and Boston University School of Medicine, Boston (W.E.B.); and Saint Luke's Mid America Heart Institute/University of Missouri-Kansas City (J.A.S.) and St. Louis University School of Medicine Center for Comprehensive Cardiovascular Care, St. Louis (B.R.C.). FAU - Stone, Gregg W AU - Stone GW AUID- ORCID: 0000-0002-3416-8210 AD - From the New York University Grossman School of Medicine (S. Bangalore, H.R.R., J.S.B., J.D.N., J.S.H.), Mount Sinai Hospital (G.W.S.), the Cardiovascular Research Foundation (G.W.S., Z.A.A.), and Columbia University Irving Medical Center/New York Presbyterian Hospital (Z.A.A.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; the Department of Medicine, Stanford University School of Medicine, Stanford, CA (D.J.M., G.M.C.); Duke Clinical Research Institute, Durham, NC (S.M.O., S. Broderick, Z.H., D.B.M., K.P.A.); the National, Heart, Lung and Blood Institute, Bethesda, MD (J.L.F.); E.N. Meshalkin National Medical Research Center, Novosibirsk (E.I.K.), and Bakulev National Medical Research Center for Cardiovascular Surgery, Moscow (O.B.) - both in Russia; Mediterranea Cardiocentro, Naples, Italy (C.B.); Batra Hospital and Medical Research Centre, New Delhi, India (U.K.); Medical University of Warsaw (T.M.) and the Department of Coronary and Structural Heart Diseases, Institute of Cardiology (R.P.) - both in Warsaw, Poland; Columbia Veterans Affairs (VA) Health Care System, Columbia, SC (R.O.M.); Hennepin Healthcare, University of Minnesota, Minneapolis (C.A.H.); VA New England Healthcare System and Boston University School of Medicine, Boston (W.E.B.); and Saint Luke's Mid America Heart Institute/University of Missouri-Kansas City (J.A.S.) and St. Louis University School of Medicine Center for Comprehensive Cardiovascular Care, St. Louis (B.R.C.). FAU - Boden, William E AU - Boden WE AD - From the New York University Grossman School of Medicine (S. Bangalore, H.R.R., J.S.B., J.D.N., J.S.H.), Mount Sinai Hospital (G.W.S.), the Cardiovascular Research Foundation (G.W.S., Z.A.A.), and Columbia University Irving Medical Center/New York Presbyterian Hospital (Z.A.A.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; the Department of Medicine, Stanford University School of Medicine, Stanford, CA (D.J.M., G.M.C.); Duke Clinical Research Institute, Durham, NC (S.M.O., S. Broderick, Z.H., D.B.M., K.P.A.); the National, Heart, Lung and Blood Institute, Bethesda, MD (J.L.F.); E.N. Meshalkin National Medical Research Center, Novosibirsk (E.I.K.), and Bakulev National Medical Research Center for Cardiovascular Surgery, Moscow (O.B.) - both in Russia; Mediterranea Cardiocentro, Naples, Italy (C.B.); Batra Hospital and Medical Research Centre, New Delhi, India (U.K.); Medical University of Warsaw (T.M.) and the Department of Coronary and Structural Heart Diseases, Institute of Cardiology (R.P.) - both in Warsaw, Poland; Columbia Veterans Affairs (VA) Health Care System, Columbia, SC (R.O.M.); Hennepin Healthcare, University of Minnesota, Minneapolis (C.A.H.); VA New England Healthcare System and Boston University School of Medicine, Boston (W.E.B.); and Saint Luke's Mid America Heart Institute/University of Missouri-Kansas City (J.A.S.) and St. Louis University School of Medicine Center for Comprehensive Cardiovascular Care, St. Louis (B.R.C.). FAU - Newman, Jonathan D AU - Newman JD AD - From the New York University Grossman School of Medicine (S. Bangalore, H.R.R., J.S.B., J.D.N., J.S.H.), Mount Sinai Hospital (G.W.S.), the Cardiovascular Research Foundation (G.W.S., Z.A.A.), and Columbia University Irving Medical Center/New York Presbyterian Hospital (Z.A.A.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; the Department of Medicine, Stanford University School of Medicine, Stanford, CA (D.J.M., G.M.C.); Duke Clinical Research Institute, Durham, NC (S.M.O., S. Broderick, Z.H., D.B.M., K.P.A.); the National, Heart, Lung and Blood Institute, Bethesda, MD (J.L.F.); E.N. Meshalkin National Medical Research Center, Novosibirsk (E.I.K.), and Bakulev National Medical Research Center for Cardiovascular Surgery, Moscow (O.B.) - both in Russia; Mediterranea Cardiocentro, Naples, Italy (C.B.); Batra Hospital and Medical Research Centre, New Delhi, India (U.K.); Medical University of Warsaw (T.M.) and the Department of Coronary and Structural Heart Diseases, Institute of Cardiology (R.P.) - both in Warsaw, Poland; Columbia Veterans Affairs (VA) Health Care System, Columbia, SC (R.O.M.); Hennepin Healthcare, University of Minnesota, Minneapolis (C.A.H.); VA New England Healthcare System and Boston University School of Medicine, Boston (W.E.B.); and Saint Luke's Mid America Heart Institute/University of Missouri-Kansas City (J.A.S.) and St. Louis University School of Medicine Center for Comprehensive Cardiovascular Care, St. Louis (B.R.C.). FAU - Ali, Ziad A AU - Ali ZA AD - From the New York University Grossman School of Medicine (S. Bangalore, H.R.R., J.S.B., J.D.N., J.S.H.), Mount Sinai Hospital (G.W.S.), the Cardiovascular Research Foundation (G.W.S., Z.A.A.), and Columbia University Irving Medical Center/New York Presbyterian Hospital (Z.A.A.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; the Department of Medicine, Stanford University School of Medicine, Stanford, CA (D.J.M., G.M.C.); Duke Clinical Research Institute, Durham, NC (S.M.O., S. Broderick, Z.H., D.B.M., K.P.A.); the National, Heart, Lung and Blood Institute, Bethesda, MD (J.L.F.); E.N. Meshalkin National Medical Research Center, Novosibirsk (E.I.K.), and Bakulev National Medical Research Center for Cardiovascular Surgery, Moscow (O.B.) - both in Russia; Mediterranea Cardiocentro, Naples, Italy (C.B.); Batra Hospital and Medical Research Centre, New Delhi, India (U.K.); Medical University of Warsaw (T.M.) and the Department of Coronary and Structural Heart Diseases, Institute of Cardiology (R.P.) - both in Warsaw, Poland; Columbia Veterans Affairs (VA) Health Care System, Columbia, SC (R.O.M.); Hennepin Healthcare, University of Minnesota, Minneapolis (C.A.H.); VA New England Healthcare System and Boston University School of Medicine, Boston (W.E.B.); and Saint Luke's Mid America Heart Institute/University of Missouri-Kansas City (J.A.S.) and St. Louis University School of Medicine Center for Comprehensive Cardiovascular Care, St. Louis (B.R.C.). FAU - Mark, Daniel B AU - Mark DB AD - From the New York University Grossman School of Medicine (S. Bangalore, H.R.R., J.S.B., J.D.N., J.S.H.), Mount Sinai Hospital (G.W.S.), the Cardiovascular Research Foundation (G.W.S., Z.A.A.), and Columbia University Irving Medical Center/New York Presbyterian Hospital (Z.A.A.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; the Department of Medicine, Stanford University School of Medicine, Stanford, CA (D.J.M., G.M.C.); Duke Clinical Research Institute, Durham, NC (S.M.O., S. Broderick, Z.H., D.B.M., K.P.A.); the National, Heart, Lung and Blood Institute, Bethesda, MD (J.L.F.); E.N. Meshalkin National Medical Research Center, Novosibirsk (E.I.K.), and Bakulev National Medical Research Center for Cardiovascular Surgery, Moscow (O.B.) - both in Russia; Mediterranea Cardiocentro, Naples, Italy (C.B.); Batra Hospital and Medical Research Centre, New Delhi, India (U.K.); Medical University of Warsaw (T.M.) and the Department of Coronary and Structural Heart Diseases, Institute of Cardiology (R.P.) - both in Warsaw, Poland; Columbia Veterans Affairs (VA) Health Care System, Columbia, SC (R.O.M.); Hennepin Healthcare, University of Minnesota, Minneapolis (C.A.H.); VA New England Healthcare System and Boston University School of Medicine, Boston (W.E.B.); and Saint Luke's Mid America Heart Institute/University of Missouri-Kansas City (J.A.S.) and St. Louis University School of Medicine Center for Comprehensive Cardiovascular Care, St. Louis (B.R.C.). FAU - Spertus, John A AU - Spertus JA AD - From the New York University Grossman School of Medicine (S. Bangalore, H.R.R., J.S.B., J.D.N., J.S.H.), Mount Sinai Hospital (G.W.S.), the Cardiovascular Research Foundation (G.W.S., Z.A.A.), and Columbia University Irving Medical Center/New York Presbyterian Hospital (Z.A.A.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; the Department of Medicine, Stanford University School of Medicine, Stanford, CA (D.J.M., G.M.C.); Duke Clinical Research Institute, Durham, NC (S.M.O., S. Broderick, Z.H., D.B.M., K.P.A.); the National, Heart, Lung and Blood Institute, Bethesda, MD (J.L.F.); E.N. Meshalkin National Medical Research Center, Novosibirsk (E.I.K.), and Bakulev National Medical Research Center for Cardiovascular Surgery, Moscow (O.B.) - both in Russia; Mediterranea Cardiocentro, Naples, Italy (C.B.); Batra Hospital and Medical Research Centre, New Delhi, India (U.K.); Medical University of Warsaw (T.M.) and the Department of Coronary and Structural Heart Diseases, Institute of Cardiology (R.P.) - both in Warsaw, Poland; Columbia Veterans Affairs (VA) Health Care System, Columbia, SC (R.O.M.); Hennepin Healthcare, University of Minnesota, Minneapolis (C.A.H.); VA New England Healthcare System and Boston University School of Medicine, Boston (W.E.B.); and Saint Luke's Mid America Heart Institute/University of Missouri-Kansas City (J.A.S.) and St. Louis University School of Medicine Center for Comprehensive Cardiovascular Care, St. Louis (B.R.C.). FAU - Alexander, Karen P AU - Alexander KP AD - From the New York University Grossman School of Medicine (S. Bangalore, H.R.R., J.S.B., J.D.N., J.S.H.), Mount Sinai Hospital (G.W.S.), the Cardiovascular Research Foundation (G.W.S., Z.A.A.), and Columbia University Irving Medical Center/New York Presbyterian Hospital (Z.A.A.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; the Department of Medicine, Stanford University School of Medicine, Stanford, CA (D.J.M., G.M.C.); Duke Clinical Research Institute, Durham, NC (S.M.O., S. Broderick, Z.H., D.B.M., K.P.A.); the National, Heart, Lung and Blood Institute, Bethesda, MD (J.L.F.); E.N. Meshalkin National Medical Research Center, Novosibirsk (E.I.K.), and Bakulev National Medical Research Center for Cardiovascular Surgery, Moscow (O.B.) - both in Russia; Mediterranea Cardiocentro, Naples, Italy (C.B.); Batra Hospital and Medical Research Centre, New Delhi, India (U.K.); Medical University of Warsaw (T.M.) and the Department of Coronary and Structural Heart Diseases, Institute of Cardiology (R.P.) - both in Warsaw, Poland; Columbia Veterans Affairs (VA) Health Care System, Columbia, SC (R.O.M.); Hennepin Healthcare, University of Minnesota, Minneapolis (C.A.H.); VA New England Healthcare System and Boston University School of Medicine, Boston (W.E.B.); and Saint Luke's Mid America Heart Institute/University of Missouri-Kansas City (J.A.S.) and St. Louis University School of Medicine Center for Comprehensive Cardiovascular Care, St. Louis (B.R.C.). FAU - Chaitman, Bernard R AU - Chaitman BR AD - From the New York University Grossman School of Medicine (S. Bangalore, H.R.R., J.S.B., J.D.N., J.S.H.), Mount Sinai Hospital (G.W.S.), the Cardiovascular Research Foundation (G.W.S., Z.A.A.), and Columbia University Irving Medical Center/New York Presbyterian Hospital (Z.A.A.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; the Department of Medicine, Stanford University School of Medicine, Stanford, CA (D.J.M., G.M.C.); Duke Clinical Research Institute, Durham, NC (S.M.O., S. Broderick, Z.H., D.B.M., K.P.A.); the National, Heart, Lung and Blood Institute, Bethesda, MD (J.L.F.); E.N. Meshalkin National Medical Research Center, Novosibirsk (E.I.K.), and Bakulev National Medical Research Center for Cardiovascular Surgery, Moscow (O.B.) - both in Russia; Mediterranea Cardiocentro, Naples, Italy (C.B.); Batra Hospital and Medical Research Centre, New Delhi, India (U.K.); Medical University of Warsaw (T.M.) and the Department of Coronary and Structural Heart Diseases, Institute of Cardiology (R.P.) - both in Warsaw, Poland; Columbia Veterans Affairs (VA) Health Care System, Columbia, SC (R.O.M.); Hennepin Healthcare, University of Minnesota, Minneapolis (C.A.H.); VA New England Healthcare System and Boston University School of Medicine, Boston (W.E.B.); and Saint Luke's Mid America Heart Institute/University of Missouri-Kansas City (J.A.S.) and St. Louis University School of Medicine Center for Comprehensive Cardiovascular Care, St. Louis (B.R.C.). FAU - Chertow, Glenn M AU - Chertow GM AD - From the New York University Grossman School of Medicine (S. Bangalore, H.R.R., J.S.B., J.D.N., J.S.H.), Mount Sinai Hospital (G.W.S.), the Cardiovascular Research Foundation (G.W.S., Z.A.A.), and Columbia University Irving Medical Center/New York Presbyterian Hospital (Z.A.A.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; the Department of Medicine, Stanford University School of Medicine, Stanford, CA (D.J.M., G.M.C.); Duke Clinical Research Institute, Durham, NC (S.M.O., S. Broderick, Z.H., D.B.M., K.P.A.); the National, Heart, Lung and Blood Institute, Bethesda, MD (J.L.F.); E.N. Meshalkin National Medical Research Center, Novosibirsk (E.I.K.), and Bakulev National Medical Research Center for Cardiovascular Surgery, Moscow (O.B.) - both in Russia; Mediterranea Cardiocentro, Naples, Italy (C.B.); Batra Hospital and Medical Research Centre, New Delhi, India (U.K.); Medical University of Warsaw (T.M.) and the Department of Coronary and Structural Heart Diseases, Institute of Cardiology (R.P.) - both in Warsaw, Poland; Columbia Veterans Affairs (VA) Health Care System, Columbia, SC (R.O.M.); Hennepin Healthcare, University of Minnesota, Minneapolis (C.A.H.); VA New England Healthcare System and Boston University School of Medicine, Boston (W.E.B.); and Saint Luke's Mid America Heart Institute/University of Missouri-Kansas City (J.A.S.) and St. Louis University School of Medicine Center for Comprehensive Cardiovascular Care, St. Louis (B.R.C.). FAU - Hochman, Judith S AU - Hochman JS AD - From the New York University Grossman School of Medicine (S. Bangalore, H.R.R., J.S.B., J.D.N., J.S.H.), Mount Sinai Hospital (G.W.S.), the Cardiovascular Research Foundation (G.W.S., Z.A.A.), and Columbia University Irving Medical Center/New York Presbyterian Hospital (Z.A.A.), New York, Albany Medical College and Albany Medical Center, Albany (M.S.S.), and St. Francis Hospital, Roslyn (Z.A.A.) - all in New York; the Department of Medicine, Stanford University School of Medicine, Stanford, CA (D.J.M., G.M.C.); Duke Clinical Research Institute, Durham, NC (S.M.O., S. Broderick, Z.H., D.B.M., K.P.A.); the National, Heart, Lung and Blood Institute, Bethesda, MD (J.L.F.); E.N. Meshalkin National Medical Research Center, Novosibirsk (E.I.K.), and Bakulev National Medical Research Center for Cardiovascular Surgery, Moscow (O.B.) - both in Russia; Mediterranea Cardiocentro, Naples, Italy (C.B.); Batra Hospital and Medical Research Centre, New Delhi, India (U.K.); Medical University of Warsaw (T.M.) and the Department of Coronary and Structural Heart Diseases, Institute of Cardiology (R.P.) - both in Warsaw, Poland; Columbia Veterans Affairs (VA) Health Care System, Columbia, SC (R.O.M.); Hennepin Healthcare, University of Minnesota, Minneapolis (C.A.H.); VA New England Healthcare System and Boston University School of Medicine, Boston (W.E.B.); and Saint Luke's Mid America Heart Institute/University of Missouri-Kansas City (J.A.S.) and St. Louis University School of Medicine Center for Comprehensive Cardiovascular Care, St. Louis (B.R.C.). CN - ISCHEMIA-CKD Research Group LA - eng SI - ClinicalTrials.gov/NCT01985360 GR - U01 HL105907/HL/NHLBI NIH HHS/United States GR - U01 HL117904/HL/NHLBI NIH HHS/United States GR - U01 HL117905/HL/NHLBI NIH HHS/United States GR - U01HL117904, U01HL117905/HL/NHLBI NIH HHS/United States PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't DEP - 20200330 PL - United States TA - N Engl J Med JT - The New England journal of medicine JID - 0255562 RN - 0 (Adrenergic beta-Antagonists) RN - 0 (Calcium Channel Blockers) SB - IM CIN - Nat Rev Cardiol. 2020 Jun;17(6):320-321. doi: 10.1038/s41569-020-0384-x. PMID: 32296146 CIN - Ann Intern Med. 2020 Aug 18;173(4):JC16. doi: 10.7326/ACPJ202008180-016. PMID: 32805175 CIN - N Engl J Med. 2020 Sep 10;383(11):1090. doi: 10.1056/NEJMc2024023. PMID: 32905686 CIN - N Engl J Med. 2020 Sep 10;383(11):1090. doi: 10.1056/NEJMc2024023. PMID: 32905687 CIN - N Engl J Med. 2020 Sep 10;383(11):1090-1091. doi: 10.1056/NEJMc2024023. PMID: 32905688 CIN - N Engl J Med. 2020 Sep 10;383(11):1091. doi: 10.1056/NEJMc2024023. PMID: 32905689 MH - Adrenergic beta-Antagonists/therapeutic use MH - Aged MH - Calcium Channel Blockers/therapeutic use MH - *Coronary Angiography MH - *Coronary Artery Bypass MH - Exercise Test MH - Female MH - Follow-Up Studies MH - Humans MH - Male MH - Middle Aged MH - Myocardial Infarction/prevention & control MH - Myocardial Ischemia/complications/*drug therapy/mortality/*surgery MH - *Percutaneous Coronary Intervention MH - Renal Insufficiency, Chronic/*complications MH - Risk Factors PMC - PMC7274537 MID - NIHMS1590458 FIR - Abdallah, Abdallah M IR - Abdallah AM FIR - Moreyra, Abel E IR - Moreyra AE FIR - Laddu, Abhay A IR - Laddu AA FIR - Dubey, Abhishek IR - Dubey A FIR - Goyal, Abhishek IR - Goyal A FIR - Knighton, Abigail IR - Knighton A FIR - Adeboye, Adedayo IR - Adeboye A FIR - Juceviciene, Agne IR - Juceviciene A FIR - Urboniene, Agne IR - Urboniene A FIR - Szramowska, Agnieszka IR - Szramowska A FIR - Abdel-Latif, Ahmed IR - Abdel-Latif A FIR - Ayoub, Ahmed IR - Ayoub A FIR - Elghamaz, Ahmed IR - Elghamaz A FIR - Kamal, Ahmed IR - Kamal A FIR - Talaat, Ahmed IR - Talaat A FIR - Sharma, Ajay IR - Sharma A FIR - Narula, Ajit Singh IR - Narula AS FIR - Bagai, Akshay IR - Bagai A FIR - Smigelskaite, Akvile IR - Smigelskaite A FIR - Raymond, Alain IR - Raymond A FIR - Rheault, Alain IR - Rheault A FIR - Loehr, Alaine Melanie IR - Loehr AM FIR - Varga, Albert IR - Varga A FIR - Maggioni, Aldo P IR - Maggioni AP FIR - Moorman, Alec IR - Moorman A FIR - Chevaile Ramos, Alejandro IR - Chevaile Ramos A FIR - Gisbert, Alejandro IR - Gisbert A FIR - Fratczak, Aleksandra IR - Fratczak A FIR - Laucevicius, Aleksandras IR - Laucevicius A FIR - Chernyavskiy, Alexander M IR - Chernyavskiy AM FIR - Borisov, Alexander Sergeevich IR - Borisov AS FIR - Craft, Alexandra IR - Craft A FIR - Hunter, Alexandra IR - Hunter A FIR - Hueb, Alexandre Ciappina IR - Hueb AC FIR - Schaan de Quadros, Alexandre IR - Schaan de Quadros A FIR - Muller, Alice Manica IR - Muller AM FIR - Deiro, Aline Peixoto IR - 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Campos-Santaolalla AS FIR - Cheema, Asim N IR - Cheema AN FIR - Ahmed, Asker IR - Ahmed A FIR - Mathur, Atul IR - Mathur A FIR - Leong, Audrey W IR - Leong AW FIR - Akerblom, Axel IR - Akerblom A FIR - Fuentes, Axelle IR - Fuentes A FIR - Naher, Aynun IR - Naher A FIR - Valaiyapathi, Badhma IR - Valaiyapathi B FIR - Srinivasan, Balaji IR - Srinivasan B FIR - Kaur, Baljeet IR - Kaur B FIR - Bhargava, Balram IR - Bhargava B FIR - Guruge, Bandula IR - Guruge B FIR - Wicklund, Barbara IR - Wicklund B FIR - Czarniak, Bartosz IR - Czarniak B FIR - Singh, Bebek IR - Singh B FIR - Igual, Begona IR - Igual B FIR - Merkely, Bela IR - Merkely B FIR - Shah, Benoy N IR - Shah BN FIR - de Bruyne, Bernard IR - de Bruyne B FIR - Abramson, Beth IR - Abramson B FIR - Stefanchik, Beth IR - Stefanchik B FIR - Harvey, Bethany IR - Harvey B FIR - Shivalkar, Bharati IR - Shivalkar B FIR - Malik, Bilal IR - Malik B FIR - Kurian, Binoy Mannekkattukudy IR - Kurian BM FIR - Hammouche, Bougrida IR - Hammouche B FIR - Beleslin, Branko D IR - Beleslin BD FIR - Ferguson, Bruce IR - Ferguson B FIR - McManus, Bruce IR - McManus B FIR - Ascoli, Bruna Maria IR - Ascoli BM FIR - Smith, Bryn IR - Smith B FIR - Allen, Byron J IR - Allen BJ FIR - Gibson, C Michael IR - Gibson CM FIR - Bairey Merz, C Noel IR - Bairey Merz CN FIR - Pop, Calin IR - Pop C FIR - Gagne, Carl-Eric IR - Gagne CE FIR - Ohmart, Carly IR - Ohmart C FIR - Kartje, Carol M IR - Kartje CM FIR - Alsweiler, Caroline IR - Alsweiler C FIR - Rodgers, Caroline IR - Rodgers C FIR - Spindler, Caroline IR - Spindler C FIR - Gruber, Carolyn J IR - Gruber CJ FIR - Albert, Catherine IR - Albert C FIR - Bone, Catherine IR - Bone C FIR - Lemay, Catherine IR - Lemay C FIR - Kepka, Cezary IR - Kepka C FIR - Suvarna, Chandini IR - Suvarna C FIR - Mercure, Chantale IR - Mercure C FIR - Wiyarand, Charlene IR - Wiyarand C FIR - Patel, Chetan IR - Patel C FIR - Attanasio, Chiara IR - Attanasio C FIR - Chow, Chi-Ming IR - Chow CM FIR - Er, Ching Min IR - Er CM FIR - Ong, Ching-Ching IR - Ong CC FIR - Manjunath, Cholenahally Nanjappa IR - Manjunath CN FIR - Buller, Chris IR - Buller C FIR - Vassaliere, Christel IR - Vassaliere C FIR - Vrints, Christiaan IR - Vrints C FIR - Witzke, Christian IR - Witzke C FIR - Ballantyne, Christie IR - Ballantyne C FIR - Bjorklund, Christina IR - Bjorklund C FIR - Roraff, Christine IR - Roraff C FIR - Laure, Christophe IR - Laure C FIR - Thuaire, Christophe IR - Thuaire C FIR - Chan, Christopher IR - Chan C FIR - Fordyce, Christopher IR - Fordyce C FIR - Kinsey, Christopher IR - Kinsey C FIR - Xia, Chunli IR - Xia C FIR - Schultz, Cidney IR - Schultz C FIR - Held, Claes IR - Held C FIR - Cortes, Claudia IR - Cortes C FIR - Escobar, Claudia IR - Escobar C FIR - Freixo, Claudia IR - Freixo C FIR - Kadalie, Clemens T IR - Kadalie CT FIR - Thobois, Corine IR - Thobois C FIR - Page, Courtney IR - Page C FIR - Bare, Cristina IR - Bare C FIR - Espinosa, Dalisa IR - Espinosa D FIR - Gao, Dan IR - Gao D FIR - Rizk, Dana IR - Rizk D FIR - Puzhevsky, Daniela IR - Puzhevsky D FIR - Analyst, Data IR - Analyst D FIR - Charytan, David M IR - Charytan DM FIR - Williams, David O IR - Williams DO FIR - Booth, David IR - Booth D FIR - Charytan, David IR - Charytan D FIR - Cohen, David IR - Cohen D FIR - DeMets, David IR - DeMets D FIR - Foo, David IR - Foo D FIR - Goldfarb, David IR - Goldfarb D FIR - Schlichting, David IR - Schlichting D FIR - Sisson, David IR - Sisson D FIR - Taggart, David IR - Taggart D FIR - Waters, David IR - Waters D FIR - Wheeler, David IR - Wheeler D FIR - Williams, David IR - Williams D FIR - Vo, Davis IR - Vo D FIR - Teodorczyk, Dawid IR - Teodorczyk D FIR - Shelstad, Dawn D IR - Shelstad DD FIR - Kereiakes, Dean IR - Kereiakes D FIR - Yip, Deborah IR - Yip D FIR - Ramaswamy, Deepa IR - Ramaswamy D FIR - Mattina, Deirdre IR - Mattina D FIR - Murphy, Deirdre IR - Murphy D FIR - Jiang, Dengke IR - Jiang D FIR - Cyr, Derek IR - Cyr D FIR - Cukali, Diana IR - Cukali D FIR - Camara, Diane IR - 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Al Solaiman F FIR - Egydio, Flavia IR - Egydio F FIR - Chereches, Florina IR - Chereches F FIR - De Micco, Francesca IR - De Micco F FIR - Bianchini, Francesca IR - Bianchini F FIR - Pietrucci, Francesca IR - Pietrucci F FIR - Orso, Francesco IR - Orso F FIR - Pisano, Francesco IR - Pisano F FIR - Patuleia Figueiras, Francisca IR - Patuleia Figueiras F FIR - Madore, Francois IR - Madore F FIR - Harrell, Frank IR - Harrell F FIR - Rockhold, Frank IR - Rockhold F FIR - Van de Werf, Frans IR - Van de Werf F FIR - Guenther, Franziska IR - Guenther F FIR - Mohr, Fred IR - Mohr F FIR - Karthikeyan, G IR - Karthikeyan G FIR - Galeote, Gabriel IR - Galeote G FIR - Grossmann, Gabriel IR - Grossmann G FIR - Steg, Gabriel IR - Steg G FIR - Guzman, Gabriela IR - Guzman G FIR - Gabrielli, Gabriele IR - Gabrielli G FIR - Chen, Gang IR - Chen G FIR - Sharma, Gautam IR - Sharma G FIR - Petty, Gaylin IR - Petty G FIR - Mikolaitiene, Gelmina IR - Mikolaitiene G FIR - Yee, Gennie IR - Yee G FIR - Devlin, Gerard Patrick IR - Devlin GP FIR - Esposito, Gerard IR - Esposito G FIR - Agoston, Gergely IR - Agoston G FIR - Lamas, Gervasio IR - Lamas G FIR - Cobb, Gia IR - Cobb G FIR - Perna, Gian Piero IR - Perna GP FIR - Leone, Gianpiero IR - Leone G FIR - Mishra, Girish IR - Mishra G FIR - Barge-Caballero, Gonzalo IR - Barge-Caballero G FIR - Young, Grace M IR - Young GM FIR - Scaro, Graciela IR - Scaro G FIR - Wong, Graham IR - Wong G FIR - Pressman, Gregg IR - Pressman G FIR - Simonis, Gregor IR - Simonis G FIR - Steinmaurer, Gudrun IR - Steinmaurer G FIR - Portugal, Guilherme IR - Portugal G FIR - Cantinho Lopes, Guilhermina IR - Cantinho Lopes G FIR - Garcia-Garcia, Guillermo IR - Garcia-Garcia G FIR - Wang, Guoqin IR - Wang G FIR - Wander, Gurpreet S IR - Wander GS FIR - Gulati, Gurpreet IR - Gulati G FIR - Zhang, Haibo IR - Zhang H FIR - Marciniak, Halina IR - Marciniak H FIR - Dai, Hao IR - Dai H FIR - Dong, Haojian IR - Dong H FIR - Franch, Harold IR - Franch H FIR - White, Harvey IR - White H FIR - Elabd, Hatem IR - Elabd H FIR - Pomeroy, Hayley IR - Pomeroy H FIR - Golden, Heather IR - Golden H FIR - Wilson, Heidi IR - Wilson H FIR - Abergel, Helene IR - Abergel H FIR - Siddaram, Hemalata IR - Siddaram H FIR - Mahapatra, Hemant Shakhar IR - Mahapatra HS FIR - Stokes, Henry C IR - Stokes HC FIR - Osseni, Hermine IR - Osseni H FIR - Schuchlenz, Herwig IR - Schuchlenz H FIR - Skali, Hicham IR - Skali H FIR - Mattix-Kramer, Holly IR - Mattix-Kramer H FIR - Cheng, Hong IR - Cheng H FIR - Mahrous, Hossam IR - Mahrous H FIR - Pejkov, Hristo IR - Pejkov H FIR - Marques, Hugo IR - Marques H FIR - Zhong, Hui IR - Zhong H FIR - El Fishawy, Hussien IR - El Fishawy H FIR - Webb, Ian IR - Webb I FIR - Kullo, Iftikhar IR - Kullo I FIR - Grazhdankin, Igor O IR - Grazhdankin IO FIR - Hassan, Ikraam IR - Hassan I FIR - Pina, Ileana L IR - Pina IL FIR - Tamasauskiene, Ilona IR - Tamasauskiene I FIR - Cabrita, Ines Zimbarra IR - Cabrita IZ FIR - Rodrigues, Ines IR - Rodrigues I FIR - Soveri, Inga IR - Soveri I FIR - Mitevska, Irena Peovska IR - Mitevska IP FIR - Lang, Irene Marthe IR - Lang IM FIR - Subbotina, Irina IR - Subbotina I FIR - Kalibataite-Rutkauskiene, Irma IR - Kalibataite-Rutkauskiene I FIR - Roy, Isabelle IR - Roy I FIR - Tejani, Ishita IR - Tejani I FIR - Naryshkin, Ivan A IR - Naryshkin IA FIR - Jankovic, Ivana IR - Jankovic I FIR - Niedzwiecka, Iwona IR - Niedzwiecka I FIR - Kusmierek, Jacek IR - Kusmierek J FIR - Chow, Jackie IR - Chow J FIR - Heo, Jaekyeong IR - Heo J FIR - Maksym, Jakub IR - Maksym J FIR - Davies, James E IR - Davies JE FIR - Jang, James J IR - Jang JJ FIR - Hirsch, James IR - Hirsch J FIR - Tatoulis, James IR - Tatoulis J FIR - Henzel, Jan IR - Henzel J FIR - Oliveira, Janaina IR - Oliveira J FIR - Rangaswami, Janani IR - Rangaswami J FIR - Eckstein, Jane IR - Eckstein J FIR - Raj, Janitha IR - Raj J FIR - Pozzibon, Jaqueline IR - Pozzibon J FIR - Drozdz, Jaroslaw IR - Drozdz J FIR - Kwok Kong, Jason Loh IR - Kwok Kong JL FIR - Call, Jason T IR - Call JT FIR - 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Yee J FIR - Berg, Jessica IR - Berg J FIR - Peteiro, Jesus IR - Peteiro J FIR - Peteiro, Jesus IR - Peteiro J FIR - Li, Jia IR - Li J FIR - Liu, Jiamin IR - Liu J FIR - Zhang, Jianxin IR - Zhang J FIR - Marcus, Jill IR - Marcus J FIR - Blankenship, Jim IR - Blankenship J FIR - Dong, Jing IR - Dong J FIR - Chen, Jiyan IR - Chen J FIR - Evans, Jo IR - Evans J FIR - Penafiel, Joaquin V IR - Penafiel JV FIR - Sabik, Joe IR - Sabik J FIR - Christopher, Johann IR - Christopher J FIR - Kostis, John B IR - Kostis JB FIR - Graham, John Joseph IR - Graham JJ FIR - Doan, John IR - Doan J FIR - Jose, John IR - Jose J FIR - Kotter, John IR - Kotter J FIR - Lehman, John IR - Lehman J FIR - Middleton, John IR - Middleton J FIR - Pownall, John IR - Pownall J FIR - Gleadle, Jonathan M IR - Gleadle JM FIR - Chavez-Iniguez, Jonathan S IR - Chavez-Iniguez JS FIR - Byrne, Jonathan IR - Byrne J FIR - Himmelfarb, Jonathan IR - Himmelfarb J FIR - Lebowitz, Jonathan IR - Lebowitz J FIR - Thorsen, Jonean IR - Thorsen J FIR - Carrillo Calvillo, Jorge IR - Carrillo Calvillo J FIR - Escobedo, Jorge IR - Escobedo J FIR - Ortega-Ramirez, Jose A IR - Ortega-Ramirez JA FIR - Cuenca-Castillo, Jose J IR - Cuenca-Castillo JJ FIR - Diez, Jose L IR - Diez JL FIR - Narro Villanueva, Jose Luis IR - Narro Villanueva JL FIR - da Costa Vieira, Jose Luiz IR - da Costa Vieira JL FIR - Flores-Palacios, Jose M IR - Flores-Palacios JM FIR - Fragata, Jose IR - Fragata J FIR - Lopes, Jose IR - Lopes J FIR - Lopez-Sendon, Jose IR - Lopez-Sendon J FIR - Lopez-Sendon, Jose IR - Lopez-Sendon J FIR - Rueda, Jose IR - Rueda J FIR - Selvanayagam, Joseph B IR - Selvanayagam JB FIR - Sacco, Joseph IR - Sacco J FIR - Loh, Joshua P IR - Loh JP FIR - Burkhardt, Joy IR - Burkhardt J FIR - Lopez Quijano, Juan Manuel IR - Lopez Quijano JM FIR - Gaztanaga, Juan IR - Gaztanaga J FIR - Sebo, Judit IR - Sebo J FIR - Wright, Judith IR - Wright J FIR - Stumpf, Juergen IR - Stumpf J FIR - de Aveiro Morata, Julia IR - de Aveiro Morata J FIR - Figal, Julio Cesar IR - Figal JC FIR - Hernandez Jaras, Julio IR - Hernandez Jaras J FIR - Yang, Junqing IR - Yang J FIR - Garg, Jyotsna IR - Garg J FIR - Rani, K Manjula IR - Rani KM FIR - Preethi, K IR - Preethi K FIR - Goetschalckx, Kaatje IR - Goetschalckx K FIR - Calfas, Karen IR - Calfas K FIR - Petrosyan, Karen IR - Petrosyan K FIR - Servilla, Karen IR - Servilla K FIR - Swan, Karen IR - Swan K FIR - Ploetze, Karin IR - Ploetze K FIR - Kryczka, Karolina IR - Kryczka K FIR - Wojtczak-Soska, Karolina IR - Wojtczak-Soska K FIR - Wojtera, Karolina IR - Wojtera K FIR - Ramasamy, Karthik IR - Ramasamy K FIR - Luczak, Katarzyna IR - Luczak K FIR - Malinowska, Katarzyna IR - Malinowska K FIR - Knaut, Katharina IR - Knaut K FIR - Martin, Katherine IR - Martin K FIR - Claes, Kathleen IR - Claes K FIR - Mason, Kathryn IR - Mason K FIR - Mahaffey, Ken IR - Mahaffey K FIR - Gin, Kenneth IR - Gin K FIR - Lee, Kerry IR - Lee K FIR - Bonin, Kerstin IR - Bonin K FIR - Mikes, Kerstin IR - Mikes K FIR - Bainey, Kevin R IR - Bainey KR FIR - Harley, Kevin T IR - Harley KT FIR - Marzo, Kevin IR - Marzo K FIR - McMahon, Kevin IR - McMahon K FIR - Abdul-Nour, Khaled IR - Abdul-Nour K FIR - Alfakih, Khaled IR - Alfakih K FIR - Dajani, Khaled IR - Dajani K FIR - Kushniriuk, Khrystyna IR - Kushniriuk K FIR - Poh, Kian-Keong IR - Poh KK FIR - Holland, Kim IR - Holland K FIR - Halverson, Kimberly E IR - Halverson KE FIR - Murphy, Kinnari IR - Murphy K FIR - Reddy, Kiran IR - Reddy K FIR - Quiles, Kirsten J IR - Quiles KJ FIR - Abercrombie, Kirsty IR - Abercrombie K FIR - Matschke, Klaus IR - Matschke K FIR - Szymczyk, Konrad IR - Szymczyk K FIR - Chan, Koo Hui IR - Chan KH FIR - Mavromatis, Kreton IR - Mavromatis K FIR - Hongalgi, Krishnakumar IR - Hongalgi K FIR - Thygesen, Kristian IR - Thygesen K FIR - Salmi, Kristin M IR - Salmi KM FIR - Newby, Kristin IR - Newby K FIR - Arges, Kristine IR - Arges K FIR - Teoh, Kristine IR - Teoh K FIR - Drzymalski, Krzysztof IR - Drzymalski K FIR - Kumbar, Lalathaksha IR - Kumbar L FIR - Matics, Laszlone IR - Matics L FIR - Hickson, LaTonya J IR - Hickson LJ FIR - Keinaite, Laura IR - Keinaite L FIR - Sarti, Laura IR - Sarti L FIR - True, Laura IR - True L FIR - Phillips, Lawrence M IR - Phillips LM FIR - Friedman, Lawrence IR - Friedman L FIR - Maranan, Leandro C IR - Maranan LC FIR - Lotaif, Leda IR - Lotaif L FIR - Dharmarajan, Lekshmi IR - Dharmarajan L FIR - Bockeria, Leo A IR - Bockeria LA FIR - Pizzol Caetano, Leonardo IR - Pizzol Caetano L FIR - Bridi, Leonardo IR - Bridi L FIR - Bershtein, Leonid L IR - Bershtein LL FIR - Yan, Li Hai IR - Yan LH FIR - Li, Li IR - Li L FIR - Sousa, Lidia IR - Sousa L FIR - Xu, Lihong IR - Xu L FIR - Zhang, Lihua IR - Zhang L FIR - Zhang, Lili IR - Zhang L FIR - Mazza Barbosa, Lilian IR - Mazza Barbosa L FIR - Tozija, Liljana IR - Tozija L FIR - Arcand, Linda IR - Arcand L FIR - Patricio, Lino IR - Patricio L FIR - Zhang, Liping IR - Zhang L FIR - Hatch, Lisa IR - Hatch L FIR - Jiang, Lixin IR - Jiang L FIR - Low, Liz IR - Low L FIR - Salman, Loay IR - Salman L FIR - Lopez, Lorena IR - Lopez L FIR - Pritchard, Lori IR - Pritchard L FIR - Bernanrdes, Luis IR - Bernanrdes L FIR - Guzman, Luis IR - Guzman L FIR - Teo, Lynette L IR - Teo LL FIR - Reddy, M Sowjanya IR - Reddy MS FIR - Simoons, Maarten IR - Simoons M FIR - Konigstein, Maayan IR - Konigstein M FIR - Selas, Mafalda IR - Selas M FIR - Madero, Magdalena IR - Madero M FIR - Miller, Magdalena IR - Miller M FIR - Misztal-Teodorczyk, Magdalena IR - Misztal-Teodorczyk M FIR - Abdelhamid, Magdy IR - Abdelhamid M FIR - Fahim, Magid IR - Fahim M FIR - Mylarappa, Mahevamma IR - Mylarappa M FIR - Joseph, Majo X IR - Joseph MX FIR - Frach, Malgorzata IR - Frach M FIR - Rani, Manjula IR - Rani M FIR - Galvani, Marcello IR - Galvani M FIR - Demkow, Marcin IR - Demkow M FIR - Szkopiak, Marcin IR - Szkopiak M FIR - De Fabritis, Marco IR - De Fabritis M FIR - Magnoni, Marco IR - Magnoni M FIR - Marini, Marco IR - Marini M FIR - Sicuro, Marco IR - Sicuro M FIR - Roik, Marek IR - Roik M FIR - Alfonso, Maria A IR - Alfonso MA FIR - Pereira de Moraes, Maria Antonieta IR - Pereira de Moraes MA FIR - Martinez-Ruiz, Maria Dolores IR - Martinez-Ruiz MD FIR - Canziani, Maria Eugenia IR - Canziani ME FIR - Martin, Maria Eugenia IR - Martin ME FIR - Caetano, Maria Ines IR - Caetano MI FIR - Corral, Maria P IR - Corral MP FIR - Perez Garcia, Maria IR - Perez Garcia M FIR - Andreasson, Maria IR - Andreasson M FIR - Posada, Maria IR - Posada M FIR - Dracoulakis, Marianna D A IR - Dracoulakis MDA FIR - Rubio, Mariano IR - Rubio M FIR - Petrovic, Marija T IR - Petrovic MT FIR - Vieira, Marina IR - Vieira M FIR - Garcia, Mario J IR - Garcia MJ FIR - D'arezzo, Mario IR - D'arezzo M FIR - Orgera, Maris IR - Orgera M FIR - Miglinas, Marius IR - Miglinas M FIR - Garand, Mark IR - Garand M FIR - Peterson, Mark IR - Peterson M FIR - Xavier, Mark IR - Xavier M FIR - Mosley, Marlowe IR - Mosley M FIR - Capinha, Marta IR - Capinha M FIR - Swiderek, Marta IR - Swiderek M FIR - Meyer, Martha IR - Meyer M FIR - Ceseri, Martina IR - Ceseri M FIR - Tricoli, Martinia IR - Tricoli M FIR - Wiilliams, Mary IR - Wiilliams M FIR - Champagne, Mary Ann IR - Champagne MA FIR - Streif, Mary IR - Streif M FIR - Leesar, Massoud IR - Leesar M FIR - Claudia, Matei IR - Claudia M FIR - Solecki, Mateusz IR - Solecki M FIR - Mungo, Matias Nicolas IR - Mungo MN FIR - Shinseki, Matthew IR - Shinseki M FIR - Weir, Matthew IR - Weir M FIR - Nedio, Maura Carina IR - Nedio MC FIR - Winter, Max-Paul IR - Winter MP FIR - Krishnam, Mayil S IR - Krishnam MS FIR - Mishra, Meenakshi IR - Mishra M FIR - Hwang, Mei IR - Hwang M FIR - Srilatha, Melemadathil IR - Srilatha M FIR - LeFevre, Melissa IR - LeFevre M FIR - Simegn, Mengistu IR - Simegn M FIR - Gibson, Michael A IR - Gibson MA FIR - Rubens, Michael B IR - Rubens MB FIR - Shapiro, Michael D IR - Shapiro MD FIR - Chobanian, Michael IR - Chobanian M FIR - Davidson, Michael IR - Davidson M FIR - Farkouh, Michael IR - Farkouh M FIR - Mack, Michael IR - Mack M FIR - Wlodarczyk, Michal IR - Wlodarczyk M FIR - Khouri, Michel G IR - Khouri MG FIR - Crowder, Michelle IR - Crowder M FIR - Ratliff, Michelle IR - Ratliff M FIR - Borges Santos, Miguel IR - Borges Santos M FIR - Nobre Menezes, Miguel IR - Nobre Menezes M FIR - Perez Fontan, Miguel IR - Perez Fontan M FIR - Barrero, Miguel IR - Barrero M FIR - Tapolyai, Mihaly IR - Tapolyai M FIR - Torosoff, Mikhail T IR - Torosoff MT FIR - Dobric, Milan R IR - Dobric MR FIR - Gadkari, Milind Avdhoot IR - Gadkari MA FIR - Kyaw, Min Tun IR - Kyaw MT FIR - Revivo, Miri IR - Revivo M FIR - Lustre, Mitchel B IR - Lustre MB FIR - Adel, Mohamed IR - Adel M FIR - Hassan, Mohamed IR - Hassan M FIR - El-Hajjar, Mohammad IR - El-Hajjar M FIR - Hussain, Mohammed IR - Hussain M FIR - Saleem, Mohammed IR - Saleem M FIR - Blanco-Calvo, Moises IR - Blanco-Calvo M FIR - Jimenez-Santos, Moises IR - Jimenez-Santos M FIR - Laukyte, Monika IR - Laukyte M FIR - Saric, Muhamed IR - Saric M FIR - Takiuti, Myrthes Emy IR - Takiuti ME FIR - Asif, Nadia IR - Asif N FIR - Moorthy, Nagaraja IR - Moorthy N FIR - Ogletree, Naima L IR - Ogletree NL FIR - Katamadze, Nana O IR - Katamadze NO FIR - Nataraj, Nandita IR - Nataraj N FIR - Uchida, Naomi IR - Uchida N FIR - Ismail, Nasrul IR - Ismail N FIR - Oliveira, Natalia S IR - Oliveira NS FIR - de Carvalho Maffei, Natalia IR - de Carvalho Maffei N FIR - Brosens, Nathalie IR - Brosens N FIR - Aslam, Naved IR - Aslam N FIR - Akhtar, Naveed IR - Akhtar N FIR - Mowafy, Neamat IR - Mowafy N FIR - Pandit, Neeraj IR - Pandit N FIR - Parakh, Neeraj IR - Parakh N FIR - Pannu, Neesh IR - Pannu N FIR - Duncan, Neill IR - Duncan N FIR - Garcevic, Nevena IR - Garcevic N FIR - Meadows, Ngaire IR - Meadows N FIR - Danchin, Nicholas IR - Danchin N FIR - Deming, Nicole IR - Deming N FIR - Boskovic, Nikola N IR - Boskovic NN FIR - Karogiannis, Nikolaos IR - Karogiannis N FIR - Zhang, Ning IR - Zhang N FIR - Kumar, Nirmal IR - Kumar N FIR - Sharma, Niruta IR - Sharma N FIR - Chadha, Nitika IR - Chadha N FIR - Naik, Nitish IR - Naik N FIR - Durfee, Noelle M IR - Durfee NM FIR - Cosgrove, Nora M IR - Cosgrove NM FIR - Urbanski, Norbert IR - Urbanski N FIR - Hogg, Norma IR - Hogg N FIR - Walesiak, Olga IR - Walesiak O FIR - Zdonczyk, Olga IR - Zdonczyk O FIR - Zhdanova, Olga IR - Zhdanova O FIR - Anaya, Olivia IR - Anaya O FIR - Bello, Olugbenga IR - Bello O FIR - Almousalli, Omar IR - Almousalli O FIR - Thompson, Omar IR - Thompson O FIR - Kliuk, Orit IR - Kliuk O FIR - Mendiz, Oscar IR - Mendiz O FIR - Prada-Delgado, Oscar IR - Prada-Delgado O FIR - Shapira, Oz IR - Shapira O FIR - Raffaele, Pablo IR - Raffaele P FIR - Salanger, Page IR - Salanger P FIR - Maurovich-Horvat, Pal IR - Maurovich-Horvat P FIR - Garg, Pallav IR - Garg P FIR - Moraga, Paloma IR - Moraga P FIR - Singh, Pam IR - Singh P FIR - Ouyang, Pamela IR - Ouyang P FIR - Woodard, Pamela IR - Woodard P FIR - Poggio Smanio, Paola Emanuela IR - Poggio Smanio PE FIR - Smanio, Paola IR - Smanio P FIR - Calabro, Paolo IR - Calabro P FIR - Nguyen, Patricia K IR - Nguyen PK FIR - Alarie, Patricia IR - Alarie P FIR - Carrilho, Patricia IR - Carrilho P FIR - Endsley, Patricia IR - Endsley P FIR - Pellikka, Patricia IR - Pellikka P FIR - Lebioda, Patrycja IR - Lebioda P FIR - Der Mesropian, Paul IR - Der Mesropian P FIR - Hauptman, Paul IR - Hauptman P FIR - Garcia-Gonzalez, Paula IR - Garcia-Gonzalez P FIR - Wilson, Paula IR - Wilson P FIR - Cury Rezende, Paulo IR - Cury Rezende P FIR - Novis Rocha, Paulo IR - Novis Rocha P FIR - Canas Silva, Pedro IR - Canas Silva P FIR - Farto E Abreu, Pedro IR - Farto E Abreu P FIR - Piccaro de Oliveira, Pedro IR - Piccaro de Oliveira P FIR - Carvalho, Pedro IR - Carvalho P FIR - Modas, Pedro IR - Modas P FIR - Rio, Pedro IR - Rio P FIR - He, Peiyu IR - He P FIR - McCullough, Peter A IR - McCullough PA FIR - Stone, Peter H IR - Stone PH FIR - Douglass, Peter IR - Douglass P FIR - Sizeland, Peter IR - Sizeland P FIR - Voros, Peter IR - Voros P FIR - Steg, Philippe Gabriel IR - Steg PG FIR - Genereux, Philippe IR - Genereux P FIR - Genereux, Philippe IR - Genereux P FIR - Menasche, Philippe IR - Menasche P FIR - Rheault, Philippe IR - Rheault P FIR - Tassinario, Piero IR - Tassinario P FIR - Gervais, Pierre IR - Gervais P FIR - Calvillo, Pilar IR - Calvillo P FIR - Chai, Ping IR - Chai P FIR - Jakubowski, Piotr IR - Jakubowski P FIR - Pruszczyk, Piotr IR - Pruszczyk P FIR - Loh, Poay-Huan IR - Loh PH FIR - Samadi, Pouneh IR - Samadi P FIR - Deedwania, Prakash IR - Deedwania P FIR - Patel, Pranav M IR - Patel PM FIR - Polamuri, Praneeth IR - Polamuri P FIR - Sharma, Pratiksha IR - Sharma P FIR - Kamath, Preeti IR - Kamath P FIR - Thomas, Prince IR - Thomas P FIR - Arambam, Priyadarshani IR - Arambam P FIR - Sodhi, Puneet IR - Sodhi P FIR - Naik, Pushpa IR - Naik P FIR - Zhong, Qi IR - Zhong Q FIR - Zhao, Qian IR - Zhao Q FIR - Yuan, Qianqian IR - Yuan Q FIR - Xie, Qiulan IR - Xie Q FIR - Murphy, Rachel IR - Murphy R FIR - Lyubarova, Radmila IR - Lyubarova R FIR - Lyubarova, Radmilar IR - Lyubarova R FIR - Fisher, Raewyn IR - Fisher R FIR - Diaz, Rafael IR - Diaz R FIR - Maldonado, Rafael IR - Maldonado R FIR - Selgas, Rafael IR - Selgas R FIR - Bugiardini, Raffaele IR - Bugiardini R FIR - Chaudhry, Rafia IR - Chaudhry R FIR - Kavalakkat, Raisa IR - Kavalakkat R FIR - Vs, Rajalekshmi IR - Vs R FIR - Nair, Rajesh Gopalan IR - Nair RG FIR - Narang, Rajiv IR - Narang R FIR - Yadav, Rakesh IR - Yadav R FIR - Carvalho, Ramiro IR - Carvalho R FIR - Jesus-Perez, Ramon de IR - Jesus-Perez R FIR - Leng, Ran IR - Leng R FIR - Kachru, Ranjan IR - Kachru R FIR - Sanchez, Raquel IR - Sanchez R FIR - Dwyer, Raven R IR - Dwyer RR FIR - Lee, Raven IR - Lee R FIR - Wyman, Ray IR - Wyman R FIR - Wong, Raymond C IR - Wong RC FIR - Hampson, Reinette IR - Hampson R FIR - Karam Kalil, Renato Abdala IR - Karam Kalil RA FIR - Lopes, Renato D IR - Lopes RD FIR - Eick, Renato George IR - Eick RG FIR - Lopes, Renato IR - Lopes R FIR - Ravindran, Reshma IR - Ravindran R FIR - Gamma, Reto Andreas IR - Gamma RA FIR - Costa, Ricardo IR - Costa R FIR - Bhatt, Richa IR - Bhatt R FIR - Trimlett, Richard H J IR - Trimlett RHJ FIR - Patel, Risha IR - Patel R FIR - Coram, Rita IR - Coram R FIR - Riezebos, Robert K IR - Riezebos RK FIR - Donnino, Robert M IR - Donnino RM FIR - Guyton, Robert IR - Guyton R FIR - Harrington, Robert IR - Harrington R FIR - Malecki, Robert IR - Malecki R FIR - Favaloro, Roberto Rene IR - Favaloro RR FIR - Elliott, Robyn IR - Elliott R FIR - Lima, Rodolfo G S D IR - Lima RGSD FIR - Tandon, Rohit IR - Tandon R FIR - Doerr, Rolf IR - Doerr R FIR - Tewari, Roma IR - Tewari R FIR - Wald, Ron IR - Wald R FIR - Hu, Rongrong IR - Hu R FIR - Collins, Rory IR - Collins R FIR - Mehran, Roxana IR - Mehran R FIR - Senior, Roxy IR - Senior R FIR - Baleon-Espinosa, Ruben IR - Baleon-Espinosa R FIR - Ramos, Ruben IR - Ramos R FIR - Ferreira, Rui IR - Ferreira R FIR - Kirby, Ruth IR - Kirby R FIR - Perez-Fernandez, Ruth IR - Perez-Fernandez R FIR - Ramakrishnan, S IR - Ramakrishnan S FIR - Dwivedi, S K IR - Dwivedi SK FIR - Lubna, Sadath IR - Lubna S FIR - Ahmed, Sadiq IR - Ahmed S FIR - Govindan, Sajeev Chakanalil IR - Govindan SC FIR - Alfalahi, Salamah IR - Alfalahi S FIR - Cruz-Flores, Salvador IR - Cruz-Flores S FIR - Costa, Salvatore P IR - Costa SP FIR - Setty, Sampoornima IR - Setty S FIR - Nwosu, Samuel IR - Nwosu S FIR - Mahajan, Sandeep IR - Mahajan S FIR - Seth, Sandeep IR - Seth S FIR - Singh, Sandeep IR - Singh S FIR - Niehe, Sander R IR - Niehe SR FIR - Carr, Sandy IR - Carr S FIR - Ogrizovic, Sanja Simic IR - Ogrizovic SS FIR - Ogrizovic, Sanja IR - Ogrizovic S FIR - Gulati, Sanjeev IR - Gulati S FIR - Sharma, Sanjeev IR - Sharma S FIR - Fernandez, Sara IR - Fernandez S FIR - Williams, Sarah IR - Williams S FIR - Ralhan, Sarju IR - Ralhan S FIR - Kedev, Sasko IR - Kedev S FIR - Singh, Satinder IR - Singh S FIR - Sankaranarayanan, Satish IR - Sankaranarayanan S FIR - Manjunath, Satvic Cholenahally IR - Manjunath SC FIR - Lee, Sau IR - Lee S FIR - Thaxton, Schawana IR - Thaxton S FIR - O'Brien, Sean M IR - O'Brien SM FIR - Sobczak, Sebastian IR - Sobczak S FIR - Nour, Seema IR - Nour S FIR - Sayganov, Sergey A IR - Sayganov SA FIR - Bravo Baptista, Sergio IR - Bravo Baptista S FIR - Draibe, Sergio IR - Draibe S FIR - Sokol, Seth IR - Sokol S FIR - Chandra, Sharad IR - Chandra S FIR - Mackedanz, Shari IR - Mackedanz S FIR - Goodman, Shaun IR - Goodman S FIR - Shirazian, Shayan IR - Shirazian S FIR - Karwa, Sheetal Rupesh IR - Karwa SR FIR - Ussery, Sheri IR - Ussery S FIR - Bajaj, Sheromani IR - Bajaj S FIR - Heydari, Shirin IR - Heydari S FIR - Choudhary, Shiv Kumar IR - Choudhary SK FIR - Patel, Shivali IR - Patel S FIR - Pandey, Shruti IR - Pandey S FIR - Zhang, Shuyang IR - Zhang S FIR - Gadage, Siddharth IR - Gadage S FIR - Tan, Sik-Yin V IR - Tan SV FIR - Poletti, Silvia Zottis IR - Poletti SZ FIR - Valbuena, Silvia IR - Valbuena S FIR - Savaris, Simone IR - Savaris S FIR - Yakubov, Solomon IR - Yakubov S FIR - Zhu, Songlin IR - Zhu S FIR - Gupta, Sonika IR - Gupta S FIR - Brener, Sorin IR - Brener S FIR - Gurunathan, Sothinathan IR - Gurunathan S FIR - Nayak, Soundarya IR - Nayak S FIR - Reddy, Sowjanya IR - Reddy S FIR - Cobos, Stanley E IR - Cobos SE FIR - Weikl, Stefan IR - Weikl S FIR - Lane, Stephanie M IR - Lane SM FIR - Ferket, Stephanie IR - Ferket S FIR - Mavromichalis, Stephanie IR - Mavromichalis S FIR - Fremes, Stephen IR - Fremes S FIR - Fein, Steven A IR - Fein SA FIR - Sedlis, Steven P IR - Sedlis SP FIR - Giovannone, Steven IR - Giovannone S FIR - Weitz, Steven IR - Weitz S FIR - Banerjee, Subhash IR - Banerjee S FIR - Hegde, Sudhanva S IR - Hegde SS FIR - Hosino, Suellen IR - Hosino S FIR - Mookherjee, Sulagna IR - Mookherjee S FIR - Singh, Suman IR - Singh S FIR - Abeygunasekara, Sumith IR - Abeygunasekara S FIR - Mishra, Sundeep IR - Mishra S FIR - Verma, Sunil Kumar IR - Verma SK FIR - Kumar, Suresh IR - Kumar S FIR - Narayanappa, Suryaprakash IR - Narayanappa S FIR - Milbrandt, Susan K IR - Milbrandt SK FIR - Silva, Susana IR - Silva S FIR - Stevens, Susanna IR - Stevens S FIR - Kolhe, Suvarna IR - Kolhe S FIR - Tavares, Suzana IR - Tavares S FIR - Welsh, Suzanne IR - Welsh S FIR - Kishore, T A IR - Kishore TA FIR - Colaiacovo Soares, Tamara IR - Colaiacovo Soares T FIR - Pillay, Tapan Umesh IR - Pillay TU FIR - Rashid, Tarek IR - Rashid T FIR - Mittal, Tarun K IR - Mittal TK FIR - Duarte, Tauane Bello IR - Duarte TB FIR - Dutoiu, Teodora IR - Dutoiu T FIR - Delgadillo, Teresa IR - Delgadillo T FIR - Chua, Terrance IR - Chua T FIR - Welch, Terrance IR - Welch T FIR - Kofidis, Theodoros IR - Kofidis T FIR - Lefevre, Thierry IR - Lefevre T FIR - Silva, Tiago IR - Silva T FIR - Boros, Timea IR - Boros T FIR - Lau, Titus IR - Lau T FIR - Formisano, Tiziana IR - Formisano T FIR - Ciurus, Tomasz IR - Ciurus T FIR - Tarchalski, Tomasz IR - Tarchalski T FIR - Tan, Tracy IR - Tan T FIR - Lingaraj, Umesh IR - Lingaraj U FIR - Bahl, V K IR - Bahl VK FIR - Narain, V S IR - Narain VS FIR - Pellu, Valentina IR - Pellu V FIR - Lobo, Valentine IR - Lobo V FIR - Robesyn, Valerie IR - Robesyn V FIR - Yadav, Vandana IR - Yadav V FIR - Gupta, Veerabhadra IR - Gupta V FIR - Mathew, Verghese IR - Mathew V FIR - Miro, Vicente IR - Miro V FIR - Gumerova, Victoria IR - Gumerova V FIR - Hernandez, Victoria IR - Hernandez V FIR - Kher, Vijay IR - Kher V FIR - Kumar, Vijay IR - Kumar V FIR - Makkar, Vikas IR - Makkar V FIR - Reddy, Vikranth IR - Reddy V FIR - Bulkley, Viktoria IR - Bulkley V FIR - David, Vinoi George IR - David VG FIR - Misra, Virendra IR - Misra V FIR - Fernandez-Figares, Virginia IR - Fernandez-Figares V FIR - Ryasniansky, Vladimir IR - Ryasniansky V FIR - Giga, Vojislav L IR - Giga VL FIR - Almahmeed, Wael A IR - Almahmeed WA FIR - Chan, Wan Xian IR - Chan WX FIR - Marfori, Wanda C IR - Marfori WC FIR - Parker, Wanda IR - Parker W FIR - Pennachi, Wayne IR - Pennachi W FIR - Lau, Wei Ling IR - Lau WL FIR - Xing, Weibing IR - Xing W FIR - Bian, Weijing IR - Bian W FIR - Stewart, Wendy L IR - Stewart WL FIR - Drewes, Wendy IR - Drewes W FIR - Hueb, Whady IR - Hueb W FIR - Weintraub, William IR - Weintraub W FIR - Sia, Winnie C IR - Sia WC FIR - Flores-Rios, Xacobe IR - Flores-Rios X FIR - Ma, Xiang IR - Ma X FIR - Gu, Xiangqiong IR - Gu X FIR - Li, Xiaomei IR - Li X FIR - Xu, Xiaoyi IR - Xu X FIR - Fu, Xin IR - Fu X FIR - Li, Xuemei IR - Li X FIR - Wang, Xutong IR - Wang X FIR - Pepin-Dubois, Yanek IR - Pepin-Dubois Y FIR - Arbel, Yaron IR - Arbel Y FIR - Han, Yechen IR - Han Y FIR - Lit, Yiming IR - Lit Y FIR - Sia, Ying Tung IR - Sia YT FIR - Wang, Ying IR - Wang Y FIR - Yang, Yining IR - Yang Y FIR - Ma, Yitong IR - Ma Y FIR - Peralta, Yolayfi IR - Peralta Y FIR - Smets, Yves IR - Smets Y FIR - Taul, Yvonne IR - Taul Y FIR - Kudzoeva, Zalina IR - Kudzoeva Z FIR - Markovic, Zeljko Z IR - Markovic ZZ FIR - Liu, Zhangsuo IR - Liu Z FIR - Liu, Zhenyu IR - Liu Z FIR - Ye, Zhiming IR - Ye Z FIR - Yu, Zixiang IR - Yu Z FIR - Davidovits, Zoltan IR - Davidovits Z FIR - Petronijevic, Zvezdana IR - Petronijevic Z EDAT- 2020/04/01 06:00 MHDA- 2020/04/29 06:00 PMCR- 2020/10/23 CRDT- 2020/04/01 06:00 PHST- 2020/04/01 06:00 [pubmed] PHST- 2020/04/29 06:00 [medline] PHST- 2020/04/01 06:00 [entrez] PHST- 2020/10/23 00:00 [pmc-release] AID - 10.1056/NEJMoa1915925 [doi] PST - ppublish SO - N Engl J Med. 2020 Apr 23;382(17):1608-1618. doi: 10.1056/NEJMoa1915925. Epub 2020 Mar 30. PMID- 32227754 OWN - NLM STAT- MEDLINE DCOM- 20200428 LR - 20260518 IS - 1533-4406 (Electronic) IS - 0028-4793 (Print) IS - 0028-4793 (Linking) VI - 382 IP - 17 DP - 2020 Apr 23 TI - Health Status after Invasive or Conservative Care in Coronary and Advanced Kidney Disease. PG - 1619-1628 LID - 10.1056/NEJMoa1916374 [doi] AB - BACKGROUND: In the ISCHEMIA-CKD trial, the primary analysis showed no significant difference in the risk of death or myocardial infarction with initial angiography and revascularization plus guideline-based medical therapy (invasive strategy) as compared with guideline-based medical therapy alone (conservative strategy) in participants with stable ischemic heart disease, moderate or severe ischemia, and advanced chronic kidney disease (an estimated glomerular filtration rate of <30 ml per minute per 1.73 m(2) or receipt of dialysis). A secondary objective of the trial was to assess angina-related health status. METHODS: We assessed health status with the Seattle Angina Questionnaire (SAQ) before randomization and at 1.5, 3, and 6 months and every 6 months thereafter. The primary outcome of this analysis was the SAQ Summary score (ranging from 0 to 100, with higher scores indicating less frequent angina and better function and quality of life). Mixed-effects cumulative probability models within a Bayesian framework were used to estimate the treatment effect with the invasive strategy. RESULTS: Health status was assessed in 705 of 777 participants. Nearly half the participants (49%) had had no angina during the month before randomization. At 3 months, the estimated mean difference between the invasive-strategy group and the conservative-strategy group in the SAQ Summary score was 2.1 points (95% credible interval, -0.4 to 4.6), a result that favored the invasive strategy. The mean difference in score at 3 months was largest among participants with daily or weekly angina at baseline (10.1 points; 95% credible interval, 0.0 to 19.9), smaller among those with monthly angina at baseline (2.2 points; 95% credible interval, -2.0 to 6.2), and nearly absent among those without angina at baseline (0.6 points; 95% credible interval, -1.9 to 3.3). By 6 months, the between-group difference in the overall trial population was attenuated (0.5 points; 95% credible interval, -2.2 to 3.4). CONCLUSIONS: Participants with stable ischemic heart disease, moderate or severe ischemia, and advanced chronic kidney disease did not have substantial or sustained benefits with regard to angina-related health status with an initially invasive strategy as compared with a conservative strategy. (Funded by the National Heart, Lung, and Blood Institute; ISCHEMIA-CKD ClinicalTrials.gov number, NCT01985360.). CI - Copyright (c) 2020 Massachusetts Medical Society. FAU - Spertus, John A AU - Spertus JA AD - From Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City, Kansas City (J.A.S., P.G.J.), and the Center for Comprehensive Cardiovascular Care, St. Louis University School of Medicine, St. Louis (B.R.C.) - all in Missouri; the Department of Medicine, Stanford University School of Medicine, Stanford, CA (D.J.M., G.M.C.); Duke Clinical Research Institute, Durham, NC (D.B.M., S.M.O.); the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (J.L.F.); and New York University Grossman School of Medicine (H.R.R., J.S.H., S.B.), Icahn School of Medicine at Mount Sinai (G.W.S.), and the Cardiovascular Research Foundation (G.W.S.), New York, and Albany Medical College and Albany Medical Center, Albany (M.S.S.) - all in New York. FAU - Jones, Philip G AU - Jones PG AD - From Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City, Kansas City (J.A.S., P.G.J.), and the Center for Comprehensive Cardiovascular Care, St. Louis University School of Medicine, St. Louis (B.R.C.) - all in Missouri; the Department of Medicine, Stanford University School of Medicine, Stanford, CA (D.J.M., G.M.C.); Duke Clinical Research Institute, Durham, NC (D.B.M., S.M.O.); the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (J.L.F.); and New York University Grossman School of Medicine (H.R.R., J.S.H., S.B.), Icahn School of Medicine at Mount Sinai (G.W.S.), and the Cardiovascular Research Foundation (G.W.S.), New York, and Albany Medical College and Albany Medical Center, Albany (M.S.S.) - all in New York. FAU - Maron, David J AU - Maron DJ AD - From Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City, Kansas City (J.A.S., P.G.J.), and the Center for Comprehensive Cardiovascular Care, St. Louis University School of Medicine, St. Louis (B.R.C.) - all in Missouri; the Department of Medicine, Stanford University School of Medicine, Stanford, CA (D.J.M., G.M.C.); Duke Clinical Research Institute, Durham, NC (D.B.M., S.M.O.); the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (J.L.F.); and New York University Grossman School of Medicine (H.R.R., J.S.H., S.B.), Icahn School of Medicine at Mount Sinai (G.W.S.), and the Cardiovascular Research Foundation (G.W.S.), New York, and Albany Medical College and Albany Medical Center, Albany (M.S.S.) - all in New York. FAU - Mark, Daniel B AU - Mark DB AD - From Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City, Kansas City (J.A.S., P.G.J.), and the Center for Comprehensive Cardiovascular Care, St. Louis University School of Medicine, St. Louis (B.R.C.) - all in Missouri; the Department of Medicine, Stanford University School of Medicine, Stanford, CA (D.J.M., G.M.C.); Duke Clinical Research Institute, Durham, NC (D.B.M., S.M.O.); the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (J.L.F.); and New York University Grossman School of Medicine (H.R.R., J.S.H., S.B.), Icahn School of Medicine at Mount Sinai (G.W.S.), and the Cardiovascular Research Foundation (G.W.S.), New York, and Albany Medical College and Albany Medical Center, Albany (M.S.S.) - all in New York. FAU - O'Brien, Sean M AU - O'Brien SM AD - From Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City, Kansas City (J.A.S., P.G.J.), and the Center for Comprehensive Cardiovascular Care, St. Louis University School of Medicine, St. Louis (B.R.C.) - all in Missouri; the Department of Medicine, Stanford University School of Medicine, Stanford, CA (D.J.M., G.M.C.); Duke Clinical Research Institute, Durham, NC (D.B.M., S.M.O.); the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (J.L.F.); and New York University Grossman School of Medicine (H.R.R., J.S.H., S.B.), Icahn School of Medicine at Mount Sinai (G.W.S.), and the Cardiovascular Research Foundation (G.W.S.), New York, and Albany Medical College and Albany Medical Center, Albany (M.S.S.) - all in New York. FAU - Fleg, Jerome L AU - Fleg JL AD - From Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City, Kansas City (J.A.S., P.G.J.), and the Center for Comprehensive Cardiovascular Care, St. Louis University School of Medicine, St. Louis (B.R.C.) - all in Missouri; the Department of Medicine, Stanford University School of Medicine, Stanford, CA (D.J.M., G.M.C.); Duke Clinical Research Institute, Durham, NC (D.B.M., S.M.O.); the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (J.L.F.); and New York University Grossman School of Medicine (H.R.R., J.S.H., S.B.), Icahn School of Medicine at Mount Sinai (G.W.S.), and the Cardiovascular Research Foundation (G.W.S.), New York, and Albany Medical College and Albany Medical Center, Albany (M.S.S.) - all in New York. FAU - Reynolds, Harmony R AU - Reynolds HR AD - From Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City, Kansas City (J.A.S., P.G.J.), and the Center for Comprehensive Cardiovascular Care, St. Louis University School of Medicine, St. Louis (B.R.C.) - all in Missouri; the Department of Medicine, Stanford University School of Medicine, Stanford, CA (D.J.M., G.M.C.); Duke Clinical Research Institute, Durham, NC (D.B.M., S.M.O.); the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (J.L.F.); and New York University Grossman School of Medicine (H.R.R., J.S.H., S.B.), Icahn School of Medicine at Mount Sinai (G.W.S.), and the Cardiovascular Research Foundation (G.W.S.), New York, and Albany Medical College and Albany Medical Center, Albany (M.S.S.) - all in New York. FAU - Stone, Gregg W AU - Stone GW AUID- ORCID: 0000-0002-3416-8210 AD - From Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City, Kansas City (J.A.S., P.G.J.), and the Center for Comprehensive Cardiovascular Care, St. Louis University School of Medicine, St. Louis (B.R.C.) - all in Missouri; the Department of Medicine, Stanford University School of Medicine, Stanford, CA (D.J.M., G.M.C.); Duke Clinical Research Institute, Durham, NC (D.B.M., S.M.O.); the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (J.L.F.); and New York University Grossman School of Medicine (H.R.R., J.S.H., S.B.), Icahn School of Medicine at Mount Sinai (G.W.S.), and the Cardiovascular Research Foundation (G.W.S.), New York, and Albany Medical College and Albany Medical Center, Albany (M.S.S.) - all in New York. FAU - Sidhu, Mandeep S AU - Sidhu MS AD - From Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City, Kansas City (J.A.S., P.G.J.), and the Center for Comprehensive Cardiovascular Care, St. Louis University School of Medicine, St. Louis (B.R.C.) - all in Missouri; the Department of Medicine, Stanford University School of Medicine, Stanford, CA (D.J.M., G.M.C.); Duke Clinical Research Institute, Durham, NC (D.B.M., S.M.O.); the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (J.L.F.); and New York University Grossman School of Medicine (H.R.R., J.S.H., S.B.), Icahn School of Medicine at Mount Sinai (G.W.S.), and the Cardiovascular Research Foundation (G.W.S.), New York, and Albany Medical College and Albany Medical Center, Albany (M.S.S.) - all in New York. FAU - Chaitman, Bernard R AU - Chaitman BR AD - From Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City, Kansas City (J.A.S., P.G.J.), and the Center for Comprehensive Cardiovascular Care, St. Louis University School of Medicine, St. Louis (B.R.C.) - all in Missouri; the Department of Medicine, Stanford University School of Medicine, Stanford, CA (D.J.M., G.M.C.); Duke Clinical Research Institute, Durham, NC (D.B.M., S.M.O.); the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (J.L.F.); and New York University Grossman School of Medicine (H.R.R., J.S.H., S.B.), Icahn School of Medicine at Mount Sinai (G.W.S.), and the Cardiovascular Research Foundation (G.W.S.), New York, and Albany Medical College and Albany Medical Center, Albany (M.S.S.) - all in New York. FAU - Chertow, Glenn M AU - Chertow GM AD - From Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City, Kansas City (J.A.S., P.G.J.), and the Center for Comprehensive Cardiovascular Care, St. Louis University School of Medicine, St. Louis (B.R.C.) - all in Missouri; the Department of Medicine, Stanford University School of Medicine, Stanford, CA (D.J.M., G.M.C.); Duke Clinical Research Institute, Durham, NC (D.B.M., S.M.O.); the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (J.L.F.); and New York University Grossman School of Medicine (H.R.R., J.S.H., S.B.), Icahn School of Medicine at Mount Sinai (G.W.S.), and the Cardiovascular Research Foundation (G.W.S.), New York, and Albany Medical College and Albany Medical Center, Albany (M.S.S.) - all in New York. FAU - Hochman, Judith S AU - Hochman JS AD - From Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City, Kansas City (J.A.S., P.G.J.), and the Center for Comprehensive Cardiovascular Care, St. Louis University School of Medicine, St. Louis (B.R.C.) - all in Missouri; the Department of Medicine, Stanford University School of Medicine, Stanford, CA (D.J.M., G.M.C.); Duke Clinical Research Institute, Durham, NC (D.B.M., S.M.O.); the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (J.L.F.); and New York University Grossman School of Medicine (H.R.R., J.S.H., S.B.), Icahn School of Medicine at Mount Sinai (G.W.S.), and the Cardiovascular Research Foundation (G.W.S.), New York, and Albany Medical College and Albany Medical Center, Albany (M.S.S.) - all in New York. FAU - Bangalore, Sripal AU - Bangalore S AD - From Saint Luke's Mid America Heart Institute and the University of Missouri-Kansas City, Kansas City (J.A.S., P.G.J.), and the Center for Comprehensive Cardiovascular Care, St. Louis University School of Medicine, St. Louis (B.R.C.) - all in Missouri; the Department of Medicine, Stanford University School of Medicine, Stanford, CA (D.J.M., G.M.C.); Duke Clinical Research Institute, Durham, NC (D.B.M., S.M.O.); the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (J.L.F.); and New York University Grossman School of Medicine (H.R.R., J.S.H., S.B.), Icahn School of Medicine at Mount Sinai (G.W.S.), and the Cardiovascular Research Foundation (G.W.S.), New York, and Albany Medical College and Albany Medical Center, Albany (M.S.S.) - all in New York. CN - ISCHEMIA-CKD Research Group LA - eng SI - ClinicalTrials.gov/NCT01985360 GR - U01 HL117905/HL/NHLBI NIH HHS/United States GR - U01HL117905/HL/NHLBI NIH HHS/United States GR - U01 HL105907/HL/NHLBI NIH HHS/United States GR - U01 HL105565/HL/NHLBI NIH HHS/United States GR - U01HL117904/HL/NHLBI NIH HHS/United States GR - U01 HL117904/HL/NHLBI NIH HHS/United States PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't DEP - 20200330 PL - United States TA - N Engl J Med JT - The New England journal of medicine JID - 0255562 SB - IM CIN - Nat Rev Cardiol. 2020 Jun;17(6):320-321. doi: 10.1038/s41569-020-0384-x. PMID: 32296146 CIN - Am J Kidney Dis. 2021 Jan;77(1):149-151. doi: 10.1053/j.ajkd.2020.06.007. PMID: 32615149 CIN - Ann Intern Med. 2020 Aug 18;173(4):JC17. doi: 10.7326/ACPJ202008180-017. PMID: 32805174 MH - Aged MH - *Coronary Angiography MH - *Coronary Artery Bypass MH - Exercise Test MH - Female MH - Follow-Up Studies MH - *Health Status MH - Healthy Lifestyle MH - Humans MH - Intention to Treat Analysis MH - Male MH - Middle Aged MH - Myocardial Ischemia/complications/*drug therapy/mortality/*surgery MH - Odds Ratio MH - *Percutaneous Coronary Intervention MH - Proportional Hazards Models MH - Renal Insufficiency, Chronic/*complications MH - Surveys and Questionnaires PMC - PMC7255621 MID - NIHMS1590457 FIR - Abdallah, Abdallah M IR - Abdallah AM FIR - Moreyra, Abel E IR - Moreyra AE FIR - Laddu, Abhay A IR - Laddu AA FIR - Dubey, Abhishek IR - Dubey A FIR - Goyal, Abhishek IR - Goyal A FIR - Knighton, Abigail IR - Knighton A FIR - Adeboye, Adedayo IR - Adeboye A FIR - Juceviciene, Agne IR - Juceviciene A FIR - Urboniene, Agne IR - Urboniene A FIR - Szramowska, Agnieszka IR - Szramowska A FIR - Abdel-Latif, Ahmed IR - Abdel-Latif A FIR - Ayoub, Ahmed IR - Ayoub A FIR - Elghamaz, Ahmed IR - Elghamaz A FIR - Kamal, Ahmed IR - Kamal A FIR - Talaat, Ahmed IR - Talaat A FIR - Sharma, Ajay IR - Sharma A FIR - Narula, Ajit Singh IR - Narula AS FIR - Bagai, Akshay IR - Bagai A FIR - Smigelskaite, Akvile IR - Smigelskaite A FIR - Raymond, Alain IR - Raymond A FIR - Rheault, Alain IR - Rheault A FIR - Loehr, Alaine Melanie IR - Loehr AM FIR - Varga, Albert IR - Varga A FIR - Maggioni, Aldo P IR - Maggioni AP FIR - Moorman, Alec IR - Moorman A FIR - Chevaile Ramos, Alejandro IR - Chevaile Ramos A FIR - Gisbert, Alejandro IR - Gisbert A FIR - Fratczak, Aleksandra IR - Fratczak A FIR - Laucevicius, Aleksandras IR - Laucevicius A FIR - Chernyavskiy, Alexander M IR - Chernyavskiy AM FIR - Borisov, Alexander Sergeevich IR - Borisov AS FIR - Craft, Alexandra IR - Craft A FIR - Hunter, Alexandra IR - Hunter A FIR - Hueb, Alexandre Ciappina IR - Hueb AC FIR - Schaan de Quadros, Alexandre IR - Schaan de Quadros A FIR - Muller, Alice Manica IR - Muller AM FIR - Deiro, Aline Peixoto IR - 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Rizk D FIR - Puzhevsky, Daniela IR - Puzhevsky D FIR - Analyst, Data IR - Analyst D FIR - Charytan, David M IR - Charytan DM FIR - Williams, David O IR - Williams DO FIR - Booth, David IR - Booth D FIR - Charytan, David IR - Charytan D FIR - Cohen, David IR - Cohen D FIR - DeMets, David IR - DeMets D FIR - Foo, David IR - Foo D FIR - Goldfarb, David IR - Goldfarb D FIR - Schlichting, David IR - Schlichting D FIR - Sisson, David IR - Sisson D FIR - Taggart, David IR - Taggart D FIR - Waters, David IR - Waters D FIR - Wheeler, David IR - Wheeler D FIR - Williams, David IR - Williams D FIR - Vo, Davis IR - Vo D FIR - Teodorczyk, Dawid IR - Teodorczyk D FIR - Shelstad, Dawn D IR - Shelstad DD FIR - Kereiakes, Dean IR - Kereiakes D FIR - Yip, Deborah IR - Yip D FIR - Ramaswamy, Deepa IR - Ramaswamy D FIR - Mattina, Deirdre IR - Mattina D FIR - Murphy, Deirdre IR - Murphy D FIR - Jiang, Dengke IR - Jiang D FIR - Cyr, Derek IR - Cyr D FIR - Cukali, Diana IR - Cukali D FIR - Camara, Diane IR - 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Fridell, Ellie IR - Fridell E FIR - Lader, Ellis W IR - Lader EW FIR - Gosmanova, Elvira IR - Gosmanova E FIR - Tachot, Emilie IR - Tachot E FIR - Howard, Emma IR - Howard E FIR - Sorbets, Emmanuel IR - Sorbets E FIR - Alonso-Alvarez, Encarnacion IR - Alonso-Alvarez E FIR - Daugas, Eric IR - Daugas E FIR - Alexanderson Rosas, Erick IR - Alexanderson Rosas E FIR - Montpetit, Estelle IR - Montpetit E FIR - Passamani, Eugene IR - Passamani E FIR - Shutov, Evgeny IR - Shutov E FIR - Szczerba, Ewa IR - Szczerba E FIR - Wojtala, Ewelina IR - Wojtala E FIR - Ribeiro Silva, Expedito Eustaquio IR - Ribeiro Silva EE FIR - Fimiani, Fabio IR - Fimiani F FIR - Hage, Fadi IR - Hage F FIR - Jafary, Fahim Haider IR - Jafary FH FIR - Feng, Fang IR - Feng F FIR - Ranjbaran, Fatima IR - Ranjbaran F FIR - Pinto, Fausto J IR - Pinto FJ FIR - Caeiro, Fernando IR - Caeiro F FIR - Nolasco, Fernando IR - Nolasco F FIR - Silva, Filipa IR - Silva F FIR - Ottani, Filippo IR - Ottani F FIR - Al Solaiman, Firas IR - Al Solaiman F FIR - Egydio, Flavia IR - Egydio F FIR - Chereches, Florina IR - Chereches F FIR - De Micco, Francesca IR - De Micco F FIR - Bianchini, Francesca IR - Bianchini F FIR - Pietrucci, Francesca IR - Pietrucci F FIR - Orso, Francesco IR - Orso F FIR - Pisano, Francesco IR - Pisano F FIR - Patuleia Figueiras, Francisca IR - Patuleia Figueiras F FIR - Madore, Francois IR - Madore F FIR - Harrell, Frank IR - Harrell F FIR - Rockhold, Frank IR - Rockhold F FIR - Van de Werf, Frans IR - Van de Werf F FIR - Guenther, Franziska IR - Guenther F FIR - Mohr, Fred IR - Mohr F FIR - Karthikeyan, G IR - Karthikeyan G FIR - Galeote, Gabriel IR - Galeote G FIR - Grossmann, Gabriel IR - Grossmann G FIR - Steg, Gabriel IR - Steg G FIR - Guzman, Gabriela IR - Guzman G FIR - Gabrielli, Gabriele IR - Gabrielli G FIR - Chen, Gang IR - Chen G FIR - Sharma, Gautam IR - Sharma G FIR - Petty, Gaylin IR - Petty G FIR - Mikolaitiene, Gelmina IR - Mikolaitiene G FIR - Yee, Gennie IR - Yee G FIR - Devlin, Gerard Patrick IR - Devlin GP FIR - Esposito, Gerard IR - Esposito G FIR - Agoston, Gergely IR - Agoston G FIR - Lamas, Gervasio IR - Lamas G FIR - Cobb, Gia IR - Cobb G FIR - Perna, Gian Piero IR - Perna GP FIR - Leone, Gianpiero IR - Leone G FIR - Mishra, Girish IR - Mishra G FIR - Barge-Caballero, Gonzalo IR - Barge-Caballero G FIR - Young, Grace M IR - Young GM FIR - Scaro, Graciela IR - Scaro G FIR - Wong, Graham IR - Wong G FIR - Pressman, Gregg IR - Pressman G FIR - Simonis, Gregor IR - Simonis G FIR - Steinmaurer, Gudrun IR - Steinmaurer G FIR - Portugal, Guilherme IR - Portugal G FIR - Cantinho Lopes, Guilhermina IR - Cantinho Lopes G FIR - Garcia-Garcia, Guillermo IR - Garcia-Garcia G FIR - Wang, Guoqin IR - Wang G FIR - Wander, Gurpreet S IR - Wander GS FIR - Gulati, Gurpreet IR - Gulati G FIR - Zhang, Haibo IR - Zhang H FIR - Marciniak, Halina IR - Marciniak H FIR - Dai, Hao IR - Dai H FIR - Dong, Haojian IR - Dong H FIR - Franch, Harold IR - Franch H FIR - White, Harvey IR - White H FIR - Elabd, Hatem IR - Elabd H FIR - Pomeroy, Hayley IR - Pomeroy H FIR - Golden, Heather IR - Golden H FIR - Wilson, Heidi IR - Wilson H FIR - Abergel, Helene IR - Abergel H FIR - Siddaram, Hemalata IR - Siddaram H FIR - Mahapatra, Hemant Shakhar IR - Mahapatra HS FIR - Stokes, Henry C IR - Stokes HC FIR - Osseni, Hermine IR - Osseni H FIR - Schuchlenz, Herwig IR - Schuchlenz H FIR - Skali, Hicham IR - Skali H FIR - Mattix-Kramer, Holly IR - Mattix-Kramer H FIR - Cheng, Hong IR - Cheng H FIR - Mahrous, Hossam IR - Mahrous H FIR - Pejkov, Hristo IR - Pejkov H FIR - Marques, Hugo IR - Marques H FIR - Zhong, Hui IR - Zhong H FIR - El Fishawy, Hussien IR - El Fishawy H FIR - Webb, Ian IR - Webb I FIR - Kullo, Iftikhar IR - Kullo I FIR - Grazhdankin, Igor O IR - Grazhdankin IO FIR - Hassan, Ikraam IR - Hassan I FIR - Pina, Ileana L IR - Pina IL FIR - Tamasauskiene, Ilona IR - Tamasauskiene I FIR - Cabrita, Ines Zimbarra IR - Cabrita IZ FIR - Rodrigues, Ines IR - Rodrigues I FIR - Soveri, Inga IR - Soveri I FIR - Mitevska, Irena Peovska IR - Mitevska IP FIR - Lang, Irene Marthe IR - Lang IM FIR - Subbotina, Irina IR - Subbotina I FIR - Kalibataite-Rutkauskiene, Irma IR - Kalibataite-Rutkauskiene I FIR - Roy, Isabelle IR - Roy I FIR - Tejani, Ishita IR - Tejani I FIR - Naryshkin, Ivan A IR - Naryshkin IA FIR - Jankovic, Ivana IR - Jankovic I FIR - Niedzwiecka, Iwona IR - Niedzwiecka I FIR - Kusmierek, Jacek IR - Kusmierek J FIR - Chow, Jackie IR - Chow J FIR - Heo, Jaekyeong IR - Heo J FIR - Maksym, Jakub IR - Maksym J FIR - Davies, James E IR - Davies JE FIR - Jang, James J IR - Jang JJ FIR - Hirsch, James IR - Hirsch J FIR - Tatoulis, James IR - Tatoulis J FIR - Henzel, Jan IR - Henzel J FIR - Oliveira, Janaina IR - Oliveira J FIR - Rangaswami, Janani IR - Rangaswami J FIR - Eckstein, Jane IR - Eckstein J FIR - Raj, Janitha IR - Raj J FIR - Pozzibon, Jaqueline IR - Pozzibon J FIR - Drozdz, Jaroslaw IR - Drozdz J FIR - Kwok Kong, Jason Loh IR - Kwok Kong JL FIR - Call, Jason T IR - Call JT FIR - Linefsky, Jason IR - Linefsky J FIR - Garcia, Javier J IR - Garcia JJ FIR - Meisner, Jay IR - Meisner J FIR - Scales, Jayne IR - Scales J FIR - Juliard, Jean Michel IR - Juliard JM FIR - Diodati, Jean IR - Diodati J FIR - Juliard, Jean-Michel IR - Juliard JM FIR - Russo, Jeanne IR - Russo J FIR - Schoep, Jeannette J M IR - Schoep JJM FIR - Leimberger, Jeff IR - Leimberger J FIR - Milliken, Jeffrey C IR - Milliken JC FIR - Anderson, Jeffrey IR - Anderson J FIR - Kanters, Jeffrey IR - Kanters J FIR - Lorin, Jeffrey IR - Lorin J FIR - Moses, Jeffrey IR - Moses J FIR - Stepanovic, Jelena J IR - Stepanovic JJ FIR - Celutkiene, Jelena IR - Celutkiene J FIR - Stojkovic, Jelena IR - Stojkovic J FIR - Jose, Jenne M IR - Jose JM FIR - Stanford, Jennifer L IR - Stanford JL FIR - Hogan, Jennifer IR - Hogan J FIR - Horst, Jennifer IR - Horst J FIR - Isaacs, Jennifer IR - Isaacs J FIR - Thomson, Jennifer IR - Thomson J FIR - Tomfohr, Jennifer IR - Tomfohr J FIR - White, Jennifer IR - White J FIR - Yee, Jerry IR - Yee J FIR - Berg, Jessica IR - Berg J FIR - Peteiro, Jesus IR - Peteiro J FIR - Peteiro, Jesus IR - Peteiro J FIR - Li, Jia IR - Li J FIR - Liu, Jiamin IR - Liu J FIR - Zhang, Jianxin IR - Zhang J FIR - Marcus, Jill IR - Marcus J FIR - Blankenship, Jim IR - Blankenship J FIR - Dong, Jing IR - Dong J FIR - Chen, Jiyan IR - Chen J FIR - Evans, Jo IR - Evans J FIR - Penafiel, Joaquin V IR - Penafiel JV FIR - Sabik, Joe IR - Sabik J FIR - Christopher, Johann IR - Christopher J FIR - Kostis, John B IR - Kostis JB FIR - Graham, John Joseph IR - Graham JJ FIR - Doan, John IR - Doan J FIR - Jose, John IR - Jose J FIR - Kotter, John IR - Kotter J FIR - Lehman, John IR - Lehman J FIR - Middleton, John IR - Middleton J FIR - Pownall, John IR - Pownall J FIR - Gleadle, Jonathan M IR - Gleadle JM FIR - Chavez-Iniguez, Jonathan S IR - Chavez-Iniguez JS FIR - Byrne, Jonathan IR - Byrne J FIR - Himmelfarb, Jonathan IR - Himmelfarb J FIR - Lebowitz, Jonathan IR - Lebowitz J FIR - Thorsen, Jonean IR - Thorsen J FIR - Carrillo Calvillo, Jorge IR - Carrillo Calvillo J FIR - Escobedo, Jorge IR - Escobedo J FIR - Ortega-Ramirez, Jose A IR - Ortega-Ramirez JA FIR - Cuenca-Castillo, Jose J IR - Cuenca-Castillo JJ FIR - Diez, Jose L IR - Diez JL FIR - Narro Villanueva, Jose Luis IR - Narro Villanueva JL FIR - da Costa Vieira, Jose Luiz IR - da Costa Vieira JL FIR - Flores-Palacios, Jose M IR - Flores-Palacios JM FIR - Fragata, Jose IR - Fragata J FIR - Lopes, Jose IR - Lopes J FIR - Lopez-Sendon, Jose IR - Lopez-Sendon J FIR - Lopez-Sendon, Jose IR - Lopez-Sendon J FIR - Rueda, Jose IR - Rueda J FIR - Selvanayagam, Joseph B IR - Selvanayagam JB FIR - Sacco, Joseph IR - Sacco J FIR - Loh, Joshua P IR - Loh JP FIR - Burkhardt, Joy IR - Burkhardt J FIR - Lopez Quijano, Juan Manuel IR - Lopez Quijano JM FIR - Gaztanaga, Juan IR - Gaztanaga J FIR - Sebo, Judit IR - Sebo J FIR - Wright, Judith IR - Wright J FIR - Stumpf, Juergen IR - Stumpf J FIR - de Aveiro Morata, Julia IR - de Aveiro Morata J FIR - Figal, Julio Cesar IR - Figal JC FIR - Hernandez Jaras, Julio IR - Hernandez Jaras J FIR - Yang, Junqing IR - Yang J FIR - Garg, Jyotsna IR - Garg J FIR - Rani, K Manjula IR - Rani KM FIR - Preethi, K IR - Preethi K FIR - Goetschalckx, Kaatje IR - Goetschalckx K FIR - Calfas, Karen IR - Calfas K FIR - Petrosyan, Karen IR - Petrosyan K FIR - Servilla, Karen IR - Servilla K FIR - Swan, Karen IR - Swan K FIR - Ploetze, Karin IR - Ploetze K FIR - Kryczka, Karolina IR - Kryczka K FIR - Wojtczak-Soska, Karolina IR - Wojtczak-Soska K FIR - Wojtera, Karolina IR - Wojtera K FIR - Ramasamy, Karthik IR - Ramasamy K FIR - Luczak, Katarzyna IR - Luczak K FIR - Malinowska, Katarzyna IR - Malinowska K FIR - Knaut, Katharina IR - Knaut K FIR - Martin, Katherine IR - Martin K FIR - Claes, Kathleen IR - Claes K FIR - Mason, Kathryn IR - Mason K FIR - Mahaffey, Ken IR - Mahaffey K FIR - Gin, Kenneth IR - Gin K FIR - Lee, Kerry IR - Lee K FIR - Bonin, Kerstin IR - Bonin K FIR - Mikes, Kerstin IR - Mikes K FIR - Bainey, Kevin R IR - Bainey KR FIR - Harley, Kevin T IR - Harley KT FIR - Marzo, Kevin IR - Marzo K FIR - McMahon, Kevin IR - McMahon K FIR - Abdul-Nour, Khaled IR - Abdul-Nour K FIR - Alfakih, Khaled IR - Alfakih K FIR - Dajani, Khaled IR - Dajani K FIR - Kushniriuk, Khrystyna IR - Kushniriuk K FIR - Poh, Kian-Keong IR - Poh KK FIR - Holland, Kim IR - Holland K FIR - Halverson, Kimberly E IR - Halverson KE FIR - Murphy, Kinnari IR - Murphy K FIR - Reddy, Kiran IR - Reddy K FIR - Quiles, Kirsten J IR - Quiles KJ FIR - Abercrombie, Kirsty IR - Abercrombie K FIR - Matschke, Klaus IR - Matschke K FIR - Szymczyk, Konrad IR - Szymczyk K FIR - Chan, Koo Hui IR - Chan KH FIR - Mavromatis, Kreton IR - Mavromatis K FIR - Hongalgi, Krishnakumar IR - Hongalgi K FIR - Thygesen, Kristian IR - Thygesen K FIR - Salmi, Kristin M IR - Salmi KM FIR - Newby, Kristin IR - Newby K FIR - Arges, Kristine IR - Arges K FIR - Teoh, Kristine IR - Teoh K FIR - Drzymalski, Krzysztof IR - Drzymalski K FIR - Kumbar, Lalathaksha IR - Kumbar L FIR - Matics, Laszlone IR - Matics L FIR - Hickson, LaTonya J IR - Hickson LJ FIR - Keinaite, Laura IR - Keinaite L FIR - Sarti, Laura IR - Sarti L FIR - True, Laura IR - True L FIR - Phillips, Lawrence M IR - Phillips LM FIR - Friedman, Lawrence IR - Friedman L FIR - Maranan, Leandro C IR - Maranan LC FIR - Lotaif, Leda IR - Lotaif L FIR - Dharmarajan, Lekshmi IR - Dharmarajan L FIR - Bockeria, Leo A IR - Bockeria LA FIR - Pizzol Caetano, Leonardo IR - Pizzol Caetano L FIR - Bridi, Leonardo IR - Bridi L FIR - Bershtein, Leonid L IR - Bershtein LL FIR - Yan, Li Hai IR - Yan LH FIR - Li, Li IR - Li L FIR - Sousa, Lidia IR - Sousa L FIR - Xu, Lihong IR - Xu L FIR - Zhang, Lihua IR - Zhang L FIR - Zhang, Lili IR - Zhang L FIR - Mazza Barbosa, Lilian IR - Mazza Barbosa L FIR - Tozija, Liljana IR - Tozija L FIR - Arcand, Linda IR - Arcand L FIR - Patricio, Lino IR - Patricio L FIR - Zhang, Liping IR - Zhang L FIR - Hatch, Lisa IR - Hatch L FIR - Jiang, Lixin IR - Jiang L FIR - Low, Liz IR - Low L FIR - Salman, Loay IR - Salman L FIR - Lopez, Lorena IR - Lopez L FIR - Pritchard, Lori IR - Pritchard L FIR - Bernanrdes, Luis IR - Bernanrdes L FIR - Guzman, Luis IR - Guzman L FIR - Teo, Lynette L IR - Teo LL FIR - Reddy, M Sowjanya IR - Reddy MS FIR - Simoons, Maarten IR - Simoons M FIR - Konigstein, Maayan IR - Konigstein M FIR - Selas, Mafalda IR - Selas M FIR - Madero, Magdalena IR - Madero M FIR - Miller, Magdalena IR - Miller M FIR - Misztal-Teodorczyk, Magdalena IR - Misztal-Teodorczyk M FIR - Abdelhamid, Magdy IR - Abdelhamid M FIR - Fahim, Magid IR - Fahim M FIR - Mylarappa, Mahevamma IR - Mylarappa M FIR - Joseph, Majo X IR - Joseph MX FIR - Frach, Malgorzata IR - Frach M FIR - Rani, Manjula IR - Rani M FIR - Galvani, Marcello IR - Galvani M FIR - Demkow, Marcin IR - Demkow M FIR - Szkopiak, Marcin IR - Szkopiak M FIR - De Fabritis, Marco IR - De Fabritis M FIR - Magnoni, Marco IR - Magnoni M FIR - Marini, Marco IR - Marini M FIR - Sicuro, Marco IR - Sicuro M FIR - Roik, Marek IR - Roik M FIR - Alfonso, Maria A IR - Alfonso MA FIR - Pereira de Moraes, Maria Antonieta IR - Pereira de Moraes MA FIR - Martinez-Ruiz, Maria Dolores IR - Martinez-Ruiz MD FIR - Canziani, Maria Eugenia IR - Canziani ME FIR - Martin, Maria Eugenia IR - Martin ME FIR - Caetano, Maria Ines IR - Caetano MI FIR - Corral, Maria P IR - Corral MP FIR - Perez Garcia, Maria IR - Perez Garcia M FIR - Andreasson, Maria IR - Andreasson M FIR - Posada, Maria IR - Posada M FIR - Dracoulakis, Marianna D A IR - Dracoulakis MDA FIR - Rubio, Mariano IR - Rubio M FIR - Petrovic, Marija T IR - Petrovic MT FIR - Vieira, Marina IR - Vieira M FIR - Garcia, Mario J IR - Garcia MJ FIR - D'arezzo, Mario IR - D'arezzo M FIR - Orgera, Maris IR - Orgera M FIR - Miglinas, Marius IR - Miglinas M FIR - Garand, Mark IR - Garand M FIR - Peterson, Mark IR - Peterson M FIR - Xavier, Mark IR - Xavier M FIR - Mosley, Marlowe IR - Mosley M FIR - Capinha, Marta IR - Capinha M FIR - Swiderek, Marta IR - Swiderek M FIR - Meyer, Martha IR - Meyer M FIR - Ceseri, Martina IR - Ceseri M FIR - Tricoli, Martinia IR - Tricoli M FIR - Wiilliams, Mary IR - Wiilliams M FIR - Champagne, Mary Ann IR - Champagne MA FIR - Streif, Mary IR - Streif M FIR - Leesar, Massoud IR - Leesar M FIR - Claudia, Matei IR - Claudia M FIR - Solecki, Mateusz IR - Solecki M FIR - Mungo, Matias Nicolas IR - Mungo MN FIR - Shinseki, Matthew IR - Shinseki M FIR - Weir, Matthew IR - Weir M FIR - Nedio, Maura Carina IR - Nedio MC FIR - Winter, Max-Paul IR - Winter MP FIR - Krishnam, Mayil S IR - Krishnam MS FIR - Mishra, Meenakshi IR - Mishra M FIR - Hwang, Mei IR - Hwang M FIR - Srilatha, Melemadathil IR - Srilatha M FIR - LeFevre, Melissa IR - LeFevre M FIR - Simegn, Mengistu IR - Simegn M FIR - Gibson, Michael A IR - Gibson MA FIR - Rubens, Michael B IR - Rubens MB FIR - Shapiro, Michael D IR - Shapiro MD FIR - Chobanian, Michael IR - Chobanian M FIR - Davidson, Michael IR - Davidson M FIR - Farkouh, Michael IR - Farkouh M FIR - Mack, Michael IR - Mack M FIR - Wlodarczyk, Michal IR - Wlodarczyk M FIR - Khouri, Michel G IR - Khouri MG FIR - Crowder, Michelle IR - Crowder M FIR - Ratliff, Michelle IR - Ratliff M FIR - Borges Santos, Miguel IR - Borges Santos M FIR - Nobre Menezes, Miguel IR - Nobre Menezes M FIR - Perez Fontan, Miguel IR - Perez Fontan M FIR - Barrero, Miguel IR - Barrero M FIR - Tapolyai, Mihaly IR - Tapolyai M FIR - Torosoff, Mikhail T IR - Torosoff MT FIR - Dobric, Milan R IR - Dobric MR FIR - Gadkari, Milind Avdhoot IR - Gadkari MA FIR - Kyaw, Min Tun IR - Kyaw MT FIR - Revivo, Miri IR - Revivo M FIR - Lustre, Mitchel B IR - Lustre MB FIR - Adel, Mohamed IR - Adel M FIR - Hassan, Mohamed IR - Hassan M FIR - El-Hajjar, Mohammad IR - El-Hajjar M FIR - Hussain, Mohammed IR - Hussain M FIR - Saleem, Mohammed IR - Saleem M FIR - Blanco-Calvo, Moises IR - Blanco-Calvo M FIR - Jimenez-Santos, Moises IR - Jimenez-Santos M FIR - Laukyte, Monika IR - Laukyte M FIR - Saric, Muhamed IR - Saric M FIR - Takiuti, Myrthes Emy IR - Takiuti ME FIR - Asif, Nadia IR - Asif N FIR - Moorthy, Nagaraja IR - Moorthy N FIR - Ogletree, Naima L IR - Ogletree NL FIR - Katamadze, Nana O IR - Katamadze NO FIR - Nataraj, Nandita IR - Nataraj N FIR - Uchida, Naomi IR - Uchida N FIR - Ismail, Nasrul IR - Ismail N FIR - Oliveira, Natalia S IR - Oliveira NS FIR - de Carvalho Maffei, Natalia IR - de Carvalho Maffei N FIR - Brosens, Nathalie IR - Brosens N FIR - Aslam, Naved IR - Aslam N FIR - Akhtar, Naveed IR - Akhtar N FIR - Mowafy, Neamat IR - Mowafy N FIR - Pandit, Neeraj IR - Pandit N FIR - Parakh, Neeraj IR - Parakh N FIR - Pannu, Neesh IR - Pannu N FIR - Duncan, Neill IR - Duncan N FIR - Garcevic, Nevena IR - Garcevic N FIR - Meadows, Ngaire IR - Meadows N FIR - Danchin, Nicholas IR - Danchin N FIR - Deming, Nicole IR - Deming N FIR - Boskovic, Nikola N IR - Boskovic NN FIR - Karogiannis, Nikolaos IR - Karogiannis N FIR - Zhang, Ning IR - Zhang N FIR - Kumar, Nirmal IR - Kumar N FIR - Sharma, Niruta IR - Sharma N FIR - Chadha, Nitika IR - Chadha N FIR - Naik, Nitish IR - Naik N FIR - Durfee, Noelle M IR - Durfee NM FIR - Cosgrove, Nora M IR - Cosgrove NM FIR - Urbanski, Norbert IR - Urbanski N FIR - Hogg, Norma IR - Hogg N FIR - Walesiak, Olga IR - Walesiak O FIR - Zdonczyk, Olga IR - Zdonczyk O FIR - Zhdanova, Olga IR - Zhdanova O FIR - Anaya, Olivia IR - Anaya O FIR - Bello, Olugbenga IR - Bello O FIR - Almousalli, Omar IR - Almousalli O FIR - Thompson, Omar IR - Thompson O FIR - Kliuk, Orit IR - Kliuk O FIR - Mendiz, Oscar IR - Mendiz O FIR - Prada-Delgado, Oscar IR - Prada-Delgado O FIR - Shapira, Oz IR - Shapira O FIR - Raffaele, Pablo IR - Raffaele P FIR - Salanger, Page IR - Salanger P FIR - Maurovich-Horvat, Pal IR - Maurovich-Horvat P FIR - Garg, Pallav IR - Garg P FIR - Moraga, Paloma IR - Moraga P FIR - Singh, Pam IR - Singh P FIR - Ouyang, Pamela IR - Ouyang P FIR - Woodard, Pamela IR - Woodard P FIR - Poggio Smanio, Paola Emanuela IR - Poggio Smanio PE FIR - Smanio, Paola IR - Smanio P FIR - Calabro, Paolo IR - Calabro P FIR - Nguyen, Patricia K IR - Nguyen PK FIR - Alarie, Patricia IR - Alarie P FIR - Carrilho, Patricia IR - Carrilho P FIR - Endsley, Patricia IR - Endsley P FIR - Pellikka, Patricia IR - Pellikka P FIR - Lebioda, Patrycja IR - Lebioda P FIR - Der Mesropian, Paul IR - Der Mesropian P FIR - Hauptman, Paul IR - Hauptman P FIR - Garcia-Gonzalez, Paula IR - Garcia-Gonzalez P FIR - Wilson, Paula IR - Wilson P FIR - Cury Rezende, Paulo IR - Cury Rezende P FIR - Novis Rocha, Paulo IR - Novis Rocha P FIR - Canas Silva, Pedro IR - Canas Silva P FIR - Farto E Abreu, Pedro IR - Farto E Abreu P FIR - Piccaro de Oliveira, Pedro IR - Piccaro de Oliveira P FIR - Carvalho, Pedro IR - Carvalho P FIR - Modas, Pedro IR - Modas P FIR - Rio, Pedro IR - Rio P FIR - He, Peiyu IR - He P FIR - McCullough, Peter A IR - McCullough PA FIR - Stone, Peter H IR - Stone PH FIR - Douglass, Peter IR - Douglass P FIR - Sizeland, Peter IR - Sizeland P FIR - Voros, Peter IR - Voros P FIR - Steg, Philippe Gabriel IR - Steg PG FIR - Genereux, Philippe IR - Genereux P FIR - Genereux, Philippe IR - Genereux P FIR - Menasche, Philippe IR - Menasche P FIR - Rheault, Philippe IR - Rheault P FIR - Tassinario, Piero IR - Tassinario P FIR - Gervais, Pierre IR - Gervais P FIR - Calvillo, Pilar IR - Calvillo P FIR - Chai, Ping IR - Chai P FIR - Jakubowski, Piotr IR - Jakubowski P FIR - Pruszczyk, Piotr IR - Pruszczyk P FIR - Loh, Poay-Huan IR - Loh PH FIR - Samadi, Pouneh IR - Samadi P FIR - Deedwania, Prakash IR - Deedwania P FIR - Patel, Pranav M IR - Patel PM FIR - Polamuri, Praneeth IR - Polamuri P FIR - Sharma, Pratiksha IR - Sharma P FIR - Kamath, Preeti IR - Kamath P FIR - Thomas, Prince IR - Thomas P FIR - Arambam, Priyadarshani IR - Arambam P FIR - Sodhi, Puneet IR - Sodhi P FIR - Naik, Pushpa IR - Naik P FIR - Zhong, Qi IR - Zhong Q FIR - Zhao, Qian IR - Zhao Q FIR - Yuan, Qianqian IR - Yuan Q FIR - Xie, Qiulan IR - Xie Q FIR - Murphy, Rachel IR - Murphy R FIR - Lyubarova, Radmila IR - Lyubarova R FIR - Lyubarova, Radmilar IR - Lyubarova R FIR - Fisher, Raewyn IR - Fisher R FIR - Diaz, Rafael IR - Diaz R FIR - Maldonado, Rafael IR - Maldonado R FIR - Selgas, Rafael IR - Selgas R FIR - Bugiardini, Raffaele IR - Bugiardini R FIR - Chaudhry, Rafia IR - Chaudhry R FIR - Kavalakkat, Raisa IR - Kavalakkat R FIR - Vs, Rajalekshmi IR - Vs R FIR - Nair, Rajesh Gopalan IR - Nair RG FIR - Narang, Rajiv IR - Narang R FIR - Yadav, Rakesh IR - Yadav R FIR - Carvalho, Ramiro IR - Carvalho R FIR - Jesus-Perez, Ramon de IR - Jesus-Perez R FIR - Leng, Ran IR - Leng R FIR - Kachru, Ranjan IR - Kachru R FIR - Sanchez, Raquel IR - Sanchez R FIR - Dwyer, Raven R IR - Dwyer RR FIR - Lee, Raven IR - Lee R FIR - Wyman, Ray IR - Wyman R FIR - Wong, Raymond C IR - Wong RC FIR - Hampson, Reinette IR - Hampson R FIR - Karam Kalil, Renato Abdala IR - Karam Kalil RA FIR - Lopes, Renato D IR - Lopes RD FIR - Eick, Renato George IR - Eick RG FIR - Lopes, Renato IR - Lopes R FIR - Ravindran, Reshma IR - Ravindran R FIR - Gamma, Reto Andreas IR - Gamma RA FIR - Costa, Ricardo IR - Costa R FIR - Bhatt, Richa IR - Bhatt R FIR - Trimlett, Richard H J IR - Trimlett RHJ FIR - Patel, Risha IR - Patel R FIR - Coram, Rita IR - Coram R FIR - Riezebos, Robert K IR - Riezebos RK FIR - Donnino, Robert M IR - Donnino RM FIR - Guyton, Robert IR - Guyton R FIR - Harrington, Robert IR - Harrington R FIR - Malecki, Robert IR - Malecki R FIR - Favaloro, Roberto Rene IR - Favaloro RR FIR - Elliott, Robyn IR - Elliott R FIR - Lima, Rodolfo G S D IR - Lima RGSD FIR - Tandon, Rohit IR - Tandon R FIR - Doerr, Rolf IR - Doerr R FIR - Tewari, Roma IR - Tewari R FIR - Wald, Ron IR - Wald R FIR - Hu, Rongrong IR - Hu R FIR - Collins, Rory IR - Collins R FIR - Mehran, Roxana IR - Mehran R FIR - Senior, Roxy IR - Senior R FIR - Baleon-Espinosa, Ruben IR - Baleon-Espinosa R FIR - Ramos, Ruben IR - Ramos R FIR - Ferreira, Rui IR - Ferreira R FIR - Kirby, Ruth IR - Kirby R FIR - Perez-Fernandez, Ruth IR - Perez-Fernandez R FIR - Ramakrishnan, S IR - Ramakrishnan S FIR - Dwivedi, S K IR - Dwivedi SK FIR - Lubna, Sadath IR - Lubna S FIR - Ahmed, Sadiq IR - Ahmed S FIR - Govindan, Sajeev Chakanalil IR - Govindan SC FIR - Alfalahi, Salamah IR - Alfalahi S FIR - Cruz-Flores, Salvador IR - Cruz-Flores S FIR - Costa, Salvatore P IR - Costa SP FIR - Setty, Sampoornima IR - Setty S FIR - Nwosu, Samuel IR - Nwosu S FIR - Mahajan, Sandeep IR - Mahajan S FIR - Seth, Sandeep IR - Seth S FIR - Singh, Sandeep IR - Singh S FIR - Niehe, Sander R IR - Niehe SR FIR - Carr, Sandy IR - Carr S FIR - Ogrizovic, Sanja Simic IR - Ogrizovic SS FIR - Ogrizovic, Sanja IR - Ogrizovic S FIR - Gulati, Sanjeev IR - Gulati S FIR - Sharma, Sanjeev IR - Sharma S FIR - Fernandez, Sara IR - Fernandez S FIR - Williams, Sarah IR - Williams S FIR - Ralhan, Sarju IR - Ralhan S FIR - Kedev, Sasko IR - Kedev S FIR - Singh, Satinder IR - Singh S FIR - Sankaranarayanan, Satish IR - Sankaranarayanan S FIR - Manjunath, Satvic Cholenahally IR - Manjunath SC FIR - Lee, Sau IR - Lee S FIR - Thaxton, Schawana IR - Thaxton S FIR - O'Brien, Sean M IR - O'Brien SM FIR - Sobczak, Sebastian IR - Sobczak S FIR - Nour, Seema IR - Nour S FIR - Sayganov, Sergey A IR - Sayganov SA FIR - Bravo Baptista, Sergio IR - Bravo Baptista S FIR - Draibe, Sergio IR - Draibe S FIR - Sokol, Seth IR - Sokol S FIR - Chandra, Sharad IR - Chandra S FIR - Mackedanz, Shari IR - Mackedanz S FIR - Goodman, Shaun IR - Goodman S FIR - Shirazian, Shayan IR - Shirazian S FIR - Karwa, Sheetal Rupesh IR - Karwa SR FIR - Ussery, Sheri IR - Ussery S FIR - Bajaj, Sheromani IR - Bajaj S FIR - Heydari, Shirin IR - Heydari S FIR - Choudhary, Shiv Kumar IR - Choudhary SK FIR - Patel, Shivali IR - Patel S FIR - Pandey, Shruti IR - Pandey S FIR - Zhang, Shuyang IR - Zhang S FIR - Gadage, Siddharth IR - Gadage S FIR - Tan, Sik-Yin V IR - Tan SV FIR - Poletti, Silvia Zottis IR - Poletti SZ FIR - Valbuena, Silvia IR - Valbuena S FIR - Savaris, Simone IR - Savaris S FIR - Yakubov, Solomon IR - Yakubov S FIR - Zhu, Songlin IR - Zhu S FIR - Gupta, Sonika IR - Gupta S FIR - Brener, Sorin IR - Brener S FIR - Gurunathan, Sothinathan IR - Gurunathan S FIR - Nayak, Soundarya IR - Nayak S FIR - Reddy, Sowjanya IR - Reddy S FIR - Cobos, Stanley E IR - Cobos SE FIR - Weikl, Stefan IR - Weikl S FIR - Lane, Stephanie M IR - Lane SM FIR - Ferket, Stephanie IR - Ferket S FIR - Mavromichalis, Stephanie IR - Mavromichalis S FIR - Fremes, Stephen IR - Fremes S FIR - Fein, Steven A IR - Fein SA FIR - Sedlis, Steven P IR - Sedlis SP FIR - Giovannone, Steven IR - Giovannone S FIR - Weitz, Steven IR - Weitz S FIR - Banerjee, Subhash IR - Banerjee S FIR - Hegde, Sudhanva S IR - Hegde SS FIR - Hosino, Suellen IR - Hosino S FIR - Mookherjee, Sulagna IR - Mookherjee S FIR - Singh, Suman IR - Singh S FIR - Abeygunasekara, Sumith IR - Abeygunasekara S FIR - Mishra, Sundeep IR - Mishra S FIR - Verma, Sunil Kumar IR - Verma SK FIR - Kumar, Suresh IR - Kumar S FIR - Narayanappa, Suryaprakash IR - Narayanappa S FIR - Milbrandt, Susan K IR - Milbrandt SK FIR - Silva, Susana IR - Silva S FIR - Stevens, Susanna IR - Stevens S FIR - Kolhe, Suvarna IR - Kolhe S FIR - Tavares, Suzana IR - Tavares S FIR - Welsh, Suzanne IR - Welsh S FIR - Kishore, T A IR - Kishore TA FIR - Colaiacovo Soares, Tamara IR - Colaiacovo Soares T FIR - Pillay, Tapan Umesh IR - Pillay TU FIR - Rashid, Tarek IR - Rashid T FIR - Mittal, Tarun K IR - Mittal TK FIR - Duarte, Tauane Bello IR - Duarte TB FIR - Dutoiu, Teodora IR - Dutoiu T FIR - Delgadillo, Teresa IR - Delgadillo T FIR - Chua, Terrance IR - Chua T FIR - Welch, Terrance IR - Welch T FIR - Kofidis, Theodoros IR - Kofidis T FIR - Lefevre, Thierry IR - Lefevre T FIR - Silva, Tiago IR - Silva T FIR - Boros, Timea IR - Boros T FIR - Lau, Titus IR - Lau T FIR - Formisano, Tiziana IR - Formisano T FIR - Ciurus, Tomasz IR - Ciurus T FIR - Tarchalski, Tomasz IR - Tarchalski T FIR - Tan, Tracy IR - Tan T FIR - Lingaraj, Umesh IR - Lingaraj U FIR - Bahl, V K IR - Bahl VK FIR - Narain, V S IR - Narain VS FIR - Pellu, Valentina IR - Pellu V FIR - Lobo, Valentine IR - Lobo V FIR - Robesyn, Valerie IR - Robesyn V FIR - Yadav, Vandana IR - Yadav V FIR - Gupta, Veerabhadra IR - Gupta V FIR - Mathew, Verghese IR - Mathew V FIR - Miro, Vicente IR - Miro V FIR - Gumerova, Victoria IR - Gumerova V FIR - Hernandez, Victoria IR - Hernandez V FIR - Kher, Vijay IR - Kher V FIR - Kumar, Vijay IR - Kumar V FIR - Makkar, Vikas IR - Makkar V FIR - Reddy, Vikranth IR - Reddy V FIR - Bulkley, Viktoria IR - Bulkley V FIR - David, Vinoi George IR - David VG FIR - Misra, Virendra IR - Misra V FIR - Fernandez-Figares, Virginia IR - Fernandez-Figares V FIR - Ryasniansky, Vladimir IR - Ryasniansky V FIR - Giga, Vojislav L IR - Giga VL FIR - Almahmeed, Wael A IR - Almahmeed WA FIR - Chan, Wan Xian IR - Chan WX FIR - Marfori, Wanda C IR - Marfori WC FIR - Parker, Wanda IR - Parker W FIR - Pennachi, Wayne IR - Pennachi W FIR - Lau, Wei Ling IR - Lau WL FIR - Xing, Weibing IR - Xing W FIR - Bian, Weijing IR - Bian W FIR - Stewart, Wendy L IR - Stewart WL FIR - Drewes, Wendy IR - Drewes W FIR - Hueb, Whady IR - Hueb W FIR - Weintraub, William IR - Weintraub W FIR - Sia, Winnie C IR - Sia WC FIR - Flores-Rios, Xacobe IR - Flores-Rios X FIR - Ma, Xiang IR - Ma X FIR - Gu, Xiangqiong IR - Gu X FIR - Li, Xiaomei IR - Li X FIR - Xu, Xiaoyi IR - Xu X FIR - Fu, Xin IR - Fu X FIR - Li, Xuemei IR - Li X FIR - Wang, Xutong IR - Wang X FIR - Pepin-Dubois, Yanek IR - Pepin-Dubois Y FIR - Arbel, Yaron IR - Arbel Y FIR - Han, Yechen IR - Han Y FIR - Lit, Yiming IR - Lit Y FIR - Sia, Ying Tung IR - Sia YT FIR - Wang, Ying IR - Wang Y FIR - Yang, Yining IR - Yang Y FIR - Ma, Yitong IR - Ma Y FIR - Peralta, Yolayfi IR - Peralta Y FIR - Smets, Yves IR - Smets Y FIR - Taul, Yvonne IR - Taul Y FIR - Kudzoeva, Zalina IR - Kudzoeva Z FIR - Markovic, Zeljko Z IR - Markovic ZZ FIR - Liu, Zhangsuo IR - Liu Z FIR - Liu, Zhenyu IR - Liu Z FIR - Ye, Zhiming IR - Ye Z FIR - Yu, Zixiang IR - Yu Z FIR - Davidovits, Zoltan IR - Davidovits Z FIR - Petronijevic, Zvezdana IR - Petronijevic Z EDAT- 2020/04/01 06:00 MHDA- 2020/04/29 06:00 PMCR- 2020/10/23 CRDT- 2020/04/01 06:00 PHST- 2020/04/01 06:00 [pubmed] PHST- 2020/04/29 06:00 [medline] PHST- 2020/04/01 06:00 [entrez] PHST- 2020/10/23 00:00 [pmc-release] AID - 10.1056/NEJMoa1916374 [doi] PST - ppublish SO - N Engl J Med. 2020 Apr 23;382(17):1619-1628. doi: 10.1056/NEJMoa1916374. Epub 2020 Mar 30. PMID- 32171721 OWN - NLM STAT- MEDLINE DCOM- 20201102 LR - 20201102 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 13 IP - 7 DP - 2020 Apr 13 TI - A Randomized Trial of Recombinant Human C1-Esterase-Inhibitor in the Prevention of Contrast-Induced Kidney Injury. PG - 833-842 LID - S1936-8798(19)32400-8 [pii] LID - 10.1016/j.jcin.2019.11.021 [doi] AB - OBJECTIVES: This study sought to determine the efficacy profile and safety of recombinant human C1 esterase inhibitor (rhC1INH) in the prevention of contrast-associated acute kidney injury after elective coronary angiography. BACKGROUND: Contrast-associated acute kidney injury is caused by tubular cytotoxicity and ischemia/reperfusion injury. rhC1INH is effective in reducing renal ischemia/reperfusion injury in experimental models. METHODS: In this placebo-controlled, double-blind, single-center trial 77 patients with chronic kidney disease were randomized to receive 50 IU/kg rhC1INH before and 4 h after elective coronary angiography or placebo. The primary outcome was the peak change of urinary neutrophil gelatinase-associated lipocalin within 48 h, a surrogate marker of kidney injury. RESULTS: Median peak change of urinary neutrophil gelatinase-associated lipocalin was lower in the rhC1INH group (4.7 ng/ml vs. 22.5 ng/ml; p = 0.038) in the per-protocol population but not in the modified intention-to-treat analysis, and in patients with percutaneous coronary interventions (median, 1.8 ng/ml vs. 26.2 ng/ml; p = 0.039 corresponding to a median proportion peak change of 11% vs. 205%; p = 0.002). The incidence of a cystatin C increase >/=10% within 24 h was lower in the rhC1INH group (16% vs. 33%; p = 0.045), whereas the frequency of contrast-associated acute kidney injury was comparable. Adverse events during a 3-month follow-up were similarly distributed. CONCLUSIONS: Administration of rhC1INH before coronary angiography may attenuate renal injury as reflected by urinary neutrophil gelatinase-associated lipocalin and cystatin C. The safety profile of rhC1INH was favorable in a patient population with multiple comorbidities. (Recombinant Human C1 Esterase Inhibitor in the Prevention of Contrast-induced Nephropathy in High-risk Subjects [PROTECT]; NCT02869347). CI - Copyright (c) 2020 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Panagiotou, Anneza AU - Panagiotou A AD - Division of Internal Medicine, University Hospital Basel, Basel, Switzerland. FAU - Trendelenburg, Marten AU - Trendelenburg M AD - Division of Internal Medicine, University Hospital Basel, Basel, Switzerland; Department of Clinical Research and Department of Biomedicine, University of Basel, Basel, Switzerland. FAU - Heijnen, Ingmar A F M AU - Heijnen IAFM AD - Division of Medical Immunology, Laboratory Medicine, University Hospital Basel, Basel, Switzerland. FAU - Moser, Stephan AU - Moser S AD - Division of Internal Medicine, University Hospital Basel, Basel, Switzerland. FAU - Bonati, Leo H AU - Bonati LH AD - Division of Neurology and Stroke Center, Department of Clinical Research, University Hospital Basel and University of Basel, Basel Switzerland. FAU - Breidthardt, Tobias AU - Breidthardt T AD - Division of Internal Medicine, University Hospital Basel, Basel, Switzerland. FAU - Fahrni, Gregor AU - Fahrni G AD - Department of Cardiology, University Hospital Basel and University of Basel, Basel, Switzerland. FAU - Kaiser, Christoph AU - Kaiser C AD - Department of Cardiology, University Hospital Basel and University of Basel, Basel, Switzerland. FAU - Jeger, Raban AU - Jeger R AD - Department of Cardiology, University Hospital Basel and University of Basel, Basel, Switzerland. FAU - Osthoff, Michael AU - Osthoff M AD - Division of Internal Medicine, University Hospital Basel, Basel, Switzerland; Department of Clinical Research and Department of Biomedicine, University of Basel, Basel, Switzerland. Electronic address: michael.osthoff@usb.ch. LA - eng SI - ClinicalTrials.gov/NCT02869347 PT - Clinical Trial, Phase II PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20200311 PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 RN - 0 (Biomarkers) RN - 0 (Complement C1 Inhibitor Protein) RN - 0 (Contrast Media) RN - 0 (LCN2 protein, human) RN - 0 (Lipocalin-2) RN - 0 (Recombinant Proteins) RN - 0 (SERPING1 protein, human) SB - IM CIN - JACC Cardiovasc Interv. 2020 Apr 13;13(7):843-845. doi: 10.1016/j.jcin.2019.12.010. PMID: 32171716 MH - Acute Kidney Injury/chemically induced/diagnosis/*prevention & control/urine MH - Aged MH - Aged, 80 and over MH - Biomarkers/urine MH - Complement C1 Inhibitor Protein/adverse effects/*therapeutic use MH - Contrast Media/administration & dosage/*adverse effects MH - Coronary Angiography/*adverse effects MH - Coronary Artery Disease/complications/*diagnostic imaging MH - Double-Blind Method MH - Female MH - Humans MH - Lipocalin-2/urine MH - Male MH - Recombinant Proteins/therapeutic use MH - Renal Insufficiency, Chronic/*complications/diagnosis MH - Risk Factors MH - Switzerland MH - Time Factors MH - Treatment Outcome OTO - NOTNLM OT - contrast-induced acute kidney injury OT - coronary angiography OT - cystatin C OT - neutrophil gelatinase-associated lipocalin OT - recombinant C1 esterase inhibitor EDAT- 2020/03/17 06:00 MHDA- 2020/11/03 06:00 CRDT- 2020/03/16 06:00 PHST- 2019/09/04 00:00 [received] PHST- 2019/10/22 00:00 [revised] PHST- 2019/11/12 00:00 [accepted] PHST- 2020/03/17 06:00 [pubmed] PHST- 2020/11/03 06:00 [medline] PHST- 2020/03/16 06:00 [entrez] AID - S1936-8798(19)32400-8 [pii] AID - 10.1016/j.jcin.2019.11.021 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2020 Apr 13;13(7):833-842. doi: 10.1016/j.jcin.2019.11.021. Epub 2020 Mar 11. PMID- 32158254 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240328 IS - 1178-7066 (Print) IS - 1178-7066 (Electronic) IS - 1178-7066 (Linking) VI - 13 DP - 2020 TI - CYP2C19*17 May Increase the Risk of Death Among Patients with an Acute Coronary Syndrome and Non-Valvular Atrial Fibrillation Who Receive Clopidogrel and Rivaroxaban. PG - 29-37 LID - 10.2147/PGPM.S234910 [doi] AB - INTRODUCTION: The aim of this study is to assess the influence of gene CYP2C19, CYP3A4, CYP3A5 and ABCB1 polymorphisms on clopidogrel antiplatelet activity, rivaroxaban concentration equilibrium, and clinical outcomes among patients with acute coronary syndrome and non-valvular atrial fibrillation. METHODS: In the multicenter prospective registry study of the efficacy and safety of a combined antithrombotic therapy 103 patients with non-valvular atrial fibrillation both undergoing or not a percutaneous coronary intervention were enrolled. The trial assessed the primary outcomes (major bleeding, in-hospital death, cardiovascular death, stroke\transient ischaemic attack, death/renal insufficiency) and secondary outcomes (platelet reactivity units (PRU), rivaroxaban concentration). RESULTS: For none of the clinical outcomes when combined with other covariates, the carriership of polymorphisms CYP3A5*3 rs776746, CYP2C19*2 rs4244285;*17 rs12248560, ABCB1 3435 C>T, ABCB1 rs4148738 was significant. None of the markers under study (CYP3A5*3 rs776746, CYP2C19*2 rs4244285, *17 rs12248560, ABCB1 3435 C>T, ABCB1 rs4148738) has proven to affect rivaroxaban equilibrium concentration in blood plasma among patients with atrial fibrillation and acute coronary syndrome. CONCLUSION: In situations of double or triple antithrombotic rivaroxaban and clopidogrel therapy among patients with atrial fibrillation and acute coronary syndrome, the genetic factors associated with bleeding complications risk (CYP2C19*17) may prove to be clinically relevant. CI - (c) 2020 Sychev et al. FAU - Sychev, D A AU - Sychev DA AD - Russian Medical Academy of Continuous Professional Education, Ministry of Health of the Russian Federation, Moscow, Russian Federation. FAU - Baturina, O A AU - Baturina OA AUID- ORCID: 0000-0002-3108-6308 AD - Sechenov University, Moscow, Russian Federation. FAU - Mirzaev, K B AU - Mirzaev KB AD - Russian Medical Academy of Continuous Professional Education, Ministry of Health of the Russian Federation, Moscow, Russian Federation. FAU - Rytkin, E AU - Rytkin E AUID- ORCID: 0000-0003-2511-0655 AD - Russian Medical Academy of Continuous Professional Education, Ministry of Health of the Russian Federation, Moscow, Russian Federation. FAU - Ivashchenko, D V AU - Ivashchenko DV AUID- ORCID: 0000-0002-2295-7167 AD - Russian Medical Academy of Continuous Professional Education, Ministry of Health of the Russian Federation, Moscow, Russian Federation. FAU - Andreev, D A AU - Andreev DA AUID- ORCID: 0000-0002-0276-7374 AD - Sechenov University, Moscow, Russian Federation. FAU - Ryzhikova, K A AU - Ryzhikova KA AUID- ORCID: 0000-0003-3505-8520 AD - Russian Medical Academy of Continuous Professional Education, Ministry of Health of the Russian Federation, Moscow, Russian Federation. FAU - Grishina, E A AU - Grishina EA AD - Russian Medical Academy of Continuous Professional Education, Ministry of Health of the Russian Federation, Moscow, Russian Federation. FAU - Bochkov, P O AU - Bochkov PO AUID- ORCID: 0000-0001-8555-5969 AD - Russian Medical Academy of Continuous Professional Education, Ministry of Health of the Russian Federation, Moscow, Russian Federation. FAU - Shevchenko, R V AU - Shevchenko RV AUID- ORCID: 0000-0003-4646-7733 AD - Russian Medical Academy of Continuous Professional Education, Ministry of Health of the Russian Federation, Moscow, Russian Federation. LA - eng PT - Journal Article DEP - 20200123 PL - New Zealand TA - Pharmgenomics Pers Med JT - Pharmacogenomics and personalized medicine JID - 101514107 PMC - PMC6986167 OTO - NOTNLM OT - acute coronary syndrome OT - atrial fibrillation OT - clopidogrel OT - polymorphism OT - rivaroxaban COIS- Dmitriy Ivashchenko reports grants from Russian Science Foundation and RFBR, outside the submitted work. The other authors report no conflicts of interest in this work. EDAT- 2020/03/12 06:00 MHDA- 2020/03/12 06:01 PMCR- 2020/01/23 CRDT- 2020/03/12 06:00 PHST- 2019/10/16 00:00 [received] PHST- 2020/01/03 00:00 [accepted] PHST- 2020/03/12 06:00 [entrez] PHST- 2020/03/12 06:00 [pubmed] PHST- 2020/03/12 06:01 [medline] PHST- 2020/01/23 00:00 [pmc-release] AID - 234910 [pii] AID - 10.2147/PGPM.S234910 [doi] PST - epublish SO - Pharmgenomics Pers Med. 2020 Jan 23;13:29-37. doi: 10.2147/PGPM.S234910. eCollection 2020. PMID- 32151161 OWN - NLM STAT- MEDLINE DCOM- 20201109 LR - 20201109 IS - 1941-7632 (Electronic) IS - 1941-7640 (Linking) VI - 13 IP - 3 DP - 2020 Mar TI - Sex-Specific Management in Patients With Acute Myocardial Infarction and Cardiogenic Shock: A Substudy of the CULPRIT-SHOCK Trial. PG - e008537 LID - 10.1161/CIRCINTERVENTIONS.119.008537 [doi] AB - BACKGROUND: Women are more likely to suffer and die from cardiogenic shock (CS) as the most severe complication of acute myocardial infarction. Data concerning optimal management for women with CS are scarce. Aim of this study was to better define characteristics of women experiencing CS and to the influence of sex on different treatment strategies. METHODS: In the CULPRIT-SHOCK trial (The Culprit Lesion Only PCI Versus Multivessel PCI in Cardiogenic Shock), patients with CS complicating acute myocardial infarction and multivessel coronary artery disease were randomly assigned to one of the following revascularization strategies: either percutaneous coronary intervention of the culprit-lesion-only or immediate multivessel percutaneous coronary intervention. Primary end point was composite of death from any cause or severe renal failure leading to renal replacement therapy within 30 days. We investigated sex-specific differences in general and according to the revascularization strategies. RESULTS: Among all 686 randomized patients included in the analysis, 24% were women. Women were older and had more often diabetes mellitus and renal insufficiency, whereas they had less often history of previous acute myocardial infarction and smoking. After 30 days, the primary clinical end point was not significantly different between groups (56% women versus 49% men; odds ratio, 1.29 [95% CI, 0.91-1.84]; P=0.15). There was no interaction between sex and coronary revascularization strategy regarding mortality and renal failure (P(interaction)=0.11). The primary end point occurred in 56% of women treated by the culprit-lesion-only strategy versus 42% men, whereas 55% of women and 55% of men in the multivessel percutaneous coronary intervention group. CONCLUSIONS: Although women presented with a different risk profile, mortality and renal replacement were similar to men. Sex did not influence mortality and renal failure according to the different coronary revascularization strategies. Based on these data, women and men presenting with CS complicating acute myocardial infarction and multivessel coronary artery disease should not be treated differently. However, further randomized trials powered to address potential sex-specific differences in CS are still necessary. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01927549. FAU - Rubini Gimenez, Maria AU - Rubini Gimenez M AD - From the Department of Internal Medicine/Cardiology, Heart Center Leipzig, Germany (M.R.G., S.D., H.T.). AD - Cardiology Department, University Hospital Basel, Switzerland (M.R.G., R.V.J.). FAU - Zeymer, Uwe AU - Zeymer U AD - Klinikum Ludwigshafen, Germany (U.Z.). FAU - Desch, Steffen AU - Desch S AD - From the Department of Internal Medicine/Cardiology, Heart Center Leipzig, Germany (M.R.G., S.D., H.T.). AD - German Center for Cardiovascular Research, Berlin, Germany (S.D., R.M.-S., G.F.). FAU - de Waha-Thiele, Suzanne AU - de Waha-Thiele S AD - Department of Internal Medicine/Cardiology/ Angiology/Intensive Care Medicine, University Heart Center Lubeck, Germany (S.d.W.-T., J.P., R.M.-S., G.F.). FAU - Ouarrak, Taoufik AU - Ouarrak T AD - Institut fur Herzinfarktforschung, Ludwigshafen, Germany (T.O., S.S.). FAU - Poess, Janine AU - Poess J AD - Department of Internal Medicine/Cardiology/ Angiology/Intensive Care Medicine, University Heart Center Lubeck, Germany (S.d.W.-T., J.P., R.M.-S., G.F.). FAU - Meyer-Saraei, Roza AU - Meyer-Saraei R AD - German Center for Cardiovascular Research, Berlin, Germany (S.D., R.M.-S., G.F.). AD - Department of Internal Medicine/Cardiology/ Angiology/Intensive Care Medicine, University Heart Center Lubeck, Germany (S.d.W.-T., J.P., R.M.-S., G.F.). FAU - Schneider, Steffen AU - Schneider S AD - Institut fur Herzinfarktforschung, Ludwigshafen, Germany (T.O., S.S.). FAU - Fuernau, Georg AU - Fuernau G AD - German Center for Cardiovascular Research, Berlin, Germany (S.D., R.M.-S., G.F.). AD - Department of Internal Medicine/Cardiology/ Angiology/Intensive Care Medicine, University Heart Center Lubeck, Germany (S.d.W.-T., J.P., R.M.-S., G.F.). FAU - Stepinska, Janina AU - Stepinska J AD - Institute of Cardiology, Warsaw, Poland (J.S.). FAU - Huber, Kurt AU - Huber K AD - 3rd Department of Internal Medicine, Cardiology and Intensive Care Medicine, Wilhelminenhospital and Sigmund Freud University, Medical School, Vienna, Austria (K.H.). FAU - Windecker, Stephan AU - Windecker S AD - Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Switzerland (S.W.). FAU - Montalescot, Gilles AU - Montalescot G AD - Department of Cardiology, Sorbonne Universite, Institut de Cardiologie (AP-HP), hopital Pitie Salpetriere, Paris, France (G.M.). FAU - Savonitto, Stefano AU - Savonitto S AD - Department of Cardiology, Manzoni Hospital, Lecco, Italy (S.S.). FAU - Jeger, Raban V AU - Jeger RV AD - Cardiology Department, University Hospital Basel, Switzerland (M.R.G., R.V.J.). FAU - Thiele, Holger AU - Thiele H AD - From the Department of Internal Medicine/Cardiology, Heart Center Leipzig, Germany (M.R.G., S.D., H.T.). LA - eng SI - ClinicalTrials.gov/NCT01927549 SI - ClinicalTrials.gov/NCT01927549 PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20200310 PL - United States TA - Circ Cardiovasc Interv JT - Circulation. Cardiovascular interventions JID - 101499602 SB - IM CIN - Circ Cardiovasc Interv. 2020 Mar;13(3):e009034. doi: 10.1161/CIRCINTERVENTIONS.120.009034. PMID: 32151160 MH - Aged MH - Aged, 80 and over MH - Female MH - *Health Status Disparities MH - *Healthcare Disparities MH - Humans MH - Male MH - Myocardial Infarction/complications/mortality/*therapy MH - *Percutaneous Coronary Intervention/adverse effects/instrumentation/mortality MH - Renal Dialysis MH - Renal Insufficiency/etiology/mortality/therapy MH - Risk Assessment MH - Risk Factors MH - Sex Factors MH - Shock, Cardiogenic/etiology/mortality/*therapy MH - Stents MH - Time Factors MH - Treatment Outcome OTO - NOTNLM OT - humans OT - myocardial infarction OT - shock, cardiogenic OT - smoking OT - women EDAT- 2020/03/11 06:00 MHDA- 2020/11/11 06:00 CRDT- 2020/03/11 06:00 PHST- 2020/03/11 06:00 [entrez] PHST- 2020/03/11 06:00 [pubmed] PHST- 2020/11/11 06:00 [medline] AID - 10.1161/CIRCINTERVENTIONS.119.008537 [doi] PST - ppublish SO - Circ Cardiovasc Interv. 2020 Mar;13(3):e008537. doi: 10.1161/CIRCINTERVENTIONS.119.008537. Epub 2020 Mar 10. PMID- 32139218 OWN - NLM STAT- MEDLINE DCOM- 20201013 LR - 20201013 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 13 IP - 5 DP - 2020 Mar 9 TI - Derivation, Validation, and Prognostic Utility of a Prediction Rule for Nonresponse to Clopidogrel: The ABCD-GENE Score. PG - 606-617 LID - S1936-8798(20)30406-4 [pii] LID - 10.1016/j.jcin.2020.01.226 [doi] AB - OBJECTIVES: The aim of this study was to develop a risk score integrating cytochrome P450 2C19 loss-of-function genotypes with clinical risk factors influencing clopidogrel response that would allow the identification with more precision of subjects at risk for high platelet reactivity (HPR) and adverse clinical outcomes. BACKGROUND: Clopidogrel is the most broadly used platelet P2Y(12) inhibitor. However, a considerable number of patients achieve inadequate platelet inhibition, with persistent HPR, an established marker of increased thrombotic risk, underscoring the need for tools to help identify these subjects. Although carriers of loss-of-function alleles of the cytochrome P450 2C19 enzyme have reduced clopidogrel metabolism leading to increased rates of HPR and thrombotic complications, this explains only a fraction of the pharmacodynamic response to clopidogrel, and a number of clinical factors have also been shown to have contributing roles. METHODS: Three prospective and independent studies were used to: 1) develop a risk score integrating genetic and clinical factors to identify patients with HPR while on clopidogrel; 2) investigate the external validity of the risk score; and 3) define clinical outcomes associated with the risk score in a cohort of patients with myocardial infarction treated with clopidogrel. RESULTS: A risk score ABCD-GENE (Age, Body Mass Index, Chronic Kidney Disease, Diabetes Mellitus, and Genotyping) was developed incorporating 5 independent predictors of HPR: 4 clinical (age >75 years, body mass index >30 kg/m(2), chronic kidney disease [glomerular filtration rate <60 ml/min], and diabetes mellitus) and 1 genetic (cytochrome P450 2C19 loss-of-function alleles). The C-statistics for the score as an integer variable were 0.71 (95% confidence interval [CI]: 0.68 to 0.75) and 0.64 (95% CI: 0.60 to 0.67) in the pharmacodynamic derivation and validation cohorts, respectively. A cutoff score >/=10 was associated with the best sensitivity and specificity to identify HPR status. The C-statistics for the score were 0.67 (95% CI: 0.64 to 0.71) for all-cause death and 0.66 (95% CI: 0.63 to 0.69) for the composite of all-cause death, stroke, or myocardial infarction at 1 year. Using multiple models for adjustment, the ABCD-GENE score consistently and independently correlated with all-cause death, as well as with the composite of all-cause death, stroke, or myocardial infarction, both as a continuous variable and by using the cutoff of >/=10. The score did not predict bleeding. CONCLUSIONS: The ABCD-GENE score is a simple tool to identify patients with HPR on clopidogrel and who are at increased risk for adverse ischemic events, including mortality, following an acute myocardial infarction. In patients with a high ABCD-GENE score, long-term oral P2Y(12) inhibitors other than clopidogrel should be considered. CI - Copyright (c) 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Angiolillo, Dominick J AU - Angiolillo DJ AD - Division of Cardiology, Department of Medicine, University of Florida College of Medicine, Jacksonville, Florida. Electronic address: dominick.angiolillo@jax.ufl.edu. FAU - Capodanno, Davide AU - Capodanno D AD - Division of Cardiology, A.O.U. "Policlinico G. Rodolico-San Marco" University of Catania, Catania, Italy. FAU - Danchin, Nicolas AU - Danchin N AD - Hopital Europeen Georges Pompidou, Department of Cardiology, Assistance Publique-Hopitaux de Paris, Paris, France; Universite Paris Descartes, Paris, France. FAU - Simon, Tabassome AU - Simon T AD - Assistance Publique-Hopitaux de Paris, Hopital Saint Antoine, Department of Clinical Pharmacology, Clinical Research Platform (URCEST-CRB-CRCEST), Paris, France; Sorbonne-Universite, Faculte de Medecine, site St. Antoine, Service de Pharmacologie, Paris, France. FAU - Bergmeijer, Thomas O AU - Bergmeijer TO AD - St. Antonius Center for Platelet Function Research, Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands. FAU - Ten Berg, Jurrien M AU - Ten Berg JM AD - St. Antonius Center for Platelet Function Research, Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands. FAU - Sibbing, Dirk AU - Sibbing D AD - Department of Cardiology, LMU Munchen, Munich, Germany; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany; Privatklinik Lauterbacher Muhle am Ostersee, Seeshaupt, Germany. FAU - Price, Matthew J AU - Price MJ AD - Division of Cardiovascular Diseases, Scripps Clinic, La Jolla, California. LA - eng PT - Journal Article PT - Validation Study PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 RN - 0 (Platelet Aggregation Inhibitors) RN - 0 (Purinergic P2Y Receptor Antagonists) RN - A74586SNO7 (Clopidogrel) RN - EC 1.14.14.1 (CYP2C19 protein, human) RN - EC 1.14.14.1 (Cytochrome P-450 CYP2C19) SB - IM CIN - JACC Cardiovasc Interv. 2020 Mar 9;13(5):618-620. doi: 10.1016/j.jcin.2020.01.228. PMID: 32139219 MH - Age Factors MH - Aged MH - Body Mass Index MH - *Clinical Decision Rules MH - Clopidogrel/adverse effects/pharmacokinetics/*therapeutic use MH - Coronary Thrombosis/diagnostic imaging/etiology/mortality/*prevention & control MH - Cytochrome P-450 CYP2C19/genetics/metabolism MH - Databases, Factual MH - Diabetes Mellitus/diagnosis MH - *Drug Resistance MH - Female MH - Humans MH - Male MH - Middle Aged MH - Myocardial Infarction/diagnosis/mortality/*therapy MH - Obesity/complications/diagnosis MH - *Percutaneous Coronary Intervention/adverse effects/mortality MH - Pharmacogenomic Variants MH - Platelet Aggregation Inhibitors/adverse effects/pharmacokinetics/*therapeutic use MH - Predictive Value of Tests MH - Purinergic P2Y Receptor Antagonists/adverse effects/pharmacokinetics/*therapeutic use MH - Randomized Controlled Trials as Topic MH - Renal Insufficiency, Chronic/complications/diagnosis MH - Reproducibility of Results MH - Risk Assessment MH - Risk Factors MH - Time Factors MH - Treatment Outcome OTO - NOTNLM OT - clopidogrel OT - genetic testing OT - outcomes OT - risk factors EDAT- 2020/03/07 06:00 MHDA- 2020/10/21 06:00 CRDT- 2020/03/07 06:00 PHST- 2019/12/09 00:00 [received] PHST- 2020/01/17 00:00 [revised] PHST- 2020/01/22 00:00 [accepted] PHST- 2020/03/07 06:00 [entrez] PHST- 2020/03/07 06:00 [pubmed] PHST- 2020/10/21 06:00 [medline] AID - S1936-8798(20)30406-4 [pii] AID - 10.1016/j.jcin.2020.01.226 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2020 Mar 9;13(5):606-617. doi: 10.1016/j.jcin.2020.01.226. PMID- 32127336 OWN - NLM STAT- MEDLINE DCOM- 20200720 LR - 20200720 IS - 1590-3729 (Electronic) IS - 0939-4753 (Linking) VI - 30 IP - 5 DP - 2020 May 7 TI - Impact of body mass index on clinical outcome among elderly patients with acute coronary syndrome treated with percutaneous coronary intervention: Insights from the ELDERLY ACS 2 trial. PG - 730-737 LID - S0939-4753(20)30017-X [pii] LID - 10.1016/j.numecd.2020.01.001 [doi] AB - BACKGROUND AND AIM: Elderly patients are at increased risk of hemorrhagic and thrombotic complications after an acute coronary syndrome (ACS). Frailty, comorbidities and low body weight have emerged as conditioning the prognostic impact of dual antiplatelet therapy (DAPT). The aim of the present study was to investigate the prognostic impact of body mass index (BMI) on clinical outcome among patients included in the Elderly-ACS 2 trial, a randomized, open-label, blinded endpoint study comparing low-dose (5 mg) prasugrel vs clopidogrel among elderly patients with ACS. METHODS AND RESULTS: Our population is represented by 1408 patients enrolled in the Elderly-ACS 2 trial. BMI was calculated at admission. The primary endpoint of this analysis was cardiovascular (CV) mortality. Secondary endpoints were all-cause death, recurrent MI, Bleeding Academic Research Consortium (BARC) type 2 or 3 bleeding, and re-hospitalization for cardiovascular reasons or stent thrombosis within 12 months after index admission. Patients were grouped according to median values of BMI (/= 25.7 kg/m2). BMI was associated with hypertension, diabetes, hypercholesterolemia, estimated glomerular filtration rate and hemoglobin (p < 0.001), and inversely with age (p = 0.005). Overweight patients displayed larger use of diuretics at admission (p = 0.03), aspirin pre-randomization (p = 0.01) and radial access (p = 0.04). At a median follow-up of 367 [337-378] days, BMI did not affect CV mortality in the overall population 4% vs 3.8%; adjusted HR [95%CI] = 2.3 [0.8-6.5], p = 0.12. Similar findings were observed for our secondary efficacy and safety endpoints. Results did not change when considering separately higher risk subsets of patients, (female gender, diabetics, ST-segment elevation myocardial infarction or the type of DAPT treatment allocation), with no significant interaction between these population characteristics and BMI. CONCLUSIONS: Among elderly patients with ACS, BMI did not condition the survival or the risk of major cardiovascular and bleeding complications. The results were consistent across several patient risk categories. CI - Copyright (c) 2020 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved. FAU - De Luca, Giuseppe AU - De Luca G AD - Azienda Ospedaliera-Universitaria "Maggiore della Carita", Eastern Piedmont University, Novara, Italy. Electronic address: giuseppe.deluca@maggioreosp.novara.it. FAU - Verdoia, Monica AU - Verdoia M AD - Azienda Ospedaliera-Universitaria "Maggiore della Carita", Eastern Piedmont University, Novara, Italy. FAU - Savonitto, Stefano AU - Savonitto S AD - Ospedale Manzoni, Lecco, Italy. FAU - Ferri, Luca A AU - Ferri LA AD - Ospedale Manzoni, Lecco, Italy. FAU - Piatti, Luigi AU - Piatti L AD - Ospedale Manzoni, Lecco, Italy. FAU - Grosseto, Daniele AU - Grosseto D AD - Ospedale Infermi, Rimini, Italy. FAU - Morici, Nuccia AU - Morici N AD - ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy. FAU - Bossi, Irene AU - Bossi I AD - ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy. FAU - Sganzerla, Paolo AU - Sganzerla P AD - Ospedale Treviglio-Caravaggio, Treviglio, Italy. FAU - Tortorella, Giovanni AU - Tortorella G AD - S.C. Cardiologia-UTIC, Ospedale Vaio, Fidenza (PR), Italy. FAU - Cacucci, Michele AU - Cacucci M AD - Ospedale Maggiore, Crema, Italy. FAU - Ferrario, Maurizio AU - Ferrario M AD - IRCCS Fondazione Policlinico S. Matteo, Pavia, Italy. FAU - Murena, Ernesto AU - Murena E AD - Ospedale S. Maria delle Grazie, Pozzuoli, Italy. FAU - Sibilio, Girolamo AU - Sibilio G AD - Ospedale S. Maria delle Grazie, Pozzuoli, Italy. FAU - Tondi, Stefano AU - Tondi S AD - Ospedale Baggiovara, Modena, Italy. FAU - Toso, Anna AU - Toso A AD - Ospedale S. Stefano, Prato, Italy. FAU - Bongioanni, Sergio AU - Bongioanni S AD - Ospedale Mauriziano, Torino, Italy. FAU - Ravera, Amelia AU - Ravera A AD - OspedaleRuggi D' Aragona, Salerno, Italy. FAU - Corrada, Elena AU - Corrada E AD - HumanitasClinical and Research Center, Rozzano, Italy. FAU - Mariani, Matteo AU - Mariani M AD - Ospedale Civile, Legnano, Italy. FAU - Di Ascenzo, Leonardo AU - Di Ascenzo L AD - Ospedale di San Dona di Piave-Portogruaro, Portogruaro, Italy. FAU - Petronio, A Sonia AU - Petronio AS AD - Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy. FAU - Cavallini, Claudio AU - Cavallini C AD - Ospedale S. Maria della Misericordia, Perugia, Italy. FAU - Vitrella, Giancarlo AU - Vitrella G AD - Ospedali Riuniti di Trieste, Trieste, Italy. FAU - Antonicelli, Roberto AU - Antonicelli R AD - Istituto Nazionale di Ricerca e Cura per l' Anziano, Ancona, Italy. FAU - Rogacka, Renata AU - Rogacka R AD - Azienda Ospedaliera di Desio e Vimercate, Desio, Italy. FAU - De Servi, Stefano AU - De Servi S AD - Multimedica IRCSS, Milan, Italy. CN - Elderly ACS 2 Investigators LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20200122 PL - Netherlands TA - Nutr Metab Cardiovasc Dis JT - Nutrition, metabolism, and cardiovascular diseases : NMCD JID - 9111474 RN - 0 (Platelet Aggregation Inhibitors) RN - A74586SNO7 (Clopidogrel) RN - G89JQ59I13 (Prasugrel Hydrochloride) SB - IM MH - Acute Coronary Syndrome/diagnostic imaging/mortality/*therapy MH - Age Factors MH - Aged MH - Aged, 80 and over MH - *Body Mass Index MH - Cause of Death MH - Clopidogrel/*administration & dosage/adverse effects MH - Comorbidity MH - Female MH - Frail Elderly MH - Geriatric Assessment MH - Hemorrhage/chemically induced/mortality MH - Humans MH - Italy MH - Male MH - Non-ST Elevated Myocardial Infarction/diagnostic imaging/mortality/*therapy MH - *Percutaneous Coronary Intervention/adverse effects/mortality MH - Platelet Aggregation Inhibitors/*administration & dosage/adverse effects MH - Prasugrel Hydrochloride/*administration & dosage/adverse effects MH - Recurrence MH - Risk Assessment MH - Risk Factors MH - ST Elevation Myocardial Infarction/diagnostic imaging/mortality/*therapy MH - Time Factors MH - Treatment Outcome OTO - NOTNLM OT - Acute coronary syndrome OT - Body mass index OT - Elderly patients COIS- Declaration of Competing Interest None. EDAT- 2020/03/05 06:00 MHDA- 2020/07/21 06:00 CRDT- 2020/03/05 06:00 PHST- 2019/08/07 00:00 [received] PHST- 2019/12/26 00:00 [revised] PHST- 2020/01/12 00:00 [accepted] PHST- 2020/03/05 06:00 [pubmed] PHST- 2020/07/21 06:00 [medline] PHST- 2020/03/05 06:00 [entrez] AID - S0939-4753(20)30017-X [pii] AID - 10.1016/j.numecd.2020.01.001 [doi] PST - ppublish SO - Nutr Metab Cardiovasc Dis. 2020 May 7;30(5):730-737. doi: 10.1016/j.numecd.2020.01.001. Epub 2020 Jan 22. PMID- 32097932 OWN - NLM STAT- MEDLINE DCOM- 20210831 LR - 20210831 IS - 1421-9751 (Electronic) IS - 0008-6312 (Linking) VI - 145 IP - 6 DP - 2020 TI - The Effect of Drug-Eluting Stents on Target Lesion Revascularization in Native Coronary Arteries: Results from the NORSTENT Randomized Study. PG - 333-341 LID - 10.1159/000506042 [doi] AB - BACKGROUND: The NORSTENT trial randomized 9,013 patients to percutaneous coronary intervention (PCI) with a drug-eluting stent (DES) or bare-metal stent (BMS) with 5-year follow-up. No difference was found in the composite primary outcome of death from any cause and nonfatal spontaneous myocardial infarction after a median of 5 years of follow-up. Secondary outcomes included repeat revascularizations, which were reduced by DES. We report the occurrence of target lesion revascularization (TLR) in time and across demographic and clinical subgroups in patients with lesions in native coronary arteries (n = 8,782). RESULTS: Clinically driven TLR was performed on 488 (5.6%) of the 8,782 patients during 5 years of follow-up. Male gender, older age, visible thrombus in the lesion, and larger stent diameter were associated with less TLR; multivessel disease and longer stents were associated with a higher risk of TLR. There was a substantial and highly significant reduction of the risk of any TLR after 5 years in the DES group (hazard ratio [HR] 0.44, 95% confidence interval [CI] 0.36-0.52], p < 0.001). The effect of DES on TLR was limited in time to the first 2 years in the study with no evidence of a later rebound effect. The reduction in TLR after DES insertion was consistent across subgroups defined by gender, age, diabetes status, renal function, and lesion and stent characteristics. The number needed to treat with DES (vs. BMS) to prevent 1 TLR ranged from 4 to 110 across clinically relevant subgroups. CONCLUSION: DES have a time-limited effect on the rate of TLR, but with a substantial and highly significant reduction in the first 2 years after the procedure. This effect was found to be consistent across all important clinical subgroups. CI - (c) 2020 S. Karger AG, Basel. FAU - Molstad, Per AU - Molstad P AD - Department of Cardiology, LHL Clinics Gardermoen, Jessheim, Norway, PerMorten.Molstad@lhl.no. FAU - Nordrehaug, Jan Erik AU - Nordrehaug JE AD - Department of Clinical Science, University of Bergen, Bergen, Norway. FAU - Steigen, Terje AU - Steigen T AD - University Hospital of North Norway and UiT The Arctic University of Norway, Tromso, Norway. FAU - Giil, Lasse Melvaer AU - Giil LM AD - Department of Internal Medicine, Haraldsplass Deaconess Hospital, Bergen, Norway. FAU - Wilsgaard, Tom AU - Wilsgaard T AD - Department of Community Medicine, UiT The Arctic University of Norway, Tromso, Norway. FAU - Wiseth, Rune AU - Wiseth R AD - Clinic of Cardiology, St. Olav's University Hospital, Trondheim, Norway. AD - Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway. FAU - Bonaa, Kaare H AU - Bonaa KH AD - Clinic of Cardiology, St. Olav's University Hospital, Trondheim, Norway. AD - Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway. LA - eng PT - Journal Article PT - Randomized Controlled Trial DEP - 20200225 PL - Switzerland TA - Cardiology JT - Cardiology JID - 1266406 RN - 0 (Metals) SB - IM MH - Aged MH - Coronary Vessels/diagnostic imaging/surgery MH - *Drug-Eluting Stents MH - Follow-Up Studies MH - Humans MH - Male MH - Metals MH - *Percutaneous Coronary Intervention MH - Prosthesis Design MH - Risk Factors MH - Stents MH - Treatment Outcome OTO - NOTNLM OT - Bare metal stent OT - Drug-eluting stent OT - Target lesion revascularization EDAT- 2020/02/26 06:00 MHDA- 2021/09/01 06:00 CRDT- 2020/02/26 06:00 PHST- 2019/12/17 00:00 [received] PHST- 2020/01/20 00:00 [accepted] PHST- 2020/02/26 06:00 [pubmed] PHST- 2021/09/01 06:00 [medline] PHST- 2020/02/26 06:00 [entrez] AID - 000506042 [pii] AID - 10.1159/000506042 [doi] PST - ppublish SO - Cardiology. 2020;145(6):333-341. doi: 10.1159/000506042. Epub 2020 Feb 25. PMID- 32024471 OWN - NLM STAT- MEDLINE DCOM- 20200929 LR - 20200929 IS - 1471-2261 (Electronic) IS - 1471-2261 (Linking) VI - 20 IP - 1 DP - 2020 Feb 5 TI - Preventable clinical and psychosocial factors predicted two out of three recurrent cardiovascular events in a coronary population. PG - 61 LID - 10.1186/s12872-020-01368-6 [doi] LID - 61 AB - BACKGROUND: The relative importance of lifestyle, medical and psychosocial factors on the risk of recurrent major cardiovascular (CV) events (MACE) in coronary patients' needs to be identified. The main objective of this study is to estimate the association between potentially preventable factors on MACE in an outpatient coronary population from routine clinical practice. METHODS: This prospective follow-up study of recurrent MACE, determine the predictive impact of risk factors and a wide range of relevant co-factors recorded at baseline. The baseline study included 1127 consecutive patients 2-36 months after myocardial infarction (MI) and/or revascularization procedure. The primary composite endpoint of recurrent MACE defined as CV death, hospitalization due to MI, revascularization, stroke/transitory ischemic attacks or heart failure was obtained from hospital records. Data were analysed using cox proportional hazard regression, stratified by prior coronary events before the index event. RESULTS: During a mean follow-up of 4.2 years from study inclusion (mean time from index event to end of study 5.7 years), 364 MACE occurred in 240 patients (21, 95% confidence interval: 19 to 24%), of which 39 were CV deaths. In multi-adjusted analyses, the strongest predictor of MACE was not taking statins (Relative risk [RR] 2.13), succeeded by physical inactivity (RR 1.73), peripheral artery disease (RR 1.73), chronic kidney failure (RR 1.52), former smoking (RR 1.46) and higher Hospital Anxiety and Depression Scale-Depression subscale score (RR 1.04 per unit increase). Preventable and potentially modifiable factors addressed accounted for 66% (95% confidence interval: 49 to 77%) of the risk for recurrent events. The major contributions were smoking, low physical activity, not taking statins, not participating in cardiac rehabilitation and diabetes. CONCLUSIONS: Coronary patients were at high risk of recurrent MACE. Potentially preventable clinical and psychosocial factors predicted two out of three MACE, which is why these factors should be targeted in coronary populations. TRIAL REGISTRATION: Registered at ClinicalTrials.gov: NCT02309255. Registered at December 5th, 2014, registered retrospectively. FAU - Sverre, E AU - Sverre E AUID- ORCID: 0000-0002-1519-9759 AD - Department of Medicine, Drammen Hospital, Drammen, Norway. elisbj@vestreviken.no. AD - Department of Behavioural Sciences in Medicine and Faculty of Medicine, University of Oslo, Oslo, Norway. elisbj@vestreviken.no. FAU - Peersen, K AU - Peersen K AD - Department of Medicine, Vestfold Hospital, Oslo, Norway. FAU - Weedon-Fekjaer, H AU - Weedon-Fekjaer H AD - Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway. FAU - Perk, J AU - Perk J AD - Department of Cardiology, Public Health Department Linnaeus University, Kalmar, Sweden. FAU - Gjertsen, E AU - Gjertsen E AD - Department of Medicine, Drammen Hospital, Drammen, Norway. FAU - Husebye, E AU - Husebye E AD - Department of Medicine, Drammen Hospital, Drammen, Norway. FAU - Gullestad, L AU - Gullestad L AD - Department of Cardiology, Oslo University Hospital Rikshospitalet, Faculty of Medicine, University of Oslo, Oslo, Norway. AD - KG Jebsen Cardiac Research Center, Oslo University Hospital Ulleval, Oslo, Norway. FAU - Dammen, T AU - Dammen T AD - Department of Behavioural Sciences in Medicine and Faculty of Medicine, University of Oslo, Oslo, Norway. FAU - Otterstad, J E AU - Otterstad JE AD - Department of Medicine, Vestfold Hospital, Oslo, Norway. FAU - Munkhaugen, J AU - Munkhaugen J AD - Department of Medicine, Drammen Hospital, Drammen, Norway. AD - Department of Behavioural Sciences in Medicine and Faculty of Medicine, University of Oslo, Oslo, Norway. LA - eng SI - ClinicalTrials.gov/NCT02309255 GR - 1703001/Vestre Viken Trust/International GR - 703110/Vestfold Hospital Trust/International GR - 2018/FO190774/EkstraStiftelsen Helse og Rehabilitering/International PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20200205 PL - England TA - BMC Cardiovasc Disord JT - BMC cardiovascular disorders JID - 100968539 SB - IM MH - Aged MH - Disease Progression MH - Female MH - Heart Failure/mortality/prevention & control MH - Humans MH - Ischemic Attack, Transient/mortality/prevention & control MH - Male MH - Middle Aged MH - Myocardial Infarction/mortality/physiopathology/psychology/*therapy MH - *Myocardial Revascularization/adverse effects/mortality MH - Norway/epidemiology MH - Patient Readmission MH - Prospective Studies MH - Recurrence MH - Risk Assessment MH - Risk Factors MH - *Secondary Prevention MH - Stroke/mortality/prevention & control MH - Time Factors MH - Treatment Outcome PMC - PMC7003324 OTO - NOTNLM OT - Coronary heart disease OT - Prognosis OT - Psychosocial factors OT - Recurrent cardiovascular events OT - Risk factors OT - Secondary prevention COIS- The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. EDAT- 2020/02/07 06:00 MHDA- 2020/09/30 06:00 PMCR- 2020/02/05 CRDT- 2020/02/07 06:00 PHST- 2019/08/06 00:00 [received] PHST- 2020/01/30 00:00 [accepted] PHST- 2020/02/07 06:00 [entrez] PHST- 2020/02/07 06:00 [pubmed] PHST- 2020/09/30 06:00 [medline] PHST- 2020/02/05 00:00 [pmc-release] AID - 10.1186/s12872-020-01368-6 [pii] AID - 1368 [pii] AID - 10.1186/s12872-020-01368-6 [doi] PST - epublish SO - BMC Cardiovasc Disord. 2020 Feb 5;20(1):61. doi: 10.1186/s12872-020-01368-6. PMID- 32000408 OWN - NLM STAT- MEDLINE DCOM- 20200211 LR - 20200219 IS - 1536-5964 (Electronic) IS - 0025-7974 (Print) IS - 0025-7974 (Linking) VI - 99 IP - 5 DP - 2020 Jan TI - Frailty syndrome in daily practice of interventional cardiology ward-rationale and design of the FRAPICA trial: A STROBE-compliant prospective observational study. PG - e18935 LID - 10.1097/MD.0000000000018935 [doi] LID - e18935 AB - The effect of frailty on short and long term results of interventional treatment of coronary heart disease is not well defined. The evaluation of frailty may be helpful in appointment of most suitable treatment option and timing of patient follow-up. The frailty syndrome in daily practice of interventional cardiology ward (FRAPICA) study objective is to evaluate prognostic capability of the Fried frailty scale and instrumental activities of daily living scale (IADL) in elderly patients with symptomatic coronary heart disease.This is a single center, prospective, observational study. Patients aged >/=65 years are eligible. The objectives are to report Fried frailty scale and IADL scale dispersion before hospital discharge and to assess predictive impact of both scores. The endpoints are: success of interventional treatment, its complications (procedure related myocardial infarction, dye-induced renal function deterioration, loss of blood), 3-year mortality, either all-cause and cardiovascular, re-infarction, re-intervention, stroke, new-onset heart failure, any hospital readmission, and a combination of all above mentioned. Secondary analyses will focus on distinct clinical patient presentations, sub-classifications of frailty for modeling of long-term risk.FRAPICA trial will improve understanding of the associations between frailty syndrome, cardiovascular system diseases, their invasive treatment, and short and long-term outcomes. It will allow for more individualized assessment of risk and will identify new goals for interventions. (ClinicalTrials.gov Identifier NCT03209414). FAU - Woloszyn-Horak, Ewa AU - Woloszyn-Horak E AD - II Department of Cardiology in Zabrze, Medical Faculty with Dentistry Division in Zabrze, Medical University of Silesia, Katowice. FAU - Salamon, Robert AU - Salamon R AD - II Department of Cardiology in Zabrze, Medical Faculty with Dentistry Division in Zabrze, Medical University of Silesia, Katowice. FAU - Chojnacka, Katarzyna AU - Chojnacka K AD - II Department of Cardiology in Zabrze, Medical Faculty with Dentistry Division in Zabrze, Medical University of Silesia, Katowice. FAU - Brzosko, Aleksandra AU - Brzosko A AD - II Department of Cardiology in Zabrze, Medical Faculty with Dentistry Division in Zabrze, Medical University of Silesia, Katowice. FAU - Bieda, Lukasz AU - Bieda L AD - II Department of Cardiology in Zabrze, Medical Faculty with Dentistry Division in Zabrze, Medical University of Silesia, Katowice. FAU - Standera, Jakub AU - Standera J AD - II Department of Cardiology in Zabrze, Medical Faculty with Dentistry Division in Zabrze, Medical University of Silesia, Katowice. FAU - Ploszaj, Karolina AU - Ploszaj K AD - Dr Teresa Fryda Medical Laboratory, Department in Zabrze. FAU - Stepien, Ewa AU - Stepien E AD - Department of Medical Physics, Faculty of Physics, Institute of Physics, Astronomy and Applied Computer Science of the Jagiellonian University, Cracow, Poland. FAU - Nowalany-Kozielska, Ewa AU - Nowalany-Kozielska E AD - II Department of Cardiology in Zabrze, Medical Faculty with Dentistry Division in Zabrze, Medical University of Silesia, Katowice. FAU - Tomasik, Andrzej AU - Tomasik A AD - II Department of Cardiology in Zabrze, Medical Faculty with Dentistry Division in Zabrze, Medical University of Silesia, Katowice. LA - eng SI - ClinicalTrials.gov/NCT03209414 PT - Clinical Trial Protocol PT - Journal Article PL - United States TA - Medicine (Baltimore) JT - Medicine JID - 2985248R SB - IM MH - Activities of Daily Living MH - Aged MH - Coronary Disease/complications/*diagnosis/mortality/therapy MH - Frail Elderly MH - Frailty/complications/*diagnosis/mortality/therapy MH - Geriatric Assessment MH - Humans MH - *Observational Studies as Topic MH - Patient Selection PMC - PMC7004665 COIS- The authors have no conflicts of interest to disclose. EDAT- 2020/02/01 06:00 MHDA- 2020/02/12 06:00 PMCR- 2020/01/31 CRDT- 2020/02/01 06:00 PHST- 2020/02/01 06:00 [entrez] PHST- 2020/02/01 06:00 [pubmed] PHST- 2020/02/12 06:00 [medline] PHST- 2020/01/31 00:00 [pmc-release] AID - 00005792-202001310-00055 [pii] AID - MD-D-19-05748 [pii] AID - 10.1097/MD.0000000000018935 [doi] PST - ppublish SO - Medicine (Baltimore). 2020 Jan;99(5):e18935. doi: 10.1097/MD.0000000000018935. PMID- 31944496 OWN - NLM STAT- MEDLINE DCOM- 20210514 LR - 20210514 IS - 1879-0844 (Electronic) IS - 1388-9842 (Linking) VI - 22 IP - 5 DP - 2020 May TI - Predictors of sudden cardiac death in high-risk patients following a myocardial infarction. PG - 848-855 LID - 10.1002/ejhf.1694 [doi] AB - AIMS: To develop a risk model for sudden cardiac death (SCD) in high-risk acute myocardial infarction (AMI) survivors. METHODS AND RESULTS: Data from the Effect of Carvedilol on Outcome After Myocardial Infarction in Patients With Left Ventricular Dysfunction trial (CAPRICORN) and the Valsartan in Acute Myocardial Infarction Trial (VALIANT) were used to create a SCD risk model (with non-SCD as a competing risk) in 13 202 patients. The risk model was validated in the Eplerenone Post-AMI Heart Failure Efficacy and Survival Study (EPHESUS). The rate of SCD was 3.3 (95% confidence interval 3.0-3.5) per 100 person-years over a median follow-up of 2.0 years. Independent predictors of SCD included age > 70 years; heart rate >/= 70 bpm; smoking; Killip class III/IV; left ventricular ejection fraction /=44.2 mumol/L or >25% above baseline within 72 hours after exposure to contrast administered during percutaneous coronary intervention. Secondary endpoints included differences in post-percutaneous coronary intervention serum creatinine, blood urea nitrogen, creatinine clearance rate, cystatin-C, and occurrence of major adverse events. RESULTS: Contrast-induced nephropathy incidence was 3.3% (5/150) in the nicorandil group vs. 10.7% (16/150) in the control group (P < 0.05). At 48 and 72 hours after contrast administration, cystatin-C levels were significantly lower and creatinine clearance rate were significantly higher with nicroandil therapy compared to conventional treatment (all P values <0.05). No statistical difference was observed in the incidence of major post-procedure side effect events in hospital and fourteen days of follow-up period between the nicorandil group and control group (3.3% vs. 4.0%, P > 0.05). CONCLUSION: Compared to conventional treatment, oral nicorandil therapy was associated with less contrast-induced nephropathy and improved renal function following contrast administration during percutaneous coronary intervention. FAU - Zhang, Xue AU - Zhang X AD - Graduate School, Tianjin Medical University. FAU - Yang, Shicheng AU - Yang S AD - Department of Cardiology, Tianjin Chest Hospital, Tianjin, China. FAU - Zhang, Peng AU - Zhang P AD - Department of Cardiology, Tianjin Chest Hospital, Tianjin, China. FAU - Fu, Naikuan AU - Fu N AD - Department of Cardiology, Tianjin Chest Hospital, Tianjin, China. LA - eng PT - Journal Article PT - Randomized Controlled Trial PL - England TA - Coron Artery Dis JT - Coronary artery disease JID - 9011445 RN - 0 (Contrast Media) RN - 0 (Cystatin C) RN - 0 (Vasodilator Agents) RN - 260456HAM0 (Nicorandil) RN - AYI8EX34EU (Creatinine) SB - IM MH - Acute Coronary Syndrome/*surgery MH - Acute Kidney Injury/blood/chemically induced/*prevention & control MH - Aged MH - Angina, Stable/*surgery MH - Blood Urea Nitrogen MH - Contrast Media/*adverse effects MH - Coronary Disease/*surgery MH - Creatinine/blood MH - Cystatin C/blood MH - Female MH - Humans MH - Male MH - Middle Aged MH - Nicorandil/*therapeutic use MH - Percutaneous Coronary Intervention MH - Vasodilator Agents/*therapeutic use EDAT- 2019/10/29 06:00 MHDA- 2021/06/29 06:00 CRDT- 2019/10/29 06:00 PHST- 2019/10/29 06:00 [pubmed] PHST- 2021/06/29 06:00 [medline] PHST- 2019/10/29 06:00 [entrez] AID - 00019501-202005000-00015 [pii] AID - 10.1097/MCA.0000000000000826 [doi] PST - ppublish SO - Coron Artery Dis. 2020 May;31(3):284-288. doi: 10.1097/MCA.0000000000000826. PMID- 31655801 OWN - NLM STAT- MEDLINE DCOM- 20200921 LR - 20200921 IS - 1421-9670 (Electronic) IS - 0250-8095 (Linking) VI - 50 IP - 6 DP - 2019 TI - Percutaneous Coronary Intervention Does Not Lower Cardiovascular Outcomes in Patients with Chronic Kidney Disease. PG - 465-472 LID - 10.1159/000503916 [doi] AB - BACKGROUND: Chronic kidney disease (CKD) is associated with an increased risk of adverse cardiovascular outcomes, in patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI). However, most studies used bare-metal stents or first-generation drug-eluting stents, and less guideline-directed therapy to reduce cardiovascular risk was reported in CKD patients. This study investigates the impact of moderate-CKD on patients undergoing PCI in the current era. METHODS: Patient level data were pooled from 2 multicenter randomized trials (BIONICS and NIREUS trials) with a near "all-comers" design, comparing PCI with ridaforolimus-eluting stents vs. zotarolimus-eluting stents in patients with CAD. Patients were classified according to the presence or absence of moderate-CKD, defined as creatinine clearance (CrCl) <60 mL/min. We compared baseline characteristics, angiographic findings, and clinical outcomes 1-year post-PCI. RESULTS: 236/2,201 (10.7%) patients had CKD, mean CrCl of 50.3 + 7.8 mL/min. These patients were generally older and more often with hypertension than non-CKD patients, but the use of guideline-directed therapy was similar between the groups. CKD was associated with an increased risk of cardiovascular death (hazard ratio [HR] 6.08; 95% CI 2.11-17.51; p < 0.001), but with a reduced occurrence of repeated revascularization, including ischemia-driven revascularization (HR 0.47; 95% CI 0.24-0.92; p < 0.05). The rate of repeated angiography per severe cardiovascular adverse event was significantly lower in the CKD than the non-CKD group (23/38 [61%] vs. 253/334 [76%], p < 0.05). CONCLUSIONS: Moderate-CKD in patients with CAD was associated with higher rates of all-cause and cardiovascular mortality, yet with a lower risk of revascularization 1-year following PCI. Lack of guideline-directed medical therapy does not explain the adverse outcome of CKD patients. CI - (c) 2019 S. Karger AG, Basel. FAU - Chernin, Gil AU - Chernin G AD - Department of Nephrology and Hypertension, Kaplan Medical Center, Hebrew University School of Medicine, Rehovot, Israel, chernin4@gmail.com. FAU - Chen, Shmuel AU - Chen S AD - Cardiovascular Research Foundation, Columbia University Medical Center, New York, New York, USA. FAU - Ozan, Ozgu AU - Ozan O AD - Cardiovascular Research Foundation, Columbia University Medical Center, New York, New York, USA. FAU - Liu, Mengdan AU - Liu M AD - Cardiovascular Research Foundation, Columbia University Medical Center, New York, New York, USA. FAU - Haberman, Dan AU - Haberman D AD - Department of Cardiology, Kaplan Medical Center, Hebrew University School of Medicine, Rehovot, Israel. FAU - Perlman, Gidon AU - Perlman G AD - Medinol Ltd, Tel-Aviv, Israel. FAU - Ben-Yehuda, Ori AU - Ben-Yehuda O AD - Cardiovascular Research Foundation, Columbia University Medical Center, New York, New York, USA. FAU - Jonas, Michael AU - Jonas M AD - Department of Cardiology, Kaplan Medical Center, Hebrew University School of Medicine, Rehovot, Israel. LA - eng PT - Comparative Study PT - Journal Article DEP - 20191025 PL - Switzerland TA - Am J Nephrol JT - American journal of nephrology JID - 8109361 SB - IM MH - Aged MH - Aged, 80 and over MH - Angiography/statistics & numerical data MH - Coronary Artery Disease/complications/diagnosis/mortality/*surgery MH - Drug-Eluting Stents MH - Female MH - Humans MH - Kaplan-Meier Estimate MH - Male MH - Middle Aged MH - Multicenter Studies as Topic MH - Percutaneous Coronary Intervention/instrumentation/*statistics & numerical data MH - Postoperative Period MH - Randomized Controlled Trials as Topic MH - Renal Insufficiency, Chronic/complications/diagnosis/*epidemiology MH - Reoperation/*statistics & numerical data MH - Risk Factors MH - Severity of Illness Index MH - Treatment Outcome OTO - NOTNLM OT - Cardiovascular OT - Chronic kidney disease OT - Coronary artery disease OT - Revascularization EDAT- 2019/10/28 06:00 MHDA- 2020/09/22 06:00 CRDT- 2019/10/28 06:00 PHST- 2019/08/11 00:00 [received] PHST- 2019/09/30 00:00 [accepted] PHST- 2019/10/28 06:00 [pubmed] PHST- 2020/09/22 06:00 [medline] PHST- 2019/10/28 06:00 [entrez] AID - 000503916 [pii] AID - 10.1159/000503916 [doi] PST - ppublish SO - Am J Nephrol. 2019;50(6):465-472. doi: 10.1159/000503916. Epub 2019 Oct 25. PMID- 31641769 OWN - NLM STAT- MEDLINE DCOM- 20210514 LR - 20220531 IS - 1522-9645 (Electronic) IS - 0195-668X (Linking) VI - 41 IP - 48 DP - 2020 Dec 21 TI - Bedtime hypertension treatment improves cardiovascular risk reduction: the Hygia Chronotherapy Trial. PG - 4565-4576 LID - 10.1093/eurheartj/ehz754 [doi] AB - AIMS: The Hygia Chronotherapy Trial, conducted within the clinical primary care setting, was designed to test whether bedtime in comparison to usual upon awakening hypertension therapy exerts better cardiovascular disease (CVD) risk reduction. METHODS AND RESULTS: In this multicentre, controlled, prospective endpoint trial, 19 084 hypertensive patients (10 614 men/8470 women, 60.5 +/- 13.7 years of age) were assigned (1:1) to ingest the entire daily dose of >/=1 hypertension medications at bedtime (n = 9552) or all of them upon awakening (n = 9532). At inclusion and at every scheduled clinic visit (at least annually) throughout follow-up, ambulatory blood pressure (ABP) monitoring was performed for 48 h. During the 6.3-year median patient follow-up, 1752 participants experienced the primary CVD outcome (CVD death, myocardial infarction, coronary revascularization, heart failure, or stroke). Patients of the bedtime, compared with the upon-waking, treatment-time regimen showed significantly lower hazard ratio-adjusted for significant influential characteristics of age, sex, type 2 diabetes, chronic kidney disease, smoking, HDL cholesterol, asleep systolic blood pressure (BP) mean, sleep-time relative systolic BP decline, and previous CVD event-of the primary CVD outcome [0.55 (95% CI 0.50-0.61), P < 0.001] and each of its single components (P < 0.001 in all cases), i.e. CVD death [0.44 (0.34-0.56)], myocardial infarction [0.66 (0.52-0.84)], coronary revascularization [0.60 (0.47-0.75)], heart failure [0.58 (0.49-0.70)], and stroke [0.51 (0.41-0.63)]. CONCLUSION: Routine ingestion by hypertensive patients of >/=1 prescribed BP-lowering medications at bedtime, as opposed to upon waking, results in improved ABP control (significantly enhanced decrease in asleep BP and increased sleep-time relative BP decline, i.e. BP dipping) and, most importantly, markedly diminished occurrence of major CVD events. TRIAL REGISTRATION: ClinicalTrials.gov, number NCT00741585. CI - Published on behalf of the European Society of Cardiology. All rights reserved. (c) The Author(s) 2019. For permissions, please email: journals.permissions@oup.com. FAU - Hermida, Ramon C AU - Hermida RC AD - Bioengineering & Chronobiology Laboratories, Atlantic Research Center for Information and Communication Technologies (AtlantTIC), University of Vigo, E.I. Telecomunicacion, Campus Universitario, Vigo 36310, Spain. FAU - Crespo, Juan J AU - Crespo JJ AD - Bioengineering & Chronobiology Laboratories, Atlantic Research Center for Information and Communication Technologies (AtlantTIC), University of Vigo, E.I. Telecomunicacion, Campus Universitario, Vigo 36310, Spain. AD - Estructura de Xestion Integrada de Vigo, Servicio Galego de Saude (SERGAS), Vigo 36214, Spain. FAU - Dominguez-Sardina, Manuel AU - Dominguez-Sardina M AD - Estructura de Xestion Integrada de Vigo, Servicio Galego de Saude (SERGAS), Vigo 36214, Spain. FAU - Otero, Alfonso AU - Otero A AD - Servicio de Nefrologia, Complejo Hospitalario Universitario, Estructura de Xestion Integrada de Ourense, Verin e O Barco de Valdeorras, Servicio Galego de Saude (SERGAS), Ourense 32005, Spain. FAU - Moya, Ana AU - Moya A AD - Estructura de Xerencia Integrada Pontevedra e O Salnes, Servicio Galego de Saude (SERGAS), Pontevedra 36156, Spain. FAU - Rios, Maria T AU - Rios MT AD - Bioengineering & Chronobiology Laboratories, Atlantic Research Center for Information and Communication Technologies (AtlantTIC), University of Vigo, E.I. Telecomunicacion, Campus Universitario, Vigo 36310, Spain. AD - Estructura de Xestion Integrada de Vigo, Servicio Galego de Saude (SERGAS), Vigo 36214, Spain. FAU - Sineiro, Elvira AU - Sineiro E AD - Bioengineering & Chronobiology Laboratories, Atlantic Research Center for Information and Communication Technologies (AtlantTIC), University of Vigo, E.I. Telecomunicacion, Campus Universitario, Vigo 36310, Spain. AD - Estructura de Xerencia Integrada Pontevedra e O Salnes, Servicio Galego de Saude (SERGAS), Pontevedra 36156, Spain. FAU - Castineira, Maria C AU - Castineira MC AD - Bioengineering & Chronobiology Laboratories, Atlantic Research Center for Information and Communication Technologies (AtlantTIC), University of Vigo, E.I. Telecomunicacion, Campus Universitario, Vigo 36310, Spain. AD - Estructura de Xestion Integrada de Lugo, Cervo e Monforte de Lemos, Servicio Galego de Saude (SERGAS), Lugo 27002, Spain. FAU - Callejas, Pedro A AU - Callejas PA AD - Bioengineering & Chronobiology Laboratories, Atlantic Research Center for Information and Communication Technologies (AtlantTIC), University of Vigo, E.I. Telecomunicacion, Campus Universitario, Vigo 36310, Spain. AD - Estructura de Xestion Integrada de Vigo, Servicio Galego de Saude (SERGAS), Vigo 36214, Spain. FAU - Pousa, Lorenzo AU - Pousa L AD - Bioengineering & Chronobiology Laboratories, Atlantic Research Center for Information and Communication Technologies (AtlantTIC), University of Vigo, E.I. Telecomunicacion, Campus Universitario, Vigo 36310, Spain. AD - Estructura de Xestion Integrada de Vigo, Servicio Galego de Saude (SERGAS), Vigo 36214, Spain. FAU - Salgado, Jose L AU - Salgado JL AD - Bioengineering & Chronobiology Laboratories, Atlantic Research Center for Information and Communication Technologies (AtlantTIC), University of Vigo, E.I. Telecomunicacion, Campus Universitario, Vigo 36310, Spain. AD - Estructura de Xestion Integrada de Vigo, Servicio Galego de Saude (SERGAS), Vigo 36214, Spain. FAU - Duran, Carmen AU - Duran C AD - Estructura de Xestion Integrada de Vigo, Servicio Galego de Saude (SERGAS), Vigo 36214, Spain. FAU - Sanchez, Juan J AU - Sanchez JJ AD - Bioengineering & Chronobiology Laboratories, Atlantic Research Center for Information and Communication Technologies (AtlantTIC), University of Vigo, E.I. Telecomunicacion, Campus Universitario, Vigo 36310, Spain. AD - Estructura de Xestion Integrada de Santiago de Compostela, Servicio Galego de Saude (SERGAS), Santiago de Compostela 15701, Spain. FAU - Fernandez, Jose R AU - Fernandez JR AD - Bioengineering & Chronobiology Laboratories, Atlantic Research Center for Information and Communication Technologies (AtlantTIC), University of Vigo, E.I. Telecomunicacion, Campus Universitario, Vigo 36310, Spain. FAU - Mojon, Artemio AU - Mojon A AD - Bioengineering & Chronobiology Laboratories, Atlantic Research Center for Information and Communication Technologies (AtlantTIC), University of Vigo, E.I. Telecomunicacion, Campus Universitario, Vigo 36310, Spain. FAU - Ayala, Diana E AU - Ayala DE AD - Bioengineering & Chronobiology Laboratories, Atlantic Research Center for Information and Communication Technologies (AtlantTIC), University of Vigo, E.I. Telecomunicacion, Campus Universitario, Vigo 36310, Spain. CN - Hygia Project Investigators LA - eng SI - ClinicalTrials.gov/NCT00741585 PT - Controlled Clinical Trial PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't PL - England TA - Eur Heart J JT - European heart journal JID - 8006263 RN - 0 (Antihypertensive Agents) SB - IM CIN - Nat Rev Cardiol. 2020 Jan;17(1):8. doi: 10.1038/s41569-019-0306-y. PMID: 31673111 CIN - Eur Heart J. 2020 Dec 21;41(48):4577-4579. doi: 10.1093/eurheartj/ehz836. PMID: 31723974 CIN - BMJ. 2019 Nov 19;367:l6570. doi: 10.1136/bmj.l6570. PMID: 31744801 CIN - MMW Fortschr Med. 2020 Mar;162(4):32. doi: 10.1007/s15006-020-0206-4. PMID: 32124357 CIN - Ann Intern Med. 2020 Mar 17;172(6):JC29. doi: 10.7326/ACPJ202003170-029. PMID: 32176895 CIN - Eur Heart J. 2020 Apr 21;41(16):1601. doi: 10.1093/eurheartj/ehaa213. PMID: 32298408 CIN - Eur Heart J. 2020 Apr 21;41(16):1602-1603. doi: 10.1093/eurheartj/ehaa214. PMID: 32298422 CIN - Eur Heart J. 2020 Apr 21;41(16):1605. doi: 10.1093/eurheartj/ehaa215. PMID: 32304207 CIN - Eur Heart J. 2020 Apr 21;41(16):1604. doi: 10.1093/eurheartj/ehaa212. PMID: 32304209 CIN - Eur Heart J. 2020 Apr 21;41(16):1606-1607. doi: 10.1093/eurheartj/ehaa265. PMID: 32306034 CIN - Eur Heart J. 2020 Apr 21;41(16):1608. doi: 10.1093/eurheartj/ehaa276. PMID: 32306035 ECI - Eur Heart J. 2020 Apr 21;41(16):1600. doi: 10.1093/eurheartj/ehaa339. PMID: 32318736 CIN - Blood Press. 2020 Jun;29(3):135-136. doi: 10.1080/08037051.2020.1747696. PMID: 32338542 CIN - J Fam Pract. 2020 Sep;69(7):362-364. PMID: 32936845 ECI - Eur Heart J. 2020 Dec 21;41(48):4564. doi: 10.1093/eurheartj/ehaa949. PMID: 33221841 CIN - Hypertension. 2021 Aug;78(2):555-558. doi: 10.1161/HYPERTENSIONAHA.121.17356. PMID: 34232677 CIN - Br J Gen Pract. 2021 Dec 31;72(714):12. doi: 10.3399/bjgp22X718061. PMID: 34972794 MH - Aged MH - Antihypertensive Agents/therapeutic use MH - Blood Pressure MH - Blood Pressure Monitoring, Ambulatory MH - *Cardiovascular Diseases/drug therapy/prevention & control MH - Chronotherapy MH - Circadian Rhythm MH - *Diabetes Mellitus, Type 2/drug therapy MH - Female MH - Heart Disease Risk Factors MH - Humans MH - *Hypertension/complications/drug therapy/epidemiology MH - Male MH - Middle Aged MH - Prospective Studies MH - Risk Factors MH - Risk Reduction Behavior MH - Time Factors OTO - NOTNLM OT - Ambulatory blood pressure monitoring OT - Angiotensin-II receptor blockers OT - Angiotensin-converting enzyme inhibitors OT - Asleep blood pressure OT - Bedtime hypertension chronotherapy OT - Cardiovascular risk OT - Coronary revascularization OT - Heart failure OT - Myocardial infarction OT - Stroke EDAT- 2019/10/24 06:00 MHDA- 2021/05/15 06:00 CRDT- 2019/10/24 06:00 PHST- 2019/06/14 00:00 [received] PHST- 2019/07/26 00:00 [revised] PHST- 2019/10/01 00:00 [accepted] PHST- 2019/10/24 06:00 [pubmed] PHST- 2021/05/15 06:00 [medline] PHST- 2019/10/24 06:00 [entrez] AID - 5602478 [pii] AID - 10.1093/eurheartj/ehz754 [doi] PST - ppublish SO - Eur Heart J. 2020 Dec 21;41(48):4565-4576. doi: 10.1093/eurheartj/ehz754. PMID- 31640466 OWN - NLM STAT- MEDLINE DCOM- 20201208 LR - 20210110 IS - 2047-9980 (Electronic) IS - 2047-9980 (Linking) VI - 8 IP - 21 DP - 2019 Nov 5 TI - Clinical and Laboratory Predictors for Plaque Erosion in Patients With Acute Coronary Syndromes. PG - e012322 LID - 10.1161/JAHA.119.012322 [doi] LID - e012322 AB - Background Plaque erosion is responsible for 25% to 40% of patients with acute coronary syndromes (ACS). Recent studies suggest that anti-thrombotic therapy without stenting may be an option for this subset of patients. Currently, however, an invasive procedure is required to make a diagnosis of plaque erosion. The aim of this study was to identify clinical or laboratory predictors of plaque erosion in patients with ACS to enable a diagnosis of erosion without additional invasive procedures. Methods and Results Patients with ACS who underwent optical coherence tomography imaging were selected from 11 institutions in 6 countries. The patients were classified into plaque rupture, plaque erosion, or calcified plaque, and predictors were identified using multivariable logistic modeling. Among 1241 patients with ACS, 477 (38.4%) patients were found to have plaque erosion. Plaque erosion was more frequent in non-ST-segment elevation-ACS than in ST-segment-elevation myocardial infarction (47.9% versus 29.8%, P=0.0002). Multivariable logistic regression models showed 5 independent parameters associated with plaque erosion: age <68 years, anterior ischemia, no diabetes mellitus, hemoglobin >15.0 g/dL, and normal renal function. When all 5 parameters are present in a patient with non-ST-segment elevation-ACS, the probability of plaque erosion increased to 73.1%. Conclusions Clinical and laboratory parameters associated with plaque erosion are explored in this retrospective registry study. These parameters may be useful to identify the subset of ACS patients with plaque erosion and guide them to conservative management without invasive procedures. The results of this exploratory analysis need to be confirmed in large scale prospective clinical studies. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT03479723. FAU - Yamamoto, Erika AU - Yamamoto E AD - Cardiology Division Massachusetts General Hospital Harvard Medical School Boston MA. AD - Department of Cardiovascular Medicine Kyoto University Graduate School of Medicine Kyoto Japan. FAU - Yonetsu, Taishi AU - Yonetsu T AD - Departmant of Interventional Cardiology Tokyo Medical and Dental University Tokyo Japan. FAU - Kakuta, Tsunekazu AU - Kakuta T AD - Department of Cardiovascular Medicine Tsuchiura Kyodo General Hospital Tsuchiura Ibaraki Japan. FAU - Soeda, Tsunenari AU - Soeda T AD - Department of Cardiovascular Medicine Nara Medical University Kashihara Nara Japan. FAU - Saito, Yoshihiko AU - Saito Y AD - Department of Cardiovascular Medicine Nara Medical University Kashihara Nara Japan. FAU - Yan, Bryan P AU - Yan BP AD - Department of Medicine and Therapeutics Faculty of Medicine The Chinese University of Hong Kong Hong Kong. FAU - Kurihara, Osamu AU - Kurihara O AD - Cardiovascular Center Nippon Medical School Chiba Hokusoh Hospital Inzai Chiba Japan. FAU - Takano, Masamichi AU - Takano M AD - Cardiovascular Center Nippon Medical School Chiba Hokusoh Hospital Inzai Chiba Japan. FAU - Niccoli, Giampaolo AU - Niccoli G AD - Department of Cardiovascular and Thoracic Science Catholic University of the Sacred Heart Fondazione Policlinico Agostino Gemelli - IRCCS Rome Italy. FAU - Higuma, Takumi AU - Higuma T AD - Department of Cardiology Hirosaki University Graduate School of Medicine Hirosaki Aomori Japan. FAU - Kimura, Shigeki AU - Kimura S AD - Division of Cardiology Kameda Medical Center Kamogawa Chiba Japan. FAU - Minami, Yoshiyasu AU - Minami Y AD - Department of Cardiovascular Medicine Kitasato University School of Medicine Sagamihara Kanagawa Japan. FAU - Ako, Junya AU - Ako J AD - Department of Cardiovascular Medicine Kitasato University School of Medicine Sagamihara Kanagawa Japan. FAU - Adriaenssens, Tom AU - Adriaenssens T AD - Department of Cardiovascular Medicine University Hospitals Leuven Leuven Belgium. FAU - Boeder, Niklas F AU - Boeder NF AD - Department of Cardiology University of Giessen Germany. FAU - Nef, Holger M AU - Nef HM AD - Department of Cardiology University of Giessen Germany. FAU - Fracassi, Francesco AU - Fracassi F AD - Cardiology Division Massachusetts General Hospital Harvard Medical School Boston MA. FAU - Sugiyama, Tomoyo AU - Sugiyama T AD - Cardiology Division Massachusetts General Hospital Harvard Medical School Boston MA. FAU - Lee, Hang AU - Lee H AD - Biostatiscs Center Massachusetts General Hospital Harvard Medical School Boston MA. FAU - Crea, Filippo AU - Crea F AD - Department of Cardiovascular and Thoracic Science Catholic University of the Sacred Heart Fondazione Policlinico Agostino Gemelli - IRCCS Rome Italy. FAU - Kimura, Takeshi AU - Kimura T AD - Department of Cardiovascular Medicine Kyoto University Graduate School of Medicine Kyoto Japan. FAU - Fujimoto, James G AU - Fujimoto JG AD - Research Laboratory of Electronics Department of Electrical Engineering and Computer Science Massachusetts Institute of Technology Cambridge MA. FAU - Fuster, Valentin AU - Fuster V AD - Zena and Michael A. Wiener Cardiovascular Institute Icahn School of Medicine at Mount Sinai New York NY. FAU - Jang, Ik-Kyung AU - Jang IK AD - Cardiology Division Massachusetts General Hospital Harvard Medical School Boston MA. AD - Division of Cardiology Kyung Hee University Hospital Seoul Republic of Korea. LA - eng SI - ClinicalTrials.gov/NCT03479723 PT - Journal Article PT - Multicenter Study DEP - 20191023 PL - England TA - J Am Heart Assoc JT - Journal of the American Heart Association JID - 101580524 SB - IM MH - Acute Coronary Syndrome/blood/*complications/diagnostic imaging MH - Aged MH - Female MH - Humans MH - Longitudinal Studies MH - Male MH - Middle Aged MH - Plaque, Atherosclerotic/blood/*diagnosis/*etiology MH - Predictive Value of Tests MH - Retrospective Studies MH - Tomography, Optical Coherence PMC - PMC6898801 OTO - NOTNLM OT - acute coronary syndrome OT - optical coherence tomography OT - plaque erosion EDAT- 2019/10/24 06:00 MHDA- 2020/12/15 06:00 PMCR- 2019/11/05 CRDT- 2019/10/24 06:00 PHST- 2019/10/24 06:00 [entrez] PHST- 2019/10/24 06:00 [pubmed] PHST- 2020/12/15 06:00 [medline] PHST- 2019/11/05 00:00 [pmc-release] AID - JAH34519 [pii] AID - 10.1161/JAHA.119.012322 [doi] PST - ppublish SO - J Am Heart Assoc. 2019 Nov 5;8(21):e012322. doi: 10.1161/JAHA.119.012322. Epub 2019 Oct 23. PMID- 31568963 OWN - NLM STAT- MEDLINE DCOM- 20200803 LR - 20200803 IS - 1879-1484 (Electronic) IS - 0021-9150 (Linking) VI - 290 DP - 2019 Nov TI - Apabetalone lowers serum alkaline phosphatase and improves cardiovascular risk in patients with cardiovascular disease. PG - 59-65 LID - S0021-9150(19)31476-5 [pii] LID - 10.1016/j.atherosclerosis.2019.09.002 [doi] AB - BACKGROUND AND AIMS: In patients with cardiovascular disease, considerable residual risk remains despite evidence-based secondary prevention measures. Alkaline phosphatase (ALP) has been suggested as a modifiable cardiovascular risk factor. We sought to determine whether cardiovascular risk reduction by the bromodomain and extra-terminal (BET) protein inhibitor apabetalone is associated with the concomitant lowering of serum ALP. METHODS: In a post-hoc analysis of 795 patients with established coronary heart disease and statin treatment, who participated in phase 2 placebo-controlled trials of apabetalone, we determined the effect of assigned treatment for up to 24 weeks on the incidence of major adverse cardiovascular events (MACE) and serum ALP. RESULTS: Baseline ALP (median 72 U/L) predicted MACE (death, non-fatal myocardial infarction, coronary revascularization, or hospitalization for cardiovascular causes), independent of high-sensitivity C-reactive protein (hsCRP), sex, age, race, study, cardiovascular risk factors, chronic kidney disease (CKD), liver function markers and treatment allocation (hazard ratio [HR] per standard deviation [SD] 1.6, 95% CI 1.19-2.16, p = 0.002). Mean placebo-corrected decreases in ALP from baseline were 9.2% (p < 0.001) after 12-14 weeks and 7.7% (p < 0.001) after 24-26 weeks of apabetalone treatment. In the apabetalone group, a 1-SD reduction in ALP was associated with a HR for MACE of 0.64 (95% CI 0.46-0.90, p = 0.009). CONCLUSIONS: Serum ALP predicts residual cardiovascular risk, independent of hsCRP, established cardiovascular risk factors and CKD, in patients with cardiovascular disease on statin treatment. Apabetalone lowers serum ALP, which was associated with a lower risk of cardiovascular events. Whether the beneficial cardiovascular effects of apabetalone are causally related to ALP reduction remains undetermined. CI - Crown Copyright (c) 2019. Published by Elsevier B.V. All rights reserved. FAU - Haarhaus, Mathias AU - Haarhaus M AD - Division of Renal Medicine and Baxter Novum, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden. Electronic address: mathias.loberg-haarhaus@sll.se. FAU - Ray, Kausik K AU - Ray KK AD - Imperial Centre for Cardiovascular Disease Prevention, School of Public Health, Imperial College London, London, UK. FAU - Nicholls, Stephen J AU - Nicholls SJ AD - South Australian Health and Medical Research Institute, University of Adelaide, PO Box 11060, Adelaide, SA, 5001, Australia. FAU - Schwartz, Gregory G AU - Schwartz GG AD - University of Colorado School of Medicine, Aurora, CO, USA. FAU - Kulikowski, Ewelina AU - Kulikowski E AD - Resverlogix Corp, Calgary, AB, Canada. FAU - Johansson, Jan O AU - Johansson JO AD - Resverlogix Inc, San Francisco, CA, USA. FAU - Sweeney, Michael AU - Sweeney M AD - Resverlogix Inc, San Francisco, CA, USA. FAU - Halliday, Christopher AU - Halliday C AD - Resverlogix Corp, Calgary, AB, Canada. FAU - Lebioda, Kenneth AU - Lebioda K AD - Resverlogix Corp, Calgary, AB, Canada. FAU - Wong, Norman AU - Wong N AD - Resverlogix Corp, Calgary, AB, Canada. FAU - Brandenburg, Vincent AU - Brandenburg V AD - Department of Cardiology and Nephrology, Rhein-Maas Klinikum Wuerselen, Wuerselen, Germany. FAU - Beddhu, Srinivasan AU - Beddhu S AD - Division of Nephrology and Hypertension and Medical Service, Veterans Affairs Salt Lake City Healthcare System, Salt Lake City, UT, USA. FAU - Tonelli, Marcello AU - Tonelli M AD - Department of Medicine, University of Calgary, Calgary, AB, Canada. FAU - Zoccali, Carmine AU - Zoccali C AD - CNR-IFC Clin Epid Renal Diseases and Hypertension, Reggio C. c/o Ospedali Riuniti, 89124, Reggio C. Italy. FAU - Kalantar-Zadeh, Kamyar AU - Kalantar-Zadeh K AD - Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine Medical Center, Orange, CA, USA; Nephrology Section, Tibor Rubin Veterans Affairs Medical Center, Long Beach, CA, USA; Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA. Electronic address: kkz@uci.edu. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20190917 PL - Ireland TA - Atherosclerosis JT - Atherosclerosis JID - 0242543 RN - 0 (Biomarkers) RN - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors) RN - 0 (Quinazolinones) RN - 8R4A7GDZ1D (apabetalone) RN - EC 3.1.3.1 (Alkaline Phosphatase) SB - IM MH - Aged MH - Alkaline Phosphatase/*blood MH - Biomarkers/blood MH - Cardiovascular Diseases/blood/diagnosis/*drug therapy/mortality MH - Clinical Trials, Phase II as Topic MH - Comorbidity MH - Dose-Response Relationship, Drug MH - Down-Regulation MH - Female MH - Humans MH - Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use MH - Male MH - Middle Aged MH - Quinazolinones/adverse effects/*therapeutic use MH - Risk Assessment MH - Risk Factors MH - Time Factors MH - Treatment Outcome OTO - NOTNLM OT - Alkaline phosphatase OT - Epigenetic OT - Major adverse cardiovascular event OT - Residual cardiovascular risk OT - apabetalone EDAT- 2019/10/01 06:00 MHDA- 2020/08/04 06:00 CRDT- 2019/10/01 06:00 PHST- 2019/04/06 00:00 [received] PHST- 2019/08/19 00:00 [revised] PHST- 2019/09/12 00:00 [accepted] PHST- 2019/10/01 06:00 [pubmed] PHST- 2020/08/04 06:00 [medline] PHST- 2019/10/01 06:00 [entrez] AID - S0021-9150(19)31476-5 [pii] AID - 10.1016/j.atherosclerosis.2019.09.002 [doi] PST - ppublish SO - Atherosclerosis. 2019 Nov;290:59-65. doi: 10.1016/j.atherosclerosis.2019.09.002. Epub 2019 Sep 17. PMID- 31539025 OWN - NLM STAT- MEDLINE DCOM- 20200609 LR - 20250530 IS - 1569-9285 (Electronic) IS - 1569-9285 (Linking) VI - 30 IP - 1 DP - 2020 Jan 1 TI - Preoperative VolumE Replacement therapy in DIabetic patients undergoing coronary artery bypass grafting surgery: results from an open parallel group randomized Controlled Trial (VeRDiCT). PG - 54-63 LID - 10.1093/icvts/ivz226 [doi] AB - OBJECTIVES: To investigate the effect of preoperative volume replacement therapy (VRT) on renal function, health outcome and time to fitness for discharge in diabetic patients undergoing coronary artery bypass grafting (CABG). METHODS: In 2 parallel randomized controlled trials, diabetic patients were allocated to preoperative VRT (1 ml/kg/h of Hartmann's solution for 12 h) or usual care. Primary outcome was time to fitness for discharge. Secondary outcomes included acute kidney injury, postoperative complications, patient-reported quality of life (QoL), hospital resource use and markers of renal, cardiac and inflammatory injury. RESULTS: In total, 169 patients were randomized (84 VRT, 85 usual care; mean age 64 years; 88% male). Time to fitness for discharge was similar between groups [median 6 days; interquartile range 5.0-9.0 in both groups; hazard ratio 0.95, 95% confidence interval (CI) 0.65-1.38; P = 0.78]. Postoperative acute kidney injury was not statistically different (VRT: 27.7% vs usual care: 18.8%, odds ratio 1.72, 95% CI 0.82-3.59; P = 0.15). Estimated glomerular filtration rate (mean difference -0.92, 95% CI -4.18 to 2.25; P = 0.56), microalbumin/creatinine ratio [geometric mean ratio (GMR) 1.16, 95% CI 0.94-1.42; P = 0.16], N-acetyl-beta-d-glucosaminidase (GMR 1.08, 95% CI 0.83-1.40; P = 0.57), C-reactive protein (GMR 1.00, 95% CI 0.88-1.13; P = 0.94), troponin T (Trop-T; GMR 1.18, 95% CI 0.78-1.79; P = 0.39) and other secondary health outcomes were similar between groups. QoL improved in both groups at 3 months with no difference observed. CONCLUSIONS: The use of preoperative VRT is not superior to usual care in diabetic patients undergoing CABG. CLINICAL TRIAL REGISTRATION NUMBER: ISRCTN02159606. CI - (c) The Author(s) 2019. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. FAU - Sarkar, Kunal AU - Sarkar K AD - Rabindranath Tagore International Institute of Cardiac Sciences (RTIICS), Kolkata, India. FAU - Harris, Rosie A AU - Harris RA AD - Clinical Trials and Evaluation Unit, Bristol Trials Centre, University of Bristol, Bristol, UK. FAU - Wells, Sian AU - Wells S AD - Clinical Trials and Evaluation Unit, Bristol Trials Centre, University of Bristol, Bristol, UK. FAU - Harris, Tracy AU - Harris T AD - Clinical Trials and Evaluation Unit, Bristol Trials Centre, University of Bristol, Bristol, UK. FAU - Clout, Madeleine AU - Clout M AD - Clinical Trials and Evaluation Unit, Bristol Trials Centre, University of Bristol, Bristol, UK. FAU - Taylor, Jodi AU - Taylor J AD - Clinical Trials and Evaluation Unit, Bristol Trials Centre, University of Bristol, Bristol, UK. FAU - Culliford, Lucy AU - Culliford L AD - Clinical Trials and Evaluation Unit, Bristol Trials Centre, University of Bristol, Bristol, UK. FAU - Angelini, Gianni D AU - Angelini GD AD - Faculty of Health Sciences, Bristol Heart Institute, University of Bristol, Bristol, UK. FAU - Pike, Katie AU - Pike K AD - Clinical Trials and Evaluation Unit, Bristol Trials Centre, University of Bristol, Bristol, UK. FAU - Ashton, Kate AU - Ashton K AD - Clinical Trials and Evaluation Unit, Bristol Trials Centre, University of Bristol, Bristol, UK. FAU - Narayan, Pradeep AU - Narayan P AD - Rabindranath Tagore International Institute of Cardiac Sciences (RTIICS), Kolkata, India. FAU - Reeves, Barney AU - Reeves B AD - Clinical Trials and Evaluation Unit, Bristol Trials Centre, University of Bristol, Bristol, UK. FAU - Hillier, James AU - Hillier J AD - Faculty of Health Sciences, Bristol Heart Institute, University of Bristol, Bristol, UK. FAU - Rogers, Chris A AU - Rogers CA AD - Clinical Trials and Evaluation Unit, Bristol Trials Centre, University of Bristol, Bristol, UK. FAU - Ascione, Raimondo AU - Ascione R AD - Faculty of Health Sciences, Bristol Heart Institute, University of Bristol, Bristol, UK. LA - eng SI - ISRCTN/ISRCTN02159606 GR - PG/13/9/29990/BHF_/British Heart Foundation/United Kingdom GR - EME/15/180/55/DH_/Department of Health/United Kingdom GR - PG/11/19/28827/BHF_/British Heart Foundation/United Kingdom GR - MR/J015350/1/MRC_/Medical Research Council/United Kingdom GR - CH/1992027/7163/BHF_/British Heart Foundation/United Kingdom PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - England TA - Interact Cardiovasc Thorac Surg JT - Interactive cardiovascular and thoracic surgery JID - 101158399 SB - IM MH - Acute Kidney Injury/etiology/*prevention & control MH - Aged MH - Coronary Artery Bypass/*adverse effects MH - Coronary Artery Disease/complications/*surgery MH - Diabetes Complications/*complications MH - Female MH - Fluid Therapy/*methods MH - Glomerular Filtration Rate MH - Humans MH - Kidney/physiopathology MH - Male MH - Middle Aged MH - Odds Ratio MH - Patient Discharge MH - Postoperative Complications/etiology/*prevention & control MH - Proportional Hazards Models MH - Quality of Life OTO - NOTNLM OT - Coronary artery bypass grafting OT - Diabetes mellitus OT - Renal failure OT - Volume replacement therapy EDAT- 2019/09/21 06:00 MHDA- 2020/06/10 06:00 CRDT- 2019/09/21 06:00 PHST- 2019/03/07 00:00 [received] PHST- 2019/08/20 00:00 [revised] PHST- 2019/08/23 00:00 [accepted] PHST- 2019/09/21 06:00 [pubmed] PHST- 2020/06/10 06:00 [medline] PHST- 2019/09/21 06:00 [entrez] AID - 5572153 [pii] AID - 10.1093/icvts/ivz226 [doi] PST - ppublish SO - Interact Cardiovasc Thorac Surg. 2020 Jan 1;30(1):54-63. doi: 10.1093/icvts/ivz226. PMID- 31522591 OWN - NLM STAT- MEDLINE DCOM- 20200914 LR - 20210110 IS - 2047-9980 (Electronic) IS - 2047-9980 (Linking) VI - 8 IP - 18 DP - 2019 Sep 17 TI - Coronary Artery Bypass Grafting in Women 50 Years or Younger. PG - e013211 LID - 10.1161/JAHA.119.013211 [doi] LID - e013211 AB - Background Prior research has shown higher mortality in women with severe coronary artery disease compared with men, particularly in younger patients. It is unknown if this could be attributable to an adverse risk factor profile. Methods and Results In a population-based cohort study, we included all adults /=70 years of age. CONCLUSIONS: Mortality and the composite outcome were similar between MAG and SAG patients at 1 year, but lower for MAG after 7 years. Patients of higher volume MAG surgeons experienced lower MAG mortality. CI - Copyright (c) 2019 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Samadashvili, Zaza AU - Samadashvili Z AD - School of Public Health, University at Albany, State University of New York, Rensselaer, New York. FAU - Sundt, Thoralf M 3rd AU - Sundt TM 3rd AD - Cardiac Surgical Division, Massachusetts General Hospital, Boston, Massachusetts. FAU - Wechsler, Andrew AU - Wechsler A AD - Department of Cardiothoracic Surgery, Drexel University, Philadelphia, Pennsylvania. FAU - Chikwe, Joanna AU - Chikwe J AD - Department of Cardiothoracic Surgery, Stony Brook School of Medicine, Stony Brook, New York. FAU - Adams, David H AU - Adams DH AD - Department of Surgery, Mount Sinai Hospital, New York, New York. FAU - Smith, Craig R AU - Smith CR AD - Department of Surgery, Columbia-Presbyterian Medical Center, New York, New York. FAU - Jordan, Desmond AU - Jordan D AD - Department of Surgery, Columbia-Presbyterian Medical Center, New York, New York. FAU - Girardi, Leonard AU - Girardi L AD - Department of Cardiothoracic Surgery, Weill Cornell Medical Center, New York, New York. FAU - Lahey, Stephen J AU - Lahey SJ AD - Division of Cardiothoracic Surgery, University of Connecticut, Storrs, Connecticut. FAU - Gold, Jeffrey P AU - Gold JP AD - Chancellor, University of Nebraska Medical Center, Omaha, Nebraska. FAU - Ashraf, Mohammed H AU - Ashraf MH AD - Department of Cardiothoracic Surgery, Kaleida Health, Buffalo, New York. FAU - Hannan, Edward L AU - Hannan EL AD - School of Public Health, University at Albany, State University of New York, Rensselaer, New York. Electronic address: Edward.Hannan@health.ny.gov. LA - eng PT - Comparative Study PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - United States TA - J Am Coll Cardiol JT - Journal of the American College of Cardiology JID - 8301365 SB - IM CIN - J Am Coll Cardiol. 2019 Sep 10;74(10):1286-1289. doi: 10.1016/j.jacc.2019.07.026. PMID: 31488264 MH - *Coronary Artery Bypass/adverse effects/methods/mortality MH - *Coronary Artery Disease/diagnosis/surgery MH - Coronary Vessels/pathology/surgery MH - Female MH - Humans MH - Male MH - Middle Aged MH - *Mortality MH - *Myocardial Infarction/epidemiology/etiology MH - New York/epidemiology MH - Outcome and Process Assessment, Health Care MH - *Postoperative Complications/epidemiology/etiology MH - Registries/statistics & numerical data MH - Reoperation/*statistics & numerical data MH - Severity of Illness Index MH - *Stroke/epidemiology/etiology OTO - NOTNLM OT - CABG surgery OT - MACE OT - mortality differences OT - multiple arterial revascularization OT - multiple vessel disease OT - observational study EDAT- 2019/09/07 06:00 MHDA- 2020/05/20 06:00 CRDT- 2019/09/07 06:00 PHST- 2019/06/04 00:00 [received] PHST- 2019/06/20 00:00 [revised] PHST- 2019/06/21 00:00 [accepted] PHST- 2019/09/07 06:00 [entrez] PHST- 2019/09/07 06:00 [pubmed] PHST- 2020/05/20 06:00 [medline] AID - S0735-1097(19)35950-9 [pii] AID - 10.1016/j.jacc.2019.06.067 [doi] PST - ppublish SO - J Am Coll Cardiol. 2019 Sep 10;74(10):1275-1285. doi: 10.1016/j.jacc.2019.06.067. PMID- 31481307 OWN - NLM STAT- MEDLINE DCOM- 20201104 LR - 20201104 IS - 1878-0938 (Electronic) IS - 1878-0938 (Linking) VI - 21 IP - 5 DP - 2020 May TI - Percutaneous Coronary Intervention for Left Main Coronary Disease in New Zealand: National Linkage Study of Characteristics and In-Hospital Outcomes (ANZACS-QI 38). PG - 573-579 LID - S1553-8389(19)30489-0 [pii] LID - 10.1016/j.carrev.2019.08.016 [doi] AB - BACKGROUND: Approximately 5% of coronary angiographies detect LMS disease >50%. Recent randomized trials showed PCI has comparable outcomes to coronary artery bypass grafting (CABG) in low or intermediate risk candidates. In clinical practice, PCI is frequently utilized in those with prohibitive surgical risk. We reviewed contemporary national results of percutaneous coronary intervention (PCI) for left main coronary disease (LMS) disease in New Zealand. METHODS: All patients undergoing PCI for LMS disease from 01/09/2014-24/09/2017 were extracted from the All New Zealand Acute Coronary Syndrome-Quality Improvement registry with national dataset linkage, analyzing characteristics and in-hospital outcomes. RESULTS: The cohort included 469 patients, mean age 70.8 +/- 10.7 years, male 331 (71%), and the majority 339 (72%) were unprotected LMS. Indications include ST-elevation myocardial infarction (STEMI) 83 (18%) and NSTEMI or unstable angina 229 (49%). Compared with protected LMS, unprotected LMS were more likely to present with an acute coronary syndrome (73% versus 48%, P < 0.001), and to die in-hospital (9.4% versus 3.9%, P = 0.045). In those with unprotected LMS, in-hospital mortality after acute STEMI PCI was higher than for other indications (21.1% versus 6.1%, P < 0.001). Independent predictors of in-hospital death and major adverse cardiovascular events included STEMI, femoral access and worse renal function. CONCLUSION: Our LMS PCI cohort had high mortality rates, especially those presenting with STEMI and an unprotected LMS. This reflects the contemporary real-world practice of LMS PCI being predominantly performed in high risk patients which differs from randomized trial populations, and this should be considered before comparing with CABG outcomes. CI - Copyright (c) 2019 Elsevier Inc. All rights reserved. FAU - Wang, Tom Kai Ming AU - Wang TKM AD - Green Lane Cardiovascular Service, Auckland City Hospital, Auckland, New Zealand; Department of Cardiology, Middlemore Hospital, Auckland, New Zealand. Electronic address: twang@adhb.govt.nz. FAU - Kerr, Andrew AU - Kerr A AD - Department of Cardiology, Middlemore Hospital, Auckland, New Zealand; Department of Medicine, University of Auckland, Auckland, New Zealand. FAU - Kasargod, Chethan AU - Kasargod C AD - Green Lane Cardiovascular Service, Auckland City Hospital, Auckland, New Zealand. FAU - Chan, Daniel AU - Chan D AD - Green Lane Cardiovascular Service, Auckland City Hospital, Auckland, New Zealand. FAU - Cicovic, Sergej AU - Cicovic S AD - Green Lane Cardiovascular Service, Auckland City Hospital, Auckland, New Zealand. FAU - Dimalapang, Eliazar AU - Dimalapang E AD - Green Lane Cardiovascular Service, Auckland City Hospital, Auckland, New Zealand. FAU - Webster, Mark AU - Webster M AD - Green Lane Cardiovascular Service, Auckland City Hospital, Auckland, New Zealand. FAU - Somaratne, Jithendra AU - Somaratne J AD - Green Lane Cardiovascular Service, Auckland City Hospital, Auckland, New Zealand. LA - eng PT - Journal Article PT - Observational Study DEP - 20190823 PL - United States TA - Cardiovasc Revasc Med JT - Cardiovascular revascularization medicine : including molecular interventions JID - 101238551 RN - 0 (Coated Materials, Biocompatible) SB - IM MH - Acute Coronary Syndrome/diagnostic imaging/mortality/*therapy MH - Aged MH - Aged, 80 and over MH - Angina, Unstable/diagnostic imaging/mortality/*therapy MH - Coated Materials, Biocompatible MH - Coronary Artery Disease/diagnostic imaging/mortality/*therapy MH - Female MH - Hospital Mortality MH - Humans MH - Male MH - Middle Aged MH - New Zealand MH - Non-ST Elevated Myocardial Infarction/diagnostic imaging/mortality/*therapy MH - *Percutaneous Coronary Intervention/adverse effects/instrumentation/mortality MH - Prospective Studies MH - Recurrence MH - Registries MH - Risk Factors MH - ST Elevation Myocardial Infarction/diagnostic imaging/mortality/*therapy MH - Stents MH - Time Factors MH - Treatment Outcome OTO - NOTNLM OT - Coronary heart disease OT - Left main OT - Percutaneous coronary intervention EDAT- 2019/09/05 06:00 MHDA- 2020/11/05 06:00 CRDT- 2019/09/05 06:00 PHST- 2019/07/18 00:00 [received] PHST- 2019/08/16 00:00 [revised] PHST- 2019/08/19 00:00 [accepted] PHST- 2019/09/05 06:00 [pubmed] PHST- 2020/11/05 06:00 [medline] PHST- 2019/09/05 06:00 [entrez] AID - S1553-8389(19)30489-0 [pii] AID - 10.1016/j.carrev.2019.08.016 [doi] PST - ppublish SO - Cardiovasc Revasc Med. 2020 May;21(5):573-579. doi: 10.1016/j.carrev.2019.08.016. Epub 2019 Aug 23. PMID- 31468075 OWN - NLM STAT- MEDLINE DCOM- 20191125 LR - 20261011 IS - 1615-6692 (Electronic) IS - 0340-9937 (Linking) VI - 44 IP - 7 DP - 2019 Nov TI - [Cardiovascular pharmacotherapy and coronary revascularization in end-stage renal failure]. PG - 611-629 LID - 10.1007/s00059-019-04846-6 [doi] AB - There is a close physiological relationship between the kidneys and the heart. Cardiovascular diseases are the most prevalent cause of death in patients with chronic kidney disease (CKD), whereas CKD may directly accelerate the progression of cardiovascular diseases and is considered to be a cardiovascular risk factor. In patients with mild CKD, i.e. an estimated glomerular filtration rate (eGFR) >60 ml/min/1.73 m(2), treatment of coronary artery disease and chronic heart failure is not essentially different from patients with preserved renal function; however, as most pivotal trials have systematically excluded patients with advanced renal failure, many treatment recommendations in this patient group are based on observational studies, post hoc subgroup analyses and meta-analyses or pathophysiological considerations, which are not supported by controlled studies. Therefore, prospective randomized studies on the management of heart failure and coronary artery disease are needed, which should specifically focus on the growing number of patients with advanced renal functional impairment. FAU - Lauder, L AU - Lauder L AD - Klinik fur Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitatsklinikum des Saarlandes und Medizinische Fakultat, Universitat des Saarlandes, Homburg/Saar, Deutschland. Lucas.Lauder@uks.eu. FAU - Ewen, S AU - Ewen S AD - Klinik fur Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitatsklinikum des Saarlandes und Medizinische Fakultat, Universitat des Saarlandes, Homburg/Saar, Deutschland. FAU - Emrich, I E AU - Emrich IE AD - Klinik fur Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitatsklinikum des Saarlandes und Medizinische Fakultat, Universitat des Saarlandes, Homburg/Saar, Deutschland. FAU - Bohm, M AU - Bohm M AD - Klinik fur Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitatsklinikum des Saarlandes und Medizinische Fakultat, Universitat des Saarlandes, Homburg/Saar, Deutschland. FAU - Mahfoud, F AU - Mahfoud F AD - Klinik fur Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitatsklinikum des Saarlandes und Medizinische Fakultat, Universitat des Saarlandes, Homburg/Saar, Deutschland. AD - Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA. LA - ger PT - Journal Article TT - Kardiovaskulare Pharmakotherapie und koronare Revaskularisation bei terminaler Niereninsuffizienz. PL - Germany TA - Herz JT - Herz JID - 7801231 SB - IM MH - *Cardiovascular Diseases/complications/surgery MH - Glomerular Filtration Rate MH - Humans MH - *Kidney Failure, Chronic MH - *Myocardial Revascularization MH - Prospective Studies MH - *Renal Insufficiency MH - *Renal Insufficiency, Chronic/complications OTO - NOTNLM OT - Cardiorenal syndrome OT - Cardiovascular diseases OT - Chronic renal insufficiency OT - Coronary disease OT - Heart failure EDAT- 2019/08/31 06:00 MHDA- 2019/11/26 06:00 CRDT- 2019/08/31 06:00 PHST- 2019/08/31 06:00 [pubmed] PHST- 2019/11/26 06:00 [medline] PHST- 2019/08/31 06:00 [entrez] AID - 10.1007/s00059-019-04846-6 [pii] AID - 10.1007/s00059-019-04846-6 [doi] PST - ppublish SO - Herz. 2019 Nov;44(7):611-629. doi: 10.1007/s00059-019-04846-6. PMID- 31439336 OWN - NLM STAT- MEDLINE DCOM- 20200901 LR - 20200901 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 12 IP - 16 DP - 2019 Aug 26 TI - Renal Function and Outcomes With Dabigatran Dual Antithrombotic Therapy in Atrial Fibrillation Patients After PCI. PG - 1553-1561 LID - S1936-8798(19)31254-3 [pii] LID - 10.1016/j.jcin.2019.05.050 [doi] AB - OBJECTIVES: The study sought to evaluate the effect of dabigatran dual therapy versus warfarin triple therapy across categories of renal function in the RE-DUAL PCI (Randomized Evaluation of Dual Antithrombotic Therapy with Dabigatran versus Triple Therapy with Warfarin in Patients with Nonvalvular Atrial Fibrillation Undergoing Percutaneous Coronary Intervention) trial. BACKGROUND: The RE-DUAL PCI (NCT02164864) trial of patients with atrial fibrillation undergoing percutaneous coronary intervention reported that dabigatran dual therapy (110 or 150 mg twice daily, plus clopidogrel or ticagrelor) reduced the primary endpoint of major bleeding events (MBE) or clinically relevant nonmajor bleeding events (CRNMBE) compared with warfarin triple therapy, with noninferiority in overall thromboembolic events. METHODS: Risk of a first MBE or CRNMBE and the composite of death or thromboembolic event (DTE) or unplanned revascularization were evaluated in 2,725 patients according to baseline creatinine clearance (CrCl) categories: 30 to <50, 50 to <80, and >/=80 ml/min. RESULTS: Compared with warfarin, dabigatran 110 mg dual therapy reduced risk of MBE or CRNMBE across all categories of CrCl (p for interaction = 0.19). Dabigatran 150 mg dual therapy reduced risk of MBE or CRNMBE regardless of the CrCl category (p for interaction = 0.31). Risk of DTE or unplanned revascularization was similar to warfarin triple therapy for dabigatran 110 mg dual therapy across all CrCl categories. Dabigatran 150 mg dual therapy versus warfarin triple therapy had similar risk for DTE or unplanned revascularization in patients with CrCl 30 to <80 ml/min and lower risk at CrCl >/=80 ml/min (p for interaction = 0.02). CONCLUSIONS: In the RE-DUAL PCI trial, dabigatran dual therapy reduced bleeding events versus warfarin triple therapy irrespective of renal function, with overall similar risks of thromboembolic events but lower risks with dabigatran 150 mg in patients with normal CrCl. CI - Copyright (c) 2019. Published by Elsevier Inc. FAU - Hohnloser, Stefan H AU - Hohnloser SH AD - Department of Cardiology, Johann Wolfgang Goethe University, Frankfurt am Main, Germany. Electronic address: hohnloser@em.uni-frankfurt.de. FAU - Steg, Philippe Gabriel AU - Steg PG AD - Departement Hospitalo-Universitaire, French Alliance for Cardiovascular Trials (FACT), Hopital Bichat, Paris, France; Universite Paris Diderot, Paris, France; INSERM U_1148, Paris, France; Hopital Bichat, Assistance Publique-Hopitaux de Paris, Paris, France. FAU - Oldgren, Jonas AU - Oldgren J AD - Uppsala Clinical Research Center and Department of Medical Sciences, Uppsala, Sweden. FAU - Nickenig, Georg AU - Nickenig G AD - Medizinische Klinik und Poliklinik II, University of Bonn, Bonn, Germany. FAU - Kiss, Robert G AU - Kiss RG AD - Medical Centre, Hungarian Defence Forces, Budapest, Hungary. FAU - Ongen, Zeki AU - Ongen Z AD - Department of Cardiology, Istanbul University Cerrahpasa, Istanbul, Turkey. FAU - Navarro Estrada, Jose L AU - Navarro Estrada JL AD - Department of Cardiology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. FAU - Oude Ophuis, Ton AU - Oude Ophuis T AD - Department of Cardiology, Canisius-Wilhelmina Hospital, Nijmegen, the Netherlands. FAU - Lip, Gregory Y H AU - Lip GYH AD - Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom; Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark. FAU - Nordaby, Matias AU - Nordaby M AD - Boehringer Ingelheim International GmbH, Ingelheim, Germany. FAU - Kleine, Eva AU - Kleine E AD - Boehringer Ingelheim International GmbH, Ingelheim, Germany. FAU - Ten Berg, Jurrien M AU - Ten Berg JM AD - Department of Cardiology, St. Antonius Ziekenhuis, Nieuwegein, the Netherlands. FAU - Bhatt, Deepak L AU - Bhatt DL AD - Brigham and Women's Hospital Heart and Vascular Center, and Harvard Medical School, Boston, Massachusetts. FAU - Cannon, Christopher P AU - Cannon CP AD - Brigham and Women's Hospital Heart and Vascular Center, and Harvard Medical School, Boston, Massachusetts. CN - RE-DUAL PCI Steering Committee and Investigators LA - eng SI - ClinicalTrials.gov/NCT02164864 PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 RN - 0 (Antithrombins) RN - 0 (Fibrinolytic Agents) RN - 0 (Platelet Aggregation Inhibitors) RN - 5Q7ZVV76EI (Warfarin) RN - I0VM4M70GC (Dabigatran) SB - IM CIN - JACC Cardiovasc Interv. 2019 Aug 26;12(16):1562-1565. doi: 10.1016/j.jcin.2019.06.032. PMID: 31439337 MH - Aged MH - Aged, 80 and over MH - Antithrombins/*administration & dosage/adverse effects MH - Atrial Fibrillation/complications/diagnosis/*drug therapy MH - Coronary Artery Disease/complications/diagnostic imaging/*therapy MH - Dabigatran/*administration & dosage/adverse effects MH - Drug Therapy, Combination MH - Female MH - Fibrinolytic Agents/*administration & dosage/adverse effects MH - Hemorrhage/chemically induced MH - Humans MH - Kidney/*physiopathology MH - Kidney Diseases/*complications/diagnosis/physiopathology MH - Male MH - Middle Aged MH - *Percutaneous Coronary Intervention/adverse effects/instrumentation MH - Platelet Aggregation Inhibitors/*administration & dosage/adverse effects MH - Prospective Studies MH - Risk Factors MH - Thromboembolism/diagnosis/etiology/*prevention & control MH - Time Factors MH - Treatment Outcome MH - Warfarin/*administration & dosage/adverse effects OTO - NOTNLM OT - atrial fibrillation OT - dabigatran dual therapy OT - percutaneous coronary intervention OT - renal function OT - warfarin triple therapy EDAT- 2019/08/24 06:00 MHDA- 2020/09/02 06:00 CRDT- 2019/08/24 06:00 PHST- 2019/01/28 00:00 [received] PHST- 2019/04/17 00:00 [revised] PHST- 2019/05/21 00:00 [accepted] PHST- 2019/08/24 06:00 [entrez] PHST- 2019/08/24 06:00 [pubmed] PHST- 2020/09/02 06:00 [medline] AID - S1936-8798(19)31254-3 [pii] AID - 10.1016/j.jcin.2019.05.050 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2019 Aug 26;12(16):1553-1561. doi: 10.1016/j.jcin.2019.05.050. PMID- 31430034 OWN - NLM STAT- MEDLINE DCOM- 20200914 LR - 20200914 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 95 IP - 1 DP - 2020 Jan TI - Impact of complete percutaneous revascularization in elderly patients with chronic total occlusion. PG - 145-153 LID - 10.1002/ccd.28452 [doi] AB - OBJECTIVE: The aim of the study was to assess the prognostic impact of successful chronic total occlusion (CTO) percutaneous coronary intervention (PCI) and completeness of revascularization in the elderly. BACKGROUND: Successful CTO-PCI is associated with clinical benefit. Notwithstanding elderly patients are currently underrepresented in CTO-PCI randomized controlled trials and registries. METHODS: From the Florence CTO-PCI registry 1,405 patients underwent CTO-PCI between 2004 and 2015; out of these, 460 consecutive patients were >/=75 years. End point of the study was long-term cardiac survival. The prognostic impact of successful CTO-PCI and complete revascularization on survival was assessed by Kaplan-Meier estimation and by Cox multivariable regression analysis. RESULTS: Patients were stratified according to success (72%) or failure of CTO-PCI. Completeness of revascularization was achieved in 57% of patients. Five-year cardiac survival was significantly higher in the successful CTO-PCI group (84 +/- 3% vs. 72 +/- 6%; p = .006) and it was further improved if complete coronary revascularization was achieved (90 +/- 3% vs. 68 +/- 5%; p < .001). At multivariable analysis, increasing age (hazard ratio [HR] 1.08; p = .001), diabetes (HR 1.55; p = .033), chronic kidney disease (HR 1.96, p = .002), left ventricular ejection fraction <0.40 (HR 2.10; p < .001), and completeness of revascularization (HR 0.58; p < .005) resulted independently associated with long-term cardiac survival. CONCLUSIONS: In the elderly successful CTO-PCI is associated with a long-term survival benefit. The results of this study suggest that, even in the elderly, a CTO-PCI attempt should be considered to achieve complete coronary revascularization. CI - (c) 2019 Wiley Periodicals, Inc. FAU - Valenti, Renato AU - Valenti R AUID- ORCID: 0000-0002-0215-9192 AD - Cardiothoracic and Vascular Department, Azienda Ospedaliero Universitaria Careggi, Florence, Italy. FAU - Migliorini, Angela AU - Migliorini A AD - Cardiothoracic and Vascular Department, Azienda Ospedaliero Universitaria Careggi, Florence, Italy. FAU - De Gregorio, Maria Grazia AU - De Gregorio MG AD - Cardiothoracic and Vascular Department, Azienda Ospedaliero Universitaria Careggi, Florence, Italy. FAU - Martone, Raffaele AU - Martone R AD - Cardiothoracic and Vascular Department, Azienda Ospedaliero Universitaria Careggi, Florence, Italy. FAU - Berteotti, Martina AU - Berteotti M AD - Cardiothoracic and Vascular Department, Azienda Ospedaliero Universitaria Careggi, Florence, Italy. FAU - Bernardini, Andrea AU - Bernardini A AD - Cardiothoracic and Vascular Department, Azienda Ospedaliero Universitaria Careggi, Florence, Italy. FAU - Carrabba, Nazario AU - Carrabba N AUID- ORCID: 0000-0002-5190-5227 AD - Cardiothoracic and Vascular Department, Azienda Ospedaliero Universitaria Careggi, Florence, Italy. FAU - Vergara, Ruben AU - Vergara R AUID- ORCID: 0000-0002-3250-4081 AD - Cardiothoracic and Vascular Department, Azienda Ospedaliero Universitaria Careggi, Florence, Italy. FAU - Marchionni, Niccolo AU - Marchionni N AD - Cardiothoracic and Vascular Department, Azienda Ospedaliero Universitaria Careggi, Florence, Italy. FAU - Antoniucci, David AU - Antoniucci D AD - Cardiothoracic and Vascular Department, Azienda Ospedaliero Universitaria Careggi, Florence, Italy. LA - eng PT - Journal Article DEP - 20190820 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Age Factors MH - Aged MH - Aged, 80 and over MH - Chronic Disease MH - Coronary Occlusion/diagnostic imaging/mortality/physiopathology/*therapy MH - Female MH - Humans MH - Italy MH - Male MH - *Percutaneous Coronary Intervention/adverse effects/mortality MH - Registries MH - Retrospective Studies MH - Risk Assessment MH - Risk Factors MH - Time Factors MH - Treatment Outcome OTO - NOTNLM OT - CTO-PCI OT - coronary artery disease EDAT- 2019/08/21 06:00 MHDA- 2020/09/15 06:00 CRDT- 2019/08/21 06:00 PHST- 2019/04/18 00:00 [received] PHST- 2019/07/10 00:00 [revised] PHST- 2019/08/01 00:00 [accepted] PHST- 2019/08/21 06:00 [pubmed] PHST- 2020/09/15 06:00 [medline] PHST- 2019/08/21 06:00 [entrez] AID - 10.1002/ccd.28452 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2020 Jan;95(1):145-153. doi: 10.1002/ccd.28452. Epub 2019 Aug 20. PMID- 31362541 OWN - NLM STAT- MEDLINE DCOM- 20200608 LR - 20250530 IS - 1941-7632 (Electronic) IS - 1941-7640 (Print) IS - 1941-7640 (Linking) VI - 12 IP - 8 DP - 2019 Aug TI - Invasive Versus Medical Management in Patients With Prior Coronary Artery Bypass Surgery With a Non-ST Segment Elevation Acute Coronary Syndrome. PG - e007830 LID - 10.1161/CIRCINTERVENTIONS.119.007830 [doi] AB - BACKGROUND: The benefits of routine invasive management in patients with prior coronary artery bypass grafts presenting with non-ST elevation acute coronary syndromes are uncertain because these patients were excluded from pivotal trials. METHODS: In a multicenter trial, non-ST elevation acute coronary syndromes patients with prior coronary artery bypass graft were prospectively screened in 4 acute hospitals. Medically stabilized patients were randomized to invasive management (invasive group) or noninvasive management (medical group). The primary outcome was adherence with the randomized strategy by 30 days. A blinded, independent Clinical Event Committee adjudicated predefined composite outcomes for efficacy (all-cause mortality, rehospitalization for refractory ischemia/angina, myocardial infarction, hospitalization because of heart failure) and safety (major bleeding, stroke, procedure-related myocardial infarction, and worsening renal function). RESULTS: Two hundred seventeen patients were screened and 60 (mean+/-SD age, 71+/-9 years, 72% male) were randomized (invasive group, n=31; medical group, n=29). One-third (n=10) of the participants in the invasive group initially received percutaneous coronary intervention. In the medical group, 1 participant crossed over to invasive management on day 30 but percutaneous coronary intervention was not performed. During 2-years' follow-up (median [interquartile range], 744 [570-853] days), the composite outcome for efficacy occurred in 13 (42%) subjects in the invasive group and 13 (45%) subjects in the medical group. The composite safety outcome occurred in 8 (26%) subjects in the invasive group and 9 (31%) subjects in the medical group. An efficacy or safety outcome occurred in 17 (55%) subjects in the invasive group and 16 (55%) subjects in the medical group. Health status (EuroQol 5 Dimensions) and angina class in each group were similar at 12 months. CONCLUSIONS: More than half of the population experienced a serious adverse event. An initial noninvasive management strategy is feasible. A substantive health outcomes trial of invasive versus noninvasive management in non-ST elevation acute coronary syndromes patients with prior coronary artery bypass grafts appears warranted. CLINICAL TRIAL REGISTRATION: URL: https://www.clinicaltrials.gov. Unique identifier: NCT01895751. FAU - Lee, Matthew M Y AU - Lee MMY AD - Department of Cardiology, West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Glasgow, United Kingdom (M.M.Y.L., M.C.P., P.R., J.S., C.E.J., D.S.C., K.M., P.C., N.P.S., M.B.M., A.S., A.P.R., S.H.M.H., E.E.P., K.G.O., C.B.). AD - British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences (M.M.Y.L., M.C.P., P.R., J.S., C.E.J., D.S.C., K.M., A.B., M.B.M., A.S., A.P.R., C.B.), University of Glasgow, United Kingdom. AD - Department of Cardiology, Western Infirmary, Glasgow, United Kingdom (M.M.Y.L., A.B., M.B.M., C.B.). AD - Department of Cardiology, Royal Alexandra Hospital, Paisley, United Kingdom (M.M.Y.L., S.H.M.H., E.E.P., I.N.F., C.L.M., A.J.C.). AD - Department of Cardiology, Glasgow Royal Infirmary, United Kingdom (M.C.P., P.R., A.S., A.P.R., M.M.Y.L.). FAU - Petrie, Mark C AU - Petrie MC AD - Department of Cardiology, West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Glasgow, United Kingdom (M.M.Y.L., M.C.P., P.R., J.S., C.E.J., D.S.C., K.M., P.C., N.P.S., M.B.M., A.S., A.P.R., S.H.M.H., E.E.P., K.G.O., C.B.). AD - British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences (M.M.Y.L., M.C.P., P.R., J.S., C.E.J., D.S.C., K.M., A.B., M.B.M., A.S., A.P.R., C.B.), University of Glasgow, United Kingdom. AD - Department of Cardiology, Glasgow Royal Infirmary, United Kingdom (M.C.P., P.R., A.S., A.P.R., M.M.Y.L.). FAU - Rocchiccioli, Paul AU - Rocchiccioli P AD - Department of Cardiology, West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Glasgow, United Kingdom (M.M.Y.L., M.C.P., P.R., J.S., C.E.J., D.S.C., K.M., P.C., N.P.S., M.B.M., A.S., A.P.R., S.H.M.H., E.E.P., K.G.O., C.B.). AD - British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences (M.M.Y.L., M.C.P., P.R., J.S., C.E.J., D.S.C., K.M., A.B., M.B.M., A.S., A.P.R., C.B.), University of Glasgow, United Kingdom. AD - Department of Cardiology, Glasgow Royal Infirmary, United Kingdom (M.C.P., P.R., A.S., A.P.R., M.M.Y.L.). FAU - Simpson, Joanne AU - Simpson J AD - Department of Cardiology, West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Glasgow, United Kingdom (M.M.Y.L., M.C.P., P.R., J.S., C.E.J., D.S.C., K.M., P.C., N.P.S., M.B.M., A.S., A.P.R., S.H.M.H., E.E.P., K.G.O., C.B.). AD - British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences (M.M.Y.L., M.C.P., P.R., J.S., C.E.J., D.S.C., K.M., A.B., M.B.M., A.S., A.P.R., C.B.), University of Glasgow, United Kingdom. FAU - Jackson, Colette E AU - Jackson CE AD - Department of Cardiology, West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Glasgow, United Kingdom (M.M.Y.L., M.C.P., P.R., J.S., C.E.J., D.S.C., K.M., P.C., N.P.S., M.B.M., A.S., A.P.R., S.H.M.H., E.E.P., K.G.O., C.B.). AD - British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences (M.M.Y.L., M.C.P., P.R., J.S., C.E.J., D.S.C., K.M., A.B., M.B.M., A.S., A.P.R., C.B.), University of Glasgow, United Kingdom. FAU - Corcoran, David S AU - Corcoran DS AD - Department of Cardiology, West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Glasgow, United Kingdom (M.M.Y.L., M.C.P., P.R., J.S., C.E.J., D.S.C., K.M., P.C., N.P.S., M.B.M., A.S., A.P.R., S.H.M.H., E.E.P., K.G.O., C.B.). AD - British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences (M.M.Y.L., M.C.P., P.R., J.S., C.E.J., D.S.C., K.M., A.B., M.B.M., A.S., A.P.R., C.B.), University of Glasgow, United Kingdom. FAU - Mangion, Kenneth AU - Mangion K AD - Department of Cardiology, West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Glasgow, United Kingdom (M.M.Y.L., M.C.P., P.R., J.S., C.E.J., D.S.C., K.M., P.C., N.P.S., M.B.M., A.S., A.P.R., S.H.M.H., E.E.P., K.G.O., C.B.). AD - British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences (M.M.Y.L., M.C.P., P.R., J.S., C.E.J., D.S.C., K.M., A.B., M.B.M., A.S., A.P.R., C.B.), University of Glasgow, United Kingdom. FAU - Brown, Ammani AU - Brown A AD - British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences (M.M.Y.L., M.C.P., P.R., J.S., C.E.J., D.S.C., K.M., A.B., M.B.M., A.S., A.P.R., C.B.), University of Glasgow, United Kingdom. AD - Department of Cardiology, Western Infirmary, Glasgow, United Kingdom (M.M.Y.L., A.B., M.B.M., C.B.). FAU - Cialdella, Pio AU - Cialdella P AD - Department of Cardiology, West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Glasgow, United Kingdom (M.M.Y.L., M.C.P., P.R., J.S., C.E.J., D.S.C., K.M., P.C., N.P.S., M.B.M., A.S., A.P.R., S.H.M.H., E.E.P., K.G.O., C.B.). FAU - Sidik, Novalia P AU - Sidik NP AD - Department of Cardiology, West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Glasgow, United Kingdom (M.M.Y.L., M.C.P., P.R., J.S., C.E.J., D.S.C., K.M., P.C., N.P.S., M.B.M., A.S., A.P.R., S.H.M.H., E.E.P., K.G.O., C.B.). FAU - McEntegart, Margaret B AU - McEntegart MB AD - Department of Cardiology, West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Glasgow, United Kingdom (M.M.Y.L., M.C.P., P.R., J.S., C.E.J., D.S.C., K.M., P.C., N.P.S., M.B.M., A.S., A.P.R., S.H.M.H., E.E.P., K.G.O., C.B.). AD - British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences (M.M.Y.L., M.C.P., P.R., J.S., C.E.J., D.S.C., K.M., A.B., M.B.M., A.S., A.P.R., C.B.), University of Glasgow, United Kingdom. AD - Department of Cardiology, Western Infirmary, Glasgow, United Kingdom (M.M.Y.L., A.B., M.B.M., C.B.). FAU - Shaukat, Aadil AU - Shaukat A AD - Department of Cardiology, West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Glasgow, United Kingdom (M.M.Y.L., M.C.P., P.R., J.S., C.E.J., D.S.C., K.M., P.C., N.P.S., M.B.M., A.S., A.P.R., S.H.M.H., E.E.P., K.G.O., C.B.). AD - British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences (M.M.Y.L., M.C.P., P.R., J.S., C.E.J., D.S.C., K.M., A.B., M.B.M., A.S., A.P.R., C.B.), University of Glasgow, United Kingdom. AD - Department of Cardiology, Glasgow Royal Infirmary, United Kingdom (M.C.P., P.R., A.S., A.P.R., M.M.Y.L.). FAU - Rae, Alan P AU - Rae AP AD - Department of Cardiology, West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Glasgow, United Kingdom (M.M.Y.L., M.C.P., P.R., J.S., C.E.J., D.S.C., K.M., P.C., N.P.S., M.B.M., A.S., A.P.R., S.H.M.H., E.E.P., K.G.O., C.B.). AD - British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences (M.M.Y.L., M.C.P., P.R., J.S., C.E.J., D.S.C., K.M., A.B., M.B.M., A.S., A.P.R., C.B.), University of Glasgow, United Kingdom. AD - Department of Cardiology, Glasgow Royal Infirmary, United Kingdom (M.C.P., P.R., A.S., A.P.R., M.M.Y.L.). FAU - Hood, Stuart H M AU - Hood SHM AD - Department of Cardiology, West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Glasgow, United Kingdom (M.M.Y.L., M.C.P., P.R., J.S., C.E.J., D.S.C., K.M., P.C., N.P.S., M.B.M., A.S., A.P.R., S.H.M.H., E.E.P., K.G.O., C.B.). AD - Department of Cardiology, Royal Alexandra Hospital, Paisley, United Kingdom (M.M.Y.L., S.H.M.H., E.E.P., I.N.F., C.L.M., A.J.C.). FAU - Peat, Eileen E AU - Peat EE AD - Department of Cardiology, West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Glasgow, United Kingdom (M.M.Y.L., M.C.P., P.R., J.S., C.E.J., D.S.C., K.M., P.C., N.P.S., M.B.M., A.S., A.P.R., S.H.M.H., E.E.P., K.G.O., C.B.). AD - Department of Cardiology, Royal Alexandra Hospital, Paisley, United Kingdom (M.M.Y.L., S.H.M.H., E.E.P., I.N.F., C.L.M., A.J.C.). FAU - Findlay, Iain N AU - Findlay IN AD - Department of Cardiology, Royal Alexandra Hospital, Paisley, United Kingdom (M.M.Y.L., S.H.M.H., E.E.P., I.N.F., C.L.M., A.J.C.). FAU - Murphy, Clare L AU - Murphy CL AD - Department of Cardiology, Royal Alexandra Hospital, Paisley, United Kingdom (M.M.Y.L., S.H.M.H., E.E.P., I.N.F., C.L.M., A.J.C.). FAU - Cormack, Alistair J AU - Cormack AJ AD - Department of Cardiology, Royal Alexandra Hospital, Paisley, United Kingdom (M.M.Y.L., S.H.M.H., E.E.P., I.N.F., C.L.M., A.J.C.). FAU - Bukov, Nikolay B AU - Bukov NB AD - Department of Cardiology, Royal Blackburn Hospital, United Kingdom (N.B.B., K.P.B.). FAU - Balachandran, Kanarath P AU - Balachandran KP AD - Department of Cardiology, Royal Blackburn Hospital, United Kingdom (N.B.B., K.P.B.). FAU - Oldroyd, Keith G AU - Oldroyd KG AD - Department of Cardiology, West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Glasgow, United Kingdom (M.M.Y.L., M.C.P., P.R., J.S., C.E.J., D.S.C., K.M., P.C., N.P.S., M.B.M., A.S., A.P.R., S.H.M.H., E.E.P., K.G.O., C.B.). FAU - Ford, Ian AU - Ford I AD - Robertson Centre for Biostatistics (I.F., A.M.), University of Glasgow, United Kingdom. FAU - Wu, Olivia AU - Wu O AD - Health Economics and Health Technology Assessment (O.W.), University of Glasgow, United Kingdom. FAU - McConnachie, Alex AU - McConnachie A AD - Robertson Centre for Biostatistics (I.F., A.M.), University of Glasgow, United Kingdom. FAU - Barry, Sarah J E AU - Barry SJE AD - Department of Mathematics and Statistics, University of Strathclyde, United Kingdom (S.J.E.B.). FAU - Berry, Colin AU - Berry C AD - Department of Cardiology, West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Glasgow, United Kingdom (M.M.Y.L., M.C.P., P.R., J.S., C.E.J., D.S.C., K.M., P.C., N.P.S., M.B.M., A.S., A.P.R., S.H.M.H., E.E.P., K.G.O., C.B.). AD - British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences (M.M.Y.L., M.C.P., P.R., J.S., C.E.J., D.S.C., K.M., A.B., M.B.M., A.S., A.P.R., C.B.), University of Glasgow, United Kingdom. AD - Department of Cardiology, Western Infirmary, Glasgow, United Kingdom (M.M.Y.L., A.B., M.B.M., C.B.). CN - CABG-ACS Investigators LA - eng SI - ClinicalTrials.gov/NCT01895751 GR - FS/15/54/31639/BHF_/British Heart Foundation/United Kingdom GR - FS/17/26/32744/BHF_/British Heart Foundation/United Kingdom GR - RE/18/6134217/BHF_/British Heart Foundation/United Kingdom GR - RE/13/5/30177/BHF_/British Heart Foundation/United Kingdom PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20190731 PL - United States TA - Circ Cardiovasc Interv JT - Circulation. Cardiovascular interventions JID - 101499602 RN - 0 (Cardiovascular Agents) SB - IM MH - Acute Coronary Syndrome/diagnostic imaging/mortality/physiopathology/*therapy MH - Aged MH - Aged, 80 and over MH - Cardiovascular Agents/adverse effects/*therapeutic use MH - Cause of Death MH - *Coronary Artery Bypass/adverse effects/mortality MH - Female MH - Health Status MH - Humans MH - Male MH - Middle Aged MH - Non-ST Elevated Myocardial Infarction/diagnostic imaging/mortality/physiopathology/*therapy MH - Patient Readmission MH - *Percutaneous Coronary Intervention/adverse effects/mortality MH - Pilot Projects MH - Prospective Studies MH - Risk Factors MH - Time Factors MH - Treatment Outcome MH - United Kingdom PMC - PMC7664981 OTO - NOTNLM OT - acute coronary syndrome OT - clinical trial OT - coronary angiography OT - coronary artery bypass surgery OT - myocardial infarction OT - percutaneous coronary intervention EDAT- 2019/08/01 06:00 MHDA- 2020/06/09 06:00 PMCR- 2020/11/13 CRDT- 2019/08/01 06:00 PHST- 2019/08/01 06:00 [entrez] PHST- 2019/08/01 06:00 [pubmed] PHST- 2020/06/09 06:00 [medline] PHST- 2020/11/13 00:00 [pmc-release] AID - 10.1161/CIRCINTERVENTIONS.119.007830 [doi] PST - ppublish SO - Circ Cardiovasc Interv. 2019 Aug;12(8):e007830. doi: 10.1161/CIRCINTERVENTIONS.119.007830. Epub 2019 Jul 31. PMID- 31334914 OWN - NLM STAT- MEDLINE DCOM- 20200818 LR - 20200818 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 94 IP - 4 DP - 2019 Oct 1 TI - Renal denervation in patients with heart failure secondary to Chagas' disease: A pilot randomized controlled trial. PG - 644-650 LID - 10.1002/ccd.28393 [doi] AB - INTRODUCTION: Chagas disease is one of the most relevant endemic parasitic diseases in Latin America, affecting approximately 6 million people. Overt Chagas heart disease is an ominous condition, occurring in 20-30% of infected individuals, which has besides the persistent myocarditis a peculiar intracardiac ganglionic neuronal depletion and dysautonomy. This study aims to evaluate the safety and feasibility of renal denervation for patients with advanced symptomatic Chagas cardiomyopathy. METHODS: Open-label prospective pilot study that randomized patients with Chagas heart disease to either renal denervation or conservative treatment (2:1 ratio). The primary endpoint was the incidence of major adverse events at 9 months, defined as a composite of all-cause death, myocardial infarction, stroke, need for renal artery invasive treatment, or worsening renal function. RESULTS: A total of 17 patients were allocated for renal denervation (n = 11) or conservative treatment (n = 6). Included patients had severe symptomatic heart disease, with markedly depressed left ventricular function (average ejection fraction 26.7 +/- 4.9%). For patients randomized to renal denervation, the procedure was performed successfully and uneventfully. After 9 months, the primary endpoint occurred in 36.4% of patients in the renal denervation group and 50.0% in the control arm (p = .6). After 9 months, clinical, laboratory, functional, echocardiographic, and quality of life parameters were similar between groups. CONCLUSIONS: This pilot study suggests that renal denervation is safe and feasible in patients with Chagas cardiomyopathy, warranting future studies to better evaluate the clinical efficacy of the interventional strategy in improving the prognosis of this high-risk population. CI - (c) 2019 Wiley Periodicals, Inc. FAU - Spadaro, Andre G AU - Spadaro AG AD - Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Sao Paulo, Brazil. FAU - Bocchi, Edimar A AU - Bocchi EA AD - Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Sao Paulo, Brazil. FAU - Souza, Germano E AU - Souza GE AD - Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Sao Paulo, Brazil. FAU - Filho, Antonio E AU - Filho AE AD - Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Sao Paulo, Brazil. FAU - Mariani, Jose Jr AU - Mariani J Jr AD - Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Sao Paulo, Brazil. AD - Hospital Israelita Albert Einstein, Sao Paulo, Sao Paulo, Brazil. FAU - Campos, Carlos M AU - Campos CM AUID- ORCID: 0000-0003-1734-6924 AD - Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Sao Paulo, Brazil. AD - Hospital Israelita Albert Einstein, Sao Paulo, Sao Paulo, Brazil. FAU - Lemos, Pedro A AU - Lemos PA AUID- ORCID: 0000-0002-6782-750X AD - Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Sao Paulo, Brazil. AD - Hospital Israelita Albert Einstein, Sao Paulo, Sao Paulo, Brazil. LA - eng PT - Journal Article PT - Randomized Controlled Trial DEP - 20190723 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Aged MH - *Autonomic Denervation/adverse effects/mortality MH - Brazil MH - *Catheter Ablation/adverse effects/mortality MH - Chagas Cardiomyopathy/mortality/parasitology/physiopathology/*surgery MH - Feasibility Studies MH - Female MH - Heart Failure/mortality/parasitology/physiopathology/*surgery MH - Humans MH - Kidney/*innervation MH - Male MH - Middle Aged MH - Pilot Projects MH - Prospective Studies MH - Recovery of Function MH - Time Factors MH - Treatment Outcome OTO - NOTNLM OT - Chagas cardiomyopathy OT - Chagas heart disease OT - heart failure OT - radiofrequency ablation OT - renal denervation EDAT- 2019/07/25 06:00 MHDA- 2020/08/19 06:00 CRDT- 2019/07/24 06:00 PHST- 2019/04/27 00:00 [received] PHST- 2019/06/27 00:00 [accepted] PHST- 2019/07/25 06:00 [pubmed] PHST- 2020/08/19 06:00 [medline] PHST- 2019/07/24 06:00 [entrez] AID - 10.1002/ccd.28393 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2019 Oct 1;94(4):644-650. doi: 10.1002/ccd.28393. Epub 2019 Jul 23. PMID- 31332700 OWN - NLM STAT- MEDLINE DCOM- 20200219 LR - 20200219 IS - 1573-2584 (Electronic) IS - 0301-1623 (Linking) VI - 51 IP - 10 DP - 2019 Oct TI - Left ventricular end-diastolic pressure-guided hydration for the prevention of contrast-induced acute kidney injury in patients with stable ischemic heart disease: the LAKESIDE trial. PG - 1815-1822 LID - 10.1007/s11255-019-02235-w [doi] AB - OBJECTIVES: Contrast-induced acute kidney injury (CI-AKI) is a serious complication in patients undergoing diagnostic cardiac angiography or percutaneous coronary intervention. We aimed to evaluate the preventive effects of left ventricular end-diastolic pressure (LVEDP)-guided hydration for the prevention of CI-AKI in patients with chronic kidney disease undergoing cardiac catheterization. METHODS: This prospective randomized single-blind clinical trial enrolled 114 eligible patients with an estimated glomerular filtration rate (eGFR) of 15 < eGFR /=5 points), and in relation to the presenting coronary syndrome. All clinical variables, except prior coronary artery bypass grafting, were independent risk predictors. The annualized incidence rate of major adverse cardiovascular events increased in a graded manner with increasing TRS 2P, ranging from 1.65 to 16.6 per 100 person-years ( P(trend)<0.001). Compared with the lowest-risk group (risk indicators=0), the hazard ratios (95% CIs) for 10-year major adverse cardiovascular events were 1.60 (95% CI, 1.36-1.89), 2.58 (95% CI, 2.21-3.02), 4.31 (95% CI, 3.69-5.05), 6.43 (95% CI, 5.47-7.56), and 10.03 (95% CI, 8.52-11.81), in those with 1, 2, 3, 4 and >/=5 risk indicators, respectively. Risk gradation was consistent among individual clinical end points. TRS 2P showed reasonable discrimination with C-statistics of 0.693 for major adverse cardiovascular events and 0.758 for mortality. The graded relationship between the risk score and event rates was observed in both patients presenting with acute and nonacute coronary syndromes. Conclusions The use of TRS 2P, a simple risk score based on routinely collected variables, enables risk stratification in patients undergoing coronary angiography. Its predictive value was demonstrated in a real-world setting with long-term follow-up and regardless of the acuity of coronary presentation. FAU - Zafrir, Barak AU - Zafrir B AD - 1 Department of Cardiology Lady Davis Carmel Medical Center Haifa Israel. AD - 4 Faculty of Medicine Technion Israel Institute of Medicine Haifa Israel. FAU - Adawi, Salim AU - Adawi S AD - 1 Department of Cardiology Lady Davis Carmel Medical Center Haifa Israel. AD - 4 Faculty of Medicine Technion Israel Institute of Medicine Haifa Israel. FAU - Khalaily, Marah AU - Khalaily M AD - 4 Faculty of Medicine Technion Israel Institute of Medicine Haifa Israel. FAU - Jaffe, Ronen AU - Jaffe R AD - 1 Department of Cardiology Lady Davis Carmel Medical Center Haifa Israel. AD - 4 Faculty of Medicine Technion Israel Institute of Medicine Haifa Israel. FAU - Eitan, Amnon AU - Eitan A AD - 1 Department of Cardiology Lady Davis Carmel Medical Center Haifa Israel. FAU - Barnett-Griness, Ofra AU - Barnett-Griness O AD - 2 Statistical Unit Lady Davis Carmel Medical Center Haifa Israel. AD - 3 Department of Community Medicine and Epidemiology Lady Davis Carmel Medical Center Haifa Israel. FAU - Saliba, Walid AU - Saliba W AD - 3 Department of Community Medicine and Epidemiology Lady Davis Carmel Medical Center Haifa Israel. AD - 4 Faculty of Medicine Technion Israel Institute of Medicine Haifa Israel. LA - eng PT - Journal Article DEP - 20190704 PL - England TA - J Am Heart Assoc JT - Journal of the American Heart Association JID - 101580524 SB - IM MH - Age Factors MH - Aged MH - Aged, 80 and over MH - Angina, Unstable/diagnosis MH - Coronary Angiography MH - Coronary Artery Bypass/statistics & numerical data MH - Coronary Artery Disease/*diagnosis MH - Diabetes Mellitus/*epidemiology MH - Female MH - Heart Failure/*epidemiology MH - Humans MH - Hypertension/*epidemiology MH - Male MH - Middle Aged MH - Mortality MH - Myocardial Infarction/*epidemiology MH - Non-ST Elevated Myocardial Infarction/diagnosis MH - Peripheral Arterial Disease/*epidemiology MH - Proportional Hazards Models MH - Renal Insufficiency/*epidemiology MH - Risk Assessment MH - ST Elevation Myocardial Infarction/diagnosis MH - Secondary Prevention MH - Smoking/epidemiology MH - Stroke/*epidemiology PMC - PMC6662136 OTO - NOTNLM OT - acute coronary syndrome OT - cardiovascular outcomes OT - coronary angiography OT - risk score OT - risk stratification EDAT- 2019/07/05 06:00 MHDA- 2020/11/13 06:00 PMCR- 2019/07/16 CRDT- 2019/07/05 06:00 PHST- 2019/07/05 06:00 [entrez] PHST- 2019/07/05 06:00 [pubmed] PHST- 2020/11/13 06:00 [medline] PHST- 2019/07/16 00:00 [pmc-release] AID - JAH34264 [pii] AID - 10.1161/JAHA.119.012433 [doi] PST - ppublish SO - J Am Heart Assoc. 2019 Jul 16;8(14):e012433. doi: 10.1161/JAHA.119.012433. Epub 2019 Jul 4. PMID- 31238029 OWN - NLM STAT- MEDLINE DCOM- 20200319 LR - 20200319 IS - 1552-6259 (Electronic) IS - 0003-4975 (Linking) VI - 108 IP - 6 DP - 2019 Dec TI - Predictive Capacity of Oxygen Delivery During Cardiopulmonary Bypass on Acute Kidney Injury. PG - 1807-1814 LID - S0003-4975(19)30881-1 [pii] LID - 10.1016/j.athoracsur.2019.04.115 [doi] AB - BACKGROUND: The randomized goal-directed perfusion trial confirmed retrospective findings that a goal-directed perfusion strategy to maintain oxygen delivery index (DO(2)i) during cardiopulmonary bypass greater than 280 mL/min/m(2) reduces the incidence of acute kidney injury (AKI). We developed a predictive model for AKI using data from the Australian and New Zealand Collaborative Perfusion Registry to determine whether these findings could be validated in a real-world clinical setting and to identify an optimal DO(2)i threshold for predictive diagnostic accuracy. METHODS: Data in 19,410 cardiopulmonary bypass procedures were randomly divided into training (n = 9705) and validation (n = 9705) datasets. Multivariate logistic regression was used to determine the best predictive models for AKI (RIFLE [renal Risk, Injury, Failure, Loss of renal function and End-stage renal disease] classification), incremental predictive value of minimum cardiopulmonary bypass DO(2)i, and optimal threshold. RESULTS: Minimum DO(2)i was significantly associated with any AKI, AKI risk, and AKI injury or greater class in both datasets (validation dataset; any AKI odds ratio [OR], 0.993; 95% confidence interval [CI], 0.991-0.995; P < .001; AKI risk OR, 0.994; 95% CI, 0.992-0.996; P < .001, AKI injury or greater 0.993; 95% CI, 0.991-0.996; P < .001), representing on average a 7% increase in the likelihood of AKI for every 10-mL/min/m(2) decrease in DO(2)i. Diagnostic accuracy was similar for both datasets, with an optimal DO(2)i threshold of 270 mL/min/m(2). The odds of any AKI were increased by 52% in those below the threshold (OR, 1.52; 95% CI, 1.29-1.77; P < .001). CONCLUSIONS: This study confirms previous findings that minimum DO(2)i during cardiopulmonary bypass is independently associated with AKI, supporting previous findings in a broader-risk, multicenter cohort. CI - Copyright (c) 2019 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved. FAU - Newland, Richard F AU - Newland RF AD - Quality and Outcomes, Cardiothoracic Surgical Unit, Flinders Medical Centre, Adelaide, Australia; Perfusion Service, Cardiothoracic Surgical Unit, Flinders Medical Centre, Adelaide, Australia; Department of Surgery, College of Medicine and Public Health, Flinders University, Adelaide, Australia. FAU - Baker, Robert A AU - Baker RA AD - Quality and Outcomes, Cardiothoracic Surgical Unit, Flinders Medical Centre, Adelaide, Australia; Perfusion Service, Cardiothoracic Surgical Unit, Flinders Medical Centre, Adelaide, Australia; Department of Surgery, College of Medicine and Public Health, Flinders University, Adelaide, Australia. Electronic address: rob.baker@sa.gov.au. FAU - Woodman, Richard J AU - Woodman RJ AD - Flinders Centre for Epidemiology and Biostatistics, Flinders University, Adelaide, Australia. FAU - Barnes, Mary B AU - Barnes MB AD - Flinders Centre for Epidemiology and Biostatistics, Flinders University, Adelaide, Australia. FAU - Willcox, Timothy W AU - Willcox TW AD - Greenlane Perfusion, Auckland City Hospital, Auckland, New Zealand; Department of Anaesthesia, University of Auckland, Auckland, New Zealand. CN - Australian and New Zealand Collaborative Perfusion Registry LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20190622 PL - Netherlands TA - Ann Thorac Surg JT - The Annals of thoracic surgery JID - 15030100R RN - S88TT14065 (Oxygen) SB - IM MH - Acute Kidney Injury/epidemiology/metabolism/*prevention & control MH - Aged MH - Australia/epidemiology MH - Cardiopulmonary Bypass/*methods MH - Coronary Artery Bypass/methods MH - Coronary Artery Disease/metabolism/*surgery MH - Female MH - Follow-Up Studies MH - Humans MH - Incidence MH - Male MH - Middle Aged MH - New Zealand/epidemiology MH - Oxygen/*administration & dosage/metabolism MH - Oxygen Consumption/*physiology MH - Oxygen Inhalation Therapy/*methods MH - Postoperative Complications/epidemiology/metabolism/*prevention & control MH - Prospective Studies MH - ROC Curve MH - Risk Factors EDAT- 2019/06/27 06:00 MHDA- 2020/03/20 06:00 CRDT- 2019/06/26 06:00 PHST- 2018/12/28 00:00 [received] PHST- 2019/04/01 00:00 [revised] PHST- 2019/04/29 00:00 [accepted] PHST- 2019/06/27 06:00 [pubmed] PHST- 2020/03/20 06:00 [medline] PHST- 2019/06/26 06:00 [entrez] AID - S0003-4975(19)30881-1 [pii] AID - 10.1016/j.athoracsur.2019.04.115 [doi] PST - ppublish SO - Ann Thorac Surg. 2019 Dec;108(6):1807-1814. doi: 10.1016/j.athoracsur.2019.04.115. Epub 2019 Jun 22. PMID- 31232940 OWN - NLM STAT- MEDLINE DCOM- 20190708 LR - 20221005 IS - 1536-5964 (Electronic) IS - 0025-7974 (Print) IS - 0025-7974 (Linking) VI - 98 IP - 25 DP - 2019 Jun TI - Effects of probucol on contrast-induced acute kidney injury in patients undergoing percutaneous coronary intervention. PG - e16049 LID - 10.1097/MD.0000000000016049 [doi] LID - e16049 AB - OBJECTIVE: This study was performed to explore the effects of probucol on contrast-induced acute kidney injury (CIAKI) in patients with coronary heart disease undergoing percutaneous coronary intervention (PCI). METHODS: In total, 220 patients undergoing PCI were randomly assigned to either the control group (hydration from 12 hours before to 12 hours after contrast administration; n = 110) or the probucol group (hydration plus probucol 500 mg twice daily 1 day before and 3 days after the operation; n = 110). The primary endpoint was the occurrence of serum creatinine (Scr)-based CIAKI, defined as an absolute increase in Scr by 0.5 mg/dl (44.2 mumol/L) or a relative 25% increase from baseline within 48 to 72 hours after exposure to contrast medium. The secondary outcomes were composite variations in Scr, blood urea nitrogen (BUN), creatinine clearance rate (Ccr) within 48 to 72 hours, and major adverse events during hospitalization or the 7-day follow-up period after PCI. RESULTS: The overall incidence of Scr-based CIAKI was 7.3% (16/220): 5.5% (6/110) in the control group and 9.1% (10/110) in the probucol group (chi = 1.078, P = .298). There were no significant differences in the occurrence rate of major adverse events during hospitalization or the 7-day follow-up period after PCI between the groups. Multivariate logistic regression analysis showed that probucol was not an independent protective factor for CIAKI (odds ratio, 1.825; 95% confidence interval, 0.639-5.212; P = .261). However, hydration was an independent protective factor (odds ratio, 0.997; 95% confidence interval, 0.995-0.999; P = .004). CONCLUSION: Probucol cannot effectively reduce the incidence of CIAKI through its anti-inflammatory and antioxidative stress effects. FAU - Wang, Yong AU - Wang Y AD - First Center Clinic College of Tianjin Medical University, Tianjin. AD - Department of Cardiology. FAU - Shi, Yun AU - Shi Y AD - First Center Clinic College of Tianjin Medical University, Tianjin. FAU - Xu, Xuesheng AU - Xu X AD - Department of Cardiology. FAU - Ge, Wenkun AU - Ge W AD - Department of Cardiology. FAU - Yang, Shuo AU - Yang S AD - Department of Hematology, The First People's Hospital of Shangqiu, Shangqiu, Henan. FAU - Lu, Chengzhi AU - Lu C AD - Department of Cardiology, Tianjin First Center Hospital, Tianjin, China. LA - eng PT - Journal Article PT - Randomized Controlled Trial PL - United States TA - Medicine (Baltimore) JT - Medicine JID - 2985248R RN - 0 (Antioxidants) RN - 0 (Contrast Media) RN - P3CTH044XJ (Probucol) SB - IM MH - Acute Kidney Injury/*drug therapy/etiology MH - Aged MH - Antioxidants/pharmacology/therapeutic use MH - China MH - Contrast Media/*adverse effects/therapeutic use MH - Coronary Angiography/adverse effects MH - Coronary Disease/diagnostic imaging/surgery MH - Double-Blind Method MH - Female MH - Humans MH - Logistic Models MH - Male MH - Middle Aged MH - Percutaneous Coronary Intervention/*adverse effects/methods MH - Probucol/*pharmacology/therapeutic use MH - Prospective Studies PMC - PMC6636920 COIS- The authors have no funding and conflicts of interest to disclose. EDAT- 2019/06/25 06:00 MHDA- 2019/07/10 06:00 PMCR- 2019/06/21 CRDT- 2019/06/25 06:00 PHST- 2019/06/25 06:00 [entrez] PHST- 2019/06/25 06:00 [pubmed] PHST- 2019/07/10 06:00 [medline] PHST- 2019/06/21 00:00 [pmc-release] AID - 00005792-201906210-00024 [pii] AID - MD-D-19-00377 [pii] AID - 10.1097/MD.0000000000016049 [doi] PST - ppublish SO - Medicine (Baltimore). 2019 Jun;98(25):e16049. doi: 10.1097/MD.0000000000016049. PMID- 31228771 OWN - NLM STAT- MEDLINE DCOM- 20200305 LR - 20200305 IS - 1097-6744 (Electronic) IS - 0002-8703 (Linking) VI - 214 DP - 2019 Aug TI - Canadian-Australasian Randomised trial of screening kidney transplant candidates for coronary artery disease-A trial protocol for the CARSK study. PG - 175-183 LID - S0002-8703(19)30127-9 [pii] LID - 10.1016/j.ahj.2019.05.008 [doi] AB - Transplantation is the preferred treatment for patients with kidney failure, but the need exceeds the supply of transplantable kidneys, and patients routinely wait >5 years on dialysis for a transplant. Coronary artery disease (CAD) is common in kidney failure and can exclude patients from transplantation or result in death before or after transplantation. Screening asymptomatic patients for CAD using noninvasive tests prior to wait-listing and at regular intervals (ie, annually) after wait-listing until transplantation is the established standard of care and is justified by the need to avoid adverse patient outcomes and loss of organs. Patients with abnormal screening tests undergo coronary angiography, and those with critical stenoses are revascularized. Screening is potentially harmful because patients may be excluded or delayed from transplantation, and complications after revascularization are more frequent in this population. CARSK will test the hypothesis that eliminating screening tests for occult CAD after wait-listing is not inferior to regular screening for the prevention of major adverse cardiac events defined as the composite of cardiovascular death, nonfatal myocardial infarction, urgent revascularization, and hospitalization for unstable angina. Secondary outcomes include the transplant rate, safety measures, and the cost-effectiveness of screening. Enrolment of 3,306 patients over 3 years is required, with patients followed for up to 5 years during wait-listing and for 1 year after transplantation. By validating or refuting the use of screening tests during wait-listing, CARSK will ensure judicious use of health resources and optimal patient outcomes. CI - Copyright (c) 2019 Elsevier Inc. All rights reserved. FAU - Ying, Tracey AU - Ying T FAU - Gill, Jagbir AU - Gill J FAU - Webster, Angela AU - Webster A FAU - Kim, S Joseph AU - Kim SJ FAU - Morton, Rachael AU - Morton R FAU - Klarenbach, Scott W AU - Klarenbach SW FAU - Kelly, Patrick AU - Kelly P FAU - Ramsay, Timothy AU - Ramsay T FAU - Knoll, Gregory A AU - Knoll GA FAU - Pilmore, Helen AU - Pilmore H FAU - Hughes, Gillian AU - Hughes G FAU - Herzog, Charles A AU - Herzog CA FAU - Chadban, Steven AU - Chadban S FAU - Gill, John S AU - Gill JS LA - eng SI - ANZCTR/ACTRN12616000736448 SI - ClinicalTrials.gov/NCT03674307 PT - Clinical Trial Protocol PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20190522 PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 SB - IM MH - *Asymptomatic Diseases MH - Coronary Artery Disease/*diagnosis/diagnostic imaging/surgery MH - Equivalence Trials as Topic MH - Humans MH - Kidney Failure, Chronic/*complications MH - *Kidney Transplantation MH - Mass Screening/adverse effects/economics MH - Postoperative Complications/etiology MH - *Randomized Controlled Trials as Topic MH - Standard of Care MH - Waiting Lists EDAT- 2019/06/23 06:00 MHDA- 2020/03/07 06:00 CRDT- 2019/06/23 06:00 PHST- 2018/12/24 00:00 [received] PHST- 2019/05/13 00:00 [accepted] PHST- 2019/06/23 06:00 [pubmed] PHST- 2020/03/07 06:00 [medline] PHST- 2019/06/23 06:00 [entrez] AID - S0002-8703(19)30127-9 [pii] AID - 10.1016/j.ahj.2019.05.008 [doi] PST - ppublish SO - Am Heart J. 2019 Aug;214:175-183. doi: 10.1016/j.ahj.2019.05.008. Epub 2019 May 22. PMID- 31227410 OWN - NLM STAT- MEDLINE DCOM- 20200615 LR - 20210927 IS - 1097-6809 (Electronic) IS - 0741-5214 (Print) IS - 0741-5214 (Linking) VI - 71 IP - 1 DP - 2020 Jan TI - In-hospital outcomes of transcarotid artery revascularization and carotid endarterectomy in the Society for Vascular Surgery Vascular Quality Initiative. PG - 87-95 LID - S0741-5214(19)30064-3 [pii] LID - 10.1016/j.jvs.2018.11.029 [doi] AB - OBJECTIVE: Transcarotid artery revascularization (TCAR) with flow reversal offers a less invasive option for carotid revascularization in high-risk patients and has the lowest reported overall stroke rate for any prospective trial of carotid artery stenting. However, outcome comparisons between TCAR and carotid endarterectomy (CEA) are needed to confirm the safety of TCAR outside of highly selected patients and providers. METHODS: We compared in-hospital outcomes of patients undergoing TCAR and CEA from January 2016 to March 2018 using the Society for Vascular Surgery Vascular Quality Initiative TCAR Surveillance Project registry and the Society for Vascular Surgery Vascular Quality Initiative CEA database, respectively. The primary outcome was a composite of in-hospital stroke and death. RESULTS: A total of 1182 patients underwent TCAR compared with 10,797 patients who underwent CEA. Patients undergoing TCAR were older (median age, 74 vs 71 years; P < .001) and more likely to be symptomatic (32% vs 27%; P < .001); they also had more medical comorbidities, including coronary artery disease (55% vs 28%; P < .001), chronic heart failure (20% vs 11%; P < .001), chronic obstructive pulmonary disease (29% vs 23%; P < .001), and chronic kidney disease (39% vs 34%; P = .001). On unadjusted analysis, TCAR had similar rates of in-hospital stroke/death (1.6% vs 1.4%; P = .33) and stroke/death/myocardial infarction (MI; 2.5% vs 1.9%; P = .16) compared with CEA. There was no difference in rates of stroke (1.4% vs 1.2%; P = .68), in-hospital death (0.3% vs 0.3%; P = .88), 30-day death (0.9% vs 0.4%; P = .06), or MI (1.1% vs 0.6%; P = .11). However, on average, TCAR procedures were 33 minutes shorter than CEA (78 +/- 33 minutes vs 111 +/- 43 minutes; P < .001). Patients undergoing TCAR were also less likely to incur cranial nerve injuries (0.6% vs 1.8%; P < .001) and less likely to have a postoperative length of stay >1 day (27% vs 30%; P = .046). On adjusted analysis, there was no difference in terms of stroke/death (odds ratio, 1.3; 95% confidence interval, 0.8-2.2; P = .28), stroke/death/MI (odds ratio, 1.4; 95% confidence interval, 0.9-2.1, P = .18), or the individual outcomes. CONCLUSIONS: Despite a substantially higher medical risk in patients undergoing TCAR, in-hospital stroke/death rates were similar between TCAR and CEA. Further comparative studies with larger samples sizes and longer follow-up will be needed to establish the role of TCAR in extracranial carotid disease management. CI - Copyright (c) 2019 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved. FAU - Schermerhorn, Marc L AU - Schermerhorn ML AD - Division of Vascular and Endovascular Surgery, Department of Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Mass. Electronic address: mscherm@bidmc.harvard.edu. FAU - Liang, Patric AU - Liang P AD - Division of Vascular and Endovascular Surgery, Department of Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Mass. FAU - Dakour-Aridi, Hanaa AU - Dakour-Aridi H AD - Johns Hopkins Bayview Vascular and Endovascular Research Center, Baltimore, Md. FAU - Kashyap, Vikram S AU - Kashyap VS AD - Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio. FAU - Wang, Grace J AU - Wang GJ AD - Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pa. FAU - Nolan, Brian W AU - Nolan BW AD - Division of Vascular and Endovascular Therapy, Department of Surgery, Maine Medical Center, Portland, Me. FAU - Cronenwett, Jack L AU - Cronenwett JL AD - Section of Vascular Surgery and The Dartmouth Institute, Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH. FAU - Eldrup-Jorgensen, Jens AU - Eldrup-Jorgensen J AD - Division of Vascular and Endovascular Therapy, Department of Surgery, Maine Medical Center, Portland, Me. FAU - Malas, Mahmoud B AU - Malas MB AD - Division of Vascular and Endovascular Surgery, Department of Surgery, University of California San Diego Health System, San Diego, Calif. LA - eng GR - T32 HL007734/HL/NHLBI NIH HHS/United States PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't DEP - 20190618 PL - United States TA - J Vasc Surg JT - Journal of vascular surgery JID - 8407742 SB - IM CIN - J Vasc Surg. 2021 Mar;73(3):743-744. doi: 10.1016/j.jvs.2020.11.043. PMID: 33632506 MH - Aged MH - Canada MH - Carotid Stenosis/diagnostic imaging/mortality/physiopathology/*therapy MH - Comorbidity MH - Databases, Factual MH - *Endarterectomy, Carotid/adverse effects/mortality MH - *Endovascular Procedures/adverse effects/instrumentation/mortality MH - Female MH - Health Status MH - Hospital Mortality MH - Humans MH - Male MH - Middle Aged MH - Myocardial Infarction/mortality MH - Registries MH - Retrospective Studies MH - Risk Assessment MH - Risk Factors MH - Stents MH - Stroke/mortality MH - Time Factors MH - Treatment Outcome MH - United States PMC - PMC6918010 MID - NIHMS1519251 OTO - NOTNLM OT - Carotid artery stenting OT - Carotid endarterectomy OT - Stroke OT - TCAR Surveillance Project OT - Transcarotid OT - Vascular Quality Initiative EDAT- 2019/06/23 06:00 MHDA- 2020/06/17 06:00 PMCR- 2021/01/01 CRDT- 2019/06/23 06:00 PHST- 2018/09/13 00:00 [received] PHST- 2018/11/03 00:00 [accepted] PHST- 2019/06/23 06:00 [pubmed] PHST- 2020/06/17 06:00 [medline] PHST- 2019/06/23 06:00 [entrez] PHST- 2021/01/01 00:00 [pmc-release] AID - S0741-5214(19)30064-3 [pii] AID - 10.1016/j.jvs.2018.11.029 [doi] PST - ppublish SO - J Vasc Surg. 2020 Jan;71(1):87-95. doi: 10.1016/j.jvs.2018.11.029. Epub 2019 Jun 18. PMID- 31196453 OWN - NLM STAT- MEDLINE DCOM- 20200410 LR - 20211204 IS - 1558-3597 (Electronic) IS - 0735-1097 (Linking) VI - 73 IP - 23 DP - 2019 Jun 18 TI - Efficacy and Safety of Evolocumab in Chronic Kidney Disease in the FOURIER Trial. PG - 2961-2970 LID - S0735-1097(19)34903-4 [pii] LID - 10.1016/j.jacc.2019.03.513 [doi] AB - BACKGROUND: Data on PCSK9 inhibition in chronic kidney disease (CKD) is limited. OBJECTIVES: The purpose of this study was to compare outcomes with evolocumab and placebo according to kidney function. METHODS: The FOURIER (Further Cardiovascular Outcomes Research with PCSK9 Inhibition in Subjects with Elevated Risk) trial randomized individuals with clinically evident atherosclerosis and low-density lipoprotein cholesterol (LDL-C) >/=70 mg/dl or non-high-density lipoprotein cholesterol >/=100 mg/dl to evolocumab or placebo. The primary endpoint (cardiovascular death, myocardial infarction, stroke, hospitalization for unstable angina, or coronary revascularization), key secondary endpoint (cardiovascular death, myocardial infarction, or stroke), and safety were analyzed according to chronic kidney disease (CKD) stage estimated from CKD-epidemiology estimated glomerular filtration rate. RESULTS: There were 8,077 patients with preserved kidney function, 15,034 with stage 2 CKD, and 4,443 with >/=stage 3 CKD. LDL-C reduction with evolocumab compared with placebo at 48 weeks was similar across CKD groups at 59%, 59%, and 58%, respectively. Relative risk reduction for the primary endpoint was similar for preserved function (hazard ratio [HR]: 0.82; 95% CI: 0.71 to 0.94), stage 2 (HR: 0.85; 95% CI: 0.77 to 0.94), and stage >/=3 CKD (HR: 0.89; 95% CI: 0.76 to 1.05); p(int) = 0.77. Relative risk reduction for the secondary endpoint was similar across CKD stages (p(int) = 0.75)-preserved function (HR: 0.75; 95% CI: 0.62 to 0.90), stage 2 (HR: 0.82; 95% CI: 0.72 to 0.93), stage >/=3 (HR: 0.79; 95% CI: 0.65 to 0.95). Absolute RRs at 30 months for the secondary endpoint were -2.5% (95% CI: -0.4% to -4.7%) for stage >/=3 CKD compared with -1.7% (95% CI: 0.5% to -2.8%) with preserved kidney function. Adverse events, including estimated glomerular filtration rate decline, were infrequent and similar regardless of CKD stage. CONCLUSIONS: LDL-C lowering and relative clinical efficacy and safety of evolocumab versus placebo were consistent across CKD groups. Absolute reduction in the composite of cardiovascular death, MI, or stroke with evolocumab was numerically greater with more advanced CKD. (Further Cardiovascular Outcomes Research With PCSK9 Inhibition in Subjects With Elevated Risk [FOURIER]; NCT01764633). CI - Copyright (c) 2019 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Charytan, David M AU - Charytan DM AD - Department of Medicine, NYU Langone Medical Center, New York, New York; Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. Electronic address: david.charytan@nyulangone.org. FAU - Sabatine, Marc S AU - Sabatine MS AD - Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; TIMI Study Group, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. FAU - Pedersen, Terje R AU - Pedersen TR AD - Department of Medicine, Oslo University Hospital, Ulleval, Oslo, Norway. FAU - Im, KyungAh AU - Im K AD - Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; TIMI Study Group, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. FAU - Park, Jeong-Gun AU - Park JG AD - Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; TIMI Study Group, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. FAU - Pineda, Armando Lira AU - Pineda AL AD - Amgen, Thousand Oaks, California. FAU - Wasserman, Scott M AU - Wasserman SM AD - Amgen, Thousand Oaks, California. FAU - Deedwania, Prakash AU - Deedwania P AD - Cardiology Division, Veteran Affairs Central California Healthcare System, Fresno, California. FAU - Olsson, Anders G AU - Olsson AG AD - University of California San Francisco School of Medicine, Fresno, California. FAU - Sever, Peter S AU - Sever PS AD - Department of Medicine and Health Sciences, Linkӧping University, Linkӧping, Sweden. FAU - Keech, Anthony C AU - Keech AC AD - Department of Medicine, Imperial College London, London, United Kingdom; NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia. FAU - Giugliano, Robert P AU - Giugliano RP AD - Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; TIMI Study Group, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. Electronic address: https://twitter.com/rgiugliano. CN - FOURIER Steering Committee and Investigators LA - eng SI - ClinicalTrials.gov/NCT01764633 PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - United States TA - J Am Coll Cardiol JT - Journal of the American College of Cardiology JID - 8301365 RN - 0 (Antibodies, Monoclonal, Humanized) RN - 0 (Anticholesteremic Agents) RN - 0 (Cholesterol, LDL) RN - 0 (PCSK9 Inhibitors) RN - EC 3.4.21.- (PCSK9 protein, human) RN - EC 3.4.21.- (Proprotein Convertase 9) RN - LKC0U3A8NJ (evolocumab) SB - IM CIN - J Am Coll Cardiol. 2019 Jun 18;73(23):2971-2975. doi: 10.1016/j.jacc.2019.03.514. PMID: 31196454 EIN - J Am Coll Cardiol. 2019 Aug 27;74(8):1162-1166. doi: 10.1016/j.jacc.2019.06.041. PMID: 31439225 MH - Adult MH - Aged MH - Aged, 80 and over MH - Antibodies, Monoclonal, Humanized/adverse effects/*therapeutic use MH - Anticholesteremic Agents/adverse effects/*therapeutic use MH - Atherosclerosis/blood/drug therapy/epidemiology MH - Cardiovascular Diseases/blood/drug therapy/epidemiology MH - Cholesterol, LDL/blood MH - Double-Blind Method MH - Female MH - Follow-Up Studies MH - Humans MH - Male MH - Middle Aged MH - *PCSK9 Inhibitors MH - Proprotein Convertase 9/blood MH - Renal Insufficiency, Chronic/blood/*drug therapy/epidemiology MH - Treatment Outcome OTO - NOTNLM OT - PCSK9 OT - atherosclerosis OT - cardiovascular disease OT - cardiovascular risk OT - chronic kidney disease OT - lipids EDAT- 2019/06/15 06:00 MHDA- 2020/04/11 06:00 CRDT- 2019/06/15 06:00 PHST- 2018/11/30 00:00 [received] PHST- 2019/03/10 00:00 [revised] PHST- 2019/03/19 00:00 [accepted] PHST- 2019/06/15 06:00 [entrez] PHST- 2019/06/15 06:00 [pubmed] PHST- 2020/04/11 06:00 [medline] AID - S0735-1097(19)34903-4 [pii] AID - 10.1016/j.jacc.2019.03.513 [doi] PST - ppublish SO - J Am Coll Cardiol. 2019 Jun 18;73(23):2961-2970. doi: 10.1016/j.jacc.2019.03.513. PMID- 31192944 OWN - NLM STAT- MEDLINE DCOM- 20190626 LR - 20250604 IS - 1536-5964 (Electronic) IS - 0025-7974 (Print) IS - 0025-7974 (Linking) VI - 98 IP - 24 DP - 2019 Jun TI - Clinical efficacy and safety of percutaneous coronary intervention for acute myocardial infarction complicated with chronic renal insufficiency: A protocol of systematic review and meta-analysis. PG - e16005 LID - 10.1097/MD.0000000000016005 [doi] LID - e16005 AB - BACKGROUND: The aim of this research is to further evaluate the efficacy and safety of percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI) complicated with chronic renal insufficiency (CRI) by meta-analysis, to provide scientific and effective medical evidence for PCI in patients with AMI complicated with CRI, and to support the clinical application of PCI. METHODS: Electronic databases will be searched, including PubMed, Cochrane Library, Embase, CNKI, CBM, VIP, and Wanfang Data. Patients with AMI complicated by renal insufficiency treated with PCI will be included. The retrieval time is from inception to January 2019. The inclusion and exclusion criteria are formulated to search only the relevant literature. Endnote software management for literature will be adopted. The literature will be independently screened by 2 researchers. Excel 2016 will be applied to extract literature data with the "Research Information Registration Form." The final selected literature will be assessed for bias risk. Stata 12.0 software will be used for the meta-analysis. RESULTS: The systematic evaluation and meta-analysis will be carried out strictly in accordance with the requirements of the Cochrane System Evaluator Manual 5.3 on meta-analyses, which will provide a high-quality evaluation of the clinical efficacy and safety of PCI in patients with AMI and CRI. ETHICS AND DISSEMINATION: This study belongs to the category of systematic reviews, not clinical trials. Therefore, it does not require ethical approval. The results of this study will be published in influential international academic journals related to this topic. CONCLUSION: PCI is an effective and safe treatment for patients with AMI and CRI. This study will provide a definite evidence-based medical conclusion and provide a scientific basis for the clinical treatment of patients with AMI and CRI. PROSPERO REGISTRATION NUMBER: CRD42019131367. FAU - Luo, Liang AU - Luo L AD - NO.2 Department of Internal Medicine-Cardiovascular, Ganzhou People's Hospital. FAU - Xu, Wen-Qing AU - Xu WQ AD - NO.2 Department of Internal Medicine-Cardiovascular, Ganzhou People's Hospital. FAU - Zhong, Ri-Xiang AU - Zhong RX AD - NO.1 Department of Internal Medicine, First People's Hospital of Longnan County. FAU - Chen, Feng AU - Chen F AD - NO.2 Department of Internal Medicine-Cardiovascular, Ganzhou People's Hospital. FAU - Fu, You-Lin AU - Fu YL AD - NO.2 Department of Internal Medicine-Cardiovascular, Ganzhou People's Hospital. FAU - Zhang, Peng AU - Zhang P AD - NO.2 Department of Internal Medicine-Cardiovascular, Ganzhou People's Hospital. FAU - Xiao, Shi-Hui AU - Xiao SH AD - NO.1 Department of Internal Medicine-Cardiovascular, Ganzhou People's Hospital, Ganzhou, Jiangxi Province, 341000, China. LA - eng PT - Journal Article PL - United States TA - Medicine (Baltimore) JT - Medicine JID - 2985248R SB - IM MH - Female MH - Humans MH - Male MH - Myocardial Infarction/complications/*surgery MH - Percutaneous Coronary Intervention/adverse effects/*methods MH - Renal Insufficiency, Chronic/*etiology MH - Research Design MH - Treatment Outcome MH - Meta-Analysis as Topic MH - Systematic Reviews as Topic PMC - PMC6587819 COIS- The authors report no conflicts of interest. EDAT- 2019/06/14 06:00 MHDA- 2019/06/27 06:00 PMCR- 2019/06/14 CRDT- 2019/06/14 06:00 PHST- 2019/06/14 06:00 [entrez] PHST- 2019/06/14 06:00 [pubmed] PHST- 2019/06/27 06:00 [medline] PHST- 2019/06/14 00:00 [pmc-release] AID - 00005792-201906140-00039 [pii] AID - MD-D-19-03918 [pii] AID - 10.1097/MD.0000000000016005 [doi] PST - ppublish SO - Medicine (Baltimore). 2019 Jun;98(24):e16005. doi: 10.1097/MD.0000000000016005. PMID- 31179103 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20231011 IS - 2072-1439 (Print) IS - 2077-6624 (Electronic) IS - 2072-1439 (Linking) VI - 11 IP - 4 DP - 2019 Apr TI - Early beta-blockers administration might be associated with a reduced risk of contrast-induced acute kidney injury in patients with acute myocardial infarction. PG - 1589-1596 LID - 10.21037/jtd.2019.04.65 [doi] AB - BACKGROUND: Contrast-induced acute kidney injury (CI-AKI) is a common complication of coronary angiography (CAG), which is associated with worse prognosis. Some studies indicated beta-blockers could preserve renal function among patients with acute myocardial infarction (AMI), but the relationship between beta-blockers and CI-AKI has not been well documented among patients with AMI who were undergoing CAG or percutaneous coronary intervention (PCI). METHODS: In this prospective, observational study, 1,309 AMI patients who were undergoing CAG or PCI were consecutively recruited between January 2010 and December 2013. Patients were assigned into beta-blockers group (n=1,074) or non-beta-blockers group (n=235) according to use or non-use of beta-blockers (including metoprolol tartrate/metoprolol succinate/Bisoprolol Fumarate) within 24 hours of perioperative period. CI-AKI was defined as an absolute increase of >0.5 mg/dL from baseline serum creatinine (SCr) within 48-72 hours after contrast medium (CM) exposure. RESULTS: The overall incidence of CI-AKI was 247/1,309 (18.9%).After multivariate adjusting, a total of 10 variables were related to CI-AKI, including beta-blockers [beta-blockers group vs. non-beta-blockers group: odds ratio (OR) =0.520; 95% confidence interval (CI), 0.291-0.930; P=0.027], age, diabetes mellitus, estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m(2), left ventricular ejection fraction (LVEF) <40%, use of intra-aortic balloon pump (IABP), peri-hypotension, emergent PCI, coronary lesions and CM dose >200 mL. During the mean follow-up of 2.35+/-0.99 years, the beta-blockers group was significantly associated with lower rates of mortality [beta-blockers group vs. non-beta-blockers group: adjusted hazard ratio (HR) =0.43; 95% CI, 0.27-0.71; P=0.001] among patients with AMI. CONCLUSIONS: Use of beta-blockers within 24 hours of perioperative period may be associated with lower rates of CI-AKI and long-term mortality among patients with AMI who are undergoing CAG or PCI. TRIAL REGISTRATION: PRECOMIN, ClinicalTrials.gov NCT01400295. FAU - Liu, Jin AU - Liu J AD - Department of Cardiology, Provincial Key Laboratory of Coronary Heart Disease, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510100, China. FAU - Sun, Guoli AU - Sun G AD - Guangdong Provincial People's Hospital, Affiliated with South China University of Technology, Guangzhou 510080, China. FAU - He, Yibo AU - He Y AD - Department of Cardiology, Provincial Key Laboratory of Coronary Heart Disease, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510100, China. FAU - Song, Feier AU - Song F AD - Department of Cardiology, Provincial Key Laboratory of Coronary Heart Disease, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510100, China. FAU - Chen, Shiqun AU - Chen S AD - Department of Cardiology, Provincial Key Laboratory of Coronary Heart Disease, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510100, China. AD - Guangdong General Hospital Zhuhai Hospital, Guangdong Academy of Medical Sciences, Zhuhai 519000, China. FAU - Guo, Zhaodong AU - Guo Z AD - Department of Cardiology, Provincial Key Laboratory of Coronary Heart Disease, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510100, China. FAU - Liu, Bowen AU - Liu B AD - Guangdong Provincial People's Hospital, Affiliated with South China University of Technology, Guangzhou 510080, China. FAU - Lei, Li AU - Lei L AD - The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510080, China. FAU - He, Lihao AU - He L AD - Department of Cardiology, Provincial Key Laboratory of Coronary Heart Disease, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510100, China. FAU - Chen, Jiyan AU - Chen J AD - Department of Cardiology, Provincial Key Laboratory of Coronary Heart Disease, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510100, China. AD - Guangdong Provincial People's Hospital, Affiliated with South China University of Technology, Guangzhou 510080, China. AD - Guangdong General Hospital Zhuhai Hospital, Guangdong Academy of Medical Sciences, Zhuhai 519000, China. FAU - Tan, Ning AU - Tan N AD - Department of Cardiology, Provincial Key Laboratory of Coronary Heart Disease, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510100, China. AD - Guangdong Provincial People's Hospital, Affiliated with South China University of Technology, Guangzhou 510080, China. AD - Guangdong General Hospital Zhuhai Hospital, Guangdong Academy of Medical Sciences, Zhuhai 519000, China. FAU - Liu, Yong AU - Liu Y AD - Department of Cardiology, Provincial Key Laboratory of Coronary Heart Disease, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510100, China. AD - Guangdong Provincial People's Hospital, Affiliated with South China University of Technology, Guangzhou 510080, China. LA - eng SI - ClinicalTrials.gov/NCT01400295 PT - Journal Article PL - China TA - J Thorac Dis JT - Journal of thoracic disease JID - 101533916 CIN - J Thorac Dis. 2019 Jul;11(7):2689-2694. doi: 10.21037/jtd.2019.06.53. PMID: 31463094 PMC - PMC6531699 OTO - NOTNLM OT - acute myocardial infarction (AMI) OT - contrast-induced acute kidney injury (CI-AKI) OT - coronary angiography (CAG) OT - mortality OT - beta-blockers COIS- Conflicts of Interest: The authors have no conflicts of interest to declare. EDAT- 2019/06/11 06:00 MHDA- 2019/06/11 06:01 PMCR- 2019/04/01 CRDT- 2019/06/11 06:00 PHST- 2019/06/11 06:00 [entrez] PHST- 2019/06/11 06:00 [pubmed] PHST- 2019/06/11 06:01 [medline] PHST- 2019/04/01 00:00 [pmc-release] AID - jtd-11-04-1589 [pii] AID - 10.21037/jtd.2019.04.65 [doi] PST - ppublish SO - J Thorac Dis. 2019 Apr;11(4):1589-1596. doi: 10.21037/jtd.2019.04.65. PMID- 31167654 OWN - NLM STAT- MEDLINE DCOM- 20200224 LR - 20260127 IS - 1475-2840 (Electronic) IS - 1475-2840 (Linking) VI - 18 IP - 1 DP - 2019 Jun 6 TI - Cardiovascular risk reduction with once-weekly semaglutide in subjects with type 2 diabetes: a post hoc analysis of gender, age, and baseline CV risk profile in the SUSTAIN 6 trial. PG - 73 LID - 10.1186/s12933-019-0871-8 [doi] LID - 73 AB - BACKGROUND: The SUSTAIN 6 trial demonstrated that once-weekly semaglutide (0.5 and 1.0 mg) significantly reduced major adverse cardiovascular (CV) events (MACE) vs placebo in subjects with type 2 diabetes (T2D) and high CV risk. The effects of gender, age and baseline CV risk on outcomes are important considerations for further study. METHODS: Subjects were grouped according to gender, age (50-65 years and > 65 years), and CV risk profile at baseline (prior myocardial infarction [MI] or stroke vs no prior MI or stroke, and established CV disease [CVD] vs CV risk factors alone, including subjects with chronic kidney disease). Time to MACE and its individual components (CV death, nonfatal MI, nonfatal stroke), hospitalization for unstable angina or heart failure, and revascularization (coronary and peripheral) were analyzed for all subgroups. Additional analyses were performed for gender and age to investigate change from baseline in HbA(1c) and body weight, as well as tolerability. RESULTS: A total of 3297 subjects were included. The majority of subjects (60.7%) were male; 43% were > 65 years of age; 41.5% had a history of MI or stroke; and 76.8% had established CVD. Compared with placebo, semaglutide reduced the risk of the first occurrence of MACE and each MACE component consistently across all subgroups (gender, age, and baseline CV risk profile). Revascularizations, HbA(1c) and body weight were also reduced consistently across all subgroups compared with placebo. Gastrointestinal adverse events in all treatment groups were more common among women than men, but rates of premature treatment discontinuation were similar for both genders. CONCLUSIONS: In this post hoc analysis of SUSTAIN 6, once-weekly semaglutide vs placebo reduced the risk of MACE in all subjects included in the trial, regardless of gender, age, or baseline CV risk profile. Trial registry Clinicaltrials.gov, Identifying number: NCT01720446, Date of registration: October 29, 2012. FAU - Leiter, Lawrence A AU - Leiter LA AD - Division of Endocrinology and Metabolism, Li Ka Shing Knowledge Institute, St. Michael's Hospital, University of Toronto, 61 Queen St. East #6121, Toronto, ON, M5C 2T2, Canada. leiterl@smh.ca. FAU - Bain, Stephen C AU - Bain SC AD - Diabetes Research Unit Cymru, Swansea University Medical School, Swansea, Wales, UK. FAU - Hramiak, Irene AU - Hramiak I AD - University of Western Ontario, London, ON, Canada. FAU - Jodar, Esteban AU - Jodar E AD - Hospital Universitario Quironsalud, Madrid, Spain. FAU - Madsbad, Sten AU - Madsbad S AD - University of Copenhagen, Hvidovre, Denmark. FAU - Gondolf, Theis AU - Gondolf T AD - Novo Nordisk A/S, Soborg, Denmark. FAU - Hansen, Thomas AU - Hansen T AD - Novo Nordisk A/S, Soborg, Denmark. FAU - Holst, Ingrid AU - Holst I AD - Novo Nordisk A/S, Soborg, Denmark. FAU - Lingvay, Ildiko AU - Lingvay I AD - UT Southwestern Medical Center, Dallas, TX, USA. LA - eng SI - ClinicalTrials.gov/NCT01720446 PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20190606 PL - England TA - Cardiovasc Diabetol JT - Cardiovascular diabetology JID - 101147637 RN - 62340-29-8 (Glucagon-Like Peptides) RN - 0 (Hypoglycemic Agents) RN - 0 (Incretins) RN - 53AXN4NNHX (Semaglutide) SB - IM MH - Age Factors MH - Aged MH - Cardiovascular Diseases/diagnosis/mortality/*prevention & control MH - Clinical Trials, Phase III as Topic MH - Diabetes Mellitus, Type 2/diagnosis/*drug therapy/mortality MH - Drug Administration Schedule MH - Female MH - Glucagon-Like Peptides/*administration & dosage/adverse effects MH - Humans MH - Hypoglycemic Agents/*administration & dosage/adverse effects MH - Incretins/*administration & dosage/adverse effects MH - Male MH - Middle Aged MH - Protective Factors MH - Randomized Controlled Trials as Topic MH - Risk Assessment MH - Risk Factors MH - Sex Factors MH - Time Factors MH - Treatment Outcome MH - Semaglutide PMC - PMC6551895 OTO - NOTNLM OT - Age OT - Baseline cardiovascular risk OT - Cardiovascular events OT - Cardiovascular outcome trial OT - Gender OT - SUSTAIN 6 OT - Semaglutide OT - Type 2 diabetes COIS- During the conduct of the study, L.A.L. received research grants to his institution from Novo Nordisk. Outside of the submitted work, he has received grants and/or personal fees for advisory panels, speakers' bureaus, and research support from AstraZeneca, Boehringer Ingelheim, Eli Lilly, Janssen Pharmaceuticals, Merck, Novo Nordisk, and Sanofi. He also reports research grants from GlaxoSmithKline and personal fees for advisory panels from Servier. Outside the submitted work, S.C.B. has received honoraria, teaching, and research sponsorship/grants from Abbott, AstraZeneca, Boehringer Ingelheim, Cellnovo, Eli Lilly, Merck Sharp & Dohme, Novo Nordisk, and Sanofi-aventis, Cardiff University, Doctors.net, Elsevier, Onmedica, Omnia-Med, Medscape, All-Wales Medicines Strategy Group, National Institute for Health and Care Excellence (NICE) UK, and Glycosmedia. Outside the submitted work, I.H. reports research grants and/or personal fees from AstraZeneca/Bristol-Myers Squibb, Boehringer Ingelheim, Dexcom, Eli Lilly, GlaxoSmithKline, Insulet Corp, Janssen Pharmaceuticals, Lexicon Pharmaceuticals, Medtronic, Merck & Co Inc, Population Health Research Institute, Roche Pharma, Sanofi, and Takeda. E.J. reports grants and personal fees from Novo Nordisk during the conduct of the study. He also reports grants and personal fees as a consultant and/or speaker from Amgen, AstraZeneca, Boehringer Ingelheim, Faes Farma, Fresenius, Janssen Pharmaceuticals, Eli Lilly, Merck Sharp & Dohme, Novartis, Novo Nordisk, Pfizer, Sanofi, Shire, and UCB. Outside of the submitted work, S.M. has received honoraria and/or lecture fees from AstraZeneca, Boehringer Ingelheim, Bristol-Meyers Squibb, Eli Lilly, Intarcia Therapeutics, Johnson & Johnson, Merck Sharp & Dohme, Novartis, Novo Nordisk, and Sanofi Aventis. He has also received a research grant from Novo Nordisk and Boehringer Ingelheim. T.G., T.H., and I.H. report that they are full-time employees of Novo Nordisk A/S. I.L. received research grants to her institution and consulting fees from Novo Nordisk during the conduct of the study. Outside the submitted work, she has received grants and/or personal fees from AstraZeneca, Boehringer Ingelheim, Eli Lilly, GI Dynamics, Intarcia, Mannkind, Merck, Mylan, Novartis, NovoNordisk, Pfizer, Sanofi, TARGETPharma, and Valeritas. EDAT- 2019/06/07 06:00 MHDA- 2020/02/25 06:00 PMCR- 2019/06/06 CRDT- 2019/06/07 06:00 PHST- 2019/03/31 00:00 [received] PHST- 2019/05/17 00:00 [accepted] PHST- 2019/06/07 06:00 [entrez] PHST- 2019/06/07 06:00 [pubmed] PHST- 2020/02/25 06:00 [medline] PHST- 2019/06/06 00:00 [pmc-release] AID - 10.1186/s12933-019-0871-8 [pii] AID - 871 [pii] AID - 10.1186/s12933-019-0871-8 [doi] PST - epublish SO - Cardiovasc Diabetol. 2019 Jun 6;18(1):73. doi: 10.1186/s12933-019-0871-8. PMID- 31165573 OWN - NLM STAT- MEDLINE DCOM- 20200901 LR - 20200901 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 94 IP - 7 DP - 2019 Dec 1 TI - Etiologies, trends, and predictors of readmission in ST-elevation myocardial infarction patients undergoing multivessel percutaneous coronary intervention. PG - 905-914 LID - 10.1002/ccd.28344 [doi] AB - BACKGROUND: Recent trials have shown benefits with percutaneous coronary intervention (PCI) on nonculprit coronary vessels in select ST-elevation myocardial infarction (STEMI) patients with multivessel coronary artery disease (CAD). However, readmission rates and causes in this high-risk group are unknown. Objective of this study is to explore pattern, causes and factors associated with 30-day readmission after multivessel PCI in STEMI patients. METHODS AND RESULTS: Nationwide Readmissions Data (NRD) between 2010 and 2014 was utilized to identify multivessel PCI cases in STEMI patients using appropriate ICD-9 codes. We evaluated 30-day readmission rate and factors associated with 30-day readmission. Hierarchical logistic regression model was used to identify factors associated with 30-day readmission. Among 22,257 STEMI patients who survived to discharge after multivessel PCI, 2,302 (10.3%) were readmitted within 30-days. Subsequent unresolved/aggravated cardiac issues most commonly triggered readmission (62.66%). Among cardiac causes, heart failure and ischemic heart disease were most frequent etiologies. Advancing age (OR: 1.073, 95%CI: 1.026 to 1.122, p = .002), female sex (OR: 1.36, 95%CI: 1.23 to 1.50, p < .001), comorbid conditions like chronic kidney disease (CKD; OR: 1.35, 95%CI: 1.17 to 1.57, p = .001), congestive heart failure (CHF; OR: 1.40, 95%CI: 1.24 to 1.57, p = .04), anemia (OR: 1.16, 95%CI: 1.002 to 1.34, p = .04), and utilization of a mechanical circulatory support (MCS) device (OR: 1.45, 95%CI: 1.19 to 1.77, p < .001) during the index procedure were predictive of subsequent readmission within 30 days. CONCLUSION: In this large nationally representative study, nearly one in 10 patients were readmitted within 30 days from discharge after index admission for multivessel PCI in STEMI, most commonly for cardiac causes. CI - (c) 2019 Wiley Periodicals, Inc. FAU - Tripathi, Byomesh AU - Tripathi B AUID- ORCID: 0000-0003-3025-7715 AD - Division of Cardiology, Banner University Medical Center, University of Arizona, Phoenix, Arizona. FAU - Yeh, Robert W AU - Yeh RW AD - Division of Cardiovascular Medicine, Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts. FAU - Bavishi, Chirag P AU - Bavishi CP AUID- ORCID: 0000-0001-6405-1606 AD - Division of Cardiology, Cardiovascular Institute, Warren Alpert Medical School at Brown University, Providence, Rhode Island. FAU - Sardar, Partha AU - Sardar P AD - Division of Cardiology, Cardiovascular Institute, Warren Alpert Medical School at Brown University, Providence, Rhode Island. FAU - Atti, Varunsiri AU - Atti V AUID- ORCID: 0000-0002-0151-1545 AD - Department of Medicine, Michigan State University, East Lansing, Michigan. FAU - Mukherjee, Debabrata AU - Mukherjee D AD - Division of Cardiology, Texas Tech University Health Sciences Center, El Paso, Texas. FAU - Bashir, Riyaz AU - Bashir R AD - Division of Cardiology, Temple University Hospital, Philadelphia, Pennsylvania. FAU - Abbott, Jinnette Dawn AU - Abbott JD AUID- ORCID: 0000-0002-2560-0155 AD - Division of Cardiology, Cardiovascular Institute, Warren Alpert Medical School at Brown University, Providence, Rhode Island. FAU - Giri, Jay AU - Giri J AD - Cardiovascular Medicine Division, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania. FAU - Chatterjee, Saurav AU - Chatterjee S AUID- ORCID: 0000-0002-1241-5030 AD - Division of Cardiovascular Medicine, Hoffman Heart Institute, Saint Francis Hospital, Teaching Affiliate of the University of Connecticut School of Medicine, Hartford, Connecticut. LA - eng PT - Journal Article PT - Multicenter Study PT - Observational Study DEP - 20190604 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM CIN - Catheter Cardiovasc Interv. 2019 Dec 1;94(7):915-916. doi: 10.1002/ccd.28604. PMID: 31793179 MH - Aged MH - Coronary Artery Disease/diagnostic imaging/*therapy MH - Databases, Factual MH - Female MH - Humans MH - Male MH - Middle Aged MH - Patient Readmission/*trends MH - Percutaneous Coronary Intervention/adverse effects/*trends MH - Risk Assessment MH - Risk Factors MH - ST Elevation Myocardial Infarction/diagnostic imaging/*therapy MH - Time Factors MH - Treatment Outcome MH - United States OTO - NOTNLM OT - Acute myocardial infarction (AMI)/STEMI OT - coronary artery disease OT - percutaneous coronary intervention (PCI) EDAT- 2019/06/06 06:00 MHDA- 2020/09/02 06:00 CRDT- 2019/06/06 06:00 PHST- 2019/05/10 00:00 [received] PHST- 2019/05/16 00:00 [accepted] PHST- 2019/06/06 06:00 [pubmed] PHST- 2020/09/02 06:00 [medline] PHST- 2019/06/06 06:00 [entrez] AID - 10.1002/ccd.28344 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2019 Dec 1;94(7):905-914. doi: 10.1002/ccd.28344. Epub 2019 Jun 4. PMID- 31140334 OWN - NLM STAT- MEDLINE DCOM- 20200831 LR - 20210109 IS - 2047-9980 (Electronic) IS - 2047-9980 (Linking) VI - 8 IP - 11 DP - 2019 Jun 4 TI - hsCRP Level and the Risk of Death or Recurrent Cardiovascular Events in Patients With Myocardial Infarction: a Healthcare-Based Study. PG - e012638 LID - 10.1161/JAHA.119.012638 [doi] LID - e012638 AB - Background Beyond the controlled setting of trials, scarce information exists on the burden, predictors, and outcomes associated with elevated hs CRP (high-sensitivity C-reactive protein) in "real-world" patients with myocardial infarction ( MI ). Methods and Results We included all-coming MI survivors undergoing hs CRP testing >30 days after an MI during routine health care in Stockholm, Sweden (2006-2011). hs CRP tests measured during hospitalization/emergency department visits, followed by antibiotics or indicative of acute illness, were excluded, together with patients with ongoing/recent cancer, chronic infections, or immunosuppression. Inflammation was defined over a 3-month baseline window and associated with subsequent death and major adverse cardiovascular events (composite of MI, ischemic stroke, or cardiovascular death). Included were 17 464 patients (63% men; mean age, 72.6 years) with a median hs CRP level of 2.2 (interquartile range, 1.0-6.0) mg/L and a median of 2.2 (interquartile range, 0.8-4.9) years since their MI . Most (66%) had hs CRP >/=2 mg/L, and 40% had hs CRP >3 mg/L. Lower hemoglobin, lower estimated glomerular filtration rate, and comorbidities (eg, heart failure, peripheral vascular disease, stroke, atrial fibrillation, diabetes mellitus, and rheumatoid diseases) were associated with higher odds of hs CRP >/=2 mg/L. Conversely, previous percutaneous coronary intervention, ongoing renin-angiotensin blockade, and statins were associated with lower hs CRP >/=2 mg/L odds. Patients with hs CRP >/=2 mg/L were at higher risk of major adverse cardiovascular events (n=3900; adjusted hazard ratio, 1.28; 95% CI, 1.18-1.38) and death (n=4138; adjusted hazard ratio, 1.42; 95% CI, 1.31-1.53). Results were robust across subgroups of patients and after exclusion of events occurring during the first 6 to 12 months. On a continuous scale, the association between hs CRP and outcomes was linear until hs CRP >5 mg/L, plateauing thereafter. Conclusions Most patients with MI exhibit elevated hs CRP levels. Besides identifying populations at high-inflammatory risk, this study extends the prognostic validity of this biomarker from trial evidence to real-world healthcare settings. FAU - Carrero, Juan Jesus AU - Carrero JJ AD - 1 Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden. FAU - Andersson Franko, Mikael AU - Andersson Franko M AD - 1 Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden. FAU - Obergfell, Achim AU - Obergfell A AD - 2 Novartis Pharma AG Zurich Switzerland. FAU - Gabrielsen, Anders AU - Gabrielsen A AD - 3 Cardiovascular Medicine Unit Department of Medicine Solna Karolinska University Hospital Solna Karolinska Institutet Stockholm Sweden. FAU - Jernberg, Tomas AU - Jernberg T AD - 4 Department of Clinical Sciences Danderyd University Hospital Karolinska Institutet Stockholm Sweden. LA - eng PT - Journal Article PT - Observational Study PT - Research Support, Non-U.S. Gov't DEP - 20190529 PL - England TA - J Am Heart Assoc JT - Journal of the American Heart Association JID - 101580524 RN - 0 (Biomarkers) RN - 0 (Inflammation Mediators) RN - 9007-41-4 (C-Reactive Protein) SB - IM MH - Aged MH - Aged, 80 and over MH - Biomarkers/blood MH - C-Reactive Protein/*analysis MH - Cause of Death MH - Emergency Service, Hospital MH - Female MH - Hospitalization MH - Humans MH - Inflammation Mediators/*blood MH - Male MH - Middle Aged MH - Myocardial Infarction/*blood/diagnosis/*mortality/therapy MH - Predictive Value of Tests MH - Prognosis MH - Recurrence MH - Risk Assessment MH - Risk Factors MH - Sweden/epidemiology MH - Time Factors PMC - PMC6585357 OTO - NOTNLM OT - acute coronary syndrome OT - inflammation OT - monitoring OT - outcome EDAT- 2019/05/30 06:00 MHDA- 2020/09/01 06:00 PMCR- 2019/06/04 CRDT- 2019/05/30 06:00 PHST- 2019/05/30 06:00 [entrez] PHST- 2019/05/30 06:00 [pubmed] PHST- 2020/09/01 06:00 [medline] PHST- 2019/06/04 00:00 [pmc-release] AID - JAH34154 [pii] AID - 10.1161/JAHA.119.012638 [doi] PST - ppublish SO - J Am Heart Assoc. 2019 Jun 4;8(11):e012638. doi: 10.1161/JAHA.119.012638. Epub 2019 May 29. PMID- 31116913 OWN - NLM STAT- MEDLINE DCOM- 20200706 LR - 20200706 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 93 IP - 7 DP - 2019 Jun 1 TI - Impact of intravascular ultrasound-guided drug-eluting stent implantation on patients with chronic kidney disease: Results from ULTIMATE trial. PG - 1184-1193 LID - 10.1002/ccd.28308 [doi] AB - OBJECTIVES: This study aimed to investigate the impacts of intravascular ultrasound (IVUS)-guided drug-eluting stent (DES) implantation on patients with chronic kidney disease (CKD) based on the ULTIMATE trial. BACKGROUND: IVUS-guided DES implantation improves clinical outcomes in complex lesions. However, routine IVUS guidance in patients with CKD remains controversial. METHODS: CKD was defined as an estimated glomerular filtration rate (eGFR) <60 mL min(-1) 1.73 m(-2) . The primary end point was target vessel failure (TVF) at 12 months, including cardiac death, target vessel myocardial infarction, and clinically driven target vessel revascularization. RESULTS: eGFR was available in 1,443 patients, of whom 723 were in the IVUS guidance group, and 720 were in the angiography guidance group. Finally, CKD was present in 349 (24.2%) patients. At 12 months, TVF in the CKD group was 7.2%, which was significantly higher than 3.2% in the non-CKD group (p = .001). Moreover, there were 25 TVFs in the CKD patients, with 7 (3.9%) TVFs in the IVUS group and 18 (10.7%) TVFs in the angiography group (hazard ratio [HR]: 0.35; 95% confidence interval [CI]: 0.15-0.84; p = .01), whereas 35 TVFs occurred in patients without CKD, with 14 (2.6%) TVFs in the IVUS group and 21 (3.8%) TVFs in the angiography group (HR: 0.67; 95% CI: 0.34-1.32; p = .25; p for interaction = .24). CONCLUSIONS: This study demonstrated that CKD patients undergoing DES implantations were associated with a higher risk of TVF at 12 months. More importantly, the risk of TVF in the CKD patients could be significantly decreased through IVUS guidance. CLINICAL TRIAL: NCT02215915. CI - (c) 2019 Wiley Periodicals, Inc. FAU - Zhang, Junjie AU - Zhang J AD - Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China. FAU - Gao, Xiaofei AU - Gao X AD - Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China. FAU - Ge, Zhen AU - Ge Z AD - Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China. FAU - Han, Leng AU - Han L AD - Department of Cardiology, Changshu No. 1 People's Hospital, Changshu, China. FAU - Lu, Shu AU - Lu S AD - Department of Cardiology, The First People's Hospital of Taicang, Taicang, China. FAU - Qian, Xuesong AU - Qian X AD - Department of Cardiology, The First People's Hospital of Zhangjiagang, Zhangjiagang, China. FAU - Li, Qihua AU - Li Q AD - Department of Cardiology, Changzhou Traditional Chinese Medicine Hospital, Changzhou, China. FAU - Lu, Qinghua AU - Lu Q AD - Department of Cardiology, The Second Hospital of Shandong University, Jinan, China. FAU - Chen, Chonghao AU - Chen C AD - Department of Cardiology, Wuxi Third People's Hospital, Wuxi, China. FAU - Chen, Shao-Liang AU - Chen SL AD - Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China. CN - ULTIMATE Investigators LA - eng SI - ClinicalTrials.gov/NCT02215915 GR - YKK16124/Nanjing Health and Family Planning Commission/ GR - QRX17017/Nanjing Health Youth Talent Training Project/ GR - 201715026/Nanjing Municipal Commission of Science & Technology/ GR - 81270191/National Natural Science Foundation of China/ GR - 91439118/National Natural Science Foundation of China/ GR - 91639303/National Natural Science Foundation of China/ GR - 2014-WSN-058/Six Talent Peaks Project in Jiangsu Province/ PT - Comparative Study PT - Journal Article PT - Multicenter Study DEP - 20190522 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Acute Kidney Injury/diagnosis/etiology/physiopathology MH - Aged MH - Aged, 80 and over MH - China MH - *Coronary Angiography/adverse effects MH - Coronary Artery Disease/complications/diagnostic imaging/*therapy MH - *Drug-Eluting Stents MH - Female MH - *Glomerular Filtration Rate/drug effects MH - Humans MH - Kidney/drug effects/*physiopathology MH - Male MH - Middle Aged MH - Percutaneous Coronary Intervention/adverse effects/*instrumentation MH - Predictive Value of Tests MH - Prospective Studies MH - Randomized Controlled Trials as Topic MH - Renal Insufficiency, Chronic/*complications/diagnosis/physiopathology MH - Risk Factors MH - Time Factors MH - Treatment Outcome MH - *Ultrasonography, Interventional/adverse effects OTO - NOTNLM OT - angiography OT - chronic kidney disease OT - drug-eluting stent OT - intravascular ultrasound OT - target vessel failure EDAT- 2019/05/23 06:00 MHDA- 2020/07/07 06:00 CRDT- 2019/05/23 06:00 PHST- 2019/04/08 00:00 [received] PHST- 2019/04/10 00:00 [accepted] PHST- 2019/05/23 06:00 [pubmed] PHST- 2020/07/07 06:00 [medline] PHST- 2019/05/23 06:00 [entrez] AID - 10.1002/ccd.28308 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2019 Jun 1;93(7):1184-1193. doi: 10.1002/ccd.28308. Epub 2019 May 22. PMID- 31079414 OWN - NLM STAT- MEDLINE DCOM- 20191220 LR - 20221207 IS - 2567-689X (Electronic) IS - 0340-6245 (Linking) VI - 119 IP - 7 DP - 2019 Jul TI - Development and Validation of an Ischemic and Bleeding Risk Evaluation Tool in East Asian Patients Receiving Percutaneous Coronary Intervention. PG - 1182-1193 LID - 10.1055/s-0039-1688792 [doi] AB - BACKGROUND: The ischemic/bleeding risk of dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) is still uncertain. We sought to develop a tool to predict ischemic and bleeding events in East Asians receiving 2nd generation drug-eluting stents (DESs) PCI. METHODS: A pooled cohort of 13,172 East Asian patients receiving PCI with 2nd generation DES (the Grand DES cohort) was analyzed to develop a scoring system. A net score was calculated by subtracting the bleeding score from the ischemic score. External validation was performed in the HOST-ASSURE and NIPPON trials. RESULTS: Among the total population, ischemic and bleeding events occurred in 195 patients (1.5%) and 166 patients (1.3%), respectively. The score to predict ischemic events included previous myocardial infarction (MI) or PCI, presentation as acute MI, anemia, stent diameter < 3 mm, and total stent length of >/=30 mm, while that for bleeding events included older age, low creatinine clearance, and anemia. C-statistics of the ischemic and bleeding model was 0.708 and 0.665, respectively. Patients with a net score of >/=1 had a higher ischemic risk compared with bleeding risk, and patients with a net score of /= 12 and /= 70 mg/dL or non-HDL cholesterol >/= 100 mg/dL, triglycerides 6.7 mm(2) ). LOCE was observed in 16/288 (5.6%), 15/265 (5.7%), and 8/266 (3.0%) (P = 0.266). Target lesion revascularization (TLR) was observed in 16/288(5.6%), 12/265 (4.5%), and 4/266 (1.5%) (P = 0.042). The multivariate analysis demonstrated that smaller post-procedural MSA, as well as creatinine clearance, history of previous stroke, chronic total occlusion, and lesion SYNTAX Score was an independent predictor of TLR. CONCLUSIONS: In the SYNTAX II trial, larger post-procedural MSA was independently associated with the lower rate of TLR at 2 years. CI - (c) 2019 Wiley Periodicals, Inc. FAU - Katagiri, Yuki AU - Katagiri Y AD - Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. FAU - De Maria, Giovanni Luigi AU - De Maria GL AUID- ORCID: 0000-0003-3572-1855 AD - Department of Cardiology, John Radcliffe Hospital, Oxford, United Kingdom. FAU - Kogame, Norihiro AU - Kogame N AD - Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. FAU - Chichareon, Ply AU - Chichareon P AD - Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. FAU - Takahashi, Kuniaki AU - Takahashi K AD - Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. FAU - Chang, Chun Chin AU - Chang CC AUID- ORCID: 0000-0003-2799-1185 AD - ThoraxCenter, Erasmus Medical Center, Rotterdam, The Netherlands. FAU - Modolo, Rodrigo AU - Modolo R AD - Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. FAU - Walsh, Simon AU - Walsh S AD - Department of Cardiology, Belfast Health & Social Care Trust, Belfast, United Kingdom. FAU - Sabate, Manel AU - Sabate M AD - Thorax Institute, Hospital Clinic I Provincial de Barcelona, Barcelona, Spain. FAU - Davies, Justin AU - Davies J AD - Department of Cardiology, Imperial College London, London, United Kingdom. FAU - Lesiak, Maciej AU - Lesiak M AD - 1st Department of Cardiology, University of Medical Sciences, Poznan, Poland. FAU - Moreno, Raul AU - Moreno R AD - Department of Cardiology, Hospital Universitario la Paz, Madrid, Spain. FAU - Cruz-Gonzalez, Ignacio AU - Cruz-Gonzalez I AD - Department of Cardiology, Hospital Universitario de Salamanca, Salamanca, Spain. FAU - West, Nick E J AU - West NEJ AD - Department of Interventional Cardiology, Royal Papworth Hospital, Cambridge, United Kingdom. FAU - Piek, Jan J AU - Piek JJ AUID- ORCID: 0000-0001-8666-7129 AD - Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. FAU - Wykrzykowska, Joanna J AU - Wykrzykowska JJ AD - Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. FAU - Farooq, Vasim AU - Farooq V AD - Manchester Heart Centre, Manchester Royal Infirmary, Central Manchester University Hospitals, Manchester, United Kingdom. FAU - Escaned, Javier AU - Escaned J AD - Hospital Cliinico San Carlos IDISSC and Universidad Complutense de Madrid, Madrid, Spain. FAU - Banning, Adrian P AU - Banning AP AD - Department of Cardiology, John Radcliffe Hospital, Oxford, United Kingdom. FAU - Onuma, Yoshinobu AU - Onuma Y AD - ThoraxCenter, Erasmus Medical Center, Rotterdam, The Netherlands. FAU - Serruys, Patrick W AU - Serruys PW AUID- ORCID: 0000-0002-9636-1104 AD - NHLI, Imperial College London, London, United Kingdom. LA - eng PT - Clinical Trial PT - Journal Article PT - Multicenter Study DEP - 20190131 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Aged MH - Coronary Artery Disease/diagnostic imaging/mortality/*therapy MH - *Drug-Eluting Stents MH - Europe MH - Female MH - Humans MH - Male MH - Middle Aged MH - Percutaneous Coronary Intervention/adverse effects/*instrumentation/mortality MH - Risk Assessment MH - Risk Factors MH - Time Factors MH - Treatment Outcome MH - Ultrasonography, Interventional OTO - NOTNLM OT - coronary artery disease OT - imaging, intravascular ultrasound OT - stent, drug eluting EDAT- 2019/02/01 06:00 MHDA- 2020/04/15 06:00 CRDT- 2019/02/01 06:00 PHST- 2018/09/21 00:00 [received] PHST- 2018/12/11 00:00 [revised] PHST- 2019/01/02 00:00 [accepted] PHST- 2019/02/01 06:00 [pubmed] PHST- 2020/04/15 06:00 [medline] PHST- 2019/02/01 06:00 [entrez] AID - 10.1002/ccd.28105 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2019 Mar 1;93(4):E225-E234. doi: 10.1002/ccd.28105. Epub 2019 Jan 31. PMID- 30690854 OWN - NLM STAT- MEDLINE DCOM- 20200803 LR - 20200803 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 94 IP - 2 DP - 2019 Aug 1 TI - Predictors of mortality in patients with non-anterior ST-segment elevation myocardial infarction: Analysis from the HORIZONS-AMI trial. PG - 172-180 LID - 10.1002/ccd.28096 [doi] AB - OBJECTIVES: We sought to identify clinical, electrocardiographic (ECG), and angiographic characteristics that are predictive of 3-year mortality after primary percutaneous coronary intervention (PCI) in patients with non-anterior ST-elevation myocardial infarction (NA-STEMI) from the Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI) trial. BACKGROUND: Which patients with NA-STEMI undergoing PCI have a poor prognosis is uncertain. METHODS: NA-STEMI was defined as ST-segment elevation in lateral (V5, V6, I, aVL), inferior (II, III, aVF), or inferolateral (I, II, III, aVF, and V5-V6) ECG leads or posterior myocardial infarction with ST-segment depression of >/=1 mm in >/=2 contiguous anterior leads. Cox regression was used to identify independent predictors of 3-year mortality. Missing data were imputed using multiple imputation. RESULTS: In HORIZONS-AMI, 2,578/3,602 patients had no prior coronary artery bypass grafting, underwent single-vessel PCI, and had baseline ECG data assessed in an independent core laboratory. Among them, 1,495 (58.0%) had NA-STEMI. Patients with NA-STEMI had lower 3-year mortality risk than those with anterior STEMI (4.5% versus 7.1%, P = 0.004). The independent predictors of increased 3-year mortality in NA-STEMI were older age (median > 59.0 years), diabetes, reduced LVEF (/=2, post-procedure TIMI flow 0-2 versus 3, renal insufficiency, and ST-resolution <30% at 60 min post-PCI. Patients with 0, 1, 2, 3, and >/=4 of these risk factors had 3-year mortality rates of 1.8%, 2.3%, 3.1%, 6.1%, and 36.3%, respectively (P < 0.0001). CONCLUSIONS: Although NA-STEMI carries a better prognosis than anterior STEMI, high-risk patient cohorts with NA-STEMI may be identified who have substantial 3-year mortality. CI - (c) 2019 Wiley Periodicals, Inc. FAU - Huang, Xin AU - Huang X AD - Clinical Trials Center, Cardiovascular Research Foundation, New York, New York. AD - Department of Cardiology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China. FAU - Redfors, Bjorn AU - Redfors B AD - Clinical Trials Center, Cardiovascular Research Foundation, New York, New York. AD - Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden. FAU - Chen, Shmuel AU - Chen S AD - Clinical Trials Center, Cardiovascular Research Foundation, New York, New York. FAU - Gersh, Bernard J AU - Gersh BJ AD - Cardiovascular Division, Mayo Clinic, Rochester, Minnesota. FAU - Mehran, Roxana AU - Mehran R AUID- ORCID: 0000-0002-5546-262X AD - Clinical Trials Center, Cardiovascular Research Foundation, New York, New York. AD - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York. FAU - Zhang, Yiran AU - Zhang Y AD - Clinical Trials Center, Cardiovascular Research Foundation, New York, New York. FAU - McAndrew, Thomas AU - McAndrew T AD - Clinical Trials Center, Cardiovascular Research Foundation, New York, New York. FAU - Ben-Yehuda, Ori AU - Ben-Yehuda O AD - Clinical Trials Center, Cardiovascular Research Foundation, New York, New York. AD - Division of Cardiology, NewYork-Presbyterian Hospital/Columbia University Medical Center, New York, New York. FAU - Mintz, Gary S AU - Mintz GS AD - Clinical Trials Center, Cardiovascular Research Foundation, New York, New York. FAU - Stone, Gregg W AU - Stone GW AD - Clinical Trials Center, Cardiovascular Research Foundation, New York, New York. AD - Division of Cardiology, NewYork-Presbyterian Hospital/Columbia University Medical Center, New York, New York. LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20190128 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Aged MH - Coronary Angiography MH - Electrocardiography MH - Female MH - Humans MH - Male MH - Middle Aged MH - Percutaneous Coronary Intervention/adverse effects/instrumentation/*mortality MH - Predictive Value of Tests MH - Prospective Studies MH - Risk Assessment MH - Risk Factors MH - ST Elevation Myocardial Infarction/diagnostic imaging/*mortality/*therapy MH - Stents MH - Time Factors MH - Treatment Outcome OTO - NOTNLM OT - non-anterior ST-segment elevation myocardial infarction OT - primary percutaneous coronary intervention EDAT- 2019/01/29 06:00 MHDA- 2020/08/04 06:00 CRDT- 2019/01/29 06:00 PHST- 2018/09/11 00:00 [received] PHST- 2018/12/14 00:00 [revised] PHST- 2019/01/02 00:00 [accepted] PHST- 2019/01/29 06:00 [pubmed] PHST- 2020/08/04 06:00 [medline] PHST- 2019/01/29 06:00 [entrez] AID - 10.1002/ccd.28096 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2019 Aug 1;94(2):172-180. doi: 10.1002/ccd.28096. Epub 2019 Jan 28. PMID- 30681262 OWN - NLM STAT- MEDLINE DCOM- 20200803 LR - 20200803 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 94 IP - 2 DP - 2019 Aug 1 TI - Impact of calcification on percutaneous coronary intervention: MACE-Trial 1-year results. PG - 187-194 LID - 10.1002/ccd.28099 [doi] AB - OBJECTIVES: The Multi-center Prospective Study to Evaluate Outcomes of Moderate to Severely Calcified Coronary Lesions (MACE-Trial) was designed to provide further insight on the impact of calcification on procedural and long-term percutaneous coronary intervention outcomes. BACKGROUND: Prior studies evaluating the impact of lesion calcification on percutaneous coronary intervention outcomes are limited by: retrospective nature, pooled data from multiple studies, or lack of specificity around calcification with only operator assessment and without core lab evaluation. METHODS: The MACE-Trial was a prospective, multicenter, observational clinical study that enrolled 350 subjects at 33 sites from September 2013 to September 2015. Core lab assessed subject stratification by lesion calcification (none/mild [N = 133], moderate [N = 99], and severe [N = 114]). Endpoints were lesion success, procedural success, and 1-year major adverse cardiac events (MACEs). RESULTS: Presence of severe calcification had significant impact on lesion success ([83.3%] versus none/mild calcification [94.7%, P = 0.006]) and procedural success ([86.8%] versus moderate [95.0%, P = 0.028], and none/mild [97.7%, P = 0.001]). 1-year MACE rates were associated with presence of calcification in subjects with none/mild (4.7%), moderate (8.7%), and severe (24.4%) (P < 0.001) calcification; however, no difference was noted between none/mild and moderate (P = 0.237). The risk adjusted multivariable model identified severe calcification and decreasing eGFR as predictors of 30-day and 1-year MACE. CONCLUSIONS: In this prospective study, patients with severe calcification had significantly worse outcomes compared to those without; however, unlike previous retrospective studies, moderate calcium resulted in similar outcomes as none/mild calcium. CLINICAL TRIAL REGISTRATION: URL: https://clinicaltrials.gov/ct2/show/NCT01930214. Unique Identifier: NCT01930214. CI - (c) 2019 Wiley Periodicals, Inc. FAU - Sharma, Samin K AU - Sharma SK AUID- ORCID: 0000-0002-1888-0793 AD - Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York. FAU - Bolduan, Ryan W AU - Bolduan RW AD - Scientific Affairs, Cardiovascular Systems, Inc., St. Paul, Minnesota. FAU - Patel, Manesh R AU - Patel MR AD - Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina. FAU - Martinsen, Brad J AU - Martinsen BJ AUID- ORCID: 0000-0002-5372-7065 AD - Scientific Affairs, Cardiovascular Systems, Inc., St. Paul, Minnesota. FAU - Azemi, Talhat AU - Azemi T AD - Department of Cardiovascular Medicine, Hartford Hospital, Hartford, Connecticut. FAU - Giugliano, Gregory AU - Giugliano G AD - Division of Cardiology, Department of Internal Medicine, Baystate Medical Center, Springfield, Massachusetts. FAU - Resar, Jon R AU - Resar JR AD - Department of Medicine, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland. FAU - Mehran, Roxana AU - Mehran R AUID- ORCID: 0000-0002-5546-262X AD - Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York. FAU - Cohen, David J AU - Cohen DJ AD - Cardiovascular Research, St. Luke's Mid America Heart Institute, Kansas City, Missouri. FAU - Popma, Jeffrey J AU - Popma JJ AD - Interventional Cardiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts. FAU - Waksman, Ron AU - Waksman R AUID- ORCID: 0000-0002-4063-9226 AD - Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia. LA - eng SI - ClinicalTrials.gov/NCT01930214 PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Observational Study DEP - 20190125 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Aged MH - Aged, 80 and over MH - Atherectomy, Coronary MH - Coronary Artery Disease/diagnostic imaging/*therapy MH - Female MH - Humans MH - Male MH - Middle Aged MH - *Percutaneous Coronary Intervention/adverse effects MH - Prospective Studies MH - Risk Factors MH - Severity of Illness Index MH - Time Factors MH - Treatment Outcome MH - United States MH - Vascular Calcification/diagnostic imaging/*therapy OTO - NOTNLM OT - atherectomy OT - coronary artery calcification OT - percutaneous coronary intervention EDAT- 2019/01/27 06:00 MHDA- 2020/08/04 06:00 CRDT- 2019/01/26 06:00 PHST- 2019/01/02 00:00 [received] PHST- 2019/01/07 00:00 [accepted] PHST- 2019/01/27 06:00 [pubmed] PHST- 2020/08/04 06:00 [medline] PHST- 2019/01/26 06:00 [entrez] AID - 10.1002/ccd.28099 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2019 Aug 1;94(2):187-194. doi: 10.1002/ccd.28099. Epub 2019 Jan 25. PMID- 30622007 OWN - NLM STAT- MEDLINE DCOM- 20200127 LR - 20200127 IS - 1097-6809 (Electronic) IS - 0741-5214 (Linking) VI - 70 IP - 1 DP - 2019 Jul TI - A multi-institutional analysis of transcarotid artery revascularization compared to carotid endarterectomy. PG - 123-129 LID - S0741-5214(18)32479-0 [pii] LID - 10.1016/j.jvs.2018.09.060 [doi] AB - OBJECTIVE: Transcarotid artery revascularization (TCAR) is a novel approach to carotid intervention that uses a direct carotid cut-down approach coupled with cerebral blood flow reversal to minimize embolic potential. The initial positive data with TCAR indicates that it may be an attractive alternative to trans-femoral carotid artery stenting and possibly carotid endarterectomy (CEA) for high-risk patients. The purpose of this study was to present 30-day and 1-year outcomes after treatment by TCAR and to compare these outcomes against a matched control group undergoing CEA at the same institutions. METHODS: A retrospective review of all patients who underwent TCAR at four institutions between 2013 and 2017 was performed to evaluate the use of the ENROUTE Transcarotid Neuroprotection System (Silk Road Medical, Inc, Sunnyvale, Calif). TCAR patients had high-risk factors and were either enrolled in prospective trials or treated with a commercially available TCAR device after US Food and Drug Administration approval. Contemporaneous patients undergoing CEA at each institution were also reviewed. Patients were propensity matched in a 1:1 (CEA:TCAR) fashion with respect to preoperative comorbidities. Data were analyzed using statistical models with a P value of less than .05 considered significant. Individual and composite stroke, myocardial infarction, and death at 30 days and 1 year postoperatively were assessed. RESULTS: Consecutive patients undergoing TCAR or CEA were identified (n = 663) and compared. Patients undergoing the TCAR procedure (n = 292) had higher rates of diabetes (P = .01), hyperlipidemia (P = .02), coronary artery disease (P < .01), and renal insufficiency (P < .01) compared with unmatched CEA patients (n = 371). Stroke rates were similar at 30 days (1.0% TCAR vs 1.1% CEA) and 1 year (2.8% TCAR vs 3.0% CEA) in the unmatched groups. After propensity matching by baseline characteristics including gender, age, symptom status (36.3%, 35.3%) and diabetes, 292 TCAR patients were compared with 292 CEA patients. TCAR patients were more likely to be treated preoperative and postoperatively with clopidogrel (preoperatively, 82.2% vs 39.4% [P < .01]; postoperatively, 98.3% vs 36.0% [P < .01]) and statins (preoperatively, 88.0% vs 75.0% [P < .01]; postoperatively, 97.8% vs 78.8% [P < .01]). Stroke (1.0% TCAR vs 0.3% CEA; P = .62) and death (0.3% TCAR vs 0.7% CEA; P = NS) rates were similar at 30 days and comparable at 1 year (stroke, 2.8% vs 2.2% [P = .79]; death 1.8% vs 4.5% [P = .09]). The composite end point of stroke/death/myocardial infarction at 1 month postoperatively was 2.1% vs 1.7% (P = NS). TCAR was associated with a decreased rate of cranial nerve injury (0.3% vs 3.8%; P = .01). CONCLUSIONS: These early data suggest that patients undergoing TCAR, even those with high-risk comorbidities, achieve broadly similar outcomes compared with patients undergoing CEA while mitigating cranial nerve injury. Further comparative studies are warranted. CI - Copyright (c) 2018 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved. FAU - Kashyap, Vikram S AU - Kashyap VS AD - Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio. Electronic address: vikram.kashyap@uhhospitals.org. FAU - King, Alexander H AU - King AH AD - Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio. FAU - Foteh, Mazin I AU - Foteh MI AD - Cardiothoracic and Vascular Surgeons, Austin, Tex. FAU - Janko, Matthew AU - Janko M AD - Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio. FAU - Jim, Jeffrey AU - Jim J AD - Division of Vascular Surgery, Washington University in St. Louis, St. Louis, Mo. FAU - Motaganahalli, Raghu L AU - Motaganahalli RL AD - Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis, Ind. FAU - Apple, Jeffrey M AU - Apple JM AD - Cardiothoracic and Vascular Surgeons, Austin, Tex. FAU - Bose, Saideep AU - Bose S AD - Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio. FAU - Kumins, Norman H AU - Kumins NH AD - Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio. LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study DEP - 20190106 PL - United States TA - J Vasc Surg JT - Journal of vascular surgery JID - 8407742 SB - IM CIN - J Vasc Surg. 2019 Nov;70(5):1726-1727. doi: 10.1016/j.jvs.2019.05.036. PMID: 31653388 CIN - J Vasc Surg. 2020 Jan;71(1):349-350. doi: 10.1016/j.jvs.2019.08.266. PMID: 31864653 CIN - J Vasc Surg. 2020 Jan;71(1):350. doi: 10.1016/j.jvs.2019.09.024. PMID: 31864655 MH - Aged MH - Carotid Artery Diseases/diagnostic imaging/mortality/physiopathology/*surgery MH - Cerebrovascular Circulation MH - *Endarterectomy, Carotid/adverse effects/mortality MH - *Endovascular Procedures/adverse effects/instrumentation/mortality MH - Female MH - Humans MH - Male MH - Middle Aged MH - Myocardial Infarction/etiology MH - Retrospective Studies MH - Risk Assessment MH - Risk Factors MH - Stents MH - Stroke/etiology MH - Time Factors MH - Treatment Outcome MH - United States OTO - NOTNLM OT - Carotid revascularization OT - Carotid stenting OT - Stroke OT - TCAR EDAT- 2019/01/10 06:00 MHDA- 2020/01/28 06:00 CRDT- 2019/01/10 06:00 PHST- 2018/05/04 00:00 [received] PHST- 2018/09/20 00:00 [accepted] PHST- 2019/01/10 06:00 [pubmed] PHST- 2020/01/28 06:00 [medline] PHST- 2019/01/10 06:00 [entrez] AID - S0741-5214(18)32479-0 [pii] AID - 10.1016/j.jvs.2018.09.060 [doi] PST - ppublish SO - J Vasc Surg. 2019 Jul;70(1):123-129. doi: 10.1016/j.jvs.2018.09.060. Epub 2019 Jan 6. PMID- 30614413 OWN - NLM STAT- MEDLINE DCOM- 20190409 LR - 20190409 IS - 1938-9116 (Electronic) IS - 1538-5744 (Linking) VI - 53 IP - 3 DP - 2019 Apr TI - Long-Term Outcomes of Carotid Endarterectomy and Carotid Artery Stenting When Performed by a Single Vascular Surgeon. PG - 216-223 LID - 10.1177/1538574418823379 [doi] AB - OBJECTIVES: Carotid artery endarterectomy (CEA) and carotid artery stenting (CAS) are 2 effective treatment options for carotid revascularization and stroke prevention. The long-term outcomes of Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) reported similar stroke and death rate between the 2 procedures. This study presents the short- and long-term outcomes of CEA and CAS of all risk patients performed by a single vascular surgeon in a real-world setting. METHODS: We retrospectively reviewed all patients who underwent CEA and CAS from September 2005 to June 2017 at our institute. Student t test, chi(2), and Fisher exact tests were used to compare patient's characteristics. Multivariate logistic, cox regression models and survival analysis were used to compare postoperative and long-term outcomes between the 2 groups. RESULTS: Over 2000 patients were evaluated for carotid artery stenosis during the study period, and 313 revascularization procedures were performed (CEA: 47%, CAS: 53%). Patients' age (Mean [95% confidence interval, CI] 68.8 [67.2-70.4] vs 69.7 [68.2-71.3], P = .40) was similar between CEA and CAS. Patients who underwent CAS had significantly higher comorbidities (chronic obstructive pulmonary disease [COPD], chronic heart failure [CHF], hyperlipidemia, and prior ipsilateral intervention, all P < .05). No difference was found in 30-day complications after CEA versus CAS including stroke (2.0% vs 1.2%), myocardial infarction (MI; 0.7% vs 1.2%), death (0% vs 1.2%) as well as combined major adverse events (stroke/death/MI; 2.7% vs 3.0%; all P > .05). Overall 7-year survival, stroke-free survival and restenosis-free survival were similar between the 2 groups ( P > .5). Significant predictors of mortality were diabetes (hazard ratio, HR [95% CI]: 2.41 [1.15-5.08]), chronic kidney disease (HR [95% CI]: 4.89 [1.97-12.13]), and COPD (HR [95% CI]: 3.31 [1.43-7.71]; all P values <.05). Statin use was protective with 71% reduction in risk of mortality (HR [95% CI]: 0.29 [0.12-0.67], P = .004). CONCLUSION: Our experience showed comparable short- and long-term outcomes of CAS and CEA performed for carotid artery stenosis by vascular surgeon. There was no difference between single institutional long-term outcomes and CREST outcomes following CEA and CAS. FAU - Rizwan, Muhammad AU - Rizwan M AD - 1 The Johns Hopkins Bayview Vascular and Endovascular Research Center, Baltimore, MD, USA. FAU - Aridi, Hanaa Dakour AU - Aridi HD AD - 1 The Johns Hopkins Bayview Vascular and Endovascular Research Center, Baltimore, MD, USA. FAU - Dang, Tru AU - Dang T AD - 1 The Johns Hopkins Bayview Vascular and Endovascular Research Center, Baltimore, MD, USA. FAU - Alshwaily, Widian AU - Alshwaily W AD - 1 The Johns Hopkins Bayview Vascular and Endovascular Research Center, Baltimore, MD, USA. FAU - Nejim, Besma AU - Nejim B AD - 1 The Johns Hopkins Bayview Vascular and Endovascular Research Center, Baltimore, MD, USA. FAU - Malas, Mahmoud B AU - Malas MB AD - 1 The Johns Hopkins Bayview Vascular and Endovascular Research Center, Baltimore, MD, USA. AD - 2 Health System, University of California San Diego, San Diego, CA, USA. AD - 3 Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. LA - eng PT - Comparative Study PT - Journal Article DEP - 20190106 PL - United States TA - Vasc Endovascular Surg JT - Vascular and endovascular surgery JID - 101136421 RN - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors) SB - IM MH - Aged MH - Baltimore MH - Carotid Stenosis/complications/diagnostic imaging/mortality/*surgery MH - Comorbidity MH - *Endarterectomy, Carotid/adverse effects/mortality MH - Endovascular Procedures/adverse effects/*instrumentation/mortality MH - Female MH - Health Status MH - Humans MH - Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use MH - Male MH - Progression-Free Survival MH - Recurrence MH - Retrospective Studies MH - Risk Factors MH - *Stents MH - Stroke/etiology MH - *Surgeons MH - Time Factors MH - Treatment Outcome OTO - NOTNLM OT - CAS OT - CEA OT - long-term outcomes EDAT- 2019/01/08 06:00 MHDA- 2019/04/10 06:00 CRDT- 2019/01/08 06:00 PHST- 2019/01/08 06:00 [pubmed] PHST- 2019/04/10 06:00 [medline] PHST- 2019/01/08 06:00 [entrez] AID - 10.1177/1538574418823379 [doi] PST - ppublish SO - Vasc Endovascular Surg. 2019 Apr;53(3):216-223. doi: 10.1177/1538574418823379. Epub 2019 Jan 6. PMID- 30612825 OWN - NLM STAT- MEDLINE DCOM- 20200127 LR - 20200127 IS - 1097-6809 (Electronic) IS - 0741-5214 (Linking) VI - 70 IP - 2 DP - 2019 Aug TI - Technical aspects and 30-day outcomes of the prospective early feasibility study of the GORE EXCLUDER Thoracoabdominal Branched Endoprosthesis (TAMBE) to treat pararenal and extent IV thoracoabdominal aortic aneurysms. PG - 358-368.e6 LID - S0741-5214(18)32565-5 [pii] LID - 10.1016/j.jvs.2018.10.103 [doi] AB - OBJECTIVE: This study reports the technical aspects and 30-day outcomes of the prospective, multicenter early feasibility study designed to evaluate the GORE EXCLUDER Thoracoabdominal Branch Endoprosthesis (TAMBE; W. L. Gore & Associates, Flagstaff, Ariz). METHODS: Thirteen patients with pararenal or extent IV thoracoabdominal aortic aneurysms were prospectively enrolled at five U.S sites and one non-U.S. site from 2014 to 2016. The TAMBE included four portals with either retrograde or antegrade renal portal configuration and used GORE VIABAHN Balloon-Expandable Endoprosthesis (W. L. Gore & Associates) for stenting of the renal and mesenteric arteries. The primary end point was procedural safety at 30 days, defined by absence of major adverse events, including any-cause mortality, myocardial infarction, stroke, paraplegia, bowel ischemia, respiratory failure, severe acute kidney injury (>50% decline in estimated glomerular filtration rate), dialysis, and procedural blood loss >1000 mL. RESULTS: There were 11 male and two female patients with a mean age of 69 +/- 8 years. Mean aneurysm diameter was 61 +/- 13 mm. A total of 52 renal and mesenteric arteries were incorporated (4 vessels/patient). Technical success was achieved in 12 patients (92%). One patient had inadvertent occlusion of a right renal artery due to dissection. There was no mortality, aneurysm rupture, conversion to open repair, dialysis, or spinal cord injury. Mean length of hospital stay was 5 +/- 3 days. At 30 days, four patients (31%) had major adverse events, all due to procedural blood loss >1000 mL. One patient had a type I endoleak at the distal renal branch, which was successfully treated by placement of an additional renal stent before dismissal. Computed tomography angiography at 30 days showed patent target vessels and no type I or type III endoleak. CONCLUSIONS: This study confirms the early feasibility of the TAMBE for treatment of pararenal and extent IV thoracoabdominal aortic aneurysms. The high technical success, no mortality, and low morbidity rate support continuation of clinical investigation in a larger population of patients. CI - Copyright (c) 2018 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved. FAU - Oderich, Gustavo S AU - Oderich GS AD - Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, Minn. Electronic address: oderich.gustavo@mayo.edu. FAU - Farber, Mark A AU - Farber MA AD - Division of Vascular and Endovascular Surgery, University of North Carolina, Chapel Hill, NC. FAU - Silveira, Pierre Galvagni AU - Silveira PG AD - Department of Surgery, Universidade Federal de Santa Catarina, Florianopolis, Brazil. FAU - Tadros, Rami AU - Tadros R AD - Division of Vascular and Endovascular Surgery, Mount Sinai Medical Center, New York, NY. FAU - Marin, Michael AU - Marin M AD - Division of Vascular and Endovascular Surgery, Mount Sinai Medical Center, New York, NY. FAU - Fillinger, Mark AU - Fillinger M AD - Division of Vascular and Endovascular Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH. FAU - Makaroun, Michel AU - Makaroun M AD - Division of Vascular and Endovascular Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pa. FAU - Hemmer, Jason AU - Hemmer J AD - W. L. Gore & Associates, Inc, TAMBE Team, Flagstaff, Ariz. FAU - Madden, Meghan AU - Madden M AD - W. L. Gore & Associates, Inc, TAMBE Team, Flagstaff, Ariz. LA - eng SI - ClinicalTrials.gov/NCT02528500 PT - Clinical Trial PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't PT - Video-Audio Media DEP - 20190103 PL - United States TA - J Vasc Surg JT - Journal of vascular surgery JID - 8407742 SB - IM MH - Aged MH - Aortic Aneurysm, Abdominal/diagnostic imaging/*surgery MH - Aortic Aneurysm, Thoracic/diagnostic imaging/*surgery MH - *Blood Vessel Prosthesis MH - Blood Vessel Prosthesis Implantation/adverse effects/*instrumentation MH - Brazil MH - Endovascular Procedures/adverse effects/*instrumentation MH - Feasibility Studies MH - Female MH - Humans MH - Male MH - Middle Aged MH - Non-Randomized Controlled Trials as Topic MH - Postoperative Complications/therapy MH - Prospective Studies MH - Prosthesis Design MH - *Stents MH - Time Factors MH - Treatment Outcome MH - United States OTO - NOTNLM OT - Feasibility OT - Thoracoabdominal Branch Endoprosthesis (TAMBE) OT - Thoracoabdominal aneurysm EDAT- 2019/01/08 06:00 MHDA- 2020/01/28 06:00 CRDT- 2019/01/08 06:00 PHST- 2018/04/02 00:00 [received] PHST- 2018/10/29 00:00 [accepted] PHST- 2019/01/08 06:00 [pubmed] PHST- 2020/01/28 06:00 [medline] PHST- 2019/01/08 06:00 [entrez] AID - S0741-5214(18)32565-5 [pii] AID - 10.1016/j.jvs.2018.10.103 [doi] PST - ppublish SO - J Vasc Surg. 2019 Aug;70(2):358-368.e6. doi: 10.1016/j.jvs.2018.10.103. Epub 2019 Jan 3. PMID- 30610759 OWN - NLM STAT- MEDLINE DCOM- 20191108 LR - 20191108 IS - 1537-2995 (Electronic) IS - 0041-1132 (Linking) VI - 59 IP - 3 DP - 2019 Mar TI - Additional filtering of blood from a cell salvage device is not likely to show important additional benefits in outcome in cardiac surgery. PG - 989-994 LID - 10.1111/trf.15130 [doi] AB - BACKGROUND: Several authors and manufacturers of cell salvage devices recommend additional filtering of processed blood before transfusion. There is no evidence to support this practice. Therefore, we compared the clinical outcome and biochemical effects of cell salvage with or without additional filtering. STUDY DESIGN AND METHODS: The patients, scheduled for coronary artery bypass grafting, valve replacement, or combined procedures were part of our randomized multicenter factorial study of cell salvage and filter use on transfusion requirements (ISRCTN 58333401). They were randomized to intraoperative cell salvage or cell salvage plus additional WBC depletion filter. We compared the occurrence of major adverse events (combined death/stroke/myocardial infarction) as primary outcome and minor adverse events (renal function disturbances, infections, delirium), ventilation time, and length of stay in the intensive care unit and hospital. We also measured biochemical markers of organ injury and inflammation. RESULTS: One hundred eighty-nine patients had cell salvage, and 175 patients had cell salvage plus filter and completed the study. Demographic data, surgical procedures, and amount of salvaged blood were not different between the groups. There was no difference in the primary outcome with a risk of 6.3% (95% confidence interval [CI], 3.34-11.25) in the cell salvage plus filter group versus 5.8% (95% CI, 3.09-10.45) in the cell salvage group, a relative risk of 1.08 (95% CI, 0.48- 2.43]. There were no differences in minor adverse events and biochemical markers between the groups. CONCLUSION: The routine use of an additional filter for transfusion of salvaged blood is unlikely to show important additional benefits. CI - (c) 2019 AABB. FAU - de Vries, Adrianus J AU - de Vries AJ AD - Department of Anesthesiology, University Medical Center Groningen, Groningen, The Netherlands. FAU - Vermeijden, Wytze J AU - Vermeijden WJ AD - Department of Critical Care, Medisch Spectrum Twente, Enschede, The Netherlands. FAU - van Pelt, L Joost AU - van Pelt LJ AD - Department of Laboratory Medicine, University Medical Center Groningen, Groningen, The Netherlands. FAU - van den Heuvel, Edwin R AU - van den Heuvel ER AD - Department of Mathematics & Computer Science, Eindhoven University of Technology, Eindhoven, The Netherlands. FAU - van Oeveren, Willem AU - van Oeveren W AD - Haemoscan b.v, Groningen, The Netherlands. LA - eng PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20190104 PL - United States TA - Transfusion JT - Transfusion JID - 0417360 SB - IM MH - Aged MH - Blood Transfusion/*methods MH - Cardiac Surgical Procedures/*methods MH - Coronary Artery Bypass/methods MH - Female MH - Humans MH - Male MH - Middle Aged MH - Myocardial Infarction/surgery/therapy MH - Stroke/surgery/therapy MH - Treatment Outcome EDAT- 2019/01/06 06:00 MHDA- 2019/11/09 06:00 CRDT- 2019/01/06 06:00 PHST- 2018/04/12 00:00 [received] PHST- 2018/10/02 00:00 [revised] PHST- 2018/11/12 00:00 [accepted] PHST- 2019/01/06 06:00 [pubmed] PHST- 2019/11/09 06:00 [medline] PHST- 2019/01/06 06:00 [entrez] AID - 10.1111/trf.15130 [doi] PST - ppublish SO - Transfusion. 2019 Mar;59(3):989-994. doi: 10.1111/trf.15130. Epub 2019 Jan 4. PMID- 30590726 OWN - NLM STAT- MEDLINE DCOM- 20201215 LR - 20201215 IS - 1460-2385 (Electronic) IS - 0931-0509 (Linking) VI - 35 IP - 8 DP - 2020 Aug 1 TI - Long-term outcomes of patients with stable coronary disease and chronic kidney dysfunction: 10-year follow-up of the Medicine, Angioplasty, or Surgery Study II Trial. PG - 1369-1376 LID - 10.1093/ndt/gfy379 [doi] AB - BACKGROUND: Chronic kidney disease (CKD) is associated with a worse prognosis in patients with stable coronary artery disease (CAD); however, there is limited randomized data on long-term outcomes of CAD therapies in these patients. We evaluated long-term outcomes of CKD patients with CAD who underwent randomized therapy with medical treatment (MT) alone, percutaneous coronary intervention (PCI) or coronary artery bypass graft surgery (CABG). METHODS: Baseline estimated glomerular filtration rate (eGFR) was obtained in 611 patients randomized to one of three therapeutic strategies in the Medicine, Angioplasty, or Surgery Study II trial. Patients were categorized in preserved renal function and mild or moderate CKD groups depending on their eGFR (>/=90, 89-60 and 59-30 mL/min/1.73 m2, respectively). The primary clinical endpoint, a composite of overall death and myocardial infarction, and its individual components were analyzed using proportional hazards regression (Clinical Trial registration information: http://www.controlled-trials.com. Registration number: ISRCTN66068876). RESULTS: Of 611 patients, 112 (18%) had preserved eGFR, 349 (57%) mild dysfunction and 150 (25%) moderate dysfunction. The primary endpoint occurred in 29.5, 32.4 and 44.7% (P = 0.02) for preserved eGFR, mild CKD and moderate CKD, respectively. Overall mortality incidence was 18.7, 23.8 and 39.3% for preserved eGFR, mild CKD and moderate CKD, respectively (P = 0.001). For preserved eGFR, there was no significant difference in outcomes between therapies. For mild CKD, the primary event rate was 29.4% for PCI, 29.1% for CABG and 41.1% for MT (P = 0.006) [adjusted hazard ratio (HR) = 0.26, 95% confidence interval (CI) 0.07-0.88; P = 0.03 for PCI versus MT; and adjusted HR = 0.48; 95% CI 0.31-0.76; P = 0.002 for CABG versus MT]. We also observed higher mortality rates in the MT group (28.6%) compared with PCI (24.1%) and CABG (19.0%) groups (P = 0.015) among mild CKD subjects (adjusted HR = 0.44, 95% CI 0.25-0.76; P = 0.003 for CABG versus MT; adjusted HR = 0.56, 95% CI 0.07-4.28; P = 0.58 for PCI versus MT). Results were similar with moderate CKD group but did not achieve significance. CONCLUSIONS: Coronary interventional therapy, both PCI and CABG, is associated with lower rates of events compared with MT in mild CKD patients >10 years of follow-up. More study is needed to confirm these benefits in moderate CKD. CI - (c) The Author(s) 2018. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. FAU - Lima, Eduardo Gomes AU - Lima EG AD - Department of Clinical Cardiology, Heart Institute (InCor), University of Sao Paulo, Sao Paulo, Brazil. FAU - Charytan, David M AU - Charytan DM AD - Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. FAU - Hueb, Whady AU - Hueb W AD - Department of Clinical Cardiology, Heart Institute (InCor), University of Sao Paulo, Sao Paulo, Brazil. FAU - de Azevedo, Diogo Freitas Cardoso AU - de Azevedo DFC AD - Department of Clinical Cardiology, Heart Institute (InCor), University of Sao Paulo, Sao Paulo, Brazil. FAU - Garzillo, Cibele Larrosa AU - Garzillo CL AD - Department of Clinical Cardiology, Heart Institute (InCor), University of Sao Paulo, Sao Paulo, Brazil. FAU - Favarato, Desiderio AU - Favarato D AD - Department of Clinical Cardiology, Heart Institute (InCor), University of Sao Paulo, Sao Paulo, Brazil. FAU - Linhares Filho, Jaime Paula Pessoa AU - Linhares Filho JPP AD - Department of Clinical Cardiology, Heart Institute (InCor), University of Sao Paulo, Sao Paulo, Brazil. FAU - Martins, Eduardo Bello AU - Martins EB AD - Department of Clinical Cardiology, Heart Institute (InCor), University of Sao Paulo, Sao Paulo, Brazil. FAU - Batista, Daniel Valente AU - Batista DV AD - Department of Clinical Cardiology, Heart Institute (InCor), University of Sao Paulo, Sao Paulo, Brazil. FAU - Rezende, Paulo Cury AU - Rezende PC AD - Department of Clinical Cardiology, Heart Institute (InCor), University of Sao Paulo, Sao Paulo, Brazil. FAU - Hueb, Alexandre Ciappina AU - Hueb AC AD - Department of Clinical Cardiology, Heart Institute (InCor), University of Sao Paulo, Sao Paulo, Brazil. FAU - Ramires, Jose Antonio Franchini AU - Ramires JAF AD - Department of Clinical Cardiology, Heart Institute (InCor), University of Sao Paulo, Sao Paulo, Brazil. FAU - Kalil Filho, Roberto AU - Kalil Filho R AD - Department of Clinical Cardiology, Heart Institute (InCor), University of Sao Paulo, Sao Paulo, Brazil. LA - eng SI - ISRCTN/ISRCTN66068876 PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - England TA - Nephrol Dial Transplant JT - Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association JID - 8706402 SB - IM MH - Aged MH - Angioplasty/*mortality MH - Coronary Artery Bypass/*mortality MH - Coronary Artery Disease/*mortality/pathology/surgery MH - Female MH - Follow-Up Studies MH - Glomerular Filtration Rate MH - Humans MH - Male MH - Middle Aged MH - Percutaneous Coronary Intervention/*mortality MH - Renal Insufficiency, Chronic/*mortality/pathology/surgery MH - Survival Rate MH - Time Factors MH - Treatment Outcome OTO - NOTNLM OT - angioplasty OT - cardiac surgery OT - chronic renal failure OT - clinical trial OT - coronary artery disease EDAT- 2018/12/28 06:00 MHDA- 2020/12/16 06:00 CRDT- 2018/12/28 06:00 PHST- 2018/07/26 00:00 [received] PHST- 2018/11/12 00:00 [accepted] PHST- 2018/12/28 06:00 [pubmed] PHST- 2020/12/16 06:00 [medline] PHST- 2018/12/28 06:00 [entrez] AID - 5259353 [pii] AID - 10.1093/ndt/gfy379 [doi] PST - ppublish SO - Nephrol Dial Transplant. 2020 Aug 1;35(8):1369-1376. doi: 10.1093/ndt/gfy379. PMID- 30580857 OWN - NLM STAT- MEDLINE DCOM- 20190110 LR - 20200225 IS - 2213-3763 (Electronic) IS - 0019-4832 (Print) IS - 0019-4832 (Linking) VI - 70 IP - 6 DP - 2018 Nov-Dec TI - Remote ischemic preconditioning for prevention of contrast induced nephropathy-Insights from an Indian study. PG - 857-863 LID - S0019-4832(17)30521-7 [pii] LID - 10.1016/j.ihj.2017.11.012 [doi] AB - OBJECTIVES: To study if four cycles of remote ischemic preconditioning (RIPC) could offer protection against contrast induced nephropathy (CIN) and post procedural renal dysfunction in high risk patients undergoing percutaneous coronary intervention (PCI). METHODS: This was a prospective single blind randomized sham controlled trial where patients undergoing coronary angioplasty with stage III chronic kidney disease were randomized into sham preconditioning and remote ischemic preconditioning. The primary outcome was the reduction in the incidence of CIN. The secondary outcomes were the maximum improvement in eGFR, maximum reduction in serum creatinine and composite of requirement of hemodialysis, death and rehospitalization for heart failure up to 6 weeks after PCI. RESULTS: Eleven out of fifty patients in the study group developed CIN (22%) compared to eighteen out of the fifty control patients (36%) (p=0.123). There was a statistically significant improvement in the post procedure creatinine values at 24h (p=0.013), 48h (p=0.015), 2 weeks (p=0.003), 6 weeks (p=0.003) and post procedure glomerular filtration rate (eGFR) values at 24h (p=0.026), 48h (p=0.044), 2 weeks (p=0.015) and 6 weeks (p=0.011) in study group compared to control group. The secondary outcome composite of requirement of hemodialysis, death and rehospitalization for heart failure was not statistically significant (p: 0.646). CONCLUSION: RIPC does not result in significant reduction of CIN. However RIPC helps in the prevention of post procedural worsening in eGFR and serum creatinine even up to 6 weeks. CI - Copyright (c) 2017. Published by Elsevier B.V. FAU - Valappil, Sanjai Pattu AU - Valappil SP AD - Department of Cardiology, Government Medical College, Thiruvananthapuram, Kerala 695011, India. Electronic address: sanjaiinorion@gmail.com. FAU - Kunjukrishnapillai, Sivaprasad AU - Kunjukrishnapillai S AD - Department of Cardiology, T. D. Medical College, Alappuzha, Kerala, India. FAU - Viswanathan, Sunitha AU - Viswanathan S AD - Department of Cardiology, Government Medical College, Thiruvananthapuram, Kerala 695011, India. FAU - Koshy, Alummoottil George AU - Koshy AG AD - Department of Cardiology, Government Medical College, Thiruvananthapuram, Kerala 695011, India. FAU - Gupta, Prabha Nini AU - Gupta PN AD - Department of Cardiology, Government Medical College, Thiruvananthapuram, Kerala 695011, India. FAU - Velayudhan, Radhakrishnan Vallikkattu AU - Velayudhan RV AD - Department of Cardiology, Government Medical College, Thiruvananthapuram, Kerala 695011, India. FAU - Iype, Mathew AU - Iype M AD - Department of Cardiology, Government Medical College, Thiruvananthapuram, Kerala 695011, India. LA - eng PT - Journal Article PT - Randomized Controlled Trial DEP - 20171116 PL - India TA - Indian Heart J JT - Indian heart journal JID - 0374675 RN - 0 (Contrast Media) SB - IM MH - Contrast Media/*adverse effects MH - Coronary Angiography/*adverse effects MH - Coronary Artery Disease/*diagnosis/surgery MH - Female MH - Follow-Up Studies MH - Glomerular Filtration Rate/drug effects MH - Humans MH - Incidence MH - India/epidemiology MH - Ischemic Preconditioning/*methods MH - Kidney Diseases/chemically induced/epidemiology/*prevention & control MH - Male MH - Middle Aged MH - Percutaneous Coronary Intervention/*adverse effects/methods MH - Prospective Studies MH - Risk Factors MH - Single-Blind Method PMC - PMC6306307 OTO - NOTNLM OT - Contrast induced nephropathy OT - Estimated glomerular filtration rate OT - Percutaneous coronary intervention OT - Remote ischemic preconditioning EDAT- 2018/12/26 06:00 MHDA- 2019/01/11 06:00 PMCR- 2019/11/01 CRDT- 2018/12/25 06:00 PHST- 2017/07/30 00:00 [received] PHST- 2017/10/26 00:00 [revised] PHST- 2017/11/15 00:00 [accepted] PHST- 2018/12/25 06:00 [entrez] PHST- 2018/12/26 06:00 [pubmed] PHST- 2019/01/11 06:00 [medline] PHST- 2019/11/01 00:00 [pmc-release] AID - S0019-4832(17)30521-7 [pii] AID - 10.1016/j.ihj.2017.11.012 [doi] PST - ppublish SO - Indian Heart J. 2018 Nov-Dec;70(6):857-863. doi: 10.1016/j.ihj.2017.11.012. Epub 2017 Nov 16. PMID- 30573053 OWN - NLM STAT- MEDLINE DCOM- 20191126 LR - 20191126 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 11 IP - 24 DP - 2018 Dec 24 TI - Left Main Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting in Patients With Prior Cerebrovascular Disease: Results From the EXCEL Trial. PG - 2441-2450 LID - S1936-8798(18)31908-3 [pii] LID - 10.1016/j.jcin.2018.09.008 [doi] AB - OBJECTIVES: The aim of this study was to determine whether high-risk patients with left main coronary artery disease (LMCAD) and prior cerebrovascular disease (CEVD) preferentially benefit from revascularization by percutaneous coronary intervention (PCI) compared with coronary artery bypass grafting (CABG). BACKGROUND: Patients with known CEVD requiring revascularization are often referred to PCI rather than CABG. There is a paucity of data regarding the impact of CEVD in patients with LMCAD undergoing revascularization. METHODS: In the EXCEL (Evaluation of XIENCE Versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization) trial, patients with LMCAD and low or intermediate SYNTAX (Synergy Between PCI with Taxus and Cardiac Surgery) scores were randomized to PCI with everolimus-eluting stents versus CABG. The effects of prior CEVD, defined as prior stroke, transient ischemic attack, or carotid artery disease, on 30-day and 3-year event rates were assessed. RESULTS: Prior CEVD was present in 233 of 1,898 patients (12.3%). These patients were older and had higher rates of comorbidities, including hypertension, diabetes, peripheral vascular disease, anemia, chronic kidney disease, and prior PCI, compared with those without prior CEVD. Patients with prior CEVD had higher rates of stroke at 30 days (2.2% vs. 0.8%; p = 0.05) and 3 years (6.4% vs. 2.2%; p = 0.0003) and higher 3-year rates of the primary endpoint of all-cause death, stroke, or myocardial infarction (25.0% vs. 13.6%; p < 0.0001). The relative effects of PCI versus CABG on the 30-day and 3-year rates of stroke (p(interaction) = 0.65 and 0.16, respectively) and the 3-year rates of the primary composite endpoint (p(interaction) = 0.14) were consistent in patients with and those without prior CEVD. CONCLUSIONS: Patients with LMCAD and prior CEVD compared with those without CEVD have higher rates of stroke and reduced event-free survival after revascularization. Data from the EXCEL trial do not a priori support a preferential role of PCI over CABG in patients with known CEVD. CI - Copyright (c) 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Diamond, Jamie AU - Diamond J AD - NewYork-Presbyterian Hospital/Columbia University Medical Center, New York, New York. FAU - Madhavan, Mahesh V AU - Madhavan MV AD - NewYork-Presbyterian Hospital/Columbia University Medical Center, New York, New York. FAU - Sabik, Joseph F 3rd AU - Sabik JF 3rd AD - Department of Surgery, UH Cleveland Medical Center, Cleveland, Ohio. FAU - Serruys, Patrick W AU - Serruys PW AD - Imperial College of Science, Technology and Medicine, London, United Kingdom. FAU - Kappetein, Arie Pieter AU - Kappetein AP AD - Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands. FAU - Leon, Martin B AU - Leon MB AD - NewYork-Presbyterian Hospital/Columbia University Medical Center, New York, New York; Clinical Trials Center, Cardiovascular Research Foundation, New York, New York. FAU - Taggart, David P AU - Taggart DP AD - John Radcliffe Hospital, Oxford, United Kingdom. FAU - Berland, Jacques AU - Berland J AD - Clinique Saint Hilaire, Rouen, France. FAU - Morice, Marie-Claude AU - Morice MC AD - Ramsay Generale de Sante - Institut Cardiovasculaire Paris Sud, Massy, France. FAU - Gersh, Bernard J AU - Gersh BJ AD - Mayo Clinic College of Medicine, Rochester, Minnesota. FAU - Kandzari, David E AU - Kandzari DE AD - Piedmont Heart Institute, Atlanta, Georgia. FAU - Dressler, Ovidiu AU - Dressler O AD - Clinical Trials Center, Cardiovascular Research Foundation, New York, New York. FAU - Stone, Gregg W AU - Stone GW AD - NewYork-Presbyterian Hospital/Columbia University Medical Center, New York, New York; Clinical Trials Center, Cardiovascular Research Foundation, New York, New York. Electronic address: gs2184@columbia.edu. LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 RN - 0 (Cardiovascular Agents) RN - 9HW64Q8G6G (Everolimus) SB - IM CIN - JACC Cardiovasc Interv. 2018 Dec 24;11(24):2451-2452. doi: 10.1016/j.jcin.2018.10.006. PMID: 30573054 MH - Aged MH - Cardiovascular Agents/therapeutic use MH - Cerebrovascular Disorders/*complications/diagnosis/mortality MH - Clinical Decision-Making MH - *Coronary Artery Bypass/adverse effects/mortality MH - Coronary Artery Disease/complications/diagnostic imaging/mortality/*therapy MH - Drug-Eluting Stents MH - Everolimus/administration & dosage MH - Female MH - Humans MH - Male MH - Middle Aged MH - Patient Selection MH - *Percutaneous Coronary Intervention/adverse effects/instrumentation/mortality MH - Progression-Free Survival MH - Risk Assessment MH - Risk Factors MH - Time Factors OTO - NOTNLM OT - cerebrovascular disease OT - coronary artery bypass graft surgery OT - coronary artery disease OT - left main disease OT - percutaneous coronary intervention EDAT- 2018/12/24 06:00 MHDA- 2019/11/27 06:00 CRDT- 2018/12/22 06:00 PHST- 2018/05/31 00:00 [received] PHST- 2018/08/13 00:00 [revised] PHST- 2018/09/04 00:00 [accepted] PHST- 2018/12/22 06:00 [entrez] PHST- 2018/12/24 06:00 [pubmed] PHST- 2019/11/27 06:00 [medline] AID - S1936-8798(18)31908-3 [pii] AID - 10.1016/j.jcin.2018.09.008 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2018 Dec 24;11(24):2441-2450. doi: 10.1016/j.jcin.2018.09.008. PMID- 30467967 OWN - NLM STAT- MEDLINE DCOM- 20200615 LR - 20200615 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 94 IP - 1 DP - 2019 Jul 1 TI - An overview of percutaneous coronary intervention in dialysis patients: Insights from a Japanese nationwide registry. PG - E1-E8 LID - 10.1002/ccd.27986 [doi] AB - OBJECTIVES: This study sought to provide an overview of percutaneous coronary intervention (PCI) in dialysis patients from a Japanese nationwide registry. BACKGROUND: Little is known about dialysis patients undergoing PCI because few are enrolled in clinical trials. METHODS: We analyzed 624,900 PCI cases including 41,384 dialysis patients (6.6%) from 1,017 Japanese hospitals between 2014 and 2016. We investigated differences in characteristics and in-hospital outcomes between dialysis and nondialysis patients, and assessed factors associated with an increased risk of adverse outcomes. RESULTS: Dialysis patients had more comorbidities than nondialysis patients and higher rates of complications including in-hospital mortality (3.3% vs. 1.5%, respectively, in the acute coronary syndrome [ACS] cohort, 0.2% vs. 0.1% in the non-ACS cohort) and bleeding complications requiring blood transfusion (1.1% vs. 0.4% in ACS, 0.5% vs. 0.2% in non-ACS). Dialysis was significantly associated with an increased risk of in-hospital mortality (odds ratio [OR]: 1.42, 95% confidence interval [CI]: 1.24-1.62 in ACS, OR: 2.25, 95% CI: 1.66-3.05 in non-ACS) and bleeding (OR: 1.60, 95% CI: 1.30-1.96 in ACS, OR: 1.55, 95% CI: 1.27-1.88 in non-ACS). For dialysis patients, age, acute heart failure, and cardiogenic shock were associated with an increased risk of in-hospital mortality in the ACS cohort, whereas age, female gender, and history of heart failure were associated with higher in-hospital mortality in the non-ACS cohort. CONCLUSIONS: PCI was widely performed for dialysis patients with either ACS or non-ACS in Japan. Dialysis patients had a greater risk of adverse outcomes than nondialysis patients after PCI. CI - (c) 2018 Wiley Periodicals, Inc. FAU - Numasawa, Yohei AU - Numasawa Y AUID- ORCID: 0000-0002-1739-2800 AD - Department of Cardiology, Japanese Red Cross Ashikaga Hospital, Ashikaga, Japan. FAU - Inohara, Taku AU - Inohara T AD - Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina. AD - Department of Cardiology, Keio University School of Medicine, Tokyo, Japan. FAU - Ishii, Hideki AU - Ishii H AUID- ORCID: 0000-0003-4348-0123 AD - Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan. FAU - Yamaji, Kyohei AU - Yamaji K AD - Division of Cardiology, Kokura Memorial Hospital, Japan. FAU - Hirano, Keita AU - Hirano K AD - Department of Nephrology, Japanese Red Cross Ashikaga Hospital, Ashikaga, Japan. FAU - Kohsaka, Shun AU - Kohsaka S AD - Department of Cardiology, Keio University School of Medicine, Tokyo, Japan. FAU - Sawano, Mitsuaki AU - Sawano M AD - Department of Cardiology, Keio University School of Medicine, Tokyo, Japan. FAU - Kuno, Toshiki AU - Kuno T AUID- ORCID: 0000-0002-2487-8366 AD - Department of Cardiology, Japanese Red Cross Ashikaga Hospital, Ashikaga, Japan. FAU - Kodaira, Masaki AU - Kodaira M AD - Department of Cardiology, Japanese Red Cross Ashikaga Hospital, Ashikaga, Japan. FAU - Uemura, Shiro AU - Uemura S AD - Department of Cardiology, Kawasaki Medical School, Kurashiki, Japan. FAU - Kadota, Kazushige AU - Kadota K AD - Department of Cardiology, Kurashiki Central Hospital, Kurashiki, Japan. FAU - Amano, Tetsuya AU - Amano T AD - Department of Cardiology, Aichi Medical University, Nagakute, Japan. FAU - Nakamura, Masato AU - Nakamura M AD - Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan. CN - J-PCI Registry Investigators LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study DEP - 20181123 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Aged MH - Aged, 80 and over MH - Comorbidity MH - Coronary Artery Disease/diagnostic imaging/mortality/*therapy MH - Female MH - Hospital Mortality MH - Humans MH - Japan/epidemiology MH - Male MH - Middle Aged MH - *Percutaneous Coronary Intervention/adverse effects/mortality MH - Registries MH - *Renal Dialysis/adverse effects/mortality MH - Renal Insufficiency, Chronic/diagnosis/mortality/*therapy MH - Retrospective Studies MH - Risk Factors MH - Time Factors MH - Treatment Outcome OTO - NOTNLM OT - chronic kidney disease OT - coronary artery disease OT - end-stage renal disease EDAT- 2018/11/24 06:00 MHDA- 2020/06/17 06:00 CRDT- 2018/11/24 06:00 PHST- 2018/04/22 00:00 [received] PHST- 2018/10/17 00:00 [revised] PHST- 2018/10/29 00:00 [accepted] PHST- 2018/11/24 06:00 [pubmed] PHST- 2020/06/17 06:00 [medline] PHST- 2018/11/24 06:00 [entrez] AID - 10.1002/ccd.27986 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2019 Jul 1;94(1):E1-E8. doi: 10.1002/ccd.27986. Epub 2018 Nov 23. PMID- 30371283 OWN - NLM STAT- MEDLINE DCOM- 20191111 LR - 20260127 IS - 2047-9980 (Electronic) IS - 2047-9980 (Linking) VI - 7 IP - 20 DP - 2018 Oct 16 TI - Cystatin C for Risk Stratification in Patients After an Acute Coronary Syndrome. PG - e009077 LID - 10.1161/JAHA.118.009077 [doi] LID - e009077 AB - Background Cystatin C (Cys-C) is a marker of renal function that has shown prognostic value for cardiovascular risk stratification across different patient populations. The incremental value of Cys-C beyond established cardiac and renal biomarkers remains incompletely explored. Methods and Results SOLID - TIMI 52 (Stabilization of Plaques Using Darapladib-Thrombolysis in Myocardial Infarction 52; www.clinicaltrials.gov , NCT01000727) randomized patients /= 60 mls/min/1.73m(2)) of chronic kidney disease (CKD). Patient's demographics, extent of coronary artery disease, procedural data, discharge medications, short (in-hospital) and long (1 year) term outcomes were critically assessed. RESULTS: A total of 6563 patients were included in the final analysis. STEMI CKD cohort was predominantly male (80%) with mean age of 61.02 +/- 9.95 years. They had higher cardiovascular risk factors namely diabetes mellitus (54.6%), hypertension (79.2%) and dyslipidemia (68.8%) in contrast to those without CKD. There were notably higher percentage of CKD patients presented with Killip class 3 and 4; 24.9 vs 8.7%. Thrombolytic therapy remained the most commonly instituted treatment regardless the status of kidney function. Furthermore, our STEMI CKD cohort also was more likely to receive less of evidence-based treatment upon discharge. In terms of outcomes, patients with CKD were more likely to develop in-hospital death (OR: 4.55, 95% CI 3.11-6.65), MACE (OR: 3.42, 95% CI 2.39-4.90) and vascular complications (OR: 1.88, 95% CI 0.95-3.7) compared to the non-CKD patients. The risk of death at 1-year post PCI in STEMI CKD patients was also reported to be high (HR: 3.79, 95% CI 2.84-5.07). CONCLUSION: STEMI and CKD is a deadly combination, proven in our cohort, adding on to the current evidence in the literature. We noted that our STEMI CKD patients tend to be younger than the Caucasian with extremely high prevalence of diabetes mellitus. The poor outcome mainly driven by immediate or short term adverse events peri-procedural, therefore suggesting that more efficient treatment in this special group is imperative. FAU - Ismail, Muhammad Dzafir AU - Ismail MD AUID- ORCID: 0000-0002-7451-1802 AD - Division of Cardiology, Department of Medicine, University Malaya Medical Centre, 59100, Kuala Lumpur, Malaysia. dzafir@ummc.edu.my. FAU - Jalalonmuhali, Maisarah AU - Jalalonmuhali M AD - Division of Nephrology, Department of Medicine, University Malaya Medical Centre, 59100, Kuala Lumpur, Malaysia. FAU - Azhari, Zaid AU - Azhari Z AD - Division of Cardiology, Department of Medicine, University Malaya Medical Centre, 59100, Kuala Lumpur, Malaysia. FAU - Mariapun, Jeevitha AU - Mariapun J AD - Department of Social and Preventive Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia. FAU - Lee, Zhen-Vin AU - Lee ZV AD - Division of Cardiology, Department of Medicine, University Malaya Medical Centre, 59100, Kuala Lumpur, Malaysia. FAU - Zainal Abidin, Imran AU - Zainal Abidin I AD - Division of Cardiology, Department of Medicine, University Malaya Medical Centre, 59100, Kuala Lumpur, Malaysia. FAU - Wan Ahmad, Wan Azman AU - Wan Ahmad WA AD - Division of Cardiology, Department of Medicine, University Malaya Medical Centre, 59100, Kuala Lumpur, Malaysia. FAU - Zuhdi, Ahmad Syadi Mahmood AU - Zuhdi ASM AD - Division of Cardiology, Department of Medicine, University Malaya Medical Centre, 59100, Kuala Lumpur, Malaysia. CN - NCVD-PCI investigators LA - eng PT - Journal Article PT - Multicenter Study DEP - 20180924 PL - England TA - BMC Cardiovasc Disord JT - BMC cardiovascular disorders JID - 100968539 SB - IM MH - Aged MH - Coronary Angiography MH - Databases, Factual MH - Female MH - Glomerular Filtration Rate MH - Hospital Mortality MH - Humans MH - Kidney/physiopathology MH - Malaysia/epidemiology MH - Male MH - Middle Aged MH - *Percutaneous Coronary Intervention/adverse effects/mortality MH - Postoperative Complications/mortality MH - Registries MH - Renal Insufficiency, Chronic/diagnosis/*epidemiology/mortality/physiopathology MH - Retrospective Studies MH - Risk Assessment MH - Risk Factors MH - ST Elevation Myocardial Infarction/diagnostic imaging/mortality/*surgery MH - Time Factors MH - Treatment Outcome PMC - PMC6154951 COIS- ETHICS APPROVAL AND CONSENT TO PARTICIPATE: The NCVD-PCI is registered in the National Medical Research Register of Malaysia (ID: NMRR-07-20-250) and received ethical approval from the Ministry of Health Medical Research and Ethics committee. Consent from individual patients was not necessary as the data collected were anonymized. Each patient will receive a unique identification number recorded in the registry. CONSENT FOR PUBLICATION: Not applicable. COMPETING INTERESTS: The authors declare that they have no competing interests. PUBLISHER'S NOTE: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. EDAT- 2018/09/27 06:00 MHDA- 2019/05/29 06:00 PMCR- 2018/09/24 CRDT- 2018/09/26 06:00 PHST- 2018/01/06 00:00 [received] PHST- 2018/09/17 00:00 [accepted] PHST- 2018/09/26 06:00 [entrez] PHST- 2018/09/27 06:00 [pubmed] PHST- 2019/05/29 06:00 [medline] PHST- 2018/09/24 00:00 [pmc-release] AID - 10.1186/s12872-018-0919-9 [pii] AID - 919 [pii] AID - 10.1186/s12872-018-0919-9 [doi] PST - epublish SO - BMC Cardiovasc Disord. 2018 Sep 24;18(1):184. doi: 10.1186/s12872-018-0919-9. PMID- 30227855 OWN - NLM STAT- MEDLINE DCOM- 20190114 LR - 20190114 IS - 1741-7015 (Electronic) IS - 1741-7015 (Linking) VI - 16 IP - 1 DP - 2018 Sep 19 TI - Practical issues in clinical scenarios involving CKD patients requiring antithrombotic therapy in light of the 2017 ESC guideline recommendations. PG - 158 LID - 10.1186/s12916-018-1145-0 [doi] LID - 158 AB - BACKGROUND: The choice of the most appropriate antithrombotic regimen that balances ischemic and bleeding risks was addressed by the August 2017 European Society of Cardiologists (ESC)/European Association for Cardio-Thoracic Surgery Focused Update recommendations, which propose new evaluation scores and protocols for patients requiring a coronary stent or patients with an acute coronary syndrome, atrial fibrillation, or a high bleeding risk and indication for oral anticoagulation therapy. DISCUSSION: Numerous questions remain regarding antithrombotic regimens and risk management algorithms for both ischemic and hemorrhagic events in patients with chronic kidney disease (CKD) in various clinical scenarios. Limitations of current studies include a general ack of advanced CKD patients in major randomized controlled trials, of evidence on algorithm implementation, and of robust assessment tools for hemorrhagic risk. Herein, we aim to analyze the ESC Update recommendations and the newly implemented risk scores (DAPT, PRECISE-DAPT, PARIS) from the point of view of CKD, providing suggestions on drug choice (which combination has the best evidence), dosage, and duration (the same or different as for non-CKD population) of antithrombotics, as well as to identify current shortcomings and to envision directions of future research. CONCLUSION: We provide an evidence-based perspective on the new proposed bleeding management protocol, with focus on the CKD population. Despite previous important steps on antithrombotic therapy of renal patients, there remain many unsolved questions for which our suggestions could fundament new randomized controlled trials and specific protocols. FAU - Covic, Adrian AU - Covic A AD - Nephrology Clinic, Dialysis and Renal Transplant Center - 'C.I. Parhon' University Hospital, Iasi, Romania. AD - 'Grigore T. Popa' University of Medicine, Iasi, Romania. FAU - Genovesi, Simonetta AU - Genovesi S AD - Department of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy. AD - Nephrology Unit, San Gerardo Hospital, Monza, Italy. FAU - Rossignol, Patrick AU - Rossignol P AD - Inserm, Centre d'Investigations Cliniques-Plurithematique 14-33, Inserm U1116, CHRU Nancy, Nancy, France. AD - Universite de Lorraine, Association Lorraine de Traitement de l'Insuffisance Renale (ALTIR) and F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France. FAU - Kalra, Philip A AU - Kalra PA AD - The University of Manchester, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Stott Lane, Salford, UK. FAU - Ortiz, Alberto AU - Ortiz A AD - IIS-Fundacion Jimenez Diaz UAM, FRIAT and REDINREN, Madrid, Spain. FAU - Banach, Maciej AU - Banach M AD - Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Lodz, Poland. FAU - Burlacu, Alexandru AU - Burlacu A AUID- ORCID: 0000-0002-3424-1588 AD - Department of Interventional Cardiology, Cardiovascular Diseases Institute, 'Grigore T. Popa' University of Medicine, Iasi, Romania. alburlacu@yahoo.com. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20180919 PL - England TA - BMC Med JT - BMC medicine JID - 101190723 RN - 0 (Hematologic Agents) SB - IM MH - Cardiovascular Diseases/*complications/*drug therapy MH - Hematologic Agents/*therapeutic use MH - Humans MH - Practice Guidelines as Topic MH - Renal Insufficiency, Chronic/*complications PMC - PMC6145111 OTO - NOTNLM OT - Anticoagulation OT - Antithrombotics OT - Bleeding OT - Cardiovascular disease OT - Chronic kidney disease OT - Ischemic heart disease OT - Risk score COIS- ETHICS APPROVAL AND CONSENT TO PARTICIPATE: Not applicable. CONSENT FOR PUBLICATION: Not applicable. COMPETING INTERESTS: AC speaker and consulting fees for Vifor-Fresenius, Otsuka, and Roche. SG speaker fees for Boeringher and Shire. AO consultant for Sanofi Genzyme and Servier, and speaker fees for Amgen, Shire, and Otsuka. PR speaker and consulting fees for Astra-Zeneca, Bayer, Novartis, Relypsa, Stealth Peptides, and Vifor Fresenius Medical Care Renal Pharma, and co-founder of CardioRenal. MB speaker fees for Amgen, Abbott, Actavis, KRKA, MSD, Mylan, and Sanofi. AB speaker fees for Astra Zeneca, Sanofi, Boeringher Ingelheim, and Pfizer. None of these companies influenced this work. PUBLISHER'S NOTE: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. EDAT- 2018/09/20 06:00 MHDA- 2019/01/15 06:00 PMCR- 2018/09/19 CRDT- 2018/09/20 06:00 PHST- 2018/04/11 00:00 [received] PHST- 2018/08/03 00:00 [accepted] PHST- 2018/09/20 06:00 [entrez] PHST- 2018/09/20 06:00 [pubmed] PHST- 2019/01/15 06:00 [medline] PHST- 2018/09/19 00:00 [pmc-release] AID - 10.1186/s12916-018-1145-0 [pii] AID - 1145 [pii] AID - 10.1186/s12916-018-1145-0 [doi] PST - epublish SO - BMC Med. 2018 Sep 19;16(1):158. doi: 10.1186/s12916-018-1145-0. PMID- 30218844 OWN - NLM STAT- MEDLINE DCOM- 20190620 LR - 20260105 IS - 1097-6744 (Electronic) IS - 0002-8703 (Linking) VI - 205 DP - 2018 Nov TI - Rationale and design of the EVOLVE Short DAPT Study to assess 3-month dual antiplatelet therapy in subjects at high risk for bleeding undergoing percutaneous coronary intervention. PG - 110-117 LID - S0002-8703(18)30246-1 [pii] LID - 10.1016/j.ahj.2018.08.004 [doi] AB - BACKGROUND: While extended dual antiplatelet therapy (DAPT) with aspirin and a platelet (P2Y(12)) inhibitor after percutaneous coronary intervention (PCI) reduces the risk of stent thrombosis (ST) and myocardial infarction (MI), it also increases bleeding. Newer generation drug-eluting stents with bioabsorbable polymer coatings may reduce thrombotic events and allow abbreviated DAPT in selected patients. The EVOLVE Short DAPT study is designed to evaluate the safety of 3-month DAPT in high bleeding risk subjects treated with the SYNERGY bioabsorbable polymer everolimus-eluting stent. TRIAL DESIGN: EVOLVE Short DAPT is a prospective, single-arm, international study that enrolled 2009 high risk bleeding subjects (defined as age >/=75 years, chronic anticoagulation, major bleeding within 12 months, history of stroke, renal insufficiency/failure, or thrombocytopenia) who underwent PCI with the SYNERGY stent. Subjects presenting with acute MI or complex lesions were excluded. After 3 months treatment with DAPT (except those on anticoagulant in whom aspirin is optional), subjects free from stroke, MI, revascularization or ST will be eligible to discontinue P2Y(12) inhibitor, but continue aspirin. Co-primary endpoints assessed between 3-15 months are: i) death/MI compared for non-inferiority with propensity-adjusted historical group receiving 12-month DAPT, and ii) definite/probable ST compared to a performance goal. The secondary endpoint is the rate of bleeding in subjects not receiving chronic anticoagulation compared for superiority against a propensity-adjusted historical control. CONCLUSION: The EVOLVE Short DAPT study will prospectively define the safety of DAPT discontinuation at 3 months in high bleeding risk patients treated with the SYNERGY stent. CI - Copyright (c) 2018 Elsevier Inc. All rights reserved. FAU - Mauri, Laura AU - Mauri L AD - Division of Cardiovascular Medicine/Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. Electronic address: laura.mauri@gmail.com. FAU - Kirtane, Ajay J AU - Kirtane AJ AD - Division of Cardiology, Columbia University/NewYork-Presbyterian Hospital and the Cardiovascular Research Foundation, New York, NY, USA. FAU - Windecker, Stephan AU - Windecker S AD - Bern University Hospital, Bern, Switzerland. FAU - Yeh, Robert W AU - Yeh RW AD - Beth Israel Deaconess Medical Center, Boston, MA, USA. FAU - Dauerman, Harold L AU - Dauerman HL AD - University of Vermont Larner College of Medicine, Burlington, VT, USA. FAU - Price, Matthew J AU - Price MJ AD - Scripps Clinic, La Jolla, CA, USA. FAU - Christen, Thomas AU - Christen T AD - Boston Scientific Corporation, Marlborough, MA, USA. FAU - Allocco, Dominic J AU - Allocco DJ AD - Boston Scientific Corporation, Marlborough, MA, USA. FAU - Meredith, Ian T AU - Meredith IT AD - Boston Scientific Corporation, Marlborough, MA, USA. FAU - Kereiakes, Dean J AU - Kereiakes DJ AD - The Christ Hospital Heart and Vascular Center/The Lindner Research Center, Cincinnati, OH, USA. Electronic address: lindner@thechristhospital.com. LA - eng SI - ClinicalTrials.gov/NCT02605447 PT - Clinical Trial Protocol PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20180817 PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 RN - 0 (Platelet Aggregation Inhibitors) RN - A74586SNO7 (Clopidogrel) RN - R16CO5Y76E (Aspirin) SB - IM MH - Aged MH - Aspirin/*administration & dosage MH - Brazil/epidemiology MH - Clopidogrel/*administration & dosage MH - Coronary Artery Disease/complications/*therapy MH - Dose-Response Relationship, Drug MH - Drug Therapy, Combination MH - *Drug-Eluting Stents MH - Europe/epidemiology MH - Female MH - Hemorrhage/complications/*epidemiology MH - Humans MH - Incidence MH - Japan/epidemiology MH - Male MH - Middle Aged MH - *Percutaneous Coronary Intervention MH - Platelet Aggregation Inhibitors/*therapeutic use MH - Prospective Studies MH - Risk Factors MH - Treatment Outcome MH - United States/epidemiology MH - Multicenter Studies as Topic MH - Randomized Controlled Trials as Topic EDAT- 2018/09/16 06:00 MHDA- 2019/06/21 06:00 CRDT- 2018/09/16 06:00 PHST- 2018/05/30 00:00 [received] PHST- 2018/08/02 00:00 [accepted] PHST- 2018/09/16 06:00 [pubmed] PHST- 2019/06/21 06:00 [medline] PHST- 2018/09/16 06:00 [entrez] AID - S0002-8703(18)30246-1 [pii] AID - 10.1016/j.ahj.2018.08.004 [doi] PST - ppublish SO - Am Heart J. 2018 Nov;205:110-117. doi: 10.1016/j.ahj.2018.08.004. Epub 2018 Aug 17. PMID- 30207603 OWN - NLM STAT- MEDLINE DCOM- 20200629 LR - 20200629 IS - 1552-4604 (Electronic) IS - 0091-2700 (Linking) VI - 59 IP - 2 DP - 2019 Feb TI - Chronic Kidney Disease and Third-Generation P2Y(12) Inhibitors Use in Patients With Acute Coronary Syndrome: Impact on the Prognosis at 1 Year. PG - 295-302 LID - 10.1002/jcph.1318 [doi] AB - Chronic kidney disease (CKD) is associated with worse clinical outcomes in patients with acute coronary syndrome. However, they are underrepresented in clinical trials. We aimed to investigate differences in prognosis of acute coronary syndrome patients with and without CKD, focusing on the use of novel P2Y(12) receptor inhibitors. This multicenter registry involved patients with acute coronary syndrome from 3 tertiary institutions. After excluding anticoagulated patients and patients on antiplatelet monotherapy, 1280 patients remained. During 1 year of follow-up, we recorded all major adverse cardiovascular events (composite of cardiovascular death, nonfatal myocardial infarction, and nonfatal ischemic stroke), bleeds (Bleeding Academic Research Consortium classification) and deaths. Of 1280 patients, 325 (25.4%) had CKD; 55.5% of non-CKD patients and 22.7% of CKD patients were prescribed novel P2Y(12) inhibitors. During follow-up, CKD patients under novel P2Y(12) inhibitors showed a not statistically significant lower mortality and incidence of thrombotic events than clopidogrel-treated ones. In contrast, non-CKD patients taking novel P2Y(12) inhibitors had better outcomes in terms of major adverse cardiovascular events (4.72 vs 9.41; P = .006), all-cause mortality (1.32 vs 4.24; P = .006), and severe bleeding events (Bleeding Academic Research Consortium 3-5) (0.94 vs 2.82; P = .030), without differences for any bleeding (8.11 vs 8.47; P = .849). Bleeding risk was not increased by using third-generation P2Y(12) inhibitors in either group of patients. In conclusion, the use of third-generation P2Y(12) inhibitors among non-CKD patients was associated with better outcomes. CKD patients receiving third-generation P2Y(12) inhibitors treatment showed no statistically significant lower mortality and thrombotic events. Bleeding risk was not increased with the use of third-generation P2Y(12) inhibitors in either group of patients. CI - (c) 2018, The American College of Clinical Pharmacology. FAU - Tello-Montoliu, Antonio AU - Tello-Montoliu A AD - Department of Cardiology, Hospital Clinico Universitario Virgen de la Arrixaca, Instituto Murciano de Investigacion Biosanitaria (IMIB-Arrixaca), CIBERCV, Murcia, Spain. FAU - Ruiz-Nodar, Juan Miguel AU - Ruiz-Nodar JM AD - Department of Cardiology, Hospital General Universitario de Alicante, Instituto de Investigacion Sanitaria y Biomedica de Alicante (ISABIAL), Alicante, Spain. FAU - Esteve-Pastor, Maria Asuncion AU - Esteve-Pastor MA AUID- ORCID: 0000-0003-3104-3460 AD - Department of Cardiology, Hospital Clinico Universitario Virgen de la Arrixaca, Instituto Murciano de Investigacion Biosanitaria (IMIB-Arrixaca), CIBERCV, Murcia, Spain. FAU - Veliz-Martinez, Andrea AU - Veliz-Martinez A AD - Department of Cardiology, Hospital Clinico Universitario Virgen de la Arrixaca, Instituto Murciano de Investigacion Biosanitaria (IMIB-Arrixaca), CIBERCV, Murcia, Spain. FAU - Orenes-Pinero, Esteban AU - Orenes-Pinero E AD - Department of Cardiology, Hospital Clinico Universitario Virgen de la Arrixaca, Instituto Murciano de Investigacion Biosanitaria (IMIB-Arrixaca), CIBERCV, Murcia, Spain. FAU - Macias-Villanego, Manuel J AU - Macias-Villanego MJ AD - Department of Cardiology, Hospital General Universitario de Alicante, Instituto de Investigacion Sanitaria y Biomedica de Alicante (ISABIAL), Alicante, Spain. FAU - Lozano, Teresa AU - Lozano T AD - Department of Cardiology, Hospital General Universitario de Alicante, Instituto de Investigacion Sanitaria y Biomedica de Alicante (ISABIAL), Alicante, Spain. FAU - Carrillo-Aleman, Luna AU - Carrillo-Aleman L AD - Department of Cardiology, Hospital General Universitario de Alicante, Instituto de Investigacion Sanitaria y Biomedica de Alicante (ISABIAL), Alicante, Spain. FAU - Vicente-Ibarra, Nuria AU - Vicente-Ibarra N AD - Department of Cardiology, Hospital General Universitario de Elche, Alicante, Spain. FAU - Pernias-Escrig, Vicente AU - Pernias-Escrig V AD - Department of Cardiology, Hospital General Universitario de Elche, Alicante, Spain. FAU - Martinez-Martinez, Juan G AU - Martinez-Martinez JG AD - Department of Cardiology, Hospital General Universitario de Alicante, Instituto de Investigacion Sanitaria y Biomedica de Alicante (ISABIAL), Alicante, Spain. FAU - Rivera-Caravaca, Jose Miguel AU - Rivera-Caravaca JM AUID- ORCID: 0000-0003-0492-6241 AD - Department of Cardiology, Hospital Clinico Universitario Virgen de la Arrixaca, Instituto Murciano de Investigacion Biosanitaria (IMIB-Arrixaca), CIBERCV, Murcia, Spain. FAU - Marin, Francisco AU - Marin F AD - Department of Cardiology, Hospital Clinico Universitario Virgen de la Arrixaca, Instituto Murciano de Investigacion Biosanitaria (IMIB-Arrixaca), CIBERCV, Murcia, Spain. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20180912 PL - England TA - J Clin Pharmacol JT - Journal of clinical pharmacology JID - 0366372 RN - 0 (Purinergic P2Y Receptor Antagonists) RN - A74586SNO7 (Clopidogrel) SB - IM MH - Acute Coronary Syndrome/*drug therapy MH - Aged MH - Clopidogrel/therapeutic use MH - Female MH - Hemorrhage/chemically induced MH - Humans MH - Male MH - Middle Aged MH - Percutaneous Coronary Intervention MH - Prognosis MH - Purinergic P2Y Receptor Antagonists/*therapeutic use MH - Renal Insufficiency, Chronic/*drug therapy OTO - NOTNLM OT - acute coronary syndrome OT - antiplatelet agents OT - hemorrhage OT - ischemia OT - platelet aggregation inhibitors OT - renal function EDAT- 2018/09/13 06:00 MHDA- 2020/07/01 06:00 CRDT- 2018/09/13 06:00 PHST- 2018/07/03 00:00 [received] PHST- 2018/08/23 00:00 [accepted] PHST- 2018/09/13 06:00 [pubmed] PHST- 2020/07/01 06:00 [medline] PHST- 2018/09/13 06:00 [entrez] AID - 10.1002/jcph.1318 [doi] PST - ppublish SO - J Clin Pharmacol. 2019 Feb;59(2):295-302. doi: 10.1002/jcph.1318. Epub 2018 Sep 12. PMID- 30172098 OWN - NLM STAT- MEDLINE DCOM- 20190620 LR - 20260105 IS - 1097-6744 (Electronic) IS - 0002-8703 (Print) IS - 0002-8703 (Linking) VI - 205 DP - 2018 Nov TI - International Study of Comparative Health Effectiveness with Medical and Invasive Approaches-Chronic Kidney Disease (ISCHEMIA-CKD): Rationale and design. PG - 42-52 LID - S0002-8703(18)30235-7 [pii] LID - 10.1016/j.ahj.2018.07.023 [doi] AB - BACKGROUND: Patients with chronic kidney disease (CKD) and stable ischemic heart disease are at markedly increased risk of cardiovascular events. Prior trials comparing a strategy of optimal medical therapy (OMT) with or without revascularization have largely excluded patients with advanced CKD. Whether a routine invasive approach when compared with a conservative strategy is beneficial in such patients is unknown. METHODS: ISCHEMIA-CKD is a National Heart, Lung, and Blood Institute-funded randomized trial designed to determine the comparative effectiveness of an initial invasive strategy (cardiac catheterization and optimal revascularization [percutaneous coronary intervention or coronary artery bypass graft surgery, if suitable] plus OMT) versus a conservative strategy (OMT alone, with cardiac catheterization and revascularization [percutaneous coronary intervention or coronary artery bypass graft surgery, if suitable] reserved for failure of OMT) on long-term clinical outcomes in 777 patients with advanced CKD (defined as those with estimated glomerular filtration rate <30 mL/min/1.73m(2) or on dialysis) and moderate or severe ischemia on stress testing. Participants were randomized in a 1:1 fashion to the invasive or a conservative strategy. The primary end point is a composite of death or nonfatal myocardial infarction. Major secondary endpoints are a composite of death, nonfatal myocardial infarction, hospitalization for unstable angina, hospitalization for heart failure, or resuscitated cardiac arrest; angina control; and disease-specific quality of life. Safety outcomes such as initiation of maintenance dialysis and a composite of initiation of maintenance dialysis or death will be reported. The trial is projected to have 80% power to detect a 22% to 24% reduction in the primary composite end point with the invasive strategy when compared with the conservative strategy. CONCLUSIONS: ISCHEMIA-CKD will determine whether an initial invasive management strategy improves clinical outcomes when added to OMT in patients with advanced CKD and stable ischemic heart disease. CI - Copyright (c) 2018 Elsevier Inc. All rights reserved. FAU - Bangalore, Sripal AU - Bangalore S AD - New York University School of Medicine, New York, NY. Electronic address: sripalbangalore@gmail.com. FAU - Maron, David J AU - Maron DJ AD - Stanford University School of Medicine, Stanford, CA. FAU - Fleg, Jerome L AU - Fleg JL AD - National Heart Lung and Blood Institute, Bethesda, MD. FAU - O'Brien, Sean M AU - O'Brien SM AD - Duke Clinical Research Institute, Durham, NC. FAU - Herzog, Charles A AU - Herzog CA AD - Hennepin County Medical Center and University of Minnesota, Minneapolis, MN. FAU - Stone, Gregg W AU - Stone GW AD - New York Presbyterian Hospital, Columbia University Medical Center and the Cardiovascular Research Foundation, New York, NY. FAU - Mark, Daniel B AU - Mark DB AD - Duke Clinical Research Institute, Durham, NC. FAU - Spertus, John A AU - Spertus JA AD - Mid-America Heart Institute/University of Missouri-Kansas City, Kansas City, MO. FAU - Alexander, Karen P AU - Alexander KP AD - Duke Clinical Research Institute, Durham, NC. FAU - Sidhu, Mandeep S AU - Sidhu MS AD - Albany Medical Center, Albany, NY. FAU - Chertow, Glenn M AU - Chertow GM AD - Stanford University School of Medicine, Stanford, CA. FAU - Boden, William E AU - Boden WE AD - Veterans Affairs New England Healthcare System, Massachusetts Veterans Epidemiology, Research, and Informatics Center, Boston, MA. FAU - Hochman, Judith S AU - Hochman JS AD - New York University School of Medicine, New York, NY. CN - ISCHEMIA-CKD Research Group LA - eng SI - ClinicalTrials.gov/NCT01985360 GR - U01 HL117904/HL/NHLBI NIH HHS/United States GR - U01 HL117905/HL/NHLBI NIH HHS/United States PT - Clinical Trial Protocol PT - Journal Article PT - Research Support, N.I.H., Extramural DEP - 20180801 PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 SB - IM MH - Aged MH - Cardiac Catheterization MH - Conservative Treatment/*methods MH - Female MH - Glomerular Filtration Rate/*physiology MH - Humans MH - Male MH - Middle Aged MH - Myocardial Ischemia/complications/*therapy MH - Myocardial Revascularization/*methods MH - *Quality of Life MH - Renal Insufficiency, Chronic/*complications MH - Treatment Outcome MH - Multicenter Studies as Topic MH - Randomized Controlled Trials as Topic PMC - PMC6283671 MID - NIHMS994044 EDAT- 2018/09/02 06:00 MHDA- 2019/06/21 06:00 PMCR- 2018/12/06 CRDT- 2018/09/02 06:00 PHST- 2018/03/27 00:00 [received] PHST- 2018/07/22 00:00 [accepted] PHST- 2018/09/02 06:00 [pubmed] PHST- 2019/06/21 06:00 [medline] PHST- 2018/09/02 06:00 [entrez] PHST- 2018/12/06 00:00 [pmc-release] AID - S0002-8703(18)30235-7 [pii] AID - 10.1016/j.ahj.2018.07.023 [doi] PST - ppublish SO - Am Heart J. 2018 Nov;205:42-52. doi: 10.1016/j.ahj.2018.07.023. Epub 2018 Aug 1. PMID- 30170456 OWN - NLM STAT- MEDLINE DCOM- 20180906 LR - 20221005 IS - 1536-5964 (Electronic) IS - 0025-7974 (Print) IS - 0025-7974 (Linking) VI - 97 IP - 35 DP - 2018 Aug TI - Off-pump versus on-pump complete coronary artery bypass grafting: Comparison of the effects on the renal damage in patients with renal dysfunction. PG - e12146 LID - 10.1097/MD.0000000000012146 [doi] LID - e12146 AB - BACKGROUND: We aimed to compare off-pump technique with on-pump technique on renal function in patients with nondialysis-dependent renal dysfunction who underwent coronary artery bypass grafting. METHODS: The 94 patients with renal dysfunction undergoing isolated coronary artery bypass grafting were retrospectively analyzed. No patient was receiving dialysis. Patients were randomly assigned to conventional revascularization with cardiopulmonary bypass and beating heart. Both groups were compared in terms of renal dysfunction parameters and dialysis requirement. The logistic regression models were constructed to identify risk factors associated with dialysis requirement. RESULTS: Renal dysfunction requiring dialysis developed in 9 patients in the on-pump group. The measures analysis of variance was performed on the data that showed worsening of renal function in the on-pump group compared with the off-pump group. Cardiopulmonary bypass is significant as independent predictor for the development of postoperative dialysis. CONCLUSION: These results suggest that off-pump coronary revascularization offers a superior renal protection and has a significantly lower risk for renal complications in patients with nondialysis-dependent renal dysfunction when compared with conventional coronary revascularization with cardiopulmonary bypass. FAU - Arslan, Umit AU - Arslan U AD - Department of Cardiovascular Surgery, Ataturk University, Erzurum Department of Cardiovascular Surgery, Health Science University, Kayseri Training and Research Hospital, Kayseri, Turkey. FAU - Calik, Eyupserhat AU - Calik E FAU - Tekin, Ali Ihsan AU - Tekin AI FAU - Erkut, Bilgehan AU - Erkut B LA - eng PT - Journal Article PT - Randomized Controlled Trial PL - United States TA - Medicine (Baltimore) JT - Medicine JID - 2985248R SB - IM MH - Coronary Artery Bypass/*adverse effects/methods MH - Coronary Artery Bypass, Off-Pump/adverse effects MH - Coronary Artery Disease/complications/*surgery MH - Female MH - Humans MH - Kidney/pathology MH - Logistic Models MH - Male MH - Middle Aged MH - Postoperative Complications/*etiology MH - Postoperative Period MH - Renal Dialysis/statistics & numerical data MH - Renal Insufficiency, Chronic/etiology/*physiopathology/surgery MH - Retrospective Studies MH - Risk Factors PMC - PMC6393058 COIS- The authors have no funding and conflicts of interest to disclose. EDAT- 2018/09/02 06:00 MHDA- 2018/09/07 06:00 PMCR- 2018/08/21 CRDT- 2018/09/02 06:00 PHST- 2018/09/02 06:00 [entrez] PHST- 2018/09/02 06:00 [pubmed] PHST- 2018/09/07 06:00 [medline] PHST- 2018/08/21 00:00 [pmc-release] AID - 00005792-201808310-00088 [pii] AID - MD-D-18-03073 [pii] AID - 10.1097/MD.0000000000012146 [doi] PST - ppublish SO - Medicine (Baltimore). 2018 Aug;97(35):e12146. doi: 10.1097/MD.0000000000012146. PMID- 30146969 OWN - NLM STAT- MEDLINE DCOM- 20181030 LR - 20260518 IS - 1533-4406 (Electronic) IS - 0028-4793 (Linking) VI - 379 IP - 13 DP - 2018 Sep 27 TI - Six-Month Outcomes after Restrictive or Liberal Transfusion for Cardiac Surgery. PG - 1224-1233 LID - 10.1056/NEJMoa1808561 [doi] AB - BACKGROUND: We reported previously that, in patients undergoing cardiac surgery who were at moderate-to-high risk for death, a restrictive transfusion strategy was noninferior to a liberal strategy with respect to the composite outcome of death from any cause, myocardial infarction, stroke, or new-onset renal failure with dialysis by hospital discharge or 28 days after surgery, whichever came first. We now report the clinical outcomes at 6 months after surgery. METHODS: We randomly assigned 5243 adults undergoing cardiac surgery to a restrictive red-cell transfusion strategy (transfusion if the hemoglobin concentration was <7.5 g per deciliter intraoperatively or postoperatively) or a liberal red-cell transfusion strategy (transfusion if the hemoglobin concentration was <9.5 g per deciliter intraoperatively or postoperatively when the patient was in the intensive care unit [ICU] or was <8.5 g per deciliter when the patient was in the non-ICU ward). The primary composite outcome was death from any cause, myocardial infarction, stroke, or new-onset renal failure with dialysis occurring within 6 months after the initial surgery. An expanded secondary composite outcome included all the components of the primary outcome as well as emergency department visit, hospital readmission, or coronary revascularization occurring within 6 months after the index surgery. The secondary outcomes included the individual components of the two composite outcomes. RESULTS: At 6 months after surgery, the primary composite outcome had occurred in 402 of 2317 patients (17.4%) in the restrictive-threshold group and in 402 of 2347 patients (17.1%) in the liberal-threshold group (absolute risk difference before rounding, 0.22 percentage points; 95% confidence interval [CI], -1.95 to 2.39; odds ratio, 1.02; 95% CI, 0.87 to 1.18; P=0.006 for noninferiority). Mortality was 6.2% in the restrictive-threshold group and 6.4% in the liberal-threshold group (odds ratio, 0.95; 95% CI, 0.75 to 1.21). There were no significant between-group differences in the secondary outcomes. CONCLUSIONS: In patients undergoing cardiac surgery who were at moderate-to-high risk for death, a restrictive strategy for red-cell transfusion was noninferior to a liberal strategy with respect to the composite outcome of death from any cause, myocardial infarction, stroke, or new-onset renal failure with dialysis at 6 months after surgery. (Funded by the Canadian Institutes of Health Research and others; TRICS III ClinicalTrials.gov number, NCT02042898 .). FAU - Mazer, C David AU - Mazer CD AD - From the Department of Anesthesia (C.D.M., G.M.T.H., N.M.) and the Department of Surgery, Division of Cardiac Surgery (S.V.), St. Michael's Hospital, Keenan Research Centre for Biomedical Science, the Li Ka Shing Knowledge Institute of St. Michael's Hospital (C.D.M., G.M.T.H., K.T., S.V., P.J.), Applied Health Research Centre (J.H., D.D., K.T., S.V., P.J.), Sunnybrook Health Sciences Centre (S.F.), Division of Hematology, Mount Sinai Hospital (N.S.), the Departments of Medicine (P.J., N.S.), Physiology (C.D.M., G.M.T.H), and Laboratory Medicine and Pathobiology (N.S.), Dalla Lana School of Public Health (K.T.), and Institute of Health Policy, Management and Evaluation, University of Toronto, and Canadian Blood Services (N.S.), Toronto, the Population Health Research Institute (R.P.W., E.B.-C.), Hamilton Health Sciences Center (R.P.W., E.B.-C., K.C., S.S.), McMaster University (R.P.W., E.B.-C., K.C., S.S.), Hamilton, ON, the Ottawa Hospital Research Institute, University of Ottawa, Ottawa (D.A.F.), the Cumming School of Medicine and Libin Cardiovascular Institute, University of Calgary, Calgary (A.J.G.), and the Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton (S.M.B.), CHUS-Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke (E.M.), and the Department of Anesthesiology and Critical Care Medicine, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Laval University, Laval (F.L.), QC, the Departments of Anesthesia and Medicine, Division of Critical Care, Centre Hospitalier de l'Universite de Montreal, Montreal (F.M.C.), and the Department of Anesthesia, Perioperative and Pain Medicine, St. Boniface Hospital, University of Manitoba, Winnipeg (H.P.G.) - all in Canada; the Department of Cardiothoracic Anesthesia, Rigshospitalet, Copenhagen University Hospital, Copenhagen (B.K.); Medical Research Institute of New Zealand, Wellington (S.M., P.J.Y.), and Waikato Hospital, Hamilton (K.B.) - both in New Zealand; Fundacion Cardioinfantil-Instituto de Cardiologia and Universidad Autonoma de Bucaramanga, Bucaramanga, Colombia (J.C.V.); the Department of Surgery, University of Melbourne (A.R., C.R.), and the Department of Anaesthesia and Pain Management, Royal Melbourne Hospital (C.R.), Melbourne, VIC, and the Department of Anaesthesia, Royal Adelaide Hospital, and the Discipline of Acute Care Medicine, University of Adelaide, Adelaide, SA (T.W.P.) - all in Australia; University of Basel, Department of Anesthesia, Surgical Intensive Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, Basel, and Klinik Hirslanden Zurich, Zurich - both in Switzerland (M.D.S.); Heart Care Associates, SAL Hospital, Gujarat, India (C.M.); and the Department of Cardiothoracic Anaesthesia, National Heart Center, and the Department of Anaesthesiology, Singapore General Hospital - both in Singapore (N.-C.H.). FAU - Whitlock, Richard P AU - Whitlock RP AD - From the Department of Anesthesia (C.D.M., G.M.T.H., N.M.) and the Department of Surgery, Division of Cardiac Surgery (S.V.), St. Michael's Hospital, Keenan Research Centre for Biomedical Science, the Li Ka Shing Knowledge Institute of St. Michael's Hospital (C.D.M., G.M.T.H., K.T., S.V., P.J.), Applied Health Research Centre (J.H., D.D., K.T., S.V., P.J.), Sunnybrook Health Sciences Centre (S.F.), Division of Hematology, Mount Sinai Hospital (N.S.), the Departments of Medicine (P.J., N.S.), Physiology (C.D.M., G.M.T.H), and Laboratory Medicine and Pathobiology (N.S.), Dalla Lana School of Public Health (K.T.), and Institute of Health Policy, Management and Evaluation, University of Toronto, and Canadian Blood Services (N.S.), Toronto, the Population Health Research Institute (R.P.W., E.B.-C.), Hamilton Health Sciences Center (R.P.W., E.B.-C., K.C., S.S.), McMaster University (R.P.W., E.B.-C., K.C., S.S.), Hamilton, ON, the Ottawa Hospital Research Institute, University of Ottawa, Ottawa (D.A.F.), the Cumming School of Medicine and Libin Cardiovascular Institute, University of Calgary, Calgary (A.J.G.), and the Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton (S.M.B.), CHUS-Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke (E.M.), and the Department of Anesthesiology and Critical Care Medicine, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Laval University, Laval (F.L.), QC, the Departments of Anesthesia and Medicine, Division of Critical Care, Centre Hospitalier de l'Universite de Montreal, Montreal (F.M.C.), and the Department of Anesthesia, Perioperative and Pain Medicine, St. Boniface Hospital, University of Manitoba, Winnipeg (H.P.G.) - all in Canada; the Department of Cardiothoracic Anesthesia, Rigshospitalet, Copenhagen University Hospital, Copenhagen (B.K.); Medical Research Institute of New Zealand, Wellington (S.M., P.J.Y.), and Waikato Hospital, Hamilton (K.B.) - both in New Zealand; Fundacion Cardioinfantil-Instituto de Cardiologia and Universidad Autonoma de Bucaramanga, Bucaramanga, Colombia (J.C.V.); the Department of Surgery, University of Melbourne (A.R., C.R.), and the Department of Anaesthesia and Pain Management, Royal Melbourne Hospital (C.R.), Melbourne, VIC, and the Department of Anaesthesia, Royal Adelaide Hospital, and the Discipline of Acute Care Medicine, University of Adelaide, Adelaide, SA (T.W.P.) - all in Australia; University of Basel, Department of Anesthesia, Surgical Intensive Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, Basel, and Klinik Hirslanden Zurich, Zurich - both in Switzerland (M.D.S.); Heart Care Associates, SAL Hospital, Gujarat, India (C.M.); and the Department of Cardiothoracic Anaesthesia, National Heart Center, and the Department of Anaesthesiology, Singapore General Hospital - both in Singapore (N.-C.H.). FAU - Fergusson, Dean A AU - Fergusson DA AD - From the Department of Anesthesia (C.D.M., G.M.T.H., N.M.) and the Department of Surgery, Division of Cardiac Surgery (S.V.), St. Michael's Hospital, Keenan Research Centre for Biomedical Science, the Li Ka Shing Knowledge Institute of St. Michael's Hospital (C.D.M., G.M.T.H., K.T., S.V., P.J.), Applied Health Research Centre (J.H., D.D., K.T., S.V., P.J.), Sunnybrook Health Sciences Centre (S.F.), Division of Hematology, Mount Sinai Hospital (N.S.), the Departments of Medicine (P.J., N.S.), Physiology (C.D.M., G.M.T.H), and Laboratory Medicine and Pathobiology (N.S.), Dalla Lana School of Public Health (K.T.), and Institute of Health Policy, Management and Evaluation, University of Toronto, and Canadian Blood Services (N.S.), Toronto, the Population Health Research Institute (R.P.W., E.B.-C.), Hamilton Health Sciences Center (R.P.W., E.B.-C., K.C., S.S.), McMaster University (R.P.W., E.B.-C., K.C., S.S.), Hamilton, ON, the Ottawa Hospital Research Institute, University of Ottawa, Ottawa (D.A.F.), the Cumming School of Medicine and Libin Cardiovascular Institute, University of Calgary, Calgary (A.J.G.), and the Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton (S.M.B.), CHUS-Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke (E.M.), and the Department of Anesthesiology and Critical Care Medicine, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Laval University, Laval (F.L.), QC, the Departments of Anesthesia and Medicine, Division of Critical Care, Centre Hospitalier de l'Universite de Montreal, Montreal (F.M.C.), and the Department of Anesthesia, Perioperative and Pain Medicine, St. Boniface Hospital, University of Manitoba, Winnipeg (H.P.G.) - all in Canada; the Department of Cardiothoracic Anesthesia, Rigshospitalet, Copenhagen University Hospital, Copenhagen (B.K.); Medical Research Institute of New Zealand, Wellington (S.M., P.J.Y.), and Waikato Hospital, Hamilton (K.B.) - both in New Zealand; Fundacion Cardioinfantil-Instituto de Cardiologia and Universidad Autonoma de Bucaramanga, Bucaramanga, Colombia (J.C.V.); the Department of Surgery, University of Melbourne (A.R., C.R.), and the Department of Anaesthesia and Pain Management, Royal Melbourne Hospital (C.R.), Melbourne, VIC, and the Department of Anaesthesia, Royal Adelaide Hospital, and the Discipline of Acute Care Medicine, University of Adelaide, Adelaide, SA (T.W.P.) - all in Australia; University of Basel, Department of Anesthesia, Surgical Intensive Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, Basel, and Klinik Hirslanden Zurich, Zurich - both in Switzerland (M.D.S.); Heart Care Associates, SAL Hospital, Gujarat, India (C.M.); and the Department of Cardiothoracic Anaesthesia, National Heart Center, and the Department of Anaesthesiology, Singapore General Hospital - both in Singapore (N.-C.H.). FAU - Belley-Cote, Emilie AU - Belley-Cote E AD - From the Department of Anesthesia (C.D.M., G.M.T.H., N.M.) and the Department of Surgery, Division of Cardiac Surgery (S.V.), St. Michael's Hospital, Keenan Research Centre for Biomedical Science, the Li Ka Shing Knowledge Institute of St. Michael's Hospital (C.D.M., G.M.T.H., K.T., S.V., P.J.), Applied Health Research Centre (J.H., D.D., K.T., S.V., P.J.), Sunnybrook Health Sciences Centre (S.F.), Division of Hematology, Mount Sinai Hospital (N.S.), the Departments of Medicine (P.J., N.S.), Physiology (C.D.M., G.M.T.H), and Laboratory Medicine and Pathobiology (N.S.), Dalla Lana School of Public Health (K.T.), and Institute of Health Policy, Management and Evaluation, University of Toronto, and Canadian Blood Services (N.S.), Toronto, the Population Health Research Institute (R.P.W., E.B.-C.), Hamilton Health Sciences Center (R.P.W., E.B.-C., K.C., S.S.), McMaster University (R.P.W., E.B.-C., K.C., S.S.), Hamilton, ON, the Ottawa Hospital Research Institute, University of Ottawa, Ottawa (D.A.F.), the Cumming School of Medicine and Libin Cardiovascular Institute, University of Calgary, Calgary (A.J.G.), and the Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton (S.M.B.), CHUS-Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke (E.M.), and the Department of Anesthesiology and Critical Care Medicine, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Laval University, Laval (F.L.), QC, the Departments of Anesthesia and Medicine, Division of Critical Care, Centre Hospitalier de l'Universite de Montreal, Montreal (F.M.C.), and the Department of Anesthesia, Perioperative and Pain Medicine, St. Boniface Hospital, University of Manitoba, Winnipeg (H.P.G.) - all in Canada; the Department of Cardiothoracic Anesthesia, Rigshospitalet, Copenhagen University Hospital, Copenhagen (B.K.); Medical Research Institute of New Zealand, Wellington (S.M., P.J.Y.), and Waikato Hospital, Hamilton (K.B.) - both in New Zealand; Fundacion Cardioinfantil-Instituto de Cardiologia and Universidad Autonoma de Bucaramanga, Bucaramanga, Colombia (J.C.V.); the Department of Surgery, University of Melbourne (A.R., C.R.), and the Department of Anaesthesia and Pain Management, Royal Melbourne Hospital (C.R.), Melbourne, VIC, and the Department of Anaesthesia, Royal Adelaide Hospital, and the Discipline of Acute Care Medicine, University of Adelaide, Adelaide, SA (T.W.P.) - all in Australia; University of Basel, Department of Anesthesia, Surgical Intensive Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, Basel, and Klinik Hirslanden Zurich, Zurich - both in Switzerland (M.D.S.); Heart Care Associates, SAL Hospital, Gujarat, India (C.M.); and the Department of Cardiothoracic Anaesthesia, National Heart Center, and the Department of Anaesthesiology, Singapore General Hospital - both in Singapore (N.-C.H.). FAU - Connolly, Katherine AU - Connolly K AD - From the Department of Anesthesia (C.D.M., G.M.T.H., N.M.) and the Department of Surgery, Division of Cardiac Surgery (S.V.), St. Michael's Hospital, Keenan Research Centre for Biomedical Science, the Li Ka Shing Knowledge Institute of St. Michael's Hospital (C.D.M., G.M.T.H., K.T., S.V., P.J.), Applied Health Research Centre (J.H., D.D., K.T., S.V., P.J.), Sunnybrook Health Sciences Centre (S.F.), Division of Hematology, Mount Sinai Hospital (N.S.), the Departments of Medicine (P.J., N.S.), Physiology (C.D.M., G.M.T.H), and Laboratory Medicine and Pathobiology (N.S.), Dalla Lana School of Public Health (K.T.), and Institute of Health Policy, Management and Evaluation, University of Toronto, and Canadian Blood Services (N.S.), Toronto, the Population Health Research Institute (R.P.W., E.B.-C.), Hamilton Health Sciences Center (R.P.W., E.B.-C., K.C., S.S.), McMaster University (R.P.W., E.B.-C., K.C., S.S.), Hamilton, ON, the Ottawa Hospital Research Institute, University of Ottawa, Ottawa (D.A.F.), the Cumming School of Medicine and Libin Cardiovascular Institute, University of Calgary, Calgary (A.J.G.), and the Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton (S.M.B.), CHUS-Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke (E.M.), and the Department of Anesthesiology and Critical Care Medicine, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Laval University, Laval (F.L.), QC, the Departments of Anesthesia and Medicine, Division of Critical Care, Centre Hospitalier de l'Universite de Montreal, Montreal (F.M.C.), and the Department of Anesthesia, Perioperative and Pain Medicine, St. Boniface Hospital, University of Manitoba, Winnipeg (H.P.G.) - all in Canada; the Department of Cardiothoracic Anesthesia, Rigshospitalet, Copenhagen University Hospital, Copenhagen (B.K.); Medical Research Institute of New Zealand, Wellington (S.M., P.J.Y.), and Waikato Hospital, Hamilton (K.B.) - both in New Zealand; Fundacion Cardioinfantil-Instituto de Cardiologia and Universidad Autonoma de Bucaramanga, Bucaramanga, Colombia (J.C.V.); the Department of Surgery, University of Melbourne (A.R., C.R.), and the Department of Anaesthesia and Pain Management, Royal Melbourne Hospital (C.R.), Melbourne, VIC, and the Department of Anaesthesia, Royal Adelaide Hospital, and the Discipline of Acute Care Medicine, University of Adelaide, Adelaide, SA (T.W.P.) - all in Australia; University of Basel, Department of Anesthesia, Surgical Intensive Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, Basel, and Klinik Hirslanden Zurich, Zurich - both in Switzerland (M.D.S.); Heart Care Associates, SAL Hospital, Gujarat, India (C.M.); and the Department of Cardiothoracic Anaesthesia, National Heart Center, and the Department of Anaesthesiology, Singapore General Hospital - both in Singapore (N.-C.H.). FAU - Khanykin, Boris AU - Khanykin B AD - From the Department of Anesthesia (C.D.M., G.M.T.H., N.M.) and the Department of Surgery, Division of Cardiac Surgery (S.V.), St. Michael's Hospital, Keenan Research Centre for Biomedical Science, the Li Ka Shing Knowledge Institute of St. Michael's Hospital (C.D.M., G.M.T.H., K.T., S.V., P.J.), Applied Health Research Centre (J.H., D.D., K.T., S.V., P.J.), Sunnybrook Health Sciences Centre (S.F.), Division of Hematology, Mount Sinai Hospital (N.S.), the Departments of Medicine (P.J., N.S.), Physiology (C.D.M., G.M.T.H), and Laboratory Medicine and Pathobiology (N.S.), Dalla Lana School of Public Health (K.T.), and Institute of Health Policy, Management and Evaluation, University of Toronto, and Canadian Blood Services (N.S.), Toronto, the Population Health Research Institute (R.P.W., E.B.-C.), Hamilton Health Sciences Center (R.P.W., E.B.-C., K.C., S.S.), McMaster University (R.P.W., E.B.-C., K.C., S.S.), Hamilton, ON, the Ottawa Hospital Research Institute, University of Ottawa, Ottawa (D.A.F.), the Cumming School of Medicine and Libin Cardiovascular Institute, University of Calgary, Calgary (A.J.G.), and the Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton (S.M.B.), CHUS-Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke (E.M.), and the Department of Anesthesiology and Critical Care Medicine, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Laval University, Laval (F.L.), QC, the Departments of Anesthesia and Medicine, Division of Critical Care, Centre Hospitalier de l'Universite de Montreal, Montreal (F.M.C.), and the Department of Anesthesia, Perioperative and Pain Medicine, St. Boniface Hospital, University of Manitoba, Winnipeg (H.P.G.) - all in Canada; the Department of Cardiothoracic Anesthesia, Rigshospitalet, Copenhagen University Hospital, Copenhagen (B.K.); Medical Research Institute of New Zealand, Wellington (S.M., P.J.Y.), and Waikato Hospital, Hamilton (K.B.) - both in New Zealand; Fundacion Cardioinfantil-Instituto de Cardiologia and Universidad Autonoma de Bucaramanga, Bucaramanga, Colombia (J.C.V.); the Department of Surgery, University of Melbourne (A.R., C.R.), and the Department of Anaesthesia and Pain Management, Royal Melbourne Hospital (C.R.), Melbourne, VIC, and the Department of Anaesthesia, Royal Adelaide Hospital, and the Discipline of Acute Care Medicine, University of Adelaide, Adelaide, SA (T.W.P.) - all in Australia; University of Basel, Department of Anesthesia, Surgical Intensive Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, Basel, and Klinik Hirslanden Zurich, Zurich - both in Switzerland (M.D.S.); Heart Care Associates, SAL Hospital, Gujarat, India (C.M.); and the Department of Cardiothoracic Anaesthesia, National Heart Center, and the Department of Anaesthesiology, Singapore General Hospital - both in Singapore (N.-C.H.). FAU - Gregory, Alexander J AU - Gregory AJ AD - From the Department of Anesthesia (C.D.M., G.M.T.H., N.M.) and the Department of Surgery, Division of Cardiac Surgery (S.V.), St. Michael's Hospital, Keenan Research Centre for Biomedical Science, the Li Ka Shing Knowledge Institute of St. Michael's Hospital (C.D.M., G.M.T.H., K.T., S.V., P.J.), Applied Health Research Centre (J.H., D.D., K.T., S.V., P.J.), Sunnybrook Health Sciences Centre (S.F.), Division of Hematology, Mount Sinai Hospital (N.S.), the Departments of Medicine (P.J., N.S.), Physiology (C.D.M., G.M.T.H), and Laboratory Medicine and Pathobiology (N.S.), Dalla Lana School of Public Health (K.T.), and Institute of Health Policy, Management and Evaluation, University of Toronto, and Canadian Blood Services (N.S.), Toronto, the Population Health Research Institute (R.P.W., E.B.-C.), Hamilton Health Sciences Center (R.P.W., E.B.-C., K.C., S.S.), McMaster University (R.P.W., E.B.-C., K.C., S.S.), Hamilton, ON, the Ottawa Hospital Research Institute, University of Ottawa, Ottawa (D.A.F.), the Cumming School of Medicine and Libin Cardiovascular Institute, University of Calgary, Calgary (A.J.G.), and the Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton (S.M.B.), CHUS-Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke (E.M.), and the Department of Anesthesiology and Critical Care Medicine, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Laval University, Laval (F.L.), QC, the Departments of Anesthesia and Medicine, Division of Critical Care, Centre Hospitalier de l'Universite de Montreal, Montreal (F.M.C.), and the Department of Anesthesia, Perioperative and Pain Medicine, St. Boniface Hospital, University of Manitoba, Winnipeg (H.P.G.) - all in Canada; the Department of Cardiothoracic Anesthesia, Rigshospitalet, Copenhagen University Hospital, Copenhagen (B.K.); Medical Research Institute of New Zealand, Wellington (S.M., P.J.Y.), and Waikato Hospital, Hamilton (K.B.) - both in New Zealand; Fundacion Cardioinfantil-Instituto de Cardiologia and Universidad Autonoma de Bucaramanga, Bucaramanga, Colombia (J.C.V.); the Department of Surgery, University of Melbourne (A.R., C.R.), and the Department of Anaesthesia and Pain Management, Royal Melbourne Hospital (C.R.), Melbourne, VIC, and the Department of Anaesthesia, Royal Adelaide Hospital, and the Discipline of Acute Care Medicine, University of Adelaide, Adelaide, SA (T.W.P.) - all in Australia; University of Basel, Department of Anesthesia, Surgical Intensive Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, Basel, and Klinik Hirslanden Zurich, Zurich - both in Switzerland (M.D.S.); Heart Care Associates, SAL Hospital, Gujarat, India (C.M.); and the Department of Cardiothoracic Anaesthesia, National Heart Center, and the Department of Anaesthesiology, Singapore General Hospital - both in Singapore (N.-C.H.). FAU - de Medicis, Etienne AU - de Medicis E AD - From the Department of Anesthesia (C.D.M., G.M.T.H., N.M.) and the Department of Surgery, Division of Cardiac Surgery (S.V.), St. Michael's Hospital, Keenan Research Centre for Biomedical Science, the Li Ka Shing Knowledge Institute of St. Michael's Hospital (C.D.M., G.M.T.H., K.T., S.V., P.J.), Applied Health Research Centre (J.H., D.D., K.T., S.V., P.J.), Sunnybrook Health Sciences Centre (S.F.), Division of Hematology, Mount Sinai Hospital (N.S.), the Departments of Medicine (P.J., N.S.), Physiology (C.D.M., G.M.T.H), and Laboratory Medicine and Pathobiology (N.S.), Dalla Lana School of Public Health (K.T.), and Institute of Health Policy, Management and Evaluation, University of Toronto, and Canadian Blood Services (N.S.), Toronto, the Population Health Research Institute (R.P.W., E.B.-C.), Hamilton Health Sciences Center (R.P.W., E.B.-C., K.C., S.S.), McMaster University (R.P.W., E.B.-C., K.C., S.S.), Hamilton, ON, the Ottawa Hospital Research Institute, University of Ottawa, Ottawa (D.A.F.), the Cumming School of Medicine and Libin Cardiovascular Institute, University of Calgary, Calgary (A.J.G.), and the Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton (S.M.B.), CHUS-Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke (E.M.), and the Department of Anesthesiology and Critical Care Medicine, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Laval University, Laval (F.L.), QC, the Departments of Anesthesia and Medicine, Division of Critical Care, Centre Hospitalier de l'Universite de Montreal, Montreal (F.M.C.), and the Department of Anesthesia, Perioperative and Pain Medicine, St. Boniface Hospital, University of Manitoba, Winnipeg (H.P.G.) - all in Canada; the Department of Cardiothoracic Anesthesia, Rigshospitalet, Copenhagen University Hospital, Copenhagen (B.K.); Medical Research Institute of New Zealand, Wellington (S.M., P.J.Y.), and Waikato Hospital, Hamilton (K.B.) - both in New Zealand; Fundacion Cardioinfantil-Instituto de Cardiologia and Universidad Autonoma de Bucaramanga, Bucaramanga, Colombia (J.C.V.); the Department of Surgery, University of Melbourne (A.R., C.R.), and the Department of Anaesthesia and Pain Management, Royal Melbourne Hospital (C.R.), Melbourne, VIC, and the Department of Anaesthesia, Royal Adelaide Hospital, and the Discipline of Acute Care Medicine, University of Adelaide, Adelaide, SA (T.W.P.) - all in Australia; University of Basel, Department of Anesthesia, Surgical Intensive Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, Basel, and Klinik Hirslanden Zurich, Zurich - both in Switzerland (M.D.S.); Heart Care Associates, SAL Hospital, Gujarat, India (C.M.); and the Department of Cardiothoracic Anaesthesia, National Heart Center, and the Department of Anaesthesiology, Singapore General Hospital - both in Singapore (N.-C.H.). FAU - Carrier, Francois M AU - Carrier FM AUID- ORCID: 0000-0003-0310-0616 AD - From the Department of Anesthesia (C.D.M., G.M.T.H., N.M.) and the Department of Surgery, Division of Cardiac Surgery (S.V.), St. Michael's Hospital, Keenan Research Centre for Biomedical Science, the Li Ka Shing Knowledge Institute of St. Michael's Hospital (C.D.M., G.M.T.H., K.T., S.V., P.J.), Applied Health Research Centre (J.H., D.D., K.T., S.V., P.J.), Sunnybrook Health Sciences Centre (S.F.), Division of Hematology, Mount Sinai Hospital (N.S.), the Departments of Medicine (P.J., N.S.), Physiology (C.D.M., G.M.T.H), and Laboratory Medicine and Pathobiology (N.S.), Dalla Lana School of Public Health (K.T.), and Institute of Health Policy, Management and Evaluation, University of Toronto, and Canadian Blood Services (N.S.), Toronto, the Population Health Research Institute (R.P.W., E.B.-C.), Hamilton Health Sciences Center (R.P.W., E.B.-C., K.C., S.S.), McMaster University (R.P.W., E.B.-C., K.C., S.S.), Hamilton, ON, the Ottawa Hospital Research Institute, University of Ottawa, Ottawa (D.A.F.), the Cumming School of Medicine and Libin Cardiovascular Institute, University of Calgary, Calgary (A.J.G.), and the Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton (S.M.B.), CHUS-Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke (E.M.), and the Department of Anesthesiology and Critical Care Medicine, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Laval University, Laval (F.L.), QC, the Departments of Anesthesia and Medicine, Division of Critical Care, Centre Hospitalier de l'Universite de Montreal, Montreal (F.M.C.), and the Department of Anesthesia, Perioperative and Pain Medicine, St. Boniface Hospital, University of Manitoba, Winnipeg (H.P.G.) - all in Canada; the Department of Cardiothoracic Anesthesia, Rigshospitalet, Copenhagen University Hospital, Copenhagen (B.K.); Medical Research Institute of New Zealand, Wellington (S.M., P.J.Y.), and Waikato Hospital, Hamilton (K.B.) - both in New Zealand; Fundacion Cardioinfantil-Instituto de Cardiologia and Universidad Autonoma de Bucaramanga, Bucaramanga, Colombia (J.C.V.); the Department of Surgery, University of Melbourne (A.R., C.R.), and the Department of Anaesthesia and Pain Management, Royal Melbourne Hospital (C.R.), Melbourne, VIC, and the Department of Anaesthesia, Royal Adelaide Hospital, and the Discipline of Acute Care Medicine, University of Adelaide, Adelaide, SA (T.W.P.) - all in Australia; University of Basel, Department of Anesthesia, Surgical Intensive Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, Basel, and Klinik Hirslanden Zurich, Zurich - both in Switzerland (M.D.S.); Heart Care Associates, SAL Hospital, Gujarat, India (C.M.); and the Department of Cardiothoracic Anaesthesia, National Heart Center, and the Department of Anaesthesiology, Singapore General Hospital - both in Singapore (N.-C.H.). FAU - McGuinness, Shay AU - McGuinness S AD - From the Department of Anesthesia (C.D.M., G.M.T.H., N.M.) and the Department of Surgery, Division of Cardiac Surgery (S.V.), St. Michael's Hospital, Keenan Research Centre for Biomedical Science, the Li Ka Shing Knowledge Institute of St. Michael's Hospital (C.D.M., G.M.T.H., K.T., S.V., P.J.), Applied Health Research Centre (J.H., D.D., K.T., S.V., P.J.), Sunnybrook Health Sciences Centre (S.F.), Division of Hematology, Mount Sinai Hospital (N.S.), the Departments of Medicine (P.J., N.S.), Physiology (C.D.M., G.M.T.H), and Laboratory Medicine and Pathobiology (N.S.), Dalla Lana School of Public Health (K.T.), and Institute of Health Policy, Management and Evaluation, University of Toronto, and Canadian Blood Services (N.S.), Toronto, the Population Health Research Institute (R.P.W., E.B.-C.), Hamilton Health Sciences Center (R.P.W., E.B.-C., K.C., S.S.), McMaster University (R.P.W., E.B.-C., K.C., S.S.), Hamilton, ON, the Ottawa Hospital Research Institute, University of Ottawa, Ottawa (D.A.F.), the Cumming School of Medicine and Libin Cardiovascular Institute, University of Calgary, Calgary (A.J.G.), and the Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton (S.M.B.), CHUS-Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke (E.M.), and the Department of Anesthesiology and Critical Care Medicine, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Laval University, Laval (F.L.), QC, the Departments of Anesthesia and Medicine, Division of Critical Care, Centre Hospitalier de l'Universite de Montreal, Montreal (F.M.C.), and the Department of Anesthesia, Perioperative and Pain Medicine, St. Boniface Hospital, University of Manitoba, Winnipeg (H.P.G.) - all in Canada; the Department of Cardiothoracic Anesthesia, Rigshospitalet, Copenhagen University Hospital, Copenhagen (B.K.); Medical Research Institute of New Zealand, Wellington (S.M., P.J.Y.), and Waikato Hospital, Hamilton (K.B.) - both in New Zealand; Fundacion Cardioinfantil-Instituto de Cardiologia and Universidad Autonoma de Bucaramanga, Bucaramanga, Colombia (J.C.V.); the Department of Surgery, University of Melbourne (A.R., C.R.), and the Department of Anaesthesia and Pain Management, Royal Melbourne Hospital (C.R.), Melbourne, VIC, and the Department of Anaesthesia, Royal Adelaide Hospital, and the Discipline of Acute Care Medicine, University of Adelaide, Adelaide, SA (T.W.P.) - all in Australia; University of Basel, Department of Anesthesia, Surgical Intensive Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, Basel, and Klinik Hirslanden Zurich, Zurich - both in Switzerland (M.D.S.); Heart Care Associates, SAL Hospital, Gujarat, India (C.M.); and the Department of Cardiothoracic Anaesthesia, National Heart Center, and the Department of Anaesthesiology, Singapore General Hospital - both in Singapore (N.-C.H.). FAU - Young, Paul J AU - Young PJ AD - From the Department of Anesthesia (C.D.M., G.M.T.H., N.M.) and the Department of Surgery, Division of Cardiac Surgery (S.V.), St. Michael's Hospital, Keenan Research Centre for Biomedical Science, the Li Ka Shing Knowledge Institute of St. Michael's Hospital (C.D.M., G.M.T.H., K.T., S.V., P.J.), Applied Health Research Centre (J.H., D.D., K.T., S.V., P.J.), Sunnybrook Health Sciences Centre (S.F.), Division of Hematology, Mount Sinai Hospital (N.S.), the Departments of Medicine (P.J., N.S.), Physiology (C.D.M., G.M.T.H), and Laboratory Medicine and Pathobiology (N.S.), Dalla Lana School of Public Health (K.T.), and Institute of Health Policy, Management and Evaluation, University of Toronto, and Canadian Blood Services (N.S.), Toronto, the Population Health Research Institute (R.P.W., E.B.-C.), Hamilton Health Sciences Center (R.P.W., E.B.-C., K.C., S.S.), McMaster University (R.P.W., E.B.-C., K.C., S.S.), Hamilton, ON, the Ottawa Hospital Research Institute, University of Ottawa, Ottawa (D.A.F.), the Cumming School of Medicine and Libin Cardiovascular Institute, University of Calgary, Calgary (A.J.G.), and the Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton (S.M.B.), CHUS-Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke (E.M.), and the Department of Anesthesiology and Critical Care Medicine, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Laval University, Laval (F.L.), QC, the Departments of Anesthesia and Medicine, Division of Critical Care, Centre Hospitalier de l'Universite de Montreal, Montreal (F.M.C.), and the Department of Anesthesia, Perioperative and Pain Medicine, St. Boniface Hospital, University of Manitoba, Winnipeg (H.P.G.) - all in Canada; the Department of Cardiothoracic Anesthesia, Rigshospitalet, Copenhagen University Hospital, Copenhagen (B.K.); Medical Research Institute of New Zealand, Wellington (S.M., P.J.Y.), and Waikato Hospital, Hamilton (K.B.) - both in New Zealand; Fundacion Cardioinfantil-Instituto de Cardiologia and Universidad Autonoma de Bucaramanga, Bucaramanga, Colombia (J.C.V.); the Department of Surgery, University of Melbourne (A.R., C.R.), and the Department of Anaesthesia and Pain Management, Royal Melbourne Hospital (C.R.), Melbourne, VIC, and the Department of Anaesthesia, Royal Adelaide Hospital, and the Discipline of Acute Care Medicine, University of Adelaide, Adelaide, SA (T.W.P.) - all in Australia; University of Basel, Department of Anesthesia, Surgical Intensive Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, Basel, and Klinik Hirslanden Zurich, Zurich - both in Switzerland (M.D.S.); Heart Care Associates, SAL Hospital, Gujarat, India (C.M.); and the Department of Cardiothoracic Anaesthesia, National Heart Center, and the Department of Anaesthesiology, Singapore General Hospital - both in Singapore (N.-C.H.). FAU - Byrne, Kelly AU - Byrne K AD - From the Department of Anesthesia (C.D.M., G.M.T.H., N.M.) and the Department of Surgery, Division of Cardiac Surgery (S.V.), St. Michael's Hospital, Keenan Research Centre for Biomedical Science, the Li Ka Shing Knowledge Institute of St. Michael's Hospital (C.D.M., G.M.T.H., K.T., S.V., P.J.), Applied Health Research Centre (J.H., D.D., K.T., S.V., P.J.), Sunnybrook Health Sciences Centre (S.F.), Division of Hematology, Mount Sinai Hospital (N.S.), the Departments of Medicine (P.J., N.S.), Physiology (C.D.M., G.M.T.H), and Laboratory Medicine and Pathobiology (N.S.), Dalla Lana School of Public Health (K.T.), and Institute of Health Policy, Management and Evaluation, University of Toronto, and Canadian Blood Services (N.S.), Toronto, the Population Health Research Institute (R.P.W., E.B.-C.), Hamilton Health Sciences Center (R.P.W., E.B.-C., K.C., S.S.), McMaster University (R.P.W., E.B.-C., K.C., S.S.), Hamilton, ON, the Ottawa Hospital Research Institute, University of Ottawa, Ottawa (D.A.F.), the Cumming School of Medicine and Libin Cardiovascular Institute, University of Calgary, Calgary (A.J.G.), and the Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton (S.M.B.), CHUS-Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke (E.M.), and the Department of Anesthesiology and Critical Care Medicine, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Laval University, Laval (F.L.), QC, the Departments of Anesthesia and Medicine, Division of Critical Care, Centre Hospitalier de l'Universite de Montreal, Montreal (F.M.C.), and the Department of Anesthesia, Perioperative and Pain Medicine, St. Boniface Hospital, University of Manitoba, Winnipeg (H.P.G.) - all in Canada; the Department of Cardiothoracic Anesthesia, Rigshospitalet, Copenhagen University Hospital, Copenhagen (B.K.); Medical Research Institute of New Zealand, Wellington (S.M., P.J.Y.), and Waikato Hospital, Hamilton (K.B.) - both in New Zealand; Fundacion Cardioinfantil-Instituto de Cardiologia and Universidad Autonoma de Bucaramanga, Bucaramanga, Colombia (J.C.V.); the Department of Surgery, University of Melbourne (A.R., C.R.), and the Department of Anaesthesia and Pain Management, Royal Melbourne Hospital (C.R.), Melbourne, VIC, and the Department of Anaesthesia, Royal Adelaide Hospital, and the Discipline of Acute Care Medicine, University of Adelaide, Adelaide, SA (T.W.P.) - all in Australia; University of Basel, Department of Anesthesia, Surgical Intensive Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, Basel, and Klinik Hirslanden Zurich, Zurich - both in Switzerland (M.D.S.); Heart Care Associates, SAL Hospital, Gujarat, India (C.M.); and the Department of Cardiothoracic Anaesthesia, National Heart Center, and the Department of Anaesthesiology, Singapore General Hospital - both in Singapore (N.-C.H.). FAU - Villar, Juan C AU - Villar JC AD - From the Department of Anesthesia (C.D.M., G.M.T.H., N.M.) and the Department of Surgery, Division of Cardiac Surgery (S.V.), St. Michael's Hospital, Keenan Research Centre for Biomedical Science, the Li Ka Shing Knowledge Institute of St. Michael's Hospital (C.D.M., G.M.T.H., K.T., S.V., P.J.), Applied Health Research Centre (J.H., D.D., K.T., S.V., P.J.), Sunnybrook Health Sciences Centre (S.F.), Division of Hematology, Mount Sinai Hospital (N.S.), the Departments of Medicine (P.J., N.S.), Physiology (C.D.M., G.M.T.H), and Laboratory Medicine and Pathobiology (N.S.), Dalla Lana School of Public Health (K.T.), and Institute of Health Policy, Management and Evaluation, University of Toronto, and Canadian Blood Services (N.S.), Toronto, the Population Health Research Institute (R.P.W., E.B.-C.), Hamilton Health Sciences Center (R.P.W., E.B.-C., K.C., S.S.), McMaster University (R.P.W., E.B.-C., K.C., S.S.), Hamilton, ON, the Ottawa Hospital Research Institute, University of Ottawa, Ottawa (D.A.F.), the Cumming School of Medicine and Libin Cardiovascular Institute, University of Calgary, Calgary (A.J.G.), and the Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton (S.M.B.), CHUS-Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke (E.M.), and the Department of Anesthesiology and Critical Care Medicine, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Laval University, Laval (F.L.), QC, the Departments of Anesthesia and Medicine, Division of Critical Care, Centre Hospitalier de l'Universite de Montreal, Montreal (F.M.C.), and the Department of Anesthesia, Perioperative and Pain Medicine, St. Boniface Hospital, University of Manitoba, Winnipeg (H.P.G.) - all in Canada; the Department of Cardiothoracic Anesthesia, Rigshospitalet, Copenhagen University Hospital, Copenhagen (B.K.); Medical Research Institute of New Zealand, Wellington (S.M., P.J.Y.), and Waikato Hospital, Hamilton (K.B.) - both in New Zealand; Fundacion Cardioinfantil-Instituto de Cardiologia and Universidad Autonoma de Bucaramanga, Bucaramanga, Colombia (J.C.V.); the Department of Surgery, University of Melbourne (A.R., C.R.), and the Department of Anaesthesia and Pain Management, Royal Melbourne Hospital (C.R.), Melbourne, VIC, and the Department of Anaesthesia, Royal Adelaide Hospital, and the Discipline of Acute Care Medicine, University of Adelaide, Adelaide, SA (T.W.P.) - all in Australia; University of Basel, Department of Anesthesia, Surgical Intensive Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, Basel, and Klinik Hirslanden Zurich, Zurich - both in Switzerland (M.D.S.); Heart Care Associates, SAL Hospital, Gujarat, India (C.M.); and the Department of Cardiothoracic Anaesthesia, National Heart Center, and the Department of Anaesthesiology, Singapore General Hospital - both in Singapore (N.-C.H.). FAU - Royse, Alistair AU - Royse A AUID- ORCID: 0000-0002-4449-663X AD - From the Department of Anesthesia (C.D.M., G.M.T.H., N.M.) and the Department of Surgery, Division of Cardiac Surgery (S.V.), St. Michael's Hospital, Keenan Research Centre for Biomedical Science, the Li Ka Shing Knowledge Institute of St. Michael's Hospital (C.D.M., G.M.T.H., K.T., S.V., P.J.), Applied Health Research Centre (J.H., D.D., K.T., S.V., P.J.), Sunnybrook Health Sciences Centre (S.F.), Division of Hematology, Mount Sinai Hospital (N.S.), the Departments of Medicine (P.J., N.S.), Physiology (C.D.M., G.M.T.H), and Laboratory Medicine and Pathobiology (N.S.), Dalla Lana School of Public Health (K.T.), and Institute of Health Policy, Management and Evaluation, University of Toronto, and Canadian Blood Services (N.S.), Toronto, the Population Health Research Institute (R.P.W., E.B.-C.), Hamilton Health Sciences Center (R.P.W., E.B.-C., K.C., S.S.), McMaster University (R.P.W., E.B.-C., K.C., S.S.), Hamilton, ON, the Ottawa Hospital Research Institute, University of Ottawa, Ottawa (D.A.F.), the Cumming School of Medicine and Libin Cardiovascular Institute, University of Calgary, Calgary (A.J.G.), and the Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton (S.M.B.), CHUS-Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke (E.M.), and the Department of Anesthesiology and Critical Care Medicine, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Laval University, Laval (F.L.), QC, the Departments of Anesthesia and Medicine, Division of Critical Care, Centre Hospitalier de l'Universite de Montreal, Montreal (F.M.C.), and the Department of Anesthesia, Perioperative and Pain Medicine, St. Boniface Hospital, University of Manitoba, Winnipeg (H.P.G.) - all in Canada; the Department of Cardiothoracic Anesthesia, Rigshospitalet, Copenhagen University Hospital, Copenhagen (B.K.); Medical Research Institute of New Zealand, Wellington (S.M., P.J.Y.), and Waikato Hospital, Hamilton (K.B.) - both in New Zealand; Fundacion Cardioinfantil-Instituto de Cardiologia and Universidad Autonoma de Bucaramanga, Bucaramanga, Colombia (J.C.V.); the Department of Surgery, University of Melbourne (A.R., C.R.), and the Department of Anaesthesia and Pain Management, Royal Melbourne Hospital (C.R.), Melbourne, VIC, and the Department of Anaesthesia, Royal Adelaide Hospital, and the Discipline of Acute Care Medicine, University of Adelaide, Adelaide, SA (T.W.P.) - all in Australia; University of Basel, Department of Anesthesia, Surgical Intensive Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, Basel, and Klinik Hirslanden Zurich, Zurich - both in Switzerland (M.D.S.); Heart Care Associates, SAL Hospital, Gujarat, India (C.M.); and the Department of Cardiothoracic Anaesthesia, National Heart Center, and the Department of Anaesthesiology, Singapore General Hospital - both in Singapore (N.-C.H.). FAU - Grocott, Hilary P AU - Grocott HP AD - From the Department of Anesthesia (C.D.M., G.M.T.H., N.M.) and the Department of Surgery, Division of Cardiac Surgery (S.V.), St. Michael's Hospital, Keenan Research Centre for Biomedical Science, the Li Ka Shing Knowledge Institute of St. Michael's Hospital (C.D.M., G.M.T.H., K.T., S.V., P.J.), Applied Health Research Centre (J.H., D.D., K.T., S.V., P.J.), Sunnybrook Health Sciences Centre (S.F.), Division of Hematology, Mount Sinai Hospital (N.S.), the Departments of Medicine (P.J., N.S.), Physiology (C.D.M., G.M.T.H), and Laboratory Medicine and Pathobiology (N.S.), Dalla Lana School of Public Health (K.T.), and Institute of Health Policy, Management and Evaluation, University of Toronto, and Canadian Blood Services (N.S.), Toronto, the Population Health Research Institute (R.P.W., E.B.-C.), Hamilton Health Sciences Center (R.P.W., E.B.-C., K.C., S.S.), McMaster University (R.P.W., E.B.-C., K.C., S.S.), Hamilton, ON, the Ottawa Hospital Research Institute, University of Ottawa, Ottawa (D.A.F.), the Cumming School of Medicine and Libin Cardiovascular Institute, University of Calgary, Calgary (A.J.G.), and the Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton (S.M.B.), CHUS-Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke (E.M.), and the Department of Anesthesiology and Critical Care Medicine, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Laval University, Laval (F.L.), QC, the Departments of Anesthesia and Medicine, Division of Critical Care, Centre Hospitalier de l'Universite de Montreal, Montreal (F.M.C.), and the Department of Anesthesia, Perioperative and Pain Medicine, St. Boniface Hospital, University of Manitoba, Winnipeg (H.P.G.) - all in Canada; the Department of Cardiothoracic Anesthesia, Rigshospitalet, Copenhagen University Hospital, Copenhagen (B.K.); Medical Research Institute of New Zealand, Wellington (S.M., P.J.Y.), and Waikato Hospital, Hamilton (K.B.) - both in New Zealand; Fundacion Cardioinfantil-Instituto de Cardiologia and Universidad Autonoma de Bucaramanga, Bucaramanga, Colombia (J.C.V.); the Department of Surgery, University of Melbourne (A.R., C.R.), and the Department of Anaesthesia and Pain Management, Royal Melbourne Hospital (C.R.), Melbourne, VIC, and the Department of Anaesthesia, Royal Adelaide Hospital, and the Discipline of Acute Care Medicine, University of Adelaide, Adelaide, SA (T.W.P.) - all in Australia; University of Basel, Department of Anesthesia, Surgical Intensive Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, Basel, and Klinik Hirslanden Zurich, Zurich - both in Switzerland (M.D.S.); Heart Care Associates, SAL Hospital, Gujarat, India (C.M.); and the Department of Cardiothoracic Anaesthesia, National Heart Center, and the Department of Anaesthesiology, Singapore General Hospital - both in Singapore (N.-C.H.). FAU - Seeberger, Manfred D AU - Seeberger MD AD - From the Department of Anesthesia (C.D.M., G.M.T.H., N.M.) and the Department of Surgery, Division of Cardiac Surgery (S.V.), St. Michael's Hospital, Keenan Research Centre for Biomedical Science, the Li Ka Shing Knowledge Institute of St. Michael's Hospital (C.D.M., G.M.T.H., K.T., S.V., P.J.), Applied Health Research Centre (J.H., D.D., K.T., S.V., P.J.), Sunnybrook Health Sciences Centre (S.F.), Division of Hematology, Mount Sinai Hospital (N.S.), the Departments of Medicine (P.J., N.S.), Physiology (C.D.M., G.M.T.H), and Laboratory Medicine and Pathobiology (N.S.), Dalla Lana School of Public Health (K.T.), and Institute of Health Policy, Management and Evaluation, University of Toronto, and Canadian Blood Services (N.S.), Toronto, the Population Health Research Institute (R.P.W., E.B.-C.), Hamilton Health Sciences Center (R.P.W., E.B.-C., K.C., S.S.), McMaster University (R.P.W., E.B.-C., K.C., S.S.), Hamilton, ON, the Ottawa Hospital Research Institute, University of Ottawa, Ottawa (D.A.F.), the Cumming School of Medicine and Libin Cardiovascular Institute, University of Calgary, Calgary (A.J.G.), and the Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton (S.M.B.), CHUS-Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke (E.M.), and the Department of Anesthesiology and Critical Care Medicine, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Laval University, Laval (F.L.), QC, the Departments of Anesthesia and Medicine, Division of Critical Care, Centre Hospitalier de l'Universite de Montreal, Montreal (F.M.C.), and the Department of Anesthesia, Perioperative and Pain Medicine, St. Boniface Hospital, University of Manitoba, Winnipeg (H.P.G.) - all in Canada; the Department of Cardiothoracic Anesthesia, Rigshospitalet, Copenhagen University Hospital, Copenhagen (B.K.); Medical Research Institute of New Zealand, Wellington (S.M., P.J.Y.), and Waikato Hospital, Hamilton (K.B.) - both in New Zealand; Fundacion Cardioinfantil-Instituto de Cardiologia and Universidad Autonoma de Bucaramanga, Bucaramanga, Colombia (J.C.V.); the Department of Surgery, University of Melbourne (A.R., C.R.), and the Department of Anaesthesia and Pain Management, Royal Melbourne Hospital (C.R.), Melbourne, VIC, and the Department of Anaesthesia, Royal Adelaide Hospital, and the Discipline of Acute Care Medicine, University of Adelaide, Adelaide, SA (T.W.P.) - all in Australia; University of Basel, Department of Anesthesia, Surgical Intensive Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, Basel, and Klinik Hirslanden Zurich, Zurich - both in Switzerland (M.D.S.); Heart Care Associates, SAL Hospital, Gujarat, India (C.M.); and the Department of Cardiothoracic Anaesthesia, National Heart Center, and the Department of Anaesthesiology, Singapore General Hospital - both in Singapore (N.-C.H.). FAU - Mehta, Chirag AU - Mehta C AD - From the Department of Anesthesia (C.D.M., G.M.T.H., N.M.) and the Department of Surgery, Division of Cardiac Surgery (S.V.), St. Michael's Hospital, Keenan Research Centre for Biomedical Science, the Li Ka Shing Knowledge Institute of St. Michael's Hospital (C.D.M., G.M.T.H., K.T., S.V., P.J.), Applied Health Research Centre (J.H., D.D., K.T., S.V., P.J.), Sunnybrook Health Sciences Centre (S.F.), Division of Hematology, Mount Sinai Hospital (N.S.), the Departments of Medicine (P.J., N.S.), Physiology (C.D.M., G.M.T.H), and Laboratory Medicine and Pathobiology (N.S.), Dalla Lana School of Public Health (K.T.), and Institute of Health Policy, Management and Evaluation, University of Toronto, and Canadian Blood Services (N.S.), Toronto, the Population Health Research Institute (R.P.W., E.B.-C.), Hamilton Health Sciences Center (R.P.W., E.B.-C., K.C., S.S.), McMaster University (R.P.W., E.B.-C., K.C., S.S.), Hamilton, ON, the Ottawa Hospital Research Institute, University of Ottawa, Ottawa (D.A.F.), the Cumming School of Medicine and Libin Cardiovascular Institute, University of Calgary, Calgary (A.J.G.), and the Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton (S.M.B.), CHUS-Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke (E.M.), and the Department of Anesthesiology and Critical Care Medicine, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Laval University, Laval (F.L.), QC, the Departments of Anesthesia and Medicine, Division of Critical Care, Centre Hospitalier de l'Universite de Montreal, Montreal (F.M.C.), and the Department of Anesthesia, Perioperative and Pain Medicine, St. Boniface Hospital, University of Manitoba, Winnipeg (H.P.G.) - all in Canada; the Department of Cardiothoracic Anesthesia, Rigshospitalet, Copenhagen University Hospital, Copenhagen (B.K.); Medical Research Institute of New Zealand, Wellington (S.M., P.J.Y.), and Waikato Hospital, Hamilton (K.B.) - both in New Zealand; Fundacion Cardioinfantil-Instituto de Cardiologia and Universidad Autonoma de Bucaramanga, Bucaramanga, Colombia (J.C.V.); the Department of Surgery, University of Melbourne (A.R., C.R.), and the Department of Anaesthesia and Pain Management, Royal Melbourne Hospital (C.R.), Melbourne, VIC, and the Department of Anaesthesia, Royal Adelaide Hospital, and the Discipline of Acute Care Medicine, University of Adelaide, Adelaide, SA (T.W.P.) - all in Australia; University of Basel, Department of Anesthesia, Surgical Intensive Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, Basel, and Klinik Hirslanden Zurich, Zurich - both in Switzerland (M.D.S.); Heart Care Associates, SAL Hospital, Gujarat, India (C.M.); and the Department of Cardiothoracic Anaesthesia, National Heart Center, and the Department of Anaesthesiology, Singapore General Hospital - both in Singapore (N.-C.H.). FAU - Lellouche, Francois AU - Lellouche F AD - From the Department of Anesthesia (C.D.M., G.M.T.H., N.M.) and the Department of Surgery, Division of Cardiac Surgery (S.V.), St. Michael's Hospital, Keenan Research Centre for Biomedical Science, the Li Ka Shing Knowledge Institute of St. Michael's Hospital (C.D.M., G.M.T.H., K.T., S.V., P.J.), Applied Health Research Centre (J.H., D.D., K.T., S.V., P.J.), Sunnybrook Health Sciences Centre (S.F.), Division of Hematology, Mount Sinai Hospital (N.S.), the Departments of Medicine (P.J., N.S.), Physiology (C.D.M., G.M.T.H), and Laboratory Medicine and Pathobiology (N.S.), Dalla Lana School of Public Health (K.T.), and Institute of Health Policy, Management and Evaluation, University of Toronto, and Canadian Blood Services (N.S.), Toronto, the Population Health Research Institute (R.P.W., E.B.-C.), Hamilton Health Sciences Center (R.P.W., E.B.-C., K.C., S.S.), McMaster University (R.P.W., E.B.-C., K.C., S.S.), Hamilton, ON, the Ottawa Hospital Research Institute, University of Ottawa, Ottawa (D.A.F.), the Cumming School of Medicine and Libin Cardiovascular Institute, University of Calgary, Calgary (A.J.G.), and the Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton (S.M.B.), CHUS-Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke (E.M.), and the Department of Anesthesiology and Critical Care Medicine, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Laval University, Laval (F.L.), QC, the Departments of Anesthesia and Medicine, Division of Critical Care, Centre Hospitalier de l'Universite de Montreal, Montreal (F.M.C.), and the Department of Anesthesia, Perioperative and Pain Medicine, St. Boniface Hospital, University of Manitoba, Winnipeg (H.P.G.) - all in Canada; the Department of Cardiothoracic Anesthesia, Rigshospitalet, Copenhagen University Hospital, Copenhagen (B.K.); Medical Research Institute of New Zealand, Wellington (S.M., P.J.Y.), and Waikato Hospital, Hamilton (K.B.) - both in New Zealand; Fundacion Cardioinfantil-Instituto de Cardiologia and Universidad Autonoma de Bucaramanga, Bucaramanga, Colombia (J.C.V.); the Department of Surgery, University of Melbourne (A.R., C.R.), and the Department of Anaesthesia and Pain Management, Royal Melbourne Hospital (C.R.), Melbourne, VIC, and the Department of Anaesthesia, Royal Adelaide Hospital, and the Discipline of Acute Care Medicine, University of Adelaide, Adelaide, SA (T.W.P.) - all in Australia; University of Basel, Department of Anesthesia, Surgical Intensive Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, Basel, and Klinik Hirslanden Zurich, Zurich - both in Switzerland (M.D.S.); Heart Care Associates, SAL Hospital, Gujarat, India (C.M.); and the Department of Cardiothoracic Anaesthesia, National Heart Center, and the Department of Anaesthesiology, Singapore General Hospital - both in Singapore (N.-C.H.). FAU - Hare, Gregory M T AU - Hare GMT AD - From the Department of Anesthesia (C.D.M., G.M.T.H., N.M.) and the Department of Surgery, Division of Cardiac Surgery (S.V.), St. Michael's Hospital, Keenan Research Centre for Biomedical Science, the Li Ka Shing Knowledge Institute of St. Michael's Hospital (C.D.M., G.M.T.H., K.T., S.V., P.J.), Applied Health Research Centre (J.H., D.D., K.T., S.V., P.J.), Sunnybrook Health Sciences Centre (S.F.), Division of Hematology, Mount Sinai Hospital (N.S.), the Departments of Medicine (P.J., N.S.), Physiology (C.D.M., G.M.T.H), and Laboratory Medicine and Pathobiology (N.S.), Dalla Lana School of Public Health (K.T.), and Institute of Health Policy, Management and Evaluation, University of Toronto, and Canadian Blood Services (N.S.), Toronto, the Population Health Research Institute (R.P.W., E.B.-C.), Hamilton Health Sciences Center (R.P.W., E.B.-C., K.C., S.S.), McMaster University (R.P.W., E.B.-C., K.C., S.S.), Hamilton, ON, the Ottawa Hospital Research Institute, University of Ottawa, Ottawa (D.A.F.), the Cumming School of Medicine and Libin Cardiovascular Institute, University of Calgary, Calgary (A.J.G.), and the Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton (S.M.B.), CHUS-Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke (E.M.), and the Department of Anesthesiology and Critical Care Medicine, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Laval University, Laval (F.L.), QC, the Departments of Anesthesia and Medicine, Division of Critical Care, Centre Hospitalier de l'Universite de Montreal, Montreal (F.M.C.), and the Department of Anesthesia, Perioperative and Pain Medicine, St. Boniface Hospital, University of Manitoba, Winnipeg (H.P.G.) - all in Canada; the Department of Cardiothoracic Anesthesia, Rigshospitalet, Copenhagen University Hospital, Copenhagen (B.K.); Medical Research Institute of New Zealand, Wellington (S.M., P.J.Y.), and Waikato Hospital, Hamilton (K.B.) - both in New Zealand; Fundacion Cardioinfantil-Instituto de Cardiologia and Universidad Autonoma de Bucaramanga, Bucaramanga, Colombia (J.C.V.); the Department of Surgery, University of Melbourne (A.R., C.R.), and the Department of Anaesthesia and Pain Management, Royal Melbourne Hospital (C.R.), Melbourne, VIC, and the Department of Anaesthesia, Royal Adelaide Hospital, and the Discipline of Acute Care Medicine, University of Adelaide, Adelaide, SA (T.W.P.) - all in Australia; University of Basel, Department of Anesthesia, Surgical Intensive Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, Basel, and Klinik Hirslanden Zurich, Zurich - both in Switzerland (M.D.S.); Heart Care Associates, SAL Hospital, Gujarat, India (C.M.); and the Department of Cardiothoracic Anaesthesia, National Heart Center, and the Department of Anaesthesiology, Singapore General Hospital - both in Singapore (N.-C.H.). FAU - Painter, Thomas W AU - Painter TW AD - From the Department of Anesthesia (C.D.M., G.M.T.H., N.M.) and the Department of Surgery, Division of Cardiac Surgery (S.V.), St. Michael's Hospital, Keenan Research Centre for Biomedical Science, the Li Ka Shing Knowledge Institute of St. Michael's Hospital (C.D.M., G.M.T.H., K.T., S.V., P.J.), Applied Health Research Centre (J.H., D.D., K.T., S.V., P.J.), Sunnybrook Health Sciences Centre (S.F.), Division of Hematology, Mount Sinai Hospital (N.S.), the Departments of Medicine (P.J., N.S.), Physiology (C.D.M., G.M.T.H), and Laboratory Medicine and Pathobiology (N.S.), Dalla Lana School of Public Health (K.T.), and Institute of Health Policy, Management and Evaluation, University of Toronto, and Canadian Blood Services (N.S.), Toronto, the Population Health Research Institute (R.P.W., E.B.-C.), Hamilton Health Sciences Center (R.P.W., E.B.-C., K.C., S.S.), McMaster University (R.P.W., E.B.-C., K.C., S.S.), Hamilton, ON, the Ottawa Hospital Research Institute, University of Ottawa, Ottawa (D.A.F.), the Cumming School of Medicine and Libin Cardiovascular Institute, University of Calgary, Calgary (A.J.G.), and the Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton (S.M.B.), CHUS-Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke (E.M.), and the Department of Anesthesiology and Critical Care Medicine, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Laval University, Laval (F.L.), QC, the Departments of Anesthesia and Medicine, Division of Critical Care, Centre Hospitalier de l'Universite de Montreal, Montreal (F.M.C.), and the Department of Anesthesia, Perioperative and Pain Medicine, St. Boniface Hospital, University of Manitoba, Winnipeg (H.P.G.) - all in Canada; the Department of Cardiothoracic Anesthesia, Rigshospitalet, Copenhagen University Hospital, Copenhagen (B.K.); Medical Research Institute of New Zealand, Wellington (S.M., P.J.Y.), and Waikato Hospital, Hamilton (K.B.) - both in New Zealand; Fundacion Cardioinfantil-Instituto de Cardiologia and Universidad Autonoma de Bucaramanga, Bucaramanga, Colombia (J.C.V.); the Department of Surgery, University of Melbourne (A.R., C.R.), and the Department of Anaesthesia and Pain Management, Royal Melbourne Hospital (C.R.), Melbourne, VIC, and the Department of Anaesthesia, Royal Adelaide Hospital, and the Discipline of Acute Care Medicine, University of Adelaide, Adelaide, SA (T.W.P.) - all in Australia; University of Basel, Department of Anesthesia, Surgical Intensive Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, Basel, and Klinik Hirslanden Zurich, Zurich - both in Switzerland (M.D.S.); Heart Care Associates, SAL Hospital, Gujarat, India (C.M.); and the Department of Cardiothoracic Anaesthesia, National Heart Center, and the Department of Anaesthesiology, Singapore General Hospital - both in Singapore (N.-C.H.). FAU - Fremes, Stephen AU - Fremes S AD - From the Department of Anesthesia (C.D.M., G.M.T.H., N.M.) and the Department of Surgery, Division of Cardiac Surgery (S.V.), St. Michael's Hospital, Keenan Research Centre for Biomedical Science, the Li Ka Shing Knowledge Institute of St. Michael's Hospital (C.D.M., G.M.T.H., K.T., S.V., P.J.), Applied Health Research Centre (J.H., D.D., K.T., S.V., P.J.), Sunnybrook Health Sciences Centre (S.F.), Division of Hematology, Mount Sinai Hospital (N.S.), the Departments of Medicine (P.J., N.S.), Physiology (C.D.M., G.M.T.H), and Laboratory Medicine and Pathobiology (N.S.), Dalla Lana School of Public Health (K.T.), and Institute of Health Policy, Management and Evaluation, University of Toronto, and Canadian Blood Services (N.S.), Toronto, the Population Health Research Institute (R.P.W., E.B.-C.), Hamilton Health Sciences Center (R.P.W., E.B.-C., K.C., S.S.), McMaster University (R.P.W., E.B.-C., K.C., S.S.), Hamilton, ON, the Ottawa Hospital Research Institute, University of Ottawa, Ottawa (D.A.F.), the Cumming School of Medicine and Libin Cardiovascular Institute, University of Calgary, Calgary (A.J.G.), and the Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton (S.M.B.), CHUS-Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke (E.M.), and the Department of Anesthesiology and Critical Care Medicine, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Laval University, Laval (F.L.), QC, the Departments of Anesthesia and Medicine, Division of Critical Care, Centre Hospitalier de l'Universite de Montreal, Montreal (F.M.C.), and the Department of Anesthesia, Perioperative and Pain Medicine, St. Boniface Hospital, University of Manitoba, Winnipeg (H.P.G.) - all in Canada; the Department of Cardiothoracic Anesthesia, Rigshospitalet, Copenhagen University Hospital, Copenhagen (B.K.); Medical Research Institute of New Zealand, Wellington (S.M., P.J.Y.), and Waikato Hospital, Hamilton (K.B.) - both in New Zealand; Fundacion Cardioinfantil-Instituto de Cardiologia and Universidad Autonoma de Bucaramanga, Bucaramanga, Colombia (J.C.V.); the Department of Surgery, University of Melbourne (A.R., C.R.), and the Department of Anaesthesia and Pain Management, Royal Melbourne Hospital (C.R.), Melbourne, VIC, and the Department of Anaesthesia, Royal Adelaide Hospital, and the Discipline of Acute Care Medicine, University of Adelaide, Adelaide, SA (T.W.P.) - all in Australia; University of Basel, Department of Anesthesia, Surgical Intensive Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, Basel, and Klinik Hirslanden Zurich, Zurich - both in Switzerland (M.D.S.); Heart Care Associates, SAL Hospital, Gujarat, India (C.M.); and the Department of Cardiothoracic Anaesthesia, National Heart Center, and the Department of Anaesthesiology, Singapore General Hospital - both in Singapore (N.-C.H.). FAU - Syed, Summer AU - Syed S AD - From the Department of Anesthesia (C.D.M., G.M.T.H., N.M.) and the Department of Surgery, Division of Cardiac Surgery (S.V.), St. Michael's Hospital, Keenan Research Centre for Biomedical Science, the Li Ka Shing Knowledge Institute of St. Michael's Hospital (C.D.M., G.M.T.H., K.T., S.V., P.J.), Applied Health Research Centre (J.H., D.D., K.T., S.V., P.J.), Sunnybrook Health Sciences Centre (S.F.), Division of Hematology, Mount Sinai Hospital (N.S.), the Departments of Medicine (P.J., N.S.), Physiology (C.D.M., G.M.T.H), and Laboratory Medicine and Pathobiology (N.S.), Dalla Lana School of Public Health (K.T.), and Institute of Health Policy, Management and Evaluation, University of Toronto, and Canadian Blood Services (N.S.), Toronto, the Population Health Research Institute (R.P.W., E.B.-C.), Hamilton Health Sciences Center (R.P.W., E.B.-C., K.C., S.S.), McMaster University (R.P.W., E.B.-C., K.C., S.S.), Hamilton, ON, the Ottawa Hospital Research Institute, University of Ottawa, Ottawa (D.A.F.), the Cumming School of Medicine and Libin Cardiovascular Institute, University of Calgary, Calgary (A.J.G.), and the Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton (S.M.B.), CHUS-Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke (E.M.), and the Department of Anesthesiology and Critical Care Medicine, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Laval University, Laval (F.L.), QC, the Departments of Anesthesia and Medicine, Division of Critical Care, Centre Hospitalier de l'Universite de Montreal, Montreal (F.M.C.), and the Department of Anesthesia, Perioperative and Pain Medicine, St. Boniface Hospital, University of Manitoba, Winnipeg (H.P.G.) - all in Canada; the Department of Cardiothoracic Anesthesia, Rigshospitalet, Copenhagen University Hospital, Copenhagen (B.K.); Medical Research Institute of New Zealand, Wellington (S.M., P.J.Y.), and Waikato Hospital, Hamilton (K.B.) - both in New Zealand; Fundacion Cardioinfantil-Instituto de Cardiologia and Universidad Autonoma de Bucaramanga, Bucaramanga, Colombia (J.C.V.); the Department of Surgery, University of Melbourne (A.R., C.R.), and the Department of Anaesthesia and Pain Management, Royal Melbourne Hospital (C.R.), Melbourne, VIC, and the Department of Anaesthesia, Royal Adelaide Hospital, and the Discipline of Acute Care Medicine, University of Adelaide, Adelaide, SA (T.W.P.) - all in Australia; University of Basel, Department of Anesthesia, Surgical Intensive Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, Basel, and Klinik Hirslanden Zurich, Zurich - both in Switzerland (M.D.S.); Heart Care Associates, SAL Hospital, Gujarat, India (C.M.); and the Department of Cardiothoracic Anaesthesia, National Heart Center, and the Department of Anaesthesiology, Singapore General Hospital - both in Singapore (N.-C.H.). FAU - Bagshaw, Sean M AU - Bagshaw SM AD - From the Department of Anesthesia (C.D.M., G.M.T.H., N.M.) and the Department of Surgery, Division of Cardiac Surgery (S.V.), St. Michael's Hospital, Keenan Research Centre for Biomedical Science, the Li Ka Shing Knowledge Institute of St. Michael's Hospital (C.D.M., G.M.T.H., K.T., S.V., P.J.), Applied Health Research Centre (J.H., D.D., K.T., S.V., P.J.), Sunnybrook Health Sciences Centre (S.F.), Division of Hematology, Mount Sinai Hospital (N.S.), the Departments of Medicine (P.J., N.S.), Physiology (C.D.M., G.M.T.H), and Laboratory Medicine and Pathobiology (N.S.), Dalla Lana School of Public Health (K.T.), and Institute of Health Policy, Management and Evaluation, University of Toronto, and Canadian Blood Services (N.S.), Toronto, the Population Health Research Institute (R.P.W., E.B.-C.), Hamilton Health Sciences Center (R.P.W., E.B.-C., K.C., S.S.), McMaster University (R.P.W., E.B.-C., K.C., S.S.), Hamilton, ON, the Ottawa Hospital Research Institute, University of Ottawa, Ottawa (D.A.F.), the Cumming School of Medicine and Libin Cardiovascular Institute, University of Calgary, Calgary (A.J.G.), and the Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton (S.M.B.), CHUS-Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke (E.M.), and the Department of Anesthesiology and Critical Care Medicine, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Laval University, Laval (F.L.), QC, the Departments of Anesthesia and Medicine, Division of Critical Care, Centre Hospitalier de l'Universite de Montreal, Montreal (F.M.C.), and the Department of Anesthesia, Perioperative and Pain Medicine, St. Boniface Hospital, University of Manitoba, Winnipeg (H.P.G.) - all in Canada; the Department of Cardiothoracic Anesthesia, Rigshospitalet, Copenhagen University Hospital, Copenhagen (B.K.); Medical Research Institute of New Zealand, Wellington (S.M., P.J.Y.), and Waikato Hospital, Hamilton (K.B.) - both in New Zealand; Fundacion Cardioinfantil-Instituto de Cardiologia and Universidad Autonoma de Bucaramanga, Bucaramanga, Colombia (J.C.V.); the Department of Surgery, University of Melbourne (A.R., C.R.), and the Department of Anaesthesia and Pain Management, Royal Melbourne Hospital (C.R.), Melbourne, VIC, and the Department of Anaesthesia, Royal Adelaide Hospital, and the Discipline of Acute Care Medicine, University of Adelaide, Adelaide, SA (T.W.P.) - all in Australia; University of Basel, Department of Anesthesia, Surgical Intensive Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, Basel, and Klinik Hirslanden Zurich, Zurich - both in Switzerland (M.D.S.); Heart Care Associates, SAL Hospital, Gujarat, India (C.M.); and the Department of Cardiothoracic Anaesthesia, National Heart Center, and the Department of Anaesthesiology, Singapore General Hospital - both in Singapore (N.-C.H.). FAU - Hwang, Nian-Chih AU - Hwang NC AD - From the Department of Anesthesia (C.D.M., G.M.T.H., N.M.) and the Department of Surgery, Division of Cardiac Surgery (S.V.), St. Michael's Hospital, Keenan Research Centre for Biomedical Science, the Li Ka Shing Knowledge Institute of St. Michael's Hospital (C.D.M., G.M.T.H., K.T., S.V., P.J.), Applied Health Research Centre (J.H., D.D., K.T., S.V., P.J.), Sunnybrook Health Sciences Centre (S.F.), Division of Hematology, Mount Sinai Hospital (N.S.), the Departments of Medicine (P.J., N.S.), Physiology (C.D.M., G.M.T.H), and Laboratory Medicine and Pathobiology (N.S.), Dalla Lana School of Public Health (K.T.), and Institute of Health Policy, Management and Evaluation, University of Toronto, and Canadian Blood Services (N.S.), Toronto, the Population Health Research Institute (R.P.W., E.B.-C.), Hamilton Health Sciences Center (R.P.W., E.B.-C., K.C., S.S.), McMaster University (R.P.W., E.B.-C., K.C., S.S.), Hamilton, ON, the Ottawa Hospital Research Institute, University of Ottawa, Ottawa (D.A.F.), the Cumming School of Medicine and Libin Cardiovascular Institute, University of Calgary, Calgary (A.J.G.), and the Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton (S.M.B.), CHUS-Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke (E.M.), and the Department of Anesthesiology and Critical Care Medicine, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Laval University, Laval (F.L.), QC, the Departments of Anesthesia and Medicine, Division of Critical Care, Centre Hospitalier de l'Universite de Montreal, Montreal (F.M.C.), and the Department of Anesthesia, Perioperative and Pain Medicine, St. Boniface Hospital, University of Manitoba, Winnipeg (H.P.G.) - all in Canada; the Department of Cardiothoracic Anesthesia, Rigshospitalet, Copenhagen University Hospital, Copenhagen (B.K.); Medical Research Institute of New Zealand, Wellington (S.M., P.J.Y.), and Waikato Hospital, Hamilton (K.B.) - both in New Zealand; Fundacion Cardioinfantil-Instituto de Cardiologia and Universidad Autonoma de Bucaramanga, Bucaramanga, Colombia (J.C.V.); the Department of Surgery, University of Melbourne (A.R., C.R.), and the Department of Anaesthesia and Pain Management, Royal Melbourne Hospital (C.R.), Melbourne, VIC, and the Department of Anaesthesia, Royal Adelaide Hospital, and the Discipline of Acute Care Medicine, University of Adelaide, Adelaide, SA (T.W.P.) - all in Australia; University of Basel, Department of Anesthesia, Surgical Intensive Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, Basel, and Klinik Hirslanden Zurich, Zurich - both in Switzerland (M.D.S.); Heart Care Associates, SAL Hospital, Gujarat, India (C.M.); and the Department of Cardiothoracic Anaesthesia, National Heart Center, and the Department of Anaesthesiology, Singapore General Hospital - both in Singapore (N.-C.H.). FAU - Royse, Colin AU - Royse C AD - From the Department of Anesthesia (C.D.M., G.M.T.H., N.M.) and the Department of Surgery, Division of Cardiac Surgery (S.V.), St. Michael's Hospital, Keenan Research Centre for Biomedical Science, the Li Ka Shing Knowledge Institute of St. Michael's Hospital (C.D.M., G.M.T.H., K.T., S.V., P.J.), Applied Health Research Centre (J.H., D.D., K.T., S.V., P.J.), Sunnybrook Health Sciences Centre (S.F.), Division of Hematology, Mount Sinai Hospital (N.S.), the Departments of Medicine (P.J., N.S.), Physiology (C.D.M., G.M.T.H), and Laboratory Medicine and Pathobiology (N.S.), Dalla Lana School of Public Health (K.T.), and Institute of Health Policy, Management and Evaluation, University of Toronto, and Canadian Blood Services (N.S.), Toronto, the Population Health Research Institute (R.P.W., E.B.-C.), Hamilton Health Sciences Center (R.P.W., E.B.-C., K.C., S.S.), McMaster University (R.P.W., E.B.-C., K.C., S.S.), Hamilton, ON, the Ottawa Hospital Research Institute, University of Ottawa, Ottawa (D.A.F.), the Cumming School of Medicine and Libin Cardiovascular Institute, University of Calgary, Calgary (A.J.G.), and the Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton (S.M.B.), CHUS-Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke (E.M.), and the Department of Anesthesiology and Critical Care Medicine, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Laval University, Laval (F.L.), QC, the Departments of Anesthesia and Medicine, Division of Critical Care, Centre Hospitalier de l'Universite de Montreal, Montreal (F.M.C.), and the Department of Anesthesia, Perioperative and Pain Medicine, St. Boniface Hospital, University of Manitoba, Winnipeg (H.P.G.) - all in Canada; the Department of Cardiothoracic Anesthesia, Rigshospitalet, Copenhagen University Hospital, Copenhagen (B.K.); Medical Research Institute of New Zealand, Wellington (S.M., P.J.Y.), and Waikato Hospital, Hamilton (K.B.) - both in New Zealand; Fundacion Cardioinfantil-Instituto de Cardiologia and Universidad Autonoma de Bucaramanga, Bucaramanga, Colombia (J.C.V.); the Department of Surgery, University of Melbourne (A.R., C.R.), and the Department of Anaesthesia and Pain Management, Royal Melbourne Hospital (C.R.), Melbourne, VIC, and the Department of Anaesthesia, Royal Adelaide Hospital, and the Discipline of Acute Care Medicine, University of Adelaide, Adelaide, SA (T.W.P.) - all in Australia; University of Basel, Department of Anesthesia, Surgical Intensive Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, Basel, and Klinik Hirslanden Zurich, Zurich - both in Switzerland (M.D.S.); Heart Care Associates, SAL Hospital, Gujarat, India (C.M.); and the Department of Cardiothoracic Anaesthesia, National Heart Center, and the Department of Anaesthesiology, Singapore General Hospital - both in Singapore (N.-C.H.). FAU - Hall, Judith AU - Hall J AD - From the Department of Anesthesia (C.D.M., G.M.T.H., N.M.) and the Department of Surgery, Division of Cardiac Surgery (S.V.), St. Michael's Hospital, Keenan Research Centre for Biomedical Science, the Li Ka Shing Knowledge Institute of St. Michael's Hospital (C.D.M., G.M.T.H., K.T., S.V., P.J.), Applied Health Research Centre (J.H., D.D., K.T., S.V., P.J.), Sunnybrook Health Sciences Centre (S.F.), Division of Hematology, Mount Sinai Hospital (N.S.), the Departments of Medicine (P.J., N.S.), Physiology (C.D.M., G.M.T.H), and Laboratory Medicine and Pathobiology (N.S.), Dalla Lana School of Public Health (K.T.), and Institute of Health Policy, Management and Evaluation, University of Toronto, and Canadian Blood Services (N.S.), Toronto, the Population Health Research Institute (R.P.W., E.B.-C.), Hamilton Health Sciences Center (R.P.W., E.B.-C., K.C., S.S.), McMaster University (R.P.W., E.B.-C., K.C., S.S.), Hamilton, ON, the Ottawa Hospital Research Institute, University of Ottawa, Ottawa (D.A.F.), the Cumming School of Medicine and Libin Cardiovascular Institute, University of Calgary, Calgary (A.J.G.), and the Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton (S.M.B.), CHUS-Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke (E.M.), and the Department of Anesthesiology and Critical Care Medicine, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Laval University, Laval (F.L.), QC, the Departments of Anesthesia and Medicine, Division of Critical Care, Centre Hospitalier de l'Universite de Montreal, Montreal (F.M.C.), and the Department of Anesthesia, Perioperative and Pain Medicine, St. Boniface Hospital, University of Manitoba, Winnipeg (H.P.G.) - all in Canada; the Department of Cardiothoracic Anesthesia, Rigshospitalet, Copenhagen University Hospital, Copenhagen (B.K.); Medical Research Institute of New Zealand, Wellington (S.M., P.J.Y.), and Waikato Hospital, Hamilton (K.B.) - both in New Zealand; Fundacion Cardioinfantil-Instituto de Cardiologia and Universidad Autonoma de Bucaramanga, Bucaramanga, Colombia (J.C.V.); the Department of Surgery, University of Melbourne (A.R., C.R.), and the Department of Anaesthesia and Pain Management, Royal Melbourne Hospital (C.R.), Melbourne, VIC, and the Department of Anaesthesia, Royal Adelaide Hospital, and the Discipline of Acute Care Medicine, University of Adelaide, Adelaide, SA (T.W.P.) - all in Australia; University of Basel, Department of Anesthesia, Surgical Intensive Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, Basel, and Klinik Hirslanden Zurich, Zurich - both in Switzerland (M.D.S.); Heart Care Associates, SAL Hospital, Gujarat, India (C.M.); and the Department of Cardiothoracic Anaesthesia, National Heart Center, and the Department of Anaesthesiology, Singapore General Hospital - both in Singapore (N.-C.H.). FAU - Dai, David AU - Dai D AD - From the Department of Anesthesia (C.D.M., G.M.T.H., N.M.) and the Department of Surgery, Division of Cardiac Surgery (S.V.), St. Michael's Hospital, Keenan Research Centre for Biomedical Science, the Li Ka Shing Knowledge Institute of St. Michael's Hospital (C.D.M., G.M.T.H., K.T., S.V., P.J.), Applied Health Research Centre (J.H., D.D., K.T., S.V., P.J.), Sunnybrook Health Sciences Centre (S.F.), Division of Hematology, Mount Sinai Hospital (N.S.), the Departments of Medicine (P.J., N.S.), Physiology (C.D.M., G.M.T.H), and Laboratory Medicine and Pathobiology (N.S.), Dalla Lana School of Public Health (K.T.), and Institute of Health Policy, Management and Evaluation, University of Toronto, and Canadian Blood Services (N.S.), Toronto, the Population Health Research Institute (R.P.W., E.B.-C.), Hamilton Health Sciences Center (R.P.W., E.B.-C., K.C., S.S.), McMaster University (R.P.W., E.B.-C., K.C., S.S.), Hamilton, ON, the Ottawa Hospital Research Institute, University of Ottawa, Ottawa (D.A.F.), the Cumming School of Medicine and Libin Cardiovascular Institute, University of Calgary, Calgary (A.J.G.), and the Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton (S.M.B.), CHUS-Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke (E.M.), and the Department of Anesthesiology and Critical Care Medicine, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Laval University, Laval (F.L.), QC, the Departments of Anesthesia and Medicine, Division of Critical Care, Centre Hospitalier de l'Universite de Montreal, Montreal (F.M.C.), and the Department of Anesthesia, Perioperative and Pain Medicine, St. Boniface Hospital, University of Manitoba, Winnipeg (H.P.G.) - all in Canada; the Department of Cardiothoracic Anesthesia, Rigshospitalet, Copenhagen University Hospital, Copenhagen (B.K.); Medical Research Institute of New Zealand, Wellington (S.M., P.J.Y.), and Waikato Hospital, Hamilton (K.B.) - both in New Zealand; Fundacion Cardioinfantil-Instituto de Cardiologia and Universidad Autonoma de Bucaramanga, Bucaramanga, Colombia (J.C.V.); the Department of Surgery, University of Melbourne (A.R., C.R.), and the Department of Anaesthesia and Pain Management, Royal Melbourne Hospital (C.R.), Melbourne, VIC, and the Department of Anaesthesia, Royal Adelaide Hospital, and the Discipline of Acute Care Medicine, University of Adelaide, Adelaide, SA (T.W.P.) - all in Australia; University of Basel, Department of Anesthesia, Surgical Intensive Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, Basel, and Klinik Hirslanden Zurich, Zurich - both in Switzerland (M.D.S.); Heart Care Associates, SAL Hospital, Gujarat, India (C.M.); and the Department of Cardiothoracic Anaesthesia, National Heart Center, and the Department of Anaesthesiology, Singapore General Hospital - both in Singapore (N.-C.H.). FAU - Mistry, Nikhil AU - Mistry N AD - From the Department of Anesthesia (C.D.M., G.M.T.H., N.M.) and the Department of Surgery, Division of Cardiac Surgery (S.V.), St. Michael's Hospital, Keenan Research Centre for Biomedical Science, the Li Ka Shing Knowledge Institute of St. Michael's Hospital (C.D.M., G.M.T.H., K.T., S.V., P.J.), Applied Health Research Centre (J.H., D.D., K.T., S.V., P.J.), Sunnybrook Health Sciences Centre (S.F.), Division of Hematology, Mount Sinai Hospital (N.S.), the Departments of Medicine (P.J., N.S.), Physiology (C.D.M., G.M.T.H), and Laboratory Medicine and Pathobiology (N.S.), Dalla Lana School of Public Health (K.T.), and Institute of Health Policy, Management and Evaluation, University of Toronto, and Canadian Blood Services (N.S.), Toronto, the Population Health Research Institute (R.P.W., E.B.-C.), Hamilton Health Sciences Center (R.P.W., E.B.-C., K.C., S.S.), McMaster University (R.P.W., E.B.-C., K.C., S.S.), Hamilton, ON, the Ottawa Hospital Research Institute, University of Ottawa, Ottawa (D.A.F.), the Cumming School of Medicine and Libin Cardiovascular Institute, University of Calgary, Calgary (A.J.G.), and the Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton (S.M.B.), CHUS-Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke (E.M.), and the Department of Anesthesiology and Critical Care Medicine, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Laval University, Laval (F.L.), QC, the Departments of Anesthesia and Medicine, Division of Critical Care, Centre Hospitalier de l'Universite de Montreal, Montreal (F.M.C.), and the Department of Anesthesia, Perioperative and Pain Medicine, St. Boniface Hospital, University of Manitoba, Winnipeg (H.P.G.) - all in Canada; the Department of Cardiothoracic Anesthesia, Rigshospitalet, Copenhagen University Hospital, Copenhagen (B.K.); Medical Research Institute of New Zealand, Wellington (S.M., P.J.Y.), and Waikato Hospital, Hamilton (K.B.) - both in New Zealand; Fundacion Cardioinfantil-Instituto de Cardiologia and Universidad Autonoma de Bucaramanga, Bucaramanga, Colombia (J.C.V.); the Department of Surgery, University of Melbourne (A.R., C.R.), and the Department of Anaesthesia and Pain Management, Royal Melbourne Hospital (C.R.), Melbourne, VIC, and the Department of Anaesthesia, Royal Adelaide Hospital, and the Discipline of Acute Care Medicine, University of Adelaide, Adelaide, SA (T.W.P.) - all in Australia; University of Basel, Department of Anesthesia, Surgical Intensive Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, Basel, and Klinik Hirslanden Zurich, Zurich - both in Switzerland (M.D.S.); Heart Care Associates, SAL Hospital, Gujarat, India (C.M.); and the Department of Cardiothoracic Anaesthesia, National Heart Center, and the Department of Anaesthesiology, Singapore General Hospital - both in Singapore (N.-C.H.). FAU - Thorpe, Kevin AU - Thorpe K AD - From the Department of Anesthesia (C.D.M., G.M.T.H., N.M.) and the Department of Surgery, Division of Cardiac Surgery (S.V.), St. Michael's Hospital, Keenan Research Centre for Biomedical Science, the Li Ka Shing Knowledge Institute of St. Michael's Hospital (C.D.M., G.M.T.H., K.T., S.V., P.J.), Applied Health Research Centre (J.H., D.D., K.T., S.V., P.J.), Sunnybrook Health Sciences Centre (S.F.), Division of Hematology, Mount Sinai Hospital (N.S.), the Departments of Medicine (P.J., N.S.), Physiology (C.D.M., G.M.T.H), and Laboratory Medicine and Pathobiology (N.S.), Dalla Lana School of Public Health (K.T.), and Institute of Health Policy, Management and Evaluation, University of Toronto, and Canadian Blood Services (N.S.), Toronto, the Population Health Research Institute (R.P.W., E.B.-C.), Hamilton Health Sciences Center (R.P.W., E.B.-C., K.C., S.S.), McMaster University (R.P.W., E.B.-C., K.C., S.S.), Hamilton, ON, the Ottawa Hospital Research Institute, University of Ottawa, Ottawa (D.A.F.), the Cumming School of Medicine and Libin Cardiovascular Institute, University of Calgary, Calgary (A.J.G.), and the Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton (S.M.B.), CHUS-Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke (E.M.), and the Department of Anesthesiology and Critical Care Medicine, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Laval University, Laval (F.L.), QC, the Departments of Anesthesia and Medicine, Division of Critical Care, Centre Hospitalier de l'Universite de Montreal, Montreal (F.M.C.), and the Department of Anesthesia, Perioperative and Pain Medicine, St. Boniface Hospital, University of Manitoba, Winnipeg (H.P.G.) - all in Canada; the Department of Cardiothoracic Anesthesia, Rigshospitalet, Copenhagen University Hospital, Copenhagen (B.K.); Medical Research Institute of New Zealand, Wellington (S.M., P.J.Y.), and Waikato Hospital, Hamilton (K.B.) - both in New Zealand; Fundacion Cardioinfantil-Instituto de Cardiologia and Universidad Autonoma de Bucaramanga, Bucaramanga, Colombia (J.C.V.); the Department of Surgery, University of Melbourne (A.R., C.R.), and the Department of Anaesthesia and Pain Management, Royal Melbourne Hospital (C.R.), Melbourne, VIC, and the Department of Anaesthesia, Royal Adelaide Hospital, and the Discipline of Acute Care Medicine, University of Adelaide, Adelaide, SA (T.W.P.) - all in Australia; University of Basel, Department of Anesthesia, Surgical Intensive Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, Basel, and Klinik Hirslanden Zurich, Zurich - both in Switzerland (M.D.S.); Heart Care Associates, SAL Hospital, Gujarat, India (C.M.); and the Department of Cardiothoracic Anaesthesia, National Heart Center, and the Department of Anaesthesiology, Singapore General Hospital - both in Singapore (N.-C.H.). FAU - Verma, Subodh AU - Verma S AD - From the Department of Anesthesia (C.D.M., G.M.T.H., N.M.) and the Department of Surgery, Division of Cardiac Surgery (S.V.), St. Michael's Hospital, Keenan Research Centre for Biomedical Science, the Li Ka Shing Knowledge Institute of St. Michael's Hospital (C.D.M., G.M.T.H., K.T., S.V., P.J.), Applied Health Research Centre (J.H., D.D., K.T., S.V., P.J.), Sunnybrook Health Sciences Centre (S.F.), Division of Hematology, Mount Sinai Hospital (N.S.), the Departments of Medicine (P.J., N.S.), Physiology (C.D.M., G.M.T.H), and Laboratory Medicine and Pathobiology (N.S.), Dalla Lana School of Public Health (K.T.), and Institute of Health Policy, Management and Evaluation, University of Toronto, and Canadian Blood Services (N.S.), Toronto, the Population Health Research Institute (R.P.W., E.B.-C.), Hamilton Health Sciences Center (R.P.W., E.B.-C., K.C., S.S.), McMaster University (R.P.W., E.B.-C., K.C., S.S.), Hamilton, ON, the Ottawa Hospital Research Institute, University of Ottawa, Ottawa (D.A.F.), the Cumming School of Medicine and Libin Cardiovascular Institute, University of Calgary, Calgary (A.J.G.), and the Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton (S.M.B.), CHUS-Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke (E.M.), and the Department of Anesthesiology and Critical Care Medicine, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Laval University, Laval (F.L.), QC, the Departments of Anesthesia and Medicine, Division of Critical Care, Centre Hospitalier de l'Universite de Montreal, Montreal (F.M.C.), and the Department of Anesthesia, Perioperative and Pain Medicine, St. Boniface Hospital, University of Manitoba, Winnipeg (H.P.G.) - all in Canada; the Department of Cardiothoracic Anesthesia, Rigshospitalet, Copenhagen University Hospital, Copenhagen (B.K.); Medical Research Institute of New Zealand, Wellington (S.M., P.J.Y.), and Waikato Hospital, Hamilton (K.B.) - both in New Zealand; Fundacion Cardioinfantil-Instituto de Cardiologia and Universidad Autonoma de Bucaramanga, Bucaramanga, Colombia (J.C.V.); the Department of Surgery, University of Melbourne (A.R., C.R.), and the Department of Anaesthesia and Pain Management, Royal Melbourne Hospital (C.R.), Melbourne, VIC, and the Department of Anaesthesia, Royal Adelaide Hospital, and the Discipline of Acute Care Medicine, University of Adelaide, Adelaide, SA (T.W.P.) - all in Australia; University of Basel, Department of Anesthesia, Surgical Intensive Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, Basel, and Klinik Hirslanden Zurich, Zurich - both in Switzerland (M.D.S.); Heart Care Associates, SAL Hospital, Gujarat, India (C.M.); and the Department of Cardiothoracic Anaesthesia, National Heart Center, and the Department of Anaesthesiology, Singapore General Hospital - both in Singapore (N.-C.H.). FAU - Juni, Peter AU - Juni P AD - From the Department of Anesthesia (C.D.M., G.M.T.H., N.M.) and the Department of Surgery, Division of Cardiac Surgery (S.V.), St. Michael's Hospital, Keenan Research Centre for Biomedical Science, the Li Ka Shing Knowledge Institute of St. Michael's Hospital (C.D.M., G.M.T.H., K.T., S.V., P.J.), Applied Health Research Centre (J.H., D.D., K.T., S.V., P.J.), Sunnybrook Health Sciences Centre (S.F.), Division of Hematology, Mount Sinai Hospital (N.S.), the Departments of Medicine (P.J., N.S.), Physiology (C.D.M., G.M.T.H), and Laboratory Medicine and Pathobiology (N.S.), Dalla Lana School of Public Health (K.T.), and Institute of Health Policy, Management and Evaluation, University of Toronto, and Canadian Blood Services (N.S.), Toronto, the Population Health Research Institute (R.P.W., E.B.-C.), Hamilton Health Sciences Center (R.P.W., E.B.-C., K.C., S.S.), McMaster University (R.P.W., E.B.-C., K.C., S.S.), Hamilton, ON, the Ottawa Hospital Research Institute, University of Ottawa, Ottawa (D.A.F.), the Cumming School of Medicine and Libin Cardiovascular Institute, University of Calgary, Calgary (A.J.G.), and the Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton (S.M.B.), CHUS-Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke (E.M.), and the Department of Anesthesiology and Critical Care Medicine, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Laval University, Laval (F.L.), QC, the Departments of Anesthesia and Medicine, Division of Critical Care, Centre Hospitalier de l'Universite de Montreal, Montreal (F.M.C.), and the Department of Anesthesia, Perioperative and Pain Medicine, St. Boniface Hospital, University of Manitoba, Winnipeg (H.P.G.) - all in Canada; the Department of Cardiothoracic Anesthesia, Rigshospitalet, Copenhagen University Hospital, Copenhagen (B.K.); Medical Research Institute of New Zealand, Wellington (S.M., P.J.Y.), and Waikato Hospital, Hamilton (K.B.) - both in New Zealand; Fundacion Cardioinfantil-Instituto de Cardiologia and Universidad Autonoma de Bucaramanga, Bucaramanga, Colombia (J.C.V.); the Department of Surgery, University of Melbourne (A.R., C.R.), and the Department of Anaesthesia and Pain Management, Royal Melbourne Hospital (C.R.), Melbourne, VIC, and the Department of Anaesthesia, Royal Adelaide Hospital, and the Discipline of Acute Care Medicine, University of Adelaide, Adelaide, SA (T.W.P.) - all in Australia; University of Basel, Department of Anesthesia, Surgical Intensive Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, Basel, and Klinik Hirslanden Zurich, Zurich - both in Switzerland (M.D.S.); Heart Care Associates, SAL Hospital, Gujarat, India (C.M.); and the Department of Cardiothoracic Anaesthesia, National Heart Center, and the Department of Anaesthesiology, Singapore General Hospital - both in Singapore (N.-C.H.). FAU - Shehata, Nadine AU - Shehata N AD - From the Department of Anesthesia (C.D.M., G.M.T.H., N.M.) and the Department of Surgery, Division of Cardiac Surgery (S.V.), St. Michael's Hospital, Keenan Research Centre for Biomedical Science, the Li Ka Shing Knowledge Institute of St. Michael's Hospital (C.D.M., G.M.T.H., K.T., S.V., P.J.), Applied Health Research Centre (J.H., D.D., K.T., S.V., P.J.), Sunnybrook Health Sciences Centre (S.F.), Division of Hematology, Mount Sinai Hospital (N.S.), the Departments of Medicine (P.J., N.S.), Physiology (C.D.M., G.M.T.H), and Laboratory Medicine and Pathobiology (N.S.), Dalla Lana School of Public Health (K.T.), and Institute of Health Policy, Management and Evaluation, University of Toronto, and Canadian Blood Services (N.S.), Toronto, the Population Health Research Institute (R.P.W., E.B.-C.), Hamilton Health Sciences Center (R.P.W., E.B.-C., K.C., S.S.), McMaster University (R.P.W., E.B.-C., K.C., S.S.), Hamilton, ON, the Ottawa Hospital Research Institute, University of Ottawa, Ottawa (D.A.F.), the Cumming School of Medicine and Libin Cardiovascular Institute, University of Calgary, Calgary (A.J.G.), and the Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton (S.M.B.), CHUS-Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke (E.M.), and the Department of Anesthesiology and Critical Care Medicine, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Laval University, Laval (F.L.), QC, the Departments of Anesthesia and Medicine, Division of Critical Care, Centre Hospitalier de l'Universite de Montreal, Montreal (F.M.C.), and the Department of Anesthesia, Perioperative and Pain Medicine, St. Boniface Hospital, University of Manitoba, Winnipeg (H.P.G.) - all in Canada; the Department of Cardiothoracic Anesthesia, Rigshospitalet, Copenhagen University Hospital, Copenhagen (B.K.); Medical Research Institute of New Zealand, Wellington (S.M., P.J.Y.), and Waikato Hospital, Hamilton (K.B.) - both in New Zealand; Fundacion Cardioinfantil-Instituto de Cardiologia and Universidad Autonoma de Bucaramanga, Bucaramanga, Colombia (J.C.V.); the Department of Surgery, University of Melbourne (A.R., C.R.), and the Department of Anaesthesia and Pain Management, Royal Melbourne Hospital (C.R.), Melbourne, VIC, and the Department of Anaesthesia, Royal Adelaide Hospital, and the Discipline of Acute Care Medicine, University of Adelaide, Adelaide, SA (T.W.P.) - all in Australia; University of Basel, Department of Anesthesia, Surgical Intensive Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, Basel, and Klinik Hirslanden Zurich, Zurich - both in Switzerland (M.D.S.); Heart Care Associates, SAL Hospital, Gujarat, India (C.M.); and the Department of Cardiothoracic Anaesthesia, National Heart Center, and the Department of Anaesthesiology, Singapore General Hospital - both in Singapore (N.-C.H.). CN - TRICS Investigators and Perioperative Anesthesia Clinical Trials Group LA - eng SI - ClinicalTrials.gov/NCT02042898 PT - Comparative Study PT - Equivalence Trial PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20180826 PL - United States TA - N Engl J Med JT - The New England journal of medicine JID - 0255562 RN - 0 (Hemoglobins) SB - IM CIN - N Engl J Med. 2018 Dec 27;379(26):2575-2576. doi: 10.1056/NEJMc1814414. PMID: 30586524 CIN - N Engl J Med. 2018 Dec 27;379(26):2576. doi: 10.1056/NEJMc1814414. PMID: 30586525 MH - Adult MH - Aged MH - Cardiac Surgical Procedures/adverse effects/*mortality MH - Cardiopulmonary Bypass MH - Cause of Death MH - Erythrocyte Transfusion/*methods MH - Female MH - Follow-Up Studies MH - Hemoglobins/analysis MH - Humans MH - Kaplan-Meier Estimate MH - Logistic Models MH - Male MH - Middle Aged MH - Myocardial Infarction/etiology MH - Postoperative Complications/etiology/*mortality MH - Renal Insufficiency/etiology MH - Stroke/etiology FIR - MacAdams, Charlie IR - MacAdams C FIR - Carson, J IR - Carson J FIR - Cook, D IR - Cook D FIR - Cook, R IR - Cook R FIR - Nathan, H IR - Nathan H FIR - Roberts, R IR - Roberts R FIR - Krahn, M IR - Krahn M FIR - Growe, G IR - Growe G FIR - Baskett, R IR - Baskett R FIR - Bainbridge, D IR - Bainbridge D FIR - Djaiani, G IR - Djaiani G FIR - Shehata, N IR - Shehata N FIR - Eaton, M IR - Eaton M FIR - Garg, A IR - Garg A FIR - Zhou, Y IR - Zhou Y FIR - Dai, B IR - Dai B FIR - Du, C IR - Du C FIR - Schulman, S IR - Schulman S FIR - Ingemann, J IR - Ingemann J FIR - Chasse, M IR - Chasse M FIR - Kuebler, W IR - Kuebler W FIR - Gofeld, M IR - Gofeld M FIR - Novoshinov, S IR - Novoshinov S FIR - Popescu, W IR - Popescu W FIR - Contreras, M IR - Contreras M FIR - Gomez-Builes, C IR - Gomez-Builes C FIR - Bittencourt, R IR - Bittencourt R FIR - Papa, F IR - Papa F FIR - Shim, Jodi IR - Shim J FIR - Dang, Alice IR - Dang A FIR - Ducharme, Christopher IR - Ducharme C FIR - McCaskell, Devin IR - McCaskell D FIR - Laksono, Isabelle IR - Laksono I FIR - Cohen, Ashley IR - Cohen A FIR - Louvelle, Leslie IR - Louvelle L FIR - DeVerno, Pamela IR - DeVerno P FIR - Wysocki, Kosma IR - Wysocki K FIR - Naydenova, Maria IR - Naydenova M FIR - Wu, Jonathan IR - Wu J FIR - Masse, M H IR - Masse MH FIR - Marchand, J IR - Marchand J FIR - MacAdams, C IR - MacAdams C FIR - Seal, D IR - Seal D FIR - Ferland, A IR - Ferland A FIR - Ali, I IR - Ali I FIR - Maier, K IR - Maier K FIR - Creary, T IR - Creary T FIR - Tittley, L IR - Tittley L FIR - Spence, J IR - Spence J FIR - Jaffer, I IR - Jaffer I FIR - Brodutch, S IR - Brodutch S FIR - Bussieres, J IR - Bussieres J FIR - Dagenais, F IR - Dagenais F FIR - Lizotte, P IR - Lizotte P FIR - Gagne, N IR - Gagne N FIR - Tremblay, H IR - Tremblay H FIR - Breton, C IR - Breton C FIR - Bouchard, P IR - Bouchard P FIR - Bentall, T IR - Bentall T FIR - Beique, F IR - Beique F FIR - Ramachandran, S IR - Ramachandran S FIR - Rochon, A IR - Rochon A FIR - Vervais, M IR - Vervais M FIR - Grenier, S IR - Grenier S FIR - Kashani, H IR - Kashani H FIR - Ambrose, E IR - Ambrose E FIR - McVagh, J IR - McVagh J FIR - Crescini, C IR - Crescini C FIR - Yagnik, S IR - Yagnik S FIR - Slabiak, A IR - Slabiak A FIR - Han, K IR - Han K FIR - Karkhanis, R IR - Karkhanis R FIR - Baig, N IR - Baig N FIR - Sidhu, S IR - Sidhu S FIR - MacArthur, R IR - MacArthur R FIR - Reid, K IR - Reid K FIR - Boehnke, S IR - Boehnke S FIR - Hudson, C IR - Hudson C FIR - Rubens, F D IR - Rubens FD FIR - Winch, D IR - Winch D FIR - Klein, R IR - Klein R FIR - Grey, R IR - Grey R FIR - Teoh, K IR - Teoh K FIR - Wiley, W IR - Wiley W FIR - Darby, C IR - Darby C FIR - Ho, A IR - Ho A FIR - Saha, T IR - Saha T FIR - DuMerton Shore, D IR - DuMerton Shore D FIR - Shelley, J IR - Shelley J FIR - Lamarche, Y IR - Lamarche Y FIR - Sirois, C IR - Sirois C FIR - Brown, C D IR - Brown CD FIR - Dube, C IR - Dube C FIR - Holden, K IR - Holden K FIR - Roy, L IR - Roy L FIR - Rolfe, B IR - Rolfe B FIR - Brown, S IR - Brown S FIR - Badner, N IR - Badner N FIR - Saczkowski, R IR - Saczkowski R FIR - Senner, W IR - Senner W FIR - Noiseux, N IR - Noiseux N FIR - Hebert, P IR - Hebert P FIR - Benettaib, F IR - Benettaib F FIR - Ghamraoui, A IR - Ghamraoui A FIR - Lebrasseur, M IR - Lebrasseur M FIR - Beattie, W S IR - Beattie WS FIR - Carroll, J IR - Carroll J FIR - Poonawala, H IR - Poonawala H FIR - Zbitnew, G IR - Zbitnew G FIR - Howells, S IR - Howells S FIR - Mawhinney, R IR - Mawhinney R FIR - Sampson, S IR - Sampson S FIR - Yegappan, C IR - Yegappan C FIR - Schroeder, R IR - Schroeder R FIR - Perfect, S IR - Perfect S FIR - Jones, M IR - Jones M FIR - Leff, J IR - Leff J FIR - Nair, S IR - Nair S FIR - Moncada, K A IR - Moncada KA FIR - Joco, C IR - Joco C FIR - Harrison, M IR - Harrison M FIR - Greilich, P IR - Greilich P FIR - Landgraf, K IR - Landgraf K FIR - Kramer, R S IR - Kramer RS FIR - Gallant, B IR - Gallant B FIR - Fontes, M IR - Fontes M FIR - Stavris, K IR - Stavris K FIR - Rosengart, T IR - Rosengart T FIR - Omer, S IR - Omer S FIR - Coffey, K IR - Coffey K FIR - Broussard, E IR - Broussard E FIR - Tseng, E IR - Tseng E FIR - London, M J IR - London MJ FIR - Stanley, K M IR - Stanley KM FIR - Casson, L IR - Casson L FIR - Julien, M IR - Julien M FIR - Myles, P IR - Myles P FIR - Wallace, S IR - Wallace S FIR - Galagher, W IR - Galagher W FIR - Ditoro, A IR - Ditoro A FIR - Williams, Z IR - Williams Z FIR - Tivendale, L IR - Tivendale L FIR - Dong, N IR - Dong N FIR - Judelman, S IR - Judelman S FIR - Leyden, J IR - Leyden J FIR - Yarad, E IR - Yarad E FIR - Player, C IR - Player C FIR - Scott, D A IR - Scott DA FIR - Slater, B IR - Slater B FIR - Corcoran, P IR - Corcoran P FIR - Hu, R IR - Hu R FIR - Sidiropoulos, S IR - Sidiropoulos S FIR - Baulch, S IR - Baulch S FIR - Brewster, D IR - Brewster D FIR - Simpson, S IR - Simpson S FIR - Smith, J IR - Smith J FIR - Hulley, A IR - Hulley A FIR - de Prinse, L IR - de Prinse L FIR - Bannon, P IR - Bannon P FIR - Turner, L IR - Turner L FIR - Beattie, L IR - Beattie L FIR - Eslick, A IR - Eslick A FIR - Cope, L IR - Cope L FIR - Baker, R A IR - Baker RA FIR - Pesudovs, B IR - Pesudovs B FIR - Bennetts, J B IR - Bennetts JB FIR - Dimovski, D IR - Dimovski D FIR - Duggan, N IR - Duggan N FIR - Ives, K IR - Ives K FIR - Yap, C IR - Yap C FIR - Mans, G IR - Mans G FIR - Termaat, J IR - Termaat J FIR - Ridgeon, E IR - Ridgeon E FIR - Reddy, S IR - Reddy S FIR - Hurford, S IR - Hurford S FIR - Mackle, D IR - Mackle D FIR - Baker, T IR - Baker T FIR - Hunt, A IR - Hunt A FIR - Cruz, R IR - Cruz R FIR - Henderson, S IR - Henderson S FIR - Mehrtens, J IR - Mehrtens J FIR - Parke, R IR - Parke R FIR - Gilder, E IR - Gilder E FIR - Cowdrey, K IR - Cowdrey K FIR - Dalton, J IR - Dalton J FIR - Butler, M IR - Butler M FIR - Long, S IR - Long S FIR - Lammert, A IR - Lammert A FIR - Blakemore, A IR - Blakemore A FIR - Walker, C IR - Walker C FIR - France, D IR - France D FIR - Hutchison, R IR - Hutchison R FIR - Xue, S IR - Xue S FIR - Gu, J IR - Gu J FIR - Chen, X IR - Chen X FIR - Fan, A IR - Fan A FIR - Suraya, S IR - Suraya S FIR - Raja, N IR - Raja N FIR - Yusnida, I IR - Yusnida I FIR - Azura, T IR - Azura T FIR - Saibon, T IR - Saibon T FIR - Tze Bing, M IR - Tze Bing M FIR - Tan, R S IR - Tan RS FIR - Ang, F IR - Ang F FIR - Chin, T T IR - Chin TT FIR - Jain, A IR - Jain A FIR - Sharma, P IR - Sharma P FIR - Shah, R IR - Shah R FIR - Shaikh, P IR - Shaikh P FIR - Kanchi, M IR - Kanchi M FIR - Sigamani, A IR - Sigamani A FIR - Anusha, K IR - Anusha K FIR - Johansson, P IR - Johansson P FIR - Anderson, T IR - Anderson T FIR - Olesen, L IR - Olesen L FIR - Lilleor, N IR - Lilleor N FIR - Rasmussen, S IR - Rasmussen S FIR - Fenger, A IR - Fenger A FIR - Treskatsch, S IR - Treskatsch S FIR - Mezger, V IR - Mezger V FIR - Falk, E IR - Falk E FIR - Habicher, M IR - Habicher M FIR - Sander, M IR - Sander M FIR - Edinger, F IR - Edinger F FIR - Koch, C IR - Koch C FIR - Boening, A IR - Boening A FIR - Oswald, I IR - Oswald I FIR - Bulat-Genc, S IR - Bulat-Genc S FIR - Bolliger, D IR - Bolliger D FIR - Fassl, J IR - Fassl J FIR - Seeberger, E IR - Seeberger E FIR - Eberle, B IR - Eberle B FIR - Takala, J IR - Takala J FIR - Stucki, M IR - Stucki M FIR - Mateo, E IR - Mateo E FIR - Moreno, J IR - Moreno J FIR - Gabaldon, T IR - Gabaldon T FIR - Cobo, I IR - Cobo I FIR - Pena, J J IR - Pena JJ FIR - Ferrer, C IR - Ferrer C FIR - Carmona, P IR - Carmona P FIR - Lopez Cantero, M IR - Lopez Cantero M FIR - Pajares, A IR - Pajares A FIR - Zarragoikoetxea, I IR - Zarragoikoetxea I FIR - Galan, J IR - Galan J FIR - Urrutia, G IR - Urrutia G FIR - Martinez-Zapata, M J IR - Martinez-Zapata MJ FIR - Rivilla, M IR - Rivilla M FIR - Cegarra, V IR - Cegarra V FIR - Acosta-Isaac, R IR - Acosta-Isaac R FIR - Gajate-Martin, L IR - Gajate-Martin L FIR - Candela-Toha, A IR - Candela-Toha A FIR - Tagarakis, G I IR - Tagarakis GI FIR - Simopoulos, V IR - Simopoulos V FIR - Karangelis, D IR - Karangelis D FIR - Filipescu, D IR - Filipescu D FIR - Paunescu, A IR - Paunescu A FIR - Fawzy, H IR - Fawzy H FIR - Mawlana, W IR - Mawlana W FIR - Preisman, S IR - Preisman S FIR - Raanani, E IR - Raanani E FIR - Kogan, D IR - Kogan D FIR - Matot, I IR - Matot I FIR - Cattan, A IR - Cattan A FIR - Artsi, H IR - Artsi H FIR - Galhardo, C IR - Galhardo C FIR - Olival, S IR - Olival S FIR - Toledo, R IR - Toledo R FIR - Hernandez, E IR - Hernandez E FIR - Montes, F R IR - Montes FR FIR - Vaquiro, E IR - Vaquiro E FIR - Garavito, C IR - Garavito C FIR - Abello, M IR - Abello M FIR - Manrique, E J IR - Manrique EJ FIR - Vasquez, S M IR - Vasquez SM FIR - Aguilar, L A IR - Aguilar LA FIR - Coral, M IR - Coral M FIR - Rodriguez, H IR - Rodriguez H FIR - Tellez, J C IR - Tellez JC FIR - Martinez, C IR - Martinez C FIR - Biccard, B M IR - Biccard BM FIR - Alphonsus, C S IR - Alphonsus CS FIR - Spiess, B IR - Spiess B FIR - Hall, R IR - Hall R FIR - Kent, B IR - Kent B FIR - Denault, A IR - Denault A FIR - Deshamps, A IR - Deshamps A EDAT- 2018/08/28 06:00 MHDA- 2018/10/31 06:00 CRDT- 2018/08/28 06:00 PHST- 2018/08/28 06:00 [pubmed] PHST- 2018/10/31 06:00 [medline] PHST- 2018/08/28 06:00 [entrez] AID - 10.1056/NEJMoa1808561 [doi] PST - ppublish SO - N Engl J Med. 2018 Sep 27;379(13):1224-1233. doi: 10.1056/NEJMoa1808561. Epub 2018 Aug 26. PMID- 30145971 OWN - NLM STAT- MEDLINE DCOM- 20181211 LR - 20260518 IS - 1533-4406 (Electronic) IS - 0028-4793 (Linking) VI - 379 IP - 18 DP - 2018 Nov 1 TI - One-Year Outcomes after PCI Strategies in Cardiogenic Shock. PG - 1699-1710 LID - 10.1056/NEJMoa1808788 [doi] AB - BACKGROUND: Among patients with acute myocardial infarction, cardiogenic shock, and multivessel coronary artery disease, the risk of a composite of death from any cause or severe renal failure leading to renal-replacement therapy at 30 days was found to be lower with percutaneous coronary intervention (PCI) of the culprit lesion only than with immediate multivessel PCI. We evaluated clinical outcomes at 1 year. METHODS: We randomly assigned 706 patients to either culprit-lesion-only PCI or immediate multivessel PCI. The results for the primary end point of death or renal-replacement therapy at 30 days have been reported previously. Prespecified secondary end points at 1 year included death from any cause, recurrent myocardial infarction, repeat revascularization, rehospitalization for congestive heart failure, the composite of death or recurrent infarction, and the composite of death, recurrent infarction, or rehospitalization for heart failure. RESULTS: As reported previously, at 30 days, the primary end point had occurred in 45.9% of the patients in the culprit-lesion-only PCI group and in 55.4% in the multivessel PCI group (P=0.01). At 1 year, death had occurred in 172 of 344 patients (50.0%) in the culprit-lesion-only PCI group and in 194 of 341 patients (56.9%) in the multivessel PCI group (relative risk, 0.88; 95% confidence interval [CI], 0.76 to 1.01). The rate of recurrent infarction was 1.7% with culprit-lesion-only PCI and 2.1% with multivessel PCI (relative risk, 0.85; 95% CI, 0.29 to 2.50), and the rate of a composite of death or recurrent infarction was 50.9% and 58.4%, respectively (relative risk, 0.87; 95% CI, 0.76 to 1.00). Repeat revascularization occurred more frequently with culprit-lesion-only PCI than with multivessel PCI (in 32.3% of the patients vs. 9.4%; relative risk, 3.44; 95% CI, 2.39 to 4.95), as did rehospitalization for heart failure (5.2% vs. 1.2%; relative risk, 4.46; 95% CI, 1.53 to 13.04). CONCLUSIONS: Among patients with acute myocardial infarction and cardiogenic shock, the risk of death or renal-replacement therapy at 30 days was lower with culprit-lesion-only PCI than with immediate multivessel PCI, and mortality did not differ significantly between the two groups at 1 year of follow-up. (Funded by the European Union Seventh Framework Program and others; CULPRIT-SHOCK ClinicalTrials.gov number, NCT01927549 .). FAU - Thiele, Holger AU - Thiele H AD - From Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig (H.T., M.S., A.J., S.D.), Universitatsmedizin Mannheim, Mannheim (I.A.), University Heart Center Lubeck, Lubeck (S.W.-T., R.M.-S., G.F., I.E.), German Center for Cardiovascular Research (I.A., S.W.-T., R.M.-S., G.F., I.E., U.L., C.S., A.J., S.B.F., S.D.) and Universitatsklinikum Charite, Campus Benjamin Franklin (U.L., C.S.), Berlin, Universitatsklinikum Wurzburg, Wurzburg (P.N.), Klinikum der Eberhard-Karls-Universitat Tubingen, Tubingen (T. Geisler), Klinikum Links der Weser, Bremen (A.F.), Helios Klinik Erfurt, Erfurt (H.L.), Ernst-Moritz-Arndt-Universitat, Greifswald (S.B.F.), Universitares Herzzentrum Regensburg, Regensburg (L.S.M.), and Institut fur Herzinfarktforschung (S. Schneider, U.Z.) and Klinikum Ludwigshafen (U.Z.), Ludwigshafen - all in Germany; Academic Medical Center, Amsterdam (J.J.P.); University Medical Center Ljubljana, Ljubljana, Slovenia (M.N., T. Goslar); Institute of Cardiology, Warsaw, Poland (J.S.); Golden Jubilee National Hospital, Glasgow, United Kingdom (K.O.); Vilnius University Hospital Santaros Klinikos and Faculty of Medicine, Vilnius University, Vilnius, Lithuania (P.S.); Sorbonne Universite Paris 6, ACTION Study Group, Centre Hospitalier Universitaire Pitie-Salpetriere (G.M., O.B.), and Applied Research, Technology Transfer, Industrial Collaboration, Societe par Actions Simplifiee (P.T.), Paris; Wilhelminenpital, Department of Cardiology, and Sigmund Freud University, Medical School, Vienna (K.H.); the Department of Cardiology, Inselspital Bern, University of Bern, Bern, Switzerland (S.W., L.H.); Manzoni Hospital, Lecco, Italy (S. Savonitto); and Universitair Ziekenhuis Antwerp, Antwerp, Belgium (C.V.). FAU - Akin, Ibrahim AU - Akin I AD - From Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig (H.T., M.S., A.J., S.D.), Universitatsmedizin Mannheim, Mannheim (I.A.), University Heart Center Lubeck, Lubeck (S.W.-T., R.M.-S., G.F., I.E.), German Center for Cardiovascular Research (I.A., S.W.-T., R.M.-S., G.F., I.E., U.L., C.S., A.J., S.B.F., S.D.) and Universitatsklinikum Charite, Campus Benjamin Franklin (U.L., C.S.), Berlin, Universitatsklinikum Wurzburg, Wurzburg (P.N.), Klinikum der Eberhard-Karls-Universitat Tubingen, Tubingen (T. Geisler), Klinikum Links der Weser, Bremen (A.F.), Helios Klinik Erfurt, Erfurt (H.L.), Ernst-Moritz-Arndt-Universitat, Greifswald (S.B.F.), Universitares Herzzentrum Regensburg, Regensburg (L.S.M.), and Institut fur Herzinfarktforschung (S. Schneider, U.Z.) and Klinikum Ludwigshafen (U.Z.), Ludwigshafen - all in Germany; Academic Medical Center, Amsterdam (J.J.P.); University Medical Center Ljubljana, Ljubljana, Slovenia (M.N., T. Goslar); Institute of Cardiology, Warsaw, Poland (J.S.); Golden Jubilee National Hospital, Glasgow, United Kingdom (K.O.); Vilnius University Hospital Santaros Klinikos and Faculty of Medicine, Vilnius University, Vilnius, Lithuania (P.S.); Sorbonne Universite Paris 6, ACTION Study Group, Centre Hospitalier Universitaire Pitie-Salpetriere (G.M., O.B.), and Applied Research, Technology Transfer, Industrial Collaboration, Societe par Actions Simplifiee (P.T.), Paris; Wilhelminenpital, Department of Cardiology, and Sigmund Freud University, Medical School, Vienna (K.H.); the Department of Cardiology, Inselspital Bern, University of Bern, Bern, Switzerland (S.W., L.H.); Manzoni Hospital, Lecco, Italy (S. Savonitto); and Universitair Ziekenhuis Antwerp, Antwerp, Belgium (C.V.). FAU - Sandri, Marcus AU - Sandri M AD - From Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig (H.T., M.S., A.J., S.D.), Universitatsmedizin Mannheim, Mannheim (I.A.), University Heart Center Lubeck, Lubeck (S.W.-T., R.M.-S., G.F., I.E.), German Center for Cardiovascular Research (I.A., S.W.-T., R.M.-S., G.F., I.E., U.L., C.S., A.J., S.B.F., S.D.) and Universitatsklinikum Charite, Campus Benjamin Franklin (U.L., C.S.), Berlin, Universitatsklinikum Wurzburg, Wurzburg (P.N.), Klinikum der Eberhard-Karls-Universitat Tubingen, Tubingen (T. Geisler), Klinikum Links der Weser, Bremen (A.F.), Helios Klinik Erfurt, Erfurt (H.L.), Ernst-Moritz-Arndt-Universitat, Greifswald (S.B.F.), Universitares Herzzentrum Regensburg, Regensburg (L.S.M.), and Institut fur Herzinfarktforschung (S. Schneider, U.Z.) and Klinikum Ludwigshafen (U.Z.), Ludwigshafen - all in Germany; Academic Medical Center, Amsterdam (J.J.P.); University Medical Center Ljubljana, Ljubljana, Slovenia (M.N., T. Goslar); Institute of Cardiology, Warsaw, Poland (J.S.); Golden Jubilee National Hospital, Glasgow, United Kingdom (K.O.); Vilnius University Hospital Santaros Klinikos and Faculty of Medicine, Vilnius University, Vilnius, Lithuania (P.S.); Sorbonne Universite Paris 6, ACTION Study Group, Centre Hospitalier Universitaire Pitie-Salpetriere (G.M., O.B.), and Applied Research, Technology Transfer, Industrial Collaboration, Societe par Actions Simplifiee (P.T.), Paris; Wilhelminenpital, Department of Cardiology, and Sigmund Freud University, Medical School, Vienna (K.H.); the Department of Cardiology, Inselspital Bern, University of Bern, Bern, Switzerland (S.W., L.H.); Manzoni Hospital, Lecco, Italy (S. Savonitto); and Universitair Ziekenhuis Antwerp, Antwerp, Belgium (C.V.). FAU - de Waha-Thiele, Suzanne AU - de Waha-Thiele S AD - From Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig (H.T., M.S., A.J., S.D.), Universitatsmedizin Mannheim, Mannheim (I.A.), University Heart Center Lubeck, Lubeck (S.W.-T., R.M.-S., G.F., I.E.), German Center for Cardiovascular Research (I.A., S.W.-T., R.M.-S., G.F., I.E., U.L., C.S., A.J., S.B.F., S.D.) and Universitatsklinikum Charite, Campus Benjamin Franklin (U.L., C.S.), Berlin, Universitatsklinikum Wurzburg, Wurzburg (P.N.), Klinikum der Eberhard-Karls-Universitat Tubingen, Tubingen (T. Geisler), Klinikum Links der Weser, Bremen (A.F.), Helios Klinik Erfurt, Erfurt (H.L.), Ernst-Moritz-Arndt-Universitat, Greifswald (S.B.F.), Universitares Herzzentrum Regensburg, Regensburg (L.S.M.), and Institut fur Herzinfarktforschung (S. Schneider, U.Z.) and Klinikum Ludwigshafen (U.Z.), Ludwigshafen - all in Germany; Academic Medical Center, Amsterdam (J.J.P.); University Medical Center Ljubljana, Ljubljana, Slovenia (M.N., T. Goslar); Institute of Cardiology, Warsaw, Poland (J.S.); Golden Jubilee National Hospital, Glasgow, United Kingdom (K.O.); Vilnius University Hospital Santaros Klinikos and Faculty of Medicine, Vilnius University, Vilnius, Lithuania (P.S.); Sorbonne Universite Paris 6, ACTION Study Group, Centre Hospitalier Universitaire Pitie-Salpetriere (G.M., O.B.), and Applied Research, Technology Transfer, Industrial Collaboration, Societe par Actions Simplifiee (P.T.), Paris; Wilhelminenpital, Department of Cardiology, and Sigmund Freud University, Medical School, Vienna (K.H.); the Department of Cardiology, Inselspital Bern, University of Bern, Bern, Switzerland (S.W., L.H.); Manzoni Hospital, Lecco, Italy (S. Savonitto); and Universitair Ziekenhuis Antwerp, Antwerp, Belgium (C.V.). FAU - Meyer-Saraei, Roza AU - Meyer-Saraei R AD - From Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig (H.T., M.S., A.J., S.D.), Universitatsmedizin Mannheim, Mannheim (I.A.), University Heart Center Lubeck, Lubeck (S.W.-T., R.M.-S., G.F., I.E.), German Center for Cardiovascular Research (I.A., S.W.-T., R.M.-S., G.F., I.E., U.L., C.S., A.J., S.B.F., S.D.) and Universitatsklinikum Charite, Campus Benjamin Franklin (U.L., C.S.), Berlin, Universitatsklinikum Wurzburg, Wurzburg (P.N.), Klinikum der Eberhard-Karls-Universitat Tubingen, Tubingen (T. Geisler), Klinikum Links der Weser, Bremen (A.F.), Helios Klinik Erfurt, Erfurt (H.L.), Ernst-Moritz-Arndt-Universitat, Greifswald (S.B.F.), Universitares Herzzentrum Regensburg, Regensburg (L.S.M.), and Institut fur Herzinfarktforschung (S. Schneider, U.Z.) and Klinikum Ludwigshafen (U.Z.), Ludwigshafen - all in Germany; Academic Medical Center, Amsterdam (J.J.P.); University Medical Center Ljubljana, Ljubljana, Slovenia (M.N., T. Goslar); Institute of Cardiology, Warsaw, Poland (J.S.); Golden Jubilee National Hospital, Glasgow, United Kingdom (K.O.); Vilnius University Hospital Santaros Klinikos and Faculty of Medicine, Vilnius University, Vilnius, Lithuania (P.S.); Sorbonne Universite Paris 6, ACTION Study Group, Centre Hospitalier Universitaire Pitie-Salpetriere (G.M., O.B.), and Applied Research, Technology Transfer, Industrial Collaboration, Societe par Actions Simplifiee (P.T.), Paris; Wilhelminenpital, Department of Cardiology, and Sigmund Freud University, Medical School, Vienna (K.H.); the Department of Cardiology, Inselspital Bern, University of Bern, Bern, Switzerland (S.W., L.H.); Manzoni Hospital, Lecco, Italy (S. Savonitto); and Universitair Ziekenhuis Antwerp, Antwerp, Belgium (C.V.). FAU - Fuernau, Georg AU - Fuernau G AUID- ORCID: 0000-0002-3813-8772 AD - From Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig (H.T., M.S., A.J., S.D.), Universitatsmedizin Mannheim, Mannheim (I.A.), University Heart Center Lubeck, Lubeck (S.W.-T., R.M.-S., G.F., I.E.), German Center for Cardiovascular Research (I.A., S.W.-T., R.M.-S., G.F., I.E., U.L., C.S., A.J., S.B.F., S.D.) and Universitatsklinikum Charite, Campus Benjamin Franklin (U.L., C.S.), Berlin, Universitatsklinikum Wurzburg, Wurzburg (P.N.), Klinikum der Eberhard-Karls-Universitat Tubingen, Tubingen (T. Geisler), Klinikum Links der Weser, Bremen (A.F.), Helios Klinik Erfurt, Erfurt (H.L.), Ernst-Moritz-Arndt-Universitat, Greifswald (S.B.F.), Universitares Herzzentrum Regensburg, Regensburg (L.S.M.), and Institut fur Herzinfarktforschung (S. Schneider, U.Z.) and Klinikum Ludwigshafen (U.Z.), Ludwigshafen - all in Germany; Academic Medical Center, Amsterdam (J.J.P.); University Medical Center Ljubljana, Ljubljana, Slovenia (M.N., T. Goslar); Institute of Cardiology, Warsaw, Poland (J.S.); Golden Jubilee National Hospital, Glasgow, United Kingdom (K.O.); Vilnius University Hospital Santaros Klinikos and Faculty of Medicine, Vilnius University, Vilnius, Lithuania (P.S.); Sorbonne Universite Paris 6, ACTION Study Group, Centre Hospitalier Universitaire Pitie-Salpetriere (G.M., O.B.), and Applied Research, Technology Transfer, Industrial Collaboration, Societe par Actions Simplifiee (P.T.), Paris; Wilhelminenpital, Department of Cardiology, and Sigmund Freud University, Medical School, Vienna (K.H.); the Department of Cardiology, Inselspital Bern, University of Bern, Bern, Switzerland (S.W., L.H.); Manzoni Hospital, Lecco, Italy (S. Savonitto); and Universitair Ziekenhuis Antwerp, Antwerp, Belgium (C.V.). FAU - Eitel, Ingo AU - Eitel I AD - From Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig (H.T., M.S., A.J., S.D.), Universitatsmedizin Mannheim, Mannheim (I.A.), University Heart Center Lubeck, Lubeck (S.W.-T., R.M.-S., G.F., I.E.), German Center for Cardiovascular Research (I.A., S.W.-T., R.M.-S., G.F., I.E., U.L., C.S., A.J., S.B.F., S.D.) and Universitatsklinikum Charite, Campus Benjamin Franklin (U.L., C.S.), Berlin, Universitatsklinikum Wurzburg, Wurzburg (P.N.), Klinikum der Eberhard-Karls-Universitat Tubingen, Tubingen (T. Geisler), Klinikum Links der Weser, Bremen (A.F.), Helios Klinik Erfurt, Erfurt (H.L.), Ernst-Moritz-Arndt-Universitat, Greifswald (S.B.F.), Universitares Herzzentrum Regensburg, Regensburg (L.S.M.), and Institut fur Herzinfarktforschung (S. Schneider, U.Z.) and Klinikum Ludwigshafen (U.Z.), Ludwigshafen - all in Germany; Academic Medical Center, Amsterdam (J.J.P.); University Medical Center Ljubljana, Ljubljana, Slovenia (M.N., T. Goslar); Institute of Cardiology, Warsaw, Poland (J.S.); Golden Jubilee National Hospital, Glasgow, United Kingdom (K.O.); Vilnius University Hospital Santaros Klinikos and Faculty of Medicine, Vilnius University, Vilnius, Lithuania (P.S.); Sorbonne Universite Paris 6, ACTION Study Group, Centre Hospitalier Universitaire Pitie-Salpetriere (G.M., O.B.), and Applied Research, Technology Transfer, Industrial Collaboration, Societe par Actions Simplifiee (P.T.), Paris; Wilhelminenpital, Department of Cardiology, and Sigmund Freud University, Medical School, Vienna (K.H.); the Department of Cardiology, Inselspital Bern, University of Bern, Bern, Switzerland (S.W., L.H.); Manzoni Hospital, Lecco, Italy (S. Savonitto); and Universitair Ziekenhuis Antwerp, Antwerp, Belgium (C.V.). FAU - Nordbeck, Peter AU - Nordbeck P AD - From Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig (H.T., M.S., A.J., S.D.), Universitatsmedizin Mannheim, Mannheim (I.A.), University Heart Center Lubeck, Lubeck (S.W.-T., R.M.-S., G.F., I.E.), German Center for Cardiovascular Research (I.A., S.W.-T., R.M.-S., G.F., I.E., U.L., C.S., A.J., S.B.F., S.D.) and Universitatsklinikum Charite, Campus Benjamin Franklin (U.L., C.S.), Berlin, Universitatsklinikum Wurzburg, Wurzburg (P.N.), Klinikum der Eberhard-Karls-Universitat Tubingen, Tubingen (T. Geisler), Klinikum Links der Weser, Bremen (A.F.), Helios Klinik Erfurt, Erfurt (H.L.), Ernst-Moritz-Arndt-Universitat, Greifswald (S.B.F.), Universitares Herzzentrum Regensburg, Regensburg (L.S.M.), and Institut fur Herzinfarktforschung (S. Schneider, U.Z.) and Klinikum Ludwigshafen (U.Z.), Ludwigshafen - all in Germany; Academic Medical Center, Amsterdam (J.J.P.); University Medical Center Ljubljana, Ljubljana, Slovenia (M.N., T. Goslar); Institute of Cardiology, Warsaw, Poland (J.S.); Golden Jubilee National Hospital, Glasgow, United Kingdom (K.O.); Vilnius University Hospital Santaros Klinikos and Faculty of Medicine, Vilnius University, Vilnius, Lithuania (P.S.); Sorbonne Universite Paris 6, ACTION Study Group, Centre Hospitalier Universitaire Pitie-Salpetriere (G.M., O.B.), and Applied Research, Technology Transfer, Industrial Collaboration, Societe par Actions Simplifiee (P.T.), Paris; Wilhelminenpital, Department of Cardiology, and Sigmund Freud University, Medical School, Vienna (K.H.); the Department of Cardiology, Inselspital Bern, University of Bern, Bern, Switzerland (S.W., L.H.); Manzoni Hospital, Lecco, Italy (S. Savonitto); and Universitair Ziekenhuis Antwerp, Antwerp, Belgium (C.V.). FAU - Geisler, Tobias AU - Geisler T AD - From Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig (H.T., M.S., A.J., S.D.), Universitatsmedizin Mannheim, Mannheim (I.A.), University Heart Center Lubeck, Lubeck (S.W.-T., R.M.-S., G.F., I.E.), German Center for Cardiovascular Research (I.A., S.W.-T., R.M.-S., G.F., I.E., U.L., C.S., A.J., S.B.F., S.D.) and Universitatsklinikum Charite, Campus Benjamin Franklin (U.L., C.S.), Berlin, Universitatsklinikum Wurzburg, Wurzburg (P.N.), Klinikum der Eberhard-Karls-Universitat Tubingen, Tubingen (T. Geisler), Klinikum Links der Weser, Bremen (A.F.), Helios Klinik Erfurt, Erfurt (H.L.), Ernst-Moritz-Arndt-Universitat, Greifswald (S.B.F.), Universitares Herzzentrum Regensburg, Regensburg (L.S.M.), and Institut fur Herzinfarktforschung (S. Schneider, U.Z.) and Klinikum Ludwigshafen (U.Z.), Ludwigshafen - all in Germany; Academic Medical Center, Amsterdam (J.J.P.); University Medical Center Ljubljana, Ljubljana, Slovenia (M.N., T. Goslar); Institute of Cardiology, Warsaw, Poland (J.S.); Golden Jubilee National Hospital, Glasgow, United Kingdom (K.O.); Vilnius University Hospital Santaros Klinikos and Faculty of Medicine, Vilnius University, Vilnius, Lithuania (P.S.); Sorbonne Universite Paris 6, ACTION Study Group, Centre Hospitalier Universitaire Pitie-Salpetriere (G.M., O.B.), and Applied Research, Technology Transfer, Industrial Collaboration, Societe par Actions Simplifiee (P.T.), Paris; Wilhelminenpital, Department of Cardiology, and Sigmund Freud University, Medical School, Vienna (K.H.); the Department of Cardiology, Inselspital Bern, University of Bern, Bern, Switzerland (S.W., L.H.); Manzoni Hospital, Lecco, Italy (S. Savonitto); and Universitair Ziekenhuis Antwerp, Antwerp, Belgium (C.V.). FAU - Landmesser, Ulf AU - Landmesser U AD - From Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig (H.T., M.S., A.J., S.D.), Universitatsmedizin Mannheim, Mannheim (I.A.), University Heart Center Lubeck, Lubeck (S.W.-T., R.M.-S., G.F., I.E.), German Center for Cardiovascular Research (I.A., S.W.-T., R.M.-S., G.F., I.E., U.L., C.S., A.J., S.B.F., S.D.) and Universitatsklinikum Charite, Campus Benjamin Franklin (U.L., C.S.), Berlin, Universitatsklinikum Wurzburg, Wurzburg (P.N.), Klinikum der Eberhard-Karls-Universitat Tubingen, Tubingen (T. Geisler), Klinikum Links der Weser, Bremen (A.F.), Helios Klinik Erfurt, Erfurt (H.L.), Ernst-Moritz-Arndt-Universitat, Greifswald (S.B.F.), Universitares Herzzentrum Regensburg, Regensburg (L.S.M.), and Institut fur Herzinfarktforschung (S. Schneider, U.Z.) and Klinikum Ludwigshafen (U.Z.), Ludwigshafen - all in Germany; Academic Medical Center, Amsterdam (J.J.P.); University Medical Center Ljubljana, Ljubljana, Slovenia (M.N., T. Goslar); Institute of Cardiology, Warsaw, Poland (J.S.); Golden Jubilee National Hospital, Glasgow, United Kingdom (K.O.); Vilnius University Hospital Santaros Klinikos and Faculty of Medicine, Vilnius University, Vilnius, Lithuania (P.S.); Sorbonne Universite Paris 6, ACTION Study Group, Centre Hospitalier Universitaire Pitie-Salpetriere (G.M., O.B.), and Applied Research, Technology Transfer, Industrial Collaboration, Societe par Actions Simplifiee (P.T.), Paris; Wilhelminenpital, Department of Cardiology, and Sigmund Freud University, Medical School, Vienna (K.H.); the Department of Cardiology, Inselspital Bern, University of Bern, Bern, Switzerland (S.W., L.H.); Manzoni Hospital, Lecco, Italy (S. Savonitto); and Universitair Ziekenhuis Antwerp, Antwerp, Belgium (C.V.). FAU - Skurk, Carsten AU - Skurk C AD - From Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig (H.T., M.S., A.J., S.D.), Universitatsmedizin Mannheim, Mannheim (I.A.), University Heart Center Lubeck, Lubeck (S.W.-T., R.M.-S., G.F., I.E.), German Center for Cardiovascular Research (I.A., S.W.-T., R.M.-S., G.F., I.E., U.L., C.S., A.J., S.B.F., S.D.) and Universitatsklinikum Charite, Campus Benjamin Franklin (U.L., C.S.), Berlin, Universitatsklinikum Wurzburg, Wurzburg (P.N.), Klinikum der Eberhard-Karls-Universitat Tubingen, Tubingen (T. Geisler), Klinikum Links der Weser, Bremen (A.F.), Helios Klinik Erfurt, Erfurt (H.L.), Ernst-Moritz-Arndt-Universitat, Greifswald (S.B.F.), Universitares Herzzentrum Regensburg, Regensburg (L.S.M.), and Institut fur Herzinfarktforschung (S. Schneider, U.Z.) and Klinikum Ludwigshafen (U.Z.), Ludwigshafen - all in Germany; Academic Medical Center, Amsterdam (J.J.P.); University Medical Center Ljubljana, Ljubljana, Slovenia (M.N., T. Goslar); Institute of Cardiology, Warsaw, Poland (J.S.); Golden Jubilee National Hospital, Glasgow, United Kingdom (K.O.); Vilnius University Hospital Santaros Klinikos and Faculty of Medicine, Vilnius University, Vilnius, Lithuania (P.S.); Sorbonne Universite Paris 6, ACTION Study Group, Centre Hospitalier Universitaire Pitie-Salpetriere (G.M., O.B.), and Applied Research, Technology Transfer, Industrial Collaboration, Societe par Actions Simplifiee (P.T.), Paris; Wilhelminenpital, Department of Cardiology, and Sigmund Freud University, Medical School, Vienna (K.H.); the Department of Cardiology, Inselspital Bern, University of Bern, Bern, Switzerland (S.W., L.H.); Manzoni Hospital, Lecco, Italy (S. Savonitto); and Universitair Ziekenhuis Antwerp, Antwerp, Belgium (C.V.). FAU - Fach, Andreas AU - Fach A AD - From Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig (H.T., M.S., A.J., S.D.), Universitatsmedizin Mannheim, Mannheim (I.A.), University Heart Center Lubeck, Lubeck (S.W.-T., R.M.-S., G.F., I.E.), German Center for Cardiovascular Research (I.A., S.W.-T., R.M.-S., G.F., I.E., U.L., C.S., A.J., S.B.F., S.D.) and Universitatsklinikum Charite, Campus Benjamin Franklin (U.L., C.S.), Berlin, Universitatsklinikum Wurzburg, Wurzburg (P.N.), Klinikum der Eberhard-Karls-Universitat Tubingen, Tubingen (T. Geisler), Klinikum Links der Weser, Bremen (A.F.), Helios Klinik Erfurt, Erfurt (H.L.), Ernst-Moritz-Arndt-Universitat, Greifswald (S.B.F.), Universitares Herzzentrum Regensburg, Regensburg (L.S.M.), and Institut fur Herzinfarktforschung (S. Schneider, U.Z.) and Klinikum Ludwigshafen (U.Z.), Ludwigshafen - all in Germany; Academic Medical Center, Amsterdam (J.J.P.); University Medical Center Ljubljana, Ljubljana, Slovenia (M.N., T. Goslar); Institute of Cardiology, Warsaw, Poland (J.S.); Golden Jubilee National Hospital, Glasgow, United Kingdom (K.O.); Vilnius University Hospital Santaros Klinikos and Faculty of Medicine, Vilnius University, Vilnius, Lithuania (P.S.); Sorbonne Universite Paris 6, ACTION Study Group, Centre Hospitalier Universitaire Pitie-Salpetriere (G.M., O.B.), and Applied Research, Technology Transfer, Industrial Collaboration, Societe par Actions Simplifiee (P.T.), Paris; Wilhelminenpital, Department of Cardiology, and Sigmund Freud University, Medical School, Vienna (K.H.); the Department of Cardiology, Inselspital Bern, University of Bern, Bern, Switzerland (S.W., L.H.); Manzoni Hospital, Lecco, Italy (S. Savonitto); and Universitair Ziekenhuis Antwerp, Antwerp, Belgium (C.V.). FAU - Jobs, Alexander AU - Jobs A AD - From Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig (H.T., M.S., A.J., S.D.), Universitatsmedizin Mannheim, Mannheim (I.A.), University Heart Center Lubeck, Lubeck (S.W.-T., R.M.-S., G.F., I.E.), German Center for Cardiovascular Research (I.A., S.W.-T., R.M.-S., G.F., I.E., U.L., C.S., A.J., S.B.F., S.D.) and Universitatsklinikum Charite, Campus Benjamin Franklin (U.L., C.S.), Berlin, Universitatsklinikum Wurzburg, Wurzburg (P.N.), Klinikum der Eberhard-Karls-Universitat Tubingen, Tubingen (T. Geisler), Klinikum Links der Weser, Bremen (A.F.), Helios Klinik Erfurt, Erfurt (H.L.), Ernst-Moritz-Arndt-Universitat, Greifswald (S.B.F.), Universitares Herzzentrum Regensburg, Regensburg (L.S.M.), and Institut fur Herzinfarktforschung (S. Schneider, U.Z.) and Klinikum Ludwigshafen (U.Z.), Ludwigshafen - all in Germany; Academic Medical Center, Amsterdam (J.J.P.); University Medical Center Ljubljana, Ljubljana, Slovenia (M.N., T. Goslar); Institute of Cardiology, Warsaw, Poland (J.S.); Golden Jubilee National Hospital, Glasgow, United Kingdom (K.O.); Vilnius University Hospital Santaros Klinikos and Faculty of Medicine, Vilnius University, Vilnius, Lithuania (P.S.); Sorbonne Universite Paris 6, ACTION Study Group, Centre Hospitalier Universitaire Pitie-Salpetriere (G.M., O.B.), and Applied Research, Technology Transfer, Industrial Collaboration, Societe par Actions Simplifiee (P.T.), Paris; Wilhelminenpital, Department of Cardiology, and Sigmund Freud University, Medical School, Vienna (K.H.); the Department of Cardiology, Inselspital Bern, University of Bern, Bern, Switzerland (S.W., L.H.); Manzoni Hospital, Lecco, Italy (S. Savonitto); and Universitair Ziekenhuis Antwerp, Antwerp, Belgium (C.V.). FAU - Lapp, Harald AU - Lapp H AD - From Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig (H.T., M.S., A.J., S.D.), Universitatsmedizin Mannheim, Mannheim (I.A.), University Heart Center Lubeck, Lubeck (S.W.-T., R.M.-S., G.F., I.E.), German Center for Cardiovascular Research (I.A., S.W.-T., R.M.-S., G.F., I.E., U.L., C.S., A.J., S.B.F., S.D.) and Universitatsklinikum Charite, Campus Benjamin Franklin (U.L., C.S.), Berlin, Universitatsklinikum Wurzburg, Wurzburg (P.N.), Klinikum der Eberhard-Karls-Universitat Tubingen, Tubingen (T. Geisler), Klinikum Links der Weser, Bremen (A.F.), Helios Klinik Erfurt, Erfurt (H.L.), Ernst-Moritz-Arndt-Universitat, Greifswald (S.B.F.), Universitares Herzzentrum Regensburg, Regensburg (L.S.M.), and Institut fur Herzinfarktforschung (S. Schneider, U.Z.) and Klinikum Ludwigshafen (U.Z.), Ludwigshafen - all in Germany; Academic Medical Center, Amsterdam (J.J.P.); University Medical Center Ljubljana, Ljubljana, Slovenia (M.N., T. Goslar); Institute of Cardiology, Warsaw, Poland (J.S.); Golden Jubilee National Hospital, Glasgow, United Kingdom (K.O.); Vilnius University Hospital Santaros Klinikos and Faculty of Medicine, Vilnius University, Vilnius, Lithuania (P.S.); Sorbonne Universite Paris 6, ACTION Study Group, Centre Hospitalier Universitaire Pitie-Salpetriere (G.M., O.B.), and Applied Research, Technology Transfer, Industrial Collaboration, Societe par Actions Simplifiee (P.T.), Paris; Wilhelminenpital, Department of Cardiology, and Sigmund Freud University, Medical School, Vienna (K.H.); the Department of Cardiology, Inselspital Bern, University of Bern, Bern, Switzerland (S.W., L.H.); Manzoni Hospital, Lecco, Italy (S. Savonitto); and Universitair Ziekenhuis Antwerp, Antwerp, Belgium (C.V.). FAU - Piek, Jan J AU - Piek JJ AD - From Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig (H.T., M.S., A.J., S.D.), Universitatsmedizin Mannheim, Mannheim (I.A.), University Heart Center Lubeck, Lubeck (S.W.-T., R.M.-S., G.F., I.E.), German Center for Cardiovascular Research (I.A., S.W.-T., R.M.-S., G.F., I.E., U.L., C.S., A.J., S.B.F., S.D.) and Universitatsklinikum Charite, Campus Benjamin Franklin (U.L., C.S.), Berlin, Universitatsklinikum Wurzburg, Wurzburg (P.N.), Klinikum der Eberhard-Karls-Universitat Tubingen, Tubingen (T. Geisler), Klinikum Links der Weser, Bremen (A.F.), Helios Klinik Erfurt, Erfurt (H.L.), Ernst-Moritz-Arndt-Universitat, Greifswald (S.B.F.), Universitares Herzzentrum Regensburg, Regensburg (L.S.M.), and Institut fur Herzinfarktforschung (S. Schneider, U.Z.) and Klinikum Ludwigshafen (U.Z.), Ludwigshafen - all in Germany; Academic Medical Center, Amsterdam (J.J.P.); University Medical Center Ljubljana, Ljubljana, Slovenia (M.N., T. Goslar); Institute of Cardiology, Warsaw, Poland (J.S.); Golden Jubilee National Hospital, Glasgow, United Kingdom (K.O.); Vilnius University Hospital Santaros Klinikos and Faculty of Medicine, Vilnius University, Vilnius, Lithuania (P.S.); Sorbonne Universite Paris 6, ACTION Study Group, Centre Hospitalier Universitaire Pitie-Salpetriere (G.M., O.B.), and Applied Research, Technology Transfer, Industrial Collaboration, Societe par Actions Simplifiee (P.T.), Paris; Wilhelminenpital, Department of Cardiology, and Sigmund Freud University, Medical School, Vienna (K.H.); the Department of Cardiology, Inselspital Bern, University of Bern, Bern, Switzerland (S.W., L.H.); Manzoni Hospital, Lecco, Italy (S. Savonitto); and Universitair Ziekenhuis Antwerp, Antwerp, Belgium (C.V.). FAU - Noc, Marko AU - Noc M AD - From Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig (H.T., M.S., A.J., S.D.), Universitatsmedizin Mannheim, Mannheim (I.A.), University Heart Center Lubeck, Lubeck (S.W.-T., R.M.-S., G.F., I.E.), German Center for Cardiovascular Research (I.A., S.W.-T., R.M.-S., G.F., I.E., U.L., C.S., A.J., S.B.F., S.D.) and Universitatsklinikum Charite, Campus Benjamin Franklin (U.L., C.S.), Berlin, Universitatsklinikum Wurzburg, Wurzburg (P.N.), Klinikum der Eberhard-Karls-Universitat Tubingen, Tubingen (T. Geisler), Klinikum Links der Weser, Bremen (A.F.), Helios Klinik Erfurt, Erfurt (H.L.), Ernst-Moritz-Arndt-Universitat, Greifswald (S.B.F.), Universitares Herzzentrum Regensburg, Regensburg (L.S.M.), and Institut fur Herzinfarktforschung (S. Schneider, U.Z.) and Klinikum Ludwigshafen (U.Z.), Ludwigshafen - all in Germany; Academic Medical Center, Amsterdam (J.J.P.); University Medical Center Ljubljana, Ljubljana, Slovenia (M.N., T. Goslar); Institute of Cardiology, Warsaw, Poland (J.S.); Golden Jubilee National Hospital, Glasgow, United Kingdom (K.O.); Vilnius University Hospital Santaros Klinikos and Faculty of Medicine, Vilnius University, Vilnius, Lithuania (P.S.); Sorbonne Universite Paris 6, ACTION Study Group, Centre Hospitalier Universitaire Pitie-Salpetriere (G.M., O.B.), and Applied Research, Technology Transfer, Industrial Collaboration, Societe par Actions Simplifiee (P.T.), Paris; Wilhelminenpital, Department of Cardiology, and Sigmund Freud University, Medical School, Vienna (K.H.); the Department of Cardiology, Inselspital Bern, University of Bern, Bern, Switzerland (S.W., L.H.); Manzoni Hospital, Lecco, Italy (S. Savonitto); and Universitair Ziekenhuis Antwerp, Antwerp, Belgium (C.V.). FAU - Goslar, Tomaz AU - Goslar T AD - From Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig (H.T., M.S., A.J., S.D.), Universitatsmedizin Mannheim, Mannheim (I.A.), University Heart Center Lubeck, Lubeck (S.W.-T., R.M.-S., G.F., I.E.), German Center for Cardiovascular Research (I.A., S.W.-T., R.M.-S., G.F., I.E., U.L., C.S., A.J., S.B.F., S.D.) and Universitatsklinikum Charite, Campus Benjamin Franklin (U.L., C.S.), Berlin, Universitatsklinikum Wurzburg, Wurzburg (P.N.), Klinikum der Eberhard-Karls-Universitat Tubingen, Tubingen (T. Geisler), Klinikum Links der Weser, Bremen (A.F.), Helios Klinik Erfurt, Erfurt (H.L.), Ernst-Moritz-Arndt-Universitat, Greifswald (S.B.F.), Universitares Herzzentrum Regensburg, Regensburg (L.S.M.), and Institut fur Herzinfarktforschung (S. Schneider, U.Z.) and Klinikum Ludwigshafen (U.Z.), Ludwigshafen - all in Germany; Academic Medical Center, Amsterdam (J.J.P.); University Medical Center Ljubljana, Ljubljana, Slovenia (M.N., T. Goslar); Institute of Cardiology, Warsaw, Poland (J.S.); Golden Jubilee National Hospital, Glasgow, United Kingdom (K.O.); Vilnius University Hospital Santaros Klinikos and Faculty of Medicine, Vilnius University, Vilnius, Lithuania (P.S.); Sorbonne Universite Paris 6, ACTION Study Group, Centre Hospitalier Universitaire Pitie-Salpetriere (G.M., O.B.), and Applied Research, Technology Transfer, Industrial Collaboration, Societe par Actions Simplifiee (P.T.), Paris; Wilhelminenpital, Department of Cardiology, and Sigmund Freud University, Medical School, Vienna (K.H.); the Department of Cardiology, Inselspital Bern, University of Bern, Bern, Switzerland (S.W., L.H.); Manzoni Hospital, Lecco, Italy (S. Savonitto); and Universitair Ziekenhuis Antwerp, Antwerp, Belgium (C.V.). FAU - Felix, Stephan B AU - Felix SB AD - From Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig (H.T., M.S., A.J., S.D.), Universitatsmedizin Mannheim, Mannheim (I.A.), University Heart Center Lubeck, Lubeck (S.W.-T., R.M.-S., G.F., I.E.), German Center for Cardiovascular Research (I.A., S.W.-T., R.M.-S., G.F., I.E., U.L., C.S., A.J., S.B.F., S.D.) and Universitatsklinikum Charite, Campus Benjamin Franklin (U.L., C.S.), Berlin, Universitatsklinikum Wurzburg, Wurzburg (P.N.), Klinikum der Eberhard-Karls-Universitat Tubingen, Tubingen (T. Geisler), Klinikum Links der Weser, Bremen (A.F.), Helios Klinik Erfurt, Erfurt (H.L.), Ernst-Moritz-Arndt-Universitat, Greifswald (S.B.F.), Universitares Herzzentrum Regensburg, Regensburg (L.S.M.), and Institut fur Herzinfarktforschung (S. Schneider, U.Z.) and Klinikum Ludwigshafen (U.Z.), Ludwigshafen - all in Germany; Academic Medical Center, Amsterdam (J.J.P.); University Medical Center Ljubljana, Ljubljana, Slovenia (M.N., T. Goslar); Institute of Cardiology, Warsaw, Poland (J.S.); Golden Jubilee National Hospital, Glasgow, United Kingdom (K.O.); Vilnius University Hospital Santaros Klinikos and Faculty of Medicine, Vilnius University, Vilnius, Lithuania (P.S.); Sorbonne Universite Paris 6, ACTION Study Group, Centre Hospitalier Universitaire Pitie-Salpetriere (G.M., O.B.), and Applied Research, Technology Transfer, Industrial Collaboration, Societe par Actions Simplifiee (P.T.), Paris; Wilhelminenpital, Department of Cardiology, and Sigmund Freud University, Medical School, Vienna (K.H.); the Department of Cardiology, Inselspital Bern, University of Bern, Bern, Switzerland (S.W., L.H.); Manzoni Hospital, Lecco, Italy (S. Savonitto); and Universitair Ziekenhuis Antwerp, Antwerp, Belgium (C.V.). FAU - Maier, Lars S AU - Maier LS AD - From Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig (H.T., M.S., A.J., S.D.), Universitatsmedizin Mannheim, Mannheim (I.A.), University Heart Center Lubeck, Lubeck (S.W.-T., R.M.-S., G.F., I.E.), German Center for Cardiovascular Research (I.A., S.W.-T., R.M.-S., G.F., I.E., U.L., C.S., A.J., S.B.F., S.D.) and Universitatsklinikum Charite, Campus Benjamin Franklin (U.L., C.S.), Berlin, Universitatsklinikum Wurzburg, Wurzburg (P.N.), Klinikum der Eberhard-Karls-Universitat Tubingen, Tubingen (T. Geisler), Klinikum Links der Weser, Bremen (A.F.), Helios Klinik Erfurt, Erfurt (H.L.), Ernst-Moritz-Arndt-Universitat, Greifswald (S.B.F.), Universitares Herzzentrum Regensburg, Regensburg (L.S.M.), and Institut fur Herzinfarktforschung (S. Schneider, U.Z.) and Klinikum Ludwigshafen (U.Z.), Ludwigshafen - all in Germany; Academic Medical Center, Amsterdam (J.J.P.); University Medical Center Ljubljana, Ljubljana, Slovenia (M.N., T. Goslar); Institute of Cardiology, Warsaw, Poland (J.S.); Golden Jubilee National Hospital, Glasgow, United Kingdom (K.O.); Vilnius University Hospital Santaros Klinikos and Faculty of Medicine, Vilnius University, Vilnius, Lithuania (P.S.); Sorbonne Universite Paris 6, ACTION Study Group, Centre Hospitalier Universitaire Pitie-Salpetriere (G.M., O.B.), and Applied Research, Technology Transfer, Industrial Collaboration, Societe par Actions Simplifiee (P.T.), Paris; Wilhelminenpital, Department of Cardiology, and Sigmund Freud University, Medical School, Vienna (K.H.); the Department of Cardiology, Inselspital Bern, University of Bern, Bern, Switzerland (S.W., L.H.); Manzoni Hospital, Lecco, Italy (S. Savonitto); and Universitair Ziekenhuis Antwerp, Antwerp, Belgium (C.V.). FAU - Stepinska, Janina AU - Stepinska J AD - From Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig (H.T., M.S., A.J., S.D.), Universitatsmedizin Mannheim, Mannheim (I.A.), University Heart Center Lubeck, Lubeck (S.W.-T., R.M.-S., G.F., I.E.), German Center for Cardiovascular Research (I.A., S.W.-T., R.M.-S., G.F., I.E., U.L., C.S., A.J., S.B.F., S.D.) and Universitatsklinikum Charite, Campus Benjamin Franklin (U.L., C.S.), Berlin, Universitatsklinikum Wurzburg, Wurzburg (P.N.), Klinikum der Eberhard-Karls-Universitat Tubingen, Tubingen (T. Geisler), Klinikum Links der Weser, Bremen (A.F.), Helios Klinik Erfurt, Erfurt (H.L.), Ernst-Moritz-Arndt-Universitat, Greifswald (S.B.F.), Universitares Herzzentrum Regensburg, Regensburg (L.S.M.), and Institut fur Herzinfarktforschung (S. Schneider, U.Z.) and Klinikum Ludwigshafen (U.Z.), Ludwigshafen - all in Germany; Academic Medical Center, Amsterdam (J.J.P.); University Medical Center Ljubljana, Ljubljana, Slovenia (M.N., T. Goslar); Institute of Cardiology, Warsaw, Poland (J.S.); Golden Jubilee National Hospital, Glasgow, United Kingdom (K.O.); Vilnius University Hospital Santaros Klinikos and Faculty of Medicine, Vilnius University, Vilnius, Lithuania (P.S.); Sorbonne Universite Paris 6, ACTION Study Group, Centre Hospitalier Universitaire Pitie-Salpetriere (G.M., O.B.), and Applied Research, Technology Transfer, Industrial Collaboration, Societe par Actions Simplifiee (P.T.), Paris; Wilhelminenpital, Department of Cardiology, and Sigmund Freud University, Medical School, Vienna (K.H.); the Department of Cardiology, Inselspital Bern, University of Bern, Bern, Switzerland (S.W., L.H.); Manzoni Hospital, Lecco, Italy (S. Savonitto); and Universitair Ziekenhuis Antwerp, Antwerp, Belgium (C.V.). FAU - Oldroyd, Keith AU - Oldroyd K AD - From Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig (H.T., M.S., A.J., S.D.), Universitatsmedizin Mannheim, Mannheim (I.A.), University Heart Center Lubeck, Lubeck (S.W.-T., R.M.-S., G.F., I.E.), German Center for Cardiovascular Research (I.A., S.W.-T., R.M.-S., G.F., I.E., U.L., C.S., A.J., S.B.F., S.D.) and Universitatsklinikum Charite, Campus Benjamin Franklin (U.L., C.S.), Berlin, Universitatsklinikum Wurzburg, Wurzburg (P.N.), Klinikum der Eberhard-Karls-Universitat Tubingen, Tubingen (T. Geisler), Klinikum Links der Weser, Bremen (A.F.), Helios Klinik Erfurt, Erfurt (H.L.), Ernst-Moritz-Arndt-Universitat, Greifswald (S.B.F.), Universitares Herzzentrum Regensburg, Regensburg (L.S.M.), and Institut fur Herzinfarktforschung (S. Schneider, U.Z.) and Klinikum Ludwigshafen (U.Z.), Ludwigshafen - all in Germany; Academic Medical Center, Amsterdam (J.J.P.); University Medical Center Ljubljana, Ljubljana, Slovenia (M.N., T. Goslar); Institute of Cardiology, Warsaw, Poland (J.S.); Golden Jubilee National Hospital, Glasgow, United Kingdom (K.O.); Vilnius University Hospital Santaros Klinikos and Faculty of Medicine, Vilnius University, Vilnius, Lithuania (P.S.); Sorbonne Universite Paris 6, ACTION Study Group, Centre Hospitalier Universitaire Pitie-Salpetriere (G.M., O.B.), and Applied Research, Technology Transfer, Industrial Collaboration, Societe par Actions Simplifiee (P.T.), Paris; Wilhelminenpital, Department of Cardiology, and Sigmund Freud University, Medical School, Vienna (K.H.); the Department of Cardiology, Inselspital Bern, University of Bern, Bern, Switzerland (S.W., L.H.); Manzoni Hospital, Lecco, Italy (S. Savonitto); and Universitair Ziekenhuis Antwerp, Antwerp, Belgium (C.V.). FAU - Serpytis, Pranas AU - Serpytis P AD - From Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig (H.T., M.S., A.J., S.D.), Universitatsmedizin Mannheim, Mannheim (I.A.), University Heart Center Lubeck, Lubeck (S.W.-T., R.M.-S., G.F., I.E.), German Center for Cardiovascular Research (I.A., S.W.-T., R.M.-S., G.F., I.E., U.L., C.S., A.J., S.B.F., S.D.) and Universitatsklinikum Charite, Campus Benjamin Franklin (U.L., C.S.), Berlin, Universitatsklinikum Wurzburg, Wurzburg (P.N.), Klinikum der Eberhard-Karls-Universitat Tubingen, Tubingen (T. Geisler), Klinikum Links der Weser, Bremen (A.F.), Helios Klinik Erfurt, Erfurt (H.L.), Ernst-Moritz-Arndt-Universitat, Greifswald (S.B.F.), Universitares Herzzentrum Regensburg, Regensburg (L.S.M.), and Institut fur Herzinfarktforschung (S. Schneider, U.Z.) and Klinikum Ludwigshafen (U.Z.), Ludwigshafen - all in Germany; Academic Medical Center, Amsterdam (J.J.P.); University Medical Center Ljubljana, Ljubljana, Slovenia (M.N., T. Goslar); Institute of Cardiology, Warsaw, Poland (J.S.); Golden Jubilee National Hospital, Glasgow, United Kingdom (K.O.); Vilnius University Hospital Santaros Klinikos and Faculty of Medicine, Vilnius University, Vilnius, Lithuania (P.S.); Sorbonne Universite Paris 6, ACTION Study Group, Centre Hospitalier Universitaire Pitie-Salpetriere (G.M., O.B.), and Applied Research, Technology Transfer, Industrial Collaboration, Societe par Actions Simplifiee (P.T.), Paris; Wilhelminenpital, Department of Cardiology, and Sigmund Freud University, Medical School, Vienna (K.H.); the Department of Cardiology, Inselspital Bern, University of Bern, Bern, Switzerland (S.W., L.H.); Manzoni Hospital, Lecco, Italy (S. Savonitto); and Universitair Ziekenhuis Antwerp, Antwerp, Belgium (C.V.). FAU - Montalescot, Gilles AU - Montalescot G AD - From Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig (H.T., M.S., A.J., S.D.), Universitatsmedizin Mannheim, Mannheim (I.A.), University Heart Center Lubeck, Lubeck (S.W.-T., R.M.-S., G.F., I.E.), German Center for Cardiovascular Research (I.A., S.W.-T., R.M.-S., G.F., I.E., U.L., C.S., A.J., S.B.F., S.D.) and Universitatsklinikum Charite, Campus Benjamin Franklin (U.L., C.S.), Berlin, Universitatsklinikum Wurzburg, Wurzburg (P.N.), Klinikum der Eberhard-Karls-Universitat Tubingen, Tubingen (T. Geisler), Klinikum Links der Weser, Bremen (A.F.), Helios Klinik Erfurt, Erfurt (H.L.), Ernst-Moritz-Arndt-Universitat, Greifswald (S.B.F.), Universitares Herzzentrum Regensburg, Regensburg (L.S.M.), and Institut fur Herzinfarktforschung (S. Schneider, U.Z.) and Klinikum Ludwigshafen (U.Z.), Ludwigshafen - all in Germany; Academic Medical Center, Amsterdam (J.J.P.); University Medical Center Ljubljana, Ljubljana, Slovenia (M.N., T. Goslar); Institute of Cardiology, Warsaw, Poland (J.S.); Golden Jubilee National Hospital, Glasgow, United Kingdom (K.O.); Vilnius University Hospital Santaros Klinikos and Faculty of Medicine, Vilnius University, Vilnius, Lithuania (P.S.); Sorbonne Universite Paris 6, ACTION Study Group, Centre Hospitalier Universitaire Pitie-Salpetriere (G.M., O.B.), and Applied Research, Technology Transfer, Industrial Collaboration, Societe par Actions Simplifiee (P.T.), Paris; Wilhelminenpital, Department of Cardiology, and Sigmund Freud University, Medical School, Vienna (K.H.); the Department of Cardiology, Inselspital Bern, University of Bern, Bern, Switzerland (S.W., L.H.); Manzoni Hospital, Lecco, Italy (S. Savonitto); and Universitair Ziekenhuis Antwerp, Antwerp, Belgium (C.V.). FAU - Barthelemy, Olivier AU - Barthelemy O AD - From Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig (H.T., M.S., A.J., S.D.), Universitatsmedizin Mannheim, Mannheim (I.A.), University Heart Center Lubeck, Lubeck (S.W.-T., R.M.-S., G.F., I.E.), German Center for Cardiovascular Research (I.A., S.W.-T., R.M.-S., G.F., I.E., U.L., C.S., A.J., S.B.F., S.D.) and Universitatsklinikum Charite, Campus Benjamin Franklin (U.L., C.S.), Berlin, Universitatsklinikum Wurzburg, Wurzburg (P.N.), Klinikum der Eberhard-Karls-Universitat Tubingen, Tubingen (T. Geisler), Klinikum Links der Weser, Bremen (A.F.), Helios Klinik Erfurt, Erfurt (H.L.), Ernst-Moritz-Arndt-Universitat, Greifswald (S.B.F.), Universitares Herzzentrum Regensburg, Regensburg (L.S.M.), and Institut fur Herzinfarktforschung (S. Schneider, U.Z.) and Klinikum Ludwigshafen (U.Z.), Ludwigshafen - all in Germany; Academic Medical Center, Amsterdam (J.J.P.); University Medical Center Ljubljana, Ljubljana, Slovenia (M.N., T. Goslar); Institute of Cardiology, Warsaw, Poland (J.S.); Golden Jubilee National Hospital, Glasgow, United Kingdom (K.O.); Vilnius University Hospital Santaros Klinikos and Faculty of Medicine, Vilnius University, Vilnius, Lithuania (P.S.); Sorbonne Universite Paris 6, ACTION Study Group, Centre Hospitalier Universitaire Pitie-Salpetriere (G.M., O.B.), and Applied Research, Technology Transfer, Industrial Collaboration, Societe par Actions Simplifiee (P.T.), Paris; Wilhelminenpital, Department of Cardiology, and Sigmund Freud University, Medical School, Vienna (K.H.); the Department of Cardiology, Inselspital Bern, University of Bern, Bern, Switzerland (S.W., L.H.); Manzoni Hospital, Lecco, Italy (S. Savonitto); and Universitair Ziekenhuis Antwerp, Antwerp, Belgium (C.V.). FAU - Huber, Kurt AU - Huber K AD - From Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig (H.T., M.S., A.J., S.D.), Universitatsmedizin Mannheim, Mannheim (I.A.), University Heart Center Lubeck, Lubeck (S.W.-T., R.M.-S., G.F., I.E.), German Center for Cardiovascular Research (I.A., S.W.-T., R.M.-S., G.F., I.E., U.L., C.S., A.J., S.B.F., S.D.) and Universitatsklinikum Charite, Campus Benjamin Franklin (U.L., C.S.), Berlin, Universitatsklinikum Wurzburg, Wurzburg (P.N.), Klinikum der Eberhard-Karls-Universitat Tubingen, Tubingen (T. Geisler), Klinikum Links der Weser, Bremen (A.F.), Helios Klinik Erfurt, Erfurt (H.L.), Ernst-Moritz-Arndt-Universitat, Greifswald (S.B.F.), Universitares Herzzentrum Regensburg, Regensburg (L.S.M.), and Institut fur Herzinfarktforschung (S. Schneider, U.Z.) and Klinikum Ludwigshafen (U.Z.), Ludwigshafen - all in Germany; Academic Medical Center, Amsterdam (J.J.P.); University Medical Center Ljubljana, Ljubljana, Slovenia (M.N., T. Goslar); Institute of Cardiology, Warsaw, Poland (J.S.); Golden Jubilee National Hospital, Glasgow, United Kingdom (K.O.); Vilnius University Hospital Santaros Klinikos and Faculty of Medicine, Vilnius University, Vilnius, Lithuania (P.S.); Sorbonne Universite Paris 6, ACTION Study Group, Centre Hospitalier Universitaire Pitie-Salpetriere (G.M., O.B.), and Applied Research, Technology Transfer, Industrial Collaboration, Societe par Actions Simplifiee (P.T.), Paris; Wilhelminenpital, Department of Cardiology, and Sigmund Freud University, Medical School, Vienna (K.H.); the Department of Cardiology, Inselspital Bern, University of Bern, Bern, Switzerland (S.W., L.H.); Manzoni Hospital, Lecco, Italy (S. Savonitto); and Universitair Ziekenhuis Antwerp, Antwerp, Belgium (C.V.). FAU - Windecker, Stephan AU - Windecker S AD - From Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig (H.T., M.S., A.J., S.D.), Universitatsmedizin Mannheim, Mannheim (I.A.), University Heart Center Lubeck, Lubeck (S.W.-T., R.M.-S., G.F., I.E.), German Center for Cardiovascular Research (I.A., S.W.-T., R.M.-S., G.F., I.E., U.L., C.S., A.J., S.B.F., S.D.) and Universitatsklinikum Charite, Campus Benjamin Franklin (U.L., C.S.), Berlin, Universitatsklinikum Wurzburg, Wurzburg (P.N.), Klinikum der Eberhard-Karls-Universitat Tubingen, Tubingen (T. Geisler), Klinikum Links der Weser, Bremen (A.F.), Helios Klinik Erfurt, Erfurt (H.L.), Ernst-Moritz-Arndt-Universitat, Greifswald (S.B.F.), Universitares Herzzentrum Regensburg, Regensburg (L.S.M.), and Institut fur Herzinfarktforschung (S. Schneider, U.Z.) and Klinikum Ludwigshafen (U.Z.), Ludwigshafen - all in Germany; Academic Medical Center, Amsterdam (J.J.P.); University Medical Center Ljubljana, Ljubljana, Slovenia (M.N., T. Goslar); Institute of Cardiology, Warsaw, Poland (J.S.); Golden Jubilee National Hospital, Glasgow, United Kingdom (K.O.); Vilnius University Hospital Santaros Klinikos and Faculty of Medicine, Vilnius University, Vilnius, Lithuania (P.S.); Sorbonne Universite Paris 6, ACTION Study Group, Centre Hospitalier Universitaire Pitie-Salpetriere (G.M., O.B.), and Applied Research, Technology Transfer, Industrial Collaboration, Societe par Actions Simplifiee (P.T.), Paris; Wilhelminenpital, Department of Cardiology, and Sigmund Freud University, Medical School, Vienna (K.H.); the Department of Cardiology, Inselspital Bern, University of Bern, Bern, Switzerland (S.W., L.H.); Manzoni Hospital, Lecco, Italy (S. Savonitto); and Universitair Ziekenhuis Antwerp, Antwerp, Belgium (C.V.). FAU - Hunziker, Lukas AU - Hunziker L AD - From Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig (H.T., M.S., A.J., S.D.), Universitatsmedizin Mannheim, Mannheim (I.A.), University Heart Center Lubeck, Lubeck (S.W.-T., R.M.-S., G.F., I.E.), German Center for Cardiovascular Research (I.A., S.W.-T., R.M.-S., G.F., I.E., U.L., C.S., A.J., S.B.F., S.D.) and Universitatsklinikum Charite, Campus Benjamin Franklin (U.L., C.S.), Berlin, Universitatsklinikum Wurzburg, Wurzburg (P.N.), Klinikum der Eberhard-Karls-Universitat Tubingen, Tubingen (T. Geisler), Klinikum Links der Weser, Bremen (A.F.), Helios Klinik Erfurt, Erfurt (H.L.), Ernst-Moritz-Arndt-Universitat, Greifswald (S.B.F.), Universitares Herzzentrum Regensburg, Regensburg (L.S.M.), and Institut fur Herzinfarktforschung (S. Schneider, U.Z.) and Klinikum Ludwigshafen (U.Z.), Ludwigshafen - all in Germany; Academic Medical Center, Amsterdam (J.J.P.); University Medical Center Ljubljana, Ljubljana, Slovenia (M.N., T. Goslar); Institute of Cardiology, Warsaw, Poland (J.S.); Golden Jubilee National Hospital, Glasgow, United Kingdom (K.O.); Vilnius University Hospital Santaros Klinikos and Faculty of Medicine, Vilnius University, Vilnius, Lithuania (P.S.); Sorbonne Universite Paris 6, ACTION Study Group, Centre Hospitalier Universitaire Pitie-Salpetriere (G.M., O.B.), and Applied Research, Technology Transfer, Industrial Collaboration, Societe par Actions Simplifiee (P.T.), Paris; Wilhelminenpital, Department of Cardiology, and Sigmund Freud University, Medical School, Vienna (K.H.); the Department of Cardiology, Inselspital Bern, University of Bern, Bern, Switzerland (S.W., L.H.); Manzoni Hospital, Lecco, Italy (S. Savonitto); and Universitair Ziekenhuis Antwerp, Antwerp, Belgium (C.V.). FAU - Savonitto, Stefano AU - Savonitto S AD - From Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig (H.T., M.S., A.J., S.D.), Universitatsmedizin Mannheim, Mannheim (I.A.), University Heart Center Lubeck, Lubeck (S.W.-T., R.M.-S., G.F., I.E.), German Center for Cardiovascular Research (I.A., S.W.-T., R.M.-S., G.F., I.E., U.L., C.S., A.J., S.B.F., S.D.) and Universitatsklinikum Charite, Campus Benjamin Franklin (U.L., C.S.), Berlin, Universitatsklinikum Wurzburg, Wurzburg (P.N.), Klinikum der Eberhard-Karls-Universitat Tubingen, Tubingen (T. Geisler), Klinikum Links der Weser, Bremen (A.F.), Helios Klinik Erfurt, Erfurt (H.L.), Ernst-Moritz-Arndt-Universitat, Greifswald (S.B.F.), Universitares Herzzentrum Regensburg, Regensburg (L.S.M.), and Institut fur Herzinfarktforschung (S. Schneider, U.Z.) and Klinikum Ludwigshafen (U.Z.), Ludwigshafen - all in Germany; Academic Medical Center, Amsterdam (J.J.P.); University Medical Center Ljubljana, Ljubljana, Slovenia (M.N., T. Goslar); Institute of Cardiology, Warsaw, Poland (J.S.); Golden Jubilee National Hospital, Glasgow, United Kingdom (K.O.); Vilnius University Hospital Santaros Klinikos and Faculty of Medicine, Vilnius University, Vilnius, Lithuania (P.S.); Sorbonne Universite Paris 6, ACTION Study Group, Centre Hospitalier Universitaire Pitie-Salpetriere (G.M., O.B.), and Applied Research, Technology Transfer, Industrial Collaboration, Societe par Actions Simplifiee (P.T.), Paris; Wilhelminenpital, Department of Cardiology, and Sigmund Freud University, Medical School, Vienna (K.H.); the Department of Cardiology, Inselspital Bern, University of Bern, Bern, Switzerland (S.W., L.H.); Manzoni Hospital, Lecco, Italy (S. Savonitto); and Universitair Ziekenhuis Antwerp, Antwerp, Belgium (C.V.). FAU - Torremante, Patrizia AU - Torremante P AD - From Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig (H.T., M.S., A.J., S.D.), Universitatsmedizin Mannheim, Mannheim (I.A.), University Heart Center Lubeck, Lubeck (S.W.-T., R.M.-S., G.F., I.E.), German Center for Cardiovascular Research (I.A., S.W.-T., R.M.-S., G.F., I.E., U.L., C.S., A.J., S.B.F., S.D.) and Universitatsklinikum Charite, Campus Benjamin Franklin (U.L., C.S.), Berlin, Universitatsklinikum Wurzburg, Wurzburg (P.N.), Klinikum der Eberhard-Karls-Universitat Tubingen, Tubingen (T. Geisler), Klinikum Links der Weser, Bremen (A.F.), Helios Klinik Erfurt, Erfurt (H.L.), Ernst-Moritz-Arndt-Universitat, Greifswald (S.B.F.), Universitares Herzzentrum Regensburg, Regensburg (L.S.M.), and Institut fur Herzinfarktforschung (S. Schneider, U.Z.) and Klinikum Ludwigshafen (U.Z.), Ludwigshafen - all in Germany; Academic Medical Center, Amsterdam (J.J.P.); University Medical Center Ljubljana, Ljubljana, Slovenia (M.N., T. Goslar); Institute of Cardiology, Warsaw, Poland (J.S.); Golden Jubilee National Hospital, Glasgow, United Kingdom (K.O.); Vilnius University Hospital Santaros Klinikos and Faculty of Medicine, Vilnius University, Vilnius, Lithuania (P.S.); Sorbonne Universite Paris 6, ACTION Study Group, Centre Hospitalier Universitaire Pitie-Salpetriere (G.M., O.B.), and Applied Research, Technology Transfer, Industrial Collaboration, Societe par Actions Simplifiee (P.T.), Paris; Wilhelminenpital, Department of Cardiology, and Sigmund Freud University, Medical School, Vienna (K.H.); the Department of Cardiology, Inselspital Bern, University of Bern, Bern, Switzerland (S.W., L.H.); Manzoni Hospital, Lecco, Italy (S. Savonitto); and Universitair Ziekenhuis Antwerp, Antwerp, Belgium (C.V.). FAU - Vrints, Christiaan AU - Vrints C AD - From Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig (H.T., M.S., A.J., S.D.), Universitatsmedizin Mannheim, Mannheim (I.A.), University Heart Center Lubeck, Lubeck (S.W.-T., R.M.-S., G.F., I.E.), German Center for Cardiovascular Research (I.A., S.W.-T., R.M.-S., G.F., I.E., U.L., C.S., A.J., S.B.F., S.D.) and Universitatsklinikum Charite, Campus Benjamin Franklin (U.L., C.S.), Berlin, Universitatsklinikum Wurzburg, Wurzburg (P.N.), Klinikum der Eberhard-Karls-Universitat Tubingen, Tubingen (T. Geisler), Klinikum Links der Weser, Bremen (A.F.), Helios Klinik Erfurt, Erfurt (H.L.), Ernst-Moritz-Arndt-Universitat, Greifswald (S.B.F.), Universitares Herzzentrum Regensburg, Regensburg (L.S.M.), and Institut fur Herzinfarktforschung (S. Schneider, U.Z.) and Klinikum Ludwigshafen (U.Z.), Ludwigshafen - all in Germany; Academic Medical Center, Amsterdam (J.J.P.); University Medical Center Ljubljana, Ljubljana, Slovenia (M.N., T. Goslar); Institute of Cardiology, Warsaw, Poland (J.S.); Golden Jubilee National Hospital, Glasgow, United Kingdom (K.O.); Vilnius University Hospital Santaros Klinikos and Faculty of Medicine, Vilnius University, Vilnius, Lithuania (P.S.); Sorbonne Universite Paris 6, ACTION Study Group, Centre Hospitalier Universitaire Pitie-Salpetriere (G.M., O.B.), and Applied Research, Technology Transfer, Industrial Collaboration, Societe par Actions Simplifiee (P.T.), Paris; Wilhelminenpital, Department of Cardiology, and Sigmund Freud University, Medical School, Vienna (K.H.); the Department of Cardiology, Inselspital Bern, University of Bern, Bern, Switzerland (S.W., L.H.); Manzoni Hospital, Lecco, Italy (S. Savonitto); and Universitair Ziekenhuis Antwerp, Antwerp, Belgium (C.V.). FAU - Schneider, Steffen AU - Schneider S AD - From Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig (H.T., M.S., A.J., S.D.), Universitatsmedizin Mannheim, Mannheim (I.A.), University Heart Center Lubeck, Lubeck (S.W.-T., R.M.-S., G.F., I.E.), German Center for Cardiovascular Research (I.A., S.W.-T., R.M.-S., G.F., I.E., U.L., C.S., A.J., S.B.F., S.D.) and Universitatsklinikum Charite, Campus Benjamin Franklin (U.L., C.S.), Berlin, Universitatsklinikum Wurzburg, Wurzburg (P.N.), Klinikum der Eberhard-Karls-Universitat Tubingen, Tubingen (T. Geisler), Klinikum Links der Weser, Bremen (A.F.), Helios Klinik Erfurt, Erfurt (H.L.), Ernst-Moritz-Arndt-Universitat, Greifswald (S.B.F.), Universitares Herzzentrum Regensburg, Regensburg (L.S.M.), and Institut fur Herzinfarktforschung (S. Schneider, U.Z.) and Klinikum Ludwigshafen (U.Z.), Ludwigshafen - all in Germany; Academic Medical Center, Amsterdam (J.J.P.); University Medical Center Ljubljana, Ljubljana, Slovenia (M.N., T. Goslar); Institute of Cardiology, Warsaw, Poland (J.S.); Golden Jubilee National Hospital, Glasgow, United Kingdom (K.O.); Vilnius University Hospital Santaros Klinikos and Faculty of Medicine, Vilnius University, Vilnius, Lithuania (P.S.); Sorbonne Universite Paris 6, ACTION Study Group, Centre Hospitalier Universitaire Pitie-Salpetriere (G.M., O.B.), and Applied Research, Technology Transfer, Industrial Collaboration, Societe par Actions Simplifiee (P.T.), Paris; Wilhelminenpital, Department of Cardiology, and Sigmund Freud University, Medical School, Vienna (K.H.); the Department of Cardiology, Inselspital Bern, University of Bern, Bern, Switzerland (S.W., L.H.); Manzoni Hospital, Lecco, Italy (S. Savonitto); and Universitair Ziekenhuis Antwerp, Antwerp, Belgium (C.V.). FAU - Zeymer, Uwe AU - Zeymer U AD - From Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig (H.T., M.S., A.J., S.D.), Universitatsmedizin Mannheim, Mannheim (I.A.), University Heart Center Lubeck, Lubeck (S.W.-T., R.M.-S., G.F., I.E.), German Center for Cardiovascular Research (I.A., S.W.-T., R.M.-S., G.F., I.E., U.L., C.S., A.J., S.B.F., S.D.) and Universitatsklinikum Charite, Campus Benjamin Franklin (U.L., C.S.), Berlin, Universitatsklinikum Wurzburg, Wurzburg (P.N.), Klinikum der Eberhard-Karls-Universitat Tubingen, Tubingen (T. Geisler), Klinikum Links der Weser, Bremen (A.F.), Helios Klinik Erfurt, Erfurt (H.L.), Ernst-Moritz-Arndt-Universitat, Greifswald (S.B.F.), Universitares Herzzentrum Regensburg, Regensburg (L.S.M.), and Institut fur Herzinfarktforschung (S. Schneider, U.Z.) and Klinikum Ludwigshafen (U.Z.), Ludwigshafen - all in Germany; Academic Medical Center, Amsterdam (J.J.P.); University Medical Center Ljubljana, Ljubljana, Slovenia (M.N., T. Goslar); Institute of Cardiology, Warsaw, Poland (J.S.); Golden Jubilee National Hospital, Glasgow, United Kingdom (K.O.); Vilnius University Hospital Santaros Klinikos and Faculty of Medicine, Vilnius University, Vilnius, Lithuania (P.S.); Sorbonne Universite Paris 6, ACTION Study Group, Centre Hospitalier Universitaire Pitie-Salpetriere (G.M., O.B.), and Applied Research, Technology Transfer, Industrial Collaboration, Societe par Actions Simplifiee (P.T.), Paris; Wilhelminenpital, Department of Cardiology, and Sigmund Freud University, Medical School, Vienna (K.H.); the Department of Cardiology, Inselspital Bern, University of Bern, Bern, Switzerland (S.W., L.H.); Manzoni Hospital, Lecco, Italy (S. Savonitto); and Universitair Ziekenhuis Antwerp, Antwerp, Belgium (C.V.). FAU - Desch, Steffen AU - Desch S AD - From Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig (H.T., M.S., A.J., S.D.), Universitatsmedizin Mannheim, Mannheim (I.A.), University Heart Center Lubeck, Lubeck (S.W.-T., R.M.-S., G.F., I.E.), German Center for Cardiovascular Research (I.A., S.W.-T., R.M.-S., G.F., I.E., U.L., C.S., A.J., S.B.F., S.D.) and Universitatsklinikum Charite, Campus Benjamin Franklin (U.L., C.S.), Berlin, Universitatsklinikum Wurzburg, Wurzburg (P.N.), Klinikum der Eberhard-Karls-Universitat Tubingen, Tubingen (T. Geisler), Klinikum Links der Weser, Bremen (A.F.), Helios Klinik Erfurt, Erfurt (H.L.), Ernst-Moritz-Arndt-Universitat, Greifswald (S.B.F.), Universitares Herzzentrum Regensburg, Regensburg (L.S.M.), and Institut fur Herzinfarktforschung (S. Schneider, U.Z.) and Klinikum Ludwigshafen (U.Z.), Ludwigshafen - all in Germany; Academic Medical Center, Amsterdam (J.J.P.); University Medical Center Ljubljana, Ljubljana, Slovenia (M.N., T. Goslar); Institute of Cardiology, Warsaw, Poland (J.S.); Golden Jubilee National Hospital, Glasgow, United Kingdom (K.O.); Vilnius University Hospital Santaros Klinikos and Faculty of Medicine, Vilnius University, Vilnius, Lithuania (P.S.); Sorbonne Universite Paris 6, ACTION Study Group, Centre Hospitalier Universitaire Pitie-Salpetriere (G.M., O.B.), and Applied Research, Technology Transfer, Industrial Collaboration, Societe par Actions Simplifiee (P.T.), Paris; Wilhelminenpital, Department of Cardiology, and Sigmund Freud University, Medical School, Vienna (K.H.); the Department of Cardiology, Inselspital Bern, University of Bern, Bern, Switzerland (S.W., L.H.); Manzoni Hospital, Lecco, Italy (S. Savonitto); and Universitair Ziekenhuis Antwerp, Antwerp, Belgium (C.V.). CN - CULPRIT-SHOCK Investigators LA - eng SI - ClinicalTrials.gov/NCT01927549 PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20180825 PL - United States TA - N Engl J Med JT - The New England journal of medicine JID - 0255562 SB - IM CIN - N Engl J Med. 2018 Nov 1;379(18):1775-1776. doi: 10.1056/NEJMe1810971. PMID: 30380397 CIN - N Engl J Med. 2019 May 9;380(19):1876-1877. doi: 10.1056/NEJMc1902949. PMID: 31067386 CIN - J Thorac Dis. 2019 May;11(Suppl 9):S1296-S1298. doi: 10.21037/jtd.2019.04.80. PMID: 31245114 MH - Aged MH - Female MH - Follow-Up Studies MH - Heart Failure/epidemiology/etiology MH - Humans MH - Kaplan-Meier Estimate MH - Male MH - Middle Aged MH - Myocardial Infarction/*complications MH - Patient Readmission MH - Percutaneous Coronary Intervention/*methods MH - Recurrence MH - Renal Insufficiency/etiology/therapy MH - Renal Replacement Therapy MH - Shock, Cardiogenic/etiology/mortality/*therapy FIR - Tebbe, Ulrich IR - Tebbe U FIR - Wohrle, Jochen IR - Wohrle J FIR - Pachinger, Otmar IR - Pachinger O FIR - Busch, Clemens IR - Busch C FIR - Pfeiffer, Nathalie IR - Pfeiffer N FIR - Neumer, Alexander IR - Neumer A FIR - Ouarrak, Taoufik IR - Ouarrak T FIR - Riemer, Thomas IR - Riemer T FIR - Lober, Christiane IR - Lober C FIR - Hochadel, Matthias IR - Hochadel M FIR - Clemmensen, Peter IR - Clemmensen P FIR - Follath, Ferenc IR - Follath F FIR - Wegscheider, Karl IR - Wegscheider K FIR - Barthelemy, O IR - Barthelemy O FIR - Zeitouni, M IR - Zeitouni M FIR - Overtchouk, P IR - Overtchouk P FIR - Guedeney, P IR - Guedeney P FIR - Hage, G IR - Hage G FIR - Hauguel-Moreau, M IR - Hauguel-Moreau M FIR - Weinschenk, Sabrina IR - Weinschenk S FIR - Borggrefe, Martin IR - Borggrefe M FIR - Neumann, Franz-Josef IR - Neumann FJ FIR - Ferenc, Miroslaw IR - Ferenc M FIR - Olbrich, Hans-Gerd IR - Olbrich HG FIR - Hopf, Hans-Bernd IR - Hopf HB FIR - Kastrati, Adnan IR - Kastrati A FIR - de Waha, Antoinette IR - de Waha A FIR - Schunkert, Heribert IR - Schunkert H FIR - Richardt, Gert IR - Richardt G FIR - Schwarz, Bettina IR - Schwarz B FIR - Abdel-Wahab, Mohamed IR - Abdel-Wahab M FIR - Toelg, Ralph IR - Toelg R FIR - Geist, Volker IR - Geist V FIR - Bahnsen-Maass, Monika IR - Bahnsen-Maass M FIR - Hennersdorf, Marcus IR - Hennersdorf M FIR - Graf, Jochen IR - Graf J FIR - Riemann, Urs IR - Riemann U FIR - Scharpf, Dominik IR - Scharpf D FIR - Empen, Klaus IR - Empen K FIR - Busch, Mathias C IR - Busch MC FIR - Werdan, Karl IR - Werdan K FIR - Nuding, Sebastian IR - Nuding S FIR - Hambrecht, Rainer IR - Hambrecht R FIR - Fiehn, Eduard IR - Fiehn E FIR - Gitt, Anselm K IR - Gitt AK FIR - Mark, Bernd IR - Mark B FIR - Winkler, Ralph IR - Winkler R FIR - Lauer, Bernward IR - Lauer B FIR - Mobius-Winkler, Sven IR - Mobius-Winkler S FIR - Schulze, Christian IR - Schulze C FIR - Minden, Hans-Heinrich IR - Minden HH FIR - Braun-Dullaeus, Rudiger C IR - Braun-Dullaeus RC FIR - Schmeisser, Alexander IR - Schmeisser A FIR - Strasser, Ruth H IR - Strasser RH FIR - Ebner, Bernd IR - Ebner B FIR - Ertl, Georg IR - Ertl G FIR - Mudra, Harald IR - Mudra H FIR - Hug, Martin IR - Hug M FIR - Endemann, Dierk IR - Endemann D FIR - Hamm, Christian IR - Hamm C FIR - Walther, Claudia IR - Walther C FIR - Liebetrau, Christoph IR - Liebetrau C FIR - Menck, Niels IR - Menck N FIR - Mehilli, Julinda IR - Mehilli J FIR - Orban, Martin IR - Orban M FIR - Hausleiter, Jorg IR - Hausleiter J FIR - Massberg, Steffen IR - Massberg S FIR - Prondzinsky, Roland IR - Prondzinsky R FIR - Gielen, Stephan IR - Gielen S FIR - Gawaz, Meinrad IR - Gawaz M FIR - Pauschinger, Matthias IR - Pauschinger M FIR - Ademaj, Fadil IR - Ademaj F FIR - Bode, Christoph IR - Bode C FIR - Nickenig, Georg IR - Nickenig G FIR - Fichtlscherer, Stephan IR - Fichtlscherer S FIR - Zeiher, Andreas IR - Zeiher A FIR - Viertel, Achim IR - Viertel A FIR - Kelm, Malte IR - Kelm M FIR - Jung, Christian IR - Jung C FIR - Sydow, Carsten IR - Sydow C FIR - Karakas, Mahir IR - Karakas M FIR - Rudolph, Volker IR - Rudolph V FIR - Baldus, Stephan IR - Baldus S FIR - Jacobshagen, Claudius IR - Jacobshagen C FIR - Hasenfuss, Gerd IR - Hasenfuss G FIR - Pfeiffer, Dietrich IR - Pfeiffer D FIR - Buchter, Bjorn IR - Buchter B FIR - Hugl, Burkhard IR - Hugl B FIR - Nef, Holger IR - Nef H FIR - Dorr, Oliver IR - Dorr O FIR - Reinig, Karsten IR - Reinig K FIR - Kuck, Karl-Heinz IR - Kuck KH FIR - Ghanem, Alexander IR - Ghanem A FIR - Katus, Hugo IR - Katus H FIR - Gori, Tommaso IR - Gori T FIR - Munzel, Thomas IR - Munzel T FIR - Schnupp, Steffen IR - Schnupp S FIR - Brachmann, Johannes IR - Brachmann J FIR - Ferrari, Markus IR - Ferrari M FIR - Achenbach, Stephan IR - Achenbach S FIR - Carrie, Didier IR - Carrie D FIR - Henry, Patrick IR - Henry P FIR - Manzo-Silberman, Stephane IR - Manzo-Silberman S FIR - Ledermann, Bertrand IR - Ledermann B FIR - Cayla, Guillaume IR - Cayla G FIR - Bonnet, Jean-Louis IR - Bonnet JL FIR - Frenk, Andre IR - Frenk A FIR - Windecker, Stephan IR - Windecker S FIR - Jeger, Raban IR - Jeger R FIR - Eeckhout, Eric IR - Eeckhout E FIR - Henriques, Jose P IR - Henriques JP FIR - Van Geuns, Robert-Jan IR - Van Geuns RJ FIR - Voskuil, Michiel IR - Voskuil M FIR - Bax, M IR - Bax M FIR - van der Harst, Pim IR - van der Harst P FIR - Serpytis, Rokas IR - Serpytis R FIR - Jarasuniene, Dalia IR - Jarasuniene D FIR - Lang, Irene Marthe IR - Lang IM FIR - Pichler, Philipp IR - Pichler P FIR - Weidinger, Franz IR - Weidinger F FIR - Zaruba, Marc-Michael IR - Zaruba MM FIR - Dudek, Darius IR - Dudek D FIR - Depukat, Rafal IR - Depukat R FIR - Witkowski, Adam IR - Witkowski A FIR - Milewski, Krzysztof IR - Milewski K FIR - Prokopczuk, Janusz IR - Prokopczuk J FIR - Gasior, Mariusz IR - Gasior M FIR - Gorycki, Bogdan IR - Gorycki B FIR - Ochala, Andrzej IR - Ochala A FIR - Piatti, Luigi IR - Piatti L FIR - Galvani, Marcello IR - Galvani M FIR - Bossi, Irene IR - Bossi I FIR - Pignatelli, Gianluca IR - Pignatelli G FIR - Berry, Colin IR - Berry C FIR - Greenwood, John IR - Greenwood J FIR - Lockie, Tim IR - Lockie T FIR - Mamas, Mamas IR - Mamas M EDAT- 2018/08/28 06:00 MHDA- 2018/12/12 06:00 CRDT- 2018/08/28 06:00 PHST- 2018/08/28 06:00 [pubmed] PHST- 2018/12/12 06:00 [medline] PHST- 2018/08/28 06:00 [entrez] AID - 10.1056/NEJMoa1808788 [doi] PST - ppublish SO - N Engl J Med. 2018 Nov 1;379(18):1699-1710. doi: 10.1056/NEJMoa1808788. Epub 2018 Aug 25. PMID- 30139467 OWN - NLM STAT- MEDLINE DCOM- 20191120 LR - 20191120 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 11 IP - 16 DP - 2018 Aug 27 TI - Effect of a Contrast Modulation System on Contrast Media Use and the Rate of Acute Kidney Injury After Coronary Angiography. PG - 1601-1610 LID - S1936-8798(18)30866-5 [pii] LID - 10.1016/j.jcin.2018.04.007 [doi] AB - OBJECTIVES: The aim of the AVERT (AVERT Clinical Trial for Contrast Media Volume Reduction and Incidence of CIN) trial was to test the efficacy of the AVERT system to reduce the contrast media volume (CMV) used during coronary angiographic procedures without impairing image quality and to prevent contrast-induced acute kidney injury (CI-AKI) in patients at risk for CI-AKI. BACKGROUND: CI-AKI is a common complication of percutaneous coronary procedures, associated with increased morbidity and mortality. The AVERT system alters the coronary injection pressure profile by diverting contrast away from the patient during coronary injection. METHODS: The AVERT trial was a prospective, multicenter, 1:1 randomized clinical trial in 578 subjects with either baseline estimated glomerular filtration rate 20 to 30 ml/min/1.73 m(2) or estimated glomerular filtration rate 30 to 60 ml/min/1.73 m(2) and at least 2 additional risk factors for CI-AKI. Patients undergoing coronary angiography with planned or possible percutaneous coronary intervention (PCI) were randomized to hydration plus the AVERT system (n = 292) or hydration only (n = 286). The primary effectiveness endpoints were: 1) the total CMV used; and 2) the incidence of CI-AKI, defined as a >/=0.3 mg/dl increase in serum creatinine within 5 days post-procedure. RESULTS: Patient demographics were well balanced between the groups, with mean baseline serum creatinine of 1.6 +/- 0.4 mg/dl and 64.9% patients with diabetes mellitus. PCI was performed in 42.2% of procedures, with coronary angiography in the remainder. Use of AVERT resulted in a 15.5% relative reduction in CMV overall (85.6 +/- 50.5 ml vs. 101.3 +/- 71.1 ml; p = 0.02) and a 22.8% relative reduction in CMV among PCI patients (114 +/- 55 ml vs. 147 +/- 81 ml; p = 0.001). The maximum relative reduction in CMV was 46% (124 +/- 48 ml vs. 232 +/- 97 ml; p = 0.01) when >/=3 lesions were treated. There were no differences in the rates of CI-AKI (27.0% vs. 26.6%; p = 0.70) between the study groups. CONCLUSIONS: Use of the AVERT system was feasible and safe, with acceptable image quality during coronary angiography and PCI. AVERT significantly reduced CMV, with the extent of CMV reduction correlating with procedural complexity. No significant differences in CI-AKI were observed with AVERT in this trial. (AVERT Clinical Trial for Contrast Media Volume Reduction and Incidence of CIN [AVERT]; NCT01976299). CI - Copyright (c) 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Mehran, Roxana AU - Mehran R AD - Icahn School of Medicine at Mount Sinai, New York, New York. Electronic address: roxana.mehran@mountsinai.org. FAU - Faggioni, Michela AU - Faggioni M AD - Icahn School of Medicine at Mount Sinai, New York, New York. FAU - Chandrasekhar, Jaya AU - Chandrasekhar J AD - Icahn School of Medicine at Mount Sinai, New York, New York. FAU - Angiolillo, Dominick J AU - Angiolillo DJ AD - University of Florida College of Medicine-Jacksonville, Jacksonville, Florida. FAU - Bertolet, Barry AU - Bertolet B AD - North Mississippi Medical Center, Tupelo, Mississippi. FAU - Jobe, Robert Lee AU - Jobe RL AD - North Carolina Heart & Vascular, Raleigh, North Carolina. FAU - Al-Joundi, Bassam AU - Al-Joundi B AD - Gateway Cardiology, Saint Louis, Montana. FAU - Brar, Somjot AU - Brar S AD - Kaiser Permanente Los Angeles Medical Center, Los Angeles, California. FAU - Dangas, George AU - Dangas G AD - Icahn School of Medicine at Mount Sinai, New York, New York. FAU - Batchelor, Wayne AU - Batchelor W AD - Tallahassee Memorial Hospital, Heart and Vascular Center, Tallahassee, Florida. FAU - Prasad, Anand AU - Prasad A AD - Division of Cardiology, Department of Medicine, The University of Texas Health Science Center San Antonio, San Antonio, Texas. FAU - Gurm, Hitinder S AU - Gurm HS AD - Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan. FAU - Tumlin, James AU - Tumlin J AD - Department of Internal Medicine, Division of Nephrology, University of Tennessee College of Medicine in Chattanooga, Southeast Renal Research Institute, Chattanooga, Tennessee. FAU - Stone, Gregg W AU - Stone GW AD - Columbia University Medical Center/NewYork-Presbyterian Hospital and the Cardiovascular Research Foundation, New York, New York. LA - eng SI - ClinicalTrials.gov/NCT01976299 PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 RN - 0 (Biomarkers) RN - 0 (Contrast Media) RN - AYI8EX34EU (Creatinine) SB - IM CIN - JACC Cardiovasc Interv. 2018 Aug 27;11(16):1611-1613. doi: 10.1016/j.jcin.2018.05.006. PMID: 30139468 MH - Acute Kidney Injury/chemically induced/diagnosis/physiopathology/*prevention & control MH - Aged MH - Aged, 80 and over MH - Biomarkers/blood MH - Contrast Media/*administration & dosage/adverse effects MH - Coronary Angiography/adverse effects/*instrumentation MH - Coronary Artery Disease/*diagnostic imaging/*therapy MH - Creatinine/blood MH - *Drug Delivery Systems MH - Equipment Design MH - Feasibility Studies MH - Female MH - Glomerular Filtration Rate/drug effects MH - Humans MH - Injections MH - Kidney/*drug effects/physiopathology MH - Male MH - Middle Aged MH - *Percutaneous Coronary Intervention/adverse effects MH - Predictive Value of Tests MH - Prospective Studies MH - Risk Factors MH - Time Factors MH - Treatment Outcome OTO - NOTNLM OT - AVERT system OT - contrast induced acute kidney injury OT - contrast media volume reduction OT - contrast modulation EDAT- 2018/08/25 06:00 MHDA- 2019/11/21 06:00 CRDT- 2018/08/25 06:00 PHST- 2018/02/12 00:00 [received] PHST- 2018/04/02 00:00 [revised] PHST- 2018/04/05 00:00 [accepted] PHST- 2018/08/25 06:00 [entrez] PHST- 2018/08/25 06:00 [pubmed] PHST- 2019/11/21 06:00 [medline] AID - S1936-8798(18)30866-5 [pii] AID - 10.1016/j.jcin.2018.04.007 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2018 Aug 27;11(16):1601-1610. doi: 10.1016/j.jcin.2018.04.007. PMID- 30111521 OWN - NLM STAT- MEDLINE DCOM- 20190730 LR - 20190730 IS - 1969-6213 (Electronic) IS - 1774-024X (Linking) VI - 14 IP - 10 DP - 2018 Nov 20 TI - Radial versus femoral artery access in patients undergoing PCI for left main coronary artery disease: analysis from the EXCEL trial. PG - 1104-1111 LID - EIJ-D-18-00711 [pii] LID - 10.4244/EIJ-D-18-00711 [doi] AB - AIMS: We sought to compare clinical outcomes and procedural characteristics with transradial access (TRA) versus transfemoral access (TFA) in patients who were treated with PCI for left main (LM) coronary artery disease. METHODS AND RESULTS: The EXCEL trial was a prospective, international, open-label, multicentre trial that randomised 1,905 patients with LM disease and SYNTAX scores /=5.0 mg/dl from baseline or a new requirement for dialysis. The primary composite endpoint was the composite of death, myocardial infarction (MI), or stroke at 3-year follow-up. RESULTS: CKD was present in 361 of 1,869 randomized patients (19.3%) in whom baseline estimated glomerular filtration rate was available. Patients with CKD had higher 3-year rates of the primary endpoint compared with those without CKD (20.8% vs. 13.5%; hazard ratio [HR]: 1.60; 95% confidence interval [CI]: 1.22 to 2.09; p = 0.0005). ARF within 30 days occurred more commonly in patients with compared with those without CKD (5.0% vs. 0.8%; p < 0.0001), and was strongly associated with the 3-year risk of death, stroke, or MI (50.7% vs. 14.4%; HR: 4.59; 95% CI: 2.73 to 7.73; p < 0.0001). ARF occurred less commonly after revascularization with PCI compared with CABG both in patients with CKD (2.3% vs. 7.7%; HR: 0.28; 95% CI: 0.09 to 0.87) and in those without CKD (0.3% vs. 1.3%; HR: 0.20; 95% CI: 0.04 to 0.90; p(interaction) = 0.71). There were no significant differences in the rates of the primary composite endpoint after PCI and CABG in patients with CKD (23.4% vs. 18.1%; HR: 1.25; 95% CI: 0.79 to 1.98) and without CKD (13.4% vs. 13.5%; HR: 0.97; 95% CI: 0.73 to 1.27; p(interaction) = 0.38). CONCLUSIONS: Patients with CKD undergoing revascularization for LMCAD in the EXCEL trial had increased rates of ARF and reduced event-free survival. ARF occurred less frequently after PCI compared with CABG. There were no significant differences between PCI and CABG in terms of death, stroke, or MI at 3 years in patients with and without CKD. (EXCEL Clinical Trial [EXCEL]; NCT01205776). CI - Copyright (c) 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Giustino, Gennaro AU - Giustino G AD - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Clinical Trials Center, Cardiovascular Research Foundation, New York, New York. Electronic address: https://twitter.com/g_giustinoMD. FAU - Mehran, Roxana AU - Mehran R AD - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Clinical Trials Center, Cardiovascular Research Foundation, New York, New York. Electronic address: https://twitter.com/Drroxmehran. FAU - Serruys, Patrick W AU - Serruys PW AD - Imperial College of Science, Technology and Medicine, London, United Kingdom. FAU - Sabik, Joseph F 3rd AU - Sabik JF 3rd AD - Department of Surgery, UH Cleveland Medical Center, Cleveland, Ohio. FAU - Milojevic, Milan AU - Milojevic M AD - Erasmus University Medical Center, Rotterdam, the Netherlands. FAU - Simonton, Charles A AU - Simonton CA AD - Abbott Vascular, Santa Clara, California. FAU - Puskas, John D AU - Puskas JD AD - Mount Sinai Heart at Mount Sinai St. Luke's, New York, New York. FAU - Kandzari, David E AU - Kandzari DE AD - Piedmont Heart Institute, Atlanta, Georgia. FAU - Morice, Marie-Claude AU - Morice MC AD - Ramsay Generale de Sante, Hopital Prive Jacques Cartier, Massy, France. FAU - Taggart, David P AU - Taggart DP AD - Department Cardiac Surgery, John Radcliffe Hospital, Oxford, United Kingdom. FAU - Gershlick, Anthony H AU - Gershlick AH AD - University Hospitals of Leicester, Leicester, United Kingdom. FAU - Genereux, Philippe AU - Genereux P AD - Clinical Trials Center, Cardiovascular Research Foundation, New York, New York; Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, New Jersey; Hopital du Sacre-Coeur de Montreal, Montreal, Quebec, Canada. FAU - Zhang, Zixuan AU - Zhang Z AD - Clinical Trials Center, Cardiovascular Research Foundation, New York, New York. FAU - McAndrew, Thomas AU - McAndrew T AD - Clinical Trials Center, Cardiovascular Research Foundation, New York, New York. FAU - Redfors, Bjorn AU - Redfors B AD - Clinical Trials Center, Cardiovascular Research Foundation, New York, New York. FAU - Ragosta, Michael 3rd AU - Ragosta M 3rd AD - Division of Cardiovascular Medicine, University of Virginia Health System, Charlottesville, Virginia. FAU - Kron, Irving L AU - Kron IL AD - Division of Cardiovascular Medicine, University of Virginia Health System, Charlottesville, Virginia. FAU - Dressler, Ovidiu AU - Dressler O AD - Clinical Trials Center, Cardiovascular Research Foundation, New York, New York. FAU - Leon, Martin B AU - Leon MB AD - Clinical Trials Center, Cardiovascular Research Foundation, New York, New York; New York-Presbyterian Hospital/Columbia University Medical Center, New York, New York. FAU - Pocock, Stuart J AU - Pocock SJ AD - London School of Hygiene and Tropical Medicine, London, United Kingdom. FAU - Ben-Yehuda, Ori AU - Ben-Yehuda O AD - Clinical Trials Center, Cardiovascular Research Foundation, New York, New York; New York-Presbyterian Hospital/Columbia University Medical Center, New York, New York. FAU - Kappetein, Arie Pieter AU - Kappetein AP AD - Erasmus University Medical Center, Rotterdam, the Netherlands. FAU - Stone, Gregg W AU - Stone GW AD - Clinical Trials Center, Cardiovascular Research Foundation, New York, New York; New York-Presbyterian Hospital/Columbia University Medical Center, New York, New York. Electronic address: gs2184@columbia.edu. LA - eng SI - ClinicalTrials.gov/NCT01205776 PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PL - United States TA - J Am Coll Cardiol JT - Journal of the American College of Cardiology JID - 8301365 SB - IM CIN - J Am Coll Cardiol. 2018 Aug 14;72(7):766-768. doi: 10.1016/j.jacc.2018.05.056. PMID: 30092953 MH - Aged MH - Aged, 80 and over MH - Coronary Artery Bypass/*methods/trends MH - Coronary Artery Disease/diagnostic imaging/epidemiology/*surgery MH - Female MH - Follow-Up Studies MH - Glomerular Filtration Rate/physiology MH - Humans MH - Internationality MH - Male MH - Middle Aged MH - Myocardial Revascularization/*methods/trends MH - Percutaneous Coronary Intervention/*methods/trends MH - Renal Insufficiency, Chronic/diagnostic imaging/epidemiology/*surgery MH - Treatment Outcome OTO - NOTNLM OT - chronic kidney disease OT - coronary artery bypass grafting OT - coronary artery disease OT - left main OT - percutaneous coronary intervention EDAT- 2018/08/11 06:00 MHDA- 2019/08/29 06:00 CRDT- 2018/08/11 06:00 PHST- 2018/03/16 00:00 [received] PHST- 2018/04/26 00:00 [revised] PHST- 2018/05/11 00:00 [accepted] PHST- 2018/08/11 06:00 [entrez] PHST- 2018/08/11 06:00 [pubmed] PHST- 2019/08/29 06:00 [medline] AID - S0735-1097(18)35196-9 [pii] AID - 10.1016/j.jacc.2018.05.057 [doi] PST - ppublish SO - J Am Coll Cardiol. 2018 Aug 14;72(7):754-765. doi: 10.1016/j.jacc.2018.05.057. PMID- 30078001 OWN - NLM STAT- MEDLINE DCOM- 20190327 LR - 20200225 IS - 1664-5502 (Electronic) IS - 1664-3828 (Print) IS - 1664-5502 (Linking) VI - 8 IP - 4 DP - 2018 TI - Detection of Atherosclerotic Cardiovascular Disease in Patients with Advanced Chronic Kidney Disease in the Cardiology and Nephrology Communities. PG - 285-295 LID - 10.1159/000490768 [doi] AB - BACKGROUND: Atherosclerotic cardiovascular disease (ASCVD) is a leading cause of morbidity and mortality among patients with chronic kidney disease (CKD) with a glomerular filtration rate of < 60 mL/min/1.73 m2 body surface area. The availability of high-quality randomized controlled trial data to guide management for the population with CKD and ASCVD is limited. Understanding current practice patterns among providers caring for individuals with CKD and CVD is important in guiding future trial questions. METHODS: A qualitative survey study was performed. An electronic survey regarding the diagnosis and management of CVD in patients with CKD was conducted using a convenience sample of 450 practicing nephrology and cardiology providers. The survey was administered using Qualtrics(R) (https://www.qualtrics.com). RESULTS: There were a total of 113 responses, 81 of which were complete responses. More than 90% of the respondents acknowledged the importance of CVD as a cause of morbidity and mortality in patients with CKD. Outside the kidney transplant evaluation setting, 5% of the respondents would screen an asymptomatic patient with advanced CKD for ASCVD. Outside the kidney transplant evaluation scenario, the respondents did not opt for invasive management strategies in advanced CKD. CONCLUSIONS: The survey results reveal a lack of consensus among providers caring for patients with advanced CKD about the management of ASCVD in this setting. Future randomized controlled trials will be needed to better inform the clinical management of ASCVD in these patients. The limitations of the study include its small sample size and the relatively low response rate among the respondents. CI - (c) 2018 S. Karger AG, Basel. FAU - Chaudhry, Rafia I AU - Chaudhry RI AD - Division of Nephrology and Hypertension, Albany Medical College, Albany, New York, USA. FAU - Mathew, Roy O AU - Mathew RO AD - Division of Nephrology, WJB Dorn VA Medical Center, Columbia, South Carolina, USA. FAU - Sidhu, Mandeep S AU - Sidhu MS AD - Division of Cardiology, Albany Medical College, Albany, New York, USA. FAU - Sidhu-Adler, Preety AU - Sidhu-Adler P AD - Cardinal Health, Cleveland, Ohio, USA. FAU - Lyubarova, Radmila AU - Lyubarova R AD - Division of Cardiology, Albany Medical College, Albany, New York, USA. FAU - Rangaswami, Janani AU - Rangaswami J AD - Division of Nephrology, Department of Medicine, Einstein Medical Center, Philadelphia, Pennsylvania, USA. FAU - Salman, Loay AU - Salman L AD - Division of Nephrology and Hypertension, Albany Medical College, Albany, New York, USA. FAU - Asif, Arif AU - Asif A AD - Department of Medicine, Jersey Shore University Medical Center, Seton Hall-Hackensack Meridian School of Medicine, Neptune City, New Jersey, USA. FAU - Fleg, Jerome L AU - Fleg JL AD - Division of Cardiovascular Sciences, National Heart, Lung and Blood Institute, Bethesda, Maryland, USA. FAU - McCullough, Peter A AU - McCullough PA AD - Baylor University Medical Center, Dallas, Texas, USA. FAU - Maddux, Frank AU - Maddux F AD - Fresenius Medical Care North America, Waltham, Massachusetts, USA. FAU - Bangalore, Sripal AU - Bangalore S AD - New York University School of Medicine, New York, New York, USA. LA - eng PT - Journal Article DEP - 20180803 PL - Switzerland TA - Cardiorenal Med JT - Cardiorenal medicine JID - 101554863 SB - IM MH - Asymptomatic Diseases MH - Cardiologists MH - Coronary Artery Disease/*diagnosis/epidemiology/etiology/*therapy MH - Female MH - Glomerular Filtration Rate MH - Humans MH - Male MH - Mass Screening MH - Nephrologists MH - *Practice Patterns, Physicians' MH - Prevalence MH - Renal Insufficiency, Chronic/*complications/physiopathology MH - Risk Factors MH - Surveys and Questionnaires PMC - PMC6477517 OTO - NOTNLM OT - Atherosclerotic cardiovascular disease OT - Chronic kidney disease OT - Coronary artery disease EDAT- 2018/08/06 06:00 MHDA- 2019/03/28 06:00 PMCR- 2019/10/01 CRDT- 2018/08/06 06:00 PHST- 2018/04/06 00:00 [received] PHST- 2018/06/10 00:00 [accepted] PHST- 2018/08/06 06:00 [pubmed] PHST- 2019/03/28 06:00 [medline] PHST- 2018/08/06 06:00 [entrez] PHST- 2019/10/01 00:00 [pmc-release] AID - 000490768 [pii] AID - crm-0008-0285 [pii] AID - 10.1159/000490768 [doi] PST - ppublish SO - Cardiorenal Med. 2018;8(4):285-295. doi: 10.1159/000490768. Epub 2018 Aug 3. PMID- 30024787 OWN - NLM STAT- MEDLINE DCOM- 20181002 LR - 20190318 IS - 1744-7666 (Electronic) IS - 1465-6566 (Linking) VI - 19 IP - 11 DP - 2018 Aug TI - Febuxostat for the treatment of hyperuricaemia in gout. PG - 1289-1299 LID - 10.1080/14656566.2018.1498842 [doi] AB - Febuxostat is a potent non-purine selective xanthine oxidase inhibitor approved by the FDA in 2009 for management of hyperuricemia in people with gout. Areas covered: The authors summarize the pre-clinical studies and pivotal randomized controlled trials of febuxostat when used as a treatment for hyperuricaemia in gout Expert opinion: Febuxostat has clinical efficacy in serum urate lowering, and long-term use leads to improved outcomes such as gout flare frequency and tophus burden. Recently published post-approval placebo-controlled trials have demonstrated urate-lowering efficacy and safety of febuxostat in patients with chronic kidney disease, and reduced frequency of gout flares in people with early onset of gout. In November 2017, the FDA issued a drug safety communication based on the preliminary results of the CARES trial. This cardiovascular safety study of 6190 patients with gout and established cardiovascular disease comparing febuxostat and allopurinol showed no difference in the primary endpoint (a composite of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, or unstable angina with urgent revascularization), but did report higher all-cause mortality (hazard ratio 1.22) and cardiovascular mortality (hazard ratio 1.34) with febuxostat. Based on currently available data, it seems likely that allopurinol, rather than febuxostat, will remain first line urate-lowering therapy for people with gout. FAU - Robinson, Philip C AU - Robinson PC AD - a Royal Brisbane Hospital , University of Queensland Faculty of Medicine , Brisbane , Queensland , Australia. AD - b Department of Rheumatology , Royal Brisbane & Women's Hospital , Brisbane , Queensland , Australia. FAU - Dalbeth, Nicola AU - Dalbeth N AD - c Bone and Joint Research Group, Department of Medicine , University of Auckland , Auckland , New Zealand. AD - d Department of Rheumatology , Auckland District Health Board , Auckland , New Zealand. LA - eng PT - Journal Article DEP - 20180719 PL - England TA - Expert Opin Pharmacother JT - Expert opinion on pharmacotherapy JID - 100897346 RN - 0 (Gout Suppressants) RN - 101V0R1N2E (Febuxostat) SB - IM MH - Febuxostat/pharmacology/*therapeutic use MH - Gout/*drug therapy/pathology MH - Gout Suppressants/pharmacology/*therapeutic use MH - Humans MH - Hyperuricemia/*drug therapy OTO - NOTNLM OT - Febuxostat OT - cardiovascular OT - gout OT - urate EDAT- 2018/07/20 06:00 MHDA- 2018/10/03 06:00 CRDT- 2018/07/20 06:00 PHST- 2018/07/20 06:00 [pubmed] PHST- 2018/10/03 06:00 [medline] PHST- 2018/07/20 06:00 [entrez] AID - 10.1080/14656566.2018.1498842 [doi] PST - ppublish SO - Expert Opin Pharmacother. 2018 Aug;19(11):1289-1299. doi: 10.1080/14656566.2018.1498842. Epub 2018 Jul 19. PMID- 29997240 OWN - NLM STAT- MEDLINE DCOM- 20190709 LR - 20190709 IS - 1941-3297 (Electronic) IS - 1941-3289 (Linking) VI - 11 IP - 7 DP - 2018 Jul TI - Data-Driven Approach to Identify Subgroups of Heart Failure With Reduced Ejection Fraction Patients With Different Prognoses and Aldosterone Antagonist Response Patterns. PG - e004926 LID - 10.1161/CIRCHEARTFAILURE.118.004926 [doi] AB - BACKGROUND: Patients with heart failure with reduced ejection fraction have a poor prognosis. The identification of subgroups with different outcomes and treatment response patterns may help to tailor strategies to each individual patient. We present an exploratory study of patients enrolled in the EMPHASIS-HF trial (Eplerenone in Patients With Systolic Heart Failure and Mild Symptoms) using latent class analysis with validation using the EPHESUS trial (Eplerenone, a Selective Aldosterone Blocker, in Patients With Left Ventricular Dysfunction After Myocardial Infarction) to identify subgroups of patients with different prognosis and response to eplerenone therapy. METHODS AND RESULTS: Latent class analysis identifies mutually exclusive groups of individuals maximizing within-group similarities and between-group differences. In the EMPHASIS-HF trial, 2279 heart failure with reduced ejection fraction patients were randomized to eplerenone or placebo and were characterized according to 18 clinical features. Subgroup definitions were applied to 6472 patients enrolled in the EPHESUS trial to validate observations. Event-free survival and effect of eplerenone on the composite of cardiovascular death and heart failure hospitalization were determined for each subgroup. Four subgroups were identified with significant differences in event-free survival (P=0.002). The subgroup C had the worst event-free survival in both studies and was characterized by older age, lower body mass index, worse renal function, higher baseline potassium levels, high prevalence of anemia, diabetes mellitus, previous revascularization and higher rates of eplerenone discontinuation, and hyperkalemia during follow-up. Two subgroups (B and C) showed a poorer response to eplerenone in both studies and these groups shared common features such as lower body mass index and high prevalence of anemia. Clinical profiles, prognosis, and treatment response patterns of the 4 subgroups applied in EPHESUS trial presented similarities to those observed in EMPHASIS. CONCLUSIONS: Using a data-driven approach, we identified heart failure with reduced ejection fraction subgroups with significantly different prognoses and potentially different responses to eplerenone. However, these data should be regarded as hypothesis-generating and prospective validation is warranted, to assess the potential clinical implications of these subgroups. CLINICAL TRIAL REGISTRATION: URL: https://www.clinicaltrials.gov. Unique identifier: NCT00232180. CI - (c) 2018 American Heart Association, Inc. FAU - Ferreira, Joao Pedro AU - Ferreira JP AD - Universite de Lorraine INSERM, Centre, d'Investigations Cliniques Plurithematique 1433, INSERM U1116, CHRU de Nancy, F-CRIN INI-CRCT, France (J.P.F., K.D., P.R., F.Z.). AD - Department of Physiology and Cardiothoracic Surgery, Cardiovascular Research and Development Unit, Faculty of Medicine, University of Porto, Portugal (J.P.F.). FAU - Duarte, Kevin AU - Duarte K AD - Universite de Lorraine INSERM, Centre, d'Investigations Cliniques Plurithematique 1433, INSERM U1116, CHRU de Nancy, F-CRIN INI-CRCT, France (J.P.F., K.D., P.R., F.Z.). FAU - McMurray, John J V AU - McMurray JJV AD - BHF Cardiovascular Research Centre, University of Glasgow, Scotland, United Kingdom (J.J.V.M). FAU - Pitt, Bertram AU - Pitt B AD - Department of Medicine, University of Michigan School of Medicine, Ann Arbor (B.P.). FAU - van Veldhuisen, Dirk J AU - van Veldhuisen DJ AD - Department of Cardiology, University of Groningen, University Medical Center Groningen, The Netherlands (D.J.v.V., J.T.). FAU - Vincent, John AU - Vincent J AD - Pfizer Inc., New York, NY (J.V.). FAU - Ahmad, Tariq AU - Ahmad T AD - Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, CT (T.A.). FAU - Tromp, Jasper AU - Tromp J AD - Department of Cardiology, University of Groningen, University Medical Center Groningen, The Netherlands (D.J.v.V., J.T.). FAU - Rossignol, Patrick AU - Rossignol P AD - Universite de Lorraine INSERM, Centre, d'Investigations Cliniques Plurithematique 1433, INSERM U1116, CHRU de Nancy, F-CRIN INI-CRCT, France (J.P.F., K.D., P.R., F.Z.). FAU - Zannad, Faiez AU - Zannad F AD - Universite de Lorraine INSERM, Centre, d'Investigations Cliniques Plurithematique 1433, INSERM U1116, CHRU de Nancy, F-CRIN INI-CRCT, France (J.P.F., K.D., P.R., F.Z.). f.zannad@chru-nancy.fr. LA - eng SI - ClinicalTrials.gov/NCT00232180 PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - United States TA - Circ Heart Fail JT - Circulation. Heart failure JID - 101479941 RN - 0 (Antihypertensive Agents) RN - 0 (Mineralocorticoid Receptor Antagonists) RN - 27O7W4T232 (Spironolactone) SB - IM CIN - Circ Heart Fail. 2018 Jul;11(7):e005089. doi: 10.1161/CIRCHEARTFAILURE.118.005089. PMID: 29997241 MH - Aged MH - Aged, 80 and over MH - Antihypertensive Agents/therapeutic use MH - Female MH - Heart Failure/*drug therapy MH - Humans MH - Hyperkalemia/diagnosis/drug therapy MH - Male MH - Middle Aged MH - Mineralocorticoid Receptor Antagonists/*therapeutic use MH - Myocardial Infarction/*drug therapy/physiopathology MH - Prognosis MH - Risk Factors MH - Spironolactone/therapeutic use MH - Treatment Outcome MH - Ventricular Dysfunction, Left/diagnosis/*drug therapy OTO - NOTNLM OT - aldosterone OT - diabetes mellitus OT - eplerenone OT - heart failure OT - hyperkalemia EDAT- 2018/07/13 06:00 MHDA- 2019/07/10 06:00 CRDT- 2018/07/13 06:00 PHST- 2018/01/16 00:00 [received] PHST- 2018/05/16 00:00 [accepted] PHST- 2018/07/13 06:00 [entrez] PHST- 2018/07/13 06:00 [pubmed] PHST- 2019/07/10 06:00 [medline] AID - CIRCHEARTFAILURE.118.004926 [pii] AID - 10.1161/CIRCHEARTFAILURE.118.004926 [doi] PST - ppublish SO - Circ Heart Fail. 2018 Jul;11(7):e004926. doi: 10.1161/CIRCHEARTFAILURE.118.004926. PMID- 29970328 OWN - NLM STAT- MEDLINE DCOM- 20200511 LR - 20200511 IS - 1878-0938 (Electronic) IS - 1878-0938 (Linking) VI - 20 IP - 3 DP - 2019 Mar TI - Efficacy and safety of adjunctive drug-coated balloon therapy in endovascular treatment of common femoral artery disease. PG - 210-214 LID - S1553-8389(18)30267-7 [pii] LID - 10.1016/j.carrev.2018.06.018 [doi] AB - BACKGROUND: Surgical endarterectomy with or without patch angioplasty has been considered the gold standard for treatment of symptomatic common femoral artery (CFA) disease. Surgical risks include wound infection, hematoma and lymph leak in approximately 17% of patients. Endovascular therapy has less procedure-related morbidity and mortality. Endovascular approaches achieve patency rates of 60% to 90% at 1 and 2 years utilizing atherectomy and balloon angioplasty. CFA stenting has been limited due to concerns of stent kinking, thrombosis and restenosis. Combined directional atherectomy with drug-coated balloon to treat CFA disease in patients with Rutherford II/III patients has been studied recently. We sought to study the safety and outcomes of adjunct drug-coated balloon (DCB) therapy in symptomatic CFA disease patients, including critical limb ischemia (Rutherford IV), after achieving procedural success. OBJECTIVE: To evaluate the additive efficacy of drug coated balloon in treating CFA disease. METHODS: Using retrospective single center data, we analyzed the outcomes of patients who underwent CFA interventions. In this non-randomized study, all patients from December 2010 to December 2014 with CFA disease underwent atherectomy (orbital, plaque excision or both) with adjunctive scoring balloon angioplasty (Ath/PTA). After December 2014, patients treated with combination atherectomy and DCB, (Ath/DCB), underwent final drug delivery to the vessel wall with drug-coated balloon. Distal embolic protection devices were used in the majority of patients. Primary efficacy endpoint was 1-year primary patency and freedom from clinically driven target lesion revascularization (CD-TLR). Patency of vessels was assessed at 12-month interval using duplex ultrasound. RESULTS: Seventy de novo common femoral artery stenotic lesions were treated in both groups. Mean age was 69 in (Ath/PTA) group and 72 in Ath/DCB group. Patients in each group had similar risk factor profiles including diabetes mellitus, hypertension, smoking, coronary artery disease, myocardial infarction, prior coronary revascularization, congestive heart failure, cerebrovascular accidents and chronic kidney disease. The Ath/DCB group had more advanced disease presentation by Rutherford classification (intermittent claudication in 61% and critical limb ischemia in 39% versus intermittent claudication in 76% and chronic limb ischemia in 24%) when compared with the Ath/PTA group. Primary efficacy endpoint was met in 85% and 94% (p = 0.26) in the Ath/PTA and Ath/DCB groups respectively. All patients had run-off angiography at the end of procedure to ensure patency. CONCLUSION: Adjunctive drug-coated balloon therapy does not increase the primary patency rate when compared with atherectomy and scoring balloon angioplasty alone at 1-year in common femoral artery disease treatment. CI - Copyright (c) 2018 Elsevier Inc. All rights reserved. FAU - Imran, Hafiz M AU - Imran HM AD - Department of Medicine, Division of Cardiology, Rhode Island Hospital/Warren Alpert Medical School of Brown University, Providence, RI, United States of America. Electronic address: hafiz_imran@brown.edu. FAU - Hyder, Omar N AU - Hyder ON AD - Department of Medicine, Division of Cardiology, Rhode Island Hospital/Warren Alpert Medical School of Brown University, Providence, RI, United States of America; Department of Medicine, Division of Cardiology, The Miriam Hospital/Warren Alpert Medical School of Brown University, Providence, RI, United States of America. FAU - Soukas, Peter A AU - Soukas PA AD - Department of Medicine, Division of Cardiology, The Miriam Hospital/Warren Alpert Medical School of Brown University, Providence, RI, United States of America. LA - eng PT - Journal Article PT - Observational Study DEP - 20180625 PL - United States TA - Cardiovasc Revasc Med JT - Cardiovascular revascularization medicine : including molecular interventions JID - 101238551 RN - 0 (Cardiovascular Agents) RN - 0 (Coated Materials, Biocompatible) SB - IM MH - Aged MH - Angioplasty, Balloon/adverse effects/*instrumentation MH - Atherectomy MH - Cardiovascular Agents/*administration & dosage/adverse effects MH - *Coated Materials, Biocompatible MH - Critical Illness MH - Embolic Protection Devices MH - Equipment Design MH - Female MH - *Femoral Artery/diagnostic imaging/physiopathology MH - Humans MH - Intermittent Claudication/diagnostic imaging/physiopathology/*therapy MH - Ischemia/diagnostic imaging/physiopathology/*therapy MH - Male MH - Middle Aged MH - Peripheral Arterial Disease/diagnostic imaging/physiopathology/*therapy MH - Retrospective Studies MH - Risk Factors MH - Time Factors MH - Treatment Outcome MH - Vascular Patency OTO - NOTNLM OT - Atherectomy OT - Claudication OT - Common femoral artery OT - Critical limb ischemia OT - Endovascular EDAT- 2018/07/05 06:00 MHDA- 2020/05/12 06:00 CRDT- 2018/07/05 06:00 PHST- 2018/03/21 00:00 [received] PHST- 2018/05/30 00:00 [revised] PHST- 2018/06/18 00:00 [accepted] PHST- 2018/07/05 06:00 [pubmed] PHST- 2020/05/12 06:00 [medline] PHST- 2018/07/05 06:00 [entrez] AID - S1553-8389(18)30267-7 [pii] AID - 10.1016/j.carrev.2018.06.018 [doi] PST - ppublish SO - Cardiovasc Revasc Med. 2019 Mar;20(3):210-214. doi: 10.1016/j.carrev.2018.06.018. Epub 2018 Jun 25. PMID- 29943364 OWN - NLM STAT- MEDLINE DCOM- 20181217 LR - 20220408 IS - 1573-7241 (Electronic) IS - 0920-3206 (Linking) VI - 32 IP - 3 DP - 2018 Jun TI - Aspirin for Primary Prevention of Cardiovascular Disease and Renal Disease Progression in Chronic Kidney Disease Patients: a Multicenter Randomized Clinical Trial (AASER Study). PG - 255-263 LID - 10.1007/s10557-018-6802-1 [doi] AB - BACKGROUND: Patients with chronic kidney disease (CKD) are at high risk for developing cardiovascular events. However, limited evidence is available regarding the use of aspirin in CKD patients to decrease cardiovascular risk and to slow renal disease progression. STUDY DESIGN: Prospective, multicenter, open-label randomized controlled trial. SETTING AND PARTICIPANTS: One hundred eleven patients with estimated glomerular filtration rate (eGFR) 15-60 ml/min/1.73 m(2) without previous cardiovascular events. INTERVENTION: Aspirin treatment (100 mg/day) (n = 50) or usual therapy (n = 61). Mean follow-up time was 64.8 +/- 16.4 months. OUTCOMES: The primary endpoint was composed of cardiovascular death, acute coronary syndrome (nonfatal MI, coronary revascularization, or unstable angina pectoris), cerebrovascular disease, heart failure, or nonfatal peripheral arterial disease. Secondary endpoints were fatal and nonfatal coronary events, renal events (defined as doubling of serum creatinine, >/= 50% decrease in eGFR, or renal replacement therapy), and bleeding episodes. RESULTS: During follow-up, 17 and 5 participants suffered from a primary endpoint in the control and aspirin groups, respectively. Aspirin did not significantly reduce primary composite endpoint (HR, 0.396 (0.146-1.076), p = 0.069. Eight patients suffered from a fatal or nonfatal coronary event in the control group compared to no patients in the aspirin group. Aspirin significantly reduced the risk of coronary events (log-rank, 5.997; p = 0.014). Seventeen patients in the control group reached the renal outcome in comparison with 3 patients in the aspirin group. Aspirin treatment decreased renal disease progression in a model adjusted for age, baseline kidney function, and diabetes mellitus (HR, 0.272; 95% CI, 0.077-0.955; p = 0.043) but did not when adjusted for albuminuria. No differences were found in minor bleeding episodes between groups and no major bleeding was registered. LIMITATIONS: Small sample size and open-label trial. CONCLUSIONS: Long-term treatment with low-dose aspirin did not reduce the composite primary endpoint; however, there were reductions in secondary endpoints with fewer coronary events and renal outcomes. ClinicalTrials.gov Identifier: NCT01709994. FAU - Goicoechea, Marian AU - Goicoechea M AD - Nephrology Department, Hospital General Universitario Gregorio Maranon, C/ Dr Esquerdo 46, 28007, Madrid, Spain. marian.goicoechea@gmail.com. AD - Spanish Kidney Research Network (REDINREN), FEDER FUND, Madrid, Spain. marian.goicoechea@gmail.com. FAU - de Vinuesa, Soledad Garcia AU - de Vinuesa SG AD - Nephrology Department, Hospital General Universitario Gregorio Maranon, C/ Dr Esquerdo 46, 28007, Madrid, Spain. AD - Spanish Kidney Research Network (REDINREN), FEDER FUND, Madrid, Spain. FAU - Quiroga, Borja AU - Quiroga B AD - Nephrology Department, Hospital Universitario La Princesa, Madrid, Spain. FAU - Verde, Eduardo AU - Verde E AD - Nephrology Department, Hospital General Universitario Gregorio Maranon, C/ Dr Esquerdo 46, 28007, Madrid, Spain. AD - Spanish Kidney Research Network (REDINREN), FEDER FUND, Madrid, Spain. FAU - Bernis, Carmen AU - Bernis C AD - Nephrology Department, Hospital Universitario La Princesa, Madrid, Spain. FAU - Morales, Enrique AU - Morales E AD - Spanish Kidney Research Network (REDINREN), FEDER FUND, Madrid, Spain. AD - Nephrology Department, Hospital Universitario Doce de Octubre, Madrid, Spain. FAU - Fernandez-Juarez, Gema AU - Fernandez-Juarez G AD - Spanish Kidney Research Network (REDINREN), FEDER FUND, Madrid, Spain. AD - Nephrology Department, Hospital Universitario Fundacion Alcorcon, Madrid, Spain. FAU - de Sequera, Patricia AU - de Sequera P AD - Nephrology Department, Hospital Universitario Infanta Leonor, Madrid, Spain. FAU - Verdalles, Ursula AU - Verdalles U AD - Nephrology Department, Hospital General Universitario Gregorio Maranon, C/ Dr Esquerdo 46, 28007, Madrid, Spain. AD - Spanish Kidney Research Network (REDINREN), FEDER FUND, Madrid, Spain. FAU - Delgado, Ramon AU - Delgado R AD - Nephrology Department, Clinica Ruber, Madrid, Spain. FAU - Torres, Alberto AU - Torres A AD - Nephrology Department, Hospital Universitario La Paz, Madrid, Spain. FAU - Arroyo, David AU - Arroyo D AD - Nephrology Department, Hospital Universitario Severo Ochoa, Madrid, Spain. FAU - Abad, Soraya AU - Abad S AD - Nephrology Department, Hospital General Universitario Gregorio Maranon, C/ Dr Esquerdo 46, 28007, Madrid, Spain. AD - Spanish Kidney Research Network (REDINREN), FEDER FUND, Madrid, Spain. FAU - Ortiz, Alberto AU - Ortiz A AD - Spanish Kidney Research Network (REDINREN), FEDER FUND, Madrid, Spain. AD - Nephrology Department, IIS-Fundacion Jimenez Diaz UAM, Madrid, Spain. FAU - Luno, Jose AU - Luno J AD - Nephrology Department, Hospital General Universitario Gregorio Maranon, C/ Dr Esquerdo 46, 28007, Madrid, Spain. AD - Spanish Kidney Research Network (REDINREN), FEDER FUND, Madrid, Spain. LA - eng SI - ClinicalTrials.gov/NCT01709994 PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PL - United States TA - Cardiovasc Drugs Ther JT - Cardiovascular drugs and therapy JID - 8712220 RN - 0 (Cardiovascular Agents) RN - R16CO5Y76E (Aspirin) SB - IM CIN - Cardiovasc Drugs Ther. 2018 Jun;32(3):241-243. doi: 10.1007/s10557-018-6803-0. PMID: 29923131 MH - Aged MH - Aspirin/adverse effects/*therapeutic use MH - Cardiovascular Agents/adverse effects/*therapeutic use MH - Cardiovascular Diseases/diagnosis/mortality/*prevention & control MH - Disease Progression MH - Female MH - Glomerular Filtration Rate/drug effects MH - Hemorrhage/chemically induced MH - Humans MH - Kidney/*drug effects/physiopathology MH - Male MH - Middle Aged MH - Primary Prevention/*methods MH - Prospective Studies MH - Renal Insufficiency, Chronic/diagnosis/*drug therapy/mortality/physiopathology MH - Risk Factors MH - Spain MH - Time Factors MH - Treatment Outcome OTO - NOTNLM OT - Aspirin OT - Cardiovascular disease OT - Chronic kidney disease OT - Dialysis OT - Primary prevention EDAT- 2018/06/27 06:00 MHDA- 2018/12/18 06:00 CRDT- 2018/06/27 06:00 PHST- 2018/06/27 06:00 [entrez] PHST- 2018/06/27 06:00 [pubmed] PHST- 2018/12/18 06:00 [medline] AID - 10.1007/s10557-018-6802-1 [pii] AID - 10.1007/s10557-018-6802-1 [doi] PST - ppublish SO - Cardiovasc Drugs Ther. 2018 Jun;32(3):255-263. doi: 10.1007/s10557-018-6802-1. PMID- 29941316 OWN - NLM STAT- MEDLINE DCOM- 20190422 LR - 20190422 IS - 1097-6809 (Electronic) IS - 0741-5214 (Linking) VI - 69 IP - 1 DP - 2019 Jan TI - Transcarotid artery revascularization versus transfemoral carotid artery stenting in the Society for Vascular Surgery Vascular Quality Initiative. PG - 92-103.e2 LID - S0741-5214(18)31054-1 [pii] LID - 10.1016/j.jvs.2018.05.011 [doi] AB - BACKGROUND: Recent evidence from the Safety and Efficacy Study for Reverse Flow Used During Carotid Artery Stenting Procedure (ROADSTER) multicenter trial in high-risk patients undergoing transcarotid artery stenting with dynamic flow reversal reported the lowest stroke rate compared with any prospective trial of carotid artery stenting. However, clinical trials have selection criteria that exclude many patients from enrollment and are highly selective of operators performing the procedures, which limit generalizability. The aim of this study was to compare in-hospital outcomes after transcarotid artery revascularization (TCAR) and transfemoral carotid artery stenting (TFCAS) as reported in the Vascular Quality Initiative (VQI). METHODS: The Society for Vascular Surgery VQI TCAR Surveillance Project (TSP) was designed to evaluate the safety and effectiveness of TCAR in real-world practice. Data from the initial 646 patients enrolled in the TSP from March 2016 to December 2017 were analyzed and compared with those of patients who underwent TFCAS between 2005 and 2017. Patients with tandem, traumatic, or dissection lesions were excluded. Multivariable logistic regression and 1:1 coarsened exact matching were used to analyze neurologic adverse events (stroke and transient ischemic attacks [TIAs]) and in-hospital mortality. Patients in the two procedures were matched on age, ethnicity, coronary artery disease, congestive heart failure, prior coronary artery bypass graft or percutaneous coronary intervention, chronic kidney disease, degree of ipsilateral stenosis, American Society of Anesthesiologists class, symptomatic status, restenosis, anatomic and medical risk, and urgency of the procedure. RESULTS: Compared with patients undergoing TFCAS (n = 10,136), those undergoing TCAR (n = 638) were significantly older, had more cardiac comorbidities, were more likely to be asymptomatic, and were less likely to have a recurrent stenosis. The rates of in-hospital TIA/stroke as well as of TIA/stroke/death were significantly higher in TFCAS compared with TCAR (3.3% vs 1.9% [P = .04] and 3.8% vs 2.2% [P = .04], respectively). In both procedures, symptomatic patients had higher rates of TIA/stroke/death compared with asymptomatic patients (TCAR, 3.7% vs 1.4% [P = .06]; TFCAS, 5.3% vs 2.7% [P < .001]). After multivariable adjustment, there was a trend of increased stroke or death rates in TFCAS compared with TCAR, but it was not statistically significant (2.5% vs 1.7%; P = .25; odds ratio, 1.75, 95% confidence interval, 0.85-3.62). However, TFCAS was associated with twice the odds of in-hospital adverse neurologic events and TIA/stroke/death compared with TCAR (odds ratio, 2.10; 95% confidence interval, 1.08-4.08; P = .03), independent of symptom status. Coarsened exact matching showed similar results. CONCLUSIONS: Compared with patients undergoing TFCAS, patients undergoing TCAR had significantly more medical comorbidities but similar stroke/death rates and half the risk of in-hospital TIA/stroke/death. These results persisted despite rigorous adjustment and matching of potential confounders. This initial evaluation of the VQI TSP demonstrates the ability to rapidly monitor new devices and procedures using the VQI. Although it is preliminary, this is the first study to demonstrate the benefit of TCAR compared with TFCAS in real-world practice. These results need to be confirmed by a clinical trial. CI - Copyright (c) 2018 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved. FAU - Malas, Mahmoud B AU - Malas MB AD - Johns Hopkins Bayview Vascular and Endovascular Research Center, Baltimore, Md. Electronic address: bmalas1@jhmi.edu. FAU - Dakour-Aridi, Hanaa AU - Dakour-Aridi H AD - Johns Hopkins Bayview Vascular and Endovascular Research Center, Baltimore, Md. FAU - Wang, Grace J AU - Wang GJ AD - Division of Vascular Surgery and Endovascular Therapy, Hospital of the University of Pennsylvania, Philadelphia, Pa. FAU - Kashyap, Vikram S AU - Kashyap VS AD - Division of Vascular Surgery and Endovascular Therapy, University Hospitals Cleveland Medical Center, Cleveland, Ohio. FAU - Motaganahalli, Raghu L AU - Motaganahalli RL AD - Division of Vascular Surgery, Department of Surgery, Indiana University School of Medicine, Indianapolis, Ind. FAU - Eldrup-Jorgensen, Jens AU - Eldrup-Jorgensen J AD - Division of Vascular Surgery and Endovascular Therapy, Maine Medical Center, Portland, Me. FAU - Cronenwett, Jack L AU - Cronenwett JL AD - Section of Vascular Surgery and The Dartmouth Institute, Dartmouth-Hitchcock Medical Center, Lebanon, NH. FAU - Schermerhorn, Marc L AU - Schermerhorn ML AD - Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Boston, Mass. LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study DEP - 20180622 PL - United States TA - J Vasc Surg JT - Journal of vascular surgery JID - 8407742 SB - IM CIN - J Vasc Surg. 2019 Jul;70(1):336-337. doi: 10.1016/j.jvs.2019.01.059. PMID: 31230655 CIN - J Vasc Surg. 2019 Jul;70(1):337. doi: 10.1016/j.jvs.2019.03.001. PMID: 31230656 CIN - J Vasc Surg. 2019 Nov;70(5):1726-1727. doi: 10.1016/j.jvs.2019.05.036. PMID: 31653388 MH - Aged MH - Aged, 80 and over MH - Carotid Stenosis/complications/diagnostic imaging/mortality/*surgery MH - *Catheterization, Peripheral/adverse effects/mortality MH - Endovascular Procedures/adverse effects/*instrumentation/mortality MH - Female MH - *Femoral Artery/diagnostic imaging MH - Hospital Mortality MH - Humans MH - Ischemic Attack, Transient/etiology/mortality MH - Male MH - Middle Aged MH - Punctures MH - Registries MH - Retrospective Studies MH - Risk Factors MH - *Stents MH - Stroke/etiology/mortality MH - Time Factors MH - Treatment Outcome MH - United States MH - Vascular Surgical Procedures/adverse effects/*instrumentation/mortality OTO - NOTNLM OT - Carotid artery stenting OT - TCAR Surveillance Project OT - Transcarotid OT - Transfemoral OT - Vascular Quality Initiative EDAT- 2018/06/27 06:00 MHDA- 2019/04/23 06:00 CRDT- 2018/06/27 06:00 PHST- 2018/03/16 00:00 [received] PHST- 2018/05/11 00:00 [accepted] PHST- 2018/06/27 06:00 [pubmed] PHST- 2019/04/23 06:00 [medline] PHST- 2018/06/27 06:00 [entrez] AID - S0741-5214(18)31054-1 [pii] AID - 10.1016/j.jvs.2018.05.011 [doi] PST - ppublish SO - J Vasc Surg. 2019 Jan;69(1):92-103.e2. doi: 10.1016/j.jvs.2018.05.011. Epub 2018 Jun 22. PMID- 29925472 OWN - NLM STAT- MEDLINE DCOM- 20190311 LR - 20190311 IS - 1874-1754 (Electronic) IS - 0167-5273 (Linking) VI - 268 DP - 2018 Oct 1 TI - Impact of statin-ezetimibe combination on coronary atheroma plaque in patients with and without chronic kidney disease - Sub-analysis of PRECISE-IVUS trial. PG - 23-26 LID - S0167-5273(18)30338-3 [pii] LID - 10.1016/j.ijcard.2018.04.051 [doi] AB - BACKGROUND: Chronic kidney disease (CKD) deteriorates the prognosis of patients undergoing percutaneous coronary intervention (PCI). Because coronary artery disease (CAD) is the major cause of death in CKD patients, cardiovascular risk reduction has been clinically important in CKD. We hypothesized intensive lipid-lowering with statin/ezetimibe attenuated coronary atherosclerotic development even in patients with CKD. METHODS: In the prospective, randomized, controlled, multicenter PRECISE-IVUS trial, 246 patients undergoing intravascular ultrasound (IVUS)-guided PCI were randomly assigned to receive atorvastatin/ezetimibe combination or atorvastatin alone (the dosage of atorvastatin was up-titrated to achieve the level of low-density lipoprotein cholesterol < 70 mg/dL). Serial volumetric IVUS findings obtained at baseline and 9-12 month follow-up to quantify the coronary plaque response in 202 patients were compared stratified by the presence or absence of CKD. RESULTS: CKD was observed in 52 patients (26%) among 202 enrolled patients. Compared with the non-CKD group, the CKD group was significantly older (71.5 +/- 8.6 years vs. 64.4 +/- 9.6 years, P < 0.001) with similar prevalence of comorbid coronary risk factors and lipid profiles. Similar to the non-CKD group (-1.4 [-2.8 to -0.1]% vs. -0.2 [-1.7 to 1.0]%, P = 0.002), the atorvastatin/ezetimibe combination significantly reduced ∆PAV compared with atorvastatin alone even in the CKD group (-2.6 [-5.6 to -0.4]% vs. -0.9 [-2.4 to 0.2]%, P = 0.04). CONCLUSIONS: As with non-CKD, intensive lipid-lowering therapy with atorvastatin/ezetimibe demonstrated stronger coronary plaque regression effect even in patients with CKD compared with atorvastatin monotherapy. TRIAL REGISTRATION: NCT01043380 (ClinicalTrials.gov). CI - Published by Elsevier B.V. FAU - Fujisue, Koichiro AU - Fujisue K AD - Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan. FAU - Nagamatsu, Suguru AU - Nagamatsu S AD - Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan. FAU - Shimomura, Hideki AU - Shimomura H AD - Department of Cardiovascular Medicine, Fukuoka Tokushukai Medical Center, Kasuga, Japan. FAU - Yamashita, Takuro AU - Yamashita T AD - Matsunaga Clinic, Omuta, Japan. FAU - Nakao, Koichi AU - Nakao K AD - Division of Cardiology, Saiseikai Kumamoto Hospital Cardiovascular Center, Kumamoto, Japan. FAU - Nakamura, Sunao AU - Nakamura S AD - Interventional Cardiology Unit, New Tokyo Hospital, Matsudo, Japan. FAU - Ishihara, Masaharu AU - Ishihara M AD - Division of Coronary Heart Disease, Hyogo College of Medicine, Nishinomiya, Japan. FAU - Matsui, Kunihiko AU - Matsui K AD - Department of Community Medicine, Kumamoto University, Kumamoto, Japan. FAU - Yamamoto, Nobuyasu AU - Yamamoto N AD - Division of Cardiology, Miyazaki Prefectural Nobeoka Hospital, Nobeoka, Japan. FAU - Koide, Shunichi AU - Koide S AD - Division of Cardiology, Health Insurance Kumamoto General Hospital, Yatsushiro, Japan. FAU - Matsumura, Toshiyuki AU - Matsumura T AD - Division of Cardiology, Japan Labor Health and Welfare Organization Kumamoto Rosai Hospital, Yatsushiro, Japan. FAU - Fujimoto, Kazuteru AU - Fujimoto K AD - Department of Cardiology, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan. FAU - Tsunoda, Ryusuke AU - Tsunoda R AD - Division of Cardiology, Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan. FAU - Morikami, Yasuhiro AU - Morikami Y AD - Division of Cardiology, Sakura Jyuji Hospital, Kumamoto, Japan. FAU - Matsuyama, Koshi AU - Matsuyama K AD - Division of Cardiology, Arao Central Hospital, Arao, Japan. FAU - Oshima, Shuichi AU - Oshima S AD - Division of Cardiology, Kumamoto Central Hospital, Kumamoto, Japan. FAU - Sakamoto, Kenji AU - Sakamoto K AD - Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan. FAU - Izumiya, Yasuhiro AU - Izumiya Y AD - Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan. FAU - Kaikita, Koichi AU - Kaikita K AD - Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan. FAU - Hokimoto, Seiji AU - Hokimoto S AD - Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan. FAU - Ogawa, Hisao AU - Ogawa H AD - National Cerebral and Cardiovascular Center, Suita, Japan. FAU - Tsujita, Kenichi AU - Tsujita K AD - Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan. Electronic address: tsujita@kumamoto-u.ac.jp. LA - eng SI - ClinicalTrials.gov/NCT01043380 PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20180618 PL - Netherlands TA - Int J Cardiol JT - International journal of cardiology JID - 8200291 RN - 0 (Anticholesteremic Agents) RN - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors) RN - EOR26LQQ24 (Ezetimibe) SB - IM CIN - Int J Cardiol. 2018 Oct 1;268:36-37. doi: 10.1016/j.ijcard.2018.05.041. PMID: 30041796 MH - Anticholesteremic Agents/*administration & dosage MH - Cohort Studies MH - Coronary Artery Disease/diagnostic imaging/*drug therapy/epidemiology MH - Drug Therapy, Combination MH - Ezetimibe/*administration & dosage MH - Female MH - Follow-Up Studies MH - Humans MH - Hydroxymethylglutaryl-CoA Reductase Inhibitors/*administration & dosage MH - Male MH - Plaque, Atherosclerotic/diagnostic imaging/*drug therapy/epidemiology MH - Prospective Studies MH - Renal Insufficiency, Chronic/diagnostic imaging/*drug therapy/epidemiology OTO - NOTNLM OT - Chronic kidney disease OT - Coronary plaque OT - Ezetimibe OT - Intravascular ultrasound OT - Statins EDAT- 2018/06/22 06:00 MHDA- 2019/03/12 06:00 CRDT- 2018/06/22 06:00 PHST- 2018/01/17 00:00 [received] PHST- 2018/03/19 00:00 [revised] PHST- 2018/04/10 00:00 [accepted] PHST- 2018/06/22 06:00 [pubmed] PHST- 2019/03/12 06:00 [medline] PHST- 2018/06/22 06:00 [entrez] AID - S0167-5273(18)30338-3 [pii] AID - 10.1016/j.ijcard.2018.04.051 [doi] PST - ppublish SO - Int J Cardiol. 2018 Oct 1;268:23-26. doi: 10.1016/j.ijcard.2018.04.051. Epub 2018 Jun 18. PMID- 29896264 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20200930 IS - 1792-0981 (Print) IS - 1792-1015 (Electronic) IS - 1792-0981 (Linking) VI - 16 IP - 1 DP - 2018 Jul TI - Effects of hyperglycaemia and elevated glycosylated haemoglobin on contrast-induced nephropathy after coronary angiography. PG - 377-383 LID - 10.3892/etm.2018.6183 [doi] AB - In patients undergoing percutaneous coronary intervention after acute myocardial infarction, hyperglycaemia on admission is associated with an increased risk of contrast-induced nephropathy (CIN). However, the effects of hyperglycaemia and elevated glycosylated haemoglobin (HbA1c) on CIN have remained to be fully elucidated. Therefore, a prospective cohort study was performed, comprising 258 patients who underwent coronary angiography between May 2017 and November 2017 at Zhongda Hospital affiliated with Southeast University (Nanjing, China). According to the diagnostic criteria for CIN (increase of serum creatinine by >44.2 micromol/l or by 25% within 48-72 h of using contrast agent), the patients were divided into two groups: CIN (45 cases) and non-CIN (213 cases). For all patients, the baseline data, medical history, laboratory parameters, medication history and intraoperative situation were recorded and assessed using single-factor analysis and multiple logistic regression analysis to analyse the risk factors of CIN. The incidence of CIN in the hyperglycaemia group (blood glucose on admission, >11.1 mmol/l) was 25%, compared with 13.8% in the non-hyperglycaemia group (P=0.026). Furthermore, the incidence of CIN in the elevated HbA1c group (HbA1c on admission, upper limit of normal) was 26.1%, compared with 14.3% in the group without elevated HbA1c (P=0.027). Hyperglycaemia was present on hospital admission in 84 of 258 patients (32.6%). The percentage of patients with elevated HbA1c was 26.7%. Age, estimated glomerular filtration rate, pre-operative blood cholesterol, hyperglycaemia on admission and elevated HbA1c were all identified to be associated with CIN. According to the multivariate logistic regression analysis, hyperglycaemia was an independent predictor of CIN (odds ratio, 2.815; 95% confidence interval, 1.042-4.581; P=0.029). In the acute coronary syndrome (ACS) and diabetes subgroups, hyperglycaemia was significantly associated with CIN. In the ACS subgroup, the incidence of CIN was 38.1%. It was indicated that hyperglycaemia is an independent risk factor for CIN, particularly in patients with ACS or diabetes. Trial registration no. ChiCTR-OOC-17011466. FAU - Qin, Yu-Han AU - Qin YH AD - Medical Department of Southeast University, Nanjing, Jiangsu 210009, P.R. China. FAU - Yan, Gao-Liang AU - Yan GL AD - Department of Cardiology, Zhongda Hospital Affiliated to Southeast University, Nanjing, Jiangsu 210009, P.R. China. FAU - Ma, Chang-Le AU - Ma CL AD - Medical Department of Southeast University, Nanjing, Jiangsu 210009, P.R. China. FAU - Tang, Cheng-Chun AU - Tang CC AD - Department of Cardiology, Zhongda Hospital Affiliated to Southeast University, Nanjing, Jiangsu 210009, P.R. China. FAU - Ma, Gen-Shan AU - Ma GS AD - Department of Cardiology, Zhongda Hospital Affiliated to Southeast University, Nanjing, Jiangsu 210009, P.R. China. LA - eng PT - Journal Article DEP - 20180518 PL - Greece TA - Exp Ther Med JT - Experimental and therapeutic medicine JID - 101531947 PMC - PMC5995054 OTO - NOTNLM OT - contrast-induced nephropathy OT - glycosylated haemoglobin OT - hyperglycaemia EDAT- 2018/06/14 06:00 MHDA- 2018/06/14 06:01 PMCR- 2018/05/18 CRDT- 2018/06/14 06:00 PHST- 2017/11/25 00:00 [received] PHST- 2018/04/06 00:00 [accepted] PHST- 2018/06/14 06:00 [entrez] PHST- 2018/06/14 06:00 [pubmed] PHST- 2018/06/14 06:01 [medline] PHST- 2018/05/18 00:00 [pmc-release] AID - ETM-0-0-6183 [pii] AID - 10.3892/etm.2018.6183 [doi] PST - ppublish SO - Exp Ther Med. 2018 Jul;16(1):377-383. doi: 10.3892/etm.2018.6183. Epub 2018 May 18. PMID- 29893677 OWN - NLM STAT- MEDLINE DCOM- 20180822 LR - 20181023 IS - 1522-6662 (Electronic) IS - 1098-3511 (Linking) VI - 21 IP - 3 DP - 2018 May 16 TI - Prospective, Randomized Un-Blinded Three Arm Controlled Study in Coronary Artery Revascularization with Minimal Invasive Extracorporeal Circulation Systems (MiECC): Surrogate Parameter Analysis of Biocompatibility. PG - E179-E186 LID - 10.1532/hsf.1946 [doi] AB - OBJECTIVES: Minimal extracorporeal circulation techniques and systems (MiECC) may reduce the negative side effects of conventional extracorporeal circulation (ECC). However, it is still unclear as to what this is caused by, the reduced priming volume and hemodilution, or the avoidance of blood-air contact and dispersion of mediastinal debris into the systemic circulation. The aim of the trial was the comparison of MiECC to an open ECC setup (openECC) or a system with reduced blood air and debris interaction (closeECC). Methods: In a prospective randomized trial, 72 patients (73 +/- 5.3 years; 83% male) referred for coronary artery bypass graft (CABG) were randomly assigned either to MiECC (priming volume 550mL), closeECC, or openECC (priming volume 1250mL). The laboratory surrogate endpoints (renal function, inflammatory response, ischemia, coagulation, and hemolysis) and clinical data were measured at six different time points (T1-6). Results: Patients were comparable for all preoperative variables. The operation times (MiECC 261 +/- 79min; openECC 264 +/- 75min; closeECC 231 +/- 68min) and perfusion times (MiECC 115 +/- 49min; openECC353 107 +/- 37min; closeECC 99 +/- 22min) revealed a trend of faster performance in the closeECC group (P < .05). Pro-inflammatory cytokines, ischemia, and coagulation markers were significantly elevated postoperatively in all cardiopulmonary bypass types, and decreased to pre-baseline levels at discharge (T5) without identifiable statistical differences between the three study groups. Free-hemoglobin was not significantly increased by centrifugal pump or cell saver procedures. Significant intraoperative hemodilution effects due to the different priming volumes were demonstrated only at the end of operation (T2) (MiECC Hb 9.6 +/- 1.1g/dL; openECC Hb 9.0 +/- 0.8g/dL; closeECC Hb 8.7 +/- 1g/dL; P =. 01). CONCLUSION: Neither the hemodilution, suction technique (MiECC), nor blood-air interface (closeECC) could show sustainable benefits in this underpowered study, compared to conventional ECC systems (openECC) in a high volume series of surrogate parameters. FAU - Kiessling, Arndt H AU - Kiessling AH AD - Department of Clinical Research, Medical School Berlin, Berlin, Germany. FAU - Keller, Harald AU - Keller H AD - University Hospital, Department of Thoracic and Cardiovascular Surgery, Frankfurt/Main, Germany. FAU - Moritz, Anton AU - Moritz A AD - University Hospital, Department of Thoracic and Cardiovascular Surgery, Frankfurt/Main, Germany. LA - eng PT - Journal Article PT - Randomized Controlled Trial DEP - 20180516 PL - United States TA - Heart Surg Forum JT - The heart surgery forum JID - 100891112 RN - 0 (Biomarkers) SB - IM MH - Aged MH - Biomarkers/*blood MH - Coronary Artery Bypass/*methods MH - Coronary Artery Disease/blood/*surgery MH - Equipment Design MH - Extracorporeal Circulation/*instrumentation MH - Female MH - Hemodilution MH - Humans MH - Male MH - Minimally Invasive Surgical Procedures/*methods MH - Prospective Studies MH - Treatment Outcome EDAT- 2018/06/13 06:00 MHDA- 2018/08/23 06:00 CRDT- 2018/06/13 06:00 PHST- 2017/11/30 00:00 [received] PHST- 2018/04/30 00:00 [accepted] PHST- 2018/06/13 06:00 [entrez] PHST- 2018/06/13 06:00 [pubmed] PHST- 2018/08/23 06:00 [medline] AID - 10.1532/hsf.1946 [doi] PST - epublish SO - Heart Surg Forum. 2018 May 16;21(3):E179-E186. doi: 10.1532/hsf.1946. PMID- 29861332 OWN - NLM STAT- MEDLINE DCOM- 20200318 LR - 20200318 IS - 1878-0938 (Electronic) IS - 1878-0938 (Linking) VI - 20 IP - 2 DP - 2019 Feb TI - Long-term clinical outcomes of permanent-polymer everolimus-eluting stent implantation following rotational atherectomy for severely calcified de novo coronary lesions: Results of a 22-center study (Tokyo-MD PCI Study). PG - 120-125 LID - S1553-8389(18)30177-5 [pii] LID - 10.1016/j.carrev.2018.04.022 [doi] AB - BACKGROUND: Long-term clinical outcomes of permanent polymer everolimus-eluting stent (PP-EES) implantation after rotational atherectomy (RA) have not been fully evaluated. We sought to investigate the long-term clinical outcomes of PP-EES implantation after RA and assess the impact of hemodialysis on this treatment strategy. METHODS: Patients who underwent percutaneous coronary intervention (PCI) with PP-EES at 22 institutions between January 2010 and December 2011 were enrolled in this multicenter, observational trial. From a total of 1918 registered patients, 113 patients with 115 de-novo lesions who underwent PCI with PP-EES following RA were retrospectively analyzed. The primary endpoint was a major adverse cardiac event (MACE) defined as the composite of cardiac death, non-fatal myocardial infarction (MI), and clinically driven target lesion revascularization (TLR). RESULTS: Long-term follow-up was available for 112 patients (99.1%). The median follow-up period was 2.9 (interquartile range 1.9-3.6) years. The mean age of the patients was 72.3 +/- 8.8 years and 64 patients (56.6%) had chronic kidney disease (>/=stage 3, 42 on hemodialysis). The cumulative incidences of MACE, non-fatal MI, and TLR were 22.1%, 5.3%, and 10.6%, respectively. Cox's proportional hazards analysis showed that the independent predictors of TLR were hemodialysis and chronic total occlusion. (HR, 14.1; 95% CI, 1.74-155.5; p = 0.01, HR, 9.01; 95% CI, 1.34-62.5; p = 0.02). CONCLUSIONS: PP-EES implantation after lesion modification by RA is considered to be a feasible treatment strategy for heavily calcified lesions. Hemodialysis and chronic total occlusion appeared to be associated with TLR. CI - Copyright (c) 2018 Elsevier Inc. All rights reserved. FAU - Otaki, Yoichi AU - Otaki Y AD - Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan. Electronic address: otaki-y@umin.ac.jp. FAU - Ashikaga, Takashi AU - Ashikaga T AD - Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan. FAU - Sasaoka, Taro AU - Sasaoka T AD - Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan. FAU - Kurihara, Ken AU - Kurihara K AD - Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan. FAU - Yoshikawa, Shunji AU - Yoshikawa S AD - Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan. FAU - Isobe, Mitsuaki AU - Isobe M AD - Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan. CN - Tokyo-MD PCI Study Investigators AD - Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan. LA - eng PT - Journal Article PT - Multicenter Study PT - Observational Study DEP - 20180427 PL - United States TA - Cardiovasc Revasc Med JT - Cardiovascular revascularization medicine : including molecular interventions JID - 101238551 RN - 0 (Cardiovascular Agents) RN - 0 (Polymers) RN - 9HW64Q8G6G (Everolimus) SB - IM CIN - Cardiovasc Revasc Med. 2019 Feb;20(2):91-92. doi: 10.1016/j.carrev.2019.01.015. PMID: 30799046 MH - Aged MH - Aged, 80 and over MH - *Atherectomy, Coronary/adverse effects/mortality MH - Cardiovascular Agents/*administration & dosage/adverse effects MH - Coronary Artery Disease/diagnostic imaging/mortality/*therapy MH - *Drug-Eluting Stents MH - Everolimus/*administration & dosage/adverse effects MH - Female MH - Humans MH - Incidence MH - Male MH - Middle Aged MH - Myocardial Infarction/mortality/therapy MH - Percutaneous Coronary Intervention/adverse effects/*instrumentation MH - *Polymers MH - Prosthesis Design MH - Renal Dialysis/adverse effects MH - Retrospective Studies MH - Risk Assessment MH - Risk Factors MH - Severity of Illness Index MH - Time Factors MH - Tokyo/epidemiology MH - Treatment Outcome MH - Vascular Calcification/diagnostic imaging/mortality/*therapy OTO - NOTNLM OT - Calcified coronary lesion OT - Everolimus-eluting stent OT - Hemodialysis OT - Rotational atherectomy EDAT- 2018/06/05 06:00 MHDA- 2020/03/19 06:00 CRDT- 2018/06/05 06:00 PHST- 2017/12/21 00:00 [received] PHST- 2018/04/24 00:00 [revised] PHST- 2018/04/24 00:00 [accepted] PHST- 2018/06/05 06:00 [pubmed] PHST- 2020/03/19 06:00 [medline] PHST- 2018/06/05 06:00 [entrez] AID - S1553-8389(18)30177-5 [pii] AID - 10.1016/j.carrev.2018.04.022 [doi] PST - ppublish SO - Cardiovasc Revasc Med. 2019 Feb;20(2):120-125. doi: 10.1016/j.carrev.2018.04.022. Epub 2018 Apr 27. PMID- 29793629 OWN - NLM STAT- MEDLINE DCOM- 20190806 LR - 20191210 IS - 1558-3597 (Electronic) IS - 0735-1097 (Linking) VI - 71 IP - 21 DP - 2018 May 29 TI - Inhibition of Interleukin-1beta by Canakinumab and Cardiovascular Outcomes in Patients With Chronic Kidney Disease. PG - 2405-2414 LID - S0735-1097(18)34271-2 [pii] LID - 10.1016/j.jacc.2018.03.490 [doi] AB - BACKGROUND: Inflammation contributes to chronic kidney disease (CKD), in part mediated through activation of interleukin (IL)-1beta by the NLRP3 inflammasome within the kidney. This process also likely contributes to the accelerated atherosclerosis associated with nephropathy. OBJECTIVES: The authors hypothesized that canakinumab, a human monoclonal antibody targeting IL-1beta, might reduce cardiovascular event rates and improve renal function among post-myocardial infarction patients with CKD. METHODS: Stable post-myocardial infarction patients with high-sensitivity C-reactive protein (hsCRP) >/= 2mg/l were randomly allocated to placebo or to 1 of 3 doses of canakinumab (50, 150, or 300 mg) given subcutaneously once every 3 months. Participants were followed for incident myocardial infarction, stroke, hospitalization for unstable angina requiring urgent revascularization, cardiovascular death, or death from any cause over a median follow-up period of 3.7 years (maximum 5 years). All patients additionally had serial monitoring of estimated glomerular filtration rate (eGFR), creatinine, the urine albumin to creatinine ratio (uACR), and were monitored for adverse renal and urinary events. RESULTS: Of 10,061 participants, 1,875 (18.6%) had baseline eGFR <60 ml/min/1.73 m(2). These moderate CKD patients had higher incidence rates for major adverse vascular events compared with those with eGFR >/=60 ml/min/1.73 m(2) (6.92 vs. 4.13 per 100 person-years; p < 0.0001). Random allocation to canakinumab reduced the risk of major adverse cardiovascular events among those with CKD (hazard ratio: 0.82; 95% confidence interval: 0.68 to 1.00; p = 0.05) with the largest cardiovascular benefits accruing among those who achieved on-treatment hsCRP levels below 2 mg/l measured after taking the first dose (hazard ratio: 0.68; 95% confidence interval: 0.53 to 0.86; p = 0.0015). Comparable effects were observed among those with baseline albuminuria or diabetes. Canakinumab had neither clinically meaningful benefits nor substantive harms with respect to serial measures of eGFR, creatinine, the uACR, or reported adverse renal events during trial follow-up. CONCLUSIONS: IL-1beta inhibition with canakinumab reduces major adverse cardiovascular event rates among high-risk atherosclerosis patients with CKD, particularly among those with a robust anti-inflammatory response to initial treatment. These cardiovascular benefits accrued with no adverse clinical renal events. (Canakinumab Anti-inflammatory Thrombosis Outcomes Study [CANTOS]; NCT01327846). CI - Copyright (c) 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Ridker, Paul M AU - Ridker PM AD - Center for Cardiovascular Disease Prevention, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: pridker@bwh.harvard.edu. FAU - MacFadyen, Jean G AU - MacFadyen JG AD - Center for Cardiovascular Disease Prevention, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. FAU - Glynn, Robert J AU - Glynn RJ AD - Center for Cardiovascular Disease Prevention, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. FAU - Koenig, Wolfgang AU - Koenig W AD - Deutsches Herzzentrum Munchen, Technische Universitat Munchen, DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany; University of Ulm Medical Center, Department of Internal Medicine II-Cardiology, Ulm, Germany. FAU - Libby, Peter AU - Libby P AD - Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. FAU - Everett, Brendan M AU - Everett BM AD - Center for Cardiovascular Disease Prevention, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. FAU - Lefkowitz, Martin AU - Lefkowitz M AD - Novartis Pharmaceutical Corporation, East Hanover, New Jersey, and Basel, Switzerland. FAU - Thuren, Tom AU - Thuren T AD - Novartis Pharmaceutical Corporation, East Hanover, New Jersey, and Basel, Switzerland. FAU - Cornel, Jan H AU - Cornel JH AD - Noordwest Ziekenhuisgroep, Alkmaar, the Netherlands. LA - eng SI - ClinicalTrials.gov/NCT01327846 PT - Journal Article PT - Randomized Controlled Trial PL - United States TA - J Am Coll Cardiol JT - Journal of the American College of Cardiology JID - 8301365 RN - 0 (Antibodies, Monoclonal) RN - 0 (Antibodies, Monoclonal, Humanized) RN - 0 (Interleukin-1beta) RN - 37CQ2C7X93 (canakinumab) CIN - J Am Coll Cardiol. 2018 May 29;71(21):2415-2418. doi: 10.1016/j.jacc.2018.04.008. PMID: 29793630 MH - Aged MH - Antibodies, Monoclonal/pharmacology/*therapeutic use MH - Antibodies, Monoclonal, Humanized MH - Cardiovascular Diseases/*diagnosis/*drug therapy/mortality MH - Double-Blind Method MH - Female MH - Follow-Up Studies MH - Humans MH - Interleukin-1beta/*antagonists & inhibitors MH - Male MH - Middle Aged MH - Mortality/trends MH - Renal Insufficiency, Chronic/*diagnosis/*drug therapy/mortality MH - Treatment Outcome OTO - NOTNLM OT - atherosclerosis OT - clinical trial OT - inflammation OT - interleukin-1 EDAT- 2018/05/26 06:00 MHDA- 2019/08/07 06:00 CRDT- 2018/05/26 06:00 PHST- 2018/02/25 00:00 [received] PHST- 2018/03/19 00:00 [revised] PHST- 2018/03/19 00:00 [accepted] PHST- 2018/05/26 06:00 [entrez] PHST- 2018/05/26 06:00 [pubmed] PHST- 2019/08/07 06:00 [medline] AID - S0735-1097(18)34271-2 [pii] AID - 10.1016/j.jacc.2018.03.490 [doi] PST - ppublish SO - J Am Coll Cardiol. 2018 May 29;71(21):2405-2414. doi: 10.1016/j.jacc.2018.03.490. PMID- 29789335 OWN - NLM STAT- MEDLINE DCOM- 20191107 LR - 20191210 IS - 2047-9980 (Electronic) IS - 2047-9980 (Linking) VI - 7 IP - 11 DP - 2018 May 22 TI - Prediction of Thrombotic and Bleeding Events After Percutaneous Coronary Intervention: CREDO-Kyoto Thrombotic and Bleeding Risk Scores. LID - 10.1161/JAHA.118.008708 [doi] LID - e008708 AB - BACKGROUND: Prediction of thrombotic and bleeding risk is important to optimize antithrombotic therapy after percutaneous coronary intervention. METHODS AND RESULTS: We developed the prediction rules for thrombotic and bleeding events separately in Japanese patients. Derivation and validation cohorts consisted of 4778 patients from CREDO-Kyoto (Coronary Revascularization Demonstrating Outcome Study in Kyoto) registry cohort 2 and 4669 patients from RESET (Randomized Evaluation of Sirolimus-Eluting Versus Everolimus-Eluting Stent Trial) and NEXT (Nobori Biolimus-Eluting Versus Xience/Promus Everolimus-Eluting Stent Trial). Primary thrombotic and bleeding events were a composite of myocardial infarction, definite or probable stent thrombosis or ischemic stroke, and GUSTO (Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries) moderate or severe bleeding. The prediction rule for thrombosis assigned 2 points for severe chronic kidney disease, atrial fibrillation, peripheral vascular disease, and anemia and 1 point for age >/=75 years, heart failure, diabetes mellitus, and chronic total occlusion. The prediction rule for bleeding assigned 2 points for thrombocytopenia, severe chronic kidney disease, peripheral vascular disease, and heart failure and 1 point for prior myocardial infarction, malignancy, and atrial fibrillation. In derivation and validation cohorts, area under the curve was 0.68 and 0.64, respectively, for thrombosis and 0.66 and 0.66, respectively, for bleeding. In the validation cohort, a high thrombosis risk score (>/=4, n=682) was associated with higher 3-year incidence of thrombotic events than a score that was intermediate (2-3, n=1178) or low (0-1, n=2809) (7.6%, 3.7%, versus 2.4%, respectively; P<0.0001). A high bleeding risk score (>/=3, n=666) was associated with higher incidence of bleeding than scores that were intermediate (1-2, n=1802) or low (0, n=2201) (8.8%, 4.1%, versus 2.3%, respectively; P<0.0001). Among 682 patients at high thrombotic risk, only 39 (5.7%) had low bleeding risk, whereas 401 (58.8%) had high bleeding risk with very high incidence of bleeding (11.6%). CONCLUSIONS: CREDO-Kyoto thrombotic and bleeding risk scores demonstrated modest accuracy in stratifying thrombotic and bleeding risks; however, a large proportion of patients at high thrombotic risk also had high bleeding risk. CI - (c) 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. FAU - Natsuaki, Masahiro AU - Natsuaki M AD - Department of Cardiovascular Medicine, Saga University, Saga, Japan. FAU - Morimoto, Takeshi AU - Morimoto T AD - Department of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya, Japan. FAU - Yamaji, Kyohei AU - Yamaji K AD - Division of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan. FAU - Watanabe, Hirotoshi AU - Watanabe H AD - Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan. FAU - Yoshikawa, Yusuke AU - Yoshikawa Y AD - Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan. FAU - Shiomi, Hiroki AU - Shiomi H AD - Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan. FAU - Nakagawa, Yoshihisa AU - Nakagawa Y AD - Division of Cardiology, Tenri Hospital, Tenri, Japan. FAU - Furukawa, Yutaka AU - Furukawa Y AD - Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan. FAU - Kadota, Kazushige AU - Kadota K AD - Division of Cardiology, Kurashiki Central Hospital, Kurashiki, Japan. FAU - Ando, Kenji AU - Ando K AD - Division of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan. FAU - Akasaka, Takashi AU - Akasaka T AD - Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan. FAU - Hanaoka, Keiichi Igarashi AU - Hanaoka KI AD - Division of Cardiology, Hanaokaseishu Memorial Cardiovascular Clinic, Sapporo, Japan. FAU - Kozuma, Ken AU - Kozuma K AD - Division of Cardiology, Teikyo University Hospital, Tokyo, Japan. FAU - Tanabe, Kengo AU - Tanabe K AD - Division of Cardiology, Mitsui Memorial Hospital, Tokyo, Japan. FAU - Morino, Yoshihiro AU - Morino Y AD - Division of Cardiology, Iwate Medical University Hospital, Morioka, Japan. FAU - Muramatsu, Toshiya AU - Muramatsu T AD - Division of Cardiology, Tokyo Hospital, Tokyo, Japan. FAU - Kimura, Takeshi AU - Kimura T AD - Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan taketaka@kuhp.kyoto-u.ac.jp. CN - CREDO-Kyoto PCI/CABG Registry Cohort 2, RESET, and NEXT trial investigators LA - eng PT - Journal Article PT - Observational Study PT - Research Support, Non-U.S. Gov't PT - Validation Study DEP - 20180522 PL - England TA - J Am Heart Assoc JT - Journal of the American Heart Association JID - 101580524 RN - 0 (Fibrinolytic Agents) SB - IM MH - Aged MH - Coronary Thrombosis/diagnosis/*etiology/prevention & control MH - Databases, Factual MH - *Decision Support Techniques MH - Female MH - Fibrinolytic Agents/*adverse effects MH - Hemorrhage/*chemically induced MH - Humans MH - Japan MH - Male MH - Middle Aged MH - Percutaneous Coronary Intervention/*adverse effects/instrumentation MH - Predictive Value of Tests MH - Randomized Controlled Trials as Topic MH - Registries MH - Reproducibility of Results MH - Risk Assessment MH - Risk Factors MH - Stents MH - Time Factors MH - Treatment Outcome PMC - PMC6015347 OTO - NOTNLM OT - bleeding OT - coronary artery disease OT - thrombosis EDAT- 2018/05/24 06:00 MHDA- 2019/11/08 06:00 PMCR- 2018/06/05 CRDT- 2018/05/24 06:00 PHST- 2018/05/24 06:00 [entrez] PHST- 2018/05/24 06:00 [pubmed] PHST- 2019/11/08 06:00 [medline] PHST- 2018/06/05 00:00 [pmc-release] AID - JAHA.118.008708 [pii] AID - JAH33195 [pii] AID - 10.1161/JAHA.118.008708 [doi] PST - epublish SO - J Am Heart Assoc. 2018 May 22;7(11):e008708. doi: 10.1161/JAHA.118.008708. PMID- 29784631 OWN - NLM STAT- MEDLINE DCOM- 20190805 LR - 20190805 IS - 1969-6213 (Electronic) IS - 1774-024X (Linking) VI - 14 IP - 7 DP - 2018 Sep 20 TI - Safety and efficacy of polymer-free biolimus-eluting stents in all-comer patients: the RUDI-FREE study. PG - 772-779 LID - EIJ-D-18-00148 [pii] LID - 10.4244/EIJ-D-18-00148 [doi] AB - AIMS: Polymer-free biolimus-eluting stents (PF-BES) have been shown to be superior to bare metal stents in high bleeding risk (HBR) patients treated with one-month dual antiplatelet therapy (DAPT). However, limited evidence is available on PF-BES in non-HBR patients. We aimed to evaluate the safety and efficacy of PF-BES in all-comer patients undergoing percutaneous coronary intervention (PCI). METHODS AND RESULTS: Patients with stable coronary artery disease or acute coronary syndromes (ACS) undergoing PCI with PF-BES in routine clinical practice were included in a multicentre, prospective registry. DAPT duration was left to the discretion of the operator. The primary endpoint was the composite of cardiovascular death, myocardial infarction (MI), and definite/probable stent thrombosis (ST) at one year. Overall, 1,104 consecutive patients treated with PF-BES were included at 16 Italian centres. Mean age was 68.7+/-11.2 years, 77.2% of patients were male, 30% had diabetes, 15.1% had chronic kidney disease, and 40.5% had ACS at baseline. Mean CRUSADE score was 24.1+/-13.1, and 83.7% of patients did not have high bleeding risk features. At one year, the primary endpoint occurred in 4.1% of patients, cardiovascular death in 2.4%, MI in 1.8%, and definite/probable ST in 1.1%. With respect to efficacy, target lesion revascularisation occurred in 1.2% of patients. CONCLUSIONS: This is the first study providing clinical evidence on the use of PF-BES in all-comer patients irrespective of HBR status. Our findings suggest that PF-BES has a favourable safety and efficacy profile in a real-world clinical setting. Further investigation in randomised clinical trials against new-generation DES is warranted. FAU - Sardella, Gennaro AU - Sardella G AD - Department of Cardiovascular Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy. FAU - Stefanini, Giulio G AU - Stefanini GG FAU - Briguori, Carlo AU - Briguori C FAU - Tamburino, Corrado AU - Tamburino C FAU - Fabbiocchi, Franco AU - Fabbiocchi F FAU - Rotolo, Francesco AU - Rotolo F FAU - Tomai, Fabrizio AU - Tomai F FAU - Paggi, Anita AU - Paggi A FAU - Lombardi, Mario AU - Lombardi M FAU - Gioffre, Gaetano AU - Gioffre G FAU - Sclafani, Rocco AU - Sclafani R FAU - Rolandi, Andrea AU - Rolandi A FAU - Sciahbasi, Alessandro AU - Sciahbasi A FAU - Scardaci, Francesco AU - Scardaci F FAU - Signore, Nicola AU - Signore N FAU - Calcagno, Simone AU - Calcagno S FAU - Mancone, Massimo AU - Mancone M FAU - Chiarito, Mauro AU - Chiarito M FAU - Giordano, Arturo AU - Giordano A LA - eng PT - Journal Article PL - France TA - EuroIntervention JT - EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology JID - 101251040 RN - 0 (Polymers) RN - W36ZG6FT64 (Sirolimus) MH - Aged MH - *Drug-Eluting Stents MH - Female MH - Humans MH - Male MH - Middle Aged MH - *Percutaneous Coronary Intervention MH - Polymers MH - Prospective Studies MH - Prosthesis Design MH - Sirolimus MH - Treatment Outcome EDAT- 2018/05/23 06:00 MHDA- 2019/08/06 06:00 CRDT- 2018/05/23 06:00 PHST- 2018/05/23 06:00 [pubmed] PHST- 2019/08/06 06:00 [medline] PHST- 2018/05/23 06:00 [entrez] AID - EIJ-D-18-00148 [pii] AID - 10.4244/EIJ-D-18-00148 [doi] PST - ppublish SO - EuroIntervention. 2018 Sep 20;14(7):772-779. doi: 10.4244/EIJ-D-18-00148. PMID- 29776437 OWN - NLM STAT- MEDLINE DCOM- 20181001 LR - 20181114 IS - 2047-783X (Electronic) IS - 0949-2321 (Print) IS - 0949-2321 (Linking) VI - 23 IP - 1 DP - 2018 May 18 TI - Coenzyme Q10 combined with trimetazidine in the prevention of contrast-induced nephropathy in patients with coronary heart disease complicated with renal dysfunction undergoing elective cardiac catheterization: a randomized control study and in vivo study. PG - 23 LID - 10.1186/s40001-018-0320-2 [doi] LID - 23 AB - BACKGROUND: Contrast-induced nephropathy (CIN) is one of the common hospital-acquired acute renal failures. The purpose of this study was to investigate whether Coenzyme Q10 (CoQ10) and trimetazidine (TMZ) can prevent the occurrence of CIN after elective cardiac catheterization in patients with coronary artery disease complicated with renal dysfunction. METHODS: Consecutive coronary artery disease patients with renal insufficiency scheduled for coronary angiography were enrolled in randomized, paralleled, double-blind, controlled trial. The development of CIN was occurrence at the 48 or 72 h after the procedure. The changes of serum creatinine (SCr), eGFR, and Cys-C within 72 h after the procedure were measured and compared. In vivo contrast medium (CM)-induced acute kidney injury (AKI) animal model was established, and CoQ10 plus TMZ was orally administrated to evaluate its renal protective effect. RESULTS: 150 patients with renal insufficiency were enrolled finally. CIN occurred in 21 (14.00%) of the 150 patients. 72 h after the procedure, the incidence of CIN was significantly lower in CoQ10 plus TMZ group compared with control group (6.67 vs. 21.3%, p = 0.01). No cardiac death occurred in this study. No side effects were observed after administration of CoQ10 and TMZ. In vivo test demonstrated that CoQ10 and TMZ could significantly reduce the concentration of blood urea nitrogen (BUN) and SCR induced by CM i.v. injection, as well as tubular pathological injuries. Meanwhile, CoQ10 and TMZ could significantly reduce the oxidation stress in kidneys from CM-AKI animals. CONCLUSION: CoQ10 plus TMZ could decrease the incidence of CIN in patients with renal insufficiency undergoing elective cardiac catheterization, and their effect may be due to its strong anti-oxidation effect. FAU - Chen, Fei AU - Chen F AD - Department of Cardiology, The Second Hospital of Hebei Medical University, No. 215 Hepingxi Road, Xinhua District, Shijiazhuang, 050005, Hebei, China. FAU - Liu, Fan AU - Liu F AD - Department of Cardiology, The Second Hospital of Hebei Medical University, No. 215 Hepingxi Road, Xinhua District, Shijiazhuang, 050005, Hebei, China. liufanmed@aliyun.com. FAU - Lu, Jingchao AU - Lu J AD - Department of Cardiology, The Second Hospital of Hebei Medical University, No. 215 Hepingxi Road, Xinhua District, Shijiazhuang, 050005, Hebei, China. FAU - Yang, Xiuchun AU - Yang X AD - Department of Cardiology, The Second Hospital of Hebei Medical University, No. 215 Hepingxi Road, Xinhua District, Shijiazhuang, 050005, Hebei, China. FAU - Xiao, Bing AU - Xiao B AD - Department of Cardiology, The Second Hospital of Hebei Medical University, No. 215 Hepingxi Road, Xinhua District, Shijiazhuang, 050005, Hebei, China. FAU - Jin, Yaqiong AU - Jin Y AD - Department of Cardiology, The Second Hospital of Hebei Medical University, No. 215 Hepingxi Road, Xinhua District, Shijiazhuang, 050005, Hebei, China. FAU - Zhang, Jie AU - Zhang J AD - Department of Cardiology, The Second Hospital of Hebei Medical University, No. 215 Hepingxi Road, Xinhua District, Shijiazhuang, 050005, Hebei, China. LA - eng PT - Journal Article PT - Randomized Controlled Trial DEP - 20180518 PL - England TA - Eur J Med Res JT - European journal of medical research JID - 9517857 RN - 0 (Antioxidants) RN - 0 (Contrast Media) RN - 1339-63-5 (Ubiquinone) RN - EJ27X76M46 (coenzyme Q10) RN - N9A0A0R9S8 (Trimetazidine) SB - IM MH - Acute Kidney Injury/chemically induced/epidemiology/*prevention & control MH - Aged MH - Animals MH - Antioxidants/*therapeutic use MH - Cardiac Catheterization/adverse effects/methods MH - Contrast Media/*adverse effects MH - Coronary Disease/complications/*therapy MH - Double-Blind Method MH - Female MH - Humans MH - Male MH - Middle Aged MH - Rats MH - Rats, Sprague-Dawley MH - Renal Insufficiency/complications MH - Trimetazidine/*therapeutic use MH - Ubiquinone/*analogs & derivatives/therapeutic use PMC - PMC5960150 OTO - NOTNLM OT - Animal model OT - Coenzyme Q10 OT - Contrast-induced nephropathy OT - Percutaneous coronary intervention OT - Prevention OT - Trimetazidine EDAT- 2018/05/20 06:00 MHDA- 2018/10/03 06:00 PMCR- 2018/05/18 CRDT- 2018/05/20 06:00 PHST- 2018/01/15 00:00 [received] PHST- 2018/04/24 00:00 [accepted] PHST- 2018/05/20 06:00 [entrez] PHST- 2018/05/20 06:00 [pubmed] PHST- 2018/10/03 06:00 [medline] PHST- 2018/05/18 00:00 [pmc-release] AID - 10.1186/s40001-018-0320-2 [pii] AID - 320 [pii] AID - 10.1186/s40001-018-0320-2 [doi] PST - epublish SO - Eur J Med Res. 2018 May 18;23(1):23. doi: 10.1186/s40001-018-0320-2. PMID- 29750365 OWN - NLM STAT- MEDLINE DCOM- 20191212 LR - 20200108 IS - 1540-8159 (Electronic) IS - 0147-8389 (Linking) VI - 41 IP - 7 DP - 2018 Jul TI - Effect of coronary revascularization on long-term clinical outcomes in patients with ischemic cardiomyopathy and recurrent ventricular arrhythmia. PG - 775-779 LID - 10.1111/pace.13375 [doi] AB - BACKGROUND: Patients with ventricular tachycardia (VT) postmyocardial infarction (MI) are a higher risk group with significant morbidity and mortality. We examined the impact of prior coronary revascularization on clinical outcomes in patients with ischemic cardiomyopathy and VT. METHODS: The VANISH trial randomized 259 patients with prior MI and antiarrhythmic drug-refractory VT to receive escalated medical therapy or catheter ablation. Clinical outcomes were compared according to whether patients have undergone prior revascularization procedures. The primary outcome was a composite of death, appropriate implantable cardiac defibrillator (ICD) shock, or VT storm. The secondary outcomes included elements of the primary outcome, hospitalization, and any ventricular arrhythmia. RESULTS: 190 patients (73%) had prior coronary revascularization. Revascularization group had more men (97% vs 83%; P = 0.0003) and patients in that group were older (mean age 69.3 +/- 7.6 vs 66.7 +/- 9.2; P = 0.04), had more renal insufficiency (22.6% vs 8.7%; P = 0.01), and were more likely to have an implanted cardiac resynchronization device (23% vs 10%, P = 0.03) as compared with the nonrevascularized patients. There were no significant differences in baseline medication use. There was a trend toward fewer hospitalizations in the revascularization group (64% vs 77%; P = 0.07); there were no differences in the individual outcomes of mortality, VT storm, ICD shocks, recurrent MI, or cardiac failure. CONCLUSIONS: In this cohort of patients with an ischemic cause for VT, a history of prior coronary revascularization was not associated with a reduction in ventricular arrhythmia or mortality. CI - (c) 2018 Wiley Periodicals, Inc. FAU - Elsokkari, Ihab AU - Elsokkari I AUID- ORCID: 0000-0001-5014-4529 AD - Queen Elizabeth II Health Sciences Centre, Halifax, NS, Canada. FAU - Parkash, Ratika AU - Parkash R AD - Queen Elizabeth II Health Sciences Centre, Halifax, NS, Canada. FAU - Gray, Chris J AU - Gray CJ AD - Queen Elizabeth II Health Sciences Centre, Halifax, NS, Canada. FAU - Gardner, Martin J AU - Gardner MJ AD - Queen Elizabeth II Health Sciences Centre, Halifax, NS, Canada. FAU - AbdelWahab, Amir M AU - AbdelWahab AM AD - Queen Elizabeth II Health Sciences Centre, Halifax, NS, Canada. FAU - Doucette, Steve AU - Doucette S AD - Dalhousie University, Halifax, NS, Canada. FAU - Tang, Anthony S AU - Tang AS AD - Western University, ON, Canada. FAU - Wells, George A AU - Wells GA AD - University of Ottawa Cardiovascular Methods Center, ON, Canada. FAU - Stevenson, William G AU - Stevenson WG AD - Brigham and Women's Hospital, Boston, MA, USA. FAU - Sapp, John L AU - Sapp JL AD - Queen Elizabeth II Health Sciences Centre, Halifax, NS, Canada. LA - eng PT - Journal Article PT - Randomized Controlled Trial DEP - 20180604 PL - United States TA - Pacing Clin Electrophysiol JT - Pacing and clinical electrophysiology : PACE JID - 7803944 SB - IM CIN - Pacing Clin Electrophysiol. 2018 Jul;41(7):780-782. doi: 10.1111/pace.13372. PMID: 29745424 MH - Aged MH - Female MH - Humans MH - Male MH - Middle Aged MH - Myocardial Ischemia/*complications/*surgery MH - *Percutaneous Coronary Intervention MH - Recurrence MH - Tachycardia, Ventricular/*complications/therapy MH - Time Factors MH - Treatment Outcome OTO - NOTNLM OT - coronary revascularization OT - implantable cardiac defibrillator OT - ischemic cardiomyopathy OT - ventricular arrhythmia EDAT- 2018/05/12 06:00 MHDA- 2019/12/18 06:00 CRDT- 2018/05/12 06:00 PHST- 2018/01/06 00:00 [received] PHST- 2018/02/14 00:00 [revised] PHST- 2018/03/04 00:00 [accepted] PHST- 2018/05/12 06:00 [pubmed] PHST- 2019/12/18 06:00 [medline] PHST- 2018/05/12 06:00 [entrez] AID - 10.1111/pace.13375 [doi] PST - ppublish SO - Pacing Clin Electrophysiol. 2018 Jul;41(7):775-779. doi: 10.1111/pace.13375. Epub 2018 Jun 4. PMID- 29744618 OWN - NLM STAT- MEDLINE DCOM- 20190605 LR - 20190605 IS - 1861-0692 (Electronic) IS - 1861-0684 (Linking) VI - 107 IP - 10 DP - 2018 Oct TI - Association between central venous pressure as assessed by echocardiography, left ventricular function and acute cardio-renal syndrome in patients with ST segment elevation myocardial infarction. PG - 937-944 LID - 10.1007/s00392-018-1266-7 [doi] AB - BACKGROUND: Recent reports have demonstrated the adverse effects of venous congestion on renal function in patients with heart failure. None of these trials, however, has evaluated the effect of acute myocardial ischemia on the occurrence of acute kidney injury (AKI). METHODS: We conducted a retrospective study of 1336 ST segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI) between June 2012 and June 2016. Comprehensive echocardiographic examination was performed within 72 h of hospital admission. Non-invasive evaluation of central venous pressure (CVP) was estimated from measurements of inferior vena cava diameter and its collapsibility. Intermediate-high CVP was defined as >/= 8 mm/Hg. Patients were stratified according to left ventricular ejection fraction (LVEF) and CVP and assessed for AKI. RESULTS: Intermediate-high CVP was associated with AKI both in patients with LVEF greater than 45% and those with 45% or lower. Patients having LVEF 45% and normal CVP (39 vs. 4%). In a multivariable logistic regression model, intermediate-high CVP was independently associated with AKI (OR = 2.73, 95% CI 1.54-4.87; p = 0.001). Other variables associated with AKI included LVEF /=6 was associated with higher in-hospital mortality risk. In conclusion, the ADVANCIS score is a novel, simple, robust tool for predicting the risk of incident AKI after PCI for ACS, and it can aid in risk stratification to monitor patient care. FAU - Fan, Pei-Chun AU - Fan PC AD - Department of Nephrology, Kidney Research Center, Chang Gung Memorial Hospital, Linkou Medical Center, Chang Gung University, No. 5 Fusing Street, Gueishan Dist., Taoyuan City 333, Taiwan (R.O.C.). AD - College of Medicine, Chang Gung University, No.259, Wenhua 1st Rd., Guishan Dist., Taoyuan City 33302, Taiwan (R.O.C.). AD - Graduate Institute of Clinical Medical Sciences, Chang Gung University, No.259, Wenhua 1st Rd., Guishan Dist., Taoyuan City 33302, Taiwan (R.O.C.). FAU - Chen, Tien-Hsing AU - Chen TH AD - College of Medicine, Chang Gung University, No.259, Wenhua 1st Rd., Guishan Dist., Taoyuan City 33302, Taiwan (R.O.C.). AD - Department of Cardiology, Chang Gung Memorial Hospital, Keelung Branch, No. 222, Maijin Rd., Anle Dist., Keelung City 20401, Taiwan (R.O.C.). FAU - Lee, Cheng-Chia AU - Lee CC AD - Department of Nephrology, Kidney Research Center, Chang Gung Memorial Hospital, Linkou Medical Center, Chang Gung University, No. 5 Fusing Street, Gueishan Dist., Taoyuan City 333, Taiwan (R.O.C.). AD - College of Medicine, Chang Gung University, No.259, Wenhua 1st Rd., Guishan Dist., Taoyuan City 33302, Taiwan (R.O.C.). AD - Graduate Institute of Clinical Medical Sciences, Chang Gung University, No.259, Wenhua 1st Rd., Guishan Dist., Taoyuan City 33302, Taiwan (R.O.C.). FAU - Tsai, Tsung-Yu AU - Tsai TY AD - Department of Nephrology, Kidney Research Center, Chang Gung Memorial Hospital, Linkou Medical Center, Chang Gung University, No. 5 Fusing Street, Gueishan Dist., Taoyuan City 333, Taiwan (R.O.C.). AD - College of Medicine, Chang Gung University, No.259, Wenhua 1st Rd., Guishan Dist., Taoyuan City 33302, Taiwan (R.O.C.). AD - Graduate Institute of Clinical Medical Sciences, Chang Gung University, No.259, Wenhua 1st Rd., Guishan Dist., Taoyuan City 33302, Taiwan (R.O.C.). FAU - Chen, Yung-Chang AU - Chen YC AD - College of Medicine, Chang Gung University, No.259, Wenhua 1st Rd., Guishan Dist., Taoyuan City 33302, Taiwan (R.O.C.). AD - Department of Nephrology, Chang Gung Memorial Hospital, Keelung Branch, No. 222, Maijin Rd., Anle Dist., Keelung City 20401, Taiwan (R.O.C.). FAU - Chang, Chih-Hsiang AU - Chang CH AD - Department of Nephrology, Kidney Research Center, Chang Gung Memorial Hospital, Linkou Medical Center, Chang Gung University, No. 5 Fusing Street, Gueishan Dist., Taoyuan City 333, Taiwan (R.O.C.). AD - College of Medicine, Chang Gung University, No.259, Wenhua 1st Rd., Guishan Dist., Taoyuan City 33302, Taiwan (R.O.C.). AD - Graduate Institute of Clinical Medical Sciences, Chang Gung University, No.259, Wenhua 1st Rd., Guishan Dist., Taoyuan City 33302, Taiwan (R.O.C.). LA - eng PT - Journal Article DEP - 20180308 PL - Australia TA - Int J Med Sci JT - International journal of medical sciences JID - 101213954 RN - 0 (Contrast Media) SB - IM MH - Acute Coronary Syndrome/complications/*epidemiology/physiopathology/surgery MH - Acute Kidney Injury/*epidemiology/etiology/physiopathology MH - Aged MH - Contrast Media MH - Female MH - Hospital Mortality MH - Humans MH - Male MH - Middle Aged MH - Myocardial Infarction/complications/*epidemiology/physiopathology/surgery MH - Percutaneous Coronary Intervention/*adverse effects MH - Risk Assessment MH - Risk Factors MH - Shock, Cardiogenic/complications/epidemiology/physiopathology/surgery MH - Taiwan/epidemiology PMC - PMC5859776 OTO - NOTNLM OT - Acute coronary syndrome OT - Acute kidney injury OT - Mortality OT - Percutaneous coronary intervention OT - Prediction model COIS- Competing Interests: The authors have declared that no competing interest exists. EDAT- 2018/03/22 06:00 MHDA- 2018/09/01 06:00 PMCR- 2018/01/01 CRDT- 2018/03/22 06:00 PHST- 2017/09/28 00:00 [received] PHST- 2018/02/02 00:00 [accepted] PHST- 2018/03/22 06:00 [entrez] PHST- 2018/03/22 06:00 [pubmed] PHST- 2018/09/01 06:00 [medline] PHST- 2018/01/01 00:00 [pmc-release] AID - ijmsv15p0528 [pii] AID - 10.7150/ijms.23064 [doi] PST - epublish SO - Int J Med Sci. 2018 Mar 8;15(5):528-535. doi: 10.7150/ijms.23064. eCollection 2018. PMID- 29527974 OWN - NLM STAT- MEDLINE DCOM- 20180404 LR - 20260518 IS - 1533-4406 (Electronic) IS - 0028-4793 (Linking) VI - 378 IP - 13 DP - 2018 Mar 29 TI - Cardiovascular Safety of Febuxostat or Allopurinol in Patients with Gout. PG - 1200-1210 LID - 10.1056/NEJMoa1710895 [doi] AB - BACKGROUND: Cardiovascular risk is increased in patients with gout. We compared cardiovascular outcomes associated with febuxostat, a nonpurine xanthine oxidase inhibitor, with those associated with allopurinol, a purine base analogue xanthine oxidase inhibitor, in patients with gout and cardiovascular disease. METHODS: We conducted a multicenter, double-blind, noninferiority trial involving patients with gout and cardiovascular disease; patients were randomly assigned to receive febuxostat or allopurinol and were stratified according to kidney function. The trial had a prespecified noninferiority margin of 1.3 for the hazard ratio for the primary end point (a composite of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, or unstable angina with urgent revascularization). RESULTS: In total, 6190 patients underwent randomization, received febuxostat or allopurinol, and were followed for a median of 32 months (maximum, 85 months). The trial regimen was discontinued in 56.6% of patients, and 45.0% discontinued follow-up. In the modified intention-to-treat analysis, a primary end-point event occurred in 335 patients (10.8%) in the febuxostat group and in 321 patients (10.4%) in the allopurinol group (hazard ratio, 1.03; upper limit of the one-sided 98.5% confidence interval [CI], 1.23; P=0.002 for noninferiority). All-cause and cardiovascular mortality were higher in the febuxostat group than in the allopurinol group (hazard ratio for death from any cause, 1.22 [95% CI, 1.01 to 1.47]; hazard ratio for cardiovascular death, 1.34 [95% CI, 1.03 to 1.73]). The results with regard to the primary end point and all-cause and cardiovascular mortality in the analysis of events that occurred while patients were being treated were similar to the results in the modified intention-to-treat analysis. CONCLUSIONS: In patients with gout and major cardiovascular coexisting conditions, febuxostat was noninferior to allopurinol with respect to rates of adverse cardiovascular events. All-cause mortality and cardiovascular mortality were higher with febuxostat than with allopurinol. (Funded by Takeda Development Center Americas; CARES ClinicalTrials.gov number, NCT01101035 .). FAU - White, William B AU - White WB AUID- ORCID: 0000-0001-8936-967X AD - From the University of Connecticut School of Medicine, Farmington (W.B.W.); the University of Alabama, Birmingham (K.G.S.); University of Chicago Medicine, Chicago (M.A.B.), and Takeda Development Center Americas, Deerfield (B.H., M.C., L.G.) - both in Illinois; the State University of New York, Downstate Medical Center, Brooklyn (J.S.B.); Michigan State University College of Human Medicine, Grand Rapids (P.B.G.); and Johns Hopkins University School of Medicine, Baltimore (A.W.). FAU - Saag, Kenneth G AU - Saag KG AD - From the University of Connecticut School of Medicine, Farmington (W.B.W.); the University of Alabama, Birmingham (K.G.S.); University of Chicago Medicine, Chicago (M.A.B.), and Takeda Development Center Americas, Deerfield (B.H., M.C., L.G.) - both in Illinois; the State University of New York, Downstate Medical Center, Brooklyn (J.S.B.); Michigan State University College of Human Medicine, Grand Rapids (P.B.G.); and Johns Hopkins University School of Medicine, Baltimore (A.W.). FAU - Becker, Michael A AU - Becker MA AD - From the University of Connecticut School of Medicine, Farmington (W.B.W.); the University of Alabama, Birmingham (K.G.S.); University of Chicago Medicine, Chicago (M.A.B.), and Takeda Development Center Americas, Deerfield (B.H., M.C., L.G.) - both in Illinois; the State University of New York, Downstate Medical Center, Brooklyn (J.S.B.); Michigan State University College of Human Medicine, Grand Rapids (P.B.G.); and Johns Hopkins University School of Medicine, Baltimore (A.W.). FAU - Borer, Jeffrey S AU - Borer JS AD - From the University of Connecticut School of Medicine, Farmington (W.B.W.); the University of Alabama, Birmingham (K.G.S.); University of Chicago Medicine, Chicago (M.A.B.), and Takeda Development Center Americas, Deerfield (B.H., M.C., L.G.) - both in Illinois; the State University of New York, Downstate Medical Center, Brooklyn (J.S.B.); Michigan State University College of Human Medicine, Grand Rapids (P.B.G.); and Johns Hopkins University School of Medicine, Baltimore (A.W.). FAU - Gorelick, Philip B AU - Gorelick PB AD - From the University of Connecticut School of Medicine, Farmington (W.B.W.); the University of Alabama, Birmingham (K.G.S.); University of Chicago Medicine, Chicago (M.A.B.), and Takeda Development Center Americas, Deerfield (B.H., M.C., L.G.) - both in Illinois; the State University of New York, Downstate Medical Center, Brooklyn (J.S.B.); Michigan State University College of Human Medicine, Grand Rapids (P.B.G.); and Johns Hopkins University School of Medicine, Baltimore (A.W.). FAU - Whelton, Andrew AU - Whelton A AD - From the University of Connecticut School of Medicine, Farmington (W.B.W.); the University of Alabama, Birmingham (K.G.S.); University of Chicago Medicine, Chicago (M.A.B.), and Takeda Development Center Americas, Deerfield (B.H., M.C., L.G.) - both in Illinois; the State University of New York, Downstate Medical Center, Brooklyn (J.S.B.); Michigan State University College of Human Medicine, Grand Rapids (P.B.G.); and Johns Hopkins University School of Medicine, Baltimore (A.W.). FAU - Hunt, Barbara AU - Hunt B AD - From the University of Connecticut School of Medicine, Farmington (W.B.W.); the University of Alabama, Birmingham (K.G.S.); University of Chicago Medicine, Chicago (M.A.B.), and Takeda Development Center Americas, Deerfield (B.H., M.C., L.G.) - both in Illinois; the State University of New York, Downstate Medical Center, Brooklyn (J.S.B.); Michigan State University College of Human Medicine, Grand Rapids (P.B.G.); and Johns Hopkins University School of Medicine, Baltimore (A.W.). FAU - Castillo, Majin AU - Castillo M AD - From the University of Connecticut School of Medicine, Farmington (W.B.W.); the University of Alabama, Birmingham (K.G.S.); University of Chicago Medicine, Chicago (M.A.B.), and Takeda Development Center Americas, Deerfield (B.H., M.C., L.G.) - both in Illinois; the State University of New York, Downstate Medical Center, Brooklyn (J.S.B.); Michigan State University College of Human Medicine, Grand Rapids (P.B.G.); and Johns Hopkins University School of Medicine, Baltimore (A.W.). FAU - Gunawardhana, Lhanoo AU - Gunawardhana L AD - From the University of Connecticut School of Medicine, Farmington (W.B.W.); the University of Alabama, Birmingham (K.G.S.); University of Chicago Medicine, Chicago (M.A.B.), and Takeda Development Center Americas, Deerfield (B.H., M.C., L.G.) - both in Illinois; the State University of New York, Downstate Medical Center, Brooklyn (J.S.B.); Michigan State University College of Human Medicine, Grand Rapids (P.B.G.); and Johns Hopkins University School of Medicine, Baltimore (A.W.). CN - CARES Investigators LA - eng SI - ClinicalTrials.gov/NCT01101035 PT - Comparative Study PT - Equivalence Trial PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20180312 PL - United States TA - N Engl J Med JT - The New England journal of medicine JID - 0255562 RN - 0 (Gout Suppressants) RN - 101V0R1N2E (Febuxostat) RN - 63CZ7GJN5I (Allopurinol) SB - IM CIN - Nat Rev Rheumatol. 2018 Jun;14(6):320. doi: 10.1038/s41584-018-0007-7. PMID: 29717259 CIN - Internist (Berl). 2018 Nov;59(11):1224-1228. doi: 10.1007/s00108-018-0486-2. PMID: 30178096 CIN - N Engl J Med. 2018 Oct 18;379(16):1582. doi: 10.1056/NEJMc1809736. PMID: 30338966 CIN - N Engl J Med. 2018 Oct 18;379(16):1583. doi: 10.1056/NEJMc1809736. PMID: 30338967 CIN - N Engl J Med. 2018 Oct 18;379(16):1583-4. doi: 10.1056/NEJMc1809736. PMID: 30338969 CIN - Arthritis Rheumatol. 2021 May;73(5):721-724. doi: 10.1002/art.41638. PMID: 33403821 MH - Aged MH - Allopurinol/*adverse effects/therapeutic use MH - Cardiovascular Diseases/*chemically induced/complications/mortality MH - Cause of Death MH - Double-Blind Method MH - Febuxostat/*adverse effects/therapeutic use MH - Female MH - Gout/complications/*drug therapy MH - Gout Suppressants/*adverse effects/therapeutic use MH - Humans MH - Male MH - Middle Aged FIR - Aggarwal, Naresh IR - Aggarwal N FIR - Bell, Alan IR - Bell A FIR - Belle Isle, Jasmin IR - Belle Isle J FIR - Brown, Jacques IR - Brown J FIR - Cividino, Alfred IR - Cividino A FIR - Dion, Danielle IR - Dion D FIR - Dzongowski, Peter IR - Dzongowski P FIR - Kelly, Allan IR - Kelly A FIR - Luton, Robert IR - Luton R FIR - Misik, Karl IR - Misik K FIR - Morin, Frederic IR - Morin F FIR - O'Mahony, William IR - O'Mahony W FIR - Pesant, Yves IR - Pesant Y FIR - Toma, Azhar IR - Toma A FIR - Van den Berg, Lucretia IR - Van den Berg L FIR - Wilderman, Igor IR - Wilderman I FIR - Abud Mendoza, Carlos IR - Abud Mendoza C FIR - Aguilera Real, Manuel IR - Aguilera Real M FIR - Alcocer Gamba, Marco Antonio IR - Alcocer Gamba MA FIR - Aldrete-Velasco, Jorge IR - Aldrete-Velasco J FIR - Alpizar Salazar, Melchor IR - Alpizar Salazar M FIR - Avila Zapata, Francisco IR - Avila Zapata F FIR - Carmona Furusho, Luis IR - Carmona Furusho L FIR - Carrillo Vazquez, Sandra Miriam IR - Carrillo Vazquez SM FIR - Chavez Paez, Jorge Guillermo IR - Chavez Paez JG FIR - De la Garza Ramos, Edmundo IR - De la Garza Ramos E FIR - Enkerlin Pauwells, Hermann Leo IR - Enkerlin Pauwells HL FIR - Esquivel Valerio, Jorge IR - Esquivel Valerio J FIR - Fajardo Campos, Pedro IR - Fajardo Campos P FIR - Garcia Olivera, Imelda IR - Garcia Olivera I FIR - Garcia Reza, Raymundo IR - Garcia Reza R FIR - Lopez Ruiz, Oscar Martin IR - Lopez Ruiz OM FIR - Luna Ceballos, Rosa Isela IR - Luna Ceballos RI FIR - Maldonado Hernandez, Hector IR - Maldonado Hernandez H FIR - Del Rosario Marrufo, Maria IR - Del Rosario Marrufo M FIR - Miracle Lopez, Sigfrido IR - Miracle Lopez S FIR - Montano Gonzalez, Efrain IR - Montano Gonzalez E FIR - Montes Cruz, Eliud IR - Montes Cruz E FIR - Nevarez Ruiz, Luis IR - Nevarez Ruiz L FIR - Ramos Lopez, Gabriel IR - Ramos Lopez G FIR - Rodriguez Briones, Ignacio IR - Rodriguez Briones I FIR - Sanchez Mijangos, Hector IR - Sanchez Mijangos H FIR - Sanchez Vazquez, Juan Carlos IR - Sanchez Vazquez JC FIR - Silveira Torre, Luis Humberto IR - Silveira Torre LH FIR - Solis Morales, Lucas IR - Solis Morales L FIR - Stobschinski de Alba, Carlos Alejandro IR - Stobschinski de Alba CA FIR - Vazquez Mellado Cervantes, Nora Janitzia IR - Vazquez Mellado Cervantes NJ FIR - Vega Elguezabal, Jorge Felipe IR - Vega Elguezabal JF FIR - Villeda Espinosa, Efrain IR - Villeda Espinosa E FIR - Violante, Rafael IR - Violante R FIR - Zazueta Montiel, Beatriz Elena IR - Zazueta Montiel BE FIR - Abalos-Galito, Marietta IR - Abalos-Galito M FIR - Abboy, Chandar IR - Abboy C FIR - Abraham, William IR - Abraham W FIR - Adams, Mark IR - Adams M FIR - Aelion, Jacob IR - Aelion J FIR - Alvarado, Odilon IR - Alvarado O FIR - Alwine, Lawrence IR - Alwine L FIR - Amin, Kaushik IR - Amin K FIR - Anderson, Alyn IR - Anderson A FIR - Anderson, Corey IR - Anderson C FIR - Andrawis, Nabil IR - Andrawis N FIR - Archuleta, Maurice IR - Archuleta M FIR - Arif, Ahmed IR - Arif A FIR - Azorr, Michael IR - Azorr M FIR - Babich, John IR - Babich J FIR - Baraf, Herbert IR - Baraf H FIR - Barag, Steven IR - Barag S FIR - Barker, Bruce IR - Barker B FIR - Barksdale, Wayne IR - Barksdale W FIR - Barreto, Angelique IR - Barreto A FIR - Bartkowiak, Anthony IR - Bartkowiak A FIR - Batongmalaque, Jenny IR - Batongmalaque J FIR - Bays, Harold IR - Bays H FIR - Bedel, Gary IR - Bedel G FIR - Berg, Isaac IR - Berg I FIR - Bernstein, Richard IR - Bernstein R FIR - Bertsch, John IR - Bertsch J FIR - Bhat, Anupama IR - Bhat A FIR - Bland, Veita IR - Bland V FIR - Bornfreund, Jonathan IR - Bornfreund J FIR - Bowling, Bruce IR - Bowling B FIR - Box, Emily IR - Box E FIR - Branum, Russell IR - Branum R FIR - Brewer, Michael IR - Brewer M FIR - Bright, Christina IR - Bright C FIR - Britt, David IR - Britt D FIR - Broker, Robert IR - Broker R FIR - Bruce, Tami IR - Bruce T FIR - Buchanan, Patricia IR - Buchanan P FIR - Burack, David IR - Burack D FIR - Burbano De Lara, Jose IR - Burbano De Lara J FIR - Burke, Deborah IR - Burke D FIR - Buynak, Robert IR - Buynak R FIR - Byars, William IR - Byars W FIR - Bybee, Kevin IR - Bybee K FIR - Campbell, Joseph IR - Campbell J FIR - Canlas, Donna IR - Canlas D FIR - Canosa, Roddy IR - Canosa R FIR - Captain, Anthony IR - Captain A FIR - Carlos, Edward IR - Carlos E FIR - Carpenter, Kent IR - Carpenter K FIR - Carter, Michael IR - Carter M FIR - Cauthen, Brett IR - Cauthen B FIR - Cha, Gloria IR - Cha G FIR - Chang, Khai IR - Chang K FIR - Chaykin, Louis IR - Chaykin L FIR - Cheung, Deanna IR - Cheung D FIR - Chilito, Alicia IR - Chilito A FIR - Chiong, Rafael IR - Chiong R FIR - Chipman, Howard IR - Chipman H FIR - Choi, Steve IR - Choi S FIR - Christensen, Jim IR - Christensen J FIR - Chuang, Rita IR - Chuang R FIR - Claassen, David IR - Claassen D FIR - Clark, Gordon IR - Clark G FIR - Clower, James IR - Clower J FIR - Coburn, Nancy Jo IR - Coburn NJ FIR - Collins, Harry IR - Collins H FIR - Corder, Clinton IR - Corder C FIR - Cox, Ralph IR - Cox R FIR - Crawford, Paul IR - Crawford P FIR - Cunnar, James IR - Cunnar J FIR - Davila, William IR - Davila W FIR - Davit, Rajesh IR - Davit R FIR - Dayon, Dominador IR - Dayon D FIR - DeBusk, Charles IR - DeBusk C FIR - Delgado, John IR - Delgado J FIR - Delmont, Jacqueline IR - Delmont J FIR - DeMatteo, Dominic IR - DeMatteo D FIR - Demetry, Kamal IR - Demetry K FIR - Dennis, David IR - Dennis D FIR - DeSantis, Donna IR - DeSantis D FIR - Diab, Isam IR - Diab I FIR - Diener, Carl IR - Diener C FIR - Dobrusin, Richard IR - Dobrusin R FIR - Dodd, John IR - Dodd J FIR - Drummond, Waymon IR - Drummond W FIR - Dulgeroff, Anthony IR - Dulgeroff A FIR - Durrence, Hugh IR - Durrence H FIR - Mari Elacion, Jose IR - Mari Elacion J FIR - Ellison, William IR - Ellison W FIR - Elzi, William IR - Elzi W FIR - Escalante, Dante IR - Escalante D FIR - Ettlinger, Robert IR - Ettlinger R FIR - Fakih, Faisal IR - Fakih F FIR - Fandino, Ana IR - Fandino A FIR - Fang, Meika IR - Fang M FIR - Farooq, Omer IR - Farooq O FIR - Farrington, Cecil IR - Farrington C FIR - Farris, Neil IR - Farris N FIR - Feinman, Mitchell IR - Feinman M FIR - Feld, Lawrence IR - Feld L FIR - Ferro, Fernando IR - Ferro F FIR - Fields, Harold IR - Fields H FIR - First, Brian IR - First B FIR - Fitz-Patrick, David IR - Fitz-Patrick D FIR - Flint, Kathleen IR - Flint K FIR - Flippo, Gregory IR - Flippo G FIR - Folkerth, Steven IR - Folkerth S FIR - Fowler, Fred IR - Fowler F FIR - Fox, Donald IR - Fox D FIR - Frandsen, Brad IR - Frandsen B FIR - Freeman, James IR - Freeman J FIR - Freyne, Brigid IR - Freyne B FIR - Fritzhand, Martin IR - Fritzhand M FIR - Fung, Eugene IR - Fung E FIR - Funk, Gregory IR - Funk G FIR - Gabra, Nashwa IR - Gabra N FIR - Gagianas, Peter IR - Gagianas P FIR - Gamarra, Lewis IR - Gamarra L FIR - Gaona, Raul IR - Gaona R FIR - Garcia, Ronald IR - Garcia R FIR - Garner, Andrew IR - Garner A FIR - Gaston, Pierre IR - Gaston P FIR - Ghanekar, Hrishikesh IR - Ghanekar H FIR - Ghosh, Chandra IR - Ghosh C FIR - Gladstein, Geoffrey IR - Gladstein G FIR - Goldfischer, Evan IR - Goldfischer E FIR - Gorman, Timothy IR - Gorman T FIR - Gottschlich, Gregory IR - Gottschlich G FIR - Grant, David IR - Grant D FIR - Gray, James IR - Gray J FIR - Green, Christopher IR - Green C FIR - Green, Benny IR - Green B FIR - Gregory, Darin IR - Gregory D FIR - Griffin, Robert IR - Griffin R FIR - Guice, Michael IR - Guice M FIR - Gupta, Ramesh IR - Gupta R FIR - Hahn, Giora IR - Hahn G FIR - Halter, Dale IR - Halter D FIR - Halter, Michael IR - Halter M FIR - Hansen, Val IR - Hansen V FIR - Harris, Anthony IR - Harris A FIR - Harris, Mark IR - Harris M FIR - Headley, David IR - Headley D FIR - Hejeebu, Srinivas IR - Hejeebu S FIR - Hendrix, Ernest IR - Hendrix E FIR - Herman, Lee IR - Herman L FIR - Herrera, Carlos IR - Herrera C FIR - Herring, Charles IR - Herring C FIR - Herrod, John IR - Herrod J FIR - Ho, Gerald IR - Ho G FIR - Hole, Susan IR - Hole S FIR - Hollister, Ripley IR - Hollister R FIR - Holt, Peter IR - Holt P FIR - Hopkins, John IR - Hopkins J FIR - Horton, Kevin IR - Horton K FIR - Howard, Timothy IR - Howard T FIR - Howell, Mary IR - Howell M FIR - Huff, John IR - Huff J FIR - Huffman, Cynthia IR - Huffman C FIR - Huling, Randall IR - Huling R FIR - Hyers, Thomas IR - Hyers T FIR - Hymowitz, Richard IR - Hymowitz R FIR - Ibraheem, Musibau IR - Ibraheem M FIR - Idarraga, Samuel IR - Idarraga S FIR - Iranmanesh, Ali IR - Iranmanesh A FIR - Isakov, Terence IR - Isakov T FIR - Jack, David IR - Jack D FIR - Jacks, Randal IR - Jacks R FIR - Jackson, Raymond IR - Jackson R FIR - Jackson, Richard IR - Jackson R FIR - Jackson, Bruce IR - Jackson B FIR - Jain, Mahendra IR - Jain M FIR - Janovitz, Richard IR - Janovitz R FIR - Jeereddi, Prasad IR - Jeereddi P FIR - Johary, Albert IR - Johary A FIR - Johnson, Chrystal IR - Johnson C FIR - Johnson, Wallace IR - Johnson W FIR - Johnson, Carol IR - Johnson C FIR - Jones, Stephen IR - Jones S FIR - Jones, Robert IR - Jones R FIR - Jordan, Rebecca IR - Jordan R FIR - June, Joshua IR - June J FIR - Kafka, Shelly IR - Kafka S FIR - Kalen, Vicki IR - Kalen V FIR - Karl, John IR - Karl J FIR - Kaufmann, Robert IR - Kaufmann R FIR - Kavanaugh, Arthur IR - Kavanaugh A FIR - Kaveh, Kianoosh IR - Kaveh K FIR - Keane, James IR - Keane J FIR - Kerzner, Boris IR - Kerzner B FIR - Khan, Jaber IR - Khan J FIR - Kidokoro, Yasuko IR - Kidokoro Y FIR - Kirstein, Judith IR - Kirstein J FIR - Kivitz, Alan IR - Kivitz A FIR - Klein, Steven IR - Klein S FIR - Klein, Thomas IR - Klein T FIR - Knight, Herbert IR - Knight H FIR - Knutson, Thomas IR - Knutson T FIR - Koch, Stanley IR - Koch S FIR - Koilpillai, Robinson IR - Koilpillai R FIR - Kolettis, Elias IR - Kolettis E FIR - Koontz, Daniel IR - Koontz D FIR - Kopp, James IR - Kopp J FIR - Koshy, Nadakavil IR - Koshy N FIR - Kotek, Larry IR - Kotek L FIR - Krause, Richard IR - Krause R FIR - LaFata, John IR - LaFata J FIR - Lang, Carl IR - Lang C FIR - Lano, Michael IR - Lano M FIR - Lasala, German IR - Lasala G FIR - Lawless, Andrea IR - Lawless A FIR - Lee, Keung IR - Lee K FIR - Lee, Denny IR - Lee D FIR - Lefebvre, Gigi IR - Lefebvre G FIR - Lester, Frank IR - Lester F FIR - Levins, Peter IR - Levins P FIR - Lewis, Derek IR - Lewis D FIR - Lieberman, Donald IR - Lieberman D FIR - Lillestol, Michael IR - Lillestol M FIR - Lillo, Joseph IR - Lillo J FIR - Littlefield, Ronald IR - Littlefield R FIR - Lockwood, Michael IR - Lockwood M FIR - Lohr, Kristine IR - Lohr K FIR - Look, Michelle IR - Look M FIR - Lorch, Daniel IR - Lorch D FIR - Ludivico, Charles IR - Ludivico C FIR - Luna, Blanca IR - Luna B FIR - Lutskiy, Maxim IR - Lutskiy M FIR - Mabaquiao, Arthur IR - Mabaquiao A FIR - Maggiacomo, Frank IR - Maggiacomo F FIR - Makam, Sashi IR - Makam S FIR - Maletz, Louis IR - Maletz L FIR - Malik, Aarti IR - Malik A FIR - Martin, Earl IR - Martin E FIR - Martinez, Juvenal IR - Martinez J FIR - Marx, Phyllis IR - Marx P FIR - May, Percy IR - May P FIR - Maynard, Kenneth IR - Maynard K FIR - McConnehey, Diane IR - McConnehey D FIR - McConnehey, Brock IR - McConnehey B FIR - McGettigan, John IR - McGettigan J FIR - McGuire, Michael IR - McGuire M FIR - McIlwain, Harris IR - McIlwain H FIR - McKenzie, Wilfred IR - McKenzie W FIR - McLean, Barry IR - McLean B FIR - McNeil, Donald IR - McNeil D FIR - Mehta, Daksha IR - Mehta D FIR - Meisner, Carl IR - Meisner C FIR - Meli, James IR - Meli J FIR - Metyas, Samy IR - Metyas S FIR - Metzger, Frank IR - Metzger F FIR - Meyers, Peter IR - Meyers P FIR - Michlin, Bernard IR - Michlin B FIR - Mihills, Cody IR - Mihills C FIR - Miller, Kenneth IR - Miller K FIR - Miller, Alan IR - Miller A FIR - Minton, Stephen IR - Minton S FIR - Mohart, Ann-Elizabeth IR - Mohart A FIR - Montenegro, Carlos IR - Montenegro C FIR - Montgomery, Richard IR - Montgomery R FIR - Morelli, John IR - Morelli J FIR - Morin, David IR - Morin D FIR - Morita, Craig IR - Morita C FIR - Morris, Frank IR - Morris F FIR - Mortensen, Steen IR - Mortensen S FIR - Movafagh, Sharareh IR - Movafagh S FIR - Multani, Pramod IR - Multani P FIR - Murphy, Dennis IR - Murphy D FIR - Muse, Derek IR - Muse D FIR - Myerson, Gary IR - Myerson G FIR - Nagrani, Mark IR - Nagrani M FIR - Naidu, Jayaram IR - Naidu J FIR - Natividad, Maria Bella IR - Natividad MB FIR - Neutel, Joel IR - Neutel J FIR - Nolen, Thomas IR - Nolen T FIR - Nussbaum, Alan IR - Nussbaum A FIR - Olson, Richard IR - Olson R FIR - Ong, Stephen IR - Ong S FIR - Osborne, John IR - Osborne J FIR - Pace, Michael IR - Pace M FIR - Paez, Henry IR - Paez H FIR - Palatnik, Mikhail IR - Palatnik M FIR - Palmer, William IR - Palmer W FIR - Pappas, John IR - Pappas J FIR - Paster, Zorba IR - Paster Z FIR - Patel, Meenakshi IR - Patel M FIR - Patel, Manoj IR - Patel M FIR - Patel, Bhadresh IR - Patel B FIR - Patton, Walter IR - Patton W FIR - Pema, Kanchan IR - Pema K FIR - Peniston, John IR - Peniston J FIR - Peppin, Gary IR - Peppin G FIR - Petit, Carlos IR - Petit C FIR - Phillips, Christopher IR - Phillips C FIR - Phillips, Andrea IR - Phillips A FIR - Piatek, Marek IR - Piatek M FIR - Pick, Michael IR - Pick M FIR - Pillinger, Michael IR - Pillinger M FIR - Pogue, Bryan IR - Pogue B FIR - Posey, Michael IR - Posey M FIR - Poss, Geri IR - Poss G FIR - Preston, Krista IR - Preston K FIR - Prupas, Henry IR - Prupas H FIR - Pullman, John IR - Pullman J FIR - Raikhel, Marina IR - Raikhel M FIR - Randall, William IR - Randall W FIR - Rangaraj, Madura IR - Rangaraj M FIR - Rapo, Seppo IR - Rapo S FIR - Rapoport, Ronald IR - Rapoport R FIR - Rastogi, Padmashri IR - Rastogi P FIR - Reddy, Jakkidi IR - Reddy J FIR - Reddy, Riteesha IR - Reddy R FIR - Reed, Larry IR - Reed L FIR - Reeves, Matthew IR - Reeves M FIR - Reiff, Myron IR - Reiff M FIR - Reynolds, Michele IR - Reynolds M FIR - Rhee, Margaret IR - Rhee M FIR - Rhudy, Jackson IR - Rhudy J FIR - Richter, Ralph IR - Richter R FIR - Ries, Daniel IR - Ries D FIR - Roberson, Kent IR - Roberson K FIR - Roberts, Douglas IR - Roberts D FIR - Robinson, Derrick IR - Robinson D FIR - Rock, Karin IR - Rock K FIR - Roer, David IR - Roer D FIR - Rosen, Robert IR - Rosen R FIR - Rosenblum, Gary IR - Rosenblum G FIR - Rosenfeld, Jack IR - Rosenfeld J FIR - Rosenthal, Ann IR - Rosenthal A FIR - Ross, Dennis IR - Ross D FIR - Rothberg, Michael IR - Rothberg M FIR - Rubino, John IR - Rubino J FIR - Rudolph, Lance IR - Rudolph L FIR - Ruoff, Gary IR - Ruoff G FIR - Ryan, Eugene IR - Ryan E FIR - Sadler, Cynthia IR - Sadler C FIR - Samson, Mercedes IR - Samson M FIR - Sanders, Robyn IR - Sanders R FIR - Scarsella, Anthony IR - Scarsella A FIR - Schmidt, Jay IR - Schmidt J FIR - Schoenwalder, Michael IR - Schoenwalder M FIR - Schreiber, Andrew IR - Schreiber A FIR - Schreiman, Robert IR - Schreiman R FIR - Schultz, David IR - Schultz D FIR - Schwartz, Alan IR - Schwartz A FIR - Sensenbrenner, John IR - Sensenbrenner J FIR - Serfer, Gregory IR - Serfer G FIR - Seshadri, Niranjan IR - Seshadri N FIR - Severa, Larry IR - Severa L FIR - Shah, Suresh IR - Shah S FIR - Shanes, Jeffrey IR - Shanes J FIR - Sharma, Marigene IR - Sharma M FIR - Sharpe, Charles IR - Sharpe C FIR - Shergy, William IR - Shergy W FIR - Sherman, Howard IR - Sherman H FIR - Shlotzhauer, Tammi IR - Shlotzhauer T FIR - Shoffner, Sylvia IR - Shoffner S FIR - Shore, Kenneth IR - Shore K FIR - Sims, James IR - Sims J FIR - Singh, Harmeet IR - Singh H FIR - Smallow, Stevan IR - Smallow S FIR - Smith, Mark Todd IR - Smith MT FIR - Snyder, Brian IR - Snyder B FIR - Soo, Allan IR - Soo A FIR - Sprague, Amy IR - Sprague A FIR - Stamps, Henry IR - Stamps H FIR - Stearns, Pamela IR - Stearns P FIR - Sudano, Dominick IR - Sudano D FIR - Sugimoto, Danny IR - Sugimoto D FIR - Suleman, Amer IR - Suleman A FIR - Sunkureddi, Prashanth IR - Sunkureddi P FIR - Tan, Ricardo IR - Tan R FIR - Tan, Alfred IR - Tan A FIR - Tannenbaum, Alan IR - Tannenbaum A FIR - Tawney, Kathryn IR - Tawney K FIR - Teixeira, Gilbert IR - Teixeira G FIR - Teltser, Matthew IR - Teltser M FIR - Torres, Arnaldo IR - Torres A FIR - Tran, Carolyn IR - Tran C FIR - Trapp, Robert IR - Trapp R FIR - Trevino, Miguel IR - Trevino M FIR - Tsai, Yong IR - Tsai Y FIR - Tuan, Wei-Ming IR - Tuan W FIR - Vaid, Brij IR - Vaid B FIR - Valente, Robert IR - Valente R FIR - Van Camp, Kipp IR - Van Camp K FIR - Van Ginkel, Erik IR - Van Ginkel E FIR - Varano, Susann IR - Varano S FIR - Vaughn, Michael IR - Vaughn M FIR - Velderman, Phillip IR - Velderman P FIR - Viera, Eduardo IR - Viera E FIR - Vijay, Nampalli IR - Vijay N FIR - Vincent, Simi IR - Vincent S FIR - Von Feldt, Joan IR - Von Feldt J FIR - Vora, Kishor IR - Vora K FIR - Vora, Sanjay IR - Vora S FIR - Vukotic, Goga IR - Vukotic G FIR - Waller, Philip IR - Waller P FIR - Walton, Marie IR - Walton M FIR - Wayne, Jeffrey IR - Wayne J FIR - Weinstein, Debra IR - Weinstein D FIR - Weiss, Daniel IR - Weiss D FIR - Weiss, Edwin IR - Weiss E FIR - Whitlock, Lawrence IR - Whitlock L FIR - Wiesenhutter, Craig IR - Wiesenhutter C FIR - Williams, Rhonda IR - Williams R FIR - Williams, Tearani IR - Williams T FIR - Williams, David IR - Williams D FIR - Wilson, Scott IR - Wilson S FIR - Wolfe, Sanford IR - Wolfe S FIR - Wombolt, Duane IR - Wombolt D FIR - Wood, John IR - Wood J FIR - Yarows, Steven IR - Yarows S FIR - Yetman, Cornelius IR - Yetman C FIR - Yiannias, Chris IR - Yiannias C FIR - Yood, Robert IR - Yood R FIR - Young, Vernon Leroy IR - Young VL FIR - Young, Douglas IR - Young D FIR - Zuzarte, Karl IR - Zuzarte K FIR - Gibofsky, Allan IR - Gibofsky A FIR - Carson, Peter E IR - Carson PE FIR - Lakatos, Edward IR - Lakatos E FIR - Ryan, Lawrence M IR - Ryan LM FIR - Waikar, Sushrut S IR - Waikar SS FIR - Morris, David D IR - Morris DD FIR - Jackson, Robert IR - Jackson R FIR - McLean, Lachy IR - McLean L FIR - Qin, Yimin IR - Qin Y FIR - Kisfalvi, Krisztina IR - Kisfalvi K FIR - MacDonald, Patricia IR - MacDonald P FIR - Palmer, Robert IR - Palmer R FIR - Yang, Teresa IR - Yang T FIR - Tsymbalov, Sarah IR - Tsymbalov S FIR - Alkawass, Nancy IR - Alkawass N FIR - Keeter, Kraig IR - Keeter K FIR - Koziol, Maria IR - Koziol M FIR - Schickedanz, Brian IR - Schickedanz B FIR - Evans, Brette IR - Evans B FIR - Chefo, Solomon IR - Chefo S FIR - Xie, Benhuai IR - Xie B FIR - Song, Eric IR - Song E FIR - Dong, Xinxin IR - Dong X FIR - Zhang, Wenwen IR - Zhang W FIR - Chen, Yinzhong IR - Chen Y FIR - Loke, Rina IR - Loke R FIR - Li, Dian IR - Li D FIR - Li, Xiao IR - Li X FIR - Max, Ethan IR - Max E FIR - Dabholkar, Aruna IR - Dabholkar A FIR - Makaratzi, Martha IR - Makaratzi M FIR - Schulz, Peter IR - Schulz P FIR - Khursheed, Mukhy IR - Khursheed M FIR - Marcinak, John IR - Marcinak J FIR - Geiger, Carol IR - Geiger C FIR - Henning, Eric IR - Henning E FIR - Harrigan, Patrick IR - Harrigan P FIR - Ludwig, Patricia IR - Ludwig P FIR - Idemoto, Christie IR - Idemoto C FIR - Bronson, Christine IR - Bronson C FIR - Gans, Jason IR - Gans J FIR - Kennedy, Justine Elizabeth IR - Kennedy JE FIR - Villinski, Allison IR - Villinski A FIR - Koehler, Leslie IR - Koehler L FIR - Parker, Jonathon IR - Parker J FIR - Desai, Esha IR - Desai E EDAT- 2018/03/13 06:00 MHDA- 2018/04/05 06:00 CRDT- 2018/03/13 06:00 PHST- 2018/03/13 06:00 [pubmed] PHST- 2018/04/05 06:00 [medline] PHST- 2018/03/13 06:00 [entrez] AID - 10.1056/NEJMoa1710895 [doi] PST - ppublish SO - N Engl J Med. 2018 Mar 29;378(13):1200-1210. doi: 10.1056/NEJMoa1710895. Epub 2018 Mar 12. PMID- 29515692 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20201001 IS - 1881-641X (Print) IS - 1881-6428 (Electronic) IS - 1881-641X (Linking) VI - 10 IP - 4 DP - 2017 Dec 25 TI - Cardiovascular Disease in Patients with End-Stage Renal Disease on Hemodialysis. PG - 327-337 LID - 10.3400/avd.ra.17-00051 [doi] AB - Cardiovascular disease is a major concern for patients with end-stage renal disease (ESRD), especially those on hemodialysis. ESRD patients with coronary artery disease often do not have symptoms or present with atypical symptoms. Coronary lesions in ESRD patients are characterized by increased media thickness, infiltration and activation of macrophages, and marked calcification. Several studies showed worsened clinical outcomes after coronary revascularization, which were dependent on the severity of renal dysfunction. ESRD patients on hemodialysis have the most severe renal dysfunction; thus, the clinical outcomes are worse in these patients than in those with other types of renal dysfunction. Medications for primary or secondary cardiovascular prevention are also insufficient in ESRD patients. Efficacy of drug-eluting stents is inferior in ESRD patients, compared to the excellent outcomes observed in patients with normal renal function. Unsatisfactory outcomes with trials targeting cardiovascular disease in patients with ESRD emphasize a large potential to improve outcomes. Thus, optimal strategies for diagnosis, prevention, and management of cardiovascular disease should be modified in ESRD patients. FAU - Aoki, Jiro AU - Aoki J AD - Division of Cardiology, Mitsui Memorial Hospital, Tokyo, Japan. FAU - Ikari, Yuji AU - Ikari Y AD - Department of Cardiovascular Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan. LA - eng PT - Journal Article PL - Japan TA - Ann Vasc Dis JT - Annals of vascular diseases JID - 101471467 PMC - PMC5835444 OTO - NOTNLM OT - bypass OT - cardiovascular disease OT - coronary OT - hemodialysis OT - stent EDAT- 2018/03/09 06:00 MHDA- 2018/03/09 06:01 PMCR- 2017/12/25 CRDT- 2018/03/09 06:00 PHST- 2018/03/09 06:00 [entrez] PHST- 2018/03/09 06:00 [pubmed] PHST- 2018/03/09 06:01 [medline] PHST- 2017/12/25 00:00 [pmc-release] AID - 10.3400/avd.ra.17-00051 [doi] PST - ppublish SO - Ann Vasc Dis. 2017 Dec 25;10(4):327-337. doi: 10.3400/avd.ra.17-00051. PMID- 29503556 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20220316 IS - 1176-6336 (Print) IS - 1178-203X (Electronic) IS - 1176-6336 (Linking) VI - 14 DP - 2018 TI - Renoprotective effect of remote ischemic postconditioning in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention. PG - 369-375 LID - 10.2147/TCRM.S158768 [doi] AB - BACKGROUND: Whether upper arm remote ischemic postconditioning (RIPostC) exerts protection to kidney in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI) remains unknown. METHODS: Sixty-four patients with STEMI were randomized to PPCI + RIPostC (n=29) and PPCI (n=35) groups. RIPostC consisting of 4 cycles of 5 minutes occlusion/reperfusion by cuff inflation/deflation of the upper arm was started within 1 minute after the first balloon dilatation. Peripheral venous blood samples were collected before PPCI and at 0.5, 8, 24, 48, and 72 hours after PPCI to detect serum creatinine (SCr) and creatine kinase-MB (CK-MB). Acute kidney injury (AKI) rate and estimated glomerular filtration rate (eGFR) were calculated. The transthoracic echocardiography was performed 7 days after PPCI to assess left ventricular ejection fraction (LVEF). RESULTS: The patients in the PPCI + RIPostC group had a lower AKI rate compared with those in the PPCI group (P=0.04). The eGFR after PPCI increased in the PPCI + RIPostC group compared to the PPCI group (P<0.01). The peak of CK-MB concentration in the PPCI + RIPostC group was significantly lower than that in the PPCI group (P<0.01). The area under the curve of CK-MB decreased in the PPCI + RIPostC group compared with that in the PPCI group. LVEF in the PPCI + RIPostC group was significantly higher than that in the PPCI group (P=0.04). CONCLUSION: Upper arm RIPostC exerts renal and cardiac protection following cardiac ischemia-reperfusion in patients with STEMI. FAU - Cao, Bangming AU - Cao B AD - Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China. FAU - Zhang, Chi AU - Zhang C AD - Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China. FAU - Wang, Haipeng AU - Wang H AD - Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China. FAU - Xia, Ming AU - Xia M AD - Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China. FAU - Yang, Xiangjun AU - Yang X AD - Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China. LA - eng PT - Journal Article DEP - 20180222 PL - New Zealand TA - Ther Clin Risk Manag JT - Therapeutics and clinical risk management JID - 101253281 PMC - PMC5826247 OTO - NOTNLM OT - ST-segmental elevation myocardial infarction OT - myocardial ischemia reperfusion OT - primary percutaneous coronary intervention OT - remote ischemic postconditioning COIS- Disclosure The authors report no conflicts of interest in this work. EDAT- 2018/03/06 06:00 MHDA- 2018/03/06 06:01 PMCR- 2018/02/22 CRDT- 2018/03/06 06:00 PHST- 2018/03/06 06:00 [entrez] PHST- 2018/03/06 06:00 [pubmed] PHST- 2018/03/06 06:01 [medline] PHST- 2018/02/22 00:00 [pmc-release] AID - tcrm-14-369 [pii] AID - 10.2147/TCRM.S158768 [doi] PST - epublish SO - Ther Clin Risk Manag. 2018 Feb 22;14:369-375. doi: 10.2147/TCRM.S158768. eCollection 2018. PMID- 29480853 OWN - NLM STAT- MEDLINE DCOM- 20180305 LR - 20210109 IS - 1536-5964 (Electronic) IS - 0025-7974 (Print) IS - 0025-7974 (Linking) VI - 97 IP - 2 DP - 2018 Jan TI - Effects of remote ischemic preconditioning on contrast induced nephropathy after percutaneous coronary intervention in patients with acute coronary syndrome. PG - e9579 LID - 10.1097/MD.0000000000009579 [doi] LID - e9579 AB - OBJECTIVE: The aim of this study was to explore the clinical effects of remote ischemic preconditioning (RIPC) on contrast-induced nephropathy after percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS). PATIENTS AND METHODS: The study was a single-center, prospective, randomized, controlled study. A total of 161 patients with ACS and the rate of estimate glomerular filtration (eGFR) 15 to 70 mL/min/1.73 m2 undergoing PCI were randomly assigned to RIPC group (induced by 4 times of 5-minute inflations of a blood pressure cuff to 200 mmHg around the upper arm, followed by 5-min intervals of reperfusion at 1 hour before PCI therapy) or control group (an uninflated cuff around the arm). Successful completion of the PCI eventually included 107 cases of patients, including 50 cases in the RIPC group and 57 cases in the control group. The level of serum creatinine (Scr), CystatinC (CysC), blood neutrophil gelatinase-associated lipocalin (NGAL), eGFR were measured in all patients at 6 AM before the day of PCI, and 4-hour NGAL, 24-hour CysC, 72-hour Scr, and eGFR after PCI in the 2 groups. The incidence of major adverse events in the kidney (including the incidence of CIN, the need for dialysis, or renal replacement therapy after using contrast agent) and the composite endpoint of cardiovascular events were recorded at 6 months after PCI. RESULTS: There were no statistically significant differences in baseline indicators between the 2 groups. Scr, CysC, and blood NGAL levels and the incidence of CIN in patients with RIPC group were significantly lower than those form the control group after PCI (P < .05), but there were no significant differences between the average value of eGFR and occurrence of Major cardiovascular events in the postoperative 6 months (P > .05). CONCLUSIONS: RIPC can reduce PCI-related CIN and protect renal function in patients with ACS. The benefits of these patients by RIPC may be related to the reduction of the NGAL and CysC. CI - Copyright (c) 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved. FAU - Zhou, Fazhan AU - Zhou F AD - Medical Examination Center of Qilu Hospital of Shandong University, Jinan Department of Cardiology, Taian City Central Hospital Taishan Medical University, Taian, Shandong, China. FAU - Song, Wei AU - Song W FAU - Wang, Zilong AU - Wang Z FAU - Yin, Luhua AU - Yin L FAU - Yang, Shen AU - Yang S FAU - Yang, Fubai AU - Yang F FAU - Song, Zhaofeng AU - Song Z FAU - Song, Yaguang AU - Song Y FAU - Zhang, Huanyi AU - Zhang H FAU - Qiao, Fengjie AU - Qiao F FAU - Zhang, Zhimian AU - Zhang Z LA - eng PT - Journal Article PT - Randomized Controlled Trial PL - United States TA - Medicine (Baltimore) JT - Medicine JID - 2985248R RN - 0 (Biomarkers) RN - 0 (Contrast Media) SB - IM MH - Acute Coronary Syndrome/complications/epidemiology/physiopathology/*therapy MH - Aged MH - Biomarkers/blood MH - Contrast Media/*toxicity MH - Female MH - Glomerular Filtration Rate MH - Humans MH - Incidence MH - *Ischemic Preconditioning/methods MH - Kidney Diseases/*chemically induced/epidemiology/physiopathology/*therapy MH - Male MH - *Percutaneous Coronary Intervention/adverse effects MH - Upper Extremity/blood supply PMC - PMC5943865 COIS- The authors report no conflicts of interest. EDAT- 2018/02/27 06:00 MHDA- 2018/03/06 06:00 PMCR- 2018/01/12 CRDT- 2018/02/27 06:00 PHST- 2018/02/27 06:00 [entrez] PHST- 2018/02/27 06:00 [pubmed] PHST- 2018/03/06 06:00 [medline] PHST- 2018/01/12 00:00 [pmc-release] AID - 00005792-201801120-00033 [pii] AID - MD-D-17-05295 [pii] AID - 10.1097/MD.0000000000009579 [doi] PST - ppublish SO - Medicine (Baltimore). 2018 Jan;97(2):e9579. doi: 10.1097/MD.0000000000009579. PMID- 29456238 OWN - NLM STAT- MEDLINE DCOM- 20180817 LR - 20190606 IS - 1643-3750 (Electronic) IS - 1234-1010 (Print) IS - 1234-1010 (Linking) VI - 24 DP - 2018 Feb 19 TI - Remote Ischemic Postconditioning (RIPC) of the Upper Arm Results in Protection from Cardiac Ischemia-Reperfusion Injury Following Primary Percutaneous Coronary Intervention (PCI) for Acute ST-Segment Elevation Myocardial Infarction (STEMI). PG - 1017-1026 AB - BACKGROUND The aim of this study was to evaluate the role of remote ischemic postconditioning (RIPC) of the upper arm on protection from cardiac ischemia-reperfusion injury following primary percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI). MATERIAL AND METHODS Eighty patients with STEMI were randomized into two groups: primary PCI (N=44) and primary PCI+RIPC (N=36). RIPC consisted of four cycles of 5 minutes of occlusion and five minutes of reperfusion by cuff inflation and deflation of the upper arm, commencing within one minute of the first PCI balloon dilatation. Peripheral venous blood samples were collected before PCI and at 0.5, 8, 24, 48, and 72 hours after PCI. Levels of creatine kinase-MB (CK-MB), serum creatinine (Cr), nitric oxide (NO), and stromal cell-derived factor-1alpha (SDF-1alpha) were measured. The rates of acute kidney injury (AKI) and the estimated glomerular filtration rate (eGFR) were calculated. RESULTS Patients in the primary PCI+RIPC group, compared with the primary PCI group, had significantly lower peak CK-MB concentrations (P<0.01), a significantly increased left ventricular ejection fraction (LVEF) (P=0.01), a significantly lower rate of AKI (P<0.01) a significantly increased eGFR (P<0.01), and decreased area under the curve (AUC) of CK-MB, NO and SDF-1alpha. CONCLUSIONS RIPC of the upper arm following primary PCI in patients with acute STEMI might provide cardiac and renal protection from ischemia-reperfusion injury via the actions of SDF-1alpha, and NO. FAU - Cao, Bangming AU - Cao B AD - Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China (mainland). FAU - Wang, Haipeng AU - Wang H AD - Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China (mainland). FAU - Zhang, Chi AU - Zhang C AD - Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China (mainland). FAU - Xia, Ming AU - Xia M AD - Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China (mainland). FAU - Yang, Xiangjun AU - Yang X AD - Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China (mainland). LA - eng PT - Journal Article PT - Randomized Controlled Trial DEP - 20180219 PL - United States TA - Med Sci Monit JT - Medical science monitor : international medical journal of experimental and clinical research JID - 9609063 RN - 0 (Chemokine CXCL12) RN - 31C4KY9ESH (Nitric Oxide) RN - EC 2.7.3.2 (Creatine Kinase, MB Form) SB - IM MH - Acute Kidney Injury/blood/complications/physiopathology MH - Area Under Curve MH - Arm/*physiopathology MH - Chemokine CXCL12/blood MH - Creatine Kinase, MB Form/blood MH - Female MH - Humans MH - *Ischemic Postconditioning MH - Kidney Function Tests MH - Male MH - Middle Aged MH - Myocardial Reperfusion Injury/blood/diagnostic imaging/*etiology/*prevention & control MH - Nitric Oxide/blood MH - Percutaneous Coronary Intervention/*adverse effects MH - ST Elevation Myocardial Infarction/blood/diagnostic imaging/*surgery PMC - PMC5827698 EDAT- 2018/02/20 06:00 MHDA- 2018/08/18 06:00 PMCR- 2018/02/19 CRDT- 2018/02/20 06:00 PHST- 2018/02/20 06:00 [entrez] PHST- 2018/02/20 06:00 [pubmed] PHST- 2018/08/18 06:00 [medline] PHST- 2018/02/19 00:00 [pmc-release] AID - 908247 [pii] AID - 10.12659/msm.908247 [doi] PST - epublish SO - Med Sci Monit. 2018 Feb 19;24:1017-1026. doi: 10.12659/msm.908247. PMID- 29447770 OWN - NLM STAT- MEDLINE DCOM- 20190130 LR - 20191210 IS - 1097-6744 (Electronic) IS - 0002-8703 (Linking) VI - 197 DP - 2018 Mar TI - Efficacy and safety of dual antiplatelet therapy after coronary stenting in patients with chronic kidney disease. PG - 103-112 LID - S0002-8703(17)30380-0 [pii] LID - 10.1016/j.ahj.2017.11.013 [doi] AB - BACKGROUND: We compared efficacy and safety of short- (3 or 6 months) versus long-term (>/=12 months) dual antiplatelet therapy (DAPT) after drug-eluting stent (DES) implantation, according to the presence of chronic kidney disease (CKD). METHODS: Patient-level pooled analysis was performed with 7242 patients (87.2% with 2nd generation DES) from 5 randomized controlled trials. RESULTS: In both CKD (1273 patients) and non-CKD (5969 patients) population, the rates of patient-oriented composite outcomes at 1-year (POCO, all-cause death, any myocardial infarction [MI], stroke and TIMI major bleeding) were not different between the short- and long-term DAPT (hazard ratio [HR] 1.19, 95% confidence interval [CI] 0.76-1.86, P=.449 in CKD population; HR 1.14, 95% CI 0.83-1.56, P=.434 in non-CKD population). The rates of coronary thrombotic events (any MI and definite/probable stent thrombosis) also did not differ between short- and long-term DAPT in either CKD or non-CKD population. As for bleeding events, long-term DAPT increased the TIMI major bleeding (HR 2.91, 95% CI 1.31-6.48, P=.009) in non-CKD population. The similar trend was observed with long-term DAPT in CKD population. But it did not reach statistical significance (HR 3.15, 95% CI 0.64-15.63, P=.160). CONCLUSIONS: The rates of POCO and coronary thrombotic events were significantly higher in patients with CKD compared with those without CKD, which were not affected by short- or long-term DAPT. Higher bleeding incidence by long-term DAPT was only observed in non-CKD patients but not in CKD patients. Further large scale studies are warranted to confirm our findings. CI - Copyright (c) 2017 Elsevier Inc. All rights reserved. FAU - Hwang, Doyeon AU - Hwang D AD - Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea. FAU - Park, Kyung Woo AU - Park KW AD - Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea. Electronic address: kwparkmd@snu.ac.kr. FAU - Lee, Joo Myung AU - Lee JM AD - Department of Internal Medicine and Cardiovascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. FAU - Rhee, Tae-Min AU - Rhee TM AD - Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea. FAU - Hong, Myeong-Ki AU - Hong MK AD - Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Republic of Korea. FAU - Jang, Yangsoo AU - Jang Y AD - Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Republic of Korea. FAU - Valgimigli, Marco AU - Valgimigli M AD - Department of Cardiology, Bern University Hospital, Bern, Switzerland. FAU - Colombo, Antonio AU - Colombo A AD - Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy. FAU - Gilard, Martine AU - Gilard M AD - Departement de cardiologie, CHU de la Cavale Blanche, Boulevard Tanguy Prigent, Brest Cedex, France. FAU - Palmerini, Tullio AU - Palmerini T AD - Dipartimento Cardiovascolare, Policlinico S. Orsola, University of Bologna, Bologna, Italy. FAU - Stone, Gregg W AU - Stone GW AD - Columbia University Medical Center/NewYork-Presbyterian Hospital, New York, NY. FAU - Kim, Hyo-Soo AU - Kim HS AD - Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea. LA - eng PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20171206 PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 RN - 0 (Platelet Aggregation Inhibitors) SB - IM MH - Aged MH - Coronary Restenosis/etiology/*prevention & control MH - *Drug Therapy, Combination/adverse effects/methods MH - Drug-Eluting Stents/adverse effects MH - Female MH - *Hemorrhage/chemically induced/prevention & control MH - Humans MH - Incidence MH - Male MH - Middle Aged MH - Myocardial Infarction/epidemiology/etiology MH - *Myocardial Ischemia/complications/epidemiology/surgery MH - Outcome Assessment, Health Care MH - *Percutaneous Coronary Intervention/adverse effects/instrumentation/methods MH - Platelet Aggregation Inhibitors/administration & dosage/adverse effects/classification MH - Renal Insufficiency, Chronic/*complications/epidemiology MH - Republic of Korea/epidemiology MH - Risk Assessment MH - Stroke/epidemiology/etiology EDAT- 2018/02/16 06:00 MHDA- 2019/01/31 06:00 CRDT- 2018/02/16 06:00 PHST- 2017/08/22 00:00 [received] PHST- 2017/11/08 00:00 [accepted] PHST- 2018/02/16 06:00 [entrez] PHST- 2018/02/16 06:00 [pubmed] PHST- 2019/01/31 06:00 [medline] AID - S0002-8703(17)30380-0 [pii] AID - 10.1016/j.ahj.2017.11.013 [doi] PST - ppublish SO - Am Heart J. 2018 Mar;197:103-112. doi: 10.1016/j.ahj.2017.11.013. Epub 2017 Dec 6. PMID- 29432119 OWN - NLM STAT- MEDLINE DCOM- 20190729 LR - 20190729 IS - 1941-7632 (Electronic) IS - 1941-7640 (Linking) VI - 11 IP - 2 DP - 2018 Feb TI - Anticoagulant Use Among Patients With End-Stage Renal Disease Undergoing Percutaneous Coronary Intervention: An Analysis From the National Cardiovascular Data Registry. PG - e005628 LID - 10.1161/CIRCINTERVENTIONS.117.005628 [doi] AB - BACKGROUND: Patients with end-stage renal disease undergoing percutaneous coronary intervention (PCI) have largely been excluded from trials of antithrombotic therapies leaving little data to guide agent choice in this population. METHODS AND RESULTS: The National Cardiovascular Data Registry CathPCI Registry was used to identify patients with end-stage renal disease undergoing PCI who received monotherapy with either bivalirudin or unfractionated heparin (UFH) (n=71 675). In hospital bleeding and mortality were compared and adjusted using the CathPCI Registry logistic regression models with generalized estimating equations with UFH as the reference. Bivalirudin was used in 51.3% of patients versus 48.7% for UFH. The use of bivalirudin decreased over time, and in 2014, UFH became the most frequently used. Patients receiving UFH were more likely to have an acute coronary syndrome presentation (37.8% versus 27.4%) or have cardiogenic shock (3.74% versus 1.98%). The observed rates for in hospital bleeding (7.0% versus 9.5%; adjusted odds ratio,0.82; 95% confidence interval, 0.76-0.87) and mortality (2.6% versus 4.2%; adjusted odds ratio, 0.87; 95% confidence interval, 0.78-0.97) were lower for patients receiving bivalirudin compared with those receiving UFH. CONCLUSIONS: In patients with end-stage renal disease undergoing PCI, bivalirudin and UFH were used with similar frequency although the patterns of use changed over the enrollment period. Patients with end-stage renal disease undergoing PCI had a lower adjusted risk of in hospital outcomes with bivalirudin; however, given the observational nature of this analysis, a randomized trial is warranted. CI - (c) 2018 American Heart Association, Inc. FAU - Washam, Jeffrey B AU - Washam JB AD - From the Duke University Medical Center, Durham, NC (J.B.W., M.R.P., S.V.R.); Duke Clinical Research Institute, Durham, NC (L.A.K., D.M.W., M.R.P., S.V.R.); Piedmont Heart Institute, Atlanta, GA (A.J.K.); and Brown Medical School, Providence, RI (J.D.A.) jeff.washam@duke.edu. FAU - Kaltenbach, Lisa A AU - Kaltenbach LA AD - From the Duke University Medical Center, Durham, NC (J.B.W., M.R.P., S.V.R.); Duke Clinical Research Institute, Durham, NC (L.A.K., D.M.W., M.R.P., S.V.R.); Piedmont Heart Institute, Atlanta, GA (A.J.K.); and Brown Medical School, Providence, RI (J.D.A.). FAU - Wojdyla, Daniel M AU - Wojdyla DM AD - From the Duke University Medical Center, Durham, NC (J.B.W., M.R.P., S.V.R.); Duke Clinical Research Institute, Durham, NC (L.A.K., D.M.W., M.R.P., S.V.R.); Piedmont Heart Institute, Atlanta, GA (A.J.K.); and Brown Medical School, Providence, RI (J.D.A.). FAU - Patel, Manesh R AU - Patel MR AD - From the Duke University Medical Center, Durham, NC (J.B.W., M.R.P., S.V.R.); Duke Clinical Research Institute, Durham, NC (L.A.K., D.M.W., M.R.P., S.V.R.); Piedmont Heart Institute, Atlanta, GA (A.J.K.); and Brown Medical School, Providence, RI (J.D.A.). FAU - Klein, Andrew J AU - Klein AJ AD - From the Duke University Medical Center, Durham, NC (J.B.W., M.R.P., S.V.R.); Duke Clinical Research Institute, Durham, NC (L.A.K., D.M.W., M.R.P., S.V.R.); Piedmont Heart Institute, Atlanta, GA (A.J.K.); and Brown Medical School, Providence, RI (J.D.A.). FAU - Abbott, J Dawn AU - Abbott JD AD - From the Duke University Medical Center, Durham, NC (J.B.W., M.R.P., S.V.R.); Duke Clinical Research Institute, Durham, NC (L.A.K., D.M.W., M.R.P., S.V.R.); Piedmont Heart Institute, Atlanta, GA (A.J.K.); and Brown Medical School, Providence, RI (J.D.A.). FAU - Rao, Sunil V AU - Rao SV AD - From the Duke University Medical Center, Durham, NC (J.B.W., M.R.P., S.V.R.); Duke Clinical Research Institute, Durham, NC (L.A.K., D.M.W., M.R.P., S.V.R.); Piedmont Heart Institute, Atlanta, GA (A.J.K.); and Brown Medical School, Providence, RI (J.D.A.). LA - eng PT - Comparative Study PT - Journal Article PT - Observational Study PL - United States TA - Circ Cardiovasc Interv JT - Circulation. Cardiovascular interventions JID - 101499602 RN - 0 (Anticoagulants) RN - 0 (Antithrombins) RN - 0 (Hirudins) RN - 0 (Peptide Fragments) RN - 0 (Recombinant Proteins) RN - 9005-49-6 (Heparin) RN - TN9BEX005G (bivalirudin) MH - Aged MH - Anticoagulants/*administration & dosage/adverse effects MH - Antithrombins/*administration & dosage/adverse effects MH - Coronary Artery Disease/complications/diagnostic imaging/mortality/*surgery MH - Female MH - Hemorrhage/chemically induced/mortality MH - Heparin/*administration & dosage/adverse effects MH - Hirudins/*administration & dosage/adverse effects MH - Hospital Mortality MH - Humans MH - Kidney/physiopathology MH - Kidney Failure, Chronic/*complications/diagnosis/mortality/physiopathology MH - Male MH - Middle Aged MH - Peptide Fragments/*administration & dosage/adverse effects MH - *Percutaneous Coronary Intervention/adverse effects/mortality MH - Practice Patterns, Physicians' MH - Recombinant Proteins/administration & dosage/adverse effects MH - Registries MH - Risk Factors MH - Time Factors MH - Treatment Outcome OTO - NOTNLM OT - acute coronary syndrome OT - bivalirudin OT - heparin OT - kidney failure, chronic OT - percutaneous coronary intervention EDAT- 2018/02/13 06:00 MHDA- 2019/07/30 06:00 CRDT- 2018/02/13 06:00 PHST- 2017/06/12 00:00 [received] PHST- 2018/01/05 00:00 [accepted] PHST- 2018/02/13 06:00 [entrez] PHST- 2018/02/13 06:00 [pubmed] PHST- 2019/07/30 06:00 [medline] AID - CIRCINTERVENTIONS.117.005628 [pii] AID - 10.1161/CIRCINTERVENTIONS.117.005628 [doi] PST - ppublish SO - Circ Cardiovasc Interv. 2018 Feb;11(2):e005628. doi: 10.1161/CIRCINTERVENTIONS.117.005628. PMID- 29397139 OWN - NLM STAT- MEDLINE DCOM- 20181221 LR - 20220321 IS - 1471-6771 (Electronic) IS - 0007-0912 (Linking) VI - 120 IP - 1 DP - 2018 Jan TI - Management of antiplatelet therapy in patients with coronary stents undergoing noncardiac surgery: association with adverse events. PG - 67-76 LID - S0007-0912(17)54001-5 [pii] LID - 10.1016/j.bja.2017.11.012 [doi] AB - BACKGROUND: Perioperative discontinuation of antiplatelet therapy (APT) in patients with coronary stents has been associated with major adverse cardiac events. Our aim was to analyse the perioperative management of APT in such patients and its relationship to the incidence of major adverse cardiac and cerebrovascular events (MACCE) and major bleeding events (MBE) in noncardiac surgery. METHODS: We completed a prospective multicentre observational study of patients with coronary stents undergoing noncardiac surgery in 11 hospitals in Spain. The main objectives were to record perioperative events and prospectively analyse the management of APT, and to assess whether the different preoperative APT regimens were associated with MACCE and MBE. RESULTS: Of 432 surgical procedures studied, 15% experienced a perioperative MACCE and 37% a MBE. Overall mortality was 3.0%. Presurgical APT was prescribed in 95% of procedures, and was preoperatively discontinued in 15%. Surgery was urgent or emergent in 22% of patients, 31% were ASA IV, and 38% had a Revised Cardiac Risk Index of IV. MACCE were related to recent myocardial infarction (P=0.038), chronic kidney disease (P<0.001), insulin-dependent diabetes (P=0.006) and no preoperative APT (P=0.018). MBE also increased MACCE risk (P<0.001). We found statin therapy (P=0.049) and obesity (P=0.016) to be protective factors for MACCE. CONCLUSIONS: Patients with coronary stents undergoing noncardiac surgery suffer a high incidence of perioperative adverse events, even with perioperative APT. Major adverse cardiac and cerebrovascular events are mainly related to previous medical conditions and perioperative major bleeingn events. Our findings should be treated with caution when applied to an elective surgery population. CLINICAL TRIAL REGISTRATION: NCT01171612. CI - Copyright (c) 2017. Published by Elsevier Ltd. FAU - Rodriguez, A AU - Rodriguez A AD - Department of Anaesthesiology, Parc Tauli Hospital Universitari, Institut d'Investigacio i Innovacio Parc Tauli I3PT, Universitat Autonoma de Barcelona, Sabadell, Spain. Electronic address: arodriguezp@tauli.cat. FAU - Guilera, N AU - Guilera N AD - Department of Anaesthesiology, Parc Tauli Hospital Universitari, Institut d'Investigacio i Innovacio Parc Tauli I3PT, Universitat Autonoma de Barcelona, Sabadell, Spain. FAU - Mases, A AU - Mases A AD - Department of Anaesthesiology, Hospital del Mar, Institut Hospital del Mar d'Investigacions Mediques (IMIM), Barcelona, Spain. FAU - Sierra, P AU - Sierra P AD - Department of Anaesthesiology, Fundacio Puigvert (IUNA), Barcelona, Spain. FAU - Oliva, J C AU - Oliva JC AD - Departament of Statistics, Parc Tauli Hospital Universitari, Institut d'Investigacio i Innovacio Parc Tauli I3PT, Universitat Autonoma de Barcelona, Sabadell, Spain. FAU - Colilles, C AU - Colilles C AD - Department of Anaesthesiology, Parc Tauli Hospital Universitari, Institut d'Investigacio i Innovacio Parc Tauli I3PT, Universitat Autonoma de Barcelona, Sabadell, Spain. CN - REGISTRESTENTS group LA - eng SI - ClinicalTrials.gov/NCT01171612 PT - Journal Article PT - Multicenter Study PT - Observational Study DEP - 20171121 PL - England TA - Br J Anaesth JT - British journal of anaesthesia JID - 0372541 RN - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors) RN - 0 (Platelet Aggregation Inhibitors) SB - IM EIN - Br J Anaesth. 2018 May;120(5):1143-1144. doi: 10.1016/j.bja.2018.02.023. PMID: 29661401 MH - Adult MH - Aged MH - Aged, 80 and over MH - *Coronary Vessels MH - Female MH - Humans MH - Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use MH - Incidence MH - Intraoperative Complications/epidemiology MH - Male MH - Medication Therapy Management MH - Middle Aged MH - Obesity/physiopathology MH - Perioperative Care/*methods MH - Platelet Aggregation Inhibitors/*therapeutic use MH - Postoperative Complications/epidemiology MH - Prospective Studies MH - Spain/epidemiology MH - *Stents MH - Surgical Procedures, Operative/*adverse effects/*methods/mortality OTO - NOTNLM OT - antiplatelet agents OT - cardiovascular system/complications OT - perioperative period/complications EDAT- 2018/02/06 06:00 MHDA- 2018/12/24 06:00 CRDT- 2018/02/05 06:00 PHST- 2017/08/10 00:00 [accepted] PHST- 2018/02/05 06:00 [entrez] PHST- 2018/02/06 06:00 [pubmed] PHST- 2018/12/24 06:00 [medline] AID - S0007-0912(17)54001-5 [pii] AID - 10.1016/j.bja.2017.11.012 [doi] PST - ppublish SO - Br J Anaesth. 2018 Jan;120(1):67-76. doi: 10.1016/j.bja.2017.11.012. Epub 2017 Nov 21. PMID- 29340315 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20241031 IS - 2468-0249 (Electronic) IS - 2468-0249 (Linking) VI - 3 IP - 1 DP - 2018 Jan TI - Contrast-Induced Nephropathy and Oxygen Pretreatment in Patients With Impaired Renal Function. PG - 65-72 LID - 10.1016/j.ekir.2017.08.002 [doi] AB - INTRODUCTION: Contrast-induced nephropathy is a complication following coronary angiography and percutaneous coronary intervention. Because contrast-induced nephropathy is a predictor of long-term mortality in patients with ischemic heart disease undergoing percutaneous coronary intervention, preventive strategies are required. We assessed the effects of periprocedural oxygenation on contrast-induced nephropathy among patients with pre-existing renal dysfunction. METHODS: A total of 200 consecutive patients with impaired renal function (estimated glomerular filtration < 60 ml/min per 1.73 m(2)) undergoing elective cardiovascular angiography were randomly assigned to an oxygenation treatment (n = 100) or control group (n = 100). In oxygenation treatment, pure oxygen (2 L/min) was administered for 10 minutes before exposure to contrast medium. The primary endpoint was the incidence of contrast-induced nephropathy, defined as a >/= 25% increase in serum creatinine levels from baseline within 48 hours of exposure. RESULTS: In the oxygenation treatment group, partial pressure of arterial oxygen was higher (135 +/- 25 mm Hg vs. 84 +/- 10 mm Hg, P < 0.001); contrast-induced nephropathy incidence was lower (1% vs. 8%, odds ratio [OR] = 0.12, 95% confidence interval [CI] = 0.01-0.95, P = 0.02); and partial pressure of arterial carbon dioxide and bicarbonate base lactate levels were similar compared with those in the control group. Upon univariate analysis, excess and absence of oxygenation treatment (OR = 9.18, CI = 1.13-74.86, P = 0.03) and anemia (OR = 4.30, CI = 1.04-17.78, P = 0.04) were shown to be associated with contrast-induced nephropathy incidence. CONCLUSION: Oxygenation, a simple, nonpharmacological strategy, may be beneficial when using contrast media in patients with impaired renal function from noninvasive angiography to emergency catheterization. FAU - Sekiguchi, Haruki AU - Sekiguchi H AD - National Hospital Organization Yokohama Medical Center, Kanagawa, Japan. AD - Aoyama Hospital Tokyo Women's Medical University, Tokyo, Japan. AD - Tokyo Women's Medical University, Tokyo, Japan. FAU - Ajiro, Yoichi AU - Ajiro Y AD - National Hospital Organization Yokohama Medical Center, Kanagawa, Japan. AD - Tokyo Women's Medical University, Tokyo, Japan. FAU - Uchida, Yoshie AU - Uchida Y AD - National Hospital Organization Yokohama Medical Center, Kanagawa, Japan. AD - Tokyo Women's Medical University, Tokyo, Japan. FAU - Jujo, Kentaro AU - Jujo K AD - Tokyo Women's Medical University, Tokyo, Japan. FAU - Iwade, Kazunori AU - Iwade K AD - National Hospital Organization Yokohama Medical Center, Kanagawa, Japan. AD - Tokyo Women's Medical University, Tokyo, Japan. FAU - Tanaka, Naohide AU - Tanaka N AD - National Hospital Organization Yokohama Medical Center, Kanagawa, Japan. AD - Tokyo Women's Medical University, Tokyo, Japan. FAU - Shimamoto, Ken AU - Shimamoto K AD - Aoyama Hospital Tokyo Women's Medical University, Tokyo, Japan. AD - Tokyo Women's Medical University, Tokyo, Japan. FAU - Tsurumi, Yukio AU - Tsurumi Y AD - Aoyama Hospital Tokyo Women's Medical University, Tokyo, Japan. AD - You Heart Clinic, Tokyo, Tokyo, Japan. FAU - Kawana, Masatoshi AU - Kawana M AD - Aoyama Hospital Tokyo Women's Medical University, Tokyo, Japan. AD - Tokyo Women's Medical University, Tokyo, Japan. FAU - Hagiwara, Nobuhisa AU - Hagiwara N AD - Tokyo Women's Medical University, Tokyo, Japan. LA - eng PT - Journal Article DEP - 20170812 PL - United States TA - Kidney Int Rep JT - Kidney international reports JID - 101684752 PMC - PMC5762947 OTO - NOTNLM OT - acute kidney injury OT - cardiovascular disease OT - chronic kidney disease OT - hypoxia OT - nephrotoxicity EDAT- 2018/01/18 06:00 MHDA- 2018/01/18 06:01 PMCR- 2017/08/12 CRDT- 2018/01/18 06:00 PHST- 2016/10/16 00:00 [received] PHST- 2017/08/01 00:00 [revised] PHST- 2017/08/07 00:00 [accepted] PHST- 2018/01/18 06:00 [entrez] PHST- 2018/01/18 06:00 [pubmed] PHST- 2018/01/18 06:01 [medline] PHST- 2017/08/12 00:00 [pmc-release] AID - S2468-0249(17)30344-3 [pii] AID - 10.1016/j.ekir.2017.08.002 [doi] PST - epublish SO - Kidney Int Rep. 2017 Aug 12;3(1):65-72. doi: 10.1016/j.ekir.2017.08.002. eCollection 2018 Jan. PMID- 29277288 OWN - NLM STAT- MEDLINE DCOM- 20190730 LR - 20190730 IS - 1878-0938 (Electronic) IS - 1878-0938 (Linking) VI - 19 IP - 3 Pt B DP - 2018 Apr-May TI - Early discontinuation of dual antiplatelet therapy in patients treated with the bio-engineered pro-healing sirolimus-eluting (COMBO) stent. PG - 373-375 LID - S1553-8389(17)30392-5 [pii] LID - 10.1016/j.carrev.2017.10.005 [doi] AB - BACKGROUND: When the pro-healing COMBO stent is used, a short duration of dual-antiplatelet therapy (DAPT) might be safe. However, no cases have been described of patients with short duration of DAPT after COMBO stent placement. METHODS AND RESULTS: We investigate clinical outcomes at 1year after early discontinuation of DAPT in patients participating in the REMEDEE Registry. This is a prospective, multicentre, European, all-comers registry with a 1000 patients treated with COMBO stent. Target lesion failure (TLF), a composite of target vessel-myocardial infarction (tv-MI), cardiac death and target lesion revascularization, and the occurrence of stent thrombosis (ST) in relation with DAPT cessation before 30 and 180days of follow-up is evaluated. At 30days follow-up 48 patients were not on DAPT, at 180days follow-up of 78 patients had no DAPT. Patients with DAPT discontinuation were older, had overall lower left ventricle ejection fraction and more frequent chronic renal failure. No TLF and especially no stent thrombosis were observed in these patients. CONCLUSIONS: Discontinuation of DAPT within 6months after COMBO stent placement did not influence the rate of TLF up to 1-year follow-up. Large randomized trials are needed to confirm the safety of short duration of DAPT after COMBO stent placement. CI - Copyright (c) 2017 Elsevier Inc. All rights reserved. FAU - Kalkman, Deborah N AU - Kalkman DN AD - Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. Electronic address: d.n.kalkman@amc.uva.nl. FAU - Woudstra, Pier AU - Woudstra P AD - Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. Electronic address: p.woudstra@amc.uva.nl. FAU - Menown, Ian B A AU - Menown IBA AD - Craigavon Cardiac Centre, Craigavon, United Kingdom. Electronic address: ian.menown@southerntrust.hscni.net. FAU - Tijssen, Jan G AU - Tijssen JG AD - Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. FAU - Beijk, Marcel A M AU - Beijk MAM AD - Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. Electronic address: m.a.beijk@amc.uva.nl. FAU - de Winter, Robbert J AU - de Winter RJ AD - Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. Electronic address: r.j.dewinter@amc.uva.nl. CN - REMEDEE Registry collaborators LA - eng PT - Journal Article PT - Multicenter Study PT - Observational Study DEP - 20171017 PL - United States TA - Cardiovasc Revasc Med JT - Cardiovascular revascularization medicine : including molecular interventions JID - 101238551 RN - 0 (Cardiovascular Agents) RN - 0 (Platelet Aggregation Inhibitors) RN - W36ZG6FT64 (Sirolimus) MH - Aged MH - Aged, 80 and over MH - Cardiovascular Agents/*administration & dosage/adverse effects MH - Coronary Artery Disease/diagnostic imaging/*surgery MH - Drug Administration Schedule MH - Drug Therapy, Combination MH - *Drug-Eluting Stents MH - Europe MH - Female MH - Humans MH - Male MH - Middle Aged MH - Percutaneous Coronary Intervention/adverse effects/*instrumentation MH - Platelet Aggregation Inhibitors/*administration & dosage/adverse effects MH - Prospective Studies MH - Prosthesis Design MH - Registries MH - Risk Factors MH - Sirolimus/*administration & dosage/adverse effects MH - Time Factors MH - Treatment Outcome OTO - NOTNLM OT - COMBO OT - DAPT OT - PCI OT - Stent EDAT- 2017/12/27 06:00 MHDA- 2019/07/31 06:00 CRDT- 2017/12/27 06:00 PHST- 2017/03/07 00:00 [received] PHST- 2017/10/12 00:00 [revised] PHST- 2017/10/12 00:00 [accepted] PHST- 2017/12/27 06:00 [pubmed] PHST- 2019/07/31 06:00 [medline] PHST- 2017/12/27 06:00 [entrez] AID - S1553-8389(17)30392-5 [pii] AID - 10.1016/j.carrev.2017.10.005 [doi] PST - ppublish SO - Cardiovasc Revasc Med. 2018 Apr-May;19(3 Pt B):373-375. doi: 10.1016/j.carrev.2017.10.005. Epub 2017 Oct 17. PMID- 29266282 OWN - NLM STAT- MEDLINE DCOM- 20180813 LR - 20260127 IS - 1932-8737 (Electronic) IS - 0160-9289 (Print) IS - 0160-9289 (Linking) VI - 40 IP - 12 DP - 2017 Dec TI - Acute kidney injury requiring dialysis and in-hospital mortality in patients with chronic kidney disease and non-ST-segment elevation acute coronary syndrome undergoing early vs delayed percutaneous coronary intervention: A nationwide analysis. PG - 1303-1308 LID - 10.1002/clc.22828 [doi] AB - BACKGROUND: Chronic kidney disease (CKD) is a well-known risk factor for coronary artery disease and is associated with poor outcomes following an acute coronary syndrome (NSTE-ACS). The optimal timing of an invasive strategy in patients with CKD and NSTE-ACS is unclear. HYPOTHESIS: Timing of PCI in CKD patients will not affect the risk of mortality or incidence of dialysis. METHODS: We queried the National Inpatient Sample database (NIS) to identify cases with NSTEMI and CKD. Patients who underwent percutaneous coronary intervention (PCI) day 0 or 1 vs day 2 or 3 after admission were categorized as early vs delayed PCI, respectively. The primary outcomes of the study were in-hospital mortality and acute kidney injury requiring hemodialysis (AKI-D). The secondary outcomes were length of stay and hospital charges. Baseline characteristics were balanced using propensity score matching (PSM). RESULTS: After PSM, 3708 cases from the delayed PCI group were matched with 3708 cases from the early PCI group. The standardized mean differences between the 2 groups were substantially reduced after PSM. All other recorded variables were balanced between the 2 groups. In the early and delayed PCI groups, the incidence of AKI-D (2.5% vs 2.3%; P = 0.54) and in-hospital mortality (1.9% vs 1.4%; P = 0.12) was similar. Hospital charges and length of stay were higher in the delayed PCI group. CONCLUSIONS: The incidence of AKI-D and in-hospital mortality among patients with CKD and NSTE-ACS were not significantly affected by the timing of PCI. However, delayed PCI added significant cost and length of stay. A prospective randomized study is required to validate this concept. CI - (c) 2017 Wiley Periodicals, Inc. FAU - Patel, Brijesh AU - Patel B AUID- ORCID: 0000-0001-8973-8228 AD - Divison of Cardiology, Lehigh Valley Hospital, Allentown, Pennsylvania. FAU - Carson, Philip AU - Carson P AD - Divison of Cardiology, Lehigh Valley Hospital, Allentown, Pennsylvania. FAU - Shah, Mahek AU - Shah M AD - Divison of Cardiology, Lehigh Valley Hospital, Allentown, Pennsylvania. FAU - Garg, Lohit AU - Garg L AUID- ORCID: 0000-0002-9387-4369 AD - Divison of Cardiology, Lehigh Valley Hospital, Allentown, Pennsylvania. FAU - Agarwal, Manyoo AU - Agarwal M AUID- ORCID: 0000-0002-0549-9440 AD - Divison of Internal Medicine, University of Tennessee Health Science Center, Memphis. FAU - Agrawal, Sahil AU - Agrawal S AUID- ORCID: 0000-0002-2075-7807 AD - Divison of Cardiology, St. Luke's University Health Network, Bethlehem, Pennsylvania. FAU - Arora, Shilpkumar AU - Arora S AD - Divison of Cardiology, Mount Sinai St. Luke's Roosevelt Hospital, New York, New York. FAU - Steigerwalt, Susan AU - Steigerwalt S AD - Divison of Nephrology, University of Michigan School of Medicine, Ann Arbor. FAU - Bavry, Anthony AU - Bavry A AD - Division of Cardiology, University of Florida, Gainesville. FAU - Dusaj, Raman AU - Dusaj R AD - Divison of Cardiology, Lehigh Valley Hospital, Allentown, Pennsylvania. FAU - Patel, Nainesh AU - Patel N AD - Divison of Cardiology, Lehigh Valley Hospital, Allentown, Pennsylvania. FAU - Feldman, Bruce AU - Feldman B AD - Divison of Cardiology, Lehigh Valley Hospital, Allentown, Pennsylvania. LA - eng PT - Journal Article PT - Multicenter Study DEP - 20171220 PL - United States TA - Clin Cardiol JT - Clinical cardiology JID - 7903272 SB - IM MH - Acute Coronary Syndrome/*complications/mortality/surgery MH - Acute Kidney Injury/epidemiology/*etiology/therapy MH - Aged MH - Aged, 80 and over MH - Coronary Angiography/adverse effects MH - *Electrocardiography MH - Female MH - Follow-Up Studies MH - Hospital Mortality/trends MH - Humans MH - Incidence MH - Male MH - Middle Aged MH - *Percutaneous Coronary Intervention MH - Prognosis MH - Propensity Score MH - Prospective Studies MH - Renal Dialysis/*statistics & numerical data MH - Renal Insufficiency, Chronic/*complications/mortality MH - *Risk Assessment MH - Risk Factors MH - Survival Rate/trends MH - United States/epidemiology PMC - PMC6490607 OTO - NOTNLM OT - Acute Coronary Syndrome OT - Cardiac Catheterization/Diagnostic OT - Interventional OT - Kidney Disease COIS- Dr. Bavry is a contractor for the American College of Cardiology. The authors declare no other potential conflicts of interest. EDAT- 2017/12/22 06:00 MHDA- 2018/08/14 06:00 PMCR- 2017/12/20 CRDT- 2017/12/22 06:00 PHST- 2017/07/10 00:00 [received] PHST- 2017/09/16 00:00 [revised] PHST- 2017/09/22 00:00 [accepted] PHST- 2017/12/22 06:00 [pubmed] PHST- 2018/08/14 06:00 [medline] PHST- 2017/12/22 06:00 [entrez] PHST- 2017/12/20 00:00 [pmc-release] AID - CLC22828 [pii] AID - 10.1002/clc.22828 [doi] PST - ppublish SO - Clin Cardiol. 2017 Dec;40(12):1303-1308. doi: 10.1002/clc.22828. Epub 2017 Dec 20. PMID- 29240736 OWN - NLM STAT- MEDLINE DCOM- 20171221 LR - 20260127 IS - 1175-8716 (Electronic) IS - 0028-8446 (Linking) VI - 130 IP - 1467 DP - 2017 Dec 15 TI - Management of coronary artery disease in patients on dialysis. PG - 11-22 AB - AIMS: Coronary artery disease is common in patients with end-stage renal failure (ESRF). However, there is little evidence that revascularisation improves outcomes, compared with medical management. This study assessed survival and cardiovascular outcomes in patients with ESRF undergoing coronary angiography and then having coronary artery bypass graft (CABG) surgery, percutaneous coronary intervention (PCI) or medical management. METHODS: Survival and major adverse cardiac events (MACE) were examined in all patients with ESRF who underwent coronary angiography at Auckland City Hospital between 2003 and 2012. Outcomes of patients who underwent revascularisation (CABG or PCI) were compared with those managed medically. RESULTS: Two hundred and eighty-eight patients with ESRF had a total of 382 diagnostic coronary angiograms. Ninety-one (32%) patients underwent revascularisation (61 PCI, 30 CABG), with the other 197 (68%) treated medically or requiring no specific cardiac treatment. The median survival was 3.3 (IQR 2.1-5.3) years in patients undergoing CABG, 2.9 (IQR 1.5-5.4) years in patients treated with PCI and 2.9 (IQR 1.3-5.5) years in patients managed medically. There was no significant difference in survival between treatment modalities in the entire cohort, nor in the 108 patients with triple vessel disease. Similarly, there was no difference in the incidence of major adverse cardiac events, comparing medical management with revascularisation. CONCLUSION: There was no apparent survival advantage with revascularisation by either CABG or PCI, compared with medical management, in patients with ESRF undergoing coronary angiography. This study confirms the poor prognosis of patients with ESRF and coronary disease. Observational studies cannot control for all potential confounders; randomised trial data are needed to guide optimal management of this high-risk patient cohort. FAU - Pilmore, Helen AU - Pilmore H AD - Department of Renal Medicine, University of Auckland, Auckland. FAU - Webster, Mark AU - Webster M AD - Cardiology, Auckland. FAU - Sidhu, Karishma AU - Sidhu K AD - Biostatistics, Auckland City Hospital, Auckland. FAU - Srikumar, Gajan AU - Srikumar G AD - University of Auckland, Auckland. LA - eng PT - Journal Article PT - Observational Study DEP - 20171215 PL - New Zealand TA - N Z Med J JT - The New Zealand medical journal JID - 0401067 SB - IM MH - Aged MH - Coronary Angiography MH - Coronary Artery Bypass/*mortality MH - Coronary Artery Disease/diagnostic imaging/*mortality/*surgery MH - Female MH - Humans MH - Kidney Failure, Chronic/*complications/therapy MH - Male MH - Middle Aged MH - Multivariate Analysis MH - New Zealand/epidemiology MH - Percutaneous Coronary Intervention/*mortality MH - *Renal Dialysis MH - Retrospective Studies MH - Survival Analysis COIS- Dr Srikumar reports grants from ADHB & A+ Trust during the conduct of the study. EDAT- 2017/12/15 06:00 MHDA- 2017/12/22 06:00 CRDT- 2017/12/15 06:00 PHST- 2017/12/15 06:00 [entrez] PHST- 2017/12/15 06:00 [pubmed] PHST- 2017/12/22 06:00 [medline] PST - epublish SO - N Z Med J. 2017 Dec 15;130(1467):11-22. PMID- 29223429 OWN - NLM STAT- MEDLINE DCOM- 20171215 LR - 20260127 IS - 1097-6744 (Electronic) IS - 0002-8703 (Linking) VI - 194 DP - 2017 Dec TI - Predicting risk of cardiac events among ST-segment elevation myocardial infarction patients with conservatively managed non-infarct-related artery coronary artery disease: An analysis of the Duke Databank for Cardiovascular Disease. PG - 116-124 LID - S0002-8703(17)30265-X [pii] LID - 10.1016/j.ahj.2017.08.023 [doi] AB - BACKGROUND: Recent randomized evidence has demonstrated benefit with complete revascularization during the index hospitalization for multivessel coronary artery disease ST-segment elevation myocardial infarction (STEMI) patients; however, this benefit likely depends on the risk of future major adverse cardiovascular events (MACE). METHODS: Using data from Duke University Medical Center (2003-2012), we identified those at high risk for 1-year MACE among 664 STEMI patients with conservatively managed non-infarct-related artery (non-IRA) lesions. Using multivariable logistic regression, we identified clinical and angiographic characteristics associated with MACE (death, myocardial infarction, urgent revascularization) to 1 year and developed an integer-based risk prediction model for clinical use. RESULTS: In this cohort (median age 60 years, 30% female), the unadjusted Kaplan-Meier rates for MACE at 30 days and 1 year were 10% and 28%, respectively. Characteristics associated with MACE at 1 year included reduced left ventricular ejection fraction, hypertension, heart failure, higher-risk non-IRA vessels (left main), renal insufficiency, and greater % stenosis of non-IRA lesions. A 15-point risk score including these variables had modest discrimination (C-index 0.67) across a spectrum of subsequent risk (4%-88%) for 1-year MACE. CONCLUSIONS: There is a wide spectrum of risk following primary percutaneous coronary intervention for STEMI patients with multivessel disease. Using readily available clinical characteristics, the expected incidence of MACE by 1 year can be calculated with a simplified risk score, facilitating a tailored approach to clinical care. CI - Copyright (c) 2017 Elsevier Inc. All rights reserved. FAU - Hirji, Sameer A AU - Hirji SA AD - Duke Clinical Research Institute, Duke University Health System, Durham, NC, USA; Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. FAU - Stevens, Susanna R AU - Stevens SR AD - Duke Clinical Research Institute, Duke University Health System, Durham, NC, USA. FAU - Shaw, Linda K AU - Shaw LK AD - Duke Clinical Research Institute, Duke University Health System, Durham, NC, USA. FAU - Campbell, Erin C AU - Campbell EC AD - Duke Clinical Research Institute, Duke University Health System, Durham, NC, USA. FAU - Granger, Christopher B AU - Granger CB AD - Duke Clinical Research Institute, Duke University Health System, Durham, NC, USA. FAU - Patel, Manesh R AU - Patel MR AD - Duke Clinical Research Institute, Duke University Health System, Durham, NC, USA. FAU - Sketch, Michael H Jr AU - Sketch MH Jr AD - Duke Clinical Research Institute, Duke University Health System, Durham, NC, USA. FAU - Wang, Tracy Y AU - Wang TY AD - Duke Clinical Research Institute, Duke University Health System, Durham, NC, USA. FAU - Ohman, E Magnus AU - Ohman EM AD - Duke Clinical Research Institute, Duke University Health System, Durham, NC, USA. FAU - Peterson, Eric D AU - Peterson ED AD - Duke Clinical Research Institute, Duke University Health System, Durham, NC, USA. FAU - Brennan, J Matthew AU - Brennan JM AD - Duke Clinical Research Institute, Duke University Health System, Durham, NC, USA. Electronic address: j.matthew.brennan@dm.duke.edu. LA - eng PT - Journal Article PT - Randomized Controlled Trial DEP - 20170901 PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 SB - IM MH - Aged MH - Coronary Artery Disease/complications/mortality/*therapy MH - *Disease Management MH - Female MH - Follow-Up Studies MH - Humans MH - Male MH - Massachusetts/epidemiology MH - Middle Aged MH - Prognosis MH - Retrospective Studies MH - *Risk Assessment MH - ST Elevation Myocardial Infarction/*complications/mortality/surgery MH - Survival Rate/trends MH - Thrombolytic Therapy/*methods EDAT- 2017/12/11 06:00 MHDA- 2017/12/16 06:00 CRDT- 2017/12/11 06:00 PHST- 2017/01/03 00:00 [received] PHST- 2017/08/30 00:00 [accepted] PHST- 2017/12/11 06:00 [entrez] PHST- 2017/12/11 06:00 [pubmed] PHST- 2017/12/16 06:00 [medline] AID - S0002-8703(17)30265-X [pii] AID - 10.1016/j.ahj.2017.08.023 [doi] PST - ppublish SO - Am Heart J. 2017 Dec;194:116-124. doi: 10.1016/j.ahj.2017.08.023. Epub 2017 Sep 1. PMID- 29181161 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20201001 IS - 2049-9434 (Print) IS - 2049-9442 (Electronic) IS - 2049-9434 (Linking) VI - 7 IP - 5 DP - 2017 Nov TI - Effects of hydration combined with Shenfu injection on contrast-induced acute kidney injury in acute coronary syndrome patients undergoing percutaneous coronary intervention. PG - 477-481 LID - 10.3892/br.2017.986 [doi] AB - The aim of the present study was to evaluate the efficacy and safety of the Shenfu injection (SFI) in the prevention of contrast-induced acute kidney injury (CI-AKI) in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI). A single-center prospective and randomized controlled trial was performed and 148 ACS patients undergoing PCI were divided randomly into control (n=74; receiving only 0.9% sodium chloride solution for routine hydration) and intervention (n=74; based upon routine hydration and receiving SFI) groups. Serum creatinine (Scr), blood urea nitrogen and urinary neutrophil gelatinase-associated lipocalin (NGAL) were evaluated at the start, and 1 and 2 days after PCI. Among the 148 patients, 14 (9.4%) experienced CI-AKI subsequent to the procedure. CI-AKI occurred in 2.7% of the SFI group and 16.2% of the control group (P<0.05). The incidence of CI-AKI was lower in the intervention group when compared with the control. No serious adverse effects were observed in all patients. No differences between the levels of Scr and estimated glomerular filtration rate in the two groups were identified. However, 12 h after PCI, the urinary NGAL level in the control group was significantly higher than that in the SFI group (P<0.05). Thus, hydration combined with SFI was identified to be more effective than hydration with sodium chloride in the prevention of CI-AKI in ACS patients undergoing PCI. FAU - Guo, Zhen AU - Guo Z AD - Department of Cardiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221002, P.R. China. FAU - Niu, Dandan AU - Niu D AD - Department of Cardiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221002, P.R. China. FAU - Yu, Yaren AU - Yu Y AD - Department of Cardiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221002, P.R. China. FAU - Zhen, Di AU - Zhen D AD - Department of Cardiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221002, P.R. China. FAU - Li, Wenhua AU - Li W AD - Department of Cardiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221002, P.R. China. LA - eng PT - Journal Article DEP - 20170922 PL - England TA - Biomed Rep JT - Biomedical reports JID - 101613227 PMC - PMC5700400 OTO - NOTNLM OT - Shenfu injection OT - contrast-induced acute kidney injury OT - prevention EDAT- 2017/11/29 06:00 MHDA- 2017/11/29 06:01 PMCR- 2017/09/22 CRDT- 2017/11/29 06:00 PHST- 2017/08/18 00:00 [received] PHST- 2017/08/30 00:00 [accepted] PHST- 2017/11/29 06:00 [entrez] PHST- 2017/11/29 06:00 [pubmed] PHST- 2017/11/29 06:01 [medline] PHST- 2017/09/22 00:00 [pmc-release] AID - BR-0-0-986 [pii] AID - 10.3892/br.2017.986 [doi] PST - ppublish SO - Biomed Rep. 2017 Nov;7(5):477-481. doi: 10.3892/br.2017.986. Epub 2017 Sep 22. PMID- 29155387 OWN - NLM STAT- MEDLINE DCOM- 20190718 LR - 20190718 IS - 1969-6213 (Electronic) IS - 1774-024X (Linking) VI - 14 IP - 1 DP - 2018 May 20 TI - The impact of chronic kidney disease on outcomes following percutaneous coronary intervention versus coronary artery bypass grafting in patients with complex coronary artery disease: five-year follow-up of the SYNTAX trial. PG - 102-111 LID - EIJ-D-17-00620 [pii] LID - 10.4244/EIJ-D-17-00620 [doi] AB - AIMS: The aim of this study was to investigate short-term and five-year follow-up results from patients randomised to coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) with paclitaxel-eluting stents in the SYNTAX trial, focusing on patients with chronic kidney disease (CKD). METHODS AND RESULTS: Baseline glomerular filtration rate estimates (eGFR) were available in 1,638 patients (PCI=852 and CABG=786). The Kidney Disease: Improving Global Outcomes (KDIGO) threshold was used to define staging of CKD. At five years, death was significantly higher in patients with CKD compared to patients with normal kidney function after PCI (26.7% vs. 10.8%, p<0.001) and CABG (21.2% vs. 10.6%, p=0.005). Comparing PCI with CABG, there was a significant interaction according to kidney function for death (pint=0.017) but not the composite endpoint of death/stroke/MI (pint=0.070) or MACCE (pint=0.15). In patients with CKD, the rate of MACCE was significantly higher after PCI compared with CABG (42.1% vs. 31.5%, p=0.019), driven by repeat revascularisation (21.9% vs. 8.9%, p=0.004) and all-cause death (26.7% vs. 21.2%, p=0.14). In patients with CKD who also had diabetes, PCI versus CABG was significantly worse in terms of death/stroke/MI (47.9% vs. 24.4%, p=0.005) and all-cause death (40.9% vs. 17.7%, p=0.004). CONCLUSIONS: During a five-year follow-up, adverse event rates were comparable between PCI and CABG patients with moderate CKD but significantly higher compared to the patients with impaired or normal kidney function. The negative impact of CKD on long-term outcome following PCI appears to be stronger when compared to CABG, especially in the CKD patients with diabetes and extensive coronary disease. FAU - Milojevic, Milan AU - Milojevic M AD - Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands. FAU - Head, Stuart J AU - Head SJ FAU - Mack, Michael J AU - Mack MJ FAU - Mohr, Friedrich W AU - Mohr FW FAU - Morice, Marie-Claude AU - Morice MC FAU - Dawkins, Keith D AU - Dawkins KD FAU - Holmes, David R Jr AU - Holmes DR Jr FAU - Serruys, Patrick W AU - Serruys PW FAU - Kappetein, A Pieter AU - Kappetein AP LA - eng PT - Journal Article PL - France TA - EuroIntervention JT - EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology JID - 101251040 SB - IM MH - Adult MH - Aged MH - Aged, 80 and over MH - *Coronary Artery Bypass/methods MH - Coronary Artery Disease/complications/*surgery MH - Diabetes Mellitus/surgery MH - Drug-Eluting Stents MH - Female MH - Follow-Up Studies MH - Humans MH - Male MH - Middle Aged MH - *Percutaneous Coronary Intervention/methods MH - Renal Insufficiency, Chronic/*complications MH - Treatment Outcome EDAT- 2017/11/21 06:00 MHDA- 2019/07/19 06:00 CRDT- 2017/11/21 06:00 PHST- 2017/11/21 06:00 [pubmed] PHST- 2019/07/19 06:00 [medline] PHST- 2017/11/21 06:00 [entrez] AID - EIJ-D-17-00620 [pii] AID - 10.4244/EIJ-D-17-00620 [doi] PST - ppublish SO - EuroIntervention. 2018 May 20;14(1):102-111. doi: 10.4244/EIJ-D-17-00620. PMID- 29150476 OWN - NLM STAT- MEDLINE DCOM- 20180705 LR - 20190202 IS - 2044-6055 (Electronic) IS - 2044-6055 (Linking) VI - 7 IP - 11 DP - 2017 Nov 16 TI - Predictive value of apelin-12 in patients with ST-elevation myocardial infarction with different renal function: a prospective observational study. PG - e018595 LID - 10.1136/bmjopen-2017-018595 [doi] LID - e018595 AB - OBJECTIVES: To investigate factors predicting the onset of major adverse cardiovascular events (MACEs) after primary percutaneous coronary intervention (pPCI) for patients with ST-segment elevation myocardial infarction (STEMI) . BACKGROUND: Apelin-12 plays an essential role in cardiovascular homoeostasis. However, current knowledge of its predictive prognostic value is limited. METHODS: 464 patients with STEMI (63.0+/-11.9 years, 355 men) who underwent successful pPCI were enrolled and followed for 2.5 years. Multivariate cox regression analysis and receiver operating characteristic (ROC) curve analysis were performed to determine the factors predicting MACEs. RESULTS: 118 patients (25.4%) experienced MACEs in the follow-up period. Multivariate cox regression analysis found low apelin-12 (HR=0.132, 95% CI 0.060 to 0.292, P<0.001), low left ventricular ejection fraction (HR=0.965, 95% CI 0.941 to 0.991, P=0.007), low estimated glomerular filtration rate (eGFR) (HR=0.985, 95% CI 0.977 to 0.993, P<0.001), Killip's classification>I (HR=0.610, 95% CI 0.408 to 0.912, P=0.016) and pathological Q-wave (HR=1.536, 95% CI 1.058 to 2.230, P=0.024) were independent predictors of MACEs in the 2.5 year follow-up period. Low apelin-12 also predicted poorer in-hospital prognosis and MACEs in the 2.5 years follow-up period compared with Deltaapelin-12 (P=0.0115) and eGFR (P=0.0071) among patients with eGFR>90 mL/minx1.73 m(2). Further analysis showed Deltaapelin-12 <20% was associated with MACEs in patients whose apelin-12 was below 0.76 ng/mL (P=0.0075) on admission. CONCLUSIONS: Patients with STEMI receiving pPCI with lower apelin-12 are more likely to suffer MACEs in hospital and 2.5 years postprocedure, particularly in those with normal eGFR levels. CI - (c) Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. FAU - Yang, Lingchang AU - Yang L AD - Department of Emergency Medicine, The First People's Hospital of Taizhou, Taizhou, Zhejiang, China. FAU - Zheng, Ting AU - Zheng T AD - Department of Emergency Medicine, The First People's Hospital of Taizhou, Taizhou, Zhejiang, China. FAU - Wu, Haopeng AU - Wu H AD - Department of Emergency Medicine, The First People's Hospital of Taizhou, Taizhou, Zhejiang, China. FAU - Xin, Wenwei AU - Xin W AD - Department of Emergency Medicine, The First People's Hospital of Taizhou, Taizhou, Zhejiang, China. FAU - Mou, Xiongneng AU - Mou X AD - Department of Emergency Medicine, The First People's Hospital of Taizhou, Taizhou, Zhejiang, China. FAU - Lin, Hui AU - Lin H AD - Department of Emergency Medicine, The First People's Hospital of Taizhou, Taizhou, Zhejiang, China. FAU - Chen, Yide AU - Chen Y AD - Department of Emergency Medicine, The First People's Hospital of Taizhou, Taizhou, Zhejiang, China. FAU - Wu, Xiaoyu AU - Wu X AD - Department of Emergency Medicine, The First People's Hospital of Taizhou, Taizhou, Zhejiang, China. LA - eng PT - Journal Article PT - Observational Study DEP - 20171116 PL - England TA - BMJ Open JT - BMJ open JID - 101552874 RN - 0 (Biomarkers) RN - 0 (Intercellular Signaling Peptides and Proteins) RN - 0 (apelin-12 peptide) SB - IM MH - Aged MH - Biomarkers/blood MH - Enzyme-Linked Immunosorbent Assay MH - Female MH - *Glomerular Filtration Rate MH - Humans MH - Intercellular Signaling Peptides and Proteins/blood MH - Kidney/physiopathology MH - Longitudinal Studies MH - Male MH - Middle Aged MH - Percutaneous Coronary Intervention/*adverse effects MH - Predictive Value of Tests MH - Proportional Hazards Models MH - Prospective Studies MH - ROC Curve MH - Risk Factors MH - ST Elevation Myocardial Infarction/*blood/physiopathology MH - Ultrasonography PMC - PMC5701982 OTO - NOTNLM OT - adult cardiology OT - clinical trials OT - ischaemic heart disease COIS- Competing interests: None declared. EDAT- 2017/11/19 06:00 MHDA- 2018/07/06 06:00 PMCR- 2017/11/16 CRDT- 2017/11/19 06:00 PHST- 2017/11/19 06:00 [entrez] PHST- 2017/11/19 06:00 [pubmed] PHST- 2018/07/06 06:00 [medline] PHST- 2017/11/16 00:00 [pmc-release] AID - bmjopen-2017-018595 [pii] AID - 10.1136/bmjopen-2017-018595 [doi] PST - epublish SO - BMJ Open. 2017 Nov 16;7(11):e018595. doi: 10.1136/bmjopen-2017-018595. PMID- 29146277 OWN - NLM STAT- MEDLINE DCOM- 20190102 LR - 20260518 IS - 1523-1755 (Electronic) IS - 0085-2538 (Print) IS - 0085-2538 (Linking) VI - 93 IP - 4 DP - 2018 Apr TI - Lowering LDL cholesterol reduces cardiovascular risk independently of presence of inflammation. PG - 1000-1007 LID - S0085-2538(17)30725-1 [pii] LID - 10.1016/j.kint.2017.09.011 [doi] AB - Markers of inflammation, including plasma C-reactive protein (CRP), are associated with an increased risk of cardiovascular disease, and it has been suggested that this association is causal. However, the relationship between inflammation and cardiovascular disease has not been extensively studied in patients with chronic kidney disease. To evaluate this, we used data from the Study of Heart and Renal Protection (SHARP) to assess associations between circulating CRP and LDL cholesterol levels and the risk of vascular and non-vascular outcomes. Major vascular events were defined as nonfatal myocardial infarction, cardiac death, stroke or arterial revascularization, with an expanded outcome of vascular events of any type. Higher baseline CRP was associated with an increased risk of major vascular events (hazard ratio per 3x increase 1.28; 95% confidence interval 1.19-1.38). Higher baseline LDL cholesterol was also associated with an increased risk of major vascular events (hazard ratio per 0.6 mmol/L higher LDL cholesterol; 1.14, 1.06-1.22). Higher baseline CRP was associated with an increased risk of a range of non-vascular events (1.16, 1.12-1.21), but there was a weak inverse association between baseline LDL cholesterol and non-vascular events (0.96, 0.92-0.99). The efficacy of lowering LDL cholesterol with simvastatin/ezetimibe on major vascular events, in the randomized comparison, was similar irrespective of CRP concentration at baseline. Thus, decisions to offer statin-based therapy to patients with chronic kidney disease should continue to be guided by their absolute risk of atherosclerotic events. Estimation of such risk may include plasma biomarkers of inflammation, but there is no evidence that the relative beneficial effects of reducing LDL cholesterol depends on plasma CRP concentration. CI - Copyright (c) 2017 International Society of Nephrology. Published by Elsevier Inc. All rights reserved. FAU - Storey, Benjamin C AU - Storey BC AD - Medical Research Council Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK; Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK. FAU - Staplin, Natalie AU - Staplin N AD - Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK. FAU - Haynes, Richard AU - Haynes R AD - Medical Research Council Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK; Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK. FAU - Reith, Christina AU - Reith C AD - Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK. FAU - Emberson, Jonathan AU - Emberson J AD - Medical Research Council Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK; Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK. FAU - Herrington, William G AU - Herrington WG AD - Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK. FAU - Wheeler, David C AU - Wheeler DC AD - Centre for Nephrology, University College London, London, UK. FAU - Walker, Robert AU - Walker R AD - Department of Medicine, University of Otago, Dunedin, New Zealand. FAU - Fellstrom, Bengt AU - Fellstrom B AD - Renal Unit, Department of Medicine, University of Uppsala, Uppsala, Sweden. FAU - Wanner, Christoph AU - Wanner C AD - Division of Nephrology, University Hospital, Wurzburg, Germany. FAU - Landray, Martin J AU - Landray MJ AD - Medical Research Council Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK; Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK; Big Data Institute, Lia Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, UK. FAU - Baigent, Colin AU - Baigent C AD - Medical Research Council Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK; Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK. Electronic address: colin.baigent@ndph.ox.ac.uk. CN - SHARP Collaborative Group LA - eng GR - MC_U137686853/MRC_/Medical Research Council/United Kingdom GR - MC_UU_12026/5/MRC_/Medical Research Council/United Kingdom GR - MC_UU_12026/6/MRC_/Medical Research Council/United Kingdom PT - Journal Article PT - Observational Study PT - Research Support, Non-U.S. Gov't DEP - 20171114 PL - United States TA - Kidney Int JT - Kidney international JID - 0323470 RN - 0 (Anticholesteremic Agents) RN - 0 (Biomarkers) RN - 0 (Cholesterol, LDL) RN - 0 (Ezetimibe, Simvastatin Drug Combination) RN - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors) RN - 0 (Inflammation Mediators) RN - 9007-41-4 (C-Reactive Protein) SB - IM CIN - Kidney Int. 2018 Apr;93(4):784-786. doi: 10.1016/j.kint.2017.11.031. PMID: 29571452 MH - Aged MH - Anticholesteremic Agents/adverse effects/*therapeutic use MH - Biomarkers/blood MH - C-Reactive Protein/metabolism MH - Cardiovascular Diseases/etiology/mortality/*prevention & control MH - Cholesterol, LDL/*blood MH - Down-Regulation MH - Dyslipidemias/blood/complications/*drug therapy/mortality MH - Ezetimibe, Simvastatin Drug Combination/adverse effects/*therapeutic use MH - Female MH - Humans MH - Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects/*therapeutic use MH - Inflammation/blood/*complications/mortality MH - Inflammation Mediators/blood MH - Male MH - Middle Aged MH - Randomized Controlled Trials as Topic MH - Renal Insufficiency, Chronic/blood/complications/mortality/*therapy MH - Risk Factors MH - Severity of Illness Index MH - Time Factors MH - Treatment Outcome PMC - PMC5978933 OTO - NOTNLM OT - C-reactive protein OT - LDL cholesterol OT - inflammation OT - randomized trials OT - vascular disease FIR - Storey, Benjamin C IR - Storey BC FIR - Staplin, Natalie IR - Staplin N FIR - Haynes, Richard IR - Haynes R FIR - Reith, Christina IR - Reith C FIR - Emberson, Jonathan IR - Emberson J FIR - Herrington, Will G IR - Herrington WG FIR - Wheeler, David C IR - Wheeler DC FIR - Walker, Robert IR - Walker R FIR - Fellstrom, Bengt IR - Fellstrom B FIR - Wanner, Christoph IR - Wanner C FIR - Landray, Martin J IR - Landray MJ FIR - Baigent, Colin IR - Baigent C FIR - Baigent, Colin IR - Baigent C FIR - Landray, Martin J IR - Landray MJ FIR - Reith, Christina IR - Reith C FIR - Emberson, Jonathan IR - Emberson J FIR - Wheeler, David C IR - Wheeler DC FIR - Tomson, Charles IR - Tomson C FIR - Wanner, Christoph IR - Wanner C FIR - Krane, Vera IR - Krane V FIR - Cass, Alan IR - Cass A FIR - Craig, Jonathan IR - Craig J FIR - Neal, Bruce IR - Neal B FIR - Jiang, Lixin IR - Jiang L FIR - Hooi, Lai Seong IR - Hooi LS FIR - Levin, Adeera IR - Levin A FIR - Agodoa, Lawrence IR - Agodoa L FIR - Gaziano, Mike IR - Gaziano M FIR - Kasiske, Bertram IR - Kasiske B FIR - Walker, Robert IR - Walker R FIR - Massy, Ziad A IR - Massy ZA FIR - Feldt-Rasmussen, Bo IR - Feldt-Rasmussen B FIR - Krairittichai, Udom IR - Krairittichai U FIR - Ophascharoensuk, Vuddidhej IR - Ophascharoensuk V FIR - Fellstrom, Bengt IR - Fellstrom B FIR - Holdaas, Hallvard IR - Holdaas H FIR - Tesar, Vladimir IR - Tesar V FIR - Wiecek, Andrzej IR - Wiecek A FIR - Grobbee, Diederick IR - Grobbee D FIR - de Zeeuw, Dick IR - de Zeeuw D FIR - Gronhagen-Riska, Carola IR - Gronhagen-Riska C FIR - Dasgupta, Tanaji IR - Dasgupta T FIR - Lewis, David IR - Lewis D FIR - Herrington, William IR - Herrington W FIR - Mafham, Marion IR - Mafham M FIR - Majoni, William IR - Majoni W FIR - Wallendszus, Karl IR - Wallendszus K FIR - Grimm, Richard IR - Grimm R FIR - Pedersen, Terje IR - Pedersen T FIR - Tobert, Jonathan IR - Tobert J FIR - Armitage, Jane IR - Armitage J FIR - Baxter, Alex IR - Baxter A FIR - Bray, Christopher IR - Bray C FIR - Chen, Yiping IR - Chen Y FIR - Chen, Zhengming IR - Chen Z FIR - Hill, Michael IR - Hill M FIR - Knott, Carol IR - Knott C FIR - Parish, Sarah IR - Parish S FIR - Simpson, David IR - Simpson D FIR - Sleight, Peter IR - Sleight P FIR - Young, Alan IR - Young A FIR - Collins, Rory IR - Collins R EDAT- 2017/11/18 06:00 MHDA- 2019/01/03 06:00 PMCR- 2018/04/01 CRDT- 2017/11/18 06:00 PHST- 2017/06/26 00:00 [received] PHST- 2017/08/23 00:00 [revised] PHST- 2017/09/07 00:00 [accepted] PHST- 2017/11/18 06:00 [pubmed] PHST- 2019/01/03 06:00 [medline] PHST- 2017/11/18 06:00 [entrez] PHST- 2018/04/01 00:00 [pmc-release] AID - S0085-2538(17)30725-1 [pii] AID - 10.1016/j.kint.2017.09.011 [doi] PST - ppublish SO - Kidney Int. 2018 Apr;93(4):1000-1007. doi: 10.1016/j.kint.2017.09.011. Epub 2017 Nov 14. PMID- 29141361 OWN - NLM STAT- MEDLINE DCOM- 20180629 LR - 20181202 IS - 0376-2491 (Print) IS - 0376-2491 (Linking) VI - 97 IP - 41 DP - 2017 Nov 7 TI - [Effect of probucol on preventing contrast-induced nephropathy in patients undergoing percutaneous coronary intervention]. PG - 3234-3238 LID - 10.3760/cma.j.issn.0376-2491.2017.41.008 [doi] AB - Objective: To investigate the preventive effect, possible mechanism and safety of probucol on contrast-induced nephropathy (CIN) after percutaneous coronary intervention (PCI) in patients with coronary heart disease (CHD). Methods: A total of 641 patients with coronary heart disease were consecutively enrolled from Department of Cardiology, in Tianjin Chest Hospital, Tianjin TEDA International Cardiovascular Hospital, Tianjin First Central Hospital, Tianjin Fourth Central Hospital. They were randomly divided into probucol group (n=321) and control group (n=320). The probucol group was given oral probucol 500 mg twice daily for day 0 to day 3 after PCI; the control group was given only conventional therapy. All patients were given intravenous drip 0.9% sodium chloride solution before 12 to 24 hours of operation. The levels of serum creatinine (Scr), blood urea nitrogen (BUN), evaluate glomerular filtration rate (eGFR), cystatin C (Cys-C), and high-sensitivity C-reactive protein (hs-CRP), neutrophil gelatinase associated lipocalin (NGAL), superoxide dismutase (SOD) and glutathione (GSH) were measured before and 72 h after the PCI operation in both groups. The incidence rates of CIN, the adverse events during hospitalization and postoperative 14-day follow-up were recorded in two groups. Results: There was no statistically significantly difference in the levels of Scr, BUN, eGFR, Cys-C, hs-CRP, NGAL, SOD and GSH between the two groups before PCI (P>0.05). The levels of serum Scr, BUN, Cys-C, hs-CRP, NGAL, SOD and GSH after operation in the two groups were higher than those before the operation (P<0.05). The levels of hs-CRP and NGAL in the probucol group were lower than those in the control group [(10+/-4) vs (11+/-4)mg/L, (25+/-8)vs (34+/-7)U/ml, P<0.05]. The levels of eGFR, SOD and GSH in probucol group were higher than those in control group [(80+/-27) vs (72+/-26) ml.min(-1).1.73 m(-2,) (67+/-9) vs (58+/-8)U/ml, (4.6+/-0.9) vs (3.9+/-0.8)U/ml, P<0.05]. The incidence of CIN was 4.0% in the probucol group and 10.9% in the control group, and the difference was statistically significant (P<0.05, chi(2)=-3.31). Multivariate Logistic regression analysis showed that probucol was an independent protective factor for CIN (OR=0.334, 95%CI 0.172-0.648, P=0.001). There were no adverse events such as myasthenia gravis, abnormal liver function and cardiovascular events during the hospitalization and 14-day follow-up. Conclusions: Probucol can reduce the incidence of contrast-induced nephropathy after PCI. The protection mechanism is related with its anti-inflammatory and anti-oxidative stress effects, and it has good safety. FAU - Suo, X Q AU - Suo XQ AD - Graduate School of Tianjin Medical University, Tianjin 300070, China. FAU - Yang, S C AU - Yang SC FAU - Ma, Z H AU - Ma ZH FAU - Sun, T T AU - Sun TT FAU - Zhang, W Y AU - Zhang WY FAU - Cong, H L AU - Cong HL FAU - Lin, W H AU - Lin WH FAU - Lu, C Z AU - Lu CZ FAU - Tian, F S AU - Tian FS FAU - Fu, N K AU - Fu NK LA - chi PT - Journal Article PT - Randomized Controlled Trial PL - China TA - Zhonghua Yi Xue Za Zhi JT - Zhonghua yi xue za zhi JID - 7511141 RN - 0 (Antioxidants) RN - 0 (Contrast Media) RN - AYI8EX34EU (Creatinine) RN - P3CTH044XJ (Probucol) SB - IM MH - Antioxidants/*pharmacology MH - Contrast Media/*adverse effects MH - Creatinine MH - Glomerular Filtration Rate MH - Humans MH - Kidney Diseases/*chemically induced/prevention & control MH - *Percutaneous Coronary Intervention MH - Probucol/*therapeutic use OTO - NOTNLM OT - Contrast media OT - Coronary heart disease OT - Nephrosis OT - Percutaneous coronary intervention OT - Prevention OT - Probucol EDAT- 2017/11/17 06:00 MHDA- 2018/06/30 06:00 CRDT- 2017/11/17 06:00 PHST- 2017/11/17 06:00 [entrez] PHST- 2017/11/17 06:00 [pubmed] PHST- 2018/06/30 06:00 [medline] AID - 10.3760/cma.j.issn.0376-2491.2017.41.008 [doi] PST - ppublish SO - Zhonghua Yi Xue Za Zhi. 2017 Nov 7;97(41):3234-3238. doi: 10.3760/cma.j.issn.0376-2491.2017.41.008. PMID- 29106471 OWN - NLM STAT- MEDLINE DCOM- 20190118 LR - 20190118 IS - 2058-1742 (Electronic) IS - 2058-1742 (Linking) VI - 4 IP - 4 DP - 2018 Oct 1 TI - Kidney function modifies the selection of treatment strategies and long-term survival in stable ischaemic heart disease: insights from the Alberta Provincial Project for Outcomes Assessment in Coronary Heart Disease (APPROACH) registry. PG - 274-282 LID - 10.1093/ehjqcco/qcx042 [doi] AB - AIMS: Patients with chronic kidney disease (CKD) have been under-represented in stable ischaemic heart disease (SIHD) trials despite their heightened risk of cardiovascular mortality. We examine associations between kidney disease, treatment selection, and long-term survival in patients with SIHD. METHODS AND RESULTS: SIHD patients with angiographically significant stenosis (>/=70%) were categorized by renal function [dialysis-dependent, severe CKD [estimated glomerular filtration rate (eGFR) < 30], mild-moderate CKD (eGFR 30-59), and no CKD (eGFR >/= 60)] and by treatment groups [revascularization /=0.5 mg/dL or>/= 25% after administration of the contrast media within 72 hours. The secondary end points were (1) changes in Scr and crCl within 72 hours and (2) the incidence of major adverse events during hospitalization. The incidence of CIN was 2.7% (4/150) in the alprostadil group, and 8.7% (13/150) in the control group (chi(2) = 5.05, P = .043).There was no difference regarding the incidence of major adverse events during hospitalization between the alprostadil group and control groups (2.7% vs 4.0%, P = .750). Multivariate logistic regression analysis showed that alprostadil was an independent protective factor for CIN (odds ratio = 0.136, 95% confidence interval: 0.020-0.944, P = .044). Prophylactic administration of alprostadil may prevent CIN in patients with renal insufficiency undergoing PCI. FAU - Yang, Shi-Cheng AU - Yang SC AUID- ORCID: 0000-0002-9083-5575 AD - 1 Tianjin Medical University, Tianjin, China. FAU - Fu, Nai-Kuan AU - Fu NK AD - 2 Department of Cardiology, Tianjin Chest Hospital, Tianjin, China. FAU - Zhang, Jing AU - Zhang J AD - 2 Department of Cardiology, Tianjin Chest Hospital, Tianjin, China. FAU - Liang, Min AU - Liang M AD - 1 Tianjin Medical University, Tianjin, China. FAU - Cong, Hong-Liang AU - Cong HL AD - 2 Department of Cardiology, Tianjin Chest Hospital, Tianjin, China. FAU - Lin, Wen-Hua AU - Lin WH AD - 3 Department of Cardiology, Taida International Cardiovascular Hospital, Tianjin, China. FAU - Tian, Feng-Shi AU - Tian FS AD - 4 Department of Cardiology, Tianjin Fourth Central Hospital, Tianjin, China. FAU - Lu, Cheng-Zhi AU - Lu CZ AD - 5 Department of Cardiology, Tianjin First Central Hospital, Tianjin, China. FAU - Sun, Ting-Ting AU - Sun TT AD - 1 Tianjin Medical University, Tianjin, China. FAU - Zhang, Wen-Ya AU - Zhang WY AD - 1 Tianjin Medical University, Tianjin, China. FAU - Ma, Zhen-Hua AU - Ma ZH AD - 1 Tianjin Medical University, Tianjin, China. LA - eng PT - Journal Article PT - Randomized Controlled Trial DEP - 20171026 PL - United States TA - Angiology JT - Angiology JID - 0203706 RN - 0 (Contrast Media) RN - 0 (Vasodilator Agents) RN - AYI8EX34EU (Creatinine) RN - F5TD010360 (Alprostadil) SB - IM MH - Aged MH - Alprostadil/*therapeutic use MH - Contrast Media/*adverse effects MH - Coronary Artery Disease/complications/surgery MH - Creatinine/blood MH - Female MH - Hospitalization MH - Humans MH - Incidence MH - Logistic Models MH - Male MH - Middle Aged MH - Percutaneous Coronary Intervention/*adverse effects MH - Renal Insufficiency/*chemically induced/diagnosis/*epidemiology MH - Vasodilator Agents/*therapeutic use OTO - NOTNLM OT - alprostadil OT - contrast agent OT - contrast-induced nephropathy OT - percutaneous coronary intervention OT - prevention OT - renal insufficiency EDAT- 2017/10/28 06:00 MHDA- 2019/01/03 06:00 CRDT- 2017/10/28 06:00 PHST- 2017/10/28 06:00 [pubmed] PHST- 2019/01/03 06:00 [medline] PHST- 2017/10/28 06:00 [entrez] AID - 10.1177/0003319717730942 [doi] PST - ppublish SO - Angiology. 2018 May;69(5):393-399. doi: 10.1177/0003319717730942. Epub 2017 Oct 26. PMID- 29071556 OWN - NLM STAT- MEDLINE DCOM- 20180809 LR - 20181113 IS - 1573-2584 (Electronic) IS - 0301-1623 (Linking) VI - 50 IP - 1 DP - 2018 Jan TI - The efficacy of probucol combined with hydration in preventing contrast-induced nephropathy in patients with coronary heart disease undergoing percutaneous coronary intervention: a multicenter, prospective, randomized controlled study. PG - 105-112 LID - 10.1007/s11255-017-1718-4 [doi] AB - PURPOSE: To investigate the preventive effect of probucol combined with hydration on contrast-induced nephropathy (CIN) in patients with coronary heart disease undergoing percutaneous coronary intervention (PCI). METHODS: A total of 641 patients undergoing PCI were randomly assigned to either a probucol group (probucol 500 mg twice daily and hydration; n = 321) or a control group (hydration only; n = 320). The primary endpoint was the incidence of CIN, defined as an increase in serum creatinine (Scr) by >/= 44.2 mumol/L or >/= 25% within 72 h after the administration of contrast agent. Secondary endpoints were changes in Scr, cystatin-C (Cys-C), creatinine clearance rate (Ccr), C-reactive protein (CRP), superoxide dismutase (SOD), and glutathione (GSH) within 72 h, and major adverse events during hospitalization or the 14-day follow-up period. RESULTS: The incidence of CIN was 4.0% (13/321) in the probucol group and 10.9% (35/320) in the control group. The probucol group had lower Cys-C and higher Ccr at 48 and 72 h after PCI compared with the control group. At 48 and 72 h following the operation, Cys-C and CRP were lower in the probucol group compared with the control group, but Ccr, SOD, and GSH were higher. There were no differences in the incidence of major adverse events during hospitalization or the 14-day follow-up between the groups. Multivariate logistic regression analysis showed that probucol was an independent protective factor for CIN. CONCLUSIONS: Probucol combined with hydration more effectively decreased the incidence of CIN in patients with coronary heart disease undergoing PCI compared with hydration alone. FAU - Fu, Naikuan AU - Fu N AD - Department of Cardiology, Tianjin Chest Hospital, No. 261, Taierzhuang South Road, Jinnan District, Tianjin, 300222, China. FAU - Yang, Shicheng AU - Yang S AD - Department of Cardiology, Tianjin Chest Hospital, No. 261, Taierzhuang South Road, Jinnan District, Tianjin, 300222, China. FAU - Zhang, Jing AU - Zhang J AD - Department of Cardiology, Tianjin Chest Hospital, No. 261, Taierzhuang South Road, Jinnan District, Tianjin, 300222, China. cdrfnk@163.com. FAU - Zhang, Peng AU - Zhang P AD - Department of Cardiology, Tianjin Chest Hospital, No. 261, Taierzhuang South Road, Jinnan District, Tianjin, 300222, China. FAU - Liang, Min AU - Liang M AD - Tianjin Medical University, Tianjin, China. FAU - Cong, Hongliang AU - Cong H AD - Department of Cardiology, Tianjin Chest Hospital, No. 261, Taierzhuang South Road, Jinnan District, Tianjin, 300222, China. FAU - Lin, Wenhua AU - Lin W AD - Department of Cardiology, Teda International Cardiovascular Hospital, Tianjin, China. FAU - Tian, Fengshi AU - Tian F AD - Department of Cardiology, Tianjin Fourth Central Hospital, Tianjin, China. FAU - Lu, Chengzhi AU - Lu C AD - Department of Cardiology, Tianjin First Central Hospital, Tianjin, China. LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20171025 PL - Netherlands TA - Int Urol Nephrol JT - International urology and nephrology JID - 0262521 RN - 0 (Antioxidants) RN - 0 (Contrast Media) RN - 0 (Cystatin C) RN - AYI8EX34EU (Creatinine) RN - EC 1.15.1.1 (Superoxide Dismutase) RN - GAN16C9B8O (Glutathione) RN - P3CTH044XJ (Probucol) SB - IM MH - Aged MH - Antioxidants/*therapeutic use MH - Combined Modality Therapy MH - Contrast Media/*adverse effects MH - Coronary Disease/complications/surgery MH - Creatinine/blood/urine MH - Cystatin C/blood MH - Female MH - *Fluid Therapy MH - Glutathione/blood MH - Heart Failure/etiology MH - Hemorrhage/etiology MH - Humans MH - Kidney Diseases/blood/chemically induced/*prevention & control MH - Male MH - Middle Aged MH - Percutaneous Coronary Intervention/adverse effects MH - Probucol/*therapeutic use MH - Prospective Studies MH - Protective Factors MH - Stroke/etiology MH - Superoxide Dismutase/blood OTO - NOTNLM OT - Contrast-induced nephropathy OT - Coronary heart disease OT - Percutaneous coronary intervention OT - Prevention OT - Probucol EDAT- 2017/10/27 06:00 MHDA- 2018/08/10 06:00 CRDT- 2017/10/27 06:00 PHST- 2017/07/01 00:00 [received] PHST- 2017/10/06 00:00 [accepted] PHST- 2017/10/27 06:00 [pubmed] PHST- 2018/08/10 06:00 [medline] PHST- 2017/10/27 06:00 [entrez] AID - 10.1007/s11255-017-1718-4 [pii] AID - 10.1007/s11255-017-1718-4 [doi] PST - ppublish SO - Int Urol Nephrol. 2018 Jan;50(1):105-112. doi: 10.1007/s11255-017-1718-4. Epub 2017 Oct 25. PMID- 29057771 OWN - NLM STAT- MEDLINE DCOM- 20190221 LR - 20241217 IS - 1347-4820 (Electronic) IS - 1346-9843 (Linking) VI - 82 IP - 2 DP - 2018 Jan 25 TI - Impact of Serum Phosphorus Levels on Outcomes After Implantation of Drug-Eluting Stents in Patients on Hemodialysis. PG - 388-395 LID - 10.1253/circj.CJ-17-0649 [doi] AB - BACKGROUND: Elevated serum phosphorus level is an important risk factor for cardiovascular death in general patients on hemodialysis (HD). However, the effect of serum phosphorus levels on outcomes after drug-eluting stent (DES) implantation in HD patients is unknown. METHODS AND RESULTS: This was a post-hoc study of the OUCH study series, a series of prospective multicenter registries of HD patients who underwent DES implantation comprising 359 patients from 31 centers in Japan. Patients were categorized into 3 groups according to their preprocedural serum phosphorus levels. The 1-year clinical outcomes of the 336 patients treated for de novo lesions were evaluated. Compared with patients with high (>5.5 mg/dL; n=65) or normal (3.5-5.5 mg/dL; n=219) serum phosphorus levels, those with low serum phosphorus levels (<3.5 mg/dL; n=52) had significantly fewer target lesion revascularization events (13.9% vs. 16.9% vs. 1.9%; P=0.0090) and major adverse cardiac and cerebrovascular events (29.2% vs. 31.1% vs. 13.5%; P=0.032). Multivariate logistic regression analysis revealed that low serum phosphorus level was an independent negative predictor for major adverse cardiac and cerebrovascular events (adjusted odds ratio, 0.31; 95% confidence interval, 0.12-0.70; P=0.0036). CONCLUSIONS: Lowering of serum phosphorus levels beyond the current recommended range may be considered in HD patients who undergo DES implantation. FAU - Sato, Tatsuyuki AU - Sato T AD - Division of Cardiology, Mitsui Memorial Hospital. FAU - Aoki, Jiro AU - Aoki J AD - Division of Cardiology, Mitsui Memorial Hospital. FAU - Kozuma, Ken AU - Kozuma K AD - Division of Cardiology, Department of Internal Medicine, Teikyo University School of Medicine. FAU - Maruyama, Yasuyuki AU - Maruyama Y AD - Division of Cardiology, Iwatsuki Minami Hospital. FAU - Nasu, Kenya AU - Nasu K AD - Division of Cardiology, Toyohashi Heart Center. FAU - Otsuka, Masaya AU - Otsuka M AD - Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital. FAU - Ando, Kenji AU - Ando K AD - Department of Cardiology, Kokura Memorial Hospital. FAU - Hibi, Kiyoshi AU - Hibi K AD - Department of Cardiology, Yokohama City University Medical Center. FAU - Uehara, Yoshiki AU - Uehara Y AD - Division of Cardiology, Mito Brain Heart Center. FAU - Tanabe, Kengo AU - Tanabe K AD - Division of Cardiology, Mitsui Memorial Hospital. FAU - Ikari, Yuji AU - Ikari Y AD - Division of Cardiology, Tokai University School of Medicine. LA - eng PT - Journal Article PT - Multicenter Study DEP - 20171020 PL - Japan TA - Circ J JT - Circulation journal : official journal of the Japanese Circulation Society JID - 101137683 RN - 0 (Antineoplastic Agents) RN - 0 (Immunosuppressive Agents) RN - 27YLU75U4W (Phosphorus) RN - 9HW64Q8G6G (Everolimus) RN - P88XT4IS4D (Paclitaxel) RN - W36ZG6FT64 (Sirolimus) SB - IM MH - Aged MH - Antineoplastic Agents/administration & dosage MH - Cardiovascular Diseases/etiology/prevention & control MH - Drug-Eluting Stents/*standards MH - Everolimus/administration & dosage MH - Female MH - Follow-Up Studies MH - Humans MH - Immunosuppressive Agents/administration & dosage MH - Japan MH - Male MH - Middle Aged MH - Paclitaxel/administration & dosage MH - Phosphorus/*blood/standards MH - Registries MH - Renal Dialysis/*adverse effects MH - Renal Insufficiency, Chronic/complications/therapy MH - Sirolimus/administration & dosage MH - Treatment Outcome OTO - NOTNLM OT - Coronary artery disease OT - Drug-eluting stent OT - Hemodialysis OT - Serum phosphorus EDAT- 2017/10/24 06:00 MHDA- 2019/02/23 06:00 CRDT- 2017/10/24 06:00 PHST- 2017/10/24 06:00 [pubmed] PHST- 2019/02/23 06:00 [medline] PHST- 2017/10/24 06:00 [entrez] AID - 10.1253/circj.CJ-17-0649 [doi] PST - ppublish SO - Circ J. 2018 Jan 25;82(2):388-395. doi: 10.1253/circj.CJ-17-0649. Epub 2017 Oct 20. PMID- 29049838 OWN - NLM STAT- MEDLINE DCOM- 20181217 LR - 20181217 IS - 1569-9285 (Electronic) IS - 1569-9285 (Linking) VI - 26 IP - 2 DP - 2018 Feb 1 TI - Predicting long-term survival after coronary artery bypass graft surgery. PG - 257-263 LID - 10.1093/icvts/ivx330 [doi] AB - OBJECTIVES: To develop a model for predicting long-term survival following coronary artery bypass graft surgery. METHODS: This study included 46 573 patients from the Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZCTS) registry, who underwent isolated coronary artery bypass graft surgery between 2001 and 2014. Data were randomly split into development (23 282) and validation (23 291) samples. Cox regression models were fitted separately, using the important preoperative variables, for 4 'time intervals' (31-90 days, 91-365 days, 1-3 years and >3 years), with optimal predictors selected using the bootstrap bagging technique. Model performance was assessed both in validation data and in combined data (development and validation samples). Coefficients of all 4 final models were estimated on the combined data adjusting for hospital-level clustering. RESULTS: The Kaplan-Meier mortality rates estimated in the sample were 1.7% at 90 days, 2.8% at 1 year, 4.4% at 2 years and 6.1% at 3 years. Age, peripheral vascular disease, respiratory disease, reduced ejection fraction, renal dysfunction, arrhythmia, diabetes, hypercholesterolaemia, cerebrovascular disease, hypertension, congestive heart failure, steroid use and smoking were included in all 4 models. However, their magnitude of effect varied across the time intervals. Harrell's C-statistics was 0.83, 0.78, 0.75 and 0.74 for 31-90 days, 91-365 days, 1-3 years and >3 years models, respectively. Models showed excellent discrimination and calibration in validation data. CONCLUSIONS: Models were developed for predicting long-term survival at 4 time intervals after isolated coronary artery bypass graft surgery. These models can be used in conjunction with the existing 30-day mortality prediction model. CI - (c) The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. FAU - Karim, Md N AU - Karim MN AD - School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia. FAU - Reid, Christopher M AU - Reid CM AD - School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia. AD - School of Public Health, Curtin University, Perth, WA, Australia. FAU - Huq, Molla AU - Huq M AD - School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia. FAU - Brilleman, Samuel L AU - Brilleman SL AD - School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia. FAU - Cochrane, Andrew AU - Cochrane A AD - Department of Cardiothoracic Surgery, Monash Medical Centre, Clayton, VIC, Australia. FAU - Tran, Lavinia AU - Tran L AD - School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia. FAU - Billah, Baki AU - Billah B AD - School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - England TA - Interact Cardiovasc Thorac Surg JT - Interactive cardiovascular and thoracic surgery JID - 101158399 SB - IM MH - Aged MH - Australia MH - Coronary Artery Bypass/*mortality MH - Coronary Artery Disease/complications/*mortality/*surgery MH - Female MH - Humans MH - Male MH - Middle Aged MH - New Zealand MH - Proportional Hazards Models MH - Registries MH - Risk Factors MH - Sensitivity and Specificity MH - Survival Rate OTO - NOTNLM OT - Cardiac surgery OT - Coronary artery bypass graft OT - Coronary revascularization OT - Long-term survival OT - Risk prediction model OT - Risk stratification EDAT- 2017/10/20 06:00 MHDA- 2018/12/18 06:00 CRDT- 2017/10/20 06:00 PHST- 2017/03/02 00:00 [received] PHST- 2017/09/07 00:00 [accepted] PHST- 2017/10/20 06:00 [pubmed] PHST- 2018/12/18 06:00 [medline] PHST- 2017/10/20 06:00 [entrez] AID - 4364859 [pii] AID - 10.1093/icvts/ivx330 [doi] PST - ppublish SO - Interact Cardiovasc Thorac Surg. 2018 Feb 1;26(2):257-263. doi: 10.1093/icvts/ivx330. PMID- 28977433 OWN - NLM STAT- MEDLINE DCOM- 20190412 LR - 20190412 IS - 2047-2412 (Electronic) IS - 2047-2404 (Linking) VI - 19 IP - 9 DP - 2018 Sep 1 TI - Even mild reversible myocardial perfusion defects predict mortality in patients evaluated for kidney transplantation. PG - 1019-1025 LID - 10.1093/ehjci/jex200 [doi] AB - AIMS: The value of single-photon emission tomography (SPECT) in patients with severe chronic kidney disease is controversial, and the implications of SPECT finding with lower level of ischaemia are unknown. We assessed the prognostic value of SPECT in patients evaluated for kidney transplantation. METHODS AND RESULTS: Five hundred and forty-eight patients underwent SPECT as a part of routine evaluation for kidney transplantation. During the median follow-up of 43.7 months (IQR 22.4-68.4 months), 112 patients (20.4%) died, 49 of cardiovascular (CV) causes (8.9%). In comparison to those with no perfusion defects, mild perfusion abnormalities (1%-9.9%) had an adjusted Cox hazard ratio (HR) of 1.80 [95% confidence interval (95% CI) 1.02-3.17, P = 0.041] for all-cause mortality, while large perfusion defects (>/=10%) demonstrated an HR of 2.20 (95% CI 1.38-3.50, P = 0.001). A competing risk analysis produced a similar prognostic capacity for CV mortality. SPECT also offered incremental prognostic impact with two reclassification methods. Revascularization was performed clearly more often on patients with severely than mildly abnormal or normal SPECT (28.0%, 4.3%, and 1.3%, respectively, P < 0.001). However, revascularization was not linked with better survival. Patients with a normal SPECT received a kidney transplant more often than patients with a mildly or severely abnormal SPECT (50.5%, 36.2%, and 36.6%, respectively, P = 0.010). CONCLUSION: Myocardial ischaemia in SPECT is clearly linked with mortality in patients screened for kidney transplantation. Contrary to populations with coronary artery disease, even a mild perfusion defect in SPECT predicts poor prognosis in this patient population. The finding deserves further attention in forthcoming trials. FAU - Helve, Salla AU - Helve S AD - Department of Cardiology, University of Helsinki, Haartmaninkatu 8, Helsinki, Finland. FAU - Laine, Mika AU - Laine M AD - Heart and Lung Center, Helsinki University Central Hospital, Helsinki, Finland. AD - University of Helsinki, Haartmaninkatu 4, Helsinki, Finland. FAU - Sinisalo, Juha AU - Sinisalo J AD - Heart and Lung Center, Helsinki University Central Hospital, Helsinki, Finland. AD - University of Helsinki, Haartmaninkatu 4, Helsinki, Finland. FAU - Helantera, Ilkka AU - Helantera I AD - University of Helsinki, Haartmaninkatu 4, Helsinki, Finland. AD - Department of Nephrology, Helsinki University Central Hospital, Haartmaninkatu 4, Helsinki, Finland. FAU - Hanninen, Helena AU - Hanninen H AD - Heart and Lung Center, Helsinki University Central Hospital, Helsinki, Finland. AD - University of Helsinki, Haartmaninkatu 4, Helsinki, Finland. FAU - Lammintausta, Olavi AU - Lammintausta O AD - Heart and Lung Center, Helsinki University Central Hospital, Helsinki, Finland. AD - University of Helsinki, Haartmaninkatu 4, Helsinki, Finland. FAU - Lehtonen, Jukka AU - Lehtonen J AD - Heart and Lung Center, Helsinki University Central Hospital, Helsinki, Finland. AD - University of Helsinki, Haartmaninkatu 4, Helsinki, Finland. FAU - Finne, Patrik AU - Finne P AD - University of Helsinki, Haartmaninkatu 4, Helsinki, Finland. AD - Department of Nephrology, Helsinki University Central Hospital, Haartmaninkatu 4, Helsinki, Finland. FAU - Nieminen, Tuomo AU - Nieminen T AD - University of Helsinki, Haartmaninkatu 4, Helsinki, Finland. AD - Department of Nephrology, Helsinki University Central Hospital, Haartmaninkatu 4, Helsinki, Finland. AD - Department of Internal Medicine, South Karelia Central Hospital, Lappeenranta, Finland. LA - eng PT - Comparative Study PT - Journal Article PL - England TA - Eur Heart J Cardiovasc Imaging JT - European heart journal. Cardiovascular Imaging JID - 101573788 SB - IM MH - Aged MH - *Cause of Death MH - Cohort Studies MH - Coronary Angiography/methods MH - Coronary Artery Disease/*diagnostic imaging/mortality MH - Female MH - Follow-Up Studies MH - Humans MH - Kaplan-Meier Estimate MH - Kidney Transplantation/methods/*mortality MH - Male MH - Middle Aged MH - Myocardial Ischemia/*diagnostic imaging/mortality MH - Myocardial Perfusion Imaging/methods MH - Predictive Value of Tests MH - Preoperative Care/methods MH - Proportional Hazards Models MH - Retrospective Studies MH - Risk Assessment MH - Survival Analysis MH - Tomography, Emission-Computed, Single-Photon/*methods EDAT- 2017/10/05 06:00 MHDA- 2019/04/13 06:00 CRDT- 2017/10/05 06:00 PHST- 2017/01/26 00:00 [received] PHST- 2017/07/17 00:00 [accepted] PHST- 2017/10/05 06:00 [pubmed] PHST- 2019/04/13 06:00 [medline] PHST- 2017/10/05 06:00 [entrez] AID - 4065242 [pii] AID - 10.1093/ehjci/jex200 [doi] PST - ppublish SO - Eur Heart J Cardiovasc Imaging. 2018 Sep 1;19(9):1019-1025. doi: 10.1093/ehjci/jex200. PMID- 28874027 OWN - NLM STAT- MEDLINE DCOM- 20180518 LR - 20260127 IS - 1873-734X (Electronic) IS - 1010-7940 (Linking) VI - 52 IP - 3 DP - 2017 Sep 1 TI - Coronary artery bypass surgery is superior to second generation drug-eluting stents in three-vessel coronary artery disease: a propensity score matched analysis. PG - 462-468 LID - 10.1093/ejcts/ezx031 [doi] AB - OBJECTIVES: Compared with percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG) appears to be a promising revascularization strategy for multivessel coronary disease. Trials comparing these treatments have not used second-generation drug-eluting stents (2nd DES). We conducted a retrospective evaluation of both treatments using a propensity score-matched analysis (PSMA). METHODS: A total of 537 patients with three-vessel with/without left-main-trunk coronary artery disease underwent CABG (n = 239) or primary PCI using 2nd DES (298) at a single institution. PSMA resulted in 168 matched pairs. For both treatments, Kaplan-Meier analysis and Cox regression were used to compare all-cause mortality, cardiac death, myocardial infarction (MI), stroke rates and target-vessel revascularization (TVR). RESULTS: The CABG group included sicker patients with renal dysfunction, peripheral vascular disease, low ejection fraction and current smokers than those in the PCI group. After PSMA, both groups were well matched in all parameters. Mean follow-up (months) was 32 in CABG and 35 in PCI. In the unmatched patient population, there was no difference in the incidence of all-cause death, cardiac death, MI, or stroke but the incidence of TVR was significantly higher in the PCI group [hazard ratio (HR) 4.63; 95% confidence interval (95% CI) 2.43-8.82; P < 0.001] and, after PSMA, the incidence of all-cause death (HR 2.71; 95% CI 1.14-6.46; P = 0.019) and TVR (HR 9.0; 95% CI 2.73-29.67; P < 0.001) was significantly higher in the PCI group than in the CABG group. CONCLUSIONS: In patients with three-vessel coronary artery disease, CABG is associated with better survival and less revascularization than PCI using 2nd DES at mid-term results. CI - (c) The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. FAU - Tsuneyoshi, Hiroshi AU - Tsuneyoshi H AD - Department of Cardiovascular Surgery, Kurashiki Central Hospital, Kurashiki Okayama, Japan. FAU - Komiya, Tatsuhiko AU - Komiya T AD - Department of Cardiovascular Surgery, Kurashiki Central Hospital, Kurashiki Okayama, Japan. FAU - Kadota, Kazushige AU - Kadota K AD - Department of Cardiology, Kurashiki Central Hospital, Kurashiki Okayama, Japan. FAU - Shimamoto, Takeshi AU - Shimamoto T AD - Department of Cardiovascular Surgery, Kurashiki Central Hospital, Kurashiki Okayama, Japan. FAU - Sakai, Jiro AU - Sakai J AD - Department of Cardiovascular Surgery, Kurashiki Central Hospital, Kurashiki Okayama, Japan. FAU - Hiraoka, Toshifumi AU - Hiraoka T AD - Department of Cardiovascular Surgery, Kurashiki Central Hospital, Kurashiki Okayama, Japan. FAU - Wada, Kenji AU - Wada K AD - Department of Cardiovascular Surgery, Kurashiki Central Hospital, Kurashiki Okayama, Japan. FAU - Kaneko, Hiroyuki AU - Kaneko H AD - Department of Cardiovascular Surgery, Kurashiki Central Hospital, Kurashiki Okayama, Japan. FAU - Fujimoto, Yuka AU - Fujimoto Y AD - Department of Cardiovascular Surgery, Kurashiki Central Hospital, Kurashiki Okayama, Japan. FAU - Furuichi, Yoshimasa AU - Furuichi Y AD - Department of Cardiovascular Surgery, Kurashiki Central Hospital, Kurashiki Okayama, Japan. FAU - Hata, Reo AU - Hata R AD - Department of Cardiology, Kurashiki Central Hospital, Kurashiki Okayama, Japan. FAU - Jinno, Taiyo AU - Jinno T AD - Department of Cardiovascular Surgery, Kurashiki Central Hospital, Kurashiki Okayama, Japan. FAU - Tominaga, Osamu AU - Tominaga O AD - Department of Cardiovascular Surgery, Kurashiki Central Hospital, Kurashiki Okayama, Japan. LA - eng PT - Journal Article PL - Germany TA - Eur J Cardiothorac Surg JT - European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery JID - 8804069 SB - IM CIN - Eur J Cardiothorac Surg. 2017 Sep 1;52(3):469-470. doi: 10.1093/ejcts/ezx243. PMID: 28874026 MH - Aged MH - Cause of Death/trends MH - Coronary Artery Bypass/*methods MH - Coronary Artery Disease/*surgery MH - *Drug-Eluting Stents MH - Female MH - Follow-Up Studies MH - Humans MH - Incidence MH - Japan/epidemiology MH - Male MH - Postoperative Complications/*epidemiology MH - *Propensity Score MH - Prosthesis Design MH - Retrospective Studies MH - Risk Factors MH - Survival Rate/trends MH - Time Factors MH - Treatment Outcome OTO - NOTNLM OT - Coronary artery bypass grafting OT - Drug-eluting stent OT - Multi-vessel coronary disease OT - Percutaneous coronary intervention OT - Second-generation DES EDAT- 2017/09/07 06:00 MHDA- 2018/05/19 06:00 CRDT- 2017/09/07 06:00 PHST- 2016/09/03 00:00 [received] PHST- 2017/01/18 00:00 [accepted] PHST- 2017/09/07 06:00 [entrez] PHST- 2017/09/07 06:00 [pubmed] PHST- 2018/05/19 06:00 [medline] AID - 3935091 [pii] AID - 10.1093/ejcts/ezx031 [doi] PST - ppublish SO - Eur J Cardiothorac Surg. 2017 Sep 1;52(3):462-468. doi: 10.1093/ejcts/ezx031. PMID- 28842165 OWN - NLM STAT- MEDLINE DCOM- 20171213 LR - 20181117 IS - 1555-7162 (Electronic) IS - 0002-9343 (Linking) VI - 130 IP - 12 DP - 2017 Dec TI - Chronic Kidney Disease, Basal Insulin Glargine, and Health Outcomes in People with Dysglycemia: The ORIGIN Study. PG - 1465.e27-1465.e39 LID - S0002-9343(17)30705-2 [pii] LID - 10.1016/j.amjmed.2017.05.047 [doi] AB - BACKGROUND: Early stages of chronic kidney disease are associated with an increased cardiovascular risk in patients with established type 2 diabetes and macrovascular disease. The role of early stages of chronic kidney disease on macrovascular outcomes in prediabetes and early type 2 diabetes mellitus is not known. In the Outcome Reduction with an Initial Glargine Intervention (ORIGIN) trial, the introduction of insulin had no effect on cardiovascular outcomes compared with standard therapy. In this post hoc analysis of ORIGIN, we compared cardiovascular outcomes in subjects without to those with mild (Stages 1-2) or moderate chronic kidney disease (Stage 3). METHODS: Tauwo co-primary composite cardiovascular outcomes were assessed. The first was the composite end point of nonfatal myocardial infarction, nonfatal stroke, or death from cardiovascular causes; and the second was a composite of any of these events plus a revascularization procedure, or hospitalization for heart failure. Several secondary outcomes were prespecified, including microvascular outcomes, incident diabetes, hypoglycemia, weight, and cancers. RESULTS: Complete renal function data were available in 12,174 of 12,537 ORIGIN participants. A total of 8114 (67%) had no chronic kidney disease, while 4060 (33%) had chronic kidney disease stage 1-3. When compared with nonchronic kidney disease participants, the risk of developing the composite primary outcome (nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death) in those with mild to moderate chronic kidney disease was 87% higher; hazard ratio (HR) 1.87; 95% confidence interval (CI), 1.71-2.04 (P < .0001). The presence of chronic kidney disease 1-3 was also associated with a greater than twofold higher risk for both all-cause mortality (HR 2.17; 95% CI, 1.98-2.38; P < .0001) and cardiovascular mortality (HR 2.39; 95% CI, 2.13-2.69; P < .0001). Moreover, patients with mild to moderate chronic kidney disease had significantly higher risk for nonfatal myocardial infarction (50%), nonfatal stroke (68%), any stroke (84%), the above composite primary end point plus revascularization or heart failure requiring hospitalization (59%), or a major coronary artery disease event (56%). Furthermore, in patients with chronic kidney disease and early diabetes mellitus type 2, the primary end point occurred 83% more frequently as compared with nonchronic kidney disease participants (HR 1.83; 95% CI, 1.67-2.01; P < .001) and in patients with prediabetes and chronic kidney disease 67% more frequently (HR 1.67; 95% CI,1.25-2.24; P < .001). CONCLUSIONS: In high-risk patients with dysglycemia (prediabetes and early diabetes), mild and moderate chronic kidney disease significantly increased cardiovascular events. CI - Copyright (c) 2017. Published by Elsevier Inc. FAU - Papademetriou, Vasilios AU - Papademetriou V AD - Veterans Administration Medical Center, Washington, DC; Georgetown University Medical Center, Washington, DC. Electronic address: vpapademetriou@va.gov. FAU - Nylen, Eric S AU - Nylen ES AD - Veterans Administration Medical Center, Washington, DC; George Washington University Medical Centers, Washington, DC. FAU - Doumas, Michael AU - Doumas M AD - George Washington University Medical Centers, Washington, DC; Aristotle University of Thessaloniki, Greece. FAU - Probstfield, Jeff AU - Probstfield J AD - University of Washington, Seattle. FAU - Mann, Johannes F E AU - Mann JFE AD - KfH kidney Center, Munchen, Germany. FAU - Gilbert, Richard E AU - Gilbert RE AD - St. Michael's Hospital, University of Toronto, Ontario, Canada. FAU - Gerstein, Hertzel C AU - Gerstein HC AD - Department of Medicine and Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada. LA - eng SI - ClinicalTrials.gov/NCT00069784 PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20170831 PL - United States TA - Am J Med JT - The American journal of medicine JID - 0267200 RN - 0 (Hypoglycemic Agents) RN - 2ZM8CX04RZ (Insulin Glargine) SB - IM CIN - Am J Med. 2018 Jul;131(7):e315. doi: 10.1016/j.amjmed.2018.01.013. PMID: 29909846 CIN - Am J Med. 2018 Jul;131(7):e317. doi: 10.1016/j.amjmed.2018.01.051. PMID: 29909847 MH - Aged MH - Diabetes Mellitus, Type 2/*complications/*drug therapy MH - Diabetic Nephropathies/*drug therapy MH - Female MH - Humans MH - Hypoglycemic Agents/*therapeutic use MH - Insulin Glargine/*therapeutic use MH - Male MH - Middle Aged MH - Prediabetic State/*complications/*drug therapy MH - Renal Insufficiency, Chronic/*complications MH - Treatment Outcome OTO - NOTNLM OT - Cardiovascular outcome OT - Chronic kidney disease OT - Dysglycemia OT - Glargine EDAT- 2017/08/27 06:00 MHDA- 2017/12/14 06:00 CRDT- 2017/08/27 06:00 PHST- 2016/12/10 00:00 [received] PHST- 2017/05/26 00:00 [revised] PHST- 2017/05/29 00:00 [accepted] PHST- 2017/08/27 06:00 [pubmed] PHST- 2017/12/14 06:00 [medline] PHST- 2017/08/27 06:00 [entrez] AID - S0002-9343(17)30705-2 [pii] AID - 10.1016/j.amjmed.2017.05.047 [doi] PST - ppublish SO - Am J Med. 2017 Dec;130(12):1465.e27-1465.e39. doi: 10.1016/j.amjmed.2017.05.047. Epub 2017 Aug 31. PMID- 28807382 OWN - NLM STAT- MEDLINE DCOM- 20171030 LR - 20260518 IS - 1097-6809 (Electronic) IS - 0741-5214 (Linking) VI - 66 IP - 5 DP - 2017 Nov TI - Association between statin therapy and amputation-free survival in patients with critical limb ischemia in the CRITISCH registry. PG - 1534-1542 LID - S0741-5214(17)31686-5 [pii] LID - 10.1016/j.jvs.2017.05.115 [doi] AB - OBJECTIVE: Secondary prevention in patients with critical limb ischemia (CLI) is crucial for the reduction of cardiovascular morbidity and mortality. Nonetheless, current recommendations are extrapolated from other high-risk populations because of the lack of CLI-dedicated trials. The aim of this explorative study was to evaluate the association of statin therapy with the outcomes of CLI patients. METHODS: The First-Line Treatments in Patients With Critical Limb Ischemia (CRITISCH) registry is a prospective multicenter registry analyzing the effectiveness of all available treatment strategies in 1200 CLI patients. For the purposes of this analysis, patients were divided into two groups based on statin administration. Treatment crossovers and nonadherent patients were excluded from analysis. The primary composite end point of this study was the amputation-free survival (AFS). Major adverse cardiovascular and cerebral events (MACCEs), time to death, and time to major amputation were also analyzed. RESULTS: Statin therapy was applied in 445 individuals (37%), 371 (31%) patients received no statins, and 384 subjects were excluded from analysis (treatment crossovers). Patients receiving statins were more likely to be younger (P < .001) and to have a history of coronary heart disease (P < .001) or previous intervention at index limb (P < .001). Patients receiving statin therapy had a lower hazard regarding AFS (hazard ratio [HR], 0.45; 95% confidence interval [CI], 0.34-0.63; P < .001) and death (HR, 0.40; 95% CI, 0.24-0.66; P < .001) as well as lower odds of MACCE (odds ratio, 0.41; 95% CI, 0.23-0.69; P = .001). However, statin therapy was not associated with reduced amputation rates (HR, 1.02; 95% CI, 0.67-1.56; P = .922). Statin effect on AFS was consistent among diabetics (HR, 0.47; 95% CI, 0.31-0.70; P < .001), patients with chronic kidney disease (HR, 0.53; 95% CI, 0.32-0.87; P = .012), and patients older than 75 years (HR, 0.40; 95% CI, 0.26-0.60; P < .001). Statin administration was also associated with an improved AFS in patients with antiplatelet medication (HR, 0.64; 95% CI, 0.41-0.99; P = .049) and without antiplatelet medication (HR, 0.26; 95% CI, 0.12-0.57; P = .001) and after both endovascular therapy (HR, 0.51; 95% CI, 0.34-0.76; P = .001) and bypass revascularization (HR, 0.38; 95% CI, 0.21-0.68; P = .001). CONCLUSIONS: Statin therapy in CLI patients is associated with an increased AFS and lower rates of mortality and MACCEs without improving, however, the salvage rates of the affected limb. CI - Copyright (c) 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved. FAU - Stavroulakis, Konstantinos AU - Stavroulakis K AD - Department of Vascular Surgery, St. Franziskus Hospital GmbH, Muenster, Germany; Department of Vascular Surgery, University Clinic of Muenster, Muenster, Germany. Electronic address: stavroulakis.konstantinos@yahoo.gr. FAU - Borowski, Matthias AU - Borowski M AD - Institute of Biostatistics and Clinical Research, Westfalische Wilhelms-Universitat Muenster, Muenster, Germany. FAU - Torsello, Giovanni AU - Torsello G AD - Department of Vascular Surgery, St. Franziskus Hospital GmbH, Muenster, Germany; Department of Vascular Surgery, University Clinic of Muenster, Muenster, Germany. FAU - Bisdas, Theodosios AU - Bisdas T AD - Department of Vascular Surgery, St. Franziskus Hospital GmbH, Muenster, Germany; Department of Vascular Surgery, University Clinic of Muenster, Muenster, Germany. CN - CRITISCH collaborators LA - eng SI - ClinicalTrials.gov/NCT01877252 PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't DEP - 20170812 PL - United States TA - J Vasc Surg JT - Journal of vascular surgery JID - 8407742 RN - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors) RN - 0 (Platelet Aggregation Inhibitors) SB - IM MH - Age Factors MH - Aged MH - Aged, 80 and over MH - *Amputation, Surgical MH - Comorbidity MH - Critical Illness MH - Disease-Free Survival MH - Dyslipidemias/blood/diagnosis/*drug therapy/mortality MH - Endovascular Procedures MH - Female MH - Germany MH - Humans MH - Hydroxymethylglutaryl-CoA Reductase Inhibitors/*therapeutic use MH - Ischemia/diagnosis/mortality/*therapy MH - Kaplan-Meier Estimate MH - Limb Salvage MH - Logistic Models MH - Male MH - Middle Aged MH - Multivariate Analysis MH - Odds Ratio MH - Peripheral Arterial Disease/diagnosis/mortality/*therapy MH - Platelet Aggregation Inhibitors/therapeutic use MH - Proportional Hazards Models MH - Protective Factors MH - Registries MH - Risk Assessment MH - Risk Factors MH - Secondary Prevention/*methods MH - Time Factors MH - Treatment Outcome MH - Vascular Grafting FIR - Adili, Farzin IR - Adili F FIR - Balzer, Kai IR - Balzer K FIR - Billing, Arend IR - Billing A FIR - Bockler, Dittmar IR - Bockler D FIR - Brixner, Daniel IR - Brixner D FIR - Debus, Sebastian E IR - Debus SE FIR - Eckstein, Hans-Henning IR - Eckstein HH FIR - Florek, Hans-Joachim IR - Florek HJ FIR - Gkremoutis, Asimakis IR - Gkremoutis A FIR - Grundmann, Reinhardt IR - Grundmann R FIR - Hupp, Thomas IR - Hupp T FIR - Keck, Tobias IR - Keck T FIR - Gerss, Joachim IR - Gerss J FIR - Klonek, Wojciech IR - Klonek W FIR - Lang, Werner IR - Lang W FIR - May, Bjorn IR - May B FIR - Meyer, Alexander IR - Meyer A FIR - Muhling, Bernhard IR - Muhling B FIR - Oberhuber, Alexander IR - Oberhuber A FIR - Reinecke, Holger IR - Reinecke H FIR - Reinhold, Christian IR - Reinhold C FIR - Ritter, Ralf-Gerhard IR - Ritter RG FIR - Schelzig, Hubert IR - Schelzig H FIR - Schlensack, Christian IR - Schlensack C FIR - Schmitz-Rixen, Thomas IR - Schmitz-Rixen T FIR - Schulte, Karl-Ludwig IR - Schulte KL FIR - Spohn, Matthias IR - Spohn M FIR - Steinbauer, Markus IR - Steinbauer M FIR - Storck, Martin IR - Storck M FIR - Trede, Matthias IR - Trede M FIR - Uhl, Christian IR - Uhl C FIR - Weis-Muller, Barbara IR - Weis-Muller B FIR - Wenk, Heiner IR - Wenk H FIR - Zeller, Thomas IR - Zeller T FIR - Zhorzel, Sven IR - Zhorzel S FIR - Zimmermann, Alexander IR - Zimmermann A EDAT- 2017/08/16 06:00 MHDA- 2017/10/31 06:00 CRDT- 2017/08/16 06:00 PHST- 2017/01/02 00:00 [received] PHST- 2017/05/15 00:00 [accepted] PHST- 2017/08/16 06:00 [pubmed] PHST- 2017/10/31 06:00 [medline] PHST- 2017/08/16 06:00 [entrez] AID - S0741-5214(17)31686-5 [pii] AID - 10.1016/j.jvs.2017.05.115 [doi] PST - ppublish SO - J Vasc Surg. 2017 Nov;66(5):1534-1542. doi: 10.1016/j.jvs.2017.05.115. Epub 2017 Aug 12. PMID- 28807045 OWN - NLM STAT- MEDLINE DCOM- 20180507 LR - 20260127 IS - 1745-6215 (Electronic) IS - 1745-6215 (Linking) VI - 18 IP - 1 DP - 2017 Aug 14 TI - A randomized, multi-center, prospective study comparing best medical treatment versus best medical treatment plus renal artery stenting in patients with hemodynamically relevant atherosclerotic renal artery stenosis (RADAR) - one-year results of a pre-maturely terminated study. PG - 380 LID - 10.1186/s13063-017-2126-x [doi] LID - 380 AB - BACKGROUND: The indications for conservative "best medical treatment" (BMT) versus additional renal artery stenting are a matter of ongoing debate. The RADAR study aimed to evaluate the impact of percutaneous renal artery stenting on the impaired renal function in patients with hemodynamically significant atherosclerotic renal artery stenosis (RAS). METHODS: RADAR is an international, prospective, randomized (1:1) controlled study comparing BMT alone versus BMT plus renal artery stenting in patients with duplex sonographic hemodynamically relevant RAS. Follow-up assessments were at 2, 6, and 12 months and at 3 years. The primary endpoint was change in estimated glomerular filtration rate (eGFR) at 12 months. RESULTS: Due to slow enrollment, RADAR was terminated early after inclusion of 86 of the scheduled 300 patients (28.7%). Change in eGFR between baseline and 12 months was 4.3 +/- 15.4 ml/min/1.73 m(2) (stent group) and 3.0 +/- 14.9 ml/min/1.73 m(2) (BMT group), p > 0.999. Clinical event rates were low with a 12-month composite of cardiac death, stroke, myocardial infarction, and hospitalization for congestive heart failure of 2.9% in the stent and 5.3% in the BMT group, p = 0.526, and a 3-year composite of 14.8% and 12.0%, p = 0.982. At 3 years, target vessel (re-)vascularization occurred in one patient (3.0%) in the stent group and in 8 patients (29.4%) in the BMT group. CONCLUSION: In RADAR, outcomes of renal artery stenting were similar to BMT. These results have to be interpreted with the caveat that the study did not reach its statistically based sample size. TRIAL REGISTRATION: Clinicaltrials.gov, NCT00640406. Registered on 17 March 2008. FAU - Zeller, Thomas AU - Zeller T AD - Department of Angiology, Universitats-Herzzentrum Freiburg-Bad Krozingen, Sudring 15, 79189, Bad Krozingen, Germany. Thomas.Zeller@universitaets-herzzentrum.de. FAU - Krankenberg, Hans AU - Krankenberg H AD - Department of Angiology, Asklepios Klinik Hamburg, Hamburg, Germany. FAU - Erglis, Andrejs AU - Erglis A AD - Latvian Center of Cardiology, P. Stradins Clinical University Hospital, Riga, Latvia. FAU - Blessing, Erwin AU - Blessing E AD - Department of Internal Medicine, SRH Klinikum Karlsbad-Langensteinbach, Karlsbad, Germany. FAU - Fuss, Torsten AU - Fuss T AD - Zentralklinikum Suhl, Suhl, Germany. AD - Department Internal Medicine, Elblandkliniken, Radebeul, Germany. FAU - Scheinert, Dierk AU - Scheinert D AD - Department of Internal, Neurological and Dermatological Medicine, Division of Interventional Angiology, Universitatsklinikum Leipzig, Leipig, Germany. FAU - Weser, Ralf AU - Weser R AD - Abt. Kardiologie und Angiologie, Herzzentrum Coswig, Coswig, Anhalt, Germany. FAU - Doerr, Beatrix B AU - Doerr BB AD - Coriuvar Clinical Research & Medical Writing, Moosburg, Germany. FAU - Yollo, Wilfrid D AU - Yollo WD AD - Statistical Programming Pool (S2P), Yaounde, Cameroon. FAU - Radermacher, Joerg AU - Radermacher J AD - Center for Internal Medicine/Nephrology, Klinikum I, Johannes Wesling Klinikum Minden, Minden, Germany. CN - RADAR Investigators LA - eng SI - ClinicalTrials.gov/NCT00640406 PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, N.I.H., Extramural DEP - 20170814 PL - England TA - Trials JT - Trials JID - 101263253 RN - 0 (Antihypertensive Agents) SB - IM MH - Adult MH - Aged MH - Aged, 80 and over MH - Angioplasty, Balloon/adverse effects/*instrumentation/mortality MH - Antihypertensive Agents/adverse effects/*therapeutic use MH - Atherosclerosis/diagnostic imaging/mortality/physiopathology/*therapy MH - Brazil MH - *Early Termination of Clinical Trials MH - Europe MH - Female MH - Glomerular Filtration Rate/drug effects MH - Hemodynamics/*drug effects MH - Humans MH - Hypertension, Renovascular/diagnostic imaging/mortality/physiopathology/*therapy MH - Male MH - Middle Aged MH - Patient Selection MH - Prospective Studies MH - Renal Artery Obstruction/diagnostic imaging/mortality/physiopathology/*therapy MH - Sample Size MH - *Stents MH - Time Factors MH - Treatment Outcome MH - Ultrasonography, Doppler, Duplex PMC - PMC5556660 OTO - NOTNLM OT - Best medical therapy OT - Best medical treatment OT - Hypertension OT - Renal artery stenosis OT - Renal artery stenting OT - Renal function COIS- ETHICS APPROVAL AND CONSENT TO PARTICIPATE: The study was approved by the respective ethics committees. A respective list is available as a separate file. All patients gave written informed consent. CONSENT FOR PUBLICATION: Not applicable. COMPETING INTERESTS: TZ has received consulting fees from Medtronic, Gore, Cook, Bard, Covidien, Biotronik, and Abbott Vascular, and serves on the advisory board of Medtronic, Boston Scientific, and Gore. AE acts as a consultant for and is on the speakers' bureaus of Abbott Vascular, Biosensors, Biotronik, Boston Scientific, Cordis (Johnson and Johnson), and Medtronic, and has received research contracts from Abbott Vascular and Boston Scientific. DS acts as a member/consultant of the advisory board of Abbott, Biotronik, Boston Scientific, Cook Medical, Cordis, CR Bard, Gardia Medical, and Medtronic/Covidien. BBD and WDY receive consultant fees from Biotronik. YHK, JR, EB, and RW have nothing to disclose. PUBLISHER'S NOTE: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. EDAT- 2017/08/16 06:00 MHDA- 2018/05/08 06:00 PMCR- 2017/08/14 CRDT- 2017/08/16 06:00 PHST- 2016/05/26 00:00 [received] PHST- 2017/07/27 00:00 [accepted] PHST- 2017/08/16 06:00 [entrez] PHST- 2017/08/16 06:00 [pubmed] PHST- 2018/05/08 06:00 [medline] PHST- 2017/08/14 00:00 [pmc-release] AID - 10.1186/s13063-017-2126-x [pii] AID - 2126 [pii] AID - 10.1186/s13063-017-2126-x [doi] PST - epublish SO - Trials. 2017 Aug 14;18(1):380. doi: 10.1186/s13063-017-2126-x. PMID- 28780028 OWN - NLM STAT- MEDLINE DCOM- 20180618 LR - 20260127 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 10 IP - 20 DP - 2017 Oct 23 TI - Associations Between Chronic Kidney Disease and Outcomes With Use of Prasugrel Versus Clopidogrel in Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention: A Report From the PROMETHEUS Study. PG - 2017-2025 LID - S1936-8798(17)30989-5 [pii] LID - 10.1016/j.jcin.2017.02.047 [doi] AB - OBJECTIVES: This study sought to compare clinical outcomes in a contemporary acute coronary syndrome (ACS) percutaneous coronary intervention (PCI) cohort stratified by chronic kidney disease (CKD) status. BACKGROUND: Patients with CKD exhibit high risks for both thrombotic and bleeding events, thus complicating decision making regarding antiplatelet therapy in the setting of ACS. METHODS: The PROMETHEUS study was a multicenter observational study comparing outcomes with prasugrel versus clopidogrel in ACS PCI patients. Major adverse cardiac events (MACE) at 90 days and at 1 year were defined as a composite of death, myocardial infarction, stroke, or unplanned revascularization. Clinically significant bleeding was defined as bleeding requiring transfusion or hospitalization. Cox regression multivariable analysis was performed for adjusted associations between CKD status and clinical outcomes. Hazard ratios for prasugrel versus clopidogrel treatment were generated using propensity score stratification. RESULTS: The total cohort included 19,832 patients, 28.3% with and 71.7% without CKD. CKD patients were older with greater comorbidities including diabetes and multivessel disease. Prasugrel was less often prescribed to CKD versus non-CKD patients (11.0% vs. 24.0%, respectively; p < 0.001). At 1 year, CKD was associated with higher adjusted risk of MACE (1.27; 95% confidence interval: 1.18 to 1.37) and bleeding (1.46; 95% confidence interval: 1.24 to 1.73). Although unadjusted rates of 1-year MACE were lower with prasugrel versus clopidogrel in both CKD (18.3% vs. 26.5%; p < 0.001) and non-CKD (10.9% vs. 17.9%; p < 0.001) patients, associations were attenuated after propensity stratification. Similarly, unadjusted differences in 1-year bleeding with prasugrel versus clopidogrel (6.0% vs. 7.4%; p = 0.18 in CKD patients; 2.6% vs. 3.5%; p = 0.008 in non-CKD patients) were not significant after propensity score adjustment. CONCLUSIONS: Although risks for 1-year MACE were significantly higher in ACS PCI patients with versus without CKD, prasugrel use was 50% lower in patients with renal impairment. Irrespective of CKD status, outcomes associated with prasugrel use were not significant after propensity adjustment. These data highlight the need for randomized studies evaluating the optimal antiplatelet therapy in CKD patients with ACS. CI - Copyright (c) 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Baber, Usman AU - Baber U AD - Division of Cardiology, Icahn School of Medicine at Mount Sinai, New York, New York. FAU - Chandrasekhar, Jaya AU - Chandrasekhar J AD - Division of Cardiology, Icahn School of Medicine at Mount Sinai, New York, New York. FAU - Sartori, Samantha AU - Sartori S AD - Division of Cardiology, Icahn School of Medicine at Mount Sinai, New York, New York. FAU - Aquino, Melissa AU - Aquino M AD - Division of Cardiology, Icahn School of Medicine at Mount Sinai, New York, New York. FAU - Kini, Annapoorna S AU - Kini AS AD - Division of Cardiology, Mount Sinai Hospital, New York, New York. FAU - Kapadia, Samir AU - Kapadia S AD - Division of Cardiology, Cleveland Clinic, Cleveland, Ohio. FAU - Weintraub, William AU - Weintraub W AD - Division of Cardiology, Christiana Care Health System, Newark, Delaware. FAU - Muhlestein, Joseph B AU - Muhlestein JB AD - Division of Cardiology, Intermountain Heart Institute, Salt Lake City, Utah. FAU - Vogel, Birgit AU - Vogel B AD - Division of Cardiology, Icahn School of Medicine at Mount Sinai, New York, New York. FAU - Faggioni, Michela AU - Faggioni M AD - Division of Cardiology, Icahn School of Medicine at Mount Sinai, New York, New York. FAU - Farhan, Serdar AU - Farhan S AD - Division of Cardiology, Icahn School of Medicine at Mount Sinai, New York, New York. FAU - Weiss, Sandra AU - Weiss S AD - Division of Cardiology, Christiana Care Health System, Newark, Delaware. FAU - Strauss, Craig AU - Strauss C AD - Division of Cardiology, Minneapolis Heart Institute, Minneapolis, Minnesota. FAU - Toma, Catalin AU - Toma C AD - Division of Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania. FAU - DeFranco, Anthony AU - DeFranco A AD - Division of Cardiology, Aurora Cardiovascular Services, Milwaukee, Wisconsin. FAU - Baker, Brian A AU - Baker BA AD - Daiichi Sankyo, Parsippany, New Jersey. FAU - Keller, Stuart AU - Keller S AD - Eli Lilly and Company, Indianapolis, Indiana. FAU - Effron, Mark B AU - Effron MB AD - Eli Lilly and Company, Indianapolis, Indiana; Division of Cardiology, John Ochsner Heart and Vascular Center, Ochsner Medical Center, New Orleans, Louisiana. FAU - Henry, Timothy D AU - Henry TD AD - Division of Cardiology, Cedars-Sinai Heart Institute, Los Angeles, California. FAU - Rao, Sunil AU - Rao S AD - Division of Cardiology, Duke University, Durham, North Carolina. FAU - Pocock, Stuart AU - Pocock S AD - London School of Hygiene and Tropical Medicine, London, United Kingdom. FAU - Dangas, George AU - Dangas G AD - Division of Cardiology, Mount Sinai Hospital, New York, New York. FAU - Mehran, Roxana AU - Mehran R AD - Division of Cardiology, Icahn School of Medicine at Mount Sinai, New York, New York. Electronic address: roxana.mehran@mountsinai.org. LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Observational Study PT - Research Support, Non-U.S. Gov't DEP - 20170802 PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 RN - 0 (Platelet Aggregation Inhibitors) RN - A74586SNO7 (Clopidogrel) RN - G89JQ59I13 (Prasugrel Hydrochloride) RN - OM90ZUW7M1 (Ticlopidine) SB - IM CIN - JACC Cardiovasc Interv. 2017 Oct 23;10(20):2026-2028. doi: 10.1016/j.jcin.2017.06.028. PMID: 28780024 CIN - JACC Cardiovasc Interv. 2017 Nov 27;10(22):2343-2344. doi: 10.1016/j.jcin.2017.08.038. PMID: 29169505 CIN - JACC Cardiovasc Interv. 2017 Nov 27;10(22):2344-2345. doi: 10.1016/j.jcin.2017.09.022. PMID: 29169506 CIN - JACC Cardiovasc Interv. 2018 Feb 12;11(3):319-320. doi: 10.1016/j.jcin.2017.11.016. PMID: 29413247 CIN - JACC Cardiovasc Interv. 2018 Feb 12;11(3):320. doi: 10.1016/j.jcin.2017.12.009. PMID: 29413248 MH - Acute Coronary Syndrome/complications/mortality/physiopathology/*therapy MH - Aged MH - Aged, 80 and over MH - Chi-Square Distribution MH - Clopidogrel MH - Coronary Thrombosis/etiology MH - Databases, Factual MH - Hemorrhage/chemically induced MH - Humans MH - Kaplan-Meier Estimate MH - Kidney/*physiopathology MH - Male MH - Middle Aged MH - Multivariate Analysis MH - Myocardial Infarction/etiology MH - *Percutaneous Coronary Intervention/adverse effects/mortality MH - Platelet Aggregation Inhibitors/*administration & dosage/adverse effects MH - Prasugrel Hydrochloride/*administration & dosage/adverse effects MH - Propensity Score MH - Proportional Hazards Models MH - Renal Insufficiency, Chronic/*complications/mortality/physiopathology MH - Risk Factors MH - Stroke/etiology MH - Ticlopidine/administration & dosage/adverse effects/*analogs & derivatives MH - Time Factors MH - Treatment Outcome MH - United States OTO - NOTNLM OT - acute coronary syndrome(s) OT - chronic kidney disease OT - long-term outcomes OT - percutaneous coronary intervention OT - prasugrel or clopidogrel EDAT- 2017/08/07 06:00 MHDA- 2018/06/19 06:00 CRDT- 2017/08/07 06:00 PHST- 2017/01/18 00:00 [received] PHST- 2017/02/09 00:00 [accepted] PHST- 2017/08/07 06:00 [pubmed] PHST- 2018/06/19 06:00 [medline] PHST- 2017/08/07 06:00 [entrez] AID - S1936-8798(17)30989-5 [pii] AID - 10.1016/j.jcin.2017.02.047 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2017 Oct 23;10(20):2017-2025. doi: 10.1016/j.jcin.2017.02.047. Epub 2017 Aug 2. PMID- 28761685 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20231112 IS - 2053-3624 (Print) IS - 2053-3624 (Electronic) IS - 2053-3624 (Linking) VI - 4 IP - 2 DP - 2017 TI - Two-year clinical outcomes of patients treated with the dual-therapy stent in a 1000 patient all-comers registry. PG - e000634 LID - 10.1136/openhrt-2017-000634 [doi] LID - e000634 AB - OBJECTIVE: The dual-therapy stent combines an abluminal biodegradable drug-eluting coating, with a 'pro-healing' luminal layer. This bioengineered layer attracts circulating endothelial progenitor cells that can differentiate into normal endothelium. Rapid endothelialisation of the stent might allow safe short dual antiplatelet therapy. We aim to assess clinical outcomes in patients treated with this novel device at 2-year follow-up. METHODS: A total of 1000 patients were included in the REMEDEE Registry to evaluate clinical outcomes after treatment with the dual-therapy stent. This prospective, multicentre, European registry included all-comers patients, which resulted in a high-risk patient population. Target lesion failure (TLF), a combined endpoint consisting of cardiac death, target vessel myocardial infarction (tv-MI) and target lesion revascularisation (TLR), at 2-year follow-up was the primary focus of this analysis. Subgroup analyses were performed according to diabetes mellitus (DM), gender, age, acute coronary syndrome, smoking, hypertension, hypercholesterolaemia, previous stroke, peripheral vascular disease and chronic renal failure. RESULTS: TLF at 2 years was observed in 84 patients (8.5%), with 3.0% cardiac death, 1.2% tv-MI and 5.9% TLR. Definite stent thrombosis at 2 years was 0.6%. In the presence of DM or chronic renal failure, a higher TLF was observed. CONCLUSIONS: The dual-therapy stent shows favourable clinical outcomes from 12 months onwards. Two years after stent placement, low TLF and very low stent thrombosis rates are observed in this large prospective all-comers cohort study. TRIAL REGISTRATION NUMBER: NCT01874002; Results. FAU - Kalkman, Deborah N AU - Kalkman DN AD - Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. FAU - Woudstra, Pier AU - Woudstra P AD - Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. FAU - Menown, Ian B A AU - Menown IBA AD - Craigavon Cardiac Centre, Craigavon, UK. FAU - den Heijer, Peter AU - den Heijer P AD - Amphia Hospital Breda, Breda, The Netherlands. FAU - Van't Hof, Arnoud Wj AU - Van't Hof AW AD - Isala Klinieken, Zwolle, The Netherlands. FAU - Erglis, Andrejs AU - Erglis A AD - Pauls Stradins Clinical University Hospital, Riga, Latvia. FAU - Suryapranata, Harry AU - Suryapranata H AD - Radboud University Medical Center, Nijmegen, The Netherlands. FAU - Arkenbout, Karin E AU - Arkenbout KE AD - Tergooi Ziekenhuis, Blaricum, The Netherlands. FAU - Iniguez, Andres AU - Iniguez A AD - Hospital Alvaro Cunqueiro - Complejo Hospitalario Universitario, Vigo, Spain. FAU - Muller, Philippe AU - Muller P AD - Institut National de Cardiochirurgie et de Cardiologie Interventionnelle, Luxembourg. FAU - Tijssen, Jan G AU - Tijssen JG AD - Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. FAU - Beijk, Marcel A M AU - Beijk MAM AD - Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. FAU - de Winter, Robbert J AU - de Winter RJ AD - Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. LA - eng SI - ClinicalTrials.gov/NCT01874002 PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20170711 PL - England TA - Open Heart JT - Open heart JID - 101631219 PMC - PMC5515182 OTO - NOTNLM OT - Coronary Artery Disease OT - Coronary Intervention (pci) OT - Coronary Stenting OT - Interventional Cardiology COIS- Competing interests: None declared. EDAT- 2017/08/02 06:00 MHDA- 2017/08/02 06:01 PMCR- 2017/07/11 CRDT- 2017/08/02 06:00 PHST- 2017/03/28 00:00 [received] PHST- 2017/05/07 00:00 [revised] PHST- 2017/06/13 00:00 [accepted] PHST- 2017/08/02 06:00 [entrez] PHST- 2017/08/02 06:00 [pubmed] PHST- 2017/08/02 06:01 [medline] PHST- 2017/07/11 00:00 [pmc-release] AID - openhrt-2017-000634 [pii] AID - 10.1136/openhrt-2017-000634 [doi] PST - epublish SO - Open Heart. 2017 Jul 11;4(2):e000634. doi: 10.1136/openhrt-2017-000634. eCollection 2017. PMID- 28746934 OWN - NLM STAT- MEDLINE DCOM- 20180813 LR - 20260127 IS - 1421-9751 (Electronic) IS - 0008-6312 (Linking) VI - 138 IP - 3 DP - 2017 TI - Protective Effects of Salvianolate on Contrast-Induced Nephropathy after Primary Percutaneous Coronary Intervention: A Prospective Multicenter Randomized Controlled Trial. PG - 169-178 LID - 10.1159/000475746 [doi] AB - OBJECTIVES: This study's aim was to evaluate the protective effects of salvianolate on contrast-induced nephropathy after primary percutaneous coronary intervention (PPCI) compared with normal saline (NS) hydration. METHODS: We enrolled patients with acute myocardial infarction who underwent PPCI in 3 centers in Shanghai. The patients were randomly assigned to the salvianolate group or the NS group. The incidence of CIN, the changes in renal function parameters, and the occurrence of adverse events after the procedure were compared between the 2 groups. We used a multivariate logistic regression analysis to determine the independent correlates of CIN after PPCI. RESULTS: A total of 484 patients were finally included in the statistical analysis. Compared with the control group, salvianolate reduced the incidence of CIN (9.1 vs. 16.3%, p = 0.018) after PPCI. The renal function parameters after PPCI in the salvianolate group were superior to those of the control group (p < 0.05). The composite adverse events rate was significantly lower in the salvianolate group within 1 month after the procedure (9.5 vs. 15.5%, p = 0.046). A higher peak of troponin I and loop diuretic therapy were the independent correlates of CIN after PPCI. CONCLUSIONS: Salvianolate reduces the incidence of CIN and protects renal function after PPCI, and the effects were superior to those of NS hydration. CI - (c) 2017 S. Karger AG, Basel. FAU - Huang, Jing AU - Huang J AD - Department of Cardiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China. FAU - Yuan, Minjie AU - Yuan M FAU - Ma, Jian AU - Ma J FAU - Liu, Rong AU - Liu R FAU - Dong, Zhifeng AU - Dong Z FAU - Zhao, Gang AU - Zhao G FAU - Hang, Jingyu AU - Hang J FAU - Wei, Junbo AU - Wei J FAU - Ma, Shixin AU - Ma S FAU - Wei, Meng AU - Wei M FAU - Jiang, Jinfa AU - Jiang J FAU - Song, Haoming AU - Song H FAU - Liu, Zongjun AU - Liu Z FAU - Zhang, Wenquan AU - Zhang W FAU - Li, Jingbo AU - Li J FAU - Lu, Zhigang AU - Lu Z LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20170727 PL - Switzerland TA - Cardiology JT - Cardiology JID - 1266406 RN - 0 (Contrast Media) RN - 0 (Plant Extracts) RN - 0 (salvianolate) SB - IM MH - Aged MH - China/epidemiology MH - Contrast Media/*adverse effects MH - Coronary Angiography/adverse effects MH - Electrocardiography MH - Female MH - Humans MH - Incidence MH - Kidney Diseases/chemically induced/*epidemiology/*prevention & control MH - Kidney Function Tests MH - Logistic Models MH - Male MH - Middle Aged MH - Multivariate Analysis MH - Myocardial Infarction/surgery MH - Percutaneous Coronary Intervention/adverse effects MH - Plant Extracts/*therapeutic use MH - Prospective Studies MH - Survival Analysis OTO - NOTNLM OT - Acute myocardial infarction OT - Contrast-induced nephropathy OT - Primary percutaneous coronary intervention OT - Salvianolate EDAT- 2017/07/27 06:00 MHDA- 2018/08/14 06:00 CRDT- 2017/07/27 06:00 PHST- 2017/01/30 00:00 [received] PHST- 2017/04/12 00:00 [accepted] PHST- 2017/07/27 06:00 [pubmed] PHST- 2018/08/14 06:00 [medline] PHST- 2017/07/27 06:00 [entrez] AID - 000475746 [pii] AID - 10.1159/000475746 [doi] PST - ppublish SO - Cardiology. 2017;138(3):169-178. doi: 10.1159/000475746. Epub 2017 Jul 27. PMID- 28734623 OWN - NLM STAT- MEDLINE DCOM- 20190918 LR - 20220408 IS - 1097-685X (Electronic) IS - 0022-5223 (Linking) VI - 155 IP - 1 DP - 2018 Jan TI - Eight-year follow-up of the Clopidogrel After Surgery for Coronary Artery Disease (CASCADE) trial. PG - 212-222.e2 LID - S0022-5223(17)31358-2 [pii] LID - 10.1016/j.jtcvs.2017.06.039 [doi] AB - OBJECTIVE: In this 8 years' follow-up study, we evaluated the long-term outcomes of the addition of clopidogrel to aspirin during the first year after coronary artery bypass grafting, versus aspirin plus placebo, with respect to survival, major adverse cardiac, or major cerebrovascular events, including revascularization, functional status, graft patency, and native coronary artery disease progression. METHODS: In the initial Clopidogrel After Surgery for Coronary Artery Disease trial, 113 patients were randomized to receive either daily clopidogrel (n = 56) or placebo (n = 57), in addition to aspirin, in a double-blind fashion for 1 year after coronary artery bypass grafting. All patients were re-evaluated to collect long-term clinical data. Surviving patients with a glomerular filtration rate > 30 mL/min were asked to undergo a coronary computed tomography angiogram to evaluate the late saphenous vein graft patency and native coronary artery disease progression. RESULTS: At a median follow-up of 7.6 years, survival rate was 85.5% +/- 3.8% (P = .23 between the 2 groups). A trend toward enhanced freedom from all-cause death or major adverse cardiac or cerebrovascular events, including revascularization, was observed in the aspirin-clopidogrel group (P = .11). No difference in functional status or freedom from angina was observed between the 2 groups (P > .57). The long-term patency of saphenous vein graft was 89.11% in the aspirin-clopidogrel group versus 91.23% in the aspirin-placebo group (P = .79). A lower incidence of moderate to severe native disease progression was observed in the aspirin-clopidogrel group versus the aspirin-placebo group (7 out of 122 vs 13 out of 78 coronary segments that showed progression, respectively [odds ratio, 0.3 +/- 0.2; 95% confidence interval, 0.1-0.8; P = .02]). CONCLUSIONS: At 8 years' follow-up, the addition of clopidogrel to aspirin during the first year after coronary artery bypass grafting exhibited a lower incidence of moderate to severe progression of native coronary artery disease and a trend toward higher freedom from major adverse cardiac or cerebrovascular events, including revascularization, or death in the aspirin-clopidogrel group. CLINICAL TRIAL REGISTRATION: http://www.clinicaltrials.gov. Unique identifier: NCT00228423. CI - Copyright (c) 2017 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved. FAU - Hage, Ali AU - Hage A AD - Division of Cardiac Surgery, Quebec Heart and Lung Institute, Quebec City, Quebec, Canada. FAU - Voisine, Pierre AU - Voisine P AD - Division of Cardiac Surgery, Quebec Heart and Lung Institute, Quebec City, Quebec, Canada. FAU - Erthal, Fernanda AU - Erthal F AD - Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada. FAU - Larose, Eric AU - Larose E AD - Division of Cardiology, Quebec Heart and Lung Institute, Quebec City, Quebec, Canada. FAU - Glineur, David AU - Glineur D AD - Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, Ontario, Canada. FAU - Chow, Benjamin AU - Chow B AD - Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada. FAU - Tremblay, Hugo AU - Tremblay H AD - Division of Cardiac Surgery, Quebec Heart and Lung Institute, Quebec City, Quebec, Canada. FAU - Fortier, Jacqueline AU - Fortier J AD - Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, Ontario, Canada. FAU - Ko, Gifferd AU - Ko G AD - Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, Ontario, Canada. FAU - Une, Dai AU - Une D AD - Division of Cardiovascular Surgery, Yamato Seiwa Hospital, Yamato, Japan. FAU - Farkouh, Michael AU - Farkouh M AD - Division of Cardiology, Mount Sinai Hospital, New York, NY. FAU - Mesana, Thierry G AU - Mesana TG AD - Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, Ontario, Canada. FAU - LeMay, Michel AU - LeMay M AD - Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada. FAU - Kulik, Alexander AU - Kulik A AD - Division of Cardiovascular Surgery, Lynn Heart & Vascular Institute, Boca Raton, Fla. FAU - Ruel, Marc AU - Ruel M AD - Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, Ontario, Canada. Electronic address: mruel@ottawaheart.ca. LA - eng SI - ClinicalTrials.gov/NCT00228423 PT - Journal Article PT - Randomized Controlled Trial DEP - 20170624 PL - United States TA - J Thorac Cardiovasc Surg JT - The Journal of thoracic and cardiovascular surgery JID - 0376343 RN - 0 (Platelet Aggregation Inhibitors) RN - A74586SNO7 (Clopidogrel) RN - R16CO5Y76E (Aspirin) SB - IM CIN - J Thorac Cardiovasc Surg. 2018 Jan;155(1):222. doi: 10.1016/j.jtcvs.2017.06.044. PMID: 28734624 CIN - J Thorac Cardiovasc Surg. 2018 Jan;155(1):223-224. doi: 10.1016/j.jtcvs.2017.08.049. PMID: 28967422 MH - Aged MH - Aspirin/administration & dosage/adverse effects MH - *Clopidogrel/administration & dosage/adverse effects MH - Computed Tomography Angiography/methods MH - Coronary Angiography/methods MH - Coronary Artery Bypass/*adverse effects/methods MH - Coronary Artery Disease/mortality/*surgery MH - Coronary Restenosis/etiology/*prevention & control MH - Double-Blind Method MH - Drug Therapy, Combination/*methods MH - Female MH - Follow-Up Studies MH - Humans MH - Male MH - Middle Aged MH - Outcome and Process Assessment, Health Care MH - Platelet Aggregation Inhibitors/administration & dosage/adverse effects MH - Survival Analysis MH - Vascular Patency/drug effects OTO - NOTNLM OT - antiplatelet drugs OT - coronary artery bypass graft OT - coronary disease EDAT- 2017/07/25 06:00 MHDA- 2019/09/19 06:00 CRDT- 2017/07/24 06:00 PHST- 2016/05/30 00:00 [received] PHST- 2017/05/18 00:00 [revised] PHST- 2017/06/14 00:00 [accepted] PHST- 2017/07/25 06:00 [pubmed] PHST- 2019/09/19 06:00 [medline] PHST- 2017/07/24 06:00 [entrez] AID - S0022-5223(17)31358-2 [pii] AID - 10.1016/j.jtcvs.2017.06.039 [doi] PST - ppublish SO - J Thorac Cardiovasc Surg. 2018 Jan;155(1):212-222.e2. doi: 10.1016/j.jtcvs.2017.06.039. Epub 2017 Jun 24. PMID- 28726115 OWN - NLM STAT- MEDLINE DCOM- 20190617 LR - 20190617 IS - 1868-4297 (Electronic) IS - 1868-4297 (Linking) VI - 33 IP - 4 DP - 2018 Oct TI - The impact of coronary calcification on angiographic and 3-year clinical outcomes of everolimus-eluting stents: results of a XIENCE V/PROMUS post-marketing surveillance study. PG - 313-320 LID - 10.1007/s12928-017-0484-7 [doi] AB - Coronary calcification (CCA) is one of the independent predictors for major adverse cardiac events (MACEs) in coronary intervention. Post-marketing surveillance study Japan is a prospective registry designed to evaluate the safety and efficacy of the everolimus-eluting stent (EES, XIENCE V/PROMUS Stent) in routine clinical practice at 47 centers. In this study, 1848 lesions (1546 patients) were assessed using quantitative coronary angiography. In these 1546 patients, renal function data were unknown in 26 patients. Three patients in 70 patients with dialysis and 56 patients in 1450 patients with no dialysis were excluded, because they had multiple lesions with mixed calcification lesions. We evaluated the effects of CCA on 8-month angiographic and 3-year clinical outcomes in dialysis and non-dialysis patients. Moderate-to-severe (Ca group) and none-to-mild CCA (non-Ca group) were observed in 33 lesions (30 patients) and 48 lesions (37 patients) in dialysis patients, and these were observed in 306 lesions (286 patients) and 1303 lesions (1108 patients) in non-dialysis patients, respectively. In non-dialysis patients, the ischemic-driven target lesion revascularization (ID-TLR) and MACE rate over the 3 years were significantly higher in the Ca group than in the non-Ca group (5.8 vs. 3.1%, p = 0.025 and 10.0 vs. 5.0%, p = 0.0011). In dialysis patients, ID-TLR and MACE rates were high in both groups (14.3 vs. 17.9%, p = 0.85 and 17.5 vs. 36.1%, p = 0.16). In non-dialysis patients, 8-month angiographic and 3-year clinical outcomes were worse in the Ca group. However, in dialysis patients, both outcomes were worse regardless of CCA.Clinical Trial registration https://clinicaltrials.gov/ct2/show/NCT01086228 . FAU - Shiode, Nobuo AU - Shiode N AD - Division of Cardiology, Akane Foundation Tsuchiya General Hospital, 3-30 Nakajima-cho, Naka-ku, Hiroshima, 730-8655, Japan. nobucode.0317@kfd.biglobe.ne.jp. FAU - Kozuma, Ken AU - Kozuma K AD - Department of Cardiology, Teikyo University Hospital, Tokyo, Japan. FAU - Aoki, Jiro AU - Aoki J AD - Division of Cardiology, Mitsui Memorial Hospital, Tokyo, Japan. FAU - Awata, Masaki AU - Awata M AD - Department of Advanced Cardiovascular Therapeutics, Osaka University Graduate School of Medicine, Osaka, Japan. FAU - Nanasato, Mamoru AU - Nanasato M AD - Cardiovascular Center, Nagoya Daini Red Cross Hospital, Aichi, Japan. FAU - Tanabe, Kengo AU - Tanabe K AD - Division of Cardiology, Mitsui Memorial Hospital, Tokyo, Japan. FAU - Yamaguchi, Junichi AU - Yamaguchi J AD - Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan. FAU - Kusano, Hajime AU - Kusano H AD - Abbott Vascular, Santa Clara, CA, USA. FAU - Nie, Hong AU - Nie H AD - Abbott Vascular, Santa Clara, CA, USA. FAU - Kimura, Takeshi AU - Kimura T AD - Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan. CN - XIEVCE V/Promus PMS Investigators LA - eng SI - ClinicalTrials.gov/NCT01086228 PT - Journal Article PT - Multicenter Study DEP - 20170719 PL - Japan TA - Cardiovasc Interv Ther JT - Cardiovascular intervention and therapeutics JID - 101522043 RN - 0 (Cardiovascular Agents) RN - 9HW64Q8G6G (Everolimus) SB - IM MH - Aged MH - Cardiovascular Agents/administration & dosage/*adverse effects MH - Coronary Angiography/adverse effects/methods MH - Coronary Artery Disease/complications/diagnostic imaging/*surgery MH - Coronary Restenosis/etiology MH - Coronary Vessels/diagnostic imaging/pathology/surgery MH - Drug-Eluting Stents/*adverse effects MH - Everolimus/*administration & dosage/adverse effects MH - Female MH - Humans MH - Japan MH - Kaplan-Meier Estimate MH - Male MH - Middle Aged MH - Percutaneous Coronary Intervention/*adverse effects/methods MH - Product Surveillance, Postmarketing MH - Prospective Studies MH - Registries MH - Renal Dialysis/adverse effects MH - Treatment Outcome MH - Vascular Calcification/*complications/diagnostic imaging OTO - NOTNLM OT - Coronary calcification OT - Dialysis OT - Everolimus-eluting stent EDAT- 2017/07/21 06:00 MHDA- 2019/06/18 06:00 CRDT- 2017/07/21 06:00 PHST- 2017/02/13 00:00 [received] PHST- 2017/07/13 00:00 [accepted] PHST- 2017/07/21 06:00 [pubmed] PHST- 2019/06/18 06:00 [medline] PHST- 2017/07/21 06:00 [entrez] AID - 10.1007/s12928-017-0484-7 [pii] AID - 10.1007/s12928-017-0484-7 [doi] PST - ppublish SO - Cardiovasc Interv Ther. 2018 Oct;33(4):313-320. doi: 10.1007/s12928-017-0484-7. Epub 2017 Jul 19. PMID- 28707322 OWN - NLM STAT- MEDLINE DCOM- 20190409 LR - 20191210 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 91 IP - 4 DP - 2018 Mar 1 TI - Development and validation of a risk model for long-term mortality after percutaneous coronary intervention: The IDEA-BIO Study. PG - 686-695 LID - 10.1002/ccd.27182 [doi] AB - OBJECTIVES: We aimed to develop a model to predict long-term mortality after percutaneous coronary intervention (PCI), to aid in selecting patients with sufficient life expectancy to benefit from bioabsorbable scaffolds. BACKGROUND: Clinical trials are currently designed to demonstrate superiority of bioabsorbable scaffolds over metal devices up to 5 years after implantation. METHODS: From 2000 to 2011, 19.532 consecutive patients underwent PCI in a tertiary referral hospital. Patients were randomly (2:1) divided into a training (N = 13,090) and validation (N = 6,442) set. Cox regression was used to identify determinants of long-term mortality in the training set and used to develop a risk model. Model performance was studied in the training and validation dataset. RESULTS: Median age was 63 years (IQR 54-72) and 72% were men. Median follow-up was 3.6 years (interquartile range [IQR] 2.4-6.8). The ratio elective vs. non-elective PCIs was 42/58. During 88,620 patient-years of follow-up, 3,156 deaths occurred, implying an incidence rate of 35.6 per 1,000. Estimated 5-year mortality was 12.9%.Regression analysis revealed age, body mass index, diabetes mellitus, renal insufficiency, prior myocardial infarction, PCI indication, lesion location, number of diseased vessels and cardiogenic shock at presentation as determinants of mortality. The long-term risk model showed good discrimination in the training and validation sets (c-indices 0.76 and 0.74), whereas calibration was appropriate. CONCLUSIONS: A simple risk model, containing 9 baseline clinical and angiographic variables effectively predicts long-term mortality after PCI and may possibly be used to select suitable patients for bioabsorbable scaffolds. CI - (c) 2017 Wiley Periodicals, Inc. FAU - van Boven, Nick AU - van Boven N AUID- ORCID: 0000-0003-3749-9303 AD - Department of Cardiology, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands. AD - Department of Cardiology and Cardiovascular Research School COEUR, Erasmus MC, Rotterdam, The Netherlands. FAU - van Domburg, Ron T AU - van Domburg RT AD - Department of Cardiology and Cardiovascular Research School COEUR, Erasmus MC, Rotterdam, The Netherlands. FAU - Kardys, Isabella AU - Kardys I AD - Department of Cardiology and Cardiovascular Research School COEUR, Erasmus MC, Rotterdam, The Netherlands. FAU - Umans, Victor A AU - Umans VA AD - Department of Cardiology, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands. FAU - Akkerhuis, K Martijn AU - Akkerhuis KM AD - Department of Cardiology and Cardiovascular Research School COEUR, Erasmus MC, Rotterdam, The Netherlands. FAU - Lenzen, Mattie J AU - Lenzen MJ AD - Department of Cardiology and Cardiovascular Research School COEUR, Erasmus MC, Rotterdam, The Netherlands. FAU - Valgimigli, Marco AU - Valgimigli M AD - Department of Cardiology and Cardiovascular Research School COEUR, Erasmus MC, Rotterdam, The Netherlands. FAU - Daemen, Joost AU - Daemen J AD - Department of Cardiology and Cardiovascular Research School COEUR, Erasmus MC, Rotterdam, The Netherlands. FAU - Zijlstra, Felix AU - Zijlstra F AD - Department of Cardiology and Cardiovascular Research School COEUR, Erasmus MC, Rotterdam, The Netherlands. FAU - Boersma, Eric AU - Boersma E AD - Department of Cardiology and Cardiovascular Research School COEUR, Erasmus MC, Rotterdam, The Netherlands. FAU - van Geuns, Robert-Jan AU - van Geuns RJ AD - Department of Cardiology and Cardiovascular Research School COEUR, Erasmus MC, Rotterdam, The Netherlands. LA - eng PT - Journal Article PT - Observational Study PT - Validation Study DEP - 20170714 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM CIN - Catheter Cardiovasc Interv. 2018 Mar 1;91(4):696. doi: 10.1002/ccd.27560. PMID: 29532644 MH - Absorbable Implants MH - Age Factors MH - Aged MH - Aged, 80 and over MH - Clinical Decision-Making MH - Comorbidity MH - Coronary Angiography MH - Coronary Artery Disease/diagnostic imaging/mortality/*surgery MH - *Decision Support Techniques MH - Drug-Eluting Stents MH - Female MH - Health Status MH - Humans MH - Male MH - Middle Aged MH - Percutaneous Coronary Intervention/adverse effects/instrumentation/*mortality MH - Predictive Value of Tests MH - Prosthesis Design MH - Reproducibility of Results MH - Risk Assessment MH - Risk Factors MH - Time Factors MH - Treatment Outcome OTO - NOTNLM OT - prognosis OT - coronary artery disease OT - stents EDAT- 2017/07/15 06:00 MHDA- 2019/04/10 06:00 CRDT- 2017/07/15 06:00 PHST- 2017/02/23 00:00 [received] PHST- 2017/06/08 00:00 [accepted] PHST- 2017/07/15 06:00 [pubmed] PHST- 2019/04/10 06:00 [medline] PHST- 2017/07/15 06:00 [entrez] AID - 10.1002/ccd.27182 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2018 Mar 1;91(4):686-695. doi: 10.1002/ccd.27182. Epub 2017 Jul 14. PMID- 28701487 OWN - NLM STAT- MEDLINE DCOM- 20180416 LR - 20260127 IS - 1941-7632 (Electronic) IS - 1941-7640 (Linking) VI - 10 IP - 7 DP - 2017 Jul TI - Differential Event Rates and Independent Predictors of Long-Term Major Cardiovascular Events and Death in 5795 Patients With Unprotected Left Main Coronary Artery Disease Treated With Stents, Bypass Surgery, or Medication: Insights From a Large International Multicenter Registry. LID - e004988 [pii] LID - 10.1161/CIRCINTERVENTIONS.116.004988 [doi] AB - BACKGROUND: Identifying predictive factors for major cardiovascular events and death in patients with unprotected left main coronary artery disease is of great clinical value for risk stratification and possible guidance for tailored preventive strategies. METHODS AND RESULTS: The Interventional Research Incorporation Society-Left MAIN Revascularization registry included 5795 patients with unprotected left main coronary artery disease (percutaneous coronary intervention, n=2850; coronary-artery bypass grafting, n=2337; medication alone, n=608). We analyzed the incidence and independent predictors of major adverse cardiac and cerebrovascular events (MACCE; a composite of death, MI, stroke, or repeat revascularization) and all-cause mortality in each treatment stratum. During follow-up (median, 4.3 years), the rates of MACCE and death were substantially higher in the medical group than in the percutaneous coronary intervention and coronary-artery bypass grafting groups (P<0.001). In the percutaneous coronary intervention group, the 3 strongest predictors for MACCE were chronic renal failure, old age (>/=65 years), and previous heart failure; those for all-cause mortality were chronic renal failure, old age, and low ejection fraction. In the coronary-artery bypass grafting group, old age, chronic renal failure, and low ejection fraction were the 3 strongest predictors of MACCE and death. In the medication group, old age, low ejection fraction, and diabetes mellitus were the 3 strongest predictors of MACCE and death. CONCLUSIONS: Among patients with unprotected left main coronary artery disease, the key clinical predictors for MACCE and death were generally similar regardless of index treatment. This study provides effect estimates for clinically relevant predictors of long-term clinical outcomes in real-world left main coronary artery patients, providing possible guidance for tailored preventive strategies. CLINICAL TRIAL REGISTRATION: URL: https://clinicaltrials.gov. Unique identifier: NCT01341327. CI - (c) 2017 American Heart Association, Inc. FAU - Kang, Se Hun AU - Kang SH AD - From the Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, Korea (S.H.K.); and Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea (J.-M.A., C.H.L., P.H.L., S.-J.K., S.-W.L., Y.-H.K., C.W.L., S.-W.P., D.-W.P., S.-J.P.). FAU - Ahn, Jung-Min AU - Ahn JM AD - From the Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, Korea (S.H.K.); and Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea (J.-M.A., C.H.L., P.H.L., S.-J.K., S.-W.L., Y.-H.K., C.W.L., S.-W.P., D.-W.P., S.-J.P.). FAU - Lee, Cheol Hyun AU - Lee CH AD - From the Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, Korea (S.H.K.); and Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea (J.-M.A., C.H.L., P.H.L., S.-J.K., S.-W.L., Y.-H.K., C.W.L., S.-W.P., D.-W.P., S.-J.P.). FAU - Lee, Pil Hyung AU - Lee PH AD - From the Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, Korea (S.H.K.); and Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea (J.-M.A., C.H.L., P.H.L., S.-J.K., S.-W.L., Y.-H.K., C.W.L., S.-W.P., D.-W.P., S.-J.P.). FAU - Kang, Soo-Jin AU - Kang SJ AD - From the Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, Korea (S.H.K.); and Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea (J.-M.A., C.H.L., P.H.L., S.-J.K., S.-W.L., Y.-H.K., C.W.L., S.-W.P., D.-W.P., S.-J.P.). FAU - Lee, Seung-Whan AU - Lee SW AD - From the Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, Korea (S.H.K.); and Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea (J.-M.A., C.H.L., P.H.L., S.-J.K., S.-W.L., Y.-H.K., C.W.L., S.-W.P., D.-W.P., S.-J.P.). FAU - Kim, Young-Hak AU - Kim YH AD - From the Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, Korea (S.H.K.); and Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea (J.-M.A., C.H.L., P.H.L., S.-J.K., S.-W.L., Y.-H.K., C.W.L., S.-W.P., D.-W.P., S.-J.P.). FAU - Lee, Cheol Whan AU - Lee CW AD - From the Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, Korea (S.H.K.); and Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea (J.-M.A., C.H.L., P.H.L., S.-J.K., S.-W.L., Y.-H.K., C.W.L., S.-W.P., D.-W.P., S.-J.P.). FAU - Park, Seong-Wook AU - Park SW AD - From the Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, Korea (S.H.K.); and Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea (J.-M.A., C.H.L., P.H.L., S.-J.K., S.-W.L., Y.-H.K., C.W.L., S.-W.P., D.-W.P., S.-J.P.). FAU - Park, Duk-Woo AU - Park DW AD - From the Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, Korea (S.H.K.); and Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea (J.-M.A., C.H.L., P.H.L., S.-J.K., S.-W.L., Y.-H.K., C.W.L., S.-W.P., D.-W.P., S.-J.P.). dwpark@amc.seoul.kr. FAU - Park, Seung-Jung AU - Park SJ AD - From the Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, Korea (S.H.K.); and Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea (J.-M.A., C.H.L., P.H.L., S.-J.K., S.-W.L., Y.-H.K., C.W.L., S.-W.P., D.-W.P., S.-J.P.). LA - eng SI - ClinicalTrials.gov/NCT01341327 PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Observational Study PL - United States TA - Circ Cardiovasc Interv JT - Circulation. Cardiovascular interventions JID - 101499602 RN - 0 (Cardiovascular Agents) SB - IM MH - Aged MH - Asia/epidemiology MH - Cardiovascular Agents/adverse effects/*therapeutic use MH - Cause of Death MH - Comorbidity MH - *Coronary Artery Bypass/adverse effects/mortality MH - Coronary Artery Disease/diagnosis/mortality/*therapy MH - Female MH - Humans MH - Kaplan-Meier Estimate MH - Male MH - Middle Aged MH - Myocardial Infarction/mortality MH - Percutaneous Coronary Intervention/adverse effects/*instrumentation/mortality MH - Proportional Hazards Models MH - Registries MH - Risk Assessment MH - Risk Factors MH - *Stents MH - Stroke/mortality MH - Time Factors MH - Treatment Outcome OTO - NOTNLM OT - coronary artery bypass surgery OT - coronary disease OT - heart failure OT - percutaneous coronary intervention OT - stroke EDAT- 2017/07/14 06:00 MHDA- 2018/04/17 06:00 CRDT- 2017/07/14 06:00 PHST- 2017/01/10 00:00 [received] PHST- 2017/06/15 00:00 [accepted] PHST- 2017/07/14 06:00 [entrez] PHST- 2017/07/14 06:00 [pubmed] PHST- 2018/04/17 06:00 [medline] AID - CIRCINTERVENTIONS.116.004988 [pii] AID - 10.1161/CIRCINTERVENTIONS.116.004988 [doi] PST - ppublish SO - Circ Cardiovasc Interv. 2017 Jul;10(7):e004988. doi: 10.1161/CIRCINTERVENTIONS.116.004988. PMID- 28644212 OWN - NLM STAT- MEDLINE DCOM- 20180611 LR - 20180611 IS - 1473-5830 (Electronic) IS - 0954-6928 (Linking) VI - 28 IP - 7 DP - 2017 Nov TI - Worsening atrioventricular conduction after hospital discharge in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention: the HORIZONS-AMI trial. PG - 550-556 LID - 10.1097/MCA.0000000000000525 [doi] AB - BACKGROUND: The chronic effects of ST-segment elevation myocardial infarction (STEMI) on the atrioventricular conduction (AVC) system have not been elucidated. This study aimed to evaluate the incidence, predictors, and outcomes of worsened AVC post-STEMI in patients treated with a primary percutaneous coronary intervention (PCI). PATIENTS AND METHODS: The current analysis included patients from the HORIZONS-AMI trial who underwent primary PCI and had available ECGs. Patients with high-grade atrioventricular block or pacemaker implant at baseline were excluded. RESULTS: Analysis of ECGs excluding the acute hospitalization period indicated worsened AVC in 131 patients (worsened AVC group) and stable AVC in 2833 patients (stable AVC group). Patients with worsened AVC were older, had a higher frequency of hypertension, diabetes, renal insufficiency, previous coronary artery bypass grafting, and predominant left anterior descending culprit lesions. Predictors of worsened AVC included age, hypertension, and previous history of coronary artery disease. Worsened AVC was associated with an increased rate of all-cause death and major adverse cardiac events (death, myocardial infarction, ischemic target vessel revascularization, and stroke) as well as death or reinfarction at 3 years. On multivariable analysis, worsened AVC remained an independent predictor of all-cause death (hazard ratio: 2.005, confidence interval: 1.051-3.827, P=0.0348) and major adverse cardiac events (hazard ratio 1.542, confidence interval: 1.059-2.244, P=0.0238). CONCLUSION: Progression of AVC system disease in patients with STEMI treated with primary PCI is uncommon, occurs primarily in the setting of anterior myocardial infarction, and portends a high risk for death and major adverse cardiac events. FAU - Kosmidou, Ioanna AU - Kosmidou I AD - aClinical Trials Center, Cardiovascular Research Foundation bNewYork-Presbyterian Hospital/Columbia University Medical Center cIcahn School of Medicine at Mount Sinai, New York City, New York, USA. FAU - Redfors, Bjorn AU - Redfors B FAU - McAndrew, Thomas AU - McAndrew T FAU - Embacher, Monica AU - Embacher M FAU - Mehran, Roxana AU - Mehran R FAU - Dizon, Jose M AU - Dizon JM FAU - Ben-Yehuda, Ori AU - Ben-Yehuda O FAU - Mintz, Gary S AU - Mintz GS FAU - Stone, Gregg W AU - Stone GW LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PL - England TA - Coron Artery Dis JT - Coronary artery disease JID - 9011445 SB - IM CIN - Coron Artery Dis. 2017 Nov;28(7):541-542. doi: 10.1097/MCA.0000000000000536. PMID: 28708660 MH - Action Potentials MH - Aged MH - Anterior Wall Myocardial Infarction/diagnosis/mortality/*therapy MH - Atrioventricular Block/diagnosis/mortality/*physiopathology MH - Chi-Square Distribution MH - Disease Progression MH - Electrocardiography MH - Female MH - Heart Conduction System/*physiopathology MH - Heart Rate MH - Humans MH - Incidence MH - Kaplan-Meier Estimate MH - Logistic Models MH - Male MH - Middle Aged MH - Multivariate Analysis MH - *Patient Discharge MH - Percutaneous Coronary Intervention/*adverse effects/mortality MH - Proportional Hazards Models MH - Prospective Studies MH - Risk Factors MH - ST Elevation Myocardial Infarction/diagnosis/mortality/*therapy MH - Time Factors MH - Treatment Outcome EDAT- 2017/06/24 06:00 MHDA- 2018/06/12 06:00 CRDT- 2017/06/24 06:00 PHST- 2017/06/24 06:00 [pubmed] PHST- 2018/06/12 06:00 [medline] PHST- 2017/06/24 06:00 [entrez] AID - 10.1097/MCA.0000000000000525 [doi] PST - ppublish SO - Coron Artery Dis. 2017 Nov;28(7):550-556. doi: 10.1097/MCA.0000000000000525. PMID- 28616432 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20201001 IS - 2319-9644 (Print) IS - 2279-042X (Electronic) IS - 2279-042X (Linking) VI - 6 IP - 2 DP - 2017 Apr-Jun TI - Effect of Pretreatment with Omega-3 Supplement on Cardiac Necrosis Markers in Chronic Kidney Disease Patients Undergoing Elective Percutaneous Coronary Intervention. PG - 94-99 LID - 10.4103/jrpp.JRPP_17_24 [doi] AB - OBJECTIVE: Studies have demonstrated the direct relation between elevation in cardiac necrosis markers and increased risk of cardiovascular complications after percutaneous coronary intervention (PCI) in chronic kidney disease (CKD) patients. In this study, we sought to evaluate the effect of omega-3 on creatine kinase-MB (CK-MB) and troponin-I in CKD patients undergoing elective PCI. METHODS: Eighty CKD patients, candidate for elective PCI, were randomly assigned into two groups: Group A - receiving omega-3 (2.5 g, 12 h before PCI) plus standard treatment (n = 37) and Group B - control group, receiving only standard therapy (aspirin 325 mg and clopidogrel 600 mg loading dose and weight-adjusted intravenous heparin) (n = 43). Blood samples were collected before and 24 h after PCI for measuring CK-MB and troponin-I. The primary endpoint was considered to be postprocedural variations of CK-MB and troponin-I levels in both groups. The secondary endpoint was the percentage of pre-procedural myocardial infarction (PMI) occurrence, defined as the elevation of post-PCI troponin-I, between study groups. FINDINGS: Both the baseline and 24-h CK-MB were significantly higher in omega-3 group. Although 24-h troponin-I increased less in omega-3-treated arm compared to the control group, no statistically significant variation was observed between the two groups. With regard to PMI occurrence, no significant difference was detected among study groups. CONCLUSION: Despite the beneficial but nonsignificant effects of omega-3 on decreasing post-PCI elevation of troponin-I and PMI occurrence, further investigations with bigger study population, higher doses of omega-3 and longer duration of treatment, and long-term follow-up of patients are required to better test the potential effects of omega-3 in improving clinical outcomes in CKD patients undergoing PCI. FAU - Foroughinia, Farzaneh AU - Foroughinia F AD - Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. AD - Clinical Pharmacy Department, Shiraz University of Medical Sciences, Shiraz, Iran. FAU - Foroozmehr, Maryam AU - Foroozmehr M AD - Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran. LA - eng PT - Journal Article PL - India TA - J Res Pharm Pract JT - Journal of research in pharmacy practice JID - 101614023 PMC - PMC5463556 OTO - NOTNLM OT - Chronic kidney disease OT - creatine kinase-MB OT - omega-3 fatty acids OT - percutaneous coronary intervention OT - preprocedural myocardial infarction OT - troponin-I COIS- There are no conflicts of interest. EDAT- 2017/06/16 06:00 MHDA- 2017/06/16 06:01 PMCR- 2017/04/01 CRDT- 2017/06/16 06:00 PHST- 2017/06/16 06:00 [entrez] PHST- 2017/06/16 06:00 [pubmed] PHST- 2017/06/16 06:01 [medline] PHST- 2017/04/01 00:00 [pmc-release] AID - JRPP-6-94 [pii] AID - 10.4103/jrpp.JRPP_17_24 [doi] PST - ppublish SO - J Res Pharm Pract. 2017 Apr-Jun;6(2):94-99. doi: 10.4103/jrpp.JRPP_17_24. PMID- 28572159 OWN - NLM STAT- MEDLINE DCOM- 20170905 LR - 20260127 IS - 1524-4636 (Electronic) IS - 1079-5642 (Print) IS - 1079-5642 (Linking) VI - 37 IP - 9 DP - 2017 Sep TI - APOL1 Risk Variants and Cardiovascular Disease: Results From the AASK (African American Study of Kidney Disease and Hypertension). PG - 1765-1769 LID - 10.1161/ATVBAHA.117.309384 [doi] AB - OBJECTIVE: Among African Americans, the apolipoprotein L1 (APOL1) risk variants have been associated with various types of kidney disease and chronic kidney disease progression. We aimed to determine whether these same risk variants also confer an increased risk for cardiovascular disease. APPROACH AND RESULTS: In a cohort of African Americans with hypertension-attributed chronic kidney disease followed for up to 12 years, we used Cox proportional hazards models to estimate the relative hazard of a composite cardiovascular disease outcome (cardiovascular death or hospitalization for myocardial infarction, cardiac revascularization procedure, heart failure, or stroke) for the APOL1 high- (2 risk variants) versus low-risk (0-1 risk variant) genotypes. We adjusted for age, sex, ancestry, smoking, heart disease history, body mass index, cholesterol, randomized treatment groups, and baseline and longitudinal estimated glomerular filtration rate, systolic blood pressure, and proteinuria. Among 693 participants with APOL1 genotyping available (23% high risk), the high-risk group had lower mean estimated glomerular filtration rate (44.7 versus 50.1 mL/min per 1.73 m(2)) and greater proteinuria (median 0.19 versus 0.06) compared with the low-risk group at baseline. There was no significant association between APOL1 genotypes and the composite cardiovascular disease outcome in both unadjusted (hazard ratio=1.23; 95% confidence interval: 0.83-1.81) and fully adjusted (hazard ratio=1.16; 95% confidence interval: 0.77-1.76) models; however, in using an additive model, APOL1 high-risk variants were associated with increased cardiovascular mortality. CONCLUSIONS: Among African Americans with hypertension-attributed chronic kidney disease, APOL1 risk variants were not associated with an overall risk for cardiovascular disease although some signals for cardiovascular mortality were noted. CI - (c) 2017 American Heart Association, Inc. FAU - Chen, Teresa K AU - Chen TK AD - From the Divisions of Nephrology (T.K.C., M.E.G., M.J.C.) and General Internal Medicine (L.J.A.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD (L.J.A., M.E.G., A.T.); Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (A.T.); Division of Nephrology and Hypertension, Department of Medicine, Georgetown University School of Medicine, Washington, DC (M.S.L.); Basic Research Laboratory, Center for Cancer Research, National Cancer Institute, National Institutes of Health and Leidos Biomedical, Frederick National Laboratory, MD (C.A.W.); and Kidney Health Research Collaborative, Department of Medicine, San Francisco VA Medical Center and University of California (M.M.E.). tchen39@jhmi.edu. FAU - Appel, Lawrence J AU - Appel LJ AD - From the Divisions of Nephrology (T.K.C., M.E.G., M.J.C.) and General Internal Medicine (L.J.A.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD (L.J.A., M.E.G., A.T.); Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (A.T.); Division of Nephrology and Hypertension, Department of Medicine, Georgetown University School of Medicine, Washington, DC (M.S.L.); Basic Research Laboratory, Center for Cancer Research, National Cancer Institute, National Institutes of Health and Leidos Biomedical, Frederick National Laboratory, MD (C.A.W.); and Kidney Health Research Collaborative, Department of Medicine, San Francisco VA Medical Center and University of California (M.M.E.). FAU - Grams, Morgan E AU - Grams ME AD - From the Divisions of Nephrology (T.K.C., M.E.G., M.J.C.) and General Internal Medicine (L.J.A.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD (L.J.A., M.E.G., A.T.); Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (A.T.); Division of Nephrology and Hypertension, Department of Medicine, Georgetown University School of Medicine, Washington, DC (M.S.L.); Basic Research Laboratory, Center for Cancer Research, National Cancer Institute, National Institutes of Health and Leidos Biomedical, Frederick National Laboratory, MD (C.A.W.); and Kidney Health Research Collaborative, Department of Medicine, San Francisco VA Medical Center and University of California (M.M.E.). FAU - Tin, Adrienne AU - Tin A AD - From the Divisions of Nephrology (T.K.C., M.E.G., M.J.C.) and General Internal Medicine (L.J.A.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD (L.J.A., M.E.G., A.T.); Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (A.T.); Division of Nephrology and Hypertension, Department of Medicine, Georgetown University School of Medicine, Washington, DC (M.S.L.); Basic Research Laboratory, Center for Cancer Research, National Cancer Institute, National Institutes of Health and Leidos Biomedical, Frederick National Laboratory, MD (C.A.W.); and Kidney Health Research Collaborative, Department of Medicine, San Francisco VA Medical Center and University of California (M.M.E.). FAU - Choi, Michael J AU - Choi MJ AD - From the Divisions of Nephrology (T.K.C., M.E.G., M.J.C.) and General Internal Medicine (L.J.A.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD (L.J.A., M.E.G., A.T.); Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (A.T.); Division of Nephrology and Hypertension, Department of Medicine, Georgetown University School of Medicine, Washington, DC (M.S.L.); Basic Research Laboratory, Center for Cancer Research, National Cancer Institute, National Institutes of Health and Leidos Biomedical, Frederick National Laboratory, MD (C.A.W.); and Kidney Health Research Collaborative, Department of Medicine, San Francisco VA Medical Center and University of California (M.M.E.). FAU - Lipkowitz, Michael S AU - Lipkowitz MS AD - From the Divisions of Nephrology (T.K.C., M.E.G., M.J.C.) and General Internal Medicine (L.J.A.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD (L.J.A., M.E.G., A.T.); Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (A.T.); Division of Nephrology and Hypertension, Department of Medicine, Georgetown University School of Medicine, Washington, DC (M.S.L.); Basic Research Laboratory, Center for Cancer Research, National Cancer Institute, National Institutes of Health and Leidos Biomedical, Frederick National Laboratory, MD (C.A.W.); and Kidney Health Research Collaborative, Department of Medicine, San Francisco VA Medical Center and University of California (M.M.E.). FAU - Winkler, Cheryl A AU - Winkler CA AD - From the Divisions of Nephrology (T.K.C., M.E.G., M.J.C.) and General Internal Medicine (L.J.A.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD (L.J.A., M.E.G., A.T.); Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (A.T.); Division of Nephrology and Hypertension, Department of Medicine, Georgetown University School of Medicine, Washington, DC (M.S.L.); Basic Research Laboratory, Center for Cancer Research, National Cancer Institute, National Institutes of Health and Leidos Biomedical, Frederick National Laboratory, MD (C.A.W.); and Kidney Health Research Collaborative, Department of Medicine, San Francisco VA Medical Center and University of California (M.M.E.). FAU - Estrella, Michelle M AU - Estrella MM AD - From the Divisions of Nephrology (T.K.C., M.E.G., M.J.C.) and General Internal Medicine (L.J.A.), Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD (L.J.A., M.E.G., A.T.); Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (A.T.); Division of Nephrology and Hypertension, Department of Medicine, Georgetown University School of Medicine, Washington, DC (M.S.L.); Basic Research Laboratory, Center for Cancer Research, National Cancer Institute, National Institutes of Health and Leidos Biomedical, Frederick National Laboratory, MD (C.A.W.); and Kidney Health Research Collaborative, Department of Medicine, San Francisco VA Medical Center and University of California (M.M.E.). LA - eng GR - R01 DK103574/DK/NIDDK NIH HHS/United States GR - R21 DK112087/DK/NIDDK NIH HHS/United States GR - U01 DK048689/DK/NIDDK NIH HHS/United States GR - P20 RR011104/RR/NCRR NIH HHS/United States GR - M01 RR000071/RR/NCRR NIH HHS/United States GR - P20 RR011145/RR/NCRR NIH HHS/United States GR - R01 DK057867/DK/NIDDK NIH HHS/United States GR - M01 RR000052/RR/NCRR NIH HHS/United States GR - R01 DK108803/DK/NIDDK NIH HHS/United States GR - UL1 RR029887/RR/NCRR NIH HHS/United States GR - K08 DK092287/DK/NIDDK NIH HHS/United States GR - K24 DK002818/DK/NIDDK NIH HHS/United States GR - M01 RR000827/RR/NCRR NIH HHS/United States GR - M01 RR000080/RR/NCRR NIH HHS/United States GR - HHSN261200800001E/CA/NCI NIH HHS/United States PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't DEP - 20170601 PL - United States TA - Arterioscler Thromb Vasc Biol JT - Arteriosclerosis, thrombosis, and vascular biology JID - 9505803 RN - 0 (APOL1 protein, human) RN - 0 (Apolipoprotein L1) RN - 0 (Apolipoproteins) RN - 0 (Lipoproteins, HDL) SB - IM CIN - Arterioscler Thromb Vasc Biol. 2017 Sep;37(9):1587-1589. doi: 10.1161/ATVBAHA.117.309756. PMID: 28835482 MH - Adult MH - Black or African American/*genetics MH - Apolipoprotein L1 MH - Apolipoproteins/*genetics MH - Chi-Square Distribution MH - Disease Progression MH - Female MH - Genetic Association Studies MH - Genetic Predisposition to Disease MH - *Genetic Variation MH - Heart Failure/ethnology/*genetics/mortality/therapy MH - Hospitalization MH - Humans MH - Hypertension/ethnology/*genetics/mortality MH - Incidence MH - Kaplan-Meier Estimate MH - Lipoproteins, HDL/*genetics MH - Male MH - Middle Aged MH - Myocardial Infarction/ethnology/*genetics/mortality/therapy MH - Myocardial Revascularization MH - Phenotype MH - Prognosis MH - Proportional Hazards Models MH - Renal Insufficiency, Chronic/ethnology/*genetics/mortality MH - Risk Assessment MH - Risk Factors MH - Stroke/ethnology/*genetics/mortality/therapy MH - Time Factors MH - United States/epidemiology PMC - PMC5570668 MID - NIHMS879238 OTO - NOTNLM OT - cardiovascular disease OT - coronary artery disease OT - heart failure OT - hypertension OT - myocardial infarction EDAT- 2017/06/03 06:00 MHDA- 2017/09/07 06:00 PMCR- 2018/09/01 CRDT- 2017/06/03 06:00 PHST- 2017/03/16 00:00 [received] PHST- 2017/05/22 00:00 [accepted] PHST- 2017/06/03 06:00 [pubmed] PHST- 2017/09/07 06:00 [medline] PHST- 2017/06/03 06:00 [entrez] PHST- 2018/09/01 00:00 [pmc-release] AID - ATVBAHA.117.309384 [pii] AID - 10.1161/ATVBAHA.117.309384 [doi] PST - ppublish SO - Arterioscler Thromb Vasc Biol. 2017 Sep;37(9):1765-1769. doi: 10.1161/ATVBAHA.117.309384. Epub 2017 Jun 1. PMID- 28530518 OWN - NLM STAT- MEDLINE DCOM- 20180307 LR - 20260127 IS - 2376-1032 (Electronic) IS - 2376-0540 (Print) IS - 2376-0540 (Linking) VI - 23 IP - 6 DP - 2017 Jun TI - Antiplatelet Therapy and Clinical Outcomes Following Myocardial Infarction Among Patients in a U.S. Employer-Based Insurance Database. PG - 684-690 LID - 10.18553/jmcp.2017.23.6.684 [doi] AB - BACKGROUND: Estimates of residual cardiovascular risks among patients who have experienced a recent acute myocardial infarction (MI) are predominantly derived from secondary prevention trial populations, patient registries, and population-based cohorts. OBJECTIVE: To generate real-world evidence of antiplatelet treatment and recurrent events following MI in patients on antiplatelet treatment among commercial, employer-based insured patients in a large administrative database. METHODS: This was a retrospective cohort claims database study using the Truven Health MarketScan Commercial Claims and Encounters and Medicare Supplemental databases between 2007-2011. Patients with an acute MI hospitalization with a discharge date between 2008 and 2010 were included. Excluded were those patients with documentation of stroke, transient ischemic attack (TIA), or severe bleeding at or before index hospitalization and with concomitant use of anticoagulant therapy following index hospitalization. Patients treated with clopidogrel following the index MI hospitalization were followed up to 1 year for repeat MI, stroke, and coronary revascularization. RESULTS: Among 33,943 post-MI continuous clopidogrel users without history of stroke, TIA, or bleeding, 22% had diabetes, whereas angina and renal impairment were less prevalent (5% and 7%, respectively). Over the 1-year follow-up, 2.4% experienced a repeat MI or stroke, and 8.2% underwent coronary revascularization. Angina, diabetes, and renal impairment were associated with elevated 1-year risk of repeat MI or stroke. CONCLUSIONS: This study suggests that there is residual cardiovascular risk, although relatively low, in an insured, secondary prevention population on antiplatelet treatment following an MI. In patients with MI, identifying angina, diabetes, and renal impairment may aid risk stratification and guide the effective management of these higher-risk patients. DISCLOSURES: Funding for this research was provided by Merck & Co. Although Merck & Co. formally reviewed a penultimate draft, the opinions expressed are those of the authorship and may not necessarily reflect those of the company. Reed Chase, Wu, Mavros, Heithoff, and Hanson are employees of Merck Sharp & Dohme, a subsidiary of Merck & Co., and may own stock and/or hold stock options in the company. Patel was an employee of Merck & Co. during the conduct of this study and preparation of the manuscript. Simpson is a paid consultant for Merck, Pfizer, and Amgen and has received speaker's fees from Merck and Pfizer. Study concept and design were contributed by all authors except Hanson. Heifhoff and Patel collected the data, and data interpretation was performed by Simpson, Mavros, Patel, Wu, and Hanson. The manuscript was written by Hanson, Mavros, and Patel and revised by Heithoff, Wu, Simpson, and Reed Chase. FAU - Patel, Mehul D AU - Patel MD AD - 1 Merck & Co., Kenilworth, New Jersey. FAU - Wu, David AU - Wu D AD - 1 Merck & Co., Kenilworth, New Jersey. FAU - Chase, Monica Reed AU - Chase MR AD - 1 Merck & Co., Kenilworth, New Jersey. FAU - Mavros, Panagiotis AU - Mavros P AD - 1 Merck & Co., Kenilworth, New Jersey. FAU - Heithoff, Kim AU - Heithoff K AD - 1 Merck & Co., Kenilworth, New Jersey. FAU - Hanson, Mary E AU - Hanson ME AD - 1 Merck & Co., Kenilworth, New Jersey. FAU - Simpson, Ross J Jr AU - Simpson RJ Jr AD - 2 University of North Carolina, Chapel Hill. LA - eng PT - Journal Article PL - United States TA - J Manag Care Spec Pharm JT - Journal of managed care & specialty pharmacy JID - 101644425 RN - 0 (Platelet Aggregation Inhibitors) RN - A74586SNO7 (Clopidogrel) RN - OM90ZUW7M1 (Ticlopidine) SB - IM MH - Adolescent MH - Adult MH - Aged MH - Clopidogrel MH - Databases, Factual MH - Female MH - Humans MH - Male MH - Medicare MH - Middle Aged MH - Myocardial Infarction/*drug therapy MH - Platelet Aggregation Inhibitors/*therapeutic use MH - Retrospective Studies MH - Risk Factors MH - Secondary Prevention/methods MH - Stroke/etiology MH - Ticlopidine/analogs & derivatives/therapeutic use MH - United States MH - Young Adult PMC - PMC10398306 COIS- Funding for this research was provided by Merck & Co. Although Merck & Co. formally reviewed a penultimate draft, the opinions expressed are those of the authorship and may not necessarily reflect those of the company. Reed Chase, Wu, Mavros, Heithoff, and Hanson are employees of Merck Sharp & Dohme, a subsidiary of Merck & Co., and may own stock and/or hold stock options in the company. Patel was an employee of Merck & Co. during the conduct of this study and preparation of the manuscript. Simpson is a paid consultant for Merck, Pfizer, and Amgen and has received speaker's fees from Merck and Pfizer. Study concept and design were contributed by all authors except Hanson. Heifhoff and Patel collected the data, and data interpretation was performed by Simpson, Mavros, Patel, Wu, and Hanson. The manuscript was written by Hanson, Mavros, and Patel and revised by Heithoff, Wu, Simpson, and Reed Chase. EDAT- 2017/05/23 06:00 MHDA- 2018/03/08 06:00 PMCR- 2017/06/01 CRDT- 2017/05/23 06:00 PHST- 2017/05/23 06:00 [entrez] PHST- 2017/05/23 06:00 [pubmed] PHST- 2018/03/08 06:00 [medline] PHST- 2017/06/01 00:00 [pmc-release] AID - 10.18553/jmcp.2017.23.6.684 [doi] PST - ppublish SO - J Manag Care Spec Pharm. 2017 Jun;23(6):684-690. doi: 10.18553/jmcp.2017.23.6.684. PMID- 28528767 OWN - NLM STAT- Publisher LR - 20240227 IS - 1558-3597 (Electronic) IS - 0735-1097 (Linking) DP - 2017 May 11 TI - Acute Kidney Injury After Radial or Femoral Access for Invasive Acute Coronary Syndrome Management: AKI-MATRIX. LID - S0735-1097(17)36897-3 [pii] LID - 10.1016/j.jacc.2017.02.070 [doi] AB - BACKGROUND: It remains unclear whether radial access (RA), compared with femoral access (FA), mitigates the risk of acute kidney injury (AKI). OBJECTIVES: The authors assessed the incidence of AKI in patients with acute coronary syndrome (ACS) enrolled in the MATRIX-Access (Minimizing Adverse Haemorrhagic Events by Transradial Access Site and Systemic Implementation of Angiox) trial. METHODS: Among 8,404 patients, 194 (2.3%) were excluded due to missing creatinine values, no or an incomplete coronary angiogram, or previous dialysis. The primary AKI-MATRIX endpoint was AKI, defined as an absolute (>0.5 mg/dl) or a relative (>25%) increase in serum creatinine (sCr). RESULTS: AKI occurred in 634 patients (15.4%) with RA and 712 patients (17.4%) with FA (odds ratio [OR]: 0.87; 95% confidence interval [CI]: 0.77 to 0.98; p = 0.0181). A >25% sCr increase was noted in 633 patients (15.4%) with RA and 710 patients (17.3%) with FA (OR: 0.87; 95% CI: 0.77 to 0.98; p = 0.0195), whereas a >0.5 mg/dl absolute sCr increase occurred in 175 patients (4.3%) with RA versus 223 patients (5.4%) with FA (OR: 0.77; 95% CI: 0.63 to 0.95; p = 0.0131). By implementing the Kidney Disease Improving Global Outcomes criteria, AKI was 3-fold less prevalent and trended lower with RA (OR: 0.85; 95% CI: 0.70 to 1.03; p = 0.090), with stage 3 AKI occurring in 28 patients (0.68%) with RA versus 46 patients (1.12%) with FA (p = 0.0367). Post-intervention dialysis was needed in 6 patients (0.15%) with RA and 14 patients (0.34%) with FA (p = 0.0814). Stratified analyses suggested greater benefit with RA than FA in patients at greater risk for AKI. CONCLUSIONS: In ACS patients who underwent invasive management, RA was associated with a reduced risk of AKI compared with FA. (Minimizing Adverse Haemorrhagic Events by TRansradial Access Site and Systemic Implementation of angioX [MATRIX]; NCT01433627). CI - Copyright (c) 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Ando, Giuseppe AU - Ando G AD - Azienda Ospedaliera Universitaria Policlinico "Gaetano Martino," University of Messina, Messina, Italy. FAU - Cortese, Bernardo AU - Cortese B AD - Department of Medicine, Ospedale Fate bene Fratelli, Milano, Italy. FAU - Russo, Filippo AU - Russo F AD - Azienda Ospedaliera Sant'Anna, Como, Italy. FAU - Rothenbuhler, Martina AU - Rothenbuhler M AD - CTU Bern, and Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland. FAU - Frigoli, Enrico AU - Frigoli E AD - EUSTRATEGY Association, Forli (FC), Italy. FAU - Gargiulo, Giuseppe AU - Gargiulo G AD - Department of Advanced Biomedical Science, University of Naples Federico II, Naples, Italy; Swiss Cardiovascular Center Bern, Bern University Hospital, Bern, Switzerland. FAU - Briguori, Carlo AU - Briguori C AD - Clinica Mediterranea, Napoli, Italy. FAU - Vranckx, Pascal AU - Vranckx P AD - Department of Cardiology and Critical Care Medicine, Hartcentrum Hasselt, Jessa Ziekenhuis, Hasselt, Belgium. FAU - Leonardi, Sergio AU - Leonardi S AD - Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. FAU - Guiducci, Vincenzo AU - Guiducci V AD - A.O. Santa Maria Nuova, Reggio Emilia, Italy. FAU - Belloni, Flavia AU - Belloni F AD - Ospedale Santo Spirito in Saxia, Roma, Italy. FAU - Ferrari, Fabio AU - Ferrari F AD - A.O. Universitaria San Luigi Gonzaga di Orbassano Turin, Italy. FAU - de la Torre Hernandez, Jose Maria AU - de la Torre Hernandez JM AD - Hospital Marques de Valdecilla, Santander, Spain. FAU - Curello, Salvatore AU - Curello S AD - A.O. Spedali Civili, Brescia, Italy. FAU - Liistro, Francesco AU - Liistro F AD - Ospedale San Donato, Arezzo, Italy. FAU - Perkan, Andrea AU - Perkan A AD - A.S.U.I, Trieste, Italy. FAU - De Servi, Stefano AU - De Servi S AD - Ospedale Civile di Legnano, Legnano, Italy. FAU - Casu, Gavino AU - Casu G AD - Ospedale San Francesco, Nuoro, Italy. FAU - Dellavalle, Antonio AU - Dellavalle A AD - Ospedali Riuniti ASL 17, Savigliano (CN), Italy. FAU - Fischetti, Dionigi AU - Fischetti D AD - Ospedale Vito Fazzi, Lecce, Italy. FAU - Micari, Antonio AU - Micari A AD - GVM Care and Research Maria Eleonora Hospital, Palermo, Italy. FAU - Loi, Bruno AU - Loi B AD - A.O. Brotzu, Cagliari, Italy. FAU - Mangiacapra, Fabio AU - Mangiacapra F AD - Campus Biomedico, Roma, Italy. FAU - Russo, Nunzio AU - Russo N AD - P.O. San Vincenzo, Taormina (ME), Italy. FAU - Tarantino, Fabio AU - Tarantino F AD - Ospedale G.B. Morgagni, Forli, Italy. FAU - Saia, Francesco AU - Saia F AD - University Hospital of Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy. FAU - Heg, Dik AU - Heg D AD - CTU Bern, and Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland. FAU - Windecker, Stephan AU - Windecker S AD - Swiss Cardiovascular Center Bern, Bern University Hospital, Bern, Switzerland. FAU - Juni, Peter AU - Juni P AD - Swiss Cardiovascular Center Bern, Bern University Hospital, Bern, Switzerland; Institute of Primary Health Care, University of Bern, Bern, Switzerland. FAU - Valgimigli, Marco AU - Valgimigli M AD - Swiss Cardiovascular Center Bern, Bern University Hospital, Bern, Switzerland. Electronic address: marco.valgimigli@insel.ch. CN - MATRIX Investigators LA - eng SI - ClinicalTrials.gov/NCT01433627 PT - Journal Article DEP - 20170511 PL - United States TA - J Am Coll Cardiol JT - Journal of the American College of Cardiology JID - 8301365 OTO - NOTNLM OT - ST-segment elevation OT - bleeding OT - coronary intervention OT - creatinine OT - estimated glomerular filtration rate EDAT- 2017/05/23 06:00 MHDA- 2017/05/23 06:00 CRDT- 2017/05/23 06:00 PHST- 2016/10/28 00:00 [received] PHST- 2017/01/31 00:00 [revised] PHST- 2017/02/02 00:00 [accepted] PHST- 2017/05/23 06:00 [entrez] PHST- 2017/05/23 06:00 [pubmed] PHST- 2017/05/23 06:00 [medline] AID - S0735-1097(17)36897-3 [pii] AID - 10.1016/j.jacc.2017.02.070 [doi] PST - aheadofprint SO - J Am Coll Cardiol. 2017 May 11:S0735-1097(17)36897-3. doi: 10.1016/j.jacc.2017.02.070. PMID- 28506550 OWN - NLM STAT- MEDLINE DCOM- 20180418 LR - 20181202 IS - 1874-1754 (Electronic) IS - 0167-5273 (Linking) VI - 243 DP - 2017 Sep 15 TI - Cardioprotective efficacy of sevoflurane vs. propofol during induction and/or maintenance in patients undergoing coronary artery revascularization surgery without pump: A randomized trial. PG - 73-80 LID - S0167-5273(17)30739-8 [pii] LID - 10.1016/j.ijcard.2017.04.105 [doi] AB - PURPOSE: Pre and post-operative administration of sevoflurane in myocardial revascularization surgery provides enhanced cardioprotective effects exerted by pharmacologic pre- and post-conditioning, as compared to propofol. The identification of the enzymes involved in conditioning mechanisms is crucial to the understanding of the effects of sevoflurane in cardiac surgery patients. The impact of sevoflurane on another crucial target organ-the kidney-was also assessed. METHODS: Ninety patients undergoing off-pump myocardial revascularization surgery were allocated to receive either intra- and postoperative sevoflurane (SS), intraoperative sevoflurane and postoperative propofol (SP), or intra- and postoperative propofol (PP)). Troponin I and hemodynamic parameters were monitored during the first 48 postoperative hours; blood and urine samples were collected at baseline and at 24h to determine Akt, ERK1/2, PKG, iNO, bradykinin receptor, caspase 3, NT proBNP and urinary NGAL. RESULTS: The enzymes were overexpressed in the SS group, remained unchanged in the SP group, and decreased in the PP group. Renal function was best preserved in the SS group. CONCLUSIONS: The overexpression of enzymes induced by intraoperative anesthesia and postoperative sedation with sevoflurane reduces myocardial damage and improves renal function in patients undergoing off-pump myocardial revascularization surgery. CI - Copyright (c) 2017. Published by Elsevier B.V. FAU - Guerrero Orriach, J L AU - Guerrero Orriach JL AD - Department of Cardio-Anaesthesiology, University Hospital Virgen de la Victoria, Malaga, Spain; Instituto de Investigaciones Biomedicas de Malaga (IBIMA), University Hospital Virgen de la Victoria, Malaga, Spain. Electronic address: guerreroorriach@terra.es. FAU - Galan Ortega, M AU - Galan Ortega M AD - Department of Cardio-Anaesthesiology, University Hospital Virgen de la Victoria, Malaga, Spain. Electronic address: mgalanortega@yahoo.es. FAU - Ramirez Fernandez, A AU - Ramirez Fernandez A AD - Department of Cardio-Anaesthesiology, University Hospital Virgen de la Victoria, Malaga, Spain. Electronic address: aliramfdez@hotmail.com. FAU - Ramirez Aliaga, M AU - Ramirez Aliaga M AD - Department of Cardio-Anaesthesiology, University Hospital Virgen de la Victoria, Malaga, Spain. Electronic address: Martaram85@hotmail.com. FAU - Moreno Cortes, M I AU - Moreno Cortes MI AD - Department of Cardio-Anaesthesiology, University Hospital Virgen de la Victoria, Malaga, Spain. Electronic address: mimorenocortes@hotmail.com. FAU - Ariza Villanueva, D AU - Ariza Villanueva D AD - Department of Cardio-Anaesthesiology, University Hospital Virgen de la Victoria, Malaga, Spain. Electronic address: danielarizavillanueva@gmail.com. FAU - Florez Vela, A AU - Florez Vela A AD - Department of Cardio-Anaesthesiology, University Hospital Virgen de la Victoria, Malaga, Spain. Electronic address: anaisfv@hotmail.com. FAU - Alcaide Torres, J AU - Alcaide Torres J AD - CIBER Unidad de Gestion Clinica de Endocrinologia y Nutricion, Malaga, Spain. FAU - Santiago Fernandez, C AU - Santiago Fernandez C AD - CIBER Unidad de Gestion Clinica de Endocrinologia y Nutricion, Malaga, Spain. FAU - Matute Gonzalez, E AU - Matute Gonzalez E AD - Department of Anesthesia, Hospital Universitario Sanitas La Moraleja, Spain. Electronic address: emiliomatute@gmail.com. FAU - Alsina Marcos, E AU - Alsina Marcos E AD - Department of Anesthesia, Hospital Universitario La Paz, Madrid. Spain. Electronic address: estibaliz.alsina@gmail.com. FAU - Escalona Belmonte, J J AU - Escalona Belmonte JJ AD - Department of Cardio-Anaesthesiology, University Hospital Virgen de la Victoria, Malaga, Spain. FAU - Rubio Navarro, M AU - Rubio Navarro M AD - Department of Cardio-Anaesthesiology, University Hospital Virgen de la Victoria, Malaga, Spain. Electronic address: mrubionav@hotmail.com. FAU - Garrido Sanchez, L AU - Garrido Sanchez L AD - CIBER Fisiologia de la Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Malaga, Spain; Unidad de Gestion Clinica de Endocrinologia y Nutricion, Spain. Electronic address: lourdesgarrido@gmail.com. FAU - Cruz Manas, J AU - Cruz Manas J AD - Department of Cardio-Anaesthesiology, University Hospital Virgen de la Victoria, Malaga, Spain. Electronic address: jose.cruz.sspa@juntadeandalucia.es. LA - eng PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial DEP - 20170503 PL - Netherlands TA - Int J Cardiol JT - International journal of cardiology JID - 8200291 RN - 0 (Anesthetics, Intravenous) RN - 0 (Cardiotonic Agents) RN - 0 (Methyl Ethers) RN - 0 (Platelet Aggregation Inhibitors) RN - 38LVP0K73A (Sevoflurane) RN - YI7VU623SF (Propofol) SB - IM CIN - Int J Cardiol. 2018 Jan 15;251:14. doi: 10.1016/j.ijcard.2017.08.057. PMID: 29197451 CIN - Int J Cardiol. 2018 Mar 1;254:342. doi: 10.1016/j.ijcard.2017.10.108. PMID: 29407117 MH - Aged MH - Anesthetics, Intravenous/administration & dosage MH - Cardiotonic Agents/*administration & dosage MH - Coronary Artery Disease/drug therapy/*surgery MH - Female MH - Humans MH - Male MH - Methyl Ethers/*administration & dosage MH - Middle Aged MH - Myocardial Revascularization/*methods MH - Platelet Aggregation Inhibitors/*administration & dosage MH - Propofol/*administration & dosage MH - Sevoflurane MH - Treatment Outcome OTO - NOTNLM OT - Anesthetic postconditioning OT - Anesthetic preconditioning OT - Enzymatic mechanisms OT - Propofol OT - Sevoflurane EDAT- 2017/05/17 06:00 MHDA- 2018/04/19 06:00 CRDT- 2017/05/17 06:00 PHST- 2017/02/03 00:00 [received] PHST- 2017/04/30 00:00 [accepted] PHST- 2017/05/17 06:00 [pubmed] PHST- 2018/04/19 06:00 [medline] PHST- 2017/05/17 06:00 [entrez] AID - S0167-5273(17)30739-8 [pii] AID - 10.1016/j.ijcard.2017.04.105 [doi] PST - ppublish SO - Int J Cardiol. 2017 Sep 15;243:73-80. doi: 10.1016/j.ijcard.2017.04.105. Epub 2017 May 3. PMID- 28445871 OWN - NLM STAT- MEDLINE DCOM- 20180813 LR - 20181220 IS - 1421-9751 (Electronic) IS - 0008-6312 (Linking) VI - 137 IP - 4 DP - 2017 TI - Three-Year Clinical Outcome of Patients with Coronary Disease and Increased Event Risk Treated with Newer-Generation Drug-Eluting Stents: From the Randomized DUTCH PEERS Trial. PG - 207-217 LID - 10.1159/000464320 [doi] AB - OBJECTIVE: Limited data is available on the long-term outcome of patients with increased cardiovascular event risk, treated with newer-generation durable polymer drug-eluting stents (DES). METHODS: We therefore assessed 3-year follow-up data of high-risk versus low- to intermediate-risk patients of the randomized DUTCH PEERS trial (NCT01331707). In both risk groups we also compared patients treated with Resolute Integrity versus Promus Element DES. Patients were categorized as "high-risk" if they met >/=1 of the following criteria: (1) diabetes (17.9%); (2) previous myocardial infarction (21.9%); (3) previous coronary revascularization (25.8%); (4) chronic renal failure (3.5%); (5) left ventricular ejection fraction /=75 years (17.3%). RESULTS: At the 3-year follow-up, the incidence of the composite endpoint target vessel failure (TVF) (13.2 vs. 7.5%; logrank p < 0.001) and 2 of its components - cardiac death (4.7 vs. 1.5%; logrank p < 0.001) and target vessel revascularization (7.3 vs. 4.7%; logrank p = 0.03) - was higher in high-risk (n = 957) versus low- to intermediate-risk patients (n = 854). Among high-risk patients, treatment with Resolute Integrity (n = 481) and Promus Element stents (n = 476) was similarly safe and efficacious (TVF: 13.3 vs. 13.1%; logrank p = 0.95; definite-or-probable stent thrombosis: 1.7 vs. 1.7%; logrank p = 1.00). CONCLUSIONS: The newer-generation Resolute Integrity and Promus Element stents showed similar results in terms of safety and efficacy for treating high-risk patients, who had significantly higher event rates than patients with low-to-intermediate risk. CI - (c) 2017 S. Karger AG, Basel. FAU - van der Heijden, Liefke C AU - van der Heijden LC AD - Department of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, The Netherlands. FAU - Kok, Marlies M AU - Kok MM FAU - Lowik, Marije M AU - Lowik MM FAU - Danse, Peter W AU - Danse PW FAU - Jessurun, Gillian A J AU - Jessurun GAJ FAU - Hartmann, Marc AU - Hartmann M FAU - Stoel, Martin G AU - Stoel MG FAU - van Houwelingen, K Gert AU - van Houwelingen KG FAU - Hautvast, Raymond W M AU - Hautvast RWM FAU - Linssen, Gerard C AU - Linssen GC FAU - Doggen, Carine J M AU - Doggen CJM FAU - von Birgelen, Clemens AU - von Birgelen C LA - eng SI - ClinicalTrials.gov/NCT01331707 PT - Clinical Trial, Phase IV PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20170427 PL - Switzerland TA - Cardiology JT - Cardiology JID - 1266406 RN - 9HW64Q8G6G (Everolimus) RN - H4GXR80IZE (zotarolimus) RN - W36ZG6FT64 (Sirolimus) SB - IM CIN - Cardiology. 2017;138(2):73-75. doi: 10.1159/000477712. PMID: 28609767 MH - Aged MH - Coronary Artery Disease/mortality/*therapy MH - *Drug-Eluting Stents MH - Everolimus/*administration & dosage MH - Female MH - Humans MH - Kaplan-Meier Estimate MH - Male MH - Middle Aged MH - Multivariate Analysis MH - Myocardial Infarction/etiology MH - Percutaneous Coronary Intervention/adverse effects/*instrumentation/mortality MH - Proportional Hazards Models MH - Prospective Studies MH - Prosthesis Design MH - Risk Factors MH - Single-Blind Method MH - Sirolimus/administration & dosage/*analogs & derivatives MH - Thrombosis/etiology MH - Treatment Outcome OTO - NOTNLM OT - High-risk patients OT - Newer-generation drug-eluting stent OT - Percutaneous coronary intervention OT - Promus Element everolimus-eluting stent OT - Resolute Integrity zotarolimus-eluting stent EDAT- 2017/04/27 06:00 MHDA- 2018/08/14 06:00 CRDT- 2017/04/27 06:00 PHST- 2016/10/04 00:00 [received] PHST- 2017/02/20 00:00 [accepted] PHST- 2017/04/27 06:00 [pubmed] PHST- 2018/08/14 06:00 [medline] PHST- 2017/04/27 06:00 [entrez] AID - 000464320 [pii] AID - 10.1159/000464320 [doi] PST - ppublish SO - Cardiology. 2017;137(4):207-217. doi: 10.1159/000464320. Epub 2017 Apr 27. PMID- 28437620 OWN - NLM STAT- MEDLINE DCOM- 20190415 LR - 20220410 IS - 1530-891X (Print) IS - 1530-891X (Linking) VI - 23 IP - Suppl 2 DP - 2017 Apr TI - AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY GUIDELINES FOR MANAGEMENT OF DYSLIPIDEMIA AND PREVENTION OF CARDIOVASCULAR DISEASE. PG - 1-87 LID - 10.4158/EP171764.APPGL [doi] AB - OBJECTIVE: The development of these guidelines is mandated by the American Association of Clinical Endocrinologists (AACE) Board of Directors and American College of Endocrinology (ACE) Board of Trustees and adheres with published AACE protocols for the standardized production of clinical practice guidelines (CPGs). METHODS: Recommendations are based on diligent reviews of the clinical evidence with transparent incorporation of subjective factors, according to established AACE/ACE guidelines for guidelines protocols. RESULTS: The Executive Summary of this document contains 87 recommendations of which 45 are Grade A (51.7%), 18 are Grade B (20.7%), 15 are Grade C (17.2%), and 9 (10.3%) are Grade D. These detailed, evidence-based recommendations allow for nuance-based clinical decision-making that addresses multiple aspects of real-world medical care. The evidence base presented in the subsequent Appendix provides relevant supporting information for Executive Summary Recommendations. This update contains 695 citations of which 203 (29.2 %) are EL 1 (strong), 137 (19.7%) are EL 2 (intermediate), 119 (17.1%) are EL 3 (weak), and 236 (34.0%) are EL 4 (no clinical evidence). CONCLUSION: This CPG is a practical tool that endocrinologists, other health care professionals, health-related organizations, and regulatory bodies can use to reduce the risks and consequences of dyslipidemia. It provides guidance on screening, risk assessment, and treatment recommendations for a range of individuals with various lipid disorders. The recommendations emphasize the importance of treating low-density lipoprotein cholesterol (LDL-C) in some individuals to lower goals than previously endorsed and support the measurement of coronary artery calcium scores and inflammatory markers to help stratify risk. Special consideration is given to individuals with diabetes, familial hypercholesterolemia, women, and youth with dyslipidemia. Both clinical and cost-effectiveness data are provided to support treatment decisions. ABBREVIATIONS: 4S = Scandinavian Simvastatin Survival Study A1C = glycated hemoglobin AACE = American Association of Clinical Endocrinologists AAP = American Academy of Pediatrics ACC = American College of Cardiology ACE = American College of Endocrinology ACS = acute coronary syndrome ADMIT = Arterial Disease Multiple Intervention Trial ADVENT = Assessment of Diabetes Control and Evaluation of the Efficacy of Niaspan Trial AFCAPS/TexCAPS = Air Force/Texas Coronary Atherosclerosis Prevention Study AHA = American Heart Association AHRQ = Agency for Healthcare Research and Quality AIM-HIGH = Atherothrombosis Intervention in Metabolic Syndrome With Low HDL/High Triglycerides trial ASCVD = atherosclerotic cardiovascular disease ATP = Adult Treatment Panel apo = apolipoprotein BEL = best evidence level BIP = Bezafibrate Infarction Prevention trial BMI = body mass index CABG = coronary artery bypass graft CAC = coronary artery calcification CARDS = Collaborative Atorvastatin Diabetes Study CDP = Coronary Drug Project trial CI = confidence interval CIMT = carotid intimal media thickness CKD = chronic kidney disease CPG(s) = clinical practice guideline(s) CRP = C-reactive protein CTT = Cholesterol Treatment Trialists CV = cerebrovascular CVA = cerebrovascular accident EL = evidence level FH = familial hypercholesterolemia FIELD = Secondary Endpoints from the Fenofibrate Intervention and Event Lowering in Diabetes trial FOURIER = Further Cardiovascular Outcomes Research with PCSK9 Inhibition in Subjects With Elevated Risk trial HATS = HDL-Atherosclerosis Treatment Study HDL-C = high-density lipoprotein cholesterol HeFH = heterozygous familial hypercholesterolemia HHS = Helsinki Heart Study HIV = human immunodeficiency virus HoFH = homozygous familial hypercholesterolemia HPS = Heart Protection Study HPS2-THRIVE = Treatment of HDL to Reduce the Incidence of Vascular Events trial HR = hazard ratio HRT = hormone replacement therapy hsCRP = high-sensitivity CRP IMPROVE-IT = Improved Reduction of Outcomes: Vytorin Efficacy International Trial IRAS = Insulin Resistance Atherosclerosis Study JUPITER = Justification for the Use of Statins in Primary Prevention: An Intervention Trial Evaluating Rosuvastatin LDL-C = low-density lipoprotein cholesterol Lp-PLA2 = lipoprotein-associated phospholipase A2 MACE = major cardiovascular events MESA = Multi-Ethnic Study of Atherosclerosis MetS = metabolic syndrome MI = myocardial infarction MRFIT = Multiple Risk Factor Intervention Trial NCEP = National Cholesterol Education Program NHLBI = National Heart, Lung, and Blood Institute PCOS = polycystic ovary syndrome PCSK9 = proprotein convertase subtilisin/kexin type 9 Post CABG = Post Coronary Artery Bypass Graft trial PROSPER = Prospective Study of Pravastatin in the Elderly at Risk trial QALY = quality-adjusted life-year ROC = receiver-operator characteristic SOC = standard of care SHARP = Study of Heart and Renal Protection T1DM = type 1 diabetes mellitus T2DM = type 2 diabetes mellitus TG = triglycerides TNT = Treating to New Targets trial VA-HIT = Veterans Affairs High-Density Lipoprotein Cholesterol Intervention Trial VLDL-C = very low-density lipoprotein cholesterol WHI = Women's Health Initiative. FAU - Jellinger, Paul S AU - Jellinger PS FAU - Handelsman, Yehuda AU - Handelsman Y FAU - Rosenblit, Paul D AU - Rosenblit PD FAU - Bloomgarden, Zachary T AU - Bloomgarden ZT FAU - Fonseca, Vivian A AU - Fonseca VA FAU - Garber, Alan J AU - Garber AJ FAU - Grunberger, George AU - Grunberger G FAU - Guerin, Chris K AU - Guerin CK FAU - Bell, David S H AU - Bell DSH FAU - Mechanick, Jeffrey I AU - Mechanick JI FAU - Pessah-Pollack, Rachel AU - Pessah-Pollack R FAU - Wyne, Kathleen AU - Wyne K FAU - Smith, Donald AU - Smith D FAU - Brinton, Eliot A AU - Brinton EA FAU - Fazio, Sergio AU - Fazio S FAU - Davidson, Michael AU - Davidson M LA - eng PT - Journal Article PL - United States TA - Endocr Pract JT - Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists JID - 9607439 RN - 0 (Cholesterol, LDL) RN - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors) RN - EC 3.4.21.- (PCSK9 protein, human) RN - EC 3.4.21.- (Proprotein Convertase 9) SB - IM MH - *Cardiovascular Diseases MH - Cholesterol, LDL MH - Diabetes Mellitus, Type 2 MH - Dyslipidemias MH - Endocrinologists MH - Female MH - Humans MH - Hydroxymethylglutaryl-CoA Reductase Inhibitors MH - Practice Guidelines as Topic MH - Proprotein Convertase 9 MH - Prospective Studies MH - United States EDAT- 2017/04/25 06:00 MHDA- 2019/04/16 06:00 CRDT- 2017/04/25 06:00 PHST- 2017/04/25 06:00 [entrez] PHST- 2017/04/25 06:00 [pubmed] PHST- 2019/04/16 06:00 [medline] AID - S1530-891X(20)42959-3 [pii] AID - 10.4158/EP171764.APPGL [doi] PST - ppublish SO - Endocr Pract. 2017 Apr;23(Suppl 2):1-87. doi: 10.4158/EP171764.APPGL. PMID- 28411246 OWN - NLM STAT- MEDLINE DCOM- 20171023 LR - 20181202 IS - 2047-9980 (Electronic) IS - 2047-9980 (Linking) VI - 6 IP - 4 DP - 2017 Apr 14 TI - Growth Differentiation Factor 15 at 1 Month After an Acute Coronary Syndrome Is Associated With Increased Risk of Major Bleeding. LID - 10.1161/JAHA.117.005580 [doi] LID - e005580 AB - BACKGROUND: Growth differentiation factor-15 (GDF-15) is related to major bleeding when measured at initial presentation in patients with acute coronary syndromes (ACSs) treated with dual antiplatelet therapy. It is unknown whether follow-up measurements provide additional information. The objective of this study was to investigate whether GDF-15 measured 1 month after an ACS provides additional information beyond the baseline levels with regard to the risk of major bleeding. METHODS AND RESULTS: GDF-15 was measured at baseline and at 1 month after an ACS in 4049 patients included in the PLATelet inhibition and patient Outcomes (PLATO) trial. The association between 1-month GDF-15 level and non-coronary artery bypass grafting surgery-related major bleeding was assessed by a multivariable Cox model, adjusting for baseline GDF-15, age, anemia, impaired renal function, history of gastrointestinal bleeding, and sex. Elevated GDF-15 (>1800 ng/L) at 1 month was associated with an increased risk of non-coronary artery bypass grafting-related major bleeding (3.9% versus 1.2%; hazard ratio, 3.38; 95% CI, 1.89-6.06), independent of baseline GDF-15. Patients who had elevated GDF-15 levels at baseline and subsequent nonelevated GDF-15 at 1 month had a similar risk as patients who had nonelevated levels at both measurements. CONCLUSIONS: GDF-15 at 1 month after an ACS is related to the risk of bleeding during DAPT and provides additional information on the bleeding risk beyond baseline GDF-15 levels. GDF-15 levels may therefore be useful as part of decision support concerning long-term antithrombotic treatment in patients post-ACS. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00391872. CI - (c) 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. FAU - Lindholm, Daniel AU - Lindholm D AD - Department of Medical Sciences, Cardiology and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden daniel.lindholm@ucr.uu.se. FAU - Hagstrom, Emil AU - Hagstrom E AD - Department of Medical Sciences, Cardiology and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden. FAU - James, Stefan K AU - James SK AD - Department of Medical Sciences, Cardiology and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden. FAU - Becker, Richard C AU - Becker RC AD - Division of Cardiovascular Health and Disease, Heart, Lung and Vascular Institute, University of Cincinnati College of Medicine, Cincinnati, OH. FAU - Cannon, Christopher P AU - Cannon CP AD - Cardiovascular Division, Brigham and Women's Hospital, Boston, MA. FAU - Himmelmann, Anders AU - Himmelmann A AD - AstraZeneca Research and Development, Gothenburg, Sweden. FAU - Katus, Hugo A AU - Katus HA AD - Medizinische Klinik, Universitatsklinikum Heidelberg, Heidelberg, Germany. FAU - Maurer, Gerald AU - Maurer G AD - Medical University of Vienna, Austria. FAU - Lopez-Sendon, Jose Luis AU - Lopez-Sendon JL AD - Hospital Universitario La Paz, IdiPaz, Madrid, Spain. FAU - Steg, Philippe Gabriel AU - Steg PG AD - Departement Hospitalo-Universitaire FIRE, AP-HP, Hopital Bichat, Paris, France. AD - Paris Diderot University, Sorbonne Paris Cite, Paris, France. AD - NHLI Imperial College, ICMS, Royal Brompton Hospital, London, United Kingdom. AD - FACT (French Alliance for Cardiovascular Trials), an F-CRIN network, INSERM U1148, Paris, France. FAU - Storey, Robert F AU - Storey RF AD - Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, United Kingdom. FAU - Siegbahn, Agneta AU - Siegbahn A AD - Department of Medical Sciences, Clinical Chemistry and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden. FAU - Wallentin, Lars AU - Wallentin L AD - Department of Medical Sciences, Cardiology and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden. LA - eng SI - ClinicalTrials.gov/NCT00391872 PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial DEP - 20170414 PL - England TA - J Am Heart Assoc JT - Journal of the American Heart Association JID - 101580524 RN - 0 (Biomarkers) RN - 0 (GDF15 protein, human) RN - 0 (Growth Differentiation Factor 15) RN - 0 (Platelet Aggregation Inhibitors) RN - A74586SNO7 (Clopidogrel) RN - GLH0314RVC (Ticagrelor) RN - K72T3FS567 (Adenosine) RN - OM90ZUW7M1 (Ticlopidine) RN - R16CO5Y76E (Aspirin) SB - IM MH - Acute Coronary Syndrome/blood/complications/diagnosis/*drug therapy MH - Adenosine/adverse effects/*analogs & derivatives MH - Aged MH - Aspirin/*adverse effects MH - Biomarkers/blood MH - Clopidogrel MH - Double-Blind Method MH - Drug Therapy, Combination MH - Female MH - Growth Differentiation Factor 15/*blood MH - Hemorrhage/blood/*chemically induced/diagnosis MH - Humans MH - Kaplan-Meier Estimate MH - Male MH - Middle Aged MH - Multivariate Analysis MH - Platelet Aggregation Inhibitors/*adverse effects MH - Predictive Value of Tests MH - Proportional Hazards Models MH - Risk Assessment MH - Risk Factors MH - Ticagrelor MH - Ticlopidine/adverse effects/*analogs & derivatives MH - Time Factors MH - Treatment Outcome MH - Up-Regulation PMC - PMC5533037 OTO - NOTNLM OT - biomarker OT - bleeding OT - ischemic heart disease EDAT- 2017/04/16 06:00 MHDA- 2017/10/24 06:00 PMCR- 2017/04/01 CRDT- 2017/04/16 06:00 PHST- 2017/04/16 06:00 [entrez] PHST- 2017/04/16 06:00 [pubmed] PHST- 2017/10/24 06:00 [medline] PHST- 2017/04/01 00:00 [pmc-release] AID - JAHA.117.005580 [pii] AID - JAH32146 [pii] AID - 10.1161/JAHA.117.005580 [doi] PST - epublish SO - J Am Heart Assoc. 2017 Apr 14;6(4):e005580. doi: 10.1161/JAHA.117.005580. PMID- 28344618 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20201001 IS - 1734-9338 (Print) IS - 1897-4295 (Electronic) IS - 1734-9338 (Linking) VI - 13 IP - 1 DP - 2017 TI - Patient- and lesion-tailored algorithm of endovascular treatment for arterial occlusive disease of extracranial arteries supplying the brain: safety of the treatment at 30-day follow-up. PG - 53-61 LID - 10.5114/aic.2017.66187 [doi] AB - INTRODUCTION: Although surgical endarterectomy remains the treatment of choice for carotid artery stenosis, stenting plays an important role as an alternative treatment modality, especially in high-risk patients. The actual safety profile associated with stenting procedures is probably better than that reported by randomized controlled trials. AIM: To assess the safety of stent implantations in extracranial arteries supplying the brain, and also to identify risk factors associated with this procedure. MATERIAL AND METHODS: This was a post hoc analysis, with 30-day follow-up. We analyzed the results of treatment of 372 patients who underwent 408 procedures, 197 such procedures in asymptomatic, and 211 in symptomatic individuals. Stenting procedures were performed using a technique and armamentarium which were tailored to the type and anatomy of lesions. RESULTS: There were 6 (1.5%) strokes, including 2 (0.5%) major strokes, 1 ipsi- and 1 contralateral, and 4 (1.0%) minor strokes. In asymptomatic patients there was 1 (0.3%) minor stroke. Transient ischemic attacks occurred in 5 (1.2%) patients. There were 2 (0.5%) non-STEMI myocardial infarctions and 2 (0.5%) non-stroke related fatalities. Risk factors of these adverse events were diabetes mellitus, lesions localized in a tortuous segment of the artery, embolic material in the filter and bilateral stenoses of carotid arteries. Additional risk factors in asymptomatic patients were renal impairment and advanced coronary artery disease; and in symptomatic patients, grade 3 arterial hypertension, dislipidemia, cigarette smoking and lesions requiring predilatation. CONCLUSIONS: Stenting procedures of extracranial arteries supplying the brain, which are tailored to the type and anatomy of lesions, seem to be relatively safe. FAU - Latacz, Pawel AU - Latacz P AD - Department of Vascular Surgery, University Hospital, Krakow, Poland. FAU - Simka, Marian AU - Simka M AD - Department of Angiology, Private Healthcare Institution SANA Outpatient, Pszczyna, Poland. FAU - Brzegowy, Pawel AU - Brzegowy P AD - Chair of Radiology, Jagiellonian University Medical College, Krakow, Poland. FAU - Janas, Piotr AU - Janas P AD - Department of Neurology, Murcki Hospital, Katowice, Poland. FAU - Kazibudzki, Marek AU - Kazibudzki M AD - Department of Vascular Surgery, John Paul II Hospital, Krakow, Poland. FAU - Pieniazek, Piotr AU - Pieniazek P AD - Department of Interventional Cardiology, Jagiellonian University Medical College, John Paul II Hospital, Krakow, Poland. FAU - Ochala, Andrzej AU - Ochala A AD - 3 Department of Cardiology, Medical University of Silesia, Katowice, Poland. FAU - Popiela, Tadeusz AU - Popiela T AD - Chair of Radiology, Jagiellonian University Medical College, Krakow, Poland. FAU - Mrowiecki, Tomasz AU - Mrowiecki T AD - Department of Vascular Surgery, University Hospital, Krakow, Poland. LA - eng PT - Journal Article DEP - 20170310 PL - Poland TA - Postepy Kardiol Interwencyjnej JT - Postepy w kardiologii interwencyjnej = Advances in interventional cardiology JID - 101272671 PMC - PMC5364283 OTO - NOTNLM OT - carotid artery stenting OT - distal protection system OT - proximal protection system COIS- The authors declare no conflict of interest. EDAT- 2017/03/28 06:00 MHDA- 2017/03/28 06:01 PMCR- 2017/01/01 CRDT- 2017/03/28 06:00 PHST- 2016/06/07 00:00 [received] PHST- 2016/10/12 00:00 [accepted] PHST- 2017/03/28 06:00 [entrez] PHST- 2017/03/28 06:00 [pubmed] PHST- 2017/03/28 06:01 [medline] PHST- 2017/01/01 00:00 [pmc-release] AID - 29542 [pii] AID - 10.5114/aic.2017.66187 [doi] PST - ppublish SO - Postepy Kardiol Interwencyjnej. 2017;13(1):53-61. doi: 10.5114/aic.2017.66187. Epub 2017 Mar 10. PMID- 28344415 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20220409 IS - 1011-6842 (Print) IS - 1011-6842 (Linking) VI - 33 IP - 2 DP - 2017 Mar TI - Percutaneous Coronary Intervention versus Coronary Artery Bypass Grafting in Patients with Diabetic Nephropathy and Left Main Coronary Artery Disease. PG - 119-126 AB - BACKGROUND: Patients with diabetic nephropathy and unprotected left main (LM) coronary artery disease suffer from high cardiovascular morbidity and mortality. Although surgical revascularization is currently recommended in this special patient population, the optimal revascularization method for this distinct patient group has remained unclear. METHODS: We collected 99 consecutive patients with unprotected LM disease and diabetic nephropathy, including 46 patients who had undergone percutaneous coronary intervention (PCI), and 53 who had coronary artery bypass grafting (CABG), with a mean age of 72 +/- 10; with 80.8% male. Diabetic nephropathy was defined as overt proteinuria (proteinuria > 500 mg/day) and estimated glomerular filtration rate (eGFR) by the modified Modification of Diet in Renal Disease (MDRD) equation of less than 60 mL/min/1.73 m(2). The baseline characteristics, angiographic results and long-term clinical outcomes were retrospectively analyzed. RESULTS: The baseline characteristic of all patients were similar except for smokers, low density lipoprotein (LDL) level and extension of coronary artery disease involvement. The median follow-up period was 3.8 years. There were 73 patients (74%) considered as high risk with additive European System for Cardiac Operative Risk Evaluation (EuroSCORE) >/= 6. During follow-up period, the long term rate of all-cause death (PCI vs. CABG: 45.7% vs. 58.5%, p = 0.20) and all-cause death/myocardial infarction (MI)/stroke (PCI vs. CABG: 52.2% vs. 60.4%, p = 0.41) were comparable between the PCI and CABG group, whereas the repeat revascularization rate was significantly higher in the PCI group (PCI vs. CABG: 32.6% vs. 9.4%, p < 0.01). eGFR remained an independent predictor for all-cause death [hazard ratio: 0.97, 95% confidence interval: 0.96 to 0.99; p = 0.002] in multivariate logistic regression. CONCLUSIONS: In the real-world practice of high-risk patients with unprotected LM disease and diabetic nephropathy, we found that PCI was a comparable alternative to CABG in terms of long-term risks of all-cause death/MI/stroke, with significantly higher repeat revascularization rate. Given the small patient number and retrospective nature, our findings should be validated by larger-scale randomized studies. FAU - Li, Hsin-Ru AU - Li HR AD - Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University. FAU - Hsu, Chiao-Po AU - Hsu CP AD - Division of Cardiovascular Surgery, Department of Surgery, Taipei Veterans General Hospital; ; School of Medicine, National Yang-Ming University. FAU - Sung, Shih-Hsien AU - Sung SH AD - School of Medicine, National Yang-Ming University; ; Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan. FAU - Shih, Chun-Che AU - Shih CC AD - Division of Cardiovascular Surgery, Department of Surgery, Taipei Veterans General Hospital; ; School of Medicine, National Yang-Ming University. FAU - Lin, Shing-Jong AU - Lin SJ AD - School of Medicine, National Yang-Ming University; ; Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan. FAU - Chan, Wan-Leong AU - Chan WL AD - School of Medicine, National Yang-Ming University; ; Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan. FAU - Wu, Cheng-Hsueh AU - Wu CH AD - Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan. FAU - Lu, Tse-Min AU - Lu TM AD - School of Medicine, National Yang-Ming University; ; Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan. LA - eng PT - Journal Article PL - China (Republic : 1949- ) TA - Acta Cardiol Sin JT - Acta Cardiologica Sinica JID - 101687085 PMC - PMC5364153 OTO - NOTNLM OT - Chronic kidney disease OT - Coronary artery bypass grafting OT - Diabetes mellitus OT - Diabetic nephropathy OT - Left main coronary artery disease OT - Percutaneous coronary intervention EDAT- 2017/03/28 06:00 MHDA- 2017/03/28 06:01 PMCR- 2017/03/01 CRDT- 2017/03/28 06:00 PHST- 2017/03/28 06:00 [entrez] PHST- 2017/03/28 06:00 [pubmed] PHST- 2017/03/28 06:01 [medline] PHST- 2017/03/01 00:00 [pmc-release] AID - 10.6515/acs20160623a [doi] PST - ppublish SO - Acta Cardiol Sin. 2017 Mar;33(2):119-126. doi: 10.6515/acs20160623a. PMID- 28344139 OWN - NLM STAT- MEDLINE DCOM- 20170919 LR - 20181117 IS - 1555-7162 (Electronic) IS - 0002-9343 (Linking) VI - 130 IP - 9 DP - 2017 Sep TI - Post-Discharge Worsening Renal Function in Patients with Type 2 Diabetes and Recent Acute Coronary Syndrome. PG - 1068-1075 LID - S0002-9343(17)30258-9 [pii] LID - 10.1016/j.amjmed.2017.02.033 [doi] AB - BACKGROUND: Worsening renal function during hospitalization for an acute coronary syndrome is strongly predictive of in-hospital and long-term outcome. However, the role of post-discharge worsening renal function has never been investigated in this setting. METHODS: We considered the placebo cohort of the AleCardio trial comparing aleglitazar with standard medical therapy among patients with type 2 diabetes mellitus and a recent acute coronary syndrome. Patients who had died or had been admitted to hospital for heart failure before the 6-month follow-up, as well as patients without complete renal function data, were excluded, leaving 2776 patients for the analysis. Worsening renal function was defined as a >20% reduction in estimated glomerular filtration rate from discharge to 6 months, or progression to macroalbuminuria. The Cox regression analysis was used to determine the prognostic impact of 6-month renal deterioration on the composite of all-cause death and hospitalization for heart failure. RESULTS: Worsening renal function occurred in 204 patients (7.34%). At a median follow-up of 2 years the estimated rates of death and hospitalization for heart failure per 100 person-years were 3.45 (95% confidence interval [CI], 2.46-6.36) for those with worsening renal function, versus 1.43 (95% CI, 1.14-1.79) for patients with stable renal function. At the adjusted analysis worsening renal function was associated with the composite endpoint (hazard ratio 2.65; 95% CI, 1.57-4.49; P <.001). CONCLUSIONS: Post-discharge worsening renal function is not infrequent among patients with type 2 diabetes and acute coronary syndromes with normal or mildly depressed renal function, and is a strong predictor of adverse cardiovascular events. CI - Copyright (c) 2017 Elsevier Inc. All rights reserved. FAU - Morici, Nuccia AU - Morici N AD - Unita di Terapia Intensiva Cardiologica, ASST Grande Ospedale Metropolitano Niguarda Ca' Granda, Milano, Italy. Electronic address: nuccia.morici@ospedaleniguarda.it. FAU - Savonitto, Stefano AU - Savonitto S AD - Dipartimento Cardiovascolare, Ospedale A. Manzoni, Lecco, Italy. FAU - Ponticelli, Claudio AU - Ponticelli C AD - Division of Nephrology, Humanitas Clinical Research Center, Rozzano (Milano), Italy. FAU - Schrieks, Ilse C AU - Schrieks IC AD - Julius Center for Health Sciences and Primary Care and Julius Clinical, Utrecht, the Netherlands. FAU - Nozza, Anna AU - Nozza A AD - Montreal Health Innovations Coordinating Center, Quebec, Canada. FAU - Cosentino, Francesco AU - Cosentino F AD - Cardiology Unit, Department of Medicine, Karolinska University Hospital, Stockholm, Sweden. FAU - Stahli, Barbara E AU - Stahli BE AD - Montreal Heart Institute, Universite de Montreal, Quebec, Canada. FAU - Perrone Filardi, Pasquale AU - Perrone Filardi P AD - Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy. FAU - Schwartz, Gregory G AU - Schwartz GG AD - Veterans Affairs Medical Center and University of Colorado School of Medicine, Denver. FAU - Mellbin, Linda AU - Mellbin L AD - Cardiology Unit, Department of Medicine, Karolinska University Hospital, Stockholm, Sweden. FAU - Lincoff, A Michael AU - Lincoff AM AD - Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Ohio. FAU - Tardif, Jean-Claude AU - Tardif JC AD - Montreal Health Innovations Coordinating Center, Quebec, Canada; Montreal Heart Institute, Universite de Montreal, Quebec, Canada. FAU - Grobbee, Diederick E AU - Grobbee DE AD - Julius Center for Health Sciences and Primary Care and Julius Clinical, Utrecht, the Netherlands. LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20170324 PL - United States TA - Am J Med JT - The American journal of medicine JID - 0267200 RN - 0 (Biomarkers) RN - 0 (Oxazoles) RN - 0 (Peroxisome Proliferator-Activated Receptors) RN - 0 (Thiophenes) RN - 41T4OAG59U (aleglitazar) RN - AYI8EX34EU (Creatinine) SB - IM MH - Acute Coronary Syndrome/epidemiology/*mortality/physiopathology/therapy MH - Aged MH - Albuminuria MH - Analysis of Variance MH - Biomarkers MH - Cause of Death MH - Comorbidity MH - Creatinine/blood MH - Diabetes Complications/*mortality MH - Diabetes Mellitus, Type 2/drug therapy/epidemiology MH - Disease Progression MH - Female MH - Follow-Up Studies MH - Glomerular Filtration Rate MH - Heart Failure/*mortality MH - Humans MH - Male MH - Oxazoles/administration & dosage/adverse effects/*therapeutic use MH - Patient Discharge/statistics & numerical data MH - Percutaneous Coronary Intervention MH - Peroxisome Proliferator-Activated Receptors/administration & dosage/adverse effects/agonists/therapeutic use MH - Predictive Value of Tests MH - Proportional Hazards Models MH - Renal Insufficiency, Chronic/epidemiology/etiology/*mortality MH - Risk Factors MH - Thiophenes/administration & dosage/adverse effects/*therapeutic use OTO - NOTNLM OT - Acute coronary syndrome OT - Diabetes mellitus OT - Worsening renal function EDAT- 2017/03/28 06:00 MHDA- 2017/09/20 06:00 CRDT- 2017/03/28 06:00 PHST- 2017/02/04 00:00 [received] PHST- 2017/02/11 00:00 [revised] PHST- 2017/02/13 00:00 [accepted] PHST- 2017/03/28 06:00 [pubmed] PHST- 2017/09/20 06:00 [medline] PHST- 2017/03/28 06:00 [entrez] AID - S0002-9343(17)30258-9 [pii] AID - 10.1016/j.amjmed.2017.02.033 [doi] PST - ppublish SO - Am J Med. 2017 Sep;130(9):1068-1075. doi: 10.1016/j.amjmed.2017.02.033. Epub 2017 Mar 24. PMID- 28318510 OWN - NLM STAT- MEDLINE DCOM- 20170425 LR - 20220310 IS - 1879-1913 (Electronic) IS - 0002-9149 (Print) IS - 0002-9149 (Linking) VI - 119 IP - 9 DP - 2017 May 1 TI - Comparative Efficacy of Coronary Revascularization Procedures for Multivessel Coronary Artery Disease in Patients With Chronic Kidney Disease. PG - 1344-1351 LID - S0002-9149(17)30128-5 [pii] LID - 10.1016/j.amjcard.2017.01.029 [doi] AB - Patients with chronic kidney disease (CKD) are at increased risk of cardiovascular disease and death, yet little data exist regarding the comparative efficacy of coronary revascularization procedures in CKD patients with multivessel disease. We created a cohort of 4,687 adults who underwent cardiac catheterization, had a serum creatinine value measured within 30 days, and had more than one vessel with >/=50% stenosis. We used Cox proportional hazard regression modeling weighted by the inverse probability of treatment to examine the association between 4 treatment strategies (medical management, percutaneous coronary intervention [PCI] with bare metal stent, PCI with drug-eluting stent, and coronary artery bypass grafting [CABG]) and mortality among patients across categories of estimated glomerular filtration rate; secondary outcome was a composite of mortality, myocardial infarction, or revascularization. Compared with medical management, CABG was associated with a reduced risk of death for patients of any nondialysis CKD severity (hazard ratio [HR] range 0.43 to 0.59). There were no significant mortality differences between CABG and PCI, except a decreased death risk in CABG-treated CKD patients (HR range 0.54 to 0.55). Compared with medical management and PCI, CABG was associated with a lower risk of death, myocardial infarction, or revascularization in nondialysis CKD patients (HR range 0.41 to 0.64). There were similar associations between decreased estimated glomerular filtration rate and increased mortality across all multivessel coronary artery disease patient treatment groups. When accounting for treatment propensity, surgical revascularization was associated with improved outcomes in patients of all CKD severities. A prospective randomized trial in CKD patients is required to confirm our findings. CI - Copyright (c) 2017 Elsevier Inc. All rights reserved. FAU - Roberts, John K AU - Roberts JK AD - Division of Nephrology, Duke University Medical Center, Durham, North Carolina; Duke University School of Medicine, Durham, North Carolina. Electronic address: john.roberts@dm.duke.edu. FAU - Rao, Sunil V AU - Rao SV AD - Duke University School of Medicine, Durham, North Carolina; Duke Clinical Research Institute, Durham, North Carolina. FAU - Shaw, Linda K AU - Shaw LK AD - Duke University School of Medicine, Durham, North Carolina. FAU - Gallup, Dianne S AU - Gallup DS AD - Duke University School of Medicine, Durham, North Carolina. FAU - Marroquin, Oscar C AU - Marroquin OC AD - Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania. FAU - Patel, Uptal D AU - Patel UD AD - Division of Nephrology, Duke University Medical Center, Durham, North Carolina; Duke University School of Medicine, Durham, North Carolina; Duke Clinical Research Institute, Durham, North Carolina. LA - eng GR - P30 DK096493/DK/NIDDK NIH HHS/United States GR - T32 DK007731/DK/NIDDK NIH HHS/United States PT - Comparative Study PT - Journal Article DEP - 20170209 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM MH - Aged MH - Conservative Treatment MH - Coronary Artery Bypass/*methods MH - Coronary Artery Disease/complications/*surgery MH - *Drug-Eluting Stents MH - Female MH - Humans MH - Kidney Failure, Chronic/complications/*therapy MH - Male MH - Middle Aged MH - Mortality MH - Myocardial Infarction/epidemiology MH - Myocardial Revascularization/statistics & numerical data MH - Percutaneous Coronary Intervention/*methods MH - Postoperative Complications/epidemiology MH - Proportional Hazards Models MH - *Registries MH - Renal Insufficiency, Chronic/complications MH - Stents MH - Treatment Outcome PMC - PMC5392163 MID - NIHMS851180 COIS- Conflict of interest disclosures: Dr. Marroquin reports grant support from Abbott Vascular EDAT- 2017/03/21 06:00 MHDA- 2017/04/26 06:00 PMCR- 2018/05/01 CRDT- 2017/03/21 06:00 PHST- 2016/09/27 00:00 [received] PHST- 2017/01/18 00:00 [revised] PHST- 2017/01/18 00:00 [accepted] PHST- 2017/03/21 06:00 [pubmed] PHST- 2017/04/26 06:00 [medline] PHST- 2017/03/21 06:00 [entrez] PHST- 2018/05/01 00:00 [pmc-release] AID - S0002-9149(17)30128-5 [pii] AID - 10.1016/j.amjcard.2017.01.029 [doi] PST - ppublish SO - Am J Cardiol. 2017 May 1;119(9):1344-1351. doi: 10.1016/j.amjcard.2017.01.029. Epub 2017 Feb 9. PMID- 28314486 OWN - NLM STAT- MEDLINE DCOM- 20180321 LR - 20220316 IS - 1874-1754 (Electronic) IS - 0167-5273 (Linking) VI - 241 DP - 2017 Aug 15 TI - Insulin provision therapy and mortality in older adults with diabetes mellitus and stable ischemic heart disease: Insights from BARI-2D trial. PG - 35-40 LID - S0167-5273(16)34713-1 [pii] LID - 10.1016/j.ijcard.2017.03.048 [doi] AB - IMPORTANCE: Optimal strategies for glucose control in very old adults with diabetes and stable ischemic heart disease (SIHD) are unclear. OBJECTIVE: To compare the effects of insulin provision (IP) therapy versus insulin sensitizing (IS) therapy for glycemic control in older (>/=75years) and younger (<75years) adults with type II diabetes (DM) and SIHD. DESIGN, SETTING, AND PARTICIPANTS: Adults enrolled in the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) were studied. The BARI 2D study population (all with type II DM and SIHD) was randomized twice: (1) between revascularization plus intensive medical therapy versus intensive medical therapy alone, and (2) between IP versus IS therapies. The primary endpoint was all-cause-mortality over five-year follow-up. In this substudy outcomes related to IP vs. IS are assessed in relation to age. Adults aged >/=75years who received IP versus IS are compared to those <75years who received IP versus IS. Multivariate Cox regression analysis was used to evaluate the effects of IP vs. IS on outcomes in the two age groups. RESULTS: 2368 subjects with SIHD and DM were enrolled in BARI 2D; 182 (8%) were >/=75years. Compared to younger subjects, the older cohort had lower BMI, higher diuretic use, worse kidney function, and increased history of heart failure. Within the older cohort, the IP and IS subgroups were similar in respect to baseline cardiovascular risk factors, medications, and coronary artery disease severity. During follow-up, the older subjects receiving IP therapy had higher cardiovascular mortality compared to those receiving IS therapy (16% vs. 11%, p=0.040). Using Cox proportional hazards analysis, the older IP subjects were at increased risk for all-cause-mortality (hazard ratio 1.89, CI 1.1-3.2, p=0.020). No mortality difference between IP and IS was observed in those <75years of age. CONCLUSION AND RELEVANCE: Among adults with diabetes and SIHD aged >/=75years, IP therapy may be associated with increased mortality compared to IS therapy. Additional studies are needed to further refine optimal treatment strategies for diabetes and SIHD in old age. CI - Copyright (c) 2017 Elsevier Ireland Ltd. All rights reserved. FAU - Damluji, Abdulla A AU - Damluji AA AD - Sinai Hospital of Baltimore, LifeBridge Health Cardiovascular Institute, Baltimore, MD, United States; Division of Cardiology, Johns Hopkins University, Baltimore, MD, United States. FAU - Cohen, Erin R AU - Cohen ER AD - Cardiovascular Division, University of Miami Miller School of Medicine, Miami, FL, United States. FAU - Moscucci, Mauro AU - Moscucci M AD - Sinai Hospital of Baltimore, LifeBridge Health Cardiovascular Institute, Baltimore, MD, United States. FAU - Myerburg, Robert J AU - Myerburg RJ AD - Cardiovascular Division, University of Miami Miller School of Medicine, Miami, FL, United States. FAU - Cohen, Mauricio G AU - Cohen MG AD - Cardiovascular Division, University of Miami Miller School of Medicine, Miami, FL, United States. FAU - Brooks, Maria M AU - Brooks MM AD - Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, United States. FAU - Rich, Michael W AU - Rich MW AD - Division of Cardiology, Washington University School of Medicine, St. Louis, MO, United States. FAU - Forman, Daniel E AU - Forman DE AD - Geriatric Cardiology Section, University of Pittsburgh, Pittsburgh, PA, United States; Geriatric Research, Education, and Clinical Center, VA Pittsburgh Healthcare System, Pittsburgh, PA, United States. Electronic address: formand@pitt.edu. LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20170311 PL - Netherlands TA - Int J Cardiol JT - International journal of cardiology JID - 8200291 RN - 0 (Blood Glucose) RN - 0 (Insulin) SB - IM MH - Aged MH - Aged, 80 and over MH - Blood Glucose/drug effects/metabolism MH - Cohort Studies MH - Coronary Artery Bypass/*trends MH - Diabetes Mellitus, Type 2/blood/*drug therapy/*mortality MH - Female MH - Follow-Up Studies MH - Humans MH - Insulin/pharmacology/*therapeutic use MH - Male MH - Mortality/trends MH - Myocardial Ischemia/blood/*drug therapy/*mortality MH - Prospective Studies MH - Treatment Outcome OTO - NOTNLM OT - BARI 2D OT - Diabetes mellitus OT - Elderly OT - Insulin OT - Ischemic heart disease EDAT- 2017/03/21 06:00 MHDA- 2018/03/22 06:00 CRDT- 2017/03/19 06:00 PHST- 2016/12/20 00:00 [received] PHST- 2017/03/08 00:00 [revised] PHST- 2017/03/10 00:00 [accepted] PHST- 2017/03/21 06:00 [pubmed] PHST- 2018/03/22 06:00 [medline] PHST- 2017/03/19 06:00 [entrez] AID - S0167-5273(16)34713-1 [pii] AID - 10.1016/j.ijcard.2017.03.048 [doi] PST - ppublish SO - Int J Cardiol. 2017 Aug 15;241:35-40. doi: 10.1016/j.ijcard.2017.03.048. Epub 2017 Mar 11. PMID- 28303632 OWN - NLM STAT- MEDLINE DCOM- 20180626 LR - 20260127 IS - 1522-726X (Electronic) IS - 1522-1946 (Print) IS - 1522-1946 (Linking) VI - 90 IP - 5 DP - 2017 Nov 1 TI - The comparative safety and effectiveness of bivalirudin versus heparin monotherapy in patients on dialysis undergoing percutaneous coronary intervention: Insights from the Blue Cross Blue Shield of Michigan cardiovascular consortium. PG - 724-732 LID - 10.1002/ccd.27001 [doi] AB - BACKGROUND: Dialysis patients are at a higher risk of bleeding after percutaneous coronary intervention (PCI); however, due to their exclusion from randomized clinical trials, the optimal antithrombotic regimen for this population remains unknown. We sought to evaluate the comparative safety and effectiveness of bivalirudin monotherapy versus unfractionated heparin (UFH) monotherapy in dialysis patients undergoing PCI. METHODS: We included dialysis patients who underwent PCI in a multicenter registry between January 2010 and September 2015 at 47 Michigan hospitals. We compared in-hospital outcomes between bivalirudin versus UFH; excluding those treated with glycoprotein IIb/IIIa inhibitors. Optimal full matching was used to account for the nonrandom use of these drugs. RESULTS: Of 177,963 patients who underwent PCI, 4,303 (2.4%) were on dialysis. Among those, 1,257 (29.2%) received bivalirudin monotherapy and 2,112 (49.1%) received UFH monotherapy. Patients treated with bivalirudin had fewer comorbidities. After matching, there were no significant differences in outcomes between those who received bivalirudin versus UFH: bleeding (adjusted odds ratio: 0.67; 95% confidence interval: 0.41-1.07; P = 0.093); major bleeding (0.81; 0.19-3.50; P = 0.77); transfusion (1.01; 0.77-1.33; P = 0.96); repeat PCI (0.57; 0.14-2.24; P = 0.42); stent thrombosis (0.56; 0.05-5.83; P = 0.63); and death (0.84; 0.46-1.51; P = 0.55). CONCLUSIONS: We found no significant differences in in-hospital outcomes between bivalirudin and UFH monotherapy among dialysis patients undergoing PCI. Randomized clinical trials are needed to determine the optimal anticoagulant regimen for this population. (c) 2017 Wiley Periodicals, Inc. CI - (c) 2017 Wiley Periodicals, Inc. FAU - Sukul, Devraj AU - Sukul D AD - Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan. FAU - Seth, Milan AU - Seth M AD - Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan. FAU - Schreiber, Theodore AU - Schreiber T AD - Detroit Medical Center-Cardiovascular Institute, Detroit, Michigan. FAU - Khandelwal, Akshay AU - Khandelwal A AD - Division of Cardiology, Henry Ford Health System, Detroit, Michigan. FAU - Cannon, Louis A AU - Cannon LA AD - McLaren-Northern Michigan Regional Hospital, Petoskey, Michigan. FAU - LaLonde, Thomas A AU - LaLonde TA AD - Department of Cardiovascular Medicine, St. John Hospital and Medical Center, Detroit, Michigan. FAU - Gurm, Hitinder S AU - Gurm HS AUID- ORCID: 0000-0002-1646-0218 AD - Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan. AD - Cardiovascular Medicine, VA Ann Arbor Healthcare System, Ann Arbor, Michigan. LA - eng GR - T32 HL007853/HL/NHLBI NIH HHS/United States PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Observational Study DEP - 20170317 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 RN - 0 (Anticoagulants) RN - 0 (Antithrombins) RN - 0 (Hirudins) RN - 0 (Peptide Fragments) RN - 0 (Recombinant Proteins) RN - 9005-49-6 (Heparin) RN - TN9BEX005G (bivalirudin) SB - IM CIN - Catheter Cardiovasc Interv. 2017 Nov 1;90(5):733-734. doi: 10.1002/ccd.27358. PMID: 29105331 MH - Aged MH - Anticoagulants/adverse effects/*therapeutic use MH - Antithrombins/adverse effects/*therapeutic use MH - *Blue Cross Blue Shield Insurance Plans MH - Comparative Effectiveness Research MH - Coronary Artery Disease/complications/diagnostic imaging/*therapy MH - Female MH - Hemorrhage/chemically induced MH - Heparin/adverse effects/*therapeutic use MH - Hirudins/adverse effects MH - Humans MH - Logistic Models MH - Male MH - Michigan MH - Middle Aged MH - Odds Ratio MH - Peptide Fragments/adverse effects/*therapeutic use MH - *Percutaneous Coronary Intervention/adverse effects/instrumentation MH - Propensity Score MH - Recombinant Proteins/adverse effects/therapeutic use MH - Registries MH - *Renal Dialysis/adverse effects MH - Renal Insufficiency, Chronic/complications/diagnosis/physiopathology/*therapy MH - Retrospective Studies MH - Risk Factors MH - Stents MH - Thrombosis/diagnosis/etiology/*prevention & control MH - Time Factors MH - Treatment Outcome PMC - PMC6850212 MID - NIHMS1053101 OTO - NOTNLM OT - anticoagulant OT - chronic kidney disease OT - dialysis OT - outcomes OT - percutaneous coronary intervention COIS- Disclosures: Hitinder S. Gurm receives research funding from Blue Cross Blue Shield of Michigan, the National Institutes of Health and is a consultant for Osprey Medical. None of the authors have any conflicts directly relevant to this study. EDAT- 2017/03/18 06:00 MHDA- 2018/06/27 06:00 PMCR- 2019/11/12 CRDT- 2017/03/18 06:00 PHST- 2017/01/27 00:00 [received] PHST- 2017/02/04 00:00 [accepted] PHST- 2017/03/18 06:00 [pubmed] PHST- 2018/06/27 06:00 [medline] PHST- 2017/03/18 06:00 [entrez] PHST- 2019/11/12 00:00 [pmc-release] AID - 10.1002/ccd.27001 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2017 Nov 1;90(5):724-732. doi: 10.1002/ccd.27001. Epub 2017 Mar 17. PMID- 28281738 OWN - NLM STAT- MEDLINE DCOM- 20180625 LR - 20260127 IS - 1898-018X (Electronic) IS - 1898-018X (Linking) VI - 24 IP - 5 DP - 2017 TI - Efficacy of nicorandil treatment for prevention of contrast-induced nephropathy in high-risk patients undergoing cardiac catheterization: A prospective randomized controlled trial. PG - 502-507 LID - 10.5603/CJ.a2017.0028 [doi] AB - BACKGROUND: Contrast-induced nephropathy (CIN) remains to be a potentially serious complication of radiographic procedures and is the third leading cause of the acute kidney injury (AKI) among hospitalized patients. This clinical trial was performed to assess the preventive effect of oral nicorandil on CIN in high-risk patients undergoing cardiac catheterization. METHODS: In this prospective, randomized, controlled trial, 128 patients with at least two risk factors for CIN undergoing elective percutaneous coronary intervention (PCI) were randomly assigned to either the nicorandil group or the control group. Patients in the nicorandil group (n = 64) received 10 mg nicorandil, daily from 30 min before and up to 3 days after procedure and intravenous hydration for 2 h before and 6 h after the procedure, whereas patients in the control group (n = 64) just received intravenous hydration. Serum creatinine (SCr) was measured before contrast exposure and at 72 h. CIN was defined as an increase of 25% in SCr or > 0.5 mg/dL 72 h after contrast administration. RESULTS: Contrast-induced nephropathy occurred in 14 out of 64 (21.9%) patients in the control group and in 3 out of 64 (4.7%) patients in the nicorandil group. There was a significant difference in the incidence of CIN between the two groups at 72 h after administering the radiocontrast agent (p = 0.008). Moreover, there were significant differences between the two groups in SCr and estimated glomerular filtration rate 72 h after radiocontrast administration (p < 0.05). CONCLUSIONS: The findings revealed that oral nicorandil had substantial efficacy over hydration protocol for the development of CIN in high-risk patients undergoing cardiac catheterization. FAU - Iranirad, Leili AU - Iranirad L FAU - Hejazi, Seyed Fakhreddin AU - Hejazi SF FAU - Sadeghi, Mohammad Saleh AU - Sadeghi MS AD - Student Research Committee, Qom University of Medical Sciences, Qom, Iran, Islamic Republic Of; School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran, Islamic Republic Of. salehsadeghi87@gmail.com. FAU - Jang, Shahram Arsang AU - Jang SA LA - eng PT - Journal Article PT - Randomized Controlled Trial DEP - 20170310 PL - Poland TA - Cardiol J JT - Cardiology journal JID - 101392712 RN - 0 (Contrast Media) RN - 0 (Renal Agents) RN - 260456HAM0 (Nicorandil) SB - IM MH - Acute Kidney Injury/chemically induced/diagnosis/physiopathology/*prevention & control MH - Administration, Oral MH - Aged MH - Cardiac Catheterization/*adverse effects MH - Contrast Media/administration & dosage/*adverse effects MH - Coronary Angiography/*adverse effects MH - Coronary Artery Disease/diagnostic imaging/*therapy MH - Female MH - Fluid Therapy MH - Glomerular Filtration Rate/drug effects MH - Humans MH - Iran MH - Kidney/*drug effects/physiopathology MH - Male MH - Middle Aged MH - Nicorandil/*administration & dosage/adverse effects MH - Percutaneous Coronary Intervention/*adverse effects MH - Prospective Studies MH - Renal Agents/*administration & dosage/adverse effects MH - Risk Factors MH - Time Factors MH - Treatment Outcome OTO - NOTNLM OT - contrast-induced nephropathy OT - nicorandil OT - percutaneous coronary intervention EDAT- 2017/03/11 06:00 MHDA- 2018/06/26 06:00 CRDT- 2017/03/11 06:00 PHST- 2016/11/08 00:00 [received] PHST- 2017/01/04 00:00 [accepted] PHST- 2017/03/09 00:00 [revised] PHST- 2017/03/11 06:00 [pubmed] PHST- 2018/06/26 06:00 [medline] PHST- 2017/03/11 06:00 [entrez] AID - VM/OJS/J/49459 [pii] AID - 10.5603/CJ.a2017.0028 [doi] PST - ppublish SO - Cardiol J. 2017;24(5):502-507. doi: 10.5603/CJ.a2017.0028. Epub 2017 Mar 10. PMID- 28253835 OWN - NLM STAT- MEDLINE DCOM- 20171121 LR - 20181113 IS - 1471-2369 (Electronic) IS - 1471-2369 (Linking) VI - 18 IP - 1 DP - 2017 Mar 2 TI - Abdominal aortic calcification on a plain X-ray and the relation with significant coronary artery disease in asymptomatic chronic dialysis patients. PG - 82 LID - 10.1186/s12882-017-0480-2 [doi] LID - 82 AB - BACKGROUND: Coronary artery disease (CAD) is common in asymptomatic chronic dialysis patients and plays an important role in their poor survival. Early identification of these high-risk patients could improve treatment and reduce mortality. Abdominal aortic calcification (AAC) has previously been associated with CAD in autopsy studies. Since the AAC can be quantified easily using a lateral lumbar X-ray we hypothesized that the extent of AAC as assessed on a lateral lumbar X-ray might be predictive of the presence of significant CAD in dialysis patients. METHODS: All patients currently enrolled in the ICD2 trial without a history of CABG or a PCI with stent implantation were included in this study. All patients underwent CT-angiography (CTA) and a lateral X-ray of the abdomen. AAC on X-ray was quantified using a previously validated scoring system whereupon the association between AAC and the presence of significant CAD was assessed. RESULTS: A total of 90 patients were included in this study (71% male, 67 +/- 7 years old). Forty-six patients were found to have significant CAD. AAC-score was significantly higher in patients with CAD (10.1 +/- 4.9 vs 6.3 +/- 4.6 (p < 0.05). Multivariate regression analysis revealed that AAC score is an independent predictor for the presence of CAD with a 1,2 fold higher risk per point increase (p < 0.01). The AAC score has a sensitivity of 85% and a specificity of 57% for the presence of significant CAD. CONCLUSION: This study shows that abdominal aortic calcification as assessed on a lateral lumbar X-ray is predictive for the presence of significant coronary artery disease in asymptomatic dialysis patients. This simple, non-invasive and cheap screening method could contribute to early identification of patients eligible for further screening of CAD. TRIAL REGISTRATION: NTR948 , registered 10-4-2007 ; ISRCTN20479861 , registered 2-5-2007. FAU - de Bie, M K AU - de Bie MK AD - Department of Cardiology, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands. FAU - Buiten, M S AU - Buiten MS AD - Department of Cardiology, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands. FAU - Rotmans, J I AU - Rotmans JI AD - Department of Nephrology, Leiden University Medical Center, Leiden, The Netherlands. FAU - Hogenbirk, M AU - Hogenbirk M AD - Department of Nephrology, Rijnstate Ziekenhuis, Arnhem, The Netherlands. FAU - Schalij, M J AU - Schalij MJ AD - Department of Cardiology, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands. FAU - Rabelink, T J AU - Rabelink TJ AD - Department of Cardiology, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands. FAU - Jukema, J W AU - Jukema JW AD - Department of Cardiology, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands. j.w.jukema@lumc.nl. LA - eng SI - ISRCTN/ISRCTN20479861 SI - NTR/NTR948 PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20170302 PL - England TA - BMC Nephrol JT - BMC nephrology JID - 100967793 SB - IM MH - Aged MH - Aorta, Abdominal/*diagnostic imaging MH - Aortic Diseases/*diagnostic imaging/epidemiology MH - *Asymptomatic Diseases MH - Computed Tomography Angiography MH - Coronary Angiography MH - Coronary Artery Disease/*diagnostic imaging/epidemiology MH - Female MH - Humans MH - Kidney Failure, Chronic/epidemiology/*therapy MH - Male MH - Middle Aged MH - Multivariate Analysis MH - Radiography MH - Renal Dialysis MH - Sensitivity and Specificity MH - Vascular Calcification/*diagnostic imaging/epidemiology PMC - PMC5335756 OTO - NOTNLM OT - Abominal aortic calcification OT - Coronary Artery disease OT - Dialysis OT - Vascular calcification EDAT- 2017/03/04 06:00 MHDA- 2017/11/29 06:00 PMCR- 2017/03/02 CRDT- 2017/03/04 06:00 PHST- 2016/04/23 00:00 [received] PHST- 2017/02/09 00:00 [accepted] PHST- 2017/03/04 06:00 [entrez] PHST- 2017/03/04 06:00 [pubmed] PHST- 2017/11/29 06:00 [medline] PHST- 2017/03/02 00:00 [pmc-release] AID - 10.1186/s12882-017-0480-2 [pii] AID - 480 [pii] AID - 10.1186/s12882-017-0480-2 [doi] PST - epublish SO - BMC Nephrol. 2017 Mar 2;18(1):82. doi: 10.1186/s12882-017-0480-2. PMID- 28241354 OWN - NLM STAT- MEDLINE DCOM- 20170320 LR - 20260127 IS - 1538-3598 (Electronic) IS - 0098-7484 (Linking) VI - 317 IP - 7 DP - 2017 Feb 21 TI - Effect of Fibrinogen Concentrate on Intraoperative Blood Loss Among Patients With Intraoperative Bleeding During High-Risk Cardiac Surgery: A Randomized Clinical Trial. PG - 738-747 LID - 10.1001/jama.2016.21037 [doi] AB - IMPORTANCE: Fibrinogen concentrate might partly restore coagulation defects and reduce intraoperative bleeding. OBJECTIVE: To determine whether fibrinogen concentrate infusion dosed to achieve a plasma fibrinogen level of 2.5 g/L in high-risk cardiac surgery patients with intraoperative bleeding reduces intraoperative blood loss. DESIGN, SETTING, AND PARTICIPANTS: A randomized, placebo-controlled, double-blind clinical trial conducted in Isala Zwolle, the Netherlands (February 2011-January 2015), involving patients undergoing elective, high-risk cardiac surgery (ie, combined coronary artery bypass graft [CABG] surgery and valve repair or replacement surgery, the replacement of multiple valves, aortic root reconstruction, or reconstruction of the ascending aorta or aortic arch) with intraoperative bleeding (blood volume between 60 and 250 mL suctioned from the thoracic cavity in a period of 5 minutes) were randomized to receive either fibrinogen concentrate or placebo. INTERVENTIONS: Intravenous, single-dose administration of fibrinogen concentrate (n = 60) or placebo (n = 60), targeted to achieve a postinfusion plasma fibrinogen level of 2.5 g/L. MAIN OUTCOMES AND MEASURES: The primary outcome was blood loss in milliliters between intervention (ie, after removal of cardiopulmonary bypass) and closure of chest. Safety variables (within 30 days) included: in-hospital mortality, myocardial infarction, cerebrovascular accident or transient ischemic attack, renal insufficiency or failure, venous thromboembolism, pulmonary embolism, and operative complications. RESULTS: Among 120 patients (mean age; 71 [SD, 10] years, 37 women [31%]) included in the study, combined CABG and valve repair or replacement surgery comprised 72% of procedures and had a mean (SD) cardiopulmonary bypass time of 200 minutes (83) minutes. For the primary outcome, median blood loss in the fibrinogen group was 50 mL (interquartile range [IQR], 29-100 mL) compared with 70 mL (IQR, 33-145 mL) in the control group (P = .19), the absolute difference 20 mL (95% CI, -13 to 35 mL). There were 6 cases of stroke or transient ischemic attack (4 in the fibrinogen group); 4 myocardial infarctions (3 in the fibrinogen group); 2 deaths (both in the fibrinogen group); 5 cases with renal insufficiency or failure (3 in the fibrinogen group); and 9 cases with reoperative thoracotomy (4 in the fibrinogen group). CONCLUSIONS AND RELEVANCE: Among patients with intraoperative bleeding during high-risk cardiac surgery, administration of fibrinogen concentrate, compared with placebo, resulted in no significant difference in the amount of intraoperative blood loss. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01124981 and EudraCT No: 2009-018086-12. FAU - Bilecen, Suleyman AU - Bilecen S AD - Division of Anesthesiology, Intensive Care and Emergency Medicine, University Medical Center Utrecht, Utrecht, the Netherlands2Department of Cardiothoracic Anesthesia and Intensive Care, Isala Zwolle, the Netherlands. FAU - de Groot, Joris A H AU - de Groot JA AD - Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands. FAU - Kalkman, Cor J AU - Kalkman CJ AD - Division of Anesthesiology, Intensive Care and Emergency Medicine, University Medical Center Utrecht, Utrecht, the Netherlands. FAU - Spanjersberg, Alexander J AU - Spanjersberg AJ AD - Department of Cardiothoracic Anesthesia and Intensive Care, Isala Zwolle, the Netherlands. FAU - Brandon Bravo Bruinsma, George J AU - Brandon Bravo Bruinsma GJ AD - Department of Cardiothoracic Surgery, Isala Zwolle, the Netherlands. FAU - Moons, Karel G M AU - Moons KG AD - Division of Anesthesiology, Intensive Care and Emergency Medicine, University Medical Center Utrecht, Utrecht, the Netherlands3Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands. FAU - Nierich, Arno P AU - Nierich AP AD - Department of Cardiothoracic Anesthesia and Intensive Care, Isala Zwolle, the Netherlands. LA - eng SI - EudraCT/2009-018086-12 SI - ClinicalTrials.gov/NCT01124981 PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - United States TA - JAMA JT - JAMA JID - 7501160 RN - 0 (Coagulants) RN - 9001-32-5 (Fibrinogen) SB - IM CIN - JAMA. 2017 Jun 27;317(24):2551. doi: 10.1001/jama.2017.6215. PMID: 28655002 CIN - JAMA. 2017 Jun 27;317(24):2550-2551. doi: 10.1001/jama.2017.6219. PMID: 28655003 CIN - Br J Anaesth. 2018 Feb;120(2):407-409. doi: 10.1016/j.bja.2017.11.092. PMID: 29406192 MH - Aged MH - Aorta/surgery MH - Blood Loss, Surgical/*prevention & control/statistics & numerical data MH - Cardiac Surgical Procedures/*adverse effects/methods MH - Cardiopulmonary Bypass MH - Coagulants/*administration & dosage MH - Double-Blind Method MH - Elective Surgical Procedures/adverse effects/methods MH - Female MH - Fibrinogen/*administration & dosage/analysis MH - Heart Valve Prosthesis Implantation/adverse effects MH - Humans MH - Intraoperative Complications/blood/epidemiology MH - Ischemic Attack, Transient/epidemiology MH - Male MH - Myocardial Infarction/epidemiology MH - Netherlands MH - Operative Time MH - Prospective Studies MH - Renal Insufficiency/epidemiology MH - Risk MH - Sample Size MH - Stroke/epidemiology EDAT- 2017/02/28 06:00 MHDA- 2017/03/21 06:00 CRDT- 2017/02/28 06:00 PHST- 2017/02/28 06:00 [entrez] PHST- 2017/02/28 06:00 [pubmed] PHST- 2017/03/21 06:00 [medline] AID - 2603928 [pii] AID - 10.1001/jama.2016.21037 [doi] PST - ppublish SO - JAMA. 2017 Feb 21;317(7):738-747. doi: 10.1001/jama.2016.21037. PMID- 28213685 OWN - NLM STAT- MEDLINE DCOM- 20180713 LR - 20260127 IS - 1868-4297 (Electronic) IS - 1868-4300 (Print) IS - 1868-4297 (Linking) VI - 33 IP - 2 DP - 2018 Apr TI - Prasugrel for Japanese patients with acute coronary syndrome in short-term clinical practice (PRASFIT-Practice I): a postmarketing observational study. PG - 135-145 LID - 10.1007/s12928-017-0459-8 [doi] AB - Data on prasugrel use in Japanese patients are limited to phase II/III clinical trials. This early postmarketing observational study evaluated the safety and efficacy of short-term prasugrel use in patients with acute coronary syndrome (ACS) in real-world clinical settings in Japan. From May 2014 to January 2015, we enrolled consecutive patients with ACS requiring percutaneous coronary intervention in each institution. Each patient started prasugrel treatment >/=1 month before the end of the study period. Safety outcomes included incidence rates of adverse drug reactions (ADRs) and bleeding adverse events (AEs). Efficacy outcomes were incidence rates of cardiovascular events (including major adverse cardiovascular events [MACE]). Case report forms were collected from 749 patients, 732 of whom were eligible for the safety and efficacy analysis sets. Approximately 95% of patients had a prasugrel loading/maintenance dose of 20 mg/3.75 mg/day. The incidences of ADRs and bleeding AEs were 8.6 and 6.4%, respectively. Twelve patients experienced major bleeding AEs; approximately 60% (seven patients) of which were gastrointestinal disorders. The incidence of bleeding AEs was significantly higher primarily in patients of female sex, aged >/=75 years, with low body weight (/=1.5 mg/dL). The primary endpoint was the 30-day rate of major adverse cardiac and cerebrovascular event (MACCE), defined as death, myocardial infarction (MI), target-vessel revascularization (TVR), and stroke. RESULTS: The CKD group had a higher prevalence of diabetes mellitus and hypertension as well as a lower mean left ventricular ejection fraction. The primary endpoint was similar in the CKD and non-CKD groups (3.4% vs 1.9%; P=.40), as were 30-day rates of death (2.2% vs 1.1%; P=.30), MI (1.1% vs 0.5%; P=.40), TVR (0% vs 0%; P>.99), and stroke (0% vs 0.3%; P>.99). Angiographic complications and stent thrombosis rates were low and did not differ between the two groups. CONCLUSION: Despite higher-risk baseline characteristics, patients with CKD had no significant differences in MACCE. Orbital atherectomy represents a reasonable treatment strategy for the treatment of severe CAC in patients with CKD. A prospective randomized trial with long-term follow-up is needed to identify the optimal treatment for these patients. FAU - Lee, Michael S AU - Lee MS FAU - Shlofmitz, Evan AU - Shlofmitz E FAU - Lluri, Gentian AU - Lluri G FAU - Shlofmitz, Richard A AU - Shlofmitz RA AD - UCLA Medical Center, 100 Medical Plaza Suite 630, Los Angeles, CA 90095 USA. mslee@mednet.ucla.edu. LA - eng PT - Journal Article PT - Multicenter Study DEP - 20170115 PL - United States TA - J Invasive Cardiol JT - The Journal of invasive cardiology JID - 8917477 RN - AYI8EX34EU (Creatinine) SB - IM MH - *Atherectomy, Coronary MH - Coronary Angiography MH - Coronary Artery Disease/complications/diagnosis/*surgery MH - Creatinine/metabolism MH - Glomerular Filtration Rate/*physiology MH - Humans MH - Incidence MH - Postoperative Complications/*epidemiology MH - *Registries MH - Renal Insufficiency/*complications/metabolism/physiopathology MH - Retrospective Studies MH - Severity of Illness Index MH - Survival Rate/trends MH - Treatment Outcome MH - United States/epidemiology MH - Vascular Calcification/complications/diagnosis/*surgery EDAT- 2017/01/17 06:00 MHDA- 2018/04/06 06:00 CRDT- 2017/01/17 06:00 PHST- 2017/01/17 06:00 [pubmed] PHST- 2018/04/06 06:00 [medline] PHST- 2017/01/17 06:00 [entrez] AID - JIC2017115-3 [pii] PST - ppublish SO - J Invasive Cardiol. 2017 Jun;29(6):203-206. Epub 2017 Jan 15. PMID- 28056847 OWN - NLM STAT- MEDLINE DCOM- 20171010 LR - 20240324 IS - 1471-2261 (Electronic) IS - 1471-2261 (Linking) VI - 17 IP - 1 DP - 2017 Jan 5 TI - Impact of diabetes and hypertension on cardiovascular outcomes in patients with coronary artery disease receiving percutaneous coronary intervention. PG - 12 LID - 10.1186/s12872-016-0454-5 [doi] LID - 12 AB - BACKGROUND: Percutaneous coronary intervention (PCI) is a necessary procedure commonly performed for patients with coronary artery disease (CAD). However, the impact of diabetes and hypertension on long-term outcomes of patients after receiving PCI has not yet been determined. METHODS: The data of 1234 patients who received PCI were collected prospectively, and patients were divided into four groups, including patients with and without DM and those with either DM or hypertension alone. Baseline characteristics, risk factors, medications and angiographic findings were compared and determinants of cardiovascular outcomes were analyzed in patients who received PCI. RESULTS: Patients with DM alone had the highest all-cause mortality (P < 0.001), cardiovascular mortality and myocardial infarctions (MI) (both P < 0.01) compared to the other groups. However, no differences were found between groups in repeat PCI (P = 0.32). Cox proportional hazard model revealed that age, chronic kidney disease (CKD), previous MI and stroke history were risk factors for all-cause mortality (OR: 1.05,1.89, 2.87, and 4.12, respectively), and use of beta-blockers (BB) and statins reduced all-cause mortality (OR: 0.47 and 0.35, respectively). Previous MI and stroke history, P2Y12 inhibitor use, and syntax scores all predicted CV mortality (OR: 4.02, 1.89, 2.87, and 1.04, respectively). Use of angiotensin converting enzyme inhibitors (ACEI), beta-blockers (BB), and statins appeared to reduce risk of CV death (OR: 0.37, 0.33, and 0.32, respectively). Previous MI and syntax scores predicted MI (OR: 3.17 and 1.03, respectively), and statin use reduced risk of MI (OR: 0.43). Smoking and BB use were associated with repeat PCI (OR: 1.48 and 1.56, respectively). CONCLUSIONS: After PCI, patients with DM alone have higher mortality compared to patients without DM and hypertension, with both DM and hypertension, and with hypertension alone. Comorbid hypertension does not appear to increase risk in DM patients, whereas comorbid DM appears to increase risk in hypertensive patients. TRIAL REGISTRATION: REC103-15 IRB of Taichung Tzu-chi Hospital. FAU - Lin, Mao-Jen AU - Lin MJ AD - Division of Cardiology, Department of Medicine, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical foundation, Taichung, Taiwan. AD - Department of Medicine, School of Medicine, Tzu Chi University, Hualien, Taiwan. FAU - Chen, Chun-Yu AU - Chen CY AD - Division of Emergency Medicine, Department of Pediatrics, Changhua Christian Hospital, Changhua, Taiwan. AD - School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. FAU - Lin, Hau-De AU - Lin HD AD - Division of Cardiology, Department of Medicine, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical foundation, Taichung, Taiwan. FAU - Wu, Han-Ping AU - Wu HP AD - Division of Pediatric General Medicine, Department of Pediatrics, Chang Gung Memorial Hospital at Linko, No. 5, Fu-Hsin Street, Kweishan, Taoyuan, 33057, Taiwan. arthur1226@gmail.com. AD - College of Medicine, Chang Gung University, Taoyuan, Taiwan. arthur1226@gmail.com. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20170105 PL - England TA - BMC Cardiovasc Disord JT - BMC cardiovascular disorders JID - 100968539 SB - IM MH - Adult MH - Aged MH - Aged, 80 and over MH - Chi-Square Distribution MH - Comorbidity MH - Coronary Angiography MH - Coronary Artery Disease/diagnostic imaging/mortality/*therapy MH - Diabetes Mellitus/diagnosis/*mortality MH - Female MH - Humans MH - Hypertension/diagnosis/*mortality MH - Kaplan-Meier Estimate MH - Male MH - Middle Aged MH - Myocardial Infarction/mortality MH - Odds Ratio MH - Percutaneous Coronary Intervention/adverse effects/*mortality MH - Proportional Hazards Models MH - Prospective Studies MH - Risk Factors MH - Time Factors MH - Treatment Outcome MH - Young Adult PMC - PMC5217339 OTO - NOTNLM OT - Coronary artery disease OT - Diabetes OT - Hypertension OT - PCI EDAT- 2017/01/07 06:00 MHDA- 2017/10/11 06:00 PMCR- 2017/01/05 CRDT- 2017/01/07 06:00 PHST- 2016/08/05 00:00 [received] PHST- 2016/12/22 00:00 [accepted] PHST- 2017/01/07 06:00 [entrez] PHST- 2017/01/07 06:00 [pubmed] PHST- 2017/10/11 06:00 [medline] PHST- 2017/01/05 00:00 [pmc-release] AID - 10.1186/s12872-016-0454-5 [pii] AID - 454 [pii] AID - 10.1186/s12872-016-0454-5 [doi] PST - epublish SO - BMC Cardiovasc Disord. 2017 Jan 5;17(1):12. doi: 10.1186/s12872-016-0454-5. PMID- 28003249 OWN - NLM STAT- MEDLINE DCOM- 20171102 LR - 20260127 IS - 2047-9980 (Electronic) IS - 2047-9980 (Linking) VI - 5 IP - 12 DP - 2016 Dec 21 TI - Endothelial Function Assessed by Automatic Measurement of Enclosed Zone Flow-Mediated Vasodilation Using an Oscillometric Method Is an Independent Predictor of Cardiovascular Events. LID - 10.1161/JAHA.116.004385 [doi] LID - e004385 AB - BACKGROUND: A new device for automatic measurement of flow-mediated vasodilation (FMD) using an oscillometric method has been developed to solve technical problems of conventional FMD measurement. This device measures enclosed zone FMD (ezFMD). The purpose of this study was to evaluate the prognostic value of endothelial function assessed by ezFMD for future cardiovascular events. METHODS AND RESULTS: We measured ezFMD in 272 participants who underwent health-screening examinations. First, we investigated cross-sectional associations between ezFMD and cardiovascular risk factors, and then we assessed the associations between ezFMD and first major cardiovascular events (death from cardiovascular causes, stroke, and coronary revascularization). Univariate regression analysis revealed that ezFMD was significantly correlated with age, triglycerides, glucose, smoking pack-years, estimated glomerular filtration rate, high-sensitivity C-reactive protein, and Framingham risk score. During a median follow-up period of 36.1 months (interquartile range 18.8-40.1 months), 12 participants died (6 from cardiovascular causes), 3 had stroke, 8 had coronary revascularization, and 10 were hospitalized for heart failure. There was no episode of acute coronary syndrome during the study period. Participants were divided into tertiles (low, intermediate, and high) based on ezFMD. Kaplan-Meier curves for first major cardiovascular events among the 3 groups were significantly different (P=0.004). After adjustment for cardiovascular risk factors, the low group was significantly associated with an increased risk of first major cardiovascular events compared with the high group (hazard ratio 6.47; 95% CI 1.09-125.55; P=0.038). CONCLUSIONS: These findings suggest that endothelial function assessed by ezFMD may be useful as a surrogate marker of future cardiovascular events. CLINICAL TRIAL REGISTRATION: URL: https://upload.umin.ac.jp. Unique identifier: UMIN000004902. CI - (c) 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell. FAU - Morimoto, Haruka AU - Morimoto H AD - Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan. AD - Nihon Kohden Co., Tokyo, Japan. FAU - Kajikawa, Masato AU - Kajikawa M AD - Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan. FAU - Oda, Nozomu AU - Oda N AD - Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan. FAU - Idei, Naomi AU - Idei N AD - Department of Cardiology, Hiroshima Red Cross Hospital, Hiroshima, Japan. FAU - Hirano, Harutoyo AU - Hirano H AD - College of Engineering, Academic Institute, Shizuoka University, Hamamatsu, Japan. FAU - Hida, Eisuke AU - Hida E AD - Center for Integrated Medical Research, Hiroshima University Hospital, Hiroshima, Japan. FAU - Maruhashi, Tatsuya AU - Maruhashi T AD - Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan. FAU - Iwamoto, Yumiko AU - Iwamoto Y AD - Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan. FAU - Kishimoto, Shinji AU - Kishimoto S AD - Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan. FAU - Matsui, Shogo AU - Matsui S AD - Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan. FAU - Aibara, Yoshiki AU - Aibara Y AD - Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan. FAU - Hidaka, Takayuki AU - Hidaka T AD - Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan. FAU - Kihara, Yasuki AU - Kihara Y AD - Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan. FAU - Chayama, Kazuaki AU - Chayama K AD - Department of Gastroenterology and Metabolism, Institute of Biomedical and Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan. FAU - Goto, Chikara AU - Goto C AD - Hiroshima International University, Hiroshima, Japan. FAU - Noma, Kensuke AU - Noma K AD - Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan. AD - Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan. FAU - Nakashima, Ayumu AU - Nakashima A AD - Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan. FAU - Ukawa, Teiji AU - Ukawa T AD - Nihon Kohden Co., Tokyo, Japan. FAU - Tsuji, Toshio AU - Tsuji T AD - Institute of Engineering, Hiroshima University, Higashi-Hiroshima, Japan. FAU - Higashi, Yukihito AU - Higashi Y AD - Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan yhigashi@hiroshima-u.ac.jp. AD - Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan. LA - eng SI - UMIN-CTR/UMIN000004902 PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20161221 PL - England TA - J Am Heart Assoc JT - Journal of the American Heart Association JID - 101580524 SB - IM MH - Blood Flow Velocity/*physiology MH - Brachial Artery/*physiopathology MH - Cardiovascular Diseases/*diagnosis/epidemiology/physiopathology MH - Cross-Sectional Studies MH - Endothelium, Vascular/*physiopathology MH - Equipment Design MH - Female MH - Follow-Up Studies MH - Humans MH - Incidence MH - Japan/epidemiology MH - Male MH - Middle Aged MH - Oscillometry/*instrumentation MH - Predictive Value of Tests MH - Prognosis MH - Reproducibility of Results MH - Retrospective Studies MH - Vasodilation/*physiology PMC - PMC5210444 OTO - NOTNLM OT - atherosclerosis OT - biomarker OT - cardiovascular events OT - endothelial function EDAT- 2016/12/23 06:00 MHDA- 2017/11/03 06:00 PMCR- 2016/12/01 CRDT- 2016/12/23 06:00 PHST- 2016/12/23 06:00 [entrez] PHST- 2016/12/23 06:00 [pubmed] PHST- 2017/11/03 06:00 [medline] PHST- 2016/12/01 00:00 [pmc-release] AID - JAHA.116.004385 [pii] AID - JAH31885 [pii] AID - 10.1161/JAHA.116.004385 [doi] PST - epublish SO - J Am Heart Assoc. 2016 Dec 21;5(12):e004385. doi: 10.1161/JAHA.116.004385. PMID- 27994300 OWN - NLM STAT- MEDLINE DCOM- 20180307 LR - 20181113 IS - 0350-199X (Print) IS - 1986-5961 (Electronic) IS - 0350-199X (Linking) VI - 70 IP - 5 DP - 2016 Oct TI - Does Remote Ischaemic Preconditioning Protect Kidney and Cardiomyocytes After Coronary Revascularization? A Double Blind Controlled Clinical Trial. PG - 373-378 AB - OBJECTIVE: To investigate efficacy of remote ischaemic preconditioning on reducing kidney injury and myocardial damage after coronary artery bypass grafting surgery (CABG). BACKGROUND: Ischaemic preconditioning of a remote organ reduces ischaemia-reperfusion injury of kidney and myocardium after CABG. METHOD: To reduce myocardial damage and kidney injury by applying Remote Ischaemic Preconditioning we recruited 100 consecutive patients undergoing elective coronary artery bypass grafting surgery. We applied three cycles of lower limb tourniquet, inflated its cuff for 5 minutes in study group or left un-inflated (sham or control group) before the procedure. The primary outcome was serum creatinine, creatinine clearance and troponin-I Levels at time 0, 6, 12, 24 and 48 h. Secondary outcomes were serum C-reactive protein, inotrope score, ventilation time and ICU stay. Data's were analyzed by MedCalc (MedCalc Software bvba, Acacialaan, Belgium). We compared the two group by student t test, chi-square and Mann-Whitney tests. RESULTS: The two groups were not statistically different in terms of age, gender, smoking habits, drug use, hypertension, hyperlipidemia and diabetes mellitus. This study showed a higher CRP level in study group comparing with control group (P=0.003), creatinine clearance was slightly higher in study group specially 24 h after procedure but was not statistically significant (p=0.11). Troponin-I level was significantly lower in study group (p=0.001). CONCLUSION: This study showed a lower Troponin-I level in study group which suggest a cardio-myocyte protective function of RIPC. It also showed slightly lower Creatinine clearance in control group, gap between two group increases significantly 24 hours after procedure which may suggest a potential kidney protection by RIPC. Serum CRP level was higher in study group. A multi-center randomized controlled trial with a longer time for creatinine clearance measurement may show the potential effectiveness of this non-invasive inexpensive intervention on reducing kidney injury after CABG. FAU - Nouraei, Seyed Mahmoud AU - Nouraei SM AD - Thoracic and cardiovascular surgery department, Mazandran University of Medical sciences, Sari, Iran. FAU - Baradari, Afshin Gholipour AU - Baradari AG AD - Anaesthesia department, Mazandran University of Medical sciences, Sari, Iran. FAU - Jazayeri, Asieh AU - Jazayeri A AD - Student Research Committee, Mazandran University of Medical sciences, Sari, Iran. LA - eng PT - Journal Article PT - Randomized Controlled Trial DEP - 20161025 PL - Bosnia and Herzegovina TA - Med Arch JT - Medical archives (Sarajevo, Bosnia and Herzegovina) JID - 101635337 SB - IM MH - Acute Kidney Injury/etiology/*prevention & control MH - Aged MH - Coronary Artery Bypass/*adverse effects MH - Double-Blind Method MH - Female MH - Humans MH - Ischemic Preconditioning/*methods MH - Male MH - Middle Aged MH - Myocardial Reperfusion Injury/etiology/*prevention & control MH - Myocytes, Cardiac/*physiology MH - Reperfusion Injury/etiology/*prevention & control MH - Treatment Outcome PMC - PMC5136438 OTO - NOTNLM OT - Cardiac Surgical Procedures OT - Complications OT - Coronary artery bypass grafting surgery OT - Ischaemic preconditioning COIS- * Conflict of interest: none declared. EDAT- 2016/12/21 06:00 MHDA- 2018/03/08 06:00 PMCR- 2016/10/01 CRDT- 2016/12/21 06:00 PHST- 2016/08/05 00:00 [received] PHST- 2016/09/25 00:00 [accepted] PHST- 2016/12/21 06:00 [entrez] PHST- 2016/12/21 06:00 [pubmed] PHST- 2018/03/08 06:00 [medline] PHST- 2016/10/01 00:00 [pmc-release] AID - MA-70-373 [pii] AID - 10.5455/medarh.2016.70.373-378 [doi] PST - ppublish SO - Med Arch. 2016 Oct;70(5):373-378. doi: 10.5455/medarh.2016.70.373-378. Epub 2016 Oct 25. PMID- 27974670 OWN - NLM STAT- MEDLINE DCOM- 20171109 LR - 20260127 IS - 1557-2501 (Electronic) IS - 1042-3931 (Linking) VI - 29 IP - 2 DP - 2017 Feb TI - The SYNTAX Score Does Not Predict Risk of Adverse Events in Patients With Non-ST Elevation Acute Coronary Syndrome Who Undergo Coronary Artery Bypass Graft Surgery. PG - 42-49 LID - JIC20161215-3 [pii] AB - OBJECTIVES: We tested the ability of the SYNTAX score (SS) to predict 1-year adverse outcomes for patients with non-ST segment elevation acute coronary syndromes (NSTE-ACS) who undergo coronary artery bypass graft (CABG) surgery. BACKGROUND: The SS effectively risk stratifies patients who undergo percutaneous coronary intervention, but not patients with stable coronary disease who undergo CABG. METHODS: We calculated the SS for 457 patients with NSTE-ACS in the angiographic substudy of the ACUITY (Acute Catheterization and Urgent Intervention Triage StrategY) trial who underwent CABG. We stratified and compared patients according to SS tertiles. We tested the ability of the SS, as a linear covariate, to predict adverse events by univariate analyses and by univariate and multivariable Cox proportional hazards model. We also tested the predictive abilities of the Age, Creatinine Clearance, and Ejection Fraction (ACEF) score, the clinical SS, and the logistic clinical SS. RESULTS: The median SS was 23 (interquartile range, 15-30). Baseline clinical characteristics were similar among the groups. One-year mortality and major adverse cardiovascular events (all-cause death, myocardial infarction, any stroke, or urgent revascularization) were similar between the groups (P=.13 and P=.62, respectively). Receiver operating characteristic curves, net reclassification indices, and integrated discrimination indices did not improve with SS, clinical SS, or logistic clinical SS compared with the ACEF score. CONCLUSIONS: The anatomical SS does not appear to be useful in risk stratifying patients with NSTE-ACS who undergo CABG. Clinical variables may better risk stratify patients with complex coronary artery disease considered for CABG. FAU - Redfors, Bjorn AU - Redfors B FAU - He, Chun-Hui AU - He CH FAU - Palmerini, Tullio AU - Palmerini T FAU - Caixeta, Adriano AU - Caixeta A FAU - Giustino, Gennaro AU - Giustino G FAU - Ayele, Girma Minalu AU - Ayele GM FAU - Kirtane, Ajay J AU - Kirtane AJ FAU - Mehran, Roxana AU - Mehran R FAU - Stone, Gregg W AU - Stone GW FAU - Genereux, Philippe AU - Genereux P AD - Cardiovascular Research Foundation, 1700 Broadway, 9th Floor, New York, NY 10019 USA. pgenereux@crf.org. LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20161215 PL - United States TA - J Invasive Cardiol JT - The Journal of invasive cardiology JID - 8917477 SB - IM MH - Acute Coronary Syndrome/diagnosis/mortality/*surgery MH - Coronary Angiography MH - Coronary Artery Bypass/*methods MH - *Electrocardiography MH - Female MH - Follow-Up Studies MH - Humans MH - Incidence MH - Male MH - Middle Aged MH - Postoperative Complications/*epidemiology MH - Prognosis MH - Prospective Studies MH - Risk Assessment/*methods MH - Risk Factors MH - Survival Rate/trends MH - United States/epidemiology EDAT- 2016/12/16 06:00 MHDA- 2017/11/10 06:00 CRDT- 2016/12/16 06:00 PHST- 2016/12/16 06:00 [pubmed] PHST- 2017/11/10 06:00 [medline] PHST- 2016/12/16 06:00 [entrez] AID - JIC20161215-3 [pii] PST - ppublish SO - J Invasive Cardiol. 2017 Feb;29(2):42-49. Epub 2016 Dec 15. PMID- 27939225 OWN - NLM STAT- MEDLINE DCOM- 20170524 LR - 20181022 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 119 IP - 4 DP - 2017 Feb 15 TI - Identification of Factors Associated With Improved Survival After Renal Artery Stenting. PG - 664-668 LID - S0002-9149(16)31832-X [pii] LID - 10.1016/j.amjcard.2016.10.054 [doi] AB - Atherosclerotic renal artery stenosis (RAS) is associated with high mortality rates, but large randomized trials have not shown improvement in survival with renal artery stenting. These results suggest that factors other than ongoing renal hypoperfusion are important in determining survival in patients with RAS. Using logistic regression models, we performed a single-center, case-control study that included 188 patients with >/=70% RAS with an average age of 67 +/- 10 years, 54% women, 20% black, and 70% smokers; 118 patients (63%) underwent renal artery stenting. A total of 89 patients (47%) died during an average follow-up of 5.1 years. Previous myocardial infarction (MI) (odds ratio 2.6 95% confidence interval [1.4 to 4.7]), left ventricular ejection fraction (LVEF) 0,6 F. Turani, A. B. Belli, S. M. Martni, V. C. Cotticelli, F. Mounajergi, R. Barchetta P197 - An observational prospective study on the onset of augmented renal clearance: the first report S. Morimoto, H. Ishikura P198 - An ultrasound- guided algorithm for the management of oliguria in severe sepsis I. Hussain, N. Salahuddin, A. Nadeem, K. Ghorab, K. Maghrabi P199 - Ultrasound in acute kidney injury (aki). First findings of farius, an education-programme in structural ultrasonography S. K. Kloesel, C. Goldfuss, A. Stieglitz, A. S. Stieglitz, L. Krstevska, G. Albuszies P200 - Effectiveness of renal angina index score predicting acute kidney injury on critically ill patients M. Aguilar Arzapalo, L. Barradas, V. Lopez, A. Escalante, G. Jimmy, M. Cetina P201 - Time length below blood pressure thresholds and progression of acute kidney injury in critically ill patients with or without sepsis: a retrospective, exploratory cohort study J. Izawa, T. Iwami, S. Uchino, M. Takinami, T. Kitamura, T. Kawamura P202 - Anaemia does not affect renal recovery in acute kidney injury J. G. Powell-Tuck, S. Crichton, M. Raimundo, L. Camporota, D. Wyncoll, M. Ostermann P203 - Estimated glomerular filtration rate based on serum creatinine: actual practice in Dutch ICU's A. Hana, H. R. De Geus P204 - Comparison of estimated glomerular filtration rate calculated by mdrd, ckd-epi-serum-creatinine and ckd-epi-cystatin-c in adult critically ill patients H. R. De Geus, A. Hana P205 - Early diagnosis of septic acute kidney injury in medical critical care patients with a urine cell cycle arrest marker: insulin like growth factor binding protein-7 (IGFBP-7) M. Aydogdu, N. Boyaci, S. Yuksel, G. Gursel, A. B. Cayci Sivri P206 - Urinary neutrophil gelatinase-associated lipocalin as early biomarker of severe acute kidney injury in intensive care J. Meza-Marquez, J. Nava-Lopez, R. Carrillo-Esper P207 - Shrunken pore syndrome is associated with a sharp rise in mortality in patients undergoing elective coronary artery bypass grafting A. Dardashti, A. Grubb P208 - The biomarker nephrocheck can discriminate the septic shock patients with an akin 1 or 2 acute renal failure who will not progress toward the akin 3 level J. Maizel, M. Wetzstein, D. Titeca, L. Kontar, F. Brazier, B. De Cagny, A. Riviere, T. Soupison, M. Joris, M. Slama P209 - A worldwide multicentre evaluation of acute kidney injury in septic and non-septic critically ill patients: the intensive care over nations (icon) audit E. Peters, H. Njimi, P. Pickkers, J. L. Vincent P210 - Does enhanced recovery after surgery reduce the incidence of acute kidney injury in those undergoing major gynae-oncological surgery? M. Waraich , J. Doyle, T. Samuels, L. Forni P211 - Identification of risk factors for the development of acute kidney injury after lower limb arthroplasty N. Desai, R. Baumber, P. Gunning, A. Sell P212 - Incidences and associations of acute kidney injury after major trauma S. Lin, H. Torrence, M. O'Dwyer, C. Kirwan, J. Prowle P213 - Acute kidney injury of major trauma patients T Kim P214 - Trajectory of serum creatinine after major surgery and the diagnosis of acute kidney injury M. E. O'Connor, R. W. Hewson, C. J. Kirwan, R. M. Pearse, J. Prowle P215 - Epidemiology of acute kidney injury after cardiac surgery. A single center retrospective study S. Hanoura , A. Omar, H. Othamn, S. Sudarsanan , M. Allam, M. Maksoud, R. Singh, A. Al Khulaifi P216 - Post-operative acute kidney injury after major non-cardiac surgery and its association with death in the following year M. E. O'Connor, R. W. Hewson, C. J. Kirwan, R. M. Pearse, J. Prowle P217 - Factors affecting acute renal failure in intensive care unit and effect of these factors on mortality O. Uzundere, D. Memis , M. Ynal, A. , N. Turan P218 - Results of the live kidney transplantations according to national data of turkish organ and tissue information system M. A. Aydin, H. Basar, I. Sencan, A. Kapuagasi, M. Ozturk, Z. Uzundurukan, D. Gokmen, A. Ozcan, C. Kaymak P219 - Anaesthesia procedure and intensive therapy in patients with neck phlegmon V. A. Artemenko, A. Budnyuk P220 - Nasal high flow oygen for acute respiratory failure: a systematic review R. Pugh , S. Bhandari P221 - Setting optimal flow rate during high flow nasal cannula support: preliminary results T. Mauri, C. Turrini, T. Langer, P. Taccone, C. A. Volta, C. Marenghi, L. Gattinoni, A. Pesenti P222 - Dose to dose consistency across two different gas flow rates using cystic fibrosis and normal adult breathing profiles during nasal high flow oxygen therapy L. Sweeney, A . O' Sullivan, P. Kelly, E. Mukeria, R. MacLoughlin P223 - Final results of an evaluation of airway medix closed suction system compared to a standard closed suction system M. Pfeffer, J. T. Thomas, G. B. Bregman, G. K. Karp, E. K. Kishinevsky, D. S. Stavi, N. A. Adi P224 - Different cuff materials and different leak tests - one size does not fit all T. Poropat, R. Knafelj P225 - Observational study on the value of the cuff-leak test and the onset of upper airway obstruction after extubation E. Llopart, M. Batlle, C. De Haro, J. Mesquida, A. Artigas P226 - A device for emergency transtracheal lung ventilation D. Pavlovic, L. Lewerentz, A. Spassov, R. Schneider P227 - Long-term outcome and health-related quality of life in patients discharged from the intensive care unit with a tracheostomy and with or without prolonged mechanical ventilation S. De Smet, S. De Raedt, E. Derom, P Depuydt, S. Oeyen, D. Benoit, J. Decruyenaere P228 - Ultrasound-guided percutaneous dilational tracheostomy versus bronchoscopy-guided percutaneous dilational tracheostomy in critically ill patients (trachus): a randomized clinical trial A. Gobatto, B. Bese, P. Tierno, L. Melro, P. Mendes, F. Cadamuro, M. Park, L. M. Malbouisson P229 - Is it safe to discharge patients with tracheostomy from the ICU to the ward? B. C. Civanto, J. L. Lopez, A. Robles, J. Figueira, S. Yus, A. Garcia P230 - The application of tracheostomy in children in ICU A. Oglinda, G. Ciobanu, C. Oglinda, L. Schirca, T. Sertinean, V. Lupu P231 - The impact of passive humidifiers on aerosol drug delivery during mechanical ventilation P. Kelly, A. O'Sullivan, L. Sweeney, R. MacLoughlin P232 - Evaluation of vibrating mesh and jet nebuliser performance at two different attachment setups in line with a humidifier nebuliser system A. O'Sullivan, P. Kelly, L. Sweeney, E. Mukeria, M. Wolny , R. MacLoughlin P233 - Psv-niv versus cpap in the treatment of acute cardiogenic pulmonary edema A. Pagano, F. Numis, G. Vison, L. Saldamarco, T. Russo, G. Porta, F. Paladino P234 - Noninvasive ventilation in patients with haematologic malignancy: a retrospective review C. Bell, J. Liu, J. Debacker, C. Lee, E. Tamberg, V. Campbell, S. Mehta P235 - Use of non-invasive ventilation in infectious diseases besides classical indications A. Silva-Pinto, A. Sarmento, L. Santos P236 - The impact of fragility on noninvasive mechanical ventilation application and results in the ICU Y. Kara, F. Yyldyrym, A. Zerman, Z. Gullu, N. Boyacy, B. Basaryk Aydogan, U. Gaygysyz, K. Gonderen, G. Aryk, M. Turkoglu, M. Aydogdu, G. Aygencel, Z. Ulger, G. Gursel P237 - Effects of metabolic alkalosis on noninvasive ventilation success and ICU outcome in patients with hypercapnic respiratory failure N. Boyacy, Z. Isykdogan, O. Ozdedeoglu, Z. Gullu, M. Badoglu, U. Gaygysyz, M. Aydogdu, G. Gursel P238 - Asynchrony index and breathing patterns of acute exacerbation copd patients assisted with noninvasive pressure support ventilation and neurally adjusted ventilatory assist N. Kongpolprom, C. Sittipunt P239 - High frequency jet ventilation for severe acute hypoxemia A. Eden, Y. Kokhanovsky, S. Bursztein - De Myttenaere, R. Pizov P240 - HFOV revisited: a 7 year retrospective analysis of patients receiving HFOV who met oscillate trial entry criteria L. Neilans, N. MacIntyre P241 - Implementation of a goal-directed mechanical ventilation order set driven by respiratory therapists can improve compliance with best practices for mechanical ventilation M. Radosevich, B. Wanta, V. Weber, T. Meyer, N. Smischney, D. Brown, D. Diedrich P242 - A reduction in tidal volumes for ventilated patients on ICU calculated from IBW. can it minimise mortality in comparison to traditional strategies? A . Fuller, P. McLindon, K. Sim P243 - Predictive value of lung aeration scoring using lung ultrasound in weaning failure M. Shoaeir, K. Noeam, A. Mahrous, R. Matsa, A. Ali P244 - Conventional versus automated weaning from mechanical ventilation using SmartCare C. Dridi, S. Koubaji, S. Kamoun, F. Haddad, A. Ben Souissi, B. Laribi, A. Riahi, M. S. Mebazaa P245 - Ultrasonographic evaluation protocol for weaning from mechanichal ventilation A. Perez-Calatayud, R. Carrillo-Esper, A. Zepeda-Mendoza, M. Diaz-Carrillo, E. Arch-Tirado P246 - Diaphragm ultrasonography: a method for weaning patients from mechanical ventilation S. Carbognin, L. Pelacani, F. Zannoni, A. Agnoli, G. Gagliardi P247 - Dorsal diaphragmatic excursion tracks transpulmonary pressure in ventilated ARDS patients: a potential non-invasive indicator of lung recruitment? R. Cho, A. Adams , S. Lunos, S. Ambur, R. Shapiro, M. Prekker P248 - Pulse oximetry in the icu patient: is the perfusion index of any value? M. Thijssen, L. Janssen, N. Foudraine P249 - Ventilation is a better assessment of respiratory status than EtCO2 C. J. Voscopoulos, J. Freeman P250 - Evaluation of the relationship between non-invasive minute ventilation and end-tidal CO2 in patients undergoing general vs spinal anesthesia C. J. Voscopoulos, J. Freeman, E. George P251 - Respiratory volume monitoring provides early warning of respiratory depression and can be used to reduce false alarms in non-intubated patients C. J. Voscopoulos, D. Eversole, J. Freeman, E. George P252 - P/i index: a predictive edi-derived weaning index during nava S. Muttini, R. Bigi, G. Villani, N. Patroniti P253 - Adequacy of ventilation in patients receiving opioids in the post anesthesia care unit: minute ventilation versus respiratory rate G. Williams, C. J. Voscopoulos, J. Freeman, E. George P254 - Comparison of regional and global expiratory time constants measured by electrical impedance tomography (EIT) A. Waldmann, S. Bohm, W. Windisch, S. Strassmann, C. Karagiannidis P255 - Electrical impedance tomography: robustness of a new pixel wise regional expiratory time constant calculation A. Waldmann, S. Bohm, W. Windisch, S. Strassmann, C. Karagiannidis P256 - Validation of regional and global expiratory time constant measurement by electrical impedance tomography in ards and obstructive pulmonary diseases C. K. Karagiannidis, A. W. Waldmann, S. B. Bohm, S. Strassmann, W. W. Windisch P257 - Transpulmonary pressure in a model with elastic recoiling lung and expanding chest wall P. Persson, S. Lundin, O. Stenqvist P258 - Lactate in pleural and abdominal effusion G. Porta, F. Numis, C. S. Serra, A. P. Pagano, M. M. Masarone, L. R. Rinaldi, A. A. Amelia, M. F. Fascione, L. A. Adinolfi, E. R. Ruggiero P259 - Outcome of patients admitted to the intensive care with pulmonary fibrosis F. Asota, K. O'Rourke, S. Ranjan, P. Morgan P260 - Sedation and analgesia practice in extra-corporeal membrane oxygenation (ECMO)-treated patients with acute respiratory distress syndrome (ARDS): a retrospective study J. W. DeBacker, E. Tamberg, L. O'Neill, L. Munshi, L. Burry, E. Fan, S. Mehta P261 - Characteristics and outcomes of patients deemed not eligible when referred for veno-venous extracorporeal membrane oxygenation (vv-ECMO) S. Poo, K. Mahendran, J. Fowles, C. Gerrard, A. Vuylsteke P262 - The SAVE SMR for veno-arterial ECMO R. Loveridge, C. Chaddock, S. Patel, V. Kakar, C. Willars, T. Hurst, C. Park, T. Best, A. Vercueil, G. Auzinger P263 - A simplified score to predict early (48 h) mortality in patients being considered for VA-ECMO A. Borgman, A. G. Proudfoot, E. Grins, K. E. Emiley, J. Schuitema, S. J. Fitch, G. Marco, J. Sturgill, M. G. Dickinson, M. Strueber, A. Khaghani, P. Wilton, S. M. Jovinge P264 - Lung function six months post extra corporeal membrane oxygenation (ECMO) for severe acute respiratory failure in adult survivors C. Sampson, S. Harris-Fox P265 - Bicarbonate dialysis removes carbon dioxide in hypoventilated rodents. M. E. Cove, L. H. Vu, A. Sen, W. J. Federspiel, J. A. Kellum P266 - Procalcitonin as predictor of primary graft dysfunction and mortality in post-lung transplantation C. Mazo Torre, J. Riera, S. Ramirez, B. Borgatta, L. Lagunes, J. Rello P267 - New molecular biomarkers of acute respiratory distress syndrome in abdominal sepsis A. K. Kuzovlev, V. Moroz, A. Goloubev, S. Polovnikov, S. Nenchuk P268 - Tight junction's proteins claudin -5 and regulation by tnf in experimental murine lung injury model of ali/ards V. Karavana, C. Glynos, A. Asimakos, K. Pappas, C. Vrettou, M. Magkou, E. Ischaki, G. Stathopoulos, S. Zakynthinos P269 - Cell counts in endobronchial aspirate to assess airway inflammation in ARDS patients: a pilot study S. Spadaro, I. Kozhevnikova, F. Dalla Corte, S. Grasso, P. Casolari, G. Caramori, C. Volta P270 - Epidemiological and clinical profile of patients with acute respiratory distress syndrome in the surgical intensive care unit surgical, hospital JRA, Antananarivo T. Andrianjafiarinoa, T. Randriamandrato, T. Rajaonera P271 - Effect of high PEEP after recruitment maneuver on right ventricular function in ARDS. Is it good for the lung and for the heart? S. El-Dash, ELV Costa, MR Tucci, F Leleu, L Kontar, B. De Cagny, F. Brazier, D. Titeca, G. Bacari-Risal, J. Maizel, M. Amato, M. Slama P272 - Effect of recruitment maneuver on left ventricular systolic strain P. Mercado, J. Maizel, L. Kontar, D. Titeca, F. Brazier, A. Riviere, M. Joris, T. Soupison, B. De Cagny, S. El Dash, M. Slama P273 - Inhaled nitric oxide - is switching supplier cost effective? Remmington, A. Fischer, S. Squire, M. Boichat P274 - Epidemiological study of severe acute pancreatitis in Japan, comparison of the etiology and the patient outcomes on 1159 patients. H. Honzawa, H. Yasuda, T. Adati, S. Suzaki, M. Horibe, M. Sasaki, M. Sanui P275 - Extracorporeal liver support therapy. Experience in an intensive care unit R. Marinho, J. Daniel, H. Miranda, A. Marinho P276 - Accuracy of mortality prediction models in acute versus acute-on-chronic liver failure in the intensive care setting K. Milinis, M. Cooper, G. R. Williams, E. McCarron, S. Simants, I. Patanwala, I. Welters P277 - Risk of coronary artery disease in patients with chronic liver disease: a population based cohort study Y. Su P278 - 20 years of liver transplantation in Santiago de Compostela (Spain). Experience review J. Fernandez Villanueva, R. Fernandez Garda, A. Lopez Lago, E. Rodriguez Ruiz, R. Hernandez Vaquero, S. Tome Martinez de Rituerto, E. Varo Perez P279 - Diarrhea is a risk factor for liver injury and may lead to intestinal failure associated liver disease in critical illness N. Lefel, F. Schaap, D. Bergmans, S. Olde Damink, M. Van de Poll P280 - Bowel care on the intensive care unit: constipation guideline compliance and complications K. Tizard, C. Lister, L. Poole P281 - Malnutrition assessed by phase angle determines outcomes in low risk cardiac surgery patients D. Ringaitiene, D. Gineityte, V. Vicka, I. Norkiene, J. Sipylaite P282 - Preoperative fasting times in an irish hospital A. O'Loughlin, V. Maraj, J. Dowling P283 - Costs and final outcome of early x delayed feeding in a private Brazil ICU M. B. Velasco, D. M. Dalcomune, E. B. Dias, S. L. Fernandes P284 - Can ventilator derived energy expenditure measurements replace indirect calorimetry? T. Oshima, S. Graf, C. Heidegger, L. Genton, V. Karsegard, Y. Dupertuis, C. Pichard P285 - Revisiting the refeeding syndrome: results of a systematic review N. Friedli, Z. Stanga, B. Mueller, P. Schuetz P286 - Compliance with the new protocol for parenteral nutrition in our ICU L. Vandersteen, B. Stessel, S. Evers, A. Van Assche, L. Jamaer, J. Dubois P287 - Nutrition may be another treatment in the intensive care unit where less is more? R. Marinho, H. Castro, J. Moura, J. Valente, P. Martins, P. Casteloes, C. Magalhaes, S. Cabral, M. Santos, B. Oliveira, A. Salgueiro, A. Marinho P288 - Should we provide more protein to critically ill patients? R. Marinho, M. Santos, E. Lafuente, H. Castro, S. Cabral, J. Moura, P. Martins, B. Oliveira, A. Salgueiro, S. Duarte, S. Castro, M. Melo, P. Casteloes, A. Marinho P289 Protein provision in an adult intensive care unit S. Gray P290 - Prevalence and clinical outcomes of vitamin d deficiency in the medical critically ill patients in Songklanagarind hospital K. Maipang, R. Bhurayanontachai P291 - Vitamin d deficiency strongly predicts adverse medical outcome across different medical inpatient populations: results from a prospective study L. G. Gradel, P. Schutz P292 - Omega-3 fatty acids in patients undergoing cardiac surgery: a systematic review and meta-analysis P. Langlois, W. Manzanares P293 - Can 5-hydroxytriptophan prevent post-traumatic stress disorder in critically ill patients? R. Tincu, C. Cobilinschi, D. Tomescu, Z. Ghiorghiu, R. Macovei P294 - Parenteral selenium in the critically ill: an updated systematic review and meta-analysis W. Manzanares, P. Langlois, M. Lemieux, G. Elke, F. Bloos, K. Reinhart, D. Heyland P295 - Probiotics in the critically ill: an updated systematic review and meta-analysis P. Langlois, M. Lemieux, I. Aramendi, D. Heyland, W. Manzanares P296 - Diabetes with hyperglycemic crisis episodes may be associated with higher risk of pancreatic cancer: a population-based cohort study Y. 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Suchomel P343 - Evaluation of levetiracetam pharmacokinetics after severe traumatic brain injury in neurocritical care patients at a level one trauma center N. Ebert, J. Jancik, H. Rhodes P344 - Model based time series cluster analysis to determine unique patient states in traumatic brain injury T. Bylinski, C. Hawthorne, M. Shaw, I. Piper, J. Kinsella P345 - Brain compartment monitoring capabilities from ICP to BI (bioimpedance) during HS (hypertonic saline) administration. State of art simulation outcome depending on brain swelling type A. K. Kink , I. R. Ratsep P346 - Transfusion of red blood cells in patients with traumatic brain injury admitted to Canadian trauma health centers: a multicenter cohort study A. Boutin, L. Moore, M. Chasse, R. Zarychanski, F. Lauzier, S. English, L. McIntyre, J. Lacroix, D. Griesdale, P. Lessard-Bonaventure, A. F. 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Leclerc P364 - A comparison of mortality scores in burns patients on the intensive care unit. O. Howarth, K. Davenport, P. Jeanrenaud, S. Raftery P365 - Clasification of pain and its treatment and an intensive care rehabiliation clinic P. MacTavish, H. Devine, J. McPeake, M. Daniel, J. Kinsella, T. Quasim P366 - Pain management adequacy in critical care areas ,the process and the barriers perceived by critical care nurses S. Alrabiee, A. Alrashid , S. Alsolamy P367 - Pain assessment in critically ill adult patients: validation of the Turkish version of the critical-care pain observation tool O. Gundogan, C. Bor, E. Akyn Korhan, K. Demirag , M. Uyar P368 - An audit of pain and sedation assessments in the intensive care unit: recommendations for clinical practice F. Frame, C. Ashton, L. Bergstrom Niska P369 - Impact of pharmaceutical care on treatment of pain and agitation in medical intensive care unit P. Dilokpattanamongkol, T. Suansanae, C. Suthisisang, S. Morakul, C. 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Hughes P382 - Systemic inflammatory response syndrome criteria and hospital mortality prediction in a brazilian cohort of critically ill patients L. U. Taniguchi, E. M. Siqueira, J. M. Vieira Jr, L. C. Azevedo P383 - Evaluating the efficacy of a risk predictor panel in identifying patients at elevated risk of morbidity following emergency admission A. N. Ahmad, M. Abu-Habsa, R. Bahl, E. Helme, S. Hadfield, R. Loveridge P384 - A retrospective comparison of outcomes for elective surgical patients admitted post-operatively to the critical care unit or general ward J. Shak, C. Senver, R. Howard-Griffin P385 - Effect of obesity on mortality in surgical critically ill patients. P. Wacharasint, P. Fuengfoo, N. Sukcharoen, R. Rangsin P386 - The national early warning score (news) reliably improves adverse clinical outcome prediction in community-acquired pneumonia - results from a 6 year follow-up D. Sbiti-Rohr, P. 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Hijazi P391 - The incidence and outcome of hyperlactatemia in the post anaesthesia care unit T. Abe, S. Uchino, M. Takinami P392 - Correlation between arterial blood gas disturbances and arterial lactate levels during hospitalization and outcome in critically septic patients N. R. Rangel Neto, S. Oliveira, F. Q. Reis, F. A. Rocha P393 - External validation of saps 3 and mpm iii scores in 48,816 patients from 72 brazilian icus G. Moralez, K. Ebecken, L. S. Rabello, M. F. Lima, R. Hatum, F. V. De Marco, A. Alves, J. E. Pinto, M. Godoy, P. E. Brasil, F. A. Bozza, J. I. Salluh, M. Soares P394 - The frailty penalty: pre-admission functional status confounds mortality prediction models in critically ill patients J. Krinsley, G. Kang P395 - 'sooner rather than later": how delayed discharge from critical care leads to increased out of hours discharges and subsequent increase in in-hospital mortality. J. Perry, H. Hines P396 - Identifying poor outcome patient groups in a resource-constrained critical care unit K. M. Wilkinson, C. Tordoff, B. Sloan, M. C. Bellamy P397 - Effects of icu weekend admission and discharge on mortality. E. Moreira, F. Verga, M. Barbato, G. Burghi P398 - Organizational factors, outcomes and resource use in 9,946 cancer patients admitted to 70 ICUs M Soares, U. V. Silva, L. C. Azevedo, A. P. Torelly, J. M. Kahn, D. C. Angus, M. F. Knibel, P. E. Brasil, F. A. Bozza, J. I. Salluh P399 - Evaluation of oncological critically ill patients, severity score and outcome compared to not oncological in a particular hospital cti. M. B. Velasco, D. M. Dalcomune P400 - Outcomes of patients admitted to a large uk critical care department with palliative oncological diagnoses R. Marshall, T. Gilpin, A. Tridente, A. Raithatha P401 - Predictors of mortality in febrile neutropenic patients with haematological malignancies admitted to an intensive care unit of a cancer center D. Mota, B. Loureiro, J. Dias, O. Afonso, F. Coelho, A. Martins, F. Faria P402 - Patients with hematologic malignancies requiring invasive mechanical ventilation: characteristics and predictors of mortality H. Al-Dorzi, H. Al Orainni , F. AlEid, H. Tlaygeh, A. Itani, A. Hejazi, Y. Arabi P403 - Patient-important outcomes in randomized controlled trials in critically ill patients: a systematic review S. Gaudry, J. Messika, J. D. Ricard, S. Guillo, B. Pasquet, E. Dubief, D. Dreyfuss, F. Tubach P404 - Alopecia in survivors of critical illness: a qualitative study C . Battle, K. James, P. Temblett P405 - The impact of mental health on icu admission L. Davies, C. Battle, C. Lynch P406 - Cognitive impairment 5 years after ICU discharge S. Pereira, S. Cavaco, J. Fernandes, I. Moreira, E. Almeida, F. Seabra Pereira, M. Malheiro, F. Cardoso, I. Aragao, T. Cardoso P407 - Apache ii versus apache iv for octagenerians in medical icu M. Fister, R. Knafelj P408 - Outcomes of octagenarians in an indian icu P. Muraray Govind, N. Brahmananda Reddy, R. Pratheema, E. D. Arul, J. Devachandran P409 - Mortality and outcomes in elderly patients 80 years of age or older admitted to the icu M. B. Velasco , D. M. Dalcomune P410 - Octagenerians in medical icu - adding days to life or life to days? R. Knafelj, M. Fister P411 - The very elderly admitted to intensive care unit: outcomes and economic evaluation N. Chin-Yee, G. D'Egidio, K. Thavorn, D. Heyland, K. Kyeremanteng P412 - The very elderly in intensive care: relationship between acuity of illness and long-term mortality A. G. Murchison, K. Swalwell, J. Mandeville, D. Stott P413 - Acquired weakness in an oncological intensive care unit I. Guerreiro P414 - Musculoskeletal problems in intensive care unit (ICU) patients post-discharge H. Devine, P. MacTavish, J. McPeake, T. Quasim, J. Kinsella, M. Daniel P415 - Premorbid obesity, but not nutrition, prevents critical illness-induced muscle wasting and weakness C. Goossens M. B. Marques, S. Derde, S. Vander Perre, T. Dufour, S. E. Thiessen, F. Guiza, T. Janssens, G. Hermans, I. Vanhorebeek, K. De Bock, G. Van den Berghe, L. Langouche P416 - Physical outcome measures for critical care patients following intensive care unit (icu) discharge H. Devine, P. MacTavish, T. Quasim, J. Kinsella, M. Daniel, J. McPeake P417 - Improving active mobilisation in a general intensive care unit B. Miles , S. Madden, H. Devine P418 - Mobilization in patients on vasoactive drugs use - a pilot study. M. Weiler, P. Marques, C. Rodrigues, M. Boeira, K. Brenner, C. Leaes, A. Machado, R. Townsend, J. Andrade P419 - Pharmacy intervention at an intensive care rehabilitation clinic P. MacTavish, J. McPeake, H. Devine, J. Kinsella, M. Daniel, R. Kishore, C. Fenlon, T. Quasim P420 - Interactive gaming is feasible and potentially increases icu patients' motivation to be engaged in rehabilitation programs T. Fiks, A. Ruijter, M. Te Raa, P. Spronk P421 - Simulation-based design of a robust stopping rule to ensure patient safety Y. S. Chiew, P. Docherty, J. Dickson, E. Moltchanova, C. Scarrot, C. Pretty, G. M. Shaw, J. G. Chase P422 - Are daily blood tests on the intensive care unit necessary? T. Hall, W. C. Ngu, J. M. Jack, P. Morgan P423 - Measuring urine output in ward patients: is it helpful? B. Avard, A. Pavli, X. Gee P424 - The incidence of pressure ulcers in an adult mixed intensive care unit in turkey C . Bor, E. Akin Korhan, K. Demirag, M. Uyar P425 - Intensivist/patient ratios in closed ICUs in Alexandria, Egypt; an overview M. Shirazy, A. Fayed P426 - Eicu (electronic intensive care unit): impact on ALOS (average length of stay) in a developing country like India S. Gupta, A. Kaushal, S. Dewan, A. Varma P427 - Predicting deterioration in general ward using early deterioration indicator E. Ghosh, L. Yang, L. Eshelman, B. Lord, E. Carlson P428 - High impact enhanced critical care outreach - the imobile service: making a difference E. Helme, R. Broderick, S. Hadfield, R. Loveridge P429 - Impact of bed availability and cognitive load on intensive care unit (ICU) bed allocation: a vignette-based trial J. Ramos, D. Forte P430 - Characteristics of critically ill patients admitted through the emergency department F. Yang, P. Hou P431 - Admission to critical care: the quantification of functional reserve J. Dudziak, J. Feeney, K. Wilkinson, K. Bauchmuller, K. Shuker, M. Faulds, A. Raithatha, D. Bryden, L. England, N. Bolton, A. Tridente P432 - Admission to critical care: the importance of frailty K. Bauchmuller, K Shuker, A Tridente, M Faulds, A Matheson, J. Gaynor, D Bryden, S South Yorkshire Hospitals Research Collaboration P433 - Development of an instrument to aid triage decisions for intensive care unit admission J. Ramos, B. Peroni, R. Daglius-Dias, L. Miranda, C. Cohen, C. Carvalho, I . Velasco, D. Forte P434 - Using selective serotonin re-uptake inhibitors and serotonin-norepinephrine re-uptake inhibitors in critical care: a systematic review of the evidence for benefit or harm J. M. Kelly, A. Neill, G. Rubenfeld, N. Masson, A. Min P435 - Measuring adaptive coping of hospitalized patients with a severe medical condition:the sickness insight in coping questionnaire (sicq) E. Boezeman, J. Hofhuis , A. Hovingh, R. De Vries, P. Spronk P436 - Results of a national survey regarding intensive care medicine training G. Cabral-Campello, I. Aragao, T. Cardoso P437 - Work engagement among healthcare professionals in the intensive care unit M. Van Mol, M. Nijkamp, E . Kompanje P438 - Empowering the intensive care practitioners. is it a burnout ameliorating intervention? P. Ostrowski, A. Omar P439 - Icu patients suffer from circadian rhythm desynchronisation K. Kiss , B. Koves, V. Csernus, Z. Molnar P440 - Noise reduction in the ICU: feasible ? Y. Hoydonckx, S. Vanwing, B. Stessel, A. Van Assche, L. Jamaer, J. Dubois P441 - Accidental removal of invasive devices in the critical patient into the bed-washing. does the presence of professional nurse modify his incidence? V. Medo, R. Galvez, J. P. Miranda P442 - Deprivation of liberty safeguards (dols): audit of compliance in a of a 16-bed specialist cancer critical care unit. C. Stone, T. Wigmore P443 - Use of a modified cristal score to predict futility of critical care in the elderly Y. Arunan, A. Wheeler, K. Bauchmuller, D. Bryden P444 - Improvement of Referral Rate to Palliative Care for Patients with Poor Prognosis in Neurosurgical Intensive Care Unit Y. Wong, C. Poi, C. Gu P445 - Factors associated with limitation of life supporting care (lsc) in a medico-surgical intermediate care unit, and outcome of patients with lsc limitation: a monocentric, six-month study. P. Molmy, N. Van Grunderbeeck, O. Nigeon, M. Lemyze, D. Thevenin, J. Mallat P446 - Palliative care consultation and intensive care unit admission request: a cohort study J. Ramos, M. Correa, R. T. Carvalho, D. Forte P447 - Nursing and medicine together in postsurgical intensive care unit: situations of prognostic conflict at the end of life. our critical care nurses suffer with our medical activism? A. Fernandez, C. McBride P448 - End of life who may decide E. Koonthalloor, C. Walsh P449 - Correctly diagnosing death A. Webber, M. Ashe, K. Smith, P. Jeanrenaud P450 - Skin procurement performed by intensive care physicians: yes, we can. A. Marudi , S. Baroni, F. Ragusa, E. Bertellini P451 - Death analysis in pediatric intensive care patients E. A. Volakli , E. Chochliourou, M. Dimitriadou, A. Violaki, P. Mantzafleri, E. Samkinidou, O. Vrani, A. Arbouti, T. Varsami, M. Sdougka P452 - The potential impact of euthanasia on organ donation: analysis of data from belgium J. A. Bollen, T. C. Van Smaalen, W. C. De Jongh, M. M. Ten Hoopen, D. Ysebaert, L. W. Van Heurn, W. N. Van Mook P453 - Communication within an intensive care setting K. Sim, A. Fuller P454 - Development and implementation of a longitudinal communication curriculum for critical care medicine fellows A. Roze des Ordons, P. Couillard, C. Doig P455 - Staff-family conflict in a multi-ethnic intensive care unit R. V. Van Keer, R. D. Deschepper, A. F. Francke, L. H. Huyghens, J. B. Bilsen P456 - Does the source of admission to critical care affect family satisfaction? B. Nyamaizi, C. Dalrymple, A. Molokhia, A. Dobru P457 - A simple alternative to the family satisfaction survey (fs-icu) E. Marrinan, A. Ankuli, A. Molokhia P458 - A study to explore the experiences of patient and family volunteers in a critical care environment: a phenomenological analysis J. McPeake, R. Struthers, R. Crawford , H. Devine , P. Mactavish , T. Quasim P459 - Prevalence and risk factors of anxiety and depression in relatives of burn patients. P. Morelli, M. Degiovanangelo, F. Lemos, V. MArtinez, F. Verga, J. Cabrera, G. Burghi P460 - Guidance of visiting children at an adult intensive care unit (icu) A. Rutten , S. Van Ieperen, S. De Geer, M. Van Vugt, E. Der Kinderen P461 - Visiting policies in Italian pediatric ICUs: an update A. Giannini, G Miccinesi, T Marchesi, E Prandi FAU - Bateman, R M AU - Bateman RM AD - University of Western Ontario, London, Canada. ISNI: 0000 0004 1936 8884. GRID: grid.39381.30 FAU - Sharpe, M D AU - Sharpe MD AD - University of Western Ontario, London, Canada. ISNI: 0000 0004 1936 8884. GRID: grid.39381.30 FAU - Jagger, J E AU - Jagger JE AD - University of Western Ontario, London, Canada. ISNI: 0000 0004 1936 8884. GRID: grid.39381.30 FAU - Ellis, C G AU - Ellis CG FAU - Sole-Violan, J AU - Sole-Violan J AD - Hospital Dr Negrin, Las Palmas de GC, Spain FAU - Lopez-Rodriguez, M AU - Lopez-Rodriguez M AD - Hospital Dr Negrin, Las Palmas de GC, Spain FAU - Herrera-Ramos, E AU - Herrera-Ramos E AD - Hospital Dr Negrin, Las Palmas de GC, Spain FAU - Ruiz-Hernandez, J AU - Ruiz-Hernandez J AD - Hospital Dr Negrin, Las Palmas de GC, Spain FAU - Borderias, L AU - Borderias L AD - Hospital San Jorge, Huesca, Spain. ISNI: 0000 0004 1765 5935. GRID: grid.415076.1 FAU - Horcajada, J AU - Horcajada J AD - Hospital Universitari del Mar, Barcelona, Spain. ISNI: 0000 0004 1767 8811. GRID: grid.411142.3 FAU - Gonzalez-Quevedo, N AU - Gonzalez-Quevedo N AD - Hospital Dr Negrin, Las Palmas de GC, Spain FAU - Rajas, O AU - Rajas O AD - Hospital Universitario de la Princesa, Madrid, Spain. ISNI: 0000 0004 1767 647X. GRID: grid.411251.2 FAU - Briones, M AU - Briones M AD - Hospital Clinico y Universitario de Valencia, Valencia, Spain. GRID: grid.411308.f FAU - Rodriguez de Castro, F AU - Rodriguez de Castro F AD - Hospital Dr Negrin, Las Palmas de GC, Spain FAU - Rodriguez Gallego, C AU - Rodriguez Gallego C AD - Hospital Universitari Son Espases, Palma de Mallorca, Spain. ISNI: 0000 0004 1796 5984. GRID: grid.411164.7 FAU - Esen, F AU - Esen F AD - Medical Faculty of Istanbul, Istanbul University, Anesthesiology and Intensive Care, Istanbul, Turkey. ISNI: 0000 0001 2166 6619. GRID: grid.9601.e FAU - Orhun, G AU - Orhun G AD - Medical Faculty of Istanbul, Istanbul University, Anesthesiology and Intensive Care, Istanbul, Turkey. ISNI: 0000 0001 2166 6619. GRID: grid.9601.e FAU - Ergin Ozcan, P AU - Ergin Ozcan P AD - Medical Faculty of Istanbul, Istanbul University, Anesthesiology and Intensive Care, Istanbul, Turkey. ISNI: 0000 0001 2166 6619. GRID: grid.9601.e FAU - Senturk, E AU - Senturk E AD - Medical Faculty of Istanbul, Istanbul University, Anesthesiology and Intensive Care, Istanbul, Turkey. ISNI: 0000 0001 2166 6619. GRID: grid.9601.e FAU - Ugur Yilmaz, C AU - Ugur Yilmaz C AD - Medical Faculty of Istanbul, Physiology, Istanbul University, Istanbul, Turkey. ISNI: 0000 0001 2166 6619. GRID: grid.9601.e FAU - Orhan, N AU - Orhan N AD - Institute of Experimental Medicine, Istanbul University, Neuroscience, Istanbul, Turkey. ISNI: 0000 0001 2166 6619. GRID: grid.9601.e FAU - Arican, N AU - Arican N AD - Medical Faculty of Istanbul, Forensic Medicine, Istanbul University, Istanbul, Turkey. ISNI: 0000 0001 2166 6619. GRID: grid.9601.e FAU - Kaya, M AU - Kaya M AD - Medical Faculty of Istanbul, Physiology, Istanbul University, Istanbul, Turkey. ISNI: 0000 0001 2166 6619. GRID: grid.9601.e FAU - Kucukerden, M AU - Kucukerden M AD - Institute of Experimental Medicine, Istanbul University, Neuroscience, Istanbul, Turkey. ISNI: 0000 0001 2166 6619. GRID: grid.9601.e FAU - Giris, M AU - Giris M AD - Institute of Experimental Medicine, Istanbul University, Neuroscience, Istanbul, Turkey. ISNI: 0000 0001 2166 6619. GRID: grid.9601.e FAU - Akcan, U AU - Akcan U AD - Institute of Experimental Medicine, Istanbul University, Neuroscience, Istanbul, Turkey. ISNI: 0000 0001 2166 6619. GRID: grid.9601.e FAU - Bilgic Gazioglu, S AU - Bilgic Gazioglu S AD - Institute of Experimental Medicine, Immunology, Istanbul University, Istanbul, Turkey. ISNI: 0000 0001 2166 6619. GRID: grid.9601.e FAU - Tuzun, E AU - Tuzun E AD - Institute of Experimental Medicine, Istanbul University, Neuroscience, Istanbul, Turkey. ISNI: 0000 0001 2166 6619. GRID: grid.9601.e FAU - Riff, R AU - Riff R AD - Ben-Gurion University of the Negev, Beer-Sheva, Israel. ISNI: 0000 0004 1937 0511. GRID: grid.7489.2 FAU - Naamani, O AU - Naamani O AD - Ben-Gurion University of the Negev, Beer-Sheva, Israel. ISNI: 0000 0004 1937 0511. GRID: grid.7489.2 FAU - Douvdevani, A AU - Douvdevani A AD - Soroka Medical Center, Beer-Sheva, Israel. ISNI: 0000 0004 0470 8989. GRID: grid.412686.f FAU - Takegawa, R AU - Takegawa R AD - Osaka University Graduate School of Medicine, Suita, Japan. ISNI: 0000 0004 0373 3971. GRID: grid.136593.b FAU - Yoshida, H AU - Yoshida H AD - Osaka University Graduate School of Medicine, Suita, Japan. ISNI: 0000 0004 0373 3971. GRID: grid.136593.b FAU - Hirose, T AU - Hirose T AD - Osaka University Graduate School of Medicine, Suita, Japan. ISNI: 0000 0004 0373 3971. GRID: grid.136593.b FAU - Yamamoto, N AU - Yamamoto N AD - Osaka University Graduate School of Medicine, Suita, Japan. ISNI: 0000 0004 0373 3971. GRID: grid.136593.b FAU - Hagiya, H AU - Hagiya H AD - Osaka University Graduate School of Medicine, Suita, Japan. ISNI: 0000 0004 0373 3971. GRID: grid.136593.b FAU - Ojima, M AU - Ojima M AD - Osaka University Graduate School of Medicine, Suita, Japan. ISNI: 0000 0004 0373 3971. GRID: grid.136593.b FAU - Akeda, Y AU - Akeda Y AD - Osaka University Graduate School of Medicine, Suita, Japan. ISNI: 0000 0004 0373 3971. GRID: grid.136593.b FAU - Tasaki, O AU - Tasaki O AD - Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. ISNI: 0000 0000 8902 2273. GRID: grid.174567.6 FAU - Tomono, K AU - Tomono K AD - Osaka University Graduate School of Medicine, Suita, Japan. ISNI: 0000 0004 0373 3971. GRID: grid.136593.b FAU - Shimazu, T AU - Shimazu T AD - Osaka University Graduate School of Medicine, Suita, Japan. ISNI: 0000 0004 0373 3971. GRID: grid.136593.b FAU - Ono, S AU - Ono S AD - Tokyo Medical University Hachioji Medical Center, Hachioji, Tokyo Japan. GRID: grid.411909.4 FAU - Kubo, T AU - Kubo T AD - National Defense Medical College, Tokorozawa, Saitama Japan. ISNI: 0000 0004 0374 0880. GRID: grid.416614.0 FAU - Suda, S AU - Suda S AD - Tokyo Medical University Hachioji Medical Center, Hachioji, Tokyo Japan. GRID: grid.411909.4 FAU - Ueno, T AU - Ueno T AD - Tokyo Medical University Hachioji Medical Center, Hachioji, Tokyo Japan. GRID: grid.411909.4 FAU - Ikeda, T AU - Ikeda T AD - Tokyo Medical University Hachioji Medical Center, Hachioji, Tokyo Japan. GRID: grid.411909.4 FAU - Hirose, T AU - Hirose T AD - Osaka University Graduate School of Medicine, Suita, Japan. ISNI: 0000 0004 0373 3971. GRID: grid.136593.b FAU - Ogura, H AU - Ogura H AD - Osaka University Graduate School of Medicine, Suita, Japan. ISNI: 0000 0004 0373 3971. GRID: grid.136593.b FAU - Takahashi, H AU - Takahashi H AD - Osaka University Graduate School of Medicine, Suita, Japan. ISNI: 0000 0004 0373 3971. GRID: grid.136593.b FAU - Ojima, M AU - Ojima M AD - Osaka University Graduate School of Medicine, Suita, Japan. ISNI: 0000 0004 0373 3971. GRID: grid.136593.b FAU - Kang, J AU - Kang J AD - Osaka University Graduate School of Medicine, Suita, Japan. ISNI: 0000 0004 0373 3971. GRID: grid.136593.b FAU - Nakamura, Y AU - Nakamura Y AD - Osaka University Graduate School of Medicine, Suita, Japan. ISNI: 0000 0004 0373 3971. GRID: grid.136593.b FAU - Kojima, T AU - Kojima T AD - Osaka University Graduate School of Medicine, Suita, Japan. ISNI: 0000 0004 0373 3971. GRID: grid.136593.b FAU - Shimazu, T AU - Shimazu T AD - Osaka University Graduate School of Medicine, Suita, Japan. ISNI: 0000 0004 0373 3971. GRID: grid.136593.b FAU - Ikeda, T AU - Ikeda T AD - Hachiouji medical center, Tokyo medical university, Tokyo, Japan. ISNI: 0000 0001 0663 3325. GRID: grid.410793.8 FAU - Suda, S AU - Suda S AD - Hachiouji medical center, Tokyo medical university, Tokyo, Japan. ISNI: 0000 0001 0663 3325. GRID: grid.410793.8 FAU - Izutani, Y AU - Izutani Y AD - Hachiouji medical center, Tokyo medical university, Tokyo, Japan. ISNI: 0000 0001 0663 3325. GRID: grid.410793.8 FAU - Ueno, T AU - Ueno T AD - Hachiouji medical center, Tokyo medical university, Tokyo, Japan. ISNI: 0000 0001 0663 3325. GRID: grid.410793.8 FAU - Ono, S AU - Ono S AD - Hachiouji medical center, Tokyo medical university, Tokyo, Japan. ISNI: 0000 0001 0663 3325. GRID: grid.410793.8 FAU - Taniguchi, T AU - Taniguchi T AD - Kanazawa University, Kanazawa, Japan. ISNI: 0000 0001 2308 3329. GRID: grid.9707.9 FAU - O, M AU - O M AD - Kanazawa University Hospital, Kanazawa, Japan. ISNI: 0000 0004 0615 9100. GRID: grid.412002.5 FAU - Dinter, C AU - Dinter C AD - ThermoFisher, Hennigsdorf, Germany FAU - Lotz, J AU - Lotz J AD - Institut fur Klinische Chemie und Laboratoriumsmedizin, Mainz, Germany FAU - Eilers, B AU - Eilers B AD - MVZ Labor Limbach Gruppe, Berlin, Germany FAU - Wissmann, C AU - Wissmann C AD - ThermoFisher, Hennigsdorf, Germany FAU - Lott, R AU - Lott R AD - Institut fur Klinische Chemie und Laboratoriumsmedizin, Mainz, Germany FAU - Meili, M M AU - Meili MM AD - Kantonsspital Aarau, Aarau, Switzerland. ISNI: 0000 0000 8704 3732. GRID: grid.413357.7 FAU - Schuetz, P S AU - Schuetz PS AD - Kantonsspital Aarau, Aarau, Switzerland. ISNI: 0000 0000 8704 3732. GRID: grid.413357.7 FAU - Hawa, H AU - Hawa H AD - King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia. ISNI: 0000 0001 2191 4301. GRID: grid.415310.2 FAU - Sharshir, M AU - Sharshir M AD - King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia. ISNI: 0000 0001 2191 4301. GRID: grid.415310.2 FAU - Aburageila, M AU - Aburageila M AD - King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia. ISNI: 0000 0001 2191 4301. GRID: grid.415310.2 FAU - Salahuddin, N AU - Salahuddin N AD - King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia. ISNI: 0000 0001 2191 4301. GRID: grid.415310.2 FAU - Chantziara, V AU - Chantziara V AD - Saint Savvas Hospital, Athens, Greece. GRID: grid.416564.4 FAU - Georgiou, S AU - Georgiou S AD - Saint Savvas Hospital, Athens, Greece. GRID: grid.416564.4 FAU - Tsimogianni, A AU - Tsimogianni A AD - Saint Savvas Hospital, Athens, Greece. GRID: grid.416564.4 FAU - Alexandropoulos, P AU - Alexandropoulos P AD - Saint Savvas Hospital, Athens, Greece. GRID: grid.416564.4 FAU - Vassi, A AU - Vassi A AD - Saint Savvas Hospital, Athens, Greece. GRID: grid.416564.4 FAU - Lagiou, F AU - Lagiou F AD - Saint Savvas Hospital, Athens, Greece. GRID: grid.416564.4 FAU - Valta, M AU - Valta M AD - Saint Savvas Hospital, Athens, Greece. GRID: grid.416564.4 FAU - Micha, G AU - Micha G AD - Saint Savvas Hospital, Athens, Greece. GRID: grid.416564.4 FAU - Chinou, E AU - Chinou E AD - Saint Savvas Hospital, Athens, Greece. GRID: grid.416564.4 FAU - Michaloudis, G AU - Michaloudis G AD - Saint Savvas Hospital, Athens, Greece. GRID: grid.416564.4 FAU - Kodaira, A AU - Kodaira A AD - Tokyo Medical University, Tokyo, Japan. ISNI: 0000 0001 0663 3325. GRID: grid.410793.8 FAU - Ikeda, T AU - Ikeda T AD - Tokyo Medical University, Hachioji Medical Center, Tokyo, Japan. GRID: grid.411909.4 FAU - Ono, S AU - Ono S AD - Tokyo Medical University, Hachioji Medical Center, Tokyo, Japan. GRID: grid.411909.4 FAU - Ueno, T AU - Ueno T AD - Tokyo Medical University, Hachioji Medical Center, Tokyo, Japan. GRID: grid.411909.4 FAU - Suda, S AU - Suda S AD - Tokyo Medical University, Hachioji Medical Center, Tokyo, Japan. GRID: grid.411909.4 FAU - Izutani, Y AU - Izutani Y AD - Tokyo Medical University, Hachioji Medical Center, Tokyo, Japan. GRID: grid.411909.4 FAU - Imaizumi, H AU - Imaizumi H AD - Tokyo Medical University, Tokyo, Japan. ISNI: 0000 0001 0663 3325. GRID: grid.410793.8 FAU - De la Torre-Prados, M V AU - De la Torre-Prados MV AD - Hospital Virgen de la Victoria, Malaga, Spain. ISNI: 0000 0000 9788 2492. GRID: grid.411062.0 FAU - Garcia-De la Torre, A AU - Garcia-De la Torre A AD - Hospital Virgen de la Victoria, Malaga, Spain. ISNI: 0000 0000 9788 2492. GRID: grid.411062.0 FAU - Enguix-Armada, A AU - Enguix-Armada A AD - Hospital Virgen de la Victoria, Malaga, Spain. ISNI: 0000 0000 9788 2492. GRID: grid.411062.0 FAU - Puerto-Morlan, A AU - Puerto-Morlan A AD - Hospital Virgen de la Victoria, Malaga, Spain. ISNI: 0000 0000 9788 2492. GRID: grid.411062.0 FAU - Perez-Valero, V AU - Perez-Valero V AD - Hospital Virgen de la Victoria, Malaga, Spain. ISNI: 0000 0000 9788 2492. GRID: grid.411062.0 FAU - Garcia-Alcantara, A AU - Garcia-Alcantara A AD - Hospital Virgen de la Victoria, Malaga, Spain. ISNI: 0000 0000 9788 2492. GRID: grid.411062.0 FAU - Bolton, N AU - Bolton N AD - St Helens and Knowsley NHS Trust, Merseyside, UK FAU - Dudziak, J AU - Dudziak J AD - St Helens and Knowsley NHS Trust, Merseyside, UK FAU - Bonney, S AU - Bonney S AD - St Helens and Knowsley NHS Trust, Merseyside, UK FAU - Tridente, A AU - Tridente A AD - St Helens and Knowsley NHS Trust, Merseyside, UK FAU - Nee, P AU - Nee P AD - St Helens and Knowsley NHS Trust, Merseyside, UK FAU - Nicolaes, G AU - Nicolaes G AD - Maastricht University, Maastricht, Netherlands. ISNI: 0000 0001 0481 6099. GRID: grid.5012.6 FAU - Wiewel, M AU - Wiewel M AD - Center for Experimental and Molecular medicine, Amsterdam, Netherlands FAU - Schultz, M AU - Schultz M AD - Academic Medical Center, Amsterdam, Netherlands. ISNI: 0000000404654431. GRID: grid.5650.6 FAU - Wildhagen, K AU - Wildhagen K AD - Maastricht University, Maastricht, Netherlands. ISNI: 0000 0001 0481 6099. GRID: grid.5012.6 FAU - Horn, J AU - Horn J AD - Academic Medical Center, Amsterdam, Netherlands. ISNI: 0000000404654431. GRID: grid.5650.6 FAU - Schrijver, R AU - Schrijver R AD - Maastricht University, Maastricht, Netherlands. ISNI: 0000 0001 0481 6099. GRID: grid.5012.6 FAU - Van der Poll, T AU - Van der Poll T AD - Center for Experimental and Molecular medicine, Amsterdam, Netherlands FAU - Reutelingsperger, C AU - Reutelingsperger C AD - Maastricht University, Maastricht, Netherlands. ISNI: 0000 0001 0481 6099. GRID: grid.5012.6 FAU - Pillai, S AU - Pillai S AD - NISCHR Haemostasis Biomarker Research Unit, Swansea, UK FAU - Davies, G AU - Davies G AD - NISCHR Haemostasis Biomarker Research Unit, Swansea, UK FAU - Mills, G AU - Mills G AD - NISCHR Haemostasis Biomarker Research Unit, Swansea, UK FAU - Aubrey, R AU - Aubrey R AD - NISCHR Haemostasis Biomarker Research Unit, Swansea, UK FAU - Morris, K AU - Morris K AD - NISCHR Haemostasis Biomarker Research Unit, Swansea, UK FAU - Williams, P AU - Williams P AD - NISCHR Haemostasis Biomarker Research Unit, Swansea, UK FAU - Evans, P AU - Evans P AD - NISCHR Haemostasis Biomarker Research Unit, Swansea, UK FAU - Gayat, E G AU - Gayat EG AD - Hopital Lariboisiere, Paris, France. ISNI: 0000 0000 9725 279X. GRID: grid.411296.9 FAU - Struck, J AU - Struck J AD - Sphingotec, Berlin, Germany FAU - Cariou, A AU - Cariou A AD - Hopital Cochin, Paris, France. ISNI: 0000 0001 0274 3893. GRID: grid.411784.f FAU - Deye, N AU - Deye N AD - Hopital Lariboisiere, Paris, France. ISNI: 0000 0000 9725 279X. GRID: grid.411296.9 FAU - Guidet, B AU - Guidet B AD - Hopital Saint-Antoine, Paris, France. ISNI: 0000 0004 1937 1100. GRID: grid.412370.3 FAU - Jabert, S AU - Jabert S AD - CHRU de Montpellier, Montpellier, France. ISNI: 0000 0000 9961 060X. GRID: grid.157868.5 FAU - Launay, J AU - Launay J AD - Hopital Lariboisiere, Paris, France. ISNI: 0000 0000 9725 279X. GRID: grid.411296.9 FAU - Legrand, M AU - Legrand M AD - Hopital Saint-Louis, Paris, France. ISNI: 0000 0001 2300 6614. GRID: grid.413328.f FAU - Leone, M AU - Leone M AD - AP-HM, Marseille, France. ISNI: 0000 0001 0407 1584. GRID: grid.414336.7 FAU - Resche-Rigon, M AU - Resche-Rigon M AD - Hopital Saint-Louis, Paris, France. ISNI: 0000 0001 2300 6614. GRID: grid.413328.f FAU - Vicaut, E AU - Vicaut E AD - Hopital Lariboisiere, Paris, France. ISNI: 0000 0000 9725 279X. GRID: grid.411296.9 FAU - Vieillard-Baron, A AU - Vieillard-Baron A AD - Hopital Ambroise Pare, Paris, France. ISNI: 0000 0000 9982 5352. GRID: grid.413756.2 FAU - Mebazaa, A AU - Mebazaa A AD - Hopital Lariboisiere, Paris, France. ISNI: 0000 0000 9725 279X. GRID: grid.411296.9 FAU - Arnold, R AU - Arnold R AD - Christiana Care Health System, Newark, USA. ISNI: 0000 0004 0444 1241. GRID: grid.414316.5 FAU - Capan, M AU - Capan M AD - Christiana Care Health System, Newark, USA. ISNI: 0000 0004 0444 1241. GRID: grid.414316.5 FAU - Linder, A AU - Linder A AD - Skane University Hospital, Lund University, Lund, Sweden. ISNI: 0000 0001 0930 2361. GRID: grid.4514.4 FAU - Akesson, P AU - Akesson P AD - Skane University Hospital, Lund University, Lund, Sweden. ISNI: 0000 0001 0930 2361. GRID: grid.4514.4 FAU - Popescu, M AU - Popescu M AD - Carol Davila University of Medicine and Pharmacy, Bucharest, Romania. ISNI: 0000 0000 9828 7548. GRID: grid.8194.4 FAU - Tomescu, D AU - Tomescu D AD - Carol Davila University of Medicine and Pharmacy, Bucharest, Romania. ISNI: 0000 0000 9828 7548. GRID: grid.8194.4 FAU - Sprung, C L AU - Sprung CL AD - Hadassah-Hebrew University Medical Center, Jerusalem, Israel. ISNI: 0000 0001 2221 2926. GRID: grid.17788.31 FAU - Calderon Morales, R AU - Calderon Morales R AD - Hadassah-Hebrew University Medical Center, Jerusalem, Israel. ISNI: 0000 0001 2221 2926. GRID: grid.17788.31 FAU - Munteanu, G AU - Munteanu G AD - Hadassah-Hebrew University Medical Center, Jerusalem, Israel. ISNI: 0000 0001 2221 2926. GRID: grid.17788.31 FAU - Orenbuch-Harroch, E AU - Orenbuch-Harroch E AD - Hadassah-Hebrew University Medical Center, Jerusalem, Israel. ISNI: 0000 0001 2221 2926. GRID: grid.17788.31 FAU - Levin, P AU - Levin P AD - Hadassah-Hebrew University Medical Center, Jerusalem, Israel. ISNI: 0000 0001 2221 2926. GRID: grid.17788.31 FAU - Kasdan, H AU - Kasdan H AD - LeukoDx, Jerusalem, Israel FAU - Reiter, A AU - Reiter A AD - LeukoDx, Jerusalem, Israel FAU - Volker, T AU - Volker T AD - LeukoDx, Jerusalem, Israel FAU - Himmel, Y AU - Himmel Y AD - LeukoDx, Jerusalem, Israel FAU - Cohen, Y AU - Cohen Y AD - LeukoDx, Jerusalem, Israel FAU - Meissonnier, J AU - Meissonnier J AD - LeukoDx, Jerusalem, Israel FAU - Girard, L AU - Girard L AD - Abionic SA, Lausanne, Switzerland FAU - Rebeaud, F AU - Rebeaud F AD - Abionic SA, Lausanne, Switzerland FAU - Herrmann, I AU - Herrmann I AD - Swiss Federal Laboratories (Empa), St. Gallen, Switzerland FAU - Delwarde, B AU - Delwarde B AD - Pathophysiology of injury induced immunosuppression (PI3) Lab, Lyon 1 University / Hospices Civils de Lyon / bioMerieux, Lyon, France FAU - Peronnet, E AU - Peronnet E AD - Pathophysiology of injury induced immunosuppression (PI3) Lab, Lyon 1 University / Hospices Civils de Lyon / bioMerieux, Lyon, France FAU - Cerrato, E AU - Cerrato E AD - Pathophysiology of injury induced immunosuppression (PI3) Lab, Lyon 1 University / Hospices Civils de Lyon / bioMerieux, Lyon, France FAU - Venet, F AU - Venet F AD - Pathophysiology of injury induced immunosuppression (PI3) Lab, Lyon 1 University / Hospices Civils de Lyon / bioMerieux, Lyon, France FAU - Lepape, A AU - Lepape A AD - Pathophysiology of injury induced immunosuppression (PI3) Lab, Lyon 1 University / Hospices Civils de Lyon / bioMerieux, Lyon, France FAU - Rimmele, T AU - Rimmele T AD - Pathophysiology of injury induced immunosuppression (PI3) Lab, Lyon 1 University / Hospices Civils de Lyon / bioMerieux, Lyon, France FAU - Monneret, G AU - Monneret G AD - Pathophysiology of injury induced immunosuppression (PI3) Lab, Lyon 1 University / Hospices Civils de Lyon / bioMerieux, Lyon, France FAU - Textoris, J AU - Textoris J AD - Pathophysiology of injury induced immunosuppression (PI3) Lab, Lyon 1 University / Hospices Civils de Lyon / bioMerieux, Lyon, France FAU - Beloborodova, N AU - Beloborodova N AD - Negovsky V.A. Research Institute of General Reanimatology, Moscow, Russia FAU - Moroz, V AU - Moroz V AD - Negovsky V.A. Research Institute of General Reanimatology, Moscow, Russia FAU - Osipov, A AU - Osipov A AD - Negovsky V.A. Research Institute of General Reanimatology, Moscow, Russia FAU - Bedova, A AU - Bedova A AD - Negovsky V.A. Research Institute of General Reanimatology, Moscow, Russia FAU - Sarshor, Y AU - Sarshor Y AD - Negovsky V.A. Research Institute of General Reanimatology, Moscow, Russia FAU - Pautova, A AU - Pautova A AD - Negovsky V.A. Research Institute of General Reanimatology, Moscow, Russia FAU - Sergeev, A AU - Sergeev A AD - Negovsky V.A. Research Institute of General Reanimatology, Moscow, Russia FAU - Chernevskaya, E AU - Chernevskaya E AD - Negovsky V.A. Research Institute of General Reanimatology, Moscow, Russia FAU - Odermatt, J AU - Odermatt J AD - Kantonsspital Aarau, Aarau, Switzerland. ISNI: 0000 0000 8704 3732. GRID: grid.413357.7 FAU - Bolliger, R AU - Bolliger R AD - Kantonsspital Aarau, Aarau, Switzerland. ISNI: 0000 0000 8704 3732. GRID: grid.413357.7 FAU - Hersberger, L AU - Hersberger L AD - Kantonsspital Aarau, Aarau, Switzerland. ISNI: 0000 0000 8704 3732. GRID: grid.413357.7 FAU - Ottiger, M AU - Ottiger M AD - Kantonsspital Aarau, Aarau, Switzerland. ISNI: 0000 0000 8704 3732. GRID: grid.413357.7 FAU - Christ-Crain, M AU - Christ-Crain M AD - University Hospital Basel, Basel, Switzerland. GRID: grid.410567.1 FAU - Mueller, B AU - Mueller B AD - Kantonsspital Aarau, Aarau, Switzerland. ISNI: 0000 0000 8704 3732. GRID: grid.413357.7 FAU - Schuetz, P AU - Schuetz P AD - Kantonsspital Aarau, Aarau, Switzerland. ISNI: 0000 0000 8704 3732. GRID: grid.413357.7 FAU - Sharma, N K AU - Sharma NK AD - UNIFESP, Sao Paulo, Brazil. ISNI: 0000 0001 0514 7202. GRID: grid.411249.b FAU - Tashima, A K AU - Tashima AK AD - UNIFESP, Sao Paulo, Brazil. ISNI: 0000 0001 0514 7202. GRID: grid.411249.b FAU - Brunialti, M K AU - Brunialti MK AD - UNIFESP, Sao Paulo, Brazil. ISNI: 0000 0001 0514 7202. GRID: grid.411249.b FAU - Machado, F R AU - Machado FR AD - UNIFESP, Sao Paulo, Brazil. ISNI: 0000 0001 0514 7202. GRID: grid.411249.b FAU - Assuncao, M AU - Assuncao M AD - Albert Einstein Hospital, Sao Paulo, Brazil. ISNI: 0000 0001 0385 1941. GRID: grid.413562.7 FAU - Rigato, O AU - Rigato O AD - Sirio Libanes Hospital, Sao Paulo, Brazil FAU - Salomao, R AU - Salomao R AD - UNIFESP, Sao Paulo, Brazil. ISNI: 0000 0001 0514 7202. GRID: grid.411249.b FAU - Cajander, S C AU - Cajander SC AD - Faculty of Medicine and Health Orebro University, Orebro, Sweden. ISNI: 0000 0001 0738 8966. GRID: grid.15895.30 FAU - Rasmussen, G AU - Rasmussen G AD - Faculty of Medicine and Health Orebro University, Orebro, Sweden. ISNI: 0000 0001 0738 8966. GRID: grid.15895.30 FAU - Tina, E AU - Tina E AD - Faculty of Medicine and Health Orebro University, Orebro, Sweden. ISNI: 0000 0001 0738 8966. GRID: grid.15895.30 FAU - Soderquist, B AU - Soderquist B AD - Faculty of Medicine and Health Orebro University, Orebro, Sweden. ISNI: 0000 0001 0738 8966. GRID: grid.15895.30 FAU - Kallman, J AU - Kallman J AD - Faculty of Medicine and Health Orebro University, Orebro, Sweden. ISNI: 0000 0001 0738 8966. GRID: grid.15895.30 FAU - Stralin, K AU - Stralin K AD - Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden. ISNI: 0000 0000 9241 5705. GRID: grid.24381.3c FAU - Lange, A L AU - Lange AL AD - Faculty of Medicine and Health, Orebro, Sweden FAU - Sunden-Cullberg, J S AU - Sunden-Cullberg JS AD - Center for Infectious Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden. ISNI: 0000 0000 9241 5705. GRID: grid.24381.3c FAU - Magnuson, A M AU - Magnuson AM AD - Faculty of Medicine and Health, Orebro, Sweden FAU - Hultgren, O H AU - Hultgren OH AD - Faculty of Medicine and Health, Orebro, Sweden FAU - Davies, G AU - Davies G AD - NISCHR Haemostasis Biomarker Research Unit, Swansea, UK FAU - Pillai, S AU - Pillai S AD - NISCHR Haemostasis Biomarker Research Unit, Swansea, UK FAU - Mills, G AU - Mills G AD - NISCHR Haemostasis Biomarker Research Unit, Swansea, UK FAU - Aubrey, R AU - Aubrey R AD - NISCHR Haemostasis Biomarker Research Unit, Swansea, UK FAU - Morris, K AU - Morris K AD - NISCHR Haemostasis Biomarker Research Unit, Swansea, UK FAU - Williams, P AU - Williams P AD - NISCHR Haemostasis Biomarker Research Unit, Swansea, UK FAU - Evans, P AU - Evans P AD - NISCHR Haemostasis Biomarker Research Unit, Swansea, UK FAU - Pillai, S AU - Pillai S AD - NISCHR Haemostasis Biomarker Research Unit, Swansea, UK FAU - Davies, G AU - Davies G AD - NISCHR Haemostasis Biomarker Research Unit, Swansea, UK FAU - Mills, G AU - Mills G AD - NISCHR Haemostasis Biomarker Research Unit, Swansea, UK FAU - Aubrey, R AU - Aubrey R AD - NISCHR Haemostasis Biomarker Research Unit, Swansea, UK FAU - Morris, K AU - Morris K AD - NISCHR Haemostasis Biomarker Research Unit, Swansea, UK FAU - Williams, P AU - Williams P AD - NISCHR Haemostasis Biomarker Research Unit, Swansea, UK FAU - Evans, P AU - Evans P AD - NISCHR Haemostasis Biomarker Research Unit, Swansea, UK FAU - Pillai, S AU - Pillai S AD - NISCHR Haemostasis Biomarker Research Unit, Swansea, UK FAU - Davies, G AU - Davies G AD - NISCHR Haemostasis Biomarker Research Unit, Swansea, UK FAU - Mills, G AU - Mills G AD - NISCHR Haemostasis Biomarker Research Unit, Swansea, UK FAU - Aubrey, R AU - Aubrey R AD - NISCHR Haemostasis Biomarker Research Unit, Swansea, UK FAU - Morris, K AU - Morris K AD - NISCHR Haemostasis Biomarker Research Unit, Swansea, UK FAU - Williams, P AU - Williams P AD - NISCHR Haemostasis Biomarker Research Unit, Swansea, UK FAU - Evans, P AU - Evans P AD - NISCHR Haemostasis Biomarker Research Unit, Swansea, UK FAU - Van der Geest, P AU - Van der Geest P AD - Erasmus Medical Center, Rotterdam, Netherlands. ISNI: 000000040459992X. GRID: grid.5645.2 FAU - Mohseni, M AU - Mohseni M AD - Erasmus Medical Center, Rotterdam, Netherlands. ISNI: 000000040459992X. GRID: grid.5645.2 FAU - Linssen, J AU - Linssen J AD - University Witten/Herdecke, Witten, Germany. ISNI: 0000 0000 9024 6397. GRID: grid.412581.b FAU - De Jonge, R AU - De Jonge R AD - Erasmus Medical Center, Rotterdam, Netherlands. ISNI: 000000040459992X. GRID: grid.5645.2 FAU - Duran, S AU - Duran S AD - Maasstad Ziekenhuis, Rotterdam, Netherlands. ISNI: 0000 0004 0460 0556. GRID: grid.416213.3 FAU - Groeneveld, J AU - Groeneveld J AD - Erasmus Medical Center, Rotterdam, Netherlands. ISNI: 000000040459992X. GRID: grid.5645.2 FAU - Miller, R III AU - Miller R III AD - Intermountain Healthcare, Salt Lake City, USA. ISNI: 0000 0004 0460 774X. GRID: grid.420884.2 FAU - Lopansri, B K AU - Lopansri BK AD - Intermountain Healthcare, Salt Lake City, USA. ISNI: 0000 0004 0460 774X. GRID: grid.420884.2 FAU - McHugh, L C AU - McHugh LC AD - Immunexpress, Seattle, USA FAU - Seldon, A AU - Seldon A AD - Immunexpress, Seattle, USA FAU - Burke, J P AU - Burke JP AD - Intermountain Healthcare, Salt Lake City, USA. ISNI: 0000 0004 0460 774X. GRID: grid.420884.2 FAU - Johnston, J AU - Johnston J AD - Lewisham and Greenwich NHS Trust, London, UK. GRID: grid.429537.e FAU - Reece-Anthony, R AU - Reece-Anthony R AD - Lewisham and Greenwich NHS Trust, London, UK. GRID: grid.429537.e FAU - Bond, A AU - Bond A AD - Lewisham and Greenwich NHS Trust, London, UK. GRID: grid.429537.e FAU - Molokhia, A AU - Molokhia A AD - Lewisham and Greenwich NHS Trust, London, UK. GRID: grid.429537.e FAU - Mcgrath, C AU - Mcgrath C AD - Wirral trust, Merseyside, UK FAU - Nsutebu, E AU - Nsutebu E AD - RLBUHT, Liverpool, UK FAU - Bank Pedersen, P AU - Bank Pedersen P AD - Department of Emergency Medicine, Odense University Hospital, Odense C, Denmark. ISNI: 0000 0004 0512 5013. GRID: grid.7143.1 FAU - Pilsgaard Henriksen, D AU - Pilsgaard Henriksen D AD - Department of Respiratory Medicine, Odense University Hospital, Odense C, Denmark. ISNI: 0000 0004 0512 5013. GRID: grid.7143.1 FAU - Mikkelsen, S AU - Mikkelsen S AD - Department of Anaesthesiology and Intensive Care Medicine, Odense University Hospital, Odense C, Denmark. ISNI: 0000 0004 0512 5013. GRID: grid.7143.1 FAU - Touborg Lassen, A AU - Touborg Lassen A AD - Wirral trust, Merseyside, UK FAU - Tincu, R AU - Tincu R AD - Bucharest Clinical Emergency Hospital, Bucharest, Romania FAU - Cobilinschi, C AU - Cobilinschi C AD - Bucharest Clinical Emergency Hospital, Bucharest, Romania FAU - Tomescu, D AU - Tomescu D AD - Fundeni Clinical Institute, Bucharest, Romania. ISNI: 0000 0004 0540 9980. GRID: grid.415180.9 FAU - Ghiorghiu, Z AU - Ghiorghiu Z AD - Bucharest Clinical Emergency Hospital, Bucharest, Romania FAU - Macovei, R AU - Macovei R AD - Bucharest Clinical Emergency Hospital, Bucharest, Romania FAU - Wiewel, M A AU - Wiewel MA AD - Amsterdam Medical Center, Amsterdam, Netherlands. ISNI: 0000000404654431. GRID: grid.5650.6 FAU - Harmon, M B AU - Harmon MB AD - Amsterdam Medical Center, Amsterdam, Netherlands. ISNI: 0000000404654431. GRID: grid.5650.6 FAU - Van Vught, L A AU - Van Vught LA AD - Amsterdam Medical Center, Amsterdam, Netherlands. ISNI: 0000000404654431. GRID: grid.5650.6 FAU - Scicluna, B P AU - Scicluna BP AD - Amsterdam Medical Center, Amsterdam, Netherlands. ISNI: 0000000404654431. GRID: grid.5650.6 FAU - Hoogendijk, A J AU - Hoogendijk AJ AD - Amsterdam Medical Center, Amsterdam, Netherlands. ISNI: 0000000404654431. GRID: grid.5650.6 FAU - Horn, J AU - Horn J AD - Amsterdam Medical Center, Amsterdam, Netherlands. ISNI: 0000000404654431. GRID: grid.5650.6 FAU - Zwinderman, A H AU - Zwinderman AH AD - Amsterdam Medical Center, Amsterdam, Netherlands. ISNI: 0000000404654431. GRID: grid.5650.6 FAU - Cremer, O L AU - Cremer OL AD - University Medical Center Utrecht, Utrecht, Netherlands. ISNI: 0000000090126352. GRID: grid.7692.a FAU - Bonten, M J AU - Bonten MJ AD - University Medical Center Utrecht, Utrecht, Netherlands. ISNI: 0000000090126352. GRID: grid.7692.a FAU - Schultz, M J AU - Schultz MJ AD - Amsterdam Medical Center, Amsterdam, Netherlands. ISNI: 0000000404654431. GRID: grid.5650.6 FAU - Van der Poll, T AU - Van der Poll T AD - Amsterdam Medical Center, Amsterdam, Netherlands. ISNI: 0000000404654431. GRID: grid.5650.6 FAU - Juffermans, N P AU - Juffermans NP AD - Amsterdam Medical Center, Amsterdam, Netherlands. ISNI: 0000000404654431. GRID: grid.5650.6 FAU - Wiersinga, W J AU - Wiersinga WJ AD - Amsterdam Medical Center, Amsterdam, Netherlands. ISNI: 0000000404654431. GRID: grid.5650.6 FAU - Eren, G AU - Eren G AD - Bakirkoy Dr.Sadi Konuk Training and Research Hospital, Istanbul, Turkey. ISNI: 0000 0004 0419 1043. GRID: grid.414177.0 FAU - Tekdos, Y AU - Tekdos Y AD - Bakirkoy Dr.Sadi Konuk Training and Research Hospital, Istanbul, Turkey. ISNI: 0000 0004 0419 1043. GRID: grid.414177.0 FAU - Dogan, M AU - Dogan M AD - Bakirkoy Dr.Sadi Konuk Training and Research Hospital, Istanbul, Turkey. ISNI: 0000 0004 0419 1043. GRID: grid.414177.0 FAU - Acicbe, O AU - Acicbe O AD - Bakirkoy Dr.Sadi Konuk Training and Research Hospital, Istanbul, Turkey. ISNI: 0000 0004 0419 1043. GRID: grid.414177.0 FAU - Kaya, E AU - Kaya E AD - Bakirkoy Dr.Sadi Konuk Training and Research Hospital, Istanbul, Turkey. ISNI: 0000 0004 0419 1043. GRID: grid.414177.0 FAU - Hergunsel, O AU - Hergunsel O AD - Bakirkoy Dr.Sadi Konuk Training and Research Hospital, Istanbul, Turkey. ISNI: 0000 0004 0419 1043. GRID: grid.414177.0 FAU - Alsolamy, S AU - Alsolamy S AD - King Saud bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research Center, Riyadh, Saudi Arabia. ISNI: 0000 0004 0608 0662. GRID: grid.412149.b FAU - Ghamdi, G AU - Ghamdi G AD - King Saud bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research Center, Riyadh, Saudi Arabia. ISNI: 0000 0004 0608 0662. GRID: grid.412149.b FAU - Alswaidan, L AU - Alswaidan L AD - King Saud bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research Center, Riyadh, Saudi Arabia. ISNI: 0000 0004 0608 0662. GRID: grid.412149.b FAU - Alharbi, S AU - Alharbi S AD - King Saud bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research Center, Riyadh, Saudi Arabia. ISNI: 0000 0004 0608 0662. GRID: grid.412149.b FAU - Alenezi, F AU - Alenezi F AD - King Saud bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research Center, Riyadh, Saudi Arabia. ISNI: 0000 0004 0608 0662. GRID: grid.412149.b FAU - Arabi, Y AU - Arabi Y AD - King Saud bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research Center, Riyadh, Saudi Arabia. ISNI: 0000 0004 0608 0662. GRID: grid.412149.b FAU - Heaton, J AU - Heaton J AD - Lewisham and Greenwich NHS Trust, London, UK. GRID: grid.429537.e FAU - Boyce, A AU - Boyce A AD - Lewisham and Greenwich NHS Trust, London, UK. GRID: grid.429537.e FAU - Nolan, L AU - Nolan L AD - Lewisham and Greenwich NHS Trust, London, UK. GRID: grid.429537.e FAU - Johnston, J AU - Johnston J AD - Lewisham and Greenwich NHS Trust, London, UK. GRID: grid.429537.e FAU - Dukoff-Gordon, A AU - Dukoff-Gordon A AD - Lewisham and Greenwich NHS Trust, London, UK. GRID: grid.429537.e FAU - Dean, A AU - Dean A AD - Lewisham and Greenwich NHS Trust, London, UK. GRID: grid.429537.e FAU - Molokhia, A AU - Molokhia A AD - Lewisham and Greenwich NHS Trust, London, UK. GRID: grid.429537.e FAU - Mann Ben Yehudah, T AU - Mann Ben Yehudah T AD - Assaf Harofeh MC, Beer Yaakov, Israel FAU - Fleischmann, C AU - Fleischmann C AD - Jena University Hopital, Jena, Germany. ISNI: 0000 0001 1939 2794. GRID: grid.9613.d FAU - Thomas-Rueddel, D AU - Thomas-Rueddel D AD - Jena University Hopital, Jena, Germany. ISNI: 0000 0001 1939 2794. GRID: grid.9613.d FAU - Haas, C AU - Haas C AD - Jena University Hopital, Jena, Germany. ISNI: 0000 0001 1939 2794. GRID: grid.9613.d FAU - Dennler, U AU - Dennler U AD - Jena University Hopital, Jena, Germany. ISNI: 0000 0001 1939 2794. GRID: grid.9613.d FAU - Reinhart, K AU - Reinhart K AD - Jena University Hopital, Jena, Germany. ISNI: 0000 0001 1939 2794. GRID: grid.9613.d FAU - Suntornlohanakul, O AU - Suntornlohanakul O AD - Prince of Songkla University, Hat Yai, Thailand. ISNI: 0000 0004 0470 1162. GRID: grid.7130.5 FAU - Khwannimit, B AU - Khwannimit B AD - Division of Critical Care Medicine, Hat Yai, Thailand FAU - Breckenridge, F AU - Breckenridge F AD - Glasgow Royal Infirmary, Glasgow, UK. ISNI: 0000 0000 9825 7840. GRID: grid.411714.6 FAU - Puxty, A AU - Puxty A AD - Glasgow Royal Infirmary, Glasgow, UK. ISNI: 0000 0000 9825 7840. GRID: grid.411714.6 FAU - Szturz, P AU - Szturz P AD - University Hospital and Faculty of Medicine Ostrava University, Ostrava, Czech Republic. ISNI: 0000 0004 0609 0692. GRID: grid.412727.5 FAU - Folwarzcny, P AU - Folwarzcny P AD - University Hospital and Faculty of Medicine Ostrava University, Ostrava, Czech Republic. ISNI: 0000 0004 0609 0692. GRID: grid.412727.5 FAU - Svancara, J AU - Svancara J AD - Institute of Biostatistics and analyses, Masaryk University, Brno, Czech Republic. ISNI: 0000 0001 2194 0956. GRID: grid.10267.32 FAU - Kula, R AU - Kula R AD - University Hospital and Faculty of Medicine Ostrava University, Ostrava, Czech Republic. ISNI: 0000 0004 0609 0692. GRID: grid.412727.5 FAU - Sevcik, P AU - Sevcik P AD - University Hospital and Faculty of Medicine Ostrava University, Ostrava, Czech Republic. ISNI: 0000 0004 0609 0692. GRID: grid.412727.5 FAU - Caneva, L AU - Caneva L AD - Universita degli studi di Pavia, scuola di specialita: Anestesia e Rianimazione, Pavia, Italy. ISNI: 0000 0004 1762 5736. GRID: grid.8982.b FAU - Casazza, A AU - Casazza A AD - UOC Anestesia e Rianimazione Ospedale Civile di Vigevano, AO Pavia, Vigevano, Italy FAU - Bellazzi, E AU - Bellazzi E AD - UOC Anestesia e Rianimazione Ospedale Civile di Vigevano, AO Pavia, Vigevano, Italy FAU - Marra, S AU - Marra S AD - Universita degli studi di Pavia, Pavia, Italy. ISNI: 0000 0004 1762 5736. GRID: grid.8982.b FAU - Pagani, L AU - Pagani L AD - Universita degli studi di Pavia, Pavia, Italy. ISNI: 0000 0004 1762 5736. GRID: grid.8982.b FAU - Vetere, M AU - Vetere M AD - UOC Anestesia e Rianimazione Ospedale Civile di Vigevano, AO Pavia, Vigevano, Italy FAU - Vanzino, R AU - Vanzino R AD - UOC Anestesia e Rianimazione Ospedale Civile di Vigevano, AO Pavia, Vigevano, Italy FAU - Ciprandi, D AU - Ciprandi D AD - UOC Anestesia e Rianimazione Ospedale Civile di Vigevano, AO Pavia, Vigevano, Italy FAU - Preda, R AU - Preda R AD - UOC Anestesia e Rianimazione Ospedale Civile di Vigevano, AO Pavia, Vigevano, Italy FAU - Boschi, R AU - Boschi R AD - UOC Anestesia e Rianimazione Ospedale Civile di Vigevano, AO Pavia, Vigevano, Italy FAU - Carnevale, L AU - Carnevale L AD - UOC Anestesia e Rianimazione Ospedale Civile di Vigevano, AO Pavia, Vigevano, Italy FAU - Lopez, V AU - Lopez V AD - Hospital O'horan, Merida, Mexico FAU - Aguilar Arzapalo, M AU - Aguilar Arzapalo M AD - Hospital O'horan, Merida, Mexico FAU - Barradas, L AU - Barradas L AD - Hospital O'horan, Merida, Mexico FAU - Escalante, A AU - Escalante A AD - Hospital O'horan, Merida, Mexico FAU - Gongora, J AU - Gongora J AD - Hospital O'horan, Merida, Mexico FAU - Cetina, M AU - Cetina M AD - Hospital O'horan, Merida, Mexico FAU - Adamik, B AU - Adamik B AD - Department of Anaesthesiology and Intensive Therapy, Medical University, Wroclaw, Poland. ISNI: 0000 0001 1090 049X. GRID: grid.4495.c FAU - Jakubczyk, D AU - Jakubczyk D AD - Department of Anaesthesiology and Intensive Therapy, Medical University, Wroclaw, Poland. ISNI: 0000 0001 1090 049X. GRID: grid.4495.c FAU - Kubler, A AU - Kubler A AD - Department of Anaesthesiology and Intensive Therapy, Medical University, Wroclaw, Poland. ISNI: 0000 0001 1090 049X. GRID: grid.4495.c FAU - Radford, A AU - Radford A AD - AKPA, Waltham, USA FAU - Lee, T AU - Lee T AD - St. Paul's Hospital, Vancouver, Canada. ISNI: 0000 0000 8589 2327. GRID: grid.416553.0 FAU - Singer, J AU - Singer J AD - St. Paul's Hospital, Vancouver, Canada. ISNI: 0000 0000 8589 2327. GRID: grid.416553.0 FAU - Boyd, J AU - Boyd J AD - St. Paul's Hospital, Vancouver, Canada. ISNI: 0000 0000 8589 2327. GRID: grid.416553.0 FAU - Fineberg, D AU - Fineberg D AD - AKPA, Waltham, USA FAU - Williams, M AU - Williams M AD - AKPA, Waltham, USA FAU - Russell, J AU - Russell J AD - St. Paul's Hospital, Vancouver, Canada. ISNI: 0000 0000 8589 2327. GRID: grid.416553.0 FAU - Scarlatescu, E AU - Scarlatescu E AD - Fundeni Clinical Institute, Bucharest, Romania. ISNI: 0000 0004 0540 9980. GRID: grid.415180.9 FAU - Tomescu, D AU - Tomescu D AD - Fundeni Clinical Institute, Bucharest, Romania. ISNI: 0000 0004 0540 9980. GRID: grid.415180.9 FAU - Droc, G AU - Droc G AD - Fundeni Clinical Institute, Bucharest, Romania. ISNI: 0000 0004 0540 9980. GRID: grid.415180.9 FAU - Arama, S AU - Arama S AD - University of Medicine and Pharmacy "Carol Davila", Bucharest, Romania. ISNI: 0000 0000 9828 7548. GRID: grid.8194.4 FAU - Muller, M AU - Muller M AD - Acedemisch Medisch Centrum, Amsterdam, Netherlands FAU - Straat, M AU - Straat M AD - Acedemisch Medisch Centrum, Amsterdam, Netherlands FAU - Zeerleder, S S AU - Zeerleder SS AD - Acedemisch Medisch Centrum, Amsterdam, Netherlands FAU - Juffermans, N P AU - Juffermans NP AD - Acedemisch Medisch Centrum, Amsterdam, Netherlands FAU - Fuchs, C F AU - Fuchs CF AD - University Hospital of Greifswald, Greifswald, Germany. ISNI: 0000 0000 9116 8976. GRID: grid.412469.c FAU - Scheer, C S AU - Scheer CS AD - University Hospital of Greifswald, Greifswald, Germany. ISNI: 0000 0000 9116 8976. GRID: grid.412469.c FAU - Wauschkuhn, S W AU - Wauschkuhn SW AD - University Hospital of Greifswald, Greifswald, Germany. ISNI: 0000 0000 9116 8976. GRID: grid.412469.c FAU - Vollmer, M V AU - Vollmer MV AD - University Hospital of Greifswald, Greifswald, Germany. ISNI: 0000 0000 9116 8976. GRID: grid.412469.c FAU - Meissner, K M AU - Meissner KM AD - University Hospital of Greifswald, Greifswald, Germany. ISNI: 0000 0000 9116 8976. GRID: grid.412469.c FAU - Kuhn, S K AU - Kuhn SK AD - University Hospital of Greifswald, Greifswald, Germany. ISNI: 0000 0000 9116 8976. GRID: grid.412469.c FAU - Hahnenkamp, K H AU - Hahnenkamp KH AD - University Hospital of Greifswald, Greifswald, Germany. ISNI: 0000 0000 9116 8976. GRID: grid.412469.c FAU - Rehberg, S R AU - Rehberg SR AD - University Hospital of Greifswald, Greifswald, Germany. ISNI: 0000 0000 9116 8976. GRID: grid.412469.c FAU - Grundling, M G AU - Grundling MG AD - University Hospital of Greifswald, Greifswald, Germany. ISNI: 0000 0000 9116 8976. GRID: grid.412469.c FAU - Yamamoto, N AU - Yamamoto N AD - Division of Infection Control and Prevention, Osaka University Graduate School of Medicine, Suita, Japan. ISNI: 0000 0004 0373 3971. GRID: grid.136593.b FAU - Ojima, M AU - Ojima M AD - Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Suita, Japan. ISNI: 0000 0004 0373 3971. GRID: grid.136593.b FAU - Hamaguchi, S AU - Hamaguchi S AD - Division of Infection Control and Prevention, Osaka University Graduate School of Medicine, Suita, Japan. ISNI: 0000 0004 0373 3971. GRID: grid.136593.b FAU - Hirose, T AU - Hirose T AD - Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Suita, Japan. ISNI: 0000 0004 0373 3971. GRID: grid.136593.b FAU - Akeda, Y AU - Akeda Y AD - Division of Infection Control and Prevention, Osaka University Graduate School of Medicine, Suita, Japan. ISNI: 0000 0004 0373 3971. GRID: grid.136593.b FAU - Takegawa, R AU - Takegawa R AD - Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Suita, Japan. ISNI: 0000 0004 0373 3971. GRID: grid.136593.b FAU - Tasaki, O AU - Tasaki O AD - Department of Emergency Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. ISNI: 0000 0000 8902 2273. GRID: grid.174567.6 FAU - Shimazu, T AU - Shimazu T AD - Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Suita, Japan. ISNI: 0000 0004 0373 3971. GRID: grid.136593.b FAU - Tomono, K AU - Tomono K AD - Division of Infection Control and Prevention, Osaka University Graduate School of Medicine, Suita, Japan. ISNI: 0000 0004 0373 3971. GRID: grid.136593.b FAU - Gomez-Sanchez, E AU - Gomez-Sanchez E AD - Hospital Clinico Universitario de Valladolid, Valladolid, Spain. ISNI: 0000 0000 9274 367X. GRID: grid.411057.6 FAU - Heredia-Rodriguez, M AU - Heredia-Rodriguez M AD - Hospital Clinico Universitario de Valladolid, Valladolid, Spain. ISNI: 0000 0000 9274 367X. GRID: grid.411057.6 FAU - Alvarez-Fuente, E AU - Alvarez-Fuente E AD - Hospital Clinico Universitario de Valladolid, Valladolid, Spain. ISNI: 0000 0000 9274 367X. GRID: grid.411057.6 FAU - Lorenzo-Lopez, M AU - Lorenzo-Lopez M AD - Hospital Clinico Universitario de Valladolid, Valladolid, Spain. ISNI: 0000 0000 9274 367X. GRID: grid.411057.6 FAU - Gomez-Pesquera, E AU - Gomez-Pesquera E AD - Hospital Clinico Universitario de Valladolid, Valladolid, Spain. ISNI: 0000 0000 9274 367X. GRID: grid.411057.6 FAU - Aragon-Camino, M AU - Aragon-Camino M AD - Hospital Clinico Universitario de Valladolid, Valladolid, Spain. ISNI: 0000 0000 9274 367X. GRID: grid.411057.6 FAU - Liu-Zhu, P AU - Liu-Zhu P AD - Hospital Clinico Universitario de Valladolid, Valladolid, Spain. ISNI: 0000 0000 9274 367X. GRID: grid.411057.6 FAU - Sanchez-Lopez, A AU - Sanchez-Lopez A AD - Hospital Clinico Universitario de Valladolid, Valladolid, Spain. ISNI: 0000 0000 9274 367X. GRID: grid.411057.6 FAU - Hernandez-Lozano, A AU - Hernandez-Lozano A AD - Hospital Clinico Universitario de Valladolid, Valladolid, Spain. ISNI: 0000 0000 9274 367X. GRID: grid.411057.6 FAU - Pelaez-Jareno, M T AU - Pelaez-Jareno MT AD - Hospital Clinico Universitario de Valladolid, Valladolid, Spain. ISNI: 0000 0000 9274 367X. GRID: grid.411057.6 FAU - Tamayo, E AU - Tamayo E AD - Hospital Clinico Universitario de Valladolid, Valladolid, Spain. ISNI: 0000 0000 9274 367X. GRID: grid.411057.6 FAU - Thomas-Ruddel, D O AU - Thomas-Ruddel DO AD - Jena University Hospital, Jena, Germany. ISNI: 0000 0000 8517 6224. GRID: grid.275559.9 FAU - Fleischmann, C AU - Fleischmann C AD - Jena University Hospital, Jena, Germany. ISNI: 0000 0000 8517 6224. GRID: grid.275559.9 FAU - Haas, C AU - Haas C AD - Jena University Hospital, Jena, Germany. ISNI: 0000 0000 8517 6224. GRID: grid.275559.9 FAU - Dennler, U AU - Dennler U AD - Jena University Hospital, Jena, Germany. ISNI: 0000 0000 8517 6224. GRID: grid.275559.9 FAU - Reinhart, K AU - Reinhart K AD - Jena University Hospital, Jena, Germany. ISNI: 0000 0000 8517 6224. GRID: grid.275559.9 FAU - Adora, V AU - Adora V AD - Medica Superspecialty Hospital, Kolkata, West Bengal India FAU - Kar, A AU - Kar A AD - Medica Superspecialty Hospital, Kolkata, West Bengal India FAU - Chakraborty, A AU - Chakraborty A AD - Medica Superspecialty Hospital, Kolkata, West Bengal India FAU - Roy, S AU - Roy S AD - Medica Superspecialty Hospital, Kolkata, West Bengal India FAU - Bandyopadhyay, A AU - Bandyopadhyay A AD - Medica Superspecialty Hospital, Kolkata, West Bengal India FAU - Das, M AU - Das M AD - Medica Superspecialty Hospital, Kolkata, West Bengal India FAU - Mann Ben Yehudah, T AU - Mann Ben Yehudah T AD - Assaf Harofeh MC, Beer Yaakov, Israel FAU - BenYehudah, G AU - BenYehudah G AD - Assaf Harofeh MC, Beer Yaakov, Israel FAU - Salim, M AU - Salim M AD - DMC, Detroit, USA. ISNI: 0000 0001 0088 6903. GRID: grid.413184.b FAU - Kumar, N AU - Kumar N AD - DMC, Detroit, USA. ISNI: 0000 0001 0088 6903. GRID: grid.413184.b FAU - Arabi, L AU - Arabi L AD - DMC, Detroit, USA. ISNI: 0000 0001 0088 6903. GRID: grid.413184.b FAU - Burger, T AU - Burger T AD - DMC, Detroit, USA. ISNI: 0000 0001 0088 6903. GRID: grid.413184.b FAU - Lephart, P AU - Lephart P AD - DMC, Detroit, USA. ISNI: 0000 0001 0088 6903. GRID: grid.413184.b FAU - Toth-martin, E AU - Toth-martin E AD - Wayne State University, Detroit, USA. ISNI: 0000 0001 1456 7807. GRID: grid.254444.7 FAU - Valencia, C AU - Valencia C AD - Scientific Institute of Public Health (WIV-ISP), Brussels, Belgium. ISNI: 0000 0004 0635 3376. GRID: grid.418170.b FAU - Hammami, N AU - Hammami N AD - Scientific Institute of Public Health (WIV-ISP), Brussels, Belgium. ISNI: 0000 0004 0635 3376. GRID: grid.418170.b FAU - Blot, S AU - Blot S AD - Ghent University, Ghent, Belgium. ISNI: 0000 0001 2069 7798. GRID: grid.5342.0 FAU - Vincent, J L AU - Vincent JL AD - Erasme University, Brussels, Belgium FAU - Lambert, M L AU - Lambert ML AD - Scientific Institute of Public Health (WIV-ISP), Brussels, Belgium. ISNI: 0000 0004 0635 3376. GRID: grid.418170.b FAU - Brunke, J AU - Brunke J AD - QualityLabs Bt GmbH, Nuremberg, Germany FAU - Riemann, T AU - Riemann T AD - B.Braun Melsungen AG, Melsungen, Germany. ISNI: 0000 0001 0699 8877. GRID: grid.462046.2 FAU - Roschke, I AU - Roschke I AD - Dr. Roschke medical marketing GmbH, Cologne, Germany FAU - Tincu, R AU - Tincu R AD - Bucharest Clinical Emergency Hospital, Bucharest, Romania FAU - Cobilinschi, C AU - Cobilinschi C AD - Bucharest Clinical Emergency Hospital, Bucharest, Romania FAU - Tomescu, D AU - Tomescu D AD - Fundeni Clinical Institute, Bucharest, Romania. ISNI: 0000 0004 0540 9980. GRID: grid.415180.9 FAU - Ghiorghiu, Z AU - Ghiorghiu Z AD - Bucharest Clinical Emergency Hospital, Bucharest, Romania FAU - Macovei, R AU - Macovei R AD - Bucharest Clinical Emergency Hospital, Bucharest, Romania FAU - Nimitvilai, S AU - Nimitvilai S AD - Nakhonpathom hospital, Nakhonpathom, Thailand FAU - Jintanapramote, K AU - Jintanapramote K AD - Nakhonpathom hospital, Nakhonpathom, Thailand FAU - Jarupongprapa, S AU - Jarupongprapa S AD - Nakhonpathom hospital, Nakhonpathom, Thailand FAU - Adukauskiene, D AU - Adukauskiene D AD - Lithuanian University of Health Sciences, Kaunas,, Lithuania. ISNI: 0000 0004 0432 6841. GRID: grid.45083.3a FAU - Valanciene, D AU - Valanciene D AD - Lithuanian University of Health Sciences, Kaunas,, Lithuania. ISNI: 0000 0004 0432 6841. GRID: grid.45083.3a FAU - Bose, G AU - Bose G AD - University Hospital North Midlands, Stoke-on-Trent, UK FAU - Lostarakos, V AU - Lostarakos V AD - University Hospital North Midlands, Stoke-on-Trent, UK FAU - Carr, B AU - Carr B AD - University Hospital North Midlands, Stoke-on-Trent, UK FAU - Khedher, S AU - Khedher S AD - EPS Charles-Nicolle, Bab Saadoun, Tunisia FAU - Maaoui, A AU - Maaoui A AD - EPS Charles-Nicolle, Bab Saadoun, Tunisia FAU - Ezzamouri, A AU - Ezzamouri A AD - EPS Charles-Nicolle, Bab Saadoun, Tunisia FAU - Salem, M AU - Salem M AD - EPS Charles-Nicolle, Bab Saadoun, Tunisia FAU - Chen, J AU - Chen J AD - Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi County, Taiwan FAU - Cranendonk, D R AU - Cranendonk DR AD - Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands. ISNI: 0000000084992262. GRID: grid.7177.6 FAU - Van Vught, L A AU - Van Vught LA AD - Academic Medical Center, University of Amsterdam, Center for Experimental and Molecular Medicine, Amsterdam, Netherlands FAU - Wiewel, M A AU - Wiewel MA AD - Academic Medical Center, University of Amsterdam, Center for Experimental and Molecular Medicine, Amsterdam, Netherlands FAU - Cremer, O L AU - Cremer OL AD - Department of Intensive Care Medicine, University Medical Center Utrecht, Utrecht, Netherlands. ISNI: 0000000090126352. GRID: grid.7692.a FAU - Horn, J AU - Horn J AD - Department of Intensive Care Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands. ISNI: 0000000404654431. GRID: grid.5650.6 FAU - Bonten, M J AU - Bonten MJ AD - Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, Netherlands. ISNI: 0000000090126352. GRID: grid.7692.a FAU - Schultz, M J AU - Schultz MJ AD - Department of Intensive Care Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands. ISNI: 0000000404654431. GRID: grid.5650.6 FAU - Van der Poll, T AU - Van der Poll T AD - Academic Medical Center, University of Amsterdam, Center for Experimental and Molecular Medicine, Amsterdam, Netherlands FAU - Wiersinga, W J AU - Wiersinga WJ AD - Academic Medical Center, University of Amsterdam, Center for Experimental and Molecular Medicine, Amsterdam, Netherlands FAU - Day, M AU - Day M AD - Glasgow Royal Infirmary, Glasgow, UK. ISNI: 0000 0000 9825 7840. GRID: grid.411714.6 FAU - Penrice, G AU - Penrice G AD - NHS Greater Glasgow and Clyde, Glasgow, UK. ISNI: 0000 0001 0523 9342. GRID: grid.413301.4 FAU - Roy, K AU - Roy K AD - Health Protection Scotland, Glasgow, UK. ISNI: 0000 0001 2232 4338. GRID: grid.413893.4 FAU - Robertson, P AU - Robertson P AD - Glasgow Royal Infirmary, Glasgow, UK. ISNI: 0000 0000 9825 7840. GRID: grid.411714.6 FAU - Godbole, G AU - Godbole G AD - Public Health England, London, UK. ISNI: 0000 0001 2196 8713. GRID: grid.9004.d FAU - Jones, B AU - Jones B AD - Glasgow Royal Infirmary, Glasgow, UK. ISNI: 0000 0000 9825 7840. GRID: grid.411714.6 FAU - Booth, M AU - Booth M AD - Glasgow Royal Infirmary, Glasgow, UK. ISNI: 0000 0000 9825 7840. GRID: grid.411714.6 FAU - Donaldson, L AU - Donaldson L AD - Glasgow Royal Infirmary, Glasgow, UK. ISNI: 0000 0000 9825 7840. GRID: grid.411714.6 FAU - Kawano, Y AU - Kawano Y AD - Fukuoka University Hospital, Fukuoka, Japan. ISNI: 0000 0004 0594 9821. GRID: grid.411556.2 FAU - Ishikura, H AU - Ishikura H AD - Fukuoka University Hospital, Fukuoka, Japan. ISNI: 0000 0004 0594 9821. GRID: grid.411556.2 FAU - Al-Dorzi, H AU - Al-Dorzi H AD - King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. ISNI: 0000 0004 0608 0662. GRID: grid.412149.b FAU - Almutairi, M AU - Almutairi M AD - King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. ISNI: 0000 0004 0608 0662. GRID: grid.412149.b FAU - Alhamadi, B AU - Alhamadi B AD - King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. ISNI: 0000 0004 0608 0662. GRID: grid.412149.b FAU - Crizaldo Toledo, A AU - Crizaldo Toledo A AD - King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. ISNI: 0000 0004 0608 0662. GRID: grid.412149.b FAU - Khan, R AU - Khan R AD - King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. ISNI: 0000 0004 0608 0662. GRID: grid.412149.b FAU - Al Raiy, B AU - Al Raiy B AD - King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. ISNI: 0000 0004 0608 0662. GRID: grid.412149.b FAU - Arabi, Y AU - Arabi Y AD - King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. ISNI: 0000 0004 0608 0662. GRID: grid.412149.b FAU - Talaie, H AU - Talaie H AD - Toxicological Research Center, Department of Clinical Toxicology, Loghman-Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. GRID: grid.411600.2 FAU - Van Oers, J A AU - Van Oers JA AD - St. Elisabeth Hospital, Tilburg, Netherlands. GRID: grid.416373.4 FAU - Harts, A AU - Harts A AD - St. Elisabeth Hospital, Tilburg, Netherlands. GRID: grid.416373.4 FAU - Nieuwkoop, E AU - Nieuwkoop E AD - St. Elisabeth Hospital, Tilburg, Netherlands. GRID: grid.416373.4 FAU - Vos, P AU - Vos P AD - St. Elisabeth Hospital, Tilburg, Netherlands. GRID: grid.416373.4 FAU - Boussarsar, Y AU - Boussarsar Y AD - Mongi Slim University Hospital, La Marsa, Tunisia FAU - Boutouta, F AU - Boutouta F AD - Mongi Slim University Hospital, La Marsa, Tunisia FAU - Kamoun, S AU - Kamoun S AD - Mongi Slim University Hospital, La Marsa, Tunisia FAU - Mezghani, I AU - Mezghani I AD - Mongi Slim University Hospital, La Marsa, Tunisia FAU - Koubaji, S AU - Koubaji S AD - Mongi Slim University Hospital, La Marsa, Tunisia FAU - Ben Souissi, A AU - Ben Souissi A AD - Mongi Slim University Hospital, La Marsa, Tunisia FAU - Riahi, A AU - Riahi A AD - Mongi Slim University Hospital, La Marsa, Tunisia FAU - Mebazaa, M S AU - Mebazaa MS AD - Mongi Slim University Hospital, La Marsa, Tunisia FAU - Giamarellos-Bourboulis, E AU - Giamarellos-Bourboulis E AD - University of Athens, Medical School, Athens, Greece. ISNI: 0000 0001 2155 0800. GRID: grid.5216.0 FAU - Tziolos, N AU - Tziolos N AD - University of Athens, Medical School, Athens, Greece. ISNI: 0000 0001 2155 0800. GRID: grid.5216.0 FAU - Routsi, C AU - Routsi C AD - University of Athens, Medical School, Athens, Greece. ISNI: 0000 0001 2155 0800. GRID: grid.5216.0 FAU - Katsenos, C AU - Katsenos C AD - Korgialeneion Benakeion Hospital, Athens, Greece FAU - Tsangaris, I AU - Tsangaris I AD - University of Athens, Medical School, Athens, Greece. ISNI: 0000 0001 2155 0800. GRID: grid.5216.0 FAU - Pneumatikos, I AU - Pneumatikos I AD - University of Thrace, Alexandroupolis, Greece. ISNI: 0000 0001 2170 8022. GRID: grid.12284.3d FAU - Vlachogiannis, G AU - Vlachogiannis G AD - Aghios Dimitrios Hospital, Thessaloniki, Greece FAU - Theodorou, V AU - Theodorou V AD - University of Thrace, Alexandroupolis, Greece. ISNI: 0000 0001 2170 8022. GRID: grid.12284.3d FAU - Prekates, A AU - Prekates A AD - Tzaneion Hospital, Piraeus, Greece FAU - Antypa, E AU - Antypa E AD - G.Gennimatas General Hospital, Thessaloniki, Greece. GRID: grid.414012.2 FAU - Koulouras, V AU - Koulouras V AD - University of Ioannina, Ioannina, Greece. ISNI: 0000 0001 2108 7481. GRID: grid.9594.1 FAU - Kapravelos, N AU - Kapravelos N AD - G.Papanikolaou General Hospital, Thessaloniki, Greece. ISNI: 0000 0004 0576 574X. GRID: grid.415248.e FAU - Gogos, C AU - Gogos C AD - University of Patras, Patras, Greece. ISNI: 0000 0004 0576 5395. GRID: grid.11047.33 FAU - Antoniadou, E AU - Antoniadou E AD - G.Gennimatas General Hospital, Thessaloniki, Greece. GRID: grid.414012.2 FAU - Mandragos, K AU - Mandragos K AD - Korgialeneion Benakeion Hospital, Athens, Greece FAU - Armaganidis, A AU - Armaganidis A AD - University of Athens, Medical School, Athens, Greece. ISNI: 0000 0001 2155 0800. GRID: grid.5216.0 FAU - Robles Caballero, A R AU - Robles Caballero AR AD - Hospital Universitario La Paz, Madrid, Spain. ISNI: 0000 0000 8970 9163. GRID: grid.81821.32 FAU - Civantos, B AU - Civantos B AD - Hospital Universitario La Paz, Madrid, Spain. ISNI: 0000 0000 8970 9163. GRID: grid.81821.32 FAU - Figueira, J C AU - Figueira JC AD - Hospital Universitario La Paz, Madrid, Spain. ISNI: 0000 0000 8970 9163. GRID: grid.81821.32 FAU - Lopez, J AU - Lopez J AD - Hospital Universitario La Paz, Madrid, Spain. ISNI: 0000 0000 8970 9163. GRID: grid.81821.32 FAU - Silva-Pinto, A AU - Silva-Pinto A AD - Centro Hospitalar Sao Joao, Porto, Portugal. ISNI: 0000 0000 9375 4688. GRID: grid.414556.7 FAU - Ceia, F AU - Ceia F AD - Centro Hospitalar Sao Joao, Porto, Portugal. ISNI: 0000 0000 9375 4688. GRID: grid.414556.7 FAU - Sarmento, A AU - Sarmento A AD - Centro Hospitalar Sao Joao, Porto, Portugal. ISNI: 0000 0000 9375 4688. GRID: grid.414556.7 FAU - Santos, L AU - Santos L AD - Centro Hospitalar Sao Joao, Porto, Portugal. ISNI: 0000 0000 9375 4688. GRID: grid.414556.7 FAU - Almekhlafi, G AU - Almekhlafi G AD - PSMMC, Riyadh, Saudi Arabia FAU - Sakr, Y AU - Sakr Y AD - UNIKLINIKUM JENA, JENA, Germany FAU - Al-Dorzi, H AU - Al-Dorzi H AD - King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. ISNI: 0000 0004 0608 0662. GRID: grid.412149.b FAU - Khan, R AU - Khan R AD - King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. ISNI: 0000 0004 0608 0662. GRID: grid.412149.b FAU - Baharoon, S AU - Baharoon S AD - King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. ISNI: 0000 0004 0608 0662. GRID: grid.412149.b FAU - Aldawood, A AU - Aldawood A AD - King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. ISNI: 0000 0004 0608 0662. GRID: grid.412149.b FAU - Matroud, A AU - Matroud A AD - King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. ISNI: 0000 0004 0608 0662. GRID: grid.412149.b FAU - Alchin, J AU - Alchin J AD - King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. ISNI: 0000 0004 0608 0662. GRID: grid.412149.b FAU - Al Johani, S AU - Al Johani S AD - King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. ISNI: 0000 0004 0608 0662. GRID: grid.412149.b FAU - Balkhy, H AU - Balkhy H AD - King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. ISNI: 0000 0004 0608 0662. GRID: grid.412149.b FAU - Arabi, Y AU - Arabi Y AD - King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. ISNI: 0000 0004 0608 0662. GRID: grid.412149.b FAU - Alsolamy, S AU - Alsolamy S AD - King Saud bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research Center, Riyadh, Saudi Arabia. ISNI: 0000 0004 0608 0662. GRID: grid.412149.b FAU - Yousif, S Y AU - Yousif SY AD - King Saud bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research Center, Riyadh, Saudi Arabia. ISNI: 0000 0004 0608 0662. GRID: grid.412149.b FAU - Alotabi, B O AU - Alotabi BO AD - King Fahad Medical City, Riyadh, Saudi Arabia. ISNI: 0000 0004 0593 1832. GRID: grid.415277.2 FAU - Alsaawi, A S AU - Alsaawi AS AD - King Saud bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research Center, Riyadh, Saudi Arabia. ISNI: 0000 0004 0608 0662. GRID: grid.412149.b FAU - Ang, J AU - Ang J AD - Addenbrooke's Hospital, Cambridge, UK. ISNI: 0000 0004 0622 5016. GRID: grid.120073.7 FAU - Curran, M D AU - Curran MD AD - Addenbrooke's Hospital, Cambridge, UK. ISNI: 0000 0004 0622 5016. GRID: grid.120073.7 FAU - Enoch, D AU - Enoch D AD - Addenbrooke's Hospital, Cambridge, UK. ISNI: 0000 0004 0622 5016. GRID: grid.120073.7 FAU - Navapurkar, V AU - Navapurkar V AD - Addenbrooke's Hospital, Cambridge, UK. ISNI: 0000 0004 0622 5016. GRID: grid.120073.7 FAU - Morris, A AU - Morris A AD - University of Cambridge, Cambridge, UK. ISNI: 0000000121885934. GRID: grid.5335.0 FAU - Sharvill, R AU - Sharvill R AD - Royal United Hospital, Bath, UK. ISNI: 0000 0004 0417 0728. GRID: grid.416091.b FAU - Astin, J AU - Astin J AD - Royal United Hospital, Bath, UK. ISNI: 0000 0004 0417 0728. GRID: grid.416091.b FAU - Heredia-Rodriguez, M AU - Heredia-Rodriguez M AD - Hospital Clinico Universitario de Valladolid, Valladolid, Spain. ISNI: 0000 0000 9274 367X. GRID: grid.411057.6 FAU - Gomez-Sanchez, E AU - Gomez-Sanchez E AD - Hospital Clinico Universitario de Valladolid, Valladolid, Spain. ISNI: 0000 0000 9274 367X. GRID: grid.411057.6 FAU - Pelaez-Jareno, M T AU - Pelaez-Jareno MT AD - Hospital Clinico Universitario de Valladolid, Valladolid, Spain. ISNI: 0000 0000 9274 367X. GRID: grid.411057.6 FAU - Gomez-Pesquera, E AU - Gomez-Pesquera E AD - Hospital Clinico Universitario de Valladolid, Valladolid, Spain. ISNI: 0000 0000 9274 367X. GRID: grid.411057.6 FAU - Lorenzo-Lopez, M AU - Lorenzo-Lopez M AD - Hospital Clinico Universitario de Valladolid, Valladolid, Spain. ISNI: 0000 0000 9274 367X. GRID: grid.411057.6 FAU - Liu-Zhu, P AU - Liu-Zhu P AD - Hospital Clinico Universitario de Valladolid, Valladolid, Spain. ISNI: 0000 0000 9274 367X. GRID: grid.411057.6 FAU - Aragon-Camino, M AU - Aragon-Camino M AD - Hospital Clinico Universitario de Valladolid, Valladolid, Spain. ISNI: 0000 0000 9274 367X. GRID: grid.411057.6 FAU - Hernandez-Lozano, A AU - Hernandez-Lozano A AD - Hospital Clinico Universitario de Valladolid, Valladolid, Spain. ISNI: 0000 0000 9274 367X. GRID: grid.411057.6 FAU - Sanchez-Lopez, A AU - Sanchez-Lopez A AD - Hospital Clinico Universitario de Valladolid, Valladolid, Spain. ISNI: 0000 0000 9274 367X. GRID: grid.411057.6 FAU - Alvarez-Fuente, E AU - Alvarez-Fuente E AD - Hospital Clinico Universitario de Valladolid, Valladolid, Spain. ISNI: 0000 0000 9274 367X. GRID: grid.411057.6 FAU - Tamayo, E AU - Tamayo E AD - Hospital Clinico Universitario de Valladolid, Valladolid, Spain. ISNI: 0000 0000 9274 367X. GRID: grid.411057.6 FAU - Patel, J AU - Patel J AD - Salford Royal Hospital, London, UK. ISNI: 0000 0000 8535 2371. GRID: grid.415721.4 FAU - Kruger, C AU - Kruger C AD - Salford Royal Hospital, London, UK. ISNI: 0000 0000 8535 2371. GRID: grid.415721.4 FAU - O'Neal, J AU - O'Neal J AD - Hennepin County Medical Center, Minneapolis, USA. ISNI: 0000 0000 9206 4546. GRID: grid.414021.2 FAU - Rhodes, H AU - Rhodes H AD - Hennepin County Medical Center, Minneapolis, USA. ISNI: 0000 0000 9206 4546. GRID: grid.414021.2 FAU - Jancik, J AU - Jancik J AD - Hennepin County Medical Center, Minneapolis, USA. ISNI: 0000 0000 9206 4546. GRID: grid.414021.2 FAU - Francois, B AU - Francois B AD - CHU Dupuytren, Limoges, France. ISNI: 0000 0001 1481 5225. GRID: grid.412212.6 FAU - Laterre, P F AU - Laterre PF AD - St Luc University Hospital, Brussels, Belgium. ISNI: 0000 0004 0461 6320. GRID: grid.48769.34 FAU - Eggimann, P AU - Eggimann P AD - CHUV, Lausanne, Switzerland. ISNI: 0000 0001 0423 4662. GRID: grid.8515.9 FAU - Torres, A AU - Torres A AD - Hospital Clinic of Barcelona, Barcelona, Spain. ISNI: 0000 0000 9635 9413. GRID: grid.410458.c FAU - Sanchez, M AU - Sanchez M AD - Hospital Clinico San Carlos, Madrid, Spain. ISNI: 0000 0001 0671 5785. GRID: grid.411068.a FAU - Dequin, P F AU - Dequin PF AD - Universite Francois Rabelais and CHU Bretonneau, Tours, France. ISNI: 0000 0001 2182 6141. GRID: grid.12366.30 FAU - Bassi, G L AU - Bassi GL AD - Hospital Clinic of Barcelona, Barcelona, Spain. ISNI: 0000 0000 9635 9413. GRID: grid.410458.c FAU - Chastre, J AU - Chastre J AD - Groupe Hospitalier Pitie-Salpetriere, Paris, France. ISNI: 0000 0001 2150 9058. GRID: grid.411439.a FAU - Jafri, H S AU - Jafri HS AD - MedImmune, Gaithersburg, USA. GRID: grid.418152.b FAU - Ben Romdhane, M AU - Ben Romdhane M AD - Mongi Slim University Hospital, La Marsa, Tunisia FAU - Douira, Z AU - Douira Z AD - Mongi Slim University Hospital, La Marsa, Tunisia FAU - Kamoun, S AU - Kamoun S AD - Mongi Slim University Hospital, La Marsa, Tunisia FAU - Bousselmi, M AU - Bousselmi M AD - Mongi Slim University Hospital, La Marsa, Tunisia FAU - Ben Souissi, A AU - Ben Souissi A AD - Mongi Slim University Hospital, La Marsa, Tunisia FAU - Boussarsar, Y AU - Boussarsar Y AD - Mongi Slim University Hospital, La Marsa, Tunisia FAU - Riahi, A AU - Riahi A AD - Mongi Slim University Hospital, La Marsa, Tunisia FAU - Mebazaa, M S AU - Mebazaa MS AD - Mongi Slim University Hospital, La Marsa, Tunisia FAU - Vakalos, A AU - Vakalos A AD - Xanthi General Hospital, Xanthi, Greece FAU - Avramidis, V AU - Avramidis V AD - Xanthi General Hospital, Xanthi, Greece FAU - Craven, T H AU - Craven TH AD - Royal Infirmary of Edinburgh, Edinburgh, UK. ISNI: 0000 0001 0709 1919. GRID: grid.418716.d FAU - Wojcik, G AU - Wojcik G AD - Royal Infirmary of Edinburgh, Edinburgh, UK. ISNI: 0000 0001 0709 1919. GRID: grid.418716.d FAU - Kefala, K AU - Kefala K AD - Royal Infirmary of Edinburgh, Edinburgh, UK. ISNI: 0000 0001 0709 1919. GRID: grid.418716.d FAU - McCoubrey, J AU - McCoubrey J AD - Royal Infirmary of Edinburgh, Edinburgh, UK. ISNI: 0000 0001 0709 1919. GRID: grid.418716.d FAU - Reilly, J AU - Reilly J AD - Health Protection Scotland, Glasgow, UK. ISNI: 0000 0001 2232 4338. GRID: grid.413893.4 FAU - Paterson, R AU - Paterson R AD - Western General Hospital, Edinburgh, UK. ISNI: 0000 0004 0624 9907. GRID: grid.417068.c FAU - Inverarity, D AU - Inverarity D AD - Royal Infirmary of Edinburgh, Edinburgh, UK. ISNI: 0000 0001 0709 1919. GRID: grid.418716.d FAU - Laurenson, I AU - Laurenson I AD - Royal Infirmary of Edinburgh, Edinburgh, UK. ISNI: 0000 0001 0709 1919. GRID: grid.418716.d FAU - Walsh, T S AU - Walsh TS AD - Royal Infirmary of Edinburgh, Edinburgh, UK. ISNI: 0000 0001 0709 1919. GRID: grid.418716.d FAU - Mongodi, S AU - Mongodi S AD - Fondazione IRCCS Policlinico S. Matteo, University of Pavia, Pavia, Italy. ISNI: 0000 0004 1762 5736. GRID: grid.8982.b FAU - Bouhemad, B AU - Bouhemad B AD - Centre Hospitalier Universitaire Dijon, Dijon, France. GRID: grid.31151.37 FAU - Orlando, A AU - Orlando A AD - Fondazione IRCCS Policlinico S. Matteo, University of Pavia, Pavia, Italy. ISNI: 0000 0004 1762 5736. GRID: grid.8982.b FAU - Stella, A AU - Stella A AD - Fondazione IRCCS Policlinico S. Matteo, University of Pavia, Pavia, Italy. ISNI: 0000 0004 1762 5736. GRID: grid.8982.b FAU - Via, G AU - Via G AD - Fondazione IRCCS Policlinico S. Matteo, University of Pavia, Pavia, Italy. ISNI: 0000 0004 1762 5736. GRID: grid.8982.b FAU - Iotti, G AU - Iotti G AD - Fondazione IRCCS Policlinico S. Matteo, University of Pavia, Pavia, Italy. ISNI: 0000 0004 1762 5736. GRID: grid.8982.b FAU - Braschi, A AU - Braschi A AD - Fondazione IRCCS Policlinico S. Matteo, University of Pavia, Pavia, Italy. ISNI: 0000 0004 1762 5736. GRID: grid.8982.b FAU - Mojoli, F AU - Mojoli F AD - Fondazione IRCCS Policlinico S. Matteo, University of Pavia, Pavia, Italy. ISNI: 0000 0004 1762 5736. GRID: grid.8982.b FAU - Haliloglu, M AU - Haliloglu M AD - Marmara University Pendik Teaching and Research Hospital, Istanbul, Turkey. ISNI: 0000 0001 0668 8422. GRID: grid.16477.33 FAU - Bilgili, B AU - Bilgili B AD - Marmara University Pendik Teaching and Research Hospital, Istanbul, Turkey. ISNI: 0000 0001 0668 8422. GRID: grid.16477.33 FAU - Kasapoglu, U AU - Kasapoglu U AD - Marmara University Pendik Teaching and Research Hospital, Istanbul, Turkey. ISNI: 0000 0001 0668 8422. GRID: grid.16477.33 FAU - Sayan, I AU - Sayan I AD - Marmara University Pendik Teaching and Research Hospital, Istanbul, Turkey. ISNI: 0000 0001 0668 8422. GRID: grid.16477.33 FAU - Suzer Aslan, M AU - Suzer Aslan M AD - Marmara University Pendik Teaching and Research Hospital, Istanbul, Turkey. ISNI: 0000 0001 0668 8422. GRID: grid.16477.33 FAU - Yalcin, A AU - Yalcin A AD - Marmara University Pendik Teaching and Research Hospital, Istanbul, Turkey. ISNI: 0000 0001 0668 8422. GRID: grid.16477.33 FAU - Cinel, I AU - Cinel I AD - Marmara University Pendik Teaching and Research Hospital, Istanbul, Turkey. ISNI: 0000 0001 0668 8422. GRID: grid.16477.33 FAU - Vakalos, A AU - Vakalos A AD - Xanthi General Hospital, Xanthi, Greece FAU - Avramidis, V AU - Avramidis V AD - Xanthi General Hospital, Xanthi, Greece FAU - Ellis, H E AU - Ellis HE AD - Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK. GRID: grid.419135.b FAU - Bauchmuller, K AU - Bauchmuller K AD - Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK. GRID: grid.419135.b FAU - Miller, D AU - Miller D AD - Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK. GRID: grid.419135.b FAU - Temple, A AU - Temple A AD - Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK. GRID: grid.419135.b FAU - Chastre, J AU - Chastre J AD - Groupe Hospitalier Pitie-Salpetriere, Paris, France. ISNI: 0000 0001 2150 9058. GRID: grid.411439.a FAU - Francois, B AU - Francois B AD - CHU Dupuytren, Limoges, France. ISNI: 0000 0001 1481 5225. GRID: grid.412212.6 FAU - Torres, A AU - Torres A AD - Hospital Clinic of Barcelona, Barcelona, Spain. ISNI: 0000 0000 9635 9413. GRID: grid.410458.c FAU - Luyt, C E AU - Luyt CE AD - Groupe Hospitalier Pitie-Salpetriere, Paris, France. ISNI: 0000 0001 2150 9058. GRID: grid.411439.a FAU - Sanchez, M AU - Sanchez M AD - Hospital Clinico San Carlos, Madrid, Spain. ISNI: 0000 0001 0671 5785. GRID: grid.411068.a FAU - Singer, M AU - Singer M AD - University College, London, UK FAU - Jafri, H S AU - Jafri HS AD - MedImmune, Gaithersburg, USA. GRID: grid.418152.b FAU - Nassar, Y AU - Nassar Y AD - Cairo University, Giza, Egypt. ISNI: 0000 0004 0639 9286. GRID: grid.7776.1 FAU - Ayad, M S AU - Ayad MS AD - Cairo University, Giza, Egypt. ISNI: 0000 0004 0639 9286. GRID: grid.7776.1 FAU - Trifi, A AU - Trifi A AD - University hospital Center of La Rabta, Tunis, Tunisia FAU - Abdellatif, S AU - Abdellatif S AD - University hospital Center of La Rabta, Tunis, Tunisia FAU - Daly, F AU - Daly F AD - University hospital Center of La Rabta, Tunis, Tunisia FAU - Nasri, R AU - Nasri R AD - University hospital Center of La Rabta, Tunis, Tunisia FAU - Ben Lakhal, S AU - Ben Lakhal S AD - University hospital Center of La Rabta, Tunis, Tunisia FAU - Bilgili, B AU - Bilgili B AD - Marmara University Pendik Teaching and Research Hospital, Istanbul, Turkey. ISNI: 0000 0001 0668 8422. GRID: grid.16477.33 FAU - Haliloglu, M AU - Haliloglu M AD - Marmara University Pendik Teaching and Research Hospital, Istanbul, Turkey. ISNI: 0000 0001 0668 8422. GRID: grid.16477.33 FAU - Gul, F AU - Gul F AD - Marmara University Pendik Teaching and Research Hospital, Istanbul, Turkey. ISNI: 0000 0001 0668 8422. GRID: grid.16477.33 FAU - Cinel, I AU - Cinel I AD - Marmara University Pendik Teaching and Research Hospital, Istanbul, Turkey. ISNI: 0000 0001 0668 8422. GRID: grid.16477.33 FAU - Kuzovlev, A AU - Kuzovlev A AD - V.A. Negovsky Research Institute of General Reanimatology, Moscow, Russia FAU - Shabanov, A AU - Shabanov A AD - N.V. Sklifosofsky Institute of Emergency Medicine, Moscow, Russia FAU - Polovnikov, S AU - Polovnikov S AD - NN Burdenko Main Military Hospital, Moscow, Russia FAU - Moroz, V AU - Moroz V AD - V.A. Negovsky Research Institute of General Reanimatology, Moscow, Russia FAU - Kadrichu, N AU - Kadrichu N AD - Novartis Pharmaceuticals, San Carlos, USA. ISNI: 0000 0004 0439 2056. GRID: grid.418424.f FAU - Dang, T AU - Dang T AD - Novartis Pharmaceuticals, San Carlos, USA. ISNI: 0000 0004 0439 2056. GRID: grid.418424.f FAU - Corkery, K AU - Corkery K AD - Novartis Pharmaceuticals, San Carlos, USA. ISNI: 0000 0004 0439 2056. GRID: grid.418424.f FAU - Challoner, P AU - Challoner P AD - Nektar Therapeutics, San Francisco, CA USA. ISNI: 0000 0004 0410 3955. GRID: grid.476522.0 FAU - Bassi, G Li AU - Bassi GL AD - Hospital Clinic, Barcelona, Spain. ISNI: 0000 0000 9635 9413. GRID: grid.410458.c FAU - Aguilera, E AU - Aguilera E AD - Hospital Clinic, Barcelona, Spain. ISNI: 0000 0000 9635 9413. GRID: grid.410458.c FAU - Chiurazzi, C AU - Chiurazzi C AD - Hospital Clinic, Barcelona, Spain. ISNI: 0000 0000 9635 9413. GRID: grid.410458.c FAU - Travierso, C AU - Travierso C AD - Hospital Clinic, Barcelona, Spain. ISNI: 0000 0000 9635 9413. GRID: grid.410458.c FAU - Motos, A AU - Motos A AD - Hospital Clinic, Barcelona, Spain. ISNI: 0000 0000 9635 9413. GRID: grid.410458.c FAU - Fernandez, L AU - Fernandez L AD - Hospital Clinic, Barcelona, Spain. ISNI: 0000 0000 9635 9413. GRID: grid.410458.c FAU - Amaro, R AU - Amaro R AD - Hospital Clinic, Barcelona, Spain. ISNI: 0000 0000 9635 9413. GRID: grid.410458.c FAU - Senussi, T AU - Senussi T AD - Hospital Clinic, Barcelona, Spain. ISNI: 0000 0000 9635 9413. GRID: grid.410458.c FAU - Idone, F AU - Idone F AD - Hospital Clinic, Barcelona, Spain. ISNI: 0000 0000 9635 9413. GRID: grid.410458.c FAU - Bobi, J AU - Bobi J AD - Hospital Clinic, Barcelona, Spain. ISNI: 0000 0000 9635 9413. GRID: grid.410458.c FAU - Rigol, M AU - Rigol M AD - Hospital Clinic, Barcelona, Spain. ISNI: 0000 0000 9635 9413. GRID: grid.410458.c FAU - Torres, A AU - Torres A AD - Hospital Clinic, Barcelona, Spain. ISNI: 0000 0000 9635 9413. GRID: grid.410458.c FAU - Hodiamont, C J AU - Hodiamont CJ AD - Academic Medical Center, Amsterdam, Netherlands. ISNI: 0000000404654431. GRID: grid.5650.6 FAU - Juffermans, N P AU - Juffermans NP AD - Academic Medical Center, Amsterdam, Netherlands. ISNI: 0000000404654431. GRID: grid.5650.6 FAU - Janssen, J M AU - Janssen JM AD - Academic Medical Center, Amsterdam, Netherlands. ISNI: 0000000404654431. GRID: grid.5650.6 FAU - Bouman, C S AU - Bouman CS AD - Academic Medical Center, Amsterdam, Netherlands. ISNI: 0000000404654431. GRID: grid.5650.6 FAU - Mathot, R A AU - Mathot RA AD - Academic Medical Center, Amsterdam, Netherlands. ISNI: 0000000404654431. GRID: grid.5650.6 FAU - De Jong, M D AU - De Jong MD AD - Academic Medical Center, Amsterdam, Netherlands. ISNI: 0000000404654431. GRID: grid.5650.6 FAU - Van Hest, R M AU - Van Hest RM AD - Academic Medical Center, Amsterdam, Netherlands. ISNI: 0000000404654431. GRID: grid.5650.6 FAU - Payne, L AU - Payne L AD - Maine Medical Center, Portland, USA. GRID: grid.240160.1 FAU - Fraser, G L AU - Fraser GL AD - Maine Medical Center, Portland, USA. GRID: grid.240160.1 FAU - Tudor, B AU - Tudor B AD - Medical University of Vienna, Vienna, Austria. ISNI: 0000 0000 9259 8492. GRID: grid.22937.3d FAU - Lahner, M AU - Lahner M AD - Medical University of Vienna, Vienna, Austria. ISNI: 0000 0000 9259 8492. GRID: grid.22937.3d FAU - Roth, G AU - Roth G AD - Medical University of Vienna, Vienna, Austria. ISNI: 0000 0000 9259 8492. GRID: grid.22937.3d FAU - Krenn, C AU - Krenn C AD - Medical University of Vienna, Vienna, Austria. ISNI: 0000 0000 9259 8492. GRID: grid.22937.3d FAU - Talaie, H AU - Talaie H AD - Toxicological Research Center, Department of Clinical Toxicology, Loghman-Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. GRID: grid.411600.2 FAU - Jault, P AU - Jault P AD - HIA Percy, Clamart, France. ISNI: 0000 0004 1795 3756. GRID: grid.414028.b FAU - Gabard, J AU - Gabard J AD - Pherecydes Pharma, Romainville, France FAU - Leclerc, T AU - Leclerc T AD - HIA Percy, Clamart, France. ISNI: 0000 0004 1795 3756. GRID: grid.414028.b FAU - Jennes, S AU - Jennes S AD - Hopital Reine Astrid, Brussels, Belgium FAU - Que, Y AU - Que Y AD - CHUV, Lausanne, Switzerland. ISNI: 0000 0001 0423 4662. GRID: grid.8515.9 FAU - Rousseau, A AU - Rousseau A AD - CHU Liege, Liege, Belgium. ISNI: 0000 0000 8607 6858. GRID: grid.411374.4 FAU - Ravat, F AU - Ravat F AD - CH Saint Jospeh Saint Luc, Lyon, France FAU - Al-Dorzi, H AU - Al-Dorzi H AD - King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. ISNI: 0000 0004 0608 0662. GRID: grid.412149.b FAU - Eissa, A AU - Eissa A AD - King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. ISNI: 0000 0004 0608 0662. GRID: grid.412149.b FAU - Al-Harbi, S AU - Al-Harbi S AD - King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. ISNI: 0000 0004 0608 0662. GRID: grid.412149.b FAU - Aldabbagh, T AU - Aldabbagh T AD - King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. ISNI: 0000 0004 0608 0662. GRID: grid.412149.b FAU - Khan, R AU - Khan R AD - King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. ISNI: 0000 0004 0608 0662. GRID: grid.412149.b FAU - Arabi, Y AU - Arabi Y AD - King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. ISNI: 0000 0004 0608 0662. GRID: grid.412149.b FAU - Trifi, A AU - Trifi A AD - University hospital center of La Rabta, Tunis, Tunisia FAU - Abdellatif., S AU - Abdellatif. S AD - University hospital center of La Rabta, Tunis, Tunisia FAU - Daly, F AU - Daly F AD - University hospital center of La Rabta, Tunis, Tunisia FAU - Nasri, R AU - Nasri R AD - University hospital center of La Rabta, Tunis, Tunisia FAU - Ben Lakhal, S AU - Ben Lakhal S AD - University hospital center of La Rabta, Tunis, Tunisia FAU - Paramba, F AU - Paramba F AD - Hamad Medical Corporation, Doha, Qatar. ISNI: 0000 0004 0571 546X. GRID: grid.413548.f FAU - Purayil, N AU - Purayil N AD - Hamad Medical Corporation, Doha, Qatar. ISNI: 0000 0004 0571 546X. GRID: grid.413548.f FAU - Naushad, V AU - Naushad V AD - Hamad Medical Corporation, Doha, Qatar. ISNI: 0000 0004 0571 546X. GRID: grid.413548.f FAU - Mohammad, O AU - Mohammad O AD - Hamad Medical Corporation, Doha, Qatar. ISNI: 0000 0004 0571 546X. GRID: grid.413548.f FAU - Negi, V AU - Negi V AD - Hamad Medical Corporation, Doha, Qatar. ISNI: 0000 0004 0571 546X. GRID: grid.413548.f FAU - Chandra, P AU - Chandra P AD - Hamad Medical Corporation, Doha, Qatar. ISNI: 0000 0004 0571 546X. GRID: grid.413548.f FAU - Kleinsasser, A AU - Kleinsasser A AD - MUI, Innsbruck, Austria. ISNI: 0000 0000 8853 2677. GRID: grid.5361.1 FAU - Witrz, M R AU - Witrz MR AD - Academic Medical Centre, Amsterdam, Netherlands. ISNI: 0000000404654431. GRID: grid.5650.6 FAU - Buchner-Doeven, J F AU - Buchner-Doeven JF AD - Academic Medical Centre, Amsterdam, Netherlands. ISNI: 0000000404654431. GRID: grid.5650.6 FAU - Tuip-de Boer, A M AU - Tuip-de Boer AM AD - Academic Medical Centre, Amsterdam, Netherlands. ISNI: 0000000404654431. GRID: grid.5650.6 FAU - Goslings, J C AU - Goslings JC AD - Academic Medical Centre, Amsterdam, Netherlands. ISNI: 0000000404654431. GRID: grid.5650.6 FAU - Juffermans, N P AU - Juffermans NP AD - Academic Medical Centre, Amsterdam, Netherlands. ISNI: 0000000404654431. GRID: grid.5650.6 FAU - Van Hezel, M AU - Van Hezel M AD - Academic Medical Center Amsterdam, Amsterdam, Netherlands. ISNI: 0000000404654431. GRID: grid.5650.6 FAU - Straat, M AU - Straat M AD - Academic Medical Center Amsterdam, Amsterdam, Netherlands. ISNI: 0000000404654431. GRID: grid.5650.6 FAU - Boing, A AU - Boing A AD - Academic Medical Center Amsterdam, Amsterdam, Netherlands. ISNI: 0000000404654431. GRID: grid.5650.6 FAU - Van Bruggen, R AU - Van Bruggen R AD - Sanquin, Amsterdam, Netherlands. ISNI: 0000 0001 2234 6887. GRID: grid.417732.4 FAU - Juffermans, N AU - Juffermans N AD - Academic Medical Center Amsterdam, Amsterdam, Netherlands. ISNI: 0000000404654431. GRID: grid.5650.6 FAU - Markopoulou, D AU - Markopoulou D AD - KAT Hospital Athens, Kifisia, Greece. ISNI: 0000 0004 0622 8129. GRID: grid.415070.7 FAU - Venetsanou, K AU - Venetsanou K AD - KAT Hospital Athens, Kifisia, Greece. ISNI: 0000 0004 0622 8129. GRID: grid.415070.7 FAU - Kaldis, V AU - Kaldis V AD - KAT Hospital Athens, Kifisia, Greece. ISNI: 0000 0004 0622 8129. GRID: grid.415070.7 FAU - Koutete, D AU - Koutete D AD - KAT Hospital Athens, Kifisia, Greece. ISNI: 0000 0004 0622 8129. GRID: grid.415070.7 FAU - Chroni, D AU - Chroni D AD - KAT Hospital Athens, Kifisia, Greece. ISNI: 0000 0004 0622 8129. GRID: grid.415070.7 FAU - Alamanos, I AU - Alamanos I AD - ICU-B, KAT Hospital Kifisia, Athens, Greece FAU - Koch, L AU - Koch L AD - Hennepin County Medical Center, Minneapolis, USA. ISNI: 0000 0000 9206 4546. GRID: grid.414021.2 FAU - Jancik, J AU - Jancik J AD - Hennepin County Medical Center, Minneapolis, USA. ISNI: 0000 0000 9206 4546. GRID: grid.414021.2 FAU - Rhodes, H AU - Rhodes H AD - Hennepin County Medical Center, Minneapolis, USA. ISNI: 0000 0000 9206 4546. GRID: grid.414021.2 FAU - Walter, E AU - Walter E AD - Hennepin County Medical Center, Minneapolis, USA. ISNI: 0000 0000 9206 4546. GRID: grid.414021.2 FAU - Maekawa, K AU - Maekawa K AD - Hokkaido University Hospital, Sapporo, Japan. ISNI: 0000 0004 0378 6088. GRID: grid.412167.7 FAU - Hayakawa, M AU - Hayakawa M AD - Hokkaido University Hospital, Sapporo, Japan. ISNI: 0000 0004 0378 6088. GRID: grid.412167.7 FAU - Kushimoto, S AU - Kushimoto S AD - Tohoku University Graduate School of Medicine, Sendai, Japan. ISNI: 0000 0001 2248 6943. GRID: grid.69566.3a FAU - Shiraishi, A AU - Shiraishi A AD - Tokyo Medical and Dental University Hospital of Medicine, Tokyo, Japan. GRID: grid.474906.8 FAU - Kato, H AU - Kato H AD - National Hospital Organization Disaster Medical Center, Tokyo, Japan. ISNI: 0000 0004 0569 9594. GRID: grid.416797.a FAU - Sasaki, J AU - Sasaki J AD - Keio University School of Medicine, Tokyo, Japan. ISNI: 0000 0004 1936 9959. GRID: grid.26091.3c FAU - Ogura, H AU - Ogura H AD - Osaka University Graduate School of Medicine, Osaka, Japan. ISNI: 0000 0004 0373 3971. GRID: grid.136593.b FAU - Matauoka, T AU - Matauoka T AD - Rinku General Medical Center, Osaka, Japan FAU - Uejima, T AU - Uejima T AD - Kinki University Faculty of Medicine, Osaka, Japan. ISNI: 0000 0004 1936 9967. GRID: grid.258622.9 FAU - Morimura, N AU - Morimura N AD - Yokohama City University Graduate School of Medicine, Yokohama, Japan. ISNI: 0000 0001 1033 6139. GRID: grid.268441.d FAU - Ishikura, H AU - Ishikura H AD - Faculty of Medicine, Fukuoka University, Fukuoka, Japan. ISNI: 0000 0001 0672 2176. GRID: grid.411497.e FAU - Hagiwara, A AU - Hagiwara A AD - National Center For Global Health and Medicine, Tokyo, Japan. ISNI: 0000 0004 0489 0290. GRID: grid.45203.30 FAU - Takeda, M AU - Takeda M AD - Tokyo Women's Medical University, Tokyo, Japan. ISNI: 0000 0001 0720 6587. GRID: grid.410818.4 FAU - Tarabrin, O AU - Tarabrin O AD - Odessa National Medical University, Odessa, Ukraine. GRID: grid.445907.b FAU - Shcherbakow, S AU - Shcherbakow S AD - Odessa National Medical University, Odessa, Ukraine. GRID: grid.445907.b FAU - Gavrychenko, D AU - Gavrychenko D AD - Odessa National Medical University, Odessa, Ukraine. GRID: grid.445907.b FAU - Mazurenko, G AU - Mazurenko G AD - Odessa National Medical University, Odessa, Ukraine. GRID: grid.445907.b FAU - Ivanova, V AU - Ivanova V AD - Odessa National Medical University, Odessa, Ukraine. GRID: grid.445907.b FAU - Chystikov, O AU - Chystikov O AD - Odessa National Medical University, Odessa, Ukraine. GRID: grid.445907.b FAU - Plourde, C AU - Plourde C AD - Hopital Sacre-Coeur de Montreal, Montreal, Canada. ISNI: 0000 0001 2160 7387. GRID: grid.414056.2 FAU - Lessard, J AU - Lessard J AD - Hopital Sacre-Coeur de Montreal, Montreal, Canada. ISNI: 0000 0001 2160 7387. GRID: grid.414056.2 FAU - Chauny, J AU - Chauny J FAU - Daoust, R AU - Daoust R AD - Hopital Sacre-Coeur de Montreal, Montreal, Canada. ISNI: 0000 0001 2160 7387. GRID: grid.414056.2 FAU - Shcherbakow, S AU - Shcherbakow S AD - Odessa National Medical University, Odessa, Ukraine. GRID: grid.445907.b FAU - Tarabrin, O AU - Tarabrin O AD - Odessa National Medical University, Odessa, Ukraine. GRID: grid.445907.b FAU - Gavrychenko, D AU - Gavrychenko D AD - Odessa National Medical University, Odessa, Ukraine. GRID: grid.445907.b FAU - Mazurenko, G AU - Mazurenko G AD - Odessa National Medical University, Odessa, Ukraine. GRID: grid.445907.b FAU - Chystikov, O AU - Chystikov O AD - Odessa National Medical University, Odessa, Ukraine. GRID: grid.445907.b FAU - Vakalos, A AU - Vakalos A AD - Xanthi General Hospital, Xanth, Greece. GRID: grid.414012.2 FAU - Avramidis, V AU - Avramidis V AD - Xanthi General Hospital, Xanth, Greece. GRID: grid.414012.2 FAU - Kropman, L AU - Kropman L AD - Maastricht UMC, Maastricht, Netherlands. GRID: grid.412966.e FAU - In het Panhuis, L AU - In het Panhuis L AD - Maastricht UMC, Maastricht, Netherlands. GRID: grid.412966.e FAU - Konings, J AU - Konings J AD - Maastricht UMC, Maastricht, Netherlands. GRID: grid.412966.e FAU - Huskens, D AU - Huskens D AD - Maastricht UMC, Maastricht, Netherlands. GRID: grid.412966.e FAU - Schurgers, E AU - Schurgers E AD - Maastricht UMC, Maastricht, Netherlands. GRID: grid.412966.e FAU - Roest, M AU - Roest M AD - Maastricht UMC, Maastricht, Netherlands. GRID: grid.412966.e FAU - De Laat, B AU - De Laat B AD - Maastricht UMC, Maastricht, Netherlands. GRID: grid.412966.e FAU - Lance, M AU - Lance M AD - Maastricht UMC, Maastricht, Netherlands. GRID: grid.412966.e FAU - Durila, M AU - Durila M AD - Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic. ISNI: 0000 0004 0611 0905. GRID: grid.412826.b FAU - Lukas, P AU - Lukas P AD - Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic. ISNI: 0000 0004 0611 0905. GRID: grid.412826.b FAU - Astraverkhava, M AU - Astraverkhava M AD - Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic. ISNI: 0000 0004 0611 0905. GRID: grid.412826.b FAU - Jonas, J AU - Jonas J AD - Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic. ISNI: 0000 0004 0611 0905. GRID: grid.412826.b FAU - Budnik, I AU - Budnik I AD - Sechenov First Moscow Stat Medical University, Moscow, Russia FAU - Shenkman, B AU - Shenkman B AD - Sheba Medical Center, Tel-Hashomer, Israel. ISNI: 0000 0001 2107 2845. GRID: grid.413795.d FAU - Hayami, H AU - Hayami H AD - Yokohama Municipal Citizen's Hospital, Yokohama, Japan. ISNI: 0000 0004 0377 5418. GRID: grid.417366.1 FAU - Koide, Y AU - Koide Y AD - Hayama Heart Center, Hayama, Japan FAU - Goto, T AU - Goto T AD - Yokohama City University Hospital, Yokohama, Japan. ISNI: 0000 0004 1767 0473. GRID: grid.470126.6 FAU - Iqbal, R AU - Iqbal R AD - Institute of Ageing and Chronic Disease, Liverpool, UK FAU - Alhamdi, Y AU - Alhamdi Y AD - Institute of Infection and Global Health, Liverpool, UK FAU - Venugopal, N AU - Venugopal N AD - Institute of Ageing and Chronic Disease, Liverpool, UK FAU - Abrams, S AU - Abrams S AD - Institute of Infection and Global Health, Liverpool, UK FAU - Downey, C AU - Downey C AD - Department of Haematology, Royal Liverpool University Hospital (RLUH), Liverpool, UK. ISNI: 0000 0004 0417 2395. GRID: grid.415970.e FAU - Toh, C H AU - Toh CH AD - Institute of Infection and Global Health, Liverpool, UK FAU - Welters, I D AU - Welters ID AD - Institute of Ageing and Chronic Disease, Liverpool, UK FAU - Bombay, V B AU - Bombay VB AD - Hopital du Sacre-Coeur de Montreal, Montreal, Canada. ISNI: 0000 0001 2160 7387. GRID: grid.414056.2 FAU - Chauny, J M AU - Chauny JM AD - Hopital du Sacre-Coeur de Montreal, Montreal, Canada. ISNI: 0000 0001 2160 7387. GRID: grid.414056.2 FAU - Daoust, R D AU - Daoust RD AD - Hopital du Sacre-Coeur de Montreal, Montreal, Canada. ISNI: 0000 0001 2160 7387. GRID: grid.414056.2 FAU - Lessard, J L AU - Lessard JL AD - Hopital du Sacre-Coeur de Montreal, Montreal, Canada. ISNI: 0000 0001 2160 7387. GRID: grid.414056.2 FAU - Marquis, M M AU - Marquis MM AD - Hopital du Sacre-Coeur de Montreal, Montreal, Canada. ISNI: 0000 0001 2160 7387. GRID: grid.414056.2 FAU - Paquet, J P AU - Paquet JP AD - Hopital du Sacre-Coeur de Montreal, Montreal, Canada. ISNI: 0000 0001 2160 7387. GRID: grid.414056.2 FAU - Siemens, K AU - Siemens K AD - Evelina London Children's Hospital, London, UK FAU - Sangaran, D AU - Sangaran D AD - Evelina London Children's Hospital, London, UK FAU - Hunt, B J AU - Hunt BJ AD - St Thomas Hospital, London, UK. GRID: grid.425213.3 FAU - Durward, A AU - Durward A AD - Evelina London Children's Hospital, London, UK FAU - Nyman, A AU - Nyman A AD - Evelina London Children's Hospital, London, UK FAU - Murdoch, I A AU - Murdoch IA AD - Evelina London Children's Hospital, London, UK FAU - Tibby, S M AU - Tibby SM AD - Evelina London Children's Hospital, London, UK FAU - Ampatzidou, F AU - Ampatzidou F AD - G.Papanikolaou General Hospital, Thessaloniki, Greece. ISNI: 0000 0004 0576 574X. GRID: grid.415248.e FAU - Moisidou, D AU - Moisidou D AD - G.Papanikolaou General Hospital, Thessaloniki, Greece. ISNI: 0000 0004 0576 574X. GRID: grid.415248.e FAU - Dalampini, E AU - Dalampini E AD - G.Papanikolaou General Hospital, Thessaloniki, Greece. ISNI: 0000 0004 0576 574X. GRID: grid.415248.e FAU - Nastou, M AU - Nastou M AD - G.Papanikolaou General Hospital, Thessaloniki, Greece. ISNI: 0000 0004 0576 574X. GRID: grid.415248.e FAU - Vasilarou, E AU - Vasilarou E AD - G.Papanikolaou General Hospital, Thessaloniki, Greece. ISNI: 0000 0004 0576 574X. GRID: grid.415248.e FAU - Kalaizi, V AU - Kalaizi V AD - G.Papanikolaou General Hospital, Thessaloniki, Greece. ISNI: 0000 0004 0576 574X. GRID: grid.415248.e FAU - Chatzikostenoglou, H AU - Chatzikostenoglou H AD - G.Papanikolaou General Hospital, Thessaloniki, Greece. ISNI: 0000 0004 0576 574X. GRID: grid.415248.e FAU - Drossos, G AU - Drossos G AD - G.Papanikolaou General Hospital, Thessaloniki, Greece. ISNI: 0000 0004 0576 574X. GRID: grid.415248.e FAU - Spadaro, S AU - Spadaro S AD - Intensive Care Unit, University of Ferrara, Italy, Ferrara, Italy. ISNI: 0000 0004 1757 2064. GRID: grid.8484.0 FAU - Fogagnolo, A AU - Fogagnolo A AD - Intensive Care Unit, University of Ferrara, Italy, Ferrara, Italy. ISNI: 0000 0004 1757 2064. GRID: grid.8484.0 FAU - Fiore, T AU - Fiore T AD - Intensive Care Unit, University of Ferrara, Italy, Ferrara, Italy. ISNI: 0000 0004 1757 2064. GRID: grid.8484.0 FAU - Schiavi, A AU - Schiavi A AD - Intensive Care Unit, University of Ferrara, Italy, Ferrara, Italy. ISNI: 0000 0004 1757 2064. GRID: grid.8484.0 FAU - Fontana, V AU - Fontana V AD - Intensive Care Unit, University of Ferrara, Italy, Ferrara, Italy. ISNI: 0000 0004 1757 2064. GRID: grid.8484.0 FAU - Taccone, F AU - Taccone F AD - Department of Intensive Care, Erasme Hospital, Universite Libre de Bruxelles, Bruxelles, Belgium FAU - Volta, C AU - Volta C AD - Intensive Care Unit, University of Ferrara, Italy, Ferrara, Italy. ISNI: 0000 0004 1757 2064. GRID: grid.8484.0 FAU - Chochliourou, E AU - Chochliourou E AD - Hippokration General Hospital Thessaloniki, Thessaloniki, Greece. ISNI: 0000 0004 0621 2899. GRID: grid.414122.0 FAU - Volakli, E AU - Volakli E AD - Hippokration General Hospital Thessaloniki, Thessaloniki, Greece. ISNI: 0000 0004 0621 2899. GRID: grid.414122.0 FAU - Violaki, A AU - Violaki A AD - Hippokration General Hospital Thessaloniki, Thessaloniki, Greece. ISNI: 0000 0004 0621 2899. GRID: grid.414122.0 FAU - Samkinidou, E AU - Samkinidou E AD - Hippokration General Hospital Thessaloniki, Thessaloniki, Greece. ISNI: 0000 0004 0621 2899. GRID: grid.414122.0 FAU - Evlavis, G AU - Evlavis G AD - Hippokration General Hospital Thessaloniki, Thessaloniki, Greece. ISNI: 0000 0004 0621 2899. GRID: grid.414122.0 FAU - Panagiotidou, V AU - Panagiotidou V AD - Hippokration General Hospital Thessaloniki, Thessaloniki, Greece. ISNI: 0000 0004 0621 2899. GRID: grid.414122.0 FAU - Sdougka, M AU - Sdougka M AD - Hippokration General Hospital Thessaloniki, Thessaloniki, Greece. ISNI: 0000 0004 0621 2899. GRID: grid.414122.0 FAU - Mothukuri, R AU - Mothukuri R AD - Morriston Hospital, Swansea, UK. ISNI: 0000 0004 0649 0266. GRID: grid.416122.2 FAU - Battle, C AU - Battle C AD - Morriston Hospital, Swansea, UK. ISNI: 0000 0004 0649 0266. GRID: grid.416122.2 FAU - Guy, K AU - Guy K AD - Morriston Hospital, Swansea, UK. ISNI: 0000 0004 0649 0266. GRID: grid.416122.2 FAU - Mills, G AU - Mills G AD - Morriston Hospital, Swansea, UK. ISNI: 0000 0004 0649 0266. GRID: grid.416122.2 FAU - Evans, P AU - Evans P AD - Morriston Hospital, Swansea, UK. ISNI: 0000 0004 0649 0266. GRID: grid.416122.2 FAU - Wijesuriya, J AU - Wijesuriya J AD - Central London School of Anaesthesia and Intensive Care Medicine, London, UK FAU - Keogh, S AU - Keogh S AD - University of the Sunshine Coast, Maroochydore, Australia. ISNI: 0000 0001 1555 3415. GRID: grid.1034.6 FAU - Docherty, A AU - Docherty A AD - University of Edinburgh, Edinburgh, UK. ISNI: 0000 0004 1936 7988. GRID: grid.4305.2 FAU - O'Donnell, R AU - O'Donnell R AD - University of Edinburgh, Edinburgh, UK. ISNI: 0000 0004 1936 7988. GRID: grid.4305.2 FAU - Brunskill, S AU - Brunskill S AD - John Radcliffe Hospital, Oxford, UK. ISNI: 0000 0001 2306 7492. GRID: grid.8348.7 FAU - Trivella, M AU - Trivella M AD - John Radcliffe Hospital, Oxford, UK. ISNI: 0000 0001 2306 7492. GRID: grid.8348.7 FAU - Doree, C AU - Doree C AD - John Radcliffe Hospital, Oxford, UK. ISNI: 0000 0001 2306 7492. GRID: grid.8348.7 FAU - Holst, L AU - Holst L AD - Copenhagen University Hospital, Copenhagen, Denmark. ISNI: 0000 0004 0646 7373. GRID: grid.4973.9 FAU - Parker, M AU - Parker M AD - Peterborough NHS Trust, Peterborough, UK FAU - Gregersen, M AU - Gregersen M AD - Aarhus University, Aarhus, Denmark. ISNI: 0000 0001 1956 2722. GRID: grid.7048.b FAU - Almeida, J AU - Almeida J AD - Hospital de Sao Paulo, Sao Paulo, Brazil. GRID: grid.413463.7 FAU - Walsh, T AU - Walsh T AD - University of Edinburgh, Edinburgh, UK. ISNI: 0000 0004 1936 7988. GRID: grid.4305.2 FAU - Stanworth, S AU - Stanworth S AD - John Radcliffe Hospital, Oxford, UK. ISNI: 0000 0001 2306 7492. GRID: grid.8348.7 FAU - Moravcova, S AU - Moravcova S AD - Royal Brompton & Harefield NHS Trust, London, UK. ISNI: 0000 0004 0581 2008. GRID: grid.451052.7 FAU - Mansell, J AU - Mansell J AD - Barts Heart Centre, London, UK FAU - Rogers, A AU - Rogers A AD - Barts Heart Centre, London, UK FAU - Smith, R A AU - Smith RA AD - Barts Heart Centre, London, UK FAU - Hamilton-Davies, C AU - Hamilton-Davies C AD - Barts Heart Centre, London, UK FAU - Omar, A AU - Omar A AD - Hamad medical corporation, Doha, Qatar. ISNI: 0000 0004 0571 546X. GRID: grid.413548.f FAU - Allam, M AU - Allam M AD - Hamad medical corporation, Doha, Qatar. ISNI: 0000 0004 0571 546X. GRID: grid.413548.f FAU - Bilala, O AU - Bilala O AD - Hamad medical corporation, Doha, Qatar. ISNI: 0000 0004 0571 546X. GRID: grid.413548.f FAU - Kindawi, A AU - Kindawi A AD - Hamad medical corporation, Doha, Qatar. ISNI: 0000 0004 0571 546X. GRID: grid.413548.f FAU - Ewila, H AU - Ewila H AD - Hamad medical corporation, Doha, Qatar. ISNI: 0000 0004 0571 546X. GRID: grid.413548.f FAU - Ampatzidou, F AU - Ampatzidou F AD - G.Papanikolaou General Hospital, Thessaloniki, Greece. ISNI: 0000 0004 0576 574X. GRID: grid.415248.e FAU - Moisidou, D AU - Moisidou D AD - G.Papanikolaou General Hospital, Thessaloniki, Greece. ISNI: 0000 0004 0576 574X. GRID: grid.415248.e FAU - Nastou, M AU - Nastou M AD - G.Papanikolaou General Hospital, Thessaloniki, Greece. ISNI: 0000 0004 0576 574X. GRID: grid.415248.e FAU - Dalampini, E AU - Dalampini E AD - G.Papanikolaou General Hospital, Thessaloniki, Greece. ISNI: 0000 0004 0576 574X. GRID: grid.415248.e FAU - Malamas, A AU - Malamas A AD - G.Papanikolaou General Hospital, Thessaloniki, Greece. ISNI: 0000 0004 0576 574X. GRID: grid.415248.e FAU - Vasilarou, E AU - Vasilarou E AD - G.Papanikolaou General Hospital, Thessaloniki, Greece. ISNI: 0000 0004 0576 574X. GRID: grid.415248.e FAU - Drossos, G AU - Drossos G AD - G.Papanikolaou General Hospital, Thessaloniki, Greece. ISNI: 0000 0004 0576 574X. GRID: grid.415248.e FAU - Ferreira, G AU - Ferreira G AD - University of Sao Paulo, Brazi, Sao Paulo, Brazil. ISNI: 0000 0004 1937 0722. GRID: grid.11899.38 FAU - Caldas, J AU - Caldas J AD - University of Sao Paulo, Brazi, Sao Paulo, Brazil. ISNI: 0000 0004 1937 0722. GRID: grid.11899.38 FAU - Fukushima, J AU - Fukushima J AD - University of Sao Paulo, Brazi, Sao Paulo, Brazil. ISNI: 0000 0004 1937 0722. GRID: grid.11899.38 FAU - Osawa, E A AU - Osawa EA AD - University of Sao Paulo, Brazi, Sao Paulo, Brazil. ISNI: 0000 0004 1937 0722. GRID: grid.11899.38 FAU - Arita, E AU - Arita E AD - University of Sao Paulo, Brazi, Sao Paulo, Brazil. ISNI: 0000 0004 1937 0722. GRID: grid.11899.38 FAU - Camara, L AU - Camara L AD - University of Sao Paulo, Brazi, Sao Paulo, Brazil. ISNI: 0000 0004 1937 0722. GRID: grid.11899.38 FAU - Zeferino, S AU - Zeferino S AD - University of Sao Paulo, Brazi, Sao Paulo, Brazil. ISNI: 0000 0004 1937 0722. GRID: grid.11899.38 FAU - Jardim, J AU - Jardim J AD - University of Sao Paulo, Brazi, Sao Paulo, Brazil. ISNI: 0000 0004 1937 0722. GRID: grid.11899.38 FAU - Gaioto, F AU - Gaioto F AD - University of Sao Paulo, Brazi, Sao Paulo, Brazil. ISNI: 0000 0004 1937 0722. GRID: grid.11899.38 FAU - Dallan, L AU - Dallan L AD - University of Sao Paulo, Brazi, Sao Paulo, Brazil. ISNI: 0000 0004 1937 0722. GRID: grid.11899.38 FAU - Jatene, F B AU - Jatene FB AD - University of Sao Paulo, Brazi, Sao Paulo, Brazil. ISNI: 0000 0004 1937 0722. GRID: grid.11899.38 FAU - Kalil Filho, R AU - Kalil Filho R AD - University of Sao Paulo, Brazi, Sao Paulo, Brazil. ISNI: 0000 0004 1937 0722. GRID: grid.11899.38 FAU - Galas, F AU - Galas F AD - University of Sao Paulo, Brazi, Sao Paulo, Brazil. ISNI: 0000 0004 1937 0722. GRID: grid.11899.38 FAU - Hajjar, L A AU - Hajjar LA AD - University of Sao Paulo, Brazi, Sao Paulo, Brazil. ISNI: 0000 0004 1937 0722. GRID: grid.11899.38 FAU - Mitaka, C AU - Mitaka C AD - Juntendo University Hospital, Tokyo, Japan. GRID: grid.411966.d FAU - Ohnuma, T AU - Ohnuma T AD - Saitama Medical Center, Jichi Medical University, Saitama, Japan. ISNI: 0000000123090000. GRID: grid.410804.9 FAU - Murayama, T AU - Murayama T FAU - Kunimoto, F AU - Kunimoto F AD - Gunma University Hospital, Maebashi, Japan. ISNI: 0000 0004 0595 7039. GRID: grid.411887.3 FAU - Nagashima, M AU - Nagashima M AD - Yokohama City Minato Red Cross Hospital, Yokohama, Japan FAU - Takei, T AU - Takei T AD - Yokohama City Minato Red Cross Hospital, Yokohama, Japan FAU - Tomita, M AU - Tomita M AD - Tokyo Medical and Dental University Hospital of Medicine, Tokyo, Japan. GRID: grid.474906.8 FAU - Omar, A AU - Omar A AD - Hamad medical corporation, Doha, Qatar. ISNI: 0000 0004 0571 546X. GRID: grid.413548.f FAU - Mahmoud, K AU - Mahmoud K AD - Hamad medical corporation, Doha, Qatar. ISNI: 0000 0004 0571 546X. GRID: grid.413548.f FAU - Hanoura, S AU - Hanoura S AD - Hamad medical corporation, Doha, Qatar. ISNI: 0000 0004 0571 546X. GRID: grid.413548.f FAU - Sudarsanan, S AU - Sudarsanan S AD - Hamad medical corporation, Doha, Qatar. ISNI: 0000 0004 0571 546X. GRID: grid.413548.f FAU - Sivadasan, P AU - Sivadasan P AD - Hamad medical corporation, Doha, Qatar. ISNI: 0000 0004 0571 546X. GRID: grid.413548.f FAU - Othamn, H AU - Othamn H AD - Hamad medical corporation, Doha, Qatar. ISNI: 0000 0004 0571 546X. GRID: grid.413548.f FAU - Shouman, Y AU - Shouman Y AD - Hamad medical corporation, Doha, Qatar. ISNI: 0000 0004 0571 546X. GRID: grid.413548.f FAU - Singh, R AU - Singh R AD - Hamad medical corporation, Doha, Qatar. ISNI: 0000 0004 0571 546X. GRID: grid.413548.f FAU - Al Khulaifi, A AU - Al Khulaifi A AD - Hamad medical corporation, Doha, Qatar. ISNI: 0000 0004 0571 546X. GRID: grid.413548.f FAU - Mandel, I AU - Mandel I AD - Research Institution for Cardiology, Tomsk, Russia FAU - Mikheev, S AU - Mikheev S AD - Research Institution for Cardiology, Tomsk, Russia FAU - Suhodolo, I AU - Suhodolo I AD - Siberian State Medical University, Tomsk, Russia. ISNI: 0000 0001 0027 1685. GRID: grid.412593.8 FAU - Kiselev, V AU - Kiselev V AD - Research Institution for Cardiology, Tomsk, Russia FAU - Svirko, Y AU - Svirko Y AD - Research Institution for Cardiology, Tomsk, Russia FAU - Podoksenov, Y AU - Podoksenov Y AD - Research Institution for Cardiology, Tomsk, Russia FAU - Jenkins, S A AU - Jenkins SA AD - The Hillingdon Hospitals NHS Foundation Trust, Middlesex, UK. ISNI: 0000 0004 0476 7073. GRID: grid.440199.1 FAU - Griffin, R AU - Griffin R AD - The Hillingdon Hospitals NHS Foundation Trust, Middlesex, UK. ISNI: 0000 0004 0476 7073. GRID: grid.440199.1 FAU - Tovar Doncel, M S AU - Tovar Doncel MS AD - University Hospital Rio Hortega, Valladolid, Spain. ISNI: 0000 0001 1842 3755. GRID: grid.411280.e FAU - Lima, A AU - Lima A AD - Erasmus MC, Rotterdam, Netherlands. ISNI: 000000040459992X. GRID: grid.5645.2 FAU - Aldecoa, C AU - Aldecoa C AD - University Hospital Rio Hortega, Valladolid, Spain. ISNI: 0000 0001 1842 3755. GRID: grid.411280.e FAU - Ince, C AU - Ince C AD - Erasmus MC, Rotterdam, Netherlands. ISNI: 000000040459992X. GRID: grid.5645.2 FAU - Taha, A AU - Taha A AD - Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates. ISNI: 0000 0004 1773 3278. GRID: grid.415670.1 FAU - Shafie, A AU - Shafie A AD - Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates. ISNI: 0000 0004 1773 3278. GRID: grid.415670.1 FAU - Mostafa, M AU - Mostafa M AD - Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates. ISNI: 0000 0004 1773 3278. GRID: grid.415670.1 FAU - Syed, N AU - Syed N AD - Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates. ISNI: 0000 0004 1773 3278. GRID: grid.415670.1 FAU - Hon, H AU - Hon H AD - Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates. ISNI: 0000 0004 1773 3278. GRID: grid.415670.1 FAU - Righetti, F AU - Righetti F AD - Intensive Care Unit, St. Boniface Hospital, Verona, Italy FAU - Colombaroli, E AU - Colombaroli E AD - Intensive Care Unit, St. Boniface Hospital, Verona, Italy FAU - Castellano, G AU - Castellano G AD - Intensive Care Unit, St. Boniface Hospital, Verona, Italy FAU - Righetti, F AU - Righetti F AD - Intensive Care Unit, St. Boniface Hospital, Verona, Italy FAU - Colombaroli, E AU - Colombaroli E AD - Intensive Care Unit, St. Boniface Hospital, Verona, Italy FAU - Hravnak, M AU - Hravnak M AD - University of Pittsburgh, Pittsburgh, USA. ISNI: 0000 0004 1936 9000. GRID: grid.21925.3d FAU - Chen, L C AU - Chen LC AD - Carnegie Mellon University, Pittsburgh, USA. ISNI: 0000 0001 2097 0344. GRID: grid.147455.6 FAU - Dubrawski, A D AU - Dubrawski AD AD - Carnegie Mellon University, Pittsburgh, USA. ISNI: 0000 0001 2097 0344. GRID: grid.147455.6 FAU - Clermont, G C AU - Clermont GC AD - University of Pittsburgh, Pittsburgh, USA. ISNI: 0000 0004 1936 9000. GRID: grid.21925.3d FAU - Pinsky, M R AU - Pinsky MR AD - University of Pittsburgh, Pittsburgh, USA. ISNI: 0000 0004 1936 9000. GRID: grid.21925.3d FAU - Gonzalez, S AU - Gonzalez S AD - Valme University Hospital, Seville, Spain. ISNI: 0000 0004 1768 1690. GRID: grid.412800.f FAU - Macias, D AU - Macias D AD - Valme University Hospital, Seville, Spain. ISNI: 0000 0004 1768 1690. GRID: grid.412800.f FAU - Acosta, J AU - Acosta J AD - Valme University Hospital, Seville, Spain. ISNI: 0000 0004 1768 1690. GRID: grid.412800.f FAU - Jimenez, P AU - Jimenez P AD - Valme University Hospital, Seville, Spain. ISNI: 0000 0004 1768 1690. GRID: grid.412800.f FAU - Loza, A AU - Loza A AD - Valme University Hospital, Seville, Spain. ISNI: 0000 0004 1768 1690. GRID: grid.412800.f FAU - Lesmes, A AU - Lesmes A AD - Valme University Hospital, Seville, Spain. ISNI: 0000 0004 1768 1690. GRID: grid.412800.f FAU - Lucena, F AU - Lucena F AD - Valme University Hospital, Seville, Spain. ISNI: 0000 0004 1768 1690. GRID: grid.412800.f FAU - Leon, C AU - Leon C AD - Valme University Hospital, Seville, Spain. ISNI: 0000 0004 1768 1690. GRID: grid.412800.f FAU - Tovar Doncel, M S AU - Tovar Doncel MS AD - University Hospital Rio Hortega, Valladolid, Spain. ISNI: 0000 0001 1842 3755. GRID: grid.411280.e FAU - Ince, C AU - Ince C AD - Erasmus MC, Rotterdam, Netherlands. ISNI: 000000040459992X. GRID: grid.5645.2 FAU - Aldecoa, C AU - Aldecoa C AD - University Hospital Rio Hortega, Valladolid, Spain. ISNI: 0000 0001 1842 3755. GRID: grid.411280.e FAU - Lima, A AU - Lima A AD - Erasmus MC, Rotterdam, Netherlands. ISNI: 000000040459992X. GRID: grid.5645.2 FAU - Bastide, M AU - Bastide M AD - CHU Amiens, Amiens, France. ISNI: 0000 0004 0593 702X. GRID: grid.134996.0 FAU - Richecoeur, J AU - Richecoeur J AD - CH Beauvais, Beauvais, France FAU - Frenoy, E AU - Frenoy E AD - Reanimation polyvalente, Le Havre, France FAU - Lemaire, C AU - Lemaire C AD - CH Roubaix, Roubaix, France. ISNI: 0000 0004 0608 7784. GRID: grid.477297.8 FAU - Sauneuf, B AU - Sauneuf B AD - CH Cotentin, Cherbourg, France FAU - Tamion, F AU - Tamion F AD - CHU Rouen, Rouen, France. GRID: grid.41724.34 FAU - Nseir, S AU - Nseir S AD - CHU Lille, Lille, France. ISNI: 0000 0004 0471 8845. GRID: grid.410463.4 FAU - Du Cheyron, D AU - Du Cheyron D AD - CHU Caen, Caen, France. ISNI: 0000 0004 0472 0160. GRID: grid.411149.8 FAU - Dupont, H AU - Dupont H AD - CHU Amiens, Amiens, France. ISNI: 0000 0004 0593 702X. GRID: grid.134996.0 FAU - Maizel, J AU - Maizel J AD - CHU Amiens, Amiens, France. ISNI: 0000 0004 0593 702X. GRID: grid.134996.0 FAU - Shaban, M AU - Shaban M AD - King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia. ISNI: 0000 0001 2191 4301. GRID: grid.415310.2 FAU - Kolko, R AU - Kolko R AD - King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia. ISNI: 0000 0001 2191 4301. GRID: grid.415310.2 FAU - Salahuddin, N AU - Salahuddin N AD - King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia. ISNI: 0000 0001 2191 4301. GRID: grid.415310.2 FAU - Sharshir, M AU - Sharshir M AD - King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia. ISNI: 0000 0001 2191 4301. GRID: grid.415310.2 FAU - AbuRageila, M AU - AbuRageila M AD - King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia. ISNI: 0000 0001 2191 4301. GRID: grid.415310.2 FAU - AlHussain, A AU - AlHussain A AD - King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia. ISNI: 0000 0001 2191 4301. GRID: grid.415310.2 FAU - Mercado, P AU - Mercado P AD - CHU Amiens, Amiens, France. ISNI: 0000 0004 0593 702X. GRID: grid.134996.0 FAU - Maizel, J AU - Maizel J AD - CHU Amiens, Amiens, France. ISNI: 0000 0004 0593 702X. GRID: grid.134996.0 FAU - Kontar, L AU - Kontar L AD - CHU Amiens, Amiens, France. ISNI: 0000 0004 0593 702X. GRID: grid.134996.0 FAU - Titeca, D AU - Titeca D AD - CHU Amiens, Amiens, France. ISNI: 0000 0004 0593 702X. GRID: grid.134996.0 FAU - Brazier, F AU - Brazier F AD - CHU Amiens, Amiens, France. ISNI: 0000 0004 0593 702X. GRID: grid.134996.0 FAU - Riviere, A AU - Riviere A AD - CHU Amiens, Amiens, France. ISNI: 0000 0004 0593 702X. GRID: grid.134996.0 FAU - Joris, M AU - Joris M AD - CHU Amiens, Amiens, France. ISNI: 0000 0004 0593 702X. GRID: grid.134996.0 FAU - Soupison, T AU - Soupison T AD - CHU Amiens, Amiens, France. ISNI: 0000 0004 0593 702X. GRID: grid.134996.0 FAU - De Cagny, B AU - De Cagny B AD - CHU Amiens, Amiens, France. ISNI: 0000 0004 0593 702X. GRID: grid.134996.0 FAU - Slama, M AU - Slama M AD - CHU Amiens, Amiens, France. ISNI: 0000 0004 0593 702X. GRID: grid.134996.0 FAU - Wagner, J AU - Wagner J AD - University Medical Center Hamburg-Eppendorf, Hamburg, Germany. ISNI: 0000 0001 2180 3484. GRID: grid.13648.38 FAU - Korner, A AU - Korner A AD - University Medical Center Hamburg-Eppendorf, Hamburg, Germany. ISNI: 0000 0001 2180 3484. GRID: grid.13648.38 FAU - Kubik, M AU - Kubik M AD - University Medical Center Hamburg-Eppendorf, Hamburg, Germany. ISNI: 0000 0001 2180 3484. GRID: grid.13648.38 FAU - Kluge, S AU - Kluge S AD - University Medical Center Hamburg-Eppendorf, Hamburg, Germany. ISNI: 0000 0001 2180 3484. GRID: grid.13648.38 FAU - Reuter, D AU - Reuter D AD - University Medical Center Hamburg-Eppendorf, Hamburg, Germany. ISNI: 0000 0001 2180 3484. GRID: grid.13648.38 FAU - Saugel, B AU - Saugel B AD - University Medical Center Hamburg-Eppendorf, Hamburg, Germany. ISNI: 0000 0001 2180 3484. GRID: grid.13648.38 FAU - Colombaroli, E AU - Colombaroli E AD - Intensive Care Unit, St. Boniface Hospital, Verona, Italy FAU - Righetti, F AU - Righetti F AD - Intensive Care Unit, St. Boniface Hospital, Verona, Italy FAU - Castellano, G AU - Castellano G AD - Intensive Care Unit, St. Boniface Hospital, Verona, Italy FAU - Tran, T AU - Tran T AD - Brugmann Hospital, Brussels, Belgium. ISNI: 0000 0004 0469 8354. GRID: grid.411371.1 FAU - De Bels, D AU - De Bels D AD - Brugmann Hospital, Brussels, Belgium. ISNI: 0000 0004 0469 8354. GRID: grid.411371.1 FAU - Cudia, A AU - Cudia A AD - Brugmann Hospital, Brussels, Belgium. ISNI: 0000 0004 0469 8354. GRID: grid.411371.1 FAU - Strachinaru, M AU - Strachinaru M AD - Brugmann Hospital, Brussels, Belgium. ISNI: 0000 0004 0469 8354. GRID: grid.411371.1 FAU - Ghottignies, P AU - Ghottignies P AD - Brugmann Hospital, Brussels, Belgium. ISNI: 0000 0004 0469 8354. GRID: grid.411371.1 FAU - Devriendt, J AU - Devriendt J AD - Brugmann Hospital, Brussels, Belgium. ISNI: 0000 0004 0469 8354. GRID: grid.411371.1 FAU - Pierrakos, C AU - Pierrakos C AD - Brugmann Hospital, Brussels, Belgium. ISNI: 0000 0004 0469 8354. GRID: grid.411371.1 FAU - Martinez Gonzalez, O AU - Martinez Gonzalez O AD - Hospital Universitario del Tajo, Aranjuez, Spain FAU - Blancas, R AU - Blancas R AD - Hospital Universitario del Tajo, Aranjuez, Spain FAU - Lujan, J AU - Lujan J AD - Hospital Universitario Principe de Asturias, Alcala de Henares, Spain. ISNI: 0000 0004 1765 5855. GRID: grid.411338.c FAU - Ballesteros, D AU - Ballesteros D AD - Hospital Universitario del Tajo, Aranjuez, Spain FAU - Martinez Diaz, C AU - Martinez Diaz C AD - Hospital Universitario Principe de Asturias, Alcala de Henares, Spain. ISNI: 0000 0004 1765 5855. GRID: grid.411338.c FAU - Nunez, A AU - Nunez A AD - Hospital Universitario de San Carlos, Madrid, Spain. ISNI: 0000 0001 0671 5785. GRID: grid.411068.a FAU - Martin Parra, C AU - Martin Parra C AD - Hospital Universitario del Tajo, Aranjuez, Spain FAU - Lopez Matamala, B AU - Lopez Matamala B AD - Hospital Universitario del Tajo, Aranjuez, Spain FAU - Alonso Fernandez, M AU - Alonso Fernandez M AD - Hospital Universitario del Tajo, Aranjuez, Spain FAU - Chana, M AU - Chana M AD - Hospital Universitario del Tajo, Aranjuez, Spain FAU - Huber, W AU - Huber W AD - Klinikum rechts der Isar, Technical University of Munich, Munich, Germany. ISNI: 0000000123222966. GRID: grid.6936.a FAU - Eckmann, M AU - Eckmann M AD - Klinikum rechts der Isar, Technical University of Munich, Munich, Germany. ISNI: 0000000123222966. GRID: grid.6936.a FAU - Elkmann, F AU - Elkmann F AD - Klinikum rechts der Isar, Technical University of Munich, Munich, Germany. ISNI: 0000000123222966. GRID: grid.6936.a FAU - Gruber, A AU - Gruber A AD - Klinikum rechts der Isar, Technical University of Munich, Munich, Germany. ISNI: 0000000123222966. GRID: grid.6936.a FAU - Klein, I AU - Klein I AD - Klinikum rechts der Isar, Technical University of Munich, Munich, Germany. ISNI: 0000000123222966. GRID: grid.6936.a FAU - Schmid, R M AU - Schmid RM AD - Klinikum rechts der Isar, Technical University of Munich, Munich, Germany. ISNI: 0000000123222966. GRID: grid.6936.a FAU - Lahmer, T AU - Lahmer T AD - Klinikum rechts der Isar, Technical University of Munich, Munich, Germany. ISNI: 0000000123222966. GRID: grid.6936.a FAU - Moller, P W AU - Moller PW AD - Department of Intensive Care Medicine, University Hospital Bern, Bern, Switzerland. ISNI: 0000 0004 0479 0855. GRID: grid.411656.1 FAU - Sondergaard, S AU - Sondergaard S AD - Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden FAU - Jakob, S M AU - Jakob SM AD - Department of Intensive Care Medicine, University Hospital Bern, Bern, Switzerland. ISNI: 0000 0004 0479 0855. GRID: grid.411656.1 FAU - Takala, J AU - Takala J AD - Department of Intensive Care Medicine, University Hospital Bern, Bern, Switzerland. ISNI: 0000 0004 0479 0855. GRID: grid.411656.1 FAU - Berger, D AU - Berger D AD - Department of Intensive Care Medicine, University Hospital Bern, Bern, Switzerland. ISNI: 0000 0004 0479 0855. GRID: grid.411656.1 FAU - Bastoni, D AU - Bastoni D AD - St George's Healthcare NHS Trust, London, UK. GRID: grid.451349.e FAU - Aya, H AU - Aya H AD - St George's Healthcare NHS Trust, London, UK. GRID: grid.451349.e FAU - Toscani, L AU - Toscani L AD - St George's Healthcare NHS Trust, London, UK. GRID: grid.451349.e FAU - Pigozzi, L AU - Pigozzi L AD - St George's Healthcare NHS Trust, London, UK. GRID: grid.451349.e FAU - Rhodes, A AU - Rhodes A AD - St George's Healthcare NHS Trust, London, UK. GRID: grid.451349.e FAU - Cecconi, M AU - Cecconi M AD - St George's Healthcare NHS Trust, London, UK. GRID: grid.451349.e FAU - Ostrowska, C AU - Ostrowska C AD - St George's Healthcare NHS Trust, London, UK. GRID: grid.451349.e FAU - Aya, H AU - Aya H AD - St George's Healthcare NHS Trust, London, UK. GRID: grid.451349.e FAU - Abbas, A AU - Abbas A AD - St George's Healthcare NHS Trust, London, UK. GRID: grid.451349.e FAU - Mellinghoff, J AU - Mellinghoff J AD - St George's Healthcare NHS Trust, London, UK. GRID: grid.451349.e FAU - Ryan, C AU - Ryan C AD - St George's Healthcare NHS Trust, London, UK. GRID: grid.451349.e FAU - Dawson, D AU - Dawson D AD - St George's Healthcare NHS Trust, London, UK. GRID: grid.451349.e FAU - Rhodes, A AU - Rhodes A AD - St George's Healthcare NHS Trust, London, UK. GRID: grid.451349.e FAU - Cecconi, M AU - Cecconi M AD - St George's Healthcare NHS Trust, London, UK. GRID: grid.451349.e FAU - Cronhjort, M AU - Cronhjort M AD - Karolinska Institutet, Stockholm, Sweden. ISNI: 0000 0004 1937 0626. GRID: grid.4714.6 FAU - Wall, O AU - Wall O AD - Karolinska Institutet, Stockholm, Sweden. ISNI: 0000 0004 1937 0626. GRID: grid.4714.6 FAU - Nyberg, E AU - Nyberg E AD - Karolinska Institutet, Stockholm, Sweden. ISNI: 0000 0004 1937 0626. GRID: grid.4714.6 FAU - Zeng, R AU - Zeng R AD - Wenzhou Medical University, Wenzhou, Zheijang China. ISNI: 0000 0001 0348 3990. GRID: grid.268099.c FAU - Svensen, C AU - Svensen C AD - Karolinska Institutet, Stockholm, Sweden. ISNI: 0000 0004 1937 0626. GRID: grid.4714.6 FAU - Martensson, J AU - Martensson J AD - Department of Intensive Care, Austin Hospital, Melbourne, VIC Australia. ISNI: 0000 0001 0162 7225. GRID: grid.414094.c FAU - Joelsson-Alm, E AU - Joelsson-Alm E AD - Karolinska Institutet, Stockholm, Sweden. ISNI: 0000 0004 1937 0626. GRID: grid.4714.6 FAU - Aguilar Arzapalo, M AU - Aguilar Arzapalo M AD - Hospital O'horan, Merida, Mexico FAU - Barradas, L AU - Barradas L AD - Hospital O'horan, Merida, Mexico FAU - Lopez, V AU - Lopez V AD - Hospital O'horan, Merida, Mexico FAU - Cetina, M AU - Cetina M AD - Hospital O'horan, Merida, Mexico FAU - Parenti, N AU - Parenti N AD - Policlinico Modena, Bologna, Italy. ISNI: 0000 0004 1769 5275. GRID: grid.413363.0 FAU - Palazzi, C AU - Palazzi C AD - Policlinico Modena, Bologna, Italy. ISNI: 0000 0004 1769 5275. GRID: grid.413363.0 FAU - Amidei, L A AU - Amidei LA AD - Policlinico Modena, Bologna, Italy. ISNI: 0000 0004 1769 5275. GRID: grid.413363.0 FAU - Borrelli, F B AU - Borrelli FB AD - Policlinico Modena, Bologna, Italy. ISNI: 0000 0004 1769 5275. GRID: grid.413363.0 FAU - Campanale, S C AU - Campanale SC AD - Policlinico Modena, Bologna, Italy. ISNI: 0000 0004 1769 5275. GRID: grid.413363.0 FAU - Tagliazucchi, F T AU - Tagliazucchi FT AD - Policlinico Modena, Bologna, Italy. ISNI: 0000 0004 1769 5275. GRID: grid.413363.0 FAU - Sedoni, G S AU - Sedoni GS AD - Policlinico Modena, Bologna, Italy. ISNI: 0000 0004 1769 5275. GRID: grid.413363.0 FAU - Lucchesi, D L AU - Lucchesi DL AD - Policlinico Modena, Bologna, Italy. ISNI: 0000 0004 1769 5275. GRID: grid.413363.0 FAU - Carella, E C AU - Carella EC AD - Policlinico Modena, Bologna, Italy. ISNI: 0000 0004 1769 5275. GRID: grid.413363.0 FAU - Luciani, A L AU - Luciani AL AD - Policlinico Modena, Bologna, Italy. ISNI: 0000 0004 1769 5275. GRID: grid.413363.0 FAU - Mackovic, M AU - Mackovic M AD - Clinical Hospital Sveti Duh, Zagreb, Croatia FAU - Maric, N AU - Maric N AD - Clinical Hospital Sveti Duh, Zagreb, Croatia FAU - Bakula, M AU - Bakula M AD - Clinical Hospital Sveti Duh, Zagreb, Croatia FAU - Aya, H AU - Aya H AD - St George's Healthcare NHS Trust, London, UK. GRID: grid.451349.e FAU - Rhodes, A AU - Rhodes A AD - St George's Healthcare NHS Trust, London, UK. GRID: grid.451349.e FAU - Grounds, R M AU - Grounds RM AD - St George's Healthcare NHS Trust, London, UK. GRID: grid.451349.e FAU - Fletcher, N AU - Fletcher N AD - St George's Healthcare NHS Trust, London, UK. GRID: grid.451349.e FAU - Cecconi, M AU - Cecconi M AD - St George's Healthcare NHS Trust, London, UK. GRID: grid.451349.e FAU - Avard, B AU - Avard B AD - The Canberra Hospital, Hughes, ACT Australia. ISNI: 0000 0000 9984 5644. GRID: grid.413314.0 FAU - Zhang, P AU - Zhang P AD - Australian National University Medical School, Canberra, Australia. ISNI: 0000 0001 2180 7477. GRID: grid.1001.0 FAU - Mezidi, M AU - Mezidi M AD - Lapeyronie University Hospital, Montpellier, France. ISNI: 0000 0004 0638 8990. GRID: grid.411572.4 FAU - Charbit, J AU - Charbit J AD - Lapeyronie University Hospital, Montpellier, France. ISNI: 0000 0004 0638 8990. GRID: grid.411572.4 FAU - Ould-Chikh, M AU - Ould-Chikh M AD - Lapeyronie University Hospital, Montpellier, France. ISNI: 0000 0004 0638 8990. GRID: grid.411572.4 FAU - Deras, P AU - Deras P AD - Lapeyronie University Hospital, Montpellier, France. ISNI: 0000 0004 0638 8990. GRID: grid.411572.4 FAU - Maury, C AU - Maury C AD - Lapeyronie University Hospital, Montpellier, France. ISNI: 0000 0004 0638 8990. GRID: grid.411572.4 FAU - Martinez, O AU - Martinez O AD - Lapeyronie University Hospital, Montpellier, France. ISNI: 0000 0004 0638 8990. GRID: grid.411572.4 FAU - Capdevila, X AU - Capdevila X AD - Lapeyronie University Hospital, Montpellier, France. ISNI: 0000 0004 0638 8990. GRID: grid.411572.4 FAU - Hou, P AU - Hou P AD - Brigham and Women's Hospital, Boston, USA. ISNI: 0000 0004 0378 8294. GRID: grid.62560.37 FAU - Linde-Zwirble, W Z AU - Linde-Zwirble WZ AD - Trexin Medical, Chicago, USA FAU - Douglas, I D AU - Douglas ID AD - University of Colorado and Denver Health, Denver, USA. ISNI: 0000000107903411. GRID: grid.241116.1 FAU - Shapiro, N S AU - Shapiro NS AD - Beth Isreal Deaconess, Boston, USA FAU - Ben Souissi, A AU - Ben Souissi A AD - Mongi Slim University Hospital, La Marsa, Tunisia FAU - Mezghani, I AU - Mezghani I AD - Mongi Slim University Hospital, La Marsa, Tunisia FAU - Ben Aicha, Y AU - Ben Aicha Y AD - Mongi Slim University Hospital, La Marsa, Tunisia FAU - Kamoun, S AU - Kamoun S AD - Mongi Slim University Hospital, La Marsa, Tunisia FAU - Laribi, B AU - Laribi B AD - Mongi Slim University Hospital, La Marsa, Tunisia FAU - Jeribi, B AU - Jeribi B AD - Mongi Slim University Hospital, La Marsa, Tunisia FAU - Riahi, A AU - Riahi A AD - Mongi Slim University Hospital, La Marsa, Tunisia FAU - Mebazaa, M S AU - Mebazaa MS AD - Mongi Slim University Hospital, La Marsa, Tunisia FAU - Pereira, C AU - Pereira C AD - Centro Hospitalar do Porto, Porto, Portugal. ISNI: 0000 0004 0392 7039. GRID: grid.418340.a FAU - Marinho, R AU - Marinho R AD - Centro Hospitalar do Porto, Porto, Portugal. ISNI: 0000 0004 0392 7039. GRID: grid.418340.a FAU - Antunes, R AU - Antunes R AD - Centro Hospitalar do Porto, Porto, Portugal. ISNI: 0000 0004 0392 7039. GRID: grid.418340.a FAU - Marinho, A AU - Marinho A AD - Centro Hospitalar do Porto, Porto, Portugal. ISNI: 0000 0004 0392 7039. GRID: grid.418340.a FAU - Crivits, M AU - Crivits M AD - University Hospital, Ghent, Belgium. ISNI: 0000 0004 0626 3303. GRID: grid.410566.0 FAU - Raes, M AU - Raes M AD - University Hospital, Ghent, Belgium. ISNI: 0000 0004 0626 3303. GRID: grid.410566.0 FAU - Decruyenaere, J AU - Decruyenaere J AD - University Hospital, Ghent, Belgium. ISNI: 0000 0004 0626 3303. GRID: grid.410566.0 FAU - Hoste, E AU - Hoste E AD - University Hospital, Ghent, Belgium. ISNI: 0000 0004 0626 3303. GRID: grid.410566.0 FAU - Bagin, V AU - Bagin V AD - City Clinical Hospital 40, Yekaterinburg, Russia FAU - Rudnov, V AU - Rudnov V AD - City Clinical Hospital 40, Yekaterinburg, Russia FAU - Savitsky, A AU - Savitsky A AD - City Clinical Hospital 40, Yekaterinburg, Russia FAU - Astafyeva, M AU - Astafyeva M AD - City Clinical Hospital 40, Yekaterinburg, Russia FAU - Korobko, I AU - Korobko I AD - City Clinical Hospital 40, Yekaterinburg, Russia FAU - Vein, V AU - Vein V AD - City Clinical Hospital 40, Yekaterinburg, Russia FAU - Kampmeier, T AU - Kampmeier T AD - University Hospital Muenster, Muenster, Germany. ISNI: 0000 0004 0551 4246. GRID: grid.16149.3b FAU - Arnemann, P AU - Arnemann P AD - University Hospital Muenster, Muenster, Germany. ISNI: 0000 0004 0551 4246. GRID: grid.16149.3b FAU - Hessler, M AU - Hessler M AD - University Hospital Muenster, Muenster, Germany. ISNI: 0000 0004 0551 4246. GRID: grid.16149.3b FAU - Wald, A AU - Wald A AD - Marienhospital Osnabruck, Osnabruck, Germany FAU - Bockbreder, K AU - Bockbreder K AD - Charite, University of Berlin, Berlin, Germany FAU - Morelli, A AU - Morelli A AD - Sapienza University of Rome, Rome, Italy. GRID: grid.7841.a FAU - Van Aken, H AU - Van Aken H AD - University Hospital Muenster, Muenster, Germany. ISNI: 0000 0004 0551 4246. GRID: grid.16149.3b FAU - Rehberg, S AU - Rehberg S AD - University Hospital of Greifswald, Greifswald, Germany. ISNI: 0000 0000 9116 8976. GRID: grid.412469.c FAU - Ertmer, C AU - Ertmer C AD - University Hospital Muenster, Muenster, Germany. ISNI: 0000 0004 0551 4246. GRID: grid.16149.3b FAU - Arnemann, P AU - Arnemann P AD - University Hospital of Muenster, Muenster, Germany. ISNI: 0000 0004 0551 4246. GRID: grid.16149.3b FAU - Hessler, M AU - Hessler M AD - University Hospital of Muenster, Muenster, Germany. ISNI: 0000 0004 0551 4246. GRID: grid.16149.3b FAU - Kampmeier, T AU - Kampmeier T AD - University Hospital of Muenster, Muenster, Germany. ISNI: 0000 0004 0551 4246. GRID: grid.16149.3b FAU - Rehberg, S AU - Rehberg S AD - University Hospital of Greifswald, Greifswald, Germany. ISNI: 0000 0000 9116 8976. GRID: grid.412469.c FAU - Van Aken, H AU - Van Aken H AD - University Hospital of Muenster, Muenster, Germany. ISNI: 0000 0004 0551 4246. GRID: grid.16149.3b FAU - Ince, C AU - Ince C AD - Erasmus MC University Hospital Rotterdam, Rotterdam, Netherlands. ISNI: 000000040459992X. GRID: grid.5645.2 FAU - Ertmer, C AU - Ertmer C AD - University Hospital of Muenster, Muenster, Germany. ISNI: 0000 0004 0551 4246. GRID: grid.16149.3b FAU - Reddy, S AU - Reddy S AD - Medical Research Institute of New Zealand, Wellington, New Zealand. ISNI: 0000 0004 0445 6830. GRID: grid.415117.7 FAU - Bailey, M AU - Bailey M AD - Monash University, Melbourne, Australia. ISNI: 0000 0004 1936 7857. GRID: grid.1002.3 FAU - Beasley, R AU - Beasley R AD - Medical Research Institute of New Zealand, Wellington, New Zealand. ISNI: 0000 0004 0445 6830. GRID: grid.415117.7 FAU - Bellomo, R AU - Bellomo R AD - Austin Hospital, Melbourne, Australia. ISNI: 0000 0001 0162 7225. GRID: grid.414094.c FAU - Mackle, D AU - Mackle D AD - Medical Research Institute of New Zealand, Wellington, New Zealand. ISNI: 0000 0004 0445 6830. GRID: grid.415117.7 FAU - Psirides, A AU - Psirides A AD - Wellington Regional Hospital, Wellington, New Zealand. ISNI: 0000 0000 8862 6892. GRID: grid.416979.4 FAU - Young, P AU - Young P AD - Medical Research Institute of New Zealand, Wellington, New Zealand. ISNI: 0000 0004 0445 6830. GRID: grid.415117.7 FAU - Reddy, S AU - Reddy S AD - Medical Research Institute of New Zealand, Wellington, New Zealand. ISNI: 0000 0004 0445 6830. GRID: grid.415117.7 FAU - Bailey, M AU - Bailey M AD - Australian and New Zealand Intensive Care Research Centre, Melbourne, Australia FAU - Beasley, R AU - Beasley R AD - Medical Research Institute of New Zealand, Wellington, New Zealand. ISNI: 0000 0004 0445 6830. GRID: grid.415117.7 FAU - Bellomo, R AU - Bellomo R AD - Austin Hospital, Melbourne, Australia. ISNI: 0000 0001 0162 7225. GRID: grid.414094.c FAU - Mackle, D AU - Mackle D AD - Medical Research Institute of New Zealand, Wellington, New Zealand. ISNI: 0000 0004 0445 6830. GRID: grid.415117.7 FAU - Young, P AU - Young P AD - Medical Research Institute of New Zealand, Wellington, New Zealand. ISNI: 0000 0004 0445 6830. GRID: grid.415117.7 FAU - Venkatesh, H AU - Venkatesh H AD - Princess of Wales Hospital, Bridgend, UK. ISNI: 0000 0004 0648 9337. GRID: grid.415249.f FAU - Ramachandran, S AU - Ramachandran S AD - Imperial College London, London, UK. ISNI: 0000 0001 2113 8111. GRID: grid.7445.2 FAU - Basu, A AU - Basu A AD - Glan Clwyd Hospital, Bodelwyddan, UK. ISNI: 0000 0000 9831 5916. GRID: grid.415564.7 FAU - Nair, H AU - Nair H AD - Glan Clwyd Hospital, Bodelwyddan, UK. ISNI: 0000 0000 9831 5916. GRID: grid.415564.7 FAU - Egan, S AU - Egan S AD - University Hospital Galway, Galway, Ireland. ISNI: 0000 0004 0617 9371. GRID: grid.412440.7 FAU - Bates, J AU - Bates J AD - University Hospital Galway, Galway, Ireland. ISNI: 0000 0004 0617 9371. GRID: grid.412440.7 FAU - Oliveira, S AU - Oliveira S AD - Albert Schweitzer State Hospital, Rio de Janeiro, Brazil FAU - Rangel Neto, N R AU - Rangel Neto NR AD - Albert Schweitzer State Hospital, Rio de Janeiro, Brazil FAU - Reis, F Q AU - Reis FQ AD - Albert Schweitzer State Hospital, Rio de Janeiro, Brazil FAU - Lee, C P AU - Lee CP AD - Tan Tock Seng Hospital, Singapore, Singapore. GRID: grid.240988.f FAU - Lin, X L AU - Lin XL AD - National Neuroscience Institute, Singapore, Singapore. ISNI: 0000 0004 0636 696X. GRID: grid.276809.2 FAU - Choong, C AU - Choong C AD - Tan Tock Seng Hospital, Singapore, Singapore. GRID: grid.240988.f FAU - Eu, K M AU - Eu KM AD - Tan Tock Seng Hospital, Singapore, Singapore. GRID: grid.240988.f FAU - Sim, W Y AU - Sim WY AD - Tan Tock Seng Hospital, Singapore, Singapore. GRID: grid.240988.f FAU - Tee, K S AU - Tee KS AD - Tan Tock Seng Hospital, Singapore, Singapore. GRID: grid.240988.f FAU - Pau, J AU - Pau J AD - Tan Tock Seng Hospital, Singapore, Singapore. GRID: grid.240988.f FAU - Abisheganaden, J AU - Abisheganaden J AD - Tan Tock Seng Hospital, Singapore, Singapore. GRID: grid.240988.f FAU - Maas, K AU - Maas K AD - Erasmus Medical Centre, Rotterdam, Netherlands. ISNI: 000000040459992X. GRID: grid.5645.2 FAU - De Geus, H AU - De Geus H AD - Erasmus Medical Centre, Rotterdam, Netherlands. ISNI: 000000040459992X. GRID: grid.5645.2 FAU - Lafuente, E AU - Lafuente E AD - Centro Hospitalar Tamega e Sousa, Penafiel, Portugal. GRID: grid.466592.a FAU - Marinho, R AU - Marinho R AD - Centro Hospitalar do Porto, Porto, Portugal. ISNI: 0000 0004 0392 7039. GRID: grid.418340.a FAU - Moura, J AU - Moura J AD - Unidade Local de Saude do Alto Minho, Viana do Castelo, Portugal FAU - Antunes, R AU - Antunes R AD - Centro Hospitalar do Porto, Porto, Portugal. ISNI: 0000 0004 0392 7039. GRID: grid.418340.a FAU - Marinho, A AU - Marinho A AD - Centro Hospitalar do Porto, Porto, Portugal. ISNI: 0000 0004 0392 7039. GRID: grid.418340.a FAU - Doris, T E AU - Doris TE AD - South Tees NHS Trust, Middlesbrough, UK FAU - Monkhouse, D AU - Monkhouse D AD - South Tees NHS Trust, Middlesbrough, UK FAU - Shipley, T AU - Shipley T AD - South Tees NHS Trust, Middlesbrough, UK FAU - Kardasz, S AU - Kardasz S AD - South Tees NHS Trust, Middlesbrough, UK FAU - Gonzalez, I AU - Gonzalez I AD - South Tees NHS Trust, Middlesbrough, UK FAU - Stads, S AU - Stads S AD - Ikazia Hospital, Rotterdam, Netherlands. ISNI: 0000 0004 0568 7120. GRID: grid.414565.7 FAU - Groeneveld, A J AU - Groeneveld AJ AD - Erasmus MC, Rotterdam, Netherlands. ISNI: 000000040459992X. GRID: grid.5645.2 FAU - Elsayed, I AU - Elsayed I AD - Sheffiled Teaching Hospitals, Sheffield, UK FAU - Ward, N AU - Ward N AD - Sheffiled Teaching Hospitals, Sheffield, UK FAU - Tridente, A AU - Tridente A AD - Whiston Hospital, St Helens & Knowsley, UK. ISNI: 0000 0004 0417 1894. GRID: grid.417083.9 FAU - Raithatha, A AU - Raithatha A AD - Sheffiled Teaching Hospitals, Sheffield, UK FAU - Steuber, A AU - Steuber A AD - University Hospital Duesseldorf, Dusseldorf, Germany. ISNI: 0000 0000 8922 7789. GRID: grid.14778.3d FAU - Pelletier, C AU - Pelletier C AD - University Hospital Duesseldorf, Dusseldorf, Germany. ISNI: 0000 0000 8922 7789. GRID: grid.14778.3d FAU - Schroeder, S AU - Schroeder S AD - University Hospital Duesseldorf, Dusseldorf, Germany. ISNI: 0000 0000 8922 7789. GRID: grid.14778.3d FAU - Michael, E AU - Michael E AD - University Hospital Duesseldorf, Dusseldorf, Germany. ISNI: 0000 0000 8922 7789. GRID: grid.14778.3d FAU - Slowinski, T AU - Slowinski T AD - Charite University Hospital, Berlin, Germany. ISNI: 0000 0001 2218 4662. GRID: grid.6363.0 FAU - Kindgen-Milles, D AU - Kindgen-Milles D AD - University Hospital Duesseldorf, Dusseldorf, Germany. ISNI: 0000 0000 8922 7789. GRID: grid.14778.3d FAU - Ghabina, S AU - Ghabina S AD - Royal London Hospital, London, UK. ISNI: 0000 0001 0738 5466. GRID: grid.416041.6 FAU - Turani, F AU - Turani F AD - Aurelia and European Hospital, Rome, Italy. GRID: grid.414645.6 FAU - Belli, A AU - Belli A AD - Aurelia and European Hospital, Rome, Italy. GRID: grid.414645.6 FAU - Busatti, S AU - Busatti S AD - Aurelia and European Hospital, Rome, Italy. GRID: grid.414645.6 FAU - Barettin, G AU - Barettin G AD - Aurelia and European Hospital, Rome, Italy. GRID: grid.414645.6 FAU - Candidi, F AU - Candidi F AD - Aurelia and European Hospital, Rome, Italy. GRID: grid.414645.6 FAU - Gargano, F AU - Gargano F AD - Aurelia and European Hospital, Rome, Italy. GRID: grid.414645.6 FAU - Barchetta, R AU - Barchetta R AD - Aurelia and European Hospital, Rome, Italy. GRID: grid.414645.6 FAU - Falco, M AU - Falco M AD - Aurelia and European Hospital, Rome, Italy. GRID: grid.414645.6 FAU - Demirkiran, O AU - Demirkiran O AD - Istanbul University Cerrahpasa Medical School, Istanbul, Turkey. ISNI: 0000 0001 2166 6619. GRID: grid.9601.e FAU - Kosuk, M AU - Kosuk M AD - Istanbul University Cerrahpasa Medical School, Istanbul, Turkey. ISNI: 0000 0001 2166 6619. GRID: grid.9601.e FAU - Bozbay, S AU - Bozbay S AD - Istanbul University Cerrahpasa Medical School, Istanbul, Turkey. ISNI: 0000 0001 2166 6619. GRID: grid.9601.e FAU - Weber, V AU - Weber V AD - Danube University Krems, Krems, Austria. ISNI: 0000 0001 2108 5830. GRID: grid.15462.34 FAU - Hartmann, J AU - Hartmann J AD - Danube University Krems, Krems, Austria. ISNI: 0000 0001 2108 5830. GRID: grid.15462.34 FAU - Harm, S AU - Harm S AD - Danube University Krems, Krems, Austria. ISNI: 0000 0001 2108 5830. GRID: grid.15462.34 FAU - Linsberger, I AU - Linsberger I AD - Danube University Krems, Krems, Austria. ISNI: 0000 0001 2108 5830. GRID: grid.15462.34 FAU - Eichhorn, T AU - Eichhorn T AD - Danube University Krems, Krems, Austria. ISNI: 0000 0001 2108 5830. GRID: grid.15462.34 FAU - Valicek, G AU - Valicek G AD - University Hospital St. Poelten, St. Poelten, Austria FAU - Miestinger, G AU - Miestinger G AD - University Hospital St. Poelten, St. Poelten, Austria FAU - Hoermann, C AU - Hoermann C AD - University Hospital St. Poelten, St. Poelten, Austria FAU - Faenza, S AU - Faenza S AD - Teaching Hospital Policlinico S.Orsola-Malpighi, Bologna, Italy. GRID: grid.412311.4 FAU - Ricci, D AU - Ricci D AD - Department of Nephrology, Dialysis, Hypertension, Bologna, Italy FAU - Mancini, E AU - Mancini E AD - Department of Nephrology, Dialysis, Hypertension, Bologna, Italy FAU - Gemelli, C AU - Gemelli C AD - Science and Technology Park for Medicine, Mirandola, Italy FAU - Cuoghi, A AU - Cuoghi A AD - Science and Technology Park for Medicine, Mirandola, Italy FAU - Magnani, S AU - Magnani S AD - Aferetica, Bologna, Italy FAU - Atti, M AU - Atti M AD - Aferetica, Bologna, Italy FAU - Laddomada, T AU - Laddomada T AD - San Marco Hospital, Zingonia, Italy FAU - Doronzio, A AU - Doronzio A AD - San Marco Hospital, Zingonia, Italy FAU - Balicco, B AU - Balicco B AD - San Marco Hospital, Zingonia, Italy FAU - Gruda, M C AU - Gruda MC AD - CytoSorbents, Monmouth Junction, USA. GRID: grid.428484.6 FAU - O'Sullivan, P AU - O'Sullivan P AD - CytoSorbents, Monmouth Junction, USA. GRID: grid.428484.6 FAU - Dan, V P AU - Dan VP AD - CytoSorbents, Monmouth Junction, USA. GRID: grid.428484.6 FAU - Guliashvili, T AU - Guliashvili T AD - CytoSorbents, Monmouth Junction, USA. GRID: grid.428484.6 FAU - Scheirer, A AU - Scheirer A AD - CytoSorbents, Monmouth Junction, USA. GRID: grid.428484.6 FAU - Golobish, T D AU - Golobish TD AD - CytoSorbents, Monmouth Junction, USA. GRID: grid.428484.6 FAU - Capponi, V J AU - Capponi VJ AD - CytoSorbents, Monmouth Junction, USA. GRID: grid.428484.6 FAU - Chan, P P AU - Chan PP AD - CytoSorbents, Monmouth Junction, USA. GRID: grid.428484.6 FAU - Kogelmann, K AU - Kogelmann K AD - Klinikum Emden, Emden, Germany FAU - Druner, M AU - Druner M AD - Klinikum Emden, Emden, Germany FAU - Jarczak, D AU - Jarczak D AD - University Hospital Eppendorf, Hamburg, Germany. ISNI: 0000 0001 2180 3484. GRID: grid.13648.38 FAU - Turani, F AU - Turani F AD - Aurelia Hospital /European Hospital, Rome, Italy. GRID: grid.414077.1 FAU - Belli, A B AU - Belli AB AD - Aurelia Hospital /European Hospital, Rome, Italy. GRID: grid.414077.1 FAU - Martni, S M AU - Martni SM AD - Aurelia Hospital /European Hospital, Rome, Italy. GRID: grid.414077.1 FAU - Cotticelli, V C AU - Cotticelli VC AD - Aurelia Hospital /European Hospital, Rome, Italy. GRID: grid.414077.1 FAU - Mounajergi, F AU - Mounajergi F AD - Aurelia Hospital /European Hospital, Rome, Italy. GRID: grid.414077.1 FAU - Barchetta, R AU - Barchetta R AD - Aurelia Hospital /European Hospital, Rome, Italy. GRID: grid.414077.1 FAU - Morimoto, S AU - Morimoto S AD - Fukuoka University hospital, Fukuoka, Japan. ISNI: 0000 0004 0594 9821. GRID: grid.411556.2 FAU - Ishikura, H AU - Ishikura H AD - Fukuoka University hospital, Fukuoka, Japan. ISNI: 0000 0004 0594 9821. GRID: grid.411556.2 FAU - Hussain, I AU - Hussain I AD - King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia. ISNI: 0000 0001 2191 4301. GRID: grid.415310.2 FAU - Salahuddin, N AU - Salahuddin N AD - King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia. ISNI: 0000 0001 2191 4301. GRID: grid.415310.2 FAU - Nadeem, A AU - Nadeem A AD - King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia. ISNI: 0000 0001 2191 4301. GRID: grid.415310.2 FAU - Ghorab, K AU - Ghorab K AD - King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia. ISNI: 0000 0001 2191 4301. GRID: grid.415310.2 FAU - Maghrabi, K AU - Maghrabi K AD - King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia. ISNI: 0000 0001 2191 4301. GRID: grid.415310.2 FAU - Kloesel, S K AU - Kloesel SK AD - GPR Klinikum Ruesselsheim, Ruesselsheim, Hessen Germany FAU - Goldfuss, C AU - Goldfuss C AD - GPR Klinikum Ruesselsheim, Ruesselsheim, Hessen Germany FAU - Stieglitz, A AU - Stieglitz A AD - GPR Klinikum Ruesselsheim, Ruesselsheim, Hessen Germany FAU - Stieglitz, A S AU - Stieglitz AS AD - GPR Klinikum Ruesselsheim, Ruesselsheim, Hessen Germany FAU - Krstevska, L AU - Krstevska L AD - GPR Klinikum Ruesselsheim, Ruesselsheim, Hessen Germany FAU - Albuszies, G AU - Albuszies G AD - GPR Klinikum Ruesselsheim, Ruesselsheim, Hessen Germany FAU - Aguilar Arzapalo, M AU - Aguilar Arzapalo M AD - Hospital O'horan, Merida, Mexico FAU - Barradas, L AU - Barradas L AD - Hospital O'horan, Merida, Mexico FAU - Lopez, V AU - Lopez V AD - Hospital O'horan, Merida, Mexico FAU - Escalante, A AU - Escalante A AD - Hospital O'horan, Merida, Mexico FAU - Jimmy, G AU - Jimmy G AD - Hospital O'horan, Merida, Mexico FAU - Cetina, M AU - Cetina M AD - Hospital O'horan, Merida, Mexico FAU - Izawa, J AU - Izawa J AD - Jikei University School of Medicine, Tokyo, Japan. ISNI: 0000 0001 0661 2073. GRID: grid.411898.d FAU - Iwami, T AU - Iwami T AD - Kyoto University, Kyoto, Japan. ISNI: 0000 0004 0372 2033. GRID: grid.258799.8 FAU - Uchino, S AU - Uchino S AD - Jikei University School of Medicine, Tokyo, Japan. ISNI: 0000 0001 0661 2073. GRID: grid.411898.d FAU - Takinami, M AU - Takinami M AD - Jikei University School of Medicine, Tokyo, Japan. ISNI: 0000 0001 0661 2073. GRID: grid.411898.d FAU - Kitamura, T AU - Kitamura T AD - Osaka University, Osaka, Japan. ISNI: 0000 0004 0373 3971. GRID: grid.136593.b FAU - Kawamura, T AU - Kawamura T AD - Kyoto University, Kyoto, Japan. ISNI: 0000 0004 0372 2033. GRID: grid.258799.8 FAU - Powell-Tuck, J G AU - Powell-Tuck JG AD - Guy's & St Thomas' NHS Foundation Trust, London, UK. GRID: grid.420545.2 FAU - Crichton, S AU - Crichton S AD - King's College, London, UK. ISNI: 0000 0001 2322 6764. GRID: grid.13097.3c FAU - Raimundo, M AU - Raimundo M AD - Hospital de Santa Maria, Lisbon, Portugal. ISNI: 0000 0001 2295 9747. GRID: grid.411265.5 FAU - Camporota, L AU - Camporota L AD - Guy's & St Thomas' NHS Foundation Trust, London, UK. GRID: grid.420545.2 FAU - Wyncoll, D AU - Wyncoll D AD - Guy's & St Thomas' NHS Foundation Trust, London, UK. GRID: grid.420545.2 FAU - Ostermann, M AU - Ostermann M AD - Guy's & St Thomas' NHS Foundation Trust, London, UK. GRID: grid.420545.2 FAU - Hana, A AU - Hana A AD - ErasmusMC, Rotterdam, Netherlands. ISNI: 000000040459992X. GRID: grid.5645.2 FAU - De Geus, H R AU - De Geus HR AD - ErasmusMC, Rotterdam, Netherlands. ISNI: 000000040459992X. GRID: grid.5645.2 FAU - De Geus, H R AU - De Geus HR AD - ErasmusMC, Rotterdam, Netherlands. ISNI: 000000040459992X. GRID: grid.5645.2 FAU - Hana, A AU - Hana A AD - ErasmusMC, Rotterdam, Netherlands. ISNI: 000000040459992X. GRID: grid.5645.2 FAU - Aydogdu, M AU - Aydogdu M AD - Gazi University Medical Faculty, Ankara, Turkey. ISNI: 0000 0001 2169 7132. GRID: grid.25769.3f FAU - Boyaci, N AU - Boyaci N AD - Gazi University School of Medicine, Critical Care Fellowship Programme, Ankara, Turkey FAU - Yuksel, S AU - Yuksel S AD - Gazi University School of Medicine Biochemistry Department, Ankara, Turkey. ISNI: 0000 0001 2169 7132. GRID: grid.25769.3f FAU - Gursel, G AU - Gursel G AD - Gazi University Medical Faculty, Ankara, Turkey. ISNI: 0000 0001 2169 7132. GRID: grid.25769.3f FAU - Cayci Sivri, A B AU - Cayci Sivri AB AD - Gazi University School of Medicine Biochemistry Department, Ankara, Turkey. ISNI: 0000 0001 2169 7132. GRID: grid.25769.3f FAU - Meza-Marquez, J AU - Meza-Marquez J AD - Fundacion Clinica Medica Sur, Mexico City, Mexico FAU - Nava-Lopez, J AU - Nava-Lopez J AD - Fundacion Clinica Medica Sur, Mexico City, Mexico FAU - Carrillo-Esper, R AU - Carrillo-Esper R AD - Fundacion Clinica Medica Sur, Mexico City, Mexico FAU - Dardashti, A AU - Dardashti A AD - Lund University and Skane University Hospital, Lund, Sweden. GRID: grid.411843.b FAU - Grubb, A AU - Grubb A AD - Lund University and Skane University Hospital, Lund, Sweden. GRID: grid.411843.b FAU - Maizel, J AU - Maizel J AD - CHU Amiens, Amiens, France. ISNI: 0000 0004 0593 702X. GRID: grid.134996.0 FAU - Wetzstein, M AU - Wetzstein M AD - CHU Amiens, Amiens, France. ISNI: 0000 0004 0593 702X. GRID: grid.134996.0 FAU - Titeca, D AU - Titeca D AD - CHU Amiens, Amiens, France. ISNI: 0000 0004 0593 702X. GRID: grid.134996.0 FAU - Kontar, L AU - Kontar L AD - CHU Amiens, Amiens, France. ISNI: 0000 0004 0593 702X. GRID: grid.134996.0 FAU - Brazier, F AU - Brazier F AD - CHU Amiens, Amiens, France. ISNI: 0000 0004 0593 702X. GRID: grid.134996.0 FAU - De Cagny, B AU - De Cagny B AD - CHU Amiens, Amiens, France. ISNI: 0000 0004 0593 702X. GRID: grid.134996.0 FAU - Riviere, A AU - Riviere A AD - CHU Amiens, Amiens, France. ISNI: 0000 0004 0593 702X. GRID: grid.134996.0 FAU - Soupison, T AU - Soupison T AD - CHU Amiens, Amiens, France. ISNI: 0000 0004 0593 702X. GRID: grid.134996.0 FAU - Joris, M AU - Joris M AD - CHU Amiens, Amiens, France. ISNI: 0000 0004 0593 702X. GRID: grid.134996.0 FAU - Slama, M AU - Slama M AD - Radboudumc, Nijmegen, Netherlands. ISNI: 0000 0004 0444 9382. GRID: grid.10417.33 FAU - Peters, E AU - Peters E FAU - Njimi, H AU - Njimi H AD - Erasme Hospital, Universite Libre de Bruxelles, Brussels, Belgium. ISNI: 0000 0001 2348 0746. GRID: grid.4989.c FAU - Pickkers, P AU - Pickkers P AD - Radboudumc, Nijmegen, Netherlands. ISNI: 0000 0004 0444 9382. GRID: grid.10417.33 FAU - Vincent, J L AU - Vincent JL AD - Erasme Hospital, Universite Libre de Bruxelles, Brussels, Belgium. ISNI: 0000 0001 2348 0746. GRID: grid.4989.c FAU - Waraich, M AU - Waraich M AD - The Royal Surrey County Hospital, Guildford, UK. ISNI: 0000 0004 0417 0648. GRID: grid.416224.7 FAU - Doyle, J AU - Doyle J AD - The Royal Surrey County Hospital, Guildford, UK. ISNI: 0000 0004 0417 0648. GRID: grid.416224.7 FAU - Samuels, T AU - Samuels T AD - The Royal Surrey County Hospital, Guildford, UK. ISNI: 0000 0004 0417 0648. GRID: grid.416224.7 FAU - Forni, L AU - Forni L AD - The Royal Surrey County Hospital, Guildford, UK. ISNI: 0000 0004 0417 0648. GRID: grid.416224.7 FAU - Desai, N AU - Desai N AD - Royal National Orthopaedic Hospital, Middlesex, UK. ISNI: 0000 0004 0417 7890. GRID: grid.416177.2 FAU - Baumber, R AU - Baumber R AD - Royal National Orthopaedic Hospital, Middlesex, UK. ISNI: 0000 0004 0417 7890. GRID: grid.416177.2 FAU - Gunning, P AU - Gunning P AD - Royal National Orthopaedic Hospital, Middlesex, UK. ISNI: 0000 0004 0417 7890. GRID: grid.416177.2 FAU - Sell, A AU - Sell A AD - Royal National Orthopaedic Hospital, Middlesex, UK. ISNI: 0000 0004 0417 7890. GRID: grid.416177.2 FAU - Lin, S AU - Lin S AD - Barts Health NHS Trust, London, UK. ISNI: 0000 0001 0372 5777. GRID: grid.139534.9 FAU - Torrence, H AU - Torrence H AD - Queen Mary University of London, London, UK. ISNI: 0000 0001 2171 1133. GRID: grid.4868.2 FAU - O'Dwyer, M AU - O'Dwyer M AD - Queen Mary University of London, London, UK. ISNI: 0000 0001 2171 1133. GRID: grid.4868.2 FAU - Kirwan, C AU - Kirwan C AD - Barts Health NHS Trust, London, UK. ISNI: 0000 0001 0372 5777. GRID: grid.139534.9 FAU - Prowle, J AU - Prowle J AD - Queen Mary University of London, London, UK. ISNI: 0000 0001 2171 1133. GRID: grid.4868.2 FAU - Kim, T AU - Kim T AD - Asan medical center, Seoul, South Korea. ISNI: 0000 0001 0842 2126. GRID: grid.413967.e FAU - O'Connor, M E AU - O'Connor ME AD - Barts Health NHS Trust, London, UK. ISNI: 0000 0001 0372 5777. GRID: grid.139534.9 FAU - Hewson, R W AU - Hewson RW AD - Barts Health NHS Trust, London, UK. ISNI: 0000 0001 0372 5777. GRID: grid.139534.9 FAU - Kirwan, C J AU - Kirwan CJ AD - Barts Health NHS Trust, London, UK. ISNI: 0000 0001 0372 5777. GRID: grid.139534.9 FAU - Pearse, R M AU - Pearse RM AD - Queen Mary University of London, London, UK. ISNI: 0000 0001 2171 1133. GRID: grid.4868.2 FAU - Prowle, J AU - Prowle J AD - Queen Mary University of London, London, UK. ISNI: 0000 0001 2171 1133. GRID: grid.4868.2 FAU - Hanoura, S AU - Hanoura S AD - Hamad medical corporation, Doha, Qatar. ISNI: 0000 0004 0571 546X. GRID: grid.413548.f FAU - Omar, A AU - Omar A AD - Hamad medical corporation, Doha, Qatar. ISNI: 0000 0004 0571 546X. GRID: grid.413548.f FAU - Othamn, H AU - Othamn H AD - Hamad medical corporation, Doha, Qatar. ISNI: 0000 0004 0571 546X. GRID: grid.413548.f FAU - Sudarsanan, S AU - Sudarsanan S AD - Hamad medical corporation, Doha, Qatar. ISNI: 0000 0004 0571 546X. GRID: grid.413548.f FAU - Allam, M AU - Allam M AD - Hamad medical corporation, Doha, Qatar. ISNI: 0000 0004 0571 546X. GRID: grid.413548.f FAU - Maksoud, M AU - Maksoud M AD - Hamad medical corporation, Doha, Qatar. ISNI: 0000 0004 0571 546X. GRID: grid.413548.f FAU - Singh, R AU - Singh R AD - Hamad medical corporation, Doha, Qatar. ISNI: 0000 0004 0571 546X. GRID: grid.413548.f FAU - Al Khulaifi, A AU - Al Khulaifi A AD - Hamad medical corporation, Doha, Qatar. ISNI: 0000 0004 0571 546X. GRID: grid.413548.f FAU - O'Connor, M E AU - O'Connor ME AD - Barts Health NHS Trust, London, UK. ISNI: 0000 0001 0372 5777. GRID: grid.139534.9 FAU - Hewson, R W AU - Hewson RW AD - Barts Health NHS Trust, London, UK. ISNI: 0000 0001 0372 5777. GRID: grid.139534.9 FAU - Kirwan, C J AU - Kirwan CJ AD - Barts Health NHS Trust, London, UK. ISNI: 0000 0001 0372 5777. GRID: grid.139534.9 FAU - Pearse, R M AU - Pearse RM AD - Queen Mary University of London, London, UK. ISNI: 0000 0001 2171 1133. GRID: grid.4868.2 FAU - Prowle, J AU - Prowle J AD - Queen Mary University of London, London, UK. ISNI: 0000 0001 2171 1133. GRID: grid.4868.2 FAU - Uzundere, O AU - Uzundere O AD - Trakya Univ, Edirne, Turkey. ISNI: 0000 0001 2342 6459. GRID: grid.411693.8 FAU - Memis, D AU - Memis D AD - Trakya Univ, Edirne, Turkey. ISNI: 0000 0001 2342 6459. GRID: grid.411693.8 FAU - Ynal, M AU - Ynal M AD - Trakya Univ, Edirne, Turkey. ISNI: 0000 0001 2342 6459. GRID: grid.411693.8 FAU - Gultekin, A AU - Gultekin A AD - Trakya Univ, Edirne, Turkey. ISNI: 0000 0001 2342 6459. GRID: grid.411693.8 FAU - Turan, N AU - Turan N AD - Trakya Univ, Edirne, Turkey. ISNI: 0000 0001 2342 6459. GRID: grid.411693.8 FAU - Aydin, M A AU - Aydin MA AD - General Directorate of Health Services, Ministry of Health, Ankara, Turkey. GRID: grid.415700.7 FAU - Basar, H AU - Basar H AD - AnkaraNKARA Research and Training Hospital, Ankara, Turkey FAU - Sencan, I AU - Sencan I AD - General Directorate of Health Services, Ministry of Health, Ankara, Turkey. GRID: grid.415700.7 FAU - Kapuagasi, A AU - Kapuagasi A AD - General Directorate of Health Services, Ministry of Health, Ankara, Turkey. GRID: grid.415700.7 FAU - Ozturk, M AU - Ozturk M AD - General Directorate of Health Services, Ministry of Health, Ankara, Turkey. GRID: grid.415700.7 FAU - Uzundurukan, Z AU - Uzundurukan Z AD - General Directorate of Health Services, Ministry of Health, Ankara, Turkey. GRID: grid.415700.7 FAU - Gokmen, D AU - Gokmen D AD - Department of Biostatistics, Faculty of Medicine, Ankara University, Ankara, Turkey. ISNI: 0000000109409118. GRID: grid.7256.6 FAU - Ozcan, A AU - Ozcan A AD - Ankara Research and Training Hospital, Ankara, Turkey. ISNI: 0000 0004 0642 6432. GRID: grid.413783.a FAU - Kaymak, C AU - Kaymak C AD - AnkaraNKARA Research and Training Hospital, Ankara, Turkey FAU - Artemenko, V A AU - Artemenko VA AD - MC Into-Sana, Odessa, Ukraine FAU - Budnyuk, A AU - Budnyuk A AD - MC Into-Sana, Odessa, Ukraine FAU - Pugh, R AU - Pugh R AD - Glan Clwyd Hospital, Rhyl, UK. ISNI: 0000 0000 9831 5916. GRID: grid.415564.7 FAU - Bhandari, S AU - Bhandari S AD - Glan Clwyd Hospital, Rhyl, UK. ISNI: 0000 0000 9831 5916. GRID: grid.415564.7 FAU - Mauri, T AU - Mauri T AD - Fondazione IRCCS Ca' Granda, Maggiore Policlinico Hospital, Milan, Italy FAU - Turrini, C AU - Turrini C AD - University of Ferrara, Sant'Anna Hospital, Ferrara, Italy FAU - Langer, T AU - Langer T AD - Fondazione IRCCS Ca' Granda, Maggiore Policlinico Hospital, Milan, Italy FAU - Taccone, P AU - Taccone P AD - Fondazione IRCCS Ca' Granda, Maggiore Policlinico Hospital, Milan, Italy FAU - Volta, C A AU - Volta CA AD - University of Ferrara, Sant'Anna Hospital, Ferrara, Italy FAU - Marenghi, C AU - Marenghi C AD - Fondazione IRCCS Ca' Granda, Maggiore Policlinico Hospital, Milan, Italy FAU - Gattinoni, L AU - Gattinoni L AD - Fondazione IRCCS Ca' Granda, Maggiore Policlinico Hospital, Milan, Italy FAU - Pesenti, A AU - Pesenti A AD - Fondazione IRCCS Ca' Granda, Maggiore Policlinico Hospital, Milan, Italy FAU - Sweeney, L AU - Sweeney L AD - Aerogen, Galway, Ireland FAU - O'Sullivan, A AU - O'Sullivan A AD - Aerogen, Galway, Ireland FAU - Kelly, P AU - Kelly P AD - Aerogen, Galway, Ireland FAU - Mukeria, E AU - Mukeria E AD - Aerogen, Galway, Ireland FAU - MacLoughlin, R AU - MacLoughlin R AD - Aerogen, Galway, Ireland FAU - Pfeffer, M AU - Pfeffer M AD - Kaplan Medical Centre, Rehovot, Israel FAU - Thomas, J T AU - Thomas JT AD - West Virginia University, Morgantown, West Virginia USA. ISNI: 0000 0001 2156 6140. GRID: grid.268154.c FAU - Bregman, G B AU - Bregman GB AD - Kaplan Medical Centre, Rehovot, Israel FAU - Karp, G K AU - Karp GK AD - Kaplan Medical Centre, Rehovot, Israel FAU - Kishinevsky, E K AU - Kishinevsky EK AD - Kaplan Medical Centre, Rehovot, Israel FAU - Stavi, D S AU - Stavi DS AD - Kaplan Medical Centre, Rehovot, Israel FAU - Adi, N A AU - Adi NA AD - Kaplan Medical Centre, Rehovot, Israel FAU - Poropat, T AU - Poropat T AD - Rihard Knafelj, Ljubljana, Slovenia FAU - Knafelj, R AU - Knafelj R AD - Rihard Knafelj, Ljubljana, Slovenia FAU - Llopart, E AU - Llopart E AD - Corporacio Sanitaria i Universitaria Parc Tauli, Universitat Autonoma de Barcelona, CIBER Enfermedades Respiratorias, Sabadell, Barcelona, Spain. GRID: grid.7080.f FAU - Batlle, M AU - Batlle M AD - Corporacio Sanitaria i Universitaria Parc Tauli, Universitat Autonoma de Barcelona, CIBER Enfermedades Respiratorias, Sabadell, Barcelona, Spain. GRID: grid.7080.f FAU - De Haro, C AU - De Haro C AD - Corporacio Sanitaria i Universitaria Parc Tauli, Universitat Autonoma de Barcelona, CIBER Enfermedades Respiratorias, Sabadell, Barcelona, Spain. GRID: grid.7080.f FAU - Mesquida, J AU - Mesquida J AD - Corporacio Sanitaria i Universitaria Parc Tauli, Universitat Autonoma de Barcelona, CIBER Enfermedades Respiratorias, Sabadell, Barcelona, Spain. GRID: grid.7080.f FAU - Artigas, A AU - Artigas A AD - Corporacio Sanitaria i Universitaria Parc Tauli, Universitat Autonoma de Barcelona, CIBER Enfermedades Respiratorias, Sabadell, Barcelona, Spain. GRID: grid.7080.f FAU - Pavlovic, D AU - Pavlovic D AD - Dalhousie University, Halifax, Canada. ISNI: 0000 0004 1936 8200. GRID: grid.55602.34 FAU - Lewerentz, L AU - Lewerentz L AD - Ernst-Moritz-Arndt-Universitat, Greifswald, Germany. GRID: grid.5603.0 FAU - Spassov, A AU - Spassov A AD - Ernst-Moritz-Arndt-Universitat, Greifswald, Germany. GRID: grid.5603.0 FAU - Schneider, R AU - Schneider R AD - Ernst-Moritz-Arndt-Universitat, Greifswald, Germany. GRID: grid.5603.0 FAU - De Smet, S AU - De Smet S AD - Ghent University Hospital, Gent, Belgium. ISNI: 0000 0004 0626 3303. GRID: grid.410566.0 FAU - De Raedt, S AU - De Raedt S AD - Ghent University Hospital, Gent, Belgium. ISNI: 0000 0004 0626 3303. GRID: grid.410566.0 FAU - Derom, E AU - Derom E AD - Ghent University Hospital, Gent, Belgium. ISNI: 0000 0004 0626 3303. GRID: grid.410566.0 FAU - Depuydt, P AU - Depuydt P AD - Ghent University Hospital, Gent, Belgium. ISNI: 0000 0004 0626 3303. GRID: grid.410566.0 FAU - Oeyen, S AU - Oeyen S AD - Ghent University Hospital, Gent, Belgium. ISNI: 0000 0004 0626 3303. GRID: grid.410566.0 FAU - Benoit, D AU - Benoit D AD - Ghent University Hospital, Gent, Belgium. ISNI: 0000 0004 0626 3303. GRID: grid.410566.0 FAU - Decruyenaere, J AU - Decruyenaere J AD - Ghent University Hospital, Gent, Belgium. ISNI: 0000 0004 0626 3303. GRID: grid.410566.0 FAU - Gobatto, A AU - Gobatto A AD - Universidade de Sao Paulo, Sao Paulo, Brazil. ISNI: 0000 0004 1937 0722. GRID: grid.11899.38 FAU - Besen, B AU - Besen B AD - Universidade de Sao Paulo, Sao Paulo, Brazil. ISNI: 0000 0004 1937 0722. GRID: grid.11899.38 FAU - Tierno, P AU - Tierno P AD - Universidade de Sao Paulo, Sao Paulo, Brazil. ISNI: 0000 0004 1937 0722. GRID: grid.11899.38 FAU - Melro, L AU - Melro L AD - Universidade de Sao Paulo, Sao Paulo, Brazil. ISNI: 0000 0004 1937 0722. GRID: grid.11899.38 FAU - Mendes, P AU - Mendes P AD - Universidade de Sao Paulo, Sao Paulo, Brazil. ISNI: 0000 0004 1937 0722. GRID: grid.11899.38 FAU - Cadamuro, F AU - Cadamuro F AD - Universidade de Sao Paulo, Sao Paulo, Brazil. ISNI: 0000 0004 1937 0722. GRID: grid.11899.38 FAU - Park, M AU - Park M AD - Universidade de Sao Paulo, Sao Paulo, Brazil. ISNI: 0000 0004 1937 0722. GRID: grid.11899.38 FAU - Malbouisson, L M AU - Malbouisson LM AD - Universidade de Sao Paulo, Sao Paulo, Brazil. ISNI: 0000 0004 1937 0722. GRID: grid.11899.38 FAU - Civantos, B C AU - Civantos BC AD - Hospital La Paz, Madrid, Spain. ISNI: 0000 0000 8970 9163. GRID: grid.81821.32 FAU - Lopez, J L AU - Lopez JL AD - Hospital La Paz, Madrid, Spain. ISNI: 0000 0000 8970 9163. GRID: grid.81821.32 FAU - Robles, A AU - Robles A AD - Hospital La Paz, Madrid, Spain. ISNI: 0000 0000 8970 9163. GRID: grid.81821.32 FAU - Figueira, J AU - Figueira J AD - Hospital La Paz, Madrid, Spain. ISNI: 0000 0000 8970 9163. GRID: grid.81821.32 FAU - Yus, S AU - Yus S AD - Hospital La Paz, Madrid, Spain. ISNI: 0000 0000 8970 9163. GRID: grid.81821.32 FAU - Garcia, A AU - Garcia A AD - Hospital La Paz, Madrid, Spain. ISNI: 0000 0000 8970 9163. GRID: grid.81821.32 FAU - Oglinda, A AU - Oglinda A AD - Institute of Mother and Child, Chisinau mun., Moldova FAU - Ciobanu, G AU - Ciobanu G AD - Institute of Emergency Medicine, Chisinau mun., Moldova FAU - Oglinda, C AU - Oglinda C AD - Institute of Mother and Child, Chisinau mun., Moldova FAU - Schirca, L AU - Schirca L AD - Institute of Mother and Child, Chisinau mun., Moldova FAU - Sertinean, T AU - Sertinean T AD - Institute of Mother and Child, Chisinau mun., Moldova FAU - Lupu, V AU - Lupu V AD - State University of Medicine and Pharmacy, Chisinau mun., Moldova FAU - Kelly, P AU - Kelly P AD - Aerogen, Galway, Ireland FAU - O'Sullivan, A AU - O'Sullivan A AD - Aerogen, Galway, Ireland FAU - Sweeney, L AU - Sweeney L AD - Aerogen, Galway, Ireland FAU - MacLoughlin, R AU - MacLoughlin R AD - Aerogen, Galway, Ireland FAU - O'Sullivan, A AU - O'Sullivan A AD - Aerogen, Galway, Ireland FAU - Kelly, P AU - Kelly P AD - Aerogen, Galway, Ireland FAU - Sweeney, L AU - Sweeney L AD - Aerogen, Galway, Ireland FAU - Mukeria, E AU - Mukeria E AD - Aerogen, Galway, Ireland FAU - Wolny, M AU - Wolny M AD - Aerogen, Galway, Ireland FAU - MacLoughlin, R AU - MacLoughlin R AD - Aerogen, Galway, Ireland FAU - Pagano, A AU - Pagano A AD - Cardarelli Hospital, Naples, Italy. GRID: grid.413172.2 FAU - Numis, F AU - Numis F AD - San Paolo Hospital, Naples, Italy FAU - Visone, G AU - Visone G AD - Cardarelli Hospital, Naples, Italy. GRID: grid.413172.2 FAU - Saldamarco, L AU - Saldamarco L AD - Cardarelli Hospital, Naples, Italy. GRID: grid.413172.2 FAU - Russo, T AU - Russo T AD - Cardarelli Hospital, Naples, Italy. GRID: grid.413172.2 FAU - Porta, G AU - Porta G AD - San Paolo Hospital, Naples, Italy FAU - Paladino, F AU - Paladino F AD - Cardarelli Hospital, Naples, Italy. GRID: grid.413172.2 FAU - Bell, C AU - Bell C AD - National University of Ireland, Galway, Galway City, Ireland. ISNI: 0000 0004 0488 0789. GRID: grid.6142.1 FAU - Liu, J AU - Liu J AD - Mount Sinai Hospital, Toronto, Canada. ISNI: 0000 0004 0473 9881. GRID: grid.416166.2 FAU - Debacker, J AU - Debacker J AD - Mount Sinai Hospital, Toronto, Canada. ISNI: 0000 0004 0473 9881. GRID: grid.416166.2 FAU - Lee, C AU - Lee C AD - Mount Sinai Hospital, Toronto, Canada. ISNI: 0000 0004 0473 9881. GRID: grid.416166.2 FAU - Tamberg, E AU - Tamberg E AD - Mount Sinai Hospital, Toronto, Canada. ISNI: 0000 0004 0473 9881. GRID: grid.416166.2 FAU - Campbell, V AU - Campbell V AD - Mount Sinai Hospital, Toronto, Canada. ISNI: 0000 0004 0473 9881. GRID: grid.416166.2 FAU - Mehta, S AU - Mehta S AD - Mount Sinai Hospital, Toronto, Canada. ISNI: 0000 0004 0473 9881. GRID: grid.416166.2 FAU - Silva-Pinto, A AU - Silva-Pinto A AD - Centro Hospitalar Sao Joao, Porto, Portugal. ISNI: 0000 0000 9375 4688. GRID: grid.414556.7 FAU - Sarmento, A AU - Sarmento A AD - Centro Hospitalar Sao Joao, Porto, Portugal. ISNI: 0000 0000 9375 4688. GRID: grid.414556.7 FAU - Santos, L AU - Santos L AD - Centro Hospitalar Sao Joao, Porto, Portugal. ISNI: 0000 0000 9375 4688. GRID: grid.414556.7 FAU - Kara, Y AU - Kara Y AD - Gazi University School of Medicine Respiratory Medicine and Critical Care Department, Ankara, Turkey. ISNI: 0000 0001 2169 7132. GRID: grid.25769.3f FAU - Yyldyrym, F AU - Yyldyrym F AD - Gazi University School of Medicine Respiratory Medicine and Critical Care Department, Ankara, Turkey. ISNI: 0000 0001 2169 7132. GRID: grid.25769.3f FAU - Zerman, A AU - Zerman A AD - Gazi University School of Medicine, Internal Medicine Critical Care Department, Ankara, Turkey FAU - Gullu, Z AU - Gullu Z AD - Gazi University School of Medicine, Internal Medicine Critical Care Department, Ankara, Turkey FAU - Boyacy, N AU - Boyacy N AD - Gazi University School of Medicine, Internal Medicine Critical Care Department, Ankara, Turkey FAU - Basaryk Aydogan, B AU - Basaryk Aydogan B AD - Gazi University School of Medicine Respiratory Medicine and Critical Care Department, Ankara, Turkey. ISNI: 0000 0001 2169 7132. GRID: grid.25769.3f FAU - Gaygysyz, U AU - Gaygysyz U AD - Gazi University School of Medicine Respiratory Medicine and Critical Care Department, Ankara, Turkey. ISNI: 0000 0001 2169 7132. GRID: grid.25769.3f FAU - Gonderen, K AU - Gonderen K AD - Gazi University School of Medicine Respiratory Medicine and Critical Care Department, Ankara, Turkey. ISNI: 0000 0001 2169 7132. GRID: grid.25769.3f FAU - Aryk, G AU - Aryk G AD - Gazi University School of Medicine, Geriatrics Department, Ankara, Turkey FAU - Turkoglu, M AU - Turkoglu M AD - Gazi University School of Medicine, Internal Medicine Critical Care Department, Ankara, Turkey FAU - Aydogdu, M AU - Aydogdu M AD - Gazi University School of Medicine Respiratory Medicine and Critical Care Department, Ankara, Turkey. ISNI: 0000 0001 2169 7132. GRID: grid.25769.3f FAU - Aygencel, G AU - Aygencel G AD - Gazi University School of Medicine, Internal Medicine Critical Care Department, Ankara, Turkey FAU - Ulger, Z AU - Ulger Z AD - Gazi University School of Medicine, Geriatrics Department, Ankara, Turkey FAU - Gursel, G AU - Gursel G AD - Gazi University School of Medicine Respiratory Medicine and Critical Care Department, Ankara, Turkey. ISNI: 0000 0001 2169 7132. GRID: grid.25769.3f FAU - Boyacy, N AU - Boyacy N AD - Gazi University School of Medicine Respiratory Medicine and Critical Care Department, Ankara, Turkey. ISNI: 0000 0001 2169 7132. GRID: grid.25769.3f FAU - Isykdogan, Z AU - Isykdogan Z AD - Gazi University School of Medicine Respiratory Medicine and Critical Care Department, Ankara, Turkey. ISNI: 0000 0001 2169 7132. GRID: grid.25769.3f FAU - Ozdedeoglu, O AU - Ozdedeoglu O AD - Gazi University School of Medicine Respiratory Medicine and Critical Care Department, Ankara, Turkey. ISNI: 0000 0001 2169 7132. GRID: grid.25769.3f FAU - Gullu, Z AU - Gullu Z AD - Gazi University School of Medicine Respiratory Medicine and Critical Care Department, Ankara, Turkey. ISNI: 0000 0001 2169 7132. GRID: grid.25769.3f FAU - Badoglu, M AU - Badoglu M AD - Gazi University School of Medicine Respiratory Medicine and Critical Care Department, Ankara, Turkey. ISNI: 0000 0001 2169 7132. GRID: grid.25769.3f FAU - Gaygysyz, U AU - Gaygysyz U AD - Gazi University School of Medicine Respiratory Medicine and Critical Care Department, Ankara, Turkey. ISNI: 0000 0001 2169 7132. GRID: grid.25769.3f FAU - Aydogdu, M AU - Aydogdu M AD - Gazi University School of Medicine Respiratory Medicine and Critical Care Department, Ankara, Turkey. ISNI: 0000 0001 2169 7132. GRID: grid.25769.3f FAU - Gursel, G AU - Gursel G AD - Gazi University School of Medicine Respiratory Medicine and Critical Care Department, Ankara, Turkey. ISNI: 0000 0001 2169 7132. GRID: grid.25769.3f FAU - Kongpolprom, N AU - Kongpolprom N AD - Chulalongkorn University, Bangkok, Thailand. ISNI: 0000 0001 0244 7875. GRID: grid.7922.e FAU - Sittipunt, C AU - Sittipunt C AD - Chulalongkorn University, Bangkok, Thailand. ISNI: 0000 0001 0244 7875. GRID: grid.7922.e FAU - Eden, A AU - Eden A AD - Carmel, Lady Davis Medical Center, Haifa, Israel. GRID: grid.471000.2 FAU - Kokhanovsky, Y AU - Kokhanovsky Y AD - Carmel, Lady Davis Medical Center, Haifa, Israel. GRID: grid.471000.2 FAU - Bursztein - De Myttenaere, S AU - Bursztein - De Myttenaere S AD - Carmel, Lady Davis Medical Center, Haifa, Israel. GRID: grid.471000.2 FAU - Pizov, R AU - Pizov R AD - Carmel, Lady Davis Medical Center, Haifa, Israel. GRID: grid.471000.2 FAU - Neilans, L AU - Neilans L AD - Duke University, Durham, USA. ISNI: 0000 0004 1936 7961. GRID: grid.26009.3d FAU - MacIntyre, N AU - MacIntyre N AD - Duke University, Durham, USA. ISNI: 0000 0004 1936 7961. GRID: grid.26009.3d FAU - Radosevich, M AU - Radosevich M AD - Mayo Clinic, Rochester, USA. ISNI: 0000 0004 0459 167X. GRID: grid.66875.3a FAU - Wanta, B AU - Wanta B AD - Mayo Clinic, Rochester, USA. ISNI: 0000 0004 0459 167X. GRID: grid.66875.3a FAU - Weber, V AU - Weber V AD - Mayo Clinic, Rochester, USA. ISNI: 0000 0004 0459 167X. GRID: grid.66875.3a FAU - Meyer, T AU - Meyer T AD - Mayo Clinic, Rochester, USA. ISNI: 0000 0004 0459 167X. GRID: grid.66875.3a FAU - Smischney, N AU - Smischney N AD - Mayo Clinic, Rochester, USA. ISNI: 0000 0004 0459 167X. GRID: grid.66875.3a FAU - Brown, D AU - Brown D AD - Mayo Clinic, Rochester, USA. ISNI: 0000 0004 0459 167X. GRID: grid.66875.3a FAU - Diedrich, D AU - Diedrich D AD - Mayo Clinic, Rochester, USA. ISNI: 0000 0004 0459 167X. GRID: grid.66875.3a FAU - Fuller, A AU - Fuller A AD - St Helens and Knoowsley, Prescot, UK FAU - McLindon, P AU - McLindon P AD - Royal Infirmary, Edinburgh, UK. ISNI: 0000 0001 0709 1919. GRID: grid.418716.d FAU - Sim, K AU - Sim K AD - St Helens and Knoowsley, Prescot, UK FAU - Shoaeir, M AU - Shoaeir M AD - Alexandria Universitry General Hospital, Alexandria, Egypt. ISNI: 0000 0001 2260 6941. GRID: grid.7155.6 FAU - Noeam, K AU - Noeam K AD - Alexandria Universitry General Hospital, Alexandria, Egypt. ISNI: 0000 0001 2260 6941. GRID: grid.7155.6 FAU - Mahrous, A AU - Mahrous A AD - Alexandria Universitry General Hospital, Alexandria, Egypt. ISNI: 0000 0001 2260 6941. GRID: grid.7155.6 FAU - Matsa, R AU - Matsa R AD - University Hospital North Middlands, Stoke On Trent, UK. ISNI: 0000 0004 0641 4263. GRID: grid.415598.4 FAU - Ali, A AU - Ali A AD - Alexandria Universitry General Hospital, Alexandria, Egypt. ISNI: 0000 0001 2260 6941. GRID: grid.7155.6 FAU - Dridi, C AU - Dridi C AD - Mongi Slim University Hospital, La Marsa, Tunisia FAU - Koubaji, S AU - Koubaji S AD - Mongi Slim University Hospital, La Marsa, Tunisia FAU - Kamoun, S AU - Kamoun S AD - Mongi Slim University Hospital, La Marsa, Tunisia FAU - Haddad, F AU - Haddad F AD - Mongi Slim University Hospital, La Marsa, Tunisia FAU - Ben Souissi, A AU - Ben Souissi A AD - Mongi Slim University Hospital, La Marsa, Tunisia FAU - Laribi, B AU - Laribi B AD - Mongi Slim University Hospital, La Marsa, Tunisia FAU - Riahi, A AU - Riahi A AD - Mongi Slim University Hospital, La Marsa, Tunisia FAU - Mebazaa, M S AU - Mebazaa MS AD - Mongi Slim University Hospital, La Marsa, Tunisia FAU - Perez-Calatayud, A AU - Perez-Calatayud A AD - Medica Sur, Mexico City, Mexico. GRID: grid.414741.3 FAU - Carrillo-Esper, R AU - Carrillo-Esper R AD - Medica Sur, Mexico City, Mexico. GRID: grid.414741.3 FAU - Zepeda-Mendoza, A AU - Zepeda-Mendoza A AD - Medica Sur, Mexico City, Mexico. GRID: grid.414741.3 FAU - Diaz-Carrillo, M AU - Diaz-Carrillo M AD - Medica Sur, Mexico City, Mexico. GRID: grid.414741.3 FAU - Arch-Tirado, E AU - Arch-Tirado E AD - Instituto Nacional de Rehabilitacion, Mexico City, Mexico. ISNI: 0000 0004 0633 2911. GRID: grid.419223.f FAU - Carbognin, S AU - Carbognin S AD - University of Padua, Padua, Italy. ISNI: 0000 0004 1757 3470. GRID: grid.5608.b FAU - Pelacani, L AU - Pelacani L AD - Sant Antony hospital, Padua, Italy FAU - Zannoni, F AU - Zannoni F AD - University of Padua, Padua, Italy. ISNI: 0000 0004 1757 3470. GRID: grid.5608.b FAU - Agnoli, A AU - Agnoli A AD - Sant Antony hospital, Padua, Italy FAU - Gagliardi, G AU - Gagliardi G AD - Sant Antony hospital, Padua, Italy FAU - Cho, R AU - Cho R AD - HCMC, Minneapolis, USA. ISNI: 0000 0000 9206 4546. GRID: grid.414021.2 FAU - Adams, A AU - Adams A AD - HCMC, Minneapolis, USA. ISNI: 0000 0000 9206 4546. GRID: grid.414021.2 FAU - Lunos, S AU - Lunos S AD - University of Minnesota, Minneapolis, USA. ISNI: 0000000419368657. GRID: grid.17635.36 FAU - Ambur, S AU - Ambur S AD - HCMC, Minneapolis, USA. ISNI: 0000 0000 9206 4546. GRID: grid.414021.2 FAU - Shapiro, R AU - Shapiro R AD - HCMC, Minneapolis, USA. ISNI: 0000 0000 9206 4546. GRID: grid.414021.2 FAU - Prekker, M AU - Prekker M AD - HCMC, Minneapolis, USA. ISNI: 0000 0000 9206 4546. GRID: grid.414021.2 FAU - Thijssen, M AU - Thijssen M AD - Viecuri Medical Center, Venlo, Netherlands. ISNI: 0000 0004 0477 5022. GRID: grid.416856.8 FAU - Janssen, L AU - Janssen L AD - Viecuri Medical Center, Venlo, Netherlands. ISNI: 0000 0004 0477 5022. GRID: grid.416856.8 FAU - Foudraine, N AU - Foudraine N AD - Viecuri Medical Center, Venlo, Netherlands. ISNI: 0000 0004 0477 5022. GRID: grid.416856.8 FAU - Voscopoulos, C J AU - Voscopoulos CJ AD - University of Hawaii, John A. Burns School of Medicine, Honolulu, USA. ISNI: 0000 0001 2188 0957. GRID: grid.410445.0 FAU - Freeman, J AU - Freeman J AD - Respiratory Motion Inc., Waltham, USA FAU - Voscopoulos, C J AU - Voscopoulos CJ AD - University of Hawaii, John A. Burns School of Medicine, Honolulu, USA. ISNI: 0000 0001 2188 0957. GRID: grid.410445.0 FAU - Freeman, J AU - Freeman J AD - Respiratory Motion Inc., Waltham, USA FAU - George, E AU - George E AD - Massachusetts General Hospital, Boston, USA. ISNI: 0000 0004 0386 9924. GRID: grid.32224.35 FAU - Voscopoulos, C J AU - Voscopoulos CJ AD - University of Hawaii, John A. Burns School of Medicine, Honolulu, USA. ISNI: 0000 0001 2188 0957. GRID: grid.410445.0 FAU - Eversole, D AU - Eversole D AD - Respiratory Motion Inc., Waltham, USA FAU - Freeman, J AU - Freeman J AD - Respiratory Motion Inc., Waltham, USA FAU - George, E AU - George E AD - Massachusetts General Hospital, Boston, USA. ISNI: 0000 0004 0386 9924. GRID: grid.32224.35 FAU - Muttini, S AU - Muttini S AD - AO Desio e Vimercate, Vimercate, Italy FAU - Bigi, R AU - Bigi R AD - AO Desio e Vimercate, Vimercate, Italy FAU - Villani, G AU - Villani G AD - AO Crema, Crema, Italy FAU - Patroniti, N AU - Patroniti N AD - University of Milan-Bicocca, Monza, Italy. ISNI: 0000 0001 2174 1754. GRID: grid.7563.7 FAU - Williams, G AU - Williams G AD - UT Health Science Center at Houston, Houston, TX USA. ISNI: 0000 0000 9206 2401. GRID: grid.267308.8 FAU - Voscopoulos, C J AU - Voscopoulos CJ AD - University of Hawaii, John A. Burns School of Medicine, Honolulu, HI USA. ISNI: 0000 0001 2188 0957. GRID: grid.410445.0 FAU - Freeman, J AU - Freeman J AD - Respiratory Motion Inc., Waltham, MA USA FAU - George, E AU - George E AD - Massachusetts General Hospital, Boston, MA USA. ISNI: 0000 0004 0386 9924. GRID: grid.32224.35 FAU - Waldmann, A AU - Waldmann A AD - Swisstom AG, Landquart, Switzerland FAU - Bohm, S AU - Bohm S AD - Swisstom AG, Landquart, Switzerland FAU - Windisch, W AU - Windisch W AD - Kliniken der Stadt Koln, Pneumology and Critical Care Medicine, Witten / Herdecke University, Ostmerheimer Str. 200, 51109 Cologne, Germany. ISNI: 0000 0000 9024 6397. GRID: grid.412581.b FAU - Strassmann, S AU - Strassmann S AD - Kliniken der Stadt Koln, Pneumology and Critical Care Medicine, Witten / Herdecke University, Ostmerheimer Str. 200, 51109 Cologne, Germany. ISNI: 0000 0000 9024 6397. GRID: grid.412581.b FAU - Karagiannidis, C AU - Karagiannidis C AD - Kliniken der Stadt Koln, Pneumology and Critical Care Medicine, Witten / Herdecke University, Ostmerheimer Str. 200, 51109 Cologne, Germany. ISNI: 0000 0000 9024 6397. GRID: grid.412581.b FAU - Waldmann, A AU - Waldmann A AD - Swisstom AG, Landquart, Switzerland FAU - Bohm, S AU - Bohm S AD - Swisstom AG, Landquart, Switzerland FAU - Windisch, W AU - Windisch W AD - Kliniken der Stadt Koln, Pneumology and Critical Care Medicine, Witten/ Herdecke University, Ostmerheimer Str. 200, 51109 Cologne, Germany. ISNI: 0000 0000 9024 6397. GRID: grid.412581.b FAU - Strassmann, S AU - Strassmann S AD - Kliniken der Stadt Koln, Pneumology and Critical Care Medicine, Witten/ Herdecke University, Ostmerheimer Str. 200, 51109 Cologne, Germany. ISNI: 0000 0000 9024 6397. GRID: grid.412581.b FAU - Karagiannidis, C AU - Karagiannidis C AD - Kliniken der Stadt Koln, Pneumology and Critical Care Medicine, Witten/ Herdecke University, Ostmerheimer Str. 200, 51109 Cologne, Germany. ISNI: 0000 0000 9024 6397. GRID: grid.412581.b FAU - Karagiannidis, C K AU - Karagiannidis CK AD - ARDS and ECMO Center Koln-Merheim, Cologne, Germany FAU - Waldmann, A W AU - Waldmann AW AD - Swisstom, Chur, Switzerland FAU - Bohm, S B AU - Bohm SB AD - Swisstom, Chur, Switzerland FAU - Strassmann, S AU - Strassmann S AD - ARDS and ECMO Center Koln-Merheim, Cologne, Germany FAU - Windisch, W W AU - Windisch WW AD - ARDS and ECMO Center Koln-Merheim, Cologne, Germany FAU - Persson, P AU - Persson P AD - Sahlgrenska Univ Hospital, Goteborg, Sweden. ISNI: 000000009445082X. GRID: grid.1649.a FAU - Lundin, S AU - Lundin S AD - Sahlgrenska Univ Hospital, Goteborg, Sweden. ISNI: 000000009445082X. GRID: grid.1649.a FAU - Stenqvist, O AU - Stenqvist O AD - Sahlgrenska Univ Hospital, Goteborg, Sweden. ISNI: 000000009445082X. GRID: grid.1649.a FAU - Porta, G AU - Porta G AD - Second University of Naples, Naples, Italy. ISNI: 0000 0001 2200 8888. GRID: grid.9841.4 FAU - Numis, F AU - Numis F AD - San Paolo Hospital, Naples, Italy FAU - Serra, C S AU - Serra CS AD - University of Sassari, Sassari, Italy. ISNI: 0000 0001 2097 9138. GRID: grid.11450.31 FAU - Pagano, A P AU - Pagano AP AD - Cardarelli Hospital, Naples, Italy. GRID: grid.413172.2 FAU - Masarone, M M AU - Masarone MM AD - University of Saerno, Salerno, Italy FAU - Rinaldi, L R AU - Rinaldi LR AD - Second University of Naples, Naples, Italy. ISNI: 0000 0001 2200 8888. GRID: grid.9841.4 FAU - Amelia, A A AU - Amelia AA AD - Second University of Naples, Naples, Italy. ISNI: 0000 0001 2200 8888. GRID: grid.9841.4 FAU - Fascione, M F AU - Fascione MF AD - Second University of Naples, Naples, Italy. ISNI: 0000 0001 2200 8888. GRID: grid.9841.4 FAU - Adinolfi, L A AU - Adinolfi LA AD - Second University of Naples, Naples, Italy. ISNI: 0000 0001 2200 8888. GRID: grid.9841.4 FAU - Ruggiero, E R AU - Ruggiero ER AD - San Paolo Hospital, Naples, Italy FAU - Asota, F AU - Asota F AD - East Surrey Hospital, Surrey and Sussex NHS Trust, Surrey, UK FAU - O'Rourke, K AU - O'Rourke K AD - East Surrey Hospital, Surrey and Sussex NHS Trust, Surrey, UK FAU - Ranjan, S AU - Ranjan S AD - East Surrey Hospital, Surrey and Sussex NHS Trust, Surrey, UK FAU - Morgan, P AU - Morgan P AD - East Surrey Hospital, Surrey and Sussex NHS Trust, Surrey, UK FAU - DeBacker, J W AU - DeBacker JW AD - Mount Sinai Hospital and University of Toronto, Toronto, Canada. ISNI: 0000 0004 0473 9881. GRID: grid.416166.2 FAU - Tamberg, E AU - Tamberg E AD - Mount Sinai Hospital and University of Toronto, Toronto, Canada. ISNI: 0000 0004 0473 9881. GRID: grid.416166.2 FAU - O'Neill, L AU - O'Neill L AD - Mount Sinai Hospital and University of Toronto, Toronto, Canada. ISNI: 0000 0004 0473 9881. GRID: grid.416166.2 FAU - Munshi, L AU - Munshi L AD - Mount Sinai Hospital and University of Toronto, Toronto, Canada. ISNI: 0000 0004 0473 9881. GRID: grid.416166.2 FAU - Burry, L AU - Burry L AD - Mount Sinai Hospital and University of Toronto, Toronto, Canada. ISNI: 0000 0004 0473 9881. GRID: grid.416166.2 FAU - Fan, E AU - Fan E AD - University Health Network-Toronto General Hospital and Univeristy of Toronto, Toronto, Canada. ISNI: 0000 0001 0661 1177. GRID: grid.417184.f FAU - Mehta, S AU - Mehta S AD - Mount Sinai Hospital and University of Toronto, Toronto, Canada. ISNI: 0000 0004 0473 9881. GRID: grid.416166.2 FAU - Poo, S AU - Poo S AD - University of Cambridge, Cambridge, UK. ISNI: 0000000121885934. GRID: grid.5335.0 FAU - Mahendran, K AU - Mahendran K AD - Papworth Hospital, Cambridge, UK. ISNI: 0000 0004 0399 2308. GRID: grid.417155.3 FAU - Fowles, J AU - Fowles J AD - Papworth Hospital, Cambridge, UK. ISNI: 0000 0004 0399 2308. GRID: grid.417155.3 FAU - Gerrard, C AU - Gerrard C AD - Papworth Hospital, Cambridge, UK. ISNI: 0000 0004 0399 2308. GRID: grid.417155.3 FAU - Vuylsteke, A AU - Vuylsteke A AD - Papworth Hospital, Cambridge, UK. ISNI: 0000 0004 0399 2308. GRID: grid.417155.3 FAU - Loveridge, R AU - Loveridge R AD - King's College Hospital NHS Foundation Trust, London, UK. ISNI: 0000 0004 0489 4320. GRID: grid.429705.d FAU - Chaddock, C AU - Chaddock C AD - King's College Hospital NHS Foundation Trust, London, UK. ISNI: 0000 0004 0489 4320. GRID: grid.429705.d FAU - Patel, S AU - Patel S AD - King's College Hospital NHS Foundation Trust, London, UK. ISNI: 0000 0004 0489 4320. GRID: grid.429705.d FAU - Kakar, V AU - Kakar V AD - King's College Hospital NHS Foundation Trust, London, UK. ISNI: 0000 0004 0489 4320. GRID: grid.429705.d FAU - Willars, C AU - Willars C AD - King's College Hospital NHS Foundation Trust, London, UK. ISNI: 0000 0004 0489 4320. GRID: grid.429705.d FAU - Hurst, T AU - Hurst T AD - King's College Hospital NHS Foundation Trust, London, UK. ISNI: 0000 0004 0489 4320. GRID: grid.429705.d FAU - Park, C AU - Park C AD - King's College Hospital NHS Foundation Trust, London, UK. ISNI: 0000 0004 0489 4320. GRID: grid.429705.d FAU - Best, T AU - Best T AD - King's College Hospital NHS Foundation Trust, London, UK. ISNI: 0000 0004 0489 4320. GRID: grid.429705.d FAU - Vercueil, A AU - Vercueil A AD - King's College Hospital NHS Foundation Trust, London, UK. ISNI: 0000 0004 0489 4320. GRID: grid.429705.d FAU - Auzinger, G AU - Auzinger G AD - King's College Hospital NHS Foundation Trust, London, UK. ISNI: 0000 0004 0489 4320. GRID: grid.429705.d FAU - Borgman, A AU - Borgman A AD - Meijer Heart & Vascular Institute, Grand Rapids, USA FAU - Proudfoot, A G AU - Proudfoot AG AD - Meijer Heart & Vascular Institute, Grand Rapids, USA FAU - Grins, E AU - Grins E AD - Meijer Heart & Vascular Institute, Grand Rapids, USA FAU - Emiley, K E AU - Emiley KE AD - Meijer Heart & Vascular Institute, Grand Rapids, USA FAU - Schuitema, J AU - Schuitema J AD - Meijer Heart & Vascular Institute, Grand Rapids, USA FAU - Fitch, S J AU - Fitch SJ AD - Meijer Heart & Vascular Institute, Grand Rapids, USA FAU - Marco, G AU - Marco G AD - Meijer Heart & Vascular Institute, Grand Rapids, USA FAU - Sturgill, J AU - Sturgill J AD - Meijer Heart & Vascular Institute, Grand Rapids, USA FAU - Dickinson, M G AU - Dickinson MG AD - Meijer Heart & Vascular Institute, Grand Rapids, USA FAU - Strueber, M AU - Strueber M AD - Meijer Heart & Vascular Institute, Grand Rapids, USA FAU - Khaghani, A AU - Khaghani A AD - Meijer Heart & Vascular Institute, Grand Rapids, USA FAU - Wilton, P AU - Wilton P AD - Meijer Heart & Vascular Institute, Grand Rapids, USA FAU - Jovinge, S M AU - Jovinge SM FAU - Sampson, C AU - Sampson C AD - Glenfield Hospital, UHL, Leicester, UK. ISNI: 0000 0004 0648 9396. GRID: grid.416025.4 FAU - Harris-Fox, S AU - Harris-Fox S AD - Glenfield Hospital, UHL, Leicester, UK. ISNI: 0000 0004 0648 9396. GRID: grid.416025.4 FAU - Cove, M E AU - Cove ME AD - National University Hospital, Singapore, Singapore. ISNI: 0000 0004 0621 9599. GRID: grid.412106.0 FAU - Vu, L H AU - Vu LH AD - National University Singapore, Singapore, Singapore. ISNI: 0000 0001 2180 6431. GRID: grid.4280.e FAU - Sen, A AU - Sen A AD - Mayo Clinic, Phoenix, AZ USA. ISNI: 0000 0000 8875 6339. GRID: grid.417468.8 FAU - Federspiel, W J AU - Federspiel WJ AD - University of Pittsburgh, Pittsburgh, PA USA. ISNI: 0000 0004 1936 9000. GRID: grid.21925.3d FAU - Kellum, J A AU - Kellum JA AD - University of Pittsburgh, Pittsburgh, PA USA. ISNI: 0000 0004 1936 9000. GRID: grid.21925.3d FAU - Mazo Torre, C AU - Mazo Torre C AD - Vall D'Hebron University Hospital, Barcelona, Spain. ISNI: 0000 0001 0675 8654. GRID: grid.411083.f FAU - Riera, J AU - Riera J AD - Vall D'Hebron University Hospital, Barcelona, Spain. ISNI: 0000 0001 0675 8654. GRID: grid.411083.f FAU - Ramirez, S AU - Ramirez S AD - Vall D'Hebron University Hospital, Barcelona, Spain. ISNI: 0000 0001 0675 8654. GRID: grid.411083.f FAU - Borgatta, B AU - Borgatta B AD - Vall D'Hebron University Hospital, Barcelona, Spain. ISNI: 0000 0001 0675 8654. GRID: grid.411083.f FAU - Lagunes, L AU - Lagunes L AD - Vall D'Hebron University Hospital, Barcelona, Spain. ISNI: 0000 0001 0675 8654. GRID: grid.411083.f FAU - Rello, J AU - Rello J AD - Universitat Autonoma de Barcelona, Barcelona, Spain. GRID: grid.7080.f FAU - Kuzovlev, A K AU - Kuzovlev AK AD - V.A. Negovsky Research Institute of General Reanimatology, Moscow, Russia FAU - Moroz, V AU - Moroz V AD - V.A. Negovsky Research Institute of General Reanimatology, Moscow, Russia FAU - Goloubev, A AU - Goloubev A AD - V.A. Negovsky Research Institute of General Reanimatology, Moscow, Russia FAU - Polovnikov, S AU - Polovnikov S AD - NN Burdenko Main Military Hospital, Moscow, Russia FAU - Nenchuk, S AU - Nenchuk S AD - NN Burdenko Main Military Hospital, Moscow, Russia FAU - Karavana, V AU - Karavana V AD - George P. Livanos and Marianthi Simou Laboratories, Athens, Greece FAU - Glynos, C AU - Glynos C AD - George P. Livanos and Marianthi Simou Laboratories, Athens, Greece FAU - Asimakos, A AU - Asimakos A AD - George P. Livanos and Marianthi Simou Laboratories, Athens, Greece FAU - Pappas, K AU - Pappas K AD - George P. Livanos and Marianthi Simou Laboratories, Athens, Greece FAU - Vrettou, C AU - Vrettou C AD - George P. Livanos and Marianthi Simou Laboratories, Athens, Greece FAU - Magkou, M AU - Magkou M AD - George P. Livanos and Marianthi Simou Laboratories, Athens, Greece FAU - Ischaki, E AU - Ischaki E AD - George P. Livanos and Marianthi Simou Laboratories, Athens, Greece FAU - Stathopoulos, G AU - Stathopoulos G AD - University of Patras, Rio, Achaia Greece. ISNI: 0000 0004 0576 5395. GRID: grid.11047.33 FAU - Zakynthinos, S AU - Zakynthinos S AD - George P. Livanos and Marianthi Simou Laboratories, Athens, Greece FAU - Spadaro, S AU - Spadaro S AD - University of Ferrara, Ferrara, Italy. ISNI: 0000 0004 1757 2064. GRID: grid.8484.0 FAU - Kozhevnikova, I AU - Kozhevnikova I AD - University of Ferrara, Ferrara, Italy. ISNI: 0000 0004 1757 2064. GRID: grid.8484.0 FAU - Dalla Corte, F AU - Dalla Corte F AD - University of Ferrara, Ferrara, Italy. ISNI: 0000 0004 1757 2064. GRID: grid.8484.0 FAU - Grasso, S AU - Grasso S AD - University of Bari, Bari, Italy. ISNI: 0000 0001 0120 3326. GRID: grid.7644.1 FAU - Casolari, P AU - Casolari P AD - University of Ferrara, Ferrara, Italy. ISNI: 0000 0004 1757 2064. GRID: grid.8484.0 FAU - Caramori, G AU - Caramori G AD - University of Ferrara, Ferrara, Italy. ISNI: 0000 0004 1757 2064. GRID: grid.8484.0 FAU - Volta, C AU - Volta C AD - University of Ferrara, Ferrara, Italy. ISNI: 0000 0004 1757 2064. GRID: grid.8484.0 FAU - Andrianjafiarinoa, T AU - Andrianjafiarinoa T AD - CHU HJRA, Antananarivo, Madagascar FAU - Randriamandrato, T AU - Randriamandrato T AD - CHU HJRA, Antananarivo, Madagascar FAU - Rajaonera, T AU - Rajaonera T AD - CHU HJRA, Antananarivo, Madagascar FAU - El-Dash, S AU - El-Dash S AD - Reanimation medicale, Centre Hospitalier Universitaire, Amiens, France. ISNI: 0000 0004 0593 702X. GRID: grid.134996.0 FAU - Costa, E L V AU - Costa ELV AD - Cardio-Pulmonary Department, Pulmonary Division, Heart Institute (Incor), University of Sao Paulo, Sao Paulo, Brazil. ISNI: 0000 0004 1937 0722. GRID: grid.11899.38 FAU - Tucci, M R AU - Tucci MR AD - Cardio-Pulmonary Department, Pulmonary Division, Heart Institute (Incor), University of Sao Paulo, Sao Paulo, Brazil. ISNI: 0000 0004 1937 0722. GRID: grid.11899.38 FAU - Leleu, F AU - Leleu F AD - Reanimation medicale, Centre Hospitalier Universitaire, Amiens, France. ISNI: 0000 0004 0593 702X. GRID: grid.134996.0 FAU - Kontar, L AU - Kontar L AD - Reanimation medicale, Centre Hospitalier Universitaire, Amiens, France. ISNI: 0000 0004 0593 702X. GRID: grid.134996.0 FAU - De Cagny, B AU - De Cagny B AD - Reanimation medicale, Centre Hospitalier Universitaire, Amiens, France. ISNI: 0000 0004 0593 702X. GRID: grid.134996.0 FAU - Brazier, F AU - Brazier F AD - Reanimation medicale, Centre Hospitalier Universitaire, Amiens, France. ISNI: 0000 0004 0593 702X. GRID: grid.134996.0 FAU - Titeca, D AU - Titeca D AD - Reanimation medicale, Centre Hospitalier Universitaire, Amiens, France. ISNI: 0000 0004 0593 702X. GRID: grid.134996.0 FAU - Bacari-Risal, G AU - Bacari-Risal G AD - Reanimation medicale, Centre Hospitalier Universitaire, Amiens, France. ISNI: 0000 0004 0593 702X. GRID: grid.134996.0 FAU - Maizel, J AU - Maizel J AD - Reanimation medicale, Centre Hospitalier Universitaire, Amiens, France. ISNI: 0000 0004 0593 702X. GRID: grid.134996.0 FAU - Amato, M AU - Amato M AD - Cardio-Pulmonary Department, Pulmonary Division, Heart Institute (Incor), University of Sao Paulo, Sao Paulo, Brazil. ISNI: 0000 0004 1937 0722. GRID: grid.11899.38 FAU - Slama, M AU - Slama M AD - Reanimation medicale, Centre Hospitalier Universitaire, Amiens, France. ISNI: 0000 0004 0593 702X. GRID: grid.134996.0 FAU - Mercado, P AU - Mercado P AD - CHU Amiens, Amiens, France. ISNI: 0000 0004 0593 702X. GRID: grid.134996.0 FAU - Maizel, J AU - Maizel J AD - CHU Amiens, Amiens, France. ISNI: 0000 0004 0593 702X. GRID: grid.134996.0 FAU - Kontar, L AU - Kontar L AD - CHU Amiens, Amiens, France. ISNI: 0000 0004 0593 702X. GRID: grid.134996.0 FAU - Titeca, D AU - Titeca D AD - CHU Amiens, Amiens, France. ISNI: 0000 0004 0593 702X. GRID: grid.134996.0 FAU - Brazier, F AU - Brazier F AD - CHU Amiens, Amiens, France. ISNI: 0000 0004 0593 702X. GRID: grid.134996.0 FAU - Riviere, A AU - Riviere A AD - CHU Amiens, Amiens, France. ISNI: 0000 0004 0593 702X. GRID: grid.134996.0 FAU - Joris, M AU - Joris M AD - CHU Amiens, Amiens, France. ISNI: 0000 0004 0593 702X. GRID: grid.134996.0 FAU - Soupison, T AU - Soupison T AD - CHU Amiens, Amiens, France. ISNI: 0000 0004 0593 702X. GRID: grid.134996.0 FAU - De Cagny, B AU - De Cagny B AD - CHU Amiens, Amiens, France. ISNI: 0000 0004 0593 702X. GRID: grid.134996.0 FAU - El Dash, S AU - El Dash S AD - CHU Amiens, Amiens, France. ISNI: 0000 0004 0593 702X. GRID: grid.134996.0 FAU - Slama, M AU - Slama M AD - CHU Amiens, Amiens, France. ISNI: 0000 0004 0593 702X. GRID: grid.134996.0 FAU - Remmington AU - Remmington AD - Royal Brompton Hospital, London, UK. GRID: grid.439338.6 FAU - Fischer, A AU - Fischer A AD - Royal Brompton Hospital, London, UK. GRID: grid.439338.6 FAU - Squire, S AU - Squire S AD - Royal Brompton Hospital, London, UK. GRID: grid.439338.6 FAU - Boichat, M AU - Boichat M AD - Royal Brompton Hospital, London, UK. GRID: grid.439338.6 FAU - Honzawa, H AU - Honzawa H AD - Musashino Red Cross Hospital, Tokyo, Japan. ISNI: 0000 0000 9887 307X. GRID: grid.416332.1 FAU - Yasuda, H AU - Yasuda H AD - Musashino Red Cross Hospital, Tokyo, Japan. ISNI: 0000 0000 9887 307X. GRID: grid.416332.1 FAU - Adati, T AU - Adati T AD - Musashino Red Cross Hospital, Tokyo, Japan. ISNI: 0000 0000 9887 307X. GRID: grid.416332.1 FAU - Suzaki, S AU - Suzaki S AD - Musashino Red Cross Hospital, Tokyo, Japan. ISNI: 0000 0000 9887 307X. GRID: grid.416332.1 FAU - Horibe, M AU - Horibe M AD - JSEPTIC Clinical Trial Group, Tokyo, Japan FAU - Sasaki, M AU - Sasaki M AD - JSEPTIC Clinical Trial Group, Tokyo, Japan FAU - Sanui, M AU - Sanui M AD - JSEPTIC Clinical Trial Group, Tokyo, Japan FAU - Marinho, R AU - Marinho R AD - Centro Hospitalar do Porto, Porto, Portugal. ISNI: 0000 0004 0392 7039. GRID: grid.418340.a FAU - Daniel, J AU - Daniel J AD - Centro Hospitalar do Porto, Porto, Portugal. ISNI: 0000 0004 0392 7039. GRID: grid.418340.a FAU - Miranda, H AU - Miranda H AD - Centro Hospitalar do Porto, Porto, Portugal. ISNI: 0000 0004 0392 7039. GRID: grid.418340.a FAU - Marinho, A AU - Marinho A FAU - Milinis, K AU - Milinis K AD - University of Liverpool, Liverpool, UK. ISNI: 0000 0004 1936 8470. GRID: grid.10025.36 FAU - Cooper, M AU - Cooper M AD - Royal Liverpool University Hospital, Liverpool, UK. ISNI: 0000 0004 0417 2395. GRID: grid.415970.e FAU - Williams, G R AU - Williams GR AD - Royal Liverpool University Hospital, Liverpool, UK. ISNI: 0000 0004 0417 2395. GRID: grid.415970.e FAU - McCarron, E AU - McCarron E AD - Royal Liverpool University Hospital, Liverpool, UK. ISNI: 0000 0004 0417 2395. GRID: grid.415970.e FAU - Simants, S AU - Simants S AD - Royal Liverpool University Hospital, Liverpool, UK. ISNI: 0000 0004 0417 2395. GRID: grid.415970.e FAU - Patanwala, I AU - Patanwala I AD - Royal Liverpool University Hospital, Liverpool, UK. ISNI: 0000 0004 0417 2395. GRID: grid.415970.e FAU - Welters, I AU - Welters I AD - University of Liverpool, Liverpool, UK. ISNI: 0000 0004 1936 8470. GRID: grid.10025.36 FAU - Su, Y AU - Su Y AD - Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi County, Taiwan FAU - Fernandez Villanueva, J AU - Fernandez Villanueva J AD - Hospital Clinico Universitario de Santiago de Compostela, Santiago de Compostela, Spain. ISNI: 0000 0000 8816 6945. GRID: grid.411048.8 FAU - Fernandez Garda, R AU - Fernandez Garda R AD - Hospital Clinico Universitario de Santiago de Compostela, Santiago de Compostela, Spain. ISNI: 0000 0000 8816 6945. GRID: grid.411048.8 FAU - Lopez Lago, A AU - Lopez Lago A AD - Hospital Clinico Universitario de Santiago de Compostela, Santiago de Compostela, Spain. ISNI: 0000 0000 8816 6945. GRID: grid.411048.8 FAU - Rodriguez Ruiz, E AU - Rodriguez Ruiz E AD - Hospital Clinico Universitario de Santiago de Compostela, Santiago de Compostela, Spain. ISNI: 0000 0000 8816 6945. GRID: grid.411048.8 FAU - Hernandez Vaquero, R AU - Hernandez Vaquero R AD - Hospital Clinico Universitario de Santiago de Compostela, Santiago de Compostela, Spain. ISNI: 0000 0000 8816 6945. GRID: grid.411048.8 FAU - Tome Martinez de Rituerto, S AU - Tome Martinez de Rituerto S AD - Hospital Clinico Universitario de Santiago de Compostela, Santiago de Compostela, Spain. ISNI: 0000 0000 8816 6945. GRID: grid.411048.8 FAU - Varo Perez, E AU - Varo Perez E AD - Hospital Clinico Universitario de Santiago de Compostela, Santiago de Compostela, Spain. ISNI: 0000 0000 8816 6945. GRID: grid.411048.8 FAU - Lefel, N AU - Lefel N AD - MUMC, Maastricht, Netherlands. GRID: grid.412966.e FAU - Schaap, F AU - Schaap F AD - MUMC, Maastricht, Netherlands. GRID: grid.412966.e FAU - Bergmans, D AU - Bergmans D AD - MUMC, Maastricht, Netherlands. GRID: grid.412966.e FAU - Olde Damink, S AU - Olde Damink S AD - MUMC, Maastricht, Netherlands. GRID: grid.412966.e FAU - Van de Poll, M AU - Van de Poll M AD - MUMC, Maastricht, Netherlands. GRID: grid.412966.e FAU - Tizard, K AU - Tizard K AD - Royal Liverpool University Hospital, Liverpool, UK. ISNI: 0000 0004 0417 2395. GRID: grid.415970.e FAU - Lister, C AU - Lister C AD - Royal Liverpool University Hospital, Liverpool, UK. ISNI: 0000 0004 0417 2395. GRID: grid.415970.e FAU - Poole, L AU - Poole L AD - Royal Liverpool University Hospital, Liverpool, UK. ISNI: 0000 0004 0417 2395. GRID: grid.415970.e FAU - Ringaitiene, D AU - Ringaitiene D AD - Vilnius University Hospital Santariskiu Clinics, Vilnius, Lithuania. ISNI: 0000 0004 0567 3159. GRID: grid.426597.b FAU - Gineityte, D AU - Gineityte D AD - Vilnius University, Faculty of Medicine, Vilnius, Lithuania FAU - Vicka, V AU - Vicka V AD - Vilnius University, Faculty of Medicine, Vilnius, Lithuania FAU - Norkiene, I AU - Norkiene I AD - Vilnius University Hospital Santariskiu Clinics, Vilnius, Lithuania. ISNI: 0000 0004 0567 3159. GRID: grid.426597.b FAU - Sipylaite, J AU - Sipylaite J AD - Vilnius University Hospital Santariskiu Clinics, Vilnius, Lithuania. ISNI: 0000 0004 0567 3159. GRID: grid.426597.b FAU - O'Loughlin, A AU - O'Loughlin A AD - Mercy University Hospital, Cork, Ireland. ISNI: 0000 0004 0575 9497. GRID: grid.411785.e FAU - Maraj, V AU - Maraj V AD - Mercy University Hospital, Cork, Ireland. ISNI: 0000 0004 0575 9497. GRID: grid.411785.e FAU - Dowling, J AU - Dowling J AD - Mercy University Hospital, Cork, Ireland. ISNI: 0000 0004 0575 9497. GRID: grid.411785.e FAU - Velasco, M B AU - Velasco MB AD - Hospital Meridional S.A., Cariacica, Brazil FAU - Dalcomune, D M AU - Dalcomune DM AD - Hospital Meridional S.A., Cariacica, Brazil FAU - Dias, E B AU - Dias EB AD - Hospital Meridional S.A., Cariacica, Brazil FAU - Fernandes, S L AU - Fernandes SL AD - Hospital Meridional S.A., Cariacica, Brazil FAU - Oshima, T AU - Oshima T AD - Geneva Universtiy Hospital, Geneva, Switzerland. ISNI: 0000 0001 0721 9812. GRID: grid.150338.c FAU - Graf, S AU - Graf S AD - Geneva Universtiy Hospital, Geneva, Switzerland. ISNI: 0000 0001 0721 9812. GRID: grid.150338.c FAU - Heidegger, C AU - Heidegger C AD - Geneva Universtiy Hospital, Geneva, Switzerland. ISNI: 0000 0001 0721 9812. GRID: grid.150338.c FAU - Genton, L AU - Genton L AD - Geneva Universtiy Hospital, Geneva, Switzerland. ISNI: 0000 0001 0721 9812. GRID: grid.150338.c FAU - Karsegard, V AU - Karsegard V AD - Geneva Universtiy Hospital, Geneva, Switzerland. ISNI: 0000 0001 0721 9812. GRID: grid.150338.c FAU - Dupertuis, Y AU - Dupertuis Y AD - Geneva Universtiy Hospital, Geneva, Switzerland. ISNI: 0000 0001 0721 9812. GRID: grid.150338.c FAU - Pichard, C AU - Pichard C AD - Geneva Universtiy Hospital, Geneva, Switzerland. ISNI: 0000 0001 0721 9812. GRID: grid.150338.c FAU - Friedli, N AU - Friedli N AD - Medical University Department, Kantonsspital Aarau, Aarau, Switzerland. ISNI: 0000 0000 8704 3732. GRID: grid.413357.7 FAU - Stanga, Z AU - Stanga Z AD - Department of Endocrinology, Diabetes and Clinical Nutrition, University Hospital Bern, Bern, Switzerland. ISNI: 0000 0004 0479 0855. GRID: grid.411656.1 FAU - Mueller, B AU - Mueller B AD - Medical University Department, Kantonsspital Aarau, Aarau, Switzerland. ISNI: 0000 0000 8704 3732. GRID: grid.413357.7 FAU - Schuetz, P AU - Schuetz P AD - Medical University Department, Kantonsspital Aarau, Aarau, Switzerland. ISNI: 0000 0000 8704 3732. GRID: grid.413357.7 FAU - Vandersteen, L AU - Vandersteen L AD - Jessa Ziekenhuis, Hasselt, Belgium. ISNI: 0000 0004 0578 1096. GRID: grid.414977.8 FAU - Stessel, B AU - Stessel B AD - Jessa Ziekenhuis, Hasselt, Belgium. ISNI: 0000 0004 0578 1096. GRID: grid.414977.8 FAU - Evers, S AU - Evers S AD - Jessa Ziekenhuis, Hasselt, Belgium. ISNI: 0000 0004 0578 1096. GRID: grid.414977.8 FAU - Van Assche, A AU - Van Assche A AD - Jessa Ziekenhuis, Hasselt, Belgium. ISNI: 0000 0004 0578 1096. GRID: grid.414977.8 FAU - Jamaer, L AU - Jamaer L AD - Jessa Ziekenhuis, Hasselt, Belgium. ISNI: 0000 0004 0578 1096. GRID: grid.414977.8 FAU - Dubois, J AU - Dubois J AD - Jessa Ziekenhuis, Hasselt, Belgium. ISNI: 0000 0004 0578 1096. GRID: grid.414977.8 FAU - Marinho, R AU - Marinho R AD - Centro Hospitalar do Porto, Porto, Portugal. ISNI: 0000 0004 0392 7039. GRID: grid.418340.a FAU - Castro, H AU - Castro H AD - Centro Hospitalar do Porto, Porto, Portugal. ISNI: 0000 0004 0392 7039. GRID: grid.418340.a FAU - Moura, J AU - Moura J AD - Unidade Local de Saude do Alto Minho, Viana do Castelo, Portugal FAU - Valente, J AU - Valente J AD - Unidade de Saude Local de Castelo Branco, Castelo Branco, Portugal FAU - Martins, P AU - Martins P AD - Centro Hospitalar e Universitario de Coimbra, Coimbra, Portugal. ISNI: 0000000106861985. GRID: grid.28911.33 FAU - Casteloes, P AU - Casteloes P AD - Centro Hospitalar de Vila Nova de Gaia, Vila Nova de Gaia, Portugal. ISNI: 0000 0000 8902 4519. GRID: grid.418336.b FAU - Magalhaes, C AU - Magalhaes C AD - Centro Hospitalar do Algarve, Faro, Portugal FAU - Cabral, S AU - Cabral S AD - Instituto Portugues de Oncologia do Porto, Porto, Portugal. GRID: grid.435544.7 FAU - Santos, M AU - Santos M AD - Faculdade de Ciencias da Nutricao e Alimentacao da Universidade do Porto, Porto, Portugal. ISNI: 0000 0001 1503 7226. GRID: grid.5808.5 FAU - Oliveira, B AU - Oliveira B AD - Faculdade de Ciencias da Nutricao e Alimentacao da Universidade do Porto, Porto, Portugal. ISNI: 0000 0001 1503 7226. GRID: grid.5808.5 FAU - Salgueiro, A AU - Salgueiro A AD - Centro Hospitalar e Universitario de Coimbra, Coimbra, Portugal. ISNI: 0000000106861985. GRID: grid.28911.33 FAU - Marinho, A AU - Marinho A AD - Centro Hospitalar do Porto, Porto, Portugal. ISNI: 0000 0004 0392 7039. GRID: grid.418340.a FAU - Marinho, R AU - Marinho R AD - Centro Hospitalar do Porto, Porto, Portugal. ISNI: 0000 0004 0392 7039. GRID: grid.418340.a FAU - Santos, M AU - Santos M AD - Faculdade de Ciencias da Nutricao e Alimentacao da Universidade do Porto, Porto, Portugal. ISNI: 0000 0001 1503 7226. GRID: grid.5808.5 FAU - Lafuente, E AU - Lafuente E AD - Centro Hospitalar Tamega e Sousa, Penafiel, Portugal. GRID: grid.466592.a FAU - Castro, H AU - Castro H AD - Centro Hospitalar do Porto, Porto, Portugal. ISNI: 0000 0004 0392 7039. GRID: grid.418340.a FAU - Cabral, S AU - Cabral S AD - Instituto Portugues de Oncologia do Porto, Porto, Portugal. ISNI: 0000 0004 0631 0608. GRID: grid.418711.a FAU - Moura, J AU - Moura J AD - Unidade Local de Saude do Alto Minho, Viana do Castelo, Portugal FAU - Martins, P AU - Martins P AD - Centro Hospitalar e Universitario de Coimbra, Coimbra, Portugal. ISNI: 0000000106861985. GRID: grid.28911.33 FAU - Oliveira, B AU - Oliveira B AD - Faculdade de Ciencias da Nutricao e Alimentacao da Universidade do Porto, Porto, Portugal. ISNI: 0000 0001 1503 7226. GRID: grid.5808.5 FAU - Salgueiro, A AU - Salgueiro A AD - Centro Hospitalar e Universitario de Coimbra, Coimbra, Portugal. ISNI: 0000000106861985. GRID: grid.28911.33 FAU - Duarte, S AU - Duarte S AD - Unidade de Saude Local de Castelo Branco, Castelo Branco, Portugal FAU - Castro, S AU - Castro S AD - Centro Hospitalar do Algarve, Faro, Portugal FAU - Melo, M AU - Melo M AD - Centro Hospitalar do Baixo Vouga, Aveiro, Portugal FAU - Casteloes, P AU - Casteloes P AD - Centro Hospitalar de Vila Nova de Gaia, Vila Nova de Gaia, Portugal. ISNI: 0000 0000 8902 4519. GRID: grid.418336.b FAU - Marinho, A AU - Marinho A AD - Centro Hospitalar do Porto, Porto, Portugal. ISNI: 0000 0004 0392 7039. GRID: grid.418340.a FAU - Gray, S AU - Gray S AD - Nottingham University Hospital NHS Trust, Nottingham, UK. ISNI: 0000 0001 0440 1889. GRID: grid.240404.6 FAU - Maipang, K AU - Maipang K AD - Prince of Songkla University, Songkla, Thailand. ISNI: 0000 0004 0470 1162. GRID: grid.7130.5 FAU - Bhurayanontachai, R AU - Bhurayanontachai R AD - Prince of Songkla University, Songkla, Thailand. ISNI: 0000 0004 0470 1162. GRID: grid.7130.5 FAU - Gradel, L G AU - Gradel LG AD - Kantonsspital Aarau, Aarau, Switzerland. ISNI: 0000 0000 8704 3732. GRID: grid.413357.7 FAU - Schutz, P AU - Schutz P AD - Kantonsspital Aarau, Aarau, Switzerland. ISNI: 0000 0000 8704 3732. GRID: grid.413357.7 FAU - Langlois, P AU - Langlois P AD - Universite de Sherbrooke, Sherbrooke, Canada. ISNI: 0000 0000 9064 6198. GRID: grid.86715.3d FAU - Manzanares, W AU - Manzanares W AD - University Hospital, Montevideo, Uruguay FAU - Tincu, R AU - Tincu R AD - Bucharest Clinical Emergency Hospital, Bucharest, Romania FAU - Cobilinschi, C AU - Cobilinschi C AD - Bucharest Clinical Emergency Hospital, Bucharest, Romania FAU - Tomescu, D AU - Tomescu D AD - Fundeni Clinical Institute, Bucharest, Romania. ISNI: 0000 0004 0540 9980. GRID: grid.415180.9 FAU - Ghiorghiu, Z AU - Ghiorghiu Z AD - Bucharest Clinical Emergency Hospital, Bucharest, Romania FAU - Macovei, R AU - Macovei R AD - Bucharest Clinical Emergency Hospital, Bucharest, Romania FAU - Manzanares, W AU - Manzanares W AD - University Hospital, Montevideo, Uruguay FAU - Langlois, P AU - Langlois P AD - Universite de Sherbrooke, Sherbrooke, Canada. ISNI: 0000 0000 9064 6198. GRID: grid.86715.3d FAU - Lemieux, M AU - Lemieux M AD - Queen's University, Kingston, Canada. ISNI: 0000 0004 1936 8331. GRID: grid.410356.5 FAU - Elke, G AU - Elke G AD - University Medical Center Schleswig-Holstein, Kiel, Germany. ISNI: 0000 0004 0646 2097. GRID: grid.412468.d FAU - Bloos, F AU - Bloos F AD - University of Jena, Jena, Germany. ISNI: 0000 0001 1939 2794. GRID: grid.9613.d FAU - Reinhart, K AU - Reinhart K AD - University of Jena, Jena, Germany. ISNI: 0000 0001 1939 2794. GRID: grid.9613.d FAU - Heyland, D AU - Heyland D AD - Queen's University, Kingston, Canada. ISNI: 0000 0004 1936 8331. GRID: grid.410356.5 FAU - Langlois, P AU - Langlois P AD - Universite de Sherbrooke, Sherbrooke, Canada. ISNI: 0000 0000 9064 6198. GRID: grid.86715.3d FAU - Lemieux, M AU - Lemieux M AD - Queen's University, Kingston, Canada. ISNI: 0000 0004 1936 8331. GRID: grid.410356.5 FAU - Aramendi, I AU - Aramendi I AD - University Hospital, Montevideo, Uruguay FAU - Heyland, D AU - Heyland D AD - Queen's University, Kingston, Canada. ISNI: 0000 0004 1936 8331. GRID: grid.410356.5 FAU - Manzanares, W AU - Manzanares W AD - University Hospital, Montevideo, Uruguay FAU - Su, Y AU - Su Y AD - Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi County, Taiwan FAU - Marinho, R AU - Marinho R AD - Centro Hospitalar do Porto, Porto, Portugal. ISNI: 0000 0004 0392 7039. GRID: grid.418340.a FAU - Babo, N AU - Babo N AD - Centro Hospitalar do Porto, Porto, Portugal. ISNI: 0000 0004 0392 7039. GRID: grid.418340.a FAU - Marinho, A AU - Marinho A AD - Centro Hospitalar do Porto, Porto, Portugal. ISNI: 0000 0004 0392 7039. GRID: grid.418340.a FAU - Hoshino, M AU - Hoshino M AD - Aida Hospital, Fukushima, Japan FAU - Haraguchi, Y AU - Haraguchi Y AD - Keiyo Hospital, Tokyo, Japan FAU - Kajiwara, S AU - Kajiwara S AD - Aida Hospital, Fukushima, Japan FAU - Mitsuhashi, T AU - Mitsuhashi T AD - Shisei Hospital, Saitama, Japan FAU - Tsubata, T AU - Tsubata T AD - Keiyo Hospital, Tokyo, Japan FAU - Aida, M AU - Aida M AD - Aida Hospital, Fukushima, Japan FAU - Rattanapraphat, T AU - Rattanapraphat T AD - Prince of Songkla University, Hat Yai City, Songkhla Province Thailand. ISNI: 0000 0004 0470 1162. GRID: grid.7130.5 FAU - Bhurayanontachai, R AU - Bhurayanontachai R AD - Prince of Songkla University, Hat Yai City, Songkhla Province Thailand. ISNI: 0000 0004 0470 1162. GRID: grid.7130.5 FAU - Kongkamol, C AU - Kongkamol C AD - Prince of Songkla University, Hat Yai City, Songkhla Province Thailand. ISNI: 0000 0004 0470 1162. GRID: grid.7130.5 FAU - Khwannimit, B AU - Khwannimit B AD - Prince of Songkla University, Hat Yai City, Songkhla Province Thailand. ISNI: 0000 0004 0470 1162. GRID: grid.7130.5 FAU - Marinho, R AU - Marinho R AD - Centro Hospitalar do Porto, Porto, Portugal. ISNI: 0000 0004 0392 7039. GRID: grid.418340.a FAU - Santos, M AU - Santos M AD - Faculdade de Ciencias da Nutricao e Alimentacao da Universidade do Porto, Porto, Portugal. ISNI: 0000 0001 1503 7226. GRID: grid.5808.5 FAU - Castro, H AU - Castro H AD - Centro Hospitalar do Porto, Porto, Portugal. ISNI: 0000 0004 0392 7039. GRID: grid.418340.a FAU - Lafuente, E AU - Lafuente E AD - Centro Hospitalar Tamega e Sousa, Penafiel, Portugal. GRID: grid.466592.a FAU - Salgueiro, A AU - Salgueiro A AD - Centro Hospitalar e Universitario de Coimbra, Coimbra, Portugal. ISNI: 0000000106861985. GRID: grid.28911.33 FAU - Cabral, S AU - Cabral S AD - Instituto Portugues de Oncologia do Porto, Porto, Portugal. ISNI: 0000 0004 0631 0608. GRID: grid.418711.a FAU - Martins, P AU - Martins P AD - Centro Hospitalar e Universitario de Coimbra, Coimbra, Portugal. ISNI: 0000000106861985. GRID: grid.28911.33 FAU - Moura, J AU - Moura J AD - Unidade Local de Saude do Alto Minho, Viana do Castelo, Portugal FAU - Oliveira, B AU - Oliveira B AD - Faculdade de Ciencias da Nutricao e Alimentacao da Universidade do Porto, Porto, Portugal. ISNI: 0000 0001 1503 7226. GRID: grid.5808.5 FAU - Melo, M AU - Melo M AD - Centro Hospitalar Baixo Vouga, Aveiro, Portugal FAU - Xavier, B AU - Xavier B AD - Centro Hospitalar Baixo Vouga, Aveiro, Portugal FAU - Valente, J AU - Valente J AD - Unidade de Saude Local de Castelo Branco, Castelo Branco, Portugal FAU - Magalhaes, C AU - Magalhaes C AD - Centro Hospitalar do Algarve, Faro, Portugal FAU - Casteloes, P AU - Casteloes P AD - Centro Hospitalar de Vila Nova de Gaia, Vila Nova de Gaia, Portugal. ISNI: 0000 0000 8902 4519. GRID: grid.418336.b FAU - Marinho, A AU - Marinho A AD - Centro Hospitalar do Porto, Porto, Portugal. ISNI: 0000 0004 0392 7039. GRID: grid.418340.a FAU - Moisidou, D AU - Moisidou D AD - Department of Cardiothoracic Surgery, George Papanikolaou General Hospital, Thessaloniki, Greece. ISNI: 0000 0004 0576 574X. GRID: grid.415248.e FAU - Ampatzidou, F AU - Ampatzidou F AD - Department of Cardiothoracic Surgery, George Papanikolaou General Hospital, Thessaloniki, Greece. ISNI: 0000 0004 0576 574X. GRID: grid.415248.e FAU - Koutsogiannidis, C AU - Koutsogiannidis C AD - Department of Cardiothoracic Surgery, George Papanikolaou General Hospital, Thessaloniki, Greece. ISNI: 0000 0004 0576 574X. GRID: grid.415248.e FAU - Moschopoulou, M AU - Moschopoulou M AD - Department of Cardiothoracic Surgery, George Papanikolaou General Hospital, Thessaloniki, Greece. ISNI: 0000 0004 0576 574X. GRID: grid.415248.e FAU - Drossos, G AU - Drossos G AD - Department of Cardiothoracic Surgery, George Papanikolaou General Hospital, Thessaloniki, Greece. ISNI: 0000 0004 0576 574X. GRID: grid.415248.e FAU - Taskin, G AU - Taskin G AD - Gulhane Military Medical Academy, Ankara, Turkey. ISNI: 0000 0001 0720 6034. GRID: grid.413460.4 FAU - Cakir, M AU - Cakir M AD - Gulhane Military Medical Academy, Ankara, Turkey. ISNI: 0000 0001 0720 6034. GRID: grid.413460.4 FAU - Guler, AK AU - Guler AK AD - Gulhane Military Medical Academy, Ankara, Turkey. ISNI: 0000 0001 0720 6034. GRID: grid.413460.4 FAU - Taskin, A AU - Taskin A AD - Ankara Mevki Military Hospital, Ankara, Turkey. GRID: grid.461837.f FAU - Ocal, N AU - Ocal N AD - Gulhane Military Medical Academy, Ankara, Turkey. ISNI: 0000 0001 0720 6034. GRID: grid.413460.4 FAU - Ozer, S AU - Ozer S AD - Gulhane Military Medical Academy, Ankara, Turkey. ISNI: 0000 0001 0720 6034. GRID: grid.413460.4 FAU - Yamanel, L AU - Yamanel L AD - Gulhane Military Medical Academy, Ankara, Turkey. ISNI: 0000 0001 0720 6034. GRID: grid.413460.4 FAU - Wong, J M AU - Wong JM AD - St Bartholomew's Hospital, London, UK. ISNI: 0000 0000 9244 0345. GRID: grid.416353.6 FAU - Fitton, C AU - Fitton C AD - St Bartholomew's Hospital, London, UK. ISNI: 0000 0000 9244 0345. GRID: grid.416353.6 FAU - Anwar, S AU - Anwar S AD - St Bartholomew's Hospital, London, UK. ISNI: 0000 0000 9244 0345. GRID: grid.416353.6 FAU - Stacey, S AU - Stacey S AD - St Bartholomew's Hospital, London, UK. ISNI: 0000 0000 9244 0345. GRID: grid.416353.6 FAU - Aggou, M AU - Aggou M AD - Aristotle Medical School, Thessaloniki, Greece FAU - Fyntanidou, B AU - Fyntanidou B AD - Aristotle Medical School, Thessaloniki, Greece FAU - Patsatzakis, S AU - Patsatzakis S AD - Aristotle Medical School, Thessaloniki, Greece FAU - Oloktsidou, E AU - Oloktsidou E AD - Aristotle Medical School, Thessaloniki, Greece FAU - Lolakos, K AU - Lolakos K AD - Aristotle Medical School, Thessaloniki, Greece FAU - Papapostolou, E AU - Papapostolou E AD - Aristotle Medical School, Thessaloniki, Greece FAU - Grosomanidis, V AU - Grosomanidis V AD - Aristotle Medical School, Thessaloniki, Greece FAU - Suda, S AU - Suda S AD - Tokyo Medical University Hachiosi Medical Center, Tokyo, Japan. ISNI: 0000 0001 0663 3325. GRID: grid.410793.8 FAU - Ikeda, T AU - Ikeda T AD - Tokyo Medical University Hachiosi Medical Center, Tokyo, Japan. ISNI: 0000 0001 0663 3325. GRID: grid.410793.8 FAU - Ono, S AU - Ono S AD - Tokyo Medical University Hachiosi Medical Center, Tokyo, Japan. ISNI: 0000 0001 0663 3325. GRID: grid.410793.8 FAU - Ueno, T AU - Ueno T AD - Tokyo Medical University Hachiosi Medical Center, Tokyo, Japan. ISNI: 0000 0001 0663 3325. GRID: grid.410793.8 FAU - Izutani, Y AU - Izutani Y AD - Tokyo Medical University Hachiosi Medical Center, Tokyo, Japan. ISNI: 0000 0001 0663 3325. GRID: grid.410793.8 FAU - Gaudry, S AU - Gaudry S AD - Hopital Louis Mourier, Colombes, France. ISNI: 0000 0001 0273 556X. GRID: grid.414205.6 FAU - Desailly, V AU - Desailly V AD - Hopital Louis Mourier, Colombes, France. ISNI: 0000 0001 0273 556X. GRID: grid.414205.6 FAU - Pasquier, P AU - Pasquier P AD - Laboratoire ILUMENS, Paris, France FAU - Brun, PB AU - Brun PB AD - Institut de Hauts de Seine, Nanterre, France FAU - Tesnieres, AT AU - Tesnieres AT AD - Laboratoire ILUMENS, Paris, France FAU - Ricard, JD AU - Ricard JD AD - Hopital Louis Mourier, Colombes, France. ISNI: 0000 0001 0273 556X. GRID: grid.414205.6 FAU - Dreyfuss, D AU - Dreyfuss D AD - Hopital Louis Mourier, Colombes, France. ISNI: 0000 0001 0273 556X. GRID: grid.414205.6 FAU - Mignon, A AU - Mignon A AD - Laboratoire ILUMENS, Paris, France FAU - White, J C AU - White JC AD - University Hospital Lewisham, London, UK. GRID: grid.439787.6 FAU - Molokhia, A AU - Molokhia A AD - University Hospital Lewisham, London, UK. GRID: grid.439787.6 FAU - Dean, A AU - Dean A AD - Queen Elizabeth Hospital, London, UK. GRID: grid.439484.6 FAU - Stilwell, A AU - Stilwell A AD - University Hospital Lewisham, London, UK. GRID: grid.439787.6 FAU - Friedlaender, G AU - Friedlaender G AD - Minet Green Health Practice, London, UK FAU - Peters, M AU - Peters M AD - Department of Public Health, University of Liege, Liege, Belgium. ISNI: 0000 0001 0805 7253. GRID: grid.4861.b FAU - Stipulante, S AU - Stipulante S AD - Department of Public Health, University of Liege, Liege, Belgium. ISNI: 0000 0001 0805 7253. GRID: grid.4861.b FAU - Delfosse, A AU - Delfosse A AD - Department of Emergency Medicine, University Hospital of Liege, Liege, Belgium. ISNI: 0000 0000 8607 6858. GRID: grid.411374.4 FAU - Donneau, AF AU - Donneau AF AD - Department of Medical Biostatistics, University of Liege, Liege, Belgium. ISNI: 0000 0001 0805 7253. GRID: grid.4861.b FAU - Ghuysen, A AU - Ghuysen A AD - Department of Public Health, University of Liege, Liege, Belgium. ISNI: 0000 0001 0805 7253. GRID: grid.4861.b FAU - Feldmann, C AU - Feldmann C AD - University Hospital, Philipps University Marburg, Marburg, Germany. ISNI: 0000 0004 1936 9756. GRID: grid.10253.35 FAU - Freitag, D AU - Freitag D AD - University Hospital, Philipps University Marburg, Marburg, Germany. ISNI: 0000 0004 1936 9756. GRID: grid.10253.35 FAU - Dersch, W AU - Dersch W AD - University Hospital, Philipps University Marburg, Marburg, Germany. ISNI: 0000 0004 1936 9756. GRID: grid.10253.35 FAU - Irqsusi, M AU - Irqsusi M AD - University Hospital, Philipps University Marburg, Marburg, Germany. ISNI: 0000 0004 1936 9756. GRID: grid.10253.35 FAU - Eschbach, D AU - Eschbach D AD - University Hospital, Philipps University Marburg, Marburg, Germany. ISNI: 0000 0004 1936 9756. GRID: grid.10253.35 FAU - Steinfeldt, T AU - Steinfeldt T AD - University Hospital, Philipps University Marburg, Marburg, Germany. ISNI: 0000 0004 1936 9756. GRID: grid.10253.35 FAU - Wulf, H AU - Wulf H AD - University Hospital, Philipps University Marburg, Marburg, Germany. ISNI: 0000 0004 1936 9756. GRID: grid.10253.35 FAU - Wiesmann, T AU - Wiesmann T AD - University Hospital, Philipps University Marburg, Marburg, Germany. ISNI: 0000 0004 1936 9756. GRID: grid.10253.35 FAU - Kongpolprom, N AU - Kongpolprom N AD - Chulalongkorn University, Bangkok, Thailand. ISNI: 0000 0001 0244 7875. GRID: grid.7922.e FAU - Cholkraisuwat, J AU - Cholkraisuwat J AD - Chulalongkorn University, Bangkok, Thailand. ISNI: 0000 0001 0244 7875. GRID: grid.7922.e FAU - Beitland, S AU - Beitland S AD - Oslo University Hospital, Oslo, Norway. ISNI: 0000 0004 0389 8485. GRID: grid.55325.34 FAU - Nakstad, E AU - Nakstad E AD - Oslo University Hospital, Oslo, Norway. ISNI: 0000 0004 0389 8485. GRID: grid.55325.34 FAU - Staer-Jensen, H AU - Staer-Jensen H AD - Oslo University Hospital, Oslo, Norway. ISNI: 0000 0004 0389 8485. GRID: grid.55325.34 FAU - Draegni, T AU - Draegni T AD - Oslo University Hospital, Oslo, Norway. ISNI: 0000 0004 0389 8485. GRID: grid.55325.34 FAU - Andersen, G AU - Andersen G AD - Oslo University Hospital, Oslo, Norway. ISNI: 0000 0004 0389 8485. GRID: grid.55325.34 FAU - Jacobsen, D AU - Jacobsen D AD - Oslo University Hospital, Oslo, Norway. ISNI: 0000 0004 0389 8485. GRID: grid.55325.34 FAU - Brunborg, C AU - Brunborg C AD - Oslo University Hospital, Oslo, Norway. ISNI: 0000 0004 0389 8485. GRID: grid.55325.34 FAU - Waldum-Grevbo, B AU - Waldum-Grevbo B AD - Oslo University Hospital, Oslo, Norway. ISNI: 0000 0004 0389 8485. GRID: grid.55325.34 FAU - Sunde, K AU - Sunde K AD - Oslo University Hospital, Oslo, Norway. ISNI: 0000 0004 0389 8485. GRID: grid.55325.34 FAU - Hoyland, K AU - Hoyland K AD - William Harvey Hospital, Ashford, UK. ISNI: 0000 0004 0398 7998. GRID: grid.417122.3 FAU - Pandit, D AU - Pandit D AD - William Harvey Hospital, Ashford, UK. ISNI: 0000 0004 0398 7998. GRID: grid.417122.3 FAU - Hayakawa, K AU - Hayakawa K AD - Kansai Medical University Takii Hospital, Moriguchi, Japan. GRID: grid.410783.9 FAU - Oloktsidou, E AU - Oloktsidou E AD - Aristotle Medical School, Thessaloniki, Greece FAU - Kotzampassi, K AU - Kotzampassi K AD - Aristotle Medical School, Thessaloniki, Greece FAU - Fyntanidou, B AU - Fyntanidou B AD - Aristotle Medical School, Thessaloniki, Greece FAU - Patsatzakis, S AU - Patsatzakis S AD - Aristotle Medical School, Thessaloniki, Greece FAU - Loukipoudi, L AU - Loukipoudi L AD - Aristotle Medical School, Thessaloniki, Greece FAU - Doumaki, E AU - Doumaki E AD - Aristotle Medical School, Thessaloniki, Greece FAU - Grosomanidis, V AU - Grosomanidis V AD - Aristotle Medical School, Thessaloniki, Greece FAU - Yasuda, H AU - Yasuda H AD - Japanese Red Cross Musashino Hospital, Tokyo, Japan. ISNI: 0000 0004 1762 2623. GRID: grid.410775.0 FAU - Admiraal, M M AU - Admiraal MM AD - Academic Medical Center, Amsterdam, Netherlands. ISNI: 0000000404654431. GRID: grid.5650.6 FAU - Van Assen, M AU - Van Assen M AD - Academic Medical Center, Amsterdam, Netherlands. ISNI: 0000000404654431. GRID: grid.5650.6 FAU - Van Putten, M J AU - Van Putten MJ AD - Medisch Spectrum Twente, Enschede, Netherlands. ISNI: 0000 0004 0399 8347. GRID: grid.415214.7 FAU - Tjepkema-Cloostermans, M AU - Tjepkema-Cloostermans M AD - Medisch Spectrum Twente, Enschede, Netherlands. ISNI: 0000 0004 0399 8347. GRID: grid.415214.7 FAU - Van Rootselaar, A F AU - Van Rootselaar AF AD - Academic Medical Center, Amsterdam, Netherlands. ISNI: 0000000404654431. GRID: grid.5650.6 FAU - Horn, J AU - Horn J AD - Academic Medical Center, Amsterdam, Netherlands. ISNI: 0000000404654431. GRID: grid.5650.6 FAU - Ragusa, F AU - Ragusa F AD - University Modena, Modena, Italy. ISNI: 0000000121697570. GRID: grid.7548.e FAU - Marudi, A AU - Marudi A AD - Nuovo Ospedale Civile Sant'Agostino Estense, Modena, Italy FAU - Baroni, S AU - Baroni S AD - Nuovo Ospedale Civile Sant'Agostino Estense, Modena, Italy FAU - Gaspari, A AU - Gaspari A AD - University Modena, Modena, Italy. ISNI: 0000000121697570. GRID: grid.7548.e FAU - Bertellini, E AU - Bertellini E AD - Nuovo Ospedale Civile Sant'Agostino Estense, Modena, Italy FAU - Taha, A AU - Taha A AD - Faculty of Medicine Alexandria University, Alexandria, Egypt. ISNI: 0000 0001 2260 6941. GRID: grid.7155.6 FAU - Abdullah, T AU - Abdullah T AD - Faculty of Medicine Alexandria University, Alexandria, Egypt. ISNI: 0000 0001 2260 6941. GRID: grid.7155.6 FAU - Abdel Monem, S AU - Abdel Monem S AD - Faculty of Medicine Alexandria University, Alexandria, Egypt. ISNI: 0000 0001 2260 6941. GRID: grid.7155.6 FAU - Alcorn, S AU - Alcorn S AD - Victoria Hospital, Kirkcaldy, UK. ISNI: 0000 0004 0624 9667. GRID: grid.416854.a FAU - McNeill, S AU - McNeill S AD - Victoria Hospital, Kirkcaldy, UK. ISNI: 0000 0004 0624 9667. GRID: grid.416854.a FAU - Russell, S AU - Russell S AD - Victoria Hospital, Kirkcaldy, UK. ISNI: 0000 0004 0624 9667. GRID: grid.416854.a FAU - Eertmans, W AU - Eertmans W AD - Ziekenhuis Oost-Limburg, Genk, Belgium. ISNI: 0000 0004 0612 7379. GRID: grid.470040.7 FAU - Genbrugge, C AU - Genbrugge C AD - Ziekenhuis Oost-Limburg, Genk, Belgium. ISNI: 0000 0004 0612 7379. GRID: grid.470040.7 FAU - Meex, I AU - Meex I AD - Ziekenhuis Oost-Limburg, Genk, Belgium. ISNI: 0000 0004 0612 7379. GRID: grid.470040.7 FAU - Dens, J AU - Dens J AD - Ziekenhuis Oost-Limburg, Genk, Belgium. ISNI: 0000 0004 0612 7379. GRID: grid.470040.7 FAU - Jans, F AU - Jans F AD - Ziekenhuis Oost-Limburg, Genk, Belgium. ISNI: 0000 0004 0612 7379. GRID: grid.470040.7 FAU - De Deyne, C AU - De Deyne C AD - Ziekenhuis Oost-Limburg, Genk, Belgium. ISNI: 0000 0004 0612 7379. GRID: grid.470040.7 FAU - Cholkraisuwat, J AU - Cholkraisuwat J AD - Chulalongkorn University, Bangkok, Thailand. ISNI: 0000 0001 0244 7875. GRID: grid.7922.e FAU - Kongpolprom, N AU - Kongpolprom N AD - Chulalongkorn University, Bangkok, Thailand. ISNI: 0000 0001 0244 7875. GRID: grid.7922.e FAU - Avard, B AU - Avard B AD - The Canberra Hospital, Hughes, ACT Australia. ISNI: 0000 0000 9984 5644. GRID: grid.413314.0 FAU - Burns, R AU - Burns R AD - ANU Medical School, Canberra, Australia. ISNI: 0000 0001 2180 7477. GRID: grid.1001.0 FAU - Patarchi, A AU - Patarchi A AD - "Spirito Santo" Hospital, Pescara, Italy. GRID: grid.416240.5 FAU - Spina, T AU - Spina T AD - "Spirito Santo" Hospital, Pescara, Italy. GRID: grid.416240.5 FAU - Tanaka, H AU - Tanaka H AD - St Lukes International Hospital, Akashi-Chou Chuo-Ku, Japan. GRID: grid.430395.8 FAU - Otani, N AU - Otani N AD - St Lukes International Hospital, Akashi-Chou Chuo-Ku, Japan. GRID: grid.430395.8 FAU - Ode, S AU - Ode S AD - St Lukes International Hospital, Akashi-Chou Chuo-Ku, Japan. GRID: grid.430395.8 FAU - Ishimatsu, S AU - Ishimatsu S AD - St Lukes International Hospital, Akashi-Chou Chuo-Ku, Japan. GRID: grid.430395.8 FAU - Cho, J AU - Cho J AD - Kangwon National University, Chuncheonsi, South Korea. ISNI: 0000 0001 0707 9039. GRID: grid.412010.6 FAU - Moon, J B AU - Moon JB AD - Kangwon National University, Chuncheonsi, South Korea. ISNI: 0000 0001 0707 9039. GRID: grid.412010.6 FAU - Park, C W AU - Park CW AD - Kangwon National University, Chuncheonsi, South Korea. ISNI: 0000 0001 0707 9039. GRID: grid.412010.6 FAU - Ohk, T G AU - Ohk TG AD - Kangwon National University, Chuncheonsi, South Korea. ISNI: 0000 0001 0707 9039. GRID: grid.412010.6 FAU - Shin, M C AU - Shin MC AD - Kangwon National University, Chuncheonsi, South Korea. ISNI: 0000 0001 0707 9039. GRID: grid.412010.6 FAU - Won, M H AU - Won MH AD - Kangwon National University, Chuncheonsi, South Korea. ISNI: 0000 0001 0707 9039. GRID: grid.412010.6 FAU - Dakova, S AU - Dakova S AD - Military Medical Academy, Sofia, Bulgaria. ISNI: 0000 0004 0621 0228. GRID: grid.413126.3 FAU - Ramsheva, Z AU - Ramsheva Z AD - Military Medical Academy, Sofia, Bulgaria. ISNI: 0000 0004 0621 0228. GRID: grid.413126.3 FAU - Ramshev, K AU - Ramshev K AD - Military Medical Academy, Sofia, Bulgaria. ISNI: 0000 0004 0621 0228. GRID: grid.413126.3 FAU - Cho, J AU - Cho J AD - Kangwon National University, Chuncheonsi, South Korea. ISNI: 0000 0001 0707 9039. GRID: grid.412010.6 FAU - Moon, J B AU - Moon JB AD - Kangwon National University, Chuncheonsi, South Korea. ISNI: 0000 0001 0707 9039. GRID: grid.412010.6 FAU - Park, C W AU - Park CW AD - Kangwon National University, Chuncheonsi, South Korea. ISNI: 0000 0001 0707 9039. GRID: grid.412010.6 FAU - Ohk, T G AU - Ohk TG AD - Kangwon National University, Chuncheonsi, South Korea. ISNI: 0000 0001 0707 9039. GRID: grid.412010.6 FAU - Shin, M C AU - Shin MC AD - Kangwon National University, Chuncheonsi, South Korea. ISNI: 0000 0001 0707 9039. GRID: grid.412010.6 FAU - Cho, J AU - Cho J AD - Kangwon National University, Chuncheonsi, South Korea. ISNI: 0000 0001 0707 9039. GRID: grid.412010.6 FAU - Moon, J B AU - Moon JB AD - Kangwon National University, Chuncheonsi, South Korea. ISNI: 0000 0001 0707 9039. GRID: grid.412010.6 FAU - Park, C W AU - Park CW AD - Kangwon National University, Chuncheonsi, South Korea. ISNI: 0000 0001 0707 9039. GRID: grid.412010.6 FAU - Ohk, T G AU - Ohk TG AD - Kangwon National University, Chuncheonsi, South Korea. ISNI: 0000 0001 0707 9039. GRID: grid.412010.6 FAU - Shin, M C AU - Shin MC AD - Kangwon National University, Chuncheonsi, South Korea. ISNI: 0000 0001 0707 9039. GRID: grid.412010.6 FAU - Marudi, A AU - Marudi A AD - Nuovo Ospedale Civile Sant'Agostino Estense, Modena, Italy FAU - Baroni, S AU - Baroni S AD - Nuovo Ospedale Civile Sant'Agostino Estense, Modena, Italy FAU - Gaspari, A AU - Gaspari A AD - University Modena, Modena, Italy. ISNI: 0000000121697570. GRID: grid.7548.e FAU - Bertellini, E AU - Bertellini E AD - Nuovo Ospedale Civile Sant'Agostino Estense, Modena, Italy FAU - Orhun, G AU - Orhun G AD - Istanbul University, Medical Faculty of Istanbul, Anesthesiology and Intensive Care, Istanbul, Turkey FAU - Senturk, E AU - Senturk E AD - Istanbul University, Medical Faculty of Istanbul, Anesthesiology and Intensive Care, Istanbul, Turkey FAU - Ozcan, P E AU - Ozcan PE AD - Istanbul University, Medical Faculty of Istanbul, Anesthesiology and Intensive Care, Istanbul, Turkey FAU - Sencer, S AU - Sencer S AD - Istanbul University, Medical Faculty of Istanbul, Department of Neuroradiology, Istanbul, Turkey. ISNI: 0000 0001 2166 6619. GRID: grid.9601.e FAU - Ulusoy, C AU - Ulusoy C AD - Istanbul University, Institute of Experimental Medicine, Neuroscience, Istanbul, Turkey. ISNI: 0000 0001 2166 6619. GRID: grid.9601.e FAU - Tuzun, E AU - Tuzun E AD - Istanbul University, Institute of Experimental Medicine, Neuroscience, Istanbul, Turkey. ISNI: 0000 0001 2166 6619. GRID: grid.9601.e FAU - Esen, F AU - Esen F AD - Istanbul University, Medical Faculty of Istanbul, Anesthesiology and Intensive Care, Istanbul, Turkey FAU - Tincu, R AU - Tincu R AD - Bucharest Clinical Emergency Hospital, Bucharest, Romania FAU - Cobilinschi, C AU - Cobilinschi C AD - Bucharest Clinical Emergency Hospital, Bucharest, Romania FAU - Tomescu, D AU - Tomescu D AD - Fundeni Clinical Institute, Bucharest, Romania. ISNI: 0000 0004 0540 9980. GRID: grid.415180.9 FAU - Ghiorghiu, Z AU - Ghiorghiu Z AD - Bucharest Clinical Emergency Hospital, Bucharest, Romania FAU - Macovei, R AU - Macovei R AD - Bucharest Clinical Emergency Hospital, Bucharest, Romania FAU - Van Assen, M AU - Van Assen M AD - Academic Medical Center, Amsterdam, Netherlands. ISNI: 0000000404654431. GRID: grid.5650.6 FAU - Admiraal, M M AU - Admiraal MM AD - Academic Medical Center, Amsterdam, Netherlands. ISNI: 0000000404654431. GRID: grid.5650.6 FAU - Van Putten, M J AU - Van Putten MJ AD - Medisch Spectrum Twente, Enschede, Netherlands. ISNI: 0000 0004 0399 8347. GRID: grid.415214.7 FAU - Tjepkema-Cloostermans, M AU - Tjepkema-Cloostermans M AD - Medisch Spectrum Twente, Enschede, Netherlands. ISNI: 0000 0004 0399 8347. GRID: grid.415214.7 FAU - Van Rootselaar, A F AU - Van Rootselaar AF AD - Academic Medical Center, Amsterdam, Netherlands. ISNI: 0000000404654431. GRID: grid.5650.6 FAU - Horn, J AU - Horn J AD - Academic Medical Center, Amsterdam, Netherlands. ISNI: 0000000404654431. GRID: grid.5650.6 FAU - Fallenius, M AU - Fallenius M AD - Helsinki University Hospital, Helsinki, Finland. ISNI: 0000 0000 9950 5666. GRID: grid.15485.3d FAU - Skrifvars, M B AU - Skrifvars MB AD - Helsinki University Hospital, Helsinki, Finland. ISNI: 0000 0000 9950 5666. GRID: grid.15485.3d FAU - Reinikainen, M AU - Reinikainen M AD - North Karelia Central Hospital, Joensuu, Finland. ISNI: 0000 0004 0368 0478. GRID: grid.416446.5 FAU - Bendel, S AU - Bendel S AD - Kuopio University Hospital, Kuopio, Finland. ISNI: 0000 0004 0628 207X. GRID: grid.410705.7 FAU - Raj, R AU - Raj R AD - Helsinki University Hospital, Helsinki, Finland. ISNI: 0000 0000 9950 5666. GRID: grid.15485.3d FAU - Abu-Habsa, M AU - Abu-Habsa M AD - King's College Hospital, London, UK. ISNI: 0000 0004 0391 9020. GRID: grid.46699.34 FAU - Hymers, C AU - Hymers C AD - King's College Hospital, London, UK. ISNI: 0000 0004 0391 9020. GRID: grid.46699.34 FAU - Borowska, A AU - Borowska A AD - King's College Hospital, London, UK. ISNI: 0000 0004 0391 9020. GRID: grid.46699.34 FAU - Sivadhas, H AU - Sivadhas H AD - King's College Hospital, London, UK. ISNI: 0000 0004 0391 9020. GRID: grid.46699.34 FAU - Sahiba, S AU - Sahiba S AD - King's College Hospital, London, UK. ISNI: 0000 0004 0391 9020. GRID: grid.46699.34 FAU - Perkins, S AU - Perkins S AD - King's College Hospital, London, UK. ISNI: 0000 0004 0391 9020. GRID: grid.46699.34 FAU - Rubio, J AU - Rubio J AD - Hospital Universitario Puerta del Mar, Cadiz, Spain. ISNI: 0000 0004 1771 1175. GRID: grid.411342.1 FAU - Rubio, J A AU - Rubio JA AD - Hospital Infanta Cristina, Badajoz, Spain. ISNI: 0000 0004 1771 0842. GRID: grid.411319.f FAU - Sierra, R AU - Sierra R AD - Hospital Universitario Puerta del Mar, Cadiz, Spain. ISNI: 0000 0004 1771 1175. GRID: grid.411342.1 FAU - English, S AU - English S AD - The Ottawa Hospital, Ottawa, Canada. ISNI: 0000 0000 9606 5108. GRID: grid.412687.e FAU - Chasse, M AU - Chasse M AD - Ulaval, Quebec City, Canada FAU - Turgeon, A AU - Turgeon A AD - Ulaval, Quebec City, Canada FAU - Lauzier, F AU - Lauzier F AD - Ulaval, Quebec City, Canada FAU - Griesdale, D AU - Griesdale D AD - UBC, Vancouver, Canada. ISNI: 0000 0001 2288 9830. GRID: grid.17091.3e FAU - Garland, A AU - Garland A AD - UManitoba, Winnipeg, Canada FAU - Fergusson, D AU - Fergusson D AD - OHRI, Ottawa, Canada FAU - Zarychanski, R AU - Zarychanski R AD - UBC, Vancouver, Canada. ISNI: 0000 0001 2288 9830. GRID: grid.17091.3e FAU - Tinmouth, A AU - Tinmouth A AD - OHRI, Ottawa, Canada FAU - Van Walraven, C AU - Van Walraven C AD - OHRI, Ottawa, Canada FAU - Montroy, K AU - Montroy K AD - OHRI, Ottawa, Canada FAU - Ziegler, J AU - Ziegler J AD - UManitoba, Winnipeg, Canada FAU - Dupont Chouinard, R AU - Dupont Chouinard R AD - Ulaval, Quebec City, Canada FAU - Carignan, R AU - Carignan R AD - Ulaval, Quebec City, Canada FAU - Dhaliwal, A AU - Dhaliwal A AD - UBC, Vancouver, Canada. ISNI: 0000 0001 2288 9830. GRID: grid.17091.3e FAU - Lum, C AU - Lum C AD - OHRI, Ottawa, Canada FAU - Sinclair, J AU - Sinclair J AD - OHRI, Ottawa, Canada FAU - Pagliarello, G AU - Pagliarello G AD - OHRI, Ottawa, Canada FAU - McIntyre, L AU - McIntyre L AD - OHRI, Ottawa, Canada FAU - English, S AU - English S AD - The Ottawa Hospital, Ottawa, Canada. ISNI: 0000 0000 9606 5108. GRID: grid.412687.e FAU - Chasse, M AU - Chasse M AD - Ulaval, Quebec City, Canada FAU - Turgeon, A AU - Turgeon A AD - Ulaval, Quebec City, Canada FAU - Lauzier, F AU - Lauzier F AD - Ulaval, Quebec City, Canada FAU - Griesdale, D AU - Griesdale D AD - UBC, Vancouver, Canada. ISNI: 0000 0001 2288 9830. GRID: grid.17091.3e FAU - Garland, A AU - Garland A AD - UManitoba, Winnipeg, Canada FAU - Fergusson, D AU - Fergusson D AD - Ottawa Hospital Research Institute, Ottawa, Canada. ISNI: 0000 0000 9606 5108. GRID: grid.412687.e FAU - Zarychanski, R AU - Zarychanski R AD - UManitoba, Winnipeg, Canada FAU - Tinmouth, A AU - Tinmouth A AD - Ottawa Hospital Research Institute, Ottawa, Canada. ISNI: 0000 0000 9606 5108. GRID: grid.412687.e FAU - Van Walraven, C AU - Van Walraven C AD - Ottawa Hospital Research Institute, Ottawa, Canada. ISNI: 0000 0000 9606 5108. GRID: grid.412687.e FAU - Montroy, K AU - Montroy K AD - Ottawa Hospital Research Institute, Ottawa, Canada. ISNI: 0000 0000 9606 5108. GRID: grid.412687.e FAU - Ziegler, J AU - Ziegler J AD - UManitoba, Winnipeg, Canada FAU - Dupont Chouinard, R AU - Dupont Chouinard R AD - Ulaval, Quebec City, Canada FAU - Carignan, R AU - Carignan R AD - Ulaval, Quebec City, Canada FAU - Dhaliwal, A AU - Dhaliwal A AD - UBC, Vancouver, Canada. ISNI: 0000 0001 2288 9830. GRID: grid.17091.3e FAU - Lum, C AU - Lum C AD - Ottawa Hospital Research Institute, Ottawa, Canada. ISNI: 0000 0000 9606 5108. GRID: grid.412687.e FAU - Sinclair, J AU - Sinclair J AD - Ottawa Hospital Research Institute, Ottawa, Canada. ISNI: 0000 0000 9606 5108. GRID: grid.412687.e FAU - Pagliarello, G AU - Pagliarello G AD - Ottawa Hospital Research Institute, Ottawa, Canada. ISNI: 0000 0000 9606 5108. GRID: grid.412687.e FAU - McIntyre, L AU - McIntyre L AD - Ottawa Hospital Research Institute, Ottawa, Canada. ISNI: 0000 0000 9606 5108. GRID: grid.412687.e FAU - Groza, T AU - Groza T AD - Cliniques St Luc, Universite catholique de Louvain, Brussels, Belgium. ISNI: 0000 0001 2294 713X. GRID: grid.7942.8 FAU - Moreau, N AU - Moreau N AD - Cliniques St Luc, Universite catholique de Louvain, Brussels, Belgium. ISNI: 0000 0001 2294 713X. GRID: grid.7942.8 FAU - Castanares-Zapatero, D AU - Castanares-Zapatero D AD - Cliniques St Luc, Universite catholique de Louvain, Brussels, Belgium. ISNI: 0000 0001 2294 713X. GRID: grid.7942.8 FAU - Hantson, P AU - Hantson P AD - Cliniques St Luc, Universite catholique de Louvain, Brussels, Belgium. ISNI: 0000 0001 2294 713X. GRID: grid.7942.8 FAU - Carbonara, M AU - Carbonara M AD - Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. ISNI: 0000 0004 1757 8749. GRID: grid.414818.0 FAU - Ortolano, F AU - Ortolano F AD - Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. ISNI: 0000 0004 1757 8749. GRID: grid.414818.0 FAU - Zoerle, T AU - Zoerle T AD - Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. ISNI: 0000 0004 1757 8749. GRID: grid.414818.0 FAU - Magnoni, S AU - Magnoni S AD - Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. ISNI: 0000 0004 1757 8749. GRID: grid.414818.0 FAU - Pifferi, S AU - Pifferi S AD - Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. ISNI: 0000 0004 1757 8749. GRID: grid.414818.0 FAU - Conte, V AU - Conte V AD - Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. ISNI: 0000 0004 1757 8749. GRID: grid.414818.0 FAU - Stocchetti, N AU - Stocchetti N AD - Milan University, Milan, Italy. ISNI: 0000 0004 1757 2822. GRID: grid.4708.b FAU - Carteron, L AU - Carteron L AD - CHUV, Lausanne, Switzerland. ISNI: 0000 0001 0423 4662. GRID: grid.8515.9 FAU - Suys, T AU - Suys T AD - CHUV, Lausanne, Switzerland. ISNI: 0000 0001 0423 4662. GRID: grid.8515.9 FAU - Patet, C AU - Patet C AD - CHUV, Lausanne, Switzerland. ISNI: 0000 0001 0423 4662. GRID: grid.8515.9 FAU - Quintard, H AU - Quintard H AD - CHU de Nice, Nice, France. ISNI: 0000 0001 2322 4179. GRID: grid.410528.a FAU - Oddo, M AU - Oddo M AD - CHUV, Lausanne, Switzerland. ISNI: 0000 0001 0423 4662. GRID: grid.8515.9 FAU - Rubio, J A AU - Rubio JA AD - Hospital Infanta Cristina, Badajoz, Spain. ISNI: 0000 0004 1771 0842. GRID: grid.411319.f FAU - Rubio, J AU - Rubio J AD - Hospital Universitario Puerta del Mar, Cadiz, Spain. ISNI: 0000 0004 1771 1175. GRID: grid.411342.1 FAU - Sierra, R AU - Sierra R AD - Hospital Universitario Puerta del Mar, Cadiz, Spain. ISNI: 0000 0004 1771 1175. GRID: grid.411342.1 FAU - Spatenkova, V AU - Spatenkova V AD - Regional Hospital, Liberec, Czech Republic. ISNI: 0000 0004 0609 0449. GRID: grid.447961.9 FAU - Pokorna, E AU - Pokorna E AD - Institute of Experimental Medicine, Prague, Czech Republic. ISNI: 0000 0004 0404 6946. GRID: grid.424967.a FAU - Suchomel, P AU - Suchomel P AD - Regional Hospital, Liberec, Czech Republic. ISNI: 0000 0004 0609 0449. GRID: grid.447961.9 FAU - Ebert, N AU - Ebert N AD - Hennepin County Medical Center, Minneapolis, USA. ISNI: 0000 0000 9206 4546. GRID: grid.414021.2 FAU - Jancik, J AU - Jancik J AD - Hennepin County Medical Center, Minneapolis, USA. ISNI: 0000 0000 9206 4546. GRID: grid.414021.2 FAU - Rhodes, H AU - Rhodes H AD - Hennepin County Medical Center, Minneapolis, USA. ISNI: 0000 0000 9206 4546. GRID: grid.414021.2 FAU - Bylinski, T AU - Bylinski T AD - University of Glasgow, Glasgow, UK. ISNI: 0000 0001 2193 314X. GRID: grid.8756.c FAU - Hawthorne, C AU - Hawthorne C AD - Institute of Neurological Sciences, NHSGGC, Glasgow, UK. ISNI: 0000 0001 0523 9342. GRID: grid.413301.4 FAU - Shaw, M AU - Shaw M AD - Department of Clinical Physics and Bioengineering, NHSGGC, Glasgow, UK. ISNI: 0000 0001 0523 9342. GRID: grid.413301.4 FAU - Piper, I AU - Piper I AD - Department of Clinical Physics and Bioengineering, NHSGGC, Glasgow, UK. ISNI: 0000 0001 0523 9342. GRID: grid.413301.4 FAU - Kinsella, J AU - Kinsella J AD - Academic Unit of Anaesthesia, Pain and Critical Care Medicine, University of Glasgow, Glasgow, UK. ISNI: 0000 0001 2193 314X. GRID: grid.8756.c FAU - Kink, A K AU - Kink AK AD - Smartimplant Ltd., Tallinn, Estonia FAU - Ratsep, I R AU - Ratsep IR AD - NEMC, Tallinn, Estonia. ISNI: 0000 0004 0631 377X. GRID: grid.454953.a FAU - Boutin, A AU - Boutin A AD - Universite Laval, Quebec, Canada. ISNI: 0000 0004 1936 8390. GRID: grid.23856.3a FAU - Moore, L AU - Moore L AD - Universite Laval, Quebec, Canada. ISNI: 0000 0004 1936 8390. GRID: grid.23856.3a FAU - Chasse, M AU - Chasse M AD - Universite Laval, Quebec, Canada. ISNI: 0000 0004 1936 8390. GRID: grid.23856.3a FAU - Zarychanski, R AU - Zarychanski R AD - University of Manitoba, Winnipeg, Canada. ISNI: 0000 0004 1936 9609. GRID: grid.21613.37 FAU - Lauzier, F AU - Lauzier F AD - Universite Laval, Quebec, Canada. ISNI: 0000 0004 1936 8390. GRID: grid.23856.3a FAU - English, S AU - English S AD - Ottawa Hospital Research Institute, Ottawa, Canada. ISNI: 0000 0000 9606 5108. GRID: grid.412687.e FAU - McIntyre, L AU - McIntyre L AD - Ottawa Hospital Research Institute, Ottawa, Canada. ISNI: 0000 0000 9606 5108. GRID: grid.412687.e FAU - Lacroix, J AU - Lacroix J AD - Universite de Montreal, Montreal, Canada. ISNI: 0000 0001 2292 3357. GRID: grid.14848.31 FAU - Griesdale, D AU - Griesdale D AD - University of British Columbia, Vancouver, Canada. ISNI: 0000 0001 2288 9830. GRID: grid.17091.3e FAU - Lessard-Bonaventure, P AU - Lessard-Bonaventure P AD - Universite Laval, Quebec, Canada. ISNI: 0000 0004 1936 8390. GRID: grid.23856.3a FAU - Turgeon, A F AU - Turgeon AF AD - Universite Laval, Quebec, Canada. ISNI: 0000 0004 1936 8390. GRID: grid.23856.3a FAU - Boutin, A AU - Boutin A AD - Universite Laval, Quebec, Canada. ISNI: 0000 0004 1936 8390. GRID: grid.23856.3a FAU - Moore, L AU - Moore L AD - Universite Laval, Quebec, Canada. ISNI: 0000 0004 1936 8390. GRID: grid.23856.3a FAU - Green, R AU - Green R AD - Dalhousie University, Halifax, Canada. ISNI: 0000 0004 1936 8200. GRID: grid.55602.34 FAU - Lessard-Bonaventure, P AU - Lessard-Bonaventure P AD - Universite Laval, Quebec, Canada. ISNI: 0000 0004 1936 8390. GRID: grid.23856.3a FAU - Erdogan, M AU - Erdogan M AD - Dalhousie University, Halifax, Canada. ISNI: 0000 0004 1936 8200. GRID: grid.55602.34 FAU - Butler, M AU - Butler M AD - Dalhousie University, Halifax, Canada. ISNI: 0000 0004 1936 8200. GRID: grid.55602.34 FAU - Lauzier, F AU - Lauzier F AD - Universite Laval, Quebec, Canada. ISNI: 0000 0004 1936 8390. GRID: grid.23856.3a FAU - Chasse, M AU - Chasse M AD - Universite Laval, Quebec, Canada. ISNI: 0000 0004 1936 8390. GRID: grid.23856.3a FAU - English, S AU - English S AD - Ottawa Hospital Research Institute, Ottawa, Canada. ISNI: 0000 0000 9606 5108. GRID: grid.412687.e FAU - McIntyre, L AU - McIntyre L AD - Ottawa Hospital Research Institute, Ottawa, Canada. ISNI: 0000 0000 9606 5108. GRID: grid.412687.e FAU - Zarychanski, R AU - Zarychanski R AD - University of Manitoba, Winnipeg, Canada. ISNI: 0000 0004 1936 9609. GRID: grid.21613.37 FAU - Lacroix, J AU - Lacroix J AD - Universite de Montreal, Montreal, Canada. ISNI: 0000 0001 2292 3357. GRID: grid.14848.31 FAU - Griesdale, D AU - Griesdale D AD - University of British Columbia, Vancouver, Canada. ISNI: 0000 0001 2288 9830. GRID: grid.17091.3e FAU - Desjardins, P AU - Desjardins P AD - Universite Laval, Quebec, Canada. ISNI: 0000 0004 1936 8390. GRID: grid.23856.3a FAU - Fergusson, D A AU - Fergusson DA AD - Ottawa Hospital Research Institute, Ottawa, Canada. ISNI: 0000 0000 9606 5108. GRID: grid.412687.e FAU - Turgeon, A F AU - Turgeon AF AD - Universite Laval, Quebec, Canada. ISNI: 0000 0004 1936 8390. GRID: grid.23856.3a FAU - Goncalves, B AU - Goncalves B AD - Hospital Estadual Getulio Vargas, Rio de Janeiro, Brazil FAU - Vidal, B AU - Vidal B AD - Hospital Estadual Getulio Vargas, Rio de Janeiro, Brazil FAU - Valdez, C AU - Valdez C AD - Hospital Estadual Getulio Vargas, Rio de Janeiro, Brazil FAU - Rodrigues, A C AU - Rodrigues AC AD - Hospital Estadual Getulio Vargas, Rio de Janeiro, Brazil FAU - Miguez, L AU - Miguez L AD - Hospital Estadual Getulio Vargas, Rio de Janeiro, Brazil FAU - Moralez, G AU - Moralez G AD - Hospital Estadual Getulio Vargas, Rio de Janeiro, Brazil FAU - Hong, T AU - Hong T AD - Yonsei University College of Medicine, Seoul, South Korea. ISNI: 0000 0004 0470 5454. GRID: grid.15444.30 FAU - Kutz, A AU - Kutz A AD - Kantonsspital Aarau, Aarau, Switzerland. ISNI: 0000 0000 8704 3732. GRID: grid.413357.7 FAU - Hausfater, P AU - Hausfater P AD - Emergency Department, Groupe Hospitalier Pitie-Salpetriere, Paris, France. ISNI: 0000 0001 2150 9058. GRID: grid.411439.a FAU - Amin, D AU - Amin D AD - Morton Plant Hospital, Clearwater, USA. ISNI: 0000 0000 8602 0133. GRID: grid.416123.3 FAU - Struja, T AU - Struja T AD - Kantonsspital Aarau, Aarau, Switzerland. ISNI: 0000 0000 8704 3732. GRID: grid.413357.7 FAU - Haubitz, S AU - Haubitz S AD - Kantonsspital Aarau, Aarau, Switzerland. ISNI: 0000 0000 8704 3732. GRID: grid.413357.7 FAU - Huber, A AU - Huber A AD - Department of Laboratory Medicine, Kantonsspital Aarau, Aarau, Switzerland. ISNI: 0000 0000 8704 3732. GRID: grid.413357.7 FAU - Mueller, B AU - Mueller B AD - Kantonsspital Aarau, Aarau, Switzerland. ISNI: 0000 0000 8704 3732. GRID: grid.413357.7 FAU - Schuetz, P AU - Schuetz P AD - Kantonsspital Aarau, Aarau, Switzerland. ISNI: 0000 0000 8704 3732. GRID: grid.413357.7 FAU - Brown, T AU - Brown T AD - Royal Cornwall Hospital Trust, Truro, UK. ISNI: 0000 0004 0474 4488. GRID: grid.412944.e FAU - Collinson, J AU - Collinson J AD - Royal Cornwall Hospital Trust, Truro, UK. ISNI: 0000 0004 0474 4488. GRID: grid.412944.e FAU - Pritchett, C AU - Pritchett C AD - Royal Cornwall Hospital Trust, Truro, UK. ISNI: 0000 0004 0474 4488. GRID: grid.412944.e FAU - Slade, T AU - Slade T AD - Royal Cornwall Hospital Trust, Truro, UK. ISNI: 0000 0004 0474 4488. GRID: grid.412944.e FAU - Le Guen, M AU - Le Guen M AD - Manchester Royal Infirmary, Manchester, UK. ISNI: 0000 0004 0641 2823. GRID: grid.419319.7 FAU - Hellings, S AU - Hellings S AD - Manchester Royal Infirmary, Manchester, UK. ISNI: 0000 0004 0641 2823. GRID: grid.419319.7 FAU - Ramsaran, R AU - Ramsaran R AD - Manchester Royal Infirmary, Manchester, UK. ISNI: 0000 0004 0641 2823. GRID: grid.419319.7 FAU - Alsheikhly, A AU - Alsheikhly A AD - Hamad Medical Corporation, Doha, Qatar. ISNI: 0000 0004 0571 546X. GRID: grid.413548.f FAU - Abe, T AU - Abe T AD - University of Tsukuba, Tsukuba Medical Center Hospital, Tsukuba, Japan. ISNI: 0000 0004 1764 0856. GRID: grid.417324.7 FAU - Kanapeckaite, L AU - Kanapeckaite L AD - King's College Hospital, London, UK. ISNI: 0000 0004 0391 9020. GRID: grid.46699.34 FAU - Abu-Habsa, M AU - Abu-Habsa M AD - King's College Hospital, London, UK. ISNI: 0000 0004 0391 9020. GRID: grid.46699.34 FAU - Bahl, R AU - Bahl R AD - King's College Hospital, London, UK. ISNI: 0000 0004 0391 9020. GRID: grid.46699.34 FAU - Russell, M Q AU - Russell MQ AD - Kent, Surrey & Sussex Air Ambulance Trust, Kent, UK FAU - Real, K J AU - Real KJ AD - Prometheus Delta-Tech, Herefordshire, UK FAU - Abu-Habsa, M AU - Abu-Habsa M AD - King's College Hospital, London, UK. ISNI: 0000 0004 0391 9020. GRID: grid.46699.34 FAU - Lyon, R M AU - Lyon RM AD - Kent, Surrey & Sussex Air Ambulance Trust, Kent, UK FAU - Oveland, N P AU - Oveland NP AD - Stavanger University Hospital, Stavanger, Norway. ISNI: 0000 0004 0627 2891. GRID: grid.412835.9 FAU - Penketh, J AU - Penketh J AD - Royal United Hospital, Bath, UK. ISNI: 0000 0004 0417 0728. GRID: grid.416091.b FAU - Mcdonald, M AU - Mcdonald M AD - Royal United Hospital, Bath, UK. ISNI: 0000 0004 0417 0728. GRID: grid.416091.b FAU - Kelly, F AU - Kelly F AD - Royal United Hospital, Bath, UK. ISNI: 0000 0004 0417 0728. GRID: grid.416091.b FAU - Alfafi, M AU - Alfafi M AD - Aseer Central Hospital, Abha, Saudi Arabia. ISNI: 0000 0004 0607 7156. GRID: grid.413974.c FAU - Alsolamy, S AU - Alsolamy S AD - King Saud bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research Center, Riyadh, Saudi Arabia. ISNI: 0000 0004 0608 0662. GRID: grid.412149.b FAU - Almutairi, W AU - Almutairi W AD - King Saud bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research Center, Riyadh, Saudi Arabia. ISNI: 0000 0004 0608 0662. GRID: grid.412149.b FAU - Alotaibi, B AU - Alotaibi B AD - King Fahad Medical City, Riyadh, Saudi Arabia. ISNI: 0000 0004 0593 1832. GRID: grid.415277.2 FAU - Van den Berg, A E AU - Van den Berg AE AD - HagaZiekenhuis, Den Haag, Netherlands. ISNI: 0000 0004 0568 6689. GRID: grid.413591.b FAU - Schriel, Y AU - Schriel Y AD - Reinier de Graaf Gasthuis, Delft, Netherlands. ISNI: 0000 0004 0624 5690. GRID: grid.415868.6 FAU - Dawson, L AU - Dawson L AD - Reinier de Graaf Gasthuis, Delft, Netherlands. ISNI: 0000 0004 0624 5690. GRID: grid.415868.6 FAU - Meynaar, I A AU - Meynaar IA AD - HagaZiekenhuis, Den Haag, Netherlands. ISNI: 0000 0004 0568 6689. GRID: grid.413591.b FAU - Talaie, H AU - Talaie H AD - Toxicological Research Center, Department of Clinical Toxicology, Loghman-Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. GRID: grid.411600.2 FAU - Silva, D AU - Silva D AD - Santa Maria University Hospital, Lisboa, Portugal. ISNI: 0000 0001 2295 9747. GRID: grid.411265.5 FAU - Fernandes, S AU - Fernandes S AD - Santa Maria University Hospital, Lisboa, Portugal. ISNI: 0000 0001 2295 9747. GRID: grid.411265.5 FAU - Gouveia, J AU - Gouveia J AD - Santa Maria University Hospital, Lisboa, Portugal. ISNI: 0000 0001 2295 9747. GRID: grid.411265.5 FAU - Santos Silva, J AU - Santos Silva J AD - Santa Maria University Hospital, Lisboa, Portugal. ISNI: 0000 0001 2295 9747. GRID: grid.411265.5 FAU - Foley, J AU - Foley J AD - St. Vincent's University Hospital, Dublin 4, Ireland. ISNI: 0000 0001 0315 8143. GRID: grid.412751.4 FAU - Kaskovagheorgescu, A AU - Kaskovagheorgescu A AD - St. Vincent's University Hospital, Dublin 4, Ireland. ISNI: 0000 0001 0315 8143. GRID: grid.412751.4 FAU - Evoy, D AU - Evoy D AD - St. Vincent's University Hospital, Dublin 4, Ireland. ISNI: 0000 0001 0315 8143. GRID: grid.412751.4 FAU - Cronin, J AU - Cronin J AD - St. Vincent's University Hospital, Dublin 4, Ireland. ISNI: 0000 0001 0315 8143. GRID: grid.412751.4 FAU - Ryan, J AU - Ryan J AD - St. Vincent's University Hospital, Dublin 4, Ireland. ISNI: 0000 0001 0315 8143. GRID: grid.412751.4 FAU - Huck, M AU - Huck M AD - Percy Military Teaching Hospital, Clamart, France FAU - Hoffmann, C AU - Hoffmann C AD - Percy Military Teaching Hospital, Clamart, France FAU - Renner, J AU - Renner J AD - Percy Military Teaching Hospital, Clamart, France FAU - Laitselart, P AU - Laitselart P AD - Percy Military Teaching Hospital, Clamart, France FAU - Donat, N AU - Donat N AD - Percy Military Teaching Hospital, Clamart, France FAU - Cirodde, A AU - Cirodde A AD - Percy Military Teaching Hospital, Clamart, France FAU - Schaal, J V AU - Schaal JV AD - Percy Military Teaching Hospital, Clamart, France FAU - Masson, Y AU - Masson Y AD - Percy Military Teaching Hospital, Clamart, France FAU - Nau, A AU - Nau A AD - Percy Military Teaching Hospital, Clamart, France FAU - Leclerc, T AU - Leclerc T AD - Percy Military Teaching Hospital, Clamart, France FAU - Howarth, O AU - Howarth O AD - Whiston Hospital, Prescot, UK. ISNI: 0000 0004 0417 1894. GRID: grid.417083.9 FAU - Davenport, K AU - Davenport K AD - Whiston Hospital, Prescot, UK. ISNI: 0000 0004 0417 1894. GRID: grid.417083.9 FAU - Jeanrenaud, P AU - Jeanrenaud P AD - Whiston Hospital, Prescot, UK. ISNI: 0000 0004 0417 1894. GRID: grid.417083.9 FAU - Raftery, S AU - Raftery S AD - Whiston Hospital, Prescot, UK. ISNI: 0000 0004 0417 1894. GRID: grid.417083.9 FAU - MacTavish, P AU - MacTavish P AD - Glasgow Royal Infirmary, Glasgow, UK. ISNI: 0000 0000 9825 7840. GRID: grid.411714.6 FAU - Devine, H AU - Devine H AD - Glasgow Royal Infirmary, Glasgow, UK. ISNI: 0000 0000 9825 7840. GRID: grid.411714.6 FAU - McPeake, J AU - McPeake J AD - Glasgow Royal Infirmary, Glasgow, UK. ISNI: 0000 0000 9825 7840. GRID: grid.411714.6 FAU - Daniel, M AU - Daniel M AD - Glasgow Royal Infirmary, Glasgow, UK. ISNI: 0000 0000 9825 7840. GRID: grid.411714.6 FAU - Kinsella, J AU - Kinsella J AD - Glasgow Royal Infirmary, Glasgow, UK. ISNI: 0000 0000 9825 7840. GRID: grid.411714.6 FAU - Quasim, T AU - Quasim T AD - Glasgow Royal Infirmary, Glasgow, UK. ISNI: 0000 0000 9825 7840. GRID: grid.411714.6 FAU - Alrabiee, S AU - Alrabiee S AD - King Abdulaziz Medical City, National Guard Hospital, Riyadh, Saudi Arabia. ISNI: 0000 0004 1790 7311. GRID: grid.415254.3 FAU - Alrashid, A AU - Alrashid A AD - Department of Management, College of Business Administration, King Saud University, Saudi Arabia, Riyadh, Saudi Arabia. ISNI: 0000 0004 1773 5396. GRID: grid.56302.32 FAU - Alsolamy, S AU - Alsolamy S AD - King Saud bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research Center, Riyadh, Saudi Arabia. ISNI: 0000 0004 0608 0662. GRID: grid.412149.b FAU - Gundogan, O AU - Gundogan O AD - Ege University Hospital, Izmir, Turkey. ISNI: 0000 0004 0535 6364. GRID: grid.412190.f FAU - Bor, C AU - Bor C AD - Ege University Hospital, Izmir, Turkey. ISNI: 0000 0004 0535 6364. GRID: grid.412190.f FAU - Akyn Korhan, E AU - Akyn Korhan E AD - Katip Celebi University, Health Sciences Faculty, Izmir, Turkey FAU - Demirag, K AU - Demirag K AD - Ege University Hospital, Izmir, Turkey. ISNI: 0000 0004 0535 6364. GRID: grid.412190.f FAU - Uyar, M AU - Uyar M AD - Ege University Hospital, Izmir, Turkey. ISNI: 0000 0004 0535 6364. GRID: grid.412190.f FAU - Frame, F AU - Frame F AD - Milton Keynes University Hospital NHS Foundation Trust, Milton Keynes, UK. GRID: grid.415667.7 FAU - Ashton, C AU - Ashton C AD - Milton Keynes University Hospital NHS Foundation Trust, Milton Keynes, UK. GRID: grid.415667.7 FAU - Bergstrom Niska, L AU - Bergstrom Niska L AD - Milton Keynes University Hospital NHS Foundation Trust, Milton Keynes, UK. GRID: grid.415667.7 FAU - Dilokpattanamongkol, P AU - Dilokpattanamongkol P AD - Faculty of Pharmacy, Mahidol University, Bangkok, Thailand. ISNI: 0000 0004 1937 0490. GRID: grid.10223.32 FAU - Suansanae, T AU - Suansanae T AD - Faculty of Pharmacy, Mahidol University, Bangkok, Thailand. ISNI: 0000 0004 1937 0490. GRID: grid.10223.32 FAU - Suthisisang, C AU - Suthisisang C AD - Faculty of Pharmacy, Mahidol University, Bangkok, Thailand. ISNI: 0000 0004 1937 0490. GRID: grid.10223.32 FAU - Morakul, S AU - Morakul S AD - Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. ISNI: 0000 0004 1937 0490. GRID: grid.10223.32 FAU - Karnjanarachata, C AU - Karnjanarachata C AD - Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. ISNI: 0000 0004 1937 0490. GRID: grid.10223.32 FAU - Tangsujaritvijit, V AU - Tangsujaritvijit V AD - Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. ISNI: 0000 0004 1937 0490. GRID: grid.10223.32 FAU - Mahmood, S AU - Mahmood S AD - Specialist Anesthesia, Doha, Qatar FAU - Al Thani, H AU - Al Thani H AD - Specialist Anesthesia, Doha, Qatar FAU - Almenyar, A AU - Almenyar A AD - Specialist Anesthesia, Doha, Qatar FAU - Vakalos, A AU - Vakalos A AD - Xanthi General Hospital, Xanthi, Greece FAU - Avramidis, V AU - Avramidis V AD - Xanthi General Hospital, Xanthi, Greece FAU - Sharvill, R AU - Sharvill R AD - Royal United Hospital, Bath, UK. ISNI: 0000 0004 0417 0728. GRID: grid.416091.b FAU - Penketh, J AU - Penketh J AD - Royal United Hospital, Bath, UK. ISNI: 0000 0004 0417 0728. GRID: grid.416091.b FAU - Morton, S E AU - Morton SE AD - University of Canterbury, Christchurch, New Zealand. ISNI: 0000 0001 2179 1970. GRID: grid.21006.35 FAU - Chiew, Y S AU - Chiew YS AD - University of Canterbury, Christchurch, New Zealand. ISNI: 0000 0001 2179 1970. GRID: grid.21006.35 FAU - Pretty, C AU - Pretty C AD - University of Canterbury, Christchurch, New Zealand. ISNI: 0000 0001 2179 1970. GRID: grid.21006.35 FAU - Chase, J G AU - Chase JG AD - University of Canterbury, Christchurch, New Zealand. ISNI: 0000 0001 2179 1970. GRID: grid.21006.35 FAU - Shaw, G M AU - Shaw GM AD - Christchurch Hospital, Christchurch, New Zealand. ISNI: 0000 0004 0614 1349. GRID: grid.414299.3 FAU - Knafelj, R AU - Knafelj R AD - Rihard Knafelj, Ljubljana, Slovenia FAU - Kordis, P AU - Kordis P AD - Clinical Center Ljubljana, Ljubljana, Slovenia. ISNI: 0000 0004 0571 7705. GRID: grid.29524.38 FAU - Patel, S AU - Patel S AD - The Royal Marsden Hospital, London, UK. ISNI: 0000 0004 0417 0461. GRID: grid.424926.f FAU - Grover, V AU - Grover V AD - The Royal Marsden Hospital, London, UK. ISNI: 0000 0004 0417 0461. GRID: grid.424926.f FAU - Kuchyn, I AU - Kuchyn I AD - Bogomolets National Medical University, Kiev, Ukraine. GRID: grid.412081.e FAU - Bielka, K AU - Bielka K AD - Bogomolets National Medical University, Kiev, Ukraine. GRID: grid.412081.e FAU - Aidoni, Z AU - Aidoni Z AD - Aristotle Medical School, Thessaloniki, Greece FAU - Grosomanidis, V AU - Grosomanidis V AD - Aristotle Medical School, Thessaloniki, Greece FAU - Kotzampassi, K AU - Kotzampassi K AD - Aristotle Medical School, Thessaloniki, Greece FAU - Stavrou, G AU - Stavrou G AD - Aristotle Medical School, Thessaloniki, Greece FAU - Fyntanidou, B AU - Fyntanidou B AD - Aristotle Medical School, Thessaloniki, Greece FAU - Patsatzakis, S AU - Patsatzakis S AD - Aristotle Medical School, Thessaloniki, Greece FAU - Skourtis, C AU - Skourtis C AD - Aristotle Medical School, Thessaloniki, Greece FAU - Lee, S D AU - Lee SD AD - Royal Liverpool Intensive Care Unit, Liverpool, UK FAU - Williams, K AU - Williams K AD - Royal Liverpool Intensive Care Unit, Liverpool, UK FAU - Weltes, I D AU - Weltes ID AD - University of Liverpool, Liverpool, UK. ISNI: 0000 0004 1936 8470. GRID: grid.10025.36 FAU - Berhane, S AU - Berhane S AD - Homerton University Hospital, London, UK. GRID: grid.439591.3 FAU - Arrowsmith, C AU - Arrowsmith C AD - Homerton University Hospital, London, UK. GRID: grid.439591.3 FAU - Peters, C AU - Peters C AD - Homerton University Hospital, London, UK. GRID: grid.439591.3 FAU - Robert, S AU - Robert S AD - Homerton University Hospital, London, UK. GRID: grid.439591.3 FAU - Caldas, J AU - Caldas J AD - University of Sao Paulo, Sao Paulo, Brazil. ISNI: 0000 0004 1937 0722. GRID: grid.11899.38 FAU - Panerai, R B AU - Panerai RB AD - University of Leicester, Leicester, UK. ISNI: 0000 0004 1936 8411. GRID: grid.9918.9 FAU - Robinson, T G AU - Robinson TG AD - University of Leicester, Leicester, UK. ISNI: 0000 0004 1936 8411. GRID: grid.9918.9 FAU - Camara, L AU - Camara L AD - University of Sao Paulo, Sao Paulo, Brazil. ISNI: 0000 0004 1937 0722. GRID: grid.11899.38 FAU - Ferreira, G AU - Ferreira G AD - University of Leicester, Leicester, UK. ISNI: 0000 0004 1936 8411. GRID: grid.9918.9 FAU - Borg-Seng-Shu, E AU - Borg-Seng-Shu E AD - University of Sao Paulo, Sao Paulo, Brazil. ISNI: 0000 0004 1937 0722. GRID: grid.11899.38 FAU - De Lima Oliveira, M AU - De Lima Oliveira M AD - University of Sao Paulo, Sao Paulo, Brazil. ISNI: 0000 0004 1937 0722. GRID: grid.11899.38 FAU - Mian, N C AU - Mian NC AD - University of Sao Paulo, Sao Paulo, Brazil. ISNI: 0000 0004 1937 0722. GRID: grid.11899.38 FAU - Santos, L AU - Santos L AD - University of Sao Paulo, Sao Paulo, Brazil. ISNI: 0000 0004 1937 0722. GRID: grid.11899.38 FAU - Nogueira, R AU - Nogueira R AD - University of Sao Paulo, Sao Paulo, Brazil. ISNI: 0000 0004 1937 0722. GRID: grid.11899.38 FAU - Zeferino, S P AU - Zeferino SP AD - University of Sao Paulo, Sao Paulo, Brazil. ISNI: 0000 0004 1937 0722. GRID: grid.11899.38 FAU - Jacobsen Teixeira, M AU - Jacobsen Teixeira M AD - University of Sao Paulo, Sao Paulo, Brazil. ISNI: 0000 0004 1937 0722. GRID: grid.11899.38 FAU - Galas, F AU - Galas F AD - University of Sao Paulo, Sao Paulo, Brazil. ISNI: 0000 0004 1937 0722. GRID: grid.11899.38 FAU - Hajjar, L A AU - Hajjar LA AD - University of Sao Paulo, Sao Paulo, Brazil. ISNI: 0000 0004 1937 0722. GRID: grid.11899.38 FAU - Killeen, P AU - Killeen P AD - King's College Hospital, London, UK. ISNI: 0000 0004 0391 9020. GRID: grid.46699.34 FAU - McPhail, M AU - McPhail M AD - King's College Hospital, London, UK. ISNI: 0000 0004 0391 9020. GRID: grid.46699.34 FAU - Bernal, W AU - Bernal W AD - King's College Hospital, London, UK. ISNI: 0000 0004 0391 9020. GRID: grid.46699.34 FAU - Maggs, J AU - Maggs J AD - King's College Hospital, London, UK. ISNI: 0000 0004 0391 9020. GRID: grid.46699.34 FAU - Wendon, J AU - Wendon J AD - King's College Hospital, London, UK. ISNI: 0000 0004 0391 9020. GRID: grid.46699.34 FAU - Hughes, T AU - Hughes T AD - King's College Hospital, London, UK. ISNI: 0000 0004 0391 9020. GRID: grid.46699.34 FAU - Taniguchi, L U AU - Taniguchi LU AD - Research and Education Institute, Sao Paulo, Brazil FAU - Siqueira, E M AU - Siqueira EM AD - Research and Education Institute, Sao Paulo, Brazil FAU - Vieira Jr, J M AU - Vieira Jr JM AD - Research and Education Institute, Sao Paulo, Brazil FAU - Azevedo, L C AU - Azevedo LC AD - Research and Education Institute, Sao Paulo, Brazil FAU - Ahmad, A N AU - Ahmad AN AD - King's College Hospital, London, UK. ISNI: 0000 0004 0391 9020. GRID: grid.46699.34 FAU - Abu-Habsa, M AU - Abu-Habsa M AD - King's College Hospital, London, UK. ISNI: 0000 0004 0391 9020. GRID: grid.46699.34 FAU - Bahl, R AU - Bahl R AD - King's College Hospital, London, UK. ISNI: 0000 0004 0391 9020. GRID: grid.46699.34 FAU - Helme, E AU - Helme E AD - King's College Hospital, London, UK. ISNI: 0000 0004 0391 9020. GRID: grid.46699.34 FAU - Hadfield, S AU - Hadfield S AD - King's College Hospital, London, UK. ISNI: 0000 0004 0391 9020. GRID: grid.46699.34 FAU - Loveridge, R AU - Loveridge R AD - King's College Hospital, London, UK. ISNI: 0000 0004 0391 9020. GRID: grid.46699.34 FAU - Shak, J AU - Shak J AD - Ipswich Hospital NHS Trust, England, UK, Ipswich, UK. ISNI: 0000 0004 0413 7370. GRID: grid.412930.d FAU - Senver, C AU - Senver C AD - Ipswich Hospital NHS Trust, England, UK, Ipswich, UK. ISNI: 0000 0004 0413 7370. GRID: grid.412930.d FAU - Howard-Griffin, R AU - Howard-Griffin R AD - Ipswich Hospital NHS Trust, England, UK, Ipswich, UK. ISNI: 0000 0004 0413 7370. GRID: grid.412930.d FAU - Wacharasint, P AU - Wacharasint P AD - Phramongkutklao Hospital, Bangkok, Thailand. ISNI: 0000 0004 0576 1212. GRID: grid.414965.b FAU - Fuengfoo, P AU - Fuengfoo P AD - Phramongkutklao Hospital, Bangkok, Thailand. ISNI: 0000 0004 0576 1212. GRID: grid.414965.b FAU - Sukcharoen, N AU - Sukcharoen N AD - Phramongkutklao Hospital, Bangkok, Thailand. ISNI: 0000 0004 0576 1212. GRID: grid.414965.b FAU - Rangsin, R AU - Rangsin R AD - Phramongkutklao College of Medicine, Bangkok, Thailand. ISNI: 0000 0004 1937 0490. GRID: grid.10223.32 FAU - Sbiti-Rohr, D AU - Sbiti-Rohr D AD - Kantonsspital Aarau, Aarau, Switzerland. ISNI: 0000 0000 8704 3732. GRID: grid.413357.7 FAU - Schuetz, P AU - Schuetz P AD - Kantonsspital Aarau, Aarau, Switzerland. ISNI: 0000 0000 8704 3732. GRID: grid.413357.7 FAU - Na, H AU - Na H AD - Pusan National University Hospital, Busan, South Korea. ISNI: 0000 0000 8611 7824. GRID: grid.412588.2 FAU - Song, S AU - Song S AD - Pusan National University Hospital, Busan, South Korea. ISNI: 0000 0000 8611 7824. GRID: grid.412588.2 FAU - Lee, S AU - Lee S AD - Pusan National University Hospital, Busan, South Korea. ISNI: 0000 0000 8611 7824. GRID: grid.412588.2 FAU - Jeong, E AU - Jeong E AD - Pusan National University Hospital, Busan, South Korea. ISNI: 0000 0000 8611 7824. GRID: grid.412588.2 FAU - Lee, K AU - Lee K AD - Pusan National University Hospital, Busan, South Korea. ISNI: 0000 0000 8611 7824. GRID: grid.412588.2 FAU - Cooper, M AU - Cooper M AD - Royal Liverpool University Hospital, Liverpool, UK. ISNI: 0000 0004 0417 2395. GRID: grid.415970.e FAU - Milinis, K AU - Milinis K AD - University of Liverpool, Liverpool, UK. ISNI: 0000 0004 1936 8470. GRID: grid.10025.36 FAU - Williams, G AU - Williams G AD - University of Liverpool, Liverpool, UK. ISNI: 0000 0004 1936 8470. GRID: grid.10025.36 FAU - McCarron, E AU - McCarron E AD - Royal Liverpool University Hospital, Liverpool, UK. ISNI: 0000 0004 0417 2395. GRID: grid.415970.e FAU - Simants, S AU - Simants S AD - Royal Liverpool University Hospital, Liverpool, UK. ISNI: 0000 0004 0417 2395. GRID: grid.415970.e FAU - Patanwala, I AU - Patanwala I AD - Royal Liverpool University Hospital, Liverpool, UK. ISNI: 0000 0004 0417 2395. GRID: grid.415970.e FAU - Welters, I D AU - Welters ID AD - University of Liverpool, Liverpool, UK. ISNI: 0000 0004 1936 8470. GRID: grid.10025.36 FAU - Zoumpelouli, E AU - Zoumpelouli E AD - PICU, Hippokration General Hospital, Thessaloniki, Greece. ISNI: 0000 0004 0621 2899. GRID: grid.414122.0 FAU - Volakli, E A AU - Volakli EA AD - PICU, Hippokration General Hospital, Thessaloniki, Greece. ISNI: 0000 0004 0621 2899. GRID: grid.414122.0 FAU - Chrysohoidou, V AU - Chrysohoidou V AD - PICU, Hippokration General Hospital, Thessaloniki, Greece. ISNI: 0000 0004 0621 2899. GRID: grid.414122.0 FAU - Georgiou, S AU - Georgiou S AD - PICU, Hippokration General Hospital, Thessaloniki, Greece. ISNI: 0000 0004 0621 2899. GRID: grid.414122.0 FAU - Charisopoulou, K AU - Charisopoulou K AD - PICU, Hippokration General Hospital, Thessaloniki, Greece. ISNI: 0000 0004 0621 2899. GRID: grid.414122.0 FAU - Kotzapanagiotou, E AU - Kotzapanagiotou E AD - PICU, Hippokration General Hospital, Thessaloniki, Greece. ISNI: 0000 0004 0621 2899. GRID: grid.414122.0 FAU - Panagiotidou, V AU - Panagiotidou V AD - PICU, Hippokration General Hospital, Thessaloniki, Greece. ISNI: 0000 0004 0621 2899. GRID: grid.414122.0 FAU - Manavidou, K AU - Manavidou K AD - PICU, Hippokration General Hospital, Thessaloniki, Greece. ISNI: 0000 0004 0621 2899. GRID: grid.414122.0 FAU - Stathi, Z AU - Stathi Z AD - PICU, Hippokration General Hospital, Thessaloniki, Greece. ISNI: 0000 0004 0621 2899. GRID: grid.414122.0 FAU - Sdougka, M AU - Sdougka M AD - PICU, Hippokration General Hospital, Thessaloniki, Greece. ISNI: 0000 0004 0621 2899. GRID: grid.414122.0 FAU - Salahuddin, N AU - Salahuddin N AD - King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia. ISNI: 0000 0001 2191 4301. GRID: grid.415310.2 FAU - AlGhamdi, B AU - AlGhamdi B AD - King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia. ISNI: 0000 0001 2191 4301. GRID: grid.415310.2 FAU - Marashly, Q AU - Marashly Q AD - King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia. ISNI: 0000 0001 2191 4301. GRID: grid.415310.2 FAU - Zaza, K AU - Zaza K AD - King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia. ISNI: 0000 0001 2191 4301. GRID: grid.415310.2 FAU - Sharshir, M AU - Sharshir M AD - King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia. ISNI: 0000 0001 2191 4301. GRID: grid.415310.2 FAU - Khurshid, M AU - Khurshid M AD - King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia. ISNI: 0000 0001 2191 4301. GRID: grid.415310.2 FAU - Ali, Z AU - Ali Z AD - King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia. ISNI: 0000 0001 2191 4301. GRID: grid.415310.2 FAU - Malgapo, M AU - Malgapo M AD - King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia. ISNI: 0000 0001 2191 4301. GRID: grid.415310.2 FAU - Jamil, M AU - Jamil M AD - King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia. ISNI: 0000 0001 2191 4301. GRID: grid.415310.2 FAU - Shafquat, A AU - Shafquat A AD - King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia. ISNI: 0000 0001 2191 4301. GRID: grid.415310.2 FAU - Shoukri, M AU - Shoukri M AD - King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia. ISNI: 0000 0001 2191 4301. GRID: grid.415310.2 FAU - Hijazi, M AU - Hijazi M AD - King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia. ISNI: 0000 0001 2191 4301. GRID: grid.415310.2 FAU - Abe, T AU - Abe T AD - The Jikei University School of Medicine, Tokyo, Japan. ISNI: 0000 0001 0661 2073. GRID: grid.411898.d FAU - Uchino, S AU - Uchino S AD - The Jikei University School of Medicine, Tokyo, Japan. ISNI: 0000 0001 0661 2073. GRID: grid.411898.d FAU - Takinami, M AU - Takinami M AD - The Jikei University School of Medicine, Tokyo, Japan. ISNI: 0000 0001 0661 2073. GRID: grid.411898.d FAU - Rangel Neto, N R AU - Rangel Neto NR AD - Albert Schweitzer State Hospital, Rio de Janeiro, Brazil FAU - Oliveira, S AU - Oliveira S AD - Albert Schweitzer State Hospital, Rio de Janeiro, Brazil FAU - Reis, F Q AU - Reis FQ AD - Albert Schweitzer State Hospital, Rio de Janeiro, Brazil FAU - Rocha, F A AU - Rocha FA AD - Albert Schweitzer State Hospital, Rio de Janeiro, Brazil FAU - Moralez, G AU - Moralez G AD - PPG Internal Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. ISNI: 0000 0001 2294 473X. GRID: grid.8536.8 FAU - Ebecken, K AU - Ebecken K AD - PPG Internal Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. ISNI: 0000 0001 2294 473X. GRID: grid.8536.8 FAU - Rabello, L S AU - Rabello LS AD - PPG Internal Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. ISNI: 0000 0001 2294 473X. GRID: grid.8536.8 FAU - Lima, M F AU - Lima MF AD - Hospital Esperanca Recife, Recife, Brazil FAU - Hatum, R AU - Hatum R AD - Hospital Total Cor, Rio de Janeiro, Brazil FAU - De Marco, F V AU - De Marco FV AD - Hospital viValle, Sao Jose dos Campos, Brazil FAU - Alves, A AU - Alves A AD - Hospital Rios DOr, Rio de Janeiro, Brazil FAU - Pinto, J E AU - Pinto JE AD - Hospital Norte DOr, Rio de Janeiro, Brazil FAU - Godoy, M AU - Godoy M AD - Hospital Esperanca Olinda, Olinda, Brazil FAU - Brasil, P E AU - Brasil PE AD - DOr Institute for Research and Education - IDOR, Rio de Janeiro, Brazil. GRID: grid.472984.4 FAU - Bozza, F A AU - Bozza FA AD - DOr Institute for Research and Education - IDOR, Rio de Janeiro, Brazil. GRID: grid.472984.4 FAU - Salluh, J I AU - Salluh JI AD - DOr Institute for Research and Education - IDOR, Rio de Janeiro, Brazil. GRID: grid.472984.4 FAU - Soares, M AU - Soares M AD - DOr Institute for Research and Education - IDOR, Rio de Janeiro, Brazil. GRID: grid.472984.4 FAU - Krinsley, J AU - Krinsley J AD - Stamford Hospital, Stamford, USA. ISNI: 0000 0004 0377 0318. GRID: grid.416984.6 FAU - Kang, G AU - Kang G AD - Stamford Hospital, Stamford, USA. ISNI: 0000 0004 0377 0318. GRID: grid.416984.6 FAU - Perry, J AU - Perry J AD - Darent Valley Hospital, Dartford, UK. ISNI: 0000 0004 0398 7314. GRID: grid.413475.0 FAU - Hines, H AU - Hines H AD - William Harvey Hospital, Ashford, UK. ISNI: 0000 0004 0398 7998. GRID: grid.417122.3 FAU - Wilkinson, K M AU - Wilkinson KM AD - St James's University Hospital, Leeds, UK. GRID: grid.443984.6 FAU - Tordoff, C AU - Tordoff C AD - St James's University Hospital, Leeds, UK. GRID: grid.443984.6 FAU - Sloan, B AU - Sloan B AD - St James's University Hospital, Leeds, UK. GRID: grid.443984.6 FAU - Bellamy, M C AU - Bellamy MC AD - St James's University Hospital, Leeds, UK. GRID: grid.443984.6 FAU - Moreira, E AU - Moreira E AD - Hospital Maciel, Montevideo, Uruguay. GRID: grid.414794.b FAU - Verga, F AU - Verga F AD - Hospital Maciel, Montevideo, Uruguay. GRID: grid.414794.b FAU - Barbato, M AU - Barbato M AD - Hospital Maciel, Montevideo, Uruguay. GRID: grid.414794.b FAU - Burghi, G AU - Burghi G AD - Hospital Maciel, Montevideo, Uruguay. GRID: grid.414794.b FAU - Soares, M AU - Soares M AD - DOr Institute for Research and Education - IDOR, Rio de Janeiro, Brazil. GRID: grid.472984.4 FAU - Silva, U V AU - Silva UV AD - Hospital de Cancer de Barretos, Barretos, Brazil. ISNI: 0000 0004 0615 7498. GRID: grid.427783.d FAU - Azevedo, L C AU - Azevedo LC AD - Hospital Sirio Libanes, Sao Paulo, Brazil. ISNI: 0000 0000 9080 8521. GRID: grid.413471.4 FAU - Torelly, A P AU - Torelly AP AD - Sta. Casa de Porto Alegre, Porto Alegre, Brazil FAU - Kahn, J M AU - Kahn JM AD - University of Pittsburgh Medical Center, Pittsburgh, USA. ISNI: 0000 0001 0650 7433. GRID: grid.412689.0 FAU - Angus, D C AU - Angus DC AD - University of Pittsburgh Medical Center, Pittsburgh, USA. ISNI: 0000 0001 0650 7433. GRID: grid.412689.0 FAU - Knibel, M F AU - Knibel MF AD - Hospital Sao Lucas, Rio de Janeiro, Brazil FAU - Brasil, P E AU - Brasil PE AD - DOr Institute for Research and Education - IDOR, Rio de Janeiro, Brazil. GRID: grid.472984.4 FAU - Bozza, F A AU - Bozza FA AD - DOr Institute for Research and Education - IDOR, Rio de Janeiro, Brazil. GRID: grid.472984.4 FAU - Salluh, J I AU - Salluh JI AD - DOr Institute for Research and Education - IDOR, Rio de Janeiro, Brazil. GRID: grid.472984.4 FAU - Velasco, M B AU - Velasco MB AD - Hospital Meridional S.A., Cariacica, Brazil FAU - Dalcomune, D M AU - Dalcomune DM AD - Hospital Meridional S.A., Cariacica, Brazil FAU - Marshall, R AU - Marshall R AD - Sheffield Teaching Hospitals, Sheffield, UK. GRID: grid.419135.b FAU - Gilpin, T AU - Gilpin T AD - Sheffield Teaching Hospitals, Sheffield, UK. GRID: grid.419135.b FAU - Tridente, A AU - Tridente A AD - Whiston Hospital, St Helens & Knowsley, UK. ISNI: 0000 0004 0417 1894. GRID: grid.417083.9 FAU - Raithatha, A AU - Raithatha A AD - Sheffield Teaching Hospitals, Sheffield, UK. GRID: grid.419135.b FAU - Mota, D AU - Mota D AD - Centro Hospitalar e Universitario de Coimbra, Coimbra, Portugal. ISNI: 0000000106861985. GRID: grid.28911.33 FAU - Loureiro, B AU - Loureiro B AD - Instituto Portugues de Oncologia Francisco Gil - Porto, Porto, Portugal. ISNI: 0000 0004 0631 0608. GRID: grid.418711.a FAU - Dias, J AU - Dias J AD - Instituto Portugues de Oncologia Francisco Gil - Porto, Porto, Portugal. ISNI: 0000 0004 0631 0608. GRID: grid.418711.a FAU - Afonso, O AU - Afonso O AD - Instituto Portugues de Oncologia Francisco Gil - Porto, Porto, Portugal. ISNI: 0000 0004 0631 0608. GRID: grid.418711.a FAU - Coelho, F AU - Coelho F AD - Instituto Portugues de Oncologia Francisco Gil - Porto, Porto, Portugal. ISNI: 0000 0004 0631 0608. GRID: grid.418711.a FAU - Martins, A AU - Martins A AD - Instituto Portugues de Oncologia Francisco Gil - Porto, Porto, Portugal. ISNI: 0000 0004 0631 0608. GRID: grid.418711.a FAU - Faria, F AU - Faria F AD - Instituto Portugues de Oncologia Francisco Gil - Porto, Porto, Portugal. ISNI: 0000 0004 0631 0608. GRID: grid.418711.a FAU - Al-Dorzi, H AU - Al-Dorzi H AD - King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. ISNI: 0000 0004 0608 0662. GRID: grid.412149.b FAU - Al Orainni, H AU - Al Orainni H AD - King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. ISNI: 0000 0004 0608 0662. GRID: grid.412149.b FAU - AlEid, F AU - AlEid F AD - King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. ISNI: 0000 0004 0608 0662. GRID: grid.412149.b FAU - Tlaygeh, H AU - Tlaygeh H AD - King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. ISNI: 0000 0004 0608 0662. GRID: grid.412149.b FAU - Itani, A AU - Itani A AD - King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. ISNI: 0000 0004 0608 0662. GRID: grid.412149.b FAU - Hejazi, A AU - Hejazi A AD - King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. ISNI: 0000 0004 0608 0662. GRID: grid.412149.b FAU - Arabi, Y AU - Arabi Y AD - King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. ISNI: 0000 0004 0608 0662. GRID: grid.412149.b FAU - Gaudry, S AU - Gaudry S AD - Hopital Louis Mourier, Colombes, France. ISNI: 0000 0001 0273 556X. GRID: grid.414205.6 FAU - Messika, J AU - Messika J AD - Hopital Louis Mourier, Colombes, France. ISNI: 0000 0001 0273 556X. GRID: grid.414205.6 FAU - Ricard, J D AU - Ricard JD AD - Hopital Louis Mourier, Colombes, France. ISNI: 0000 0001 0273 556X. GRID: grid.414205.6 FAU - Guillo, S AU - Guillo S AD - Hopital Bichat, Paris, France. ISNI: 0000 0000 8588 831X. GRID: grid.411119.d FAU - Pasquet, B AU - Pasquet B AD - Hopital Bichat, Paris, France. ISNI: 0000 0000 8588 831X. GRID: grid.411119.d FAU - Dubief, E AU - Dubief E AD - Hopital Louis Mourier, Colombes, France. ISNI: 0000 0001 0273 556X. GRID: grid.414205.6 FAU - Dreyfuss, D AU - Dreyfuss D AD - Hopital Louis Mourier, Colombes, France. ISNI: 0000 0001 0273 556X. GRID: grid.414205.6 FAU - Tubach, F AU - Tubach F AD - Hopital Bichat, Paris, France. ISNI: 0000 0000 8588 831X. GRID: grid.411119.d FAU - Battle, C AU - Battle C AD - Morriston Hospital, Swansea, UK. ISNI: 0000 0004 0649 0266. GRID: grid.416122.2 FAU - James, K AU - James K AD - Morriston Hospital, Swansea, UK. ISNI: 0000 0004 0649 0266. GRID: grid.416122.2 FAU - Temblett, P AU - Temblett P AD - Morriston Hospital, Swansea, UK. ISNI: 0000 0004 0649 0266. GRID: grid.416122.2 FAU - Davies, L AU - Davies L AD - Abertawe Bro Morgannwg University Health Board, Swansea, UK. ISNI: 0000 0000 8959 0182. GRID: grid.419728.1 FAU - Battle, C AU - Battle C AD - Abertawe Bro Morgannwg University Health Board, Swansea, UK. ISNI: 0000 0000 8959 0182. GRID: grid.419728.1 FAU - Lynch, C AU - Lynch C AD - Abertawe Bro Morgannwg University Health Board, Swansea, UK. ISNI: 0000 0000 8959 0182. GRID: grid.419728.1 FAU - Pereira, S AU - Pereira S AD - Centro Hospitalar Porto, Porto, Portugal. ISNI: 0000 0004 0392 7039. GRID: grid.418340.a FAU - Cavaco, S AU - Cavaco S AD - Centro Hospitalar Porto, Porto, Portugal. ISNI: 0000 0004 0392 7039. GRID: grid.418340.a FAU - Fernandes, J AU - Fernandes J AD - Centro Hospitalar Porto, Porto, Portugal. ISNI: 0000 0004 0392 7039. GRID: grid.418340.a FAU - Moreira, I AU - Moreira I AD - Centro Hospitalar Porto, Porto, Portugal. ISNI: 0000 0004 0392 7039. GRID: grid.418340.a FAU - Almeida, E AU - Almeida E AD - Centro Hospitalar Porto, Porto, Portugal. ISNI: 0000 0004 0392 7039. GRID: grid.418340.a FAU - Seabra Pereira, F AU - Seabra Pereira F AD - Centro Hospitalar Porto, Porto, Portugal. ISNI: 0000 0004 0392 7039. GRID: grid.418340.a FAU - Malheiro, M AU - Malheiro M AD - Centro Hospitalar Porto, Porto, Portugal. ISNI: 0000 0004 0392 7039. GRID: grid.418340.a FAU - Cardoso, F AU - Cardoso F AD - Centro Hospitalar Porto, Porto, Portugal. ISNI: 0000 0004 0392 7039. GRID: grid.418340.a FAU - Aragao, I AU - Aragao I AD - Centro Hospitalar Porto, Porto, Portugal. ISNI: 0000 0004 0392 7039. GRID: grid.418340.a FAU - Cardoso, T AU - Cardoso T AD - Centro Hospitalar Porto, Porto, Portugal. ISNI: 0000 0004 0392 7039. GRID: grid.418340.a FAU - Fister, M AU - Fister M AD - Rihard Knafelj, Ljubljana, Slovenia FAU - Knafelj, R AU - Knafelj R AD - Rihard Knafelj, Ljubljana, Slovenia FAU - Muraray Govind, P AU - Muraray Govind P AD - Apollo Speciality Hospital - OMR, Chennai, India. ISNI: 0000 0004 1802 3550. GRID: grid.413839.4 FAU - Brahmananda Reddy, N AU - Brahmananda Reddy N AD - Apollo Speciality Hospital - OMR, Chennai, India. ISNI: 0000 0004 1802 3550. GRID: grid.413839.4 FAU - Pratheema, R AU - Pratheema R AD - Apollo Speciality Hospital - OMR, Chennai, India. ISNI: 0000 0004 1802 3550. GRID: grid.413839.4 FAU - Arul, E D AU - Arul ED AD - Apollo Speciality Hospital - OMR, Chennai, India. ISNI: 0000 0004 1802 3550. GRID: grid.413839.4 FAU - Devachandran, J AU - Devachandran J AD - Apollo Speciality Hospital - OMR, Chennai, India. ISNI: 0000 0004 1802 3550. GRID: grid.413839.4 FAU - Velasco, M B AU - Velasco MB AD - Hospital Meridional S.A., Cariacica, Brazil FAU - Dalcomune, D M AU - Dalcomune DM AD - Hospital Meridional S.A., Cariacica, Brazil FAU - Knafelj, R AU - Knafelj R AD - Rihard Knafelj, Ljubljana, Slovenia FAU - Fister, M AU - Fister M AD - Rihard Knafelj, Ljubljana, Slovenia FAU - Chin-Yee, N AU - Chin-Yee N AD - The Ottawa Hospital, Ottawa, Canada. ISNI: 0000 0000 9606 5108. GRID: grid.412687.e FAU - D'Egidio, G AU - D'Egidio G AD - The Ottawa Hospital, Ottawa, Canada. ISNI: 0000 0000 9606 5108. GRID: grid.412687.e FAU - Thavorn, K AU - Thavorn K AD - The Ottawa Hospital, Ottawa, Canada. ISNI: 0000 0000 9606 5108. GRID: grid.412687.e FAU - Heyland, D AU - Heyland D AD - Kingston General Hospital, Kingston, Canada. ISNI: 0000 0004 0633 727X. GRID: grid.415354.2 FAU - Kyeremanteng, K AU - Kyeremanteng K AD - The Ottawa Hospital, Ottawa, Canada. ISNI: 0000 0000 9606 5108. GRID: grid.412687.e FAU - Murchison, A G AU - Murchison AG AD - Milton Keynes Hospital, Milton Keynes, UK. GRID: grid.415667.7 FAU - Swalwell, K AU - Swalwell K AD - Imperial College, London, UK. ISNI: 0000 0001 2113 8111. GRID: grid.7445.2 FAU - Mandeville, J AU - Mandeville J AD - Buckinghamshire Healthcare NHS Trust, Aylesbury, UK. ISNI: 0000 0004 0368 863X. GRID: grid.439664.a FAU - Stott, D AU - Stott D AD - Buckinghamshire Healthcare NHS Trust, Aylesbury, UK. ISNI: 0000 0004 0368 863X. GRID: grid.439664.a FAU - Guerreiro, I AU - Guerreiro I AD - IPO -Porto, Porto, Portugal. GRID: grid.435544.7 FAU - Devine, H AU - Devine H AD - Glasgow Royal Infirmary, Glasgow, UK. ISNI: 0000 0000 9825 7840. GRID: grid.411714.6 FAU - MacTavish, P AU - MacTavish P AD - Glasgow Royal Infirmary, Glasgow, UK. ISNI: 0000 0000 9825 7840. GRID: grid.411714.6 FAU - McPeake, J AU - McPeake J AD - Glasgow Royal Infirmary, Glasgow, UK. ISNI: 0000 0000 9825 7840. GRID: grid.411714.6 FAU - Quasim, T AU - Quasim T AD - Glasgow Royal Infirmary, Glasgow, UK. ISNI: 0000 0000 9825 7840. GRID: grid.411714.6 FAU - Kinsella, J AU - Kinsella J AD - Glasgow Royal Infirmary, Glasgow, UK. ISNI: 0000 0000 9825 7840. GRID: grid.411714.6 FAU - Daniel, M AU - Daniel M AD - Glasgow Royal Infirmary, Glasgow, UK. ISNI: 0000 0000 9825 7840. GRID: grid.411714.6 FAU - Goossens, C AU - Goossens C AD - KU Leuven, Leuven, Belgium. ISNI: 0000 0001 0668 7884. GRID: grid.5596.f FAU - Marques, M B AU - Marques MB FAU - Derde, S AU - Derde S AD - KU Leuven, Leuven, Belgium. ISNI: 0000 0001 0668 7884. GRID: grid.5596.f FAU - Vander Perre, S AU - Vander Perre S AD - KU Leuven, Leuven, Belgium. ISNI: 0000 0001 0668 7884. GRID: grid.5596.f FAU - Dufour, T AU - Dufour T AD - KU Leuven, Leuven, Belgium. ISNI: 0000 0001 0668 7884. GRID: grid.5596.f FAU - Thiessen, S E AU - Thiessen SE AD - KU Leuven, Leuven, Belgium. ISNI: 0000 0001 0668 7884. GRID: grid.5596.f FAU - Guiza, F AU - Guiza F AD - KU Leuven, Leuven, Belgium. ISNI: 0000 0001 0668 7884. GRID: grid.5596.f FAU - Janssens, T AU - Janssens T AD - KU Leuven, Leuven, Belgium. ISNI: 0000 0001 0668 7884. GRID: grid.5596.f FAU - Hermans, G AU - Hermans G AD - KU Leuven, Leuven, Belgium. ISNI: 0000 0001 0668 7884. GRID: grid.5596.f FAU - Vanhorebeek, I AU - Vanhorebeek I AD - KU Leuven, Leuven, Belgium. ISNI: 0000 0001 0668 7884. GRID: grid.5596.f FAU - De Bock, K AU - De Bock K AD - KU Leuven, Leuven, Belgium. ISNI: 0000 0001 0668 7884. GRID: grid.5596.f FAU - Van den Berghe, G AU - Van den Berghe G AD - KU Leuven, Leuven, Belgium. ISNI: 0000 0001 0668 7884. GRID: grid.5596.f FAU - Langouche, L AU - Langouche L AD - KU Leuven, Leuven, Belgium. ISNI: 0000 0001 0668 7884. GRID: grid.5596.f FAU - Devine, H AU - Devine H AD - Glasgow Royal Infirmary, Glasgow, UK. ISNI: 0000 0000 9825 7840. GRID: grid.411714.6 FAU - MacTavish, P AU - MacTavish P AD - Glasgow Royal Infirmary, Glasgow, UK. ISNI: 0000 0000 9825 7840. GRID: grid.411714.6 FAU - Quasim, T AU - Quasim T AD - Glasgow Royal Infirmary, Glasgow, UK. ISNI: 0000 0000 9825 7840. GRID: grid.411714.6 FAU - Kinsella, J AU - Kinsella J AD - Glasgow Royal Infirmary, Glasgow, UK. ISNI: 0000 0000 9825 7840. GRID: grid.411714.6 FAU - Daniel, M AU - Daniel M AD - Glasgow Royal Infirmary, Glasgow, UK. ISNI: 0000 0000 9825 7840. GRID: grid.411714.6 FAU - McPeake, J AU - McPeake J AD - Glasgow Royal Infirmary, Glasgow, UK. ISNI: 0000 0000 9825 7840. GRID: grid.411714.6 FAU - Miles, B AU - Miles B AD - Glasgow Royal Infirmary, Glasgow, UK. ISNI: 0000 0000 9825 7840. GRID: grid.411714.6 FAU - Madden, S AU - Madden S AD - Glasgow Royal Infirmary, Glasgow, UK. ISNI: 0000 0000 9825 7840. GRID: grid.411714.6 FAU - Devine, H AU - Devine H AD - Glasgow Royal Infirmary, Glasgow, UK. ISNI: 0000 0000 9825 7840. GRID: grid.411714.6 FAU - Weiler, M AU - Weiler M AD - Ernesto Dornelles Hospital, Porto Alegre, Brazil FAU - Marques, P AU - Marques P AD - Ernesto Dornelles Hospital, Porto Alegre, Brazil FAU - Rodrigues, C AU - Rodrigues C AD - Ernesto Dornelles Hospital, Porto Alegre, Brazil FAU - Boeira, M AU - Boeira M AD - Ernesto Dornelles Hospital, Porto Alegre, Brazil FAU - Brenner, K AU - Brenner K FAU - Leaes, C AU - Leaes C AD - Ernesto Dornelles Hospital, Porto Alegre, Brazil FAU - Machado, A AU - Machado A AD - Ernesto Dornelles Hospital, Porto Alegre, Brazil FAU - Townsend, R AU - Townsend R AD - Ernesto Dornelles Hospital, Porto Alegre, Brazil FAU - Andrade, J AU - Andrade J AD - Ernesto Dornelles Hospital, Porto Alegre, Brazil FAU - MacTavish, P AU - MacTavish P AD - Glasgow Royal Infirmary, Glasgow, UK. ISNI: 0000 0000 9825 7840. GRID: grid.411714.6 FAU - McPeake, J AU - McPeake J AD - Glasgow Royal Infirmary, Glasgow, UK. ISNI: 0000 0000 9825 7840. GRID: grid.411714.6 FAU - Devine, H AU - Devine H AD - Glasgow Royal Infirmary, Glasgow, UK. ISNI: 0000 0000 9825 7840. GRID: grid.411714.6 FAU - Kinsella, J AU - Kinsella J AD - Glasgow Royal Infirmary, Glasgow, UK. ISNI: 0000 0000 9825 7840. GRID: grid.411714.6 FAU - Daniel, M AU - Daniel M AD - Glasgow Royal Infirmary, Glasgow, UK. ISNI: 0000 0000 9825 7840. GRID: grid.411714.6 FAU - Kishore, R AU - Kishore R AD - Glasgow Royal Infirmary, Glasgow, UK. ISNI: 0000 0000 9825 7840. GRID: grid.411714.6 FAU - Fenlon, C AU - Fenlon C AD - Glasgow Royal Infirmary, Glasgow, UK. ISNI: 0000 0000 9825 7840. GRID: grid.411714.6 FAU - Quasim, T AU - Quasim T AD - Glasgow Royal Infirmary, Glasgow, UK. ISNI: 0000 0000 9825 7840. GRID: grid.411714.6 FAU - Fiks, T AU - Fiks T AD - Gelre Ziekenhuizen, Apeldoorn, Netherlands. ISNI: 0000 0004 0370 4214. GRID: grid.415355.3 FAU - Ruijter, A AU - Ruijter A AD - Gelre Ziekenhuizen, Apeldoorn, Netherlands. ISNI: 0000 0004 0370 4214. GRID: grid.415355.3 FAU - Te Raa, M AU - Te Raa M AD - Gelre Ziekenhuizen, Apeldoorn, Netherlands. ISNI: 0000 0004 0370 4214. GRID: grid.415355.3 FAU - Spronk, P AU - Spronk P AD - Gelre Ziekenhuizen, Apeldoorn, Netherlands. ISNI: 0000 0004 0370 4214. GRID: grid.415355.3 FAU - Chiew, Y S AU - Chiew YS AD - University of Canterbury, Christchurch, New Zealand. ISNI: 0000 0001 2179 1970. GRID: grid.21006.35 FAU - Docherty, P AU - Docherty P AD - University of Canterbury, Christchurch, New Zealand. ISNI: 0000 0001 2179 1970. GRID: grid.21006.35 FAU - Dickson, J AU - Dickson J AD - University of Canterbury, Christchurch, New Zealand. ISNI: 0000 0001 2179 1970. GRID: grid.21006.35 FAU - Moltchanova, E AU - Moltchanova E AD - University of Canterbury, Christchurch, New Zealand. ISNI: 0000 0001 2179 1970. GRID: grid.21006.35 FAU - Scarrot, C AU - Scarrot C AD - University of Canterbury, Christchurch, New Zealand. ISNI: 0000 0001 2179 1970. GRID: grid.21006.35 FAU - Pretty, C AU - Pretty C AD - University of Canterbury, Christchurch, New Zealand. ISNI: 0000 0001 2179 1970. GRID: grid.21006.35 FAU - Shaw, G M AU - Shaw GM AD - Christchurch Hospital, Christchurch, New Zealand. ISNI: 0000 0004 0614 1349. GRID: grid.414299.3 FAU - Chase, J G AU - Chase JG AD - University of Western Ontario, London, Canada. ISNI: 0000 0004 1936 8884. GRID: grid.39381.30 FAU - Hall, T AU - Hall T AD - Surrey and Sussex NHS Trust, Redhill, UK FAU - Ngu, W C AU - Ngu WC AD - Surrey and Sussex NHS Trust, Redhill, UK FAU - Jack, J M AU - Jack JM AD - Surrey and Sussex NHS Trust, Redhill, UK FAU - Morgan, P AU - Morgan P AD - Surrey and Sussex NHS Trust, Redhill, UK FAU - Avard, B AU - Avard B AD - The Canberra Hospital, Hughes, ACT Australia. ISNI: 0000 0000 9984 5644. GRID: grid.413314.0 FAU - Pavli, A AU - Pavli A AD - The Canberra Hospital, Hughes, ACT Australia. ISNI: 0000 0000 9984 5644. GRID: grid.413314.0 FAU - Gee, X AU - Gee X AD - ANU Medical School, Canberra, Australia. ISNI: 0000 0001 2180 7477. GRID: grid.1001.0 FAU - Bor, C AU - Bor C AD - Ege University School of Medicine, Izmir, Turkey. ISNI: 0000 0001 1092 2592. GRID: grid.8302.9 FAU - Akin Korhan, E AU - Akin Korhan E AD - katip Celebi University, Izmir, Turkey. ISNI: 0000 0004 0454 9420. GRID: grid.411795.f FAU - Demirag, K AU - Demirag K AD - Ege University School of Medicine, Izmir, Turkey. ISNI: 0000 0001 1092 2592. GRID: grid.8302.9 FAU - Uyar, M AU - Uyar M AD - Ege University School of Medicine, Izmir, Turkey. ISNI: 0000 0001 1092 2592. GRID: grid.8302.9 FAU - Shirazy, M AU - Shirazy M AD - Alexandria University Faculty of medicine, Alexandria, Egypt. ISNI: 0000 0001 2260 6941. GRID: grid.7155.6 FAU - Fayed, A AU - Fayed A AD - Alexandria University Faculty of medicine, Alexandria, Egypt. ISNI: 0000 0001 2260 6941. GRID: grid.7155.6 FAU - Gupta, S AU - Gupta S AD - Fortis Escorts Heart Institute, New Delhi, India. ISNI: 0000 0004 1804 7827. GRID: grid.417966.b FAU - Kaushal, A AU - Kaushal A AD - Fortis Escorts Heart Institute, New Delhi, India. ISNI: 0000 0004 1804 7827. GRID: grid.417966.b FAU - Dewan, S AU - Dewan S FAU - Varma, A AU - Varma A AD - FMRI, Gurgaon, India. ISNI: 0000 0004 4653 2037. GRID: grid.464839.4 FAU - Ghosh, E AU - Ghosh E AD - Philips Research North America, Cambridge, USA. GRID: grid.417285.d FAU - Yang, L AU - Yang L AD - Philips Research North America, Cambridge, USA. GRID: grid.417285.d FAU - Eshelman, L AU - Eshelman L AD - Philips Research North America, Cambridge, USA. GRID: grid.417285.d FAU - Lord, B AU - Lord B AD - Philips Research North America, Cambridge, USA. GRID: grid.417285.d FAU - Carlson, E AU - Carlson E AD - Philips Research North America, Cambridge, USA. GRID: grid.417285.d FAU - Helme, E AU - Helme E AD - King's College Hospital NHS Foundation Trust, London, UK. ISNI: 0000 0004 0489 4320. GRID: grid.429705.d FAU - Broderick, R AU - Broderick R AD - King's College Hospital NHS Foundation Trust, London, UK. ISNI: 0000 0004 0489 4320. GRID: grid.429705.d FAU - Hadfield, S AU - Hadfield S AD - King's College Hospital NHS Foundation Trust, London, UK. ISNI: 0000 0004 0489 4320. GRID: grid.429705.d FAU - Loveridge, R AU - Loveridge R AD - King's College Hospital NHS Foundation Trust, London, UK. ISNI: 0000 0004 0489 4320. GRID: grid.429705.d FAU - Ramos, J AU - Ramos J AD - Hospital Sao Rafael, Salvador, Brazil. GRID: grid.413466.2 FAU - Forte, D AU - Forte D AD - Hospital das Clinicas, Sao Paulo, Brazil. ISNI: 0000 0001 2297 2036. GRID: grid.411074.7 FAU - Yang, F AU - Yang F AD - Brigham and Women's Hospital, Boston, USA. ISNI: 0000 0004 0378 8294. GRID: grid.62560.37 FAU - Hou, P AU - Hou P AD - Brigham and Women's Hospital, Boston, USA. ISNI: 0000 0004 0378 8294. GRID: grid.62560.37 FAU - Dudziak, J AU - Dudziak J AD - St Helens and Knowsley, Liverpool, UK FAU - Feeney, J AU - Feeney J AD - St Helens and Knowsley, Liverpool, UK FAU - Wilkinson, K AU - Wilkinson K AD - St Helens and Knowsley, Liverpool, UK FAU - Bauchmuller, K AU - Bauchmuller K AD - STH, Sheffield, UK FAU - Shuker, K AU - Shuker K AD - STH, Sheffield, UK FAU - Faulds, M AU - Faulds M AD - STH, Sheffield, UK FAU - Raithatha, A AU - Raithatha A AD - STH, Sheffield, UK FAU - Bryden, D AU - Bryden D AD - STH, Sheffield, UK FAU - England, L AU - England L AD - St Helens and Knowsley, Liverpool, UK FAU - Bolton, N AU - Bolton N AD - St Helens and Knowsley, Liverpool, UK FAU - Tridente, A AU - Tridente A AD - St Helens and Knowsley, Liverpool, UK FAU - Bauchmuller, K AU - Bauchmuller K FAU - Shuker, K AU - Shuker K FAU - Tridente, A AU - Tridente A AD - Whiston Hospital, Prescot, UK. ISNI: 0000 0004 0417 1894. GRID: grid.417083.9 FAU - Faulds, M AU - Faulds M AD - Freeman Hospital, Newcastle upon Tyne, UK. ISNI: 0000 0004 0641 3308. GRID: grid.415050.5 FAU - Matheson, A AU - Matheson A AD - Sheffield Teaching Hospitals, Sheffield, UK. GRID: grid.419135.b FAU - Gaynor, J AU - Gaynor J FAU - Bryden, D AU - Bryden D CN - S South Yorkshire Hospitals Research Collaboration FAU - Ramos, J AU - Ramos J AD - Hospital Sao Rafael, Salvador, Brazil. GRID: grid.413466.2 FAU - Peroni, B AU - Peroni B AD - Hospital das Clinicas, Sao Paulo, Brazil. ISNI: 0000 0001 2297 2036. GRID: grid.411074.7 FAU - Daglius-Dias, R AU - Daglius-Dias R AD - Hospital das Clinicas, Sao Paulo, Brazil. ISNI: 0000 0001 2297 2036. GRID: grid.411074.7 FAU - Miranda, L AU - Miranda L AD - Hospital Nove de Julho, Sao Paulo, Brazil FAU - Cohen, C AU - Cohen C AD - Hospital das Clinicas, Sao Paulo, Brazil. ISNI: 0000 0001 2297 2036. GRID: grid.411074.7 FAU - Carvalho, C AU - Carvalho C AD - Hospital das Clinicas, Sao Paulo, Brazil. ISNI: 0000 0001 2297 2036. GRID: grid.411074.7 FAU - Velasco, I AU - Velasco I AD - Hospital das Clinicas, Sao Paulo, Brazil. ISNI: 0000 0001 2297 2036. GRID: grid.411074.7 FAU - Forte, D AU - Forte D AD - Hospital das Clinicas, Sao Paulo, Brazil. ISNI: 0000 0001 2297 2036. GRID: grid.411074.7 FAU - Kelly, J M AU - Kelly JM AD - University Hospital Coventry and Warwickshire, Coventry, UK. GRID: grid.15628.38 FAU - Neill, A AU - Neill A AD - Sunnybrook Health Sciences Centre, Toronto, Canada. ISNI: 0000 0000 9743 1587. GRID: grid.413104.3 FAU - Rubenfeld, G AU - Rubenfeld G AD - Sunnybrook Health Sciences Centre, Toronto, Canada. ISNI: 0000 0000 9743 1587. GRID: grid.413104.3 FAU - Masson, N AU - Masson N AD - NHS Scotland, Glasgow, UK. ISNI: 0000 0000 9506 6213. GRID: grid.422655.2 FAU - Min, A AU - Min A AD - Royal College of Surgeons of Ireland, Dublin, Ireland. ISNI: 0000 0004 0488 7120. GRID: grid.4912.e FAU - Boezeman, E AU - Boezeman E AD - University Leiden, Leiden, Netherlands. ISNI: 0000 0001 2312 1970. GRID: grid.5132.5 FAU - Hofhuis, J AU - Hofhuis J AD - Gelre Hospitals, Apeldoorn, Netherlands. ISNI: 0000 0004 0370 4214. GRID: grid.415355.3 FAU - Hovingh, A AU - Hovingh A AD - Gelre Hospitals, Apeldoorn, Netherlands. ISNI: 0000 0004 0370 4214. GRID: grid.415355.3 FAU - De Vries, R AU - De Vries R AD - VU University Amsterdam, Amsterdam, Netherlands. ISNI: 0000 0004 1754 9227. GRID: grid.12380.38 FAU - Spronk, P AU - Spronk P AD - Gelre Hospitals, Apeldoorn, Netherlands. ISNI: 0000 0004 0370 4214. GRID: grid.415355.3 FAU - Cabral-Campello, G AU - Cabral-Campello G AD - Hospital de Santo Antonio, Oporto Hospital Center, Porto, Portugal FAU - Aragao, I AU - Aragao I AD - Hospital de Santo Antonio, Oporto Hospital Center, Porto, Portugal FAU - Cardoso, T AU - Cardoso T AD - Hospital de Santo Antonio, Oporto Hospital Center, Porto, Portugal FAU - Van Mol, M AU - Van Mol M AD - Erasmus MC, Rotterdam, Netherlands. ISNI: 000000040459992X. GRID: grid.5645.2 FAU - Nijkamp, M AU - Nijkamp M AD - Faculty of Psychology and Educational Sciences, Heerlen, Netherlands FAU - Kompanje, E AU - Kompanje E AD - Erasmus MC, Rotterdam, Netherlands. ISNI: 000000040459992X. GRID: grid.5645.2 FAU - Ostrowski, P AU - Ostrowski P AD - University of Toronto at Scarborough, Scarborough, ON Canada. ISNI: 0000 0001 2157 2938. GRID: grid.17063.33 FAU - Omar, A AU - Omar A AD - Hamad medical corporation, Doha, Qatar. ISNI: 0000 0004 0571 546X. GRID: grid.413548.f FAU - Kiss, K AU - Kiss K AD - University of Szeged, Szeged, Hungary. ISNI: 0000 0001 1016 9625. GRID: grid.9008.1 FAU - Koves, B AU - Koves B AD - Jahn Ferenc Hospital, Budapest, Hungary FAU - Csernus, V AU - Csernus V AD - University of Pecs, Pecs, Hungary. ISNI: 0000 0001 0663 9479. GRID: grid.9679.1 FAU - Molnar, Z AU - Molnar Z AD - University of Szeged, Szeged, Hungary. ISNI: 0000 0001 1016 9625. GRID: grid.9008.1 FAU - Hoydonckx, Y AU - Hoydonckx Y AD - Jessa Ziekenhuis, Hasselt, Belgium. ISNI: 0000 0004 0578 1096. GRID: grid.414977.8 FAU - Vanwing, S AU - Vanwing S AD - Jessa Ziekenhuis, Hasselt, Belgium. ISNI: 0000 0004 0578 1096. GRID: grid.414977.8 FAU - Stessel, B AU - Stessel B AD - Jessa Ziekenhuis, Hasselt, Belgium. ISNI: 0000 0004 0578 1096. GRID: grid.414977.8 FAU - Van Assche, A AU - Van Assche A AD - Jessa Ziekenhuis, Hasselt, Belgium. ISNI: 0000 0004 0578 1096. GRID: grid.414977.8 FAU - Jamaer, L AU - Jamaer L AD - Jessa Ziekenhuis, Hasselt, Belgium. ISNI: 0000 0004 0578 1096. GRID: grid.414977.8 FAU - Dubois, J AU - Dubois J AD - Jessa Ziekenhuis, Hasselt, Belgium. ISNI: 0000 0004 0578 1096. GRID: grid.414977.8 FAU - Medo, V AU - Medo V AD - Hospital Clinico Universidad de Chile, Santiago, Chile. GRID: grid.412248.9 FAU - Galvez, R AU - Galvez R AD - Hospital Clinico Universidad de Chile, Santiago, Chile. GRID: grid.412248.9 FAU - Miranda, J P AU - Miranda JP AD - Hospital Clinico Universidad de Chile, Santiago, Chile. GRID: grid.412248.9 FAU - Stone, C AU - Stone C AD - Royal Marsden Hospital, London, UK. ISNI: 0000 0004 0417 0461. GRID: grid.424926.f FAU - Wigmore, T AU - Wigmore T AD - Royal Marsden Hospital, London, UK. ISNI: 0000 0004 0417 0461. GRID: grid.424926.f FAU - Arunan, Y AU - Arunan Y AD - Sheffield Teaching Hospitals, Sheffield, UK. GRID: grid.419135.b FAU - Wheeler, A AU - Wheeler A AD - Sheffield Teaching Hospitals, Sheffield, UK. GRID: grid.419135.b FAU - Bauchmuller, K AU - Bauchmuller K AD - Sheffield Teaching Hospitals, Sheffield, UK. GRID: grid.419135.b FAU - Bryden, D AU - Bryden D AD - Sheffield Teaching Hospitals, Sheffield, UK. GRID: grid.419135.b FAU - Wong, Y AU - Wong Y AD - Tan Tock Seng hospital, Singapore, Singapore. GRID: grid.240988.f FAU - Poi, C AU - Poi C FAU - Gu, C AU - Gu C AD - Tan Tock Seng hospital, Singapore, Singapore. GRID: grid.240988.f FAU - Molmy, P AU - Molmy P AD - Centre Hospitalier de Lens, Lens, France. ISNI: 0000 0004 0642 1236. GRID: grid.470048.f FAU - Van Grunderbeeck, N AU - Van Grunderbeeck N AD - Centre Hospitalier de Lens, Lens, France. ISNI: 0000 0004 0642 1236. GRID: grid.470048.f FAU - Nigeon, O AU - Nigeon O AD - Centre Hospitalier de Lens, Lens, France. ISNI: 0000 0004 0642 1236. GRID: grid.470048.f FAU - Lemyze, M AU - Lemyze M AD - Centre Hospitalier de Lens, Lens, France. ISNI: 0000 0004 0642 1236. GRID: grid.470048.f FAU - Thevenin, D AU - Thevenin D AD - Centre Hospitalier de Lens, Lens, France. ISNI: 0000 0004 0642 1236. GRID: grid.470048.f FAU - Mallat, J AU - Mallat J AD - Centre Hospitalier de Lens, Lens, France. ISNI: 0000 0004 0642 1236. GRID: grid.470048.f FAU - Ramos, J AU - Ramos J AD - Hospital Sao Rafael, Salvador, Brazil. GRID: grid.413466.2 FAU - Correa, M AU - Correa M AD - Hospital das Clinicas, Sao Paulo, Brazil. ISNI: 0000 0001 2297 2036. GRID: grid.411074.7 FAU - Carvalho, R T AU - Carvalho RT AD - Hospital das Clinicas, Sao Paulo, Brazil. ISNI: 0000 0001 2297 2036. GRID: grid.411074.7 FAU - Forte, D AU - Forte D AD - Hospital das Clinicas, Sao Paulo, Brazil. ISNI: 0000 0001 2297 2036. GRID: grid.411074.7 FAU - Fernandez, A AU - Fernandez A AD - Ntra Sra de Candelaria University Hospital, Santa Cruz de Tenerife, Spain FAU - McBride, C AU - McBride C AD - University of Texas at Austin, San Antonio, USA. ISNI: 0000 0004 1936 9924. GRID: grid.89336.37 FAU - Koonthalloor, E AU - Koonthalloor E AD - Beaumont Hospital, Dublin, Ireland. ISNI: 0000 0004 0617 6058. GRID: grid.414315.6 FAU - Walsh, C AU - Walsh C AD - Beaumont Hospital, Dublin, Ireland. ISNI: 0000 0004 0617 6058. GRID: grid.414315.6 FAU - Webber, A AU - Webber A AD - St Helens and Knowsley teaching hospitals, Liverpool, UK. GRID: grid.430747.3 FAU - Ashe, M AU - Ashe M AD - St Helens and Knowsley teaching hospitals, Liverpool, UK. GRID: grid.430747.3 FAU - Smith, K AU - Smith K AD - St Helens and Knowsley teaching hospitals, Liverpool, UK. GRID: grid.430747.3 FAU - Jeanrenaud, P AU - Jeanrenaud P AD - St Helens and Knowsley teaching hospitals, Liverpool, UK. GRID: grid.430747.3 FAU - Marudi, A AU - Marudi A AD - Nuovo Ospedale Civile Sant'Agostino Estense, Modena, Italy FAU - Baroni, S AU - Baroni S AD - Nuovo Ospedale Civile Sant'Agostino Estense, Modena, Italy FAU - Ragusa, F AU - Ragusa F AD - Nuovo Ospedale Civile Sant'Agostino Estense, Modena, Italy FAU - Bertellini, E AU - Bertellini E AD - Nuovo Ospedale Civile Sant'Agostino Estense, Modena, Italy FAU - Volakli, E A AU - Volakli EA AD - PICU, Hippokration General Hospital, Thessaloniki, Greece. ISNI: 0000 0004 0621 2899. GRID: grid.414122.0 FAU - Chochliourou, E AU - Chochliourou E AD - PICU, Hippokration General Hospital, Thessaloniki, Greece. ISNI: 0000 0004 0621 2899. GRID: grid.414122.0 FAU - Dimitriadou, M AU - Dimitriadou M AD - PICU, Hippokration General Hospital, Thessaloniki, Greece. ISNI: 0000 0004 0621 2899. GRID: grid.414122.0 FAU - Violaki, A AU - Violaki A AD - PICU, Hippokration General Hospital, Thessaloniki, Greece. ISNI: 0000 0004 0621 2899. GRID: grid.414122.0 FAU - Mantzafleri, P AU - Mantzafleri P AD - PICU, Hippokration General Hospital, Thessaloniki, Greece. ISNI: 0000 0004 0621 2899. GRID: grid.414122.0 FAU - Samkinidou, E AU - Samkinidou E AD - PICU, Hippokration General Hospital, Thessaloniki, Greece. ISNI: 0000 0004 0621 2899. GRID: grid.414122.0 FAU - Vrani, O AU - Vrani O AD - PICU, Hippokration General Hospital, Thessaloniki, Greece. ISNI: 0000 0004 0621 2899. GRID: grid.414122.0 FAU - Arbouti, A AU - Arbouti A AD - PICU, Hippokration General Hospital, Thessaloniki, Greece. ISNI: 0000 0004 0621 2899. GRID: grid.414122.0 FAU - Varsami, T AU - Varsami T AD - PICU, Hippokration General Hospital, Thessaloniki, Greece. ISNI: 0000 0004 0621 2899. GRID: grid.414122.0 FAU - Sdougka, M AU - Sdougka M AD - PICU, Hippokration General Hospital, Thessaloniki, Greece. ISNI: 0000 0004 0621 2899. GRID: grid.414122.0 FAU - Bollen, J A AU - Bollen JA AD - Maastricht University, Maastricht, Netherlands. ISNI: 0000 0001 0481 6099. GRID: grid.5012.6 FAU - Van Smaalen, T C AU - Van Smaalen TC AD - Maastricht University Medical Center, Maastricht, Netherlands. GRID: grid.412966.e FAU - De Jongh, W C AU - De Jongh WC AD - Maastricht University Medical Center, Maastricht, Netherlands. GRID: grid.412966.e FAU - Ten Hoopen, M M AU - Ten Hoopen MM AD - Maastricht University, Maastricht, Netherlands. ISNI: 0000 0001 0481 6099. GRID: grid.5012.6 FAU - Ysebaert, D AU - Ysebaert D AD - University Hospital Antwerp, Edegem, Belgium. ISNI: 0000 0004 0626 3418. GRID: grid.411414.5 FAU - Van Heurn, L W AU - Van Heurn LW AD - Academic Medical Center, Amsterdam, Netherlands. ISNI: 0000000404654431. GRID: grid.5650.6 FAU - Van Mook, W N AU - Van Mook WN AD - Maastricht University Medical Center, Maastricht, Netherlands. GRID: grid.412966.e FAU - Sim, K AU - Sim K AD - St Helens and Knoowsley, Prescot, UK FAU - Fuller, A AU - Fuller A AD - St Helens and Knoowsley, Prescot, UK FAU - Roze des Ordons, A AU - Roze des Ordons A AD - University of Calgary, Calgary, Canada. ISNI: 0000 0004 1936 7697. GRID: grid.22072.35 FAU - Couillard, P AU - Couillard P AD - University of Calgary, Calgary, Canada. ISNI: 0000 0004 1936 7697. GRID: grid.22072.35 FAU - Doig, C AU - Doig C AD - University of Calgary, Calgary, Canada. ISNI: 0000 0004 1936 7697. GRID: grid.22072.35 FAU - Van Keer, R V AU - Van Keer RV AD - Vrije Universiteit Brussel, Brussel, Belgium. ISNI: 0000 0001 2290 8069. GRID: grid.8767.e FAU - Deschepper, R D AU - Deschepper RD AD - Vrije Universiteit Brussel, Brussel, Belgium. ISNI: 0000 0001 2290 8069. GRID: grid.8767.e FAU - Francke, A F AU - Francke AF AD - EMGO+/VU University medical center, Utrecht, Netherlands. ISNI: 0000000090126352. GRID: grid.7692.a FAU - Huyghens, L H AU - Huyghens LH AD - Universitair Ziekenhuis Brussel, Brussel, Belgium. ISNI: 0000 0004 0626 3362. GRID: grid.411326.3 FAU - Bilsen, J B AU - Bilsen JB AD - Vrije Universiteit Brussel, Brussel, Belgium. ISNI: 0000 0001 2290 8069. GRID: grid.8767.e FAU - Nyamaizi, B AU - Nyamaizi B AD - University Hospital Lewisham, London, UK. GRID: grid.439787.6 FAU - Dalrymple, C AU - Dalrymple C AD - Queen Elizabeth Hospital, London, UK. GRID: grid.439484.6 FAU - Molokhia, A AU - Molokhia A AD - University Hospital Lewisham, London, UK. GRID: grid.439787.6 FAU - Dobru, A AU - Dobru A AD - University Hospital Lewisham, London, UK. GRID: grid.439787.6 FAU - Marrinan, E AU - Marrinan E AD - Lewisham & Greenwich NHS Trust, London, UK. GRID: grid.429537.e FAU - Ankuli, A AU - Ankuli A AD - Lewisham & Greenwich NHS Trust, London, UK. GRID: grid.429537.e FAU - Molokhia, A AU - Molokhia A AD - Lewisham & Greenwich NHS Trust, London, UK. GRID: grid.429537.e FAU - McPeake, J AU - McPeake J AD - University of Glasgow, Glasgow, UK. ISNI: 0000 0001 2193 314X. GRID: grid.8756.c FAU - Struthers, R AU - Struthers R AD - NHS Greater Glasgow and Clyde, Glasgow, UK. ISNI: 0000 0001 0523 9342. GRID: grid.413301.4 FAU - Crawford, R AU - Crawford R AD - NHS Greater Glasgow and Clyde, Glasgow, UK. ISNI: 0000 0001 0523 9342. GRID: grid.413301.4 FAU - Devine, H AU - Devine H AD - NHS Greater Glasgow and Clyde, Glasgow, UK. ISNI: 0000 0001 0523 9342. GRID: grid.413301.4 FAU - Mactavish, P AU - Mactavish P AD - NHS Greater Glasgow and Clyde, Glasgow, UK. ISNI: 0000 0001 0523 9342. GRID: grid.413301.4 FAU - Quasim, T AU - Quasim T AD - University of Glasgow, Glasgow, UK. ISNI: 0000 0001 2193 314X. GRID: grid.8756.c FAU - Morelli, P AU - Morelli P AD - National Burn Unit, Montevideo, Uruguay FAU - Degiovanangelo, M AU - Degiovanangelo M AD - National Burn Unit, Montevideo, Uruguay FAU - Lemos, F AU - Lemos F AD - National Burn Unit, Montevideo, Uruguay FAU - MArtinez, V AU - MArtinez V AD - Hospital Maciel, Montevideo, Uruguay. GRID: grid.414794.b FAU - Verga, F AU - Verga F AD - National Burn Unit, Montevideo, Uruguay FAU - Cabrera, J AU - Cabrera J AD - National Burn Unit, Montevideo, Uruguay FAU - Burghi, G AU - Burghi G AD - Hospital Maciel, Montevideo, Uruguay. GRID: grid.414794.b FAU - Rutten, A AU - Rutten A AD - St Elisabeth Ziekenhuis, Tilburg, Netherlands. GRID: grid.416373.4 FAU - Van Ieperen, S AU - Van Ieperen S AD - St Elisabeth Ziekenhuis, Tilburg, Netherlands. GRID: grid.416373.4 FAU - De Geer, S AU - De Geer S AD - St Elisabeth Ziekenhuis, Tilburg, Netherlands. GRID: grid.416373.4 FAU - Van Vugt, M AU - Van Vugt M AD - St Elisabeth Ziekenhuis, Tilburg, Netherlands. GRID: grid.416373.4 FAU - Der Kinderen, E AU - Der Kinderen E AD - St Elisabeth Ziekenhuis, Tilburg, Netherlands. GRID: grid.416373.4 FAU - Giannini, A AU - Giannini A AD - Fondazione IRCCS Ca' Granda - Ospedale maggiore Policlinico, Milan, Italy. ISNI: 0000 0004 1757 8749. GRID: grid.414818.0 FAU - Miccinesi, G AU - Miccinesi G AD - Istituto per lo Studio e la Prevenzione Oncologica, Florence, Italy. ISNI: 0000 0004 1758 0566. GRID: grid.417623.5 FAU - Marchesi, T AU - Marchesi T AD - Fondazione IRCCS Ca' Granda - Ospedale maggiore Policlinico, Milan, Italy. ISNI: 0000 0004 1757 8749. GRID: grid.414818.0 FAU - Prandi, E AU - Prandi E AD - Fondazione IRCCS Ca' Granda - Ospedale maggiore Policlinico, Milan, Italy. ISNI: 0000 0004 1757 8749. GRID: grid.414818.0 LA - eng PT - Conference Proceedings DEP - 20160420 PL - England TA - Crit Care JT - Critical care (London, England) JID - 9801902 EIN - Crit Care. 2016 Oct 24;20:347. doi: 10.1186/s13054-016-1358-6. PMID: 31268434 PMC - PMC5493079 EDAT- 2016/11/26 06:00 MHDA- 2016/11/26 06:01 PMCR- 2016/04/20 CRDT- 2016/11/26 06:00 PHST- 2016/11/26 06:00 [entrez] PHST- 2016/11/26 06:00 [pubmed] PHST- 2016/11/26 06:01 [medline] PHST- 2016/04/20 00:00 [pmc-release] AID - 10.1186/s13054-016-1208-6 [pii] AID - 1208 [pii] AID - 10.1186/s13054-016-1208-6 [doi] PST - epublish SO - Crit Care. 2016 Apr 20;20(Suppl 2):94. doi: 10.1186/s13054-016-1208-6. PMID- 27797889 OWN - NLM STAT- MEDLINE DCOM- 20171201 LR - 20230813 IS - 1555-905X (Electronic) IS - 1555-9041 (Print) IS - 1555-9041 (Linking) VI - 11 IP - 11 DP - 2016 Nov 7 TI - Albuminuria Changes and Cardiovascular and Renal Outcomes in Type 1 Diabetes: The DCCT/EDIC Study. PG - 1969-1977 LID - 10.2215/CJN.02870316 [doi] AB - BACKGROUND AND OBJECTIVES: In trials of people with type 2 diabetes, albuminuria reduction with renin-angiotensin system inhibitors is associated with lower risks of cardiovascular events and CKD progression. We tested whether progression or remission of microalbuminuria is associated with cardiovascular and renal risk in a well characterized cohort of type 1 diabetes. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We studied 1441 participants in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications study. Albumin excretion rate (AER) was quantified annually or biennially for up to 30 years. For each participant, albuminuria status was defined over time as normoalbuminuria (AER continuously <30 mg/d), sustained microalbuminuria (AER, 30-299 mg/d on two consecutive visits), macroalbuminuria (AER>/=300 mg/d), or remitted microalbuminuria (transition from sustained microalbuminuria to AER<30 mg/d on two consecutive visits). We tested associations of time-updated albuminuria status with adjudicated clinical cardiovascular events, the development of reduced GFR (<60 ml/min per 1.73 m(2) on two consecutive visits), and subclinical cardiovascular disease. RESULTS: At least one cardiovascular event occurred in 184 participants, and 98 participants developed reduced eGFR. Compared with normoalbuminuria, sustained microalbuminuria, remitted microalbuminuria, and macroalbuminuria were each associated with higher risk of cardiovascular events (adjusted hazard ratios [HRs] and 95% confidence intervals [95% CIs]: 1.79 [1.13 to 2.85], 2.62 [1.68 to 4.07], and 2.65 [1.68 to 4.19], respectively) and reduced eGFR (adjusted HRs [95% CIs], 5.26 [2.43 to 11.41], 4.36 [1.80 to 10.57], and 54.35 [30.79 to 95.94], respectively). Compared with sustained microalbuminuria, remission to normoalbuminuria was not associated with reduced risk of cardiovascular events (adjusted HR, 1.33; 95% CI, 0.68 to 2.59) or reduced eGFR (adjusted HR, 1.75; 95% CI, 0.56 to 5.49). Compared with normoalbuminuria, sustained microalbuminuria, remitted microalbuminuria, and macroalbuminuria were associated with greater carotid intima-media thickness, and macroalbuminuria was associated with a greater degree of coronary artery calcification. CONCLUSIONS: In type 1 diabetes, microalbuminuria and macroalbuminuria are associated with higher risks of cardiovascular disease and reduced eGFR, but achieving a remission of established microalbuminuria to normoalbuminuria does not appear to improve outcomes. CI - Copyright (c) 2016 by the American Society of Nephrology. FAU - de Boer, Ian H AU - de Boer IH AD - Division of Nephrology and Kidney Research Institute, University of Washington, Seattle, Washington. FAU - Gao, Xiaoyu AU - Gao X AD - Biostatistics Center, The George Washington University, Rockville, Maryland. FAU - Cleary, Patricia A AU - Cleary PA AD - Biostatistics Center, The George Washington University, Rockville, Maryland. FAU - Bebu, Ionut AU - Bebu I AD - Biostatistics Center, The George Washington University, Rockville, Maryland. FAU - Lachin, John M AU - Lachin JM AD - Division of Nephrology and Kidney Research Institute, University of Washington, Seattle, Washington. AD - Biostatistics Center, The George Washington University, Rockville, Maryland. AD - Division of Endocrinology, Metabolism & Molecular Medicine, Northwestern University, Chicago, Illinois. AD - Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania. AD - Dalla Lana School of Public Health, Hospital for Sick Children, Toronto, Ontario, Canada. AD - Division of Endocrinology and Metabolism, University of Toronto and University Health Network, Toronto, Ontario, Canada. AD - Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota; and. AD - Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada. FAU - Molitch, Mark E AU - Molitch ME AD - Division of Endocrinology, Metabolism & Molecular Medicine, Northwestern University, Chicago, Illinois. FAU - Orchard, Trevor AU - Orchard T AD - Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania. FAU - Paterson, Andrew D AU - Paterson AD AD - Dalla Lana School of Public Health, Hospital for Sick Children, Toronto, Ontario, Canada. FAU - Perkins, Bruce A AU - Perkins BA AD - Division of Endocrinology and Metabolism, University of Toronto and University Health Network, Toronto, Ontario, Canada. FAU - Steffes, Michael W AU - Steffes MW AD - Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota; and. FAU - Zinman, Bernard AU - Zinman B AD - Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada. CN - Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Research Group LA - eng SI - ClinicalTrials.gov/NCT00360893 SI - ClinicalTrials.gov/NCT00360815 GR - U01 DK094157/DK/NIDDK NIH HHS/United States GR - U01 DK094176/DK/NIDDK NIH HHS/United States GR - R01 DK088762/DK/NIDDK NIH HHS/United States GR - R01 DK087726/DK/NIDDK NIH HHS/United States GR - P30 DK017047/DK/NIDDK NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural DEP - 20161024 PL - United States TA - Clin J Am Soc Nephrol JT - Clinical journal of the American Society of Nephrology : CJASN JID - 101271570 SB - IM CIN - Clin J Am Soc Nephrol. 2016 Nov 7;11(11):1921-1923. doi: 10.2215/CJN.09540916. PMID: 27797905 MH - Adult MH - Albuminuria/*urine MH - Angina Pectoris/epidemiology MH - Cardiovascular Diseases/*epidemiology/mortality MH - Carotid Intima-Media Thickness MH - Coronary Artery Disease/epidemiology MH - Diabetes Mellitus, Type 1/drug therapy/*epidemiology MH - Female MH - Follow-Up Studies MH - Glomerular Filtration Rate MH - Humans MH - Male MH - Middle Aged MH - Myocardial Infarction/epidemiology MH - Percutaneous Coronary Intervention/statistics & numerical data MH - Randomized Controlled Trials as Topic MH - Renal Insufficiency, Chronic/*epidemiology MH - Stroke/epidemiology MH - Vascular Calcification/*epidemiology MH - Young Adult PMC - PMC5108190 OTO - NOTNLM OT - albumins OT - albuminuria OT - cardiovascular disease OT - cardiovascular diseases OT - carotid intima-media thickness OT - chronic kidney disease OT - coronary vessels OT - diabetes OT - diabetes mellitus, type 1 OT - diabetes mellitus, type 2 OT - disease progression OT - kidney OT - progression of chronic renal failure OT - renin-angiotensin system OT - risk EDAT- 2016/11/01 06:00 MHDA- 2017/12/02 06:00 PMCR- 2017/11/07 CRDT- 2016/11/01 06:00 PHST- 2016/03/14 00:00 [received] PHST- 2016/07/14 00:00 [accepted] PHST- 2016/11/01 06:00 [pubmed] PHST- 2017/12/02 06:00 [medline] PHST- 2016/11/01 06:00 [entrez] PHST- 2017/11/07 00:00 [pmc-release] AID - 01277230-201611000-00010 [pii] AID - 02870316 [pii] AID - 10.2215/CJN.02870316 [doi] PST - ppublish SO - Clin J Am Soc Nephrol. 2016 Nov 7;11(11):1969-1977. doi: 10.2215/CJN.02870316. Epub 2016 Oct 24. PMID- 27771985 OWN - NLM STAT- MEDLINE DCOM- 20170103 LR - 20260518 IS - 1533-4406 (Electronic) IS - 0028-4793 (Linking) VI - 375 IP - 24 DP - 2016 Dec 15 TI - Five-Year Outcomes after Off-Pump or On-Pump Coronary-Artery Bypass Grafting. PG - 2359-2368 AB - BACKGROUND: We previously reported that there was no significant difference at 30 days or at 1 year in the rate of the composite outcome of death, stroke, myocardial infarction, or renal failure between patients who underwent coronary-artery bypass grafting (CABG) performed with a beating-heart technique (off-pump) and those who underwent CABG performed with cardiopulmonary bypass (on-pump). We now report the results at 5 years (the end of the trial). METHODS: A total of 4752 patients (from 19 countries) who had coronary artery disease were randomly assigned to undergo off-pump or on-pump CABG. For this report, we analyzed a composite outcome of death, stroke, myocardial infarction, renal failure, or repeat coronary revascularization (either CABG or percutaneous coronary intervention). The mean follow-up period was 4.8 years. RESULTS: There were no significant differences between the off-pump group and the on-pump group in the rate of the composite outcome (23.1% and 23.6%, respectively; hazard ratio with off-pump CABG, 0.98; 95% confidence interval [CI], 0.87 to 1.10; P=0.72) or in the rates of the components of the outcome, including repeat coronary revascularization, which was performed in 2.8% of the patients in the off-pump group and in 2.3% of the patients in the on-pump group (hazard ratio, 1.21; 95% CI, 0.85 to 1.73; P=0.29). The secondary outcome for the overall period of the trial - the mean cost in U.S. dollars per patient - also did not differ significantly between the off-pump group and the on-pump group ($15,107 and $14,992, respectively; between-group difference, $115; 95% CI, -$697 to $927). There were no significant between-group differences in quality-of-life measures. CONCLUSIONS: In our trial, the rate of the composite outcome of death, stroke, myocardial infarction, renal failure, or repeat revascularization at 5 years of follow-up was similar among patients who underwent off-pump CABG and those who underwent on-pump CABG. (Funded by the Canadian Institutes of Health Research; CORONARY ClinicalTrials.gov number, NCT00463294 .). FAU - Lamy, Andre AU - Lamy A AD - From the Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, ON (A.L., P.J.D., R.P.W., Y.O., P.G., S.P., S.Y.), Centre Hospitalier de l'Universite de Montreal, Montreal (N.N.), and the University of Calgary, Calgary, AB (R.J.N.) - all in Canada; the Center for Chronic Disease Control, Gurgaon (D.P.), SAL Hospital, Ahmedabad (A.R.J.), G. Kuppuswamy Naidu Memorial Hospital, Coimbatore (C.P.), and All India Institute of Medical Sciences, New Delhi (B.A.) - all in India; the University of Oxford, Oxford, United Kingdom (D.P.T.); Fu Wai Cardiovascular Hospital, Xicheng District, Beijing (S.H.), and Wuhan Asia Heart Hospital, Wuhan (L.T.) - both in China; Third Faculty of Medicine Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic (Z.S.); Instituto Dante Pazzanese de Cardiologia, Sao Paulo (L.S.P., A.A.); Ankara University School of Medicine, Ankara, Turkey (A.R.A.); Hospital Regional de Temuco and Universidad de la Frontera, Temuco, Chile (F.L.Z., J.-C.B.); Fundacion Medica de Rio Negro y Neuquen, Rio Negro, Argentina (P.A.O.); and North Estonia Medical Center, Tallinn, Estonia (T.-A.S.). FAU - Devereaux, P J AU - Devereaux PJ AD - From the Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, ON (A.L., P.J.D., R.P.W., Y.O., P.G., S.P., S.Y.), Centre Hospitalier de l'Universite de Montreal, Montreal (N.N.), and the University of Calgary, Calgary, AB (R.J.N.) - all in Canada; the Center for Chronic Disease Control, Gurgaon (D.P.), SAL Hospital, Ahmedabad (A.R.J.), G. Kuppuswamy Naidu Memorial Hospital, Coimbatore (C.P.), and All India Institute of Medical Sciences, New Delhi (B.A.) - all in India; the University of Oxford, Oxford, United Kingdom (D.P.T.); Fu Wai Cardiovascular Hospital, Xicheng District, Beijing (S.H.), and Wuhan Asia Heart Hospital, Wuhan (L.T.) - both in China; Third Faculty of Medicine Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic (Z.S.); Instituto Dante Pazzanese de Cardiologia, Sao Paulo (L.S.P., A.A.); Ankara University School of Medicine, Ankara, Turkey (A.R.A.); Hospital Regional de Temuco and Universidad de la Frontera, Temuco, Chile (F.L.Z., J.-C.B.); Fundacion Medica de Rio Negro y Neuquen, Rio Negro, Argentina (P.A.O.); and North Estonia Medical Center, Tallinn, Estonia (T.-A.S.). FAU - Prabhakaran, Dorairaj AU - Prabhakaran D AD - From the Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, ON (A.L., P.J.D., R.P.W., Y.O., P.G., S.P., S.Y.), Centre Hospitalier de l'Universite de Montreal, Montreal (N.N.), and the University of Calgary, Calgary, AB (R.J.N.) - all in Canada; the Center for Chronic Disease Control, Gurgaon (D.P.), SAL Hospital, Ahmedabad (A.R.J.), G. Kuppuswamy Naidu Memorial Hospital, Coimbatore (C.P.), and All India Institute of Medical Sciences, New Delhi (B.A.) - all in India; the University of Oxford, Oxford, United Kingdom (D.P.T.); Fu Wai Cardiovascular Hospital, Xicheng District, Beijing (S.H.), and Wuhan Asia Heart Hospital, Wuhan (L.T.) - both in China; Third Faculty of Medicine Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic (Z.S.); Instituto Dante Pazzanese de Cardiologia, Sao Paulo (L.S.P., A.A.); Ankara University School of Medicine, Ankara, Turkey (A.R.A.); Hospital Regional de Temuco and Universidad de la Frontera, Temuco, Chile (F.L.Z., J.-C.B.); Fundacion Medica de Rio Negro y Neuquen, Rio Negro, Argentina (P.A.O.); and North Estonia Medical Center, Tallinn, Estonia (T.-A.S.). FAU - Taggart, David P AU - Taggart DP AD - From the Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, ON (A.L., P.J.D., R.P.W., Y.O., P.G., S.P., S.Y.), Centre Hospitalier de l'Universite de Montreal, Montreal (N.N.), and the University of Calgary, Calgary, AB (R.J.N.) - all in Canada; the Center for Chronic Disease Control, Gurgaon (D.P.), SAL Hospital, Ahmedabad (A.R.J.), G. Kuppuswamy Naidu Memorial Hospital, Coimbatore (C.P.), and All India Institute of Medical Sciences, New Delhi (B.A.) - all in India; the University of Oxford, Oxford, United Kingdom (D.P.T.); Fu Wai Cardiovascular Hospital, Xicheng District, Beijing (S.H.), and Wuhan Asia Heart Hospital, Wuhan (L.T.) - both in China; Third Faculty of Medicine Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic (Z.S.); Instituto Dante Pazzanese de Cardiologia, Sao Paulo (L.S.P., A.A.); Ankara University School of Medicine, Ankara, Turkey (A.R.A.); Hospital Regional de Temuco and Universidad de la Frontera, Temuco, Chile (F.L.Z., J.-C.B.); Fundacion Medica de Rio Negro y Neuquen, Rio Negro, Argentina (P.A.O.); and North Estonia Medical Center, Tallinn, Estonia (T.-A.S.). FAU - Hu, Shengshou AU - Hu S AD - From the Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, ON (A.L., P.J.D., R.P.W., Y.O., P.G., S.P., S.Y.), Centre Hospitalier de l'Universite de Montreal, Montreal (N.N.), and the University of Calgary, Calgary, AB (R.J.N.) - all in Canada; the Center for Chronic Disease Control, Gurgaon (D.P.), SAL Hospital, Ahmedabad (A.R.J.), G. Kuppuswamy Naidu Memorial Hospital, Coimbatore (C.P.), and All India Institute of Medical Sciences, New Delhi (B.A.) - all in India; the University of Oxford, Oxford, United Kingdom (D.P.T.); Fu Wai Cardiovascular Hospital, Xicheng District, Beijing (S.H.), and Wuhan Asia Heart Hospital, Wuhan (L.T.) - both in China; Third Faculty of Medicine Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic (Z.S.); Instituto Dante Pazzanese de Cardiologia, Sao Paulo (L.S.P., A.A.); Ankara University School of Medicine, Ankara, Turkey (A.R.A.); Hospital Regional de Temuco and Universidad de la Frontera, Temuco, Chile (F.L.Z., J.-C.B.); Fundacion Medica de Rio Negro y Neuquen, Rio Negro, Argentina (P.A.O.); and North Estonia Medical Center, Tallinn, Estonia (T.-A.S.). FAU - Straka, Zbynek AU - Straka Z AD - From the Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, ON (A.L., P.J.D., R.P.W., Y.O., P.G., S.P., S.Y.), Centre Hospitalier de l'Universite de Montreal, Montreal (N.N.), and the University of Calgary, Calgary, AB (R.J.N.) - all in Canada; the Center for Chronic Disease Control, Gurgaon (D.P.), SAL Hospital, Ahmedabad (A.R.J.), G. Kuppuswamy Naidu Memorial Hospital, Coimbatore (C.P.), and All India Institute of Medical Sciences, New Delhi (B.A.) - all in India; the University of Oxford, Oxford, United Kingdom (D.P.T.); Fu Wai Cardiovascular Hospital, Xicheng District, Beijing (S.H.), and Wuhan Asia Heart Hospital, Wuhan (L.T.) - both in China; Third Faculty of Medicine Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic (Z.S.); Instituto Dante Pazzanese de Cardiologia, Sao Paulo (L.S.P., A.A.); Ankara University School of Medicine, Ankara, Turkey (A.R.A.); Hospital Regional de Temuco and Universidad de la Frontera, Temuco, Chile (F.L.Z., J.-C.B.); Fundacion Medica de Rio Negro y Neuquen, Rio Negro, Argentina (P.A.O.); and North Estonia Medical Center, Tallinn, Estonia (T.-A.S.). FAU - Piegas, Leopoldo S AU - Piegas LS AD - From the Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, ON (A.L., P.J.D., R.P.W., Y.O., P.G., S.P., S.Y.), Centre Hospitalier de l'Universite de Montreal, Montreal (N.N.), and the University of Calgary, Calgary, AB (R.J.N.) - all in Canada; the Center for Chronic Disease Control, Gurgaon (D.P.), SAL Hospital, Ahmedabad (A.R.J.), G. Kuppuswamy Naidu Memorial Hospital, Coimbatore (C.P.), and All India Institute of Medical Sciences, New Delhi (B.A.) - all in India; the University of Oxford, Oxford, United Kingdom (D.P.T.); Fu Wai Cardiovascular Hospital, Xicheng District, Beijing (S.H.), and Wuhan Asia Heart Hospital, Wuhan (L.T.) - both in China; Third Faculty of Medicine Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic (Z.S.); Instituto Dante Pazzanese de Cardiologia, Sao Paulo (L.S.P., A.A.); Ankara University School of Medicine, Ankara, Turkey (A.R.A.); Hospital Regional de Temuco and Universidad de la Frontera, Temuco, Chile (F.L.Z., J.-C.B.); Fundacion Medica de Rio Negro y Neuquen, Rio Negro, Argentina (P.A.O.); and North Estonia Medical Center, Tallinn, Estonia (T.-A.S.). FAU - Avezum, Alvaro AU - Avezum A AD - From the Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, ON (A.L., P.J.D., R.P.W., Y.O., P.G., S.P., S.Y.), Centre Hospitalier de l'Universite de Montreal, Montreal (N.N.), and the University of Calgary, Calgary, AB (R.J.N.) - all in Canada; the Center for Chronic Disease Control, Gurgaon (D.P.), SAL Hospital, Ahmedabad (A.R.J.), G. Kuppuswamy Naidu Memorial Hospital, Coimbatore (C.P.), and All India Institute of Medical Sciences, New Delhi (B.A.) - all in India; the University of Oxford, Oxford, United Kingdom (D.P.T.); Fu Wai Cardiovascular Hospital, Xicheng District, Beijing (S.H.), and Wuhan Asia Heart Hospital, Wuhan (L.T.) - both in China; Third Faculty of Medicine Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic (Z.S.); Instituto Dante Pazzanese de Cardiologia, Sao Paulo (L.S.P., A.A.); Ankara University School of Medicine, Ankara, Turkey (A.R.A.); Hospital Regional de Temuco and Universidad de la Frontera, Temuco, Chile (F.L.Z., J.-C.B.); Fundacion Medica de Rio Negro y Neuquen, Rio Negro, Argentina (P.A.O.); and North Estonia Medical Center, Tallinn, Estonia (T.-A.S.). FAU - Akar, Ahmet R AU - Akar AR AD - From the Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, ON (A.L., P.J.D., R.P.W., Y.O., P.G., S.P., S.Y.), Centre Hospitalier de l'Universite de Montreal, Montreal (N.N.), and the University of Calgary, Calgary, AB (R.J.N.) - all in Canada; the Center for Chronic Disease Control, Gurgaon (D.P.), SAL Hospital, Ahmedabad (A.R.J.), G. Kuppuswamy Naidu Memorial Hospital, Coimbatore (C.P.), and All India Institute of Medical Sciences, New Delhi (B.A.) - all in India; the University of Oxford, Oxford, United Kingdom (D.P.T.); Fu Wai Cardiovascular Hospital, Xicheng District, Beijing (S.H.), and Wuhan Asia Heart Hospital, Wuhan (L.T.) - both in China; Third Faculty of Medicine Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic (Z.S.); Instituto Dante Pazzanese de Cardiologia, Sao Paulo (L.S.P., A.A.); Ankara University School of Medicine, Ankara, Turkey (A.R.A.); Hospital Regional de Temuco and Universidad de la Frontera, Temuco, Chile (F.L.Z., J.-C.B.); Fundacion Medica de Rio Negro y Neuquen, Rio Negro, Argentina (P.A.O.); and North Estonia Medical Center, Tallinn, Estonia (T.-A.S.). FAU - Lanas Zanetti, Fernando AU - Lanas Zanetti F AD - From the Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, ON (A.L., P.J.D., R.P.W., Y.O., P.G., S.P., S.Y.), Centre Hospitalier de l'Universite de Montreal, Montreal (N.N.), and the University of Calgary, Calgary, AB (R.J.N.) - all in Canada; the Center for Chronic Disease Control, Gurgaon (D.P.), SAL Hospital, Ahmedabad (A.R.J.), G. Kuppuswamy Naidu Memorial Hospital, Coimbatore (C.P.), and All India Institute of Medical Sciences, New Delhi (B.A.) - all in India; the University of Oxford, Oxford, United Kingdom (D.P.T.); Fu Wai Cardiovascular Hospital, Xicheng District, Beijing (S.H.), and Wuhan Asia Heart Hospital, Wuhan (L.T.) - both in China; Third Faculty of Medicine Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic (Z.S.); Instituto Dante Pazzanese de Cardiologia, Sao Paulo (L.S.P., A.A.); Ankara University School of Medicine, Ankara, Turkey (A.R.A.); Hospital Regional de Temuco and Universidad de la Frontera, Temuco, Chile (F.L.Z., J.-C.B.); Fundacion Medica de Rio Negro y Neuquen, Rio Negro, Argentina (P.A.O.); and North Estonia Medical Center, Tallinn, Estonia (T.-A.S.). FAU - Jain, Anil R AU - Jain AR AD - From the Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, ON (A.L., P.J.D., R.P.W., Y.O., P.G., S.P., S.Y.), Centre Hospitalier de l'Universite de Montreal, Montreal (N.N.), and the University of Calgary, Calgary, AB (R.J.N.) - all in Canada; the Center for Chronic Disease Control, Gurgaon (D.P.), SAL Hospital, Ahmedabad (A.R.J.), G. Kuppuswamy Naidu Memorial Hospital, Coimbatore (C.P.), and All India Institute of Medical Sciences, New Delhi (B.A.) - all in India; the University of Oxford, Oxford, United Kingdom (D.P.T.); Fu Wai Cardiovascular Hospital, Xicheng District, Beijing (S.H.), and Wuhan Asia Heart Hospital, Wuhan (L.T.) - both in China; Third Faculty of Medicine Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic (Z.S.); Instituto Dante Pazzanese de Cardiologia, Sao Paulo (L.S.P., A.A.); Ankara University School of Medicine, Ankara, Turkey (A.R.A.); Hospital Regional de Temuco and Universidad de la Frontera, Temuco, Chile (F.L.Z., J.-C.B.); Fundacion Medica de Rio Negro y Neuquen, Rio Negro, Argentina (P.A.O.); and North Estonia Medical Center, Tallinn, Estonia (T.-A.S.). FAU - Noiseux, Nicolas AU - Noiseux N AD - From the Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, ON (A.L., P.J.D., R.P.W., Y.O., P.G., S.P., S.Y.), Centre Hospitalier de l'Universite de Montreal, Montreal (N.N.), and the University of Calgary, Calgary, AB (R.J.N.) - all in Canada; the Center for Chronic Disease Control, Gurgaon (D.P.), SAL Hospital, Ahmedabad (A.R.J.), G. Kuppuswamy Naidu Memorial Hospital, Coimbatore (C.P.), and All India Institute of Medical Sciences, New Delhi (B.A.) - all in India; the University of Oxford, Oxford, United Kingdom (D.P.T.); Fu Wai Cardiovascular Hospital, Xicheng District, Beijing (S.H.), and Wuhan Asia Heart Hospital, Wuhan (L.T.) - both in China; Third Faculty of Medicine Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic (Z.S.); Instituto Dante Pazzanese de Cardiologia, Sao Paulo (L.S.P., A.A.); Ankara University School of Medicine, Ankara, Turkey (A.R.A.); Hospital Regional de Temuco and Universidad de la Frontera, Temuco, Chile (F.L.Z., J.-C.B.); Fundacion Medica de Rio Negro y Neuquen, Rio Negro, Argentina (P.A.O.); and North Estonia Medical Center, Tallinn, Estonia (T.-A.S.). FAU - Padmanabhan, Chandrasekar AU - Padmanabhan C AD - From the Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, ON (A.L., P.J.D., R.P.W., Y.O., P.G., S.P., S.Y.), Centre Hospitalier de l'Universite de Montreal, Montreal (N.N.), and the University of Calgary, Calgary, AB (R.J.N.) - all in Canada; the Center for Chronic Disease Control, Gurgaon (D.P.), SAL Hospital, Ahmedabad (A.R.J.), G. Kuppuswamy Naidu Memorial Hospital, Coimbatore (C.P.), and All India Institute of Medical Sciences, New Delhi (B.A.) - all in India; the University of Oxford, Oxford, United Kingdom (D.P.T.); Fu Wai Cardiovascular Hospital, Xicheng District, Beijing (S.H.), and Wuhan Asia Heart Hospital, Wuhan (L.T.) - both in China; Third Faculty of Medicine Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic (Z.S.); Instituto Dante Pazzanese de Cardiologia, Sao Paulo (L.S.P., A.A.); Ankara University School of Medicine, Ankara, Turkey (A.R.A.); Hospital Regional de Temuco and Universidad de la Frontera, Temuco, Chile (F.L.Z., J.-C.B.); Fundacion Medica de Rio Negro y Neuquen, Rio Negro, Argentina (P.A.O.); and North Estonia Medical Center, Tallinn, Estonia (T.-A.S.). FAU - Bahamondes, Juan-Carlos AU - Bahamondes JC AD - From the Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, ON (A.L., P.J.D., R.P.W., Y.O., P.G., S.P., S.Y.), Centre Hospitalier de l'Universite de Montreal, Montreal (N.N.), and the University of Calgary, Calgary, AB (R.J.N.) - all in Canada; the Center for Chronic Disease Control, Gurgaon (D.P.), SAL Hospital, Ahmedabad (A.R.J.), G. Kuppuswamy Naidu Memorial Hospital, Coimbatore (C.P.), and All India Institute of Medical Sciences, New Delhi (B.A.) - all in India; the University of Oxford, Oxford, United Kingdom (D.P.T.); Fu Wai Cardiovascular Hospital, Xicheng District, Beijing (S.H.), and Wuhan Asia Heart Hospital, Wuhan (L.T.) - both in China; Third Faculty of Medicine Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic (Z.S.); Instituto Dante Pazzanese de Cardiologia, Sao Paulo (L.S.P., A.A.); Ankara University School of Medicine, Ankara, Turkey (A.R.A.); Hospital Regional de Temuco and Universidad de la Frontera, Temuco, Chile (F.L.Z., J.-C.B.); Fundacion Medica de Rio Negro y Neuquen, Rio Negro, Argentina (P.A.O.); and North Estonia Medical Center, Tallinn, Estonia (T.-A.S.). FAU - Novick, Richard J AU - Novick RJ AD - From the Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, ON (A.L., P.J.D., R.P.W., Y.O., P.G., S.P., S.Y.), Centre Hospitalier de l'Universite de Montreal, Montreal (N.N.), and the University of Calgary, Calgary, AB (R.J.N.) - all in Canada; the Center for Chronic Disease Control, Gurgaon (D.P.), SAL Hospital, Ahmedabad (A.R.J.), G. Kuppuswamy Naidu Memorial Hospital, Coimbatore (C.P.), and All India Institute of Medical Sciences, New Delhi (B.A.) - all in India; the University of Oxford, Oxford, United Kingdom (D.P.T.); Fu Wai Cardiovascular Hospital, Xicheng District, Beijing (S.H.), and Wuhan Asia Heart Hospital, Wuhan (L.T.) - both in China; Third Faculty of Medicine Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic (Z.S.); Instituto Dante Pazzanese de Cardiologia, Sao Paulo (L.S.P., A.A.); Ankara University School of Medicine, Ankara, Turkey (A.R.A.); Hospital Regional de Temuco and Universidad de la Frontera, Temuco, Chile (F.L.Z., J.-C.B.); Fundacion Medica de Rio Negro y Neuquen, Rio Negro, Argentina (P.A.O.); and North Estonia Medical Center, Tallinn, Estonia (T.-A.S.). FAU - Tao, Liang AU - Tao L AD - From the Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, ON (A.L., P.J.D., R.P.W., Y.O., P.G., S.P., S.Y.), Centre Hospitalier de l'Universite de Montreal, Montreal (N.N.), and the University of Calgary, Calgary, AB (R.J.N.) - all in Canada; the Center for Chronic Disease Control, Gurgaon (D.P.), SAL Hospital, Ahmedabad (A.R.J.), G. Kuppuswamy Naidu Memorial Hospital, Coimbatore (C.P.), and All India Institute of Medical Sciences, New Delhi (B.A.) - all in India; the University of Oxford, Oxford, United Kingdom (D.P.T.); Fu Wai Cardiovascular Hospital, Xicheng District, Beijing (S.H.), and Wuhan Asia Heart Hospital, Wuhan (L.T.) - both in China; Third Faculty of Medicine Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic (Z.S.); Instituto Dante Pazzanese de Cardiologia, Sao Paulo (L.S.P., A.A.); Ankara University School of Medicine, Ankara, Turkey (A.R.A.); Hospital Regional de Temuco and Universidad de la Frontera, Temuco, Chile (F.L.Z., J.-C.B.); Fundacion Medica de Rio Negro y Neuquen, Rio Negro, Argentina (P.A.O.); and North Estonia Medical Center, Tallinn, Estonia (T.-A.S.). FAU - Olavegogeascoechea, Pablo A AU - Olavegogeascoechea PA AD - From the Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, ON (A.L., P.J.D., R.P.W., Y.O., P.G., S.P., S.Y.), Centre Hospitalier de l'Universite de Montreal, Montreal (N.N.), and the University of Calgary, Calgary, AB (R.J.N.) - all in Canada; the Center for Chronic Disease Control, Gurgaon (D.P.), SAL Hospital, Ahmedabad (A.R.J.), G. Kuppuswamy Naidu Memorial Hospital, Coimbatore (C.P.), and All India Institute of Medical Sciences, New Delhi (B.A.) - all in India; the University of Oxford, Oxford, United Kingdom (D.P.T.); Fu Wai Cardiovascular Hospital, Xicheng District, Beijing (S.H.), and Wuhan Asia Heart Hospital, Wuhan (L.T.) - both in China; Third Faculty of Medicine Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic (Z.S.); Instituto Dante Pazzanese de Cardiologia, Sao Paulo (L.S.P., A.A.); Ankara University School of Medicine, Ankara, Turkey (A.R.A.); Hospital Regional de Temuco and Universidad de la Frontera, Temuco, Chile (F.L.Z., J.-C.B.); Fundacion Medica de Rio Negro y Neuquen, Rio Negro, Argentina (P.A.O.); and North Estonia Medical Center, Tallinn, Estonia (T.-A.S.). FAU - Airan, Balram AU - Airan B AD - From the Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, ON (A.L., P.J.D., R.P.W., Y.O., P.G., S.P., S.Y.), Centre Hospitalier de l'Universite de Montreal, Montreal (N.N.), and the University of Calgary, Calgary, AB (R.J.N.) - all in Canada; the Center for Chronic Disease Control, Gurgaon (D.P.), SAL Hospital, Ahmedabad (A.R.J.), G. Kuppuswamy Naidu Memorial Hospital, Coimbatore (C.P.), and All India Institute of Medical Sciences, New Delhi (B.A.) - all in India; the University of Oxford, Oxford, United Kingdom (D.P.T.); Fu Wai Cardiovascular Hospital, Xicheng District, Beijing (S.H.), and Wuhan Asia Heart Hospital, Wuhan (L.T.) - both in China; Third Faculty of Medicine Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic (Z.S.); Instituto Dante Pazzanese de Cardiologia, Sao Paulo (L.S.P., A.A.); Ankara University School of Medicine, Ankara, Turkey (A.R.A.); Hospital Regional de Temuco and Universidad de la Frontera, Temuco, Chile (F.L.Z., J.-C.B.); Fundacion Medica de Rio Negro y Neuquen, Rio Negro, Argentina (P.A.O.); and North Estonia Medical Center, Tallinn, Estonia (T.-A.S.). FAU - Sulling, Toomas-Andres AU - Sulling TA AD - From the Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, ON (A.L., P.J.D., R.P.W., Y.O., P.G., S.P., S.Y.), Centre Hospitalier de l'Universite de Montreal, Montreal (N.N.), and the University of Calgary, Calgary, AB (R.J.N.) - all in Canada; the Center for Chronic Disease Control, Gurgaon (D.P.), SAL Hospital, Ahmedabad (A.R.J.), G. Kuppuswamy Naidu Memorial Hospital, Coimbatore (C.P.), and All India Institute of Medical Sciences, New Delhi (B.A.) - all in India; the University of Oxford, Oxford, United Kingdom (D.P.T.); Fu Wai Cardiovascular Hospital, Xicheng District, Beijing (S.H.), and Wuhan Asia Heart Hospital, Wuhan (L.T.) - both in China; Third Faculty of Medicine Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic (Z.S.); Instituto Dante Pazzanese de Cardiologia, Sao Paulo (L.S.P., A.A.); Ankara University School of Medicine, Ankara, Turkey (A.R.A.); Hospital Regional de Temuco and Universidad de la Frontera, Temuco, Chile (F.L.Z., J.-C.B.); Fundacion Medica de Rio Negro y Neuquen, Rio Negro, Argentina (P.A.O.); and North Estonia Medical Center, Tallinn, Estonia (T.-A.S.). FAU - Whitlock, Richard P AU - Whitlock RP AD - From the Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, ON (A.L., P.J.D., R.P.W., Y.O., P.G., S.P., S.Y.), Centre Hospitalier de l'Universite de Montreal, Montreal (N.N.), and the University of Calgary, Calgary, AB (R.J.N.) - all in Canada; the Center for Chronic Disease Control, Gurgaon (D.P.), SAL Hospital, Ahmedabad (A.R.J.), G. Kuppuswamy Naidu Memorial Hospital, Coimbatore (C.P.), and All India Institute of Medical Sciences, New Delhi (B.A.) - all in India; the University of Oxford, Oxford, United Kingdom (D.P.T.); Fu Wai Cardiovascular Hospital, Xicheng District, Beijing (S.H.), and Wuhan Asia Heart Hospital, Wuhan (L.T.) - both in China; Third Faculty of Medicine Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic (Z.S.); Instituto Dante Pazzanese de Cardiologia, Sao Paulo (L.S.P., A.A.); Ankara University School of Medicine, Ankara, Turkey (A.R.A.); Hospital Regional de Temuco and Universidad de la Frontera, Temuco, Chile (F.L.Z., J.-C.B.); Fundacion Medica de Rio Negro y Neuquen, Rio Negro, Argentina (P.A.O.); and North Estonia Medical Center, Tallinn, Estonia (T.-A.S.). FAU - Ou, Yongning AU - Ou Y AD - From the Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, ON (A.L., P.J.D., R.P.W., Y.O., P.G., S.P., S.Y.), Centre Hospitalier de l'Universite de Montreal, Montreal (N.N.), and the University of Calgary, Calgary, AB (R.J.N.) - all in Canada; the Center for Chronic Disease Control, Gurgaon (D.P.), SAL Hospital, Ahmedabad (A.R.J.), G. Kuppuswamy Naidu Memorial Hospital, Coimbatore (C.P.), and All India Institute of Medical Sciences, New Delhi (B.A.) - all in India; the University of Oxford, Oxford, United Kingdom (D.P.T.); Fu Wai Cardiovascular Hospital, Xicheng District, Beijing (S.H.), and Wuhan Asia Heart Hospital, Wuhan (L.T.) - both in China; Third Faculty of Medicine Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic (Z.S.); Instituto Dante Pazzanese de Cardiologia, Sao Paulo (L.S.P., A.A.); Ankara University School of Medicine, Ankara, Turkey (A.R.A.); Hospital Regional de Temuco and Universidad de la Frontera, Temuco, Chile (F.L.Z., J.-C.B.); Fundacion Medica de Rio Negro y Neuquen, Rio Negro, Argentina (P.A.O.); and North Estonia Medical Center, Tallinn, Estonia (T.-A.S.). FAU - Gao, Peggy AU - Gao P AD - From the Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, ON (A.L., P.J.D., R.P.W., Y.O., P.G., S.P., S.Y.), Centre Hospitalier de l'Universite de Montreal, Montreal (N.N.), and the University of Calgary, Calgary, AB (R.J.N.) - all in Canada; the Center for Chronic Disease Control, Gurgaon (D.P.), SAL Hospital, Ahmedabad (A.R.J.), G. Kuppuswamy Naidu Memorial Hospital, Coimbatore (C.P.), and All India Institute of Medical Sciences, New Delhi (B.A.) - all in India; the University of Oxford, Oxford, United Kingdom (D.P.T.); Fu Wai Cardiovascular Hospital, Xicheng District, Beijing (S.H.), and Wuhan Asia Heart Hospital, Wuhan (L.T.) - both in China; Third Faculty of Medicine Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic (Z.S.); Instituto Dante Pazzanese de Cardiologia, Sao Paulo (L.S.P., A.A.); Ankara University School of Medicine, Ankara, Turkey (A.R.A.); Hospital Regional de Temuco and Universidad de la Frontera, Temuco, Chile (F.L.Z., J.-C.B.); Fundacion Medica de Rio Negro y Neuquen, Rio Negro, Argentina (P.A.O.); and North Estonia Medical Center, Tallinn, Estonia (T.-A.S.). FAU - Pettit, Shirley AU - Pettit S AD - From the Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, ON (A.L., P.J.D., R.P.W., Y.O., P.G., S.P., S.Y.), Centre Hospitalier de l'Universite de Montreal, Montreal (N.N.), and the University of Calgary, Calgary, AB (R.J.N.) - all in Canada; the Center for Chronic Disease Control, Gurgaon (D.P.), SAL Hospital, Ahmedabad (A.R.J.), G. Kuppuswamy Naidu Memorial Hospital, Coimbatore (C.P.), and All India Institute of Medical Sciences, New Delhi (B.A.) - all in India; the University of Oxford, Oxford, United Kingdom (D.P.T.); Fu Wai Cardiovascular Hospital, Xicheng District, Beijing (S.H.), and Wuhan Asia Heart Hospital, Wuhan (L.T.) - both in China; Third Faculty of Medicine Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic (Z.S.); Instituto Dante Pazzanese de Cardiologia, Sao Paulo (L.S.P., A.A.); Ankara University School of Medicine, Ankara, Turkey (A.R.A.); Hospital Regional de Temuco and Universidad de la Frontera, Temuco, Chile (F.L.Z., J.-C.B.); Fundacion Medica de Rio Negro y Neuquen, Rio Negro, Argentina (P.A.O.); and North Estonia Medical Center, Tallinn, Estonia (T.-A.S.). FAU - Yusuf, Salim AU - Yusuf S AD - From the Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, ON (A.L., P.J.D., R.P.W., Y.O., P.G., S.P., S.Y.), Centre Hospitalier de l'Universite de Montreal, Montreal (N.N.), and the University of Calgary, Calgary, AB (R.J.N.) - all in Canada; the Center for Chronic Disease Control, Gurgaon (D.P.), SAL Hospital, Ahmedabad (A.R.J.), G. Kuppuswamy Naidu Memorial Hospital, Coimbatore (C.P.), and All India Institute of Medical Sciences, New Delhi (B.A.) - all in India; the University of Oxford, Oxford, United Kingdom (D.P.T.); Fu Wai Cardiovascular Hospital, Xicheng District, Beijing (S.H.), and Wuhan Asia Heart Hospital, Wuhan (L.T.) - both in China; Third Faculty of Medicine Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic (Z.S.); Instituto Dante Pazzanese de Cardiologia, Sao Paulo (L.S.P., A.A.); Ankara University School of Medicine, Ankara, Turkey (A.R.A.); Hospital Regional de Temuco and Universidad de la Frontera, Temuco, Chile (F.L.Z., J.-C.B.); Fundacion Medica de Rio Negro y Neuquen, Rio Negro, Argentina (P.A.O.); and North Estonia Medical Center, Tallinn, Estonia (T.-A.S.). CN - CORONARY Investigators LA - eng SI - ClinicalTrials.gov/NCT00463294 PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial DEP - 20161023 PL - United States TA - N Engl J Med JT - The New England journal of medicine JID - 0255562 SB - IM CIN - N Engl J Med. ;376(9):894. doi: 10.1056/NEJMc1700247. PMID: 28252267 CIN - Ann Transl Med. 2017 Mar;5(5):116. doi: 10.21037/atm.2017.01.51. PMID: 28361081 MH - Aged MH - Coronary Artery Bypass/economics/*methods MH - *Coronary Artery Bypass, Off-Pump MH - Coronary Artery Disease/mortality/surgery MH - Female MH - Follow-Up Studies MH - Humans MH - Kaplan-Meier Estimate MH - Male MH - Middle Aged MH - Myocardial Infarction/etiology MH - Postoperative Complications/epidemiology MH - Proportional Hazards Models MH - Quality of Life MH - Renal Insufficiency/etiology MH - Reoperation/statistics & numerical data MH - Stroke/etiology FIR - Cartier, R IR - Cartier R FIR - Chocron, S IR - Chocron S FIR - Fremes, S E IR - Fremes SE FIR - Lopez, P J IR - Lopez PJ FIR - Martinelli, L IR - Martinelli L FIR - Murkin, J IR - Murkin J FIR - Cairns, J A IR - Cairns JA FIR - Dagenais, F IR - Dagenais F FIR - Follmann, D IR - Follmann D FIR - Nathan, H J IR - Nathan HJ FIR - Silver, F L IR - Silver FL FIR - Fodor, G IR - Fodor G FIR - Belley-Cote, E IR - Belley-Cote E FIR - Duceppe, E IR - Duceppe E FIR - Hussain, S IR - Hussain S FIR - Bessissow, A IR - Bessissow A FIR - Khan, J IR - Khan J FIR - Robinson, L IR - Robinson L FIR - Miranda, T IR - Miranda T FIR - Vincent, J IR - Vincent J FIR - Abud, J A IR - Abud JA FIR - Cacheda, H IR - Cacheda H FIR - Casal, J P IR - Casal JP FIR - Escarain, M C IR - Escarain MC FIR - Favaloro, R R IR - Favaloro RR FIR - Ferrara, W D IR - Ferrara WD FIR - Giner, P E IR - Giner PE FIR - Girela, A G IR - Girela AG FIR - Quiroga, J M IR - Quiroga JM FIR - Raffaelli, H A IR - Raffaelli HA FIR - Valenzuela, G IR - Valenzuela G FIR - Bannon, P G IR - Bannon PG FIR - Vallely, M P IR - Vallely MP FIR - Braile, D M IR - Braile DM FIR - Buffolo, E IR - Buffolo E FIR - Chamlian, E G IR - Chamlian EG FIR - Costa, F D A IR - Costa FDA FIR - Ferreira, A D IR - Ferreira AD FIR - Oliveira, J B IR - Oliveira JB FIR - Oliveira Freitas, A C IR - Oliveira Freitas AC FIR - Stolf, N A IR - Stolf NA FIR - Guilhen, J C IR - Guilhen JC FIR - Hueb, W IR - Hueb W FIR - Leal, J C IR - Leal JC FIR - Lucchese, F A IR - Lucchese FA FIR - Penna, A C IR - Penna AC FIR - Pires, A C IR - Pires AC FIR - Rivetti, L A IR - Rivetti LA FIR - Rosler, A M IR - Rosler AM FIR - Vila Nova, D C IR - Vila Nova DC FIR - Basile, F IR - Basile F FIR - Bergeron, C IR - Bergeron C FIR - Cheung, A IR - Cheung A FIR - Chu, M W A IR - Chu MWA FIR - Cusimano, R J IR - Cusimano RJ FIR - Dyub, A IR - Dyub A FIR - Greentree, D M IR - Greentree DM FIR - Guo, L R IR - Guo LR FIR - Kiaii, B IR - Kiaii B FIR - Kieser, T M IR - Kieser TM FIR - Moussa, F IR - Moussa F FIR - Noora, J IR - Noora J FIR - Perrault, L P IR - Perrault LP FIR - Prieto, I IR - Prieto I FIR - Stevens, L M IR - Stevens LM FIR - Trombetta, L IR - Trombetta L FIR - Yau, T M IR - Yau TM FIR - Chen, X IR - Chen X FIR - Chen, X IR - Chen X FIR - Gao, C IR - Gao C FIR - Gao, J IR - Gao J FIR - Gu, S IR - Gu S FIR - Gu, T IR - Gu T FIR - Huang, H IR - Huang H FIR - Jiang, S IR - Jiang S FIR - Liu, G IR - Liu G FIR - Lv, F IR - Lv F FIR - Meng, X IR - Meng X FIR - Pan, X IR - Pan X FIR - Su, P IR - Su P FIR - Sun, X IR - Sun X FIR - Tan, L IR - Tan L FIR - Wang, C IR - Wang C FIR - Wang, C IR - Wang C FIR - Wang, R IR - Wang R FIR - Xue, S IR - Xue S FIR - Yang, J IR - Yang J FIR - Yi, D IR - Yi D FIR - Yu, H IR - Yu H FIR - Zhang, H IR - Zhang H FIR - Zhao, G IR - Zhao G FIR - Zhao, Q IR - Zhao Q FIR - Zheng, Z IR - Zheng Z FIR - Zhou, H IR - Zhou H FIR - Zhou, X IR - Zhou X FIR - Cadavid, E A IR - Cadavid EA FIR - Castillo, V R IR - Castillo VR FIR - Chalela, T IR - Chalela T FIR - Figueredo, A IR - Figueredo A FIR - Sandoval, N F IR - Sandoval NF FIR - Brat, R IR - Brat R FIR - Danek, T IR - Danek T FIR - Harrer, J IR - Harrer J FIR - Hlavicka, J IR - Hlavicka J FIR - Holubec, M IR - Holubec M FIR - Holubec, T IR - Holubec T FIR - Kraupnerova, A IR - Kraupnerova A FIR - Mikulenka, V IR - Mikulenka V FIR - Setina, M IR - Setina M FIR - Vanek, T IR - Vanek T FIR - Vik, K IR - Vik K FIR - Zacek, P IR - Zacek P FIR - Alver, M IR - Alver M FIR - Vahi, H IR - Vahi H FIR - Sulling, S IR - Sulling S FIR - Kaili, D IR - Kaili D FIR - Agarwal, S K IR - Agarwal SK FIR - Arunachalam, K V IR - Arunachalam KV FIR - Cherian, K IR - Cherian K FIR - Choudhary, S K IR - Choudhary SK FIR - Gokhale, A G IR - Gokhale AG FIR - Gupta, V M IR - Gupta VM FIR - Hote, M P IR - Hote MP FIR - Jose, R IR - Jose R FIR - Karthikeyan, G IR - Karthikeyan G FIR - Kaul, U IR - Kaul U FIR - Kodem, D IR - Kodem D FIR - Kumar, S IR - Kumar S FIR - Madathana Palli, G S IR - Madathana Palli GS FIR - Malempati, A R IR - Malempati AR FIR - Malipeddi, B R IR - Malipeddi BR FIR - Mishra, Y K IR - Mishra YK FIR - Padhy, K IR - Padhy K FIR - Pande, S IR - Pande S FIR - Pithva, V IR - Pithva V FIR - Ponangi, S V IR - Ponangi SV FIR - Reddy, S K IR - Reddy SK FIR - Reddy, N C IR - Reddy NC FIR - Saxena, A IR - Saxena A FIR - Shankar, B IR - Shankar B FIR - Shankar, A IR - Shankar A FIR - Shanmugam, M IR - Shanmugam M FIR - Sinha, N IR - Sinha N FIR - Srinivasan, M IR - Srinivasan M FIR - Thakor, A IR - Thakor A FIR - Vaijyanath, P IR - Vaijyanath P FIR - Varma, P K IR - Varma PK FIR - Vettath, M P IR - Vettath MP FIR - Singh, K IR - Singh K FIR - Devarajan, R IR - Devarajan R FIR - Agostini, M IR - Agostini M FIR - Passini, L IR - Passini L FIR - Pelenghi, S IR - Pelenghi S FIR - Bentala, M IR - Bentala M FIR - Arbeus, M J IR - Arbeus MJ FIR - De Souza, D R IR - De Souza DR FIR - Cakici, M IR - Cakici M FIR - Durdu, S IR - Durdu S FIR - Kaya, K IR - Kaya K FIR - Ozcinar, E IR - Ozcinar E FIR - Sener, E IR - Sener E FIR - Telli, A IR - Telli A FIR - Uguz, E IR - Uguz E FIR - Gogayeva, O IR - Gogayeva O FIR - Rudenko, A IR - Rudenko A FIR - Birdi, I J IR - Birdi IJ FIR - Godsell, K IR - Godsell K FIR - Ritchie, A J IR - Ritchie AJ FIR - Wallis, C M IR - Wallis CM FIR - Zamvar, V IR - Zamvar V FIR - Chafes, D IR - Chafes D FIR - Montana, O IR - Montana O FIR - Huang, K F IR - Huang KF FIR - Parvathaneni, S V IR - Parvathaneni SV EDAT- 2016/10/25 06:00 MHDA- 2017/01/04 06:00 CRDT- 2016/10/25 06:00 PHST- 2016/10/25 06:00 [pubmed] PHST- 2017/01/04 06:00 [medline] PHST- 2016/10/25 06:00 [entrez] AID - 10.1056/NEJMoa1601564 [doi] PST - ppublish SO - N Engl J Med. 2016 Dec 15;375(24):2359-2368. doi: 10.1056/NEJMoa1601564. Epub 2016 Oct 23. PMID- 27558882 OWN - NLM STAT- MEDLINE DCOM- 20170130 LR - 20260127 IS - 2186-1005 (Electronic) IS - 1341-1098 (Print) IS - 1341-1098 (Linking) VI - 22 IP - 5 DP - 2016 Oct 20 TI - Renin-Angiotensin System Control for Chronic Kidney Disease Patients Undergoing Coronary Surgery. PG - 291-297 AB - PURPOSE: We investigated the effectiveness of active renin-angiotensin-aldosterone system (RAAS) control with human atrial natriuretic peptide (hANP) and an angiotensin II receptor blocker (ARB) in patients with chronic kidney disease (CKD) undergoing coronary artery bypass grafting (CABG). METHODS: A total of 286 consecutive patients with CKD undergoing CABG were divided into three groups: Group C (n = 50) receiving placebo, the hANP group (n = 60) receiving hANP, and the active RAAS control therapy (ARC) group (n = 56) receiving hANP plus an ARB. Renal function, brain natriuretic peptide (BNP) and RAAS parameters were analyzed. RESULTS: After 1 year, renal function parameters were better in the hANP and ARC groups compared with group C, and the dialysis rate was significantly lower (group C: 12%, hANP group: 1.7%, ARC group: 1.8%, p = 0.018) in the hANP and ARC groups. BNP levels were significantly lower in the hANP and ARC groups compared with group C (p = 0.001). There was also a significant difference of aldosterone among the groups (p = 0.023), as well as a significant difference between group C and the ARC group (p = 0.017). CONCLUSIONS: The present study showed that active RAAS control preserved renal function in patients with CKD undergoing CABG. The improved early postoperative outcome with RAAS control may lead to long-term inhibition of cardiovascular events. FAU - Yoshitake, Isamu AU - Yoshitake I AD - Department of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo, Japan. FAU - Sezai, Akira AU - Sezai A FAU - Hata, Mitsumasa AU - Hata M FAU - Osaka, Shunji AU - Osaka S FAU - Kimura, Haruka AU - Kimura H FAU - Hata, Hiroaki AU - Hata H FAU - Shiono, Motomi AU - Shiono M LA - eng PT - Journal Article DEP - 20160823 PL - Japan TA - Ann Thorac Cardiovasc Surg JT - Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia JID - 9703158 RN - 0 (Angiotensin II Type 1 Receptor Blockers) RN - 85637-73-6 (Atrial Natriuretic Factor) SB - IM MH - Aged MH - Angiotensin II Type 1 Receptor Blockers/adverse effects/*therapeutic use MH - Atrial Natriuretic Factor/adverse effects/*therapeutic use MH - *Coronary Artery Bypass/adverse effects MH - Coronary Artery Disease/complications/diagnosis/physiopathology/*surgery MH - Databases, Factual MH - Female MH - Humans MH - Japan MH - Kidney/*drug effects/physiopathology MH - Male MH - Middle Aged MH - Randomized Controlled Trials as Topic MH - Renal Dialysis MH - Renal Insufficiency, Chronic/complications/diagnosis/*drug therapy/physiopathology MH - Renin-Angiotensin System/*drug effects MH - Time Factors MH - Treatment Outcome PMC - PMC5088394 EDAT- 2016/10/21 06:00 MHDA- 2017/01/31 06:00 PMCR- 2016/01/01 CRDT- 2016/08/26 06:00 PHST- 2016/10/21 06:00 [pubmed] PHST- 2017/01/31 06:00 [medline] PHST- 2016/08/26 06:00 [entrez] PHST- 2016/01/01 00:00 [pmc-release] AID - atcs.oa.16-00105 [pii] AID - 10.5761/atcs.oa.16-00105 [doi] PST - ppublish SO - Ann Thorac Cardiovasc Surg. 2016 Oct 20;22(5):291-297. doi: 10.5761/atcs.oa.16-00105. Epub 2016 Aug 23. PMID- 27753599 OWN - NLM STAT- MEDLINE DCOM- 20170726 LR - 20170817 IS - 1969-6213 (Electronic) IS - 1774-024X (Linking) VI - 12 IP - 9 DP - 2016 Oct 20 TI - External validity of a contemporaneous primary percutaneous coronary intervention trial in patients with acute ST-elevation myocardial infarction: insights from a single-centre investigation. PG - 1135-1143 LID - EIJV12I9A185 [pii] LID - 10.4244/EIJV12I9A185 [doi] AB - AIMS: Randomised controlled trials (RCTs) represent the most robust source of evidence-based medicine. However, the generalisability of RCTs is limited by the inclusion of selected populations. We sought to assess the external validity of a contemporary trial including patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). METHODS AND RESULTS: Patients presenting to Bern University Hospital during the inclusion period of the COMFORTABLE AMI trial were divided into three groups: RCT participants (41%), eligible not included (17.5%), and excluded patients (41.5%). Major adverse cardiac events (MACE) were defined as one-year death and myocardial infarction. RCT participants compared with RCT-eligible patients had comparable baseline characteristics and outcomes; however, excluded patients differed in risk and had higher rates of MACE (HR 3.63, 95% CI: 2.03-6.48, p<0.001), death (HR 6.23, 95% CI: 2.93-13.24, p<0,001) and definite/probable stent thrombosis (HR 3.63, 95% CI: 1.79-7.36, p<0.001). Inability to provide consent was the most frequent exclusion criterion and was independently associated with an increased risk for MACE (HR 6.85, 95% CI: 3.97-11.81, p<0.001). CONCLUSIONS: In this single-centre investigation, results from the COMFORTABLE AMI trial appeared applicable to a broad representation of RCT-eligible patients. However, patients excluded from the trial represented a higher-risk population with impaired clinical outcomes and a lower adherence to cardiovascular medication. FAU - Spitzer, Ernest AU - Spitzer E AD - Department of Cardiology, Bern University Hospital, Bern, Switzerland. FAU - Hadorn, Susanne AU - Hadorn S FAU - Zanchin, Thomas AU - Zanchin T FAU - Yamaji, Kyohei AU - Yamaji K FAU - Moschovitis, Aris AU - Moschovitis A FAU - Pilgrim, Thomas AU - Pilgrim T FAU - Stortecky, Stefan AU - Stortecky S FAU - Juni, Peter AU - Juni P FAU - Heg, Dik AU - Heg D FAU - Windecker, Stephan AU - Windecker S FAU - Raber, Lorenz AU - Raber L LA - eng PT - Journal Article PL - France TA - EuroIntervention JT - EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology JID - 101251040 RN - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors) RN - 0 (Platelet Aggregation Inhibitors) SB - IM MH - Aged MH - Aged, 80 and over MH - Cause of Death MH - Comorbidity MH - Eligibility Determination MH - Female MH - Humans MH - Hydroxymethylglutaryl-CoA Reductase Inhibitors/*therapeutic use MH - Logistic Models MH - Male MH - Middle Aged MH - Mortality MH - Myocardial Infarction/epidemiology MH - Percutaneous Coronary Intervention/*methods MH - Platelet Aggregation Inhibitors/*therapeutic use MH - Postoperative Care MH - Proportional Hazards Models MH - Randomized Controlled Trials as Topic MH - Recurrence MH - Renal Insufficiency/epidemiology MH - Reproducibility of Results MH - ST Elevation Myocardial Infarction/epidemiology/*therapy MH - Secondary Prevention MH - Treatment Outcome EDAT- 2016/10/19 06:00 MHDA- 2017/07/27 06:00 CRDT- 2016/10/19 06:00 PHST- 2016/10/19 06:00 [pubmed] PHST- 2017/07/27 06:00 [medline] PHST- 2016/10/19 06:00 [entrez] AID - EIJV12I9A185 [pii] AID - 10.4244/EIJV12I9A185 [doi] PST - ppublish SO - EuroIntervention. 2016 Oct 20;12(9):1135-1143. doi: 10.4244/EIJV12I9A185. PMID- 27723839 OWN - NLM STAT- MEDLINE DCOM- 20170502 LR - 20220310 IS - 1932-6203 (Electronic) IS - 1932-6203 (Linking) VI - 11 IP - 10 DP - 2016 TI - Remote Ischemic Preconditioning for the Prevention of Contrast-Induced Acute Kidney Injury in Diabetics Receiving Elective Percutaneous Coronary Intervention. PG - e0164256 LID - 10.1371/journal.pone.0164256 [doi] LID - e0164256 AB - OBJECTIVE: Remote ischemic preconditioning (RIPC) induces transient episodes of ischemia by the occlusion of blood flow in non-target tissue, before a subsequent ischemia-reperfusion injury. When RIPC is applied before percutaneous coronary intervention (PCI), the kidneys may be protected against ischemia-reperfusion injury and subsequently contrast-induced acute kidney injury (CI-AKI). The aim of this study was to evaluate the efficacy of RIPC for the prevention of CI-AKI in patients with diabetes with pre-existing chronic kidney disease (CKD) undergoing elective PCI. METHODS: This randomized, double-blind, sham-controlled study enrolled patients with diabetes scheduled for elective PCI with eGFR 300 mg/g to receive either RIPC or the sham ischemic preconditioning. RESULTS: One hundred and two patients (68.9 +/- 8.2 years old, 47.1% men) were included. Baseline eGFR, creatinine and serum NGAL was similar between RIPC and control groups (48.5 +/- 12 ml/min vs. 46.6 +/- 10 ml/min, p = 0.391; 1.42 +/- 0.58 mg/dl vs. 1.41 +/- 0.34 mg/dl, p = 0.924; and 136.0 +/- 45.0 ng/ml vs. 137.6 +/- 43.3 ng/ml, p = 0.961, respectively). CI-AKI occurred in 13.7% (14/102) of the total subjects, with both RIPC and control groups having an equal incidence of 13.7% (7/51). No significant differences were seen in creatinine, NGAL, cardiac enzymes (troponin T, CKMB) and hs-CRP between the groups post-procedure. CONCLUSIONS: In this study, RIPC applied prior to elective PCI was not effective in preventing CI-AKI in patients with diabetes with pre-existing CKD. TRIAL REGISTRATION: ClinicalTrials.gov NCT02329444. FAU - Balbir Singh, Gillian AU - Balbir Singh G AD - Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea. FAU - Ann, Soe Hee AU - Ann SH AD - Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea. FAU - Park, Jongha AU - Park J AD - Division of Nephrology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea. FAU - Chung, Hyun Chul AU - Chung HC AD - Division of Nephrology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea. FAU - Lee, Jong Soo AU - Lee JS AD - Division of Nephrology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea. FAU - Kim, Eun-Sook AU - Kim ES AD - Division of Endocrinology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea. FAU - Choi, Jung Il AU - Choi JI AD - Division of Endocrinology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea. FAU - Lee, Jiho AU - Lee J AD - Department of Occupational & Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea. FAU - Kim, Shin-Jae AU - Kim SJ AD - Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea. FAU - Shin, Eun-Seok AU - Shin ES AD - Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea. LA - eng SI - ClinicalTrials.gov/NCT02329444 PT - Journal Article PT - Randomized Controlled Trial DEP - 20161010 PL - United States TA - PLoS One JT - PloS one JID - 101285081 RN - 0 (Contrast Media) RN - 0 (Lipocalin-2) RN - 0 (Troponin T) RN - 9007-41-4 (C-Reactive Protein) RN - AYI8EX34EU (Creatinine) RN - EC 2.7.3.2 (Creatine Kinase, MB Form) SB - IM MH - Acute Kidney Injury/etiology/*prevention & control MH - Aged MH - C-Reactive Protein/analysis MH - Contrast Media/*adverse effects MH - Coronary Disease/therapy MH - Creatine Kinase, MB Form/blood MH - Creatinine/blood MH - Diabetes Mellitus, Type 2/*pathology MH - Double-Blind Method MH - Female MH - Glomerular Filtration Rate MH - Humans MH - *Ischemic Preconditioning MH - Kidney/blood supply MH - Lipocalin-2/blood MH - Male MH - Middle Aged MH - Percutaneous Coronary Intervention MH - Troponin T/blood PMC - PMC5056748 COIS- The authors have declared that no competing interests exist. EDAT- 2016/10/11 06:00 MHDA- 2017/05/04 06:00 PMCR- 2016/10/10 CRDT- 2016/10/11 06:00 PHST- 2016/06/09 00:00 [received] PHST- 2016/09/20 00:00 [accepted] PHST- 2016/10/11 06:00 [entrez] PHST- 2016/10/11 06:00 [pubmed] PHST- 2017/05/04 06:00 [medline] PHST- 2016/10/10 00:00 [pmc-release] AID - PONE-D-16-21851 [pii] AID - 10.1371/journal.pone.0164256 [doi] PST - epublish SO - PLoS One. 2016 Oct 10;11(10):e0164256. doi: 10.1371/journal.pone.0164256. eCollection 2016. PMID- 27677387 OWN - NLM STAT- MEDLINE DCOM- 20170427 LR - 20260127 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 118 IP - 10 DP - 2016 Nov 15 TI - Prognostic Value of the Thrombolysis in Myocardial Infarction Risk Score in ST-Elevation Myocardial Infarction Patients With Left Ventricular Dysfunction (from the EPHESUS Trial). PG - 1442-1447 LID - S0002-9149(16)31363-7 [pii] LID - 10.1016/j.amjcard.2016.08.004 [doi] AB - The Thrombolysis in Myocardial Infarction (TIMI) risk score remains a robust prediction tool for short-term and midterm outcome in the patients with ST-elevation myocardial infarction (STEMI). However, the validity of this risk score in patients with STEMI with reduced left ventricular ejection fraction (LVEF) remains unclear. A total of 2,854 patients with STEMI with early coronary revascularization participating in the randomized EPHESUS (Epleronone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study) trial were analyzed. TIMI risk score was calculated at baseline, and its predictive value was evaluated using C-indexes from Cox models. The increase in reclassification of other variables in addition to TIMI score was assessed using the net reclassification index. TIMI risk score had a poor predictive accuracy for all-cause mortality (C-index values at 30 days and 1 year 100 beats/min, and systolic blood pressure <100 mm Hg were inconsistently associated with survival, whereas none of the TIMI score items, aside from age, were significantly associated with MI recurrence. Using a constructed predictive model, lower LVEF, lower estimated glomerular filtration rate (eGFR), and previous MI were significantly associated with all-cause mortality. The predictive accuracy of this model, which included LVEF and eGFR, was fair for both 30-day and 1-year all-cause mortality (C-index values ranging from 0.71 to 0.75). In conclusion, TIMI risk score demonstrates poor discrimination in predicting mortality or recurrent MI in patients with STEMI with reduced LVEF. LVEF and eGFR are major factors that should not be ignored by predictive risk scores in this population. CI - Copyright (c) 2016 Elsevier Inc. All rights reserved. FAU - Popovic, Batric AU - Popovic B AD - CHU Nancy, Departement de Cardiologie, Nancy, France. Electronic address: b.popovic@chu-nancy.fr. FAU - Girerd, Nicolas AU - Girerd N AD - CHU Nancy, Departement de Cardiologie, Nancy, France; INSERM, Centre d'Investigation Clinique CIC-P 9501, Nancy, France. FAU - Rossignol, Patrick AU - Rossignol P AD - INSERM, Centre d'Investigation Clinique CIC-P 9501, Nancy, France. FAU - Agrinier, Nelly AU - Agrinier N AD - CHU Nancy, Epidemiologie et Evaluation Cliniques, Nancy, France. FAU - Camenzind, Edoardo AU - Camenzind E AD - CHU Nancy, Departement de Cardiologie, Nancy, France. FAU - Fay, Renaud AU - Fay R AD - INSERM, Centre d'Investigation Clinique CIC-P 9501, Nancy, France. FAU - Pitt, Bertram AU - Pitt B AD - University of Michigan School of Medicine, Ann Arbor, Michigan. FAU - Zannad, Faiez AU - Zannad F AD - CHU Nancy, Departement de Cardiologie, Nancy, France; INSERM, Centre d'Investigation Clinique CIC-P 9501, Nancy, France. LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20160822 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 RN - 0 (Mineralocorticoid Receptor Antagonists) RN - 27O7W4T232 (Spironolactone) RN - 6995V82D0B (Eplerenone) SB - IM MH - Aged MH - Cause of Death/trends MH - Double-Blind Method MH - Electrocardiography MH - Eplerenone MH - Female MH - Follow-Up Studies MH - France/epidemiology MH - Humans MH - Male MH - Mineralocorticoid Receptor Antagonists/administration & dosage MH - Myocardial Revascularization MH - Prognosis MH - Proportional Hazards Models MH - Retrospective Studies MH - Risk Assessment MH - ST Elevation Myocardial Infarction/complications/mortality/*therapy MH - Spironolactone/administration & dosage/*analogs & derivatives MH - Stroke Volume MH - Survival Rate/trends MH - Thrombolytic Therapy/*methods MH - Time Factors MH - Ventricular Dysfunction, Left/diagnosis/etiology/*physiopathology EDAT- 2016/09/30 06:00 MHDA- 2017/04/28 06:00 CRDT- 2016/09/29 06:00 PHST- 2016/04/20 00:00 [received] PHST- 2016/08/09 00:00 [revised] PHST- 2016/08/09 00:00 [accepted] PHST- 2016/09/30 06:00 [pubmed] PHST- 2017/04/28 06:00 [medline] PHST- 2016/09/29 06:00 [entrez] AID - S0002-9149(16)31363-7 [pii] AID - 10.1016/j.amjcard.2016.08.004 [doi] PST - ppublish SO - Am J Cardiol. 2016 Nov 15;118(10):1442-1447. doi: 10.1016/j.amjcard.2016.08.004. Epub 2016 Aug 22. PMID- 27671037 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20231122 IS - 1748-5908 (Electronic) IS - 1748-5908 (Linking) VI - 11 IP - 1 DP - 2016 Sep 26 TI - Assessing outcomes of enhanced chronic disease care through patient education and a value-based formulary study (ACCESS)-study protocol for a 2x2 factorial randomized trial. PG - 131 LID - 131 AB - BACKGROUND: Chronic diseases result in significant morbidity and costs. Although medications and lifestyle changes are effective for improving outcomes in chronic diseases, many patients do not receive these treatments, in part because of financial barriers, patient and provider-level knowledge gaps, and low patient motivation. The Assessing outcomes of enhanced chronic disease care through patient education and a value-based formulary study (ACCESS) will determine the impact of two interventions: (1) a value-based formulary which eliminates copayment for high-value preventive medications; and (2) a comprehensive self-management support program aimed at promoting health behavior change and medication adherence, combined with relay of information on medication use to healthcare providers, on cardiovascular events and/or mortality in low-income seniors with elevated cardiovascular risk. METHODS: The ACCESS study will use a parallel, open label, factorial randomized trial design, with blinded endpoint evaluation in 4714 participants who are over age >65 (and therefore have drug insurance provided by Alberta Blue Cross with 30 % co-payment); are at a high risk for cardiovascular events based on a history of any one of the following: coronary heart disease, prior stroke, chronic kidney disease, heart failure, or any two of the following: current cigarette smoking, diabetes mellitus, hypertension, or hypercholesterolemia; and have a household income 3 x ULN, total bilirubin >2 x ULN, serum creatinine >/=1.5xbaseline value, or a new requirement for renal replacement therapy through the end of the active treatment period. SUMMARY: The AEGIS-I trial will characterize the safety profile of CSL112, a reconstituted formulation of apolipoprotein A-I, and will assess if administration to patients with a recent AMI is associated with a clinically significant alteration in either liver or kidney function when compared with placebo. CI - Copyright (c) 2016 Elsevier Inc. All rights reserved. FAU - Gibson, C Michael AU - Gibson CM AD - PERFUSE Study Group, Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical, Harvard Medical School, Boston, MA. Electronic address: mgibson@bidmc.harvard.edu. FAU - Korjian, Serge AU - Korjian S AD - PERFUSE Study Group, Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical, Harvard Medical School, Boston, MA. FAU - Tricoci, Pierluigi AU - Tricoci P AD - Duke Clinical Research Institute, Department of Medicine, Duke University, Durhman, NC. FAU - Daaboul, Yazan AU - Daaboul Y AD - PERFUSE Study Group, Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical, Harvard Medical School, Boston, MA. FAU - Alexander, John H AU - Alexander JH AD - Duke Clinical Research Institute, Department of Medicine, Duke University, Durhman, NC. FAU - Steg, Philippe G AU - Steg PG AD - INSERM-Unite 1148, France Assistance Publique-Hopitaux de Paris, Hopital Bichat, France Universite Paris-Diderot, Sorbonne-Paris Cite, France National Heart and Lung Institute, Imperial College London, UK Institute of Cardiovascular Medicine and Science, Royal Brompton Hospital, United Kingdom. FAU - Lincoff, A Michael AU - Lincoff AM AD - Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, OH. FAU - Kastelein, John J P AU - Kastelein JJ AD - Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. FAU - Mehran, Roxana AU - Mehran R AD - Columbia University Medical Center and the Cardiovascular Research Foundation, New York, NY. FAU - D'Andrea, Denise AU - D'Andrea D AD - CSL Behring, LLC, King of Prussia, PA. FAU - Merkely, Bela AU - Merkely B AD - Heart and Vascular Center, Semmelweis University, Varosmajor str. 68, Budapest, Hungary. FAU - Zarebinski, Maciej AU - Zarebinski M AD - Department of Cardiology, Warsaw Medical University, Warsaw, Poland. FAU - Ophius, Ton Oude AU - Ophius TO AD - Department of Cardiology, Canisius Wilhelmina Ziekenhuis, Nijmegen, The Netherlands. FAU - Harrington, Robert A AU - Harrington RA AD - Department of Medicine, Stanford University, Stanford, CA. LA - eng SI - ClinicalTrials.gov/NCT02108262 PT - Clinical Trial, Phase II PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20160705 PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 RN - 0 (CSL112) RN - 0 (Lipoproteins, HDL) SB - IM MH - Adult MH - Dose-Response Relationship, Drug MH - Double-Blind Method MH - Female MH - Humans MH - Infusions, Intravenous MH - Kaplan-Meier Estimate MH - Kidney/drug effects MH - Lipoproteins, HDL/*administration & dosage/adverse effects MH - Liver/drug effects MH - Male MH - Myocardial Infarction/*drug therapy MH - Research Design EDAT- 2016/09/24 06:00 MHDA- 2017/05/24 06:00 CRDT- 2016/09/24 06:00 PHST- 2016/05/13 00:00 [received] PHST- 2016/06/28 00:00 [accepted] PHST- 2016/09/24 06:00 [entrez] PHST- 2016/09/24 06:00 [pubmed] PHST- 2017/05/24 06:00 [medline] AID - S0002-8703(16)30108-9 [pii] AID - 10.1016/j.ahj.2016.06.017 [doi] PST - ppublish SO - Am Heart J. 2016 Oct;180:22-8. doi: 10.1016/j.ahj.2016.06.017. Epub 2016 Jul 5. PMID- 27659564 OWN - NLM STAT- MEDLINE DCOM- 20170925 LR - 20180919 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 9 IP - 18 DP - 2016 Sep 26 TI - Correlates and Impact of Coronary Artery Calcifications in Women Undergoing Percutaneous Coronary Intervention With Drug-Eluting Stents: From the Women in Innovation and Drug-Eluting Stents (WIN-DES) Collaboration. PG - 1890-901 LID - S1936-8798(16)30931-1 [pii] LID - 10.1016/j.jcin.2016.06.022 [doi] AB - OBJECTIVES: The aim of this study was to investigate the clinical correlates and prognostic impact of coronary artery calcification (CAC) in women undergoing percutaneous coronary intervention with drug-eluting stents (DES). BACKGROUND: The clinical correlates and the prognostic significance of CAC in women undergoing percutaneous coronary intervention with DES remain unclear. METHODS: Patient-level data from female participants in 26 randomized trials of DES were pooled. Study population was categorized according to the presence of moderate or severe versus mild or no target lesion CAC, assessed through coronary angiography. Co-primary endpoints of interest were the composite of death, myocardial infarction (MI), or target lesion revascularization and death, MI, or stent thrombosis at 3-year follow-up. RESULTS: Among 11,557 women included in the pooled dataset, CAC status was available in 6,371 women. Of these, 1,622 (25.5%) had moderate or severe CAC. In fully adjusted models, independent correlates of CAC were age, hypertension, hypercholesterolemia, smoking, previous coronary artery bypass graft surgery, and worse left ventricular and renal function. At 3 years, women with CAC were at higher risk for death, MI, or target lesion revascularization (18.2% vs. 13.1%; adjusted hazard ratio: 1.56; 95% confidence interval: 1.33 to 1.84; p < 0.0001) and death, MI, or stent thrombosis (12.7% vs. 8.6%; adjusted hazard ratio: 1.48; 95% confidence interval: 1.21 to 1.80; p = 0.0001). The adverse effect of CAC on ischemic outcomes appeared to be consistent across clinical and angiographic subsets of women, including new-generation DES. CONCLUSIONS: Women undergoing PCI of calcified lesions tend to have worse clinical profile and remain at increased ischemic risk, irrespective of new-generation DES. CI - Copyright (c) 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Giustino, Gennaro AU - Giustino G AD - Interventional Cardiovascular Research and Clinical Trials, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York. FAU - Mastoris, Ioannis AU - Mastoris I AD - Interventional Cardiovascular Research and Clinical Trials, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York. FAU - Baber, Usman AU - Baber U AD - Interventional Cardiovascular Research and Clinical Trials, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York. FAU - Sartori, Samantha AU - Sartori S AD - Interventional Cardiovascular Research and Clinical Trials, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York. FAU - Stone, Gregg W AU - Stone GW AD - Department of Cardiology, Columbia University Medical Center, New York, New York. FAU - Leon, Martin B AU - Leon MB AD - Department of Cardiology, Columbia University Medical Center, New York, New York. FAU - Serruys, Patrick W AU - Serruys PW AD - Department of Cardiology, Erasmus MC, Rotterdam, the Netherlands. FAU - Kastrati, Adnan AU - Kastrati A AD - Department of Cardiology, Herzzentrum, Munich, Germany. FAU - Windecker, Stephan AU - Windecker S AD - Department of Cardiology, Bern University Hospital, Bern, Switzerland. FAU - Valgimigli, Marco AU - Valgimigli M AD - Department of Cardiology, Bern University Hospital, Bern, Switzerland. FAU - Dangas, George D AU - Dangas GD AD - Interventional Cardiovascular Research and Clinical Trials, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York. FAU - Von Birgelen, Clemens AU - Von Birgelen C AD - Department of Cardiology, Thoraxcentrum Twente, Enschede, the Netherlands. FAU - Smits, Pieter C AU - Smits PC AD - Department of Cardiology, Maasstad Hospital, Rotterdam, the Netherlands. FAU - Kandzari, David AU - Kandzari D AD - Piedmont Heart Institute, Atlanta, Georgia. FAU - Galatius, Soren AU - Galatius S AD - Department of Cardiology, Bispebjerg University Hospital, Copenhagen, Denmark. FAU - Wijns, William AU - Wijns W AD - Cardiovascular Center Aalst, Onze-Lieve-Vrouwziekenhuis Ziekenhuis, Aalst, Belgium. FAU - Steg, P Gabriel AU - Steg PG AD - Departement Hospitalo Universitaire Fibrose, Inflammation et Remodelage, Assistance Publique-Hopitaux de Paris, Universite Paris Diderot, INSERM U114, Paris, France. FAU - Stefanini, Giulio G AU - Stefanini GG AD - Division of Clinical and Interventional Cardiology, Humanitas Research Hospital, Rozzano, Milan, Italy. FAU - Aquino, Melissa AU - Aquino M AD - Interventional Cardiovascular Research and Clinical Trials, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York. FAU - Morice, Marie-Claude AU - Morice MC AD - Department of Cardiology and Cardiovascular Surgery, Institut Cardiovasculaire Paris Sud, Paris, France. FAU - Camenzind, Edoardo AU - Camenzind E AD - Department of Cardiology, Institut Lorrain du Coeur et des Vaisseaux University Hospital Nancy - Brabois, Vandoeuvre-les-Nancy, France. FAU - Weisz, Giora AU - Weisz G AD - Department of Cardiology, Shaare Zedek Medical Center, Jerusalem, Israel; Columbia University Medical Center, New York, New York. FAU - Jeger, Raban V AU - Jeger RV AD - Department of Cardiology, University Hospital Basel, Basel, Switzerland. FAU - Kimura, Takeshi AU - Kimura T AD - Department of Cardiology, Kyoto University Graduate School of Medicine, Kyoto, Japan. FAU - Mikhail, Ghada W AU - Mikhail GW AD - Department of Cardiology, Imperial College Healthcare NHS Trust, London, United Kingdom. FAU - Itchhaporia, Dipti AU - Itchhaporia D AD - Department of Cardiology, Hoag Memorial Hospital Presbyterian, Newport Beach, California. FAU - Mehta, Laxmi AU - Mehta L AD - Department of Cardiology, The Ohio State University Medical Center, Columbus, Ohio. FAU - Ortega, Rebecca AU - Ortega R AD - Duke Clinical Research Institute, Durham, North Carolina. FAU - Kim, Hyo-Soo AU - Kim HS AD - Department of Cardiology, Seoul National University Main Hospital, Seoul, Korea. FAU - Chieffo, Alaide AU - Chieffo A AD - Cardiothoracic Department, San Raffaele Scientific Institute, Milan, Italy. FAU - Mehran, Roxana AU - Mehran R AD - Interventional Cardiovascular Research and Clinical Trials, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York. Electronic address: roxana.mehran@mountsinai.org. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 SB - IM CIN - JACC Cardiovasc Interv. 2016 Sep 26;9(18):1902-4. doi: 10.1016/j.jcin.2016.08.008. PMID: 27659565 MH - Aged MH - Aged, 80 and over MH - Coronary Angiography MH - Coronary Artery Disease/diagnostic imaging/mortality/*therapy MH - Coronary Thrombosis/etiology MH - *Drug-Eluting Stents MH - Evidence-Based Medicine MH - Female MH - Humans MH - Kaplan-Meier Estimate MH - Logistic Models MH - Middle Aged MH - Myocardial Infarction/etiology MH - Odds Ratio MH - Percutaneous Coronary Intervention/adverse effects/*instrumentation/mortality MH - Proportional Hazards Models MH - Prosthesis Design MH - Randomized Controlled Trials as Topic MH - Risk Assessment MH - Risk Factors MH - Severity of Illness Index MH - Sex Factors MH - Time Factors MH - Treatment Outcome MH - Vascular Calcification/diagnostic imaging/mortality/*therapy OTO - NOTNLM OT - DES OT - PCI OT - coronary artery calcifications OT - women EDAT- 2016/09/24 06:00 MHDA- 2017/09/26 06:00 CRDT- 2016/09/24 06:00 PHST- 2016/04/05 00:00 [received] PHST- 2016/05/17 00:00 [revised] PHST- 2016/06/16 00:00 [accepted] PHST- 2016/09/24 06:00 [entrez] PHST- 2016/09/24 06:00 [pubmed] PHST- 2017/09/26 06:00 [medline] AID - S1936-8798(16)30931-1 [pii] AID - 10.1016/j.jcin.2016.06.022 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2016 Sep 26;9(18):1890-901. doi: 10.1016/j.jcin.2016.06.022. PMID- 27647847 OWN - NLM STAT- MEDLINE DCOM- 20170807 LR - 20220408 IS - 1524-4563 (Electronic) IS - 0194-911X (Print) IS - 0194-911X (Linking) VI - 68 IP - 5 DP - 2016 Nov TI - Relationship of Albuminuria and Renal Artery Stent Outcomes: Results From the CORAL Randomized Clinical Trial (Cardiovascular Outcomes With Renal Artery Lesions). PG - 1145-1152 AB - Randomized clinical trials have not shown an additional clinical benefit of renal artery stent placement over optimal medical therapy alone. However, studies of renal artery stent placement have not examined the relationship of albuminuria and treatment group outcomes. The CORAL study (Cardiovascular Outcomes in Renal Atherosclerotic Lesions) is a prospective clinical trial of 947 participants with atherosclerotic renal artery stenosis randomized to optimal medical therapy with or without renal artery stent which showed no treatment differences (3(5.8% and 35.1% event rate at mean 43-month follow-up). In a post hoc analysis, the study population was stratified by the median baseline urine albumin/creatinine ratio (n=826) and analyzed for the 5-year incidence of the primary end point (myocardial infarction, hospitalization for congestive heart failure, stroke, renal replacement therapy, progressive renal insufficiency, or cardiovascular disease- or kidney disease-related death), for each component of the primary end point, and overall survival. When baseline urine albumin/creatinine ratio was 75 years), hypertension, diabetes mellitus, renal dysfunction (serum creatinine >/=2.0 mg/dL), and multi-vessel disease. The DAPT strategy differentially contributed to the occurrence of NACEs according to the risk burden (p for interaction <0.001). In patients with low risk for NACEs, bleeding events were less in short-term DAPT than in prolonged DAPT (HR 0.332, 95 % CI 0.130-0.849, p = 0.021) (p for interaction = 0.098). Meanwhile, short-term DAPT was associated with more ischemic events that included cardiac death, myocardial infarction, target vessel revascularization, or definite/probable stent thrombosis (HR 2.164, 95 % CI 1.340-3.494, p = 0.002) (p for interaction <0.001) in patients with high risk for NACEs. CONCLUSION: One-year clinical outcomes of DAPT after DES implantation depended on the burden of cardiovascular risk. FAU - Lee, Seung-Yul AU - Lee SY AD - Sanbon Hospital, Wonkwang University College of Medicine, Gunpo, Korea. FAU - Hong, Myeong-Ki AU - Hong MK AD - Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 03722 Yonsei-ro 50-1, Seodaemun-Gu, Seoul, Korea. mkhong61@yuhs.ac. AD - Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea. mkhong61@yuhs.ac. AD - Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea. mkhong61@yuhs.ac. FAU - Shin, Dong-Ho AU - Shin DH AD - Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 03722 Yonsei-ro 50-1, Seodaemun-Gu, Seoul, Korea. AD - Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea. FAU - Kim, Jung-Sun AU - Kim JS AD - Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 03722 Yonsei-ro 50-1, Seodaemun-Gu, Seoul, Korea. AD - Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea. FAU - Kim, Byeong-Keuk AU - Kim BK AD - Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 03722 Yonsei-ro 50-1, Seodaemun-Gu, Seoul, Korea. AD - Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea. FAU - Ko, Young-Guk AU - Ko YG AD - Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 03722 Yonsei-ro 50-1, Seodaemun-Gu, Seoul, Korea. AD - Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea. FAU - Choi, Donghoon AU - Choi D AD - Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 03722 Yonsei-ro 50-1, Seodaemun-Gu, Seoul, Korea. AD - Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea. FAU - Jang, Yangsoo AU - Jang Y AD - Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 03722 Yonsei-ro 50-1, Seodaemun-Gu, Seoul, Korea. AD - Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea. AD - Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea. FAU - Kim, Hyo-Soo AU - Kim HS AD - Cardiovascular Center, Seoul National University Hospital, Seoul, Korea. FAU - Valgimigli, Marco AU - Valgimigli M AD - Department of Cardiology, Bern University Hospital, Bern, Switzerland. FAU - Palmerini, Tullio AU - Palmerini T AD - Dipartimento Cardiovascolare, Policlinico S. Orsola, University of Bologna, Bologna, Italy. FAU - Stone, Gregg W AU - Stone GW AD - Columbia University Medical Center, NewYork-Presbyterian Hospital, New York, NY, USA. LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20160908 PL - Germany TA - Clin Res Cardiol JT - Clinical research in cardiology : official journal of the German Cardiac Society JID - 101264123 RN - 0 (Immunosuppressive Agents) RN - 0 (Platelet Aggregation Inhibitors) RN - A74586SNO7 (Clopidogrel) RN - H4GXR80IZE (zotarolimus) RN - OM90ZUW7M1 (Ticlopidine) RN - R16CO5Y76E (Aspirin) RN - W36ZG6FT64 (Sirolimus) SB - IM MH - Aged MH - Aspirin/*administration & dosage MH - Clopidogrel MH - Coronary Artery Disease/diagnosis/*surgery MH - Death, Sudden, Cardiac/epidemiology/*prevention & control MH - Dose-Response Relationship, Drug MH - Drug Therapy, Combination MH - *Drug-Eluting Stents MH - Female MH - Follow-Up Studies MH - Humans MH - Immunosuppressive Agents/pharmacology MH - Incidence MH - Male MH - Middle Aged MH - Myocardial Infarction/epidemiology/*prevention & control MH - *Percutaneous Coronary Intervention MH - Platelet Aggregation Inhibitors/administration & dosage MH - Republic of Korea/epidemiology MH - Risk Factors MH - Sirolimus/analogs & derivatives/pharmacology MH - Ticlopidine/administration & dosage/*analogs & derivatives MH - Time Factors OTO - NOTNLM OT - Antiplatelet therapy OT - Coronary artery disease OT - Drug-eluting stent EDAT- 2016/09/16 06:00 MHDA- 2017/03/30 06:00 CRDT- 2016/09/16 06:00 PHST- 2016/06/28 00:00 [received] PHST- 2016/09/02 00:00 [accepted] PHST- 2016/09/16 06:00 [pubmed] PHST- 2017/03/30 06:00 [medline] PHST- 2016/09/16 06:00 [entrez] AID - 10.1007/s00392-016-1035-4 [pii] AID - 10.1007/s00392-016-1035-4 [doi] PST - ppublish SO - Clin Res Cardiol. 2017 Mar;106(3):165-173. doi: 10.1007/s00392-016-1035-4. Epub 2016 Sep 8. PMID- 27572072 OWN - NLM STAT- MEDLINE DCOM- 20180409 LR - 20190318 IS - 1522-9645 (Electronic) IS - 0195-668X (Linking) VI - 37 IP - 46 DP - 2016 Dec 7 TI - Comparative efficacy of coronary artery bypass surgery vs. percutaneous coronary intervention in patients with diabetes and multivessel coronary artery disease with or without chronic kidney disease. PG - 3440-3447 LID - 10.1093/eurheartj/ehw378 [doi] AB - BACKGROUND: The optimal method of coronary revascularization among patients with diabetes mellitus (DM) and multivessel coronary artery disease (CAD) complicated by chronic kidney disease (CKD) remains unknown. PURPOSE: To examine the impact of coronary artery bypass surgery (CABG) vs. percutaneous coronary intervention (PCI) on cardiovascular outcomes in patients with diabetes with and without CKD. METHODS: We conducted an 'as-treated' subgroup analysis of the FREEDOM trial to examine the therapeutic efficacy of CABG vs. PCI among patients with DM stratified by the presence (n = 451) or absence (n = 1392) of CKD. We defined CKD as an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73m(2). Baseline characteristics and clinical outcomes were compared between PCI and CABG groups within each CKD stratum. The primary endpoint was the composite occurrence of all-cause death, stroke or myocardial infarction [major adverse cardiovascular and cerebrovascular events (MACCE)]. Event rates were estimated at 5 years using the Kaplan-Meier approach and hazard ratios (HRs) for CABG (vs. PCI) were generated using Cox regression. RESULTS: Patients with CKD (mean eGFR 47 mL/min/1.73m(2)) were older and more often female compared to those without renal impairment. Over a median follow-up of 3.8 years, the effect of CABG on MACCE was consistent among those with CKD (26.0% vs. 35.6%; HR [95% CI]: 0.73 [0.50-1.05]) and without CKD (16.2% vs. 23.6%; HR [95% CI)]: 0.76 [0.58-1.00]) with no evidence of interaction (p(int) = 0.83). Stroke rates were non-significantly higher with CABG whereas rates of MI and repeat revascularization were significantly reduced with CABG in both groups. CONCLUSIONS: Compared to PCI, the effects of CABG on long-term risks for MACCE observed in the FREEDOM trial are preserved among patients with mild to moderate CKD. CI - Published on behalf of the European Society of Cardiology. All rights reserved. (c) The Author 2016. For Permissions, please email: journals.permissions@oup.com. FAU - Baber, Usman AU - Baber U AD - Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York City, NY 10029, USA valentin.fuster@mountsinai.org. FAU - Farkouh, Michael E AU - Farkouh ME AD - Peter Munk Cardiac Centre, University of Toronto, 585 University Avenue, Room 4N474, Toronto, Ontario M5G 2N2, Canada. FAU - Arbel, Yaron AU - Arbel Y AD - Tel Aviv Sourasky Medical Center, Tel Aviv University, 6 Weizmann Street, Tel Aviv 64239, Israel. FAU - Muntner, Paul AU - Muntner P AD - Department of Epidemiology, University of Alabama at Birmingham, 1700 University Boulevard, Suite LHL 450, Birmingham, AL 35294, USA. FAU - Dangas, George AU - Dangas G AD - Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York City, NY 10029, USA. FAU - Mack, Michael J AU - Mack MJ AD - The Heart Hospital Baylor Plano, Cardiovascular Surgery, 4716 Alliance Boulevard, Suite 310 Plano, TX 75093, USA. FAU - Hamza, Taye H AU - Hamza TH AD - New England Research Institute, 480 Pleasant St, Watertown, MA 02472, USA. FAU - Mehran, Roxana AU - Mehran R AD - Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York City, NY 10029, USA. FAU - Fuster, Valentin AU - Fuster V AD - Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York City, NY 10029, USA valentin.fuster@mountsinai.org. LA - eng PT - Comparative Study PT - Journal Article DEP - 20160829 PL - England TA - Eur Heart J JT - European heart journal JID - 8006263 SB - IM CIN - Eur Heart J. 2016 Dec 7;37(46):3448-3451. doi: 10.1093/eurheartj/ehw453. PMID: 27974347 MH - Coronary Artery Bypass MH - *Coronary Artery Disease MH - Diabetes Mellitus MH - Drug-Eluting Stents MH - Female MH - Humans MH - Male MH - Percutaneous Coronary Intervention MH - Renal Insufficiency, Chronic MH - Treatment Outcome OTO - NOTNLM OT - *CABG OT - *CKD OT - *Diabetes mellitus OT - *PCI EDAT- 2016/08/31 06:00 MHDA- 2018/04/10 06:00 CRDT- 2016/08/31 06:00 PHST- 2016/06/29 00:00 [received] PHST- 2016/07/27 00:00 [revised] PHST- 2016/08/01 00:00 [accepted] PHST- 2016/08/31 06:00 [pubmed] PHST- 2018/04/10 06:00 [medline] PHST- 2016/08/31 06:00 [entrez] AID - ehw378 [pii] AID - 10.1093/eurheartj/ehw378 [doi] PST - ppublish SO - Eur Heart J. 2016 Dec 7;37(46):3440-3447. doi: 10.1093/eurheartj/ehw378. Epub 2016 Aug 29. PMID- 27567020 OWN - NLM STAT- MEDLINE DCOM- 20170621 LR - 20260127 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 89 IP - 5 DP - 2017 Apr TI - ORBIT II sub-analysis: Impact of impaired renal function following treatment of severely calcified coronary lesions with the Orbital Atherectomy System. PG - 841-848 LID - 10.1002/ccd.26778 [doi] AB - OBJECTIVES: To investigate the safety and efficacy of the coronary Orbital Atherectomy System (OAS) to prepare severely calcified lesions for stent deployment in patients grouped by renal function. BACKGROUND: Percutaneous coronary intervention (PCI) of severely calcified lesions is associated with increased rates of major adverse cardiac events (MACE), including death, myocardial infarction (MI), and target vessel revascularization (TVR) compared with PCI of non-calcified vessels. Patients with chronic kidney disease (CKD) are at increased risk for MACE after PCI. The impact of CKD on coronary orbital atherectomy treatment has not been well characterized. METHODS: ORBIT II was a prospective, multicenter trial in the U.S., which enrolled 443 patients with severely calcified coronary lesions. The MACE rate was defined as a composite of cardiac death, MI, and target vessel revascularization. RESULTS: Of the 441 patients enrolled with known estimated glomerular filtration rate (eGFR) values at baseline, 333 (75.5%) patients had eGFR < 90 ml/min/1.73 m(2) and 108 patients had eGFR >/= 90 ml/min/1.73 m(2) . The mean eGFR at baseline in the eGFR < 90 ml/min/1.73 m(2) and eGFR >/= 90 ml/min/1.73 m(2) groups was 65.0 +/- 0.9 ml/min/1.73 m(2) and 109.1 +/- 2.0 ml/min/1.73 m(2) , respectively. Freedom from MACE was lower in the eGFR < 90 ml/min/1.73 m(2) group at 30 days (87.4% vs. 96.3%, P = 0.02) and 1-year (80.6% vs. 90.7%, P = 0.02). CONCLUSIONS: Patients with renal impairment had a higher MACE rate through one year follow-up due to a higher rate of periprocedural MI. Interestingly, the rates of cardiac death and revascularization through 1-year were similar in patients with eGFR < 90 ml/min/1.73 m(2) and eGFR >/= 90 ml/min/1.73 m(2) . Future studies are needed to identify the ideal revascularization strategy for patients with renal impairment and severely calcified coronary lesions. (c) 2016 Wiley Periodicals, Inc. CI - (c) 2016 Wiley Periodicals, Inc. FAU - Lee, Michael S AU - Lee MS AD - UCLA Medical Center, Los Angeles, California. FAU - Lee, Arthur C AU - Lee AC AD - The Cardiac and Vascular Institute, Gainesville, Florida. FAU - Shlofmitz, Richard A AU - Shlofmitz RA AD - St. Francis Hospital-The Heart Center, Roslyn, New York. FAU - Martinsen, Brad J AU - Martinsen BJ AD - Cardiovascular Systems, Inc, Saint Paul, Minnesota. FAU - Hargus, Nick J AU - Hargus NJ AD - Cardiovascular Systems, Inc, Saint Paul, Minnesota. FAU - Elder, Mahir D AU - Elder MD AD - Detroit Medical Center - Heart Hospital Detroit, Michigan. FAU - Genereux, Philippe AU - Genereux P AD - New York-Presbyterian Hospital and Columbia University Medical & Cardiovascular Research Foundation, New York, New York. FAU - Chambers, Jeffrey W AU - Chambers JW AD - Metropolitan Heart and Vascular Institute, Mercy Hospital, Minneapolis, Minnesota. LA - eng PT - Clinical Trial, Phase II PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20160827 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Aged MH - Atherectomy, Coronary/*adverse effects/methods MH - Calcinosis/complications/diagnosis/*surgery MH - Cause of Death/trends MH - Coronary Angiography MH - Coronary Artery Disease/complications/diagnosis/*surgery MH - Female MH - Follow-Up Studies MH - Glomerular Filtration Rate/*physiology MH - Humans MH - Incidence MH - Male MH - Myocardial Infarction/*epidemiology/etiology MH - *Postoperative Complications MH - Prospective Studies MH - Renal Insufficiency, Chronic/*complications/diagnosis/physiopathology MH - Risk Factors MH - Severity of Illness Index MH - Survival Rate/trends MH - United States/epidemiology OTO - NOTNLM OT - atherectomy OT - calcification OT - cardiovascular intervention OT - coronary artery disease OT - renal disease EDAT- 2016/08/28 06:00 MHDA- 2017/06/22 06:00 CRDT- 2016/08/28 06:00 PHST- 2016/02/07 00:00 [received] PHST- 2016/05/17 00:00 [revised] PHST- 2016/08/10 00:00 [accepted] PHST- 2016/08/28 06:00 [pubmed] PHST- 2017/06/22 06:00 [medline] PHST- 2016/08/28 06:00 [entrez] AID - 10.1002/ccd.26778 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2017 Apr;89(5):841-848. doi: 10.1002/ccd.26778. Epub 2016 Aug 27. PMID- 27553100 OWN - NLM STAT- MEDLINE DCOM- 20170524 LR - 20260127 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 118 IP - 8 DP - 2016 Oct 15 TI - Comparison of the Effects of Incomplete Revascularization on 12-Month Mortality in Patients <80 Compared With >/=80 Years Who Underwent Percutaneous Coronary Intervention. PG - 1164-1170 LID - S0002-9149(16)31240-1 [pii] LID - 10.1016/j.amjcard.2016.07.031 [doi] AB - Although randomized trial data suggest that complete revascularization improves outcomes after percutaneous coronary intervention (PCI), the impact of differing revascularization strategies in octogenarians is not well defined. We performed a retrospective analysis, which was conducted of 9,628 consecutive patients who underwent PCI at a large UK center. Octogenarians were more likely to have significant co-morbidity, a higher Mehran bleed risk score (24.5 +/- 6.8 vs 13.3 +/- 7.4, p <0.0001), and more complex disease (baseline SYNTAX score 18.7 +/- 11.0 vs 13.1 +/- 8.9, p = 0.002) than younger patients. During PCI, octogenarians were more likely to undergo left main or proximal LAD intervention, but despite this, significantly less likely to receive drug-eluting stents (66.5% vs 80.1%, p <0.001). Postprocedurally, octogenarians had greater residual disease burden (residual SYNTAX score 10.1 +/- 8.7 vs 1.6 +/- 3.3, p <0.0001). At 12 months, adverse outcomes (definite stent thrombosis 3.3% vs 1.1%, p <0.001, clinically driven in-stent restenosis PCI 3.7% vs 2.6%, p = 0.005, and 12-month mortality 12.8% vs 4.2%, p <0.0001) were all more frequent in octogenarians. Although age, shock, diabetes, and BMS use were independently predictive of increased 12-month mortality, incomplete revascularization was not. In conclusion, octogenarians are a complex group to treat balancing high-risk bleeding profile and complex coronary disease. However, in multivariate analysis, incomplete revascularization was not independently predictive of adverse outcomes. These data support a conservative target lesion-only DES-driven revascularization strategy. CI - Copyright (c) 2016 Elsevier Inc. All rights reserved. FAU - Yazji, Khaled AU - Yazji K AD - Department of Cardiology, University Hospital of Wales, Heath Park, Cardiff, United Kingdom. FAU - Abdul, Fairoz AU - Abdul F AD - Department of Cardiology, University Hospital of Wales, Heath Park, Cardiff, United Kingdom. FAU - Elangovan, Senthil AU - Elangovan S AD - Department of Cardiology, University Hospital of Wales, Heath Park, Cardiff, United Kingdom. FAU - Ossei-Gerning, Nick AU - Ossei-Gerning N AD - Department of Cardiology, University Hospital of Wales, Heath Park, Cardiff, United Kingdom. FAU - Choudhury, Anirban AU - Choudhury A AD - Department of Cardiology, University Hospital of Wales, Heath Park, Cardiff, United Kingdom. FAU - Cockburn, James AU - Cockburn J AD - Department of Cardiology, Royal Sussex County Hospital Brighton, United Kingdom. FAU - Anderson, Richard AU - Anderson R AD - Department of Cardiology, University Hospital of Wales, Heath Park, Cardiff, United Kingdom. FAU - Mamas, Mamas AU - Mamas M AD - Institute for Science and Technology, Keele University, Stoke-on-Trent, United Kingdom. FAU - Kinnaird, Tim AU - Kinnaird T AD - Department of Cardiology, University Hospital of Wales, Heath Park, Cardiff, United Kingdom. Electronic address: tim.kinnaird2@wales.nhs.uk. LA - eng PT - Comparative Study PT - Journal Article DEP - 20160729 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM MH - Age Factors MH - Aged MH - Aged, 80 and over MH - Comorbidity MH - Coronary Artery Disease/mortality/*surgery MH - Coronary Stenosis/epidemiology/mortality/*surgery MH - Drug-Eluting Stents MH - Female MH - Graft Occlusion, Vascular/epidemiology MH - Humans MH - Hypertension/epidemiology MH - Male MH - Middle Aged MH - *Mortality MH - *Percutaneous Coronary Intervention MH - Postoperative Hemorrhage/epidemiology MH - Renal Insufficiency, Chronic/epidemiology MH - Retrospective Studies MH - Shock/epidemiology MH - Smoking/epidemiology MH - Stents MH - United Kingdom/epidemiology EDAT- 2016/08/25 06:00 MHDA- 2017/05/26 06:00 CRDT- 2016/08/25 06:00 PHST- 2016/04/21 00:00 [received] PHST- 2016/07/10 00:00 [revised] PHST- 2016/07/10 00:00 [accepted] PHST- 2016/08/25 06:00 [pubmed] PHST- 2017/05/26 06:00 [medline] PHST- 2016/08/25 06:00 [entrez] AID - S0002-9149(16)31240-1 [pii] AID - 10.1016/j.amjcard.2016.07.031 [doi] PST - ppublish SO - Am J Cardiol. 2016 Oct 15;118(8):1164-1170. doi: 10.1016/j.amjcard.2016.07.031. Epub 2016 Jul 29. PMID- 27544007 OWN - NLM STAT- MEDLINE DCOM- 20171003 LR - 20260127 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 9 IP - 17 DP - 2016 Sep 12 TI - Impact of Sex on 2-Year Clinical Outcomes in Patients Treated With 6-Month or 24-Month Dual-Antiplatelet Therapy Duration: A Pre-Specified Analysis From the PRODIGY Trial. PG - 1780-9 LID - S1936-8798(16)30747-6 [pii] LID - 10.1016/j.jcin.2016.05.046 [doi] AB - OBJECTIVES: The aim of this study was to assess the impact of sex on 2-year outcomes after percutaneous coronary intervention (PCI) in patients randomly allocated to 24-month versus 6-month dual-antiplatelet therapy (DAPT). BACKGROUND: The optimal duration of DAPT after PCI is highly debated. Whether sex per se should drive decision making on DAPT duration remains unclear. METHODS: The primary efficacy endpoint of PRODIGY (Prolonging Dual Antiplatelet Treatment After Grading Stent-Induced Intimal Hyperplasia Study) was the composite of death, myocardial infarction, or cerebrovascular accident at 24-month follow-up. The key safety endpoint was type 2, 3, or 5 bleeding according to the Bleeding Academic Research Consortium criteria. RESULTS: Women (n = 459 [23.3%]) were older and more likely to have hypertension, lower creatinine clearance, and acute coronary syndrome but had a lower severity of coronary artery disease. After adjustment, prolonged DAPT, compared with 6-month treatment, did not reduce the primary endpoint in both men (adjusted hazard ratio: 1.080; 95% confidence interval: 0.766 to 1.522; p = 0.661) and women (adjusted hazard ratio: 1.013; 95% confidence interval: 0.588 to 1.748; p = 0.962) (interaction p = 0.785). No sex disparity was identified across multiple secondary ischemic endpoints, including overall or cardiovascular mortality, myocardial infarction, and stent thrombosis. There was also no clear sex-related effect on clinically relevant bleeding, including Bleeding Academic Research Consortium type 3 or 5, TIMI (Thrombolysis in Myocardial Infarction), and GUSTO (Global Use of Strategies to Open Occluded Coronary Arteries) scales. CONCLUSIONS: The present findings suggest that men and women undergoing PCI have similar adjusted 2-year ischemic and bleeding outcomes, despite being characterized by different clinical presentation. Sex failed to emerge as a treatment modifier with respect to DAPT duration, suggesting that decision making on DAPT duration in female patients should weigh ischemic versus bleeding risks. CI - Copyright (c) 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Gargiulo, Giuseppe AU - Gargiulo G AD - Department of Cardiology, Bern University Hospital, University of Bern, Bern, Switzerland; Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy. FAU - Ariotti, Sara AU - Ariotti S AD - Department of Cardiology, Bern University Hospital, University of Bern, Bern, Switzerland; Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands. FAU - Santucci, Andrea AU - Santucci A AD - Department of Cardiology, Bern University Hospital, University of Bern, Bern, Switzerland. FAU - Piccolo, Raffaele AU - Piccolo R AD - Department of Cardiology, Bern University Hospital, University of Bern, Bern, Switzerland. FAU - Baldo, Andrea AU - Baldo A AD - Department of Cardiology, Bern University Hospital, University of Bern, Bern, Switzerland. FAU - Franzone, Anna AU - Franzone A AD - Department of Cardiology, Bern University Hospital, University of Bern, Bern, Switzerland. FAU - Magnani, Giulia AU - Magnani G AD - Department of Cardiology, Bern University Hospital, University of Bern, Bern, Switzerland. FAU - Marino, Marcello AU - Marino M AD - Department of Cardiology, Bern University Hospital, University of Bern, Bern, Switzerland. FAU - Esposito, Giovanni AU - Esposito G AD - Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy. FAU - Windecker, Stephan AU - Windecker S AD - Department of Cardiology, Bern University Hospital, University of Bern, Bern, Switzerland. FAU - Valgimigli, Marco AU - Valgimigli M AD - Department of Cardiology, Bern University Hospital, University of Bern, Bern, Switzerland; Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands. Electronic address: marco.valgimigli@insel.ch. LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20160817 PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 RN - 0 (Platelet Aggregation Inhibitors) RN - A74586SNO7 (Clopidogrel) RN - OM90ZUW7M1 (Ticlopidine) RN - R16CO5Y76E (Aspirin) SB - IM MH - Acute Coronary Syndrome/blood/diagnostic imaging/mortality/*therapy MH - Aged MH - Aspirin/*administration & dosage/adverse effects MH - Clopidogrel MH - Coronary Artery Disease/blood/diagnostic imaging/mortality/*therapy MH - Coronary Restenosis/etiology MH - Coronary Thrombosis/etiology MH - Drug Administration Schedule MH - Drug Therapy, Combination MH - Female MH - Hemorrhage/chemically induced MH - Humans MH - Italy MH - Male MH - Middle Aged MH - Myocardial Infarction/etiology MH - Neointima MH - *Percutaneous Coronary Intervention/adverse effects/instrumentation/mortality MH - Platelet Aggregation Inhibitors/*administration & dosage/adverse effects MH - Proportional Hazards Models MH - Risk Assessment MH - Risk Factors MH - Sex Factors MH - Stents MH - Stroke/etiology MH - Ticlopidine/administration & dosage/adverse effects/*analogs & derivatives MH - Time Factors MH - Treatment Outcome OTO - NOTNLM OT - DAPT OT - bleeding OT - clopidogrel OT - ischemic events OT - sex EDAT- 2016/08/22 06:00 MHDA- 2017/10/04 06:00 CRDT- 2016/08/22 06:00 PHST- 2016/02/15 00:00 [received] PHST- 2016/04/14 00:00 [revised] PHST- 2016/05/28 00:00 [accepted] PHST- 2016/08/22 06:00 [entrez] PHST- 2016/08/22 06:00 [pubmed] PHST- 2017/10/04 06:00 [medline] AID - S1936-8798(16)30747-6 [pii] AID - 10.1016/j.jcin.2016.05.046 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2016 Sep 12;9(17):1780-9. doi: 10.1016/j.jcin.2016.05.046. Epub 2016 Aug 17. PMID- 27533756 OWN - NLM STAT- MEDLINE DCOM- 20180323 LR - 20180323 IS - 2055-6845 (Electronic) VI - 2 IP - 3 DP - 2016 Jul TI - Impact of renal impairment on platelet reactivity and clinical outcomes during chronic dual antiplatelet therapy following coronary stenting. PG - 145-51 LID - 10.1093/ehjcvp/pvv052 [doi] AB - AIMS: Clinical utilization of dual antiplatelet therapy (DAPT) in patients with renal impairment (RI) following percutaneous coronary interventions (PCI) represents an urgent, unmet need choosing optimal agents, duration of treatment, and potential dose/regimen adjustment. The lack of any large randomized trials specifically in RI patients, and the absence of the uniformed clinical data reporting policy, clouds the reality. Moreover, triaging RI patients is problematic due to ongoing kidney deterioration, and the fact that RI patients are prone to both vascular occlusions and bleeding. METHODS AND RESULTS: Seven hundred and one Korean patients receiving DAPT with aspirin 100 mg/daily and clopidogrel 75 mg/daily after PCI were prospectively enrolled in the study. Patients were dichotomized into five groups according to RI: estimated glomerular filtration rate (eGFR) >90 mL/min/1.73 m(2) (RI1), 60-89 mL/min/1.73 m(2) (RI2), 30-59 mL/min/1.73 m(2) (RI3), <30 mL/min/1.73 m(2) (RI4), and undergoing dialysis (RI5). Major adverse clinical events (MACEs; cardiovascular death, myocardial infarction, stent thrombosis, and stroke) were collected for 1 year. Platelet reactivity by VerifyNow assay and eGFR were simultaneously assessed at 1 month after maintenance DAPT. Patients with RI exhibited a gradual significant increase of residual platelet reactivity during DAPT, dependent on eGFR deterioration [191 +/- 72 PRU (RI1) vs. 216 +/- 78 PRU (RI2) vs. 248 +/- 80 PRU (RI3) vs. 264 +/- 70 PRU (RI4) vs. 317 +/- 96 PRU (RI5), P < 0.001] being the highest in the dialyses group. Declined eGFR has been gradually associated with advancing age (OR = 1.03, 95% CI = 1.00-1.05; P = 0.032), female gender (OR = 1.7, 95% CI = 1.1-2.5; P = 0.01), diminished smoking rates (OR = 0.6, 95% CI = 0.37-1.00; P = 0.05), hypertension (OR = 1.8, 95% CI = 1.3-2.5; P < 0.001); diabetes (OR = 1.5, 95% CI = 1.1-2.1; P = 0.007), and MACE (HR = 13.9; 95% CI = 1.6-124.3; P = 0.02 for RI4; and HR = 31.9; 95% CI = 2.9-351.9; P = 0.005 for dialysis), but not for bleeding (P = 0.143). Major adverse clinical event risks still remained significant for RI4 (P = 0.027) and RI5 (P = 0.002) by multivariate Cox hazard regression estimates. CONCLUSION: Renal impairment is associated with gradual elevation of residual platelet reactivity while on DAPT, enhancing MACE risks, but not bleeding events. These data should be confirmed in a large randomized outcome-driven trial, and may justify future maintenance-phase DAPT regimen/dose adjustment in RI patients. CI - Published on behalf of the European Society of Cardiology. All rights reserved. (c) The Author 2015. For permissions please email: journals.permissions@oup.com. FAU - Guo, Long Zhe AU - Guo LZ AD - Department of Cardiology, Dong-A University Hospital, Busan, South Korea Clinical Trial Center, Dong-A University Hospital, Busan, South Korea Department of Cardiology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China. FAU - Kim, Moo Hyun AU - Kim MH AD - Department of Cardiology, Dong-A University Hospital, Busan, South Korea Clinical Trial Center, Dong-A University Hospital, Busan, South Korea kimmh@dau.ac.kr. FAU - Shim, Chang Heon AU - Shim CH AD - Clinical Trial Center, Dong-A University Hospital, Busan, South Korea. FAU - Choi, Sun Young AU - Choi SY AD - Clinical Trial Center, Dong-A University Hospital, Busan, South Korea. FAU - Serebruany, Victor L AU - Serebruany VL AD - HeartDrug Research Laboratories, Johns Hopkins University, Osler Medical Building, 7600 Osler Drive, Suite 307, Baltimore, MD 21204, USA. LA - eng PT - Journal Article PT - Observational Study PT - Research Support, Non-U.S. Gov't DEP - 20151217 PL - England TA - Eur Heart J Cardiovasc Pharmacother JT - European heart journal. Cardiovascular pharmacotherapy JID - 101669491 RN - 0 (Platelet Aggregation Inhibitors) SB - IM MH - Aged MH - Blood Platelets/*drug effects MH - Coronary Disease/*surgery MH - Coronary Thrombosis/prevention & control MH - Drug Therapy, Combination MH - Female MH - Humans MH - Kaplan-Meier Estimate MH - Kidney Diseases/*blood/*complications MH - Male MH - Middle Aged MH - Percutaneous Coronary Intervention MH - Platelet Aggregation/drug effects MH - Platelet Aggregation Inhibitors/adverse effects/*therapeutic use MH - Postoperative Complications/prevention & control MH - Prospective Studies MH - *Stents OTO - NOTNLM OT - Antiplatelet therapy OT - Clinical outcomes OT - Glomerular filtration OT - Renal function EDAT- 2016/08/18 06:00 MHDA- 2018/03/24 06:00 CRDT- 2016/08/18 06:00 PHST- 2015/10/20 00:00 [received] PHST- 2015/12/07 00:00 [accepted] PHST- 2016/08/18 06:00 [entrez] PHST- 2016/08/18 06:00 [pubmed] PHST- 2018/03/24 06:00 [medline] AID - pvv052 [pii] AID - 10.1093/ehjcvp/pvv052 [doi] PST - ppublish SO - Eur Heart J Cardiovasc Pharmacother. 2016 Jul;2(3):145-51. doi: 10.1093/ehjcvp/pvv052. Epub 2015 Dec 17. PMID- 27506888 OWN - NLM STAT- MEDLINE DCOM- 20170929 LR - 20260127 IS - 1874-1754 (Electronic) IS - 0167-5273 (Linking) VI - 222 DP - 2016 Nov 1 TI - Primary percutaneous coronary intervention in octogenarians. PG - 1129-1135 LID - S0167-5273(16)31598-4 [pii] LID - 10.1016/j.ijcard.2016.07.204 [doi] AB - BACKGROUND: Limited data are available on the outcome of primary percutaneous coronary intervention (PCI) in octogenarian patients, as the elderly are under-represented in randomized trials. This study aims to provide insights on clinical characteristics, management and outcome of the elderly and very elderly presenting with STEMI. METHODS: 2225 STEMI patients >/=70years old (mean age 76.8+/-5.1years and 53.8% men) were admitted into the network of the ISACS-TC registry. Of these patients, 72.8% were >/=70 to 79years old (elderly) and 27.2% were >/=80years old (very-elderly). The primary end-point was 30-day mortality. RESULTS: Thirty-day mortality rates were 13.4% in the elderly and 23.9% in the very-elderly. Primary PCI decreased the unadjusted risk of death both in the elderly (OR: 0.32, 95% CI: 0.24-0.43) and very-elderly patients (OR: 0.45, 95% CI 0.30-0.68), without significant difference between groups. In the very-elderly hypertension and Killip class >/=2 were the only independent factors associated with mortality; whereas in the elderly female gender, prior stroke, chronic kidney disease and Killip class >/=2 were all factors independently associated with mortality. Factors associated with the lack of use of reperfusion were female gender and atypical chest pain in the very-elderly and in the elderly; in the elderly, however, there were some more factors, namely: history of diabetes, current smoking, prior stroke, Killip class >/=2 and history chronic kidney disease. CONCLUSIONS: Age is relevant in the prognosis of STEMI, but its importance should not be considered secondary to other major clinical factors. Primary PCI appears to have beneficial effects in the octogenarian STEMI patients. CI - Copyright (c) 2016. Published by Elsevier Ireland Ltd. FAU - Ricci, Beatrice AU - Ricci B AD - Department of Experimental, Diagnostic and Specialty Medicine, Section of Cardiology, University of Bologna, Bologna, Italy. FAU - Manfrini, Olivia AU - Manfrini O AD - Department of Experimental, Diagnostic and Specialty Medicine, Section of Cardiology, University of Bologna, Bologna, Italy. Electronic address: olivia.manfrini@unibo.it. FAU - Cenko, Edina AU - Cenko E AD - Department of Experimental, Diagnostic and Specialty Medicine, Section of Cardiology, University of Bologna, Bologna, Italy. FAU - Vasiljevic, Zorana AU - Vasiljevic Z AD - Clinical Center of Serbia, Medical Faculty, University of Belgrade, Belgrade, Serbia. FAU - Dorobantu, Maria AU - Dorobantu M AD - University of Medicine and Pharmacy "Carol Davila", Bucharest, Romania; Department of Cardiology and Internal Medicine, Floreasca Emergency Hospital, Bucharest, Romania. FAU - Kedev, Sasko AU - Kedev S AD - University Clinic of Cardiology, Medical Faculty, University "Ss. Cyril and Methodius", Skopje, Macedonia. FAU - Davidovic, Goran AU - Davidovic G AD - Clinic for Cardiology, Clinical Center Kragujevac, Kragujevac Faculty of Medical Sciences, University in Kragujevac, Kragujevac, Serbia. FAU - Zdravkovic, Marija AU - Zdravkovic M AD - University Clinical Hospital Center Bezanijska Kosa, Faculty of Medicine, University of Belgrade, Belgrade, Serbia. FAU - Gustiene, Olivija AU - Gustiene O AD - Department of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania. FAU - Knezevic, Bozidarka AU - Knezevic B AD - Clinical Center of Montenegro, Center of Cardiology, Podgorica, Montenegro. FAU - Milicic, Davor AU - Milicic D AD - Department for Cardiovascular Diseases, University Hospital Center Zagreb, University of Zagreb, Zagreb, Croatia. FAU - Badimon, Lina AU - Badimon L AD - Cardiovascular Research Center, CSIC-ICCC, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Barcelona, Spain. FAU - Bugiardini, Raffaele AU - Bugiardini R AD - Department of Experimental, Diagnostic and Specialty Medicine, Section of Cardiology, University of Bologna, Bologna, Italy. LA - eng PT - Clinical Trial PT - Journal Article PT - Multicenter Study DEP - 20160802 PL - Netherlands TA - Int J Cardiol JT - International journal of cardiology JID - 8200291 SB - IM MH - Acute Coronary Syndrome/mortality/*surgery MH - Age Factors MH - Aged MH - Aged, 80 and over MH - Europe/epidemiology MH - Female MH - Humans MH - Male MH - *Percutaneous Coronary Intervention MH - Prognosis MH - *Registries MH - Risk Factors MH - Sex Factors MH - Survival Rate/trends MH - Time Factors OTO - NOTNLM OT - Elderly patients OT - Octogenarians OT - Primary percutaneous intervention OT - Reperfusion OT - ST segment elevation myocardial infarction EDAT- 2016/08/11 06:00 MHDA- 2017/09/30 06:00 CRDT- 2016/08/11 06:00 PHST- 2016/07/25 00:00 [received] PHST- 2016/07/28 00:00 [accepted] PHST- 2016/08/11 06:00 [entrez] PHST- 2016/08/11 06:00 [pubmed] PHST- 2017/09/30 06:00 [medline] AID - S0167-5273(16)31598-4 [pii] AID - 10.1016/j.ijcard.2016.07.204 [doi] PST - ppublish SO - Int J Cardiol. 2016 Nov 1;222:1129-1135. doi: 10.1016/j.ijcard.2016.07.204. Epub 2016 Aug 2. PMID- 27502866 OWN - NLM STAT- MEDLINE DCOM- 20170525 LR - 20180911 IS - 1097-6744 (Electronic) IS - 0002-8703 (Linking) VI - 178 DP - 2016 Aug TI - Effect of age on efficacy and safety of vorapaxar in patients with non-ST-segment elevation acute coronary syndrome: Insights from the Thrombin Receptor Antagonist for Clinical Event Reduction in Acute Coronary Syndrome (TRACER) trial. PG - 176-84 LID - S0002-8703(16)30081-3 [pii] LID - 10.1016/j.ahj.2016.05.012 [doi] AB - BACKGROUND: Antithrombotic therapy plays an important role in the treatment of non-ST-segment elevation acute coronary syndromes (NSTE ACS) but is associated with bleeding risk. Advanced age may modify the relationship between efficacy and safety. METHODS: Efficacy and safety of vorapaxar (a protease-activated receptor 1 antagonist) was analyzed across ages as a continuous and a categorical variable in the 12,944 patients with NSTE ACS enrolled in the TRACER trial. To evaluate the effect of age, Cox regression models were developed to estimate hazard ratios (HRs) with the adjustment of other baseline characteristics and randomized treatment for the primary efficacy composite of cardiovascular death, myocardial infarction (MI), stroke, recurrent ischemia with rehospitalization, or urgent coronary revascularization, and the primary safety composite of moderate or severe Global Use of Strategies to Open Occluded Coronary Arteries (GUSTO) bleeding. RESULTS: The median age of the population was 64years (25th, 75th percentiles = 58, 71). Also, 1,791 patients (13.8%) were /=75years) had substantially higher 2-year rates of the composite ischemic end point and moderate or severe GUSTO bleeding compared with the youngest age group (/= 2) (P = .93) between the aminophylline (n = 274) and placebo (n = 274) groups. There was no interaction between aminophylline use and SDS as a determinant of the composite endpoint of cardiac death or MI (P = .32) or the composite endpoint of cardiac death, MI, or coronary revascularization (P = .92). CONCLUSION: In patients undergoing regadenoson-stress SPECT-MPI, the intravenous administration of 75 mg of aminophylline as early as 90 seconds after radioisotope injection does not seem to attenuate the burden of myocardial ischemia. FAU - Fughhi, Ibtihaj AU - Fughhi I AD - Division of Cardiology, Rush University Medical Center, Chicago, IL, USA. FAU - Campagnoli, Tania AU - Campagnoli T AD - Division of Cardiology, Rush University Medical Center, Chicago, IL, USA. FAU - Ali, Amjad AU - Ali A AD - Division of Cardiology, John H. Stroger, Jr. Hospital of Cook County, 1901 W. Harrison St, Chicago, IL, 60612, USA. FAU - Doukky, Rami AU - Doukky R AD - Division of Cardiology, Rush University Medical Center, Chicago, IL, USA. rami_doukky@rush.edu. AD - Division of Cardiology, John H. Stroger, Jr. Hospital of Cook County, 1901 W. Harrison St, Chicago, IL, 60612, USA. rami_doukky@rush.edu. AD - Department of Radiology and Nuclear Medicine, Rush University Medical Center, Chicago, IL, USA. rami_doukky@rush.edu. LA - eng PT - Journal Article PT - Randomized Controlled Trial DEP - 20160527 PL - United States TA - J Nucl Cardiol JT - Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology JID - 9423534 RN - 0 (Organophosphorus Compounds) RN - 0 (Organotechnetium Compounds) RN - 0 (Purines) RN - 0 (Pyrazoles) RN - 27Y3KJK423 (Aminophylline) RN - 2XLN4Y044H (regadenoson) RN - 42FOP1YX93 (technetium tc-99m tetrofosmin) SB - IM CIN - J Nucl Cardiol. 2017 Oct;24(5):1579-1582. doi: 10.1007/s12350-016-0553-9. PMID: 27259883 MH - Administration, Intravenous MH - Aged MH - Aminophylline/*administration & dosage MH - Double-Blind Method MH - Drug Administration Schedule MH - Exercise Test MH - Female MH - Follow-Up Studies MH - Humans MH - Male MH - Middle Aged MH - Myocardial Ischemia/*chemically induced/*diagnostic imaging MH - *Myocardial Perfusion Imaging MH - Organophosphorus Compounds/administration & dosage MH - Organotechnetium Compounds/administration & dosage MH - Prospective Studies MH - Purines/*adverse effects MH - Pyrazoles/*adverse effects MH - *Tomography, Emission-Computed, Single-Photon OTO - NOTNLM OT - Regadenoson OT - SPECT OT - aminophylline OT - ischemia OT - myocardial perfusion imaging (MPI) EDAT- 2016/05/29 06:00 MHDA- 2018/10/12 06:00 CRDT- 2016/05/29 06:00 PHST- 2016/03/02 00:00 [received] PHST- 2016/04/06 00:00 [accepted] PHST- 2016/05/29 06:00 [pubmed] PHST- 2018/10/12 06:00 [medline] PHST- 2016/05/29 06:00 [entrez] AID - S1071-3581(23)06668-0 [pii] AID - 10.1007/s12350-016-0506-3 [doi] PST - ppublish SO - J Nucl Cardiol. 2017 Oct;24(5):1571-1578. doi: 10.1007/s12350-016-0506-3. Epub 2016 May 27. PMID- 27225988 OWN - NLM STAT- MEDLINE DCOM- 20171212 LR - 20230815 IS - 1555-905X (Electronic) IS - 1555-9041 (Print) IS - 1555-9041 (Linking) VI - 11 IP - 7 DP - 2016 Jul 7 TI - Effects of Stenting for Atherosclerotic Renal Artery Stenosis on eGFR and Predictors of Clinical Events in the CORAL Trial. PG - 1180-1188 LID - 10.2215/CJN.10491015 [doi] AB - BACKGROUND AND OBJECTIVES: Atherosclerotic renal artery stenosis may cause kidney function loss, but effects of stenting on eGFR and clinical events associated with CKD are uncertain. Our study objectives were to determine effects of stenting on eGFR and predictors of clinical events. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Participants (n=931) in the Cardiovascular Outcomes in Renal Artery Stenosis Trial (from May of 2005 to September of 2012) had >60% atherosclerotic renal artery stenosis and systolic hypertension on two or more antihypertensive drugs and/or stage >/=3 CKD. The intervention was stenting versus no stenting on a background of risk factor management: renin-angiotensin system inhibition, statin, antiplatelet therapy, and smoking cessation education. The effect of stenting on eGFR by the serum creatinine-cystatin C Chronic Kidney Disease Epidemiology Collaboration equation was the prespecified analysis of kidney function. Predictors of eGFR and CKD outcomes (>/=30% eGFR loss, ESRD, and death) and cardiovascular disease outcomes (stroke, myocardial infarction, heart failure, and death) controlling for eGFR and albuminuria were also determined. RESULTS: eGFR was 59+/-24 ml/min per 1.73 m(2) (mean+/-SD) at baseline. Over 3 years, eGFR change, assessed by generalized estimating equations, was -1.5+/-7.0 ml/min per 1.73 m(2) per year in the stent group versus -2.3+/-6.3 ml/min per 1.73 m(2) per year in the medical therapy only group (P=0.18). eGFR predictors (multiple variable generalized estimating equations) were age, albuminuria, systolic BP, and diabetes (inverse associations) as well as men, total cholesterol, and HDL cholesterol (positive associations). CKD outcomes events occurred in 19% (175 of 931), and predictors (Cox proportional hazards models) included albuminuria (positive association), systolic BP (positive association), and HDL cholesterol (inverse association). Cardiovascular disease outcomes events occurred in 22% (207 of 931), and predictors included age, albuminuria, total cholesterol, prior cardiovascular disease, and bilateral atherosclerotic renal artery stenosis (positive associations). CONCLUSIONS: Stenting did not influence eGFR in participants with atherosclerotic renal artery stenosis receiving renin-angiotensin system inhibition-based therapy. Predictors of clinical events were traditional risk factors for CKD and cardiovascular disease. CI - Copyright (c) 2016 by the American Society of Nephrology. FAU - Tuttle, Katherine R AU - Tuttle KR AD - Providence Health Care, University of Washington, Spokane, Washington. FAU - Dworkin, Lance D AU - Dworkin LD AD - Brown University, Providence, Rhode Island. AD - Rhode Island Hospital, Providence, Rhode Island. FAU - Henrich, William AU - Henrich W AD - University of Texas Health Science Center, San Antonio, Texas. FAU - Greco, Barbara A AU - Greco BA AD - Baystate Health, Springfield, Massachusetts. FAU - Steffes, Michael AU - Steffes M AD - University of Minnesota, Minneapolis, Minnesota. FAU - Tobe, Sheldon AU - Tobe S AD - University of Toronto, Toronto, Ontario, Canada. FAU - Shapiro, Joseph I AU - Shapiro JI AD - Marshall University, Huntington, West Virginia. FAU - Jamerson, Kenneth AU - Jamerson K AD - University of Michigan, Ann Arbor, Michigan. FAU - Lyass, Asya AU - Lyass A AD - Harvard Clinical Research Institute, Boston University, Boston, Massachusetts. FAU - Pencina, Karol AU - Pencina K AD - Harvard Clinical Research Institute, Boston University, Boston, Massachusetts. FAU - Massaro, Joseph M AU - Massaro JM AD - Harvard Clinical Research Institute, Boston University, Boston, Massachusetts. FAU - D'Agostino, Ralph B Sr AU - D'Agostino RB Sr AD - Harvard Clinical Research Institute, Boston University, Boston, Massachusetts. FAU - Cutlip, Donald E AU - Cutlip DE AD - Beth Israel Deaconess Medical Center, Boston, Massachusetts; and. FAU - Murphy, Timothy P AU - Murphy TP AD - Brown University, Providence, Rhode Island. AD - Rhode Island Hospital, Providence, Rhode Island. FAU - Cooper, Christopher J AU - Cooper CJ AD - University of Toledo, Toledo, Ohio. LA - eng GR - U01 HL072735/HL/NHLBI NIH HHS/United States GR - U01 HL071556/HL/NHLBI NIH HHS/United States GR - U01 HL072734/HL/NHLBI NIH HHS/United States GR - U01 HL072736/HL/NHLBI NIH HHS/United States GR - R01 HL109015/HL/NHLBI NIH HHS/United States GR - U01 HL072737/HL/NHLBI NIH HHS/United States PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't DEP - 20160525 PL - United States TA - Clin J Am Soc Nephrol JT - Clinical journal of the American Society of Nephrology : CJASN JID - 101271570 RN - 0 (Angiotensin Receptor Antagonists) RN - 0 (Angiotensin-Converting Enzyme Inhibitors) RN - 0 (Cholesterol, HDL) RN - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors) RN - 0 (Platelet Aggregation Inhibitors) SB - IM CIN - Clin J Am Soc Nephrol. 2016 Jul 7;11(7):1125-1127. doi: 10.2215/CJN.04640416. PMID: 27225989 MH - Age Factors MH - Aged MH - Albuminuria/etiology MH - Angiotensin Receptor Antagonists/therapeutic use MH - Angiotensin-Converting Enzyme Inhibitors/therapeutic use MH - Atherosclerosis/complications/drug therapy MH - Blood Pressure MH - Cardiovascular Diseases/*etiology MH - Cholesterol, HDL/blood MH - Female MH - *Glomerular Filtration Rate MH - Humans MH - Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use MH - Hypertension/complications/drug therapy MH - Kaplan-Meier Estimate MH - Kidney Failure, Chronic/physiopathology MH - Male MH - Middle Aged MH - Platelet Aggregation Inhibitors/therapeutic use MH - Proportional Hazards Models MH - Renal Artery Obstruction/etiology/*physiopathology/*therapy MH - Renal Insufficiency, Chronic/complications/*physiopathology MH - Sex Factors MH - Smoking Cessation MH - *Stents PMC - PMC4934844 OTO - NOTNLM OT - Renal Artery Obstruction OT - Stents OT - albuminuria OT - blood pressure OT - cardiovascular disease OT - chronic kidney disease OT - glomerular filtration rate OT - hypertension OT - renin angiotensin system EDAT- 2016/05/27 06:00 MHDA- 2017/12/13 06:00 PMCR- 2017/07/07 CRDT- 2016/05/27 06:00 PHST- 2015/10/01 00:00 [received] PHST- 2016/04/05 00:00 [accepted] PHST- 2016/05/27 06:00 [entrez] PHST- 2016/05/27 06:00 [pubmed] PHST- 2017/12/13 06:00 [medline] PHST- 2017/07/07 00:00 [pmc-release] AID - 01277230-201607000-00011 [pii] AID - 10491015 [pii] AID - 10.2215/CJN.10491015 [doi] PST - ppublish SO - Clin J Am Soc Nephrol. 2016 Jul 7;11(7):1180-1188. doi: 10.2215/CJN.10491015. Epub 2016 May 25. PMID- 27221952 OWN - NLM STAT- MEDLINE DCOM- 20180131 LR - 20180201 IS - 1525-6073 (Electronic) IS - 0742-0528 (Linking) VI - 33 IP - 7 DP - 2016 TI - Sleep-time ambulatory blood pressure as a prognostic marker of vascular and other risks and therapeutic target for prevention by hypertension chronotherapy: Rationale and design of the Hygia Project. PG - 906-36 LID - 10.1080/07420528.2016.1181078 [doi] AB - This article describes the rationale, objectives, design and conduct of the ambulatory blood pressure monitoring (ABPM)-based Hygia Project. Given the substantial evidence of the significantly better prognostic value of ABPM compared to clinic BP measurements, several international guidelines now propose ABPM as a requirement to confirm the office diagnosis of hypertension. Nonetheless, all previous ABPM outcome investigations, except the Monitorizacion Ambulatoria para Prediccion de Eventos Cardiovasculares study (MAPEC) study, relied upon only a single, low-reproducible 24 h ABPM assessment per participant done at study inclusion, thus precluding the opportunity to explore the potential reduction in cardiovascular disease (CVD) risk associated with modification of prognostic ABPM-derived parameters by hypertension therapy. The findings of the single-center MAPEC study, based upon periodic systematic 48 h ABPM evaluation of all participants during a median follow-up of 5.6 years, constitute the first proof-of-concept evidence that the progressive reduction of the asleep systolic blood pressure (SBP) mean and correction of the sleep-time relative SBP decline toward the normal dipper BP profile, most efficiently accomplished by a bedtime hypertension treatment strategy, best attenuates the risk of CVD, stroke and development of new-onset diabetes. The Hygia Project, primarily designed to extend the use of ABPM in primary care as a requirement for diagnosis of hypertension, evaluation of response to treatment and individualized assessment of CVD and other risks, is a research network presently composed of 40 clinical sites and 292 investigators. Its main objectives are to (i) investigate whether specific treatment-induced changes in ABPM-derived parameters reduce risk of CVD events, stroke, new-onset diabetes and/or development of chronic kidney disease (CKD); and (ii) test the hypothesis that bedtime chronotherapy entailing the entire daily dose of >/=1 conventional hypertension medications exerts better ambulatory BP control and CVD, metabolic and renal risk reduction than all such medications ingested in the morning upon awakening. Between 2007 and 2015, investigators recruited 18 078 persons [9769 men/8309 women, 59.1 +/- 14.3 years of age (mean +/- SD)], including 15 764 with hypertension according to ABPM criteria as participants in the prospective randomized chronotherapy trial. The initial evaluation includes 48 h ABPM, detailed medical history and screening laboratory blood and urine tests. The same evaluation procedure is scheduled annually, or more frequently when treatment adjustment is required for proper ambulatory BP control, targeting a median follow-up of >5 years. The primary CVD outcome end point is the composite of CVD death, myocardial infarction, coronary revascularization, heart failure, ischemic stroke and hemorrhagic stroke. The independent Hygia Project Events Committee periodically evaluates blinded clinical reports to ascertain and certify every documented event. Beyond the potential findings resulting from testing the main hypotheses, the Hygia Project has already demonstrated, as proof of concept, that the routine diagnosis of hypertension and individualized assessment of CVD and other risks by ABPM, as currently recommended, is fully viable in the primary care setting, where most people with either hypertension, dyslipidemia, type 2 diabetes or CKD receive routine medical attention. FAU - Hermida, Ramon C AU - Hermida RC AD - a Bioengineering & Chronobiology Laboratories; Atlantic Research Center for Information and Communication Technologies (AtlantTIC) ; E.E. Telecomunicacion, University of Vigo , Vigo , Spain. LA - eng SI - ClinicalTrials.gov/NCT00741585 PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20160524 PL - England TA - Chronobiol Int JT - Chronobiology international JID - 8501362 RN - 0 (Antihypertensive Agents) SB - IM MH - Adult MH - Aged MH - Aged, 80 and over MH - Antihypertensive Agents/therapeutic use MH - Blood Pressure/drug effects/*physiology MH - *Chronotherapy MH - Circadian Rhythm/*physiology MH - Diabetes Mellitus, Type 2/complications/drug therapy MH - Female MH - Humans MH - Hypertension/drug therapy/*prevention & control MH - Male MH - Middle Aged MH - Prospective Studies MH - Risk Factors MH - Sleep/drug effects/*physiology MH - Time Factors OTO - NOTNLM OT - ambulatory blood pressure monitoring OT - cardiovascular risk OT - chronic kidney disease OT - circadian rhythm OT - diabetes OT - hypertension chronotherapy OT - sleep-time blood pressure EDAT- 2016/05/26 06:00 MHDA- 2018/02/01 06:00 CRDT- 2016/05/26 06:00 PHST- 2016/05/26 06:00 [entrez] PHST- 2016/05/26 06:00 [pubmed] PHST- 2018/02/01 06:00 [medline] AID - 10.1080/07420528.2016.1181078 [doi] PST - ppublish SO - Chronobiol Int. 2016;33(7):906-36. doi: 10.1080/07420528.2016.1181078. Epub 2016 May 24. PMID- 27182610 OWN - NLM STAT- MEDLINE DCOM- 20181018 LR - 20181113 IS - 2149-2271 (Electronic) IS - 2149-2263 (Print) IS - 2149-2263 (Linking) VI - 16 IP - 10 DP - 2016 Oct TI - Serum cystatin C and neutrophil gelatinase-associated lipocalin in predicting the severity of coronary artery disease in diabetic patients. PG - 756-761 LID - 10.5152/AnatolJCardiol.2015.6645 [doi] AB - OBJECTIVE: Cystatin C and neutrophil gelatinase-associated lipocalin (NGAL) are biomarkers of renal functions. We evaluated their roles in predicting the severity of coronary artery disease (CAD). METHODS: Fifty-two consecutive type 2 diabetic patients (32 males, 65.7+/-8.6 years) who underwent coronary angiography (CAG) for stable CAD were included in this single-center, prospective, cross-sectional study. Patients with an estimated glomerular filtration rate <60 mL/min/1.73 m2 and with a history of by-pass surgery and/or coronary stent implantation were excluded. The vessel score and Gensini score were calculated to assess the presence and severity of CAD. Mann-Whitney U test, Spearman test, and multiple linear regression analysis were used for the main statistical analyses. RESULTS: Serum cystatin C levels were higher in patients with multivessel disease than in those with single vessel disease [1260 ng/mL (953-1640) vs. 977 ng/mL (599-1114), p=0.017]. According to the median Gensini score, the higher score group also had higher cystatin C levels than the lower score group [1114 ng/mL (948-1567) vs. 929 ng/mL (569-1156), p=0.009]. However, serum NGAL levels were similar between these subgroups. There was a positive correlation between cystatin C and Gensini score (r=0.334, p=0.016). Multiple linear regression analysis revealed serum cystatin C as an independent predictor of the Gensini score (ss=0.360, t=2.311, p=0.026). These results may aid in defining cystatin C as a surrogate marker of the extent of CAD in further clinical trials. CONCLUSION: Serum Cystatin C, but not NGAL levels, could predict the severity of CAD in diabetic patients. FAU - Okyay, Kaan AU - Okyay K AD - Department of Cardiology, Faculty of Medicine, Baskent University Ankara Education and Research Hospital, Ankara-Turkey. drokyay@yahoo.com. FAU - Yildirir, Aylin AU - Yildirir A AD - Department of Cardiology, Faculty of Medicine, Baskent University Ankara Education and Research Hospital, Ankara-Turkey. FAU - Cicek, Mutlu AU - Cicek M AD - Department of Cardiology, Faculty of Medicine, Baskent University Ankara Education and Research Hospital, Ankara-Turkey. FAU - Aydinalp, Alp AU - Aydinalp A AD - Department of Cardiology, Faculty of Medicine, Baskent University Ankara Education and Research Hospital, Ankara-Turkey. FAU - Muderrisoglu, Haldun AU - Muderrisoglu H AD - Department of Cardiology, Faculty of Medicine, Baskent University Ankara Education and Research Hospital, Ankara-Turkey. LA - eng PT - Journal Article DEP - 20151126 PL - Turkey TA - Anatol J Cardiol JT - Anatolian journal of cardiology JID - 101652981 RN - 0 (Biomarkers) RN - 0 (Cystatin C) RN - 0 (Lipocalin-2) RN - 0 (Lipocalins) SB - IM MH - Aged MH - Biomarkers/blood MH - Coronary Artery Disease/etiology/*pathology MH - Cross-Sectional Studies MH - Cystatin C/*blood MH - *Diabetes Complications MH - Diabetes Mellitus MH - Female MH - Glomerular Filtration Rate MH - Humans MH - Lipocalin-2/*blood MH - Lipocalins MH - Male MH - Middle Aged MH - Prospective Studies PMC - PMC5324935 COIS- Conflict of interest: None declared. EDAT- 2016/05/18 06:00 MHDA- 2018/10/20 06:00 PMCR- 2016/10/01 CRDT- 2016/05/17 06:00 PHST- 2016/05/18 06:00 [pubmed] PHST- 2018/10/20 06:00 [medline] PHST- 2016/05/17 06:00 [entrez] PHST- 2016/10/01 00:00 [pmc-release] AID - AJC-16-756 [pii] AID - 10.5152/AnatolJCardiol.2015.6645 [doi] PST - ppublish SO - Anatol J Cardiol. 2016 Oct;16(10):756-761. doi: 10.5152/AnatolJCardiol.2015.6645. Epub 2015 Nov 26. PMID- 27110377 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20160425 LR - 20250529 IS - 2053-3624 (Print) IS - 2053-3624 (Electronic) IS - 2053-3624 (Linking) VI - 3 IP - 1 DP - 2016 TI - Non-invasive versus invasive management in patients with prior coronary artery bypass surgery with a non-ST segment elevation acute coronary syndrome: study design of the pilot randomised controlled trial and registry (CABG-ACS). PG - e000371 LID - 10.1136/openhrt-2015-000371 [doi] LID - e000371 AB - INTRODUCTION: There is an evidence gap about how to best treat patients with prior coronary artery bypass grafts (CABGs) presenting with non-ST segment elevation acute coronary syndromes (NSTE-ACS) because historically, these patients were excluded from pivotal randomised trials. We aim to undertake a pilot trial of routine non-invasive management versus routine invasive management in patients with NSTE-ACS with prior CABG and optimal medical therapy during routine clinical care. Our trial is a proof-of-concept study for feasibility, safety, potential efficacy and health economic modelling. We hypothesise that a routine invasive approach in patients with NSTE-ACS with prior CABG is not superior to a non-invasive approach with optimal medical therapy. METHODS AND ANALYSIS: 60 patients will be enrolled in a randomised clinical trial in 4 hospitals. A screening log will be prospectively completed. Patients not randomised due to lack of eligibility criteria and/or patient or physician preference and who give consent will be included in a registry. We will gather information about screening, enrolment, eligibility, randomisation, patient characteristics and adverse events (including post-discharge). The primary efficacy outcome is the composite of all-cause mortality, rehospitalisation for refractory ischaemia/angina, myocardial infarction and hospitalisation for heart failure. The primary safety outcome is the composite of bleeding, stroke, procedure-related myocardial infarction and worsening renal function. Health status will be assessed using EuroQol 5 Dimensions (EQ-5D) assessed at baseline and 6 monthly intervals, for at least 18 months. TRIAL REGISTRATION NUMBER: NCT01895751 (ClinicalTrials.gov). FAU - Lee, Matthew M Y AU - Lee MM AD - West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Glasgow, UK; Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK; Western Infirmary, Glasgow, UK; Royal Alexandra Hospital, Paisley, UK; Glasgow Royal Infirmary, Glasgow, UK. FAU - Petrie, Mark C AU - Petrie MC AD - West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Glasgow, UK; Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK; Glasgow Royal Infirmary, Glasgow, UK. FAU - Rocchiccioli, Paul AU - Rocchiccioli P AD - West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Glasgow, UK; Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK; Glasgow Royal Infirmary, Glasgow, UK. FAU - Simpson, Joanne AU - Simpson J AD - West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Glasgow, UK; Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK. FAU - Jackson, Colette AU - Jackson C AD - West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Glasgow, UK; Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK. FAU - Brown, Ammani AU - Brown A AD - Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK; Western Infirmary, Glasgow, UK. FAU - Corcoran, David AU - Corcoran D AD - West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Glasgow, UK; Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK. FAU - Mangion, Kenneth AU - Mangion K AD - West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Glasgow, UK; Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK. FAU - McEntegart, Margaret AU - McEntegart M AD - West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Glasgow, UK; Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK; Western Infirmary, Glasgow, UK. FAU - Shaukat, Aadil AU - Shaukat A AD - West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Glasgow, UK; Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK; Glasgow Royal Infirmary, Glasgow, UK. FAU - Rae, Alan AU - Rae A AD - West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Glasgow, UK; Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK; Glasgow Royal Infirmary, Glasgow, UK. FAU - Hood, Stuart AU - Hood S AD - West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Glasgow, UK; Royal Alexandra Hospital, Paisley, UK. FAU - Peat, Eileen AU - Peat E AD - West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Glasgow, UK; Royal Alexandra Hospital, Paisley, UK. FAU - Findlay, Iain AU - Findlay I AD - Royal Alexandra Hospital , Paisley , UK. FAU - Murphy, Clare AU - Murphy C AD - Royal Alexandra Hospital , Paisley , UK. FAU - Cormack, Alistair AU - Cormack A AD - Royal Alexandra Hospital , Paisley , UK. FAU - Bukov, Nikolay AU - Bukov N AD - Royal Blackburn Hospital , Blackburn , UK. FAU - Balachandran, Kanarath AU - Balachandran K AD - Royal Blackburn Hospital , Blackburn , UK. FAU - Papworth, Richard AU - Papworth R AD - Robertson Centre for Biostatistics, University of Glasgow , Glasgow , UK. FAU - Ford, Ian AU - Ford I AD - Robertson Centre for Biostatistics, University of Glasgow , Glasgow , UK. FAU - Briggs, Andrew AU - Briggs A AD - Department of Health Economics and Health Technology Assessment , University of Glasgow , Glasgow , UK. FAU - Berry, Colin AU - Berry C AD - West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Glasgow, UK; Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK; Western Infirmary, Glasgow, UK. LA - eng SI - ClinicalTrials.gov/NCT01895751 GR - FS/14/15/30661/BHF_/British Heart Foundation/United Kingdom GR - FS/15/54/31639/BHF_/British Heart Foundation/United Kingdom PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20160420 PL - England TA - Open Heart JT - Open heart JID - 101631219 PMC - PMC4838768 OTO - NOTNLM OT - CABG OT - Invasive OT - NSTE-ACS OT - RCT OT - Registry EDAT- 2016/04/26 06:00 MHDA- 2016/04/26 06:01 PMCR- 2016/04/20 CRDT- 2016/04/26 06:00 PHST- 2015/11/28 00:00 [received] PHST- 2016/01/06 00:00 [accepted] PHST- 2016/04/26 06:00 [entrez] PHST- 2016/04/26 06:00 [pubmed] PHST- 2016/04/26 06:01 [medline] PHST- 2016/04/20 00:00 [pmc-release] AID - openhrt-2015-000371 [pii] AID - 10.1136/openhrt-2015-000371 [doi] PST - epublish SO - Open Heart. 2016 Apr 20;3(1):e000371. doi: 10.1136/openhrt-2015-000371. eCollection 2016. PMID- 27100661 OWN - NLM STAT- MEDLINE DCOM- 20170328 LR - 20260127 IS - 1473-5830 (Electronic) IS - 0954-6928 (Linking) VI - 27 IP - 6 DP - 2016 Sep TI - Comparisons of the uptake and in-hospital outcomes associated with second-generation drug-eluting stents between men and women: results from the CathPCI Registry. PG - 442-8 LID - 10.1097/MCA.0000000000000376 [doi] AB - OBJECTIVES: We sought to examine trends in use and outcomes of second-generation drug-eluting stents (DES) across sexes in a contemporary percutaneous coronary intervention (PCI) cohort. BACKGROUND: Sparse female enrollment in trials comparing first-generation versus second-generation DES may influence clinical decision making at the time of PCI. METHODS: We studied patients undergoing PCI with DES enrolled in the CathPCI Registry between July 2009 and March 2013. We compared the prevalence of second-generation DES use by sex over time. Outcomes included procedural success, post-PCI bleeding, and vascular complications. Associations between sex and DES type on outcomes were assessed using logistic regression with formal interaction tests. RESULTS: Compared with men (n=1 129 122; 67.7%), women (n=538 835; 32.3%) were older, with a higher prevalence of diabetes mellitus, peripheral vascular, and chronic kidney disease. Although use of second-generation DES increased among both men and women over time, use was higher among men in the first 1.5 years, with no differences thereafter. There were no differences in procedural success, bleeding, or vascular complications across sexes between first-generation and second-generation DES. CONCLUSION: Uptake of second-generation DES increased over time in women, with comparable in-hospital benefits as first-generation DES across sexes. FAU - Baber, Usman AU - Baber U AD - aInterventional Cardiovascular Research and Clinical Trials, The Icahn School of Medicine at Mount Sinai, New York, New York bDuke Clinical Research Institute, Durham, North Carolina cHeart Hospital, The Detroit Medical Center, Detroit, Michigan dDepartment of Medicine, Mayo Clinic, Rochester, Minnesota eGeisinger Center for Health Research, Danville, Pennsylvania, USA fInterventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy gDeutsches Zentrum fur Herz Kreislaufforschung, partner site Munich Heart Alliance, Munich, Germany. FAU - Giustino, Gennaro AU - Giustino G FAU - Wang, Tracy AU - Wang T FAU - Grines, Cindy AU - Grines C FAU - McCoy, Lisa A AU - McCoy LA FAU - Saha-Chaudhuri, Paramita AU - Saha-Chaudhuri P FAU - Best, Patricia AU - Best P FAU - Skelding, Kimberly A AU - Skelding KA FAU - Ortega, Rebecca AU - Ortega R FAU - Chieffo, Alaide AU - Chieffo A FAU - Mehilli, Julinda AU - Mehilli J FAU - Tcheng, James AU - Tcheng J FAU - Mehran, Roxana AU - Mehran R LA - eng PT - Comparative Study PT - Journal Article PT - Observational Study PL - England TA - Coron Artery Dis JT - Coronary artery disease JID - 9011445 SB - IM CIN - Coron Artery Dis. 2016 Sep;27(6):437-8. doi: 10.1097/MCA.0000000000000393. PMID: 27465639 MH - Aged MH - Chi-Square Distribution MH - Comorbidity MH - Coronary Artery Disease/diagnostic imaging/epidemiology/*therapy MH - *Drug-Eluting Stents/trends MH - Female MH - *Healthcare Disparities/trends MH - Humans MH - Logistic Models MH - Male MH - Middle Aged MH - Percutaneous Coronary Intervention/adverse effects/*instrumentation/trends MH - Practice Patterns, Physicians'/trends MH - Prevalence MH - Prosthesis Design MH - Registries MH - Risk Factors MH - Sex Factors MH - Treatment Outcome MH - United States/epidemiology EDAT- 2016/04/22 06:00 MHDA- 2017/03/30 06:00 CRDT- 2016/04/22 06:00 PHST- 2016/04/22 06:00 [entrez] PHST- 2016/04/22 06:00 [pubmed] PHST- 2017/03/30 06:00 [medline] AID - 10.1097/MCA.0000000000000376 [doi] PST - ppublish SO - Coron Artery Dis. 2016 Sep;27(6):442-8. doi: 10.1097/MCA.0000000000000376. PMID- 27050796 OWN - NLM STAT- MEDLINE DCOM- 20170310 LR - 20220330 IS - 1369-1635 (Electronic) IS - 0953-7104 (Linking) VI - 27 IP - 5 DP - 2016 Jul TI - Occurrence, causes, and outcome after switching from ticagrelor to clopidogrel in a real-life scenario: data from a prospective registry. PG - 484-7 LID - 10.3109/09537104.2015.1119815 [doi] AB - In randomized clinical trials, ticagrelor has been substituted in roughly one-third of the patients during follow-up. To date, there are no studies addressing safety and modalities of switching from ticagrelor to clopidogrel. The aim of our study is to describe the occurrence, causes, and outcome of the switch from ticagrelor to clopidogrel in a real-life scenario. From June 2013 to March 2015, 586 patients were treated with ticagrelor in our centre. Overall, 101 (17%) patients were switched to clopidogrel through a standardized protocol, and they were followed-up for 12 months. Ischemic and bleeding events were prospectively recorded. The switch from ticagrelor to clopidogrel occurred mostly after discharge (69 +/- 40 days), and the most frequent cause was the need of oral anticoagulation treatment, followed by bleeding events. Patients requiring ticagrelor discontinuation were older, more frequently female, with lower body mass index and creatinine clearance if compared to the "non-switched" group. In the 10 days after the switch, we did not observe ischemic adverse events. No definite/probable stent thrombosis was recorded. Before the switch, there was a significant higher occurrence of BARC bleedings in the "switched" group, particularly BARC 1 and 2. Our data confirm that the switch from ticagrelor to clopidogrel is common, and it occurs for several reasons. Our analysis did not demonstrate a significant increase in adverse cardiovascular events in the days following the switch from ticagrelor to clopidogrel, although larger studies are needed to validate our findings. FAU - Biscaglia, Simone AU - Biscaglia S AD - a Cardiovascular Institute , Azienda Ospedaliera Universitaria S.Anna , Ferrara , Italy. FAU - Campo, Gianluca AU - Campo G AD - a Cardiovascular Institute , Azienda Ospedaliera Universitaria S.Anna , Ferrara , Italy. AD - b Department of Morphology, Surgery and Experimental Medicine, LTTA Centre , Ferrara , Italy. FAU - Pavasini, Rita AU - Pavasini R AD - a Cardiovascular Institute , Azienda Ospedaliera Universitaria S.Anna , Ferrara , Italy. FAU - Tebaldi, Matteo AU - Tebaldi M AD - a Cardiovascular Institute , Azienda Ospedaliera Universitaria S.Anna , Ferrara , Italy. FAU - Tumscitz, Carlo AU - Tumscitz C AD - a Cardiovascular Institute , Azienda Ospedaliera Universitaria S.Anna , Ferrara , Italy. FAU - Ferrari, Roberto AU - Ferrari R AD - a Cardiovascular Institute , Azienda Ospedaliera Universitaria S.Anna , Ferrara , Italy. AD - b Department of Morphology, Surgery and Experimental Medicine, LTTA Centre , Ferrara , Italy. AD - c Maria Cecilia Hospital , GVM Care & Research, E.S.: Health Science Foundation , Cotignola , Italy. LA - eng PT - Journal Article DEP - 20160114 PL - England TA - Platelets JT - Platelets JID - 9208117 RN - A74586SNO7 (Clopidogrel) RN - GLH0314RVC (Ticagrelor) RN - K72T3FS567 (Adenosine) RN - OM90ZUW7M1 (Ticlopidine) SB - IM MH - Acute Coronary Syndrome/diagnosis/epidemiology/therapy MH - Adenosine/adverse effects/*analogs & derivatives/therapeutic use MH - Aged MH - Aged, 80 and over MH - Angiography MH - Cause of Death MH - Clopidogrel MH - Comorbidity MH - Drug Substitution/*statistics & numerical data MH - Female MH - *Health Care Surveys MH - Humans MH - Male MH - Middle Aged MH - Percutaneous Coronary Intervention MH - Registries MH - Risk Factors MH - Ticagrelor MH - Ticlopidine/adverse effects/*analogs & derivatives/therapeutic use OTO - NOTNLM OT - Acute coronary syndrome OT - bleeding OT - clopidogrel OT - drug switching OT - ticagrelor EDAT- 2016/04/07 06:00 MHDA- 2017/03/11 06:00 CRDT- 2016/04/07 06:00 PHST- 2016/04/07 06:00 [entrez] PHST- 2016/04/07 06:00 [pubmed] PHST- 2017/03/11 06:00 [medline] AID - 10.3109/09537104.2015.1119815 [doi] PST - ppublish SO - Platelets. 2016 Jul;27(5):484-7. doi: 10.3109/09537104.2015.1119815. Epub 2016 Jan 14. PMID- 27038714 OWN - NLM STAT- MEDLINE DCOM- 20170608 LR - 20181202 IS - 1874-1754 (Electronic) IS - 0167-5273 (Linking) VI - 212 DP - 2016 Jun 1 TI - Role of stent type and of duration of dual antiplatelet therapy in patients with chronic kidney disease undergoing percutaneous coronary interventions. Is bare metal stent implantation still a justifiable choice? A post-hoc analysis of the all comer PRODIGY trial. PG - 110-7 LID - S0167-5273(16)30444-2 [pii] LID - 10.1016/j.ijcard.2016.03.033 [doi] AB - AIM: Chronic kidney disease (CKD) is a powerful predictor of major cardiovascular events and stent thrombosis (ST) in patients undergoing percutaneous coronary interventions (PCI). No randomized data are available to compare, and guide the selection of type of stent between bare metal (BMS) or drug eluting stent (DES) in this population. METHODS AND RESULTS: We performed a post-hoc analysis of the PROlonging Dual antiplatelet treatment after Grading stent-induced Intimal hyperplasia studY (PRODIGY) trial, in which stable or unstable patients with coronary artery disease undergoing PCI were randomized 1:1:1:1 to receive BMS, paclitaxel- (PES), zotarolimus- (ZES-S), or everolimus- (EES) eluting stent. A total of 2003 patients were randomized, and 22 patients were excluded for missing serum creatinine leading to a final population of 1981 patients. Primary outcome was definite or probable ST. We also assessed MACE (myocardial infarction, stroke, or death), and all-cause death, as secondary outcome. CKD, defined with estimated glomerular filtration rate <60ml/min/1.73m(2), was found in 373 patients (18.8%). The incidence of ST at 2years was 5.1% in CKD and 2.1% in non-CKD patients (HR 2.57, 95% confidence interval (CI) 1.46 to 4.52, p<0.001). At multivariable regression we found that patients randomized to EES or ZES-S, but not PES, had lower risk of ST at two years as compared with BMS: adjusted HR=0.288, 95% CI [0.107-0.778, p=0.014] and HR=0.394, 95% CI [0.164-0.947, p=0.037] respectively. The number of patients needed to be treated to prevent 1 ST with an EES vs BMS was 20 in CKD and 50 in patients without CKD. EES patients had the lowest incident MACE events 26.4% as compared to BMS 35.1%, ZES-S 33.0%, or PES 35.7% patients, p=0.551. All-cause death was lowest in ZES-S group 10.6% as compared to BMS 18.1%, PES 25.5% and EES 14.9%, p=0.040. We found no significant interaction between DAPT duration (6 vs 24months) and stent type on primary outcome, PINT=0.47 for BMS, PINT=0.57 for PES, PINT=0.41 for ZES-S and PINT=0.28 for EES. CONCLUSIONS: In an all-comer population of patients with stable and unstable CAD, CKD at baseline was associated with a double risk of ST and MACE. CKD patients receiving EES had less than half risk of ST 2years after PCI as compared with BMS and PES. Our analysis suggests that 2nd generation limus-based stent should be favored over paclitaxel-based DES or BMS to reduce ST and MACE in CKD patients. CI - Copyright (c) 2016 Elsevier Ireland Ltd. All rights reserved. FAU - Crimi, Gabriele AU - Crimi G AD - SC. Cardiologia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. FAU - Leonardi, Sergio AU - Leonardi S AD - SC. Cardiologia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. FAU - Costa, Francesco AU - Costa F AD - Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands. FAU - Adamo, Marianna AU - Adamo M AD - Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands. FAU - Ariotti, Sara AU - Ariotti S AD - Swiss Cardiovascular Center Bern, Switzerland. FAU - Valgimigli, Marco AU - Valgimigli M AD - Swiss Cardiovascular Center Bern, Switzerland. Electronic address: marco.valgimigli@insel.ch. LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20160317 PL - Netherlands TA - Int J Cardiol JT - International journal of cardiology JID - 8200291 RN - 0 (Metals) RN - 0 (Platelet Aggregation Inhibitors) RN - A74586SNO7 (Clopidogrel) RN - OM90ZUW7M1 (Ticlopidine) RN - R16CO5Y76E (Aspirin) SB - IM MH - Aged MH - Aged, 80 and over MH - Aspirin/administration & dosage MH - Clinical Decision-Making/methods MH - Clopidogrel MH - Coronary Thrombosis/diagnosis/*etiology/mortality MH - Drug Therapy, Combination MH - Drug-Eluting Stents/*adverse effects MH - Female MH - Humans MH - Male MH - Metals/adverse effects MH - Middle Aged MH - Percutaneous Coronary Intervention/*adverse effects/*instrumentation/methods MH - Platelet Aggregation Inhibitors/*administration & dosage MH - Prosthesis Design MH - Renal Insufficiency, Chronic/mortality/*therapy MH - Stents/adverse effects MH - Ticlopidine/administration & dosage/analogs & derivatives MH - Time Factors MH - Treatment Outcome OTO - NOTNLM OT - 2nd generation drug eluting stent OT - Chronic kidney disease OT - Drug eluting stent OT - Stent thrombosis EDAT- 2016/04/04 06:00 MHDA- 2017/06/09 06:00 CRDT- 2016/04/04 06:00 PHST- 2015/09/26 00:00 [received] PHST- 2016/03/04 00:00 [revised] PHST- 2016/03/13 00:00 [accepted] PHST- 2016/04/04 06:00 [entrez] PHST- 2016/04/04 06:00 [pubmed] PHST- 2017/06/09 06:00 [medline] AID - S0167-5273(16)30444-2 [pii] AID - 10.1016/j.ijcard.2016.03.033 [doi] PST - ppublish SO - Int J Cardiol. 2016 Jun 1;212:110-7. doi: 10.1016/j.ijcard.2016.03.033. Epub 2016 Mar 17. PMID- 27033859 OWN - NLM STAT- MEDLINE DCOM- 20170221 LR - 20260127 IS - 1861-0692 (Electronic) IS - 1861-0684 (Linking) VI - 105 IP - 9 DP - 2016 Sep TI - External validity of the "all-comers" design: insights from the BIOSCIENCE trial. PG - 744-54 LID - 10.1007/s00392-016-0983-z [doi] AB - OBJECTIVES: We sought to systematically evaluate the external validity of a contemporary randomized controlled stent trial (BIOSCIENCE). METHODS: Baseline characteristics and clinical outcomes of patients enrolled into the BIOSCIENCE trial at Bern University Hospital (n = 1216) were compared to those of patients included in the CARDIOBASE Bern PCI Registry at the same institution (n = 1045). The primary study endpoint was the rate of target lesion failure (TLF), defined as a composite of cardiac death, target vessel-myocardial infarction (MI) or target lesion revascularization (TLR), at 1 year. RESULTS: Women were underrepresented in the RCT compared to the registry (25 vs. 29.4 %, p = 0.020). Non-participants were older compared to study participants (69.2 +/- 12.4 vs. 67.0 +/- 11.6, p < 0.001), and had a higher prevalence of previous cerebrovascular events (10.8 vs. 5.2 %, p < 0.001), and chronic renal failure (35.5 vs. 15.6 %, p < 0.001). ST-segment elevation myocardial infarction (STEMI) and Killip class IV at presentation were more common among non-participants than participants (30.7 vs. 21.1 %, p < 0.001 and 7.8 vs. 0.4 %, p < 0.001, respectively). At 1 year, non-participants experienced a significantly higher rate of TLF, (15.0 vs. 6.5 %, p < 0.001), and patient-oriented composite endpoint (POCE), including death, MI or any repeat revascularization (21.6 vs. 11.2 %, p < 0.001). There was a significant interaction between POCE and presence or absence of an acute coronary syndrome in participants versus non-participants, respectively (p = 0.009). CONCLUSIONS: Non-participants of this all-comers trial had a higher risk profile and adverse prognosis compared to study participants. Further efforts are needed to improve the external validity of contemporary RCTs. FAU - Franzone, Anna AU - Franzone A AD - Department of Cardiology, Swiss Cardiovascular Center, Bern University Hospital, 3010, Bern, Switzerland. FAU - Heg, Dik AU - Heg D AD - Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland. AD - Clinical Trials Unit, Department of Clinical Research, University of Bern, Bern, Switzerland. FAU - Raber, Lorenz AU - Raber L AD - Department of Cardiology, Swiss Cardiovascular Center, Bern University Hospital, 3010, Bern, Switzerland. FAU - Valgimigli, Marco AU - Valgimigli M AD - Department of Cardiology, Swiss Cardiovascular Center, Bern University Hospital, 3010, Bern, Switzerland. FAU - Piccolo, Raffaele AU - Piccolo R AD - Department of Cardiology, Swiss Cardiovascular Center, Bern University Hospital, 3010, Bern, Switzerland. FAU - Zanchin, Thomas AU - Zanchin T AD - Department of Cardiology, Swiss Cardiovascular Center, Bern University Hospital, 3010, Bern, Switzerland. FAU - Yamaji, Kyohei AU - Yamaji K AD - Department of Cardiology, Swiss Cardiovascular Center, Bern University Hospital, 3010, Bern, Switzerland. FAU - Stortecky, Stefan AU - Stortecky S AD - Department of Cardiology, Swiss Cardiovascular Center, Bern University Hospital, 3010, Bern, Switzerland. FAU - Blochlinger, Stefan AU - Blochlinger S AD - Department of Cardiology, Swiss Cardiovascular Center, Bern University Hospital, 3010, Bern, Switzerland. FAU - Hunziker, Lukas AU - Hunziker L AD - Department of Cardiology, Swiss Cardiovascular Center, Bern University Hospital, 3010, Bern, Switzerland. FAU - Praz, Fabien AU - Praz F AD - Department of Cardiology, Swiss Cardiovascular Center, Bern University Hospital, 3010, Bern, Switzerland. FAU - Juni, Peter AU - Juni P AD - Applied Health Research Centre (AHRC), Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Canada. AD - Department of Medicine, University of Toronto, Toronto, Canada. FAU - Windecker, Stephan AU - Windecker S AD - Department of Cardiology, Swiss Cardiovascular Center, Bern University Hospital, 3010, Bern, Switzerland. stephan.windecker@insel.ch. FAU - Pilgrim, Thomas AU - Pilgrim T AD - Department of Cardiology, Swiss Cardiovascular Center, Bern University Hospital, 3010, Bern, Switzerland. LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20160401 PL - Germany TA - Clin Res Cardiol JT - Clinical research in cardiology : official journal of the German Cardiac Society JID - 101264123 SB - IM MH - Age Factors MH - Aged MH - Aged, 80 and over MH - Comorbidity MH - Coronary Artery Disease/diagnosis/mortality/*therapy MH - Drug-Eluting Stents MH - Female MH - Hospitals, University MH - Humans MH - Male MH - Middle Aged MH - Myocardial Infarction/etiology MH - *Patient Selection MH - *Percutaneous Coronary Intervention/adverse effects/instrumentation/mortality MH - Registries MH - Reproducibility of Results MH - Risk Assessment MH - Risk Factors MH - Sex Factors MH - Switzerland MH - Time Factors MH - Treatment Outcome OTO - NOTNLM OT - Drug-eluting stents OT - Generalizability OT - Interventional trial EDAT- 2016/04/02 06:00 MHDA- 2017/02/22 06:00 CRDT- 2016/04/02 06:00 PHST- 2016/01/11 00:00 [received] PHST- 2016/03/22 00:00 [accepted] PHST- 2016/04/02 06:00 [entrez] PHST- 2016/04/02 06:00 [pubmed] PHST- 2017/02/22 06:00 [medline] AID - 10.1007/s00392-016-0983-z [pii] AID - 10.1007/s00392-016-0983-z [doi] PST - ppublish SO - Clin Res Cardiol. 2016 Sep;105(9):744-54. doi: 10.1007/s00392-016-0983-z. Epub 2016 Apr 1. PMID- 26995375 OWN - NLM STAT- MEDLINE DCOM- 20160802 LR - 20181202 IS - 1097-6744 (Electronic) IS - 0002-8703 (Linking) VI - 174 DP - 2016 Apr TI - Impact of proton pump inhibitors on clinical outcomes in patients treated with a 6- or 24-month dual-antiplatelet therapy duration: Insights from the PROlonging Dual-antiplatelet treatment after Grading stent-induced Intimal hyperplasia studY trial. PG - 95-102 LID - S0002-8703(16)00031-4 [pii] LID - 10.1016/j.ahj.2016.01.015 [doi] AB - BACKGROUND: Proton pump inhibitors (PPIs) are frequently prescribed in combination with clopidogrel, but conflicting data exist as to whether PPIs diminish the efficacy of clopidogrel. We assessed the association between PPI use and clinical outcomes for patients treated with percutaneous coronary intervention (PCI) and dual-antiplatelet therapy (DAPT) with clopidogrel plus aspirin. METHODS AND RESULTS: In the PRODIGY trial, 1,970 patients were randomized to 6- or 24-month DAPT at 30 days from index procedure. Among them, 738 patients (37.5%) received PPI (mainly lansoprazole; 90.1%) at the time of randomization. Proton pump inhibitor users were older, were most likely to be woman, had a lower creatinine clearance, presented more frequently with acute coronary syndrome, and had a higher CRUSADE bleeding score. After adjustment, the primary efficacy end point (composite of all-cause death, myocardial infarction, and cerebrovascular accident) was similar between no PPI and PPI users (9.2% vs 11.5%, adjusted hazard ratio [HR] 1.051, 95% CI 0.788-1.400, P = .736). Bleeding rates did not differ between the 2 groups (Bleeding Academic Research Consortium type 2, 3, or 5: adjusted HR 0.996, 95% CI 0.672-1.474, P = .980). Net clinical adverse events were also similar in no PPI and PPI patients (12.9% vs 14.9%, adjusted HR 0.99, 95% CI 0.772-1.268, P = .93). Results remained consistent at sensitivity analysis when focusing on the 548 patients who remained on PPI for the whole study duration. CONCLUSIONS: The current findings suggest that the concomitant use of PPIs, when clinically indicated, in patients receiving clopidogrel is not associated with adverse clinical outcome. CI - Copyright (c) 2016 Elsevier Inc. All rights reserved. FAU - Gargiulo, Giuseppe AU - Gargiulo G AD - Department of Cardiology, Bern University Hospital, Bern, Switzerland; Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy. FAU - Costa, Francesco AU - Costa F AD - Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Clinical and Experimental Medicine, Policlinico "G. Martino," University of Messina, Messina, Italy. FAU - Ariotti, Sara AU - Ariotti S AD - Department of Cardiology, Bern University Hospital, Bern, Switzerland. FAU - Biscaglia, Simone AU - Biscaglia S AD - Cardiovascular Institute, Azienda Ospedaliero-Universitaria Sant'Anna, Ferrara, Italy. FAU - Campo, Gianluca AU - Campo G AD - Cardiovascular Institute, Azienda Ospedaliero-Universitaria Sant'Anna, Ferrara, Italy. FAU - Esposito, Giovanni AU - Esposito G AD - Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy. FAU - Leonardi, Sergio AU - Leonardi S AD - Fondazione I.R.C.C.S. Policlinico San Matteo, Pavia, Italy. FAU - Vranckx, Pascal AU - Vranckx P AD - Department of Cardiology and Critical Care Medicine, Hartcentrum Hasselt, Hasselt, Belgium. FAU - Windecker, Stephan AU - Windecker S AD - Department of Cardiology, Bern University Hospital, Bern, Switzerland. FAU - Valgimigli, Marco AU - Valgimigli M AD - Department of Cardiology, Bern University Hospital, Bern, Switzerland; Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands. Electronic address: marco.valgimigli@insel.ch. LA - eng SI - ClinicalTrials.gov/NCT00611286 PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20160125 PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 RN - 0 (Platelet Aggregation Inhibitors) RN - 0 (Proton Pump Inhibitors) RN - A74586SNO7 (Clopidogrel) RN - OM90ZUW7M1 (Ticlopidine) RN - R16CO5Y76E (Aspirin) SB - IM MH - Administration, Oral MH - Aged MH - Aspirin/administration & dosage MH - Clopidogrel MH - Coronary Vessels/drug effects/*pathology/surgery MH - Drug Therapy, Combination MH - Electrocardiography MH - Female MH - Follow-Up Studies MH - Graft Occlusion, Vascular/*drug therapy/etiology/pathology MH - Humans MH - Hyperplasia/drug therapy/etiology/pathology MH - Male MH - Middle Aged MH - Myocardial Infarction/diagnosis/*surgery MH - Percutaneous Coronary Intervention/*adverse effects MH - Platelet Aggregation Inhibitors/*administration & dosage MH - Proton Pump Inhibitors/*administration & dosage MH - Stents/*adverse effects MH - Ticlopidine/administration & dosage/analogs & derivatives MH - Time Factors MH - Treatment Outcome MH - Tunica Intima/drug effects/pathology EDAT- 2016/03/21 06:00 MHDA- 2016/08/03 06:00 CRDT- 2016/03/21 06:00 PHST- 2015/10/12 00:00 [received] PHST- 2016/01/20 00:00 [accepted] PHST- 2016/03/21 06:00 [entrez] PHST- 2016/03/21 06:00 [pubmed] PHST- 2016/08/03 06:00 [medline] AID - S0002-8703(16)00031-4 [pii] AID - 10.1016/j.ahj.2016.01.015 [doi] PST - ppublish SO - Am Heart J. 2016 Apr;174:95-102. doi: 10.1016/j.ahj.2016.01.015. Epub 2016 Jan 25. PMID- 26923421 OWN - NLM STAT- MEDLINE DCOM- 20170713 LR - 20260127 IS - 1540-8175 (Electronic) IS - 0742-2822 (Linking) VI - 33 IP - 7 DP - 2016 Jul TI - Relation of Pulmonary Artery Pressure and Renal Impairment in ST Segment Elevation Myocardial Infarction Patients. PG - 956-61 LID - 10.1111/echo.13206 [doi] AB - BACKGROUND: Recent reports have demonstrated the adverse effects of venous congestion on renal function in patients having heart failure. None of the above trials, however, included patients with acute ischemia. HYPOTHESIS: Echocardiographic correlates of increased right ventricular afterload would be associated with an increased risk of acute kidney injury (AKI) in ST elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI). METHODS: We conducted a retrospective study of consecutive 930 STEMI patients who underwent primary PCI and had a full echocardiography study performed within 72 hours of hospital admission between June 2011 and December 2014. RESULTS: Echocardiography demonstrated that patients with AKI had significantly lower left ventricular (LV) ejection fraction, higher systolic pulmonary artery pressure (SPAP), and right atrial pressures (P < 0.001 for all). Following the performance of logistic multivariate analysis model, SPAP (HR 1.07, 95% CI 1.04-1.11; P < 0.001) and LV ejection fraction (HR 0.95, 95% CI 0.92-0.99; P = 0.03) emerged as independent predictors of AKI. On receiver operating characteristic (ROC) curve analysis, the optimal cutoff value of SPAP to predict AKI was measured as more than 32 mmHg, with 71% sensitivity and 62% specificity (AUC 0.739, 95% CI 0.671-0.806, P < 0.001). CONCLUSIONS: Among STEMI patients undergoing primary PCI, worse LV function and elevated SPAP were associated with increased risk of AKI. CI - (c) 2016, Wiley Periodicals, Inc. FAU - Shacham, Yacov AU - Shacham Y AD - Department of Cardiology, Tel-Aviv Sourasky Medical Center affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. FAU - Gal-Oz, Amir AU - Gal-Oz A AD - Department of Nephrology, Tel-Aviv Sourasky Medical Center affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. FAU - Topilsky, Yan AU - Topilsky Y AD - Department of Cardiology, Tel-Aviv Sourasky Medical Center affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. FAU - Keren, Gad AU - Keren G AD - Department of Cardiology, Tel-Aviv Sourasky Medical Center affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. FAU - Arbel, Yaron AU - Arbel Y AD - Department of Cardiology, Tel-Aviv Sourasky Medical Center affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. LA - eng PT - Journal Article PT - Observational Study DEP - 20160228 PL - United States TA - Echocardiography JT - Echocardiography (Mount Kisco, N.Y.) JID - 8511187 SB - IM MH - Acute Kidney Injury/*diagnostic imaging/*epidemiology MH - Arterial Pressure MH - Causality MH - Comorbidity MH - Echocardiography/methods MH - Female MH - Humans MH - Israel/epidemiology MH - Male MH - Middle Aged MH - Prevalence MH - Prognosis MH - Pulmonary Artery/diagnostic imaging/*physiopathology MH - Reproducibility of Results MH - Risk Factors MH - ST Elevation Myocardial Infarction/*diagnostic imaging/*epidemiology/physiopathology MH - Sensitivity and Specificity MH - Ventricular Dysfunction, Left/diagnostic imaging/*epidemiology OTO - NOTNLM OT - ST elevation myocardial infarction OT - acute kidney injury OT - percutaneous coronary intervention OT - pulmonary artery pressure EDAT- 2016/03/01 06:00 MHDA- 2017/07/14 06:00 CRDT- 2016/03/01 06:00 PHST- 2016/03/01 06:00 [entrez] PHST- 2016/03/01 06:00 [pubmed] PHST- 2017/07/14 06:00 [medline] AID - 10.1111/echo.13206 [doi] PST - ppublish SO - Echocardiography. 2016 Jul;33(7):956-61. doi: 10.1111/echo.13206. Epub 2016 Feb 28. PMID- 26920597 OWN - NLM STAT- MEDLINE DCOM- 20160712 LR - 20260127 IS - 1097-6744 (Electronic) IS - 0002-8703 (Linking) VI - 173 DP - 2016 Mar TI - Renal failure in patients with ST-segment elevation acute myocardial infarction treated with primary percutaneous coronary intervention: Predictors, clinical and angiographic features, and outcomes. PG - 57-66 LID - S0002-8703(15)00682-1 [pii] LID - 10.1016/j.ahj.2015.12.001 [doi] AB - BACKGROUND: Among patients presenting with ST-segment elevation myocardial infarction (STEMI) for primary percutaneous coronary intervention (PCI), the associations between clinical outcomes and both baseline renal function and the development of acute kidney injury (AKI) have not been reported in a trial population with unselected baseline renal function. METHODS: Patients enrolled in the APEX-AMI trial who underwent primary PCI for the treatment of STEMI were categorized according to (a) baseline renal function and (b) the development of AKI. Patient characteristics, clinical outcomes, and treatment patterns were analyzed according to baseline renal function and the development of AKI. A prediction model for AKI after primary PCI for STEMI was also developed. RESULTS: A total of 5,244 patients were included in this analysis and stratified according to baseline estimated glomerular filtration rate (eGFR) (milliliters per minute per 1.73 m(2)) of >90, 60 to 90, 30 to 59, or <30 or as dialysis dependent. Patients with lower eGFR were older, more often female, and less often treated with evidence-based medicines and had worse angiographic outcomes and higher mortality. The rates of AKI for patients with a baseline eGFR of >90, 60 to 90, 30 to 59, and <30 were 2.5%, 4.1%, 8.1%, and 1.6%, respectively (P < .0001). The strongest predictors of AKI were age and presenting in Killip class III or IV. CONCLUSIONS: Among patients undergoing primary PCI for STEMI, impaired renal function at presentation and development of post-PCI AKI were highly associated with worse clinical and angiographic outcomes, including death. The risk of developing AKI was low and only modestly associated with baseline renal function. CI - Copyright (c) 2015 Elsevier Inc. All rights reserved. FAU - Vavalle, John P AU - Vavalle JP AD - Center for Heart & Vascular Care, University of North Carolina at Chapel Hill, Chapel Hill, NC; Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC. FAU - van Diepen, Sean AU - van Diepen S AD - Department of Medicine, University of Alberta, Edmonton, AB, Canada. FAU - Clare, Robert M AU - Clare RM AD - Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC. FAU - Hochman, Judith S AU - Hochman JS AD - Department of Medicine, New York University, New York, NY. FAU - Weaver, W Douglas AU - Weaver WD AD - Henry Ford Hospital, Detroit, MI. FAU - Mehta, Rajendra H AU - Mehta RH AD - Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC. FAU - Pieper, Karen S AU - Pieper KS AD - Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC. FAU - Patel, Manesh R AU - Patel MR AD - Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC; Department of Medicine, Duke University School of Medicine, Durham, NC. FAU - Patel, Uptal D AU - Patel UD AD - Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC; Department of Medicine, Duke University School of Medicine, Durham, NC. FAU - Armstrong, Paul W AU - Armstrong PW AD - Department of Medicine, University of Alberta, Edmonton, AB, Canada. FAU - Granger, Christopher B AU - Granger CB AD - Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC; Department of Medicine, Duke University School of Medicine, Durham, NC. FAU - Lopes, Renato D AU - Lopes RD AD - Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC; Department of Medicine, Duke University School of Medicine, Durham, NC. Electronic address: renato.lopes@duke.edu. LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20151211 PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 RN - AYI8EX34EU (Creatinine) SB - IM MH - Aged MH - Aged, 80 and over MH - Alberta/epidemiology MH - *Coronary Angiography MH - Creatinine/blood MH - Disease Progression MH - Double-Blind Method MH - *Electrocardiography MH - Female MH - Follow-Up Studies MH - Glomerular Filtration Rate/physiology MH - Humans MH - Incidence MH - Male MH - Middle Aged MH - Myocardial Infarction/*complications/diagnostic imaging/surgery MH - Percutaneous Coronary Intervention/*methods MH - Prognosis MH - Renal Insufficiency/diagnosis/epidemiology/*etiology MH - Risk Assessment MH - Risk Factors MH - Survival Rate/trends MH - Time Factors MH - United States/epidemiology EDAT- 2016/02/28 06:00 MHDA- 2016/07/13 06:00 CRDT- 2016/02/28 06:00 PHST- 2015/04/15 00:00 [received] PHST- 2015/12/05 00:00 [accepted] PHST- 2016/02/28 06:00 [entrez] PHST- 2016/02/28 06:00 [pubmed] PHST- 2016/07/13 06:00 [medline] AID - S0002-8703(15)00682-1 [pii] AID - 10.1016/j.ahj.2015.12.001 [doi] PST - ppublish SO - Am Heart J. 2016 Mar;173:57-66. doi: 10.1016/j.ahj.2015.12.001. Epub 2015 Dec 11. PMID- 26920590 OWN - NLM STAT- MEDLINE DCOM- 20160712 LR - 20160227 IS - 1097-6744 (Electronic) IS - 0002-8703 (Linking) VI - 173 DP - 2016 Mar TI - Can the optimal type of stent be predicted based on clinical risk factors? A subgroup analysis of the randomized BASKET-PROVE trial. PG - 1-7 LID - S0002-8703(15)00664-X [pii] LID - 10.1016/j.ahj.2015.11.007 [doi] AB - BACKGROUND: The randomized BASKET-PROVE study showed no significant differences between sirolimus-eluting stents (SES), everolimus-eluting stents (EES), and bare-metal stents (BMS) with respect to the primary end point, rates of death from cardiac causes, or myocardial infarction (MI) at 2 years of follow-up, in patients requiring stenting of a large coronary artery. Clinical risk factors may affect clinical outcomes after percutaneous coronary interventions. We present a retrospective analysis of the BASKET-PROVE data addressing the question as to whether the optimal type of stent can be predicted based on a cumulative clinical risk score. METHODS: A total of 2,314 patients (mean age 66 years) who underwent coronary angioplasty and implantation of >/=1 stents that were >/=3.0 mm in diameter were randomly assigned to receive SES, EES, or BMS. A cumulative clinical risk score was derived using a Cox model that included age, gender, cardiovascular risk factors (hypercholesterolemia, hypertension, family history of cardiovascular disease, diabetes, smoking), presence of >/=2 comorbidities (stroke, peripheral artery disease, chronic kidney disease, chronic rheumatic disease), a history of MI or coronary revascularization, and clinical presentation (stable angina, unstable angina, ST-segment elevation MI). RESULTS: An aggregate drug-eluting stent (DES) group (n = 1,549) comprising 775 patients receiving SES and 774 patients receiving EES was compared to 765 patients receiving BMS. Rates of death from cardiac causes or nonfatal MI at 2 years of follow-up were significantly increased in patients who were in the high tertile of risk stratification for the clinical risk score compared to those who were in the aggregate low-mid tertiles. In patients with a high clinical risk score, rates of death from cardiac causes or nonfatal MI were lower in patients receiving DES (2.4 per 100 person-years, 95% CI 1.6-3.6) compared with BMS (5.5 per 100 person-years, 95% CI 3.7-8.2, hazard ratio 0.45, 95% CI 0.26-0.80, P = .007). However, they were not significantly different between receivers of DES and BMS in patients in the low-mid risk tertiles. CONCLUSIONS: This exploratory analysis suggests that, in patients who require stenting of a large coronary artery, use of a clinical risk score may identify those patients for whom DES use may confer a clinical advantage over BMS, beyond lower restenosis rates. CI - Copyright (c) 2015 Elsevier Inc. All rights reserved. FAU - Vassalli, Giuseppe AU - Vassalli G AD - Fondazione Cardiocentro Ticino, Lugano, Switzerland; Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. FAU - Klersy, Catherine AU - Klersy C AD - IRCCS Policlinico San Matteo, Servizio di Biometria e Statistica, Pavia, Italy. FAU - De Servi, Stefano AU - De Servi S AD - Ospedale Civile di Legnano, Milan, Italy. FAU - Galatius, Soeren AU - Galatius S AD - Gentofte University Hospital, Hellerup, Denmark. FAU - Erne, Paul AU - Erne P AD - State Hospital, Lucerne, Switzerland. FAU - Eberli, Franz AU - Eberli F AD - Triemli Hospital, Zurich, Switzerland. FAU - Rickli, Hans AU - Rickli H AD - State Hospital, St Gallen, Switzerland. FAU - Hornig, Burkhard AU - Hornig B AD - Clara Hospital, Basel, Switzerland. FAU - Bertel, Osmund AU - Bertel O AD - Cardiovascular Center Zurich, Zurich, Switzerland. FAU - Bonetti, Piero AU - Bonetti P AD - State Hospital, Chur, Switzerland. FAU - Moccetti, Tiziano AU - Moccetti T AD - Fondazione Cardiocentro Ticino, Lugano, Switzerland. FAU - Kaiser, Christoph AU - Kaiser C AD - University Hospital Basel, Basel, Switzerland. FAU - Pfisterer, Matthias AU - Pfisterer M AD - University Hospital Basel, Basel, Switzerland. FAU - Pedrazzini, Giovanni AU - Pedrazzini G AD - Fondazione Cardiocentro Ticino, Lugano, Switzerland. Electronic address: giovanni.pedrazzini@cardiocentro.org. CN - BASKET-PROVE Investigators LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20151201 PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 SB - IM MH - Age Factors MH - Aged MH - Angioplasty, Balloon, Coronary/*methods MH - Austria/epidemiology MH - Cause of Death/trends MH - Coronary Artery Disease/mortality/*surgery MH - Denmark/epidemiology MH - Female MH - Follow-Up Studies MH - Humans MH - Incidence MH - Male MH - Postoperative Complications/*epidemiology MH - Prognosis MH - Prosthesis Design MH - Retrospective Studies MH - Risk Assessment/*methods MH - Risk Factors MH - Stents/*standards MH - Survival Rate/trends MH - Switzerland/epidemiology MH - Time Factors EDAT- 2016/02/28 06:00 MHDA- 2016/07/13 06:00 CRDT- 2016/02/28 06:00 PHST- 2015/03/02 00:00 [received] PHST- 2015/11/14 00:00 [accepted] PHST- 2016/02/28 06:00 [entrez] PHST- 2016/02/28 06:00 [pubmed] PHST- 2016/07/13 06:00 [medline] AID - S0002-8703(15)00664-X [pii] AID - 10.1016/j.ahj.2015.11.007 [doi] PST - ppublish SO - Am Heart J. 2016 Mar;173:1-7. doi: 10.1016/j.ahj.2015.11.007. Epub 2015 Dec 1. PMID- 26875901 OWN - NLM STAT- MEDLINE DCOM- 20160811 LR - 20181202 IS - 2284-0729 (Electronic) IS - 1128-3602 (Linking) VI - 20 IP - 2 DP - 2016 TI - The clinical research of off-pump coronary artery bypass grafting by small incision at the left chest. PG - 305-10 LID - 10221 [pii] AB - OBJECTIVE: To explore the clinical value of off-pump coronary artery bypass grafting by small incision at the left chest, and develop a better surgical regimen for coronary heart disease patients. PATIENTS AND METHODS: 201 coronary heart disease patients who need coronary artery bypass grafting were required and randomly divided into 2 groups including a control group and an observation group. There were 107 cases in the control group who received coronary bypass grafting by extracorporeal circulation; there were 103 cases in the observation group who received off-pump coronary bypass grafting by small incision at the left chest. The duration of the mechanism ventilation, length of stay in ICU, hospitalization time, postoperative drainage volume, and the occurrence rate of complications were recorded and compared. RESULTS: The duration of mechanism ventilation, length of stay in ICU, hospitalization time and postoperative drainage volume in the control group were (19.21 +/- 1.33) hours, (5.08 +/- 0.57) days, (21.20 +/- 2.34) days and (997.68 +/- 96.35) mL, which were (7.73 +/- 0.74) hours, (2.83 +/- 0.16) days, (15.67 +/- 1.18) days and (901.53 +/- 89.32) mL in the observation group respectively, with statistical difference between the two groups (p<0.05). The occurrence rates of renal insufficiency and arrhythmia were both 6.54% and 0.97% in the control group and the observation group, respectively. The occurrence rates of postoperative renal insufficiency and arrhythmia in the observation group were both significantly lower than those in the control group, with statistical significance analysis (p < 0.05). Postoperative low cardiac output, second thoracotomy, cerebrovascular disease, pulmonary infection, perioperative cardiac infarction and mortality did not display a significant difference between the two groups (p > 0.05). CONCLUSIONS: Off-pump coronary artery bypass grafting by small incision at the left chest is a surgical method with less injury and fast recovery, which can be used as the preferred therapeutical method for the coronary heart disease patients who need coronary artery bypass grafting. FAU - Xiao, L-B AU - Xiao LB AD - Cardio-Thoracic Surgery Department, Cangzhou Center Hospital, Cangzhou, China. drzhoujiwu@163.com. FAU - Zhang, Y-H AU - Zhang YH FAU - Zhou, J-W AU - Zhou JW FAU - Yang, M AU - Yang M FAU - Ling, Y-P AU - Ling YP FAU - Gao, Z-S AU - Gao ZS FAU - Wang, Y-S AU - Wang YS LA - eng PT - Journal Article PT - Randomized Controlled Trial PL - United States TA - Eur Rev Med Pharmacol Sci JT - European review for medical and pharmacological sciences JID - 9717360 SB - IM MH - Aged MH - *Coronary Artery Bypass, Off-Pump MH - Coronary Artery Disease/*surgery MH - Female MH - Humans MH - Length of Stay MH - Male MH - Middle Aged MH - Postoperative Complications EDAT- 2016/02/16 06:00 MHDA- 2016/08/12 06:00 CRDT- 2016/02/16 06:00 PHST- 2016/02/16 06:00 [entrez] PHST- 2016/02/16 06:00 [pubmed] PHST- 2016/08/12 06:00 [medline] AID - 10221 [pii] PST - ppublish SO - Eur Rev Med Pharmacol Sci. 2016;20(2):305-10. PMID- 26858529 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20160209 LR - 20200930 IS - 1178-7058 (Print) IS - 1178-7058 (Electronic) IS - 1178-7058 (Linking) VI - 9 DP - 2016 TI - Is kidney function affecting the management of myocardial infarction? A retrospective cohort study in patients with normal kidney function, chronic kidney disease stage III-V, and ESRD. PG - 5-10 LID - 10.2147/IJNRD.S91567 [doi] AB - Patients with chronic kidney disease (CKD) are three times more likely to have myocardial infarction (MI) and suffer from increased morbidity and higher mortality. Traditional and unique risk factors are prevalent and constitute challenges for the standard of care. However, CKD patients have been largely excluded from clinical trials and little evidence is available to guide evidence-based treatment of coronary artery disease in patients with CKD. Our objective was to assess whether a difference exists in the management of MI (ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction) among patients with normal kidney function, CKD stage III-V, and end-stage renal disease (ESRD) patients. We conducted a retrospective cohort study on patients admitted to Staten Island University Hospital for the diagnosis of MI between January 2005 and December 2012. Patients were assigned to one of three groups according to their kidney function: Data collected on the medical management and the use of statins, platelet inhibitors, beta-blockers, and angiotensin converting enzyme inhibitors/angiotensin receptor blockers were compared among the three cohorts, as well as medical interventions including: catheterization and coronary artery bypass graft (CABG) when indicated. Chi-square test was used to compare the proportions between nominal variables. Binary logistic analysis was used in order to determine associations between treatment modalities and comorbidities, and to account for possible confounding factors. Three hundred and thirty-four patients (mean age 67.2+/-13.9 years) were included. In terms of management, medical treatment was not different among the three groups. However, cardiac catheterization was performed less in ESRD when compared with no CKD and CKD stage III-V (45.6% vs 74% and 93.9%) (P<0.001). CABG was performed in comparable proportions in the three groups and CABG was not associated with the degree of CKD (P=0.078) in binary logistics regression. Cardiac catheterization on the other hand carried the strongest association among all studied variables (P<0.001). This association was maintained after adjusting for other comorbidities. The length of stay for the three cohorts (non-CKD, CKD stage III-V, and ESRD on hemodialysis) was 16, 17, and 15 days, respectively and was not statistically different. Many observations have reported discrimination of care for patients with CKD considered suboptimal candidates for aggressive management of their cardiac disease. In our study, medical therapy was achieved at high percentage and was comparable among groups of different kidney function. However, kidney disease seems to affect the management of patients with acute MI; percutaneous coronary angiography is not uniformly performed in patients with CKD and ESRD when compared with patients with normal kidney function. FAU - Saad, Marc AU - Saad M AD - Department of Internal Medicine, Staten Island University Hospital, Staten Island, NY, USA. FAU - Karam, Boutros AU - Karam B AD - Department of Internal Medicine, Staten Island University Hospital, Staten Island, NY, USA. FAU - Faddoul, Geovani AU - Faddoul G AD - Department of Nephrology, Icahn School of Medicine, New York, NY, USA. FAU - Douaihy, Youssef El AU - Douaihy YE AD - Department of Internal Medicine, Staten Island University Hospital, Staten Island, NY, USA. FAU - Yacoub, Harout AU - Yacoub H AD - Department of Internal Medicine, Staten Island University Hospital, Staten Island, NY, USA. FAU - Baydoun, Hassan AU - Baydoun H AD - Department of Cardiology, Tulane University Medical Center, New Orleans, LA, USA. FAU - Boumitri, Christine AU - Boumitri C AD - Department of Internal Medicine, Staten Island University Hospital, Staten Island, NY, USA. FAU - Barakat, Iskandar AU - Barakat I AD - Department of Internal Medicine, Staten Island University Hospital, Staten Island, NY, USA. FAU - Saifan, Chadi AU - Saifan C AD - Department of Nephrology, Staten Island University Hospital, Staten Island, NY, USA. FAU - El-Charabaty, Elie AU - El-Charabaty E AD - Department of Nephrology, Staten Island University Hospital, Staten Island, NY, USA. FAU - Sayegh, Suzanne El AU - Sayegh SE AD - Department of Nephrology, Staten Island University Hospital, Staten Island, NY, USA. LA - eng PT - Journal Article DEP - 20160122 PL - New Zealand TA - Int J Nephrol Renovasc Dis JT - International journal of nephrology and renovascular disease JID - 101550217 PMC - PMC4730996 OTO - NOTNLM OT - chronic kidney disease OT - end-stage renal disease OT - myocardial infarction EDAT- 2016/02/10 06:00 MHDA- 2016/02/10 06:01 PMCR- 2016/01/22 CRDT- 2016/02/10 06:00 PHST- 2016/02/10 06:00 [entrez] PHST- 2016/02/10 06:00 [pubmed] PHST- 2016/02/10 06:01 [medline] PHST- 2016/01/22 00:00 [pmc-release] AID - ijnrd-9-005 [pii] AID - 10.2147/IJNRD.S91567 [doi] PST - epublish SO - Int J Nephrol Renovasc Dis. 2016 Jan 22;9:5-10. doi: 10.2147/IJNRD.S91567. eCollection 2016. PMID- 26816582 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20160128 LR - 20240523 IS - 2008-5842 (Print) IS - 2008-5842 (Electronic) IS - 2008-5842 (Linking) VI - 7 IP - 8 DP - 2015 Dec TI - The Impact of Remote Ischemic Pre-Conditioning on Contrast-Induced Nephropathy in Patients Undergoing Coronary Angiography and Angioplasty: A Double-Blind Randomized Clinical Trial. PG - 1557-65 LID - 10.19082/1557 [doi] AB - BACKGROUND AND OBJECTIVE: Contrast-induced nephropathy (CIN) is an acute major complication following intravascular administration of iodinated contrast agents; however, the best approach for preventing CIN is not clear. Remote ischemic pre-conditioning (RIPC) is a new, non-pharmacological method that has been considered for the prevention of CIN following coronary angiography. This study assessed the effects of RIPC with four brief episodes of upper limb ischemia and reperfusion in the prevention of contrast-induced nephropathy (CIN) after coronary angiography and/or angioplasty. METHODS: In this double-blind randomized clinical trial, we enrolled 51 patients with chronic stable angina and non-ST elevation acute coronary syndrome (NSTE.ACS), and they underwent coronary angiography and/or angioplasty. Standard fluid therapy with normal saline was prescribed for all patients before and after the procedure. The patients were divided into two groups, i.e., a study group of patients who had undergone RIPC intervention and a control group of patients who had not undergone RIPC. One hour before the procedure, a sphygmomanometer cuff was placed around one arm and inflated up to 50 mmHg above the systolic pressure for five minutes; then, the cuff was deflated for another five minutes, and this cycle was repeated four times. The patients' serum creatinine levels were measured at baseline and 48 hours after the procedure, and the incidence of CIN was calculated. RESULTS: Twenty-one males and 30 females were studied in two groups, i.e., an RIPC intervention group (n = 25) and a control group (n = 26) that were homogenous considering baseline characteristics. No significant difference was observed in the mean level of serum creatinine between the two groups at a post-intervention time of 48 hours (RICP: 1.74 +/- 0.70 mg/dL vs. CONTROL: 1.75 +/- 0.87 mg/dL; P = 0.64). However, a lower incidence rate of CIN was observed 48 hours after the administration of the contrast medium in the RIPC group, but it was not statistically significant (RIPC: 23.1% vs. CONTROL: 12.0%; P = 0.30). CONCLUSION: It seems that adequate fluid therapy is still the most effective strategy for preventing CIN and that RIPC might have additional protective effects in very high risk patients, such as those with severe renal insufficiency and heart failure. FAU - Gholoobi, Arash AU - Gholoobi A AD - MD, Assistant Professor, Department of Cardiology, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. FAU - Sajjadi, Seyyed Masoud AU - Sajjadi SM AD - MD, Resident of Cardiology, Department of Cardiology, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. FAU - Shabestari, Mahmoud Mohammadzadeh AU - Shabestari MM AD - MD, Professor, Atherosclerosis Prevention Research Center, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. FAU - Eshraghi, Ali AU - Eshraghi A AD - MD, Assistant Professor, Department of Cardiology, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. FAU - Shamloo, Alireza Sepehri AU - Shamloo AS AD - Medical Student, Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran. LA - eng PT - Journal Article DEP - 20151220 PL - Iran TA - Electron Physician JT - Electronic physician JID - 101645099 PMC - PMC4725407 OTO - NOTNLM OT - contrast-induced nephropathy OT - coronary angiography OT - kidney diseases OT - percutaneous coronary intervention OT - remote ischemic pre-conditioning EDAT- 2016/01/28 06:00 MHDA- 2016/01/28 06:01 PMCR- 2015/12/20 CRDT- 2016/01/28 06:00 PHST- 2015/08/02 00:00 [received] PHST- 2015/10/05 00:00 [accepted] PHST- 2016/01/28 06:00 [entrez] PHST- 2016/01/28 06:00 [pubmed] PHST- 2016/01/28 06:01 [medline] PHST- 2015/12/20 00:00 [pmc-release] AID - epj-07-1557 [pii] AID - 10.19082/1557 [doi] PST - epublish SO - Electron Physician. 2015 Dec 20;7(8):1557-65. doi: 10.19082/1557. eCollection 2015 Dec. PMID- 26794894 OWN - NLM STAT- MEDLINE DCOM- 20170227 LR - 20220317 IS - 1552-6259 (Electronic) IS - 0003-4975 (Linking) VI - 101 IP - 5 DP - 2016 May TI - Impact of Chronic Kidney Disease on Long-Term Outcomes in Type 2 Diabetic Patients With Coronary Artery Disease on Surgical, Angioplasty, or Medical Treatment. PG - 1735-44 LID - S0003-4975(15)01707-5 [pii] LID - 10.1016/j.athoracsur.2015.10.036 [doi] AB - BACKGROUND: Coronary artery disease (CAD) among patients with diabetes and chronic kidney disease (CKD) is not well studied, and the best treatment for this condition is not established. Our aim was to compare three therapeutic strategies for CAD in diabetic patients stratified by renal function. METHODS: Patients with multivessel CAD that underwent coronary artery bypass graft (CABG), angioplasty (percutaneous coronary intervention [PCI]), or medical therapy alone (MT) were included. Data were analyzed according to glomerular filtration rate in three strata: normal (>90 mL/min), mild CKD (60 to 89 mL/min), and moderate CKD (30 to 59 mL/min). End points comprised overall rate of mortality, acute myocardial infarction, and need for additional revascularization. RESULTS: Among patients with normal renal function (n = 270), 122 underwent CABG, 72 PCI, and 76 MT; among patients with mild CKD (n = 367), 167 underwent CABG, 92 PCI, and 108 MT; and among patients with moderate CKD (n = 126), 46 underwent CABG, 40 PCI, and 40 MT. Event-free survival was 80.4%, 75.7%, 67.5% for strata 1, 2, and 3, respectively (p = 0.037). Survival rates among patients with no, mild, and moderate CKD are 91.1%, 89.6%, and 76.2%, respectively (p = 0.001) (hazard ratio 0.69; 95% confidence interval 0.51 to 0.95; p = 0.024 for stratum 1 versus 3). We found no differences for overall number of deaths or acute myocardial infarctions irrespective of strata. The need of new revascularization was different in all strata, favoring CABG (p < 0.001, p < 0.001, and p = 0.029 for no, mild, and moderate CKD, respectively). CONCLUSIONS: Mortality rates were higher in patients with mild and moderate CKD. Higher event-free survival was observed in the CABG group among patients with no and mild CKD. Besides, CABG was associated with less need for new revascularization compared with PCI and MT in all renal function strata. This trial was registered at http://www.controlled-trials.com as ISRCTN66068876. CI - Copyright (c) 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved. FAU - Lima, Eduardo Gomes AU - Lima EG AD - Department of Clinical Cardiology, Heart Institute (InCor) University of Sao Paulo, Sao Paulo, Brazil. FAU - Hueb, Whady AU - Hueb W AD - Department of Clinical Cardiology, Heart Institute (InCor) University of Sao Paulo, Sao Paulo, Brazil. Electronic address: mass@incor.usp.br. FAU - Gersh, Bernard J AU - Gersh BJ AD - Mayo Clinic Foundation, Rochester, Minnesota. FAU - Rezende, Paulo Cury AU - Rezende PC AD - Department of Clinical Cardiology, Heart Institute (InCor) University of Sao Paulo, Sao Paulo, Brazil. FAU - Garzillo, Cibele Larrosa AU - Garzillo CL AD - Department of Clinical Cardiology, Heart Institute (InCor) University of Sao Paulo, Sao Paulo, Brazil. FAU - Favarato, Desiderio AU - Favarato D AD - Department of Clinical Cardiology, Heart Institute (InCor) University of Sao Paulo, Sao Paulo, Brazil. FAU - Hueb, Alexandre Ciappina AU - Hueb AC AD - Department of Clinical Cardiology, Heart Institute (InCor) University of Sao Paulo, Sao Paulo, Brazil. FAU - Rahmi Garcia, Rosa Maria AU - Rahmi Garcia RM AD - Department of Clinical Cardiology, Heart Institute (InCor) University of Sao Paulo, Sao Paulo, Brazil. FAU - Franchini Ramires, Jose Antonio AU - Franchini Ramires JA AD - Department of Clinical Cardiology, Heart Institute (InCor) University of Sao Paulo, Sao Paulo, Brazil. FAU - Filho, Roberto Kalil AU - Filho RK AD - Department of Clinical Cardiology, Heart Institute (InCor) University of Sao Paulo, Sao Paulo, Brazil. LA - eng PT - Journal Article DEP - 20160112 PL - Netherlands TA - Ann Thorac Surg JT - The Annals of thoracic surgery JID - 15030100R SB - IM MH - Aged MH - *Coronary Artery Bypass MH - Coronary Artery Disease/mortality/physiopathology/*therapy MH - Diabetes Mellitus, Type 2/*complications/physiopathology MH - Female MH - Glomerular Filtration Rate MH - Humans MH - Male MH - Middle Aged MH - *Percutaneous Coronary Intervention MH - Renal Insufficiency, Chronic/*mortality MH - Survival Rate MH - Treatment Outcome EDAT- 2016/01/23 06:00 MHDA- 2017/02/28 06:00 CRDT- 2016/01/23 06:00 PHST- 2015/05/22 00:00 [received] PHST- 2015/10/01 00:00 [revised] PHST- 2015/10/12 00:00 [accepted] PHST- 2016/01/23 06:00 [entrez] PHST- 2016/01/23 06:00 [pubmed] PHST- 2017/02/28 06:00 [medline] AID - S0003-4975(15)01707-5 [pii] AID - 10.1016/j.athoracsur.2015.10.036 [doi] PST - ppublish SO - Ann Thorac Surg. 2016 May;101(5):1735-44. doi: 10.1016/j.athoracsur.2015.10.036. Epub 2016 Jan 12. PMID- 26770436 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20160115 LR - 20201001 IS - 1940-5901 (Print) IS - 1940-5901 (Electronic) IS - 1940-5901 (Linking) VI - 8 IP - 10 DP - 2015 TI - Long term prognosis of acute coronary syndrome with chronic renal dysfunction treated in different therapy units at department of cardiology: a retrospective cohort study. PG - 18335-42 AB - Coronary care unit is common in hospitals and clinical centers which offer intensive care and therapy for severe coronary artery disease patients. However, if coronary care unit could improve the long term prognosis of acute coronary syndrome patients with renal dysfunction remain unknown. Accordingly, we designed this study to evaluate the differences of incidence of major adverse cardiovascular events for acute coronary syndromes patients with renal dysfunction who treated in coronary care unit or normal unit. The primary end point was all cause mortality. A total of 414 acute coronary syndromes patients with renal dysfunction involved in the study. The results showed that during 12-48 months follow-up, death of any cause occurred in 1.8% patients (4 of 247) in coronary care unit group, as compared with 1.8% in the normal group (3 of 167) (hazard ratio, 1.098; 95% confidence interval, 0.246 to 4.904; P=0.903). Kaplan-Meier survival analysis showed that there were no significant differences between the two groups with respect to the risk of death (P=0.903), revascularization (P=0.948), stroke (P=0.542), heart failure (P=0.198). This trial firstly revealed that acute coronary syndromes patients with renal dysfunction treated in coronary care unit and normal units. Our study showed that acute coronary syndromes patients with renal dysfunction treated in coronary care unit obtained no significant benefits compared with patients in normal units, although there was a declining tendency of the risk of major adverse cardiovascular effectswith patients in coronary care unit. FAU - Fu, Cong AU - Fu C AD - Department of Cardiology, Zhong Da Hospital Affiliated to Southeast University Nanjing, Jiangsu, China. FAU - Sheng, Zulong AU - Sheng Z AD - Department of Cardiology, Zhong Da Hospital Affiliated to Southeast University Nanjing, Jiangsu, China. FAU - Yao, Yuyu AU - Yao Y AD - Department of Cardiology, Zhong Da Hospital Affiliated to Southeast University Nanjing, Jiangsu, China. FAU - Wang, Xin AU - Wang X AD - Department of Cardiology, Zhong Da Hospital Affiliated to Southeast University Nanjing, Jiangsu, China. FAU - Yu, Chaojun AU - Yu C AD - Department of Cardiology, Jiang Yin Peoples' Hospital Jiang Yin, Jiangsu, China. FAU - Ma, Genshan AU - Ma G AD - Department of Cardiology, Zhong Da Hospital Affiliated to Southeast University Nanjing, Jiangsu, China. LA - eng PT - Journal Article DEP - 20151015 PL - United States TA - Int J Clin Exp Med JT - International journal of clinical and experimental medicine JID - 101471010 PMC - PMC4694336 OTO - NOTNLM OT - Acute coronary syndrome OT - chronic renal dysfunction OT - coronary care units OT - outcomes EDAT- 2016/01/16 06:00 MHDA- 2016/01/16 06:01 PMCR- 2015/10/15 CRDT- 2016/01/16 06:00 PHST- 2015/06/22 00:00 [received] PHST- 2015/09/18 00:00 [accepted] PHST- 2016/01/16 06:00 [entrez] PHST- 2016/01/16 06:00 [pubmed] PHST- 2016/01/16 06:01 [medline] PHST- 2015/10/15 00:00 [pmc-release] PST - epublish SO - Int J Clin Exp Med. 2015 Oct 15;8(10):18335-42. eCollection 2015. PMID- 26762908 OWN - NLM STAT- MEDLINE DCOM- 20161019 LR - 20241219 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 9 IP - 1 DP - 2016 Jan 11 TI - Effect of Chronic Kidney Disease in Women Undergoing Percutaneous Coronary Intervention With Drug-Eluting Stents: A Patient-Level Pooled Analysis of Randomized Controlled Trials. PG - 28-38 LID - S1936-8798(15)01575-7 [pii] LID - 10.1016/j.jcin.2015.09.023 [doi] AB - OBJECTIVES: This study sought to evaluate: 1) the effect of impaired renal function on long-term clinical outcomes in women undergoing percutaneous coronary intervention (PCI) with drug-eluting stent (DES); and 2) the safety and efficacy of new-generation compared with early-generation DES in women with chronic kidney disease (CKD). BACKGROUND: The prevalence and effect of CKD in women undergoing PCI with DES is unclear. METHODS: We pooled patient-level data for women enrolled in 26 randomized trials. The study population was categorized by creatinine clearance (CrCl) <45 ml/min, 45 to 59 ml/min, and >/=60 ml/min. The primary endpoint was the 3-year rate of major adverse cardiovascular events (MACE). Participants for whom baseline creatinine was missing were excluded from the analysis. RESULTS: Of 4,217 women included in the pooled cohort treated with DES and for whom serum creatinine was available, 603 (14%) had a CrCl <45 ml/min, 811 (19%) had a CrCl 45 to 59 ml/min, and 2,803 (66%) had a CrCl >/=60 ml/min. A significant stepwise gradient in risk for MACE was observed with worsening renal function (26.6% vs. 15.8% vs. 12.9%; p < 0.01). Following multivariable adjustment, CrCl <45 ml/min was independently associated with a higher risk of MACE (adjusted hazard ratio: 1.56; 95% confidence interval: 1.23 to 1.98) and all-cause mortality (adjusted hazard ratio: 2.67; 95% confidence interval: 1.85 to 3.85). Compared with older-generation DES, the use of newer-generation DES was associated with a reduction in the risk of cardiac death, myocardial infarction, or stent thrombosis in women with CKD. The effect of new-generation DES on outcomes was uniform, between women with or without CKD, without evidence of interaction. CONCLUSIONS: Among women undergoing PCI with DES, CKD is a common comorbidity associated with a strong and independent risk for MACE that is durable over 3 years. The benefits of newer-generation DES are uniform in women with or without CKD. CI - Copyright (c) 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Baber, Usman AU - Baber U AD - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York City, New York. FAU - Giustino, Gennaro AU - Giustino G AD - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York City, New York. FAU - Sartori, Samantha AU - Sartori S AD - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York City, New York. FAU - Aquino, Melissa AU - Aquino M AD - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York City, New York. FAU - Stefanini, Giulio G AU - Stefanini GG AD - Division of Clinical and Interventional Cardiology, Humanitas Research Hospital, Rozzano, Milan, Italy. FAU - Steg, P Gabriel AU - Steg PG AD - Departement Hospitalo Universitaire Fibrose, Inflammation et REmodelage, Assistance Publique-Hopitaux de Paris, Universite Paris Diderot, INSERM U698, Paris, France. FAU - Windecker, Stephan AU - Windecker S AD - Department of Cardiology, Bern University Hospital, Bern, Switzerland. FAU - Leon, Martin B AU - Leon MB AD - Division of Cardiology, Columbia University Medical Center, New York City, New York. FAU - Wijns, William AU - Wijns W AD - Cardiovascular Center Aalst, Onze-Lieve-Vrouwziekenhuis Ziekenhuis, Aalst, Belgium. FAU - Serruys, Patrick W AU - Serruys PW AD - Thoraxcenter, Erasmus MC, Rotterdam, the Netherlands. FAU - Valgimigli, Marco AU - Valgimigli M AD - Department of Cardiology, University of Ferrara, Ferrara, Italy. FAU - Stone, Gregg W AU - Stone GW AD - Division of Cardiology, Columbia University Medical Center, New York City, New York. FAU - Dangas, George D AU - Dangas GD AD - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York City, New York. FAU - Morice, Marie-Claude AU - Morice MC AD - Department of Cardiology and Cardiovascular Surgery, Institut Cardiovasculaire Paris Sud, France. FAU - Camenzind, Edoardo AU - Camenzind E AD - Institut Lorrain du Coeur et des Vaisseaux (ILCV) University Hospital Nancy-Brabois Vandoeuvre-les-Nancy France. FAU - Weisz, Giora AU - Weisz G AD - Thoraxcenter, Erasmus MC, Rotterdam, the Netherlands. FAU - Smits, Pieter C AU - Smits PC AD - Department of Cardiology, Maasstad Hospital, Rotterdam, the Netherlands. FAU - Kandzari, David AU - Kandzari D AD - Piedmont Heart Institute, Atlanta, Georgia. FAU - Von Birgelen, Clemens AU - Von Birgelen C AD - Thoraxcentrum Twente, Enschede, the Netherlands. FAU - Mastoris, Ioannis AU - Mastoris I AD - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York City, New York. FAU - Galatius, Soren AU - Galatius S AD - Department of Cardiology, Bispebjerg University Hospital, Copenhagen, Denmark. FAU - Jeger, Raban V AU - Jeger RV AD - Department of Cardiology, University Hospital Basel, Basel, Switzerland. FAU - Kimura, Takeshi AU - Kimura T AD - Department of Cardiology, Kyoto University Graduate School of Medicine, Kyoto, Japan. FAU - Mikhail, Ghada W AU - Mikhail GW AD - Department of Cardiology, Imperial College Healthcare NHS Trust, London, United Kingdom. FAU - Itchhaporia, Dipti AU - Itchhaporia D AD - Department of Cardiology, Hoag Memorial Hospital Presbyterian, Newport Beach, California. FAU - Mehta, Laxmi AU - Mehta L AD - Department of Cardiology, Ohio State University Medical Center, Columbus, Ohio. FAU - Ortega, Rebecca AU - Ortega R AD - Society of Cardiovascular Angiography and Interventions, Washington, DC. FAU - Kim, Hyo-Soo AU - Kim HS AD - Department of Cardiology, Seoul National University Main Hospital, Seoul, South Korea. FAU - Kastrati, Adnan AU - Kastrati A AD - Herzzentrum, Munich, Germany. FAU - Chieffo, Alaide AU - Chieffo A AD - Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy. FAU - Mehran, Roxana AU - Mehran R AD - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York City, New York. Electronic address: Roxana.Mehran@mountsinai.org. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 RN - 0 (Biomarkers) RN - AYI8EX34EU (Creatinine) SB - IM CIN - JACC Cardiovasc Interv. 2016 Jan 11;9(1):39-41. doi: 10.1016/j.jcin.2015.11.006. PMID: 26762909 MH - Aged MH - Aged, 80 and over MH - Biomarkers/blood MH - Comorbidity MH - Coronary Artery Disease/complications/diagnosis/mortality/*therapy MH - Creatinine/blood MH - *Drug-Eluting Stents MH - Female MH - Glomerular Filtration Rate MH - Humans MH - Kaplan-Meier Estimate MH - Kidney/physiopathology MH - Middle Aged MH - Multivariate Analysis MH - Percutaneous Coronary Intervention/adverse effects/*instrumentation/mortality MH - Prosthesis Design MH - Randomized Controlled Trials as Topic MH - Renal Insufficiency, Chronic/blood/*complications/diagnosis/mortality/physiopathology MH - Risk Assessment MH - Risk Factors MH - Time Factors MH - Treatment Outcome MH - *Women's Health OTO - NOTNLM OT - chronic kidney disease OT - drug-eluting stents OT - outcomes OT - women EDAT- 2016/01/15 06:00 MHDA- 2016/11/12 06:00 CRDT- 2016/01/15 06:00 PHST- 2015/05/11 00:00 [received] PHST- 2015/08/05 00:00 [revised] PHST- 2015/09/10 00:00 [accepted] PHST- 2016/01/15 06:00 [entrez] PHST- 2016/01/15 06:00 [pubmed] PHST- 2016/11/12 06:00 [medline] AID - S1936-8798(15)01575-7 [pii] AID - 10.1016/j.jcin.2015.09.023 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2016 Jan 11;9(1):28-38. doi: 10.1016/j.jcin.2015.09.023. PMID- 26748815 OWN - NLM STAT- MEDLINE DCOM- 20161019 LR - 20200225 IS - 1932-8737 (Electronic) IS - 0160-9289 (Print) IS - 0160-9289 (Linking) VI - 39 IP - 1 DP - 2016 Jan TI - Ticagrelor in Triple Antithrombotic Therapy: Predictors of Ischemic and Bleeding Complications. PG - 19-23 LID - 10.1002/clc.22486 [doi] AB - BACKGROUND: Patients on dual antiplatelet therapy following percutaneous coronary intervention often have indications for concurrent oral anticoagulation or triple antithrombotic therapy (TT). Although TT may decrease ischemic complications, it may confer increased bleeding risk. HYPOTHESIS: We hypothesize that the use of ticagrelor in TT is associated with higher risk of complications; accordingly, we sought to determine predictors of complications in patients on TT. METHODS: Patients discharged on TT after percutaneous coronary intervention were followed prospectively for 12 months. The primary endpoint was a composite of ischemic (death, myocardial infarction, stroke) and major bleeding complications or net adverse clinical event (NACE). A major secondary endpoint was BARC (Bleeding Academic Research Consortium) types 2, 3, or 5 bleeding. Outcomes were compared between ticagrelor- and clopidogrel-treated patients. Multivariable analyses were performed to elucidate predictors of complications. RESULTS: Twenty-seven of 152 patients discharged on TT were on ticagrelor. NACE occurred in 52% of patients and BARC 2, 3, or 5 bleeding occurred in 18%. There was no difference in the primary or secondary outcome between ticagrelor vs clopidogrel subgroup. On logistic regressions, use of TT in patients with acute coronary syndrome (P = 0.002) and bridging in with ticagrelor (P = 0.02) were associated with increased NACE. Low estimated glomerular filtration rate was an independent predictor of bleeding (P = 0.03). CONCLUSIONS: The risk of bleeding and ischemic complications among patients on TT is similar between those on ticagrelor and clopidogrel. However, caution with use of bridging anticoagulation should be taken when using ticagrelor. CI - (c) 2016 Wiley Periodicals, Inc. FAU - Fu, Angel AU - Fu A AD - Department of Medicine (Cardiology), University of Ottawa Heart Institute, Ottawa, Canada. FAU - Singh, Kuljit AU - Singh K AD - Department of Medicine (Cardiology), University of Ottawa Heart Institute, Ottawa, Canada. FAU - Abunassar, Joseph AU - Abunassar J AD - Department of Medicine (Cardiology), University of Ottawa Heart Institute, Ottawa, Canada. FAU - Malhotra, Nikita AU - Malhotra N AD - Department of Medicine (Cardiology), University of Ottawa Heart Institute, Ottawa, Canada. FAU - Le May, Michel AU - Le May M AD - Department of Medicine (Cardiology), University of Ottawa Heart Institute, Ottawa, Canada. FAU - Labinaz, Marino AU - Labinaz M AD - Department of Medicine (Cardiology), University of Ottawa Heart Institute, Ottawa, Canada. FAU - Glover, Christopher AU - Glover C AD - Department of Medicine (Cardiology), University of Ottawa Heart Institute, Ottawa, Canada. FAU - Marquis, Jean-Francois AU - Marquis JF AD - Department of Medicine (Cardiology), University of Ottawa Heart Institute, Ottawa, Canada. FAU - Froeschl, Michael AU - Froeschl M AD - Department of Medicine (Cardiology), University of Ottawa Heart Institute, Ottawa, Canada. FAU - Dick, Alexander AU - Dick A AD - Department of Medicine (Cardiology), University of Ottawa Heart Institute, Ottawa, Canada. FAU - Hibbert, Benjamin AU - Hibbert B AD - Department of Medicine (Cardiology), University of Ottawa Heart Institute, Ottawa, Canada. FAU - Chong, Aun-Yeong AU - Chong AY AD - Department of Medicine (Cardiology), University of Ottawa Heart Institute, Ottawa, Canada. FAU - So, Derek Y F AU - So DY AD - Department of Medicine (Cardiology), University of Ottawa Heart Institute, Ottawa, Canada. CN - CAPITAL Investigators LA - eng GR - Canadian Institutes of Health Research/Canada PT - Comparative Study PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20160108 PL - United States TA - Clin Cardiol JT - Clinical cardiology JID - 7903272 RN - 0 (Fibrinolytic Agents) RN - 0 (Platelet Aggregation Inhibitors) RN - A74586SNO7 (Clopidogrel) RN - GLH0314RVC (Ticagrelor) RN - K72T3FS567 (Adenosine) RN - OM90ZUW7M1 (Ticlopidine) SB - IM MH - Adenosine/adverse effects/*analogs & derivatives MH - Chi-Square Distribution MH - Clinical Trials as Topic MH - Clopidogrel MH - Drug Therapy, Combination MH - Fibrinolytic Agents/*adverse effects MH - Hemorrhage/*chemically induced MH - Humans MH - Logistic Models MH - Multivariate Analysis MH - Myocardial Infarction/diagnosis/*etiology/mortality/prevention & control MH - Odds Ratio MH - Percutaneous Coronary Intervention/*adverse effects/mortality MH - Platelet Aggregation Inhibitors/*adverse effects MH - Registries MH - Retrospective Studies MH - Risk Assessment MH - Risk Factors MH - Stroke/diagnosis/*etiology/mortality/prevention & control MH - Ticagrelor MH - Ticlopidine/adverse effects/*analogs & derivatives MH - Treatment Outcome PMC - PMC6490865 EDAT- 2016/01/11 06:00 MHDA- 2016/11/12 06:00 PMCR- 2016/01/08 CRDT- 2016/01/11 06:00 PHST- 2015/06/11 00:00 [received] PHST- 2015/09/23 00:00 [revised] PHST- 2016/01/11 06:00 [entrez] PHST- 2016/01/11 06:00 [pubmed] PHST- 2016/11/12 06:00 [medline] PHST- 2016/01/08 00:00 [pmc-release] AID - CLC22486 [pii] AID - 10.1002/clc.22486 [doi] PST - ppublish SO - Clin Cardiol. 2016 Jan;39(1):19-23. doi: 10.1002/clc.22486. Epub 2016 Jan 8. PMID- 26738667 OWN - NLM STAT- MEDLINE DCOM- 20161019 LR - 20170910 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 8 IP - 15 DP - 2015 Dec 28 TI - Effect of Ischemia Duration and Door-to-Balloon Time on Myocardial Perfusion in ST-Segment Elevation Myocardial Infarction: An Analysis From HORIZONS-AMI Trial (Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction). PG - 1966-1974 LID - S1936-8798(15)01539-3 [pii] LID - 10.1016/j.jcin.2015.08.031 [doi] AB - OBJECTIVES: This study sought to investigate the effect of treatment delay on microvascular reperfusion in ST-segment elevation myocardial infarction (STEMI) patients from the large, multicenter, prospective HORIZONS-AMI (Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction) trial. BACKGROUND: Despite restoration of epicardial blood flow during primary percutaneous coronary intervention (PCI), one-third of patients do not obtain myocardial perfusion due to impairment in the microvascular circulation. METHODS: We examined the effect of symptom onset-to-balloon time (SBT) and door-to-balloon time (DBT) on myocardial reperfusion during primary PCI in STEMI, utilizing resolution of ST-segment elevation (STR) and the myocardial blush grade (MBG). The primary analysis was the relationships between SBT 2 to 4, and >4 h and DBT 1 to 1.5, >1.5 to 2, and >2 h with MBG and STR. Clinical risk was assessed using a modified version of the Thrombolysis In Myocardial Infarction risk score for STEMI. RESULTS: In 2,056 patients, absent microvascular perfusion (MBG 0/1) and STR (STR <30%) after primary PCI was significantly more common in patients with longer SBT, in patients with both low and high clinical risk profiles. By multivariable analysis, SBT (p < 0.0001), anterior infarction (p < 0.0001), reference vessel diameter (p = 0.005), lesion minimum lumen diameter (p < 0.0001), hyperlipidemia (p = 0.03), and current smoking (p = 0.001) were independent predictors of MBG 0/1, whereas SBT (p = 0.007), anterior infarction (p < 0.0001), and history of renal insufficiency (p = 0.0002) were independent predictors of absent STR. DBT (p < 0.0001) was an independent predictor of MBG 0/1. MBG 0/1 and STR<30% identified patients with increased 3-year mortality. CONCLUSIONS: The present study suggests that delay in mechanical reperfusion therapy during STEMI is associated with greater injury to the microcirculation. CI - Copyright (c) 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Prasad, Abhiram AU - Prasad A AD - Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota; St. George's, University of London, London, United Kingdom. FAU - Gersh, Bernard J AU - Gersh BJ AD - Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota. FAU - Mehran, Roxana AU - Mehran R AD - The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Clinical Trials Center, Cardiovascular Research Foundation, New York, New York. Electronic address: roxana.mehran@mssm.edu. FAU - Brodie, Bruce R AU - Brodie BR AD - LeBauer Cardiovascular Research Foundation/Cone Health, Greensboro, North Carolina. FAU - Brener, Sorin J AU - Brener SJ AD - Clinical Trials Center, Cardiovascular Research Foundation, New York, New York; New York Methodist Hospital, Brooklyn, New York. FAU - Dizon, Jose M AU - Dizon JM AD - Center for Interventional Vascular Therapy, Division of Cardiology, Columbia University Medical Center, New York, New York. FAU - Lansky, Alexandra J AU - Lansky AJ AD - Yale Cardiovascular Research Program, Yale University Medical Center, New Haven, Connecticut. FAU - Witzenbichler, Bernhard AU - Witzenbichler B AD - Department of Cardiology and Pneumology, Helios Amper-Klinikum, Dachau, Germany. FAU - Kornowski, Ran AU - Kornowski R AD - Cardiology Division, Rabin Medical Center, Petah-Tikva, Israel. FAU - Guagliumi, Giulio AU - Guagliumi G AD - Ospedale Papa Giovanni XXIII, Bergamo, Italy. FAU - Dudek, Dariusz AU - Dudek D AD - Department of Interventional Cardiology, Jagiellonian University, Krakow, Poland. FAU - Stone, Gregg W AU - Stone GW AD - Clinical Trials Center, Cardiovascular Research Foundation, New York, New York; Center for Interventional Vascular Therapy, Division of Cardiology, Columbia University Medical Center, New York, New York. LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 RN - 0 (Metals) SB - IM EIN - JACC Cardiovasc Interv. 2016 Mar 14;9(5):516 CIN - BMJ. 2015 Dec 30;351:h6992. doi: 10.1136/bmj.h6992. PMID: 26722121 CIN - JACC Cardiovasc Interv. 2015 Dec 28;8(15):1975-1977. doi: 10.1016/j.jcin.2015.10.007. PMID: 26738668 MH - Aged MH - Aged, 80 and over MH - Coronary Circulation MH - Drug-Eluting Stents MH - Female MH - Humans MH - Male MH - Metals MH - Microcirculation MH - Middle Aged MH - Myocardial Infarction/diagnosis/mortality/physiopathology/*therapy MH - Myocardial Perfusion Imaging MH - Percutaneous Coronary Intervention/adverse effects/*instrumentation/mortality MH - Prospective Studies MH - Prosthesis Design MH - Risk Assessment MH - Risk Factors MH - *Stents MH - Time Factors MH - *Time-to-Treatment MH - Treatment Outcome OTO - NOTNLM OT - PCI OT - STEMI OT - ischemia duration OT - myocardial infarction OT - perfusion EDAT- 2016/01/08 06:00 MHDA- 2016/12/30 06:00 CRDT- 2016/01/08 06:00 PHST- 2015/04/07 00:00 [received] PHST- 2015/07/14 00:00 [revised] PHST- 2015/08/27 00:00 [accepted] PHST- 2016/01/08 06:00 [entrez] PHST- 2016/01/08 06:00 [pubmed] PHST- 2016/12/30 06:00 [medline] AID - S1936-8798(15)01539-3 [pii] AID - 10.1016/j.jcin.2015.08.031 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2015 Dec 28;8(15):1966-1974. doi: 10.1016/j.jcin.2015.08.031. PMID- 26699599 OWN - NLM STAT- MEDLINE DCOM- 20160426 LR - 20260127 IS - 1097-6744 (Electronic) IS - 0002-8703 (Linking) VI - 171 IP - 1 DP - 2016 Jan TI - Incidence and impact of acute kidney injury in patients with acute coronary syndromes treated with coronary artery bypass grafting: Insights from the Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI) and Acute Catheterization and Urgent Intervention Triage Strategy (ACUITY) trials. PG - 40-7 LID - S0002-8703(15)00438-X [pii] LID - 10.1016/j.ahj.2015.07.001 [doi] AB - BACKGROUND: Acute kidney injury (AKI) is a well-recognized predictor of morbidity and mortality after percutaneous coronary intervention. However, the impact of AKI on the outcome of patients with acute coronary syndromes (ACS) in relation to coronary artery bypass grafting (CABG) has not been established. METHODS: Of the 17,421 patients who presented with non-ST-segment elevation ACS or ST-segment elevation myocardial infarction enrolled in the ACUITY and HORIZONS-AMI trials, 1,406 (8.0%) underwent CABG as principal treatment after coronary angiography. End points were measured at 1 month and 1 year and included death, myocardial infarction, and ischemia-driven target vessel revascularization. Acute kidney injury was defined as a rise in creatinine of >/= 0.5 mg/dL, or > 25%, from baseline at initial angiography. RESULTS: Acute kidney injury occurred during hospital admission in 449 (31.9%) of the 1,406 patients treated with CABG. One-month and 1-year mortality was 6.7% vs 2.2% (P < .0001) and 10.4% vs 4.3% (P < .0001) for patients with vs without AKI, respectively. Analogously, the 1-month and 1-year incidence of composite major adverse cardiac events (MACEs; death, MI, or target vessel revascularization) was 17.6% vs 12.4% (P = .003) and 22.0% vs 15.3% (P = .002) for patients with vs without AKI, respectively. After adjustment for age, sex, race, diabetes, hypertension, and baseline creatinine clearance, AKI was an independent predictor of mortality (overall and cardiac-related) and MACE at both 1 month and 1 year in patients treated with CABG. CONCLUSIONS: Acute kidney injury occurred in approximately 1 of every 3 patients with ACS treated with CABG and is a powerful independent predictor of death and MACE. These data highlight the need for AKI prevention strategies in patients undergoing CABG. CI - Copyright (c) 2015. Published by Elsevier Inc. FAU - Warren, Josephine AU - Warren J AD - Icahn School of Medicine at Mount Sinai, New York, NY. FAU - Mehran, Roxana AU - Mehran R AD - Icahn School of Medicine at Mount Sinai, New York, NY; Cardiovascular Research Foundation, New York, NY. Electronic address: roxana.mehran@mountsinai.org. FAU - Baber, Usman AU - Baber U AD - Icahn School of Medicine at Mount Sinai, New York, NY. FAU - Xu, Ke AU - Xu K AD - Cardiovascular Research Foundation, New York, NY. FAU - Giacoppo, Daniele AU - Giacoppo D AD - Icahn School of Medicine at Mount Sinai, New York, NY. FAU - Gersh, Bernard J AU - Gersh BJ AD - Mayo Clinic College of Medicine, Rochester, MN. FAU - Guagliumi, Giulio AU - Guagliumi G AD - Ospedale Papa Giovanni XXIII, Bergamo, Italy. FAU - Witzenbichler, Bernhard AU - Witzenbichler B AD - Helios Amper-Klinikum, Dachau, Germany. FAU - Magnus Ohman, E AU - Magnus Ohman E AD - Duke University Medical Center, Durham, NC. FAU - Pocock, Stuart J AU - Pocock SJ AD - Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom. FAU - Stone, Gregg W AU - Stone GW AD - Cardiovascular Research Foundation, New York, NY; NewYork-Presbyterian Hospital/Columbia University Medical Center, New York, NY. LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20150708 PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 RN - AYI8EX34EU (Creatinine) SB - IM MH - Acute Coronary Syndrome/complications/diagnosis/*surgery MH - Acute Kidney Injury/diagnosis/epidemiology/*etiology MH - Aged MH - Cardiac Catheterization MH - Coronary Angiography MH - Coronary Artery Bypass/*adverse effects MH - Creatinine/metabolism MH - Electrocardiography MH - Europe/epidemiology MH - Female MH - Follow-Up Studies MH - Glomerular Filtration Rate MH - Humans MH - Incidence MH - Male MH - Middle Aged MH - Myocardial Infarction/diagnostic imaging/mortality/*surgery MH - Percutaneous Coronary Intervention/*methods MH - Prognosis MH - Prospective Studies MH - *Stents MH - Survival Rate/trends MH - Triage/*methods MH - United States/epidemiology EDAT- 2015/12/25 06:00 MHDA- 2016/04/27 06:00 CRDT- 2015/12/25 06:00 PHST- 2015/02/02 00:00 [received] PHST- 2015/07/02 00:00 [accepted] PHST- 2015/12/25 06:00 [entrez] PHST- 2015/12/25 06:00 [pubmed] PHST- 2016/04/27 06:00 [medline] AID - S0002-8703(15)00438-X [pii] AID - 10.1016/j.ahj.2015.07.001 [doi] PST - ppublish SO - Am Heart J. 2016 Jan;171(1):40-7. doi: 10.1016/j.ahj.2015.07.001. Epub 2015 Jul 8. PMID- 26693807 OWN - NLM STAT- MEDLINE DCOM- 20161101 LR - 20161230 IS - 1473-5830 (Electronic) IS - 0954-6928 (Linking) VI - 27 IP - 2 DP - 2016 Mar TI - Comparison of clinical outcomes according to presentation of angina pectoris versus acute myocardial infarction in patients who underwent a percutaneous coronary intervention with a drug-eluting stent. PG - 143-50 LID - 10.1097/MCA.0000000000000338 [doi] AB - BACKGROUND: Although randomized clinical trials are valuable tools to compare treatment effects, the results of randomized clinical trials cannot usually be extrapolated to the real-world setting because of selected patient subsets. To categorize the risk of future cardiovascular events in drug-eluting stent (DES)-treated patients, we analyzed demographic, clinical, and procedural data in all-comers who underwent a percutaneous coronary intervention (PCI). METHODS: Patients who underwent PCI using DES from January 2004 were prospectively enrolled in the Catholic University of Korea-PCI registry and were followed up for a median of 2 years. We analyzed the risk of clinical outcomes in the all-patient cohort and in subsets of patients with angina and acute myocardial infarction (AMI). RESULTS: The patients were categorized into two groups: those with angina (angina group, n=6183, 67.7%) and those with AMI (AMI group, n=2944, 32.3%). The AMI group had greater occurrence of major adverse cardiac events (MACE) during long-term follow-up than the angina group (23.8 vs. 20.1%, P<0.001). However, in the landmark analysis of data beyond 1 year, there was no significant difference in the occurrence of MACE between the two groups (P=0.44). In multivariable modeling, age, renal function, left ventricular ejection fraction, and multivessel disease were associated significantly with increasing MACE in the study population, angina or AMI groups. CONCLUSION: We found that higher MACE in patients with AMI during long-term follow-up after PCI was mainly because of higher mortality in the first year. Some demographic, clinical, and angiographic factors still significantly influence the long-term occurrence of MACE in the era of DES. FAU - Seo, Suk-Min AU - Seo SM AD - aCardiovascular Center and Cardiology Division, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon bCardiovascular Center and Cardiology Division, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu cCardiovascular Center and Cardiology Division, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea dCardiovascular Center and Cardiology Division, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea eCardiovascular Center and Cardiology Division, St. Paul's Hospital, College of Medicine, The Catholic University of Korea, Seoul fCardiovascular Center and Cardiology Division, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon gCardiovascular Center and Cardiology Division, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon hCardiovascular Center and Cardiology Division, St Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Republic of Korea. FAU - Kim, Tae-Hoon AU - Kim TH FAU - Koh, Yoon-Seok AU - Koh YS FAU - Her, Sung-Ho AU - Her SH FAU - Shin, Dong Il AU - Shin DI FAU - Park, Hun-Jun AU - Park HJ FAU - Kim, Pum-Joon AU - Kim PJ FAU - Park, Chul Soo AU - Park CS FAU - Lee, Jong Min AU - Lee JM FAU - Kim, Dong-Bin AU - Kim DB FAU - Kim, Hee-Yeol AU - Kim HY FAU - Chang, Kiyuk AU - Chang K FAU - Yoo, Ki-Dong AU - Yoo KD FAU - Jeon, Doo Soo AU - Jeon DS FAU - Chung, Wook-Sung AU - Chung WS FAU - Seung, Ki-Bae AU - Seung KB CN - CathOlic University of Korea - percutAneous Coronary inTervention registry investigators LA - eng PT - Comparative Study PT - Journal Article PT - Observational Study PL - England TA - Coron Artery Dis JT - Coronary artery disease JID - 9011445 SB - IM MH - Aged MH - Angina Pectoris/surgery MH - Angina, Stable/*surgery MH - Angina, Unstable/*surgery MH - Coronary Artery Disease/*surgery MH - *Drug-Eluting Stents MH - Female MH - Humans MH - Male MH - Middle Aged MH - Myocardial Infarction/*surgery MH - Percutaneous Coronary Intervention MH - Prospective Studies MH - *Registries MH - Treatment Outcome EDAT- 2015/12/24 06:00 MHDA- 2016/11/02 06:00 CRDT- 2015/12/24 06:00 PHST- 2015/12/24 06:00 [entrez] PHST- 2015/12/24 06:00 [pubmed] PHST- 2016/11/02 06:00 [medline] AID - 10.1097/MCA.0000000000000338 [doi] PST - ppublish SO - Coron Artery Dis. 2016 Mar;27(2):143-50. doi: 10.1097/MCA.0000000000000338. PMID- 26643737 OWN - NLM STAT- MEDLINE DCOM- 20160929 LR - 20220409 IS - 1941-7632 (Electronic) IS - 1941-7640 (Linking) VI - 8 IP - 12 DP - 2015 Dec TI - Etiology, Frequency, and Clinical Outcomes of Myocardial Infarction After Successful Drug-Eluting Stent Implantation: Two-Year Follow-Up From the ADAPT-DES Study. PG - e002447 LID - 10.1161/CIRCINTERVENTIONS.114.002447 [doi] AB - BACKGROUND: The frequency, causes, and impact of myocardial infarction (MI) after successful percutaneous coronary intervention have not been well studied. METHODS AND RESULTS: The Assessment of Dual Antiplatelet Therapy With Drug-Eluting Stents (ADAPT-DES) study was a prospective, multicenter registry study of 8582 patients undergoing successful drug-eluting stent implantation at 11 centers in the United States and Germany. After excluding 128 patients with periprocedural MI, we investigated the pathogenesis, frequency, and long-term consequences of non-periprocedural MI in 8454 patients. MI during 2-year follow-up developed in 263 patients (3.3%) at a median (25th and 75th percentiles) time of 318 (129, 503) days. The 263 MIs were subclassified as spontaneous MI (n=78; 29.7%), secondary or indeterminate MI (n=64; 24.3%), stent thrombosis-related MI (n=63; 24.0%), and in-stent restenosis-related MI (n=58; 22.1%). Multivariable predictors of MI included clinical and angiographic factors (acute coronary syndromes presentation, diabetes mellitus, current smoker, multivessel disease, treatment of an in-stent restenotic lesion), laboratory findings (low baseline hemoglobin and reduced creatinine clearance), antiplatelet agent-related factors (higher on-treatment platelet P2Y12 receptor reactivity and premature thienopyridine discontinuation), and not being on a statin at discharge. Patients who experienced an MI during the follow-up period had significantly greater 2-year mortality than those without MI (17.3% [42 deaths] versus 3.4% [265 deaths], P<0.001). By multivariable analysis, the adjusted hazard ratio (95% confidence interval) for subsequent mortality during follow-up was 2.17 (1.06, 4.45) in patients with versus without a non-periprocedural MI (P=0.03). CONCLUSIONS: The occurrence of a non-periprocedural MI within 2 years after successful drug-eluting stent implantation is relatively infrequent, but has numerous etiologies and is significantly associated with subsequent mortality. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00638794. CI - (c) 2015 American Heart Association, Inc. FAU - Dohi, Tomotaka AU - Dohi T AD - From the Center for Interventional Vascular Therapy, Division of Cardiology, Columbia University Medical Center/NewYork-Presbyterian Hospital, New York (T.D., A.M., G.W., A.J.K., G.W.S.); Clinical Trials Center, Cardiovascular Research Foundation, New York, NY (T.D., A.M., G.W., C.L., S.J.B., A.J.K., G.S.M., G.W.S.); Department of Cardiology and Pneumology, Helios Amper-Klinikum, Dachau, Germany (B.W.); Sanger Heart & Vascular Institute/Carolinas HealthCare System, Charlotte, NC (M.J.R.); The Ohio State University, Columbus (E.L.M.); Reid Heart Center, FirstHealth of the Carolinas, Pinehurst, NC (P.L.D.); Els & Charles Bendheim Department of Cardiology, Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Department of Cardiology and Angiology II, Universitats-Herzzentrum Freibrug Bad Krozingen, Bad Krozingen, Germany (F.-J.N.); Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, MN (T.D.H.); Cedars-Sinai Medical Center, Los Angeles, CA (T.D.H.); Lehigh Valley Health Network, Allentown, PA (D.A.C.); LeBauer Cardiovascular Research Foundation/Cone Health, Greensboro, NC (T.D.S., B.R.B.); and New York Methodist Hospital, Brooklyn (S.J.B.). FAU - Maehara, Akiko AU - Maehara A AD - From the Center for Interventional Vascular Therapy, Division of Cardiology, Columbia University Medical Center/NewYork-Presbyterian Hospital, New York (T.D., A.M., G.W., A.J.K., G.W.S.); Clinical Trials Center, Cardiovascular Research Foundation, New York, NY (T.D., A.M., G.W., C.L., S.J.B., A.J.K., G.S.M., G.W.S.); Department of Cardiology and Pneumology, Helios Amper-Klinikum, Dachau, Germany (B.W.); Sanger Heart & Vascular Institute/Carolinas HealthCare System, Charlotte, NC (M.J.R.); The Ohio State University, Columbus (E.L.M.); Reid Heart Center, FirstHealth of the Carolinas, Pinehurst, NC (P.L.D.); Els & Charles Bendheim Department of Cardiology, Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Department of Cardiology and Angiology II, Universitats-Herzzentrum Freibrug Bad Krozingen, Bad Krozingen, Germany (F.-J.N.); Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, MN (T.D.H.); Cedars-Sinai Medical Center, Los Angeles, CA (T.D.H.); Lehigh Valley Health Network, Allentown, PA (D.A.C.); LeBauer Cardiovascular Research Foundation/Cone Health, Greensboro, NC (T.D.S., B.R.B.); and New York Methodist Hospital, Brooklyn (S.J.B.). amaehara@crf.org. FAU - Witzenbichler, Bernhard AU - Witzenbichler B AD - From the Center for Interventional Vascular Therapy, Division of Cardiology, Columbia University Medical Center/NewYork-Presbyterian Hospital, New York (T.D., A.M., G.W., A.J.K., G.W.S.); Clinical Trials Center, Cardiovascular Research Foundation, New York, NY (T.D., A.M., G.W., C.L., S.J.B., A.J.K., G.S.M., G.W.S.); Department of Cardiology and Pneumology, Helios Amper-Klinikum, Dachau, Germany (B.W.); Sanger Heart & Vascular Institute/Carolinas HealthCare System, Charlotte, NC (M.J.R.); The Ohio State University, Columbus (E.L.M.); Reid Heart Center, FirstHealth of the Carolinas, Pinehurst, NC (P.L.D.); Els & Charles Bendheim Department of Cardiology, Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Department of Cardiology and Angiology II, Universitats-Herzzentrum Freibrug Bad Krozingen, Bad Krozingen, Germany (F.-J.N.); Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, MN (T.D.H.); Cedars-Sinai Medical Center, Los Angeles, CA (T.D.H.); Lehigh Valley Health Network, Allentown, PA (D.A.C.); LeBauer Cardiovascular Research Foundation/Cone Health, Greensboro, NC (T.D.S., B.R.B.); and New York Methodist Hospital, Brooklyn (S.J.B.). FAU - Rinaldi, Michael J AU - Rinaldi MJ AD - From the Center for Interventional Vascular Therapy, Division of Cardiology, Columbia University Medical Center/NewYork-Presbyterian Hospital, New York (T.D., A.M., G.W., A.J.K., G.W.S.); Clinical Trials Center, Cardiovascular Research Foundation, New York, NY (T.D., A.M., G.W., C.L., S.J.B., A.J.K., G.S.M., G.W.S.); Department of Cardiology and Pneumology, Helios Amper-Klinikum, Dachau, Germany (B.W.); Sanger Heart & Vascular Institute/Carolinas HealthCare System, Charlotte, NC (M.J.R.); The Ohio State University, Columbus (E.L.M.); Reid Heart Center, FirstHealth of the Carolinas, Pinehurst, NC (P.L.D.); Els & Charles Bendheim Department of Cardiology, Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Department of Cardiology and Angiology II, Universitats-Herzzentrum Freibrug Bad Krozingen, Bad Krozingen, Germany (F.-J.N.); Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, MN (T.D.H.); Cedars-Sinai Medical Center, Los Angeles, CA (T.D.H.); Lehigh Valley Health Network, Allentown, PA (D.A.C.); LeBauer Cardiovascular Research Foundation/Cone Health, Greensboro, NC (T.D.S., B.R.B.); and New York Methodist Hospital, Brooklyn (S.J.B.). FAU - Mazzaferri, Ernest L Jr AU - Mazzaferri EL Jr AD - From the Center for Interventional Vascular Therapy, Division of Cardiology, Columbia University Medical Center/NewYork-Presbyterian Hospital, New York (T.D., A.M., G.W., A.J.K., G.W.S.); Clinical Trials Center, Cardiovascular Research Foundation, New York, NY (T.D., A.M., G.W., C.L., S.J.B., A.J.K., G.S.M., G.W.S.); Department of Cardiology and Pneumology, Helios Amper-Klinikum, Dachau, Germany (B.W.); Sanger Heart & Vascular Institute/Carolinas HealthCare System, Charlotte, NC (M.J.R.); The Ohio State University, Columbus (E.L.M.); Reid Heart Center, FirstHealth of the Carolinas, Pinehurst, NC (P.L.D.); Els & Charles Bendheim Department of Cardiology, Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Department of Cardiology and Angiology II, Universitats-Herzzentrum Freibrug Bad Krozingen, Bad Krozingen, Germany (F.-J.N.); Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, MN (T.D.H.); Cedars-Sinai Medical Center, Los Angeles, CA (T.D.H.); Lehigh Valley Health Network, Allentown, PA (D.A.C.); LeBauer Cardiovascular Research Foundation/Cone Health, Greensboro, NC (T.D.S., B.R.B.); and New York Methodist Hospital, Brooklyn (S.J.B.). FAU - Duffy, Peter L AU - Duffy PL AD - From the Center for Interventional Vascular Therapy, Division of Cardiology, Columbia University Medical Center/NewYork-Presbyterian Hospital, New York (T.D., A.M., G.W., A.J.K., G.W.S.); Clinical Trials Center, Cardiovascular Research Foundation, New York, NY (T.D., A.M., G.W., C.L., S.J.B., A.J.K., G.S.M., G.W.S.); Department of Cardiology and Pneumology, Helios Amper-Klinikum, Dachau, Germany (B.W.); Sanger Heart & Vascular Institute/Carolinas HealthCare System, Charlotte, NC (M.J.R.); The Ohio State University, Columbus (E.L.M.); Reid Heart Center, FirstHealth of the Carolinas, Pinehurst, NC (P.L.D.); Els & Charles Bendheim Department of Cardiology, Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Department of Cardiology and Angiology II, Universitats-Herzzentrum Freibrug Bad Krozingen, Bad Krozingen, Germany (F.-J.N.); Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, MN (T.D.H.); Cedars-Sinai Medical Center, Los Angeles, CA (T.D.H.); Lehigh Valley Health Network, Allentown, PA (D.A.C.); LeBauer Cardiovascular Research Foundation/Cone Health, Greensboro, NC (T.D.S., B.R.B.); and New York Methodist Hospital, Brooklyn (S.J.B.). FAU - Weisz, Giora AU - Weisz G AD - From the Center for Interventional Vascular Therapy, Division of Cardiology, Columbia University Medical Center/NewYork-Presbyterian Hospital, New York (T.D., A.M., G.W., A.J.K., G.W.S.); Clinical Trials Center, Cardiovascular Research Foundation, New York, NY (T.D., A.M., G.W., C.L., S.J.B., A.J.K., G.S.M., G.W.S.); Department of Cardiology and Pneumology, Helios Amper-Klinikum, Dachau, Germany (B.W.); Sanger Heart & Vascular Institute/Carolinas HealthCare System, Charlotte, NC (M.J.R.); The Ohio State University, Columbus (E.L.M.); Reid Heart Center, FirstHealth of the Carolinas, Pinehurst, NC (P.L.D.); Els & Charles Bendheim Department of Cardiology, Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Department of Cardiology and Angiology II, Universitats-Herzzentrum Freibrug Bad Krozingen, Bad Krozingen, Germany (F.-J.N.); Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, MN (T.D.H.); Cedars-Sinai Medical Center, Los Angeles, CA (T.D.H.); Lehigh Valley Health Network, Allentown, PA (D.A.C.); LeBauer Cardiovascular Research Foundation/Cone Health, Greensboro, NC (T.D.S., B.R.B.); and New York Methodist Hospital, Brooklyn (S.J.B.). FAU - Neumann, Franz-Josef AU - Neumann FJ AD - From the Center for Interventional Vascular Therapy, Division of Cardiology, Columbia University Medical Center/NewYork-Presbyterian Hospital, New York (T.D., A.M., G.W., A.J.K., G.W.S.); Clinical Trials Center, Cardiovascular Research Foundation, New York, NY (T.D., A.M., G.W., C.L., S.J.B., A.J.K., G.S.M., G.W.S.); Department of Cardiology and Pneumology, Helios Amper-Klinikum, Dachau, Germany (B.W.); Sanger Heart & Vascular Institute/Carolinas HealthCare System, Charlotte, NC (M.J.R.); The Ohio State University, Columbus (E.L.M.); Reid Heart Center, FirstHealth of the Carolinas, Pinehurst, NC (P.L.D.); Els & Charles Bendheim Department of Cardiology, Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Department of Cardiology and Angiology II, Universitats-Herzzentrum Freibrug Bad Krozingen, Bad Krozingen, Germany (F.-J.N.); Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, MN (T.D.H.); Cedars-Sinai Medical Center, Los Angeles, CA (T.D.H.); Lehigh Valley Health Network, Allentown, PA (D.A.C.); LeBauer Cardiovascular Research Foundation/Cone Health, Greensboro, NC (T.D.S., B.R.B.); and New York Methodist Hospital, Brooklyn (S.J.B.). FAU - Henry, Timothy D AU - Henry TD AD - From the Center for Interventional Vascular Therapy, Division of Cardiology, Columbia University Medical Center/NewYork-Presbyterian Hospital, New York (T.D., A.M., G.W., A.J.K., G.W.S.); Clinical Trials Center, Cardiovascular Research Foundation, New York, NY (T.D., A.M., G.W., C.L., S.J.B., A.J.K., G.S.M., G.W.S.); Department of Cardiology and Pneumology, Helios Amper-Klinikum, Dachau, Germany (B.W.); Sanger Heart & Vascular Institute/Carolinas HealthCare System, Charlotte, NC (M.J.R.); The Ohio State University, Columbus (E.L.M.); Reid Heart Center, FirstHealth of the Carolinas, Pinehurst, NC (P.L.D.); Els & Charles Bendheim Department of Cardiology, Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Department of Cardiology and Angiology II, Universitats-Herzzentrum Freibrug Bad Krozingen, Bad Krozingen, Germany (F.-J.N.); Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, MN (T.D.H.); Cedars-Sinai Medical Center, Los Angeles, CA (T.D.H.); Lehigh Valley Health Network, Allentown, PA (D.A.C.); LeBauer Cardiovascular Research Foundation/Cone Health, Greensboro, NC (T.D.S., B.R.B.); and New York Methodist Hospital, Brooklyn (S.J.B.). FAU - Cox, David A AU - Cox DA AD - From the Center for Interventional Vascular Therapy, Division of Cardiology, Columbia University Medical Center/NewYork-Presbyterian Hospital, New York (T.D., A.M., G.W., A.J.K., G.W.S.); Clinical Trials Center, Cardiovascular Research Foundation, New York, NY (T.D., A.M., G.W., C.L., S.J.B., A.J.K., G.S.M., G.W.S.); Department of Cardiology and Pneumology, Helios Amper-Klinikum, Dachau, Germany (B.W.); Sanger Heart & Vascular Institute/Carolinas HealthCare System, Charlotte, NC (M.J.R.); The Ohio State University, Columbus (E.L.M.); Reid Heart Center, FirstHealth of the Carolinas, Pinehurst, NC (P.L.D.); Els & Charles Bendheim Department of Cardiology, Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Department of Cardiology and Angiology II, Universitats-Herzzentrum Freibrug Bad Krozingen, Bad Krozingen, Germany (F.-J.N.); Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, MN (T.D.H.); Cedars-Sinai Medical Center, Los Angeles, CA (T.D.H.); Lehigh Valley Health Network, Allentown, PA (D.A.C.); LeBauer Cardiovascular Research Foundation/Cone Health, Greensboro, NC (T.D.S., B.R.B.); and New York Methodist Hospital, Brooklyn (S.J.B.). FAU - Stuckey, Thomas D AU - Stuckey TD AD - From the Center for Interventional Vascular Therapy, Division of Cardiology, Columbia University Medical Center/NewYork-Presbyterian Hospital, New York (T.D., A.M., G.W., A.J.K., G.W.S.); Clinical Trials Center, Cardiovascular Research Foundation, New York, NY (T.D., A.M., G.W., C.L., S.J.B., A.J.K., G.S.M., G.W.S.); Department of Cardiology and Pneumology, Helios Amper-Klinikum, Dachau, Germany (B.W.); Sanger Heart & Vascular Institute/Carolinas HealthCare System, Charlotte, NC (M.J.R.); The Ohio State University, Columbus (E.L.M.); Reid Heart Center, FirstHealth of the Carolinas, Pinehurst, NC (P.L.D.); Els & Charles Bendheim Department of Cardiology, Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Department of Cardiology and Angiology II, Universitats-Herzzentrum Freibrug Bad Krozingen, Bad Krozingen, Germany (F.-J.N.); Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, MN (T.D.H.); Cedars-Sinai Medical Center, Los Angeles, CA (T.D.H.); Lehigh Valley Health Network, Allentown, PA (D.A.C.); LeBauer Cardiovascular Research Foundation/Cone Health, Greensboro, NC (T.D.S., B.R.B.); and New York Methodist Hospital, Brooklyn (S.J.B.). FAU - Brodie, Bruce R AU - Brodie BR AD - From the Center for Interventional Vascular Therapy, Division of Cardiology, Columbia University Medical Center/NewYork-Presbyterian Hospital, New York (T.D., A.M., G.W., A.J.K., G.W.S.); Clinical Trials Center, Cardiovascular Research Foundation, New York, NY (T.D., A.M., G.W., C.L., S.J.B., A.J.K., G.S.M., G.W.S.); Department of Cardiology and Pneumology, Helios Amper-Klinikum, Dachau, Germany (B.W.); Sanger Heart & Vascular Institute/Carolinas HealthCare System, Charlotte, NC (M.J.R.); The Ohio State University, Columbus (E.L.M.); Reid Heart Center, FirstHealth of the Carolinas, Pinehurst, NC (P.L.D.); Els & Charles Bendheim Department of Cardiology, Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Department of Cardiology and Angiology II, Universitats-Herzzentrum Freibrug Bad Krozingen, Bad Krozingen, Germany (F.-J.N.); Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, MN (T.D.H.); Cedars-Sinai Medical Center, Los Angeles, CA (T.D.H.); Lehigh Valley Health Network, Allentown, PA (D.A.C.); LeBauer Cardiovascular Research Foundation/Cone Health, Greensboro, NC (T.D.S., B.R.B.); and New York Methodist Hospital, Brooklyn (S.J.B.). FAU - Litherland, Claire AU - Litherland C AD - From the Center for Interventional Vascular Therapy, Division of Cardiology, Columbia University Medical Center/NewYork-Presbyterian Hospital, New York (T.D., A.M., G.W., A.J.K., G.W.S.); Clinical Trials Center, Cardiovascular Research Foundation, New York, NY (T.D., A.M., G.W., C.L., S.J.B., A.J.K., G.S.M., G.W.S.); Department of Cardiology and Pneumology, Helios Amper-Klinikum, Dachau, Germany (B.W.); Sanger Heart & Vascular Institute/Carolinas HealthCare System, Charlotte, NC (M.J.R.); The Ohio State University, Columbus (E.L.M.); Reid Heart Center, FirstHealth of the Carolinas, Pinehurst, NC (P.L.D.); Els & Charles Bendheim Department of Cardiology, Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Department of Cardiology and Angiology II, Universitats-Herzzentrum Freibrug Bad Krozingen, Bad Krozingen, Germany (F.-J.N.); Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, MN (T.D.H.); Cedars-Sinai Medical Center, Los Angeles, CA (T.D.H.); Lehigh Valley Health Network, Allentown, PA (D.A.C.); LeBauer Cardiovascular Research Foundation/Cone Health, Greensboro, NC (T.D.S., B.R.B.); and New York Methodist Hospital, Brooklyn (S.J.B.). FAU - Brener, Sorin J AU - Brener SJ AD - From the Center for Interventional Vascular Therapy, Division of Cardiology, Columbia University Medical Center/NewYork-Presbyterian Hospital, New York (T.D., A.M., G.W., A.J.K., G.W.S.); Clinical Trials Center, Cardiovascular Research Foundation, New York, NY (T.D., A.M., G.W., C.L., S.J.B., A.J.K., G.S.M., G.W.S.); Department of Cardiology and Pneumology, Helios Amper-Klinikum, Dachau, Germany (B.W.); Sanger Heart & Vascular Institute/Carolinas HealthCare System, Charlotte, NC (M.J.R.); The Ohio State University, Columbus (E.L.M.); Reid Heart Center, FirstHealth of the Carolinas, Pinehurst, NC (P.L.D.); Els & Charles Bendheim Department of Cardiology, Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Department of Cardiology and Angiology II, Universitats-Herzzentrum Freibrug Bad Krozingen, Bad Krozingen, Germany (F.-J.N.); Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, MN (T.D.H.); Cedars-Sinai Medical Center, Los Angeles, CA (T.D.H.); Lehigh Valley Health Network, Allentown, PA (D.A.C.); LeBauer Cardiovascular Research Foundation/Cone Health, Greensboro, NC (T.D.S., B.R.B.); and New York Methodist Hospital, Brooklyn (S.J.B.). FAU - Kirtane, Ajay J AU - Kirtane AJ AD - From the Center for Interventional Vascular Therapy, Division of Cardiology, Columbia University Medical Center/NewYork-Presbyterian Hospital, New York (T.D., A.M., G.W., A.J.K., G.W.S.); Clinical Trials Center, Cardiovascular Research Foundation, New York, NY (T.D., A.M., G.W., C.L., S.J.B., A.J.K., G.S.M., G.W.S.); Department of Cardiology and Pneumology, Helios Amper-Klinikum, Dachau, Germany (B.W.); Sanger Heart & Vascular Institute/Carolinas HealthCare System, Charlotte, NC (M.J.R.); The Ohio State University, Columbus (E.L.M.); Reid Heart Center, FirstHealth of the Carolinas, Pinehurst, NC (P.L.D.); Els & Charles Bendheim Department of Cardiology, Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Department of Cardiology and Angiology II, Universitats-Herzzentrum Freibrug Bad Krozingen, Bad Krozingen, Germany (F.-J.N.); Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, MN (T.D.H.); Cedars-Sinai Medical Center, Los Angeles, CA (T.D.H.); Lehigh Valley Health Network, Allentown, PA (D.A.C.); LeBauer Cardiovascular Research Foundation/Cone Health, Greensboro, NC (T.D.S., B.R.B.); and New York Methodist Hospital, Brooklyn (S.J.B.). FAU - Mintz, Gary S AU - Mintz GS AD - From the Center for Interventional Vascular Therapy, Division of Cardiology, Columbia University Medical Center/NewYork-Presbyterian Hospital, New York (T.D., A.M., G.W., A.J.K., G.W.S.); Clinical Trials Center, Cardiovascular Research Foundation, New York, NY (T.D., A.M., G.W., C.L., S.J.B., A.J.K., G.S.M., G.W.S.); Department of Cardiology and Pneumology, Helios Amper-Klinikum, Dachau, Germany (B.W.); Sanger Heart & Vascular Institute/Carolinas HealthCare System, Charlotte, NC (M.J.R.); The Ohio State University, Columbus (E.L.M.); Reid Heart Center, FirstHealth of the Carolinas, Pinehurst, NC (P.L.D.); Els & Charles Bendheim Department of Cardiology, Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Department of Cardiology and Angiology II, Universitats-Herzzentrum Freibrug Bad Krozingen, Bad Krozingen, Germany (F.-J.N.); Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, MN (T.D.H.); Cedars-Sinai Medical Center, Los Angeles, CA (T.D.H.); Lehigh Valley Health Network, Allentown, PA (D.A.C.); LeBauer Cardiovascular Research Foundation/Cone Health, Greensboro, NC (T.D.S., B.R.B.); and New York Methodist Hospital, Brooklyn (S.J.B.). FAU - Stone, Gregg W AU - Stone GW AD - From the Center for Interventional Vascular Therapy, Division of Cardiology, Columbia University Medical Center/NewYork-Presbyterian Hospital, New York (T.D., A.M., G.W., A.J.K., G.W.S.); Clinical Trials Center, Cardiovascular Research Foundation, New York, NY (T.D., A.M., G.W., C.L., S.J.B., A.J.K., G.S.M., G.W.S.); Department of Cardiology and Pneumology, Helios Amper-Klinikum, Dachau, Germany (B.W.); Sanger Heart & Vascular Institute/Carolinas HealthCare System, Charlotte, NC (M.J.R.); The Ohio State University, Columbus (E.L.M.); Reid Heart Center, FirstHealth of the Carolinas, Pinehurst, NC (P.L.D.); Els & Charles Bendheim Department of Cardiology, Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Department of Cardiology and Angiology II, Universitats-Herzzentrum Freibrug Bad Krozingen, Bad Krozingen, Germany (F.-J.N.); Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, MN (T.D.H.); Cedars-Sinai Medical Center, Los Angeles, CA (T.D.H.); Lehigh Valley Health Network, Allentown, PA (D.A.C.); LeBauer Cardiovascular Research Foundation/Cone Health, Greensboro, NC (T.D.S., B.R.B.); and New York Methodist Hospital, Brooklyn (S.J.B.). LA - eng SI - ClinicalTrials.gov/NCT00638794 PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't PL - United States TA - Circ Cardiovasc Interv JT - Circulation. Cardiovascular interventions JID - 101499602 SB - IM MH - Aged MH - *Drug-Eluting Stents MH - Female MH - Follow-Up Studies MH - Humans MH - Male MH - Middle Aged MH - Myocardial Infarction/epidemiology/*etiology/mortality MH - Percutaneous Coronary Intervention/*adverse effects MH - Prospective Studies MH - Treatment Outcome OTO - NOTNLM OT - acute coronary syndromes OT - diabetes mellitus OT - drug-eluting stent OT - myocardial infarction OT - percutaneous coronary intervention OT - stent EDAT- 2015/12/09 06:00 MHDA- 2016/09/30 06:00 CRDT- 2015/12/09 06:00 PHST- 2015/12/09 06:00 [entrez] PHST- 2015/12/09 06:00 [pubmed] PHST- 2016/09/30 06:00 [medline] AID - CIRCINTERVENTIONS.114.002447 [pii] AID - 10.1161/CIRCINTERVENTIONS.114.002447 [doi] PST - ppublish SO - Circ Cardiovasc Interv. 2015 Dec;8(12):e002447. doi: 10.1161/CIRCINTERVENTIONS.114.002447. PMID- 26582040 OWN - NLM STAT- MEDLINE DCOM- 20180216 LR - 20260127 IS - 1532-6551 (Electronic) IS - 1071-3581 (Linking) VI - 24 IP - 1 DP - 2017 Feb TI - The prognostic value of regadenoson SPECT myocardial perfusion imaging in patients with end-stage renal disease. PG - 112-118 LID - 10.1007/s12350-015-0303-4 [doi] AB - BACKGROUND: The prognostic value of regadenoson SPECT myocardial perfusion imaging (MPI) has not been specifically studied in patients with end-stage renal disease (ESRD). METHODS AND RESULTS: We prospectively followed ESRD patients enrolled in the ASSUAGE and ASSUAGE-CKD trials in which they received regadenoson-stress (99m)Tc-tetrofosmin SPECT-MPI. Images were semiquantitatively analyzed by an investigator blinded to clinical and outcome data. Patients were followed for cardiac death, myocardial infarction (MI), and coronary revascularization (CR). Revascularizations occurring >90 days post-MPI were considered "late" events. Survival analysis was performed using Cox regression models, adjusting for age, gender, diabetes, dyslipidemia, smoking, and known coronary artery disease. We analyzed 303 patients (mean age 54 years; 64% men), who were followed for 35 +/- 10 months. Adjusting for clinical covariates, abnormal regadenoson-stress MPI (SSS >/= 4) was associated with increased risk of the composite of cardiac death or MI (23.9% vs 14.4%; HR 1.88; CI 1.04-3.41; P = .037) and the composite of cardiac death, MI, or late CR (27.3% vs 16.7%; HR 1.80; CI 1.03-3.14; P = .039). Adjusting for clinical covariates, regadenoson-induced myocardial ischemia (SDS >/= 2) was associated with increased rate of the composite endpoint of cardiac death, MI, or CR (33.3% vs 16.9%; HR 1.97; CI 1.19-3.27; P = .008). CONCLUSION: Regadenoson-stress SPECT-MPI provides a significant prognostic value in patients with ESRD. ESRD patients with normal SPECT-MPI have relatively high adverse event rates. FAU - Doukky, Rami AU - Doukky R AD - Division of Cardiology, John H. Stroger, Jr. Hospital of Cook County, 1901 W. Harrison St., Suite # 3620, Chicago, IL, 60612, USA. rami_doukky@rush.edu. AD - Division of Cardiology, Rush University Medical Center, Chicago, IL, USA. rami_doukky@rush.edu. FAU - Fughhi, Ibtihaj AU - Fughhi I AD - Division of Cardiology, Rush University Medical Center, Chicago, IL, USA. FAU - Campagnoli, Tania AU - Campagnoli T AD - Division of Cardiology, Rush University Medical Center, Chicago, IL, USA. FAU - Wassouf, Marwan AU - Wassouf M AD - Division of Cardiology, Rush University Medical Center, Chicago, IL, USA. FAU - Ali, Amjad AU - Ali A AD - Department of Radiology and Nuclear Medicine, Rush University Medical Center, Chicago, IL, USA. LA - eng PT - Journal Article DEP - 20151118 PL - United States TA - J Nucl Cardiol JT - Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology JID - 9423534 RN - 0 (Purines) RN - 0 (Pyrazoles) RN - 0 (Vasodilator Agents) RN - 2XLN4Y044H (regadenoson) SB - IM MH - Age Distribution MH - Cardio-Renal Syndrome/diagnostic imaging/*mortality MH - Chicago/epidemiology MH - Comorbidity MH - Coronary Artery Disease/*diagnostic imaging/*mortality MH - Death, Sudden, Cardiac/*epidemiology MH - Exercise Test/methods MH - Female MH - Humans MH - Incidence MH - Kidney Failure, Chronic/diagnostic imaging/*mortality MH - Male MH - Middle Aged MH - Myocardial Perfusion Imaging/methods/*statistics & numerical data MH - Prognosis MH - *Purines MH - *Pyrazoles MH - Reproducibility of Results MH - Risk Assessment MH - Sensitivity and Specificity MH - Sex Distribution MH - Single-Blind Method MH - Survival Rate MH - Tomography, Emission-Computed, Single-Photon/methods/statistics & numerical data MH - Vasodilator Agents OTO - NOTNLM OT - Regadenoson OT - coronary artery disease OT - end-stage renal disease (ESRD) OT - myocardial perfusion imaging (MPI) OT - outcome OT - prognosis EDAT- 2015/11/20 06:00 MHDA- 2018/02/17 06:00 CRDT- 2015/11/20 06:00 PHST- 2015/08/29 00:00 [received] PHST- 2015/10/01 00:00 [revised] PHST- 2015/11/20 06:00 [pubmed] PHST- 2018/02/17 06:00 [medline] PHST- 2015/11/20 06:00 [entrez] AID - S1071-3581(23)06415-2 [pii] AID - 10.1007/s12350-015-0303-4 [doi] PST - ppublish SO - J Nucl Cardiol. 2017 Feb;24(1):112-118. doi: 10.1007/s12350-015-0303-4. Epub 2015 Nov 18. PMID- 26547292 OWN - NLM STAT- MEDLINE DCOM- 20160426 LR - 20240522 IS - 1879-1913 (Electronic) IS - 0002-9149 (Print) IS - 0002-9149 (Linking) VI - 117 IP - 1 DP - 2016 Jan 1 TI - Use of Mechanical Circulatory Support in Percutaneous Coronary Intervention in the United States. PG - 10-6 LID - S0002-9149(15)02077-9 [pii] LID - 10.1016/j.amjcard.2015.10.005 [doi] AB - Percutaneous ventricular assist devices (PVADs) and intraaortic balloon pump (IABP) are used to provide mechanical circulatory support (MCS) for high-risk percutaneous coronary intervention (PCI). Contemporary trends in their utilization and impact on in-hospital mortality are not known. Using the National Inpatient Sample (2004 to 2012), we identified 5,031 patients who received a PVAD and 122,333 who received an IABP on the same day as PCI using International Classification of Diseases, Ninth Edition codes. Utilization of MCS increased from 1.3% of all PCIs in 2004 to 3.4% in 2012 (p trend <0.001), with increase in the use of both PVAD (<1/10,000 PCIs [2004 to 2007] to 38/10,000 [2012]) and IABP (132/10,000 PCIs [2004] to 299/10,000[2012] p <0.0001 for both). PVAD recipients were older (69 vs 65 years), more likely to have heart failure (68% vs 41%), chronic kidney disease (27% vs 11%, p <0.001 for all), and be admitted electively (30% vs 11%), but less likely to have acute myocardial infarction (52% vs 90%), cardiogenic shock (23% vs 50%), or need mechanical ventilation (16% vs 29%) compared with IABP recipients. Unadjusted in-hospital mortality was lower in PVAD compared with IABP recipients (12.8% vs 20.9%, p <0.001). However, in propensity-matched analyses (1:2), in-hospital mortality was similar in both groups (odds ratio 0.88, 95% confidence interval 0.70 to 1.09). In conclusion, there has been a marked increase in the utilization of MCS in patients undergoing PCI. Unadjusted mortality using PVADs is lower than IABP but may be due to their selective use in patients at lower risk. Randomized trials are necessary to establish their effectiveness in supporting high-risk PCI. CI - Copyright (c) 2016 Elsevier Inc. All rights reserved. FAU - Khera, Rohan AU - Khera R AD - Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa. Electronic address: rohan-khera@uiowa.edu. FAU - Cram, Peter AU - Cram P AD - Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Division of General Internal Medicine, University Health Network/ Mount Sinai Hospital, Toronto, Ontario, Canada. FAU - Vaughan-Sarrazin, Mary AU - Vaughan-Sarrazin M AD - Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa; Center for Comprehensive Access and Delivery Research and Evaluation, Iowa City Veterans Affairs Medical Center, Iowa City, Iowa; Institute of Clinical and Translational Science, University of Iowa Carver College of Medicine, Iowa City, Iowa. FAU - Horwitz, Phillip A AU - Horwitz PA AD - Division of Cardiovascular Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa. FAU - Girotra, Saket AU - Girotra S AD - Institute of Clinical and Translational Science, University of Iowa Carver College of Medicine, Iowa City, Iowa; Division of Cardiovascular Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa. LA - eng GR - K08 HL122527/HL/NHLBI NIH HHS/United States GR - K24 AR062133/AR/NIAMS NIH HHS/United States GR - K08HL122527/HL/NHLBI NIH HHS/United States PT - Journal Article PT - Multicenter Study PT - Research Support, N.I.H., Extramural DEP - 20151023 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM CIN - Am J Cardiol. 2016 Jun 1;117(11):1859. doi: 10.1016/j.amjcard.2016.02.051. PMID: 27084052 CIN - Am J Cardiol. 2017 Aug 1;120(3):e5. doi: 10.1016/j.amjcard.2016.05.001. PMID: 27269587 MH - Aged MH - Female MH - *Heart-Assist Devices MH - Hospital Mortality/trends MH - Humans MH - *Intra-Aortic Balloon Pumping MH - Intraoperative Period MH - Male MH - Middle Aged MH - Myocardial Infarction/mortality/*surgery MH - *Percutaneous Coronary Intervention MH - Retrospective Studies MH - Risk Factors MH - Shock, Cardiogenic/mortality/*prevention & control MH - Survival Rate/trends MH - Treatment Outcome MH - United States/epidemiology PMC - PMC4690753 MID - NIHMS731196 EDAT- 2015/11/09 06:00 MHDA- 2016/04/27 06:00 PMCR- 2017/01/01 CRDT- 2015/11/09 06:00 PHST- 2015/07/06 00:00 [received] PHST- 2015/10/09 00:00 [revised] PHST- 2015/10/09 00:00 [accepted] PHST- 2015/11/09 06:00 [entrez] PHST- 2015/11/09 06:00 [pubmed] PHST- 2016/04/27 06:00 [medline] PHST- 2017/01/01 00:00 [pmc-release] AID - S0002-9149(15)02077-9 [pii] AID - 10.1016/j.amjcard.2015.10.005 [doi] PST - ppublish SO - Am J Cardiol. 2016 Jan 1;117(1):10-6. doi: 10.1016/j.amjcard.2015.10.005. Epub 2015 Oct 23. PMID- 26542494 OWN - NLM STAT- MEDLINE DCOM- 20160216 LR - 20151106 IS - 1097-6744 (Electronic) IS - 0002-8703 (Linking) VI - 170 IP - 5 DP - 2015 Nov TI - Percutaneous left ventricular assist device for high-risk percutaneous coronary interventions: Real-world versus clinical trial experience. PG - 872-9 LID - S0002-8703(15)00525-6 [pii] LID - 10.1016/j.ahj.2015.08.009 [doi] AB - BACKGROUND: High-risk percutaneous coronary intervention (PCI) supported by percutaneous left ventricular assist devices offers a treatment option for patients with severe symptoms, complex and extensive coronary artery disease, and multiple comorbidities. The extrapolation from clinical trial to real-world practice has inherent uncertainties. We compared the characteristics, procedures, and outcomes of high-risk PCI supported by a microaxial pump (Impella 2.5) in a multicenter registry versus the randomized PROTECT II trial (NCT00562016). METHODS: The USpella registry is an observational multicenter voluntary registry of Impella technology. A total of 637 patients treated between June 2007 and September 2013 were included. Of them, 339 patients would have met enrollment criteria for the PROTECT II trial. These were compared with 216 patients treated in the Impella arm of PROTECT II. RESULTS: Compared to the clinical trial, registry patients were older (70 +/- 11.5 vs 67.5 +/- 11.0 years); more likely to have chronic kidney disease (30% vs 22.7%), prior myocardial infarction (69.3% vs 56.5%), or prior bypass surgery (39.4% vs. 30.2%); and had similar prevalence of diabetes, peripheral vascular disease, and prior stroke. Registry patients had more extensive coronary artery disease (2.2 vs 1.8 diseased vessels) and had a similar Society of Thoracic Surgeons predicted risk of mortality. At hospital discharge, registry patients experienced a similar reduction in New York Heart Association class III to IV symptoms compared to trial patients. Registry patients had a trend toward lower in-hospital mortality (2.7% vs 4.6, P = .27). CONCLUSIONS: USpella provides a real-world and contemporary estimation of the type of procedures and outcomes of high-risk patients undergoing PCI supported by Impella 2.5. Despite the higher risk of registry patients, clinical outcomes appeared to be favorable and consistent compared with the randomized trial. CI - Copyright (c) 2015 Elsevier Inc. All rights reserved. FAU - Cohen, Mauricio G AU - Cohen MG AD - University of Miami Hospital, Miami, FL. Electronic address: mgcohen@med.miami.edu. FAU - Matthews, Ray AU - Matthews R AD - Keck School of Medicine, University of Southern California, Los Angeles, CA. FAU - Maini, Brij AU - Maini B AD - Pinnacle Health System, Harrisburg, PA. FAU - Dixon, Simon AU - Dixon S AD - William Beaumont University Hospital, Royal Oak, MI. FAU - Vetrovec, George AU - Vetrovec G AD - Pauley Heart Center, Virginia Commonwealth University, Richmond, VA. FAU - Wohns, David AU - Wohns D AD - Spectrum Health, Grand Rapids, MI. FAU - Palacios, Igor AU - Palacios I AD - Massachusetts General Hospital, Boston, MA. FAU - Popma, Jeffrey AU - Popma J AD - Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. FAU - Ohman, E Magnus AU - Ohman EM AD - Duke Clinical Research Institute, Durham, NC. FAU - Schreiber, Theodore AU - Schreiber T AD - Harper University Hospital, Detroit, MI. FAU - O'Neill, William W AU - O'Neill WW AD - Henry Ford Hospital, Detroit, MI. LA - eng SI - ClinicalTrials.gov/NCT00562016 PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20150815 PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 SB - IM MH - Aged MH - Coronary Angiography MH - Coronary Artery Disease/diagnosis/physiopathology/*therapy MH - Female MH - *Heart-Assist Devices MH - Humans MH - Male MH - Percutaneous Coronary Intervention/*methods MH - Prospective Studies MH - *Registries MH - Stroke Volume MH - Treatment Outcome MH - Ventricular Function, Left EDAT- 2015/11/07 06:00 MHDA- 2016/02/18 06:00 CRDT- 2015/11/07 06:00 PHST- 2015/05/31 00:00 [received] PHST- 2015/08/08 00:00 [accepted] PHST- 2015/11/07 06:00 [entrez] PHST- 2015/11/07 06:00 [pubmed] PHST- 2016/02/18 06:00 [medline] AID - S0002-8703(15)00525-6 [pii] AID - 10.1016/j.ahj.2015.08.009 [doi] PST - ppublish SO - Am Heart J. 2015 Nov;170(5):872-9. doi: 10.1016/j.ahj.2015.08.009. Epub 2015 Aug 15. PMID- 26537755 OWN - NLM STAT- MEDLINE DCOM- 20170314 LR - 20250703 IS - 1873-734X (Electronic) IS - 1010-7940 (Linking) VI - 49 IP - 5 DP - 2016 May TI - Safety and efficacy of miniaturized extracorporeal circulation when compared with off-pump and conventional coronary artery bypass grafting: evidence synthesis from a comprehensive Bayesian-framework network meta-analysis of 134 randomized controlled trials involving 22 778 patients. PG - 1428-40 LID - 10.1093/ejcts/ezv387 [doi] AB - OBJECTIVES: Coronary artery bypass grafting (CABG) remains the standard of care in patients with extensive coronary artery disease. Yet the use of cardiopulmonary bypass (CPB) is believed to be a major determinant of perioperative morbidity. Novel techniques are sought to tackle the shortcomings of CPB, among them off-pump coronary artery bypass (OPCAB) and miniaturized extracorporeal circulation (MECC) systems have been extensively tested in randomized controlled trials (RCTs). To assess perioperative safety and efficacy of MECC and OPCAB when compared with conventional extracorporeal circulation (CECC). METHODS: Published literature and major congress proceedings were screened for RCTs evaluating the safety and efficacy of MECC, OPCAB and CECC. Selected end-points such as 30-day all-cause mortality, myocardial infarction (MI), cerebral stroke, postoperative atrial fibrillation (POAF) and renal dysfunction were assessed in a Bayesian-framework network meta-analysis. RESULTS: A total of 134 studies with 22 778 patients were included. When compared with CECC, both OPCAB and MECC significantly reduced 30-day all-cause mortality [odds ratios (95% credible intervals): 0.75 (0.51-0.99) and 0.46 (0.22-0.91)], respectively. No differences in respect to MI were demonstrated with either strategy. OPCAB, when compared with CECC, reduced the odds of cerebral stroke [0.57 (0.34-0.80)]; 60% reduction was observed with MECC when compared with CECC [0.40 (0.19-0.78)]. Both OPCAB and MECC reduced the odds of POAF [0.66 (0.48-0.90) and 0.62 (0.35-0.98), respectively] when compared with CECC. OPCAB conferred over 30% reduction of renal dysfunction when compared with CECC [0.69 (0.46-0.92)]. MECC reduced these odds by more than 50% [0.47 (0.24-0.89)]. Ranking of treatments emerging from the probability analysis (highest to lowest SUCRA values) was MECC followed by OPCAB and CECC. CONCLUSIONS: MECC and OPCAB both improve perioperative outcomes following coronary bypass surgery when compared with conventional CABG performed with extracorporeal circulation. MECC may represent an attractive compromise between OPCAB and CECC. CI - (c) The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. FAU - Kowalewski, Mariusz AU - Kowalewski M AD - Department of Cardiac Surgery, Dr Antoni Jurasz Memorial University Hospital in Bydgoszcz, Bydgoszcz, Poland Faculty of Health Sciences, Collegium Medicum, Nicolaus Copernicus Univeristy in Torun, Torun, Poland kowalewskimariusz@gazeta.pl. FAU - Pawliszak, Wojciech AU - Pawliszak W AD - Department of Cardiac Surgery, Dr Antoni Jurasz Memorial University Hospital in Bydgoszcz, Bydgoszcz, Poland. FAU - Raffa, Giuseppe Maria AU - Raffa GM AD - Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy. FAU - Malvindi, Pietro Giorgio AU - Malvindi PG AD - University Hospital Southampton NHS Foundation Trust, Wessex Cardiothoracic Centre, Southampton, UK. FAU - Kowalkowska, Magdalena Ewa AU - Kowalkowska ME AD - Department and Clinic of Obstetrics, Gynecology, and Oncological Gynecology, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland. FAU - Zaborowska, Katarzyna AU - Zaborowska K AD - Department of Cardiac Surgery, Dr Antoni Jurasz Memorial University Hospital in Bydgoszcz, Bydgoszcz, Poland. FAU - Kowalewski, Janusz AU - Kowalewski J AD - Department of Lung Cancer and Thoracic Surgery, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Torun, Poland. FAU - Tarelli, Giuseppe AU - Tarelli G AD - Department of Cardiac Surgery, Humanitas Clinical and Research Center, Rozzano, Milan, Italy. FAU - Taggart, David Paul AU - Taggart DP AD - Department of Cardiac Surgery, John Radcliffe Hospital, Oxford, UK. FAU - Anisimowicz, Lech AU - Anisimowicz L AD - Department of Cardiac Surgery, Dr Antoni Jurasz Memorial University Hospital in Bydgoszcz, Bydgoszcz, Poland. LA - eng PT - Journal Article PT - Network Meta-Analysis DEP - 20151103 PL - Germany TA - Eur J Cardiothorac Surg JT - European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery JID - 8804069 SB - IM CIN - Eur J Cardiothorac Surg. 2016 Jul;50(1):189. doi: 10.1093/ejcts/ezw004. PMID: 26834234 MH - Bayes Theorem MH - *Coronary Artery Bypass/adverse effects/methods/statistics & numerical data MH - *Extracorporeal Circulation/adverse effects/methods/statistics & numerical data MH - Humans MH - Postoperative Complications MH - Randomized Controlled Trials as Topic MH - Treatment Outcome OTO - NOTNLM OT - Artery bypass OT - Coronary artery bypass grafting OT - Coronary artery disease OT - Extracorporeal circulation OT - Network meta-analysis OT - Off-pump coronary EDAT- 2015/11/06 06:00 MHDA- 2017/03/16 06:00 CRDT- 2015/11/06 06:00 PHST- 2015/08/07 00:00 [received] PHST- 2015/09/30 00:00 [accepted] PHST- 2015/11/06 06:00 [entrez] PHST- 2015/11/06 06:00 [pubmed] PHST- 2017/03/16 06:00 [medline] AID - ezv387 [pii] AID - 10.1093/ejcts/ezv387 [doi] PST - ppublish SO - Eur J Cardiothorac Surg. 2016 May;49(5):1428-40. doi: 10.1093/ejcts/ezv387. Epub 2015 Nov 3. PMID- 26488749 OWN - NLM STAT- MEDLINE DCOM- 20160630 LR - 20220317 IS - 1932-6203 (Electronic) IS - 1932-6203 (Linking) VI - 10 IP - 10 DP - 2015 TI - Angiotensin Receptor Blockers Decrease the Risk of Major Adverse Cardiovascular Events in Patients with End-Stage Renal Disease on Maintenance Dialysis: A Nationwide Matched-Cohort Study. PG - e0140633 LID - 10.1371/journal.pone.0140633 [doi] LID - e0140633 AB - BACKGROUND: Major adverse cardiovascular events (MACE) cause the leading cause of morbidity and mortality in patients with end-stage renal disease (ESRD) on maintenance Hemodialysis (HD) or peritoneal dialysis (PD). Many randomized-controlled trials (RCTs) have proved that angiotensin receptor blockers (ARBs) can reduce the risk of MACE in the people with normal or impaired kidney function without dialysis. This study seeks to clarify whether ARBs therapy could also attenuate this risk in patients with ESRD on maintenance dialysis. MATERIALS AND METHODS: The National Health Research Institute provided a database of one million random subjects for the study. A random sample was taken of 1800 patients >/=18 years y/o with ESRD on dialysis without a history of MACE and use of ARBs within 6-months prior to enrollment. Cox proportional hazard regression analysis was used to identify the risk factors and compute the hazard ratios accompanying 95% confidence intervals. RESULTS: In these 1800 patients, 1061 had never used ARBs, while 224 had used them for 1-90 days, and 515 had used them for more than 90 days. We found that ARBs significantly decrease the incidences of acute myocardial infarctions (AMI), coronary artery diseases (CAD) requiring coronary stent or percutaneous transluminal coronary angioplasty (PTCA), peripheral artery disease (PAD) requiring percutaneous transluminal angioplasty (PTA), and acute stroke. Cumulative prescription days of ARBs beyond 365-760 days or more were found to be negatively correlated with incidence of MACEs. For patients with dual comorbidity (i.e., mellitus and hyperlipidemia), 91-365 cumulative prescription days might also attenuate the risk. CONCLUSIONS: For patients on maintenance dialysis, the use of ARBs could significantly attenuate the risk of major cardiovascular events: AMI, acute stroke, and PAD requiring PTA. FAU - Yang, Chung-Wei AU - Yang CW AD - Division of Nephrology, Department of Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-chu, Taiwan; Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan. FAU - Tzeng, Nian-Sheng AU - Tzeng NS AD - Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan; Student Counseling Center, National Defense Medical Center, Taipei, Taiwan. FAU - Yin, Yun-Ju AU - Yin YJ AD - Institute of Bioinformatics and Systems Biology, National Chiao Tung University, Hsinchu, Taiwan. FAU - Li, Chien-Hsun AU - Li CH AD - Institute of Bioinformatics and Systems Biology, National Chiao Tung University, Hsinchu, Taiwan; Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan. FAU - Chen, Hung-An AU - Chen HA AD - Institute of Bioinformatics and Systems Biology, National Chiao Tung University, Hsinchu, Taiwan. FAU - Chiu, Shih-Hsiang AU - Chiu SH AD - Institute of Bioinformatics and Systems Biology, National Chiao Tung University, Hsinchu, Taiwan. FAU - Ho, Shinn-Ying AU - Ho SY AD - Institute of Bioinformatics and Systems Biology, National Chiao Tung University, Hsinchu, Taiwan; Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan. FAU - Huang, Hui-Ling AU - Huang HL AD - Institute of Bioinformatics and Systems Biology, National Chiao Tung University, Hsinchu, Taiwan; Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20151021 PL - United States TA - PLoS One JT - PloS one JID - 101285081 RN - 0 (Angiotensin Receptor Antagonists) RN - 0 (Antihypertensive Agents) SB - IM MH - Adolescent MH - Adult MH - Aged MH - Angiotensin Receptor Antagonists/*therapeutic use MH - Antihypertensive Agents/*therapeutic use MH - Cardiovascular Diseases/drug therapy/*prevention & control MH - Cohort Studies MH - Female MH - Humans MH - Hypertension/*drug therapy MH - Kidney Failure, Chronic/*complications MH - Male MH - Middle Aged MH - Peritoneal Dialysis MH - Taiwan MH - Young Adult PMC - PMC4619342 COIS- Competing Interests: The authors have declared that no competing interests exist. EDAT- 2015/10/22 06:00 MHDA- 2016/07/01 06:00 PMCR- 2015/10/21 CRDT- 2015/10/22 06:00 PHST- 2015/04/17 00:00 [received] PHST- 2015/08/18 00:00 [accepted] PHST- 2015/10/22 06:00 [entrez] PHST- 2015/10/22 06:00 [pubmed] PHST- 2016/07/01 06:00 [medline] PHST- 2015/10/21 00:00 [pmc-release] AID - PONE-D-15-16826 [pii] AID - 10.1371/journal.pone.0140633 [doi] PST - epublish SO - PLoS One. 2015 Oct 21;10(10):e0140633. doi: 10.1371/journal.pone.0140633. eCollection 2015. PMID- 26481591 OWN - NLM STAT- MEDLINE DCOM- 20161227 LR - 20161230 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 87 IP - 4 DP - 2016 Mar TI - One-year results of the ICON (Ionic versus non-ionic Contrast to Obviate worsening Nephropathy after angioplasty in chronic renal failure patients) Study. PG - 703-9 LID - 10.1002/ccd.26106 [doi] AB - BACKGROUND: Long-term clinical outcomes after exposure to non-ionic iso-osmolar contrast medium (IOCM) or ionic low-osmolar CM (LOCM) in patients with chronic kidney disease (CKD) undergoing coronary angiography are unclear. METHODS: The ICON trial was a prospective, double-blinded, multicentre study that randomly assigned 146 patients with CKD undergoing coronary angiography with or without percutaneous coronary intervention to the non-ionic IOCM Iodixanol or the ionic LOCM Ioxaglate. We report the 1-year clinical outcomes. RESULTS: After randomization, baseline and procedural characteristics were well-matched between the two groups. At 1 year, three deaths (4.1%) occurred in the ioxaglate and nine deaths in the iodixanol group (13.6%, P = 0.07). The cardiac death rate at 1 year was 2.7% in the ioxaglate group and 9.1% in the iodixanol group (P = 0.07). There were no significant differences in the rates of myocardial infarction (1.4% vs. 1.5%; P = 1.00) and repeated revascularization (6.8% vs. 9.1%; P = 0.75). CONCLUSIONS: The use of ionic LOCM ioxaglate was associated with a numerically lower mortality at 1 year as compared to iodixanol in patients who underwent cardiac catheterization. Future studies evaluating long-term safety following exposure to different types of CM are warranted. CI - (c) 2015 Wiley Periodicals, Inc. FAU - Giustino, Gennaro AU - Giustino G AD - Mount Sinai Medical Center, New York, New York. FAU - Baber, Usman AU - Baber U AD - Mount Sinai Medical Center, New York, New York. FAU - Mastoris, Ioannis AU - Mastoris I AD - Mount Sinai Medical Center, New York, New York. FAU - Vlachojannis, Georgios J AU - Vlachojannis GJ AD - Mount Sinai Medical Center, New York, New York. FAU - Yu, Jennifer AU - Yu J AD - Mount Sinai Medical Center, New York, New York. FAU - Teirstein, Paul S AU - Teirstein PS AD - Scripps Clinic, San Diego, California. FAU - Downey, William E AU - Downey WE AD - Moses Cone Heart and Vascular Center, Greensboro, North Carolina. FAU - Batchelor, Wayne B AU - Batchelor WB AD - St. Michaels Hospital, Toronto, Ontario, Canada. FAU - Casterella, Peter J AU - Casterella PJ AD - Swedish Heart and Vascular Institute, Seattle, Washington. FAU - Nikolsky, Eugenia AU - Nikolsky E AD - Cardiovascular Research Foundation, New York, New York. FAU - Wong, S Chiu AU - Wong SC AD - Department of Medicine, Weill-Cornell Medical College, New York, New York. FAU - Theodoropoulos, Kleanthis N AU - Theodoropoulos KN AD - Mount Sinai Medical Center, New York, New York. FAU - Dangas, George D AU - Dangas GD AD - Mount Sinai Medical Center, New York, New York. FAU - Mehran, Roxana AU - Mehran R AD - Mount Sinai Medical Center, New York, New York. LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20151020 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 RN - 0 (Contrast Media) RN - 0 (Triiodobenzoic Acids) RN - HW8W27HTXX (iodixanol) RN - Z40X7EI2AF (Ioxaglic Acid) SB - IM CIN - Catheter Cardiovasc Interv. 2016 Mar;87(4):710-1. doi: 10.1002/ccd.26483. PMID: 26994980 MH - Acute Kidney Injury/*chemically induced/diagnosis/mortality MH - Aged MH - Aged, 80 and over MH - Angioplasty, Balloon, Coronary/*adverse effects/mortality MH - Contrast Media/*adverse effects MH - Coronary Angiography/*adverse effects/mortality MH - Coronary Artery Disease/*diagnostic imaging/mortality/*therapy MH - Disease Progression MH - Double-Blind Method MH - Female MH - Humans MH - Ioxaglic Acid/*adverse effects/analogs & derivatives MH - Kidney Failure, Chronic/*complications/diagnosis/mortality MH - Male MH - Middle Aged MH - Myocardial Infarction/etiology/mortality MH - Predictive Value of Tests MH - Prospective Studies MH - Risk Factors MH - Time Factors MH - Treatment Outcome MH - Triiodobenzoic Acids/*adverse effects OTO - NOTNLM OT - contrast media OT - contrast-induced nephropathy OT - iodixanol OT - ioxaglate OT - iso-osmolar OT - low-osmolar EDAT- 2015/10/21 06:00 MHDA- 2016/12/28 06:00 CRDT- 2015/10/21 06:00 PHST- 2014/12/16 00:00 [received] PHST- 2015/06/21 00:00 [accepted] PHST- 2015/10/21 06:00 [entrez] PHST- 2015/10/21 06:00 [pubmed] PHST- 2016/12/28 06:00 [medline] AID - 10.1002/ccd.26106 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2016 Mar;87(4):703-9. doi: 10.1002/ccd.26106. Epub 2015 Oct 20. PMID- 26459932 OWN - NLM STAT- MEDLINE DCOM- 20160707 LR - 20210109 IS - 2047-9980 (Electronic) IS - 2047-9980 (Linking) VI - 4 IP - 10 DP - 2015 Oct 12 TI - Atherosclerotic Renal Artery Stenosis Prevalence and Correlations in Acute Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Interventions: Data From Nonrandomized Single-Center Study (REN-ACS)-A Single Center, Prospective, Observational Study. PG - e002379 LID - 10.1161/JAHA.115.002379 [doi] LID - e002379 AB - BACKGROUND: We are the first to evaluate the prevalence of renal artery stenosis (RAS) in consecutive patients with acute myocardial infarction (AMI) referred for primary percutaneous coronary intervention from a single tertiary center. As a novelty, we assessed hydration and metabolic status and measured arterial stiffness. We elaborated a predicting model for RAS in AMI. METHODS AND RESULTS: One hundred and eighty-one patients with AMI underwent concomitantly primary percutaneous coronary intervention and renal angiography. We obtained data on demographics, medical history, cardiovascular risk factors, echocardiography, Killip class, and blood tests. In the first 24 hours post-primary percutaneous coronary intervention, we assessed bioimpedance through Body Composition Monitoring((R)) and arterial stiffness through pulsed-wave velocity, SphygmoCor((R)). Significant RAS (>50% lumen narrowing, RAS+) was present in 16.6% patients. In the RAS+ group we recorded significantly higher stiffness, CRUSADE score and dehydration, and more women with higher prevalence of multivascular coronary artery disease and heart failure. In our multivariate models, variables independently associated with RAS+ were previous percutaneous coronary intervention, low estimated glomerular filtration rate, multivascular coronary artery disease, and total/extracellular body water. These models had good specificity and low sensitivity. CONCLUSIONS: We observed that RAS+ AMI patients have a particular hydration, metabolic, and endothelial profile that could generate more future major adverse cardiac events. Hence, renal angiography in AMI should be considered in specific subsets of patients. CLINICAL TRIAL REGISTRATION: URL: https://www.clinicaltrials.gov/. Unique identifier: NCT02388139. CI - (c) 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell. FAU - Burlacu, Alexandru AU - Burlacu A AD - Department of Interventional Cardiology, Cardiovascular Diseases Institute, Iasi, Romania (A.B., I.N.). FAU - Siriopol, Dimitrie AU - Siriopol D AD - Department of Nephrology, University of Medicine "Gr. T. Popa", Iasi, Romania (D.S., L.V., I.N., S.H., A.C.). FAU - Voroneanu, Luminita AU - Voroneanu L AD - Department of Nephrology, University of Medicine "Gr. T. Popa", Iasi, Romania (D.S., L.V., I.N., S.H., A.C.). FAU - Nistor, Ionut AU - Nistor I AD - Department of Nephrology, University of Medicine "Gr. T. Popa", Iasi, Romania (D.S., L.V., I.N., S.H., A.C.). FAU - Hogas, Simona AU - Hogas S AD - Department of Nephrology, University of Medicine "Gr. T. Popa", Iasi, Romania (D.S., L.V., I.N., S.H., A.C.). FAU - Nicolae, Ana AU - Nicolae A AD - Department of Cardiology, Cardiovascular Diseases Institute, Iasi, Romania (A.N.). FAU - Nedelciuc, Igor AU - Nedelciuc I AD - Department of Interventional Cardiology, Cardiovascular Diseases Institute, Iasi, Romania (A.B., I.N.). FAU - Tinica, Grigore AU - Tinica G AD - Department of Cardiovascular Surgery, Cardiovascular Diseases Institute, Iasi, Romania (G.T.). FAU - Covic, Adrian AU - Covic A AD - Department of Nephrology, University of Medicine "Gr. T. Popa", Iasi, Romania (D.S., L.V., I.N., S.H., A.C.). LA - eng SI - ClinicalTrials.gov/NCT02388139 PT - Journal Article PT - Observational Study DEP - 20151012 PL - England TA - J Am Heart Assoc JT - Journal of the American Heart Association JID - 101580524 RN - 0 (Biomarkers) SB - IM MH - Aged MH - Atherosclerosis/blood/diagnosis/*epidemiology/physiopathology MH - Biomarkers/blood MH - Body Composition MH - Chi-Square Distribution MH - Coronary Angiography MH - Cross-Sectional Studies MH - Electric Impedance MH - Female MH - Humans MH - Logistic Models MH - Male MH - Middle Aged MH - Multivariate Analysis MH - Myocardial Infarction/blood/diagnosis/epidemiology/physiopathology/*therapy MH - *Percutaneous Coronary Intervention/adverse effects MH - Prevalence MH - Prospective Studies MH - Pulse Wave Analysis MH - Renal Artery Obstruction/blood/diagnosis/*epidemiology/physiopathology MH - Risk Factors MH - Romania/epidemiology MH - Tertiary Care Centers MH - Treatment Outcome MH - Vascular Stiffness MH - Water-Electrolyte Balance PMC - PMC4845148 OTO - NOTNLM OT - angiography OT - arteries OT - hypertension OT - myocardial infarction OT - renal EDAT- 2015/10/16 06:00 MHDA- 2016/07/09 06:00 PMCR- 2015/10/01 CRDT- 2015/10/14 06:00 PHST- 2015/10/14 06:00 [entrez] PHST- 2015/10/16 06:00 [pubmed] PHST- 2016/07/09 06:00 [medline] PHST- 2015/10/01 00:00 [pmc-release] AID - JAHA.115.002379 [pii] AID - JAH31118 [pii] AID - 10.1161/JAHA.115.002379 [doi] PST - epublish SO - J Am Heart Assoc. 2015 Oct 12;4(10):e002379. doi: 10.1161/JAHA.115.002379. PMID- 26430428 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20151002 LR - 20220409 IS - 1682-024X (Print) IS - 1681-715X (Electronic) IS - 1681-715X (Linking) VI - 31 IP - 4 DP - 2015 Jul-Aug TI - Early outcome of Coronary Artery Bypass Graft Surgery in patients with significant Left Main Stem stenosis at a tertiary cardiac care center. PG - 909-14 LID - 10.12669/pjms.314.7597 [doi] AB - OBJECTIVE: Primary objective of this study was to evaluate the impact of significant left main stem (LMS) stenosis on the early outcome of coronary artery bypass graft (CABG) surgery. METHODS: A Retrospective non-randomized analytical study was conducted in Cardiac surgery department, Chaudhary Pervaiz Elahi Institute of Cardiology (CPEIC) Multan, Pakistan. The data of patients who underwent isolated CABG at our institution from February 2008 to March 2014 were analyzed. Two thousand six hundred two (2602) patients of isolated CABG were divided into 2 groups according to the LMS disease. Group I (n=2088): without significant LMS disease and Group II (n=514): with LMS disease. Data was analyzed using SPSS V16. The groups were compared using Student's t-test for numeric variables. Chi-square test and Fishers Exact test were used for categorical variables. P-value /=75 years and/or <60 kg) versus clopidogrel 75 mg/d. Sex-specific differences in 30-day platelet reactivity were analyzed in 2,564 (27%) patients participating in a platelet function substudy. RESULTS: Compared with men, women were older, weighed less, were less likely to have prior myocardial infarction or revascularization, and had lower baseline creatinine clearance and hemoglobin level values. Rates of the composite of cardiovascular death/myocardial infarction/stroke (20.2% vs 19.1%; P = .56), all-cause mortality (12.2% vs 11.7%; P = .88), and Global Use of Strategies to Open Occluded Arteries severe/life-threatening/moderate bleeding (3.8% vs 2.8%; P = .74) through 30 months were similar in women versus men. After adjustment, women had significantly lower risk for ischemic outcomes and all-cause mortality. There were no sex-specific, treatment-related differences in 30-day platelet reactivity. CONCLUSIONS: Long-term ischemic and bleeding outcomes in medically managed ACS patients were similar for women versus men, as was treatment-related platelet reactivity. Women had a higher baseline risk profile and, after adjustment, significantly lower risk of the primary composite end point and all-cause death through 30 months. CI - Copyright (c) 2015 Elsevier Inc. All rights reserved. FAU - Clemmensen, Peter AU - Clemmensen P AD - Department of Medicine, Division of Cardiology, Nykoebing F Hospital and Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark. FAU - Roe, Matthew T AU - Roe MT AD - Division of Cardiology, Department of Medicine, Duke University School of Medicine, Durham, NC; Duke Clinical Research Institute, Durham, NC. Electronic address: matthew.roe@dm.duke.edu. FAU - Hochman, Judith S AU - Hochman JS AD - New York University Langone Medical Center, New York, NY. FAU - Cyr, Derek D AU - Cyr DD AD - Duke Clinical Research Institute, Durham, NC. FAU - Neely, Megan L AU - Neely ML AD - Duke Clinical Research Institute, Durham, NC. FAU - McGuire, Darren K AU - McGuire DK AD - University of Texas-Southwestern Medical Center, Dallas, TX. FAU - Cornel, Jan H AU - Cornel JH AD - Medisch Centrum Alkmaar, Alkmaar, the Netherlands. FAU - Huber, Kurt AU - Huber K AD - Department of Cardiology and Intensive Care Medicine, Wilhelminen Hospital, Vienna, Austria. FAU - Zamoryakhin, Dmitry AU - Zamoryakhin D AD - Daiichi Sankyo Development Ltd, London, United Kingdom. FAU - White, Harvey D AU - White HD AD - Green Lane Cardiovascular Service, Auckland City Hospital, Auckland, New Zealand. FAU - Armstrong, Paul W AU - Armstrong PW AD - Canadian VIGOUR Centre, University of Alberta, Edmonton, Alberta, Canada. FAU - Fox, Keith A A AU - Fox KA AD - Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, Scotland, United Kingdom. FAU - Prabhakaran, Dorairaj AU - Prabhakaran D AD - Centre for Chronic Disease Control and Public Health Foundation of India, New Delhi, India. FAU - Ohman, Erik Magnus AU - Ohman EM AD - Division of Cardiology, Department of Medicine, Duke University School of Medicine, Durham, NC; Duke Clinical Research Institute, Durham, NC. CN - TRILOGY ACS Investigators LA - eng SI - ClinicalTrials.gov/NCT00699998 PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20150620 PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 RN - 0 (Platelet Aggregation Inhibitors) RN - 0 (Purinergic P2Y Receptor Antagonists) RN - A74586SNO7 (Clopidogrel) RN - G89JQ59I13 (Prasugrel Hydrochloride) RN - OM90ZUW7M1 (Ticlopidine) SB - IM MH - Acute Coronary Syndrome/complications/*drug therapy MH - Aged MH - Angina, Unstable/complications/*drug therapy MH - Clopidogrel MH - Coronary Angiography MH - Double-Blind Method MH - *Electrocardiography MH - Female MH - Follow-Up Studies MH - Humans MH - Male MH - Myocardial Infarction/diagnosis/*drug therapy/etiology MH - Myocardial Revascularization MH - Platelet Aggregation Inhibitors/therapeutic use MH - Prasugrel Hydrochloride/*therapeutic use MH - Purinergic P2Y Receptor Antagonists/therapeutic use MH - Retrospective Studies MH - Ticlopidine/*analogs & derivatives/therapeutic use MH - Time Factors MH - Treatment Outcome EDAT- 2015/09/21 06:00 MHDA- 2015/12/17 06:00 CRDT- 2015/09/21 06:00 PHST- 2015/03/05 00:00 [received] PHST- 2015/06/16 00:00 [accepted] PHST- 2015/09/21 06:00 [entrez] PHST- 2015/09/21 06:00 [pubmed] PHST- 2015/12/17 06:00 [medline] AID - S0002-8703(15)00385-3 [pii] AID - 10.1016/j.ahj.2015.06.011 [doi] PST - ppublish SO - Am Heart J. 2015 Oct;170(4):695-705.e5. doi: 10.1016/j.ahj.2015.06.011. Epub 2015 Jun 20. PMID- 26385817 OWN - NLM STAT- MEDLINE DCOM- 20160502 LR - 20250529 IS - 1523-6838 (Electronic) IS - 0272-6386 (Print) IS - 0272-6386 (Linking) VI - 67 IP - 1 DP - 2016 Jan TI - Impact of Educational Attainment on Health Outcomes in Moderate to Severe CKD. PG - 31-9 LID - S0272-6386(15)01044-6 [pii] LID - 10.1053/j.ajkd.2015.07.021 [doi] AB - BACKGROUND: The inverse association between educational attainment and mortality is well established, but its relevance to vascular events and renal progression in a population with chronic kidney disease (CKD) is less clear. This study aims to determine the association between highest educational attainment and risk of vascular events, cause-specific mortality, and CKD progression. STUDY DESIGN: Prospective epidemiologic analysis among participants in the Study of Heart and Renal Protection (SHARP), a randomized controlled trial. SETTING & PARTICIPANTS: 9,270 adults with moderate to severe CKD (6,245 not receiving dialysis at baseline) and no history of myocardial infarction or coronary revascularization recruited in Europe, North America, Asia, Australia, and New Zealand. PREDICTOR: Highest educational attainment measured at study entry using 6 levels that ranged from "no formal education" to "tertiary education." OUTCOMES: Any vascular event (any fatal or nonfatal cardiac, cerebrovascular, or peripheral vascular event), cause-specific mortality, and CKD progression during 4.9 years' median follow-up. RESULTS: There was a significant trend (P<0.001) toward increased vascular risk with decreasing levels of education. Participants with no formal education were at a 46% higher risk of vascular events (relative risk [RR], 1.46; 95% CI, 1.14-1.86) compared with participants with tertiary education. The trend for mortality across education levels was also significant (P<0.001): all-cause mortality was twice as high among those with no formal education compared with tertiary-educated individuals (RR, 2.05; 95% CI, 1.62-2.58), and significant increases were seen for both vascular (RR, 1.84; 95% CI, 1.21-2.81) and nonvascular (RR, 2.15; 95% CI, 1.60-2.89) deaths. Lifestyle factors and prior disease explain most of the excess mortality risk. Among 6,245 participants not receiving dialysis at baseline, education level was not significantly associated with progression to end-stage renal disease or doubling of creatinine level (P for trend = 0.4). LIMITATIONS: No data for employment or health insurance coverage. CONCLUSIONS: Lower educational attainment is associated with increased risk of adverse health outcomes in individuals with CKD. CI - Copyright (c) 2016 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Morton, Rachael L AU - Morton RL AD - NHMRC Clinical Trials Centre, The University of Sydney, Sydney, Australia; Health Economics Research Centre, University of Oxford, Oxford, United Kingdom. FAU - Schlackow, Iryna AU - Schlackow I AD - Health Economics Research Centre, University of Oxford, Oxford, United Kingdom. FAU - Staplin, Natalie AU - Staplin N AD - Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom. FAU - Gray, Alastair AU - Gray A AD - Health Economics Research Centre, University of Oxford, Oxford, United Kingdom. FAU - Cass, Alan AU - Cass A AD - Menzies School of Health Research, Charles Darwin University, Darwin, Australia. FAU - Haynes, Richard AU - Haynes R AD - Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom. FAU - Emberson, Jonathan AU - Emberson J AD - Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom. FAU - Herrington, William AU - Herrington W AD - Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom. FAU - Landray, Martin J AU - Landray MJ AD - Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom. FAU - Baigent, Colin AU - Baigent C AD - Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom. FAU - Mihaylova, Borislava AU - Mihaylova B AD - Health Economics Research Centre, University of Oxford, Oxford, United Kingdom. Electronic address: boby.mihaylova@dph.ox.ac.uk. CN - SHARP Collaborative Group LA - eng SI - ClinicalTrials.gov/NCT00125593 GR - MC_U137686860/MRC_/Medical Research Council/United Kingdom PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20150916 PL - United States TA - Am J Kidney Dis JT - American journal of kidney diseases : the official journal of the National Kidney Foundation JID - 8110075 RN - 0 (Anticholesteremic Agents) RN - AGG2FN16EV (Simvastatin) RN - EOR26LQQ24 (Ezetimibe) SB - IM CIN - Am J Kidney Dis. 2016 Jan;67(1):1-4. doi: 10.1053/j.ajkd.2015.09.017. PMID: 26708191 MH - Aged MH - Anticholesteremic Agents/*therapeutic use MH - Disease Progression MH - *Educational Status MH - Ezetimibe/*therapeutic use MH - Female MH - Humans MH - Male MH - Middle Aged MH - Prospective Studies MH - Renal Insufficiency, Chronic/complications/mortality/*prevention & control MH - Severity of Illness Index MH - Simvastatin/*therapeutic use MH - Vascular Diseases/etiology PMC - PMC4685934 OTO - NOTNLM OT - Chronic kidney failure OT - Study of Heart and Renal Protection (SHARP) OT - chronic kidney disease (CKD) OT - disease progression OT - education OT - educational attainment OT - end-stage renal disease (ESRD) OT - health behavior OT - inequalities OT - mortality OT - renal dialysis OT - risk factor OT - socioeconomic factors OT - vascular event EDAT- 2015/09/20 06:00 MHDA- 2016/05/03 06:00 PMCR- 2016/01/01 CRDT- 2015/09/20 06:00 PHST- 2015/03/26 00:00 [received] PHST- 2015/07/06 00:00 [accepted] PHST- 2015/09/20 06:00 [entrez] PHST- 2015/09/20 06:00 [pubmed] PHST- 2016/05/03 06:00 [medline] PHST- 2016/01/01 00:00 [pmc-release] AID - S0272-6386(15)01044-6 [pii] AID - 10.1053/j.ajkd.2015.07.021 [doi] PST - ppublish SO - Am J Kidney Dis. 2016 Jan;67(1):31-9. doi: 10.1053/j.ajkd.2015.07.021. Epub 2015 Sep 16. PMID- 26361150 OWN - NLM STAT- MEDLINE DCOM- 20151204 LR - 20220316 IS - 1558-3597 (Electronic) IS - 0735-1097 (Print) IS - 0735-1097 (Linking) VI - 66 IP - 11 DP - 2015 Sep 15 TI - Revascularization in Patients With Multivessel Coronary Artery Disease and Chronic Kidney Disease: Everolimus-Eluting Stents Versus Coronary Artery Bypass Graft Surgery. PG - 1209-1220 LID - S0735-1097(15)04429-0 [pii] LID - 10.1016/j.jacc.2015.06.1334 [doi] AB - BACKGROUND: Randomized trials of percutaneous coronary intervention (PCI) versus coronary artery bypass graft (CABG) routinely exclude patients with chronic kidney disease (CKD). OBJECTIVES: This study evaluated outcomes of PCI versus CABG in patients with CKD. METHODS: Patients with CKD who underwent PCI using everolimus-eluting stents were propensity-score matched to patients who underwent isolated CABG for multivessel coronary disease in New York. The primary outcome was all-cause mortality. Secondary outcomes were myocardial infarction (MI), stroke, and repeat revascularization. RESULTS: Of 11,305 patients with CKD, 5,920 patients were propensity-score matched. In the short term, PCI was associated with a lower risk of death (hazard ratio [HR]: 0.55; 95% confidence interval [CI]: 0.35 to 0.87), stroke (HR: 0.22; 95% CI: 0.12 to 0.42), and repeat revascularization (HR: 0.48; 95% CI: 0.23 to 0.98) compared with CABG. In the longer term, PCI was associated with a similar risk of death (HR: 1.07; 95% CI: 0.92 to 1.24), higher risk of MI (HR: 1.76; 95% CI: 1.40 to 2.23), a lower risk of stroke (HR: 0.56; 95% CI: 0.41 to 0.76), and a higher risk of repeat revascularization (HR: 2.42; 95% CI: 2.05 to 2.85). In the subgroup with complete revascularization with PCI, the increased risk of MI was no longer statistically significant (HR: 1.18; 95% CI: 0.67 to 2.09). In the 243 matched pairs of patients with end-stage renal disease on hemodialysis, PCI was associated with significantly higher risk of death (HR: 2.02; 95% CI: 1.40 to 2.93) and repeat revascularization (HR: 2.44; 95% CI: 1.50 to 3.96) compared with CABG. CONCLUSIONS: In patients with CKD, CABG is associated with higher short-term risk of death, stroke, and repeat revascularization, whereas PCI with everolimus-eluting stents is associated with a higher long-term risk of repeat revascularization and perhaps MI, with no long-term mortality difference. In the subgroup on dialysis, the results favored CABG over PCI. CI - Copyright (c) 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Bangalore, Sripal AU - Bangalore S AD - New York University School of Medicine, New York, New York. Electronic address: sripalbangalore@gmail.com. FAU - Guo, Yu AU - Guo Y AD - New York University School of Medicine, New York, New York. FAU - Samadashvili, Zaza AU - Samadashvili Z AD - School of Public Health, State University of New York at Albany, Albany, New York. FAU - Blecker, Saul AU - Blecker S AD - New York University School of Medicine, New York, New York. FAU - Xu, Jinfeng AU - Xu J AD - New York University School of Medicine, New York, New York. FAU - Hannan, Edward L AU - Hannan EL AD - School of Public Health, State University of New York at Albany, Albany, New York. LA - eng GR - K08 HS023683/HS/AHRQ HHS/United States GR - U01 HL117905/HL/NHLBI NIH HHS/United States GR - K08 HS23683/HS/AHRQ HHS/United States PT - Comparative Study PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't PL - United States TA - J Am Coll Cardiol JT - Journal of the American College of Cardiology JID - 8301365 RN - 9HW64Q8G6G (Everolimus) SB - IM CIN - J Am Coll Cardiol. 2015 Sep 15;66(11):1221-1223. doi: 10.1016/j.jacc.2015.07.034. PMID: 26361151 MH - Aged MH - Aged, 80 and over MH - Cohort Studies MH - *Coronary Artery Bypass/adverse effects/mortality MH - Coronary Artery Disease/diagnosis/mortality/*surgery MH - *Drug-Eluting Stents/adverse effects MH - Everolimus/*administration & dosage MH - Female MH - Follow-Up Studies MH - Humans MH - Male MH - Middle Aged MH - Myocardial Revascularization/adverse effects/mortality MH - *Percutaneous Coronary Intervention/adverse effects/mortality MH - Registries MH - Renal Insufficiency, Chronic/diagnosis/mortality/*surgery MH - Risk Factors PMC - PMC4944845 MID - NIHMS732800 OTO - NOTNLM OT - chronic kidney disease OT - multivessel disease OT - percutaneous coronary intervention EDAT- 2015/09/12 06:00 MHDA- 2015/12/15 06:00 PMCR- 2016/07/14 CRDT- 2015/09/12 06:00 PHST- 2015/05/13 00:00 [received] PHST- 2015/06/26 00:00 [revised] PHST- 2015/06/30 00:00 [accepted] PHST- 2015/09/12 06:00 [entrez] PHST- 2015/09/12 06:00 [pubmed] PHST- 2015/12/15 06:00 [medline] PHST- 2016/07/14 00:00 [pmc-release] AID - S0735-1097(15)04429-0 [pii] AID - 10.1016/j.jacc.2015.06.1334 [doi] PST - ppublish SO - J Am Coll Cardiol. 2015 Sep 15;66(11):1209-1220. doi: 10.1016/j.jacc.2015.06.1334. PMID- 26334853 OWN - NLM STAT- MEDLINE DCOM- 20161213 LR - 20181023 IS - 1522-6662 (Electronic) IS - 1098-3511 (Linking) VI - 18 IP - 4 DP - 2015 Aug 30 TI - Comparative effects of hemodilutional anemia and transfusion during cardiopulmonary bypass on acute kidney injury: a prospective randomized study. PG - E154-60 LID - 10.1532/hsf.1387 [doi] AB - AIM: Acute kidney injury after cardiopulmonary bypass has been associated with dilutional anemia during surgery. We aimed both to explore if this relation is modulated by blood transfusion and to understand the postoperative contribution of protein oxidation. METHODS: In this randomized prospective study, after ethics committee approval and informed consent, 30 patients undergoing first-time elective coronary artery bypass grafting (CABG) with hematocrit between 21% and 25% at any time during extracorporeal circulation (ECC) were randomly and equally allocated into two groups. Group I consisted of patients who received red blood cells (RBC) during ECC, while in Group II, patients did not receive any RBCs. Besides routine hemodynamic and biochemical parameters, markers of renal injury such as neutrophil gelatinase-associated lipocalin (NGAL), creatinine clearance, and protein oxidation parameters (advanced oxidative protein products [AOPP], total thiol [T-SH]) were determined in both groups. RESULTS: (1) Both cardiovascular parameters (MAP, HR) and the hospitalization period of the transfused group were not significantly different compared to the non-transfused group (P > .05); (2) While urine NGAL level (P < .05) increased and GFR (P < .01) decreased in the transfused group compared to the preoperative period, there were no significant changes in respective parameters of the non-transfused group compared to preoperative period; (3) AOPP concentrations did not change compared to postoperative periods in both groups (P > .05). However, T-SH concentration showed a transient increased at postoperative hour 6 (P < .001 vs preoperative period) but normalized at postoperative hour 24 (P > .05 versus preoperative period). CONCLUSION: These findings suggest that a hematocrit value over 21% during ECC is safe for renal functions. RBC transfusion just to increase hematocrit may be deleterious. FAU - Ariturk, Cem AU - Ariturk C AD - Department of Cardiovascular Surgery, Acibadem University, School of Medicine, Istanbul, Turkey. FAU - Ozgen, Zehra Serpil AU - Ozgen ZS AD - Department of Anesthesiology and Reanimation, Acibadem University, School of Medicine, Istanbul, Turkey. FAU - Kilercik, Meltem AU - Kilercik M AD - Department of Anesthesiology and Reanimation, Acibadem University, School of Medicine, Istanbul, Turkey. FAU - Ulugol, Halim AU - Ulugol H AD - Department of Anesthesiology and Reanimation, Acibadem University, School of Medicine, Istanbul, Turkey. FAU - Okten, Eyup Murat AU - Okten EM AD - Department of Cardiovascular Surgery, Acibadem University, School of Medicine, Istanbul, Turkey. FAU - Aksu, Ugur AU - Aksu U AD - Istanbul University, School of Biology, Istanbul, Turkey. FAU - Karabulut, Hasan AU - Karabulut H AD - Department of Cardiovascular Surgery, Acibadem University, School of Medicine, Istanbul, Turkey. FAU - Toraman, Fevzi AU - Toraman F AD - Department of Anesthesiology and Reanimation, Acibadem University, School of Medicine, Istanbul, Turkey. LA - eng PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial DEP - 20150830 PL - United States TA - Heart Surg Forum JT - The heart surgery forum JID - 100891112 SB - IM MH - Acute Kidney Injury/*etiology/*prevention & control MH - Aged MH - Anemia/diagnosis/*etiology/prevention & control MH - Cardiopulmonary Bypass/*adverse effects MH - Combined Modality Therapy/methods MH - Coronary Artery Disease/complications/diagnosis/therapy MH - Erythrocyte Transfusion/*methods MH - Female MH - Hemodilution/*methods MH - Humans MH - Male MH - Middle Aged MH - Prospective Studies MH - Treatment Outcome EDAT- 2015/09/04 06:00 MHDA- 2016/12/15 06:00 CRDT- 2015/09/04 06:00 PHST- 2015/08/27 00:00 [received] PHST- 2015/08/27 00:00 [accepted] PHST- 2015/09/04 06:00 [entrez] PHST- 2015/09/04 06:00 [pubmed] PHST- 2016/12/15 06:00 [medline] AID - 10.1532/hsf.1387 [doi] PST - epublish SO - Heart Surg Forum. 2015 Aug 30;18(4):E154-60. doi: 10.1532/hsf.1387. PMID- 26333343 OWN - NLM STAT- MEDLINE DCOM- 20160523 LR - 20220310 IS - 1941-7632 (Electronic) IS - 1941-7640 (Linking) VI - 8 IP - 9 DP - 2015 Sep TI - Neutrophil Gelatinase-Associated Lipocalin and Contrast-Induced Acute Kidney Injury. PG - e002673 LID - 10.1161/CIRCINTERVENTIONS.115.002673 [doi] AB - BACKGROUND: Neutrophil gelatinase-associated lipocalin (NGAL) is an early marker of acute kidney injury (AKI). METHODS AND RESULTS: Urine NGAL and serum NGAL (sNGAL) were assessed at 2, 6, 24, and 48 hours after contrast media (CM) exposure in 458 high-risk patients (development set). Optimal thresholds in predicting contrast-induced AKI (serum creatinine [sCr] increase >/=0.3 mg/dL at 48 hours after CM administration) were identified. Major adverse events (MAE; death, dialysis, nonfatal myocardial infarction, sustained kidney injury, and myocardial revascularization) at 1 year were assessed. In the development set, optimal thresholds for contrast-induced AKI occurred at 6 hours for both urine NGAL (>/=20 ng/mL; 97% negative predictive value and 27% positive predictive value) and sNGAL (>/=179 ng/mL; 93% negative predictive value and 20% positive predictive value). Furthermore, sNGAL >/=179 ng/mL at 6 hours was an independent predictor of 1-year MAE. 1-year MAE occurred in 27/198 patients (13.5%) with sNGAL <179 ng/mL and sCr <0.3 mg/dL, in 57/193 (29.5%) patients with only sNGAL >/=179 ng/mL, and in 37/67 (55%) patients with sCr >/=0.3 mg/dL. In additional 253 patients (validation set), no patient with urine NGAL <20 ng/mL or sNGAL <179 ng/mL at 6 hours developed contrast-induced AKI. Furthermore, 6/68 (9%) patients with sNGAL <179 ng/mL and sCr increase <0.3 mg/dL had 1-year MAE versus 17/57 (30%) patients with sNGAL >/=179 ng/mL and sCr increase <0.3 mg/dL and 8/16 (50%) patients with sCr increase >/=0.3 mg/dL. CONCLUSIONS: Urine NGAL <20 ng/mL and sNGAL <179 ng/mL at 6 hours are reliable markers for ruling out contrast-induced AKI. sNGAL >/=179 ng/mL at 6 hours predicts 1-year MAE. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01098032. CI - (c) 2015 American Heart Association, Inc. FAU - Quintavalle, Cristina AU - Quintavalle C AD - From the Department of Molecular Medicine and Medical Biotechnology, "Federico II" University, Naples, Italy (C.Q., E.P., G.C.); Institute of Genetics and Biomedical Research, Milan Unit, Milan, Italy (C.V.A., E.D.); Humanitas Research Hospital, Rozzano, Italy (C.V.A., E.D.); Laboratory of Interventional Cardiology and Department of Cardiology, Clinica Mediterranea, Naples, Italy (F.D.M., G.V., B.G., A.F., B.R., C.B.); Institute for Endocrinology and Experimental Oncology, National Research Council, Naples, Italy (G.R., L.P., G.C.); and SDN Foundation, Naples, Italy (E.D.). FAU - Anselmi, Chiara Viviani AU - Anselmi CV AD - From the Department of Molecular Medicine and Medical Biotechnology, "Federico II" University, Naples, Italy (C.Q., E.P., G.C.); Institute of Genetics and Biomedical Research, Milan Unit, Milan, Italy (C.V.A., E.D.); Humanitas Research Hospital, Rozzano, Italy (C.V.A., E.D.); Laboratory of Interventional Cardiology and Department of Cardiology, Clinica Mediterranea, Naples, Italy (F.D.M., G.V., B.G., A.F., B.R., C.B.); Institute for Endocrinology and Experimental Oncology, National Research Council, Naples, Italy (G.R., L.P., G.C.); and SDN Foundation, Naples, Italy (E.D.). FAU - De Micco, Francesca AU - De Micco F AD - From the Department of Molecular Medicine and Medical Biotechnology, "Federico II" University, Naples, Italy (C.Q., E.P., G.C.); Institute of Genetics and Biomedical Research, Milan Unit, Milan, Italy (C.V.A., E.D.); Humanitas Research Hospital, Rozzano, Italy (C.V.A., E.D.); Laboratory of Interventional Cardiology and Department of Cardiology, Clinica Mediterranea, Naples, Italy (F.D.M., G.V., B.G., A.F., B.R., C.B.); Institute for Endocrinology and Experimental Oncology, National Research Council, Naples, Italy (G.R., L.P., G.C.); and SDN Foundation, Naples, Italy (E.D.). FAU - Roscigno, Giuseppina AU - Roscigno G AD - From the Department of Molecular Medicine and Medical Biotechnology, "Federico II" University, Naples, Italy (C.Q., E.P., G.C.); Institute of Genetics and Biomedical Research, Milan Unit, Milan, Italy (C.V.A., E.D.); Humanitas Research Hospital, Rozzano, Italy (C.V.A., E.D.); Laboratory of Interventional Cardiology and Department of Cardiology, Clinica Mediterranea, Naples, Italy (F.D.M., G.V., B.G., A.F., B.R., C.B.); Institute for Endocrinology and Experimental Oncology, National Research Council, Naples, Italy (G.R., L.P., G.C.); and SDN Foundation, Naples, Italy (E.D.). FAU - Visconti, Gabriella AU - Visconti G AD - From the Department of Molecular Medicine and Medical Biotechnology, "Federico II" University, Naples, Italy (C.Q., E.P., G.C.); Institute of Genetics and Biomedical Research, Milan Unit, Milan, Italy (C.V.A., E.D.); Humanitas Research Hospital, Rozzano, Italy (C.V.A., E.D.); Laboratory of Interventional Cardiology and Department of Cardiology, Clinica Mediterranea, Naples, Italy (F.D.M., G.V., B.G., A.F., B.R., C.B.); Institute for Endocrinology and Experimental Oncology, National Research Council, Naples, Italy (G.R., L.P., G.C.); and SDN Foundation, Naples, Italy (E.D.). FAU - Golia, Bruno AU - Golia B AD - From the Department of Molecular Medicine and Medical Biotechnology, "Federico II" University, Naples, Italy (C.Q., E.P., G.C.); Institute of Genetics and Biomedical Research, Milan Unit, Milan, Italy (C.V.A., E.D.); Humanitas Research Hospital, Rozzano, Italy (C.V.A., E.D.); Laboratory of Interventional Cardiology and Department of Cardiology, Clinica Mediterranea, Naples, Italy (F.D.M., G.V., B.G., A.F., B.R., C.B.); Institute for Endocrinology and Experimental Oncology, National Research Council, Naples, Italy (G.R., L.P., G.C.); and SDN Foundation, Naples, Italy (E.D.). FAU - Focaccio, Amelia AU - Focaccio A AD - From the Department of Molecular Medicine and Medical Biotechnology, "Federico II" University, Naples, Italy (C.Q., E.P., G.C.); Institute of Genetics and Biomedical Research, Milan Unit, Milan, Italy (C.V.A., E.D.); Humanitas Research Hospital, Rozzano, Italy (C.V.A., E.D.); Laboratory of Interventional Cardiology and Department of Cardiology, Clinica Mediterranea, Naples, Italy (F.D.M., G.V., B.G., A.F., B.R., C.B.); Institute for Endocrinology and Experimental Oncology, National Research Council, Naples, Italy (G.R., L.P., G.C.); and SDN Foundation, Naples, Italy (E.D.). FAU - Ricciardelli, Bruno AU - Ricciardelli B AD - From the Department of Molecular Medicine and Medical Biotechnology, "Federico II" University, Naples, Italy (C.Q., E.P., G.C.); Institute of Genetics and Biomedical Research, Milan Unit, Milan, Italy (C.V.A., E.D.); Humanitas Research Hospital, Rozzano, Italy (C.V.A., E.D.); Laboratory of Interventional Cardiology and Department of Cardiology, Clinica Mediterranea, Naples, Italy (F.D.M., G.V., B.G., A.F., B.R., C.B.); Institute for Endocrinology and Experimental Oncology, National Research Council, Naples, Italy (G.R., L.P., G.C.); and SDN Foundation, Naples, Italy (E.D.). FAU - Perna, Enzo AU - Perna E AD - From the Department of Molecular Medicine and Medical Biotechnology, "Federico II" University, Naples, Italy (C.Q., E.P., G.C.); Institute of Genetics and Biomedical Research, Milan Unit, Milan, Italy (C.V.A., E.D.); Humanitas Research Hospital, Rozzano, Italy (C.V.A., E.D.); Laboratory of Interventional Cardiology and Department of Cardiology, Clinica Mediterranea, Naples, Italy (F.D.M., G.V., B.G., A.F., B.R., C.B.); Institute for Endocrinology and Experimental Oncology, National Research Council, Naples, Italy (G.R., L.P., G.C.); and SDN Foundation, Naples, Italy (E.D.). FAU - Papa, Laura AU - Papa L AD - From the Department of Molecular Medicine and Medical Biotechnology, "Federico II" University, Naples, Italy (C.Q., E.P., G.C.); Institute of Genetics and Biomedical Research, Milan Unit, Milan, Italy (C.V.A., E.D.); Humanitas Research Hospital, Rozzano, Italy (C.V.A., E.D.); Laboratory of Interventional Cardiology and Department of Cardiology, Clinica Mediterranea, Naples, Italy (F.D.M., G.V., B.G., A.F., B.R., C.B.); Institute for Endocrinology and Experimental Oncology, National Research Council, Naples, Italy (G.R., L.P., G.C.); and SDN Foundation, Naples, Italy (E.D.). FAU - Donnarumma, Elvira AU - Donnarumma E AD - From the Department of Molecular Medicine and Medical Biotechnology, "Federico II" University, Naples, Italy (C.Q., E.P., G.C.); Institute of Genetics and Biomedical Research, Milan Unit, Milan, Italy (C.V.A., E.D.); Humanitas Research Hospital, Rozzano, Italy (C.V.A., E.D.); Laboratory of Interventional Cardiology and Department of Cardiology, Clinica Mediterranea, Naples, Italy (F.D.M., G.V., B.G., A.F., B.R., C.B.); Institute for Endocrinology and Experimental Oncology, National Research Council, Naples, Italy (G.R., L.P., G.C.); and SDN Foundation, Naples, Italy (E.D.). FAU - Condorelli, Gerolama AU - Condorelli G AD - From the Department of Molecular Medicine and Medical Biotechnology, "Federico II" University, Naples, Italy (C.Q., E.P., G.C.); Institute of Genetics and Biomedical Research, Milan Unit, Milan, Italy (C.V.A., E.D.); Humanitas Research Hospital, Rozzano, Italy (C.V.A., E.D.); Laboratory of Interventional Cardiology and Department of Cardiology, Clinica Mediterranea, Naples, Italy (F.D.M., G.V., B.G., A.F., B.R., C.B.); Institute for Endocrinology and Experimental Oncology, National Research Council, Naples, Italy (G.R., L.P., G.C.); and SDN Foundation, Naples, Italy (E.D.). carlobriguori@clinicamediterranea.it gecondor@unina.it. FAU - Briguori, Carlo AU - Briguori C AD - From the Department of Molecular Medicine and Medical Biotechnology, "Federico II" University, Naples, Italy (C.Q., E.P., G.C.); Institute of Genetics and Biomedical Research, Milan Unit, Milan, Italy (C.V.A., E.D.); Humanitas Research Hospital, Rozzano, Italy (C.V.A., E.D.); Laboratory of Interventional Cardiology and Department of Cardiology, Clinica Mediterranea, Naples, Italy (F.D.M., G.V., B.G., A.F., B.R., C.B.); Institute for Endocrinology and Experimental Oncology, National Research Council, Naples, Italy (G.R., L.P., G.C.); and SDN Foundation, Naples, Italy (E.D.). carlobriguori@clinicamediterranea.it gecondor@unina.it. LA - eng SI - ClinicalTrials.gov/NCT01098032 PT - Clinical Trial PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - United States TA - Circ Cardiovasc Interv JT - Circulation. Cardiovascular interventions JID - 101499602 RN - 0 (Acute-Phase Proteins) RN - 0 (Biomarkers) RN - 0 (Contrast Media) RN - 0 (LCN2 protein, human) RN - 0 (Lipocalin-2) RN - 0 (Lipocalins) RN - 0 (Proto-Oncogene Proteins) RN - 0 (Triiodobenzoic Acids) RN - AYI8EX34EU (Creatinine) RN - HW8W27HTXX (iodixanol) SB - IM CIN - Circ Cardiovasc Interv. 2015 Sep;8(9):e003088. doi: 10.1161/CIRCINTERVENTIONS.115.003088. PMID: 26333344 EIN - Circ Cardiovasc Interv. 2015 Oct;8(10):e000015. doi: 10.1161/HCV.0000000000000015. PMID: 26420816 MH - Acute Kidney Injury/chemically induced/*diagnosis/metabolism MH - Acute-Phase Proteins/urine MH - Aged MH - Aged, 80 and over MH - Angiography MH - Angioplasty MH - Biomarkers/blood/urine MH - Contrast Media/*adverse effects MH - Creatinine/blood MH - Female MH - Humans MH - Lipocalin-2 MH - Lipocalins/*blood/urine MH - Male MH - Proto-Oncogene Proteins/*blood/urine MH - Renal Insufficiency, Chronic/*complications MH - Triiodobenzoic Acids/*adverse effects OTO - NOTNLM OT - NGAL OT - contrast media OT - kidney OT - kidney disease OT - prognostic factor EDAT- 2015/09/04 06:00 MHDA- 2016/05/24 06:00 CRDT- 2015/09/04 06:00 PHST- 2015/09/04 06:00 [entrez] PHST- 2015/09/04 06:00 [pubmed] PHST- 2016/05/24 06:00 [medline] AID - CIRCINTERVENTIONS.115.002673 [pii] AID - 10.1161/CIRCINTERVENTIONS.115.002673 [doi] PST - ppublish SO - Circ Cardiovasc Interv. 2015 Sep;8(9):e002673. doi: 10.1161/CIRCINTERVENTIONS.115.002673. PMID- 26331279 OWN - NLM STAT- MEDLINE DCOM- 20161227 LR - 20161230 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 87 IP - 4 DP - 2016 Mar TI - Gender differences in acute and 30-day outcomes after orbital atherectomy treatment of de novo, severely calcified coronary lesions. PG - 671-7 LID - 10.1002/ccd.26163 [doi] AB - OBJECTIVES: The aim of this analysis is to evaluate potential differences according to gender in terms of acute and 30-day clinical outcomes in patients enrolled in the ORBIT II trial with de novo, severely calcified coronary lesions treated with orbital atherectomy to facilitate stent delivery. BACKGROUND: Previous studies have shown an increased risk of safety events in females compared to males undergoing percutaneous coronary intervention. METHODS: ORBIT II, a prospective, nonrandomized, multicenter, single arm study conducted in the US evaluated the safety and efficacy of the coronary OAS to facilitate stent placement in de novo, severely calcified coronary lesions in 443 subjects (286 males and 157 females). The rate of major adverse cardiac events (MACE) defined as a composite of myocardial infarction, target vessel revascularization, and cardiac death was evaluated in-hospital and 30-days postprocedure. For this analysis, the ORBIT II safety and efficacy results were stratified by gender. RESULTS: At baseline, females were significantly older than males and had a lower mean estimated glomerular filtration rate. Males had a higher rate of previous coronary artery bypass grafting and history of smoking. The rates of successful stent delivery and <50% residual stenosis were similar in males and females. In-hospital and 30-day MACE rates did not differ by gender. CONCLUSIONS: Despite females being older, having smaller arteries, and more renal dysfunction, preparation of severely calcified coronary lesions with orbital atherectomy to facilitate stent deployment results in similar rates of in-hospital and 30-day MACE, irrespective of gender. CI - (c) 2015 Wiley Periodicals, Inc. FAU - Kim, Christopher Y AU - Kim CY AD - Utah Cardiology, Layton, Utah. FAU - Lee, Arthur C AU - Lee AC AD - Interventional Cardiologists of Gainesville, PA, Gainesville, Florida. FAU - Wiedenbeck, Troy L AU - Wiedenbeck TL AD - Renown Institute for Heart and Vascular Health, Reno, Nevada. FAU - Lee, Michael S AU - Lee MS AD - UCLA School of Medicine, Los Angeles, California. FAU - Chambers, Jeff W AU - Chambers JW AD - Metropolitan Heart and Vascular Institute-Mercy Hospital, Minneapolis, Minnesota. LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't DEP - 20150902 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM CIN - Catheter Cardiovasc Interv. 2016 Mar;87(4):678-9. doi: 10.1002/ccd.26492. PMID: 26994977 MH - Age Factors MH - Aged MH - Aged, 80 and over MH - Atherectomy, Coronary/adverse effects/*methods/mortality MH - Clinical Trials as Topic MH - Coronary Angiography MH - Coronary Artery Disease/diagnostic imaging/mortality/*therapy MH - Female MH - *Health Status Disparities MH - Hospital Mortality MH - Humans MH - Male MH - Middle Aged MH - *Percutaneous Coronary Intervention/adverse effects/instrumentation/mortality MH - Retrospective Studies MH - Risk Factors MH - Severity of Illness Index MH - Sex Factors MH - Stents MH - Time Factors MH - Treatment Outcome MH - Vascular Calcification/diagnostic imaging/mortality/*therapy OTO - NOTNLM OT - clinical study OT - coronary artery disease OT - female OT - percutaneous coronary intervention OT - vascular calcification EDAT- 2015/09/04 06:00 MHDA- 2016/12/28 06:00 CRDT- 2015/09/03 06:00 PHST- 2015/01/19 00:00 [received] PHST- 2015/04/29 00:00 [revised] PHST- 2015/07/27 00:00 [accepted] PHST- 2015/09/03 06:00 [entrez] PHST- 2015/09/04 06:00 [pubmed] PHST- 2016/12/28 06:00 [medline] AID - 10.1002/ccd.26163 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2016 Mar;87(4):671-7. doi: 10.1002/ccd.26163. Epub 2015 Sep 2. PMID- 26304663 OWN - NLM STAT- MEDLINE DCOM- 20151116 LR - 20201216 IS - 1524-4539 (Electronic) IS - 0009-7322 (Print) IS - 0009-7322 (Linking) VI - 132 IP - 8 DP - 2015 Aug 25 TI - Influence of Baseline Characteristics, Operative Conduct, and Postoperative Course on 30-Day Outcomes of Coronary Artery Bypass Grafting Among Patients With Left Ventricular Dysfunction: Results From the Surgical Treatment for Ischemic Heart Failure (STICH) Trial. PG - 720-30 LID - 10.1161/CIRCULATIONAHA.114.014932 [doi] AB - BACKGROUND: Patients with severe left ventricular dysfunction, ischemic heart failure, and coronary artery disease suitable for coronary artery bypass grafting (CABG) are at higher risk for surgical morbidity and mortality. Paradoxically, those patients with the most severe coronary artery disease and ventricular dysfunction who derive the greatest clinical benefit from CABG are also at the greatest operative risk, which makes decision making regarding whether to proceed to surgery difficult in such patients. To better inform such decision making, we analyzed the Surgical Treatment for Ischemic Heart Failure (STICH) CABG population for detailed information on perioperative risk and outcomes. METHODS AND RESULTS: In both STICH trials (hypotheses), 2136 patients with a left ventricular ejection fraction of /=28%, which were propensity-score matched based on 22 clinical and imaging covariates. The Primary endpoint was all-cause death. The secondary cardiac-specific endpoints included: (1) the composite endpoint of cardiac death or myocardial infarction; (2) the composite endpoint of cardiac death, myocardial infarction, or late (>90 days) coronary revascularization. RESULTS: There were 303 patients followed for 35 +/- 10 months. In the entire cohort, there was a stepwise increase in the rates of death and all secondary endpoints with worsening HRR (P values /= 80 years undergoing primary percutaneous coronary intervention (PCI) is rising, but clinical trials have primarily been performed in younger patients. METHODS: Patients undergoing primary PCI between 2003 and 2008 were subdivided into 3 groups: < 60, 60-79, and >/= 80 years. Endpoints at 3-year follow-up included all-cause mortality, recurrent myocardial infarction (reMI), stent thrombosis, target lesion revascularisation (TLR), bleeding (BARC bleeding >/= 3), stroke, and major adverse cardiovascular events (MACE, a composite of cardiac mortality, reMI, stroke and TLR). RESULTS: 2002 patients with ST-segment elevation myocardial infarction (STEMI) were included, 885 (44.2 %) aged < 60, 921 (46.0 %) 60-79, and 196 (9.7 %) >/= 80 years. Comorbidities such as diabetes mellitus, prior stroke, malignant disease, anaemia, and chronic kidney disease were more prevalent in patients >/= 80 years. The incidence of both ischaemic and bleeding events strongly increased with age. Age >/= 80 years was an independent predictor of mortality (HR 2.56, 95 % CI1.69-3.87, p < 0.001), a borderline non-significant predictor of overall bleeding (HR 1.38, 95 %CI 0.95-2.00, p = 0.088), and a significant predictor of non-access site bleeding (HR 2.26, 95 %CI 1.46-3.51, p < 0.001). CONCLUSION: Patients >/= 80 years experienced high rates of ischaemic and bleeding complications; especially in this high-risk patient group individualised therapy is needed to optimise clinical outcomes. FAU - Claessen, Bimmer E P M AU - Claessen BEPM AD - Department of Cardiology, B2-115, Academic Medical Center - University of Amsterdam, Meibergdreef 9, 1105, Amsterdam, AZ, The Netherlands. b.e.claessen@amc.uva.nl. FAU - Kikkert, Wouter J AU - Kikkert WJ AD - Department of Cardiology, B2-115, Academic Medical Center - University of Amsterdam, Meibergdreef 9, 1105, Amsterdam, AZ, The Netherlands. FAU - Hoebers, Loes P AU - Hoebers LP AD - Department of Cardiology, B2-115, Academic Medical Center - University of Amsterdam, Meibergdreef 9, 1105, Amsterdam, AZ, The Netherlands. FAU - Bahadurzada, Hassina AU - Bahadurzada H AD - Department of Cardiology, B2-115, Academic Medical Center - University of Amsterdam, Meibergdreef 9, 1105, Amsterdam, AZ, The Netherlands. FAU - Vis, Marije M AU - Vis MM AD - Department of Cardiology, B2-115, Academic Medical Center - University of Amsterdam, Meibergdreef 9, 1105, Amsterdam, AZ, The Netherlands. FAU - Baan, Jan AU - Baan J AD - Department of Cardiology, B2-115, Academic Medical Center - University of Amsterdam, Meibergdreef 9, 1105, Amsterdam, AZ, The Netherlands. FAU - Koch, Karel T AU - Koch KT AD - Department of Cardiology, B2-115, Academic Medical Center - University of Amsterdam, Meibergdreef 9, 1105, Amsterdam, AZ, The Netherlands. FAU - de Winter, Robbert J AU - de Winter RJ AD - Department of Cardiology, B2-115, Academic Medical Center - University of Amsterdam, Meibergdreef 9, 1105, Amsterdam, AZ, The Netherlands. FAU - Tijssen, Jan G P AU - Tijssen JGP AD - Department of Cardiology, B2-115, Academic Medical Center - University of Amsterdam, Meibergdreef 9, 1105, Amsterdam, AZ, The Netherlands. FAU - Piek, Jan J AU - Piek JJ AD - Department of Cardiology, B2-115, Academic Medical Center - University of Amsterdam, Meibergdreef 9, 1105, Amsterdam, AZ, The Netherlands. FAU - Henriques, Jose P S AU - Henriques JPS AD - Department of Cardiology, B2-115, Academic Medical Center - University of Amsterdam, Meibergdreef 9, 1105, Amsterdam, AZ, The Netherlands. LA - eng PT - Journal Article PL - Netherlands TA - Neth Heart J JT - Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation JID - 101095458 PMC - PMC4580666 OTO - NOTNLM OT - Acute myocardial infarction OT - Elderly OT - Primary percutaneous coronary intervention OT - Stent EDAT- 2015/08/12 06:00 MHDA- 2015/08/12 06:01 PMCR- 2015/08/11 CRDT- 2015/08/12 06:00 PHST- 2015/08/12 06:00 [entrez] PHST- 2015/08/12 06:00 [pubmed] PHST- 2015/08/12 06:01 [medline] PHST- 2015/08/11 00:00 [pmc-release] AID - 10.1007/s12471-015-0733-2 [pii] AID - 733 [pii] AID - 10.1007/s12471-015-0733-2 [doi] PST - ppublish SO - Neth Heart J. 2015 Sep;23(10):477-482. doi: 10.1007/s12471-015-0733-2. PMID- 26221368 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20150729 LR - 20220318 IS - 1940-5901 (Print) IS - 1940-5901 (Electronic) IS - 1940-5901 (Linking) VI - 8 IP - 5 DP - 2015 TI - Risk factors and clinical characteristics of in-hospital death in acute myocardial infarction with IABP support. PG - 8032-41 AB - BACKGROUND: Despite the widespread use of the intra-aortic balloon pump (IABP) in acute myocardial infarction (AMI), there were few clinical trials regarding the deceased's feature. Therefore, we conducted a study to investigate the clinical characteristics and risk factor led to in-hospital deaths among AMI patients with IABP support. OBJECTIVE: To investigate the clinical characteristics and risk factors of in-hospital death with IABP support in AMI patients. METHODS: The clinical data of 572 consecutive IABP supported patients with AMI within 72 hours from symptom onset from July 2005 to July 2013 were retrospectively analyzed. The evolution of the risk factors of in-hospital death and clinical characteristics was compared in 81 non-survivors and the survivors. RESULTS: Non-survivors had a more severe clinical profile at admission. Fewer patients were treated with emergency reperfusion therapy in the non-survivors group. Cardiogenic shock, Mechanical complications, ventricular tachycardia/fibrillation and MODS were much common in non-survivors (P<0.001). Multivariate logistic regression analysis showed advanced age (>65 years), prolonged time from symptom onset to first medical contact (FMC), Killip class III/IV, renal dysfunction(GFR <60 ml/min/1.73 m(2)), and left ventricular ejection fraction (LVEF) <30% were risk factors associated with higher in-hospital mortality. CONCLUSIONS: IABP support may be more effective combined with revascularization for AMI patients whose hemodynamics is compromised. Patients accompanied with cardiogenic shock and other life-threatening complications are often uselesswith IABP support. Meanwhile, patient whose hemodynamics parameters have significant response to IABP may get benefits with IABP to improve in-hospital survival. FAU - Cao, Jianing AU - Cao J AD - Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Disease Beijing 100029, China. FAU - Liu, Wenxian AU - Liu W AD - Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Disease Beijing 100029, China. FAU - Zhu, Jiajia AU - Zhu J AD - Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Disease Beijing 100029, China. FAU - Zhao, Han AU - Zhao H AD - Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Disease Beijing 100029, China. LA - eng PT - Journal Article DEP - 20150515 PL - United States TA - Int J Clin Exp Med JT - International journal of clinical and experimental medicine JID - 101471010 PMC - PMC4509313 OTO - NOTNLM OT - Intra-aortic balloon pump OT - acute myocardial infarction OT - in-hospital mortality OT - risk factors EDAT- 2015/07/30 06:00 MHDA- 2015/07/30 06:01 PMCR- 2015/05/15 CRDT- 2015/07/30 06:00 PHST- 2015/02/26 00:00 [received] PHST- 2015/05/02 00:00 [accepted] PHST- 2015/07/30 06:00 [entrez] PHST- 2015/07/30 06:00 [pubmed] PHST- 2015/07/30 06:01 [medline] PHST- 2015/05/15 00:00 [pmc-release] PST - epublish SO - Int J Clin Exp Med. 2015 May 15;8(5):8032-41. eCollection 2015. PMID- 26187674 OWN - NLM STAT- MEDLINE DCOM- 20151110 LR - 20240521 IS - 1879-1913 (Electronic) IS - 0002-9149 (Print) IS - 0002-9149 (Linking) VI - 116 IP - 5 DP - 2015 Sep 1 TI - Balancing Long-Term Risks of Ischemic and Bleeding Complications After Percutaneous Coronary Intervention With Drug-Eluting Stents. PG - 686-93 LID - S0002-9149(15)01420-4 [pii] LID - 10.1016/j.amjcard.2015.05.036 [doi] AB - Although trials comparing antiplatelet strategies after percutaneous coronary intervention report average risks of bleeding and ischemia in a population, there is limited information to guide choices based on individual patient risks, particularly beyond 1 year after treatment. Patient-level data from Patient Related Outcomes With Endeavor vs Cypher Stenting Trial (PROTECT), a broadly inclusive trial enrolling 8,709 subjects treated with drug-eluting stents (sirolimus vs zotarolimus-eluting stent), and PROTECT US, a single-arm study including 1,018 subjects treated with a zotarolimus-eluting stent, were combined. The risk of ischemic events, cardiovascular death/non-periprocedural myocardial infarction (MI)/definite or probable stent thrombosis, and bleeding events, Global Use of Strategies to Open Occluded Arteries moderate or severe bleed, were predicted using logistic regression. At median follow-up of 4.1 years, major bleeding occurred in 260 subjects (2.8%) and ischemic events in 595 (6.3%). Multivariate predictors of bleeding were older age, smoking, diabetes mellitus, congestive heart failure, and chronic kidney disease (all p <0.05). Ischemic events shared all the same predictors with bleeding events and gender, body mass index, previous MI, previous coronary artery bypass graft surgery, ST-segment elevation MI on presentation, stent length, and sirolimus-eluting stent use (all p <0.05). Within individual subjects, bleeding and ischemic risks were strongly correlated; 97% of subjects had a greater risk of ischemic events than bleeding. In conclusion, individual patient risks of ischemia and bleeding are related to many common risk factors, yet the predicted risks of ischemic events are greater than those of major bleeding in the large majority of patients in long-term follow-up. CI - Copyright (c) 2015 Elsevier Inc. All rights reserved. FAU - Matteau, Alexis AU - Matteau A AD - Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts. FAU - Yeh, Robert W AU - Yeh RW AD - Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts. FAU - Camenzind, Edoardo AU - Camenzind E AD - Cardiology Department, University of Geneva, Geneva, Switzerland. FAU - Steg, P Gabriel AU - Steg PG AD - Cardiology Department, DHU-FIRE, Hopital Bichat, Paris, France; Universite Paris-Diderot, Paris, France; INSERM U1148, Paris, France. FAU - Wijns, William AU - Wijns W AD - Cardiology Department, Cardiovascular Research Center Aalst, OLV Hospital, Aalst, Belgium. FAU - Mills, Joseph AU - Mills J AD - Cardiology Department, Cardiothoracic Centre, Liverpool, United Kingdom. FAU - Gershlick, Anthony AU - Gershlick A AD - Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom; NIHR Leicester Cardiovascular Biomedical Research Unit, University Hospitals of Leicester Glenfield Hospital, Leicester, United Kingdom. FAU - de Belder, Mark AU - de Belder M AD - Cardiology Department, The James Cook University Hospital, Middlesbrough, United Kingdom. FAU - Ducrocq, Gregory AU - Ducrocq G AD - Cardiology Department, DHU-FIRE, Hopital Bichat, Paris, France; Universite Paris-Diderot, Paris, France; INSERM U1148, Paris, France. FAU - Mauri, Laura AU - Mauri L AD - Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts. Electronic address: lmauri1@partners.org. LA - eng GR - K23 HL118138/HL/NHLBI NIH HHS/United States GR - UL1 RR025758/RR/NCRR NIH HHS/United States PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20150603 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 RN - 0 (Immunosuppressive Agents) RN - 0 (Platelet Aggregation Inhibitors) RN - H4GXR80IZE (zotarolimus) RN - W36ZG6FT64 (Sirolimus) SB - IM MH - Aged MH - Blood Transfusion/*methods MH - Coronary Artery Disease/*surgery MH - Dose-Response Relationship, Drug MH - Drug-Eluting Stents/*adverse effects MH - Europe/epidemiology MH - Female MH - Follow-Up Studies MH - Humans MH - Immunosuppressive Agents/pharmacology MH - Incidence MH - Male MH - Middle Aged MH - Myocardial Infarction/epidemiology/etiology/*prevention & control MH - Percutaneous Coronary Intervention/*adverse effects MH - Platelet Aggregation Inhibitors/administration & dosage/*therapeutic use MH - Postoperative Hemorrhage/epidemiology/etiology/*prevention & control MH - Prognosis MH - Retrospective Studies MH - Sirolimus/analogs & derivatives/pharmacology MH - Survival Rate/trends MH - Time Factors PMC - PMC4670082 MID - NIHMS741167 EDAT- 2015/07/19 06:00 MHDA- 2015/11/11 06:00 PMCR- 2016/09/01 CRDT- 2015/07/19 06:00 PHST- 2015/03/09 00:00 [received] PHST- 2015/05/28 00:00 [revised] PHST- 2015/05/28 00:00 [accepted] PHST- 2015/07/19 06:00 [entrez] PHST- 2015/07/19 06:00 [pubmed] PHST- 2015/11/11 06:00 [medline] PHST- 2016/09/01 00:00 [pmc-release] AID - S0002-9149(15)01420-4 [pii] AID - 10.1016/j.amjcard.2015.05.036 [doi] PST - ppublish SO - Am J Cardiol. 2015 Sep 1;116(5):686-93. doi: 10.1016/j.amjcard.2015.05.036. Epub 2015 Jun 3. PMID- 26184868 OWN - NLM STAT- MEDLINE DCOM- 20160829 LR - 20151113 IS - 1875-2128 (Electronic) IS - 1875-2128 (Linking) VI - 108 IP - 11 DP - 2015 Nov TI - Impact of renal failure on all-cause mortality and other outcomes in patients treated by percutaneous coronary intervention. PG - 554-62 LID - S1875-2136(15)00114-X [pii] LID - 10.1016/j.acvd.2015.06.001 [doi] AB - BACKGROUND: Patients with renal failure (RF) have been systematically excluded from clinical trials; consequently their outcomes have not been well studied in the setting of percutaneous coronary intervention (PCI). AIMS: To compare cardiovascular outcomes after contemporary PCI in patients with versus without RF, according to clinical presentation (ST-segment elevation myocardial infarction [STEMI], acute coronary syndrome [ACS] or stable coronary artery disease [sCAD]). METHODS: Consecutive patients undergoing PCI with stent were prospectively included from 2007 to 2012. RF was defined as creatinine clearance<60mL/min. The primary endpoint was all-cause mortality; secondary endpoints were major adverse cardiovascular and cerebrovascular events (MACCE: composite of cardiovascular death, myocardial infarction, stroke and target lesion revascularization [TLR]), TLR and Academic Research Consortium definite/probable stent thrombosis (ST) at 1 year. RESULTS: Among 5337 patients, 23% had PCI for STEMI, 34% for ACS and 43% for sCAD, while 27% had RF. RF patients had a higher unadjusted death rate than those with preserved renal function (nRF) in all PCI indication groups (STEMI, 41% vs. 7.5%; ACS, 19% vs. 6%; sCAD, 10% vs. 3%; P<0.0001 for all). The rate of MACCE was also higher in RF patients whatever the PCI indication (STEMI, 45% vs. 15%; ACS, 23% vs. 14%; sCAD, 14% vs. 9%; P<0.05 for all). Rates of TLR (5.5-7.4%) and ST (<2.5%) were similar (P>0.05 for both). sCAD-RF and STEMI-nRF patients had similar rates of mortality (P=0.209) and MACCE (P=0.658). RF was independently associated with mortality, with a doubled relative risk in STEMI versus ACS and sCAD groups (odds ratio 5.3, 95% confidence interval 3.627-7.821 vs. 2.1, 1.465-3.140 and 2.3, 1.507-3.469, respectively; P<0.0001). CONCLUSION: RF is a stronger independent predictor of death after PCI in STEMI than in ACS or sCAD patients. sCAD-RF and STEMI-nRF patients had similar prognoses. CI - Copyright (c) 2015 Elsevier Masson SAS. All rights reserved. FAU - Loncar, Goran AU - Loncar G AD - Institut de cardiologie, universite Paris 6, CHU Pitie-Salpetriere, AP-HP, Paris, France; Cardiology Department, Clinical Hospital Zvezdara, Belgrade, Serbia. FAU - Barthelemy, Olivier AU - Barthelemy O AD - Institut de cardiologie, universite Paris 6, CHU Pitie-Salpetriere, AP-HP, Paris, France. Electronic address: olivier.barthelemy@psl.aphp.fr. FAU - Berman, Emmanuel AU - Berman E AD - Institut de cardiologie, universite Paris 6, CHU Pitie-Salpetriere, AP-HP, Paris, France. FAU - Kerneis, Mathieu AU - Kerneis M AD - Institut de cardiologie, universite Paris 6, CHU Pitie-Salpetriere, AP-HP, Paris, France. FAU - Petroni, Thibault AU - Petroni T AD - Institut de cardiologie, universite Paris 6, CHU Pitie-Salpetriere, AP-HP, Paris, France. FAU - Payot, Laurent AU - Payot L AD - Institut de cardiologie, universite Paris 6, CHU Pitie-Salpetriere, AP-HP, Paris, France. FAU - Choussat, Remi AU - Choussat R AD - Institut de cardiologie, universite Paris 6, CHU Pitie-Salpetriere, AP-HP, Paris, France. FAU - Silvain, Johanne AU - Silvain J AD - Institut de cardiologie, universite Paris 6, CHU Pitie-Salpetriere, AP-HP, Paris, France. FAU - Collet, Jean-Philippe AU - Collet JP AD - Institut de cardiologie, universite Paris 6, CHU Pitie-Salpetriere, AP-HP, Paris, France. FAU - Helft, Gerard AU - Helft G AD - Institut de cardiologie, universite Paris 6, CHU Pitie-Salpetriere, AP-HP, Paris, France. FAU - Montalescot, Gilles AU - Montalescot G AD - Institut de cardiologie, universite Paris 6, CHU Pitie-Salpetriere, AP-HP, Paris, France. FAU - Le Feuvre, Claude AU - Le Feuvre C AD - Institut de cardiologie, universite Paris 6, CHU Pitie-Salpetriere, AP-HP, Paris, France. LA - eng PT - Comparative Study PT - Journal Article PT - Observational Study DEP - 20150713 PL - Netherlands TA - Arch Cardiovasc Dis JT - Archives of cardiovascular diseases JID - 101465655 SB - IM MH - Acute Coronary Syndrome/diagnosis/mortality/therapy MH - Aged MH - Cause of Death MH - Chi-Square Distribution MH - Coronary Artery Disease/diagnosis/mortality/therapy MH - Female MH - France/epidemiology MH - Humans MH - Kaplan-Meier Estimate MH - Logistic Models MH - Male MH - Middle Aged MH - Multivariate Analysis MH - Myocardial Infarction/diagnosis/mortality/therapy MH - Myocardial Ischemia/diagnosis/*mortality/*therapy MH - Odds Ratio MH - Percutaneous Coronary Intervention/adverse effects/instrumentation/*mortality MH - Prospective Studies MH - Registries MH - Renal Insufficiency/diagnosis/*mortality/therapy MH - Risk Assessment MH - Risk Factors MH - Stents MH - Time Factors MH - Treatment Outcome OTO - NOTNLM OT - Angioplastie coronaire OT - Insuffisance renale OT - PCI OT - Renal failure OT - STEMI EDAT- 2015/07/18 06:00 MHDA- 2016/08/30 06:00 CRDT- 2015/07/18 06:00 PHST- 2015/02/07 00:00 [received] PHST- 2015/05/11 00:00 [revised] PHST- 2015/06/01 00:00 [accepted] PHST- 2015/07/18 06:00 [entrez] PHST- 2015/07/18 06:00 [pubmed] PHST- 2016/08/30 06:00 [medline] AID - S1875-2136(15)00114-X [pii] AID - 10.1016/j.acvd.2015.06.001 [doi] PST - ppublish SO - Arch Cardiovasc Dis. 2015 Nov;108(11):554-62. doi: 10.1016/j.acvd.2015.06.001. Epub 2015 Jul 13. PMID- 26152402 OWN - NLM STAT- MEDLINE DCOM- 20161018 LR - 20260128 IS - 1460-2385 (Electronic) IS - 0931-0509 (Print) IS - 0931-0509 (Linking) VI - 31 IP - 3 DP - 2016 Mar TI - Effects of blood pressure on renal and cardiovascular outcomes in Asian patients with type 2 diabetes and overt nephropathy: a post hoc analysis (ORIENT-blood pressure). PG - 447-54 LID - 10.1093/ndt/gfv272 [doi] AB - BACKGROUND: Blood pressure (BP) control may have different effects on cardiovascular (CV) and renal outcomes in diabetes. We examined the impact of systolic BP (SBP) on renal and CV outcomes in a post hoc analysis in the Olmesartan Reducing Incidence of Endstage Renal Disease in Diabetic Nephropathy Trial. METHODS: We stratified mean follow-up SBP into three categories (140 mmHg) and used a Cox regression model to estimate the hazard ratio (HR, 95% confidence interval) for the outcomes. The composite renal outcome was doubling of serum creatinine, end-stage renal disease and all-cause death. The composite CV outcome included CV death, nonfatal stroke, nonfatal myocardial infarction, hospitalization for unstable angina or heart failure, revascularization and lower extremity amputation. We also compared the slope of estimated glomerular filtration rate (eGFR) in all three groups. RESULTS: After a mean follow-up period of 3.2 years, the follow-up SBP was linearly associated with risk of renal outcomes in all 566 patients. In patients with heavy proteinuria (>/=1 g/gCr), a follow-up SBP > 130 mmHg was associated with an HR of 2.33 (1.62-3.36) for renal outcomes with referent to SBP 140 mmHg was associated with an HR of 2.04 (1.23-3.40) for CV outcomes with referent to SBP < 140 mmHg. The median (interquartile range) slopes of eGFR were -3.27 (-6.90, -1.63), -4.53 (-8.08, -2.29) and -7.13 (-10.90, -3.99) dL/mg/year in patients with SBP 140 mmHg, respectively (P = 0.008 between 140 mmHg). CONCLUSION: In Asian type 2 diabetic patients with chronic kidney disease and heavy proteinuria, reduction of SBP 60% of major bleeding events occurred >30 days after the end of the index hospitalisation. Gastrointestinal bleeding was the most common cause of major bleeding, accounting for 45.9% of TIMI major or minor and 39.5% of ISTH major or CRNM bleeding events. Independent predictors of ISTH major or CRNM bleeding events included older age, renal dysfunction, dual oral antiplatelet therapy, smoking history, increased white cell count and coronary revascularisation. CONCLUSIONS: When compared with placebo, the use of apixaban is associated with an important short-term and long-term risk of bleeding in high-risk post-ACS patients, with gastrointestinal bleeding being the most common source of major bleeding. The baseline predictors of major bleeding appear to be consistent with those identified in lower-risk ACS populations with shorter-term follow-up. CLINICAL TRIAL NO: NCT00831441. CI - Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions. FAU - Khan, Razi AU - Khan R AD - Montreal Heart Institute, University of Montreal, Montreal, Quebec, Canada. FAU - Lopes, Renato D AU - Lopes RD AD - Duke Clinical Research Institute, Duke Medicine, Durham, North Carolina, United States. FAU - Neely, Megan L AU - Neely ML AD - Duke Clinical Research Institute, Duke Medicine, Durham, North Carolina, United States. FAU - Stevens, Susanna R AU - Stevens SR AD - Duke Clinical Research Institute, Duke Medicine, Durham, North Carolina, United States. FAU - Harrington, Robert A AU - Harrington RA AD - Stanford School of Medicine, Stanford, California, USA. FAU - Diaz, Rafael AU - Diaz R AD - ECLA Estudios Cardiologicos Latinoamerica, Rosario, Argentina. FAU - Cools, Frank AU - Cools F AD - Academisch Ziekenhuis Klina, Brasschaat, Belgium. FAU - Jansky, Petr AU - Jansky P AD - University Hospital Motol, Prague, Czech Republic. FAU - Montalescot, Gilles AU - Montalescot G AD - Institute of Cardiology, Pitie-Salpetriere University Hospital, Paris, France. FAU - Atar, Dan AU - Atar D AD - Oslo University Hospital, and Institute of Clinical Sciences, University of Oslo, Oslo, Norway. FAU - Lopez-Sendon, Jose AU - Lopez-Sendon J AD - University Hospital La Paz, Madrid, Spain. FAU - Flather, Marcus AU - Flather M AD - Clinical Trials and Evaluation Unit, Royal Brompton Hospital and Harefield NHS Foundation Trust, London, UK. FAU - Liaw, Danny AU - Liaw D AD - Bristol-Myers Squibb, Princeton, New Jersey, USA. FAU - Wallentin, Lars AU - Wallentin L AD - Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden. FAU - Alexander, John H AU - Alexander JH AD - Duke Clinical Research Institute, Duke Medicine, Durham, North Carolina, United States. FAU - Goodman, Shaun G AU - Goodman SG AD - Terrence Donnelly Heart Centre, St Michael's Hospital, University of Toronto, and the Canadian Heart Research Centre, Toronto, Ontario, Canada. CN - Apixaban for Prevention of Acute Ischemic Safety Events (APPRAISE)-2 Steering Committee and Investigators LA - eng SI - ClinicalTrials.gov/NCT00831441 PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20150624 PL - England TA - Heart JT - Heart (British Cardiac Society) JID - 9602087 RN - 0 (Factor Xa Inhibitors) RN - 0 (Pyrazoles) RN - 0 (Pyridones) RN - 3Z9Y7UWC1J (apixaban) SB - IM MH - Acute Coronary Syndrome/*drug therapy MH - Aged MH - Factor Xa Inhibitors/administration & dosage/adverse effects MH - Female MH - *Gastrointestinal Hemorrhage/chemically induced/epidemiology MH - *Hemorrhage/chemically induced/classification/epidemiology MH - Humans MH - Incidence MH - Kaplan-Meier Estimate MH - Male MH - Middle Aged MH - Outcome Assessment, Health Care MH - Prognosis MH - Proportional Hazards Models MH - *Pyrazoles/administration & dosage/adverse effects MH - *Pyridones/administration & dosage/adverse effects MH - Risk Assessment MH - Risk Factors MH - Secondary Prevention/methods MH - Time Factors EDAT- 2015/06/26 06:00 MHDA- 2015/11/17 06:00 CRDT- 2015/06/26 06:00 PHST- 2014/12/15 00:00 [received] PHST- 2015/05/27 00:00 [accepted] PHST- 2015/06/26 06:00 [entrez] PHST- 2015/06/26 06:00 [pubmed] PHST- 2015/11/17 06:00 [medline] AID - heartjnl-2014-307346 [pii] AID - 10.1136/heartjnl-2014-307346 [doi] PST - ppublish SO - Heart. 2015 Sep;101(18):1475-84. doi: 10.1136/heartjnl-2014-307346. Epub 2015 Jun 24. PMID- 26093871 OWN - NLM STAT- MEDLINE DCOM- 20150831 LR - 20150622 IS - 1097-6744 (Electronic) IS - 0002-8703 (Linking) VI - 170 IP - 1 DP - 2015 Jul TI - Effects of withdrawing vs continuing renin-angiotensin blockers on incidence of acute kidney injury in patients with renal insufficiency undergoing cardiac catheterization: Results from the Angiotensin Converting Enzyme Inhibitor/Angiotensin Receptor Blocker and Contrast Induced Nephropathy in Patients Receiving Cardiac Catheterization (CAPTAIN) trial. PG - 110-6 LID - S0002-8703(15)00252-5 [pii] LID - 10.1016/j.ahj.2015.04.019 [doi] AB - BACKGROUND: It is unclear if holding angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB) prior to coronary angiography reduces contrast-induced acute kidney injury (AKI). We undertook a randomized trial to investigate the effect of holding ACEI/ARB therapy prior to coronary angiography on the incidence of AKI. METHODS: We randomly assigned 208 patients with moderate renal insufficiency (creatinine >/= 1.7mg/dL within 3 months and/or documented creatinine >/= 1.5mg/dL within 1 week before cardiac catheterization) to hold ACEI/ARB >/=24 hours preprocedure or continue ACEI/ARB. The primary outcome was the incidence of AKI defined as an absolute rise in serum creatinine of >/=0.5mg/dL from baseline and/or a relative rise in serum creatinine of >/=25% compared with baseline measured at 48 to 96 hours postcardiac catheterization. RESULTS: All patients were taking an ACEI (72.1%) or ARB (27.9%) prior to randomization. At 48 to 96 hours, the primary outcome occurred in 18.4% of patients who continued ACEI/ARB compared with 10.9% of the patients who held ACEI/ARB (hazard ratio 0.59, 95% CI 0.30-1.19, P = .16). In a prespecified secondary outcome, there was a lower rise in mean serum creatinine after the procedure in patients who held ACEI/ARB (0.3 +/- 0.5 vs 0.1 +/- 0.3mg/dL, P = .03). The clinical composite of death, myocardial infarction, ischemic stroke, congestive heart failure, rehospitalization for cardiovascular cause, or need for dialysis preprocedure occurred in 3.9% who continued ACEI/ARB compared with 0% who held the ACEI/ARB (hazard ratio 0.11, 95% CI 0.01-2.96, P = .06). CONCLUSION: In this pilot study of patients with moderate renal insufficiency undergoing cardiac catheterization, with-holding ACEI/ARB resulted in a non-significant reduction in contrast-induced AKI and a significant reduction in post-procedural rise of creatinine. This low cost intervention could be considered when referring a patient for cardiac catheterization. CI - Copyright (c) 2015 Elsevier Inc. All rights reserved. FAU - Bainey, Kevin R AU - Bainey KR AD - Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada. FAU - Rahim, Sherali AU - Rahim S AD - Interventional Cardiology Research Group and Division of Cardiology, Department of Medicine, McMaster University, and Hamilton Health Sciences Hamilton, Ontario, Canada. FAU - Etherington, Krystal AU - Etherington K AD - Interventional Cardiology Research Group and Division of Cardiology, Department of Medicine, McMaster University, and Hamilton Health Sciences Hamilton, Ontario, Canada. FAU - Rokoss, Michael L AU - Rokoss ML AD - Interventional Cardiology Research Group and Division of Cardiology, Department of Medicine, McMaster University, and Hamilton Health Sciences Hamilton, Ontario, Canada. FAU - Natarajan, Madhu K AU - Natarajan MK AD - Interventional Cardiology Research Group and Division of Cardiology, Department of Medicine, McMaster University, and Hamilton Health Sciences Hamilton, Ontario, Canada. FAU - Velianou, James L AU - Velianou JL AD - Interventional Cardiology Research Group and Division of Cardiology, Department of Medicine, McMaster University, and Hamilton Health Sciences Hamilton, Ontario, Canada. FAU - Brons, Sonya AU - Brons S AD - Interventional Cardiology Research Group and Division of Cardiology, Department of Medicine, McMaster University, and Hamilton Health Sciences Hamilton, Ontario, Canada. FAU - Mehta, Shamir R AU - Mehta SR AD - Interventional Cardiology Research Group and Division of Cardiology, Department of Medicine, McMaster University, and Hamilton Health Sciences Hamilton, Ontario, Canada. Electronic address: smehta@mcmaster.ca. CN - CAPTAIN Investigators LA - eng SI - ClinicalTrials.gov/NCT00317252 PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial DEP - 20150418 PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 RN - 0 (Angiotensin Receptor Antagonists) RN - 0 (Angiotensin-Converting Enzyme Inhibitors) RN - 0 (Contrast Media) RN - AYI8EX34EU (Creatinine) SB - IM MH - Acute Kidney Injury/blood/chemically induced/*prevention & control MH - Aged MH - Aged, 80 and over MH - Angiotensin Receptor Antagonists/*therapeutic use MH - Angiotensin-Converting Enzyme Inhibitors/*therapeutic use MH - Cardiac Catheterization/*methods MH - Contrast Media/adverse effects MH - Coronary Angiography/*methods MH - Coronary Artery Disease/complications/*diagnosis MH - Creatinine/blood MH - Female MH - Humans MH - Male MH - Middle Aged MH - Percutaneous Coronary Intervention/methods MH - Pilot Projects MH - Preoperative Care/*methods MH - Renal Insufficiency, Chronic/blood/*complications MH - Single-Blind Method EDAT- 2015/06/22 06:00 MHDA- 2015/09/01 06:00 CRDT- 2015/06/22 06:00 PHST- 2014/09/10 00:00 [received] PHST- 2015/04/15 00:00 [accepted] PHST- 2015/06/22 06:00 [entrez] PHST- 2015/06/22 06:00 [pubmed] PHST- 2015/09/01 06:00 [medline] AID - S0002-8703(15)00252-5 [pii] AID - 10.1016/j.ahj.2015.04.019 [doi] PST - ppublish SO - Am Heart J. 2015 Jul;170(1):110-6. doi: 10.1016/j.ahj.2015.04.019. Epub 2015 Apr 18. PMID- 26065487 OWN - NLM STAT- MEDLINE DCOM- 20160421 LR - 20260128 IS - 1540-8183 (Electronic) IS - 0896-4327 (Linking) VI - 28 IP - 3 DP - 2015 Jun TI - Institutional Switch from Transfemoral to Transradial Vascular Access for Percutaneous Coronary Intervention was Associated with a Reduction in Bleeding Events: A Singlecenter Experience of >10,000 Consecutive Cases. PG - 296-304 LID - 10.1111/joic.12205 [doi] AB - BACKGROUND: Transradial (TR) access for percutaneous coronary intervention (PCI) reduces bleeding compared with transfemoral (TF) access, and may reduce mortality in specific patient subsets. However, switching from TF to TR access is associated with a learning curve and it is unclear whether benefits observed in randomized trials translate into practice. We sought to characterize the trends in bleeding and mortality rates at our institution, as we changed from being a TF to predominantly TR center over a 5-year period. METHODS AND RESULTS: 10,213 consecutive patients presenting for PCI were included (mean age 65.0 +/- 11.6 years, 76.1% male, 48.0% PCI for acute coronary syndrome) over 5 years at a single center with PCI volume >2,000 cases per annum. Patients were stratified by initial arterial access site (TR or TF) and outcome measures included temporal trends in TR procedural failure, 30-day bleeding complications and all-cause 1-year mortality. TR procedural failure fell to a consistently low rate within 1 year (11.8% in 2008 to 2.9% in 2009, P < 0.001). As TR volume increased, the annual 30-day bleeding rate fell (1.64% in 2008 to 0.68% in 2012, P = 0.006). TR access predicted reduced 30-day bleeding (OR 0.17 [95%CI 0.07-0.38], P < 0.001), but was not a predictor of 1-year survival (HR 0.78 [95%CI 0.58-1.05], P = 0.10). CONCLUSION: Successful transition from TF to TR PCI at our institution was rapid and associated with a reduction in 30-day bleeding. These data should encourage other centers considering the adoption of TR access. CI - (c) 2015, Wiley Periodicals, Inc. FAU - Rajani, Nikil K AU - Rajani NK AD - Department of Interventional Cardiology, Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom. FAU - Brown, Adam J AU - Brown AJ AD - Department of Interventional Cardiology, Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom. FAU - McCormick, Liam M AU - McCormick LM AD - Department of Interventional Cardiology, Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom. FAU - Parwaiz, Hammad AU - Parwaiz H AD - Department of Interventional Cardiology, Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom. FAU - Kaushal, Anmol AU - Kaushal A AD - Department of Interventional Cardiology, Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom. FAU - Hoole, Stephen P AU - Hoole SP AD - Department of Interventional Cardiology, Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom. FAU - West, Nick E J AU - West NE AD - Department of Interventional Cardiology, Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom. LA - eng PT - Journal Article PL - United States TA - J Interv Cardiol JT - Journal of interventional cardiology JID - 8907826 SB - IM MH - Acute Coronary Syndrome/*therapy MH - Aged MH - Female MH - *Femoral Artery MH - Hemorrhage/epidemiology MH - Humans MH - Male MH - Middle Aged MH - Percutaneous Coronary Intervention/*methods MH - *Radial Artery MH - Renal Insufficiency, Chronic/mortality MH - Shock, Cardiogenic/mortality MH - United Kingdom/epidemiology EDAT- 2015/06/13 06:00 MHDA- 2016/04/22 06:00 CRDT- 2015/06/13 06:00 PHST- 2015/06/13 06:00 [entrez] PHST- 2015/06/13 06:00 [pubmed] PHST- 2016/04/22 06:00 [medline] AID - 10.1111/joic.12205 [doi] PST - ppublish SO - J Interv Cardiol. 2015 Jun;28(3):296-304. doi: 10.1111/joic.12205. PMID- 26056248 OWN - NLM STAT- MEDLINE DCOM- 20160310 LR - 20150609 IS - 1941-7632 (Electronic) IS - 1941-7640 (Linking) VI - 8 IP - 6 DP - 2015 Jun TI - Prevalence and impact of high platelet reactivity in chronic kidney disease: results from the Assessment of Dual Antiplatelet Therapy with Drug-Eluting Stents registry. PG - e001683 LID - 10.1161/CIRCINTERVENTIONS.115.001683 [doi] AB - BACKGROUND: Chronic kidney disease (CKD) is associated with increased rates of adverse events after percutaneous coronary intervention. We sought to determine the impact of CKD on platelet reactivity in clopidogrel-treated patients and whether high platelet reactivity (HPR) confers a similar or differential risk for adverse events among patients with CKD and non-CKD. METHODS AND RESULTS: We performed a post hoc analysis of the Assessment of Dual Antiplatelet Therapy With Drug-Eluting Stents (ADAPT-DES) registry, which included 8582 patients undergoing percutaneous coronary intervention with drug-eluting stents and platelet function testing using the VerifyNow assay. We compared HPR and its impact on ischemic and bleeding events >2 years among patients with CKD and non-CKD. Patients with CKD (n=1367) were older, more often female, diabetic, and had lower ejection fraction compared with their non-CKD counterparts (n=7043). Although HPR prevalence increased with worsening renal function in unadjusted analyses, these associations were no longer present after adjustment. Major adverse cardiac event rates at 2 years among those without CKD or HPR, HPR alone, CKD alone, and both CKD and HPR were 9.0%, 11.2%, 13.3%, and 17.5%, respectively (P<0.001). Associations between HPR and adverse events were uniform across CKD strata without evidence of interaction. CONCLUSIONS: HPR is more common among those with versus without CKD, an association that is attributable to confounding risk factors that are more prevalent in CKD. The impact of HPR on ischemic and bleeding events is similar irrespective of CKD status. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00638794. CI - (c) 2015 American Heart Association, Inc. FAU - Baber, Usman AU - Baber U AD - From the Icahn School of Medicine at Mount Sinai, New York (U.B., R.M., G.C.); Cardiovascular Research Foundation, New York (R.M., A.J.K., A.M., G.W., K.X., H.P., G.W.S.); NewYork-Presbyterian/Columbia University Medical Center, New York, NY (A.J.K., A.M., G.W., G.W.S.); Sinai Hospital of Baltimore, MD (P.A.G.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Sanger Heart and Vascular Institute/Carolinas HealthCare System, Charlotte, NC (M.J.R.); Wellmont CVA Heart Institute, Kingsport, TN (D.C.M.); Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, MN (T.D.H.); Lehigh Valley Health Network, Allentown, PA (D.A.C.); Reid Heart Center, FirstHealth of the Carolinas, Pinehurst, NC (P.L.D.); The Ohio State University Wexner Medical Center, Columbus (E.L.M.); and LeBauer Cardiovascular Research Foundation/Cone Health, Greensboro, NC (B.R.B., T.D.S.). FAU - Mehran, Roxana AU - Mehran R AD - From the Icahn School of Medicine at Mount Sinai, New York (U.B., R.M., G.C.); Cardiovascular Research Foundation, New York (R.M., A.J.K., A.M., G.W., K.X., H.P., G.W.S.); NewYork-Presbyterian/Columbia University Medical Center, New York, NY (A.J.K., A.M., G.W., G.W.S.); Sinai Hospital of Baltimore, MD (P.A.G.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Sanger Heart and Vascular Institute/Carolinas HealthCare System, Charlotte, NC (M.J.R.); Wellmont CVA Heart Institute, Kingsport, TN (D.C.M.); Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, MN (T.D.H.); Lehigh Valley Health Network, Allentown, PA (D.A.C.); Reid Heart Center, FirstHealth of the Carolinas, Pinehurst, NC (P.L.D.); The Ohio State University Wexner Medical Center, Columbus (E.L.M.); and LeBauer Cardiovascular Research Foundation/Cone Health, Greensboro, NC (B.R.B., T.D.S.). roxana.mehran@mssm.edu. FAU - Kirtane, Ajay J AU - Kirtane AJ AD - From the Icahn School of Medicine at Mount Sinai, New York (U.B., R.M., G.C.); Cardiovascular Research Foundation, New York (R.M., A.J.K., A.M., G.W., K.X., H.P., G.W.S.); NewYork-Presbyterian/Columbia University Medical Center, New York, NY (A.J.K., A.M., G.W., G.W.S.); Sinai Hospital of Baltimore, MD (P.A.G.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Sanger Heart and Vascular Institute/Carolinas HealthCare System, Charlotte, NC (M.J.R.); Wellmont CVA Heart Institute, Kingsport, TN (D.C.M.); Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, MN (T.D.H.); Lehigh Valley Health Network, Allentown, PA (D.A.C.); Reid Heart Center, FirstHealth of the Carolinas, Pinehurst, NC (P.L.D.); The Ohio State University Wexner Medical Center, Columbus (E.L.M.); and LeBauer Cardiovascular Research Foundation/Cone Health, Greensboro, NC (B.R.B., T.D.S.). FAU - Gurbel, Paul A AU - Gurbel PA AD - From the Icahn School of Medicine at Mount Sinai, New York (U.B., R.M., G.C.); Cardiovascular Research Foundation, New York (R.M., A.J.K., A.M., G.W., K.X., H.P., G.W.S.); NewYork-Presbyterian/Columbia University Medical Center, New York, NY (A.J.K., A.M., G.W., G.W.S.); Sinai Hospital of Baltimore, MD (P.A.G.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Sanger Heart and Vascular Institute/Carolinas HealthCare System, Charlotte, NC (M.J.R.); Wellmont CVA Heart Institute, Kingsport, TN (D.C.M.); Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, MN (T.D.H.); Lehigh Valley Health Network, Allentown, PA (D.A.C.); Reid Heart Center, FirstHealth of the Carolinas, Pinehurst, NC (P.L.D.); The Ohio State University Wexner Medical Center, Columbus (E.L.M.); and LeBauer Cardiovascular Research Foundation/Cone Health, Greensboro, NC (B.R.B., T.D.S.). FAU - Christodoulidis, Georgios AU - Christodoulidis G AD - From the Icahn School of Medicine at Mount Sinai, New York (U.B., R.M., G.C.); Cardiovascular Research Foundation, New York (R.M., A.J.K., A.M., G.W., K.X., H.P., G.W.S.); NewYork-Presbyterian/Columbia University Medical Center, New York, NY (A.J.K., A.M., G.W., G.W.S.); Sinai Hospital of Baltimore, MD (P.A.G.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Sanger Heart and Vascular Institute/Carolinas HealthCare System, Charlotte, NC (M.J.R.); Wellmont CVA Heart Institute, Kingsport, TN (D.C.M.); Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, MN (T.D.H.); Lehigh Valley Health Network, Allentown, PA (D.A.C.); Reid Heart Center, FirstHealth of the Carolinas, Pinehurst, NC (P.L.D.); The Ohio State University Wexner Medical Center, Columbus (E.L.M.); and LeBauer Cardiovascular Research Foundation/Cone Health, Greensboro, NC (B.R.B., T.D.S.). FAU - Maehara, Akiko AU - Maehara A AD - From the Icahn School of Medicine at Mount Sinai, New York (U.B., R.M., G.C.); Cardiovascular Research Foundation, New York (R.M., A.J.K., A.M., G.W., K.X., H.P., G.W.S.); NewYork-Presbyterian/Columbia University Medical Center, New York, NY (A.J.K., A.M., G.W., G.W.S.); Sinai Hospital of Baltimore, MD (P.A.G.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Sanger Heart and Vascular Institute/Carolinas HealthCare System, Charlotte, NC (M.J.R.); Wellmont CVA Heart Institute, Kingsport, TN (D.C.M.); Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, MN (T.D.H.); Lehigh Valley Health Network, Allentown, PA (D.A.C.); Reid Heart Center, FirstHealth of the Carolinas, Pinehurst, NC (P.L.D.); The Ohio State University Wexner Medical Center, Columbus (E.L.M.); and LeBauer Cardiovascular Research Foundation/Cone Health, Greensboro, NC (B.R.B., T.D.S.). FAU - Witzenbichler, Bernhard AU - Witzenbichler B AD - From the Icahn School of Medicine at Mount Sinai, New York (U.B., R.M., G.C.); Cardiovascular Research Foundation, New York (R.M., A.J.K., A.M., G.W., K.X., H.P., G.W.S.); NewYork-Presbyterian/Columbia University Medical Center, New York, NY (A.J.K., A.M., G.W., G.W.S.); Sinai Hospital of Baltimore, MD (P.A.G.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Sanger Heart and Vascular Institute/Carolinas HealthCare System, Charlotte, NC (M.J.R.); Wellmont CVA Heart Institute, Kingsport, TN (D.C.M.); Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, MN (T.D.H.); Lehigh Valley Health Network, Allentown, PA (D.A.C.); Reid Heart Center, FirstHealth of the Carolinas, Pinehurst, NC (P.L.D.); The Ohio State University Wexner Medical Center, Columbus (E.L.M.); and LeBauer Cardiovascular Research Foundation/Cone Health, Greensboro, NC (B.R.B., T.D.S.). FAU - Weisz, Giora AU - Weisz G AD - From the Icahn School of Medicine at Mount Sinai, New York (U.B., R.M., G.C.); Cardiovascular Research Foundation, New York (R.M., A.J.K., A.M., G.W., K.X., H.P., G.W.S.); NewYork-Presbyterian/Columbia University Medical Center, New York, NY (A.J.K., A.M., G.W., G.W.S.); Sinai Hospital of Baltimore, MD (P.A.G.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Sanger Heart and Vascular Institute/Carolinas HealthCare System, Charlotte, NC (M.J.R.); Wellmont CVA Heart Institute, Kingsport, TN (D.C.M.); Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, MN (T.D.H.); Lehigh Valley Health Network, Allentown, PA (D.A.C.); Reid Heart Center, FirstHealth of the Carolinas, Pinehurst, NC (P.L.D.); The Ohio State University Wexner Medical Center, Columbus (E.L.M.); and LeBauer Cardiovascular Research Foundation/Cone Health, Greensboro, NC (B.R.B., T.D.S.). FAU - Rinaldi, Michael J AU - Rinaldi MJ AD - From the Icahn School of Medicine at Mount Sinai, New York (U.B., R.M., G.C.); Cardiovascular Research Foundation, New York (R.M., A.J.K., A.M., G.W., K.X., H.P., G.W.S.); NewYork-Presbyterian/Columbia University Medical Center, New York, NY (A.J.K., A.M., G.W., G.W.S.); Sinai Hospital of Baltimore, MD (P.A.G.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Sanger Heart and Vascular Institute/Carolinas HealthCare System, Charlotte, NC (M.J.R.); Wellmont CVA Heart Institute, Kingsport, TN (D.C.M.); Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, MN (T.D.H.); Lehigh Valley Health Network, Allentown, PA (D.A.C.); Reid Heart Center, FirstHealth of the Carolinas, Pinehurst, NC (P.L.D.); The Ohio State University Wexner Medical Center, Columbus (E.L.M.); and LeBauer Cardiovascular Research Foundation/Cone Health, Greensboro, NC (B.R.B., T.D.S.). FAU - Metzger, D Christopher AU - Metzger DC AD - From the Icahn School of Medicine at Mount Sinai, New York (U.B., R.M., G.C.); Cardiovascular Research Foundation, New York (R.M., A.J.K., A.M., G.W., K.X., H.P., G.W.S.); NewYork-Presbyterian/Columbia University Medical Center, New York, NY (A.J.K., A.M., G.W., G.W.S.); Sinai Hospital of Baltimore, MD (P.A.G.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Sanger Heart and Vascular Institute/Carolinas HealthCare System, Charlotte, NC (M.J.R.); Wellmont CVA Heart Institute, Kingsport, TN (D.C.M.); Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, MN (T.D.H.); Lehigh Valley Health Network, Allentown, PA (D.A.C.); Reid Heart Center, FirstHealth of the Carolinas, Pinehurst, NC (P.L.D.); The Ohio State University Wexner Medical Center, Columbus (E.L.M.); and LeBauer Cardiovascular Research Foundation/Cone Health, Greensboro, NC (B.R.B., T.D.S.). FAU - Henry, Timothy D AU - Henry TD AD - From the Icahn School of Medicine at Mount Sinai, New York (U.B., R.M., G.C.); Cardiovascular Research Foundation, New York (R.M., A.J.K., A.M., G.W., K.X., H.P., G.W.S.); NewYork-Presbyterian/Columbia University Medical Center, New York, NY (A.J.K., A.M., G.W., G.W.S.); Sinai Hospital of Baltimore, MD (P.A.G.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Sanger Heart and Vascular Institute/Carolinas HealthCare System, Charlotte, NC (M.J.R.); Wellmont CVA Heart Institute, Kingsport, TN (D.C.M.); Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, MN (T.D.H.); Lehigh Valley Health Network, Allentown, PA (D.A.C.); Reid Heart Center, FirstHealth of the Carolinas, Pinehurst, NC (P.L.D.); The Ohio State University Wexner Medical Center, Columbus (E.L.M.); and LeBauer Cardiovascular Research Foundation/Cone Health, Greensboro, NC (B.R.B., T.D.S.). FAU - Cox, David A AU - Cox DA AD - From the Icahn School of Medicine at Mount Sinai, New York (U.B., R.M., G.C.); Cardiovascular Research Foundation, New York (R.M., A.J.K., A.M., G.W., K.X., H.P., G.W.S.); NewYork-Presbyterian/Columbia University Medical Center, New York, NY (A.J.K., A.M., G.W., G.W.S.); Sinai Hospital of Baltimore, MD (P.A.G.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Sanger Heart and Vascular Institute/Carolinas HealthCare System, Charlotte, NC (M.J.R.); Wellmont CVA Heart Institute, Kingsport, TN (D.C.M.); Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, MN (T.D.H.); Lehigh Valley Health Network, Allentown, PA (D.A.C.); Reid Heart Center, FirstHealth of the Carolinas, Pinehurst, NC (P.L.D.); The Ohio State University Wexner Medical Center, Columbus (E.L.M.); and LeBauer Cardiovascular Research Foundation/Cone Health, Greensboro, NC (B.R.B., T.D.S.). FAU - Duffy, Peter L AU - Duffy PL AD - From the Icahn School of Medicine at Mount Sinai, New York (U.B., R.M., G.C.); Cardiovascular Research Foundation, New York (R.M., A.J.K., A.M., G.W., K.X., H.P., G.W.S.); NewYork-Presbyterian/Columbia University Medical Center, New York, NY (A.J.K., A.M., G.W., G.W.S.); Sinai Hospital of Baltimore, MD (P.A.G.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Sanger Heart and Vascular Institute/Carolinas HealthCare System, Charlotte, NC (M.J.R.); Wellmont CVA Heart Institute, Kingsport, TN (D.C.M.); Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, MN (T.D.H.); Lehigh Valley Health Network, Allentown, PA (D.A.C.); Reid Heart Center, FirstHealth of the Carolinas, Pinehurst, NC (P.L.D.); The Ohio State University Wexner Medical Center, Columbus (E.L.M.); and LeBauer Cardiovascular Research Foundation/Cone Health, Greensboro, NC (B.R.B., T.D.S.). FAU - Mazzaferri, Ernest L Jr AU - Mazzaferri EL Jr AD - From the Icahn School of Medicine at Mount Sinai, New York (U.B., R.M., G.C.); Cardiovascular Research Foundation, New York (R.M., A.J.K., A.M., G.W., K.X., H.P., G.W.S.); NewYork-Presbyterian/Columbia University Medical Center, New York, NY (A.J.K., A.M., G.W., G.W.S.); Sinai Hospital of Baltimore, MD (P.A.G.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Sanger Heart and Vascular Institute/Carolinas HealthCare System, Charlotte, NC (M.J.R.); Wellmont CVA Heart Institute, Kingsport, TN (D.C.M.); Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, MN (T.D.H.); Lehigh Valley Health Network, Allentown, PA (D.A.C.); Reid Heart Center, FirstHealth of the Carolinas, Pinehurst, NC (P.L.D.); The Ohio State University Wexner Medical Center, Columbus (E.L.M.); and LeBauer Cardiovascular Research Foundation/Cone Health, Greensboro, NC (B.R.B., T.D.S.). FAU - Xu, Ke AU - Xu K AD - From the Icahn School of Medicine at Mount Sinai, New York (U.B., R.M., G.C.); Cardiovascular Research Foundation, New York (R.M., A.J.K., A.M., G.W., K.X., H.P., G.W.S.); NewYork-Presbyterian/Columbia University Medical Center, New York, NY (A.J.K., A.M., G.W., G.W.S.); Sinai Hospital of Baltimore, MD (P.A.G.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Sanger Heart and Vascular Institute/Carolinas HealthCare System, Charlotte, NC (M.J.R.); Wellmont CVA Heart Institute, Kingsport, TN (D.C.M.); Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, MN (T.D.H.); Lehigh Valley Health Network, Allentown, PA (D.A.C.); Reid Heart Center, FirstHealth of the Carolinas, Pinehurst, NC (P.L.D.); The Ohio State University Wexner Medical Center, Columbus (E.L.M.); and LeBauer Cardiovascular Research Foundation/Cone Health, Greensboro, NC (B.R.B., T.D.S.). FAU - Parise, Helen AU - Parise H AD - From the Icahn School of Medicine at Mount Sinai, New York (U.B., R.M., G.C.); Cardiovascular Research Foundation, New York (R.M., A.J.K., A.M., G.W., K.X., H.P., G.W.S.); NewYork-Presbyterian/Columbia University Medical Center, New York, NY (A.J.K., A.M., G.W., G.W.S.); Sinai Hospital of Baltimore, MD (P.A.G.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Sanger Heart and Vascular Institute/Carolinas HealthCare System, Charlotte, NC (M.J.R.); Wellmont CVA Heart Institute, Kingsport, TN (D.C.M.); Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, MN (T.D.H.); Lehigh Valley Health Network, Allentown, PA (D.A.C.); Reid Heart Center, FirstHealth of the Carolinas, Pinehurst, NC (P.L.D.); The Ohio State University Wexner Medical Center, Columbus (E.L.M.); and LeBauer Cardiovascular Research Foundation/Cone Health, Greensboro, NC (B.R.B., T.D.S.). FAU - Brodie, Bruce R AU - Brodie BR AD - From the Icahn School of Medicine at Mount Sinai, New York (U.B., R.M., G.C.); Cardiovascular Research Foundation, New York (R.M., A.J.K., A.M., G.W., K.X., H.P., G.W.S.); NewYork-Presbyterian/Columbia University Medical Center, New York, NY (A.J.K., A.M., G.W., G.W.S.); Sinai Hospital of Baltimore, MD (P.A.G.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Sanger Heart and Vascular Institute/Carolinas HealthCare System, Charlotte, NC (M.J.R.); Wellmont CVA Heart Institute, Kingsport, TN (D.C.M.); Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, MN (T.D.H.); Lehigh Valley Health Network, Allentown, PA (D.A.C.); Reid Heart Center, FirstHealth of the Carolinas, Pinehurst, NC (P.L.D.); The Ohio State University Wexner Medical Center, Columbus (E.L.M.); and LeBauer Cardiovascular Research Foundation/Cone Health, Greensboro, NC (B.R.B., T.D.S.). FAU - Stuckey, Thomas D AU - Stuckey TD AD - From the Icahn School of Medicine at Mount Sinai, New York (U.B., R.M., G.C.); Cardiovascular Research Foundation, New York (R.M., A.J.K., A.M., G.W., K.X., H.P., G.W.S.); NewYork-Presbyterian/Columbia University Medical Center, New York, NY (A.J.K., A.M., G.W., G.W.S.); Sinai Hospital of Baltimore, MD (P.A.G.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Sanger Heart and Vascular Institute/Carolinas HealthCare System, Charlotte, NC (M.J.R.); Wellmont CVA Heart Institute, Kingsport, TN (D.C.M.); Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, MN (T.D.H.); Lehigh Valley Health Network, Allentown, PA (D.A.C.); Reid Heart Center, FirstHealth of the Carolinas, Pinehurst, NC (P.L.D.); The Ohio State University Wexner Medical Center, Columbus (E.L.M.); and LeBauer Cardiovascular Research Foundation/Cone Health, Greensboro, NC (B.R.B., T.D.S.). FAU - Stone, Gregg W AU - Stone GW AD - From the Icahn School of Medicine at Mount Sinai, New York (U.B., R.M., G.C.); Cardiovascular Research Foundation, New York (R.M., A.J.K., A.M., G.W., K.X., H.P., G.W.S.); NewYork-Presbyterian/Columbia University Medical Center, New York, NY (A.J.K., A.M., G.W., G.W.S.); Sinai Hospital of Baltimore, MD (P.A.G.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Shaare Zedek Medical Center, Jerusalem, Israel (G.W.); Sanger Heart and Vascular Institute/Carolinas HealthCare System, Charlotte, NC (M.J.R.); Wellmont CVA Heart Institute, Kingsport, TN (D.C.M.); Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, MN (T.D.H.); Lehigh Valley Health Network, Allentown, PA (D.A.C.); Reid Heart Center, FirstHealth of the Carolinas, Pinehurst, NC (P.L.D.); The Ohio State University Wexner Medical Center, Columbus (E.L.M.); and LeBauer Cardiovascular Research Foundation/Cone Health, Greensboro, NC (B.R.B., T.D.S.). LA - eng SI - ClinicalTrials.gov/NCT00638794 PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't PL - United States TA - Circ Cardiovasc Interv JT - Circulation. Cardiovascular interventions JID - 101499602 RN - 0 (Platelet Aggregation Inhibitors) SB - IM CIN - Circ Cardiovasc Interv. 2015 Jun;8(6):e002760. doi: 10.1161/CIRCINTERVENTIONS.115.002760. PMID: 26056251 MH - Aged MH - Aged, 80 and over MH - Blood Platelets/physiology MH - Coronary Artery Disease/*complications/drug therapy/surgery MH - Drug-Eluting Stents MH - Female MH - Hemorrhage/*etiology MH - Humans MH - Ischemia/*etiology MH - Male MH - Middle Aged MH - Percutaneous Coronary Intervention/*adverse effects MH - Platelet Aggregation Inhibitors/therapeutic use MH - Platelet Function Tests MH - Prospective Studies MH - *Registries MH - Renal Insufficiency, Chronic/*blood/complications OTO - NOTNLM OT - blood platelet OT - kidney OT - stents EDAT- 2015/06/10 06:00 MHDA- 2016/03/11 06:00 CRDT- 2015/06/10 06:00 PHST- 2015/06/10 06:00 [entrez] PHST- 2015/06/10 06:00 [pubmed] PHST- 2016/03/11 06:00 [medline] AID - CIRCINTERVENTIONS.115.001683 [pii] AID - 10.1161/CIRCINTERVENTIONS.115.001683 [doi] PST - ppublish SO - Circ Cardiovasc Interv. 2015 Jun;8(6):e001683. doi: 10.1161/CIRCINTERVENTIONS.115.001683. PMID- 26048382 OWN - NLM STAT- MEDLINE DCOM- 20160323 LR - 20150622 IS - 1874-1754 (Electronic) IS - 0167-5273 (Linking) VI - 195 DP - 2015 Sep 15 TI - Continuous intravenous infusion of nicorandil for 4 hours before and 24 hours after percutaneous coronary intervention protects against contrast-induced nephropathy in patients with poor renal function. PG - 228-34 LID - S0167-5273(15)01135-3 [pii] LID - 10.1016/j.ijcard.2015.05.078 [doi] AB - BACKGROUND: We conducted a prospective randomized trial to assess the protective effect of continuous intravenous infusion of nicorandil against contrast-induced nephropathy (CIN) in patients with poor renal function. METHODS AND RESULTS: We randomly assigned 213 patients who would subsequently undergo elective percutaneous coronary intervention (PCI) and who had a high serum cystatin C level to a saline group (n=107) or a nicorandil group (n=106, nicorandil infused in addition to saline for 4h before and 24h after PCI). There were no significant differences in baseline characteristics between the two groups. However, the average percent increases in serum creatinine and cystatin C following PCI were significantly smaller in the nicorandil group than the saline group. Likewise, the average percent decline in the estimated glomerular filtration rate was smaller in the nicorandil group. Correspondingly, the incidence of CIN was dramatically lower in the nicorandil group than the saline group (2.0% vs. 10.7%, p<0.02). Univariate regression analysis revealed nicorandil treatment to be the only significant predictor of CIN development (odds ratio: 0.173, 95% confidence interval: 0.037-0.812, p=0.026). CONCLUSIONS: Nicorandil strongly prevents CIN in patients with poor renal function undergoing PCI. CI - Copyright (c) 2015 Elsevier Ireland Ltd. All rights reserved. FAU - Nawa, Takahide AU - Nawa T AD - Department of Cardiology, Respirology, and Nephrology, Gifu University Graduate School of Medicine, Gifu, Japan. FAU - Nishigaki, Kazuhiko AU - Nishigaki K AD - Department of Cardiology, Respirology, and Nephrology, Gifu University Graduate School of Medicine, Gifu, Japan. Electronic address: nissy@gifu-u.ac.jp. FAU - Kinomura, Yujiro AU - Kinomura Y AD - Department of Cardiology, Respirology, and Nephrology, Gifu University Graduate School of Medicine, Gifu, Japan. FAU - Tanaka, Toshiki AU - Tanaka T AD - Department of Cardiology, Respirology, and Nephrology, Gifu University Graduate School of Medicine, Gifu, Japan. FAU - Yamada, Yoshihisa AU - Yamada Y AD - Department of Cardiology, Respirology, and Nephrology, Gifu University Graduate School of Medicine, Gifu, Japan. FAU - Kawasaki, Masanori AU - Kawasaki M AD - Department of Cardiology, Respirology, and Nephrology, Gifu University Graduate School of Medicine, Gifu, Japan. FAU - Minatoguchi, Shinya AU - Minatoguchi S AD - Department of Cardiology, Respirology, and Nephrology, Gifu University Graduate School of Medicine, Gifu, Japan. LA - eng PT - Journal Article PT - Randomized Controlled Trial DEP - 20150522 PL - Netherlands TA - Int J Cardiol JT - International journal of cardiology JID - 8200291 RN - 0 (Contrast Media) RN - 0 (Cystatin C) RN - 0 (Protective Agents) RN - 260456HAM0 (Nicorandil) RN - AYI8EX34EU (Creatinine) SB - IM MH - *Acute Kidney Injury/blood/chemically induced/diagnosis/prevention & control MH - Aged MH - Contrast Media/administration & dosage/*adverse effects MH - Coronary Angiography/*adverse effects/methods MH - *Coronary Disease/complications/surgery MH - Creatinine/blood MH - Cystatin C/blood MH - Female MH - Glomerular Filtration Rate MH - Humans MH - Infusions, Intravenous MH - Kidney Function Tests/methods MH - Male MH - Middle Aged MH - Nicorandil/*administration & dosage MH - *Percutaneous Coronary Intervention/adverse effects/methods MH - Perioperative Care/methods MH - *Postoperative Complications/blood/diagnosis/prevention & control MH - Protective Agents/administration & dosage MH - Regression Analysis MH - *Renal Insufficiency, Chronic/complications/diagnosis MH - Treatment Outcome OTO - NOTNLM OT - Contrast-induced nephropathy OT - Nicorandil OT - Prognosis OT - Randomized trial EDAT- 2015/06/07 06:00 MHDA- 2016/03/24 06:00 CRDT- 2015/06/07 06:00 PHST- 2014/12/27 00:00 [received] PHST- 2015/04/27 00:00 [revised] PHST- 2015/05/14 00:00 [accepted] PHST- 2015/06/07 06:00 [entrez] PHST- 2015/06/07 06:00 [pubmed] PHST- 2016/03/24 06:00 [medline] AID - S0167-5273(15)01135-3 [pii] AID - 10.1016/j.ijcard.2015.05.078 [doi] PST - ppublish SO - Int J Cardiol. 2015 Sep 15;195:228-34. doi: 10.1016/j.ijcard.2015.05.078. Epub 2015 May 22. PMID- 25978978 OWN - NLM STAT- MEDLINE DCOM- 20150825 LR - 20150619 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 116 IP - 2 DP - 2015 Jul 15 TI - A risk score for predicting 1-year mortality in patients >/=75 years of age presenting with non-ST-elevation acute coronary syndrome. PG - 208-13 LID - S0002-9149(15)01110-8 [pii] LID - 10.1016/j.amjcard.2015.04.015 [doi] AB - Approximately 1/3 of patients with non-ST-segment elevation (NSTE) acute coronary syndromes (ACS) are >/=75 years of age. Risk stratification in these patients is generally difficult because supporting evidence is scarce. The investigators developed and validated a simple risk prediction score for 1-year mortality in patients >/=75 years of age presenting with NSTE ACS. The derivation cohort was the Italian Elderly ACS trial, which included 313 patients with NSTE ACS aged >/=75 years. A logistic regression model was developed to predict 1-year mortality. The validation cohort was a registry cohort of 332 patients with NSTE ACS meeting the same inclusion criteria as for the Italian Elderly ACS trial but excluded from the trial for any reason. The risk score included 5 statistically significant covariates: previous vascular event, hemoglobin level, estimated glomerular filtration rate, ischemic electrocardiographic changes, and elevated troponin level. The model allowed a maximum score of 6. The score demonstrated a good discriminating power (C statistic = 0.739) and calibration, even among subgroups defined by gender and age. When validated in the registry cohort, the scoring system confirmed a strong association with the risk for all-cause death. Moreover, a score >/=3 (the highest baseline risk group) identified a subset of patients with NSTE ACS most likely to benefit from an invasive approach. In conclusion, the risk for 1-year mortality in patients >/=75 years of age with NSTE ACS is substantial and can be predicted through a score that can be easily derived at the bedside at hospital presentation. The score may help in guiding treatment strategy. CI - Copyright (c) 2015 Elsevier Inc. All rights reserved. FAU - Angeli, Fabio AU - Angeli F AD - Dipartimento di Cardiologia, Ospedale S. M. Della Misericordia, Perugia, Italy. Electronic address: fangeli@cardionet.it. FAU - Cavallini, Claudio AU - Cavallini C AD - Dipartimento di Cardiologia, Ospedale S. M. Della Misericordia, Perugia, Italy. FAU - Verdecchia, Paolo AU - Verdecchia P AD - Dipartimento di Medicina Interna, Ospedale di Assisi, Assisi, Italy. FAU - Morici, Nuccia AU - Morici N AD - Dipartimento cardiotoracovascolare, Ospedale Niguarda Ca Granda, Milano, Italy. FAU - Del Pinto, Maurizio AU - Del Pinto M AD - Dipartimento di Cardiologia, Ospedale S. M. Della Misericordia, Perugia, Italy. FAU - Petronio, Anna Sonia AU - Petronio AS AD - Dipartimento cardiotoracovascolare, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy. FAU - Antonicelli, Roberto AU - Antonicelli R AD - Dipartimento di Cardiologia, INRCA, Ancona, Italy. FAU - Murena, Ernesto AU - Murena E AD - Dipartimento di Cardiologia, Ospedale S. Maria Delle Grazie, Naples, Italy. FAU - Bossi, Irene AU - Bossi I AD - Dipartimento cardiotoracovascolare, Ospedale Niguarda Ca Granda, Milano, Italy. FAU - De Servi, Stefano AU - De Servi S AD - Dipartimento cardiotoracovascolare, IRCCS Policlinico S. Matteo, Pavia, Italy. FAU - Savonitto, Stefano AU - Savonitto S AD - Dipartimento Cardiovascolare, Ospedale A. Manzoni, Lecco, Italy. LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20150418 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM MH - Acute Coronary Syndrome/diagnosis/*mortality MH - Age Factors MH - Aged MH - Aged, 80 and over MH - Cause of Death/trends MH - Coronary Angiography MH - *Electrocardiography MH - Female MH - Follow-Up Studies MH - Hospital Mortality/trends MH - Humans MH - Italy/epidemiology MH - Male MH - Prognosis MH - *Registries MH - Risk Assessment/*methods MH - Survival Rate/trends EDAT- 2015/05/17 06:00 MHDA- 2015/08/26 06:00 CRDT- 2015/05/17 06:00 PHST- 2015/03/12 00:00 [received] PHST- 2015/04/09 00:00 [revised] PHST- 2015/04/09 00:00 [accepted] PHST- 2015/05/17 06:00 [entrez] PHST- 2015/05/17 06:00 [pubmed] PHST- 2015/08/26 06:00 [medline] AID - S0002-9149(15)01110-8 [pii] AID - 10.1016/j.amjcard.2015.04.015 [doi] PST - ppublish SO - Am J Cardiol. 2015 Jul 15;116(2):208-13. doi: 10.1016/j.amjcard.2015.04.015. Epub 2015 Apr 18. PMID- 25965624 OWN - NLM STAT- MEDLINE DCOM- 20160301 LR - 20150608 IS - 1874-1754 (Electronic) IS - 0167-5273 (Linking) VI - 191 DP - 2015 Jul 15 TI - Prognostic impact of established and novel renal function biomarkers in myocardial infarction with cardiogenic shock: A biomarker substudy of the IABP-SHOCK II-trial. PG - 159-66 LID - S0167-5273(15)00976-6 [pii] LID - 10.1016/j.ijcard.2015.04.242 [doi] AB - BACKGROUND: In cardiogenic shock (CS) renal dysfunction is an important parameter of inadequate end-organ perfusion and an independent predictor of adverse outcome. Early detection of renal dysfunction is therefore important, and novel biomarkers such as Neutrophil Gelatinase-Associated Lipocalin (NGAL), Kidney Injury Molecule 1 (KIM1) and Cystatin C (CysC) have been suggested. However, in high-risk CS patients their role for assessing renal injury has not yet been investigated in comparison to the most widely used serum creatinine. METHODS: This predefined substudy included 190 patients of the randomized Intraaortic Balloon Pump in Cardiogenic Shock II (IABP-SHOCK II)-trial. Blood samples were collected directly during primary percutaneous coronary intervention, one day and two days after randomization. The primary endpoint for outcome assessment was 1 year mortality. RESULTS: Creatinine, NGAL and KIM-1 were significantly higher in non-survivors in comparison to survivors over time in ANOVA (p<0.001; p=0.002 and p=0.04, respectively). In contrast, CysC levels were not associated with the primary endpoint (p=0.15). Receiver operator characteristics revealed that creatinine at any time point had the best predictive value for 1 year mortality. This was also true when comparing creatinine to different equations for glomerular filtration rate. In multivariable Cox-regression analysis creatinine remained the only significant independent predictor of kidney biomarkers of time to death during the first year. CONCLUSIONS: Assessment of novel biomarkers such as CysC, NGAL and KIM-1 or calculation of glomerular filtration rate provide no additional prognostic information in patients with CS complicating acute myocardial infarction in comparison to creatinine. CI - Copyright (c) 2015 Elsevier Ireland Ltd. All rights reserved. FAU - Fuernau, Georg AU - Fuernau G AD - Department of Internal Medicine/Cardiology, University of Leipzig - Heart Center, Leipzig, Germany. Electronic address: georg.fuernau@medizin.uni-leipzig.de. FAU - Poenisch, Christian AU - Poenisch C AD - Department of Internal Medicine/Cardiology, University of Leipzig - Heart Center, Leipzig, Germany. FAU - Eitel, Ingo AU - Eitel I AD - Department of Internal Medicine II, University Heart Center Lubeck, Lubeck, Germany. FAU - Denks, Daniel AU - Denks D AD - Department of Internal Medicine/Cardiology, University of Leipzig - Heart Center, Leipzig, Germany. FAU - de Waha, Suzanne AU - de Waha S AD - Department of Cardiology/Angiology, Bad Segeberg Heart Center, Bad Segeberg, Germany. FAU - Poss, Janine AU - Poss J AD - Department of Internal Medicine II, University Heart Center Lubeck, Lubeck, Germany. FAU - Heine, Gunnar H AU - Heine GH AD - Internal Medicine IV - Nephrology and Hypertension, Saarland University, Homburg, Germany. FAU - Desch, Steffen AU - Desch S AD - Department of Internal Medicine II, University Heart Center Lubeck, Lubeck, Germany. FAU - Schuler, Gerhard AU - Schuler G AD - Department of Internal Medicine/Cardiology, University of Leipzig - Heart Center, Leipzig, Germany. FAU - Adams, Volker AU - Adams V AD - Department of Internal Medicine/Cardiology, University of Leipzig - Heart Center, Leipzig, Germany. FAU - Werdan, Karl AU - Werdan K AD - Department of Medicine III, Martin Luther University Halle-Wittenberg, Halle/Saale, Germany. FAU - Zeymer, Uwe AU - Zeymer U AD - Medizinische Klinik B, Klinikum Ludwigshafen and Institut fur Herzinfarktforschung, Ludwigshafen, Germany. FAU - Thiele, Holger AU - Thiele H AD - Department of Internal Medicine II, University Heart Center Lubeck, Lubeck, Germany. LA - eng PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20150501 PL - Netherlands TA - Int J Cardiol JT - International journal of cardiology JID - 8200291 RN - 0 (Biomarkers) SB - IM MH - Acute Kidney Injury/*blood/etiology/physiopathology MH - Aged MH - Aged, 80 and over MH - Biomarkers/*blood MH - Female MH - Follow-Up Studies MH - Glomerular Filtration Rate MH - Humans MH - Intra-Aortic Balloon Pumping/*methods MH - Male MH - Middle Aged MH - Myocardial Infarction/*blood/complications MH - Prognosis MH - Retrospective Studies MH - Severity of Illness Index MH - Shock, Cardiogenic/*blood/etiology/therapy OTO - NOTNLM OT - Acute kidney injury OT - Biomarkers OT - Cardiogenic shock OT - Myocardial infarction EDAT- 2015/05/13 06:00 MHDA- 2016/03/02 06:00 CRDT- 2015/05/13 06:00 PHST- 2015/01/08 00:00 [received] PHST- 2015/03/19 00:00 [revised] PHST- 2015/04/30 00:00 [accepted] PHST- 2015/05/13 06:00 [entrez] PHST- 2015/05/13 06:00 [pubmed] PHST- 2016/03/02 06:00 [medline] AID - S0167-5273(15)00976-6 [pii] AID - 10.1016/j.ijcard.2015.04.242 [doi] PST - ppublish SO - Int J Cardiol. 2015 Jul 15;191:159-66. doi: 10.1016/j.ijcard.2015.04.242. Epub 2015 May 1. PMID- 25940521 OWN - NLM STAT- MEDLINE DCOM- 20160225 LR - 20191210 IS - 1941-7632 (Electronic) IS - 1941-7640 (Linking) VI - 8 IP - 5 DP - 2015 May TI - Incremental Value of Platelet Reactivity Over a Risk Score of Clinical and Procedural Variables in Predicting Bleeding After Percutaneous Coronary Intervention via the Femoral Approach: Development and Validation of a New Bleeding Risk Score. LID - e002106 [pii] LID - 10.1161/CIRCINTERVENTIONS.114.002106 [doi] AB - BACKGROUND: Growing evidence suggests that platelet reactivity (PR) may predict bleeding. We investigate the incremental value of PR in predicting bleeding after percutaneous coronary intervention (PCI) via the femoral approach over a validated bleeding risk score (BRS) of clinical and procedural variables. METHODS AND RESULTS: A total of 800 patients undergoing elective PCI via the femoral approach were included. PR was measured before PCI with the VerifyNow P2Y12 assay and low PR was defined as a P2Y12 reaction unit value 0.7 for all definitions). Discriminatory power of BRS-PR (AUC = 0.809 for thrombolysis in myocardial infarction bleeding; AUC = 0.814 for Bleeding Academic Research Consortium class >/= 2 bleeding; AUC = 0.708 for Bleeding Academic Research Consortium class >/= 3 bleeding; and AUC = 0.813 for REPLACE-2 bleeding) was significantly higher than that of BRS alone (P < 0.001 for all bleeding definitions). In the validation set, BRS-PR showed higher discriminatory power for thrombolysis in myocardial infarction bleeding than BRS alone (AUC = 0.788 versus 0.709; P = 0.036). CONCLUSIONS: PR has incremental predictive value on bleeding events after elective PCI via the femoral approach over a validated risk score of clinical and procedural variables. A risk score including PR yields significantly better prognostic performance compared with the original BRS. CI - (c) 2015 American Heart Association, Inc. FAU - Mangiacapra, Fabio AU - Mangiacapra F AD - From the Department of Cardiovascular Sciences, Campus Bio-Medico University, Rome, Italy (F.M., E.R., C.D., G.P., V.V., G.D.S.); and Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium (E.B., A.P., B.D.B., W.W.). f.mangiacapra@unicampus.it g.disciascio@unicampus.it. FAU - Ricottini, Elisabetta AU - Ricottini E AD - From the Department of Cardiovascular Sciences, Campus Bio-Medico University, Rome, Italy (F.M., E.R., C.D., G.P., V.V., G.D.S.); and Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium (E.B., A.P., B.D.B., W.W.). FAU - Barbato, Emanuele AU - Barbato E AD - From the Department of Cardiovascular Sciences, Campus Bio-Medico University, Rome, Italy (F.M., E.R., C.D., G.P., V.V., G.D.S.); and Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium (E.B., A.P., B.D.B., W.W.). FAU - Demartini, Chiara AU - Demartini C AD - From the Department of Cardiovascular Sciences, Campus Bio-Medico University, Rome, Italy (F.M., E.R., C.D., G.P., V.V., G.D.S.); and Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium (E.B., A.P., B.D.B., W.W.). FAU - Peace, Aaron AU - Peace A AD - From the Department of Cardiovascular Sciences, Campus Bio-Medico University, Rome, Italy (F.M., E.R., C.D., G.P., V.V., G.D.S.); and Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium (E.B., A.P., B.D.B., W.W.). FAU - Patti, Giuseppe AU - Patti G AD - From the Department of Cardiovascular Sciences, Campus Bio-Medico University, Rome, Italy (F.M., E.R., C.D., G.P., V.V., G.D.S.); and Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium (E.B., A.P., B.D.B., W.W.). FAU - Vizzi, Vincenzo AU - Vizzi V AD - From the Department of Cardiovascular Sciences, Campus Bio-Medico University, Rome, Italy (F.M., E.R., C.D., G.P., V.V., G.D.S.); and Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium (E.B., A.P., B.D.B., W.W.). FAU - De Bruyne, Bernard AU - De Bruyne B AD - From the Department of Cardiovascular Sciences, Campus Bio-Medico University, Rome, Italy (F.M., E.R., C.D., G.P., V.V., G.D.S.); and Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium (E.B., A.P., B.D.B., W.W.). FAU - Wijns, William AU - Wijns W AD - From the Department of Cardiovascular Sciences, Campus Bio-Medico University, Rome, Italy (F.M., E.R., C.D., G.P., V.V., G.D.S.); and Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium (E.B., A.P., B.D.B., W.W.). FAU - Di Sciascio, Germano AU - Di Sciascio G AD - From the Department of Cardiovascular Sciences, Campus Bio-Medico University, Rome, Italy (F.M., E.R., C.D., G.P., V.V., G.D.S.); and Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium (E.B., A.P., B.D.B., W.W.). f.mangiacapra@unicampus.it g.disciascio@unicampus.it. LA - eng PT - Journal Article PT - Validation Study PL - United States TA - Circ Cardiovasc Interv JT - Circulation. Cardiovascular interventions JID - 101499602 RN - 0 (Platelet Aggregation Inhibitors) RN - 0 (Receptors, Purinergic P2Y12) SB - IM MH - Aged MH - Angioplasty, Balloon, Coronary/*adverse effects MH - Blood Platelets/*physiology MH - Coronary Artery Disease/blood/*therapy MH - Female MH - *Femoral Artery MH - Humans MH - Male MH - Middle Aged MH - Platelet Aggregation MH - Platelet Aggregation Inhibitors/administration & dosage MH - *Platelet Function Tests MH - Postoperative Hemorrhage/*diagnosis/etiology MH - Prospective Studies MH - Receptors, Purinergic P2Y12/blood MH - Risk Factors OTO - NOTNLM OT - hemorrhage OT - percutaneous coronary intervention OT - platelet reactivity EDAT- 2015/05/06 06:00 MHDA- 2016/02/26 06:00 CRDT- 2015/05/06 06:00 PHST- 2015/05/06 06:00 [entrez] PHST- 2015/05/06 06:00 [pubmed] PHST- 2016/02/26 06:00 [medline] AID - CIRCINTERVENTIONS.114.002106 [pii] AID - 10.1161/CIRCINTERVENTIONS.114.002106 [doi] PST - ppublish SO - Circ Cardiovasc Interv. 2015 May;8(5):e002106. doi: 10.1161/CIRCINTERVENTIONS.114.002106. PMID- 25917561 OWN - NLM STAT- MEDLINE DCOM- 20160325 LR - 20181202 IS - 1879-2472 (Electronic) IS - 0049-3848 (Linking) VI - 135 IP - 6 DP - 2015 Jun TI - Selection of P2Y12 antagonist, treatment initiation, and predictors of high on-treatment platelet reactivity in a "Real World" registry. PG - 1093-9 LID - S0049-3848(15)00169-3 [pii] LID - 10.1016/j.thromres.2015.04.014 [doi] AB - OBJECTIVE: The present study aimed to compare characteristics related to selection of a P2Y(1)(2) antagonist, investigate initiation of therapy with new-generation drugs, and identify predictors of high on-treatment platelet reactivity (HTPR) in patients with acute coronary syndrome treated with stent percutaneous coronary intervention (PCI). METHODS AND RESULTS: Data from 589 patients in the LAPCOR (Laboratory AntiPlatelet efficacy and Clinical Outcome Registry; ClinicalTrials.gov Identifier: NCT02264912) registry was analyzed. P2Y(1)(2) receptor antagonist efficacy was measured by VASP phosphorylation 24 +/- 4 hours after a loading dose of clopidogrel (600 mg, N=407), prasugrel (60 mg, N=106), or ticagrelor (180 mg, N=76) and expressed by platelet reactivity index (PRI). HTPR was defined as PRI >/=50%. Patients treated with prasugrel were significantly younger and had significantly higher hemoglobin levels than those who received clopidogrel or ticagrelor, while chronic kidney disease was significantly more prevalent in the ticagrelor group. Almost all invasively managed patients given new-generation drugs received a loading dose after coronary angiography. Mean residual PRI and HTPR were significantly higher after clopidogrel (44.2 +/- 23.1% and 42.2%, respectively) vs. prasugrel (17.7 +/- 18.0% and 9.4%, respectively) or ticagrelor (18.8 +/- 17.0% and 7.9%, respectively; all p<0.001). Among multiple variables tested, HTPR in patients treated with the new agents significantly related only to platelet count (p=0.014) and mean platelet volume (p=0.03). CONCLUSION: Safety is the most important aspect under consideration in choosing new agents for an individual patient. Other than platelet count and mean platelet volume, factors known as predictors of higher platelet reactivity, did not influence the efficacy of new-generation P2Y(1)(2) receptor antagonists. CI - Copyright (c) 2015 Elsevier Ltd. All rights reserved. FAU - Motovska, Zuzana AU - Motovska Z AD - Third Medical Faculty Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic. Electronic address: zuzana.motovska@fnkv.cz. FAU - Ondrakova, Martina AU - Ondrakova M AD - Third Medical Faculty Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic. FAU - Bednar, Frantisek AU - Bednar F AD - Third Medical Faculty Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic. FAU - Knot, Jiri AU - Knot J AD - Third Medical Faculty Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic. FAU - Ulman, Jaroslav AU - Ulman J AD - Third Medical Faculty Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic. FAU - Maly, Marek AU - Maly M AD - National Institute of Public Health, Prague, Czech Republic. LA - eng SI - ClinicalTrials.gov/NCT02264912 PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20150416 PL - United States TA - Thromb Res JT - Thrombosis research JID - 0326377 RN - 0 (P2RY12 protein, human) RN - 0 (Purinergic P2Y Receptor Antagonists) RN - 0 (Receptors, Purinergic P2Y12) RN - A74586SNO7 (Clopidogrel) RN - G89JQ59I13 (Prasugrel Hydrochloride) RN - GLH0314RVC (Ticagrelor) RN - K72T3FS567 (Adenosine) RN - OM90ZUW7M1 (Ticlopidine) SB - IM MH - Acute Coronary Syndrome/*drug therapy MH - Adenosine/analogs & derivatives/therapeutic use MH - Aged MH - Blood Platelets/drug effects MH - Clinical Trials as Topic MH - Clopidogrel MH - Coronary Angiography/methods MH - Drug Design MH - Female MH - Humans MH - Male MH - Middle Aged MH - Patient Admission MH - Percutaneous Coronary Intervention MH - Platelet Count MH - Prasugrel Hydrochloride/therapeutic use MH - Precision Medicine MH - Prospective Studies MH - Purinergic P2Y Receptor Antagonists/*chemistry MH - Receptors, Purinergic P2Y12/*chemistry MH - Registries MH - Ticagrelor MH - Ticlopidine/analogs & derivatives/therapeutic use OTO - NOTNLM OT - High residual platelet reactivity OT - P2Y(12) receptor antagonist OT - Platelet count OT - Platelet volume OT - Predictors OT - Selection EDAT- 2015/04/29 06:00 MHDA- 2016/03/26 06:00 CRDT- 2015/04/29 06:00 PHST- 2015/01/28 00:00 [received] PHST- 2015/03/19 00:00 [revised] PHST- 2015/04/06 00:00 [accepted] PHST- 2015/04/29 06:00 [entrez] PHST- 2015/04/29 06:00 [pubmed] PHST- 2016/03/26 06:00 [medline] AID - S0049-3848(15)00169-3 [pii] AID - 10.1016/j.thromres.2015.04.014 [doi] PST - ppublish SO - Thromb Res. 2015 Jun;135(6):1093-9. doi: 10.1016/j.thromres.2015.04.014. Epub 2015 Apr 16. PMID- 25912390 OWN - NLM STAT- MEDLINE DCOM- 20160126 LR - 20150427 IS - 1969-6213 (Electronic) IS - 1774-024X (Linking) VI - 10 IP - 12 DP - 2015 Apr TI - Five-year outcomes of staged percutaneous coronary intervention in the SYNTAX study. PG - 1402-8 LID - 20140303-01 [pii] LID - 10.4244/EIJV10I12A244 [doi] AB - AIMS: The SYNTAX study compared PCI with TAXUS Express stents to CABG for the treatment of de novo 3-vessel and/or left main coronary disease. This study aimed to determine patient characteristics and five-year outcomes after a staged PCI strategy compared to single-session PCI. METHODS AND RESULTS: In the SYNTAX trial, staged procedures were discouraged but were allowed within 72 hours or, if renal insufficiency or contrast-induced nephropathy occurred, within 14 days (mean 9.8+/-18.1 days post initial procedure). A total of 125 (14%) patients underwent staged PCI. These patients had greater disease severity and/or required a more complex procedure. MACCE was significantly increased in staged patients (48.1% vs. 35.5%, p=0.004), as was the composite of death/stroke/MI (32.2% vs. 19%, p=0.0007). Individually, cardiac death and stroke occurred more frequently in the staged PCI group (p=0.03). Repeat revascularisation was significantly higher in staged patients (32.8% vs 24.8%, p=0.035), as was stent thrombosis (10.9% vs. 4.7%, p=0.005). CONCLUSIONS: There is a higher incidence of MACCE in patients undergoing staged compared to single-session PCI for 3-vessel and/or left main disease over the first five years of follow-up. However, these patients had more comorbidities and more diffuse disease. FAU - Watkins, Stuart AU - Watkins S AD - Golden Jubilee National Hospital, Glasgow, United Kingdom. FAU - Oldroyd, Keith G AU - Oldroyd KG FAU - Preda, Istvan AU - Preda I FAU - Holmes, David R Jr AU - Holmes DR Jr FAU - Colombo, Antonio AU - Colombo A FAU - Morice, Marie-Claude AU - Morice MC FAU - Leadley, Katrin AU - Leadley K FAU - Dawkins, Keith D AU - Dawkins KD FAU - Mohr, Friedrich W AU - Mohr FW FAU - Serruys, Patrick W AU - Serruys PW FAU - Feldman, Ted E AU - Feldman TE LA - eng PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - France TA - EuroIntervention JT - EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology JID - 101251040 SB - IM MH - Aged MH - Cardiovascular Diseases/mortality MH - Case-Control Studies MH - Coronary Artery Bypass MH - Coronary Stenosis/*surgery MH - *Drug-Eluting Stents MH - Female MH - Humans MH - Incidence MH - Longitudinal Studies MH - Male MH - Middle Aged MH - Myocardial Infarction/epidemiology MH - Percutaneous Coronary Intervention/*methods MH - Reoperation MH - Severity of Illness Index MH - Stroke/epidemiology MH - Time Factors MH - Treatment Outcome EDAT- 2015/04/29 06:00 MHDA- 2016/01/27 06:00 CRDT- 2015/04/28 06:00 PHST- 2015/04/28 06:00 [entrez] PHST- 2015/04/29 06:00 [pubmed] PHST- 2016/01/27 06:00 [medline] AID - 20140303-01 [pii] AID - 10.4244/EIJV10I12A244 [doi] PST - ppublish SO - EuroIntervention. 2015 Apr;10(12):1402-8. doi: 10.4244/EIJV10I12A244. PMID- 25891091 OWN - NLM STAT- MEDLINE DCOM- 20160504 LR - 20260128 IS - 1559-2030 (Electronic) IS - 1551-7144 (Linking) VI - 43 DP - 2015 Jul TI - Study design of the influence of SErotonin inhibition on patients with RENAl impairment or diabetes undergoing drug-eluting stent implantation (SERENADE) study: A multicenter, open-label, prospective, randomized study. PG - 20-4 LID - S1551-7144(15)00076-2 [pii] LID - 10.1016/j.cct.2015.04.005 [doi] AB - BACKGROUND: The rates of stent failure after percutaneous coronary intervention have decreased since the introduction of the drug-eluting stent (DES). However, chronic kidney disease (CKD) and diabetes mellitus (DM) remain strong clinical predictors of poor prognosis despite DES implantation. Sarpogrelate, a selective serotonin (5-hydroxytryptamine (HT)2a [5-HT2A]) receptor antagonist, has antiproliferative effects, reducing neointimal hyperplasia and smooth muscle cell proliferation, as well as potent antiplatelet action, inhibiting 5-HT-induced platelet aggregation. However, efficacy and safety data for sarpogrelate in patients with CKD or DM are limited. We aim to determine whether sarpogrelate has beneficial effects in patients with CDK or DM treated with DES implantation. METHODS/DESIGN: The SERENADE trial is a multicenter, open-label, prospective, randomized study that will test the superiority of triple anti-platelet therapy (TAT; aspirin, clopidogrel, and sarpogrelate) to conventional dual antiplatelet therapy (DAT; aspirin and clopidogrel) in preventing late lumen loss 9 months after the index procedure in patients with CKD or DM. A total of 220 patients diagnosed with coronary artery disease with DM or CKD will be randomized to the TAT or DAT groups (1:1 ratio) after DES implantation. The primary endpoint is late lumen loss at 9 months assessed by quantitative coronary angiography. Secondary efficacy endpoints are composites of major adverse cardiovascular events including cardiac death, nonfatal myocardial infarction, and target lesion revascularization. Secondary safety endpoints are major bleeding events and hepatic or renal impairment. DISCUSSION: The SERENADE trial will provide insight on the efficacy of adjunctive therapy with sarpogrelate after DES implantation for patients with high-risk profiles such as CKD or DM. TRIAL REGISTRATION: National Institutes of Health Clinical Trials Registry (ClinicalTrials.gov NCT02294643). CI - Copyright (c) 2015. Published by Elsevier Inc. FAU - Lee, Seung-Ah AU - Lee SA AD - Division of Cardiology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. FAU - Suh, Jung-Won AU - Suh JW AD - Division of Cardiology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. FAU - Park, Jin Joo AU - Park JJ AD - Division of Cardiology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. FAU - Yoon, Chang-Hwan AU - Yoon CH AD - Division of Cardiology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. FAU - Cho, Young-Suk AU - Cho YS AD - Division of Cardiology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. FAU - Youn, Tae-Jin AU - Youn TJ AD - Division of Cardiology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. FAU - Chae, In-Ho AU - Chae IH AD - Division of Cardiology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. FAU - Kim, Hyo-Soo AU - Kim HS AD - Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea. FAU - Kim, Sang-Hyun AU - Kim SH AD - Seoul National University Boramae Medical Center, Seoul, Republic of Korea. FAU - Choi, Dong-Ju AU - Choi DJ AD - Division of Cardiology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. Electronic address: djchoi@snubh.org. LA - eng SI - ClinicalTrials.gov/NCT02294643 PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20150416 PL - United States TA - Contemp Clin Trials JT - Contemporary clinical trials JID - 101242342 RN - 0 (Platelet Aggregation Inhibitors) RN - 0 (Serotonin Antagonists) RN - 0 (Succinates) RN - 19P708E787 (sarpogrelate) RN - A74586SNO7 (Clopidogrel) RN - OM90ZUW7M1 (Ticlopidine) RN - R16CO5Y76E (Aspirin) SB - IM MH - Aspirin/administration & dosage MH - Clopidogrel MH - Coronary Angiography MH - Coronary Restenosis/*prevention & control MH - Diabetes Mellitus/*epidemiology/physiopathology MH - Drug Therapy, Combination MH - Drug-Eluting Stents MH - Female MH - Hemorrhage/chemically induced MH - Hepatic Insufficiency/chemically induced MH - Humans MH - Male MH - Percutaneous Coronary Intervention/methods MH - Platelet Aggregation Inhibitors/*administration & dosage/adverse effects MH - Prospective Studies MH - Renal Insufficiency, Chronic/*epidemiology MH - Republic of Korea MH - Research Design MH - Serotonin Antagonists/*administration & dosage/adverse effects MH - Succinates/*administration & dosage/adverse effects MH - Ticlopidine/administration & dosage/analogs & derivatives OTO - NOTNLM OT - Chronic kidney disease OT - Clinical trial OT - Diabetes melitus OT - Drug eluting stent OT - Randomized controlled trial EDAT- 2015/04/22 06:00 MHDA- 2016/05/05 06:00 CRDT- 2015/04/21 06:00 PHST- 2014/12/22 00:00 [received] PHST- 2015/04/08 00:00 [revised] PHST- 2015/04/08 00:00 [accepted] PHST- 2015/04/21 06:00 [entrez] PHST- 2015/04/22 06:00 [pubmed] PHST- 2016/05/05 06:00 [medline] AID - S1551-7144(15)00076-2 [pii] AID - 10.1016/j.cct.2015.04.005 [doi] PST - ppublish SO - Contemp Clin Trials. 2015 Jul;43:20-4. doi: 10.1016/j.cct.2015.04.005. Epub 2015 Apr 16. PMID- 25859014 OWN - NLM STAT- MEDLINE DCOM- 20160107 LR - 20150410 IS - 1873-734X (Electronic) IS - 1010-7940 (Linking) VI - 47 IP - 5 DP - 2015 May TI - Coronary artery bypass grafting and percutaneous coronary intervention in patients with end-stage renal disease. PG - e193-8 LID - 10.1093/ejcts/ezv104 [doi] AB - OBJECTIVES: To determine the relative risks of long-term mortality between coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) among patients with end-stage renal disease (ESRD). METHODS: We identified 1015 patients with ESRD who underwent coronary revascularization between 1996 and 2008 within Kaiser Permanente Northern California. We obtained clinical variables from health plan databases, state death certificates and social security administration files. Our primary and secondary outcomes, respectively, were all-cause mortality and repeat revascularization. Our primary predictor was CABG compared with PCI. We used a Cox proportional hazards model for multivariable analyses. RESULTS: The mean age of CABG and PCI patients was similar (64.7 +/- 10.6 and 63.4 +/- 9.3, respectively, P = 0.06). The CABG group had a higher proportion of diabetics (P = 0.045), and higher nitrate use (P = 0.01). Adjusted for age, gender, race, year of index revascularization, number of vessels intervened, duration of dialysis and baseline comorbidities, patients referred for CABG during the first year had a hazard ratio (HR) of 1.16 [95% confidence interval (CI), 0.80-1.67] for mortality compared with PCI. During Years 1-5, the HR was 0.91 (95% CI, 0.63-1.33) with an overall HR of 0.73 (95% CI, 0.43-1.22). The sub-HR as calculated by the Fine-Gray competing risk model was 0.51 (95% CI, 0.31-0.85). CONCLUSIONS: As there are no randomized clinical trials in this area, our observational study adds to the growing body of literature that suggests a significant decrease in repeat revascularization with CABG and at least equivalency in long-term mortality with CABG when compared with PCI in ESRD patients. CI - (c) The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. FAU - Krishnaswami, Ashok AU - Krishnaswami A AD - Division of Cardiology, Kaiser Permanente San Jose Medical Center, San Jose, CA, USA ashok.krishnaswami@kp.org. FAU - McCulloch, Charles E AU - McCulloch CE AD - Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA. FAU - Tawadrous, Magdy AU - Tawadrous M AD - Division of Cardiology, Kaiser Permanente San Francisco Medical Center, San Francisco, CA, USA. FAU - Jang, James J AU - Jang JJ AD - Division of Cardiology, Kaiser Permanente San Jose Medical Center, San Jose, CA, USA. FAU - Lee, Hon AU - Lee H AD - Department of Cardiothoracic Surgery, Kaiser Permanente Santa Clara Medical Center, Santa Clara, CA, USA. FAU - Melikian, Vicken AU - Melikian V AD - Department of Cardiothoracic Surgery, Kaiser Permanente San Francisco Medical Center, San Francisco, CA, USA. FAU - Yee, Gennie AU - Yee G AD - Department of Cardiology, Kaiser Permanente Santa Clara Medical Center, Santa Clara, CA, USA. FAU - Leong, Thomas K AU - Leong TK AD - Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA. FAU - Go, Alan S AU - Go AS AD - Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - Germany TA - Eur J Cardiothorac Surg JT - European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery JID - 8804069 SB - IM MH - Coronary Artery Bypass/*methods MH - Coronary Artery Disease/complications/*surgery MH - Female MH - Humans MH - Kidney Failure, Chronic/*complications MH - Male MH - Middle Aged MH - Percutaneous Coronary Intervention/*methods MH - *Registries MH - Retrospective Studies MH - Risk Factors MH - Treatment Outcome OTO - NOTNLM OT - Angioplasty OT - Chronic kidney disease OT - Comparative effectiveness OT - Coronary artery bypass grafting OT - Coronary revascularization OT - Dialysis OT - End-stage renal disease OT - Percutaneous coronary intervention OT - Stent EDAT- 2015/04/11 06:00 MHDA- 2016/01/08 06:00 CRDT- 2015/04/11 06:00 PHST- 2015/04/11 06:00 [entrez] PHST- 2015/04/11 06:00 [pubmed] PHST- 2016/01/08 06:00 [medline] AID - ezv104 [pii] AID - 10.1093/ejcts/ezv104 [doi] PST - ppublish SO - Eur J Cardiothorac Surg. 2015 May;47(5):e193-8. doi: 10.1093/ejcts/ezv104. PMID- 25858976 OWN - NLM STAT- MEDLINE DCOM- 20160201 LR - 20150410 IS - 1941-7632 (Electronic) IS - 1941-7640 (Linking) VI - 8 IP - 4 DP - 2015 Apr TI - Cerebrovascular events after a primary percutaneous coronary intervention strategy for acute ST-segment-elevation myocardial infarction: analysis from the HORIZONS-AMI Trial. LID - e002283 [pii] LID - 10.1161/CIRCINTERVENTIONS.114.002283 [doi] AB - BACKGROUND: Patients with ST-segment-elevation myocardial infarction are at increased risk of cerebrovascular events. We assessed the incidence, predictors, and implications of cerebrovascular events in patients with ST-segment-elevation myocardial infarction managed with a primary percutaneous coronary intervention strategy. METHODS AND RESULTS: In the Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI) trial, 72 of 3602 patients (2.0%) experienced at least 1 cerebrovascular event (stroke: 63 patients; transient ischemic attack: 12 patients) during the 3-year follow-up (40.3% within 30 days, 20.8% between 30 days and 1 year, and 38.9% between 1 and 3 years). Stroke was ischemic in 58 (92.1%) patients and hemorrhagic in 5 (7.9%) patients. More than half of all strokes (52.3%) were disabling. By principal management strategy, cerebrovascular events developed in 2.0%, 14.9%, and 1.9% of patients triaged to primary percutaneous coronary intervention, coronary artery bypass grafting, and medical therapy, respectively (P<0.0001). Cerebrovascular events were independently predicted by older age, creatinine clearance <60 mL/min, treatment with coronary artery bypass grafting, anemia, and diabetes mellitus. Cerebrovascular events were associated with significantly increased rates of 3-year mortality (20.5% versus 6.5%; P<0.0001), as well as reinfarction (14.3% versus 3.8%; P=0.0007), ischemia-driven target vessel revascularization (22.8% versus 13.0%; P=0.006), and major bleeding (23.5% versus 8.4%; P<0.0001). CONCLUSIONS: In HORIZONS-AMI, cerebrovascular events within 3 years after ST-segment-elevation myocardial infarction in patients undergoing a primary percutaneous coronary intervention management strategy occurred in 2.0% of patients and were most frequent after coronary artery bypass grafting. Cerebrovascular events were often disabling and were strongly associated with high rates of death, reinfarction, recurrent ischemia, and major bleeding. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00433966. CI - (c) 2015 American Heart Association, Inc. FAU - Nikolsky, Eugenia AU - Nikolsky E AD - From the Cardiology Department, Rambam Health Care Campus and the Technion-Israel Institute of Technology, Haifa, Israel (E.N.); Cardiovascular Research Foundation, New York, NY (R.M., G.D.D., K.X., R.P., P.G., S.J.B., G.W.S.); Icahn School of Medicine at Mount Sinai, New York, NY (R.M., G.D.D.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Ospedale Papa Giovanni XXIII, Bergamo, Italy (G.G.); Rabin Medical Center, Petach-Tikva, Israel (R.K.); Hopital du Sacre-Coeur de Montreal, Quebec, Canada (P.G.); Columbia University Medical Center, New York, NY (P.G., G.W.S.); and New York Methodist Hospital, Brooklyn (S.J.B.). e_nikolsky@rambam.health.gov.il. FAU - Mehran, Roxana AU - Mehran R AD - From the Cardiology Department, Rambam Health Care Campus and the Technion-Israel Institute of Technology, Haifa, Israel (E.N.); Cardiovascular Research Foundation, New York, NY (R.M., G.D.D., K.X., R.P., P.G., S.J.B., G.W.S.); Icahn School of Medicine at Mount Sinai, New York, NY (R.M., G.D.D.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Ospedale Papa Giovanni XXIII, Bergamo, Italy (G.G.); Rabin Medical Center, Petach-Tikva, Israel (R.K.); Hopital du Sacre-Coeur de Montreal, Quebec, Canada (P.G.); Columbia University Medical Center, New York, NY (P.G., G.W.S.); and New York Methodist Hospital, Brooklyn (S.J.B.). FAU - Dangas, George D AU - Dangas GD AD - From the Cardiology Department, Rambam Health Care Campus and the Technion-Israel Institute of Technology, Haifa, Israel (E.N.); Cardiovascular Research Foundation, New York, NY (R.M., G.D.D., K.X., R.P., P.G., S.J.B., G.W.S.); Icahn School of Medicine at Mount Sinai, New York, NY (R.M., G.D.D.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Ospedale Papa Giovanni XXIII, Bergamo, Italy (G.G.); Rabin Medical Center, Petach-Tikva, Israel (R.K.); Hopital du Sacre-Coeur de Montreal, Quebec, Canada (P.G.); Columbia University Medical Center, New York, NY (P.G., G.W.S.); and New York Methodist Hospital, Brooklyn (S.J.B.). FAU - Xu, Ke AU - Xu K AD - From the Cardiology Department, Rambam Health Care Campus and the Technion-Israel Institute of Technology, Haifa, Israel (E.N.); Cardiovascular Research Foundation, New York, NY (R.M., G.D.D., K.X., R.P., P.G., S.J.B., G.W.S.); Icahn School of Medicine at Mount Sinai, New York, NY (R.M., G.D.D.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Ospedale Papa Giovanni XXIII, Bergamo, Italy (G.G.); Rabin Medical Center, Petach-Tikva, Israel (R.K.); Hopital du Sacre-Coeur de Montreal, Quebec, Canada (P.G.); Columbia University Medical Center, New York, NY (P.G., G.W.S.); and New York Methodist Hospital, Brooklyn (S.J.B.). FAU - Parvataneni, Rupa AU - Parvataneni R AD - From the Cardiology Department, Rambam Health Care Campus and the Technion-Israel Institute of Technology, Haifa, Israel (E.N.); Cardiovascular Research Foundation, New York, NY (R.M., G.D.D., K.X., R.P., P.G., S.J.B., G.W.S.); Icahn School of Medicine at Mount Sinai, New York, NY (R.M., G.D.D.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Ospedale Papa Giovanni XXIII, Bergamo, Italy (G.G.); Rabin Medical Center, Petach-Tikva, Israel (R.K.); Hopital du Sacre-Coeur de Montreal, Quebec, Canada (P.G.); Columbia University Medical Center, New York, NY (P.G., G.W.S.); and New York Methodist Hospital, Brooklyn (S.J.B.). FAU - Witzenbichler, Bernhard AU - Witzenbichler B AD - From the Cardiology Department, Rambam Health Care Campus and the Technion-Israel Institute of Technology, Haifa, Israel (E.N.); Cardiovascular Research Foundation, New York, NY (R.M., G.D.D., K.X., R.P., P.G., S.J.B., G.W.S.); Icahn School of Medicine at Mount Sinai, New York, NY (R.M., G.D.D.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Ospedale Papa Giovanni XXIII, Bergamo, Italy (G.G.); Rabin Medical Center, Petach-Tikva, Israel (R.K.); Hopital du Sacre-Coeur de Montreal, Quebec, Canada (P.G.); Columbia University Medical Center, New York, NY (P.G., G.W.S.); and New York Methodist Hospital, Brooklyn (S.J.B.). FAU - Guagliumi, Giulio AU - Guagliumi G AD - From the Cardiology Department, Rambam Health Care Campus and the Technion-Israel Institute of Technology, Haifa, Israel (E.N.); Cardiovascular Research Foundation, New York, NY (R.M., G.D.D., K.X., R.P., P.G., S.J.B., G.W.S.); Icahn School of Medicine at Mount Sinai, New York, NY (R.M., G.D.D.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Ospedale Papa Giovanni XXIII, Bergamo, Italy (G.G.); Rabin Medical Center, Petach-Tikva, Israel (R.K.); Hopital du Sacre-Coeur de Montreal, Quebec, Canada (P.G.); Columbia University Medical Center, New York, NY (P.G., G.W.S.); and New York Methodist Hospital, Brooklyn (S.J.B.). FAU - Kornowski, Ran AU - Kornowski R AD - From the Cardiology Department, Rambam Health Care Campus and the Technion-Israel Institute of Technology, Haifa, Israel (E.N.); Cardiovascular Research Foundation, New York, NY (R.M., G.D.D., K.X., R.P., P.G., S.J.B., G.W.S.); Icahn School of Medicine at Mount Sinai, New York, NY (R.M., G.D.D.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Ospedale Papa Giovanni XXIII, Bergamo, Italy (G.G.); Rabin Medical Center, Petach-Tikva, Israel (R.K.); Hopital du Sacre-Coeur de Montreal, Quebec, Canada (P.G.); Columbia University Medical Center, New York, NY (P.G., G.W.S.); and New York Methodist Hospital, Brooklyn (S.J.B.). FAU - Genereux, Philippe AU - Genereux P AD - From the Cardiology Department, Rambam Health Care Campus and the Technion-Israel Institute of Technology, Haifa, Israel (E.N.); Cardiovascular Research Foundation, New York, NY (R.M., G.D.D., K.X., R.P., P.G., S.J.B., G.W.S.); Icahn School of Medicine at Mount Sinai, New York, NY (R.M., G.D.D.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Ospedale Papa Giovanni XXIII, Bergamo, Italy (G.G.); Rabin Medical Center, Petach-Tikva, Israel (R.K.); Hopital du Sacre-Coeur de Montreal, Quebec, Canada (P.G.); Columbia University Medical Center, New York, NY (P.G., G.W.S.); and New York Methodist Hospital, Brooklyn (S.J.B.). FAU - Brener, Sorin J AU - Brener SJ AD - From the Cardiology Department, Rambam Health Care Campus and the Technion-Israel Institute of Technology, Haifa, Israel (E.N.); Cardiovascular Research Foundation, New York, NY (R.M., G.D.D., K.X., R.P., P.G., S.J.B., G.W.S.); Icahn School of Medicine at Mount Sinai, New York, NY (R.M., G.D.D.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Ospedale Papa Giovanni XXIII, Bergamo, Italy (G.G.); Rabin Medical Center, Petach-Tikva, Israel (R.K.); Hopital du Sacre-Coeur de Montreal, Quebec, Canada (P.G.); Columbia University Medical Center, New York, NY (P.G., G.W.S.); and New York Methodist Hospital, Brooklyn (S.J.B.). FAU - Stone, Gregg W AU - Stone GW AD - From the Cardiology Department, Rambam Health Care Campus and the Technion-Israel Institute of Technology, Haifa, Israel (E.N.); Cardiovascular Research Foundation, New York, NY (R.M., G.D.D., K.X., R.P., P.G., S.J.B., G.W.S.); Icahn School of Medicine at Mount Sinai, New York, NY (R.M., G.D.D.); Helios Amper-Klinikum, Dachau, Germany (B.W.); Ospedale Papa Giovanni XXIII, Bergamo, Italy (G.G.); Rabin Medical Center, Petach-Tikva, Israel (R.K.); Hopital du Sacre-Coeur de Montreal, Quebec, Canada (P.G.); Columbia University Medical Center, New York, NY (P.G., G.W.S.); and New York Methodist Hospital, Brooklyn (S.J.B.). LA - eng SI - ClinicalTrials.gov/NCT00433966 PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - United States TA - Circ Cardiovasc Interv JT - Circulation. Cardiovascular interventions JID - 101499602 RN - AYI8EX34EU (Creatinine) SB - IM MH - Acute Disease MH - *Age Factors MH - Aged MH - Creatinine/metabolism MH - Electrocardiography MH - Female MH - Follow-Up Studies MH - Humans MH - Incidence MH - Male MH - Middle Aged MH - Myocardial Infarction/*surgery MH - *Percutaneous Coronary Intervention MH - Postoperative Complications/*diagnosis/epidemiology/mortality MH - Predictive Value of Tests MH - Prognosis MH - Prospective Studies MH - Risk MH - Stroke/*diagnosis/epidemiology/etiology/mortality MH - Survival Analysis OTO - NOTNLM OT - angioplasty OT - bivalirudin OT - ischemic attack, transient OT - myocardial infarction OT - stents OT - stroke EDAT- 2015/04/11 06:00 MHDA- 2016/02/02 06:00 CRDT- 2015/04/11 06:00 PHST- 2015/04/11 06:00 [entrez] PHST- 2015/04/11 06:00 [pubmed] PHST- 2016/02/02 06:00 [medline] AID - CIRCINTERVENTIONS.114.002283 [pii] AID - 10.1161/CIRCINTERVENTIONS.114.002283 [doi] PST - ppublish SO - Circ Cardiovasc Interv. 2015 Apr;8(4):e002283. doi: 10.1161/CIRCINTERVENTIONS.114.002283. PMID- 25837357 OWN - NLM STAT- MEDLINE DCOM- 20150611 LR - 20191113 IS - 1001-9294 (Print) IS - 1001-9294 (Linking) VI - 30 IP - 1 DP - 2015 Mar TI - Redo coronary artery bypass grafting: on-pump and off-pump coronary artery bypass grafting revascularization techniques. PG - 28-33 AB - OBJECTIVE: To analyze the short-term outcomes of redo coronary artery bypass grafting (CABG) using on-pump and off-pump CABG techniques. METHODS: From January 2003 to August 2013, non-randomized 80 patients were treated with redo CABG in the Department of Cardiac Surgery, Peking University Third Hospital. Among these patients, 40 underwent on-pump CABG technique (redo-ONCAB group) and 40 underwent off-pump CABG technique (redo-OPCAB group). Furthermore, transmyocardial laser revascularization was performed in high-risk patients who were not suitable to conventional grafting. Clinical data of the two groups were recorded and analyzed including operation time, coronary grafts, incomplete revascularization, postoperative ventilation, perioperative stroke, and low output syndrome, etc. RESULTS: There were no significantly differences in age, gender distribution, incidences of hypertension, stroke, and other clinical characteristics between redo-OPCAB group and redo-ONCAB group (all P>0.05), except for incidences of renal dysfunction and pulmonary disease (all P<0.05). The number of grafting vessels in the redo-ONCAB and redo-OPCAB groups was 2.1 +/- 0.74 and 1.4 +/-0.52 respectively. There was significant difference between the two groups (P=0.0243). Compared with the redo-ONCAB group, there was shorter operation time (P=0.0045), postoperative ventilation (P=0.0211) and intensive care unit stay (P=0.0400), as well as fewer use of platelet (P=0.0338) and blood transfusion (P=0.0034) in the redo-OPCAB group. The incidence of incomplete revascularization (P=0.0253) and the use of transmyocardial laser revascularization (P=0.0052) were higher in the redo-OPCAB group than those in the redo-ONCAB group (all P<0.05). However, no significant differences were showed for the incidence of the use of intra aortic balloon pump and continuous renal replacement therapy, perioperative stroke, low output syndrome, and in-hospital mortality between the two groups (all P>0.05). CONCLUSION: Redo CABG is the safety and efficacy surgical procedure, and redo-OPCAB technique with better outcomes is commended especially in high-risk patients. FAU - Wu, Song AU - Wu S AD - Department of Cardiac Surgery, Peking University Third Hospital, Beijing 100191, China. FAU - Wan, Feng AU - Wan F AD - Department of Cardiac Surgery, Peking University Third Hospital, Beijing 100191, China. FAU - Zhang, Zhe AU - Zhang Z AD - Department of Cardiac Surgery, Peking University Third Hospital, Beijing 100191, China. FAU - Zhao, Hong AU - Zhao H AD - Department of Cardiac Surgery, Peking University Third Hospital, Beijing 100191, China. FAU - Cui, Zhong-qi AU - Cui ZQ AD - Department of Cardiac Surgery, Peking University Third Hospital, Beijing 100191, China. FAU - Xie, Ji-yan AU - Xie JY AD - Department of Cardiac Surgery, Peking University Third Hospital, Beijing 100191, China. LA - eng PT - Journal Article PL - Netherlands TA - Chin Med Sci J JT - Chinese medical sciences journal = Chung-kuo i hsueh k'o hsueh tsa chih JID - 9112559 SB - IM MH - Aged MH - Coronary Artery Bypass/*methods MH - Coronary Artery Disease/*surgery MH - Female MH - Humans MH - Male MH - Middle Aged MH - *Reoperation EDAT- 2015/04/04 06:00 MHDA- 2015/06/13 06:00 CRDT- 2015/04/04 06:00 PHST- 2015/04/04 06:00 [entrez] PHST- 2015/04/04 06:00 [pubmed] PHST- 2015/06/13 06:00 [medline] AID - 10457 [pii] AID - 10.1016/s1001-9294(15)30005-5 [doi] PST - ppublish SO - Chin Med Sci J. 2015 Mar;30(1):28-33. doi: 10.1016/s1001-9294(15)30005-5. PMID- 25824543 OWN - NLM STAT- MEDLINE DCOM- 20150707 LR - 20150429 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 115 IP - 10 DP - 2015 May 15 TI - Predictors of stroke associated with coronary artery bypass grafting in patients with diabetes mellitus and multivessel coronary artery disease. PG - 1382-8 LID - S0002-9149(15)00729-8 [pii] LID - 10.1016/j.amjcard.2015.02.033 [doi] AB - This study assesses demographic and clinical variables associated with perioperative and late stroke in diabetes mellitus patients after multivessel coronary artery bypass grafting (CABG). Future Revascularization Evaluation in Patients with Diabetes Mellitus: Optimal Management of Multivessel Disease (FREEDOM) is the largest randomized trial of diabetic patients undergoing multivessel CABG. FREEDOM patients had improved survival free of death, myocardial infarction, or stroke and increased overall survival after CABG compared to percutaneous intervention. However, the stroke rate was greater following CABG than percutaneous intervention. We studied predictors of stroke in CABG-treated patients analyzing separately overall, perioperative (30 days after surgery) stroke. For long-term outcomes (overall stroke and late stroke), Cox proportional hazards regression was used, accounting for time to event, and logistic regression was used for perioperative stroke. Independent perioperative stroke predictors were previous stroke (odds ratio [OR] 6.96, 95% confidence interval [CI] 1.43 to 33.96; p = 0.02), warfarin use (OR 10.26, 95% CI 1.10 to 96.03; p = 0.02), and surgery outside the United States or Canada (OR 9.81, 95% CI 1.28 to 75.40; p = 0.03). Independent late stroke predictors: renal insufficiency (hazard ratio [HR] 3.57, 95% CI 1.01 to 12.64; p = 0.048), baseline low-density lipoprotein >/=105 mg/dl (HR 3.28, 95% CI 1.19 to 9.02; p = 0.02), and baseline diastolic blood pressure (each 1 mm Hg increase reduces stroke hazard by 5%; HR 0.95, 95% CI 0.91 to 0.99; p = 0.03). There was no overlap between predictors of perioperative versus late stroke. In conclusion, late post-CABG strokes were associated with well-described risk factors. Nearly half of the strokes were perioperative. Independent risk factors for perioperative stroke: previous stroke, previous warfarin use, and CABG performed outside the United States or Canada. CI - Copyright (c) 2015 Elsevier Inc. All rights reserved. FAU - Domanski, Michael J AU - Domanski MJ AD - Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York. Electronic address: Michael.Domanski@MSSM.EDU. FAU - Farkouh, Michael E AU - Farkouh ME AD - Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Peter Munk Cardiac Centre and Heart and Stroke Richard Lewar Centre of Excellence, University of Toronto, Toronto, Canada. FAU - Zak, Victor AU - Zak V AD - The New England Research Institutes, Boston, Massachusetts. FAU - Feske, Steven AU - Feske S AD - Brigham and Women's Hospital, Boston, Massachusetts. FAU - Easton, Donald AU - Easton D AD - University of California at San Francisco School of Medicine, San Francisco, California. FAU - Weinberger, Jesse AU - Weinberger J AD - Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York. FAU - Hamon, Martial AU - Hamon M AD - University Hospital of Caen, Normandy, France. FAU - Escobedo, Jorge AU - Escobedo J AD - Unidad de Investigacion en Epidemiologia Clinica, Instituto Mexicano del Seguro Social, Mexico City, Mexico. FAU - Shrader, Peter AU - Shrader P AD - The New England Research Institutes, Boston, Massachusetts. FAU - Siami, Flora S AU - Siami FS AD - The New England Research Institutes, Boston, Massachusetts. FAU - Fuster, Valentin AU - Fuster V AD - Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain. LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20150219 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM MH - Adult MH - Aged MH - Aged, 80 and over MH - Coronary Artery Bypass/*adverse effects MH - Coronary Artery Disease/complications/diagnosis/*surgery MH - *Diabetes Mellitus MH - Female MH - Follow-Up Studies MH - Global Health MH - Humans MH - Incidence MH - Male MH - Middle Aged MH - Postoperative Complications MH - Prognosis MH - Retrospective Studies MH - Risk Assessment/*methods MH - Stroke/diagnosis/*epidemiology/etiology MH - Survival Rate/trends MH - Time Factors EDAT- 2015/04/01 06:00 MHDA- 2015/07/08 06:00 CRDT- 2015/04/01 06:00 PHST- 2014/10/31 00:00 [received] PHST- 2015/02/11 00:00 [revised] PHST- 2015/02/11 00:00 [accepted] PHST- 2015/04/01 06:00 [entrez] PHST- 2015/04/01 06:00 [pubmed] PHST- 2015/07/08 06:00 [medline] AID - S0002-9149(15)00729-8 [pii] AID - 10.1016/j.amjcard.2015.02.033 [doi] PST - ppublish SO - Am J Cardiol. 2015 May 15;115(10):1382-8. doi: 10.1016/j.amjcard.2015.02.033. Epub 2015 Feb 19. PMID- 25822170 OWN - NLM STAT- MEDLINE DCOM- 20150812 LR - 20260128 IS - 2168-6114 (Electronic) IS - 2168-6106 (Print) IS - 2168-6106 (Linking) VI - 175 IP - 6 DP - 2015 Jun TI - Trends in the use of percutaneous ventricular assist devices: analysis of national inpatient sample data, 2007 through 2012. PG - 941-50 LID - 10.1001/jamainternmed.2014.7856 [doi] AB - IMPORTANCE: Percutaneous ventricular assist devices (PVADs) provide robust hemodynamic support compared with intra-aortic balloon pumps (IABPs), but clinical use patterns are unknown. OBJECTIVE: To examine contemporary patterns in PVAD use in the United States and compare them with use of IABPs. DESIGN, SETTING, AND PARTICIPANTS: Retrospective study of adults older than 18 years who received a PVAD or IABP while hospitalized in the United States (2007-2012). MAIN OUTCOMES AND MEASURES: Temporal trends in utilization, patient and hospital characteristics, in-hospital mortality, and cost of PVAD use compared with IABP. RESULTS: During 2007 through 2012, utilization of PVADs increased 30-fold (4.6 per million discharges in 2007 to 138 per million discharges in 2012; P for trend < .001) while utilization of IABPs decreased from 1738 per million discharges in 2008 to 1608 per million discharges in 2012 (P for trend = .02). In 2007, an estimated 72 hospitals used PVADs, increasing to 477 in 2011 (P for trend < .001). The number of hospitals with an annual volume of 10 or more PVAD procedures per year increased from 0 in 2007 to 102 in 2011 (21.4% of PVAD-using hospitals; P for trend < .001). Among PVAD recipients, 67.3% had a diagnosis of cardiogenic shock or acute myocardial infarction (AMI). There was a temporal increase in the use of PVADs in older patients and patients with AMI, hypertension, diabetes mellitus, and chronic kidney disease (P for trend < .001 for all). Overall, mortality in PVAD recipients was 28.8%, and mean (SE) hospitalization cost was $85,580 ($4165); both were significantly higher in PVAD recipients with cardiogenic shock (mortality, 47.5%; mean [SE] cost, $113,695 [$6260]; P < .001 for both). The PVAD recipients were less likely than IABP recipients to have cardiogenic shock (34.3% vs 41.2%; P = .001), AMI (48.0% vs 68.6%; P < .001), and undergo coronary artery bypass graft surgery (6.2% vs 43.2%; P < .001), but more likely to undergo percutaneous coronary intervention (70.9% vs 40.4%; P < .001). In propensity-matched analysis, PVADs were associated with higher mortality compared with IABP (odds ratio, 1.23 [95% CI, 1.06-1.43]; P = .007). CONCLUSIONS AND RELEVANCE: There has been a substantial increase in the use of PVADs in recent years with an accompanying decrease in the use of IABPs. Given the high mortality, associated cost, and uncertain evidence for a clear benefit, randomized clinical trials are needed to determine whether use of PVADs leads to improved patient outcomes. FAU - Khera, Rohan AU - Khera R AD - Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City. FAU - Cram, Peter AU - Cram P AD - Department of Medicine, University of Toronto, Toronto, Ontario, Canada3Division of General Internal Medicine, University Health Network/Mt Sinai Hospitals, Toronto, Ontario, Canada. FAU - Lu, Xin AU - Lu X AD - Institute of Clinical and Translational Science, University of Iowa Carver College of Medicine, Iowa City. FAU - Vyas, Ankur AU - Vyas A AD - Division of Cardiovascular Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City. FAU - Gerke, Alicia AU - Gerke A AD - Division of Pulmonary, Critical Care, and Occupational Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City. FAU - Rosenthal, Gary E AU - Rosenthal GE AD - Institute of Clinical and Translational Science, University of Iowa Carver College of Medicine, Iowa City7Division of General Internal Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City. FAU - Horwitz, Phillip A AU - Horwitz PA AD - Division of Cardiovascular Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City. FAU - Girotra, Saket AU - Girotra S AD - Institute of Clinical and Translational Science, University of Iowa Carver College of Medicine, Iowa City5Division of Cardiovascular Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City. LA - eng GR - K08 HL122527/HL/NHLBI NIH HHS/United States GR - K23 HL114640/HL/NHLBI NIH HHS/United States GR - K08HL122527/HL/NHLBI NIH HHS/United States GR - K24-AR062133/AR/NIAMS NIH HHS/United States GR - K24 AR062133/AR/NIAMS NIH HHS/United States PT - Comparative Study PT - Journal Article PT - Research Support, N.I.H., Extramural PL - United States TA - JAMA Intern Med JT - JAMA internal medicine JID - 101589534 SB - IM CIN - JAMA Intern Med. 2015 Jun;175(6):939-40. doi: 10.1001/jamainternmed.2015.0578. PMID: 25822990 CIN - JAMA Intern Med. 2016 May 1;176(5):714. doi: 10.1001/jamainternmed.2016.0807. PMID: 27136337 CIN - JAMA Intern Med. 2016 May 1;176(5):714-5. doi: 10.1001/jamainternmed.2016.0810. PMID: 27136338 CIN - JAMA Intern Med. 2016 May 1;176(5):715-6. doi: 10.1001/jamainternmed.2016.0813. PMID: 27136339 MH - Aged MH - Female MH - Heart-Assist Devices/*statistics & numerical data/trends MH - Humans MH - Intra-Aortic Balloon Pumping/*statistics & numerical data/trends MH - Male MH - Middle Aged MH - Mortality MH - Retrospective Studies MH - United States PMC - PMC4780323 MID - NIHMS764069 COIS- Conflict of Interest Disclosures: Dr Horwitz receives grant support from Edwards Lifesciences, St Jude Medical, and Biotronik. No other disclosures are reported. EDAT- 2015/03/31 06:00 MHDA- 2015/08/13 06:00 PMCR- 2016/06/01 CRDT- 2015/03/31 06:00 PHST- 2015/03/31 06:00 [entrez] PHST- 2015/03/31 06:00 [pubmed] PHST- 2015/08/13 06:00 [medline] PHST- 2016/06/01 00:00 [pmc-release] AID - 2210884 [pii] AID - 10.1001/jamainternmed.2014.7856 [doi] PST - ppublish SO - JAMA Intern Med. 2015 Jun;175(6):941-50. doi: 10.1001/jamainternmed.2014.7856. PMID- 25820680 OWN - NLM STAT- MEDLINE DCOM- 20160223 LR - 20260518 IS - 1879-0844 (Electronic) IS - 1388-9842 (Linking) VI - 17 IP - 5 DP - 2015 May TI - Clinical picture and risk prediction of short-term mortality in cardiogenic shock. PG - 501-9 LID - 10.1002/ejhf.260 [doi] AB - AIMS: The aim of this study was to investigate the clinical picture and outcome of cardiogenic shock and to develop a risk prediction score for short-term mortality. METHODS AND RESULTS: The CardShock study was a multicentre, prospective, observational study conducted between 2010 and 2012. Patients with either acute coronary syndrome (ACS) or non-ACS aetiologies were enrolled within 6 h from detection of cardiogenic shock defined as severe hypotension with clinical signs of hypoperfusion and/or serum lactate >2 mmol/L despite fluid resuscitation (n = 219, mean age 67, 74% men). Data on clinical presentation, management, and biochemical variables were compared between different aetiologies of shock. Systolic blood pressure was on average 78 mmHg (standard deviation 14 mmHg) and mean arterial pressure 57 (11) mmHg. The most common cause (81%) was ACS (68% ST-elevation myocardial infarction and 8% mechanical complications); 94% underwent coronary angiography, of which 89% PCI. Main non-ACS aetiologies were severe chronic heart failure and valvular causes. In-hospital mortality was 37% (n = 80). ACS aetiology, age, previous myocardial infarction, prior coronary artery bypass, confusion, low LVEF, and blood lactate levels were independently associated with increased mortality. The CardShock risk Score including these variables and estimated glomerular filtration rate predicted in-hospital mortality well (area under the curve 0.85). CONCLUSION: Although most commonly due to ACS, other causes account for one-fifth of cases with shock. ACS is independently associated with in-hospital mortality. The CardShock risk Score, consisting of seven common variables, easily stratifies risk of short-term mortality. It might facilitate early decision-making in intensive care or guide patient selection in clinical trials. TRIAL REGISTRATION: NCT01374867. CI - (c) 2015 The Authors. European Journal of Heart Failure (c) 2015 European Society of Cardiology. FAU - Harjola, Veli-Pekka AU - Harjola VP AD - Emergency Medicine, University of Helsinki, Helsinki University Hospital, Helsinki, Finland. FAU - Lassus, Johan AU - Lassus J FAU - Sionis, Alessandro AU - Sionis A FAU - Kober, Lars AU - Kober L FAU - Tarvasmaki, Tuukka AU - Tarvasmaki T FAU - Spinar, Jindrich AU - Spinar J FAU - Parissis, John AU - Parissis J FAU - Banaszewski, Marek AU - Banaszewski M FAU - Silva-Cardoso, Jose AU - Silva-Cardoso J FAU - Carubelli, Valentina AU - Carubelli V FAU - Di Somma, Salvatore AU - Di Somma S FAU - Tolppanen, Heli AU - Tolppanen H FAU - Zeymer, Uwe AU - Zeymer U FAU - Thiele, Holger AU - Thiele H FAU - Nieminen, Markku S AU - Nieminen MS FAU - Mebazaa, Alexandre AU - Mebazaa A CN - CardShock Study Investigators CN - GREAT network LA - eng SI - ClinicalTrials.gov/NCT01374867 PT - Journal Article PT - Multicenter Study PT - Observational Study PT - Research Support, Non-U.S. Gov't DEP - 20150328 PL - England TA - Eur J Heart Fail JT - European journal of heart failure JID - 100887595 SB - IM CIN - Eur J Heart Fail. 2015 May;17(5):466-7. doi: 10.1002/ejhf.265. PMID: 25858545 EIN - Eur J Heart Fail. 2015 Sep;17(9):984. doi: 10.1002/ejhf.349. PMID: 26377116 MH - Acute Coronary Syndrome/complications MH - Aged MH - Coronary Angiography MH - Female MH - Heart Failure/complications MH - Heart Valve Diseases/complications MH - Humans MH - Male MH - Middle Aged MH - Prospective Studies MH - Risk Factors MH - Shock, Cardiogenic/*diagnosis/etiology/*mortality OTO - NOTNLM OT - Acute coronary syndromes OT - Acute myocardial infarction OT - Cardiogenic shock OT - Management OT - Prognosis OT - Risk score FIR - Koniari, Katerina IR - Koniari K FIR - Voumvourakis, Astrinos IR - Voumvourakis A FIR - Karavidas, Apostolos IR - Karavidas A FIR - Sans-Rosello, Jordi IR - Sans-Rosello J FIR - Vila, Montserrat IR - Vila M FIR - Duran-Cambra, Albert IR - Duran-Cambra A FIR - Metra, Marco IR - Metra M FIR - Bulgari, Michela IR - Bulgari M FIR - Lazzarini, Valentina IR - Lazzarini V FIR - Parenica, Jiri IR - Parenica J FIR - Stipal, Roman IR - Stipal R FIR - Ludka, Ondrej IR - Ludka O FIR - Palsuva, Marie IR - Palsuva M FIR - Ganovska, Eva IR - Ganovska E FIR - Kubena, Petr IR - Kubena P FIR - Lindholm, Matias G IR - Lindholm MG FIR - Hassager, Christian IR - Hassager C FIR - Backlund, Tom IR - Backlund T FIR - Jurkko, Raija IR - Jurkko R FIR - Jarvinen, Kristiina IR - Jarvinen K FIR - Nieminen, Tuomo IR - Nieminen T FIR - Pulkki, Kari IR - Pulkki K FIR - Soininen, Leena IR - Soininen L FIR - Sund, Reijo IR - Sund R FIR - Tierala, Ilkka IR - Tierala I FIR - Tolonen, Jukka IR - Tolonen J FIR - Varpula, Marjut IR - Varpula M FIR - Korva, Tuomas IR - Korva T FIR - Pietila, Mervi IR - Pietila M FIR - Pitkala, Anne IR - Pitkala A FIR - Marino, Rossella IR - Marino R FIR - Sousa, Alexandra IR - Sousa A FIR - Sousa, Carla IR - Sousa C FIR - Paiva, Mariana IR - Paiva M FIR - Rangel, Ines IR - Rangel I FIR - Almeida, Rui IR - Almeida R FIR - Pinho, Teresa IR - Pinho T FIR - Maciel, Maria Julia IR - Maciel MJ FIR - Stepinska, Janina IR - Stepinska J FIR - Skrobisz, Anna IR - Skrobisz A FIR - Goral, Piotr IR - Goral P EDAT- 2015/03/31 06:00 MHDA- 2016/02/26 06:00 CRDT- 2015/03/31 06:00 PHST- 2014/11/11 00:00 [received] PHST- 2015/01/12 00:00 [revised] PHST- 2015/01/23 00:00 [accepted] PHST- 2015/03/31 06:00 [entrez] PHST- 2015/03/31 06:00 [pubmed] PHST- 2016/02/26 06:00 [medline] AID - 10.1002/ejhf.260 [doi] PST - ppublish SO - Eur J Heart Fail. 2015 May;17(5):501-9. doi: 10.1002/ejhf.260. Epub 2015 Mar 28. PMID- 25788458 OWN - NLM STAT- MEDLINE DCOM- 20150729 LR - 20260128 IS - 1524-4539 (Electronic) IS - 0009-7322 (Linking) VI - 131 IP - 20 DP - 2015 May 19 TI - Coronary artery bypass grafting in patients 50 years or younger: a Swedish nationwide cohort study. PG - 1748-54 LID - 10.1161/CIRCULATIONAHA.114.014335 [doi] AB - BACKGROUND: There are limited data regarding long-term results after coronary artery bypass grafting (CABG) in young adults. We performed a nationwide population-based cohort study to analyze long-term survival, major adverse cardiovascular events, and factors associated with elevated risk in young adults undergoing CABG. METHODS AND RESULTS: We included all adult patients 70 years who underwent CABG during the same period. The cumulative incidence of death or a major adverse cardiovascular event during 17 years after CABG was mainly driven by myocardial infarction or the need for repeat revascularization. The most important risk factors for all-cause mortality were chronic kidney disease, reduced left ventricular ejection fraction, peripheral vascular disease, or chronic obstructive pulmonary disease. CONCLUSIONS: Long-term survival and freedom from major cardiovascular events after CABG was better in young adults than in older patients. Factors significantly associated with an elevated long-term risk of death or adverse outcome were similar to well-known risk factors for older age groups following CABG. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT02276950. CI - (c) 2015 American Heart Association, Inc. FAU - Dalen, Magnus AU - Dalen M AD - From Department of Cardiothoracic Surgery and Anesthesiology, Karolinska University Hospital, Stockholm, Sweden (M.D., T.I., U.S.); Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden (M.D., T.I., U.S.); Department of Emergency Medicine, Karolinska University Hospital, Stockholm, Sweden (M.J.H.); and Department of Internal Medicine, Karolinska Institutet, Stockholm, Sweden (M.J.H.). FAU - Ivert, Torbjorn AU - Ivert T AD - From Department of Cardiothoracic Surgery and Anesthesiology, Karolinska University Hospital, Stockholm, Sweden (M.D., T.I., U.S.); Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden (M.D., T.I., U.S.); Department of Emergency Medicine, Karolinska University Hospital, Stockholm, Sweden (M.J.H.); and Department of Internal Medicine, Karolinska Institutet, Stockholm, Sweden (M.J.H.). FAU - Holzmann, Martin J AU - Holzmann MJ AD - From Department of Cardiothoracic Surgery and Anesthesiology, Karolinska University Hospital, Stockholm, Sweden (M.D., T.I., U.S.); Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden (M.D., T.I., U.S.); Department of Emergency Medicine, Karolinska University Hospital, Stockholm, Sweden (M.J.H.); and Department of Internal Medicine, Karolinska Institutet, Stockholm, Sweden (M.J.H.). FAU - Sartipy, Ulrik AU - Sartipy U AD - From Department of Cardiothoracic Surgery and Anesthesiology, Karolinska University Hospital, Stockholm, Sweden (M.D., T.I., U.S.); Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden (M.D., T.I., U.S.); Department of Emergency Medicine, Karolinska University Hospital, Stockholm, Sweden (M.J.H.); and Department of Internal Medicine, Karolinska Institutet, Stockholm, Sweden (M.J.H.). Ulrik.Sartipy@karolinska.se. LA - eng SI - ClinicalTrials.gov/NCT02276950 PT - Journal Article PT - Observational Study PT - Research Support, Non-U.S. Gov't DEP - 20150318 PL - United States TA - Circulation JT - Circulation JID - 0147763 SB - IM MH - Adult MH - Age Factors MH - Cardiovascular Diseases/mortality MH - Comorbidity MH - Coronary Artery Bypass/*statistics & numerical data MH - Diabetes Mellitus/epidemiology MH - Female MH - Follow-Up Studies MH - Humans MH - Incidence MH - Kidney Diseases/mortality MH - Male MH - Postoperative Complications/mortality MH - Proportional Hazards Models MH - Pulmonary Disease, Chronic Obstructive/mortality MH - Risk Factors MH - Socioeconomic Factors MH - Survival Analysis MH - Sweden/epidemiology MH - Young Adult OTO - NOTNLM OT - cohort studies OT - coronary artery bypass OT - coronary artery disease OT - outcome assessment (health care) OT - young adult EDAT- 2015/03/20 06:00 MHDA- 2015/07/30 06:00 CRDT- 2015/03/20 06:00 PHST- 2014/11/19 00:00 [received] PHST- 2015/02/19 00:00 [accepted] PHST- 2015/03/20 06:00 [entrez] PHST- 2015/03/20 06:00 [pubmed] PHST- 2015/07/30 06:00 [medline] AID - CIRCULATIONAHA.114.014335 [pii] AID - 10.1161/CIRCULATIONAHA.114.014335 [doi] PST - ppublish SO - Circulation. 2015 May 19;131(20):1748-54. doi: 10.1161/CIRCULATIONAHA.114.014335. Epub 2015 Mar 18. PMID- 25778426 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20150317 LR - 20261011 IS - 1092-8464 (Print) IS - 1092-8464 (Linking) VI - 17 IP - 4 DP - 2015 Apr TI - Statins in the prevention of contrast-induced nephropathy. PG - 375 LID - 10.1007/s11936-015-0375-0 [doi] AB - Coronary angiography and percutaneous coronary interventions are common procedures that utilize iodinated contrast medium to visualize the coronary arterial tree and treat stable and unstable ischemic heart syndromes. Exposure to contrast agents can cause acute and persistent worsening of renal function leading to increased morbidity and mortality. Certain patient characteristics such as age, presence of diabetes, congestive heart failure, chronic kidney disease, hemodynamic instability on presentation, and type and volume of contrast used can increase the risk of developing contrast-induced nephropathy (CIN) and its subsequent complications. Despite the lack of a universal definition, CIN is typically defined as an increase in serum creatinine >/=0.5 mg/dL or 25 % above baseline 48 to 72 h after contrast exposure. Previous research has shown the benefits of adequate intravenous hydration with iso-osmolar crystalloids and the importance of limiting the amount of low-osmolar and iso-osmolar contrast used to prevent the development of CIN. 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) have anti-inflammatory and anti-apoptotic properties with few side effects, making it an attractive therapeutic option for prevention of CIN. A number of trials have examined the benefit of different types of statins, high-dose versus low-dose statins, loading versus chronic dosing of statins, in various clinical presentations including acute coronary syndromes and elective procedures, and in those with associated comorbidities such as anemia and chronic kidney disease. In this review, we will summarize recent data regarding statin therapy for prevention of contrast-induced nephropathy. FAU - Chyou, Anthony C AU - Chyou AC AD - Greenberg Division of Cardiology, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY, USA. FAU - Thodge, Anay AU - Thodge A FAU - Feldman, Dmitriy N AU - Feldman DN FAU - Swaminathan, Rajesh V AU - Swaminathan RV LA - eng PT - Journal Article PL - United States TA - Curr Treat Options Cardiovasc Med JT - Current treatment options in cardiovascular medicine JID - 9815942 EDAT- 2015/03/18 06:00 MHDA- 2015/03/18 06:01 CRDT- 2015/03/18 06:00 PHST- 2015/03/18 06:00 [entrez] PHST- 2015/03/18 06:00 [pubmed] PHST- 2015/03/18 06:01 [medline] AID - 10.1007/s11936-015-0375-0 [doi] PST - ppublish SO - Curr Treat Options Cardiovasc Med. 2015 Apr;17(4):375. doi: 10.1007/s11936-015-0375-0. PMID- 25731671 OWN - NLM STAT- MEDLINE DCOM- 20160308 LR - 20150613 IS - 1879-1484 (Electronic) IS - 0021-9150 (Linking) VI - 241 IP - 1 DP - 2015 Jul TI - Long-term outcome in men and women after CABG; results from the IMAGINE trial. PG - 284-8 LID - S0021-9150(15)00129-X [pii] LID - 10.1016/j.atherosclerosis.2015.02.039 [doi] AB - BACKGROUND: The aim of this study is to determine sex differences in long-term outcome after coronary artery bypass grafting (CABG). METHODS: The international randomized controlled IMAGINE study included 2553 consecutive patients with a left ventricular ejection fraction of >40% who underwent isolated CABG. Median follow-up was 32 months (IQR 17-42 months). The composite endpoint comprised of death, myocardial infarction (MI), cerebrovascular event, angina, revascularization and congestive heart failure. Cox regression analysis was used to examine sex differences in outcome post-CABG. RESULTS: Of the 2553 patients, 2229 were men and 324 (13%) were women. Women were older and more often reported diabetes and hypertension. Smoking and impaired renal function were more prevalent in men. Women experienced a higher event rate during follow-up (composite endpoint 18% vs 12%; P = 0.007). Cox regression showed an increased risk of the composite endpoint in women after adjustment for age (HR 1.48 (95% CI: 1.11-1.97)) which was non-significant after additional adjustment for other confounders (HR 1.26 (95% CI: 0.92-1.72)). CONCLUSION: Women have a worse long-term outcome after CABG than men in univariate analysis. However, after adjusting for potential confounders female sex became a non-significant predictor for prognosis, possibly due to the small sample size of women. Definite answers regarding sex-differences in long-term outcome after CABG should come from future pooling of studies comprising a larger number of women. CI - Copyright (c) 2015 Elsevier Ireland Ltd. All rights reserved. FAU - den Ruijter, Hester M AU - den Ruijter HM AD - Experimental Cardiology Laboratory, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, The Netherlands. FAU - Haitjema, Saskia AU - Haitjema S AD - Experimental Cardiology Laboratory, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, The Netherlands. Electronic address: s.haitjema@umcutrecht.nl. FAU - van der Meer, Manon G AU - van der Meer MG AD - Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, The Netherlands. FAU - van der Harst, Pim AU - van der Harst P AD - Experimental Cardiology Laboratory, University Medical Center Groningen, Groningen, The Netherlands; Durrer Center for Cardiogenetic Research, Interuniversity Cardiology Institute Netherlands-Netherlands Heart Institute, Utrecht, The Netherlands. FAU - Rouleau, Jean L AU - Rouleau JL AD - Institute of Circulatory and Respiratory Health, Canadian Institutes of Health Research, University of Montreal, Montreal, Canada. FAU - Asselbergs, Folkert W AU - Asselbergs FW AD - Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, The Netherlands; Institute of Cardiovascular Science, Faculty of Population Health Sciences, University College London, London, United Kingdom; Durrer Center for Cardiogenetic Research, Interuniversity Cardiology Institute Netherlands-Netherlands Heart Institute, Utrecht, The Netherlands. FAU - van Gilst, Wiek H AU - van Gilst WH AD - Experimental Cardiology Laboratory, University Medical Center Groningen, Groningen, The Netherlands. CN - IMAGINE Investigators LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20150224 PL - Ireland TA - Atherosclerosis JT - Atherosclerosis JID - 0242543 SB - IM MH - Age Factors MH - Aged MH - Chi-Square Distribution MH - Comorbidity MH - *Coronary Artery Bypass/adverse effects/mortality MH - Coronary Artery Disease/diagnosis/mortality/*surgery MH - Disease Progression MH - Disease-Free Survival MH - Female MH - Health Status Disparities MH - Humans MH - Male MH - Middle Aged MH - Multivariate Analysis MH - Prevalence MH - Proportional Hazards Models MH - Risk Factors MH - Sex Factors MH - Time Factors MH - Treatment Outcome OTO - NOTNLM OT - CABG OT - Long-term outcome OT - Major adverse cardiac event OT - Sex EDAT- 2015/03/04 06:00 MHDA- 2016/03/10 06:00 CRDT- 2015/03/04 06:00 PHST- 2014/12/24 00:00 [received] PHST- 2015/02/05 00:00 [revised] PHST- 2015/02/18 00:00 [accepted] PHST- 2015/03/04 06:00 [entrez] PHST- 2015/03/04 06:00 [pubmed] PHST- 2016/03/10 06:00 [medline] AID - S0021-9150(15)00129-X [pii] AID - 10.1016/j.atherosclerosis.2015.02.039 [doi] PST - ppublish SO - Atherosclerosis. 2015 Jul;241(1):284-8. doi: 10.1016/j.atherosclerosis.2015.02.039. Epub 2015 Feb 24. PMID- 25729675 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20150302 LR - 20220317 IS - 2228-7523 (Print) IS - 2228-7531 (Electronic) IS - 2228-7523 (Linking) VI - 4 IP - 5 DP - 2014 Dec TI - Intravenous patient-controlled remifentanil versus paracetamol in post-operative pain management in patients undergoing coronary artery bypass graft surgery. PG - e19862 LID - 10.5812/aapm.19862 [doi] LID - e19862 AB - BACKGROUND: Pain management after cardiac surgery has been based on parenteral long-acting opioids such as morphine. The other alternatives are paracetamol and remifentanil. OBJECTIVES: In this prospective, double-blind, randomized study, we compared the efficacy of intravenous patient-controlled analgesia (IV-PCA) paracetamol and remifentanil for post cardiac surgery pain relief. MATERIALS AND METHODS: One-hundred patients scheduled for elective coronary artery bypass grafting from May to October 2011, were randomized into two groups after the surgery. For the first group (group R, n = 50, with mean age of 58.16 +/- 11.80), the IV-PCA protocol was remifentanil infusion 100 mug/h; bolus of 25 mug and lockout time of 15 minutes. In the second group (group P, n = 50, with mean age of 53.8 +/- 15.08), patients received paracetamol 15 mg/kg as a bolus at the end of surgery and then IV-PCA protocol was 100 mug/h, bolus of 25 mug; and lockout time of 15 minutes. Pain was assessed with visual analog scale score (VAS) in the first 24 hours after surgery for seven times. RESULTS: The trend of pain scores did not have any significantly difference between group R and group P except for hour 8 and hour 18 after surgery that VAS was significantly lower in group P than group R (P = 0.031, P = 0.023, respectively). Respiratory rate (RR) was also statistically lower in group R comparing to group P in all seven evaluating times. The groups were similar in terms of hemodynamic, ABG results (except for PaO2, which was significantly lower in group R than group P at 6 evaluating times), intubation time, renal function tests, and incidences of atelectasis, myocardial infarction or adverse effects. CONCLUSIONS: Both PCA techniques provided effective pain scores (< 3) after cardiac surgery; but generally, PCA-paracetamol infusion has a better analgesic effect. FAU - Jahangiri Fard, Alireza AU - Jahangiri Fard A AD - Masih Daneshvari Institute of Tuberculosis and Lung Disease, Shahid Beheshti University of Medical Sciences, Tehran, Iran. FAU - Babaee, Touraj AU - Babaee T AD - Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran. FAU - Alavi, Seyed Mostafa AU - Alavi SM AD - Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran. FAU - Nasiri, Ali Akbar AU - Nasiri AA AD - Department of Anesthesiology, Zabol University of Medical Sciences, Zabol, Iran. FAU - Ghoreishi, Seyed Mohamad Mehran AU - Ghoreishi SM AD - Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran. FAU - Noori, Noor Mohammad AU - Noori NM AD - Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran. FAU - Mahjoubifard, Maziar AU - Mahjoubifard M AD - Research Center of Children and Adolescent Health, Ali-Ebn E-Abitaleb Hospital, Zahedan University of Medical Sciences, Zahedan, Iran. LA - eng PT - Journal Article DEP - 20140916 PL - Netherlands TA - Anesth Pain Med JT - Anesthesiology and pain medicine JID - 101585412 PMC - PMC4333302 OTO - NOTNLM OT - Cardiac Surgery OT - Patient-Controlled Analgesia OT - Remifentanil EDAT- 2015/03/03 06:00 MHDA- 2015/03/03 06:01 PMCR- 2014/12/01 CRDT- 2015/03/03 06:00 PHST- 2014/06/05 00:00 [revised] PHST- 2014/06/11 00:00 [accepted] PHST- 2015/03/03 06:00 [entrez] PHST- 2015/03/03 06:00 [pubmed] PHST- 2015/03/03 06:01 [medline] PHST- 2014/12/01 00:00 [pmc-release] AID - 10.5812/aapm.19862 [doi] PST - epublish SO - Anesth Pain Med. 2014 Sep 16;4(5):e19862. doi: 10.5812/aapm.19862. eCollection 2014 Dec. PMID- 25700931 OWN - NLM STAT- MEDLINE DCOM- 20160505 LR - 20220311 IS - 1724-6059 (Electronic) IS - 1121-8428 (Print) IS - 1121-8428 (Linking) VI - 28 IP - 4 DP - 2015 Aug TI - Impact of fractional phosphate excretion on the relation of FGF23 with outcome in CKD patients. PG - 477-84 LID - 10.1007/s40620-015-0178-0 [doi] AB - BACKGROUND: Cardiovascular risk is increased in patients with chronic kidney disease (CKD). Fibroblast growth factor 23 (FGF23) has emerged as an important, independent predictor of outcome in CKD patients. High FGF23 may, however, be a reflection of renal tissue resistance to its actions, reflected by low fractional excretion of phosphate (FePi). We evaluated the modifying effect of FePi on the association between FGF23 and outcome in patients with CKD stage 3-4. METHODS: An analysis was performed in a subset of 166 adult patients of two participating centers of the MASTERPLAN trial of whom urine samples at baseline were available to calculate FePi. Outcome was defined as a composite of death, renal failure (defined as need for renal replacement therapy or doubling of serum creatinine) and cardiovascular events (myocardial infarction, cerebrovascular accident, percutaneous transluminal coronary angioplasty or coronary artery bypass graft. Patients were categorized by FGF23 and FePi. A product term was added to Cox regression and RERIs were calculated. RESULTS: Patients had a median estimated glomerular filtration rate (eGFR) of 36 ml/min/1.73 m(2) [interquartile range (IQR) 27-44], serum phosphate 1.04 mmol/l (IQR 0.92-1.20), FGF23 140 RU/ml (IQR 81-236) and FePi 0.32 (IQR 0.25-0.44). A total of 96 events occurred during 5 years of follow up. LnFGF23 was a significant, independent predictor for the composite outcome [hazard ratio (HR) 2.13, 95% confidence interval (CI) 1.53-2.95]. FePi did not modify the relation between FGF23 and outcome in these patients with CKD. CONCLUSIONS: Our study shows that FGF23 itself, but not its renal tissue resistance as reflected by FePi, is an important risk factor for clinical events in subjects with CKD stage 3-4. FAU - Bech, Anneke P AU - Bech AP AD - Department of Nephrology, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands, annekebech@hotmail.com. FAU - Bouma-de Krijger, Annet AU - Bouma-de Krijger A FAU - van Zuilen, Arjan D AU - van Zuilen AD FAU - Bots, Michiel L AU - Bots ML FAU - van den Brand, Jan A J G AU - van den Brand JA FAU - Blankestijn, Peter J AU - Blankestijn PJ FAU - Wetzels, Jack F M AU - Wetzels JF FAU - Vervloet, Marc G AU - Vervloet MG LA - eng SI - ISRCTN/ISRCTN73187232 PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20150221 PL - England TA - J Nephrol JT - Journal of nephrology JID - 9012268 RN - 0 (Biomarkers) RN - 0 (FGF23 protein, human) RN - 0 (Phosphates) RN - 62031-54-3 (Fibroblast Growth Factors) RN - 7Q7P4S7RRE (Fibroblast Growth Factor-23) RN - AYI8EX34EU (Creatinine) SB - IM MH - Adult MH - Biomarkers/blood MH - Cardiovascular Diseases/etiology/therapy MH - Creatinine/blood MH - Female MH - Fibroblast Growth Factor-23 MH - Fibroblast Growth Factors/*blood MH - Glomerular Filtration Rate MH - Humans MH - Kidney/*physiopathology MH - Male MH - Middle Aged MH - Multivariate Analysis MH - Netherlands MH - Phosphates/*blood MH - Prognosis MH - Proportional Hazards Models MH - Renal Dialysis MH - *Renal Elimination MH - Renal Insufficiency, Chronic/*blood/complications/diagnosis/mortality/physiopathology/therapy MH - Risk Factors MH - Severity of Illness Index MH - Time Factors PMC - PMC4498282 EDAT- 2015/02/24 06:00 MHDA- 2016/05/06 06:00 PMCR- 2015/02/21 CRDT- 2015/02/22 06:00 PHST- 2014/12/05 00:00 [received] PHST- 2015/02/04 00:00 [accepted] PHST- 2015/02/22 06:00 [entrez] PHST- 2015/02/24 06:00 [pubmed] PHST- 2016/05/06 06:00 [medline] PHST- 2015/02/21 00:00 [pmc-release] AID - 178 [pii] AID - 10.1007/s40620-015-0178-0 [doi] PST - ppublish SO - J Nephrol. 2015 Aug;28(4):477-84. doi: 10.1007/s40620-015-0178-0. Epub 2015 Feb 21. PMID- 25697382 OWN - NLM STAT- MEDLINE DCOM- 20160310 LR - 20191210 IS - 1444-2892 (Electronic) IS - 1443-9506 (Linking) VI - 24 IP - 7 DP - 2015 Jul TI - Prognostic Significance of Peri-procedural Myocardial Infarction in the Era of High Sensitivity Troponin: A Validation of the Joint ACCF/AHA/ESC/WHF Universal Definition of Type 4a Myocardial Infarction with High Sensitivity Troponin T. PG - 673-81 LID - S1443-9506(15)00045-1 [pii] LID - 10.1016/j.hlc.2015.01.007 [doi] AB - AIMS: This study aims to validate the joint ACCF/AHA/ESC/WHF Universal Definition of peri-procedural myocardial infarction (PMI) with high sensitivity troponin T (hsTnT). METHODS: A retrospective cohort study encompassing patients admitted to our institution between May 2012 and April 2013 was performed. RESULTS: 630 patients underwent percutaneous coronary interventions during the study period. Among them, 459 patients met the inclusion criteria and were eligible for analyses. 76.9% of these patients were male, while the mean age was 68.6. PMI was observed in 4.3% of the patients based on the Universal Definition. The predictors of PMI were chronic kidney disease (OR: 3.0, p=0.026), family history of cardiovascular disease (OR: 2.7, p=0.043) and use of IIb/IIIa inhibitors (OR 4.2, p=0.01). MACE was reported in 4.4% of the patients at 12 months, and was significantly and independently associated with PMI (OR 7.3, p=0.003) in a multivariate model which accounted for lesion complexity, patients' baseline clinical information, dual-antiplatelet status at follow-up and various procedural characteristics. The post-procedural hsTnT was much higher in those who suffered MACE than those who did not (156 v.s. 43 ng/L, p<0.001). CONCLUSION: PMI as defined by the current Universal Definition using hsTnT is an independent predictor of adverse clinical outcome at 12 months in patients undergoing PCI. Accordingly, PMI remains a clinically relevant factor in current practice and should be considered a key outcome measure in clinical trials and a potential target for therapy. CI - Copyright (c) 2015 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved. FAU - Liou, Kevin AU - Liou K AD - Eastern Heart Clinic, Prince of Wales Hospital, Randwick, NSW Australia; University of New South Wales, Randwick, NSW, Australia. Electronic address: kevin.liou@sesiahs.health.nsw.gov.au. FAU - Jepson, Nigel AU - Jepson N AD - Eastern Heart Clinic, Prince of Wales Hospital, Randwick, NSW Australia. FAU - Kellar, Petrina AU - Kellar P AD - Eastern Heart Clinic, Prince of Wales Hospital, Randwick, NSW Australia. FAU - Ng, Ben AU - Ng B AD - Eastern Heart Clinic, Prince of Wales Hospital, Randwick, NSW Australia. FAU - Isbister, Julia AU - Isbister J AD - Eastern Heart Clinic, Prince of Wales Hospital, Randwick, NSW Australia. FAU - Giles, Robert AU - Giles R AD - Eastern Heart Clinic, Prince of Wales Hospital, Randwick, NSW Australia. FAU - Friedman, Daniel AU - Friedman D AD - Eastern Heart Clinic, Prince of Wales Hospital, Randwick, NSW Australia. FAU - Allan, Roger AU - Allan R AD - Eastern Heart Clinic, Prince of Wales Hospital, Randwick, NSW Australia; University of New South Wales, Randwick, NSW, Australia. FAU - Lau, Antony AU - Lau A AD - Eastern Heart Clinic, Prince of Wales Hospital, Randwick, NSW Australia; University of New South Wales, Randwick, NSW, Australia. FAU - Pitney, Mark AU - Pitney M AD - Eastern Heart Clinic, Prince of Wales Hospital, Randwick, NSW Australia. FAU - Ooi, Sze-Yuan AU - Ooi SY AD - Eastern Heart Clinic, Prince of Wales Hospital, Randwick, NSW Australia; University of New South Wales, Randwick, NSW, Australia. LA - eng PT - Journal Article PT - Validation Study DEP - 20150202 PL - Australia TA - Heart Lung Circ JT - Heart, lung & circulation JID - 100963739 RN - 0 (Troponin T) SB - IM MH - Aged MH - Aged, 80 and over MH - Female MH - Humans MH - Male MH - Middle Aged MH - Myocardial Infarction/*blood/*diagnosis/etiology/surgery MH - Percutaneous Coronary Intervention MH - Prognosis MH - Renal Insufficiency, Chronic/blood/complications/diagnosis MH - Retrospective Studies MH - Troponin T/*blood OTO - NOTNLM OT - High sensitivity troponin T OT - MACE OT - Percutaneous coronary intervention OT - Periprocedural myocardial infarction OT - Universal definition EDAT- 2015/02/24 06:00 MHDA- 2016/03/11 06:00 CRDT- 2015/02/21 06:00 PHST- 2014/11/18 00:00 [received] PHST- 2015/01/01 00:00 [revised] PHST- 2015/01/05 00:00 [accepted] PHST- 2015/02/21 06:00 [entrez] PHST- 2015/02/24 06:00 [pubmed] PHST- 2016/03/11 06:00 [medline] AID - S1443-9506(15)00045-1 [pii] AID - 10.1016/j.hlc.2015.01.007 [doi] PST - ppublish SO - Heart Lung Circ. 2015 Jul;24(7):673-81. doi: 10.1016/j.hlc.2015.01.007. Epub 2015 Feb 2. PMID- 25688782 OWN - NLM STAT- MEDLINE DCOM- 20150303 LR - 20260128 IS - 1538-3598 (Electronic) IS - 0098-7484 (Linking) VI - 313 IP - 7 DP - 2015 Feb 17 TI - Association between the use of fondaparinux vs low-molecular-weight heparin and clinical outcomes in patients with non-ST-segment elevation myocardial infarction. PG - 707-16 LID - 10.1001/jama.2015.517 [doi] AB - IMPORTANCE: Fondaparinux was associated with reduced major bleeding events and improved survival compared with low-molecular-weight heparin (LMWH) in a large randomized clinical trial involving patients with non-ST-segment elevation myocardial infarction (NSTEMI). Large-scale experience of the use of fondaparinux vs LMWH in a nontrial setting is lacking. OBJECTIVE: To study the association between the use of fondaparinux vs LMWH and outcomes in patients with NSTEMI in Sweden. DESIGN, SETTING, AND PATIENTS: Prospective multicenter cohort study from the Swedish Web-System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies registry involving 40,616 consecutive patients with NSTEMI who received fondaparinux or LMWH between September 1, 2006, through June 30, 2010, with the last follow-up on December 31, 2010. EXPOSURES: In-hospital treatment with fondaparinux or LMWH during the hospital stay. MAIN OUTCOMES AND MEASURES: In-hospital severe bleeding events and death and 30- and 180-day death, MI, stroke, and major bleeding events. Logistic regression models adjusted for calendar time, admitting hospital, baseline characteristics, and in-hospital revascularization. RESULTS: In total, 14,791 patients (36.4%) were treated with fondaparinux and 25,825 (63.6%) with LMWH. One hundred sixty-five patients (1.1%) in the fondaparinux group vs 461 patients (1.8%) in the LMWH group experienced in-hospital bleeding events (adjusted odds ratio [OR], 0.54; 95% CI, 0.42-0.70). A total of 394 patients (2.7%) in the fondaparinux group died while in the hospital vs 1022 (4.0%) in the LMWH group (adjusted OR, 0.75; 95% CI, 0.63-0.89). The differences in major bleeding events and mortality between the 2 treatments were similar at 30 and 180 days. There were no significant differences in the number of recurrent MI and stroke events at 30 or 180 days among the 2 treatment groups. CONCLUSIONS AND RELEVANCE: In routine clinical care of patients with NSTEMI, fondaparinux was associated with lower odds than LMWH of major bleeding events and death both in-hospital and up to 180 days afterward. FAU - Szummer, Karolina AU - Szummer K AD - Section of Cardiology, Department of Medicine, Huddinge, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden. FAU - Oldgren, Jonas AU - Oldgren J AD - Uppsala Clinical Research Center and Department of Medical Sciences, Uppsala University, Uppsala, Sweden. FAU - Lindhagen, Lars AU - Lindhagen L AD - Uppsala Clinical Research Center, Uppsala, Sweden. FAU - Carrero, Juan Jesus AU - Carrero JJ AD - Division of Renal Medicine, CLINTEC, Karolinska Institutet, Stockholm, Sweden. FAU - Evans, Marie AU - Evans M AD - Division of Renal Medicine, CLINTEC, Karolinska Institutet, Stockholm, Sweden. FAU - Spaak, Jonas AU - Spaak J AD - Division of Cardiovascular Medicine, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden. FAU - Edfors, Robert AU - Edfors R AD - Section of Cardiology, Department of Medicine, Huddinge, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden. FAU - Jacobson, Stefan H AU - Jacobson SH AD - Division of Nephrology, Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden. FAU - Andell, Pontus AU - Andell P AD - Department of Cardiology, Clinical Sciences, Lund University, Lund, Sweden. FAU - Wallentin, Lars AU - Wallentin L AD - Uppsala Clinical Research Center and Department of Medical Sciences, Uppsala University, Uppsala, Sweden. FAU - Jernberg, Tomas AU - Jernberg T AD - Section of Cardiology, Department of Medicine, Huddinge, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden. LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't PL - United States TA - JAMA JT - JAMA JID - 7501160 RN - 0 (Heparin, Low-Molecular-Weight) RN - 0 (Polysaccharides) RN - J177FOW5JL (Fondaparinux) SB - IM MH - Aged MH - Cardiovascular Diseases/complications MH - Cohort Studies MH - Electrocardiography MH - Female MH - Fondaparinux MH - Glomerular Filtration Rate/drug effects MH - Hemorrhage/*chemically induced MH - Heparin, Low-Molecular-Weight/adverse effects/*therapeutic use MH - Hospital Mortality MH - Humans MH - Kidney Diseases/chemically induced MH - Male MH - Middle Aged MH - Myocardial Infarction/complications/*drug therapy/mortality MH - Odds Ratio MH - Polysaccharides/adverse effects/*therapeutic use MH - Registries MH - Sweden EDAT- 2015/02/18 06:00 MHDA- 2015/03/04 06:00 CRDT- 2015/02/18 06:00 PHST- 2015/02/18 06:00 [entrez] PHST- 2015/02/18 06:00 [pubmed] PHST- 2015/03/04 06:00 [medline] AID - 2110970 [pii] AID - 10.1001/jama.2015.517 [doi] PST - ppublish SO - JAMA. 2015 Feb 17;313(7):707-16. doi: 10.1001/jama.2015.517. PMID- 25677920 OWN - NLM STAT- MEDLINE DCOM- 20151221 LR - 20260128 IS - 1755-5922 (Electronic) IS - 1755-5914 (Linking) VI - 33 IP - 2 DP - 2015 Apr TI - Impact of high loading dose of atorvastatin in diabetic patients with renal dysfunction undergoing elective percutaneous coronary intervention: a randomized controlled trial. PG - 35-41 LID - 10.1111/1755-5922.12108 [doi] AB - INTRODUCTION: The effectiveness of statin pretreatment in reducing the incidence of contrast-induced nephropathy (CIN) has been examined in some observational and randomized studies, yielding controversial results. AIM: This study sought to evaluate the role of atorvastatin in prevention of CIN in diabetic patients with mild-to-moderate chronic kidney disease (CKD), undergoing elective percutaneous coronary intervention (PCI). METHODS: 130 patients with mean glomerular filtration rate of 48.5 +/- 16 mL/min/1.73 m were prospectively enrolled, then randomly (double blind) assigned in 1:1 ratio to receive atorvastatin (80 mg daily for 48 h) or placebo. Serum creatinine and glomerular filtration rate were measured preintervention, 72 h and 10 days thereafter. An increase in serum creatinine by >0.5 mg/dL (44.2 mumol/L) or >25% of baseline value was considered as CIN. RESULTS: Mean age of the study cohort was 56 +/- 5 years (males: 62%). Mean serum creatinine level in the placebo group increased significantly 3 days after coronary intervention and declined on the 10th day to a level that did not differ significantly from the baseline level, but still higher. However, in atorvastatin group, mean serum creatinine level showed a nonsignificant rise on the third day and then decreased to a level close to the baseline one, on the 10th day. Incidence of CIN was 7.7% in atorvastatin group and 20% in the placebo group (P < 0.05). CONCLUSION: Atorvastatin dose of 80 mg per day for 48 h is associated with decreased incidence of CIN in diabetic patients with CKD undergoing PCI. CI - (c) 2015 John Wiley & Sons Ltd. FAU - Shehata, Mohamed AU - Shehata M AD - Department of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt. FAU - Hamza, Mohamed AU - Hamza M LA - eng PT - Journal Article PT - Randomized Controlled Trial PL - England TA - Cardiovasc Ther JT - Cardiovascular therapeutics JID - 101319630 RN - 0 (Biomarkers) RN - 0 (Contrast Media) RN - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors) RN - A0JWA85V8F (Atorvastatin) RN - AYI8EX34EU (Creatinine) SB - IM MH - Acute Kidney Injury/chemically induced/diagnosis/physiopathology/*prevention & control MH - Atorvastatin/*administration & dosage MH - Biomarkers/blood MH - Contrast Media/adverse effects MH - Coronary Angiography/adverse effects MH - Coronary Artery Disease/complications/diagnosis/*therapy MH - Creatinine/blood MH - Diabetic Nephropathies/*complications/diagnosis/physiopathology MH - Double-Blind Method MH - Egypt MH - Female MH - Glomerular Filtration Rate MH - Humans MH - Hydroxymethylglutaryl-CoA Reductase Inhibitors/*administration & dosage MH - Kidney/*physiopathology MH - Male MH - Middle Aged MH - *Percutaneous Coronary Intervention/adverse effects MH - Prospective Studies MH - Protective Factors MH - Renal Insufficiency, Chronic/*complications/diagnostic imaging/physiopathology MH - Risk Factors MH - Time Factors MH - Treatment Outcome OTO - NOTNLM OT - Contrast-induced nephropathy OT - Coronary intervention OT - Diabetes mellitus OT - Statins EDAT- 2015/02/14 06:00 MHDA- 2015/12/22 06:00 CRDT- 2015/02/14 06:00 PHST- 2015/02/14 06:00 [entrez] PHST- 2015/02/14 06:00 [pubmed] PHST- 2015/12/22 06:00 [medline] AID - 10.1111/1755-5922.12108 [doi] PST - ppublish SO - Cardiovasc Ther. 2015 Apr;33(2):35-41. doi: 10.1111/1755-5922.12108. PMID- 25664103 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20150209 LR - 20220311 IS - 1940-5901 (Print) IS - 1940-5901 (Electronic) IS - 1940-5901 (Linking) VI - 7 IP - 12 DP - 2014 TI - Efficacy of short-term cordyceps sinensis for prevention of contrast-induced nephropathy in patients with acute coronary syndrome undergoing elective percutaneous coronary intervention. PG - 5758-64 AB - Contrast-induced nephropathy (CIN) is one of the major causes of hospital-acquired acute renal failure. The pathophysiological mechanism of CIN remains unknown. There has been little evidence regarding the effects of Traditional Chinese Medicine (TCM) on CIN. Cordyceps sinensis (CS), a traditional Chinese herb, has been widely used clinically for the prevention of the progression of renal failure. We performed a prospective, randomized controlled trial to investigate the role of CS in the prevention of CIN in patients with acute coronary syndrome (ACS) undergoing elective percutaneous coronary intervention (PCI). The 150 ACS patients were randomly assigned to three groups, basic treatment group (n=51), standard CS therapy group (n=49, corbrin capsule 2 g, 3 times/d were used 3 days before and after angiography), and intensive CS therapy group (n=50, corbrin capsule 3 g, 3 times/d were used 3 days before and after angiography). Renal function was assessed at the time of hospital admission and on days 1, 2, and 3 after PCI. CIN occurred in 13 of 150 patients (8.67%). The incidence of CIN was lower in the CS treatment groups than in the basic treatment group (P<0.05), and a significant decrease in the incidence of CIN in the intensive CS therapy group was shown (P<0.01). In conclusion, prophylactic treatment with CS during the peri-procedural stage in ACS patients undergoing elective PCI has a preventive role against CIN, and intensive CS therapy could be more effective. FAU - Zhao, Kai AU - Zhao K AD - Department of Cardiology, Tianjin Nankai Hospital Tianjin 300100, China. FAU - Lin, Yu AU - Lin Y AD - Department of Cardiology, Tianjin Nankai Hospital Tianjin 300100, China. FAU - Li, Yong-Jian AU - Li YJ AD - Department of Cardiology, Tianjin Nankai Hospital Tianjin 300100, China. FAU - Gao, Sheng AU - Gao S AD - Department of Cardiology, Tianjin Nankai Hospital Tianjin 300100, China. LA - eng PT - Journal Article DEP - 20141215 PL - United States TA - Int J Clin Exp Med JT - International journal of clinical and experimental medicine JID - 101471010 PMC - PMC4307550 OTO - NOTNLM OT - Cordyceps sinensis OT - acute coronary syndrome OT - contrast induced nephropathy OT - percutaneous coronary intervention EDAT- 2015/02/11 06:00 MHDA- 2015/02/11 06:01 PMCR- 2014/12/15 CRDT- 2015/02/10 06:00 PHST- 2014/10/03 00:00 [received] PHST- 2014/12/08 00:00 [accepted] PHST- 2015/02/10 06:00 [entrez] PHST- 2015/02/11 06:00 [pubmed] PHST- 2015/02/11 06:01 [medline] PHST- 2014/12/15 00:00 [pmc-release] PST - epublish SO - Int J Clin Exp Med. 2014 Dec 15;7(12):5758-64. eCollection 2014. PMID- 25637044 OWN - NLM STAT- MEDLINE DCOM- 20170109 LR - 20220318 IS - 1615-2573 (Electronic) IS - 0910-8327 (Linking) VI - 31 IP - 4 DP - 2016 Apr TI - Effect of rhBNP on renal function in STEMI-HF patients with mild renal insufficiency undergoing primary PCI. PG - 490-8 LID - 10.1007/s00380-015-0642-8 [doi] AB - This study aims to investigate the effect of recombinant human brain natriuretic peptide (rhBNP) on renal function and contrast-induced nephropathy (CIN) incidence in ST-segment elevation myocardial infarction and heart failure (STEMI-HF) patients with mild renal insufficiency undergoing primary percutaneous coronary intervention (PCI). A total of 116 participants were randomized into rhBNP (rhBNP, n = 57) and nitroglycerin group (NIT, n = 59), receiving intravenous rhBNP or nitroglycerin from admission to 72 h after PCI. Renal function was assessed by serum creatinine (SCr), estimated glomerular filtration rate (eGFR), Cystatin-C (Cys-C) and beta2-microglobulin before and after primary PCI, and calculated the incidence of CIN within 72 h after PCI. There were no significant differences in SCr, eGFR and beta2-microglobulin between the two groups (P > 0.05, respectively). Compared with the NIT group, the total urinary volume within 72 h was higher while the level of Cys-C at 24 and 72 h after PCI was lower in the rhBNP group. rhBNP was associated with a decline in the incidence of CIN (12.28 vs. 28.81 %, P < 0.05). No differences were detected in mortality and re-hospitalization in 3 months between the two groups. The incidence of renal injury was not different between rhBNP and nitroglycerin in STEMI-HF patients with mild renal insufficiency. However, infusion of rhBNP was associated with a decline in incidence of CIN. FAU - Xing, Kun AU - Xing K AD - Department of Cardiology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China. FAU - Fu, Xianghua AU - Fu X AD - Department of Cardiology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China. fuxh99@126.com. FAU - Wang, Yanbo AU - Wang Y AD - Department of Cardiology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China. FAU - Li, Wei AU - Li W AD - Department of Cardiology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China. FAU - Gu, Xinshun AU - Gu X AD - Department of Cardiology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China. FAU - Hao, Guozhen AU - Hao G AD - Department of Cardiology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China. FAU - Miao, Qing AU - Miao Q AD - Department of Cardiology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China. FAU - Li, Shiqiang AU - Li S AD - Department of Cardiology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China. FAU - Jiang, Yunfa AU - Jiang Y AD - Department of Cardiology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China. FAU - Fan, Weize AU - Fan W AD - Department of Cardiology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China. FAU - Geng, Wei AU - Geng W AD - Department of Cardiology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China. LA - eng PT - Journal Article PT - Randomized Controlled Trial DEP - 20150131 PL - Japan TA - Heart Vessels JT - Heart and vessels JID - 8511258 RN - 0 (Natriuretic Agents) RN - 0 (Recombinant Proteins) RN - 114471-18-0 (Natriuretic Peptide, Brain) RN - AYI8EX34EU (Creatinine) SB - IM MH - Creatinine/*blood MH - Electrocardiography MH - Female MH - Follow-Up Studies MH - Glomerular Filtration Rate/*drug effects MH - Heart Failure/diagnosis/*drug therapy/etiology MH - Humans MH - Infusions, Intravenous MH - Male MH - Middle Aged MH - Natriuretic Agents/administration & dosage MH - Natriuretic Peptide, Brain/*administration & dosage MH - Percutaneous Coronary Intervention/*methods MH - Prognosis MH - Prospective Studies MH - Recombinant Proteins MH - Renal Insufficiency/blood/*complications/physiopathology MH - ST Elevation Myocardial Infarction/complications/diagnosis/*therapy OTO - NOTNLM OT - Acute myocardial infarction OT - Cystatin-C OT - Mild renal insufficiency OT - Percutaneous coronary intervention OT - Serum creatinine OT - rhBNP EDAT- 2015/02/01 06:00 MHDA- 2017/01/10 06:00 CRDT- 2015/02/01 06:00 PHST- 2014/10/10 00:00 [received] PHST- 2015/01/23 00:00 [accepted] PHST- 2015/02/01 06:00 [entrez] PHST- 2015/02/01 06:00 [pubmed] PHST- 2017/01/10 06:00 [medline] AID - 10.1007/s00380-015-0642-8 [pii] AID - 10.1007/s00380-015-0642-8 [doi] PST - ppublish SO - Heart Vessels. 2016 Apr;31(4):490-8. doi: 10.1007/s00380-015-0642-8. Epub 2015 Jan 31. PMID- 25635402 OWN - NLM STAT- MEDLINE DCOM- 20161109 LR - 20161230 IS - 0317-1671 (Print) IS - 0317-1671 (Linking) VI - 42 IP - 1 DP - 2015 Jan TI - Factors Determining Periprocedural and Long-term Complications of High Risk Carotid Artery Stenting. PG - 48-54 LID - 10.1017/cjn.2014.125 [doi] AB - BACKGROUND AND PURPOSE: Carotid artery stenting (CAS) has been, historically, an alternative to open endarterectomy (CEA) for stroke prevention in high risk patients with carotid atherosclerosis. We sought to determine the rates of periprocedural and long-term stroke or death and the risk factors for complications after CAS in our high risk patient population. METHODS: Clinical and treatment variables of consecutive CAS procedures performed between 2002 and 2011 were analyzed. Using univariate and multivariate logistic regression analyses we examined how patient characteristics influenced outcomes and changes in modified Rankin Score (mRS). RESULTS: In 152 patients, the composite total of periprocedural death, stroke, transient ischemic attack (TIA) and myocardial infarction (MI) rate was 3.95% (6/152). Chronic kidney disease (CKD) was strongly associated with periprocedural complications (p<0.001). Coronary artery disease/peripheral vascular disease (CAD/PVD) (p=0.03), dyslipidemia (p=0.02), CKD (p=0.01), and contralateral internal carotid artery stenosis (p=0.02) were non-modifiable risk factors for mRS increase. There were 25 deaths, 8 strokes, 11 TIAs, and 1 MI (mean follow-up 38.4 months, range 0-116 months). The presence of CAD/PVD (p=0.009) and dyslipidemia (p=0.002) were significantly associated with long-term complications. CONCLUSION: CAS was performed with low periprocedural complications in high-risk patients. Our rates compare very favorably to large-scale trials that have ideal patients. This data encourages the consideration of CAS in patients considered high risk for CEA and provides possible patient characteristics (CKD) to help with periprocedural risk stratification. FAU - Dinculescu, Vincent AU - Dinculescu V AD - 1Faculty of Medicine. FAU - Ritter, Anne C M AU - Ritter AC AD - 5Royal College of Surgeons in Ireland,Dublin,Ireland. FAU - dos Santos, Marlise P AU - dos Santos MP AD - 3Department of Diagnostic Imaging,The Ottawa Hospital,Ottawa. FAU - Mohan, Ravi M AU - Mohan RM AD - 4Department of Medical Imaging,University of Toronto,Toronto,Ontario,Canada. FAU - Schwarz, Betty A AU - Schwarz BA AD - 3Department of Diagnostic Imaging,The Ottawa Hospital,Ottawa. FAU - Lesiuk, Howard J AU - Lesiuk HJ AD - 2Department of Neurosurgery,University of Ottawa. FAU - Lum, Cheemun AU - Lum C AD - 3Department of Diagnostic Imaging,The Ottawa Hospital,Ottawa. LA - eng PT - Journal Article PL - England TA - Can J Neurol Sci JT - The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques JID - 0415227 SB - IM MH - Age Factors MH - Aged MH - Aged, 80 and over MH - Angiography, Digital Subtraction MH - Carotid Stenosis/*mortality/*therapy MH - Coronary Angiography MH - Female MH - Glomerular Filtration Rate MH - Humans MH - Ischemic Attack, Transient/etiology MH - Logistic Models MH - Longitudinal Studies MH - Male MH - Myocardial Infarction/etiology MH - Postoperative Complications/*epidemiology MH - Proportional Hazards Models MH - Retrospective Studies MH - Risk Assessment MH - Risk Factors MH - Stents/*adverse effects MH - Stroke/etiology MH - Time Factors MH - Treatment Outcome OTO - NOTNLM OT - long term EDAT- 2015/01/31 06:00 MHDA- 2016/11/10 06:00 CRDT- 2015/01/31 06:00 PHST- 2015/01/31 06:00 [entrez] PHST- 2015/01/31 06:00 [pubmed] PHST- 2016/11/10 06:00 [medline] AID - S0317167114001255 [pii] AID - 10.1017/cjn.2014.125 [doi] PST - ppublish SO - Can J Neurol Sci. 2015 Jan;42(1):48-54. doi: 10.1017/cjn.2014.125. PMID- 25603659 OWN - NLM STAT- MEDLINE DCOM- 20150219 LR - 20150121 IS - 1025-9589 (Print) IS - 1025-9589 (Linking) VI - 26 IP - 2 DP - 2014 Apr-Jun TI - Stroke after coronary artery bypass surgery with and without cardiopulmonary bypass. PG - 123-8 AB - BACKGROUND: Stroke is a devastating complication of coronary artery bypass grafting (CABG). This study was carried out with the aim that the development of off pump coronary artery surgery decreases the incidence/adverse outcome due to extra corporeal circulation. METHODS: The data utilized in this study was extracted from a randomized controlled trial that was conducted from January 2006 to March 2007 at Punjab Institute of Cardiology. One hundred patients were included in 'on pump' group-A, and 100 patients in 'off pump' group-B. RESULTS: The mean age of the patients in group-A was 53.51 +/- 9.96 years and in group-B it was 51.59 +/- 10.30 years. Renal failure occurred in 21% patients of group-A as compared to 10% of group-B while Acute Myocardial Infarction occurred in significantly higher number of patients in group-B (11%) as compared to group-A (2%). Off pump was associated with significant decrease in rate of stroke 1.5% as compared to on pump 3.5%. similarly there was decreased in the risk of deaths after stroke 0% as compared to on pump 1.5% mortality after stroke. In group A 6 (3.5%) patients developed stroke where as in group-B 2 (1.5%) patients developed stroke out of these 6 patients there were 2 mortalities after stroke in group-A while in group-B there was no mortality after stroke within 30 days postoperatively. CONCLUSION: Off pump CABG is associated with significantly decreased rate of stroke in comparison with the on-pump CABG. FAU - Iqbal, Javed AU - Iqbal J AD - Punjab Institute of Cardiology, Lahore, Pakistan. aw_3989@yahoo.com FAU - Ghaffar, Abdul AU - Ghaffar A FAU - Shahbaz, Ahmad AU - Shahbaz A FAU - Abid, Abdul Rehman AU - Abid AR LA - eng PT - Journal Article PT - Randomized Controlled Trial PL - Pakistan TA - J Ayub Med Coll Abbottabad JT - Journal of Ayub Medical College, Abbottabad : JAMC JID - 8910750 SB - IM MH - Adult MH - Coronary Artery Bypass/*adverse effects MH - Coronary Artery Bypass, Off-Pump/adverse effects MH - Female MH - Humans MH - Male MH - Middle Aged MH - Myocardial Infarction/epidemiology MH - Postoperative Complications/epidemiology MH - Prognosis MH - Renal Insufficiency/epidemiology MH - Risk Factors MH - Stroke/*epidemiology EDAT- 2015/01/22 06:00 MHDA- 2015/02/20 06:00 CRDT- 2015/01/22 06:00 PHST- 2015/01/22 06:00 [entrez] PHST- 2015/01/22 06:00 [pubmed] PHST- 2015/02/20 06:00 [medline] PST - ppublish SO - J Ayub Med Coll Abbottabad. 2014 Apr-Jun;26(2):123-8. PMID- 25595565 OWN - NLM STAT- MEDLINE DCOM- 20150611 LR - 20220408 IS - 1523-6838 (Electronic) IS - 0272-6386 (Linking) VI - 65 IP - 4 DP - 2015 Apr TI - Allopurinol and progression of CKD and cardiovascular events: long-term follow-up of a randomized clinical trial. PG - 543-9 LID - S0272-6386(14)01476-0 [pii] LID - 10.1053/j.ajkd.2014.11.016 [doi] AB - BACKGROUND: Asymptomatic hyperuricemia increases renal and cardiovascular (CV) risk. We previously conducted a 2-year, single-blind, randomized, controlled trial of allopurinol treatment that showed improved estimated glomerular filtration rate and reduced CV risk. STUDY DESIGN: Post hoc analysis of a long-term follow-up after completion of the 2-year trial. SETTING & PARTICIPANTS: 113 participants (57 in the allopurinol group and 56 in the control group) initially followed up for 2 years and 107 participants followed up to 5 additional years. INTERVENTION: Continuation of allopurinol treatment, 100mg/d, or standard treatment. OUTCOME: Renal event (defined as starting dialysis therapy and/or doubling serum creatinine and/or >/=50% decrease in estimated estimated glomerular filtration rate) and CV events (defined as myocardial infarction, coronary revascularization or angina pectoris, congestive heart failure, cerebrovascular disease, and peripheral vascular disease). RESULTS: During initial follow-up, there were 2 renal and 7 CV events in the allopurinol group compared with 6 renal and 15 CV events in the control group. In the long-term follow-up period, 12 of 56 participants taking allopurinol stopped treatment and 10 of 51 control participants received allopurinol. During long-term follow-up, an additional 7 and 9 participants in the allopurinol group experienced a renal or CV event, respectively, and an additional 18 and 8 participants in the control group experienced a renal or CV event, respectively. Thus, during the initial and long-term follow-up (median, 84 months), 9 patients in the allopurinol group had a renal event compared with 24 patients in the control group (HR, 0.32; 95% CI, 0.15-0.69; P=0.004; adjusted for age, sex, baseline kidney function, uric acid level, and renin-angiotensin-aldosterone system blockers). Overall, 16 patients treated with allopurinol experienced CV events compared with 23 in the control group (HR, 0.43; 95% CI, 0.21-0.88; P=0.02; adjusted for age, sex, and baseline kidney function). LIMITATIONS: Small sample size, single center, not double blind, post hoc follow-up and analysis. CONCLUSIONS: Long-term treatment with allopurinol may slow the rate of progression of kidney disease and reduce CV risk. CI - Copyright (c) 2015 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved. FAU - Goicoechea, Marian AU - Goicoechea M AD - Department of Nephrology, Hospital General Universitario Gregorio Maranon, Madrid, Spain. Electronic address: marian.goicoechea@gmail.com. FAU - Garcia de Vinuesa, Soledad AU - Garcia de Vinuesa S AD - Department of Nephrology, Hospital General Universitario Gregorio Maranon, Madrid, Spain. FAU - Verdalles, Ursula AU - Verdalles U AD - Department of Nephrology, Hospital General Universitario Gregorio Maranon, Madrid, Spain. FAU - Verde, Eduardo AU - Verde E AD - Department of Nephrology, Hospital General Universitario Gregorio Maranon, Madrid, Spain. FAU - Macias, Nicolas AU - Macias N AD - Department of Nephrology, Hospital General Universitario Gregorio Maranon, Madrid, Spain. FAU - Santos, Alba AU - Santos A AD - Department of Nephrology, Hospital General Universitario Gregorio Maranon, Madrid, Spain. FAU - Perez de Jose, Ana AU - Perez de Jose A AD - Department of Nephrology, Hospital General Universitario Gregorio Maranon, Madrid, Spain. FAU - Cedeno, Santiago AU - Cedeno S AD - Department of Nephrology, Hospital General Universitario Gregorio Maranon, Madrid, Spain. FAU - Linares, Tania AU - Linares T AD - Department of Nephrology, Hospital General Universitario Gregorio Maranon, Madrid, Spain. FAU - Luno, Jose AU - Luno J AD - Department of Nephrology, Hospital General Universitario Gregorio Maranon, Madrid, Spain. LA - eng PT - Journal Article PT - Randomized Controlled Trial DEP - 20150113 PL - United States TA - Am J Kidney Dis JT - American journal of kidney diseases : the official journal of the National Kidney Foundation JID - 8110075 RN - 0 (Gout Suppressants) RN - 268B43MJ25 (Uric Acid) RN - 63CZ7GJN5I (Allopurinol) RN - AYI8EX34EU (Creatinine) SB - IM CIN - Am J Kidney Dis. 2015 Apr;65(4):525-7. doi: 10.1053/j.ajkd.2015.01.001. PMID: 25791959 MH - Aged MH - Aged, 80 and over MH - Allopurinol/pharmacology/*therapeutic use MH - Cardiovascular Diseases/*epidemiology MH - Creatinine/blood MH - *Disease Progression MH - Female MH - Follow-Up Studies MH - Glomerular Filtration Rate/drug effects MH - Gout Suppressants/pharmacology/*therapeutic use MH - Humans MH - Incidence MH - Longitudinal Studies MH - Male MH - Middle Aged MH - Renal Insufficiency, Chronic/*drug therapy/mortality MH - Risk Factors MH - Treatment Outcome MH - Uric Acid/blood OTO - NOTNLM OT - Chronic kidney disease (CKD) progression OT - allopurinol treatment OT - cardiovascular (CV) risk OT - hyperuricemia OT - renal disease OT - uric acid concentration EDAT- 2015/01/18 06:00 MHDA- 2015/06/13 06:00 CRDT- 2015/01/18 06:00 PHST- 2014/08/20 00:00 [received] PHST- 2014/11/02 00:00 [accepted] PHST- 2015/01/18 06:00 [entrez] PHST- 2015/01/18 06:00 [pubmed] PHST- 2015/06/13 06:00 [medline] AID - S0272-6386(14)01476-0 [pii] AID - 10.1053/j.ajkd.2014.11.016 [doi] PST - ppublish SO - Am J Kidney Dis. 2015 Apr;65(4):543-9. doi: 10.1053/j.ajkd.2014.11.016. Epub 2015 Jan 13. PMID- 25583761 OWN - NLM STAT- MEDLINE DCOM- 20160216 LR - 20220419 IS - 1522-9645 (Electronic) IS - 0195-668X (Linking) VI - 36 IP - 20 DP - 2015 May 21 TI - Long-term forecasting and comparison of mortality in the Evaluation of the Xience Everolimus Eluting Stent vs. Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization (EXCEL) trial: prospective validation of the SYNTAX Score II. PG - 1231-41 LID - 10.1093/eurheartj/ehu518 [doi] AB - AIMS: To prospectively validate the SYNTAX Score II and forecast the outcomes of the randomized Evaluation of the Xience Everolimus-Eluting Stent Versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization (EXCEL) Trial. METHODS AND RESULTS: Evaluation of the Xience Everolimus Eluting Stent vs. Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization is a prospective, randomized multicenter trial designed to establish the efficacy and safety of percutaneous coronary intervention (PCI) with the everolimus-eluting stent compared with coronary artery bypass graft (CABG) surgery in subjects with unprotected left-main coronary artery (ULMCA) disease and low-intermediate anatomical SYNTAX scores (<33). After completion of patient recruitment in EXCEL, the SYNTAX Score II was prospectively applied to predict 4-year mortality in the CABG and PCI arms. The 95% prediction intervals (PIs) for mortality were computed using simulation with bootstrap resampling (10 000 times). For the entire study cohort, the 4-year predicted mortalities were 8.5 and 10.5% in the PCI and CABG arms, respectively [odds ratios (OR) 0.79; 95% PI 0.43-1.50). In subjects with low (20% and completion of CT coronary angiography at 6 months >80%. Statistical investigation was performed on an intention to treat analysis. RESULTS: Of 421 eligible patients, 60 were enrolled and 2 withdrew (n = 30 in TAG, n = 28 LIMA+SVG) for 14% enrolment rate. Patient characteristics were similar in each group. No patients died in hospital and adverse events such as MI, stroke and deep sternal wound infection were not significantly different between groups. Clinical follow-up was complete in 100% of patients, with 44/58 (76%) undergoing CT coronary angio at 6 months. Graft occlusion occurred in 2 patients in each group for patency rates of 89% (TAG) and 91% (LIMA+SVG). CONCLUSIONS: We provide evidence that an RCT comparing grafting strategy is possible but also show that achieving recruitment or follow-up CT may be difficult. Given the excellent patency results and little difference between groups, our findings suggest that the sample size required may make it infeasible to compare graft patency at 6 months as a study end-point. TRIAL REGISTRATION: Randomized Controlled Trial number: ISRCTN80270323 . Few RCT's exist comparing conventional CABG performed with a LIMA-LAD plus saphenous vein grafts (LIMA+SVG) compared to CABG performed with total arterial grafting (TAG). This study is a pilot RCT designed to test the feasibility of such a trial and identify pitfalls. FAU - Le, Jeffrey AU - Le J AD - Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada. htjle@dal.ca. FAU - Baskett, Roger J F AU - Baskett RJ AD - Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada. rbaskett@dal.ca. FAU - Buth, Karen J AU - Buth KJ AD - Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada. K.J.Buth@Dal.Ca. FAU - Hirsch, Gregory M AU - Hirsch GM AD - Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada. Greg.hirsch@dal.ca. FAU - Brydie, Allan AU - Brydie A AD - Department of Radiology, Dalhousie University, Halifax, Nova Scotia, Canada. Abrydie@eastlink.ca. FAU - Gayner, Ryan AU - Gayner R AD - Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada. RGAINER@dal.ca. FAU - Legare, Jean-Francois AU - Legare JF AD - Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada. jean.legare@cdha.nshealth.ca. AD - Division of Cardiovascular Surgery, The Maritime Heart Center, 2269-1796 Summer Street, Halifax, NS, B3H 3A7, Canada. jean.legare@cdha.nshealth.ca. LA - eng SI - ISRCTN/ISRCTN80270323 PT - Journal Article PT - Randomized Controlled Trial DEP - 20150108 PL - England TA - J Cardiothorac Surg JT - Journal of cardiothoracic surgery JID - 101265113 SB - IM MH - Aged MH - Coronary Angiography MH - *Coronary Artery Bypass MH - Coronary Artery Disease/diagnostic imaging/pathology/*surgery MH - Female MH - Follow-Up Studies MH - Graft Occlusion, Vascular/diagnostic imaging/etiology MH - Humans MH - Male MH - Mammary Arteries/transplantation MH - Pilot Projects MH - Severity of Illness Index MH - Treatment Outcome MH - *Vascular Patency PMC - PMC4299408 EDAT- 2015/01/09 06:00 MHDA- 2015/11/12 06:00 PMCR- 2015/01/08 CRDT- 2015/01/09 06:00 PHST- 2014/08/29 00:00 [received] PHST- 2014/12/26 00:00 [accepted] PHST- 2015/01/09 06:00 [entrez] PHST- 2015/01/09 06:00 [pubmed] PHST- 2015/11/12 06:00 [medline] PHST- 2015/01/08 00:00 [pmc-release] AID - s13019-014-0203-8 [pii] AID - 203 [pii] AID - 10.1186/s13019-014-0203-8 [doi] PST - epublish SO - J Cardiothorac Surg. 2015 Jan 8;10:1. doi: 10.1186/s13019-014-0203-8. PMID- 27656713 OWN - NLM STAT- MEDLINE DCOM- 20160922 LR - 20190918 IS - 1573-7241 (Electronic) IS - 0920-3206 (Print) IS - 0920-3206 (Linking) VI - 29 IP - 5 DP - 2015 TI - Effect of Metformin on Renal Function After Primary Percutaneous Coronary Intervention in Patients Without Diabetes Presenting with ST-elevation Myocardial Infarction: Data from the GIPS-III Trial. PG - 451-9 AB - PURPOSE: The association between metformin use and renal function needs further to be elucidated since data are insufficient whether metformin affects renal function in higher risk populations such as after ST-elevation myocardial infarction (STEMI). METHODS: We studied 379 patients included in the GIPS-III trial in which patients without diabetes or renal dysfunction, who underwent primary percutaneous coronary interventions (PCI) for STEMI, were randomized to metformin 500 mg or placebo twice daily for four months. At baseline and at seven scheduled visits up to four months after PCI, estimated glomerular filtration rate (eGFR) was determined (2582 values). Contrast-induced acute kidney injury (CI-AKI) was defined as an increase in serum creatinine of >/=0.3 mg/dl or 25 % rise within 48 h after PCI. RESULTS: At all visits, the mean eGFR was similar in patients randomized to metformin or placebo. Over the four month period, mixed-effect repeated-measures model analysis showed a least-squares mean +/- standard error change in eGFR of -5.9+/-0.8 ml/min/1.73 m2 in the metformin group and -7.1 +/-0.8 ml/min/1.73 m2 in the control group (P=0.27 for overall interaction). The incidence of CI-AKI was 14.8 %; 29 (15.2 %) patients in the metformin group versus 27 (14.4 %) controls (P=0.89). After adjustment for covariates, metformin treatment was not associated with CI-AKI (odds ratio: 0.96, 95%CI 0.52-1.75, P=0.88). CONCLUSION: We conclude that initiation of metformin shortly after primary PCI has no adverse effect on renal function in patients without diabetes or prior renal impairment, further providing evidence of the safety of metformin use after myocardial infarction and subsequent contrast exposure. FAU - Posma, Rene A AU - Posma RA FAU - Lexis, Chris P H AU - Lexis CP FAU - Lipsic, Erik AU - Lipsic E FAU - Nijsten, Maarten W N AU - Nijsten MW FAU - Damman, Kevin AU - Damman K FAU - Touw, Daan J AU - Touw DJ FAU - van Veldhuisen, Dirk Jan AU - van Veldhuisen DJ FAU - van der Harst, Pim AU - van der Harst P FAU - van der Horst, Iwan C C AU - van der Horst IC LA - eng PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - United States TA - Cardiovasc Drugs Ther JT - Cardiovascular drugs and therapy JID - 8712220 RN - 0 (Hypoglycemic Agents) RN - 9100L32L2N (Metformin) RN - AYI8EX34EU (Creatinine) SB - IM MH - Acute Kidney Injury/blood/*chemically induced/*complications MH - Creatinine/blood MH - Diabetes Mellitus MH - Female MH - Glomerular Filtration Rate/drug effects MH - Humans MH - Hypoglycemic Agents/adverse effects MH - Kidney/*drug effects/physiopathology MH - Male MH - Metformin/*adverse effects MH - Middle Aged MH - Myocardial Infarction/*complications/surgery MH - *Percutaneous Coronary Intervention PMC - PMC4636992 EDAT- 2015/01/01 00:00 MHDA- 2015/01/01 00:01 PMCR- 2015/10/20 CRDT- 2016/09/23 06:00 PHST- 2016/09/23 06:00 [entrez] PHST- 2015/01/01 00:00 [pubmed] PHST- 2015/01/01 00:01 [medline] PHST- 2015/10/20 00:00 [pmc-release] AID - 6618 [pii] AID - 10.1007/s10557-015-6618-1 [doi] PST - ppublish SO - Cardiovasc Drugs Ther. 2015;29(5):451-9. doi: 10.1007/s10557-015-6618-1. PMID- 25516439 OWN - NLM STAT- MEDLINE DCOM- 20151015 LR - 20220410 IS - 2047-9980 (Electronic) IS - 2047-9980 (Linking) VI - 3 IP - 6 DP - 2014 Dec TI - Validated contemporary risk model of acute kidney injury in patients undergoing percutaneous coronary interventions: insights from the National Cardiovascular Data Registry Cath-PCI Registry. PG - e001380 LID - e001380 AB - BACKGROUND: We developed risk models for predicting acute kidney injury (AKI) and AKI requiring dialysis (AKI-D) after percutaneous coronary intervention (PCI) to support quality assessment and the use of preventative strategies. METHODS AND RESULTS: AKI was defined as an absolute increase of >/=0.3 mg/dL or a relative increase of 50% in serum creatinine (AKIN Stage 1 or greater) and AKI-D was a new requirement for dialysis following PCI. Data from 947 012 consecutive PCI patients and 1253 sites participating in the NCDR Cath/PCI registry between 6/09 and 7/11 were used to develop the model, with 70% randomly assigned to a derivation cohort and 30% for validation. AKI occurred in 7.33% of the derivation and validation cohorts. Eleven variables were associated with AKI: older age, baseline renal impairment (categorized as mild, moderate, and severe), prior cerebrovascular disease, prior heart failure, prior PCI, presentation (non-ACS versus NSTEMI versus STEMI), diabetes, chronic lung disease, hypertension, cardiac arrest, anemia, heart failure on presentation, balloon pump use, and cardiogenic shock. STEMI presentation, cardiogenic shock, and severe baseline CKD were the strongest predictors for AKI. The full model showed good discrimination in the derivation and validation cohorts (c-statistic of 0.72 and 0.71, respectively) and identical calibration (slope of calibration line=1.01). The AKI-D model had even better discrimination (c-statistic=0.89) and good calibration (slope of calibration line=0.99). CONCLUSION: The NCDR AKI prediction models can successfully risk-stratify patients undergoing PCI. The potential for this tool to aid clinicians in counseling patients regarding the risk of PCI, identify patients for preventative strategies, and support local quality improvement efforts should be prospectively tested. FAU - Tsai, Thomas T AU - Tsai TT AD - Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado FAU - Patel, Uptal D AU - Patel UD FAU - Chang, Tara I AU - Chang TI FAU - Kennedy, Kevin F AU - Kennedy KF FAU - Masoudi, Frederick A AU - Masoudi FA FAU - Matheny, Michael E AU - Matheny ME FAU - Kosiborod, Mikhail AU - Kosiborod M FAU - Amin, Amit P AU - Amin AP FAU - Weintraub, William S AU - Weintraub WS FAU - Curtis, Jeptha P AU - Curtis JP FAU - Messenger, John C AU - Messenger JC FAU - Rumsfeld, John S AU - Rumsfeld JS FAU - Spertus, John A AU - Spertus JA LA - eng GR - I01 HX000853/HX/HSRD VA/United States PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Research Support, U.S. Gov't, Non-P.H.S. PT - Validation Study PL - England TA - J Am Heart Assoc JT - Journal of the American Heart Association JID - 101580524 RN - 0 (Biomarkers) RN - AYI8EX34EU (Creatinine) SB - IM MH - Acute Kidney Injury/blood/diagnosis/*etiology/physiopathology/therapy MH - Age Factors MH - Aged MH - Biomarkers/blood MH - Comorbidity MH - Creatinine/blood MH - *Decision Support Techniques MH - Female MH - Glomerular Filtration Rate MH - Humans MH - Kidney/physiopathology MH - Male MH - Middle Aged MH - Percutaneous Coronary Intervention/*adverse effects MH - Predictive Value of Tests MH - Registries MH - Renal Dialysis MH - Reproducibility of Results MH - Risk Assessment MH - Risk Factors MH - Severity of Illness Index MH - Treatment Outcome MH - United States PMC - PMC4338731 EDAT- 2014/12/18 06:00 MHDA- 2015/10/16 06:00 PMCR- 2014/12/01 CRDT- 2014/12/18 06:00 PHST- 2014/12/18 06:00 [entrez] PHST- 2014/12/18 06:00 [pubmed] PHST- 2015/10/16 06:00 [medline] PHST- 2014/12/01 00:00 [pmc-release] AID - jah3785 [pii] AID - 10.1161/JAHA.114.001380 [doi] PST - ppublish SO - J Am Heart Assoc. 2014 Dec;3(6):e001380. doi: 10.1161/JAHA.114.001380. PMID- 25499479 OWN - NLM STAT- MEDLINE DCOM- 20150413 LR - 20191210 IS - 1552-6259 (Electronic) IS - 0003-4975 (Linking) VI - 99 IP - 2 DP - 2015 Feb TI - Coronary artery surgery versus percutaneous coronary intervention in octogenarians: long-term results. PG - 567-74 LID - S0003-4975(14)01831-1 [pii] LID - 10.1016/j.athoracsur.2014.09.019 [doi] AB - BACKGROUND: The aim of this study was to compare 7-year rates of all-cause death, cardiac death, myocardial infarction, target vessel revascularization, and stroke in a large cohort of octogenarians with left main coronary artery or multivessel disease, treated with coronary artery bypass grafting or percutaneous coronary intervention. METHODS: Two propensity score-matched cohorts of patients undergoing revascularization procedures at regional public and private centers of Emilia-Romagna, Italy, from July 2002 to December 2008 were used to compare long-term outcomes of percutaneous coronary intervention (947 patients) and coronary artery bypass grafting (441 patients). RESULTS: There were no significant differences between groups in 30-day mortality. In the follow-up the overall and the matched percutaneous coronary intervention population experienced significantly worse outcomes in terms of cardiac mortality, myocardial infarction, and target vessel revascularization. No difference was found for stroke between treatment groups. Percutaneous coronary intervention was an independent predictor of increased death at long-term follow-up. The subgroups in which coronary artery bypass grafting reduced more clearly the risk of death were age 80 to 85 years, previous myocardial infarction, history of cardiac heart failure, chronic renal failure, peripheral vascular disease, and patients with three-vessel disease associated with the left main coronary artery. CONCLUSIONS: In this real-world setting, surgical coronary revascularization remains the standard of care for patients with left main or multivessel disease. The long-term outcomes of current percutaneous coronary intervention technology in octogenarians are yet to be determined with adequately powered prospective randomized studies. CI - Copyright (c) 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved. FAU - Nicolini, Francesco AU - Nicolini F AD - Cardiac Surgery Unit, Clinical and Experimental Medicine Department, University of Parma, Parma, Italy. Electronic address: francesco.nicolini@unipr.it. FAU - Contini, Giovanni Andrea AU - Contini GA AD - Cardiac Surgery Unit, Cardio-Nephro-Pulmonary Department, Parma Hospital, Parma, Italy. FAU - Fortuna, Daniela AU - Fortuna D AD - Regional Agency for Health and Social Care, Emilia-Romagna Region, Bologna, Italy. FAU - Pacini, Davide AU - Pacini D AD - Cardio-Thoracic-Vascular Department, University Hospital S. Orsola-Malpighi, Bologna, Italy. FAU - Gabbieri, Davide AU - Gabbieri D AD - Clinical Surgical Cardiology and Thoracic Vascular Department, Hesperia Hospital, Modena, Italy. FAU - Vignali, Luigi AU - Vignali L AD - Cardiology Unit, Cardio-Nephro-Pulmonary Department, Parma Hospital, Parma, Italy. FAU - Campo, Gianluca AU - Campo G AD - Cardiology Department, University Hospital of Ferrara, Ferrara, Italy. FAU - Manari, Antonio AU - Manari A AD - Cardiology Department, S. Maria Nuova Hospital, Reggio Emilia, Italy. FAU - Zussa, Claudio AU - Zussa C AD - Department of Cardiology and Cardiac Surgery, Villa Maria Cecilia Hospital, Lugo, Italy. FAU - Guastaroba, Paolo AU - Guastaroba P AD - Regional Agency for Health and Social Care, Emilia-Romagna Region, Bologna, Italy. FAU - De Palma, Rossana AU - De Palma R AD - Regional Agency for Health and Social Care, Emilia-Romagna Region, Bologna, Italy. FAU - Gherli, Tiziano AU - Gherli T AD - Cardiac Surgery Unit, Clinical and Experimental Medicine Department, University of Parma, Parma, Italy. LA - eng PT - Comparative Study PT - Evaluation Study PT - Journal Article DEP - 20141210 PL - Netherlands TA - Ann Thorac Surg JT - The Annals of thoracic surgery JID - 15030100R SB - IM CIN - Ann Thorac Surg. 2015 Feb;99(2):574-5. doi: 10.1016/j.athoracsur.2014.10.051. PMID: 25639398 MH - Aged, 80 and over MH - *Coronary Artery Bypass MH - Coronary Artery Disease/*surgery MH - Female MH - Humans MH - Male MH - *Percutaneous Coronary Intervention MH - Postoperative Complications/epidemiology MH - Retrospective Studies MH - Risk Factors MH - Time Factors MH - Treatment Outcome EDAT- 2014/12/17 06:00 MHDA- 2015/04/14 06:00 CRDT- 2014/12/16 06:00 PHST- 2014/02/15 00:00 [received] PHST- 2014/09/05 00:00 [revised] PHST- 2014/09/09 00:00 [accepted] PHST- 2014/12/16 06:00 [entrez] PHST- 2014/12/17 06:00 [pubmed] PHST- 2015/04/14 06:00 [medline] AID - S0003-4975(14)01831-1 [pii] AID - 10.1016/j.athoracsur.2014.09.019 [doi] PST - ppublish SO - Ann Thorac Surg. 2015 Feb;99(2):567-74. doi: 10.1016/j.athoracsur.2014.09.019. Epub 2014 Dec 10. PMID- 25497252 OWN - NLM STAT- MEDLINE DCOM- 20150330 LR - 20201216 IS - 1097-6744 (Electronic) IS - 0002-8703 (Linking) VI - 169 IP - 1 DP - 2015 Jan TI - Sex, adverse cardiac events, and infarct size in anterior myocardial infarction: an analysis of intracoronary abciximab and aspiration thrombectomy in patients with large anterior myocardial infarction (INFUSE-AMI). PG - 86-93 LID - S0002-8703(14)00403-7 [pii] LID - 10.1016/j.ahj.2014.06.019 [doi] AB - BACKGROUND: Women are more likely than men to experience adverse cardiac events after ST-elevation myocardial (STEMI). Whether differences in infarct size or reperfusion contribute to sex differences in outcomes is unknown. METHODS: We compared baseline and procedural characteristics, angiographic and electrocardiographic indices of reperfusion, microvascular obstruction, infarct size, and clinical outcomes in 118 women and 334 men with anterior STEMI enrolled in the INFUSE-AMI randomized trial of intralesion abciximab and aspiration thrombectomy (NCT00976521). Infarct size was assessed by cardiac magnetic resonance imaging at 30 days, and clinical end points were adjudicated by an independent committee. RESULTS: Women were older, were more commonly affected by hypertension and renal impairment, and had a 50.5-minute longer delay to reperfusion. There were no differences in infarct size, microvascular obstruction, or reperfusion success. At 30 days, major adverse cardiac events (MACE), defined as death, reinfarction, new-onset severe heart failure, or rehospitalization for heart failure, were more common in women (11.1% vs 5.4%, hazard ratio 2.09, 95% CI 1.03-4.27, P = .04). After multivariable adjustment, age, but not sex or time to reperfusion, was an independent predictor of MACE. CONCLUSIONS: In the INFUSE-AMI randomized trial, women with anterior STEMI experienced a higher rate of MACE, attributable to older age. Despite longer delay from symptom onset to reperfusion therapy, there was no difference between women and men in infarct size or reperfusion success. CI - Copyright (c) 2014 Elsevier Inc. All rights reserved. FAU - Tomey, Matthew I AU - Tomey MI AD - The Icahn School of Medicine at Mount Sinai, New York, NY. FAU - Mehran, Roxana AU - Mehran R AD - The Icahn School of Medicine at Mount Sinai, New York, NY; Cardiovascular Research Foundation, New York, NY. Electronic address: roxana.mehran@mountsinai.org. FAU - Brener, Sorin J AU - Brener SJ AD - Cardiovascular Research Foundation, New York, NY; New York Methodist Hospital, Brooklyn, NY. FAU - Maehara, Akiko AU - Maehara A AD - Cardiovascular Research Foundation, New York, NY; Columbia University Medical Center, New York, NY. FAU - Witzenbichler, Bernhard AU - Witzenbichler B AD - Charite Campus Benjamin Franklin, Berlin, Germany. FAU - Dizon, Jose M AU - Dizon JM AD - Columbia University Medical Center, New York, NY. FAU - El-Omar, Magdi AU - El-Omar M AD - Manchester Heart Centre, Manchester, United Kingdom. FAU - Xu, Ke AU - Xu K AD - Cardiovascular Research Foundation, New York, NY. FAU - Gibson, C Michael AU - Gibson CM AD - Beth Israel Deaconess Medical Center-Harvard Medical School, Boston, MA. FAU - Stone, Gregg W AU - Stone GW AD - Cardiovascular Research Foundation, New York, NY; Columbia University Medical Center, New York, NY. LA - eng SI - ClinicalTrials.gov/NCT00976521 PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20140703 PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 RN - 0 (Antibodies, Monoclonal) RN - 0 (Immunoglobulin Fab Fragments) RN - 0 (Platelet Aggregation Inhibitors) RN - X85G7936GV (Abciximab) SB - IM MH - Abciximab MH - Aged MH - Anterior Wall Myocardial Infarction/*complications/drug therapy/*epidemiology/pathology MH - Antibodies, Monoclonal/administration & dosage MH - Coronary Angiography MH - Female MH - Heart Failure/etiology MH - Hospitalization/statistics & numerical data MH - Humans MH - Immunoglobulin Fab Fragments/administration & dosage MH - Male MH - Middle Aged MH - Percutaneous Coronary Intervention MH - Platelet Aggregation Inhibitors/administration & dosage MH - Recurrence MH - Sex Factors MH - Thrombectomy MH - Treatment Outcome EDAT- 2014/12/17 06:00 MHDA- 2015/03/31 06:00 CRDT- 2014/12/16 06:00 PHST- 2013/10/17 00:00 [received] PHST- 2014/06/23 00:00 [accepted] PHST- 2014/12/16 06:00 [entrez] PHST- 2014/12/17 06:00 [pubmed] PHST- 2015/03/31 06:00 [medline] AID - S0002-8703(14)00403-7 [pii] AID - 10.1016/j.ahj.2014.06.019 [doi] PST - ppublish SO - Am Heart J. 2015 Jan;169(1):86-93. doi: 10.1016/j.ahj.2014.06.019. Epub 2014 Jul 3. PMID- 25481578 OWN - NLM STAT- MEDLINE DCOM- 20150223 LR - 20191210 IS - 1022-4742 (Print) IS - 1022-4742 (Linking) VI - 23 IP - 4 DP - 2014 Oct TI - Correlation of platelet count and acute ST-elevation myocardial infarction. PG - 637-43 AB - The study was conducted in the Department of cardiology, NICVD Dhaka during the period January 2006 to December 2007 to assess the impact of platelet on ST-elevation myocardial infarction (STEMI). To perform this prospective study 200 patients with STEMI within 72 hours of chest pain of both sexes were randomly selected and were evaluated by clinical history, physical examination and with the help of ECG, Echocardiography and others cardiac risk factors analysis. Heparin therapy before admission, previously documented thrombocytopenia (<140,000/cmm), history of previous or current haemostatic disorder, renal impairment (Creatinine >1.6mg/dl) and history of PCI & CABG were excluded in this study. Patient of Platelet count (PC) 200000/cmm. Follow up period was 3 days to 7 days after hospital admission. Primary outcome heart failure (any Killip class) was significantly more in Group II than Group I (40.0% vs. 23.0%; p=0.009). Though the incidence of Killip class I and cardiogenic shock were not significant between these two groups but Killip class II (18.0% vs. 8.0%; p=0.036) and Killip class III (15.0% vs. 6.0%; p=0.037) heart failure were significantly more among the patient with higher platelet counts. In-hospital mortality, one of the primary outcomes of this study, was significantly higher in Group II (13.0%) than Group I (5.0 %) and p value was 0.048. Re-infarction was more in patient with higher platelet counts group (Group II) than patients with lower platelet count (Group I) but statistically was not significant (16.0% vs.11.0%; p=0.300). FAU - Paul, G K AU - Paul GK AD - Dr Gobinda Kanti Paul, Assistant Professor, Department of Cardiology, Mymensingh Medical College (MMC), Mymensingh, Bangladesh. FAU - Sen, B AU - Sen B FAU - Rahman, M Z AU - Rahman MZ FAU - Ali, M AU - Ali M FAU - Rahman, M M AU - Rahman MM FAU - Rokonuzzaman, S M AU - Rokonuzzaman SM LA - eng PT - Journal Article PT - Observational Study PL - Bangladesh TA - Mymensingh Med J JT - Mymensingh medical journal : MMJ JID - 9601799 SB - IM MH - Adult MH - Bangladesh/epidemiology MH - Electrocardiography MH - Female MH - *Heart Failure/epidemiology/etiology MH - Hospital Mortality MH - Humans MH - Male MH - Middle Aged MH - *Myocardial Infarction/blood/complications/diagnosis/mortality MH - Outcome Assessment, Health Care MH - Platelet Count/*methods MH - Prospective Studies MH - Random Allocation MH - Reproducibility of Results MH - Risk Factors MH - *Shock, Cardiogenic/epidemiology/etiology MH - Statistics as Topic MH - Survival Analysis EDAT- 2014/12/08 06:00 MHDA- 2015/02/24 06:00 CRDT- 2014/12/08 06:00 PHST- 2014/12/08 06:00 [entrez] PHST- 2014/12/08 06:00 [pubmed] PHST- 2015/02/24 06:00 [medline] PST - ppublish SO - Mymensingh Med J. 2014 Oct;23(4):637-43. PMID- 25418218 OWN - NLM STAT- MEDLINE DCOM- 20150218 LR - 20161125 IS - 1916-7075 (Electronic) IS - 0828-282X (Linking) VI - 30 IP - 12 DP - 2014 Dec TI - Brain natriuretic peptide for prevention of contrast-induced nephropathy after percutaneous coronary intervention or coronary angiography. PG - 1607-12 LID - S0828-282X(14)01280-X [pii] LID - 10.1016/j.cjca.2014.08.012 [doi] AB - BACKGROUND: Many methods reportedly prevent contrast-induced nephropathy (CIN), but the effect of brain natriuretic peptide (BNP) on CIN is unknown. In this study we investigated recombinant BNP use before coronary angiography (CA) or nonemergent percutaneous coronary intervention (PCI) in patients with unstable angina. METHODS: One thousand patients with unstable angina were prospectively evaluated. The patients were randomly assigned to: group A, isotonic normal saline (NaCl 0.9%, 1 mL/kg/h) for 24 hours before CA or PCI; and group B, human recombinant BNP (rhBNP; 0.005 mug/kg/min). Serum creatinine (Scr) levels and estimated glomerular filtration rate were measured before and 24, 48, and 72 hours, and 7 days after the procedure. The primary outcome was CIN incidence defined according to a relative (>/= 25%) or absolute (>/= 0.5 mg/dL and 44 mumol/L, respectively) increase in Scr from baseline within 48 hours. The secondary end points were the changes in the Scr and estimated glomerular filtration rate, before and after the procedure. RESULTS: Contrast volume, a history of diabetes mellitus, and BNP administration independently predicted CIN. The incidence of CIN was significantly greater in group A than in group B (14.8% vs 5.6%; P < 0.01). Renal function was less compromised in patients who received rhBNP. The Scr of all patients with CIN remained increased for 24 hours, but it was lower and recovered faster in patients who received rhBNP. CONCLUSIONS: rhBNP administration before CA or PCI protects renal function and can significantly decrease CIN incidence. CI - Copyright (c) 2014 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved. FAU - Liu, Jin-Ming AU - Liu JM AD - Department of Cardiology, the Second Hospital of Hebei Medical University, Shijiazhuang, China. FAU - Xie, Ya-Nan AU - Xie YN AD - Department of Cardiology, the Second Hospital of Hebei Medical University, Shijiazhuang, China. FAU - Gao, Zi-Han AU - Gao ZH AD - Department of Cardiology, the Second Hospital of Hebei Medical University, Shijiazhuang, China. FAU - Zu, Xiu-Guang AU - Zu XG AD - Department of Cardiology, the Second Hospital of Hebei Medical University, Shijiazhuang, China. FAU - Li, Yong-Jun AU - Li YJ AD - Department of Cardiology, the Second Hospital of Hebei Medical University, Shijiazhuang, China. Electronic address: Liyongjunmedsci@163.com. FAU - Hao, Yu-Ming AU - Hao YM AD - Department of Cardiology, the Second Hospital of Hebei Medical University, Shijiazhuang, China. FAU - Chang, Liang AU - Chang L AD - Department of Cardiology, the Second Hospital of Hebei Medical University, Shijiazhuang, China. LA - eng PT - Journal Article PT - Randomized Controlled Trial DEP - 20140823 PL - England TA - Can J Cardiol JT - The Canadian journal of cardiology JID - 8510280 RN - 0 (Biomarkers) RN - 0 (Contrast Media) RN - 0 (Natriuretic Agents) RN - 114471-18-0 (Natriuretic Peptide, Brain) RN - AYI8EX34EU (Creatinine) SB - IM MH - Aged MH - Angina, Unstable/blood/diagnostic imaging/*surgery MH - Biomarkers/blood MH - Contrast Media/*adverse effects MH - Coronary Angiography/*adverse effects MH - Creatinine/blood MH - Female MH - Follow-Up Studies MH - Glomerular Filtration Rate MH - Humans MH - Kidney Diseases/blood/chemically induced/*prevention & control MH - Kidney Function Tests MH - Male MH - Natriuretic Agents/therapeutic use MH - Natriuretic Peptide, Brain/*therapeutic use MH - *Percutaneous Coronary Intervention MH - Prospective Studies MH - Treatment Outcome EDAT- 2014/11/25 06:00 MHDA- 2015/02/19 06:00 CRDT- 2014/11/25 06:00 PHST- 2014/03/12 00:00 [received] PHST- 2014/08/05 00:00 [revised] PHST- 2014/08/05 00:00 [accepted] PHST- 2014/11/25 06:00 [entrez] PHST- 2014/11/25 06:00 [pubmed] PHST- 2015/02/19 06:00 [medline] AID - S0828-282X(14)01280-X [pii] AID - 10.1016/j.cjca.2014.08.012 [doi] PST - ppublish SO - Can J Cardiol. 2014 Dec;30(12):1607-12. doi: 10.1016/j.cjca.2014.08.012. Epub 2014 Aug 23. PMID- 25392341 OWN - NLM STAT- MEDLINE DCOM- 20150921 LR - 20260128 IS - 1569-9285 (Electronic) IS - 1569-9285 (Linking) VI - 20 IP - 2 DP - 2015 Feb TI - The dose-related effects of dexmedetomidine on renal functions and serum neutrophil gelatinase-associated lipocalin values after coronary artery bypass grafting: a randomized, triple-blind, placebo-controlled study. PG - 209-14 LID - 10.1093/icvts/ivu367 [doi] AB - OBJECTIVES: Acute kidney failure after coronary artery bypass grafting (CABG) is a serious complication that increases morbidity and mortality rates. Early detection and prevention of this complication are very important. A novel biomarker named neutrophil gelatinase-associated lipocalin (NGAL) can play an important role in early diagnosis of acute kidney injury. Recent studies on the favourable effects of Dexmedetomidine on cardiac surgery have been published. The aim of this study is to investigate whether there is a dose-dependent positive effect of Dexmedetomidine on neutrophil gelatinase-associated lipocalin levels and renal functions when used after CABG. METHODS: Our randomized, triple-blinded, placebo-controlled study was conducted among 295 patients scheduled for CABG surgery between August 2009 and March 2011 in a tertiary cardiac and vascular surgery clinic. A total of 90 consecutive patients who met inclusion criteria were randomized and divided into three groups. The first group received a placebo. The second and the third groups received 4 and 8 microg/cc concentration of the Dexmedetomidine infusion, respectively. Infusion rates were regulated to obtain sedation with a Ramsey sedation score of 2 or 3. Patients were regrouped according to the total Dexmedetomidine dose. Statistical analyses of variables including serum neutrophil gelatinase-associated lipocalin values and conventional renal function tests were made for all six possibilities before the blind was broken. RESULTS: Results of conventional renal function tests were not significantly different. However, neutrophil gelatinase-associated lipocalin levels for the first postoperative day for placebo, low-dose and high-dose Dexmedetomidine groups were 176.8 +/- 145.9, 97.7 +/- 63.4 and 67.3 +/- 10.9 ng/ml, respectively. These values were significantly different among the groups (P <0.001). CONCLUSIONS: In our study, we found that Dexmedetomidine infusion for sedation after CABG under cardiopulmonary bypass can be useful in the prevention of kidney injury. Conventional renal function tests, including blood urea nitrogen, serum creatinine, urine output and creatinine clearance rate measurements typically may not detect the development of acute kidney dysfunction in the first 48-h postoperative period. Differences were detected in renal function in the early postoperative period and the development of acute kidney injury, as determined by measurements of blood NGAL levels, was significant and dose-dependent. CI - (c) The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. FAU - Balkanay, Ozan Onur AU - Balkanay OO AD - Department of Cardiovascular Surgery, Manisa State Hospital, Manisa, Turkey balkanay@doctor.com. FAU - Goksedef, Deniz AU - Goksedef D AD - Department of Cardiovascular Surgery, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey. FAU - Omeroglu, Suat Nail AU - Omeroglu SN AD - Department of Cardiovascular Surgery, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey. FAU - Ipek, Gokhan AU - Ipek G AD - Department of Cardiovascular Surgery, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey. LA - eng PT - Journal Article PT - Randomized Controlled Trial DEP - 20141112 PL - England TA - Interact Cardiovasc Thorac Surg JT - Interactive cardiovascular and thoracic surgery JID - 101158399 RN - 0 (Acute-Phase Proteins) RN - 0 (Biomarkers) RN - 0 (Hypnotics and Sedatives) RN - 0 (LCN2 protein, human) RN - 0 (Lipocalin-2) RN - 0 (Lipocalins) RN - 0 (Proto-Oncogene Proteins) RN - 67VB76HONO (Dexmedetomidine) RN - AYI8EX34EU (Creatinine) SB - IM MH - Acute Kidney Injury/blood/diagnosis/etiology/physiopathology/*prevention & control MH - Acute-Phase Proteins MH - Aged MH - Biomarkers/blood MH - Blood Urea Nitrogen MH - Coronary Artery Bypass/*adverse effects MH - Coronary Artery Disease/diagnosis/*surgery MH - Creatinine/blood MH - Cytoprotection MH - Dexmedetomidine/administration & dosage/*therapeutic use MH - Dose-Response Relationship, Drug MH - Female MH - Humans MH - Hypnotics and Sedatives/administration & dosage/*therapeutic use MH - Infusions, Intravenous MH - Kidney/*drug effects/physiopathology MH - Lipocalin-2 MH - Lipocalins/*blood MH - Male MH - Middle Aged MH - Predictive Value of Tests MH - Proto-Oncogene Proteins/*blood MH - Tertiary Care Centers MH - Time Factors MH - Treatment Outcome MH - Turkey OTO - NOTNLM OT - Coronary artery bypass grafting OT - Dexmedetomidine OT - Kidney injury OT - Neutrophil gelatinase-associated lipocalin EDAT- 2014/11/14 06:00 MHDA- 2015/09/22 06:00 CRDT- 2014/11/14 06:00 PHST- 2014/11/14 06:00 [entrez] PHST- 2014/11/14 06:00 [pubmed] PHST- 2015/09/22 06:00 [medline] AID - ivu367 [pii] AID - 10.1093/icvts/ivu367 [doi] PST - ppublish SO - Interact Cardiovasc Thorac Surg. 2015 Feb;20(2):209-14. doi: 10.1093/icvts/ivu367. Epub 2014 Nov 12. PMID- 25330500 OWN - NLM STAT- MEDLINE DCOM- 20150710 LR - 20151119 IS - 1969-6213 (Electronic) IS - 1774-024X (Linking) VI - 10 IP - 6 DP - 2014 Oct TI - Clinical outcome following second-generation drug-eluting stent use for off-label versus on-label indications: insights from the two-year outcome of the TWENTE trial. PG - 664-71 LID - EIJV10I6A117 [pii] LID - 10.4244/EIJV10I6A117 [doi] AB - Drug-eluting stents (DES) were first used on-label - in simple patients with low clinical risk and easily accessible lesions. Currently, DES are increasingly used off-label - in complex patients undergoing percutaneous coronary interventions (PCI) with historically higher event risk. Therefore, our aim was to investigate whether patients with off-label indications for DES use had similar outcomes compared to patients who were treated for on-label indications only. We analysed two-year follow-up data of 1,387 TWENTE trial patients, treated with second-generation everolimus-eluting XIENCE V or zotarolimus-eluting Resolute stents, and compared off-label vs. on-label DES use with regard to the following clinical endpoints: cardiac death, myocardial infarction (MI), periprocedural MI (0.8). Following off-label DES use, there was a higher incidence of PMI (5.0% vs. 1.4%; p=0.003), of which only 1.1% reached creatine kinase levels >5x the upper limit of normal (ULN). Despite differences in risk profile, patients with off-label DES use did not differ from patients with on-label DES use in clinical endpoints other than periprocedural MI. These largely positive findings underline the favourable safety profile of second-generation DES. FAU - Sen, Hanim AU - Sen H AD - Department of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, The Netherlands. FAU - Lam, Ming Kai AU - Lam MK FAU - Tandjung, Kenneth AU - Tandjung K FAU - Basalus, Mounir W Z AU - Basalus MW FAU - de Man, Frits H A F AU - de Man FH FAU - Louwerenburg, J Hans W AU - Louwerenburg JH FAU - Stoel, Martin G AU - Stoel MG FAU - van Houwelingen, Gert K AU - van Houwelingen GK FAU - Lowik, Marije M AU - Lowik MM FAU - Linssen, Gerard C M AU - Linssen GC FAU - Said, Salah A M AU - Said SA FAU - Nienhuis, Mark B AU - Nienhuis MB FAU - Verhorst, Patrick M J AU - Verhorst PM FAU - van der Palen, Job AU - van der Palen J FAU - von Birgelen, Clemens AU - von Birgelen C LA - eng PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - France TA - EuroIntervention JT - EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology JID - 101251040 RN - 9HW64Q8G6G (Everolimus) RN - EC 2.7.3.2 (Creatine Kinase) RN - H4GXR80IZE (zotarolimus) RN - W36ZG6FT64 (Sirolimus) SB - IM MH - Acute Coronary Syndrome/epidemiology MH - Calcinosis/epidemiology MH - Creatine Kinase/analysis MH - Diabetes Mellitus/epidemiology MH - *Drug-Eluting Stents MH - Everolimus MH - Female MH - Humans MH - Kidney Failure, Chronic/epidemiology MH - Male MH - Middle Aged MH - Myocardial Infarction/epidemiology MH - *Off-Label Use MH - *Patient Outcome Assessment MH - *Percutaneous Coronary Intervention MH - Severity of Illness Index MH - Sirolimus/administration & dosage/analogs & derivatives EDAT- 2014/10/21 06:00 MHDA- 2015/07/15 06:00 CRDT- 2014/10/21 06:00 PHST- 2014/10/21 06:00 [entrez] PHST- 2014/10/21 06:00 [pubmed] PHST- 2015/07/15 06:00 [medline] AID - EIJV10I6A117 [pii] AID - 10.4244/EIJV10I6A117 [doi] PST - ppublish SO - EuroIntervention. 2014 Oct;10(6):664-71. doi: 10.4244/EIJV10I6A117. PMID- 25326742 OWN - NLM STAT- MEDLINE DCOM- 20150804 LR - 20220408 IS - 1876-7605 (Electronic) IS - 1936-8798 (Print) IS - 1936-8798 (Linking) VI - 7 IP - 11 DP - 2014 Nov TI - Intravascular ultrasound guidance to minimize the use of iodine contrast in percutaneous coronary intervention: the MOZART (Minimizing cOntrast utiliZation With IVUS Guidance in coRonary angioplasTy) randomized controlled trial. PG - 1287-93 LID - S1936-8798(14)01236-9 [pii] LID - 10.1016/j.jcin.2014.05.024 [doi] AB - OBJECTIVES: The aim of this study was to evaluate the impact of intravascular ultrasound (IVUS) guidance on the final volume of contrast agent used in patients undergoing percutaneous coronary intervention (PCI). BACKGROUND: To date, few approaches have been described to reduce the final dose of contrast agent in PCIs. We hypothesized that IVUS might serve as an alternative imaging tool to angiography in many steps during PCI, thereby reducing the use of iodine contrast. METHODS: A total of 83 patients were randomized to angiography-guided PCI or IVUS-guided PCI; both groups were treated according to a pre-defined meticulous procedural strategy. The primary endpoint was the total volume contrast agent used during PCI. Patients were followed clinically for an average of 4 months. RESULTS: The median total volume of contrast was 64.5 ml (interquartile range [IQR]: 42.8 to 97.0 ml; minimum, 19 ml; maximum, 170 ml) in the angiography-guided group versus 20.0 ml (IQR: 12.5 to 30.0 ml; minimum, 3 ml; maximum, 54 ml) in the IVUS-guided group (p < 0.001). Similarly, the median volume of contrast/creatinine clearance ratio was significantly lower among patients treated with IVUS-guided PCI (1.0 [IQR: 0.6 to 1.9] vs. 0.4 [IQR: 0.2 to 0.6, respectively; p < 0.001). In-hospital and 4-month outcomes were not different between patients randomized to angiography-guided and IVUS-guided PCI. CONCLUSIONS: Thoughtful and extensive use of IVUS as the primary imaging tool to guide PCI is safe and markedly reduces the volume of iodine contrast compared with angiography-alone guidance. The use of IVUS should be considered for patients at high risk of contrast-induced acute kidney injury or volume overload undergoing coronary angioplasty. (Minimizing cOntrast utiliZation With IVUS Guidance in coRonary angioplasTy [MOZART]; NCT01947335). CI - Copyright (c) 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Mariani, Jose Jr AU - Mariani J Jr AD - Department of Interventional Cardiology, Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil. FAU - Guedes, Cristiano AU - Guedes C AD - Department of Interventional Cardiology, Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil. FAU - Soares, Paulo AU - Soares P AD - Department of Interventional Cardiology, Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil. FAU - Zalc, Silvio AU - Zalc S AD - Department of Interventional Cardiology, Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil. FAU - Campos, Carlos M AU - Campos CM AD - Department of Interventional Cardiology, Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil; Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands. FAU - Lopes, Augusto C AU - Lopes AC AD - Institute of Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, Massachusetts. FAU - Spadaro, Andre G AU - Spadaro AG AD - Department of Interventional Cardiology, Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil. FAU - Perin, Marco A AU - Perin MA AD - Department of Interventional Cardiology, Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil. FAU - Filho, Antonio Esteves AU - Filho AE AD - Department of Interventional Cardiology, Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil. FAU - Takimura, Celso K AU - Takimura CK AD - Department of Interventional Cardiology, Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil. FAU - Ribeiro, Expedito AU - Ribeiro E AD - Department of Interventional Cardiology, Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil. FAU - Kalil-Filho, Roberto AU - Kalil-Filho R AD - Department of Interventional Cardiology, Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil. FAU - Edelman, Elazer R AU - Edelman ER AD - Institute of Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, Massachusetts; Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. FAU - Serruys, Patrick W AU - Serruys PW AD - Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands; Imperial College London, London, United Kingdom. FAU - Lemos, Pedro A AU - Lemos PA AD - Department of Interventional Cardiology, Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil. Electronic address: pedro.lemos@incor.usp.br. LA - eng SI - ClinicalTrials.gov/NCT01947335 GR - R01 GM049039/GM/NIGMS NIH HHS/United States GR - R01 GM49039/GM/NIGMS NIH HHS/United States PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't DEP - 20141015 PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 RN - 0 (Biomarkers) RN - 0 (Contrast Media) RN - 0 (Triiodobenzoic Acids) RN - 4419T9MX03 (Iohexol) RN - 712BAC33MZ (iopromide) RN - AYI8EX34EU (Creatinine) RN - HW8W27HTXX (iodixanol) SB - IM CIN - JACC Cardiovasc Interv. 2014 Nov;7(11):1294-6. doi: 10.1016/j.jcin.2014.06.011. PMID: 25459042 MH - Acute Kidney Injury/blood/chemically induced/diagnosis/prevention & control MH - Aged MH - Biomarkers/blood MH - *Contrast Media/adverse effects MH - *Coronary Angiography/adverse effects MH - Coronary Artery Disease/diagnostic imaging/*therapy MH - Creatinine/blood MH - Female MH - Humans MH - Iohexol/adverse effects/*analogs & derivatives MH - Male MH - Middle Aged MH - Percutaneous Coronary Intervention/adverse effects/*methods MH - Risk Factors MH - Time Factors MH - Treatment Outcome MH - *Triiodobenzoic Acids/adverse effects MH - *Ultrasonography, Interventional PMC - PMC4637944 MID - NIHMS733770 OTO - NOTNLM OT - contrast OT - coronary intravascular ultrasound OT - renal failure OT - stent EDAT- 2014/10/20 06:00 MHDA- 2015/08/05 06:00 PMCR- 2015/11/09 CRDT- 2014/10/20 06:00 PHST- 2013/12/17 00:00 [received] PHST- 2014/04/25 00:00 [revised] PHST- 2014/05/22 00:00 [accepted] PHST- 2014/10/20 06:00 [entrez] PHST- 2014/10/20 06:00 [pubmed] PHST- 2015/08/05 06:00 [medline] PHST- 2015/11/09 00:00 [pmc-release] AID - S1936-8798(14)01236-9 [pii] AID - 10.1016/j.jcin.2014.05.024 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2014 Nov;7(11):1287-93. doi: 10.1016/j.jcin.2014.05.024. Epub 2014 Oct 15. PMID- 25318787 OWN - NLM STAT- MEDLINE DCOM- 20150615 LR - 20220408 IS - 1349-7235 (Electronic) IS - 0918-2918 (Linking) VI - 53 IP - 20 DP - 2014 TI - Remedial hydration reduces the incidence of contrast-induced nephropathy and short-term adverse events in patients with ST-segment elevation myocardial infarction: a single-center, randomized trial. PG - 2265-72 AB - OBJECTIVE: The aim of this study was to investigate whether remedial hydration (RH) reduces the incidence of contrast-induced nephropathy (CIN) and short-term adverse events in ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI). METHODS: A total of 216 consecutive STEMI patients were prospectively and randomly assigned into two groups: 108 patients in the RH group and 108 patients in the no RH (control) group. The serum creatinine (SCr) and creatinine clearance (CCr) levels were measured on admission and at 24, 48 and 72 hours after primary PCI. The rates of CIN and short-term adverse events were analyzed for each group. After surgery, the patients were categorized into four groups according to the Mehran risk score: low (/=16, n=22). RESULTS: The incidence of CIN in the RH group was lower than that observed in the control group (22/108; 20.4% vs. 38/108; 35.2%, p<0.05). The subgroup analysis showed that the rate of CIN was lower in the moderate (6/29; 20.7% vs. 13/30; 43.3%, p<0.10) and significantly lower in both the high (5/21; 23.8% vs. 10/18; 55.6%, p<0.05) and very high score groups (3/12; 25.0% vs. 8/12; 66.7%, p<0.05) among the RH patients compared to the controls. At 24, 48 and 72 hours after PCI, the patients in the RH group exhibited lower SCr levels and higher CCr levels than the patients in the control group (both p<0.05). A lower incidence of in-hospital clinical events was also observed in the RH group. CONCLUSION: Remedial hydration decreases the occurrence of CIN and improves the short-term prognosis of STEMI patients undergoing primary PCI. FAU - Luo, Yu AU - Luo Y AD - Department of Cardiology, Shanghai East Hospital, Tongji University School of Medicine, China. FAU - Wang, Xiaodong AU - Wang X FAU - Ye, Zi AU - Ye Z FAU - Lai, Yan AU - Lai Y FAU - Yao, Yian AU - Yao Y FAU - Li, Jimin AU - Li J FAU - Liu, Xuebo AU - Liu X LA - eng PT - Journal Article PT - Randomized Controlled Trial DEP - 20141015 PL - Japan TA - Intern Med JT - Internal medicine (Tokyo, Japan) JID - 9204241 RN - 0 (Contrast Media) RN - AYI8EX34EU (Creatinine) SB - IM MH - Aged MH - *Angioplasty, Balloon, Coronary MH - Contrast Media/*adverse effects MH - Creatinine/blood MH - Electrocardiography MH - Female MH - *Fluid Therapy MH - Humans MH - Kidney Diseases/chemically induced/*prevention & control MH - Kidney Function Tests MH - Male MH - Middle Aged MH - Myocardial Infarction/complications/*therapy MH - Percutaneous Coronary Intervention MH - Prognosis MH - Prospective Studies MH - Risk Factors EDAT- 2014/10/17 06:00 MHDA- 2015/06/16 06:00 CRDT- 2014/10/17 06:00 PHST- 2014/10/17 06:00 [entrez] PHST- 2014/10/17 06:00 [pubmed] PHST- 2015/06/16 06:00 [medline] AID - DN/JST.JSTAGE/internalmedicine/53.1853 [pii] AID - 10.2169/internalmedicine.53.1853 [doi] PST - ppublish SO - Intern Med. 2014;53(20):2265-72. doi: 10.2169/internalmedicine.53.1853. Epub 2014 Oct 15. PMID- 25284808 OWN - NLM STAT- MEDLINE DCOM- 20160321 LR - 20141202 IS - 1878-0938 (Electronic) IS - 1878-0938 (Linking) VI - 15 IP - 6-7 DP - 2014 Sep-Oct TI - Comparison of sirolimus- and paclitaxel-eluting stents in patients with moderate renal insufficiency: results from the J-DESsERT trial. PG - 323-8 LID - S1553-8389(14)00211-5 [pii] LID - 10.1016/j.carrev.2014.09.003 [doi] AB - BACKGROUND: It is unclear whether there are differences in clinical outcomes between sirolimus-eluting stents (SES) and paclitaxel-eluting stents (PES) in patients with moderate renal insufficiency (RI). METHODS: The Japan-Drug Eluting Stents Evaluation; a Randomized Trial (J-DESsERT) was a prospective, randomized multicenter trial which compared 1:1 coronary stenting between SES and PES patients. Patient with serious RI (serum creatinine value 2mg/dL or higher) were excluded. Patients were classified into 2 arms according to renal function: a non-RI arm of 2220 patients (SES 1094 and PES 1126 patients with estimated glomerular filtration rate (eGFR) >/=60 mL min(-1) 1.73 m(-2)) and an RI arm of 1206 patients (SES 613, PES 593 with 30/=0.5 mg/dL or >/=25% above baseline within 72 hours after PCI. RESULTS: The incidence of CIN was significantly lower in the statin group than that in the control group (18.8% vs. 13.5%, p=0.040). The maximum percent changes in serum creatinine and estimated glomerular filtration rate in the statin group within 48 hours were significantly lower than those in the control group (5.84+/-22.59% vs. 2.43+/-24.49%, p=0.038; -11.44+/-14.00 vs. -9.51+/-13.89, p=0.048, respectively). The effect of rosuvastatin on preventing CIN was greater in the subgroups of patients with diabetes, high-dose contrast medium, multivessel stents, high baseline C-reactive protein, and myocardial infarction. A multivariate analysis revealed that rosuvastatin loading was independently associated with a decreased risk for CIN (odds ratio, 0.64; 95% confidence interval, 0.43-0.95, p=0.026). CONCLUSION: High-dose rosuvastatin loading before PCI was associated with a significantly lower incidence of CIN in patients with ACS. FAU - Yun, Kyeong Ho AU - Yun KH AD - Department of Cardiovascular Medicine, Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan, Korea. FAU - Lim, Jae Hong AU - Lim JH AD - Department of Cardiovascular Medicine, Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan, Korea. FAU - Hwang, Kyo Bum AU - Hwang KB AD - Department of Cardiovascular Medicine, Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan, Korea. FAU - Woo, Sun Ho AU - Woo SH AD - Department of Cardiovascular Medicine, Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan, Korea. FAU - Jeong, Jin Woo AU - Jeong JW AD - Department of Cardiovascular Medicine, Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan, Korea. FAU - Kim, Yong Cheol AU - Kim YC AD - Department of Cardiovascular Medicine, Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan, Korea. FAU - Joe, Dai-Yeol AU - Joe DY AD - Department of Cardiovascular Medicine, Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan, Korea. FAU - Ko, Jum Suk AU - Ko JS AD - Department of Cardiovascular Medicine, Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan, Korea. FAU - Rhee, Sang Jae AU - Rhee SJ AD - Department of Cardiovascular Medicine, Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan, Korea. FAU - Lee, Eun Mi AU - Lee EM AD - Department of Cardiovascular Medicine, Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan, Korea. FAU - Oh, Seok Kyu AU - Oh SK AD - Department of Cardiovascular Medicine, Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan, Korea. LA - eng PT - Journal Article DEP - 20140925 PL - Korea (South) TA - Korean Circ J JT - Korean circulation journal JID - 101247141 PMC - PMC4180606 OTO - NOTNLM OT - Contrast media OT - Kidney OT - Statins COIS- The authors have no financial conflicts of interest. EDAT- 2014/10/04 06:00 MHDA- 2014/10/04 06:01 PMCR- 2014/09/01 CRDT- 2014/10/04 06:00 PHST- 2014/06/02 00:00 [received] PHST- 2014/06/30 00:00 [revised] PHST- 2014/07/18 00:00 [accepted] PHST- 2014/10/04 06:00 [entrez] PHST- 2014/10/04 06:00 [pubmed] PHST- 2014/10/04 06:01 [medline] PHST- 2014/09/01 00:00 [pmc-release] AID - 10.4070/kcj.2014.44.5.301 [doi] PST - ppublish SO - Korean Circ J. 2014 Sep;44(5):301-6. doi: 10.4070/kcj.2014.44.5.301. Epub 2014 Sep 25. PMID- 25217457 OWN - NLM STAT- MEDLINE DCOM- 20141216 LR - 20260128 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 114 IP - 9 DP - 2014 Nov 1 TI - Three-year patient-related and stent-related outcomes of second-generation everolimus-eluting Xience V stents versus zotarolimus-eluting resolute stents in real-world practice (from the Multicenter Prospective EXCELLENT and RESOLUTE-Korea Registries). PG - 1329-38 LID - S0002-9149(14)01586-0 [pii] LID - 10.1016/j.amjcard.2014.07.065 [doi] AB - Long-term outcomes are imperative to confirm safety of drug-eluting stents. There have been 2 randomized controlled trials comparing everolimus-eluting stents (EESs) and Resolute zotarolimus-eluting stents (ZES-Rs). To date, long-term clinical outcomes of these stents were limited to only 1 report, which has recently reported 4-year comparisons of these stents. Therefore, more evidence is needed regarding long-term clinical outcomes of the second-generation stents. This study compared the long-term clinical outcomes of EES with ZES-R in "all-comer" cohorts up to 3-year follow-up. The EXCELLENT and RESOLUTE-Korea registries prospectively enrolled 3,056 patients treated with EES and 1,998 with ZES-R, respectively, without exclusions. Stent-related composite outcomes (target lesion failure) and patient-related composite events up to 3-year follow-up were compared in crude and propensity score-matched analyses. Of 5,054 patients, 3,830 patients (75.8%) had off-label indication (2,217 treated with EES and 1,613 treated with ZES-R). The stent-related outcome (189 [6.2%] vs 127 [6.4%], p = 0.812) and the patient-related outcome (420 [13.7%] vs 250 [12.5%], p = 0.581) did not differ between EES and ZES-R, respectively, at 3 years, which was corroborated by similar results from the propensity score-matched cohort (hazard ratio [HR] 0.92, 95% confidence interval [CI] 0.70 to 1.20, p = 0.523 and 0.85, 95% CI 0.70 to 1.02, p = 0.081, for stent- and patient-related outcomes, respectively). The rate of definite or probable stent thrombosis up to 3 years (22 [0.7%] vs 10 [0.5%], p = 0.370) was also similar. The rate of very late definite or probable stent thrombosis was very low and comparable between the 2 stents (3 [0.1%] vs 1 [0.1%], p = 0.657). In multivariate analysis, chronic renal failure (adjusted HR 3.615, 95% CI 2.440 to 5.354, p <0.001) and off-label indication (adjusted HR 1.782, 95% CI 1.169 to 2.718, p = 0.007) were the strongest predictors of target lesion failure at 3 years. In conclusion, both stents showed comparable safety and efficacy at 3-year follow-up in this robust real-world registry with unrestricted use of EES and ZES-R. Overall incidences of target lesion failure and definite stent thrombosis, including very late stent thrombosis, were low, even in the patients with off-label indications, suggesting excellent long-term safety and sustained efficacy of both types of second-generation drug-eluting stents. CI - Copyright (c) 2014 Elsevier Inc. All rights reserved. FAU - Lee, Joo Myung AU - Lee JM AD - Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea. FAU - Park, Kyung Woo AU - Park KW AD - Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea. FAU - Han, Jung-Kyu AU - Han JK AD - Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea. FAU - Yang, Han-Mo AU - Yang HM AD - Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea. FAU - Kang, Hyun-Jae AU - Kang HJ AD - Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea. FAU - Koo, Bon-Kwon AU - Koo BK AD - Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea. FAU - Bae, Jang-Whan AU - Bae JW AD - Chungbuk National University, Cheongju, Republic of Korea. FAU - Woo, Sung-Il AU - Woo SI AD - Inha University Hospital, Incheon, Republic of Korea. FAU - Park, Jin Sik AU - Park JS AD - Sejong General Hospital, Sejong Heart Institute, Bucheon, Republic of Korea. FAU - Jin, Dong-Kyu AU - Jin DK AD - Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea. FAU - Jeon, Dong Woon AU - Jeon DW AD - National Health Insurance Corporation Ilsan Hospital, Goyang, Republic of Korea. FAU - Oh, Seok Kyu AU - Oh SK AD - Wonkwang University School of Medicine, Iksan, Republic of Korea. FAU - Park, Jong-Seon AU - Park JS AD - Yeungnam University Medical Center, Daegu, Republic of Korea. FAU - Kim, Doo-Il AU - Kim DI AD - Inje University, Haeundae Paik Hospital, Busan, Republic of Korea. FAU - Hyon, Min Su AU - Hyon MS AD - Soonchunhyang University Hospital, Seoul, Republic of Korea. FAU - Jeon, Hui-Kyung AU - Jeon HK AD - Uijeongbu St Mary's Hospital, Uijeongbu, Republic of Korea. FAU - Lim, Do-Sun AU - Lim DS AD - Korea University Anam Hospital, Seoul, Republic of Korea. FAU - Kim, Myeong-Gon AU - Kim MG AD - Kyunghee University College of Medicine, Seoul, Republic of Korea. FAU - Rha, Seung-Woon AU - Rha SW AD - Korea University Guro, Hospital, Seoul, Republic of Korea. FAU - Her, Sung-Ho AU - Her SH AD - Daejeon St. Mary's Hospital, Daejeon, Republic of Korea. FAU - Hwang, Jin-Yong AU - Hwang JY AD - Gyeongsang National University Hospital, Jinju, Republic of Korea. FAU - Kim, Sanghyun AU - Kim S AD - Boramae Medical Center, Seoul, Republic of Korea. FAU - Choi, Young Jin AU - Choi YJ AD - Sejong General Hospital, Sejong Heart Institute, Bucheon, Republic of Korea. FAU - Kang, Jin Ho AU - Kang JH AD - Kangbuk Samsung Hospital, Seoul, Republic of Korea. FAU - Moon, Keon-Woong AU - Moon KW AD - St. Vincent's Hospital, Suwon, Republic of Korea. FAU - Jang, Yangsoo AU - Jang Y AD - Yonsei University College of Medicine, Seoul, Republic of Korea. FAU - Kim, Hyo-Soo AU - Kim HS AD - Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea. Electronic address: hyosoo@snu.ac.kr. LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20140812 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 RN - 0 (Antineoplastic Agents) RN - 0 (Immunosuppressive Agents) RN - 9HW64Q8G6G (Everolimus) RN - H4GXR80IZE (zotarolimus) RN - W36ZG6FT64 (Sirolimus) SB - IM MH - Antineoplastic Agents MH - Coronary Angiography MH - Coronary Artery Disease/diagnostic imaging/mortality/*surgery MH - *Drug-Eluting Stents MH - Electrocardiography MH - Everolimus MH - Female MH - Follow-Up Studies MH - Humans MH - Immunosuppressive Agents/pharmacology MH - Male MH - Middle Aged MH - Percutaneous Coronary Intervention/*methods MH - Prospective Studies MH - Prosthesis Design MH - *Registries MH - Republic of Korea/epidemiology MH - Sirolimus/*analogs & derivatives/pharmacology MH - Survival Rate/trends MH - Time Factors MH - Treatment Outcome EDAT- 2014/09/14 06:00 MHDA- 2014/12/17 06:00 CRDT- 2014/09/14 06:00 PHST- 2014/07/06 00:00 [received] PHST- 2014/07/30 00:00 [revised] PHST- 2014/07/30 00:00 [accepted] PHST- 2014/09/14 06:00 [entrez] PHST- 2014/09/14 06:00 [pubmed] PHST- 2014/12/17 06:00 [medline] AID - S0002-9149(14)01586-0 [pii] AID - 10.1016/j.amjcard.2014.07.065 [doi] PST - ppublish SO - Am J Cardiol. 2014 Nov 1;114(9):1329-38. doi: 10.1016/j.amjcard.2014.07.065. Epub 2014 Aug 12. PMID- 25184244 OWN - NLM STAT- MEDLINE DCOM- 20150514 LR - 20211021 IS - 1932-6203 (Electronic) IS - 1932-6203 (Linking) VI - 9 IP - 9 DP - 2014 TI - The impact of renal impairment on long-term safety and effectiveness of drug-eluting stents. PG - e106450 LID - 10.1371/journal.pone.0106450 [doi] LID - e106450 AB - BACKGROUND: Renal impairment (RI) is associated with impaired prognosis in patients with coronary artery disease. Clinical and angiographic outcomes of patients undergoing percutaneous coronary intervention (PCI) with the use of drug-eluting stents (DES) in this patient population are not well established. METHODS: We pooled individual data for 5,011 patients from 3 trials with the exclusive and unrestricted use of DES (SIRTAX - N = 1,012, LEADERS - N = 1,707, RESOLUTE AC - N = 2,292). Angiographic follow-up was available for 1,544 lesions. Outcomes through 2 years were stratified according to glomerular filtration rate (normal renal function: GFR >/= 90 ml/min; mild RI: 90/= 60 ml/min; moderate/severe RI GFR<60 ml/min). RESULTS: Patients with moderate/severe RI had an increased risk of cardiac death or myocardial infarction ([MI], OR 2.14, 95%CI 1.36-3.36), cardiac death (OR 2.21, 95%CI 1.10-4.46), and MI (OR 2.02, 95%CI 1.19-3.43) compared with patients with normal renal function at 2 years follow-up. There was no difference in cardiac death or MI between patients with mild RI compared to those with normal renal function (OR 1.10, 95%CI 0.75-1.61). The risk of target-lesion revascularization was similar for patients with moderate/severe RI (OR 1.17, 95%CI 0.70-1.95) and mild RI (OR 1.16, 95%CI 0.81-1.64) compared with patients with normal renal function. In-stent late loss and in-segment restenosis were not different for patients with moderate/severe RI, mild RI, and normal renal function. CONCLUSIONS: Renal function does not affect clinical and angiographic effectiveness of DES. However, prognosis remains impaired among patients with moderate/severe RI. FAU - Stefanini, Giulio G AU - Stefanini GG AD - Department of Cardiology, Bern University Hospital, Bern, Switzerland. FAU - Taniwaki, Masanori AU - Taniwaki M AD - Department of Cardiology, Bern University Hospital, Bern, Switzerland. FAU - Kalesan, Bindu AU - Kalesan B AD - Clinical Trials Unit, Bern University Hospital, Bern, Switzerland; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland. FAU - Raber, Lorenz AU - Raber L AD - Department of Cardiology, Bern University Hospital, Bern, Switzerland. FAU - Stortecky, Stefan AU - Stortecky S AD - Department of Cardiology, Bern University Hospital, Bern, Switzerland. FAU - Pilgrim, Thomas AU - Pilgrim T AD - Department of Cardiology, Bern University Hospital, Bern, Switzerland. FAU - Onuma, Yoshinobu AU - Onuma Y AD - Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands. FAU - Silber, Sigmund AU - Silber S AD - Heart Center at the Isar, Munich, Germany. FAU - Serruys, Patrick W AU - Serruys PW AD - Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands. FAU - Meier, Bernhard AU - Meier B AD - Department of Cardiology, Bern University Hospital, Bern, Switzerland. FAU - Juni, Peter AU - Juni P AD - Clinical Trials Unit, Bern University Hospital, Bern, Switzerland; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland. FAU - Windecker, Stephan AU - Windecker S AD - Department of Cardiology, Bern University Hospital, Bern, Switzerland; Clinical Trials Unit, Bern University Hospital, Bern, Switzerland. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20140903 PL - United States TA - PLoS One JT - PloS one JID - 101285081 SB - IM MH - Angioplasty, Balloon, Coronary MH - Clinical Trials as Topic MH - Coronary Angiography MH - Coronary Artery Disease/complications/*drug therapy/pathology MH - Drug-Eluting Stents/*adverse effects MH - Humans MH - Renal Insufficiency/chemically induced/*pathology MH - Risk Factors MH - Treatment Outcome PMC - PMC4153613 COIS- Competing Interests: Dr. Silber has received lecture fees from Abbott. Dr. Meier has received educational and research support to the institution from Abbott, Cordis, Boston Scientific, and Medtronic. Dr. Windecker has received research contracts to the institution from Abbott, Boston Scientific, Biosensors, Cordis, and Medtronic. The other authors report no conflict of interest. This does not alter the authors' adherence to PLOS ONE policies on sharing data and materials. EDAT- 2014/09/04 06:00 MHDA- 2015/05/15 06:00 PMCR- 2014/09/03 CRDT- 2014/09/04 06:00 PHST- 2013/11/26 00:00 [received] PHST- 2014/08/08 00:00 [accepted] PHST- 2014/09/04 06:00 [entrez] PHST- 2014/09/04 06:00 [pubmed] PHST- 2015/05/15 06:00 [medline] PHST- 2014/09/03 00:00 [pmc-release] AID - PONE-D-13-49906 [pii] AID - 10.1371/journal.pone.0106450 [doi] PST - epublish SO - PLoS One. 2014 Sep 3;9(9):e106450. doi: 10.1371/journal.pone.0106450. eCollection 2014. PMID- 25029429 OWN - NLM STAT- MEDLINE DCOM- 20160229 LR - 20250529 IS - 1523-1755 (Electronic) IS - 0085-2538 (Print) IS - 0085-2538 (Linking) VI - 87 IP - 1 DP - 2015 Jan TI - Apolipoprotein L1 gene variants associate with prevalent kidney but not prevalent cardiovascular disease in the Systolic Blood Pressure Intervention Trial. PG - 169-75 LID - 10.1038/ki.2014.254 [doi] AB - Apolipoprotein L1 gene (APOL1) G1 and G2 coding variants are strongly associated with chronic kidney disease (CKD) in African Americans (AAs). Here APOL1 association was tested with baseline estimated glomerular filtration rate (eGFR), urine albumin:creatinine ratio (UACR), and prevalent cardiovascular disease (CVD) in 2571 AAs from the Systolic Blood Pressure Intervention Trial (SPRINT), a trial assessing effects of systolic blood pressure reduction on renal and CVD outcomes. Logistic regression models that adjusted for potentially important confounders tested for association between APOL1 risk variants and baseline clinical CVD (myocardial infarction, coronary, or carotid artery revascularization) and CKD (eGFR under 60 ml/min per 1.73 m(2) and/or UACR over 30 mg/g). AA SPRINT participants were 45.3% female with a mean (median) age of 64.3 (63) years, mean arterial pressure 100.7 (100) mm Hg, eGFR 76.3 (77.1) ml/min per 1.73 m(2), and UACR 49.9 (9.2) mg/g, and 8.2% had clinical CVD. APOL1 (recessive inheritance) was positively associated with CKD (odds ratio 1.37, 95% confidence interval 1.08-1.73) and log UACR estimated slope (beta) 0.33) and negatively associated with eGFR (beta -3.58), all significant. APOL1 risk variants were not significantly associated with prevalent CVD (1.02, 0.82-1.27). Thus, SPRINT data show that APOL1 risk variants are associated with mild CKD but not with prevalent CVD in AAs with a UACR under 1000 mg/g. FAU - Langefeld, Carl D AU - Langefeld CD AD - 1] Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA [2] Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA. FAU - Divers, Jasmin AU - Divers J AD - 1] Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA [2] Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA. FAU - Pajewski, Nicholas M AU - Pajewski NM AD - 1] Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA [2] Center for Public Health Genomics, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA. FAU - Hawfield, Amret T AU - Hawfield AT AD - Internal Medicine-Nephrology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA. FAU - Reboussin, David M AU - Reboussin DM AD - Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA. FAU - Bild, Diane E AU - Bild DE AD - Patient-Centered Outcomes Research Institute (PCORI), Washington, District of Columbia, USA. FAU - Kaysen, George A AU - Kaysen GA AD - Medicine, Biochemistry and Molecular Medicine, University of California, Davis, Davis, California, USA. FAU - Kimmel, Paul L AU - Kimmel PL AD - National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, USA. FAU - Raj, Dominic S AU - Raj DS AD - Medicine-Nephrology, George Washington University School of Medicine, Washington, District of Columbia, USA. FAU - Ricardo, Ana C AU - Ricardo AC AD - Medicine-Nephrology, University of Illinois College of Medicine at Chicago, Chicago, Illinois, USA. FAU - Wright, Jackson T Jr AU - Wright JT Jr AD - Medicine-Hypertension, University Hospitals, Case Medical Center, Cleveland, Ohio, USA. FAU - Sedor, John R AU - Sedor JR AD - Medicine, Physiology and Biophysics, Case Western Reserve University, Cleveland, Ohio, USA. FAU - Rocco, Michael V AU - Rocco MV AD - Internal Medicine-Nephrology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA. FAU - Freedman, Barry I AU - Freedman BI AD - Internal Medicine-Nephrology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA. CN - Systolic Blood Pressure Intervention Trial (SPRINT) LA - eng GR - R01 DK084149/DK/NIDDK NIH HHS/United States GR - UL1RR025755/RR/NCRR NIH HHS/United States GR - UL1 TR001064/TR/NCATS NIH HHS/United States GR - UL1TR000433/TR/NCATS NIH HHS/United States GR - UL1RR025752/RR/NCRR NIH HHS/United States GR - UL1 TR000093/TR/NCATS NIH HHS/United States GR - UL1 TR000003/TR/NCATS NIH HHS/United States GR - UL1 RR025755/RR/NCRR NIH HHS/United States GR - UL1 TR001085/TR/NCATS NIH HHS/United States GR - UL1TR000439/TR/NCATS NIH HHS/United States GR - UL1 TR000002/TR/NCATS NIH HHS/United States GR - UL1RR024134/RR/NCRR NIH HHS/United States GR - K23 DK094829/DK/NIDDK NIH HHS/United States GR - Y1-HV-0514-01/HV/NHLBI NIH HHS/United States GR - R01 DK097836/DK/NIDDK NIH HHS/United States GR - P30 AG021332/AG/NIA NIH HHS/United States GR - UL1 RR024134/RR/NCRR NIH HHS/United States GR - UL1 TR000433/TR/NCATS NIH HHS/United States GR - UL1 TR001070/TR/NCATS NIH HHS/United States GR - UL1TR000050/TR/NCATS NIH HHS/United States GR - 9U54TR000017-06/TR/NCATS NIH HHS/United States GR - UL1 TR000445/TR/NCATS NIH HHS/United States GR - HHSN268200900040C/HL/NHLBI NIH HHS/United States GR - R01 DK070941/DK/NIDDK NIH HHS/United States GR - UL1 RR025752/RR/NCRR NIH HHS/United States GR - UL1TR000105-05/TR/NCATS NIH HHS/United States GR - UL1 RR025771/RR/NCRR NIH HHS/United States GR - P30-AG21332/AG/NIA NIH HHS/United States GR - UL1 TR000050/TR/NCATS NIH HHS/United States GR - UL1TR000003/TR/NCATS NIH HHS/United States GR - UL1 TR000439/TR/NCATS NIH HHS/United States GR - UL1 TR000073/TR/NCATS NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural DEP - 20140716 PL - United States TA - Kidney Int JT - Kidney international JID - 0323470 RN - 0 (APOL1 protein, human) RN - 0 (Apolipoprotein L1) RN - 0 (Apolipoproteins) RN - 0 (Lipoproteins, HDL) SB - IM CIN - Kidney Int. 2015 Jan;87(1):14-7. doi: 10.1038/ki.2014.319. PMID: 25549121 MH - Black or African American/genetics MH - Apolipoprotein L1 MH - Apolipoproteins/*genetics MH - Cardiovascular Diseases/*genetics MH - Female MH - Genetic Variation MH - Humans MH - Lipoproteins, HDL/*genetics MH - Male MH - Middle Aged MH - Renal Insufficiency, Chronic/*genetics PMC - PMC4281289 MID - NIHMS607977 COIS- No author reports a conflict of interest related to this work. EDAT- 2014/07/17 06:00 MHDA- 2016/03/02 06:00 PMCR- 2015/07/01 CRDT- 2014/07/17 06:00 PHST- 2014/03/17 00:00 [received] PHST- 2014/05/27 00:00 [revised] PHST- 2014/05/29 00:00 [accepted] PHST- 2014/07/17 06:00 [entrez] PHST- 2014/07/17 06:00 [pubmed] PHST- 2016/03/02 06:00 [medline] PHST- 2015/07/01 00:00 [pmc-release] AID - S0085-2538(15)30020-X [pii] AID - 10.1038/ki.2014.254 [doi] PST - ppublish SO - Kidney Int. 2015 Jan;87(1):169-75. doi: 10.1038/ki.2014.254. Epub 2014 Jul 16. PMID- 25022226 OWN - NLM STAT- MEDLINE DCOM- 20160607 LR - 20150824 IS - 1969-6213 (Electronic) IS - 1774-024X (Linking) VI - 11 IP - 4 DP - 2015 Aug TI - Incidence, predictors, and impact of neurological events in non-ST-segment elevation acute coronary syndromes: the ACUITY trial. PG - 399-406 LID - 20130426-04 [pii] LID - 10.4244/EIJY14M07_06 [doi] AB - AIMS: We sought to describe the incidence, predictors, and impact of adverse neurological events (NE) in a non-ST-segment elevation acute coronary syndromes (NSTEACS) population undergoing percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG), or medical therapy (MT). METHODS AND RESULTS: 13,819 patients with moderate and high-risk NSTEACS were enrolled in the prospective ACUITY trial. Angiography was performed within 72 hours of presentation, after which 7,789 patients (56.4%) underwent PCI, 1,539 (11.1%) underwent CABG, and 4,491 (32.5%) received MT. The rate of NE (stroke or transient ischaemic attack) at 30 days and one year and its relationship to adverse ischaemic events, including death, were assessed. Thirty-day rates of NE were 1.1% with CABG, 0.3% with PCI, and 0.5% with MT (p<0.001). One-year rates of NE were 1.1% with CABG, 0.3% with PCI, and 0.6% with MT (p<0.001). Independent predictors of NE at 30 days and one year included age, renal insufficiency, baseline troponin elevation, and initial treatment with CABG. The occurrence of NE was a strong independent predictor of death at 30 days and one year (HR 4.07, 95% CI [1.49, 11.11], p=0.006, and HR 4.25, 95% CI [2.37, 7.62], p<0.001, respectively). CONCLUSIONS: In the large-scale ACUITY trial, CABG was associated with a higher risk of NE at 30 days and one year compared to PCI and MT. The occurrence of NE in patients with NSTEACS was strongly associated with increased early and late mortality. Clinical Trials.gov Identifier NCT00093158. FAU - Genereux, Philippe AU - Genereux P AD - Columbia University Medical Center and Cardiovascular Research Foundation, New York, NY, USA. FAU - Bernard, Samuel AU - Bernard S FAU - Palmerini, Tullio AU - Palmerini T FAU - Caixeta, Adriano AU - Caixeta A FAU - Rosner, Gregg AU - Rosner G FAU - Reiss, George R AU - Reiss GR FAU - Xu, Ke AU - Xu K FAU - Mehran, Roxana AU - Mehran R FAU - Stone, Gregg W AU - Stone GW CN - ACUITY Trial Investigators LA - eng SI - ClinicalTrials.gov/NCT00093158 PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PL - France TA - EuroIntervention JT - EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology JID - 101251040 SB - IM MH - Acute Coronary Syndrome/diagnosis/mortality/surgery/*therapy MH - Age Factors MH - Aged MH - Aged, 80 and over MH - Comorbidity MH - Coronary Angiography MH - Coronary Artery Bypass/*adverse effects/mortality MH - Female MH - Humans MH - Incidence MH - Ischemic Attack, Transient/diagnosis/*epidemiology/mortality MH - Kaplan-Meier Estimate MH - Male MH - Middle Aged MH - Percutaneous Coronary Intervention/*adverse effects/mortality MH - Proportional Hazards Models MH - Prospective Studies MH - Risk Assessment MH - Risk Factors MH - Stroke/diagnosis/*epidemiology/mortality MH - Time Factors MH - Treatment Outcome EDAT- 2014/07/16 06:00 MHDA- 2016/06/09 06:00 CRDT- 2014/07/16 06:00 PHST- 2014/07/16 06:00 [entrez] PHST- 2014/07/16 06:00 [pubmed] PHST- 2016/06/09 06:00 [medline] AID - 20130426-04 [pii] AID - 10.4244/EIJY14M07_06 [doi] PST - ppublish SO - EuroIntervention. 2015 Aug;11(4):399-406. doi: 10.4244/EIJY14M07_06. PMID- 24980833 OWN - NLM STAT- MEDLINE DCOM- 20150529 LR - 20211021 IS - 1932-8737 (Electronic) IS - 0160-9289 (Print) IS - 0160-9289 (Linking) VI - 37 IP - 9 DP - 2014 Sep TI - The association of gender to cardiovascular outcomes after coronary artery revascularization in patients with end-stage renal disease. PG - 546-51 LID - 10.1002/clc.22306 [doi] AB - BACKGROUND: Inadequate recruitment of women and an exclusion of patients with end-stage renal disease (ESRD) in coronary revascularization trials have led to knowledge gaps of gender-based outcomes. HYPOTHESIS: Women have equivalent cardiovascular outcomes when compared to men. METHODS: We conducted a retrospective observational study utilizing Kaiser Permanente Northern California (KPNC) databases and identified 1015 adults with ESRD who underwent coronary revascularization between 1996 and 2008. We ascertained baseline characteristics, primary (mortality at 5 years) and secondary (myocardial infarction [MI] and repeat revascularization) outcomes from KPNC databases, state death certificates, and Social Security Administration files. A multivariable logistic regression was used to determine the association of gender to the prespecified outcomes. RESULTS: Men and women were similar in age (P = 0.23). The mean number of baseline comorbidities was higher in women (2.7, 95% confidence interval [CI]: 2.5-2.9) compared to men (2.3, 95% CI: 2.1-2.4, P = 0.0002). The risk-adjusted odds ratios (OR) of female gender to death at 5 years (OR: 1.12, 95% CI: 0.83-1.52), MI (OR: 1.19, 95% CI: 0.86-1.64), and repeat revascularization (OR: 1.01, 95% CI: 0.70-1.45) were similar to men. Age modified the effect of gender for the primary outcome death (Pinteraction < 0.048), with a trend toward worse outcomes in younger women and improved outcomes in older women. This effect was noted more in patients who underwent coronary artery bypass grafting. CONCLUSIONS: Although the overall relative risk of cardiovascular outcomes after coronary revascularization in ESRD was equivalent between men and women, age had a significant interaction with gender on overall mortality. CI - (c) 2014 Wiley Periodicals, Inc. FAU - Krishnaswami, Ashok AU - Krishnaswami A AD - Division of Cardiology, Kaiser Permanente San Jose Medical Center, San Jose, California. FAU - Chang, Tara I AU - Chang TI FAU - Jang, James J AU - Jang JJ FAU - Leong, Thomas K AU - Leong TK FAU - Go, Alan S AU - Go AS LA - eng PT - Comparative Study PT - Journal Article PT - Observational Study PT - Research Support, Non-U.S. Gov't DEP - 20140630 PL - United States TA - Clin Cardiol JT - Clinical cardiology JID - 7903272 SB - IM MH - Age Factors MH - Aged MH - California MH - Chi-Square Distribution MH - Coronary Artery Disease/complications/diagnosis/mortality/*therapy MH - Databases, Factual MH - Female MH - Health Maintenance Organizations MH - Humans MH - Kidney Failure, Chronic/*complications/diagnosis/mortality MH - Logistic Models MH - Male MH - Middle Aged MH - Multivariate Analysis MH - Myocardial Infarction/etiology/mortality MH - *Myocardial Revascularization/adverse effects/mortality MH - Odds Ratio MH - Retrospective Studies MH - Risk Factors MH - Sex Factors MH - Time Factors MH - Treatment Outcome PMC - PMC6649527 EDAT- 2014/07/02 06:00 MHDA- 2015/05/30 06:00 PMCR- 2014/06/30 CRDT- 2014/07/02 06:00 PHST- 2014/04/18 00:00 [received] PHST- 2014/05/27 00:00 [revised] PHST- 2014/05/28 00:00 [accepted] PHST- 2014/07/02 06:00 [entrez] PHST- 2014/07/02 06:00 [pubmed] PHST- 2015/05/30 06:00 [medline] PHST- 2014/06/30 00:00 [pmc-release] AID - CLC22306 [pii] AID - 10.1002/clc.22306 [doi] PST - ppublish SO - Clin Cardiol. 2014 Sep;37(9):546-51. doi: 10.1002/clc.22306. Epub 2014 Jun 30. PMID- 24948413 OWN - NLM STAT- MEDLINE DCOM- 20151117 LR - 20260518 IS - 1873-734X (Electronic) IS - 1010-7940 (Print) IS - 1010-7940 (Linking) VI - 47 IP - 3 DP - 2015 Mar TI - The effect of perhexiline on myocardial protection during coronary artery surgery: a two-centre, randomized, double-blind, placebo-controlled trial. PG - 464-72 LID - 10.1093/ejcts/ezu238 [doi] AB - OBJECTIVES: Perhexiline is thought to modulate metabolism by inhibiting mitochondrial carnitine palmitoyltransferase-1, reducing fatty acid uptake and increasing carbohydrate utilization. This study assessed whether preoperative perhexiline improves markers of myocardial protection in patients undergoing coronary artery bypass graft surgery and analysed its effect on the myocardial metabolome. METHODS: In a prospective, randomized, double-blind, placebo-controlled trial, patients at two centres were randomized to receive either oral perhexiline or placebo for at least 5 days prior to surgery. The primary outcome was a low cardiac output episode in the first 6 h. All pre-specified analyses were conducted according to the intention-to-treat principle with a statistical power of 90% to detect a relative risk of 0.5 and a conventional one-sided alpha-value of 0.025. A subset of pre-ischaemic left ventricular biopsies was analysed using mass spectrometry-based metabolomics. RESULTS: Over a 3-year period, 286 patients were randomized, received the intervention and were included in the analysis. The incidence rate of a low cardiac output episode in the perhexiline arm was 36.7% (51/139) vs 34.7% (51/147) in the control arm [odds ratio (OR) 0.92, 95% confidence interval (CI) 0.56-1.50, P = 0.74]. Perhexiline was associated with a reduction in the cardiac index at 6 h [difference in means 0.19, 95% CI 0.07-0.31, P = 0.001] and an increase in inotropic support in the first 12 h (OR 0.55, 95% CI 0.34-0.89, P = 0.015). There were no significant differences in myocardial injury with troponin-T or electrocardiogram, reoperation, renal dysfunction or length of stay. No difference in the preischaemic left ventricular metabolism was identified between groups on metabolomics analysis. CONCLUSIONS: Preoperative perhexiline does not improve myocardial protection in patients undergoing coronary surgery and in fact reduced perioperative cardiac output, increasing the need for inotropic support. Perhexiline has no significant effect on the mass spectrometry-visible polar myocardial metabolome in vivo in humans, supporting the suggestion that it acts via a pathway that is independent of myocardial carnitine palmitoyltransferase inhibition and may explain the lack of clinical benefit observed following surgery. CLINICALTRIALSGOV ID: NCT00845364. CI - (c) The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. FAU - Drury, Nigel E AU - Drury NE AD - Department of Cardiothoracic Surgery, Queen Elizabeth Hospital Birmingham, Birmingham, UK School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, UK. FAU - Howell, Neil J AU - Howell NJ AD - Department of Cardiothoracic Surgery, Queen Elizabeth Hospital Birmingham, Birmingham, UK School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, UK. FAU - Calvert, Melanie J AU - Calvert MJ AD - School of Health and Population Sciences, University of Birmingham, Birmingham, UK. FAU - Weber, Ralf J M AU - Weber RJ AD - Centre for Systems Biology, School of Biosciences, University of Birmingham, Birmingham, UK. FAU - Senanayake, Eshan L AU - Senanayake EL AD - Department of Cardiothoracic Surgery, Queen Elizabeth Hospital Birmingham, Birmingham, UK School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, UK. FAU - Lewis, Michael E AU - Lewis ME AD - Department of Cardiothoracic Surgery, Royal Sussex County Hospital, Brighton. FAU - Hyde, Jonathan A J AU - Hyde JA AD - Department of Cardiothoracic Surgery, Royal Sussex County Hospital, Brighton. FAU - Green, David H AU - Green DH AD - Department of Cardiac Anesthesia, Queen Elizabeth Hospital Birmingham, Birmingham, UK. FAU - Mascaro, Jorge G AU - Mascaro JG AD - Department of Cardiothoracic Surgery, Queen Elizabeth Hospital Birmingham, Birmingham, UK. FAU - Wilson, Ian C AU - Wilson IC AD - Department of Cardiothoracic Surgery, Queen Elizabeth Hospital Birmingham, Birmingham, UK. FAU - Graham, Timothy R AU - Graham TR AD - Department of Cardiothoracic Surgery, Queen Elizabeth Hospital Birmingham, Birmingham, UK. FAU - Rooney, Stephen J AU - Rooney SJ AD - Department of Cardiothoracic Surgery, Queen Elizabeth Hospital Birmingham, Birmingham, UK. FAU - Viant, Mark R AU - Viant MR AD - Centre for Systems Biology, School of Biosciences, University of Birmingham, Birmingham, UK. FAU - Freemantle, Nick AU - Freemantle N AD - Department of Primary Care and Population Health, University College London, London, UK. FAU - Frenneaux, Michael P AU - Frenneaux MP AD - School of Medicine, University of Aberdeen, Aberdeen, UK. FAU - Pagano, Domenico AU - Pagano D AD - Department of Cardiothoracic Surgery, Queen Elizabeth Hospital Birmingham, Birmingham, UK School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, UK domenico.pagano@uhb.nhs.uk. CN - investigators LA - eng SI - ClinicalTrials.gov/NCT00845364 GR - PG/08/040/24556/BHF_/British Heart Foundation/United Kingdom GR - PG/10/36/28341/BHF_/British Heart Foundation/United Kingdom GR - PG/06/044/20703/BHF_/British Heart Foundation/United Kingdom GR - PG/10/036/28341/BHF_/British Heart Foundation/United Kingdom PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20140619 PL - Germany TA - Eur J Cardiothorac Surg JT - European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery JID - 8804069 RN - 0 (Cardiotonic Agents) RN - 0 (Placebos) RN - KU65374X44 (Perhexiline) SB - IM MH - Aged MH - Cardiac Output/drug effects MH - Cardiotonic Agents/*therapeutic use MH - Coronary Artery Bypass/adverse effects/*methods MH - Coronary Vessels/*surgery MH - Double-Blind Method MH - Female MH - Heart Ventricles/chemistry/metabolism MH - Humans MH - Male MH - Metabolome/drug effects MH - Middle Aged MH - Myocardial Reperfusion Injury/metabolism/*prevention & control MH - Perhexiline/*therapeutic use MH - Placebos MH - Postoperative Complications MH - Prospective Studies PMC - PMC4324609 OTO - NOTNLM OT - Cardiac output OT - Metabolism OT - Metabolomics OT - Myocardial reperfusion injury OT - Myocardial stunning FIR - Williams, Lynne K IR - Williams LK FIR - Ranasinghe, Aaron M IR - Ranasinghe AM FIR - Hauton, David IR - Hauton D FIR - Cramb, Robert IR - Cramb R FIR - Dandekar, Uday IR - Dandekar U FIR - Cohen, Andrew S IR - Cohen AS FIR - Kong, Robert IR - Kong R FIR - Cooter, Nina IR - Cooter N FIR - Gardner, Emma IR - Gardner E FIR - MacKenzie, Ailie IR - MacKenzie A EDAT- 2014/06/21 06:00 MHDA- 2015/11/18 06:00 PMCR- 2014/06/19 CRDT- 2014/06/21 06:00 PHST- 2014/06/21 06:00 [entrez] PHST- 2014/06/21 06:00 [pubmed] PHST- 2015/11/18 06:00 [medline] PHST- 2014/06/19 00:00 [pmc-release] AID - ezu238 [pii] AID - 10.1093/ejcts/ezu238 [doi] PST - ppublish SO - Eur J Cardiothorac Surg. 2015 Mar;47(3):464-72. doi: 10.1093/ejcts/ezu238. Epub 2014 Jun 19. PMID- 24937680 OWN - NLM STAT- MEDLINE DCOM- 20150212 LR - 20211021 IS - 1932-6203 (Electronic) IS - 1932-6203 (Linking) VI - 9 IP - 6 DP - 2014 TI - Inpatient coronary angiography and revascularisation following non-ST-elevation acute coronary syndrome in patients with renal impairment: a cohort study using the Myocardial Ischaemia National Audit Project. PG - e99925 LID - 10.1371/journal.pone.0099925 [doi] LID - e99925 AB - BACKGROUND: International guidelines support an early invasive management strategy (including early coronary angiography and revascularisation) for non-ST-elevation acute coronary syndrome (NSTE-ACS) in patients with renal impairment. However, evidence from outside the UK suggests that this approach is underutilised. We aimed to describe practice within the NHS, and to determine whether the severity of renal dysfunction influenced the provision of angiography and modified the association between early revascularisation and survival. METHODS: We performed a cohort study, using multivariable logistic regression and propensity score analyses, of data from the Myocardial Ischaemia National Audit Project for patients presenting with NSTE-ACS to English or Welsh hospitals between 2008 and 2010. FINDINGS: Of 35 881 patients diagnosed with NSTE-ACS, eGFR of <60 ml/minute/1.73 m(2) was present in 15 680 (43.7%). There was a stepwise decline in the odds of undergoing inpatient angiography with worsening renal dysfunction. Compared with an eGFR>90 ml/minute/1.73 m(2), patients with an eGFR between 45-59 ml/minute/1.73 m(2) were 33% less likely to undergo angiography (adjusted OR 0.67, 95% CI 0.55-0.81); those with an eGFR<30/minute/1.73 m(2) had a 64% reduction in odds of undergoing angiography (adjusted OR 0.36, 95%CI 0.29-0.43). Of 16 646 patients who had inpatient coronary angiography, 58.5% underwent inpatient revascularisation. After adjusting for co-variables, inpatient revascularisation was associated with approximately a 30% reduction in death within 1 year compared with those managed medically after coronary angiography (adjusted OR 0.66, 95%CI 0.57-0.77), with no evidence of modification by renal function (p(interaction) = 0.744). INTERPRETATION: Early revascularisation may offer a similar survival benefit in patients with and without renal dysfunction, yet renal impairment is an important determinant of the provision of coronary angiography following NSTE-ACS. A randomised controlled trial is needed to evaluate the efficacy of an early invasive approach in patients with severe renal dysfunction to ensure that all patients who may benefit are offered this treatment option. FAU - Shaw, Catriona AU - Shaw C AD - UK Renal Registry, Southmead Hospital, Bristol, United Kingdom; Department of Renal Sciences, Division of Transplantation Immunology and Mucosal Biology, Kings College London, London, United Kingdom. FAU - Nitsch, Dorothea AU - Nitsch D AD - London School of Hygiene and Tropical Medicine, London, United Kingdom. FAU - Steenkamp, Retha AU - Steenkamp R AD - UK Renal Registry, Southmead Hospital, Bristol, United Kingdom. FAU - Junghans, Cornelia AU - Junghans C AD - Department of Epidemiology and Public Health, University College London, London, United Kingdom. FAU - Shah, Sapna AU - Shah S AD - Department of Renal Medicine, Kings College Hospital, London, United Kingdom. FAU - O'Donoghue, Donal AU - O'Donoghue D AD - Department of Renal Medicine, Salford Royal NHS Foundation Trust, Salford, United Kingdom. FAU - Fogarty, Damian AU - Fogarty D AD - Department of Renal Medicine, Belfast Health and Social Care Trust, Belfast, Northern Ireland, United Kingdom. FAU - Weston, Clive AU - Weston C AD - Myocardial Ischaemia National Audit Project, College of Medicine, Swansea University, Swansea, Wales, United Kingdom. FAU - Sharpe, Claire C AU - Sharpe CC AD - Department of Renal Sciences, Division of Transplantation Immunology and Mucosal Biology, Kings College London, London, United Kingdom. LA - eng GR - R25 TW009337/TW/FIC NIH HHS/United States PT - Journal Article DEP - 20140617 PL - United States TA - PLoS One JT - PloS one JID - 101285081 SB - IM MH - Acute Coronary Syndrome/diagnostic imaging/*mortality/physiopathology/surgery MH - Aged MH - Aged, 80 and over MH - Cohort Studies MH - Coronary Angiography MH - Female MH - Glomerular Filtration Rate MH - Humans MH - Inpatients MH - Male MH - Middle Aged MH - Multivariate Analysis MH - Myocardial Ischemia/*mortality/physiopathology/surgery MH - Percutaneous Coronary Intervention MH - Propensity Score MH - Renal Insufficiency/*mortality/physiopathology MH - Treatment Outcome PMC - PMC4061061 COIS- Competing Interests: The authors have declared that no competing interests exist. EDAT- 2014/06/18 06:00 MHDA- 2015/02/13 06:00 PMCR- 2014/06/17 CRDT- 2014/06/18 06:00 PHST- 2014/01/20 00:00 [received] PHST- 2014/05/20 00:00 [accepted] PHST- 2014/06/18 06:00 [entrez] PHST- 2014/06/18 06:00 [pubmed] PHST- 2015/02/13 06:00 [medline] PHST- 2014/06/17 00:00 [pmc-release] AID - PONE-D-14-01993 [pii] AID - 10.1371/journal.pone.0099925 [doi] PST - epublish SO - PLoS One. 2014 Jun 17;9(6):e99925. doi: 10.1371/journal.pone.0099925. eCollection 2014. PMID- 24927970 OWN - NLM STAT- MEDLINE DCOM- 20140923 LR - 20220311 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 114 IP - 3 DP - 2014 Aug 1 TI - Impact of trimetazidine on incidence of myocardial injury and contrast-induced nephropathy in diabetic patients with renal dysfunction undergoing elective percutaneous coronary intervention. PG - 389-94 LID - S0002-9149(14)01123-0 [pii] LID - 10.1016/j.amjcard.2014.04.052 [doi] AB - Trimetazidine is an anti-ischemic agent with antioxidant activity. This study evaluated the effect of periprocedural administration of trimetazidine on the incidence of percutaneous coronary intervention (PCI)-induced myocardial injury and contrast-induced nephropathy (CIN) in diabetic patients with mild-to-moderate renal dysfunction. One hundred patients with a mean glomerular filtration rate of 48 +/- 16 (ml/min/1.73 m(2)) were prospectively enrolled, then randomly assigned to receive (50 patients; trimetazidine group) or not receive (50 patients; control group) periprocedural trimetazidine (70 mg/day) for 72 hours. The serum creatinine level was measured pre-PCI, 72 hours, and 10 days thereafter. An increase in the serum creatinine level by >0.5 mg/dl or 0.25% of the baseline value is considered as CIN. Cardiac troponin I levels were measured before and 6, 12, and 24 hours after PCI. Mean age of the study cohort was 59 +/- 6 years (men 68%). The serum creatinine level in the control group increased significantly 3 days after PCI and decreased on the tenth day. However, it showed no significant change in the trimetazidine group. Incidence of CIN was 12% in the trimetazidine group and 28% in the control group (p <0.05). Cardiac troponin I levels were significantly reduced in the trimetazidine group (6 hours: 8 +/- 0.3 vs 16 +/- 0.2 pg/ml, 12 hours: 13 +/- 0.9 vs 24 +/- 0.8 pg/ml, 24 hours: 7 +/- 0.7 vs 14 +/- 0.3 pg/ml, p <0.001). In conclusion, trimetazidine intake before elective PCI in diabetic patients with mild-to-moderate renal dysfunction is associated with decreased incidence of CIN and myocardial injury. CI - Copyright (c) 2014 Elsevier Inc. All rights reserved. FAU - Shehata, Mohamed AU - Shehata M AD - Department of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt. Electronic address: smarttmann@hotmail.com. LA - eng PT - Journal Article PT - Randomized Controlled Trial DEP - 20140516 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 RN - 0 (Contrast Media) RN - 0 (Vasodilator Agents) RN - N9A0A0R9S8 (Trimetazidine) SB - IM MH - Contrast Media/*adverse effects MH - Coronary Angiography/adverse effects MH - Diabetes Mellitus, Type 2/*complications/physiopathology MH - Dose-Response Relationship, Drug MH - *Elective Surgical Procedures MH - Female MH - Follow-Up Studies MH - Glomerular Filtration Rate MH - Humans MH - Male MH - Middle Aged MH - Myocardial Ischemia/complications/diagnostic imaging/*epidemiology MH - Percutaneous Coronary Intervention/*methods MH - Prospective Studies MH - Renal Insufficiency/chemically induced/*epidemiology/physiopathology MH - Treatment Outcome MH - Trimetazidine/administration & dosage/*therapeutic use MH - Vasodilator Agents/administration & dosage/therapeutic use EDAT- 2014/06/15 06:00 MHDA- 2014/09/24 06:00 CRDT- 2014/06/15 06:00 PHST- 2014/03/14 00:00 [received] PHST- 2014/04/29 00:00 [revised] PHST- 2014/04/29 00:00 [accepted] PHST- 2014/06/15 06:00 [entrez] PHST- 2014/06/15 06:00 [pubmed] PHST- 2014/09/24 06:00 [medline] AID - S0002-9149(14)01123-0 [pii] AID - 10.1016/j.amjcard.2014.04.052 [doi] PST - ppublish SO - Am J Cardiol. 2014 Aug 1;114(3):389-94. doi: 10.1016/j.amjcard.2014.04.052. Epub 2014 May 16. PMID- 24913197 OWN - NLM STAT- MEDLINE DCOM- 20150610 LR - 20260128 IS - 1940-1574 (Electronic) IS - 0003-3197 (Linking) VI - 66 IP - 4 DP - 2015 Apr TI - High clopidogrel dose in patients with chronic kidney disease having clopidogrel resistance after percutaneous coronary intervention. PG - 319-25 LID - 10.1177/0003319714538804 [doi] AB - We evaluated the impact of clopidogrel 150 mg/d in patients with chronic kidney disease (CKD) having clopidogrel resistance (CR) after percutaneous coronary intervention (PCI); 1076 consecutive patients with coronary artery disease (CAD) having CKD were enrolled. Maximal platelet aggregation (MPA) was assessed before, 24 hours, and 30 days after a 300-mg loading dose of clopidogrel prior to PCI. After PCI, 370 patients with CR were randomized to receive clopidogrel 75 mg/d (n = 184) or 150 mg/d (n = 186) for 30 days. Stent thrombosis (ST), major adverse cardiac events (MACEs), and bleeding were analyzed after 1 month. Patients in the 150 mg group had significant lower rates of ST and MACE. There was no significant difference in major or minor bleeding. Patients in the 150 mg group had lower MPA and greater inhibition of platelet aggregation. One-month administration of 150 mg/d of clopidogrel decreases the rate of ST and MACE without increasing bleeding in patients with CKD having CR after PCI. CI - (c) The Author(s) 2014. FAU - Liang, Jing AU - Liang J AD - Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China. FAU - Wang, Zhijian AU - Wang Z AD - Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China. FAU - Shi, Dongmei AU - Shi D AD - Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China. FAU - Liu, Yuyang AU - Liu Y AD - Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China. FAU - Zhao, Yingxin AU - Zhao Y AD - Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China. FAU - Han, Hongya AU - Han H AD - Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China. FAU - Li, Yueping AU - Li Y AD - Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China. FAU - Liu, Wei AU - Liu W AD - Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China. FAU - Zhang, Linlin AU - Zhang L AD - Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China. FAU - Yang, Lixia AU - Yang L AD - Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China. FAU - Zhou, Yujie AU - Zhou Y AD - Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China azgbjl12@163.com. LA - eng PT - Journal Article PT - Randomized Controlled Trial DEP - 20140608 PL - United States TA - Angiology JT - Angiology JID - 0203706 RN - 0 (Platelet Aggregation Inhibitors) RN - A74586SNO7 (Clopidogrel) RN - OM90ZUW7M1 (Ticlopidine) SB - IM MH - Aged MH - China MH - Clopidogrel MH - Coronary Artery Disease/complications/diagnosis/*therapy MH - Coronary Thrombosis/blood/etiology/prevention & control MH - Drug Administration Schedule MH - *Drug Resistance MH - Drug-Eluting Stents MH - Female MH - Hemorrhage/chemically induced MH - Humans MH - Kaplan-Meier Estimate MH - Male MH - Middle Aged MH - Myocardial Infarction/blood/etiology/prevention & control MH - *Percutaneous Coronary Intervention/adverse effects/instrumentation MH - Platelet Aggregation/drug effects MH - Platelet Aggregation Inhibitors/*administration & dosage/adverse effects MH - Platelet Function Tests MH - Prospective Studies MH - Renal Insufficiency, Chronic/*complications/diagnosis MH - Risk Factors MH - Ticlopidine/administration & dosage/adverse effects/*analogs & derivatives MH - Time Factors MH - Treatment Outcome OTO - NOTNLM OT - chronic kidney disease OT - clopidogrel resistance OT - coronary artery disease OT - percutaneous coronary intervention OT - stent thrombosis EDAT- 2014/06/11 06:00 MHDA- 2015/06/11 06:00 CRDT- 2014/06/11 06:00 PHST- 2014/06/11 06:00 [entrez] PHST- 2014/06/11 06:00 [pubmed] PHST- 2015/06/11 06:00 [medline] AID - 0003319714538804 [pii] AID - 10.1177/0003319714538804 [doi] PST - ppublish SO - Angiology. 2015 Apr;66(4):319-25. doi: 10.1177/0003319714538804. Epub 2014 Jun 8. PMID- 24881861 OWN - NLM STAT- MEDLINE DCOM- 20140923 LR - 20220408 IS - 1552-6259 (Electronic) IS - 0003-4975 (Linking) VI - 98 IP - 1 DP - 2014 Jul TI - Acute kidney injury after on-pump or off-pump coronary artery bypass grafting in elderly patients. PG - 9-14; discussion 14-5 LID - S0003-4975(14)01038-8 [pii] LID - 10.1016/j.athoracsur.2014.01.088 [doi] AB - BACKGROUND: An exploratory analysis of the German Off Pump Coronary Artery Bypass Grafting in Elderly Patients (GOPCABE) trial was performed to investigate the effect of off-pump coronary artery bypass grafting (CABG) on kidney function after the operation. METHODS: Data on kidney function were available from 1,612 patients, representing 67% of the study population. Preoperative kidney function was graded according to the glomerular filtration rate. Acute kidney injury (AKI) within the first week after the operation was defined and classified according to the Acute Kidney Injury Network (AKIN) criteria. The incidence and severity of AKI was compared between patients operated on on-pump or off-pump. RESULTS: Impaired kidney function was seen in 642 patients (40%), and 19 patients had preexisting end-stage kidney disease. AKI of any severity occurred in half of all patients undergoing CABG, with AKIN stage 1 accounting for most of the cases. The incidence and severity of AKI in patients undergoing on-pump vs off-pump CABG was AKIN stage 1: 298 (37%) vs 329 (42%); AKIN stage 2: 38 (5%) vs 43 (5%); and AKIN stage 3: 44 (6%) vs 44 (6%), which did not differ significantly (p=0.174). New renal replacement therapy was necessary in 3.2% (on-pump) and in 2.7% (off-pump) of all patients. Stratification according to preoperative kidney function yielded comparable frequencies of AKI for on-pump and off-pump CABG. CONCLUSIONS: AKI was common in elderly patients undergoing CABG, but deterioration of kidney function requiring renal replacement therapy was a rare event. Off-pump CABG was not associated with decreased rates or reduced severity of AKI in elderly patients. CI - Copyright (c) 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved. FAU - Reents, Wilko AU - Reents W AD - Cardiovascular Clinic Bad Neustadt, Bad Neustadt, Germany. Electronic address: wilko.reents@herzchirurgie.de. FAU - Hilker, Michael AU - Hilker M AD - Department of Cardiothoracic Surgery, University Medical Center, Regensburg, Germany. FAU - Borgermann, Jochen AU - Borgermann J AD - Clinic for Heart, Thoracic and Cardiovascular Surgery, Heart and Diabetes Centre NRW, Ruhr University Bochum, Bad Oeynhausen, Germany. FAU - Albert, Marc AU - Albert M AD - Department of Cardiac and Vascular Surgery, Robert Bosch Hospital, Stuttgart, Germany. FAU - Plotze, Katrin AU - Plotze K AD - Department of Cardiac Surgery, University Heart Center Dresden, Germany. FAU - Zacher, Michael AU - Zacher M AD - Cardiovascular Clinic Bad Neustadt, Bad Neustadt, Germany. FAU - Diegeler, Anno AU - Diegeler A AD - Cardiovascular Clinic Bad Neustadt, Bad Neustadt, Germany. FAU - Boning, Andreas AU - Boning A AD - Department of Cardiovascular Surgery, Justus-Liebig University Giessen, Germany. LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20140602 PL - Netherlands TA - Ann Thorac Surg JT - The Annals of thoracic surgery JID - 15030100R SB - IM MH - Acute Kidney Injury/diagnosis/epidemiology/*etiology MH - Aged MH - Aged, 80 and over MH - Coronary Artery Bypass/*adverse effects MH - Coronary Artery Bypass, Off-Pump/adverse effects MH - Coronary Artery Disease/*surgery MH - Female MH - Follow-Up Studies MH - Germany/epidemiology MH - Glomerular Filtration Rate MH - Humans MH - Incidence MH - Male MH - Postoperative Complications MH - Retrospective Studies MH - Risk Factors MH - Severity of Illness Index MH - Treatment Outcome EDAT- 2014/06/03 06:00 MHDA- 2014/09/24 06:00 CRDT- 2014/06/03 06:00 PHST- 2013/11/17 00:00 [received] PHST- 2014/01/20 00:00 [revised] PHST- 2014/01/28 00:00 [accepted] PHST- 2014/06/03 06:00 [entrez] PHST- 2014/06/03 06:00 [pubmed] PHST- 2014/09/24 06:00 [medline] AID - S0003-4975(14)01038-8 [pii] AID - 10.1016/j.athoracsur.2014.01.088 [doi] PST - ppublish SO - Ann Thorac Surg. 2014 Jul;98(1):9-14; discussion 14-5. doi: 10.1016/j.athoracsur.2014.01.088. Epub 2014 Jun 2. PMID- 24852801 OWN - NLM STAT- MEDLINE DCOM- 20150130 LR - 20250529 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 7 IP - 5 DP - 2014 May TI - Predicting 3-year mortality after percutaneous coronary intervention: updated logistic clinical SYNTAX score based on patient-level data from 7 contemporary stent trials. PG - 464-70 LID - S1936-8798(14)00580-9 [pii] LID - 10.1016/j.jcin.2014.02.007 [doi] AB - OBJECTIVES: This study aimed to update the Logistic Clinical SYNTAX score to predict 3-year survival after percutaneous coronary intervention (PCI) and compare the performance with the SYNTAX score alone. BACKGROUND: The SYNTAX score is a well-established angiographic tool to predict long-term outcomes after PCI. The Logistic Clinical SYNTAX score, developed by combining clinical variables with the anatomic SYNTAX score, has been shown to perform better than the SYNTAX score alone in predicting 1-year outcomes after PCI. However, the ability of this score to predict long-term survival is unknown. METHODS: Patient-level data (N = 6,304, 399 deaths within 3 years) from 7 contemporary PCI trials were analyzed. We revised the overall risk and the predictor effects in the core model (SYNTAX score, age, creatinine clearance, and left ventricular ejection fraction) using Cox regression analysis to predict mortality at 3 years. We also updated the extended model by combining the core model with additional independent predictors of 3-year mortality (i.e., diabetes mellitus, peripheral vascular disease, and body mass index). RESULTS: The revised Logistic Clinical SYNTAX models showed better discriminative ability than the anatomic SYNTAX score for the prediction of 3-year mortality after PCI (c-index: SYNTAX score, 0.61; core model, 0.71; and extended model, 0.73 in a cross-validation procedure). The extended model in particular performed better in differentiating low- and intermediate-risk groups. CONCLUSIONS: Risk scores combining clinical characteristics with the anatomic SYNTAX score substantially better predict 3-year mortality than the SYNTAX score alone and should be used for long-term risk stratification of patients undergoing PCI. CI - Copyright (c) 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Iqbal, Javaid AU - Iqbal J AD - Department of Interventional Cardiology, Thoraxcenter, Rotterdam, the Netherlands; Department of Cardiovascular Science, University of Sheffield, Sheffield, United Kingdom. FAU - Vergouwe, Yvonne AU - Vergouwe Y AD - Department of Public Health, Erasmus Medical Center, Rotterdam, the Netherlands. FAU - Bourantas, Christos V AU - Bourantas CV AD - Department of Interventional Cardiology, Thoraxcenter, Rotterdam, the Netherlands. FAU - van Klaveren, David AU - van Klaveren D FAU - Zhang, Yao-Jun AU - Zhang YJ AD - Department of Interventional Cardiology, Thoraxcenter, Rotterdam, the Netherlands. FAU - Campos, Carlos M AU - Campos CM AD - Department of Interventional Cardiology, Thoraxcenter, Rotterdam, the Netherlands. FAU - Garcia-Garcia, Hector M AU - Garcia-Garcia HM AD - Cardialysis, Rotterdam, the Netherlands. FAU - Morel, Marie-Angele AU - Morel MA AD - Cardialysis, Rotterdam, the Netherlands. FAU - Valgimigli, Marco AU - Valgimigli M AD - Department of Interventional Cardiology, Thoraxcenter, Rotterdam, the Netherlands. FAU - Windecker, Stephan AU - Windecker S AD - Cardiology Department, Bern University Hospital, Bern, Switzerland. FAU - Steyerberg, Ewout W AU - Steyerberg EW AD - Department of Cardiovascular Science, University of Sheffield, Sheffield, United Kingdom. FAU - Serruys, Patrick W AU - Serruys PW AD - Department of Interventional Cardiology, Thoraxcenter, Rotterdam, the Netherlands; Department of Cardiology, Imperial College London, London, United Kingdom. Electronic address: patrick.w.j.c.serruys@gmail.com. LA - eng GR - PG/13/74/30264/BHF_/British Heart Foundation/United Kingdom PT - Comparative Study PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 SB - IM EIN - JACC Cardiovasc Interv. 2014 Aug;7(8):946. Klaveren, David V [Corrected to van Klaveren, David] MH - Aged MH - Clinical Trials as Topic MH - *Coronary Angiography MH - Coronary Artery Disease/diagnostic imaging/mortality/physiopathology/*therapy MH - *Decision Support Techniques MH - Female MH - Humans MH - Logistic Models MH - Male MH - Middle Aged MH - Percutaneous Coronary Intervention/adverse effects/*mortality MH - Predictive Value of Tests MH - Proportional Hazards Models MH - Risk Assessment MH - Risk Factors MH - Time Factors MH - Treatment Outcome OTO - NOTNLM OT - SYNTAX score OT - logistic clinical SYNTAX score OT - percutaneous coronary intervention OT - risk stratification EDAT- 2014/05/24 06:00 MHDA- 2015/01/31 06:00 CRDT- 2014/05/24 06:00 PHST- 2013/11/26 00:00 [received] PHST- 2014/02/04 00:00 [revised] PHST- 2014/02/24 00:00 [accepted] PHST- 2014/05/24 06:00 [entrez] PHST- 2014/05/24 06:00 [pubmed] PHST- 2015/01/31 06:00 [medline] AID - S1936-8798(14)00580-9 [pii] AID - 10.1016/j.jcin.2014.02.007 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2014 May;7(5):464-70. doi: 10.1016/j.jcin.2014.02.007. PMID- 24823675 OWN - NLM STAT- MEDLINE DCOM- 20160527 LR - 20211021 IS - 2044-6055 (Print) IS - 2044-6055 (Electronic) IS - 2044-6055 (Linking) VI - 4 IP - 5 DP - 2014 May 13 TI - Impact of anaemia on clinical outcome in patients with atrial fibrillation undergoing percutaneous coronary intervention: insights from the AFCAS registry. PG - e004700 LID - 10.1136/bmjopen-2013-004700 [doi] LID - e004700 AB - 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. CI - Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions. FAU - Puurunen, Marja AU - Puurunen M AD - Hemostasis Laboratory, Finnish Red Cross Blood Service, Helsinki, Finland. FAU - Kiviniemi, Tuomas AU - Kiviniemi T AD - Heart Center, Turku University Hospital and University of Turku, Turku, Finland. FAU - Nammas, Wail AU - Nammas W AD - Heart Center, Turku University Hospital and University of Turku, Turku, Finland. FAU - Schlitt, Axel AU - Schlitt A AD - Medical Faculty, Martin Luther University Halle-Wittenberg, Halle-Wittenberg, Germany. FAU - Rubboli, Andrea AU - Rubboli A AD - Division of Cardiology, Laboratory of Interventional Cardiology, Ospedale Maggiore, Bologna, Italy. FAU - Nyman, Kai AU - Nyman K AD - Department of Cardiology, Central Finland Central Hospital, Jyvaskyla, Finland. FAU - Karjalainen, Pasi AU - Karjalainen P AD - Heart Center, Satakunta Central Hospital, Pori, Finland. FAU - Kirchhof, Paulus AU - Kirchhof P AD - Department of Cardiovascular Medicine, Hospital of the University of Munster, Munster, Germany University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, UK. FAU - Lip, Gregory Y H AU - Lip GY AD - Department of Cardiovascular Medicine, Hospital of the University of Munster, Munster, Germany. FAU - Airaksinen, Juhani K E AU - Airaksinen JK AD - Heart Center, Turku University Hospital and University of Turku, Turku, Finland. LA - eng SI - ClinicalTrials.gov/NCT00596570 PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20140513 PL - England TA - BMJ Open JT - BMJ open JID - 101552874 SB - IM MH - Aged MH - Anemia/*complications MH - Atrial Fibrillation/*complications MH - Female MH - Humans MH - Male MH - *Percutaneous Coronary Intervention MH - Postoperative Complications/*epidemiology/*etiology MH - Prospective Studies MH - Registries MH - Treatment Outcome PMC - PMC4025460 OTO - NOTNLM OT - CARDIOLOGY OT - HAEMATOLOGY EDAT- 2014/05/16 06:00 MHDA- 2014/05/16 06:01 PMCR- 2014/05/13 CRDT- 2014/05/15 06:00 PHST- 2014/05/15 06:00 [entrez] PHST- 2014/05/16 06:00 [pubmed] PHST- 2014/05/16 06:01 [medline] PHST- 2014/05/13 00:00 [pmc-release] AID - bmjopen-2013-004700 [pii] AID - 10.1136/bmjopen-2013-004700 [doi] PST - epublish SO - BMJ Open. 2014 May 13;4(5):e004700. doi: 10.1136/bmjopen-2013-004700. PMID- 24801558 OWN - NLM STAT- MEDLINE DCOM- 20150416 LR - 20151119 IS - 1473-5830 (Electronic) IS - 0954-6928 (Linking) VI - 25 IP - 6 DP - 2014 Sep TI - Correlates of poor outcome among patients with bleeding after coronary interventions. PG - 456-62 LID - 10.1097/MCA.0000000000000126 [doi] AB - OBJECTIVES: The objective of this study was to identify factors associated with the increased risk of mortality among patients with bleeding complications during percutaneous coronary intervention (PCI). METHODS: The study included 1510 patients with periprocedural bleeding complications of the 14 180 patients undergoing PCI. Bleeding was defined and scaled according to the Bleeding Academic Research Consortium criteria. The main outcome was all-cause mortality at 1 year after PCI. RESULTS: Of the 1510 patients with bleeding within the first 30 days of PCI, 104 patients (6.9%) died during the first year after PCI. One-year survival according to the Bleeding Academic Research Consortium classes was as follows: 96.4% (22 deaths) in class 1, 94.7% (12 deaths) in class 2, 91.0% (42 deaths) in class 3a, 85.4% (23 deaths) in class 3b, and 58.3% (five deaths) in class 3c (P<0.001). The Cox proportional hazards model identified bleeding severity [hazard ratio (HR)=1.55, 95% confidence interval 1.25-1.93 for one class increase in bleeding scale, P<0.001], bleeding site [HR=1.79 (1.18-2.71) for nonaccess vs. access site, P=0.006], elevated troponin levels [HR=1.66 (1.09-2.53), P=0.018], multivessel disease [HR=2.15 (1.01-4.56), P=0.047], C-reactive protein [HR=1.04 (1.01-1.06) for 5 mg/l increase, P=0.002], anemia [HR=2.27 (1.39-3.71) for 4 g/dl decrease in hemoglobin, P=0.001], and platelet count [HR=1.11 (1.02-1.21) for 50x10/l increase in platelet count, P=0.013] as independent associates of mortality. Age (P=0.072) and reduced estimated creatinine clearance (P=0.066) were close to reaching statistical significance as associates of mortality. CONCLUSION: Among patients with peri-PCI bleeding, the characteristics of bleeding itself and the cardiovascular risk profile underlie the increased risk for poor outcome after PCI. FAU - Ndrepepa, Gjin AU - Ndrepepa G AD - aDeutsches Herzzentrum, Munchen b1.Medizinische Klinik rechts der Isar, Technische Universitat cDZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany. FAU - Guerra, Elena AU - Guerra E FAU - Schulz, Stefanie AU - Schulz S FAU - Hoppmann, Petra AU - Hoppmann P FAU - Laugwitz, Karl-Ludwig AU - Laugwitz KL FAU - Kastrati, Adnan AU - Kastrati A LA - eng PT - Journal Article PL - England TA - Coron Artery Dis JT - Coronary artery disease JID - 9011445 RN - 0 (Biomarkers) SB - IM CIN - Coron Artery Dis. 2014 Sep;25(6):453-5. doi: 10.1097/MCA.0000000000000137. PMID: 25072657 MH - Aged MH - Aged, 80 and over MH - Anemia/complications/mortality MH - Biomarkers/blood MH - Chi-Square Distribution MH - Coronary Artery Disease/diagnosis/mortality/*therapy MH - Female MH - Hemorrhage/blood/diagnosis/*etiology/mortality MH - Humans MH - Kaplan-Meier Estimate MH - Kidney Diseases/complications/mortality MH - Male MH - Middle Aged MH - Multicenter Studies as Topic MH - Percutaneous Coronary Intervention/*adverse effects/mortality MH - Proportional Hazards Models MH - Randomized Controlled Trials as Topic MH - Risk Assessment MH - Risk Factors MH - Severity of Illness Index MH - Time Factors MH - Treatment Outcome EDAT- 2014/05/08 06:00 MHDA- 2015/04/17 06:00 CRDT- 2014/05/08 06:00 PHST- 2014/05/08 06:00 [entrez] PHST- 2014/05/08 06:00 [pubmed] PHST- 2015/04/17 06:00 [medline] AID - 10.1097/MCA.0000000000000126 [doi] PST - ppublish SO - Coron Artery Dis. 2014 Sep;25(6):456-62. doi: 10.1097/MCA.0000000000000126. PMID- 24714489 OWN - NLM STAT- MEDLINE DCOM- 20150904 LR - 20140416 IS - 1941-7632 (Electronic) IS - 1941-7640 (Linking) VI - 7 IP - 2 DP - 2014 Apr TI - Prevention of contrast-induced nephropathy with N-acetylcysteine or sodium bicarbonate in patients with ST-segment-myocardial infarction: a prospective, randomized, open-labeled trial. PG - 216-24 LID - 10.1161/CIRCINTERVENTIONS.113.000653 [doi] AB - BACKGROUND: Contrast-induced nephropathy (CIN) is a serious condition in patients with ST-segment-elevation myocardial infarction treated with primary percutaneous coronary intervention. We compared the risk of acute CIN and the influence of preventive strategies in patients with ST-segment-elevation myocardial infarction undergoing primary percutaneous coronary intervention. METHODS AND RESULTS: A total of 720 patients were randomized in the Prevention of Contrast-induced Nephropathy in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention (CINSTEMI) trial. Patients were randomly assigned in a 1:1:1:1 ratio to receive hydration with sodium chloride together with 1 of 4 prophylactic regimes (1) N-acetylcysteine (NAC), (2) sodium bicarbonate (NaHCO3) infusion, (3) NAC in combination with NaHCO3, or (4) hydration with sodium chloride infusion alone. Patients in cardiogenic shock were excluded. Acute CIN was defined as an increase in serum creatinine concentration >25% from the baseline value within a 3-day period. Overall, CIN occurred in 141 (21.9%) patients. The prevention treatment with NAC, NaHCO3, or the combined NAC and NaHCO3 did not reduce the rate of CIN significantly compared with hydration with intravenous sodium chloride infusion alone (20.1% versus 20.1% versus 20.8% versus 26.5%; P=NS). However, an increase in serum creatinine >25% from the baseline value to 30 day was significantly lower in patients treated with combined NAC and NaHCO3 (18.7% versus 19.1% versus 9.2% versus 21.3%; P=0.033). CONCLUSIONS: Treatment with NAC or NaHCO3 did not reduce the rate of acute CIN significantly. Combined treatment with NAC and NaHCO3 may reduce the risk of renal dysfunction after 30 days. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT01160627. FAU - Thayssen, Per AU - Thayssen P AD - From the Department of Cardiology, Odense University Hospital, Odense, Denmark (P.T., K.N.H., H.S.H., A.J., K.T.V., L.O.J.); Department of Cardiology, Aarhus University Hospital, Skejby, Denmark (J.F.L., E.H.C., L.T.); and Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark (S.E.J., J.R.). FAU - Lassen, Jens Flensted AU - Lassen JF FAU - Jensen, Svend Eggert AU - Jensen SE FAU - Hansen, Knud Norregaard AU - Hansen KN FAU - Hansen, Henrik Steen AU - Hansen HS FAU - Christiansen, Evald Hoj AU - Christiansen EH FAU - Junker, Anders AU - Junker A FAU - Ravkilde, Jan AU - Ravkilde J FAU - Thuesen, Leif AU - Thuesen L FAU - Veien, Karsten Tange AU - Veien KT FAU - Jensen, Lisette Okkels AU - Jensen LO LA - eng SI - ClinicalTrials.gov/NCT01160627 PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20140408 PL - United States TA - Circ Cardiovasc Interv JT - Circulation. Cardiovascular interventions JID - 101499602 RN - 0 (Contrast Media) RN - 8MDF5V39QO (Sodium Bicarbonate) RN - AYI8EX34EU (Creatinine) RN - WYQ7N0BPYC (Acetylcysteine) SB - IM MH - Acetylcysteine/administration & dosage/*therapeutic use MH - Aged MH - Contrast Media/*adverse effects MH - Creatinine/blood MH - Drug Therapy, Combination MH - Electrocardiography MH - Female MH - Humans MH - Incidence MH - Infusions, Intravenous MH - Kidney Diseases/*chemically induced/epidemiology/*prevention & control MH - Male MH - Middle Aged MH - Myocardial Infarction/physiopathology/*therapy MH - *Percutaneous Coronary Intervention/adverse effects/methods MH - Prospective Studies MH - Sodium Bicarbonate/administration & dosage/*therapeutic use MH - Treatment Outcome OTO - NOTNLM OT - ST-segment-elevation myocardial infarction OT - contrast-induced nephropathy EDAT- 2014/04/10 06:00 MHDA- 2015/09/05 06:00 CRDT- 2014/04/10 06:00 PHST- 2014/04/10 06:00 [entrez] PHST- 2014/04/10 06:00 [pubmed] PHST- 2015/09/05 06:00 [medline] AID - CIRCINTERVENTIONS.113.000653 [pii] AID - 10.1161/CIRCINTERVENTIONS.113.000653 [doi] PST - ppublish SO - Circ Cardiovasc Interv. 2014 Apr;7(2):216-24. doi: 10.1161/CIRCINTERVENTIONS.113.000653. Epub 2014 Apr 8. PMID- 24706498 OWN - NLM STAT- MEDLINE DCOM- 20150224 LR - 20250529 IS - 1879-0844 (Electronic) IS - 1388-9842 (Linking) VI - 16 IP - 6 DP - 2014 Jun TI - Effect of eplerenone in percutaneous coronary intervention-treated post-myocardial infarction patients with left ventricular systolic dysfunction: a subanalysis of the EPHESUS trial. PG - 685-91 LID - 10.1002/ejhf.88 [doi] AB - AIMS: EPHESUS was a multicentre, double-blind clinical trial in which 6632 patients with acute myocardial infarction (AMI) complicated by LV systolic dysfunction (LVSD) were randomized to receive eplerenone (n = 3319) or placebo (n = 3313). A total of 1580 EPHESUS patients were treated with PCI, which is now the standard treatment for AMI. This EPHESUS substudy examined the effects of eplerenone upon cardiovascular outcomes in PCI-treated patients. METHODS AND RESULTS: EPHESUS patients were divided into PCI-treated and non-PCI-treated cohorts, and the effect of eplerenone upon mortality and other major adverse cardiovascular outcomes was assessed in each cohort. The PCI-treated patients (n = 1580) were younger, and had better renal function and fewer co-morbidities than non-PCI-treated patients (n = 5052). Cardiovascular mortality was significantly lower in PCI-treated patients as compared with non-PCI-treated patients (7% vs. 16%, P < 0.0001). However, the incidence of non-fatal events was similar in PCI-treated and non-PCI-treated cohorts. There was no statistical difference between the PCI-treated and non-PCI-treated cohorts in the primary or secondary outcomes of the trial. Eplerenone administration, compared with placebo, in the PCI-treated cohort did not affect PCI-related clinical outcomes, including recurrence of angina, the occurrence of acute coronary syndromes, or the need for further revascularization. CONCLUSIONS: The beneficial effects of eplerenone in the EPHESUS trial exist for both PCI- and non-PCI-treated AMI patients with LVSD. Eplerenone has minimal, if any, effect upon reducing PCI-related adverse events in the PCI-treated cohort. CI - (c) 2014 The Authors. European Journal of Heart Failure (c) 2014 European Society of Cardiology. FAU - Iqbal, Javaid AU - Iqbal J AD - Department of Cardiovascular Science at the University of Sheffield, and Cardiology Department at Sheffield Teaching Hospitals NHS Trust, Sheffield, UK. FAU - Fay, Renaud AU - Fay R FAU - Adlam, David AU - Adlam D FAU - Squire, Iain AU - Squire I FAU - Parviz, Yasir AU - Parviz Y FAU - Gunn, Julian AU - Gunn J FAU - Pitt, Bertram AU - Pitt B FAU - Zannad, Faiez AU - Zannad F LA - eng GR - PG/13/74/30264/BHF_/British Heart Foundation/United Kingdom PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20140404 PL - England TA - Eur J Heart Fail JT - European journal of heart failure JID - 100887595 RN - 0 (Mineralocorticoid Receptor Antagonists) RN - 27O7W4T232 (Spironolactone) RN - 6995V82D0B (Eplerenone) SB - IM MH - Aged MH - Aged, 80 and over MH - Comorbidity MH - Double-Blind Method MH - Eplerenone MH - Female MH - Humans MH - Male MH - Middle Aged MH - Mineralocorticoid Receptor Antagonists/*therapeutic use MH - Myocardial Infarction/*drug therapy/surgery MH - *Percutaneous Coronary Intervention MH - Spironolactone/*analogs & derivatives/therapeutic use MH - Treatment Outcome MH - Ventricular Dysfunction, Left/*drug therapy/mortality OTO - NOTNLM OT - Angioplasty OT - Eplerenone OT - Heart failure OT - Myocardial infarction EDAT- 2014/04/08 06:00 MHDA- 2015/02/25 06:00 CRDT- 2014/04/08 06:00 PHST- 2013/12/27 00:00 [received] PHST- 2014/02/14 00:00 [revised] PHST- 2014/02/21 00:00 [accepted] PHST- 2014/04/08 06:00 [entrez] PHST- 2014/04/08 06:00 [pubmed] PHST- 2015/02/25 06:00 [medline] AID - 10.1002/ejhf.88 [doi] PST - ppublish SO - Eur J Heart Fail. 2014 Jun;16(6):685-91. doi: 10.1002/ejhf.88. Epub 2014 Apr 4. PMID- 24657033 OWN - NLM STAT- MEDLINE DCOM- 20140624 LR - 20161125 IS - 1552-6259 (Electronic) IS - 0003-4975 (Linking) VI - 97 IP - 5 DP - 2014 May TI - High dose of N-acetylcystein prevents acute kidney injury in chronic kidney disease patients undergoing myocardial revascularization. PG - 1617-23 LID - S0003-4975(14)00341-5 [pii] LID - 10.1016/j.athoracsur.2014.01.056 [doi] AB - BACKGROUND: The renoprotective effect of N-acetylcystein in patients undergoing coronary artery bypass graft surgery is controversial. METHODS: We assessed the renoprotective effect of the highest dose of N-acetylcystein sanctioned for clinical use in a prospective, double-blind, placebo-controlled study including 70 chronic kidney disease patients, stage 3 or 4, who underwent coronary artery bypass graft surgery, on cardiopulmonary bypass (CPB) and off CPB, and were randomly allocated to receive either N-acetylcystein 150 mg/kg followed by 50 mg/kg for 6 hours in 0.9% saline or only 0.9% saline. Acute kidney injury was defined by the Acute Kidney Injury Network classification. RESULTS: The incidence of kidney injury was reduced in the N-acetylcystein group (57.1% versus 28.6%, p=0.016). Nonuse of N-acetylcystein (relative risk 3.58, 95% confidence interval: 1.04 to 12.33, p=0.04) and cardiopulmonary bypass (relative risk 4.55, 95% confidence interval: 1.28 to 16.15, p=0.02) were independent predictors of kidney injury. In patients treated with CPB, N-acetylcystein reduced the incidence of kidney injury from 63% to 46%. Oxidative stress was increased in control subjects (p=0.01) and abolished in patients receiving N-acetylcystein. CONCLUSIONS: Maximum intravenous doses of N-acetylcystein reduce the incidence of acute kidney injury in patients with kidney disease undergoing coronary artery bypass graft surgery, abolish oxidative stress, and mitigate the negative effect of CPB on renal function. CI - Copyright (c) 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved. FAU - Santana-Santos, Eduesley AU - Santana-Santos E AD - Heart Institute (InCor), Hospital das Clinicas, University of Sao Paulo Medical School, Sao Paulo, Brazil. FAU - Gowdak, Luis Henrique W AU - Gowdak LH AD - Heart Institute (InCor), Hospital das Clinicas, University of Sao Paulo Medical School, Sao Paulo, Brazil. FAU - Gaiotto, Fabio A AU - Gaiotto FA AD - Heart Institute (InCor), Hospital das Clinicas, University of Sao Paulo Medical School, Sao Paulo, Brazil. FAU - Puig, Luiz B AU - Puig LB AD - Heart Institute (InCor), Hospital das Clinicas, University of Sao Paulo Medical School, Sao Paulo, Brazil. FAU - Hajjar, Ludhmila A AU - Hajjar LA AD - Heart Institute (InCor), Hospital das Clinicas, University of Sao Paulo Medical School, Sao Paulo, Brazil. FAU - Zeferino, Suely P AU - Zeferino SP AD - Heart Institute (InCor), Hospital das Clinicas, University of Sao Paulo Medical School, Sao Paulo, Brazil. FAU - Drager, Luciano F AU - Drager LF AD - Heart Institute (InCor), Hospital das Clinicas, University of Sao Paulo Medical School, Sao Paulo, Brazil. FAU - Shimizu, Maria Heloisa M AU - Shimizu MH AD - Heart Institute (InCor), Hospital das Clinicas, University of Sao Paulo Medical School, Sao Paulo, Brazil. FAU - Bortolotto, Luiz A AU - Bortolotto LA AD - Heart Institute (InCor), Hospital das Clinicas, University of Sao Paulo Medical School, Sao Paulo, Brazil. FAU - De Lima, Jose J G AU - De Lima JJ AD - Heart Institute (InCor), Hospital das Clinicas, University of Sao Paulo Medical School, Sao Paulo, Brazil. Electronic address: jose.lima@incor.usp.br. LA - eng PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20140320 PL - Netherlands TA - Ann Thorac Surg JT - The Annals of thoracic surgery JID - 15030100R RN - WYQ7N0BPYC (Acetylcysteine) SB - IM MH - Acetylcysteine/*administration & dosage MH - Acute Kidney Injury/*prevention & control MH - Aged MH - Cardiopulmonary Bypass/adverse effects/methods MH - Confidence Intervals MH - Coronary Artery Bypass/adverse effects/*methods MH - Coronary Stenosis/complications/diagnostic imaging/mortality/*surgery MH - Dose-Response Relationship, Drug MH - Double-Blind Method MH - Female MH - Hospital Mortality MH - Humans MH - Kidney Failure, Chronic/complications/*diagnosis/surgery MH - Male MH - Middle Aged MH - Postoperative Complications/prevention & control MH - Prognosis MH - Prospective Studies MH - Pulse Therapy, Drug/*methods MH - Radiography MH - Reference Values MH - Risk Assessment MH - Statistics, Nonparametric MH - Survival Rate MH - Treatment Outcome EDAT- 2014/03/25 06:00 MHDA- 2014/06/25 06:00 CRDT- 2014/03/25 06:00 PHST- 2013/10/31 00:00 [received] PHST- 2014/01/15 00:00 [revised] PHST- 2014/01/17 00:00 [accepted] PHST- 2014/03/25 06:00 [entrez] PHST- 2014/03/25 06:00 [pubmed] PHST- 2014/06/25 06:00 [medline] AID - S0003-4975(14)00341-5 [pii] AID - 10.1016/j.athoracsur.2014.01.056 [doi] PST - ppublish SO - Ann Thorac Surg. 2014 May;97(5):1617-23. doi: 10.1016/j.athoracsur.2014.01.056. Epub 2014 Mar 20. PMID- 24603308 OWN - NLM STAT- MEDLINE DCOM- 20150202 LR - 20220410 IS - 1522-9645 (Electronic) IS - 0195-668X (Linking) VI - 35 IP - 23 DP - 2014 Jun 14 TI - Contrast-induced acute kidney injury after primary percutaneous coronary intervention: results from the HORIZONS-AMI substudy. PG - 1533-40 LID - 10.1093/eurheartj/ehu063 [doi] AB - AIM: We sought to examine the short- and long-term outcomes of patients who developed contrast-induced acute kidney injury (CI-AKI; defined as an increase in serum creatinine of >/=0.5 mg/dL or a 25% relative rise within 48 h after contrast exposure) from the large-scale HORIZONS-AMI trial. METHODS AND RESULTS: Multivariable analyses were used to identify predictors of CI-AKI, as well predictors of the primary and secondary endpoints. The incidence of CI-AKI in this cohort of ST-segment elevation myocardial infarction (STEMI) patients was 16.1% (479/2968). Predictors of CI-AKI were contrast volume, white blood cell count, left anterior descending infarct-related artery, age, anaemia, creatinine clearance <60 mL/min, and history of congestive heart failure. Patients with CI-AKI had higher rates of net adverse clinical events [NACE; a combination of major bleeding or composite major adverse cardiac events (MACE; consisting of death, reinfarction, target vessel revascularization for ischaemia, or stroke)] at 30 days (22.0 vs. 9.3%; P < 0.0001) and 3 years (40.3 vs. 24.6%; P < 0.0001). They also had higher rates of mortality at 30 days (8.0 vs. 0.9%; P < 0.0001) and 3 years (16.2 vs. 4.5%; P < 0.0001). Multivariable analysis confirmed CI-AKI as an independent predictor of NACE [hazard ratio ([HR), 1.53; 95% confidence interval (CI), 1.23-1.90; P = 0.0001], MACE (HR, 1.56; 95% CI, 1.23-1.98; P = 0.0002), non-coronary artery bypass grafting major bleeding (HR, 2.07; 95% CI, 1.57-2.73; P < 0.0001), and mortality (HR, 1.80; 95% CI, 1.19-2.73; P = 0.005) at 3-year follow-up. CONCLUSION: Contrast-induced acute kidney injury is associated with poor short- and long-term outcomes after primary percutaneous coronary intervention in STEMI. CI - Published on behalf of the European Society of Cardiology. All rights reserved. (c) The Author 2014. For permissions please email: journals.permissions@oup.com. FAU - Narula, Amar AU - Narula A AD - NYU Langone Medical Center, New York, NY, USA. FAU - Mehran, Roxana AU - Mehran R AD - Icahn School of Medicine at Mount Sinai, New York, NY, USA Cardiovascular Research Foundation, New York, NY, USA roxana.mehran@mountsinai.org. FAU - Weisz, Giora AU - Weisz G AD - Cardiovascular Research Foundation, New York, NY, USA Columbia University Medical Center, New York, NY, USA Shaare Zedek Medical Center, Jerusalem, Israel. FAU - Dangas, George D AU - Dangas GD AD - Icahn School of Medicine at Mount Sinai, New York, NY, USA Cardiovascular Research Foundation, New York, NY, USA. FAU - Yu, Jennifer AU - Yu J AD - Icahn School of Medicine at Mount Sinai, New York, NY, USA. FAU - Genereux, Philippe AU - Genereux P AD - Cardiovascular Research Foundation, New York, NY, USA Columbia University Medical Center, New York, NY, USA Hopital du Sacre-Coeur de Montreal, Montreal, Quebec, Canada. FAU - Nikolsky, Eugenia AU - Nikolsky E AD - Rambam Health Care Campus and the Technion - Israel Institute of Technology, Haifa, Israel. FAU - Brener, Sorin J AU - Brener SJ AD - Cardiovascular Research Foundation, New York, NY, USA New York Methodist Hospital, Brooklyn, NY, USA. FAU - Witzenbichler, Bernhard AU - Witzenbichler B AD - Amper Kliniken AG, Dachau, Germany. FAU - Guagliumi, Giulio AU - Guagliumi G AD - Ospedale Papa Giovanni XXIII, Bergamo, Italy. FAU - Clark, Avery E AU - Clark AE AD - The Warren Alpert Medical School of Brown University, Providence, RI, USA. FAU - Fahy, Martin AU - Fahy M AD - Cardiovascular Research Foundation, New York, NY, USA. FAU - Xu, Ke AU - Xu K AD - Cardiovascular Research Foundation, New York, NY, USA. FAU - Brodie, Bruce R AU - Brodie BR AD - LeBauer Cardiovascular Research Foundation and Moses Cone Heart and Vascular Center, Greensboro, NC, USA. FAU - Stone, Gregg W AU - Stone GW AD - Cardiovascular Research Foundation, New York, NY, USA Columbia University Medical Center, New York, NY, USA. LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20140306 PL - England TA - Eur Heart J JT - European heart journal JID - 8006263 RN - 0 (Contrast Media) SB - IM CIN - Eur Heart J. 2014 Jun 14;35(23):1504-6. doi: 10.1093/eurheartj/ehu126. PMID: 24722806 MH - Acute Kidney Injury/*chemically induced MH - Aged MH - Contrast Media/*adverse effects MH - Epidemiologic Methods MH - Female MH - Humans MH - Male MH - Middle Aged MH - Myocardial Infarction/*therapy MH - Osmolar Concentration MH - *Percutaneous Coronary Intervention MH - Postoperative Hemorrhage/chemically induced MH - Recurrence MH - Stents MH - Stroke/chemically induced MH - Treatment Outcome OTO - NOTNLM OT - Contrast media OT - Kidney OT - Myocardial infarction EDAT- 2014/03/08 06:00 MHDA- 2015/02/03 06:00 CRDT- 2014/03/08 06:00 PHST- 2014/03/08 06:00 [entrez] PHST- 2014/03/08 06:00 [pubmed] PHST- 2015/02/03 06:00 [medline] AID - ehu063 [pii] AID - 10.1093/eurheartj/ehu063 [doi] PST - ppublish SO - Eur Heart J. 2014 Jun 14;35(23):1533-40. doi: 10.1093/eurheartj/ehu063. Epub 2014 Mar 6. PMID- 24585520 OWN - NLM STAT- MEDLINE DCOM- 20150928 LR - 20150124 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 85 IP - 2 DP - 2015 Feb 1 TI - Safety and long-term outcomes after percutaneous coronary intervention in patients with human immunodeficiency virus. PG - 192-8 LID - 10.1002/ccd.25466 [doi] AB - OBJECTIVE: This study aims to report the long-term outcomes after percutaneous coronary intervention (PCI) in human immunodeficiency virus (HIV+) patients. BACKGROUND: Sparse data exists regarding the risk of patients with HIV who undergo PCI. METHODS: Using a case-control design, we compared baseline characteristics, procedure-related outcomes, in-hospital, and 2-year clinical outcomes of 112 consecutive HIV+ patients versus 112 HIV- controls matched for age, gender, and diabetes mellitus who underwent PCI from April 2003 to September 2011. RESULTS: Baseline characteristics were generally comparable, save for more African Americans and history of chronic renal insufficiency in the HIV+ vs. HIV- group (62.5% vs. 21.4%, P < 0.001) and (27.7% vs. 9.9%, P < 0.001). There was no correlation between CD4 nadir count and extent and diffuseness of coronary artery disease. The occurrence of major adverse cardiac events at 2 years was similar in both groups. Multivariable analysis for independent correlates of major adverse cardiac events at 2 years detected patients with a history of chronic renal insufficiency (OR: 2.44, 95% confidence interval: 1.02-5.83; P = 0.04) and acute myocardial infarction (OR: 2.92, 95% confidence interval: 1.39-6.15; P = 0.005) as correlates for outcome. Post-hoc analysis showed that drug-eluting stent (DES) use in the HIV+ group was beneficial. CONCLUSION: PCI in HIV+ patients is safe, with high procedural success rates, and produces similar outcomes to those seen in HIV- patients at 2 years. HIV+ patients should be treated with DES if possible. CI - (c) 2014 Wiley Periodicals, Inc. FAU - Badr, Salem AU - Badr S AD - Section of Interventional Cardiology, MedStar Heart Institute, MedStar Washington Hospital Center, Washington, District of Columbia. FAU - Minha, Sa'ar AU - Minha S FAU - Kitabata, Hironori AU - Kitabata H FAU - Fatemi, Omid AU - Fatemi O FAU - Torguson, Rebecca AU - Torguson R FAU - Suddath, William O AU - Suddath WO FAU - Satler, Lowell F AU - Satler LF FAU - Pichard, Augusto D AU - Pichard AD FAU - Waksman, Ron AU - Waksman R LA - eng PT - Journal Article PT - Observational Study DEP - 20140617 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Aged MH - Chi-Square Distribution MH - Coronary Artery Disease/complications/diagnosis/mortality/*therapy MH - Databases, Factual MH - Drug-Eluting Stents MH - Female MH - HIV Infections/*complications/diagnosis/mortality MH - Humans MH - Kaplan-Meier Estimate MH - Male MH - Middle Aged MH - Multivariate Analysis MH - Myocardial Infarction/etiology MH - Odds Ratio MH - Patient Selection MH - *Percutaneous Coronary Intervention/adverse effects/instrumentation/mortality MH - Proportional Hazards Models MH - Retrospective Studies MH - Risk Assessment MH - Risk Factors MH - Time Factors MH - Treatment Outcome OTO - NOTNLM OT - coronary artery disease OT - human immunodeficiency virus OT - percutaneous coronary intervention EDAT- 2014/03/04 06:00 MHDA- 2015/09/29 06:00 CRDT- 2014/03/04 06:00 PHST- 2013/10/04 00:00 [received] PHST- 2014/02/12 00:00 [revised] PHST- 2014/02/25 00:00 [accepted] PHST- 2014/03/04 06:00 [entrez] PHST- 2014/03/04 06:00 [pubmed] PHST- 2015/09/29 06:00 [medline] AID - 10.1002/ccd.25466 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2015 Feb 1;85(2):192-8. doi: 10.1002/ccd.25466. Epub 2014 Jun 17. PMID- 24585502 OWN - NLM STAT- MEDLINE DCOM- 20150824 LR - 20220321 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 85 IP - 1 DP - 2015 Jan 1 TI - Complex patients treated with zotarolimus-eluting resolute and everolimus-eluting Xience V stents in the randomized TWENTE trial: comparison of 2-year clinical outcome. PG - 74-81 LID - 10.1002/ccd.25464 [doi] AB - OBJECTIVE: To assess the differences in clinical outcome between complex patients treated with Resolute zotarolimus-eluting stents (ZES) versus Xience V everolimus-eluting stents (EES). BACKGROUND: Nowadays, many complex patients with coronary disease are treated with percutaneous coronary interventions, using drug-eluting stents (DES). METHODS: We analyzed 2-year outcome data of 1,033 complex patients of the TWENTE trial, treated with second-generation Resolute ZES or Xience V EES. Complex patients had at least one of the following characteristics: renal insufficiency (creatinine >/= 140 micromol/l); ejection fraction < 30%; acute myocardial infarction (MI) within previous 72 hrs; >1 lesion/vessel; >2 vessels treated; lesion length > 27 mm; bifurcation; saphenous vein graft lesion; arterial bypass graft lesion; in-stent restenosis; unprotected left main lesion; lesion with thrombus; or lesion with total occlusion. Target vessel failure (TVF), the primary composite endpoint of the trial, was defined as cardiac death, target vessel-related MI, or target vessel revascularization. RESULTS: Among the 1,033 complex patients, 529 (51%) were treated with Resolute ZES and 504 (49%) with Xience V EES. Patient- and procedure-related characteristics were similar between DES groups. After 2-year follow-up, outcome was also similar between DES groups. TVF occurred in 12.1% of patients treated with Resolute ZES and 12.3% of patients treated with Xience V EES. In addition, DES groups did not differ significantly in cardiac death, MI, or target vessel revascularization-the individual components of TVF. CONCLUSION: Complex patients treated with Resolute ZES and Xience V EES showed similar safety and efficacy during 2-year follow-up. (c) 2014 Wiley Periodicals, Inc. CI - (c) 2014 Wiley Periodicals, Inc. FAU - Sen, Hanim AU - Sen H AD - Department of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, The Netherlands. FAU - Lam, Ming Kai AU - Lam MK FAU - Tandjung, Kenneth AU - Tandjung K FAU - Lowik, Marije M AU - Lowik MM FAU - Stoel, Martin G AU - Stoel MG FAU - de Man, Frits H A F AU - de Man FH FAU - Louwerenburg, J Hans W AU - Louwerenburg JH FAU - van Houwelingen, Gert K AU - van Houwelingen GK FAU - Linssen, Gerard C M AU - Linssen GC FAU - Doggen, Carine J M AU - Doggen CJ FAU - Basalus, Mounir W Z AU - Basalus MW FAU - von Birgelen, Clemens AU - von Birgelen C LA - eng SI - ClinicalTrials.gov/NCT01066650 PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20140314 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 RN - 0 (Cardiovascular Agents) RN - 9HW64Q8G6G (Everolimus) RN - H4GXR80IZE (zotarolimus) RN - W36ZG6FT64 (Sirolimus) SB - IM MH - Aged MH - Cardiovascular Agents/*administration & dosage MH - Coronary Disease/diagnosis/mortality/*therapy MH - *Drug-Eluting Stents MH - Everolimus MH - Female MH - Humans MH - Kaplan-Meier Estimate MH - Male MH - Middle Aged MH - Netherlands MH - Percutaneous Coronary Intervention/adverse effects/*instrumentation/mortality MH - Prosthesis Design MH - Risk Factors MH - Sirolimus/administration & dosage/*analogs & derivatives MH - Time Factors MH - Treatment Outcome OTO - NOTNLM OT - TWENTE trial OT - drug-eluting stent OT - off-label OT - percutaneous coronary intervention EDAT- 2014/03/04 06:00 MHDA- 2015/08/25 06:00 CRDT- 2014/03/04 06:00 PHST- 2013/11/12 00:00 [received] PHST- 2014/02/25 00:00 [accepted] PHST- 2014/03/04 06:00 [entrez] PHST- 2014/03/04 06:00 [pubmed] PHST- 2015/08/25 06:00 [medline] AID - 10.1002/ccd.25464 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2015 Jan 1;85(1):74-81. doi: 10.1002/ccd.25464. Epub 2014 Mar 14. PMID- 24576541 OWN - NLM STAT- MEDLINE DCOM- 20140520 LR - 20140401 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 113 IP - 8 DP - 2014 Apr 15 TI - Comparison of outcomes in patients with ST-segment elevation myocardial infarction discharged on versus not on statin therapy (from the Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction Trial). PG - 1273-9 LID - S0002-9149(14)00536-0 [pii] LID - 10.1016/j.amjcard.2014.01.401 [doi] AB - Statin therapy is indicated after ST-segment elevation myocardial infarction (STEMI) to reduce recurrent ischemic events, but approximately 6% of patients with STEMI do not receive a statin prescription at discharge. This substudy aimed to define the clinical outcomes and patient characteristics associated with statin nonprescription after STEMI. We compared clinical, angiographic, and procedural characteristics and in-hospital, 30-day, 1-year, 2-year, and 3-year outcomes in 3,512 patients discharged after STEMI with and without (6%) statin prescriptions in the harmonizing outcomes with revascularization and stents in acute myocardial infarction trial (www.clinicaltrials.gov, NCT00433966). Statin nonprescription was associated with female sex, nonwhite race, previous bypass surgery, heart failure, renal impairment, anemia, thrombocytopenia, care in the United States, lower prescription rates of antiplatelets and neurohormonal antagonists, less percutaneous coronary intervention and stents, and, in 26% of cases, angiographically normal or nonobstructed coronary arteries. At every time point of follow-up after discharge, patients with no discharge statin prescription had significantly higher rates of net adverse clinical events, major adverse cardiac events, major bleeding unrelated to bypass surgery, and death. After multivariable adjustment, absence of a discharge statin prescription independently predicted 3-year major adverse cardiac event (hazard ratio 1.54, 95% confidence interval 1.15 to 2.07, p=0.0037) and death (hazard ratio 2.30, 95% confidence interval 1.41 to 3.77, p=0.0009). In conclusion, within the framework of this randomized trial of patients presenting with STEMI, approximately 6% of patients were discharged without statin therapy. Absence of a discharge statin prescription after STEMI was an independent predictor of ischemic events including death. CI - Copyright (c) 2014 Elsevier Inc. All rights reserved. FAU - Larsen, Alf I AU - Larsen AI AD - Department of Cardiology, Stavanger University Hospital, Stavanger, Norway; Institute of Medicine, University of Bergen, Bergen, Norway. FAU - Tomey, Matthew I AU - Tomey MI AD - Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York. FAU - Mehran, Roxana AU - Mehran R AD - Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Cardiovascular Research Foundation, New York, New York. Electronic address: roxana.mehran@mountsinai.org. FAU - Nilsen, Dennis W T AU - Nilsen DW AD - Department of Cardiology, Stavanger University Hospital, Stavanger, Norway; Institute of Medicine, University of Bergen, Bergen, Norway. FAU - Kirtane, Ajay J AU - Kirtane AJ AD - Cardiovascular Research Foundation, New York, New York; Division of Cardiology, Columbia University Medical Center, New York, New York. FAU - Witzenbichler, Bernhard AU - Witzenbichler B AD - Amper Kliniken AG, Dachau, Germany. FAU - Guagliumi, Giulio AU - Guagliumi G AD - Cardiovascular Department, Ospedale Papa Giovanni XXIII, Bergamo, Italy. FAU - Brener, Sorin J AU - Brener SJ AD - Cardiovascular Research Foundation, New York, New York; Division of Cardiology, New York Methodist Hospital, Brooklyn, New York. FAU - Genereux, Philippe AU - Genereux P AD - Cardiovascular Research Foundation, New York, New York; Division of Cardiology, Columbia University Medical Center, New York, New York; Hopital du Sacre-Coeur de Montreal, Montreal, Quebec, Canada. FAU - Kornowski, Ran AU - Kornowski R AD - Cardiology Department, Rabin Medical Center, Petach-Tikva, Israel. FAU - Dudek, Dariusz AU - Dudek D AD - Institute of Cardiology, Jagiellonian University, Krakow, Poland. FAU - Gersh, Bernard J AU - Gersh BJ AD - Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota. FAU - Stone, Gregg W AU - Stone GW AD - Cardiovascular Research Foundation, New York, New York; Division of Cardiology, Columbia University Medical Center, New York, New York. LA - eng SI - ClinicalTrials.gov/NCT00433966 PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20140131 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 RN - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors) SB - IM MH - Coronary Angiography MH - *Electrocardiography MH - Female MH - Follow-Up Studies MH - Hospital Mortality/trends MH - Humans MH - Hydroxymethylglutaryl-CoA Reductase Inhibitors/*therapeutic use MH - Male MH - Middle Aged MH - Myocardial Infarction/diagnosis/mortality/*therapy MH - Myocardial Revascularization/*methods MH - *Patient Discharge MH - *Stents MH - Treatment Outcome MH - United States/epidemiology EDAT- 2014/03/01 06:00 MHDA- 2014/05/21 06:00 CRDT- 2014/03/01 06:00 PHST- 2013/11/22 00:00 [received] PHST- 2014/01/08 00:00 [revised] PHST- 2014/01/08 00:00 [accepted] PHST- 2014/03/01 06:00 [entrez] PHST- 2014/03/01 06:00 [pubmed] PHST- 2014/05/21 06:00 [medline] AID - S0002-9149(14)00536-0 [pii] AID - 10.1016/j.amjcard.2014.01.401 [doi] PST - ppublish SO - Am J Cardiol. 2014 Apr 15;113(8):1273-9. doi: 10.1016/j.amjcard.2014.01.401. Epub 2014 Jan 31. PMID- 24570694 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20140226 LR - 20211021 IS - 1734-9338 (Print) IS - 1897-4295 (Electronic) IS - 1734-9338 (Linking) VI - 9 IP - 1 DP - 2013 TI - Percutaneous angioplasty of the only patent renal artery - treatment of choice for end-stage heart failure. PG - 83-5 LID - 10.5114/pwki.2013.34031 [doi] AB - The causes leading to the exacerbation of preexisting chronic heart failure can be various. Renal artery stenosis is an important cause of renal dysfunction, and can lead to worsening of heart failure and increased mortality. We present a 49-year old male patient after acute myocardial infarction, heart failure with left ventricle ejection fraction of 20%, permanent atrial flutter, peripheral vascular disease, chronic kidney disease and arterial hypertension. In 2008 the patient underwent stenting of the left renal artery. At that time there was only discrete stenosis of the right renal artery. Two years later the patient presented with exacerbation of bi-ventricular chronic heart failure and renal failure. The echocardiography revealed dramatically reduced systolic function of both ventricles. As no response to intravenous diuretics was achieved, the patient underwent several courses of hemodialysis. Before considering the patient as a potential candidate for orthotopic heart transplantation, color Doppler ultrasound showed the occlusion of the left renal artery and significant stenosis of the right renal artery, which was stented. After the procedure spectacular clinical improvement was observed. The results of two randomized trials, ASTRAL and STAR, were discouraging for invasive treatment of renal artery stenosis. Still, serious doubts regarding the methodology of the studies were raised. Renal artery stenting may be the treatment of choice in highly selected patients and lead to clinical improvement. FAU - Kadziela, Jacek AU - Kadziela J AD - Institute of Cardiology, Warsaw, Poland. FAU - Tyczynski, Pawel AU - Tyczynski P AD - Institute of Cardiology, Warsaw, Poland. FAU - Michalowska, Ilona AU - Michalowska I AD - Institute of Cardiology, Warsaw, Poland. FAU - Konka, Marek AU - Konka M AD - Institute of Cardiology, Warsaw, Poland. FAU - Duda, Bartosz AU - Duda B AD - Institute of Cardiology, Warsaw, Poland. FAU - Witkowski, Adam AU - Witkowski A AD - Institute of Cardiology, Warsaw, Poland. LA - eng PT - Journal Article DEP - 20130321 PL - Poland TA - Postepy Kardiol Interwencyjnej JT - Postepy w kardiologii interwencyjnej = Advances in interventional cardiology JID - 101272671 PMC - PMC3915945 OTO - NOTNLM OT - end-stage heart failure OT - renal artery stenting EDAT- 2014/02/27 06:00 MHDA- 2014/02/27 06:01 PMCR- 2013/01/01 CRDT- 2014/02/27 06:00 PHST- 2012/10/17 00:00 [received] PHST- 2012/11/02 00:00 [revised] PHST- 2012/11/08 00:00 [accepted] PHST- 2014/02/27 06:00 [entrez] PHST- 2014/02/27 06:00 [pubmed] PHST- 2014/02/27 06:01 [medline] PHST- 2013/01/01 00:00 [pmc-release] AID - 20456 [pii] AID - 10.5114/pwki.2013.34031 [doi] PST - ppublish SO - Postepy Kardiol Interwencyjnej. 2013;9(1):83-5. doi: 10.5114/pwki.2013.34031. Epub 2013 Mar 21. PMID- 24570247 OWN - NLM STAT- MEDLINE DCOM- 20140303 LR - 20211021 IS - 1538-3598 (Electronic) IS - 0098-7484 (Print) IS - 0098-7484 (Linking) VI - 311 IP - 8 DP - 2014 Feb 26 TI - Patterns and outcomes of red blood cell transfusion in patients undergoing percutaneous coronary intervention. PG - 836-43 LID - 10.1001/jama.2014.980 [doi] AB - IMPORTANCE: Studies have shown variation in the use of red blood cell transfusion among patients with acute coronary syndromes. There are no definitive data for the efficacy of transfusion in improving outcomes, and concerning data exist about possible association with harm. Current transfusion practices in patients undergoing percutaneous coronary intervention (PCI) are not well understood. OBJECTIVE: To determine the current patterns of blood transfusion among patients undergoing PCI and the association of transfusion with adverse cardiac outcomes across hospitals in the United States. DESIGN, SETTING, AND PARTICIPANTS: Retrospective cohort study of all patient visits from the CathPCI Registry from July 2009 to March 2013 that included PCI, excluding those with missing data on bleeding complications or who underwent in-hospital coronary artery bypass graft surgery (N = 2,258,711 visits). MAIN OUTCOMES AND MEASURES: Transfusion rates in the overall population and by hospital (N = 1431) were the primary outcomes. The association of transfusion with myocardial infarction, stroke, and death after accounting for a patient's propensity for transfusion was also measured. RESULTS: The overall rate of transfusion was 2.14% (95% CI, 2.13%-2.16%) and quarterly transfusion rates slightly declined from July 2009 to March 2013 (from 2.11% [95% CI, 2.03%-2.19%] to 2.04% [95% CI, 1.97%-2.12%]; P < .001). Patients who were more likely to receive transfusion were older (mean, 70.5 vs 64.6 years), were women (56.3% vs 32.5%), and had hypertension (86.4% vs 82.0%), diabetes (44.8% vs 34.6%), advanced renal dysfunction (8.7% vs 2.3%), prior myocardial infarction (33.0% vs 30.2%), or prior heart failure (27.0% vs 11.8%). Overall, 96.3% of sites gave a transfusion to less than 5% of patients and 3.7% of sites gave a transfusion to 5% of patients or more. Variation in hospital risk-standardized rates of transfusion persisted after adjustment, and hospitals showed variability in their transfusion thresholds. Receipt of transfusion was associated with myocardial infarction (42,803 events; 4.5% vs 1.8%; odds ratio [OR], 2.60; 95% CI, 2.57-2.63), stroke (5011 events; 2.0% vs 0.2%; OR, 7.72; 95% CI, 7.47-7.98), and in-hospital death (31,885 events; 12.5% vs 1.2%; OR, 4.63; 95% CI, 4.57-4.69), irrespective of bleeding complications. CONCLUSIONS AND RELEVANCE: Among patients undergoing PCI at US hospitals, there was considerable variation in blood transfusion practices, and receipt of transfusion was associated with increased risk of in-hospital adverse cardiac events. These observational findings may warrant a randomized trial of transfusion strategies for patients undergoing PCI. FAU - Sherwood, Matthew W AU - Sherwood MW AD - Duke Clinical Research Institute, Durham, North Carolina. FAU - Wang, Yongfei AU - Wang Y AD - Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut. FAU - Curtis, Jeptha P AU - Curtis JP AD - Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut. FAU - Peterson, Eric D AU - Peterson ED AD - Duke Clinical Research Institute, Durham, North Carolina. FAU - Rao, Sunil V AU - Rao SV AD - Duke Clinical Research Institute, Durham, North Carolina. LA - eng GR - T32 HL007101/HL/NHLBI NIH HHS/United States PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - United States TA - JAMA JT - JAMA JID - 7501160 SB - IM CIN - Ann Intern Med. 2014 Jun 17;160(12):JC12. doi: 10.7326/0003-4819-160-12-201406170-02012. PMID: 24935506 MH - Aged MH - Cohort Studies MH - Erythrocyte Transfusion/*adverse effects/*statistics & numerical data MH - Female MH - Hospital Mortality MH - Hospitals/statistics & numerical data MH - Humans MH - Male MH - Middle Aged MH - Myocardial Infarction/*epidemiology MH - *Percutaneous Coronary Intervention MH - Practice Patterns, Physicians'/statistics & numerical data MH - Registries/statistics & numerical data MH - Retrospective Studies MH - Risk MH - Stroke/*epidemiology MH - Treatment Outcome PMC - PMC4276400 MID - NIHMS571468 EDAT- 2014/02/27 06:00 MHDA- 2014/03/04 06:00 PMCR- 2014/12/24 CRDT- 2014/02/27 06:00 PHST- 2014/02/27 06:00 [entrez] PHST- 2014/02/27 06:00 [pubmed] PHST- 2014/03/04 06:00 [medline] PHST- 2014/12/24 00:00 [pmc-release] AID - 1832543 [pii] AID - 10.1001/jama.2014.980 [doi] PST - ppublish SO - JAMA. 2014 Feb 26;311(8):836-43. doi: 10.1001/jama.2014.980. PMID- 24569598 OWN - NLM STAT- MEDLINE DCOM- 20150904 LR - 20140416 IS - 1941-7632 (Electronic) IS - 1941-7640 (Linking) VI - 7 IP - 2 DP - 2014 Apr TI - Risk of acute kidney injury after percutaneous coronary interventions using radial versus femoral vascular access: insights from the Blue Cross Blue Shield of Michigan Cardiovascular Consortium. PG - 190-8 LID - 10.1161/CIRCINTERVENTIONS.113.000778 [doi] AB - BACKGROUND: Transradial percutaneous coronary intervention (PCI [TRI]) does not involve catheter manipulation in the descending aorta, whereas transfemoral PCI (TFI) does. Therefore, the risk of acute kidney injury (AKI) after PCI might be influenced by vascular access site. We compared risks of AKI and nephropathy requiring dialysis (NRD) among patients treated with TRI and TFI. METHODS AND RESULTS: We included patients across 47 hospitals in Michigan. Primary end point was AKI (serum creatinine increase >/=0.5 mg/dL). Secondary end points were NRD and postprocedural bleeding. Odds ratios (OR) for study end points were calculated for the entire and propensity-matched population, reported as crude, and values adjusted for preprocedural calculated AKI risk. Between 2010 and 2012, a total of 82 225 PCI procedures were performed, of which 8915 were TRI. After adjustment, TRI was associated with a reduction in AKI (OR, 0.76, 95% confidence intervals [0.62-0.92]) and bleeding with a trend toward lower NRD risk. The propensity-matched population consisted of 8857 procedures per group. In this population, TRI was associated with lower adjusted odds of AKI (OR, 0.74; 95% confidence intervals [0.58-0.96]), and bleeding (OR, 0.47; 95% confidence intervals [0.36-0.63]), but no difference in NRD was observed. Although postprocedural bleeding was independently associated with AKI (OR, 2.86; 95% confidence intervals [1.75-4.66]) in the propensity-matched population, the lower odds of AKI was not mediated by a reduction in bleeding with TRI. Sensitivity analysis demonstrated that the observed association between access site and AKI could potentially be explained by a moderately strong unknown confounder. CONCLUSIONS: The risk of AKI was significantly lower after TRI compared with TFI. This finding needs to be evaluated in randomized controlled trials. FAU - Kooiman, Judith AU - Kooiman J AD - From the Departments of Thrombosis and Hemostasis and Nephrology, Leiden University Medical Center, Leiden, Zuid-Holland, the Netherlands (J.K.); Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan, Ann Arbor (M.S., H.S.G.); Department of Cardiology, William Beaumont Hospital, Royal Oak, MI (S.D.); Frederik Meijer Heart and Vascular Institute, Spectrum Health, Grand Rapids, MI (D.W.); Department of Cardiology, St John Hospital and Medical Center, Detroit, MI (T.L.L.); and The Duke Clinical Research Institute, Durham, NC (S.V.R.). FAU - Seth, Milan AU - Seth M FAU - Dixon, Simon AU - Dixon S FAU - Wohns, David AU - Wohns D FAU - LaLonde, Thomas AU - LaLonde T FAU - Rao, Sunil V AU - Rao SV FAU - Gurm, Hitinder S AU - Gurm HS LA - eng PT - Comparative Study PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't PT - Research Support, U.S. Gov't, P.H.S. DEP - 20140225 PL - United States TA - Circ Cardiovasc Interv JT - Circulation. Cardiovascular interventions JID - 101499602 SB - IM CIN - Circ Cardiovasc Interv. 2014 Jun;7(3):419. doi: 10.1161/CIRCINTERVENTIONS.114.001433. PMID: 24944308 CIN - Circ Cardiovasc Interv. 2014 Jun;7(3):420. doi: 10.1161/CIRCINTERVENTIONS.114.001462. PMID: 24944309 CIN - Circ Cardiovasc Interv. 2014 Jun;7(3):421. doi: 10.1161/CIRCINTERVENTIONS.114.001590. PMID: 24944310 MH - Acute Kidney Injury/*epidemiology/therapy MH - Aged MH - Blue Cross Blue Shield Insurance Plans/*statistics & numerical data MH - Coronary Artery Disease/*therapy MH - Female MH - *Femoral Artery MH - Hemorrhage/epidemiology MH - Humans MH - Incidence MH - Kidney Diseases/epidemiology MH - Male MH - Michigan MH - Middle Aged MH - Percutaneous Coronary Intervention/*adverse effects/*methods MH - *Radial Artery MH - Renal Dialysis MH - Retrospective Studies MH - Risk Factors MH - Treatment Outcome OTO - NOTNLM OT - hemorrhage OT - percutaneous coronary intervention OT - renal insufficiency EDAT- 2014/02/27 06:00 MHDA- 2015/09/05 06:00 CRDT- 2014/02/27 06:00 PHST- 2014/02/27 06:00 [entrez] PHST- 2014/02/27 06:00 [pubmed] PHST- 2015/09/05 06:00 [medline] AID - CIRCINTERVENTIONS.113.000778 [pii] AID - 10.1161/CIRCINTERVENTIONS.113.000778 [doi] PST - ppublish SO - Circ Cardiovasc Interv. 2014 Apr;7(2):190-8. doi: 10.1161/CIRCINTERVENTIONS.113.000778. Epub 2014 Feb 25. PMID- 24560867 OWN - NLM STAT- MEDLINE DCOM- 20140708 LR - 20140519 IS - 1097-6809 (Electronic) IS - 0741-5214 (Linking) VI - 59 IP - 6 DP - 2014 Jun TI - Impact of postoperative transient ischemic attack on survival after carotid revascularization. PG - 1570-6 LID - S0741-5214(14)00101-3 [pii] LID - 10.1016/j.jvs.2013.12.048 [doi] AB - OBJECTIVE: Major postoperative complications such as stroke and myocardial infarction are usually carefully evaluated in the analysis of carotid revascularization performance. Although transient ischemic attacks (TIAs) are often left unreported, they also may influence long-term outcome. The aim of our study was to evaluate the influence of postoperative TIA in the long-term survival of patients submitted to carotid revascularization. METHODS: All consecutive patients submitted to either carotid artery stenting or carotid endarterectomy for symptomatic or asymptomatic carotid stenosis from 2005 to 2012 were retrospectively analyzed. Patients were stratified according to their postoperative (30-day) neurologic course (no symptoms, TIA, or stroke). Kaplan-Maier with log-rank analysis was performed to compare the 5-year survival of patients with postoperative TIA, stroke, or neither; factors affecting the 5-year mortality were evaluated by multivariable Cox proportional hazards models. RESULTS: Over a total of 1390 carotid revascularizations (carotid endarterectomy, n = 868 [62.4%]; carotid artery stenting, n = 522 [37.6%]), neurological perioperative complications occurred in 67 (4.7%) cases (38, 2.7% TIA; 29, 2.0% stroke). At 5-year follow-up, overall survival was significantly lower in patients with postoperative TIA (78.4 +/- 8.0% vs 97.4 +/- 0.6%; P < .001) and postoperative stroke (68.2 +/- 14.4% vs 97.4 +/- 0.6%; P = .03) compared with patients without neurological complications. By means of multivariate Cox analysis, postoperative TIA and stroke were independent predictors of decreased survival (hazard ratio [HR], 3.10; 95% confidence interval [CI], 1.01-9.72; P = .04, and HR, 3.87; 95% CI, 1.13-13.19; P = .03, respectively), other than age >80 years, postoperative myocardial infarction, and chronic renal failure (HR, 2.07; 95% CI, 1.41-4.90; P = .01; HR, 4.33; 95% CI, 2.74-23.79; P = .04; HR, 2.54; 95% CI, 1.04-6.19; P = .04, respectively). CONCLUSIONS: TIAs are significant events, possibly determined by a wider extent of atherosclerotic disease, with important effects on long-term mortality similar to that in strokes. Different from most trials evaluating the outcomes of revascularization techniques, the incidence of perioperative TIA should be accurately considered in the analysis. CI - Copyright (c) 2014 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved. FAU - Pini, Rodolfo AU - Pini R AD - Vascular Surgery, University of Bologna, Bologna, Italy. FAU - Faggioli, Gianluca AU - Faggioli G AD - Vascular Surgery, University of Bologna, Bologna, Italy. Electronic address: gianluca.faggioli@unibo.it. FAU - Longhi, Matteo AU - Longhi M AD - Vascular Surgery, University of Bologna, Bologna, Italy. FAU - Mauro, Raffaella AU - Mauro R AD - Vascular Surgery, University of Bologna, Bologna, Italy. FAU - Freyrie, Antonio AU - Freyrie A AD - Vascular Surgery, University of Bologna, Bologna, Italy. FAU - Gargiulo, Mauro AU - Gargiulo M AD - Vascular Surgery, University of Bologna, Bologna, Italy. FAU - Stella, Andrea AU - Stella A AD - Vascular Surgery, University of Bologna, Bologna, Italy. LA - eng PT - Journal Article DEP - 20140221 PL - United States TA - J Vasc Surg JT - Journal of vascular surgery JID - 8407742 SB - IM MH - Aged MH - Blood Vessel Prosthesis Implantation/*adverse effects MH - Carotid Stenosis/mortality/*surgery MH - Cause of Death/trends MH - Endarterectomy, Carotid/*adverse effects/methods MH - Female MH - Follow-Up Studies MH - Humans MH - Ischemic Attack, Transient/etiology/*mortality MH - Italy/epidemiology MH - Male MH - *Postoperative Complications MH - Prospective Studies MH - Reproducibility of Results MH - Survival Rate/trends MH - Time Factors EDAT- 2014/02/25 06:00 MHDA- 2014/07/09 06:00 CRDT- 2014/02/25 06:00 PHST- 2013/11/13 00:00 [received] PHST- 2013/12/20 00:00 [revised] PHST- 2013/12/24 00:00 [accepted] PHST- 2014/02/25 06:00 [entrez] PHST- 2014/02/25 06:00 [pubmed] PHST- 2014/07/09 06:00 [medline] AID - S0741-5214(14)00101-3 [pii] AID - 10.1016/j.jvs.2013.12.048 [doi] PST - ppublish SO - J Vasc Surg. 2014 Jun;59(6):1570-6. doi: 10.1016/j.jvs.2013.12.048. Epub 2014 Feb 21. PMID- 24560063 OWN - NLM STAT- MEDLINE DCOM- 20140520 LR - 20220331 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 113 IP - 8 DP - 2014 Apr 15 TI - Usefulness of the SYNTAX score to predict acute kidney injury after percutaneous coronary intervention (from the Acute Catheterization and Urgent Intervention Triage Strategy Trial). PG - 1331-7 LID - S0002-9149(14)00545-1 [pii] LID - 10.1016/j.amjcard.2013.12.041 [doi] AB - The synergy between percutaneous coronary intervention (PCI) with Taxus and cardiac surgery (SYNTAX) score (SS) has prognostic utility for ischemic outcomes in patients undergoing PCI. Acute kidney injury (AKI) after PCI has been demonstrated to be associated with adverse outcomes. However, the relation between the SS and AKI after PCI has yet to be fully investigated. We therefore sought to study this relation in the formal angiographic substudy of the large Acute Catheterization and Urgent Intervention Triage Strategy trial. We stratified 2,268 patients who underwent PCI for non-ST-segment elevation acute coronary syndromes by postprocedural AKI status and by SS tertiles (SS<7, 7 to 12, and >12). We also assessed rates of in-hospital, 30-day, and 1-year adverse outcomes. A total of 226 patients (10%) developed AKI, and rates in the highest Acute Catheterization and Urgent Intervention Triage Strategy SS tertile (>12) were significantly greater than those in the intermediate (7 to 12) and lowest tertiles (<7; 13% vs 8.9% vs 7.7%, respectively, p=0.002). By multivariable analysis, the SS was independently associated with AKI (odds ratio per 10 SS points 1.22, 95% confidence interval 1.04 to 1.43, p=0.02. Rates of major adverse cardiovascular events and net adverse clinical events increased significantly by SS tertile and were more common in patients who developed AKI. Patients who developed AKI experienced higher in-hospital, 30-day, and 1-year rates of mortality. In this large study, the SS was independently associated with AKI after PCI for non-ST-segment elevation acute coronary syndromes, and patients who developed AKI experienced worse short-term and long-term outcomes. CI - Copyright (c) 2014 Elsevier Inc. All rights reserved. FAU - Madhavan, Mahesh V AU - Madhavan MV AD - NewYork-Presbyterian Hospital and the Columbia University Medical Center, New York, New York. FAU - Genereux, Philippe AU - Genereux P AD - NewYork-Presbyterian Hospital and the Columbia University Medical Center, New York, New York; Cardiovascular Research Foundation, New York, New York; Hopital du Sacre-Coeur de Montreal, Universite de Montreal, Montreal, Canada. Electronic address: pg2295@columbia.edu. FAU - Rubin, Jonah AU - Rubin J AD - NewYork-Presbyterian Hospital and the Columbia University Medical Center, New York, New York. FAU - Palmerini, Tullio AU - Palmerini T AD - Istituto di Cardiologia, University of Bologna, Italy. FAU - Caixeta, Adriano AU - Caixeta A AD - Hospital Israelita Albert Einstein and Escola Paulista de Medicina, Universidade Federal de Sao Paulo, Brazil. FAU - Xu, Ke AU - Xu K AD - Cardiovascular Research Foundation, New York, New York. FAU - Weisz, Giora AU - Weisz G AD - NewYork-Presbyterian Hospital and the Columbia University Medical Center, New York, New York; Cardiovascular Research Foundation, New York, New York. FAU - Mehran, Roxana AU - Mehran R AD - Cardiovascular Research Foundation, New York, New York; Mount Sinai Medical Center, New York, New York. FAU - Stone, Gregg W AU - Stone GW AD - NewYork-Presbyterian Hospital and the Columbia University Medical Center, New York, New York; Cardiovascular Research Foundation, New York, New York. LA - eng SI - ClinicalTrials.gov/NCT00093158 PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20140131 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM MH - Acute Coronary Syndrome/diagnosis/*surgery MH - Acute Kidney Injury/*diagnosis/epidemiology/etiology MH - Coronary Angiography MH - Electrocardiography MH - Female MH - Follow-Up Studies MH - Global Health MH - Glomerular Filtration Rate MH - Humans MH - Incidence MH - Male MH - Middle Aged MH - Percutaneous Coronary Intervention/*adverse effects MH - Prognosis MH - Prospective Studies MH - Risk Assessment/*methods MH - Risk Factors MH - Survival Rate/trends MH - Triage/*methods EDAT- 2014/02/25 06:00 MHDA- 2014/05/21 06:00 CRDT- 2014/02/25 06:00 PHST- 2013/08/25 00:00 [received] PHST- 2013/12/30 00:00 [revised] PHST- 2013/12/30 00:00 [accepted] PHST- 2014/02/25 06:00 [entrez] PHST- 2014/02/25 06:00 [pubmed] PHST- 2014/05/21 06:00 [medline] AID - S0002-9149(14)00545-1 [pii] AID - 10.1016/j.amjcard.2013.12.041 [doi] PST - ppublish SO - Am J Cardiol. 2014 Apr 15;113(8):1331-7. doi: 10.1016/j.amjcard.2013.12.041. Epub 2014 Jan 31. PMID- 24558113 OWN - NLM STAT- MEDLINE DCOM- 20141216 LR - 20220318 IS - 1522-9645 (Electronic) IS - 0195-668X (Linking) VI - 35 IP - 15 DP - 2014 Apr TI - German nationwide data on current trends and management of acute myocardial infarction: discrepancies between trials and real-life. PG - 979-88 LID - 10.1093/eurheartj/ehu043 [doi] AB - AIMS: Recent guidelines on acute myocardial infarction (AMI) are based on randomized clinical trials (RCTs) and registries with selected patients, and may therefore not represent 'real-life'. This analysis shows for the first time nationwide trends in AMI from Germany. METHODS AND RESULTS: We were provided with data on all in-patient hospitalizations by the Federal Statistical Office. All hospitalized cases with AMI (onset of symptoms <28 days) from the years 2005, 2007, and 2009 were analysed regarding morbidity, in-hospital mortality, treatments, and costs. Analysis of a total of 16.1, 16.6, and 17.2 million hospitalizations showed the proportion of coded AMI to remain relatively constant (1276, 1272, and 1181 per 100 000 hospitalizations in 2005, 2007, and 2009). The proportion of ST-elevation AMI decreased over time (STEMI; 631, 546, and 454 per 100 000 hospitalizations),while non-ST-elevation AMI increased (NSTEMI; 645, 726, and 727 per 100 000 hospitalizations). The proportion of older patients >75 years (+4.6%), of comorbidities such as hypertension (+5.8%), diabetes (+17.7%), left ventricular failure (+19.8%), peripheral artery disease (+13.3%), and chronic kidney disease (+165.4%) increased as well. In-hospital mortality remained relatively stable during this period in AMI cases overall (11.1, 10.7, 10.8%) but changed slightly in STEMI (11.2, 11.9, 12.2%) and NSTEMI (11.0, 9.9, 9.9%). Causing about 1.2% of hospitalizations, AMI accounted for 2.5% (1.2 billion euro) of in-hospital health expenses. CONCLUSION: This hospitalization-based analysis revealed a marked increase of NSTEMI among constant AMI frequency. Despite all current efforts, in-hospital mortality was stagnating on a high level compared with data of RCTs. FAU - Freisinger, Eva AU - Freisinger E AD - Division of Vascular Medicine, Department of Cardiovascular Medicine, University Hospital Muenster, D-48149 Muenster, Germany. FAU - Fuerstenberg, Torsten AU - Fuerstenberg T FAU - Malyar, Nasser M AU - Malyar NM FAU - Wellmann, Juergen AU - Wellmann J FAU - Keil, Ulrich AU - Keil U FAU - Breithardt, Guenter AU - Breithardt G FAU - Reinecke, Holger AU - Reinecke H LA - eng PT - Journal Article DEP - 20140220 PL - England TA - Eur Heart J JT - European heart journal JID - 8006263 SB - IM MH - Aged MH - Coronary Artery Bypass/trends MH - Costs and Cost Analysis MH - Female MH - Germany MH - Hospital Mortality/trends MH - Hospitalization/economics/trends MH - Humans MH - Male MH - Middle Aged MH - Myocardial Infarction/economics/mortality/*therapy MH - Percutaneous Coronary Intervention/trends MH - Practice Patterns, Physicians'/economics/trends MH - Randomized Controlled Trials as Topic MH - Stents/trends MH - Thrombolytic Therapy/trends OTO - NOTNLM OT - Acute myocardial infarction OT - Cardiovascular disease OT - Mortality OT - Population-based study EDAT- 2014/02/22 06:00 MHDA- 2014/12/17 06:00 CRDT- 2014/02/22 06:00 PHST- 2014/02/22 06:00 [entrez] PHST- 2014/02/22 06:00 [pubmed] PHST- 2014/12/17 06:00 [medline] AID - ehu043 [pii] AID - 10.1093/eurheartj/ehu043 [doi] PST - ppublish SO - Eur Heart J. 2014 Apr;35(15):979-88. doi: 10.1093/eurheartj/ehu043. Epub 2014 Feb 20. PMID- 24515307 OWN - NLM STAT- MEDLINE DCOM- 20150904 LR - 20220321 IS - 1437-7799 (Electronic) IS - 1342-1751 (Linking) VI - 18 IP - 6 DP - 2014 Dec TI - Derivation and validation of a risk score for contrast-induced nephropathy after cardiac catheterization in Chinese patients. PG - 892-8 LID - 10.1007/s10157-014-0942-9 [doi] AB - BACKGROUND: To derive and validate a risk score for prediction of contrast-induced nephropathy (CIN) in the Chinese patients undergoing cardiac catheterization. METHODS: The hospital medical records of 3945 patients undergoing coronary angiography or percutaneous coronary intervention were reviewed. Patients were randomly assigned into two cohorts: one was for derivation of risk score (n = 2764) and another for validation (n = 1181). The CIN was defined as an increase of serum creatinine level >/=44.2 mumol/L or >/=25 % and beyond its upper limit of normal value within 72 h following the procedure. On the basis of the odds ratio obtained from multivariate logistic regression, risk score of CIN was built up. The discrimination of the risk score was assessed using the area under the receiver operating characteristic curve and the calibration was assessed using the Hosmer-Lemeshow goodness-of-fit test. RESULTS: The incidences of CIN in the derivation and validation cohorts were 4.6 and 4.2 %, respectively. Independent predictors included age >60 years, hypertension, acute myocardial infarction, heart failure, use of intra-aortic balloon pump, decreased glomerular filtration rate and contrast volume >100 mL. The incidence of CIN was increased with increment of risk score. Both the derivation and validation cohorts showed adequate discrimination (an area under the ROC curve, 0.76 and 0.71, respectively) and good calibration (Hosmer-Lemeshow statistic test, P = 0.50 and P = 0.54, respectively). CONCLUSION: A simple risk score for prediction of CIN development after cardiac catheterization in Chinese patients was built up by this study. Use of this risk score may help clinicians to perform early preventative strategies to minimize the risk of CIN. FAU - Gao, Yu-mei AU - Gao YM AD - Division of Nephrology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, People's Republic of China. FAU - Li, Di AU - Li D FAU - Cheng, Hong AU - Cheng H FAU - Chen, Yi-pu AU - Chen YP LA - eng PT - Comparative Study PT - Journal Article PT - Validation Study DEP - 20140211 PL - Japan TA - Clin Exp Nephrol JT - Clinical and experimental nephrology JID - 9709923 RN - 0 (Contrast Media) RN - AYI8EX34EU (Creatinine) SB - IM MH - Acute Kidney Injury/blood/*chemically induced/*epidemiology MH - Aged MH - Cardiac Catheterization/*adverse effects MH - China/epidemiology MH - Cohort Studies MH - Contrast Media/*adverse effects MH - Coronary Angiography/*adverse effects MH - Creatinine/blood MH - Female MH - *Health Status Indicators MH - Humans MH - Incidence MH - Logistic Models MH - Male MH - Middle Aged MH - Percutaneous Coronary Intervention/*adverse effects MH - ROC Curve MH - Random Allocation MH - Retrospective Studies MH - Risk Factors EDAT- 2014/02/12 06:00 MHDA- 2015/09/05 06:00 CRDT- 2014/02/12 06:00 PHST- 2013/07/01 00:00 [received] PHST- 2014/01/16 00:00 [accepted] PHST- 2014/02/12 06:00 [entrez] PHST- 2014/02/12 06:00 [pubmed] PHST- 2015/09/05 06:00 [medline] AID - 10.1007/s10157-014-0942-9 [doi] PST - ppublish SO - Clin Exp Nephrol. 2014 Dec;18(6):892-8. doi: 10.1007/s10157-014-0942-9. Epub 2014 Feb 11. PMID- 24481910 OWN - NLM STAT- MEDLINE DCOM- 20150929 LR - 20211021 IS - 1932-8737 (Electronic) IS - 0160-9289 (Print) IS - 0160-9289 (Linking) VI - 37 IP - 6 DP - 2014 Jun TI - Clinical features, use of evidence-based therapies, and cardiovascular outcomes among patients with chronic kidney disease following non-ST-elevation acute coronary syndrome. PG - 350-6 LID - 10.1002/clc.22253 [doi] AB - BACKGROUND: Chronic kidney disease (CKD) is associated with an increased risk of cardiovascular events following acute coronary syndrome (ACS). The underlying pathobiology and optimal treatments for this population continue to be evaluated. HYPOTHESIS: Patients with CKD will receive fewer evidence-based therapies and experience high rates of adverse cardiovascular events in both the short- and long term. METHODS: The MERLIN-TIMI 36 (Metabolic Efficiency With Ranolazine for Less Ischemia in Non-ST-Elevation Acute Coronary Syndromes-Thrombolysis in Myocardial Infarction 36) trial randomized non-ST-elevation ACS patients to ranolazine or placebo, with no exclusion for renal dysfunction (except dialysis). We conducted a prespecified analysis among 6543 patients based on the degree of CKD. RESULTS: Patients with worse renal function were older with more comorbidities (P < 0.0001 for each). They were less likely to receive evidence-based cardiovascular medicines (P < 0.04 for each). Rates of an early invasive management strategy varied based on renal function; however, among patients with the highest TIMI risk scores, the rates of an early invasive management strategy were similar regardless of glomerular filtration rate (GFR) (Pinteraction = 0.005). Lower GFR was associated with increased rates of cardiovascular disease or myocardial infarction in the short and long term, even after adjustment (GFR <30 vs >/=90 mL/min/1.73 m(2) ; hazard ratio [HR]: 3.24 [95% confidence interval CI: 1.26-8.38] through 7 days and HR: 2.12 [95% CI: 1.33-3.39] through 1 year). The effect of ranolazine vs placebo on clinical outcomes was similar among those with and without CKD (Pinteraction = not significant). CONCLUSIONS: Following ACS, patients with renal dysfunction had more cardiovascular risk factors but were less likely to receive evidence-based medical therapies. A strong graded, independent relationship between the degree of CKD and poor clinical outcomes was observed over time. Continued efforts to optimize ACS treatment strategies in patients with CKD are warranted. CI - (c) 2014 Wiley Periodicals, Inc. FAU - Rhee, June-Wha AU - Rhee JW AD - Department of Medicine, Stanford University Medical Center, Stanford, California. FAU - Wiviott, Stephen D AU - Wiviott SD FAU - Scirica, Benjamin M AU - Scirica BM FAU - Gibson, C Michael AU - Gibson CM FAU - Murphy, Sabina A AU - Murphy SA FAU - Bonaca, Marc P AU - Bonaca MP FAU - Morrow, David A AU - Morrow DA FAU - Mega, Jessica L AU - Mega JL LA - eng SI - ClinicalTrials.gov/NCT00099788 PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20140130 PL - United States TA - Clin Cardiol JT - Clinical cardiology JID - 7903272 RN - 0 (Acetanilides) RN - 0 (Enzyme Inhibitors) RN - 0 (Piperazines) RN - A6IEZ5M406 (Ranolazine) RN - AYI8EX34EU (Creatinine) SB - IM MH - Acetanilides/*therapeutic use MH - Acute Coronary Syndrome/*diagnosis/*drug therapy/physiopathology MH - Aged MH - Creatinine/blood MH - Double-Blind Method MH - Electrocardiography MH - Enzyme Inhibitors/*therapeutic use MH - Evidence-Based Medicine MH - Female MH - Glomerular Filtration Rate MH - Humans MH - Incidence MH - Male MH - Middle Aged MH - Piperazines/*therapeutic use MH - Ranolazine MH - Renal Insufficiency, Chronic/*complications PMC - PMC6649480 EDAT- 2014/02/01 06:00 MHDA- 2015/09/30 06:00 PMCR- 2014/01/30 CRDT- 2014/02/01 06:00 PHST- 2013/08/19 00:00 [received] PHST- 2013/12/31 00:00 [revised] PHST- 2014/02/01 06:00 [entrez] PHST- 2014/02/01 06:00 [pubmed] PHST- 2015/09/30 06:00 [medline] PHST- 2014/01/30 00:00 [pmc-release] AID - CLC22253 [pii] AID - 10.1002/clc.22253 [doi] PST - ppublish SO - Clin Cardiol. 2014 Jun;37(6):350-6. doi: 10.1002/clc.22253. Epub 2014 Jan 30. PMID- 24448173 OWN - NLM STAT- MEDLINE DCOM- 20141208 LR - 20151119 IS - 1473-5830 (Electronic) IS - 0954-6928 (Linking) VI - 25 IP - 4 DP - 2014 Jun TI - Correlations between serum uric acid and coronary atherosclerosis before and during statin therapy. PG - 343-8 LID - 10.1097/MCA.0000000000000084 [doi] AB - OBJECTIVE: The role of serum uric acid (UA) in the pathophysiology of atherosclerosis is ambiguous and remains controversial. The purpose of the present study was to evaluate the relationship between serum UA and coronary atherosclerosis. PATIENTS AND METHODS: Coronary atherosclerosis in the nonculprit lesions was evaluated using virtual histology intravascular ultrasound in 119 patients with angina pectoris at the time of percutaneous coronary intervention and 8 months after statin therapy. RESULTS: Serum UA levels showed weak but significant positive correlations with external elastic membrane volume (baseline: r=0.236, P=0.02; 8-month follow-up: r=0.307, P=0.0009) and with plaque volume (baseline: r=0.263, P=0.007; 8-month follow-up: r=0.349, P=0.0001). Significant decreases in the fibrofatty and fibrous components and increases in the necrotic core and dense calcium components were observed during statin therapy. Serum UA (r=0.257, P=0.009) and unstable angina pectoris (r=0.208, P=0.02) correlated significantly with change in the calcified plaque volume, whereas the estimated glomerular filtration rate trended (r=-0.166, P=0.07). Multivariate regression analyses showed that UA was a significant independent predictor associated with an increase in the dense calcium plaque volume during statin therapy (beta=0.244, P=0.03). CONCLUSION: In this preliminary study, serum UA levels correlated with coronary atherosclerosis before and during statin therapy. It remains unknown whether these correlations are a direct effect of UA itself or a marker of increased risk. FAU - Nozue, Tsuyoshi AU - Nozue T AD - aDivision of Cardiology, Department of Internal Medicine, Yokohama Sakae Kyosai Hospital, Federation of National Public Service Personnel Mutual Associations bDepartment of Cardiology, Tsurumi Nishiguchi Hospital cDepartment of Cardiology, Yokohama Seamen's Insurance Hospital dDepartment of Cardiology, Kanagawa Cardiovascular and Respiratory Center eDivision of Cardiology, Yokohama City University Medical Center, Yokohama fDepartment of Cardiology, Hiratsuka Kyosai Hospital, Hiratsuka gFourth Department of Internal Medicine, Mizonokuchi Hospital, Teikyo University School of Medicine, Kawasaki hCardiovascular Imaging Center, Toyohashi, Japan. FAU - Yamamoto, Shingo AU - Yamamoto S FAU - Tohyama, Shinichi AU - Tohyama S FAU - Fukui, Kazuki AU - Fukui K FAU - Umezawa, Shigeo AU - Umezawa S FAU - Onishi, Yuko AU - Onishi Y FAU - Kunishima, Tomoyuki AU - Kunishima T FAU - Hibi, Kiyoshi AU - Hibi K FAU - Terashima, Mitsuyasu AU - Terashima M FAU - Michishita, Ichiro AU - Michishita I LA - eng PT - Journal Article PL - England TA - Coron Artery Dis JT - Coronary artery disease JID - 9011445 RN - 0 (Biomarkers) RN - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors) RN - 268B43MJ25 (Uric Acid) SB - IM MH - Aged MH - Angina, Unstable/blood/diagnosis/*therapy MH - Biomarkers/blood MH - Coronary Artery Disease/blood/diagnosis/*therapy MH - Female MH - Humans MH - Hydroxymethylglutaryl-CoA Reductase Inhibitors/*therapeutic use MH - Male MH - Middle Aged MH - Multivariate Analysis MH - *Percutaneous Coronary Intervention MH - Predictive Value of Tests MH - Randomized Controlled Trials as Topic MH - Retrospective Studies MH - Risk Factors MH - Time Factors MH - Treatment Outcome MH - Ultrasonography, Interventional MH - Uric Acid/*blood EDAT- 2014/01/23 06:00 MHDA- 2014/12/15 06:00 CRDT- 2014/01/23 06:00 PHST- 2014/01/23 06:00 [entrez] PHST- 2014/01/23 06:00 [pubmed] PHST- 2014/12/15 06:00 [medline] AID - 10.1097/MCA.0000000000000084 [doi] PST - ppublish SO - Coron Artery Dis. 2014 Jun;25(4):343-8. doi: 10.1097/MCA.0000000000000084. PMID- 24434794 OWN - NLM STAT- MEDLINE DCOM- 20150116 LR - 20161125 IS - 1660-2110 (Electronic) IS - 1660-2110 (Linking) VI - 126 IP - 1 DP - 2014 TI - Clinical potential of oral nicorandil to improve myocardial fatty acid metabolism after percutaneous coronary intervention in hemodialysis patients. PG - 24-32 LID - 10.1159/000357579 [doi] AB - BACKGROUND/AIMS: The assessment of myocardial fatty acid metabolism impairment by single-photon emission computed tomography (SPECT) using (123)I-beta-methyliodophenyl-pentadecanoic acid (BMIPP) might predict the risk of cardiac death in hemodialysis patients. We investigated the potential of oral nicorandil to improve myocardial fatty acid metabolism after percutaneous coronary intervention (PCI) in this population. METHODS: We evaluated 128 hemodialysis patients who had obtained coronary revascularization by PCI (90 men and 38 women, 66 +/- 9 years). Participants for the analysis were randomly assigned to either the nicorandil (n = 63) or control group (n = 65). BMIPP SPECT was performed every year after coronary revascularization by PCI. Uptake on SPECT was graded in 17 segments on a 5-point scale (0, normal; 4, absent) and assessed as BMIPP summed scores (SS). RESULTS: The incidence of cardiac death was lower (p = 0.004) in the nicorandil group (7/63, 11.1%) than in the control group (21/65, 32.3%) during a mean follow-up of 2.7 +/- 1.4 years. BMIPP SS reduction rates improved in the nicorandil group compared with the control group from 3 years of administration. In Kaplan-Meier analyses, free survival rate of cardiac death was higher in patients with a >/=20% BMIPP SS reduction rate as compared with those with a <20% BMIPP SS reduction rate (p = 0.0001). In multiple logistic analysis, oral administration of nicorandil was associated with >/=20% reduction rates of BMIPP SS (odds ratio 2.823, p = 0.011). CONCLUSION: Long-term oral administration of nicorandil may improve impaired myocardial fatty acid metabolism after coronary revascularization by PCI in hemodialysis patients. CI - (c) 2014 S. Karger AG, Basel. FAU - Nishimura, Masato AU - Nishimura M AD - Cardiovascular Division, Toujinkai Hospital, Kyoto, Japan. FAU - Okamoto, Yu AU - Okamoto Y FAU - Tokoro, Toshiko AU - Tokoro T FAU - Sato, Nodoka AU - Sato N FAU - Nishida, Masaya AU - Nishida M FAU - Hashimoto, Tetsuya AU - Hashimoto T FAU - Kobayashi, Hiroyuki AU - Kobayashi H FAU - Yamazaki, Satoru AU - Yamazaki S FAU - Okino, Koji AU - Okino K FAU - Iwamoto, Noriyuki AU - Iwamoto N FAU - Takahashi, Hakuo AU - Takahashi H FAU - Ono, Toshihiko AU - Ono T LA - eng PT - Journal Article PT - Randomized Controlled Trial DEP - 20140115 PL - Switzerland TA - Nephron Clin Pract JT - Nephron. Clinical practice JID - 101159763 RN - 0 (Fatty Acids) RN - 0 (Iodine Radioisotopes) RN - 0 (Iodobenzenes) RN - 0 (Vasodilator Agents) RN - 0J7USQ749M (iodofiltic acid) RN - 260456HAM0 (Nicorandil) SB - IM MH - Aged MH - Coronary Artery Disease/complications/diagnostic imaging/*therapy MH - Death, Sudden, Cardiac/etiology MH - Fatty Acids/*metabolism MH - Female MH - Follow-Up Studies MH - Heart/*drug effects MH - Heart Failure/etiology MH - Humans MH - Iodine Radioisotopes MH - Iodobenzenes MH - Kaplan-Meier Estimate MH - Male MH - Middle Aged MH - Myocardial Infarction/etiology MH - Myocardium/*metabolism MH - Nicorandil/administration & dosage/*pharmacology MH - Percutaneous Coronary Intervention/adverse effects MH - Renal Dialysis MH - Renal Insufficiency, Chronic/*complications/therapy MH - Survival Rate MH - Tomography, Emission-Computed, Single-Photon MH - Vasodilator Agents/administration & dosage/*pharmacology EDAT- 2014/01/18 06:00 MHDA- 2015/01/17 06:00 CRDT- 2014/01/18 06:00 PHST- 2013/07/16 00:00 [received] PHST- 2013/11/12 00:00 [accepted] PHST- 2014/01/18 06:00 [entrez] PHST- 2014/01/18 06:00 [pubmed] PHST- 2015/01/17 06:00 [medline] AID - 000357579 [pii] AID - 10.1159/000357579 [doi] PST - ppublish SO - Nephron Clin Pract. 2014;126(1):24-32. doi: 10.1159/000357579. Epub 2014 Jan 15. PMID- 24357403 OWN - NLM STAT- MEDLINE DCOM- 20140911 LR - 20161125 IS - 1524-4539 (Electronic) IS - 0009-7322 (Linking) VI - 129 IP - 10 DP - 2014 Mar 11 TI - Randomized Comparison of Xience V and Multi-Link Vision Coronary Stents in the Same Multivessel Patient With Chronic Kidney Disease (RENAL-DES) Study. PG - 1104-12 LID - 10.1161/CIRCULATIONAHA.113.005186 [doi] AB - BACKGROUND: Percutaneous coronary interventions in patients with chronic kidney disease have shown suboptimal results. Drug-eluting stents (DES) might reduce the rate of target vessel revascularization in comparison with bare-metal stents (BMS) in patients with chronic kidney disease. However, given the multiple concomitant individual variables present in such patients, the comparison of neointimal growth after percutaneous coronary intervention is complex and difficult to assess. METHODS AND RESULTS: Randomized Comparison of Xience V and Multi-Link Vision Coronary Stents in the Same Multivessel Patient with Chronic Kidney Disease (RENAL-DES) was a prospective, randomized, multicenter study to directly compare the efficacy in the prevention of clinical restenosis of everolimus-eluting stent (Xience V) and BMS with an identical design (Multi-Link Vision), both implanted in the same patient with multivessel coronary artery disease and chronic kidney disease (estimated glomerular filtration rate <60 mL/min). The primary end point of the study was the ischemia-driven target vessel revascularization as detected with myocardial scintigraphy at 12 months. In 215 patients, 512 coronary vessels were successfully treated with the randomly assigned DES (n=257) or BMS (n=255). At 1 year, the rate of ischemia-driven target vessel revascularization for DES and BMS groups was 2.7% (95% confidence interval, 1.1%-5.6%) and 11.4% (95% confidence interval, 7.8% to 16%), respectively, P<0.001. For the multivariate analysis, independent predictors of the ischemia-driven target vessel revascularization were BMS implantation (odds ratio, 4.95; 95% confidence interval, 2.1-11.6; P<0.001) and vessel size (odds ratio, 0.32; 95% confidence interval, 0.1-0.7; P=0.006). CONCLUSIONS: This is the first randomized trial showing a reduction of clinical restenosis with a new-generation DES in comparison with a BMS of equal design, in patients who have chronic kidney disease with multivessel coronary artery disease. CLINICAL TRIAL REGISTRATION URL: http://clinicaltrials.gov. Unique identifier: NCT00818792. FAU - Tomai, Fabrizio AU - Tomai F AD - Department of Cardiovascular Sciences, European Hospital, Rome, Italy (F.T., L.D.L., A.P., A.S.G., L.W.); Division of Cardiology of the Department of Medicine, University of Verona, Verona, Italy (F.R., M.P., C.V.); Institute of Cardiology, University Magna Grecia, Catanzaro, Italy (C.S.); Department of Cardiology, Vannini Hospital, Rome, Italy (I.P.); Institute of Cardiology, Cattolica University, Rome, Italy (C.T.); and Division of Nuclear Medicine, Madonna della Fiducia Clinic, Rome, Italy (F.N.). FAU - Ribichini, Flavio AU - Ribichini F FAU - De Luca, Leonardo AU - De Luca L FAU - Petrolini, Alessandro AU - Petrolini A FAU - Ghini, Anna S AU - Ghini AS FAU - Weltert, Luca AU - Weltert L FAU - Spaccarotella, Carmen AU - Spaccarotella C FAU - Proietti, Igino AU - Proietti I FAU - Trani, Carlo AU - Trani C FAU - Nudi, Francesco AU - Nudi F FAU - Pighi, Michele AU - Pighi M FAU - Vassanelli, Corrado AU - Vassanelli C LA - eng SI - ClinicalTrials.gov/NCT00818792 PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20131219 PL - United States TA - Circulation JT - Circulation JID - 0147763 RN - 9HW64Q8G6G (Everolimus) RN - W36ZG6FT64 (Sirolimus) SB - IM MH - Aged MH - Aged, 80 and over MH - Comorbidity MH - Coronary Angiography MH - Coronary Artery Disease/diagnostic imaging/*epidemiology/*therapy MH - *Drug-Eluting Stents MH - Endpoint Determination MH - Everolimus MH - Female MH - Glomerular Filtration Rate/physiology MH - Humans MH - Male MH - Middle Aged MH - Multivariate Analysis MH - Percutaneous Coronary Intervention/*instrumentation/*methods MH - Prospective Studies MH - Renal Insufficiency, Chronic/*epidemiology/physiopathology MH - Risk Factors MH - Sirolimus/analogs & derivatives MH - *Stents MH - Treatment Outcome OTO - NOTNLM OT - drug-eluting stents OT - percutaneous coronary intervention OT - renal insufficiency OT - renal insufficiency, chronic EDAT- 2013/12/21 06:00 MHDA- 2014/09/12 06:00 CRDT- 2013/12/21 06:00 PHST- 2013/12/21 06:00 [entrez] PHST- 2013/12/21 06:00 [pubmed] PHST- 2014/09/12 06:00 [medline] AID - CIRCULATIONAHA.113.005186 [pii] AID - 10.1161/CIRCULATIONAHA.113.005186 [doi] PST - ppublish SO - Circulation. 2014 Mar 11;129(10):1104-12. doi: 10.1161/CIRCULATIONAHA.113.005186. Epub 2013 Dec 19. PMID- 24342762 OWN - NLM STAT- MEDLINE DCOM- 20140327 LR - 20140203 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 113 IP - 4 DP - 2014 Feb 15 TI - Statin therapy in patients with chronic kidney disease undergoing percutaneous coronary intervention (from the Evaluation of Drug Eluting Stents and Ischemic Events Registry). PG - 621-5 LID - S0002-9149(13)02250-9 [pii] LID - 10.1016/j.amjcard.2013.11.006 [doi] AB - Secondary prevention trials have demonstrated the efficacy of statins in reducing cardiovascular morbidity and mortality in patients with coronary artery disease and events after percutaneous coronary intervention (PCI). However, there are few data describing the clinical value of statins in patients with coronary artery disease and chronic kidney disease (CKD) undergoing PCI. Of 10,148 patients who entered into Evaluation of Drug Eluting Stents and Ischemic Events, a multicenter registry of unselected patients undergoing PCI from July 2004 to December 2007, we studied 2,306 patients with CKD (estimated glomerular filtration rate /=19 demonstrated enhanced MACE sensitivity and specificity of 84.0% and 76.0% (MACE as the state variable), respectively, which were similar to the NERS score but significantly higher compared with the SYNTAX score. A NERS score II >/=19 was the only independent predictor of cumulative MACE (hazard ratio: 3.27; 95% confidence interval [CI]: 1.86 to 5.23; p 25% decline in estimated GFR and annualized decline of >3 ml/min per 1.73 m(2) per year. RESULTS: By 6 months and thereafter, the mean glycated hemoglobin levels were lower in the insulin-sensitization group compared with the insulin-provision group (P<0.002 for each time point; absolute difference=0.4%). Albumin/creatinine ratio increased over time in the insulin-sensitization group (P value for trend<0.001) and was stable in the insulin-provision group. Risk for progression of albumin/creatinine ratio was higher in the insulin-sensitization group compared with the insulin-provision group (odds ratio, 1.59; 95% confidence interval, 1.25 to 2.02; P=0.02). Over 5 years, albumin/creatinine ratio increased from 11.5 (interquartile range=5.0-46.7) to 15.7 mg/g (interquartile range=6.2-55.4) in the insulin-sensitization group (P<0.001) and from 12.1 (interquartile range=5.3-41.3) to 12.4 mg/g (interquartile range=5.8-50.6) in the insulin-provision group (P=0.21). Estimated GFR declined from 75.0+/-20.6 to 66.3+/-22.6 ml/min per 1.73 m(2) in the insulin-sensitization group (P<0.001) and from 76.1+/-29.5 to 66.8+/-22.1 ml/min per 1.73 m(2) in the insulin-provision group (P<0.001). CONCLUSION: Over 5 years, despite lower glycated hemoglobin levels, the insulin-sensitization treatment group had greater progression of albumin/creatinine ratio compared with the insulin-provision treatment group. Decline in estimated GFR was similar. FAU - August, Phyllis AU - August P AD - Due to the number of contributing authors, the affiliations are provided in the Supplemental Material. FAU - Hardison, Regina M AU - Hardison RM FAU - Hage, Fadi G AU - Hage FG FAU - Marroquin, Oscar C AU - Marroquin OC FAU - McGill, Janet B AU - McGill JB FAU - Rosenberg, Yves AU - Rosenberg Y FAU - Steffes, Michael AU - Steffes M FAU - Wall, Barry M AU - Wall BM FAU - Molitch, Mark AU - Molitch M CN - BARI 2D Study Group LA - eng SI - ClinicalTrials.gov/NCT00006305 GR - U01HL061748/HL/NHLBI NIH HHS/United States GR - U01HL061744/HL/NHLBI NIH HHS/United States GR - P30 DK079626/DK/NIDDK NIH HHS/United States GR - U01 HL061746/HL/NHLBI NIH HHS/United States GR - U01 HL061748/HL/NHLBI NIH HHS/United States GR - U01 HL061744/HL/NHLBI NIH HHS/United States GR - U01 HL063804/HL/NHLBI NIH HHS/United States GR - P30 DK020579/DK/NIDDK NIH HHS/United States PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, N.I.H., Extramural DEP - 20131031 PL - United States TA - Clin J Am Soc Nephrol JT - Clinical journal of the American Society of Nephrology : CJASN JID - 101271570 RN - 0 (Biomarkers) RN - AYI8EX34EU (Creatinine) RN - 0 (Glycated Hemoglobin) RN - 0 (Hypoglycemic Agents) RN - 0 (Insulin) RN - 0 (hemoglobin A1c protein, human) SB - IM MH - Aged MH - Albuminuria/diagnosis/*drug therapy/etiology/physiopathology MH - Biomarkers/blood/urine MH - Coronary Artery Disease/complications MH - Creatinine/blood/urine MH - Diabetes Mellitus, Type 2/complications/diagnosis/*drug therapy MH - Diabetic Nephropathies/diagnosis/*drug therapy/etiology/physiopathology MH - Disease Progression MH - Female MH - Glomerular Filtration Rate/*drug effects MH - Glycated Hemoglobin/metabolism MH - Humans MH - Hypoglycemic Agents/*therapeutic use MH - Insulin/*therapeutic use MH - Kidney/*drug effects/physiopathology MH - Linear Models MH - Logistic Models MH - Male MH - Middle Aged MH - Odds Ratio MH - Risk Factors MH - Time Factors MH - Treatment Outcome PMC - PMC3878713 EDAT- 2013/11/02 06:00 MHDA- 2014/09/10 06:00 PMCR- 2015/01/07 CRDT- 2013/11/02 06:00 PHST- 2013/11/02 06:00 [entrez] PHST- 2013/11/02 06:00 [pubmed] PHST- 2014/09/10 06:00 [medline] PHST- 2015/01/07 00:00 [pmc-release] AID - CJN.12281211 [pii] AID - 12281211 [pii] AID - 10.2215/CJN.12281211 [doi] PST - ppublish SO - Clin J Am Soc Nephrol. 2014 Jan;9(1):64-71. doi: 10.2215/CJN.12281211. Epub 2013 Oct 31. PMID- 24092474 OWN - NLM STAT- MEDLINE DCOM- 20140911 LR - 20211021 IS - 1861-0692 (Electronic) IS - 1861-0684 (Linking) VI - 103 IP - 1 DP - 2014 Jan TI - Incidence and impact on prognosis of bleeding during percutaneous coronary interventions in patients with chronic kidney disease. PG - 49-56 LID - 10.1007/s00392-013-0622-x [doi] AB - BACKGROUND: Limited information exists on the prognostic impact of bleeding after percutaneous coronary intervention (PCI) in patients with chronic kidney disease (CKD). We investigated the impact of bleeding after PCI on the outcome of these patients. METHODS: The study included 2,934 patients with estimated creatinine clearance <60 ml/min. Bleeding events within 30 days after PCI were assessed using the Bleeding Academic Research Consortium (BARC) criteria. The primary outcome was 1-year mortality. RESULTS: Bleeding events occurred in 485 patients (16.5 %). BARC classes were: class 1 (n = 155), class 2 (n = 73), class 3a (n = 182), class 3b (n = 68), class 3c (n = 6) and class 4 (n = 1). There were 212 deaths over the first year after PCI: 60 deaths in patients who bled and 152 deaths in patients who did not bleed (Kaplan-Meier [KM] estimates, 12.5 and 6.3 %; odds ratio [OR] = 2.11, 95 % confidence interval [CI] 1.57-2.83, P < 0.001). Nonfatal myocardial infarction occurred in 71 patients who bled and in 141 patients who did not bleed (KM estimates, 14.8 and 5.8 %; OR = 2.70 [2.05-3.55], P < 0.001). After adjustment, bleeding was independently associated with increased risk of 1-year mortality (adjusted hazard ratio [HR] = 1.90 [1.33-2.72], P < 0.001) and myocardial infarction (adjusted HR = 2.74 [1.99-3.78], P < 0.001). Bleeding improved the discriminatory power of the multivariable model for prediction of mortality (absolute and relative integrated discrimination improvement [IDI], 0.011 and 15.4 %; P = 0.004) or myocardial infarction (absolute and relative IDI, 0.017 and 70.8 %; P < 0.001). CONCLUSIONS: Peri-PCI bleeding in patients with CKD is independently associated with the increased risk of 1-year mortality and nonfatal myocardial infarction. FAU - Ndrepepa, Gjin AU - Ndrepepa G AD - Deutsches Herzzentrum, Lazarettstrasse 36, 80636, Munich, Germany, ndrepepa@dhm.mhn.de. FAU - Neumann, Franz-Josef AU - Neumann FJ FAU - Cassese, Salvatore AU - Cassese S FAU - Fusaro, Massimiliano AU - Fusaro M FAU - Ott, Ilka AU - Ott I FAU - Schulz, Stefanie AU - Schulz S FAU - Hoppmann, Petra AU - Hoppmann P FAU - Richardt, Gert AU - Richardt G FAU - Laugwitz, Karl-Ludwig AU - Laugwitz KL FAU - Schunkert, Heribert AU - Schunkert H FAU - Kastrati, Adnan AU - Kastrati A LA - eng PT - Journal Article DEP - 20131004 PL - Germany TA - Clin Res Cardiol JT - Clinical research in cardiology : official journal of the German Cardiac Society JID - 101264123 RN - 0 (Biomarkers) RN - AYI8EX34EU (Creatinine) SB - IM MH - Aged MH - Aged, 80 and over MH - Biomarkers/blood MH - Chi-Square Distribution MH - Coronary Artery Disease/diagnosis/epidemiology/mortality/*therapy MH - Creatinine/blood MH - Female MH - Germany/epidemiology MH - Hemorrhage/diagnosis/*epidemiology/mortality MH - Humans MH - Incidence MH - Kaplan-Meier Estimate MH - Logistic Models MH - Male MH - Myocardial Infarction/epidemiology MH - Odds Ratio MH - Percutaneous Coronary Intervention/*adverse effects/mortality MH - Proportional Hazards Models MH - Randomized Controlled Trials as Topic MH - Renal Insufficiency, Chronic/blood/diagnosis/*epidemiology/mortality MH - Retrospective Studies MH - Risk Factors MH - Time Factors MH - Treatment Outcome EDAT- 2013/10/05 06:00 MHDA- 2014/09/12 06:00 CRDT- 2013/10/05 06:00 PHST- 2013/07/24 00:00 [received] PHST- 2013/09/18 00:00 [accepted] PHST- 2013/10/05 06:00 [entrez] PHST- 2013/10/05 06:00 [pubmed] PHST- 2014/09/12 06:00 [medline] AID - 10.1007/s00392-013-0622-x [doi] PST - ppublish SO - Clin Res Cardiol. 2014 Jan;103(1):49-56. doi: 10.1007/s00392-013-0622-x. Epub 2013 Oct 4. PMID- 24076283 OWN - NLM STAT- MEDLINE DCOM- 20140311 LR - 20220410 IS - 1558-3597 (Electronic) IS - 0735-1097 (Linking) VI - 63 IP - 1 DP - 2014 Jan 7-14 TI - Early high-dose rosuvastatin for contrast-induced nephropathy prevention in acute coronary syndrome: Results from the PRATO-ACS Study (Protective Effect of Rosuvastatin and Antiplatelet Therapy On contrast-induced acute kidney injury and myocardial damage in patients with Acute Coronary Syndrome). PG - 71-9 LID - S0735-1097(13)05355-2 [pii] LID - 10.1016/j.jacc.2013.04.105 [doi] AB - OBJECTIVES: This study sought to determine if in addition to standard preventive measures on-admission, high-dose rosuvastatin exerts a protective effect against contrast-induced acute kidney injury (CI-AKI). BACKGROUND: Patients with acute coronary syndrome (ACS) are at high risk for CI-AKI, and the role of statin pre-treatment in preventing renal damage remains uncertain. METHODS: Consecutive statin-naive non-ST elevation ACS patients scheduled to undergo early invasive strategy were randomly assigned to receive rosuvastatin (40 mg on admission, followed by 20 mg/day; statin group n = 252) or no statin treatment (control group n = 252). CI-AKI was defined as an increase in creatinine concentration of >/=0.5 mg/dl or >/=25% above baseline within 72 h after contrast administration. RESULTS: The incidence of CI-AKI was significantly lower in the statin group than in controls (6.7% vs. 15.1%; adjusted odds ratio: 0.38; 95% confidence interval [CI]: 0.20 to 0.71; p = 0.003). The benefits against CI-AKI were consistent, even applying different CI-AKI definition criteria and in all the pre-specified risk categories. The 30-day incidence of adverse cardiovascular and renal events (death, dialysis, myocardial infarction, stroke, or persistent renal damage) was significantly lower in the statin group (3.6% vs. 7.9%, respectively; p = 0.036). Moreover, statin treatment given on admission was associated with a lower rate of death or nonfatal myocardial infarction at 6 month follow-up (3.6% vs. 7.2%, respectively; p = 0.07). CONCLUSIONS: High-dose rosuvastatin given on admission to statin-naive patients with ACS who are scheduled for an early invasive procedure can prevent CI-AKI and improve short-term clinical outcome. (Statin Contrast Induced Nephropathy Prevention [PRATO-ACS]; NCT01185938). CI - Copyright (c) 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Leoncini, Mario AU - Leoncini M AD - Cardiology Division, Prato Hospital, Prato, Italy. FAU - Toso, Anna AU - Toso A AD - Cardiology Division, Prato Hospital, Prato, Italy. Electronic address: anna.toso@libero.it. FAU - Maioli, Mauro AU - Maioli M AD - Cardiology Division, Prato Hospital, Prato, Italy. FAU - Tropeano, Francesco AU - Tropeano F AD - Cardiology Division, Prato Hospital, Prato, Italy. FAU - Villani, Simona AU - Villani S AD - Section of Biostatistics and Clinical Epidemiology, Department of Public Health, Neurosciences, Experimental and Forensic Medicine, Pavia University, Pavia, Italy. FAU - Bellandi, Francesco AU - Bellandi F AD - Cardiology Division, Prato Hospital, Prato, Italy. LA - eng SI - ClinicalTrials.gov/NCT01185938 PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20130926 PL - United States TA - J Am Coll Cardiol JT - Journal of the American College of Cardiology JID - 8301365 RN - 0 (Contrast Media) RN - 0 (Fluorobenzenes) RN - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors) RN - 0 (Platelet Aggregation Inhibitors) RN - 0 (Pyrimidines) RN - 0 (Sulfonamides) RN - 83MVU38M7Q (Rosuvastatin Calcium) SB - IM CIN - J Am Coll Cardiol. 2014 Jan 7-14;63(1):80-2. doi: 10.1016/j.jacc.2013.07.097. PMID: 24076280 CIN - Nat Rev Cardiol. 2013 Dec;10(12):679. doi: 10.1038/nrcardio.2013.166. PMID: 24165911 CIN - Ann Intern Med. 2014 May 20;160(10):JC9. doi: 10.7326/0003-4819-160-10-201405200-02009. PMID: 24842443 MH - Acute Coronary Syndrome/*diagnostic imaging/drug therapy MH - Acute Kidney Injury/chemically induced/*prevention & control MH - Aged MH - Contrast Media/*adverse effects MH - Coronary Angiography/*adverse effects/methods MH - Dose-Response Relationship, Drug MH - Drug Therapy, Combination MH - Female MH - Fluorobenzenes/*administration & dosage MH - Follow-Up Studies MH - Humans MH - Hydroxymethylglutaryl-CoA Reductase Inhibitors/administration & dosage MH - Male MH - Platelet Aggregation Inhibitors/*therapeutic use MH - Prospective Studies MH - Pyrimidines/*administration & dosage MH - Rosuvastatin Calcium MH - Sulfonamides/*administration & dosage MH - Time Factors MH - Treatment Outcome OTO - NOTNLM OT - 3-hydroxyl-3-methylglutaryl coenzyme A OT - ACS OT - CI-AKI OT - HMG-CoA OT - LVEF OT - N-acetylcysteine OT - NAC OT - NSTE OT - PCI OT - acute coronary syndrome(s) OT - contrast-induced acute kidney injury OT - contrast-induced nephropathy OT - eCrCl OT - eGFR OT - estimated creatinine clearance OT - estimated glomerular filtration rate OT - left ventricular ejection fraction OT - percutaneous coronary intervention OT - statins OT - without ST-segment elevation EDAT- 2013/10/01 06:00 MHDA- 2014/03/13 06:00 CRDT- 2013/10/01 06:00 PHST- 2013/03/25 00:00 [received] PHST- 2013/04/19 00:00 [revised] PHST- 2013/04/30 00:00 [accepted] PHST- 2013/10/01 06:00 [entrez] PHST- 2013/10/01 06:00 [pubmed] PHST- 2014/03/13 06:00 [medline] AID - S0735-1097(13)05355-2 [pii] AID - 10.1016/j.jacc.2013.04.105 [doi] PST - ppublish SO - J Am Coll Cardiol. 2014 Jan 7-14;63(1):71-9. doi: 10.1016/j.jacc.2013.04.105. Epub 2013 Sep 26. PMID- 24060465 OWN - NLM STAT- MEDLINE DCOM- 20140707 LR - 20260128 IS - 1768-3181 (Electronic) IS - 0003-3928 (Linking) VI - 62 IP - 5 DP - 2013 Nov TI - [Acute coronary syndrome in elderly patients: experience of Aix-en-Provence General Hospital]. PG - 308-15 LID - S0003-3928(13)00138-8 [pii] LID - 10.1016/j.ancard.2013.08.009 [doi] AB - INTRODUCTION: Cardiovascular causes are the first causes of death in elderly patients. Nevertheless, elderly patients are underrepresented in randomized studies of acute coronary syndromes although treatment of ACS for elderly patients has specificities that need special attention. METHODS AND RESULTS: To discuss these specificities, we realized a retrospective study involving patients aged more than 75years old and admitted for ACS in the cardiology department of Aix-en-Provence General Hospital in the first six months of 2010 (Group A) and 2012 (Group B) which we compared. Initial presentation was chest pain in only 78.6% of Group A versus 81.6% in Group B (NS), renal insufficiency was found in 41.4% of the patients of Group A versus 50.5% of the patients in Group B (NS), anaemia was found in 34.3% of Group A patients versus 40.2% of Group B (NS), invasive strategy is less systematic with 74.2% of Group A patients having a revascularization versus 73.6% of Group B (NS), Drug Eluting Stents were less frequently used with 14.3% of Group A patients versus 14.7% of Group B (NS), radial access was used for angioplasty in 61.2% of Group A patients versus 80.2% of Group B (P=0.02), unfractioned heparin was used in 74.3% of the cases in Group A versus 68% in Group B (NS). DISCUSSION AND CONCLUSION: Acute coronary syndrome of the elderly patients has numerous specificities, first there are frequent unusual presentation making diagnosis more difficult, second they have frequent co morbidities making them frail patients with higher risk of hemorrhagic complications and lesser tendency to invasive evidence based treatment. In the absence of specific recommendations, their treatment should not differ from younger patients. This work allowed us also to evaluate our professional practices in order to improve them; we note a positive evolution with the significant raise in the use of radial access, invasive strategy though should be more systematic and use of low molecular weight heparin and Fondaparinux should be more frequent. CI - Copyright (c) 2013 Elsevier Masson SAS. All rights reserved. FAU - Khachab, H AU - Khachab H AD - Service de cardiologie, centre hospitalier d'Aix-en-Provence, avenue des Tamaris, 13616 Aix-en-Provence cedex 1, France. Electronic address: hadi_kha@hotmail.com. FAU - Rahal, Y AU - Rahal Y FAU - Boulain, L AU - Boulain L FAU - Barnay, C AU - Barnay C FAU - Morice, R AU - Morice R FAU - Taieb, J AU - Taieb J FAU - Benchaa, T AU - Benchaa T FAU - Jouve, B AU - Jouve B LA - fre PT - Comparative Study PT - Journal Article TT - Le syndrome coronarien aigu chez le sujet age : experience du centre hospitalier d'Aix-en-Provence. DEP - 20130827 PL - France TA - Ann Cardiol Angeiol (Paris) JT - Annales de cardiologie et d'angeiologie JID - 0142167 RN - 0 (Anticoagulants) RN - 0 (Platelet Aggregation Inhibitors) RN - 9005-49-6 (Heparin) SB - IM MH - Acute Coronary Syndrome/*mortality/*therapy MH - Aged MH - Aged, 80 and over MH - Anemia/epidemiology MH - Angioplasty, Balloon, Coronary/adverse effects/methods/*statistics & numerical data MH - Anticoagulants/therapeutic use MH - Blood Transfusion/statistics & numerical data MH - Chest Pain/epidemiology/etiology MH - Coronary Thrombosis/epidemiology MH - Drug-Eluting Stents/adverse effects/*statistics & numerical data MH - Dyspnea/epidemiology/etiology MH - Fatigue/epidemiology/etiology MH - Female MH - France/epidemiology MH - Hemorrhage/epidemiology MH - Heparin/therapeutic use MH - Hospitalization MH - Hospitals, General MH - Humans MH - Male MH - Platelet Aggregation Inhibitors/therapeutic use MH - Radial Artery MH - Renal Insufficiency/epidemiology MH - Retrospective Studies MH - Stroke/epidemiology OTO - NOTNLM OT - Acute coronary syndrome OT - Comorbidities OT - Comorbidites OT - Elderly patients OT - Sujet age OT - Syndrome coronarien aigu EDAT- 2013/09/26 06:00 MHDA- 2014/07/08 06:00 CRDT- 2013/09/25 06:00 PHST- 2013/07/29 00:00 [received] PHST- 2013/08/12 00:00 [accepted] PHST- 2013/09/25 06:00 [entrez] PHST- 2013/09/26 06:00 [pubmed] PHST- 2014/07/08 06:00 [medline] AID - S0003-3928(13)00138-8 [pii] AID - 10.1016/j.ancard.2013.08.009 [doi] PST - ppublish SO - Ann Cardiol Angeiol (Paris). 2013 Nov;62(5):308-15. doi: 10.1016/j.ancard.2013.08.009. Epub 2013 Aug 27. PMID- 24030753 OWN - NLM STAT- MEDLINE DCOM- 20140929 LR - 20161125 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 83 IP - 2 DP - 2014 Feb TI - Incidence and prognostic value of bleeding after percutaneous coronary intervention in patients older than 75 years of age. PG - 182-9 LID - 10.1002/ccd.25189 [doi] AB - OBJECTIVES: We aimed to assess the impact of bleeding after percutaneous coronary intervention (PCI) on the outcome of patients >75 years of age. BACKGROUND: Limited information exists on the impact of post-PCI bleeding on the outcome in elderly patients. METHODS: This study included 3,255 patients >75 years of age. Bleeding events were assessed using the Bleeding Academic Research Consortium (BARC) criteria. The primary outcome was 1-year mortality. RESULTS: Within 30 days after PCI, bleeding occurred in 501 patients (15.4%). Bleeding according to BARC was: class 1 (170 patients; 33.9%), class 2 (81 patients; 16.2%), class 3a (177 patients; 35.3%), class 3b (65 patients; 13.0%), class 3c (four patients; 0.8%), and class 4 (four patients; 0.8%). There were 201 deaths within the first year after PCI: 61 deaths (12.3%) among bleeders and 140 deaths (5.1%) among nonbleeders (adjusted hazard ratio = 2.03, 95% confidence interval [CI] 1.42-2.91, P < 0.001). Bleeding improved the discriminatory power of multivariable model for mortality prediction (P = 0.001). Female sex (adjusted odds ratio [OR] = 1.49 [1.17-1.88], P = 0.001) and reduced renal function (adjusted OR = 1.30 [1.04-1.63], P = 0.019 for each 30 ml/min decrease in the creatinine clearance) were independent associates of increased bleeding risk. Bivalirudin reduced the bleeding risk by 24% compared with unfractionated heparin and 33% compared with abciximab plus unfractionated heparin. CONCLUSIONS: Post-PCI bleeding is an important prognostic factor in patients >75 years of age. The risk for bleeding in this age category is increased in women and patients with impaired renal function. Bleeding risk is reduced by bivalirudin. CI - Copyright (c) 2013 Wiley Periodicals, Inc. FAU - Ndrepepa, Gjin AU - Ndrepepa G AD - Deutsches Herzzentrum Munchen, Germany. FAU - Neumann, Franz-Josef AU - Neumann FJ FAU - Schulz, Stefanie AU - Schulz S FAU - Fusaro, Massimiliano AU - Fusaro M FAU - Cassese, Salvatore AU - Cassese S FAU - Byrne, Robert A AU - Byrne RA FAU - Richardt, Gert AU - Richardt G FAU - Laugwitz, Karl-Ludwig AU - Laugwitz KL FAU - Kastrati, Adnan AU - Kastrati A LA - eng PT - Journal Article DEP - 20131019 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 RN - 0 (Antithrombins) RN - 0 (Hirudins) RN - 0 (Peptide Fragments) RN - 0 (Recombinant Proteins) RN - TN9BEX005G (bivalirudin) SB - IM CIN - Catheter Cardiovasc Interv. 2014 Feb;83(2):190-1. doi: 10.1002/ccd.25315. PMID: 24446319 MH - Age Factors MH - Aged MH - Aged, 80 and over MH - Antithrombins/therapeutic use MH - Chi-Square Distribution MH - Female MH - Hemorrhage/*epidemiology/mortality/prevention & control MH - Hirudins MH - Humans MH - Incidence MH - Kaplan-Meier Estimate MH - Logistic Models MH - Male MH - Multivariate Analysis MH - Odds Ratio MH - Peptide Fragments/therapeutic use MH - Percutaneous Coronary Intervention/*adverse effects/mortality MH - Proportional Hazards Models MH - Randomized Controlled Trials as Topic MH - Recombinant Proteins/therapeutic use MH - Retrospective Studies MH - Risk Factors MH - Time Factors MH - Treatment Outcome OTO - NOTNLM OT - bleeding OT - elderly OT - mortality OT - myocardial infarction OT - stenting EDAT- 2013/09/14 06:00 MHDA- 2014/09/30 06:00 CRDT- 2013/09/14 06:00 PHST- 2013/06/18 00:00 [received] PHST- 2013/08/06 00:00 [revised] PHST- 2013/09/02 00:00 [accepted] PHST- 2013/09/14 06:00 [entrez] PHST- 2013/09/14 06:00 [pubmed] PHST- 2014/09/30 06:00 [medline] AID - 10.1002/ccd.25189 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2014 Feb;83(2):182-9. doi: 10.1002/ccd.25189. Epub 2013 Oct 19. PMID- 24011740 OWN - NLM STAT- MEDLINE DCOM- 20140522 LR - 20211021 IS - 1879-1913 (Electronic) IS - 0002-9149 (Print) IS - 0002-9149 (Linking) VI - 112 IP - 11 DP - 2013 Dec 1 TI - Health status and quality of life in patients with stable coronary artery disease and chronic kidney disease treated with optimal medical therapy or percutaneous coronary intervention (post hoc findings from the COURAGE trial). PG - 1703-8 LID - S0002-9149(13)01613-5 [pii] LID - 10.1016/j.amjcard.2013.07.034 [doi] AB - Chronic kidney disease (CKD) is an important clinical co-morbidity that increases the risk of death and myocardial infarction in patients with coronary artery disease (CAD) even when treated with guideline-directed therapies. It is unknown, however, whether CKD influences the effects of CAD treatments on patients' health status, their symptoms, function, and quality of life. We performed a post hoc analysis of the Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE) study to compare health status in patients with stable CAD with and without CKD defined as a glomerular filtration rate of <60 ml/min/1.73 m(2) randomized to either percutaneous coronary intervention (PCI) and optimal medical therapy (OMT) or OMT alone. Health status was measured at baseline, 1, 3, 6, 12, 24, and 36 months of follow-up with the Seattle Angina Questionnaire in 310 patients with CKD and 1,719 patients without CKD. Linear mixed-effects models were used to analyze Seattle Angina Questionnaire scores longitudinally. Mean scores for angina-related quality of life, angina frequency, and physical limitation domains improved from baseline values in both patients with and without CKD and plateaued. Early improvement (1 to 6 months) was more common in patients treated with PCI plus OMT than with OMT alone in both patients with and without CKD. Treatment satisfaction scores were high at baseline in all groups and did not change significantly over time. In conclusion, although CKD is an important determinant of event-free survival in patients with stable CAD, it neither precludes satisfactory treatment of angina with PCI plus OMT or OMT alone nor is it associated with an unsatisfactory quality of life. CI - Published by Elsevier Inc. FAU - Sedlis, Steven P AU - Sedlis SP AD - Department of Medicine, Veterans Affairs New York Harbor Health Care System, New York University School of Medicine, New York, New York. Electronic address: steven.sedlis@va.gov. FAU - Jurkovitz, Claudine T AU - Jurkovitz CT FAU - Hartigan, Pamela M AU - Hartigan PM FAU - Kolm, Paul AU - Kolm P FAU - Goldfarb, David S AU - Goldfarb DS FAU - Lorin, Jeffrey D AU - Lorin JD FAU - Dada, Marcin AU - Dada M FAU - Maron, David J AU - Maron DJ FAU - Spertus, John A AU - Spertus JA FAU - Mancini, G B John AU - Mancini GB FAU - Teo, Koon K AU - Teo KK FAU - Boden, William E AU - Boden WE FAU - Weintraub, William S AU - Weintraub WS CN - COURAGE Study Investigators LA - eng GR - U54 GM104941/GM/NIGMS NIH HHS/United States PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, U.S. Gov't, Non-P.H.S. DEP - 20130903 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM MH - Aged MH - Angina Pectoris/complications/*therapy MH - Case-Control Studies MH - Combined Modality Therapy/methods MH - Coronary Artery Disease/complications/*therapy MH - Female MH - *Health Status MH - Humans MH - Linear Models MH - Male MH - Middle Aged MH - Patient Satisfaction MH - Percutaneous Coronary Intervention MH - *Quality of Life MH - Renal Insufficiency, Chronic/*complications MH - Surveys and Questionnaires MH - Treatment Outcome PMC - PMC5681221 MID - NIHMS864656 COIS- Disclosures The authors have no conflicts of interest to disclose. EDAT- 2013/09/10 06:00 MHDA- 2014/05/23 06:00 PMCR- 2017/11/10 CRDT- 2013/09/10 06:00 PHST- 2013/04/15 00:00 [received] PHST- 2013/07/12 00:00 [revised] PHST- 2013/07/12 00:00 [accepted] PHST- 2013/09/10 06:00 [entrez] PHST- 2013/09/10 06:00 [pubmed] PHST- 2014/05/23 06:00 [medline] PHST- 2017/11/10 00:00 [pmc-release] AID - S0002-9149(13)01613-5 [pii] AID - 10.1016/j.amjcard.2013.07.034 [doi] PST - ppublish SO - Am J Cardiol. 2013 Dec 1;112(11):1703-8. doi: 10.1016/j.amjcard.2013.07.034. Epub 2013 Sep 3. PMID- 23988855 OWN - NLM STAT- MEDLINE DCOM- 20140604 LR - 20201216 IS - 1421-9751 (Electronic) IS - 0008-6312 (Linking) VI - 126 IP - 3 DP - 2013 TI - Alpha-lipoic acid for the prevention of contrast-induced nephropathy in patients undergoing coronary angiography: the ALIVE study - a prospective randomized trial. PG - 159-66 LID - 10.1159/000353812 [doi] AB - OBJECTIVES: alpha-Lipoic acid (ALA) is widely used for diabetic neuropathy due to its antioxidant properties. We evaluated its potential for preventing contrast-induced nephropathy (CIN). METHODS: We conducted a prospective randomized controlled trial to evaluate the efficacy of ALA in CIN prevention. Two hundred and two patients with basal renal insufficiency who received elective coronary angiography were randomized to the ALA group [ALA treatment for 2 days (600 mg orally three times a day before and after coronary catheterization, n = 100)] or the control group (n = 102). The primary end point was the maximum increase in serum creatinine (sCr) and the secondary end point was the incidence of CIN defined as an increase in sCr of either >/= 25% or >/= 44.2 micromol/l. RESULTS: Mean maximum increase in sCr was not different between the ALA and the control group (-1.32 +/- 30.5 vs. -1.19 +/- 30.1 micromol/l, respectively; p = 0.977). sCr did not significantly change from baseline (120.8 +/- 69.8 vs. 122 +/- 88.1 micromol/l) in the ALA group and the simple saline hydration group (108.2 +/- 37.5 vs. 110 +/- 49 micromol/l). There was a lower rate of CIN in the ALA group than in the control group, but the difference was not statistically significant (3.0 vs. 6.9%, respectively; p = 0.332). CONCLUSION: ALA showed no benefit in CIN prevention. CI - Copyright (c) 2013 S. Karger AG, Basel. FAU - Jo, Sang-Ho AU - Jo SH AD - Division of Cardiology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang-si, Korea. FAU - Kim, Sung-Ai AU - Kim SA FAU - Kim, Hyun-Sook AU - Kim HS FAU - Han, Sang-Jin AU - Han SJ FAU - Park, Woo-Jung AU - Park WJ FAU - Choi, Young Jin AU - Choi YJ LA - eng PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20130829 PL - Switzerland TA - Cardiology JT - Cardiology JID - 1266406 RN - 0 (Antioxidants) RN - 0 (Contrast Media) RN - 0 (Isotonic Solutions) RN - 451W47IQ8X (Sodium Chloride) RN - 73Y7P0K73Y (Thioctic Acid) RN - AYI8EX34EU (Creatinine) SB - IM MH - Administration, Oral MH - Aged MH - Angina, Stable/diagnostic imaging/therapy MH - Antioxidants/*administration & dosage MH - Contrast Media/*adverse effects MH - Coronary Angiography/*adverse effects MH - Creatinine/metabolism MH - Female MH - Humans MH - Isotonic Solutions/administration & dosage MH - Kidney Diseases/chemically induced/*prevention & control MH - Male MH - Percutaneous Coronary Intervention MH - Prospective Studies MH - Renal Insufficiency/complications MH - Sodium Chloride/administration & dosage MH - Thioctic Acid/*administration & dosage MH - Treatment Outcome EDAT- 2013/08/31 06:00 MHDA- 2014/06/05 06:00 CRDT- 2013/08/31 06:00 PHST- 2013/03/11 00:00 [received] PHST- 2013/06/18 00:00 [accepted] PHST- 2013/08/31 06:00 [entrez] PHST- 2013/08/31 06:00 [pubmed] PHST- 2014/06/05 06:00 [medline] AID - 000353812 [pii] AID - 10.1159/000353812 [doi] PST - ppublish SO - Cardiology. 2013;126(3):159-66. doi: 10.1159/000353812. Epub 2013 Aug 29. PMID- 23927055 OWN - NLM STAT- MEDLINE DCOM- 20140926 LR - 20131217 IS - 1440-1797 (Electronic) IS - 1320-5358 (Linking) VI - 19 IP - 1 DP - 2014 Jan TI - Cardiovascular disease in patients with chronic kidney disease. PG - 3-10 LID - 10.1111/nep.12148 [doi] FAU - Pilmore, Helen AU - Pilmore H AD - Department of Renal Medicine, Auckland City Hospital and Department of Medicine, Auckland University, Auckland, New Zealand. FAU - Dogra, Gursharan AU - Dogra G FAU - Roberts, Matthew AU - Roberts M FAU - Lambers Heerspink, Hiddo J AU - Lambers Heerspink HJ FAU - Ninomiya, Toshiharu AU - Ninomiya T FAU - Huxley, Rachel AU - Huxley R FAU - Perkovic, Vlado AU - Perkovic V LA - eng PT - Journal Article PL - Australia TA - Nephrology (Carlton) JT - Nephrology (Carlton, Vic.) JID - 9615568 RN - 0 (Antihypertensive Agents) SB - IM MH - Acute Coronary Syndrome/therapy MH - Angioplasty, Balloon, Coronary MH - Antihypertensive Agents/therapeutic use MH - Coronary Artery Bypass MH - Coronary Artery Disease/*therapy MH - Heart Failure/therapy MH - Humans MH - *Practice Guidelines as Topic MH - Randomized Controlled Trials as Topic MH - Renal Insufficiency, Chronic/*complications EDAT- 2013/08/10 06:00 MHDA- 2014/09/27 06:00 CRDT- 2013/08/10 06:00 PHST- 2013/08/01 00:00 [accepted] PHST- 2013/08/10 06:00 [entrez] PHST- 2013/08/10 06:00 [pubmed] PHST- 2014/09/27 06:00 [medline] AID - 10.1111/nep.12148 [doi] PST - ppublish SO - Nephrology (Carlton). 2014 Jan;19(1):3-10. doi: 10.1111/nep.12148. PMID- 23907993 OWN - NLM STAT- MEDLINE DCOM- 20140818 LR - 20220408 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 83 IP - 1 DP - 2014 Jan 1 TI - A simple preprocedural score for risk of contrast-induced acute kidney injury after percutaneous coronary intervention. PG - E8-16 LID - 10.1002/ccd.25109 [doi] AB - OBJECTIVE: To develop a simple scoring system based on preprocedural clinical features that is capable of predicting contrast-induced acute kidney injury (CI-AKI) before percutaneous coronary intervention (PCI). BACKGROUND: CI-AKI is associated with increased in-hospital morbidity and mortality, prolonged hospitalization, and long-term renal impairment. Although several scoring methods have been developed to determine risk of CI-AKI, no simple scoring method based on PCI preprocedural clinical features yet exists for Chinese patients. METHODS: A total of 2,500 Chinese patients were randomly and retrospectively assigned in a 3:2 manner to create a training and validation dataset, respectively. CI-AKI was defined as an increase of >/=25% or >/=0.5 mg/dL serum creatinine within 5 days after PCI. Preprocedural clinical variables showing independent correlation to CI-AKI were used to derive the risk score from the training dataset and then subsequently tested in the validation dataset. The odds ratios from multivariate logistic regression were used to assign a weighted integer to age >/=70 years = 4, history of myocardial infarction = 5, diabetes mellitus = 4, hypotension = 6, left ventricular ejection fraction /=17) risk scores]. The rates of CI-AKI, 1-year dialysis, and 1-year mortality increased significantly with each group (Cochran-Armitage test of trend, P < 0.001). The risk score facilitated appropriate classification of patients with low and high risk for CI-AKI after PCI in the validation dataset (c-statistic = 0.82). CONCLUSION: Risk classification based on the most significantly correlated parameters is useful for predicting CI-AKI before contrast exposure. The simple preprocedural score showed excellent predictive ability for identifying patients at high risk of nephropathy and those with deteriorative prognosis after PCI. CI - (c) 2013 Wiley Periodicals, Inc. FAU - Chen, Yong-Li AU - Chen YL AD - Department of Cardiology, Tianjin Chest Hospital, Tianjin, China. FAU - Fu, Nai-Kuan AU - Fu NK FAU - Xu, Jing AU - Xu J FAU - Yang, Shi-Cheng AU - Yang SC FAU - Li, Shanshan AU - Li S FAU - Liu, Yuan-Yuan AU - Liu YY FAU - Cong, Hong-Liang AU - Cong HL LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Validation Study DEP - 20130930 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 RN - 0 (Biomarkers) RN - 0 (Contrast Media) RN - AYI8EX34EU (Creatinine) SB - IM MH - Acute Kidney Injury/blood/*chemically induced/diagnosis/mortality/therapy MH - Aged MH - Biomarkers/blood MH - China/epidemiology MH - Contrast Media/*adverse effects MH - Creatinine/blood MH - Decision Support Techniques MH - Hospital Mortality MH - Humans MH - Incidence MH - Logistic Models MH - Male MH - Middle Aged MH - Multivariate Analysis MH - Odds Ratio MH - Percutaneous Coronary Intervention/*adverse effects/mortality MH - Predictive Value of Tests MH - Prognosis MH - Renal Dialysis MH - Reproducibility of Results MH - Retrospective Studies MH - Risk Assessment MH - Risk Factors MH - Time Factors OTO - NOTNLM OT - acute kidney injury OT - contrast OT - percutaneous coronary intervention OT - score EDAT- 2013/08/03 06:00 MHDA- 2014/08/19 06:00 CRDT- 2013/08/03 06:00 PHST- 2012/07/30 00:00 [received] PHST- 2012/10/19 00:00 [revised] PHST- 2013/06/28 00:00 [accepted] PHST- 2013/08/03 06:00 [entrez] PHST- 2013/08/03 06:00 [pubmed] PHST- 2014/08/19 06:00 [medline] AID - 10.1002/ccd.25109 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2014 Jan 1;83(1):E8-16. doi: 10.1002/ccd.25109. Epub 2013 Sep 30. PMID- 23874471 OWN - NLM STAT- MEDLINE DCOM- 20140331 LR - 20211021 IS - 1932-6203 (Electronic) IS - 1932-6203 (Linking) VI - 8 IP - 7 DP - 2013 TI - CT coronary angiography is feasible for the assessment of coronary artery disease in chronic dialysis patients, despite high average calcium scores. PG - e67936 LID - 10.1371/journal.pone.0067936 [doi] LID - e67936 AB - PURPOSE: Significant obstructive coronary artery disease (CAD) is common in asymptomatic dialysis patients. Identifying these high risk patients is warranted and may improve the prognosis of this vulnerable patient group. Routine catheterization of incident dialysis patients has been proposed, but is considered too invasive. CT-angiography may therefore be more appropriate. However, extensive coronary calcification, often present in this patient group, might hamper adequate lumen evaluation. The objective of this study was to assess the feasibility of CT-angiography in this patient group. METHODS: For this analysis all patients currently participating in the ICD2 trial (ISRCTN20479861), with no history of PCI or CABG were included. The major epicardial vessels were evaluated on a segment basis (segment 1-3, 5-8, 11 and 13) by a team consisting of an interventional and an imaging specialist. Segments were scored as not significant, significant and not interpretable. RESULTS: A total of 70 dialysis patients, with a mean age of 66+/-8 yrs and predominantly male (70%) were included. The median calcium score was 623 [79, 1619]. Over 90% of the analyzed segments were considered interpretable. The incidence of significant CAD on CT was 43% and was associated with cardiovascular events during follow-up. The incidence of cardiovascular events after 2-years follow-up: 36% vs. 0% in patients with no significant CAD (p<0.01). CONCLUSION: Despite the high calcium scores CT-angiography is feasible for the evaluation of the extent of CAD in dialysis patients. Moreover the presence of significant CAD on CT was associated with events during follow-up. FAU - de Bie, Mihaly K AU - de Bie MK AD - Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands. fariba@neuro.hut.fi FAU - Buiten, Maurits S AU - Buiten MS FAU - Gaasbeek, Andre AU - Gaasbeek A FAU - Boogers, Mark J AU - Boogers MJ FAU - Roos, Cornelis J AU - Roos CJ FAU - Schuijf, Joanne D AU - Schuijf JD FAU - Krol, M Jacqueline AU - Krol MJ FAU - Rabelink, Ton J AU - Rabelink TJ FAU - Bax, Jeroen J AU - Bax JJ FAU - Schalij, Martin J AU - Schalij MJ FAU - Jukema, J Wouter AU - Jukema JW LA - eng PT - Evaluation Study PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20130710 PL - United States TA - PLoS One JT - PloS one JID - 101285081 RN - SY7Q814VUP (Calcium) SB - IM MH - Aged MH - Calcium/*blood MH - Clinical Trials as Topic/statistics & numerical data MH - Coronary Angiography/*methods MH - Coronary Artery Disease/complications/*diagnostic imaging/epidemiology MH - Feasibility Studies MH - Female MH - Humans MH - Male MH - Middle Aged MH - *Renal Dialysis MH - Renal Insufficiency, Chronic/complications/diagnostic imaging/epidemiology/*therapy MH - Research Design MH - *Tomography, X-Ray Computed PMC - PMC3707871 COIS- Competing Interests: This study was funded by an unrestricted research grant given by Biotronik. Joanne D. Schuijf is currently an employee of Thoshiba Medical Systems. However while being involved with this study Joanne D. Schuijf had no competing interests. This current relationship and the funding from Biotronik does not alter the authors' adherence to all the PLOS ONE policies on sharing data and materials. EDAT- 2013/07/23 06:00 MHDA- 2014/04/01 06:00 PMCR- 2013/07/10 CRDT- 2013/07/23 06:00 PHST- 2013/01/31 00:00 [received] PHST- 2013/05/23 00:00 [accepted] PHST- 2013/07/23 06:00 [entrez] PHST- 2013/07/23 06:00 [pubmed] PHST- 2014/04/01 06:00 [medline] PHST- 2013/07/10 00:00 [pmc-release] AID - PONE-D-13-04449 [pii] AID - 10.1371/journal.pone.0067936 [doi] PST - epublish SO - PLoS One. 2013 Jul 10;8(7):e67936. doi: 10.1371/journal.pone.0067936. Print 2013. PMID- 23866185 OWN - NLM STAT- MEDLINE DCOM- 20140214 LR - 20220321 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 6 IP - 7 DP - 2013 Jul TI - Prediction of 1-year mortality in patients with acute coronary syndromes undergoing percutaneous coronary intervention: validation of the logistic clinical SYNTAX (Synergy Between Percutaneous Coronary Interventions With Taxus and Cardiac Surgery) score. PG - 737-45 LID - S1936-8798(13)00806-6 [pii] LID - 10.1016/j.jcin.2013.04.004 [doi] AB - OBJECTIVES: This study sought to validate the Logistic Clinical SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) score in patients with non-ST-segment elevation acute coronary syndromes (ACS), in order to further legitimize its clinical application. BACKGROUND: The Logistic Clinical SYNTAX score allows for an individualized prediction of 1-year mortality in patients undergoing contemporary percutaneous coronary intervention. It is composed of a "Core" Model (anatomical SYNTAX score, age, creatinine clearance, and left ventricular ejection fraction), and "Extended" Model (composed of an additional 6 clinical variables), and has previously been cross validated in 7 contemporary stent trials (>6,000 patients). METHODS: One-year all-cause death was analyzed in 2,627 patients undergoing percutaneous coronary intervention from the ACUITY (Acute Catheterization and Urgent Intervention Triage Strategy) trial. Mortality predictions from the Core and Extended Models were studied with respect to discrimination, that is, separation of those with and without 1-year all-cause death (assessed by the concordance [C] statistic), and calibration, that is, agreement between observed and predicted outcomes (assessed with validation plots). Decision curve analyses, which weight the harms (false positives) against benefits (true positives) of using a risk score to make mortality predictions, were undertaken to assess clinical usefulness. RESULTS: In the ACUITY trial, the median SYNTAX score was 9.0 (interquartile range 5.0 to 16.0); approximately 40% of patients had 3-vessel disease, 29% diabetes, and 85% underwent drug-eluting stent implantation. Validation plots confirmed agreement between observed and predicted mortality. The Core and Extended Models demonstrated substantial improvements in the discriminative ability for 1-year all-cause death compared with the anatomical SYNTAX score in isolation (C-statistics: SYNTAX score: 0.64, 95% confidence interval [CI]: 0.56 to 0.71; Core Model: 0.74, 95% CI: 0.66 to 0.79; Extended Model: 0.77, 95% CI: 0.70 to 0.83). Decision curve analyses confirmed the increasing ability to correctly identify patients who would die at 1 year with the Extended Model versus the Core Model versus the anatomical SYNTAX score, over a wide range of thresholds for mortality risk predictions. CONCLUSIONS: Compared to the anatomical SYNTAX score alone, the Core and Extended Models of the Logistic Clinical SYNTAX score more accurately predicted individual 1-year mortality in patients presenting with non-ST-segment elevation acute coronary syndromes undergoing percutaneous coronary intervention. These findings support the clinical application of the Logistic Clinical SYNTAX score. CI - Copyright (c) 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Farooq, Vasim AU - Farooq V AD - Department of Interventional Cardiology, Erasmus University Medical Centre, Thoraxcenter, Rotterdam, the Netherlands. FAU - Vergouwe, Yvonne AU - Vergouwe Y FAU - Genereux, Philippe AU - Genereux P FAU - Bourantas, Christos V AU - Bourantas CV FAU - Palmerini, Tullio AU - Palmerini T FAU - Caixeta, Adriano AU - Caixeta A FAU - Garcia-Garcia, Hector M AU - Garcia-Garcia HM FAU - Diletti, Roberto AU - Diletti R FAU - Morel, Marie-angele AU - Morel MA FAU - McAndrew, Thomas C AU - McAndrew TC FAU - Kappetein, Arie Pieter AU - Kappetein AP FAU - Valgimigli, Marco AU - Valgimigli M FAU - Windecker, Stephan AU - Windecker S FAU - Dawkins, Keith D AU - Dawkins KD FAU - Steyerberg, Ewout W AU - Steyerberg EW FAU - Serruys, Patrick W AU - Serruys PW FAU - Stone, Gregg W AU - Stone GW LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 SB - IM MH - Acute Coronary Syndrome/diagnosis/mortality/physiopathology/*therapy MH - Aged MH - Coronary Angiography MH - *Decision Support Techniques MH - Discriminant Analysis MH - Female MH - Humans MH - Logistic Models MH - Male MH - Middle Aged MH - Percutaneous Coronary Intervention/adverse effects/instrumentation/*mortality MH - Prospective Studies MH - Reproducibility of Results MH - Risk Assessment MH - Risk Factors MH - Stents MH - Time Factors MH - Treatment Outcome OTO - NOTNLM OT - ACS OT - BMS OT - CrCl OT - DES OT - IQR OT - LVEF OT - PCI OT - PVD OT - SYNTAX score OT - acute coronary syndrome OT - acute coronary syndromes OT - bare-metal stent(s) OT - creatinine clearance OT - drug-eluting stent(s) OT - drug-eluting stents OT - interquartile range(s) OT - left ventricular ejection fraction OT - mortality OT - percutaneous coronary intervention OT - peripheral vascular disease OT - predictions OT - validation EDAT- 2013/07/20 06:00 MHDA- 2014/02/15 06:00 CRDT- 2013/07/20 06:00 PHST- 2013/03/18 00:00 [received] PHST- 2013/04/01 00:00 [accepted] PHST- 2013/07/20 06:00 [entrez] PHST- 2013/07/20 06:00 [pubmed] PHST- 2014/02/15 06:00 [medline] AID - S1936-8798(13)00806-6 [pii] AID - 10.1016/j.jcin.2013.04.004 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2013 Jul;6(7):737-45. doi: 10.1016/j.jcin.2013.04.004. PMID- 23864130 OWN - NLM STAT- MEDLINE DCOM- 20140416 LR - 20181202 IS - 1522-9645 (Electronic) IS - 0195-668X (Linking) VI - 34 IP - 36 DP - 2013 Sep TI - The impact of eplerenone at different levels of risk in patients with systolic heart failure and mild symptoms: insight from a novel risk score for prognosis derived from the EMPHASIS-HF trial. PG - 2823-9 LID - 10.1093/eurheartj/eht247 [doi] AB - AIMS: Our objective was to create a simple prognostic risk score for patients with systolic heart failure and mild symptoms. We then assessed the efficacy of eplerenone across different categories of risk. METHODS AND RESULTS: The Eplerenone in Mild Patients Hospitalization and Survival Study in Heart Failure trial (EMPHASIS-HF) was an international randomized trial, comparing eplerenone with placebo in 2737 patients with systolic heart failure and mild symptoms. The primary outcome was a composite of cardiovascular death or hospitalization for heart failure, over a median 2.1 years follow-up. Using multivariable Cox modelling age, sex, systolic blood pressure, estimated glomerular filtration rate, diabetes, BMI, haemoglobin, prior heart failure (HF) hospitalization, prior myocardial infarction/coronary artery bypass surgery (CABG), and heart rate were identified as strong independent risk factors. Estimates from the model were converted into a simple integer risk score which was categorized into three groups of low-, medium-, and high risk. In placebo patients, the rates (per 100 patient-years) for the primary outcome were 7.6, 19.0, and 39.4 in the low-, medium-, and high-risk groups, respectively. On eplerenone, these rates were reduced to 5.6, 12.2, and 24.2, respectively. Eplerenone was beneficial across all risk categories and the hazard ratios were similar. The absolute treatment benefit was greatest among those at highest risk. Similar patterns emerged for all-cause mortality and for all HF hospitalizations. CONCLUSION: This easy-to-use integer risk score should be of value in quantifying individual patient risk in patients with systolic HF and mild symptoms. The relative benefits of eplerenone appeared consistent across the whole spectrum of risk, including those at lower risk. FAU - Collier, Timothy J AU - Collier TJ AD - Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK. FAU - Pocock, Stuart J AU - Pocock SJ FAU - McMurray, John J V AU - McMurray JJ FAU - Zannad, Faiez AU - Zannad F FAU - Krum, Henry AU - Krum H FAU - van Veldhuisen, Dirk J AU - van Veldhuisen DJ FAU - Swedberg, Karl AU - Swedberg K FAU - Shi, Harry AU - Shi H FAU - Vincent, John AU - Vincent J FAU - Pitt, Bertram AU - Pitt B LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20130717 PL - England TA - Eur Heart J JT - European heart journal JID - 8006263 RN - 0 (Mineralocorticoid Receptor Antagonists) RN - 27O7W4T232 (Spironolactone) RN - 6995V82D0B (Eplerenone) SB - IM MH - Adult MH - Aged MH - Death, Sudden, Cardiac/etiology MH - Eplerenone MH - Female MH - Heart Failure, Systolic/*drug therapy/mortality MH - Hospitalization/statistics & numerical data MH - Humans MH - Kaplan-Meier Estimate MH - Male MH - Middle Aged MH - Mineralocorticoid Receptor Antagonists/*therapeutic use MH - Prognosis MH - Proportional Hazards Models MH - Risk Assessment MH - Spironolactone/*analogs & derivatives/therapeutic use OTO - NOTNLM OT - Heart failure OT - Prognosis OT - Risk score EDAT- 2013/07/19 06:00 MHDA- 2014/04/17 06:00 CRDT- 2013/07/19 06:00 PHST- 2013/07/19 06:00 [entrez] PHST- 2013/07/19 06:00 [pubmed] PHST- 2014/04/17 06:00 [medline] AID - eht247 [pii] AID - 10.1093/eurheartj/eht247 [doi] PST - ppublish SO - Eur Heart J. 2013 Sep;34(36):2823-9. doi: 10.1093/eurheartj/eht247. Epub 2013 Jul 17. PMID- 23847661 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20130712 LR - 20240420 IS - 1734-1922 (Print) IS - 1896-9151 (Electronic) IS - 1734-1922 (Linking) VI - 9 IP - 3 DP - 2013 Jun 20 TI - Statins and cardiovascular outcomes in elderly and younger patients with coronary artery disease: a post hoc analysis of the GREACE study. PG - 418-26 LID - 10.5114/aoms.2013.35424 [doi] AB - INTRODUCTION: The effect of cardiovascular disease (CVD) prevention measures aimed at elderly patients requires further evidence. We investigated the effect of statin treatment (targeted to achieve guideline goals) on CVD outcomes in different age groups to determine whether statins are more beneficial in the elderly. MATERIAL AND METHODS: The primary endpoint of this post hoc analysis of the GREek Atorvastatin and Coronary-heart-disease Evaluation (GREACE) study (n = 1,600 patients with established coronary heart disease (CHD), mean follow-up 3 years) was the absolute and relative CVD event (a composite of death, myocardial infarction, revascularization, unstable angina, heart failure and stroke) risk reduction in age quartiles (each n = 200). Patients on "structured care" with atorvastatin (n = 800) followed up by the university clinic and treated to lipid goal were compared with the corresponding quartiles on "usual care" (n = 800) followed up by specialists or general practitioners of the patient's choice outside the hospital. RESULTS: In the elderly (mean age 69 +/-4 and 70 +/-3 years in the "structured" and "usual care", respectively) the absolute CVD event reduction between "structured" and "usual care" was 16.5% (p < 0.0001), while in the younger patients (mean age 51 +/-3 years and 52 +/-3 years in the "structured" and "usual care", respectively) this was 8.5% (p = 0.016); relative risk reduction (RRR) 60% (p < 0.0001) vs. 42% respectively (p = 0.001). The elderly had higher rates of chronic kidney disease and higher uric acid levels, plus an increased prevalence of diabetes, metabolic syndrome and non-alcoholic fatty liver disease. These factors might contribute to the increased CVD risk in older patients. CONCLUSIONS: All age groups benefited from statin treatment, but the elderly on "structured care" had a greater absolute and relative CVD risk reduction than the younger patients when compared with the corresponding patients assigned to "usual care". These findings suggest that we should not deprive older patients of CVD prevention treatment and lipid target achievement. FAU - Athyros, Vasilios G AU - Athyros VG AD - Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece. FAU - Katsiki, Niki AU - Katsiki N FAU - Tziomalos, Konstantinos AU - Tziomalos K FAU - Gossios, Thomas D AU - Gossios TD FAU - Theocharidou, Eleni AU - Theocharidou E FAU - Gkaliagkousi, Eygenia AU - Gkaliagkousi E FAU - Anagnostis, Panagiotis AU - Anagnostis P FAU - Pagourelias, Efstathios D AU - Pagourelias ED FAU - Karagiannis, Asterios AU - Karagiannis A FAU - Mikhailidis, Dimitri P AU - Mikhailidis DP CN - GREACE Study Collaborative Group LA - eng PT - Journal Article DEP - 20130528 PL - Poland TA - Arch Med Sci JT - Archives of medical science : AMS JID - 101258257 PMC - PMC3701988 OTO - NOTNLM OT - GREek Atorvastatin and Coronary-heart-disease Evaluation OT - age OT - cardiovascular disease OT - chronic kidney disease OT - statin EDAT- 2013/07/13 06:00 MHDA- 2013/07/13 06:01 PMCR- 2013/06/20 CRDT- 2013/07/13 06:00 PHST- 2013/03/30 00:00 [received] PHST- 2013/04/03 00:00 [revised] PHST- 2013/04/04 00:00 [accepted] PHST- 2013/07/13 06:00 [entrez] PHST- 2013/07/13 06:00 [pubmed] PHST- 2013/07/13 06:01 [medline] PHST- 2013/06/20 00:00 [pmc-release] AID - 20885 [pii] AID - 10.5114/aoms.2013.35424 [doi] PST - ppublish SO - Arch Med Sci. 2013 Jun 20;9(3):418-26. doi: 10.5114/aoms.2013.35424. Epub 2013 May 28. PMID- 25135288 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20140819 LR - 20211021 IS - 2193-8261 (Print) IS - 2193-6544 (Electronic) IS - 2193-6544 (Linking) VI - 2 IP - 1 DP - 2013 Jun TI - Oral antiplatelet therapy in acute coronary syndromes: recent developments. PG - 47-56 LID - 10.1007/s40119-013-0011-6 [doi] AB - The purpose of this article is to summarize the current knowledge about treatment with oral platelet inhibitors in patients with acute coronary syndrome (ACS). Antiplatelet therapy has been shown to improve the prognosis of patients with ACS with ST segment elevation myocardial infarction (STEMI) and non-ST segment elevation ACS (NSTE-ACS). Aspirin should be given with a loading dose of 250-500 mg, followed by 75-100 mg/day. Dual antiplatelet therapy is recommended for all patients with ACS for 12 months regardless of the initial revascularization strategy. Clopidogrel should be administered at first medical contact in STEMI with a loading dose of 600 mg. In patients with ACS and percutaneous coronary intervention (PCI) 2 x 75 mg clopidogrel should be given daily over 7 days, while in all other patients 75 mg per day appears to be sufficient. The two newer adenosine diphosphate-receptor antagonists prasugrel and ticagrelor lead to a more rapid and effective inhibition of platelet aggregation compared with clopidogrel, which was associated with an improved clinical outcome in two large randomized studies. Prasugrel is indicated in patients with ACS undergoing PCI and was most effective in diabetics and in patients with STEMI. In the recent TaRgeted platelet Inhibition to cLarify the Optimal strateGy to medicallY manage Acute Coronary Syndromes trial in medically treated patients with NSTE-ACS, prasugrel did not significantly reduce ischemic events compared with clopidogrel. Ticagrelor has been studied in the whole spectrum of ACS patients and reduced cardiovascular and total mortality in comparison with clopidogrel. The greatest benefit has been observed in patients with planned conservative treatment and in patients with impaired renal function. Expanding antiplatelet therapy from dual to triple therapy including a platelet thrombin receptor antagonist in the thrombin receptor antagonist for clinical event reduction in acute coronary syndrome trial was not associated with a significant reduction in the primary combined endpoint but an increase in bleeding complications. However, in the Thrombin Receptor Antagonist in Secondary Prevention of atherothrombotic ischemic events study in patients with prior myocardial infarction, vorapaxar on top of standard antiplatelet therapy was effective. FAU - Zeymer, Uwe AU - Zeymer U AD - Klinikum der Stadt Ludwigshafen GmbH, Bremserstrasse 79, 67063, Ludwigshafen, Germany, Uwe.Zeymer@t-online.de. LA - eng PT - Journal Article DEP - 20130228 PL - England TA - Cardiol Ther JT - Cardiology and therapy JID - 101634495 PMC - PMC4107436 EDAT- 2013/06/01 00:00 MHDA- 2013/06/01 00:01 PMCR- 2013/02/28 CRDT- 2014/08/20 06:00 PHST- 2012/10/10 00:00 [received] PHST- 2014/08/20 06:00 [entrez] PHST- 2013/06/01 00:00 [pubmed] PHST- 2013/06/01 00:01 [medline] PHST- 2013/02/28 00:00 [pmc-release] AID - 11 [pii] AID - 10.1007/s40119-013-0011-6 [doi] PST - ppublish SO - Cardiol Ther. 2013 Jun;2(1):47-56. doi: 10.1007/s40119-013-0011-6. Epub 2013 Feb 28. PMID- 23674398 OWN - NLM STAT- MEDLINE DCOM- 20130925 LR - 20191210 IS - 1524-4539 (Electronic) IS - 0009-7322 (Linking) VI - 127 IP - 25 DP - 2013 Jun 25 TI - High-dose statin therapy in patients with stable coronary artery disease: treating the right patients based on individualized prediction of treatment effect. PG - 2485-93 LID - 10.1161/CIRCULATIONAHA.112.000712 [doi] AB - BACKGROUND: Clinicians need to identify coronary artery disease patients for whom the benefits of high-dose versus usual-dose statin therapy outweigh potential harm. We therefore aimed to develop and validate a model for prediction of the incremental treatment effect of high-dose statins for individual patients in terms of reduction of 5-year absolute risk for myocardial infarction, stroke, coronary death, or cardiac resuscitation. METHODS AND RESULTS: Based on data from the Treating to New Targets trial (TNT; n=10 001), a Cox proportional hazards model was developed comprising 13 easy-to-measure clinical predictors: age, sex, smoking, diabetes mellitus, total cholesterol, high-density lipoprotein cholesterol, systolic blood pressure, history of myocardial infarction, coronary artery bypass grafting, congestive heart failure or abdominal aortic aneurysm, glomerular filtration rate, and treatment status (ie, atorvastatin 80 mg or 10 mg). External validation in the Incremental Decrease in End Points Through Aggressive Lipid Lowering trial (IDEAL; n=8888) confirmed adequate goodness-of-fit and calibration, but moderate discrimination (C-statistic, 0.63; 95% confidence interval, 0.62-0.65). Still, among participants of both trials combined, the model identified a group of 11.7% whose predicted 5-year number needed to treat was /=50. A decision curve shows that making treatment decisions on the basis of predictions using our model may improve net benefit. CONCLUSIONS: Estimation of the incremental treatment effect of high-dose versus usual-dose statin therapy in individual coronary artery disease patients enables selection of high-risk patients that benefit most from more aggressive therapy. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifiers: NCT00327691 and NCT00159835. FAU - Dorresteijn, Johannes A N AU - Dorresteijn JA AD - Department of Vascular Medicine, University Medical Center Utrecht, P.O. Box 85500, 3508 GA Utrecht, The Netherlands. FAU - Boekholdt, S Matthijs AU - Boekholdt SM FAU - van der Graaf, Yolanda AU - van der Graaf Y FAU - Kastelein, John J P AU - Kastelein JJ FAU - LaRosa, John C AU - LaRosa JC FAU - Pedersen, Terje R AU - Pedersen TR FAU - DeMicco, David A AU - DeMicco DA FAU - Ridker, Paul M AU - Ridker PM FAU - Cook, Nancy R AU - Cook NR FAU - Visseren, Frank L J AU - Visseren FL LA - eng SI - ClinicalTrials.gov/NCT00159835 SI - ClinicalTrials.gov/NCT00327691 PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Validation Study DEP - 20130514 PL - United States TA - Circulation JT - Circulation JID - 0147763 RN - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors) SB - IM MH - Aged MH - Coronary Artery Disease/*drug therapy MH - Death, Sudden, Cardiac/epidemiology MH - Dose-Response Relationship, Drug MH - Female MH - Follow-Up Studies MH - Humans MH - Hydroxymethylglutaryl-CoA Reductase Inhibitors/*administration & dosage/*therapeutic use MH - Longitudinal Studies MH - Male MH - Middle Aged MH - *Models, Statistical MH - Myocardial Infarction/epidemiology MH - *Precision Medicine MH - Proportional Hazards Models MH - Risk Factors MH - Stroke/epidemiology MH - Treatment Outcome OTO - NOTNLM OT - coronary disease OT - forecasting OT - prevention & control OT - statins, HMG-CoA OT - treatment outcome EDAT- 2013/05/16 06:00 MHDA- 2013/09/26 06:00 CRDT- 2013/05/16 06:00 PHST- 2013/05/16 06:00 [entrez] PHST- 2013/05/16 06:00 [pubmed] PHST- 2013/09/26 06:00 [medline] AID - CIRCULATIONAHA.112.000712 [pii] AID - 10.1161/CIRCULATIONAHA.112.000712 [doi] PST - ppublish SO - Circulation. 2013 Jun 25;127(25):2485-93. doi: 10.1161/CIRCULATIONAHA.112.000712. Epub 2013 May 14. PMID- 23622918 OWN - NLM STAT- MEDLINE DCOM- 20130618 LR - 20240321 IS - 1097-6744 (Electronic) IS - 0002-8703 (Print) IS - 0002-8703 (Linking) VI - 165 IP - 5 DP - 2013 May TI - Comparative effectiveness of coronary artery bypass grafting and percutaneous coronary intervention for multivessel coronary disease in a community-based population with chronic kidney disease. PG - 800-8, 808.e1-2 LID - S0002-8703(13)00139-7 [pii] LID - 10.1016/j.ahj.2013.02.012 [doi] AB - BACKGROUND: Randomized clinical trials comparing coronary artery bypass grafting (CABG) with percutaneous coronary intervention (PCI) have largely excluded patients with chronic kidney disease (CKD), leading to uncertainty about the optimal coronary revascularization strategy. We sought to test the hypothesis that an initial strategy of CABG would be associated with lower risks of long-term mortality and cardiovascular morbidity compared with PCI for the treatment of multivessel coronary heart disease in the setting of CKD. METHODS: We created a propensity score-matched cohort of patients aged >/=30 years with no prior dialysis or renal transplant who received multivessel coronary revascularization between 1996 and 2008 within a large integrated health care delivery system in northern California. We used extended Cox regression to examine death from any cause, acute coronary syndrome, and repeat revascularization. RESULTS: Coronary artery bypass grafting was associated with a significantly lower adjusted rate of death than PCI across all strata of estimated glomerular filtration rate (eGFR) (in mL/min per 1.73 m(2)): the adjusted hazard ratio (HR) was 0.81, 95% CI 0.68 to 1.00 for patients with eGFR >/=60; HR 0.73 (CI 0.56-0.95) for eGFR of 45 to 59; and HR 0.87 (CI 0.67-1.14) for eGFR <45. Coronary artery bypass grafting was also associated with significantly lower rates of acute coronary syndrome and repeat revascularization at all levels of eGFR compared with PCI. CONCLUSIONS: Among adults with and without CKD, multivessel CABG was associated with lower risks of death and coronary events compared with multivessel PCI. CI - Copyright (c) 2013 Mosby, Inc. All rights reserved. FAU - Chang, Tara I AU - Chang TI AD - Stanford University School of Medicine, Division of Nephrology, Stanford, CA. FAU - Leong, Thomas K AU - Leong TK FAU - Kazi, Dhruv S AU - Kazi DS FAU - Lee, Hon S AU - Lee HS FAU - Hlatky, Mark A AU - Hlatky MA FAU - Go, Alan S AU - Go AS LA - eng GR - T32 DK007357/DK/NIDDK NIH HHS/United States PT - Comparative Study PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20130402 PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 SB - IM MH - Aged MH - California/epidemiology MH - Coronary Artery Bypass/*methods MH - Coronary Artery Disease/complications/mortality/*surgery MH - Female MH - Humans MH - Incidence MH - Kaplan-Meier Estimate MH - Male MH - Middle Aged MH - Percutaneous Coronary Intervention/*methods MH - *Registries MH - Renal Insufficiency, Chronic/*complications/mortality MH - Risk Factors MH - Survival Rate/trends MH - Treatment Outcome PMC - PMC4125571 MID - NIHMS609417 EDAT- 2013/04/30 06:00 MHDA- 2013/06/19 06:00 PMCR- 2014/08/07 CRDT- 2013/04/30 06:00 PHST- 2012/11/12 00:00 [received] PHST- 2013/02/17 00:00 [accepted] PHST- 2013/04/30 06:00 [entrez] PHST- 2013/04/30 06:00 [pubmed] PHST- 2013/06/19 06:00 [medline] PHST- 2014/08/07 00:00 [pmc-release] AID - S0002-8703(13)00139-7 [pii] AID - 10.1016/j.ahj.2013.02.012 [doi] PST - ppublish SO - Am Heart J. 2013 May;165(5):800-8, 808.e1-2. doi: 10.1016/j.ahj.2013.02.012. Epub 2013 Apr 2. PMID- 23603843 OWN - NLM STAT- MEDLINE DCOM- 20140204 LR - 20190819 IS - 1347-4820 (Electronic) IS - 1346-9843 (Linking) VI - 77 IP - 7 DP - 2013 TI - Simple risk algorithm to predict serious bleeding in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention: RISK-PCI bleeding score. PG - 1719-27 AB - BACKGROUND: Bleeding is a potentially catastrophic complication after primary percutaneous coronary intervention (PPCI). It occurs most frequently within the first 30 days following the intervention. The aim of this study was to generate a simple and accurate risk model for the prediction of bleeding after PPCI. METHODS AND RESULTS: The training set included 2,096 patients enrolled in the RISK-PCI trial. The model was validated using a database of 961 patients enrolled in the ART-PCI trial. Bleeding was defined as type >/=3a bleeding according to the Bleeding Academic Research Consortium definition. Multivariate logistic regression was used to evaluate the predictors of outcome. A sum of weighted points for specific predictors was calculated to determine the final score. The model included 5 independent predictors of 30-day bleeding: gender (female); history of peptic ulcer; creatinine clearance at admission (<60 ml/min); hemoglobin at presentation (<125 g/dl); and Killip class >1 heart failure at admission. The model showed good discrimination and calibration for the prediction of bleeding in the derivation set (C-statistic, 0.79; goodness of fit, P=0.12) and in the validation set (C-statistic, 0.76; goodness of fit, P=0.37). Patients were classified into 3 risk classes and the observed incidence of 30-day bleeding of 1.0%, 3.5% and 10.7% corresponded to the low-, intermediate- and high-risk classes, respectively. CONCLUSIONS: A simple risk model was developed that has a reasonably good capacity for the prediction of 30-day bleeding after PPCI. FAU - Mrdovic, Igor AU - Mrdovic I AD - University of Belgrade School of Medicine, Belgrade, Serbia. igormrd@gmail.com FAU - Savic, Lidija AU - Savic L FAU - Krljanac, Gordana AU - Krljanac G FAU - Asanin, Milika AU - Asanin M FAU - Lasica, Ratko AU - Lasica R FAU - Djuricic, Nemanja AU - Djuricic N FAU - Brdar, Natasa AU - Brdar N FAU - Marinkovic, Jelena AU - Marinkovic J FAU - Kocev, Nikola AU - Kocev N FAU - Perunicic, Jovan AU - Perunicic J LA - eng PT - Clinical Trial PT - Journal Article DEP - 20130420 PL - Japan TA - Circ J JT - Circulation journal : official journal of the Japanese Circulation Society JID - 101137683 SB - IM MH - Aged MH - *Algorithms MH - Female MH - Follow-Up Studies MH - Humans MH - Incidence MH - Male MH - Middle Aged MH - *Models, Cardiovascular MH - Myocardial Infarction/epidemiology/physiopathology/*therapy MH - Percutaneous Coronary Intervention/*adverse effects MH - Postoperative Hemorrhage/*epidemiology/etiology/physiopathology MH - Predictive Value of Tests MH - Risk Assessment/methods MH - Risk Factors MH - Sex Factors MH - Time Factors EDAT- 2013/04/23 06:00 MHDA- 2014/02/05 06:00 CRDT- 2013/04/23 06:00 PHST- 2013/04/23 06:00 [entrez] PHST- 2013/04/23 06:00 [pubmed] PHST- 2014/02/05 06:00 [medline] AID - DN/JST.JSTAGE/circj/CJ-12-1177 [pii] AID - 10.1253/circj.cj-12-1177 [doi] PST - ppublish SO - Circ J. 2013;77(7):1719-27. doi: 10.1253/circj.cj-12-1177. Epub 2013 Apr 20. PMID- 23574999 OWN - NLM STAT- MEDLINE DCOM- 20150219 LR - 20190608 IS - 2186-1005 (Electronic) IS - 1341-1098 (Linking) VI - 20 IP - 3 DP - 2014 TI - Early results of human atrial natriuretic peptide infusion in non-dialysis patients with chronic kidney disease undergoing isolated coronary artery bypass grafting: the NU-HIT trial for CKD-II. PG - 217-22 AB - BACKGROUND: Chronic kidney disease (CKD) is an important risk factor for cardiac surgery. In the most recently reported NU-HIT trial for CKD with CKD patients underwent coronary artery bypass grafting (CABG) as subjects, carperitide was reported to be effective in terms of renal function. In the present study, a subanalysis was performed on patients registered in the NU-HIT trial for CKD from the standpoint of renin-angiotensin system, natriuresis and renal function. METHODS: 303 patients with CKD who underwent isolated CABG were divided into a group that received carperitide infusion and another group without carperitide. The renin activity, angiotensin-II, aldosterone, urine-sodium, urine- creatinine, fractional sodium excretion, renal failure index, and BNP levels. RESULTS: There were significant lower in hANP group than the placebo group, in angiotensin-II at one day postoperatively, and in aldosterone from 0 day to one month postoperatively. FENa was significantly lower in the hANP group at 3 day and one week postoperatively. CONCLUSIONS: In on pump isolated CABG patients with CKD, carperitide showed a potent natriuretic action and inhibited the renin-angiotensin system, suggesting that it prevented deterioration of postoperative renal function. Our findings raise new possibilities for the perioperative and postoperative management of patients undergoing surgery with cardiopulmonary bypass. FAU - Sezai, Akira AU - Sezai A AD - The Department of Cardiovascular Surgery, Nihon University School of Medicine. FAU - Nakata, Kin-ichi AU - Nakata K FAU - Iida, Mitsuru AU - Iida M FAU - Yoshitake, Isamu AU - Yoshitake I FAU - Wakui, Shinji AU - Wakui S FAU - Hata, Hiroaki AU - Hata H FAU - Shiono, Motomi AU - Shiono M LA - eng PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20130411 PL - Japan TA - Ann Thorac Cardiovasc Surg JT - Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia JID - 9703158 RN - 0 (Biomarkers) RN - 0 (NPPA protein, human) RN - 0 (Renal Agents) RN - 85637-73-6 (Atrial Natriuretic Factor) SB - IM MH - Atrial Natriuretic Factor/administration & dosage/adverse effects/*therapeutic use MH - Biomarkers/blood/urine MH - Cardiopulmonary Bypass MH - *Coronary Artery Bypass/adverse effects MH - Coronary Artery Disease/complications/diagnosis/*surgery MH - Double-Blind Method MH - Humans MH - Infusions, Parenteral MH - Japan MH - Kidney/*drug effects/metabolism/physiopathology MH - Natriuresis/drug effects MH - Renal Agents/administration & dosage/adverse effects/*therapeutic use MH - Renal Insufficiency, Chronic/complications/diagnosis/*drug therapy/physiopathology MH - Renin-Angiotensin System/drug effects MH - Time Factors MH - Treatment Outcome EDAT- 2013/04/12 06:00 MHDA- 2015/02/20 06:00 CRDT- 2013/04/12 06:00 PHST- 2013/04/12 06:00 [entrez] PHST- 2013/04/12 06:00 [pubmed] PHST- 2015/02/20 06:00 [medline] AID - DN/JST.JSTAGE/atcs/oa.13.02252 [pii] AID - 10.5761/atcs.oa.13.02252 [doi] PST - ppublish SO - Ann Thorac Cardiovasc Surg. 2014;20(3):217-22. doi: 10.5761/atcs.oa.13.02252. Epub 2013 Apr 11. PMID- 23528027 OWN - NLM STAT- MEDLINE DCOM- 20130913 LR - 20130614 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 111 IP - 12 DP - 2013 Jun 15 TI - Safety and efficacy of adjuvant glycoprotein IIb/IIIa inhibitors during primary percutaneous coronary intervention performed from the radial approach for acute ST segment elevation myocardial infarction. PG - 1727-33 LID - S0002-9149(13)00623-1 [pii] LID - 10.1016/j.amjcard.2013.02.020 [doi] AB - The use of glycoprotein IIb/IIIa receptor inhibitors (GPIs) in high-risk patients with acute coronary syndromes has been associated with reductions in ischemic events but increases in bleeding complications. The role of GPIs in patients who undergo primary percutaneous coronary intervention (PCI) by the transradial approach (TRA) is not well studied. The aim of this post hoc analysis from the randomized prospective Acute Myocardial Infarction Treated With Primary Angioplasty and Intravenous Enoxaparin or Unfractionated Heparin to Lower Ischemic and Bleeding Events at Short- and Long-Term Follow-Up (ATOLL) trial was to assess the safety and efficacy of GPIs in primary PCI performed using the TRA. A total of 910 patients were enrolled in ATOLL; 522 patients (67%) underwent PCI using the TRA. Two comparative analyses were performed. First, patients who underwent PCI using the TRA who received GPIs were compared with those who did not receive GPIs. Second, patients who underwent PCI using the TRA who received GPIs were compared with those who underwent PCI using a nonradial route and received GPIs. Composite end points of net clinical benefit, ischemic outcomes, and safety consisting of bleeding and transfusion at 1 month were analyzed. A propensity score was constructed, and weight adjustment were made for variables, including but not limited to age, weight, gender, renal function, concomitant use of other medications, Killip class, and medical history, when analyzing the end points. There was no significant difference in net clinical benefit or ischemic outcomes between either TRA patients with versus without GPIs or TRA patients with GPIs versus non-TRA patients with GPIs. Additionally, there were significantly fewer major bleeding events and blood transfusions in TRA patients with GPIs compared with non-TRA patients with GPIs. In conclusion, the addition of GPIs in the setting of primary PCI using the TRA was not associated with bleeding liability. The use of GPIs with TRA was associated with safer outcomes than using GPIs with a nontransradial approach. This study was limited in that it was a nonrandomized retrospective analysis. CI - Copyright (c) 2013 Elsevier Inc. All rights reserved. FAU - Iqbal, Zafar AU - Iqbal Z AD - Division of Cardiology, Newark Beth Israel Medical Center, Newark, NJ, USA. drzafarzafar@yahoo.com FAU - Cohen, Marc AU - Cohen M FAU - Pollack, Charles AU - Pollack C FAU - Goldstein, Patrick AU - Goldstein P FAU - Zeymer, Uwe AU - Zeymer U FAU - Huber, Kurt AU - Huber K FAU - Barthelemy, Olivier AU - Barthelemy O FAU - Cayla, Guillaume AU - Cayla G FAU - Aout, Mounir AU - Aout M FAU - Vicaut, Eric AU - Vicaut E FAU - Montalescot, Gilles AU - Montalescot G CN - ATOLL Investigators LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20130322 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 RN - 0 (Platelet Aggregation Inhibitors) RN - 0 (Platelet Glycoprotein GPIIb-IIIa Complex) SB - IM MH - Aged MH - *Angioplasty, Balloon, Coronary MH - Female MH - Heart Conduction System/physiopathology MH - Humans MH - Israel MH - Male MH - Middle Aged MH - Myocardial Infarction/*diagnosis/physiopathology/*therapy MH - Platelet Aggregation Inhibitors/*therapeutic use MH - Platelet Glycoprotein GPIIb-IIIa Complex/*antagonists & inhibitors MH - Prospective Studies MH - Radial Artery/*surgery MH - Retrospective Studies MH - Risk Assessment MH - Risk Factors MH - Treatment Outcome MH - United States EDAT- 2013/03/27 06:00 MHDA- 2013/09/14 06:00 CRDT- 2013/03/27 06:00 PHST- 2012/11/18 00:00 [received] PHST- 2013/02/17 00:00 [revised] PHST- 2013/02/17 00:00 [accepted] PHST- 2013/03/27 06:00 [entrez] PHST- 2013/03/27 06:00 [pubmed] PHST- 2013/09/14 06:00 [medline] AID - S0002-9149(13)00623-1 [pii] AID - 10.1016/j.amjcard.2013.02.020 [doi] PST - ppublish SO - Am J Cardiol. 2013 Jun 15;111(12):1727-33. doi: 10.1016/j.amjcard.2013.02.020. Epub 2013 Mar 22. PMID- 23520169 OWN - NLM STAT- MEDLINE DCOM- 20140117 LR - 20141120 IS - 1477-111X (Electronic) IS - 0267-6591 (Linking) VI - 28 IP - 4 DP - 2013 Jul TI - Minimal extracorporeal circulation reduces the incidence of postoperative major adverse events after elective coronary artery bypass grafting in high-risk patients. A single-institutional prospective randomized study. PG - 350-6 LID - 10.1177/0267659113479135 [doi] AB - Coronary artery bypass grafting (CABG) using minimal extracorporeal circulation (MECC) has been associated with an improved short-term clinical outcome compared to conventional extracorporeal circulation (CECC). The aim of this study was to evaluate the impact of MECC compared to CECC on postoperative major adverse events in high-risk patients undergoing elective coronary revascularization procedures. Two hundred patients undergoing elective CABG were randomized into two groups. In Group A (n=100), MECC was used while Group B (n=100) included patients who were operated on CECC. The incidence of postoperative major adverse events (myocardial infarction, renal failure, stroke, death) was the primary end-point of the study. MECC was associated with a 77% relative risk reduction in the incidence of major adverse events compared to CECC (p=0.004). The rate of major adverse events occurring in the high-risk patient subgroup (preoperative left ventricular ejection fraction 65 years, EuroSCORE II >5) operated on with MECC was significantly lower in comparison to their CECC counterparts. Based on our results, cardiac centres should be encouraged to use MECC as the standard circuit when performing elective coronary procedures, even in a high-risk population. FAU - Asteriou, C AU - Asteriou C AD - Department of Cardiothoracic Surgery, AHEPA University Hospital, 542 48, Thessaloniki, Greece. FAU - Antonitsis, P AU - Antonitsis P FAU - Argiriadou, H AU - Argiriadou H FAU - Deliopoulos, A AU - Deliopoulos A FAU - Konstantinou, D AU - Konstantinou D FAU - Foroulis, C AU - Foroulis C FAU - Papakonstantinou, C AU - Papakonstantinou C FAU - Anastasiadis, K AU - Anastasiadis K LA - eng PT - Journal Article PT - Randomized Controlled Trial DEP - 20130321 PL - England TA - Perfusion JT - Perfusion JID - 8700166 SB - IM MH - Aged MH - Coronary Artery Bypass/*adverse effects/*methods MH - Elective Surgical Procedures/adverse effects MH - Extracorporeal Circulation/*methods MH - Humans MH - Incidence MH - Middle Aged MH - Myocardial Infarction/etiology MH - Postoperative Period MH - Prospective Studies MH - Renal Insufficiency/etiology MH - Stroke/etiology MH - Survival Rate OTO - NOTNLM OT - coronary artery bypass grafting OT - extracorporeal circulation OT - myocardial infarction OT - randomized controlled trial OT - renal failure EDAT- 2013/03/23 06:00 MHDA- 2014/01/18 06:00 CRDT- 2013/03/23 06:00 PHST- 2013/03/23 06:00 [entrez] PHST- 2013/03/23 06:00 [pubmed] PHST- 2014/01/18 06:00 [medline] AID - 0267659113479135 [pii] AID - 10.1177/0267659113479135 [doi] PST - ppublish SO - Perfusion. 2013 Jul;28(4):350-6. doi: 10.1177/0267659113479135. Epub 2013 Mar 21. PMID- 23500314 OWN - NLM STAT- MEDLINE DCOM- 20130708 LR - 20220316 IS - 1558-3597 (Electronic) IS - 0735-1097 (Linking) VI - 61 IP - 19 DP - 2013 May 14 TI - Renoprotective effect of remote ischemic post-conditioning by intermittent balloon inflations in patients undergoing percutaneous coronary intervention. PG - 1949-55 LID - S0735-1097(13)01001-2 [pii] LID - 10.1016/j.jacc.2013.02.023 [doi] AB - OBJECTIVES: The aim of the present study was to assess the efficacy of remote ischemic post-conditioning (RIPC) by repeated intermittent balloon inflations in preventing acute kidney injury (AKI) in patients with a non-ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention (PCI). BACKGROUND: AKI complicating PCI is associated with increased morbidity and mortality. Remote ischemic preconditioning, using cycles of upper limb ischemia-reperfusion as a conditioning stimulus, has been recently shown to prevent AKI in patients undergoing elective coronary angiography. METHODS: Eligible patients were randomized to receive RIPC by cycles of inflation and deflation of the stent balloon during PCI or a sham procedure (control patients). The primary endpoint was AKI, defined as an increase of >/= 0.5 mg/dl or >/= 25% in serum creatinine within 96 h from PCI. The 30-day rate of death or re-hospitalization for any cause was one of the secondary endpoints. RESULTS: A total of 225 patients were included (median age, 68 years; 36% female). The AKI rate in the RIPC group was 12.4% versus 29.5% in the control group (p = 0.002; odds ratio: 0.34; 95% confidence interval: 0.16 to 0.71). The number needed to treat to avoid 1 case of AKI was 6 (95% confidence interval: 3.6 to 15.2). The 30-day rate of death or re-hospitalization for any cause was 22.3% in the control group versus 12.4% in RIPC patients (p = 0.05). CONCLUSIONS: RIPC by serial balloon inflations and deflations during PCI was found to confer protection against AKI in patients with a non-ST-segment elevation myocardial infarction undergoing PCI. The reduction in the rate of AKI translated into a clear trend (of borderline significance) toward better 30-day clinical outcome. CI - Copyright (c) 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Deftereos, Spyridon AU - Deftereos S AD - Department of Cardiology, Athens General Hospital "G. Gennimatas," Athens, Greece. FAU - Giannopoulos, Georgios AU - Giannopoulos G FAU - Tzalamouras, Vasileios AU - Tzalamouras V FAU - Raisakis, Konstantinos AU - Raisakis K FAU - Kossyvakis, Charalambos AU - Kossyvakis C FAU - Kaoukis, Andreas AU - Kaoukis A FAU - Panagopoulou, Vasiliki AU - Panagopoulou V FAU - Karageorgiou, Sofia AU - Karageorgiou S FAU - Avramides, Dimitrios AU - Avramides D FAU - Toutouzas, Konstantinos AU - Toutouzas K FAU - Hahalis, George AU - Hahalis G FAU - Pyrgakis, Vlassios AU - Pyrgakis V FAU - Manolis, Antonis S AU - Manolis AS FAU - Alexopoulos, Dimitrios AU - Alexopoulos D FAU - Stefanadis, Christodoulos AU - Stefanadis C FAU - Cleman, Michael W AU - Cleman MW LA - eng PT - Journal Article PT - Randomized Controlled Trial DEP - 20130314 PL - United States TA - J Am Coll Cardiol JT - Journal of the American College of Cardiology JID - 8301365 SB - IM CIN - J Am Coll Cardiol. 2013 Sep 24;62(13):1216. doi: 10.1016/j.jacc.2013.04.095. PMID: 23892251 CIN - J Am Coll Cardiol. 2013 Sep 24;62(13):1216-7. doi: 10.1016/j.jacc.2013.05.083. PMID: 23892255 CIN - J Am Coll Cardiol. 2013 Sep 24;62(13):1217. doi: 10.1016/j.jacc.2013.06.038. PMID: 23892258 CIN - J Am Coll Cardiol. 2013 Sep 24;62(13):1215-6. doi: 10.1016/j.jacc.2013.04.094. PMID: 23892261 MH - Acute Kidney Injury/etiology/*prevention & control MH - Aged MH - Female MH - Glomerular Filtration Rate MH - Humans MH - *Ischemic Postconditioning MH - Male MH - Middle Aged MH - Myocardial Infarction/*surgery MH - Percutaneous Coronary Intervention/*adverse effects/statistics & numerical data MH - Prospective Studies EDAT- 2013/03/19 06:00 MHDA- 2013/07/09 06:00 CRDT- 2013/03/19 06:00 PHST- 2012/08/21 00:00 [received] PHST- 2013/01/29 00:00 [revised] PHST- 2013/02/25 00:00 [accepted] PHST- 2013/03/19 06:00 [entrez] PHST- 2013/03/19 06:00 [pubmed] PHST- 2013/07/09 06:00 [medline] AID - S0735-1097(13)01001-2 [pii] AID - 10.1016/j.jacc.2013.02.023 [doi] PST - ppublish SO - J Am Coll Cardiol. 2013 May 14;61(19):1949-55. doi: 10.1016/j.jacc.2013.02.023. Epub 2013 Mar 14. PMID- 23477676 OWN - NLM STAT- MEDLINE DCOM- 20130404 LR - 20260518 IS - 1533-4406 (Electronic) IS - 0028-4793 (Linking) VI - 368 IP - 13 DP - 2013 Mar 28 TI - Effects of off-pump and on-pump coronary-artery bypass grafting at 1 year. PG - 1179-88 LID - 10.1056/NEJMoa1301228 [doi] AB - BACKGROUND: Previously, we reported that there was no significant difference at 30 days in the rate of a primary composite outcome of death, myocardial infarction, stroke, or new renal failure requiring dialysis between patients who underwent coronary-artery bypass grafting (CABG) performed with a beating-heart technique (off-pump) and those who underwent CABG performed with cardiopulmonary bypass (on-pump). We now report results on quality of life and cognitive function and on clinical outcomes at 1 year. METHODS: We enrolled 4752 patients with coronary artery disease who were scheduled to undergo CABG and randomly assigned them to undergo the procedure off-pump or on-pump. Patients were enrolled at 79 centers in 19 countries. We assessed quality of life and cognitive function at discharge, at 30 days, and at 1 year and clinical outcomes at 1 year. RESULTS: At 1 year, there was no significant difference in the rate of the primary composite outcome between off-pump and on-pump CABG (12.1% and 13.3%, respectively; hazard ratio with off-pump CABG, 0.91; 95% confidence interval [CI], 0.77 to 1.07; P=0.24). The rate of the primary outcome was also similar in the two groups in the period between 31 days and 1 year (hazard ratio, 0.79; 95% CI, 0.55 to 1.13; P=0.19). The rate of repeat coronary revascularization at 1 year was 1.4% in the off-pump group and 0.8% in the on-pump group (hazard ratio, 1.66; 95% CI, 0.95 to 2.89; P=0.07). There were no significant differences between the two groups at 1 year in measures of quality of life or neurocognitive function. CONCLUSIONS: At 1 year after CABG, there was no significant difference between off-pump and on-pump CABG with respect to the primary composite outcome, the rate of repeat coronary revascularization, quality of life, or neurocognitive function. (Funded by the Canadian Institutes of Health Research; CORONARY ClinicalTrials.gov number, NCT00463294.). FAU - Lamy, Andre AU - Lamy A AD - The Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, ON, Canada. lamya@mcmaster.ca FAU - Devereaux, P J AU - Devereaux PJ FAU - Prabhakaran, Dorairaj AU - Prabhakaran D FAU - Taggart, David P AU - Taggart DP FAU - Hu, Shengshou AU - Hu S FAU - Paolasso, Ernesto AU - Paolasso E FAU - Straka, Zbynek AU - Straka Z FAU - Piegas, Leopoldo S AU - Piegas LS FAU - Akar, Ahmet Ruchan AU - Akar AR FAU - Jain, Anil R AU - Jain AR FAU - Noiseux, Nicolas AU - Noiseux N FAU - Padmanabhan, Chandrasekar AU - Padmanabhan C FAU - Bahamondes, Juan-Carlos AU - Bahamondes JC FAU - Novick, Richard J AU - Novick RJ FAU - Vaijyanath, Prashant AU - Vaijyanath P FAU - Reddy, Sukesh Kumar AU - Reddy SK FAU - Tao, Liang AU - Tao L FAU - Olavegogeascoechea, Pablo A AU - Olavegogeascoechea PA FAU - Airan, Balram AU - Airan B FAU - Sulling, Toomas-Andres AU - Sulling TA FAU - Whitlock, Richard P AU - Whitlock RP FAU - Ou, Yongning AU - Ou Y FAU - Pogue, Janice AU - Pogue J FAU - Chrolavicius, Susan AU - Chrolavicius S FAU - Yusuf, Salim AU - Yusuf S CN - CORONARY Investigators LA - eng SI - ClinicalTrials.gov/NCT00463294 GR - Canadian Institutes of Health Research/Canada PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20130311 PL - United States TA - N Engl J Med JT - The New England journal of medicine JID - 0255562 SB - IM CIN - N Engl J Med. 2013 Mar 28;368(13):1247-8. doi: 10.1056/NEJMe1302717. PMID: 23534564 CIN - N Engl J Med. 2013 Jul 11;369(2):196. doi: 10.1056/NEJMc1306329. PMID: 23841737 CIN - N Engl J Med. 2013 Jul 11;369(2):194. doi: 10.1056/NEJMc1306329. PMID: 23841738 CIN - N Engl J Med. 2013 Jul 11;369(2):195-6. doi: 10.1056/NEJMc1306329. PMID: 23841742 MH - Aged MH - Coronary Artery Bypass/*methods MH - *Coronary Artery Bypass, Off-Pump MH - Coronary Artery Disease/mortality/*surgery MH - Female MH - Follow-Up Studies MH - Humans MH - Kaplan-Meier Estimate MH - Male MH - Myocardial Infarction/etiology MH - Postoperative Complications MH - Proportional Hazards Models MH - Quality of Life MH - Renal Insufficiency/etiology MH - Reoperation/statistics & numerical data MH - Stroke/etiology FIR - Yusuf, S IR - Yusuf S FIR - Taggart, D P IR - Taggart DP FIR - Lamy, A IR - Lamy A FIR - Akar, A R IR - Akar AR FIR - Avezum, A IR - Avezum A FIR - Cartier, R IR - Cartier R FIR - Chocron, S IR - Chocron S FIR - Chrolavicius, S IR - Chrolavicius S FIR - Devereaux, P J IR - Devereaux P FIR - Dorairaj, P IR - Dorairaj P FIR - Fremes, S E IR - Fremes SE FIR - Hu, S IR - Hu S FIR - Lanas, F IR - Lanas F FIR - Lopez, P J IR - Lopez PJ FIR - Martinelli, L IR - Martinelli L FIR - Murkin, J IR - Murkin J FIR - Novick, R J IR - Novick RJ FIR - Paolasso, E IR - Paolasso E FIR - Piegas, L IR - Piegas L FIR - Straka, Z IR - Straka Z FIR - Cairns, J A IR - Cairns JA FIR - Dagenais, F IR - Dagenais F FIR - Follmann, D IR - Follmann D FIR - Nathan, H J IR - Nathan HJ FIR - Silver, F L IR - Silver FL FIR - Avezum, A IR - Avezum A FIR - Botto, F IR - Botto F FIR - Dyub, A IR - Dyub A FIR - Fodor, G IR - Fodor G FIR - Healey, J IR - Healey J FIR - Jolly, S IR - Jolly S FIR - Lawrence, M IR - Lawrence M FIR - Lurati, G IR - Lurati G FIR - Malikov, K IR - Malikov K FIR - Morillo, C IR - Morillo C FIR - Chrolavicius, S IR - Chrolavicius S FIR - Ou, Y IR - Ou Y FIR - Jedrzejowski, B IR - Jedrzejowski B FIR - Lawrence, M IR - Lawrence M FIR - Floyd, L IR - Floyd L FIR - Manojlovic, R IR - Manojlovic R FIR - Ng, J IR - Ng J FIR - Pasadyn, E IR - Pasadyn E FIR - Pogue, J IR - Pogue J FIR - Robinson, L IR - Robinson L FIR - Vincent, J IR - Vincent J FIR - Lamy, A IR - Lamy A FIR - Devereaux, P J IR - Devereaux PJ FIR - Whitlock, R IR - Whitlock R FIR - Yusuf, S IR - Yusuf S FIR - Abud, J A IR - Abud JA FIR - Aventin, G IR - Aventin G FIR - Cacheda, H IR - Cacheda H FIR - Casal, J P IR - Casal JP FIR - Collantes, J A IR - Collantes JA FIR - Escarain, M C IR - Escarain MC FIR - Favaloro, R R IR - Favaloro RR FIR - Ferrara, W D IR - Ferrara WD FIR - Giner, P E IR - Giner PE FIR - Girela, A G IR - Girela AG FIR - Olavegogeascoechea, P A IR - Olavegogeascoechea PA FIR - Quiroga, J M IR - Quiroga JM FIR - Raffaelli, H A IR - Raffaelli HA FIR - Valenzuela, G IR - Valenzuela G FIR - Bannon, P G IR - Bannon PG FIR - Vallely, M P IR - Vallely MP FIR - Barros, R T IR - Barros RT FIR - Braile, D M IR - Braile DM FIR - Buffolo, E IR - Buffolo E FIR - Chamlian, E G IR - Chamlian EG FIR - Costa, F D A IR - Costa FD FIR - de Cunha Sales, M IR - de Cunha Sales M FIR - de Oliveira, B C IR - de Oliveira BC FIR - de Oliveira, J B P IR - de Oliveira JB FIR - de Rueda, F IR - de Rueda F FIR - de Sousa, L C B IR - de Sousa LC FIR - Farsky, P IR - Farsky P FIR - Ferreira, A D de A IR - Ferreira AD FIR - Frota, J D IR - Frota JD FIR - Groppo Stolf, N A IR - Groppo Stolf NA FIR - Guilhen, J C S IR - Guilhen JC FIR - Hueb, A C IR - Hueb AC FIR - Hueb, W IR - Hueb W FIR - Issa, M IR - Issa M FIR - Jatene, F B IR - Jatene FB FIR - Leal, J C IR - Leal JC FIR - Lima, R IR - Lima R FIR - Lucchese, F A IR - Lucchese FA FIR - Moraes, C IR - Moraes C FIR - Moraes, F IR - Moraes F FIR - Muzio, H IR - Muzio H FIR - Oliveira Freitas, A C IR - Oliveira Freitas AC FIR - Penna, A C IR - Penna AC FIR - Pires, A C IR - Pires AC FIR - Rivetti, L A IR - Rivetti LA FIR - Rosler, A M IR - Rosler AM FIR - Seixas, L E V C IR - Seixas LE FIR - Vila Nova, D C IR - Vila Nova DC FIR - Smith, P IR - Smith P FIR - Basile, F IR - Basile F FIR - Cartier, R IR - Cartier R FIR - Cheung, A W-C IR - Cheung AW FIR - Cusimano, R J IR - Cusimano RJ FIR - Dyub, A IR - Dyub A FIR - Esmaeili, N IR - Esmaeili N FIR - Fox, S A IR - Fox SA FIR - Fremes, S E IR - Fremes SE FIR - Greentree, D M IR - Greentree DM FIR - Guo, L IR - Guo L FIR - Kiaii, B IR - Kiaii B FIR - Kieser, T M IR - Kieser TM FIR - Lamy, A IR - Lamy A FIR - Moussa, F IR - Moussa F FIR - Noiseux, N IR - Noiseux N FIR - Normandin, L IR - Normandin L FIR - Novick, R J IR - Novick RJ FIR - Perrault, L P IR - Perrault LP FIR - Prieto, I IR - Prieto I FIR - Rizzo, T IR - Rizzo T FIR - Stevens, L M IR - Stevens LM FIR - Toito, F IR - Toito F FIR - Yau, T M IR - Yau TM FIR - Ye, J IR - Ye J FIR - Bahamondes, J C IR - Bahamondes JC FIR - Merino, G H IR - Merino GH FIR - Salman, J A IR - Salman JA FIR - Silva, A A IR - Silva AA FIR - Villavicencio, M A IR - Villavicencio MA FIR - An, X IR - An X FIR - Chen, X IR - Chen X FIR - Chen, X IR - Chen X FIR - Gao, C IR - Gao C FIR - Gu, S IR - Gu S FIR - Gu, T IR - Gu T FIR - Hu, S IR - Hu S FIR - Kong, Y IR - Kong Y FIR - Lai, H IR - Lai H FIR - Liu, Y IR - Liu Y FIR - Meng, X IR - Meng X FIR - Pan, X IR - Pan X FIR - Su, P IR - Su P FIR - Sun, X IR - Sun X FIR - Tang, H IR - Tang H FIR - Tao, L IR - Tao L FIR - Wang, C IR - Wang C FIR - Wang, C IR - Wang C FIR - Wang, L IR - Wang L FIR - Wang, R IR - Wang R FIR - Wang, W IR - Wang W FIR - Wang, Y IR - Wang Y FIR - Wu, Y IR - Wu Y FIR - Xia, L IR - Xia L FIR - Xu, M IR - Xu M FIR - Xue, S IR - Xue S FIR - Yang, J IR - Yang J FIR - Yi, D IR - Yi D FIR - Yu, H IR - Yu H FIR - Zhang, H IR - Zhang H FIR - Zhao, Q IR - Zhao Q FIR - Zheng, Z IR - Zheng Z FIR - Zhou, H IR - Zhou H FIR - Zhou, X IR - Zhou X FIR - Borrero, A J IR - Borrero AJ FIR - Cadavid, E A IR - Cadavid EA FIR - Castillo, V R IR - Castillo VR FIR - Chalela, T IR - Chalela T FIR - Figueredo, A IR - Figueredo A FIR - Machuca, A S IR - Machuca AS FIR - Sandoval, N F IR - Sandoval NF FIR - Brat, R IR - Brat R FIR - Danek, T IR - Danek T FIR - Harrer, J IR - Harrer J FIR - Hlavicka, J IR - Hlavicka J FIR - Holubcova, Z IR - Holubcova Z FIR - Holubec, T IR - Holubec T FIR - Jelinek, S IR - Jelinek S FIR - Mikulenka, V IR - Mikulenka V FIR - Setina, M IR - Setina M FIR - Straka, Z IR - Straka Z FIR - Vanek, T IR - Vanek T FIR - Vik, K IR - Vik K FIR - Zacek, P IR - Zacek P FIR - Alver, M IR - Alver M FIR - Sulling, T A IR - Sulling TA FIR - Vahi, H IR - Vahi H FIR - Chocron, S IR - Chocron S FIR - Kaili, D IR - Kaili D FIR - Agarwal, S K IR - Agarwal SK FIR - Airan, B IR - Airan B FIR - Arunachalam, K V IR - Arunachalam KV FIR - Ayapati, D R IR - Ayapati DR FIR - Choudhary, S K IR - Choudhary SK FIR - Ganesh, S B IR - Ganesh SB FIR - Gokhale, A G IR - Gokhale AG FIR - Gupta, V M IR - Gupta VM FIR - Hote, M P IR - Hote MP FIR - Jain, A R IR - Jain AR FIR - Kaul, U IR - Kaul U FIR - Kumar, S IR - Kumar S FIR - Malipeddi, B R IR - Malipeddi BR FIR - Mallya, B S IR - Mallya BS FIR - Mishra, Y K IR - Mishra YK FIR - Modi, R V IR - Modi RV FIR - Mohammed, A P IR - Mohammed AP FIR - Nair, S K IR - Nair SK FIR - Padhy, K IR - Padhy K FIR - Padmanabhan, C IR - Padmanabhan C FIR - Pande, S IR - Pande S FIR - Podduturi Naveen, C R IR - Podduturi Naveen CR FIR - Ponangi, S V IR - Ponangi SV FIR - Reddy, S K IR - Reddy SK FIR - Sinha, N IR - Sinha N FIR - Srinivasan, M IR - Srinivasan M FIR - Sundar, A IR - Sundar A FIR - Thomas, M S IR - Thomas MS FIR - Vaijyanath, P IR - Vaijyanath P FIR - Vettath, M P IR - Vettath MP FIR - Kavita IR - Kavita FIR - Agostini, M IR - Agostini M FIR - Di Gregorio, V IR - Di Gregorio V FIR - Martinelli, L IR - Martinelli L FIR - Pelenghi, S IR - Pelenghi S FIR - Bentala, M IR - Bentala M FIR - Arbeus, M J IR - Arbeus MJ FIR - De Souza, D R IR - De Souza DR FIR - Akar, A R IR - Akar AR FIR - Aykut Aka, S IR - Aykut Aka S FIR - Baran, C IR - Baran C FIR - Durdu, S IR - Durdu S FIR - Hidiroglu, M IR - Hidiroglu M FIR - Kahraman, D IR - Kahraman D FIR - Kaya, K IR - Kaya K FIR - Sener, E IR - Sener E FIR - Sinci, V IR - Sinci V FIR - Zaim, C IR - Zaim C FIR - Gogayeva, O IR - Gogayeva O FIR - Rudenko, A IR - Rudenko A FIR - Birdi, I IR - Birdi I FIR - Lloyd, S IR - Lloyd S FIR - Ritchie, A J IR - Ritchie AJ FIR - Taggart, D P IR - Taggart DP FIR - Zamvar, V IR - Zamvar V FIR - Chafes, D IR - Chafes D FIR - Montana, O IR - Montana O FIR - Huang, K F IR - Huang KF FIR - Parvathaneni, S V IR - Parvathaneni SV FIR - Tourville, R L IR - Tourville RL EDAT- 2013/03/13 06:00 MHDA- 2013/04/05 06:00 CRDT- 2013/03/13 06:00 PHST- 2013/03/13 06:00 [entrez] PHST- 2013/03/13 06:00 [pubmed] PHST- 2013/04/05 06:00 [medline] AID - 10.1056/NEJMoa1301228 [doi] PST - ppublish SO - N Engl J Med. 2013 Mar 28;368(13):1179-88. doi: 10.1056/NEJMoa1301228. Epub 2013 Mar 11. PMID- 23477657 OWN - NLM STAT- MEDLINE DCOM- 20130404 LR - 20260518 IS - 1533-4406 (Electronic) IS - 0028-4793 (Linking) VI - 368 IP - 13 DP - 2013 Mar 28 TI - Off-pump versus on-pump coronary-artery bypass grafting in elderly patients. PG - 1189-98 LID - 10.1056/NEJMoa1211666 [doi] AB - BACKGROUND: The benefits of coronary-artery bypass grafting (CABG) without cardiopulmonary bypass in the elderly are still undetermined. METHODS: We randomly assigned patients 75 years of age or older who were scheduled for elective first-time CABG to undergo the procedure either without cardiopulmonary bypass (off-pump CABG) or with it (on-pump CABG). The primary end point was a composite of death, stroke, myocardial infarction, repeat revascularization, or new renal-replacement therapy at 30 days and at 12 months after surgery. RESULTS: A total of 2539 patients underwent randomization. At 30 days after surgery, there was no significant difference between patients who underwent off-pump surgery and those who underwent on-pump surgery in terms of the composite outcome (7.8% vs. 8.2%; odds ratio, 0.95; 95% confidence interval [CI], 0.71 to 1.28; P=0.74) or four of the components (death, stroke, myocardial infarction, or new renal-replacement therapy). Repeat revascularization occurred more frequently after off-pump CABG than after on-pump CABG (1.3% vs. 0.4%; odds ratio, 2.42; 95% CI, 1.03 to 5.72; P=0.04). At 12 months, there was no significant between-group difference in the composite end point (13.1% vs. 14.0%; hazard ratio, 0.93; 95% CI, 0.76 to 1.16; P=0.48) or in any of the individual components. Similar results were obtained in a per-protocol analysis that excluded the 177 patients who crossed over from the assigned treatment to the other treatment. CONCLUSIONS: In patients 75 years of age or older, there was no significant difference between on-pump and off-pump CABG with regard to the composite outcome of death, stroke, myocardial infarction, repeat revascularization, or new renal-replacement therapy within 30 days and within 12 months after surgery. (Funded by Maquet; GOPCABE ClinicalTrials.gov number, NCT00719667.). FAU - Diegeler, Anno AU - Diegeler A AD - Herz- und Gefass-Klinik Bad Neustadt, Bad Neustadt, Germany. cachir@herzchirurgie.de FAU - Borgermann, Jochen AU - Borgermann J FAU - Kappert, Utz AU - Kappert U FAU - Breuer, Martin AU - Breuer M FAU - Boning, Andreas AU - Boning A FAU - Ursulescu, Adrian AU - Ursulescu A FAU - Rastan, Ardawan AU - Rastan A FAU - Holzhey, David AU - Holzhey D FAU - Treede, Hendrik AU - Treede H FAU - Riess, Friedrich-Christian AU - Riess FC FAU - Veeckmann, Philippe AU - Veeckmann P FAU - Asfoor, Amjad AU - Asfoor A FAU - Reents, Wilko AU - Reents W FAU - Zacher, Michael AU - Zacher M FAU - Hilker, Michael AU - Hilker M CN - GOPCABE Study Group LA - eng SI - ClinicalTrials.gov/NCT00719667 PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20130311 PL - United States TA - N Engl J Med JT - The New England journal of medicine JID - 0255562 SB - IM CIN - N Engl J Med. 2013 Mar 28;368(13):1247-8. doi: 10.1056/NEJMe1302717. PMID: 23534564 CIN - N Engl J Med. 2013 Jul 11;369(2):194. doi: 10.1056/NEJMc1306329. PMID: 23841739 CIN - N Engl J Med. 2013 Jul 11;369(2):194-5. doi: 10.1056/NEJMc1306329. PMID: 23841740 CIN - N Engl J Med. 2013 Jul 11;369(2):195. doi: 10.1056/NEJMc1306329. PMID: 23841741 CIN - N Engl J Med. 2013 Jul 11;369(2):195-6. doi: 10.1056/NEJMc1306329. PMID: 23841742 CIN - N Engl J Med. 2013 Jul 11;369(2):196-7. doi: 10.1056/NEJMc1306329. PMID: 23847788 MH - Aged MH - Aged, 80 and over MH - Coronary Artery Bypass/*methods MH - *Coronary Artery Bypass, Off-Pump MH - Coronary Artery Disease/mortality/*surgery MH - Female MH - Follow-Up Studies MH - Humans MH - Intention to Treat Analysis MH - Kaplan-Meier Estimate MH - Male MH - Myocardial Infarction/etiology MH - Postoperative Complications MH - Proportional Hazards Models MH - Quality of Life MH - Renal Insufficiency/etiology MH - Reoperation/statistics & numerical data MH - Stroke/etiology FIR - Diegeler, A IR - Diegeler A FIR - Hilker, M IR - Hilker M FIR - Krian, A IR - Krian A FIR - Birnbaum, D IR - Birnbaum D FIR - Fetsch, T IR - Fetsch T FIR - Brunn, E IR - Brunn E FIR - Zacher, M IR - Zacher M FIR - Boedeker, R H IR - Boedeker RH FIR - Diegeler, A IR - Diegeler A FIR - Dinstak, W IR - Dinstak W FIR - Friesewinkel, O IR - Friesewinkel O FIR - Klugl, S IR - Klugl S FIR - Reents, W IR - Reents W FIR - Rosada, B IR - Rosada B FIR - Borgermann, J IR - Borgermann J FIR - Gummert, J IR - Gummert J FIR - Hakim, K IR - Hakim K FIR - Hornik, L IR - Hornik L FIR - Mirow, N IR - Mirow N FIR - Alexiou, K IR - Alexiou K FIR - Brose, S IR - Brose S FIR - Kappert, U IR - Kappert U FIR - Matschke, K IR - Matschke K FIR - Plotze, K IR - Plotze K FIR - Tugetkin, S M IR - Tugetkin SM FIR - Hilker, M IR - Hilker M FIR - Kobuch, R IR - Kobuch R FIR - Rupprecht, L IR - Rupprecht L FIR - Schmid, C IR - Schmid C FIR - Bossert, T IR - Bossert T FIR - Breuer, M IR - Breuer M FIR - Doenst, T IR - Doenst T FIR - Farber, G IR - Farber G FIR - Hekmat, K IR - Hekmat K FIR - Boning, A IR - Boning A FIR - Coskun, O IR - Coskun O FIR - Roth, P IR - Roth P FIR - Albert, M IR - Albert M FIR - Blehm, A IR - Blehm A FIR - Franke, U F W IR - Franke UF FIR - Maedge, M IR - Maedge M FIR - Nagib, R IR - Nagib R FIR - Ursulescu, A IR - Ursulescu A FIR - Bakhtiary, F IR - Bakhtiary F FIR - Funkat, A K IR - Funkat AK FIR - Garbade, J IR - Garbade J FIR - Holzhey, D IR - Holzhey D FIR - Lehmann, S IR - Lehmann S FIR - Rastan, A IR - Rastan A FIR - Gulbins, H IR - Gulbins H FIR - Ismail, M IR - Ismail M FIR - Marcsek, P IR - Marcsek P FIR - Treede, H IR - Treede H FIR - Cramer, E IR - Cramer E FIR - Hansen, L IR - Hansen L FIR - Lehmann, C IR - Lehmann C FIR - Riess, F C IR - Riess FC FIR - Stripling, J IR - Stripling J FIR - Winkel, S IR - Winkel S FIR - Cakir, M IR - Cakir M FIR - Kiefer, R IR - Kiefer R FIR - Loew, J IR - Loew J FIR - Noak, F IR - Noak F FIR - Rose, F IR - Rose F FIR - Veeckman, P IR - Veeckman P FIR - Asfoor, A IR - Asfoor A FIR - Laczkovics, A IR - Laczkovics A FIR - Reber, D IR - Reber D EDAT- 2013/03/13 06:00 MHDA- 2013/04/05 06:00 CRDT- 2013/03/13 06:00 PHST- 2013/03/13 06:00 [entrez] PHST- 2013/03/13 06:00 [pubmed] PHST- 2013/04/05 06:00 [medline] AID - 10.1056/NEJMoa1211666 [doi] PST - ppublish SO - N Engl J Med. 2013 Mar 28;368(13):1189-98. doi: 10.1056/NEJMoa1211666. Epub 2013 Mar 11. PMID- 23453439 OWN - NLM STAT- MEDLINE DCOM- 20141222 LR - 20131014 IS - 1874-1754 (Electronic) IS - 0167-5273 (Linking) VI - 168 IP - 3 DP - 2013 Oct 3 TI - Long-term benefits and risks of drug-eluting compared to bare-metal stents in patients with versus without chronic kidney disease. PG - 2381-8 LID - S0167-5273(13)00317-3 [pii] LID - 10.1016/j.ijcard.2013.01.257 [doi] AB - AIMS: Chronic kidney disease (CKD) is associated with worse outcomes in patients with coronary artery disease (CAD). How CKD influences the benefit-risk balance of drug-eluting stents (DES) versus bare-metal stents (BMS) is less known. METHODS AND RESULTS: In the multicentre BASKET-PROVE trial, 2314 patients in need of large coronary stenting (>/= 3.0mm) were randomised 2:1 to DES or BMS. In an a priori planned secondary analysis, outcomes were evaluated according to renal function defined by estimated glomerular filtration rates (eGFR; normal: eGFR >/= 60 ml/min/1.73 m(2); CKD: eGFR<60 ml/min/1.73 m(2)). The primary endpoint was the first major adverse cardiac event (MACE: cardiac death, myocardial infarction, target vessel revascularisation) up to 2 years. A Cox proportional-hazard model was used to evaluate adjusted relative risks (hazard rates, HRs) for BMS versus DES. The interaction of stent type and renal function was tested. CKD patients (189 (11.2%)/1681 with such data) had a 2-year MACE rate of 8.5% versus 7.4% in those without CKD [HR 0.98 (0.56-1.72), p=0.95] with cardiac mortalities of 5.3% and 1.5%, respectively (p=0.002, non-significant after baseline adjustments). The MACE rate was lower in CKD patients with DES than with BMS [4.9% versus 15.2%, p=0.017, HR 0.29(0.10-0.80)] as was the MACE rate in patients without CKD [5.6% with DES versus 11.1% with BMS, p<0.0001, HR 0.51(0.35-0.75)]. No significant interaction between stent type and renal function was found. CONCLUSIONS: This analysis of patients needing large coronary artery stenting confirms the increased mortality of CKD patients and documents a long-term benefit of DES compared to BMS irrespective of kidney function. CI - Copyright (c) 2013 Elsevier Ireland Ltd. All rights reserved. FAU - Wanitschek, Maria AU - Wanitschek M AD - Department of Cardiology, Innsbruck Medical University, Austria. FAU - Pfisterer, Matthias AU - Pfisterer M FAU - Hvelplund, Anders AU - Hvelplund A FAU - De Servi, Stefano AU - De Servi S FAU - Bertel, Osmund AU - Bertel O FAU - Jeger, Raban AU - Jeger R FAU - Rickenbacher, Peter AU - Rickenbacher P FAU - Iversen, Allan AU - Iversen A FAU - Jensen, Jan Skov AU - Jensen JS FAU - Galatius, Soeren AU - Galatius S FAU - Kaiser, Christoph AU - Kaiser C FAU - Alber, Hannes AU - Alber H CN - BASKET-PROVE Investigators LA - eng SI - ISRCTN/ISRCTN72444640 PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial DEP - 20130227 PL - Netherlands TA - Int J Cardiol JT - International journal of cardiology JID - 8200291 SB - IM MH - Aged MH - Coronary Artery Disease/*complications/*surgery MH - *Drug-Eluting Stents MH - Female MH - Humans MH - Male MH - Middle Aged MH - Prospective Studies MH - Prosthesis Design MH - Renal Insufficiency, Chronic/*complications MH - Risk Assessment MH - Risk Factors MH - Stents MH - Time Factors OTO - NOTNLM OT - Bare metal stent OT - Chronic kidney disease OT - Coronary artery disease OT - Drug eluting stent OT - Large coronary artery stenting OT - MACE rates EDAT- 2013/03/05 06:00 MHDA- 2014/12/23 06:00 CRDT- 2013/03/05 06:00 PHST- 2012/08/22 00:00 [received] PHST- 2013/01/21 00:00 [accepted] PHST- 2013/03/05 06:00 [entrez] PHST- 2013/03/05 06:00 [pubmed] PHST- 2014/12/23 06:00 [medline] AID - S0167-5273(13)00317-3 [pii] AID - 10.1016/j.ijcard.2013.01.257 [doi] PST - ppublish SO - Int J Cardiol. 2013 Oct 3;168(3):2381-8. doi: 10.1016/j.ijcard.2013.01.257. Epub 2013 Feb 27. PMID- 23439103 OWN - NLM STAT- MEDLINE DCOM- 20130408 LR - 20220705 IS - 1474-547X (Electronic) IS - 0140-6736 (Linking) VI - 381 IP - 9867 DP - 2013 Feb 23 TI - Anatomical and clinical characteristics to guide decision making between coronary artery bypass surgery and percutaneous coronary intervention for individual patients: development and validation of SYNTAX score II. PG - 639-50 LID - S0140-6736(13)60108-7 [pii] LID - 10.1016/S0140-6736(13)60108-7 [doi] AB - BACKGROUND: The anatomical SYNTAX score is advocated in European and US guidelines as an instrument to help clinicians decide the optimum revascularisation method in patients with complex coronary artery disease. The absence of an individualised approach and of clinical variables to guide decision making between coronary artery bypass graft surgery (CABG) and percutaneous coronary intervention (PCI) are limitations of the SYNTAX score. SYNTAX score II aimed to overcome these limitations. METHODS: SYNTAX score II was developed by applying a Cox proportional hazards model to results of the randomised all comers SYNTAX trial (n=1800). Baseline features with strong associations to 4-year mortality in either the CABG or the PCI settings (interactions), or in both (predictive accuracy), were added to the anatomical SYNTAX score. Comparisons of 4-year mortality predictions between CABG and PCI were made for each patient. Discriminatory performance was quantified by concordance statistics and internally validated with bootstrap resampling. External validation was done in the multinational all comers DELTA registry (n=2891), a heterogeneous population that included patients with three-vessel disease (26%) or complex coronary artery disease (anatomical SYNTAX score >/=33, 30%) who underwent CABG or PCI. The SYNTAX trial is registered with ClinicalTrials.gov, number NCT00114972. FINDINGS: SYNTAX score II contained eight predictors: anatomical SYNTAX score, age, creatinine clearance, left ventricular ejection fraction (LVEF), presence of unprotected left main coronary artery (ULMCA) disease, peripheral vascular disease, female sex, and chronic obstructive pulmonary disease (COPD). SYNTAX score II significantly predicted a difference in 4-year mortality between patients undergoing CABG and those undergoing PCI (p(interaction) 0.0037). To achieve similar 4-year mortality after CABG or PCI, younger patients, women, and patients with reduced LVEF required lower anatomical SYNTAX scores, whereas older patients, patients with ULMCA disease, and those with COPD, required higher anatomical SYNTAX scores. Presence of diabetes was not important for decision making between CABG and PCI (p(interaction) 0.67). SYNTAX score II discriminated well in all patients who underwent CABG or PCI, with concordance indices for internal (SYNTAX trial) validation of 0.725 and for external (DELTA registry) validation of 0.716, which were substantially higher than for the anatomical SYNTAX score alone (concordance indices of 0.567 and 0.612, respectively). A nomogram was constructed that allowed for an accurate individualised prediction of 4-year mortality in patients proposing to undergo CABG or PCI. INTERPRETATION: Long-term (4-year) mortality in patients with complex coronary artery disease can be well predicted by a combination of anatomical and clinical factors in SYNTAX score II. SYNTAX score II can better guide decision making between CABG and PCI than the original anatomical SYNTAX score. FUNDING: Boston Scientific Corporation. CI - Copyright (c) 2013 Elsevier Ltd. All rights reserved. FAU - Farooq, Vasim AU - Farooq V AD - Thoraxcenter, Erasmus University Medical Center, Rotterdam, Netherlands. FAU - van Klaveren, David AU - van Klaveren D FAU - Steyerberg, Ewout W AU - Steyerberg EW FAU - Meliga, Emanuele AU - Meliga E FAU - Vergouwe, Yvonne AU - Vergouwe Y FAU - Chieffo, Alaide AU - Chieffo A FAU - Kappetein, Arie Pieter AU - Kappetein AP FAU - Colombo, Antonio AU - Colombo A FAU - Holmes, David R Jr AU - Holmes DR Jr FAU - Mack, Michael AU - Mack M FAU - Feldman, Ted AU - Feldman T FAU - Morice, Marie-Claude AU - Morice MC FAU - Stahle, Elisabeth AU - Stahle E FAU - Onuma, Yoshinobu AU - Onuma Y FAU - Morel, Marie-angele AU - Morel MA FAU - Garcia-Garcia, Hector M AU - Garcia-Garcia HM FAU - van Es, Gerrit Anne AU - van Es GA FAU - Dawkins, Keith D AU - Dawkins KD FAU - Mohr, Friedrich W AU - Mohr FW FAU - Serruys, Patrick W AU - Serruys PW LA - eng SI - ClinicalTrials.gov/NCT00114972 PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Validation Study PL - England TA - Lancet JT - Lancet (London, England) JID - 2985213R RN - AYI8EX34EU (Creatinine) SB - IM CIN - Lancet. 2013 Feb 23;381(9867):605-7. doi: 10.1016/S0140-6736(13)60258-5. PMID: 23439089 CIN - Lancet. 2013 Jun 1;381(9881):1899-900. doi: 10.1016/S0140-6736(13)61152-6. PMID: 23725720 CIN - Lancet. 2013 Jun 1;381(9881):1899. doi: 10.1016/S0140-6736(13)61151-4. PMID: 23725721 CIN - Ann Intern Med. 2013 Jul 16;159(2):JC5. doi: 10.7326/0003-4819-159-2-201307160-02005. PMID: 23856703 MH - Age Factors MH - *Angioplasty, Balloon, Coronary MH - *Coronary Artery Bypass MH - Coronary Artery Disease/*mortality/*therapy MH - Creatinine/analysis MH - *Decision Making MH - Female MH - Humans MH - Male MH - Patient Selection MH - Peripheral Vascular Diseases/epidemiology MH - Predictive Value of Tests MH - Proportional Hazards Models MH - Pulmonary Disease, Chronic Obstructive/epidemiology MH - Randomized Controlled Trials as Topic MH - *Risk Assessment MH - Stroke Volume EDAT- 2013/02/27 06:00 MHDA- 2013/04/09 06:00 CRDT- 2013/02/27 06:00 PHST- 2013/02/27 06:00 [entrez] PHST- 2013/02/27 06:00 [pubmed] PHST- 2013/04/09 06:00 [medline] AID - S0140-6736(13)60108-7 [pii] AID - 10.1016/S0140-6736(13)60108-7 [doi] PST - ppublish SO - Lancet. 2013 Feb 23;381(9867):639-50. doi: 10.1016/S0140-6736(13)60108-7. PMID- 23425539 OWN - NLM STAT- MEDLINE DCOM- 20130813 LR - 20130221 IS - 1969-6213 (Electronic) IS - 1774-024X (Linking) VI - 8 IP - 10 DP - 2013 Feb 22 TI - Adverse event rates following primary PCI for STEMI at US and non-US hospitals: three-year analysis from the HORIZONS-AMI trial. PG - 1134-42 LID - EIJV8I10A176 [pii] LID - 10.4244/EIJV8I10A176 [doi] AB - AIMS: To examine outcomes in patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI) at US sites versus sites outside the US (OUS). METHODS AND RESULTS: In the HORIZONS-AMI trial 3,602 STEMI patients in 11 countries were randomised to primary PCI with bivalirudin versus heparin + glycoprotein IIb/IIIa inhibitors. US patients (n=814) had more diabetes, prior infarction, prior bypass surgery, and renal insufficiency. OUS patients (n=2,788) had longer door-to-balloon times, more radial access, fewer bypass surgeries, and were discharged more often on beta-blockers and statins. At three years US patients had higher mortality (9.7% vs. 6.0%, p=0.0003), reinfarction (10.2% vs. 6.4%, p=0.001), major adverse cardiac events (MACE; 28.2% vs. 20.1%, p<0.0001), major bleeding (16.9% vs. 6.4%, p<0.0001) and net adverse clinical events (NACE; 36.6% vs. 23.8%, p<0.0001), which persisted after adjusting for baseline risk. CONCLUSIONS: In the HORIZONS-AMI trial, STEMI patients undergoing primary PCI at US versus OUS sites had higher rates of adverse events, which persisted after adjusting for baseline risk. The reasons for these differences are not clear but may be due to unmeasured confounders, different thresholds for event reporting, or valid differences in systems of care and treatments. FAU - Tobbia, Patrick AU - Tobbia P AD - LeBauer Cardiovascular Research Foundation and Moses Cone Hospital, Greensboro, NC 27408, USA. FAU - Brodie, Bruce R AU - Brodie BR FAU - Witzenbichler, Bernhard AU - Witzenbichler B FAU - Metzger, Chris AU - Metzger C FAU - Guagliumi, Giulio AU - Guagliumi G FAU - Yu, Jennifer AU - Yu J FAU - Kellett, Mirle A AU - Kellett MA FAU - Stuckey, Thomas AU - Stuckey T FAU - Fahy, Martin AU - Fahy M FAU - Mehran, Roxana AU - Mehran R FAU - Stone, Gregg W AU - Stone GW LA - eng SI - ClinicalTrials.gov/NCT00433966 PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - France TA - EuroIntervention JT - EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology JID - 101251040 SB - IM CIN - EuroIntervention. 2013 Feb 22;8(10):1115-7. doi: 10.4244/EIJV8I10A172. PMID: 23425535 MH - Aged MH - Electrocardiography MH - Female MH - Humans MH - Male MH - Middle Aged MH - Myocardial Infarction/mortality/*therapy MH - Percutaneous Coronary Intervention/*adverse effects EDAT- 2013/02/22 06:00 MHDA- 2013/08/14 06:00 CRDT- 2013/02/22 06:00 PHST- 2013/02/22 06:00 [entrez] PHST- 2013/02/22 06:00 [pubmed] PHST- 2013/08/14 06:00 [medline] AID - EIJV8I10A176 [pii] AID - 10.4244/EIJV8I10A176 [doi] PST - ppublish SO - EuroIntervention. 2013 Feb 22;8(10):1134-42. doi: 10.4244/EIJV8I10A176. PMID- 23423270 OWN - NLM STAT- MEDLINE DCOM- 20130410 LR - 20260128 IS - 1534-6080 (Electronic) IS - 0041-1337 (Linking) VI - 95 IP - 4 DP - 2013 Feb 27 TI - Ten-year results of a randomized trial comparing tacrolimus versus cyclosporine a in combination with mycophenolate mofetil after heart transplantation. PG - 629-34 LID - 10.1097/TP.0b013e318277e378 [doi] AB - BACKGROUND: Long-term results of prospective randomized trials comparing triple immunosuppressive strategies combining tacrolimus (TAC) or cyclosporine A (CsA) with mycophenolate mofetil (MMF) and steroids after heart transplantation (HTX) are rarely published. Therefore, we collected long-term follow-up data of an intervention cohort 10 years after randomization. METHODS: Ten-year follow-up data of 60 patients included in a prospective, randomized trial between 1998 and 2000 were analyzed as intention-to-treat (TAC-MMF n=30; CsA-MMF n=30). Baseline characteristics were well balanced. Cardiac allograft vasculopathy (CAV) was graduated in accordance with the new ISHLT classification. RESULTS: Survival at 1, 5, and 10 years was 96.7%, 80.0%, and 66.7% for TAC-MMF and 90.0%, 83.3%, and 80.0% for CsA-MMF (P=ns). Freedom from acute rejection (AR) was significantly higher in TAC-MMF versus CsA-MMF (65.5% vs. 21.7%, log-rank 8.3, P=0.004). Freedom from ISHLT>/=CAV1 after 5 and 10 years was in TAC-MMF 64.0% and 45.8%, and in CsA-MMF 36.0% (log-rank 3.0, P=0.085) and 8.0% (log-rank 9.0, P=0.003). No difference in long-term results for freedom from coronary angioplasty or stenting, renal dysfunction, diabetes mellitus, CMV infection, or malignancy was detected. CONCLUSION: Cross-over effects because of treatment switch may result in impairment of significance between the groups. The long-term analysis resulted in a significant difference in manifestation of CAV between the groups after 10 years. Less rejection in the TAC-group might have contributed to the lower incidence of CAV. Superior freedom from AR and CAV in the TAC-MMF group did not result in better long-term survival. FAU - Guethoff, Sonja AU - Guethoff S AD - DepDepartment of Cardiac Surgery, University of Munich, Marchioninistr. 15, 81377 Munchen, Germany. Sonja.Guethoff@med.uni-muenchen.de FAU - Meiser, Bruno M AU - Meiser BM FAU - Groetzner, Jan AU - Groetzner J FAU - Eifert, Sandra AU - Eifert S FAU - Grinninger, Carola AU - Grinninger C FAU - Ueberfuhr, Peter AU - Ueberfuhr P FAU - Reichart, Bruno AU - Reichart B FAU - Hagl, Christian AU - Hagl C FAU - Kaczmarek, Ingo AU - Kaczmarek I LA - eng PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - United States TA - Transplantation JT - Transplantation JID - 0132144 RN - 0 (Immunosuppressive Agents) RN - 83HN0GTJ6D (Cyclosporine) RN - HU9DX48N0T (Mycophenolic Acid) RN - WM0HAQ4WNM (Tacrolimus) SB - IM MH - Adult MH - Chi-Square Distribution MH - Coronary Artery Disease/etiology/therapy MH - Cyclosporine/adverse effects/blood/*therapeutic use MH - Drug Monitoring MH - Drug Therapy, Combination MH - Female MH - Germany MH - Graft Rejection/immunology/mortality/*prevention & control MH - Graft Survival/*drug effects MH - Heart Transplantation/adverse effects/*immunology/mortality MH - Humans MH - Immunosuppressive Agents/adverse effects/blood/*therapeutic use MH - Kaplan-Meier Estimate MH - Logistic Models MH - Male MH - Middle Aged MH - Mycophenolic Acid/adverse effects/*analogs & derivatives/blood/therapeutic use MH - Prospective Studies MH - Risk Factors MH - Tacrolimus/adverse effects/blood/*therapeutic use MH - Time Factors MH - Treatment Outcome MH - Young Adult EDAT- 2013/02/21 06:00 MHDA- 2013/04/11 06:00 CRDT- 2013/02/21 06:00 PHST- 2013/02/21 06:00 [entrez] PHST- 2013/02/21 06:00 [pubmed] PHST- 2013/04/11 06:00 [medline] AID - 00007890-201302270-00015 [pii] AID - 10.1097/TP.0b013e318277e378 [doi] PST - ppublish SO - Transplantation. 2013 Feb 27;95(4):629-34. doi: 10.1097/TP.0b013e318277e378. PMID- 23414904 OWN - NLM STAT- MEDLINE DCOM- 20131119 LR - 20220310 IS - 1916-7075 (Electronic) IS - 0828-282X (Linking) VI - 29 IP - 9 DP - 2013 Sep TI - Remote ischemic preconditioning reduces myocardial injury in patients undergoing coronary stent implantation. PG - 1084-9 LID - S0828-282X(12)01477-8 [pii] LID - 10.1016/j.cjca.2012.11.022 [doi] AB - BACKGROUND: Myocardial necrosis occurs frequently in elective percutaneous coronary intervention (PCI) and is associated with subsequent major adverse cardiovascular events (MACEs). This study assessed the protective effect of remote ischemic preconditioning (RIPC) in patients undergoing successful drug-eluting stent implantation with normal baseline troponin values. METHODS: We analyzed 205 participants with normal baseline troponin values undergoing successful coronary stent implantation. Subjects were randomized to 2 groups: The RIPC group (n = 101), whose members received RIPC (created by three 5-minute inflations of a pneumatic medical tourniquet cuff to 200 mm Hg around the upper arm, interspersed with 5-minute intervals of reperfusion) < 2 hours before the PCI procedure, and the control group (n = 104). RESULTS: The primary outcomes were high sensitive cardiac troponin I (hscTnI) levels and incidence of myocardial infarction (MI 4a, defined as hscTnI > 0.20 ng/mL) at 16 hours after the PCI procedure. The median hscTnI at 16 hours after PCI was lower in the RIPC group compared with the unpreconditioned, control group (0.11 vs 0.21 ng/mL; P < 0.01). The incidence of MI 4a was lower in the RIPC group compared with the control group (39% vs 54%, P < 0.05). Index of renal function showed no difference between the 2 groups at 16 hours after PCI (P > 0.05). CONCLUSION: RIPC reduced post-PCI TnI release and incidence of MI 4a in patients undergoing elective coronary stent implantation. CI - Copyright (c) 2013 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved. FAU - Luo, Sheng Jie AU - Luo SJ AD - Department of Cardiology, An Zhen Hospital, Capital Medical University, Beijing, China. FAU - Zhou, Yu Jie AU - Zhou YJ FAU - Shi, Dong Mei AU - Shi DM FAU - Ge, Hai Long AU - Ge HL FAU - Wang, Jian Long AU - Wang JL FAU - Liu, Rui Fang AU - Liu RF LA - eng PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20130212 PL - England TA - Can J Cardiol JT - The Canadian journal of cardiology JID - 8510280 RN - 0 (Troponin I) SB - IM MH - Aged MH - Case-Control Studies MH - Coronary Artery Disease/blood/*surgery MH - *Drug-Eluting Stents MH - Female MH - Humans MH - Incidence MH - Ischemic Preconditioning, Myocardial/*methods MH - Male MH - Middle Aged MH - Myocardial Infarction/epidemiology/*prevention & control MH - *Percutaneous Coronary Intervention MH - Troponin I/*blood EDAT- 2013/02/19 06:00 MHDA- 2013/11/20 06:00 CRDT- 2013/02/19 06:00 PHST- 2012/10/12 00:00 [received] PHST- 2012/11/03 00:00 [revised] PHST- 2012/11/17 00:00 [accepted] PHST- 2013/02/19 06:00 [entrez] PHST- 2013/02/19 06:00 [pubmed] PHST- 2013/11/20 06:00 [medline] AID - S0828-282X(12)01477-8 [pii] AID - 10.1016/j.cjca.2012.11.022 [doi] PST - ppublish SO - Can J Cardiol. 2013 Sep;29(9):1084-9. doi: 10.1016/j.cjca.2012.11.022. Epub 2013 Feb 12. PMID- 23411106 OWN - NLM STAT- MEDLINE DCOM- 20130618 LR - 20130429 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 111 IP - 9 DP - 2013 May 1 TI - Association among leukocyte count, mortality, and bleeding in patients with non-ST-segment elevation acute coronary syndromes (from the Acute Catheterization and Urgent Intervention Triage StrategY [ACUITY] trial). PG - 1237-45 LID - S0002-9149(13)00329-9 [pii] LID - 10.1016/j.amjcard.2012.12.056 [doi] AB - Although inflammation is involved in the pathogenesis of acute coronary syndromes, the extent of inflammation is not routinely assessed, and its prognostic implications in patients with non-ST-segment elevation acute coronary syndrome have not been investigated in depth. We analyzed the prognostic implications of an elevated white blood cell count (WBCc) in patients with moderate and high-risk non-ST-segment elevation acute coronary syndrome undergoing an early invasive strategy in the large-scale Acute Catheterization and Urgent Intervention Triage StrategY trial. The WBCc at admission was available for 13,678 of 13,819 patients (98.9%). The patients in the upper tertile of the WBCc had an increased risk of 30-day major bleeding, 1-year mortality, and definite/probable stent thrombosis compared to those in the mid or lower tertiles. On multivariate analysis, the WBCc was an independent predictor of 30-day major bleeding and 1-year cardiac, noncardiac, and all-cause mortality. The association between the WBCc and cardiac mortality was present in multiple prespecified subgroups, with no significant interaction between the WBCc and age, gender, diabetes, smoking, renal dysfunction, elevated baseline biomarkers, antithrombotic therapy, revascularization, and Thrombolysis In Myocardial Infarction risk score. The WBCc remained an independent predictor of mortality after adjusting for bleeding, C-reactive protein level, and angiographic variables, including left ventricular ejection fraction, Thrombolysis In Myocardial Infarction flow, and number of diseased vessels. The WBCc significantly improved the prognostic accuracy of the Thrombolysis In Myocardial Infarction risk score, with a net reclassification improvement of 11% (p <0.0001). In conclusion, in patients with moderate- and high-risk non-ST-segment elevation acute coronary syndrome, an elevated admission WBCc was an independent predictor of 30-day major bleeding, and 1-year cardiac, noncardiac, and all-cause mortality. CI - Copyright (c) 2013 Elsevier Inc. All rights reserved. FAU - Palmerini, Tullio AU - Palmerini T AD - Istituto di Cardiologia, Policlinico S. Orsola, Bologna, Italy. FAU - Genereux, Philippe AU - Genereux P FAU - Mehran, Roxana AU - Mehran R FAU - Dangas, George AU - Dangas G FAU - Caixeta, Adriano AU - Caixeta A FAU - Riva, Diego Della AU - Riva DD FAU - Mariani, Andrea AU - Mariani A FAU - Xu, Ke AU - Xu K FAU - Stone, Gregg W AU - Stone GW LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20130211 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 RN - 0 (Fibrinolytic Agents) SB - IM MH - Acute Coronary Syndrome/*diagnosis/mortality/therapy MH - Cardiac Catheterization/*methods MH - Coronary Angiography MH - Female MH - Fibrinolytic Agents/*adverse effects/therapeutic use MH - Follow-Up Studies MH - Hemorrhage/blood/*epidemiology/etiology MH - Humans MH - Incidence MH - Italy/epidemiology MH - Leukocyte Count MH - Male MH - Middle Aged MH - New York/epidemiology MH - Prognosis MH - Prospective Studies MH - Quebec/epidemiology MH - Risk Factors MH - Survival Rate/trends MH - Thrombolytic Therapy/*adverse effects/methods MH - Thrombosis/blood/mortality/*prevention & control MH - *Triage EDAT- 2013/02/16 06:00 MHDA- 2013/06/19 06:00 CRDT- 2013/02/16 06:00 PHST- 2012/10/31 00:00 [received] PHST- 2012/12/26 00:00 [revised] PHST- 2012/12/26 00:00 [accepted] PHST- 2013/02/16 06:00 [entrez] PHST- 2013/02/16 06:00 [pubmed] PHST- 2013/06/19 06:00 [medline] AID - S0002-9149(13)00329-9 [pii] AID - 10.1016/j.amjcard.2012.12.056 [doi] PST - ppublish SO - Am J Cardiol. 2013 May 1;111(9):1237-45. doi: 10.1016/j.amjcard.2012.12.056. Epub 2013 Feb 11. PMID- 23363669 OWN - NLM STAT- MEDLINE DCOM- 20131107 LR - 20181202 IS - 0253-3758 (Print) IS - 0253-3758 (Linking) VI - 40 IP - 11 DP - 2012 Nov TI - [Analysis of the risk factors of patients with acute coronary syndrome suffering hemorrhage during hospitalization]. PG - 902-7 AB - OBJECTIVE: To analyze the risk factors related to in-hospital bleeding for patients with acute coronary syndrome (ACS). METHODS: Clinical and therapeutic data of 3807 patients who were registered with acute coronary syndrome in SINO-GRACE in China from March 2001 to December 2007 were reviewed. A total of 57 patients were grouped to bleeding group and 234 out of the remaining 3750 patients without bleeding were randomly chosen and served as non-bleeding group. Hemorrhage-related factors were screened and compared between the two groups. Unitary logistic regression analysis was performed to detect the possible factors related to hemorrhage. Factors with P < 0.1 were further analyzed by stepwise regression method and multivariate conditional logistic regression analyses. RESULTS: (1) Age, history of coronary artery bypass graft (CABG), previous hemorrhage, renal failure and heart failure as well incidence of acute coronary syndrome were significantly higher in bleeding group than in non-bleeding group (all P 70 years, history of previous bleeding, renal failure, heart failure, clopidogrel and GP IIb/IIIa receptor antagonists use, non-ST-segment elevation myocardial infarction, inferior wall, lateral myocardial infarction, CABG were risk factors for bleeding (all P < 0.05). (3) Multivariate logistic regression analysis showed that history of renal failure (OR = 19.77, 95%CI 4.38 - 89.18, P < 0.01) and clopidogrel (OR = 19.77, 95%CI 4.38 - 89.18, P < 0.01) and GPIIb/IIIa receptor antagonist (OR = 343.57, 95%CI 40.39 - 999.99, P < 0.01) use were the independent risk factors for bleeding. CONCLUSION: Our results show that renal failure history and clopidogrel and GPIIb/IIIa receptor antagonist use are independent risk factors for in-hospital bleeding in patients with acute coronary syndrome. FAU - Liu, Xin AU - Liu X AD - Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China. FAU - Chen, Yun-dai AU - Chen YD FAU - Lu, Shu-zheng AU - Lu SZ FAU - Jin, Ze-ning AU - Jin ZN FAU - Liu, Hong AU - Liu H FAU - Song, Xian-tao AU - Song XT CN - China GRACE Investigation Group LA - chi PT - Journal Article PL - China TA - Zhonghua Xin Xue Guan Bing Za Zhi JT - Zhonghua xin xue guan bing za zhi JID - 7910682 RN - 0 (Platelet Glycoprotein GPIIb-IIIa Complex) RN - A74586SNO7 (Clopidogrel) RN - OM90ZUW7M1 (Ticlopidine) SB - IM MH - Acute Coronary Syndrome/*complications/pathology MH - Age of Onset MH - Aged MH - Clopidogrel MH - Female MH - Hemorrhage/*etiology MH - Hospitalization MH - Humans MH - Incidence MH - Logistic Models MH - Male MH - Middle Aged MH - Platelet Glycoprotein GPIIb-IIIa Complex/antagonists & inhibitors MH - Renal Insufficiency MH - Risk Factors MH - Ticlopidine/analogs & derivatives/therapeutic use EDAT- 2013/02/01 06:00 MHDA- 2013/11/08 06:00 CRDT- 2013/02/01 06:00 PHST- 2013/02/01 06:00 [entrez] PHST- 2013/02/01 06:00 [pubmed] PHST- 2013/11/08 06:00 [medline] PST - ppublish SO - Zhonghua Xin Xue Guan Bing Za Zhi. 2012 Nov;40(11):902-7. PMID- 23355629 OWN - NLM STAT- MEDLINE DCOM- 20140123 LR - 20260518 IS - 1460-2385 (Electronic) IS - 0931-0509 (Linking) VI - 28 IP - 6 DP - 2013 Jun TI - Effects of angiotensin receptor blockade (ARB) on mortality and cardiovascular outcomes in patients with long-term haemodialysis: a randomized controlled trial. PG - 1579-89 LID - 10.1093/ndt/gfs590 [doi] AB - BACKGROUND: Hypertension is a major risk factor for death and cardiovascular disease (CVD) in patients undergoing chronic haemodialysis (HD), but there is uncertainty surrounding the effects of blood pressure (BP) lowering on this high-risk patient group. METHODS: In a multicenter, prospective, randomized, open-label, blinded-endpoint trial, 469 patients with chronic HD and elevated BP (140-199/90-99 mmHg) were assigned to receive the angiotensin receptor blockade (ARB) olmesartan (at a dose of 10-40 mg daily; n = 235) or another treatment that does not include angiotensin receptor blockers and angiotensin-converting enzyme (ACE) inhibitors (n = 234). The primary outcomes were the following: (i) composite of death, nonfatal stroke, nonfatal myocardial infarction and coronary revascularization and (ii) all-cause death. RESULTS: During a mean follow-up of 3.5 years, the mean BP was 0.9/0.0 mmHg lower in the olmesartan group than in the control group (not significant). A total of 68 patients (28.9%) in the olmesartan group and 67 patients (28.6%) in the control group had subsequent primary composite endpoints [hazard ratio (HR) in the olmesartan group 1.00, 95% confidence interval (CI) 0.71-1.40, P = 0.99]. All-cause deaths occurred in 38 patients (16.2%) in the olmesartan group and 39 (16.7%) in the control group (HR, 0.97; 95% CI, 0.62-1.52, P = 0.91). Olmesartan did not alter the risks of serious adverse events. CONCLUSIONS: BP-lowering treatment with an ARB did not significantly lower the risks of major cardiovascular events or death among patients with hypertension on chronic HD. (Cochrane Renal Group Prospective Trial Register number CRG010600030). FAU - Iseki, Kunitoshi AU - Iseki K AD - Dialysis Unit, University Hospital of the Ryukyus, Nishihara, Okinawa, Japan. chihokun@med.u-ryukyu.ac.jp FAU - Arima, Hisatomi AU - Arima H FAU - Kohagura, Kentaro AU - Kohagura K FAU - Komiya, Ichiro AU - Komiya I FAU - Ueda, Shinichiro AU - Ueda S FAU - Tokuyama, Kiyoyuki AU - Tokuyama K FAU - Shiohira, Yoshiki AU - Shiohira Y FAU - Uehara, Hajime AU - Uehara H FAU - Toma, Shigeki AU - Toma S CN - Olmesartan Clinical Trial in Okinawan Patients Under OKIDS (OCTOPUS) Group LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20130125 PL - England TA - Nephrol Dial Transplant JT - Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association JID - 8706402 RN - 0 (Angiotensin II Type 1 Receptor Blockers) RN - 0 (Imidazoles) RN - 0 (Tetrazoles) RN - 8W1IQP3U10 (olmesartan) SB - IM MH - Adult MH - Aged MH - Angiotensin II Type 1 Receptor Blockers/*therapeutic use MH - Cardiovascular Diseases/*drug therapy/etiology/mortality MH - Case-Control Studies MH - Female MH - Humans MH - Hypertension/drug therapy/*etiology/mortality MH - Imidazoles/*therapeutic use MH - Male MH - Middle Aged MH - Prognosis MH - Prospective Studies MH - Renal Dialysis/*adverse effects MH - Renal Insufficiency, Chronic/*complications/therapy MH - Survival Rate MH - Tetrazoles/*therapeutic use MH - Young Adult OTO - NOTNLM OT - ARB OT - cardiovascular disease OT - haemodialysis, survival OT - hypertension FIR - Iseki, Kunitoshi IR - Iseki K FIR - Ueda, Shinichiro IR - Ueda S FIR - Kohagura, Kentaro IR - Kohagura K FIR - Komiya, Ichiro IR - Komiya I FIR - Toma, Shigeki IR - Toma S FIR - Tana, Takeshi IR - Tana T FIR - Higa, Akira IR - Higa A FIR - Yamazato, Masanobu IR - Yamazato M FIR - Ishida, Yuriko IR - Ishida Y FIR - Tokuyama, Kiyoyuki IR - Tokuyama K FIR - Nagayoshi, Naoko IR - Nagayoshi N FIR - Miyagi, Shinyu IR - Miyagi S FIR - Asato, Tadashi IR - Asato T FIR - Kobayashi, Ryuji IR - Kobayashi R FIR - Shiohira, Yoshiki IR - Shiohira Y FIR - Yonaha, Tomoki IR - Yonaha T FIR - Uezu, Yoshinao IR - Uezu Y FIR - Kuwae, Noriko IR - Kuwae N FIR - Nakasato, Satoshi IR - Nakasato S FIR - Oshiro, Yoko IR - Oshiro Y FIR - Nashiro, Kazuomi IR - Nashiro K FIR - Asato, Tetsuyoshi IR - Asato T FIR - Katsuren, Hideo IR - Katsuren H FIR - Kagawa, Haruo IR - Kagawa H FIR - Higa, Tukasa IR - Higa T FIR - Ikema, Minori IR - Ikema M FIR - Akamine, Katsunari IR - Akamine K FIR - Nishihira, Moriki IR - Nishihira M FIR - Jahana, Masahide IR - Jahana M FIR - Imai, Chiharu IR - Imai C FIR - Yonaha, Tomohiro IR - Yonaha T FIR - Ikemura, Makoto IR - Ikemura M FIR - Uechi, Masato IR - Uechi M FIR - Yamazato, Masahiro IR - Yamazato M FIR - Yoshihara, Kunio IR - Yoshihara K FIR - Arakaki, Manabu IR - Arakaki M FIR - Iha, Kiyoshi IR - Iha K FIR - Afuso, Hisaaki IR - Afuso H FIR - Kiyuna, Susumu IR - Kiyuna S FIR - Shiroma, Kazuo IR - Shiroma K FIR - Miyara, Tadashi IR - Miyara T FIR - Itokazu, Masayoshi IR - Itokazu M FIR - Naka, Tamayo IR - Naka T FIR - Naka, Shoei IR - Naka S FIR - Yamaguchi, Eirei IR - Yamaguchi E FIR - Uechi, Yoichi IR - Uechi Y FIR - Kowatari, Teruo IR - Kowatari T FIR - Yamada, Hirohiko IR - Yamada H FIR - Yoshi, Shinichiro IR - Yoshi S FIR - Sunagawa, Hiroshi IR - Sunagawa H FIR - Tozawa, Masahiko IR - Tozawa M FIR - Uechi, Masato IR - Uechi M FIR - Adaniya, Masaaki IR - Adaniya M FIR - Afuso, Hisaaki IR - Afuso H FIR - Uehara, Hajime IR - Uehara H FIR - Miyazato, Hitoshi IR - Miyazato H FIR - Sakuda, Choko IR - Sakuda C FIR - Taminato, Tomotake IR - Taminato T FIR - Uchima, Hisakichi IR - Uchima H FIR - Nakasone, Yasuki IR - Nakasone Y FIR - Funakoshi, Toru IR - Funakoshi T FIR - Nakazato, Masayasu IR - Nakazato M FIR - Nagata, Norikatsu IR - Nagata N FIR - Miyazato, Sakae IR - Miyazato S FIR - Katsuren, Hideo IR - Katsuren H FIR - Miyagi, Takeatsu IR - Miyagi T FIR - Hirano, Hiroshi IR - Hirano H FIR - Iwashiro, Katsunori IR - Iwashiro K FIR - Sunagawa, Tadahiro IR - Sunagawa T FIR - Yoshida, Hisashi IR - Yoshida H FIR - Oshiro, Yasuhiko IR - Oshiro Y FIR - Shimabukuro, Toshihide IR - Shimabukuro T FIR - Oura, Takashi IR - Oura T FIR - Henzan, Hideki IR - Henzan H FIR - Kyan, Ikuo IR - Kyan I FIR - Maeshiro, Shuji IR - Maeshiro S FIR - Wake, Toru IR - Wake T FIR - Ueda, Shinichiro IR - Ueda S FIR - Tagawa, Shinya IR - Tagawa S FIR - Inoue, Taku IR - Inoue T FIR - Tokashiki, Takashi IR - Tokashiki T FIR - Ishii, Hideki IR - Ishii H FIR - Ogura, Chikara IR - Ogura C FIR - Miyagi, Seishiro IR - Miyagi S FIR - Takishita, Shuichi IR - Takishita S FIR - Saito, Seiichi IR - Saito S FIR - Shimizu, Kazushige IR - Shimizu K FIR - Ohya, Yusuke IR - Ohya Y FIR - Arima, Hisatomi IR - Arima H FIR - Barzi, Federica IR - Barzi F EDAT- 2013/01/29 06:00 MHDA- 2014/01/24 06:00 CRDT- 2013/01/29 06:00 PHST- 2013/01/29 06:00 [entrez] PHST- 2013/01/29 06:00 [pubmed] PHST- 2014/01/24 06:00 [medline] AID - gfs590 [pii] AID - 10.1093/ndt/gfs590 [doi] PST - ppublish SO - Nephrol Dial Transplant. 2013 Jun;28(6):1579-89. doi: 10.1093/ndt/gfs590. Epub 2013 Jan 25. PMID- 23335377 OWN - NLM STAT- MEDLINE DCOM- 20130729 LR - 20211021 IS - 1932-8737 (Electronic) IS - 0160-9289 (Print) IS - 0160-9289 (Linking) VI - 36 IP - 2 DP - 2013 Feb TI - Is serum uric acid level an independent predictor of heart failure among patients with coronary artery disease? PG - 110-6 LID - 10.1002/clc.22083 [doi] AB - BACKGROUND: Uric acid (UA) is elevated in patients with the metabolic syndrome, and there is a possible association with coronary events. Its association with future risk of heart failure (HF) is not clear. Our objective was to evaluate the association between levels of UA and risk of HF in patients with stable coronary artery disease (CAD). HYPOTHESIS: Serum UA is associated with HF in CAD patients. METHODS: A retrospective cohort analysis among 2939 participants of the bezafibrate infarction prevention study, assessing long-term risk of HF incidence over an 8-year of follow-up in relation to baseline UA. RESULTS: Among patients with high levels of UA, there was a larger proportion of men, systolic hypertension, diabetes mellitus, metabolic syndrome, elevated total cholesterol, chronic renal failure, and previous coronary revascularization procedures. The rate of myocardial infarction during the follow-up was 10.9%, 10.3%, and 11.6% in the 1st, 2nd and 3rd tertiles of UA, respectively (P = 0.68). Age-adjusted hazard ratios for HF were 1.16 (95% confidence interval [CI]: 0.94-1.45) and 1.28 (95% CI: 1.04-1.59) in the 2nd and 3rd tertiles, respectively, as compared to the 1st tertile. After adjusting for multiple confounders and myocardial infarction, the hazard ratio for developing HF was 1.18 (95% CI: 0.95-1.47) and 1.25 (95% CI: 1.00-1.56) in the 2nd and 3rd tertiles of UA levels, respectively. CONCLUSIONS: UA levels are associated with future risk of HF in patients with stable CAD, but this association is attenuated after adjusting for traditional CAD risk factors. CI - (c) 2013 Wiley Periodicals, Inc. FAU - Eisen, Alon AU - Eisen A AD - Cardiology Department, Rabin Medical Center, Petah-Tikva, Israel. a_alon1@netvision.net.il FAU - Benderly, Michal AU - Benderly M FAU - Goldbourt, Uri AU - Goldbourt U FAU - Haim, Moti AU - Haim M LA - eng PT - Journal Article DEP - 20130117 PL - United States TA - Clin Cardiol JT - Clinical cardiology JID - 7903272 RN - 0 (Biomarkers) RN - 268B43MJ25 (Uric Acid) SB - IM MH - Aged MH - Biomarkers/blood MH - Chi-Square Distribution MH - Coronary Artery Disease/blood/*complications MH - Female MH - Heart Failure/blood/*etiology MH - Humans MH - Hyperuricemia/blood/*complications MH - Linear Models MH - Male MH - Middle Aged MH - Multivariate Analysis MH - Prognosis MH - Proportional Hazards Models MH - Randomized Controlled Trials as Topic MH - Retrospective Studies MH - Risk Assessment MH - Risk Factors MH - Up-Regulation MH - Uric Acid/*blood PMC - PMC6649401 EDAT- 2013/01/22 06:00 MHDA- 2013/07/31 06:00 PMCR- 2013/01/17 CRDT- 2013/01/22 06:00 PHST- 2012/10/19 00:00 [received] PHST- 2012/11/16 00:00 [accepted] PHST- 2013/01/22 06:00 [entrez] PHST- 2013/01/22 06:00 [pubmed] PHST- 2013/07/31 06:00 [medline] PHST- 2013/01/17 00:00 [pmc-release] AID - CLC22083 [pii] AID - 10.1002/clc.22083 [doi] PST - ppublish SO - Clin Cardiol. 2013 Feb;36(2):110-6. doi: 10.1002/clc.22083. Epub 2013 Jan 17. PMID- 23323121 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20130117 LR - 20211021 IS - 1738-5520 (Print) IS - 1738-5555 (Electronic) IS - 1738-5520 (Linking) VI - 42 IP - 12 DP - 2012 Dec TI - Coronary Stents in Patients with ST-Elevation Myocardial Infarction and Chronic Kidney Disease Undergoing Primary Percutaneous Coronary Intervention. PG - 830-8 LID - 10.4070/kcj.2012.42.12.830 [doi] AB - BACKGROUND AND OBJECTIVES: Chronic kidney disease (CKD) is associated with poor outcomes after percutaneous coronary intervention (PCI). We sought to compare different coronary stents used during primary PCI in patients with ST-elevation myocardial infarction (STEMI) and CKD. SUBJECTS AND METHODS: We selected 2408 consecutive STEMI patients with CKD (estimated glomerular filtration rate <60 mL/min/1.73 m(2)) undergoing primary PCI and divided them into 5 groups based on the type of stent implanted: 1) bare metal stent (BMS), 2) paclitaxel-eluting stent (PES), 3) sirolimus-eluting stent (SES), 4) zotarolimus-eluting stent (ZES), or 5) everolimus-eluting stent (EES). The study endpoint was the number of major adverse cardiac events (MACE) at 12 months. RESULTS: There was no significant difference in the incidence of 12-month myocardial infarction, target lesion revascularization, or target vessel revascularization between stent groups; however, the overall rate of repeat revascularization differed significantly between groups. All-cause death differed significantly among the groups. The incidence of 12-month MACE in BMS, PES, SES, ZES, and EES was 8.3%, 9.8%, 8.6%, 5.5%, and 2.6%, respectively (p<0.001). Kaplan-Meier analysis did not show a significant differences in 12-month MACE-free survival among the groups (log-rank p=0.076). This finding remained the same after adjusting for multiple confounders (p=0.147). CONCLUSION: Any of the 5 stents can be used to treat STEMI patients with CKD undergoing primary PCI; all have similar risk of 12-month MACE. This result is hypothesis-generating and warrants further evaluation with a long-term randomized study. FAU - Ahmed, Khurshid AU - Ahmed K AD - The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea. ; Apollo Gleneagles Hospital, Kolkata, India. FAU - Jeong, Myung Ho AU - Jeong MH FAU - Chakraborty, Rabin AU - Chakraborty R FAU - Ahmed, Sumera AU - Ahmed S FAU - Hong, Young Joon AU - Hong YJ FAU - Sim, Doo Sun AU - Sim DS FAU - Park, Keun Ho AU - Park KH FAU - Kim, Ju Han AU - Kim JH FAU - Ahn, Youngkeun AU - Ahn Y FAU - Kang, Jung Chaee AU - Kang JC FAU - Cho, Myeong Chan AU - Cho MC FAU - Kim, Chong Jin AU - Kim CJ FAU - Kim, Young Jo AU - Kim YJ CN - Other Korea Acute Myocardial Infarction Registry Investigators LA - eng PT - Journal Article DEP - 20121231 PL - Korea (South) TA - Korean Circ J JT - Korean circulation journal JID - 101247141 PMC - PMC3539049 OTO - NOTNLM OT - Angioplasty OT - Kidney failure, chronic OT - Myocardial infarction OT - Stents COIS- The authors have no financial conflicts of interest. EDAT- 2013/01/17 06:00 MHDA- 2013/01/17 06:01 PMCR- 2012/12/01 CRDT- 2013/01/17 06:00 PHST- 2012/06/20 00:00 [received] PHST- 2012/08/04 00:00 [revised] PHST- 2012/08/05 00:00 [accepted] PHST- 2013/01/17 06:00 [entrez] PHST- 2013/01/17 06:00 [pubmed] PHST- 2013/01/17 06:01 [medline] PHST- 2012/12/01 00:00 [pmc-release] AID - 10.4070/kcj.2012.42.12.830 [doi] PST - ppublish SO - Korean Circ J. 2012 Dec;42(12):830-8. doi: 10.4070/kcj.2012.42.12.830. Epub 2012 Dec 31. PMID- 23279734 OWN - NLM STAT- MEDLINE DCOM- 20140305 LR - 20130703 IS - 1447-0594 (Electronic) IS - 1447-0594 (Linking) VI - 13 IP - 3 DP - 2013 Jul TI - Trends in mortality rates in elderly ST elevation myocardial infarction patients submitted to primary percutaneous coronary intervention: a 7-year single-center experience. PG - 711-7 LID - 10.1111/ggi.12005 [doi] AB - AIM: Limited data are available on the safety and outcome of percutaneous coronary intervention (PCI) in elderly patients with ST elevation myocardial infarction (STEMI), as elderly patients are under-represented in randomized trials. METHODS: We therefore aimed at assessing the trends in mortality rates (both at short-term and at 1-year follow up) in an unselected cohort of 404 STEMI patients aged >/= 75 years all submitted to primary PCI and consecutively admitted to our Intensive Cardiac Care Unit from 2004 to 2010. RESULTS: In the first period (2004-2006), 202 patients (202/661, 30.6%) were aged >/= 75 years, whereas in the second period (2007-2010), 203 patients (203/607, 33.4%) were aged >/= 75 years. In the second period, STEMI patients were older (P<0.001), more diabetic (P<0.001) and with a higher incidence of comorbidities (P<0.001). A significantly lower use of intra-aortic balloon pump was observed, together with a reduced rate of bleeding, whereas the incidence of worsening renal function significantly increased (P=0.011). No difference was observed in the length of stay and in mortality rate (both in-hospital and 1-year post-discharge) between the first and the second period. CONCLUSIONS: According to our data, patients aged >/= 75 years are characterized by an increasing number of comorbidities (in particular, a higher incidence of diabetes). Over a 6-year period, despite a more advanced age, early mortality (and length of stay) remained unchanged (probably thanks to a significant reduction in bleeding events), and no difference was observed in 1-year post-discharge mortality in these patients. CI - (c) 2012 Japan Geriatrics Society. FAU - Lazzeri, Chiara AU - Lazzeri C AD - Intensive Cardiac Coronary Unit, Heart and Vessel Department, Teaching Hospital Careggi, Florence, Italy. lazzeric@libero.it FAU - Valente, Serafina AU - Valente S FAU - Chiostri, Marco AU - Chiostri M FAU - Attana, Paola AU - Attana P FAU - Picariello, Claudio AU - Picariello C FAU - Gensini, Gian Franco AU - Gensini GF LA - eng PT - Comparative Study PT - Journal Article DEP - 20121221 PL - Japan TA - Geriatr Gerontol Int JT - Geriatrics & gerontology international JID - 101135738 SB - IM MH - Aged MH - Aged, 80 and over MH - *Electrocardiography MH - Female MH - Follow-Up Studies MH - Hospital Mortality/trends MH - Humans MH - Italy/epidemiology MH - Male MH - Myocardial Infarction/diagnosis/*mortality/surgery MH - *Percutaneous Coronary Intervention MH - Retrospective Studies MH - Risk Factors MH - Survival Rate/trends MH - Time Factors MH - Treatment Outcome OTO - NOTNLM OT - ST elevation myocardial infarction OT - elderly OT - long-term follow up OT - percutaneous coronary intervention OT - prognosis EDAT- 2013/01/03 06:00 MHDA- 2014/03/07 06:00 CRDT- 2013/01/03 06:00 PHST- 2012/10/11 00:00 [accepted] PHST- 2013/01/03 06:00 [entrez] PHST- 2013/01/03 06:00 [pubmed] PHST- 2014/03/07 06:00 [medline] AID - 10.1111/ggi.12005 [doi] PST - ppublish SO - Geriatr Gerontol Int. 2013 Jul;13(3):711-7. doi: 10.1111/ggi.12005. Epub 2012 Dec 21. PMID- 23252007 OWN - NLM STAT- MEDLINE DCOM- 20130108 LR - 20191112 IS - 0001-5385 (Print) IS - 0001-5385 (Linking) VI - 67 IP - 5 DP - 2012 Oct TI - Comparison of oral and intravenous hydration strategies for the prevention of contrast-induced nephropathy in patients undergoing coronary angiography or angioplasty: a randomized clinical trial. PG - 565-9 AB - OBJECTIVE: The efficacy of oral hydration in the prevention of contrast-induced nephropathy in patients undergoing elective coronary intervention is unclear. METHODS: A total of 120 patients were randomly assigned to three groups. Group A (n = 40) received intravenous hydration before and after coronary angiography or angioplasty. Group B (n = 40) received oral tap water before and after the procedures, whereas group C (n = 40) received only postprocedural drinking water. Levels of serum creatinine and urea nitrogen were measured before, 12 hours after, 2 and 3 days after the coronary angiography or angioplasty. RESULTS: : There was no statistically significant difference in the age, sex, baseline renal function and the volume of contrast medium used during the coronary procedures among the three groups (P > 0.05).There was no statistically significant difference in the mean serum creatinine or urea nitrogen among the three groups 12 hours, and 3 days after the coronary procedures ( P > 0.05).The incidence of contrast-induced nephropathy in group A, B and C was 5.0% (2/40), 7.5% (3/40) and 5.0% (2/40), respectively (P = 0.86). Renal function in the seven patients who experienced contrast-induced nephropathy recovered within a week following rehydration treatment. CONCLUSIONS: Pre- and post-procedural oral hydration was as effective as intravenous rehydration in the prevention of contrast-induced nephropathy in patients undergoing coronary angiography or angioplasty. FAU - Kong, De-Gui AU - Kong DG AD - Department of Cardiology, Liaocheng People's Hospital of Taishan Medical University, Liaocheng, Shandong, P.R. China. FAU - Hou, Yan-Fang AU - Hou YF FAU - Ma, Long-Le AU - Ma LL FAU - Yao, Dao-Kuo AU - Yao DK FAU - Wang, Le-Xin AU - Wang LX LA - eng PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial PL - England TA - Acta Cardiol JT - Acta cardiologica JID - 0370570 RN - 0 (Contrast Media) RN - 0 (Drinking Water) RN - 0 (Isotonic Solutions) SB - IM MH - Administration, Oral MH - Adolescent MH - Adult MH - Aged MH - Aged, 80 and over MH - Angioplasty, Balloon, Coronary/*adverse effects MH - Contrast Media/*adverse effects MH - Coronary Angiography/*adverse effects MH - Coronary Disease/diagnostic imaging/therapy MH - Drinking Water/*administration & dosage MH - Female MH - Fluid Therapy/*methods MH - Follow-Up Studies MH - Humans MH - Infusions, Intravenous MH - Isotonic Solutions/*administration & dosage MH - Kidney Diseases/chemically induced/*prevention & control MH - Male MH - Middle Aged MH - Practice Guidelines as Topic MH - Retrospective Studies MH - Treatment Outcome MH - Young Adult EDAT- 2012/12/21 06:00 MHDA- 2013/01/09 06:00 CRDT- 2012/12/21 06:00 PHST- 2012/12/21 06:00 [entrez] PHST- 2012/12/21 06:00 [pubmed] PHST- 2013/01/09 06:00 [medline] AID - 10.1080/ac.67.5.2174131 [doi] PST - ppublish SO - Acta Cardiol. 2012 Oct;67(5):565-9. doi: 10.1080/ac.67.5.2174131. PMID- 23219177 OWN - NLM STAT- MEDLINE DCOM- 20130415 LR - 20161125 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 111 IP - 4 DP - 2013 Feb 15 TI - Safety and efficacy of prasugrel use in patients undergoing percutaneous coronary intervention and anticoagulated with bivalirudin. PG - 516-20 LID - S0002-9149(12)02320-X [pii] LID - 10.1016/j.amjcard.2012.10.035 [doi] AB - The randomized TRial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet InhibitioN with Prasugrel-Thrombolysis In Myocardial Infarction (TRITON-TIMI) 38 trial compared prasugrel and clopidogrel in patients with acute coronary syndrome undergoing percutaneous coronary intervention (PCI). Patients treated with prasugrel had fewer ischemic events but more procedure-related bleeding. In the present study, we aimed to determine the effect of bivalirudin on bleeding in patients treated with prasugrel. A total of 692 patients with consecutive acute coronary syndrome underwent PCI with stent implantation and were anticoagulated with bivalirudin. The patients were divided into 2 groups according to the antiplatelet regimen (clopidogrel or prasugrel) chosen during or just after PCI. The bleeding complications during hospitalization were tabulated. Ischemic events were analyzed during hospitalization and at 30 days. Prasugrel was used in 96 patients (13.9%) and clopidogrel in 596 (86.1%). The clinical and procedural characteristics were similar, although the clopidogrel patients more often reported systemic hypertension (p = 0.01), previous PCI (p <0.001), and chronic renal insufficiency (p = 0.05). During hospitalization, the bleeding and ischemic complication rates were similar and low in both groups (major in-hospital complications 4.2% for clopidogrel vs 2.1% for prasugrel, p = 0.6; Thrombolysis In Myocardial Infarction major bleeding 2.5% vs 2.1%, p = 1.00; Thrombolysis In Myocardial Infarction minor bleeding 4.2% vs 5.2%, p = 0.6). At 30 days, no differences were found in ischemic events between both groups (target vessel revascularization/major adverse cardiac events 5.4% vs 2.1%, p = 0.2). In conclusion, prasugrel, when given after bivalirudin as the intraprocedural antithrombin agent for patients with acute coronary syndrome undergoing PCI, is as safe and effective as clopidogrel. CI - Copyright (c) 2013 Elsevier Inc. All rights reserved. FAU - Laynez, Ana AU - Laynez A AD - Division of Cardiology, Department of Internal Medicine, MedStar Washington Hospital Center, Washington, DC, USA. FAU - Sardi, Gabriel AU - Sardi G FAU - Torguson, Rebecca AU - Torguson R FAU - Xue, Zhenyi AU - Xue Z FAU - Suddath, William O AU - Suddath WO FAU - Satler, Lowell F AU - Satler LF FAU - Kent, Kenneth M AU - Kent KM FAU - Pichard, Augusto D AU - Pichard AD FAU - Lindsay, Joseph AU - Lindsay J FAU - Waksman, Ron AU - Waksman R LA - eng PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial DEP - 20121204 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 RN - 0 (Antithrombins) RN - 0 (Hirudins) RN - 0 (Peptide Fragments) RN - 0 (Piperazines) RN - 0 (Purinergic P2Y Receptor Antagonists) RN - 0 (Recombinant Proteins) RN - 0 (Thiophenes) RN - G89JQ59I13 (Prasugrel Hydrochloride) RN - TN9BEX005G (bivalirudin) SB - IM MH - Acute Coronary Syndrome/diagnostic imaging/*therapy MH - Antithrombins/administration & dosage/therapeutic use MH - Coronary Angiography MH - Dose-Response Relationship, Drug MH - Drug Therapy, Combination MH - Female MH - Follow-Up Studies MH - Hirudins MH - Humans MH - Male MH - Middle Aged MH - Peptide Fragments MH - *Percutaneous Coronary Intervention MH - Piperazines/*administration & dosage/therapeutic use MH - Prasugrel Hydrochloride MH - Preoperative Care/*methods MH - Purinergic P2Y Receptor Antagonists/administration & dosage/therapeutic use MH - Recombinant Proteins MH - Retrospective Studies MH - Thiophenes/*administration & dosage/therapeutic use MH - Treatment Outcome EDAT- 2012/12/12 06:00 MHDA- 2013/04/16 06:00 CRDT- 2012/12/11 06:00 PHST- 2012/07/19 00:00 [received] PHST- 2012/10/19 00:00 [revised] PHST- 2012/10/19 00:00 [accepted] PHST- 2012/12/11 06:00 [entrez] PHST- 2012/12/12 06:00 [pubmed] PHST- 2013/04/16 06:00 [medline] AID - S0002-9149(12)02320-X [pii] AID - 10.1016/j.amjcard.2012.10.035 [doi] PST - ppublish SO - Am J Cardiol. 2013 Feb 15;111(4):516-20. doi: 10.1016/j.amjcard.2012.10.035. Epub 2012 Dec 4. PMID- 23204445 OWN - NLM STAT- MEDLINE DCOM- 20130204 LR - 20260413 IS - 1533-3450 (Electronic) IS - 1046-6673 (Print) IS - 1046-6673 (Linking) VI - 23 IP - 12 DP - 2012 Dec TI - Multivessel coronary artery bypass grafting versus percutaneous coronary intervention in ESRD. PG - 2042-9 LID - 10.1681/ASN.2012060554 [doi] AB - Thirty to sixty percent of patients with ESRD on dialysis have coronary heart disease, but the optimal strategy for coronary revascularization is unknown. We used data from the United States Renal Data System to define a cohort of 21,981 patients on maintenance dialysis who received initial coronary revascularization with either coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) between 1997 and 2009 and had at least 6 months of prior Medicare coverage as their primary payer. The primary outcome was death from any cause, and the secondary outcome was a composite of death or myocardial infarction. Overall survival rates were consistently poor during the study period, with unadjusted 5-year survival rates of 22%-25% irrespective of revascularization strategy. Using multivariable-adjusted proportional hazards regression, we found that CABG compared with PCI associated with significantly lower risks for both death (HR=0.87, 95% CI=0.84-0.90) and the composite of death or myocardial infarction (HR=0.88, 95% CI=0.86-0.91). Results were similar in analyses using a propensity score-matched cohort. In the absence of data from randomized trials, these results suggest that CABG may be preferred over PCI for multivessel coronary revascularization in appropriately selected patients on maintenance dialysis. FAU - Chang, Tara I AU - Chang TI AD - Division of Nephrology, Department of Medicine, Stanford University, 780 Welch Road Suite 106, Palo Alto, CA 94304, USA. tichang@stanford.edu FAU - Shilane, David AU - Shilane D FAU - Kazi, Dhruv S AU - Kazi DS FAU - Montez-Rath, Maria E AU - Montez-Rath ME FAU - Hlatky, Mark A AU - Hlatky MA FAU - Winkelmayer, Wolfgang C AU - Winkelmayer WC LA - eng GR - HHSAA2900200500401/PHS HHS/United States GR - R01 AR057327/AR/NIAMS NIH HHS/United States GR - HHSN268201100003C/WH/WHI NIH HHS/United States GR - T32 DK007357/DK/NIDDK NIH HHS/United States GR - 1R01AR057327/AR/NIAMS NIH HHS/United States GR - R01 DK090181/DK/NIDDK NIH HHS/United States GR - 1R01DK090181/DK/NIDDK NIH HHS/United States GR - R01 DK095024/DK/NIDDK NIH HHS/United States GR - R01 DK090008/DK/NIDDK NIH HHS/United States GR - R21 DK077336/DK/NIDDK NIH HHS/United States GR - 1R01DK095024/DK/NIDDK NIH HHS/United States GR - 1R21DK089368/DK/NIDDK NIH HHS/United States GR - 1R21DK077336/DK/NIDDK NIH HHS/United States GR - 1R01DK090008/DK/NIDDK NIH HHS/United States GR - R21 DK089368/DK/NIDDK NIH HHS/United States GR - HHSN268201100003I/HL/NHLBI NIH HHS/United States PT - Comparative Study PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't PL - United States TA - J Am Soc Nephrol JT - Journal of the American Society of Nephrology : JASN JID - 9013836 SB - IM MH - Aged MH - *Coronary Artery Bypass MH - Coronary Disease/mortality/*surgery MH - Female MH - Humans MH - Kaplan-Meier Estimate MH - Kidney Failure, Chronic/*complications/mortality MH - Male MH - Middle Aged MH - *Percutaneous Coronary Intervention MH - United States/epidemiology PMC - PMC3507369 EDAT- 2012/12/04 06:00 MHDA- 2013/02/05 06:00 PMCR- 2013/11/30 CRDT- 2012/12/04 06:00 PHST- 2012/12/04 06:00 [entrez] PHST- 2012/12/04 06:00 [pubmed] PHST- 2013/02/05 06:00 [medline] PHST- 2013/11/30 00:00 [pmc-release] AID - 23/12/2042 [pii] AID - 2012060554 [pii] AID - 10.1681/ASN.2012060554 [doi] PST - ppublish SO - J Am Soc Nephrol. 2012 Dec;23(12):2042-9. doi: 10.1681/ASN.2012060554. PMID- 23194494 OWN - NLM STAT- MEDLINE DCOM- 20130212 LR - 20250529 IS - 1097-6744 (Electronic) IS - 0002-8703 (Print) IS - 0002-8703 (Linking) VI - 164 IP - 6 DP - 2012 Dec TI - Cardiovascular risk assessment: addition of CKD and race to the Framingham equation. PG - 925-31.e2 LID - S0002-8703(12)00603-5 [pii] LID - 10.1016/j.ahj.2012.09.003 [doi] AB - BACKGROUND/AIMS: The value of the Framingham equation in predicting cardiovascular risk in African Americans and patients with chronic kidney disease (CKD) is unclear. The purpose of the study was to evaluate whether the addition of CKD and race to the Framingham equation improves risk stratification in hypertensive patients. METHODS: Participants in the ALLHAT were studied. Those randomized to doxazosin, older than 74 years, and those with a history of coronary heart disease were excluded. Two risk stratification models were developed using Cox proportional hazards models in a two-thirds developmental sample. The first model included the traditional Framingham risk factors. The second model included the traditional risk factors plus CKD, defined by estimated glomerular filtration rate categories, and stratification by race (black vs non-black). The primary outcome was a composite of fatal coronary heart disease, nonfatal myocardial infarction, coronary revascularization, and hospitalized angina. RESULTS: There were a total of 19,811 eligible subjects. In the validation cohort, there was no difference in C-statistics between the Framingham equation and the ALLHAT model including CKD and race. This was consistent across subgroups by race and sex and among those with CKD. One exception was among Non-Black women where the C-statistic was higher for the Framingham equation (0.68 vs 0.65, P = .02). In addition, net reclassification improvement was not significant for any subgroup based on race and sex, ranging from -5.5% to 4.4%. CONCLUSION: The addition of CKD status and stratification by race does not improve risk prediction in high-risk hypertensive patients. CI - Copyright (c) 2012 Mosby, Inc. All rights reserved. FAU - Drawz, Paul E AU - Drawz PE AD - MetroHealth Medical Center, Cleveland, OH, USA. draw0003@umn.edu FAU - Baraniuk, Sarah AU - Baraniuk S FAU - Davis, Barry R AU - Davis BR FAU - Brown, Clinton D AU - Brown CD FAU - Colon, Pedro J Sr AU - Colon PJ Sr FAU - Cujyet, Aloysius B AU - Cujyet AB FAU - Dart, Richard A AU - Dart RA FAU - Graumlich, James F AU - Graumlich JF FAU - Henriquez, Mario A AU - Henriquez MA FAU - Moloo, Jamaluddin AU - Moloo J FAU - Sakalayen, Mohammed G AU - Sakalayen MG FAU - Simmons, Debra L AU - Simmons DL FAU - Stanford, Carol AU - Stanford C FAU - Sweeney, Mary Ellen AU - Sweeney ME FAU - Wong, Nathan D AU - Wong ND FAU - Rahman, Mahboob AU - Rahman M LA - eng SI - ClinicalTrials.gov/NCT00000542 GR - K23 DK087919/DK/NIDDK NIH HHS/United States GR - N01 HC035130/HL/NHLBI NIH HHS/United States GR - N01-HC-35130/HC/NHLBI NIH HHS/United States GR - 1K23DK087919/DK/NIDDK NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't DEP - 20121029 PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 SB - IM MH - Angina Pectoris/ethnology MH - Black People MH - Cohort Studies MH - Coronary Disease/*ethnology MH - Female MH - Humans MH - Hypertension/*ethnology MH - Male MH - Middle Aged MH - Myocardial Infarction/ethnology MH - Myocardial Revascularization MH - Proportional Hazards Models MH - Racial Groups MH - Renal Insufficiency, Chronic/*ethnology MH - Risk Assessment MH - Black or African American PMC - PMC3511773 MID - NIHMS407420 COIS- Financial Disclosures: None of the authors reports a conflict of interest with regard to the content of this paper. Drs. Baraniuk, Colon, Cuyjet, Dart, Drawz, Graumlich, Moloo, Saklayen, Simmons, and Stanford have no financial interests to disclose. EDAT- 2012/12/01 06:00 MHDA- 2013/02/13 06:00 PMCR- 2013/12/01 CRDT- 2012/12/01 06:00 PHST- 2011/10/17 00:00 [received] PHST- 2012/09/05 00:00 [accepted] PHST- 2012/12/01 06:00 [entrez] PHST- 2012/12/01 06:00 [pubmed] PHST- 2013/02/13 06:00 [medline] PHST- 2013/12/01 00:00 [pmc-release] AID - S0002-8703(12)00603-5 [pii] AID - 10.1016/j.ahj.2012.09.003 [doi] PST - ppublish SO - Am Heart J. 2012 Dec;164(6):925-31.e2. doi: 10.1016/j.ahj.2012.09.003. Epub 2012 Oct 29. PMID- 23174634 OWN - NLM STAT- MEDLINE DCOM- 20130701 LR - 20220408 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 5 IP - 11 DP - 2012 Nov TI - A new score for risk stratification of patients with acute coronary syndromes undergoing percutaneous coronary intervention: the ACUITY-PCI (Acute Catheterization and Urgent Intervention Triage Strategy-Percutaneous Coronary Intervention) risk score. PG - 1108-16 LID - S1936-8798(12)00869-2 [pii] LID - 10.1016/j.jcin.2012.07.011 [doi] AB - OBJECTIVES: This study sought to develop a new score specific for patients with non-ST-segment elevation acute coronary syndromes (NSTEACS) undergoing percutaneous coronary intervention (PCI) (the ACUITY-PCI [Acute Catheterization and Urgent Intervention Triage Strategy-Percutaneous Coronary Intervention] risk score). BACKGROUND: The TIMI (Thrombolysis In Myocardial Infarction) and GRACE (Global Registry for Acute Coronary Events) risk scores are recommended for risk stratification of patients with NSTEACS. However, these scores were not optimized for patients undergoing an early invasive strategy with PCI. METHODS: The ACUITY-PCI risk score was created from data for 1,692 patients enrolled in the formal angiographic substudy of the ACUITY (Acute Catheterization and Urgent Intervention Triage Strategy) trial by integrating clinical, angiographic, laboratory, and electrocardiographic variables selected by multivariable analysis. The score was subsequently validated in a different population of 846 patients and compared with the GRACE and TIMI risk scores, and the SYNTAX (Synergy Between PCI with Taxus and Cardiac Surgery) and Clinical SYNTAX scores. RESULTS: Six variables (2 clinical, 1 laboratory/electrocardiographic, and 3 angiographic) were included in the ACUITY-PCI score: insulin-treated diabetes; renal insufficiency; baseline cardiac biomarker elevation or ST-segment deviation; bifurcation lesion; small vessel/diffuse coronary artery disease; and the extent of coronary artery disease. Event rates increased significantly across tertiles of ACUITY-PCI score. Compared with the other scores, the ACUITY-PCI score had the best discrimination (C-statistic), calibration (Hosmer-Lemeshow statistic), and index of separation. Moreover, the net reclassification improvement varied from 9% to 38% and the integrated discrimination index from 1.9% to 2.7%. CONCLUSIONS: The ACUITY-PCI risk score is a new tool integrating clinical, angiographic, and laboratory/electrocardiographic variables specifically developed for patients with NSTEACS undergoing PCI. This score displayed better prognostic accuracy in terms of discrimination and calibration than other currently available scores for risk stratification of patients with NSTEACS. (Comparison of Angiomax Versus Heparin in Acute Coronary Syndromes [ACS]; NCT00093158). CI - Copyright (c) 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Palmerini, Tullio AU - Palmerini T AD - Dipartmento Cardiovascolare, Policlinico S. Orsola, Bologna, Italy. FAU - Genereux, Philippe AU - Genereux P FAU - Caixeta, Adriano AU - Caixeta A FAU - Cristea, Ecaterina AU - Cristea E FAU - Lansky, Alexandra AU - Lansky A FAU - Mehran, Roxana AU - Mehran R FAU - Della Riva, Diego AU - Della Riva D FAU - Fahy, Martin AU - Fahy M FAU - Xu, Ke AU - Xu K FAU - Stone, Gregg W AU - Stone GW LA - eng SI - ClinicalTrials.gov/NCT00093158 PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 SB - IM MH - Acute Coronary Syndrome/*surgery MH - Cardiac Catheterization MH - Emergency Treatment MH - Female MH - Humans MH - Male MH - Middle Aged MH - *Percutaneous Coronary Intervention MH - Prospective Studies MH - Risk Assessment/*methods MH - Triage EDAT- 2012/11/24 06:00 MHDA- 2013/07/03 06:00 CRDT- 2012/11/24 06:00 PHST- 2012/06/01 00:00 [received] PHST- 2012/07/25 00:00 [accepted] PHST- 2012/11/24 06:00 [entrez] PHST- 2012/11/24 06:00 [pubmed] PHST- 2013/07/03 06:00 [medline] AID - S1936-8798(12)00869-2 [pii] AID - 10.1016/j.jcin.2012.07.011 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2012 Nov;5(11):1108-16. doi: 10.1016/j.jcin.2012.07.011. PMID- 23140546 OWN - NLM STAT- MEDLINE DCOM- 20140424 LR - 20260518 IS - 1875-6212 (Electronic) IS - 1570-1611 (Linking) VI - 11 IP - 5 DP - 2013 Sep TI - The impact of smoking on cardiovascular outcomes and comorbidities in statin-treated patients with coronary artery disease: a post hoc analysis of the GREACE study. PG - 779-84 AB - BACKGROUND: Smoking adversely affects cardiovascular disease (CVD) morbidity and mortality; however the effect of long-term statin treatment in high risk smokers is not entirely clear. The primary endpoint of this post hoc analysis of the GREek Atorvastatin and Coronary Heart Disease Evaluation (GREACE) study (n=1,600 patients with established coronary heart disease, mean follow-up 3-years) was the incidence of major CVD events, a composite of death, myocardial infarction, revascularization, unstable angina, heart failure, and stroke in statin-treated patients (n=880) who continued to smoke (n=129) compared with ex-smokers (n=309) and never smokers (n=442) as well as on patients not treated with a statin (n=720) of all smoking categories. Secondary endpoints were the effect of smoking on chronic kidney disease (CKD) and on non-alcoholic fatty liver disease (NAFLD), two major and common independent CVD risk factors. RESULTS: Among statin treated patients the hazard ratio (HR) for current smokers compared with never smokers was 1.86 [95% confidence interval-(CI) 1.19-2.10); similar was the HR for current smokers compared with ex-smokers. Absolute (16.3%) and relative (45.6%) CVD risk reduction was great in current smokers on statins compared with those not on a statin; however they still had the highest absolute CVD event incidence (19.4%). Low high density lipoprotein cholesterol and higher triglycerides may account, at least in part, for this. The highest risk of CVD events in any of the 6 groups was in the smokers not on a statin (35.7%). CKD and NAFLD were not negatively affected by smoking and they do not appear to be implicated in the adverse effect of smoking on CVD event rate in patients on a statin. CONCLUSIONS: Statins reduce CVD morbidity and mortality in current smokers with CVD, but these remain high in terms of absolute incidence compared with ex- and never smokers. CKD and NAFLD are not affected by smoking and do not seem to contribute to this high CVD event incidence. These make smoking cessation imperative in high risk patients even if they are on statins. FAU - Athyros, Vasilios G AU - Athyros VG AD - Academic Head, Department of Clinical Biochemistry, Royal Free Hospital Campus, University College London Medical School, University College London (UCL), Pond Street, London NW3 2QG, UK. MIKHAILIDIS@aol.com. FAU - Tziomalos, Konstantinos AU - Tziomalos K FAU - Katsiki, Niki AU - Katsiki N FAU - Gossios, Thomas D AU - Gossios TD FAU - Giouleme, Olga AU - Giouleme O FAU - Anagnostis, Panagiotis AU - Anagnostis P FAU - Pagourelias, Efstathios D AU - Pagourelias ED FAU - Theocharidou, Eleni AU - Theocharidou E FAU - Karagiannis, Asterios AU - Karagiannis A FAU - Mikhailidis, Dimitri P AU - Mikhailidis DP CN - GREACE Study Collaborative Group LA - eng PT - Journal Article PT - Randomized Controlled Trial PL - United Arab Emirates TA - Curr Vasc Pharmacol JT - Current vascular pharmacology JID - 101157208 RN - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors) SB - IM CIN - Curr Vasc Pharmacol. 2013 Sep;11(5):777-8. doi: 10.2174/1570161111311050015. PMID: 23256877 MH - Cardiovascular Diseases/*epidemiology/*etiology/physiopathology MH - Coronary Artery Disease/*epidemiology/*physiopathology MH - Fatty Liver/epidemiology/etiology/physiopathology MH - Female MH - Humans MH - Hydroxymethylglutaryl-CoA Reductase Inhibitors/*therapeutic use MH - Male MH - Middle Aged MH - Non-alcoholic Fatty Liver Disease MH - Prospective Studies MH - Renal Insufficiency, Chronic/epidemiology/etiology/physiopathology MH - Smoking/*adverse effects FIR - Baharoudis, G IR - Baharoudis G FIR - Basdekas, S IR - Basdekas S FIR - Bouloukos, V IR - Bouloukos V FIR - Christaki, E IR - Christaki E FIR - Daskalopoulos, G IR - Daskalopoulos G FIR - Dimopoulou, S IR - Dimopoulou S FIR - Griva, T IR - Griva T FIR - Kakafika, A IR - Kakafika A FIR - Kargiotis, K IR - Kargiotis K FIR - Koumaras, H IR - Koumaras H FIR - Mitsiou, E IR - Mitsiou E FIR - Papageorgiou, A IR - Papageorgiou A FIR - Pehlivanidis, A IR - Pehlivanidis A FIR - Petridis, D IR - Petridis D FIR - Sfikas, G IR - Sfikas G FIR - Sekeri, Z IR - Sekeri Z FIR - Skaperdas, A IR - Skaperdas A FIR - Symeonidis, A IR - Symeonidis A EDAT- 2012/11/13 06:00 MHDA- 2014/04/25 06:00 CRDT- 2012/11/13 06:00 PHST- 2012/09/29 00:00 [received] PHST- 2012/11/05 00:00 [revised] PHST- 2012/11/07 00:00 [accepted] PHST- 2012/11/13 06:00 [entrez] PHST- 2012/11/13 06:00 [pubmed] PHST- 2014/04/25 06:00 [medline] AID - CVP-EPUB-20121107-1 [pii] AID - 10.2174/1570161111311050016 [doi] PST - ppublish SO - Curr Vasc Pharmacol. 2013 Sep;11(5):779-84. doi: 10.2174/1570161111311050016. PMID- 23045301 OWN - NLM STAT- MEDLINE DCOM- 20130509 LR - 20260128 IS - 1969-6213 (Electronic) IS - 1774-024X (Linking) VI - 8 IP - 7 DP - 2012 Nov 22 TI - Renal tolerability of iopromide and iodixanol in 562 renally impaired patients undergoing cardiac catheterisation: the DIRECT study. PG - 830-8 LID - 20120628-02 [pii] LID - 10.4244/EIJV8I7A126 [doi] AB - AIMS: This multi-centre, randomised, double-blind study compared the nephrotoxicity of low-osmolar, low-viscous iopromide and iso-osmolar, high-viscous iodixanol in Chinese patients with moderate renal dysfunction, after coronary angiography or percutaneous coronary intervention (PCI). METHODS AND RESULTS: The primary endpoint was contrast-induced nephropathy (CIN) on day 3, defined as a post-dose increase in serum creatinine (SCr) of >/=50% from baseline. All patients were rigorously hydrated from six hours before intervention. In 562 evaluable patients (of 592 recruited), the contrast volume, presence of diabetes mellitus, mean baseline SCr and estimated glomerular filtration rate (eGFR) were comparable between the iopromide- and iodixanol-treated groups. SCr increases of >/=50% occurred in 1/278 (0.4%) of patients after iopromide and 1/284 (0.3%) after iodixanol. Incidences in the secondary endpoints were the following: SCr increases of >/=0.5 mg/dL, 1.4% and 0.7%, respectively; SCr increases of >/=25%, 5.4% and 2.8%; eGFR decreases of >/=25%, 3.6% and 2.5%. Only one patient showed renal failure, one week after dosing with iodixanol. All differences were statistically insignificant, in the overall collective group and in the subgroup with diabetes (n=170). CONCLUSIONS: With rigorous hydration, the CIN incidence was very low in patients with moderate renal dysfunction who underwent coronary angiography or PCI. No difference in nephrotoxicity was found between iopromide and iodixanol. FAU - Chen, Yundai AU - Chen Y AD - Department of Cardiology, Chinese PLA General Hospital, Beijing 100853, China. cyundai@medmail.com.cn FAU - Hu, Shunying AU - Hu S FAU - Liu, Yin AU - Liu Y FAU - Zhao, Ru AU - Zhao R FAU - Wang, Lefeng AU - Wang L FAU - Fu, Guosheng AU - Fu G FAU - He, Qing AU - He Q FAU - Su, Xi AU - Su X FAU - Zheng, Yang AU - Zheng Y FAU - Qi, Xiangqian AU - Qi X FAU - Liu, Huiliang AU - Liu H FAU - Wang, Jianan AU - Wang J FAU - Gao, Wei AU - Gao W FAU - Wang, Mingsheng AU - Wang M FAU - Liu, Shaowen AU - Liu S FAU - Zheng, Xing AU - Zheng X FAU - He, Ben AU - He B FAU - Yang, Ping AU - Yang P FAU - Zhou, Shenghua AU - Zhou S FAU - Gao, Chuanyu AU - Gao C FAU - Qiu, Chunguang AU - Qiu C LA - eng SI - ClinicalTrials.gov/NCT00926562 PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - France TA - EuroIntervention JT - EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology JID - 101251040 RN - 0 (Biomarkers) RN - 0 (Contrast Media) RN - 0 (Triiodobenzoic Acids) RN - 4419T9MX03 (Iohexol) RN - 712BAC33MZ (iopromide) RN - AYI8EX34EU (Creatinine) RN - HW8W27HTXX (iodixanol) SB - IM MH - Aged MH - Biomarkers/blood MH - *Cardiac Catheterization/adverse effects MH - China/epidemiology MH - *Contrast Media/adverse effects MH - *Coronary Angiography/adverse effects MH - Coronary Artery Disease/*diagnostic imaging/epidemiology/*therapy MH - Creatinine/blood MH - Diabetes Mellitus/epidemiology MH - Double-Blind Method MH - Female MH - Fluid Therapy MH - Glomerular Filtration Rate MH - Humans MH - Incidence MH - Iohexol/adverse effects/*analogs & derivatives MH - Kidney/metabolism/*physiopathology MH - Kidney Diseases/blood/*epidemiology/physiopathology MH - Male MH - Middle Aged MH - *Percutaneous Coronary Intervention/adverse effects MH - Predictive Value of Tests MH - Prevalence MH - Renal Insufficiency/chemically induced/epidemiology MH - Treatment Outcome MH - *Triiodobenzoic Acids/adverse effects EDAT- 2012/10/10 06:00 MHDA- 2013/05/10 06:00 CRDT- 2012/10/10 06:00 PHST- 2012/10/10 06:00 [entrez] PHST- 2012/10/10 06:00 [pubmed] PHST- 2013/05/10 06:00 [medline] AID - 20120628-02 [pii] AID - 10.4244/EIJV8I7A126 [doi] PST - ppublish SO - EuroIntervention. 2012 Nov 22;8(7):830-8. doi: 10.4244/EIJV8I7A126. PMID- 22999071 OWN - NLM STAT- MEDLINE DCOM- 20130416 LR - 20181202 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 110 IP - 12 DP - 2012 Dec 15 TI - Gender does not affect postdischarge outcomes in patients hospitalized for worsening heart failure with reduced ejection fraction (from the Efficacy of Vasopressin Antagonism in Heart Failure Outcome Study with Tolvaptan [EVEREST] Trial). PG - 1803-8 LID - S0002-9149(12)01945-5 [pii] LID - 10.1016/j.amjcard.2012.08.016 [doi] AB - Women have traditionally been underrepresented in heart failure (HF) trials, and their baseline characteristics and outcomes after hospitalization for HF are unclear. We retrospectively analyzed the clinical characteristics and outcomes of patients according to gender in the Efficacy of Vasopressin Antagonism in Heart Failure Outcome Study with Tolvaptan (EVEREST) trial. EVEREST randomized 4,133 patients hospitalized for HF and ejection fraction of 0.30). Despite a high event rate, no difference was seen in all-cause mortality (men 27% vs women 24%, multivariate hazard ratio 1.04, p = 0.61) or cardiovascular mortality plus HF hospitalization (men 42% vs women 39%, multivariate hazard ratio 1.11, p = 0.10) on univariate analysis or after adjusting for baseline covariates. In conclusion, women hospitalized for worsening HF with an ejection fraction of I, and lower creatinine clearance compared to men. Time from symptom onset to PCI >3 hours was associated with a trend toward worse 90-day mortality (adjusted hazard ratio 1.5, 95% confidence interval 0.9 to 2.2) in men but not in women (0.8, 0.5 to 1.4). In contrast, presence of Q waves on baseline electrocardiogram was associated with significantly higher 90-day mortality in men (adjusted hazard ratio 1.7, 95% confidence interval 1.0 to 2.7) and women (2.3, 1.2 to 4.2). In conclusion, in this gender-specific analysis, baseline Q wave was found be a better marker of risk of 90-day mortality than time from symptom onset to PCI, overall, and especially in women. CI - Copyright (c) 2012 Elsevier Inc. All rights reserved. FAU - Kaul, Padma AU - Kaul P AD - University of Alberta, Edmonton, Alberta, Canada. pkaul@ualberta.ca FAU - Fu, Yuling AU - Fu Y FAU - Westerhout, Cynthia M AU - Westerhout CM FAU - Granger, Christopher B AU - Granger CB FAU - Armstrong, Paul W AU - Armstrong PW LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20120822 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 RN - 0 (Antibodies, Monoclonal, Humanized) RN - 0 (Single-Chain Antibodies) RN - CHZ6OLQ3UU (pexelizumab) SB - IM MH - Aged MH - Alberta/epidemiology MH - *Angioplasty, Balloon, Coronary MH - Antibodies, Monoclonal, Humanized/*administration & dosage MH - Confidence Intervals MH - *Electrocardiography MH - Female MH - Follow-Up Studies MH - Humans MH - Injections, Intravenous MH - Male MH - Middle Aged MH - Myocardial Infarction/*diagnosis/mortality/therapy MH - North Carolina/epidemiology MH - Prognosis MH - Prospective Studies MH - Single-Chain Antibodies/*administration & dosage MH - Survival Rate/trends MH - Treatment Outcome EDAT- 2012/08/28 06:00 MHDA- 2013/01/16 06:00 CRDT- 2012/08/28 06:00 PHST- 2012/05/30 00:00 [received] PHST- 2012/07/13 00:00 [revised] PHST- 2012/07/13 00:00 [accepted] PHST- 2012/08/28 06:00 [entrez] PHST- 2012/08/28 06:00 [pubmed] PHST- 2013/01/16 06:00 [medline] AID - S0002-9149(12)01841-3 [pii] AID - 10.1016/j.amjcard.2012.07.020 [doi] PST - ppublish SO - Am J Cardiol. 2012 Dec 1;110(11):1555-60. doi: 10.1016/j.amjcard.2012.07.020. Epub 2012 Aug 22. PMID- 22920912 OWN - NLM STAT- MEDLINE DCOM- 20121016 LR - 20260518 IS - 1533-4406 (Electronic) IS - 0028-4793 (Linking) VI - 367 IP - 14 DP - 2012 Oct 4 TI - Intraaortic balloon support for myocardial infarction with cardiogenic shock. PG - 1287-96 LID - 10.1056/NEJMoa1208410 [doi] AB - BACKGROUND: In current international guidelines, intraaortic balloon counterpulsation is considered to be a class I treatment for cardiogenic shock complicating acute myocardial infarction. However, evidence is based mainly on registry data, and there is a paucity of randomized clinical trials. METHODS: In this randomized, prospective, open-label, multicenter trial, we randomly assigned 600 patients with cardiogenic shock complicating acute myocardial infarction to intraaortic balloon counterpulsation (IABP group, 301 patients) or no intraaortic balloon counterpulsation (control group, 299 patients). All patients were expected to undergo early revascularization (by means of percutaneous coronary intervention or bypass surgery) and to receive the best available medical therapy. The primary efficacy end point was 30-day all-cause mortality. Safety assessments included major bleeding, peripheral ischemic complications, sepsis, and stroke. RESULTS: A total of 300 patients in the IABP group and 298 in the control group were included in the analysis of the primary end point. At 30 days, 119 patients in the IABP group (39.7%) and 123 patients in the control group (41.3%) had died (relative risk with IABP, 0.96; 95% confidence interval, 0.79 to 1.17; P=0.69). There were no significant differences in secondary end points or in process-of-care measures, including the time to hemodynamic stabilization, the length of stay in the intensive care unit, serum lactate levels, the dose and duration of catecholamine therapy, and renal function. The IABP group and the control group did not differ significantly with respect to the rates of major bleeding (3.3% and 4.4%, respectively; P=0.51), peripheral ischemic complications (4.3% and 3.4%, P=0.53), sepsis (15.7% and 20.5%, P=0.15), and stroke (0.7% and 1.7%, P=0.28). CONCLUSIONS: The use of intraaortic balloon counterpulsation did not significantly reduce 30-day mortality in patients with cardiogenic shock complicating acute myocardial infarction for whom an early revascularization strategy was planned. (Funded by the German Research Foundation and others; IABP-SHOCK II ClinicalTrials.gov number, NCT00491036.). FAU - Thiele, Holger AU - Thiele H AD - University of Leipzig-Heart Center, Department of Internal Medicine/Cardiology, Leipzig, Germany. thielh@medizin.uni-leipzig.de FAU - Zeymer, Uwe AU - Zeymer U FAU - Neumann, Franz-Josef AU - Neumann FJ FAU - Ferenc, Miroslaw AU - Ferenc M FAU - Olbrich, Hans-Georg AU - Olbrich HG FAU - Hausleiter, Jorg AU - Hausleiter J FAU - Richardt, Gert AU - Richardt G FAU - Hennersdorf, Marcus AU - Hennersdorf M FAU - Empen, Klaus AU - Empen K FAU - Fuernau, Georg AU - Fuernau G FAU - Desch, Steffen AU - Desch S FAU - Eitel, Ingo AU - Eitel I FAU - Hambrecht, Rainer AU - Hambrecht R FAU - Fuhrmann, Jorg AU - Fuhrmann J FAU - Bohm, Michael AU - Bohm M FAU - Ebelt, Henning AU - Ebelt H FAU - Schneider, Steffen AU - Schneider S FAU - Schuler, Gerhard AU - Schuler G FAU - Werdan, Karl AU - Werdan K CN - IABP-SHOCK II Trial Investigators LA - eng SI - ClinicalTrials.gov/NCT00491036 PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20120826 PL - United States TA - N Engl J Med JT - The New England journal of medicine JID - 0255562 SB - IM CIN - N Engl J Med. 2012 Oct 4;367(14):1349-50. doi: 10.1056/NEJMe1209601. PMID: 22920913 CIN - Nat Rev Cardiol. 2012 Oct;9(10):551. doi: 10.1038/nrcardio.2012.132. PMID: 22965109 CIN - Med Klin Intensivmed Notfmed. 2012 Oct;107(7):567-70. doi: 10.1007/s00063-012-0168-0. PMID: 23052992 CIN - Ann Intern Med. 2012 Dec 18;157(12):JC6-11. doi: 10.7326/0003-4819-157-12-201212180-02011. PMID: 23247960 CIN - N Engl J Med. 2013 Jan 3;368(1):81. doi: 10.1056/NEJMc1213513. PMID: 23281982 CIN - N Engl J Med. 2013 Jan 3;368(1):80. doi: 10.1056/NEJMc1213513. PMID: 23281983 CIN - N Engl J Med. 2013 Jan 3;368(1):80-1. doi: 10.1056/NEJMc1213513. PMID: 23281984 CIN - Expert Rev Cardiovasc Ther. 2013 Feb;11(2):147-9. doi: 10.1586/erc.12.185. PMID: 23405835 CIN - Crit Care. 2013 Mar 06;17(2):307. doi: 10.1186/cc12520. PMID: 23472937 MH - Aged MH - Angioplasty, Balloon, Coronary MH - Coronary Artery Bypass MH - Female MH - Humans MH - Intention to Treat Analysis MH - *Intra-Aortic Balloon Pumping MH - Male MH - Middle Aged MH - Myocardial Infarction/*complications/therapy MH - Practice Guidelines as Topic MH - Prospective Studies MH - Shock, Cardiogenic/etiology/mortality/*therapy MH - Stents/adverse effects MH - Survival Rate MH - Treatment Failure FIR - Schuler, Gerhard IR - Schuler G FIR - Werdan, Karl IR - Werdan K FIR - Zeymer, Uwe IR - Zeymer U FIR - Thiele, Holger IR - Thiele H FIR - Zeymer, Uwe IR - Zeymer U FIR - Vonderschmitt, Karin IR - Vonderschmitt K FIR - Frey, Sonja IR - Frey S FIR - Messemer, Beate IR - Messemer B FIR - Alkisoglu, Zehra IR - Alkisoglu Z FIR - Vonderschmitt, Karin IR - Vonderschmitt K FIR - Schneider, Steffen IR - Schneider S FIR - Ourrak, Taoufik IR - Ourrak T FIR - Haerting, Johannes IR - Haerting J FIR - Huber, Kurt IR - Huber K FIR - Maisch, Bernhard IR - Maisch B FIR - Follath, Ferenc IR - Follath F FIR - Thiele, Holger IR - Thiele H FIR - Desch, Steffen IR - Desch S FIR - Fuernau, Georg IR - Fuernau G FIR - Schuler, Gerhard IR - Schuler G FIR - Leuschner, Anja IR - Leuschner A FIR - de Waha, Suzanne IR - de Waha S FIR - Eitel, Ingo IR - Eitel I FIR - Wetzel, Sabrina IR - Wetzel S FIR - Pausewang, Tom IR - Pausewang T FIR - Neumann, Franz-Josef IR - Neumann FJ FIR - Ferenc, Miroslaw IR - Ferenc M FIR - Olbrich, Hans-Gerd IR - Olbrich HG FIR - Hopf, Hans-Bernd IR - Hopf HB FIR - Hausleiter, Jorg IR - Hausleiter J FIR - de Waha, Antoinette IR - de Waha A FIR - Orban, Martin IR - Orban M FIR - Lennerz, Carsten IR - Lennerz C FIR - Seyfarth, Melchior IR - Seyfarth M FIR - Richardt, Gert IR - Richardt G FIR - Schwarz, Bettina IR - Schwarz B FIR - Abdel-Wahab, Mohamed IR - Abdel-Wahab M FIR - Toelg, Ralph IR - Toelg R FIR - Geist, Volker IR - Geist V FIR - Bahnsen-Maass, Monika IR - Bahnsen-Maass M FIR - Hennersdorf, Marcus IR - Hennersdorf M FIR - Graf, Jochen IR - Graf J FIR - Riemann, Urs IR - Riemann U FIR - Kuhn, Andreas IR - Kuhn A FIR - Scharpf, Dominik IR - Scharpf D FIR - Empen, Klaus IR - Empen K FIR - Felix, Stefan IR - Felix S FIR - Werdan, Karl IR - Werdan K FIR - Ebelt, Henning IR - Ebelt H FIR - Buerke, Michael IR - Buerke M FIR - Schlitt, Axel IR - Schlitt A FIR - Hambrecht, Rainer IR - Hambrecht R FIR - Fach, Andreas IR - Fach A FIR - Fiehn, Eduard IR - Fiehn E FIR - Zeymer, Uwe IR - Zeymer U FIR - Gitt, Anselm K IR - Gitt AK FIR - Mark, Bernd IR - Mark B FIR - Winkler, Ralph IR - Winkler R FIR - Lauer, Bernward IR - Lauer B FIR - Fuhrmann, Jorg IR - Fuhrmann J FIR - Bohm, Michael IR - Bohm M FIR - Link, Andreas IR - Link A FIR - Figulla, Hans-Reiner IR - Figulla HR FIR - Ferrari, Markus IR - Ferrari M FIR - Jung, Christian IR - Jung C FIR - Utschig, Stephan IR - Utschig S FIR - Kurowski, Volkhard IR - Kurowski V FIR - Wolfrum, Sebastian IR - Wolfrum S FIR - Radke, Peter W IR - Radke PW FIR - Schunkert, Heribert IR - Schunkert H FIR - Minden, Hans-Heinrich IR - Minden HH FIR - Braun-Dullaeus, Rudiger C IR - Braun-Dullaeus RC FIR - Schmeisser, Alexander IR - Schmeisser A FIR - Walz, Friederike IR - Walz F FIR - Krulls-Munch, Jurgen IR - Krulls-Munch J FIR - Rochor, Kristin IR - Rochor K FIR - Strasser, Ruth H IR - Strasser RH FIR - Simonis, Gregor IR - Simonis G FIR - Maier, Sebastian IR - Maier S FIR - Ertl, Georg IR - Ertl G FIR - Mudra, Harald IR - Mudra H FIR - Hug, Martin IR - Hug M FIR - Sick, Peter IR - Sick P FIR - Bomba, Peter IR - Bomba P FIR - Schultheiss, Hans-Peter IR - Schultheiss HP FIR - Tschope, Carsten IR - Tschope C FIR - Andresen, Dietrich IR - Andresen D FIR - Roth, Harry IR - Roth H FIR - Krulls-Munch, Jurgen IR - Krulls-Munch J FIR - Kurek, Christian IR - Kurek C FIR - Nienaber, Christoph IR - Nienaber C FIR - Ince, Huseyin IR - Ince H FIR - Schneider, Hendrick IR - Schneider H FIR - Hamm, Christian IR - Hamm C FIR - Mollmann, Helge IR - Mollmann H FIR - Lapp, Harald IR - Lapp H FIR - Baumann, Gert IR - Baumann G FIR - Knebel, Fabian IR - Knebel F FIR - Franz, Wolfgang IR - Franz W FIR - Schuhlen, Helmut IR - Schuhlen H FIR - Stracke, Lars U IR - Stracke LU FIR - Schwinger, Robert H IR - Schwinger RH FIR - Bauml, Herrmann IR - Bauml H FIR - Schachinger, Volker IR - Schachinger V FIR - Giessmann, Daniel IR - Giessmann D FIR - Lichtenberg, Michael IR - Lichtenberg M FIR - Prondzinsky, Roland IR - Prondzinsky R FIR - Tebbe, Ulrich IR - Tebbe U FIR - Birkemeyer, Ralf IR - Birkemeyer R EDAT- 2012/08/28 06:00 MHDA- 2012/10/17 06:00 CRDT- 2012/08/28 06:00 PHST- 2012/08/28 06:00 [entrez] PHST- 2012/08/28 06:00 [pubmed] PHST- 2012/10/17 06:00 [medline] AID - 10.1056/NEJMoa1208410 [doi] PST - ppublish SO - N Engl J Med. 2012 Oct 4;367(14):1287-96. doi: 10.1056/NEJMoa1208410. Epub 2012 Aug 26. PMID- 22898367 OWN - NLM STAT- MEDLINE DCOM- 20150511 LR - 20211021 IS - 1466-609X (Electronic) IS - 1364-8535 (Print) IS - 1364-8535 (Linking) VI - 16 IP - 4 DP - 2012 Aug 16 TI - A perioperative infusion of sodium bicarbonate does not improve renal function in cardiac surgery patients: a prospective observational cohort study. PG - R156 LID - 10.1186/cc11476 [doi] AB - INTRODUCTION: Cardiac-surgery-associated-acute-kidney-injury (CSA-AKI) is associated with increased morbidity and mortality. Recent data from patients undergoing on-pump coronary artery bypass grafting suggest that a perioperative infusion of sodium-bicarbonate may decrease the incidence of CSA-AKI. The present study aims to analyze the renoprotective effects of a 24h infusion of sodium-bicarbonate in a large, heterogeneous group of cardiac surgical patients METHODS: Starting in 4/2009, all patients undergoing cardiac surgery at our institution were enrolled in a prospective trial analyzing the relationship between preoperative cerebral oxygen saturation and postoperative organ dysfunction. We used this prospectively sampled data set to perform a cohort analysis of the renoprotective efficiency of a 24h continuous perioperative infusion of sodium-bicarbonate on the incidence of CSA-AKI that was routinely introduced in 7/2009. After exclusion of patients with endstage chronic kidney disease, off-pump procedures, and emergency cases, perioperative changes in renal function were assessed in 280 patients treated with a perioperative infusion of 4 mmol sodium-bicarbonate / kg body weight in comparison with a control cohort of 304 patients enrolled from April to June in this prospective cohort study. RESULTS: With the exception of a lower prevalence of a history of myocardial infarction and a lower preoperative use of intravenous heparin in the bicarbonate-group, no significant between group differences in patient demographics, surgical risk, type, and duration of surgery were observed. Patients in the bicarbonate group had a lower mean arterial blood pressure after induction of anesthesia, needed more fluids, more vasopressors, and a longer treatment time in the high dependency unit. Despite a higher postoperative diuresis, no differences in the incidence of AKI grade 1 to 3 and the need for renal replacement were observed. CONCLUSIONS: Routine perioperative administration of sodium bicarbonate failed to improve postoperative renal function in a large population of cardiac surgical patients. FAU - Heringlake, Matthias AU - Heringlake M FAU - Heinze, Hermann AU - Heinze H FAU - Schubert, Maria AU - Schubert M FAU - Nowak, Yvonne AU - Nowak Y FAU - Guder, Janina AU - Guder J FAU - Kleinebrahm, Maria AU - Kleinebrahm M FAU - Paarmann, Hauke AU - Paarmann H FAU - Hanke, Thorsten AU - Hanke T FAU - Schon, Julika AU - Schon J LA - eng PT - Journal Article PT - Observational Study PT - Research Support, Non-U.S. Gov't DEP - 20120816 PL - England TA - Crit Care JT - Critical care (London, England) JID - 9801902 RN - 8MDF5V39QO (Sodium Bicarbonate) SB - IM CIN - Crit Care. 2012 Dec 12;16(6):186. doi: 10.1186/cc11837. PMID: 23234469 MH - Acute Kidney Injury/*prevention & control/therapy MH - Aged MH - Cardiac Surgical Procedures/*adverse effects MH - Female MH - Hemodynamics MH - Humans MH - Infusions, Intravenous MH - Kidney/drug effects MH - Male MH - Perioperative Period MH - Prospective Studies MH - Renal Replacement Therapy MH - Sodium Bicarbonate/*administration & dosage PMC - PMC3580746 EDAT- 2012/08/18 06:00 MHDA- 2015/05/12 06:00 PMCR- 2012/08/16 CRDT- 2012/08/18 06:00 PHST- 2012/07/04 00:00 [received] PHST- 2012/08/16 00:00 [accepted] PHST- 2012/08/18 06:00 [entrez] PHST- 2012/08/18 06:00 [pubmed] PHST- 2015/05/12 06:00 [medline] PHST- 2012/08/16 00:00 [pmc-release] AID - cc11476 [pii] AID - 10.1186/cc11476 [doi] PST - epublish SO - Crit Care. 2012 Aug 16;16(4):R156. doi: 10.1186/cc11476. PMID- 22854323 OWN - NLM STAT- MEDLINE DCOM- 20121214 LR - 20220321 IS - 1421-9751 (Electronic) IS - 0008-6312 (Linking) VI - 122 IP - 3 DP - 2012 TI - Beneficial effects of high-dose atorvastatin pretreatment on renal function in patients with acute ST-segment elevation myocardial infarction undergoing emergency percutaneous coronary intervention. PG - 195-202 LID - 10.1159/000339472 [doi] AB - OBJECTIVES: To investigate whether preprocedural high-dose atorvastatin decreases the incidence of contrast-induced nephropathy (CIN) and protects the renal function after emergency percutaneous coronary intervention (PCI). METHODS: Statin-naive patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing emergency PCI (n = 161) randomly received atorvastatin (80 mg, n = 78, ATOR group) or placebo [n = 83, control (CON) group] followed by long-term atorvastatin (40 mg/day). The primary end point was incidence of CIN. RESULTS: In the ATOR group, 2.6% of the patients developed CIN versus 15.7% in the CON group (p = 0.01). In the ATOR group, postprocedural serum creatinine was significantly lower (93.4 +/- 17.1 vs. 112.6 +/- 23.3 micromol/l at 48 h and 84.2 +/- 14.2 vs. 95.3 +/- 17.7 micromol/l at 72 h, both p < 0.0001) and in the CON group, peak serum cystatin C was lower (0.51 +/- 0.14 vs. 0.61 +/- 0.13 mg/l, p < 0.0001). Atorvastatin pretreatment was independently associated with a decreased risk of CIN (OR 0.084, 95% CI 0.015-0.462, p = 0.004). The proportion of alanine aminotransferase > 3 x upper limit of the normal value within 1 month was 3.85 versus 1.20% (ATOR vs. CON group, p = 0.57). CONCLUSION: Preprocedural high-dose atorvastatin prevents CIN and protects the renal function in patients with acute STEMI undergoing emergency PCI. CI - Copyright (c) 2012 S. Karger AG, Basel. FAU - Li, Wei AU - Li W AD - Department of Cardiology, the Second Hospital of Hebei Medical University, Shijiazhuang, PR China. FAU - Fu, Xianghua AU - Fu X FAU - Wang, Yanbo AU - Wang Y FAU - Li, Xiangnan AU - Li X FAU - Yang, Zengxin AU - Yang Z FAU - Wang, Xuechao AU - Wang X FAU - Geng, Wei AU - Geng W FAU - Gu, Xinshun AU - Gu X FAU - Hao, Guozhen AU - Hao G FAU - Jiang, Yunfa AU - Jiang Y FAU - Fan, Weize AU - Fan W FAU - Wu, Weili AU - Wu W FAU - Li, Shiqiang AU - Li S LA - eng PT - Journal Article PT - Randomized Controlled Trial DEP - 20120731 PL - Switzerland TA - Cardiology JT - Cardiology JID - 1266406 RN - 0 (Contrast Media) RN - 0 (Cystatin C) RN - 0 (Heptanoic Acids) RN - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors) RN - 0 (Pyrroles) RN - A0JWA85V8F (Atorvastatin) RN - AYI8EX34EU (Creatinine) SB - IM MH - Aged MH - Angioplasty, Balloon, Coronary/*methods MH - Atorvastatin MH - Contrast Media/adverse effects MH - Creatinine/metabolism MH - Cystatin C/metabolism MH - Emergency Treatment MH - Female MH - Heptanoic Acids/*administration & dosage MH - Humans MH - Hydroxymethylglutaryl-CoA Reductase Inhibitors/*administration & dosage MH - Kidney Diseases/chemically induced/*prevention & control MH - Kidney Function Tests MH - Male MH - Myocardial Infarction/*therapy MH - Pyrroles/*administration & dosage EDAT- 2012/08/03 06:00 MHDA- 2012/12/15 06:00 CRDT- 2012/08/03 06:00 PHST- 2012/03/15 00:00 [received] PHST- 2012/05/07 00:00 [accepted] PHST- 2012/08/03 06:00 [entrez] PHST- 2012/08/03 06:00 [pubmed] PHST- 2012/12/15 06:00 [medline] AID - 000339472 [pii] AID - 10.1159/000339472 [doi] PST - ppublish SO - Cardiology. 2012;122(3):195-202. doi: 10.1159/000339472. Epub 2012 Jul 31. PMID- 22825901 OWN - NLM STAT- MEDLINE DCOM- 20121203 LR - 20191210 IS - 1898-018X (Electronic) IS - 1898-018X (Linking) VI - 19 IP - 4 DP - 2012 TI - Management of elderly patients with troponin positive chest pain in a district general hospital. PG - 395-401 AB - BACKGROUND: The number of elderly patients that present with an acute coronary syndrome (ACS) is increasing, reflecting the growing number of people in the general population in this age group. The various guidelines do not generally specify a management strategy in this elderly group and the management is often at the discretion of the treating physician. We conducted an audit within our Cardiology Department to compare our practice of management of ACS in the elderly population based on the European Society of Cardiology guidelines. METHODS: We conducted a retrospective analysis of the management of patients aged 80 and above that were admitted with troponin positive chest pain from 1(st) January to 31(st) December 2010. Patient information was primarily obtained from our computer data base system that includes blood results, ECHOs, diagnostic angiograms, discharge and clinic letters. If the information was inadequate we obtained patient files or contacted the relevant general practitioner. RESULTS: Octo-nonagenarians represented just over a third (35%) of all patients that were admitted with a troponin positive event during the study period. We noted a 10% mortality rate observed in our study population over a 12 month period. Atrial fibrillation was an incidental finding in 22% of patients. Nearly half of these patients (49%) were managed by the cardiologists. 68% of these patients underwent diagnostic coronary angiography, of which 32% went on to have percutaneous coronary intervention and 7% underwent surgical intervention. Majority (80%) of patients that underwent angioplasty had more than 1 stent and 74% of patients required more than one coronary vessel to be stented. The length of stay in hospital was double for patients who were under the care of the general medical teams rather than the cardiology team. This group also had a higher number of other comorbidities such as dementia, malignancy, a history of gastro intestinal bleeds and chronic renal impairment. CONCLUSIONS: Octo and nonagenarians represent a significant proportion of our ACS patients. They have high mortality, greater number of comorbidities, diseased coronary vessels and if intervention was undertaken required more than one stent. Therefore, octo-nonagenarians represent a very complex group of patients. Guidelines and risk stratification are of limited value in this group as clinical trial data is currently lacking. Quality of life and risk to benefit assessments are of paramount importance in this group. FAU - Sandhu, Kulwinder S AU - Sandhu KS AD - Department of Cardiology, Goodhope Hospital, Sutton Coldfield, West Midlands, United Kingdom. FAU - Singh, Avtar AU - Singh A FAU - Nadar, Sunil K AU - Nadar SK LA - eng PT - Journal Article PL - Poland TA - Cardiol J JT - Cardiology journal JID - 101392712 RN - 0 (Biomarkers) RN - 0 (Troponin) SB - IM MH - Acute Coronary Syndrome/blood/diagnosis/mortality/*therapy MH - Age Factors MH - Aged, 80 and over MH - Angina Pectoris/blood/diagnosis/mortality/*therapy MH - Biomarkers/blood MH - *Cardiology Service, Hospital/standards MH - Comorbidity MH - Guideline Adherence MH - *Health Services for the Aged/standards MH - *Hospitals, District/standards MH - *Hospitals, General/standards MH - Humans MH - Length of Stay MH - Medical Audit MH - *Outcome and Process Assessment, Health Care/standards MH - Practice Guidelines as Topic MH - *Practice Patterns, Physicians'/standards MH - Retrospective Studies MH - Risk Assessment MH - Risk Factors MH - Time Factors MH - Treatment Outcome MH - Troponin/*blood MH - United Kingdom EDAT- 2012/07/25 06:00 MHDA- 2012/12/10 06:00 CRDT- 2012/07/25 06:00 PHST- 2012/07/25 06:00 [entrez] PHST- 2012/07/25 06:00 [pubmed] PHST- 2012/12/10 06:00 [medline] AID - 10.5603/cj.2012.0071 [doi] PST - ppublish SO - Cardiol J. 2012;19(4):395-401. doi: 10.5603/cj.2012.0071. PMID- 22818068 OWN - NLM STAT- MEDLINE DCOM- 20121102 LR - 20121115 IS - 1558-3597 (Electronic) IS - 0735-1097 (Linking) VI - 60 IP - 10 DP - 2012 Sep 4 TI - Sex differences in mortality after transcatheter aortic valve replacement for severe aortic stenosis. PG - 882-6 LID - 10.1016/j.jacc.2012.05.009 [doi] AB - OBJECTIVES: The aim of this study was to examine sex differences in outcome after transcatheter aortic valve replacement (TAVR) with real-world data from 2 large centers in Canada. BACKGROUND: Transcatheter aortic valve replacement is an effective alternative to surgical valve replacement in symptomatic patients with severe aortic stenosis, but the impact of sex on outcomes remains unclear. The PARTNER (Placement of Aortic Transcatheter Valves) 1A trial demonstrated greater benefit of TAVR over surgery in women, but whether this was due to the poorer surgical outcome of women or better TAVR outcome, compared with men, is unknown. METHODS: Consecutive patients (n = 641) undergoing TAVR in Vancouver and Quebec City, Canada, were evaluated. Differences in all-cause mortality were examined with Kaplan-Meier estimates, adjusted logistic regression, and proportional hazards models. RESULTS: Women comprised 51.3% of the cohort. Balloon-expandable valves were used in 97% of cases, with transapical approach in 51.7 % women and 38.1% men. Women had more major vascular complications (12.4% vs. 5.4%, p = 0.003) and borderline significantly more major/life-threatening bleeds (21.6% vs. 15.8%, p = 0.08). At baseline, women had higher aortic gradients and worse renal function but better ejection fractions. Men had more comorbidities: prior myocardial infarction, prior revascularization, and chronic obstructive pulmonary disease. The adjusted odds ratio for 30-day all-cause mortality favored women, 0.39 (95% confidence interval: 0.19 to 0.80; p = 0.01), and this benefit persisted for 2 years, hazard ratio 0.60 (95% confidence interval: 0.41 to 0.88; p = 0.008). CONCLUSIONS: Female sex is associated with better short- and long-term survival after TAVR. Added to the PARTNER 1A findings, these results suggest TAVR might be the preferred treatment option for elderly women with symptomatic severe aortic stenosis. CI - Copyright (c) 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Humphries, Karin H AU - Humphries KH AD - Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada. khumphries@providencehealth.bc.ca FAU - Toggweiler, Stefan AU - Toggweiler S FAU - Rodes-Cabau, Josep AU - Rodes-Cabau J FAU - Nombela-Franco, Luis AU - Nombela-Franco L FAU - Dumont, Eric AU - Dumont E FAU - Wood, David A AU - Wood DA FAU - Willson, Alexander B AU - Willson AB FAU - Binder, Ronald K AU - Binder RK FAU - Freeman, Melanie AU - Freeman M FAU - Lee, May K AU - Lee MK FAU - Gao, Min AU - Gao M FAU - Izadnegahdar, Mona AU - Izadnegahdar M FAU - Ye, Jian AU - Ye J FAU - Cheung, Anson AU - Cheung A FAU - Webb, John G AU - Webb JG LA - eng PT - Journal Article PT - Multicenter Study DEP - 20120718 PL - United States TA - J Am Coll Cardiol JT - Journal of the American College of Cardiology JID - 8301365 SB - IM MH - Aged MH - Aged, 80 and over MH - Aortic Valve Stenosis/mortality/*therapy MH - Canada MH - *Cardiac Catheterization MH - Catheterization MH - Female MH - Heart Valve Prosthesis MH - Heart Valve Prosthesis Implantation/*methods/*mortality MH - Humans MH - Kaplan-Meier Estimate MH - Logistic Models MH - Male MH - Proportional Hazards Models MH - Prospective Studies MH - Severity of Illness Index MH - Sex Factors MH - Stroke Volume MH - Treatment Outcome EDAT- 2012/07/24 06:00 MHDA- 2012/11/03 06:00 CRDT- 2012/07/24 06:00 PHST- 2012/02/21 00:00 [received] PHST- 2012/04/13 00:00 [revised] PHST- 2012/05/11 00:00 [accepted] PHST- 2012/07/24 06:00 [entrez] PHST- 2012/07/24 06:00 [pubmed] PHST- 2012/11/03 06:00 [medline] AID - S0735-1097(12)01821-9 [pii] AID - 10.1016/j.jacc.2012.05.009 [doi] PST - ppublish SO - J Am Coll Cardiol. 2012 Sep 4;60(10):882-6. doi: 10.1016/j.jacc.2012.05.009. Epub 2012 Jul 18. PMID- 22795712 OWN - NLM STAT- MEDLINE DCOM- 20140422 LR - 20130904 IS - 1874-1754 (Electronic) IS - 0167-5273 (Linking) VI - 167 IP - 6 DP - 2013 Sep 10 TI - Optimal time for catheterization in NSTE-ACS patients with impaired renal function: insights from the ABOARD Study. PG - 2646-52 LID - S0167-5273(12)00917-5 [pii] LID - 10.1016/j.ijcard.2012.06.126 [doi] AB - BACKGROUND: To assess the impact of impaired renal function (IRF) and timing of catheterization (immediate versus delayed intervention) on outcomes in intermediate/high risk NSTE-ACS patients. METHODS: We performed a post-hoc analysis of the randomized ABOARD population to compare 1) patients with vs. without IRF and 2) the two intervention strategies in patients with IRF. A creatinine clearance <60 mL/min defined IRF. The primary endpoint was the in-hospital peak troponin I value; the secondary endpoints were a) the composite of death, myocardial infarction, urgent revascularization or recurrent ischemia (death/MI/UR/RI) and b) STEEPLE major bleeding (MB) at 1-month follow-up. RESULTS: Among the 345 patients, 75 (21.7%) had IRF. Patients with IRF were older, had more comorbidities and were at higher cardiovascular risk. Radial catheterization was predominant (84%). Among IRF patients, 37 (49%) and 38 (51%) patients were randomized to an immediate and delayed strategy, respectively. The primary and secondary endpoints rates were not different for the two comparisons. IRF was associated with more death (5.3% vs. 1.1%, p=0.043) and non-CABG MB (9.3% vs. 2.2%, p=0.001). In patients with IRF, a delayed strategy was associated with more recurrent ischemia (28.9% vs. 8.1%, p=0.021). Absence of clopidogrel pretreatment, insulin therapy and left main culprit lesion were independently associated with death/MI/UR/RI, while age and CABG surgery were related with MB. CONCLUSION: IRF is associated with worse outcomes in NSTE-ACS patients. The primary results of the ABOARD study apply also to patients with IRF in which the timing of catheterization does not impact hard outcomes. CI - Copyright (c) 2012 Elsevier Ireland Ltd. All rights reserved. FAU - Barthelemy, O AU - Barthelemy O AD - Institut de Cardiologie, Centre Hospitalier Universitaire Pitie-Salpetriere, Universite Paris 6, INSERM CMR 937, Paris, France. FAU - Cayla, G AU - Cayla G FAU - Silvain, J AU - Silvain J FAU - O'Connor, S A AU - O'Connor SA FAU - Bellemain-Appaix, A AU - Bellemain-Appaix A FAU - Beygui, F AU - Beygui F FAU - Sideris, G AU - Sideris G FAU - Varenne, O AU - Varenne O FAU - Collet, J P AU - Collet JP FAU - Vicaut, E AU - Vicaut E FAU - Montalescot, G AU - Montalescot G CN - ABOARD Investigators LA - eng SI - ClinicalTrials.gov/NCT00442949 PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20120712 PL - Netherlands TA - Int J Cardiol JT - International journal of cardiology JID - 8200291 RN - 0 (Troponin I) SB - IM MH - Acute Coronary Syndrome/*blood/epidemiology/*therapy MH - Adult MH - Aged MH - Angioplasty, Balloon, Coronary/methods MH - Cardiac Catheterization/*methods MH - Female MH - Humans MH - Male MH - Middle Aged MH - Renal Insufficiency/*blood/epidemiology/*therapy MH - Time Factors MH - Treatment Outcome MH - Troponin I/*blood OTO - NOTNLM OT - ACS OT - PCI OT - Renal failure EDAT- 2012/07/17 06:00 MHDA- 2014/04/23 06:00 CRDT- 2012/07/17 06:00 PHST- 2011/08/25 00:00 [received] PHST- 2012/06/01 00:00 [revised] PHST- 2012/06/24 00:00 [accepted] PHST- 2012/07/17 06:00 [entrez] PHST- 2012/07/17 06:00 [pubmed] PHST- 2014/04/23 06:00 [medline] AID - S0167-5273(12)00917-5 [pii] AID - 10.1016/j.ijcard.2012.06.126 [doi] PST - ppublish SO - Int J Cardiol. 2013 Sep 10;167(6):2646-52. doi: 10.1016/j.ijcard.2012.06.126. Epub 2012 Jul 12. PMID- 22795519 OWN - NLM STAT- MEDLINE DCOM- 20121231 LR - 20121022 IS - 1097-6809 (Electronic) IS - 0741-5214 (Linking) VI - 56 IP - 5 DP - 2012 Nov TI - The Modification of Diet in Renal Disease 4-calculated glomerular filtration rate is a better prognostic factor of cardiovascular events than classical cardiovascular risk factors in patients with peripheral arterial disease. PG - 1324-30 LID - S0741-5214(12)01034-8 [pii] LID - 10.1016/j.jvs.2012.04.049 [doi] AB - OBJECTIVE: Risk prediction is important in medical management, especially to optimize patient management before surgical intervention. No quantitative risk scores or predictors are available for patients with peripheral arterial disease (PAD). Surgical risk and prognosis are usually based on anesthetic scores or clinical evaluation. We suggest that renal function is a better predictor of risk than other cardiovascular parameters. This study used the four-variable Modification of Diet in Renal Disease (MDRD-4)-calculated glomerular filtration rate (GFR) to compare classical cardiovascular risk factors with prognosis and cardiovascular events of hospitalized PAD patients. METHODS: The study evaluated 204 patients who were admitted for vascular intervention and diagnosed with grade IIb, III, or IV PAD or with carotid or renal stenosis. Those with carotid or renal stenosis were excluded, leaving 188 patients who were randomized from 2004 to 2005 and monitored until 2010. We performed a life-table analysis with a 6-year follow-up period and one final checkpoint. The following risk factors were evaluated: age, sex, ischemic heart disease, ictus (as a manifestation of cerebrovascular disease related to systemic arterial disease), diabetes, arterial hypertension, dyslipidemia, smoking, chronic obstructive pulmonary disease, type of vascular intervention, and urea and creatinine plasma levels. The GFR was calculated using the MDRD-4 equation. Death, major cardiovascular events, and reintervention for arterial disease were recorded during the follow-up. RESULTS: Patients (73% men) were a mean age of 71.38 +/- 11.43 (standard deviation) years. PAD grade IIb was diagnosed in 41 (20%) and grade III-IV in 147 (72%). Forty-two minor amputations (20.6%), 21 major amputations (10.3%), and 102 revascularizations (50%) were performed. A major cardiovascular event occurred in 60 patients (29.4%), and 71 (34.8%) died. Multivariate logistic regression analysis showed that the MDRD-4 GFR, age, and male sex were independent variables related to death and that the MDRD-4 GFR and chronic obstructive pulmonary disease were related to major cardiovascular events. A statistically significant relationship was also found between serum creatinine levels and reintervention rates. CONCLUSIONS: The MDRD-4 GFR was a better predictor of risk of death or infarction than classical cardiovascular risk factors in patients with PAD. This suggests that its routine use in the initial evaluation in patients with PAD is beneficial. CI - Copyright (c) 2012 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved. FAU - Romero, Jose-Maria AU - Romero JM AD - Vascular Surgery Department, Institute of Biomedical Research, II-B Sant Pau, Barcelona, Spain. jromeroc@santpau.cat FAU - Bover, Jordi AU - Bover J FAU - Fite, Joan AU - Fite J FAU - Bellmunt, Sergi AU - Bellmunt S FAU - Dilme, Jaime-Felix AU - Dilme JF FAU - Camacho, Mercedes AU - Camacho M FAU - Vila, Luis AU - Vila L FAU - Escudero, Jose-Roman AU - Escudero JR LA - eng PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20120712 PL - United States TA - J Vasc Surg JT - Journal of vascular surgery JID - 8407742 SB - IM MH - Aged MH - Cardiovascular Diseases/*epidemiology/*etiology MH - *Diet MH - Female MH - *Glomerular Filtration Rate MH - Humans MH - Male MH - Peripheral Arterial Disease/*complications/*physiopathology MH - Prognosis MH - Renal Insufficiency, Chronic/*complications/*physiopathology MH - Risk Factors EDAT- 2012/07/17 06:00 MHDA- 2013/01/01 06:00 CRDT- 2012/07/17 06:00 PHST- 2012/02/08 00:00 [received] PHST- 2012/04/16 00:00 [revised] PHST- 2012/04/17 00:00 [accepted] PHST- 2012/07/17 06:00 [entrez] PHST- 2012/07/17 06:00 [pubmed] PHST- 2013/01/01 06:00 [medline] AID - S0741-5214(12)01034-8 [pii] AID - 10.1016/j.jvs.2012.04.049 [doi] PST - ppublish SO - J Vasc Surg. 2012 Nov;56(5):1324-30. doi: 10.1016/j.jvs.2012.04.049. Epub 2012 Jul 12. PMID- 22728005 OWN - NLM STAT- MEDLINE DCOM- 20121127 LR - 20211021 IS - 1879-1913 (Electronic) IS - 0002-9149 (Print) IS - 0002-9149 (Linking) VI - 110 IP - 7 DP - 2012 Oct 1 TI - Effect of late revascularization of a totally occluded coronary artery after myocardial infarction on mortality rates in patients with renal impairment. PG - 954-60 LID - 10.1016/j.amjcard.2012.05.024 [doi] AB - Renal dysfunction is an independent predictor of cardiovascular events and a negative prognostic indicator after myocardial infarction (MI). Randomized data comparing percutaneous coronary intervention to medical therapy in patients with MI with renal insufficiency are needed. The Occluded Artery Trial (OAT) compared optimal medical therapy alone to percutaneous coronary intervention with optimal medical therapy in 2,201 high-risk patients with occluded infarct arteries >24 hours after MI with serum creatinine levels 90 ml/min/1.73 m(2), 19.2% for eGFR 60 to 89 ml/min/1.73 m(2), and 34.9% for eGFR <60 ml/min/1.73 m(2); p <0.0001), death, and class IV HF, with no difference in rates of reinfarction. On multivariate analysis, eGFR was an independent predictor of death and HF. There was no effect of treatment assignment on the primary end point regardless of eGFR, and there was no significant interaction between eGFR and treatment assignment on any outcome. In conclusion, lower eGFR at enrollment was independently associated with death and HF in OAT participants. Despite this increased risk, the lack of benefit from percutaneous coronary intervention in the overall trial was also seen in patients with renal dysfunction and persistent occlusion of the infarct artery in the subacute phase after MI. CI - Copyright (c) 2012 Elsevier Inc. All rights reserved. FAU - Hastings, Ramin S AU - Hastings RS AD - Cardiovascular Clinical Research Center, Division of Cardiology, New York University School of Medicine, New York, New York, USA. FAU - Hochman, Judith S AU - Hochman JS FAU - Dzavik, Vladimir AU - Dzavik V FAU - Lamas, Gervasio A AU - Lamas GA FAU - Forman, Sandra A AU - Forman SA FAU - Schiele, Francois AU - Schiele F FAU - Michalis, Lampros K AU - Michalis LK FAU - Nikas, Dimitris AU - Nikas D FAU - Jaroch, Joanna AU - Jaroch J FAU - Reynolds, Harmony R AU - Reynolds HR LA - eng GR - U01 HL062509/HL/NHLBI NIH HHS/United States GR - U01 HL062511/HL/NHLBI NIH HHS/United States PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, N.I.H., Extramural DEP - 20120622 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM MH - Aged MH - Coronary Angiography MH - Coronary Stenosis/diagnostic imaging/etiology/*surgery MH - Female MH - Follow-Up Studies MH - Glomerular Filtration Rate MH - Humans MH - Male MH - Middle Aged MH - Myocardial Infarction/*complications/diagnosis/surgery MH - Myocardial Revascularization/*methods MH - Prognosis MH - Renal Insufficiency/complications/diagnosis/*mortality MH - Retrospective Studies MH - Risk Factors MH - Severity of Illness Index MH - Time Factors PMC - PMC3439588 MID - NIHMS388479 EDAT- 2012/06/26 06:00 MHDA- 2012/12/10 06:00 PMCR- 2013/10/01 CRDT- 2012/06/26 06:00 PHST- 2012/03/14 00:00 [received] PHST- 2012/05/23 00:00 [revised] PHST- 2012/05/23 00:00 [accepted] PHST- 2012/06/26 06:00 [entrez] PHST- 2012/06/26 06:00 [pubmed] PHST- 2012/12/10 06:00 [medline] PHST- 2013/10/01 00:00 [pmc-release] AID - S0002-9149(12)01425-7 [pii] AID - 10.1016/j.amjcard.2012.05.024 [doi] PST - ppublish SO - Am J Cardiol. 2012 Oct 1;110(7):954-60. doi: 10.1016/j.amjcard.2012.05.024. Epub 2012 Jun 22. PMID- 22721657 OWN - NLM STAT- MEDLINE DCOM- 20121029 LR - 20220331 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 5 IP - 6 DP - 2012 Jun TI - Contemporary incidence and predictors of stent thrombosis and other major adverse cardiac events in the year after XIENCE V implantation: results from the 8,061-patient XIENCE V United States study. PG - 626-35 LID - 10.1016/j.jcin.2012.02.014 [doi] AB - OBJECTIVES: The aim of this study was to identify predictors of clinical events after XIENCE V (Abbott Vascular, Santa Clara, California) stenting. BACKGROUND: The XIENCE V USA (XIENCE V Everolimus Eluting Coronary Stent System [EECSS] USA Post-Approval) study is a prospective, multicenter, Food and Drug Administration-required post-approval study to examine safety and effectiveness in real-world settings. After an initial 5,062 patients, 2,999 more were included as part of the DAPT (Dual Antiplatelet Therapy) trial (total n = 8,061). METHODS: One-year clinical events, including stent thrombosis (ST), cardiac death/myocardial infarction (MI), target lesion failure, and target lesion revascularization, were adjudicated according to Academic Research Consortium criteria, with ST and cardiac death/MI as primary and co-primary endpoints. Demographic, clinical, and procedural variables were assessed by multivariable analysis. A time-dependent covariate assessed the association between DAPT usage and ST. RESULTS: Roughly 61% were off-label; 85.6% remained on DAPT without interruption through 1 year. Incidences of definite/probable ST, cardiac death/MI, target lesion failure, and target lesion revascularization were 0.80% (95% confidence interval [CI]: 0.61% to 1.03%), 7.1% (95% CI: 6.51% to 7.68%), 8.9% (95% CI: 8.30% to 9.60%), and 4.3% (95% CI: 3.82% to 4.75%), respectively. Several independent clinical and angiographic predictors were identified for each outcome. Predictors of ST included DAPT interruption 30 days was not predictive of ST. CONCLUSIONS: In this large, real-world population, XIENCE V demonstrated low event rates at 1 year, with several independent predictors. Early DAPT interruption (30 days) was not predictive. (XIENCE V Everolimus Eluting Coronary Stent System [EECSS] USA Post-Approval Study; NCT00676520). CI - Copyright (c) 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Naidu, Srihari S AU - Naidu SS AD - Division of Cardiology, Winthrop University Hospital, Mineola, New York 11501, USA. ssnaidu@winthrop.org FAU - Krucoff, Mitchell W AU - Krucoff MW FAU - Rutledge, David R AU - Rutledge DR FAU - Mao, Vivian W AU - Mao VW FAU - Zhao, Weiying AU - Zhao W FAU - Zheng, Qing AU - Zheng Q FAU - Wilburn, Olivia AU - Wilburn O FAU - Sudhir, Krishnankutty AU - Sudhir K FAU - Simonton, Charles AU - Simonton C FAU - Hermiller, James B AU - Hermiller JB LA - eng SI - ClinicalTrials.gov/NCT00676520 PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 RN - 0 (Cardiovascular Agents) RN - 0 (Platelet Aggregation Inhibitors) RN - 9HW64Q8G6G (Everolimus) RN - W36ZG6FT64 (Sirolimus) SB - IM MH - Aged MH - Angioplasty, Balloon, Coronary/*adverse effects/instrumentation/mortality MH - Cardiovascular Agents/administration & dosage MH - Coronary Artery Disease/mortality/*therapy MH - Coronary Thrombosis/*etiology/mortality MH - Drug Therapy, Combination MH - Drug-Eluting Stents MH - Everolimus MH - Female MH - Humans MH - Incidence MH - Kaplan-Meier Estimate MH - Male MH - Middle Aged MH - Multivariate Analysis MH - Myocardial Infarction/etiology/mortality MH - Platelet Aggregation Inhibitors/administration & dosage MH - Proportional Hazards Models MH - Prospective Studies MH - Prosthesis Design MH - Risk Assessment MH - Risk Factors MH - Sirolimus/administration & dosage/analogs & derivatives MH - Time Factors MH - Treatment Outcome MH - United States/epidemiology EDAT- 2012/06/23 06:00 MHDA- 2012/10/30 06:00 CRDT- 2012/06/23 06:00 PHST- 2011/09/10 00:00 [received] PHST- 2012/02/10 00:00 [revised] PHST- 2012/02/18 00:00 [accepted] PHST- 2012/06/23 06:00 [entrez] PHST- 2012/06/23 06:00 [pubmed] PHST- 2012/10/30 06:00 [medline] AID - S1936-8798(12)00298-1 [pii] AID - 10.1016/j.jcin.2012.02.014 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2012 Jun;5(6):626-35. doi: 10.1016/j.jcin.2012.02.014. PMID- 22718372 OWN - NLM STAT- MEDLINE DCOM- 20121102 LR - 20120621 IS - 1897-4279 (Electronic) IS - 0022-9032 (Linking) VI - 70 IP - 6 DP - 2012 TI - What level of hyperglycaemia on admission indicates a poor prognosis in patients with myocardial infarction treated invasively? PG - 564-72 AB - BACKGROUND: Stress hyperglycaemia on admission is a predictor of mortality in patients with acute myocardial infarction (MI). AIM: To establish what level of hyperglycaemia on admission indicates a significantly poorer long-term prognosis in patients with MI treated invasively. METHODS: Glycaemia on admission was measured in patients with both ST-segment elevation MI (STEMI) and non-ST- -segment elevation MI (NSTEMI) treated with percutaneous coronary intervention (PCI). In-hospital and late mortality were evaluated during a 679.3 +/- 202 day follow-up. RESULTS: We enrolled 794 patients (564 men; 71%), mean age 63.8 +/- 11.3 years. One per cent of the patients died during initial hospitalisation, and 10% during the two-year follow-up. The mean value of glycaemia in the whole population was 115 +/- 36 mg/dL (6.32 +/- 1.98 mmol/L). Admission glycaemia in patients who died in hospital was 194 +/- 71 mg/dL (10.67 +/- 3.91 mmol/L), while in the patients discharged home it was 114 +/- 35 mg/dL (6.27 +/- 1.93 mmol/L) (p < 0.0001). In terms of two-year mortality, the patients who died had also significantly higher glycaemia on admission (145 +/- 48 mg/dL; 7.98 +/- 2.64 mmol/L) vs 112 +/- 31 mg/dL (6.16 +/- 1.71 mmol/L, p < 0.0001). Apart from admission hyperglycaemia, we found the following risk factors of late mortality in univariate analysis: age, heart rate (HR), left ventricular ejection fraction (LVEF), glomerular filtration rate (GFR), creatinine level, number of significantly narrowed coronary vessels other than the infarct related artery (IRA), and unsuccessful PCI. In multivariate analysis, the following parameters correlated with death in the two-year follow-up: glycaemia on admission, age, HR, LVEF, GFR, creatinine level, total cholesterol, number of significantly narrowed coronary vessels other than the IRA, and unsuccessful PCI. Hyperglycaemia on admission was an independent risk factor of death even after adjustment for confounding variables such as age, sex and LVEF. We compared the areas under ROC curve for in-hospital mortality and the areas under ROC curve for late mortality according to glycaemia on admission. Both were significantly different from those of a random model (p < 0.001 and p < 0.001, respectively). A glycaemia value of 205 mg/dL (11.28 mmol/L) calculated from ROC curve had the highest sensitivity and specificity for late mortality. Apart from these findings, we observed a linear correlation between glycaemia and mortality. CONCLUSIONS: The best cut-off value for stress hyperglycaemia determined by ROC curve in patients with acute MI treated invasively is 205 mg/dL (11.28 mmol/L). Patients with glucose levels > 205 mg/dL (11.28 mmol/L) on admission have significantly higher late mortality compared to those with glucose levels < 205 mg/dL (11.28 mmol/L). Our results suggest that hyperglycaemia is a reliable marker of poor outcome in acute MI patients with and without previously diagnosed diabetes mellitus. This level of glucose may be used in risk stratification in patients with acute MI. FAU - Tomaszuk Kazberuk, Anna AU - Tomaszuk Kazberuk A AD - Department of Cardiology, Medical University in Bialystok, ul. M. Sklodowskiej-Curie 24A, Bialystok, Poland. walkaz@poczta.fm FAU - Kozuch, Marcin AU - Kozuch M FAU - Malyszko, Jolanta AU - Malyszko J FAU - Bachorzewska Gajewska, Hanna AU - Bachorzewska Gajewska H FAU - Dobrzycki, Slawomir AU - Dobrzycki S FAU - Kosacka, Urszula AU - Kosacka U FAU - Musial, Wlodzimierz J AU - Musial WJ LA - eng LA - pol PT - Journal Article PL - Poland TA - Kardiol Pol JT - Kardiologia polska JID - 0376352 SB - IM CIN - Kardiol Pol. 2012;70(6):573. PMID: 22718373 MH - Angioplasty, Balloon, Coronary MH - Area Under Curve MH - Comorbidity MH - Coronary Angiography MH - Echocardiography MH - Female MH - Hospitalization/statistics & numerical data MH - Humans MH - Hyperglycemia/*classification/*epidemiology MH - Kaplan-Meier Estimate MH - Male MH - Middle Aged MH - Myocardial Infarction/diagnosis/*epidemiology/*therapy MH - Prognosis MH - ROC Curve MH - Retrospective Studies MH - Sex Distribution MH - Sex Factors MH - Survival Rate EDAT- 2012/06/22 06:00 MHDA- 2012/11/03 06:00 CRDT- 2012/06/22 06:00 PHST- 2012/06/22 06:00 [entrez] PHST- 2012/06/22 06:00 [pubmed] PHST- 2012/11/03 06:00 [medline] PST - ppublish SO - Kardiol Pol. 2012;70(6):564-72. PMID- 22664573 OWN - NLM STAT- MEDLINE DCOM- 20121217 LR - 20190819 IS - 1347-4820 (Electronic) IS - 1346-9843 (Linking) VI - 76 IP - 8 DP - 2012 TI - Sirolimus eluting coronary stent implantation in patients on maintenance hemodialysis: the OUCH study (outcome of cypher stent inhemodialysis patients). PG - 1856-63 AB - BACKGROUND: Pivotal studies on drug-eluting stents have excluded hemodialysis (HD) patients. No quantitative coronary angiography (QCA) analysis has been reported. METHODS AND RESULTS: The OUtcome of Cypher stent in Hemodialysis patients (OUCH) Study is a prospective non-randomized single-arm registry designed to assess the results of sirolimus-eluting stents in HD patients, with follow-up QCA in an independent core laboratory. The primary endpoint was the occurrence of target-vessel failure (TVF) defined as cardiac death, myocardial infarction (MI), and target-vessel revascularization (TVR) at 1 year. A total of 117 patients were enrolled. The TVF rate was 24.9% (2.6% cardiac death, 1.4% MI, 23.9% TVR), and stent thrombosis was documented in 1 patient (0.9%). Coronary calcification was a predictor of TVF. Late lumen loss (LLL) averaged 0.69+/-0.93mm. The histogram of LLL showed that a total of 76% of lesions were distributed the same normally as that in normal renal function (average LLL 0.20+/-0.29mm), but 24% of lesions were outliers (average LLL 2.07+/-0.62mm). CONCLUSIONS: This report describes different clinical and QCA results in HD patients as higher TVF rate, different predictive factors, and different histogram of LLL compared with normal renal function. The different histogram of LLL was the existence of many outliers with the same average and the same deviation, suggesting the loss of sirolimus had an effect on a significant number of HD patients. FAU - Ikari, Yuji AU - Ikari Y AD - Department of Cardiovascular Medicine, Tokai University School of Medicine, Isehara, Japan. ikari@is.icc.u-tokai.ac.jp FAU - Tanabe, Kengo AU - Tanabe K FAU - Koyama, Yutaka AU - Koyama Y FAU - Kozuma, Ken AU - Kozuma K FAU - Sano, Koichi AU - Sano K FAU - Isshiki, Takaaki AU - Isshiki T FAU - Katsuki, Takaaki AU - Katsuki T FAU - Kimura, Kazuo AU - Kimura K FAU - Yamane, Masahisa AU - Yamane M FAU - Takahashi, Nozomu AU - Takahashi N FAU - Hibi, Kiyoshi AU - Hibi K FAU - Hasegawa, Kotaro AU - Hasegawa K FAU - Ishiwata, Sugao AU - Ishiwata S FAU - Kiyooka, Takahiko AU - Kiyooka T FAU - Yokoi, Hiroyoshi AU - Yokoi H FAU - Uehara, Yoshiki AU - Uehara Y FAU - Hara, Kazuhiro AU - Hara K LA - eng PT - Clinical Trial PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't DEP - 20120511 PL - Japan TA - Circ J JT - Circulation journal : official journal of the Japanese Circulation Society JID - 101137683 RN - 0 (Immunosuppressive Agents) RN - W36ZG6FT64 (Sirolimus) SB - IM MH - Aged MH - Coronary Disease/mortality/physiopathology/*therapy MH - Death MH - *Drug-Eluting Stents MH - Female MH - Humans MH - Immunosuppressive Agents/*pharmacology MH - Kidney Function Tests MH - Male MH - Middle Aged MH - Myocardial Infarction/etiology/mortality/physiopathology/therapy MH - *Myocardial Revascularization MH - Prospective Studies MH - *Renal Dialysis MH - Sirolimus/*pharmacology MH - Time Factors MH - Vascular Calcification/mortality/physiopathology/*therapy EDAT- 2012/06/06 06:00 MHDA- 2012/12/18 06:00 CRDT- 2012/06/06 06:00 PHST- 2012/06/06 06:00 [entrez] PHST- 2012/06/06 06:00 [pubmed] PHST- 2012/12/18 06:00 [medline] AID - DN/JST.JSTAGE/circj/CJ-12-0046 [pii] AID - 10.1253/circj.cj-12-0046 [doi] PST - ppublish SO - Circ J. 2012;76(8):1856-63. doi: 10.1253/circj.cj-12-0046. Epub 2012 May 11. PMID- 22635965 OWN - NLM STAT- MEDLINE DCOM- 20130326 LR - 20120827 IS - 1477-111X (Electronic) IS - 0267-6591 (Linking) VI - 27 IP - 5 DP - 2012 Sep TI - Pre-filling of the extracorporeal circuit with autologous blood is safe, but not effective in optimizing biocompatibility in high-risk patients. PG - 371-7 LID - 10.1177/0267659112447654 [doi] AB - OBJECTIVES: Haemodilution resulting from crystalloid priming of the cardiopulmonary bypass circuit represents a major risk factor for blood transfusions in high-risk cardiac surgery patients. We designed this study to evaluate the effects of antegrade autologous priming (AAP) on reducing perioperative blood transfusion and markers of the inflammatory response in older patients (>75 years). METHODS: Seventy-two patients undergoing first-time coronary bypass and/or aortic valve replacement were prospectively randomised to a cardiopulmonary bypass (CPB) with or without AAP. AAP was performed by adding the patient's own blood to the prime solution (mean 280 ml). Perfusion and anaesthetic techniques were as usual. The haematocrit was maintained at a minimum of 21% during CPB. Patients were well matched for all preoperative variables, including established transfusion risk factors. The primary endpoint was the requirement of red cell transfusion. The surrogate endpoints were renal function, inflammatory response and ischaemic parameters. Blood samples were drawn pre- and intraoperatively and at intervals of 6 hours till POD 6. RESULTS: Current analysis shows no differences in patients receiving homologous packed red cell transfusions. Also, markers of the inflammatory response (IL6, IL8), renal function (cystatin C, creatinine) and myocardial ischaemia (troponin T, CK-MB) were comparable in both groups (p>0.05). Clinical outcomes were similar with respect to pulmonary, renal and hepatic function, length of ICU stay and hospital stay. CONCLUSION: These data suggest that antegrade autologous priming is a safe procedure, but an ineffective way for improving biocompatibility and reducing the need for blood transfusion in older patients. FAU - Kiessling, A-H AU - Kiessling AH AD - Department of Thoracic and Cardiovascular Surgery, Johann Wolfgang Goethe University, Frankfurt am Main, Germany. cardiac.surgeon@dr-kiessling.com FAU - Wedde, S AU - Wedde S FAU - Keller, H AU - Keller H FAU - Reyher, C AU - Reyher C FAU - Stock, U AU - Stock U FAU - Beiras-Fernandez, A AU - Beiras-Fernandez A FAU - Moritz, A AU - Moritz A LA - eng PT - Journal Article PT - Randomized Controlled Trial DEP - 20120525 PL - England TA - Perfusion JT - Perfusion JID - 8700166 SB - IM MH - Aged MH - Blood Transfusion, Autologous/*methods MH - Coronary Artery Bypass/*adverse effects/methods MH - Extracorporeal Circulation/*methods MH - Female MH - Hemodilution/*methods MH - Humans MH - Male MH - Perfusion/*methods MH - Prospective Studies MH - Risk Factors MH - Treatment Outcome EDAT- 2012/05/29 06:00 MHDA- 2013/03/27 06:00 CRDT- 2012/05/29 06:00 PHST- 2012/05/29 06:00 [entrez] PHST- 2012/05/29 06:00 [pubmed] PHST- 2013/03/27 06:00 [medline] AID - 0267659112447654 [pii] AID - 10.1177/0267659112447654 [doi] PST - ppublish SO - Perfusion. 2012 Sep;27(5):371-7. doi: 10.1177/0267659112447654. Epub 2012 May 25. PMID- 22619318 OWN - NLM STAT- MEDLINE DCOM- 20131104 LR - 20130211 IS - 1873-734X (Electronic) IS - 1010-7940 (Linking) VI - 43 IP - 3 DP - 2013 Mar TI - Surgical treatment of left main disease and severe carotid stenosis: does the off-pump technique provide a better outcome? PG - 541-8; discussion 548 LID - 10.1093/ejcts/ezs277 [doi] AB - OBJECTIVES: Left main disease (LMD), combined with carotid artery stenosis (CAS), constitutes a high-risk patient population. Priority is often given to coronary revascularization, due to the severity of the angina. However, the choice of revascularization strategy [off-pump coronary artery bypass (OPCAB) vs coronary artery bypass grafting (CABG)] remains elusive. METHODS: A total of 1340 patients with LMD were non-randomly assigned to either on-pump (CABG group, n = 680) or off-pump (OPCAB group, n = 634) revascularization between 1 January 2006 and 21 September 2010. Multivariable regression was used to determine the risk-adjusted impact of a revascularization strategy on a composite in-hospital outcome (MACCE), and proportional hazards regression was used to define the variables affecting long-term survival. RESULTS: Significant CAS was found in 130 patients: 84 (13.1%) patients underwent OPCAB, while 46 patients (6.8%) underwent CABG (P < 0.05). Patients with a history of stroke/transient ischaemic attack were also more likely to receive OPCAB (7.1 vs 4.7%; P = 0.08). OPCAB patients were older, in a higher New York Heart Association (NYHA) class, with a lower LVEF and higher EuroSCORE. A calcified aorta was found in 79 patients [OPCAB-CABG: 49 (7.73%) vs 30 (4.41%); P = 0.016] and resulted in a less complex revascularization (OPCAB-CABG: 2.3 +/- 0.71 vs 3.19 +/- 0.82; P < 0.05), and 30-day mortality was insignificantly higher in the CABG (2.7 vs 2.8%) as well as MACCE (11.2 vs 12.2%; P = NS). This trend reversed when late mortality was evaluated; however, it did not reach significance at 60 months. Preoperative renal impairment requiring dialysis was found to be a technique-independent predictor of MACCE. The number of arterial conduits also influenced MACCE. CONCLUSIONS: Off-pump coronary revascularization may offer risk reduction of neurological complications in patients with a significant carotid artery disease and a history of previous stroke, but a larger study population is needed to support this thesis. The growing discrepancy in long-term survival should draw attention to a more complete revascularization in OPCAB patients. FAU - Zembala, Michael O AU - Zembala MO AD - Department of Cardiac Surgery and Transplantology, Silesian Center for Heart Diseases, Zabrze, Poland. m.zembala.jr@sccs.pl FAU - Filipiak, Krzysztof AU - Filipiak K FAU - Ciesla, Daniel AU - Ciesla D FAU - Pacholewicz, Jerzy AU - Pacholewicz J FAU - Hrapkowicz, Tomasz AU - Hrapkowicz T FAU - Knapik, Piotr AU - Knapik P FAU - Przybylski, Roman AU - Przybylski R FAU - Zembala, Marian AU - Zembala M LA - eng PT - Clinical Trial PT - Comparative Study PT - Journal Article DEP - 20120522 PL - Germany TA - Eur J Cardiothorac Surg JT - European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery JID - 8804069 SB - IM MH - Aged MH - Carotid Stenosis/*surgery MH - Coronary Artery Bypass/adverse effects/*methods/standards MH - Coronary Artery Bypass, Off-Pump/adverse effects/*methods/standards MH - Coronary Artery Disease/*surgery MH - Female MH - Humans MH - Ischemic Attack, Transient/physiopathology MH - Kaplan-Meier Estimate MH - Male MH - Middle Aged MH - Multivariate Analysis MH - Retrospective Studies MH - Statistics, Nonparametric MH - Stroke/physiopathology MH - Treatment Outcome EDAT- 2012/05/24 06:00 MHDA- 2013/11/05 06:00 CRDT- 2012/05/24 06:00 PHST- 2012/05/24 06:00 [entrez] PHST- 2012/05/24 06:00 [pubmed] PHST- 2013/11/05 06:00 [medline] AID - ezs277 [pii] AID - 10.1093/ejcts/ezs277 [doi] PST - ppublish SO - Eur J Cardiothorac Surg. 2013 Mar;43(3):541-8; discussion 548. doi: 10.1093/ejcts/ezs277. Epub 2012 May 22. PMID- 22613532 OWN - NLM STAT- MEDLINE DCOM- 20120926 LR - 20131121 IS - 2542-5641 (Electronic) IS - 0366-6999 (Linking) VI - 125 IP - 6 DP - 2012 Mar TI - Safety and efficacy of anisodamine on prevention of contrast induced nephropathy in patients with acute coronary syndrome. PG - 1063-7 AB - BACKGROUND: Previous studies have proved the renal protective effects of anisodamine in patients with septic shock. The aim of this study was to investigate anisodamine for the prevention of contrast induced nephropathy (CIN) in patients with acute coronary syndrome (ACS). METHODS: Consecutive ACS patients undergoing elective percutaneous coronary intervention (PCI) were randomly assigned to one of two groups: patients in the anisodamine group (ANI group) were assigned to receive intravenous infusions of anisodamine by an adjusted-dose (0.1 - 0.2 microg x kg(-1)x min(-1)) from the PCI procedure to 24 hours after PCI, and the control group (CON group) received 0.9% isotonic saline of the same volume. All patients were hydrated for 6 to 12 hours before and 12 hours after PCI. Blood samples were taken on the day of PCI and at 24, 48 and 72 hours after PCI to measure the serum creatinine (SCr). RESULTS: A total of 177 patients were involved in the study, 88 in the ANI group and 89 in the CON group. In both groups, the SCr concentrations significantly increased after PCI, with the peak value occurring at 48 hours. At 72 hours, the SCr concentration in the ANI group retuned to the baseline level (P > 0.05), but the SCr concentration in CON group was still higher than baseline level (P < 0.01). The SCr concentrations at 48 and 72 hours after PCI were much lower in the ANI group than those in the CON group (both P < 0.01). The estimated glomerular filtration rate (eGFR) significantly decreased after PCI, the lowest value occurred at 48 hours. In the ANI group, the eGFR at 72 hours was similar to the baseline level. In the CON group, the eGFR failed to return to baseline at 72 hours (P < 0.01). The eGFR at 24, 48 and 72 hours after PCI were higher in the ANI group (all P < 0.05). The incidence of CIN in the ANI group was lower than that in the CON group within 72 hours after PCI (P < 0.05). The results of multiple Logistic regression proved that both diabetes and left ventricular ejection fraction (LVEF) were independent predictors of CIN, and treatment with anisodamine was an independent preventive factor of CIN (OR 0.369 and 95%CI 0.171 to 0.794, P = 0.011). No serious side effects were found in the ANI group. CONCLUSION: Intravenous infusion of anisodamine during and after elective PCI may safely prevent the occurrence of CIN in ACS patients. FAU - Wang, Yan-bo AU - Wang YB AD - Department of Cardiology, Second Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, China. FAU - Fu, Xiang-hua AU - Fu XH FAU - Gu, Xin-shun AU - Gu XS FAU - Wang, Xue-chao AU - Wang XC FAU - Zhao, Yu-jun AU - Zhao YJ FAU - Hao, Guo-zhen AU - Hao GZ FAU - Jiang, Yun-fa AU - Jiang YF FAU - Fan, Wei-ze AU - Fan WZ FAU - Wu, Wei-li AU - Wu WL FAU - Li, Shi-qiang AU - Li SQ FAU - Xue, Ling AU - Xue L LA - eng PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - China TA - Chin Med J (Engl) JT - Chinese medical journal JID - 7513795 RN - 0 (Contrast Media) RN - 0 (Solanaceous Alkaloids) RN - 01343Q8EL8 (anisodamine) RN - AYI8EX34EU (Creatinine) SB - IM MH - Acute Coronary Syndrome/*therapy MH - Adult MH - Aged MH - *Angioplasty, Balloon, Coronary MH - Contrast Media/*adverse effects MH - Creatinine/blood MH - Female MH - Glomerular Filtration Rate MH - Humans MH - Kidney Diseases/chemically induced/epidemiology/*prevention & control MH - Logistic Models MH - Male MH - Middle Aged MH - Solanaceous Alkaloids/adverse effects/*therapeutic use EDAT- 2012/05/23 06:00 MHDA- 2012/09/27 06:00 CRDT- 2012/05/23 06:00 PHST- 2012/05/23 06:00 [entrez] PHST- 2012/05/23 06:00 [pubmed] PHST- 2012/09/27 06:00 [medline] PST - ppublish SO - Chin Med J (Engl). 2012 Mar;125(6):1063-7. PMID- 22607857 OWN - NLM STAT- MEDLINE DCOM- 20120731 LR - 20260128 IS - 1097-6744 (Electronic) IS - 0002-8703 (Linking) VI - 163 IP - 5 DP - 2012 May TI - Variations in practice and outcomes in patients undergoing primary percutaneous coronary intervention in the United States and Canada: insights from the Assessment of Pexelizumab in Acute Myocardial Infarction (APEX AMI) trial. PG - 797-803 LID - 10.1016/j.ahj.2012.03.001 [doi] AB - BACKGROUND: Information on practice patterns and outcomes in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary interventions (PCIs) in Canada vs United States is limited. METHODS: We evaluated differences in clinical and angiographic features, practice patterns, and outcomes between Canada and United States in 2,086 patients with ST-elevation myocardial infarction undergoing primary PCI in the APEX AMI trial. RESULTS: Of 2,086 patients, 335 (19%) were enrolled in Canada. Compared with US patients, Canadians were older with lower body mass index and creatinine clearance and less likely to have history of hypertension, smoking, or prior revascularization. Baseline infarct artery patency was higher, and the use of intra-aortic balloon pump and drug-eluting stents was lower in Canadian patients. Median door-to-PCI time was significantly shorter among Canadian patients (0.9 hours [interquartile range 0.6-1.3] vs 1.2 hours [interquartile range 0.8-1.7]). Clinical outcomes at 90 days were lower among Canadian patients, including shock (2.7% vs 4.2%), heart failure (3.6% vs 5.6%), bleeding (3.6% vs 9.6%), and atrial (3.6% vs 7.4%) and ventricular (3.0% vs 6.4%) arrhythmias. However, 90-day mortality (2.7% vs 4.8%, adjusted hazard ratio 0.62, 95% CI 0.47-1.28) and composite of death, shock, or heart failure (6.8% vs 11.5%, adjusted hazard ratio 0.77, 95% CI 0.47-1.27) were similar in the 2 cohorts. CONCLUSIONS: Compared with US patients, Canadian patients had shorter door-to-PCI time but similar 90-day outcomes. These data suggest an opportunity for US sites to examine and learn from the Canadian systems of processes of care and implement changes so as to improve the timeliness of primary PCI. CI - Copyright (c) 2012 Mosby, Inc. All rights reserved. FAU - Mehta, Rajendra H AU - Mehta RH AD - Duke Clinical Research Institute, Durham, NC 27715, USA. raj.mehta@dm.duke.edu FAU - Kaul, Padma AU - Kaul P FAU - Lopes, Renato D AU - Lopes RD FAU - Patel, Manesh R AU - Patel MR FAU - Zheng, Yinggan AU - Zheng Y FAU - Pieper, Karen S AU - Pieper KS FAU - Welsh, Robert C AU - Welsh RC FAU - Armstrong, Paul W AU - Armstrong PW FAU - Granger, Christopher B AU - Granger CB LA - eng PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 RN - 0 (Antibodies, Monoclonal, Humanized) RN - 0 (Single-Chain Antibodies) RN - CHZ6OLQ3UU (pexelizumab) SB - IM MH - Age Factors MH - Aged MH - Analysis of Variance MH - Angioplasty, Balloon, Coronary/*methods/mortality MH - Antibodies, Monoclonal, Humanized/*therapeutic use MH - Canada MH - Combined Modality Therapy MH - Confidence Intervals MH - Coronary Angiography/methods MH - Electrocardiography/methods MH - Emergencies MH - Evaluation Studies as Topic MH - Female MH - Follow-Up Studies MH - Hospital Mortality/*trends MH - Humans MH - *Length of Stay MH - Male MH - Middle Aged MH - Myocardial Infarction/diagnostic imaging/*mortality/*therapy MH - Practice Patterns, Physicians' MH - Proportional Hazards Models MH - Risk Assessment MH - Sex Factors MH - Single-Chain Antibodies/*therapeutic use MH - Stents MH - Survival Rate MH - Treatment Outcome MH - United States EDAT- 2012/05/23 06:00 MHDA- 2012/08/01 06:00 CRDT- 2012/05/22 06:00 PHST- 2012/02/11 00:00 [received] PHST- 2012/03/08 00:00 [accepted] PHST- 2012/05/22 06:00 [entrez] PHST- 2012/05/23 06:00 [pubmed] PHST- 2012/08/01 06:00 [medline] AID - S0002-8703(12)00166-4 [pii] AID - 10.1016/j.ahj.2012.03.001 [doi] PST - ppublish SO - Am Heart J. 2012 May;163(5):797-803. doi: 10.1016/j.ahj.2012.03.001. PMID- 22583760 OWN - NLM STAT- MEDLINE DCOM- 20121204 LR - 20220318 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 110 IP - 4 DP - 2012 Aug 15 TI - Comparison of safety and efficacy of bivalirudin versus unfractionated heparin in high-risk patients undergoing percutaneous coronary intervention (from the Anti-Thrombotic Strategy for Reduction of Myocardial Damage During Angioplasty-Bivalirudin vs Heparin study). PG - 478-84 LID - 10.1016/j.amjcard.2012.04.017 [doi] AB - Bivalirudin, a direct thrombin inhibitor, is as effective as unfractionated heparin (UFH), with decreased bleeding in patients with acute coronary syndromes who undergo percutaneous coronary intervention (PCI). The aim of this study was to evaluate the effectiveness of bivalirudin versus UFH in selected PCI patients at high bleeding risk. Four hundred one consecutive patients who underwent PCI fulfilling >/= 1 enrollment criterion (age >75 years, chronic renal failure, and diabetes mellitus) were randomized to bivalirudin (bolus 0.75 mg/kg followed by infusion during the procedure; n = 198) or UFH (75 IU/kg; n = 203). In the overall population, 39% were aged >75 years, 22% had renal failure, 63% had diabetes, and 29% had acute coronary syndromes. The primary efficacy end point was the 30-day incidence of major adverse cardiac events (cardiac death, myocardial infarction, stent thrombosis, or target vessel revascularization). The primary safety end point was the occurrence of any bleeding or entry-site complications after PCI. All patients were preloaded with clopidogrel 600 mg. Glycoprotein IIb/IIIa inhibitors were used at the operators' discretion. Thirty-day major adverse cardiac event rates were 11.1% in the bivalirudin group and 8.9% in the UFH group (p = 0.56); the primary efficacy end point was reached mainly because of periprocedural myocardial infarction; 1 patient in the bivalirudin group had stent thrombosis. Occurrence of the primary safety end point was 1.5% in the bivalirudin group and 9.9% in the UFH group (p = 0.0001); this benefit was essentially driven by the prevention of entry-site hematomas >10 cm (0.5% vs 6.9%, p = 0.002). In conclusion, Anti-Thrombotic Strategy for Reduction of Myocardial Damage During Angioplasty-Bivalirudin vs Heparin (ARMYDA-7 BIVALVE) indicates that bivalirudin, compared with UFH, causes significantly lower bleeding and has a similar incidence of major adverse cardiac events in patients with older age, diabetes mellitus, or chronic renal failure who undergo PCI. CI - Copyright (c) 2012 Elsevier Inc. All rights reserved. FAU - Patti, Giuseppe AU - Patti G AD - Campus Bio-Medico University of Rome, Rome, Italy. g.patti@unicampus.it FAU - Pasceri, Vincenzo AU - Pasceri V FAU - D'Antonio, Luca AU - D'Antonio L FAU - D'Ambrosio, Andrea AU - D'Ambrosio A FAU - Macri, Michele AU - Macri M FAU - Dicuonzo, Giordano AU - Dicuonzo G FAU - Colonna, Giuseppe AU - Colonna G FAU - Montinaro, Antonio AU - Montinaro A FAU - Di Sciascio, Germano AU - Di Sciascio G LA - eng PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial DEP - 20120512 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 RN - 0 (Antithrombins) RN - 0 (Hirudins) RN - 0 (Peptide Fragments) RN - 0 (Platelet Glycoprotein GPIIb-IIIa Complex) RN - 0 (Recombinant Proteins) RN - 9005-49-6 (Heparin) RN - TN9BEX005G (bivalirudin) SB - IM MH - Aged MH - Aged, 80 and over MH - *Angioplasty, Balloon, Coronary MH - Antithrombins/administration & dosage/*adverse effects MH - Coronary Artery Disease/complications/*therapy MH - Diabetes Complications/therapy MH - Drug Therapy, Combination MH - Female MH - Heart Diseases/epidemiology/etiology MH - Heparin/administration & dosage/*adverse effects MH - Hirudins/administration & dosage/*adverse effects MH - Humans MH - Incidence MH - Male MH - Myocardial Infarction/etiology/prevention & control MH - Peptide Fragments/administration & dosage/*adverse effects MH - Platelet Glycoprotein GPIIb-IIIa Complex/administration & dosage/antagonists & inhibitors MH - Postoperative Complications MH - Postoperative Hemorrhage/etiology/*prevention & control MH - Recombinant Proteins/administration & dosage/adverse effects MH - Renal Insufficiency/complications/therapy MH - Treatment Outcome EDAT- 2012/05/16 06:00 MHDA- 2012/12/10 06:00 CRDT- 2012/05/16 06:00 PHST- 2012/02/17 00:00 [received] PHST- 2012/04/08 00:00 [revised] PHST- 2012/04/08 00:00 [accepted] PHST- 2012/05/16 06:00 [entrez] PHST- 2012/05/16 06:00 [pubmed] PHST- 2012/12/10 06:00 [medline] AID - S0002-9149(12)01176-9 [pii] AID - 10.1016/j.amjcard.2012.04.017 [doi] PST - ppublish SO - Am J Cardiol. 2012 Aug 15;110(4):478-84. doi: 10.1016/j.amjcard.2012.04.017. Epub 2012 May 12. PMID- 22565140 OWN - NLM STAT- MEDLINE DCOM- 20121029 LR - 20191210 IS - 1531-7080 (Electronic) IS - 0268-4705 (Linking) VI - 27 IP - 4 DP - 2012 Jul TI - Lessons from platelet inhibition and patient outcomes. PG - 355-60 LID - 10.1097/HCO.0b013e328353fe7e [doi] AB - PURPOSE OF REVIEW: Ticagrelor is a new, direct acting, reversibly binding P2Y12 receptor antagonist with more potent inhibition of platelets than clopidogrel and which does not require metabolic activation. It was compared with clopidogrel, on a background of the standard of care in a randomized trial in the Platelet Inhibition and Patient Outcomes (PLATO) study, on patients with acute coronary syndrome (ACS). The purpose was to evaluate the efficacy and safety results from the global, prospective trial in a broad population [ST-elevation myocardial infarction (STEMI) and non-ST elevation myocardial infarction (NSTEMI) patients] with ACS. RECENT FINDINGS: The main findings were a significant reduction of the primary outcome (death from vascular causes/myocardial infarction/stroke) with ticagrelor versus clopidogrel [9.8 versus 11.7% (hazard ratio 0.84; 95% confidence interval: 0.77-0.92); P < 0.001] without a significant increase in PLATO-defined major bleeding (11.6 versus 11.2%, respectively; P = 0.43), but a higher occurrence of noncoronary artery bypass grafting (CABG) related major bleeding (4.5 versus 3.8%; P = 0.026). In addition, there was a significant reduction in vascular mortality (4.0 versus 5.1%; P = 0.001). The findings were consistent in all subgroups, such as for STEMI, NSTEMI, planned invasive or noninvasive strategy, diabetes, renal function, and CABG. SUMMARY: Among patients with an ACS with or without ST-segment elevation, treatment with ticagrelor, as compared with clopidogrel, significantly reduced the rate of death from vascular causes, myocardial infarction, or stroke without an increase in the rate of overall major bleeding but with an increase in the rate of nonprocedure-related bleeding. FAU - Held, Claes AU - Held C AD - Department of Medical Sciences, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden. claes.held@ucr.uu.se LA - eng PT - Journal Article PT - Randomized Controlled Trial PL - United States TA - Curr Opin Cardiol JT - Current opinion in cardiology JID - 8608087 RN - 0 (Platelet Aggregation Inhibitors) RN - 0 (Purinergic P2Y Receptor Antagonists) RN - A74586SNO7 (Clopidogrel) RN - GLH0314RVC (Ticagrelor) RN - K72T3FS567 (Adenosine) RN - OM90ZUW7M1 (Ticlopidine) SB - IM MH - Acute Coronary Syndrome/*drug therapy/economics/mortality MH - Adenosine/*analogs & derivatives/therapeutic use MH - Blood Platelets/drug effects MH - Clopidogrel MH - Confidence Intervals MH - Humans MH - Myocardial Infarction/drug therapy MH - *Outcome Assessment, Health Care MH - Platelet Aggregation Inhibitors/*therapeutic use MH - Purinergic P2Y Receptor Antagonists/*therapeutic use MH - Statistics as Topic MH - Ticagrelor MH - Ticlopidine/analogs & derivatives/therapeutic use MH - United States EDAT- 2012/05/09 06:00 MHDA- 2012/10/30 06:00 CRDT- 2012/05/09 06:00 PHST- 2012/05/09 06:00 [entrez] PHST- 2012/05/09 06:00 [pubmed] PHST- 2012/10/30 06:00 [medline] AID - 10.1097/HCO.0b013e328353fe7e [doi] PST - ppublish SO - Curr Opin Cardiol. 2012 Jul;27(4):355-60. doi: 10.1097/HCO.0b013e328353fe7e. PMID- 22560231 OWN - NLM STAT- MEDLINE DCOM- 20121016 LR - 20181201 IS - 1097-6809 (Electronic) IS - 0741-5214 (Linking) VI - 56 IP - 2 DP - 2012 Aug TI - Clopidogrel use before renal artery angioplasty with/without stent placement resulted in tertiary procedure risk reduction. PG - 416-23 LID - 10.1016/j.jvs.2012.01.027 [doi] AB - OBJECTIVE: Contrary to coronary artery literature, the effect of preprocedural clopidogrel on renal artery restenosis (RAR) has not been characterized. This study was designed to evaluate the effect of preprocedural clopidogrel on target vessel revascularization (TVR), reintervention, and restenosis for patients who underwent recurrent renal artery angioplasty. METHODS: A retrospective analysis of patients treated for RAR in a single tertiary center from January 1999 to December 2009 was conducted. Patients were divided into preadmission use of (1) clopidogrel or (2) aspirin only (acetylsalicylic acid [ASA]) for the initial procedure. TVR was defined as occurrence of a tertiary procedure for symptomatic RAR. Rate of freedom from event (ie, tertiary restenosis and TVR) was analyzed using Kaplan-Meier method. RESULTS: Eighty-eight interventions were performed on 77 patients with RAR; 66% were females with average (mean +/- SEM) age and body mass index of 68.8 +/- 1.1 and 28.6 +/- 0.8, respectively. Comorbidities included 96% chronic hypertension, 33% diabetes, 76% hyperlipidemia, 20% renal insufficiency, 39% tobacco use, 58% coronary artery disease, and 51% peripheral vascular disease. Clopidogrel use increased significantly during the index procedure from admission 35.2% to discharge 97.7% (P < .001, McNemar test). There was a trend toward risk reduction of a tertiary intervention (23%) for patients admitted on clopidogrel compared with ASA (P = .052). Likewise, there was a trend (P = .051) toward increased freedom from a tertiary intervention, with cumulative freedom at 8 years 93.5% for clopidogrel vs 61% for ASA. No differences were found for restenosis. CONCLUSIONS: The use of preprocedural clopidogrel was associated with a possible risk reduction of TVR reintervention, but this finding needs to be validated in randomized clinical trial. CI - Copyright (c) 2012 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved. FAU - Mousa, Albeir Y AU - Mousa AY AD - Department of Surgery, Robert C. Byrd Health Sciences Center, West Virginia University, Charleston, WV 25304, USA. amousa@hsc.wvu.edu FAU - Broce, Mike AU - Broce M FAU - Campbell, John AU - Campbell J FAU - Nanjundappa, Aravinda AU - Nanjundappa A FAU - Stone, Patrick A AU - Stone PA FAU - Abu-Halimah, Shadi AU - Abu-Halimah S FAU - Srivastava, Mohit AU - Srivastava M FAU - Bates, Mark C AU - Bates MC FAU - Aburahma, Ali F AU - Aburahma AF LA - eng PT - Journal Article DEP - 20120503 PL - United States TA - J Vasc Surg JT - Journal of vascular surgery JID - 8407742 RN - 0 (Platelet Aggregation Inhibitors) RN - A74586SNO7 (Clopidogrel) RN - OM90ZUW7M1 (Ticlopidine) RN - R16CO5Y76E (Aspirin) SB - IM MH - Aged MH - *Angioplasty, Balloon MH - Aspirin/therapeutic use MH - Clopidogrel MH - Comorbidity MH - Female MH - Humans MH - Life Tables MH - Male MH - Platelet Aggregation Inhibitors/*therapeutic use MH - Renal Artery Obstruction/epidemiology/*therapy MH - Retreatment MH - Secondary Prevention MH - Stents MH - Ticlopidine/*analogs & derivatives/therapeutic use EDAT- 2012/05/09 06:00 MHDA- 2012/10/17 06:00 CRDT- 2012/05/08 06:00 PHST- 2011/10/04 00:00 [received] PHST- 2011/12/12 00:00 [revised] PHST- 2012/01/06 00:00 [accepted] PHST- 2012/05/08 06:00 [entrez] PHST- 2012/05/09 06:00 [pubmed] PHST- 2012/10/17 06:00 [medline] AID - S0741-5214(12)00096-1 [pii] AID - 10.1016/j.jvs.2012.01.027 [doi] PST - ppublish SO - J Vasc Surg. 2012 Aug;56(2):416-23. doi: 10.1016/j.jvs.2012.01.027. Epub 2012 May 3. PMID- 22500512 OWN - NLM STAT- MEDLINE DCOM- 20120529 LR - 20181201 IS - 1878-1810 (Electronic) IS - 1878-1810 (Linking) VI - 159 IP - 5 DP - 2012 May TI - Chronic kidney disease as a risk factor for acute coronary syndromes in patients presenting to the emergency room with chest pain. PG - 391-6 LID - 10.1016/j.trsl.2011.12.006 [doi] AB - We sought to determine whether persons with intermediate risk factors for cardiovascular disease presenting to an emergency department with chest pain and chronic kidney disease (CKD) were triaged effectively by chest pain units (CPUs). CPUs evaluate patients with intermediate risk and acute chest pain effectively. CKD is a risk factor for poor outcomes once cardiovascular disease has developed. However, current algorithms to risk stratify patients with acute chest pain do not include renal function. A total of 408 patients enrolled previously in the CHEER study of intermediate risk patients with chest pain, assigned randomly to hospitalization or observation in a CPU where an estimated glomerular filtration rate (GFR) was available, were included. No difference was found in short-term outcomes of patients including in-hospital death, myocardial infarction, or coronary revascularization based on renal function. For the 205 patients randomized to the CPU, the rate of admission to the hospital was significantly higher in the group with CKD compared with the group with normal renal function (68.2 vs 48.2%, P=0.007). In a multivariate analysis, decreased renal function was not associated with adverse short-term outcomes. On 5 years follow-up, the overall long-term mortality was significantly higher in the group with CKD (14.1% vs 5.5%, P=0.003). We concluded that CKD is a strong predictor of hospitalization and overall long-term mortality in patients presenting with chest pain to the emergency department. Current risk factor stratification scoring systems should consider CKD as a predictor of increased risk in patients with chest pain. CI - Copyright (c) 2012. Published by Mosby, Inc. FAU - Khambatta, Sherezade AU - Khambatta S AD - St. John Providence Health System, Detroit, MI, USA. FAU - Farkouh, Michael E AU - Farkouh ME FAU - Wright, R Scott AU - Wright RS FAU - Reeder, Guy S AU - Reeder GS FAU - McCullough, Peter A AU - McCullough PA FAU - Smars, Peter A AU - Smars PA FAU - Hickson, Latonya J AU - Hickson LJ FAU - Best, Patricia J M AU - Best PJ LA - eng GR - 1 KL2 RR024151-01/RR/NCRR NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't DEP - 20120109 PL - United States TA - Transl Res JT - Translational research : the journal of laboratory and clinical medicine JID - 101280339 SB - IM MH - Acute Coronary Syndrome/*complications MH - Chest Pain/*complications MH - Emergency Service, Hospital/*statistics & numerical data MH - Glomerular Filtration Rate MH - Humans MH - Kidney Failure, Chronic/*complications/physiopathology EDAT- 2012/04/17 06:00 MHDA- 2012/05/30 06:00 CRDT- 2012/04/17 06:00 PHST- 2011/07/22 00:00 [received] PHST- 2011/11/28 00:00 [revised] PHST- 2011/12/19 00:00 [accepted] PHST- 2012/04/17 06:00 [entrez] PHST- 2012/04/17 06:00 [pubmed] PHST- 2012/05/30 06:00 [medline] AID - S1931-5244(11)00455-5 [pii] AID - 10.1016/j.trsl.2011.12.006 [doi] PST - ppublish SO - Transl Res. 2012 May;159(5):391-6. doi: 10.1016/j.trsl.2011.12.006. Epub 2012 Jan 9. PMID- 22496275 OWN - NLM STAT- MEDLINE DCOM- 20140213 LR - 20260128 IS - 2047-4881 (Electronic) IS - 2047-4873 (Linking) VI - 20 IP - 4 DP - 2013 Aug TI - Secondary prevention and risk factor target achievement in a global, high-risk population with established coronary heart disease: baseline results from the STABILITY study. PG - 678-85 LID - 10.1177/2047487312444995 [doi] AB - AIM: There is limited contemporary data on achievement of risk factor goals for secondary prevention of cardiovascular (CV) disease from countries in many regions of the world. This report describes the global and regional prevalence of CV risk factors and use of preventive medications at baseline in participants in the ongoing STabilization of Atherosclerotic plaque By Initiation of darapLadIb TherapY (STABILITY) trial. METHODS AND RESULTS: Detailed individual data on CV risk factors were obtained before randomization in 15,828 patients with chronic coronary heart disease (CHD) from 39 countries on five continents. Subjects had a history of myocardial infarction, prior coronary revascularization, or multi-vessel CHD without revascularization and at least one additional CV risk factor. The majority were taking a statin (97%), antiplatelet therapy (96%), beta-blocker (79%), or angiotensin converting enzyme inhibitor/angiotensin receptor blocker (77%). However, a large proportion of patients did not achieve guideline-recommended targets. For instance, in 29% low-density lipoprotein (LDL) cholesterol was >2.5 mmol/l and in 46% blood pressure was >/=140/90 mmHg or >/=130/80 mmHg in those with diabetes or renal impairment. The body mass index was >30 kg/m(2) in 36%, waist circumference >/=102 cm for men or >/=88 cm for women in 54%, and 18% were smoking. Regional differences in risk factor prevalence and target achievement were observed and were more marked for LDL cholesterol and obesity. CONCLUSION: The prevalence of modifiable CV risk factors was generally high in the STABILITY population. Although, most patients were receiving evidence-based secondary preventive therapy many subjects from all regions did not reach recommended secondary prevention goals. FAU - Vedin, Ola AU - Vedin O AD - Department of Medical Sciences, Uppsala University, Uppsala, Sweden. ola.vedin@akademiska.se FAU - Hagstrom, Emil AU - Hagstrom E FAU - Stewart, Ralph AU - Stewart R FAU - Brown, Rebekkah AU - Brown R FAU - Krug-Gourley, Susan AU - Krug-Gourley S FAU - Davies, Richard AU - Davies R FAU - Wallentin, Lars AU - Wallentin L FAU - White, Harvey AU - White H FAU - Held, Claes AU - Held C LA - eng SI - ClinicalTrials.gov/NCT00799903 PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20120410 PL - England TA - Eur J Prev Cardiol JT - European journal of preventive cardiology JID - 101564430 RN - 0 (Benzaldehydes) RN - 0 (Biomarkers) RN - 0 (Blood Glucose) RN - 0 (Cardiovascular Agents) RN - 0 (Hypolipidemic Agents) RN - 0 (Lipids) RN - 0 (Oximes) RN - 0 (Phospholipase A2 Inhibitors) RN - UI1U1MYH09 (darapladib) RN - 0 (Biphenyl Compounds) RN - 0 (Diethylamines) RN - 0 (Pyrimidinones) RN - 0 (Sulfides) SB - IM MH - Aged MH - Benzaldehydes/*therapeutic use MH - Biomarkers/blood MH - Blood Glucose/analysis MH - Blood Pressure MH - Cardiovascular Agents/*therapeutic use MH - Coronary Disease/blood/diagnosis/*drug therapy/epidemiology MH - Double-Blind Method MH - Female MH - Guideline Adherence MH - Humans MH - Hypolipidemic Agents/*therapeutic use MH - Lipids/blood MH - Male MH - Middle Aged MH - Oximes/*therapeutic use MH - Phospholipase A2 Inhibitors/*therapeutic use MH - Practice Guidelines as Topic MH - Practice Patterns, Physicians' MH - Prevalence MH - Prospective Studies MH - Risk Factors MH - *Secondary Prevention/methods MH - Time Factors MH - Treatment Outcome MH - Biphenyl Compounds MH - Diethylamines MH - Pyrimidinones MH - Sulfides OTO - NOTNLM OT - Cardiovascular risk factors OT - coronary heart disease OT - guideline recommendations OT - guidelines OT - secondary prevention EDAT- 2012/04/13 06:00 MHDA- 2014/02/14 06:00 CRDT- 2012/04/13 06:00 PHST- 2012/04/13 06:00 [entrez] PHST- 2012/04/13 06:00 [pubmed] PHST- 2014/02/14 06:00 [medline] AID - 2047487312444995 [pii] AID - 10.1177/2047487312444995 [doi] PST - ppublish SO - Eur J Prev Cardiol. 2013 Aug;20(4):678-85. doi: 10.1177/2047487312444995. Epub 2012 Apr 10. PMID- 22495466 OWN - NLM STAT- MEDLINE DCOM- 20120823 LR - 20120619 IS - 1523-6838 (Electronic) IS - 0272-6386 (Linking) VI - 60 IP - 1 DP - 2012 Jul TI - Effect of renal artery stenting on left ventricular mass: a randomized clinical trial. PG - 39-46 LID - 10.1053/j.ajkd.2012.01.022 [doi] AB - BACKGROUND: Whether renal revascularization reduces left ventricular hypertrophy in patients with coronary artery disease is uncertain. STUDY DESIGN: Randomized clinical trial testing the effect of renal artery stenting versus medical therapy on left ventricular hypertrophy progression in patients affected by ischemic heart disease and renal artery stenosis. SETTING & PARTICIPANTS: Incident patients with ischemic heart disease undergoing cardiac catheterization with renal artery stenosis >50%-/=50 s) for recurrent ischemic events and above an upper threshold (>70 vs. 6-12 (n = 3,021), >12-24 (n = 3,406), and >24-48 (n = 2,497) h, 34, 41, and 46% of patients achieved the target aPTT range, respectively. Both before and after adjusting for baseline predictors of anticoagulant response and risk score (age, hypertension, diabetes, smoking, ST depression, and renal function), no significant relationship between aPTT values and recurrent ischemic events or major bleeding was found. No relationship was observed between clinical outcomes and aPTT values persistently above or below the designated thresholds. Measurements of aPTT were not associated with clinical outcomes among patients with NSTE ACS treated with UFH. The required intensity of anticoagulation for benefit may be relatively modest when UFH is administered concomitantly with dual or triple platelet-directed therapy, particularly in patients undergoing early coronary revascularization. FAU - Thomas, Michael P AU - Thomas MP AD - Duke Clinical Research Institute, 2400 Pratt Street, Durham, NC 27705, USA. michptho@med.umich.edu FAU - Mahaffey, Kenneth W AU - Mahaffey KW FAU - Chiswell, Karen AU - Chiswell K FAU - Cohen, Marc AU - Cohen M FAU - Kontos, Michael C AU - Kontos MC FAU - Antman, Elliott M AU - Antman EM FAU - Ferguson, James J AU - Ferguson JJ FAU - Califf, Robert M AU - Califf RM FAU - Goodman, Shaun G AU - Goodman SG FAU - Becker, Richard C AU - Becker RC LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - Netherlands TA - J Thromb Thrombolysis JT - Journal of thrombosis and thrombolysis JID - 9502018 RN - 0 (Fibrinolytic Agents) RN - 0 (Platelet Aggregation Inhibitors) RN - 9005-49-6 (Heparin) SB - IM MH - Acute Coronary Syndrome/*blood/complications/therapy MH - Aged MH - Aged, 80 and over MH - Angioplasty, Balloon, Coronary MH - Female MH - Fibrinolytic Agents/administration & dosage MH - Hemorrhage/blood/drug therapy/etiology MH - Heparin/administration & dosage MH - Humans MH - Male MH - Middle Aged MH - *Partial Thromboplastin Time MH - Platelet Aggregation Inhibitors/administration & dosage MH - Predictive Value of Tests MH - Proportional Hazards Models MH - Prospective Studies MH - Risk Factors EDAT- 2012/02/11 06:00 MHDA- 2012/11/01 06:00 CRDT- 2012/02/11 06:00 PHST- 2012/02/11 06:00 [entrez] PHST- 2012/02/11 06:00 [pubmed] PHST- 2012/11/01 06:00 [medline] AID - 10.1007/s11239-012-0693-y [doi] PST - ppublish SO - J Thromb Thrombolysis. 2012 Jul;34(1):114-9. doi: 10.1007/s11239-012-0693-y. PMID- 22305817 OWN - NLM STAT- MEDLINE DCOM- 20140224 LR - 20130617 IS - 1874-1754 (Electronic) IS - 0167-5273 (Linking) VI - 167 IP - 2 DP - 2013 Jul 31 TI - The prognostic value of very low admission LDL-cholesterol levels in ST-segment elevation myocardial infarction compared in statin-pretreated and statin-naive patients undergoing primary percutaneous coronary intervention. PG - 458-63 LID - S0167-5273(12)00012-5 [pii] LID - 10.1016/j.ijcard.2012.01.009 [doi] AB - BACKGROUND: Some recent trials reported that, low admission low-density lipoprotein-cholesterol (LDL-C) levels were associated with increased mortality in patients with acute coronary syndromes. We aimed to compare the effect of very low admission LDL-C levels on prognosis in statin-pretreated and statin-naive patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing primary angioplasty. METHODS: The study population consisted of 1808 patients with acute STEMIs who underwent primary angioplasty. The patients were categorized into four groups as: statin-pretreated/LDL-C<70 mg/dl (n=128), statin-pretreated/LDL-C >/= 70 mg/dl (n=290), statin-naive/LDL-C <70 mg/dl (n=146), statin-naive/LDL-C >/= 70 mg/dl (n=1244). The median follow-up was 40 months. RESULTS: The incidences of diabetes mellitus, hypertension, renal insufficiency, anemia, cardiogenic shock on presentation and the mean age were significantly higher in the statin-naive/LDL-C < 70 mg/dl group. In-hospital (2.3% vs 2.4% vs 12.3% vs 3.9%, respectively p<0.001) and long-term mortalities (6.3% vs 7.3% vs 25.9% vs 11.3% respectively, p<0.001) were significantly lower in the "statin-pretreated/LDL-C<70" group. Statin pretreatment was independently predicting lower long-term mortality irrespective of LDL-C level [for the subgroup with LDL-C < 70 mg/dl, Hazard Ratio (HR) 0.24, 95% CI 0.10-0.59, p=0.013; for the subgroup with LDL-C >/= 70 mg/dl, HR 0.31, 95% CI 0.14-0.83, p=0.022]. LDL-C levels on admission had no independent predictive role on long-term mortality. CONCLUSIONS: Statin induced low LDL-C levels on admission are associated with better short- and long-term outcomes in patients with STEMI and independently predict lower long-term mortality. However, spontaneously low admission LDL-C levels were associated with increased short- and long-term mortalities. CI - Copyright (c) 2011 Elsevier Ireland Ltd. All rights reserved. FAU - Oduncu, Vecih AU - Oduncu V AD - ayhanerkol@yahoo.com FAU - Erkol, Ayhan AU - Erkol A FAU - Kurt, Mustafa AU - Kurt M FAU - Tanboga, Ibrahim Halil AU - Tanboga IH FAU - Karabay, Can Yucel AU - Karabay CY FAU - Sengul, Cihan AU - Sengul C FAU - Bulut, Mustafa AU - Bulut M FAU - Ozveren, Olcay AU - Ozveren O FAU - Fotbolcu, Hakan AU - Fotbolcu H FAU - Akgun, Taylan AU - Akgun T FAU - Turkyilmaz, Erdem AU - Turkyilmaz E FAU - Kirma, Cevat AU - Kirma C LA - eng PT - Comparative Study PT - Journal Article DEP - 20120202 PL - Netherlands TA - Int J Cardiol JT - International journal of cardiology JID - 8200291 RN - 0 (Cholesterol, LDL) RN - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors) SB - IM MH - Adult MH - Aged MH - Cholesterol, LDL/*blood MH - Female MH - Follow-Up Studies MH - Humans MH - Hydroxymethylglutaryl-CoA Reductase Inhibitors/*administration & dosage MH - Male MH - Middle Aged MH - Myocardial Infarction/*blood/diagnosis/*therapy MH - *Patient Admission/trends MH - Percutaneous Coronary Intervention/*methods MH - Prognosis MH - Retrospective Studies EDAT- 2012/02/07 06:00 MHDA- 2014/02/25 06:00 CRDT- 2012/02/07 06:00 PHST- 2011/11/22 00:00 [received] PHST- 2012/01/01 00:00 [revised] PHST- 2012/01/06 00:00 [accepted] PHST- 2012/02/07 06:00 [entrez] PHST- 2012/02/07 06:00 [pubmed] PHST- 2014/02/25 06:00 [medline] AID - S0167-5273(12)00012-5 [pii] AID - 10.1016/j.ijcard.2012.01.009 [doi] PST - ppublish SO - Int J Cardiol. 2013 Jul 31;167(2):458-63. doi: 10.1016/j.ijcard.2012.01.009. Epub 2012 Feb 2. PMID- 22210580 OWN - NLM STAT- MEDLINE DCOM- 20120726 LR - 20181201 IS - 1557-2501 (Electronic) IS - 1042-3931 (Linking) VI - 24 IP - 1 DP - 2012 Jan TI - Embolic protection device use and outcomes in patients receiving saphenous vein graft interventions--a single-center experience. PG - 1-3 AB - BACKGROUND: Percutaneous treatment of saphenous vein graft disease is hampered by high rates of periprocedural myocardial infarction (MI). The use of embolic protection devices (EPD) during these interventions is a class IB recommendation when technically feasible, yet they are used routinely in less than half of all cases. Our aim was to explore whether or not the under-utilization of EPDs led to any untoward cardiovascular events. METHODS: Consecutive vein graft interventions from 2003-2008 were identified and stratified by EPD use. Information pertaining to demographics, comorbidities, medication use, and procedural details was collected. Primary endpoint was to compare the incidence of periprocedural MI, defined as any creatinine kinase-MB fraction elevation greater than 3 times the upper limit of normal between patients who underwent percutaneous coronary intervention (PCI) for saphenous vein grafts (SVG) with EPD versus patients who underwent PCI for SVG without EPD. Secondary endpoints included comparison of the incidence of recurrent ischemia, MI, revascularization (PCI or coronary artery bypass graft [CABG]), and mortality in the above 2 groups by the end of 1 year. RESULTS: A total of 164 consecutive vein graft interventions were identified. EPDs were used in 71 cases (43.4%). The EPD group was further out since their CABG and had a higher prevalence of hypertension and diabetes. Periprocedural MI occurred in 22 cases; 12 in the non-EPD group and 10 in the EPD group (14.1 vs. 12.9%; P=.82). The composite endpoint of death, MI, or target vessel revascularization at 12 months was significantly lower when EPDs were used (11.3 vs. 25.8%; P=.03). On multivariate analysis, chronic kidney disease increased the risk of periprocedural MI (odds ratio [OR], 5.36; 95% confidence interval [CI], 1.90-15.13; P=.002), whereas the use of beta-blockers was protective (OR, 0.22; 95% CI, 0.07-0.70; P=.011). CONCLUSIONS: EPD use during vein graft interventions did not improve periprocedural MI rates. However, the composite endpoint of adverse cardiovascular outcomes at 1 year was significantly reduced. EPDs are used in a minority of vein graft interventions. Efforts aimed at improving adherence to EPD use may improve long-term outcomes, though this hypothesis should be tested using prospective, randomized studies. FAU - Golwala, Harsh AU - Golwala H AD - Department of Internal Medicine, 920 Stanton L. Young Boulevard, WP 3010, Oklahoma City, OK 73104, USA. FAU - Hawkins, Beau M AU - Hawkins BM FAU - Stavrakis, Stavros AU - Stavrakis S FAU - Abu-Fadel, Mazen S AU - Abu-Fadel MS LA - eng PT - Comparative Study PT - Journal Article PL - United States TA - J Invasive Cardiol JT - The Journal of invasive cardiology JID - 8917477 SB - IM CIN - J Invasive Cardiol. 2012 Jan;24(1):4. PMID: 22210581 MH - Aged MH - Angioplasty, Balloon, Coronary/*adverse effects MH - Cost-Benefit Analysis MH - Embolic Protection Devices/economics/*statistics & numerical data MH - Graft Occlusion, Vascular/mortality/*therapy MH - Humans MH - Incidence MH - Logistic Models MH - Middle Aged MH - Myocardial Infarction/*epidemiology MH - Recurrence MH - Retrospective Studies MH - Risk Factors MH - Saphenous Vein/*transplantation MH - Survival Rate MH - Treatment Outcome EDAT- 2012/01/03 06:00 MHDA- 2012/07/27 06:00 CRDT- 2012/01/03 06:00 PHST- 2012/01/03 06:00 [entrez] PHST- 2012/01/03 06:00 [pubmed] PHST- 2012/07/27 06:00 [medline] PST - ppublish SO - J Invasive Cardiol. 2012 Jan;24(1):1-3. PMID- 22210576 OWN - NLM STAT- MEDLINE DCOM- 20120612 LR - 20260518 IS - 1935-5548 (Electronic) IS - 0149-5992 (Print) IS - 0149-5992 (Linking) VI - 35 IP - 2 DP - 2012 Feb TI - Benefits and safety of long-term fenofibrate therapy in people with type 2 diabetes and renal impairment: the FIELD Study. PG - 218-25 LID - 10.2337/dc11-1109 [doi] AB - OBJECTIVE: Diabetic patients with moderate renal impairment (estimated glomerular filtration rate [eGFR] 30-59 mL/min/1.73 m(2)) are at particular cardiovascular risk. Fenofibrate's safety in these patients is an issue because it may elevate plasma creatinine. Furthermore, guidelines regarding fenofibrate dosing in renal impairment vary internationally. We investigated fenofibrate's effects on cardiovascular and end-stage renal disease (ESRD) events, according to eGFR, in the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) Study. RESEARCH DESIGN AND METHODS: Type 2 diabetic patients (aged 50-75 years) with eGFR >/=30 mL/min/1.73 m(2) were randomly allocated to a fixed dose of fenofibrate (200 mg daily) (n = 4,895) or placebo (n = 4,900) for 5 years. Baseline renal function (Modification of Diet in Renal Disease equation) was grouped by eGFR (30-59, 60-89, and >/=90 mL/min/1.73 m(2)). The prespecified outcome was total cardiovascular events (composite of cardiovascular death, myocardial infarction, stroke, and coronary/carotid revascularization). Serious adverse events and instances of ESRD (plasma creatinine >400 mumol/L, dialysis, renal transplant, or renal death) were recorded. Analysis was by intention to treat. RESULTS: Overall, fenofibrate reduced total cardiovascular events, compared with placebo (hazard ratio 0.89 [95% CI 0.80-0.99]; P = 0.035). This benefit was not statistically different across eGFR groupings (P = 0.2 for interaction) (eGFR 30-59 mL/min/1.73 m(2): 0.68 [0.47-0.97], P = 0.035; eGFR >/=90 mL/min/1.73 m(2): 0.85 [0.70-1.02], P = 0.08). ESRD rates were similar between treatment arms, without adverse safety signals of fenofibrate use in renal impairment. CONCLUSIONS: Patients with type 2 diabetes and moderate renal impairment benefit from long-term fenofibrate, without excess drug-related safety concerns compared with those with no or mild renal impairment. Fenofibrate treatment should not be contraindicated in moderate renal impairment, suggesting that current guidelines may be too restrictive. FAU - Ting, Ru-Dee AU - Ting RD AD - National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia. rudee.ting@ctc.usyd.edu.au FAU - Keech, Anthony C AU - Keech AC FAU - Drury, Paul L AU - Drury PL FAU - Donoghoe, Mark W AU - Donoghoe MW FAU - Hedley, John AU - Hedley J FAU - Jenkins, Alicia J AU - Jenkins AJ FAU - Davis, Timothy M E AU - Davis TM FAU - Lehto, Seppo AU - Lehto S FAU - Celermajer, David AU - Celermajer D FAU - Simes, R John AU - Simes RJ FAU - Rajamani, Kushwin AU - Rajamani K FAU - Stanton, Kim AU - Stanton K CN - FIELD Study Investigators LA - eng SI - ISRCTN/ISRCTN64783481 PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20111230 PL - United States TA - Diabetes Care JT - Diabetes care JID - 7805975 RN - 0 (Hypolipidemic Agents) RN - U202363UOS (Fenofibrate) SB - IM MH - Aged MH - Cardiovascular Diseases/etiology/metabolism/*prevention & control MH - Diabetes Mellitus, Type 2/complications/*drug therapy MH - Female MH - Fenofibrate/*adverse effects/*therapeutic use MH - Glomerular Filtration Rate/drug effects MH - Humans MH - Hypolipidemic Agents/*adverse effects/*therapeutic use MH - Kidney Failure, Chronic/*chemically induced MH - Male MH - Middle Aged PMC - PMC3263870 FIR - Akauola, H IR - Akauola H FIR - Alford, F IR - Alford F FIR - Barter, P IR - Barter P FIR - Beinart, I IR - Beinart I FIR - Best, J IR - Best J FIR - Bohra, S IR - Bohra S FIR - Boyages, S IR - Boyages S FIR - Colman, P IR - Colman P FIR - Connor, H IR - Connor H FIR - Darnell, D IR - Darnell D FIR - Davis, T IR - Davis T FIR - Davoren, P IR - Davoren P FIR - Lepre, F IR - Lepre F FIR - De Looze, F IR - De Looze F FIR - d'Emden, M IR - d'Emden M FIR - Duffield, A IR - Duffield A FIR - Fassett, R IR - Fassett R FIR - Flack, J IR - Flack J FIR - Fulcher, G IR - Fulcher G FIR - Hamwood, S IR - Hamwood S FIR - Harmelin, D IR - Harmelin D FIR - Jackson, R IR - Jackson R FIR - Jeffries, W IR - Jeffries W FIR - Kamp, M IR - Kamp M FIR - Kritharides, L IR - Kritharides L FIR - Mahar, L IR - Mahar L FIR - McCann, V IR - McCann V FIR - McIntyre, D IR - McIntyre D FIR - Moses, R IR - Moses R FIR - Newnham, H IR - Newnham H FIR - Nicholson, G IR - Nicholson G FIR - O'Brien, R IR - O'Brien R FIR - Park, K IR - Park K FIR - Petrovsky, N IR - Petrovsky N FIR - Phillips, P IR - Phillips P FIR - Pinn, G IR - Pinn G FIR - Simmons, D IR - Simmons D FIR - Stanton, K IR - Stanton K FIR - Stuckey, B IR - Stuckey B FIR - Sullivan, D R IR - Sullivan DR FIR - Suranyi, M IR - Suranyi M FIR - Suthers, M IR - Suthers M FIR - Tan, Y IR - Tan Y FIR - Templer, M IR - Templer M FIR - Topliss, D IR - Topliss D FIR - Waites, J H IR - Waites JH FIR - Watts, G IR - Watts G FIR - Welborn, T IR - Welborn T FIR - Wilson, D IR - Wilson D FIR - Wyndham, R IR - Wyndham R FIR - Haapamaki, H IR - Haapamaki H FIR - Kesaniemi, A IR - Kesaniemi A FIR - Laakso, M IR - Laakso M FIR - Lahtela, J IR - Lahtela J FIR - Levanen, H IR - Levanen H FIR - Saltevo, J IR - Saltevo J FIR - Sodervik, H IR - Sodervik H FIR - Taskinen, M IR - Taskinen M FIR - Vanhala, M IR - Vanhala M FIR - Baker, J IR - Baker J FIR - Burton, A IR - Burton A FIR - Dixon, P IR - Dixon P FIR - Doran, J IR - Doran J FIR - Drury, P IR - Drury P FIR - Dunn, P IR - Dunn P FIR - Graham, N IR - Graham N FIR - Hamer, A IR - Hamer A FIR - Hedley, J IR - Hedley J FIR - Manning, P IR - Manning P FIR - McPherson, I IR - McPherson I FIR - Morris, S IR - Morris S FIR - Renner, C IR - Renner C FIR - Scott, R IR - Scott R FIR - Smith, R IR - Smith R FIR - Wackrow, M IR - Wackrow M FIR - Young, S IR - Young S FIR - Alcoe, J IR - Alcoe J FIR - Allan, C IR - Allan C FIR - Amerena, J IR - Amerena J FIR - Arnold, N IR - Arnold N FIR - Arsov, T IR - Arsov T FIR - Ashby, D IR - Ashby D FIR - Atkinson, C IR - Atkinson C FIR - Badhni, L IR - Badhni L FIR - Balme, M IR - Balme M FIR - Barton, D IR - Barton D FIR - Batrouney, B IR - Batrouney B FIR - Beare, C IR - Beare C FIR - Beattie, T IR - Beattie T FIR - Beggs, J IR - Beggs J FIR - Bendall, C IR - Bendall C FIR - Bendall, C IR - Bendall C FIR - Benz, A IR - Benz A FIR - Black, D IR - Black D FIR - Bond, A IR - Bond A FIR - Bradfield, R IR - Bradfield R FIR - Bradshaw, J IR - Bradshaw J FIR - Brearley, S IR - Brearley S FIR - Bruce, D IR - Bruce D FIR - Buckland, A IR - Buckland A FIR - Burgess, J IR - Burgess J FIR - Butler, J IR - Butler J FIR - Callary, M IR - Callary M FIR - Campbell, J IR - Campbell J FIR - Carr, H IR - Carr H FIR - Chambers, K IR - Chambers K FIR - Chow, J IR - Chow J FIR - Chow, S IR - Chow S FIR - Ciszek, K IR - Ciszek K FIR - Clifton, P IR - Clifton P FIR - Clifton-Bligh, P IR - Clifton-Bligh P FIR - Clowes, V IR - Clowes V FIR - Coates, P IR - Coates P FIR - Cocks, C IR - Cocks C FIR - Cole, S IR - Cole S FIR - Colquhoun, D IR - Colquhoun D FIR - Correcha, M IR - Correcha M FIR - Coverdale, S IR - Coverdale S FIR - Croft, M IR - Croft M FIR - Crowe, J IR - Crowe J FIR - Dal Sasso, S IR - Dal Sasso S FIR - Davis, W IR - Davis W FIR - Dunn, J IR - Dunn J FIR - Edwards, S IR - Edwards S FIR - Elder, R IR - Elder R FIR - El-Kaissi, S IR - El-Kaissi S FIR - Emery, L IR - Emery L FIR - England, M IR - England M FIR - Farouque, O IR - Farouque O FIR - Fernandez, M IR - Fernandez M FIR - Fitzpatrick, B IR - Fitzpatrick B FIR - Francis, N IR - Francis N FIR - Francis, P IR - Francis P FIR - Freeman, P IR - Freeman P FIR - Fuller, A IR - Fuller A FIR - Gale, D IR - Gale D FIR - Gaylard, V IR - Gaylard V FIR - George, C IR - George C FIR - Gillzan, C IR - Gillzan C FIR - Glatthaar, C IR - Glatthaar C FIR - Goddard, J IR - Goddard J FIR - Grange, V IR - Grange V FIR - Greenaway, T IR - Greenaway T FIR - Griffin, J IR - Griffin J FIR - Grogan, A IR - Grogan A FIR - Guha, S IR - Guha S FIR - Gustafson, J IR - Gustafson J FIR - Hamblin, P S IR - Hamblin PS FIR - Hamilton-Craig, I IR - Hamilton-Craig I FIR - Hannay, T IR - Hannay T FIR - Hardie, C IR - Hardie C FIR - Harper, A IR - Harper A FIR - Hartl, G IR - Hartl G FIR - Harvey, A IR - Harvey A FIR - Havlin, S IR - Havlin S FIR - Haworth, K IR - Haworth K FIR - Hay, P IR - Hay P FIR - Hay, L IR - Hay L FIR - Heenan, B IR - Heenan B FIR - Hesketh, R IR - Hesketh R FIR - Heyworth, A IR - Heyworth A FIR - Hines, M IR - Hines M FIR - Hockings, G IR - Hockings G FIR - Hodge, A IR - Hodge A FIR - Hoffman, L IR - Hoffman L FIR - Hoskin, L IR - Hoskin L FIR - Howells, M IR - Howells M FIR - Hunt, D IR - Hunt D FIR - Hunt, A IR - Hunt A FIR - Inder, W IR - Inder W FIR - Irvine, D IR - Irvine D FIR - Jackson, D IR - Jackson D FIR - Jang, C IR - Jang C FIR - Kearins, K IR - Kearins K FIR - Kee, P IR - Kee P FIR - Keen, J IR - Keen J FIR - Kilpatrick, D IR - Kilpatrick D FIR - Kindellan, J IR - Kindellan J FIR - Kingston-Ray, M IR - Kingston-Ray M FIR - Kotowicz, M IR - Kotowicz M FIR - Lahz, E IR - Lahz E FIR - Lassig, A IR - Lassig A FIR - Layton, M IR - Layton M FIR - Lean, S IR - Lean S FIR - Legg, H IR - Legg H FIR - Lim, E IR - Lim E FIR - Long, F IR - Long F FIR - Lucas, L IR - Lucas L FIR - Ludeman, D IR - Ludeman D FIR - Ludeman-Robertson, C IR - Ludeman-Robertson C FIR - Lyall, M IR - Lyall M FIR - Lynch, L IR - Lynch L FIR - Maddison, C IR - Maddison C FIR - Malkus, B IR - Malkus B FIR - Marangou, A IR - Marangou A FIR - Margrie, F IR - Margrie F FIR - Martyn, N IR - Martyn N FIR - Matthiesson, K IR - Matthiesson K FIR - Matthiesson, J IR - Matthiesson J FIR - Maxwell, S IR - Maxwell S FIR - Maxwell, V IR - Maxwell V FIR - McCarthy, K IR - McCarthy K FIR - McElduff, A IR - McElduff A FIR - McKee, H IR - McKee H FIR - McKenzie, J IR - McKenzie J FIR - McLachan, K IR - McLachan K FIR - McNair, P IR - McNair P FIR - Meischke, M IR - Meischke M FIR - Merkel, A IR - Merkel A FIR - Miller, C IR - Miller C FIR - Morrison, E IR - Morrison E FIR - Morton, A IR - Morton A FIR - Mossman, W IR - Mossman W FIR - Mowat, A IR - Mowat A FIR - Muecke, J IR - Muecke J FIR - Murie, P IR - Murie P FIR - Murray, S IR - Murray S FIR - Nadorp, P IR - Nadorp P FIR - Nair, S IR - Nair S FIR - Nairn, J IR - Nairn J FIR - Nankervis, A IR - Nankervis A FIR - Narayan, K IR - Narayan K FIR - Nattrass, N IR - Nattrass N FIR - Ngui, J IR - Ngui J FIR - Nicholls, S IR - Nicholls S FIR - Nicholls, V IR - Nicholls V FIR - Nolan, C IR - Nolan C FIR - Nye, J A IR - Nye JA FIR - Nye, E IR - Nye E FIR - O'Neil, D IR - O'Neil D FIR - O'Neill, M IR - O'Neill M FIR - O'Rourke, S IR - O'Rourke S FIR - Pearse, J IR - Pearse J FIR - Pearson, C IR - Pearson C FIR - Phillips, J IR - Phillips J FIR - Pittis, L IR - Pittis L FIR - Playford, D IR - Playford D FIR - Porter, L IR - Porter L FIR - Porter, L IR - Porter L FIR - Portley, R IR - Portley R FIR - Powell, M IR - Powell M FIR - Preston, C IR - Preston C FIR - Pringle, S IR - Pringle S FIR - Raffaele, J IR - Raffaele J FIR - Ramnath, G IR - Ramnath G FIR - Ramsden, J IR - Ramsden J FIR - Rayment, G IR - Rayment G FIR - Roffe, S IR - Roffe S FIR - Rosen, S IR - Rosen S FIR - Ross, G IR - Ross G FIR - Ross, Z IR - Ross Z FIR - Rowe, J IR - Rowe J FIR - Rumble, D IR - Rumble D FIR - Ryan, S IR - Ryan S FIR - Sachithanandan, N IR - Sachithanandan N FIR - Sansom, J IR - Sansom J FIR - Sefert, L IR - Sefert L FIR - Shanahan, E IR - Shanahan E FIR - Shepherd, J IR - Shepherd J FIR - Sherman, G IR - Sherman G FIR - Siddall, R IR - Siddall R FIR - Silva, D IR - Silva D FIR - Simmons, S IR - Simmons S FIR - Simpson, R IR - Simpson R FIR - Sinha, A IR - Sinha A FIR - Slobodniuk, R IR - Slobodniuk R FIR - Smith, M IR - Smith M FIR - Smith, P IR - Smith P FIR - Smith, S IR - Smith S FIR - Smith-Orr, V IR - Smith-Orr V FIR - Socha, L IR - Socha L FIR - Stack, T IR - Stack T FIR - Steed, K IR - Steed K FIR - Steele, K IR - Steele K FIR - Stephensen, J IR - Stephensen J FIR - Stevens, P IR - Stevens P FIR - Stewart, G IR - Stewart G FIR - Stewart, R IR - Stewart R FIR - Strakosch, C IR - Strakosch C FIR - Sullivan, M IR - Sullivan M FIR - Sunder, S IR - Sunder S FIR - Sunderland, J IR - Sunderland J FIR - Tapp, E IR - Tapp E FIR - Taylor, J IR - Taylor J FIR - Thorn, D IR - Thorn D FIR - Tolley, A IR - Tolley A FIR - Torpy, D IR - Torpy D FIR - Truran, G IR - Truran G FIR - Turner, F IR - Turner F FIR - Turner, J IR - Turner J FIR - Varley, S IR - Varley S FIR - Wallace, J IR - Wallace J FIR - Walsh, J IR - Walsh J FIR - Walsh, J IR - Walsh J FIR - Ward, G IR - Ward G FIR - Watson, B IR - Watson B FIR - Watson, J IR - Watson J FIR - Webb, A IR - Webb A FIR - Werner, F IR - Werner F FIR - White, E IR - White E FIR - Whitehouse, A IR - Whitehouse A FIR - Whitehouse, N IR - Whitehouse N FIR - Wigg, S IR - Wigg S FIR - Wilmshurst, E IR - Wilmshurst E FIR - Wittert, G IR - Wittert G FIR - Wong, B IR - Wong B FIR - Wong, M IR - Wong M FIR - Worboys, S IR - Worboys S FIR - Wright, S IR - Wright S FIR - Wu, S IR - Wu S FIR - Yarker, J IR - Yarker J FIR - Yeo, M IR - Yeo M FIR - Young, K IR - Young K FIR - Youssef, J IR - Youssef J FIR - Yuen, R IR - Yuen R FIR - Zeimer, H IR - Zeimer H FIR - Ziffer, R W IR - Ziffer RW FIR - Aura, A IR - Aura A FIR - Friman, A IR - Friman A FIR - Hanninen, J IR - Hanninen J FIR - Henell, J IR - Henell J FIR - Hyvarinen, N IR - Hyvarinen N FIR - Ikonen, M IR - Ikonen M FIR - Itkonen, A IR - Itkonen A FIR - Jantunen, A IR - Jantunen A FIR - Jarva, A IR - Jarva A FIR - Jerkkola, T IR - Jerkkola T FIR - Jokinen, V IR - Jokinen V FIR - Juutilainen, J IR - Juutilainen J FIR - Kahkonen, H IR - Kahkonen H FIR - Kangas, T IR - Kangas T FIR - Karttunen, M IR - Karttunen M FIR - Kauranen, P IR - Kauranen P FIR - Kortelainen, S IR - Kortelainen S FIR - Koukkunen, H IR - Koukkunen H FIR - Kumpulainen, L IR - Kumpulainen L FIR - Laitinen, T IR - Laitinen T FIR - Laitinen, M IR - Laitinen M FIR - Lehto, S IR - Lehto S FIR - Lehto, R IR - Lehto R FIR - Leinonen, E IR - Leinonen E FIR - Lindstron-Karjalainen, M IR - Lindstron-Karjalainen M FIR - Lumiaho, A IR - Lumiaho A FIR - Makela, J IR - Makela J FIR - Makinen, K IR - Makinen K FIR - Mannermaa, L IR - Mannermaa L FIR - Mard, T IR - Mard T FIR - Miettinen, J IR - Miettinen J FIR - Naatti, V IR - Naatti V FIR - Paavola, S IR - Paavola S FIR - Ripatti, J IR - Ripatti J FIR - Ruotsalainen, S IR - Ruotsalainen S FIR - Salo, A IR - Salo A FIR - Siiskonen, M IR - Siiskonen M FIR - Soppela, A IR - Soppela A FIR - Starck, J IR - Starck J FIR - Suonranta, I IR - Suonranta I FIR - Ukkola, L IR - Ukkola L FIR - Valli, K IR - Valli K FIR - Virolainen, J IR - Virolainen J FIR - Allan, P IR - Allan P FIR - Arnold, W IR - Arnold W FIR - Bagg, W IR - Bagg W FIR - Balfour, K IR - Balfour K FIR - Ball, P IR - Ball P FIR - Ballantine, B IR - Ballantine B FIR - Barker, C IR - Barker C FIR - Bartley, F IR - Bartley F FIR - Berry, E IR - Berry E FIR - Braatvedt, G IR - Braatvedt G FIR - Campbell, A IR - Campbell A FIR - Clarke, T IR - Clarke T FIR - Clarke, R IR - Clarke R FIR - Claydon, A IR - Claydon A FIR - Clayton, S IR - Clayton S FIR - Cresswell, P IR - Cresswell P FIR - Cutfield, R IR - Cutfield R FIR - Delahunt, J IR - Delahunt J FIR - Dissnayake, A IR - Dissnayake A FIR - Eagleton, C IR - Eagleton C FIR - Ferguson, C IR - Ferguson C FIR - Florkowski, C IR - Florkowski C FIR - Fry, D IR - Fry D FIR - Giles, P IR - Giles P FIR - Gluyas, M IR - Gluyas M FIR - Grant, C IR - Grant C FIR - Guile, P IR - Guile P FIR - Guolo, M IR - Guolo M FIR - Hale, P IR - Hale P FIR - Hammond, M IR - Hammond M FIR - Healy, P IR - Healy P FIR - Hills, M IR - Hills M FIR - Hinge, J IR - Hinge J FIR - Holland, J IR - Holland J FIR - Hyne, B IR - Hyne B FIR - Ireland, A IR - Ireland A FIR - Johnstone, A IR - Johnstone A FIR - Jones, S IR - Jones S FIR - Kerr, G IR - Kerr G FIR - Kerr, K IR - Kerr K FIR - Khant, M IR - Khant M FIR - Krebs, J IR - Krebs J FIR - Law, L IR - Law L FIR - Lydon, B IR - Lydon B FIR - MacAuley, K IR - MacAuley K FIR - McEwan, R IR - McEwan R FIR - McGregor, P IR - McGregor P FIR - McLaren, B IR - McLaren B FIR - McLeod, L IR - McLeod L FIR - Medforth, J IR - Medforth J FIR - Miskimmin, R IR - Miskimmin R FIR - Moffat, J IR - Moffat J FIR - Pickup, M IR - Pickup M FIR - Reda, E IR - Reda E FIR - Ross, C IR - Ross C FIR - Ryalls, A IR - Ryalls A FIR - Schmid, D IR - Schmid D FIR - Shergill, N IR - Shergill N FIR - Snell, H IR - Snell H FIR - Stevens, L IR - Stevens L FIR - Waterman, A IR - Waterman A FIR - Watts, V IR - Watts V FIR - Jayne, K IR - Jayne K FIR - Keirnan, E IR - Keirnan E FIR - Newman, P IR - Newman P FIR - Ritchie, G IR - Ritchie G FIR - Rosenfeld, A IR - Rosenfeld A FIR - Beller, E IR - Beller E FIR - Donoghoe, M IR - Donoghoe M FIR - Forder, P IR - Forder P FIR - Gebski, V IR - Gebski V FIR - Mann, K IR - Mann K FIR - O'Connell, R IR - O'Connell R FIR - Pardy, C IR - Pardy C FIR - Pillai, A IR - Pillai A FIR - Veillard, A S IR - Veillard AS FIR - Voysey, M IR - Voysey M FIR - Zannino, D IR - Zannino D FIR - Anderson, C IR - Anderson C FIR - Biddle, T IR - Biddle T FIR - Blakesmith, S IR - Blakesmith S FIR - Chan, S-Y IR - Chan SY FIR - Czyniewski, S IR - Czyniewski S FIR - Dobbie, A IR - Dobbie A FIR - Doshi, S IR - Doshi S FIR - Dupuy, A IR - Dupuy A FIR - Eckermann, S IR - Eckermann S FIR - Edwards, M IR - Edwards M FIR - Fields, N IR - Fields N FIR - Flood, K IR - Flood K FIR - Ford, S IR - Ford S FIR - French, C IR - French C FIR - Geldard, H IR - Geldard H FIR - Gillies, S IR - Gillies S FIR - Greig, C IR - Greig C FIR - Groshens, M IR - Groshens M FIR - Gu, J IR - Gu J FIR - Guo, M IR - Guo M FIR - Guo, Y IR - Guo Y FIR - Hague, W IR - Hague W FIR - Healey, S IR - Healey S FIR - Hones, L IR - Hones L FIR - Hossain, Z IR - Hossain Z FIR - Howlett, M IR - Howlett M FIR - Lee, J IR - Lee J FIR - Li, L-P IR - Li LP FIR - Matthews, T IR - Matthews T FIR - Micallef, J IR - Micallef J FIR - Minns, I IR - Minns I FIR - Nguyen, A IR - Nguyen A FIR - Papuni, F IR - Papuni F FIR - Patel, A IR - Patel A FIR - Pearse, J IR - Pearse J FIR - Pike, R IR - Pike R FIR - Pena, M IR - Pena M FIR - Pinto, K IR - Pinto K FIR - Schipp, D IR - Schipp D FIR - Schroeder, J IR - Schroeder J FIR - Sim, B IR - Sim B FIR - Sourjina, T IR - Sourjina T FIR - Sutton, C IR - Sutton C FIR - Taylor, R IR - Taylor R FIR - Vlagsma, P IR - Vlagsma P FIR - Walder, S IR - Walder S FIR - Walker, R IR - Walker R FIR - Zhang, J IR - Zhang J FIR - Zhong, B IR - Zhong B FIR - Keech, A IR - Keech A FIR - Simes, R J IR - Simes RJ FIR - Huntus, C IR - Huntus C FIR - Kokkonen, A IR - Kokkonen A FIR - Narva, P IR - Narva P FIR - Niemi, E-L IR - Niemi EL FIR - Salo, A IR - Salo A FIR - Syrjanen, A-M IR - Syrjanen AM FIR - Taskinen, M-R IR - Taskinen MR FIR - Lintott, C IR - Lintott C FIR - Scott, R IR - Scott R EDAT- 2012/01/03 06:00 MHDA- 2012/06/13 06:00 PMCR- 2013/02/01 CRDT- 2012/01/03 06:00 PHST- 2012/01/03 06:00 [entrez] PHST- 2012/01/03 06:00 [pubmed] PHST- 2012/06/13 06:00 [medline] PHST- 2013/02/01 00:00 [pmc-release] AID - dc11-1109 [pii] AID - 1109 [pii] AID - 10.2337/dc11-1109 [doi] PST - ppublish SO - Diabetes Care. 2012 Feb;35(2):218-25. doi: 10.2337/dc11-1109. Epub 2011 Dec 30. PMID- 22172429 OWN - NLM STAT- MEDLINE DCOM- 20120210 LR - 20141120 IS - 1097-6744 (Electronic) IS - 0002-8703 (Linking) VI - 163 IP - 1 DP - 2012 Jan TI - Rationale and design of the coronary artery bypass grafting surgery off or on pump revascularization study: a large international randomized trial in cardiac surgery. PG - 1-6 LID - 10.1016/j.ahj.2011.10.007 [doi] AB - BACKGROUND: Uncertainty remains regarding the benefits and risks of the technique of operating on a beating heart (off pump) for coronary artery bypass grafting (CABG) surgery versus on-pump CABG. Prior trials had few events and relatively short follow-up. There is a need for a large randomized, controlled trial with long-term follow-up to inform both the short- and long-term impact of the 2 approaches to CABG. METHODS: We plan to randomize 4,700 patients in whom CABG is planned to undergo the procedure on pump or off pump. The coprimary outcomes are a composite of total mortality, myocardial infarction (MI), stroke, and renal failure at 30 days and a composite of total mortality, MI, stroke, renal failure, and repeat revascularization at 5 years. We will also undertake a cost-effectiveness analysis at 30 days and 5 years after CABG surgery. Other outcomes include neurocognitive dysfunction, recurrence of angina, cardiovascular mortality, blood transfusions, and quality of life. RESULTS: As of May 3, 2011, CORONARY has recruited >3,884 patients from 79 centers in 19 countries. Currently, patient's mean age is 67.6 years, 80.7% are men, 47.0% have a history of diabetes, 51.4% have a history of smoking, and 34.4% had a previous MI. In addition, 20.9% of patients have a left main disease, and 96.6% have double or triple vessel disease. CONCLUSIONS: CORONARY is the largest trial yet conducted comparing off-pump CABG to on-pump CABG. Its results will lead to a better understanding of the safety and efficacy of off-pump CABG. CI - Copyright (c) 2012 Mosby, Inc. All rights reserved. FAU - Lamy, Andre AU - Lamy A AD - Population Health Research Institute, Hamilton Health Sciences, McMaster University, Canada. lamya@mcmaster.ca FAU - Devereaux, Philip J AU - Devereaux PJ FAU - Prabhakaran, Dorairaj AU - Prabhakaran D FAU - Hu, Shengshou AU - Hu S FAU - Piegas, Leopoldo S AU - Piegas LS FAU - Straka, Zbynek AU - Straka Z FAU - Paolasso, Ernesto AU - Paolasso E FAU - Taggart, David AU - Taggart D FAU - Lanas, Fernando AU - Lanas F FAU - Akar, A Ruchan AU - Akar AR FAU - Jain, Anil AU - Jain A FAU - Noiseux, Nicolas AU - Noiseux N FAU - Ou, Yongning AU - Ou Y FAU - Chrolavicius, Susan AU - Chrolavicius S FAU - Ng, Jennifer AU - Ng J FAU - Yusuf, Salim AU - Yusuf S LA - eng SI - ClinicalTrials.gov/NCT00463294 GR - Canadian Institutes of Health Research/Canada PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 SB - IM MH - Aged MH - Coronary Artery Bypass/adverse effects/economics/*methods MH - Coronary Artery Bypass, Off-Pump/adverse effects/economics/methods MH - Cost-Benefit Analysis MH - Disease-Free Survival MH - Female MH - Global Health MH - Humans MH - Male MH - Middle Aged MH - Myocardial Infarction/mortality MH - Patient Selection MH - Postoperative Complications/*mortality MH - Renal Insufficiency/mortality MH - Research Design MH - Stroke/mortality EDAT- 2011/12/17 06:00 MHDA- 2012/02/11 06:00 CRDT- 2011/12/17 06:00 PHST- 2011/07/12 00:00 [received] PHST- 2011/10/07 00:00 [accepted] PHST- 2011/12/17 06:00 [entrez] PHST- 2011/12/17 06:00 [pubmed] PHST- 2012/02/11 06:00 [medline] AID - S0002-8703(11)00720-4 [pii] AID - 10.1016/j.ahj.2011.10.007 [doi] PST - ppublish SO - Am Heart J. 2012 Jan;163(1):1-6. doi: 10.1016/j.ahj.2011.10.007. PMID- 22154798 OWN - NLM STAT- MEDLINE DCOM- 20120404 LR - 20220317 IS - 1097-685X (Electronic) IS - 0022-5223 (Linking) VI - 143 IP - 3 DP - 2012 Mar TI - On-pump versus off-pump coronary artery bypass surgery in high-risk patients: operative results of a prospective randomized trial (on-off study). PG - 625-31 LID - 10.1016/j.jtcvs.2011.11.011 [doi] AB - OBJECTIVE: To analyze the risk reduction of cardiopulmonary bypass complications between on-pump and off-pump coronary artery bypass grafting in high-risk patients. METHODS: This multicenter, prospective, randomized, parallel trial enrolled patients for elective or urgent isolated coronary artery bypass grafting with an additive European System for Cardiac Operative Risk Evaluation of 6 or more. The patients in cardiogenic shock were excluded. The composite primary end point included operative mortality, myocardial infarction, stroke, renal failure, reoperation for bleeding and adult respiratory distress syndrome within 30 days after surgery. The total sample size was 693 patients, according to a scheduled interim analysis at 400 patients enrolled (alpha-spending = 0.029, Pocock method). RESULTS: A total of 411 patients were included in the interim analysis. Randomization assigned 203 patients to on-pump and 208 patients to off-pump treatment. Of the 411 patients, 24 crossed over; thus, 195 patients were actually treated on-pump and 216 off-pump. According to the intention to treat analysis, the rate of the composite primary end point was significantly lower (unadjusted P = .009, adjusted P = .010) in the off-pump group (5.8% vs 13.3%). The risk of experiencing the primary end point was significantly greater for the on-pump group (unadjusted odds ratio, 2.51; 95% confidence interval, 1.23-5.10; P = .011; adjusted odds ratio, 3.07; 95% confidence interval, 1.32-7.14; P = .009). CONCLUSIONS: Off-pump coronary artery bypass grafting reduces early mortality and morbidity in high-risk patients. CI - Copyright A(c) 2012 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved. FAU - Lemma, Massimo G AU - Lemma MG AD - Cardiovascular Surgery Department, Luigi Sacco University General Hospital, Milano, Italy. lemma.massimo@hsacco.it FAU - Coscioni, Enrico AU - Coscioni E FAU - Tritto, Francesco P AU - Tritto FP FAU - Centofanti, Paolo AU - Centofanti P FAU - Fondacone, Corrado AU - Fondacone C FAU - Salica, Andrea AU - Salica A FAU - Rossi, Agnese AU - Rossi A FAU - De Santo, Tiziana AU - De Santo T FAU - Di Benedetto, Giuseppe AU - Di Benedetto G FAU - Piazza, Luigi AU - Piazza L FAU - Rinaldi, Mauro AU - Rinaldi M FAU - Schinosa, Antonio L De Luca Tupputi AU - Schinosa AL FAU - De Paulis, Ruggero AU - De Paulis R FAU - Contino, Monica AU - Contino M FAU - Genoni, Michele AU - Genoni M LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20111210 PL - United States TA - J Thorac Cardiovasc Surg JT - The Journal of thoracic and cardiovascular surgery JID - 0376343 SB - IM MH - Aged MH - *Cardiopulmonary Bypass/adverse effects/mortality MH - *Coronary Artery Bypass/adverse effects/mortality MH - *Coronary Artery Bypass, Off-Pump/adverse effects/mortality MH - Coronary Artery Disease/mortality/*surgery MH - Female MH - Hospital Mortality MH - Humans MH - Italy MH - Logistic Models MH - Male MH - Myocardial Infarction/etiology/prevention & control MH - Odds Ratio MH - Postoperative Hemorrhage/etiology/surgery MH - Prospective Studies MH - Renal Insufficiency/etiology/prevention & control MH - Reoperation MH - Respiratory Distress Syndrome/etiology/prevention & control MH - Risk Assessment MH - Risk Factors MH - Stroke/etiology/prevention & control MH - Switzerland MH - Time Factors MH - Treatment Outcome EDAT- 2011/12/14 06:00 MHDA- 2012/04/05 06:00 CRDT- 2011/12/14 06:00 PHST- 2011/04/12 00:00 [received] PHST- 2011/10/19 00:00 [revised] PHST- 2011/11/08 00:00 [accepted] PHST- 2011/12/14 06:00 [entrez] PHST- 2011/12/14 06:00 [pubmed] PHST- 2012/04/05 06:00 [medline] AID - S0022-5223(11)01285-2 [pii] AID - 10.1016/j.jtcvs.2011.11.011 [doi] PST - ppublish SO - J Thorac Cardiovasc Surg. 2012 Mar;143(3):625-31. doi: 10.1016/j.jtcvs.2011.11.011. Epub 2011 Dec 10. PMID- 22137075 OWN - NLM STAT- MEDLINE DCOM- 20120301 LR - 20181201 IS - 1097-6744 (Electronic) IS - 0002-8703 (Linking) VI - 162 IP - 6 DP - 2011 Dec TI - Platelet reactivity in patients with chronic kidney disease receiving adjunctive cilostazol compared with a high-maintenance dose of clopidogrel: results of the effect of platelet inhibition according to clopidogrel dose in patients with chronic kidney disease (PIANO-2 CKD) randomized study. PG - 1018-25 LID - 10.1016/j.ahj.2011.09.003 [doi] AB - BACKGROUND: Chronic kidney disease (CKD) is a factor of low response to clopidogrel. We sought to assess the functional impact of cilostazol in CKD patients with undergoing hemodialysis. METHODS: Seventy-four patients with CKD undergoing hemodialysis and percutaneous coronary intervention were enrolled. Patients were randomly assigned to receive clopidogrel (75 mg/d [group 1, n = 24]), high-maintenance dose of clopidogrel (150 mg/d [group 2, n = 25]), or clopidogrel (75 mg/d) with cilostazol (200 mg/d [group 3, n = 25]) for 14 days. Another 50 patients with normal renal function undergoing percutaneous coronary intervention were treated with 75 mg of clopidogrel and served as the control group. Platelet function was evaluated before and after antiplatelet therapy with light transmittance aggregometry and with VerifyNow P2Y12 assay (Accumetrics, San Diego, CA). Platelet activation markers (soluble CD40 ligand and soluble P-selectin) were also assessed. RESULTS: The baseline platelet function measurements were similar in the 3 groups of patients; however, the CKD groups had significantly higher platelet aggregation activity compared with the control groups. The rate of high on-treatment platelet reactivity was significantly lower in group 3 than in groups 1 and 2 (10% vs 43% vs 32%, respectively; P < .05). After 14 days of antiplatelet therapy, the changes in plasma soluble CD40 ligand and soluble P-selectin levels were significantly higher in group 3 compared with groups 1 and 2 (P < .01); however, there were no significant differences in platelet function and activation markers between groups 1 and 2. CONCLUSIONS: Adjunctive cilostazol improves platelet inhibition compared with 75 or 150 mg of clopidogrel in CKD patients undergoing hemodialysis. CI - Copyright (c) 2011 Mosby, Inc. All rights reserved. FAU - Woo, Jong Shin AU - Woo JS AD - Department of Internal Medicine, Division of Cardiology, School of Medicine, Kyung Hee University, Seoul, Republic of Korea. FAU - Kim, Weon AU - Kim W FAU - Lee, Sul Ra AU - Lee SR FAU - Jung, Kyung Hwan AU - Jung KH FAU - Kim, Woo Shik AU - Kim WS FAU - Lew, Jae Hwan AU - Lew JH FAU - Lee, Tae Won AU - Lee TW FAU - Lim, Chun Kyu AU - Lim CK LA - eng SI - ClinicalTrials.gov/NCT01328470 PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20111108 PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 RN - 0 (Platelet Aggregation Inhibitors) RN - 0 (Tetrazoles) RN - A74586SNO7 (Clopidogrel) RN - N7Z035406B (Cilostazol) RN - OM90ZUW7M1 (Ticlopidine) SB - IM CIN - Am Heart J. 2012 May;163(5):e31; author reply e33. doi: 10.1016/j.ahj.2012.01.034. PMID: 22607871 MH - Adult MH - Aged MH - Angioplasty, Balloon, Coronary MH - Chronic Disease MH - Cilostazol MH - Clopidogrel MH - Coronary Artery Disease/complications/*therapy MH - Female MH - Humans MH - Kidney Diseases/*therapy MH - Male MH - Middle Aged MH - Platelet Activation/*drug effects MH - Platelet Aggregation/drug effects MH - Platelet Aggregation Inhibitors/*pharmacology MH - Prospective Studies MH - Renal Dialysis MH - Tetrazoles/*pharmacology MH - Ticlopidine/analogs & derivatives EDAT- 2011/12/06 06:00 MHDA- 2012/03/02 06:00 CRDT- 2011/12/06 06:00 PHST- 2011/04/02 00:00 [received] PHST- 2011/09/03 00:00 [accepted] PHST- 2011/12/06 06:00 [entrez] PHST- 2011/12/06 06:00 [pubmed] PHST- 2012/03/02 06:00 [medline] AID - S0002-8703(11)00643-0 [pii] AID - 10.1016/j.ahj.2011.09.003 [doi] PST - ppublish SO - Am Heart J. 2011 Dec;162(6):1018-25. doi: 10.1016/j.ahj.2011.09.003. Epub 2011 Nov 8. PMID- 22130317 OWN - NLM STAT- MEDLINE DCOM- 20120529 LR - 20190819 IS - 1347-4820 (Electronic) IS - 1346-9843 (Linking) VI - 76 IP - 2 DP - 2012 TI - Sirolimus-eluting stent vs. everolimus-eluting stent for coronary intervention in patients on chronic hemodialysis. PG - 351-5 AB - BACKGROUND: Even in the drug-eluting stent era, adverse cardiac events, including restenosis after percutaneous coronary intervention (PCI), have been more frequently seen in patients on hemodialysis (HD) than in non-HD patients. The objective of this study was to compare the sirolimus-eluting stent (SES) and everolimus-eluting stent (EES) for prevention of adverse cardiac events, including restenosis, in HD patients. METHODS AND RESULTS: A total of 100 consecutive patients on HD who underwent PCI were enrolled and randomly assigned to receive SES or EES. Although there was no difference between the 2 groups in baseline patient and lesion characteristics, the angiographic restenosis rate at 8-month follow-up was 21.2% in the SES group and 8.7% in the EES group (P = 0.041). Significant differences were also seen in % diameter stenosis (%DS), minimal lumen diameter, and late lumen loss at 8-month follow-up (P = 0.0024, P = 0.0040, and P = 0.033, respectively). During the 1-year follow-up, major adverse cardiac events occurred in 11 (22.0%) patients in the SES group and in 5 (10.0%) patients in the EES group (P = 0.10). CONCLUSIONS: The use of EES was as safe as that of SES. Moreover, EES significantly prevented restenosis in patients on maintenance HD compared with SES. FAU - Sakakibara, Takashi AU - Sakakibara T AD - Cardiovascular Center, Nagoya Kyoritsu Hospital, Nagoya, Japan. FAU - Ishii, Hideki AU - Ishii H FAU - Toriyama, Takanobu AU - Toriyama T FAU - Aoyama, Toru AU - Aoyama T FAU - Takahashi, Hiroshi AU - Takahashi H FAU - Kamoi, Daisuke AU - Kamoi D FAU - Kawamura, Yoshihiro AU - Kawamura Y FAU - Kawashima, Kazuhiro AU - Kawashima K FAU - Yoneda, Kohei AU - Yoneda K FAU - Amano, Tetsuya AU - Amano T FAU - Tanaka, Miho AU - Tanaka M FAU - Yoshikawa, Daiji AU - Yoshikawa D FAU - Hayashi, Mutsuharu AU - Hayashi M FAU - Matsubara, Tatsuaki AU - Matsubara T FAU - Murohara, Toyoaki AU - Murohara T LA - eng PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20111130 PL - Japan TA - Circ J JT - Circulation journal : official journal of the Japanese Circulation Society JID - 101137683 RN - 0 (Immunosuppressive Agents) RN - 9HW64Q8G6G (Everolimus) RN - W36ZG6FT64 (Sirolimus) SB - IM MH - Aged MH - Angioplasty, Balloon, Coronary/methods MH - Coronary Disease/complications/*therapy MH - Coronary Restenosis/prevention & control MH - *Drug-Eluting Stents MH - Everolimus MH - Female MH - Follow-Up Studies MH - Humans MH - Immunosuppressive Agents/therapeutic use MH - Kidney Failure, Chronic/complications/*therapy MH - Male MH - Middle Aged MH - Prospective Studies MH - *Renal Dialysis MH - Sirolimus/*analogs & derivatives/*therapeutic use MH - Treatment Outcome EDAT- 2011/12/02 06:00 MHDA- 2012/05/30 06:00 CRDT- 2011/12/02 06:00 PHST- 2011/12/02 06:00 [entrez] PHST- 2011/12/02 06:00 [pubmed] PHST- 2012/05/30 06:00 [medline] AID - JST.JSTAGE/circj/CJ-11-0814 [pii] AID - 10.1253/circj.cj-11-0814 [doi] PST - ppublish SO - Circ J. 2012;76(2):351-5. doi: 10.1253/circj.cj-11-0814. Epub 2011 Nov 30. PMID- 22124800 OWN - NLM STAT- MEDLINE DCOM- 20120424 LR - 20211021 IS - 1435-1544 (Electronic) IS - 0938-7412 (Linking) VI - 22 IP - 4 DP - 2011 Dec TI - Ventricular tachycardia and sudden death after primary PCI-reperfusion therapy: impact on primary prevention of sudden cardiac death. PG - 243-8 LID - 10.1007/s00399-011-0160-z [doi] AB - BACKGROUND: Current approaches to coronary artery disease (CAD) and acute myocardial infarction (MI) may not be well represented in most primary prevention trials of sudden cardiac death (SCD). METHODS: The contemporary and ongoing registry of the Rostock infarction network (Drip & Ship) represents a well-defined cohort of patients subjected to percutaneous coronary intervention (PCI) for ST-elevation infarction (STEMI) and served as the database for both candidates for an ICD for primary prevention of SCD and for sudden death (SCD) or ventricular tachycardia (VT) during follow-up. RESULTS: A total of 855 consecutive patients were treated with PCI for STEMI or NSTEMI in the region of Rostock (Germany) between 2001 and 2004. While all cause mortality was still 17.2%, the SCD rate was low at 1.3% during 728 +/- 366 days of follow-up. Within that time 85 patients (9.9%) developed an indication for ICD therapy due to an impaired LV function (LVEF /=75 years (25.7%). RESULTS: Elderly patients had a worse risk profile (except for smoking), more previous history of coronary disease and a worse profile on admission, with the exception of lipid profile, which was more favorable. With regard to treatment of the elderly, although less optimized than in other age-groups, it was significantly better compared to other registries, including for percutaneous coronary angioplasty. Both complications and mortality were worse in the older groups. In elderly patients (>/=75 years), adjusted risk of mortality was 4.9-6.3 times higher (p<0.001) than patients in the reference age-group (45-64 years). In these patients, the independent predictors of death were left ventricular function and renal function, use of beta-blockers being a predictor of survival. CONCLUSIONS: Elderly patients represent a substantial proportion of the population admitted with myocardial infarction, and receive less evidenced-based therapy. Age is an independent predictor of short- and medium-term mortality. CI - Copyright (c) 2011 Sociedade Portuguesa de Cardiologia. Published by Elsevier Espana. All rights reserved. FAU - Timoteo, Ana Teresa AU - Timoteo AT AD - Servico de Cardiologia, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central EPE, Lisboa, Portugal. ana.timoteo@yahoo.com FAU - Ramos, Ruben AU - Ramos R FAU - Toste, Alexandra AU - Toste A FAU - Lousinha, Ana AU - Lousinha A FAU - Oliveira, Jose Alberto AU - Oliveira JA FAU - Ferreira, Maria Lurdes AU - Ferreira ML FAU - Cruz Ferreira, Rui AU - Cruz Ferreira R LA - por PT - English Abstract PT - Journal Article TT - Impacto da idade no tratamento e resultados apos enfarte agudo do miocardio em particular nos muito idosos. DEP - 20111123 PL - Portugal TA - Rev Port Cardiol JT - Revista portuguesa de cardiologia : orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology JID - 8710716 SB - IM MH - Age Factors MH - Aged MH - Female MH - Follow-Up Studies MH - Humans MH - Male MH - Middle Aged MH - Myocardial Infarction/*therapy MH - Retrospective Studies MH - Treatment Outcome EDAT- 2011/11/25 06:00 MHDA- 2012/07/04 06:00 CRDT- 2011/11/25 06:00 PHST- 2011/02/17 00:00 [received] PHST- 2011/09/08 00:00 [accepted] PHST- 2011/11/25 06:00 [entrez] PHST- 2011/11/25 06:00 [pubmed] PHST- 2012/07/04 06:00 [medline] AID - S0870-2551(11)00036-9 [pii] AID - 10.1016/j.repc.2011.09.013 [doi] PST - ppublish SO - Rev Port Cardiol. 2011 Dec;30(12):897-903. doi: 10.1016/j.repc.2011.09.013. Epub 2011 Nov 23. PMID- 22107800 OWN - NLM STAT- MEDLINE DCOM- 20120416 LR - 20260128 IS - 1473-5830 (Electronic) IS - 0954-6928 (Linking) VI - 23 IP - 1 DP - 2012 Jan TI - Incidence, predictors, and 30-day outcomes of new-onset atrial fibrillation after primary percutaneous coronary intervention: insight into the RISK-PCI trial. PG - 1-8 LID - 10.1097/MCA.0b013e32834df552 [doi] AB - OBJECTIVES: Limited data exist about the prognostic significance of new-onset atrial fibrillation (AF) after contemporary primary percutaneous coronary intervention (pPCI). The objective of this study was to identify the incidence and predictors of new-onset AF and associated adverse 30-day outcomes in AF patients who underwent pPCI. METHODS: We analyzed 2096 patients undergoing pPCI after pretreatment with 600 mg clopidogrel. Composite 30-day major adverse cardiovascular events were the primary end point. A logistic regression model was developed to identify risk factors for the occurrence of AF and prediction of its impact on 30-day outcomes. RESULTS: AF occurred in 6.2% of patients. Older age, Killip >1 heart failure at admission, systolic blood pressure of greater than 100 mmHg at admission, creatinine clearance greater than 60 ml/min, preprocedural infarction-related artery occlusion and postprocedural thrombolysis in myocardial infarction flow less than 3 were identified as independent predictors of the occurrence of AF. Rates of 30-day major adverse cardiovascular events [adjusted odds ratio (OR) 2.39, 95% confidence interval (CI): 1.47-3.87] and 30-day death (adjusted OR 2.67, 95% CI: 1.46-4.89) were higher in AF patients compared with patients without AF. A trend toward higher rate of ischemia-driven target vessel revascularization was observed in the AF group (adjusted OR 2.61, 95% CI: 0.82-8.39, P=0.10). CONCLUSION: New-onset AF after pPCI is associated with adverse 30-day outcomes. Accurate prediction of AF after pPCI might help deciding a more aggressive treatment approach aimed at preventing the adverse prognosis of these patients. FAU - Mrdovic, Igor AU - Mrdovic I AD - University of Belgrade School of Medicine, Belgrade, Serbia. igormrd@gmail.com FAU - Savic, Lidija AU - Savic L FAU - Krljanac, Gordana AU - Krljanac G FAU - Perunicic, Jovan AU - Perunicic J FAU - Asanin, Milika AU - Asanin M FAU - Lasica, Ratko AU - Lasica R FAU - Antonijevic, Nebojsa AU - Antonijevic N FAU - Kocev, Nikola AU - Kocev N FAU - Marinkovic, Jelena AU - Marinkovic J FAU - Vasiljevic, Zorana AU - Vasiljevic Z FAU - Ostojic, Miodrag AU - Ostojic M LA - eng SI - ISRCTN/ISRCTN83474650 PT - Clinical Trial PT - Journal Article PL - England TA - Coron Artery Dis JT - Coronary artery disease JID - 9011445 RN - 0 (Platelet Aggregation Inhibitors) RN - A74586SNO7 (Clopidogrel) RN - OM90ZUW7M1 (Ticlopidine) SB - IM MH - Aged MH - Angioplasty, Balloon, Coronary/*adverse effects/mortality MH - Atrial Fibrillation/diagnosis/*etiology/mortality MH - Chi-Square Distribution MH - Clopidogrel MH - Coronary Angiography MH - Coronary Artery Disease/diagnostic imaging/mortality/*therapy MH - Female MH - Hospital Mortality MH - Humans MH - Incidence MH - Kaplan-Meier Estimate MH - Logistic Models MH - Male MH - Middle Aged MH - Odds Ratio MH - Platelet Aggregation Inhibitors/therapeutic use MH - Risk Assessment MH - Risk Factors MH - Serbia MH - Ticlopidine/analogs & derivatives/therapeutic use MH - Time Factors MH - Treatment Outcome EDAT- 2011/11/24 06:00 MHDA- 2012/04/17 06:00 CRDT- 2011/11/24 06:00 PHST- 2011/11/24 06:00 [entrez] PHST- 2011/11/24 06:00 [pubmed] PHST- 2012/04/17 06:00 [medline] AID - 10.1097/MCA.0b013e32834df552 [doi] PST - ppublish SO - Coron Artery Dis. 2012 Jan;23(1):1-8. doi: 10.1097/MCA.0b013e32834df552. PMID- 22093205 OWN - NLM STAT- MEDLINE DCOM- 20120109 LR - 20181201 IS - 1097-6744 (Electronic) IS - 0002-8703 (Linking) VI - 162 IP - 5 DP - 2011 Nov TI - Safety and efficacy of adjusted-dose eptifibatide in patients with acute coronary syndromes and reduced renal function. PG - 884-892.e1 LID - 10.1016/j.ahj.2011.08.020 [doi] AB - BACKGROUND: Dose adjustment of renally excreted antithrombotic drugs is recommended for patients with reduced renal function. We examined the influence of dose modification on bleeding and efficacy. METHODS: Based on initial study drug infusion rate, Early GP IIb/IIIa Inhibition in non-ST-segment elevation acute coronary syndromes (EARLY ACS) patients were categorized into groups: standard dose (2 mug/kg/min; estimated creatinine clearance [eCrCl] >/=50 ml/min), adjusted dose (1 mug/kg/min; eCrCl <50 ml/min, per protocol), excess dose (2 mug/kg/min; eCrCl <50 ml/min). We explored relationships among initial dosing, randomized treatment assignment, and bleeding and ischemic end points (96-h composite of death, myocardial infarction [MI], recurrent ischemia requiring urgent revascularization or thrombotic bailout, and 30-d death or MI). RESULTS: Of 8,708 patients with eCrCl and dosing data, 19% had eCrCl <50 ml/min. Of these, 13% received adjusted dose eptifibatide and 6% received an excess dose. Across all dosing groups, no significant reductions were found in ischemic end points between early versus delayed provisional eptifibatide (OR 1.14, 95% CI 0.80-1.65; OR 1.13, 95% CI 0.81-1.56, respectively, for 96-h and 30-d composite end points). Bleeding risk was not significantly increased in the early versus delayed provisional treatment group in either the adjusted (OR 1.50, 95% CI 0.95-2.39) or excess dose group (OR 1.67, 95% CI 0.85-3.39). There were no significant interactions between dose group and treatment strategy on bleeding or efficacy. CONCLUSION: Similar to observations in practice, despite guidelines recommendations and protocol guidance, 34% of EARLY ACS patients with reduced renal function failed to receive an appropriately adjusted study drug infusion. Use of an appropriately adjusted eptifibatide infusion was not associated with expected reductions in bleeding among patients with renal insufficiency. CI - Copyright (c) 2011 Mosby, Inc. All rights reserved. FAU - Melloni, Chiara AU - Melloni C AD - Division of Cardiology and Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA. mello004@mc.duke.edu FAU - James, Stefan K AU - James SK FAU - White, Jennifer A AU - White JA FAU - Giugliano, Robert P AU - Giugliano RP FAU - Harrington, Robert A AU - Harrington RA FAU - Huber, Kurt AU - Huber K FAU - Tricoci, Pierluigi AU - Tricoci P FAU - Armstrong, Paul W AU - Armstrong PW FAU - Van de Werf, Frans AU - Van de Werf F FAU - Montalescot, Gilles AU - Montalescot G FAU - Califf, Robert M AU - Califf RM FAU - Newby, L Kristin AU - Newby LK LA - eng PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 RN - 0 (Peptides) RN - 0 (Platelet Aggregation Inhibitors) RN - 0 (Platelet Glycoprotein GPIIb-IIIa Complex) RN - AYI8EX34EU (Creatinine) RN - NA8320J834 (Eptifibatide) SB - IM MH - Acute Coronary Syndrome/complications/*drug therapy MH - Aged MH - Aged, 80 and over MH - Creatinine/metabolism MH - *Delivery of Health Care MH - Drug Dosage Calculations MH - Eptifibatide MH - Female MH - Hemorrhage/etiology MH - Humans MH - Kidney Function Tests/*statistics & numerical data MH - Male MH - Peptides/*administration & dosage/adverse effects MH - Platelet Aggregation Inhibitors/*adverse effects MH - Platelet Glycoprotein GPIIb-IIIa Complex/*antagonists & inhibitors MH - Practice Guidelines as Topic MH - Renal Insufficiency/*complications/physiopathology MH - Treatment Outcome EDAT- 2011/11/19 06:00 MHDA- 2012/01/10 06:00 CRDT- 2011/11/19 06:00 PHST- 2011/01/06 00:00 [received] PHST- 2011/08/26 00:00 [accepted] PHST- 2011/11/19 06:00 [entrez] PHST- 2011/11/19 06:00 [pubmed] PHST- 2012/01/10 06:00 [medline] AID - S0002-8703(11)00639-9 [pii] AID - 10.1016/j.ahj.2011.08.020 [doi] PST - ppublish SO - Am Heart J. 2011 Nov;162(5):884-892.e1. doi: 10.1016/j.ahj.2011.08.020. PMID- 22090660 OWN - NLM STAT- MEDLINE DCOM- 20120131 LR - 20220419 IS - 1522-9645 (Electronic) IS - 0195-668X (Linking) VI - 32 IP - 23 DP - 2011 Dec TI - Bleeding complications with the P2Y12 receptor antagonists clopidogrel and ticagrelor in the PLATelet inhibition and patient Outcomes (PLATO) trial. PG - 2933-44 LID - 10.1093/eurheartj/ehr422 [doi] AB - AIMS More intense platelet-directed therapy for acute coronary syndrome (ACS) may increase bleeding risk. The aim of the current analysis was to determine the rate, clinical impact, and predictors of major and fatal bleeding complications in the PLATO study. METHODS AND RESULTS PLATO was a randomized, double-blind, active control international, phase 3 clinical trial in patients with acute ST elevation and non-ST-segment elevation ACS. A total of 18 624 patients were randomized to either ticagrelor, a non-thienopyridine, reversibly binding platelet P2Y(12) receptor antagonist, or clopidogrel in addition to aspirin. Patients randomized to ticagrelor and clopidogrel had similar rates of PLATO major bleeding (11.6 vs. 11.2%; P = 0.43), TIMI major bleeding (7.9 vs. 7.7%, P = 0.56) and GUSTO severe bleeding (2.9 vs. 3.1%, P = 0.22). Procedure-related bleeding rates were also similar. Non-CABG major bleeding (4.5 vs. 3.8%, P = 0.02) and non-procedure-related major bleeding (3.1 vs. 2.3%, P = 0.05) were more common in ticagrelor-treated patients, primarily after 30 days on treatment. Fatal bleeding and transfusion rates did not differ between groups. There were no significant interactions for major bleeding or combined minor plus major bleeding between treatment groups and age >/=75 years, weight <60 kg, region, chronic kidney disease, creatinine clearance <60 mL/min, aspirin dose >325 mg on the day of randomization, pre-randomization clopidogrel administration, or clopidogrel loading dose. CONCLUSION Ticagrelor compared with clopidogrel was associated with similar total major bleeding but increased non-CABG and non-procedure-related major bleeding, primarily after 30 days on study drug treatment. Fatal bleeding was low and did not differ between groups. FAU - Becker, Richard C AU - Becker RC AD - Duke University School of Medicine, Duke Clinical Research Institute, Durham, NC 27715, USA. becke021@mc.duke.edu FAU - Bassand, Jean Pierre AU - Bassand JP FAU - Budaj, Andrzej AU - Budaj A FAU - Wojdyla, Daniel M AU - Wojdyla DM FAU - James, Stefan K AU - James SK FAU - Cornel, Jan H AU - Cornel JH FAU - French, John AU - French J FAU - Held, Claes AU - Held C FAU - Horrow, Jay AU - Horrow J FAU - Husted, Steen AU - Husted S FAU - Lopez-Sendon, Jose AU - Lopez-Sendon J FAU - Lassila, Riitta AU - Lassila R FAU - Mahaffey, Kenneth W AU - Mahaffey KW FAU - Storey, Robert F AU - Storey RF FAU - Harrington, Robert A AU - Harrington RA FAU - Wallentin, Lars AU - Wallentin L LA - eng SI - ClinicalTrials.gov/NCT00391872 PT - Clinical Trial, Phase III PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20111116 PL - England TA - Eur Heart J JT - European heart journal JID - 8006263 RN - 0 (Platelet Aggregation Inhibitors) RN - 0 (Purinergic P2 Receptor Antagonists) RN - A74586SNO7 (Clopidogrel) RN - GLH0314RVC (Ticagrelor) RN - K72T3FS567 (Adenosine) RN - OM90ZUW7M1 (Ticlopidine) RN - R16CO5Y76E (Aspirin) SB - IM EIN - Eur Heart J. 2012 Nov;33(21):2750 CIN - Eur Heart J. 2011 Dec;32(23):2919-21. doi: 10.1093/eurheartj/ehr424. PMID: 22096089 MH - Acute Coronary Syndrome/mortality/*prevention & control MH - Adenosine/adverse effects/*analogs & derivatives MH - Aged MH - Aspirin/therapeutic use MH - Clopidogrel MH - Coronary Artery Bypass/adverse effects/mortality MH - Double-Blind Method MH - Female MH - Hemorrhage/*chemically induced MH - Humans MH - Male MH - Middle Aged MH - Platelet Aggregation Inhibitors/*adverse effects MH - Purinergic P2 Receptor Antagonists/*adverse effects MH - Stroke/chemically induced MH - Ticagrelor MH - Ticlopidine/adverse effects/*analogs & derivatives MH - Treatment Outcome EDAT- 2011/11/18 06:00 MHDA- 2012/02/01 06:00 CRDT- 2011/11/18 06:00 PHST- 2011/11/18 06:00 [entrez] PHST- 2011/11/18 06:00 [pubmed] PHST- 2012/02/01 06:00 [medline] AID - ehr422 [pii] AID - 10.1093/eurheartj/ehr422 [doi] PST - ppublish SO - Eur Heart J. 2011 Dec;32(23):2933-44. doi: 10.1093/eurheartj/ehr422. Epub 2011 Nov 16. PMID- 22025630 OWN - NLM STAT- MEDLINE DCOM- 20120123 LR - 20220330 IS - 1533-3450 (Electronic) IS - 1046-6673 (Print) IS - 1046-6673 (Linking) VI - 22 IP - 12 DP - 2011 Dec TI - Bedtime dosing of antihypertensive medications reduces cardiovascular risk in CKD. PG - 2313-21 LID - 10.1681/ASN.2011040361 [doi] AB - Time of ingestion of hypertension medications can affect circadian patterns of BP, but whether this translates into an effect on clinical outcomes is unknown. Here, in an open-label trial, we randomly assigned 661 patients with CKD either to take all prescribed hypertension medications upon awakening or to take at least one of them at bedtime. We measured 48-hour ambulatory BP at baseline and 3 months after any adjustment in treatment or, at the least, annually. After a median follow-up of 5.4 years, patients who took at least one BP-lowering medication at bedtime had an adjusted risk for total cardiovascular events (a composite of death, myocardial infarction, angina pectoris, revascularization, heart failure, arterial occlusion of lower extremities, occlusion of the retinal artery, and stroke) that was approximately one-third that of patients who took all medications upon awakening (adjusted HR 0.31; 95% CI 0.21 to 0.46; P < 0.001). Bedtime dosing demonstrated a similar significant reduction in risk for a composite outcome of cardiovascular death, myocardial infarction, and stroke (adjusted HR 0.28; 95% CI 0.13 to 0.61; P < 0.001). Furthermore, patients on bedtime treatment had a significantly lower mean sleep-time BP and a greater proportion demonstrated control of their ambulatory BP (56% versus 45%, P = 0.003). Each 5-mmHg decrease in mean sleep-time systolic BP was associated with a 14% reduction in the risk for cardiovascular events during follow-up (P < 0.001). In conclusion, among patients with CKD and hypertension, taking at least one antihypertensive medication at bedtime improves control of BP and reduces the risk for cardiovascular events. FAU - Hermida, Ramon C AU - Hermida RC AD - Bioengineering and Chronobiology Laboratories, E.T.S.I. Telecomunicacion, Campus Universitario, Vigo (Pontevedra) 36310, Spain. rhermida@uvigo.es FAU - Ayala, Diana E AU - Ayala DE FAU - Mojon, Artemio AU - Mojon A FAU - Fernandez, Jose R AU - Fernandez JR LA - eng PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20111024 PL - United States TA - J Am Soc Nephrol JT - Journal of the American Society of Nephrology : JASN JID - 9013836 RN - 0 (Antihypertensive Agents) SB - IM CIN - J Am Soc Nephrol. 2011 Dec;22(12):2152-5. doi: 10.1681/ASN.2011101012. PMID: 22080422 CIN - Nat Rev Nephrol. 2011 Nov 22;8(1):4. doi: 10.1038/nrneph.2011.188. PMID: 22105157 CIN - Ann Intern Med. 2012 Jun 19;156(12):JC6-8. doi: 10.7326/0003-4819-156-12-201206190-02008. PMID: 22711109 MH - Antihypertensive Agents/*administration & dosage/pharmacology MH - Blood Pressure/drug effects MH - Cardiovascular Diseases/*etiology/*prevention & control MH - Chronic Disease MH - *Drug Chronotherapy MH - Female MH - Humans MH - Hypertension/*complications/*drug therapy MH - Kidney Diseases/*complications MH - Male MH - Middle Aged MH - Prospective Studies MH - Risk Factors PMC - PMC3279936 EDAT- 2011/10/26 06:00 MHDA- 2012/01/24 06:00 PMCR- 2012/12/01 CRDT- 2011/10/26 06:00 PHST- 2011/10/26 06:00 [entrez] PHST- 2011/10/26 06:00 [pubmed] PHST- 2012/01/24 06:00 [medline] PHST- 2012/12/01 00:00 [pmc-release] AID - ASN.2011040361 [pii] AID - 2011040361 [pii] AID - 10.1681/ASN.2011040361 [doi] PST - ppublish SO - J Am Soc Nephrol. 2011 Dec;22(12):2313-21. doi: 10.1681/ASN.2011040361. Epub 2011 Oct 24. PMID- 21996202 OWN - NLM STAT- MEDLINE DCOM- 20120213 LR - 20211203 IS - 1873-2623 (Electronic) IS - 0041-1345 (Linking) VI - 43 IP - 8 DP - 2011 Oct TI - Cardiovascular risk in kidney transplant recipients receiving mammalian target of rapamycin inhibitors. PG - 2967-9 LID - 10.1016/j.transproceed.2011.08.009 [doi] AB - Cardiovascular diseases (CVD) are the leading cause of mortality in renal transplant recipients. Various traditional and unconventional cardiovascular risk factors are potentiated by the adverse effects of immunosuppressive drugs. The mammalian target of rapamycin (mTOR) inhibitors have shown cardioprotective effects in experimental studies, but their influence on CVD in renal transplantation is unclear. The study included 115 kidney transplant recipients treated with mTOR inhibitors with steroids. A group of 38 patients received additionally small doses of calcineurin inhibitor. The control group consisted of 58 kidney transplant recipients randomly chosen among the population of patients transplanted at the same time, who received a calcineurin inhibitor, mycophenolate mofetil or sodium plus steroids. No differences in age, gender, duration of pretransplantat dialysis, time after transplantation, body mass index or glycated hemoglobin existed between the groups. Blood pressure and number of antihypertensive agents, high-density lipoprotein cholesterol, and uric acid levels were similar. The prevalence of diabetic, ischemic, or hypertensive nephropathy as the reason for end-stage renal disease was similar (P=.08). The study group showed higher mean values of total cholesterol (249 vs 204.6 mg/dL; P<.0001) and low-density lipoprotein 136.5 vs 117.7 mg/dL; (P=.015), as well as median values of triglycerides (202 vs 142 mg/dL; P<.0001) and proteinuria (P=.0002). mean estimated glomerular filtration rate was lower in the study group (42.9 vs 51.9 mL/min; P=.0003). Posttransplant diabetes appeared in 38% of the study group compared to 20% of the controls (P=.08). The incidence of coronary artery disease was higher among patients treated with mTOR inhibitors (P=.04). CVD, defined as myocardial infarction, percutaneous coronary intervention, stroke, aortic aneurysm, pulmonary thromboembolism, sudden cardiac death appeared in 26 study group compared with four control patients (P=.24). The risk of any CVD was not significantly higher among patients receiving mTOR inhibitors hazard ratio 1.94; 95% confidence interval 0.83-4.52). In conclusion, no correlation was observed between the duration of mTOR therapy and CVD. CI - Copyright (c) 2011 Elsevier Inc. All rights reserved. FAU - Watorek, E AU - Watorek E AD - Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland. ewatorek@wp.pl FAU - Szymczak, M AU - Szymczak M FAU - Boratynska, M AU - Boratynska M FAU - Patrzalek, D AU - Patrzalek D FAU - Klinger, M AU - Klinger M LA - eng PT - Journal Article PT - Randomized Controlled Trial PL - United States TA - Transplant Proc JT - Transplantation proceedings JID - 0243532 RN - 0 (Calcineurin Inhibitors) RN - 0 (Immunosuppressive Agents) RN - 0 (Steroids) RN - EC 2.7.1.1 (MTOR protein, human) RN - EC 2.7.11.1 (TOR Serine-Threonine Kinases) RN - HU9DX48N0T (Mycophenolic Acid) SB - IM MH - Calcineurin Inhibitors MH - Cardiovascular Diseases/*etiology MH - Female MH - Humans MH - Immunosuppressive Agents/administration & dosage/*adverse effects MH - Kidney Transplantation/*adverse effects MH - Male MH - Middle Aged MH - Mycophenolic Acid/administration & dosage/analogs & derivatives MH - Risk Factors MH - Steroids/administration & dosage MH - TOR Serine-Threonine Kinases/*antagonists & inhibitors EDAT- 2011/10/15 06:00 MHDA- 2012/02/14 06:00 CRDT- 2011/10/15 06:00 PHST- 2011/10/15 06:00 [entrez] PHST- 2011/10/15 06:00 [pubmed] PHST- 2012/02/14 06:00 [medline] AID - S0041-1345(11)01053-0 [pii] AID - 10.1016/j.transproceed.2011.08.009 [doi] PST - ppublish SO - Transplant Proc. 2011 Oct;43(8):2967-9. doi: 10.1016/j.transproceed.2011.08.009. PMID- 21951630 OWN - NLM STAT- MEDLINE DCOM- 20120209 LR - 20220321 IS - 1522-9645 (Electronic) IS - 0195-668X (Linking) VI - 32 IP - 24 DP - 2011 Dec TI - SYNTAX score and Clinical SYNTAX score as predictors of very long-term clinical outcomes in patients undergoing percutaneous coronary interventions: a substudy of SIRolimus-eluting stent compared with pacliTAXel-eluting stent for coronary revascularization (SIRTAX) trial. PG - 3115-27 LID - 10.1093/eurheartj/ehr369 [doi] AB - AIMS: To investigate the ability of SYNTAX score and Clinical SYNTAX score (CSS) to predict very long-term outcomes in an all-comers population receiving drug-eluting stents. METHODS AND RESULTS: The SYNTAX score was retrospectively calculated in 848 patients enrolled in the SIRolimus-eluting stent compared with pacliTAXel-Eluting Stent for coronary revascularization (SIRTAX) trial. The CSS was calculated using age, and baseline left ventricular ejection fraction and creatinine clearance. A stratified post hoc comparison was performed for all-cause mortality, cardiac death, myocardial infarction (MI), ischaemia-driven target lesion revascularization (TLR), definite stent thrombosis, and major adverse cardiac events (MACE) at 1- and 5-year follow-up. Tertiles for SYNTAX score and CSS were defined as SS(LOW) 14 and CSS(LOW) 17.0, respectively. Major adverse cardiac events rates were significantly higher in SS(HIGH) compared with SS(LOW) at 1- and 5-year follow-up, which was also seen at 5 years for all-cause mortality, cardiac death, MI, and TLR. Stratifying outcomes across CSS tertiles confirmed and augmented these results. Within CSS(HIGH), 5-year MACE increased with use of paclitaxel- compared with sirolimus-eluting stents (34.7 vs. 21.3%, P = 0.008). SYNTAX score and CSS were independent predictors of 5-year MACE; CSS was an independent predictor for 5-year mortality. Areas-under-the-curve for SYNTAX score and CSS for 5-year MACE were 0.61 (0.56-0.65) and 0.62 (0.57-0.67), for 5-year all-cause mortality 0.58 (0.51-0.65) and 0.66 (0.59-0.73) and for 5-year cardiac death 0.63 (0.54-0.72) and 0.72 (0.63-0.81), respectively. CONCLUSION: SYNTAX score and to a greater extent CSS were able to stratify risk for very long-term adverse clinical outcomes in an all-comers population receiving drug-eluting stents. Predictive accuracy for 5-year all-cause mortality was improved using CSS. TRIAL REGISTRATION NUMBER: NCT00297661. FAU - Girasis, Chrysafios AU - Girasis C AD - Department of Interventional Cardiology, Thoraxcenter, Erasmus Medical Center, Ba-583, 's Gravendijkwal 230, 3015 Rotterdam, The Netherlands. FAU - Garg, Scot AU - Garg S FAU - Raber, Lorenz AU - Raber L FAU - Sarno, Giovanna AU - Sarno G FAU - Morel, Marie-Angele AU - Morel MA FAU - Garcia-Garcia, Hector M AU - Garcia-Garcia HM FAU - Luscher, Thomas F AU - Luscher TF FAU - Serruys, Patrick W AU - Serruys PW FAU - Windecker, Stephan AU - Windecker S LA - eng SI - ClinicalTrials.gov/NCT00297661 PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20110927 PL - England TA - Eur Heart J JT - European heart journal JID - 8006263 RN - 0 (Tubulin Modulators) RN - P88XT4IS4D (Paclitaxel) RN - W36ZG6FT64 (Sirolimus) SB - IM MH - Aged MH - Angioplasty, Balloon, Coronary/methods/mortality MH - Coronary Stenosis/mortality/*therapy MH - *Drug-Eluting Stents MH - Female MH - Humans MH - Male MH - Middle Aged MH - Myocardial Revascularization/methods/mortality MH - Paclitaxel/*administration & dosage MH - Predictive Value of Tests MH - Prospective Studies MH - ROC Curve MH - Retrospective Studies MH - *Severity of Illness Index MH - Sirolimus/*administration & dosage MH - Treatment Outcome MH - Tubulin Modulators/*administration & dosage EDAT- 2011/09/29 06:00 MHDA- 2012/02/10 06:00 CRDT- 2011/09/29 06:00 PHST- 2011/09/29 06:00 [entrez] PHST- 2011/09/29 06:00 [pubmed] PHST- 2012/02/10 06:00 [medline] AID - ehr369 [pii] AID - 10.1093/eurheartj/ehr369 [doi] PST - ppublish SO - Eur Heart J. 2011 Dec;32(24):3115-27. doi: 10.1093/eurheartj/ehr369. Epub 2011 Sep 27. PMID- 21943940 OWN - NLM STAT- MEDLINE DCOM- 20120207 LR - 20260128 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 109 IP - 1 DP - 2012 Jan 1 TI - Impact of iso-osmolar versus low-osmolar contrast agents on contrast-induced nephropathy and tissue reperfusion in unselected patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention (from the Contrast Media and Nephrotoxicity Following Primary Angioplasty for Acute Myocardial Infarction [CONTRAST-AMI] Trial). PG - 67-74 LID - 10.1016/j.amjcard.2011.08.006 [doi] AB - Conflicting data have been reported on the effects of low-osmolar and iso-osmolar contrast media on contrast-induced acute kidney injury (CI-AKI). In particular, no clinical trial has yet focused on the effect of contemporary contrast media on CI-AKI, epicardial flow, and microcirculatory function in patients with ST-segment elevation acute myocardial infarction who undergo primary percutaneous coronary intervention. The Contrast Media and Nephrotoxicity Following Coronary Revascularization by Angioplasty for Acute Myocardial Infarction (CONTRAST-AMI) trial is a prospective, randomized, single-blind, parallel-group, noninferiority study aiming to evaluate the effects of the low-osmolar contrast medium iopromide compared to the iso-osmolar agent iodixanol on CI-AKI and tissue-level perfusion in patients with ST-segment elevation acute myocardial infarction. Four hundred seventy-five consecutive, unselected patients who underwent primary percutaneous coronary intervention were randomized to iopromide (n = 239) or iodixanol (n = 236). All patients received high-dose N-acetylcysteine and hydration. The primary end point was the proportion of patients with serum creatinine (sCr) increases >/=25% from baseline to 72 hours. Secondary end points were Thrombolysis In Myocardial Infarction (TIMI) myocardial perfusion grade, increase in sCr >/=50%, increase in sCr >/=0.5 or >/=1 mg/dl, and 1-month major adverse cardiac events. The primary end point occurred in 10% of the iopromide group and in 13% of the iodixanol group (95% confidence interval -9% to 3%, p for noninferiority = 0.0002). A TIMI myocardial perfusion grade of 0 or 1 was present in 14% of patients in the 2 groups. No differences between the 2 groups were found in any of the secondary analyses of sCr increase. No significant difference in 1-month major adverse cardiac events was found (8% vs 6%, p = 0.37). In conclusion, in a population of unselected patients with ST-segment elevation acute myocardial infarction who underwent primary percutaneous coronary intervention, iopromide was not inferior to iodixanol in the occurrence of CI-AKI; no significant differences were found in terms of tissue-level reperfusion and major adverse cardiac events between the 2 contrast agents. CI - Copyright (c) 2012 Elsevier Inc. All rights reserved. FAU - Bolognese, Leonardo AU - Bolognese L AD - Department of Cardiovascular Diseases, San Donato Hospital, Arezzo, Italy. leonardobolognese@hotmail.com FAU - Falsini, Giovanni AU - Falsini G FAU - Schwenke, Carsten AU - Schwenke C FAU - Grotti, Simone AU - Grotti S FAU - Limbruno, Ugo AU - Limbruno U FAU - Liistro, Francesco AU - Liistro F FAU - Carrera, Arcangelo AU - Carrera A FAU - Angioli, Paolo AU - Angioli P FAU - Picchi, Andrea AU - Picchi A FAU - Ducci, Kenneth AU - Ducci K FAU - Pierli, Carlo AU - Pierli C LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20110922 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 RN - 0 (Contrast Media) RN - 0 (Triiodobenzoic Acids) RN - 4419T9MX03 (Iohexol) RN - 712BAC33MZ (iopromide) RN - HW8W27HTXX (iodixanol) SB - IM MH - Acute Kidney Injury/*chemically induced/epidemiology/physiopathology MH - Aged MH - Angioplasty, Balloon, Coronary/*methods MH - Contrast Media/*adverse effects MH - Coronary Angiography/*adverse effects/methods MH - Coronary Circulation/drug effects MH - *Electrocardiography MH - Female MH - Follow-Up Studies MH - Glomerular Filtration Rate/drug effects MH - Humans MH - Incidence MH - Iohexol/adverse effects/analogs & derivatives MH - Italy/epidemiology MH - Male MH - Myocardial Infarction/*diagnostic imaging/physiopathology/therapy MH - Myocardial Reperfusion Injury/*chemically induced/epidemiology/physiopathology MH - Prognosis MH - Prospective Studies MH - Risk Factors MH - Single-Blind Method MH - Triiodobenzoic Acids/adverse effects EDAT- 2011/09/29 06:00 MHDA- 2012/02/09 06:00 CRDT- 2011/09/28 06:00 PHST- 2011/05/26 00:00 [received] PHST- 2011/08/04 00:00 [revised] PHST- 2011/08/04 00:00 [accepted] PHST- 2011/09/28 06:00 [entrez] PHST- 2011/09/29 06:00 [pubmed] PHST- 2012/02/09 06:00 [medline] AID - S0002-9149(11)02548-3 [pii] AID - 10.1016/j.amjcard.2011.08.006 [doi] PST - ppublish SO - Am J Cardiol. 2012 Jan 1;109(1):67-74. doi: 10.1016/j.amjcard.2011.08.006. Epub 2011 Sep 22. PMID- 21939942 OWN - NLM STAT- MEDLINE DCOM- 20120120 LR - 20260128 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 4 IP - 9 DP - 2011 Sep TI - Long-term impact of chronic kidney disease in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention: the HORIZONS-AMI (Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction) trial. PG - 1011-9 LID - 10.1016/j.jcin.2011.06.012 [doi] AB - OBJECTIVES: This study sought to investigate the impact of chronic kidney disease (CKD) in patients undergoing percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) with different antithrombotic strategies. BACKGROUND: CKD is associated with increased risk of adverse ischemic and hemorrhagic events after primary PCI for STEMI. METHODS: HORIZONS-AMI (Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction) trial was a multicenter, international, randomized trial comparing bivalirudin monotherapy or heparin plus a glycoprotein IIb/IIIa inhibitor (GPI) during primary PCI in STEMI. CKD, defined as creatinine clearance <60 ml/min, was present at baseline in 554 of 3,397 patients (16.3%). Patients were followed for 3 years. Net adverse cardiac event (NACE) was defined as the composite of death, reinfarction, ischemia-driven target vessel revascularization (TVR), stroke or non-coronary artery bypass grafting (CABG)-related major bleeding. RESULTS: Patients with CKD compared with patients without had higher rates of NACE (41.4% vs. 23.8%, p < 0.0001), death (18.7% vs. 4.4%, p < 0.0001), and major bleeding (19.3% vs. 6.7%, p < 0.0001). Multivariable analysis identified baseline creatinine as an independent predictor of death at 3 years (hazard ratio: 1.51, 95% confidence interval: 1.21 to 1.87, p < 0.001). Patients with CKD randomized to bivalirudin monotherapy versus heparin plus GPI had no significant difference in major bleeding (19.0% vs. 19.6%, p = 0.72) or death (19.0% vs. 18.4%, p = 0.88) at 3 years. In patients with CKD, there was no difference in the rates of TVR in bare-metal stents (BMS) versus drug-eluting stents (DES) at 3 years (14.1% vs. 15.1%, p = 0.8). CONCLUSIONS: STEMI patients with CKD have significantly higher rates of death and major bleeding compared with those without CKD. In patients with CKD, there appears to be no benefit of bivalirudin compared with heparin + GPI, or DES versus BMS during primary PCI in improving clinical outcomes. CI - Copyright (c) 2011 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Saltzman, Adam J AU - Saltzman AJ AD - Columbia University Medical Center and the Cardiovascular Research Foundation, New York, New York, USA. FAU - Stone, Gregg W AU - Stone GW FAU - Claessen, Bimmer E AU - Claessen BE FAU - Narula, Amar AU - Narula A FAU - Leon-Reyes, Selene AU - Leon-Reyes S FAU - Weisz, Giora AU - Weisz G FAU - Brodie, Bruce AU - Brodie B FAU - Witzenbichler, Bernhard AU - Witzenbichler B FAU - Guagliumi, Giulio AU - Guagliumi G FAU - Kornowski, Ran AU - Kornowski R FAU - Dudek, Dariusz AU - Dudek D FAU - Metzger, D Christopher AU - Metzger DC FAU - Lansky, Alexandra J AU - Lansky AJ FAU - Nikolsky, Eugenia AU - Nikolsky E FAU - Dangas, George D AU - Dangas GD FAU - Mehran, Roxana AU - Mehran R LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 RN - 0 (Anticoagulants) RN - 0 (Fibrinolytic Agents) RN - 0 (Hirudins) RN - 0 (Metals) RN - 0 (Peptide Fragments) RN - 0 (Platelet Aggregation Inhibitors) RN - 0 (Platelet Glycoprotein GPIIb-IIIa Complex) RN - 0 (Recombinant Proteins) RN - 9005-49-6 (Heparin) RN - TN9BEX005G (bivalirudin) SB - IM MH - Aged MH - Aged, 80 and over MH - Angioplasty, Balloon, Coronary/adverse effects/*instrumentation/mortality MH - Anticoagulants/therapeutic use MH - Chi-Square Distribution MH - Chronic Disease MH - Drug-Eluting Stents MH - Europe MH - Female MH - Fibrinolytic Agents/therapeutic use MH - Hemorrhage MH - Heparin/therapeutic use MH - Hirudins MH - Humans MH - Israel MH - Kaplan-Meier Estimate MH - Kidney Diseases/*complications/mortality MH - Male MH - Metals MH - Middle Aged MH - Myocardial Infarction/complications/mortality/*therapy MH - Peptide Fragments/therapeutic use MH - Platelet Aggregation Inhibitors/therapeutic use MH - Platelet Glycoprotein GPIIb-IIIa Complex/antagonists & inhibitors MH - Proportional Hazards Models MH - Prospective Studies MH - Prosthesis Design MH - Recombinant Proteins/therapeutic use MH - Recurrence MH - Risk Assessment MH - Risk Factors MH - *Stents MH - Stroke/etiology MH - Thrombosis/etiology MH - Time Factors MH - Treatment Outcome MH - United States EDAT- 2011/09/24 06:00 MHDA- 2012/01/21 06:00 CRDT- 2011/09/24 06:00 PHST- 2011/04/29 00:00 [received] PHST- 2011/06/08 00:00 [revised] PHST- 2011/06/23 00:00 [accepted] PHST- 2011/09/24 06:00 [entrez] PHST- 2011/09/24 06:00 [pubmed] PHST- 2012/01/21 06:00 [medline] AID - S1936-8798(11)00545-0 [pii] AID - 10.1016/j.jcin.2011.06.012 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2011 Sep;4(9):1011-9. doi: 10.1016/j.jcin.2011.06.012. PMID- 21918165 OWN - NLM STAT- MEDLINE DCOM- 20111207 LR - 20220330 IS - 1526-7598 (Electronic) IS - 0003-2999 (Linking) VI - 113 IP - 5 DP - 2011 Nov TI - Lack of effectiveness of the pulmonary artery catheter in cardiac surgery. PG - 994-1002 LID - 10.1213/ANE.0b013e31822c94a8 [doi] AB - BACKGROUND: The pulmonary artery catheter (PAC) continues to be used for monitoring of hemodynamics in patients undergoing coronary artery bypass graft (CABG) surgery despite concerns raised in other settings regarding both effectiveness and safety. Given the relative paucity of data regarding its use in CABG patients, and given entrenched practice patterns, we assessed the impact of PAC use on fatal and nonfatal CABG outcomes as practiced at a diverse set of medical centers. METHODS: Using a formal prospective observational study design, 5065 CABG patients from 70 centers were enrolled between November 1996 and June 2000 using a systemic sampling protocol. Propensity score matched-pair analysis was used to adjust for differences in likelihood of PAC insertion. The predefined composite endpoint was the occurrence of any of the following: death (any cause), cardiac dysfunction (myocardial infarction or congestive heart failure), cerebral dysfunction (stroke or encephalopathy), renal dysfunction (dysfunction or failure), or pulmonary dysfunction (acute respiratory distress syndrome). Secondary variables included treatment indices (inotrope use, fluid administration), duration of postoperative intubation, and intensive care unit length of stay. After categorization based on PAC and transesophageal echocardiography use (both, neither, PAC only, transesophageal echocardiography only), we performed the primary analysis contrasting PAC only and neither (total, 3321 patients), from which propensity paring yielded 1273 matched pairs. RESULTS: The primary endpoint occurred in 271 PAC patients versus 196 without PAC (21.3% vs.15.4%; adjusted odds ratio [AOR], 1.68; 95% confidence interval [CI], 1.24 to 2.26; P<0.001). The PAC group had an increased risk of all-cause mortality, 3.5% vs 1.7% (AOR, 2.08; 95% CI, 1.11 to 3.88; P=0.02) and an increased risk of cardiac (AOR, 1.58; 95% CI, 1.14 to 2.20; P=0.007), cerebral (AOR, 2.02; 95% CI, 1.08 to 3.77; P=0.03) and renal (AOR, 2.47; 95% CI, 1.68 to 3.62; P<0.001) morbid outcomes. PAC patients received inotropic drugs more frequently (57.8% vs 50.0%; P<0.001), had a larger positive IV fluid balance after surgery (3220 mL vs 3022 mL; P=0.003), and experienced longer time to tracheal extubation (15.40 hours [11.28/20.80] versus 13.18 hours [9.58/19.33], median plus Q1/Q3 interquartile range; P<0.0001). Use of PAC was also associated with prolonged intensive care unit stay (14.5% vs 10.1%; AOR, 1.55; 95% CI, 1.06 to 2.27; P=0.02). CONCLUSIONS: Use of a PAC during CABG surgery was associated with increased mortality and a higher risk of severe end-organ complications in this propensity-matched observational study. A randomized controlled trial with defined hemodynamic goals would be ideal to either confirm or refute our findings. FAU - Schwann, Nanette M AU - Schwann NM AD - Allentown Anesthesia Associates and the Leigh Valley Healthcare Network, Department of Anesthesiology, 1245 Cedar Crest Blvd., Suite 300, Allentown, PA 18103, USA. schwann@mac.com FAU - Hillel, Zak AU - Hillel Z FAU - Hoeft, Andreas AU - Hoeft A FAU - Barash, Paul AU - Barash P FAU - Mohnle, Patrick AU - Mohnle P FAU - Miao, Yinghui AU - Miao Y FAU - Mangano, Dennis T AU - Mangano DT LA - eng PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't DEP - 20110914 PL - United States TA - Anesth Analg JT - Anesthesia and analgesia JID - 1310650 SB - IM CIN - Anesth Analg. 2011 Nov;113(5):987-9. doi: 10.1213/ANE.0b013e31822dd4b0. PMID: 22021799 CIN - Anesth Analg. 2012 Jun;114(6):1368; author reply 1369. doi: 10.1213/ANE.0b013e318254d056. PMID: 22615446 CIN - Anesth Analg. 2012 Jun;114(6):1368-9; author reply 1369. doi: 10.1213/ANE.0b013e318254d073. PMID: 22615447 MH - Aged MH - Cardiac Surgical Procedures/*methods MH - *Catheterization, Swan-Ganz MH - Cohort Studies MH - Confidence Intervals MH - Coronary Artery Bypass/*methods/mortality MH - Coronary Artery Disease/mortality/surgery MH - Critical Care MH - Echocardiography, Transesophageal MH - Endpoint Determination MH - Female MH - Fluid Therapy MH - Hemodynamics/physiology MH - Humans MH - Length of Stay MH - Longitudinal Studies MH - Male MH - Middle Aged MH - Monitoring, Intraoperative MH - Myocardial Revascularization MH - Odds Ratio MH - Prospective Studies MH - Risk Factors MH - Socioeconomic Factors EDAT- 2011/09/16 06:00 MHDA- 2011/12/13 00:00 CRDT- 2011/09/16 06:00 PHST- 2011/09/16 06:00 [entrez] PHST- 2011/09/16 06:00 [pubmed] PHST- 2011/12/13 00:00 [medline] AID - ANE.0b013e31822c94a8 [pii] AID - 10.1213/ANE.0b013e31822c94a8 [doi] PST - ppublish SO - Anesth Analg. 2011 Nov;113(5):994-1002. doi: 10.1213/ANE.0b013e31822c94a8. Epub 2011 Sep 14. PMID- 21912915 OWN - NLM STAT- MEDLINE DCOM- 20120319 LR - 20211020 IS - 1861-0692 (Electronic) IS - 1861-0684 (Linking) VI - 100 IP - 12 DP - 2011 Dec TI - Impact of chronic kidney disease on the prognosis of patients undergoing percutaneous coronary interventions using drug-eluting stents. PG - 1103-9 LID - 10.1007/s00392-011-0347-7 [doi] AB - BACKGROUND: Chronic kidney disease (CKD) has an adverse impact on survival of patients with coronary artery disease and is associated with poor outcomes after percutaneous coronary intervention (PCI). Although small randomized, controlled clinical trials showed a reduced target vessel revascularization rate and a good safety profile for sirolimus-eluting coronary stents (SES), safety data need to be confirmed in clinical practice. Therefore, the data of the German DES.DE registry were evaluated to obtain acute and long-term data of this high-risk subgroup. METHODS: The prospective multicenter German DES.DE registry enables to monitor the therapeutic outcome of different drug-eluting stents in the context of the German Health Care System. Baseline clinical and angiographic characteristics as well as one-year-follow-up data were recorded. From October 2005 to October 2006, 6,384 patients were enrolled at 98 DES.DE sites and stratified according to kidney disease progression: normal and impaired renal function and patients under chronic hemodialysis. RESULTS: CKD was associated with several acute and chronic medical conditions and suffer from significantly more cardiac and cerebrovascular events after PCI as compared to patients without CKD. One-year-follow-up showed a significantly increased risk of restenosis and bleeding complications in patients with impaired renal function, especially in hemodialysis patients. CONCLUSIONS: Impaired renal function in patients undergoing DES stenting carries an independent risk factor for restenosis and bleeding. FAU - Kaya, Elif AU - Kaya E AD - Department of Cardiology and Angiology, University Hospital of Munster, Albert-Schweitzer Strasse 33, 48149, Munster, Germany. Elif.Kaya@ukmuenster.de FAU - Cuneo, Alessandro AU - Cuneo A FAU - Hochadel, Matthias AU - Hochadel M FAU - Junger, Claus AU - Junger C FAU - Stepper, Wibke AU - Stepper W FAU - Bramlage, Peter AU - Bramlage P FAU - Kuck, Karl-Heinz AU - Kuck KH FAU - Nienaber, Christoph A AU - Nienaber CA FAU - Senges, Jochen AU - Senges J FAU - Eckardt, Lars AU - Eckardt L FAU - Tebbe, Ulrich AU - Tebbe U FAU - Reinecke, Holger AU - Reinecke H LA - eng PT - Journal Article PT - Multicenter Study DEP - 20110909 PL - Germany TA - Clin Res Cardiol JT - Clinical research in cardiology : official journal of the German Cardiac Society JID - 101264123 SB - IM MH - Aged MH - Analysis of Variance MH - Angioplasty, Balloon, Coronary/adverse effects/*instrumentation/mortality MH - Chronic Disease MH - Coronary Artery Disease/complications/mortality/*therapy MH - Coronary Restenosis/etiology MH - *Drug-Eluting Stents MH - Female MH - Germany MH - Hemorrhage/etiology MH - Hospital Mortality MH - Humans MH - Kidney Diseases/*complications/mortality/therapy MH - Logistic Models MH - Male MH - Middle Aged MH - Odds Ratio MH - Prospective Studies MH - Prosthesis Design MH - Registries MH - Renal Dialysis MH - Risk Assessment MH - Risk Factors MH - Time Factors MH - Treatment Outcome EDAT- 2011/09/14 06:00 MHDA- 2012/03/20 06:00 CRDT- 2011/09/14 06:00 PHST- 2011/01/04 00:00 [received] PHST- 2011/07/13 00:00 [accepted] PHST- 2011/09/14 06:00 [entrez] PHST- 2011/09/14 06:00 [pubmed] PHST- 2012/03/20 06:00 [medline] AID - 10.1007/s00392-011-0347-7 [doi] PST - ppublish SO - Clin Res Cardiol. 2011 Dec;100(12):1103-9. doi: 10.1007/s00392-011-0347-7. Epub 2011 Sep 9. PMID- 21881323 OWN - NLM STAT- MEDLINE DCOM- 20120111 LR - 20190608 IS - 2186-1005 (Electronic) IS - 1341-1098 (Linking) VI - 17 IP - 4 DP - 2011 TI - Low-dose atrial natriuretic peptide for chronic kidney disease in coronary surgery. PG - 363-8 AB - PURPOSE: Chronic kidney disease (CKD) is an independent risk factor for cardiovascular disease. We investigated the effectiveness of human atrial natriuretic peptide (hANP) infusion in CKD patients undergoing coronary artery bypass grafting (CABG). PATIENTS AND METHODS: We analyzed 134 consecutive cases in which CABG had been performed in our hospital from 2002 to 2005. They were divided into four groups: Group A (n = 19) was CKD + placebo, Group B (n = 30) was non-CKD + placebo, Group C (n = 22) was CKD + hANP, and Group D (n = 63) was non-CKD + hANP). The serum creatinine (mg/dl) and estimated glomerular filtration rate (ml/min/1.73 m(2)) were measured as evaluation values. RESULTS: The value of sCr changed preoperatively and at 1 year postoperatively from 1.09 +/- 0.09, 51.3 +/- 4.4 to 1.26 +/- 0.42, 49.4 +/- 14.4 in Group A, from 0.77 +/- 0.14, 75.5 +/- 12.1 to 0.91 +/- 0.40, 72.3 +/- 19.5 in Group B, from 0.99 +/- 0.12, 54.8 +/- 3.0 to 0.93 +/- 0.16, 64.2 +/- 12.3 in Group C and from 0.77 +/- 0.13, 77.7 +/- 13.4 to 0.83 +/- 0.17, 75.9 +/- 16.2 in Group D, respectively. There was a significant difference between Group A and Group C regarding the change of creatinine (p =0.0022). CONCLUSION: Our study has confirmed that an infusion of hANP during CABG in patients with CKD not only improves perioperative renal function, but also prevents the progression of CKD. FAU - Yoshitake, Isamu AU - Yoshitake I AD - Department of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo, Japan. iyoshita@med.nihon-u.ac.jp FAU - Sezai, Akira AU - Sezai A FAU - Hata, Mitsumasa AU - Hata M FAU - Niino, Tetsuya AU - Niino T FAU - Unosawa, Satoshi AU - Unosawa S FAU - Wakui, Shinji AU - Wakui S FAU - Shiono, Motomi AU - Shiono M LA - eng PT - Journal Article PL - Japan TA - Ann Thorac Cardiovasc Surg JT - Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia JID - 9703158 RN - 0 (Biomarkers) RN - 85637-73-6 (Atrial Natriuretic Factor) RN - AYI8EX34EU (Creatinine) SB - IM MH - Aged MH - Analysis of Variance MH - Atrial Natriuretic Factor/*administration & dosage MH - Biomarkers/blood MH - Chi-Square Distribution MH - Chronic Disease MH - *Coronary Artery Bypass/adverse effects MH - Coronary Artery Disease/complications/*surgery MH - Creatinine/blood MH - Female MH - Glomerular Filtration Rate MH - Humans MH - Infusions, Parenteral MH - Japan MH - Kidney/*drug effects/metabolism/physiopathology MH - Kidney Diseases/blood/complications/*drug therapy/physiopathology MH - Male MH - Middle Aged MH - Randomized Controlled Trials as Topic MH - Retrospective Studies MH - Time Factors MH - Treatment Outcome EDAT- 2011/09/02 06:00 MHDA- 2012/01/12 06:00 CRDT- 2011/09/02 06:00 PHST- 2011/09/02 06:00 [entrez] PHST- 2011/09/02 06:00 [pubmed] PHST- 2012/01/12 06:00 [medline] AID - JST.JSTAGE/atcs/oa.10.01617 [pii] AID - 10.5761/atcs.oa.10.01617 [doi] PST - ppublish SO - Ann Thorac Cardiovasc Surg. 2011;17(4):363-8. doi: 10.5761/atcs.oa.10.01617. PMID- 21873621 OWN - NLM STAT- MEDLINE DCOM- 20120814 LR - 20120402 IS - 1460-2385 (Electronic) IS - 0931-0509 (Linking) VI - 27 IP - 4 DP - 2012 Apr TI - Beta-blockers and cardiovascular outcomes in dialysis patients: a cohort study in Ontario, Canada. PG - 1591-8 LID - 10.1093/ndt/gfr460 [doi] AB - BACKGROUND: Beta-blockers may be cardioprotective in patients receiving chronic dialysis. We examined cardiovascular outcomes among incident dialysis patients receiving beta-blocker therapy. METHODS: We conducted a retrospective cohort study employing linked healthcare databases in Ontario, Canada. We studied all consecutive chronic dialysis patients aged>/=66 years who initiated dialysis between 1 July 1991 and 31 July 2007. Patients were divided into three groups according to new medication use after the initiation of chronic dialysis. The three groups were patients initiated on beta-blockers, calcium channel blockers and statins only. Patients in the beta-blocker and calcium channel blocker groups could also be concurrently receiving a statin. The primary outcome was time to a composite endpoint of death, myocardial infarction, stroke or coronary revascularization. RESULTS: There were a total of 1836 patients (504 beta-blocker, 570 calcium channel blocker and 762 statin-only users). Compared to statin-only use, beta-blocker use was not associated with improved cardiovascular outcomes [adjusted hazard ratio (aHR) 1.07, 95% confidence interval (CI) 0.92-1.23]. As expected, calcium channel blocker use was also not associated with improved cardiovascular outcomes (aHR 0.91, 95% CI 0.79-1.06). Among all subgroup analyses by beta-blocker attributes, only high-dose beta-blocker therapy was associated with better cardiovascular outcomes as compared to low-dose beta-blockers (aHR 0.50, 95% CI 0.29-0.88). CONCLUSIONS: We observed no beneficial effect of beta-blocker use among patients receiving chronic dialysis relative to our comparator groups. Given current uncertainty around the cardioprotective benefits of beta-blockers in patients receiving dialysis, a large randomized clinical trial is warranted. FAU - Kitchlu, Abhijat AU - Kitchlu A AD - Department of Medicine, University of Western Ontario, London, Ontario, Canada. FAU - Clemens, Kristin AU - Clemens K FAU - Gomes, Tara AU - Gomes T FAU - Hackam, Daniel G AU - Hackam DG FAU - Juurlink, David N AU - Juurlink DN FAU - Mamdani, Muhammad AU - Mamdani M FAU - Manno, Michael AU - Manno M FAU - Oliver, Matthew J AU - Oliver MJ FAU - Quinn, Robert R AU - Quinn RR FAU - Suri, Rita S AU - Suri RS FAU - Wald, Ron AU - Wald R FAU - Yan, Andrew T AU - Yan AT FAU - Garg, Amit X AU - Garg AX LA - eng GR - Canadian Institutes of Health Research/Canada PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20110826 PL - England TA - Nephrol Dial Transplant JT - Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association JID - 8706402 RN - 0 (Adrenergic beta-Antagonists) RN - 0 (Calcium Channel Blockers) RN - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors) SB - IM MH - Adrenergic beta-Antagonists/*therapeutic use MH - Aged MH - Aged, 80 and over MH - Calcium Channel Blockers/*therapeutic use MH - Cardiovascular Diseases/etiology/*prevention & control MH - Female MH - Follow-Up Studies MH - Humans MH - Hydroxymethylglutaryl-CoA Reductase Inhibitors/*therapeutic use MH - Kidney Failure, Chronic/*complications MH - Male MH - Ontario MH - Prognosis MH - Renal Dialysis/*adverse effects MH - Retrospective Studies EDAT- 2011/08/30 06:00 MHDA- 2012/08/15 06:00 CRDT- 2011/08/30 06:00 PHST- 2011/08/30 06:00 [entrez] PHST- 2011/08/30 06:00 [pubmed] PHST- 2012/08/15 06:00 [medline] AID - gfr460 [pii] AID - 10.1093/ndt/gfr460 [doi] PST - ppublish SO - Nephrol Dial Transplant. 2012 Apr;27(4):1591-8. doi: 10.1093/ndt/gfr460. Epub 2011 Aug 26. PMID- 21791513 OWN - NLM STAT- MEDLINE DCOM- 20111031 LR - 20260128 IS - 1468-201X (Electronic) IS - 1355-6037 (Linking) VI - 97 IP - 19 DP - 2011 Oct TI - Non-cardiac surgery in patients with coronary stents: the RECO study. PG - 1566-72 LID - 10.1136/hrt.2011.224519 [doi] AB - CONTEXT: Interruption or maintenance of oral antiplatelet therapy (OAT) during an invasive procedure may result in ischaemic and/or haemorrhagic complications. There is currently a lack of clear guidance regarding the issue of treatment interruption during surgical procedures. OBJECTIVE: To evaluate the rate of major adverse cardiac and cerebrovascular events (MACCEs) and major or minor bleeding complications and their associated independent correlates in coronary stented patients undergoing urgent or planned non-cardiac surgery. DESIGN, SETTING, AND PATIENTS: Prospective, multicentre, observational cohort study of 1134 consecutive patients with coronary stents. MAIN OUTCOME MEASURES: The co-primary endpoints consisted of the incidence of MACCE and major bleeding within the first 30 days of an invasive procedure. RESULTS: MACCE and haemorrhagic complications were observed in 124 (10.9%) and 108 (9.5%) patients, respectively, within an average time delay from invasive procedure to event of 3.3+/-3.9 and 5.3+/-5.3 days. Independent preoperative correlates for MACCE were complete OAT interruption for more than 5 days prior to surgery, preoperative haemoglobin <10 g/dl, creatinine clearance of <30 ml/min and emergency or high-risk surgery. Independent factors for haemorrhagic complications were preoperative haemoglobin <10 g/dl, creatinine clearance between 30 and 60 ml/min, a delay from stent implantation to surgery <3 months and high-risk surgery according to the Lee classification. CONCLUSIONS: Patients with coronary stents undergoing an invasive procedure are at high risk of perioperative myocardial infarction including stent thrombosis irrespective of the stent type and major bleeding. Interruption of OAT more than 5 days prior to an invasive procedure is a key player for MACCE. CLINICAL TRIAL REGISTRATION: NCT01045850. FAU - Albaladejo, Pierre AU - Albaladejo P AD - Department of Anaesthesia and Intensive Care Medicine, Grenoble University Hospital, Grenoble, France. palbaladejo@chu-grenoble.fr FAU - Marret, Emmanuel AU - Marret E FAU - Samama, Charles-Marc AU - Samama CM FAU - Collet, Jean-Philippe AU - Collet JP FAU - Abhay, Kou AU - Abhay K FAU - Loutrel, Olivier AU - Loutrel O FAU - Charbonneau, Helene AU - Charbonneau H FAU - Jaber, Samir AU - Jaber S FAU - Thoret, Sophie AU - Thoret S FAU - Bosson, Jean-Luc AU - Bosson JL FAU - Piriou, Vincent AU - Piriou V LA - eng SI - ClinicalTrials.gov/NCT01045850 PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't DEP - 20110726 PL - England TA - Heart JT - Heart (British Cardiac Society) JID - 9602087 RN - 0 (Platelet Aggregation Inhibitors) RN - A74586SNO7 (Clopidogrel) RN - OM90ZUW7M1 (Ticlopidine) RN - R16CO5Y76E (Aspirin) SB - IM CIN - Nat Rev Cardiol. 2011 Aug 16;8(10):540. doi: 10.1038/nrcardio.2011.125. PMID: 21844916 CIN - Evid Based Med. 2012 Aug;17(4):122-3. doi: 10.1136/ebmed.2011.100381. PMID: 22293337 MH - Administration, Oral MH - Aged MH - Angioplasty, Balloon, Coronary/adverse effects/*instrumentation MH - Aspirin/*administration & dosage/adverse effects MH - Cardiovascular Diseases/*etiology/prevention & control MH - Cerebrovascular Disorders/etiology MH - Chi-Square Distribution MH - Clopidogrel MH - Drug Administration Schedule MH - Drug Therapy, Combination MH - Female MH - France MH - Humans MH - Logistic Models MH - Male MH - Middle Aged MH - Myocardial Infarction/etiology MH - Odds Ratio MH - Platelet Aggregation Inhibitors/*administration & dosage/adverse effects MH - Postoperative Hemorrhage/chemically induced MH - Prospective Studies MH - Risk Assessment MH - Risk Factors MH - *Stents MH - Surgical Procedures, Operative/*adverse effects MH - Thrombosis/etiology MH - Ticlopidine/administration & dosage/adverse effects/*analogs & derivatives MH - Time Factors MH - Treatment Outcome EDAT- 2011/07/28 06:00 MHDA- 2011/11/01 06:00 CRDT- 2011/07/28 06:00 PHST- 2011/07/28 06:00 [entrez] PHST- 2011/07/28 06:00 [pubmed] PHST- 2011/11/01 06:00 [medline] AID - hrt.2011.224519 [pii] AID - 10.1136/hrt.2011.224519 [doi] PST - ppublish SO - Heart. 2011 Oct;97(19):1566-72. doi: 10.1136/hrt.2011.224519. Epub 2011 Jul 26. PMID- 21693564 OWN - NLM STAT- MEDLINE DCOM- 20111128 LR - 20131121 IS - 1753-9455 (Electronic) IS - 1753-9447 (Linking) VI - 5 IP - 4 DP - 2011 Aug TI - A targeted metabolic protocol with D-ribose for off-pump coronary artery bypass procedures: a retrospective analysis. PG - 185-92 LID - 10.1177/1753944711412421 [doi] AB - OBJECTIVES: Coronary revascularization using cardiopulmonary bypass is an effective surgical procedure for ischemic coronary artery disease. Complications associated with cardiopulmonary bypass have included cerebral vascular accidents, neurocognitive disorders, renal dysfunction, and acute systemic inflammatory responses. Within the last two decades off-pump coronary artery bypass has emerged as an approach to reduce the incidence of these complications, as well as shorten hospital stays and recovery times. Many patients with coronary artery disease have insulin resistance and altered energy metabolism, which can exacerbate around the time of coronary revascularization. D-ribose has been shown to enhance the recovery of high-energy phosphates following myocardial ischemia. We hypothesized that patient outcomes could improve using a perioperative metabolic protocol with D-ribose. METHODS: A perioperative metabolic protocol was used in 366 patients undergoing off-pump coronary artery bypass during 2004-2008. D-ribose was added in 308 of these 366 patients. Data were collected prospectively as part of the Society of Thoracic Surgeons database and retrospectively analyzed. RESULTS: D-ribose patients were generally similar to those who did not receive D-ribose. There was one death, two patients suffered strokes and renal failure requiring dialysis occurred in two patients postoperatively among the entire group of patients. D-ribose patients enjoyed a greater improvement in cardiac index postrevascularization compared with non-D-ribose patients (37% vs. 17%, respectively, p < 0.001). CONCLUSIONS: This metabolic protocol was associated with very low mortality and morbidity with a significant early postoperative improvement in cardiac index using D-ribose supplementation. These preliminary results support a prospective randomized trial using this protocol and D-ribose. FAU - Perkowski, David J AU - Perkowski DJ AD - Saddleback Memorial Medical Center, Laguna Hills, CA, USA. FAU - Wagner, Susan AU - Wagner S FAU - Schneider, Joseph R AU - Schneider JR FAU - St Cyr, J A AU - St Cyr JA LA - eng PT - Journal Article DEP - 20110621 PL - England TA - Ther Adv Cardiovasc Dis JT - Therapeutic advances in cardiovascular disease JID - 101316343 RN - 681HV46001 (Ribose) SB - IM MH - Adult MH - Aged MH - Aged, 80 and over MH - Coronary Artery Bypass, Off-Pump/*methods MH - Databases, Factual MH - Female MH - Humans MH - Male MH - Middle Aged MH - *Myocardial Revascularization MH - Postoperative Complications/epidemiology MH - Retrospective Studies MH - Ribose/pharmacology/*therapeutic use MH - Treatment Outcome EDAT- 2011/06/23 06:00 MHDA- 2011/12/13 00:00 CRDT- 2011/06/23 06:00 PHST- 2011/06/23 06:00 [entrez] PHST- 2011/06/23 06:00 [pubmed] PHST- 2011/12/13 00:00 [medline] AID - 1753944711412421 [pii] AID - 10.1177/1753944711412421 [doi] PST - ppublish SO - Ther Adv Cardiovasc Dis. 2011 Aug;5(4):185-92. doi: 10.1177/1753944711412421. Epub 2011 Jun 21. PMID- 21691204 OWN - NLM STAT- MEDLINE DCOM- 20111209 LR - 20260128 IS - 1473-5830 (Electronic) IS - 0954-6928 (Linking) VI - 22 IP - 6 DP - 2011 TI - Impact of renal dysfunction on the prognostic value of the TIMI risk score in patients with non-ST elevation acute coronary syndrome. PG - 411-5 LID - 10.1097/MCA.0b013e3283487de2 [doi] AB - BACKGROUND: The thrombolysis-in-myocardial-infarction risk score (TRS) is a validated risk-assessment tool based on randomized clinical trials. Its applicability to an unselected group of patients seen in general clinical practice may be limited as renal dysfunction was an exclusion criteria in the original trials upon which the TRS was determined. MATERIALS AND METHODS: Consecutive patients with non-ST elevation acute coronary syndrome were stratified based on renal function. Normal renal function was defined as a creatinine clearance (CrCl) of more than 60 ml/min, moderate renal dysfunction was defined as a CrCl of at least 30 ml/min but 60 ml/min or less, and severe renal dysfunction was defined as a CrCl of less than 30 ml/min. A TRS was calculated using the original seven criteria (TRS-7) which did not consider renal function. A second TRS was calculated using the original seven criteria plus the addition of renal dysfunction if the CrCl was 60 ml/min or less (TRS-8 0.05). At a calculated TRS of 6 or 7, the TRS-8<30 was associated with a significantly greater prevalence of the composite outcome compared with the TRS-7 (P=0.02) and the TRS-8 /= 25% above the baseline level within 72 hr of the administration of intravenous contrast. RESULTS: There was no difference found for the primary end point with CIN in 16% of the NAC group and in 13% of the placebo group (p = 0.40). Change in serum cystatin-C, a sensitive marker for renal function, was 0.046 +/- 0.204 in the NAC group and 0.002 +/- 0.260 in the control group (p = 0.07). CONCLUSION: In ACS patients undergoing angiography +/- PCI, high-dose intravenous NAC failed to reduce the incidence of CIN. CI - Copyright (c) 2011 Wiley Periodicals, Inc. FAU - Jaffery, Zehra AU - Jaffery Z AD - Department of Cardiovascular Diseases, The John Ochsner Heart & Vascular Institute, Ochsner Clinic Foundation, New Orleans, Louisiana, USA. zjaffery@ochsner.org FAU - Verma, Anil AU - Verma A FAU - White, Christopher J AU - White CJ FAU - Grant, Arthur G AU - Grant AG FAU - Collins, Tyrone J AU - Collins TJ FAU - Grise, Mark A AU - Grise MA FAU - Jenkins, James S AU - Jenkins JS FAU - McMullan, Paul W AU - McMullan PW FAU - Patel, Rajan A AU - Patel RA FAU - Reilly, John P AU - Reilly JP FAU - Thornton, Stanley N AU - Thornton SN FAU - Ramee, Stephen R AU - Ramee SR LA - eng SI - ClinicalTrials.gov/NCT00939913 PT - Journal Article PT - Randomized Controlled Trial DEP - 20111130 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 RN - 0 (Antioxidants) RN - 0 (Biomarkers) RN - 0 (CST3 protein, human) RN - 0 (Contrast Media) RN - 0 (Cystatin C) RN - 0 (Placebos) RN - AYI8EX34EU (Creatinine) RN - WYQ7N0BPYC (Acetylcysteine) SB - IM CIN - Catheter Cardiovasc Interv. 2012 May 1;79(6):927-8. doi: 10.1002/ccd.24424. PMID: 22511379 MH - Acetylcysteine/*administration & dosage MH - Acute Coronary Syndrome/*diagnostic imaging/therapy MH - Aged MH - *Angioplasty, Balloon, Coronary MH - Antioxidants/*administration & dosage MH - Biomarkers/blood MH - Chi-Square Distribution MH - Contrast Media/*adverse effects MH - Coronary Angiography/*adverse effects MH - Creatinine/blood MH - Cystatin C/blood MH - Double-Blind Method MH - Female MH - Humans MH - Infusions, Intravenous MH - Kidney Diseases/blood/chemically induced/diagnosis/*prevention & control MH - Male MH - Middle Aged MH - New Orleans MH - Placebos MH - Prospective Studies MH - Risk Assessment MH - Risk Factors MH - Time Factors MH - Treatment Outcome EDAT- 2011/05/05 06:00 MHDA- 2012/08/14 06:00 CRDT- 2011/05/05 06:00 PHST- 2011/03/17 00:00 [received] PHST- 2011/03/19 00:00 [accepted] PHST- 2011/05/05 06:00 [entrez] PHST- 2011/05/05 06:00 [pubmed] PHST- 2012/08/14 06:00 [medline] AID - 10.1002/ccd.23157 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2012 May 1;79(6):921-6. doi: 10.1002/ccd.23157. Epub 2011 Nov 30. PMID- 21529740 OWN - NLM STAT- MEDLINE DCOM- 20110823 LR - 20220408 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 108 IP - 1 DP - 2011 Jul 1 TI - Short-term, high-dose Atorvastatin pretreatment to prevent contrast-induced nephropathy in patients with acute coronary syndromes undergoing percutaneous coronary intervention (from the ARMYDA-CIN [atorvastatin for reduction of myocardial damage during angioplasty--contrast-induced nephropathy] trial. PG - 1-7 LID - 10.1016/j.amjcard.2011.03.001 [doi] AB - Contrast-induced nephropathy (CIN) impairs clinical outcome in patients undergoing angiographic procedures. The aim of this study was to investigate whether short-term high-dose atorvastatin load decreases the incidence of CIN after percutaneous coronary intervention (PCI). Statin-naive patients with acute coronary syndrome undergoing PCI (n = 241) randomly received atorvastatin (80 mg 12 hours before intervention with another 40-mg preprocedure dose, n = 120) or placebo (n = 121). All patients had long-term atorvastatin treatment thereafter (40 mg/day). Primary end point was incidence of CIN defined as postintervention increase in serum creatinine >/=0.5 mg/dl or >25% from baseline. Five percent of patients in the atorvastatin arm developed CIN versus 13.2% of those in the placebo arm (p = 0.046). In the atorvastatin group, postprocedure serum creatinine was significantly lower (1.06 +/- 0.35 vs 1.12 +/- 0.27 mg/dl in placebo, p = 0.01), creatinine clearance was decreased (80.1 +/- 32.2 vs 72.0 +/- 26.6 ml/min, p = 0.034), and C-reactive protein peak levels after intervention were decreased (8.4 +/- 10.5 vs 13.1 +/- 20.8 mg/l, p = 0.01). Multivariable analysis showed that atorvastatin pretreatment was independently associated with a decreased risk of CIN (odds ratios 0.34, 95% confidence interval 0.12 to 0.97, p = 0.043). Prevention of CIN with atorvastatin was paralleled by a shorter hospital stay (p = 0.007). In conclusion, short-term pretreatment with high-dose atorvastatin load prevents CIN and shortens hospital stay in patients with acute coronary syndrome undergoing PCI; anti-inflammatory effects may be involved in this renal protection. These results lend further support to early use of high-dose statins as adjuvant pharmacologic therapy before percutaneous coronary revascularization. CI - Copyright (c) 2011 Elsevier Inc. All rights reserved. FAU - Patti, Giuseppe AU - Patti G AD - Department of Cardiovascular Sciences, Campus Bio-Medico University, Rome, Italy. FAU - Ricottini, Elisabetta AU - Ricottini E FAU - Nusca, Annunziata AU - Nusca A FAU - Colonna, Giuseppe AU - Colonna G FAU - Pasceri, Vincenzo AU - Pasceri V FAU - D'Ambrosio, Andrea AU - D'Ambrosio A FAU - Montinaro, Antonio AU - Montinaro A FAU - Di Sciascio, Germano AU - Di Sciascio G LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20110427 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 RN - 0 (Contrast Media) RN - 0 (Heptanoic Acids) RN - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors) RN - 0 (Pyrroles) RN - A0JWA85V8F (Atorvastatin) RN - AYI8EX34EU (Creatinine) SB - IM MH - Acute Coronary Syndrome/*diagnostic imaging/physiopathology/therapy MH - Aged MH - *Angioplasty, Balloon, Coronary MH - Atorvastatin MH - Contrast Media/*adverse effects MH - Coronary Angiography/*adverse effects MH - Creatinine/blood MH - Dose-Response Relationship, Drug MH - Double-Blind Method MH - Electrocardiography MH - Female MH - Follow-Up Studies MH - Heptanoic Acids/*administration & dosage MH - Humans MH - Hydroxymethylglutaryl-CoA Reductase Inhibitors/*administration & dosage MH - Kidney Diseases/chemically induced/physiopathology/*prevention & control MH - Kidney Function Tests MH - Male MH - Prospective Studies MH - Pyrroles/*administration & dosage MH - Time Factors MH - Treatment Outcome EDAT- 2011/05/03 06:00 MHDA- 2011/08/24 06:00 CRDT- 2011/05/03 06:00 PHST- 2011/01/14 00:00 [received] PHST- 2011/03/03 00:00 [revised] PHST- 2011/03/03 00:00 [accepted] PHST- 2011/05/03 06:00 [entrez] PHST- 2011/05/03 06:00 [pubmed] PHST- 2011/08/24 06:00 [medline] AID - S0002-9149(11)01134-9 [pii] AID - 10.1016/j.amjcard.2011.03.001 [doi] PST - ppublish SO - Am J Cardiol. 2011 Jul 1;108(1):1-7. doi: 10.1016/j.amjcard.2011.03.001. Epub 2011 Apr 27. PMID- 21482964 OWN - NLM STAT- MEDLINE DCOM- 20110630 LR - 20220317 IS - 1524-4539 (Electronic) IS - 0009-7322 (Print) IS - 0009-7322 (Linking) VI - 123 IP - 16 DP - 2011 Apr 26 TI - Homocysteine-lowering and cardiovascular disease outcomes in kidney transplant recipients: primary results from the Folic Acid for Vascular Outcome Reduction in Transplantation trial. PG - 1763-70 LID - 10.1161/CIRCULATIONAHA.110.000588 [doi] AB - BACKGROUND: Kidney transplant recipients, like other patients with chronic kidney disease, experience excess risk of cardiovascular disease and elevated total homocysteine concentrations. Observational studies of patients with chronic kidney disease suggest increased homocysteine is a risk factor for cardiovascular disease. The impact of lowering total homocysteine levels in kidney transplant recipients is unknown. METHODS AND RESULTS: In a double-blind controlled trial, we randomized 4110 stable kidney transplant recipients to a multivitamin that included either a high dose (n=2056) or low dose (n=2054) of folic acid, vitamin B6, and vitamin B12 to determine whether decreasing total homocysteine concentrations reduced the rate of the primary composite arteriosclerotic cardiovascular disease outcome (myocardial infarction, stroke, cardiovascular disease death, resuscitated sudden death, coronary artery or renal artery revascularization, lower-extremity arterial disease, carotid endarterectomy or angioplasty, or abdominal aortic aneurysm repair). Mean follow-up was 4.0 years. Treatment with the high-dose multivitamin reduced homocysteine but did not reduce the rates of the primary outcome (n=547 total events; hazards ratio [95 confidence interval]=0.99 [0.84 to 1.17]), secondary outcomes of all-cause mortality (n=431 deaths; 1.04 [0.86 to 1.26]), or dialysis-dependent kidney failure (n=343 events; 1.15 [0.93 to 1.43]) compared to the low-dose multivitamin. CONCLUSIONS: Treatment with a high-dose folic acid, B6, and B12 multivitamin in kidney transplant recipients did not reduce a composite cardiovascular disease outcome, all-cause mortality, or dialysis-dependent kidney failure despite significant reduction in homocysteine level. FAU - Bostom, Andrew G AU - Bostom AG AD - Rhode Island Hospital, 110 Lockwood Street, Providence, RI 02903, USA. abostom@lifespan.org FAU - Carpenter, Myra A AU - Carpenter MA FAU - Kusek, John W AU - Kusek JW FAU - Levey, Andrew S AU - Levey AS FAU - Hunsicker, Lawrence AU - Hunsicker L FAU - Pfeffer, Marc A AU - Pfeffer MA FAU - Selhub, Jacob AU - Selhub J FAU - Jacques, Paul F AU - Jacques PF FAU - Cole, Edward AU - Cole E FAU - Gravens-Mueller, Lisa AU - Gravens-Mueller L FAU - House, Andrew A AU - House AA FAU - Kew, Clifton AU - Kew C FAU - McKenney, Joyce L AU - McKenney JL FAU - Pacheco-Silva, Alvaro AU - Pacheco-Silva A FAU - Pesavento, Todd AU - Pesavento T FAU - Pirsch, John AU - Pirsch J FAU - Smith, Stephen AU - Smith S FAU - Solomon, Scott AU - Solomon S FAU - Weir, Matthew AU - Weir M LA - eng SI - ClinicalTrials.gov/NCT00064753 GR - U01 DK061700/DK/NIDDK NIH HHS/United States GR - U01 DK61700/DK/NIDDK NIH HHS/United States PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, N.I.H., Extramural DEP - 20110411 PL - United States TA - Circulation JT - Circulation JID - 0147763 RN - 12001-76-2 (Vitamin B Complex) RN - 935E97BOY8 (Folic Acid) SB - IM CIN - Nat Rev Nephrol. 2011 Jun;7(6):304. doi: 10.1038/nrneph.2011.45. PMID: 21625204 CIN - Am J Kidney Dis. 2012 Jun;59(6):754-7. doi: 10.1053/j.ajkd.2011.11.022. PMID: 22177656 MH - Adult MH - Aged MH - Arteriosclerosis/mortality/prevention & control MH - Cardiovascular Diseases/mortality/*prevention & control MH - Death, Sudden, Cardiac/epidemiology/prevention & control MH - Female MH - Folic Acid/*administration & dosage MH - Follow-Up Studies MH - Humans MH - Hyperhomocysteinemia/*drug therapy/mortality MH - Kaplan-Meier Estimate MH - Kidney Failure, Chronic/mortality/surgery MH - *Kidney Transplantation MH - Male MH - Middle Aged MH - Myocardial Infarction/mortality/prevention & control MH - Risk Factors MH - Risk Reduction Behavior MH - Stroke/mortality/prevention & control MH - Vitamin B Complex/*administration & dosage PMC - PMC4887854 MID - NIHMS287662 EDAT- 2011/04/13 06:00 MHDA- 2011/07/01 06:00 PMCR- 2016/06/01 CRDT- 2011/04/13 06:00 PHST- 2011/04/13 06:00 [entrez] PHST- 2011/04/13 06:00 [pubmed] PHST- 2011/07/01 06:00 [medline] PHST- 2016/06/01 00:00 [pmc-release] AID - CIRCULATIONAHA.110.000588 [pii] AID - 10.1161/CIRCULATIONAHA.110.000588 [doi] PST - ppublish SO - Circulation. 2011 Apr 26;123(16):1763-70. doi: 10.1161/CIRCULATIONAHA.110.000588. Epub 2011 Apr 11. PMID- 21478119 OWN - NLM STAT- MEDLINE DCOM- 20110922 LR - 20180815 IS - 2241-5955 (Electronic) IS - 1109-9666 (Linking) VI - 52 IP - 2 DP - 2011 Mar-Apr TI - The impact of new generation drug-eluting stent implantation on patients with chronic kidney disease and a single lesion in the proximal segment of the left anterior descending artery. PG - 103-10 AB - INTRODUCTION: The impact of drug-eluting stents (DES) has not been extensively investigated in patients with moderate to severe renal dysfunction, as these patients are consistently excluded from randomised studies. We sought to assess prospectively the effectiveness and safety of the new-generation DES in patients with moderate chronic kidney disease (CKD) and an isolated de novo lesion in the proximal segment of the left anterior descending artery (pLAD). METHODS: We evaluated 400 consecutive patients with a pLAD lesion. There were 96 patients with moderate CKD (estimated glomerular filtration rate 59 ml/min/1.73 m2) and 304 without CKD. Major adverse cardiac events (MACE) were defined as death, non-fatal myocardial infarction and target lesion revascularisation (TLR). Clinical or telephone follow up was performed. RESULTS: There was a significantly higher incidence of mortality in patients with CKD (n=4) as compared with non-CKD (n=2) (4.16% versus 0.65%, respectively, p=0.03). The rate of non-fatal myocardial infarction was similar in the 2 cohorts (p=0.59), as was the TLR rate (p=0.99). Overall, there were no significant differences regarding MACE between the 2 groups of patients (p=0.19) during the 13.62 +/- 6.22 month follow-up period. The rate of angiographic stent thrombosis was 2.08% in the CKD group versus 0.98% in the non-CKD group (p=0.59). CONCLUSIONS: New generation DES implantation in patients with CKD and a pLAD lesion is effective and safe, with rates of TLR and stent thrombosis comparable to those in patients with normal renal function. However, the higher mortality in patients with CKD needs further evaluation. FAU - Toutouzas, Konstantinos AU - Toutouzas K AD - First Department of Cardiology, Athens Medical School, Hippokration Hospital, Athens, Greece. ktoutouz@otenet.gr FAU - Patsa, Chrysoula AU - Patsa C FAU - Synetos, Andreas AU - Synetos A FAU - Karanasos, Antonis AU - Karanasos A FAU - Karampelas, John AU - Karampelas J FAU - Tsiamis, Eleftherios AU - Tsiamis E FAU - Spanos, Anastasios AU - Spanos A FAU - Stefanadi, Elli AU - Stefanadi E FAU - Tousoulis, Dimitris AU - Tousoulis D FAU - Stefanadis, Christodoulos AU - Stefanadis C LA - eng PT - Journal Article PL - Netherlands TA - Hellenic J Cardiol JT - Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese JID - 101257381 RN - 0 (Immunosuppressive Agents) RN - 9HW64Q8G6G (Everolimus) RN - H4GXR80IZE (zotarolimus) RN - W36ZG6FT64 (Sirolimus) SB - IM MH - Adult MH - Aged MH - *Angioplasty, Balloon, Coronary MH - Cohort Studies MH - Coronary Stenosis/*complications/*therapy MH - *Drug-Eluting Stents MH - Everolimus MH - Female MH - Humans MH - Immunosuppressive Agents/administration & dosage MH - Male MH - Middle Aged MH - Renal Insufficiency, Chronic/*complications MH - Sirolimus/administration & dosage/analogs & derivatives MH - Treatment Outcome EDAT- 2011/04/12 06:00 MHDA- 2011/09/23 06:00 CRDT- 2011/04/12 06:00 PHST- 2011/04/12 06:00 [entrez] PHST- 2011/04/12 06:00 [pubmed] PHST- 2011/09/23 06:00 [medline] PST - ppublish SO - Hellenic J Cardiol. 2011 Mar-Apr;52(2):103-10. PMID- 21420063 OWN - NLM STAT- MEDLINE DCOM- 20110630 LR - 20151119 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 107 IP - 10 DP - 2011 May 15 TI - Preventive strategies of renal insufficiency in patients with diabetes undergoing intervention or arteriography (the PREVENT Trial). PG - 1447-52 LID - 10.1016/j.amjcard.2011.01.019 [doi] AB - Few studies have compared the ability of sodium bicarbonate plus N-acetylcysteine (NAC) and sodium chloride plus NAC to prevent contrast-induced nephropathy (CIN) in diabetic patients with impaired renal function undergoing coronary or endovascular angiography or intervention. Diabetic patients (n = 382) with renal disease (serum creatinine >/=1.1 mg/dl and estimated glomerular filtration rate <60 ml/min/1.73 m(2)) were randomly assigned to receive prophylactic sodium chloride (saline group, n = 189) or sodium bicarbonate (bicarbonate group, n = 193) before elective coronary or endovascular angiography or intervention. All patients received oral NAC 1,200 mg 2 times/day for 2 days. The primary end point was CIN, defined as an increase in serum creatinine >25% or an absolute increase in serum creatinine >/=0.5 mg/dl within 48 hours after contrast exposure. There were no significant between-group differences in baseline characteristics. The primary end point was met in 10 patients (5.3%) in the saline group and 17 (9.0%) in the bicarbonate group (p = 0.17), with 2 (1.1%) and 4 (2.1%), respectively, requiring hemodialysis (p = 0.69). Rates of death, myocardial infarction, and stroke did not differ significantly at 1 month and 6 months after contrast exposure. In conclusion, hydration with sodium bicarbonate is not superior to hydration with sodium chloride in preventing CIN in patients with diabetic nephropathy undergoing coronary or endovascular angiography or intervention. CI - Copyright (c) 2011 Elsevier Inc. All rights reserved. FAU - Lee, Seung-Whan AU - Lee SW AD - Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. FAU - Kim, Won-Jang AU - Kim WJ FAU - Kim, Young-Hak AU - Kim YH FAU - Park, Seong-Wook AU - Park SW FAU - Park, Duk-Woo AU - Park DW FAU - Yun, Sung-Cheol AU - Yun SC FAU - Lee, Jong-Young AU - Lee JY FAU - Kang, Soo-Jin AU - Kang SJ FAU - Lee, Cheol Whan AU - Lee CW FAU - Lee, Jae-Hwan AU - Lee JH FAU - Choi, Si Wan AU - Choi SW FAU - Seong, In-Whan AU - Seong IW FAU - Suh, Jon AU - Suh J FAU - Cho, Yoon Haeng AU - Cho YH FAU - Lee, Nae-Hee AU - Lee NH FAU - Cheong, Sang-Sig AU - Cheong SS FAU - Yoo, Sang-Yong AU - Yoo SY FAU - Lee, Bong-Ki AU - Lee BK FAU - Lee, Sang-Gon AU - Lee SG FAU - Hyon, Min-Su AU - Hyon MS FAU - Shin, Won-Yong AU - Shin WY FAU - Lee, Se-Whan AU - Lee SW FAU - Jang, Jae-Sik AU - Jang JS FAU - Park, Seung-Jung AU - Park SJ LA - eng PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20110317 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 RN - 0 (Contrast Media) RN - 451W47IQ8X (Sodium Chloride) RN - 8MDF5V39QO (Sodium Bicarbonate) RN - AYI8EX34EU (Creatinine) RN - WYQ7N0BPYC (Acetylcysteine) SB - IM MH - Acetylcysteine/*administration & dosage MH - Administration, Oral MH - Aged MH - Angioplasty, Balloon, Coronary/*adverse effects MH - Contrast Media/*adverse effects MH - Coronary Angiography/*adverse effects MH - Creatinine/blood MH - Diabetic Nephropathies/*complications MH - Female MH - Humans MH - Male MH - Middle Aged MH - Renal Insufficiency/chemically induced/*prevention & control MH - Sodium Bicarbonate/*administration & dosage MH - Sodium Chloride/*administration & dosage EDAT- 2011/03/23 06:00 MHDA- 2011/07/01 06:00 CRDT- 2011/03/23 06:00 PHST- 2010/12/13 00:00 [received] PHST- 2011/01/18 00:00 [revised] PHST- 2011/01/18 00:00 [accepted] PHST- 2011/03/23 06:00 [entrez] PHST- 2011/03/23 06:00 [pubmed] PHST- 2011/07/01 06:00 [medline] AID - S0002-9149(11)00331-6 [pii] AID - 10.1016/j.amjcard.2011.01.019 [doi] PST - ppublish SO - Am J Cardiol. 2011 May 15;107(10):1447-52. doi: 10.1016/j.amjcard.2011.01.019. Epub 2011 Mar 17. PMID- 21411203 OWN - NLM STAT- MEDLINE DCOM- 20110721 LR - 20260518 IS - 1523-6838 (Electronic) IS - 0272-6386 (Print) IS - 0272-6386 (Linking) VI - 57 IP - 6 DP - 2011 Jun TI - Design considerations and feasibility for a clinical trial to examine coronary screening before kidney transplantation (COST). PG - 908-16 LID - 10.1053/j.ajkd.2011.01.020 [doi] AB - BACKGROUND: It is unclear whether benefits outweigh harms for routine screening and prophylactic revascularization to prevent coronary artery disease (CAD) in asymptomatic kidney transplant candidates. STUDY DESIGN: Pilot feasibility study with prospective observational data collection and patient interviews. SETTING & PARTICIPANTS: Consecutive patients referred for kidney and/or pancreas transplant at 26 major transplant centers in the United States. PREDICTORS: Older age, diabetes, prior cardiovascular disease, and multiple traditional CAD risk factors. OUTCOMES: Eligibility and willingness to participate in a randomized controlled trial (RCT) to study the effect of CAD screening on major adverse cardiac events. MEASUREMENTS: Patients who would be candidates for a hypothetical RCT of CAD screening were interviewed and asked if they would participate in such a trial. Sample size for the trial was estimated using data for Medicare patients in the US Renal Data System with major adverse cardiac events as the primary end point. RESULTS: Of consecutive eligible patients, CAD evaluation was not indicated in 398 (24%), already completed before referral in 602 (36%), and pending (and hence eligible for an RCT) in 665 (40%). Of 241 interviewed, 73% indicated they would be willing to participate in an RCT. We estimated that ~4,000 would need to be enrolled to detect a 20% decrease in major adverse cardiac events at >80% power at P < 0.05. LIMITATIONS: Willingness to participate in an actual clinical trial may be different from indicated in an interview. CONCLUSION: An RCT to compare the effects of routine screening for CAD versus no screening on major adverse cardiac events is feasible. CI - Copyright (c) 2011 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved. FAU - Kasiske, Bertram L AU - Kasiske BL AD - Department of Medicine, Hennepin County Medical Center, 701 Park Avenue, Minneapolis, MN 55415, USA. kasis001@umn.edu FAU - Israni, Ajay K AU - Israni AK FAU - Snyder, Jon J AU - Snyder JJ FAU - Camarena, Alexa AU - Camarena A CN - COST Investigators LA - eng GR - R21 DK080315/DK/NIDDK NIH HHS/United States GR - 1R21DK080315-01/DK/NIDDK NIH HHS/United States PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, N.I.H., Extramural DEP - 20110315 PL - United States TA - Am J Kidney Dis JT - American journal of kidney diseases : the official journal of the National Kidney Foundation JID - 8110075 SB - IM MH - Adult MH - Coronary Angiography/*methods MH - Coronary Disease/complications/*diagnosis/epidemiology MH - Feasibility Studies MH - Female MH - Humans MH - Incidence MH - Kidney Failure, Chronic/complications/*surgery MH - *Kidney Transplantation MH - Male MH - Middle Aged MH - Patient Compliance MH - Pilot Projects MH - Preoperative Period MH - Risk Factors MH - United States/epidemiology PMC - PMC3587732 MID - NIHMS272611 FIR - Alachkar, Nada IR - Alachkar N FIR - Bloom, Roy D IR - Bloom RD FIR - Brennan, Daniel C IR - Brennan DC FIR - Bromberg, Jonathan S IR - Bromberg JS FIR - Chakkera, Harini A IR - Chakkera HA FIR - Chan, Laurence K F IR - Chan LK FIR - Cohen, David J IR - Cohen DJ FIR - Gallon, Lorenzo G IR - Gallon LG FIR - Goggins, William C IR - Goggins WC FIR - Helderman, J Harold IR - Helderman JH FIR - Hricik, Donald E IR - Hricik DE FIR - Israni, Ajay A K IR - Israni AA FIR - Katznelson, Steven IR - Katznelson S FIR - Leichtman, Alan B IR - Leichtman AB FIR - Light, Jimmy A IR - Light JA FIR - Manske, Connie C L IR - Manske CC FIR - McCune, Thomas R IR - McCune TR FIR - Nogueira, Joseph M IR - Nogueira JM FIR - Pesavento, Todd E IR - Pesavento TE FIR - Prendergast, Mary IR - Prendergast M FIR - Serur, David IR - Serur D FIR - Tomlanovich, Steve L IR - Tomlanovich SL FIR - Villicana, Rafael IR - Villicana R FIR - Weng, Francis L IR - Weng FL FIR - West-Thielke, Patricia IR - West-Thielke P FIR - Zayas, Carlos F IR - Zayas CF EDAT- 2011/03/18 06:00 MHDA- 2011/07/22 06:00 PMCR- 2013/03/05 CRDT- 2011/03/18 06:00 PHST- 2010/09/04 00:00 [received] PHST- 2011/01/12 00:00 [accepted] PHST- 2011/03/18 06:00 [entrez] PHST- 2011/03/18 06:00 [pubmed] PHST- 2011/07/22 06:00 [medline] PHST- 2013/03/05 00:00 [pmc-release] AID - S0272-6386(11)00132-6 [pii] AID - 10.1053/j.ajkd.2011.01.020 [doi] PST - ppublish SO - Am J Kidney Dis. 2011 Jun;57(6):908-16. doi: 10.1053/j.ajkd.2011.01.020. Epub 2011 Mar 15. PMID- 21400543 OWN - NLM STAT- MEDLINE DCOM- 20110714 LR - 20220317 IS - 1932-8737 (Electronic) IS - 0160-9289 (Print) IS - 0160-9289 (Linking) VI - 34 IP - 3 DP - 2011 Mar TI - Multivessel vs single-vessel revascularization in patients with non-ST-segment elevation acute coronary syndrome and multivessel disease in the drug-eluting stent era. PG - 160-5 LID - 10.1002/clc.20858 [doi] AB - BACKGROUND: We sought to compare long-term outcomes for multivessel revascularization (MVR) vs single-vessel revascularization (SVR) with drug-eluting stents (DES) in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) and multivessel coronary artery disease (MVD). HYPOTHESIS: In DES era, MVR would improve long-term clinical outcomes in patients with NSTE-ACS. METHODS: We studied 179 patients undergoing MVR and 187 patients undergoing SVR for NSTE-ACS and MVD. Major adverse cardiac events (MACE) were defined as death, myocardial infarction, or any revascularization. RESULTS: During follow-up (median 36 months), MACE occurred in 96 patients (26.2%); 35 (19.6%) in the MVR group and 61 (32.6%) in the SVR group (P=0.003). In multivariate analysis, MVR was associated with a lower incidence of MACE (hazard ratio [HR]: 0.50, 95% confidence interval [CI]: 0.30-0.85) and revascularization (HR: 0.43, 95% CI: 0.24-0.78), but not of death (HR: 0.69, 95% CI: 0.25-1.93) and myocardial infarction (HR: 0.39, 95% CI: 0.11-1.47). The incidence of periprocedural renal dysfunction was not significantly different between patients undergoing MVR vs SVR (3.4% vs 1.6%, P=0.33). Definite or probable stent thrombosis occurred at a similar rate (2.2% in the MVR group and 2.7% in the SVR group, P=0.99). CONCLUSIONS: In patients with NSTE-ACS and MVD, MVR using drug-eluting stents may reduce MACE. Our findings should be confirmed by a prospective, randomized trial. CI - (c) 2011 Wiley Periodicals, Inc. FAU - Lee, Hyun Jong AU - Lee HJ AD - Division of Cardiology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. FAU - Song, Young Bin AU - Song YB FAU - Hahn, Joo-Yong AU - Hahn JY FAU - Kim, Sang Min AU - Kim SM FAU - Yang, Ji Hyun AU - Yang JH FAU - Choi, Joon Hyouk AU - Choi JH FAU - Choi, Seung-Hyuk AU - Choi SH FAU - Choi, Jin-Ho AU - Choi JH FAU - Lee, Sang Hoon AU - Lee SH FAU - Gwon, Hyeon-Cheol AU - Gwon HC LA - eng PT - Comparative Study PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - United States TA - Clin Cardiol JT - Clinical cardiology JID - 7903272 SB - IM CIN - Clin Cardiol. 2011 Mar;34(3):141-2. doi: 10.1002/clc.20899. PMID: 21400539 MH - Acute Coronary Syndrome/*surgery MH - Aged MH - Coronary Artery Disease/*surgery MH - *Drug-Eluting Stents MH - Female MH - Follow-Up Studies MH - Humans MH - Male MH - Middle Aged MH - Myocardial Revascularization/*methods MH - Prospective Studies MH - Time Factors MH - Treatment Outcome PMC - PMC6652744 EDAT- 2011/03/15 06:00 MHDA- 2011/07/16 06:00 PMCR- 2011/03/13 CRDT- 2011/03/15 06:00 PHST- 2011/03/15 06:00 [entrez] PHST- 2011/03/15 06:00 [pubmed] PHST- 2011/07/16 06:00 [medline] PHST- 2011/03/13 00:00 [pmc-release] AID - CLC20858 [pii] AID - 10.1002/clc.20858 [doi] PST - ppublish SO - Clin Cardiol. 2011 Mar;34(3):160-5. doi: 10.1002/clc.20858. PMID- 21349483 OWN - NLM STAT- MEDLINE DCOM- 20110607 LR - 20161125 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 107 IP - 8 DP - 2011 Apr 15 TI - Prevention of contrast-induced nephropathy by bolus injection of sodium bicarbonate in patients with chronic kidney disease undergoing emergent coronary procedures. PG - 1163-7 LID - 10.1016/j.amjcard.2010.12.012 [doi] AB - We conducted a prospective study to determine whether a bolus injection of sodium bicarbonate before emergent coronary procedures in patients with chronic kidney disease (CKD) might prevent contrast-induced nephropathy (CIN). We enrolled 59 patients with CKD, defined by a serum creatinine concentration of >1.1 mg/dl or an estimated glomerular filtration rate of <60 ml/min, who were scheduled at admission to undergo an emergent coronary procedure. The patients were randomized to receive a bolus intravenous injection of 154 mEq/L of sodium bicarbonate (n = 30) or sodium chloride (n = 29) at the dose of 0.5 ml/kg, before contrast administration, followed by infusion of 154 mEq/L sodium bicarbonate at 1 ml/kg/hour for 6 hours in both groups. The primary end point was the occurrence of CIN, defined as an increase by > 25% or > 0.5 mg/dl of the serum creatinine level within 2 days after the procedure. In the sodium bicarbonate group, the serum creatinine concentration remained unchanged within 2 days of contrast administration (from 1.32 +/- 0.46 to 1.38 +/- 0.60 mg/dl, p = 0.33). In contrast, it had increased in the sodium chloride group (1.51 +/- 0.59 to 1.91 +/- 1.19 mg/dl, p = 0.006). The incidence of CIN was significantly lower in the sodium bicarbonate group than in the sodium chloride group (3.3% vs 27.6%, p = 0.01). In conclusion, rapid alkalization by bolus injection of sodium bicarbonate was effective for the prevention of CIN in patients with CKD undergoing emergent procedures. CI - Copyright (c) 2011 Elsevier Inc. All rights reserved. FAU - Ueda, Hiromichi AU - Ueda H AD - Division of Cardiology, Osaka General Medical Center, Osaka, Japan. u_hiromichi@yahoo.co.jp FAU - Yamada, Takahisa AU - Yamada T FAU - Masuda, Masaharu AU - Masuda M FAU - Okuyama, Yuji AU - Okuyama Y FAU - Morita, Takashi AU - Morita T FAU - Furukawa, Yoshio AU - Furukawa Y FAU - Koji, Tanaka AU - Koji T FAU - Iwasaki, Yusuke AU - Iwasaki Y FAU - Okada, Takeshi AU - Okada T FAU - Kawasaki, Masato AU - Kawasaki M FAU - Kuramoto, Yuki AU - Kuramoto Y FAU - Naito, Takashi AU - Naito T FAU - Fujimoto, Tadao AU - Fujimoto T FAU - Komuro, Issei AU - Komuro I FAU - Fukunami, Masatake AU - Fukunami M LA - eng PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial DEP - 20110223 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 RN - 0 (Contrast Media) RN - 8MDF5V39QO (Sodium Bicarbonate) SB - IM MH - Acute Coronary Syndrome/diagnostic imaging/*therapy MH - Aged MH - *Angioplasty, Balloon, Coronary MH - Contrast Media/*adverse effects MH - Coronary Angiography/*adverse effects/methods MH - Dose-Response Relationship, Drug MH - Female MH - Follow-Up Studies MH - Glomerular Filtration Rate/drug effects MH - Humans MH - Injections, Intravenous MH - Male MH - Prospective Studies MH - Renal Insufficiency/chemically induced/*prevention & control MH - Sodium Bicarbonate/*administration & dosage MH - Treatment Outcome EDAT- 2011/02/26 06:00 MHDA- 2011/06/08 06:00 CRDT- 2011/02/26 06:00 PHST- 2010/08/21 00:00 [received] PHST- 2010/12/10 00:00 [revised] PHST- 2010/12/10 00:00 [accepted] PHST- 2011/02/26 06:00 [entrez] PHST- 2011/02/26 06:00 [pubmed] PHST- 2011/06/08 06:00 [medline] AID - S0002-9149(10)02715-3 [pii] AID - 10.1016/j.amjcard.2010.12.012 [doi] PST - ppublish SO - Am J Cardiol. 2011 Apr 15;107(8):1163-7. doi: 10.1016/j.amjcard.2010.12.012. Epub 2011 Feb 23. PMID- 21318582 OWN - NLM STAT- MEDLINE DCOM- 20110902 LR - 20211020 IS - 1573-742X (Electronic) IS - 0929-5305 (Linking) VI - 31 IP - 4 DP - 2011 May TI - Impact of reduced glomerular filtration rate on outcomes in patients with ST-segment elevation myocardial infarction undergoing fibrinolysis: a CLARITY-TIMI 28 analysis. PG - 493-500 LID - 10.1007/s11239-011-0566-9 [doi] AB - Reduced glomerular filtration rate (GFR) is associated with adverse outcomes in patients with cardiovascular disease. We explored the relationship between GFR and angiographic and clinical outcomes in ST-segment elevation myocardial infarction (STEMI) patients receiving pharamacologic reperfusion, with or without clopidogrel. Data were available to estimate GFR in 3,252 STEMI patients undergoing fibrinolysis, randomized to clopidogrel versus placebo in the CLARITY-TIMI 28 trial. Patients with a creatinine > 2.5 mg/dl were excluded from the trial. We compared outcomes between patients with no, mild or moderate reductions in baseline estimated GFR (ml/min/1.73 m(2)) of >/= 90, 60-89, and <60, respectively. Compared to patients with no (n = 841) or mildly reduced GFR (n = 1897), those with moderately reduced GFR (n = 514) were older, more often female, and were more likely to have diabetes and hypertension (P /=90 mL/min/1.73 m(2) (n = 47, 26.1%). The eGFR was calculated using the new Japanese equation. Long-term outcomes were compared over a follow-up period of 1538 +/- 707 days. RESULTS: Cumulative incidence rates of MACCE did not significantly differ between groups 1 year after ACS onset (P = 0.384), whereas significant differences appeared during the long-term follow-up (10.6 versus 27.0% versus 35.4% in the non-CKD, mild CKD and moderate-to-severe CKD groups, respectively; log-rank test, P = 0.022). In a multivariate Cox hazard regression model, moderate-to-severe CKD and mild CKD were associated with a higher rate of MACCE after adjusting for confounding variables (hazard ratios = 3.46 and 2.67, respectively; P = 0.043). CONCLUSIONS: The presence of mild CKD at ACS occurrence is associated with a worse outcome in the long term, but not the short term. FAU - Dohi, Tomotaka AU - Dohi T AD - Department of Cardiovascular Medicine, Juntendo University School of Medicine, Tokyo 113-0033, Japan. FAU - Miyauchi, Katsumi AU - Miyauchi K FAU - Okazaki, Shinya AU - Okazaki S FAU - Yokoyama, Takayuki AU - Yokoyama T FAU - Tamura, Hiroshi AU - Tamura H FAU - Kojima, Takahiko AU - Kojima T FAU - Yokoyama, Ken AU - Yokoyama K FAU - Kurata, Takeshi AU - Kurata T FAU - Daida, Hiroyuki AU - Daida H LA - eng PT - Clinical Trial PT - Journal Article PT - Randomized Controlled Trial DEP - 20110207 PL - England TA - Nephrol Dial Transplant JT - Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association JID - 8706402 SB - IM MH - Acute Coronary Syndrome/complications/*therapy MH - Aged MH - Angioplasty, Balloon, Coronary/*adverse effects MH - Cohort Studies MH - Coronary Angiography MH - Female MH - Follow-Up Studies MH - Glomerular Filtration Rate MH - Humans MH - Kidney Failure, Chronic/*etiology/mortality MH - Male MH - Middle Aged MH - Prognosis MH - Prospective Studies MH - Risk Factors MH - Survival Rate MH - Time Factors EDAT- 2011/02/09 06:00 MHDA- 2012/01/20 06:00 CRDT- 2011/02/09 06:00 PHST- 2011/02/09 06:00 [entrez] PHST- 2011/02/09 06:00 [pubmed] PHST- 2012/01/20 06:00 [medline] AID - gfq820 [pii] AID - 10.1093/ndt/gfq820 [doi] PST - ppublish SO - Nephrol Dial Transplant. 2011 Sep;26(9):2906-11. doi: 10.1093/ndt/gfq820. Epub 2011 Feb 7. PMID- 21297202 OWN - NLM STAT- MEDLINE DCOM- 20110623 LR - 20220321 IS - 1557-2501 (Electronic) IS - 1042-3931 (Linking) VI - 23 IP - 2 DP - 2011 Feb TI - Relationship between the angiographically derived SYNTAX score and outcomes in high-risk patients undergoing percutaneous coronary intervention. PG - 66-9 AB - Numerous risk scores have been designed to predict the outcome of percutaneous coronary intervention (PCI). The Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score has been shown to predict outcome in patients with severe coronary artery disease (CAD) randomized to PCI or bypass surgery, but its utility in patients with less severe CAD is less well established. METHODS: We calculated the SYNTAX score in 482 patients with diabetes mellitus or chronic kidney disease (serum creatinine > 1.5 mg/ml) undergoing non-emergency PCI. The study endpoint was 3-year all-cause mortality or repeat revascularization. RESULTS: The mean age was 69 +/- 11 years, 44% were women, 82% had diabetes and they had 1.82 +/- 0.78 diseased vessels. The mean creatinine clearance was 67.3 +/- 37.2 ml/min. The mean SYNTAX score was 11 +/- 8, median of 9 (5-15), tertiles < 7, 7-12 and > 12. There was good interobserver concordance (0.784 and 0.816, p < 0.01, respectively among two pairs of observers). The 3-year estimated survival rate was 0.85 (95% confidence interval [CI] 0.82-0.88). By multivariable analysis, creatinine clearance (hazard ratio [HR] 0.82 per 10 ml/min, p < 0.001), ejection fraction (HR 0.82 per 10%, p = 0.004) and prior infarction (HR 1.7, p = 0.03) were the only predictors of death. The SYNTAX score did not predict mortality. The incidence of repeat PCI by increasing tertiles of SYNTAX score was 19.2%, 32.2% and 33.2%, respectively, p < 0.001. CONCLUSION: In patients at high risk for ischemic events without severe CAD, the SYNTAX score is not associated with mortality at 3 years. FAU - Brener, Sorin J AU - Brener SJ AD - Cardiac Catheterization Laboratory, NY Methodist Hospital, 506 6th Street, KP-2, Brooklyn, NY 11215, USA. sjb9005@nyp.org FAU - Prasad, Ashok J AU - Prasad AJ FAU - Abdula, Raushan AU - Abdula R FAU - Sacchi, Terrence J AU - Sacchi TJ LA - eng PT - Journal Article PL - United States TA - J Invasive Cardiol JT - The Journal of invasive cardiology JID - 8917477 SB - IM CIN - J Invasive Cardiol. 2011 Feb;23(2):70-1. PMID: 21297203 MH - Aged MH - Aged, 80 and over MH - *Angioplasty, Balloon, Coronary MH - Chronic Disease MH - Coronary Angiography/*methods MH - Coronary Artery Disease/*diagnostic imaging/mortality/*therapy MH - Diabetes Complications/complications MH - Female MH - Humans MH - Kidney Diseases/complications MH - Male MH - Middle Aged MH - Multivariate Analysis MH - Myocardial Infarction/epidemiology MH - Prospective Studies MH - Retrospective Studies MH - Risk Factors MH - *Severity of Illness Index MH - Survival Rate MH - Treatment Outcome EDAT- 2011/02/08 06:00 MHDA- 2011/06/24 06:00 CRDT- 2011/02/08 06:00 PHST- 2011/02/08 06:00 [entrez] PHST- 2011/02/08 06:00 [pubmed] PHST- 2011/06/24 06:00 [medline] PST - ppublish SO - J Invasive Cardiol. 2011 Feb;23(2):66-9. PMID- 21186075 OWN - NLM STAT- MEDLINE DCOM- 20110301 LR - 20220317 IS - 1523-6838 (Electronic) IS - 0272-6386 (Linking) VI - 57 IP - 2 DP - 2011 Feb TI - Long-term clinical outcomes following drug-eluting or bare-metal stent placement in patients with severely reduced GFR: Results of the Massachusetts Data Analysis Center (Mass-DAC) State Registry. PG - 202-11 LID - 10.1053/j.ajkd.2010.09.017 [doi] AB - BACKGROUND: Patients with chronic kidney disease have been under-represented in randomized trials of drug-eluting stents relative to bare-metal stents and are at high risk of mortality. STUDY DESIGN: Cohort study with propensity score matching. SETTINGS & PARTICIPANTS: All adults with chronic kidney disease and severely decreased glomerular filtration rate (GFR; serum creatinine >2.0 mg/dL or dialysis dependence) undergoing percutaneous coronary intervention with stent placement between April 1, 2003, and September 30, 2005, at all acute-care nonfederal hospitals in Massachusetts. PREDICTOR: Patients were classified as drug-eluting stent-treated if all stents were drug eluting and bare-metal stent-treated if all stents were bare metal. Patients treated with both types of stents were excluded from the primary analysis. OUTCOMES & MEASUREMENTS: 2-year crude mortality risk differences (drug-eluting - bare-metal stents) were determined from vital statistics records, and risk-adjusted mortality, myocardial infraction (MI), and revascularization differences were estimated using propensity score matching of patients with severely reduced GFR based on clinical and procedural information collected at the index admission. RESULTS: 1,749 patients with severely reduced GFR (24% dialysis dependent) were treated with drug-eluting (n = 1,256) or bare-metal stents (n = 493) during the study. Overall 2-year mortality was 32.8% (unadjusted drug-eluting stent vs bare-metal stent; 30.1% vs 39.8%; P < 0.001). After propensity score matching 431 patients with a drug-eluting stent to 431 patients with a bare-metal stent, 2-year risk-adjusted mortality, MI, and target-vessel revascularization rates were 39.4% versus 37.4% (risk difference, 2.1%; 95% CI, -4.3 to 8.5; P = 0.5), 16.0% versus 19.0% (risk difference, -3.0%; 95% CI, -8.2 to 2.1; P = 0.3), and 13.0% versus 17.6% (risk difference, -4.6%; 95% CI, -9.5 to 0.3; P = 0.06). LIMITATIONS: Observational design, ascertainment of serum creatinine level >2.0 mg/dL and dialysis dependence from case report forms. CONCLUSIONS: In patients with severely decreased GFR, treatment with drug-eluting stents was associated with a modest decrease in target-vessel revascularization not reaching statistical significance and was not associated with a difference in risk-adjusted rates of mortality or MI at 2 years compared with bare-metal stents. CI - Copyright A(c) 2011 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved. FAU - Charytan, David M AU - Charytan DM AD - Brigham and Women's Hospital, Boston, MA 02115, USA. FAU - Varma, Manu R AU - Varma MR FAU - Silbaugh, Treacy S AU - Silbaugh TS FAU - Lovett, Ann F AU - Lovett AF FAU - Normand, Sharon-Lise T AU - Normand SL FAU - Mauri, Laura AU - Mauri L LA - eng PT - Comparative Study PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20101224 PL - United States TA - Am J Kidney Dis JT - American journal of kidney diseases : the official journal of the National Kidney Foundation JID - 8110075 RN - 0 (Metals) SB - IM CIN - Am J Kidney Dis. 2011 Feb;57(2):188-9. doi: 10.1053/j.ajkd.2010.12.002. PMID: 21251538 MH - Aged MH - Aged, 80 and over MH - Angioplasty, Balloon, Coronary/*methods MH - Chronic Disease MH - Cohort Studies MH - Comorbidity MH - Coronary Artery Disease/therapy MH - *Drug-Eluting Stents MH - Female MH - Follow-Up Studies MH - Glomerular Filtration Rate/*physiology MH - Humans MH - Kidney Diseases/*mortality/*physiopathology/therapy MH - Male MH - Massachusetts MH - *Metals MH - Middle Aged MH - Myocardial Infarction/epidemiology/mortality/prevention & control MH - Registries MH - Renal Replacement Therapy MH - Retrospective Studies MH - Risk Factors MH - Severity of Illness Index MH - *Stents MH - Treatment Outcome EDAT- 2010/12/28 06:00 MHDA- 2011/03/02 06:00 CRDT- 2010/12/28 06:00 PHST- 2010/06/03 00:00 [received] PHST- 2010/09/10 00:00 [accepted] PHST- 2010/12/28 06:00 [entrez] PHST- 2010/12/28 06:00 [pubmed] PHST- 2011/03/02 06:00 [medline] AID - S0272-6386(10)01437-X [pii] AID - 10.1053/j.ajkd.2010.09.017 [doi] PST - ppublish SO - Am J Kidney Dis. 2011 Feb;57(2):202-11. doi: 10.1053/j.ajkd.2010.09.017. Epub 2010 Dec 24. PMID- 21147288 OWN - NLM STAT- MEDLINE DCOM- 20110104 LR - 20101214 IS - 1097-6744 (Electronic) IS - 0002-8703 (Linking) VI - 160 IP - 6 Suppl DP - 2010 Dec TI - Evaluation and management of special subgroups after primary percutaneous coronary intervention. PG - S22-7 LID - 10.1016/j.ahj.2010.10.012 [doi] AB - In recent decades, the increased use of novel pharmacologic therapies and primary percutaneous coronary intervention has considerably improved survival in the setting of ST-segment elevation myocardial infarction. Nevertheless, optimal management and care of particular subgroups of patients such as the elderly and individuals with diabetes mellitus, renal dysfunction, or cardiogenic shock are still debated. In fact, because of their clinically relevant comorbidities, these patients are often excluded from randomized trials; thus, data are largely limited to those from retrospective cohorts or subgroup analyses of large clinical studies. These particular subgroups of patients require special management during and after prompt mechanical reperfusion because of their high risk of both thrombotic and bleeding events. Therefore, cardiologists should accurately assess the risk-benefit equation before administrating and dosing currently available antithrombotic and antiplatelets agents in these high-risk populations. CI - Copyright (c) 2010 Mosby, Inc. All rights reserved. FAU - De Luca, Leonardo AU - De Luca L AD - Interventional Cardiology Unit, Department of Cardiovascular Sciences, European Hospital, Rome, Italy. leo.deluca@libero.it FAU - Tomai, Fabrizio AU - Tomai F FAU - Verdoia, Monica AU - Verdoia M FAU - De Luca, Giuseppe AU - De Luca G LA - eng PT - Journal Article PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 RN - 0 (Cardiovascular Agents) RN - 0 (Fibrinolytic Agents) RN - 0 (Platelet Aggregation Inhibitors) SB - IM MH - Acute Disease MH - Aged MH - *Angioplasty, Balloon, Coronary MH - Cardiovascular Agents/therapeutic use MH - *Diabetes Complications MH - *Electrocardiography MH - Fibrinolytic Agents/adverse effects/therapeutic use MH - Heart-Assist Devices MH - Humans MH - Kidney Diseases/*complications/therapy MH - Myocardial Infarction/*complications/diagnosis/physiopathology/*therapy MH - Platelet Aggregation Inhibitors/adverse effects/therapeutic use MH - Risk Assessment MH - Shock, Cardiogenic/*complications/therapy EDAT- 2010/12/22 06:00 MHDA- 2011/01/05 06:00 CRDT- 2010/12/15 06:00 PHST- 2010/12/15 06:00 [entrez] PHST- 2010/12/22 06:00 [pubmed] PHST- 2011/01/05 06:00 [medline] AID - S0002-8703(10)00912-9 [pii] AID - 10.1016/j.ahj.2010.10.012 [doi] PST - ppublish SO - Am Heart J. 2010 Dec;160(6 Suppl):S22-7. doi: 10.1016/j.ahj.2010.10.012. PMID- 21124771 OWN - NLM STAT- MEDLINE DCOM- 20110427 LR - 20211020 IS - 1932-6203 (Electronic) IS - 1932-6203 (Linking) VI - 5 IP - 11 DP - 2010 Nov 29 TI - Drug-eluting stents in patients with chronic kidney disease: a prospective registry study. PG - e15070 LID - 10.1371/journal.pone.0015070 [doi] LID - e15070 AB - BACKGROUND: Chronic kidney disease (CKD) is strongly associated with adverse outcomes after percutaneous coronary intervention (PCI). There are limited data on the effectiveness of drug-eluting stents (DES) in patients with CKD. METHODOLOGY/PRINCIPAL FINDINGS: Of 3,752 consecutive patients enrolled in the Guthrie PCI Registry between 2001 and 2006, 436 patients with CKD - defined as a creatinine clearance <60 mL/min - were included in this study. Patients who received DES were compared to those who received bare metal stents (BMS). Patients were followed for a mean duration of 3 years after the index PCI to determine the prognostic impact of stent type. Study end-points were all-cause death, myocardial infarction (MI), target vessel revascularization (TVR), stent thrombosis (ST) and the composite of major adverse cardiovascular events (MACE), defined as death, MI or TVR. Patients receiving DES in our study, by virtue of physician selection, had more stable coronary artery disease and had lower baseline risk of thrombotic or restenotic events. Kaplan-Meier estimates of proportions of patients reaching the end-points were significantly lower for DES vs. BMS for all-cause death (p = 0.0008), TVR (p = 0.029) and MACE (p = 0.0015), but not MI (p = 0.945) or ST (p = 0.88). Multivariable analysis with propensity adjustment demonstrated that DES implantation was an independent predictor of lower rates of all-cause death (hazard ratio [HR] 0.48, 95% confidence interval [CI] 0.25-0.92), TVR (HR 0.50, 95% CI 0.27-0.94) and MACE (HR 0.62, 95% CI 0.41-0.94). CONCLUSIONS: In a contemporary PCI registry, selective use of DES in patients with CKD was safe and effective in the long term, with lower risk of all-cause death, TVR and MACE and similar risk of MI and ST as compared with BMS. The mortality benefit may be a result of selection bias and residual confounding, or represent a true finding; a hypothesis that warrants clarification by randomized clinical trials. FAU - Shenoy, Chetan AU - Shenoy C AD - Guthrie Clinic, Sayre, Pennsylvania, USA. FAU - Boura, Judy AU - Boura J FAU - Orshaw, Pamela AU - Orshaw P FAU - Harjai, Kishore J AU - Harjai KJ LA - eng PT - Journal Article DEP - 20101129 PL - United States TA - PLoS One JT - PloS one JID - 101285081 SB - IM MH - Aged MH - Aged, 80 and over MH - Angioplasty, Balloon, Coronary MH - *Drug-Eluting Stents MH - Female MH - Humans MH - Kaplan-Meier Estimate MH - Kidney Failure, Chronic/mortality/*therapy MH - Male MH - Middle Aged MH - Multivariate Analysis MH - Proportional Hazards Models MH - Prospective Studies MH - Registries/*statistics & numerical data MH - Risk Assessment/methods/statistics & numerical data MH - Risk Factors MH - Survival Rate MH - Treatment Outcome PMC - PMC2993936 COIS- Competing Interests: The authors have declared that no competing interests exist. EDAT- 2010/12/03 06:00 MHDA- 2011/04/28 06:00 PMCR- 2010/11/29 CRDT- 2010/12/03 06:00 PHST- 2010/08/21 00:00 [received] PHST- 2010/10/16 00:00 [accepted] PHST- 2010/12/03 06:00 [entrez] PHST- 2010/12/03 06:00 [pubmed] PHST- 2011/04/28 06:00 [medline] PHST- 2010/11/29 00:00 [pmc-release] AID - PONE-D-10-01462 [pii] AID - 10.1371/journal.pone.0015070 [doi] PST - epublish SO - PLoS One. 2010 Nov 29;5(11):e15070. doi: 10.1371/journal.pone.0015070. PMID- 21122202 OWN - NLM STAT- MEDLINE DCOM- 20120123 LR - 20101202 IS - 1003-0603 (Print) IS - 1003-0603 (Linking) VI - 22 IP - 11 DP - 2010 Nov TI - [The use of recombinant human B-type natriuretic peptide for the protection of cardiac and renal functions in heart failure patients with acute anterior myocardial infarction in peri-operative period of primary percutaneous coronary intervention]. PG - 669-73 AB - OBJECTIVE: To evaluate the protective effect of recombinant human B-type natriuretic peptide (rhBNP) on cardiac and renal functions in heart failure (HF) patients as a result of acute anterior myocardial infarction (AAMI) in peri-operative period of primary percutaneous coronary intervention (pPCI). METHODS: One hundred and twenty-six patients with AAMI-HF were enrolled into this study. All patients undertaken pPCI were randomly assigned to the rhBNP group (n=62) or the control group (n=64). rhBNP or nitroglycerin was intravenously administered on the basis of conventional treatment from first day of admission to 24 hours after pPCI in both groups. Heart rate (HR), systolic blood pressure (SBP), B-type natriuretic peptide (BNP), estimated glomerular filtration rate (eGFR) and heart function were observed. All patients were followed up for 30 days for the observation of main adverse cardiac events (MACE). RESULTS: The HR was significantly decreased compared with that at admission in rhBNP group, but such condition was not found in the control group. The SBP was reduced obviously in both groups. The plasma level of BNP, left ventricular ejection fraction (LVEF) and left ventricular end-diastolic dimension (LVEDD) were improved significantly at different time points compared with those before administration in both groups. The improvement of above parameters in rhBNP group was more significant than that in the control group [BNP (ng/L) 30 hours after pPCI: 303.5+/-128.4 vs. 354.0+/-133.6, 14 days after pPCI: 157.8+/-78.6 vs. 201.1+/-91.7; LVEF 1 day after pPCI: 0.420+/-0.052 vs. 0.378+/-0.055, 14 days after pPCI : 0.444+/-0.050 vs. 0.393+/-0.055, 30 days after pPCI: 0.469+/-0.053 vs. 0.413+/-0.052; LVEDD (mm) 1 day after pPCI: 53.5+/-4.4 vs. 57.6+/-4.4, 14 days after pPCI : 49.6+/-5.1 vs. 53.4+/-4.6, 30 days after pPCI: 46.5+/-4.4 vs. 50.2+/-4.8, P<0.05 or P<0.01]. The eGFR was reduced obviously 1 day after pPCI than that at admission in both groups, and eGFR recovered to baseline 3 days after pPCI. The level of eGFR was significantly increased 7 days and 14 days after pPCI than that at admission, but there was no difference between rhBNP group and control group. The incidence of contrast-induced nephropathy showed a lowering tendency in the rhBNP group than that in the control group [19.4% (12/62) vs. 29.7% (19/64), P=0.178]. The incidence of ventricular arrhythmias was obviously lowered 7 days after pPCI in the rhBNP group than that in the control group [48.4% (30/62) vs. 75.0% (48/64), P<0.01]. The rate of MACE was lower in rhBNP group than that in control group in 30 days [12.9% (8/62) vs. 26.6% (17/64), P<0.05]. CONCLUSION: Administration of rhBNP can effectively improve the heart function in AAMI-HF patients undergoing pPCI, and it lowered the incidence of MACE in 30 days, without influence on renal function, and it can reduce the incidence of contrast-induced nephropathy. FAU - Zhang, Jing AU - Zhang J AD - Department of Cardiology, Second Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei, China. FAU - Fu, Xiang-hua AU - Fu XH FAU - Fan, Xin-na AU - Fan XN FAU - Jia, Xin-wei AU - Jia XW FAU - Gu, Xin-shun AU - Gu XS FAU - Li, Shi-qiang AU - Li SQ FAU - Jiang, Yun-fa AU - Jiang YF FAU - Fan, Wei-ze AU - Fan WZ FAU - Su, Jian-ling AU - Su JL LA - chi PT - English Abstract PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - China TA - Zhongguo Wei Zhong Bing Ji Jiu Yi Xue JT - Zhongguo wei zhong bing ji jiu yi xue = Chinese critical care medicine = Zhongguo weizhongbing jijiuyixue JID - 9887521 RN - 0 (Recombinant Proteins) RN - 114471-18-0 (Natriuretic Peptide, Brain) SB - IM MH - Aged MH - Angioplasty, Balloon, Coronary/methods MH - Anterior Wall Myocardial Infarction/complications/*therapy MH - Electrocardiography MH - Female MH - Heart Failure/complications/*therapy MH - Humans MH - Kidney Function Tests MH - Male MH - Middle Aged MH - Natriuretic Peptide, Brain/*therapeutic use MH - Prognosis MH - Recombinant Proteins/*therapeutic use EDAT- 2010/12/03 06:00 MHDA- 2012/01/24 06:00 CRDT- 2010/12/03 06:00 PHST- 2010/12/03 06:00 [entrez] PHST- 2010/12/03 06:00 [pubmed] PHST- 2012/01/24 06:00 [medline] PST - ppublish SO - Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2010 Nov;22(11):669-73. PMID- 21106264 OWN - NLM STAT- MEDLINE DCOM- 20120726 LR - 20201216 IS - 1874-1754 (Electronic) IS - 0167-5273 (Linking) VI - 155 IP - 3 DP - 2012 Mar 22 TI - Intravenous N-acetylcysteine plus high-dose hydration versus high-dose hydration and standard hydration for the prevention of contrast-induced nephropathy: CASIS--a multicenter prospective controlled trial. PG - 418-23 LID - 10.1016/j.ijcard.2010.10.041 [doi] AB - BACKGROUND: Contrast-induced nephropathy (CIN) is a leading cause of acute renal failure and affects mortality and morbidity. We investigated the efficacy of prophylactic intravenous (IV) N-acetylcysteine (NAC) and hydration for the prevention of CIN in patients with mild to moderate renal dysfunction who are undergoing coronary angiography and/or percutaneous coronary intervention (PCI). METHODS: A total of 220 patients who had mild to moderate renal dysfunction with serum creatinine (SCr) >/= 1.1mg/dL or creatinine clearance /= 1.7 mg/dL [>/= 150 mumol/L] in men or >/= 1.5 mg/dL [ >/= 130 mumol/L] in women) with no known history of myocardial infarction or coronary revascularization were randomized in a ratio of 4:4:1 to ezetimibe 10 mg plus simvastatin 20 mg daily versus matching placebo versus simvastatin 20 mg daily (with the latter arm rerandomized at 1 year to ezetimibe 10 mg plus simvastatin 20 mg daily vs placebo). The key outcome will be major atherosclerotic events, defined as the combination of myocardial infarction, coronary death, ischemic stroke, or any revascularization procedure. RESULTS: A total of 9,438 CKD patients were randomized, of whom 3,056 were on dialysis. Mean age was 61 years, two thirds were male, one fifth had diabetes mellitus, and one sixth had vascular disease. Compared with either placebo or simvastatin alone, allocation to ezetimibe plus simvastatin was not associated with any excess of myopathy, hepatic toxicity, or biliary complications during the first year of follow-up. Compared with placebo, allocation to ezetimibe 10 mg plus simvastatin 20 mg daily yielded average LDL cholesterol differences of 43 mg/dL (1.10 mmol/L) at 1 year and 33 mg/dL (0.85 mmol/L) at 2.5 years. Follow-up is scheduled to continue until August 2010, when all patients will have been followed for at least 4 years. CONCLUSIONS: SHARP should provide evidence about the efficacy and safety of lowering LDL cholesterol with the combination of ezetimibe and simvastatin among a wide range of patients with CKD. CI - Copyright (c) 2010 Mosby, Inc. All rights reserved. FAU - Sharp Collaborative Group AU - Sharp Collaborative Group LA - eng SI - ClinicalTrials.gov/NCT00125593 SI - ISRCTN/ISRCTN54137607 GR - MC_EX_G0801669/MRC_/Medical Research Council/United Kingdom GR - MC_U137686853/MRC_/Medical Research Council/United Kingdom GR - BHF_/British Heart Foundation/United Kingdom PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20100918 PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 RN - 0 (Anticholesteremic Agents) RN - 0 (Azetidines) RN - 0 (Cholesterol, LDL) RN - AGG2FN16EV (Simvastatin) RN - EOR26LQQ24 (Ezetimibe) SB - IM CIN - Am Heart J. 2011 Jul;162(1):e15. doi: 10.1016/j.ahj.2011.04.024. PMID: 21742076 MH - Adult MH - Aged MH - Anticholesteremic Agents/administration & dosage/*therapeutic use MH - Atherosclerosis/blood/etiology/*prevention & control MH - Azetidines/administration & dosage/*therapeutic use MH - Cholesterol, LDL/*blood/drug effects MH - Dose-Response Relationship, Drug MH - Double-Blind Method MH - Drug Therapy, Combination MH - Ezetimibe MH - Female MH - Follow-Up Studies MH - Humans MH - Incidence MH - Kidney Failure, Chronic/*blood/complications/therapy MH - Male MH - Middle Aged MH - Renal Dialysis MH - Retrospective Studies MH - Simvastatin/administration & dosage/*therapeutic use MH - Treatment Outcome EDAT- 2010/11/26 06:00 MHDA- 2011/01/19 06:00 CRDT- 2010/11/25 06:00 PHST- 2010/07/21 00:00 [received] PHST- 2010/08/10 00:00 [accepted] PHST- 2010/11/25 06:00 [entrez] PHST- 2010/11/26 06:00 [pubmed] PHST- 2011/01/19 06:00 [medline] AID - S0002-8703(10)00759-3 [pii] AID - 10.1016/j.ahj.2010.08.012 [doi] PST - ppublish SO - Am Heart J. 2010 Nov;160(5):785-794.e10. doi: 10.1016/j.ahj.2010.08.012. Epub 2010 Sep 18. PMID- 21059433 OWN - NLM STAT- MEDLINE DCOM- 20101202 LR - 20131121 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 106 IP - 10 DP - 2010 Nov 15 TI - Impact of moderate renal insufficiency on restenosis and adverse clinical events after sirolimus-eluting and bare metal stent implantation (from the SIRIUS trials). PG - 1436-42 LID - 10.1016/j.amjcard.2010.07.011 [doi] AB - Whether drug-eluting stents are effective and safe in patients with moderate renal insufficiency (RI) is unknown. We performed a pooled analysis of data from 3 blinded randomized trials of sirolimus-eluting stents (SESs) versus bare metal stents (BMSs; SIRIUS, C-SIRIUS, E-SIRIUS) that included 1,510 patients. Clinical and angiographic outcomes were stratified by the presence of RI defined by creatinine clearance calculated by the Cockcroft-Gault formula (normal >/= 90, mild 60 to 89, moderate < 60 ml/min). Patients with baseline creatinine > 3.0 mg/dl were excluded from these trials. Baseline mild RI was present in 517 patients (34.7%, mean creatinine clearance 75.7 ml/min) and moderate RI in 228 patients (15.3%, mean creatinine clearance 47.2 ml/min). Treatment with SESs resulted in lower rates of 8-month angiographic restenosis rates in patients with RI (mild RI 6.7% vs 42.6%, p < 0.001; moderate RI 9.7% vs 39.7%, p < 0.001) and without baseline RI (7.7% vs 37.2%, p < 0.001). One-year target vessel revascularization rates were similarly decreased with SESs in patients with (mild RI 4.7% vs 24.2%, p < 0.001; moderate RI 5.5% vs 26.9%, p < 0.001) and without (8.1% vs 22.4%, p < 0.001) RI, and this benefit was maintained at 5 years. Compared to patients with normal or mild RI, patients with moderate RI had higher rates of overall mortality and cardiac death at 1 year and 5 years (death 2.6% vs 0.6%, p <0.01, and 17.5% vs 6.3%, p < 0.01, at 1 year and 5 years, respectively; cardiac death 1.3% vs 0.2%, p = 0.05, and 6.6% vs 3.4%, p = 0.04, at 1 year and 5 years, respectively). However, there was no differential effect of SESs versus BMSs on any safety end point. In conclusion, patients with moderate RI have a nearly threefold increase in 5-year mortality after percutaneous coronary intervention compared to patients without RI. The effectiveness of SESs in decreasing restenosis compared to BMSs in patients with moderate RI was preserved and rates of death and myocardial infarction were not adversely affected. CI - Copyright (c) 2010 Elsevier Inc. All rights reserved. FAU - Garg, Pallav AU - Garg P AD - Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA. FAU - Charytan, David M AU - Charytan DM FAU - Novack, Lena AU - Novack L FAU - Cutlip, Donald E AU - Cutlip DE FAU - Popma, Jeffrey J AU - Popma JJ FAU - Moses, Jeffrey AU - Moses J FAU - Leon, Martin B AU - Leon MB FAU - Schofer, Joachim AU - Schofer J FAU - Breithardt, Guenter AU - Breithardt G FAU - Schampaert, Erick AU - Schampaert E FAU - Mauri, Laura AU - Mauri L LA - eng PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 RN - W36ZG6FT64 (Sirolimus) SB - IM MH - Aged MH - Angioplasty, Balloon, Coronary MH - Coronary Restenosis/*etiology/*prevention & control MH - Double-Blind Method MH - *Drug-Eluting Stents MH - Female MH - Humans MH - Male MH - Middle Aged MH - Postoperative Complications/etiology MH - Renal Insufficiency/*complications MH - Severity of Illness Index MH - Sirolimus/*administration & dosage MH - Stents EDAT- 2010/11/10 06:00 MHDA- 2010/12/14 06:00 CRDT- 2010/11/10 06:00 PHST- 2010/04/27 00:00 [received] PHST- 2010/07/14 00:00 [revised] PHST- 2010/07/14 00:00 [accepted] PHST- 2010/11/10 06:00 [entrez] PHST- 2010/11/10 06:00 [pubmed] PHST- 2010/12/14 06:00 [medline] AID - S0002-9149(10)01406-2 [pii] AID - 10.1016/j.amjcard.2010.07.011 [doi] PST - ppublish SO - Am J Cardiol. 2010 Nov 15;106(10):1436-42. doi: 10.1016/j.amjcard.2010.07.011. PMID- 21045713 OWN - NLM STAT- MEDLINE DCOM- 20110809 LR - 20260128 IS - 1558-2035 (Electronic) IS - 1558-2027 (Linking) VI - 12 IP - 5 DP - 2011 May TI - Short-term high-dose atorvastatin for periprocedural myocardial infarction prevention in patients with renal dysfunction. PG - 318-21 LID - 10.2459/JCM.0b013e328341024f [doi] AB - OBJECTIVES: Short-term high-dose atorvastatin administered before percutaneous coronary intervention (PCI) reduces the rate of periprocedural myocardial infarction (pMI) in high-risk patients, such as those with acute coronary syndromes and those with elevated high-sensitivity C-reactive protein. It is unknown whether short-term high-dose administration reduces the rate of pMI in patients with chronic kidney disease. Recently, we observed that in 304 patients with estimated creatinine clearance less than 60 ml/min randomized to receive 80 mg/day of atorvastatin or placebo for 48 h before elective coronary angiography and/or angioplasty, statin administration did not reduce contrast-induced nephropathy (CIN). In this post-hoc analysis, we evaluate the pMI in the subgroup of 161 patients who underwent PCI. METHODS: In all patients, creatine kinase myocardial isoenzyme (CK-MB) [upper reference limit (URL) 5 ng/ml] was assessed before and at 12 and 24 h after PCI. The pMI, defined as CK-MB elevation more than three times the URL, occurred in 27 (17%) patients. RESULTS: The incidence of pMI was 10.4% (of 77 patients) in the atorvastatin and 23% (of 84 patients) in the placebo group (P < 0.05). Multivariate analysis identified the pretreatment with high-dose atorvastatin as an independent predictor of reduced risk of pMI [odds ratio 0.39, 95% confidence interval 0.16-0.96, P < 0.05]. CONCLUSION: This post-hoc analysis shows that short-term high-dose atorvastatin administration reduced pMI in patients with renal dysfunction submitted to elective PCI, but without benefit regarding CIN prevention. FAU - Toso, Anna AU - Toso A AD - Division of Cardiology, Misericordia e Dolce Hospital, Prato, Italy. anna.toso@libero.it FAU - Leoncini, Mario AU - Leoncini M FAU - Maioli, Mauro AU - Maioli M FAU - Gallopin, Michela AU - Gallopin M FAU - Tedeschi, Delio AU - Tedeschi D FAU - Amato, Marcello AU - Amato M FAU - Bellandi, Francesco AU - Bellandi F LA - eng PT - Journal Article PL - United States TA - J Cardiovasc Med (Hagerstown) JT - Journal of cardiovascular medicine (Hagerstown, Md.) JID - 101259752 RN - 0 (Biomarkers) RN - 0 (Heptanoic Acids) RN - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors) RN - 0 (Pyrroles) RN - A0JWA85V8F (Atorvastatin) RN - AYI8EX34EU (Creatinine) RN - EC 2.7.3.2 (Creatine Kinase, MB Form) SB - IM CIN - J Cardiovasc Med (Hagerstown). 2011 May;12(5):305-8. doi: 10.2459/JCM.0b013e3283454faa. PMID: 21451331 MH - Aged MH - Aged, 80 and over MH - Analysis of Variance MH - Angioplasty, Balloon, Coronary/*adverse effects MH - Atorvastatin MH - Biomarkers/blood MH - Chi-Square Distribution MH - Coronary Angiography/adverse effects MH - Coronary Artery Disease/complications/diagnostic imaging/*therapy MH - Creatine Kinase, MB Form/blood MH - Creatinine/blood MH - Drug Administration Schedule MH - Female MH - Glomerular Filtration Rate MH - Heptanoic Acids/*administration & dosage MH - Humans MH - Hydroxymethylglutaryl-CoA Reductase Inhibitors/*administration & dosage MH - Italy MH - Kidney Diseases/blood/*complications/physiopathology MH - Logistic Models MH - Male MH - Myocardial Infarction/blood/etiology/*prevention & control MH - Odds Ratio MH - Pyrroles/*administration & dosage MH - Randomized Controlled Trials as Topic MH - Retrospective Studies MH - Risk Assessment MH - Risk Factors MH - Time Factors MH - Treatment Outcome MH - Up-Regulation EDAT- 2010/11/04 06:00 MHDA- 2011/08/10 06:00 CRDT- 2010/11/04 06:00 PHST- 2010/11/04 06:00 [entrez] PHST- 2010/11/04 06:00 [pubmed] PHST- 2011/08/10 06:00 [medline] AID - 10.2459/JCM.0b013e328341024f [doi] PST - ppublish SO - J Cardiovasc Med (Hagerstown). 2011 May;12(5):318-21. doi: 10.2459/JCM.0b013e328341024f. PMID- 20980943 OWN - NLM STAT- MEDLINE DCOM- 20110310 LR - 20170306 VI - 120 IP - 10 DP - 2010 Oct TI - N-acetylcysteine fails to prevent renal dysfunction and oxidative stress after noniodine contrast media administration during percutaneous coronary interventions. PG - 383-9 LID - 494 [pii] AB - INTRODUCTION: Oxidative stress is believed to have a role in contrast-induced nephropathy. Based on this assumption, several known antioxidants have been studied to assess their effect on nephropathy, especially N-acetylcysteine (NAC). However, its usefulness has yet to be confirmed. OBJECTIVES: We aimed to assess whether NAC has any protective effect on contrast-induced renal dysfunction, and whether NAC affects the parameters of oxidative stress in serum and urine. PATIENTS AND METHODS: Sixty patients with coronary artery disease, who presented for an elective percutaneous coronary intervention (PCI), were randomized into 2 groups in an age- and gender-matched fashion: one group received 600 mg intravenous NAC and the other did not. Before and 24 hours after the procedure, blood and urine samples were obtained to assess total oxidant capacity (TOC), total antioxidant capacity (TAC), oxidative stress index (OSI), and renal function. RESULTS: Twenty-four hours after PCI, TOC and OSI levels were significantly increased and TAC levels significantly decreased, both in serum and urine. However, we did not observe any differences in oxidative parameters between patients who received NAC and those who did not. Multivariate analyses identified no protective effect of NAC on renal function, and no effect on oxidative parameters in either serum or urine. CONCLUSIONS: In this first clinical study that determined TOC and TAC levels in both serum and urine after exposure to contrast media, NAC was not found to affect oxidant parameters or protect against contrast nephropathy, at least in patients without the risk factors for nephropathy, such as diabetes mellitus or baseline renal or cardiac dysfunction. FAU - Buyukhatipoglu, Hakan AU - Buyukhatipoglu H AD - Harran University School of Medicine, Department of Internal Medicine, Sanliurfa, Turkey. buyukhatipoglu@gmail.com FAU - Sezen, Yusuf AU - Sezen Y FAU - Yildiz, Ali AU - Yildiz A FAU - Bas, Memduh AU - Bas M FAU - Kirhan, Idris AU - Kirhan I FAU - Ulas, Turgay AU - Ulas T FAU - Turan, Mehmet Nuri AU - Turan MN FAU - Taskin, Abdullah AU - Taskin A FAU - Aksoy, Nurten AU - Aksoy N LA - eng PT - Journal Article PT - Randomized Controlled Trial PL - Poland TA - Pol Arch Med Wewn JT - Polskie Archiwum Medycyny Wewnetrznej JID - 0401225 RN - 0 (Contrast Media) RN - WYQ7N0BPYC (Acetylcysteine) SB - IM MH - Acetylcysteine/*administration & dosage/therapeutic use MH - Acute Kidney Injury/*chemically induced/*prevention & control MH - Aged MH - Angioplasty, Balloon, Coronary/adverse effects MH - Contrast Media/*adverse effects MH - Coronary Angiography/adverse effects MH - Female MH - Humans MH - Male MH - Middle Aged MH - Oxidative Stress/drug effects MH - Treatment Outcome EDAT- 2010/10/29 06:00 MHDA- 2011/03/11 06:00 CRDT- 2010/10/29 06:00 PHST- 2010/10/29 06:00 [entrez] PHST- 2010/10/29 06:00 [pubmed] PHST- 2011/03/11 06:00 [medline] AID - 494 [pii] PST - ppublish SO - Pol Arch Med Wewn. 2010 Oct;120(10):383-9. PMID- 20971446 OWN - NLM STAT- MEDLINE DCOM- 20110429 LR - 20101124 IS - 1768-3181 (Electronic) IS - 0003-3928 (Linking) VI - 59 IP - 6 DP - 2010 Dec TI - [ST-elevation myocardial infarction in octogerians]. PG - 349-55 LID - 10.1016/j.ancard.2010.10.005 [doi] AB - Coronary artery disease is the leading cause of death in developed countries and its incidence and severity is greater among older patients. So, because of the ageing of the population, clinicians will be increasingly confronted in daily practice with managing acute coronary syndrome in extreme old age and high-risk patients. Despite this demographic reality, several large randomized controlled trials evaluating the benefit-risk ratio of invasive versus conservative approach have systematically excluded elderly patients. The extrapolation of evidence-based medicine, initially focused on younger patients, is often contentious in this population and because of the lack of clear and specific recommendations in the elderly, the optimal management of STEMI in octogenarians remains a topic of debate. Elderly patients present unique issues related to the ageing process and multiple comorbid diseases making difficult the extrapolation of evidence obtained on younger demographics. Data from registries seem to support, nevertheless, the benefit of primary revascularization by PCI of the culprit lesion in "selected" octogenarians with a high technical success rate, few complications, acceptable short and long-term mortality rate and quality of life. Obviously, the "ideal octogenarian" doesn't exist and all the old patients are not suitable for an invasive approach. Managing elderly patients requires not only cardiological skills but also geriatric acknowledges and the individualized geriatric assessment is the corner store of the decision process. The aim is to screen for the presence of comorbidities (cognitive disorders, functional decline, anemia, renal insufficiency...), social isolation and existence of an underlying frailty. To conclude, the optimal strategy for the management of STEMI in octogenarians is not univocal: the best approach is the one that offers the greater benefits regard considerations of general health. CI - Copyright (c) 2010. Published by Elsevier SAS. FAU - Martin, A-C AU - Martin AC AD - Hopital du Val-de-Grace, Paris, France. ac.angel@hotmail.fr FAU - Monsegu, J AU - Monsegu J LA - fre PT - English Abstract PT - Journal Article TT - Syndrome coronaire aigu avec elevation du segment ST chez l'octogenaire. DEP - 20101015 PL - France TA - Ann Cardiol Angeiol (Paris) JT - Annales de cardiologie et d'angeiologie JID - 0142167 SB - IM MH - Acute Coronary Syndrome/physiopathology/*therapy MH - Aged, 80 and over MH - Decision Trees MH - Humans MH - Myocardial Infarction/physiopathology/*therapy EDAT- 2010/10/26 06:00 MHDA- 2011/04/30 06:00 CRDT- 2010/10/26 06:00 PHST- 2010/10/26 06:00 [entrez] PHST- 2010/10/26 06:00 [pubmed] PHST- 2011/04/30 06:00 [medline] AID - S0003-3928(10)00134-4 [pii] AID - 10.1016/j.ancard.2010.10.005 [doi] PST - ppublish SO - Ann Cardiol Angeiol (Paris). 2010 Dec;59(6):349-55. doi: 10.1016/j.ancard.2010.10.005. Epub 2010 Oct 15. PMID- 20935576 OWN - NLM STAT- MEDLINE DCOM- 20110419 LR - 20260518 IS - 1558-2035 (Electronic) IS - 1558-2027 (Linking) VI - 12 IP - 1 DP - 2011 Jan TI - LombardIMA: a regional registry for coronary angioplasty in ST-elevation myocardial infarction. PG - 43-50 LID - 10.2459/JCM.0b013e328340334d [doi] AB - BACKGROUND: Percutaneous coronary intervention (PCI) has been shown to be the best reperfusion therapy for acute myocardial infarction with ST-elevation (STEMI), but data from registries show differences in patient populations and outcomes between randomized trials and real life. OBJECTIVES: We sought to provide information about the current status of this treatment with a registry collecting data in Lombardy, the most densely populated region in Italy, with widespread availability of cathlabs and a well-established network for the treatment of STEMI. METHODS AND RESULTS: Patient enrollment was performed by 32 hub centres recruiting 3901 STEMI patients who underwent PCI procedures within 12 h of the onset of symptoms, of whom 3317 patients underwent primary PCI, 376 'facilitated' PCI, and 208 rescue PCI in cathlabs located, in 77% of cases, in the same hospital of admission. In-hospital and 30-day total death were 4.4 and 6.6%, respectively. At multivariate analysis independent negative predictors of 30-day mortality were Killip class 3-4, number of involved ECG leads, chronic renal failure and age, whereas positive predictors were ST resolution more than 50% and postprocedural grade 3 thrombolysis in myocardial infarction flow. CONCLUSIONS: LombardIMA PCI registry enrolled STEMI patients representing a real-world population treated with PCI. Findings presented in this study may provide a benchmark for similar registries undertaken in other Italian regions and may be helpful to assess future possible developments of care for STEMI patients. FAU - Politi, Alessandro AU - Politi A AD - Cardiology Department, Ospedale Moriggia Pelascini, Italia Hospital, Gravedona, Italy. politiarea@tiscali.it FAU - Martinoni, Alessandro AU - Martinoni A FAU - Klugmann, Silvio AU - Klugmann S FAU - Zanini, Roberto AU - Zanini R FAU - Onofri, Marco AU - Onofri M FAU - Guagliumi, Giulio AU - Guagliumi G FAU - Fiorentini, Cesare AU - Fiorentini C FAU - Lettieri, Corrado AU - Lettieri C FAU - Belli, Guido AU - Belli G FAU - Piccaluga, Emanuela AU - Piccaluga E FAU - De Cesare, Nicoletta AU - De Cesare N FAU - D'Urbano, Maurizio AU - D'Urbano M FAU - Ettori, Federica AU - Ettori F FAU - Repetto, Alessandra AU - Repetto A FAU - Musumeci, Giuseppe AU - Musumeci G FAU - Castiglioni, Battistina AU - Castiglioni B FAU - Colombo, Paola AU - Colombo P FAU - Passamonti, Enrico AU - Passamonti E FAU - Bramucci, Ezio AU - Bramucci E FAU - Cattaneo, Laura AU - Cattaneo L FAU - Ferrari, Giovanni AU - Ferrari G FAU - Repetto, Sergio AU - Repetto S FAU - Bartorelli, Antonio AU - Bartorelli A FAU - Pirelli, Salvatore AU - Pirelli S FAU - De Servi, Stefano AU - De Servi S CN - LombardIMA Study Group LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - United States TA - J Cardiovasc Med (Hagerstown) JT - Journal of cardiovascular medicine (Hagerstown, Md.) JID - 101259752 SB - IM MH - Aged MH - Angioplasty/*statistics & numerical data MH - Female MH - Humans MH - Italy/epidemiology MH - Male MH - Middle Aged MH - Myocardial Infarction/epidemiology/mortality/*therapy MH - *Registries MH - Treatment Outcome FIR - Bramucci, Ezio IR - Bramucci E FIR - Repetto, Alessandra IR - Repetto A FIR - Russo, Filippo IR - Russo F FIR - Niccoli, Luigi IR - Niccoli L FIR - Ettori, Federica IR - Ettori F FIR - Curello, Salvatore IR - Curello S FIR - Zanini, Roberto IR - Zanini R FIR - Lettieri, Corrado IR - Lettieri C FIR - Romano, Michele IR - Romano M FIR - Guagliumi, Giulio IR - Guagliumi G FIR - Musumeci, Giuseppe IR - Musumeci G FIR - Valsecchi, Orazio IR - Valsecchi O FIR - Galli, Mario IR - Galli M FIR - Zerboni, Santino IR - Zerboni S FIR - Llambro, Maksim IR - Llambro M FIR - Viecca, Maurizio IR - Viecca M FIR - Piccaluga, Emanuela IR - Piccaluga E FIR - Danna, Paolo IR - Danna P FIR - Klugmann, Silvio IR - Klugmann S FIR - Pirola, Roberto IR - Pirola R FIR - Colombo, Paola IR - Colombo P FIR - De Servi, Stefano IR - De Servi S FIR - D'Urbano, Maurizio IR - D'Urbano M FIR - Poletti, Fabrizio IR - Poletti F FIR - Presbitero, Patrizia IR - Presbitero P FIR - Corrada, Elena IR - Corrada E FIR - Belli, Guido IR - Belli G FIR - De Cesare, Nicolett IR - De Cesare N FIR - De Benedictis, Marialuisa IR - De Benedictis M FIR - Sganzerla, Paolo IR - Sganzerla P FIR - Savasta, Carlo IR - Savasta C FIR - Borghini, Elena IR - Borghini E FIR - Garducci, Stefano IR - Garducci S FIR - Zaro, Tiziana IR - Zaro T FIR - Piti, Antonio IR - Piti A FIR - Centonze, Fabrizio IR - Centonze F FIR - Rondi, Mauro IR - Rondi M FIR - Bartorelli, Antonio IR - Bartorelli A FIR - Fabbiocchi, Franco IR - Fabbiocchi F FIR - Montorsi, Piero IR - Montorsi P FIR - Onofri, Marco IR - Onofri M FIR - Balian, Vrujr IR - Balian V FIR - Rovelli, Gianni IR - Rovelli G FIR - Musmeci, Mauro IR - Musmeci M FIR - Pirelli, Salvatore IR - Pirelli S FIR - Passamonti, Enrico IR - Passamonti E FIR - Ferrari, Ostilio IR - Ferrari O FIR - Marzegalli, Maurizio IR - Marzegalli M FIR - Caprari, Marco IR - Caprari M FIR - Canziani, Roberto IR - Canziani R FIR - Galdangelo, Francesco IR - Galdangelo F FIR - Colombo, Antonio IR - Colombo A FIR - Sangiorgi, Giuseppe IR - Sangiorgi G FIR - Bortolini, Franco IR - Bortolini F FIR - Gentilini, Claudio IR - Gentilini C FIR - Vandoni, Pietro IR - Vandoni P FIR - Tresoldi, Simone IR - Tresoldi S FIR - Castiglioni, Battistina IR - Castiglioni B FIR - Verna, Edoardo IR - Verna E FIR - Bedogni, Francesco IR - Bedogni F FIR - Salvade, Paolo IR - Salvade P FIR - Falcone, Camillo IR - Falcone C FIR - Maiello, Luigi IR - Maiello L FIR - Piatti, Luigi IR - Piatti L FIR - Tiberti, Gianluca IR - Tiberti G FIR - Forzani, Teresio IR - Forzani T FIR - Pera, Isidoro IR - Pera I FIR - Sponzilli, Carlo IR - Sponzilli C FIR - Colombo, Virgilio IR - Colombo V FIR - Baglini, Roberto IR - Baglini R EDAT- 2010/10/12 06:00 MHDA- 2011/04/20 06:00 CRDT- 2010/10/12 06:00 PHST- 2010/10/12 06:00 [entrez] PHST- 2010/10/12 06:00 [pubmed] PHST- 2011/04/20 06:00 [medline] AID - 10.2459/JCM.0b013e328340334d [doi] PST - ppublish SO - J Cardiovasc Med (Hagerstown). 2011 Jan;12(1):43-50. doi: 10.2459/JCM.0b013e328340334d. PMID- 20823380 OWN - NLM STAT- MEDLINE DCOM- 20101110 LR - 20250529 IS - 1524-4563 (Electronic) IS - 0194-911X (Print) IS - 0194-911X (Linking) VI - 56 IP - 5 DP - 2010 Nov TI - Renal ischemia regulates marinobufagenin release in humans. PG - 914-9 LID - 10.1161/HYPERTENSIONAHA.110.155564 [doi] AB - Cardiotonic steroids, including marinobufagenin, are a group of new steroid hormones found in plasma and urine of patients with congestive heart failure, myocardial infarction, and chronic renal failure. In animal studies, partial nephrectomy induces marinobufagenin elevation, cardiac hypertrophy, and fibrosis. The objective of this study is to test the effect of renal ischemia on marinobufagenin levels in humans with renal artery stenosis (RAS). To test this, plasma marinobufagenin levels were measured in patients with RAS of the Prospective Randomized Study Comparing Renal Artery Stenting With or Without Distal Protection, non-RAS patient controls who were scheduled for coronary angiography, and normal healthy individuals. Marinobufagenin levels were significantly higher in patients with RAS compared with those of the other 2 groups. Multivariate analysis shows that occurrence of RAS is independently related to marinobufagenin levels. In addition, renal artery revascularization by stenting partially reversed marinobufagenin levels in the patients with RAS (0.77+/-0.06 nmol/L at baseline; 0.66+/-0.06 nmol/L at 24 hours; and 0.61+/-0.05 nmol/L at 1 month). In conclusion, we have found that marinobufagenin levels are increased in patients with RAS, whereas reversal of renal ischemia by stenting treatment reduces marinobufagenin levels. These results suggest that RAS-induced renal ischemia may be a major cause of marinobufagenin release. FAU - Tian, Jiang AU - Tian J AD - Department of Medicine Cardiovascular Division, University of Toledo, Toledo, OH 43614, USA. Jiang.tian@utoledo.edu FAU - Haller, Steven AU - Haller S FAU - Periyasamy, Sankaridrug AU - Periyasamy S FAU - Brewster, Pamela AU - Brewster P FAU - Zhang, Haifeng AU - Zhang H FAU - Adlakha, Satjit AU - Adlakha S FAU - Fedorova, Olga V AU - Fedorova OV FAU - Xie, Zi-Jian AU - Xie ZJ FAU - Bagrov, Alexei Y AU - Bagrov AY FAU - Shapiro, Joseph I AU - Shapiro JI FAU - Cooper, Christopher J AU - Cooper CJ LA - eng SI - ClinicalTrials.gov/NCT00234585 GR - U01 HL071556/HL/NHLBI NIH HHS/United States GR - Z01 AG000609/ImNIH/Intramural NIH HHS/United States PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, N.I.H., Intramural PT - Research Support, Non-U.S. Gov't DEP - 20100907 PL - United States TA - Hypertension JT - Hypertension (Dallas, Tex. : 1979) JID - 7906255 RN - 0 (Bufanolides) RN - 3KBT25GV2B (marinobufagenin) SB - IM MH - Aged MH - Analysis of Variance MH - Bufanolides/*blood MH - Enzyme-Linked Immunosorbent Assay MH - Female MH - Glomerular Filtration Rate MH - Humans MH - Hypertension/*blood/complications MH - Ischemia/*blood MH - Kidney/*blood supply MH - Logistic Models MH - Male MH - Middle Aged MH - Patient Selection MH - Prospective Studies MH - Renal Artery Obstruction/*blood/therapy MH - Stents PMC - PMC2959137 MID - NIHMS235420 EDAT- 2010/09/09 06:00 MHDA- 2010/11/11 06:00 PMCR- 2011/05/01 CRDT- 2010/09/09 06:00 PHST- 2010/09/09 06:00 [entrez] PHST- 2010/09/09 06:00 [pubmed] PHST- 2010/11/11 06:00 [medline] PHST- 2011/05/01 00:00 [pmc-release] AID - HYPERTENSIONAHA.110.155564 [pii] AID - 10.1161/HYPERTENSIONAHA.110.155564 [doi] PST - ppublish SO - Hypertension. 2010 Nov;56(5):914-9. doi: 10.1161/HYPERTENSIONAHA.110.155564. Epub 2010 Sep 7. PMID- 22933908 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20120830 LR - 20220321 IS - 1581-3207 (Electronic) IS - 1318-2099 (Print) IS - 1318-2099 (Linking) VI - 44 IP - 3 DP - 2010 Sep TI - Direct coronary stenting in reducing radiation and radiocontrast consumption. PG - 153-7 LID - 10.2478/v10019-010-0016-x [doi] AB - INTRODUCTION: Coronary stenting is the primary means of coronary revascularization. There are two basic techniques of stent implantation: stenting with balloon predilatation of stenosis and stenting without predilatation (direct stenting). Limiting the time that a fluoroscope is activated and by appropriately managing the intensity of the applied radiation, the operator limits radiation in the environment, and this saves the exposure to the patient and all personnel in the room. Nephrotoxicity is one of the most important properties of radiocontrast. The smaller amount of radiocontrast used also provides multiple positive effects, primarily regarding the periprocedural risk for the patients with the reduced renal function. The goal of the study was to compare fluoroscopy time, the amount of radiocontrast, and expenses of material used in direct stenting and in stenting with predilatation. PATIENTS AND METHODS: In a prospective study, 70 patients with coronary disease were randomized to direct stenting, or stenting with predilatation. RESULTS: Fluoroscopy time and radiocontrast use were significantly reduced in the directly stented patients in comparison to the patients stented with balloon-predilatation. The study showed a significant reduction of expenses when using a direct stenting method in comparison to stenting with predilatation. CONCLUSIONS: If the operator predicts that the procedure can be performed using direct stenting, he is encouraged to do so. Direct stenting is recommended for all percutaneous coronary interventions when appropriate conditions have been met. If direct stenting has been unsuccessful, the procedure can be converted to predilatation. FAU - Caluk, Jasmin AU - Caluk J AD - BH Heart Center Tuzla, Department of Interventional Cardiology, Tuzla, Bosnia-Herzegovina. FAU - Osmanovic, Enes AU - Osmanovic E FAU - Barakovic, Fahir AU - Barakovic F FAU - Kusljugic, Zumreta AU - Kusljugic Z FAU - Terzic, Ibrahim AU - Terzic I FAU - Caluk, Selma AU - Caluk S FAU - Sofic, Amela AU - Sofic A LA - eng PT - Journal Article DEP - 20100909 PL - Poland TA - Radiol Oncol JT - Radiology and oncology JID - 9317213 PMC - PMC3423693 OTO - NOTNLM OT - balloon predilatation OT - coronary stenting OT - expenses OT - percutaneous transluminal coronary angioplasty EDAT- 2010/09/01 00:00 MHDA- 2010/09/01 00:01 PMCR- 2010/09/01 CRDT- 2012/08/31 06:00 PHST- 2009/11/24 00:00 [received] PHST- 2010/02/11 00:00 [accepted] PHST- 2012/08/31 06:00 [entrez] PHST- 2010/09/01 00:00 [pubmed] PHST- 2010/09/01 00:01 [medline] PHST- 2010/09/01 00:00 [pmc-release] AID - rado-44-03-153 [pii] AID - 10.2478/v10019-010-0016-x [doi] PST - ppublish SO - Radiol Oncol. 2010 Sep;44(3):153-7. doi: 10.2478/v10019-010-0016-x. Epub 2010 Sep 9. PMID- 20647564 OWN - NLM STAT- MEDLINE DCOM- 20110408 LR - 20220410 IS - 1941-7632 (Electronic) IS - 1941-7640 (Linking) VI - 3 IP - 4 DP - 2010 Aug TI - Clinical and angiographic predictors of short- and long-term ischemic events in acute coronary syndromes: results from the Acute Catheterization and Urgent Intervention Triage strategY (ACUITY) trial. PG - 308-16 LID - 10.1161/CIRCINTERVENTIONS.109.887604 [doi] AB - BACKGROUND: Contemporary adjunctive pharmacology and revascularization strategies have improved the prognosis of patients with acute coronary syndromes (ACSs). We sought to identify the clinical and angiographic predictors of cardiac ischemic events in patients with ACSs treated with an early invasive strategy. METHODS AND RESULTS: Multivariable logistic regression was used to analyze the relation between baseline characteristics and 30-day and 1-year composite ischemia (death, myocardial infarction, or unplanned revascularization) among the 6921 ACS patients included in the prespecified angiographic substudy of the Acute Catheterization and Urgent Intervention Triage strategY (ACUITY) trial. Of the 6921 patients, 3826 (55.3%) were treated with percutaneous coronary intervention, 755 (10.9%) with coronary artery bypass grafting, and 2340 (33.8%) with medical therapy. Composite ischemia occurred in 595 (8.6%) patients at 30 days and in 1153 (17.4%) at 1 year. Renal insufficiency, biomarker elevation, ST-segment deviation, nonuse of aspirin or thienopyridine, insulin-treated diabetes, older age, baseline lower hemoglobin value, history of percutaneous coronary intervention, and current smoking were independently associated with 30-day or 1-year ischemic events. Angiographic characteristics predicting ischemic events included number of diseased vessels, moderate/severe calcification, worst percent diameter stenosis, jeopardy score, lower left ventricular ejection fraction, lesion eccentricity, and thrombus. With use of receiver operating characteristic methodology, the c statistic improved for the predictive model by adding angiographic to clinical parameters for the 30-day composite ischemia (from 0.62 to 0.68) and myocardial infarction (from 0.64 to 0.71) and 1-year composite ischemia (from 0.61 to 0.65) and myocardial infarction (from 0.63 to 0.69) end points. CONCLUSIONS: Among ACS patients managed with an early invasive strategy, baseline angiographic markers of disease burden, calcification, lesion severity, lower left ventricular ejection fraction, and morphological characteristics provided important added independent predictive value for 30-day and 1-year ischemic outcomes, beyond the well-recognized clinical risk factors. These findings emphasize the prognostic importance of the diagnostic angiogram in the risk stratification of patients presenting with ACSs. CLINICAL TRIAL REGISTRATION: URL: http://clinicaltrials.gov. Unique identifier: NCT00093158. FAU - Lansky, Alexandra J AU - Lansky AJ AD - Columbia University Medical Center, New York, NY 10022, USA. alexandralansky@gmail.com FAU - Goto, Kenji AU - Goto K FAU - Cristea, Ecaterina AU - Cristea E FAU - Fahy, Martin AU - Fahy M FAU - Parise, Helen AU - Parise H FAU - Feit, Frederick AU - Feit F FAU - Ohman, E Magnus AU - Ohman EM FAU - White, Harvey D AU - White HD FAU - Alexander, Karen P AU - Alexander KP FAU - Bertrand, Michel E AU - Bertrand ME FAU - Desmet, Walter AU - Desmet W FAU - Hamon, Martial AU - Hamon M FAU - Mehran, Roxana AU - Mehran R FAU - Moses, Jeffrey AU - Moses J FAU - Leon, Martin AU - Leon M FAU - Stone, Gregg W AU - Stone GW LA - eng SI - ClinicalTrials.gov/NCT00093158 PT - Clinical Trial PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20100720 PL - United States TA - Circ Cardiovasc Interv JT - Circulation. Cardiovascular interventions JID - 101499602 SB - IM MH - Acute Coronary Syndrome/*diagnosis/mortality/pathology/physiopathology/*therapy MH - Aged MH - Calcinosis MH - *Catheterization MH - Coronary Angiography/*methods MH - *Coronary Artery Bypass MH - Coronary Restenosis MH - Disease Progression MH - Female MH - Follow-Up Studies MH - Humans MH - Ischemia MH - Male MH - Middle Aged MH - Prognosis MH - Risk Factors MH - Stroke Volume MH - Survival Analysis EDAT- 2010/07/22 06:00 MHDA- 2011/04/09 06:00 CRDT- 2010/07/22 06:00 PHST- 2010/07/22 06:00 [entrez] PHST- 2010/07/22 06:00 [pubmed] PHST- 2011/04/09 06:00 [medline] AID - CIRCINTERVENTIONS.109.887604 [pii] AID - 10.1161/CIRCINTERVENTIONS.109.887604 [doi] PST - ppublish SO - Circ Cardiovasc Interv. 2010 Aug;3(4):308-16. doi: 10.1161/CIRCINTERVENTIONS.109.887604. Epub 2010 Jul 20. PMID- 20647561 OWN - NLM STAT- MEDLINE DCOM- 20110408 LR - 20220408 IS - 1941-7632 (Electronic) IS - 1941-7640 (Linking) VI - 3 IP - 4 DP - 2010 Aug TI - A new tool for the risk stratification of patients with complex coronary artery disease: the Clinical SYNTAX Score. PG - 317-26 LID - 10.1161/CIRCINTERVENTIONS.109.914051 [doi] AB - BACKGROUND: Presently, no effective risk model exists to predict long-term mortality or other major adverse cardiovascular and cerebrovascular events (MACCE) in those patients undergoing percutaneous coronary intervention (PCI). This study aimed to assess whether the Clinical SYNTAX Score (CSS) calculated by multiplying the SYNTAX Score to a modified ACEF score (age/ejection fraction +1 for each 10 mL the creatinine clearance <60 mL/min per 1.73 m(2)) would improve the ability of either score to predict mortality and MACCE. METHODS AND RESULTS: The CSS was calculated in 512 patients enrolled in the ARTS-II study who had serum creatinine levels, ejection fraction, and body weight recorded at baseline. Clinical outcomes in terms of MACCE and mortality at 1- and 5-year follow-up were stratified according to CSS tertiles: CSS(LOW)< or =15.6 (n=170), 15.627.5 (n=171). At 1-year follow-up, rates of repeat revascularization and MACCE were significantly higher in the highest tertile group. At 5-year follow-up, CSS(HIGH) had a comparable rate of myocardial infarction, a trend toward a significantly higher rate of death, and significantly higher rates of repeat revascularization and overall MACCE compared with patients in the lower 2 tertiles. The respective C-statistics for the CSS, SYNTAX Score, and ACEF score for 5-year mortality were 0.69, 0.62, and 0.65 and for 5-year MACCE were 0.62, 0.59, and 0.57. CONCLUSIONS: An improvement in the ability of the SYNTAX Score to predict MACCE and mortality can be achieved by combining the SYNTAX Score with a simple clinical risk score incorporating age, ejection fraction, and creatinine clearance to produce the Clinical SYNTAX score. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00235170. FAU - Garg, Scot AU - Garg S AD - Department of Interventional Cardiology, Erasmus MC, Rotterdam, The Netherlands. FAU - Sarno, Giovanna AU - Sarno G FAU - Garcia-Garcia, Hector M AU - Garcia-Garcia HM FAU - Girasis, Chrysafios AU - Girasis C FAU - Wykrzykowska, Joanna AU - Wykrzykowska J FAU - Dawkins, Keith D AU - Dawkins KD FAU - Serruys, Patrick W AU - Serruys PW CN - ARTS-II Investigators LA - eng SI - ClinicalTrials.gov/NCT00235170 PT - Clinical Trial PT - Comparative Study PT - Journal Article PT - Multicenter Study DEP - 20100720 PL - United States TA - Circ Cardiovasc Interv JT - Circulation. Cardiovascular interventions JID - 101499602 RN - AYI8EX34EU (Creatinine) SB - IM MH - Aged MH - *Angioplasty MH - Coronary Artery Disease/*diagnosis/mortality/pathology/physiopathology/*therapy MH - Creatinine/*metabolism MH - Female MH - Follow-Up Studies MH - Humans MH - Male MH - Middle Aged MH - Myocardial Infarction MH - Prognosis MH - Reoperation MH - Risk Assessment MH - Severity of Illness Index MH - *Software MH - Stroke Volume MH - Survival Analysis EDAT- 2010/07/22 06:00 MHDA- 2011/04/09 06:00 CRDT- 2010/07/22 06:00 PHST- 2010/07/22 06:00 [entrez] PHST- 2010/07/22 06:00 [pubmed] PHST- 2011/04/09 06:00 [medline] AID - CIRCINTERVENTIONS.109.914051 [pii] AID - 10.1161/CIRCINTERVENTIONS.109.914051 [doi] PST - ppublish SO - Circ Cardiovasc Interv. 2010 Aug;3(4):317-26. doi: 10.1161/CIRCINTERVENTIONS.109.914051. Epub 2010 Jul 20. PMID- 20639765 OWN - NLM STAT- MEDLINE DCOM- 20110419 LR - 20181201 IS - 1558-2035 (Electronic) IS - 1558-2027 (Linking) VI - 12 IP - 1 DP - 2011 Jan TI - Long-term efficacy of high-dose tirofiban versus double-bolus eptifibatide in patients undergoing percutaneous coronary intervention. PG - 29-36 LID - 10.2459/JCM.0b013e32833cdd04 [doi] AB - BACKGROUND: There is no head-to-head comparison between tirofiban versus eptifibatide in patients undergoing percutaneous coronary intervention (PCI) when added to standard antiaggregating drugs (AAD) to prevent ischemic events within 1 year. METHODS: We compared real-world patients undergoing PCI who were on oral single AAD and were block randomized to receive, immediately preintervention, high-dose tirofiban (n = 519) or double-bolus eptifibatide (n = 147) and a second oral antiplatelet agent. The incidence of composite ischemic events within 1 year, including death, acute myocardial infarction, angina, stent thrombosis or repeat PCI or coronary bypass surgery (primary end-point) was modelled by forced Cox's regression. RESULTS: There were overall 65 composite ischemic events: 47 (9.1%) in the tirofiban group and 18 (12.2%) in the eptifibatide group (univariate log-rank test: P = 0.22). On the basis of 21 potential covariates fitted simultaneously, multivariable adjusted hazard ratios showed that age [hazard ratio 1.03, 95% confidence interval (CI) 1.01-1.07, P = 0.01], chronic renal failure (hazard ratio 3.21, 95% CI 1.02-10.10, P = 0.05), pre-PCI values of creatine kinase-myocardial band (CK-MB) (hazard ratio 1.002, 95% CI 1.0002-1.0054, P = 0.04), intra-aortic balloon pump (hazard ratio 5.88, 95% CI 12.33-14.85, P = 0.0002) and the presence of eptifibatide (hazard ratio 1.85, 95% CI 1.04-3.29, P = 0.04) were significant risk factors whereas thrombolysis by tenecteplase (hazard ratio 0.19, 95% CI 0.05-0.69, P = 0.01) was a significant protector. Interestingly, eptifibatide versus tirofiban efficacy was explained based on pre-PCI values of CK-MB. CONCLUSION: Head-to-head comparison between eptifibatide and tirofiban in patients undergoing PCI while on double AAD showed that eptifibatide had a lower efficacy on the incidence of composite ischemic events within 1 year, which might be explained by a reduced action on CK-MB pre-PCI. FAU - Schiariti, Michele AU - Schiariti M AD - S. Anna Hospital, Catanzaro, Italy. FAU - Saladini, Angela AU - Saladini A FAU - Cuturello, Domenico AU - Cuturello D FAU - Missiroli, Bindo AU - Missiroli B FAU - Puddu, Paolo Emilio AU - Puddu PE LA - eng PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial PL - United States TA - J Cardiovasc Med (Hagerstown) JT - Journal of cardiovascular medicine (Hagerstown, Md.) JID - 101259752 RN - 0 (Peptides) RN - 0 (Platelet Aggregation Inhibitors) RN - 42HK56048U (Tyrosine) RN - GGX234SI5H (Tirofiban) RN - NA8320J834 (Eptifibatide) SB - IM MH - Aged MH - *Angioplasty MH - Eptifibatide MH - Female MH - Humans MH - Male MH - Middle Aged MH - Myocardial Ischemia/drug therapy/*therapy MH - Peptides/administration & dosage/*therapeutic use MH - Platelet Aggregation Inhibitors/administration & dosage/*therapeutic use MH - Tirofiban MH - Treatment Outcome MH - Tyrosine/administration & dosage/*analogs & derivatives/therapeutic use EDAT- 2010/07/20 06:00 MHDA- 2011/04/20 06:00 CRDT- 2010/07/20 06:00 PHST- 2010/07/20 06:00 [entrez] PHST- 2010/07/20 06:00 [pubmed] PHST- 2011/04/20 06:00 [medline] AID - 10.2459/JCM.0b013e32833cdd04 [doi] PST - ppublish SO - J Cardiovasc Med (Hagerstown). 2011 Jan;12(1):29-36. doi: 10.2459/JCM.0b013e32833cdd04. PMID- 20591890 OWN - NLM STAT- MEDLINE DCOM- 20110127 LR - 20100922 IS - 1569-9285 (Electronic) IS - 1569-9285 (Linking) VI - 11 IP - 4 DP - 2010 Oct TI - A prospective randomized study to evaluate the renal impact of surgical revascularization strategy in diabetic patients. PG - 406-10 LID - 10.1510/icvts.2009.230839 [doi] AB - Acute kidney injury (AKI) is a major postoperative complication following cardiac surgery. Diabetes mellitus is a major cause of nephropathy and end-stage renal failure. We aimed to evaluate the occurrence of adverse renal outcomes, in diabetic patients, between on-pump (CPB) and off-pump (OPCAB) coronary artery bypass graft (CABG). Seventy-one diabetic patients (36 and 35 patients in the CPB and OPCAB groups, respectively) were enrolled in a prospective randomized study. Renal tubular and glomerular functions, were monitored preoperatively and over five consecutive days. There was no significant difference between the groups in terms of age, gender, New York Heart Association class, Canadian Cardiovascular Society functional classification of angina grade and number of CABG. Intensive care unit stay, duration of intubation, hospital stay and bleeding were significantly higher in the CPB group. No significant differences in plasmatic creatinine, urinary creatinine, creatinine clearance, proteinuria or osmolality were detected. A significant rise in urinary albumine excretion occurred in both groups peaking on the operative day; for the on-pump CABG group (10+/-5 vs. 48+/-57; P=0.015) and for the OPCAB group (11+/-6 vs. 37+/-59; P=0.04). Values were less important in the OPCAB group and return to the baseline was faster than in the CPB group. OPCAB attenuates sub-clinical AKI, in diabetic patients. FAU - Modine, Thomas AU - Modine T AD - Department of Cardiovascular Surgery, Centre Hospitalier Regional et Universitaire de Lille, Lille, France. t-modine@chru-lille.fr FAU - Zannis, Costas AU - Zannis C FAU - Salleron, Julia AU - Salleron J FAU - Provot, Francois AU - Provot F FAU - Gourlay, Terence AU - Gourlay T FAU - Duhamel, Alain AU - Duhamel A FAU - Koussa, Mohamad AU - Koussa M FAU - Fayad, Georges AU - Fayad G LA - eng PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial DEP - 20100630 PL - England TA - Interact Cardiovasc Thorac Surg JT - Interactive cardiovascular and thoracic surgery JID - 101158399 SB - IM MH - Acute Kidney Injury/*etiology MH - Aged MH - Coronary Artery Bypass/*adverse effects MH - Coronary Artery Bypass, Off-Pump/*adverse effects MH - Coronary Artery Disease/complications/*surgery MH - Diabetes Complications/*complications MH - Female MH - Humans MH - Male MH - Middle Aged MH - Prospective Studies EDAT- 2010/07/02 06:00 MHDA- 2011/01/29 06:00 CRDT- 2010/07/02 06:00 PHST- 2010/07/02 06:00 [entrez] PHST- 2010/07/02 06:00 [pubmed] PHST- 2011/01/29 06:00 [medline] AID - icvts.2009.230839 [pii] AID - 10.1510/icvts.2009.230839 [doi] PST - ppublish SO - Interact Cardiovasc Thorac Surg. 2010 Oct;11(4):406-10. doi: 10.1510/icvts.2009.230839. Epub 2010 Jun 30. PMID- 20535581 OWN - NLM STAT- MEDLINE DCOM- 20110201 LR - 20261011 IS - 1993-0402 (Electronic) IS - 1672-0415 (Linking) VI - 16 IP - 5 DP - 2010 Oct TI - Effect of Xuefu Zhuyu Capsule (血府逐瘀胶囊) on the symptoms and signs and health-related quality of life in the unstable angina patients with blood-stasis syndrome after percutaneous coronary intervention: A Randomized controlled trial. PG - 399-405 LID - 10.1007/s11655-010-9999-9 [doi] AB - OBJECTIVE: Compared with Shengmai Capsule (生脉胶囊, SM), the study was conducted to evaluate the efficacy and safety of Xuefu Zhuyu Capsule (血府逐瘀胶囊, XFZY) on the symptoms and signs and health-related quality of life (HR-QOL) in the unstable angina (UA) patients with blood-stasis syndrome (BSS) after percutaneous coronary intervention (PCI). METHODS: A randomized, double-blinded, double-dummy, and placebo-controlled trial was applied. Ninety patients, diagnosed as UA and BSS after successful PCI, were enrolled and equally randomized into three groups, XFZY group, SM group, and placebo group, and administered with the corresponding medications respectively for four weeks. The clinical symptoms and signs (CSS), electrocardiography (ECG), and BSS scores were recorded and compared among groups during and after the treatment. Short-form 36 (SF-36) and Seattle Angina Questionnaire (SAQ) were applied to assess the HR-QOL in each group before and after the treatment. Safety indexes (blood routine and liver and kidney function tests) were also examined at the beginning and after the treatment. RESULTS: Eighty-six patients completed the whole study. After the treatment, the total effective rates of the XFZY group in ameliorating CSS and ECG were 76.7% and 60.0%, respectively, which were obviously higher than those in SM (CSS: 53.3%; ECG: 36.7%) and the placebo (CSS: 43.3%; ECG: 30.0%) groups. After one week's treatment, BSS scores slightly decreased in each group, but no significant differences were found among three groups (P>0.05). After four weeks' treatment, BSS scores in the XFZY group decreased to a lower level compared with SM (P <0.05) and the placebo (P <0.01) groups. After the treatment, the efficacy of XFZY group in improving body pain (BP), general health (GH), vitality (VT), society functioning (SF), role emotional (RE), angina stability (AS), angina frequency (AF), and treatment satisfaction (TS) were better than those in the placebo group (P <0.05,P <0.01). Meanwhile, the dimensions of BP, GH, SF, AS, AF, and TS were better improved than those in the SM group P <0.05). No obvious adverse reaction was found during and after the treatment except one case in the XFZY group reporting of stomach discomfort. CONCLUSIONS: Compared with SM Capsule treatment, a short-term treatment with XFZY Capsule exhibits better efficacy on CSS and BSS scores, and HR-QOL in UA patients with BSS after PCI. However, its long-term efficacy and safety still needs further investigation. FAU - Chu, Fu-yong AU - Chu FY AD - Department of Cardiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China. FAU - Wang, Jie AU - Wang J FAU - Yao, Kui-wu AU - Yao KW FAU - Li, Zhi-zhong AU - Li ZZ LA - eng SI - ClinicalTrials.gov/NCT00817024 PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20100610 PL - China TA - Chin J Integr Med JT - Chinese journal of integrative medicine JID - 101181180 RN - 0 (Drugs, Chinese Herbal) RN - 0 (Placebos) RN - 0 (Xue-Fu-Zhu-Yu decoction) SB - IM MH - Aged MH - Angina Pectoris/drug therapy/physiopathology/surgery MH - *Angioplasty, Balloon, Coronary MH - Double-Blind Method MH - Drugs, Chinese Herbal/administration & dosage/adverse effects/*therapeutic use MH - Electrocardiography MH - Female MH - Humans MH - Male MH - Middle Aged MH - Placebos MH - *Quality of Life EDAT- 2010/06/11 06:00 MHDA- 2011/02/02 06:00 CRDT- 2010/06/11 06:00 PHST- 2009/09/23 00:00 [received] PHST- 2010/06/11 06:00 [entrez] PHST- 2010/06/11 06:00 [pubmed] PHST- 2011/02/02 06:00 [medline] AID - 10.1007/s11655-010-9999-9 [doi] PST - ppublish SO - Chin J Integr Med. 2010 Oct;16(5):399-405. doi: 10.1007/s11655-010-9999-9. Epub 2010 Jun 10. PMID- 20527709 OWN - NLM STAT- MEDLINE DCOM- 20100920 LR - 20191111 IS - 1558-2035 (Electronic) IS - 1558-2027 (Linking) VI - 11 IP - 7 DP - 2010 Jul TI - Off-pump coronary revascularization in chronic dialysis-dependent patients: early outcomes at a single institution. PG - 481-7 AB - INTRODUCTION: Atherosclerotic vascular disease is the leading cause of morbidity and mortality in patients with end-stage renal disease. Several authors reported that chronic dialytic patients have a high operative risk when submitted to coronary artery bypass grafting (CABG) on cardiopulmonary bypass (CPB) whereas little information exists about off-pump myocardial revascularization in these patients. MATERIAL AND METHODS: Between January 2000 and December 2008, 17 consecutive patients (12 men, mean age of 62.3 +/- 12.3 years) with end-stage renal failure maintained on chronic hemodialysis underwent isolated off-pump CABG at our center. To evaluate this approach we compared the outcomes of off-pump revascularization with those obtained in the same period in 23 patients (20 men, mean age of 64.0 +/- 9.7 years), with the same preoperative features, who underwent conventional CABG on the arrested heart using CPB. RESULTS: Off-pump revascularization in end-stage renal disease patients showed a satisfactory incidence of mortality and morbidity rates. When compared with conventional CPB CABG group, off-pump patients had a lower incidence of bleeding, transfusions, ventilation support time, length of inotropic support and perioperative myocardial infarction. Also ICU and hospital stay and incidence of new-onset atrial fibrillation were lower in off-pump CABG patients. CONCLUSION: In our experience, avoidance of CPB in end-stage renal disease patients was associated with an acceptable incidence of postoperative complications and of major adverse events. Off-pump CABG is a safe and effective method of myocardial revascularization in chronically dialyzed patients that should strongly be taken in consideration when planning the surgical strategy in this selected cohort of patients, although multicentric prospective randomized controlled trials are strongly recommended. FAU - Bruschi, Giuseppe AU - Bruschi G AD - A De Gasperis Cardiology and Cardiac Surgery Department, Niguarda Ca' Granda Hospital, Milan, Italy. giuseppe.bruschi@fastwebnet.it FAU - Colombo, Tiziano AU - Colombo T FAU - Botta, Luca AU - Botta L FAU - Colombo, Paola AU - Colombo P FAU - Pelenghi, Stefano AU - Pelenghi S FAU - Trunfio, Salvatore AU - Trunfio S FAU - Cannata, Aldo AU - Cannata A FAU - Merlanti, Bruno AU - Merlanti B FAU - Paino, Roberto AU - Paino R FAU - Klugmann, Silvio AU - Klugmann S FAU - Martinelli, Luigi AU - Martinelli L LA - eng PT - Comparative Study PT - Journal Article PL - United States TA - J Cardiovasc Med (Hagerstown) JT - Journal of cardiovascular medicine (Hagerstown, Md.) JID - 101259752 SB - IM MH - Adult MH - Aged MH - *Coronary Artery Bypass/adverse effects/mortality MH - *Coronary Artery Bypass, Off-Pump/adverse effects/mortality MH - Coronary Artery Disease/complications/mortality/*surgery MH - Female MH - Humans MH - Italy MH - Kidney Failure, Chronic/complications/mortality/*therapy MH - Male MH - Middle Aged MH - *Renal Dialysis/adverse effects/mortality MH - Retrospective Studies MH - Risk Assessment MH - Risk Factors MH - Time Factors MH - Treatment Outcome EDAT- 2010/06/10 06:00 MHDA- 2010/09/21 06:00 CRDT- 2010/06/10 06:00 PHST- 2010/06/10 06:00 [entrez] PHST- 2010/06/10 06:00 [pubmed] PHST- 2010/09/21 06:00 [medline] AID - 10.2459/jcm.0b013e328335730a [doi] PST - ppublish SO - J Cardiovasc Med (Hagerstown). 2010 Jul;11(7):481-7. doi: 10.2459/jcm.0b013e328335730a. PMID- 20452234 OWN - NLM STAT- MEDLINE DCOM- 20110728 LR - 20220317 IS - 1873-734X (Electronic) IS - 1010-7940 (Linking) VI - 38 IP - 6 DP - 2010 Dec TI - Cold blood versus cold crystalloid cardioplegia: a prospective randomised study of 345 aortic valve patients. PG - 745-9 LID - 10.1016/j.ejcts.2010.03.052 [doi] AB - OBJECTIVE: Although experimental studies have indicated that blood cardioplegia may be superior to crystalloid cardioplegia for myocardial protection, clinical data still remain uncertain. In a previous randomised study from our institution, including 1440 patients undergoing coronary artery bypass grafting (CABG), no beneficial effects of blood cardioplegia were seen in any relevant outcome variables. The investigation was therefore extended to a patient population having longer pump times and ischaemic periods. METHODS: Over a 48-month period, all patients undergoing aortic valve replacement with or without CABG performed by two surgeons, were prospectively randomised to receive either intermittent cold retrograde blood cardioplegia (group B) or intermittent cold retrograde crystalloid cardioplegia (group C) during aortic cross-clamping. RESULTS: A total of 345 patients aged 28-90 years (median, 72 years) entered the study (group B, n=172, group C, n=173). All relevant demographic and operative variables were similar for both groups. As for the clinical course, no statistically significant differences were seen concerning spontaneous sinus rhythm after aortic declamping, use of inotropic drugs, duration of ventilatory support, bleeding and rate of allogeneic blood transfusions, perioperative myocardial infarction, episodes of atrial fibrillation, stroke or minor neurological dysfunction, renal function, infections, physical rehabilitation or mortality. Further, in the patients with the longest ischaemic times, no statistically significant differences between the groups could be demonstrated. CONCLUSIONS: There were no indications that retrograde cold blood cardioplegia was superior to retrograde cold crystalloid cardioplegia patients undergoing aortic valve replacement, with or without CABG. CI - Copyright (c) 2010 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved. FAU - Ovrum, Eivind AU - Ovrum E AD - Oslo Heart Center, Division of Cardiovascular and Respiratory Medicine and Surgery, Oslo University Hospital, Rikshospitalet, Box 2684, St. Hanshaugen, 0131 Oslo, Norway. eivind.ovrum@hjertesenteret.no FAU - Tangen, Geir AU - Tangen G FAU - Tollofsrud, Stein AU - Tollofsrud S FAU - Oystese, Rolf AU - Oystese R FAU - Ringdal, Mari-Anne L AU - Ringdal MA FAU - Istad, Reidar AU - Istad R LA - eng PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial DEP - 20100507 PL - Germany TA - Eur J Cardiothorac Surg JT - European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery JID - 8804069 RN - 0 (Cardioplegic Solutions) RN - 0 (Crystalloid Solutions) RN - 0 (Isotonic Solutions) SB - IM CIN - Eur J Cardiothorac Surg. 2012 Aug;42(2):383; author reply 383-4. doi: 10.1093/ejcts/ezs034. PMID: 22328625 MH - Aged MH - Aged, 80 and over MH - Aortic Valve/*surgery MH - Blood MH - Cardioplegic Solutions MH - Coronary Artery Bypass/methods MH - Crystalloid Solutions MH - Female MH - Heart Arrest, Induced/*methods MH - Heart Valve Prosthesis Implantation/*methods MH - Humans MH - Hypothermia, Induced/methods MH - Intraoperative Care/methods MH - Isotonic Solutions MH - Male MH - Middle Aged MH - Prospective Studies EDAT- 2010/05/11 06:00 MHDA- 2011/07/29 06:00 CRDT- 2010/05/11 06:00 PHST- 2010/01/05 00:00 [received] PHST- 2010/03/22 00:00 [revised] PHST- 2010/03/25 00:00 [accepted] PHST- 2010/05/11 06:00 [entrez] PHST- 2010/05/11 06:00 [pubmed] PHST- 2011/07/29 06:00 [medline] AID - S1010-7940(10)00332-5 [pii] AID - 10.1016/j.ejcts.2010.03.052 [doi] PST - ppublish SO - Eur J Cardiothorac Surg. 2010 Dec;38(6):745-9. doi: 10.1016/j.ejcts.2010.03.052. Epub 2010 May 7. PMID- 20438292 OWN - NLM STAT- MEDLINE DCOM- 20100630 LR - 20220321 IS - 1600-0455 (Electronic) IS - 0284-1851 (Linking) VI - 51 IP - 6 DP - 2010 Jul TI - B-type natriuretic peptide for prevention of contrast-induced nephropathy in patients with heart failure undergoing primary percutaneous coronary intervention. PG - 641-8 LID - 10.3109/02841851.2010.486804 [doi] AB - BACKGROUND: Contrast-induced nephropathy (CIN) is one of the leading causes of hospital-acquired renal failure and increase in the mortality and length of hospital stay after percutaneous coronary intervention (PCI). PURPOSE: To evaluate the protective effect of B-type natriuretic peptide (BNP) on CIN in patients with heart failure undergoing PCI. MATERIAL AND METHODS: In the prospective, placebo-controlled, randomized trial, 149 consecutive acute myocardial infarction (AMI) patients with heart failure undergoing primary PCI received recombinant human BNP (rhBNP) or placebo from the time of admission to 24 h after PCI. Serum creatinine (SCr) levels were measured to evaluate the protective effect of rhBNP on renal function. Estimated glomerular filtration rate (eGFR) was calculated by the simplified modification of diet in renal disease study equation. CIN was defined as a postprocedure peak increase in SCr of >0.5 mg/dl or >25% from baseline. RESULTS: The baseline characteristics were similar in the two groups. The SCr significantly increased after PCI, with the peak value at 48 h, and then began to decrease. At day 7 after PCI, the SCr had lowered to the baseline level in the BNP group, but it failed to do so in the control group. At 24, 48, and 72 h and 7 days after PCI, the SCr was lower in the BNP group than that in the control group. The eGFR decreased significantly after PCI, with the lowest value at 48 h, and then it began to increase. The eGFR after PCI was higher in the rhBNP group than that in the control group. The occurrence of CIN was significantly lower in the rhBNP group than in the control group. CONCLUSION: Periprocedural use of BNP could further promote the recovery of renal function and decrease the occurrence of CIN compared with routine treatment alone in patients with heart failure undergoing primary PCI. FAU - Zhang, Jing AU - Zhang J AD - Cardiology Interventional Center, Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China. FAU - Fu, Xianghua AU - Fu X FAU - Jia, Xinwei AU - Jia X FAU - Fan, Xinna AU - Fan X FAU - Gu, Xinshun AU - Gu X FAU - Li, Shiqiang AU - Li S FAU - Wu, Weili AU - Wu W FAU - Fan, Weize AU - Fan W FAU - Su, Jianling AU - Su J FAU - Hao, Guozhen AU - Hao G FAU - Jiang, Yunfa AU - Jiang Y FAU - Xue, Ling AU - Xue L LA - eng PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - England TA - Acta Radiol JT - Acta radiologica (Stockholm, Sweden : 1987) JID - 8706123 RN - 0 (Contrast Media) RN - 0 (Protective Agents) RN - 114471-18-0 (Natriuretic Peptide, Brain) RN - AYI8EX34EU (Creatinine) SB - IM MH - Aged MH - *Angioplasty MH - Contrast Media/*adverse effects MH - Creatinine/blood MH - Female MH - Glomerular Filtration Rate MH - Heart Failure/blood/*surgery MH - Humans MH - Kidney Diseases/blood/chemically induced/*prevention & control MH - Male MH - Middle Aged MH - Natriuretic Peptide, Brain/*therapeutic use MH - Protective Agents/*therapeutic use EDAT- 2010/05/05 06:00 MHDA- 2010/07/01 06:00 CRDT- 2010/05/05 06:00 PHST- 2010/05/05 06:00 [entrez] PHST- 2010/05/05 06:00 [pubmed] PHST- 2010/07/01 06:00 [medline] AID - 10.3109/02841851.2010.486804 [doi] PST - ppublish SO - Acta Radiol. 2010 Jul;51(6):641-8. doi: 10.3109/02841851.2010.486804. PMID- 20424250 OWN - NLM STAT- MEDLINE DCOM- 20100428 LR - 20220310 IS - 1538-3598 (Electronic) IS - 0098-7484 (Linking) VI - 303 IP - 16 DP - 2010 Apr 28 TI - Effect of B-vitamin therapy on progression of diabetic nephropathy: a randomized controlled trial. PG - 1603-9 LID - 10.1001/jama.2010.490 [doi] AB - CONTEXT: Hyperhomocysteinemia is frequently observed in patients with diabetic nephropathy. B-vitamin therapy (folic acid, vitamin B(6), and vitamin B(12)) has been shown to lower the plasma concentration of homocysteine. OBJECTIVE: To determine whether B-vitamin therapy can slow progression of diabetic nephropathy and prevent vascular complications. DESIGN, SETTING, AND PARTICIPANTS: A multicenter, randomized, double-blind, placebo-controlled trial (Diabetic Intervention with Vitamins to Improve Nephropathy [DIVINe]) at 5 university medical centers in Canada conducted between May 2001 and July 2007 of 238 participants who had type 1 or 2 diabetes and a clinical diagnosis of diabetic nephropathy. INTERVENTION: Single tablet of B vitamins containing folic acid (2.5 mg/d), vitamin B(6) (25 mg/d), and vitamin B(12) (1 mg/d), or matching placebo. MAIN OUTCOME MEASURES: Change in radionuclide glomerular filtration rate (GFR) between baseline and 36 months. Secondary outcomes were dialysis and a composite of myocardial infarction, stroke, revascularization, and all-cause mortality. Plasma total homocysteine was also measured. RESULTS: The mean (SD) follow-up during the trial was 31.9 (14.4) months. At 36 months, radionuclide GFR decreased by a mean (SE) of 16.5 (1.7) mL/min/1.73 m(2) in the B-vitamin group compared with 10.7 (1.7) mL/min/1.73 m(2) in the placebo group (mean difference, -5.8; 95% confidence interval [CI], -10.6 to -1.1; P = .02). There was no difference in requirement of dialysis (hazard ratio [HR], 1.1; 95% CI, 0.4-2.6; P = .88). The composite outcome occurred more often in the B-vitamin group (HR, 2.0; 95% CI, 1.0-4.0; P = .04). Plasma total homocysteine decreased by a mean (SE) of 2.2 (0.4) micromol/L at 36 months in the B-vitamin group compared with a mean (SE) increase of 2.6 (0.4) micromol/L in the placebo group (mean difference, -4.8; 95% CI, -6.1 to -3.7; P < .001, in favor of B vitamins). CONCLUSION: Among patients with diabetic nephropathy, high doses of B vitamins compared with placebo resulted in a greater decrease in GFR and an increase in vascular events. TRIAL REGISTRATION: isrctn.org Identifier: ISRCTN41332305. FAU - House, Andrew A AU - House AA AD - Division of Nephrology, University of Western Ontario, London, Ontario, Canada. FAU - Eliasziw, Misha AU - Eliasziw M FAU - Cattran, Daniel C AU - Cattran DC FAU - Churchill, David N AU - Churchill DN FAU - Oliver, Matthew J AU - Oliver MJ FAU - Fine, Adrian AU - Fine A FAU - Dresser, George K AU - Dresser GK FAU - Spence, J David AU - Spence JD LA - eng SI - ISRCTN/ISRCTN41332305 GR - MCT-41551/Canadian Institutes of Health Research/Canada PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - United States TA - JAMA JT - JAMA JID - 7501160 RN - 12001-76-2 (Vitamin B Complex) RN - 8059-24-3 (Vitamin B 6) RN - 935E97BOY8 (Folic Acid) RN - P6YC3EG204 (Vitamin B 12) SB - IM CIN - JAMA. 2010 Aug 11;304(6):636; author reply 636-7. doi: 10.1001/jama.2010.1105. PMID: 20699451 CIN - JAMA. 2010 Aug 11;304(6):636; author reply 636-7. doi: 10.1001/jama.2010.1104. PMID: 20699452 CIN - Evid Based Med. 2011 Feb;16(1):14-5. doi: 10.1136/ebm1141. PMID: 21047842 MH - Aged MH - Diabetic Nephropathies/*complications/drug therapy MH - Double-Blind Method MH - Female MH - Folic Acid/*administration & dosage/adverse effects MH - Glomerular Filtration Rate MH - Humans MH - Hyperhomocysteinemia/*drug therapy/etiology MH - Kidney/drug effects/physiopathology MH - Male MH - Middle Aged MH - Vitamin B 12/*administration & dosage/adverse effects MH - Vitamin B 6/*administration & dosage/adverse effects MH - Vitamin B Complex/*administration & dosage/adverse effects EDAT- 2010/04/29 06:00 MHDA- 2010/04/29 06:01 CRDT- 2010/04/29 06:00 PHST- 2010/04/29 06:00 [entrez] PHST- 2010/04/29 06:00 [pubmed] PHST- 2010/04/29 06:01 [medline] AID - 303/16/1603 [pii] AID - 10.1001/jama.2010.490 [doi] PST - ppublish SO - JAMA. 2010 Apr 28;303(16):1603-9. doi: 10.1001/jama.2010.490. PMID- 20409690 OWN - NLM STAT- MEDLINE DCOM- 20100930 LR - 20260518 IS - 0914-5087 (Print) IS - 0914-5087 (Linking) VI - 56 IP - 1 DP - 2010 Jul TI - Rationale and design of the NAGOYA HEART Study: comparison between valsartan and amlodipine regarding morbidity and mortality in patients with hypertension and glucose intolerance. PG - 111-7 LID - 10.1016/j.jjcc.2010.03.004 [doi] AB - BACKGROUND: Inhibitors of the renin angiotensin system are recommended as the first-line medications for diabetic hypertensive patients. However, there is less evidence supporting this recommendation especially among East Asians, a population with a unique distribution of cardiovascular disease compared to the Western population. METHODS AND RESULTS: The NAGOYA HEART Study is a prospective randomized open-label blinded-endpoint study to compare an angiotensin II receptor blocker, valsartan, and a calcium channel blocker, amlodipine, regarding their efficacies on cardiovascular morbidity and mortality in Japanese hypertensive patients with glucose intolerance. Of 1168 eligible patients, we enrolled 1150 patients from October 2004 to January 2009. The participants will be followed for more than a median follow-up period of 3 years. The primary composite endpoint includes myocardial infarction, stroke, coronary revascularization, and admission due to congestive heart failure or sudden cardiac death. Any of these events are adjudicated by an independent committee under blinded information regarding the treatment arm. Secondary endpoints include all-cause mortality, changes in glucose tolerance status, kidney function, left ventricular structure measured by echocardiogram, and incident atrial fibrillation/flutter. The study was registered at ClinicalTrials.gov NCT00129233. CONCLUSION: The NAGOYA HEART Study will provide us with a relevant insight for appropriate treatment of hypertension with glucose intolerance. CI - Copyright 2010 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved. FAU - Matsushita, Kunihiro AU - Matsushita K AD - Department of Cardiology, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya 466-8550, Japan. FAU - Muramatsu, Takashi AU - Muramatsu T FAU - Kondo, Takahisa AU - Kondo T FAU - Maeda, Kengo AU - Maeda K FAU - Shintani, Satoshi AU - Shintani S FAU - Murohara, Toyoaki AU - Murohara T CN - NAGOYA HEART Study Group LA - eng SI - ClinicalTrials.gov/NCT00129233 PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial DEP - 20100420 PL - Netherlands TA - J Cardiol JT - Journal of cardiology JID - 8804703 RN - 0 (Angiotensin II Type 1 Receptor Blockers) RN - 0 (Antihypertensive Agents) RN - 0 (Calcium Channel Blockers) RN - 0 (Tetrazoles) RN - 1J444QC288 (Amlodipine) RN - 80M03YXJ7I (Valsartan) RN - HG18B9YRS7 (Valine) SB - IM EIN - J Cardiol. 2015 Mar;65(3):259. PMID: 25927094 MH - Adult MH - Aged MH - Amlodipine/*therapeutic use MH - Angiotensin II Type 1 Receptor Blockers/*therapeutic use MH - Antihypertensive Agents/*therapeutic use MH - Calcium Channel Blockers/*therapeutic use MH - Diabetes Complications/*drug therapy MH - Humans MH - Hypertension/*drug therapy MH - Middle Aged MH - Prospective Studies MH - Tetrazoles/*therapeutic use MH - Valine/*analogs & derivatives/therapeutic use MH - Valsartan FIR - Murohara, Toyoaki IR - Murohara T FIR - Kondo, Takahisa IR - Kondo T FIR - Shintani, Satoshi IR - Shintani S FIR - Maeda, Kengo IR - Maeda K FIR - Matsushita, Kunihiro IR - Matsushita K FIR - Muramatsu, Takashi IR - Muramatsu T FIR - Watarai, Masato IR - Watarai M FIR - Marui, Nobuyuki IR - Marui N FIR - Takanaka, Chiei IR - Takanaka C FIR - Ohno, Miyoshi IR - Ohno M FIR - Obayashi, Toshihiro IR - Obayashi T FIR - Kondo, Taizo IR - Kondo T FIR - Takada, Yasunobu IR - Takada Y FIR - Iwama, Yoshio IR - Iwama Y FIR - Akahoshi, Makoto IR - Akahoshi M FIR - Iida, Masato IR - Iida M FIR - Hirayama, Haruo IR - Hirayama H FIR - Sone, Shizuoka IR - Sone S FIR - Ohno, Osamu IR - Ohno O FIR - Kaneko, Shinji IR - Kaneko S FIR - Ichimiya, Satoshi IR - Ichimiya S FIR - Matsubara, Tatsuaki IR - Matsubara T FIR - Komori, Kimihiro IR - Komori K FIR - Doyu, Manabu IR - Doyu M FIR - Toyoshima, Hideaki IR - Toyoshima H FIR - Oiso, Yutaka IR - Oiso Y FIR - Hirai, Makoto IR - Hirai M FIR - Murohara, Toyoaki IR - Murohara T FIR - Kondo, Takahisa IR - Kondo T FIR - Shintani, Satoshi IR - Shintani S FIR - Maeda, Kengo IR - Maeda K FIR - Matsushita, Kunihiro IR - Matsushita K FIR - Muramatsu, Takashi IR - Muramatsu T FIR - Sasaki, Kumi IR - Sasaki K FIR - Watanabe, Emiko IR - Watanabe E FIR - Inoue, Yoko IR - Inoue Y FIR - Shirahashi, Nobuo IR - Shirahashi N EDAT- 2010/04/23 06:00 MHDA- 2010/10/01 06:00 CRDT- 2010/04/23 06:00 PHST- 2010/01/14 00:00 [received] PHST- 2010/03/15 00:00 [revised] PHST- 2010/03/17 00:00 [accepted] PHST- 2010/04/23 06:00 [entrez] PHST- 2010/04/23 06:00 [pubmed] PHST- 2010/10/01 06:00 [medline] AID - S0914-5087(10)00058-4 [pii] AID - 10.1016/j.jjcc.2010.03.004 [doi] PST - ppublish SO - J Cardiol. 2010 Jul;56(1):111-7. doi: 10.1016/j.jjcc.2010.03.004. Epub 2010 Apr 20. PMID- 20375690 OWN - NLM STAT- MEDLINE DCOM- 20100602 LR - 20250529 IS - 1538-2990 (Electronic) IS - 0002-9629 (Print) IS - 0002-9629 (Linking) VI - 339 IP - 5 DP - 2010 May TI - High prevalence and diversity of kidney dysfunction in patients with type 2 diabetes mellitus and coronary artery disease: the BARI 2D baseline data. PG - 401-10 LID - 10.1097/MAJ.0b013e3181d430ad [doi] AB - BACKGROUND: We describe baseline renal function and albumin excretion rate in patients enrolled in Bypass Angioplasty Revascularization Investigation 2 Diabetes, a randomized clinical trial comparing the impact of revascularization and medical therapy with medical therapy alone and deferred or no revascularization and the impact of glycemic control with either insulin-providing or insulin-sensitizing drugs, on 5-year mortality. METHODS: Study participants had type 2 diabetes mellitus, documented coronary artery disease, and creatinine <2 mg/dL. Albuminuria status (albumin/creatinine ratio [ACR]) and estimated glomerular filtration rate (eGFR), using the abbreviated Modified Diet in Renal Disease equation, were determined at baseline. Univariate and multivariate relationships between baseline clinical characteristics and the presence of albuminuria and reduced eGFR rate were estimated. RESULTS: Two thousand one hundred forty-six subjects were included in the analysis. Forty-three percent of the cohort had evidence of kidney dysfunction at baseline: 23% had an eGFR > or =60 mL/min/1.73 m with either microalbuminuria ( >30 ACR; 17%) or macroalbuminuria (>300 ACR; 6%). Twenty-one percent had a reduced eGFR <60 mL/min/1.73 m; 52% with reduced eGFR had no albuminuria; 28% had microalbuminuria, and 20% had macroalbuminuria. Race, smoking status, duration of diabetes, hypertension, hemoglobin A1c, triglycerides, vascular disease, abnormal ejection fraction, and reduced eGFR were associated with greater albuminuria. Age, sex, duration of diabetes, ACR, hemoglobin A1c, high density lipoprotein, and number of hypertensive medications were associated with reduced eGFR. CONCLUSION: Kidney dysfunction is common in older patients with type 2 diabetes mellitus and coronary artery disease; Albuminuria was present in 33%. Reduced eGFR was present in 21%, and half the patients with reduced eGFR had no evidence of albuminuria. FAU - Wall, Barry M AU - Wall BM AD - Veterans Affairs Medical Center, University of Tennessee Health Science Center, Memphis, Tennessee 38104, USA. Barry.Wall@med.va.gov FAU - Hardison, Regina M AU - Hardison RM FAU - Molitch, Mark E AU - Molitch ME FAU - Marroquin, Oscar C AU - Marroquin OC FAU - McGill, Janet B AU - McGill JB FAU - August, Phyllis A AU - August PA CN - BARI 2D Study Group LA - eng GR - U01 HL061744/HL/NHLBI NIH HHS/United States GR - U01 HL061746/HL/NHLBI NIH HHS/United States GR - U01 HL061748/HL/NHLBI NIH HHS/United States GR - U01 HL063804/HL/NHLBI NIH HHS/United States PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't PL - United States TA - Am J Med Sci JT - The American journal of the medical sciences JID - 0370506 SB - IM MH - Aged MH - Aged, 80 and over MH - Albuminuria MH - Coronary Artery Bypass MH - Coronary Artery Disease/*complications MH - Diabetes Mellitus, Type 2/*complications MH - Female MH - Humans MH - Male MH - Renal Insufficiency/*complications PMC - PMC4312489 MID - NIHMS201742 EDAT- 2010/04/09 06:00 MHDA- 2010/06/03 06:00 PMCR- 2015/01/31 CRDT- 2010/04/09 06:00 PHST- 2010/04/09 06:00 [entrez] PHST- 2010/04/09 06:00 [pubmed] PHST- 2010/06/03 06:00 [medline] PHST- 2015/01/31 00:00 [pmc-release] AID - S0002-9629(15)31594-9 [pii] AID - 10.1097/MAJ.0b013e3181d430ad [doi] PST - ppublish SO - Am J Med Sci. 2010 May;339(5):401-10. doi: 10.1097/MAJ.0b013e3181d430ad. PMID- 20372752 OWN - NLM STAT- MEDLINE DCOM- 20100805 LR - 20200825 IS - 2972-4066 (Electronic) IS - 0304-4602 (Linking) VI - 39 IP - 3 DP - 2010 Mar TI - Reperfusion strategy and mortality in ST-elevation myocardial infarction among patients with and without impaired renal function. PG - 179-84 AB - INTRODUCTION: Several randomised controlled trials have demonstrated better outcomes with primary percutaneous coronary intervention (PCI) over fibrinolytic therapy in the treatment of patients with ST-segment elevation myocardial infarction (STEMI) and normal renal function. Whether this benefit extends to patients with impaired renal function is uncertain. MATERIALS AND METHODS: We studied 1672 patients with STEMI within 12 hours of symptom onset who were admitted to 2 major public hospitals in Singapore from 2000 to 2002. All patients received either upfront fibrinolytic or PCI as determined by the attending cardiologist. Serum creatinine was measured on admission and the glomerular filtration rate (GFR) was determined using the Modification of Diet in Renal Disease equation. The impact of reperfusion strategy on 30-ay mortality was then determined for patients with GFR > or =60 mL min-(1) 1.73 m-(2) and GFR <60 mL min-(1) 1.73 m-(2). RESULTS: The mean age was 56 +/- 12 years (85% male) and mean GFR was 81 +/- 30 mL min-(1) 1.73 m-(2). Unadjusted 30-day mortality rates for fibrinolytic-treated vs primary PCI-treated patients were 29.4% vs 17.9%, P <0.05, in the impaired renal function group and 5.4% vs 3.1%, P <0.05, in the normal renal function group. After adjusting for covariates, primary PCI was associated with a significantly lower mortality in the normal renal function group [odds ratio (OR), 0.41; 95% confidence interval (CI), 0.19-0.89] but not in the impaired renal function group [OR, 0.70; 95% CI, 0.31-1.60]. CONCLUSIONS: Primary PCI was associated with improved 30-day survival among patients with normal renal function but not among those with impaired renal function. Randomised trials are needed to study the relative efficacy of both reperfusion strategies in patients with impaired renal function. FAU - Chan, Mark Y AU - Chan MY AD - National University Heart Centre, Singapore, Singapore. chanyymark@gmail.com FAU - Becker, Richard C AU - Becker RC FAU - Sim, Ling-Ling AU - Sim LL FAU - Tan, Virlynn AU - Tan V FAU - Lee, Chi-Hang AU - Lee CH FAU - Low, Adrian F H AU - Low AF FAU - Teo, Swee-Guan AU - Teo SG FAU - Ng, Kheng-Siang AU - Ng KS FAU - Tan, Huay-Cheem AU - Tan HC FAU - Yeo, Tiong-Cheng AU - Yeo TC LA - eng PT - Journal Article PT - Multicenter Study PL - Singapore TA - Ann Acad Med Singap JT - Annals of the Academy of Medicine, Singapore JID - 7503289 RN - 0 (Antifibrinolytic Agents) SB - IM MH - Adult MH - *Angioplasty, Balloon, Coronary MH - Antifibrinolytic Agents/therapeutic use MH - Electrocardiography MH - Female MH - Glomerular Filtration Rate MH - Humans MH - Male MH - Middle Aged MH - Myocardial Infarction/*complications/drug therapy/*surgery MH - Registries MH - Renal Insufficiency, Chronic/*complications MH - Retrospective Studies MH - Survival Analysis EDAT- 2010/04/08 06:00 MHDA- 2010/08/06 06:00 CRDT- 2010/04/08 06:00 PHST- 2010/04/08 06:00 [entrez] PHST- 2010/04/08 06:00 [pubmed] PHST- 2010/08/06 06:00 [medline] PST - ppublish SO - Ann Acad Med Singap. 2010 Mar;39(3):179-84. PMID- 20350512 OWN - NLM STAT- MEDLINE DCOM- 20100826 LR - 20101118 IS - 0914-5087 (Print) IS - 0914-5087 (Linking) VI - 55 IP - 3 DP - 2010 May TI - Mid-term mortality of very elderly patients with acute myocardial infarction with or without coronary intervention. PG - 397-403 LID - 10.1016/j.jjcc.2010.01.004 [doi] AB - BACKGROUND: The risk benefit of percutaneous coronary intervention (PCI) in very elderly patients with acute myocardial infarction (AMI) is currently unclear. Here, we aim to identify the characteristics of these patients and clarify their mid-term mortality rate with or without PCI. METHODS AND RESULTS: 77 patients (> or =80 years) were chosen from 506 patients with AMI, and treated with (n=32) or without (n=45) PCI. The mean age and time from onset to admission increased in patients having undergone no PCI. The reasons for PCI refusal were patient/family preference (40%), renal dysfunction (17.8%), or cognitive impairment (13.3%). Patients treated with PCI had lower mid-term mortality than those without PCI (34.4% vs 62.2%; p=0.02), while patients taking beta-blockers displayed a significantly lower mortality rate than those without (18.2% vs 63.6%; p=0.0003). Cognitively impaired patients had a higher mortality rate compared with cognitively normal patients (80.0% vs 46.3%; p=0.005). Multivariate analysis indicated that systolic blood pressure on admission, PCI, and beta-blocker therapy independently decreased mid-term mortality in these patients. CONCLUSIONS: PCI and beta-blocker therapy displayed significantly beneficial effects on mid-term mortality in very elderly AMI patients. Elderly-specific trials concerning coexisting disorders are needed to further examine the treatment-related benefits. CI - Copyright 2010 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved. FAU - Kashima, Katsuro AU - Kashima K AD - Department of Cardiology, National Hospital Organization, Kagoshima Medical Center, 8-1 Shiroyama-cho, Kagoshima 892-0853, Japan. k-kashima@kagomc2.hosp.go.jp FAU - Ikeda, Daisuke AU - Ikeda D FAU - Tanaka, Hideki AU - Tanaka H FAU - Yamashita, Erika AU - Yamashita E FAU - Nagayoshi, Shinya AU - Nagayoshi S FAU - Yoshishige, Yusuke AU - Yoshishige Y FAU - Tanoue, Kazuyuki AU - Tanoue K FAU - Nagano, Shinjirou AU - Nagano S FAU - Nuruki, Norihito AU - Nuruki N FAU - Yoshinaga, Masao AU - Yoshinaga M FAU - Sonoda, Masahiro AU - Sonoda M LA - eng PT - Journal Article DEP - 20100218 PL - Netherlands TA - J Cardiol JT - Journal of cardiology JID - 8804703 RN - 0 (Adrenergic beta-Antagonists) SB - IM MH - Adrenergic beta-Antagonists/therapeutic use MH - Aged, 80 and over MH - *Angioplasty, Balloon, Coronary MH - Blood Pressure MH - Cause of Death MH - Cognition Disorders/complications MH - Coronary Angiography MH - Female MH - Humans MH - Male MH - Myocardial Infarction/*mortality/*therapy MH - Treatment Refusal EDAT- 2010/03/31 06:00 MHDA- 2010/08/27 06:00 CRDT- 2010/03/31 06:00 PHST- 2009/09/15 00:00 [received] PHST- 2010/01/12 00:00 [revised] PHST- 2010/01/13 00:00 [accepted] PHST- 2010/03/31 06:00 [entrez] PHST- 2010/03/31 06:00 [pubmed] PHST- 2010/08/27 06:00 [medline] AID - S0914-5087(10)00014-6 [pii] AID - 10.1016/j.jjcc.2010.01.004 [doi] PST - ppublish SO - J Cardiol. 2010 May;55(3):397-403. doi: 10.1016/j.jjcc.2010.01.004. Epub 2010 Feb 18. PMID- 20332382 OWN - NLM STAT- MEDLINE DCOM- 20100914 LR - 20131121 IS - 1941-7632 (Electronic) IS - 1941-7640 (Linking) VI - 3 IP - 2 DP - 2010 Apr TI - Incidence, predictors, and prognostic implications of hospitalization for late bleeding after percutaneous coronary intervention for patients older than 65 years. PG - 140-7 LID - 10.1161/CIRCINTERVENTIONS.109.928721 [doi] AB - BACKGROUND: Previous data on bleeding after percutaneous coronary intervention (PCI) have been obtained primarily from randomized trials that focused on in-hospital bleeding. The incidence of late bleeding after PCI, its independent predictors, and its prognostic importance in clinical practice has not been fully addressed. METHODS AND RESULTS: We evaluated 22 798 patients aged >65 years who underwent PCI from December 1, 2003, to March 31, 2007, in Ontario, Canada. Cox proportional hazard models were used to determine factors associated with late bleeding, which was defined as hospitalization for bleeding after discharge from the index PCI, and to estimate risk of death or myocardial infarction associated with late bleeding. We found that 2.5% of patients were hospitalized for bleeding in the year after PCI, with 56% of bleeding episodes due to gastrointestinal bleed. The most significant predictor of late bleeding was warfarin use after PCI (hazard ratio [HR], 3.12). Other significant predictors included age (HR, 1.41 per 10 years), male sex (HR, 1.24), cancer (HR, 1.80), previous bleeding (HR, 2.42), chronic kidney disease (HR, 1.93), and nonsteroidal antiinflammatory drug use (HR, 1.73). After adjusting for baseline covariates, hospitalization for a bleeding episode was associated with a significantly increased 1-year hazard of death or myocardial infarction (HR, 2.39; 95% CI, 1.93 to 2.97) and death (HR, 3.38; 95% CI, 2.60 to 4.40). CONCLUSIONS: Hospitalization for late bleeding after PCI is associated with substantially increased risk of death and myocardial infarction. The use of triple therapy (i.e., aspirin, thienopyridine, and warfarin) is associated with the highest risk of late bleeding. FAU - Ko, Dennis T AU - Ko DT AD - Institute for Clinical Evaluative Sciences, Division of Cardiology, Schulich Heart Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. dennis.ko@ices.on.ca FAU - Yun, Lingsong AU - Yun L FAU - Wijeysundera, Harindra C AU - Wijeysundera HC FAU - Jackevicius, Cynthia A AU - Jackevicius CA FAU - Rao, Sunil V AU - Rao SV FAU - Austin, Peter C AU - Austin PC FAU - Marquis, Jean-Francois AU - Marquis JF FAU - Tu, Jack V AU - Tu JV LA - eng GR - MOP 82747/Canadian Institutes of Health Research/Canada PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20100323 PL - United States TA - Circ Cardiovasc Interv JT - Circulation. Cardiovascular interventions JID - 101499602 RN - 0 (Anticoagulants) RN - 5Q7ZVV76EI (Warfarin) SB - IM MH - Age Factors MH - Aged MH - Aged, 80 and over MH - Angioplasty, Balloon, Coronary/*adverse effects MH - Anticoagulants/therapeutic use MH - Coronary Artery Disease/*diagnosis/*epidemiology/physiopathology/therapy MH - Female MH - Hospitalization MH - Humans MH - Incidence MH - Male MH - Myocardial Infarction/*etiology/mortality MH - Postoperative Hemorrhage/*etiology/mortality MH - Prognosis MH - Risk Factors MH - Survival Analysis MH - Warfarin/therapeutic use EDAT- 2010/03/25 06:00 MHDA- 2010/09/15 06:00 CRDT- 2010/03/25 06:00 PHST- 2010/03/25 06:00 [entrez] PHST- 2010/03/25 06:00 [pubmed] PHST- 2010/09/15 06:00 [medline] AID - CIRCINTERVENTIONS.109.928721 [pii] AID - 10.1161/CIRCINTERVENTIONS.109.928721 [doi] PST - ppublish SO - Circ Cardiovasc Interv. 2010 Apr;3(2):140-7. doi: 10.1161/CIRCINTERVENTIONS.109.928721. Epub 2010 Mar 23. PMID- 20298505 OWN - NLM STAT- MEDLINE DCOM- 20120627 LR - 20131121 IS - 1445-5994 (Electronic) IS - 1444-0903 (Linking) VI - 41 IP - 12 DP - 2011 Dec TI - Advanced chronic kidney disease, cardiovascular events and the effect of diabetes: data from the Atherosclerosis and Folic Acid Supplementation Trial. PG - 825-32 LID - 10.1111/j.1445-5994.2010.02226.x [doi] AB - BACKGROUND: End-stage kidney disease registry data have reported increased mortality in patients with diabetes as compared with those without. Here we examine whether diabetes is independently associated with an increased risk of major cardiovascular events and death in patients with advanced chronic kidney disease (CKD). METHODS: Data from 315 participants with CKD in the Atherosclerosis and Folic Acid Supplementation Trial (ASFAST) were assessed. Primary end-points were fatal or non-fatal cardiovascular events, including myocardial infarction, stroke, unstable angina, coronary revascularisation and peripheral vascular events assessed both jointly and separately using Cox-proportional hazard models. RESULTS: Twenty-three per cent reported diabetes. Median follow up was 3.6 years. In those with diabetes, an increased risk for major cardiovascular events was observed, crude hazard ratio (HR) 2.87 (95% confidence interval (CI) 2.11-3.90). After adjustment for age, gender, smoking, systolic blood pressure, body mass index, past ischaemic heart disease and use of preventive therapies, diabetes was associated with an HR of 1.83 (1.28-2.61) for major cardiovascular events. The risk for peripheral vascular events was also increased, adjusted HR 6.31 (2.61-15.25). For all-cause death, major coronary and stroke events, the risk in those with diabetes was not significantly increased (all-cause death, adjusted HR 1.31 (95% CI 0.80-2.14); major coronary events, adjusted HR 1.26 (95% CI 0.64-2.49); and major stroke events, adjusted HR 1.28 (95% CI 0.55-2.99)). CONCLUSIONS: Diabetes significantly increases the risk of major cardiovascular events, especially peripheral vascular events in patients with advanced CKD. Trials of multifactorial management of cardiovascular risk factors are required to determine if outcomes for this population may be improved. CI - (c) 2011 The Authors. Internal Medicine Journal (c) 2011 Royal Australasian College of Physicians. FAU - Zoungas, S AU - Zoungas S AD - School of Public Health, Monash University, Melbourne, Victoria, Australia. sophia.zoungas@med.monash.edu.au FAU - Lui, M AU - Lui M FAU - Kerr, P G AU - Kerr PG FAU - Teede, H J AU - Teede HJ FAU - McNeil, J J AU - McNeil JJ FAU - McGrath, B P AU - McGrath BP FAU - Polkinghorne, K R AU - Polkinghorne KR LA - eng PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial DEP - 20100318 PL - Australia TA - Intern Med J JT - Internal medicine journal JID - 101092952 RN - 935E97BOY8 (Folic Acid) SB - IM MH - Adult MH - Aged MH - Atherosclerosis/drug therapy/*epidemiology MH - Cardiovascular Diseases/drug therapy/*epidemiology MH - Diabetes Mellitus/drug therapy/*epidemiology MH - *Dietary Supplements MH - Double-Blind Method MH - Female MH - Folic Acid/*therapeutic use MH - Follow-Up Studies MH - Humans MH - Kidney Failure, Chronic/drug therapy/*epidemiology MH - Male MH - Middle Aged MH - Risk Factors EDAT- 2010/03/20 06:00 MHDA- 2012/06/28 06:00 CRDT- 2010/03/20 06:00 PHST- 2010/03/20 06:00 [entrez] PHST- 2010/03/20 06:00 [pubmed] PHST- 2012/06/28 06:00 [medline] AID - IMJ2226 [pii] AID - 10.1111/j.1445-5994.2010.02226.x [doi] PST - ppublish SO - Intern Med J. 2011 Dec;41(12):825-32. doi: 10.1111/j.1445-5994.2010.02226.x. Epub 2010 Mar 18. PMID- 20206456 OWN - NLM STAT- MEDLINE DCOM- 20100506 LR - 20220408 IS - 1558-3597 (Electronic) IS - 0735-1097 (Linking) VI - 55 IP - 12 DP - 2010 Mar 23 TI - Efficacy of rosuvastatin among men and women with moderate chronic kidney disease and elevated high-sensitivity C-reactive protein: a secondary analysis from the JUPITER (Justification for the Use of Statins in Prevention-an Intervention Trial Evaluating Rosuvastatin) trial. PG - 1266-1273 LID - S0735-1097(10)00587-5 [pii] LID - 10.1016/j.jacc.2010.01.020 [doi] AB - OBJECTIVES: We evaluated the efficacy of statin therapy in primary prevention among individuals with moderate chronic kidney disease (CKD). BACKGROUND: Whether patents with moderate CKD (estimated glomerular filtration rate [eGFR] <60 ml/min/1.73 m(2)) benefit from statin therapy is uncertain, particularly among those without hyperlipidemia or known cardiovascular disease. METHODS: Within the JUPITER (Justification for the Use of statins in Prevention-an Intervention Trial Evaluating Rosuvastatin) primary prevention trial of rosuvastatin 20 mg compared with placebo among men and women free of cardiovascular disease who had low-density lipoprotein cholesterol (LDL-C) <130 mg/dl and high-sensitivity C-reactive protein (hsCRP) >or=2 mg/l, we performed a secondary analysis comparing cardiovascular and mortality outcomes among those with moderate CKD at study entry (n = 3,267) with those with baseline eGFR >or=60 ml/min/1.73 m(2) (n = 14,528). Median follow-up was 1.9 years (maximum 5 years). RESULTS: Compared with those with eGFR >or=60 ml/min/1.73 m(2), JUPITER participants with moderate CKD had higher vascular event rates (hazard ratio [HR]: 1.54, 95% confidence interval [CI]: 1.23 to 1.92, p = 0.0002). Among those with moderate CKD, rosuvastatin was associated with a 45% reduction in risk of myocardial infarction, stroke, hospital stay for unstable angina, arterial revascularization, or confirmed cardiovascular death (HR: 0.55, 95% CI: 0.38 to 0.82, p = 0.002) and a 44% reduction in all-cause mortality (HR: 0.56, 95% CI: 0.37 to 0.85, p = 0.005). Median LDL-C and hsCRP reductions as well as side effect profiles associated with rosuvastatin were similar among those with and without CKD. Median eGFR at 12 months was marginally improved among those allocated to rosuvastatin as compared with placebo. CONCLUSIONS: Rosuvastatin reduces first cardiovascular events and all-cause mortality among men and women with LDL-C <130 mg/dl, elevated hsCRP, and concomitant evidence of moderate CKD. (JUPITER-Crestor 20 mg Versus Placebo in Prevention of Cardiovascular [CV] Events; NCT00239681). CI - Copyright (c) 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Ridker, Paul M AU - Ridker PM AD - Center for Cardiovascular Disease Prevention, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: pridker@partners.org. FAU - MacFadyen, Jean AU - MacFadyen J AD - Center for Cardiovascular Disease Prevention, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. FAU - Cressman, Michael AU - Cressman M AD - AstraZeneca, Wilmington, Delaware. FAU - Glynn, Robert J AU - Glynn RJ AD - Center for Cardiovascular Disease Prevention, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. LA - eng SI - ClinicalTrials.gov/NCT00239681 PT - Clinical Trial PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't DEP - 20100304 PL - United States TA - J Am Coll Cardiol JT - Journal of the American College of Cardiology JID - 8301365 RN - 0 (Biomarkers) RN - 0 (Fluorobenzenes) RN - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors) RN - 0 (Pyrimidines) RN - 0 (Sulfonamides) RN - 83MVU38M7Q (Rosuvastatin Calcium) RN - 9007-41-4 (C-Reactive Protein) SB - IM CIN - J Am Coll Cardiol. 2010 Aug 3;56(6):528; author reply 530. doi: 10.1016/j.jacc.2010.04.025. PMID: 20670769 CIN - J Am Coll Cardiol. 2010 Aug 3;56(6):529. doi: 10.1016/j.jacc.2010.04.027. PMID: 20670770 MH - Aged MH - Biomarkers/analysis MH - C-Reactive Protein/*analysis MH - Female MH - Fluorobenzenes/*pharmacology MH - Humans MH - Hydroxymethylglutaryl-CoA Reductase Inhibitors/*pharmacology MH - Male MH - Middle Aged MH - Primary Prevention MH - Pyrimidines/*pharmacology MH - Renal Insufficiency, Chronic/*drug therapy MH - Rosuvastatin Calcium MH - Severity of Illness Index MH - Sulfonamides/*pharmacology EDAT- 2010/03/09 06:00 MHDA- 2010/05/07 06:00 CRDT- 2010/03/09 06:00 PHST- 2009/12/09 00:00 [received] PHST- 2010/01/20 00:00 [revised] PHST- 2010/01/25 00:00 [accepted] PHST- 2010/03/09 06:00 [entrez] PHST- 2010/03/09 06:00 [pubmed] PHST- 2010/05/07 06:00 [medline] AID - S0735-1097(10)00587-5 [pii] AID - 10.1016/j.jacc.2010.01.020 [doi] PST - ppublish SO - J Am Coll Cardiol. 2010 Mar 23;55(12):1266-1273. doi: 10.1016/j.jacc.2010.01.020. Epub 2010 Mar 4. PMID- 20185789 OWN - NLM STAT- MEDLINE DCOM- 20100503 LR - 20161122 IS - 1524-4628 (Electronic) IS - 0039-2499 (Linking) VI - 41 IP - 4 DP - 2010 Apr TI - Carotid artery stenting in octogenarians: periprocedural stroke risk predictor analysis from the multicenter Carotid ACCULINK/ACCUNET Post Approval Trial to Uncover Rare Events (CAPTURE 2) clinical trial. PG - 757-64 LID - 10.1161/STROKEAHA.109.569426 [doi] AB - BACKGROUND AND PURPOSE: Carotid ACCULINK/ACCUNET Post Approval Trial to Uncover Rare Events (CAPTURE 2) is an ongoing prospective, nonrandomized, multicenter clinical trial enrolling patients undergoing carotid artery stenting. The aim of this analysis is to identify risk predictors for periprocedural stroke in patients > or = 80 years old. METHODS: Symptomatic patients with > or = 50% stenosis and asymptomatic patients with > or = 80% stenosis were enrolled. Patients' neurological status was assessed by an independent neurologist before as well as 24 hours and 30 days postprocedure. All strokes and suspected strokes were adjudicated by an independent committee. Logistic regression analysis was conducted to identify baseline demographic, lesion, procedural, or comorbidity parameters associated with outcomes in patients > or = 80 years of age. RESULTS: As of January 10, 2009, 5297 patients underwent carotid artery stenting in 186 US CAPTURE 2 clinical centers and 1166 were > or = 80 years old. Octogenarians were similar to nonoctogenarians in terms of gender and symptomatic status but had fewer of certain risk factors (prior myocardial infarction or carotid endarterectomy, diabetes, smoking history) and more cardiac arrhythmia and renal insufficiency. For the overall cohort, death/stroke rate was 3.3%; stroke rate was 2.7% (0.8% major, 1.9% minor). Death/stroke rates were significantly higher for octogenarians than nonoctogenarians (4.5% versus 3.0%) as were stroke rates (3.8% versus 2.4%). Symptomatic status, embolic protection device dwell time, and lesion length were risk predictors for periprocedural stroke in octogenarians. CONCLUSIONS: Patients > or = 80 years old have higher periprocedural event rates than nonoctogenarians. Age, symptomatic status, and lesion length should be considered when identifying appropriate candidates for the procedure. FAU - Chaturvedi, Seemant AU - Chaturvedi S AD - Department of Neurology and Stroke Program, Wayne State University, Detroit, MI 48201, USA. schaturv@med.wayne.edu FAU - Matsumura, Jon S AU - Matsumura JS FAU - Gray, William AU - Gray W FAU - Xu, Chuanbo AU - Xu C FAU - Verta, Patrick AU - Verta P CN - CAPTURE 2 Investigators and Executive Committee LA - eng PT - Clinical Trial PT - Journal Article PT - Multicenter Study DEP - 20100225 PL - United States TA - Stroke JT - Stroke JID - 0235266 SB - IM MH - Aged MH - *Aged, 80 and over MH - Carotid Arteries/pathology/*surgery MH - *Carotid Stenosis/complications/surgery MH - Endarterectomy, Carotid/adverse effects MH - Female MH - Humans MH - Male MH - Prospective Studies MH - Regression Analysis MH - Risk Assessment MH - Risk Factors MH - Stents/*adverse effects MH - Stroke/*etiology/prevention & control MH - Treatment Outcome EDAT- 2010/02/27 06:00 MHDA- 2010/05/04 06:00 CRDT- 2010/02/27 06:00 PHST- 2010/02/27 06:00 [entrez] PHST- 2010/02/27 06:00 [pubmed] PHST- 2010/05/04 06:00 [medline] AID - STROKEAHA.109.569426 [pii] AID - 10.1161/STROKEAHA.109.569426 [doi] PST - ppublish SO - Stroke. 2010 Apr;41(4):757-64. doi: 10.1161/STROKEAHA.109.569426. Epub 2010 Feb 25. PMID- 20160200 OWN - NLM STAT- MEDLINE DCOM- 20100520 LR - 20151119 IS - 1942-3268 (Electronic) IS - 1942-3268 (Linking) VI - 3 IP - 1 DP - 2010 Feb TI - Growth-differentiation factor-15 for long-term risk prediction in patients stabilized after an episode of non-ST-segment-elevation acute coronary syndrome. PG - 88-96 LID - 10.1161/CIRCGENETICS.109.877456 [doi] AB - BACKGROUND: Growth-differentiation factor-15 (GDF-15) has emerged as a prognostic biomarker in patients with non-ST-segment-elevation acute coronary syndrome. This study assessed the time course and the long-term prognostic relevance of GDF-15 levels measured repetitively in patients with non-ST-segment-elevation acute coronary syndrome during 6 months after the acute event. METHODS AND RESULTS: GDF-15 and other biomarkers were measured at randomization, after 6 weeks, and after 3 and 6 months in 950 patients with non-ST-segment-elevation acute coronary syndrome included in the FRagmin and Fast Revascularization during InStability in Coronary artery disease II study. Study end points were death, recurrent myocardial infarction, and their composite during 5-year follow-up. Median GDF-15 levels decreased slightly from 1357 ng/L at randomization to 1302 ng/L at 6 months (P<0.001). GDF-15 was consistently related to cardiovascular risk factors and biochemical markers of hemodynamic stress, renal dysfunction, and inflammation. Moreover, GDF-15 was independently related to the 5-year risk of the composite end point when measured at both 3 months (adjusted hazard ratio, 1.8 [1.0 to 3.0]) and 6 months (adjusted hazard ratio, 2.3 [1.3 to 4.1]). Serial measurements of GDF-15 at randomization and 6 months helped to identify patient cohorts at different levels of risk, with patients with persistently elevated GDF-15 levels >1800 ng/L having the highest rate of the composite end point. CONCLUSIONS: GDF-15 is independently related to adverse events in non-ST-segment-elevation acute coronary syndrome both in the acute setting and for at least 6 months after clinical stabilization. Therefore, continued research on GDF-15 should be focused on the usefulness of GDF-15 for support of clinical management in acute and chronic ischemic heart disease. FAU - Eggers, Kai M AU - Eggers KM AD - Department of Medical Sciences, Cardiology, Uppsala University Hospital and Uppsala Clinical Research Center, Uppsala, Sweden. kai.eggers@ucr.uu.se FAU - Kempf, Tibor AU - Kempf T FAU - Lagerqvist, Bo AU - Lagerqvist B FAU - Lindahl, Bertil AU - Lindahl B FAU - Olofsson, Sylvia AU - Olofsson S FAU - Jantzen, Franziska AU - Jantzen F FAU - Peter, Timo AU - Peter T FAU - Allhoff, Tim AU - Allhoff T FAU - Siegbahn, Agneta AU - Siegbahn A FAU - Venge, Per AU - Venge P FAU - Wollert, Kai C AU - Wollert KC FAU - Wallentin, Lars AU - Wallentin L LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20091211 PL - United States TA - Circ Cardiovasc Genet JT - Circulation. Cardiovascular genetics JID - 101489144 RN - 0 (Biomarkers) RN - 0 (Growth Differentiation Factor 15) SB - IM MH - Acute Coronary Syndrome/complications/*diagnosis/therapy MH - Aged MH - Biomarkers/analysis MH - Cohort Studies MH - Electrocardiography MH - Female MH - Follow-Up Studies MH - Growth Differentiation Factor 15/*analysis MH - Humans MH - Male MH - Middle Aged MH - Myocardial Infarction/complications MH - Predictive Value of Tests MH - Prognosis MH - Randomized Controlled Trials as Topic MH - Risk Factors EDAT- 2010/02/18 06:00 MHDA- 2010/05/21 06:00 CRDT- 2010/02/18 06:00 PHST- 2010/02/18 06:00 [entrez] PHST- 2010/02/18 06:00 [pubmed] PHST- 2010/05/21 06:00 [medline] AID - CIRCGENETICS.109.877456 [pii] AID - 10.1161/CIRCGENETICS.109.877456 [doi] PST - ppublish SO - Circ Cardiovasc Genet. 2010 Feb;3(1):88-96. doi: 10.1161/CIRCGENETICS.109.877456. Epub 2009 Dec 11. PMID- 20141344 OWN - NLM STAT- MEDLINE DCOM- 20101012 LR - 20131121 IS - 1651-2006 (Electronic) IS - 1401-7431 (Linking) VI - 44 IP - 1 DP - 2010 Feb TI - A metabolic protective strategy could improve long-term survival in patients with LV-dysfunction undergoing CABG. PG - 45-58 LID - 10.3109/14017430903531008 [doi] AB - OBJECTIVE: Adverse outcome after CABG is closely related to postoperative heart failure precipitated by ischemia and myocardial infarction. Restrictive use of inotropes is therefore desirable. Patients with preoperative left ventricular dysfunction are a high-risk group in this respect. To reduce myocardial oxygen expenditure we evolved a metabolic strategy for perioperative care. DESIGN: Observational study on 104 consecutive patients with severe left ventricular dysfunction undergoing CABG. The metabolic strategy implied physiological measures to minimize myocardial oxygen expenditure including restrictive use of inotropes and specific measures such as extended CPB and metabolic support to facilitate myocardial recovery. Hemodynamic state was primarily assessed by mixed venous oxygen saturation (SvO(2)). Follow-up averaged 9.7+/-1.4 years. RESULTS: LVEF was 0.30+/-0.05 (range 0.20-0.37) and 3.5+/-1.3 vessels were bypassed. Inotropes were used in 6.7% for weaning from CPB. Increase of s-creatinine by > or =50% compared to preoperative values was observed in 2.9%. Logistic EuroSCORE was 8.3% whereas observed 30-day mortality was 1.0%. Crude 5-year survival was 89.4%. CONCLUSIONS: The metabolic strategy allowed restrictive use of inotropes and was associated with encouraging long-term survival. Renal function was well preserved suggesting that SvO(2) served as an adequate marker of circulation. Randomized trials with metabolic support are warranted. FAU - Svedjeholm, Rolf AU - Svedjeholm R AD - Departments of Cardiothoracic Surgery and Cardiothoracic Anesthesia, Linkoping Heart Center, Linkoping University Hospital, Linkoping University, Linkoping, Sweden. rolf.svedjeholm@lio.se FAU - Vidlund, Marten AU - Vidlund M FAU - Vanhanen, Ingemar AU - Vanhanen I FAU - Hakanson, Erik AU - Hakanson E LA - eng PT - Journal Article PL - England TA - Scand Cardiovasc J JT - Scandinavian cardiovascular journal : SCJ JID - 9708377 RN - 0 (Cardioplegic Solutions) RN - 0 (Cardiotonic Agents) RN - 0 (Insulin) RN - 0 (glucose-insulin-potassium cardioplegic solution) RN - 3KX376GY7L (Glutamic Acid) RN - IY9XDZ35W2 (Glucose) RN - RWP5GA015D (Potassium) SB - IM CIN - Scand Cardiovasc J. 2010 Feb;44(1):4-8. doi: 10.3109/14017430903469928. PMID: 20141343 MH - Aged MH - Cardioplegic Solutions/*therapeutic use MH - Cardiopulmonary Bypass MH - Cardiotonic Agents/therapeutic use MH - *Coronary Artery Bypass/adverse effects/mortality MH - *Energy Metabolism MH - Female MH - Glucose/therapeutic use MH - Glutamic Acid/administration & dosage MH - Heart Failure/etiology/metabolism/physiopathology/*prevention & control MH - Humans MH - Insulin/therapeutic use MH - Kaplan-Meier Estimate MH - Logistic Models MH - Male MH - Middle Aged MH - *Myocardial Contraction MH - Myocardial Ischemia/complications/metabolism/mortality/physiopathology/*surgery MH - Myocardium/*metabolism MH - Oxygen Consumption MH - Potassium/therapeutic use MH - Recovery of Function MH - Risk Assessment MH - Risk Factors MH - Severity of Illness Index MH - Stroke Volume MH - Sweden MH - Time Factors MH - Treatment Outcome MH - Ventricular Dysfunction, Left/*complications/metabolism/mortality/physiopathology MH - Ventricular Function, Left EDAT- 2010/02/10 06:00 MHDA- 2010/10/13 06:00 CRDT- 2010/02/10 06:00 PHST- 2010/02/10 06:00 [entrez] PHST- 2010/02/10 06:00 [pubmed] PHST- 2010/10/13 06:00 [medline] AID - 10.3109/14017430903531008 [doi] PST - ppublish SO - Scand Cardiovasc J. 2010 Feb;44(1):45-58. doi: 10.3109/14017430903531008. PMID- 20067988 OWN - NLM STAT- MEDLINE DCOM- 20100610 LR - 20181201 IS - 1569-9285 (Electronic) IS - 1569-9285 (Linking) VI - 10 IP - 4 DP - 2010 Apr TI - Low postoperative dose of aprotinin reduces bleeding and is safe in patients receiving clopidogrel before coronary artery bypass surgery. A prospective randomized study. PG - 545-8 LID - 10.1510/icvts.2009.226613 [doi] AB - Clopidogrel (Plavix) given before the operation increases bleeding complications following coronary artery bypass grafting (CABG). High perioperative doses of aprotinin (Trasylol) are known to reduce bleeding and transfusions after cardiac surgery, but may increase the risk of thrombosis, renal impairment, and mortality. The aim of the study was to evaluate the clinical effects of aprotinin given in high doses intra- and postoperatively vs. a low postoperative dose in patients on clopidogrel. Patients admitted for first-time CABG and receiving clopidogrel with or without aspirin, were prospectively randomized either to receive a total of 75,000 kallikrein inhibitor unit (KIU)/kg aprotinin given intra- and postoperatively or 25,000 KIU/kg aprotinin after the operation. Three hundred and ninety-nine patients aged 32-87 years (median 67 years) were included. Postoperative bleeding was slightly different, but moderate in both groups. The transfusion rate was similar, as were the incidences of postoperative neurological disturbances and myocardial infarction. Renal impairment and need for inotropic drugs were more frequent in the high dose group. Thirty-day mortality was similar (high dose 2%, low dose 0.5%, P=0.22). A low postoperative dose of aprotinin in patients receiving clopidogrel is safe and has comparable effects regarding postoperative bleeding complications as a high dose. FAU - Ovrum, Eivind AU - Ovrum E AD - Division of Cardiovascular and Respiratory Medicine and Surgery, Oslo Heart Center, Oslo University Hospital, Rikshospitalet, Norway. eivind.ovrum@hjertesenteret.no FAU - Tangen, Geir AU - Tangen G FAU - Tollofsrud, Stein AU - Tollofsrud S FAU - Ringdal, Mari-Anne L AU - Ringdal MA FAU - Oystese, Rolf AU - Oystese R FAU - Istad, Reidar AU - Istad R LA - eng PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial DEP - 20100112 PL - England TA - Interact Cardiovasc Thorac Surg JT - Interactive cardiovascular and thoracic surgery JID - 101158399 RN - 0 (Hemostatics) RN - 0 (Platelet Aggregation Inhibitors) RN - 9087-70-1 (Aprotinin) RN - A74586SNO7 (Clopidogrel) RN - OM90ZUW7M1 (Ticlopidine) SB - IM MH - Adult MH - Aged MH - Aged, 80 and over MH - Aprotinin/*administration & dosage MH - Blood Transfusion MH - Cerebrovascular Disorders/etiology MH - Clopidogrel MH - *Coronary Artery Bypass/adverse effects/mortality MH - Drug Administration Schedule MH - Female MH - Hemostatics/*administration & dosage MH - Humans MH - Intraoperative Care MH - Kidney Diseases/etiology MH - Male MH - Middle Aged MH - Myocardial Infarction/etiology MH - Platelet Aggregation Inhibitors/*administration & dosage/adverse effects MH - Postoperative Care MH - Postoperative Hemorrhage/etiology/*prevention & control MH - Prospective Studies MH - Ticlopidine/administration & dosage/adverse effects/*analogs & derivatives MH - Time Factors MH - Treatment Outcome EDAT- 2010/01/14 06:00 MHDA- 2010/06/11 06:00 CRDT- 2010/01/14 06:00 PHST- 2010/01/14 06:00 [entrez] PHST- 2010/01/14 06:00 [pubmed] PHST- 2010/06/11 06:00 [medline] AID - icvts.2009.226613 [pii] AID - 10.1510/icvts.2009.226613 [doi] PST - ppublish SO - Interact Cardiovasc Thorac Surg. 2010 Apr;10(4):545-8. doi: 10.1510/icvts.2009.226613. Epub 2010 Jan 12. PMID- 20031753 OWN - NLM STAT- MEDLINE DCOM- 20100329 LR - 20260518 IS - 1941-7632 (Electronic) IS - 1941-7640 (Linking) VI - 2 IP - 5 DP - 2009 Oct TI - Choice of contrast medium in patients with impaired renal function undergoing percutaneous coronary intervention. PG - 430-7 LID - 10.1161/CIRCINTERVENTIONS.109.874933 [doi] AB - BACKGROUND: No clinical trial has yet focused on contrast-mediated nephrotoxicity in patients with chronic renal failure exclusively undergoing percutaneous coronary intervention (PCI). Therefore, the aim of this study was to compare the effect of contemporary contrast media on nephrotoxicity in this high-risk patient population. METHODS AND RESULTS: This prospective, randomized, double-blind, comparative clinical trial randomly selected 939 patients with chronic renal failure undergoing coronary angiography with potential PCI to receive either the iso-osmolar contrast medium iodixanol or the low-osmolar contrast medium iomeprol. Of those 939 patients, 615 received diagnostic angiography only and were not included in the primary study analysis, but were followed up in a registry. Three hundred twenty-four patients underwent PCI, of which one-half received iodixanol or iomeprol, respectively, and were included in the primary study analysis. The primary end point was the peak increase in S-creatinine during hospitalization for PCI. Maximum increase in S-creatinine after PCI was lower than expected and thus impaired the power of the study. It was not significantly different between the 2 contrast groups (0.19+/-0.40 mg/dL for iodixanol and 0.21+/-0.34 mg/dL for iomeprol; P=0.53). Albeit contrast media-induced nephropathy rates were lower with iodixanol (22.2% compared with 27.8% for iomeprol), this difference was not statistically different (P=0.25). Subgroup analysis suggested a favorable outcome regarding nephrotoxicity in patients who received higher contrast volumes (>340 mL) in the iodixanol group (P(interaction)=0.016). CONCLUSIONS: Routine use of iso-osmolar contrast medium is not associated with a significant reduction of nephrotoxicity compared with low-osmolar contrast medium in patients with chronic renal failure undergoing PCI. However, a positive effect was seen in the iso-osmolar contrast group for patients receiving high amounts of contrast medium, which awaits confirmation of a specifically designed randomized clinical trial. Clinical Trial Registration- clinicaltrials.gov Identifier: NCT00390585. FAU - Wessely, Rainer AU - Wessely R AD - Deutsches Herzzentrum and 1 Medizinische Klinik, Klinikum rechts der Isar, Technische Universitat, Munich, Germany. rwessely@web.de FAU - Koppara, Tobias AU - Koppara T FAU - Bradaric, Christian AU - Bradaric C FAU - Vorpahl, Marc AU - Vorpahl M FAU - Braun, Siegmund AU - Braun S FAU - Schulz, Stefanie AU - Schulz S FAU - Mehilli, Julinda AU - Mehilli J FAU - Schomig, Albert AU - Schomig A FAU - Kastrati, Adnan AU - Kastrati A CN - Contrast Media and Nephrotoxicity Following Coronary Revascularization by Angioplasty Trial Investigators LA - eng SI - ClinicalTrials.gov/NCT00390585 PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20090922 PL - United States TA - Circ Cardiovasc Interv JT - Circulation. Cardiovascular interventions JID - 101499602 RN - 0 (Biomarkers) RN - 0 (Contrast Media) RN - 0 (Triiodobenzoic Acids) RN - 17E17JBP8L (iomeprol) RN - AYI8EX34EU (Creatinine) RN - HW8W27HTXX (iodixanol) RN - JR13W81H44 (Iopamidol) SB - IM MH - Aged MH - Aged, 80 and over MH - Angina, Unstable/therapy MH - Angioplasty, Balloon, Coronary/adverse effects/*methods MH - Biomarkers/metabolism MH - Contrast Media/*toxicity MH - Creatinine/metabolism MH - Double-Blind Method MH - Female MH - Follow-Up Studies MH - Humans MH - Iopamidol/*analogs & derivatives/toxicity MH - Kidney Diseases/chemically induced/epidemiology/physiopathology MH - Kidney Failure, Chronic/metabolism/*physiopathology MH - Male MH - Prospective Studies MH - Risk Factors MH - Triiodobenzoic Acids/*toxicity FIR - Schomig, A IR - Schomig A FIR - Wessely, R IR - Wessely R FIR - Kastrati, A IR - Kastrati A FIR - Mehilli, J IR - Mehilli J FIR - Koppara, T IR - Koppara T FIR - Bradaric, C IR - Bradaric C FIR - Vorpahl, M IR - Vorpahl M FIR - Schulz, S IR - Schulz S FIR - Holle, H IR - Holle H FIR - Maimer-Rodrigues, F IR - Maimer-Rodrigues F FIR - Fabry, A IR - Fabry A FIR - Hosl, K IR - Hosl K FIR - Gliessl, B IR - Gliessl B FIR - Turk, E IR - Turk E FIR - Dirlewanger, M IR - Dirlewanger M FIR - Sargon, N IR - Sargon N FIR - Rifatov, N IR - Rifatov N FIR - Pache, J IR - Pache J FIR - Beckerath, N V IR - Beckerath NV FIR - Markwardt, C IR - Markwardt C FIR - Bollwein, H IR - Bollwein H FIR - Byrne, R A IR - Byrne RA FIR - Iijima, R IR - Iijima R FIR - Bruskina, O IR - Bruskina O FIR - Piniek, S IR - Piniek S FIR - Hurt, S IR - Hurt S FIR - Bergbauer, A IR - Bergbauer A EDAT- 2009/12/25 06:00 MHDA- 2010/03/30 06:00 CRDT- 2009/12/25 06:00 PHST- 2009/12/25 06:00 [entrez] PHST- 2009/12/25 06:00 [pubmed] PHST- 2010/03/30 06:00 [medline] AID - CIRCINTERVENTIONS.109.874933 [pii] AID - 10.1161/CIRCINTERVENTIONS.109.874933 [doi] PST - ppublish SO - Circ Cardiovasc Interv. 2009 Oct;2(5):430-7. doi: 10.1161/CIRCINTERVENTIONS.109.874933. Epub 2009 Sep 22. PMID- 20031719 OWN - NLM STAT- MEDLINE DCOM- 20100305 LR - 20220317 IS - 1941-7632 (Electronic) IS - 1941-7640 (Linking) VI - 2 IP - 3 DP - 2009 Jun TI - Bleeding in patients undergoing percutaneous coronary intervention: the development of a clinical risk algorithm from the National Cardiovascular Data Registry. PG - 222-9 LID - 10.1161/CIRCINTERVENTIONS.108.846741 [doi] AB - BACKGROUND: Bleeding in patients undergoing percutaneous coronary intervention (PCI) is associated with increased morbidity, mortality, length of hospitalization, and cost. We identified baseline clinical characteristics associated with bleeding complications after PCI and developed a simplified, clinically useful algorithm to predict patient risk. METHODS AND RESULTS: Data were analyzed from 302 152 PCI procedures performed at 440 US centers participating in the National Cardiovascular Data Registry. As defined by the National Cardiovascular Data Registry, bleeding required transfusion, prolonged hospital stay, and/or a drop in hemoglobin >3.0 g/dL from any location, including percutaneous entry site, retroperitoneal, gastrointestinal, genitourinary, and other/unknown location. Bleeding complications occurred in 2.4% of patients. From the best-fitting model consisting of 15 clinical elements associated with post-PCI bleeding in a random 80% training cohort, we developed a parsimonious risk algorithm. Predictors of bleeding included age, gender, previous heart failure, glomerular filtration rate, peripheral vascular disease, no previous PCI, New York Heart Association/Canadian Cardiovascular Society Functional Classification class IV heart failure, ST-elevation myocardial infarction, non-ST-elevation myocardial infarction, and cardiogenic shock. The parsimonious model was validated in the remaining 20% of the population (c-statistic, 0.72) and in clinically relevant subgroups of patients. This simplified model was used to derive a clinical risk algorithm, with larger numbers corresponding with greater risk. In 3 categories, bleeding rates were greater in patients with higher estimates (or=18, 5.1%). CONCLUSIONS: This report identifies baseline clinical factors associated with bleeding and proposes a clinically useful algorithm to estimate bleeding risk. This model is potentially actionable in altering therapeutic decision making and improving outcomes in patients undergoing PCI. FAU - Mehta, Sameer K AU - Mehta SK AD - Division of Cardiovascular Research, Mid America Heart Institute, Saint Luke's Hospital, Kansas City, MO 64111, USA. FAU - Frutkin, Andrew D AU - Frutkin AD FAU - Lindsey, Jason B AU - Lindsey JB FAU - House, John A AU - House JA FAU - Spertus, John A AU - Spertus JA FAU - Rao, Sunil V AU - Rao SV FAU - Ou, Fang-Shu AU - Ou FS FAU - Roe, Matthew T AU - Roe MT FAU - Peterson, Eric D AU - Peterson ED FAU - Marso, Steven P AU - Marso SP CN - National Cardiovascular Data Registry LA - eng PT - Journal Article PT - Multicenter Study DEP - 20090508 PL - United States TA - Circ Cardiovasc Interv JT - Circulation. Cardiovascular interventions JID - 101499602 RN - 0 (Hemoglobins) RN - 0 (Platelet Aggregation Inhibitors) SB - IM MH - Aged MH - Algorithms MH - Angioplasty, Balloon, Coronary/*adverse effects MH - Blood Transfusion MH - *Decision Support Techniques MH - Female MH - Hemoglobins/metabolism MH - Hemorrhage/blood/*chemically induced/therapy MH - Humans MH - Length of Stay MH - Male MH - Middle Aged MH - Platelet Aggregation Inhibitors/*adverse effects MH - Registries MH - Reproducibility of Results MH - Risk Assessment MH - Risk Factors MH - Thrombosis/etiology/*prevention & control MH - Time Factors MH - Treatment Outcome MH - United States EDAT- 2009/12/25 06:00 MHDA- 2010/03/06 06:00 CRDT- 2009/12/25 06:00 PHST- 2009/12/25 06:00 [entrez] PHST- 2009/12/25 06:00 [pubmed] PHST- 2010/03/06 06:00 [medline] AID - CIRCINTERVENTIONS.108.846741 [pii] AID - 10.1161/CIRCINTERVENTIONS.108.846741 [doi] PST - ppublish SO - Circ Cardiovasc Interv. 2009 Jun;2(3):222-9. doi: 10.1161/CIRCINTERVENTIONS.108.846741. Epub 2009 May 8. PMID- 19962469 OWN - NLM STAT- MEDLINE DCOM- 20100216 LR - 20101118 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 104 IP - 12 DP - 2009 Dec 15 TI - Optimal medical therapy with or without percutaneous coronary intervention for patients with stable coronary artery disease and chronic kidney disease. PG - 1647-53 LID - 10.1016/j.amjcard.2009.07.043 [doi] AB - Chronic kidney disease (CKD) is a risk factor for poor outcomes in patients with coronary artery disease (CAD), but it is unknown whether CKD influences the efficacy of alternative CAD treatment strategies. Thus, we compared outcomes in stable CAD patients with and without CKD randomized to percutaneous coronary intervention (PCI) and optimal medical therapy (OMT) or OMT alone in a post hoc analysis of the 2,287 patient COURAGE study. At baseline, 320 patients (14%) had CKD defined as a glomerular filtration rate of <60 mL/min/1.73 m(2), as estimated by the abbreviated 4-variable Modification of Diet in Renal Disease equation. The patients with CKD were older (68 +/- 9 vs 61 +/- 10 years; p <0.001) and more often had diabetes mellitus (42% vs 33%; p = 0.002), hypertension (81% vs 65%; p <0.03), heart failure (13% vs 3.4%; p <001), and three-vessel CAD (37% vs 29%, p = 0.01). After adjustment for these differences, CKD remained an independent predictor of death or nonfatal myocardial infarction (hazard ratio 1.48, 95% confidence interval 1.15 to 1.90). PCI had no effect on these outcomes. Furthermore, at 36 months, a similar percentage of patients with CKD treated with OMT (70%) and PCI plus OMT (76%) were angina free compared to patients without CKD. In conclusion, CKD is an important determinant of clinical outcomes in patients with stable CAD, regardless of the treatment strategy. Although PCI did not reduce the risk of death or myocardial infarction when added to OMT for patients with CKD, it also was not associated with worse outcomes in this high-risk group. FAU - Sedlis, Steven P AU - Sedlis SP AD - New York University School of Medicine, New York, NY, USA. steven.sedlis@va.gov FAU - Jurkovitz, Claudine T AU - Jurkovitz CT FAU - Hartigan, Pamela M AU - Hartigan PM FAU - Goldfarb, David S AU - Goldfarb DS FAU - Lorin, Jeffrey D AU - Lorin JD FAU - Dada, Marcin AU - Dada M FAU - Maron, David J AU - Maron DJ FAU - Spertus, John A AU - Spertus JA FAU - Mancini, G B John AU - Mancini GB FAU - Teo, Koon K AU - Teo KK FAU - O'Rourke, Robert A AU - O'Rourke RA FAU - Boden, William E AU - Boden WE FAU - Weintraub, William S AU - Weintraub WS CN - COURAGE Study Investigators LA - eng GR - Canadian Institutes of Health Research/Canada PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PT - Research Support, U.S. Gov't, Non-P.H.S. PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM MH - Aged MH - *Angioplasty, Balloon, Coronary MH - Coronary Artery Disease/*complications/*therapy MH - Female MH - Humans MH - Male MH - Middle Aged MH - Renal Insufficiency, Chronic/*complications MH - Risk Factors MH - Treatment Outcome EDAT- 2009/12/08 06:00 MHDA- 2010/02/17 06:00 CRDT- 2009/12/08 06:00 PHST- 2009/06/12 00:00 [received] PHST- 2009/07/19 00:00 [revised] PHST- 2009/07/19 00:00 [accepted] PHST- 2009/12/08 06:00 [entrez] PHST- 2009/12/08 06:00 [pubmed] PHST- 2010/02/17 06:00 [medline] AID - S0002-9149(09)01474-X [pii] AID - 10.1016/j.amjcard.2009.07.043 [doi] PST - ppublish SO - Am J Cardiol. 2009 Dec 15;104(12):1647-53. doi: 10.1016/j.amjcard.2009.07.043. PMID- 19944392 OWN - NLM STAT- MEDLINE DCOM- 20100301 LR - 20151119 IS - 1875-2128 (Electronic) IS - 1875-2128 (Linking) VI - 102 IP - 11 DP - 2009 Nov TI - Preventing acute decrease in renal function induced by coronary angiography (PRECORD): a prospective randomized trial. PG - 761-7 LID - 10.1016/j.acvd.2009.07.001 [doi] AB - BACKGROUND: Infusion of saline attenuates the decrease in renal function induced by radiographic contrast agents among patients with chronic renal insufficiency. AIM: The Preventing Renal alteration in Coronary Disease (PRECORD) trial was a randomized trial to assess the effect on renal function of saline infusion during and after coronary angiography in 201 patients without severe chronic renal insufficiency (serum creatinine<140micromol/L). METHODS: All patients received standard oral hydration: 2000mL of tap water within the 24 hours after coronary angiography. Patients were randomized before the procedure to intravenous hydration (1000mL of 0.9% saline infusion) or no additional hydration. The infusion was started in the catheterization laboratory and continued for 24 hours. The primary endpoint was the change in calculated creatinine clearance between baseline and 24 hours after coronary angiography. The same ionic low osmolar radiographic contrast agent (ioxaglate) was used in all patients. RESULTS: Both groups had similar baseline characteristics, including age, serum creatinine, volume of contrast and proportion of patients undergoing ad hoc coronary angioplasty. The overall decrease in serum creatinine clearance 24 hours after the procedure was -3.44 (0.68)mL/min. The change in serum creatinine clearance 24 hours after the procedure was -2.81 (1.07)mL/min in the infusion group vs -4.09 (0.91)mL/min in the control group (p=0.38). CONCLUSION: Renal function is altered only slightly 24 hours after coronary angiography with standard oral hydration alone and is not affected by saline infusion started at the beginning of coronary angiography, even in patients with mild-to-moderate renal dysfunction. FAU - Angoulvant, Denis AU - Angoulvant D AD - Service de cardiologie D, hopital cardiovasculaire et pneumologique Louis-Pradel, groupement hospitalier Est, universite Claude-Bernard Lyon-1, avenue Doyen-Lepine, Bron cedex, France. FAU - Cucherat, Michel AU - Cucherat M FAU - Rioufol, Gilles AU - Rioufol G FAU - Finet, Gerard AU - Finet G FAU - Beaune, Jacques AU - Beaune J FAU - Revel, Didier AU - Revel D FAU - Laville, Maurice AU - Laville M FAU - Ovize, Michel AU - Ovize M FAU - Andre-Fouet, Xavier AU - Andre-Fouet X LA - eng PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20091015 PL - Netherlands TA - Arch Cardiovasc Dis JT - Archives of cardiovascular diseases JID - 101465655 RN - 0 (Biomarkers) RN - 0 (Contrast Media) RN - 451W47IQ8X (Sodium Chloride) RN - AYI8EX34EU (Creatinine) RN - Z40X7EI2AF (Ioxaglic Acid) SB - IM MH - Acute Disease MH - Biomarkers/blood MH - Contrast Media/*adverse effects MH - Coronary Angiography/*adverse effects MH - Creatinine/blood MH - Female MH - *Fluid Therapy MH - Humans MH - Infusions, Intravenous MH - Ioxaglic Acid/*adverse effects MH - Kidney Diseases/blood/etiology/*prevention & control MH - Male MH - Middle Aged MH - Prospective Studies MH - Sodium Chloride/*administration & dosage MH - Time Factors MH - Treatment Outcome EDAT- 2009/12/01 06:00 MHDA- 2010/03/02 06:00 CRDT- 2009/12/01 06:00 PHST- 2009/06/04 00:00 [received] PHST- 2009/07/20 00:00 [revised] PHST- 2009/07/23 00:00 [accepted] PHST- 2009/12/01 06:00 [entrez] PHST- 2009/12/01 06:00 [pubmed] PHST- 2010/03/02 06:00 [medline] AID - S1875-2136(09)00228-9 [pii] AID - 10.1016/j.acvd.2009.07.001 [doi] PST - ppublish SO - Arch Cardiovasc Dis. 2009 Nov;102(11):761-7. doi: 10.1016/j.acvd.2009.07.001. Epub 2009 Oct 15. PMID- 19926042 OWN - NLM STAT- MEDLINE DCOM- 20100127 LR - 20260209 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 2 IP - 11 DP - 2009 Nov TI - A randomized comparison of transradial versus transfemoral approach for coronary angiography and angioplasty. PG - 1047-54 LID - 10.1016/j.jcin.2009.07.016 [doi] AB - OBJECTIVES: The aim of the study was to evaluate the safety, feasibility, and procedural variables by the transradial approach compared with the transfemoral access in a standard population of patients undergoing coronary catheterization. BACKGROUND: Coronary catheterization is usually performed via the transfemoral approach. Transradial access may offer some advantages in comparison with transfemoral access especially under conditions of aggressive anticoagulation and antiplatelet treatment. METHODS: Between July 2006 and January 2008, a total of 1,024 patients undergoing coronary catheterization were randomly assigned to the transradial or transfemoral approach. Patients with an abnormal Allen's test, history of coronary artery bypass surgery, simultaneous right heart catheterization, chronic renal insufficiency, or known difficulties with the radial or femoral access were excluded. RESULTS: Successful catheterization was achieved in 494 of 512 patients (96.5%) in the transradial and in 511 of 512 patients (99.8%) in the transfemoral group (p < 0.0001). Median procedural duration (37.0 min, interquartile range [IQR] 19.6 to 49.1 min vs. 40.2 min, IQR 24.3 to 50.8 min; p = 0.046) and median dose area product (38.2 Gycm(2), IQR 20.4 to 48.5 Gycm(2) vs. 41.9 Gycm(2), IQR 22.6 to 52.2 Gycm(2); p = 0.034) were significantly lower in the transfemoral group compared with the transradial access group. A median amount of contrast agent was similar among both groups. Vascular access site complications were higher in the transfemoral group (3.71%) than in the transradial group (0.58%; p = 0.0008) CONCLUSIONS: The findings of the present study show that transradial coronary angiography and angioplasty are safe, feasible, and effective with similar results to those of the transfemoral approach. However, procedural duration and radiation exposure are higher using the transradial access. In contrast to the transfemoral route, the rate of major vascular complications was negligible using the transradial approach. FAU - Brueck, Martin AU - Brueck M AD - Department of Cardiology, Clinic of Wetzlar, Wetzlar, Germany. Martin.Brueck@hkw.med.uni-giessen.de FAU - Bandorski, Dirk AU - Bandorski D FAU - Kramer, Wilfried AU - Kramer W FAU - Wieczorek, Marcus AU - Wieczorek M FAU - Holtgen, Reinhard AU - Holtgen R FAU - Tillmanns, Harald AU - Tillmanns H LA - eng PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 RN - 0 (Anticoagulants) RN - 0 (Platelet Aggregation Inhibitors) SB - IM CIN - JACC Cardiovasc Interv. 2009 Nov;2(11):1055-6. doi: 10.1016/j.jcin.2009.08.017. PMID: 19926043 CIN - JACC Cardiovasc Interv. 2010 Apr;3(4):463; author reply 463-4. doi: 10.1016/j.jcin.2010.01.013. PMID: 20398879 MH - Aged MH - Angioplasty, Balloon, Coronary/adverse effects/*methods MH - Anticoagulants/therapeutic use MH - Cardiac Catheterization/adverse effects/*methods MH - Coronary Angiography/adverse effects/*methods MH - Coronary Artery Disease/*diagnostic imaging/*therapy MH - Feasibility Studies MH - Female MH - *Femoral Artery MH - Humans MH - Male MH - Middle Aged MH - Platelet Aggregation Inhibitors/therapeutic use MH - Prospective Studies MH - *Radial Artery MH - Radiography, Interventional MH - Time Factors MH - Treatment Outcome EDAT- 2009/11/21 06:00 MHDA- 2010/01/28 06:00 CRDT- 2009/11/21 06:00 PHST- 2009/07/13 00:00 [received] PHST- 2009/07/25 00:00 [accepted] PHST- 2009/11/21 06:00 [entrez] PHST- 2009/11/21 06:00 [pubmed] PHST- 2010/01/28 06:00 [medline] AID - S1936-8798(09)00584-6 [pii] AID - 10.1016/j.jcin.2009.07.016 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2009 Nov;2(11):1047-54. doi: 10.1016/j.jcin.2009.07.016. PMID- 19924001 OWN - NLM STAT- MEDLINE DCOM- 20100615 LR - 20161125 IS - 1558-2035 (Electronic) IS - 1558-2027 (Linking) VI - 11 IP - 4 DP - 2010 Apr TI - Rationale and design of the Randomized comparison of XiEnce V and Multilink VisioN coronary stents in the sAme muLtivessel patient with chronic kiDnEy disease (RENAL-DES) study. PG - 310-7 LID - 10.2459/JCM.0b013e3283347e24 [doi] AB - BACKGROUND: Percutaneous coronary intervention with bare metal stents (BMS) in patients with chronic kidney disease (CKD) has shown suboptimal results. Drug-eluting stents (DESs) might reduce the incidence of restenosis and therefore of target lesion revascularization in these patients. Of note, in patients with CKD, multiple concomitant individual variables may be responsible for neointimal hyperplasia after coronary stenting, thus making the comparison of BMS and DES in different patient groups difficult. STUDY DESIGN: The RENAL-DES is a prospective, randomized, multicenter, not-sponsored study to directly compare the efficacy in the prevention of clinical restenosis, of everolimus-eluting stent (Xience V) and BMS with identical design (Multilink Vision), both implanted in the same patient with multivessel coronary artery disease and CKD in order to obviate the multiple and unpredictable baseline differences. The primary endpoint of the study is 9-month ischemia-driven target vessel revascularization. SAMPLE SIZE: The expected primary endpoint rates are 20% for BMS and 10% for DES. According to these estimates, with a significant level of 0.05, a sample size of 194 patients provides an 80% statistical power. Assuming a 10% dropout rate, the goal is to enroll 213 patients (426 treated vessels) from five Italian centers. As 20% of the patients will likely require stent implantation in three vessels, approximately 500 treated vessels will be analyzed. CONCLUSION: This intraindividual, randomized study will provide, for the first time, data on the efficacy, in the prevention of clinical restenosis, of DES compared to BMS in patients with multivessel coronary artery disease and CKD (ClinicalTrials.gov Identifier: NCT 00818792). FAU - Tomai, Fabrizio AU - Tomai F AD - Division of Cardiology, Department of Cardiovascular Sciences, European Hospital, Rome, Italy. f.tomai@tiscali.it FAU - Petrolini, Alessandro AU - Petrolini A FAU - De Luca, Leonardo AU - De Luca L FAU - Nudi, Francesco AU - Nudi F FAU - Lanza, Gaetano AU - Lanza G FAU - Vassanelli, Corrado AU - Vassanelli C FAU - Ribichini, Flavio AU - Ribichini F LA - eng SI - ClinicalTrials.gov/NCT00818792 PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PL - United States TA - J Cardiovasc Med (Hagerstown) JT - Journal of cardiovascular medicine (Hagerstown, Md.) JID - 101259752 SB - IM MH - Blood Vessel Prosthesis Implantation MH - Clinical Protocols MH - Coronary Angiography MH - Coronary Artery Disease/complications/diagnostic imaging/*therapy MH - Coronary Restenosis/*prevention & control MH - *Drug-Eluting Stents MH - Humans MH - Myocardial Revascularization MH - Prospective Studies MH - Renal Insufficiency, Chronic/*complications MH - *Research Design EDAT- 2009/11/20 06:00 MHDA- 2010/06/16 06:00 CRDT- 2009/11/20 06:00 PHST- 2009/11/20 06:00 [entrez] PHST- 2009/11/20 06:00 [pubmed] PHST- 2010/06/16 06:00 [medline] AID - 10.2459/JCM.0b013e3283347e24 [doi] PST - ppublish SO - J Cardiovasc Med (Hagerstown). 2010 Apr;11(4):310-7. doi: 10.2459/JCM.0b013e3283347e24. PMID- 19816915 OWN - NLM STAT- MEDLINE DCOM- 20100225 LR - 20091019 IS - 1096-9101 (Electronic) IS - 0196-8092 (Linking) VI - 41 IP - 9 DP - 2009 Nov TI - Utilization of excimer laser debulking for critical lesions unsuitable for standard renal angioplasty. PG - 622-7 LID - 10.1002/lsm.20854 [doi] AB - BACKGROUND: The energy emitted by ultraviolet laser is avidly absorbed in atherosclerotic plaques. Conceptually, it could be applied for debulking of selected atherosclerotic renal artery stenoses. We describe early experience with revascularization of critical renal artery lesions deemed unsuitable for standard renal angioplasty. Institutional Review Board permission to conduct the data analysis was obtained. METHODS: Among 130 percutaneous renal artery interventions with balloon angioplasty and adjunct stenting, there were 12 (9%) patients who underwent laser debulking prior to stenting. These patients presented with critical (95+/-3.5% stenoses) lesions (11 de novo, 1 stent restenosis) deemed unsuitable for standard renal angioplasty because of marked eccentricity and presence of thrombus. Indications for intervention included preservation of kidney function, treatment of uncontrolled hypertension, management of congestive heart failure, and treatment of unstable angina. Blood pressure and estimated glomerular filtration rate (eGFR) were measured pre- and 3 weeks post-intervention. RESULTS: A baseline angiographic stenosis of 95+/-3.5% was reduced to 50+/-13% with laser debulking. There were no laser-induced complications. Post-stenting the angiographic residual stenosis was 0%. The mean gradient across the lesions was reduced from baseline 85+/-40 to 0 mmHg. A normal post-intervention antegrade renal flow was observed in all patients. Baseline mean systolic BP of 178+/-20 mmHg decreased to 132+/-12 mmHg (P<0.0001) and mean diastolic pressure of 85+/-16 mmHg reduced to 71+/-9 mmHg (P = 0.01). A pre-intervention mean eGFR of 47.7+/-19 ml/min/1.73 m(2) increased to 56+/-20.4 ml/min/1.73 m(2) (P = 0.05) post-procedure. The interventions were not associated with major renal or cardiac adverse events. During follow-up one patient developed transient contrast-induced nephropathy. CONCLUSIONS: Debulking of select renal artery stenoses with laser angioplasty followed by adjunct stenting is feasible. Further prospective, randomized studies will be required to explore the role of debulking and laser angioplasty in renal artery revascularization. CI - Copyright 2009 Wiley-Liss, Inc. FAU - Topaz, On AU - Topaz O AD - Division of Cardiology and Nephrology, McGuire Veterans Affairs Medical Center, MCV/Virginia Commonwealth University School of Medicine, Richmond, Virginia 23249, USA. on.topaz@med.va.gov FAU - Polkampally, Pritam R AU - Polkampally PR FAU - Topaz, Allyne AU - Topaz A FAU - Polkampally, Chudamani R AU - Polkampally CR FAU - Jara, Jessica AU - Jara J FAU - Rizk, Majid AU - Rizk M FAU - McDowell, Kara AU - McDowell K FAU - Feldman, George AU - Feldman G LA - eng PT - Clinical Trial PT - Journal Article PL - United States TA - Lasers Surg Med JT - Lasers in surgery and medicine JID - 8007168 SB - IM MH - Aged MH - Aged, 80 and over MH - *Angioplasty, Balloon, Laser-Assisted MH - Cohort Studies MH - Feasibility Studies MH - Female MH - Humans MH - Lasers, Excimer/*therapeutic use MH - Male MH - Middle Aged MH - Pilot Projects MH - Renal Artery Obstruction/complications/pathology/*therapy MH - *Stents MH - Thrombosis/complications/pathology/*therapy EDAT- 2009/10/10 06:00 MHDA- 2010/02/26 06:00 CRDT- 2009/10/10 06:00 PHST- 2009/10/10 06:00 [entrez] PHST- 2009/10/10 06:00 [pubmed] PHST- 2010/02/26 06:00 [medline] AID - 10.1002/lsm.20854 [doi] PST - ppublish SO - Lasers Surg Med. 2009 Nov;41(9):622-7. doi: 10.1002/lsm.20854. PMID- 19801027 OWN - NLM STAT- MEDLINE DCOM- 20091020 LR - 20260128 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 104 IP - 8 DP - 2009 Oct 15 TI - Clinical benefit of early reperfusion therapy in patients with ST-elevation myocardial infarction usually excluded from randomized clinical trials (results from the Maximal Individual Therapy in Acute Myocardial Infarction Plus [MITRA Plus] registry). PG - 1074-7 LID - 10.1016/j.amjcard.2009.05.054 [doi] AB - Randomized clinical trials (RCTs) usually enroll selected patient populations that may not be representative for patients seen in everyday practice. Therefore, concerns have been raised regarding their external validity. For the present study we evaluated the MITRA Plus registry and included 20,175 patients with ST-elevation myocardial infarction. We defined RCT-ineligible patients as patients fulfilling >or=1 of the following criteria: age >or=75 years, prehospital delay >12 hours, prehospital cardiopulmonary resuscitation, cardiogenic shock, impaired renal function, and previous stroke. Those patients (n = 9,369, 46.4%) were compared to patients eligible for enrollment in RCTs (n = 11,806, 53.6%). Ineligible patients were older (p <0.0001), more often were women (p <0.0001), and more often had concomitant diseases (p <0.0001). Ineligible patients less often received early reperfusion therapy (p <0.0001), aspirin (p <0.0001), clopidogrel (p <0.0001), and statins (p <0.0001). Ineligible patients had a higher hospital mortality (20.1% vs 4.9%; p <0.0001) and a higher rate of nonfatal strokes (1.5% vs 0.4%, p <0.0001) compared to eligible patients. Early reperfusion therapy (thrombolysis and/or percutaneous coronary intervention [PCI]) in ineligible patients was associated with a significant decrease of hospital mortality (odds ratio 0.62, 95% confidence interval 0.49 to 0.79), with primary PCI being more effective than thrombolytic therapy (odds ratio 0.52, 95% confidence interval 0.41 to 0.65). In conclusion, about 50% of patients with ST-elevation myocardial infarction seen in clinical practice are usually excluded from RCTs. Hospital mortality in those patients is very high. Primary PCI improves the prognosis and is therefore the preferred reperfusion strategy in these patients. FAU - Koeth, Oliver AU - Koeth O AD - Department of Cardiology, Herzzentrum Ludwigshafen, Ludwigshafen, Germany. FAU - Zahn, Ralf AU - Zahn R FAU - Gitt, Anselm Kai AU - Gitt AK FAU - Bauer, Timm AU - Bauer T FAU - Juenger, Claus AU - Juenger C FAU - Senges, Jochen AU - Senges J FAU - Zeymer, Uwe AU - Zeymer U CN - Maximal Individual Therapy in Acute Myocardial Infarction Plus Study Group LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 RN - 0 (Adrenergic beta-Antagonists) RN - 0 (Angiotensin-Converting Enzyme Inhibitors) RN - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors) RN - 0 (Platelet Aggregation Inhibitors) RN - A74586SNO7 (Clopidogrel) RN - OM90ZUW7M1 (Ticlopidine) RN - R16CO5Y76E (Aspirin) SB - IM MH - Adrenergic beta-Antagonists/therapeutic use MH - Aged MH - Angiotensin-Converting Enzyme Inhibitors/therapeutic use MH - Aspirin/therapeutic use MH - Clopidogrel MH - *Electrocardiography MH - Female MH - Follow-Up Studies MH - Germany/epidemiology MH - Guideline Adherence MH - Hospital Mortality/trends MH - Humans MH - Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use MH - Male MH - Middle Aged MH - Myocardial Infarction/mortality/physiopathology/*therapy MH - Myocardial Reperfusion/*methods MH - Odds Ratio MH - Platelet Aggregation Inhibitors/therapeutic use MH - Prospective Studies MH - Randomized Controlled Trials as Topic MH - Registries MH - Ticlopidine/analogs & derivatives/therapeutic use MH - Treatment Outcome EDAT- 2009/10/06 06:00 MHDA- 2009/10/21 06:00 CRDT- 2009/10/06 06:00 PHST- 2009/03/19 00:00 [received] PHST- 2009/05/29 00:00 [revised] PHST- 2009/05/29 00:00 [accepted] PHST- 2009/10/06 06:00 [entrez] PHST- 2009/10/06 06:00 [pubmed] PHST- 2009/10/21 06:00 [medline] AID - S0002-9149(09)01177-1 [pii] AID - 10.1016/j.amjcard.2009.05.054 [doi] PST - ppublish SO - Am J Cardiol. 2009 Oct 15;104(8):1074-7. doi: 10.1016/j.amjcard.2009.05.054. PMID- 19797974 OWN - NLM STAT- MEDLINE DCOM- 20100128 LR - 20161125 IS - 1558-2035 (Electronic) IS - 1558-2027 (Linking) VI - 11 IP - 1 DP - 2010 Jan TI - The Bypass Angioplasty Revascularization in Type 1 and Type 2 Diabetes Study: 5-year follow-up of revascularization with percutaneous coronary intervention versus coronary artery bypass grafting in diabetic patients with multivessel disease. PG - 26-33 LID - 10.2459/JCM.0b013e328330ea32 [doi] AB - OBJECTIVES: The aim of the Bypass Angioplasty Revascularization in Type 1 and Type 2 Diabetes study was to assess percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) as treatments for multivessel coronary artery disease in diabetic patients. BACKGROUND: CABG is generally regarded as the treatment of choice for multivessel coronary artery disease in diabetes. PCI is an alternative therapy. The Bypass Angioplasty Revascularization in Type 1 and 2 Diabetes study compared long-term outcomes of CABG with PCI in diabetic patients treated during the bare-metal stent era. METHODS: We collected data prospectively on consecutive diabetic patients undergoing index angiography in a single tertiary centre from January 1998 to December 2001. Multivessel coronary artery disease was defined as more than 50% luminal stenosis in two or more vessels. Exclusion criteria included left main stem disease and previous revascularization. RESULTS: Two hundred and thirty-five eligible patients underwent CABG and 237 PCI. Median follow-up was 5.4 years. There were 46 (19%) deaths in the CABG group and 43 (18%) deaths in the PCI group (P = 0.64). Cox regression analysis revealed baseline glomerular filtration rate (hazard ratio 0.979, P = 0.001), age (hazard ratio 1.034, P = 0.033), urgent procedure (hazard ratio 1.97, P = 0.008) and myocardial infarction within 4 weeks (hazard ratio 2.494, P = 0.041) to be important predictors of outcome. At 5 years, there was no mortality difference (hazard ratio 1.0) following adjustment for baseline characteristics, and the Kaplan-Meier survival curves were similar. A subanalysis of patients with three-vessel disease revealed similar outcomes with both PCI and CABG. CONCLUSION: In the Bypass Angioplasty Revascularization in Type 1 and Type 2 Diabetes study, diabetic patients with multivessel coronary artery disease had similar long-term mortality whether treated with CABG or PCI, the revascularization determined by the physician's choice. This was despite the frequent use of a strategy of selective revascularization in the PCI arm. Randomized trials comparing PCI and CABG specifically in diabetes, that is, Coronary Artery Revascularization in Diabetes and Future Revascularization Evaluation in Diabetes Mellitus: Optimal Management, will show whether drug-eluting stents further enhance PCI outcomes over the long term. FAU - Kapur, Akhil AU - Kapur A AD - Barts and The London NHS Trust, London, UK. akhil.kapur@bartsandthelondon.nhs.uk FAU - Bartolini, Davide AU - Bartolini D FAU - Finlay, Malcolm C AU - Finlay MC FAU - Qureshi, Ayesha C AU - Qureshi AC FAU - Flather, Marcus AU - Flather M FAU - Strange, Julian W AU - Strange JW FAU - Hall, Roger J AU - Hall RJ LA - eng PT - Comparative Study PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - United States TA - J Cardiovasc Med (Hagerstown) JT - Journal of cardiovascular medicine (Hagerstown, Md.) JID - 101259752 SB - IM MH - *Angioplasty, Balloon, Coronary/adverse effects/mortality MH - Coronary Angiography MH - *Coronary Artery Bypass/adverse effects/mortality MH - Coronary Stenosis/diagnostic imaging/etiology/mortality/surgery/*therapy MH - Diabetes Complications/diagnostic imaging/etiology/mortality/surgery/*therapy MH - Diabetes Mellitus, Type 1/*complications/mortality/therapy MH - Diabetes Mellitus, Type 2/*complications/mortality/therapy MH - Female MH - Humans MH - Kaplan-Meier Estimate MH - Male MH - Middle Aged MH - Patient Selection MH - Proportional Hazards Models MH - Prospective Studies MH - Registries MH - Risk Assessment MH - Risk Factors MH - Severity of Illness Index MH - Time Factors MH - Treatment Outcome EDAT- 2009/10/03 06:00 MHDA- 2010/01/29 06:00 CRDT- 2009/10/03 06:00 PHST- 2009/10/03 06:00 [entrez] PHST- 2009/10/03 06:00 [pubmed] PHST- 2010/01/29 06:00 [medline] AID - 10.2459/JCM.0b013e328330ea32 [doi] PST - ppublish SO - J Cardiovasc Med (Hagerstown). 2010 Jan;11(1):26-33. doi: 10.2459/JCM.0b013e328330ea32. PMID- 19766757 OWN - NLM STAT- MEDLINE DCOM- 20091006 LR - 20201216 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 104 IP - 7 DP - 2009 Oct 1 TI - Efficacy of single-bolus administration of sodium bicarbonate to prevent contrast-induced nephropathy in patients with mild renal insufficiency undergoing an elective coronary procedure. PG - 921-5 LID - 10.1016/j.amjcard.2009.05.034 [doi] AB - We sought to clarify whether a single-bolus intravenous administration of sodium bicarbonate in addition to hydration with sodium chloride prevents contrast-induced nephropathy (CIN). One hundred forty-four patients with mild renal insufficiency (serum creatinine >1.1 to <2.0 mg/dl) undergoing an elective coronary procedure were randomly assigned to the following 2 groups: standard hydration with sodium chloride plus single-bolus intravenous administration of sodium bicarbonate (20 mEq) immediately before contrast exposure (group A, n = 72) and standard hydration alone (group B, n = 72). The primary end point was development of CIN, defined as an increase >25% or >0.5 mg/dl in serum creatinine within 3 days after the procedure. Incidence of the primary end point was lower in group A than in group B (1.4% vs 12.5%, p = 0.017). Incidence of adverse clinical events (acute pulmonary edema, acute renal failure requiring dialysis, and death within 7 days of procedure) did not differ between the 2 groups (0% vs 1.4%). In conclusion, single-bolus intravenous administration of sodium bicarbonate in addition to standard hydration can more effectively prevent CIN than standard hydration alone in patients with mild renal insufficiency undergoing an elective coronary procedure. FAU - Tamura, Akira AU - Tamura A AD - Internal Medicine 2, Oita University, Yufu, Japan. akira@med.oita-u.ac.jp FAU - Goto, Yukie AU - Goto Y FAU - Miyamoto, Kumie AU - Miyamoto K FAU - Naono, Shigeru AU - Naono S FAU - Kawano, Yoshiyuki AU - Kawano Y FAU - Kotoku, Munenori AU - Kotoku M FAU - Watanabe, Toru AU - Watanabe T FAU - Kadota, Junichi AU - Kadota J LA - eng PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 RN - 0 (Contrast Media) RN - 8MDF5V39QO (Sodium Bicarbonate) SB - IM CIN - Am J Cardiol. 2010 Apr 1;105(7):1042-3. doi: 10.1016/j.amjcard.2009.11.011. PMID: 20346331 MH - Acute Kidney Injury/*chemically induced/*prevention & control MH - Aged MH - Aged, 80 and over MH - Angioplasty, Balloon, Coronary/methods MH - Contrast Media/*adverse effects MH - Coronary Angiography/methods MH - Coronary Disease/*complications/diagnostic imaging/*therapy MH - Dose-Response Relationship, Drug MH - Elective Surgical Procedures MH - Female MH - Fluid Therapy/methods MH - Follow-Up Studies MH - Humans MH - Infusions, Intravenous MH - Kidney Function Tests MH - Male MH - Reference Values MH - Renal Insufficiency, Chronic/*complications/diagnosis MH - Risk Assessment MH - Severity of Illness Index MH - Sodium Bicarbonate/*administration & dosage MH - Treatment Outcome EDAT- 2009/09/22 06:00 MHDA- 2009/10/07 06:00 CRDT- 2009/09/22 06:00 PHST- 2009/04/08 00:00 [received] PHST- 2009/05/10 00:00 [revised] PHST- 2009/05/10 00:00 [accepted] PHST- 2009/09/22 06:00 [entrez] PHST- 2009/09/22 06:00 [pubmed] PHST- 2009/10/07 06:00 [medline] AID - S0002-9149(09)01101-1 [pii] AID - 10.1016/j.amjcard.2009.05.034 [doi] PST - ppublish SO - Am J Cardiol. 2009 Oct 1;104(7):921-5. doi: 10.1016/j.amjcard.2009.05.034. PMID- 19761983 OWN - NLM STAT- MEDLINE DCOM- 20091207 LR - 20220331 IS - 1876-7591 (Electronic) IS - 1876-7591 (Linking) VI - 2 IP - 9 DP - 2009 Sep TI - Increasing benefit from revascularization is associated with increasing amounts of myocardial hibernation: a substudy of the PARR-2 trial. PG - 1060-8 LID - 10.1016/j.jcmg.2009.02.017 [doi] AB - OBJECTIVES: We sought to determine: 1) whether F-18-fluorodeoxyglucose (FDG) positron emission tomography (PET) parameters identify high-risk patients who gain benefit from revascularization; 2) whether there is a cut point for such benefit; and 3) predictors of outcome in patients with severe left ventricular (LV) dysfunction due to coronary artery disease. BACKGROUND: Patients with ischemic LV dysfunction might benefit from revascularization but not without risk. The FDG PET imaging can detect viable myocardium that recovers after revascularization. In the PARR-2 (PET and Recovery Following Revascularization-2) trial, FDG PET imaging showed a nonsignificant trend for improved outcome compared with standard care. Understanding the predictors of outcome from this prospective trial should help better identify patients at risk and which patients most benefit from revascularization. METHODS: This post hoc analysis included 182 patients with left ventricular ejection fraction (LVEF) <35% and coronary artery disease, being considered for revascularization work-up, and randomized to the PET arm of PARR-2. The primary outcome was a composite of cardiac death, myocardial infarction, or cardiac repeat hospital stay at 1 year. RESULTS: There is an interaction between PET mismatch and protocol revascularization such that higher mismatch, when combined with revascularization, yields fewer primary outcome events (p = 0.02). On the basis of adjusted Cox modeling, with reduced mismatch (<7%), the risk is not significantly different with or without revascularization. As mismatch increases above this mark, risk is reduced with revascularization. Increasing creatinine (for a 10-mumol/l increase: hazard ratio: 1.03, 95% confidence interval: 1.01 to 1.06, p = 0.010) is also associated with increased risk, whereas decreasing LVEF (for a 2% decrease: hazard ratio: 1.08, 95% confidence interval: 0.99 to 1.18, p = 0.087) trends toward an association with increased risk. CONCLUSIONS: In this post hoc analysis, patients with ischemic cardiomyopathy with larger amounts of mismatch have improved outcome with revascularization. Renal function was also an independent predictor of outcome. The FDG PET seems to define high-risk patients that gain benefit from revascularization. (PET and Recovery Following Revascularization [PARR 2]; NCT00385242). FAU - D'Egidio, Gianni AU - D'Egidio G AD - National Cardiac PET Centre, Division of Cardiology, Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Ottawa, Ontario K1Y 4W7, Canada. FAU - Nichol, Graham AU - Nichol G FAU - Williams, Kathryn A AU - Williams KA FAU - Guo, Ann AU - Guo A FAU - Garrard, Linda AU - Garrard L FAU - deKemp, Robert AU - deKemp R FAU - Ruddy, Terrence D AU - Ruddy TD FAU - DaSilva, Jean AU - DaSilva J FAU - Humen, Dennis AU - Humen D FAU - Gulenchyn, Karen Y AU - Gulenchyn KY FAU - Freeman, Michael AU - Freeman M FAU - Racine, Normand AU - Racine N FAU - Benard, Francois AU - Benard F FAU - Hendry, Paul AU - Hendry P FAU - Beanlands, Rob S B AU - Beanlands RS CN - PARR-2 Investigators LA - eng SI - ClinicalTrials.gov/NCT00385242 PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - United States TA - JACC Cardiovasc Imaging JT - JACC. Cardiovascular imaging JID - 101467978 RN - 0 (Radiopharmaceuticals) RN - 0Z5B2CJX4D (Fluorodeoxyglucose F18) SB - IM CIN - JACC Cardiovasc Imaging. 2009 Sep;2(9):1069-71. doi: 10.1016/j.jcmg.2009.06.005. PMID: 19761984 MH - Aged MH - Coronary Artery Disease/complications/diagnostic imaging/mortality/*therapy MH - Female MH - *Fluorodeoxyglucose F18 MH - Humans MH - Kidney/physiopathology MH - Male MH - Middle Aged MH - Myocardial Infarction/etiology/mortality MH - *Myocardial Revascularization/adverse effects/mortality MH - Myocardial Stunning/diagnostic imaging/*etiology/mortality/physiopathology MH - Myocardium/*pathology MH - Patient Readmission MH - Patient Selection MH - *Positron-Emission Tomography MH - Predictive Value of Tests MH - Proportional Hazards Models MH - Prospective Studies MH - *Radiopharmaceuticals MH - Risk Assessment MH - Risk Factors MH - Stroke Volume MH - Time Factors MH - Tissue Survival MH - Treatment Outcome MH - Ventricular Dysfunction, Left/diagnostic imaging/*etiology/mortality/physiopathology EDAT- 2009/09/19 06:00 MHDA- 2009/12/16 06:00 CRDT- 2009/09/19 06:00 PHST- 2008/10/02 00:00 [received] PHST- 2009/01/21 00:00 [revised] PHST- 2009/02/02 00:00 [accepted] PHST- 2009/09/19 06:00 [entrez] PHST- 2009/09/19 06:00 [pubmed] PHST- 2009/12/16 06:00 [medline] AID - S1936-878X(09)00455-0 [pii] AID - 10.1016/j.jcmg.2009.02.017 [doi] PST - ppublish SO - JACC Cardiovasc Imaging. 2009 Sep;2(9):1060-8. doi: 10.1016/j.jcmg.2009.02.017. PMID- 19744614 OWN - NLM STAT- MEDLINE DCOM- 20090929 LR - 20140730 IS - 1558-3597 (Electronic) IS - 0735-1097 (Linking) VI - 54 IP - 12 DP - 2009 Sep 15 TI - Influence of continuous infusion of low-dose human atrial natriuretic peptide on renal function during cardiac surgery: a randomized controlled study. PG - 1058-64 LID - 10.1016/j.jacc.2009.05.047 [doi] AB - OBJECTIVES: The purpose of this study was to determine the effect of human atrial natriuretic peptide (hANP) in patients who underwent coronary artery bypass grafting (CABG) on renal function. BACKGROUND: Acute renal failure after cardiac surgery is associated with high morbidity and mortality. METHODS: A total of 504 patients who underwent CABG were divided into 2 groups: 1 group received hANP at 0.02 microg/kg/min from the start of cardiopulmonary bypass (hANP group), and 1 group did not receive hANP (placebo group). Various parameters were measured before and after surgery. RESULTS: There was no difference in mortality between the 2 groups, but post-operative complications were less frequent in the hANP group (p = 0.0208). In the hANP group, serum creatinine (Cr) was significantly lower and urinary Cr and Cr clearance were significantly higher from post-operative day 1 to week 1. The maximum post-operative Cr level and percent increase of Cr were significantly lower in the hANP group (p < 0.0001). Patients with Cr exceeding 2.0 mg/dl included 1 in the hANP group and 8 in the placebo group, showing a significant difference (p = 0.0374). Four patients in the placebo group and none in the hANP group required hemodialysis, but the difference was not statistically significant. CONCLUSIONS: Continuous infusion of low-dose hANP from the start of cardiopulmonary bypass effectively maintained post-operative renal function. Infusion of hANP prevents early post-operative acute renal failure and helps to achieve safer cardiac surgery. ( CLINICAL TRIAL REGISTRATION NUMBER: UMIN000001440). FAU - Sezai, Akira AU - Sezai A AD - Department of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo, Japan. asezai@med.nihon-u.ac.jp FAU - Hata, Mitsumasa AU - Hata M FAU - Niino, Tetsuya AU - Niino T FAU - Yoshitake, Isamu AU - Yoshitake I FAU - Unosawa, Satoshi AU - Unosawa S FAU - Wakui, Shinji AU - Wakui S FAU - Osaka, Shunji AU - Osaka S FAU - Takayama, Tadateru AU - Takayama T FAU - Kasamaki, Yuji AU - Kasamaki Y FAU - Hirayama, Atsushi AU - Hirayama A FAU - Minami, Kazutomo AU - Minami K LA - eng PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - United States TA - J Am Coll Cardiol JT - Journal of the American College of Cardiology JID - 8301365 RN - 85637-73-6 (Atrial Natriuretic Factor) RN - AYI8EX34EU (Creatinine) SB - IM MH - Aged MH - Atrial Natriuretic Factor/*administration & dosage/pharmacokinetics MH - *Cardiopulmonary Bypass MH - *Coronary Artery Bypass MH - Creatinine/blood/urine MH - Dose-Response Relationship, Drug MH - Female MH - Follow-Up Studies MH - Glomerular Filtration Rate/drug effects MH - Humans MH - Infusions, Intravenous MH - Intraoperative Care/*methods MH - Kidney/drug effects/*physiopathology MH - Male MH - Myocardial Ischemia/physiopathology/*surgery MH - Postoperative Complications/prevention & control MH - Renal Insufficiency/physiopathology/*prevention & control MH - Treatment Outcome EDAT- 2009/09/12 06:00 MHDA- 2009/09/30 06:00 CRDT- 2009/09/12 06:00 PHST- 2009/01/08 00:00 [received] PHST- 2009/04/29 00:00 [revised] PHST- 2009/05/25 00:00 [accepted] PHST- 2009/09/12 06:00 [entrez] PHST- 2009/09/12 06:00 [pubmed] PHST- 2009/09/30 06:00 [medline] AID - S0735-1097(09)02147-0 [pii] AID - 10.1016/j.jacc.2009.05.047 [doi] PST - ppublish SO - J Am Coll Cardiol. 2009 Sep 15;54(12):1058-64. doi: 10.1016/j.jacc.2009.05.047. PMID- 19732282 OWN - NLM STAT- MEDLINE DCOM- 20110131 LR - 20260128 IS - 1540-8183 (Electronic) IS - 0896-4327 (Linking) VI - 22 IP - 6 DP - 2009 Dec TI - Favorable long-term survival in patients undergoing multivessel-PCI compared to predicted prognosis of CABG estimated by EuroSCORE: procedural and clinical determinants of long-term outcome. PG - 511-9 LID - 10.1111/j.1540-8183.2009.00498.x [doi] AB - AIMS/METHODS: Treatment of patients with multivessel coronary artery disease (CAD) has been an ongoing focus of recent clinical studies, questioning the ideal treatment. Randomized trials comparing coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) have so far only included a minority of screened patients. Therefore, we analyzed data from 679 consecutive "all-comer" patients, who underwent PCI in at least two main vessels. Expected in-hospital mortality for CABG was calculated using the EuroSCORE and compared to the observed mortality rate during in-hospital as well as long-term follow-up. RESULTS: The patients were suffering from 2.5 +/- 0.6 diseased vessels, and 2.8 +/- 1.0 lesions were stented (32% of patients received at least one drug-eluting stent [DES]; 20% of lesions were treated with DES). Forty-seven percent of patients were treated for acute coronary syndrome (ACS) (N = 176 ST-elevation myocardial infarction [STEMI]; N = 140 non-ST-elevation myocardial infarction [NSTEMI]). The EuroSCORE was significantly higher in ACS patients compared to stable patients (logistic: STEMI 16.3 +/- 17.2; NSTEMI 13.6 +/- 13.0; stable CAD 3.9 +/- 4.2). The observed in-hospital mortality (STEMI 13.0%; NSTEMI 2.9%; stable CAD 1.7%, P < 0.001) was far lower than the estimated 30-day mortality. Cox regression analysis identified an elevated logistic EuroSCORE (HR per quartile 2.7, P = 0.003), severely reduced left ventricular ejection fraction (HR 2.7, P < 0.001), elevated C-reactive protein (HR 1.8, P = 0.012), and chronic renal failure (HR 2.8, P = 0.001) as independent predictors of long-term mortality. CONCLUSIONS: The EuroSCORE, which is routinely used to estimate the perioperative risk of patients undergoing CABG, also predicts short- and long-term prognosis of patients undergoing MV-PCI. The observed mortality of patients undergoing MV-PCI seems to be much lower than the estimated mortality of CABG. FAU - Lehmann, Ralf AU - Lehmann R AD - Department of Cardiology, Johann Wolfgang Goethe-University, Frankfurt, Germany. FAU - Fichtlscherer, Stephan AU - Fichtlscherer S FAU - Schachinger, Volker AU - Schachinger V FAU - Held, Laura AU - Held L FAU - Hobler, Carola AU - Hobler C FAU - Baier, Gregor AU - Baier G FAU - Zeiher, Andreas M AU - Zeiher AM FAU - Spyridopoulos, Ioakim AU - Spyridopoulos I LA - eng PT - Comparative Study PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20090902 PL - United States TA - J Interv Cardiol JT - Journal of interventional cardiology JID - 8907826 SB - IM MH - Aged MH - Analysis of Variance MH - Angioplasty, Balloon, Coronary/*mortality/statistics & numerical data MH - Coronary Artery Bypass/*mortality/statistics & numerical data MH - Coronary Artery Disease/surgery/*therapy MH - Drug-Eluting Stents MH - Female MH - Health Status Indicators MH - Hospital Mortality MH - Humans MH - Logistic Models MH - Male MH - Middle Aged MH - Multivariate Analysis MH - Prognosis MH - Proportional Hazards Models MH - ROC Curve MH - Retrospective Studies MH - Risk Assessment MH - Time Factors MH - Treatment Outcome MH - United Kingdom EDAT- 2009/09/08 06:00 MHDA- 2011/02/01 06:00 CRDT- 2009/09/08 06:00 PHST- 2009/09/08 06:00 [entrez] PHST- 2009/09/08 06:00 [pubmed] PHST- 2011/02/01 06:00 [medline] AID - JOIC498 [pii] AID - 10.1111/j.1540-8183.2009.00498.x [doi] PST - ppublish SO - J Interv Cardiol. 2009 Dec;22(6):511-9. doi: 10.1111/j.1540-8183.2009.00498.x. Epub 2009 Sep 2. PMID- 19702677 OWN - NLM STAT- MEDLINE DCOM- 20100106 LR - 20161125 IS - 1540-8183 (Electronic) IS - 0896-4327 (Linking) VI - 22 IP - 5 DP - 2009 Oct TI - Outcomes of patients with coronary artery perforation complicating percutaneous coronary intervention and correlations with the type of adjunctive antithrombotic therapy: pooled analysis from REPLACE-2, ACUITY, and HORIZONS-AMI trials. PG - 453-9 LID - 10.1111/j.1540-8183.2009.00494.x [doi] AB - BACKGROUND: The lack of a specific counteragent to bivalirudin may complicate the management of patients with coronary artery (CA) perforation during percutaneous coronary intervention (PCI). AIM: Assess outcomes of patients with CA perforation from three PCI trials comparing intravenous bivalirudin with provisional glycoprotein (GP) IIb/IIIa inhibition versus unfractionated heparin (UFH) plus GP IIb/IIIa. METHODS: A pooled analysis of patients treated with PCI in three randomized trials including REPLACE-2, ACUITY, and HORIZONS-AMI. RESULTS: Among a total of 12,921 patients, CA perforation occurred in 35 patients (0.27%). By multivariable analysis, baseline creatinine clearance was the only independent predictor of CA perforation (per 10 mL/min decrease, odds ratio [95% confidence interval]= 1.28 [1.11, 1.47], P = 0.0007). At 30 days, patients with versus without CA perforation had significantly (all P values < or =0.001) higher rates of 30-day mortality (11.4% vs. 1.0%), myocardial infarction (MI) [Q wave: 22.9% vs. 5.7%; non-Q wave: 17.1% vs. 4.9%], target vessel revascularization (TVR) [20.1% vs. 1.8%], and composite end-point of death/MI/TVR (31.4% vs. 7.8%). Patients assigned to bivalirudin versus UFH plus a GP IIb/IIIa inhibitor had nonsignificantly lower rates of death (0% vs. 18.8%, P = 0.08), similar rates of MI (26.7% vs. 25.0%, P = 0.92), significantly lower rates of TVR (6.7% vs. 37.5%, P = 0.04), and similar rates of the composite end-point of death/MI/TVR (35.5% vs. 26.7%, P = 0.54). CONCLUSION: In three PCI trials, treatment of patients experiencing CA perforation with adjunctive antithrombotic therapy of bivalirudin monotherapy was not associated with worse outcomes compared to treatment with UFH plus GP IIb/IIIa inhibitors. FAU - Doll, Jacob A AU - Doll JA AD - Columbia University Medical Center and the Cardiovascular Research Foundation, New York, USA. FAU - Nikolsky, Eugenia AU - Nikolsky E FAU - Stone, Gregg W AU - Stone GW FAU - Mehran, Roxana AU - Mehran R FAU - Lincoff, A Michael AU - Lincoff AM FAU - Caixeta, Adriano AU - Caixeta A FAU - McLaurin, Brent AU - McLaurin B FAU - Cristea, Ecaterina AU - Cristea E FAU - Fahy, Martin AU - Fahy M FAU - Kesanakurthy, Vijaya AU - Kesanakurthy V FAU - Lansky, Alexandra J AU - Lansky AJ LA - eng PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial DEP - 20090820 PL - United States TA - J Interv Cardiol JT - Journal of interventional cardiology JID - 8907826 RN - 0 (Anticoagulants) RN - 0 (Fibrinolytic Agents) RN - 0 (Hirudins) RN - 0 (Peptide Fragments) RN - 0 (Platelet Glycoprotein GPIIb-IIIa Complex) RN - 0 (Recombinant Proteins) RN - 9005-49-6 (Heparin) RN - TN9BEX005G (bivalirudin) SB - IM CIN - J Interv Cardiol. 2010 Apr;23(2):203. doi: 10.1111/j.1540-8183.2010.00528.x. PMID: 20236210 MH - Aged MH - Anticoagulants/administration & dosage MH - Chemotherapy, Adjuvant MH - Coronary Vessels/*injuries MH - Drug Therapy, Combination MH - Female MH - Fibrinolytic Agents/*administration & dosage MH - Heparin/administration & dosage MH - Hirudins/*administration & dosage MH - Humans MH - Male MH - Middle Aged MH - Myocardial Infarction/mortality/*surgery MH - Myocardial Revascularization/*adverse effects/methods/mortality MH - Peptide Fragments/*administration & dosage MH - Platelet Glycoprotein GPIIb-IIIa Complex/antagonists & inhibitors MH - Recombinant Proteins/administration & dosage MH - Survival Rate MH - Treatment Outcome MH - Wounds, Penetrating/*etiology/*therapy EDAT- 2009/08/26 09:00 MHDA- 2010/01/07 06:00 CRDT- 2009/08/26 09:00 PHST- 2009/08/26 09:00 [entrez] PHST- 2009/08/26 09:00 [pubmed] PHST- 2010/01/07 06:00 [medline] AID - JOIC494 [pii] AID - 10.1111/j.1540-8183.2009.00494.x [doi] PST - ppublish SO - J Interv Cardiol. 2009 Oct;22(5):453-9. doi: 10.1111/j.1540-8183.2009.00494.x. Epub 2009 Aug 20. PMID- 19699846 OWN - NLM STAT- MEDLINE DCOM- 20091008 LR - 20181201 IS - 1097-6744 (Electronic) IS - 0002-8703 (Linking) VI - 158 IP - 3 DP - 2009 Sep TI - Effect of prasugrel versus clopidogrel on outcomes among patients with acute coronary syndrome undergoing percutaneous coronary intervention without stent implantation: a TRial to assess Improvement in Therapeutic Outcomes by optimizing platelet inhibitioN with prasugrel (TRITON)-Thrombolysis in Myocardial Infarction (TIMI) 38 substudy. PG - e21-6 LID - 10.1016/j.ahj.2009.06.021 [doi] AB - BACKGROUND: Prasugrel led to a significant reduction in ischemic cardiovascular events among patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI) with stent implantation compared to clopidogrel. Whether this benefit extends to patients undergoing PCI without stent implantation is unknown. METHODS: In TRial to assess Improvement in Therapeutic Outcomes by optimizing platelet inhibitioN with prasugrel (TRITON)-Thrombolysis in Myocardial Infarction (TIMI) 38, patients (n = 13 608) undergoing PCI for ACS were randomized to aspirin plus clopidogrel or prasugrel. This postrandomization analysis of a prespecified subgroup was restricted to patients who underwent PCI without stent implantation (n = 569). RESULTS: Patients who underwent PCI without stent implantation were older and had a higher incidence of hypertension, diabetes, prior myocardial infarction (MI), prior coronary artery bypass (CABG) surgery, and renal dysfunction than patients who underwent stent implantation. In the group that did not undergo stent implantation, baseline characteristics were similar between patients receiving clopidogrel and prasugrel. The composite of cardiovascular death, nonfatal MI, and nonfatal stroke occurred in 14.2% of patients receiving prasugrel and 17.1% of patients receiving clopidogrel (HR 0.82, P = .27). There were significant reductions favoring prasugrel in the rates of urgent target vessel revascularization (TVR; HR 0.46, P = .040) and any TVR (HR 0.40, P = .009) and a trend toward a reduction in the incidence of nonfatal MI (HR 0.65, P = .11). CABG-related TIMI major bleeding was more frequent among patients receiving prasugrel. There were no significant interactions between treatment and PCI type. CONCLUSION: Among ACS patients who underwent PCI without stent implantation, prasugrel therapy tended to reduce clinical ischemic events and to increase bleeding events to a similar magnitude as among patients who received stents. FAU - Pride, Yuri B AU - Pride YB AD - Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02115, USA. FAU - Wiviott, Stephen D AU - Wiviott SD FAU - Buros, Jacqueline L AU - Buros JL FAU - Zorkun, Cafer AU - Zorkun C FAU - Tariq, M Umer AU - Tariq MU FAU - Antman, Elliott M AU - Antman EM FAU - Braunwald, Eugene AU - Braunwald E FAU - Gibson, C Michael AU - Gibson CM CN - TIMI Study Group LA - eng SI - ClinicalTrials.gov/NCT00097591 PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 RN - 0 (Piperazines) RN - 0 (Platelet Aggregation Inhibitors) RN - 0 (Thiophenes) RN - A74586SNO7 (Clopidogrel) RN - G89JQ59I13 (Prasugrel Hydrochloride) RN - OM90ZUW7M1 (Ticlopidine) RN - R16CO5Y76E (Aspirin) SB - IM MH - Acute Coronary Syndrome/drug therapy/*therapy MH - Aged MH - *Angioplasty, Balloon, Coronary MH - Aspirin/therapeutic use MH - Clopidogrel MH - Female MH - Humans MH - Male MH - Middle Aged MH - Piperazines/*therapeutic use MH - Platelet Aggregation Inhibitors/*therapeutic use MH - Prasugrel Hydrochloride MH - Thiophenes/*therapeutic use MH - Ticlopidine/*analogs & derivatives/therapeutic use EDAT- 2009/08/25 09:00 MHDA- 2009/10/09 06:00 CRDT- 2009/08/25 09:00 PHST- 2009/05/01 00:00 [received] PHST- 2009/06/20 00:00 [accepted] PHST- 2009/08/25 09:00 [entrez] PHST- 2009/08/25 09:00 [pubmed] PHST- 2009/10/09 06:00 [medline] AID - S0002-8703(09)00476-1 [pii] AID - 10.1016/j.ahj.2009.06.021 [doi] PST - ppublish SO - Am Heart J. 2009 Sep;158(3):e21-6. doi: 10.1016/j.ahj.2009.06.021. PMID- 19695543 OWN - NLM STAT- MEDLINE DCOM- 20091029 LR - 20161125 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 2 IP - 8 DP - 2009 Aug TI - Impact of chronic kidney disease on early (30-day) and late (1-year) outcomes of patients with acute coronary syndromes treated with alternative antithrombotic treatment strategies: an ACUITY (Acute Catheterization and Urgent Intervention Triage strategY) substudy. PG - 748-57 LID - 10.1016/j.jcin.2009.05.018 [doi] AB - OBJECTIVES: In this substudy of the ACUITY (Acute Catheterization and Urgent Intervention Triage strategY) trial, we investigated the relationship between chronic kidney disease (CKD) and clinical outcomes, and compared the safety and efficacy of bivalirudin monotherapy versus heparin plus a glycoprotein IIb/IIIa inhibitor (GPI). BACKGROUND: CKD is an important predictor of prognosis in the general population. The outcomes of patients with CKD and acute coronary syndromes (ACS) have not been well studied. METHODS: In the ACUITY study, 13,819 patients with moderate- and high-risk ACS undergoing an early, invasive strategy were randomly assigned to 1 of 3 antithrombin regimens: a heparin plus a GPI, bivalirudin plus a GPI, or bivalirudin monotherapy. CKD (creatinine clearance <60 ml/min) was present in 2,469 (19.1%) of 12,939 randomized patients with baseline creatinine clearance data. RESULTS: Patients with CKD had worse 30-day and 1-year clinical outcomes than those with normal renal function. There were no significant differences between bivalirudin monotherapy and heparin plus a GPI in rates of 30-day composite ischemia (11.1% vs. 9.4%, p = 0.27) and net clinical adverse outcomes (16.1% vs. 16.9%, p = 0.65). There was remarkably less major bleeding (6.2% vs. 9.8%, p = 0.008) at 30 days, but no significant difference in 1-year composite ischemia (22.0% vs. 18.9%, p = 0.10) or mortality (7.1% vs. 7.3%, p = 0.96). CONCLUSIONS: In patients with ACS, CKD is associated with higher 30-day and 1-year adverse event rates. Compared with heparin plus a GPI, the use of bivalirudin monotherapy in patients with CKD results in nonstatistically different ischemic outcomes, but significantly less 30-day major bleeding. FAU - Mehran, Roxana AU - Mehran R AD - Columbia University Medical Center and Cardiovascular Research Foundation, New York, New York 10032, USA. rmehran@crf.org FAU - Nikolsky, Eugenia AU - Nikolsky E FAU - Lansky, Alexandra J AU - Lansky AJ FAU - Kirtane, Ajay J AU - Kirtane AJ FAU - Kim, Young-Hak AU - Kim YH FAU - Feit, Frederick AU - Feit F FAU - Manoukian, Steven AU - Manoukian S FAU - Moses, Jeffrey W AU - Moses JW FAU - Ebrahimi, Ramin AU - Ebrahimi R FAU - Ohman, E Magnus AU - Ohman EM FAU - White, Harvey D AU - White HD FAU - Pocock, Stuart J AU - Pocock SJ FAU - Dangas, George D AU - Dangas GD FAU - Stone, Gregg W AU - Stone GW LA - eng PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 RN - 0 (Biomarkers) RN - 0 (Fibrinolytic Agents) RN - 0 (Hirudins) RN - 0 (Peptide Fragments) RN - 0 (Platelet Aggregation Inhibitors) RN - 0 (Platelet Glycoprotein GPIIb-IIIa Complex) RN - 0 (Recombinant Proteins) RN - 9005-49-6 (Heparin) RN - AYI8EX34EU (Creatinine) RN - TN9BEX005G (bivalirudin) SB - IM MH - Acute Coronary Syndrome/*drug therapy/mortality MH - Adult MH - Aged MH - Aged, 80 and over MH - *Angioplasty, Balloon, Coronary/adverse effects/mortality MH - Biomarkers/blood MH - Chronic Disease MH - *Coronary Artery Bypass/adverse effects/mortality MH - Creatinine/blood MH - Drug Therapy, Combination MH - Female MH - Fibrinolytic Agents/*therapeutic use MH - Hemorrhage/chemically induced MH - Heparin/adverse effects/*therapeutic use MH - Hirudins/adverse effects MH - Humans MH - Kidney Diseases/*complications/mortality MH - Logistic Models MH - Male MH - Middle Aged MH - Myocardial Infarction/etiology MH - Myocardial Ischemia/etiology MH - Odds Ratio MH - Peptide Fragments/adverse effects/*therapeutic use MH - Platelet Aggregation Inhibitors/adverse effects/*therapeutic use MH - Platelet Glycoprotein GPIIb-IIIa Complex/*antagonists & inhibitors MH - Prospective Studies MH - Recombinant Proteins/adverse effects/therapeutic use MH - Risk Assessment MH - Time Factors MH - Treatment Outcome MH - Triage EDAT- 2009/08/22 09:00 MHDA- 2009/10/30 06:00 CRDT- 2009/08/22 09:00 PHST- 2009/02/04 00:00 [received] PHST- 2009/05/26 00:00 [revised] PHST- 2009/05/29 00:00 [accepted] PHST- 2009/08/22 09:00 [entrez] PHST- 2009/08/22 09:00 [pubmed] PHST- 2009/10/30 06:00 [medline] AID - S1936-8798(09)00359-8 [pii] AID - 10.1016/j.jcin.2009.05.018 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2009 Aug;2(8):748-57. doi: 10.1016/j.jcin.2009.05.018. PMID- 19668788 OWN - NLM STAT- MEDLINE DCOM- 20091008 LR - 20211020 IS - 1916-7075 (Electronic) IS - 0828-282X (Print) IS - 0828-282X (Linking) VI - 25 IP - 8 DP - 2009 Aug TI - Experience of stenting for atherosclerotic renal artery stenosis in a cardiac catheterization laboratory: technical considerations and complications. PG - e273-8 AB - BACKGROUND: Atherosclerotic renal artery (RA) stenosis contributes to hypertension, renal insufficiency and end stage renal disease, and is independently associated with adverse cardiovascular events. Percutaneous renal intervention is efficacious in treating renovascular hypertension and may be effective in stabilizing or improving renal function, thereby reducing cardiovascular risk. However, high rates of procedural complications have been reported. OBJECTIVES: To determine the nature and frequency of complications of percutaneous renal intervention using contemporary techniques and equipment in a high-volume cardiac catheterization laboratory. METHODS: Consecutive patients undergoing attempted RA stenting for atherosclerotic RA stenosis in the cardiac catheterization laboratory at the Vancouver General Hospital (Vancouver, British Columbia) between June 2000 and March 2007 were enrolled in a prospective registry. Baseline clinical characteristics, procedural and technical information, and complications were recorded. RESULTS: A total of 132 RAs were stented in 106 patients during 108 procedures. The procedural success rate was 100%, with no related death, myocardial infarction, nephrectomy or dialysis. Major complications included three pseudoaneurysms (2.8%) and acute deterioration in renal function in six patients (5.5%), although renal function returned to baseline in one patient at 12 months. CONCLUSIONS: RA stenting can be successfully and safely performed using contemporary techniques, and the low complication rates described should be the minimum standard for contemporary trials evaluating RA stenting. FAU - Jokhi, Percy P AU - Jokhi PP AD - Department of Cardiology, Vancouver Hospital and Health Sciences Centre, Vancouver, British Columbia, Canada. percyjokhi@yahoo.co.uk FAU - Ramanathan, Krishnan AU - Ramanathan K FAU - Walsh, Simon AU - Walsh S FAU - Fung, Anthony Y AU - Fung AY FAU - Saw, Jacqueline AU - Saw J FAU - Fox, Rebecca S AU - Fox RS FAU - Zalunardo, Nadia AU - Zalunardo N FAU - Buller, Christopher E AU - Buller CE LA - eng PT - Journal Article PL - England TA - Can J Cardiol JT - The Canadian journal of cardiology JID - 8510280 SB - IM MH - Adult MH - Aged MH - Aged, 80 and over MH - Angioplasty, Balloon/*adverse effects MH - Atherosclerosis/*therapy MH - Female MH - Humans MH - Male MH - Middle Aged MH - Renal Artery Obstruction/*therapy MH - Stents MH - Treatment Outcome PMC - PMC2732381 EDAT- 2009/08/12 09:00 MHDA- 2009/10/09 06:00 PMCR- 2010/08/01 CRDT- 2009/08/12 09:00 PHST- 2009/08/12 09:00 [entrez] PHST- 2009/08/12 09:00 [pubmed] PHST- 2009/10/09 06:00 [medline] PHST- 2010/08/01 00:00 [pmc-release] AID - S0828-282X(09)70121-7 [pii] AID - cjc25e273 [pii] AID - 10.1016/s0828-282x(09)70121-7 [doi] PST - ppublish SO - Can J Cardiol. 2009 Aug;25(8):e273-8. doi: 10.1016/s0828-282x(09)70121-7. PMID- 19660605 OWN - NLM STAT- MEDLINE DCOM- 20090827 LR - 20220318 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 104 IP - 4 DP - 2009 Aug 15 TI - Comparison of usefulness of simvastatin 20 mg versus 80 mg in preventing contrast-induced nephropathy in patients with acute coronary syndrome undergoing percutaneous coronary intervention. PG - 519-24 LID - 10.1016/j.amjcard.2009.04.014 [doi] AB - Contrast-induced nephropathy limits the outcomes of percutaneous coronary intervention (PCI). The present study compared the protective effects of different statin doses on renal function. A total of 228 patients with acute coronary syndrome undergoing selective PCI were randomly divided into simvastatin 20-mg group (S20, n = 115) and simvastatin 80-mg group (S80, n = 113). Serum creatinine was measured at admission, the day of PCI, and 24 and 48 hours after PCI. The creatinine clearance was calculated using the Cochcroft-Gault formula. High-sensitive C-reactive protein, P-selectin, and intercellular adhesion molecule-1 were also measured before and after the procedure. Contrast-induced nephropathy was defined as a postprocedure increase in serum creatinine of > or =0.5 mg/dl or >25% from baseline. The serum creatinine significantly increased after PCI, with the peak value occurring at 24 hours, and then began to decrease. At 48 hours, the serum creatinine had decreased to the baseline level in the S80 group, but it had failed to do so in the S20 group. At 24 and 48 hours after PCI, the serum creatinine was lower in the S80 group than in the S20 group (p <0.05 and p <0.001, respectively). The creatinine clearance significantly decreased after PCI, with the lowest value occurring at 24 hours, and then it began to increase. In the S80 group, the creatinine clearance recovered to baseline level at 48 hours, but it failed to do so in the S20 group. The creatinine clearance was greater at 24 and 48 hours in the S80 group than that in the S20 group. Although the procedure caused a significant increase in high-sensitive C-reactive protein, P-selectin, and intercellular adhesion molecule-1 levels, the value was lower in the S80 group than in the S20 group (p <0.001). In conclusion, pretreatment with simvastatin 80 mg before PCI could further decrease the occurrence of contrast-induced nephropathy compared with simvastatin 20 mg. This benefit was associated with the lowering of high-sensitive C-reactive protein, P-selectin, and intercellular adhesion molecule-1 levels. FAU - Xinwei, Jia AU - Xinwei J AD - Second Hospital of Hebei Medical University, Shijiazhuang City, Hebei Province, China. FAU - Xianghua, Fu AU - Xianghua F FAU - Jing, Zhang AU - Jing Z FAU - Xinshun, Gu AU - Xinshun G FAU - Ling, Xue AU - Ling X FAU - Weize, Fan AU - Weize F FAU - Guozhen, Hao AU - Guozhen H FAU - Yunfa, Jiang AU - Yunfa J FAU - Weili, Wu AU - Weili W FAU - Shiqiang, Li AU - Shiqiang L LA - eng PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial DEP - 20090621 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 RN - 0 (Contrast Media) RN - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors) RN - 0 (P-Selectin) RN - 126547-89-5 (Intercellular Adhesion Molecule-1) RN - 9007-41-4 (C-Reactive Protein) RN - AGG2FN16EV (Simvastatin) RN - AYI8EX34EU (Creatinine) SB - IM MH - Acute Coronary Syndrome/*therapy MH - Acute Kidney Injury/*chemically induced/*prevention & control MH - Aged MH - *Angioplasty, Balloon, Coronary MH - C-Reactive Protein/metabolism MH - Contrast Media/adverse effects MH - Creatinine/blood MH - Dose-Response Relationship, Drug MH - Female MH - Humans MH - Hydroxymethylglutaryl-CoA Reductase Inhibitors/*administration & dosage MH - Intercellular Adhesion Molecule-1/blood MH - Kidney Function Tests MH - Male MH - Middle Aged MH - P-Selectin/blood MH - Prospective Studies MH - Simvastatin/*administration & dosage EDAT- 2009/08/08 09:00 MHDA- 2009/08/28 09:00 CRDT- 2009/08/08 09:00 PHST- 2008/12/25 00:00 [received] PHST- 2009/04/08 00:00 [revised] PHST- 2009/04/08 00:00 [accepted] PHST- 2009/08/08 09:00 [entrez] PHST- 2009/08/08 09:00 [pubmed] PHST- 2009/08/28 09:00 [medline] AID - S0002-9149(09)00916-3 [pii] AID - 10.1016/j.amjcard.2009.04.014 [doi] PST - ppublish SO - Am J Cardiol. 2009 Aug 15;104(4):519-24. doi: 10.1016/j.amjcard.2009.04.014. Epub 2009 Jun 21. PMID- 19635148 OWN - NLM STAT- MEDLINE DCOM- 20090918 LR - 20211020 IS - 1745-6215 (Electronic) IS - 1745-6215 (Linking) VI - 10 DP - 2009 Jul 27 TI - RADAR - A randomised, multi-centre, prospective study comparing best medical treatment versus best medical treatment plus renal artery stenting in patients with haemodynamically relevant atherosclerotic renal artery stenosis. PG - 60 LID - 10.1186/1745-6215-10-60 [doi] AB - BACKGROUND: Prospective, international, multi-centre, randomised (1:1) trial to evaluate the clinical impact of percutaneous transluminal renal artery stenting (PTRAS) on the impaired renal function measured by the estimated glomerular filtration rate (eGFR) in patients with haemodynamically significant atherosclerotic renal artery stenosis. METHODS: Patients will be randomised to receive either PTRAS using the Dynamic Renal Stent system plus best medical treatment or best medical treatment. Renal stenting will be performed under angiographic imaging. For patients randomised to best medical treatment the degree of stenosis measured by renal duplex sonography (RDS) will be confirmed by MR angio or multi-slice CT where possible. Best medical treatment will be initiated at randomisation or post procedure (for PTRAS arm only), and adjusted as needed at all visits. Best medical treatment is defined as optimal drug therapy for control of the major risk factors (blood pressure < or = 125/80 mmHg, LDL cholesterol < or = 100 mg/dL, HbA1c < or = 6.5%). Data recordings include serum creatinine values, eGFR, brain natriuretic peptide, patients' medical history and concomitant medication, clinical events, quality of life questionnaire (SF-12v2), 24 hour ambulatory blood pressure measurement, renal artery duplex ultrasound and echocardiography. Follow-up intervals are at 2, 6, 12 and 36 months following randomisation.The primary endpoint is the difference between treatments in change of eGFR over 12 months. Major secondary endpoints are technical success, change of renal function based on the eGFR slope change between pre-treatment and post-treatment (i.e. improvement, stabilisation, failure), clinical events overall such as renal or cardiac death, stroke, myocardial infarction, hospitalisation for congestive heart failure, progressive renal insufficiency (i.e. need for dialysis), need of target vessel revascularisation or target lesion revascularisation, change in average systolic and diastolic blood pressure, change in left ventricular mass index calculated from echocardiography, difference in the size of kidney (pole to pole length) measured by renal duplex sonography, total number, drug name, drug class, daily dose, regimen and Defined Daily Dose (DDD), of anti-hypertensive drugs, and change in New York Heart Association (NYHA) classification. Approximately 30 centres in Europe and South America will enrol patients. Duration of enrolment is expected to be 12 months resulting in study duration of 48 months. TRIAL REGISTRATION NUMBER: NCT00640406. FAU - Schwarzwalder, Uwe AU - Schwarzwalder U AD - Department Angiology, Herz-Zentrum Bad Krozingen, Sudring 15, 79189 Bad Krozingen, Germany. uwe.schwarzwaelder@herzzentrum.de FAU - Hauk, Michael AU - Hauk M FAU - Zeller, Thomas AU - Zeller T LA - eng SI - ClinicalTrials.gov/NCT00640406 PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20090727 PL - England TA - Trials JT - Trials JID - 101263253 SB - IM MH - *Angioplasty MH - Atherosclerosis/surgery/therapy MH - Combined Modality Therapy MH - Humans MH - Prospective Studies MH - Renal Artery Obstruction/*surgery/*therapy MH - Renal Circulation MH - Research Design MH - *Stents PMC - PMC2724429 EDAT- 2009/07/29 09:00 MHDA- 2009/09/19 06:00 PMCR- 2009/07/27 CRDT- 2009/07/29 09:00 PHST- 2009/04/23 00:00 [received] PHST- 2009/07/27 00:00 [accepted] PHST- 2009/07/29 09:00 [entrez] PHST- 2009/07/29 09:00 [pubmed] PHST- 2009/09/19 06:00 [medline] PHST- 2009/07/27 00:00 [pmc-release] AID - 1745-6215-10-60 [pii] AID - 10.1186/1745-6215-10-60 [doi] PST - epublish SO - Trials. 2009 Jul 27;10:60. doi: 10.1186/1745-6215-10-60. PMID- 19608034 OWN - NLM STAT- MEDLINE DCOM- 20090831 LR - 20220318 IS - 1558-3597 (Electronic) IS - 0735-1097 (Linking) VI - 54 IP - 4 DP - 2009 Jul 21 TI - Prognostic value of biomarkers during and after non-ST-segment elevation acute coronary syndrome. PG - 357-64 LID - 10.1016/j.jacc.2009.03.056 [doi] AB - OBJECTIVES: The aim of this study was to assess risk prediction by different biomarkers in patients with an ongoing non-ST-segment elevation acute coronary syndrome (NSTE-ACS) and after clinical stabilization. BACKGROUND: Different biomarkers reflect different aspects of the pathobiology in NSTE-ACS. However, there is little information regarding their relative prognostic value during the time course of disease. METHODS: The N-terminal pro-brain natriuretic peptide (NT-proBNP), C-reactive protein (CRP), cardiac troponin I (cTnI), and the estimated glomerular filtration rate (eGFR) were measured at randomization and after 6 weeks and 6 months in 877 NSTE-ACS patients included in the FRISC (FRagmin and fast revascularization during InStability in Coronary artery disease) II trial. The biomarkers' prognostic value during 5-year follow-up was evaluated by Cox regression models, calculation of the c-statistics, and estimation of the net reclassification improvement (NRI). RESULTS: Among the biomarkers measured at randomization, NT-proBNP was the strongest predictor for mortality (adjusted hazard ratio [HR]: 1.7; 95% confidence interval [CI]: 1.3 to 2.1; p < 0.001). Even during follow-up, NT-proBNP demonstrated the strongest association to the composite end point of death/myocardial infarction (adjusted HR at 6 weeks: 1.5; 95% CI: 1.3 to 1.7; p < 0.001; adjusted HR at 6 months: 1.4; 95% CI: 1.2 to 1.7; p = 0.001). Even CRP was independently predictive at 6 months for the composite end point (adjusted HR: 1.3; 95% CI: 1.1 to 1.5; p = 0.003). Only 6-week results of NT-proBNP provided significant incremental prognostic value to established risk indicators regarding the composite end point (c-statistics 0.69 [p = 0.03]; NRI 0.11 [p = 0.03]). CONCLUSIONS: The NT-proBNP is an independent risk predictor in patients with ongoing NSTE-ACS and after clinical stabilization. The CRP exhibits increasing predictive value at later measurements. However, only NT-proBNP provided incremental prognostic value and might therefore be considered as a complement for early follow-up controls after NSTE-ACS. FAU - Eggers, Kai M AU - Eggers KM AD - Department of Medical Sciences, Cardiology, Uppsala University Hospital and Uppsala Clinical Research Centre, Uppsala, Sweden. kai.eggers@ucr.uu.se FAU - Lagerqvist, Bo AU - Lagerqvist B FAU - Venge, Per AU - Venge P FAU - Wallentin, Lars AU - Wallentin L FAU - Lindahl, Bertil AU - Lindahl B LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - United States TA - J Am Coll Cardiol JT - Journal of the American College of Cardiology JID - 8301365 RN - 0 (Biomarkers) RN - 0 (Peptide Fragments) RN - 0 (Troponin I) RN - 0 (pro-brain natriuretic peptide (1-76)) RN - 114471-18-0 (Natriuretic Peptide, Brain) RN - 9007-41-4 (C-Reactive Protein) SB - IM CIN - J Am Coll Cardiol. 2009 Jul 21;54(4):365-7. doi: 10.1016/j.jacc.2009.04.031. PMID: 19608035 MH - Acute Coronary Syndrome/*blood/*diagnosis MH - Aged MH - Biomarkers/blood MH - C-Reactive Protein/analysis MH - Female MH - Glomerular Filtration Rate MH - Humans MH - Male MH - Middle Aged MH - Natriuretic Peptide, Brain/blood MH - Peptide Fragments/blood MH - Predictive Value of Tests MH - Risk Assessment MH - Risk Factors MH - Troponin I/blood EDAT- 2009/07/18 09:00 MHDA- 2009/09/01 06:00 CRDT- 2009/07/18 09:00 PHST- 2008/10/20 00:00 [received] PHST- 2009/01/30 00:00 [revised] PHST- 2009/03/10 00:00 [accepted] PHST- 2009/07/18 09:00 [entrez] PHST- 2009/07/18 09:00 [pubmed] PHST- 2009/09/01 06:00 [medline] AID - S0735-1097(09)01445-4 [pii] AID - 10.1016/j.jacc.2009.03.056 [doi] PST - ppublish SO - J Am Coll Cardiol. 2009 Jul 21;54(4):357-64. doi: 10.1016/j.jacc.2009.03.056. PMID- 19594771 OWN - NLM STAT- MEDLINE DCOM- 20100923 LR - 20220408 IS - 1399-0012 (Electronic) IS - 0902-0063 (Linking) VI - 23 IP - 6 DP - 2009 Nov-Dec TI - Metabolic syndrome and cardiovascular risk in renal transplant recipients: effects of statin treatment. PG - 914-20 LID - 10.1111/j.1399-0012.2009.01025.x [doi] AB - BACKGROUND: Renal transplant recipients (RTR) have high risk for cardiovascular disease (CVD). They also have high prevalence of insulin resistance and metabolic syndrome (MS). Statin treatment reduces CVD risk in RTR. The aim was to study MS as CVD risk factor in RTR, and to investigate the effect of statin treatment in RTR with MS. METHODS: In total, 1706 non-diabetic RTR from the Assessment of Lescol in Renal Transplantation trial were followed for 7-8 yr. The captured endpoints included major adverse cardiac events [MACE, defined as cardiac death (CD), non-fatal myocardial infarction or coronary revascularization procedure], and CD. MS was defined at baseline according to Adult Treatment Panel III definition with waist girth replaced by body mass index > or =30 kg/m2. RESULTS: MS was diagnosed in 32% of the patients. During the follow-up, MACE incidence was 16% in those with MS and 11% in those without MS (p < 0.001). Statin treatment reduced MACE risk by 53% in the group with MS. CD risk was 74% higher in RTR with MS (p = 0.012), and statin treatment reduced CD risk in those with MS (p = 0.03). CONCLUSIONS: RTR with MS have increased risk for CVD. RTR with MS are an easily identifiable group of patients who benefit from statin treatment. FAU - Soveri, Inga AU - Soveri I AD - Department of Medical Sciences, Uppsala University, Uppsala, Sweden. inga.soveri@medsci.uu.se FAU - Abedini, Sadollah AU - Abedini S FAU - Holdaas, Hallvard AU - Holdaas H FAU - Jardine, Alan AU - Jardine A FAU - Eriksson, Niclas AU - Eriksson N FAU - Fellstrom, Bengt AU - Fellstrom B LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20090705 PL - Denmark TA - Clin Transplant JT - Clinical transplantation JID - 8710240 RN - 0 (Antioxidants) RN - 0 (Fatty Acids, Monounsaturated) RN - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors) RN - 0 (Indoles) RN - 0 (Lipids) RN - 4L066368AS (Fluvastatin) SB - IM MH - Antioxidants MH - Body Mass Index MH - Cardiovascular Diseases/blood/epidemiology/*prevention & control MH - Dose-Response Relationship, Drug MH - Fatty Acids, Monounsaturated/administration & dosage/*therapeutic use MH - Female MH - Fluvastatin MH - Follow-Up Studies MH - Humans MH - Hydroxymethylglutaryl-CoA Reductase Inhibitors/administration & dosage/*therapeutic use MH - Incidence MH - Indoles/administration & dosage/*therapeutic use MH - Insulin Resistance MH - Kidney Failure, Chronic/metabolism/surgery MH - *Kidney Transplantation MH - Lipids/blood MH - Male MH - Metabolic Syndrome/blood/epidemiology/*prevention & control MH - Middle Aged MH - Retrospective Studies MH - Risk Factors MH - Time Factors MH - Treatment Outcome EDAT- 2009/07/15 09:00 MHDA- 2010/09/24 06:00 CRDT- 2009/07/15 09:00 PHST- 2009/07/15 09:00 [entrez] PHST- 2009/07/15 09:00 [pubmed] PHST- 2010/09/24 06:00 [medline] AID - CTR1025 [pii] AID - 10.1111/j.1399-0012.2009.01025.x [doi] PST - ppublish SO - Clin Transplant. 2009 Nov-Dec;23(6):914-20. doi: 10.1111/j.1399-0012.2009.01025.x. Epub 2009 Jul 5. PMID- 19577217 OWN - NLM STAT- MEDLINE DCOM- 20090915 LR - 20260128 IS - 1876-861X (Electronic) IS - 1876-861X (Linking) VI - 3 IP - 4 DP - 2009 Jul-Aug TI - Rationale and design of a randomized controlled trial comparing stress myocardial perfusion imaging with coronary CT angiography as the initial imaging study for intermediate-risk patients admitted with chest pain. PG - 264-71 LID - 10.1016/j.jcct.2009.05.006 [doi] AB - BACKGROUND: Noninvasive cardiac imaging plays an important role in the diagnosis and management of coronary artery disease (CAD). Prior studies have focused on the diagnostic performance of noninvasive modalities using angiographically significant stenoses as the reference standard. Recent trends in evidence-based medicine and increasing imaging utilization call for validation of diagnostic algorithms with well-designed, controlled trials with clinical outcome endpoints. OBJECTIVE: To compare the performance of stress radionuclide myocardial perfusion imaging (MPI) and coronary computed tomography angiography (CTA) in terms of outcomes. METHODS: We designed a single-center, randomized controlled trial that compares MPI and CTA as the initial modality for the evaluation of patients hospitalized for chest pain without known CAD or acute myocardial infarction. Patients with intermediate-risk characteristics and a clinical need for noninvasive imaging are included. The primary outcome measured is the incidence of conventional angiography not leading to subsequent coronary revascularization within 1 year. The study is powered to detect a reduction from 11% to 3% in catheterization not leading to an intervention with a sample size of 400. Secondary outcomes include procedural complications and posttest renal dysfunction (safety outcomes), major adverse cardiovascular events, length of hospital stay, subsequent hospitalizations and imaging, changes in medical management, and tolerability of the noninvasive test. CONCLUSIONS: The results of this trial will further our understanding of the relative appropriateness of CTA and MPI in evaluating intermediate-risk patients hospitalized with chest pain. It will also have implications for the design and probability of success of multicentered trials that are currently being planned. FAU - Levsky, Jeffrey M AU - Levsky JM AD - Departments of Radiology, Montefiore Medical Center/Albert Einstein College of Medicine, 111 E 210 Street,Bronx, NY 10467, USA. jlevsky@montefiore.org FAU - Travin, Mark I AU - Travin MI FAU - Spevack, Daniel M AU - Spevack DM FAU - Menegus, Mark A AU - Menegus MA FAU - Huang, Paul W AU - Huang PW FAU - Goldberg, Ythan AU - Goldberg Y FAU - Clark, Elana T AU - Clark ET FAU - Banoth, Prameela AU - Banoth P FAU - Freeman, Katherine D AU - Freeman KD FAU - Tobin, Jonathan N AU - Tobin JN FAU - Haramati, Linda B AU - Haramati LB LA - eng SI - ClinicalTrials.gov/NCT00705458 PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20090521 PL - United States TA - J Cardiovasc Comput Tomogr JT - Journal of cardiovascular computed tomography JID - 101308347 SB - IM MH - *Body Burden MH - Chest Pain/complications/*diagnostic imaging MH - Coronary Angiography/*methods MH - Coronary Artery Disease/complications/*diagnostic imaging MH - Exercise Test MH - Humans MH - New York MH - Perfusion Imaging/*methods MH - Pilot Projects MH - Randomized Controlled Trials as Topic/*methods MH - Reproducibility of Results MH - Risk Assessment MH - Risk Factors MH - Sensitivity and Specificity MH - Tomography, X-Ray Computed/*methods EDAT- 2009/07/07 09:00 MHDA- 2009/09/16 06:00 CRDT- 2009/07/07 09:00 PHST- 2009/02/12 00:00 [received] PHST- 2009/03/17 00:00 [revised] PHST- 2009/05/05 00:00 [accepted] PHST- 2009/07/07 09:00 [entrez] PHST- 2009/07/07 09:00 [pubmed] PHST- 2009/09/16 06:00 [medline] AID - S1934-5925(09)00159-2 [pii] AID - 10.1016/j.jcct.2009.05.006 [doi] PST - ppublish SO - J Cardiovasc Comput Tomogr. 2009 Jul-Aug;3(4):264-71. doi: 10.1016/j.jcct.2009.05.006. Epub 2009 May 21. PMID- 19564178 OWN - NLM STAT- MEDLINE DCOM- 20090720 LR - 20250529 IS - 1756-1833 (Electronic) IS - 0959-8138 (Print) IS - 0959-8138 (Linking) VI - 338 DP - 2009 Jun 29 TI - Kidney function and risk of cardiovascular disease and mortality in women: a prospective cohort study. PG - b2392 LID - bmj.b2392 [pii] LID - 10.1136/bmj.b2392 [doi] LID - b2392 AB - OBJECTIVE: To evaluate the association of kidney function with cardiovascular disease and mortality among apparently healthy women. DESIGN: Prospective cohort study. SETTING: Women's Health Study, United States. PARTICIPANTS: 27 939 female health professionals aged >or=45 who were free of cardiovascular disease and other major disease and who provided a blood sample at study entry. MAIN OUTCOME MEASURES: Time to cardiovascular disease (non-fatal stroke, non-fatal myocardial infarction, coronary revascularisation procedures, or death from cardiovascular cause), specific cardiovascular disease events, and all-cause mortality. End points were confirmed after review of medical records and death certificates. RESULTS: Glomerular filtration rate (GFR) was estimated with the abbreviated Modification of Diet in Renal Disease Study equation. At baseline, 1315 (4.7%) women had GFR <60 ml/min/1.73 m(2). During 12 years of follow-up, 1199 incident cardiovascular disease events and 856 deaths (179 from cardiovascular disease) occurred. Compared with women with GFR >or=90 ml/min/1.73 m(2), the multivariable adjusted hazard ratios for any first cardiovascular disease were 0.95 (95% CI 0.83 to 1.08), 0.84 (0.70 to 1.00), and 1.00 (0.79 to 1.27) among women with GFR of 75-89.9, 60-74.9, and <60 ml/min/1.73 m(2), respectively; the equivalent hazard ratios for all cause mortality were 0.93 (0.79 to 1.09), 1.03 (0.85 to 1.26), and 1.09 (0.83 to 1.45). Similar null findings were observed for myocardial infarction, stroke, coronary revascularisation, and non-cardiovascular death. However, an increased risk of death from cardiovascular disease was found among women with GFR <60 ml/min/1.73 m(2) (hazard ratio 1.68 (1.02 to 2.79)). CONCLUSIONS: In this large cohort of women, a glomerular filtration rate <60 ml/min/1.73 m(2) was associated with increased risk of cardiovascular disease death but not other cardiovascular disease events or non-cardiovascular disease mortality. We observed no increase in risk of any of the outcomes among women with less severe impairment of kidney function. FAU - Kurth, Tobias AU - Kurth T AD - Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston MA, USA. tkurth@rics.bwh.harvard.edu FAU - de Jong, Paul E AU - de Jong PE FAU - Cook, Nancy R AU - Cook NR FAU - Buring, Julie E AU - Buring JE FAU - Ridker, Paul M AU - Ridker PM LA - eng GR - R01 HL043851/HL/NHLBI NIH HHS/United States GR - CA-047988/CA/NCI NIH HHS/United States GR - HL-043851/HL/NHLBI NIH HHS/United States GR - R01 HL080467/HL/NHLBI NIH HHS/United States GR - R01 CA047988/CA/NCI NIH HHS/United States GR - HL-080467/HL/NHLBI NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't DEP - 20090629 PL - England TA - BMJ JT - BMJ (Clinical research ed.) JID - 8900488 SB - IM EIN - BMJ. 2009;339:b2769 CIN - BMJ. 2009 Jun 29;338:b1307. doi: 10.1136/bmj.b1307. PMID: 19564177 MH - Cardiovascular Diseases/*etiology/mortality/physiopathology MH - Cohort Studies MH - Female MH - Glomerular Filtration Rate MH - Humans MH - Kidney Diseases/*complications/mortality/physiopathology MH - Middle Aged MH - Prognosis MH - Proportional Hazards Models MH - Randomized Controlled Trials as Topic MH - Risk Factors MH - United States/epidemiology PMC - PMC2704981 MID - NIHMS102158 COIS- Competing interests: None declared, but we report a full disclosure for the past five years. TK has received research funding from Merck, McNeil Consumer & Specialty Pharmaceuticals, the National Institutes of Health, and Wyeth Consumer Healthcare; is a consultant to i3 Drug Safety and World Health Information Science Consultants, LLC; and received honorariums from Genzyme, Merck, and Pfizer for lectures. PEdJ has received research funding from the Dutch Kidney Foundation. NRC has received research funding and support from the National Institutes of Health and from Roche Molecular Systems. JEB has received research funding and support from Dow Corning Corporation and the National Institutes of Health; research support from Bayer Heath Care and the Natural Source Vitamin E Association; honorariums from Bayer for lectures; and serves on an external scientific advisory committee for a study by Procter & Gamble. PMR has received research funding and support from the American Heart Association, AstraZeneca, Bayer, Bristol-Myers Squibb, Dade-Behring, Doris Duke Charitable Foundation, James and Polly Annenberg La Vea Charitable Trusts, Leducq Foundation, the National Institutes of Health, Novartis, Merck, Donald W Reynolds Foundation, Pharmacia, Roche, Sanofi/Aventis, and Variagenics; is listed as coinventor on patents held by Brigham and Women's Hospital on the use of inflammatory biomarkers in cardiovascular disease; and has served as consultant to AstraZeneca, Dade-Behring, Interleukin Genetics, Isis Pharmaceuticals, Sanofi/Aventis, and Schering-Plough, EDAT- 2009/07/01 09:00 MHDA- 2009/07/21 09:00 PMCR- 2009/06/29 CRDT- 2009/07/01 09:00 PHST- 2009/07/01 09:00 [entrez] PHST- 2009/07/01 09:00 [pubmed] PHST- 2009/07/21 09:00 [medline] PHST- 2009/06/29 00:00 [pmc-release] AID - bmj.b2392 [pii] AID - kurt614073 [pii] AID - 10.1136/bmj.b2392 [doi] PST - epublish SO - BMJ. 2009 Jun 29;338:b2392. doi: 10.1136/bmj.b2392. PMID- 19540391 OWN - NLM STAT- MEDLINE DCOM- 20090707 LR - 20090622 IS - 1097-6744 (Electronic) IS - 0002-8703 (Linking) VI - 158 IP - 1 DP - 2009 Jul TI - Variation in perioperative vasoactive therapy in cardiovascular surgical care: data from the Society of Thoracic Surgeons. PG - 47-52 LID - 10.1016/j.ahj.2009.05.014 [doi] AB - BACKGROUND: The appropriate use of vasoactive cardiovascular drugs in high-risk coronary artery bypass grafting (CABG) patients has not been well characterized. METHODS: We performed a detailed chart analysis on 2,390 randomly selected patients undergoing CABG between January 2004 and June 2005 at 55 hospitals participating in the Society of Thoracic Surgeons' National Adult Cardiac Surgery Database. Patients were eligible if they had elective/urgent CABG with an ejection fraction (EF) <40%, or if they had an elective or urgent CABG at > or =65 years with diabetes, or a glomerular filtration rate <60 mL/min per 1.73 m(2). Logistic regression modeling was used to determine predictors of and provide risk-adjusted frequencies of postoperative vasoactive therapies. RESULTS: Vasoactive therapy was used in 90% of patients. Inotropes/vasopressors were used in 28% (668), vasodilators in 18% (430), and the combination in 43% (1,037). Predictors of any inotrope use were preoperative atrial fibrillation (odds ratio [OR] 1.48), other arrhythmia (OR 2.09), EF (OR 1.09 per 5-unit decrease), severe mitral regurgitation (OR 2.56), 3-vessel coronary artery disease (OR 1.35), New York Heart Association class IV (1.38), on-pump (OR 1.86), other procedure (OR 2.51), and peripheral vascular disease (OR 1.28) (all OR P < .05). Hospital-level risk-adjusted rates of any inotrope use varied significantly from 100% to 35% (P < .01) and vasodilator rates varied from 100% to 10% (P < .01). CONCLUSIONS: There is marked hospital variation in the use of vasoactive therapies in high-risk CABG patients in clinical practice, indicating an important area for further research to better clarify best practice. FAU - Hernandez, Adrian F AU - Hernandez AF AD - Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC 27715, USA. adrian.hernandez@duke.edu FAU - Li, Shuang AU - Li S FAU - Dokholyan, Rachel S AU - Dokholyan RS FAU - O'Brien, Sean M AU - O'Brien SM FAU - Ferguson, T Bruce AU - Ferguson TB FAU - Peterson, Eric D AU - Peterson ED LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 RN - 0 (Cardiotonic Agents) RN - 0 (Vasoconstrictor Agents) RN - 0 (Vasodilator Agents) SB - IM MH - Aged MH - Cardiotonic Agents/*administration & dosage MH - Combined Modality Therapy MH - *Coronary Artery Bypass MH - Coronary Artery Bypass, Off-Pump MH - Databases, Factual MH - Drug Therapy, Combination MH - Drug Utilization/statistics & numerical data MH - Female MH - Heart Arrest, Induced MH - Heart Valve Prosthesis Implantation MH - Humans MH - Intra-Aortic Balloon Pumping MH - Male MH - Perioperative Care/*statistics & numerical data MH - Postoperative Complications/*drug therapy MH - Quality Assurance, Health Care MH - Retrospective Studies MH - United States MH - Vasoconstrictor Agents/*administration & dosage MH - Vasodilator Agents/*administration & dosage EDAT- 2009/06/23 09:00 MHDA- 2009/07/08 09:00 CRDT- 2009/06/23 09:00 PHST- 2008/12/10 00:00 [received] PHST- 2009/05/05 00:00 [accepted] PHST- 2009/06/23 09:00 [entrez] PHST- 2009/06/23 09:00 [pubmed] PHST- 2009/07/08 09:00 [medline] AID - S0002-8703(09)00365-2 [pii] AID - 10.1016/j.ahj.2009.05.014 [doi] PST - ppublish SO - Am Heart J. 2009 Jul;158(1):47-52. doi: 10.1016/j.ahj.2009.05.014. PMID- 19535190 OWN - NLM STAT- MEDLINE DCOM- 20090806 LR - 20131121 IS - 1523-6838 (Electronic) IS - 0272-6386 (Linking) VI - 54 IP - 2 DP - 2009 Aug TI - Oral nicorandil to reduce cardiac death after coronary revascularization in hemodialysis patients: a randomized trial. PG - 307-17 LID - 10.1053/j.ajkd.2009.03.025 [doi] AB - BACKGROUND: Survival after invasive coronary revascularization is worse in patients with chronic kidney disease than in patients without chronic kidney disease. We examined whether oral administration of nicorandil, a hybrid nitrate and adenosine triphosphate-sensitive potassium channel opener, could improve outcome after coronary revascularization in hemodialysis patients. STUDY DESIGN: Open-labeled prospective randomized trial. SETTING & PARTICIPANTS: Maintenance hemodialysis patients who underwent percutaneous coronary artery intervention and had complete coronary revascularization (absence of both restenosis and de novo coronary lesion) at coronary arteriography 6 months later. Enrollment occurred between January 1, 2002, and December 31, 2004. INTERVENTIONS: Treatment with or without oral administration of nicorandil, 15 mg/d. OUTCOMES & MEASUREMENTS: The primary end point was cardiac death (sudden cardiac death or death from acute myocardial infarction or congestive heart failure). The secondary end point was all-cause death. End-point adjudication was performed masked to the intervention. RESULTS: 129 patients (91 men, 38 women) with a mean age of 66 +/- 9 (SD) years. During a 2.7 +/- 1.5-year follow-up, 26 died of cardiac events (acute myocardial infarction, 6; congestive heart failure, 5; sudden cardiac death, 15), and 12 died of noncardiac causes. Cardiac death-free survival rates were greater in the nicorandil group than in the control group (P = 0.009; at 3 years, 86.6% in the nicorandil group and 70.7% in the control group). All-cause death-free survival rates were also greater in the nicorandil group than in the control group (P = 0.01; at 3 years, 79.2% in the nicorandil group versus 60.5% in the control group). Additional percutaneous coronary artery intervention was performed in 6 participants in the nicorandil group and 2 participants in the control group. No serious side effects of nicorandil were reported during the course of the study. LIMITATIONS: Small sample size and open-label design. CONCLUSIONS: Oral administration of nicorandil may reduce cardiac death and improve the survival of hemodialysis patients after coronary revascularization. FAU - Nishimura, Masato AU - Nishimura M AD - Cardiovascular Division, Toujinkai Hospital, Kyoto, Japan. mnishimura@tea.ocn.ne.jp FAU - Tokoro, Toshiko AU - Tokoro T FAU - Nishida, Masasya AU - Nishida M FAU - Hashimoto, Tetsuya AU - Hashimoto T FAU - Kobayashi, Hiroyuki AU - Kobayashi H FAU - Imai, Ryo AU - Imai R FAU - Yamazaki, Satoru AU - Yamazaki S FAU - Okino, Koji AU - Okino K FAU - Iwamoto, Noriyuki AU - Iwamoto N FAU - Takahashi, Hakuo AU - Takahashi H FAU - Ono, Toshihiko AU - Ono T LA - eng PT - Journal Article PT - Randomized Controlled Trial DEP - 20090617 PL - United States TA - Am J Kidney Dis JT - American journal of kidney diseases : the official journal of the National Kidney Foundation JID - 8110075 RN - 0 (Vasodilator Agents) RN - 260456HAM0 (Nicorandil) SB - IM MH - Administration, Oral MH - Aged MH - Angioplasty, Balloon, Coronary/*adverse effects MH - Death, Sudden, Cardiac/*prevention & control MH - Female MH - Heart Failure/*mortality/*prevention & control MH - Humans MH - Male MH - Middle Aged MH - Myocardial Infarction/*mortality/*prevention & control MH - Nicorandil/*administration & dosage MH - Postoperative Complications/prevention & control MH - Prospective Studies MH - *Renal Dialysis MH - Vasodilator Agents/*administration & dosage EDAT- 2009/06/19 09:00 MHDA- 2009/08/07 09:00 CRDT- 2009/06/19 09:00 PHST- 2008/11/24 00:00 [received] PHST- 2009/03/31 00:00 [accepted] PHST- 2009/06/19 09:00 [entrez] PHST- 2009/06/19 09:00 [pubmed] PHST- 2009/08/07 09:00 [medline] AID - S0272-6386(09)00723-9 [pii] AID - 10.1053/j.ajkd.2009.03.025 [doi] PST - ppublish SO - Am J Kidney Dis. 2009 Aug;54(2):307-17. doi: 10.1053/j.ajkd.2009.03.025. Epub 2009 Jun 17. PMID- 19494400 OWN - NLM STAT- MEDLINE DCOM- 20090930 LR - 20181201 IS - 1557-2501 (Electronic) IS - 1042-3931 (Linking) VI - 21 IP - 6 DP - 2009 Jun TI - Frequency and outcomes of provisional glycoprotein IIb/IIIa blockade in patients receiving bivalirudin during percutaneous coronary intervention. PG - 258-63 AB - OBJECTIVES: This study sought to evaluate the frequency and efficacy of combination of bivalirudin and provisional glycoprotein (GP) IIb/IIIa blockade compared with bivalirudin monotherapy in current clinical practice of percutaneous coronary intervention (PCI) with drug-eluting stents (DES). BACKGROUND: Previous randomized trials have demonstrated that a strategy of bivalirudin with provisional (bailout) GP IIb/IIIa inhibition was non-inferior to unfractionated heparin (UFH) plus planned GP IIb/IIIa blockade for the prevention of acute and long-term adverse clinical events. However, the frequency and efficacy of provisional GP IIb/IIIa inhibition in addition to the full-dose bivalirudin in current practice is not well established. METHODS: Using the 2004/2005 Cornell Angioplasty Registry, we studied 1,340 consecutive patients undergoing urgent or elective PCI with periprocedural use of bivalirudin. We excluded patients presenting with an acute ST-elevation myocardial infarction (MI) within < or = 24 hours, hemodynamic instability/shock, thrombolytic therapy within < or = 7 days, or renal insufficiency. Mean clinical follow up was 24.2 +/- 7.7 months. RESULTS: Of the study cohort, 1,184 patients (88.4%) received bivalirudin alone and 156 (11.6%) received bivalirudin plus bailout GP IIb/IIIa blockade. DES were used in 86% of PCIs. The incidence of in-hospital mortality (0% vs. 0.3% p = 1.000), MI (7.1% vs. 6.6%; p = 0.864), and the combined endpoint of death, stroke, emergent coronary artery bypass graft surgery (CABG)/PCI, or MI (7.1% vs. 6.9%; p = 0.868) were similar in the bivalirudin-plus-bailout GP IIb/IIIa inhibitor versus the bivalirudin-alone arm. There was a higher incidence of bleeding complications (16.0% vs. 9.6%; p = 0.018) in the bivalirudin-plus-bailout GP IIb/IIIa versus the bivalirudin-alone group. At follow up, there were 4 (2.6%) deaths in the bivalirudin-plus-GP IIb/IIIa inhibitor group versus 83 (7.0%) deaths in the bivalirudin-alone arm (HR 0.36, 95% confidence interval [CI] 0.13-0.98; p = 0.044). After multivariate Cox regression analysis, bailout GP IIb/IIIa use in addition to bivalirudin was associated with similar long-term survival when compared to bivalirudin monotherapy (HR 0.41, 95% CI 0.15-1.12; p = 0.081). CONCLUSIONS: Provisional GP IIb/IIIa use in bivalirudin-treated patients is higher in contemporary non-emergent PCI practice than that seen in randomized trials and is associated with similar in-hospital ischemic events, but more frequent bleeding events. These data suggest that a strategy of bivalirudin monotherapy is preferable in order to reduce bleeding complications, and GP IIb/IIIa blockade should be reserved for patients with periprocedural complications in bivalirudin-treated patients undergoing PCI. FAU - Feldman, Dmitriy N AU - Feldman DN AD - New York Presbyterian Hospital, Weill Cornell Medical College, Greenberg Division of Cardiology, 520 East 70th Street, Starr-434 Pavilion, New York, NY 10021, USA. dnf9001@med.cornell.edu FAU - Wong, S Chiu AU - Wong SC FAU - Bergman, Geoffrey AU - Bergman G FAU - Minutello, Robert M AU - Minutello RM LA - eng PT - Journal Article PL - United States TA - J Invasive Cardiol JT - The Journal of invasive cardiology JID - 8917477 RN - 0 (Antibodies, Monoclonal) RN - 0 (Anticoagulants) RN - 0 (Hirudins) RN - 0 (Immunoglobulin Fab Fragments) RN - 0 (Peptide Fragments) RN - 0 (Peptides) RN - 0 (Platelet Aggregation Inhibitors) RN - 0 (Platelet Glycoprotein GPIIb-IIIa Complex) RN - 0 (Recombinant Proteins) RN - A74586SNO7 (Clopidogrel) RN - NA8320J834 (Eptifibatide) RN - OM90ZUW7M1 (Ticlopidine) RN - R16CO5Y76E (Aspirin) RN - TN9BEX005G (bivalirudin) RN - X85G7936GV (Abciximab) SB - IM CIN - J Invasive Cardiol. 2009 Jun;21(6):264-5. PMID: 19494401 MH - Abciximab MH - Aged MH - Aged, 80 and over MH - Angioplasty, Balloon, Coronary/adverse effects/*methods MH - Antibodies, Monoclonal/therapeutic use MH - Anticoagulants/*therapeutic use MH - Aspirin/therapeutic use MH - Clopidogrel MH - Drug Therapy, Combination MH - Embolism/*prevention & control MH - Eptifibatide MH - Female MH - Follow-Up Studies MH - Hirudins MH - Humans MH - Immunoglobulin Fab Fragments/therapeutic use MH - Male MH - Middle Aged MH - Peptide Fragments/*therapeutic use MH - Peptides/therapeutic use MH - Platelet Aggregation Inhibitors/therapeutic use MH - Platelet Glycoprotein GPIIb-IIIa Complex/*antagonists & inhibitors MH - Recombinant Proteins/therapeutic use MH - Registries MH - Regression Analysis MH - Retrospective Studies MH - Thrombosis/*prevention & control MH - Ticlopidine/analogs & derivatives/therapeutic use MH - Treatment Outcome EDAT- 2009/06/06 09:00 MHDA- 2009/10/01 06:00 CRDT- 2009/06/05 09:00 PHST- 2009/06/05 09:00 [entrez] PHST- 2009/06/06 09:00 [pubmed] PHST- 2009/10/01 06:00 [medline] PST - ppublish SO - J Invasive Cardiol. 2009 Jun;21(6):258-63. PMID- 19464462 OWN - NLM STAT- MEDLINE DCOM- 20090609 LR - 20131121 IS - 1097-685X (Electronic) IS - 0022-5223 (Linking) VI - 137 IP - 6 DP - 2009 Jun TI - Mild chronic kidney dysfunction and treatment strategies for stable coronary artery disease. PG - 1443-9 LID - 10.1016/j.jtcvs.2008.11.028 [doi] AB - OBJECTIVE: Our objective was to evaluate the association of chronic kidney dysfunction in patients with multivessel chronic coronary artery disease, preserved left ventricular function, and the possible interaction between received treatment and cardiovascular events. METHODS: The glomerular filtration rate was determined at baseline on 611 patients who were randomized into three treatment groups: medical treatment, percutaneous coronary intervention, and coronary artery bypass surgery. Incidence of myocardial infarction, angina requiring a new revascularization procedure, and death were analyzed during 5 years in each group. RESULTS: Of 611 patients, 112 (18%) were classified as having normal renal function, 349 (57%) were classified as having mild dysfunction, and 150 (25%) were classified as having moderate dysfunction. There were significant differences among the cumulative overall mortality curves among the three renal function groups. Death was observed more frequently in the moderate dysfunction group than the other two groups (P < .001). Interestingly, in patients with mild chronic kidney dysfunction, we observed that coronary artery bypass treatment presented a statistically higher percentage of event-free survival and lower percentage of mortality than did percutaneous coronary intervention or medical treatment CONCLUSIONS: Our results confirm that coronary artery disease accompanied by chronic kidney dysfunction has a worse prognosis, regardless of the therapeutic strategy for coronary artery disease, when renal function is at least mildly impaired. Additionally, our data suggest that the different treatment strategies available for stable coronary artery disease may have differential beneficial effects according to the range of glomerular filtration rate strata. FAU - Lopes, Neuza Helena AU - Lopes NH AD - Heart Institute, University of Sao Paulo Medical School, Sao Paulo, Brazil. mass@incor.usp.br FAU - da Silva Paulitsch, Felipe AU - da Silva Paulitsch F FAU - Pereira, Alexandre AU - Pereira A FAU - Garzillo, Cibele Larossa AU - Garzillo CL FAU - Ferreira, Joao Fernando AU - Ferreira JF FAU - Stolf, Noedir AU - Stolf N FAU - Hueb, Whady AU - Hueb W LA - eng SI - ISRCTN/ISRCTN66068876 PT - Journal Article DEP - 20090205 PL - United States TA - J Thorac Cardiovasc Surg JT - The Journal of thoracic and cardiovascular surgery JID - 0376343 RN - 0 (Cardiovascular Agents) RN - AYI8EX34EU (Creatinine) SB - IM MH - Aged MH - *Angioplasty, Balloon, Coronary MH - Cardiovascular Agents/therapeutic use MH - *Coronary Artery Bypass MH - Coronary Artery Disease/complications/physiopathology/*therapy MH - Creatinine/blood MH - Disease-Free Survival MH - Female MH - Glomerular Filtration Rate MH - Humans MH - Kidney/physiopathology MH - Male MH - Middle Aged MH - Prognosis MH - Randomized Controlled Trials as Topic MH - Renal Insufficiency/complications/*physiopathology EDAT- 2009/05/26 09:00 MHDA- 2009/06/10 09:00 CRDT- 2009/05/26 09:00 PHST- 2008/07/24 00:00 [received] PHST- 2008/10/21 00:00 [revised] PHST- 2008/11/19 00:00 [accepted] PHST- 2009/05/26 09:00 [entrez] PHST- 2009/05/26 09:00 [pubmed] PHST- 2009/06/10 09:00 [medline] AID - S0022-5223(08)02035-7 [pii] AID - 10.1016/j.jtcvs.2008.11.028 [doi] PST - ppublish SO - J Thorac Cardiovasc Surg. 2009 Jun;137(6):1443-9. doi: 10.1016/j.jtcvs.2008.11.028. Epub 2009 Feb 5. PMID- 19463396 OWN - NLM STAT- MEDLINE DCOM- 20100929 LR - 20220408 IS - 1876-7605 (Electronic) IS - 1936-8798 (Linking) VI - 2 IP - 1 DP - 2009 Jan TI - In-hospital and 1-year outcomes among percutaneous coronary intervention patients with chronic kidney disease in the era of drug-eluting stents: a report from the EVENT (Evaluation of Drug Eluting Stents and Ischemic Events) registry. PG - 37-45 LID - 10.1016/j.jcin.2008.06.012 [doi] AB - OBJECTIVES: This study sought to evaluate ischemic and bleeding outcomes in patients with chronic kidney disease (CKD) undergoing percutaneous coronary intervention (PCI) with drug-eluting stents (DES). BACKGROUND: Previous studies have shown that CKD is associated with poor outcomes after PCI. However, these studies were largely conducted before the introduction of DES and aggressive antithrombotic therapy or were performed in the setting of randomized trials. With data from a contemporary registry, we evaluated the influence of CKD on major cardiovascular events and bleeding complications in unselected "real-world" patients undergoing PCI. METHODS: Data from 4,791 patients enrolled in the EVENT (Evaluation of Drug Eluting Stents and Ischemic Events) Registry between July 2004 and September 2005 were analyzed. Patients were stratified into 4 groups: creatinine clearance (CrCl) >75, 50 to 75, 30 to 49 and <30 ml/min. RESULTS: During the index hospital stay, there was a step-wise increase in bleeding complications with decreasing CrCl (3.3%, 5.0%, 8.8%, and 14.3%; p < 0.0001 for trend). Lower CrCl was also associated with more frequent death or myocardial infarction (MI) during the initial hospital stay (p = 0.001) and at 1 year (p < 0.001). These findings were confirmed in multivariate analyses that adjusted for baseline differences in demographic, clinical, and angiographic factors. Use of guideline-recommended medications at 1 year, including aspirin, clopidogrel, angiotensin-converting enzyme inhibitors, and statins, also decreased with declining renal function. CONCLUSIONS: Renal function is an independent and powerful predictor of bleeding and ischemic complications in the era of DES and contemporary antithrombotic therapy in patients undergoing PCI. The low use of guideline-recommended drugs among patients with CKD undergoing PCI might contribute to these adverse outcomes and warrants further evaluation. FAU - Latif, Faisal AU - Latif F AD - University of Oklahoma, Oklahoma City, Oklahoma, USA. FAU - Kleiman, Neal S AU - Kleiman NS FAU - Cohen, David J AU - Cohen DJ FAU - Pencina, Michael J AU - Pencina MJ FAU - Yen, Chen-Hsing AU - Yen CH FAU - Cutlip, Donald E AU - Cutlip DE FAU - Moliterno, David J AU - Moliterno DJ FAU - Nassif, Deborah AU - Nassif D FAU - Lopez, John J AU - Lopez JJ FAU - Saucedo, Jorge F AU - Saucedo JF CN - EVENT Investigators LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 RN - 0 (Fibrinolytic Agents) SB - IM MH - Aged MH - *Angioplasty, Balloon, Coronary MH - Coronary Artery Bypass MH - Coronary Artery Disease/drug therapy/therapy MH - *Drug-Eluting Stents MH - Female MH - Fibrinolytic Agents/therapeutic use MH - Humans MH - Inpatients MH - *Kidney Failure, Chronic MH - Male MH - Middle Aged MH - Multivariate Analysis MH - Myocardial Ischemia/drug therapy/surgery/*therapy MH - Registries MH - Time Factors MH - Treatment Outcome EDAT- 2009/05/26 09:00 MHDA- 2010/09/30 06:00 CRDT- 2009/05/26 09:00 PHST- 2008/02/04 00:00 [received] PHST- 2008/06/04 00:00 [revised] PHST- 2008/06/13 00:00 [accepted] PHST- 2009/05/26 09:00 [entrez] PHST- 2009/05/26 09:00 [pubmed] PHST- 2010/09/30 06:00 [medline] AID - S1936-8798(08)00449-4 [pii] AID - 10.1016/j.jcin.2008.06.012 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2009 Jan;2(1):37-45. doi: 10.1016/j.jcin.2008.06.012. PMID- 19460482 OWN - NLM STAT- MEDLINE DCOM- 20091123 LR - 20090522 IS - 0025-7753 (Print) IS - 0025-7753 (Linking) VI - 132 Suppl 1 DP - 2009 May TI - [Myocardial revascularization in patients with chronic renal failure]. PG - 55-60 LID - 10.1016/S0025-7753(09)70964-9 [doi] AB - The incidence of chronic renal failure has increased in the last years in industrialized countries. In Spain the prevalence of this pathology is estimated at 10-12% of the population, and the stages III-V of the disease, corresponding to the estimated glomerular filtration rate less than 60 ml/min/m2, represent the 5%. From the cardiovascular point of view, both chronic and acute coronary syndrome is a very important subgroup of patients because of the increased association between chronic renal failure and coronary artery disease. In fact, ACS is the main cause of death in patients with advanced chronic renal failure. Frequently, this kind of patients are excluded from prospective randomized clinical trials, consequently scientific evidence is not available to guide the therapy of coronary revascularization. FAU - Lopez Otero, D AU - Lopez Otero D AD - Seccion de Hemodinamica y Cardiologia Intervencionista, Servicio de Cardiologia, Hospital Clinico Universitario Santiago de Compostela, Santiago de Compostela, A Coruna, Spain. birihh@yahoo.es FAU - Souto Castro, P AU - Souto Castro P FAU - Trillo Nouche, R AU - Trillo Nouche R FAU - Gonzalez-Juanatey, J R AU - Gonzalez-Juanatey JR LA - spa PT - English Abstract PT - Journal Article TT - Revascularizacion miocardica en pacientes con insuficiencia renal cronica. PL - Spain TA - Med Clin (Barc) JT - Medicina clinica JID - 0376377 SB - IM MH - Coronary Artery Disease/*complications/*surgery MH - Humans MH - Kidney Failure, Chronic/*complications MH - *Myocardial Revascularization EDAT- 2009/05/23 09:00 MHDA- 2009/12/16 06:00 CRDT- 2009/05/23 09:00 PHST- 2009/05/23 09:00 [entrez] PHST- 2009/05/23 09:00 [pubmed] PHST- 2009/12/16 06:00 [medline] AID - S0025-7753(09)70964-9 [pii] AID - 10.1016/S0025-7753(09)70964-9 [doi] PST - ppublish SO - Med Clin (Barc). 2009 May;132 Suppl 1:55-60. doi: 10.1016/S0025-7753(09)70964-9. PMID- 19417195 OWN - NLM STAT- MEDLINE DCOM- 20090511 LR - 20220318 IS - 1538-3598 (Electronic) IS - 0098-7484 (Linking) VI - 301 IP - 17 DP - 2009 May 6 TI - Incidence of and outcomes associated with ventricular tachycardia or fibrillation in patients undergoing primary percutaneous coronary intervention. PG - 1779-89 LID - 10.1001/jama.2009.600 [doi] AB - CONTEXT: The incidence and timing of sustained ventricular tachycardia or fibrillation (VT/VF) and its impact on outcomes in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) are poorly understood. OBJECTIVE: To evaluate the association of sustained VT/VF and its timing on the outcomes of patients presenting for primary PCI-an aim not prespecified in the APEX AMI trial. DESIGN, SETTING, AND PATIENTS: We studied 5745 STEMI patients presenting for primary PCI at 296 hospitals in 17 countries between July 13, 2004, and May 11, 2006, from the APEX AMI trial. We categorized them into 4 groups: no VT/VF; VT/VF any time; early VT/VF, before the end of cardiac catheterization; and late VT/VF, after the end of cardiac catheterization. MAIN OUTCOME MEASURE: Ninety-day total mortality. RESULTS: VT/VF occurred in 329 STEMI patients (5.7%) presenting for primary PCI. The majority of these occurred before the end of catheterization (n = 205, 64%), and 90% occurred within 48 hours of presentation with symptoms of STEMI. Clinical outcomes were worse in patients with vs those without VT/VF (90-day mortality, 23.2% vs 3.6%; adjusted HR, 3.63; 95% CI, 2.59-5.09), and outcomes were worse if the VT/VF occurred late instead of early (90-day mortality for early VT/VF, 17.2% [adjusted HR, 2.34; 95% CI, 1.44-3.80]; for late VT/VF, 33.3% [adjusted HR, 5.59; 95% CI, 3.71-8.43]; for no VT/VF, 3.6% [referent]). In multivariate analyses, factors associated with early VT/VF included pre-PCI thrombolysis in MI (TIMI) flow grade 0 (HR, 2.94; 95% CI, 1.93-4.47), inferior infarction (HR, 2.16; 95% CI, 1.58-2.93), total baseline ST deviation (HR, 1.39; 95% CI, 1.19-1.63), creatinine clearance (HR, 0.88; 95% CI, 0.83-0.94), Killip class greater than I (HR, 1.88; 95% CI, 1.29-2.76), baseline systolic blood pressure (HR, 0.92; 95% CI, 0.87-0.98), body weight (HR, 1.16; 95% CI, 1.04-1.29), and baseline heart rate greater than 70/min (HR, 1.10; 95% CI, 1.01-1.20) (c index, 0.75). Factors related to late VT/VF were systolic blood pressure (HR, 0.83; 95% CI, 0.76-0.91), ST resolution less than 70% (HR, 3.17; 95% CI, 1.60-6.28), baseline heart rate greater than 70/min (HR, 1.20; 95% CI, 1.08-1.33), total baseline ST deviation (HR, 1.43; 95% CI, 1.14-1.79), post-PCI TIMI flow less than grade 3 (HR, 2.09; 95% CI, 1.24-3.52), pre-PCI TIMI flow grade 0 (HR, 2.12; 95% CI, 1.20-3.75), and beta-blockers less than 24 hours (HR, 0.52; 95% CI, 0.32-0.85) (c index, 0.74). CONCLUSIONS: In this study, occurrence of VT/VF before or after the end of cardiac catheterization in patients presenting for primary PCI was associated with increased 90-day mortality. FAU - Mehta, Rajendra H AU - Mehta RH AD - Duke Clinical Research Institute, Box 17969, Durham, NC 27715, USA. mehta007@dcri.duke.edu FAU - Starr, Aijing Z AU - Starr AZ FAU - Lopes, Renato D AU - Lopes RD FAU - Hochman, Judith S AU - Hochman JS FAU - Widimsky, Petr AU - Widimsky P FAU - Pieper, Karen S AU - Pieper KS FAU - Armstrong, Paul W AU - Armstrong PW FAU - Granger, Christopher B AU - Granger CB CN - APEX AMI Investigators LA - eng PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't PL - United States TA - JAMA JT - JAMA JID - 7501160 SB - IM CIN - JAMA. 2009 Sep 2;302(9):943-4; author reply 944-5. doi: 10.1001/jama.2009.1238. PMID: 19724039 MH - Age Distribution MH - Aged MH - *Angioplasty, Balloon, Coronary MH - Female MH - Humans MH - Incidence MH - Male MH - Middle Aged MH - Myocardial Infarction/*complications/mortality/therapy MH - Prognosis MH - Proportional Hazards Models MH - Randomized Controlled Trials as Topic MH - Risk Factors MH - Tachycardia, Ventricular/epidemiology/*etiology MH - Treatment Outcome MH - Ventricular Fibrillation/epidemiology/*etiology EDAT- 2009/05/07 09:00 MHDA- 2009/05/12 09:00 CRDT- 2009/05/07 09:00 PHST- 2009/05/07 09:00 [entrez] PHST- 2009/05/07 09:00 [pubmed] PHST- 2009/05/12 09:00 [medline] AID - 301/17/1779 [pii] AID - 10.1001/jama.2009.600 [doi] PST - ppublish SO - JAMA. 2009 May 6;301(17):1779-89. doi: 10.1001/jama.2009.600. PMID- 19406493 OWN - NLM STAT- MEDLINE DCOM- 20110322 LR - 20131121 IS - 1874-1754 (Electronic) IS - 0167-5273 (Linking) VI - 144 IP - 1 DP - 2010 Sep 24 TI - Relationship between renal function and outcomes in high-risk patients with non-ST-segment elevation acute coronary syndromes: results from SYNERGY. PG - 36-41 LID - 10.1016/j.ijcard.2009.03.119 [doi] AB - BACKGROUND: Chronic kidney disease (CKD) is a risk factor for coronary heart disease and bleeding with antithrombotic therapy in patients with acute coronary syndromes (ACS). We evaluated the effect of renal function on efficacy and outcomes in high-risk patients with NSTE ACS in the SYNERGY trial. METHODS: Creatinine clearance (CrCl) at the time of randomization was analyzed as a continuous variable added to multivariable logistic regression models for 30-day death or MI, non-CABG-associated TIMI major bleeding, GUSTO severe bleeding, and transfusion in the overall study population, patients undergoing coronary angiography, and patients undergoing PCI. RESULTS: Of 9838 patients with a CrCl value, 70.6% (N=6950) had CrCl>/=60 mL/min, 27.8% (N=2732) had CrCl 30-59 mL/min, and 1.6% (N=156) had CrCl<30 mL/min. No randomized treatment by CrCl interaction test was found to be statistically significant, suggesting renal insufficiency affected enoxaparin and unfractionated heparin outcomes similarly. After adjustment, CrCl was an independent predictor of 30-day death or MI (OR 1.06, 95% CI 1.03-1.09), TIMI major bleeding (OR 1.06, 95% CI 1.02-1.10), GUSTO severe bleeding (OR 1.10, 95% CI 1.03-1.17), and transfusion (OR 1.07, 95% CI 1.04-1.11). CONCLUSIONS: Patients with CKD had higher rates of 30-day death or MI and bleeding than those without CKD, regardless of randomized antithrombin therapy. While this analysis suggests that there is a rise in bleeding events as CrCl falls for patients in either treatment group, it is unknown whether a reduction in dose would decrease bleeding risk. CI - Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved. FAU - Spinler, Sarah A AU - Spinler SA AD - Department of Pharmacy Practice and Pharmacy Administration, Philadelphia College of Pharmacy, University of the Sciences in Philadelphia, Philadelphia, PA, USA. s.spinle@usp.edu FAU - Mahaffey, Kenneth W AU - Mahaffey KW FAU - Gallup, Dianne AU - Gallup D FAU - Levine, Glenn N AU - Levine GN FAU - Ferguson, James J 3rd AU - Ferguson JJ 3rd FAU - Rao, Sunil V AU - Rao SV FAU - Gallo, Richard AU - Gallo R FAU - Ducas, John AU - Ducas J FAU - Goodman, Shaun G AU - Goodman SG FAU - Antman, Elliott AU - Antman E FAU - White, Harvey D AU - White HD FAU - Biasucci, Luigi AU - Biasucci L FAU - Becker, Richard C AU - Becker RC FAU - Col, Jacques J AU - Col JJ FAU - Cohen, Marc AU - Cohen M FAU - Harrington, Robert A AU - Harrington RA FAU - Califf, Robert M AU - Califf RM CN - SYNERGY Trial Investigators LA - eng PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20090505 PL - Netherlands TA - Int J Cardiol JT - International journal of cardiology JID - 8200291 RN - 0 (Fibrinolytic Agents) RN - AYI8EX34EU (Creatinine) SB - IM CIN - Int J Cardiol. 2010 Nov 5;145(1):91-2. doi: 10.1016/j.ijcard.2009.05.041. PMID: 19535159 MH - Acute Coronary Syndrome/complications/*physiopathology/therapy MH - Aged MH - Aged, 80 and over MH - Angioplasty, Balloon, Coronary/methods MH - Cardiac Catheterization MH - Creatinine/metabolism MH - *Electrocardiography MH - Female MH - Fibrinolytic Agents/therapeutic use MH - Follow-Up Studies MH - Glomerular Filtration Rate/*physiology MH - Humans MH - Kidney/*physiopathology MH - Male MH - Middle Aged MH - Prognosis MH - Renal Insufficiency/*etiology/metabolism/physiopathology MH - Risk Factors EDAT- 2009/05/02 09:00 MHDA- 2011/03/23 06:00 CRDT- 2009/05/02 09:00 PHST- 2008/08/15 00:00 [received] PHST- 2009/03/17 00:00 [revised] PHST- 2009/03/26 00:00 [accepted] PHST- 2009/05/02 09:00 [entrez] PHST- 2009/05/02 09:00 [pubmed] PHST- 2011/03/23 06:00 [medline] AID - S0167-5273(09)00414-8 [pii] AID - 10.1016/j.ijcard.2009.03.119 [doi] PST - ppublish SO - Int J Cardiol. 2010 Sep 24;144(1):36-41. doi: 10.1016/j.ijcard.2009.03.119. Epub 2009 May 5. PMID- 19359536 OWN - NLM STAT- MEDLINE DCOM- 20090619 LR - 20190722 IS - 1530-8561 (Electronic) IS - 0009-9147 (Linking) VI - 55 IP - 6 DP - 2009 Jun TI - Cystatin C for enhancement of risk stratification in non-ST elevation acute coronary syndrome patients with an increased troponin T. PG - 1118-25 LID - 10.1373/clinchem.2008.119669 [doi] AB - BACKGROUND: We assessed the value of cystatin C for improvement of risk stratification in patients with non-ST elevation acute coronary syndrome (nSTE-ACS) and increased cardiac troponin T (cTnT), and we compared the long-term effects of an early invasive treatment strategy (EIS) with a selective invasive treatment strategy (SIS) with regard to renal function. METHODS: Patients (n = 1128) randomized to an EIS or an SIS in the ICTUS trial were stratified according to the tertiles of the cystatin C concentration at baseline. The end points were death within 4 years and spontaneous myocardial infarction (MI) within 3 years. RESULTS: Mortality was 3.4%, 6.2%, and 13.5% in the first, second, and third tertiles, respectively, of cystatin C concentration (log-rank P < 0.001), and the respective rates of spontaneous MI were 5.5%, 7.5%, and 9.8% (log-rank P = 0.03). In a multivariate Cox regression analysis, the cystatin C concentration in the third quartile remained independently predictive of mortality [hazard ratio (HR), 2.04; 95% CI, 1.02-4.10; P = 0.04] and spontaneous MI (HR, 1.95; 95% CI, 1.05-3.63; P = 0.04). The mortality rate in the second tertile was lower with the EIS than with the SIS (3.8% vs 8.7%). In the third tertile, the mortality rates with the EIS and the SIS were, respectively, 15.0% and 12.2% (P for interaction = 0.04). Rates of spontaneous MI were similar for the EIS and the SIS within cystatin C tertiles (P for interaction = 0.22). CONCLUSIONS: In patients with nSTE-ACS and an increased cTnT concentration, mild to moderate renal dysfunction is associated with a higher risk of death and spontaneous MI. Use of cystatin C as a serum marker of renal function may improve risk stratification. FAU - Windhausen, Fons AU - Windhausen F AD - Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands. FAU - Hirsch, Alexander AU - Hirsch A FAU - Fischer, Johan AU - Fischer J FAU - van der Zee, P Marc AU - van der Zee PM FAU - Sanders, Gerard T AU - Sanders GT FAU - van Straalen, Jan P AU - van Straalen JP FAU - Cornel, Jan Hein AU - Cornel JH FAU - Tijssen, Jan G P AU - Tijssen JG FAU - Verheugt, Freek W A AU - Verheugt FW FAU - de Winter, Robbert J AU - de Winter RJ CN - Invasive versus Conservative Treatment in Unstable Coronary Syndromes (ICTUS) Investigators LA - eng PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20090409 PL - England TA - Clin Chem JT - Clinical chemistry JID - 9421549 RN - 0 (Cystatin C) RN - 0 (Troponin T) SB - IM MH - Acute Coronary Syndrome/*blood/therapy MH - Aged MH - Coronary Angiography MH - Cystatin C/*blood MH - Female MH - Humans MH - Male MH - Middle Aged MH - Risk Assessment MH - Troponin T/*blood EDAT- 2009/04/11 09:00 MHDA- 2009/06/20 09:00 CRDT- 2009/04/11 09:00 PHST- 2009/04/11 09:00 [entrez] PHST- 2009/04/11 09:00 [pubmed] PHST- 2009/06/20 09:00 [medline] AID - clinchem.2008.119669 [pii] AID - 10.1373/clinchem.2008.119669 [doi] PST - ppublish SO - Clin Chem. 2009 Jun;55(6):1118-25. doi: 10.1373/clinchem.2008.119669. Epub 2009 Apr 9. PMID- 19332204 OWN - NLM STAT- MEDLINE DCOM- 20090421 LR - 20260128 IS - 1097-6744 (Electronic) IS - 0002-8703 (Linking) VI - 157 IP - 4 DP - 2009 Apr TI - Impact of female gender and transradial coronary stenting with maximal antiplatelet therapy on bleeding and ischemic outcomes. PG - 740-5 LID - 10.1016/j.ahj.2008.12.003 [doi] AB - BACKGROUND: Female gender has been associated with poorer outcomes after percutaneous coronary intervention (PCI) and femoral approach. However, no data are available on the impact of gender and transradial PCI with maximal antiplatelet therapy on bleeding and ischemic outcomes. METHODS: In the EArly discharge after Stenting of coronarY arteries (EASY) trial, 1,348 patients with acute coronary syndrome underwent transradial PCI. All patients were pretreated with aspirin and clopidogrel. After sheath insertion, 70 U/kg heparin was administered and a bolus of abciximab was given before first balloon inflation. Major adverse cardiac events including death, myocardial infarction, and target vessel revascularization; major bleeding; and local hematomas were evaluated at 30 days, 6 months, and 12 months. RESULTS: Women (n = 298, 22%) were older, had more hypertension, more family history, and less previous PCI than men. Weight, baseline hemoglobin, and creatinine clearance were significantly lower in women. The number of dilated sites, complex lesions, and procedure duration was similar, but 5F sheath size was more frequent in women. Major adverse cardiac events remained similar at 30 days (3.4% vs 3.9%, P = .86), at 6 months (11.5% vs 7.8%, P = .06), and at 1 year (14.1% vs 12.6%) in both groups. There was no significant difference in the incidence of major bleeding between the 2 groups, but female gender was the only independent predictor of hematomas (odds ratio 4.40, 95% confidence interval 2.49-7.81, P < .0001). CONCLUSION: Despite more comorbidities, female gender was not a predictor of adverse clinical outcomes after transradial PCI with maximal antiplatelet therapy. Still, female gender remained associated with a higher risk of local hematomas. Efforts should continue to identify modifiable factors to reduce procedural bleeding in women, regardless of the access site. FAU - Tizon-Marcos, Helena AU - Tizon-Marcos H AD - Laval Hospital, Quebec Heart-Lung Institute, Canada. FAU - Bertrand, Olivier F AU - Bertrand OF FAU - Rodes-Cabau, Josep AU - Rodes-Cabau J FAU - Larose, Eric AU - Larose E FAU - Gaudreault, Valerie AU - Gaudreault V FAU - Bagur, Rodrigo AU - Bagur R FAU - Gleeton, Onil AU - Gleeton O FAU - Courtis, Javier AU - Courtis J FAU - Roy, Louis AU - Roy L FAU - Poirier, Paul AU - Poirier P FAU - Costerousse, Olivier AU - Costerousse O FAU - De Larochelliere, Robert AU - De Larochelliere R LA - eng PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20090131 PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 RN - 0 (Platelet Aggregation Inhibitors) RN - 0 (Sulfanilamides) RN - 46Z36VJE7H (risotilide) RN - 0 (Benzenesulfonamides) SB - IM MH - Acute Coronary Syndrome/diagnosis/epidemiology/*therapy MH - Coronary Angiography MH - Coronary Restenosis/diagnosis/*epidemiology/etiology MH - Female MH - Follow-Up Studies MH - Hemorrhage/*epidemiology/etiology MH - Humans MH - Incidence MH - Male MH - Middle Aged MH - Myocardial Revascularization/*methods MH - Platelet Aggregation Inhibitors/*therapeutic use MH - Quebec/epidemiology MH - Radial Artery MH - Retrospective Studies MH - Sex Factors MH - *Stents MH - Sulfanilamides MH - Treatment Outcome MH - Benzenesulfonamides EDAT- 2009/04/01 09:00 MHDA- 2009/04/22 09:00 CRDT- 2009/04/01 09:00 PHST- 2008/10/16 00:00 [received] PHST- 2008/12/06 00:00 [accepted] PHST- 2009/04/01 09:00 [entrez] PHST- 2009/04/01 09:00 [pubmed] PHST- 2009/04/22 09:00 [medline] AID - S0002-8703(08)01046-6 [pii] AID - 10.1016/j.ahj.2008.12.003 [doi] PST - ppublish SO - Am Heart J. 2009 Apr;157(4):740-5. doi: 10.1016/j.ahj.2008.12.003. Epub 2009 Jan 31. PMID- 19293712 OWN - NLM STAT- MEDLINE DCOM- 20090604 LR - 20161125 IS - 1473-5830 (Electronic) IS - 0954-6928 (Linking) VI - 20 IP - 2 DP - 2009 Mar TI - In-hospital outcomes of emergent and elective percutaneous coronary intervention in octogenarians. PG - 118-23 LID - 10.1097/MCA.0b013e3283292ae1 [doi] AB - OBJECTIVES: Although the prevalence of coronary artery disease increases with age, elderly patients are underrepresented in clinical trials. We sought to describe the short-term outcomes of octogenarians undergoing percutaneous coronary intervention (PCI) in both emergent and elective settings. METHODS: We retrospectively identified all octogenarians undergoing PCI at our institution from January 2002 to December 2005. The outcomes of those undergoing primary PCI for ST-segment elevation myocardial infarction (group A) were compared with a randomly selected cohort of octogenarians undergoing elective PCI (group B). RESULTS: Group A comprised 91 patients and group B 88 patients. Procedure success was high with Thrombolysis in Myocardial Infarction grade 3 flow achieved in greater than 90% of patients in both groups. Group A experienced more postprocedure morbidity including acute renal failure (47 vs. 8%) and bleeding requiring transfusion (51 vs. 17%) (P<0.0001 for both comparisons). In-hospital mortality was higher in group A (21 vs. 0%). In multivariate analysis, the risk of in-hospital mortality was predicted by lower admission systolic blood pressure (odds ratio 1.026 per point decrease in systolic blood pressure; 95% confidence interval 1.003-1.049; P = 0.030) and development of cardiogenic shock (odds ratio 7.506; 95% confidence interval, 1.865-30.207; P = 0.005). Mortality in group A was significantly higher among patients with cardiogenic shock (42 vs. 6%, P<0.001). CONCLUSION: PCI is a safe and highly effective procedure in octogenarians during both emergent and elective settings. However, elderly patients undergoing primary angioplasty who develop hemodynamic instability during ST-segment elevation myocardial infarction remain at increased risk for mortality. Measures to reduce postprocedure bleeding and renal dysfunction may improve outcomes among elderly patients undergoing PCI. FAU - Merchant, Faisal M AU - Merchant FM AD - Cardiology Division, Massachusetts General Hospital, Boston, Massachusetts 02114, USA. FAU - Weiner, Rory B AU - Weiner RB FAU - Rao, Sowmya R AU - Rao SR FAU - Lawrence, Ryan AU - Lawrence R FAU - Healy, Joanne L AU - Healy JL FAU - Pomerantsev, Eugene AU - Pomerantsev E FAU - Rosenfield, Kenneth AU - Rosenfield K FAU - Jang, Ik-Kyung AU - Jang IK LA - eng PT - Comparative Study PT - Journal Article PL - England TA - Coron Artery Dis JT - Coronary artery disease JID - 9011445 SB - IM MH - Acute Kidney Injury/etiology MH - Aged, 80 and over MH - Angioplasty, Balloon, Coronary/*adverse effects/mortality MH - Blood Pressure MH - Coronary Angiography MH - Coronary Artery Disease/complications/diagnostic imaging/mortality/*therapy MH - Elective Surgical Procedures/adverse effects MH - Emergency Treatment/adverse effects MH - Female MH - *Health Services for the Aged MH - Hospital Mortality MH - Humans MH - Male MH - Myocardial Infarction/diagnostic imaging/etiology/mortality/*therapy MH - Odds Ratio MH - Patient Selection MH - Postoperative Hemorrhage/etiology MH - Retrospective Studies MH - Risk Assessment MH - Risk Factors MH - Severity of Illness Index MH - Shock, Cardiogenic/etiology MH - Time Factors MH - Treatment Outcome EDAT- 2009/03/19 09:00 MHDA- 2009/06/06 09:00 CRDT- 2009/03/19 09:00 PHST- 2009/03/19 09:00 [entrez] PHST- 2009/03/19 09:00 [pubmed] PHST- 2009/06/06 09:00 [medline] AID - 10.1097/MCA.0b013e3283292ae1 [doi] PST - ppublish SO - Coron Artery Dis. 2009 Mar;20(2):118-23. doi: 10.1097/MCA.0b013e3283292ae1. PMID- 19282606 OWN - NLM STAT- MEDLINE DCOM- 20090803 LR - 20190819 IS - 1346-9843 (Print) IS - 1346-9843 (Linking) VI - 73 IP - 5 DP - 2009 May TI - Predictive value of C-reactive protein for major postoperative complications following off-pump coronary artery bypass surgery: prospective and observational trial. PG - 872-7 AB - BACKGROUND: To prospectively investigate the predictive value of the preoperative C-reactive protein (CRP) concentration for major postoperative complications following off-pump coronary artery bypass (OPCAB) surgery. METHODS AND RESULTS: From January 2007 to December 2007, 185 consecutive patients scheduled for elective OPCAB surgery were allocated to a low-CRP group (n=137, CRP <0.3 mg/dl) and a high-CRP group (n=48, CRP > or = 0.3 mg/dl). The incidence of major postoperative complications, defined as postoperative myocardial infarction, and 5 major morbidity endpoints including permanent stroke, renal dysfunction, any cardiac surgery reoperation, ventilation for more than 48 h, and deep sternal wound infection were assessed and compared. Multivariate logistic regression was used to determine the predictors of major postoperative complications. Patients in the high-CRP group had a significantly higher overall incidence of major postoperative complications, particularly renal dysfunction. In the multivariate logistic regression model, adjusting all the significant univariate predictors, baseline CRP >0.3 mg/dl and preoperative chronic renal failure (CRF) remained as significant independent predictors of major postoperative complications. CONCLUSIONS: Elevated preoperative CRP level and/or preoperative CRF indicate increased risk of developing major postoperative complications, particularly acute postoperative renal dysfunction in patients undergoing OPCAB surgery. FAU - Kim, Dae Hee AU - Kim DH AD - Department of Anesthesiology and Pain Medicine, Ajou University College of Medicine, Suwon, South Korea. FAU - Shim, Jae Kwang AU - Shim JK FAU - Hong, Seong Wook AU - Hong SW FAU - Cho, Kwang Rae AU - Cho KR FAU - Kang, Seung Youn AU - Kang SY FAU - Kwak, Young Lan AU - Kwak YL LA - eng PT - Comparative Study PT - Journal Article DEP - 20090313 PL - Japan TA - Circ J JT - Circulation journal : official journal of the Japanese Circulation Society JID - 101137683 RN - 0 (Biomarkers) RN - 9007-41-4 (C-Reactive Protein) SB - IM CIN - Circ J. 2009 May;73(5):818-9. doi: 10.1253/circj.cj-09-0180. PMID: 19390157 MH - Acute Kidney Injury/etiology MH - Aged MH - Biomarkers/blood MH - C-Reactive Protein/*analysis MH - Cardiovascular Diseases/etiology MH - Coronary Artery Bypass, Off-Pump/*adverse effects/mortality MH - Coronary Artery Disease/blood/mortality/*surgery MH - Female MH - Humans MH - Kidney Failure, Chronic/complications MH - Length of Stay MH - Logistic Models MH - Male MH - Middle Aged MH - Predictive Value of Tests MH - Preoperative Care MH - Prospective Studies MH - Reoperation MH - Respiration, Artificial MH - Risk Assessment MH - Risk Factors MH - Surgical Wound Infection/etiology MH - Treatment Outcome EDAT- 2009/03/14 09:00 MHDA- 2009/08/04 09:00 CRDT- 2009/03/14 09:00 PHST- 2009/03/14 09:00 [entrez] PHST- 2009/03/14 09:00 [pubmed] PHST- 2009/08/04 09:00 [medline] AID - JST.JSTAGE/circj/CJ-08-1010 [pii] AID - 10.1253/circj.cj-08-1010 [doi] PST - ppublish SO - Circ J. 2009 May;73(5):872-7. doi: 10.1253/circj.cj-08-1010. Epub 2009 Mar 13. PMID- 19247187 OWN - NLM STAT- MEDLINE DCOM- 20090824 LR - 20250103 IS - 1533-4023 (Electronic) IS - 0160-2446 (Linking) VI - 53 IP - 5 DP - 2009 May TI - Factors influencing clopidogrel efficacy in patients with stable coronary artery disease undergoing elective percutaneous coronary intervention: statin's advantage and the smoking "paradox". PG - 368-72 LID - 10.1097/FJC.0b013e31819d616b [doi] AB - PURPOSE: The aim was to identify factors that influence the efficacy of 600 mg of clopidogrel pretreatment in patients with stable coronary artery disease undergoing elective percutaneous coronary intervention. METHODS: In a laboratory substudy of the PRAGUE-8 trial, the influences of nonmodifiable (age and sex) and modifiable (body mass index and tobacco smoke) factors, comorbidity (hypertension, hyperlipidemia, diabetes mellitus, and renal insufficiency) and cotherapy (statin, aspirin, and heparin), on the course of clopidogrel efficacy were investigated in 105 patients pretreated with clopidogrel >or=6 hours before coronary angiography +/- percutaneous coronary intervention. Flow cytometric analysis of the vasodilator-stimulated phosphoprotein phosphorylation state was used. Independent predictors that influenced clopidogrel action were identified using linear regression. RESULTS: There was no correlation between baseline platelet reactivity index (PRI) and severity of coronary atherosclerosis; mean index of platelet reactivity for a nonsignificant lesion was 72% +/- 5.98% and for a significant lesion 70.08% +/- 8.43%. The highest proportion of low responders was patients with diabetes (50% at 28 hours). Among tobacco smokers, the response to clopidogrel occurred quickly and 80% of smokers had effective inhibition of PRI, 12 hours after drug use. After adjustments, tobacco smoking was an independent predictor for the most robust drop of PRI 12 hours after clopidogrel (P = 0.027). The magnitude of total decrease of PRI at 28 hours was not significantly influenced by cigarette smoking (P = 0.12). Linear regression showed that patients on statin therapy had a better response to clopidogrel than those without statins-the mean decrease of PRI at 28 hours was significantly higher (P = 0.02) among these patients (40.0 vs. 27.6). CONCLUSIONS: In stable coronary artery disease, no correlation exists between baseline PRI and the severity and extent of coronary atherosclerosis. A high loading dose of clopidogrel does not satisfactorily suppress enhanced PRI in patients with diabetes. Cigarette smoking is independently associated with a prompt antiplatelet response to clopidogrel. Ongoing statin therapy is an independent determinant of more effective clopidogrel-mediated inhibition of platelet reactivity. FAU - Motovska, Zuzana AU - Motovska Z AD - Third Medical Faculty, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic. zuzana.motovska@iex.cz FAU - Widimsky, Petr AU - Widimsky P FAU - Petr, Robert AU - Petr R FAU - Bilkova, Dana AU - Bilkova D FAU - Marinov, Iuri AU - Marinov I FAU - Simek, Stanislav AU - Simek S FAU - Kala, Petr AU - Kala P CN - PRAGUE-8 Study Investigators LA - eng PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - United States TA - J Cardiovasc Pharmacol JT - Journal of cardiovascular pharmacology JID - 7902492 RN - 0 (Cell Adhesion Molecules) RN - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors) RN - 0 (Microfilament Proteins) RN - 0 (Phosphoproteins) RN - 0 (Platelet Aggregation Inhibitors) RN - 0 (Vasodilator-Stimulated Phosphoprotein) RN - 9005-49-6 (Heparin) RN - A74586SNO7 (Clopidogrel) RN - OM90ZUW7M1 (Ticlopidine) RN - R16CO5Y76E (Aspirin) SB - IM MH - Age Factors MH - Aged MH - *Angioplasty, Balloon, Coronary MH - Aspirin/therapeutic use MH - Body Mass Index MH - Cell Adhesion Molecules/metabolism MH - Clopidogrel MH - Coronary Angiography MH - Coronary Artery Disease/complications/diagnostic imaging/*drug therapy/therapy MH - Diabetes Mellitus, Type 2/complications/physiopathology MH - Drug Therapy, Combination MH - Female MH - Heparin/therapeutic use MH - Humans MH - Hydroxymethylglutaryl-CoA Reductase Inhibitors/*therapeutic use MH - Hypercholesterolemia/epidemiology/physiopathology MH - Hypertension/complications/physiopathology MH - Male MH - Microfilament Proteins/metabolism MH - Phosphoproteins/metabolism MH - Platelet Aggregation Inhibitors/administration & dosage/*therapeutic use MH - Renal Insufficiency/complications/physiopathology MH - Sex Factors MH - *Smoking/adverse effects MH - Ticlopidine/administration & dosage/*analogs & derivatives/therapeutic use MH - Treatment Outcome MH - Vasodilator-Stimulated Phosphoprotein EDAT- 2009/02/28 09:00 MHDA- 2009/08/25 09:00 CRDT- 2009/02/28 09:00 PHST- 2009/02/28 09:00 [entrez] PHST- 2009/02/28 09:00 [pubmed] PHST- 2009/08/25 09:00 [medline] AID - 10.1097/FJC.0b013e31819d616b [doi] PST - ppublish SO - J Cardiovasc Pharmacol. 2009 May;53(5):368-72. doi: 10.1097/FJC.0b013e31819d616b. PMID- 19237895 OWN - NLM STAT- MEDLINE DCOM- 20090325 LR - 20220316 IS - 1530-0293 (Electronic) IS - 0090-3493 (Linking) VI - 37 IP - 3 DP - 2009 Mar TI - Pulsatile perfusion with intra-aortic balloon pumping ameliorates whole body response to cardiopulmonary bypass in the elderly. PG - 902-11 LID - 10.1097/CCM.0b013e3181962aa9 [doi] AB - OBJECTIVE: The growing life expectancy has led the elderly to be increasingly referred to coronary artery bypass grafting. Preexisting comorbidities may benefit from theoretical advantages of pulsatile perfusion during cardiopulmonary bypass (CPB). DESIGN: Prospective randomized trial. SETTING: Cardiac surgery unit in a university hospital. PATIENTS: Eighty consecutive patients older than 70 years. INTERVENTIONS: Elective coronary artery bypass grafting on CPB, randomizing to conventional linear CPB (40 patients, group A) or intra-aortic balloon pump (IABP)-induced pulsatile CPB (40 patients, group B). MEASUREMENTS AND MAIN RESULTS: We evaluated hemodynamic response by pulmonary artery flotation catheter, metabolic/splanchnic response by lactate and transaminase, bilirubin, amylase, and renal function (creatinine clearance, creatinine, incidence of renal insufficiency and failure), respiratory response by Pao2/Fio2, respiratory compliance, scoring of chest radiograph, intubation time, and need for noninvasive positive-pressure ventilation, hematologic response by chest drainage, hemocoagulative and fibrinolytic cascades, and transfusions. IABP-related complications were recorded. Two minor IABP-related complications (2.5%) were registered. Hemodynamics was comparable, except for a slightly better cardiac index and indexed systemic vascular resistances at the end of CPB and at intensive therapy unit (ITU) admission (p < 0.05). Transaminases, bilirubin, amylase, proved lower in group B (p < 0.05 from ITU admission to 48 hours). Creatinine clearance, serum creatinine, and lactate were better in group B (p < 0.05), and acute renal insufficiency was accordingly lower (p = 0.02). Respiratory response demonstrated better Pao2/Fio2 and respiratory compliance from aortic declamping to 48 hours, with better scoring of chest radiograph (p < 0.05 from ITU admission to 48 hours), lower noninvasive positive-pressure ventilation (p = 0.002) and intubation time (p = 0.031) in group B. Lower chest drainage (p < 0.05 at first and second day), transfusions (p < 0.05), activated partial thromboplastin time, international normalized ratio, white blood cells, and D-dimer (p < 0.05 from ITU admission to 48 hours), together with higher platelets, fibrinogen, and antithrombin III (p < 0.05 from ITU admission to 48 hours) were demonstrated in the pulsated group. CONCLUSIONS: IABP-induced pulsatile flow significantly improves whole body perfusion in the elderly undergoing CPB. FAU - Onorati, Francesco AU - Onorati F AD - Cardiac Surgery Unit, Magna Graecia University of Catanzaro, Catanzaro, Italy. frankono@libero.it FAU - Santarpino, Giuseppe AU - Santarpino G FAU - Presta, Pierangela AU - Presta P FAU - Caroleo, Santo AU - Caroleo S FAU - Abdalla, Karim AU - Abdalla K FAU - Santangelo, Ermenegildo AU - Santangelo E FAU - Gulletta, Elio AU - Gulletta E FAU - Fuiano, Giorgio AU - Fuiano G FAU - Costanzo, Francesco Saverio AU - Costanzo FS FAU - Renzulli, Attilio AU - Renzulli A LA - eng PT - Journal Article PT - Randomized Controlled Trial PL - United States TA - Crit Care Med JT - Critical care medicine JID - 0355501 SB - IM CIN - Crit Care Med. 2009 Mar;37(3):1142-3. doi: 10.1097/CCM.0b013e31819872a5. PMID: 19237937 CIN - Crit Care Med. 2009 Aug;37(8):2489; author reply 2489-90. doi: 10.1097/CCM.0b013e3181ac4886. PMID: 19609127 MH - Aged MH - *Cardiopulmonary Bypass MH - Combined Modality Therapy MH - Coronary Artery Disease/*surgery MH - Female MH - Humans MH - *Intra-Aortic Balloon Pumping MH - Male MH - Prospective Studies MH - *Pulsatile Flow MH - Treatment Outcome EDAT- 2009/02/25 09:00 MHDA- 2009/03/26 09:00 CRDT- 2009/02/25 09:00 PHST- 2009/02/25 09:00 [entrez] PHST- 2009/02/25 09:00 [pubmed] PHST- 2009/03/26 09:00 [medline] AID - 00003246-200903000-00015 [pii] AID - 10.1097/CCM.0b013e3181962aa9 [doi] PST - ppublish SO - Crit Care Med. 2009 Mar;37(3):902-11. doi: 10.1097/CCM.0b013e3181962aa9. PMID- 19201761 OWN - NLM STAT- MEDLINE DCOM- 20090401 LR - 20181201 IS - 1522-9645 (Electronic) IS - 0195-668X (Linking) VI - 30 IP - 5 DP - 2009 Mar TI - Temporal management patterns and outcomes of non-ST elevation acute coronary syndromes in patients with kidney dysfunction. PG - 549-57 LID - 10.1093/eurheartj/ehp014 [doi] AB - AIMS: To examine: (i) the temporal changes in the management pattern; (ii) the reasons for any treatment disparities; (iii) the relationship between invasive treatment and outcome, among acute coronary syndrome (ACS) patients with vs. without kidney dysfunction. METHODS AND RESULTS: Canadian ACS I, ACS II registries and Global Registry of Acute Coronary Events (GRACE) were prospective, multi-centre, observational studies of patients with ACS. From 1999 to 2007, non-ST elevation (NSTE) ACS patients were recruited in ACS I (n = 3295; 1999-2001), ACS II (n = 1956; 2002-2003), and GRACE (n = 6491; 2004-2007) in Canada. Using the four-variable Modified Diet in Renal Disease equation, we stratified the study population (n = 11,377) into three groups based on their estimated glomerular filtration rate (eGFR), and examined their treatment and outcome. While in-hospital use of coronary angiography and revascularization increased over time in all groups (P < 0.001), patients with kidney dysfunction were less likely to undergo invasive management (P < 0.001). Unadjusted 1 year mortality was lower among patients receiving in-hospital coronary angiography within all eGFR categories (> or =60 mL/min/1.73 m(2): 2.5 vs. 7.6%, P < 0.001; 30-59 mL/min/1.73 m(2): 8.0 vs. 14.6%, P < 0.001; <30 mL/min/1.73 m(2): 27.5 vs. 41.5%, P = 0.043). In-hospital revascularization was independently associated with lower 1-year mortality (adjusted OR = 0.52, 95% CI 0.36-0.77, P = 0.001), irrespective of eGFR (P for heterogeneity = 0.39). Underestimation of patient risk was the most common barrier to an invasive treatment strategy. CONCLUSION: Despite temporal increases in invasive management of NSTE-ACS, patients with kidney dysfunction are more commonly treated conservatively, with an associated worse outcome. In-hospital revascularization was independently associated with improved survival, irrespective of eGFR. Randomized controlled trials involving patients with kidney dysfunction are needed to confirm whether more aggressive treatment will improve their poor outcome. FAU - Wong, Jorge A AU - Wong JA AD - Terrence Donnelly Heart Centre, Division of Cardiology, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada. FAU - Goodman, Shaun G AU - Goodman SG FAU - Yan, Raymond T AU - Yan RT FAU - Wald, Ron AU - Wald R FAU - Bagnall, Alan J AU - Bagnall AJ FAU - Welsh, Robert C AU - Welsh RC FAU - Wong, Graham C AU - Wong GC FAU - Kornder, Jan AU - Kornder J FAU - Eagle, Kim A AU - Eagle KA FAU - Steg, Philippe Gabriel AU - Steg PG FAU - Yan, Andrew T AU - Yan AT CN - Canadian Acute Coronary Syndromes I and II, and Canadian Global Registry of Acute Coronary Events (GRACE/GRACE) Investigators LA - eng PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't DEP - 20090206 PL - England TA - Eur Heart J JT - European heart journal JID - 8006263 SB - IM CIN - Eur Heart J. 2009 Mar;30(5):526-7. doi: 10.1093/eurheartj/ehp028. PMID: 19201760 MH - Acute Coronary Syndrome/complications/diagnostic imaging/*therapy MH - Aged MH - Aged, 80 and over MH - Coronary Angiography MH - Electrocardiography MH - Female MH - Glomerular Filtration Rate MH - Hospitalization MH - Humans MH - Kidney Diseases/*complications MH - Male MH - Middle Aged MH - Myocardial Revascularization/statistics & numerical data MH - Prospective Studies MH - Treatment Outcome EDAT- 2009/02/10 09:00 MHDA- 2009/04/02 09:00 CRDT- 2009/02/10 09:00 PHST- 2009/02/10 09:00 [entrez] PHST- 2009/02/10 09:00 [pubmed] PHST- 2009/04/02 09:00 [medline] AID - ehp014 [pii] AID - 10.1093/eurheartj/ehp014 [doi] PST - ppublish SO - Eur Heart J. 2009 Mar;30(5):549-57. doi: 10.1093/eurheartj/ehp014. Epub 2009 Feb 6. PMID- 19194534 OWN - NLM STAT- MEDLINE DCOM- 20090611 LR - 20250529 IS - 1876-7605 (Electronic) IS - 1936-8798 (Print) IS - 1936-8798 (Linking) VI - 1 IP - 5 DP - 2008 Oct TI - Predictors of outcome and the lack of effect of percutaneous coronary intervention across the risk strata in patients with persistent total occlusion after myocardial infarction: Results from the OAT (Occluded Artery Trial) study. PG - 511-20 LID - 10.1016/j.jcin.2008.08.007 [doi] AB - OBJECTIVES: This study sought to determine predictors of outcome and examine the influence of baseline risk on therapeutic impact of late mechanical opening of a persistently occluded infarct related artery after myocardial infarction in stable patients. BACKGROUND: Previous studies in patients with acute coronary syndromes suggest that the impact of infarct-related artery recanalization on clinical outcome is greatest in patients at highest risk. METHODS: Of 2,201 patients (age 58.6 +/- 11.0 years) with infarct-related artery occlusion on days 3 to 28 after myocardial infarction in the OAT (Occluded Artery Trial) study, 1,101 were assigned to percutaneous coronary intervention (PCI) and 1,100 to medical therapy alone and followed for a mean of 3.2 years. The primary end point was a composite of death, reinfarction, or New York Heart Association functional class IV heart failure. Interaction of treatment effect with tertiles of predicted survival were examined using the Cox survival model. RESULTS: The 5-year rate for the primary end point was 18.9% versus 16.1% for patients assigned to PCI and medical treatment alone, respectively (hazard ratio [HR]: 1.14, 95% confidence interval [CI]: 0.92 to 1.43, p 0.23). Lack of benefit of PCI was consistent across the risk spectrum for both the primary end point and total mortality, including for the highest tertile (33.9% PCI vs. 27.3% medical treatment alone, HR: 1.27, 99% CI: 0.87 to 1.85 primary end point and 23.5% PCI vs. 21.7% medical treatment alone, HR: 1.16, 99% CI: 0.73 to 1.85 mortality). The independent predictors of the composite outcome were history of heart failure (HR: 2.06, p < 0.001), peripheral vascular disease (HR: 1.93, p 0.001), diabetes (HR: 1.49, p 0.002), rales (HR: 1.88, p < 0.001), decreasing ejection fraction (HR: 1.48 per 10%, p < 0.001), decreasing days from myocardial infarction to randomization (HR: 1.04 per day, p < 0.001), and decreasing glomerular filtration rate (HR: 1.11 per 10 ml/min/1.73 m(2), p < 0.001). CONCLUSIONS: In the OAT study, there was no variation in the effect of PCI on clinical outcomes at different levels of patient risk, including the subset with very high event rates. (Occluded Artery Trial [OAT]; NCT00004562) FAU - Kruk, Mariusz AU - Kruk M AD - Institute of Cardiology, Warsaw, Poland. FAU - Kadziela, Jacek AU - Kadziela J FAU - Reynolds, Harmony R AU - Reynolds HR FAU - Forman, Sandra A AU - Forman SA FAU - Sadowski, Zygmunt AU - Sadowski Z FAU - Barton, Bruce A AU - Barton BA FAU - Mark, Daniel B AU - Mark DB FAU - Maggioni, Aldo P AU - Maggioni AP FAU - Leor, Jonathan AU - Leor J FAU - Webb, John G AU - Webb JG FAU - Kapeliovich, Michael AU - Kapeliovich M FAU - Marin-Neto, Jose A AU - Marin-Neto JA FAU - White, Harvey D AU - White HD FAU - Lamas, Gervasio A AU - Lamas GA FAU - Hochman, Judith S AU - Hochman JS LA - eng SI - ClinicalTrials.gov/NCT00004562 GR - U01 HL062509/HL/NHLBI NIH HHS/United States GR - U01 HL062511/HL/NHLBI NIH HHS/United States PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, N.I.H., Extramural PL - United States TA - JACC Cardiovasc Interv JT - JACC. Cardiovascular interventions JID - 101467004 RN - 0 (Cardiovascular Agents) SB - IM CIN - JACC Cardiovasc Interv. 2008 Oct;1(5):521-3. doi: 10.1016/j.jcin.2008.08.009. PMID: 19463353 MH - Aged MH - *Angioplasty, Balloon, Coronary/adverse effects/mortality MH - Cardiovascular Agents/*therapeutic use MH - Coronary Occlusion/complications/drug therapy/mortality/*therapy MH - Female MH - Heart Failure/etiology/prevention & control MH - Humans MH - Kaplan-Meier Estimate MH - Male MH - Middle Aged MH - Multivariate Analysis MH - Myocardial Infarction/drug therapy/etiology/mortality/*therapy MH - Patient Selection MH - Proportional Hazards Models MH - Recurrence MH - Risk Assessment MH - Risk Factors MH - Time Factors MH - Treatment Outcome PMC - PMC2635493 MID - NIHMS82380 OTO - NOTNLM OT - myocardial infarction OT - revascularization OT - risk factors OT - trials COIS- No conflict of interest exists EDAT- 2009/02/06 09:00 MHDA- 2009/06/12 09:00 PMCR- 2009/10/01 CRDT- 2009/02/06 09:00 PHST- 2009/02/06 09:00 [entrez] PHST- 2009/02/06 09:00 [pubmed] PHST- 2009/06/12 09:00 [medline] PHST- 2009/10/01 00:00 [pmc-release] AID - S1936-8798(08)00348-8 [pii] AID - 10.1016/j.jcin.2008.08.007 [doi] PST - ppublish SO - JACC Cardiovasc Interv. 2008 Oct;1(5):511-20. doi: 10.1016/j.jcin.2008.08.007. PMID- 19161766 OWN - NLM STAT- MEDLINE DCOM- 20090211 LR - 20220330 IS - 1552-6259 (Electronic) IS - 0003-4975 (Linking) VI - 87 IP - 2 DP - 2009 Feb TI - Effects of mild hypothermia and rewarming on renal function after coronary artery bypass grafting. PG - 489-95 LID - 10.1016/j.athoracsur.2008.10.078 [doi] AB - BACKGROUND: Hypothermia is a potential strategy for visceral organ protection during cardiopulmonary bypass (CPB). We report data from two randomized studies evaluating mild hypothermia and rewarming on postoperative renal function in cardiac surgical patients. METHODS: Patients undergoing nonemergency, isolated coronary artery bypass grafting were enrolled into two studies. In the first, 223 patients were cooled to 32 degrees C during CPB and randomly assigned to rewarming to 37 degrees C (RW-37 degrees) or 34 degrees C (RW-34 degrees). The second study randomized 267 patients to sustained mild hypothermia at 34 degrees C (S-34 degrees) or normothermia (S-37 degrees) without rewarming. Serum creatinine levels were measured. Creatinine clearance was calculated. Significant renal dysfunction was defined as a 25% increase in serum creatinine or a 25% decrease in creatinine clearance postoperatively. RESULTS: Postoperative serum creatinine levels were persistently higher in the RW-37 degrees patients than in the RW-34 degrees group (p < 0.01). RW-37 degrees patients had a higher incidence of renal dysfunction (17%) than RW-34 degrees patients (9%, p = 0.07). Sustained mild hypothermia had no beneficial effect on postoperative serum creatinine levels (p = 0.44) or significant renal dysfunction: S-34 degrees, 20% vs S-37 degrees, 15% (p = 0.28). Diabetes (odds ratio [OR], 1.6; 95% confidence interval [CI] 1.3 to 2.1), prolonged CPB time (OR, 1.1; 95% CI, 1.0 to 1.2), and rewarming (OR, 1.4; 95% CI, 1.0 to 1.9) were independent risk factors for significant renal dysfunction. Renal dysfunction was associated with longer hospital stay (8.4 +/- 0.8 vs 6.8 +/- 04 days, p < 0.001). CONCLUSIONS: Sustained mild hypothermia does not improve renal outcome. However, rewarming on CPB is associated with increased renal injury and should be avoided. FAU - Boodhwani, Munir AU - Boodhwani M AD - Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, Ontario, Canada. FAU - Rubens, Fraser D AU - Rubens FD FAU - Wozny, Denise AU - Wozny D FAU - Nathan, Howard J AU - Nathan HJ LA - eng SI - ISRCTN/ISRCTN59467488 PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - Netherlands TA - Ann Thorac Surg JT - The Annals of thoracic surgery JID - 15030100R RN - AYI8EX34EU (Creatinine) SB - IM MH - Aged MH - Analysis of Variance MH - Cardiopulmonary Bypass/methods MH - Confidence Intervals MH - Coronary Artery Bypass/*methods/mortality MH - Coronary Stenosis/diagnostic imaging/mortality/*surgery MH - Creatinine/*urine MH - Elective Surgical Procedures/methods MH - Female MH - Follow-Up Studies MH - Humans MH - Hypothermia, Induced/*methods MH - Kidney Function Tests MH - Length of Stay MH - Male MH - Middle Aged MH - Multivariate Analysis MH - Postoperative Care MH - Probability MH - Radiography MH - Randomized Controlled Trials as Topic MH - Reference Values MH - Rewarming/adverse effects/*methods MH - Risk Assessment MH - Statistics, Nonparametric MH - Survival Analysis MH - Treatment Outcome EDAT- 2009/01/24 09:00 MHDA- 2009/02/12 09:00 CRDT- 2009/01/24 09:00 PHST- 2008/08/16 00:00 [received] PHST- 2008/10/25 00:00 [revised] PHST- 2008/10/28 00:00 [accepted] PHST- 2009/01/24 09:00 [entrez] PHST- 2009/01/24 09:00 [pubmed] PHST- 2009/02/12 09:00 [medline] AID - S0003-4975(08)02296-0 [pii] AID - 10.1016/j.athoracsur.2008.10.078 [doi] PST - ppublish SO - Ann Thorac Surg. 2009 Feb;87(2):489-95. doi: 10.1016/j.athoracsur.2008.10.078. PMID- 19084425 OWN - NLM STAT- MEDLINE DCOM- 20090608 LR - 20131121 IS - 1873-734X (Electronic) IS - 1010-7940 (Linking) VI - 35 IP - 3 DP - 2009 Mar TI - Association of IL6 and IL10 with renal dysfunction and the use of haemofiltration during cardiopulmonary bypass. PG - 511-4 LID - 10.1016/j.ejcts.2008.10.010 [doi] AB - OBJECTIVE: Assessment of the effects of haemofiltration during cardiopulmonary bypass (CPB) in coronary artery bypass grafting (CABG) on the renal function and correlation with interleukin 6 (IL6) and interleukin 10 (IL10) levels. METHODS: Seventy-nine patients scheduled for elective CABG were prospectively randomised into two groups. Group A with a haemofilter attached to arterial line of the CPB circuit and group B without a haemofilter. The two groups were comparable in their symptoms, sex, and previous history of myocardial infarction, left ventricular function, cross-clamp time, bypass time and total grafting per patients. Blood urea and creatinine levels were measured the day before operation, 12h after operation and on the 3rd postoperative day. IL6 and IL10 were measured in blood samples collected 1h before surgery, on arrival to ITU and after 12h. IL6 and IL10 levels were measured using ELISA test. RESULTS: High levels of IL6 (>100 pg/ml) postoperatively were associated with increased incidence of renal dysfunction (p<0.017). Additionally, high IL10 (>30 pg/ml) levels postoperatively were associated with increased incidence of renal dysfunction (p<0.014). There were no effects of the haemofilter on postoperative IL6 and IL10 levels. Use of haemofiltration during CPB was found not to be protective against renal dysfunction (p<0.071). CONCLUSIONS: Haemofilter use during cardiopulmonary bypass does not have a protective effect on postoperative kidney function. Haemofilter has no effect on the level of IL6 and IL10. FAU - Musleh, Ghassan S AU - Musleh GS AD - Manchester Royal Infirmary, Manchester, UK. eindara@yahoo.com FAU - Datta, Subir S AU - Datta SS FAU - Yonan, Nizar N AU - Yonan NN FAU - Grotte, Geir J AU - Grotte GJ FAU - Prendergast, Brian A AU - Prendergast BA FAU - Hasan, Ragheb I AU - Hasan RI FAU - Deyrania, Abdul K AU - Deyrania AK LA - eng PT - Journal Article DEP - 20081211 PL - Germany TA - Eur J Cardiothorac Surg JT - European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery JID - 8804069 RN - 0 (Interleukin-6) RN - 130068-27-8 (Interleukin-10) RN - AYI8EX34EU (Creatinine) SB - IM CIN - Eur J Cardiothorac Surg. 2011 Mar;39(3):425. doi: 10.1016/j.ejcts.2010.06.014. PMID: 20674383 MH - Acute Kidney Injury/etiology/prevention & control MH - Aged MH - Cardiopulmonary Bypass/adverse effects/*methods MH - Coronary Artery Bypass/adverse effects/*methods MH - Coronary Artery Disease/blood/surgery MH - Creatinine/blood MH - Female MH - Hemofiltration/*adverse effects/instrumentation MH - Humans MH - Interleukin-10/*blood MH - Interleukin-6/*blood MH - Kidney Function Tests MH - Male MH - Middle Aged MH - Monitoring, Intraoperative MH - Postoperative Complications EDAT- 2008/12/17 09:00 MHDA- 2009/06/09 09:00 CRDT- 2008/12/17 09:00 PHST- 2007/11/18 00:00 [received] PHST- 2008/09/13 00:00 [revised] PHST- 2008/10/14 00:00 [accepted] PHST- 2008/12/17 09:00 [entrez] PHST- 2008/12/17 09:00 [pubmed] PHST- 2009/06/09 09:00 [medline] AID - S1010-7940(08)01017-8 [pii] AID - 10.1016/j.ejcts.2008.10.010 [doi] PST - ppublish SO - Eur J Cardiothorac Surg. 2009 Mar;35(3):511-4. doi: 10.1016/j.ejcts.2008.10.010. Epub 2008 Dec 11. PMID- 19081414 OWN - NLM STAT- MEDLINE DCOM- 20090122 LR - 20101118 IS - 1097-6744 (Electronic) IS - 0002-8703 (Linking) VI - 157 IP - 1 DP - 2009 Jan TI - Incidence, predictors, and clinical impact of bleeding after transradial coronary stenting and maximal antiplatelet therapy. PG - 164-9 LID - 10.1016/j.ahj.2008.09.010 [doi] AB - BACKGROUND: Bleeding has recently emerged as predictor of early and late mortality after percutaneous coronary intervention (PCI) using femoral approach. Transradial PCI is associated with a lower risk of access-site complications than femoral approach. We evaluated the predictors of bleeding and the impact of major bleeding on death and major adverse cardiac events (MACE) after transradial PCI and maximal antiplatelet therapy. METHODS: In the EASY (EArly discharge after transradial Stenting of coronarY arteries) trial, 1,348 patients with acute coronary syndrome were enrolled and underwent transradial PCI. All patients received clopidogrel (90% > or =12 hours pre-PCI) and a bolus of abciximab before first balloon inflation. Univariate and multivariate analyses to identify predictors and prognostic impact of major bleeding on death and MACE (death, myocardial infarction, and target vessel revascularization) were performed. RESULTS: From the study population, 19 (1.4%) patients presented major bleeding. Patients with bleeding were older, had lower creatinine clearance, more often had 3-vessel disease and > or =3 dilated sites, and had longer procedures. Independent predictors of bleeding were creatinine clearance <60 mL/min (odds ratio [OR] 3.26, 95% confidence interval [CI] 1.10-8.67, P = .022), procedure duration (OR 2.95, 95% CI 1.12-8.31, P = .032), and sheath size (OR 5.34, 95% CI 1.44-34.65, P = .029). In patients with major bleeding, the incidence of MACE was higher at 30 days (37% vs 3%), 6 months (42% vs 8%), and 12 months (53% vs 12%; P < .0001 for all comparisons). By multivariate analysis, major bleeding was an independent predictive factor of 1-year mortality and MACE. CONCLUSION: After transradial PCI and maximal antiplatelet therapy, the incidence of major bleeding remains low. Major bleeding is an independent predictive factor of adverse acute and 1-year outcomes, regardless of the access site. FAU - Bertrand, Olivier F AU - Bertrand OF AD - Hopital Laval, Institut Universitaire de Cardiologie et de Pneumologie, Quebec City, Quebec, Canada. olivier.bertrand@crhl.ulaval.ca FAU - Larose, Eric AU - Larose E FAU - Rodes-Cabau, Josep AU - Rodes-Cabau J FAU - Gleeton, Onil AU - Gleeton O FAU - Taillon, Isabelle AU - Taillon I FAU - Roy, Louis AU - Roy L FAU - Poirier, Paul AU - Poirier P FAU - Costerousse, Olivier AU - Costerousse O FAU - Larochelliere, Robert De AU - Larochelliere RD LA - eng SI - ClinicalTrials.gov/NCT01169819 PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20081106 PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 RN - 0 (Platelet Aggregation Inhibitors) SB - IM MH - Aged MH - Angioplasty, Balloon, Coronary/*adverse effects/*methods MH - Female MH - Humans MH - Incidence MH - Male MH - Middle Aged MH - Platelet Aggregation Inhibitors/*therapeutic use MH - Postoperative Hemorrhage/*epidemiology/etiology/*prevention & control MH - *Stents EDAT- 2008/12/17 09:00 MHDA- 2009/01/23 09:00 CRDT- 2008/12/17 09:00 PHST- 2008/04/06 00:00 [received] PHST- 2008/09/14 00:00 [accepted] PHST- 2008/12/17 09:00 [entrez] PHST- 2008/12/17 09:00 [pubmed] PHST- 2009/01/23 09:00 [medline] AID - S0002-8703(08)00803-X [pii] AID - 10.1016/j.ahj.2008.09.010 [doi] PST - ppublish SO - Am Heart J. 2009 Jan;157(1):164-9. doi: 10.1016/j.ahj.2008.09.010. Epub 2008 Nov 6. PMID- 19081408 OWN - NLM STAT- MEDLINE DCOM- 20090122 LR - 20141120 IS - 1097-6744 (Electronic) IS - 0002-8703 (Linking) VI - 157 IP - 1 DP - 2009 Jan TI - The use of intravenous enoxaparin in elective percutaneous coronary intervention in patients with renal impairment: results from the SafeTy and Efficacy of Enoxaparin in PCI patients, an internationaL randomized Evaluation (STEEPLE) trial. PG - 125-31 LID - 10.1016/j.ahj.2008.08.019 [doi] AB - BACKGROUND: The STEEPLE trial assessed outcomes of patients undergoing elective percutaneous coronary intervention randomized to receive a bolus of intravenous enoxaparin (0.5 or 0.75 mg/kg, n = 2,298) or activated clotting time-adjusted unfractionated heparin (UFH, n = 1,230), stratified according to planned glycoprotein IIb/IIIa inhibitor use. METHODS: In this subanalysis, we assessed outcomes in patients with renal impairment (creatinine clearance < or =60 mL/min, n = 659). RESULTS: Major bleeding occurred more often in patients with renal impairment compared with those without (2.7% vs 1.5%, P = .04). Enoxaparin was associated with less major bleeding than UFH with normal renal function (0.9% for enoxaparin 0.5 mg/kg or 1.0% for enoxaparin 0.75 mg/kg vs 2.6%, respectively; both P = .01 vs UFH), with a trend toward less major bleeding with impaired renal function (2.6% or 1.8% vs 3.8%, P = .18 for enoxaparin 0.5 mg/kg and P = .47 for 0.75 mg/kg vs UFH). Minor bleeding rates were similar irrespective of renal function or anticoagulation regimen. The incidence of death, nonfatal myocardial infarction, or urgent target-vessel revascularization was similar between patients with and without renal impairment (5.7% vs 6.5%, P = .45). In patients with renal impairment, event rates were 6.2% or 5.3% with enoxaparin vs 5.6% with UFH (P = nonsignificant). Target anticoagulation levels were achieved 4 to 5 times more often with enoxaparin compared with UFH in patients with normal and impaired renal function (both P < .0001). CONCLUSIONS: A single bolus of enoxaparin was associated with similar ischemic events and a trend for less major bleeding compared with UFH in patients with renal impairment undergoing percutaneous coronary intervention. Enoxaparin can be administered safely without dose adjustment in these patients. FAU - White, Harvey D AU - White HD AD - Green Lane Cardiovascular Service, Auckland City Hospital, Auckland, New Zealand. harveyw@adhb.govt.nz FAU - Gallo, Richard AU - Gallo R FAU - Cohen, Marc AU - Cohen M FAU - Steg, Ph Gabriel AU - Steg PG FAU - Aylward, Philip E AU - Aylward PE FAU - Bode, Christoph AU - Bode C FAU - Steinhubl, Steve AU - Steinhubl S FAU - Montalescot, Gilles AU - Montalescot G LA - eng SI - ClinicalTrials.gov/NCT00077844 PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20081112 PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 RN - 0 (Anticoagulants) RN - 0 (Enoxaparin) RN - 9005-49-6 (Heparin) SB - IM MH - Aged MH - *Angioplasty, Balloon, Coronary MH - Anticoagulants/*administration & dosage MH - Elective Surgical Procedures MH - Enoxaparin/*administration & dosage MH - Female MH - Hemorrhage/*etiology MH - Heparin/administration & dosage MH - Humans MH - Injections, Intravenous MH - Kidney Diseases/*complications MH - Male MH - Prospective Studies EDAT- 2008/12/17 09:00 MHDA- 2009/01/23 09:00 CRDT- 2008/12/17 09:00 PHST- 2008/05/15 00:00 [received] PHST- 2008/08/20 00:00 [accepted] PHST- 2008/12/17 09:00 [entrez] PHST- 2008/12/17 09:00 [pubmed] PHST- 2009/01/23 09:00 [medline] AID - S0002-8703(08)00734-5 [pii] AID - 10.1016/j.ahj.2008.08.019 [doi] PST - ppublish SO - Am Heart J. 2009 Jan;157(1):125-31. doi: 10.1016/j.ahj.2008.08.019. Epub 2008 Nov 12. PMID- 18837764 OWN - NLM STAT- MEDLINE DCOM- 20090109 LR - 20161124 IS - 1492-7535 (Print) IS - 1492-7535 (Linking) VI - 12 Suppl 2 DP - 2008 Oct TI - Percutaneous coronary intervention and the use of glycoprotein IIb/IIIa inhibitors in patients with chronic kidney disease on dialysis: a single center experience. PG - S2-8 LID - 10.1111/j.1542-4758.2008.00316.x [doi] AB - Patients on dialysis constitute a major healthcare burden with high prevalence of coronary artery disease frequently requiring coronary revascularization. Prior studies have reported high complications rates with revascularization in patients on dialysis. However, information on the use glycoprotein and direct thrombin inhibitors in this patient population undergoing percutaneous revascularization is limited. We retrospectively analyzed the procedural success and in-hospital outcomes of percutaneous coronary revascularization in 56 consecutive patients on dialysis compared with 524 patients without renal failure, between January 2001 and August 2007 at our facility. Additionally, we also analyzed the off-label use of glycoprotein IIb/IIIa (GP IIb/IIIa) inhibitors during revascularization in this high-risk group of patients to evaluate for possible increased bleeding complications. In the study group, 7 interventions were performed on peritoneal dialysis and 49 on hemodialysis patients. Sixty-one percent of these patients had diabetes mellitus. A total of 72 lesions were intervened upon; 12 underwent angioplasty and 60 underwent stenting. Four of 72 interventions were not successful, giving a procedural success rate of 94%. There were 6 immediate complications (10.7%), but no deaths. Thirty-two patients (57%) received GP IIb/IIIa inhibitors while direct thrombin inhibitors were used during percutaneous coronary intervention in 11(20%) patients. There were no bleeding complications with use of either GP IIb/IIIa inhibitors or direct thrombin inhibitors. In our experience, percutaneous coronary intervention has high procedural success in dialysis patients and concomitant use of GP IIb/IIIa inhibitors is not associated with any major bleeding complications, making this a feasible, safe and effective revascularization option for patients on dialysis; however, this merits further study in a randomized prospective trial. FAU - Khaja, Azam AU - Khaja A AD - Division of Cardiology, Department of Biostatistics, University of Missouri, Columbia, Missouri, USA. khaja73@gmail.com FAU - Garg, Rajeev AU - Garg R FAU - Govindarajan, Gurushanker AU - Govindarajan G FAU - Madsen, Richard AU - Madsen R FAU - Aggarwal, Kul AU - Aggarwal K LA - eng PT - Journal Article PL - Canada TA - Hemodial Int JT - Hemodialysis international. International Symposium on Home Hemodialysis JID - 101093910 RN - 0 (Anticoagulants) RN - 0 (Antithrombins) RN - 0 (Hirudins) RN - 0 (Peptide Fragments) RN - 0 (Platelet Glycoprotein GPIIb-IIIa Complex) RN - 0 (Recombinant Proteins) RN - TN9BEX005G (bivalirudin) SB - IM MH - *Angioplasty, Balloon, Coronary MH - Anticoagulants/therapeutic use MH - Antithrombins/therapeutic use MH - Combined Modality Therapy MH - Coronary Artery Disease/*complications/*drug therapy/epidemiology MH - Female MH - Hirudins MH - Humans MH - Kidney Failure, Chronic/*complications/epidemiology/therapy MH - Male MH - Middle Aged MH - Peptide Fragments/*therapeutic use MH - Platelet Glycoprotein GPIIb-IIIa Complex/antagonists & inhibitors MH - Recombinant Proteins/therapeutic use MH - *Renal Dialysis MH - Retrospective Studies MH - Risk Factors MH - Treatment Outcome EDAT- 2008/12/05 09:00 MHDA- 2009/01/10 09:00 CRDT- 2008/12/05 09:00 PHST- 2008/12/05 09:00 [pubmed] PHST- 2009/01/10 09:00 [medline] PHST- 2008/12/05 09:00 [entrez] AID - HDI316 [pii] AID - 10.1111/j.1542-4758.2008.00316.x [doi] PST - ppublish SO - Hemodial Int. 2008 Oct;12 Suppl 2:S2-8. doi: 10.1111/j.1542-4758.2008.00316.x. PMID- 19021282 OWN - NLM STAT- MEDLINE DCOM- 20090226 LR - 20161124 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 72 IP - 7 DP - 2008 Dec 1 TI - A prospective, double-blind, randomized, controlled trial on the efficacy and cardiorenal safety of iodixanol vs. iopromide in patients with chronic kidney disease undergoing coronary angiography with or without percutaneous coronary intervention. PG - 958-65 LID - 10.1002/ccd.21713 [doi] AB - OBJECTIVES: This study was undertaken to compare the renal safety as well as cardiovascular (CV) effects and diagnostic image quality of iso-osmolar iodixanol vs. low-osmolar iopromide in patients with chronic kidney disease (CKD) undergoing coronary interventions. BACKGROUND: With the growing number of contrast-enhanced procedures being performed for coronary artery disease management, the safety and efficacy of iodinated contrast media (CM) have come under increased scrutiny. METHODS: : Patients with CKD (CrCl < or =60 mL/min) were randomized to iodixanol (n = 106) or iopromide (n = 102). The primary endpoint was incidence of contrast-induced nephropathy (CIN), defined as an increase in serum creatinine (SCr) > or =25% or 0.5 mg/dL within 72 hr of CM administration. Secondary endpoints were mean SCr increase, a composite of CV events in-hospital and 30 days postdischarge, and diagnostic image quality. RESULTS: : CIN incidence was significantly lower with iodixanol than iopromide (5.7% vs. 16.7%; P = 0.011). Baseline SCr (OR 2.21, 95% CI: 1.25-3.47; P = 0.031), iopromide use (OR 2.56, 95% CI: 1.18-5.76; P = 0.024), and CM volume (OR 2.01, 95% CI: 1.01-3.21; P = 0.038) were identified as independent risk factors for CIN. Cardiovascular events were reduced with iodixanol (1.9% vs. 8.8%; P = 0.025); diagnostic image quality was similar for both CM (P = 0.353). CONCLUSIONS: : Consistent with several previous trials comparing iso-osmolar iodixanol and low-osmolar comparator CM, iodixanol was associated with a lower incidence of CIN and fewer CV events than iopromide. CI - Copyright 2008 Wiley-Liss, Inc. FAU - Nie, Bin AU - Nie B AD - Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, People's Republic of China. FAU - Cheng, Wan-Jun AU - Cheng WJ FAU - Li, Yan-Fang AU - Li YF FAU - Cao, Zheng AU - Cao Z FAU - Yang, Qing AU - Yang Q FAU - Zhao, Ying-Xin AU - Zhao YX FAU - Guo, Yong-He AU - Guo YH FAU - Zhou, Yu-Jie AU - Zhou YJ LA - eng PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 RN - 0 (Contrast Media) RN - 0 (Triiodobenzoic Acids) RN - 4419T9MX03 (Iohexol) RN - 712BAC33MZ (iopromide) RN - AYI8EX34EU (Creatinine) RN - HW8W27HTXX (iodixanol) SB - IM MH - Acute Kidney Injury/*chemically induced/physiopathology/therapy MH - Aged MH - *Angioplasty, Balloon, Coronary MH - Cardiovascular Diseases/*chemically induced MH - Contrast Media/*adverse effects MH - Coronary Angiography/*adverse effects MH - Coronary Artery Disease/complications/*diagnostic imaging/therapy MH - Creatinine/blood MH - Double-Blind Method MH - Female MH - Humans MH - Iohexol/adverse effects/*analogs & derivatives MH - Kidney Diseases/*complications/physiopathology MH - Male MH - Middle Aged MH - Odds Ratio MH - Predictive Value of Tests MH - Prospective Studies MH - Radiographic Image Interpretation, Computer-Assisted MH - Renal Dialysis MH - Risk Assessment MH - Risk Factors MH - Time Factors MH - Treatment Outcome MH - Triiodobenzoic Acids/*adverse effects EDAT- 2008/11/21 09:00 MHDA- 2009/02/27 09:00 CRDT- 2008/11/21 09:00 PHST- 2008/11/21 09:00 [pubmed] PHST- 2009/02/27 09:00 [medline] PHST- 2008/11/21 09:00 [entrez] AID - 10.1002/ccd.21713 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2008 Dec 1;72(7):958-65. doi: 10.1002/ccd.21713. PMID- 18940282 OWN - NLM STAT- MEDLINE DCOM- 20090106 LR - 20151119 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 102 IP - 9 DP - 2008 Nov 1 TI - Usefulness of proteinuria as a prognostic marker of mortality and cardiovascular events among patients undergoing percutaneous coronary intervention (data from the Evaluation of Oral Xemilofiban in Controlling Thrombotic Events [EXCITE] trial). PG - 1151-5 LID - 10.1016/j.amjcard.2008.06.035 [doi] AB - Proteinuria was associated with cardiovascular events and mortality in community-based cohorts. The association of proteinuria with mortality and cardiovascular events in patients undergoing percutaneous coronary intervention (PCI) was unknown. The association of urinary dipstick proteinuria with mortality and cardiovascular events (composite of death, myocardial infarction, or nonhemorrhagic stroke) in 5,835 subjects of the EXCITE trial was evaluated. Dipstick urinalysis was performed before PCI, and proteinuria was defined as trace or greater. Subjects were followed up for 210 days/7 months after enrollment for the occurrence of events. Multivariate Cox regression analysis evaluated the independent association of proteinuria with each outcome. Mean age was 59 years, 21% were women, 18% had diabetes mellitus, and mean estimated glomerular filtration rate was 90 ml/min/1.73 m(2). Proteinuria was present in 750 patients (13%). During follow-up, 22 subjects (2.9%) with proteinuria and 54 subjects (1.1%) without proteinuria died (adjusted hazard ratio 2.83, 95% confidence interval [CI] 1.65 to 4.84, p <0.001). The severity of proteinuria attenuated the strength of the association with mortality after PCI (low-grade proteinuria, hazard ratio 2.67, 95% CI 1.50 to 4.75; high-grade proteinuria, hazard ratio 3.76, 95% CI 1.24 to 11.37). No significant association was present for cardiovascular events during the relatively short follow-up, but high-grade proteinuria tended toward increased risk of cardiovascular events (hazard ratio 1.45, 95% CI 0.81 to 2.61).In conclusion, proteinuria was strongly and independently associated with mortality in patients undergoing PCI. These data suggest that such a relatively simple and clinically easy to use tool as urinary dipstick may be useful to identify and treat patients at high risk of mortality at the time of PCI. FAU - Mercado, Nestor AU - Mercado N AD - Division of Cardiovascular Diseases, Scripps Clinic, La Jolla, California. FAU - Brugts, Jasper J AU - Brugts JJ FAU - Ix, Joachim H AU - Ix JH FAU - Shlipak, Michael G AU - Shlipak MG FAU - Dixon, Simon R AU - Dixon SR FAU - Gersh, Bernard J AU - Gersh BJ FAU - Lemos, Pedro A AU - Lemos PA FAU - Guarneri, Mimi AU - Guarneri M FAU - Teirstein, Paul S AU - Teirstein PS FAU - Wijns, William AU - Wijns W FAU - Serruys, Patrick W AU - Serruys PW FAU - Boersma, Eric AU - Boersma E FAU - O'Neill, William W AU - O'Neill WW LA - eng PT - Journal Article PT - Randomized Controlled Trial DEP - 20080809 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 RN - 0 (Biomarkers) SB - IM MH - Aged MH - Angioplasty, Balloon, Coronary/adverse effects/*mortality MH - Biomarkers/urine MH - Cardiovascular Diseases/etiology/*mortality/*urine MH - Coronary Artery Disease/*therapy MH - Female MH - Humans MH - Male MH - Middle Aged MH - Predictive Value of Tests MH - Prognosis MH - *Proteinuria MH - Risk Factors MH - Severity of Illness Index EDAT- 2008/10/23 09:00 MHDA- 2009/01/07 09:00 CRDT- 2008/10/23 09:00 PHST- 2008/04/15 00:00 [received] PHST- 2008/06/11 00:00 [revised] PHST- 2008/06/11 00:00 [accepted] PHST- 2008/10/23 09:00 [pubmed] PHST- 2009/01/07 09:00 [medline] PHST- 2008/10/23 09:00 [entrez] AID - S0002-9149(08)01137-5 [pii] AID - 10.1016/j.amjcard.2008.06.035 [doi] PST - ppublish SO - Am J Cardiol. 2008 Nov 1;102(9):1151-5. doi: 10.1016/j.amjcard.2008.06.035. Epub 2008 Aug 9. PMID- 18929701 OWN - NLM STAT- MEDLINE DCOM- 20081106 LR - 20161124 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 102 IP - 8 DP - 2008 Oct 15 TI - Impact of mild or moderate renal insufficiency on the intravascular ultrasonic analysis of chronic vascular response to paclitaxel-eluting and bare-metal stents (from the TAXUS IV, V, and VI trials). PG - 1009-16 LID - 10.1016/j.amjcard.2008.05.051 [doi] AB - The presence of even mild renal insufficiency is usually associated with an increased rate of cardiovascular events after coronary stenting. The aim of this study was to evaluate the impact of mild to moderate renal insufficiency on the chronic vascular responses to the implantation of paclitaxel-eluting stents (PES; Taxus) and bare-metal stents (BMS). In the TAXUS IV, TAXUS V, and TAXUS VI trials, patients with serum creatinine levels >2.0 mg/dl were excluded. In the present analysis, 816 patients with serum creatinine levels or=80 ml/min/1.73 m(2)). For all levels of Ccr, patients with PES compared with those with BMS had less intimal hyperplasia area (group 1: 0.97 +/- 0.98 vs 2.94 +/- 1.89; group 2: 0.94 +/- 0.86 vs 2.30 +/- 1.21; group 3: 0.99 +/- 1.02 vs 2.53 +/- 1.29; group 4: 0.87 +/- 0.95 vs 2.12 +/- 1.29 mm(2), all p values <0.0001) and greater increases in peristent plaque and media area (group 1: 0.90 +/- 0.98 vs -0.02 +/- 0.98 mm(2), p = 0.03; group 2: 0.57 +/- 1.43 vs 0.20 +/- 1.14 mm(2), p = 0.11; group 3: 1.20 +/- 1.95 vs 0.02 +/- 1.17, p <0.0001; group 4: 0.35 +/- 1.44 vs -0.19 +/- 1.08 mm(2), p = 0.08). Neointimal growth and vessel remodeling were not affected by variations in Ccr after either BMS or PES implantation over the range studied. The incidence of incomplete stent apposition at follow-up was lowest in patients with the greatest renal impairment after BMS and PES implantation. In conclusion, neointimal proliferation was less prominent and expansive vessel remodeling was more prominent after PES than BMS implantation, independent of the severity of renal dysfunction. FAU - Aoki, Jiro AU - Aoki J AD - Columbia University Medical Center, New York, New York, USA. FAU - Mintz, Gary S AU - Mintz GS FAU - Weissman, Neil J AU - Weissman NJ FAU - Mandinov, Lazar AU - Mandinov L FAU - Grube, Eberhard AU - Grube E FAU - Dawkins, Keith D AU - Dawkins KD FAU - Ellis, Stephen G AU - Ellis SG FAU - Greenberg, Joel AU - Greenberg J FAU - Yu, Alan AU - Yu A FAU - Mann, J Tift AU - Mann JT FAU - Cannon, Louis AU - Cannon L FAU - Cambier, Patrick A AU - Cambier PA FAU - Stone, Gregg W AU - Stone GW LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20080726 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 RN - 0 (Coated Materials, Biocompatible) RN - 0 (Metals) RN - 0 (Tubulin Modulators) RN - AYI8EX34EU (Creatinine) RN - P88XT4IS4D (Paclitaxel) SB - IM MH - Aged MH - Blood Vessel Prosthesis Implantation/*instrumentation MH - Coated Materials, Biocompatible MH - Coronary Circulation/physiology MH - Coronary Disease/complications/diagnostic imaging/*surgery MH - Creatinine/metabolism MH - Female MH - Follow-Up Studies MH - Humans MH - Male MH - *Metals MH - Middle Aged MH - Paclitaxel/*therapeutic use MH - Prospective Studies MH - Renal Insufficiency/*complications/metabolism/physiopathology MH - Severity of Illness Index MH - Stents MH - Time Factors MH - Treatment Outcome MH - Tubulin Modulators/therapeutic use MH - *Ultrasonography, Interventional MH - Vascular Resistance/*physiology EDAT- 2008/10/22 09:00 MHDA- 2008/11/07 09:00 CRDT- 2008/10/22 09:00 PHST- 2008/04/06 00:00 [received] PHST- 2008/05/23 00:00 [revised] PHST- 2008/05/23 00:00 [accepted] PHST- 2008/10/22 09:00 [pubmed] PHST- 2008/11/07 09:00 [medline] PHST- 2008/10/22 09:00 [entrez] AID - S0002-9149(08)01014-X [pii] AID - 10.1016/j.amjcard.2008.05.051 [doi] PST - ppublish SO - Am J Cardiol. 2008 Oct 15;102(8):1009-16. doi: 10.1016/j.amjcard.2008.05.051. Epub 2008 Jul 26. PMID- 18923757 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20100616 LR - 20200928 IS - 1790-8019 (Electronic) IS - 1108-4189 (Print) IS - 1108-4189 (Linking) VI - 12 IP - 1 DP - 2008 Jan TI - Revascularization treatment in patients with coronary artery disease. PG - 3-10 AB - The choice of optimal revascularization strategy in patients with coronary artery disease (CAD) is becoming more challenging lately, due to recent advances in percutaneous coronary intervention (PCI) and coronary artery bypass grafting surgery (CABG). On one hand, drug-eluting stents (DES) have emerged as a solution to the problem of restenosis after balloon angioplasty or bare-metal stent implantation, which was responsible for a higher rate of events (mainly repeat revascularization) in relation to CABG. On the other hand, off-pump bypass techniques and minimally invasive grafting of the left anterior descending artery appear to be safe and efficacious alternatives to traditional, on-pump CABG. Available literature includes studies outdated by current technologies, leaving the dilemma of best revascularization strategy unanswered in the general CAD population, but also in high-risk groups, such as diabetics and patients with chronic kidney disease. A number of ongoing trials, especially designed for this purpose, are set to end the debate, providing headto- head comparisons between DES-assisted PCI and contemporary bypass surgery. FAU - Foussas, S G AU - Foussas SG AD - Cardiology Department, Tzanio Hospital, Piraeus, Greece. stefanso@hellasnet.gr FAU - Tsiaousis, G Z AU - Tsiaousis GZ LA - eng PT - Journal Article PL - Greece TA - Hippokratia JT - Hippokratia JID - 101296613 PMC - PMC2532965 OTO - NOTNLM OT - coronary artery bypass grafting OT - drug-eluting stents OT - percutaneous coronary intervention OT - pump bypass surgery EDAT- 2008/10/17 09:00 MHDA- 2008/10/17 09:01 PMCR- 2008/01/01 CRDT- 2008/10/17 09:00 PHST- 2008/10/17 09:00 [pubmed] PHST- 2008/10/17 09:01 [medline] PHST- 2008/10/17 09:00 [entrez] PHST- 2008/01/01 00:00 [pmc-release] AID - 08121003 [pii] PST - ppublish SO - Hippokratia. 2008 Jan;12(1):3-10. PMID- 18853093 OWN - NLM STAT- MEDLINE DCOM- 20090327 LR - 20211203 IS - 1861-0692 (Electronic) IS - 1861-0684 (Linking) VI - 98 IP - 1 DP - 2009 Jan TI - ARTA: AT1-receptor blocker therapy in patients undergoing coronary artery bypass grafting. PG - 33-43 LID - 10.1007/s00392-008-0719-9 [doi] AB - BACKGROUND: Decline in renal and cognitive function may complicate early recovery after coronary-artery bypass grafting. AT(1)-receptor antagonists have been demonstrated to be neuro- and renoprotective. Aim of ARTA, a prospective, double-blind, randomised and placebo controlled study, was to detect whether preoperative treatment with candesartan influences postoperative cognitive and renal function. STUDY PROTOCOL: One hundred and five patients eligible for coronary artery bypass graft surgery (65-85 years old, all suffering from hypertension and coronary artery disease, with stable kidney function) were randomized to candesartan (8 mg od) or placebo for between 8 and 11 days prior to surgery. Existing ACE-inhibitor/angiotensin receptor antagonist-therapy had to be stopped prior to the study. Validated cognitive function tests (trail making, Horn's perfomance III und VI, divided attention and change of reaction, memory - immediate and delayed recall, digit span) were performed preoperatively, 1 week and 3 months after surgery. Renal function was assessed by creatinine clearance on the day before, 1 week and 3 months after surgery. RESULTS: Eighty-seven patients (n = 43 Candesartan, n = 44 placebo) were included in the ITT-population for analysis. Drug treatment had no adverse effect on perioperative blood pressure. Only five patients experienced a period of hypotension during introduction of anaesthesia (Candesartan 1/44, placebo 4/44). One week as well as three months after surgery, there were no differences in relevant cognitive function parameters compared to the status prior to surgery, independent from treatment. Creatinine clearance showed a clear decrease one week after surgery with a minor further reduction observed 3 months after surgery, but there was no difference between Candesartan and placebo treated patients. Between both groups, there were no significant differences in the number of adverse events and number of patients with adverse events nor in the incidence of renal failure with consecutive dialysis and cerebral strokes (candesartan 2, placebo 5) and possibly drug related severe adverse events. CONCLUSION: This randomised placebo-controlled and prospective study in elderly patients does not support previous reports suggesting a substantial impairment of cognitive function after coronary artery bypass graft surgery. Preservation of cognitive and renal function was independent of pre-surgical administration of candesartan. FAU - Flesch, Markus AU - Flesch M AD - Klinik III fur Innere Medizin der, Universitat zu Koln, Kerpener Strasse 62, 50937, Cologne, Germany. markus.flesch@uni-koeln.de FAU - Knipp, Stephan AU - Knipp S FAU - Kessler, Gerhard AU - Kessler G FAU - Geissler, Hans-Joachim AU - Geissler HJ FAU - Massoudy, Parwis AU - Massoudy P FAU - Wilhelm, Hans AU - Wilhelm H FAU - Philipp, Thomas AU - Philipp T FAU - Erdmann, Erland AU - Erdmann E LA - eng PT - Journal Article PT - Randomized Controlled Trial DEP - 20081013 PL - Germany TA - Clin Res Cardiol JT - Clinical research in cardiology : official journal of the German Cardiac Society JID - 101264123 RN - 0 (Angiotensin II Type 1 Receptor Blockers) RN - 0 (Benzimidazoles) RN - 0 (Biphenyl Compounds) RN - 0 (Tetrazoles) RN - AYI8EX34EU (Creatinine) RN - S8Q36MD2XX (candesartan) SB - IM MH - Aged MH - Aged, 80 and over MH - Angiotensin II Type 1 Receptor Blockers/adverse effects/*therapeutic use MH - Benzimidazoles/adverse effects/*therapeutic use MH - Biphenyl Compounds MH - Blood Pressure/drug effects MH - Cognition Disorders/etiology/prevention & control MH - *Coronary Artery Bypass/adverse effects MH - Coronary Artery Disease/surgery MH - Creatinine/blood/urine MH - Double-Blind Method MH - Female MH - Humans MH - Hypertension/complications MH - Male MH - Postoperative Complications/*prevention & control MH - Preoperative Care MH - Prospective Studies MH - Renal Insufficiency/etiology/prevention & control MH - Tetrazoles/adverse effects/*therapeutic use EDAT- 2008/10/15 09:00 MHDA- 2009/03/28 09:00 CRDT- 2008/10/15 09:00 PHST- 2008/06/12 00:00 [received] PHST- 2008/09/03 00:00 [accepted] PHST- 2008/10/15 09:00 [pubmed] PHST- 2009/03/28 09:00 [medline] PHST- 2008/10/15 09:00 [entrez] AID - 10.1007/s00392-008-0719-9 [doi] PST - ppublish SO - Clin Res Cardiol. 2009 Jan;98(1):33-43. doi: 10.1007/s00392-008-0719-9. Epub 2008 Oct 13. PMID- 18778116 OWN - NLM STAT- MEDLINE DCOM- 20081113 LR - 20181025 IS - 1173-8804 (Print) IS - 1173-8804 (Linking) VI - 22 IP - 5 DP - 2008 TI - Spotlight on enoxaparin in ST-segment elevation myocardial infarction. PG - 343-5 AB - Enoxaparin (enoxaparin sodium; Lovenox) is a low-molecular-weight heparin (LMWH) that has recently been approved by the US FDA for use in patients with medically managed ST-segment myocardial infarction (STEMI), or STEMI with subsequent percutaneous coronary intervention. It binds to and potentiates the action of antithrombin, and inhibits coagulation factors XIa, IXa, Xa, and IIa (thrombin), thereby preventing formation of blood clots. Unfractionated heparin (UFH) has long been regarded as the antithrombotic agent of choice in the adjunctive treatment of patients with STEMI. However, compared with UFH, enoxaparin has many advantages in terms of its pharmacodynamic profile and, potentially, also its efficacy. Enoxaparin was significantly more effective than UFH in patients presenting with STEMI who underwent fibrinolytic therapy in terms of the 30-day combined incidence of all-cause mortality plus recurrent nonfatal myocardial infarction (MI) [primary endpoint], and all-cause mortality plus recurrent nonfatal MI plus urgent revascularization (secondary endpoint) in the ExTRACT-TIMI 25 trial. The significant difference in the incidence of the composite primary endpoint between these two groups was maintained at the 1-year follow-up. Although bleeding was reported more frequently with enoxaparin than with UFH in the ExTRACT-TIMI 25 trial, enoxaparin was associated with a net clinical benefit relative to UFH. Patients in this trial received enoxaparin as an initial 30 mg intravenous bolus, followed by 1 mg/kg subcutaneously within 15 minutes and then every 12 hours for up to 8 days; the first two subcutaneous dosages were not to exceed 100 mg. Patients > or =75 years of age did not receive the initial bolus of enoxaparin and the 12-hourly dosages were reduced to 0.75 mg/kg; the dose was also reduced to 1 mg/kg every 24 hours in patients of any age who had an estimated creatinine clearance of <30 mL/min. Data from several earlier randomized, multicentre, phase III trials support these results. FAU - Carter, Natalie J AU - Carter NJ AD - Wolters Kluwer Health | Adis, 41 Centorian Drive, Mairangi Bay, Auckland, New Zealand. demail@adis.co.nz FAU - McCormack, Paul L AU - McCormack PL FAU - Plosker, Greg L AU - Plosker GL LA - eng PT - Journal Article PL - New Zealand TA - BioDrugs JT - BioDrugs : clinical immunotherapeutics, biopharmaceuticals and gene therapy JID - 9705305 RN - 0 (Anticoagulants) RN - 0 (Enoxaparin) SB - IM MH - Anticoagulants/*therapeutic use MH - *Electrocardiography MH - Enoxaparin/adverse effects/pharmacology/*therapeutic use MH - Humans MH - Myocardial Infarction/drug therapy/physiopathology EDAT- 2008/09/10 09:00 MHDA- 2008/11/14 09:00 CRDT- 2008/09/10 09:00 PHST- 2008/09/10 09:00 [pubmed] PHST- 2008/11/14 09:00 [medline] PHST- 2008/09/10 09:00 [entrez] AID - 2257 [pii] AID - 10.2165/00063030-200822050-00007 [doi] PST - ppublish SO - BioDrugs. 2008;22(5):343-5. doi: 10.2165/00063030-200822050-00007. PMID- 18706201 OWN - NLM STAT- MEDLINE DCOM- 20081126 LR - 20101118 IS - 0366-6999 (Print) IS - 0366-6999 (Linking) VI - 121 IP - 10 DP - 2008 May 20 TI - Long-term outcome of patients of over 85 years old with acute coronary syndrome undergoing percutaneous coronary stenting: a comparison of bare metal stent and drug eluting stent. PG - 887-91 AB - BACKGROUND: Patients aged over 85 years have been under-represented in percutaneous coronary intervention (PCI) trials despite an increase in referrals for PCI. The long-term safety and efficacy of percutaneous coronary stenting in patients aged over 85 years with acute coronary syndrome (ACS) remain unclear. Moreover it is unknown whether there are differences between bare metal stent (BMS) and drug eluting stent (DES) in this special population. METHODS: A total of 80 patients with ACS aged over 85 years undergoing stenting (BMS group n = 21 vs DES group n = 59) were retrospectively studied. In-hospital, one year and overall clinical follow-up (12 - 36 months) of major adverse cardiac events (MACEs) including cardiac deaths, myocardial infarction, target lesion revascularization (TLR) and target vessel revascularization (TVR) as well as stroke and other major bleeding were compared between the two groups. RESULTS: In the entire cohort, the procedure success rate was 93.8% with TIMI-3 coronary flow post-PCI in 93.8% of the vessels and the procedure related complication was 17.5%. The incidence of in-hospital MACEs in BMS group was higher (14.3% vs 6.8%, P = 0.30). The 1-year incidence of MACEs in DES group was 7.0% while there was no MACE in the BMS group. Clinical follow-up for 12 - 36 months showed that the overall survival free from MACE was 82.9% and the incidence of MACE in the BMS group was lower (5.3% vs 21.1%, P = 0.20). Multivariate regression analysis showed that the creatinine level (OR: 1.013; 95% CI: 1.006 - 1.020; P = 0.004) and hypertension (OR: 3.201; 95% CI: 1.000 - 10.663; P = 0.04) are two major factors affecting the long-term MACE. CONCLUSIONS: Percutaneous coronary stenting in patients aged over 85 years is safe and provides good short and long-term efficacy. Patients with renal dysfunction and hypertension may have a relatively high incidence of MACE. FAU - Ma, Han-ying AU - Ma HY AD - 12th Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China. FAU - Zhou, Yu-jie AU - Zhou YJ FAU - Dick, Ronald J AU - Dick RJ FAU - Shi, Dong-mei AU - Shi DM FAU - Liu, Yu-yang AU - Liu YY FAU - Cheng, Wan-jun AU - Cheng WJ FAU - Guo, Yong-he AU - Guo YH FAU - Wang, Jian-long AU - Wang JL FAU - Ge, Hai-long AU - Ge HL LA - eng PT - Comparative Study PT - Journal Article PL - China TA - Chin Med J (Engl) JT - Chinese medical journal JID - 7513795 RN - 0 (Metals) SB - IM MH - Acute Coronary Syndrome/pathology/*therapy MH - Aged, 80 and over MH - Angioplasty, Balloon, Coronary/*adverse effects/methods MH - Drug-Eluting Stents/*adverse effects MH - Female MH - Humans MH - Male MH - Metals MH - Myocardial Infarction/etiology MH - Retrospective Studies MH - Stents/*adverse effects MH - Stroke/etiology MH - Time Factors MH - Treatment Outcome EDAT- 2008/08/19 09:00 MHDA- 2008/12/17 09:00 CRDT- 2008/08/19 09:00 PHST- 2008/08/19 09:00 [pubmed] PHST- 2008/12/17 09:00 [medline] PHST- 2008/08/19 09:00 [entrez] PST - ppublish SO - Chin Med J (Engl). 2008 May 20;121(10):887-91. PMID- 18702961 OWN - NLM STAT- MEDLINE DCOM- 20080916 LR - 20231024 IS - 1558-3597 (Electronic) IS - 0735-1097 (Linking) VI - 52 IP - 8 DP - 2008 Aug 19 TI - Sodium bicarbonate versus saline for the prevention of contrast-induced nephropathy in patients with renal dysfunction undergoing coronary angiography or intervention. PG - 599-604 LID - 10.1016/j.jacc.2008.05.026 [doi] AB - OBJECTIVES: The purpose of this study was to compare the efficacy of sodium bicarbonate versus isotonic saline in addition to N-acetylcysteine (NAC) to prevent contrast-induced nephropathy (CIN) in a larger population of patients with renal dysfunction undergoing coronary angiography or intervention. BACKGROUND: Contrast-induced nephropathy accounts for more than 10% of hospital-acquired renal failure. Recent studies suggest that hydration with sodium bicarbonate is more protective than isotonic saline in the prevention of CIN. METHODS: The prospective, single center study included 502 patients with estimated creatinine clearance <60 ml/min, randomized to receive infusion of either saline or sodium bicarbonate before and after iso-osmolar contrast medium administration. All patients received oral NAC 600 mg twice a day. Contrast-induced nephropathy was defined as an absolute increase of serum creatinine > or =0.5 mg/dl measured within 5 days. RESULTS: Contrast-induced nephropathy occurred in 54 patients (10.8%); 25 (10%) were treated with sodium bicarbonate and 29 (11.5%) with saline (p = 0.60). In patients with CIN, the mean increase in creatinine was not significantly different in the 2 study groups (0.9 +/- 0.6 mg/dl vs. 0.7 +/- 0.2 mg/dl, respectively; p = 0.15). Only 2 patients needed temporary hemofiltration. CONCLUSIONS: Hydration with sodium bicarbonate plus NAC before contrast medium exposure is not more effective than hydration with isotonic saline plus NAC for prophylaxis of CIN in patients with moderate-to-severe renal dysfunction. (Sodium Bicarbonate Versus Saline for the Prevention of Contrast-Induced Nephropathy; NCT00606827). FAU - Maioli, Mauro AU - Maioli M AD - Division of Cardiology, Misericordia e Dolce Hospital, Prato, Italy. mauro.maioli@fastwebnet.it FAU - Toso, Anna AU - Toso A FAU - Leoncini, Mario AU - Leoncini M FAU - Gallopin, Michela AU - Gallopin M FAU - Tedeschi, Delio AU - Tedeschi D FAU - Micheletti, Carlo AU - Micheletti C FAU - Bellandi, Francesco AU - Bellandi F LA - eng SI - ClinicalTrials.gov/NCT00606827 PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial PL - United States TA - J Am Coll Cardiol JT - Journal of the American College of Cardiology JID - 8301365 RN - 451W47IQ8X (Sodium Chloride) RN - 8MDF5V39QO (Sodium Bicarbonate) RN - AYI8EX34EU (Creatinine) SB - IM MH - Aged MH - Angioplasty, Balloon, Coronary MH - *Coronary Angiography MH - Coronary Disease/epidemiology/therapy MH - Creatinine/blood MH - Female MH - Humans MH - Kidney Diseases/*chemically induced/*prevention & control MH - Male MH - Prospective Studies MH - Renal Insufficiency/epidemiology MH - Risk Factors MH - Sodium Bicarbonate/*administration & dosage MH - Sodium Chloride/*administration & dosage EDAT- 2008/08/16 09:00 MHDA- 2008/09/17 09:00 CRDT- 2008/08/16 09:00 PHST- 2008/03/07 00:00 [received] PHST- 2008/05/05 00:00 [revised] PHST- 2008/05/05 00:00 [accepted] PHST- 2008/08/16 09:00 [pubmed] PHST- 2008/09/17 09:00 [medline] PHST- 2008/08/16 09:00 [entrez] AID - S0735-1097(08)01941-4 [pii] AID - 10.1016/j.jacc.2008.05.026 [doi] PST - ppublish SO - J Am Coll Cardiol. 2008 Aug 19;52(8):599-604. doi: 10.1016/j.jacc.2008.05.026. PMID- 18653268 OWN - NLM STAT- MEDLINE DCOM- 20080918 LR - 20220330 IS - 1523-6838 (Electronic) IS - 0272-6386 (Linking) VI - 52 IP - 3 DP - 2008 Sep TI - Effect of angiotensin receptor blockers on cardiovascular events in patients undergoing hemodialysis: an open-label randomized controlled trial. PG - 501-6 LID - 10.1053/j.ajkd.2008.04.031 [doi] AB - BACKGROUND: Cardiovascular disease is the leading cause of mortality in patients with kidney failure treated with hemodialysis (HD). Although angiotensin receptor blockers (ARBs) reduce cardiovascular disease (CVD) events in patients with diabetes and chronic kidney disease, their effect in patients with kidney failure on HD therapy is not known. STUDY DESIGN: Open-labeled randomized trial. SETTING & PARTICIPANTS: Patients aged 30 to 80 years receiving HD 2 to 3 times weekly for 1 to 5 years at 5 university-affiliated dialysis centers. INTERVENTIONS: Treatment with ARBs (valsartan, candesartan, and losartan) versus without ARBs after stratification by sex, age, systolic blood pressure, and diabetes. OUTCOMES: The primary end point is the development of fatal and nonfatal CVD events, defined as the composite of CVD death, myocardial infarction, stroke, congestive heart failure, coronary artery bypass grafting, or percutaneous coronary intervention. The secondary end point is all-cause death. RESULTS: 366 subjects initially were randomly assigned to an ARB or no ARB (control), but after a run-in phase, 180 were retained in each group. Mean age was 60 years, 59% were men, 51% had diabetes, and mean predialysis systolic blood pressure was 154 mm Hg. There were 93 fatal or nonfatal CVD events (52%); 34 (19%) in the ARB group and 59 (33%) in the non-ARB group. After adjustment for age, sex, diabetes, systolic blood pressure, and center, treatment with an ARB was independently associated with reduced fatal and nonfatal CVD events (hazard ratio, 0.51; 95% confidence interval, 0.33 to 0.79; P = 0.002). There were 63 deaths (35%); 25 (14%) in the ARB group and 38 (21%) in the non-ARB group. After adjustment, all-cause mortality differed between the 2 groups (hazard ratio, 0.64; 95% confidence interval, 0.39 to 1.06; P = 0.1). LIMITATIONS: Because of the small sample size of this trial, the large effect may be a spurious finding. Use of an open-label design and 3 different agents in the ARB group might have influenced results. CONCLUSION: Use of an ARB may be effective in reducing nonfatal CVD events in patients undergoing long-term HD. A larger study is required to confirm these results. FAU - Suzuki, Hiromichi AU - Suzuki H AD - Department of Nephrology, School of Medicine, Faculty of Medicine, Saitama Medical University, Saitama, Japan. iromichi@saitama-med.ac.jp FAU - Kanno, Yoshihiko AU - Kanno Y FAU - Sugahara, Soichi AU - Sugahara S FAU - Ikeda, Naofumi AU - Ikeda N FAU - Shoda, Junko AU - Shoda J FAU - Takenaka, Tsuneo AU - Takenaka T FAU - Inoue, Tsutomu AU - Inoue T FAU - Araki, Ryuichiro AU - Araki R LA - eng SI - ClinicalTrials.gov/NCT00530595 PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20080724 PL - United States TA - Am J Kidney Dis JT - American journal of kidney diseases : the official journal of the National Kidney Foundation JID - 8110075 RN - 0 (Angiotensin II Type 1 Receptor Blockers) RN - 0 (Benzimidazoles) RN - 0 (Biphenyl Compounds) RN - 0 (Tetrazoles) RN - 80M03YXJ7I (Valsartan) RN - HG18B9YRS7 (Valine) RN - JMS50MPO89 (Losartan) RN - S8Q36MD2XX (candesartan) SB - IM CIN - Am J Kidney Dis. 2008 Sep;52(3):400-2. doi: 10.1053/j.ajkd.2008.07.009. PMID: 18725012 MH - Aged MH - Aged, 80 and over MH - Angiotensin II Type 1 Receptor Blockers/adverse effects/*therapeutic use MH - Benzimidazoles/adverse effects/therapeutic use MH - Biphenyl Compounds MH - Cardiovascular Diseases/epidemiology/*etiology/mortality/*prevention & control MH - Female MH - Humans MH - Incidence MH - Kidney Failure, Chronic/*therapy MH - Losartan/adverse effects/therapeutic use MH - Male MH - Middle Aged MH - Renal Dialysis/*adverse effects MH - Tetrazoles/adverse effects/therapeutic use MH - Valine/adverse effects/analogs & derivatives/therapeutic use MH - Valsartan EDAT- 2008/07/26 09:00 MHDA- 2008/09/19 09:00 CRDT- 2008/07/26 09:00 PHST- 2007/07/12 00:00 [received] PHST- 2008/04/11 00:00 [accepted] PHST- 2008/07/26 09:00 [pubmed] PHST- 2008/09/19 09:00 [medline] PHST- 2008/07/26 09:00 [entrez] AID - S0272-6386(08)00955-4 [pii] AID - 10.1053/j.ajkd.2008.04.031 [doi] PST - ppublish SO - Am J Kidney Dis. 2008 Sep;52(3):501-6. doi: 10.1053/j.ajkd.2008.04.031. Epub 2008 Jul 24. PMID- 18427130 OWN - NLM STAT- MEDLINE DCOM- 20080610 LR - 20250529 IS - 1524-4539 (Electronic) IS - 0009-7322 (Print) IS - 0009-7322 (Linking) VI - 117 IP - 18 DP - 2008 May 6 TI - Depressive symptoms and the risk of atherosclerotic progression among patients with coronary artery bypass grafts. PG - 2313-9 LID - 10.1161/CIRCULATIONAHA.107.741058 [doi] AB - BACKGROUND: Depressive symptoms have been associated with increased risk of coronary artery disease and poor prognosis among patients with existing coronary artery disease, but whether depressive symptoms specifically influence atherosclerotic progression among such patients is uncertain. METHODS AND RESULTS: The Post-CABG Trial randomized patients with a history of coronary bypass graft surgery to either an aggressive or a moderate lipid-lowering strategy and to either warfarin or placebo. Coronary angiography was conducted at enrollment and after a median follow-up of 4.2 years. Depressive symptoms were assessed at enrollment with the Centers for Epidemiologic Studies Depression scale (CES-D) in 1319 patients with 2496 grafts. In models that adjusted for age, gender, race, treatment assignment, and years since coronary bypass graft surgery, a CES-D score > or =16 was positively associated with risk of substantial graft disease progression (OR 1.50, 95% CI 1.08 to 2.10, P=0.02) and marginally associated with a 0.11-mm (95% CI -0.22 to 0.01 mm, P=0.07) decrease in minimum lumen diameter, but not with risk of graft occlusion (P=0.30). Additional adjustment for past medical history, blood pressure, and renal function did not materially alter these results. This association was virtually absent among participants randomly assigned to aggressive lipid-lowering therapy. CONCLUSIONS: These findings suggest that depressive symptoms are associated with a higher risk of atherosclerotic progression among patients with saphenous vein grafts and that aggressive lipid lowering can minimize this increased risk. Whether depressive symptoms increase progression in other types of coronary atherosclerosis and whether aggressive lipid lowering attenuates such progression will require additional study. FAU - Wellenius, Gregory A AU - Wellenius GA AD - Cardiovascular Epidemiology Research Unit, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA. gwelleni@bidmc.harvard.edu FAU - Mukamal, Kenneth J AU - Mukamal KJ FAU - Kulshreshtha, Ambar AU - Kulshreshtha A FAU - Asonganyi, Sharon AU - Asonganyi S FAU - Mittleman, Murray A AU - Mittleman MA LA - eng GR - F32 ES013804/ES/NIEHS NIH HHS/United States GR - R00 ES015774/ES/NIEHS NIH HHS/United States GR - F32-ES013804/ES/NIEHS NIH HHS/United States PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't DEP - 20080421 PL - United States TA - Circulation JT - Circulation JID - 0147763 RN - 0 (Cardiovascular Agents) SB - IM MH - Adult MH - Aged MH - Aged, 80 and over MH - Atherosclerosis/drug therapy/*etiology/*psychology MH - Cardiovascular Agents/therapeutic use MH - Coronary Artery Bypass/adverse effects/*psychology MH - Coronary Artery Disease/complications/drug therapy/psychology MH - Depression/*complications/drug therapy/*psychology MH - Disease Progression MH - Female MH - Humans MH - Male MH - Middle Aged MH - Prospective Studies MH - Risk Factors PMC - PMC2393552 MID - NIHMS46645 EDAT- 2008/04/23 09:00 MHDA- 2008/06/11 09:00 PMCR- 2009/05/06 CRDT- 2008/04/23 09:00 PHST- 2008/04/23 09:00 [pubmed] PHST- 2008/06/11 09:00 [medline] PHST- 2008/04/23 09:00 [entrez] PHST- 2009/05/06 00:00 [pmc-release] AID - CIRCULATIONAHA.107.741058 [pii] AID - 10.1161/CIRCULATIONAHA.107.741058 [doi] PST - ppublish SO - Circulation. 2008 May 6;117(18):2313-9. doi: 10.1161/CIRCULATIONAHA.107.741058. Epub 2008 Apr 21. PMID- 18393110 OWN - NLM STAT- MEDLINE DCOM- 20080826 LR - 20161124 IS - 0022-9032 (Print) IS - 0022-9032 (Linking) VI - 66 IP - 3 DP - 2008 Mar TI - Early and late outcomes of percutaneous transluminal angioplasty of cephalad arteries. PG - 233-42, discussion 243 AB - BACKGROUND: Efficacy of carotid endarterectomy (CEA) in prevention of stroke in patients with carotid artery stenosis has been confirmed in randomised trials. Carotid artery stenting (CAS) is a routine clinical practice and recent results of CAS are not worse than CEA. Moreover, percutaneous transluminal angioplasty (PTA) techniques allow other cephalad arteries to be dilated. AIM: To assess early and long-term outcome of PTA of cephalad arteries and to determine risk factors of early and late major adverse cardiovascular and cerebral events (MACCE). METHODS: The study group consisted of 223 consecutive patients (151 males, 67.7%, mean age 65.3+/-8.6) in whom 256 PTA procedures of cephalad arteries were performed. Two hundred and forty-two internal carotid, 7 common carotid and 15 vertebral arteries were dilated. Thirty-four patients underwent one-stage carotid and coronary procedures, while in 46 patients one-stage carotid and peripheral procedures were performed. Neuroprotection with a distal protection device was used in 51.5% of cases. The procedures were divided into two groups: with high (n=181) and low (n=75) risk of cardiovascular events. Early and late events were recorded and analysed subsequently. RESULTS: In hospital 30-day MACCE occurred in 12 (4.6%) patients, including 7 (2.7%) strokes, 3 (1.1%) myocardial infarctions and two (0.8%) deaths. Transient ischaemic attacks were observed in 8 patients, pulmonary oedema in 3 cases, as well as a single episode of retinal artery embolisation and acute renal insufficiency. The incidence of 30-day MACCE was not significantly higher in the high-risk group (6.07 vs. 1.33%; NS), but the risk of any adverse event was significantly higher (p=0.03). There was no difference in stroke incidence between procedures with or without neuroprotection (2.27 vs. 3.22%; NS). There was no difference in risk of MACCE between angioplasty of cephalad artery and one-stage cephalad and coronary artery angioplasty procedure (3.6 vs. 5.5%; NS). During 50.3+/-20 months of follow-up there were 16 (7.1%) deaths, 9 (3.5%) strokes and 6 (2.3%) re-stenoses confirmed angiographically. One-year total survival and one-year MACCE-free survival rates according to the Kaplan-Meier analysis were 94.9% and 89.0%, showing a trend towards better outcome in the low-risk group (F-Cox=2.46; p=0.19 and F-Cox=2.17; p=0.09 respectively). CONCLUSIONS: Percutaneous transluminal angioplasty of cephalad arteries is safe and feasible, with a low periprocedural complication rate and good late outcome. Carotid artery stenting is an alternative method to CEA. FAU - Buszman, Pawel AU - Buszman P AD - Oddzial Ostrych Zespolow Wiencowych, Gornoslaskie Centrum Medyczne, Slaski Uniwersytet Medyczny, ul. Ziolowa 47, Katowice. pbuszman@ka.onet.pl FAU - Debinski, Marcin AU - Debinski M FAU - Gruszka, Agata AU - Gruszka A FAU - Janas, Piotr AU - Janas P FAU - Krol, Marek AU - Krol M FAU - Kondys, Marek AU - Kondys M FAU - Iwinski, Janusz AU - Iwinski J FAU - Kazibutowska-Zaranska, Zofia AU - Kazibutowska-Zaranska Z FAU - Cierpka, Lech AU - Cierpka L FAU - Tendera, Michal AU - Tendera M LA - eng PT - Clinical Trial PT - Comparative Study PT - Journal Article PL - Poland TA - Kardiol Pol JT - Kardiologia polska JID - 0376352 SB - IM MH - Aged MH - Angiography MH - *Angioplasty, Balloon MH - Angioplasty, Balloon, Coronary MH - Carotid Artery, Common/diagnostic imaging MH - Carotid Artery, Internal/diagnostic imaging MH - Carotid Stenosis/diagnostic imaging/*therapy MH - Coronary Stenosis/therapy MH - Female MH - Humans MH - Male MH - Middle Aged MH - Risk Factors MH - Stents MH - Treatment Outcome MH - Vertebrobasilar Insufficiency/diagnostic imaging/*therapy EDAT- 2008/04/09 09:00 MHDA- 2008/08/30 09:00 CRDT- 2008/04/09 09:00 PHST- 2008/04/09 09:00 [pubmed] PHST- 2008/08/30 09:00 [medline] PHST- 2008/04/09 09:00 [entrez] AID - 10054 [pii] PST - ppublish SO - Kardiol Pol. 2008 Mar;66(3):233-42, discussion 243. PMID- 18381138 OWN - NLM STAT- MEDLINE DCOM- 20080513 LR - 20171116 IS - 0741-5214 (Print) IS - 0741-5214 (Linking) VI - 47 IP - 4 DP - 2008 Apr TI - Statins are independently associated with reduced mortality in patients undergoing infrainguinal bypass graft surgery for critical limb ischemia. PG - 774-781 LID - 10.1016/j.jvs.2007.11.056 [doi] AB - OBJECTIVE: Evidence suggesting a beneficial effect of cardioprotective medications in patients with lower extremity atherosclerosis derives largely from secondary prevention studies of heterogeneous populations. Patients with critical limb ischemia (CLI) have a large atherosclerotic burden with related high mortality. The effect of such therapies in this population is largely inferred and unproven. METHODS: The Project of Ex-Vivo vein graft Engineering via Transfection III (PREVENT III) cohort comprised 1404 patients with CLI who underwent lower extremity bypass grafting in a multicenter, randomized prospective trial testing the efficacy of edifoligide for the prevention of graft failure. Propensity scores were used to evaluate the influence of statins, beta-blockers, and antiplatelet agents on outcomes while adjusting for demographics, comorbidities, medications, and surgical variables that may influence drug use. Primary outcomes were major adverse cardiovascular events < or =30 days, vein graft patency, and 1-year survival assessed by Kaplan-Meier method. Potential determinants of 1-year survival were modeled using a multivariate Cox regression. RESULTS: In this cohort, 636 patients (45%) were taking statins, 835 (59%) were taking beta-blockers, and 1121 (80%) were taking antiplatelet drugs. Perioperative major adverse cardiovascular events (7.8%) and early mortality (2.7%) were not measurably affected by the use of any drug class. Statin use was associated with a significant survival advantage at 1 year of 86% vs 81% (hazard ratio [HR], 0.71; 95% confidence interval [CI], 0.52-0.98; P = .03) by analysis of both unweighted and propensity score-weighted data. Use of beta-blockers and antiplatelet drugs had no appreciable impact on survival. None of the drug classes were associated with graft patency measures at 1 year. Significant predictors of 1-year mortality by Cox regression modeling were statin use (HR, 0.67; 95% CI, 0.51-0.90; P = .001), age >75 (HR, 2.1; 95% CI, 1.60-2.82; P = .001), coronary artery disease (HR, 1.5; 95% CI, 1.15-2.01; P = .001), chronic kidney disease stages 4 (HR, 2.0; 95% CI, 1.17-3.55; P = .001) and 5 (HR, 3.4; 95% CI, 2.39-4.73; P < .001), and tissue loss (HR, 1.9; 95% CI, 1.23-2.80; P = .003). CONCLUSIONS: Statin use is associated with improved survival in CLI patients 1 year after surgical revascularization. Further studies are indicated to determine optimal dosing in this population and to definitively address the question of relationship to graft patency. These data add to the growing literature supporting statin use in patients with advanced peripheral arterial disease. FAU - Schanzer, Andres AU - Schanzer A AD - Division of Vascular and Endovascular Surgery, University of Massachusetts, Worcester, MA, USA. FAU - Hevelone, Nathanael AU - Hevelone N FAU - Owens, Christopher D AU - Owens CD FAU - Beckman, Joshua A AU - Beckman JA FAU - Belkin, Michael AU - Belkin M FAU - Conte, Michael S AU - Conte MS LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PL - United States TA - J Vasc Surg JT - Journal of vascular surgery JID - 8407742 RN - 0 (Adrenergic beta-Antagonists) RN - 0 (Cardiotonic Agents) RN - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors) RN - 0 (Oligonucleotides) RN - 0 (Platelet Aggregation Inhibitors) RN - 4UG613F036 (edifoligide) SB - IM CIN - J Vasc Surg. 2008 Dec;48(6):1639-40; author reply 1640. doi: 10.1016/j.jvs.2008.05.086. PMID: 19118751 CIN - J Vasc Surg. 2009 Jun;49(6):1635; author reply 1636. doi: 10.1016/j.jvs.2008.12.079. PMID: 19201143 MH - Adrenergic beta-Antagonists/therapeutic use MH - Aged MH - Arteriosclerosis/*surgery MH - Cardiotonic Agents/*therapeutic use MH - Cardiovascular Diseases/etiology MH - Female MH - Graft Survival/drug effects MH - Humans MH - Hydroxymethylglutaryl-CoA Reductase Inhibitors/*therapeutic use MH - Ischemia/*mortality/*surgery MH - Leg/*blood supply MH - Male MH - Oligonucleotides/therapeutic use MH - Platelet Aggregation Inhibitors/therapeutic use MH - Prospective Studies MH - Transplantation, Autologous MH - Vascular Patency/drug effects MH - Veins/transplantation EDAT- 2008/04/03 09:00 MHDA- 2008/05/14 09:00 CRDT- 2008/04/03 09:00 PHST- 2007/10/01 00:00 [received] PHST- 2007/11/17 00:00 [revised] PHST- 2007/11/20 00:00 [accepted] PHST- 2008/04/03 09:00 [pubmed] PHST- 2008/05/14 09:00 [medline] PHST- 2008/04/03 09:00 [entrez] AID - S0741-5214(07)01931-3 [pii] AID - 10.1016/j.jvs.2007.11.056 [doi] PST - ppublish SO - J Vasc Surg. 2008 Apr;47(4):774-781. doi: 10.1016/j.jvs.2007.11.056. PMID- 18371477 OWN - NLM STAT- MEDLINE DCOM- 20080418 LR - 20181201 IS - 1097-6744 (Electronic) IS - 0002-8703 (Linking) VI - 155 IP - 4 DP - 2008 Apr TI - The efficacy and safety of short- and long-term dual antiplatelet therapy in patients with mild or moderate chronic kidney disease: results from the Clopidogrel for the Reduction of Events During Observation (CREDO) trial. PG - 687-93 LID - 10.1016/j.ahj.2007.10.046 [doi] AB - BACKGROUND: Mild and moderate chronic kidney disease (CKD) is associated with decreased survival and increased adverse events after a percutaneous coronary intervention (PCI). Therapy with clopidogrel decreases adverse events in large patient populations. Therefore, we sought to determine the efficacy and safety of long-term clopidogrel therapy in patients with CKD. METHODS: Two thousand two patients from the CREDO trial in whom an elective PCI of a single or multiple vessels was planned were analyzed. Patients were randomly assigned to a 300-mg loading dose of clopidogrel before PCI followed by clopidogrel 75 mg/d for a year versus a placebo loading dose at the time of the PCI procedure and clopidogrel 75 mg/d for 28 days and placebo for the remainder of a year. Patients were categorized by their estimated creatinine clearance (>90 [normal, n = 999], 60-89 [mild CKD, n = 672], <60 mL/min [moderate CKD, n = 331]). RESULTS: Diminished renal function was associated with worse outcomes. Patients with normal renal function who received 1 year of clopidogrel had a marked reduction in death, myocardial infarction, or stroke compared with those who received placebo (10.4% vs 4.4%, P < .001), whereas patients with mild and moderate CKD did not have a significant difference in outcomes with clopidogrel therapy versus placebo (mild: 12.8% vs 10.3%, P = .30; moderate: 13.1% vs 17.8%, P = .24). Clopidogrel use was associated with an increased relative risk of major or minor bleeding, but this increased risk was not different based on renal function (relative risk 1.2, 1.3, 1.1). CONCLUSIONS: Clopidogrel in mild or moderate CKD patients may not have the same beneficial effect as it does in patients with normal renal function, but was not associated with a greater relative risk of bleeding based on renal function. Further studies are needed to define the role of clopidogrel therapy in patients with CKD. FAU - Best, Patricia J M AU - Best PJ AD - Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55905, USA. best.patricia@mayo.edu FAU - Steinhubl, Steven R AU - Steinhubl SR FAU - Berger, Peter B AU - Berger PB FAU - Dasgupta, Arijit AU - Dasgupta A FAU - Brennan, Danielle M AU - Brennan DM FAU - Szczech, Lynda A AU - Szczech LA FAU - Califf, Robert M AU - Califf RM FAU - Topol, Eric J AU - Topol EJ CN - CREDO Investigators LA - eng PT - Journal Article PT - Randomized Controlled Trial DEP - 20080221 PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 RN - 0 (Platelet Aggregation Inhibitors) RN - A74586SNO7 (Clopidogrel) RN - OM90ZUW7M1 (Ticlopidine) SB - IM MH - Aged MH - *Angioplasty, Balloon, Coronary MH - Clopidogrel MH - Coronary Disease/complications/*therapy MH - Drug Therapy, Combination MH - Female MH - Hemorrhage/chemically induced MH - Humans MH - Kaplan-Meier Estimate MH - Male MH - Middle Aged MH - Multivariate Analysis MH - Myocardial Infarction/prevention & control MH - Platelet Aggregation Inhibitors/adverse effects/*therapeutic use MH - Renal Insufficiency, Chronic/*complications MH - Stents MH - Ticlopidine/adverse effects/*analogs & derivatives/therapeutic use MH - Treatment Outcome EDAT- 2008/03/29 09:00 MHDA- 2008/04/19 09:00 CRDT- 2008/03/29 09:00 PHST- 2006/01/29 00:00 [received] PHST- 2007/10/31 00:00 [accepted] PHST- 2008/03/29 09:00 [pubmed] PHST- 2008/04/19 09:00 [medline] PHST- 2008/03/29 09:00 [entrez] AID - S0002-8703(07)00986-6 [pii] AID - 10.1016/j.ahj.2007.10.046 [doi] PST - ppublish SO - Am Heart J. 2008 Apr;155(4):687-93. doi: 10.1016/j.ahj.2007.10.046. Epub 2008 Feb 21. PMID- 19608489 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20121002 LR - 20191111 IS - 1774-024X (Print) IS - 1774-024X (Linking) VI - 3 IP - 5 DP - 2008 Mar TI - Ischaemic events and bleeding in patients undergoing percutaneous coronary intervention with concomitant bivalirudin treatment. PG - 610-6 LID - EIJV3I5A109 [pii] AB - AIMS: The European ImproveR registry aimed to characterise the patient population undergoing percutaneous coronary intervention (PCI) with bivalirudin treatment in a routine clinical setting and to evaluate associated ischaemic and bleeding events. METHODS AND RESULTS: A total of 3,799 evaluable patients, aged > 18 years, were enrolled in 102 centres across 12 European countries from January 2005 to June 2006. The population was elderly (median age, 67.2 years; 24% > 75 years) and comprised 27.1% female patients, 27.9% with diabetes and 14.9% with renal impairment. Forty-nine percent of patients presented with acute coronary syndromes (ACS), 22% of these with ST-segment elevation myocardial infarction (STEMI). In-hospital and 30-day rates of major adverse cardiac events (death, myocardial infarction or urgent revascularisation) were 2.3% and 5.6%, respectively. In-hospital ischaemic complications were associated with a STEMI diagnosis and age > 65 years. In-hospital significant bleeding occurred in 1.7% of patients and was associated with renal impairment, female gender and glycoprotein IIb/IIIa inhibitor use. CONCLUSION: The ImproveR registry population is characterised by a high proportion of elderly patients and patients with diabetes, renal impairment and ACS. In clinical practice, bivalirudin effectively suppresses ischaemic complications while maintaining a low rate of haemorrhagic consequences, as expected from randomised trials. FAU - Madsen, Jan Kyst AU - Madsen JK AD - Gentofte University Hospital, University of Copenhagen, Hellerup, Denmark. FAU - Chevalier, Bernard AU - Chevalier B FAU - Darius, Harald AU - Darius H FAU - Rutsch, Wolfgang AU - Rutsch W FAU - Wojcik, Jaroslaw AU - Wojcik J FAU - Schneider, Steffen AU - Schneider S FAU - Allikmets, Kristina AU - Allikmets K LA - eng PT - Journal Article PL - France TA - EuroIntervention JT - EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology JID - 101251040 EDAT- 2008/03/01 00:00 MHDA- 2008/03/01 00:01 CRDT- 2009/07/18 09:00 PHST- 2009/07/18 09:00 [entrez] PHST- 2008/03/01 00:00 [pubmed] PHST- 2008/03/01 00:01 [medline] AID - EIJV3I5A109 [pii] AID - 10.4244/eijv3i5a109 [doi] PST - ppublish SO - EuroIntervention. 2008 Mar;3(5):610-6. doi: 10.4244/eijv3i5a109. PMID- 18300748 OWN - NLM STAT- MEDLINE DCOM- 20080422 LR - 20131121 IS - 0954-6928 (Print) IS - 0954-6928 (Linking) VI - 19 IP - 2 DP - 2008 Mar TI - Differential outcomes after sirolimus-eluting stent implantation: comparing on-label versus off-label patients in the 'real world'. PG - 111-5 LID - 10.1097/MCA.0b013e3282f34220 [doi] AB - BACKGROUND: Randomized controlled trials indicate that sirolimus-eluting stents (SES) reduce the rates of restenosis and need for subsequent revascularization procedures, but patients enrolled in randomized trials represent a highly selected population. This study examined the performance of SES in a 'real world' setting by comparing the outcomes of trial-eligible versus ineligible patients undergoing percutaneous coronary intervention. METHODS: From the US commercial introduction of SES in April 2003 until December 2003, all patients that received an SES at our institution were followed in a prospective registry (n=838). For the purpose of this analysis, the registry population was divided into two groups based on the inclusion and exclusion criteria of the stenosis in a native coronary artery (SIRIUS) trial. The primary endpoint of the study was the rate of target lesion revascularization (TLR) at follow-up. Secondary endpoints included major adverse cardiac events (MACE) such as cardiac death, myocardial infarction, and target vessel revascularization. Clinical follow-up was complete for 92% of patients with a median duration of 14.2 months. RESULTS: Overall, 296 patients (35.3%) met entry criteria for the SIRIUS trial and thus comprised the SIRIUS eligible group. Patients in the SIRIUS ineligible group (n=542) were more likely to have chronic kidney disease and earlier bypass surgery and had longer mean stent length. At 1 year, TLR occurred in 3.0% of the SIRIUS eligible population and in 9.2% of the SIRIUS ineligible group (P=0.001). The secondary endpoint of cumulative MACE occurred in 6.6% of the SIRIUS eligible versus in 17.7% of the SIRIUS ineligible population (P<0.001). Two patients (0.4%) in the SIRIUS ineligible group had a late stent thrombosis on days 39 and 99, respectively, versus none in the SIRIUS eligible group. CONCLUSION: Among 'real world' patients treated with SES, the incidence of TLR and MACE at 1 year was substantially greater among SIRIUS ineligible patients compared with SIRIUS eligible patients. These findings confirm that pivotal clinical trials of drug-eluting stents tend to enroll low-risk patients and that the estimated rates of TLR and MACE derived from such trials may not reflect subsequent outcomes with unrestricted clinical use. FAU - Jeremias, Allen AU - Jeremias A AD - Division of Cardiovascular Medicine, Stony Brook University Medical Center, Stony Brook, NY 11794, USA. allen.jeremias@stonybrook.edu FAU - Ruisi, Christopher P AU - Ruisi CP FAU - Kirtane, Ajay J AU - Kirtane AJ FAU - Lee, Tobias AU - Lee T FAU - Sylvia, Brett AU - Sylvia B FAU - Pinto, Duane S AU - Pinto DS FAU - Ho, Kalon K L AU - Ho KK FAU - Cutlip, Donald E AU - Cutlip DE FAU - Carrozza, Joseph P Jr AU - Carrozza JP Jr FAU - Cohen, David J AU - Cohen DJ LA - eng PT - Comparative Study PT - Journal Article PL - England TA - Coron Artery Dis JT - Coronary artery disease JID - 9011445 RN - 0 (Anti-Inflammatory Agents) RN - W36ZG6FT64 (Sirolimus) SB - IM MH - Aged MH - Anti-Inflammatory Agents/*adverse effects MH - *Coronary Restenosis MH - Coronary Stenosis/therapy MH - *Death MH - Drug-Eluting Stents/*adverse effects MH - Eligibility Determination MH - Female MH - Follow-Up Studies MH - Humans MH - Kaplan-Meier Estimate MH - Male MH - Middle Aged MH - Myocardial Revascularization/methods MH - Patient Selection MH - Randomized Controlled Trials as Topic MH - Registries MH - Reproducibility of Results MH - Sirolimus/*adverse effects EDAT- 2008/02/28 09:00 MHDA- 2008/04/23 09:00 CRDT- 2008/02/28 09:00 PHST- 2008/02/28 09:00 [pubmed] PHST- 2008/04/23 09:00 [medline] PHST- 2008/02/28 09:00 [entrez] AID - 00019501-200803000-00008 [pii] AID - 10.1097/MCA.0b013e3282f34220 [doi] PST - ppublish SO - Coron Artery Dis. 2008 Mar;19(2):111-5. doi: 10.1097/MCA.0b013e3282f34220. PMID- 18255012 OWN - NLM STAT- MEDLINE DCOM- 20080227 LR - 20211020 IS - 1534-4827 (Print) IS - 1534-4827 (Linking) VI - 7 IP - 6 DP - 2007 Dec TI - Statin therapy in renal disease: harmful or protective? PG - 467-73 AB - Chronic kidney disease (CKD) creates one of the highest-risk atherosclerotic states that can occur in human beings. The use of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) has gained widespread acceptance in the general population for the purposes of lowering low-density lipoprotein cholesterol (LDL-C) and reducing the future risks of myocardial infarction, stroke, and cardiac death. In patients with CKD, these benefits are believed to be enjoyed to the same or greater degrees. Reductions in LDL-C with statins may be associated with a reduced progression of CKD. Importantly, recent studies suggest statins are associated with a reduction in rates of acute renal failure after cardiopulmonary bypass surgery and exposure to iodinated contrast. In patients with end-stage renal disease (ESRD), recent data suggest that the annual rate of coronary artery calcification can be attenuated or reduced with LDL-C reduction. However, two large trials demonstrating LDL-C reduction with statins and with these drugs have failed to demonstrate a reduction in cardiovascular events in ESRD. Thus, the potential benefits of statins and LDL-C reduction in CKD have to be considered in light of evidence suggesting a reduced benefit, if any, in patients with ESRD. In addition, studies suggest that there are higher adverse drug effects with statins in CKD. FAU - McCullough, Peter A AU - McCullough PA AD - Division of Nutrition and Preventive Medicine, William Beaumont Hospital, 4949 Coolidge, Royal Oak, MI 48073, USA. pmc975@yahoo.com FAU - Rocher, Leslie R AU - Rocher LR LA - eng PT - Journal Article PL - United States TA - Curr Diab Rep JT - Current diabetes reports JID - 101093791 RN - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors) SB - IM MH - Acute Kidney Injury/drug therapy/pathology/prevention & control MH - Calcinosis/complications MH - Cardiovascular Diseases/complications MH - Disease Progression MH - Dyslipidemias/therapy MH - Humans MH - Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects/*therapeutic use MH - Kidney Diseases/complications/*drug therapy/pathology/prevention & control MH - Kidney Failure, Chronic/drug therapy/pathology/prevention & control MH - Risk Factors EDAT- 2008/02/08 09:00 MHDA- 2008/02/28 09:00 CRDT- 2008/02/08 09:00 PHST- 2008/02/08 09:00 [pubmed] PHST- 2008/02/28 09:00 [medline] PHST- 2008/02/08 09:00 [entrez] AID - 10.1007/s11892-007-0079-2 [doi] PST - ppublish SO - Curr Diab Rep. 2007 Dec;7(6):467-73. doi: 10.1007/s11892-007-0079-2. PMID- 18245699 OWN - NLM STAT- MEDLINE DCOM- 20080501 LR - 20170214 IS - 1816-5370 (Electronic) IS - 0218-4923 (Linking) VI - 16 IP - 1 DP - 2008 Jan TI - Off-pump coronary artery bypass grafting in left ventricular dysfunction. PG - 16-20 AB - Between August 2004 and May 2006, 124 patients undergoing coronary artery bypass grafting with ejection fractions 70%, and ten had asymptomatic stenoses >80%. Twenty-three (50%) patients were diagnosed with grade II cerebrovascular insufficiency (CVI) (transitory ischaemic attacks). Amongst the most frequently encountered accompanying pathologies were various-severity CADs in forty (95.2%) patients, and arterial hypertension in thirty-eight (90.4%). The cerebral blood flow state during CAS interventions was controlled by means of transcranial Doppler ultrasonography in sixteen patients. In twelve patients, the main stage of the intervention was performed under control of ultrasonographic duplex scanning (USDS). The technical success of the operation was achieved in forty-four (95.7%) cases. Failures were primarily caused by impossibility of passing the guidewire catheter in type 3 aortic arch in two patients. Twenty-six (56.5%) patients developed bradycardia and hypotension after CAS. No haemodynamically significant restenoses following CAS within the follow-up terms from 2 to 12 months were observed in twenty-two patients. The article also contains a brief comparative analysis of multicenter randomized studies on the CAS-related problem. In conclusion, the authors note safety and high efficiency of CAS, considering this intervention an alternative to carotid endarterectomy in patients with elevated surgical risk. A USDS-controlled operation significantly broadens the possibilities of the method concerned. FAU - Ignat'ev, I M AU - Ignat'ev IM FAU - Volodiukhin, M Iu AU - Volodiukhin MIu FAU - Malinovskii, M N AU - Malinovskii MN LA - rus PT - Comparative Study PT - English Abstract PT - Journal Article PL - Russia (Federation) TA - Angiol Sosud Khir JT - Angiologiia i sosudistaia khirurgiia = Angiology and vascular surgery JID - 9604504 SB - IM MH - Aged MH - Angiography MH - Angioplasty, Balloon/*methods MH - Carotid Stenosis/diagnosis/*therapy MH - Female MH - Follow-Up Studies MH - Humans MH - Hypertension/*complications MH - Male MH - Middle Aged MH - Myocardial Ischemia/*complications MH - Renal Insufficiency/*complications MH - Retrospective Studies MH - Risk Factors MH - *Stents MH - Treatment Outcome MH - Ultrasonography, Doppler, Duplex EDAT- 2008/01/01 00:00 MHDA- 2009/11/05 06:00 CRDT- 2009/10/02 06:00 PHST- 2009/10/02 06:00 [entrez] PHST- 2008/01/01 00:00 [pubmed] PHST- 2009/11/05 06:00 [medline] PST - ppublish SO - Angiol Sosud Khir. 2008;14(4):83-9. PMID- 18161210 OWN - NLM STAT- MEDLINE DCOM- 20080108 LR - 20181201 IS - 0036-5599 (Print) IS - 0036-5599 (Linking) VI - 39 IP - 6 DP - 2005 TI - Low-dose atorvastatin in severe chronic kidney disease patients: a randomized, controlled endpoint study. PG - 489-97 AB - OBJECTIVE: There have been no endpoint studies with statins for patients with severe renal failure. The purpose of this prospective, open, randomized, controlled study was to investigate whether atorvastatin (10 mg/day) would alter cardiovascular endpoints and the overall mortality rate of patients with chronic kidney disease stage 4 or 5 (creatinine clearance < 30 ml/min). MATERIAL AND METHODS: The study subjects comprised 143 patients who were randomized either to placebo (controls; n=73; mean age 69.5 years) or to treatment with atorvastatin (n=70; mean age 67.9 years). The patients included were either non-dialysis (n=33), haemodialysis (n=97) or peritoneal dialysis (n=13) patients. Analysis focused on the primary endpoints of all-cause mortality, non-lethal acute myocardial infarction, coronary artery bypass graft surgery and percutaneous transluminal coronary angioplasty. Statistical analysis for endpoint data was mainly by intention-to-treat. RESULTS: Primary endpoints occurred in 74% of the subjects. There was no difference in outcome between the control and atorvastatin groups. The 5-year endpoint-free survival rate from study entry was 20%. Atorvastatin was withdrawn in 20% of patients due to unacceptable side-effects. In the atorvastatin group, low-density lipoprotein (LDL) cholesterol was reduced by 35% at 1 month and then sustained. The controls showed a progressive reduction in LDL cholesterol until 36 months. CONCLUSIONS: Although atorvastatin reduced total and LDL cholesterol effectively it was not beneficial regarding the long-term outcomes of cardiovascular endpoints or survival. In contrast to other patient groups, patients with severe chronic kidney disease, especially those on dialysis, seem to derive limited benefit from this lower dose of atorvastatin. FAU - Stegmayr, B G AU - Stegmayr BG AD - Department of Internal Medicine, Division of Nephrology, University Hospital Umea, 901 85 Umea, Sweden. bernd.stegmayr@medicin.umu.se FAU - Brannstrom, M AU - Brannstrom M FAU - Bucht, S AU - Bucht S FAU - Crougneau, V AU - Crougneau V FAU - Dimeny, E AU - Dimeny E FAU - Ekspong, A AU - Ekspong A FAU - Eriksson, M AU - Eriksson M FAU - Granroth, B AU - Granroth B FAU - Grontoft, K C AU - Grontoft KC FAU - Hadimeri, H AU - Hadimeri H FAU - Holmberg, B AU - Holmberg B FAU - Ingman, B AU - Ingman B FAU - Isaksson, B AU - Isaksson B FAU - Johansson, G AU - Johansson G FAU - Lindberger, K AU - Lindberger K FAU - Lundberg, L AU - Lundberg L FAU - Mikaelsson, L AU - Mikaelsson L FAU - Olausson, E AU - Olausson E FAU - Persson, B AU - Persson B FAU - Stenlund, H AU - Stenlund H FAU - Wikdahl, A M AU - Wikdahl AM CN - Nediat Study Group LA - eng PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - England TA - Scand J Urol Nephrol JT - Scandinavian journal of urology and nephrology JID - 0114501 RN - 0 (Heptanoic Acids) RN - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors) RN - 0 (Pyrroles) RN - A0JWA85V8F (Atorvastatin) SB - IM MH - Aged MH - Angioplasty, Balloon, Coronary MH - Atorvastatin MH - Cardiovascular Diseases/complications/*epidemiology/*prevention & control/therapy MH - Coronary Artery Bypass MH - Dose-Response Relationship, Drug MH - Female MH - Heptanoic Acids/*administration & dosage MH - Humans MH - Hydroxymethylglutaryl-CoA Reductase Inhibitors/*administration & dosage MH - Kidney Failure, Chronic/complications/*mortality MH - Male MH - Myocardial Infarction/etiology/prevention & control/therapy MH - Prospective Studies MH - Pyrroles/*administration & dosage EDAT- 2007/12/29 09:00 MHDA- 2008/01/09 09:00 CRDT- 2007/12/29 09:00 PHST- 2007/12/29 09:00 [pubmed] PHST- 2008/01/09 09:00 [medline] PHST- 2007/12/29 09:00 [entrez] AID - 10.1080/00365590500329304 [doi] PST - ppublish SO - Scand J Urol Nephrol. 2005;39(6):489-97. doi: 10.1080/00365590500329304. PMID- 18057215 OWN - NLM STAT- MEDLINE DCOM- 20080305 LR - 20240414 IS - 1533-3450 (Electronic) IS - 1046-6673 (Print) IS - 1046-6673 (Linking) VI - 19 IP - 1 DP - 2008 Jan TI - Effect of pioglitazone on cardiovascular outcome in diabetes and chronic kidney disease. PG - 182-7 AB - Patients with diabetes and chronic kidney disease (CKD) are at particularly high risk for cardiovascular disease (CVD). This post hoc analysis from the PROspective pioglitAzone Clinical Trial In macroVascular Events (PROactive) investigated the relationship between CKD and incident CVD in a population of patients with diabetes and documented macrovascular disease, as well as the effects of pioglitazone treatment on recurrent CVD. CKD, defined as an estimated GFR <60 ml/min per 1.73m(2), was present in 597 (11.6%) of 5154 patients. More patients with CKD reached the primary composite end point (all-cause mortality, myocardial infarction (MI), stroke, acute coronary syndrome, coronary/carotid arterial intervention, leg revascularization, or amputation above the ankle) than patients without CKD (27.5 versus 19.6%; P < 0.0001). Patients with CKD were also more likely to reach a secondary composite end point (all-cause mortality, MI, and stroke). Patients who had CKD and were treated with pioglitazone were less likely to reach the secondary end point (hazard ratio 0.66; 95% confidence interval 0.45 to 0.98), but this association was not observed among those with better renal function. In addition, there was a greater decline in estimated GFR with pioglitazone (between-group difference 0.8 ml/min per 1.73 m(2)/yr) than with placebo. In conclusion, CKD is an independent risk factor for cardiovascular events and death among patients with diabetes and preexisting macrovascular disease. Patients who had CKD and were treated with pioglitazone were less likely to reach a composite end point of all-cause death, MI, and stroke, independent of the severity of renal impairment. FAU - Schneider, Christian A AU - Schneider CA AD - Facharzt fur Innere Medizin/Kardiologie Klinik III fur Innere Medizin, Zimmer 0, C, 329 Universitat zu Koln Kerpener Strasse 68, 50937 Koln, Germany. FAU - Ferrannini, Ele AU - Ferrannini E FAU - Defronzo, Ralph AU - Defronzo R FAU - Schernthaner, Guntram AU - Schernthaner G FAU - Yates, John AU - Yates J FAU - Erdmann, Erland AU - Erdmann E LA - eng PT - Controlled Clinical Trial PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20071205 PL - United States TA - J Am Soc Nephrol JT - Journal of the American Society of Nephrology : JASN JID - 9013836 RN - 0 (Hypoglycemic Agents) RN - 0 (Placebos) RN - 0 (Thiazolidinediones) RN - X4OV71U42S (Pioglitazone) SB - IM CIN - J Am Soc Nephrol. 2008 Jan;19(1):4-7. doi: 10.1681/ASN.2007111182. PMID: 18178795 EIN - J Am Soc Nephrol. 2016 Sep;27(9):2918. doi: 10.1681/ASN.2016060616. PMID: 27581106 MH - Aged MH - Body Mass Index MH - Cardiovascular Diseases/*drug therapy/etiology MH - Diabetic Angiopathies/*drug therapy MH - Diabetic Nephropathies/*drug therapy MH - Female MH - Glomerular Filtration Rate MH - Humans MH - Hypoglycemic Agents/*therapeutic use MH - Kidney Failure, Chronic/*drug therapy/etiology/physiopathology MH - Male MH - Middle Aged MH - Pioglitazone MH - Placebos MH - Thiazolidinediones/*therapeutic use PMC - PMC2391042 EDAT- 2007/12/07 09:00 MHDA- 2008/03/06 09:00 PMCR- 2009/01/01 CRDT- 2007/12/07 09:00 PHST- 2007/12/07 09:00 [pubmed] PHST- 2008/03/06 09:00 [medline] PHST- 2007/12/07 09:00 [entrez] PHST- 2009/01/01 00:00 [pmc-release] AID - ASN.2007060678 [pii] AID - 0678 [pii] AID - 10.1681/ASN.2007060678 [doi] PST - ppublish SO - J Am Soc Nephrol. 2008 Jan;19(1):182-7. doi: 10.1681/ASN.2007060678. Epub 2007 Dec 5. PMID- 18035078 OWN - NLM STAT- MEDLINE DCOM- 20071203 LR - 20131121 IS - 1097-6744 (Electronic) IS - 0002-8703 (Linking) VI - 154 IP - 6 DP - 2007 Dec TI - Effect of enoxaparin versus unfractionated heparin in diabetic patients with ST-elevation myocardial infarction in the Enoxaparin and Thrombolysis Reperfusion for Acute Myocardial Infarction Treatment-Thrombolysis In Myocardial Infarction study 25 (ExTRACT-TIMI 25) trial. PG - 1078-84, 1084.e1 AB - BACKGROUND: Patients with diabetes mellitus (DM) are at higher risk for complications after ST-elevation myocardial infarction (STEMI) than patients without DM. Potent antithrombotic therapies may offer particular benefit for these high-risk patients and must be balanced against the potential for increased bleeding. METHODS: We performed a prospectively planned analysis of efficacy and safety in patients with DM among 20,479 patients with STEMI treated with fibrinolysis and randomized to a strategy of enoxaparin (up to 8 days) or unfractionated heparin (UFH) (48 hours) in ExTRACT-TIMI 25. RESULTS: Patients with DM (n = 3060) were older and more likely to be women and to present with heart failure (P < .0001 for each) than those without DM. After adjustment for the TIMI Risk Score, sex, and renal function, patients with DM were at 30% higher risk for death or myocardial infarction (MI) by 30 days (OR(adj) 1.29, 95% CI 1.14-1.46). Among patients with DM, the enoxaparin strategy reduced mortality (9.5% vs 11.8%, relative risk [RR] 0.81, 95% CI 0.66-0.99), death/MI (13.6% vs 17.1%, RR 0.80; 95% CI 0.67-0.94), and death/MI/urgent revascularization (16.0% vs 19.7%, RR 0.81, 95% CI 0.70-0.94). The enoxaparin strategy was associated with a trend toward higher major bleeding (2.6% vs 1.6%, RR 1.63, 95% CI 0.99-2.69). Taking efficacy and safety into account, the enoxaparin strategy offered superior net clinical benefit (death/MI/major bleed, 14.8% vs 18.0%, RR 0.83, 95% CI 0.70-0.97) compared with UFH in patients with DM. CONCLUSIONS: In a subgroup analysis, a reperfusion strategy including enoxaparin significantly improved outcomes compared with UFH among high-risk STEMI patients with DM undergoing fibrinolysis. FAU - Morrow, David A AU - Morrow DA AD - Department of Medicine, Harvard Medical School, Boston, MA, USA. dmorrow@partners.org FAU - Antman, Elliott M AU - Antman EM FAU - Murphy, Sabina A AU - Murphy SA FAU - Qin, Jie AU - Qin J FAU - Ruda, Mikhail AU - Ruda M FAU - Guneri, Sema AU - Guneri S FAU - Jacob, Ashok Joseph AU - Jacob AJ FAU - Budaj, Andrzej AU - Budaj A FAU - Braunwald, Eugene AU - Braunwald E CN - TIMI Study Group LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 RN - 0 (Enoxaparin) RN - 0 (Fibrinolytic Agents) RN - 0 (Platelet Aggregation Inhibitors) RN - 9005-49-6 (Heparin) RN - R16CO5Y76E (Aspirin) SB - IM MH - Aged MH - Aspirin/therapeutic use MH - Diabetes Complications/*drug therapy MH - Drug Therapy, Combination MH - Electrocardiography MH - Enoxaparin/adverse effects/*therapeutic use MH - Female MH - Fibrinolytic Agents/adverse effects/*therapeutic use MH - Hemorrhage/chemically induced MH - Heparin/adverse effects/*therapeutic use MH - Humans MH - Male MH - Myocardial Infarction/complications/*drug therapy MH - Platelet Aggregation Inhibitors/therapeutic use MH - Prospective Studies EDAT- 2007/11/24 09:00 MHDA- 2007/12/06 09:00 CRDT- 2007/11/24 09:00 PHST- 2007/01/31 00:00 [received] PHST- 2007/07/23 00:00 [accepted] PHST- 2007/11/24 09:00 [pubmed] PHST- 2007/12/06 09:00 [medline] PHST- 2007/11/24 09:00 [entrez] AID - S0002-8703(07)00610-2 [pii] AID - 10.1016/j.ahj.2007.07.027 [doi] PST - ppublish SO - Am Heart J. 2007 Dec;154(6):1078-84, 1084.e1. doi: 10.1016/j.ahj.2007.07.027. PMID- 17984102 OWN - NLM STAT- MEDLINE DCOM- 20080423 LR - 20211020 IS - 1460-2385 (Electronic) IS - 0931-0509 (Linking) VI - 23 IP - 3 DP - 2008 Mar TI - Mortality, kidney disease and cardiac procedures following acute coronary syndrome. PG - 934-40 AB - BACKGROUND: Cardiac interventions are underutilized in patients with chronic kidney disease (CKD) following acute coronary syndrome (ACS) partly due to nephrotoxicity concerns. METHODS: We analyzed outcomes of 4631 subjects with ACS enrolled in the Blockade of the Glycoprotein IIb/IIIa Receptor to Avoid Vascular Occlusion trial, including time to death, time to reduced renal function (50% reduction in estimated glomerular filtration rate (eGFR) or development of end-stage renal disease (ESRD)) and percent change in eGFR from baseline. RESULTS: Subjects with a lower baseline eGFR were more likely to be older, female and have diabetes, hypertension, congestive heart failure or peripheral vascular disease (all P < 0.0001); they were less likely to be taking aspirin > or = 162 mg or to have undergone a percutaneous coronary intervention (PCI) prior to enrollment (P < 0.0001). As eGFR declined, the proportion of subjects experiencing death versus reduced eGFR or ESRD qualitatively increased. In adjusted analyses, every 10 ml/min/1.73 m(2) decrease in eGFR < or = 90 was associated with a 15% increased hazard of death (HR 1.15, P = 0.01). In adjusted analyses of predictors of percent change in eGFR, catheterization (cath) with or without PCI compared to medical therapy during follow-up was not associated with significant differences in long-term eGFR (P = 0.09). CONCLUSIONS: Among CKD subjects in this study, the risk of death greatly outweighed the risk of reduced eGFR or development of ESRD following ACS and the occurrence of cath +/- PCI was not associated with significant differences in long-term renal function. The presence of CKD should not preclude potentially beneficial interventions and research should focus on reducing the high cardiovascular burden in this population. FAU - Inrig, Jula K AU - Inrig JK AD - Duke Clinical Research Institute, Duke University Medical Center, Durham, NC 27710, USA. inrig001@mc.duke.edu FAU - Patel, Uptal D AU - Patel UD FAU - Briley, Libbie P AU - Briley LP FAU - She, Lilin AU - She L FAU - Gillespie, Barbara S AU - Gillespie BS FAU - Easton, J Donald AU - Easton JD FAU - Topol, Eric J AU - Topol EJ FAU - Szczech, Lynda A AU - Szczech LA LA - eng GR - K23 DK075929/DK/NIDDK NIH HHS/United States GR - K12 RR17630/RR/NCRR NIH HHS/United States GR - 1K23DK075929-01/DK/NIDDK NIH HHS/United States GR - 1KL2 RR024127-01/RR/NCRR NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural DEP - 20071104 PL - England TA - Nephrol Dial Transplant JT - Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association JID - 8706402 SB - IM MH - Acute Coronary Syndrome/*complications/mortality/*therapy MH - Aged MH - Angioplasty, Balloon, Coronary MH - Cardiac Catheterization MH - Case-Control Studies MH - Chronic Disease MH - Female MH - Glomerular Filtration Rate/physiology MH - Humans MH - Kidney Diseases/*etiology/physiopathology MH - Kidney Failure, Chronic/etiology/physiopathology MH - Male MH - Middle Aged MH - Risk Factors MH - Survival Analysis MH - Treatment Outcome EDAT- 2007/11/07 09:00 MHDA- 2008/04/24 09:00 CRDT- 2007/11/07 09:00 PHST- 2007/11/07 09:00 [pubmed] PHST- 2008/04/24 09:00 [medline] PHST- 2007/11/07 09:00 [entrez] AID - gfm689 [pii] AID - 10.1093/ndt/gfm689 [doi] PST - ppublish SO - Nephrol Dial Transplant. 2008 Mar;23(3):934-40. doi: 10.1093/ndt/gfm689. Epub 2007 Nov 4. PMID- 17950791 OWN - NLM STAT- MEDLINE DCOM- 20071220 LR - 20220321 IS - 0002-9149 (Print) IS - 0002-9149 (Linking) VI - 100 IP - 9 DP - 2007 Nov 1 TI - Predictors and impact of major hemorrhage on mortality following percutaneous coronary intervention from the REPLACE-2 Trial. PG - 1364-9 AB - Patients undergoing percutaneous coronary intervention (PCI) have a significant risk of hemorrhagic complications. Predictors of major hemorrhage and its relation to mortality in PCI are not well defined. Baseline and periprocedural predictors of major hemorrhage and its impact on mortality in patients undergoing elective or urgent PCI randomly assigned to heparin plus planned glycoprotein IIb/IIIa inhibitor (GPI) versus bivalirudin plus provisional GPIs in the REPLACE-2 Trial were determined. Of 6,001 patients, 3.2% experienced a major hemorrhage. Independent baseline predictors of major hemorrhage included advanced age, female gender, impaired creatinine clearance, and anemia. Independent periprocedural predictors of major hemorrhage included treatment with heparin plus GPI, increased procedural duration, provisional use of GPI, increased time to sheath removal, length of intensive care unit stay, and use of an intra-aortic balloon pump (all p <0.05). Mortality rates were higher in patients with than without major hemorrhage at 30 days (5.1% vs 0.2%), 6 months (6.7% vs 1.0%), and 1 year (8.7% vs 1.9%; p <0.001 for all). Furthermore, major hemorrhage was an independent predictor of 1-year mortality (odds ratio 2.66, 95% confidence interval 1.44 to 4.92, p = 0.002). In conclusion, in patients undergoing elective or urgent PCI, major hemorrhage was an independent predictor of 1-year mortality. A number of baseline and periprocedural factors independently predicted major hemorrhage, including treatment with heparin plus GPI. FAU - Feit, Frederick AU - Feit F AD - Department of Medicine, New York University School of Medicine, New York, NY, USA. frederick.feit@med.nyu.edu FAU - Voeltz, Michele D AU - Voeltz MD FAU - Attubato, Michael J AU - Attubato MJ FAU - Lincoff, A Michael AU - Lincoff AM FAU - Chew, Derek P AU - Chew DP FAU - Bittl, John A AU - Bittl JA FAU - Topol, Eric J AU - Topol EJ FAU - Manoukian, Steven V AU - Manoukian SV LA - eng PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20070816 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 RN - 0 (Antithrombins) RN - 0 (Fibrinolytic Agents) RN - 0 (Hirudins) RN - 0 (Peptide Fragments) RN - 0 (Recombinant Proteins) RN - TN9BEX005G (bivalirudin) SB - IM MH - Aged MH - Angioplasty, Balloon, Coronary/*adverse effects/mortality MH - Antithrombins/therapeutic use MH - Coronary Disease/mortality/*therapy MH - Female MH - Fibrinolytic Agents/therapeutic use MH - Hemorrhage/*epidemiology MH - Hirudins MH - Humans MH - Logistic Models MH - Male MH - Middle Aged MH - Multivariate Analysis MH - Peptide Fragments/therapeutic use MH - Prospective Studies MH - Recombinant Proteins/therapeutic use EDAT- 2007/10/24 09:00 MHDA- 2007/12/21 09:00 CRDT- 2007/10/24 09:00 PHST- 2007/03/20 00:00 [received] PHST- 2007/06/06 00:00 [revised] PHST- 2007/06/06 00:00 [accepted] PHST- 2007/10/24 09:00 [pubmed] PHST- 2007/12/21 09:00 [medline] PHST- 2007/10/24 09:00 [entrez] AID - S0002-9149(07)01430-0 [pii] AID - 10.1016/j.amjcard.2007.06.026 [doi] PST - ppublish SO - Am J Cardiol. 2007 Nov 1;100(9):1364-9. doi: 10.1016/j.amjcard.2007.06.026. Epub 2007 Aug 16. PMID- 17712200 OWN - NLM STAT- MEDLINE DCOM- 20070918 LR - 20131121 IS - 1557-2501 (Electronic) IS - 1042-3931 (Linking) VI - 19 IP - 8 DP - 2007 Aug TI - Short- and long-term clinical outcomes of coronary drug-eluting stent recipients presenting with chronic renal disease. PG - 331-7 AB - BACKGROUND: Randomized trials of drug-eluting stents (DES) excluded patients with severe renal insufficiency. We sought to evaluate the impact of baseline renal function on clinical outcomes in recipients of coronary DES. METHODS: We retrospectively reviewed our hospital databases to identify consecutive patients who underwent DES implantations between May 2003 and December 2004, subgrouped among 4 ranges of glomerular filtration rate (GFR) between > or = 90 ml per minute and < 30 ml per minute, in 30 ml per minute decrements, and 1 group treated with long-term dialysis. Clinical follow up was obtained at 6 months, 1 year and annually thereafter. RESULTS: Our study group included 2,758 patients with long-term outcomes recorded over a mean follow up of 706 +/- 273 days. The rates of in-hospital adverse events increased significantly as GFR decreased, though no major adverse event occurred among the dialyzed patients. Actuarial survival analyses up to 2 years revealed significant between-groups differences in rates of major adverse cardiac events (MACE) and death (both p < 0.001), while the differences in target vessel revascularization (TVR) rates did not reach statistical significance (p = 0.069). By Cox regression analysis, a GFR < 60 ml per minute remained a significant predictor of 2-year mortality (p < 0.001) and MACE (p < 0.001), but not TVR (p = 0.839). CONCLUSIONS: In conclusion, low rates of TVR were observed over 2 years in DES recipients with a wide range of renal function. Low rates of TVR were countered by high rates of death and MACE among renally insufficient patients over the long term. FAU - Mishkel, Gregory J AU - Mishkel GJ AD - Prairie Cardiovascular Consultants, Ltd., Prairie Heart Institute at St. John's Hospital, Springfield, IL 62794-9420, USA. gmishkel@prairieheart.com FAU - Varghese, Joji J AU - Varghese JJ FAU - Moore, Anna L AU - Moore AL FAU - Aguirre, Frank AU - Aguirre F FAU - Markwell, Stephen J AU - Markwell SJ FAU - Shelton, Marc AU - Shelton M LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - United States TA - J Invasive Cardiol JT - The Journal of invasive cardiology JID - 8917477 RN - W36ZG6FT64 (Sirolimus) SB - IM CIN - J Invasive Cardiol. 2007 Aug;19(8):338. PMID: 17712201 CIN - J Invasive Cardiol. 2008 Jan;20(1):44. PMID: 18174620 MH - Aged MH - Coronary Disease/*complications/mortality/*therapy MH - *Drug Delivery Systems MH - Female MH - Follow-Up Studies MH - Glomerular Filtration Rate MH - Humans MH - Kidney Failure, Chronic/*complications/physiopathology/therapy MH - Male MH - Middle Aged MH - Myocardial Infarction/etiology MH - Myocardial Revascularization/statistics & numerical data MH - Predictive Value of Tests MH - Proportional Hazards Models MH - Renal Dialysis MH - Retrospective Studies MH - Sirolimus/administration & dosage MH - Stents/*adverse effects MH - Survival Analysis MH - Thrombosis/etiology EDAT- 2007/08/23 09:00 MHDA- 2007/09/19 09:00 CRDT- 2007/08/23 09:00 PHST- 2007/08/23 09:00 [pubmed] PHST- 2007/09/19 09:00 [medline] PHST- 2007/08/23 09:00 [entrez] PST - ppublish SO - J Invasive Cardiol. 2007 Aug;19(8):331-7. PMID- 17664205 OWN - NLM STAT- MEDLINE DCOM- 20080429 LR - 20170214 IS - 1816-5370 (Electronic) IS - 0218-4923 (Linking) VI - 15 IP - 4 DP - 2007 Aug TI - Tranexamic acid and primary coronary artery bypass surgery: a prospective study. PG - 313-9 AB - Tranexamic acid was used to reduce postoperative drainage and allogenic blood transfusion requirements in patients undergoing on-pump primary coronary bypass surgery. Over 12 months, 222 patients participated in this prospective, randomized, placebo-controlled, double-blind study conducted at a tertiary center. Half of the patients were randomly allocated to receive tranexamic acid as a bolus (10 mg x kg(-1)) prior to sternotomy, followed by an infusion (1 mg x kg(-1) x hr(-1)) up to the time of starting of protamine. The other 111 patients received a saline bolus and infusion. Postoperative drainage and transfusion requirements were measured in all patients. Markers of graft patency, hemostasis, hemodynamic stability, and fibrinolysis were evaluated. Chest closure time, renal function parameters, allergic reactions, incidence of stroke, re-exploration, and hospital mortality were also noted. Postoperative drainage was significantly less and blood conservation considerably better when tranexamic acid was used. Post-bypass hemostasis was achieved faster, fibrinolysis was less, and there was no evidence of increased incidence of graft occlusion in the group given tranexamic acid. FAU - Maddali, Madan M AU - Maddali MM AD - Department of Anesthesia, Royal Hospital, Seeb, Muscat, Sultanate of Oman. madan@omantel.net.om FAU - Rajakumar, Muthukkumar C AU - Rajakumar MC LA - eng PT - Journal Article PT - Randomized Controlled Trial PL - England TA - Asian Cardiovasc Thorac Ann JT - Asian cardiovascular & thoracic annals JID - 9503417 RN - 0 (Antifibrinolytic Agents) RN - 6T84R30KC1 (Tranexamic Acid) SB - IM MH - Aged MH - Antifibrinolytic Agents/*administration & dosage/adverse effects MH - Blood Loss, Surgical/*prevention & control MH - Blood Transfusion MH - Coronary Artery Bypass/*adverse effects MH - Coronary Artery Disease/blood/physiopathology/*surgery MH - Double-Blind Method MH - Drainage MH - Drug Administration Schedule MH - Female MH - Fibrinolysis/drug effects MH - Hemodynamics/drug effects MH - Hemostasis/drug effects MH - *Hemostasis, Surgical MH - Humans MH - Male MH - Middle Aged MH - Postoperative Hemorrhage/blood/etiology/physiopathology/*prevention & control MH - Prospective Studies MH - Tranexamic Acid/*administration & dosage/adverse effects MH - Treatment Outcome MH - Vascular Patency/drug effects EDAT- 2007/08/01 09:00 MHDA- 2008/04/30 09:00 CRDT- 2007/08/01 09:00 PHST- 2007/08/01 09:00 [pubmed] PHST- 2008/04/30 09:00 [medline] PHST- 2007/08/01 09:00 [entrez] AID - 15/4/313 [pii] AID - 10.1177/021849230701500410 [doi] PST - ppublish SO - Asian Cardiovasc Thorac Ann. 2007 Aug;15(4):313-9. doi: 10.1177/021849230701500410. PMID- 17651830 OWN - NLM STAT- MEDLINE DCOM- 20080729 LR - 20220317 IS - 1874-1754 (Electronic) IS - 0167-5273 (Linking) VI - 126 IP - 3 DP - 2008 Jun 6 TI - Clinical outcomes of contrast-induced nephropathy in patients undergoing percutaneous coronary intervention: a prospective, multicenter, randomized study to analyze the effect of hydration and acetylcysteine. PG - 407-13 AB - BACKGROUND: The potential role of hydration in prevention of contrast-induced nephropathy (CIN) still remains to be unclear. METHODS: Nine-hundred and thirty-six patients scheduled for percutaneous coronary intervention (PCI) were enrolled into the present study, and divided into normal (serum creatinine<1.5 mg/dl) and abnormal (serum creatine> or =1.5 mg/dl) groups according to their baseline serum concentration of creatinine. Each group was further randomly divided into two subgroups: hydration and nonhydration. All patients in abnormal group took twice orally loading dose of 1200 mg acetylcysteine (ATLS) at 12 h before scheduled time for coronary angiogram and immediately after procedure. Creatinine concentration was remeasured at the time of admission (just before catheterization), every day for the following three days. The primary end point during 6-month follow-up included clinical driven revascularization (either PCI or CABG), death from all causes, and requiring emergency renal-replacement therapy. RESULTS: The incidence of CIN was more commonly in abnormal group that in normal group (6.52% vs. 37.68%, p<0.001). Hydration had potentials in prevention of CIN only in patients with elevated baseline concentration of creatinine. Multivariate analysis demonstrated that the following variables remained to be significant factors correlating with CIN: age> or =70 years (odds ration [OR] 5.27, 95% confidence interval [CI] 1.94 to 13.07, p=0.0007), contrast volume> or =320 ml (OR 3.26, 95% CL 2.14 to 7.58, p=0.01), diabetes mellitus (OR 9.86, 95% CL 5.38 to 31.67, p<0.0001), and peripheral arterial disease (OR 11.25, 95% CL 5.12 to 43.19, p<0.0001). Patients with CIN in abnormal group had worse clinical outcomes, compared to patients with CIN in normal group. CONCLUSION: Patients with CIN and preexisting renal insufficiency had worse clinical outcomes. Hydration with 0.45% sodium chloride alone had no potential effect on the occurrence of CIN in patients with normal renal function. Combination of hydration with ATLS could reduce the incidence of CIN in patients at high risk. FAU - Chen, Shao Liang AU - Chen SL AD - Nanjing First Hospital of Nanjing Medical University, Department of Cardiology, 68# Changle Road, 210006, Nanjing, China. chmengx@126.com FAU - Zhang, Junjie AU - Zhang J FAU - Yei, Fei AU - Yei F FAU - Zhu, Zhongsheng AU - Zhu Z FAU - Liu, Zhizhong AU - Liu Z FAU - Lin, Song AU - Lin S FAU - Chu, Jun AU - Chu J FAU - Yan, Ji AU - Yan J FAU - Zhang, Ruiyan AU - Zhang R FAU - Kwan, Tak W AU - Kwan TW LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20070724 PL - Netherlands TA - Int J Cardiol JT - International journal of cardiology JID - 8200291 RN - 0 (Contrast Media) RN - AYI8EX34EU (Creatinine) RN - WYQ7N0BPYC (Acetylcysteine) SB - IM CIN - Int J Cardiol. 2009 May 29;134(3):431-3; author reply 434. doi: 10.1016/j.ijcard.2007.12.123. PMID: 18501445 MH - Acetylcysteine/*therapeutic use MH - Acute Kidney Injury/*chemically induced/*prevention & control MH - Aged MH - Angioplasty, Balloon, Coronary/adverse effects/*methods MH - Combined Modality Therapy MH - Contrast Media/*adverse effects MH - Coronary Stenosis/diagnostic imaging/therapy MH - Creatinine/blood MH - Female MH - Fluid Therapy/*methods MH - Follow-Up Studies MH - Humans MH - Kidney Function Tests MH - Logistic Models MH - Male MH - Middle Aged MH - Multivariate Analysis MH - Probability MH - Prospective Studies MH - Radiography MH - Reference Values MH - Risk Assessment MH - Severity of Illness Index MH - Treatment Outcome EDAT- 2007/07/27 09:00 MHDA- 2008/07/30 09:00 CRDT- 2007/07/27 09:00 PHST- 2006/08/15 00:00 [received] PHST- 2007/03/31 00:00 [revised] PHST- 2007/05/11 00:00 [accepted] PHST- 2007/07/27 09:00 [pubmed] PHST- 2008/07/30 09:00 [medline] PHST- 2007/07/27 09:00 [entrez] AID - S0167-5273(07)01024-8 [pii] AID - 10.1016/j.ijcard.2007.05.004 [doi] PST - ppublish SO - Int J Cardiol. 2008 Jun 6;126(3):407-13. doi: 10.1016/j.ijcard.2007.05.004. Epub 2007 Jul 24. PMID- 17635756 OWN - NLM STAT- MEDLINE DCOM- 20071102 LR - 20220321 IS - 1320-5358 (Print) IS - 1320-5358 (Linking) VI - 12 IP - 4 DP - 2007 Aug TI - Metabolic syndrome in severe chronic kidney disease: Prevalence, predictors, prognostic significance and effects of risk factor modification. PG - 391-8 AB - BACKGROUND: Metabolic syndrome (MS) is a significant risk factor for cardiovascular disease, mortality and chronic kidney disease (CKD) in the general population. However, the prevalence, predictors, prognostic value and treatment of MS in the CKD population have not been rigorously studied. METHODS: The study involved 200 stages 4 and 5 CKD patients enrolled in a randomized controlled trial of intensive multiple risk factor modification (targeting hypercholesterolaemia, hyperhomocysteinaemia, anaemia and disordered bone mineral metabolism) versus usual care. Participants were followed for a median period of 22 months. RESULTS: The overall prevalence of MS was 30.5%. MS was independently predicted by older age, peritoneal dialysis and Maori/Pacific Islander origin. When laboratory parameters were included as covariates, the only significant predictors of MS were higher serum malondialdehyde and lower serum adiponectin concentrations. MS was an independent predictor of time to composite end-point of cardiovascular death, acute coronary syndrome, revascularization, non-fatal stroke and amputation (adjusted hazard ratio 2.46, 95% CI 1.17-5.18). No significant difference in cardiovascular event-free survival was observed in those allocated to intensive risk factor modification compared with usual care. CONCLUSION: Metabolic syndrome occurs in 30.5% of stages 4 and 5 CKD patients and is associated with older age, peritoneal dialysis, ethnicity, increased oxidative stress, lower serum adiponectin concentrations and a significantly increased risk of future cardiovascular events. Intervention strategies targeting hypercholesterolaemia, hyperhomocysteinaemia, anaemia and disordered bone mineral metabolism may not be effective in ameliorating the heightened cardiovascular risk of CKD patients with MS. FAU - Johnson, David W AU - Johnson DW AD - Department of Renal Medicine, University of Queensland at Princess Alexandra Hospital, Queensland, Australia. david_johnson@health.qld.gov.au FAU - Armstrong, Kirsten AU - Armstrong K FAU - Campbell, Scott B AU - Campbell SB FAU - Mudge, David W AU - Mudge DW FAU - Hawley, Carmel M AU - Hawley CM FAU - Coombes, Jeff S AU - Coombes JS FAU - Prins, Johannes B AU - Prins JB FAU - Isbel, Nicole M AU - Isbel NM LA - eng PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - Australia TA - Nephrology (Carlton) JT - Nephrology (Carlton, Vic.) JID - 9615568 SB - IM MH - Chronic Disease MH - Female MH - Humans MH - Kidney Diseases/*complications MH - Male MH - Metabolic Syndrome/epidemiology/*etiology MH - Middle Aged MH - Prevalence MH - Prognosis MH - Risk Factors MH - Severity of Illness Index EDAT- 2007/07/20 09:00 MHDA- 2007/11/06 09:00 CRDT- 2007/07/20 09:00 PHST- 2007/07/20 09:00 [pubmed] PHST- 2007/11/06 09:00 [medline] PHST- 2007/07/20 09:00 [entrez] AID - NEP804 [pii] AID - 10.1111/j.1440-1797.2007.00804.x [doi] PST - ppublish SO - Nephrology (Carlton). 2007 Aug;12(4):391-8. doi: 10.1111/j.1440-1797.2007.00804.x. PMID- 17611249 OWN - NLM STAT- MEDLINE DCOM- 20080513 LR - 20131121 IS - 0931-0509 (Print) IS - 0931-0509 (Linking) VI - 22 IP - 12 DP - 2007 Dec TI - Predictors of cardiovascular events in patients with end-stage renal disease: an analysis from the Fosinopril in dialysis study. PG - 3573-9 AB - BACKGROUND: Cardiovascular events (CVE) are a major cause of morbidity and mortality in end-stage renal disease (ESRD) patients. These patients are often excluded from CV clinical trials, and the prognostic factors associated with CVE in patients with ESRD have not been fully explored. A risk prediction model was created from the FOSIDIAL trial to identify factors predictive of CVE and to evaluate the relative strength of known predictors when considered together in a multivariate model. METHODS: FOSIDIAL was a prospective, randomized, double-blind study with 2-year follow-up and CVE adjudication. The study enrolled 397 patients with ESRD and left ventricular hypertrophy (LVH). CVE included cardiovascular death, non-fatal myocardial infarction, unstable angina, stroke, revascularization, heart failure hospitalization, resuscitated cardiac arrest and confirmed stroke. The model was built using a forward selection of all baseline variables. A structural equation model (SEM) was used to identify factors with an indirect association with CVE. RESULTS: CV history was the most important prognostic factor, followed by C-reactive protein (CRP), left ventricular mass index, diabetes and age. Smoking, low HDL, female gender and Kt/V were indirectly associated with CVE. CONCLUSION: Prior CV disease, elevated CRP, LVH, diabetes or advanced age identifies patients at the highest risk for CVE. These data may be useful to detect high risk patients, to define potential targets for pharmacologic intervention, and to plan future studies in ESRD. Further research is needed to identify effective approaches that reduce the rate of CVE in these patients. FAU - Kessler, Michele AU - Kessler M AD - Department of Nephrology, University Hospital of Nancy, Nancy, France. m.kessler@chu-nancy.fr FAU - Zannad, Faiez AU - Zannad F FAU - Lehert, Philippe AU - Lehert P FAU - Grunfeld, Jean Pierre AU - Grunfeld JP FAU - Thuilliez, Christian AU - Thuilliez C FAU - Leizorovicz, Alain AU - Leizorovicz A FAU - Lechat, Philippe AU - Lechat P CN - FOSIDIAL Investigators LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20070704 PL - England TA - Nephrol Dial Transplant JT - Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association JID - 8706402 RN - 0 (Antihypertensive Agents) RN - R43D2573WO (Fosinopril) SB - IM MH - Aged MH - Antihypertensive Agents/therapeutic use MH - Cardiovascular Diseases/*etiology MH - Female MH - Fosinopril/therapeutic use MH - Humans MH - Kidney Failure, Chronic/*complications/*therapy MH - Male MH - Models, Statistical MH - Multicenter Studies as Topic MH - Prognosis MH - Prospective Studies MH - Randomized Controlled Trials as Topic MH - *Renal Dialysis MH - Risk Factors EDAT- 2007/07/06 09:00 MHDA- 2008/05/14 09:00 CRDT- 2007/07/06 09:00 PHST- 2007/07/06 09:00 [pubmed] PHST- 2008/05/14 09:00 [medline] PHST- 2007/07/06 09:00 [entrez] AID - gfm417 [pii] AID - 10.1093/ndt/gfm417 [doi] PST - ppublish SO - Nephrol Dial Transplant. 2007 Dec;22(12):3573-9. doi: 10.1093/ndt/gfm417. Epub 2007 Jul 4. PMID- 19804226 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20100520 LR - 20091006 IS - 1744-8298 (Electronic) IS - 1479-6678 (Linking) VI - 3 IP - 4 DP - 2007 Jul TI - Antithrombotic strategies in non-ST elevation acute coronary syndromes: focus on bivalirudin. PG - 345-64 LID - 10.2217/14796678.3.4.345 [doi] AB - Acute coronary syndromes (ACS) are a common presentation of coronary artery disease, accounting for more than one million hospital admissions in the US annually. Owing to high rates of mortality and reinfarction, ACS represent a major public health concern. The following review discusses the pathogenesis of ACS and optimal approaches for the management of patients with ACS, with special focus on new antithrombotic strategies, including the direct thrombin inhibitor bivalirudin. Bivalirudin has several notable mechanistic advantages compared with unfractionated heparin, including activity against clot-bound thrombin, inhibition of thrombin-induced platelet activation, short plasma half-life in patients with normal or mildly impaired renal function (25 minutes), and linear pharmacokinetics less affected by plasma proteins and renal insufficiency. These properties provide a more predictable inhibition of coagulant activity than unfractionated heparin, with less degree of inter-patient variability in anticoagulation response. The findings from the several clinical trials assessing safety and efficacy of bivalirudin are analyzed in detail, including the recent randomized controlled Acute Catheterization and Urgent Intervention Triage Strategy (ACUITY) trial. Based on the results of the ACUITY trial, a newer streamlined strategy for the invasive treatment of moderate- and high-risk patients with ACS is discussed. FAU - Nikolsky, Eugenia AU - Nikolsky E AD - Rambam Medical Center, Haifa 31096, Israel. e_nikolsky@rambam.health.gov.il FAU - Stone, Gregg W AU - Stone GW LA - eng PT - Journal Article PL - England TA - Future Cardiol JT - Future cardiology JID - 101239345 EDAT- 2007/07/01 00:00 MHDA- 2007/07/01 00:01 CRDT- 2009/10/07 06:00 PHST- 2009/10/07 06:00 [entrez] PHST- 2007/07/01 00:00 [pubmed] PHST- 2007/07/01 00:01 [medline] AID - 10.2217/14796678.3.4.345 [doi] PST - ppublish SO - Future Cardiol. 2007 Jul;3(4):345-64. doi: 10.2217/14796678.3.4.345. PMID- 17517798 OWN - NLM STAT- MEDLINE DCOM- 20071130 LR - 20070828 IS - 0931-0509 (Print) IS - 0931-0509 (Linking) VI - 22 IP - 9 DP - 2007 Sep TI - Risk of target lesion revascularization after coronary stenting in patients with and without chronic kidney disease. PG - 2578-85 AB - BACKGROUND: Rates of restenosis following percutaneous coronary intervention with stent placement are high in patients with advanced renal failure. Whether mild to moderate chronic kidney disease (CKD) is associated with a similarly increased need for short or long-term target lesion revascularization (TLR) following coronary stenting is uncertain. METHODS: We analysed results from 1228 patients enrolled in four separate, randomized, controlled clinical trials who underwent elective coronary angioplasty with stenting and were prospectively followed for 5 years after the index procedure. Cox proportional hazards regression was used to correct for confounding and to estimate the short and long-terms risks of target lesion revascularization in patients with vs without mild to moderate CKD. RESULTS: During a median follow-up of 5 years, 205 patients (16.7%) required TLR with 59 (4.8%) requiring TLR after the first year. Mild (HR 1.07, 95% CI 0.74-1.53) and moderate (HR 0.95, 95% CI 0.552-1.64) CKD were not associated with an increase in the adjusted, overall-risk of TLR. However, mild to moderate CKD was associated with a non-significantly increased risk of late TLR (HR 1.40, 95% CI 0.73-2.69). CONCLUSIONS: Coronary stenting appears to be similarly effective in patients with mild to moderate CKD and patients with normal renal function. While target lesion revascularization is rarely needed beyond the first year after revascularization, long-term results of coronary stenting may be less-favourable in patients with CKD. FAU - Charytan, David AU - Charytan D AD - Department of Medicine, Brigham and Women's Hospital, Renal Division, Clinical Biometrics, 1 Brigham Circle, 3rd Floor, Boston, MA 02115, USA. dcharytan@partners.org FAU - Forman, John P AU - Forman JP FAU - Cutlip, Donald E AU - Cutlip DE LA - eng PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial DEP - 20070521 PL - England TA - Nephrol Dial Transplant JT - Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association JID - 8706402 SB - IM MH - Coronary Restenosis/physiopathology MH - Female MH - Humans MH - Kidney Failure, Chronic/*complications/physiopathology MH - Kidney Function Tests MH - Male MH - Middle Aged MH - Myocardial Revascularization/*methods MH - Myocardium/*pathology MH - Risk Factors MH - *Stents MH - Time Factors EDAT- 2007/05/23 09:00 MHDA- 2007/12/06 09:00 CRDT- 2007/05/23 09:00 PHST- 2007/05/23 09:00 [pubmed] PHST- 2007/12/06 09:00 [medline] PHST- 2007/05/23 09:00 [entrez] AID - gfm241 [pii] AID - 10.1093/ndt/gfm241 [doi] PST - ppublish SO - Nephrol Dial Transplant. 2007 Sep;22(9):2578-85. doi: 10.1093/ndt/gfm241. Epub 2007 May 21. PMID- 17509426 OWN - NLM STAT- MEDLINE DCOM- 20070920 LR - 20250428 IS - 0147-9563 (Print) IS - 0147-9563 (Linking) VI - 36 IP - 3 DP - 2007 May-Jun TI - Efficacy of N-acetylcysteine and hydration versus placebo and hydration in decreasing contrast-induced renal dysfunction in patients undergoing coronary angiography with or without concomitant percutaneous coronary intervention. PG - 195-204 AB - OBJECTIVE: Contrast-induced renal dysfunction is an iatrogenic complication that occurs more frequently in patients with preexisting renal dysfunction. A prospective, double-blind, randomized, placebo, controlled trial was completed to assess the efficacy of N-acetylcysteine in decreasing the incidence of contrast-induced renal dysfunction in patients with an acute coronary syndrome and renal insufficiency who underwent coronary angiography with or without percutaneous coronary intervention. METHODS: With similar intravenous hydration protocols, 20 patients received N-acetylcysteine (treatment group) and 20 patients received placebo (control group) in a twice per day dosing regimen with one dose before and three doses after contrast media exposure. RESULTS: The two groups were similar at baseline on demographic and clinical characteristics, and preexisting renal insufficiency. Contrast-induced renal dysfunction, defined as an increase in serum creatinine greater than 44 micromol/L (.5 mg/dL) and/or 25% above baseline within 48 hours, occurred in 7.5% of the cohort, with 2.5% in the treatment group, and 5% in the control group, for an absolute difference of 2.5%. There was no difference in serum creatinine or creatinine clearance at 24 hours or at 48 hours between the treatment and control groups. CONCLUSION: These results suggest that this cohort gained no added protection to renal function with the use of N-acetylcysteine. FAU - Seyon, Rajamalar A AU - Seyon RA AD - Department of Cardiology, Royal Alexandra Hospital, University of Alberta, Edmonton, Alberta, Canada. FAU - Jensen, Louise A AU - Jensen LA FAU - Ferguson, Ian A AU - Ferguson IA FAU - Williams, Randall G AU - Williams RG LA - eng PT - Journal Article PT - Randomized Controlled Trial PL - United States TA - Heart Lung JT - Heart & lung : the journal of critical care JID - 0330057 RN - 0 (Contrast Media) RN - 0 (Free Radical Scavengers) RN - 0 (Placebos) RN - 451W47IQ8X (Sodium Chloride) RN - WYQ7N0BPYC (Acetylcysteine) SB - IM MH - Acetylcysteine/administration & dosage/*pharmacology/*therapeutic use MH - Acute Kidney Injury/*chemically induced/epidemiology/prevention & control MH - Aged MH - Angioplasty, Balloon, Coronary MH - Contrast Media/*adverse effects MH - Coronary Angiography/*adverse effects/methods MH - Double-Blind Method MH - Female MH - *Fluid Therapy MH - Free Radical Scavengers/administration & dosage/*therapeutic use MH - Humans MH - Incidence MH - Infusions, Intravenous MH - Male MH - Placebos MH - Risk Factors MH - Sodium Chloride/administration & dosage EDAT- 2007/05/19 09:00 MHDA- 2007/09/21 09:00 CRDT- 2007/05/19 09:00 PHST- 2006/04/04 00:00 [received] PHST- 2006/08/09 00:00 [revised] PHST- 2006/08/14 00:00 [accepted] PHST- 2007/05/19 09:00 [pubmed] PHST- 2007/09/21 09:00 [medline] PHST- 2007/05/19 09:00 [entrez] AID - S0147-9563(06)00227-5 [pii] AID - 10.1016/j.hrtlng.2006.08.004 [doi] PST - ppublish SO - Heart Lung. 2007 May-Jun;36(3):195-204. doi: 10.1016/j.hrtlng.2006.08.004. PMID- 19737695 OWN - NLM STAT- PubMed-not-MEDLINE DCOM- 20121002 LR - 20090909 IS - 1774-024X (Print) IS - 1774-024X (Linking) VI - 3 IP - 1 DP - 2007 May TI - A review of the early experience with Targeted Renal Therapy for renal function preservation during endovascular and surgical treatments for cardiovascular disease. PG - 121-7 LID - EIJV3I1A19 [pii] AB - Multiple reports describe the high clinical morbidity and mortality associated with contrast-induced nephropathy (CIN). Similarly, reports have described the glomerular filtration rate (GFR) and worsening renal function as predictors of adverse short and long-term outcomes in several large cardiovascular patient populations including acute myocardial infarction, congestive heart failure, coronary artery bypass surgery (CABG), and endovascular aneurysm repair (EVAR). Targeted renal therapy (TRT) is a novel emerging treatment where high-dose fenoldopam (FEN), a selective renal dopamine-1 receptor agonist and renal arteriolar vasodilator, is infused into both renal arteries via the US FDA-approved 5 Fr bifurcated Benephit PV Catheter Infusion System. TRT has been shown to significantly increase the GFR by 25% vs. placebo and IV-FEN (p < 0.001), which may have important clinical implications in CIN prophylaxis and during surgical procedures including CABG. The aim of this report is to review the early clinical experience and pilot trials with TRT in several clinical scenarios at high-risk for CIN or worsening renal function including percutaneous peripheral vascular interventions (PPI), percutaneous coronary interventions (PCI), CABG and EVAR. FAU - Allie, David E AU - Allie DE AD - Cardiovascular Institute of the South Lafayette, Lafayette, LA, USA. FAU - Hebert, Chris J AU - Hebert CJ FAU - Patlola, Raghotham AU - Patlola R FAU - Lirtzman, Mitchell D AU - Lirtzman MD FAU - Wyatt, Charles H AU - Wyatt CH FAU - Keller, V Antoine AU - Keller VA FAU - Mitran, Elena V AU - Mitran EV FAU - Veerina, Kalyan K AU - Veerina KK FAU - Walker, Craig M AU - Walker CM LA - eng PT - Journal Article PL - France TA - EuroIntervention JT - EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology JID - 101251040 EDAT- 2007/05/01 00:00 MHDA- 2007/05/01 00:01 CRDT- 2009/09/10 06:00 PHST- 2009/09/10 06:00 [entrez] PHST- 2007/05/01 00:00 [pubmed] PHST- 2007/05/01 00:01 [medline] AID - EIJV3I1A19 [pii] PST - ppublish SO - EuroIntervention. 2007 May;3(1):121-7. PMID- 17408780 OWN - NLM STAT- MEDLINE DCOM- 20080221 LR - 20161124 IS - 1874-1754 (Electronic) IS - 0167-5273 (Linking) VI - 124 IP - 1 DP - 2008 Feb 20 TI - Causes of ineligibility in randomized controlled trials and long-term mortality in patients with non-ST-segment elevation acute coronary syndromes. PG - 86-91 AB - PURPOSE: To determine the long-term mortality of patients with non-ST-segment elevation acute coronary syndromes (NSTEACS) that are eligible versus those not eligible in randomized controlled trials (RCT), and how each exclusion criteria is associated with outcome. METHODS: Common causes of exclusion in six published RCT on intravenous antithrombotic therapy were prospectively assessed in a cohort of 452 consecutive patients with NSTEACS that were followed for up to 3 years. RESULTS: Forty-one percent of patients had one or more exclusion criteria establishing the ineligible group. These patients were older, more likely to have coronary risk factors, ischemic ECG changes, heart failure at admission, higher creatinine levels and a lower ejection fraction than eligible patients. There were no differences between both groups in the antithrombotic treatment received or in the performance of revascularization procedures during hospitalization or in the prescription of antiplatelet treatment and beta-blockers at discharge. Cumulative 3-year mortality rate was 25% in ineligible patients compared to 9% in eligible patients (p<0.001). The hazard ratio (HR) of mortality was of 9.1 (95% CI: 4.5-18.7) for severe renal dysfunction; 6.0 (3.3-11.4) for concomitant non-vascular diseases; 3.0 (1.6-5.5) for contraindications to anticoagulation; 2.5 (1.1-5.7) for heart failure; and 2.3 (1.1-4.6) for prior cerebrovascular disease. After adjusting for baseline differences, ineligible patients had a HR of total mortality of 1.88 (1.04-3.38), and of cardiac mortality of 2 (1.01-3.98). CONCLUSION: Patients with NSTEACS who are ineligible in RCT have a higher risk profile and a two-fold adjusted long-term mortality than eligible patients, especially those with comorbid conditions and those with contraindications to anticoagulation. FAU - Bosch, Xavier AU - Bosch X AD - Department of Cardiology, Hospital Clinic, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), University of Barcelona, Spain. xbosch@clinic.ub.es FAU - Delgado, Victoria AU - Delgado V FAU - Verbal, Fernando AU - Verbal F FAU - Borquez, Emiliano AU - Borquez E FAU - Loma-Osorio, Pablo AU - Loma-Osorio P FAU - Diez-Aja, Salvador AU - Diez-Aja S FAU - Miranda-Guardiola, Faustino AU - Miranda-Guardiola F FAU - Sanchis, Juan AU - Sanchis J LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20070403 PL - Netherlands TA - Int J Cardiol JT - International journal of cardiology JID - 8200291 SB - IM MH - Acute Coronary Syndrome/diagnostic imaging/*mortality/therapy MH - Echocardiography MH - Electrocardiography MH - Female MH - Humans MH - Male MH - *Patient Selection MH - Proportional Hazards Models MH - Prospective Studies MH - *Randomized Controlled Trials as Topic MH - Risk Factors MH - Thrombolytic Therapy MH - Treatment Outcome EDAT- 2007/04/06 09:00 MHDA- 2008/02/22 09:00 CRDT- 2007/04/06 09:00 PHST- 2006/06/13 00:00 [received] PHST- 2006/10/30 00:00 [revised] PHST- 2006/12/30 00:00 [accepted] PHST- 2007/04/06 09:00 [pubmed] PHST- 2008/02/22 09:00 [medline] PHST- 2007/04/06 09:00 [entrez] AID - S0167-5273(07)00344-0 [pii] AID - 10.1016/j.ijcard.2006.12.027 [doi] PST - ppublish SO - Int J Cardiol. 2008 Feb 20;124(1):86-91. doi: 10.1016/j.ijcard.2006.12.027. Epub 2007 Apr 3. PMID- 17403120 OWN - NLM STAT- MEDLINE DCOM- 20071107 LR - 20221207 IS - 0742-3071 (Print) IS - 0742-3071 (Linking) VI - 24 IP - 7 DP - 2007 Jul TI - Interactive effect of retinopathy and macroalbuminuria on all-cause mortality, cardiovascular and renal end points in Chinese patients with Type 2 diabetes mellitus. PG - 741-6 AB - AIMS: To examine the effect of albuminuria and retinopathy on the risk of cardiovascular and renal events, and all-cause mortality in patients with Type 2 diabetes. METHODS: A post-hoc analysis of 4416 Chinese patients without macrovascular complications at baseline (age 57.6 +/- 13.3 years). Glomerular filtration rate (eGFR) was estimated by the abbreviated Modification of Diet in Renal Disease Study Group Formula, further adjusted for Chinese ethnicity. Clinical end points were all-cause mortality, cardiovascular events (heart failure or angina, myocardial infarction, lower limb amputation, re-vascularization procedures and stroke) and renal end points (reduction in eGFR by more than 50% or eGFR < 15 ml/min/1.73 m2 or death as a result of renal causes or need for dialysis). RESULTS: Compared with individuals without complications, subjects with retinopathy and macroalbuminuria had higher rates of cardiovascular events (14.1 vs. 2.4%), renal events (40.0 vs. 0.8%) and death (9.3 vs. 1.7%, P < 0.001). For composite event of death, cardiovascular and renal events, the presence of retinopathy, microalbuminuria alone, macroalbuminuria alone, retinopathy with microalbuminuria or retinopathy with macroalbuminuria increased the risk [hazard ratio (95% CI)] by 1.61 (1.05 to 2.47; P = 0.04), 1.93 (1.38 to 2.69; P < 0.001), 4.34 (3.02 to 6.22; P < 0.001), 2.59 [1.76 to 3.81; P < 0.001) and 6.83 (4.89 to 9.55; P < 0.001) fold, respectively. The relative excess risk as a result of interaction between retinopathy and macroalbuminuria was 15.31, implying biological interaction in the development of renal events. CONCLUSIONS: In Chinese patients with Type 2 diabetes, retinopathy interacts with macroalbuminuria to increase the risk of composite cardio-renal events. FAU - Tong, P C Y AU - Tong PC AD - Department of Medicine and Therapeutics, The Chinese University of Hong Kong, The Prince of Wales Hospital, NT, Hong Kong. ptong@cuhk.edu.hk FAU - Kong, A P AU - Kong AP FAU - So, W Y AU - So WY FAU - Yang, X AU - Yang X FAU - Ng, M C Y AU - Ng MC FAU - Ho, C S AU - Ho CS FAU - Ma, R C W AU - Ma RC FAU - Ozaki, R AU - Ozaki R FAU - Ng, V AU - Ng V FAU - Chow, C C AU - Chow CC FAU - Lam, C W K AU - Lam CW FAU - Chan, J C N AU - Chan JC FAU - Cockram, C S AU - Cockram CS LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20070402 PL - England TA - Diabet Med JT - Diabetic medicine : a journal of the British Diabetic Association JID - 8500858 RN - 0 (Biomarkers) SB - IM MH - Adult MH - Aged MH - Albuminuria/*complications MH - Asian People MH - Biomarkers/metabolism MH - Cardiovascular Diseases/*mortality MH - Cohort Studies MH - Diabetes Mellitus, Type 2/complications/*mortality MH - Diabetic Angiopathies/complications/*mortality MH - Diabetic Nephropathies/*complications/mortality MH - Diabetic Retinopathy/*complications MH - Female MH - Glomerular Filtration Rate MH - Humans MH - Male MH - Middle Aged MH - Risk Factors EDAT- 2007/04/04 09:00 MHDA- 2007/11/08 09:00 CRDT- 2007/04/04 09:00 PHST- 2007/04/04 09:00 [pubmed] PHST- 2007/11/08 09:00 [medline] PHST- 2007/04/04 09:00 [entrez] AID - DME2145 [pii] AID - 10.1111/j.1464-5491.2007.02145.x [doi] PST - ppublish SO - Diabet Med. 2007 Jul;24(7):741-6. doi: 10.1111/j.1464-5491.2007.02145.x. Epub 2007 Apr 2. PMID- 17394970 OWN - NLM STAT- MEDLINE DCOM- 20070430 LR - 20231024 IS - 1558-3597 (Electronic) IS - 0735-1097 (Linking) VI - 49 IP - 12 DP - 2007 Mar 27 TI - Impact of major bleeding on 30-day mortality and clinical outcomes in patients with acute coronary syndromes: an analysis from the ACUITY Trial. PG - 1362-8 AB - OBJECTIVES: The purpose of this study was to determine the predictors of major bleeding and the impact of major bleeding on outcomes, including mortality, in acute coronary syndromes (ACS). BACKGROUND: Whether major bleeding independently predicts mortality in patients with ACS undergoing an early invasive strategy is undefined. METHODS: Patients (n = 13,819) with moderate- and high-risk ACS were randomized to heparin (unfractionated or enoxaparin) plus glycoprotein IIb/IIIa inhibition (GPI), bivalirudin plus GPI, or bivalirudin monotherapy (plus provisional GPI). Logistic regression was used to determine predictors of 30-day major bleeding and mortality. RESULTS: Major bleeding rates in patients treated with heparin plus GPI were higher versus bivalirudin monotherapy (5.7% vs. 3.0%, p < 0.001) and similar versus bivalirudin plus GPI (5.7% vs. 5.3%, p = 0.38). Independent predictors of major bleeding were advanced age, female gender, diabetes, hypertension, renal insufficiency, anemia, no prior percutaneous coronary intervention, cardiac biomarker elevation, ST-segment deviation >/=1 mm, and treatment with heparin plus GPI versus bivalirudin monotherapy. Patients with major bleeding had higher 30-day rates of mortality (7.3% vs. 1.2%, p < 0.0001), composite ischemia (23.1% vs. 6.8%, p < 0.0001), and stent thrombosis (3.4% vs. 0.6%, p < 0.0001) versus those without major bleeding. Major bleeding was an independent predictor of 30-day mortality (odds ratio 7.55, 95% confidence interval 4.68 to 12.18, p < 0.0001). CONCLUSIONS: Major bleeding is a powerful independent predictor of 30-day mortality in patients with ACS managed invasively. Several factors independently predict major bleeding, including treatment with heparin plus GPI compared with bivalirudin monotherapy. Knowledge of these findings might be useful to reduce bleeding risk and improve outcomes in ACS. FAU - Manoukian, Steven V AU - Manoukian SV AD - Department of Medicine, Emory University School of Medicine, Atlanta, Georgia 30308, USA. steven.manoukian@emory.edu FAU - Feit, Frederick AU - Feit F FAU - Mehran, Roxana AU - Mehran R FAU - Voeltz, Michele D AU - Voeltz MD FAU - Ebrahimi, Ramin AU - Ebrahimi R FAU - Hamon, Martial AU - Hamon M FAU - Dangas, George D AU - Dangas GD FAU - Lincoff, A Michael AU - Lincoff AM FAU - White, Harvey D AU - White HD FAU - Moses, Jeffrey W AU - Moses JW FAU - King, Spencer B 3rd AU - King SB 3rd FAU - Ohman, E Magnus AU - Ohman EM FAU - Stone, Gregg W AU - Stone GW LA - eng PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20070309 PL - United States TA - J Am Coll Cardiol JT - Journal of the American College of Cardiology JID - 8301365 RN - 9005-49-6 (Heparin) SB - IM MH - Acute Disease MH - Adult MH - Aged MH - Aged, 80 and over MH - Coronary Disease/drug therapy/*mortality/physiopathology MH - Female MH - Hemorrhage/*mortality/physiopathology MH - Heparin/adverse effects MH - Humans MH - Male MH - Middle Aged MH - Syndrome MH - Time Factors MH - Treatment Outcome EDAT- 2007/03/31 09:00 MHDA- 2007/05/01 09:00 CRDT- 2007/03/31 09:00 PHST- 2007/02/10 00:00 [received] PHST- 2007/02/26 00:00 [revised] PHST- 2007/02/26 00:00 [accepted] PHST- 2007/03/31 09:00 [pubmed] PHST- 2007/05/01 09:00 [medline] PHST- 2007/03/31 09:00 [entrez] AID - S0735-1097(07)00663-8 [pii] AID - 10.1016/j.jacc.2007.02.027 [doi] PST - ppublish SO - J Am Coll Cardiol. 2007 Mar 27;49(12):1362-8. doi: 10.1016/j.jacc.2007.02.027. Epub 2007 Mar 9. PMID- 17391900 OWN - NLM STAT- MEDLINE DCOM- 20070524 LR - 20131121 IS - 0741-5214 (Print) IS - 0741-5214 (Linking) VI - 45 IP - 5 DP - 2007 May TI - Refinement of survival prediction in patients undergoing lower extremity bypass surgery: stratification by chronic kidney disease classification. PG - 944-52 AB - OBJECTIVE: End-stage renal disease (ESRD) imparts a significant survival disadvantage to individuals undergoing lower extremity revascularization; however, the influence of lesser degrees of renal impairment remains unclear. This study examined the prognostic significance of the chronic kidney disease (CKD) classification on survival, limb salvage, and graft patency in patients undergoing lower extremity arterial reconstruction. METHODS: A prospective registry was evaluated for consecutive patients between January 31, 1995, and December 21, 2004, undergoing first-time, lower extremity vein bypass surgery. Glomerular filtration rate (GFR) was estimated with the Modification of Diet in Renal Disease equation using each patient's preoperative creatinine concentration. CKD categories were taken from current National Kidney Foundation Kidney Disease Outcomes Quality Initiative staging criteria. RESULTS: The cohort included 456 subjects, with a mean (+/- SD) age of 68.1 +/- 10.8 years. There were 274 men (60%) and 378 Caucasians (82.5%). Comorbidities included diabetes mellitus in 270 (59.0%), hypertension in 333 (72.7%), coronary artery disease in 242 (52.8%), and dyslipidemia in 203 (44.5%). The surgical indication was critical limb ischemia in 384 (83.8%). Among the variables examined, diabetes and critical ischemia as the indication for bypass were significantly skewed toward higher CKD classifications (P < .001). The 5-year survival rates by CKD class were, CKD 1 and 2, 57%; CKD 3, 46%; CKD 4, 23%; and CKD 5, 9.5%. On univariate analysis, age, coronary artery disease, diabetes mellitus, hypertension, critical ischemia, and CKD were significant predictors of mortality. After adjustment, however, only age (hazard ratio [HR], 1.05, 95% confidence interval [CI], 1.03 to 1.06) and CKD stages 4 (HR, 4.23; 95% CI, 2.04 to 8.75) and 5 (HR, 3.27; 95% CI, 1.96 to 5.45) retained significance. Subjects within the CKD 5 classification were more likely to have a major amputation (P = .018) compared with all other CKD classes. Notably, no relationship was detected between CKD category and graft patency. CONCLUSION: CKD staging adequately differentiates survival curves and risk for major amputation among patients with renal impairment who are undergoing lower extremity bypass surgery. This may help in clinical decision analysis as well as in the refinement of stratification in future clinical trial design where survival is an end point. FAU - Owens, Christopher D AU - Owens CD AD - Division of Vascular Surgery, Brigham and Women's Hospital, Boston, MA 02115, USA. FAU - Ho, Karen J AU - Ho KJ FAU - Kim, Sang AU - Kim S FAU - Schanzer, Andres AU - Schanzer A FAU - Lin, Julie AU - Lin J FAU - Matros, Evan AU - Matros E FAU - Belkin, Michael AU - Belkin M FAU - Conte, Michael S AU - Conte MS LA - eng PT - Journal Article DEP - 20070328 PL - United States TA - J Vasc Surg JT - Journal of vascular surgery JID - 8407742 RN - AYI8EX34EU (Creatinine) SB - IM MH - Aged MH - Comorbidity MH - Creatinine/blood MH - Decision Support Techniques MH - Diabetes Mellitus/physiopathology MH - Female MH - Glomerular Filtration Rate MH - Humans MH - Male MH - Middle Aged MH - Peripheral Vascular Diseases/*epidemiology/*surgery MH - Renal Insufficiency, Chronic/classification/*epidemiology/physiopathology MH - Saphenous Vein/transplantation MH - Vascular Surgical Procedures EDAT- 2007/03/30 09:00 MHDA- 2007/05/26 09:00 CRDT- 2007/03/30 09:00 PHST- 2006/09/27 00:00 [received] PHST- 2007/01/05 00:00 [accepted] PHST- 2007/03/30 09:00 [pubmed] PHST- 2007/05/26 09:00 [medline] PHST- 2007/03/30 09:00 [entrez] AID - S0741-5214(07)00039-0 [pii] AID - 10.1016/j.jvs.2007.01.025 [doi] PST - ppublish SO - J Vasc Surg. 2007 May;45(5):944-52. doi: 10.1016/j.jvs.2007.01.025. Epub 2007 Mar 28. PMID- 17387132 OWN - NLM STAT- MEDLINE DCOM- 20070425 LR - 20260128 IS - 1538-3598 (Electronic) IS - 0098-7484 (Linking) VI - 297 IP - 15 DP - 2007 Apr 18 TI - Effect of tilarginine acetate in patients with acute myocardial infarction and cardiogenic shock: the TRIUMPH randomized controlled trial. PG - 1657-66 AB - CONTEXT: Cardiogenic shock complicating acute myocardial infarction (MI) remains a common and lethal disorder despite aggressive use of early revascularization. Systemic inflammation, including expression of inducible nitric oxide synthase (NOS) and generation of excess nitric oxide, is believed to contribute to the pathogenesis and inappropriate vasodilatation of persistent cardiogenic shock. Preliminary, single-center studies suggested a beneficial effect of NOS inhibition on hemodynamics, renal function, and survival in patients with cardiogenic shock. OBJECTIVE: To examine the effects of an isoform-nonselective NOS inhibitor in patients with MI and refractory cardiogenic shock despite establishment of an open infarct artery. DESIGN, SETTING, AND PATIENTS: International, multicenter, randomized, double-blind, placebo-controlled trial (Tilarginine Acetate Injection in a Randomized International Study in Unstable MI Patients With Cardiogenic Shock [TRIUMPH]) with planned enrollment of 658 patients at 130 centers. Participants were enrolled between January 2005 and August 2006 when the study was terminated early. INTERVENTION: Tilarginine (L-N(G)-monomethylarginine [L-NMMA]), 1-mg/kg bolus and 1-mg/kg per hour 5-hour infusion, vs matching placebo. MAIN OUTCOME MEASURES: The primary outcome was 30-day all-cause mortality among patients who received study medication. Secondary outcomes included shock resolution and duration, New York Heart Association (NYHA) functional class at 30 days, and 6-month mortality. RESULTS: Enrollment was terminated at 398 patients based on a prespecified futility analysis. Six-month follow-up was completed in February 2007. There was no difference in 30-day all-cause mortality between patients who received tilarginine (97/201 [48%]) vs placebo (76/180 [42%]) (risk ratio, 1.14; 95% confidence interval, 0.92-1.41; P = .24). Resolution of shock (133/201 [66%] tilarginine vs 110/180 [61%] placebo; P = .31) and duration of shock (median, 156 [interquartile range, 78-759] hours tilarginine vs 190 [100-759] placebo; P = .16) were similar. At 30 days a similar percentage of patients had heart failure (48% tilarginine vs 51% placebo; P = .51) with a similar percentage of those patients in NYHA class I/II (73% tilarginine vs 75% placebo; P = .27). After 6 months mortality rates were similar in the 2 groups (58% tilarginine vs 59% placebo; hazard ratio, 1.04; 95% confidence interval, 0.79-1.36; P = .80). CONCLUSIONS: Tilarginine, 1-mg/kg bolus and 5-hour infusion, did not reduce mortality rates in patients with refractory cardiogenic shock complicating MI despite an open infarct artery. Early mortality rates in this patient group are high. Further research is needed to develop effective therapies for patients with cardiogenic shock following acute MI. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00112281 CN - TRIUMPH Investigators AD - Duke University, Durham, NC, USa. FAU - Alexander, John H AU - Alexander JH FAU - Reynolds, Harmony R AU - Reynolds HR FAU - Stebbins, Amanda L AU - Stebbins AL FAU - Dzavik, Vladimir AU - Dzavik V FAU - Harrington, Robert A AU - Harrington RA FAU - Van de Werf, Frans AU - Van de Werf F FAU - Hochman, Judith S AU - Hochman JS LA - eng SI - ClinicalTrials.gov/NCT00112281 PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20070326 PL - United States TA - JAMA JT - JAMA JID - 7501160 RN - 94ZLA3W45F (Arginine) RN - 0 (Enzyme Inhibitors) RN - EC 1.14.13.39 (Nitric Oxide Synthase) RN - 0 (Protein Isoforms) RN - 0 (Vasoconstrictor Agents) RN - 0 (N(G)-monomethylarginine acetate) RN - 27JT06E6GR (omega-N-Methylarginine) SB - IM CIN - JAMA. 2007 Apr 18;297(15):1711-3. doi: 10.1001/jama.297.15.1711. PMID: 17440148 CIN - JAMA. 2007 Sep 5;298(9):971-2; author reply 972-3. doi: 10.1001/jama.298.9.971-b. PMID: 17785640 CIN - JAMA. 2007 Sep 5;298(9):971; author reply 972-3. doi: 10.1001/jama.298.9.971-a. PMID: 17785641 MH - Aged MH - Arginine/adverse effects/*analogs & derivatives/therapeutic use MH - Blood Pressure MH - Double-Blind Method MH - Enzyme Inhibitors/adverse effects/*therapeutic use MH - Female MH - Humans MH - Kaplan-Meier Estimate MH - Male MH - Middle Aged MH - Myocardial Infarction/*drug therapy MH - Nitric Oxide Synthase/*antagonists & inhibitors MH - Prospective Studies MH - Protein Isoforms MH - Shock, Cardiogenic/*drug therapy MH - Vascular Patency MH - Vasoconstrictor Agents/adverse effects/*therapeutic use MH - omega-N-Methylarginine EDAT- 2007/03/28 09:00 MHDA- 2007/04/26 09:00 CRDT- 2007/03/28 09:00 PHST- 2007/03/28 09:00 [pubmed] PHST- 2007/04/26 09:00 [medline] PHST- 2007/03/28 09:00 [entrez] AID - 297.15.joc70035 [pii] AID - 10.1001/jama.297.15.joc70035 [doi] PST - ppublish SO - JAMA. 2007 Apr 18;297(15):1657-66. doi: 10.1001/jama.297.15.joc70035. Epub 2007 Mar 26. PMID- 17377860 OWN - NLM STAT- MEDLINE DCOM- 20070824 LR - 20151119 IS - 0171-6425 (Print) IS - 0171-6425 (Linking) VI - 55 IP - 2 DP - 2007 Mar TI - Leukodepletion improves renal function in patients with renal dysfunction undergoing on-pump coronary bypass surgery: a prospective randomized study. PG - 89-93 AB - BACKGROUND: We aimed to show the impact of leukodepletion on renal function in patients undergoing on-pump coronary revascularization. PATIENTS AND METHODS: Fifty patients awaiting elective on-pump coronary revascularization with normal preoperative cardiac functions and with plasma creatinine levels ranging between 1.5 and 2.0 mg/dL were prospectively randomized into two groups: on-pump CABG with (group A: n = 25) and without leukodepletion (group B, n = 25). Renal glomerular and tubular injury were assessed by urinary alpha glutathione s-transferase (GST), plasma creatinine, and blood urea nitrogen (BUN) levels. RESULTS: The patients consisted of 14 females and 36 males with a mean age of 57.6 +/- 5.3 years. In the leukodepletion group, the mean levels of creatinine, BUN and urinary GST were found to be decreased on the first, third and fifth postoperative days compared with the control group. There was no mortality. Three patients in the control group needed postoperative dialysis. CONCLUSION: Patients with renal dysfunction undergoing on-pump CABG surgery seem to benefit from leukodepletion as a measure to prevent tubular damage and renal impairment compared with a control group. FAU - Bolcal, C AU - Bolcal C AD - Department of Cardiovascular Surgery, Gulhane Military Medical Academy, Ankara, Turkey. FAU - Akay, H T AU - Akay HT FAU - Bingol, H AU - Bingol H FAU - Doganci, S AU - Doganci S FAU - Yildirim, V AU - Yildirim V FAU - Yenicesu, M AU - Yenicesu M FAU - Demirkilic, U AU - Demirkilic U FAU - Tatar, H AU - Tatar H LA - eng PT - Journal Article PT - Randomized Controlled Trial PL - Germany TA - Thorac Cardiovasc Surg JT - The Thoracic and cardiovascular surgeon JID - 7903387 RN - 0 (Biomarkers) RN - 0 (Isoenzymes) RN - AYI8EX34EU (Creatinine) RN - EC 2.5.1.18 (Glutathione Transferase) RN - EC 2.5.1.18 (glutathione S-transferase alpha) RN - RWP5GA015D (Potassium) SB - IM MH - Acute Kidney Injury/epidemiology/etiology/metabolism/physiopathology/*prevention & control MH - Aged MH - Analysis of Variance MH - Biomarkers/blood/urine MH - Blood Urea Nitrogen MH - *Coronary Artery Bypass/methods MH - Coronary Disease/*surgery MH - Creatinine/blood MH - Female MH - Glutathione Transferase/urine MH - Humans MH - Incidence MH - Isoenzymes/urine MH - *Leukocyte Reduction Procedures MH - Male MH - Middle Aged MH - Postoperative Period MH - Potassium/blood MH - Prospective Studies MH - Renal Dialysis MH - Research Design MH - Treatment Outcome MH - Turkey MH - Water-Electrolyte Balance EDAT- 2007/03/23 09:00 MHDA- 2007/08/25 09:00 CRDT- 2007/03/23 09:00 PHST- 2007/03/23 09:00 [pubmed] PHST- 2007/08/25 09:00 [medline] PHST- 2007/03/23 09:00 [entrez] AID - 10.1055/s-2006-924571 [doi] PST - ppublish SO - Thorac Cardiovasc Surg. 2007 Mar;55(2):89-93. doi: 10.1055/s-2006-924571. PMID- 17366357 OWN - NLM STAT- MEDLINE DCOM- 20070614 LR - 20101118 IS - 0022-9032 (Print) IS - 0022-9032 (Linking) VI - 65 IP - 2 DP - 2007 Feb TI - Characteristics of patients with coronary artery disease managed on an outpatient basis in the population of Poland. Results of the multicentre RECENT trial. PG - 132-40; discussion 141-2 AB - INTRODUCTION: Comprehension of clinical characteristics and therapeutic methods in patients with coronary artery disease (CAD) is mandatory for the introduction of successful prevention. AIM: The aim of the multicentre RECENT trial carried out in Poland in 2005 was to gather comprehensive information regarding individuals with CAD treated by specialists as well as by general practitioners on an outpatient basis. In this report, clinical characteristics of the Polish patient population with confirmed CAD are presented. METHODS: A representative group of 215 general practitioners and 67 specialists participated in this study. They collected information about 2593 patients with CAD and filled-in a specially designed questionnaire. RESULTS: Coronary artery disease was confirmed predominantly based on a history of myocardial infarction (50.1%), followed by positive electrocardiographic stress test (38.8%), history of typical angina in subjects at the age of >60 years (36.4%), history of previous acute coronary syndrome (29.0%), PCI (22.1%) or CABG (14.3%) or positive coronary angiography (17.6%). In patients with diagnosed stable CAD, 44.6% were women and the mean age was 65.0+/-9.8 years. Among patients with a history of hypertension (78.0%), only 34.0% had blood pressure within the normal range. History of dyslipidaemia was positive in 57.6% of patients. Normal LDL cholesterol concentrations (<3.36 mmol/L) were found in 56.7% of patients. A family history of CAD had 17.3% of subjects, 23.5% had previously detected diabetes mellitus and 11.0% were active smokers at the time of study enrolment. Overweight or obesity both in men and women was found in 79.3% of patients while metabolic syndrome (diagnosed according to NCEP ATP III criteria) was found in 31.3%. The following comorbidities were detected: 34.3% presented symptoms of congestive heart failure, 32.1% had rhythm or conduction disturbances (most commonly atrial fibrillation--in 19.0% of cases). Previous stroke was noted in 4.7% of patients with CAD and transient ischaemic attack in 5.5%. Peripheral artery disease was observed in 9.9% of CAD patients, whereas asthma or COPD--in 9.0%. CONCLUSIONS: The results of the RECENT trial are representative for the CAD patient population managed on an outpatient basis in our country. They suggest that CAD in the Polish population is rather advanced, and indicate still insufficient use of imaging modalities (particularly coronary angiography) and significant prevalence of risk factors throughout this population. FAU - Banasiak, Waldemar AU - Banasiak W AD - Klinika Kardiologii, Osrodek Chorob Serca, 4. Wojskowy Szpital Kliniczny, ul. Weigla 5, 50-089 Wroclaw. FAU - Pociupany, Robert AU - Pociupany R FAU - Wilkins, Arleta AU - Wilkins A FAU - Ponikowski, Piotr AU - Ponikowski P LA - eng LA - pol PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PL - Poland TA - Kardiol Pol JT - Kardiologia polska JID - 0376352 SB - IM MH - Adult MH - Aged MH - Aged, 80 and over MH - Asthma/epidemiology MH - Comorbidity MH - Coronary Angiography MH - Coronary Artery Disease/*diagnosis/epidemiology MH - Diabetes Mellitus/epidemiology MH - Female MH - Humans MH - Hypercholesterolemia/epidemiology MH - Hypertension/epidemiology MH - Male MH - Middle Aged MH - Myocardial Infarction/*diagnosis/epidemiology MH - Obesity/epidemiology MH - Occupations/statistics & numerical data MH - Outpatients/*statistics & numerical data MH - Poland/epidemiology MH - Prevalence MH - Renal Insufficiency/epidemiology MH - Risk Factors EDAT- 2007/03/17 09:00 MHDA- 2007/06/15 09:00 CRDT- 2007/03/17 09:00 PHST- 2007/03/17 09:00 [pubmed] PHST- 2007/06/15 09:00 [medline] PHST- 2007/03/17 09:00 [entrez] AID - 7567 [pii] PST - ppublish SO - Kardiol Pol. 2007 Feb;65(2):132-40; discussion 141-2. PMID- 17336698 OWN - NLM STAT- MEDLINE DCOM- 20070323 LR - 20220310 IS - 1523-6838 (Electronic) IS - 0272-6386 (Linking) VI - 49 IP - 3 DP - 2007 Mar TI - Simvastatin for secondary prevention of all-cause mortality and major coronary events in patients with mild chronic renal insufficiency. PG - 373-82 AB - BACKGROUND: A potentially modifiable risk factor for cardiovascular disease in patients with mild chronic renal insufficiency is dyslipidemia. Few studies examined the effects of statins on all-cause mortality and major coronary events in patients with renal dysfunction. METHODS: We performed a post hoc analysis from the Randomized Trial of Cholesterol Lowering in 4,444 Patients with Coronary Heart Disease: The Scandinavian Simvastatin Survival Study. Of 4,444 participants, 2,314 (52.1%) had mild chronic renal insufficiency defined as an estimated glomerular filtration rate less than 75 mL/min/1.73 m(2) (<1.25 mL/s), measured using the Modification of Diet in Renal Disease equation. The primary end point was all-cause mortality. RESULTS: During the follow-up period, simvastatin use was associated with decreased all-cause mortality (adjusted hazard ratio [HR], 0.69; confidence interval [CI], 0.54 to 0.89) in the 2,314 participants with mild chronic renal insufficiency. Rates of major coronary events (adjusted HR, 0.67; CI, 0.56 to 0.79) and coronary revascularization (adjusted HR, 0.62; CI, 0.49 to 0.77) also were significantly lower in the simvastatin group. No significant decreases in stroke incidence were observed in the simvastatin group (adjusted HR, 0.88; CI, 0.55 to 1.39). The side-effect profile was similar between the 2 treatment groups. CONCLUSION: Simvastatin therapy appears to be effective and safe for the secondary prevention of all-cause mortality and major coronary events in patients with mild chronic renal dysfunction. FAU - Chonchol, Michel AU - Chonchol M AD - Division of Renal Diseases and Hypertension, University of Colorado Health Sciences Center, Denver, CO 80262, USA. michel.chonchol@uchsc.edu FAU - Cook, Thomas AU - Cook T FAU - Kjekshus, John AU - Kjekshus J FAU - Pedersen, Terje R AU - Pedersen TR FAU - Lindenfeld, JoAnn AU - Lindenfeld J LA - eng PT - Journal Article PT - Randomized Controlled Trial PL - United States TA - Am J Kidney Dis JT - American journal of kidney diseases : the official journal of the National Kidney Foundation JID - 8110075 RN - 0 (Anticholesteremic Agents) RN - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors) RN - AGG2FN16EV (Simvastatin) SB - IM MH - Adult MH - Aged MH - Anticholesteremic Agents/adverse effects/*therapeutic use MH - Coronary Disease/mortality/*prevention & control MH - Double-Blind Method MH - Dyslipidemias/complications/*drug therapy MH - Female MH - Humans MH - Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects/therapeutic use MH - Male MH - Middle Aged MH - Myocardial Infarction/mortality/*prevention & control MH - Odds Ratio MH - Renal Insufficiency, Chronic/*complications/mortality MH - Risk Factors MH - Scandinavian and Nordic Countries MH - Simvastatin/adverse effects/*therapeutic use EDAT- 2007/03/06 09:00 MHDA- 2007/03/24 09:00 CRDT- 2007/03/06 09:00 PHST- 2006/07/19 00:00 [received] PHST- 2006/11/27 00:00 [accepted] PHST- 2007/03/06 09:00 [pubmed] PHST- 2007/03/24 09:00 [medline] PHST- 2007/03/06 09:00 [entrez] AID - S0272-6386(06)01837-3 [pii] AID - 10.1053/j.ajkd.2006.11.043 [doi] PST - ppublish SO - Am J Kidney Dis. 2007 Mar;49(3):373-82. doi: 10.1053/j.ajkd.2006.11.043. PMID- 17258568 OWN - NLM STAT- MEDLINE DCOM- 20070223 LR - 20161124 IS - 1097-685X (Electronic) IS - 0022-5223 (Linking) VI - 133 IP - 2 DP - 2007 Feb TI - Coronary artery bypass grafting with or without cardiopulmonary bypass in patients with preoperative non-dialysis dependent renal insufficiency: a randomized study. PG - 378-88 AB - OBJECTIVE: Preoperative renal insufficiency is a predictor of acute renal failure in patients undergoing coronary artery revascularization with cardiopulmonary bypass. Off-pump coronary artery bypass grafting has been shown to be less deleterious than on-pump bypass in patients with normal renal function, but the effect of this technique in patients with non-dialysis dependent renal insufficiency in a randomized study is unknown. METHODS: From August 2004 through October 2005, 116 consecutive patients with preoperative non-dialysis-dependent renal insufficiency (glomerular filtration rate measured using the Modification of Diet in Renal Disease equation [MDRD GFR] < or = 60 mL x min(-1) x 1.73 m(-2)) undergoing primary coronary artery bypass grafting were randomized to on-pump (n = 60) and off-pump (n = 56) groups. MDRD GFR and serum creatinine levels were measured preoperatively and postoperatively at days 1 and 5. The changes in renal function and clinical outcomes were compared between the two groups. RESULTS: Preoperative characteristics were comparable between the two groups. The repeated-measures analysis of variance was performed on the data that showed worsening of renal function in the on-pump group compared with the off-pump group (serum creatinine, P < .000; glomerular filtration rate, P < .000). Further analysis of subgroups of patients with diabetes alone, hypertension alone, and combined hypertension and diabetes also showed significant deterioration renal function in the on-pump group compared with the off-pump group. In covariate analysis, diabetes has emerged as a significant covariate by serum creatinine criteria while compromised left ventricular function has emerged as a significant covariate by glomerular filtration rate criteria. These analyses showed that the use of cardiopulmonary bypass is significantly associated with adverse renal outcome (P < .000). Three patents required hemodialysis in the on-pump group and none in the off-pump group. The mean number of grafts per patient was 3.85 +/- 0.86 and 3.11 +/- 0.89 in the on-pump and off-pump groups, respectively (P < .001), but the indices of completeness of revascularization, 1.00 +/- 0.08 for off-pump coronary bypass and 1.01 +/- 0.08 for on-pump coronary bypass, were similar (P = .60). CONCLUSIONS: This study suggests that on-pump as compared with off-pump coronary artery bypass grafting is more deleterious to renal function in diabetic patients with non-dialysis dependent renal insufficiency. MDRD GFR is a more sensitive investigation than serum creatinine levels to assess renal insufficiency in patients undergoing coronary bypass. FAU - Sajja, Lokeswara Rao AU - Sajja LR AD - Division of Cardiothoracic Surgery, CARE Hospital, The Institute of Medical Sciences, Hyderabad, India. FAU - Mannam, Gopichand AU - Mannam G FAU - Chakravarthi, Rajasekara M AU - Chakravarthi RM FAU - Sompalli, Sriramulu AU - Sompalli S FAU - Naidu, Shanti K AU - Naidu SK FAU - Somaraju, Bhupathiraju AU - Somaraju B FAU - Penumatsa, Raghava Raju AU - Penumatsa RR LA - eng PT - Journal Article PT - Randomized Controlled Trial DEP - 20070116 PL - United States TA - J Thorac Cardiovasc Surg JT - The Journal of thoracic and cardiovascular surgery JID - 0376343 SB - IM MH - Aged MH - Analysis of Variance MH - Cardiopulmonary Bypass/*methods MH - Comorbidity MH - Coronary Angiography MH - Coronary Artery Bypass/*methods/mortality MH - Coronary Artery Bypass, Off-Pump/methods/mortality MH - Coronary Disease/diagnostic imaging/epidemiology/*surgery MH - Female MH - Follow-Up Studies MH - Glomerular Filtration Rate MH - Humans MH - Male MH - Middle Aged MH - Preoperative Care MH - Probability MH - Renal Dialysis MH - Renal Insufficiency, Chronic/*diagnosis/epidemiology/therapy MH - Risk Assessment MH - Severity of Illness Index MH - Stroke Volume/physiology MH - Survival Rate EDAT- 2007/01/30 09:00 MHDA- 2007/02/24 09:00 CRDT- 2007/01/30 09:00 PHST- 2006/04/11 00:00 [received] PHST- 2006/08/19 00:00 [revised] PHST- 2006/09/28 00:00 [accepted] PHST- 2007/01/30 09:00 [pubmed] PHST- 2007/02/24 09:00 [medline] PHST- 2007/01/30 09:00 [entrez] AID - S0022-5223(06)01762-4 [pii] AID - 10.1016/j.jtcvs.2006.09.028 [doi] PST - ppublish SO - J Thorac Cardiovasc Surg. 2007 Feb;133(2):378-88. doi: 10.1016/j.jtcvs.2006.09.028. Epub 2007 Jan 16. PMID- 17257990 OWN - NLM STAT- MEDLINE DCOM- 20070306 LR - 20161124 IS - 1552-6259 (Electronic) IS - 0003-4975 (Linking) VI - 83 IP - 2 DP - 2007 Feb TI - Bivalirudin during cardiopulmonary bypass in patients with previous or acute heparin-induced thrombocytopenia and heparin antibodies: results of the CHOOSE-ON trial. PG - 572-7 AB - BACKGROUND: The coronary artery bypass grafting (CABG) heparin-induced thrombocytopenia thrombosis syndrome (HITTS) on- and off-pump safety and efficacy (CHOOSE-ON) trial was designed as a safety and efficacy trial of bivalirudin for use in anticoagulation during cardiopulmonary bypass (CPB) in patients with confirmed or suspected HIT and (or) antiplatelet factor 4/heparin (anti-PF4/H) antibodies. METHODS: In an open-label, multicenter trial, 50 patients were enrolled prospectively. The primary study endpoint was in-hospital acute procedural success, defined as the absence of death, Q-wave myocardial infarction (MI), repeat operation for coronary revascularization, and stroke at day seven after surgery or hospital discharge, whichever occurred first. The secondary study endpoints were procedural success, defined as the absence of death, Q-wave MI, repeat operation for coronary revascularization, and stroke, at 30 days and 12 weeks after surgery. Perioperative blood loss, transfusions, and the incidence of major bleeding events were also captured. RESULTS: There were 49 patients treated with bivalirudin of which 43 had acute HIT and thrombosis syndrome (HITTS) with antibodies at time of surgery. Procedural success in-hospital or at 7 days was achieved in 46 (94%) patients. At day 30 procedural success was achieved in 42 (86%) patients, and after 12 weeks in 40 (82%) patients. Mean intraoperative blood loss was 575 +/- 524 mL, and mean 24-hour postoperative blood loss was 998 +/- 595 mL. Forty-one (84%) patients received transfusions before day 7 or discharge with a mean of 5.6 +/- 3.8 units of red blood cells, 8.6 +/- 7.2 units of platelets, and 6.0 +/- 4.7 units of fresh frozen plasma. No differences in outcome among bivalirudin-treated patients were observed between those in the overall group and those with moderately impaired renal function (n = 10). CONCLUSIONS: The current investigation expands the experience of safe and effective anticoagulation with bivalirudin during CPB to patients with confirmed or suspected HIT and anti-PF4/H antibodies, including in the setting of impaired renal function. FAU - Koster, Andreas AU - Koster A AD - Department of Anesthesia, Deutsches Herzzentrum Berlin, Germany. koster@dhzb.de FAU - Dyke, Cornelius M AU - Dyke CM FAU - Aldea, Gabriel AU - Aldea G FAU - Smedira, Nicholas G AU - Smedira NG FAU - McCarthy, Harry L 2nd AU - McCarthy HL 2nd FAU - Aronson, Solomon AU - Aronson S FAU - Hetzer, Roland AU - Hetzer R FAU - Avery, Edwin AU - Avery E FAU - Spiess, Bruce AU - Spiess B FAU - Lincoff, A Michael AU - Lincoff AM LA - eng PT - Clinical Trial PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't PL - Netherlands TA - Ann Thorac Surg JT - The Annals of thoracic surgery JID - 15030100R RN - 0 (Antibodies) RN - 0 (Anticoagulants) RN - 0 (Hirudins) RN - 0 (Peptide Fragments) RN - 0 (Recombinant Proteins) RN - 9005-49-6 (Heparin) RN - TN9BEX005G (bivalirudin) SB - IM MH - Acute Disease MH - Aged MH - Aged, 80 and over MH - Antibodies/*blood MH - Anticoagulants/*adverse effects/immunology/*therapeutic use MH - Blood Loss, Surgical MH - *Cardiopulmonary Bypass MH - Erythrocyte Transfusion/statistics & numerical data MH - Female MH - Heparin/*adverse effects/immunology/therapeutic use MH - Hirudins MH - Humans MH - Intraoperative Care MH - Male MH - Middle Aged MH - Peptide Fragments/*therapeutic use MH - Recombinant Proteins/therapeutic use MH - Syndrome MH - Thrombocytopenia/*chemically induced/immunology MH - Thrombosis/*chemically induced MH - Time Factors MH - Treatment Outcome EDAT- 2007/01/30 09:00 MHDA- 2007/03/07 09:00 CRDT- 2007/01/30 09:00 PHST- 2006/07/06 00:00 [received] PHST- 2006/09/08 00:00 [revised] PHST- 2006/09/11 00:00 [accepted] PHST- 2007/01/30 09:00 [pubmed] PHST- 2007/03/07 09:00 [medline] PHST- 2007/01/30 09:00 [entrez] AID - S0003-4975(06)01774-7 [pii] AID - 10.1016/j.athoracsur.2006.09.038 [doi] PST - ppublish SO - Ann Thorac Surg. 2007 Feb;83(2):572-7. doi: 10.1016/j.athoracsur.2006.09.038. PMID- 17197706 OWN - NLM STAT- MEDLINE DCOM- 20070209 LR - 20220317 IS - 1557-2501 (Electronic) IS - 1042-3931 (Linking) VI - 18 IP - 12 DP - 2006 Dec TI - Clinical outcomes following percutaneous coronary intervention with drug-eluting vs. bare-metal stents in dialysis patients. PG - 577-83 AB - BACKGROUND: Late mortality among dialysis patients undergoing PCI with bare-metal stents is high. The impact of drug-eluting stent use on outcomes in such patients is unclear. OBJECTIVE: To compare the clinical outcomes of dialysis patients undergoing coronary stenting with versus without the use of drug-eluting stents. METHODS: Baseline features and outcomes were compared in dialysis patients undergoing coronary stent implantation using either bare-metal devices only (n = 41) or drug-eluting stents (n = 33), in recruitment waves 3 (2001-2002; n = 2,047) and 4 (2004; n = 2,112) of the National Heart Lung, and Blood Institute Dynamic Registry. The primary study endpoint was the composite of major adverse cardiac events (MACE), defined as death, myocardial infarction (MI) or any repeat revascularization procedure at 1-year follow up. RESULTS: Baseline and procedural features and in-hospital MACE rates were similar in both groups. Cumulative 1-year rates of the composite MACE endpoint and all-cause mortality were lower in patients treated with drug-eluting versus bare-metal stents (25.2% vs. 57.3%; p = 0.01, and 18.4% and 36.8%, respectively; p = 0.09). By multivariable analysis, drug-eluting versus bare-metal stent use was independently associated with freedom from the composite MACE endpoint (hazard ratio = 0.24, 95% CI [0.10-0.60]; p = 0.002) and with a trend to lower all-cause mortality (HR = 0.40 [0.15-1.05]; p = 0.06) at 1 year. CONCLUSION: In this cohort of dialysis patients undergoing percutaneous coronary intervention (PCI), drug-eluting versus bare-metal stent implantation was associated with enhanced freedom from 1-year MACE. Given previous bare-metal stent data indicating worse outcomes after PCI than after bypass surgery in dialysis patients, randomized trials comparing these strategies in the drug-eluting stent era are needed. FAU - Halkin, Amir AU - Halkin A AD - Interventional Cardiology Department, Lenox Hill Hospital, New York, NY 10021, USA. ahalkin@netvision.net.il FAU - Selzer, Faith AU - Selzer F FAU - Marroquin, Oscar AU - Marroquin O FAU - Laskey, Warren AU - Laskey W FAU - Detre, Katherine AU - Detre K FAU - Cohen, Howard AU - Cohen H LA - eng PT - Comparative Study PT - Journal Article PL - United States TA - J Invasive Cardiol JT - The Journal of invasive cardiology JID - 8917477 RN - 0 (Immunosuppressive Agents) SB - IM MH - Aged MH - Angioplasty, Balloon, Coronary/methods/*mortality MH - Coronary Artery Disease/*mortality/*therapy MH - Coronary Restenosis/mortality MH - Drug Delivery Systems MH - Female MH - Humans MH - Immunosuppressive Agents/therapeutic use MH - Kidney Failure, Chronic/*mortality/therapy MH - Male MH - Middle Aged MH - Prospective Studies MH - Registries/statistics & numerical data MH - Renal Dialysis MH - Risk Factors MH - Stents/standards/*statistics & numerical data MH - Survival Analysis MH - Treatment Outcome EDAT- 2007/01/02 09:00 MHDA- 2007/02/10 09:00 CRDT- 2007/01/02 09:00 PHST- 2007/01/02 09:00 [pubmed] PHST- 2007/02/10 09:00 [medline] PHST- 2007/01/02 09:00 [entrez] PST - ppublish SO - J Invasive Cardiol. 2006 Dec;18(12):577-83. PMID- 17174634 OWN - NLM STAT- MEDLINE DCOM- 20070125 LR - 20181201 IS - 1097-6744 (Electronic) IS - 0002-8703 (Linking) VI - 153 IP - 1 DP - 2007 Jan TI - Risk stratification for patients undergoing nonurgent percutaneous coronary intervention using N-terminal pro-B-type natriuretic peptide: a Clopidogrel for the Reduction of Events During Observation (CREDO) substudy. PG - 36-41 AB - BACKGROUND: The utility of N-terminal pro-BNP (NT-proBNP) measurement as a prognostic marker during nonurgent percutaneous coronary intervention (PCI) has been suggested in several studies. The comparative prognostic values between NT-proBNP levels and left ventricular ejection fraction (LVEF) in the nonurgent PCI setting are unclear. METHODS: CREDO was a double blind, placebo-controlled, randomized trial comparing 2 clopidogrel regimens before and after nonurgent PCI. Baseline NT-proBNP levels and LVEF were measured in 1468 subjects using the Roche Elecsys proBNP assay (Roche Diagnostics, Indianapolis, IN), and the 1-year combined end point of death/myocardial infarction (MI)/stroke was analyzed according to NT-proBNP quartiles in impaired and preserved LVEF. RESULTS: In this patient cohort (mean age 61.6 +/- 10 years, 22% with LVEF < 50%), the median NT-proBNP level was 131 pg/mL. Increasing quartiles of NT-proBNP were associated with a higher rate of death, MI, and the combined end point (but not stroke) at 1 year, including those with LVEF > or = 50% (P < .001 for trend). This prognostic power for death and MI remained robust even when adjusted for other clinical or biochemical markers including cardiac troponin, creatinine clearance, and high-sensitive C-reactive protein (hazard ratio 1.249, P = .006). Despite its robust prognostic value, baseline NT-proBNP levels did not identify patients with enhanced benefit from pre-procedural and prolonged clopidogrel therapy. CONCLUSIONS: In patients undergoing a nonurgent PCI, NT-proBNP levels may provide important prognostic value for death and MI, even in patients with preserved cardiac function, However, NT-proBNP levels were unable to identify patients with enhanced benefit from pre-procedural and prolonged clopidogrel therapy. FAU - Tang, W H Wilson AU - Tang WH AD - Department of Cardiovascular Medicine, The Cleveland Clinic, Cleveland, OH 44195, USA. tangw@ccf.org FAU - Steinhubl, Steven R AU - Steinhubl SR FAU - Van Lente, Frederick AU - Van Lente F FAU - Brennan, Danielle AU - Brennan D FAU - McErlean, Ellen AU - McErlean E FAU - Maroo, Anjli AU - Maroo A FAU - Francis, Gary S AU - Francis GS FAU - Topol, Eric J AU - Topol EJ LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 RN - 0 (Peptide Fragments) RN - 0 (Platelet Aggregation Inhibitors) RN - 0 (pro-brain natriuretic peptide (1-76)) RN - 114471-18-0 (Natriuretic Peptide, Brain) RN - A74586SNO7 (Clopidogrel) RN - OM90ZUW7M1 (Ticlopidine) SB - IM MH - Aged MH - *Angioplasty, Balloon, Coronary MH - Clopidogrel MH - Coronary Disease/*blood/drug therapy/*mortality/therapy MH - Female MH - Humans MH - Male MH - Middle Aged MH - Multicenter Studies as Topic MH - Multivariate Analysis MH - Myocardial Infarction/epidemiology MH - Natriuretic Peptide, Brain/*blood MH - Peptide Fragments/*blood MH - Platelet Aggregation Inhibitors/therapeutic use MH - Prognosis MH - Randomized Controlled Trials as Topic MH - Risk Assessment MH - Stroke Volume MH - Survival Analysis MH - Ticlopidine/analogs & derivatives/therapeutic use EDAT- 2006/12/19 09:00 MHDA- 2007/01/26 09:00 CRDT- 2006/12/19 09:00 PHST- 2006/05/14 00:00 [received] PHST- 2006/10/09 00:00 [accepted] PHST- 2006/12/19 09:00 [pubmed] PHST- 2007/01/26 09:00 [medline] PHST- 2006/12/19 09:00 [entrez] AID - S0002-8703(06)00903-3 [pii] AID - 10.1016/j.ahj.2006.10.011 [doi] PST - ppublish SO - Am Heart J. 2007 Jan;153(1):36-41. doi: 10.1016/j.ahj.2006.10.011. PMID- 17174559 OWN - NLM STAT- MEDLINE DCOM- 20070416 LR - 20151119 IS - 1010-7940 (Print) IS - 1010-7940 (Linking) VI - 31 IP - 2 DP - 2007 Feb TI - The effect of sodium nitroprusside infusion on renal function during reperfusion period in patients undergoing coronary artery bypass grafting: a prospective randomized clinical trial. PG - 290-7 AB - OBJECTIVE: Acute renal failure remains a common and serious complication of cardiac surgery. In this randomized trial, we aimed to assess whether sodium nitroprusside (SNP) infusion during cardiopulmonary bypass (CPB) could prevent renal dysfunction after coronary artery bypass grafting (CABG) surgery. METHODS: Between October 2004 and May 2006, 240 consecutive patients with stable angina undergoing elective CABG for multi-vessel coronary artery disease were prospectively randomized into control (n=116, 72 men, mean age 61.3+/-9.7 years) or SNP groups (n=124, 81 men, 60.8+/-10.8 years). SNP group received SNP after initiation of rewarming period during CPB at a dose of 0.1mg/kg/h and the infusion was concluded by weaning from CPB. The anesthetic and CPB regimes were standardized. Blood urea nitrogen (BUN), serum creatinine (SCr), estimated glomerular filtration rate (eGFR), creatinine clearance (C(Cr)), urine output, serum cardiac specific troponin I (cTnI), creatine kinase cardiac isoenzyme (CKMB), and CPK were measured preoperatively and daily until day 5 after surgery. RESULTS: There were no differences in baseline levels of BUN, SCr, eGFR, C(Cr), cTnI, CKMB, CPK levels and EuroSCORES between the groups. Although the durations of cross clamp, CPB times, and postoperative cardiac enzymes were similar in both groups; in the control group, there was a significantly lower urine excretion during CPB (p=0.002) and the operation (p=0.041). Peak postoperative SCr levels were significantly (p=0.001) lower in the SNP group than in the control group (1.29+/-0.28 vs 1.42+/-0.34mg/dl). The incidence of >or=50%DeltaSCr was significantly higher in the control group when compared with the SNP group (35.3 vs 13.7%, p<0.001). Development of new C(Cr) less than 50ml/min postoperatively was significantly higher in the control group compared with the SNP group (14 vs 38%, p<0.001). CONCLUSION: SNP administration during rewarming period of non-pulsatile CPB in patients undergoing CABG surgery is associated with improved renal function compared with conventional medical treatment providing adequate preload and mean arterial pressures. FAU - Kaya, Kaan AU - Kaya K AD - Division of Cardiovascular Surgery, Umut Heart Hospital, Ankara, Turkey. FAU - Oguz, Mehmet AU - Oguz M FAU - Akar, Ahmet Ruchan AU - Akar AR FAU - Durdu, Serkan AU - Durdu S FAU - Aslan, Alp AU - Aslan A FAU - Erturk, Sebnem AU - Erturk S FAU - Tasoz, Refik AU - Tasoz R FAU - Ozyurda, Umit AU - Ozyurda U LA - eng PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20061215 PL - Germany TA - Eur J Cardiothorac Surg JT - European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery JID - 8804069 RN - 0 (Biomarkers) RN - 0 (Vasodilator Agents) RN - 169D1260KM (Nitroprusside) RN - AYI8EX34EU (Creatinine) SB - IM MH - Acute Kidney Injury/etiology/*prevention & control MH - Aged MH - Biomarkers/blood MH - Cardiopulmonary Bypass MH - Coronary Artery Bypass/*adverse effects MH - Coronary Disease/surgery MH - Creatinine/blood MH - Female MH - Glomerular Filtration Rate/drug effects MH - Humans MH - Kidney/blood supply MH - Male MH - Middle Aged MH - Nitroprusside/*therapeutic use MH - Prospective Studies MH - Reperfusion Injury/prevention & control MH - Treatment Outcome MH - Vasodilator Agents/*therapeutic use EDAT- 2006/12/19 09:00 MHDA- 2007/04/17 09:00 CRDT- 2006/12/19 09:00 PHST- 2006/08/24 00:00 [received] PHST- 2006/10/27 00:00 [revised] PHST- 2006/11/14 00:00 [accepted] PHST- 2006/12/19 09:00 [pubmed] PHST- 2007/04/17 09:00 [medline] PHST- 2006/12/19 09:00 [entrez] AID - S1010-7940(06)01033-5 [pii] AID - 10.1016/j.ejcts.2006.11.015 [doi] PST - ppublish SO - Eur J Cardiothorac Surg. 2007 Feb;31(2):290-7. doi: 10.1016/j.ejcts.2006.11.015. Epub 2006 Dec 15. PMID- 17173250 OWN - NLM STAT- MEDLINE DCOM- 20070405 LR - 20250529 IS - 1121-8428 (Print) IS - 1724-6059 (Electronic) IS - 1121-8428 (Linking) VI - 19 IP - 6 DP - 2006 Nov-Dec TI - Relationship of chronic kidney disease to cardiovascular death and myocardial infarction following coronary stenting. PG - 764-70 AB - BACKGROUND: Chronic kidney disease is a risk factor for death in the year following myocardial infarction or coronary angioplasty. Whether the risk is similar after coronary stenting, whether impaired renal function is associated with an increased risk of cardiovascular death or myocardial infarction (MI) after coronary stenting and whether this risk is maintained beyond the first year are uncertain. METHODS: We analyzed the long-term risks of MI or the combination of cardiovascular death and non-fatal MI in patients participating in 4 coronary stenting trials with mandated, prospective long-term follow-up. Cox proportional hazards models were used to adjust for confounding and to generate multivariable odds ratios. RESULTS: Patients (n=1,228) were followed for a median of 5 years. There were 125 MIs and 55 cardiovascular deaths. Patients with a serum creatinine>or=1.3 mg/dL had markedly elevated risks of cardiovascular death and MI that emerged during the first year and were maintained throughout follow-up. The adjusted hazard ratio of MI was 2.14 (p=0.006) while the adjusted hazard ratio of a combined end point of MI or cardiovascular death was 2.13 (p=0.001). The risks were similar in patients with moderate (serum creatinine 1.3-1.9 mg/dL) or advanced chronic kidney disease. CONCLUSIONS: The presence of even mild chronic kidney disease is associated with a high risk of cardiovascular death and MI following coronary stenting. Further research to address the causes of the association and to define the best therapy for these patients is necessary. FAU - Charytan, David M AU - Charytan DM AD - Department of Medicine, Brigham & Women's Hospital, Boston, Massachusetts 02120, USA. dcharytan@partners.org FAU - Kuntz, Richard E AU - Kuntz RE FAU - Chhabra, Amit AU - Chhabra A FAU - Cutlip, Donald E AU - Cutlip DE LA - eng GR - T32 DK007199/DK/NIDDK NIH HHS/United States GR - T32 DK07199-25/DK/NIDDK NIH HHS/United States PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, N.I.H., Extramural PL - England TA - J Nephrol JT - Journal of nephrology JID - 9012268 SB - IM MH - Aged MH - *Death MH - Disease-Free Survival MH - Female MH - Follow-Up Studies MH - Humans MH - Kidney Failure, Chronic/blood/complications/*mortality MH - Male MH - Middle Aged MH - Myocardial Infarction/blood/etiology/*mortality MH - Risk Factors MH - *Stents MH - Survival Rate PMC - PMC4398775 MID - NIHMS14983 EDAT- 2006/12/19 09:00 MHDA- 2007/04/06 09:00 PMCR- 2015/04/16 CRDT- 2006/12/19 09:00 PHST- 2006/12/19 09:00 [pubmed] PHST- 2007/04/06 09:00 [medline] PHST- 2006/12/19 09:00 [entrez] PHST- 2015/04/16 00:00 [pmc-release] PST - ppublish SO - J Nephrol. 2006 Nov-Dec;19(6):764-70. PMID- 17161052 OWN - NLM STAT- MEDLINE DCOM- 20070108 LR - 20131121 IS - 1097-6744 (Electronic) IS - 0002-8703 (Linking) VI - 152 IP - 6 DP - 2006 Dec TI - Early invasive treatment benefits patients with renal dysfunction in unstable coronary artery disease. PG - 1052-8 AB - BACKGROUND: Few studies have investigated the effects of an early revascularization in relation to renal function in patients with unstable coronary artery disease (CAD). METHODS: Patients (n = 2457) with unstable CAD randomized to a noninvasive or invasive treatment strategy in the Fast Revascularisation during InStability in Coronary artery disease (FRISC-II) trial were stratified according to tertiles of creatinine clearance (CrCl < 69 mL/min, CrCl 69-90 mL/min, CrCl > 90 mL/min) and followed for 2 years regarding death and/or myocardial infarction (MI). RESULTS: In the noninvasive cohort, the rate of death or MI at 2 years was 22.4% at CrCl < 69 mL/min, 14.6% at CrCl 60-90 mL/min, and 11.6% at CrCl > 90 mL/min. In the invasive cohort, the rate of death or MI was reduced to 14.6% (P = .003) at CrCl < 69 mL/min and to 9.9% (P = .048) at CrCl 69 to 90 mL/min, but no significant reduction (11.2%) at CrCl > 90 mL/min. In a logistic regression analysis adjusting for other important covariables, CrCl < 69 mL/min remained independently associated with the risk of the combined end point in the noninvasively treated group (odds ratio, 1.96; 95% confidence interval, 1.12-3.42) but not in the invasively treated group (odds ratio, 1.09; 95% confidence interval, 0.56-2.14). When the interaction term for treatment strategy and CrCl group was included in the analysis, the interaction between treatment strategy and CrCl <90 mL/min was independently associated with the risk of future MI (P = .006). CONCLUSION: In unstable CAD, an early invasive treatment strategy reduces the long-term risk of future death and MI in patients with mildly to moderately reduced CrCl. FAU - Johnston, Nina AU - Johnston N AD - Department of Medical Sciences, Cardiology, Cardiothoracic Center, University Hospital, Uppsala, Sweden. nina.johnston@akademiska.se FAU - Jernberg, Tomas AU - Jernberg T FAU - Lagerqvist, Bo AU - Lagerqvist B FAU - Wallentin, Lars AU - Wallentin L LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 RN - AYI8EX34EU (Creatinine) SB - IM MH - Aged MH - *Angioplasty, Balloon, Coronary MH - Cohort Studies MH - *Coronary Artery Bypass MH - Coronary Artery Disease/blood/*complications/mortality/*therapy MH - Creatinine/blood MH - Female MH - Follow-Up Studies MH - Humans MH - Kidney Diseases/*etiology MH - Male MH - Middle Aged MH - Multicenter Studies as Topic MH - Myocardial Infarction/etiology MH - Randomized Controlled Trials as Topic MH - Time Factors EDAT- 2006/12/13 09:00 MHDA- 2007/01/09 09:00 CRDT- 2006/12/13 09:00 PHST- 2006/03/02 00:00 [received] PHST- 2006/07/19 00:00 [accepted] PHST- 2006/12/13 09:00 [pubmed] PHST- 2007/01/09 09:00 [medline] PHST- 2006/12/13 09:00 [entrez] AID - S0002-8703(06)00665-X [pii] AID - 10.1016/j.ahj.2006.07.014 [doi] PST - ppublish SO - Am Heart J. 2006 Dec;152(6):1052-8. doi: 10.1016/j.ahj.2006.07.014. PMID- 17134624 OWN - NLM STAT- MEDLINE DCOM- 20070119 LR - 20220409 IS - 0002-9149 (Print) IS - 0002-9149 (Linking) VI - 98 IP - 10 DP - 2006 Nov 15 TI - Comparison of outcomes of percutaneous coronary interventions in patients of three age groups (<60, 60 to 80, and >80 years) (from the New York State Angioplasty Registry). PG - 1334-9 AB - Octogenarians have been under-represented in percutaneous coronary intervention (PCI) trials despite an increase in referrals for PCI. As the United States population ages, the number of high-risk PCIs in the elderly will continue to increase. This study investigated the effect of age on short-term prognosis after PCI in 3 age groups. Using the 2000/2001 New York State Angioplasty Registry, we compared in-hospital mortality and major adverse cardiac events (MACEs; death, stroke, or coronary artery bypass grafting) in emergency and elective PCI cohorts across 3 age categories of patients: 10,964 patients who underwent emergency PCI (<60 years of age, n = 5,354; 60 to 80 years of age, n = 4,939; >80 years of age, n = 671) and 71,176 patients who underwent elective PCI (<60 years of age, n = 24,525; 60 to 80 years of age, n = 40,869; >80 years of age, n = 5,782). Patients were considered to have undergone an emergency PCI if they had an acute myocardial infarction within 24 hours, had thrombolytic therapy within 7 days, or presented with hemodynamic instability or shock. Elderly patients had more co-morbidities, including more extensive coronary atherosclerosis, hypertension, peripheral vascular disease, and renal insufficiency, and presented more frequently with hemodynamic instability or shock. In the emergency PCI group, in-hospital mortality (1.0% vs 4.1% vs 11.5%, p <0.05) and MACEs (1.6% vs 5.2% vs 13.1%, p <0.05) increased incrementally by age group. In the elective PCI group, rates of in-hospital complications were considerably lower, with an incremental increase in mortality (0.1% vs 0.4% vs 1.1%, p <0.05) and MACEs (0.4% vs 0.7% vs 1.6%, p <0.05). Age was strongly predictive of in-hospital mortality for emergency and elective PCI by multivariate analysis. In conclusion, elective PCI in the elderly has favorable outcome and acceptable short-term mortality in the stent era. Elderly patients, in particular octogenarians undergoing emergency PCI, have a substantially higher risk of in-hospital death. FAU - Feldman, Dmitriy N AU - Feldman DN AD - Division of Cardiology, New York Presbyterian Hospital-Weill Medical College of Cornell University, New York, New York, USA. dnf9001@nyp.org FAU - Gade, Christopher L AU - Gade CL FAU - Slotwiner, Alexander J AU - Slotwiner AJ FAU - Parikh, Manish AU - Parikh M FAU - Bergman, Geoffrey AU - Bergman G FAU - Wong, S Chiu AU - Wong SC FAU - Minutello, Robert M AU - Minutello RM CN - New York State Angioplasty Registry LA - eng PT - Comparative Study PT - Journal Article DEP - 20060928 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM MH - Age Factors MH - Aged MH - Aged, 80 and over MH - Angioplasty, Balloon, Coronary/*statistics & numerical data MH - Chi-Square Distribution MH - Comorbidity MH - Coronary Disease/epidemiology/*therapy MH - Female MH - Hospital Mortality MH - Humans MH - Logistic Models MH - Male MH - Middle Aged MH - New York/epidemiology MH - *Outcome Assessment, Health Care MH - Prognosis MH - Risk Factors EDAT- 2006/12/01 09:00 MHDA- 2007/01/20 09:00 CRDT- 2006/12/01 09:00 PHST- 2006/04/18 00:00 [received] PHST- 2006/06/12 00:00 [revised] PHST- 2006/06/12 00:00 [accepted] PHST- 2006/12/01 09:00 [pubmed] PHST- 2007/01/20 09:00 [medline] PHST- 2006/12/01 09:00 [entrez] AID - S0002-9149(06)01509-8 [pii] AID - 10.1016/j.amjcard.2006.06.026 [doi] PST - ppublish SO - Am J Cardiol. 2006 Nov 15;98(10):1334-9. doi: 10.1016/j.amjcard.2006.06.026. Epub 2006 Sep 28. PMID- 17023289 OWN - NLM STAT- MEDLINE DCOM- 20070116 LR - 20181201 IS - 1053-0770 (Print) IS - 1053-0770 (Linking) VI - 20 IP - 5 DP - 2006 Oct TI - Effects of sevoflurane on biomechanical markers of hepatic and renal dysfunction after coronary artery surgery. PG - 684-90 AB - OBJECTIVE: The purpose of this study was to compare the effects of a total intravenous and a volatile anesthetic regimen on biochemical markers of hepatic and renal dysfunction after coronary artery surgery. DESIGN: Prospective, double-blind, randomized clinical study. SETTING: University hospital, single institutional. PARTICIPANTS: Three hundred twenty patients undergoing elective coronary artery surgery were divided into 2 different anesthetic protocols: propofol group (n = 160) and sevoflurane group (n = 160). INTERVENTIONS: Hemodynamic data were registered before the start of surgery, before the start of CPB, 15 minutes after the end of CPB, at arrival in the intensive care unit, and 6 and 12 hours after arrival in the intensive care unit. Serum glutamic oxaloacetic transaminase (SGOT), serum glutamate pyruvate transaminase (SGPT), serum lactate dehydrogenase (LDH), and serum creatinine concentrations were measured before surgery, at arrival in the intensive care unit, and after 6, 12, 24, and 48 hours. MEASUREMENTS AND MAIN RESULTS: Postoperative levels of serum SGOT, SGPT, and LDH increased transiently in both anesthetic groups, but the increase was significantly lower in the sevoflurane group compared with the propofol group. Creatinine levels remained largely unchanged in both groups. CONCLUSION: Postoperative biochemical markers of hepatic dysfunction were lower with a sevoflurane-based anesthetic regimen in patients undergoing coronary artery surgery with cardiopulmonary bypass. FAU - Lorsomradee, Suraphong AU - Lorsomradee S AD - Department of Anesthesiology, University Hospital, Antwerp, Edegem, Belgium. FAU - Cromheecke, Stefanie AU - Cromheecke S FAU - Lorsomradee, Sratwadee AU - Lorsomradee S FAU - De Hert, Stefan G AU - De Hert SG LA - eng PT - Journal Article PT - Randomized Controlled Trial DEP - 20060605 PL - United States TA - J Cardiothorac Vasc Anesth JT - Journal of cardiothoracic and vascular anesthesia JID - 9110208 RN - 0 (Anesthetics, Inhalation) RN - 0 (Biomarkers) RN - 0 (Methyl Ethers) RN - 38LVP0K73A (Sevoflurane) RN - AYI8EX34EU (Creatinine) RN - EC 1.1.1.27 (L-Lactate Dehydrogenase) RN - EC 2.6.1.1 (Aspartate Aminotransferases) RN - EC 2.6.1.2 (Alanine Transaminase) SB - IM MH - Administration, Inhalation MH - Aged MH - Alanine Transaminase/blood MH - Anesthesia, General/*methods MH - Anesthetics, Inhalation/administration & dosage MH - Aspartate Aminotransferases/blood MH - Biomarkers/*blood MH - Cardiopulmonary Bypass/methods MH - Coronary Artery Bypass/*adverse effects MH - Coronary Disease/blood/*surgery MH - Creatinine/blood MH - Double-Blind Method MH - Female MH - Follow-Up Studies MH - Humans MH - Kidney Diseases/*blood/etiology MH - L-Lactate Dehydrogenase/blood MH - Liver Diseases/*blood/etiology MH - Male MH - Methyl Ethers/*administration & dosage MH - Prognosis MH - Prospective Studies MH - Sevoflurane EDAT- 2006/10/07 09:00 MHDA- 2007/01/17 09:00 CRDT- 2006/10/07 09:00 PHST- 2006/01/06 00:00 [received] PHST- 2006/10/07 09:00 [pubmed] PHST- 2007/01/17 09:00 [medline] PHST- 2006/10/07 09:00 [entrez] AID - S1053-0770(06)00095-4 [pii] AID - 10.1053/j.jvca.2006.02.035 [doi] PST - ppublish SO - J Cardiothorac Vasc Anesth. 2006 Oct;20(5):684-90. doi: 10.1053/j.jvca.2006.02.035. Epub 2006 Jun 5. PMID- 17001234 OWN - NLM STAT- MEDLINE DCOM- 20091015 LR - 20220318 IS - 1558-2035 (Electronic) IS - 1558-2027 (Linking) VI - 7 IP - 10 DP - 2006 Oct TI - Contrast-induced nephropathy in urgent coronary interventions. PG - 737-41 AB - OBJECTIVES: Patients submitted to urgent percutaneous coronary interventions (PCIs) are quite often at high risk for contrast-induced nephropathy (CIN) since they exhibit several predisposing factors such as electrical and haemodynamic instability together with the lack of time to undergo adequate prophylaxis. This was a not blinded, non-randomized study whose aims were (i) to evaluate the incidence of CIN after urgent PCI in a high-volume cardiovascular referral practice (patients with acute myocardial infarction or with acute coronary syndromes enrolled in a single centre), and (ii) to assess the prognostic implications of CIN during hospitalization and at 1-month follow-up. METHODS: Between 1 October 2003 and 1 April 2004, 194 consecutive patients undergoing urgent coronary angiography and PCIs at our catheterization laboratory were enrolled in the study: 67 patients (34.5%) received the iso-osmolar contrast medium iodixanol (group A) and 127 patients (65.5%) received the hypo-osmolar contrast medium iopromid (group B). RESULTS: The overall incidence of CIN was 10.82%. Patients of group A showed a higher incidence of CIN than patients of group B (22.3 vs. 4.7%, P < 0.05). On univariate logistic analysis, age, pre-existing renal insufficiency, intra-aortic balloon pump (an indirect indicator of haemodynamic instability), dyslipidaemia, and postprocedural hypotension were risk indicators for the development of CIN after primary PCI. On multivariate logistic analysis, age and postprocedural hypotension remained significant independent correlates of CIN. CONCLUSIONS: In emergency PCIs, CIN is a frequent complication mainly related to haemodynamic instability and pre-existing renal dysfunction. Since CIN is associated with a high in-hospital mortality rate, our data stress the need for the development and validation of new preventive strategies for renal protection during emergency PCIs. FAU - Valente, Serafina AU - Valente S AD - Coronary Care Unit, Heart and Vessel Department, University of Florence School of Medicine, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy. seravalente@hotmail.com FAU - Lazzeri, Chiara AU - Lazzeri C FAU - Giglioli, Cristina AU - Giglioli C FAU - Margheri, Massimo AU - Margheri M FAU - Comeglio, Marco AU - Comeglio M FAU - Nicolaci, Letizia AU - Nicolaci L FAU - Chechi, Tania AU - Chechi T FAU - Gensini, Gian Franco AU - Gensini GF LA - eng PT - Comparative Study PT - Journal Article PL - United States TA - J Cardiovasc Med (Hagerstown) JT - Journal of cardiovascular medicine (Hagerstown, Md.) JID - 101259752 RN - 0 (Contrast Media) RN - 0 (Triiodobenzoic Acids) RN - 4419T9MX03 (Iohexol) RN - 712BAC33MZ (iopromide) RN - HW8W27HTXX (iodixanol) SB - IM MH - Acute Kidney Injury/*chemically induced/epidemiology/physiopathology MH - Aged MH - Aged, 80 and over MH - Analysis of Variance MH - Angioplasty, Balloon, Coronary/adverse effects/*methods MH - Cardiac Catheterization/adverse effects/methods MH - Contrast Media/*adverse effects MH - Coronary Disease/diagnostic imaging/mortality/*therapy MH - Emergency Treatment MH - Female MH - Follow-Up Studies MH - Humans MH - Incidence MH - Iohexol/adverse effects/*analogs & derivatives MH - Kidney Function Tests MH - Logistic Models MH - Male MH - Probability MH - Prospective Studies MH - Radiography MH - Risk Assessment MH - Survival Rate MH - Triiodobenzoic Acids/*adverse effects EDAT- 2006/09/27 09:00 MHDA- 2009/10/16 06:00 CRDT- 2006/09/27 09:00 PHST- 2006/09/27 09:00 [pubmed] PHST- 2009/10/16 06:00 [medline] PHST- 2006/09/27 09:00 [entrez] AID - 01244665-200610000-00004 [pii] AID - 10.2459/01.JCM.0000247320.72783.1c [doi] PST - ppublish SO - J Cardiovasc Med (Hagerstown). 2006 Oct;7(10):737-41. doi: 10.2459/01.JCM.0000247320.72783.1c. PMID- 16978997 OWN - NLM STAT- MEDLINE DCOM- 20061017 LR - 20231024 IS - 1558-3597 (Electronic) IS - 0735-1097 (Linking) VI - 48 IP - 6 DP - 2006 Sep 19 TI - Troponin-T and N-terminal pro-B-type natriuretic peptide predict mortality benefit from coronary revascularization in acute coronary syndromes: a GUSTO-IV substudy. PG - 1146-54 AB - OBJECTIVES: This study was designed to evaluate biomarkers for selection of patients with non-ST-segment elevation acute coronary syndromes (ACS) that derive mortality benefit from revascularization. BACKGROUND: Biomarkers are essential for identification of patients at increased risk, which may be reduced by revascularization. METHODS: During the initial 30 days, 2,340 patients of 7,800 (30%) with non-ST-segment elevation ACS in the GUSTO (Global Utilization of Strategies To open Occluded arteries)-IV trial underwent coronary revascularization. The 1-year mortality was calculated in 30-day survivors stratified by status of revascularization and levels of biomarkers. A propensity score for receiving revascularization was constructed and included in a survival analysis that also included the time point of revascularization as a time-dependent covariate. RESULTS: Elevation of troponin-T or N-terminal pro-B-type natriuretic peptide (NT-proBNP) was associated with a high mortality. In patients with either or both of these markers elevated, a lower mortality following revascularization was observed. In contrast, patients without elevation of these markers had low 1-year mortality without any reduction in mortality following revascularization. In fact, in patients with normal levels of both troponin-T and NT-proBNP, a significant increase in 1-year mortality after revascularization was observed. Elevation of C-reactive protein, interleukin-6, creatinine clearance, and ST-segment depression was also related to a higher mortality. However, independent of these markers, mortality was lower after revascularization. CONCLUSIONS: Markers of troponin-T and NT-proBNP not only assist in risk stratification of patients with non-ST-segment elevation ACS but also appear to identify patients who have a reduced mortality associated with early coronary revascularization. FAU - James, Stefan K AU - James SK AD - Uppsala Clinical Research Center, Uppsala, Sweden. stefan.james@akademiska.se FAU - Lindback, Johan AU - Lindback J FAU - Tilly, Johanna AU - Tilly J FAU - Siegbahn, Agneta AU - Siegbahn A FAU - Venge, Per AU - Venge P FAU - Armstrong, Paul AU - Armstrong P FAU - Califf, Robert AU - Califf R FAU - Simoons, Maarten L AU - Simoons ML FAU - Wallentin, Lars AU - Wallentin L FAU - Lindahl, Bertil AU - Lindahl B LA - eng PT - Journal Article PT - Randomized Controlled Trial DEP - 20060828 PL - United States TA - J Am Coll Cardiol JT - Journal of the American College of Cardiology JID - 8301365 RN - 0 (Peptide Fragments) RN - 0 (Troponin T) RN - 0 (pro-brain natriuretic peptide (1-76)) RN - 114471-18-0 (Natriuretic Peptide, Brain) SB - IM MH - Acute Disease MH - Aged MH - Coronary Disease/*surgery MH - Female MH - Humans MH - Male MH - Middle Aged MH - Myocardial Revascularization/*mortality MH - Natriuretic Peptide, Brain/*blood MH - Peptide Fragments/*blood MH - Predictive Value of Tests MH - Risk Assessment MH - Survival Analysis MH - Syndrome MH - Troponin T/*blood EDAT- 2006/09/19 09:00 MHDA- 2006/10/18 09:00 CRDT- 2006/09/19 09:00 PHST- 2005/11/30 00:00 [received] PHST- 2006/05/16 00:00 [revised] PHST- 2006/05/23 00:00 [accepted] PHST- 2006/09/19 09:00 [pubmed] PHST- 2006/10/18 09:00 [medline] PHST- 2006/09/19 09:00 [entrez] AID - S0735-1097(06)01739-6 [pii] AID - 10.1016/j.jacc.2006.05.056 [doi] PST - ppublish SO - J Am Coll Cardiol. 2006 Sep 19;48(6):1146-54. doi: 10.1016/j.jacc.2006.05.056. Epub 2006 Aug 28. PMID- 16954577 OWN - NLM STAT- MEDLINE DCOM- 20060927 LR - 20220317 IS - 1557-2501 (Electronic) IS - 1042-3931 (Linking) VI - 18 IP - 9 DP - 2006 Sep TI - Impact of drug-eluting stents on outcomes of patients with end-stage renal disease undergoing percutaneous coronary revascularization. PG - 405-8 AB - BACKGROUND AND OBJECTIVE: End-stage renal disease (ESRD) patients on chronic dialysis are at heightened risk for target vessel revascularization (TVR) after coronary stenting. However, ESRD patients were excluded from the trials that demonstrated the superiority of drug-eluting stents (DES) over bare metal stents (BMS) in reducing TVR. We sought to identify the impact of stent type (DES versus BMS) on TVR and other cardiac adverse events in ESRD patients. METHODS: The study included 89 consecutive ESRD patients who underwent coronary stenting and were followed for greater than or equal to 9 months. TVR was the primary endpoint, and the secondary endpoint was a composite of death, myocardial infarction (MI) and TVR. Multivariate logistic regression models were used to adjust for differences in clinical and procedural characteristics. RESULTS: DES were used in 24 and BMS in 65 patients. The stent diameter was smaller (p = 0.008), but the stent length was longer (p = 0.006) in the DES group. TVR was required in 1 (4%) of DES and 17 (26%) BMS patients, while 8 (33%) DES and 39 (60%) BMS patients met the secondary endpoint. By multivariate logistic regression, DES use was associated with a significant reduction in TVR (OR 0.07, 95% CI 0.006-0.844; p = 0.036) and a significant reduction in death, MI and TVR (OR 0.11, 95% CI 0.022-0.513; p = 0.005). CONCLUSION: A high rate of ischemic events was noted for ESRD patients, regardless of stent type. However, in ESRD patients undergoing coronary revascularization, DES use is effective in reducing 9-month TVR and the composite of death, MI and TVR. FAU - Das, Pranab AU - Das P AD - Division of Cardiovascular Medicine, Gill Heart Institute, University of Kentucky and the VA Medical Center, Lexington, Kentucky 40536-0200, USA. FAU - Moliterno, David J AU - Moliterno DJ FAU - Charnigo, Richard AU - Charnigo R FAU - Mukherjee, Debabrata AU - Mukherjee D FAU - Steinhubl, Steven R AU - Steinhubl SR FAU - Sneed, J Darrell AU - Sneed JD FAU - Booth, David C AU - Booth DC FAU - Ziada, Khaled M AU - Ziada KM LA - eng PT - Comparative Study PT - Journal Article PL - United States TA - J Invasive Cardiol JT - The Journal of invasive cardiology JID - 8917477 SB - IM CIN - J Invasive Cardiol. 2006 Sep;18(9):409-10. PMID: 16954578 MH - Aged MH - Angioplasty, Balloon, Coronary/instrumentation/*methods MH - Coronary Angiography/methods MH - Coronary Artery Disease/*etiology/prevention & control/*therapy MH - Drug Delivery Systems MH - Female MH - Follow-Up Studies MH - Humans MH - Kidney Failure, Chronic/*complications MH - Male MH - Middle Aged MH - Multivariate Analysis MH - Myocardial Infarction/etiology/prevention & control/therapy MH - Myocardial Ischemia/etiology/prevention & control/therapy MH - Myocardial Revascularization/instrumentation/*methods MH - Prevalence MH - Prospective Studies MH - Risk Factors MH - *Stents MH - Treatment Outcome EDAT- 2006/09/07 09:00 MHDA- 2006/09/28 09:00 CRDT- 2006/09/07 09:00 PHST- 2006/09/07 09:00 [pubmed] PHST- 2006/09/28 09:00 [medline] PHST- 2006/09/07 09:00 [entrez] PST - ppublish SO - J Invasive Cardiol. 2006 Sep;18(9):405-8. PMID- 16905139 OWN - NLM STAT- MEDLINE DCOM- 20071016 LR - 20250529 IS - 0021-9150 (Print) IS - 0021-9150 (Linking) VI - 193 IP - 2 DP - 2007 Aug TI - Renal dysfunction increases the risk of saphenous vein graft occlusion: results from the Post-CABG trial. PG - 414-20 AB - OBJECTIVES: Saphenous vein grafts are common among patients with a history of coronary artery bypass graft (CABG) surgery. Chronic kidney disease (CKD) is an established cardiovascular risk factor, but its role in graft disease has not been evaluated. METHODS AND RESULTS: The Post-CABG Trial randomized 1351 patients who had undergone CABG surgery 1-11 years earlier to high- or low-dose lovastatin and to low-dose warfarin or placebo. Coronary angiography was conducted at baseline and after a median follow-up time of 4.2 years. Subjects were grouped according to their baseline estimated glomerular filtration rate (eGFR). The primary trial endpoint was significant graft disease progression assessed angiographically. Additional pre-defined endpoints included occlusion of grafts patent at baseline, change in minimum lumen diameter, and a composite endpoint of recurrent clinical events. Decreasing eGFR was associated with an increased risk of graft occlusion (P(trend)=0.040), but not substantial atherosclerotic progression (P(trend)=0.30), per-graft change in minimum lumen diameter (P(trend)=0.067), or recurrent clinical events (P(trend)=0.86). We did not observe significant effect modification of treatment effects by the presence of CKD. CONCLUSIONS: CKD may be associated with increased risk of atherosclerotic plaque disruption rather than atherosclerotic progression in saphenous vein grafts. FAU - Wellenius, Gregory A AU - Wellenius GA AD - Cardiovascular Epidemiology Research Unit, Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Deaconess 306, Boston, MA 02215, USA. gwelleni@bidmc.harvard.edu FAU - Mukamal, Kenneth J AU - Mukamal KJ FAU - Winkelmayer, Wolfgang C AU - Winkelmayer WC FAU - Mittleman, Murray A AU - Mittleman MA LA - eng GR - F32 ES013804/ES/NIEHS NIH HHS/United States GR - F32-ES013804/ES/NIEHS NIH HHS/United States PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't DEP - 20060814 PL - Ireland TA - Atherosclerosis JT - Atherosclerosis JID - 0242543 SB - IM MH - Aged MH - Chronic Disease MH - *Coronary Artery Bypass MH - Coronary Artery Disease/complications/surgery MH - Double-Blind Method MH - Female MH - Graft Occlusion, Vascular/*etiology MH - Humans MH - Kidney Diseases/*complications MH - Male MH - Middle Aged MH - Postoperative Period MH - Risk Factors MH - Saphenous Vein/*transplantation EDAT- 2006/08/15 09:00 MHDA- 2007/10/17 09:00 CRDT- 2006/08/15 09:00 PHST- 2006/04/06 00:00 [received] PHST- 2006/06/14 00:00 [revised] PHST- 2006/07/05 00:00 [accepted] PHST- 2006/08/15 09:00 [pubmed] PHST- 2007/10/17 09:00 [medline] PHST- 2006/08/15 09:00 [entrez] AID - S0021-9150(06)00406-0 [pii] AID - 10.1016/j.atherosclerosis.2006.07.008 [doi] PST - ppublish SO - Atherosclerosis. 2007 Aug;193(2):414-20. doi: 10.1016/j.atherosclerosis.2006.07.008. Epub 2006 Aug 14. PMID- 16871247 OWN - NLM STAT- MEDLINE DCOM- 20061128 LR - 20230112 IS - 0085-2538 (Print) IS - 0085-2538 (Linking) VI - 70 IP - 7 DP - 2006 Oct TI - Prevention of cardiovascular events in end-stage renal disease: results of a randomized trial of fosinopril and implications for future studies. PG - 1318-24 AB - Cardiovascular events (CVEs) are the leading cause of death in chronic hemodialysis patients. Results of trials in non-end-stage renal disease (ESRD) patients cannot be extrapolated to patients with ESRD. It is critical to test cardiovascular therapies in these high-risk patients who are usually excluded from major cardiovascular trials. The study objective was to evaluate the effect of fosinopril on CVEs in patients with ESRD. Eligible patients were randomized to fosinopril 5 mg titrated to 20 mg daily (n=196) or placebo (n=201) plus conventional therapy for 24 months. The primary end point was combined fatal and nonfatal first major CVEs (cardiovascular death, resuscitated death, nonfatal stroke, heart failure, myocardial infarction, or revascularization). No significant benefit for fosinopril was observed in the intent to treat analysis (n=397) after adjusting for independent predictors of CVEs (RR=0.93, 95% confidence interval (CI) 0.68-1.26, P=0.35). The per protocol secondary supportive analysis (n=380) found a trend towards benefit for fosinopril (adjusted RR=0.79 (95% CI 0.59-1.1, P=0.099)). In the patients who were hypertensive at baseline, systolic and diastolic blood pressures were significantly decreased in the fosinopril as compared to the placebo group. After adjustment for risk factors, trends were observed suggesting fosinopril may be associated with a lower risk of CVEs. These trends may have become statistically significant had the sample size been larger, and these findings warrant further study. FAU - Zannad, F AU - Zannad F AD - Hypertension and Preventive Cardiology Division, Department of Cardiovascular Disease, Centre d'Investigations Cliniques INSERM-CHU, INSERM U684, Nancy, France. f.zannad@chu-nancy.fr FAU - Kessler, M AU - Kessler M FAU - Lehert, P AU - Lehert P FAU - Grunfeld, J P AU - Grunfeld JP FAU - Thuilliez, C AU - Thuilliez C FAU - Leizorovicz, A AU - Leizorovicz A FAU - Lechat, P AU - Lechat P LA - eng PT - Comparative Study PT - Evaluation Study PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20060719 PL - United States TA - Kidney Int JT - Kidney international JID - 0323470 RN - 0 (Angiotensin-Converting Enzyme Inhibitors) RN - 0 (Antihypertensive Agents) RN - 0 (Placebos) RN - R43D2573WO (Fosinopril) SB - IM MH - Aged MH - Angiotensin-Converting Enzyme Inhibitors/administration & dosage/*therapeutic use MH - Antihypertensive Agents/administration & dosage/*therapeutic use MH - Cardiovascular Diseases/*prevention & control MH - Clinical Protocols MH - Confidence Intervals MH - Data Interpretation, Statistical MH - Female MH - Forecasting MH - Fosinopril/administration & dosage/*therapeutic use MH - Humans MH - Hypertension/drug therapy MH - Kidney Failure, Chronic/*complications/*drug therapy/therapy MH - Male MH - Placebos MH - Renal Dialysis MH - Risk Factors MH - Time Factors MH - Treatment Outcome EDAT- 2006/07/28 09:00 MHDA- 2006/12/09 09:00 CRDT- 2006/07/28 09:00 PHST- 2006/07/28 09:00 [pubmed] PHST- 2006/12/09 09:00 [medline] PHST- 2006/07/28 09:00 [entrez] AID - S0085-2538(15)52102-9 [pii] AID - 10.1038/sj.ki.5001657 [doi] PST - ppublish SO - Kidney Int. 2006 Oct;70(7):1318-24. doi: 10.1038/sj.ki.5001657. Epub 2006 Jul 19. PMID- 16860606 OWN - NLM STAT- MEDLINE DCOM- 20070104 LR - 20220321 IS - 1443-9506 (Print) IS - 1443-9506 (Linking) VI - 15 IP - 5 DP - 2006 Oct TI - Does off-pump coronary revascularization reduce the release of the cerebral markers, S-100beta and NSE? PG - 314-9 AB - OBJECTIVES: The aims of this study were to (1) compare the release of S-100 beta and NSE in off-pump coronary artery bypass grafting (CABG) versus on-pump surgery; (2) investigate whether the S-100 beta and NSE serum concentrations correlate with cardiopulmonary bypass (CPB) duration. MATERIALS AND METHODS: Between October 2002 and May 2004, 42 patients undergoing first time CABG surgery were enrolled in the study. The exclusion criteria were: LVEF<35%, age>70 years, previous myocardial infarction, REDO surgery, the presence of valvular heart disease and/or cerebrovascular disease, abnormal preoperative carotid vessels angiography, coronary artery disease involving the distal circumflex artery, renal dysfunction, coagulopathy. The patients were randomly assigned either to undergo on-pump CABG surgery [group I, n=24 patients] or off-pump CABG [group II, n=18 patients]. Blood was not re-transfused from the cardiotomy suction. All patients presenting haemolysis were excluded from the study. RESULTS: The preoperative S-100beta was 0.13+/-0.08 (microg/l) and NSE 7+/-1.5 (microg/l) in group I and 0.12+/-0.1 (microg/l) and 6.9+/-2.7 (microg/l), respectively in group II. Six hours after the surgery, S-100beta in patients of group I reached a maximum level of 1.38+/-0.4 (microg/l) and NSE of 17.7+/-6.5 (microg/l) compared to 0.5+/-0.11 (microg/l) [S-100B] and NSE 8.6+/-4.2 (microg/l) in group II (p=0.001). Three (12%) patients in group I and none (0%) in group II suffered postoperative delirium, p=0.247. No strokes occurred linear regression analysis revealed a strong correlation between cardiopulmonary bypass duration and S-100beta and NSE peak levels, p<0.0021 (r(2)=0.36) and p<0.0001 (r=0.81), respectively. CONCLUSION: Coronary artery bypass surgery with CPB causes a significantly greater increase in NSE and S-100beta serum levels than off-pump surgery and correlates with CPB duration. FAU - Bonacchi, Massimo AU - Bonacchi M AD - Cardiac Surgery Department, Policlinico Careggi, Firenze, Italy. mbonacchi@unifi.it FAU - Prifti, Edvin AU - Prifti E FAU - Maiani, Massimo AU - Maiani M FAU - Bartolozzi, Fabio AU - Bartolozzi F FAU - Di Eusanio, Marco AU - Di Eusanio M FAU - Leacche, Marzia AU - Leacche M LA - eng PT - Journal Article PT - Randomized Controlled Trial DEP - 20060724 PL - Australia TA - Heart Lung Circ JT - Heart, lung & circulation JID - 100963739 RN - 0 (Biomarkers) RN - 0 (Nerve Growth Factors) RN - 0 (S100 Calcium Binding Protein beta Subunit) RN - 0 (S100 Proteins) RN - EC 4.2.1.11 (Phosphopyruvate Hydratase) SB - IM MH - Aged MH - Biomarkers/blood MH - Brain/*metabolism MH - Coronary Angiography MH - *Coronary Artery Bypass, Off-Pump MH - Coronary Disease/*blood/diagnostic imaging/surgery MH - Female MH - Follow-Up Studies MH - Humans MH - Male MH - Middle Aged MH - Nerve Growth Factors/*blood MH - Phosphopyruvate Hydratase/*blood MH - Retrospective Studies MH - S100 Calcium Binding Protein beta Subunit MH - S100 Proteins/*blood MH - Treatment Outcome EDAT- 2006/07/25 09:00 MHDA- 2007/01/05 09:00 CRDT- 2006/07/25 09:00 PHST- 2005/03/26 00:00 [received] PHST- 2006/05/04 00:00 [revised] PHST- 2006/05/21 00:00 [accepted] PHST- 2006/07/25 09:00 [pubmed] PHST- 2007/01/05 09:00 [medline] PHST- 2006/07/25 09:00 [entrez] AID - S1443-9506(06)00118-1 [pii] AID - 10.1016/j.hlc.2006.05.007 [doi] PST - ppublish SO - Heart Lung Circ. 2006 Oct;15(5):314-9. doi: 10.1016/j.hlc.2006.05.007. Epub 2006 Jul 24. PMID- 16824832 OWN - NLM STAT- MEDLINE DCOM- 20060823 LR - 20220316 IS - 1097-6744 (Electronic) IS - 0002-8703 (Linking) VI - 152 IP - 1 DP - 2006 Jul TI - Stent revascularization for the prevention of cardiovascular and renal events among patients with renal artery stenosis and systolic hypertension: rationale and design of the CORAL trial. PG - 59-66 AB - BACKGROUND: Atherosclerotic renal artery stenosis is a problem with no consensus on diagnosis or therapy. The consequences of renal ischemia are neuroendocrine activation, hypertension, and renal insufficiency that can potentially result in acceleration of atherosclerosis, further renal dysfunction, myocardial infarction, heart failure, stroke, and death. Whether revascularization improves clinical outcomes when compared with optimum medical therapy is unknown. METHODS: CORAL is a randomized clinical trial contrasting optimum medical therapy alone to stenting with optimum medical therapy on a composite cardiovascular and renal end point: cardiovascular or renal death, myocardial infarction, hospitalization for congestive heart failure, stroke, doubling of serum creatinine, and need for renal replacement therapy. The secondary end points evaluate the effectiveness of revascularization in important subgroups of patients and with respect to all-cause mortality, kidney function, renal artery patency, microvascular renal function, and blood pressure control. We will also correlate stenosis severity with longitudinal renal function and determine the value of stenting from the perspectives of quality of life and cost-effectiveness. The primary entry criteria are (1) an atherosclerotic renal stenosis of > or = 60% with a 20 mm Hg systolic pressure gradient or > or = 80% with no gradient necessary and (2) systolic hypertension of > or = 155 mm Hg on > or = 2 antihypertensive medications. Randomization will occur in 1080 subjects. The study has 90% power to detect a 28% reduction in primary end point hazard rate. CONCLUSIONS: CORAL represents a unique opportunity to determine the incremental value of stent revascularization, in addition to optimal medical therapy, for the treatment of atherosclerotic renal artery stenosis. FAU - Cooper, Christopher J AU - Cooper CJ AD - Department of Medicine, Medical University of Ohio, Toledo, OH 43614-2598, USA. ccooper@mco.edu FAU - Murphy, Timothy P AU - Murphy TP FAU - Matsumoto, Alan AU - Matsumoto A FAU - Steffes, Michael AU - Steffes M FAU - Cohen, David J AU - Cohen DJ FAU - Jaff, Michael AU - Jaff M FAU - Kuntz, Richard AU - Kuntz R FAU - Jamerson, Kenneth AU - Jamerson K FAU - Reid, Diane AU - Reid D FAU - Rosenfield, Kenneth AU - Rosenfield K FAU - Rundback, John AU - Rundback J FAU - D'Agostino, Ralph AU - D'Agostino R FAU - Henrich, William AU - Henrich W FAU - Dworkin, Lance AU - Dworkin L LA - eng GR - HL071556/HL/NHLBI NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 RN - 0 (Angiotensin II Type 1 Receptor Blockers) RN - 0 (Benzimidazoles) RN - 0 (Biphenyl Compounds) RN - 0 (Tetrazoles) RN - S8Q36MD2XX (candesartan) SB - IM MH - *Angioplasty, Balloon MH - Angiotensin II Type 1 Receptor Blockers/therapeutic use MH - Atherosclerosis/therapy MH - Benzimidazoles/therapeutic use MH - Biphenyl Compounds MH - Cardiovascular Diseases/*etiology/prevention & control MH - Combined Modality Therapy MH - Disease Progression MH - Female MH - Humans MH - Hypertension/etiology/prevention & control MH - Hypertension, Renovascular/etiology/physiopathology MH - Male MH - Patient Selection MH - Prospective Studies MH - Randomized Controlled Trials as Topic MH - Renal Artery Obstruction/complications/mortality/physiopathology/*therapy MH - Research Design MH - Risk Factors MH - *Stents MH - Tetrazoles/therapeutic use EDAT- 2006/07/11 09:00 MHDA- 2006/08/24 09:00 CRDT- 2006/07/11 09:00 PHST- 2005/07/22 00:00 [received] PHST- 2005/09/09 00:00 [accepted] PHST- 2006/07/11 09:00 [pubmed] PHST- 2006/08/24 09:00 [medline] PHST- 2006/07/11 09:00 [entrez] AID - S0002-8703(05)00866-5 [pii] AID - 10.1016/j.ahj.2005.09.011 [doi] PST - ppublish SO - Am Heart J. 2006 Jul;152(1):59-66. doi: 10.1016/j.ahj.2005.09.011. PMID- 16781363 OWN - NLM STAT- MEDLINE DCOM- 20060725 LR - 20220331 IS - 1558-3597 (Electronic) IS - 0735-1097 (Linking) VI - 47 IP - 12 DP - 2006 Jun 20 TI - Protected carotid stenting in high-risk patients with severe carotid artery stenosis. PG - 2384-9 AB - OBJECTIVES: The purpose of this study was to determine the safety of carotid artery stenting with a unique distal embolic protection system in high-risk patients with severe carotid stenosis. BACKGROUND: Previous studies suggest that some patients with carotid stenosis and serious comorbid conditions are at high risk for carotid endarterectomy, and may be safely treated by carotid artery stenting. METHODS: A prospective non-randomized multicenter registry of 419 patients with severe carotid stenosis and high-risk features for carotid endarterectomy was conducted between April 2004 and October 2004. Carotid artery stenting was performed with the Protege Self-Expanding Nitinol Stent and the SPIDER Embolic Protection System (ev3 Inc., Plymouth, Minnesota). Aspirin and clopidogrel were prescribed at least 24 h before and three months after revascularization. The primary outcome was the combined incidence of major adverse cardiac and cerebrovascular events at 30 days after intervention, including death, stroke, and myocardial infarction. A secondary outcome was the technical success, defined as successful deployment of all devices, filter retrieval, and final diameter stenosis <50%. RESULTS: Technical success was achieved in 408 of 419 patients (97.4%). The primary end point was observed in 26 patients (6.2%), including death in 8 (1.9%), nonfatal stroke in 14 (3.3%), and nonfatal myocardial infarction in 4 (1%). Independent predictors of death or stroke at 30 days included duration of filter deployment, symptomatic carotid stenosis, and baseline renal insufficiency. CONCLUSIONS: For some patients with severe carotid stenosis and high-risk features for carotid endarterectomy, carotid artery stenting with distal embolic protection is a reasonable alternative for revascularization. FAU - Safian, Robert D AU - Safian RD AD - Cardiac and Vascular Intervention, William Beaumont Hospital, Royal Oak, Michigan 48073, USA. rsafian@beaumont.edu FAU - Bresnahan, John F AU - Bresnahan JF FAU - Jaff, Michael R AU - Jaff MR FAU - Foster, Malcolm AU - Foster M FAU - Bacharach, J Michael AU - Bacharach JM FAU - Maini, Brijeshwar AU - Maini B FAU - Turco, Mark AU - Turco M FAU - Myla, Subbarao AU - Myla S FAU - Eles, Gustav AU - Eles G FAU - Ansel, Gary M AU - Ansel GM CN - CREATE Pivotal Trial Investigators LA - eng PT - Clinical Trial PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't PL - United States TA - J Am Coll Cardiol JT - Journal of the American College of Cardiology JID - 8301365 SB - IM CIN - J Am Coll Cardiol. 2006 Jun 20;47(12):2397-8. doi: 10.1016/j.jacc.2006.03.023. PMID: 16781365 MH - Aged MH - Carotid Stenosis/complications/*surgery MH - Female MH - Humans MH - Male MH - Postoperative Complications/epidemiology MH - Prospective Studies MH - Risk Factors MH - Severity of Illness Index MH - *Stents EDAT- 2006/06/20 09:00 MHDA- 2006/07/26 09:00 CRDT- 2006/06/20 09:00 PHST- 2005/10/18 00:00 [received] PHST- 2005/11/29 00:00 [revised] PHST- 2005/12/05 00:00 [accepted] PHST- 2006/06/20 09:00 [pubmed] PHST- 2006/07/26 09:00 [medline] PHST- 2006/06/20 09:00 [entrez] AID - S0735-1097(06)00850-3 [pii] AID - 10.1016/j.jacc.2005.12.076 [doi] PST - ppublish SO - J Am Coll Cardiol. 2006 Jun 20;47(12):2384-9. doi: 10.1016/j.jacc.2005.12.076. PMID- 16781361 OWN - NLM STAT- MEDLINE DCOM- 20060725 LR - 20181201 IS - 1558-3597 (Electronic) IS - 0735-1097 (Linking) VI - 47 IP - 12 DP - 2006 Jun 20 TI - Correlates of bleeding events among moderate- to high-risk patients undergoing percutaneous coronary intervention and treated with eptifibatide: observations from the PROTECT-TIMI-30 trial. PG - 2374-9 AB - OBJECTIVES: We aimed to identify correlates of Thrombolysis In Mycocardial Infarction (TIMI) major/minor bleeding among eptifibatide-treated patients undergoing percutaneous coronary intervention (PCI). BACKGROUND: Evaluation of bleeding predictors among patients treated with glycoprotein IIb/IIIa receptor inhibition might aid in the identification of targets to reduce bleeding risk. METHODS: Data were analyzed from 567 moderate- to high-risk PCI patients with non-ST-segment elevation acute coronary syndrome (NSTEACS) treated with eptifibatide/reduced-dose unfractionated heparin or eptifibatide/reduced-dose enoxaparin enrolled in the Randomized Trial to Evaluate the Relative Protection Against Post-PCI Microvascular Dysfunction and Post-PCI Ischemia Among Anti-Platelet and Anti-Thrombotic Agents-Thrombolysis In Myocardial Infarction-30 (PROTECT-TIMI-30). RESULTS: The incidence of significant bleeding was 3.2% with a median time to event of 7.0 h after the first eptifibatide bolus. Increased age was the only independent correlate of bleeding events. Among patients with reduced creatinine clearance (CrCl), lack of adjustment of the maintenance infusion for CrCl < or =50 ml/min occurred frequently (15 of 33 patients, or 45%) and was associated with a high rate of bleeding (20%). The association of CrCl with bleeding appeared to be largely mediated by the incorporation of age in the estimation of CrCl. Patient gender, Cr, weight, and the peak activated clotting time were not associated with bleeding. CONCLUSIONS: Among NSTEACS PCI patients treated with eptifibatide, increased age was a significant correlate of bleeding events and appeared to explain the association between low CrCl and bleeding. The more widespread use of CrCl or other estimates of renal function over Cr may lead to more appropriate dose adjustments of eptifibatide. FAU - Kirtane, Ajay J AU - Kirtane AJ AD - Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, USA. FAU - Piazza, Gregory AU - Piazza G FAU - Murphy, Sabina A AU - Murphy SA FAU - Budiu, Daniela AU - Budiu D FAU - Morrow, David A AU - Morrow DA FAU - Cohen, David J AU - Cohen DJ FAU - Peterson, Eric AU - Peterson E FAU - Lakkis, Nasser AU - Lakkis N FAU - Herrmann, Howard C AU - Herrmann HC FAU - Palabrica, Theresa M AU - Palabrica TM FAU - Gibson, C Michael AU - Gibson CM CN - TIMI Study Group LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20060530 PL - United States TA - J Am Coll Cardiol JT - Journal of the American College of Cardiology JID - 8301365 RN - 0 (Peptides) RN - 0 (Platelet Glycoprotein GPIIb-IIIa Complex) RN - NA8320J834 (Eptifibatide) SB - IM CIN - J Am Coll Cardiol. 2006 Jun 20;47(12):2380-3. doi: 10.1016/j.jacc.2006.03.029. PMID: 16781362 MH - Acute Disease MH - Aged MH - Angina, Unstable/*therapy MH - Angioplasty, Balloon, Coronary/*adverse effects MH - Eptifibatide MH - Female MH - Humans MH - Male MH - Middle Aged MH - Myocardial Infarction/*therapy MH - Peptides/*therapeutic use MH - Platelet Glycoprotein GPIIb-IIIa Complex/*antagonists & inhibitors MH - Postoperative Hemorrhage/epidemiology/*etiology/*prevention & control MH - Risk Factors MH - Syndrome MH - Thrombolytic Therapy EDAT- 2006/06/20 09:00 MHDA- 2006/07/26 09:00 CRDT- 2006/06/20 09:00 PHST- 2005/05/29 00:00 [received] PHST- 2005/09/01 00:00 [revised] PHST- 2005/09/08 00:00 [accepted] PHST- 2006/06/20 09:00 [pubmed] PHST- 2006/07/26 09:00 [medline] PHST- 2006/06/20 09:00 [entrez] AID - S0735-1097(06)00858-8 [pii] AID - 10.1016/j.jacc.2005.09.080 [doi] PST - ppublish SO - J Am Coll Cardiol. 2006 Jun 20;47(12):2374-9. doi: 10.1016/j.jacc.2005.09.080. Epub 2006 May 30. PMID- 16764007 OWN - NLM STAT- MEDLINE DCOM- 20061201 LR - 20220321 IS - 1522-1946 (Print) IS - 1522-1946 (Linking) VI - 68 IP - 1 DP - 2006 Jul TI - Percutaneous coronary intervention with drug-eluting stents in octogenarians: characteristics, clinical presentation, and outcomes. PG - 36-43 AB - OBJECTIVES: We aimed to compare clinical outcomes of octogenarians > or =80 years of age after coronary drug-eluting stent (DES) implantation. BACKGROUND: Although octogenarians constitute a fast-growing portion of cardiovascular patients, they are not adequately represented in current clinical revascularization trials. METHODS: We analyzed the data of 3,166 consecutive patients who underwent percutaneous coronary intervention (PCI) and DES implantation since March 2003. Periprocedural events, 1- and 6-month clinical outcomes were compared between octogenarians (n = 339) and patients <80 years of age (n = 2,827). RESULTS: Baseline characteristics revealed a higher prevalence of females (P < 0.001), Caucasians (P = 0.004), chronic renal failure (P < 0.001), heart failure (P < 0.001), number of diseased vessels (P = 0.009), and lower ejection fraction (P = 0.03) in octogenarians. Patients <80 years showed more positive family history (P < 0.001), hyperlipidemia (P = 0.006), smoking (P < 0.001), and obesity (P < 0.001). Clinical presentation and procedural success were similar in both groups as were death, myocardial infarction (MI), and repeat revascularization in-hospital. At 6 months, restenosis rates were low and comparable. In the subgroup of octogenarians who presented with acute coronary syndrome, mortality (15% vs. 3%, P < 0.001) and Q-wave MI occurred more often. Multivariate analysis revealed age >80 (P = 0.008), cardiogenic shock (P < 0.001), Q-wave MI at presentation (P = 0.003), and length of hospital stay (P = 0.003) to be independent predictors of mortality. CONCLUSIONS: PCI with DES in octogenarians results in a similar reduction of restenosis rates when compared to patients <80 years. Yet in octogenarians who presented with acute coronary syndrome, incidence of mortality and Q-wave MI at 6 months was higher as compared to younger patients. CI - Copyright 2006 Wiley-Liss, Inc. FAU - Hassani, Salah-Eddine AU - Hassani SE AD - Department of Internal Medicine, Division of Cardiology, Washington Hospital Center, Washington, DC 20010, USA. FAU - Wolfram, Roswitha M AU - Wolfram RM FAU - Kuchulakanti, Pramod K AU - Kuchulakanti PK FAU - Xue, Zhenyi AU - Xue Z FAU - Gevorkian, Natalie AU - Gevorkian N FAU - Suddath, William O AU - Suddath WO FAU - Satler, Lowell F AU - Satler LF FAU - Kent, Kenneth M AU - Kent KM FAU - Pichard, Augusto D AU - Pichard AD FAU - Weissman, Neil J AU - Weissman NJ FAU - Waksman, Ron AU - Waksman R LA - eng PT - Comparative Study PT - Journal Article PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM MH - Aged MH - Aged, 80 and over MH - Angina Pectoris/mortality/*therapy MH - *Angioplasty, Balloon, Coronary/adverse effects MH - Coronary Restenosis/etiology MH - Female MH - Follow-Up Studies MH - *Health Services for the Aged MH - Hemorrhage/etiology MH - Humans MH - Male MH - Middle Aged MH - Myocardial Infarction/mortality/*therapy MH - Renal Insufficiency/etiology MH - Severity of Illness Index MH - *Stents MH - Survival Analysis MH - Treatment Outcome EDAT- 2006/06/10 09:00 MHDA- 2006/12/09 09:00 CRDT- 2006/06/10 09:00 PHST- 2006/06/10 09:00 [pubmed] PHST- 2006/12/09 09:00 [medline] PHST- 2006/06/10 09:00 [entrez] AID - 10.1002/ccd.20768 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2006 Jul;68(1):36-43. doi: 10.1002/ccd.20768. PMID- 16751681 OWN - NLM STAT- MEDLINE DCOM- 20060816 LR - 20101118 IS - 1557-2501 (Electronic) IS - 1042-3931 (Linking) VI - 18 IP - 6 DP - 2006 Jun TI - Clinical outcomes after percutaneous coronary intervention with drug-eluting stents in dialysis patients. PG - 273-7 AB - OBJECTIVES: We aimed to compare the clinical outcomes of dialysis versus nondialysis patients after coronary drug-eluting stent (DES) implantation. BACKGROUND: The revascularization of ischemic heart disease in dialysis patients has remained controversial due to consistent exclusion of this population from major trials, especially in the context of percutaneous coronary interventions (PCI) with DES. METHODS: We analyzed the data on 3,442 consecutive patients who underwent PCI and DES implantation since March 2003. Periprocedural events, 1- and 6-month clinical outcomes were then compared between dialysis (n = 72) and nondialysis patients (n = 3,370). RESULTS: Baseline characteristics revealed a higher prevalence of female gender (p = 0.03), African Americans (p < 0.001), hypertension (p < 0.001), diabetes mellitus (p < 0.001), number of diseased vessels (p = 0.04), lower ejection fraction (p < 0.001), and a higher prevalence of acute myocardial infarction (MI) (p = 0.04) in dialysis patients. Nondialysis patients showed more history of smoking (p < 0.001) and obesity (p = 0.02). Procedural success was higher (p = 0.05), while there was a trend toward a lower mortality rate, in the nondialysis group during hospitalization. At 6 months, the restenosis rate was low and comparable, but mortality occurred more often (16% vs. 3.8%; p < 0.001) in dialysis patients. Multivariate analysis revealed cardiogenic shock (p = 0.04) to be an independent predictor of mortality. CONCLUSIONS: PCI with DES in dialysis patients is safe and feasible, with a similar reduction of repeat revascularization when compared with nondialysis patients. There was, however, a higher incidence of mortality in dialysis patients at 6 months, mostly influenced by contributing comorbidities and more severe conditions at presentation. FAU - Hassani, Salah-Eddine AU - Hassani SE AD - Department of Internal Medicine, Division of Cardiology, Washington Hospital Center, Washington, DC, USA. FAU - Chu, William W AU - Chu WW FAU - Wolfram, Roswitha M AU - Wolfram RM FAU - Kuchulakanti, Pramod K AU - Kuchulakanti PK FAU - Xue, Zhenyi AU - Xue Z FAU - Gevorkian, Natalie AU - Gevorkian N FAU - Suddath, William O AU - Suddath WO FAU - Satler, Lowell F AU - Satler LF FAU - Kent, Kenneth M AU - Kent KM FAU - Pichard, Augusto D AU - Pichard AD FAU - Weissman, Neil J AU - Weissman NJ FAU - Waksman, Ron AU - Waksman R LA - eng PT - Journal Article PL - United States TA - J Invasive Cardiol JT - The Journal of invasive cardiology JID - 8917477 SB - IM MH - Aged MH - Angioplasty, Balloon, Coronary/*methods MH - Comorbidity MH - Coronary Artery Disease/*mortality/*therapy MH - Female MH - Follow-Up Studies MH - Humans MH - Incidence MH - Kidney Failure, Chronic/*mortality/therapy MH - Male MH - Middle Aged MH - Postoperative Complications/mortality MH - Predictive Value of Tests MH - Prevalence MH - Renal Dialysis MH - Risk Factors MH - Severity of Illness Index MH - *Stents MH - Treatment Outcome EDAT- 2006/06/06 09:00 MHDA- 2006/08/17 09:00 CRDT- 2006/06/06 09:00 PHST- 2006/06/06 09:00 [pubmed] PHST- 2006/08/17 09:00 [medline] PHST- 2006/06/06 09:00 [entrez] PST - ppublish SO - J Invasive Cardiol. 2006 Jun;18(6):273-7. PMID- 16750426 OWN - NLM STAT- MEDLINE DCOM- 20070614 LR - 20070226 IS - 1474-5151 (Print) IS - 1474-5151 (Linking) VI - 6 IP - 1 DP - 2007 Mar TI - Costs, clinical outcomes, and health-related quality of life of off-pump vs. on-pump coronary bypass surgery. PG - 54-9 AB - BACKGROUND: Off-pump coronary bypass surgery avoids the potential complications of cardiopulmonary bypass. However, its acceptance depends on medical and economic outcome. The aim of this prospective non-randomised study was to compare functional and economic outcome of off-pump and on-pump surgery at 1-year follow-up. METHODS: 102 patients (pts) treated with either off-pump (60pts) or on-pump surgery (42pts) were studied. Pts with left ventricular dysfunction, recent myocardial infarction (<1 month), renal impairment, valve surgery, previous stroke or coagulopathy were excluded. Variable and fixed costs were obtained for each treatment group during operative and postoperative care. In-hospital endpoints included all-cause mortality and complications (defined as excessive bleeding [>6 units blood transfusion], peri-operative myocardial infarction, atrial fibrillation, stroke, and infection). All cause mortality; cost-effectiveness and quality of life were assessed 1 year after surgery. RESULTS: The in-hospital mortality was similar in the two treatment groups. Off-pump group had significantly fewer postoperative complication rate (off-pump 41% vs. on-pump 72%, p=0.001). The mean in-hospital cost was lower for off-pump surgery (off-pump 6.515+/-926 euro vs. on-pump 9.872+/-1.299 euro, p<0.0001) as well as the mean length of hospital stay (off-pump 4.93+/-0.93 days vs. on-pump 6.58+/-1.04 days, p<0.0001). At 1 year, all cause mortality, quality of life indices, return to work rate and treatment satisfaction was similar in both groups. CONCLUSION: Off-pump myocardial revascularization maintains the advantages of conventional surgery in terms of survival and freedom from cardiac events while reducing the in-hospital cost. FAU - Kastanioti, C AU - Kastanioti C AD - Economic Department, University Hospital of Ioannina 1, L. Stavrou Niarchou 45500 Ioannina, Greece. catherinekastanioti@yahoo.gr LA - eng PT - Comparative Study PT - Journal Article DEP - 20060605 PL - England TA - Eur J Cardiovasc Nurs JT - European journal of cardiovascular nursing JID - 101128793 SB - IM MH - Aged MH - *Coronary Artery Bypass/adverse effects/economics/mortality MH - *Coronary Artery Bypass, Off-Pump/adverse effects/economics/mortality MH - Cost-Benefit Analysis MH - Female MH - Greece MH - Health Care Costs MH - Hospital Mortality MH - Humans MH - Male MH - *Quality of Life EDAT- 2006/06/06 09:00 MHDA- 2007/06/15 09:00 CRDT- 2006/06/06 09:00 PHST- 2004/09/28 00:00 [received] PHST- 2006/03/23 00:00 [revised] PHST- 2006/04/06 00:00 [accepted] PHST- 2006/06/06 09:00 [pubmed] PHST- 2007/06/15 09:00 [medline] PHST- 2006/06/06 09:00 [entrez] AID - S1474-5151(06)00063-6 [pii] AID - 10.1016/j.ejcnurse.2006.04.001 [doi] PST - ppublish SO - Eur J Cardiovasc Nurs. 2007 Mar;6(1):54-9. doi: 10.1016/j.ejcnurse.2006.04.001. Epub 2006 Jun 5. PMID- 16636488 OWN - NLM STAT- MEDLINE DCOM- 20060731 LR - 20190819 IS - 1346-9843 (Print) IS - 1346-9843 (Linking) VI - 70 IP - 5 DP - 2006 May TI - Valsartan cardio-renal protection in patients undergoing coronary angiography complicated with chronic renal insufficiency (VAL-CARP) trial: rationale and design. PG - 548-52 AB - BACKGROUND: Despite an increase in the frequency of coronary angiography (CAG) in Japan, the exact incidence of contrast-induced nephropathy (CIN) remains unknown in the Japanese population, especially in patients with chronic renal insufficiency. In addition, the nature of pharmacological interventions that would benefit the patients before or after procedures such as coronary bypass graft (CABG) and percutaneous coronary intervention (PCI) has not been fully investigated. METHODS: In the trial 500 patients with renal insufficiency (defined as a glomerular filtration rate (GFR) of between 89 and 30 ml . min(-1) . (1.73 m(-2)) following CAG will be randomly assigned to receive either valsartan, an angiotensin receptor blocker or angiotensin converting enzyme (ACE) inhibitor plus valsartan.1 The primary end-point is a change in the GFR of patients, which will be followed up for 3 years, including following CABG surgery or PCI. The incidence of cardiac events as well as the adverse effects of pharmacological intervention will be evaluated. In addition, the incidence of renal artery stenosis at the time of CAG will be reported also; however, the patients with renal artery stenosis will be excluded from the present study. CONCLUSION: The present study will provide data on: 1) the exact incidence and course of renal function of CIN after CAG; and 2) the comparative therapeutic benefit of pharmacological intervention with valsartan alone or with valsartan and an ACE inhibitor in combination in patients with coexisting coronary artery diseases and chronic renal insufficiency, regardless of whether they receive CABG or PCI. In addition to these studies, an estimate of the incidence of renal artery stenosis in these patients will be demonstrated. FAU - Ikeda, Naofumi AU - Ikeda N AD - Department of Nephrology, Saitama Medical School, Saitama, Japan. n_ikeda@saitama-med.ac.jp FAU - Nishimura, Shigeyuki AU - Nishimura S FAU - Kyo, Shunei AU - Kyo S FAU - Komiyama, Nobuyuki AU - Komiyama N FAU - Matsumoto, Kazuo AU - Matsumoto K FAU - Inoue, Tsutomu AU - Inoue T FAU - Suzuki, Hiromichi AU - Suzuki H LA - eng PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - Japan TA - Circ J JT - Circulation journal : official journal of the Japanese Circulation Society JID - 101137683 RN - 0 (Angiotensin II Type 1 Receptor Blockers) RN - 0 (Angiotensin-Converting Enzyme Inhibitors) RN - 0 (Protective Agents) RN - 0 (Tetrazoles) RN - 80M03YXJ7I (Valsartan) RN - HG18B9YRS7 (Valine) SB - IM MH - Adult MH - Aged MH - Angiotensin II Type 1 Receptor Blockers/therapeutic use MH - Angiotensin-Converting Enzyme Inhibitors/therapeutic use MH - *Clinical Protocols MH - *Coronary Angiography MH - Coronary Artery Disease/*complications/drug therapy MH - Drug Therapy, Combination MH - Female MH - Glomerular Filtration Rate/drug effects MH - Humans MH - Male MH - Middle Aged MH - Patient Selection MH - Protective Agents/therapeutic use MH - Renal Artery Obstruction MH - Renal Insufficiency, Chronic/*complications/drug therapy MH - Tetrazoles/*administration & dosage MH - Valine/administration & dosage/*analogs & derivatives MH - Valsartan EDAT- 2006/04/26 09:00 MHDA- 2006/08/01 09:00 CRDT- 2006/04/26 09:00 PHST- 2006/04/26 09:00 [pubmed] PHST- 2006/08/01 09:00 [medline] PHST- 2006/04/26 09:00 [entrez] AID - JST.JSTAGE/circj/70.548 [pii] AID - 10.1253/circj.70.548 [doi] PST - ppublish SO - Circ J. 2006 May;70(5):548-52. doi: 10.1253/circj.70.548. PMID- 16620270 OWN - NLM STAT- MEDLINE DCOM- 20060822 LR - 20260128 IS - 0742-3071 (Print) IS - 0742-3071 (Linking) VI - 23 IP - 4 DP - 2006 Apr TI - Myocardial perfusion imaging and cardiac events in a cohort of asymptomatic patients with diabetes living in southern France. PG - 410-8 AB - AIMS: To assess the association between abnormal stress myocardial perfusion imaging (MPI) and cardiac events (CE) in asymptomatic patients with diabetes and with > or = 1 additional risk factor. Predictors of abnormal stress MPI were also evaluated. METHODS: Four hundred and forty-seven consecutive patients who underwent stress MPI were prospectively followed for 2.1 [0.5-4.1] years for the subsequent occurrence of hard CE (myocardial infarction and sudden or coronary death) and soft CE (unstable angina and ischaemic heart failure requiring hospitalization). Re-vascularization procedures performed as a result of the screening protocol were not included in the analysis. RESULTS: Follow-up was successful in 419 of 447 patients (94%), of whom 71 had abnormal MPI at baseline. Medical therapy was intensified in all subjects and especially in those with abnormal MPI. Twenty-three patients with abnormal MPI underwent a re-vascularization procedure. CEs occurred in 14 patients, including six of 71 patients (8.5%) with abnormal MPI and eight of 348 patients (2.3%) with normal MPI (P < 0.005). Only two patients developed a hard CE and 12 a soft CE. In multivariate analysis, abnormal MPI was the strongest predictor for CEs [odds ratio (OR) (95% CI) = 5.6 (1.7-18.5)]. Low-density lipoprotein cholesterol > or = 3.35 mmol/l [OR (95% CI) = 7.3; 1.5-34.7] and age > median [OR (95% CI) = 6.0 (1.2-28.6)] were additional independent predictors for CE. The independent predictors for abnormal MPI were male gender, plasma triglycerides > or = 1.70 mmol/l, creatinine clearance < 60 ml/min and HbA1c > 8%, with male gender the strongest [OR (95% CI) = 4.0 (1.8-8.8)]. CONCLUSIONS: Asymptomatic patients with diabetes in this study had a very low hard cardiac event rate over an intermediate period. This could be explained by the effects of intervention or by the low event rate in the background population. Randomized studies of cardiac heart disease screening are required in asymptomatic subjects with diabetes to determine the effectiveness of this intervention. FAU - Sultan, A AU - Sultan A AD - Metabolic Diseases Department, Montpellier University Hospital, Montpellier, France. FAU - Piot, C AU - Piot C FAU - Mariano-Goulart, D AU - Mariano-Goulart D FAU - Daures, J P AU - Daures JP FAU - Comte, F AU - Comte F FAU - Renard, E AU - Renard E FAU - Avignon, A AU - Avignon A LA - eng PT - Journal Article PL - England TA - Diabet Med JT - Diabetic medicine : a journal of the British Diabetic Association JID - 8500858 RN - 0 (Radiopharmaceuticals) RN - 0 (Vasodilator Agents) RN - 64ALC7F90C (Dipyridamole) RN - 971Z4W1S09 (Technetium Tc 99m Sestamibi) SB - IM MH - Aged MH - Angina Pectoris/diagnosis MH - Coronary Disease/*diagnostic imaging MH - Diabetes Mellitus, Type 1/*diagnostic imaging MH - Diabetes Mellitus, Type 2/*diagnostic imaging MH - Dipyridamole MH - Electrocardiography MH - Exercise Test MH - Female MH - France MH - Heart/*diagnostic imaging MH - Humans MH - Male MH - Middle Aged MH - Multivariate Analysis MH - Myocardial Infarction/diagnosis MH - Myocardial Ischemia/diagnosis MH - Prognosis MH - Prospective Studies MH - *Radionuclide Ventriculography MH - Radiopharmaceuticals MH - Risk MH - Sex Factors MH - Technetium Tc 99m Sestamibi MH - Vasodilator Agents EDAT- 2006/04/20 09:00 MHDA- 2006/08/23 09:00 CRDT- 2006/04/20 09:00 PHST- 2006/04/20 09:00 [pubmed] PHST- 2006/08/23 09:00 [medline] PHST- 2006/04/20 09:00 [entrez] AID - DME1818 [pii] AID - 10.1111/j.1464-5491.2006.01818.x [doi] PST - ppublish SO - Diabet Med. 2006 Apr;23(4):410-8. doi: 10.1111/j.1464-5491.2006.01818.x. PMID- 16616015 OWN - NLM STAT- MEDLINE DCOM- 20060602 LR - 20101118 IS - 0002-9149 (Print) IS - 0002-9149 (Linking) VI - 97 IP - 8 DP - 2006 Apr 15 TI - Should primary percutaneous coronary intervention be the preferred method of reperfusion therapy for patients with renal failure and ST-elevation acute myocardial infarction? PG - 1142-5 AB - Data from patients who had ST-elevation acute myocardial infarction and renal failure and were enrolled in the 2002 Acute Coronary Syndrome Israeli Survey (ACSIS) were studied to determine the effect of different myocardial reperfusion modalities on short- and long-term outcomes. Thirty-day crude mortalities were 8.3% in the thrombolysis group, 40.0% in the primary percutaneous coronary intervention group, and 29.7% in the no-reperfusion group (p = 0.03). Crude and adjusted mortality odds ratios that were observed at 7, 30, and 365 days, with the thrombolysis group as the reference, were 3.1 to 8.1 in the percutaneous coronary intervention group and 1.5 to 4.6 in the no-reperfusion group. Our results suggest that thrombolysis may represent the preferred modality of reperfusion therapy in patients with renal failure and ST-elevation acute myocardial infarction. A large randomized prospective study is needed to confirm these results. FAU - Dragu, Robert AU - Dragu R AD - Intensive Cardiac Care Unit, Rambam Medical Center, Haifa, Israel. dragu@tx.technion.ac.il FAU - Behar, Solomon AU - Behar S FAU - Sandach, Amir AU - Sandach A FAU - Boyko, Valentina AU - Boyko V FAU - Kapeliovich, Michael AU - Kapeliovich M FAU - Rispler, Shmuel AU - Rispler S FAU - Hammerman, Haim AU - Hammerman H LA - eng PT - Journal Article PT - Multicenter Study DEP - 20060228 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 RN - 0 (Fibrinolytic Agents) RN - EC 3.4.- (Streptokinase) RN - EC 3.4.21.- (Plasminogen Activators) SB - IM CIN - Am J Cardiol. 2006 Sep 1;98(5):710. doi: 10.1016/j.amjcard.2006.05.003. PMID: 16923472 MH - Aged MH - *Angioplasty, Balloon, Coronary MH - Electrocardiography MH - Female MH - Fibrinolytic Agents/therapeutic use MH - Health Surveys MH - Humans MH - Male MH - Myocardial Infarction/complications/*mortality/*therapy MH - Myocardial Reperfusion MH - Patient Readmission MH - Plasminogen Activators/therapeutic use MH - Prospective Studies MH - Renal Insufficiency/*complications MH - Streptokinase/therapeutic use MH - *Thrombolytic Therapy MH - Treatment Outcome EDAT- 2006/04/18 09:00 MHDA- 2006/06/03 09:00 CRDT- 2006/04/18 09:00 PHST- 2005/06/13 00:00 [received] PHST- 2005/11/08 00:00 [revised] PHST- 2005/11/08 00:00 [accepted] PHST- 2006/04/18 09:00 [pubmed] PHST- 2006/06/03 09:00 [medline] PHST- 2006/04/18 09:00 [entrez] AID - S0002-9149(06)00032-4 [pii] AID - 10.1016/j.amjcard.2005.11.028 [doi] PST - ppublish SO - Am J Cardiol. 2006 Apr 15;97(8):1142-5. doi: 10.1016/j.amjcard.2005.11.028. Epub 2006 Feb 28. PMID- 16534220 OWN - NLM STAT- MEDLINE DCOM- 20060501 LR - 20060314 IS - 1420-4096 (Print) IS - 1420-4096 (Linking) VI - 28 IP - 5-6 DP - 2005 TI - Coronary surgery in patients requiring chronic hemodialysis. PG - 270-4 AB - BACKGROUND: In uremic patients coronary surgery and the entire perioperative management is demanding. METHODS: We analyzed retrospectively data from all patients requiring chronic hemodialysis who under went coronary artery bypass grafting (CABG) between January 1 2001 and December 31 2004 at the Deutsches Herzzentrum Berlin and compared them to those of a randomized nonuremic control group (n = 68), which consisted of patients who underwent CABG during the same period. RESULTS: During the study period 6315 patients underwent coronary artery bypass grafting at the Deutsches Herzzentrum Berlin. Among these patients, we identified 71 chronic dialysis patients (1.12%). Among dialysis patients, we recorded a perioperative mortality of 5.6%. One-year survival rate was 87.7% among uremic patients and 91.0% in the control group; the corresponding 4-year survival rates were 56.7 and 88.0%, respectively. The incidence of peripheral artery disease was significantly higher in the dialysis group. Uremic patients showed significantly lower hemoglobin serum levels at the time of admission compared to the control group (11.4 +/- 1.62 vs. 13.3 +/- 1.81 mg/dl). These patients received significantly higher numbers of blood transfusions (6.7 +/- 5.6 vs. 2.75 +/- 3.8), and platelet transfusions. CONCLUSION: Our preliminary study indicates that coronary surgery can be performed with acceptable mid-term results when the specific requirements of this patient group are taken into account. CI - Copyright 2005 S. Karger AG, Basel. FAU - Krabatsch, T AU - Krabatsch T AD - Deutsches Herzzentrum Berlin, Klinik fur Herz-, Thorax- und Gefasschirurgie, Berlin, Deutschland, Germany. krabatsch@dhzb.de FAU - Yeter, R AU - Yeter R FAU - Hetzer, R AU - Hetzer R LA - eng PT - Journal Article DEP - 20060307 PL - Switzerland TA - Kidney Blood Press Res JT - Kidney & blood pressure research JID - 9610505 SB - IM MH - Adult MH - Aged MH - Aged, 80 and over MH - *Cardiac Surgical Procedures/mortality MH - Coronary Artery Bypass MH - Coronary Disease/mortality/*surgery MH - Coronary Vessels/*surgery MH - Female MH - Humans MH - Kidney Failure, Chronic/*complications MH - Male MH - Middle Aged MH - *Renal Dialysis MH - Retrospective Studies MH - Survival Analysis EDAT- 2006/03/15 09:00 MHDA- 2006/05/02 09:00 CRDT- 2006/03/15 09:00 PHST- 2006/03/15 09:00 [pubmed] PHST- 2006/05/02 09:00 [medline] PHST- 2006/03/15 09:00 [entrez] AID - 90180 [pii] AID - 10.1159/000090180 [doi] PST - ppublish SO - Kidney Blood Press Res. 2005;28(5-6):270-4. doi: 10.1159/000090180. Epub 2006 Mar 7. PMID- 16504645 OWN - NLM STAT- MEDLINE DCOM- 20060321 LR - 20061115 IS - 1097-6744 (Electronic) IS - 0002-8703 (Linking) VI - 151 IP - 3 DP - 2006 Mar TI - Increased targeting of cardiovascular risk factors in patients with chronic kidney disease does not improve atheroma burden or cardiovascular function. PG - 745-53 AB - BACKGROUND: Although multiple risk factor intervention (MRFI) is recommended to reduce the increased morbidity and mortality of cardiovascular disease (CVD) in chronic kidney disease (CKD), its efficacy is unknown. We studied the efficacy of a MRFI program in CKD. METHODS: This randomized controlled study of 200 patients with stage 4 or 5 CKD compared a physician-supervised, nurse-driven MRFI clinic (focused on dyslipidemia, hyperhomocysteinemia, blood pressure [BP], anemia, and hyperphosphatemia) with conventional care in CKD. One hundred eleven subjects completed 2 years of follow-up (median follow-up 674 days [interquartile range IQR 348-719 days]). Outcome measures were atheroma burden (carotid intimamedia thickness [IMT]) and endothelial function (brachial artery reactivity [BAR]). RESULTS: The MRFI group showed significant improvements, compared with usual care, in serum low-density lipoprotein cholesterol (-30.9 mg/dL vs -12.7 mg/dL, P = .001), homocysteine (-6.95 vs -0.67 micromol/L, P < .001), systolic BP (-6.9 vs -0.2 mm Hg, P = .049), and diastolic BP (-4.8 vs -1.0 mm of Hg, P = .043). No significant changes were seen in serum phosphate or hemoglobin level. Despite observed improvements in risk factors, no differences from baseline were demonstrated for IMT (-0.00 vs -0.01 mm, P = .533) or BAR (0.09% vs 0.22%, P = .834). Forty-two patients reached a composite end point of CVD death, acute coronary syndrome, revascularization, nonfatal stroke, and amputation and this was similar between groups (23 vs 19 events, P = .475). CONCLUSIONS: A MRFI program was not associated with improvement in vascular structure or function in stage 4 or 5 patients with CKD. FAU - Isbel, Nicole M AU - Isbel NM AD - Department of Renal Medicine, Princess Alexandra Hospital, Brisbane, Australia. nikky_isbel@health.qld.gov.au FAU - Haluska, Brian AU - Haluska B FAU - Johnson, David W AU - Johnson DW FAU - Beller, Elaine AU - Beller E FAU - Hawley, Carmel AU - Hawley C FAU - Marwick, Thomas H AU - Marwick TH LA - eng PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 RN - 0 (Cholesterol, LDL) RN - 9007-41-4 (C-Reactive Protein) SB - IM MH - Adult MH - Blood Pressure MH - C-Reactive Protein/analysis MH - Cardiovascular Diseases/epidemiology/physiopathology/*prevention & control MH - Cholesterol, LDL/analysis MH - Chronic Disease MH - Endothelium, Vascular/physiopathology MH - Humans MH - Hyperhomocysteinemia/epidemiology MH - Kidney Diseases/epidemiology/physiopathology/*therapy MH - Male MH - Middle Aged MH - *Patient Care Management MH - Risk Factors EDAT- 2006/03/01 09:00 MHDA- 2006/03/22 09:00 CRDT- 2006/03/01 09:00 PHST- 2004/12/30 00:00 [received] PHST- 2005/06/05 00:00 [accepted] PHST- 2006/03/01 09:00 [pubmed] PHST- 2006/03/22 09:00 [medline] PHST- 2006/03/01 09:00 [entrez] AID - S0002-8703(05)00619-8 [pii] AID - 10.1016/j.ahj.2005.06.017 [doi] PST - ppublish SO - Am Heart J. 2006 Mar;151(3):745-53. doi: 10.1016/j.ahj.2005.06.017. PMID- 16490471 OWN - NLM STAT- MEDLINE DCOM- 20060302 LR - 20101118 IS - 1555-7162 (Electronic) IS - 0002-9343 (Linking) VI - 119 IP - 3 DP - 2006 Mar TI - Chronic kidney disease in patients with non-ST-segment elevation acute coronary syndromes. PG - 248-54 AB - PURPOSE: Chronic kidney disease has been linked to high mortality rates in patients with ST-segment elevation myocardial infarction but has not been well described for patients with non-ST-segment elevation acute coronary syndromes. We examined the treatment and outcomes of patients with both non-ST-segment elevation acute coronary syndromes and moderate to severe chronic kidney disease. SUBJECTS AND METHODS: We evaluated 45343 patients with non-ST-segment elevation acute coronary syndromes enrolled in the CRUSADE Quality Improvement Initiative and compared treatments and outcomes in patients with and without moderate to severe chronic kidney disease. RESULTS: Patients presenting with moderate to severe chronic kidney disease (n = 6560) were older, more often diabetic, and more likely to present with signs of congestive heart failure. Adherence to Class IA/IB guidelines recommendations was lower in patients with moderate to severe chronic kidney disease, who were significantly less likely to be treated with medications, undergo invasive cardiac procedures, and be given discharge counseling. Moderate to severe chronic kidney disease was associated with a 50% increased risk of mortality and a 70% increased likelihood of transfusion. Despite having a higher risk of adverse outcomes, patients with moderate to severe chronic kidney disease were treated less aggressively than patients with normal renal function. CONCLUSIONS: These findings suggest that, in patients with moderate to severe chronic kidney disease, safety concerns about adverse outcomes and the absence of trial data for this population may limit the use of guidelines-recommended therapies and interventions for non-ST-segment elevation acute coronary syndromes. The decreased use of discharge counseling in patients with moderate to severe chronic kidney disease and non-ST-segment elevation acute coronary syndromes may represent therapeutic nihilism. FAU - Han, Jin H AU - Han JH AD - Department of Emergency Medicine, University of Cincinnati School of Medicine, Cincinnati, Ohio, USA. jin.h.han@vanderbilt.edu FAU - Chandra, Abhinav AU - Chandra A FAU - Mulgund, Jyotsna AU - Mulgund J FAU - Roe, Matthew T AU - Roe MT FAU - Peterson, Eric D AU - Peterson ED FAU - Szczech, Lynda A AU - Szczech LA FAU - Patel, Uptal AU - Patel U FAU - Ohman, E Magnus AU - Ohman EM FAU - Lindsell, Christopher J AU - Lindsell CJ FAU - Gibler, W Brian AU - Gibler WB LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - United States TA - Am J Med JT - The American journal of medicine JID - 0267200 SB - IM MH - Aged MH - Aged, 80 and over MH - Angioplasty, Balloon, Coronary MH - Coronary Artery Bypass MH - Coronary Disease/*complications/therapy MH - Diabetes Mellitus, Type 1/complications MH - Diabetes Mellitus, Type 2/complications MH - Electrocardiography MH - Female MH - Hospital Mortality MH - Humans MH - Kidney Failure, Chronic/classification/*complications/drug therapy MH - Male MH - Middle Aged MH - Multicenter Studies as Topic MH - Registries MH - Severity of Illness Index EDAT- 2006/02/24 09:00 MHDA- 2006/03/03 09:00 CRDT- 2006/02/24 09:00 PHST- 2005/01/01 00:00 [received] PHST- 2005/08/22 00:00 [revised] PHST- 2005/08/22 00:00 [accepted] PHST- 2006/02/24 09:00 [pubmed] PHST- 2006/03/03 09:00 [medline] PHST- 2006/02/24 09:00 [entrez] AID - S0002-9343(06)00003-9 [pii] AID - 10.1016/j.amjmed.2005.08.057 [doi] PST - ppublish SO - Am J Med. 2006 Mar;119(3):248-54. doi: 10.1016/j.amjmed.2005.08.057. PMID- 16461961 OWN - NLM STAT- MEDLINE DCOM- 20060307 LR - 20190619 IS - 1539-3704 (Electronic) IS - 0003-4819 (Linking) VI - 144 IP - 3 DP - 2006 Feb 7 TI - Cardiovascular outcomes in high-risk hypertensive patients stratified by baseline glomerular filtration rate. PG - 172-80 AB - BACKGROUND: Chronic kidney disease is common in older patients with hypertension. OBJECTIVE: To compare rates of coronary heart disease (CHD) and end-stage renal disease (ESRD) events; to determine whether glomerular filtration rate (GFR) independently predicts risk for CHD; and to report the efficacy of first-step treatment with a calcium-channel blocker (amlodipine) or an angiotensin-converting enzyme inhibitor (lisinopril), each compared with a diuretic (chlorthalidone), in modifying cardiovascular disease (CVD) outcomes in high-risk patients with hypertension stratified by GFR. DESIGN: Post hoc subgroup analysis. SETTING: Multicenter randomized, double-blind, controlled trial. PARTICIPANTS: Persons with hypertension who were 55 years of age or older with 1 or more risk factors for CHD and who were stratified into 3 baseline GFR groups: normal or increased (> or = 90 mL/min per 1.73 m2; n = 8126 patients), mild reduction (60 to 89 mL/min per 1.73 m2; n = 18,109 patients), and moderate or severe reduction (< 60 mL/min per 1.73 m2; n = 5662 patients). INTERVENTIONS: Random assignment to chlorthalidone, amlodipine, or lisinopril. MEASUREMENTS: Rates of ESRD, CHD, stroke, and combined CVD (CHD, coronary revascularization, angina, stroke, heart failure, and peripheral arterial disease). RESULTS: In participants with a moderate to severe reduction in GFR, 6-year rates were higher for CHD than for ESRD (15.4% vs. 6.0%, respectively). A baseline GFR of less than 53 mL/min per 1.73 m2 (compared with >104 mL/min per 1.73 m2) was independently associated with a 32% higher risk for CHD. Amlodipine was similar to chlorthalidone in reducing CHD (16.0% vs. 15.2%, respectively; hazard ratio, 1.06 [95% CI, 0.89 to 1.27]), stroke, and combined CVD (CHD, coronary revascularization, angina, stroke, heart failure, and peripheral arterial disease), but less effective in preventing heart failure. Lisinopril was similar to chlorthalidone in preventing CHD (15.1% vs. 15.2%, respectively; hazard ratio, 1.00 [CI, 0.84 to 1.20]), but was less effective in reducing stroke, combined CVD events, and heart failure. LIMITATIONS: Proteinuria data were not available, and combination therapies were not tested. CONCLUSIONS: Older high-risk patients with hypertension and reduced GFR are more likely to develop CHD than to develop ESRD. A low GFR independently predicts increased risk for CHD. Neither amlodipine nor lisinopril is superior to chlorthalidone in preventing CHD, stroke, or combined CVD, and chlorthalidone is superior to both for preventing heart failure, independent of level of renal function. FAU - Rahman, Mahboob AU - Rahman M AD - Case Western Reserve University, Cleveland, Ohio, USA. FAU - Pressel, Sara AU - Pressel S FAU - Davis, Barry R AU - Davis BR FAU - Nwachuku, Chuke AU - Nwachuku C FAU - Wright, Jackson T Jr AU - Wright JT Jr FAU - Whelton, Paul K AU - Whelton PK FAU - Barzilay, Joshua AU - Barzilay J FAU - Batuman, Vecihi AU - Batuman V FAU - Eckfeldt, John H AU - Eckfeldt JH FAU - Farber, Michael A AU - Farber MA FAU - Franklin, Stanley AU - Franklin S FAU - Henriquez, Mario AU - Henriquez M FAU - Kopyt, Nelson AU - Kopyt N FAU - Louis, Gail T AU - Louis GT FAU - Saklayen, Mohammad AU - Saklayen M FAU - Stanford, Carole AU - Stanford C FAU - Walworth, Candace AU - Walworth C FAU - Ward, Harry AU - Ward H FAU - Wiegmann, Thomas AU - Wiegmann T CN - ALLHAT Collaborative Research Group LA - eng SI - ClinicalTrials.gov/NCT00000542 GR - N01-HC-35130/HC/NHLBI NIH HHS/United States PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't PL - United States TA - Ann Intern Med JT - Annals of internal medicine JID - 0372351 RN - 0 (Antihypertensive Agents) RN - 1J444QC288 (Amlodipine) RN - E7199S1YWR (Lisinopril) RN - Q0MQD1073Q (Chlorthalidone) SB - IM SPIN- Ann Intern Med. 2006 Feb 7;144(3):I33. doi: 10.7326/0003-4819-144-3-200602070-00001. PMID: 16461958 CIN - Ann Intern Med. 2006 Feb 7;144(3):213-5. doi: 10.7326/0003-4819-144-3-200602070-00011. PMID: 16461967 MH - Aged MH - Amlodipine/therapeutic use MH - Antihypertensive Agents/*therapeutic use MH - Cardiovascular Diseases/epidemiology/*prevention & control MH - Chlorthalidone/therapeutic use MH - Chronic Disease MH - Double-Blind Method MH - Female MH - *Glomerular Filtration Rate MH - Humans MH - Hypertension/complications/*drug therapy/*physiopathology MH - Kidney Diseases/complications/*physiopathology MH - Kidney Failure, Chronic/epidemiology/*prevention & control MH - Lisinopril/therapeutic use MH - Male MH - Middle Aged MH - Risk Factors EDAT- 2006/02/08 09:00 MHDA- 2006/03/08 09:00 CRDT- 2006/02/08 09:00 PHST- 2006/02/08 09:00 [pubmed] PHST- 2006/03/08 09:00 [medline] PHST- 2006/02/08 09:00 [entrez] AID - 144/3/172 [pii] AID - 10.7326/0003-4819-144-3-200602070-00005 [doi] PST - ppublish SO - Ann Intern Med. 2006 Feb 7;144(3):172-80. doi: 10.7326/0003-4819-144-3-200602070-00005. PMID- 16458766 OWN - NLM STAT- MEDLINE DCOM- 20060216 LR - 20150616 IS - 1474-547X (Electronic) IS - 0140-6736 (Linking) VI - 367 IP - 9508 DP - 2006 Feb 4 TI - Statins and sepsis in patients with cardiovascular disease: a population-based cohort analysis. PG - 413-8 AB - BACKGROUND: Atherosclerosis and sepsis share several pathophysiological similarities, including immune dysregulation, increased thrombogenesis, and systemic inflammation. The relation between statins and risk of sepsis in patients with atherosclerosis is unknown. METHODS: We did a population-based cohort analysis through linked administrative databases in Ontario, Canada, with accrual from 1997 to 2002. We identified 141,487 patients older than 65 years who had been hospitalised for an acute coronary syndrome, ischaemic stroke, or revascularisation, who survived for at least 3 months after discharge. 46,662 (33%) were prescribed a statin within 90 days of discharge, 94,825 (67%) were not. Propensity-based matching, which accounted for each individual's likelihood of receiving a statin, yielded a cohort of 69,168 patients, of whom half (34,584) received a statin and half (34,584) did not. FINDINGS: Incidence of sepsis was lower in patients receiving statins than in controls (71.2 vs 88.0 events per 10,000 person-years; hazard ratio [HR] 0.81; 95% CI 0.72-0.91). Adjustment for demographic characteristics, sepsis risk factors, comorbidities, and health-care use gave similar results (HR 0.81; 95% CI 0.72-0.90). The protective association between statins and sepsis persisted in high-risk subgroups, including patients with diabetes mellitus, chronic renal failure, or a history of infections. Significant reductions in severe sepsis (HR 0.83; 95% CI 0.70-0.97) and fatal sepsis (0.75; 0.61-0.93) were also observed. No benefit was noted with non-statin lipid-lowering agents (0.95; 0.75-1.22). IMPLICATIONS: Use of statins in patients with atherosclerosis is associated with a reduced risk of subsequent sepsis. Randomised trials of statins for prevention of sepsis are warranted. FAU - Hackam, Daniel G AU - Hackam DG AD - Division of Clinical Pharmacology and Toxicology, Sunnybrook and Women's College Health Sciences Centre, Toronto, Canada. FAU - Mamdani, Muhammad AU - Mamdani M FAU - Li, Ping AU - Li P FAU - Redelmeier, Donald A AU - Redelmeier DA LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - England TA - Lancet JT - Lancet (London, England) JID - 2985213R RN - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors) SB - IM CIN - Lancet. 2006 Feb 4;367(9508):372-3. doi: 10.1016/S0140-6736(06)68042-2. PMID: 16458744 CIN - Lancet. 2006 May 20;367(9523):1651; author reply 1651. doi: 10.1016/S0140-6736(06)68720-5. PMID: 16714174 CIN - Lancet. 2006 May 20;367(9523):1651; author reply 1651. doi: 10.1016/S0140-6736(06)68721-7. PMID: 16714176 MH - Aged MH - Cardiovascular Diseases/*drug therapy MH - Comorbidity MH - Databases, Factual MH - Female MH - Follow-Up Studies MH - Hospitalization MH - Humans MH - Hydroxymethylglutaryl-CoA Reductase Inhibitors/*therapeutic use MH - Male MH - Ontario MH - Retrospective Studies MH - Sepsis/classification/etiology/*prevention & control MH - Severity of Illness Index EDAT- 2006/02/07 09:00 MHDA- 2006/02/17 09:00 CRDT- 2006/02/07 09:00 PHST- 2006/02/07 09:00 [pubmed] PHST- 2006/02/17 09:00 [medline] PHST- 2006/02/07 09:00 [entrez] AID - S0140-6736(06)68041-0 [pii] AID - 10.1016/S0140-6736(06)68041-0 [doi] PST - ppublish SO - Lancet. 2006 Feb 4;367(9508):413-8. doi: 10.1016/S0140-6736(06)68041-0. PMID- 16458134 OWN - NLM STAT- MEDLINE DCOM- 20060327 LR - 20141120 IS - 1558-3597 (Electronic) IS - 0735-1097 (Linking) VI - 47 IP - 3 DP - 2006 Feb 7 TI - Predictors of adverse outcome among patients with hypertension and coronary artery disease. PG - 547-51 AB - OBJECTIVES: We sought to determine predictors for adverse outcomes in hypertensive patients with coronary artery disease (CAD). BACKGROUND: Factors leading to adverse outcomes in hypertensive patients with CAD are poorly understood. The INternational VErapamil-trandolapril STudy (INVEST) compared outcomes in hypertensive patients with CAD that were assigned randomly to either a verapamil sustained-release (SR)- or an atenolol-based strategy for blood pressure (BP) control. Trandolapril and hydrochlorothiazide were used as added agents. During follow-up (61,835 patient-years), BP control and the primary outcome (death, nonfatal myocardial infarction, and nonfatal stroke) were not different between strategies. METHODS: We investigated risk for adverse outcome associated with baseline factors, follow-up BP, and drug treatments using Cox modeling. RESULTS: Previous heart failure (adjusted hazard ratio [HR] 1.96), as well as diabetes (HR 1.77), increased age (HR 1.63), U.S. residency (HR 1.61), renal impairment (HR 1.50), stroke/transient ischemic attack (HR 1.43), smoking (HR 1.41), myocardial infarction (HR 1.34), peripheral vascular disease (HR 1.27), and revascularization (HR 1.15) predicted increased risk. Follow-up systolic BP <140 mm Hg or diastolic BP <90 mm Hg (HRs 0.82 or 0.70, respectively) and trandolapril with verapamil SR (HRs 0.78 and 0.79) were associated with reduced risk. CONCLUSIONS: In hypertensive patients with CAD, increased risk for adverse outcomes was associated with conditions related to the severity of CAD and diminished left ventricular function. Lower follow-up BP and addition of trandolapril to verapamil SR each were associated with reduced risk. FAU - Pepine, Carl J AU - Pepine CJ AD - Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida 32610-0277, USA. pepincj@medicine.ufl.edu FAU - Kowey, Peter R AU - Kowey PR FAU - Kupfer, Stuart AU - Kupfer S FAU - Kolloch, Rainer E AU - Kolloch RE FAU - Benetos, Athanase AU - Benetos A FAU - Mancia, Giuseppe AU - Mancia G FAU - Coca, Antonio AU - Coca A FAU - Cooper-DeHoff, Rhonda M AU - Cooper-DeHoff RM FAU - Handberg, Eileen AU - Handberg E FAU - Gaxiola, Efrain AU - Gaxiola E FAU - Sleight, Peter AU - Sleight P FAU - Conti, C Richard AU - Conti CR FAU - Hewkin, Ann C AU - Hewkin AC FAU - Tavazzi, Luigi AU - Tavazzi L CN - INVEST Investigators LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20060118 PL - United States TA - J Am Coll Cardiol JT - Journal of the American College of Cardiology JID - 8301365 RN - 0 (Angiotensin-Converting Enzyme Inhibitors) RN - 0 (Antihypertensive Agents) RN - 0 (Calcium Channel Blockers) RN - 0 (Indoles) RN - 1T0N3G9CRC (trandolapril) RN - 50VV3VW0TI (Atenolol) RN - CJ0O37KU29 (Verapamil) SB - IM MH - Angiotensin-Converting Enzyme Inhibitors/therapeutic use MH - Antihypertensive Agents/therapeutic use MH - Atenolol/therapeutic use MH - Blood Pressure MH - Calcium Channel Blockers/therapeutic use MH - Coronary Artery Disease/*complications/drug therapy/physiopathology MH - Humans MH - Hypertension/*complications/drug therapy MH - Indoles/therapeutic use MH - Middle Aged MH - Myocardial Infarction/etiology MH - Proportional Hazards Models MH - Risk Factors MH - Stroke/etiology MH - Verapamil/therapeutic use EDAT- 2006/02/07 09:00 MHDA- 2006/03/28 09:00 CRDT- 2006/02/07 09:00 PHST- 2004/05/28 00:00 [received] PHST- 2005/09/02 00:00 [revised] PHST- 2005/09/12 00:00 [accepted] PHST- 2006/02/07 09:00 [pubmed] PHST- 2006/03/28 09:00 [medline] PHST- 2006/02/07 09:00 [entrez] AID - S0735-1097(05)02621-5 [pii] AID - 10.1016/j.jacc.2005.09.031 [doi] PST - ppublish SO - J Am Coll Cardiol. 2006 Feb 7;47(3):547-51. doi: 10.1016/j.jacc.2005.09.031. Epub 2006 Jan 18. PMID- 16400465 OWN - NLM STAT- MEDLINE DCOM- 20061019 LR - 20190606 IS - 0100-879X (Print) IS - 0100-879X (Linking) VI - 39 IP - 1 DP - 2006 Jan TI - A randomized, double-blind, and placebo-controlled study with tranexamic acid of bleeding and fibrinolytic activity after primary coronary artery bypass grafting. PG - 63-9 AB - Cardiopulmonary bypass is frequently associated with excessive blood loss. Platelet dysfunction is the main cause of non-surgical bleeding after open-heart surgery. We randomized 65 patients in a double-blind fashion to receive tranexamic acid or placebo in order to determine whether antifibrinolytic therapy reduces chest tube drainage. The tranexamic acid group received an intravenous loading dose of 10 mg/kg, before the skin incision, followed by a continuous infusion of 1 mg kg(-1) h(-1) for 5 h. The placebo group received a bolus of normal saline solution and continuous infusion of normal saline for 5 h. Postoperative bleeding and fibrinolytic activity were assessed. Hematologic data, convulsive seizures, allogeneic transfusion, occurrence of myocardial infarction, mortality, allergic reactions, postoperative renal insufficiency, and reopening rate were also evaluated. The placebo group had a greater postoperative blood loss (median (25th to 75th percentile) 12 h after surgery (540 (350-750) vs 300 (250-455) mL, P = 0.001). The placebo group also had greater blood loss 24 h after surgery (800 (520-1050) vs 500 (415-725) mL, P = 0.008). There was a significant increase in plasma D-dimer levels after coronary artery bypass grafting only in patients of the placebo group, whereas no significant changes were observed in the group treated with tranexamic acid. The D-dimer levels were 1057 (1025-1100) microg/L in the placebo group and 520 (435-837) microg/L in the tranexamic acid group (P = 0.01). We conclude that tranexamic acid effectively reduces postoperative bleeding and fibrinolysis in patients undergoing first-time coronary artery bypass grafting compared to placebo. FAU - Santos, A T L AU - Santos AT AD - Instituto de Cardiologia do Rio Grande do Sul, Fundacao Universitaria de Cardiologia, Porto Alegre, RS, Brazil. pesquisa@cardiologia.org.br FAU - Kalil, R A K AU - Kalil RA FAU - Bauemann, C AU - Bauemann C FAU - Pereira, J B AU - Pereira JB FAU - Nesralla, I A AU - Nesralla IA LA - eng PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20051215 PL - Brazil TA - Braz J Med Biol Res JT - Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologicas JID - 8112917 RN - 0 (Antifibrinolytic Agents) RN - 6T84R30KC1 (Tranexamic Acid) SB - IM MH - Antifibrinolytic Agents/*therapeutic use MH - Cardiopulmonary Bypass/*adverse effects/methods MH - Coronary Artery Bypass/*adverse effects/methods MH - Double-Blind Method MH - Female MH - Fibrinolysis/*drug effects MH - Humans MH - Male MH - Middle Aged MH - Postoperative Hemorrhage/*prevention & control MH - Prospective Studies MH - Tranexamic Acid/*therapeutic use EDAT- 2006/01/10 09:00 MHDA- 2006/10/20 09:00 CRDT- 2006/01/10 09:00 PHST- 2006/01/10 09:00 [pubmed] PHST- 2006/10/20 09:00 [medline] PHST- 2006/01/10 09:00 [entrez] AID - S0100-879X2006000100007 [pii] AID - 10.1590/s0100-879x2006000100007 [doi] PST - ppublish SO - Braz J Med Biol Res. 2006 Jan;39(1):63-9. doi: 10.1590/s0100-879x2006000100007. Epub 2005 Dec 15. PMID- 16382257 OWN - NLM STAT- MEDLINE DCOM- 20060421 LR - 20241219 IS - 1074-2484 (Print) IS - 1074-2484 (Linking) VI - 10 IP - 4 DP - 2005 Dec TI - Bivalirudin vs heparin in percutaneous coronary intervention: a pooled analysis. PG - 209-16 AB - OBJECTIVE: This study evaluates outcomes with bivalirudin vs heparin in various patient subgroups and the overall population during percutaneous coronary interventions (PCI). BACKGROUND: Recent data suggest that bivalirudin, a reversible direct thrombin inhibitor, provides ischemic protection superior to heparin and comparable to heparin plus glycoprotein (GP) IIb/IIIa inhibitors but with significantly fewer bleeding complications. Whether this advantage persists in different subgroups has not been fully defined. To our knowledge, this is the largest pooled analysis of bivalirudin to date. METHODS: Four randomized controlled trials were identified that compared bivalirudin to heparin (with or without GP IIb/IIIa inhibitors) in PCI. The incidence of death, myocardial infarction (MI), revascularization, and major bleeding at 48 hours was compared between these two agents overall and in patients with and without diabetes mellitus, hypertension, renal insufficiency, and advanced age. RESULTS: The trials consisted of 11,638 patients (bivalirudin, 5,861; heparin, 5,777). There were no significant differences in patient characteristics between the two groups. At 48 hours, the incidence of death, MI, revascularization, and major bleeding was significantly reduced in the bivalirudin group (7.8% vs 1.08%, P < .001); individual ischemic end points were significantly reduced for death (0.01% vs 0.02%, P = .049) and revascularization (2.0% vs 2.7%, P = .02), with similar reductions for major bleeding (2.7% vs 5.8%, P < .001). Subgroup analysis was generally consistent with the overall findings. CONCLUSION: This analysis further supports the superiority of bivalirudin compared with heparin. Bivalirudin provides excellent ischemic protection with a significant reduction of bleeding complications, even in high-risk subgroups. FAU - Ebrahimi, Ramin AU - Ebrahimi R AD - University of California, Los Angeles School of Medicine, West Los Angeles VA, Los Angeles, USA. ramin.ebrahimi@med.va.gov FAU - Lincoff, A Michael AU - Lincoff AM FAU - Bittl, John A AU - Bittl JA FAU - Chew, Derek AU - Chew D FAU - Wolski, Kathy AU - Wolski K FAU - Wadhan, Nitin AU - Wadhan N FAU - Toggart, Edward J AU - Toggart EJ FAU - Topol, Eric J AU - Topol EJ LA - eng PT - Comparative Study PT - Journal Article PL - United States TA - J Cardiovasc Pharmacol Ther JT - Journal of cardiovascular pharmacology and therapeutics JID - 9602617 RN - 0 (Anticoagulants) RN - 0 (Hirudins) RN - 0 (Peptide Fragments) RN - 0 (Recombinant Proteins) RN - 9005-49-6 (Heparin) RN - TN9BEX005G (bivalirudin) SB - IM MH - *Angioplasty, Balloon, Coronary/adverse effects MH - Anticoagulants/*therapeutic use MH - Heparin/*therapeutic use MH - Hirudins MH - Humans MH - Myocardial Ischemia/etiology/*prevention & control MH - Peptide Fragments/*therapeutic use MH - Postoperative Hemorrhage/etiology/*prevention & control MH - Randomized Controlled Trials as Topic MH - Recombinant Proteins/therapeutic use MH - Time Factors EDAT- 2005/12/31 09:00 MHDA- 2006/04/25 09:00 CRDT- 2005/12/31 09:00 PHST- 2005/12/31 09:00 [pubmed] PHST- 2006/04/25 09:00 [medline] PHST- 2005/12/31 09:00 [entrez] AID - 10.1177/107424840501000401 [doi] PST - ppublish SO - J Cardiovasc Pharmacol Ther. 2005 Dec;10(4):209-16. doi: 10.1177/107424840501000401. PMID- 16368312 OWN - NLM STAT- MEDLINE DCOM- 20060331 LR - 20101118 IS - 1097-6744 (Electronic) IS - 0002-8703 (Linking) VI - 151 IP - 1 DP - 2006 Jan TI - Impact of body mass index on outcomes after primary angioplasty in acute myocardial infarction. PG - 168-75 AB - BACKGROUND: The prognostic importance of obesity after primary percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI) is unknown. We therefore sought to investigate the impact of body mass index (BMI) in patients with AMI undergoing primary PCI. METHODS: In the CADILLAC trial, 2082 patients of any age with AMI within 12 hours onset undergoing primary PCI were randomized to balloon angioplasty versus stenting, each +/-abciximab. Outcomes were stratified by baseline BMI. RESULTS: Baseline BMI was measured in 2035 (98%) randomized patients; 552 (27%) patients have normal weight (BMI < 25 kg/m2), 915 (45%) were overweight (> or = 25 to < 30 kg/m2), and 568 (28%) were obese (> or = 30 kg/m2). Compared with normal-weight patients, obese patients were younger and more frequently had diabetes, hyperlipidemia, hypertension, non-anterior myocardial infarction, and higher creatinine clearance. Obese patients were less likely to develop thrombocytopenia (1.8% vs 4.2%), moderate hemorrhagic complications (1.4% vs 3.3%), or required blood product transfusions (3.2% vs 6.3%) (all P < or = .04). Obese compared with normal-weight patients had lower inhospital mortality (0.9% vs 2.7%, P = .03) at 30 days (1.1% vs 3.8%, P = .02) and 1 year (1.8% vs 7.5%, P < .0001). Independent predictors of 30-day and 1-year mortality included lower ejection fraction, advanced age, 3-vessel disease, anterior AMI, and lower creatinine clearance, but not BMI. CONCLUSIONS: Obese patients with AMI have an improved prognosis after primary PCI compared with normal-weight patients, a finding attributable to AMI onset at younger age, with better renal function and less anterior infarction. FAU - Nikolsky, Eugenia AU - Nikolsky E AD - Columbia University Medical Center, New York, NY, USA. FAU - Stone, Gregg W AU - Stone GW FAU - Grines, Cindy L AU - Grines CL FAU - Cox, David A AU - Cox DA FAU - Garcia, Eulogio AU - Garcia E FAU - Tcheng, James E AU - Tcheng JE FAU - Griffin, John J AU - Griffin JJ FAU - Guagliumi, Giulio AU - Guagliumi G FAU - Stuckey, Thomas AU - Stuckey T FAU - Turco, Mark AU - Turco M FAU - Negoita, Manuela AU - Negoita M FAU - Lansky, Alexandra J AU - Lansky AJ FAU - Mehran, Roxana AU - Mehran R LA - eng PT - Journal Article PT - Randomized Controlled Trial PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 SB - IM MH - Aged MH - *Angioplasty, Balloon, Coronary MH - *Body Mass Index MH - Female MH - Follow-Up Studies MH - Humans MH - Male MH - Middle Aged MH - Myocardial Infarction/*complications/mortality/*surgery MH - Obesity/*complications MH - Treatment Outcome EDAT- 2005/12/22 09:00 MHDA- 2006/04/01 09:00 CRDT- 2005/12/22 09:00 PHST- 2004/06/14 00:00 [received] PHST- 2005/03/15 00:00 [accepted] PHST- 2005/12/22 09:00 [pubmed] PHST- 2006/04/01 09:00 [medline] PHST- 2005/12/22 09:00 [entrez] AID - S0002-8703(05)00319-4 [pii] AID - 10.1016/j.ahj.2005.03.024 [doi] PST - ppublish SO - Am Heart J. 2006 Jan;151(1):168-75. doi: 10.1016/j.ahj.2005.03.024. PMID- 16361300 OWN - NLM STAT- MEDLINE DCOM- 20060216 LR - 20260128 IS - 0007-0912 (Print) IS - 0007-0912 (Linking) VI - 96 IP - 2 DP - 2006 Feb TI - Single dose parecoxib significantly improves ventilatory function in early extubation coronary artery bypass surgery: a prospective randomized double blind placebo controlled trial. PG - 171-8 AB - BACKGROUND: Parecoxib, a cyclo oxygenase-2 inhibiting non-steroidal anti-inflammatory drug, has been widely used for postoperative analgesia. Our aim was to quantify the benefit of a single dose after coronary artery bypass grafting. METHODS: The investigation was carried out as a randomized double blind placebo controlled study. A single i.v. dose of parecoxib 40 mg or placebo was given at closure of sternotomy. No opioid other than morphine was given in the first 24 postoperative hours. Pain was assessed using both a Visual Analogue Score (1-10), and the amount of morphine used via a morphine patient controlled analgesia pump. Creatinine clearance was measured before and after operation from 24 h urine collections. After a global announcement by Pfizer that paracoxib was 'contraindicated in patients with ischaemic heart disease' further recruitment was suspended and the collected data from 40 patients were analysed. RESULTS: Twenty-one patients received parecoxib and 19 received placebo. Amongst those who received parecoxib, there was a highly significant sparing of rescue medication before tracheal extubation (P=0.004) compared with placebo, and an overall 35% morphine sparing effect during the first 6 h post extubation after correction for the variability in extubation time (P=0.037). Respiration, as measured by arterial carbon dioxide tension at the time of extubation, was significantly better in the parecoxib group (P=0.045). Significantly more furosemide was given for postoperative oliguria in those patients who received parecoxib (P=0.036). After correcting for differences in diuretic usage and fluid balance, parecoxib was associated with a significant increase in plasma creatinine (P=0.041). CONCLUSION: A single dose of parecoxib has a significant opioid sparing effect in the first 6 h after coronary artery bypass grafting which resulted in significantly improved ventilation with mild elevation of plasma creatinine within normal limits. FAU - Khalil, M W AU - Khalil MW AD - South Yorkshire Cardiothoracic Unit, Sheffield Teaching Hospitals NHS Foundation Trust, The Northern General Hospital, Herries Road, Sheffield S5 7AU, UK. FAU - Chaterjee, A AU - Chaterjee A FAU - Macbryde, G AU - Macbryde G FAU - Sarkar, P K AU - Sarkar PK FAU - Marks, R R D AU - Marks RR LA - eng PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20051216 PL - England TA - Br J Anaesth JT - British journal of anaesthesia JID - 0372541 RN - 0 (Analgesics, Opioid) RN - 0 (Anti-Inflammatory Agents, Non-Steroidal) RN - 0 (Cyclooxygenase 2 Inhibitors) RN - 0 (Isoxazoles) RN - 142M471B3J (Carbon Dioxide) RN - 76I7G6D29C (Morphine) RN - 9TUW81Y3CE (parecoxib) RN - AYI8EX34EU (Creatinine) SB - IM MH - Adult MH - Aged MH - Analgesia, Patient-Controlled MH - Analgesics, Opioid/administration & dosage MH - Anti-Inflammatory Agents, Non-Steroidal/administration & dosage MH - Carbon Dioxide/blood MH - *Coronary Artery Bypass MH - Creatinine/blood MH - Cyclooxygenase 2 Inhibitors/*administration & dosage MH - Device Removal MH - Double-Blind Method MH - Drug Administration Schedule MH - Fluid Therapy MH - Humans MH - Intubation, Intratracheal MH - Isoxazoles/*administration & dosage MH - Kidney/physiopathology MH - Middle Aged MH - Morphine/administration & dosage MH - Postoperative Pain/*prevention & control MH - Postoperative Care/methods MH - Respiration/*drug effects EDAT- 2005/12/20 09:00 MHDA- 2006/02/17 09:00 CRDT- 2005/12/20 09:00 PHST- 2005/12/20 09:00 [pubmed] PHST- 2006/02/17 09:00 [medline] PHST- 2005/12/20 09:00 [entrez] AID - S0007-0912(17)35228-5 [pii] AID - 10.1093/bja/aei298 [doi] PST - ppublish SO - Br J Anaesth. 2006 Feb;96(2):171-8. doi: 10.1093/bja/aei298. Epub 2005 Dec 16. PMID- 16338253 OWN - NLM STAT- MEDLINE DCOM- 20060214 LR - 20151119 IS - 1097-6744 (Electronic) IS - 0002-8703 (Linking) VI - 150 IP - 6 DP - 2005 Dec TI - Impact of moderate renal insufficiency on restenosis and adverse clinical events after paclitaxel-eluting and bare metal stent implantation: results from the TAXUS-IV Trial. PG - 1163-70 AB - BACKGROUND: Mortality and restenosis may be increased in patients with mild to moderate renal insufficiency (RI) after coronary stent implantation. Whether drug-eluting stents safely reduce restenosis and enhance event-free survival in these patients is unknown. We sought to evaluate the impact of baseline RI on clinical and angiographic outcomes in patients undergoing elective percutaneous coronary intervention using either bare metal or paclitaxel-eluting stents. METHODS: In the TAXUS-IV trial, 1314 patients were randomized to either the polymer-based paclitaxel-eluting TAXUS stent or an identical-appearing bare metal stent. Outcomes were stratified on the basis of the presence of RI, defined as a baseline creatinine clearance < 60 cm3/min calculated by the Cockcroft-Gault formula. RESULTS: Baseline RI was present in 223 (17.2%) patients, in whom the mean creatinine clearance was 49.6 +/- 8.5 cm3/min. Compared with bare metal stents, treatment with the TAXUS stent resulted in lower rates of 9-month angiographic restenosis rates in both patients with (2.1% vs 20.5%, P = .009) and without (9.2% vs 27.8%, P < .0001) baseline RI. Similarly, 1-year target lesion revascularization rates were reduced with the TAXUS stent in patients with (3.3% vs 12.2%, P = .01) and without (4.7% vs 15.8%, P < .0001) baseline RI. The occurrence of death, myocardial infarction, and stent thrombosis at 1 year were similar in both randomization groups, independent of renal function. CONCLUSIONS: The polymer-based paclitaxel-eluting TAXUS stent safely reduces clinical and angiographic restenosis in patients with preserved as well as moderate impairment of baseline renal function. FAU - Halkin, Amir AU - Halkin A AD - Cardiovascular Research Foundation, New York, NY 10022, USA. FAU - Mehran, Roxana AU - Mehran R FAU - Casey, Christopher W AU - Casey CW FAU - Gordon, Paul AU - Gordon P FAU - Matthews, Ray AU - Matthews R FAU - Wilson, B Hadley AU - Wilson BH FAU - Leon, Martin B AU - Leon MB FAU - Russell, Mary E AU - Russell ME FAU - Ellis, Stephen G AU - Ellis SG FAU - Stone, Gregg W AU - Stone GW LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 RN - 0 (Delayed-Action Preparations) RN - AYI8EX34EU (Creatinine) RN - P88XT4IS4D (Paclitaxel) SB - IM MH - Aged MH - Coronary Disease/complications/*surgery MH - Coronary Restenosis MH - Creatinine/blood MH - Delayed-Action Preparations MH - Female MH - Humans MH - Kidney Failure, Chronic/*complications/physiopathology MH - Kidney Function Tests MH - Male MH - Middle Aged MH - Paclitaxel/adverse effects/*therapeutic use MH - Risk Factors MH - *Stents/adverse effects EDAT- 2005/12/13 09:00 MHDA- 2006/02/16 09:00 CRDT- 2005/12/13 09:00 PHST- 2004/10/06 00:00 [received] PHST- 2005/01/19 00:00 [accepted] PHST- 2005/12/13 09:00 [pubmed] PHST- 2006/02/16 09:00 [medline] PHST- 2005/12/13 09:00 [entrez] AID - S0002-8703(05)00064-5 [pii] AID - 10.1016/j.ahj.2005.01.032 [doi] PST - ppublish SO - Am Heart J. 2005 Dec;150(6):1163-70. doi: 10.1016/j.ahj.2005.01.032. PMID- 16298256 OWN - NLM STAT- MEDLINE DCOM- 20060123 LR - 20161124 IS - 0270-9295 (Print) IS - 0270-9295 (Linking) VI - 25 IP - 6 DP - 2005 Nov TI - Sudden cardiac death and acute myocardial infarction in dialysis patients: perspectives of a cardiologist. PG - 363-6 AB - Chronic renal failure is characterized by an increased risk for cardiovascular morbidity and mortality, including acute myocardial infarction (AMI). AMI is associated with poor long-term survival in dialysis patients; the 2-year survival rate of 25% has remained unchanged over the past 2 decades. Although underuse of appropriate therapies likely contributes to adverse outcomes, recent data suggest that dialysis patients with AMI are more likely to have clinical presentations atypical for acute coronary syndrome. The risk for cardiac arrest and in-hospital death are increased in dialysis patients with AMI compared with a nondialysis cohort. The phenomenon of increased AMI mortality in patients with chronic kidney disease is not restricted to end-stage renal disease because there is a gradient of mortality risk related to decreased renal function. Sudden cardiac death is the single largest cause of mortality in dialysis patients. Dialysis patients are vulnerable to sudden cardiac death, and myocardial ischemia likely plays a major role. Nevertheless, after percutaneous and surgical coronary revascularization dialysis patients remain at high risk for sudden cardiac death, implying that other factors besides myocardial ischemia are important. A randomized trial testing the efficacy of implantable cardioverter-defibrillators for the prevention of sudden cardiac death in dialysis patients is warranted. FAU - Herzog, Charles A AU - Herzog CA AD - Cardiovascular Special Studies Center, United States Renal Data System, Hennepin County Medical Center and University of Minnesota, Minneapolis, MN 55404, USA. Cherzog@usrds.org LA - eng PT - Comparative Study PT - Journal Article PL - United States TA - Semin Nephrol JT - Seminars in nephrology JID - 8110298 SB - IM MH - Age Factors MH - Aged MH - Angioplasty, Balloon, Coronary/methods MH - Cardiology MH - Coronary Angiography MH - Death, Sudden, Cardiac/*epidemiology MH - Female MH - Follow-Up Studies MH - Humans MH - Incidence MH - Kidney Failure, Chronic/diagnosis/mortality/*therapy MH - Kidney Function Tests MH - Male MH - Middle Aged MH - Myocardial Infarction/diagnostic imaging/*mortality/therapy MH - Renal Dialysis/*adverse effects/methods MH - Risk Assessment MH - Severity of Illness Index MH - Sex Factors EDAT- 2005/11/22 09:00 MHDA- 2006/01/24 09:00 CRDT- 2005/11/22 09:00 PHST- 2005/11/22 09:00 [pubmed] PHST- 2006/01/24 09:00 [medline] PHST- 2005/11/22 09:00 [entrez] AID - S0270-9295(05)00098-7 [pii] AID - 10.1016/j.semnephrol.2005.05.003 [doi] PST - ppublish SO - Semin Nephrol. 2005 Nov;25(6):363-6. doi: 10.1016/j.semnephrol.2005.05.003. PMID- 16251235 OWN - NLM STAT- MEDLINE DCOM- 20060427 LR - 20131121 IS - 1046-6673 (Print) IS - 1046-6673 (Linking) VI - 16 IP - 12 DP - 2005 Dec TI - Effect of pravastatin in people with diabetes and chronic kidney disease. PG - 3748-54 AB - Although diabetes is a major cause of chronic kidney disease (CKD), limited data describe the cardiovascular benefit of hydroxymethyl glutaryl CoA reductase inhibitors (statins) in people with both of these conditions. This study sought to determine whether pravastatin reduced the incidence of first or recurrent cardiovascular events in people with non-dialysis-dependent CKD and concomitant diabetes, using data from three randomized trials of pravastatin 40 mg daily versus placebo. CKD was defined by estimated GFR <60 or 60 to 89.9 ml/min per 1.73 m2 with proteinuria. Of 19,737 patients, 4099 (20.8%) had CKD but not diabetes at baseline, 873 (4.4%) had diabetes but not CKD, and 571 (2.9%) had both conditions. The primary composite outcome was time to myocardial infarction, coronary death, or percutaneous/surgical coronary revascularization. Median follow-up was 64 mo. After adjustment for trial and random treatment assignment, the incidence of the primary outcome was lowest in individuals with neither CKD nor diabetes (15.2%), intermediate in individuals with only CKD (18.6%) or only diabetes (21.3%), and highest in individuals with both characteristics (27.0%). Pravastatin reduced the relative likelihood of the primary outcome to a similar extent in subgroups defined by the presence or absence of CKD and diabetes. For example, pravastatin was associated with a significant reduction in the relative risk of the primary outcome by 25% in patients with CKD and concomitant diabetes and by 24% in individuals with neither characteristic. However, the absolute reduction in the risk of the primary outcome as a result of pravastatin use was highest in patients with both CKD and diabetes (6.4%) and lowest in individuals with neither characteristic (3.5%). In conclusion, stage 2 or early stage 3 CKD and diabetes both are associated with higher cardiovascular risk, and pravastatin reduces cardiovascular event rates in people with neither, one, or both characteristics. Given the high absolute benefit of pravastatin in patient with diabetes and stage 2 or early stage 3 CKD, this population in particular should be targeted for widespread use of statins. Additional studies are needed to determine whether these benefits apply to patients with more severe CKD, and recruitment to such studies should be given high priority. FAU - Tonelli, Marcello AU - Tonelli M AD - Division of Nephrology, University of Alberta, Edmonton, Alberta, Canada. mtonelli@ualberta.ca FAU - Keech, Anthony AU - Keech A FAU - Shepherd, Jim AU - Shepherd J FAU - Sacks, Frank AU - Sacks F FAU - Tonkin, Andrew AU - Tonkin A FAU - Packard, Chris AU - Packard C FAU - Pfeffer, Marc AU - Pfeffer M FAU - Simes, John AU - Simes J FAU - Isles, Chris AU - Isles C FAU - Furberg, Curt AU - Furberg C FAU - West, Malcolm AU - West M FAU - Craven, Tim AU - Craven T FAU - Curhan, Gary AU - Curhan G LA - eng PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20051026 PL - United States TA - J Am Soc Nephrol JT - Journal of the American Society of Nephrology : JASN JID - 9013836 RN - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors) RN - KXO2KT9N0G (Pravastatin) SB - IM MH - Adult MH - Age Distribution MH - Aged MH - Cardiovascular Diseases/*drug therapy/*epidemiology/prevention & control MH - Diabetes Mellitus, Type 2/diagnosis/epidemiology/therapy MH - Diabetic Nephropathies/diagnosis/*epidemiology/therapy MH - Dose-Response Relationship, Drug MH - Drug Administration Schedule MH - Female MH - Humans MH - Hydroxymethylglutaryl-CoA Reductase Inhibitors/*therapeutic use MH - Male MH - Middle Aged MH - Pravastatin/*therapeutic use MH - Prevalence MH - Probability MH - Prognosis MH - Renal Insufficiency, Chronic/diagnosis/*epidemiology/therapy MH - Risk Assessment MH - Sex Distribution MH - Treatment Outcome EDAT- 2005/10/28 09:00 MHDA- 2006/04/28 09:00 CRDT- 2005/10/28 09:00 PHST- 2005/10/28 09:00 [pubmed] PHST- 2006/04/28 09:00 [medline] PHST- 2005/10/28 09:00 [entrez] AID - ASN.2005070779 [pii] AID - 10.1681/ASN.2005070779 [doi] PST - ppublish SO - J Am Soc Nephrol. 2005 Dec;16(12):3748-54. doi: 10.1681/ASN.2005070779. Epub 2005 Oct 26. PMID- 16226173 OWN - NLM STAT- MEDLINE DCOM- 20060119 LR - 20220311 IS - 1558-3597 (Electronic) IS - 0735-1097 (Linking) VI - 46 IP - 8 DP - 2005 Oct 18 TI - The implications of blood transfusions for patients with non-ST-segment elevation acute coronary syndromes: results from the CRUSADE National Quality Improvement Initiative. PG - 1490-5 AB - OBJECTIVES: In a large contemporary population of patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS), we sought to describe blood transfusion rates (overall and in patients who did not undergo coronary artery bypass grafting [CABG]), patient characteristics and practices associated with transfusion, variation among hospitals, and in-hospital outcomes in patients receiving transfusions. BACKGROUND: The use of antithrombotic agents and invasive procedures reduces ischemic complications but increases risks for bleeding and need for blood transfusion in patients with NSTE ACS. METHODS: We evaluated patient characteristics and transfusion rates in the overall population (n = 85,111) and determined outcomes and factors associated with need for transfusion in a subpopulation of patients who did not undergo CABG (n = 74,271) from 478 U.S. hospitals between January 1, 2001, and March 31, 2004. RESULTS: A total of 14.9% of the overall and 10.3% of the non-CABG population underwent transfusion during their hospitalization. Renal insufficiency and advanced age were strongly associated with the likelihood of transfusion. Interhospital transfusion rates varied significantly. Non-CABG patients who received transfusions had a greater risk of death (11.5% vs. 3.8%) and death or reinfarction (13.4% vs. 5.8%) than patients who did not undergo transfusion. CONCLUSIONS: Transfusion is common in the setting of NSTE ACS, and patients who undergo transfusion are sicker at baseline and experience a higher risk of adverse outcomes than their nontransfused counterparts. Given the wide variation in transfusion practice, further efforts to understand patient and process factors that result in bleeding and need for transfusion in NSTE ACS are needed. FAU - Yang, Xin AU - Yang X AD - Division of Cardiology and Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina 27715, USA. FAU - Alexander, Karen P AU - Alexander KP FAU - Chen, Anita Y AU - Chen AY FAU - Roe, Matthew T AU - Roe MT FAU - Brindis, Ralph G AU - Brindis RG FAU - Rao, Sunil V AU - Rao SV FAU - Gibler, W Brian AU - Gibler WB FAU - Ohman, E Magnus AU - Ohman EM FAU - Peterson, Eric D AU - Peterson ED CN - CRUSADE Investigators LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20050929 PL - United States TA - J Am Coll Cardiol JT - Journal of the American College of Cardiology JID - 8301365 SB - IM MH - Acute Disease MH - Aged MH - Angina, Unstable/*therapy MH - Blood Transfusion/*statistics & numerical data MH - Clinical Trials as Topic MH - Female MH - Humans MH - Male MH - Middle Aged MH - Myocardial Infarction/*therapy MH - Risk Factors MH - Syndrome EDAT- 2005/10/18 09:00 MHDA- 2006/01/20 09:00 CRDT- 2005/10/18 09:00 PHST- 2005/04/21 00:00 [received] PHST- 2005/06/21 00:00 [revised] PHST- 2005/06/27 00:00 [accepted] PHST- 2005/10/18 09:00 [pubmed] PHST- 2006/01/20 09:00 [medline] PHST- 2005/10/18 09:00 [entrez] AID - S0735-1097(05)01772-9 [pii] AID - 10.1016/j.jacc.2005.06.072 [doi] PST - ppublish SO - J Am Coll Cardiol. 2005 Oct 18;46(8):1490-5. doi: 10.1016/j.jacc.2005.06.072. Epub 2005 Sep 29. PMID- 16117464 OWN - NLM STAT- MEDLINE DCOM- 20050915 LR - 20181113 IS - 0022-1058 (Print) IS - 0022-1058 (Linking) VI - 37 IP - 2 DP - 2005 Jun TI - Embol-X intra-aortic filtration system: capturing particulate emboli in the cardiac surgery patient. PG - 222-6 AB - We sought to evaluate the effectiveness of using an intra-aortic filtration system for the prevention of particulate emboli transport and the minimization of significant postoperative complications associated with particulate emboli. Between October of 2000 and October 2001, a total of 146 patients were enrolled at Advocate Christ Medical Center as part of the multi-institutional randomized trial (1289 patients at 22 centers). A total of 74 patients (51%) received the Embol-X intra-aortic filter and 72 patients (49%) were enrolled in the control group. Patients were evaluated for neurological deficit, myocardial infarction, renal insufficiency/failure, limb ischemia, and death at 12-hour, 24-hour, 72-hour, 7-day, and 30-day postoperative intervals. All filters received histological examination for particulate matter. Particulate matter was isolated in 70 (94.5%) of the filters successfully deployed. There was no statistically significant difference in the device related events between the filter and conventional cannulation groups (9/74 = 12.1% vs. 7/72 = 9.7%). Although not clinically evident, the primary event for both groups was ascending aortic intimal tears. There was one death in each of the groups not related to the filter or cannula used. The use of the Embol-X intra-aortic filter system has proven to be a safe and effective means to reduce the introduction of particulate emboli into the systemic circulation. Clearly, the reduction of particulate matter by as much as 95% justifies its use in cardiac surgery patients identified with an increased pre-operative embolic risk. FAU - Sobieski, Michael A 2nd AU - Sobieski MA 2nd AD - Division of Cardiac Surgery, Advocate Christ Medical Center, Oak Lawn, Illinois, USA. cardiacresearch1@aol.com FAU - Pappas, Patroklos S AU - Pappas PS FAU - Tatooles, Antone J AU - Tatooles AJ FAU - Slaughter, Mark S AU - Slaughter MS LA - eng PT - Clinical Trial PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PL - France TA - J Extra Corpor Technol JT - The journal of extra-corporeal technology JID - 0267637 MH - *Aorta MH - *Coronary Artery Bypass/methods MH - Embolism/blood/*prevention & control MH - Female MH - Filtration/*instrumentation MH - Humans MH - Illinois MH - Male PMC - PMC4682540 COIS- The senior author has stated that authors have reported no material, financial or other relationship with any healthcare-related business or other entity whose products or services are discussed in this paper. EDAT- 2005/08/25 09:00 MHDA- 2005/09/16 09:00 PMCR- 2005/12/01 CRDT- 2005/08/25 09:00 PHST- 2005/08/25 09:00 [pubmed] PHST- 2005/09/16 09:00 [medline] PHST- 2005/08/25 09:00 [entrez] PHST- 2005/12/01 00:00 [pmc-release] AID - ject.2005.37.2.222 [pii] PST - ppublish SO - J Extra Corpor Technol. 2005 Jun;37(2):222-6. PMID- 15957128 OWN - NLM STAT- MEDLINE DCOM- 20051021 LR - 20191210 IS - 1523-6838 (Electronic) IS - 0272-6386 (Linking) VI - 45 IP - 6 DP - 2005 Jun TI - Outcomes after percutaneous coronary interventions in patients with CKD: improved outcome in the stenting era. PG - 1002-9 AB - BACKGROUND: Percutaneous coronary intervention (PCI) with stenting reduces adverse events in the general population compared with balloon angioplasty. The benefit of stents in high-risk patients normally excluded from clinical trials has not been well studied. Outcomes after PCIs in patients with chronic kidney disease (CKD) before and after widespread use of stents were compared. METHODS: All patients undergoing PCIs at our center within 2 periods selected for high and low stent use were included. Demographic, kidney and cardiac function, and PCI data were collected. Kaplan-Meier curves were constructed, and Cox proportional hazards analysis was used to assess the effect of high stent use on major adverse cardiac event, a composite of cardiac revascularization, myocardial infarction, or death 3 years after PCI. RESULTS: A total of 1,879 patients (780 patients, low stent use; 1,099 patients, high stent use; 18% and 94.1% stent use, respectively) with a mean age of 63 years, 73% men, and 26% of patients with a glomerular filtration rate less than 60 mL/min were included. At baseline, there was a greater prevalence of severe CKD, cardiac risk factors, and cardiovascular disease in the high-stent-use cohort. Major adverse cardiac events were reduced in the contemporary cohort (hazard ratio, 0.61; 95% confidence interval, 0.52 to 0.72); this benefit extended across all stages of kidney function. CONCLUSION: Patients with CKD undergoing PCI in the stenting era show improved outcomes. Additional studies are needed to determine optimal revascularization strategies in patients with CKD. FAU - Stigant, Caroline AU - Stigant C AD - Department of Health Care and Epidemiology, St Paul's Hospital, University of British Columbia, Vancouver, BC, Canada. FAU - Izadnegahdar, Mona AU - Izadnegahdar M FAU - Levin, Adeera AU - Levin A FAU - Buller, Christopher E AU - Buller CE FAU - Humphries, Karin H AU - Humphries KH LA - eng PT - Comparative Study PT - Evaluation Study PT - Journal Article PL - United States TA - Am J Kidney Dis JT - American journal of kidney diseases : the official journal of the National Kidney Foundation JID - 8110075 SB - IM MH - Aged MH - Angioplasty, Balloon, Coronary/*statistics & numerical data MH - Chronic Disease MH - Cohort Studies MH - Comorbidity MH - Coronary Artery Bypass/statistics & numerical data MH - Coronary Stenosis/complications/*therapy MH - Female MH - Humans MH - Kidney Diseases/*complications/epidemiology MH - Life Tables MH - Male MH - Middle Aged MH - Myocardial Infarction/epidemiology/prevention & control MH - Prevalence MH - Proportional Hazards Models MH - Recurrence MH - Risk MH - Stents/*statistics & numerical data MH - Treatment Outcome EDAT- 2005/06/16 09:00 MHDA- 2005/10/22 09:00 CRDT- 2005/06/16 09:00 PHST- 2005/06/16 09:00 [pubmed] PHST- 2005/10/22 09:00 [medline] PHST- 2005/06/16 09:00 [entrez] AID - S0272638605002891 [pii] AID - 10.1053/j.ajkd.2005.02.018 [doi] PST - ppublish SO - Am J Kidney Dis. 2005 Jun;45(6):1002-9. doi: 10.1053/j.ajkd.2005.02.018. PMID- 15919304 OWN - NLM STAT- MEDLINE DCOM- 20060808 LR - 20141120 IS - 1552-6259 (Electronic) IS - 0003-4975 (Linking) VI - 79 IP - 6 DP - 2005 Jun TI - Total leukocyte control for elective coronary bypass surgery does not improve short-term outcome. PG - 2032-8 AB - BACKGROUND: Despite early promise as a means of reducing the inflammatory response to surgery and subsequent organ damage, the evidence of the clinical value of leukocyte filtration remains equivocal. METHODS: Three hundred patients presenting for routine coronary artery bypass surgery were randomized to a total leukocyte filtration group (filters in five different locations) and a control group with a standard 40-mum filter in the bypass return line only. Data on efficacy and safety of leukocyte filtration were collected by research and postoperative care staff who were blinded to the mode of filtration. RESULTS: Leukofiltration achieved a transient fall in white cells immediately after surgery (p = 0.07) and a sustained fall in platelets, which was still significant on the second postoperative day (p = 0.0001). However, there were no significant differences in postoperative hospital stay, the primary outcome variable (p = 0.35), in ICU stay (p = 0.92), or mortality (p = 1.0). There were no differences in postoperative cardiac status including cardiac output (p = 0.16), inotrope (p = 0.93) or balloon pump (p = 0.48) requirement, or 24-hour troponin (p = 0.60). Similarly there were no differences in pulmonary or renal function (intubation time (p = 0.83), respiratory index (p = 0.19) rise in creatinine (p = 0.13) or hemofiltration (1.0)). Leukofitration was not associated with a statistically significant increase in bleeding or requirement for blood or blood products. It was associated with a decrease approaching significance (p = 0.1) in number and severity of postoperative wound infections. Three filters were blocked during use but were changed without incident or compromise to patient safety. CONCLUSIONS: Leukocyte filtration is safe but not efficacious in improving short-term outcome. FAU - Salamonsen, Robert F AU - Salamonsen RF AD - Department of Intensive Care, Alfred Hospital, Melbourne, Australia. r.salamonsen@alfred.org.au FAU - Anderson, James AU - Anderson J FAU - Anderson, Michael AU - Anderson M FAU - Bailey, Michael AU - Bailey M FAU - Magrin, Geoff AU - Magrin G FAU - Rosenfeldt, Franklin AU - Rosenfeldt F LA - eng PT - Journal Article PT - Randomized Controlled Trial PL - Netherlands TA - Ann Thorac Surg JT - The Annals of thoracic surgery JID - 15030100R SB - IM CIN - Ann Thorac Surg. 2005 Jun;79(6):2038-9. doi: 10.1016/j.athoracsur.2005.01.029. PMID: 15919305 MH - Aged MH - Blood Transfusion MH - Coronary Artery Bypass/*methods MH - Coronary Artery Disease/surgery MH - Elective Surgical Procedures MH - Female MH - Filtration MH - Hemofiltration MH - Humans MH - Inflammation/prevention & control MH - Length of Stay MH - *Leukocyte Reduction Procedures MH - Leukocytes/immunology MH - Male MH - Middle Aged MH - Postoperative Complications/*prevention & control MH - Treatment Outcome EDAT- 2005/05/28 09:00 MHDA- 2006/08/09 09:00 CRDT- 2005/05/28 09:00 PHST- 2004/05/17 00:00 [received] PHST- 2004/11/17 00:00 [revised] PHST- 2004/11/19 00:00 [accepted] PHST- 2005/05/28 09:00 [pubmed] PHST- 2006/08/09 09:00 [medline] PHST- 2005/05/28 09:00 [entrez] AID - S0003-4975(04)02309-4 [pii] AID - 10.1016/j.athoracsur.2004.11.038 [doi] PST - ppublish SO - Ann Thorac Surg. 2005 Jun;79(6):2032-8. doi: 10.1016/j.athoracsur.2004.11.038. PMID- 15894970 OWN - NLM STAT- MEDLINE DCOM- 20051221 LR - 20220318 IS - 1097-6744 (Electronic) IS - 0002-8703 (Linking) VI - 149 IP - 5 DP - 2005 May TI - The relation of renal function to ischemic and bleeding outcomes with 2 different glycoprotein IIb/IIIa inhibitors: the do Tirofiban and ReoPro Give Similar Efficacy Outcome (TARGET) trial. PG - 869-75 AB - BACKGROUND: Renal function significantly impacts morbidity and mortality after a percutaneous coronary intervention. Platelet glycoprotein (GP) IIb/IIIa inhibitors reduce ischemic complications during percutaneous coronary intervention; little is known of whether their safety and efficacy are influenced by renal function. In particular, whether outcome differences exist between agents that are renally excreted (tirofiban) or not (abciximab) in patients with mild renal impairment is not known. METHODS: The TARGET trial randomized 4623 patients to tirofiban or abciximab. In this analysis, patients were grouped in creatinine clearance quartiles (<70, 70-90, 90-114, >114 mL/min) and analyzed for efficacy and bleeding risk. Univariate and multivariate analyses were performed to identify interactions between GP IIb/IIIa inhibitor used and creatinine clearance with respect to ischemic outcomes and bleeding. RESULTS: Using unadjusted logistic regression tests for trend, 30-day death/myocardial infarction/urgent target vessel revascularization was greater in patients with lower creatinine clearances (7.3%, 8.5%, 5.1%, and 5.8%, P = .005), as were both major and minor bleeding. There was no interaction between assigned GP IIb/IIIa inhibitor, creatinine clearance and ischemic outcome, major bleeding or minor bleeding. CONCLUSIONS: Both ischemic and bleeding complications are highest in the lowest creatinine clearance quartile of patients treated with GP IIb/IIIa inhibitors. Although tirofiban is renally cleared and abciximab is not, there was no interaction between these GP IIb/IIIa inhibitors and creatinine clearance regarding ischemic or bleeding events. FAU - Berger, Peter B AU - Berger PB AD - Division of Cardiovascular Medicine, Mayo Clinic, Rochester, Minn 55905, USA. berger.peter@mayo.edu FAU - Best, Patricia J M AU - Best PJ FAU - Topol, Eric J AU - Topol EJ FAU - White, Jennifer AU - White J FAU - DiBattiste, Peter M AU - DiBattiste PM FAU - Chan, Albert W AU - Chan AW FAU - Kristensen, Steen D AU - Kristensen SD FAU - Herrmann, Howard C AU - Herrmann HC FAU - Moliterno, David J AU - Moliterno DJ LA - eng PT - Journal Article PT - Randomized Controlled Trial PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 RN - 0 (Antibodies, Monoclonal) RN - 0 (Immunoglobulin Fab Fragments) RN - 0 (Platelet Glycoprotein GPIIb-IIIa Complex) RN - 42HK56048U (Tyrosine) RN - AYI8EX34EU (Creatinine) RN - GGX234SI5H (Tirofiban) RN - X85G7936GV (Abciximab) SB - IM MH - Abciximab MH - Aged MH - Aged, 80 and over MH - *Angioplasty, Balloon, Coronary MH - Antibodies, Monoclonal/pharmacokinetics/*therapeutic use MH - Coronary Stenosis/therapy MH - Creatinine/metabolism MH - Female MH - Hemorrhage/*etiology MH - Humans MH - Immunoglobulin Fab Fragments/*therapeutic use MH - Logistic Models MH - Male MH - Middle Aged MH - Myocardial Ischemia/*etiology MH - Platelet Glycoprotein GPIIb-IIIa Complex/*antagonists & inhibitors MH - Renal Insufficiency/*complications/metabolism MH - Tirofiban MH - Treatment Outcome MH - Tyrosine/*analogs & derivatives/pharmacokinetics/therapeutic use EDAT- 2005/05/17 09:00 MHDA- 2005/12/22 09:00 CRDT- 2005/05/17 09:00 PHST- 2005/05/17 09:00 [pubmed] PHST- 2005/12/22 09:00 [medline] PHST- 2005/05/17 09:00 [entrez] AID - S0002870304008841 [pii] AID - 10.1016/j.ahj.2004.12.002 [doi] PST - ppublish SO - Am Heart J. 2005 May;149(5):869-75. doi: 10.1016/j.ahj.2004.12.002. PMID- 15864241 OWN - NLM STAT- MEDLINE DCOM- 20051031 LR - 20101118 IS - 1097-6744 (Electronic) IS - 0002-8703 (Linking) VI - 149 IP - 3 DP - 2005 Mar TI - Association of chronic kidney disease with clinical outcomes after coronary revascularization: the Arterial Revascularization Therapies Study (ARTS). PG - 512-9 AB - BACKGROUND: Chronic kidney disease (CKD) is associated with adverse outcomes after coronary artery bypass graft surgery (CABG) and percutaneous coronary interventions (PCI), but it is unclear which of these revascularization strategies is associated with lower risk for morbidity and mortality in this population. In the Arterial Revascularization Therapies Study (ARTS), we compared long-term clinical outcomes after CABG or PCI with multivessel stenting in patients with CKD. METHODS: The ARTS randomly assigned 1205 participants with and without CKD to CABG or PCI with multivessel stenting. We defined CKD as creatinine clearance < or =60 mL/min, estimated by the Cockroft-Gault equation. The primary outcome was the composite of death, myocardial infarction (MI), or stroke; and, a secondary outcome was repeat revascularization. Participants were followed for a mean of 3 years after their intervention. We evaluated whether randomization to CABG or PCI was associated with different outcomes among participants with CKD. RESULTS: Two hundred ninety participants (25%) had CKD at entry into ARTS. One hundred fifty-one received PCI, and 139 received CABG. No difference was observed in the primary endpoint with CABG or PCI among CKD participants (adjusted Hazard Ratio [HR] CABG vs PCI = 0.93; 95% CI 0.54-1.60; P = .97). However, CABG was associated with a reduced risk for repeat revascularization (HR = 0.28; 95% CI 0.14-0.54; P < .01). Compared with participants with normal renal function, CKD was associated with a nearly 2-fold risk for the primary outcome (unadjusted HR = 1.9; 95% CI 1.4-2.7; P < .01). After multivariate adjustment, this association remained significant (HR 1.6; 95% CI 1.1-2.4). CONCLUSIONS: In patients with multivessel CAD and CKD, treatment with CABG or PCI with multivessel stenting led to similar outcomes of death, MI, or stroke, but CABG was associated with decreased repeat revascularizations. When compared with ARTS participants with normal renal function, those with CKD had substantially elevated risk of adverse clinical outcomes after coronary revascularization. FAU - Ix, Joachim H AU - Ix JH AD - Department of Medicine, University of California, San Francisco, Calif, USA. FAU - Mercado, Nestor AU - Mercado N FAU - Shlipak, Michael G AU - Shlipak MG FAU - Lemos, Pedro A AU - Lemos PA FAU - Boersma, Eric AU - Boersma E FAU - Lindeboom, Wietze AU - Lindeboom W FAU - O'Neill, William W AU - O'Neill WW FAU - Wijns, William AU - Wijns W FAU - Serruys, Patrick W AU - Serruys PW LA - eng PT - Clinical Trial PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 SB - IM MH - Aged MH - Angioplasty, Balloon, Coronary/*statistics & numerical data MH - Chronic Disease MH - Comorbidity MH - Coronary Artery Bypass/*statistics & numerical data MH - Coronary Disease/*epidemiology/*therapy MH - Disease-Free Survival MH - Female MH - Humans MH - Hypertension/epidemiology MH - Kidney Diseases/diagnosis/*epidemiology MH - Male MH - Myocardial Revascularization/*mortality/*statistics & numerical data MH - Risk Assessment MH - Stents MH - Stroke/epidemiology MH - Survival Rate MH - Treatment Outcome EDAT- 2005/05/03 09:00 MHDA- 2005/11/01 09:00 CRDT- 2005/05/03 09:00 PHST- 2005/05/03 09:00 [pubmed] PHST- 2005/11/01 09:00 [medline] PHST- 2005/05/03 09:00 [entrez] AID - S0002870304007550 [pii] AID - 10.1016/j.ahj.2004.10.010 [doi] PST - ppublish SO - Am Heart J. 2005 Mar;149(3):512-9. doi: 10.1016/j.ahj.2004.10.010. PMID- 15864236 OWN - NLM STAT- MEDLINE DCOM- 20051031 LR - 20191210 IS - 1097-6744 (Electronic) IS - 0002-8703 (Linking) VI - 149 IP - 3 DP - 2005 Mar TI - Influence of clinical trial enrollment on the quality of care and outcomes for patients with non-ST-segment elevation acute coronary syndromes. PG - 474-81 AB - BACKGROUND: Clinical trials provide evidence that is formulated into recommendations for practice guidelines, but it remains uncertain whether patients enrolled in trials are similar to those treated in routine practice and whether trial enrollment influences inhospital treatments and outcomes. METHODS: Using data from the CRUSADE quality improvement initiative, we evaluated predictors of trial enrollment, treatment patterns, and clinical outcomes among high-risk patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS) who were and were not enrolled in a clinical trial during hospitalization. RESULTS: Among 55,172 high-risk patients presenting with NSTE ACS at 443 US hospitals, 1397 (2.5%) patients were enrolled in a clinical trial during index hospitalization. Significant predictors of trial enrollment included male sex, lack of renal insufficiency, and absence of congestive heart failure on presentation. Acute (<24 hours) and discharge secondary prevention interventions recommended by the American College of Cardiology/American Heart Association guidelines for NSTE ACS were used more commonly in patients enrolled in clinical trials. Cardiac catheterization (84.5% vs 65.8%, P < .0001), percutaneous coronary intervention (48.2% vs 36.3%, P < .0001), and bypass surgery (19.1% vs 11.3%, P < .0001) were also performed more frequently in trial patients. The adjusted risk of inhospital mortality was similar in trial versus nontrial patients (odds ratio 0.86, 95% CI 0.60-1.24). CONCLUSIONS: Patients with NSTE ACS participating in clinical trials are more likely to receive beneficial therapies and interventions throughout hospitalization, but preferential recruitment of patients with lower-risk features may limit the external validity of trial results. FAU - Kandzari, David E AU - Kandzari DE AD - Duke Clinical Research Institute, Duke University Medical Center, Durham, NC 27705, USA. david.kandzari@duke.edu FAU - Roe, Matthew T AU - Roe MT FAU - Chen, Anita Y AU - Chen AY FAU - Lytle, Barbara L AU - Lytle BL FAU - Pollack, Charles V Jr AU - Pollack CV Jr FAU - Harrington, Robert A AU - Harrington RA FAU - Ohman, E Magnus AU - Ohman EM FAU - Gibler, W Brian AU - Gibler WB FAU - Peterson, Eric D AU - Peterson ED LA - eng PT - Journal Article PT - Multicenter Study PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 SB - IM MH - Acute Disease MH - Aged MH - Clinical Trials as Topic/*statistics & numerical data MH - Comorbidity MH - Coronary Disease/*mortality/*therapy MH - Diabetes Mellitus/epidemiology MH - Evidence-Based Medicine MH - Female MH - Hospital Mortality MH - Humans MH - Hyperlipidemias/epidemiology MH - Hypertension/epidemiology MH - Male MH - Middle Aged MH - Outcome Assessment, Health Care/*statistics & numerical data MH - Quality of Health Care/*statistics & numerical data MH - Renal Insufficiency/epidemiology MH - Risk Assessment MH - Smoking/epidemiology MH - Survival Analysis MH - Syndrome MH - United States EDAT- 2005/05/03 09:00 MHDA- 2005/11/01 09:00 CRDT- 2005/05/03 09:00 PHST- 2005/05/03 09:00 [pubmed] PHST- 2005/11/01 09:00 [medline] PHST- 2005/05/03 09:00 [entrez] AID - S0002870304008695 [pii] AID - 10.1016/j.ahj.2004.11.014 [doi] PST - ppublish SO - Am Heart J. 2005 Mar;149(3):474-81. doi: 10.1016/j.ahj.2004.11.014. PMID- 15862409 OWN - NLM STAT- MEDLINE DCOM- 20050519 LR - 20201216 IS - 0735-1097 (Print) IS - 0735-1097 (Linking) VI - 45 IP - 9 DP - 2005 May 3 TI - Prediction of mortality after primary percutaneous coronary intervention for acute myocardial infarction: the CADILLAC risk score. PG - 1397-405 AB - OBJECTIVES: We sought to develop a simple risk score for predicting mortality after primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI). BACKGROUND: Accurate risk stratification after primary PCI is important. Previous risk scores after reperfusion therapy have incorporated clinical +/- angiographic variables but have not considered baseline left ventricular function. Moreover, prior studies have not been validated against independent databases or studies. METHODS: The databases from the two largest multicenter, randomized AMI trials of primary PCI were utilized for score derivation (the Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications [CADILLAC] trial, n = 2,082) and subsequent validation (the Stent-Primary Angioplasty in Myocardial Infarction [Stent-PAMI] trial, n = 900). Logistic regression and the jackknife procedure were used to select correlates of one-year mortality that were subsequently weighted and integrated into an integer scoring system. RESULTS: Seven variables selected from the initial multivariate model were weighted proportionally to their respective odds ratio for one-year mortality (age >65 years [2 points], Killip class 2/3 [3 points], baseline left ventricular ejection fraction <40% [4 points], anemia [2 points], renal insufficiency [3 points], triple-vessel disease [2 points], and post-procedural Thrombolysis In Myocardial Infarction flow grade [2 points]). Three strata of risk were defined (low risk, score 0 to 2; intermediate risk, score 3 to 5; and high risk, score >/=6) with excellent prognostic accuracy for survival in the derivation and validation sets (c statistics = 0.83 and 0.81 for 30-day mortality and 0.79 and 0.78 for 1-year mortality, respectively). CONCLUSIONS: In AMI patients treated with primary PCI, seven risk factors readily available at the time of intervention accurately predict short- and long-term mortality. Of note, measurement of baseline left ventricular function is the single most powerful predictor of survival and should be incorporated into risk score models. FAU - Halkin, Amir AU - Halkin A AD - Columbia University Medical Center and the Cardiovascular Research Foundation, New York, New York 10022, USA. FAU - Singh, Mandeep AU - Singh M FAU - Nikolsky, Eugenia AU - Nikolsky E FAU - Grines, Cindy L AU - Grines CL FAU - Tcheng, James E AU - Tcheng JE FAU - Garcia, Eulogio AU - Garcia E FAU - Cox, David A AU - Cox DA FAU - Turco, Mark AU - Turco M FAU - Stuckey, Thomas D AU - Stuckey TD FAU - Na, Yingo AU - Na Y FAU - Lansky, Alexandra J AU - Lansky AJ FAU - Gersh, Bernard J AU - Gersh BJ FAU - O'Neill, William W AU - O'Neill WW FAU - Mehran, Roxana AU - Mehran R FAU - Stone, Gregg W AU - Stone GW LA - eng PT - Journal Article PT - Validation Study PL - United States TA - J Am Coll Cardiol JT - Journal of the American College of Cardiology JID - 8301365 SB - IM MH - Aged MH - *Angioplasty, Balloon, Coronary MH - Female MH - Humans MH - Male MH - Multicenter Studies as Topic MH - Myocardial Infarction/*mortality/pathology/*therapy MH - Predictive Value of Tests MH - Randomized Controlled Trials as Topic MH - Risk Factors MH - Severity of Illness Index MH - Survival Analysis MH - Ventricular Dysfunction, Left/physiopathology EDAT- 2005/05/03 09:00 MHDA- 2005/05/20 09:00 CRDT- 2005/05/03 09:00 PHST- 2004/10/25 00:00 [received] PHST- 2005/01/19 00:00 [revised] PHST- 2005/01/19 00:00 [accepted] PHST- 2005/05/03 09:00 [pubmed] PHST- 2005/05/20 09:00 [medline] PHST- 2005/05/03 09:00 [entrez] AID - S0735-1097(05)00417-1 [pii] AID - 10.1016/j.jacc.2005.01.041 [doi] PST - ppublish SO - J Am Coll Cardiol. 2005 May 3;45(9):1397-405. doi: 10.1016/j.jacc.2005.01.041. PMID- 15860519 OWN - NLM STAT- MEDLINE DCOM- 20051020 LR - 20061115 IS - 0195-668X (Print) IS - 0195-668X (Linking) VI - 26 IP - 15 DP - 2005 Aug TI - Five year clinical effect of coronary stenting and coronary artery bypass grafting in renal insufficient patients with multivessel coronary artery disease: insights from ARTS trial. PG - 1488-93 AB - AIMS: To compare coronary stent implantation and bypass surgery for multivessel coronary disease in patients with renal insufficiency. METHODS AND RESULTS: In the ARTS trial, 142 moderate renal insufficient patients (Ccr<60 mL/min) with multivessel coronary disease were randomly assigned to stent implantation (n=69) or CABG (n=73). At 5 years, there was no significant difference between the two groups in terms of mortality (14.5% in the stent group vs. 12.3% in the CABG group, P=0.81), or combined endpoint of death, cerebrovascular accident (CVA), or myocardial infarction (MI) (30.4% in the stent group vs. 23.3% in the CABG group, P=0.35). Among patients who survived without CVA or MI, 18.8% in the stent group underwent a second revascularization procedure when compared with 8.2% in the surgery group (P=0.08). The event-free survival at 5 years was 50.7% in the stent group and 68.5% in the surgery group (P=0.04). CONCLUSION: At 5 years, the differences in mortality and combined incidence of death, CVA, and MI between coronary stenting and surgery did not reach statistically significant level. However, the occurrence of MACCE in the stent group was higher than in the CABG group, mainly driven by the higher incidence of repeat revascularization in the stent group. FAU - Aoki, Jiro AU - Aoki J AD - Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands. FAU - Ong, Andrew T L AU - Ong AT FAU - Hoye, Angela AU - Hoye A FAU - van Herwerden, Lex A AU - van Herwerden LA FAU - Sousa, J Eduardo AU - Sousa JE FAU - Jatene, Adib AU - Jatene A FAU - Bonnier, Johannes J R M AU - Bonnier JJ FAU - Schonberger, Jacques P M A AU - Schonberger JP FAU - Buller, Nigel AU - Buller N FAU - Bonser, Robert AU - Bonser R FAU - Lindeboom, Wietze AU - Lindeboom W FAU - Unger, Felix AU - Unger F FAU - Serruys, Patrick W AU - Serruys PW LA - eng PT - Clinical Trial PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial DEP - 20050428 PL - England TA - Eur Heart J JT - European heart journal JID - 8006263 SB - IM CIN - Eur Heart J. 2005 Aug;26(15):1456-7. doi: 10.1093/eurheartj/ehi332. PMID: 15917278 MH - Aged MH - Coronary Artery Bypass/*methods MH - Coronary Disease/*surgery MH - Female MH - Humans MH - Kidney Failure, Chronic/*complications MH - Male MH - Middle Aged MH - Myocardial Revascularization/methods MH - *Stents MH - Survival Analysis MH - Treatment Outcome EDAT- 2005/04/30 09:00 MHDA- 2005/10/21 09:00 CRDT- 2005/04/30 09:00 PHST- 2005/04/30 09:00 [pubmed] PHST- 2005/10/21 09:00 [medline] PHST- 2005/04/30 09:00 [entrez] AID - ehi288 [pii] AID - 10.1093/eurheartj/ehi288 [doi] PST - ppublish SO - Eur Heart J. 2005 Aug;26(15):1488-93. doi: 10.1093/eurheartj/ehi288. Epub 2005 Apr 28. PMID- 15837246 OWN - NLM STAT- MEDLINE DCOM- 20050512 LR - 20151119 IS - 0735-1097 (Print) IS - 0735-1097 (Linking) VI - 45 IP - 8 DP - 2005 Apr 19 TI - Gender-based outcomes after paclitaxel-eluting stent implantation in patients with coronary artery disease. PG - 1180-5 AB - OBJECTIVES: We sought to determine whether gender influences the results of paclitaxel-eluting stent implantation. BACKGROUND: The TAXUS-IV trial demonstrated the safety and effectiveness of the slow-release, polymer-based, paclitaxel-eluting TAXUS stent compared to bare-metal stents in patients undergoing elective coronary intervention. Whether these results are generalizable to women is not known. METHODS: A total of 1,314 patients with coronary lesions 10- to 28-mm long in 2.5- to 3.75-mm vessels were randomized to TAXUS stent versus bare-metal EXPRESS stents (Boston Scientific Corp., Natick, Massachusetts). Outcomes examined were stratified by gender. RESULTS: A total of 662 patients (including 187 women) were assigned to the TAXUS stent, and 652 (180 women) received the control stent. Women were older than men, and had more hypertension, diabetes, renal insufficiency, unstable angina, and heart failure, but less smoking. Among patients receiving the TAXUS stent, women compared with men had higher unadjusted one-year rates of target lesion revascularization (TLR) (7.6% vs. 3.2%, p = 0.03), though female gender was not an independent predictor of TLR (odds ratio [OR] = 1.72 [95% confidence interval (CI) 0.68 to 4.37], p = 0.25). Moreover, restenosis rates were similar in men and women treated with the TAXUS stent (8.6% vs. 7.6%, respectively, p = 0.80), as was late loss (0.22 vs. 0.23 mm, p = 0.90). Compared to control stents, treatment with the TAXUS stent in women resulted in a significant reduction in nine-month restenosis (8.6% vs. 29.2%, p = 0.0001) and one-year TLR (7.6% vs. 14.9%, p = 0.02). The only independent predictor of freedom from restenosis in women was randomization to the TAXUS stent (OR = 0.28 [95% CI 0.11 to 0.74], p = 0.01). CONCLUSIONS: The benefits of the paclitaxel-eluting stent in reducing clinical and angiographic restenosis are generalizable to women. FAU - Lansky, Alexandra J AU - Lansky AJ AD - Columbia University Medical Center and Cardiovascular Research Foundation, New York, New York, USA. FAU - Costa, Ricardo A AU - Costa RA FAU - Mooney, Michael AU - Mooney M FAU - Midei, Mark G AU - Midei MG FAU - Lui, Henry K AU - Lui HK FAU - Strickland, Warren AU - Strickland W FAU - Mehran, Roxana AU - Mehran R FAU - Leon, Martin B AU - Leon MB FAU - Russell, Mary E AU - Russell ME FAU - Ellis, Stephen G AU - Ellis SG FAU - Stone, Gregg W AU - Stone GW CN - TAXUS-IV Investigators LA - eng PT - Clinical Trial PT - Clinical Trial, Phase IV PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial PL - United States TA - J Am Coll Cardiol JT - Journal of the American College of Cardiology JID - 8301365 RN - 0 (Antineoplastic Agents) RN - 0 (Polymers) RN - P88XT4IS4D (Paclitaxel) SB - IM CIN - J Am Coll Cardiol. 2005 Apr 19;45(8):1206-12. doi: 10.1016/j.jacc.2005.01.005. PMID: 15837250 MH - Age Factors MH - Aged MH - Antineoplastic Agents/*administration & dosage MH - Coronary Angiography MH - Coronary Disease/*therapy MH - Coronary Restenosis/prevention & control MH - Female MH - Humans MH - Male MH - Myocardial Revascularization MH - Paclitaxel/*administration & dosage MH - Polymers MH - Sex Factors MH - *Stents MH - Treatment Outcome EDAT- 2005/04/20 09:00 MHDA- 2005/05/13 09:00 CRDT- 2005/04/20 09:00 PHST- 2004/06/28 00:00 [received] PHST- 2004/10/18 00:00 [revised] PHST- 2004/10/25 00:00 [accepted] PHST- 2005/04/20 09:00 [pubmed] PHST- 2005/05/13 09:00 [medline] PHST- 2005/04/20 09:00 [entrez] AID - S0735-1097(05)00129-4 [pii] AID - 10.1016/j.jacc.2004.10.076 [doi] PST - ppublish SO - J Am Coll Cardiol. 2005 Apr 19;45(8):1180-5. doi: 10.1016/j.jacc.2004.10.076. PMID- 15820288 OWN - NLM STAT- MEDLINE DCOM- 20050831 LR - 20181201 IS - 0167-5273 (Print) IS - 0167-5273 (Linking) VI - 100 IP - 1 DP - 2005 Apr 8 TI - Analysis of bleeding complications associated with glycoprotein IIb/IIIa receptors blockade in patients with high-risk acute coronary syndromes: insights from the PRISM-PLUS study. PG - 73-8 AB - We aim to characterize the hemorrhagic complications and predictors of increased bleeding risk in a population of patients with high-risk acute coronary syndromes (ACS), enrolled in the PRISM-PLUS study. Patients treated with heparin plus tirofiban had more bleeding events compared to patients treated with heparin alone. No significant increase in major bleeding, thrombocytopenia, blood loss and blood products transfusions was observed among the patients who received the combination therapy. Several clinical variables were independently associated with increased risk of bleeding for both treatment groups: advanced age, lower body weight, female gender, decreased creatinine clearance (<30 ml/min). Females, patients with impaired renal function, patients requiring percutaneous coronary intervention (PCI), especially prolonged PCI (>100 min duration) or coronary artery bypass surgery (CABG) were at risk for increased major bleeding complications. Increased blood loss was also found in females, patients with elevated diastolic blood pressure, PCI, duration of PCI>100 min or CABG. No incremental risk was detected with the addition of tirofiban to heparin in patients at risk for major bleeding or increased blood loss. We concluded that identification of patients with high-risk ACS, at risk for bleeding complications and blood loss can be done with specific clinical variables. Tirofiban added to heparin increased minor hemorrhagic complications. Although there was no significant increase in major bleeding, thrombocytopenia and blood transfusions with the combination of tirofiban plus heparin, the power to detect a statistically significant difference in these endpoints was limited by the small number of events. FAU - Huynh, Thao AU - Huynh T AD - Montreal General Hospital, McGill University Health Center, 1650 Cedar Avenue, Room E-5200, Montreal, Quebec, Canada H3G-1A4. thao.huynh@muhc.mcgill.ca FAU - Piazza, Nicolo AU - Piazza N FAU - DiBattiste, Peter M AU - DiBattiste PM FAU - Snapinn, Steven M AU - Snapinn SM FAU - Wan, Ying AU - Wan Y FAU - Pharand, Chantal AU - Pharand C FAU - Theroux, Pierre AU - Theroux P LA - eng PT - Comparative Study PT - Journal Article PL - Netherlands TA - Int J Cardiol JT - International journal of cardiology JID - 8200291 RN - 0 (Anticoagulants) RN - 0 (Platelet Glycoprotein GPIIb-IIIa Complex) RN - 42HK56048U (Tyrosine) RN - 9005-49-6 (Heparin) RN - GGX234SI5H (Tirofiban) SB - IM MH - Aged MH - Angina, Unstable/*drug therapy MH - Anticoagulants/*administration & dosage/adverse effects MH - Drug Therapy, Combination MH - Female MH - Hemorrhage/*chemically induced MH - Heparin/*administration & dosage/adverse effects MH - Humans MH - Male MH - Middle Aged MH - Myocardial Infarction/*drug therapy MH - Platelet Glycoprotein GPIIb-IIIa Complex/*antagonists & inhibitors MH - Randomized Controlled Trials as Topic MH - Risk Factors MH - Syndrome MH - Tirofiban MH - Tyrosine/administration & dosage/adverse effects/*analogs & derivatives EDAT- 2005/04/12 09:00 MHDA- 2005/09/01 09:00 CRDT- 2005/04/12 09:00 PHST- 2004/05/13 00:00 [received] PHST- 2004/07/24 00:00 [accepted] PHST- 2005/04/12 09:00 [pubmed] PHST- 2005/09/01 09:00 [medline] PHST- 2005/04/12 09:00 [entrez] AID - S0167-5273(05)00011-2 [pii] AID - 10.1016/j.ijcard.2004.07.014 [doi] PST - ppublish SO - Int J Cardiol. 2005 Apr 8;100(1):73-8. doi: 10.1016/j.ijcard.2004.07.014. PMID- 15695126 OWN - NLM STAT- MEDLINE DCOM- 20050405 LR - 20260128 IS - 0002-9149 (Print) IS - 0002-9149 (Linking) VI - 95 IP - 4 DP - 2005 Feb 15 TI - Long-term fluvastatin reduces the hazardous effect of renal impairment on four-year atherosclerotic outcomes (a LIPS substudy). PG - 445-51 AB - Mild renal impairment is an important risk factor for late cardiovascular complications. This substudy of the Lescol Intervention Prevention Study (LIPS) assessed the effect of fluvastatin on outcome of patients who had renal dysfunction and those who did not. Complete data for creatinine clearance calculation (Cockcroft-Gault formula) were available for 1,558 patients (92.9% of the LIPS population). Patients were randomized to fluvastatin or placebo after successful completion of a first percutaneous coronary intervention. Follow-up time was 3 to 4 years. The effect of baseline creatinine clearance on coronary atherosclerotic events (cardiac death, nonfatal myocardial infarction, and coronary reinterventions not related to restenosis) was evaluated. Baseline creatinine clearance (logarithmic transformation) was inversely associated with an incidence of adverse events among patients who received placebo (hazard ratio 0.99, 95% confidence interval 0.982 to 0.998, p = 0.01). However, no association was noted between creatinine clearance and the incidence of adverse events among patients who received fluvastatin (hazard ratio 1.0, 95% confidence interval 0.99 to 1.0, p = 0.63). No further deterioration in creatinine clearance was observed during follow-up, regardless of baseline renal function or allocated treatment. Occurrence of adverse events was not related to changes in renal function during follow-up. Fluvastatin therapy markedly decreased the risk of coronary atherosclerotic events after percutaneous intervention in patients who had lower values of creatinine clearance at baseline. The benefit of fluvastatin was unrelated to any effect on renal function. FAU - Lemos, Pedro A AU - Lemos PA AD - Erasmus Medical Center, Thoraxcenter, Rotterdam, The Netherlands. FAU - Serruys, Patrick W AU - Serruys PW FAU - de Feyter, Pim AU - de Feyter P FAU - Mercado, Nestor F AU - Mercado NF FAU - Goedhart, Dick AU - Goedhart D FAU - Saia, Francesco AU - Saia F FAU - Arampatzis, Chourmouzios A AU - Arampatzis CA FAU - Soares, Paulo R AU - Soares PR FAU - Ciccone, Marco AU - Ciccone M FAU - Arquati, Massimo AU - Arquati M FAU - Cortellaro, Michele AU - Cortellaro M FAU - Rutsch, Wolfgang AU - Rutsch W FAU - Legrand, Victor AU - Legrand V LA - eng PT - Clinical Trial PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 RN - 0 (Fatty Acids, Monounsaturated) RN - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors) RN - 0 (Indoles) RN - 0 (Lipoproteins) RN - 4L066368AS (Fluvastatin) RN - AYI8EX34EU (Creatinine) SB - IM MH - Age Factors MH - Aged MH - Angioplasty, Balloon, Coronary MH - Coronary Artery Disease/*mortality/therapy MH - Creatinine/blood MH - Europe/epidemiology MH - Fatty Acids, Monounsaturated/*therapeutic use MH - Female MH - Fluvastatin MH - Humans MH - Hydroxymethylglutaryl-CoA Reductase Inhibitors/*therapeutic use MH - Indoles/*therapeutic use MH - Kidney Diseases/blood/*prevention & control MH - Lipoproteins/blood/drug effects MH - Male MH - Middle Aged MH - Multivariate Analysis MH - Proportional Hazards Models MH - Severity of Illness Index MH - Sex Factors EDAT- 2005/02/08 09:00 MHDA- 2005/04/06 09:00 CRDT- 2005/02/08 09:00 PHST- 2004/06/23 00:00 [received] PHST- 2004/10/01 00:00 [revised] PHST- 2004/10/01 00:00 [accepted] PHST- 2005/02/08 09:00 [pubmed] PHST- 2005/04/06 09:00 [medline] PHST- 2005/02/08 09:00 [entrez] AID - S0002-9149(04)01632-7 [pii] AID - 10.1016/j.amjcard.2004.10.008 [doi] PST - ppublish SO - Am J Cardiol. 2005 Feb 15;95(4):445-51. doi: 10.1016/j.amjcard.2004.10.008. PMID- 15687530 OWN - NLM STAT- MEDLINE DCOM- 20060425 LR - 20260128 IS - 1042-3931 (Print) IS - 1042-3931 (Linking) VI - 17 IP - 2 DP - 2005 Feb TI - Effectiveness of acetylcysteine in prevention of contrast nephropathy. PG - 80-4 AB - BACKGROUND: Acetylcysteine may provide prophylaxis against contrast nephropathy (CN) in some patients. Its benefit may vary according to the characteristics of patients and contrast used. The objective is to evaluate the effectiveness of oral acetylcysteine in preventing CN after coronary procedures in our practice. METHODS: We prospectively studied 397 patients with a creatinine level equal to or above 1.3 mg/dl, diabetes mellitus, or 70+ years of age who underwent a coronary procedure. Patients were randomly assigned to receive either acetylcysteine or placebo and 0.9% saline before and after the contrast agent. High- or low-osmolality contrast was used according to the discretion of the interventional cardiologist. Serum creatinine was measured before and 24 to 48 hours after the procedure. RESULTS: An increase of greater than or equal to 25% in the baseline creatinine level 24 to 48 hours after the procedure occurred in 14 (7.1%) of 196 acetylcysteine patients and in 17 (8.4%) of 201 placebo patients (p=0.62). In the acetylcysteine group, the mean baseline serum creatinine concentration was 1.30+/-0.56 mg/dl and increased 0.076+/-0.21 mg/dl 24 to 48 hours after administration of contrast, whereas in the placebo group, it was 1.27+/-0.51 mg/dl and increased 0.101+/-0.28 mg/dl (p=0.33). In the subgroup with estimated baseline creatinine clearance <60 ml/minute, no difference was found in the incidence of CN (9.1% in the acetylcysteine group; 11.7% in the placebo; p=0.66). By multivariate analysis, left ventricular ejection fraction less than or equal to 40%, volume of contrast >200 ml, and estimated creatinine clearance (but not acetylcysteine) were related to CN. CONCLUSIONS: Oral acetylcysteine was not effective as a prophylactic treatment against CN for patients with a potential risk and submitted to coronary angiographic procedures with predominantly high-osmolality contrast. FAU - Azmus, Alexandre D AU - Azmus AD AD - Hemodynamic Service, Institute of Cardiology of Rio Grande do Sul/Fundacao Universitaria de Cardiologia, Av. Princesa Isabel, 310 U. Pesquisa, Porto Alegre, RS, 90620-001, Brazil. pesquisa@cardiologia.org.br FAU - Gottschall, Carlos AU - Gottschall C FAU - Manica, Andre AU - Manica A FAU - Manica, Joao AU - Manica J FAU - Duro, Kaue AU - Duro K FAU - Frey, Marcos AU - Frey M FAU - Bulcao, Lauro AU - Bulcao L FAU - Lima, Cristiane AU - Lima C LA - eng PT - Journal Article PT - Randomized Controlled Trial PL - United States TA - J Invasive Cardiol JT - The Journal of invasive cardiology JID - 8917477 RN - 0 (Contrast Media) RN - AYI8EX34EU (Creatinine) RN - WYQ7N0BPYC (Acetylcysteine) SB - IM MH - Acetylcysteine/*therapeutic use MH - Aged MH - Angioplasty, Balloon, Coronary MH - Blood Urea Nitrogen MH - Brazil/epidemiology MH - Contrast Media/*adverse effects MH - Coronary Angiography MH - Coronary Disease/*diagnostic imaging/metabolism/therapy MH - Creatinine/metabolism MH - Double-Blind Method MH - Female MH - Follow-Up Studies MH - Glomerular Filtration Rate/drug effects MH - Humans MH - Kidney Diseases/*chemically induced/metabolism/*prevention & control MH - Male MH - Middle Aged MH - Osmolar Concentration MH - Prospective Studies MH - Stroke Volume MH - Treatment Outcome EDAT- 2005/02/03 09:00 MHDA- 2006/04/28 09:00 CRDT- 2005/02/03 09:00 PHST- 2005/02/03 09:00 [pubmed] PHST- 2006/04/28 09:00 [medline] PHST- 2005/02/03 09:00 [entrez] PST - ppublish SO - J Invasive Cardiol. 2005 Feb;17(2):80-4. PMID- 15671702 OWN - NLM STAT- MEDLINE DCOM- 20050304 LR - 20171116 IS - 1540-9996 (Print) IS - 1540-9996 (Linking) VI - 13 IP - 8 DP - 2004 Oct TI - Postmenopausal hormone use in women with acute coronary syndromes. PG - 863-71 AB - BACKGROUND: Recent trials reveal no benefit and possible harm from chronic hormone replacement therapy (HRT). Less is known about intermediate-term outcomes associated with HRT use in the setting of acute coronary syndromes (ACS). METHODS: To examine the prevalence of HRT use and relationships with intermediate-term outcomes among women with ACS, we classified as HRT users or nonusers 4029 postmenopausal women (age > 50 years or postmenopausal by case report form) randomized in the Sibrafiban versus Aspirin to Yield Maximum Protection from Ischemic Heart Events Post-Acute Coronary Syndromes (SYMPHONY) and 2nd SYMPHONY trials. Outcomes included 90-day and 1-year death and 90-day stroke, death, or myocardial infarction (MI); death, MI, or stroke; and death, MI, or severe recurrent ischemia (SRI). RESULTS: HRT use was 13% overall and varied by region (Asia, 0%; Eastern Europe, 0.2%; Latin America, 0.8%; Western Europe, 4%; Australia/New Zealand, 12%; Canada, 14%; United States, 24%); estrogen-only regimens were most common (90%). HRT users were younger, had higher estimated creatinine clearance, more frequently were smokers and had prior revascularization, but less frequently had diabetes, prior angina, or heart failure. Unadjusted 90-day and 1-year mortality rates were lower among HRT users (hazard ratios [95% CI] 0.48 [0.23-0.98] and 0.35 [0.18-0.68], respectively) but after multivariable adjustment, were not significantly different. Ninety-day stroke and composite end points did not differ between HRT users and nonusers. CONCLUSIONS: HRT use (predominantly estrogen-only) was low among patients with ACS but varied by region and was not associated with improved intermediate-term outcomes. These results are consistent with the absence of benefit from HRT use (combination or estrogen only) in previous studies in more stable populations. FAU - Parsons, Elizabeth AU - Parsons E AD - Duke University School of Medicine, Durham, North Carolina, USA. FAU - Newby, L Kristin AU - Newby LK FAU - Bhapkar, Manjushri V AU - Bhapkar MV FAU - Alexander, Karen P AU - Alexander KP FAU - White, Harvey D AU - White HD FAU - Shah, Svati H AU - Shah SH FAU - Bushnell, Cheryl D AU - Bushnell CD FAU - Califf, Robert M AU - Califf RM CN - Symphony and 2nd Symphony Investigators LA - eng GR - K23 HL03999/HL/NHLBI NIH HHS/United States PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Research Support, U.S. Gov't, P.H.S. PL - United States TA - J Womens Health (Larchmt) JT - Journal of women's health (2002) JID - 101159262 RN - 0 (Oximes) RN - 0 (Piperidines) RN - 0 (Platelet Aggregation Inhibitors) RN - R16CO5Y76E (Aspirin) RN - YUE443B0NF (sibrafiban) SB - IM MH - Aged MH - Aspirin/therapeutic use MH - Attitude to Health MH - Coronary Disease/*epidemiology/etiology MH - Estrogen Replacement Therapy/adverse effects/*statistics & numerical data MH - Female MH - Global Health MH - Humans MH - Middle Aged MH - Myocardial Infarction/*epidemiology/etiology MH - Odds Ratio MH - Oximes/therapeutic use MH - Piperidines/therapeutic use MH - Platelet Aggregation Inhibitors/therapeutic use MH - *Postmenopause MH - Prevalence MH - Randomized Controlled Trials as Topic MH - Surveys and Questionnaires MH - Survival Analysis MH - Time Factors MH - Treatment Outcome MH - *Women's Health EDAT- 2005/01/27 09:00 MHDA- 2005/03/05 09:00 CRDT- 2005/01/27 09:00 PHST- 2005/01/27 09:00 [pubmed] PHST- 2005/03/05 09:00 [medline] PHST- 2005/01/27 09:00 [entrez] AID - 10.1089/jwh.2004.13.863 [doi] PST - ppublish SO - J Womens Health (Larchmt). 2004 Oct;13(8):863-71. doi: 10.1089/jwh.2004.13.863. PMID- 15573070 OWN - NLM STAT- MEDLINE DCOM- 20050104 LR - 20220317 IS - 0022-5223 (Print) IS - 0022-5223 (Linking) VI - 128 IP - 6 DP - 2004 Dec TI - Cold blood cardioplegia versus cold crystalloid cardioplegia: a prospective randomized study of 1440 patients undergoing coronary artery bypass grafting. PG - 860-5 AB - OBJECTIVES: A large number of experimental studies have indicated that blood cardioplegia might be superior to crystalloid cardioplegia for myocardial protection during ischemic arrest. However, no prospectively randomized studies of large patient series have been undertaken to prove potential differences in clinical course. METHODS: Over a 52-month period, all patients undergoing on-pump coronary artery bypass operated on by 2 surgeons were prospectively randomized to receive either cold crystalloid cardioplegia (group C) or cold blood cardioplegia (group B) during aortic crossclamping. RESULTS: Altogether, 1440 patients aged 37 to 89 years (median, 66 years) entered the study (group C, n = 719; group B, n = 721). The groups were comparable in all major demographic, preoperative, and operative variables. The clinical course turned out to be nearly identical for both groups. No statistically significant differences were seen concerning spontaneous sinus rhythm after aortic declamping, use of inotropic drugs or intra-aortic balloon pumping, postoperative ventilatory support, bleeding and rate of allogeneic blood transfusions, perioperative myocardial infarction, episodes of atrial fibrillation, stroke or minor neurologic dysfunction, renal function, infections, physical rehabilitation, or mortality. Also, in subgroups of patients at higher operative risk (female sex, age >70 years, unstable angina, diabetes, emergency operation, ejection fraction <0.50, crossclamping time >50 minutes, and EuroSCORE >4), no statistically significant differences could be demonstrated between the groups. CONCLUSIONS: There were no significant differences whether myocardial protection was performed with cold blood cardioplegia or cold crystalloid cardioplegia during aortic crossclamping in patients undergoing coronary artery bypass grafting. The extra costs related to blood cardioplegia might be saved. FAU - Ovrum, Eivind AU - Ovrum E AD - Oslo Heart Center, Box 2684, St Hanshaugen, 0131 Oslo, Norway. eivind.ovrum@hjertesenteret.no FAU - Tangen, Geir AU - Tangen G FAU - Tollofsrud, Stein AU - Tollofsrud S FAU - Oystese, Rolf AU - Oystese R FAU - Ringdal, Mari Anne L AU - Ringdal MA FAU - Istad, Reidar AU - Istad R LA - eng PT - Clinical Trial PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial PL - United States TA - J Thorac Cardiovasc Surg JT - The Journal of thoracic and cardiovascular surgery JID - 0376343 SB - IM MH - Aged MH - Coronary Artery Bypass/*methods MH - Female MH - Heart Arrest, Induced/*methods MH - Humans MH - Male MH - Middle Aged MH - Prospective Studies MH - Risk Factors EDAT- 2004/12/02 09:00 MHDA- 2005/01/05 09:00 CRDT- 2004/12/02 09:00 PHST- 2004/12/02 09:00 [pubmed] PHST- 2005/01/05 09:00 [medline] PHST- 2004/12/02 09:00 [entrez] AID - S0022522304005094 [pii] AID - 10.1016/j.jtcvs.2004.03.032 [doi] PST - ppublish SO - J Thorac Cardiovasc Surg. 2004 Dec;128(6):860-5. doi: 10.1016/j.jtcvs.2004.03.032. PMID- 15523070 OWN - NLM STAT- MEDLINE DCOM- 20041108 LR - 20231024 IS - 1538-3598 (Electronic) IS - 0098-7484 (Linking) VI - 292 IP - 17 DP - 2004 Nov 3 TI - Utilization of early invasive management strategies for high-risk patients with non-ST-segment elevation acute coronary syndromes: results from the CRUSADE Quality Improvement Initiative. PG - 2096-104 AB - CONTEXT: The American College of Cardiology/American Heart Association (ACC/AHA) guidelines for the management of non-ST-segment elevation acute coronary syndromes (NSTE ACS) recommend early invasive management for high-risk patients, given the benefits with this approach demonstrated in randomized clinical trials. OBJECTIVES: To determine the use and predictors of early invasive management strategies (cardiac catheterization <48 hours following presentation) in high-risk patients with NSTE ACS and to examine the association of early invasive management with mortality. DESIGN, SETTING, AND PATIENTS: The CRUSADE (Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes With Early Implementation of the ACC/AHA Guidelines) Quality Improvement Initiative evaluated care patterns and outcomes for 17,926 high-risk NSTE ACS patients (positive cardiac markers and/or ischemic electrocardiographic changes) based on ACC/AHA guidelines recommendations at 248 US hospitals with catheterization and revascularization facilities between March 2000 and September 2002. MAIN OUTCOME MEASURES: Use of early invasive management within 48 hours of presentation, predictors of early invasive management, and in-hospital mortality. Results Of the 17,926 patients analyzed, 8037 (44.8%) underwent early cardiac catheterization less than 48 hours following presentation. Predictors of early invasive management included cardiology care, younger age, lack of prior or current congestive heart failure, lack of renal insufficiency, ischemic electrocardiographic changes, positive cardiac markers, white race, and male sex. Patients treated with early invasive management were more likely to be treated with medications and interventions recommended by the ACC/AHA guidelines and had a lower risk of in-hospital mortality after adjusting for differences in clinical characteristics and after comparing propensity-matched pairs (2.5% vs 3.7%, P<.001). Conclusions An early invasive management strategy is not utilized in the majority of high-risk patients with NSTE ACS. This strategy appears to be reserved for patients without significant comorbidities and those cared for by cardiologists and is associated with a lower risk of in-hospital mortality. FAU - Bhatt, Deepak L AU - Bhatt DL AD - Cleveland Clinic Foundation, Department of Cardiovascular Medicine/Desk F25, Cleveland, Ohio 44195, USA. bhattd@ccf.org FAU - Roe, Matthew T AU - Roe MT FAU - Peterson, Eric D AU - Peterson ED FAU - Li, Yun AU - Li Y FAU - Chen, Anita Y AU - Chen AY FAU - Harrington, Robert A AU - Harrington RA FAU - Greenbaum, Adam B AU - Greenbaum AB FAU - Berger, Peter B AU - Berger PB FAU - Cannon, Christopher P AU - Cannon CP FAU - Cohen, David J AU - Cohen DJ FAU - Gibson, C Michael AU - Gibson CM FAU - Saucedo, Jorge F AU - Saucedo JF FAU - Kleiman, Neal S AU - Kleiman NS FAU - Hochman, Judith S AU - Hochman JS FAU - Boden, William E AU - Boden WE FAU - Brindis, Ralph G AU - Brindis RG FAU - Peacock, W Frank AU - Peacock WF FAU - Smith, Sidney C Jr AU - Smith SC Jr FAU - Pollack, Charles V Jr AU - Pollack CV Jr FAU - Gibler, W Brian AU - Gibler WB FAU - Ohman, E Magnus AU - Ohman EM CN - CRUSADE Investigators LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - United States TA - JAMA JT - JAMA JID - 7501160 SB - IM MH - Aged MH - Aged, 80 and over MH - Angina, Unstable/mortality/*therapy MH - Angioplasty, Balloon, Coronary/statistics & numerical data MH - *Cardiac Catheterization/statistics & numerical data MH - Coronary Artery Bypass/statistics & numerical data MH - Female MH - Hospital Mortality MH - Humans MH - Male MH - Middle Aged MH - Myocardial Ischemia/mortality/*therapy MH - *Myocardial Revascularization/statistics & numerical data MH - *Outcome Assessment, Health Care MH - Risk Factors MH - Time Factors EDAT- 2004/11/04 09:00 MHDA- 2004/11/09 09:00 CRDT- 2004/11/04 09:00 PHST- 2004/11/04 09:00 [pubmed] PHST- 2004/11/09 09:00 [medline] PHST- 2004/11/04 09:00 [entrez] AID - 292/17/2096 [pii] AID - 10.1001/jama.292.17.2096 [doi] PST - ppublish SO - JAMA. 2004 Nov 3;292(17):2096-104. doi: 10.1001/jama.292.17.2096. PMID- 15519008 OWN - NLM STAT- MEDLINE DCOM- 20050118 LR - 20161124 IS - 0735-1097 (Print) IS - 0735-1097 (Linking) VI - 44 IP - 9 DP - 2004 Nov 2 TI - Impact of mild or moderate chronic kidney disease on the frequency of restenosis: results from the PRESTO trial. PG - 1786-91 AB - OBJECTIVES: The goal of this study was to determine if restenosis is increased in mild and moderate chronic kidney disease (CKD) patients after percutaneous coronary intervention (PCI). BACKGROUND: Mortality is increased in CKD after PCI. Restenosis may contribute to increased late mortality. METHODS: We analyzed 11,187 patients with a creatinine <1.8 mg/dl from the Prevention of REStenosis with Tranilast and its Outcomes (PRESTO) trial, grouped by estimated creatinine clearance (CrCl) (<60, 60 to 89, >89 ml/min). The Cox proportional hazards models investigated the association between CrCl group and death, myocardial infarction, and target vessel revascularization (TVR). Generalized estimating equation regression models determined the association between CrCl group and lesion-specific restenosis. RESULTS: At 30 days, there was no difference in myocardial infarction, death, or TVR between the CrCl groups. At nine months, mortality was higher in the lowest CrCl group (2.2%, 1.2%, 0.8%; p < 0.001), which was no longer significant after adjusting for confounding variables. Myocardial infarction and TVR were not different between the groups. In patients undergoing protocol follow-up angiography, restenosis (>/=50%) was not increased with CKD (32%, 32%, 37%; p = 0.02). CONCLUSIONS: Mortality nine months after PCI is mildly increased in mild or moderate CKD patients. However, restenosis is not and does not account for the increased mortality. FAU - Best, Patricia J M AU - Best PJ AD - Mayo Clinic, Rochester, Minnesota, USA. FAU - Berger, Peter B AU - Berger PB FAU - Davis, Barry R AU - Davis BR FAU - Grines, Cindy L AU - Grines CL FAU - Sadeghi, H Mehrdad AU - Sadeghi HM FAU - Williams, Brent A AU - Williams BA FAU - Willerson, James T AU - Willerson JT FAU - Granett, Jeffrey R AU - Granett JR FAU - Holmes, David R Jr AU - Holmes DR Jr CN - PRESTO Investigators LA - eng PT - Clinical Trial PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - United States TA - J Am Coll Cardiol JT - Journal of the American College of Cardiology JID - 8301365 RN - 0 (Biomarkers) RN - AYI8EX34EU (Creatinine) SB - IM MH - Aged MH - Angioplasty, Balloon, Coronary MH - Biomarkers/blood/urine MH - Blood Vessel Prosthesis Implantation MH - Chronic Disease MH - Coronary Angiography MH - Coronary Restenosis/diagnostic imaging/*etiology MH - Creatinine/metabolism MH - Diabetes Mellitus/diagnostic imaging/therapy MH - Female MH - Follow-Up Studies MH - Humans MH - Kidney Diseases/diagnostic imaging/*therapy MH - Male MH - Middle Aged MH - Postoperative Complications/diagnostic imaging/*etiology MH - Prospective Studies MH - Severity of Illness Index MH - Stents MH - Treatment Outcome EDAT- 2004/11/03 09:00 MHDA- 2005/01/19 09:00 CRDT- 2004/11/03 09:00 PHST- 2004/02/20 00:00 [received] PHST- 2004/07/06 00:00 [revised] PHST- 2004/07/12 00:00 [accepted] PHST- 2004/11/03 09:00 [pubmed] PHST- 2005/01/19 09:00 [medline] PHST- 2004/11/03 09:00 [entrez] AID - S0735-1097(04)01635-3 [pii] AID - 10.1016/j.jacc.2004.07.052 [doi] PST - ppublish SO - J Am Coll Cardiol. 2004 Nov 2;44(9):1786-91. doi: 10.1016/j.jacc.2004.07.052. PMID- 15459602 OWN - NLM STAT- MEDLINE DCOM- 20050125 LR - 20201216 IS - 1097-6744 (Electronic) IS - 0002-8703 (Linking) VI - 148 IP - 4 DP - 2004 Oct TI - N-acetylcysteine reduces contrast-associated nephropathy but not clinical events during long-term follow-up. PG - 690-5 AB - BACKGROUND: Contrast-associated nephropathy (CAN) is associated with increased morbidity and mortality following percutaneous coronary intervention (PCI). N-acetylcysteine (NAC) has been shown to reduce the risk of nephropathy; however, the impact of NAC on long-term clinical outcomes has not been assessed. METHODS: This randomized, double-blind, placebo-controlled trial enrolled 180 patients with moderate renal dysfunction undergoing PCI or coronary angiography with a high likelihood of ad hoc PCI; 171 patients completed the clinical follow-up. Patients received oral NAC (2000 mg/dose, n = 95) or placebo (n = 85) twice a day for 3 doses if randomized the night prior to the procedure, and 2 doses if randomized the day of the procedure. The primary end point was the incidence of a > or =25% increase in serum creatinine level 48 to 72 hours after PCI. Secondary end points were the inhospital incidence of death, nonfatal myocardial infarction, or urgent dialysis, and the 9-month incidence of death, nonfatal myocardial infarction, need for dialysis, or repeat hospitalization for cardiac reasons. RESULTS: CAN occurred in 9.6% of patients assigned to NAC and 22.2% of patients assigned to placebo (P =.04); 1 patient receiving NAC required urgent dialysis. The inhospital composite end point occurred in 7 (7.4%) NAC-treated and 3 (3.5%) placebo-treated patients, P = NS. At 9 months, the composite end point occurred in 23 (24.2%) NAC-treated patients and 18 (21.2%) placebo-treated, P = NS. CONCLUSION: Although high-dose NAC prevented periprocedural CAN, this benefit did not translate into a decrease in adverse outcomes over 9 months. Further studies to determine the clinical utility of this drug are required. FAU - Miner, Steven E S AU - Miner SE AD - University of Toronto and the Department of Medicine at the University Health Network, Toronto, Ontario, Canada. FAU - Dzavik, Vladimir AU - Dzavik V FAU - Nguyen-Ho, Phong AU - Nguyen-Ho P FAU - Richardson, Robert AU - Richardson R FAU - Mitchell, Jan AU - Mitchell J FAU - Atchison, Deborah AU - Atchison D FAU - Seidelin, Peter AU - Seidelin P FAU - Daly, Paul AU - Daly P FAU - Ross, John AU - Ross J FAU - McLaughlin, Peter R AU - McLaughlin PR FAU - Ing, Douglas AU - Ing D FAU - Lewycky, Peter AU - Lewycky P FAU - Barolet, Alan AU - Barolet A FAU - Schwartz, Leonard AU - Schwartz L LA - eng PT - Clinical Trial PT - Journal Article PT - Randomized Controlled Trial PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 RN - 0 (Contrast Media) RN - AYI8EX34EU (Creatinine) RN - WYQ7N0BPYC (Acetylcysteine) SB - IM MH - Acetylcysteine/*therapeutic use MH - Aged MH - Angioplasty, Balloon, Coronary/*adverse effects MH - Contrast Media/*adverse effects MH - Coronary Angiography/*adverse effects MH - Coronary Disease/complications/diagnostic imaging/mortality/therapy MH - Creatinine/blood MH - Diabetes Complications MH - Double-Blind Method MH - Female MH - Follow-Up Studies MH - Humans MH - Kidney Diseases/blood/chemically induced/*prevention & control MH - Male MH - Middle Aged EDAT- 2004/10/02 05:00 MHDA- 2005/01/26 09:00 CRDT- 2004/10/02 05:00 PHST- 2004/10/02 05:00 [pubmed] PHST- 2005/01/26 09:00 [medline] PHST- 2004/10/02 05:00 [entrez] AID - S0002870304002637 [pii] AID - 10.1016/j.ahj.2004.05.015 [doi] PST - ppublish SO - Am Heart J. 2004 Oct;148(4):690-5. doi: 10.1016/j.ahj.2004.05.015. PMID- 15451148 OWN - NLM STAT- MEDLINE DCOM- 20050224 LR - 20061115 IS - 0195-668X (Print) IS - 0195-668X (Linking) VI - 25 IP - 19 DP - 2004 Oct TI - Severity of heart failure, treatments, and outcomes after fibrinolysis in patients with ST-elevation myocardial infarction. PG - 1702-10 AB - AIMS: To define the clinical characteristics, co-morbidities, treatment, and clinical outcomes of patients with varying degrees of heart failure (HF) complicating ST-elevation myocardial infarction (STEMI), and to identify patients at high risk for HF following fibrinolysis. METHODS AND RESULTS: 15,078 STEMI patients enrolled in a worldwide fibrinolytic trial (InTIME-II) were categorised into one of four hierarchical, mutually exclusive groups of HF: shock (n = 719, 5%); severe HF (n = 1082, 7%); mild HF (n = 1619, 11%); no HF (n = 11,658, 77%). In a multivariable model, anterior MI (OR 1.8, 95% CI [1.6; 1.9]), age > or = 65 (OR 1.8 [1.6; 2.0]), prior HF (OR 3.3 [2.6; 4.2]), and creatinine clearance < 60 mL/min (OR 1.8 [1.6; 2.1]) were the four most powerful correlates of HF. Although 30-day mortality was sixfold higher for patients with HF (18.9% vs. 3.1%, P < 0.0001), these patients were less likely to undergo angiography (30% vs. 40%, P < 0.0001) and revascularisation (19% vs. 25%, P , 0.0001), than patients without HF. Likewise, angiotensin-inhibitors and beta-blockers were not optimally utilised in patients with HF following MI. CONCLUSIONS: During the index admission following fibrinolysis 23% of patients had HF. Despite a higher risk profile, patients with more severe HF were treated less aggressively than patients without HF. FAU - Kashani, Amir AU - Kashani A AD - Department of Internal Medicine, Rochester General Hospital, Rochester, NY, USA. FAU - Giugliano, Robert P AU - Giugliano RP FAU - Antman, Elliott M AU - Antman EM FAU - Morrow, David A AU - Morrow DA FAU - Gibson, C Michael AU - Gibson CM FAU - Murphy, Sabina A AU - Murphy SA FAU - Braunwald, Eugene AU - Braunwald E LA - eng PT - Clinical Trial PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - England TA - Eur Heart J JT - European heart journal JID - 8006263 RN - 0 (Adrenergic beta-Antagonists) RN - 0 (Angiotensin-Converting Enzyme Inhibitors) SB - IM MH - Adrenergic beta-Antagonists/therapeutic use MH - Aged MH - Angiotensin-Converting Enzyme Inhibitors/therapeutic use MH - Cardiac Output, Low/*drug therapy/etiology/mortality MH - Disease-Free Survival MH - Female MH - Humans MH - Male MH - Middle Aged MH - Myocardial Infarction/*drug therapy MH - Thrombolytic Therapy/*methods MH - Treatment Outcome EDAT- 2004/09/29 05:00 MHDA- 2005/02/25 09:00 CRDT- 2004/09/29 05:00 PHST- 2004/02/05 00:00 [received] PHST- 2004/04/28 00:00 [revised] PHST- 2004/05/05 00:00 [accepted] PHST- 2004/09/29 05:00 [pubmed] PHST- 2005/02/25 09:00 [medline] PHST- 2004/09/29 05:00 [entrez] AID - S0195668X04003161 [pii] AID - 10.1016/j.ehj.2004.05.009 [doi] PST - ppublish SO - Eur Heart J. 2004 Oct;25(19):1702-10. doi: 10.1016/j.ehj.2004.05.009. PMID- 15385655 OWN - NLM STAT- MEDLINE DCOM- 20040929 LR - 20220317 IS - 1533-4406 (Electronic) IS - 0028-4793 (Linking) VI - 351 IP - 13 DP - 2004 Sep 23 TI - Relation between renal dysfunction and cardiovascular outcomes after myocardial infarction. PG - 1285-95 AB - BACKGROUND: The presence of coexisting conditions has a substantial effect on the outcome of acute myocardial infarction. Renal failure is associated with one of the highest risks, but the influence of milder degrees of renal impairment is less well defined. METHODS: As part of the Valsartan in Acute Myocardial Infarction Trial (VALIANT), we identified 14,527 patients with acute myocardial infarction complicated by clinical or radiologic signs of heart failure, left ventricular dysfunction, or both, and a documented serum creatinine measurement. Patients were randomly assigned to receive captopril, valsartan, or both. The glomerular filtration rate (GFR) was estimated by means of the four-component Modification of Diet in Renal Disease equation, and the patients were grouped according to their estimated GFR. We used a 70-candidate variable model to adjust and compare overall mortality and composite cardiovascular events among four GFR groups. RESULTS: The distribution of estimated GFR was wide and normally shaped, with a mean (+/-SD) value of 70+/-21 ml per minute per 1.73 m2 of body-surface area. The prevalence of coexisting risk factors, prior cardiovascular disease, and a Killip class of more than I was greatest among patients with a reduced estimated GFR (less than 45.0 ml per minute per 1.73 m2), and the use of aspirin, beta-blockers, statins, or coronary-revascularization procedures was lowest in this group. The risk of death or the composite end point of death from cardiovascular causes, reinfarction, congestive heart failure, stroke, or resuscitation after cardiac arrest increased with declining estimated GFRs. Although the rate of renal events increased with declining estimated GFRs, the adverse outcomes were predominantly cardiovascular. Below 81.0 ml per minute per 1.73 m2, each reduction of the estimated GFR by 10 units was associated with a hazard ratio for death and nonfatal cardiovascular outcomes of 1.10 (95 percent confidence interval, 1.08 to 1.12), which was independent of the treatment assignment. CONCLUSIONS: Even mild renal disease, as assessed by the estimated GFR, should be considered a major risk factor for cardiovascular complications after a myocardial infarction. CI - Copyright 2004 Massachusetts Medical Society FAU - Anavekar, Nagesh S AU - Anavekar NS AD - Cardiovascular Division, Brigham and Women's Hospital, Boston, MA 02115, USA. FAU - McMurray, John J V AU - McMurray JJ FAU - Velazquez, Eric J AU - Velazquez EJ FAU - Solomon, Scott D AU - Solomon SD FAU - Kober, Lars AU - Kober L FAU - Rouleau, Jean-Lucien AU - Rouleau JL FAU - White, Harvey D AU - White HD FAU - Nordlander, Rolf AU - Nordlander R FAU - Maggioni, Aldo AU - Maggioni A FAU - Dickstein, Kenneth AU - Dickstein K FAU - Zelenkofske, Steven AU - Zelenkofske S FAU - Leimberger, Jeffrey D AU - Leimberger JD FAU - Califf, Robert M AU - Califf RM FAU - Pfeffer, Marc A AU - Pfeffer MA LA - eng PT - Clinical Trial PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - United States TA - N Engl J Med JT - The New England journal of medicine JID - 0255562 RN - 0 (Angiotensin II Type 1 Receptor Blockers) RN - 0 (Angiotensin-Converting Enzyme Inhibitors) RN - 0 (Tetrazoles) RN - 80M03YXJ7I (Valsartan) RN - 9G64RSX1XD (Captopril) RN - AYI8EX34EU (Creatinine) RN - HG18B9YRS7 (Valine) SB - IM CIN - N Engl J Med. 2004 Sep 23;351(13):1344-6. doi: 10.1056/NEJMe048211. PMID: 15385664 CIN - N Engl J Med. 2005 Jan 13;352(2):199-200; author reply 199-200. PMID: 15651121 CIN - ACP J Club. 2005 Mar-Apr;142(2):51. doi: 10.7326/ACPJC-2005-142-2-051. PMID: 15739997 MH - Aged MH - *Angiotensin II Type 1 Receptor Blockers MH - Angiotensin-Converting Enzyme Inhibitors/*therapeutic use MH - Captopril/*therapeutic use MH - Cardiovascular Diseases/*etiology/mortality MH - Chronic Disease MH - Creatinine/blood MH - Double-Blind Method MH - Drug Therapy, Combination MH - Female MH - Glomerular Filtration Rate MH - Humans MH - Kidney Diseases/*complications/diagnosis MH - Male MH - Middle Aged MH - Myocardial Infarction/blood/*complications/drug therapy/mortality MH - Proportional Hazards Models MH - Risk Factors MH - Survival Rate MH - Tetrazoles/*therapeutic use MH - Valine/analogs & derivatives/*therapeutic use MH - Valsartan EDAT- 2004/09/24 05:00 MHDA- 2004/09/30 05:00 CRDT- 2004/09/24 05:00 PHST- 2004/09/24 05:00 [pubmed] PHST- 2004/09/30 05:00 [medline] PHST- 2004/09/24 05:00 [entrez] AID - 351/13/1285 [pii] AID - 10.1056/NEJMoa041365 [doi] PST - ppublish SO - N Engl J Med. 2004 Sep 23;351(13):1285-95. doi: 10.1056/NEJMoa041365. PMID- 15384013 OWN - NLM STAT- MEDLINE DCOM- 20050301 LR - 20101118 IS - 1523-6838 (Electronic) IS - 0272-6386 (Linking) VI - 44 IP - 4 DP - 2004 Oct TI - Coronary revascularization in patients with renal insufficiency: restenosis rate and cardiovascular outcomes. PG - 627-35 AB - BACKGROUND: Several interventional trials have shown a lower success rate for coronary angioplasty and lower long-term event-free survival in patients with renal insufficiency, and data are conflicting about restenosis after coronary angioplasty. METHODS: This study included 4,131 consecutive patients with coronary artery disease treated with coronary angioplasty (23%) or stenting (77%). Renal insufficiency is defined as a creatinine clearance (CrCl) less than 60 mL/min (<1.0 mL/s). Of 4,131 patients, 1,412 patients (34.2%) had renal insufficiency and 2,719 patients (65.8%) did not have renal insufficiency. The primary end point of the study is clinical restenosis, defined as the need for target-lesion revascularization. RESULTS: There was no difference in clinical restenosis rates between groups after 1 year (18.8% versus 18.4%; P = 0.75). The incidence of angiographic restenosis at the 6-month angiography was 32.7% in the group with renal insufficiency and 29.7% in the group without renal insufficiency ( P = 0.10). The composite end point of death and myocardial infarction was observed more frequently in patients with than without renal insufficiency (8.3% versus 3.2%; P < 0.001). Renal insufficiency was not independently associated with clinical restenosis (for 10-mL/min [0.167-mL/s]) decrease in CrCl, adjusted odds ratio, 1.03; 95% confidence interval [CI], 0.98 to 1.08; P = 0.198), but remained as an independent predictor for death or myocardial infarction (for 10-mL/min [0.167-mL/s] decrease in CrCl, hazard ratio, 1.29; 95% CI, 1.18 to 1.42; P < 0.001). CONCLUSION: Patients with renal insufficiency do not show an increased incidence of restenosis after coronary revascularization. FAU - Pinkau, Tobias AU - Pinkau T AD - Deutsches Herzzentrum, Technische Universitat, Munich, Germany. pinkau@web.de FAU - Mann, Johannes F E AU - Mann JF FAU - Ndrepepa, Gjin AU - Ndrepepa G FAU - Mehilli, Julinda AU - Mehilli J FAU - Hadamitzky, Martin AU - Hadamitzky M FAU - Braun, Siegmund AU - Braun S FAU - Kastrati, Adnan AU - Kastrati A FAU - Schomig, Albert AU - Schomig A LA - eng PT - Journal Article PL - United States TA - Am J Kidney Dis JT - American journal of kidney diseases : the official journal of the National Kidney Foundation JID - 8110075 SB - IM MH - Aged MH - *Angioplasty, Balloon, Coronary MH - Coronary Angiography MH - Coronary Artery Disease/*complications/*therapy MH - Coronary Restenosis/*epidemiology MH - Female MH - Humans MH - Male MH - Multivariate Analysis MH - Renal Insufficiency/*complications MH - Retrospective Studies MH - Stents MH - Treatment Outcome EDAT- 2004/09/24 05:00 MHDA- 2005/03/02 09:00 CRDT- 2004/09/24 05:00 PHST- 2004/09/24 05:00 [pubmed] PHST- 2005/03/02 09:00 [medline] PHST- 2004/09/24 05:00 [entrez] AID - S027263860400945X [pii] PST - ppublish SO - Am J Kidney Dis. 2004 Oct;44(4):627-35. PMID- 15327407 OWN - NLM STAT- MEDLINE DCOM- 20041101 LR - 20131121 IS - 0085-2538 (Print) IS - 0085-2538 (Linking) VI - 66 IP - 3 DP - 2004 Sep TI - Gemfibrozil for secondary prevention of cardiovascular events in mild to moderate chronic renal insufficiency. PG - 1123-30 AB - BACKGROUND: Although cardiovascular disease and low high-density lipoprotein (HDL) cholesterol are common in people with renal insufficiency, data addressing the cardiovascular benefits of fibric acid derivatives in this population are sparse. We conducted a post hoc subgroup analysis of a randomized double-blind, placebo-controlled trial to determine whether gemfibrozil is effective and safe for secondary prevention of cardiovascular events in individuals with chronic renal insufficiency (CRI). METHODS: Using an analysis plan that was developed a priori, we analyzed data from the Veterans' Affairs High-Density Lipoprotein Intervention Trial (VA-HIT) study; a randomized trial of gemfibrozil versus placebo in 2531 men with established coronary disease, an HDL cholesterol level of 40 mg/dL (1.0 mmol/L) or less, and a low-density lipoprotein (LDL) cholesterol level of 140 mg/dL (3.6 mmol/L) or less. Of these, 1046 men had CRI as defined by creatinine clearance 75 ml/min/1.73 m2) and by hematocrit (<35, 35 to 39 and 40). GFR was calculated as GFR = 186 x (serum creatinine-1.154) x (age-0.203) x 1.212 (if black) or x 0.742 (if female). There were 20 deaths (3.2%) among 638 patients with a hematocrit of <35, 41 deaths among 2,066 patients (2.0%) with a hematocrit of 35 to 39, and 43 deaths in 3,618 patients (1.2%) with a hematocrit >40 at 6 months (p <0.001). Similarly, a significant increase in mortality was seen with lower GFR [33 of 1,168 (2.9%) at GFR <60, 33 of 1,766 (1.9%) at GFR 60 to 75 and 37 of 3,317 (1.1%) at GFR >75, p <0.001)]. Further, GFR and anemia independently and in combination predicted mortality at 3 years. Thus, renal insufficiency and anemia are significant independent and additive predictors of short- and long-term complications in patients undergoing percutaneous coronary intervention. FAU - Gurm, Hitinder S AU - Gurm HS AD - Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, 44195, USA. FAU - Lincoff, A Michael AU - Lincoff AM FAU - Kleiman, Neil S AU - Kleiman NS FAU - Kereiakes, Dean J AU - Kereiakes DJ FAU - Tcheng, James E AU - Tcheng JE FAU - Aronow, Herbert D AU - Aronow HD FAU - Askari, Arman T AU - Askari AT FAU - Brennan, Danielle M AU - Brennan DM FAU - Topol, Eric J AU - Topol EJ LA - eng PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM MH - Aged MH - Anemia/*epidemiology MH - *Angioplasty, Balloon, Coronary MH - Canada/epidemiology MH - Female MH - Glomerular Filtration Rate MH - Hematocrit MH - Humans MH - Male MH - Middle Aged MH - Myocardial Infarction/*mortality/*therapy MH - Proportional Hazards Models MH - Randomized Controlled Trials as Topic MH - Renal Insufficiency/*epidemiology MH - Survival Analysis EDAT- 2004/06/29 05:00 MHDA- 2004/07/22 05:00 CRDT- 2004/06/29 05:00 PHST- 2004/01/22 00:00 [received] PHST- 2004/03/19 00:00 [revised] PHST- 2004/03/19 00:00 [accepted] PHST- 2004/06/29 05:00 [pubmed] PHST- 2004/07/22 05:00 [medline] PHST- 2004/06/29 05:00 [entrez] AID - S0002914904004394 [pii] AID - 10.1016/j.amjcard.2004.03.025 [doi] PST - ppublish SO - Am J Cardiol. 2004 Jul 1;94(1):30-4. doi: 10.1016/j.amjcard.2004.03.025. PMID- 15199357 OWN - NLM STAT- MEDLINE DCOM- 20040921 LR - 20161124 IS - 1097-6744 (Electronic) IS - 0002-8703 (Linking) VI - 147 IP - 6 DP - 2004 Jun TI - Outcomes of elderly patients with cardiogenic shock treated with early percutaneous revascularization. PG - 1066-70 AB - BACKGROUND: Subgroup analysis from the Should We Emergently Revascularize Occluded Coronaries for Cardiogenic Shock (SHOCK) trial indicated that patients with acute myocardial infarction (MI) complicated by cardiogenic shock (CS) who were > or =75 years old did not benefit from early revascularization and may have been harmed; their mortality rate at 30 days was 75%. The applicability of this subset analysis from a select patient population enrolled in a randomized trial to the general population is unclear. METHODS: At the Mayo Clinic between 1991 and 2000, we evaluated the outcome of all patients > or =75 years old with CS caused by MI who underwent urgent percutaneous coronary intervention (PCI). RESULTS: The study included 61 patients with a mean age of 79.5 +/- 3 years; 21% of these patients had a history of prior coronary artery bypass grafting (CABG), 41% had had a prior MI, 28% had diabetes mellitus, and 18% had a history of a cerebrovascular accident (CVA). PCI was performed 8.0 +/- 7.2 hours after onset of MI. Angiographic success (<50% residual stenosis) was achieved in 91% of the lesions that were dilated. In hospital outcomes included death (44%), CABG (1.6%), and CVA (4.9%). The 30-day mortality rate was 47%. The estimated survival rate 1 year after discharge (Kaplan Meier method) was 75%. CONCLUSIONS: These data confirm a high early mortality rate among patients > or =75 years old with MI complicated by CS, but suggest that among patients referred for angiography, outcomes may be better than previously believed when early revascularization is performed. In this population, 56% of patients survived to be discharged from the hospital, and of the hospital survivors, 75% were alive at 1 year. FAU - Prasad, Abhiram AU - Prasad A AD - Division of Cardiovascular Diseases and Department of Internal Medicine, Rochester, Minn, USA. FAU - Lennon, Ryan J AU - Lennon RJ FAU - Rihal, Charanjit S AU - Rihal CS FAU - Berger, Peter B AU - Berger PB FAU - Holmes, David R Jr AU - Holmes DR Jr LA - eng PT - Journal Article PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 SB - IM CIN - Am Heart J. 2004 Jun;147(6):950-2. doi: 10.1016/j.ahj.2003.12.026. PMID: 15199339 MH - Aged MH - *Angioplasty, Balloon, Coronary MH - Cardiovascular Diseases/epidemiology MH - Comorbidity MH - Coronary Angiography MH - Diabetes Mellitus/epidemiology MH - Female MH - Humans MH - Kidney Failure, Chronic/epidemiology MH - Male MH - Myocardial Infarction/diagnostic imaging/epidemiology MH - Retrospective Studies MH - Shock, Cardiogenic/epidemiology/*mortality/*surgery MH - Smoking/epidemiology MH - Stents MH - Survival Rate MH - Treatment Outcome EDAT- 2004/06/17 05:00 MHDA- 2004/09/24 05:00 CRDT- 2004/06/17 05:00 PHST- 2004/06/17 05:00 [pubmed] PHST- 2004/09/24 05:00 [medline] PHST- 2004/06/17 05:00 [entrez] AID - S0002870304000195 [pii] AID - 10.1016/j.ahj.2003.07.030 [doi] PST - ppublish SO - Am Heart J. 2004 Jun;147(6):1066-70. doi: 10.1016/j.ahj.2003.07.030. PMID- 15117846 OWN - NLM STAT- MEDLINE DCOM- 20041008 LR - 20101118 IS - 1524-4539 (Electronic) IS - 0009-7322 (Linking) VI - 109 IP - 19 DP - 2004 May 18 TI - Propensity analysis of long-term survival after surgical or percutaneous revascularization in patients with multivessel coronary artery disease and high-risk features. PG - 2290-5 AB - BACKGROUND: Although most randomized clinical trials have suggested that long-term survival rates after percutaneous coronary intervention (PCI) or surgical multivessel coronary revascularization (CABG) are equivalent, some post hoc analyses in high-risk groups and adjustment for severity of coronary disease have suggested higher mortality after PCI. METHODS AND RESULTS: We studied 6033 consecutive patients who underwent revascularization in the late 1990s. PCI was performed in 872 patients; 5161 underwent CABG. Half the patients had significant left ventricular dysfunction or diabetes. Propensity analysis to predict the probability of undergoing PCI according to 22 variables and their interactions was used. The C-statistic for this model was 0.90, indicating excellent discrimination between treatments. There were 931 deaths during 5 years of follow-up. The 1- and 5-year unadjusted mortality rates were 5% and 16% for PCI and 4% and 14% for CABG (unadjusted hazard ratio, 1.13; 95% CI, 1.0 to 1.4; P=0.07). PCI was associated with an increased risk of death (propensity-adjusted hazard ratio, 2.3; 95% CI, 1.9 to 2.9; P<0.0001). This difference was observed across all categories of propensity for PCI and in patients with diabetes or left ventricular dysfunction. Other independent predictors of mortality (P< or =0.01 for all) were renal dysfunction, age, diabetes mellitus, chronic lung disease, peripheral vascular disease, left main trunk stenosis, and extent of coronary disease (Duke angiographic score). CONCLUSIONS: In patients with multivessel coronary artery disease and many high-risk characteristics, CABG was associated with better survival than PCI after adjustment for risk profile. FAU - Brener, Sorin J AU - Brener SJ AD - Department of Cardiovascular Medicine, Cleveland Clinic Foundation, 9500 Euclid Ave, Desk F-25, Cleveland, Ohio 44195, USA. breners@ccf.org FAU - Lytle, Bruce W AU - Lytle BW FAU - Casserly, Ivan P AU - Casserly IP FAU - Schneider, Jakob P AU - Schneider JP FAU - Topol, Eric J AU - Topol EJ FAU - Lauer, Michael S AU - Lauer MS LA - eng PT - Comparative Study PT - Journal Article DEP - 20040426 PL - United States TA - Circulation JT - Circulation JID - 0147763 SB - IM CIN - Circulation. 2004 May 18;109(19):e9043-4. doi: 10.1161/01.CIR.0000133005.91952.C4. PMID: 15148285 MH - Aged MH - Angioplasty, Balloon, Coronary/*statistics & numerical data MH - Cohort Studies MH - Comorbidity MH - Coronary Artery Bypass/*statistics & numerical data MH - Coronary Disease/surgery/*therapy MH - Diabetes Mellitus/epidemiology MH - Female MH - Follow-Up Studies MH - Humans MH - Life Tables MH - Logistic Models MH - Male MH - Middle Aged MH - Proportional Hazards Models MH - Registries MH - Retrospective Studies MH - Risk Factors MH - Stents MH - Survival Analysis MH - Treatment Outcome MH - Ventricular Dysfunction, Left/epidemiology EDAT- 2004/05/01 05:00 MHDA- 2004/10/09 09:00 CRDT- 2004/05/01 05:00 PHST- 2004/05/01 05:00 [pubmed] PHST- 2004/10/09 09:00 [medline] PHST- 2004/05/01 05:00 [entrez] AID - 01.CIR.0000126826.58526.14 [pii] AID - 10.1161/01.CIR.0000126826.58526.14 [doi] PST - ppublish SO - Circulation. 2004 May 18;109(19):2290-5. doi: 10.1161/01.CIR.0000126826.58526.14. Epub 2004 Apr 26. PMID- 15100752 OWN - NLM STAT- MEDLINE DCOM- 20040527 LR - 20101118 IS - 0828-282X (Print) IS - 0828-282X (Linking) VI - 20 IP - 5 DP - 2004 Apr TI - Female sex and risk of contrast nephropathy after percutaneous coronary intervention. PG - 505-9 AB - BACKGROUND: Women undergoing percutaneous coronary intervention (PCI) seem to have a higher in-hospital mortality than men. The reason for this difference in outcome is unknown. Contrast nephropathy (CN) remains a major complication of PCI and a common cause of acute renal failure. OBJECTIVE: To test the hypothesis that women have a higher incidence of CN, which April contribute in part to their increased in-hospital mortality following PCI. METHODS: Sex-based differences in the development of CN were studied in 1383 patients undergoing PCI who were included in a randomized trial of two hydration regimens. Baseline renal function was assessed by calculating the glomerular filtration rate (GFR) using the abbreviated Modification of Diet in Renal Disease Study equation. CN was defined as an increase in serum creatinine of at least 44 micromol/L within 48 h. RESULTS: Women and men differed in several baseline characteristics. Women were older and had a higher incidence of arterial hypertension and diabetes. In addition, baseline GFR was significantly lower in women than in men. The incidence of CN was significantly higher in women. CN developed in 10 of 354 (2.8%) women compared with nine of 1029 (0.9%) men (odds ratio 3.3, 95% CI 1.3 to 8.2, P=0.01). After adjusting for confounders including baseline GFR and incidence of arterial hypertension, female sex was no longer a significant independent predictor of CN (odds ratio 2.2, 95% CI 0.8 to 5.6, P=0.12). CONCLUSIONS: The significantly higher incidence of CN after PCI in women seemed largely due to their less favourable baseline characteristics, including lower GFR and higher incidence of arterial hypertension, rather than to female sex itself. FAU - Mueller, Christian AU - Mueller C AD - Herz-Zentrum Bad Krozingen, Bad Krozingen, Germany. chmueller@uhbs.ch FAU - Buerkle, Gerd AU - Buerkle G FAU - Perruchoud, Andre P AU - Perruchoud AP FAU - Buettner, Heinz J AU - Buettner HJ LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - England TA - Can J Cardiol JT - The Canadian journal of cardiology JID - 8510280 RN - 0 (Contrast Media) SB - IM MH - Acute Kidney Injury/chemically induced/*epidemiology MH - Aged MH - *Angioplasty, Balloon, Coronary MH - Contrast Media/*adverse effects MH - Coronary Artery Disease/*therapy MH - Female MH - Glomerular Filtration Rate MH - Humans MH - Incidence MH - Length of Stay MH - Male MH - Middle Aged MH - Prospective Studies MH - Randomized Controlled Trials as Topic MH - Sex Factors MH - Switzerland/epidemiology EDAT- 2004/04/22 05:00 MHDA- 2004/05/28 05:00 CRDT- 2004/04/22 05:00 PHST- 2004/04/22 05:00 [pubmed] PHST- 2004/05/28 05:00 [medline] PHST- 2004/04/22 05:00 [entrez] PST - ppublish SO - Can J Cardiol. 2004 Apr;20(5):505-9. PMID- 15086477 OWN - NLM STAT- MEDLINE DCOM- 20041021 LR - 20071115 IS - 0085-2538 (Print) IS - 0085-2538 (Linking) VI - 65 IP - 4 DP - 2004 Apr TI - Effects of vitamin E on cardiovascular outcomes in people with mild-to-moderate renal insufficiency: results of the HOPE study. PG - 1375-80 AB - BACKGROUND: A controlled trial reported cardiovascular benefits of vitamin E in terminal renal insufficiency. There are no data for renal insufficiency before the stage of terminal renal failure. We evaluated effects of vitamin E supplementation on cardiovascular and renal outcomes in 993 people with a serum creatinine > or =1.4 to 2.3 mg/dL. METHODS: Post-hoc analysis of a randomized trial that compared treatment with natural source vitamin E (400 IU/day) to placebo in 9541 people, 993 of which had renal insufficiency. Participants had either known cardiovascular disease or diabetes and at least one additional coronary risk factor. Exclusion criteria included a serum creatinine > 2.3 mg/dL and dipstick-positive proteinuria. The primary study outcome after an average of 4.5 years was the composite of myocardial infarction, stroke, or cardiovascular death. Secondary outcomes included revascularizations, total mortality, and clinical proteinuria. RESULTS: In renal insufficiency, vitamin E supplementation had a neutral effect on the primary study outcome, on each component of the composite primary outcome, and on all secondary outcomes. Two hundred twenty-four primary outcomes, 23% of the vitamin E group and 22.1% of the placebo group, relative risk 1.03 (95% CI, 0.79-1.34; P= 0.82), were observed, and 585 secondary outcomes, including death in 17% and 18.8% of the vitamin E and placebo groups, respectively (RR 0.88, 95% CI, 0.66-1.18; P= 0.40). There was no effect of vitamin E on progression of proteinuria. CONCLUSION: In people with mild-to-moderate renal insufficiency at high cardiovascular risk, vitamin E at a dose of 400 IU/day had no apparent effect on cardiovascular outcomes. FAU - Mann, Johannes F E AU - Mann JF AD - Department of Nephrology and Hypertension, Schwabing General Hospital, Munich, Germany. Johannes.mann@kms.mhn.de FAU - Lonn, Eva M AU - Lonn EM FAU - Yi, Qilong AU - Yi Q FAU - Gerstein, Hertzel C AU - Gerstein HC FAU - Hoogwerf, Byron J AU - Hoogwerf BJ FAU - Pogue, Janice AU - Pogue J FAU - Bosch, Jackie AU - Bosch J FAU - Dagenais, Gilles R AU - Dagenais GR FAU - Yusuf, Salim AU - Yusuf S CN - HOPE Investigators LA - eng PT - Clinical Trial PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - United States TA - Kidney Int JT - Kidney international JID - 0323470 RN - 0 (Antioxidants) RN - 1406-18-4 (Vitamin E) SB - IM MH - Aged MH - Antioxidants/*therapeutic use MH - Cardiovascular Diseases/etiology/*mortality MH - Female MH - Humans MH - Kidney Failure, Chronic/complications/*drug therapy/mortality/*physiopathology MH - Male MH - Middle Aged MH - Myocardial Infarction/etiology/*mortality MH - Risk Factors MH - Severity of Illness Index MH - Stroke/etiology/*mortality MH - Treatment Failure MH - Vitamin E/*therapeutic use EDAT- 2004/04/17 05:00 MHDA- 2004/10/22 09:00 CRDT- 2004/04/17 05:00 PHST- 2004/04/17 05:00 [pubmed] PHST- 2004/10/22 09:00 [medline] PHST- 2004/04/17 05:00 [entrez] AID - S0085-2538(15)49846-1 [pii] AID - 10.1111/j.1523-1755.2004.00513.x [doi] PST - ppublish SO - Kidney Int. 2004 Apr;65(4):1375-80. doi: 10.1111/j.1523-1755.2004.00513.x. PMID- 15057439 OWN - NLM STAT- MEDLINE DCOM- 20040910 LR - 20191210 IS - 0340-9937 (Print) IS - 0340-9937 (Linking) VI - 29 IP - 2 DP - 2004 Mar TI - [Safety and current indications during "real life" use of sirolimus-eluting coronary stents in Germany. Results from the prospective multicenter German Cypher Registry]. PG - 181-6 AB - BACKGROUND: Although randomized, controlled clinical trials (RCTs) showed a reduced target vessel revascularization rate and a good safety profile for the sirolimus-eluting coronary Cypher stent, at least the safety data need to be confirmed by larger data in clinical practice. Under the circumstances of frozen medical budgets in Germany, there may also be a shift toward implantation of a drug-eluting stent (DES) for indications not yet evaluated by RCTs. METHODS: The authors analyzed the data of the German Cypher Registry a nationwide registry which was initiated in parallel to the launch of the first DES, the Cypher stent, in April 2002. RESULTS: From April 2002 until December 2003, 3,579 interventions using a Cypher stent at 102 centers were included in the German Cypher Registry. This reflects a proportion of this DES compared to all stents implanted at the participating centers of < 10%. Patients' median age was 63.4 years (quartiles: 55-70 years) with 75% men. Renal insufficiency was seen in 10.1%, previous myocardial infarction in 37%, prior percutaneous coronary intervention (PCI) in 54.6%, and prior coronary artery bypass grafting (CABG) in 18.7%. In a large proportion of interventions, Cypher stents were implanted in lesions or in clinical situations not yet evaluated by RCTs: 10.1% ST elevation myocardial infarction, 1.8% cardiogenic shock, 2.1% left main stenoses, 5.5% CABG lesions, 23.2% in-stent stenosis, and 6% chronic total occlusions. PCI before DES implantation was performed in 65.5% of cases, a mean of 1.02 +/- 0.43 Cypher stents per lesion were implanted with a median sum length of all Cypher stents per lesion of 18 mm (quartiles: 13-21 mm). Maximum median balloon diameter during stent implantation was 3.00 mm (quartiles: 2.75-3.00 mm). Acute complication rate was low, with 0.2% deaths, 0.3% subacute stent thromboses, 1.3% myocardial infarctions, 2.1% urgent PCIs, and 0.2% CABGs. CONCLUSION: In about one half of the patients included into the German Cypher Registry, the DES were implanted in lesions that were excluded from RCTs. The use of this sirolimus-eluting coronary stent in "real life" conditions was found to be safe concerning acute complications. FAU - Zahn, Ralf AU - Zahn R AD - Herzzentrum, Kardiologie, Ludwigshafen, erzahn@aol.com FAU - Hamm, Christian W AU - Hamm CW FAU - Zeymer, Uwe AU - Zeymer U FAU - Schneider, Steffen AU - Schneider S FAU - Nienaber, Christoph A AU - Nienaber CA FAU - Richardt, Gert AU - Richardt G FAU - Kelm, Malte AU - Kelm M FAU - Levenson, Benny AU - Levenson B FAU - Bonzel, Tassilo AU - Bonzel T FAU - Tebbe, Ulrich AU - Tebbe U FAU - Schobel, Wolfgang A AU - Schobel WA FAU - Sabin, Georg AU - Sabin G FAU - Senges, Jochen AU - Senges J CN - deutsche Cyper-Register LA - ger PT - Journal Article TT - Aktuelle Indikationsstellung und Sicherheit beim Einsatz des koronaren Sirolimus-Stents im klinischen Alltag in Deutschland. Ergebnisse des deutschen prospektiven multizentrischen Cypher-Registers. PL - Germany TA - Herz JT - Herz JID - 7801231 RN - 0 (Antibiotics, Antineoplastic) RN - 0 (Coated Materials, Biocompatible) RN - 0 (Immunosuppressive Agents) RN - W36ZG6FT64 (Sirolimus) SB - IM MH - Administration, Topical MH - Aged MH - Angioplasty, Balloon, Coronary/*instrumentation MH - Antibiotics, Antineoplastic/*administration & dosage/adverse effects/pharmacokinetics MH - *Coated Materials, Biocompatible MH - Coronary Artery Bypass MH - Coronary Restenosis/blood/*prevention & control MH - Coronary Stenosis/blood/*therapy MH - Coronary Vessels/drug effects MH - Female MH - Follow-Up Studies MH - Germany MH - Graft Occlusion, Vascular/blood/therapy MH - Humans MH - Immunosuppressive Agents/*administration & dosage/adverse effects/pharmacokinetics MH - Male MH - Middle Aged MH - Multicenter Studies as Topic MH - Myocardial Infarction/blood/therapy MH - Outcome Assessment, Health Care/statistics & numerical data MH - Prospective Studies MH - Randomized Controlled Trials as Topic/statistics & numerical data MH - Registries MH - Shock, Cardiogenic/blood/therapy MH - Sirolimus/*administration & dosage/adverse effects/pharmacokinetics MH - *Stents MH - Treatment Outcome EDAT- 2004/04/02 05:00 MHDA- 2004/09/11 05:00 CRDT- 2004/04/02 05:00 PHST- 2004/04/02 05:00 [pubmed] PHST- 2004/09/11 05:00 [medline] PHST- 2004/04/02 05:00 [entrez] AID - 10.1007/s00059-004-2560-x [doi] PST - ppublish SO - Herz. 2004 Mar;29(2):181-6. doi: 10.1007/s00059-004-2560-x. PMID- 15034108 OWN - NLM STAT- MEDLINE DCOM- 20041026 LR - 20220409 IS - 1046-6673 (Print) IS - 1046-6673 (Linking) VI - 15 IP - 4 DP - 2004 Apr TI - Renal insufficiency and the risk of lower extremity peripheral arterial disease: results from the Heart and Estrogen/Progestin Replacement Study (HERS). PG - 1046-51 AB - Renal insufficiency is a risk factor for coronary heart disease and stroke, but whether it predicts lower extremity peripheral arterial disease (PAD) is unknown. The authors evaluated was the association of baseline renal insufficiency with future PAD events in the Heart and Estrogen/Progestin Replacement Study (HERS) and follow-up study (HERS II). A total of 2763 postmenopausal women with known coronary heart disease were enrolled in HERS and randomly assigned to receive hormone therapy with conjugated estrogens and medroxyprogesterone acetate or placebo and followed for up to 8 yr for clinical end points. The outcome was time from randomization to first occurrence of either a lower extremity amputation, revascularization (surgical or percutaneous), or lumbar sympathectomy during follow-up. Incident lower extremity PAD event rates among women with creatinine clearances > or =60, 30 to 59, and < 30 ml/min/1.73 m(2) were, respectively, 0.55%, 0.92%, and 2.73% per year. After multivariable proportional-hazard adjustment for potential confounders and other known risk factors for PAD, women with a creatinine clearance 30 to 59 ml/min/1.73 m(2) (hazard ratio [HR], 1.63; 95% confidence interval [CI], 1.04 to 2.54, P = 0.032) and <30 ml/min/1.73 m(2) (HR, 3.24; 95% CI, 1.20 to 8.78, P = 0.021) had a significantly increased risk of PAD compared with participants with a creatinine clearance > or =60 ml/min/1.73 m(2). Renal insufficiency was independently associated with future PAD events among postmenopausal women with coronary heart disease. Future studies should determine whether this association is present in other populations and investigate its potential mechanisms. FAU - O'Hare, Ann M AU - O'Hare AM AD - Department of Medicine, Box 111J, VA Medical Center San Francisco, 4150 Clement Street, San Francisco, CA 94121, USA. Ann.O'Hare@med.va.gov FAU - Vittinghoff, Eric AU - Vittinghoff E FAU - Hsia, Judith AU - Hsia J FAU - Shlipak, Michael G AU - Shlipak MG LA - eng PT - Clinical Trial PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, U.S. Gov't, Non-P.H.S. PL - United States TA - J Am Soc Nephrol JT - Journal of the American Society of Nephrology : JASN JID - 9013836 RN - 0 (Progestins) SB - IM MH - Aged MH - Arterial Occlusive Diseases/epidemiology/*etiology MH - Coronary Disease/complications MH - Estrogen Replacement Therapy MH - Female MH - Follow-Up Studies MH - Humans MH - Leg/*blood supply MH - Male MH - Middle Aged MH - Progestins/therapeutic use MH - Randomized Controlled Trials as Topic MH - Renal Insufficiency/*complications MH - Risk Factors EDAT- 2004/03/23 05:00 MHDA- 2004/10/27 09:00 CRDT- 2004/03/23 05:00 PHST- 2004/03/23 05:00 [pubmed] PHST- 2004/10/27 09:00 [medline] PHST- 2004/03/23 05:00 [entrez] AID - 10.1097/01.asn.0000119574.27772.fd [doi] PST - ppublish SO - J Am Soc Nephrol. 2004 Apr;15(4):1046-51. doi: 10.1097/01.asn.0000119574.27772.fd. PMID- 15016048 OWN - NLM STAT- MEDLINE DCOM- 20041106 LR - 20190922 IS - 0886-0440 (Print) IS - 0886-0440 (Linking) VI - 19 IP - 2 DP - 2004 Mar-Apr TI - Should we give prophylactic renal-dose dopamine after coronary artery bypass surgery? PG - 128-33 AB - OBJECTIVE: A prospective double-blind randomized study undertaken to assess the effect of postoperative prophylactic "renal-dose" dopamine on post-coronary artery bypass grafting surgery's clinical outcome. METHODS: Eighty-five consecutive patients undergoing CABG operation were randomized to receive either 3-5 microg/kg/min dopamine (group D, n = 41) or saline as placebo (group P, n = 45) for 48 postoperative hours. Clinical outcome parameters were collected for four postoperative days. RESULTS: Preoperative and operative parameters were similar in both groups. Four patients from group P and none from group D reached an end-point of the study (oliguria, renal dysfunction) and received dopamine. Two patients from group P and none from group D needed an additional inotropic support. Mean arterial pressure values were similar during the first 24 hours after operation, but left atrial pressure values tended to be higher in group P (10 +/- 4 vs 7 +/- 3 mmH2O, p = 0.18). The mean pH was higher in group D at 8 hours after operation (7.38 +/- 0.2 vs 7.36 +/- 0.3, p = NS), due to higher bicarbonate levels (23 +/- 2 mmol/l vs 21 +/- 2, p = 0.49). The incidence of lung congestion in chest X-rays and CT scans was significantly higher in group P (50% vs 29%, p = 0.073 at 48 hours postoperatively). Room air blood O2 saturation and maximal expiratory volume tended to be higher in group D (at 72 hours after operation- 92 +/- 4 vs 90%+/- 5, p = 0.29 and 646 +/- 276 vs 485 ml +/- 206, p = 0.16, respectively). There was no statistical difference in urine output but the amount of furosemide given to patients in group P was significantly higher (during the first 8 hours 2.5 +/- 0.5 vs. 0.3 mg +/- 1.6, p = 0.07). Plasma creatinine levels were significantly lower in group D (at 24 hours 0.93 +/- 0.02 vs 1.05 mg/dL +/- 0.02, p = 0.02). Mobilization after surgery was faster in group D. CONCLUSIONS: Prophylactic dopamine administration after coronary artery bypass grafting surgery improves patient hemodynamic and renal status, reduces the need for additional medical support (inotropes and furosemide) and thus, provides stable postoperative course. FAU - Gatot, Inbar AU - Gatot I AD - Department of Cardiothoracic Surgery, Soroka Medical Center, Beer Sheva, Israel. FAU - Abramov, Dan AU - Abramov D FAU - Tsodikov, Vadim AU - Tsodikov V FAU - Yeshayahu, Michal AU - Yeshayahu M FAU - Orman, Solomon AU - Orman S FAU - Gavriel, Aharon AU - Gavriel A FAU - Chorni, Ilia AU - Chorni I FAU - Tuvbin, David AU - Tuvbin D FAU - Tager, Salis AU - Tager S FAU - Apelbom, Azai AU - Apelbom A LA - eng PT - Clinical Trial PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial PL - United States TA - J Card Surg JT - Journal of cardiac surgery JID - 8908809 RN - 0 (Bicarbonates) RN - 0 (Biomarkers) RN - 0 (Cardiotonic Agents) RN - S88TT14065 (Oxygen) RN - VTD58H1Z2X (Dopamine) SB - IM EIN - J Card Surg. 2011 Mar;26(2):244. Yeshaaiahu, Michal [corrected to Yeshayahu, Michal] MH - Aged MH - Bicarbonates/blood MH - Biomarkers/blood/urine MH - Blood Pressure/physiology MH - Cardiotonic Agents/*administration & dosage MH - *Coronary Artery Bypass MH - Coronary Disease/metabolism/physiopathology/*therapy MH - Dopamine/*administration & dosage MH - Dose-Response Relationship, Drug MH - Double-Blind Method MH - Female MH - Follow-Up Studies MH - Forced Expiratory Volume/physiology MH - Humans MH - Israel MH - Kidney/*drug effects/metabolism/*physiology MH - Male MH - Middle Aged MH - Oxygen/blood MH - *Postoperative Care MH - Prospective Studies MH - Treatment Outcome EDAT- 2004/03/16 05:00 MHDA- 2004/11/09 09:00 CRDT- 2004/03/16 05:00 PHST- 2004/03/16 05:00 [pubmed] PHST- 2004/11/09 09:00 [medline] PHST- 2004/03/16 05:00 [entrez] AID - 10.1111/j.0886-0440.2004.04044.x [doi] PST - ppublish SO - J Card Surg. 2004 Mar-Apr;19(2):128-33. doi: 10.1111/j.0886-0440.2004.04044.x. PMID- 15013113 OWN - NLM STAT- MEDLINE DCOM- 20040415 LR - 20191210 IS - 0735-1097 (Print) IS - 0735-1097 (Linking) VI - 43 IP - 3 DP - 2004 Feb 4 TI - Importance of increasing age on the presentation and outcome of acute coronary syndromes in elderly patients. PG - 346-52 AB - OBJECTIVES: The study examined differences in presentation and outcome between elderly (> or =70 years) and very elderly (> or =80 years) patients hospitalized for acute coronary syndromes (ACS). BACKGROUND: The elderly constitute an increasingly important sector of patients with ACS but have been underrepresented in many therapeutic trials. METHODS: We compiled a registry of 449 consecutive patients, 251 elderly (70 to 79 years) (septuagenarians, group 1) and 198 very elderly (> or =80 years) (group 2), to examine outcomes in relation to baseline characteristics and treatment. We recorded survival over a period of 24 +/- 4 months and rehospitalization and symptomatic status at 16 +/- 4 months. RESULTS: At index hospitalization, the older cohort (group 2) more often had acute myocardial infarction (35% vs. 9.7%, p < 0.0001), heart failure (33.3% vs. 19.4%, p < 0.001), and renal dysfunction (21.6% vs. 12.3%, p = 0.01). They were less likely to undergo coronary angiography (29.3% vs. 43.8%, p = 0.002), but those selected for angiography more often underwent revascularization so that revascularization rates were similar (22.7% group 2 vs. 24.3% group 1, p = NS). Two-year survival rate was poorer in group 2 (67.4 +/- 3.5% vs. 83.5 +/- 2.5% in group 1, p < 0.0001). Repeat rehospitalization was similar (53.0% vs. 48.2%, respectively, p = 0.31), but improvement in well-being of survivors was greater (60.0% vs. 46.3%, p = 0.01). CONCLUSIONS: The study demonstrated important differences between elderly (70 to 79 years) and very elderly (> or =80 years) patients hospitalized with ACS. The older cohort was sicker on admission and had poorer outcome, but a subgroup selected for angiography and possible intervention had two-year outcomes similar to the younger cohort. FAU - Halon, David A AU - Halon DA AD - Department of Cardiology, Lady Davis Carmel Medical Center, 7 Michal Street, Haifa 34362, Israel. halon@clalit.org.il FAU - Adawi, Salim AU - Adawi S FAU - Dobrecky-Mery, Idit AU - Dobrecky-Mery I FAU - Lewis, Basil S AU - Lewis BS LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - United States TA - J Am Coll Cardiol JT - Journal of the American College of Cardiology JID - 8301365 SB - IM MH - Age Factors MH - Aged MH - Aged, 80 and over MH - Angina, Unstable/*epidemiology/therapy MH - Cohort Studies MH - Female MH - Hospitalization MH - Humans MH - Male MH - Myocardial Infarction/*epidemiology/therapy MH - Outcome Assessment, Health Care MH - Survival Analysis EDAT- 2004/03/12 05:00 MHDA- 2004/04/16 05:00 CRDT- 2004/03/12 05:00 PHST- 2003/06/25 00:00 [received] PHST- 2003/08/06 00:00 [revised] PHST- 2003/08/18 00:00 [accepted] PHST- 2004/03/12 05:00 [pubmed] PHST- 2004/04/16 05:00 [medline] PHST- 2004/03/12 05:00 [entrez] AID - S0735109703014396 [pii] AID - 10.1016/j.jacc.2003.08.044 [doi] PST - ppublish SO - J Am Coll Cardiol. 2004 Feb 4;43(3):346-52. doi: 10.1016/j.jacc.2003.08.044. PMID- 14713182 OWN - NLM STAT- MEDLINE DCOM- 20040423 LR - 20170511 IS - 0001-5385 (Print) IS - 0001-5385 (Linking) VI - 58 IP - 6 DP - 2003 Dec TI - Acetylcysteine, coronary procedure and prevention of contrast-induced worsening of renal function: which benefit for which patient? PG - 555-60 AB - OBJECTIVES: This study was designed to determine whether acetylcysteine could provide a protective effect on renal function in a population of patients with normal renal function or mild to moderate chronic renal failure, usually referred for a coronary procedure. BACKGROUND: Contrast-induced nephropathy is a well-recognized complication of coronary angiography. Recent studies suggest that saline hydration and acetylcysteine reduce the incidence of contrast-induced worsening of renal function in patients with pre-existing chronic renal failure who are undergoing computed tomography examinations. METHODS: One hundred eight patients were blindly and randomly assigned to receive either acetylcysteine or placebo before and after administration of contrast agent in association with a moderate hydration protocol. Serum creatinine and urea nitrogen were measured before and 24 hours after coronary procedure. RESULTS: The mean serum creatinine concentration remained unchanged 24 hours after contrast agent administration in both groups: from 1.04 +/- 0.26 to 1.03 +/- 0.29 mg/dl in the acetylcysteine group and from 1.16 +/- 1.1 to 1.06 +/- 0.41 mg/dl in the control group (p = 0.29, for the comparison between two groups, NS). We divided the population into 3 subgroups according to their creatinine clearance: no significant change of serum creatinine concentration was observed in patients with normal renal function nor in patients with pre-existing mild to moderate chronic renal failure in both groups. There was no significant difference for the incidence of contrast-induced nephropathy between both groups (2 of the 53 patients in the acetylcysteine group and 3 of the 51 patients in the placebo group, p = 0.98, NS). CONCLUSIONS: Our data do not support the systematic use of acetylcysteine before a coronary procedure in patients with normal renal function or mild to moderate chronic renal failure, to prevent contrast-induced nephropathy. FAU - Kefer, Joelle M AU - Kefer JM AD - Division of Cardiology, University of Louvain, Brussels, Belgium. FAU - Hanet, Claude E AU - Hanet CE FAU - Boitte, Sabine AU - Boitte S FAU - Wilmotte, Leon AU - Wilmotte L FAU - De Kock, Martine AU - De Kock M LA - eng PT - Clinical Trial PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial PL - England TA - Acta Cardiol JT - Acta cardiologica JID - 0370570 RN - 0 (Biomarkers) RN - 0 (Contrast Media) RN - 0 (Free Radical Scavengers) RN - AYI8EX34EU (Creatinine) RN - WYQ7N0BPYC (Acetylcysteine) SB - IM MH - Acetylcysteine/*therapeutic use MH - Aged MH - *Angioplasty, Balloon, Coronary MH - Biomarkers/blood MH - Contrast Media/*adverse effects MH - *Coronary Angiography MH - Coronary Disease/diagnostic imaging/epidemiology/therapy MH - Creatinine/blood MH - Female MH - Free Radical Scavengers/*therapeutic use MH - Humans MH - Kidney Failure, Chronic/*chemically induced/physiopathology/*prevention & control MH - Male MH - Middle Aged MH - Prospective Studies MH - Risk Assessment MH - Risk Factors MH - Severity of Illness Index MH - Single-Blind Method MH - Stroke Volume/drug effects/physiology MH - Treatment Outcome EDAT- 2004/01/10 05:00 MHDA- 2004/04/24 05:00 CRDT- 2004/01/10 05:00 PHST- 2004/01/10 05:00 [pubmed] PHST- 2004/04/24 05:00 [medline] PHST- 2004/01/10 05:00 [entrez] AID - 10.2143/AC.58.6.2005321 [doi] PST - ppublish SO - Acta Cardiol. 2003 Dec;58(6):555-60. doi: 10.2143/AC.58.6.2005321. PMID- 14677735 OWN - NLM STAT- MEDLINE DCOM- 20040423 LR - 20181113 IS - 0730-2347 (Print) IS - 0730-2347 (Linking) VI - 30 IP - 4 DP - 2003 TI - Full-sternotomy off-pump versus on-pump coronary artery bypass procedures: in-hospital outcomes and complications during one year in a single center. PG - 261-7 AB - We prospectively compared, according to their preoperative clinical profiles, the in-hospital outcomes of patients operated on consecutively (but without randomization) for isolated coronary artery disease with on-pump or off-pump techniques. During 2001, 324 patients underwent coronary artery bypass grafting: 216 patients (mean age, 66.7 +/- 8.9 years; range, 41-85 years) underwent on-pump revascularization, and 108 patients (mean age, 676 +/- 10 years; range, 37-90 years) underwent full-sternotomy off-pump revascularization. The 2 groups were homogeneous with regard to female sex (22.6% vs 26.8%), previous cardiac operation (2.8% vs 4.6%), cardiogenic shock (1.3% vs 1.9%), diabetes (30% vs 33%), and chronic renal failure that required hemodialysis (3% vs 3.5%). Postoperative complications, including bleeding, myocardial infarction, acute renal failure, mediastinitis with sternal dehiscence, cerebrovascular events, and prolonged respiratory assistance were more frequent in on-pump patients (P = 0.004). The total number of grafts and the grafts per patient ratio were significantly higher in on-pump patients (P = 0.0001), whereas the total number of full arterial revascularizations was higher in off-pump patients (P = 0.0001). Off-pump patients showed a significantly shorter intensive care unit stay (P = 0.02), and less need for intra-aortic balloon pump insertion (P = 0.04). In-hospital mortality was 2.8% in on-pump patients and 2.7% in off-pump patients (P = NS). Although the hospital mortality rate was comparable for the 2 techniques, the in-hospital comparison between the 2 groups showed how the avoidance of cardiopulmonary bypass can significantly reduce the cumulative postoperative incidence of complications in patients undergoing coronary artery bypass grafting. FAU - Bottio, Tomaso AU - Bottio T AD - Department of Cardiovascular Surgery, University of Padua Medical School, Padua, Italy. tomaso.bottio@unipd.it FAU - Rizzoli, Giulio AU - Rizzoli G FAU - Caprili, Luca AU - Caprili L FAU - Nesseris, Georgios AU - Nesseris G FAU - Thiene, Gaetano AU - Thiene G FAU - Gerosa, Gino AU - Gerosa G LA - eng PT - Clinical Trial PT - Comparative Study PT - Journal Article PL - United States TA - Tex Heart Inst J JT - Texas Heart Institute journal JID - 8214622 SB - IM CIN - Tex Heart Inst J. 2003;30(4):258-60. PMID: 14677734 MH - Adult MH - Aged MH - Aged, 80 and over MH - Cardiopulmonary Bypass/*adverse effects/*mortality MH - Coronary Artery Bypass/*adverse effects/methods/*mortality MH - Coronary Artery Disease/mortality/surgery MH - Female MH - Follow-Up Studies MH - *Hospital Mortality MH - Humans MH - Male MH - Middle Aged MH - *Postoperative Complications MH - Prospective Studies MH - Thoracotomy/adverse effects/methods/mortality MH - Treatment Outcome PMC - PMC307710 EDAT- 2003/12/18 05:00 MHDA- 2004/04/24 05:00 PMCR- 2003/01/01 CRDT- 2003/12/18 05:00 PHST- 2003/12/18 05:00 [pubmed] PHST- 2004/04/24 05:00 [medline] PHST- 2003/12/18 05:00 [entrez] PHST- 2003/01/01 00:00 [pmc-release] AID - 0010801-200312000-00003 [pii] PST - ppublish SO - Tex Heart Inst J. 2003;30(4):261-7. PMID- 14638545 OWN - NLM STAT- MEDLINE DCOM- 20040109 LR - 20220410 IS - 1524-4539 (Electronic) IS - 0009-7322 (Linking) VI - 108 IP - 22 DP - 2003 Dec 2 TI - Impact of renal insufficiency in patients undergoing primary angioplasty for acute myocardial infarction. PG - 2769-75 AB - BACKGROUND: The prognostic importance of renal insufficiency (RI) in patients undergoing primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) has not been well characterized. METHODS AND RESULTS: PCI was performed in 2082 AMI patients without shock presenting within 12 hours of symptom onset in a prospective, multicenter randomized trial. RI was defined as a calculated (Cockroft-Gault) creatinine clearance (CrCl) < or =60 mL/min. RI at baseline was present in 18% of patients. Compared with patients without RI, patients with RI were older and were more likely to be female; to have hypertension, peripheral vascular disease, or cerebrovascular disease; and to present in heart failure. Mortality was markedly increased in patients with versus without baseline RI both at 30 days (7.5% versus 0.8%, P<0.0001) and at 1 year (12.7% versus 2.4%, P<0.0001). Mortality rates increased incrementally for every 10-mL/min decrease in baseline CrCl. By multivariate analysis, reduced baseline CrCl was a powerful independent predictor of 30-day mortality (hazard ratio, 5.77; P<0.0001) and remained associated with reduced survival at 1 year (hazard ratio, 1.98; P=0.08). Hemorrhagic complications and transfusion requirements were also increased more than 2-fold in patients with RI, as were severe restenosis (diameter stenosis > or =70%; 20.6% versus 11.8%, P=0.024) and infarct artery reocclusion (14.7% versus 7.3%, P=0.02). CONCLUSIONS: Baseline RI in patients with AMI undergoing primary PCI is associated with a markedly increased risk of mortality, as well as bleeding and restenosis. Novel approaches are needed to improve the otherwise poor prognosis of patients with RI and AMI. FAU - Sadeghi, H Mehrdad AU - Sadeghi HM AD - William Beaumont Hospital, Royal Oak, Mich, USA. FAU - Stone, Gregg W AU - Stone GW FAU - Grines, Cindy L AU - Grines CL FAU - Mehran, Roxana AU - Mehran R FAU - Dixon, Simon R AU - Dixon SR FAU - Lansky, Alexandra J AU - Lansky AJ FAU - Fahy, Martin AU - Fahy M FAU - Cox, David A AU - Cox DA FAU - Garcia, Eulogio AU - Garcia E FAU - Tcheng, James E AU - Tcheng JE FAU - Griffin, John J AU - Griffin JJ FAU - Stuckey, Thomas D AU - Stuckey TD FAU - Turco, Mark AU - Turco M FAU - Carroll, John D AU - Carroll JD LA - eng PT - Clinical Trial PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20031124 PL - United States TA - Circulation JT - Circulation JID - 0147763 RN - 0 (Antibodies, Monoclonal) RN - 0 (Contrast Media) RN - 0 (Immunoglobulin Fab Fragments) RN - 0 (Platelet Aggregation Inhibitors) RN - AYI8EX34EU (Creatinine) RN - X85G7936GV (Abciximab) SB - IM MH - Abciximab MH - Acute Disease MH - Aged MH - *Angioplasty, Balloon, Coronary/adverse effects MH - Antibodies, Monoclonal/therapeutic use MH - Contrast Media/adverse effects MH - Coronary Restenosis/diagnosis/prevention & control MH - Creatinine/blood/urine MH - Female MH - Humans MH - Immunoglobulin Fab Fragments/therapeutic use MH - Male MH - Middle Aged MH - Myocardial Infarction/*complications/drug therapy/*therapy MH - Platelet Aggregation Inhibitors/therapeutic use MH - Predictive Value of Tests MH - Prognosis MH - Prospective Studies MH - Renal Insufficiency/chemically induced/*complications/diagnosis MH - Risk Assessment MH - Stents/adverse effects MH - Survival Rate MH - Treatment Outcome EDAT- 2003/11/26 05:00 MHDA- 2004/01/10 05:00 CRDT- 2003/11/26 05:00 PHST- 2003/11/26 05:00 [pubmed] PHST- 2004/01/10 05:00 [medline] PHST- 2003/11/26 05:00 [entrez] AID - 01.CIR.0000103623.63687.21 [pii] AID - 10.1161/01.CIR.0000103623.63687.21 [doi] PST - ppublish SO - Circulation. 2003 Dec 2;108(22):2769-75. doi: 10.1161/01.CIR.0000103623.63687.21. Epub 2003 Nov 24. PMID- 14607434 OWN - NLM STAT- MEDLINE DCOM- 20031204 LR - 20201216 IS - 0735-1097 (Print) IS - 0735-1097 (Linking) VI - 42 IP - 9 DP - 2003 Nov 5 TI - Association of creatinine and creatinine clearance on presentation in acute myocardial infarction with subsequent mortality. PG - 1535-43 AB - OBJECTIVES: We hypothesized that impaired renal function would also be associated with poorer clinical outcomes among patients with ST-segment elevation myocardial infarction (STEMI) treated with fibrinolysis. BACKGROUND: Previous studies have demonstrated that impaired renal function is associated with poorer clinical outcomes in the setting of unstable angina and non-STEMI and after percutaneous coronary intervention. METHODS: Data were drawn from the Thrombolysis In Myocardial Infarction (TIMI)-10, TIMI-14, and Intravenous nPA for the Treatment of Infarcting Myocardium Early (InTIME-II) trials. RESULTS: Within each TIMI risk score (TRS) for STEMI category (0 to 2, 3 to 4, >/=5), 30-day mortality increased stepwise among patients with normal (creatinine [Cr] 1.2 to 2 mg/dl), and severely (Cr >2.0 mg/dl) impaired renal function (p < 0.001) and in patients with normal (creatinine clearance [CrCl] >/=90 ml/min), mildly (60 to <90 ml/min), moderately (30 to <60 ml/min), and severely (<30 ml/min) impaired CrCl (p < 0.001). Impaired renal function was associated with increased mortality after adjusting for previously identified correlates of mortality (using Cr: odds ratio [OR] for mild impairment 1.52, 95% confidence interval [CI] 1.30 to 1.77, p < 0.001; OR for severe impairment 3.73, 95% CI 2.55 to 5.45, p < 0.001; using CrCl: OR for mild impairment 1.38, 95% CI 1.10 to 1.73, p = 0.006; OR for moderate impairment 2.06, 95% CI 1.59 to 2.66, p < 0.001; OR for severe impairment 3.81, 95% CI 2.57 to 5.65, p < 0.001). CONCLUSIONS: In the setting of STEMI, elevated Cr and/or impaired CrCl on presentation is associated with increased mortality, independent of other conventional risk factors and TRS. This association does not appear to be mediated by reduced fibrinolytic efficacy among patients with impaired renal function or by the presence of congestive heart failure on presentation. FAU - Gibson, C Michael AU - Gibson CM AD - TIMI Study Chairman's Office, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA. mgibson@tini.org FAU - Pinto, Duane S AU - Pinto DS FAU - Murphy, Sabina A AU - Murphy SA FAU - Morrow, David A AU - Morrow DA FAU - Hobbach, Hans Peter AU - Hobbach HP FAU - Wiviott, Stephen D AU - Wiviott SD FAU - Giugliano, Robert P AU - Giugliano RP FAU - Cannon, Christopher P AU - Cannon CP FAU - Antman, Elliott M AU - Antman EM FAU - Braunwald, Eugene AU - Braunwald E CN - TIMI Study Group LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - United States TA - J Am Coll Cardiol JT - Journal of the American College of Cardiology JID - 8301365 RN - 0 (Fibrinolytic Agents) RN - AYI8EX34EU (Creatinine) SB - IM CIN - J Am Coll Cardiol. 2003 Nov 5;42(9):1544-6. doi: 10.1016/j.jacc.2003.08.001. PMID: 14607435 MH - Aged MH - Coronary Angiography MH - Creatinine/*blood MH - Female MH - Fibrinolytic Agents/therapeutic use MH - Humans MH - Intracranial Hemorrhages/epidemiology MH - Kidney/*physiopathology MH - Logistic Models MH - Male MH - Middle Aged MH - Myocardial Infarction/diagnostic imaging/drug therapy/*mortality/*physiopathology MH - Odds Ratio MH - Prognosis MH - Retrospective Studies MH - Survival Analysis EDAT- 2003/11/11 05:00 MHDA- 2003/12/05 05:00 CRDT- 2003/11/11 05:00 PHST- 2003/11/11 05:00 [pubmed] PHST- 2003/12/05 05:00 [medline] PHST- 2003/11/11 05:00 [entrez] AID - S0735109703010672 [pii] AID - 10.1016/j.jacc.2003.06.001 [doi] PST - ppublish SO - J Am Coll Cardiol. 2003 Nov 5;42(9):1535-43. doi: 10.1016/j.jacc.2003.06.001. PMID- 14583175 OWN - NLM STAT- MEDLINE DCOM- 20040722 LR - 20260128 IS - 1056-8727 (Print) IS - 1056-8727 (Linking) VI - 17 IP - 6 DP - 2003 Nov-Dec TI - Design of the cooperative study on glycemic control and complications in diabetes mellitus type 2: Veterans Affairs Diabetes Trial. PG - 314-22 AB - INTRODUCTION: Long-term glycemic control trials in type 2 diabetes show as the main clinical benefit a difference in retinal photocoagulation (3/1000 in the UK Prospective Diabetes Study [UKPDS]), but no effect on visual acuity or renal failure. No intensive glycemic control trial has yet affected cardiovascular (CV) events, the main cause of morbidity and mortality. By contrast, modest blood pressure reduction has protective effects on visual acuity, renal function, CV events, and mortality. Optimal glycemic control goals are not established in elderly, obese persons with advanced complications, the most common patients in the Veterans Affairs (VA) system. The earlier feasibility trial in such patients (VA-CSDM) suggested potentially worse CV outcomes with lower attained hemoglobin A1c (HbA1c) levels. OBJECTIVES: The primary objective of the Veterans Affairs Diabetes Trial (VADT) is the assessment of the effect of intensive glycemic treatment on CV events. Other objectives are effects on microangiopathy, quality of life, and cost effectiveness. RESEARCH DESIGN AND METHODS: The VADT, started in December 2000, is enrolling 1700 men and women previously uncontrolled on insulin or maximum doses of oral agents at 20 VA medical centers. Accrual is 2 years and follow-up is 5-7 years, with visits every 1.5 months. The study has a power of 86% to detect a 21% relative reduction in major CV events (CV death, myocardial infarction [MI], cerebrovascular accident [CVA], congestive heart failure [CHF], revascularization and amputation for ischemia). Subjects are randomized to an intensive arm aiming at normal HbA1c levels or to a standard arm with usual, improved glycemic control. An HbA1c separation of >1.5% is to be maintained (expected 2%). Both arms receive step therapy: glimepiride or metformin plus rosiglitazone and addition of insulin or other oral agents to achieve goals. Strict control of blood pressure and dyslipidemia, daily aspirin, diet, and education are identical in both arms. Plasma fibrinogen, plasminogen-activating inhibitor I (PAI-I), lipids, renal function parameters, and ECG are measured throughout. Stereo retinal photographs are obtained at entry and 5 years, eye examinations yearly, and intervention as needed to prevent visual deterioration. Recruitment is proceeding on schedule: the current mean HbA1c at entry is 9.4+/-1.6% and mean duration of diagnosed diabetes 11+/-8 years. FAU - Abraira, Carlos AU - Abraira C AD - VA Medical Center, Miami, FL 33125, USA. FAU - Duckworth, William AU - Duckworth W FAU - McCarren, Madeline AU - McCarren M FAU - Emanuele, Nicholas AU - Emanuele N FAU - Arca, Danielle AU - Arca D FAU - Reda, Domenic AU - Reda D FAU - Henderson, William AU - Henderson W CN - VA Cooperative Study of Glycemic Control and Complications in Diabetes Mellitus Type 2 LA - eng PT - Clinical Trial PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PT - Research Support, U.S. Gov't, Non-P.H.S. PT - Research Support, U.S. Gov't, P.H.S. PL - United States TA - J Diabetes Complications JT - Journal of diabetes and its complications JID - 9204583 RN - 0 (Blood Glucose) RN - 0 (Glycated Hemoglobin) SB - IM MH - Adult MH - Blood Glucose/analysis/*metabolism MH - Blood Glucose Self-Monitoring/methods MH - Cardiovascular Diseases/etiology/*prevention & control MH - Diabetes Mellitus, Type 2/blood/complications/physiopathology/*therapy MH - Diabetic Angiopathies/etiology/*prevention & control MH - Diabetic Retinopathy/etiology/*prevention & control MH - Female MH - Glycated Hemoglobin/analysis MH - Humans MH - Male MH - Middle Aged MH - Prospective Studies MH - Randomized Controlled Trials as Topic/*methods MH - United States MH - United States Department of Veterans Affairs MH - Veterans/statistics & numerical data EDAT- 2003/10/30 05:00 MHDA- 2004/07/23 05:00 CRDT- 2003/10/30 05:00 PHST- 2003/10/30 05:00 [pubmed] PHST- 2004/07/23 05:00 [medline] PHST- 2003/10/30 05:00 [entrez] AID - S1056872702002775 [pii] AID - 10.1016/s1056-8727(02)00277-5 [doi] PST - ppublish SO - J Diabetes Complications. 2003 Nov-Dec;17(6):314-22. doi: 10.1016/s1056-8727(02)00277-5. PMID- 12902095 OWN - NLM STAT- MEDLINE DCOM- 20030911 LR - 20190628 IS - 0003-4975 (Print) IS - 0003-4975 (Linking) VI - 76 IP - 2 DP - 2003 Aug TI - Emboli capture using the Embol-X intraaortic filter in cardiac surgery: a multicentered randomized trial of 1,289 patients. PG - 508-15; discussion 515 AB - BACKGROUND: Particulate emboli are thought to play a significant role in the development of cardiac surgical complications. Intraaortic filtration of particulate emboli may reduce the burden of this morbidity in cardiac patients. METHODS: A multiinstitutional randomized trial was designed and enrolled 1,289 patients at 22 centers. Six hundred forty-five patients were assigned to the treatment arm and received the Embol-X intraaortic filter, whereas 644 patients were assigned to the control arm. The endpoints examined were mortality, stroke, transient ischemic attack, renal insufficiency/failure, myocardial infarction, gastrointestinal complications, and limb-threatening ischemia. All filters were examined for histologic evidence of particulate emboli. RESULTS: Particulate emboli were identified in 598 (96.8%) of 618 filters successfully deployed. Composite event rates for the clinical endpoints were similar in both the filtered and nonfiltered arm (110/645 = 17% vs 122/644 = 19%, respectively). Individual event rates were also similar in both arms. A post hoc comparison of patients with moderate or greater preoperative risk scores demonstrated event reduction favoring the filtered group for renal complications (17/124 = 14% vs 28/117 = 24%, p = 0.04) and for the composite endpoint (30/124 = 24% vs 42/117 = 36%, p = 0.047). No clinically evident complications attributed to the use of the filter were identified. CONCLUSIONS: The use of the Embol-X intraaortic filter is both safe and effective, as demonstrated by the emboli capture rate of 97%. In addition, post hoc analysis indicates a reduction in postoperative renal complications for patients with moderate or greater preoperative risk. Further study of high-risk patients is warranted. FAU - Banbury, Michael K AU - Banbury MK AD - The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA. banburm@ccf.org FAU - Kouchoukos, Nicholas T AU - Kouchoukos NT FAU - Allen, Keith B AU - Allen KB FAU - Slaughter, Mark S AU - Slaughter MS FAU - Weissman, Neil J AU - Weissman NJ FAU - Berry, Gerald J AU - Berry GJ FAU - Horvath, Keith A AU - Horvath KA CN - ICEM 2000 Investigators LA - eng PT - Clinical Trial PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, U.S. Gov't, P.H.S. PL - Netherlands TA - Ann Thorac Surg JT - The Annals of thoracic surgery JID - 15030100R SB - IM MH - Aged MH - Aged, 80 and over MH - Cardiac Surgical Procedures/*instrumentation/methods MH - Confidence Intervals MH - Coronary Artery Bypass/instrumentation/methods MH - Coronary Disease/surgery MH - Embolism/*prevention & control MH - Equipment Design MH - Female MH - Follow-Up Studies MH - Heart Valve Diseases/surgery MH - Heart Valve Prosthesis Implantation/instrumentation/methods MH - Humans MH - Intraoperative Complications/*prevention & control MH - Male MH - *Micropore Filters MH - Middle Aged MH - Odds Ratio MH - Probability MH - Reference Values MH - Risk Assessment MH - Sensitivity and Specificity MH - Survival Rate MH - Treatment Outcome EDAT- 2003/08/07 05:00 MHDA- 2003/09/13 05:00 CRDT- 2003/08/07 05:00 PHST- 2003/08/07 05:00 [pubmed] PHST- 2003/09/13 05:00 [medline] PHST- 2003/08/07 05:00 [entrez] AID - S0003497503005307 [pii] AID - 10.1016/s0003-4975(03)00530-7 [doi] PST - ppublish SO - Ann Thorac Surg. 2003 Aug;76(2):508-15; discussion 515. doi: 10.1016/s0003-4975(03)00530-7. PMID- 12887532 OWN - NLM STAT- MEDLINE DCOM- 20040204 LR - 20191026 IS - 1445-1433 (Print) IS - 1445-1433 (Linking) VI - 73 IP - 8 DP - 2003 Aug TI - Preoperative cardiac assessment for patients with infrarenal abdominal aortic aneurysms: a survey of current practice by vascular surgeons in New South Wales and Australian Capital Territory. PG - 615-20 AB - BACKGROUND: The reported mortality rate following open elective repair of abdominal aortic aneurysm (AAA) varies between 0 and 12%. Much of the mortality and major morbidity is caused by cardiac events. The evidence regarding best practice for cardiac assessment and optimization of this patient group is unclear. The aim of the present study was to evaluate current practice of cardiac risk factor assessment by vascular surgeons in New South Wales (NSW) and Australian Capital Territory (ACT) for patients undergoing open elective repair of infrarenal AAA. METHODS: A postal questionnaire was sent to 46 surgeons in NSW and ACT identified as expressing a principal or major interest in vascular surgery. If no response was received within 3 weeks, a second questionnaire was sent and if no response was received after the second mailing, a telephone survey of non-responders was conducted. Data were collated regarding the importance of risk factors elicited by clinical history, preoperative investigation, referral for cardiological opinion, use of perioperative beta-blockade and the timing of aortic surgery in relation to coronary artery revascularization and acute myocardial infarction. RESULTS: The overall response rate was 87% (40/46) and the median (range) response time was 14 (4-109) days. Only 22 of 40 and 23 of 40 surgeons consider diabetes mellitus or renal impairment, respectively, to be important when assessing cardiac risk and 34 of 40 surgeons do not employ a validated risk index in preoperative assessment. Sixteen of 40 surgeons refer all patients needing AAA repair to a cardiologist, while 24 of 40 would initiate cardiac investigations themselves (either stress electrocardiography, scintigraphy or echocardiography). Seventeen surgeons always or usually commenced perioperative beta-blockade with wide variations in the commencement (1 to > 28 days preoperatively) and duration (< 1 week to > 28 days postoperatively) of treatment. The timing of AAA repair following coronary revascularization ranged from < 1 week to 6 months and delay in surgical repair of AAA following myocardial infarction ranged from < 1 week to > 6 months. CONCLUSION: Preoperative assessment of cardiac risk in patients for repair of AAA lacks consensus among vascular surgeons in NSW and ACT. The diversity of clinical practice may rest with the paucity of prospective trials published in the medical literature or the influence of local institutional facilities. FAU - Wong, Shen AU - Wong S AD - Department of Vascular Surgery, The Royal North Shore Hospital, St Leonards, New South Wales, Australia. FAU - Appleberg, Michael AU - Appleberg M FAU - Neale, Michael L AU - Neale ML FAU - Fisher, Charles M AU - Fisher CM FAU - Lewis, David R AU - Lewis DR LA - eng PT - Journal Article PL - Australia TA - ANZ J Surg JT - ANZ journal of surgery JID - 101086634 SB - IM MH - Aortic Aneurysm, Abdominal/*surgery MH - Australia/epidemiology MH - Heart Diseases/*epidemiology MH - Humans MH - New South Wales/epidemiology MH - Preoperative Care/*methods MH - Professional Practice MH - Risk Factors MH - *Surveys and Questionnaires MH - Vascular Surgical Procedures/*mortality EDAT- 2003/07/31 05:00 MHDA- 2004/02/05 05:00 CRDT- 2003/07/31 05:00 PHST- 2003/07/31 05:00 [pubmed] PHST- 2004/02/05 05:00 [medline] PHST- 2003/07/31 05:00 [entrez] AID - 2674 [pii] AID - 10.1046/j.1445-2197.2003.t01-1-02674.x [doi] PST - ppublish SO - ANZ J Surg. 2003 Aug;73(8):615-20. doi: 10.1046/j.1445-2197.2003.t01-1-02674.x. PMID- 12874182 OWN - NLM STAT- MEDLINE DCOM- 20030909 LR - 20131121 IS - 1524-4539 (Electronic) IS - 0009-7322 (Linking) VI - 108 IP - 4 DP - 2003 Jul 29 TI - Randomized, double-blind, placebo-controlled, international trial of the oral IIb/IIIa antagonist lotrafiban in coronary and cerebrovascular disease. PG - 399-406 AB - BACKGROUND: This is the primary report of the large-scale evaluation of lotrafiban, an orally administered IIb/IIIa receptor antagonist, a unique trial with respect to the platelet antagonist, protocol design, and inclusion of cerebrovascular disease in a significant proportion of patients. METHODS AND RESULTS: Patients with vascular disease were randomized to lotrafiban 30 or 50 mg BID on the basis of age and predicted creatinine clearance or placebo in addition to aspirin at a dose ranging from 75 to 325 mg/d at the discretion of the physician-investigator. Follow-up was for up to 2 years. The primary end point was the composite of all-cause mortality, myocardial infarction, stroke, recurrent ischemia requiring hospitalization, and urgent revascularization. Of 9190 patients enrolled from 23 countries and 690 hospitals, 41% had cerebrovascular disease at the time of entry, and 59% had coronary artery disease. Death occurred in 2.3% of placebo-assigned patients and 3.0% of lotrafiban-group patients (hazard ratio 1.33, 95% CI 1.03 to 1.72, P=0.026), and the cause of excess death was vascular related. There was no significant difference in the primary end point (17.5% compared with 16.4%, respectively; hazard ratio 0.94, 95% CI 0.85 to 1.03, P=0.19). Serious bleeding was more frequent in the lotrafiban group (8.0% compared with 2.8%; P<0.001). Serious bleeding was more common among patients who received higher doses of aspirin (>162 mg/d), with or without lotrafiban. CONCLUSIONS: Lotrafiban, an orally administered platelet glycoprotein IIb/IIIa blocker, induced a 33% increase in death rate, which was vascular in origin and not affected by the type of atherosclerotic involvement at entry to the trial. Although the dose of aspirin was not randomly assigned, the finding of increased bleeding with doses >162 mg/d is noteworthy. FAU - Topol, Eric J AU - Topol EJ AD - Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA. topole@ccf.org FAU - Easton, Donald AU - Easton D FAU - Harrington, Robert A AU - Harrington RA FAU - Amarenco, Pierre AU - Amarenco P FAU - Califf, Robert M AU - Califf RM FAU - Graffagnino, Carmen AU - Graffagnino C FAU - Davis, Stephen AU - Davis S FAU - Diener, Hans-Christophe AU - Diener HC FAU - Ferguson, James AU - Ferguson J FAU - Fitzgerald, Desmond AU - Fitzgerald D FAU - Granett, Jeffrey AU - Granett J FAU - Shuaib, Ashfaq AU - Shuaib A FAU - Koudstaal, Peter J AU - Koudstaal PJ FAU - Theroux, Pierre AU - Theroux P FAU - Van de Werf, Frans AU - Van de Werf F FAU - Sigmon, Kristina AU - Sigmon K FAU - Pieper, Karen AU - Pieper K FAU - Vallee, Marc AU - Vallee M FAU - Willerson, James T AU - Willerson JT CN - Blockade of the Glycoprotein IIb/IIIa Receptor to Avoid Vascular Occlusion Trial Investigators LA - eng PT - Clinical Trial PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20030721 PL - United States TA - Circulation JT - Circulation JID - 0147763 RN - 0 (Piperidines) RN - 0 (Platelet Aggregation Inhibitors) RN - 0 (Platelet Glycoprotein GPIIb-IIIa Complex) RN - 12794-10-4 (Benzodiazepines) RN - AYI8EX34EU (Creatinine) RN - KLQ306I83X (lotrafiban) RN - R16CO5Y76E (Aspirin) SB - IM CIN - Expert Opin Investig Drugs. 2003 Oct;12(10):1709-12. doi: 10.1517/13543784.12.10.1709. PMID: 14519089 MH - Administration, Oral MH - Adult MH - Aged MH - Aged, 80 and over MH - Aspirin/adverse effects/therapeutic use MH - Benzodiazepines/*adverse effects/therapeutic use MH - Cerebrovascular Disorders/*drug therapy/mortality MH - Coronary Disease/*drug therapy/mortality MH - Creatinine/blood/urine MH - Dose-Response Relationship, Drug MH - Double-Blind Method MH - Female MH - Follow-Up Studies MH - Hemorrhage/chemically induced MH - Humans MH - Male MH - Middle Aged MH - Multivariate Analysis MH - Piperidines/*adverse effects/therapeutic use MH - Platelet Aggregation Inhibitors/*adverse effects/therapeutic use MH - Platelet Glycoprotein GPIIb-IIIa Complex/*antagonists & inhibitors MH - Proportional Hazards Models MH - Risk Assessment MH - Treatment Outcome EDAT- 2003/07/23 05:00 MHDA- 2003/09/10 05:00 CRDT- 2003/07/23 05:00 PHST- 2003/07/23 05:00 [pubmed] PHST- 2003/09/10 05:00 [medline] PHST- 2003/07/23 05:00 [entrez] AID - 01.CIR.0000084501.48570.F6 [pii] AID - 10.1161/01.CIR.0000084501.48570.F6 [doi] PST - ppublish SO - Circulation. 2003 Jul 29;108(4):399-406. doi: 10.1161/01.CIR.0000084501.48570.F6. Epub 2003 Jul 21. PMID- 12851605 OWN - NLM STAT- MEDLINE DCOM- 20030725 LR - 20141120 IS - 1097-6744 (Electronic) IS - 0002-8703 (Linking) VI - 146 IP - 1 DP - 2003 Jul TI - Safety and efficacy of unfractionated heparin versus enoxaparin in patients who are obese and patients with severe renal impairment: analysis from the ESSENCE and TIMI 11B studies. PG - 33-41 AB - BACKGROUND: The advantages of enoxaparin over unfractionated heparin (UFH) for the treatment of patients with non-ST-segment elevation acute coronary syndromes are well established. However, no data are available about the safety and efficacy in patients who are obese and patients with severe renal impairment. METHODS: A retrospective analysis of treatment effects was performed on patients who were obese and patients with severe renal impairment from the Efficacy Safety Subcutaenous Enoxaparin in Non-Q-wave Coronary Events (ESSENCE) and Thrombolysis in Myocardial Infarction (TIMI) 11B trials, in which patients were treated with enoxaparin or UFH. The primary composite end point was death, myocardial infarction (MI), and urgent revascularization (UR), and the secondary end points were major and any hemorrhage. RESULTS: When compared with UFH, enoxaparin reduced the rate of the primary end point in patients who were obese (14.3% vs 18.0%, P =.05), patients who were not obese (16.1% vs 19.2%, P <.01), and patients without severe renal impairment (15.7% vs 18.4%, P <.01). There was no significant difference in major bleeding between enoxaparin and UFH in any of the 4 subgroups. There were no differences in either the primary end point (17.6% vs 16.2%, P =.39) or major hemorrhage (1.3% vs 0.8%, P =.12) in patients who were obese receiving either UFH or enoxaparin compared with patients who were not obese. Patients with severe renal impairment tended toward a higher rate of the primary end point (25.9% vs 17%, P =.09) and experienced more major hemorrhages (6.6% vs 1.1%, P <.0001). CONCLUSIONS: Enoxaparin reduced the rate of the combined end point of death/MI/UR in the subgroups of patients who were obese, patients who were not obese, and patients without renal insufficiency. Obesity did not impact clinical outcomes in the combined analysis of ESSENCE and TIMI 11B. Patients with severe renal impairment have a higher risk of clinical events and major and any hemorrhages than patients without severe renal impairment, whether they are treated with UFH or enoxaparin. FAU - Spinler, Sarah A AU - Spinler SA AD - Philadelphia College of Pharmacy, University of the Sciences in Philadelphia, PA 19104, USA. s.spinle@usip.edu FAU - Inverso, Stephanie M AU - Inverso SM FAU - Cohen, Marc AU - Cohen M FAU - Goodman, Shaun G AU - Goodman SG FAU - Stringer, Kathleen A AU - Stringer KA FAU - Antman, Elliott M AU - Antman EM CN - ESSENCE and TIMI 11B Investigators LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 RN - 0 (Anticoagulants) RN - 0 (Enoxaparin) RN - 0 (Fibrinolytic Agents) RN - 9005-49-6 (Heparin) SB - IM MH - Aged MH - Anticoagulants/administration & dosage/*therapeutic use MH - Coronary Disease/complications/*drug therapy MH - Enoxaparin/adverse effects/*therapeutic use MH - Female MH - Fibrinolytic Agents/adverse effects/*therapeutic use MH - Heparin/adverse effects/*therapeutic use MH - Humans MH - Kidney Diseases/*complications MH - Logistic Models MH - Male MH - Meta-Analysis as Topic MH - Middle Aged MH - Myocardial Infarction/drug therapy MH - Obesity/*complications MH - Randomized Controlled Trials as Topic MH - Retrospective Studies MH - Secondary Prevention EDAT- 2003/07/10 05:00 MHDA- 2003/07/26 05:00 CRDT- 2003/07/10 05:00 PHST- 2003/07/10 05:00 [pubmed] PHST- 2003/07/26 05:00 [medline] PHST- 2003/07/10 05:00 [entrez] AID - S0002870303001212 [pii] AID - 10.1016/S0002-8703(03)00121-2 [doi] PST - ppublish SO - Am Heart J. 2003 Jul;146(1):33-41. doi: 10.1016/S0002-8703(03)00121-2. PMID- 12830070 OWN - NLM STAT- MEDLINE DCOM- 20030725 LR - 20260128 IS - 0022-5223 (Print) IS - 0022-5223 (Linking) VI - 125 IP - 6 DP - 2003 Jun TI - Efficacy and safety of the cyclooxygenase 2 inhibitors parecoxib and valdecoxib in patients undergoing coronary artery bypass surgery. PG - 1481-92 AB - OBJECTIVE: Inhibition of cyclooxygenase 2 provides analgesia in ambulatory patients. We prospectively evaluated the safety and efficacy of a newly introduced cyclooxygenase 2 inhibitor in patients undergoing coronary artery bypass grafting surgery through a median sternotomy in a randomized clinical trial. METHODS: A total of 462 patients with New York Heart Association classes I to III who were less than 77 years of age and were from 58 institutions in the United States, Canada, Germany, and the United Kingdom participated in this multicenter, phase III, placebo-controlled, double-blind, randomized, parallel-group trial. Patients were allocated at a ratio of 2:1 to parecoxib/valdecoxib or standard care (control) groups, respectively. Intravenous study drug (40 mg) was administered within 30 minutes after extubation and every 12 hours for a minimum of 3 days. Subsequently, oral treatment at a dose of 40 mg every 12 hours was initiated and administered for a combined total of 14 days. Patient-controlled analgesia with morphine, oral opioids, or acetaminophen was available as required. Assessment of the analgesic efficacy of the study drug was primarily based on morphine and morphine equivalent use. Additional efficacy evaluations included daily pain intensity, patient and physician global evaluation of study medication, and pain effect on quality of life. Clinical adverse events were assessed by the principal investigator at each site from the time of the first dose through the 30-day postdosing period. RESULTS: Patients in the parecoxib/valdecoxib group received significantly less morphine or morphine equivalents than patients in the control group during the 0- to 24-hour (P =.009), 24- to 48-hour (P =.017), 72- to 96-hour (P =.002), 96- to 120-hour (P =.004), and 120- to 144-hour (P =.037) periods. Both patients (P <.001) and physicians (P <.001) evaluated the study medication as significantly better than control therapy. The modified Brief Pain Inventory questionnaire used in the oral dosing period detected significant improvements in the parecoxib/valdecoxib treatment group in 6 of 8 domains tested (eg, current pain, worst pain, and mood) beginning on day 4 and continuing for at least 4 days. Although there were no differences between the groups in overall adverse events, serious adverse events occurred twice as frequently in parecoxib/valdecoxib-treated patients (19.0%, 59/311 patients) than in control patients (9.9%, 15/151 patients; P =.015). Regarding individual serious adverse events, a greater incidence in sternal wound infection was found in the parecoxib/valdecoxib patients (10 [3.2%]) versus control patients (0 [0%]) (P =.035). The incidences of other individual serious adverse events, including cerebrovascular complications, myocardial infarction, and renal dysfunction, were proportionally greater but not significantly different between the groups. CONCLUSIONS: In patients undergoing coronary artery bypass grafting surgery, the cyclooxygenase 2 inhibitor combination, parecoxib/valdecoxib, was effective for postoperative analgesia. However, the 14-day treatment regimen also was associated with an increased incidence of serious adverse events overall and sternal wound infections in particular. Therefore our study raises important concerns requiring their comprehensive evaluation in a large-scale trial before these cyclooxygenase 2 inhibitors are used in patients undergoing coronary artery bypass grafting surgery. FAU - Ott, Elisabeth AU - Ott E AD - Ischemia Research and Education Foundation, San Francisco, CA 94143, USA. dnmngn@aol.com FAU - Nussmeier, Nancy A AU - Nussmeier NA FAU - Duke, Peter C AU - Duke PC FAU - Feneck, Robert O AU - Feneck RO FAU - Alston, R Peter AU - Alston RP FAU - Snabes, Michael C AU - Snabes MC FAU - Hubbard, Richard C AU - Hubbard RC FAU - Hsu, Ping H AU - Hsu PH FAU - Saidman, Lawrence J AU - Saidman LJ FAU - Mangano, Dennis T AU - Mangano DT CN - Multicenter Study of Perioperative Ischemia (McSPI) Research Group CN - Ischemia Research and Education Foundation (IREF) Investigators LA - eng PT - Clinical Trial PT - Clinical Trial, Phase III PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PL - United States TA - J Thorac Cardiovasc Surg JT - The Journal of thoracic and cardiovascular surgery JID - 0376343 RN - EC 1.14.99.1 (Cyclooxygenase 2) RN - 0 (Cyclooxygenase 2 Inhibitors) RN - 0 (Cyclooxygenase Inhibitors) RN - 0 (Isoenzymes) RN - 0 (Isoxazoles) RN - 0 (Membrane Proteins) RN - 76I7G6D29C (Morphine) RN - EC 1.14.99.1 (Prostaglandin-Endoperoxide Synthases) RN - 0 (Sulfonamides) RN - 2919279Q3W (valdecoxib) RN - 0 (Benzenesulfonamides) RN - 9TUW81Y3CE (parecoxib) RN - EC 1.14.99.1 (PTGS2 protein, human) SB - IM CIN - J Thorac Cardiovasc Surg. 2004 Feb;127(2):605; author reply 606. doi: 10.1016/j.jtcvs.2003.08.038. PMID: 14762388 MH - Administration, Oral MH - Adult MH - Aged MH - Analgesia/*methods MH - Analgesia, Patient-Controlled MH - *Coronary Artery Bypass MH - Cyclooxygenase 2 MH - Cyclooxygenase 2 Inhibitors MH - Cyclooxygenase Inhibitors/*administration & dosage/adverse effects MH - Double-Blind Method MH - Drug Therapy, Combination MH - Female MH - Humans MH - Injections, Intravenous MH - Isoenzymes/*antagonists & inhibitors MH - Isoxazoles/*administration & dosage/adverse effects MH - Male MH - Membrane Proteins MH - Middle Aged MH - Morphine/administration & dosage MH - Pain Measurement MH - Prospective Studies MH - Prostaglandin-Endoperoxide Synthases MH - Safety MH - Sulfonamides/*administration & dosage/adverse effects MH - Benzenesulfonamides EDAT- 2003/06/28 05:00 MHDA- 2003/07/26 05:00 CRDT- 2003/06/28 05:00 PHST- 2003/06/28 05:00 [pubmed] PHST- 2003/07/26 05:00 [medline] PHST- 2003/06/28 05:00 [entrez] AID - S0022522303001259 [pii] AID - 10.1016/s0022-5223(03)00125-9 [doi] PST - ppublish SO - J Thorac Cardiovasc Surg. 2003 Jun;125(6):1481-92. doi: 10.1016/s0022-5223(03)00125-9. PMID- 12742978 OWN - NLM STAT- MEDLINE DCOM- 20030805 LR - 20220331 IS - 1524-4539 (Electronic) IS - 0009-7322 (Linking) VI - 108 IP - 1 DP - 2003 Jul 8 TI - Use of rapamycin slows progression of cardiac transplantation vasculopathy. PG - 48-53 AB - BACKGROUND: Cardiac transplantation vasculopathy is the leading cause of late death in heart transplantation recipients. Rapamycin is an immunosuppressant drug with potent antiproliferative and antimigratory effects. We investigated whether rapamycin could prevent progression of graft vasculopathy in 46 patients (age, 54+/-10 years; 4.3+/-2.3 years after transplantation) with severe disease. METHODS AND RESULTS: At annual cardiac catheterization, patients were randomly assigned to treatment with rapamycin (n=22) versus continued current immunosuppression (n=24). Clinical characteristics including recipient age and sex, underlying cause of congestive heart failure, donor age and sex, and ischemic time were recorded. Cardiac catheterization was graded with the use of a semiquantitative scale and repeated annually. Clinically significant adverse events were defined as death, need for angioplasty or bypass surgery, myocardial infarction, and a >25% worsening of the catheterization score. These events were monitored as primary study end points. Anti-HLA class I and II antibody production and lymphocyte growth assays were measured with each biopsy. Patients selected for rapamycin had azathioprine or mycophenolate mofetil discontinued and were given rapamycin. Outcomes were compared by means of log-rank analysis. There were no significant differences in baseline characteristics. Duration of follow-up was comparable (rapamycin, 689+/-261; control, 630+/-207 days; NS). In the rapamycin group, 3 patients reached primary end points versus 14 patients in the control group (P<0.001). There was no difference in baseline or subsequent anti-HLA class I or II antibody production. CONCLUSIONS: In this patient cohort with cardiac vasculopathy, treatment with rapamycin slowed disease progression probably by its antiproliferative and antimigratory effects. FAU - Mancini, Donna AU - Mancini D AD - Columbia University, New York, NY, USA. dmm31@columbia.edu FAU - Pinney, Sean AU - Pinney S FAU - Burkhoff, Daniel AU - Burkhoff D FAU - LaManca, John AU - LaManca J FAU - Itescu, Silviu AU - Itescu S FAU - Burke, Elizabeth AU - Burke E FAU - Edwards, Niloo AU - Edwards N FAU - Oz, Mehmet AU - Oz M FAU - Marks, Andrew R AU - Marks AR LA - eng PT - Clinical Trial PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20030512 PL - United States TA - Circulation JT - Circulation JID - 0147763 RN - 0 (Autoantibodies) RN - 0 (Immunosuppressive Agents) RN - 83HN0GTJ6D (Cyclosporine) RN - W36ZG6FT64 (Sirolimus) SB - IM CIN - Circulation. 2003 Jul 8;108(1):6-8. doi: 10.1161/01.CIR.0000080228.97133.4D. PMID: 12847052 CIN - Circulation. 2003 Jul 8;108(1):e9001. doi: 10.1161/01.CIR.0000085986.49142.66. PMID: 12847063 MH - Arterial Occlusive Diseases/diagnosis/etiology/*prevention & control MH - Autoantibodies/blood MH - Cardiac Catheterization MH - Cohort Studies MH - Coronary Artery Disease/etiology/prevention & control MH - Cyclosporine/blood/therapeutic use MH - Disease Progression MH - Female MH - Graft Rejection/diagnosis/immunology/*prevention & control MH - Heart Transplantation/*adverse effects MH - Humans MH - Immunosuppressive Agents/adverse effects/blood/*therapeutic use MH - Infections/etiology MH - Male MH - Middle Aged MH - Neoplasms/etiology MH - Prospective Studies MH - Renal Insufficiency/etiology MH - Sirolimus/adverse effects/blood/*therapeutic use MH - Survival Analysis MH - Treatment Outcome EDAT- 2003/05/14 05:00 MHDA- 2003/08/06 05:00 CRDT- 2003/05/14 05:00 PHST- 2003/05/14 05:00 [pubmed] PHST- 2003/08/06 05:00 [medline] PHST- 2003/05/14 05:00 [entrez] AID - 01.CIR.0000070421.38604.2B [pii] AID - 10.1161/01.CIR.0000070421.38604.2B [doi] PST - ppublish SO - Circulation. 2003 Jul 8;108(1):48-53. doi: 10.1161/01.CIR.0000070421.38604.2B. Epub 2003 May 12. PMID- 12727150 OWN - NLM STAT- MEDLINE DCOM- 20030626 LR - 20241219 IS - 0195-668X (Print) IS - 0195-668X (Linking) VI - 24 IP - 9 DP - 2003 May TI - Early revascularization is associated with improved survival in elderly patients with acute myocardial infarction complicated by cardiogenic shock: a report from the SHOCK Trial Registry. PG - 828-37 AB - AIMS: The SHould we emergently revascularize Occluded Coronaries in cardiogenic shocK (SHOCK) Trial showed no benefit of early revascularization in patients aged >/=75 years with acute myocardial infarction and cardiogenic shock. We examined the effect of age on treatment and outcomes of patients with cardiogenic shock in the SHOCK Trial Registry. METHODS AND RESULTS: We compared clinical and treatment factors in patients in the SHOCK Trial Registry with shock due to pump failure aged <75 years (n=588) and >/=75 years (n=277), and 30-day mortality of patients treated with early revascularization <18 hours since onset of shock and those undergoing a later or no revascularization procedure. After excluding early deaths covariate-adjusted relative risk and 95% confidence intervals were calculated to compare the revascularization strategies within the two age groups. Older patients more often had prior myocardial infarction, congestive heart failure, renal insufficiency, other comorbidities, and severe coronary anatomy. In-hospital mortality in the early vs. late or no revascularization groups was 45 vs. 61% for patients aged <75 years (p=0.002) and 48 vs. 81% for those aged >/=75 years (p=0.0003). After exclusion of 65 early deaths and covariate adjustment, the relative risk was 0.76 (0.59, 0.99; p=0.045) in patients aged <75 years and 0.46 (0.28, 0.75; p=0.002) in patients aged >/=75 years. CONCLUSIONS: Elderly patients with myocardial infarction complicated by cardiogenic shock are less likely to be treated with invasive therapies than younger patients with shock. Covariate-adjusted modeling reveals that elderly patients selected for early revascularization have a lower mortality rate than those receiving a revascularization procedure later or never. FAU - Dzavik, V AU - Dzavik V AD - University of Toronto, Toronto, Ontario, Canada. vlad.dzavik@uhn.on.ca FAU - Sleeper, L A AU - Sleeper LA FAU - Cocke, T P AU - Cocke TP FAU - Moscucci, M AU - Moscucci M FAU - Saucedo, J AU - Saucedo J FAU - Hosat, S AU - Hosat S FAU - Jiang, X AU - Jiang X FAU - Slater, J AU - Slater J FAU - LeJemtel, T AU - LeJemtel T FAU - Hochman, J S AU - Hochman JS CN - SHOCK Investigators LA - eng GR - HL49970/HL/NHLBI NIH HHS/United States GR - R01 HL50020/HL/NHLBI NIH HHS/United States PT - Clinical Trial PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, U.S. Gov't, P.H.S. PL - England TA - Eur Heart J JT - European heart journal JID - 8006263 SB - IM MH - Aged MH - Data Collection MH - Female MH - Humans MH - Male MH - Myocardial Infarction/complications/mortality/*therapy MH - Myocardial Revascularization/*methods/mortality MH - Prospective Studies MH - Registries MH - Shock, Cardiogenic/*complications/mortality MH - Survival Analysis EDAT- 2003/05/03 05:00 MHDA- 2003/06/27 05:00 CRDT- 2003/05/03 05:00 PHST- 2003/05/03 05:00 [pubmed] PHST- 2003/06/27 05:00 [medline] PHST- 2003/05/03 05:00 [entrez] AID - S0195668X02008448 [pii] AID - 10.1016/s0195-668x(02)00844-8 [doi] PST - ppublish SO - Eur Heart J. 2003 May;24(9):828-37. doi: 10.1016/s0195-668x(02)00844-8. PMID- 12667024 OWN - NLM STAT- MEDLINE DCOM- 20030417 LR - 20220318 IS - 1539-3704 (Electronic) IS - 0003-4819 (Linking) VI - 138 IP - 7 DP - 2003 Apr 1 TI - Cardiovascular outcomes in the Irbesartan Diabetic Nephropathy Trial of patients with type 2 diabetes and overt nephropathy. PG - 542-9 AB - BACKGROUND: Patients with diabetes have increased risk for adverse cardiovascular events. Angiotensin-converting enzyme inhibitors are protective in type 1 diabetes. However, no definitive studies have examined the use of angiotensin-receptor blockers in patients with type 2 diabetes and overt nephropathy. The primary outcomes of the Irbesartan Diabetic Nephropathy Trial were doubling of serum creatinine levels, end-stage renal disease, and death from any cause. OBJECTIVE: To compare rates of cardiovascular events among patients with type 2 diabetic nephropathy who received conventional antihypertensive therapy with an angiotensin-receptor blocker (irbesartan) or a calcium-channel blocker (amlodipine), or placebo. DESIGN: Randomized double-blind, placebo-controlled trial with a median follow-up of 2.6 years. A time event analysis was used. SETTING: 209 centers in the Americas, Europe, Israel, and Australasia. PARTICIPANTS: 1715 adults with type 2 diabetic nephropathy and hypertension; serum creatinine levels of 89 micromol/L (1.0 mg/dL) to 266 micromol/L (3.0 mg/dL) in women and 106 micromol/L (1.2 mg/dL) to 266 micromol/L (3.0 mg/dL) in men; and urinary protein excretion rates of at least 900 mg/d. INTERVENTION: Treatment with irbesartan, amlodipine, or placebo. MEASUREMENTS: Time to cardiovascular death, myocardial infarction, congestive heart failure, strokes, and coronary revascularization. RESULTS: The three groups were not statistically different in the composite of cardiovascular events. Among the components of the composite, there was a trend toward a decrease in strokes in patients receiving amlodipine versus those receiving placebo (hazard ratio, 0.65 [95% CI, 0.35 to 1.22]; P = 0.18). Likewise, patients receiving amlodipine had a significantly lower rate of myocardial infarction when compared with placebo recipients (hazard ratio, 0.58 [CI, 0.37 to 0.92]; P = 0.02). In contrast, patients receiving irbesartan had a significantly lower incidence of congestive heart failure when compared with placebo recipients (hazard ratio, 0.72 [CI, 0.52 to 1.00]; P = 0.048) or amlodipine recipients (hazard ratio, 0.65 [CI, 0.48 to 0.87]; P = 0.004). CONCLUSION: The composite cardiovascular event rate did not differ in patients with type 2 diabetes and overt nephropathy treated with irbesartan, amlodipine, or placebo in addition to conventional antihypertensive therapy. FAU - Berl, Tomas AU - Berl T AD - University of Colorado Medical School, Denver, Colorado, USA. FAU - Hunsicker, Lawrence G AU - Hunsicker LG FAU - Lewis, Julia B AU - Lewis JB FAU - Pfeffer, Marc A AU - Pfeffer MA FAU - Porush, Jerome G AU - Porush JG FAU - Rouleau, Jean-Lucien AU - Rouleau JL FAU - Drury, Paul L AU - Drury PL FAU - Esmatjes, Enric AU - Esmatjes E FAU - Hricik, Donald AU - Hricik D FAU - Parikh, Chirag R AU - Parikh CR FAU - Raz, Itamar AU - Raz I FAU - Vanhille, Philippe AU - Vanhille P FAU - Wiegmann, Thomas B AU - Wiegmann TB FAU - Wolfe, Bernard M AU - Wolfe BM FAU - Locatelli, Francesco AU - Locatelli F FAU - Goldhaber, Samuel Z AU - Goldhaber SZ FAU - Lewis, Edmund J AU - Lewis EJ CN - Irbesartan Diabetic Nephropathy Trial. Collaborative Study Group LA - eng PT - Clinical Trial PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - United States TA - Ann Intern Med JT - Annals of internal medicine JID - 0372351 RN - 0 (Angiotensin Receptor Antagonists) RN - 0 (Antihypertensive Agents) RN - 0 (Biphenyl Compounds) RN - 0 (Calcium Channel Blockers) RN - 0 (Placebos) RN - 0 (Tetrazoles) RN - 11128-99-7 (Angiotensin II) RN - 1J444QC288 (Amlodipine) RN - AYI8EX34EU (Creatinine) RN - J0E2756Z7N (Irbesartan) SB - IM SPIN- Ann Intern Med. 2003 Apr 1;138(7):I43. doi: 10.7326/0003-4819-138-7-200304010-00003. PMID: 12667050 CIN - J Fam Pract. 2003 Aug;52(8):593-4. PMID: 12899808 MH - Amlodipine/therapeutic use MH - Angiotensin II MH - *Angiotensin Receptor Antagonists MH - Antihypertensive Agents/*therapeutic use MH - Biphenyl Compounds/*therapeutic use MH - Calcium Channel Blockers/therapeutic use MH - Cardiovascular Diseases/*prevention & control MH - Creatinine/blood MH - Diabetes Mellitus, Type 2/*complications MH - Diabetic Angiopathies/drug therapy MH - Diabetic Nephropathies/*drug therapy/etiology MH - Double-Blind Method MH - Female MH - Follow-Up Studies MH - Humans MH - Hypertension/*drug therapy MH - Irbesartan MH - Kidney Failure, Chronic/etiology MH - Male MH - Middle Aged MH - Placebos MH - Risk Factors MH - Tetrazoles/*therapeutic use MH - Treatment Outcome EDAT- 2003/04/02 05:00 MHDA- 2003/04/18 05:00 CRDT- 2003/04/02 05:00 PHST- 2003/04/02 05:00 [pubmed] PHST- 2003/04/18 05:00 [medline] PHST- 2003/04/02 05:00 [entrez] AID - 200304010-00010 [pii] AID - 10.7326/0003-4819-138-7-200304010-00010 [doi] PST - ppublish SO - Ann Intern Med. 2003 Apr 1;138(7):542-9. doi: 10.7326/0003-4819-138-7-200304010-00010. PMID- 12619535 OWN - NLM STAT- MEDLINE DCOM- 20030402 LR - 20191210 IS - 1061-3749 (Print) IS - 1061-3749 (Linking) VI - 10 IP - 2 DP - 2002 Fall TI - Assessing data adequacy for clinical research: reliability and validity of a surgical database. PG - 155-64 AB - As clinical databases are utilized more frequently for clinical research, it is essential that researchers assess the quality of databased information. While researchers have begun to report strategies to measure accuracy of databased information, knowledge remains limited. The purpose of this study was to assess the reliability and validity of databased information among selected study variables contained within a computerized coronary artery surgery clinical database using the written patient medical record as an external standard. Both reliability (N = 400) and validity (N = 100) samples were randomly selected from a databased sampling frame of 548 Medicare subjects who underwent coronary artery bypass grafting surgery in 1998. Reliability assessed by consistency rates were age (95%), race (94%), gender (99%), congestive heart failure (CHF) (60.5%), angina (91.5%), renal insufficiency (82%), hypertension (91.7%), diabetes mellitus (93.7%), chronic obstructive pulmonary disease (COPD) (75.5%), clinical status (97%), American Society of Anesthesiologists classification (99%), prior peripheral vascular surgery (15.5%), prior CABGS (99%), and duration of mechanical ventilation (87.5%). These percentages reflected a large portion of missing data for CHF, COPD, and prior peripheral vascular surgery. Validity assessed by sensitivity and specificity analyses were all greater than 80%. The majority of computerized databased information among selected study variables was the same information recorded in the written patient medical record. Using the same external standard to assess both reliability and validity was a significant limitation of this study, which resulted in the same measure of data adequacy by utilizing differing statistical methods. FAU - Bezanson, Judy L AU - Bezanson JL AD - Scientific Research Solutions, Inc., Roswell, GA, USA. DrJudyB@scientificResearchSolutions.com FAU - Strickland, Ora L AU - Strickland OL FAU - Kinney, Marguerite R AU - Kinney MR FAU - Weintraub, William S AU - Weintraub WS LA - eng PT - Evaluation Study PT - Journal Article PL - United States TA - J Nurs Meas JT - Journal of nursing measurement JID - 9318902 SB - IM MH - Aged MH - Clinical Nursing Research/*statistics & numerical data MH - Coronary Artery Bypass/*statistics & numerical data MH - Data Collection/*methods MH - Humans MH - Medical Records Systems, Computerized/*statistics & numerical data MH - Reproducibility of Results MH - Sensitivity and Specificity EDAT- 2003/03/07 04:00 MHDA- 2003/04/04 05:00 CRDT- 2003/03/07 04:00 PHST- 2003/03/07 04:00 [pubmed] PHST- 2003/04/04 05:00 [medline] PHST- 2003/03/07 04:00 [entrez] AID - 10.1891/jnum.10.2.155.52556 [doi] PST - ppublish SO - J Nurs Meas. 2002 Fall;10(2):155-64. doi: 10.1891/jnum.10.2.155.52556. PMID- 12600912 OWN - NLM STAT- MEDLINE DCOM- 20030312 LR - 20190623 IS - 1524-4539 (Electronic) IS - 0009-7322 (Linking) VI - 107 IP - 7 DP - 2003 Feb 25 TI - The antioxidant acetylcysteine reduces cardiovascular events in patients with end-stage renal failure: a randomized, controlled trial. PG - 992-5 AB - BACKGROUND: Patients with end-stage renal failure have increased oxidative stress and show elevated cardiovascular mortality. Whether increased cardiovascular events can be prevented by the administration of antioxidants is unknown. METHODS AND RESULTS: We evaluated the effects of acetylcysteine, a thiol-containing antioxidant, on cardiovascular events in patients undergoing hemodialysis. A prospective, randomized, placebo-controlled trial was conducted between October 1, 1999, and September 30, 2001, in 134 patients (76 male and 58 female) with a mean age of 62+/-16 years (mean+/-SD) who had been undergoing maintenance hemodialysis for a minimum of 3 months 3 times weekly in an ambulatory center. Median (range) follow-up was 14.5 (1 to 24) months. Patients were randomly assigned either to receive acetylcysteine (600 mg BID) or placebo. The primary end point was a composite variable consisting of cardiac events including fatal and nonfatal myocardial infarction, cardiovascular disease death, need for coronary angioplasty or coronary bypass surgery, ischemic stroke, peripheral vascular disease with amputation, or need for angioplasty. Secondary end points included each of the component outcomes, total mortality, and cardiovascular mortality. A total of 18 (28%) of the 64 hemodialysis patients assigned to acetylcysteine group and 33 (47%) of the 70 hemodialysis patients assigned to control group had a primary end point (relative risk, 0.60 [95% CI, 0.38 to 0.95], P=0.03). No significant differences in secondary end points or total mortality were detected. CONCLUSIONS: In hemodialysis patients, treatment with acetylcysteine (600 mg BID) reduces composite cardiovascular end points. FAU - Tepel, Martin AU - Tepel M AD - Med Klinik IV, Univ.-Klinik Benjamin Franklin, Freie Universitat Berlin, Germany. Tepel@zedat.fu-berlin.de FAU - van der Giet, Markus AU - van der Giet M FAU - Statz, Mario AU - Statz M FAU - Jankowski, Joachim AU - Jankowski J FAU - Zidek, Walter AU - Zidek W LA - eng PT - Clinical Trial PT - Journal Article PT - Randomized Controlled Trial PL - United States TA - Circulation JT - Circulation JID - 0147763 RN - 0 (Antioxidants) RN - WYQ7N0BPYC (Acetylcysteine) SB - IM MH - Acetylcysteine/*therapeutic use MH - Antioxidants/*therapeutic use MH - Cardiovascular Diseases/mortality/*prevention & control MH - Endpoint Determination MH - Female MH - Humans MH - Kidney Failure, Chronic/diagnosis/*drug therapy/therapy MH - Male MH - Middle Aged MH - Myocardial Infarction/mortality/prevention & control MH - Renal Dialysis MH - Survival Analysis MH - Treatment Outcome EDAT- 2003/02/26 04:00 MHDA- 2003/03/13 04:00 CRDT- 2003/02/26 04:00 PHST- 2003/02/26 04:00 [pubmed] PHST- 2003/03/13 04:00 [medline] PHST- 2003/02/26 04:00 [entrez] AID - 10.1161/01.cir.0000050628.11305.30 [doi] PST - ppublish SO - Circulation. 2003 Feb 25;107(7):992-5. doi: 10.1161/01.cir.0000050628.11305.30. PMID- 12573274 OWN - NLM STAT- MEDLINE DCOM- 20030319 LR - 20190513 IS - 0195-668X (Print) IS - 0195-668X (Linking) VI - 24 IP - 2 DP - 2003 Jan TI - Predictors of 90-day outcome in patients stabilized after acute coronary syndromes. PG - 172-81 AB - AIMS: We investigated predictors of 90-day risk among patients surviving the early period after an acute coronary syndrome (ACS). METHODS AND RESULTS: The study population included 15 904 stabilized ST-segment elevation or non-ST-segment elevation ACS patients randomized in SYMPHONY and 2nd SYMPHONY. We developed risk models for death, death or myocardial infarction (MI), and death, MI, or severe recurrent ischaemia (SRI) using Cox proportional-hazards techniques. Demographic, history, and pre-randomization clinical and medication variables were tested. Validation techniques included development of individual trial models, backward elimination and bootstrapping. Of 118 variables, 17 independently predicted mortality. The strongest associations included greater age (chi(2)=31.1), higher randomization heart rate (chi(2)=27.4), and heart failure (HF) variables (HF between qualifying event and randomization, chi(2)=21.8; history of HF, chi(2)=12.2). Higher creatinine clearance (chi(2)=17.7) and percutaneous coronary intervention between qualifying event and randomization (chi(2)=11.1) most strongly predicted lower risk. Similar characteristics entered the double and triple composite models, but HF variables and age less strongly predicted these end-points. CONCLUSIONS: In patients stabilized after ACS, those at highest risk over the next 90 days can be identified. Typical clinical markers are better at identifying risk of death than non-fatal MI or SRI. Novel risk markers are needed for these outcomes. FAU - Newby, L K AU - Newby LK AD - Duke Clinical Research Institute, Durham, NC 27715-7969, USA. FAU - Bhapkar, M V AU - Bhapkar MV FAU - White, H D AU - White HD FAU - Topol, E J AU - Topol EJ FAU - Dougherty, F C AU - Dougherty FC FAU - Harrington, R A AU - Harrington RA FAU - Smith, M C AU - Smith MC FAU - Asarch, L F AU - Asarch LF FAU - Califf, R M AU - Califf RM CN - SYMPHONY and 2nd SYMPHONY Investigators LA - eng PT - Clinical Trial PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - England TA - Eur Heart J JT - European heart journal JID - 8006263 SB - IM MH - Aged MH - Follow-Up Studies MH - Humans MH - Models, Biological MH - Myocardial Infarction/mortality/therapy MH - Myocardial Ischemia/*mortality/therapy MH - Predictive Value of Tests MH - Prognosis MH - Recurrence MH - Risk Factors MH - Switzerland/epidemiology EDAT- 2003/02/08 04:00 MHDA- 2003/03/20 04:00 CRDT- 2003/02/08 04:00 PHST- 2003/02/08 04:00 [pubmed] PHST- 2003/03/20 04:00 [medline] PHST- 2003/02/08 04:00 [entrez] AID - S0195668X02003251 [pii] AID - 10.1016/s0195-668x(02)00325-1 [doi] PST - ppublish SO - Eur Heart J. 2003 Jan;24(2):172-81. doi: 10.1016/s0195-668x(02)00325-1. PMID- 12559338 OWN - NLM STAT- MEDLINE DCOM- 20030506 LR - 20190513 IS - 1010-7940 (Print) IS - 1010-7940 (Linking) VI - 23 IP - 2 DP - 2003 Feb TI - Off-pump coronary artery bypass surgery does not reduce gastrointestinal complications. PG - 170-4 AB - OBJECTIVES: Gastrointestinal (GI) complications following on-pump coronary artery bypass grafting (CABG) are rare, but carry a high mortality rate. Prolonged cardiopulmonary bypass (CPB) has been associated with a higher incidence of such complications. Little is known about the effect of avoiding CPB on GI complications. Our hypothesis was that off-pump CABG might reduce such complications. METHODS: A total of 2327 consecutive cases undergoing isolated CABG between April 1997 and May 2001 were identified from four consultants' practice at the two cardiothoracic centres involved in this study. We performed a multivariable logistic regression analysis to identify the risk factors for development of post-operative GI complications. Potential risk factors considered in the logistic model were age, sex, angina, ejection fraction, peripheral vascular disease, renal dysfunction, redo operations, previous GI complications, priority of surgery and the use of CPB. RESULTS: A total of 1210 cases were performed on CPB, compared to 1117 off-pump. The incidence of GI complications was 1.2% (n = 14) in the on-pump group and 1.6% (n = 18) in the off-pump group (P = 0.347). The incidence of in-hospital mortality, in the patients who had a GI complication, was 28.6% (n = 4) and 22.2% (n = 4), respectively (P = 0.681). The results of the logistic regression analysis showed that renal dysfunction, advancing age and previous history of GI surgery are significant risk factors for GI complications after coronary bypass surgery whether CPB is used or not. CONCLUSIONS: Our study suggests that off-pump and on-pump techniques are similar in the rates of GI complications. We suggest that a properly designed randomized control trial is needed to verify our findings. CI - Copyright 2002 Elsevier Science B.V. FAU - Musleh, Ghassan S AU - Musleh GS AD - Department of Cardiothoracic Surgery, Manchester Royal Infirmary, Oxford Road, Manchester, M13 9WL, UK. FAU - Patel, Nirav C AU - Patel NC FAU - Grayson, Antony D AU - Grayson AD FAU - Pullan, D Mark AU - Pullan DM FAU - Keenan, Daniel J M AU - Keenan DJ FAU - Fabri, Brian M AU - Fabri BM FAU - Hasan, Ragheb AU - Hasan R LA - eng PT - Journal Article PL - Germany TA - Eur J Cardiothorac Surg JT - European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery JID - 8804069 SB - IM MH - Age Factors MH - Aged MH - Colitis, Ischemic/etiology MH - Colonic Diseases/etiology MH - Coronary Artery Bypass/*adverse effects/methods MH - Coronary Disease/*surgery MH - Female MH - Gastrointestinal Diseases/*etiology MH - Gastrointestinal Hemorrhage/etiology MH - Humans MH - Intestinal Perforation/etiology MH - Kidney Diseases/complications MH - Logistic Models MH - Male MH - Middle Aged MH - Pancreatitis/etiology MH - Postoperative Complications/*etiology MH - Reoperation MH - Retrospective Studies MH - Risk Factors EDAT- 2003/02/01 04:00 MHDA- 2003/05/07 05:00 CRDT- 2003/02/01 04:00 PHST- 2003/02/01 04:00 [pubmed] PHST- 2003/05/07 05:00 [medline] PHST- 2003/02/01 04:00 [entrez] AID - S1010794002007625 [pii] AID - 10.1016/s1010-7940(02)00762-5 [doi] PST - ppublish SO - Eur J Cardiothorac Surg. 2003 Feb;23(2):170-4. doi: 10.1016/s1010-7940(02)00762-5. PMID- 12529091 OWN - NLM STAT- MEDLINE DCOM- 20030123 LR - 20220310 IS - 1539-3704 (Electronic) IS - 0003-4819 (Linking) VI - 138 IP - 2 DP - 2003 Jan 21 TI - Pravastatin for secondary prevention of cardiovascular events in persons with mild chronic renal insufficiency. PG - 98-104 AB - BACKGROUND: Cardiovascular disease is a common cause of morbidity and death in persons with renal insufficiency. Although 3-hydroxy-3methylglutaryl coenzyme A reductase inhibitors (statins) are effective for secondary prevention of cardiovascular events in the general population, they have not been specifically studied in chronic renal insufficiency. OBJECTIVE: To determine whether pravastatin is effective and safe for secondary prevention of cardiovascular events in persons with chronic renal insufficiency. DESIGN: Post hoc subgroup analysis of a randomized, double-blind, placebo-controlled trial. SETTING: The Cholesterol and Recurrent Events (CARE) study, a randomized trial of pravastatin versus placebo in 4159 participants with previous myocardial infarction and total plasma cholesterol levels less than 6.21 mmol/L (<240 mg/dL). PARTICIPANTS: 1711 participants with chronic renal insufficiency defined by creatinine clearance less than or equal to 75 mL/min, using the Cockcroft-Gault equation. MEASUREMENTS: The primary outcome was death from coronary disease or symptomatic nonfatal myocardial infarction. RESULTS: After a median follow-up of 58.9 months, the incidence of the primary end point was lower in participants receiving pravastatin than in those receiving placebo (adjusted hazard ratio, 0.72 [95% CI, 0.55 to 0.95]; P = 0.02). Pravastatin was associated with lower adjusted hazard ratios for major coronary events (0.72 [CI, 0.59 to 0.88]; P = 0.001) and coronary revascularization (0.65 [CI, 0.50 to 0.83]; P = 0.001), but not total mortality (0.81 [CI, 0.61 to 1.08]; P = 0.14) or stroke (0.62 [CI, 0.39 to 1.00]; P = 0.051). Tests for interaction suggested that the observed benefit was independent of the presence and severity of renal insufficiency. Incidence of side effects was similar in persons receiving pravastatin and those receiving placebo. CONCLUSIONS: These data suggest that pravastatin is effective and appears safe for secondary prevention of cardiovascular events in persons with mild chronic renal insufficiency. Since statins may be underused in this setting, physicians should consider prescribing them for patients with chronic renal insufficiency and known coronary disease. FAU - Tonelli, Marcello AU - Tonelli M AD - Division of Nephrology and Immunology, University of Alberta, Clinical Sciences Building, Suite 11-108C, 8440 112 Street, Edmonton, Alberta T6B 2B7, Canada. FAU - Moye, Lemuel AU - Moye L FAU - Sacks, Frank M AU - Sacks FM FAU - Kiberd, Bryce AU - Kiberd B FAU - Curhan, Gary AU - Curhan G CN - Cholesterol and Recurrent Events (CARE) Trial Investigators LA - eng PT - Clinical Trial PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - United States TA - Ann Intern Med JT - Annals of internal medicine JID - 0372351 RN - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors) RN - AYI8EX34EU (Creatinine) RN - KXO2KT9N0G (Pravastatin) SB - IM SPIN- Ann Intern Med. 2003 Jan 21;138(2):I28. doi: 10.7326/0003-4819-138-2-200301210-00003. PMID: 12529112 MH - Aged MH - Cardiovascular Diseases/epidemiology/*prevention & control MH - Creatinine/urine MH - Double-Blind Method MH - Female MH - Humans MH - Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects/*therapeutic use MH - Incidence MH - Kidney Failure, Chronic/*complications/urine MH - Male MH - Middle Aged MH - Patient Compliance MH - Pravastatin/adverse effects/*therapeutic use MH - Stroke/prevention & control EDAT- 2003/01/17 04:00 MHDA- 2003/01/24 04:00 CRDT- 2003/01/17 04:00 PHST- 2003/01/17 04:00 [pubmed] PHST- 2003/01/24 04:00 [medline] PHST- 2003/01/17 04:00 [entrez] AID - 200301210-00010 [pii] AID - 10.7326/0003-4819-138-2-200301210-00010 [doi] PST - ppublish SO - Ann Intern Med. 2003 Jan 21;138(2):98-104. doi: 10.7326/0003-4819-138-2-200301210-00010. PMID- 12505565 OWN - NLM STAT- MEDLINE DCOM- 20030206 LR - 20190623 IS - 0002-9149 (Print) IS - 0002-9149 (Linking) VI - 91 IP - 1 DP - 2003 Jan 1 TI - Treatment effects of eptifibatide in planned coronary stent implantation in patients with chronic kidney disease (ESPRIT Trial). PG - 17-21 AB - The role of platelet glycoprotein IIb/IIIa inhibitor therapy in patients with mild renal impairment is not well characterized. Our objective was to explore the associations of creatinine clearance (CrCl) with outcomes in a trial of eptifibatide therapy in patients who underwent percutaneous coronary intervention (PCI). We analyzed 48-hour and 30-day outcomes of patients enrolled in the Enhanced Suppression of the Platelet IIb/IIIa Receptor with Integrilin Therapy (ESPRIT) trial. Patients were randomly assigned to placebo or eptifibatide as an adjunct to stent implantation (1,755 with CrCl > or =60 ml/min and 289 with CrCl <60 ml/min). CrCl was calculated using the Cockcroft and Gault formula, and the associations of CrCl with outcomes were evaluated using logistic regression models. Patients with CrCl <60 ml/min were more likely to be older, women, hypertensive, and have a history of coronary artery bypass surgery, stroke, or peripheral vascular disease. The interaction of eptifibatide with CrCl had borderline significance for the 30-day outcome (p = 0.109). Treatment effect trended toward a greater magnitude in patients with lower CrCl (60 ml/min) (odds ratio 0.53, confidence interval 0.34 to 0.83) compared with those with higher CrCl (90 ml/min) (odds ratio 0.68, confidence interval 0.49 to 0.94). An accompanying increase in bleeding risk also was not apparent with lower CrCl. The treatment effect of eptifibatide is realized regardless of renal function and trends toward being greater in patients with mild renal impairment. FAU - Reddan, Donal N AU - Reddan DN AD - Division of Nephrology and Duke Institute for Renal Outcomes and Health Policy, Durham, North Carolina 27705, USA. redda001@mc.duke.edu FAU - O'Shea, John Conor AU - O'Shea JC FAU - Sarembock, Ian J AU - Sarembock IJ FAU - Williams, Kathryn A AU - Williams KA FAU - Pieper, Karen S AU - Pieper KS FAU - Santoian, Edward AU - Santoian E FAU - Owen, William F AU - Owen WF FAU - Kitt, Michael M AU - Kitt MM FAU - Tcheng, James E AU - Tcheng JE LA - eng PT - Clinical Trial PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 RN - 0 (Peptides) RN - 0 (Platelet Aggregation Inhibitors) RN - AYI8EX34EU (Creatinine) RN - NA8320J834 (Eptifibatide) SB - IM MH - Aged MH - *Angioplasty, Balloon, Coronary MH - Chi-Square Distribution MH - Coronary Disease/complications/*drug therapy/therapy MH - Creatinine/metabolism MH - Double-Blind Method MH - Eptifibatide MH - Female MH - Humans MH - Kidney Failure, Chronic/*complications MH - Male MH - Middle Aged MH - Peptides/*therapeutic use MH - Platelet Aggregation Inhibitors/*therapeutic use MH - *Stents MH - Treatment Outcome EDAT- 2002/12/31 04:00 MHDA- 2003/02/07 04:00 CRDT- 2002/12/31 04:00 PHST- 2002/12/31 04:00 [pubmed] PHST- 2003/02/07 04:00 [medline] PHST- 2002/12/31 04:00 [entrez] AID - S0002914902029910 [pii] AID - 10.1016/s0002-9149(02)02991-0 [doi] PST - ppublish SO - Am J Cardiol. 2003 Jan 1;91(1):17-21. doi: 10.1016/s0002-9149(02)02991-0. PMID- 12463732 OWN - NLM STAT- MEDLINE DCOM- 20030314 LR - 20190826 IS - 0091-2700 (Print) IS - 0091-2700 (Linking) VI - 42 IP - 12 DP - 2002 Dec TI - Bleeding associated with eptifibatide targeting higher risk patients with acute coronary syndromes: incidence and multivariate risk factors. PG - 1366-73 AB - The objective of this study was to determine the safety of the glycoprotein IIb/IIIa receptor inhibitor eptifibatide in patients at high risk for adverse clinical outcomes and to determine risk factors for eptifibatide-associated bleeding. Consecutive patients (n = 175) who presented with an acute coronary syndrome and who were at high risk for adverse clinical outcomes were prospectively observed for eptifibatide-associated bleeding, which was classified according to Thrombolysis in Myocardial Infarction (TIMI) and Global Use of Strategies to Open Occluded arteries (GUSTO) criteria. High risk was defined as unstable angina or non-Q-wave myocardial infarction with at least one of the following: left ventricular ejection fraction < 40%, diabetes mellitus, ST segment depression or transient ST segment elevation, serum [troponin I] > 2.5 ng/mL, and recurrent angina symptoms after initiation of conventional antianginal therapy. Bleeding incidences in the patients in this study were compared with those in the 4722 eptifibatide-treated patients in the Platelet Glycoprotein IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy (PURSUIT) trial. Compared to PURSUIT patients, the population in this study was similar in age but had a higher proportion of females, African Americans, hypertension, diabetes, prior myocardial infarction, heart failure, and revascularization. Bleeding incidences in this study's patients were similar to or lower than those in the PURSUIT population: TIMI major 1.1% versus 10.8%, TAMI minor 12.6% versus 13.1%, GUSTO severe 1.7% versus 1.5%, GUSTO moderate 3.9% versus 11.3%, and GUSTO mild 19.7% versus 26.1%. Renal dysfunction was an independent risk factor for TIMI (odds ratio = 9.1 ([95% CI= 1.6-52.5]) and GUSTO (odds ratio = 6.1 [95% CI = 1.2-30.0]) bleeding. In conclusion, despite being at higher risk for adverse outcomes, patients administered eptifibatide according to this study's institutional guidelines had comparable or lower bleeding rates than in the PURSUIT trial. Renal dysfunction is an independent risk factor for eptifibatide-induced bleeding. FAU - Rasty, Saeed AU - Rasty S FAU - Borzak, Steven AU - Borzak S FAU - Tisdale, James E AU - Tisdale JE LA - eng PT - Clinical Trial PT - Comparative Study PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - England TA - J Clin Pharmacol JT - Journal of clinical pharmacology JID - 0366372 RN - 0 (Peptides) RN - 0 (Platelet Aggregation Inhibitors) RN - 0 (Platelet Glycoprotein GPIIb-IIIa Complex) RN - NA8320J834 (Eptifibatide) SB - IM MH - Acute Disease MH - Aged MH - Angina, Unstable/complications/drug therapy MH - Coronary Disease/complications/*drug therapy MH - Dose-Response Relationship, Drug MH - Eptifibatide MH - Female MH - Hemorrhage/*chemically induced MH - Humans MH - Kidney Diseases/complications/physiopathology MH - Male MH - Middle Aged MH - Multivariate Analysis MH - Peptides/*adverse effects MH - Platelet Aggregation Inhibitors/*adverse effects MH - Platelet Glycoprotein GPIIb-IIIa Complex/*antagonists & inhibitors MH - Prospective Studies MH - Risk Factors EDAT- 2002/12/05 04:00 MHDA- 2003/03/15 04:00 CRDT- 2002/12/05 04:00 PHST- 2002/12/05 04:00 [pubmed] PHST- 2003/03/15 04:00 [medline] PHST- 2002/12/05 04:00 [entrez] AID - 10.1177/0091270002239367 [doi] PST - ppublish SO - J Clin Pharmacol. 2002 Dec;42(12):1366-73. doi: 10.1177/0091270002239367. PMID- 12450608 OWN - NLM STAT- MEDLINE DCOM- 20030130 LR - 20190623 IS - 0002-9149 (Print) IS - 0002-9149 (Linking) VI - 90 IP - 11 DP - 2002 Dec 1 TI - Effects of renal insufficiency on early invasive management in patients with acute coronary syndromes (The TACTICS-TIMI 18 Trial). PG - 1246-9 FAU - Januzzi, James L AU - Januzzi JL AD - Cardiology Division, Massachusetts General Hospital, Boston, Masssachusetts 02114, USA. jjanuzzi@partners.org FAU - Cannon, Christopher P AU - Cannon CP FAU - DiBattiste, Peter M AU - DiBattiste PM FAU - Murphy, Sabina AU - Murphy S FAU - Weintraub, William AU - Weintraub W FAU - Braunwald, Eugene AU - Braunwald E CN - TACTICS-TIMI 18 Investigators LA - eng PT - Clinical Trial PT - Journal Article PT - Randomized Controlled Trial PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 RN - 0 (Platelet Aggregation Inhibitors) RN - 42HK56048U (Tyrosine) RN - AYI8EX34EU (Creatinine) RN - GGX234SI5H (Tirofiban) SB - IM MH - Acute Disease MH - Aged MH - Angina, Unstable/complications/physiopathology/*therapy MH - Cardiac Catheterization MH - Coronary Disease/complications/physiopathology/*therapy MH - Creatinine/*blood MH - Female MH - Humans MH - Male MH - Middle Aged MH - Platelet Aggregation Inhibitors/*therapeutic use MH - Renal Insufficiency/*complications MH - Risk Factors MH - Tirofiban MH - Treatment Outcome MH - Tyrosine/analogs & derivatives/*therapeutic use EDAT- 2002/11/27 04:00 MHDA- 2003/01/31 04:00 CRDT- 2002/11/27 04:00 PHST- 2002/11/27 04:00 [pubmed] PHST- 2003/01/31 04:00 [medline] PHST- 2002/11/27 04:00 [entrez] AID - S0002914902028448 [pii] AID - 10.1016/s0002-9149(02)02844-8 [doi] PST - ppublish SO - Am J Cardiol. 2002 Dec 1;90(11):1246-9. doi: 10.1016/s0002-9149(02)02844-8. PMID- 12390949 OWN - NLM STAT- MEDLINE DCOM- 20021105 LR - 20220331 IS - 1524-4539 (Electronic) IS - 0009-7322 (Linking) VI - 106 IP - 17 DP - 2002 Oct 22 TI - Comparative survival of dialysis patients in the United States after coronary angioplasty, coronary artery stenting, and coronary artery bypass surgery and impact of diabetes. PG - 2207-11 AB - BACKGROUND: The optimal method of coronary revascularization in dialysis patients is controversial. The purpose of this study was to compare the long-term survival of dialysis patients in the United States after PTCA, coronary stenting, or CABG. METHODS AND RESULTS: Dialysis patients hospitalized from 1995 to 1998 for first coronary revascularization procedures after renal replacement therapy initiation were identified from the US Renal Data System database. All-cause and cardiac survival was estimated by the life-table method and compared by the log-rank test. The impact of independent predictors on survival was examined in a Cox regression model. The in-hospital mortality was 8.6% for 6668 CABG patients, 6.4% for 4836 PTCA patients, and 4.1% for 4280 stent patients. The 2-year all-cause survival (mean+/-SEM) was 56.4+/-1.4% for CABG patients, 48.2+/-1.5% for PTCA patients, and 48.4+/-2.0% for stent patients (P<0.0001). After comorbidity adjustment, the relative risk (RR) for CABG (versus PTCA) patients was 0.80 (95% CI 0.76 to 0.84, P<0.0001) for all-cause death and 0.72 (95% CI 0.67 to 0.77, P<0.0001) for cardiac death. For stent (versus PTCA) patients, the RR was 0.94 (95% CI 0.88 to 0.99, P=0.03) for all-cause death and 0.92 (95% CI 0.85 to 0.99, P=0.04) for cardiac death. In diabetic (versus PTCA) patients, the RR for CABG surgery was 0.81 (95% CI 0.75 to 0.88, P<0.0001) for all-cause death and 0.71 (95% CI 0.64 to 0.78, P<0.0001) for cardiac death, and the RR for the stent procedure was 0.99 (95% CI 0.91 to 1.08, P=NS) for all-cause death and 0.99 (95% CI 0.89 to 1.11, P=NS) for cardiac death. CONCLUSIONS: In this retrospective study, dialysis patients in the United States had better long-term survival after CABG surgery than after percutaneous coronary intervention. Stent outcomes were relatively worse in diabetic patients. Our data support the need for large clinical registries and prospective trials of surgical and percutaneous coronary revascularization procedures in dialysis patients. FAU - Herzog, Charles A AU - Herzog CA AD - Cardiovascular Special Studies Center, United States Renal Data System, Minneapolis, Minn., USA. cherzog@usrds.org FAU - Ma, Jennie Z AU - Ma JZ FAU - Collins, Allan J AU - Collins AJ LA - eng GR - N01-DK-9-2344/DK/NIDDK NIH HHS/United States PT - Comparative Study PT - Journal Article PT - Research Support, U.S. Gov't, P.H.S. PL - United States TA - Circulation JT - Circulation JID - 0147763 SB - IM MH - Adult MH - Aged MH - *Angioplasty, Balloon, Coronary MH - *Coronary Artery Bypass MH - Coronary Disease/surgery MH - Diabetic Nephropathies/*mortality MH - Female MH - Humans MH - Kidney Failure, Chronic/mortality/therapy MH - Male MH - Middle Aged MH - Proportional Hazards Models MH - Renal Dialysis/*mortality MH - Retrospective Studies MH - *Stents MH - Survival Analysis MH - Survival Rate MH - Treatment Outcome MH - United States EDAT- 2002/10/23 04:00 MHDA- 2002/11/26 04:00 CRDT- 2002/10/23 04:00 PHST- 2002/10/23 04:00 [pubmed] PHST- 2002/11/26 04:00 [medline] PHST- 2002/10/23 04:00 [entrez] AID - 10.1161/01.cir.0000035248.71165.eb [doi] PST - ppublish SO - Circulation. 2002 Oct 22;106(17):2207-11. doi: 10.1161/01.cir.0000035248.71165.eb. PMID- 12154417 OWN - NLM STAT- MEDLINE DCOM- 20021115 LR - 20190910 IS - 1053-0770 (Print) IS - 1053-0770 (Linking) VI - 16 IP - 4 DP - 2002 Aug TI - Coronary revascularization: a procedure in transition from on-pump to off-pump? The role of glucose-insulin-potassium revisited in a randomized, placebo-controlled study. PG - 413-20 AB - OBJECTIVE: To investigate an optimized glucose-insulin-potassium (GIK) solution regimen as an alternate myocardial protective strategy in off-pump coronary artery bypass graft (OP-CAB) surgery and as a supplement to conventional coronary artery bypass graft (CABG) surgery using cardiopulmonary bypass (CPB). DESIGN: Prospective, randomized, placebo-controlled. SETTING: Single institution, cardiothoracic specialty hospital. PARTICIPANTS: Forty-four patients scheduled for elective multivessel coronary artery surgery using either conventional CPB (n = 22) or OP-CAB techniques (n = 22). INTERVENTIONS: Preischemic, ischemic, and postischemic administration of GIK solution was carried out, optimally dosed to ensure nonesterified fatty acid (NEFA) suppression, and supplemented with magnesium, a glycolytic enzymatic cofactor. MEASUREMENTS AND MAIN RESULTS: GIK solution therapy reduced plasma NEFA levels (p < 0.001) in OP-CAB surgery and CPB groups but failed to affect the incidence of non-Q wave perioperative myocardial infarction, incidence of postoperative atrial fibrillation, incidence of postoperative infection, reduction in creatinine clearance, or duration of postoperative intensive care unit or hospital length of stay. After adjusting for GIK solution therapy, OP-CAB surgery resulted in significantly less ischemic injury (troponin I >15 microg/L, 19.0% v 91.3%; p = 0.0001) and reduced postoperative infections (14.3% v 43.5%; p = 0.049). CONCLUSION: GIK solution therapy achieved NEFA suppression and an insignificant trend toward reduced biochemical parameters of ischemic injury in OP-CAB surgery and CPB groups, but no major clinical benefit (perioperative myocardial infarction, intensive care unit length of stay, or hospital length of stay) was shown after elective CABG surgery in low-risk patients. Compared with CPB, OP-CAB surgery significantly reduced ischemic injury and postoperative infections. CI - Copyright 2002, Elsevier Science (USA). All rights reserved. FAU - Smith, Andrew AU - Smith A AD - Department of Anesthesiology, Royal Brompton and Harefield NHS Trust, London, United Kingdom. FAU - Grattan, Amanda AU - Grattan A FAU - Harper, Mark AU - Harper M FAU - Royston, David AU - Royston D FAU - Riedel, Bernhard J C J AU - Riedel BJ LA - eng PT - Clinical Trial PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - United States TA - J Cardiothorac Vasc Anesth JT - Journal of cardiothoracic and vascular anesthesia JID - 9110208 RN - 0 (Biomarkers) RN - 0 (Fatty Acids, Nonesterified) RN - 0 (Insulin) RN - 0 (Isoenzymes) RN - 0 (Troponin I) RN - 0 (glucose-insulin-potassium cardioplegic solution) RN - AYI8EX34EU (Creatinine) RN - EC 2.7.3.2 (Creatine Kinase) RN - EC 2.7.3.2 (Creatine Kinase, MB Form) RN - IY9XDZ35W2 (Glucose) RN - RWP5GA015D (Potassium) SB - IM MH - Aged MH - Area Under Curve MH - Biomarkers/blood MH - *Cardiopulmonary Bypass MH - *Coronary Artery Bypass MH - Coronary Stenosis/blood/drug therapy/surgery MH - Creatine Kinase/blood/drug effects MH - Creatine Kinase, MB Form MH - Creatinine/blood MH - Electrocardiography MH - Fatty Acids, Nonesterified/blood MH - Female MH - Follow-Up Studies MH - Glucose/physiology MH - Humans MH - Incidence MH - Insulin/physiology MH - Isoenzymes/blood/drug effects MH - Male MH - Middle Aged MH - Myocardial Infarction/blood/drug therapy/surgery MH - Myocardial Revascularization/*methods MH - Pilot Projects MH - Postoperative Complications/blood/epidemiology/etiology MH - Potassium/physiology MH - Prospective Studies MH - Treatment Outcome MH - Troponin I/blood/drug effects MH - Ventricular Dysfunction, Left/blood/drug therapy/surgery EDAT- 2002/08/03 10:00 MHDA- 2002/11/26 04:00 CRDT- 2002/08/03 10:00 PHST- 2002/08/03 10:00 [pubmed] PHST- 2002/11/26 04:00 [medline] PHST- 2002/08/03 10:00 [entrez] AID - S1053077002000290 [pii] AID - 10.1053/jcan.2002.125151 [doi] PST - ppublish SO - J Cardiothorac Vasc Anesth. 2002 Aug;16(4):413-20. doi: 10.1053/jcan.2002.125151. PMID- 12087140 OWN - NLM STAT- MEDLINE DCOM- 20020702 LR - 20220318 IS - 1533-4406 (Electronic) IS - 0028-4793 (Linking) VI - 346 IP - 26 DP - 2002 Jun 27 TI - Troponin T levels in patients with acute coronary syndromes, with or without renal dysfunction. PG - 2047-52 AB - BACKGROUND: Among patients with suspected acute coronary syndromes, cardiac troponin T levels have prognostic value. However, there is concern that renal dysfunction may impair the prognostic value, because cardiac troponin T may be cleared by the kidney. METHODS: We analyzed the outcomes in 7033 patients enrolled in the Global Use of Strategies to Open Occluded Coronary Arteries IV trial who had complete base-line data on troponin T levels and creatinine clearance rates. The troponin T level was considered abnormal if it was 0.1 ng per milliliter or higher, and creatinine clearance was assessed in quartiles. The primary end point was a composite of death or myocardial infarction within 30 days. RESULTS: Death or myocardial infarction occurred in 581 patients. Among patients with a creatinine clearance above the 25th percentile value of 58.4 ml per minute, an abnormally elevated troponin T level was predictive of an increased risk of myocardial infarction or death (7 percent vs. 5 percent; adjusted odds ratio, 1.7; 95 percent confidence interval, 1.3 to 2.2; P<0.001). Among patients with a creatinine clearance in the lowest quartile, an elevated troponin T level was similarly predictive of increased risk (20 percent vs. 9 percent; adjusted odds ratio, 2.5; 95 percent confidence interval, 1.8 to 3.3; P<0.001). When the creatinine clearance rate was considered as a continuous variable and age, sex, ST-segment depression, heart failure, previous revascularization, diabetes mellitus, and other confounders had been accounted for, elevation of the troponin T level was independently predictive of risk across the entire spectrum of renal function. CONCLUSIONS: Cardiac troponin T levels predict short-term prognosis in patients with acute coronary syndromes regardless of their level of creatinine clearance. FAU - Aviles, Ronnier J AU - Aviles RJ AD - Department of Cardiology, the Cleveland Clinic Foundation, Cleveland, OH 44951, USA. FAU - Askari, Arman T AU - Askari AT FAU - Lindahl, Bertil AU - Lindahl B FAU - Wallentin, Lars AU - Wallentin L FAU - Jia, Gang AU - Jia G FAU - Ohman, E Magnus AU - Ohman EM FAU - Mahaffey, Kenneth W AU - Mahaffey KW FAU - Newby, L Kristin AU - Newby LK FAU - Califf, Robert M AU - Califf RM FAU - Simoons, Maarten L AU - Simoons ML FAU - Topol, Eric J AU - Topol EJ FAU - Berger, Peter AU - Berger P FAU - Lauer, Michael S AU - Lauer MS LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - United States TA - N Engl J Med JT - The New England journal of medicine JID - 0255562 RN - 0 (Antibodies, Monoclonal) RN - 0 (Biomarkers) RN - 0 (Immunoglobulin Fab Fragments) RN - 0 (Platelet Aggregation Inhibitors) RN - 0 (Platelet Glycoprotein GPIIb-IIIa Complex) RN - 0 (Troponin T) RN - AYI8EX34EU (Creatinine) RN - R16CO5Y76E (Aspirin) RN - X85G7936GV (Abciximab) SB - IM CIN - N Engl J Med. 2002 Jun 27;346(26):2079-82. doi: 10.1056/NEJMe020049. PMID: 12087146 SPIN- CMAJ. 2002 Sep 17;167(6):671. PMID: 12358205 CIN - N Engl J Med. 2002 Nov 21;347(21):1722-3; author reply 1722-3. doi: 10.1056/NEJM200211213472120. PMID: 12444195 MH - Abciximab MH - Aged MH - Angina Pectoris/complications/drug therapy/metabolism MH - Antibodies, Monoclonal/therapeutic use MH - Aspirin/therapeutic use MH - Biomarkers MH - Creatinine/metabolism MH - Female MH - Humans MH - Immunoglobulin Fab Fragments/therapeutic use MH - Logistic Models MH - Male MH - Middle Aged MH - Myocardial Infarction/complications/drug therapy/metabolism MH - Myocardial Ischemia/*complications/drug therapy/*metabolism MH - Platelet Aggregation Inhibitors/therapeutic use MH - Platelet Glycoprotein GPIIb-IIIa Complex/antagonists & inhibitors MH - Prognosis MH - Randomized Controlled Trials as Topic MH - Renal Insufficiency/*complications/*metabolism MH - Survival Analysis MH - Troponin T/*metabolism EDAT- 2002/06/28 10:00 MHDA- 2002/07/03 10:01 CRDT- 2002/06/28 10:00 PHST- 2002/06/28 10:00 [pubmed] PHST- 2002/07/03 10:01 [medline] PHST- 2002/06/28 10:00 [entrez] AID - 346/26/2047 [pii] AID - 10.1056/NEJMoa013456 [doi] PST - ppublish SO - N Engl J Med. 2002 Jun 27;346(26):2047-52. doi: 10.1056/NEJMoa013456. PMID- 12064569 OWN - NLM STAT- MEDLINE DCOM- 20030107 LR - 20190916 IS - 0277-0008 (Print) IS - 0277-0008 (Linking) VI - 22 IP - 6 Pt 2 DP - 2002 Jun TI - A practical cost analysis of bivalirudin. PG - 119S-127S AB - Despite advances in percutaneous coronary intervention (PCI) techniques and adjunctive therapies, the risks of ischemic and bleeding complications with PCI remain significant. These complications are associated with significant morbidity and mortality, as well as substantially higher costs. Bivalirudin is the only antithrombotic agent that has been shown to reduce both ischemic and hemorrhagic complications associated with PCI. Cost models drawn from the results of three clinical trials of bivalirudin have estimated its potential impact on total medical costs. In addition, the number needed to treat to avoid a bleeding complication has been calculated based on patients shown to have a heightened risk of bleeding in the Bivalirudin Angioplasty Trial. In all models assessed, the use of bivalirudin offset most of its own cost through reductions in bleeding and ischemic complications. FAU - Compton, Anthony AU - Compton A AD - Saint Joseph's Hospital of Atlanta, Georgia 30342, USA. acompton@sjha.org LA - eng PT - Comparative Study PT - Journal Article PL - United States TA - Pharmacotherapy JT - Pharmacotherapy JID - 8111305 RN - 0 (Anticoagulants) RN - 0 (Fibrinolytic Agents) RN - 0 (Hirudins) RN - 0 (Peptide Fragments) RN - 0 (Recombinant Proteins) RN - 9005-49-6 (Heparin) RN - TN9BEX005G (bivalirudin) SB - IM MH - Aged MH - Angioplasty, Balloon, Coronary/adverse effects/*economics MH - Anticoagulants/administration & dosage/*economics MH - Blood Transfusion/economics MH - Costs and Cost Analysis MH - Female MH - Fibrinolytic Agents/administration & dosage/*economics MH - Heparin/economics MH - Hirudins/administration & dosage/*analogs & derivatives/*economics MH - Humans MH - Myocardial Infarction/economics/etiology/prevention & control MH - Peptide Fragments/administration & dosage/*economics MH - Randomized Controlled Trials as Topic/economics MH - Recombinant Proteins/administration & dosage/*economics MH - Renal Insufficiency/complications/metabolism MH - Reoperation/economics EDAT- 2002/06/18 10:00 MHDA- 2003/01/08 04:00 CRDT- 2002/06/18 10:00 PHST- 2002/06/18 10:00 [pubmed] PHST- 2003/01/08 04:00 [medline] PHST- 2002/06/18 10:00 [entrez] AID - 10.1592/phco.22.10.119s.33615 [doi] PST - ppublish SO - Pharmacotherapy. 2002 Jun;22(6 Pt 2):119S-127S. doi: 10.1592/phco.22.10.119s.33615. PMID- 12063455 OWN - NLM STAT- MEDLINE DCOM- 20020712 LR - 20190916 IS - 0022-5223 (Print) IS - 0022-5223 (Linking) VI - 123 IP - 6 DP - 2002 Jun TI - Normothermia does not improve postoperative hemostasis nor does it reduce inflammatory activation in patients undergoing primary isolated coronary artery bypass. PG - 1092-100 AB - BACKGROUND: Despite its common acceptance in clinical practice, the effective benefits of normothermic systemic perfusion during coronary artery bypass operations are far from established. METHODS: A total of 113 patients undergoing primary isolated coronary artery bypass were randomly assigned to normothermic (37 degrees C) or hypothermic (26 degrees C) systemic perfusion. The clinical course of the patients was prospectively recorded, and several inflammatory and fibrinolytic markers (C-reactive protein, fibrinogen, interleukin 6, plasminogen activator inhibitor 1, prothrombin time, activated partial thromboplastin time, platelets, and white blood cell counts) were determined before surgical intervention; 24, 48, and 72 hours thereafter; and at hospital discharge. RESULTS: Postoperatively, 2 in-hospital deaths occurred in the normothermic series and none in the hypothermic series. Four patients had a myocardial infarction, 1 had respiratory insufficiency, 1 had to be reoperated on for graft malfunction, and none had renal insufficiency in the hypothermic group versus 1 patient with each of these complications in the normothermic series. Mean blood loss in the first 24 hours was 766 +/- 223 mL in the normothermic group and 740 +/- 220 mL in the hypothermic group. None of these differences was statistically significant. Similarly, no significant difference in the postoperative level of any of the measured variables at any time point was evident between the patients in the normothermic and hypothermic groups. CONCLUSION: Normothermic systemic perfusion does not influence the clinical course or the extent of inflammatory and hemostatic activation in patients undergoing primary isolated coronary artery bypass. FAU - Gaudino, Mario AU - Gaudino M AD - Department of Cardiac Surgery, Catholic University, Rome, Italy. mgaudino@tiscalinet.it FAU - Zamparelli, Roberto AU - Zamparelli R FAU - Andreotti, Felicita AU - Andreotti F FAU - Burzotta, Francesco AU - Burzotta F FAU - Iacoviello, Licia AU - Iacoviello L FAU - Glieca, Franco AU - Glieca F FAU - Benedett, Maria AU - Benedett M FAU - Maseri, Attilio AU - Maseri A FAU - Schiavello, Rocco AU - Schiavello R FAU - Possati, Gianfederico AU - Possati G LA - eng PT - Clinical Trial PT - Journal Article PT - Randomized Controlled Trial PL - United States TA - J Thorac Cardiovasc Surg JT - The Journal of thoracic and cardiovascular surgery JID - 0376343 RN - 0 (Interleukin-6) RN - 0 (Plasminogen Activator Inhibitor 1) RN - 9007-41-4 (C-Reactive Protein) SB - IM CIN - J Thorac Cardiovasc Surg. 2003 May;125(5):1174-5; author reply 1175. doi: 10.1067/mtc.2003.266. PMID: 12771902 MH - C-Reactive Protein/analysis MH - Cardiopulmonary Bypass/*methods MH - *Coronary Artery Bypass MH - Female MH - *Hemostasis, Surgical MH - Humans MH - *Hypothermia, Induced MH - Interleukin-6/blood MH - Male MH - Plasminogen Activator Inhibitor 1/blood MH - Postoperative Period MH - Prospective Studies EDAT- 2002/06/14 10:00 MHDA- 2002/07/13 10:01 CRDT- 2002/06/14 10:00 PHST- 2002/06/14 10:00 [pubmed] PHST- 2002/07/13 10:01 [medline] PHST- 2002/06/14 10:00 [entrez] AID - S0022522302000107 [pii] AID - 10.1067/mtc.2002.120709 [doi] PST - ppublish SO - J Thorac Cardiovasc Surg. 2002 Jun;123(6):1092-100. doi: 10.1067/mtc.2002.120709. PMID- 12010906 OWN - NLM STAT- MEDLINE DCOM- 20020524 LR - 20220317 IS - 1524-4539 (Electronic) IS - 0009-7322 (Linking) VI - 105 IP - 19 DP - 2002 May 14 TI - Outcomes of patients with chronic renal insufficiency in the bypass angioplasty revascularization investigation. PG - 2253-8 AB - BACKGROUND: Although severe chronic kidney disease (CKD) is an independent predictor of mortality among patients with coronary artery disease, the impact of mild CKD on morbidity and mortality has not been fully defined. METHODS AND RESULTS: Morbidity and mortality for the 3608 patients with multivessel coronary artery disease enrolled in the Bypass Angioplasty Revascularization Investigation randomized trial and registry were compared on the basis of the presence and absence of CKD, defined as a preprocedure serum creatinine level of >1.5 mg/dL. Seventy-six patients had CKD. Patients with renal insufficiency were older and more likely to have a history of diabetes, hypertension, and other comorbidities. Among patients undergoing PTCA, patients with CKD had a greater frequency of in-hospital death and cardiogenic shock (P<0.05 and 0.01, respectively). There was a trend toward a larger proportion of patients with CKD experiencing angina at 5 years (P=0.079). Patients with CKD had more cardiac admissions (P=0.003 and <0.0001 for patients undergoing PTCA and CABG, respectively) and a shorter time to subsequent CABG after initial revascularization than patients without CKD (P=0.01). CKD was associated with a higher risk of death at 7 years, both of all causes (relative risk 2.2, P<0.001) and of cardiac causes (relative risk 2.8, P<0.001). CONCLUSIONS: CKD is associated with an increased risk of recurrent hospitalization, subsequent CABG, and mortality. This increased risk of death is independent of and additive to the risk associated with diabetes. FAU - Szczech, L A AU - Szczech LA AD - Duke University Medical Center, Division of Nephrology, Durham, NC 27710, USA. szcze001@mc.duke.edu FAU - Best, P J AU - Best PJ FAU - Crowley, E AU - Crowley E FAU - Brooks, M M AU - Brooks MM FAU - Berger, P B AU - Berger PB FAU - Bittner, V AU - Bittner V FAU - Gersh, B J AU - Gersh BJ FAU - Jones, R AU - Jones R FAU - Califf, R M AU - Califf RM FAU - Ting, H H AU - Ting HH FAU - Whitlow, P J AU - Whitlow PJ FAU - Detre, K M AU - Detre KM FAU - Holmes, D AU - Holmes D CN - Bypass Angioplasty Revascularization Investigation (BARI) Investigators LA - eng PT - Clinical Trial PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial PL - United States TA - Circulation JT - Circulation JID - 0147763 RN - AYI8EX34EU (Creatinine) SB - IM MH - Angina Pectoris/etiology MH - *Angioplasty, Balloon, Coronary/adverse effects MH - *Coronary Artery Bypass/adverse effects MH - Coronary Artery Disease/*complications/surgery MH - Creatinine/blood MH - Diabetes Complications MH - Female MH - Follow-Up Studies MH - Hospitalization/statistics & numerical data MH - Humans MH - Kidney Failure, Chronic/blood/*complications MH - Male MH - Middle Aged MH - *Myocardial Revascularization MH - Postoperative Complications MH - Proportional Hazards Models MH - Recurrence MH - Reoperation/statistics & numerical data MH - Risk MH - Risk Assessment MH - Risk Factors MH - Survival Rate EDAT- 2002/05/16 10:00 MHDA- 2002/05/25 10:01 CRDT- 2002/05/16 10:00 PHST- 2002/05/16 10:00 [pubmed] PHST- 2002/05/25 10:01 [medline] PHST- 2002/05/16 10:00 [entrez] AID - 10.1161/01.cir.0000016051.33225.33 [doi] PST - ppublish SO - Circulation. 2002 May 14;105(19):2253-8. doi: 10.1161/01.cir.0000016051.33225.33. PMID- 11994267 OWN - NLM STAT- MEDLINE DCOM- 20020613 LR - 20260128 IS - 1524-4539 (Electronic) IS - 0009-7322 (Linking) VI - 105 IP - 18 DP - 2002 May 7 TI - Prevention Conference VI: Diabetes and Cardiovascular Disease: Writing Group V: management of cardiovascular-renal complications. PG - e159-64 FAU - Bonow, Robert O AU - Bonow RO FAU - Mitch, William E AU - Mitch WE FAU - Nesto, Richard W AU - Nesto RW FAU - O'Gara, Patrick T AU - O'Gara PT FAU - Becker, Richard C AU - Becker RC FAU - Clark, Luther T AU - Clark LT FAU - Hunt, Sharon AU - Hunt S FAU - Jialal, Ishwarlal AU - Jialal I FAU - Lipshultz, Stephen E AU - Lipshultz SE FAU - Loh, Evan AU - Loh E LA - eng PT - Conference Proceedings PL - United States TA - Circulation JT - Circulation JID - 0147763 SB - IM MH - Clinical Trials as Topic MH - Diabetic Angiopathies/*prevention & control/therapy MH - Diabetic Nephropathies/diagnosis/*prevention & control MH - Disease Progression MH - Heart Diseases/*prevention & control MH - Heart Failure/drug therapy/etiology/prevention & control MH - Humans MH - Hypertension/drug therapy MH - Myocardial Infarction/etiology/prevention & control MH - Myocardial Revascularization MH - Renal Insufficiency/diagnosis/*prevention & control MH - Systole MH - Ventricular Dysfunction, Left/etiology/prevention & control EDAT- 2002/05/08 10:00 MHDA- 2002/06/14 10:01 CRDT- 2002/05/08 10:00 PHST- 2002/05/08 10:00 [pubmed] PHST- 2002/06/14 10:01 [medline] PHST- 2002/05/08 10:00 [entrez] AID - 10.1161/01.cir.0000013956.95796.74 [doi] PST - ppublish SO - Circulation. 2002 May 7;105(18):e159-64. doi: 10.1161/01.cir.0000013956.95796.74. PMID- 11847596 OWN - NLM STAT- MEDLINE DCOM- 20020528 LR - 20071115 IS - 0171-6425 (Print) IS - 0171-6425 (Linking) VI - 50 IP - 1 DP - 2002 Feb TI - Cardiopulmonary bypass copolymer surface modification reduces neither blood loss nor transfusions in coronary artery surgery. PG - 5-10 AB - OBJECTIVE: Surface-modifying additives (SMA) have been suggested for improving cardiopulmonary bypass (CPB) circuit biocompatibility, potentially minimizing inflammatory complications and bleeding associated with CPB. The purpose of this prospective, randomized clinical study was to compare a novel copolymer surface-modified CPB circuit (SMARXT; COBE Cardiovascular) against the unmodified circuit. METHODS: We randomized 122 patients with isolated coronary artery disease subjected to first-time surgery on CPB into either the SMA (n = 62) or the control group (n = 60). Exclusion criteria included renal insufficiency, liver disease, coagulopathy, anticoagulation therapy < 6 days preop, carotid artery stenosis > 70 %, and a history of stroke. We collected perioperative clinical data including drainage blood loss, transfusion requirements, duration of mechanical ventilation, and ICU stay. Platelet function was determined pre- and post-CPB. RESULTS: SMA patients received 3.2 +/- 0.9 (SD) grafts during 48 +/- 16 min of aortic cross clamp and 91 +/- 30 min CPB (Control: 3.0 +/- 0.9 grafts; p = 0.33, 46 +/- 14 min AXC; p = 0.36, and 84 +/- 23 min CPB; p = 0.14). In the SMA group, 23 patients (37 %) received red blood-cell transfusions, 9 patients (15 %) fresh frozen plasma, and 3 patients (5 %) received platelets (control: n = 27 [46 %], p = 0.44; n = 10 [17 %], p = 0.91; and n=4 [7 %], p = 0.71, respectively). Platelet count on CPB fell to the same level in both groups. In SMA patients, platelet function decreased from 94.2 +/- 24.9 % pre-CPB to 79.5 +/- 32.8 % post-CPB (p = 0.043) (control: from 87.7 +/- 25.6 % to 69.4 +/- 34.7 %; p = 0.001). Postoperative drainage blood loss, mechanical ventilation duration, and ICU stay were similar in both groups (p > 0.3). One patient of the control group was excluded due to surgical bleeding, and one SMA patient died. CONCLUSIONS: Our results show that the surface-modified CPB circuit decreased neither blood loss nor transfusions despite slightly better platelet function preservation compared to the unmodified circuit. This type of CPB circuit surface modification does not appear to improve clinical outcome in low-risk coronary artery surgery patients. FAU - Sudkamp, M AU - Sudkamp M AD - Clinic for Cardiothoracic Surgery, University of Cologne, Germany. FAU - Mehlhorn, U AU - Mehlhorn U FAU - Reza Raji, M AU - Reza Raji M FAU - Hekmat, K AU - Hekmat K FAU - Easo, J AU - Easo J FAU - Geissler, H-J AU - Geissler HJ FAU - Sindhu, D AU - Sindhu D FAU - de Vivie, R AU - de Vivie R LA - eng PT - Clinical Trial PT - Journal Article PT - Randomized Controlled Trial PL - Germany TA - Thorac Cardiovasc Surg JT - The Thoracic and cardiovascular surgeon JID - 7903387 RN - 0 (Biocompatible Materials) SB - IM CIN - Thorac Cardiovasc Surg. 2002 Dec;50(6):384. doi: 10.1055/s-2002-35737. PMID: 12457322 MH - Aged MH - *Biocompatible Materials MH - Cardiopulmonary Bypass/*instrumentation MH - Coronary Artery Bypass/*instrumentation MH - Coronary Artery Disease/*surgery MH - Data Interpretation, Statistical MH - Equipment Design MH - Female MH - Humans MH - Male MH - Middle Aged MH - Platelet Function Tests EDAT- 2002/02/16 10:00 MHDA- 2002/05/29 10:01 CRDT- 2002/02/16 10:00 PHST- 2002/02/16 10:00 [pubmed] PHST- 2002/05/29 10:01 [medline] PHST- 2002/02/16 10:00 [entrez] AID - 10.1055/s-2002-20156 [doi] PST - ppublish SO - Thorac Cardiovasc Surg. 2002 Feb;50(1):5-10. doi: 10.1055/s-2002-20156. PMID- 11803323 OWN - NLM STAT- MEDLINE DCOM- 20020503 LR - 20161026 IS - 0021-9509 (Print) IS - 0021-9509 (Linking) VI - 43 IP - 1 DP - 2002 Feb TI - Renal dose dopamine in open heart surgery. Does it protect renal tubular function? PG - 25-30 AB - BACKGROUND: This prospective, randomized study assessed the effect of dopamine on renal tubular function in patients who had coronary artery bypass grafting. METHODS: Two groups of patients with normal preoperative renal function were randomly divided into a dopamine group (n=11), who received dopamine in a dose of 2 mg/kg x min, and a control group (n=11), who received no treatment. Dopamine infusion was initiated 24 hours before the operation and was continued for 48 hours postoperatively. Measurements of renal function obtained 2 days before the operation were considered preoperative and were repeated on the 1st, 3rd, and 7th postoperative days. Urinary excretion of b2-Microglobulin (b2-M), considered a sensitive means for diagnosing proximal tubular damage, was measured during the early (day 3) and late (day 7) postoperative period. RESULTS: There were no significant differences respect to the clearances of creatinine, osmotic, and free-water in the dopamine group compared with the control group (p>0.05). Urine microalbumin levels significantly increased on postoperative day 3 in both groups. During the early postoperative period, excretion of urine b2-M was significantly greater in the dopamine group than in the control group (p<0.05). CONCLUSIONS: Consequently, in patients with normal preoperative renal and cardiac function scheduled for elective coronary artery bypass grafting, renal dose dopamine infusion alone may not provide sufficient protection on tubular function and increases renal tubular injury during the early postoperative period. FAU - Yavuz, S AU - Yavuz S AD - Department of Cardiovascular Surgery, Bursa Yuksek Ihtisas Hospital, Bursa, Turkey. FAU - Ayabakan, N AU - Ayabakan N FAU - Dilek, K AU - Dilek K FAU - Ozdemir, A AU - Ozdemir A LA - eng PT - Clinical Trial PT - Journal Article PT - Randomized Controlled Trial PL - Italy TA - J Cardiovasc Surg (Torino) JT - The Journal of cardiovascular surgery JID - 0066127 RN - 0 (Cardiotonic Agents) RN - 0 (beta 2-Microglobulin) RN - VTD58H1Z2X (Dopamine) SB - IM MH - Adult MH - Aged MH - Cardiotonic Agents/administration & dosage/*therapeutic use MH - Coronary Artery Bypass/*adverse effects MH - Coronary Artery Disease/physiopathology/*surgery/*urine MH - Dopamine/administration & dosage/*therapeutic use MH - Female MH - Humans MH - Infusions, Parenteral MH - Kidney Diseases/*etiology/physiopathology/*urine MH - Kidney Tubules/*drug effects/injuries/*physiopathology MH - Male MH - Middle Aged MH - *Postoperative Complications MH - Prospective Studies MH - beta 2-Microglobulin/*urine EDAT- 2002/01/23 10:00 MHDA- 2002/05/04 10:01 CRDT- 2002/01/23 10:00 PHST- 2002/01/23 10:00 [pubmed] PHST- 2002/05/04 10:01 [medline] PHST- 2002/01/23 10:00 [entrez] PST - ppublish SO - J Cardiovasc Surg (Torino). 2002 Feb;43(1):25-30. PMID- 11730274 OWN - NLM STAT- MEDLINE DCOM- 20020416 LR - 20131121 IS - 1121-8428 (Print) IS - 1121-8428 (Linking) VI - 14 IP - 5 DP - 2001 Sep-Oct TI - Low dose dopamine infusion reduces renal tubular injury following cardiopulmonary bypass surgery. PG - 397-402 AB - BACKGROUND: The use of dopamine to protect the kidneys against hypoperfusion injury remains controversial with little clinical evidence of benefit and increasing concerns regarding safety. In this double-blind, prospective, randomised study, we investigated the effect of dopamine infusion (2.5 microg/kg/min) on glomerular filtration rate (GFR) and tubular injury in patients undergoing routine cardiopulmonary bypass (CPB). METHODS: Forty eight patients were randomly assigned to receive intravenous dopamine or saline from induction of anaesthesia until 48 hours post-operatively. There were no differences in mean age, bypass time or pre-op creatinine in the 36 patients (33 men) who completed the study. 51Cr-EDTA GFR (ml/min/1.73 m2) was measured pre-operatively and on day 5 only. Urinary markers of tubular injury (albumin, N-acetyl glucosaminidase, NAG; retinol binding protein, RBP) were measured pre-operatively, and on days 1, 2 and 5. RESULTS: GFR was preserved equally in both groups. All patients demonstrated significant tubular injury but urinary levels of NAG and RBP were lower in the dopamine group (41%, p=0.057 and 41%, p=0.007, respectively) on the first post-operative day. CONCLUSION: We conclude that low dose dopamine infusion may reduce renal tubular injury following CPB in patients with normal or near normal baseline renal function. FAU - Sumeray, M AU - Sumeray M AD - Department of Cardiothoracic Surgery, Middlesex Hospital, UCLH Trust, London, UK. FAU - Robertson, C AU - Robertson C FAU - Lapsley, M AU - Lapsley M FAU - Bomanji, J AU - Bomanji J FAU - Norman, A G AU - Norman AG FAU - Woolfson, R G AU - Woolfson RG LA - eng PT - Clinical Trial PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - England TA - J Nephrol JT - Journal of nephrology JID - 9012268 RN - 0 (Cardiotonic Agents) RN - VTD58H1Z2X (Dopamine) SB - IM MH - Acute Kidney Injury/etiology/prevention & control MH - Aged MH - Cardiopulmonary Bypass/*adverse effects/methods MH - Cardiotonic Agents/*administration & dosage MH - Coronary Artery Disease/surgery MH - Dopamine/*administration & dosage MH - Double-Blind Method MH - Female MH - Glomerular Filtration Rate MH - Heart Valve Diseases/surgery MH - Humans MH - Infusions, Intravenous MH - Kidney Tubules/*drug effects/pathology MH - Male MH - Middle Aged MH - Prospective Studies MH - Renal Circulation/*drug effects MH - Treatment Outcome EDAT- 2001/12/04 10:00 MHDA- 2002/04/17 10:01 CRDT- 2001/12/04 10:00 PHST- 2001/12/04 10:00 [pubmed] PHST- 2002/04/17 10:01 [medline] PHST- 2001/12/04 10:00 [entrez] PST - ppublish SO - J Nephrol. 2001 Sep-Oct;14(5):397-402. PMID- 11432470 OWN - NLM STAT- MEDLINE DCOM- 20011101 LR - 20191210 IS - 0171-6425 (Print) IS - 0171-6425 (Linking) VI - 49 IP - 3 DP - 2001 Jun TI - Clinical use of heparin-coated cardiopulmonary bypass in coronary artery bypass grafting. PG - 131-6 AB - Clinical handling, risk and benefit of a heparin-coated cardiopulmonary bypass system combined with reduced systemic heparinization in coronary bypass surgery was investigated in a prospective, randomized clinical study. 243 patients (Pts.) were divided into 3 groups: group A (n = 83) had a standard uncoated extracorporeal circulation (ECC) set, and systemic heparin was administered in an initial dose of 400 IE/kg body weight. During ECC activated clotting time (ACT) was kept > or = 480 sec. Group B (n = 77) had the same ECC set completely coated with low-molecular-weight heparin; i.v. heparin was given in the same dose as in group A, ACT was kept at the same level. Group C (n = 83) had the same coated ECC set as group B, but i.v. heparin was reduced to 150 IE/kg, and was set to be > or = 240 sec during ECC ACT. The same circulatory components were used in all 3 groups including roller pumps, coronary suction and an open cardiotomy reservoir. In the postoperative clinical course, recovery was not significantly different between groups, especially with respect to organ dysfunction; but there was significantly reduced postoperative bleeding where heparin-coated ECC and low-dose systemic heparinization were both used. This circulatory technique was also associated with a distinctly lower need for postoperative blood replacement. We conclude that heparin-coated extracorporeal circulation combined with either full-dose or reduced systemic heparinization can be used effectively with the same standard equipment and procedures as in uncoated technology. Combination with low-dose i.v. heparin leads to significantly decreased blood loss and less need for blood replacement. FAU - Mirow, N AU - Mirow N AD - Department of Thoracic and Cardiovascular Surgery, Heart Center NRW, Ruhr University of Bochum, Bad Oeynhausen, Germany. nmirow@hdz-nrw.ruhr-uni-bochum.de FAU - Minami, K AU - Minami K FAU - Kleikamp, G AU - Kleikamp G FAU - Tenderich, G AU - Tenderich G FAU - Puhlmann, T AU - Puhlmann T FAU - Korfer, R AU - Korfer R LA - eng PT - Clinical Trial PT - Comparative Study PT - Evaluation Study PT - Journal Article PT - Randomized Controlled Trial PL - Germany TA - Thorac Cardiovasc Surg JT - The Thoracic and cardiovascular surgeon JID - 7903387 RN - 0 (Anticoagulants) RN - 0 (Heparin, Low-Molecular-Weight) RN - 0 (Protamines) SB - IM MH - Adult MH - Aged MH - Anticoagulants/administration & dosage/*therapeutic use MH - *Cardiopulmonary Bypass MH - *Coronary Artery Bypass MH - Coronary Disease/complications/surgery MH - Dose-Response Relationship, Drug MH - Hemorrhage/etiology MH - Heparin, Low-Molecular-Weight/administration & dosage/*therapeutic use MH - Humans MH - Length of Stay MH - Middle Aged MH - Myocardial Infarction/etiology MH - Paresis/etiology MH - Postoperative Complications/etiology MH - Prospective Studies MH - Protamines/therapeutic use MH - Renal Insufficiency/etiology MH - Stroke/etiology EDAT- 2001/07/04 10:00 MHDA- 2001/11/03 10:01 CRDT- 2001/07/04 10:00 PHST- 2001/07/04 10:00 [pubmed] PHST- 2001/11/03 10:01 [medline] PHST- 2001/07/04 10:00 [entrez] AID - 10.1055/s-2001-14287 [doi] PST - ppublish SO - Thorac Cardiovasc Surg. 2001 Jun;49(3):131-6. doi: 10.1055/s-2001-14287. PMID- 11423581 OWN - NLM STAT- MEDLINE DCOM- 20010830 LR - 20210513 IS - 1046-6673 (Print) IS - 1046-6673 (Linking) VI - 12 IP - 7 DP - 2001 Jul TI - Prevalence and clinical correlates of coronary artery disease among new dialysis patients in the United States: a cross-sectional study. PG - 1516-1523 LID - 10.1681/ASN.V1271516 [doi] AB - Despite the high prevalence of coronary artery disease (CAD) among patients with end-stage renal disease (ESRD), few studies have identified clinical correlates using national data. The purpose of this study was to determine the prevalence and clinical associations of CAD in a national random sample of new ESRD in the United States in 1996/1997 (n = 4025). Data on demographic characteristics and comorbidities were obtained from the Dialysis Morbidity and Mortality Study, Wave 2. The principal outcome was CAD, defined as the presence of a previous history of CAD, myocardial infarction, or angina, coronary artery bypass surgery, coronary angioplasty, or abnormal coronary angiographic findings. Multivariate logistic regression analysis was used to assess the relationship of conventional factors and proposed uremic factors to the presence of CAD. CAD was present in 38% of patients. Of the total cohort, 17% had a history of myocardial infarction and 23% had angina. Several conventional risk factors, including advancing age, male gender, diabetes mellitus, and smoking, were significantly associated with CAD. Of the proposed uremic factors, lower serum albumin levels but higher residual renal function and higher hematocrit values were significantly associated with the presence of CAD. Vascular comorbid conditions, structural cardiac abnormalities, white race, and geographic location were also strongly correlated with the presence of CAD. This national study suggests that several conventional CAD risk factors may also be risk factors for CAD among the ESRD population. This study identifies nonconventional factors such as serum albumin levels, vascular comorbid conditions, and structural cardiac abnormalities as important disease correlates. Future logitudinal studies are required to explore the relative importance of the relationships observed here. FAU - Stack, Austin G AU - Stack AG AD - Division of Nephrology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan. FAU - Bloembergen, Wendy E AU - Bloembergen WE AD - Division of Nephrology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - United States TA - J Am Soc Nephrol JT - Journal of the American Society of Nephrology : JASN JID - 9013836 SB - IM MH - Adult MH - Aged MH - Coronary Disease/*epidemiology/*etiology/physiopathology MH - Cross-Sectional Studies MH - Female MH - Humans MH - Kidney Failure, Chronic/blood/*complications/*therapy MH - Male MH - Middle Aged MH - Prevalence MH - Random Allocation MH - Regression Analysis MH - *Renal Replacement Therapy MH - Risk Factors MH - United States MH - Uremia/etiology EDAT- 2001/06/26 10:00 MHDA- 2001/08/31 10:01 CRDT- 2001/06/26 10:00 PHST- 2001/06/26 10:00 [pubmed] PHST- 2001/08/31 10:01 [medline] PHST- 2001/06/26 10:00 [entrez] AID - 12/7/1516 [pii] AID - 10.1681/ASN.V1271516 [doi] PST - ppublish SO - J Am Soc Nephrol. 2001 Jul;12(7):1516-1523. doi: 10.1681/ASN.V1271516. PMID- 11331052 OWN - NLM STAT- MEDLINE DCOM- 20010531 LR - 20190627 IS - 0002-9343 (Print) IS - 0002-9343 (Linking) VI - 110 IP - 6 DP - 2001 Apr 15 TI - Comparison of the effects of angiotensin converting-enzyme inhibitors and beta blockers on survival in elderly patients with reduced left ventricular function after myocardial infarction. PG - 425-33 AB - PURPOSE: Angiotensin converting-enzyme (ACE) inhibitors decrease mortality after myocardial infarction among patients with depressed left ventricular function. Beta blockers may also improve survival in these patients. We compared the relative effects of these agents on the survival of elderly patients with a left ventricular ejection fraction less than 40% after myocardial infarction. SUBJECTS AND METHODS: The Cooperative Cardiovascular Project collected data on patients aged 65 years and older who were admitted with myocardial infarction from April 1994 to July 1995, including 20,902 with a measured left ventricular ejection fraction less than 40% before discharge. Using proportional hazard regression models that adjusted for patient characteristics and in-hospital treatments, we compared survival among patients discharged on ACE inhibitors, beta blockers, both medications, or neither medication. RESULTS: Among patients surviving hospitalization with reduced left ventricular function, 9,108 (44%) were discharged on ACE inhibitors, 2,613 (13%) on beta blockers, 3,309 (16%) on both medications, and 5,872 (28%) on neither medication. Patients treated with ACE inhibitors were more likely to have a prior diagnosis of heart failure and less likely to have undergone revascularization, whereas those treated with beta blockers were more often treated with thrombolytic therapy and aspirin. Patients treated with ACE inhibitors [hazard ratio (HR = 0.80), 0.80; 95% confidence interval (CI), 0.73 to 0.87] or beta blockers (HR = 0.76, 0.76; 95% CI, 0.64 to 0.90) had lower adjusted 1-year mortality than those who were not treated with either medication. The combination of both medications was associated with additional benefit (HR = 0.68, 0.68; 95% CI, 0.59 to 0.80). The relative benefit of each medication was greatest among patients with an ejection fraction less than 30%, a serum creatinine level 2.0 mg/dL or greater, or both. To prevent a death within a year, the number of patients who needed to be treated with both medications varied from 5 to 15, depending on ejection fraction and renal function. CONCLUSION: ACE inhibitors and beta blockers were associated with similar improvements in survival among elderly patients with reduced left ventricular ejection fraction after myocardial infarction. Our results suggest that patients who can tolerate both medications gain additional benefit from the combination. FAU - Shlipak, M G AU - Shlipak MG AD - Medical Service, Veterans Affairs Medical Center, University of California, San Francisco 94121, USA. FAU - Browner, W S AU - Browner WS FAU - Noguchi, H AU - Noguchi H FAU - Massie, B AU - Massie B FAU - Frances, C D AU - Frances CD FAU - McClellan, M AU - McClellan M LA - eng PT - Comparative Study PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Research Support, U.S. Gov't, P.H.S. PL - United States TA - Am J Med JT - The American journal of medicine JID - 0267200 RN - 0 (Adrenergic beta-Antagonists) RN - 0 (Angiotensin-Converting Enzyme Inhibitors) RN - AYI8EX34EU (Creatinine) SB - IM CIN - Am J Med. 2001 Apr 15;110(6):497-8. doi: 10.1016/s0002-9343(01)00686-6. PMID: 11331064 MH - Adrenergic beta-Antagonists/*therapeutic use MH - Aged MH - Analysis of Variance MH - Angiotensin-Converting Enzyme Inhibitors/*therapeutic use MH - Clinical Trials as Topic MH - Creatinine/blood MH - Female MH - Hospitalization MH - Humans MH - Male MH - Myocardial Infarction/*complications/*drug therapy/mortality MH - Ventricular Dysfunction, Left/*complications EDAT- 2001/05/02 10:00 MHDA- 2001/06/02 10:01 CRDT- 2001/05/02 10:00 PHST- 2001/05/02 10:00 [pubmed] PHST- 2001/06/02 10:01 [medline] PHST- 2001/05/02 10:00 [entrez] AID - S0002-9343(01)00652-0 [pii] AID - 10.1016/s0002-9343(01)00652-0 [doi] PST - ppublish SO - Am J Med. 2001 Apr 15;110(6):425-33. doi: 10.1016/s0002-9343(01)00652-0. PMID- 11276456 OWN - NLM STAT- MEDLINE DCOM- 20010628 LR - 20141120 IS - 1098-3511 (Print) IS - 1098-3511 (Linking) VI - 2 IP - 1 DP - 1999 TI - Off-pump multivessel coronary artery bypass utilizing the Octopus tissue stabilization system: initial experience in 374 patients from three separate centers. PG - 15-28 AB - BACKGROUND: Renewed interest in coronary artery bypass without heart-lung support has lead to the development of specialized instrumentation to permit surgical exposure and grafting in all territories of the beating heart. This report summarizes the results of a multicenter, prospective trial using a single system of mechanical stabilization for multivessel revascularization without cardiopulmonary bypass. METHODS: Three principal investigators at different institutions performed off-pump coronary grafting utilizing the Medtronic Octopus suction stabilization system which provides a motionless region encompassing the target coronary artery. Positioning and stabilization strategies evolved during the trial but eventually lead to a consistent approach for accessing all regions of the heart. Clinical data sets were collected prospectively and pooled for evaluation of early and short-term endpoints of success. RESULTS: A total of 374 patients underwent beating heart coronary bypass procedures with only a single death for an in-hospital 30-day mortality rate of 0.26%. There were 140 single-vessel revascularizations (37.4% of patients), 119 double coronary grafts (31.8%), 90 triple-vessel grafts (24.1%), and 25 four-vessel grafts (6.7%), for a mean of 1.96 grafts per patient. If the single vessel cases are removed from analysis, the mean number of grafts performed in the multivessel cohort was 2.6 grafts per patient. All anatomic regions of the heart were successfully grafted including traditionally difficult locations such as the obtuse marginal branches of the circumflex and posterior descending branches of the right coronary artery. Only one patient suffered a new neurologic deficit which occurred 15 days postoperatively, for an overall incidence of only 0.26%. No patient required a new intra-aortic balloon pump or dialysis for renal insufficiency. The incidence of atrial fibrillation (12.8%) was age related and essentially unchanged from the overall incidence observed in patients operated at the same institutions using conventional techniques. CONCLUSIONS: Multivessel grafting on the beating heart using the Octopus stabilization system results in remarkably low perioperative mortality and morbidity, with very low incidences of cerebrovascular, renal, and respiratory complications. However, the incidence of postoperative atrial fibrillation is not reduced. Expanded clinical use of beating heart surgery with suction-based stabilization appears to be a promising technique for achieving global revascularization without the need for cardiopulmonary bypass. FAU - Hart, J C AU - Hart JC AD - Pinnacle Health, Harrisburg, Pennsylvania, USA, Park Nicollet Heart Center, Minneapolis, Minnesota, USA. jchart@concentric.net FAU - Spooner, T AU - Spooner T FAU - Edgerton, J AU - Edgerton J FAU - Milsteen, S A AU - Milsteen SA LA - eng PT - Journal Article PT - Multicenter Study PL - United States TA - Heart Surg Forum JT - The heart surgery forum JID - 100891112 SB - IM MH - Coronary Artery Bypass/*instrumentation MH - Equipment Design MH - *Heart-Lung Machine MH - Hospital Mortality MH - Humans MH - *Immobilization MH - Minimally Invasive Surgical Procedures/*instrumentation MH - Postoperative Complications/mortality MH - Prospective Studies MH - Surgical Instruments MH - Survival Rate EDAT- 2001/03/29 10:00 MHDA- 2001/06/29 10:01 CRDT- 2001/03/29 10:00 PHST- 1999/01/10 00:00 [accepted] PHST- 2001/03/29 10:00 [pubmed] PHST- 2001/06/29 10:01 [medline] PHST- 2001/03/29 10:00 [entrez] PST - ppublish SO - Heart Surg Forum. 1999;2(1):15-28. PMID- 11273907 OWN - NLM STAT- MEDLINE DCOM- 20010426 LR - 20190704 IS - 0003-2999 (Print) IS - 0003-2999 (Linking) VI - 92 IP - 4 DP - 2001 Apr TI - The effect of insulin cardioplegia on atrial fibrillation after high-risk coronary bypass surgery: a double-blinded, randomized, controlled trial. PG - 810-6 AB - Atrial fibrillation after coronary bypass (CABG) surgery is an important cause of morbidity and increased resource utilization. Insulin-enhanced cardioplegia may reduce postoperative arrhythmias by improving aerobic myocardial metabolism and mitigating the deleterious effects of ischemia. We performed a double-blinded, randomized, controlled clinical trial to determine if insulin-enhanced cardioplegia decreases the risk of post-CABG atrial fibrillation in a high-risk patient population. We randomized 501 patients undergoing urgent CABG to receive insulin-enhanced (Humulin R 10 IU/L, Insulin group, n = 243) or standard (Control group, n = 258) blood cardioplegia during cardiopulmonary bypass. Patients were monitored by using continuous electrocardiography for a minimum of 3 days postoperatively. All standard cardiac medications, including beta-adrenergic blockers, were continued postoperatively. Insulin-enhanced cardioplegia did not result in a significant reduction in postoperative atrial fibrillation. Furthermore, we failed to detect a difference in the incidence of conduction defects, ventricular tachycardia, or pacemaker requirements between insulin and placebo patients. Atrial fibrillation was the most common arrhythmia, occurring in 31% of all patients. Independent predictors of atrial fibrillation were elderly age, preoperative atrial fibrillation, and renal insufficiency. Right bundle branch block was the most common conduction abnormality. Predictors of right bundle branch block were elderly age, female sex, and circumflex coronary artery disease. The incidence of postoperative ventricular tachycardia, left bundle branch block, and permanent pacemaker requirement was small. We conclude that insulin-enhanced cardioplegia does not reduce the incidence of postoperative atrial fibrillation in high-risk CABG patients. IMPLICATIONS: We conducted a double-blinded, randomized, placebo-controlled trial of insulin-enhanced cardioplegia in 501 patients undergoing urgent coronary bypass surgery. Insulin did not decrease the incidence of postoperative atrial fibrillation when compared with placebo. We also failed to demonstrate a difference in the incidence of other postoperative arrhythmias between the two groups of patients. FAU - Hynninen, M AU - Hynninen M AD - Division of Cardiac Anesthesia and Intensive Care, Toronto General Hospital, University Health Network, University of Toronto, Ontario, Canada. FAU - Borger, M A AU - Borger MA FAU - Rao, V AU - Rao V FAU - Weisel, R D AU - Weisel RD FAU - Christakis, G T AU - Christakis GT FAU - Carroll, J A AU - Carroll JA FAU - Cheng, D C AU - Cheng DC LA - eng PT - Clinical Trial PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - United States TA - Anesth Analg JT - Anesthesia and analgesia JID - 1310650 RN - 0 (Cardioplegic Solutions) RN - 0 (Hypoglycemic Agents) RN - 0 (Insulin) SB - IM MH - Aged MH - Anesthesia, General MH - Atrial Fibrillation/*drug therapy/etiology/pathology MH - Bundle-Branch Block/epidemiology/etiology MH - Cardioplegic Solutions/*therapeutic use MH - Coronary Artery Bypass/*adverse effects MH - Double-Blind Method MH - Female MH - Heart Conduction System/drug effects MH - Humans MH - Hypoglycemic Agents/*therapeutic use MH - Insulin/*therapeutic use MH - Male MH - Middle Aged MH - Myocardium/pathology MH - Risk EDAT- 2001/03/29 10:00 MHDA- 2001/05/01 10:01 CRDT- 2001/03/29 10:00 PHST- 2001/03/29 10:00 [pubmed] PHST- 2001/05/01 10:01 [medline] PHST- 2001/03/29 10:00 [entrez] AID - 10.1097/00000539-200104000-00004 [doi] PST - ppublish SO - Anesth Analg. 2001 Apr;92(4):810-6. doi: 10.1097/00000539-200104000-00004. PMID- 11174738 OWN - NLM STAT- MEDLINE DCOM- 20010322 LR - 20061115 IS - 0022-5223 (Print) IS - 0022-5223 (Linking) VI - 121 IP - 2 DP - 2001 Feb TI - Comparison of two heparin-coated extracorporeal circuits with reduced systemic anticoagulation in routine coronary artery bypass operations. PG - 324-30 AB - OBJECTIVES: The use of heparin-coated circuits for cardiopulmonary bypass attenuates the postperfusion inflammatory response. Postoperative bleeding and the need for allogeneic blood transfusions are reduced, particularly in combination with lowered systemic anticoagulation. The two most commonly used heparin-coated systems are the Carmeda BioActive Surface (Medtronic Inc, Minneapolis, Minn) and the Duraflo II coating (Baxter Healthcare Corp, Bentley Laboratories Division, Irvine, Calif). The 2 surfaces are technically unequal, and previous experimental studies have demonstrated disparities in effects on the immune system and the blood cells. However, no larger comparative studies of relevant clinical end points have thus far been reported. METHODS: Over a 24-month period, all patients undergoing coronary artery bypass were prospectively randomized to one of the two heparin-coated circuits. Altogether, 1336 consecutive patients were included. The heparin dose was reduced in all cases, with an activated coagulation time of more than 250 seconds. Clinical data were consecutively collected and stored on a computer for comparative analyses. RESULTS: There were no statistically significant differences in any demographic or operative parameters. The Duraflo II patients required less heparin to keep the target-activated clotting time, confirming the previous finding of some leakage of heparin from the surface to the circulation. Otherwise, there were no significant differences in time for ventilatory support (Duraflo II, 1.7 +/- 1.3 hours; Carmeda BioActive Surface, 1.6 +/- 1.0 hours; P =.37), amount of postoperative mediastinal drainage (Duraflo II, 665 +/- 257 mL; Carmeda BioActive Surface, 688 +/- 243 mL; P =.07), need for allogeneic blood-plasma transfusions (Duraflo II, 4.2% of the patients; Carmeda BioActive Surface, 4.4% of the patients; P =.93), or hemoglobin concentration at hospital discharge (Duraflo II, 120 +/- 13 g/L; Carmeda BioActive Surface, 119 +/- 13 g/L; P =.08). The effects on renal function and platelets were similar, as were the incidences of perioperative myocardial infarction (Duraflo II, 1.5%; Carmeda BioActive Surface, 1.5%; P =.96), stroke (Duraflo II, 1.3%; Carmeda BioActive Surface, 1.2%; P =.47), and hospital mortality (Duraflo II, 1 [0.14%] patient; Carmeda BioActive Surface, 3 [0.45%] patients; P =.31). CONCLUSIONS: Despite differences in technology, complexity, and effects on biologic markers, no clinical differences were observed between the Carmeda BioActive Surface system and the Duraflo II coating after coronary artery bypass operations. The overall clinical results were favorable in both groups, confirming the safety and feasibility of routine use of heparin-coated circuits in combination with reduced systemic anticoagulation. FAU - Ovrum, E AU - Ovrum E AD - Oslo Heart Center, Box 2684 St, Hanshaugen, 0131 Oslo, Norway. FAU - Tangen, G AU - Tangen G FAU - Oystese, R AU - Oystese R FAU - Ringdal, M A AU - Ringdal MA FAU - Istad, R AU - Istad R LA - eng PT - Clinical Trial PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial PL - United States TA - J Thorac Cardiovasc Surg JT - The Journal of thoracic and cardiovascular surgery JID - 0376343 RN - 0 (Anticoagulants) RN - 0 (Coated Materials, Biocompatible) RN - 0 (Fibrinolytic Agents) RN - 9005-49-6 (Heparin) SB - IM CIN - J Thorac Cardiovasc Surg. 2001 Feb;121(2):200-1. doi: 10.1067/mtc.2001.112818. PMID: 11174722 MH - *Anticoagulants/administration & dosage MH - Blood Coagulation MH - Cardiopulmonary Bypass/*instrumentation MH - *Coated Materials, Biocompatible MH - Female MH - *Fibrinolytic Agents/administration & dosage MH - *Heparin/administration & dosage MH - Humans MH - Male MH - Middle Aged MH - Prospective Studies MH - Time Factors EDAT- 2001/02/15 11:00 MHDA- 2001/03/27 10:01 CRDT- 2001/02/15 11:00 PHST- 2001/02/15 11:00 [pubmed] PHST- 2001/03/27 10:01 [medline] PHST- 2001/02/15 11:00 [entrez] AID - S0022-5223(01)25757-2 [pii] AID - 10.1067/mtc.2001.111205 [doi] PST - ppublish SO - J Thorac Cardiovasc Surg. 2001 Feb;121(2):324-30. doi: 10.1067/mtc.2001.111205. PMID- 11158861 OWN - NLM STAT- MEDLINE DCOM- 20010426 LR - 20190815 IS - 1523-6838 (Electronic) IS - 0272-6386 (Linking) VI - 37 IP - 1 Suppl 2 DP - 2001 Jan TI - The CHORUS (Cerivastatin in Heart Outcomes in Renal Disease: Understanding Survival) protocol: a double-blind, placebo-controlled trial in patients with esrd. PG - S48-53 AB - The 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor (statin)-mediated lowering of serum cholesterol has been associated with a significant reduction in cardiovascular morbidity and mortality. Recent studies suggest that additional non-lipid lowering effects (eg, endothelial stabilization, anti-inflammatory, antithrombogenic) may be important in modulating their effectiveness. Dyslipidemia is common in end-stage renal disease (ESRD), and hemodialysis patients have increased cardiovascular morbidity and mortality. Cerivastatin, a new statin with powerful low-density lipoprotein-cholesterol (LDL-C) lowering capabilities, possesses some unique non-LDL-C-mediated properties that may contribute to a reduction of coronary events in the patient with ESRD. The primary objective of this multicenter multinational study of 1,054 hemodialysis patients is to compare 2 years of treatment with cerivastatin (0.4 mg/d) versus placebo on the composite clinical event rate of myocardial infarction, sudden cardiac death, ischemic stroke, and the need for coronary arterial bypass graft (CABG) or percutaneous transluminal coronary angioplasty (PTCA) procedures in these patients. Changes in lipids, inflammatory proteins including heat stable C-reactive protein (hsCRP), interleukin-6 (IL-6), oncostatin-M, intracellular adhesion molecule-1 (ICAM-1) and monocyte-chemoattractant protein-1 (MCP-1), as well as markers of cardiac muscle pathology, such as troponin I and troponin T, will be assessed in a subset of patients. This study is the first of its kind to assess the effect of a statin on the reduction of cardiovascular morbidity and mortality in an incident hemodialysis population. It will determine whether treatment with cerivastatin can effectively reduce the significant cardiovascular morbidity and mortality. FAU - Keane, W F AU - Keane WF AD - Department of Medicine, Hennepin County Medical Center, University of Minnesota Medical School, Minneapolis, MN, USA. g.macgregor@sghms.ac.uk FAU - Brenner, B M AU - Brenner BM FAU - Mazzu, A AU - Mazzu A FAU - Agro, A AU - Agro A LA - eng PT - Clinical Trial PT - Journal Article PT - Randomized Controlled Trial PL - United States TA - Am J Kidney Dis JT - American journal of kidney diseases : the official journal of the National Kidney Foundation JID - 8110075 RN - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors) RN - 0 (Pyridines) RN - AM91H2KS67 (cerivastatin) SB - IM MH - Adult MH - Aged MH - Aged, 80 and over MH - Area Under Curve MH - Double-Blind Method MH - Female MH - Follow-Up Studies MH - Heart/drug effects/physiopathology MH - Humans MH - Hydroxymethylglutaryl-CoA Reductase Inhibitors/*therapeutic use MH - Kidney Failure, Chronic/*drug therapy/metabolism/therapy MH - Male MH - Middle Aged MH - Multicenter Studies as Topic MH - Pyridines/pharmacokinetics/*therapeutic use MH - Randomized Controlled Trials as Topic MH - Renal Dialysis MH - Research Design MH - Survival Analysis EDAT- 2001/02/13 11:00 MHDA- 2001/05/11 10:01 CRDT- 2001/02/13 11:00 PHST- 2001/02/13 11:00 [pubmed] PHST- 2001/05/11 10:01 [medline] PHST- 2001/02/13 11:00 [entrez] AID - S0272-6386(01)84851-4 [pii] AID - 10.1053/ajkd.2001.20739 [doi] PST - ppublish SO - Am J Kidney Dis. 2001 Jan;37(1 Suppl 2):S48-53. doi: 10.1053/ajkd.2001.20739. PMID- 10752967 OWN - NLM STAT- MEDLINE DCOM- 20000419 LR - 20190822 IS - 0025-7079 (Print) IS - 0025-7079 (Linking) VI - 38 IP - 4 DP - 2000 Apr TI - Relation of gender and health insurance to cardiovascular procedure use in persons with progression of chronic renal disease. PG - 354-65 AB - BACKGROUND: Women often are less likely than men to receive diagnostic and therapeutic invasive procedures for coronary disease. OBJECTIVE: To examine the relation between gender, health insurance, and access to cardiovascular procedures over time in persons with chronic illness. RESEARCH DESIGN: Seven-year longitudinal analyses in a cohort from the United States Renal Data System. SUBJECTS: National random sample of women and men who progressed to end-stage renal disease (ESRD) in 1986 to 1987 and were treated at 303 dialysis facilities (n = 4,987). MEASURES: Medical history and utilization records, physical examination, and laboratory data. MAIN OUTCOME MEASURES: Receipt of a coronary catheterization or revascularization procedure before (baseline) and after (follow-up) the development of ESRD and acquisition of Medicare, adjusted for clinical and socioeconomic variables. RESULTS: At baseline, 5.2% of women and 9.2% of men had undergone a cardiac procedure; the odds of women receiving a procedure were one third lower than for men (adjusted odds ratio 0.66 [95% CI 0.49-0.88]). During follow-up, women were just as likely as men to undergo a procedure (adjusted odds ratio 0.94 [95% CI 0.74-1.20]). Compared with men with baseline private insurance, men and women with other and no insurance had 34% to 81% lower odds of receiving procedures at baseline. Women with private insurance had 42% lower odds of having a procedure at baseline compared with men (adjusted odds ratio 0.58 [95% CI 0.42-0.78]) but had the same odds at follow-up (adjusted odds ratio 1.09 [95% CI 0.82-1.45]). At follow-up, gender differences in procedure use were eliminated for groups with baseline Medicaid or no insurance. CONCLUSIONS: Overall gender differences in cardiac procedure use were narrowed markedly after progression of a serious illness, the assurance of health insurance, and entry into a comprehensive care system. Gender disparities in procedure use for different baseline insurance groups were largely equalized in follow-up. These findings suggest that provision of insurance with disease-managed care for a chronic disease can provide equalized access to care for women. FAU - Daumit, G L AU - Daumit GL AD - Robert Wood Johnson Clinical Scholars Program, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. gdaumit@jhmi.edu FAU - Hermann, J A AU - Hermann JA FAU - Powe, N R AU - Powe NR LA - eng GR - 5T32HLO7024/HL/NHLBI NIH HHS/United States GR - K24DK02643/DK/NIDDK NIH HHS/United States GR - R01DK47797/DK/NIDDK NIH HHS/United States PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Research Support, U.S. Gov't, P.H.S. PL - United States TA - Med Care JT - Medical care JID - 0230027 SB - IM CIN - Med Care. 2000 Apr;38(4):351-3. doi: 10.1097/00005650-200004000-00001. PMID: 10752966 MH - Adult MH - Aged MH - Cardiac Catheterization/statistics & numerical data MH - Cohort Studies MH - Coronary Disease/diagnosis/*epidemiology/therapy MH - Disease Progression MH - Female MH - Follow-Up Studies MH - Health Services Accessibility/*statistics & numerical data MH - Humans MH - Insurance Coverage/*statistics & numerical data MH - Kidney Failure, Chronic/*epidemiology/therapy MH - Male MH - Middle Aged MH - Myocardial Revascularization/*statistics & numerical data MH - Sex Factors MH - United States/epidemiology MH - Utilization Review MH - Women's Health Services/*statistics & numerical data EDAT- 2001/02/07 11:00 MHDA- 2001/02/07 11:01 CRDT- 2001/02/07 11:00 PHST- 2001/02/07 11:00 [pubmed] PHST- 2001/02/07 11:01 [medline] PHST- 2001/02/07 11:00 [entrez] AID - 10.1097/00005650-200004000-00002 [doi] PST - ppublish SO - Med Care. 2000 Apr;38(4):354-65. doi: 10.1097/00005650-200004000-00002. PMID- 11088035 OWN - NLM STAT- MEDLINE DCOM- 20010104 LR - 20260128 IS - 0022-5223 (Print) IS - 0022-5223 (Linking) VI - 120 IP - 6 DP - 2000 Dec TI - Prophylactic value of preincision intra-aortic balloon pump: analysis of a statewide experience. PG - 1112-9 AB - OBJECTIVE: The objective of this study was to determine whether preincision use of an intra-aortic balloon pump improves survival and shortens postoperative length of stay in hemodynamically stable, high-risk patients undergoing coronary artery bypass grafting. METHODS: A post hoc analysis of the Alabama CABG Cooperative Project database was performed by using propensity scores to model the likelihood of receiving a prophylactic preincision intra-aortic balloon pump. Every patient receiving a prophylactic preincision balloon pump was matched with another patient of similar propensity score who did not receive one. We then compared outcomes for matched pairs. RESULTS: There were 7581 patients of whom 592 received a prophylactic preincision balloon pump. Patients with preoperative renal insufficiency, heart failure, or left main coronary artery disease, or who had undergone previous bypass grafting were significantly more likely to receive a prophylactic preincision balloon pump. By using propensity scores, we matched 550 patients who received a prophylactic preincision balloon pump with 550 who did not. Survival did not significantly differ by whether a prophylactic preincision balloon pump was used. However, surviving patients who received a preincision balloon pump had a significantly shorter postbypass length of stay (7 +/- 7.3 days) than did matched patients not receiving a balloon pump (8 +/- 6.2 days; P <.05). CONCLUSIONS: No survival advantage was found for use of a prophylactic intra-aortic balloon pump in hemodynamically stable, high-risk patients undergoing bypass grafting, as opposed to placing a balloon pump on an "as needed" basis during or after the operation. However, the patients receiving the balloon pump had improved convalescence as shown by significantly shorter length of stay. FAU - Holman, W L AU - Holman WL AD - Departments of Surgery, Medicine, and Anesthesiology, University of Alabama at Birmingham, Birmingham. wholman@its.uab.edu FAU - Li, Q AU - Li Q FAU - Kiefe, C I AU - Kiefe CI FAU - McGiffin, D C AU - McGiffin DC FAU - Peterson, E D AU - Peterson ED FAU - Allman, R M AU - Allman RM FAU - Nielsen, V G AU - Nielsen VG FAU - Pacifico, A D AU - Pacifico AD LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Research Support, U.S. Gov't, P.H.S. PL - United States TA - J Thorac Cardiovasc Surg JT - The Journal of thoracic and cardiovascular surgery JID - 0376343 SB - IM MH - Aged MH - Alabama/epidemiology MH - Analysis of Variance MH - Comorbidity MH - *Coronary Artery Bypass/adverse effects/mortality MH - Coronary Disease/complications/mortality/*surgery MH - Female MH - Follow-Up Studies MH - Hemodynamics MH - Humans MH - *Intra-Aortic Balloon Pumping/methods/statistics & numerical data MH - Intraoperative Care/*methods MH - Length of Stay/statistics & numerical data MH - Logistic Models MH - Male MH - *Patient Selection MH - Postoperative Complications/etiology/mortality/prevention & control MH - Proportional Hazards Models MH - Risk Factors MH - Survival Analysis MH - Time Factors MH - Treatment Outcome EDAT- 2000/11/23 11:00 MHDA- 2001/02/28 10:01 CRDT- 2000/11/23 11:00 PHST- 2000/11/23 11:00 [pubmed] PHST- 2001/02/28 10:01 [medline] PHST- 2000/11/23 11:00 [entrez] AID - S0022522300097816 [pii] AID - 10.1067/mtc.2000.110459 [doi] PST - ppublish SO - J Thorac Cardiovasc Surg. 2000 Dec;120(6):1112-9. doi: 10.1067/mtc.2000.110459. PMID- 11082411 OWN - NLM STAT- MEDLINE DCOM- 20001228 LR - 20220309 IS - 1524-4539 (Electronic) IS - 0009-7322 (Linking) VI - 102 IP - 19 Suppl 3 DP - 2000 Nov 7 TI - Late results of the Warm Heart Trial: the influence of nonfatal cardiac events on late survival. PG - III339-45 AB - BACKGROUND: The Warm Heart Trial randomized 1732 CABG patients to receive warm or cold blood cardioplegia. In the warm cardioplegia patients, nonfatal perioperative cardiac events were significantly decreased and the mortality rate was nonsignificantly decreased (1. 4% versus 2.5%, P:=0.12). The purpose of the present study was to evaluate the late results of these trial patients. METHODS AND RESULTS: Randomization was stratified according to surgeon and urgency of the operation. Seven hundred sixty-two patients recruited from 1 of the centers were followed through the hospital clinic for late events. Late survival (including perioperative deaths) at 72 months was nonsignificantly greater in the warm cardioplegia patients (94.5+/-1.7%, mean+/-SEM) than in the cold cardioplegia patients (90.9+/-2.6%). Independent predictors of mortality by Cox proportional hazards model were redo CABG, diabetes mellitus, renal insufficiency, and increasing age. The influence of nonfatal perioperative events (perioperative myocardial infarction according to computerized ECG readings or low output syndrome as determined by an outcome committee) on late survival was also analyzed. Late survival at 84 months was significantly reduced in the group who experienced nonfatal perioperative outcomes (94.5+/-1.7% versus 84. 9+/-4.5%, P:<0.001) and remained a significant predictor after adjustment for other important variables (risk ratio 6.4, 95% CI 1. 87 to 8.73, P:<0.0001). CONCLUSIONS: Effective myocardial protection through either cold or warm blood cardioplegia is essential, because late survival is significantly reduced in patients with nonfatal perioperative cardiac outcomes. FAU - Fremes, S E AU - Fremes SE AD - Division of Cardiovascular Surgery of Sunnybrook and Women's College Health Sciences Centre, St Paul's Hospital, Toronto, Ontario, Canada. FAU - Tamariz, M G AU - Tamariz MG FAU - Abramov, D AU - Abramov D FAU - Christakis, G T AU - Christakis GT FAU - Sever, J Y AU - Sever JY FAU - Sykora, K AU - Sykora K FAU - Goldman, B S AU - Goldman BS FAU - Feindel, C M AU - Feindel CM FAU - Lichtenstein, S V AU - Lichtenstein SV LA - eng PT - Clinical Trial PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - United States TA - Circulation JT - Circulation JID - 0147763 RN - 0 (Cardioplegic Solutions) SB - IM MH - Cardioplegic Solutions/*administration & dosage MH - *Coronary Artery Bypass/adverse effects/mortality MH - Electrocardiography MH - Female MH - Follow-Up Studies MH - Heart Arrest, Induced/*methods MH - Humans MH - Intraoperative Complications MH - Male MH - Middle Aged MH - Postoperative Complications MH - Proportional Hazards Models MH - Risk Assessment MH - Survival Rate/trends MH - Temperature MH - Time MH - Treatment Outcome EDAT- 2000/11/18 11:00 MHDA- 2001/02/28 10:01 CRDT- 2000/11/18 11:00 PHST- 2000/11/18 11:00 [pubmed] PHST- 2001/02/28 10:01 [medline] PHST- 2000/11/18 11:00 [entrez] AID - 10.1161/01.cir.102.suppl_3.iii-339 [doi] PST - ppublish SO - Circulation. 2000 Nov 7;102(19 Suppl 3):III339-45. doi: 10.1161/01.cir.102.suppl_3.iii-339. PMID- 11009262 OWN - NLM STAT- MEDLINE DCOM- 20001005 LR - 20190622 IS - 0002-9149 (Print) IS - 0002-9149 (Linking) VI - 86 IP - 5 DP - 2000 Sep 1 TI - Impact of end-stage renal disease on clinical and angiographic outcomes after coronary stenting. PG - 485-9 AB - Although patients with end-stage renal disease (ESRD) are at high risk for restenosis that requires repeat revascularization after balloon angioplasty, their restenosis rate after coronary stenting is still unknown. Over a 4-year period, we performed coronary stenting on 40 lesions in 34 patients with ESRD. We compared these lesions with 80 lesions from patients without renal disease who underwent coronary stenting in the STARS and WINS clinical trials, matched for treatment site, diabetes, lesion length, and reference vessel diameter. Quantitative coronary angiography was performed on all lesions and clinical outcomes were assessed at 9-month follow-up. Clinical and angiographic characteristics were well matched between the 2 groups and acute clinical success rates were similar. Despite comparable initial angiographic results over the 9-month follow-up period, repeat target lesion revascularization was twice as frequent in the ESRD group compared with the control group (35% vs 16%, p <0.05). After adjusting for differences in postprocedural minimum lumen diameter and other angiographic and clinical characteristics, ESRD remained the most important predictor of late target lesion revascularization (relative risk = 2.3, p = 0.04). In addition, overall 9-month mortality was higher for ESRD patients than for the control population (18% vs 2%, p <0.01). Thus, despite similar angiographic results, patients with ESRD are at higher risk for target lesion revascularization after coronary stenting than controls. Nonetheless, most patients with ESRD do not develop restenosis after stent placement, suggesting an important role for stenting in the management of this challenging population. FAU - Azar, R R AU - Azar RR AD - Cardiovascular Division, Beth Israel Deaconess Medical Center, and Brigham and Women's Hospital, Boston, Massachusetts 02215, USA. FAU - Prpic, R AU - Prpic R FAU - Ho, K K AU - Ho KK FAU - Kiernan, F J AU - Kiernan FJ FAU - Shubrooks, S J Jr AU - Shubrooks SJ Jr FAU - Baim, D S AU - Baim DS FAU - Popma, J J AU - Popma JJ FAU - Kuntz, R E AU - Kuntz RE FAU - Cohen, D J AU - Cohen DJ LA - eng PT - Clinical Trial PT - Comparative Study PT - Controlled Clinical Trial PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM MH - Aged MH - Angioplasty, Balloon, Coronary MH - Coronary Angiography MH - Coronary Disease/complications/diagnostic imaging/*therapy MH - Disease-Free Survival MH - Female MH - Follow-Up Studies MH - Humans MH - Kidney Failure, Chronic/*complications MH - Male MH - Middle Aged MH - Recurrence MH - *Stents MH - Treatment Outcome EDAT- 2000/09/29 11:00 MHDA- 2000/10/07 11:01 CRDT- 2000/09/29 11:00 PHST- 2000/09/29 11:00 [pubmed] PHST- 2000/10/07 11:01 [medline] PHST- 2000/09/29 11:00 [entrez] AID - S0002-9149(00)00998-X [pii] AID - 10.1016/s0002-9149(00)00998-x [doi] PST - ppublish SO - Am J Cardiol. 2000 Sep 1;86(5):485-9. doi: 10.1016/s0002-9149(00)00998-x. PMID- 10985707 OWN - NLM STAT- MEDLINE DCOM- 20000926 LR - 20190708 IS - 0735-1097 (Print) IS - 0735-1097 (Linking) VI - 36 IP - 3 Suppl A DP - 2000 Sep TI - The clinical profile of patients with suspected cardiogenic shock due to predominant left ventricular failure: a report from the SHOCK Trial Registry. SHould we emergently revascularize Occluded Coronaries in cardiogenic shocK? PG - 1071-6 AB - OBJECTIVES: We sought to evaluate the frequency of pulmonary congestion and associated clinical and hemodynamic findings in patients with suspected cardiogenic shock (CS). BACKGROUND: The prevalence of pulmonary congestion in the setting of CS is uncertain. METHODS: The 571 SHOCK Trial Registry patients with predominant left ventricular failure (LVF) were divided into four groups: Group A = no pulmonary congestion/no hypoperfusion = 14 (3%), Group B = isolated pulmonary congestion = 32 (6%), Group C = isolated hypoperfusion = 158 (28%) and Group D = congestion with hypoperfusion = 367 (64%). Statistical comparisons between Group C and D only, with regard to patient demographics, hemodynamics, treatment and outcome, were made. RESULTS: A significant proportion of patients with shock had no pulmonary congestion (Group C = 28%, 95% CI, 24% to 31%). Age and gender in this group were similar to Group D. Group C patients were less likely to have a prior MI (p = 0.028), congestive heart failure (p = 0.005) and renal insufficiency (p = 0.032), and the index MI was less likely to be anterior (p = 0.044). Cardiac output, cardiac index and ejection fraction were similar for the two groups but pulmonary capillary wedge pressure was slightly lower for Group C (22 vs. 24 mm Hg, p = 0.012). Treatment with thrombolysis, angioplasty and bypass surgery was similar in the two groups. In-hospital mortality rates for Groups C and D were 70% and 60%, respectively (p = 0.036). After adjustment, this difference was no longer statistically significant (p = 0.153). CONCLUSIONS: Absence of pulmonary congestion at initial clinical evaluation does not exclude a diagnosis of CS due to predominant LVF and is not associated with a better prognosis. FAU - Menon, V AU - Menon V AD - Division of Cardiology, St. Luke's-Roosevelt Hospital Center, Columbia University, New York, New York 10025, USA. Vmenon@aol.com FAU - White, H AU - White H FAU - LeJemtel, T AU - LeJemtel T FAU - Webb, J G AU - Webb JG FAU - Sleeper, L A AU - Sleeper LA FAU - Hochman, J S AU - Hochman JS LA - eng GR - R01 HL49970/HL/NHLBI NIH HHS/United States GR - R01 HL50020-018Z/HL/NHLBI NIH HHS/United States PT - Clinical Trial PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, U.S. Gov't, P.H.S. PL - United States TA - J Am Coll Cardiol JT - Journal of the American College of Cardiology JID - 8301365 RN - 0 (Cardiotonic Agents) RN - 0 (Vasoconstrictor Agents) SB - IM MH - Aged MH - Blood Pressure MH - Cardiac Catheterization MH - Cardiotonic Agents/therapeutic use MH - Coronary Angiography MH - Female MH - Heart Failure/*complications/diagnosis/physiopathology/therapy MH - Hospital Mortality MH - Humans MH - Hypotension/complications/etiology/physiopathology MH - Intra-Aortic Balloon Pumping MH - Male MH - Middle Aged MH - Myocardial Infarction/complications/diagnosis/therapy MH - Myocardial Revascularization MH - Prospective Studies MH - Pulmonary Wedge Pressure MH - *Registries MH - Shock, Cardiogenic/*etiology/mortality/physiopathology/therapy MH - Thrombolytic Therapy MH - Vasoconstrictor Agents/therapeutic use MH - Ventricular Dysfunction, Left/*complications/diagnosis/physiopathology/therapy EDAT- 2000/09/14 11:00 MHDA- 2000/09/30 11:01 CRDT- 2000/09/14 11:00 PHST- 2000/09/14 11:00 [pubmed] PHST- 2000/09/30 11:01 [medline] PHST- 2000/09/14 11:00 [entrez] AID - S0735-1097(00)00874-3 [pii] AID - 10.1016/s0735-1097(00)00874-3 [doi] PST - ppublish SO - J Am Coll Cardiol. 2000 Sep;36(3 Suppl A):1071-6. doi: 10.1016/s0735-1097(00)00874-3. PMID- 10845815 OWN - NLM STAT- MEDLINE DCOM- 20000629 LR - 20191210 IS - 1523-6838 (Electronic) IS - 0272-6386 (Linking) VI - 35 IP - 6 DP - 2000 Jun TI - Survival after acute myocardial infarction in patients with end-stage renal disease: results from the cooperative cardiovascular project. PG - 1044-51 AB - Cardiovascular disease (CVD) is the most common cause of death in patients with end-stage renal disease (ESRD). The optimal management strategy in this population is unknown. We studied 640 patients with ESRD and acute myocardial infarction during 1994 to 1995 as part of the Health Care Financing Administration's Cooperative Cardiovascular Project. The majority of patients were treated with medical therapy alone, 46 patients (7%) were treated with percutaneous transluminal coronary angioplasty (PTCA), and 29 patients (5%) underwent coronary artery bypass grafting (CABG). Patient characteristics and comorbid conditions were similar among the three groups. The overall 1-year mortality rate was 53%. Advanced age, low or high body mass index, history of peripheral vascular disease or stroke, the inability to walk independently, and several indicators of cardiac dysfunction were associated with an increased relative risk (RR) for death. Survival curves differed significantly by treatment modality, with 1-year survival rates of 45%, 54%, and 69% in the medical therapy alone, PTCA, and CABG groups, respectively (P = 0.03). After adjustment for confounding variables, the RR for death was less (but not significantly so) in the CABG group (RR, 0.6; 95% confidence interval, 0.3 to 1.1). There are no randomized clinical trial data to guide therapy of CVD in patients with ESRD. On the basis of these and other available data, CABG may be the optimal therapy for CVD in ESRD. In light of the exceptionally poor outcomes observed for patients treated with medical therapy alone, it may be premature to dismiss PTCA as a therapeutic option in this population. FAU - Chertow, G M AU - Chertow GM AD - Division of Nephrology, Moffitt-Long Hospitals and UCSF-Mount Zion Medical Center, Department of Medicine, University of California San Francisco, San Francisco, CA, USA. chertowg@medicine.ucsf.edu FAU - Normand, S L AU - Normand SL FAU - Silva, L R AU - Silva LR FAU - McNeil, B J AU - McNeil BJ LA - eng GR - HS06503/HS/AHRQ HHS/United States GR - HS08071/HS/AHRQ HHS/United States PT - Journal Article PT - Research Support, U.S. Gov't, P.H.S. PL - United States TA - Am J Kidney Dis JT - American journal of kidney diseases : the official journal of the National Kidney Foundation JID - 8110075 SB - IM CIN - Am J Kidney Dis. 2000 Jun;35(6):1217-20. doi: 10.1016/s0272-6386(00)70061-8. PMID: 10845838 MH - Age Factors MH - Aged MH - Analysis of Variance MH - Angioplasty, Balloon, Coronary/statistics & numerical data MH - Body Mass Index MH - Centers for Medicare and Medicaid Services, U.S. MH - Cohort Studies MH - Comorbidity MH - Confidence Intervals MH - Confounding Factors, Epidemiologic MH - Coronary Artery Bypass/statistics & numerical data MH - Female MH - Follow-Up Studies MH - Humans MH - Kidney Failure, Chronic/*epidemiology MH - Male MH - Multivariate Analysis MH - Myocardial Infarction/drug therapy/*mortality/surgery MH - Peripheral Vascular Diseases/epidemiology MH - Proportional Hazards Models MH - Risk Factors MH - Stroke/epidemiology MH - Survival Rate MH - Treatment Outcome MH - United States/epidemiology MH - Walking EDAT- 2000/06/10 00:00 MHDA- 2000/07/06 00:00 CRDT- 2000/06/10 00:00 PHST- 2000/06/10 00:00 [pubmed] PHST- 2000/07/06 00:00 [medline] PHST- 2000/06/10 00:00 [entrez] AID - S0272-6386(00)70038-2 [pii] AID - 10.1016/s0272-6386(00)70038-2 [doi] PST - ppublish SO - Am J Kidney Dis. 2000 Jun;35(6):1044-51. doi: 10.1016/s0272-6386(00)70038-2. PMID- 10773561 OWN - NLM STAT- MEDLINE DCOM- 20000620 LR - 20260128 IS - 1010-7940 (Print) IS - 1010-7940 (Linking) VI - 17 IP - 4 DP - 2000 Apr TI - Coronary surgery in Europe: comparison of the national subsets of the European system for cardiac operative risk evaluation database. PG - 396-9 AB - OBJECTIVE: To compare the national samples of patients who underwent isolated coronary artery bypass grafting (CABG) during the European System for Cardiac Operative Risk Evaluation (EuroSCORE) trial in order to evaluate national differences in epidemiology, patient risk profile and surgical methods. METHODS: From September to November 1995, 11731 patients had CABG in the six largest contributing nations to the EuroSCORE project: Germany, UK, Spain, Finland, France and Italy. The Chi-square and Kruskal-Wallis tests were applied to obtain an international comparison of patient general status, including pre-operative risk factors, cardiac status, critical pre-operative states, rare conditions, urgency of surgery, angina status, coronary lesions, procedures and EuroSCORE risk assessment. RESULTS: Large national samples (from 984 patients in Finland to 3138 in Germany) identified significant differences in epidemiology, risk profile and surgical practice. Regarding epidemiology, CABG accounted for 62.8% of adult cardiac surgery, with a range of 46.2 in Spain to 77.7% in Finland (P<0.001). The mean age was 62.9 years (61.4 in Britain to 64.4 in France, P<0.001). The mean body mass index was 26.8 (26 in France to 27.5 in Finland, P<0.001). With regard to risk profile, diabetes was present in 20.3% of patients (11.8% in Britain to 27.7% in Spain, P<0.001). Chronic renal failure was present in 8.3% (6.8% in Germany to 10.6% in Spain, P<0.001). Chronic airway disease affected 3.8% (1.9% in Italy to 5. 1% in Germany, P<0.001). The mean ejection fraction was 0.56 (0.48 in Britain to 0.58 in Finland, P<0.001). The mean predicted mortality (according to EuroSCORE) was 3.3% (2.8% in Finland to 3.6% in France, P<0.001). The prevalence of chronic congestive heart failure, unstable angina and recent myocardial infarction also showed statistically significant differences. No differences were found for some critical preoperative states (such as immediate preoperative cardiac massage and pre-operative intubation), or for surgery for catheter laboratory complication. Regarding surgical practice, major differences were noted in preoperative intra-aortic balloon use (mean 1%, Finland 0%, Spain 2.3%, P<0.001), the number of mammary artery conduits used (mean 0.9, Spain 0.7, France 1.1, P=0.0001) and the number of distal anastomoses (mean 3, France 2.7, Finland 3.8, P=0.001). CONCLUSION: There are important epidemiological differences in the national cohorts of CABG patients in the EuroSCORE database. Any international comparison of European surgical results must therefore take into account the risk profile of patients by using a compatible risk stratification system. FAU - Nashef, S A AU - Nashef SA AD - Papworth Hospital, Cambridge, UK. sam.nashef@papworth-tr.anglox.nhs.uk FAU - Roques, F AU - Roques F FAU - Michel, P AU - Michel P FAU - Cortina, J AU - Cortina J FAU - Faichney, A AU - Faichney A FAU - Gams, E AU - Gams E FAU - Harjula, A AU - Harjula A FAU - Jones, M T AU - Jones MT LA - eng PT - Comparative Study PT - Journal Article PL - Germany TA - Eur J Cardiothorac Surg JT - European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery JID - 8804069 SB - IM MH - Aged MH - Chi-Square Distribution MH - Coronary Artery Bypass/standards/*trends MH - Coronary Disease/*epidemiology/*surgery MH - *Databases, Factual MH - Europe/epidemiology MH - Evaluation Studies as Topic MH - Female MH - Humans MH - Male MH - Middle Aged MH - Prognosis MH - Registries MH - Reproducibility of Results MH - Risk Assessment MH - Risk Factors MH - Sampling Studies MH - Survival Analysis MH - United Kingdom/epidemiology EDAT- 2000/04/25 09:00 MHDA- 2000/06/24 11:00 CRDT- 2000/04/25 09:00 PHST- 2000/04/25 09:00 [pubmed] PHST- 2000/06/24 11:00 [medline] PHST- 2000/04/25 09:00 [entrez] AID - S1010-7940(00)00380-8 [pii] AID - 10.1016/s1010-7940(00)00380-8 [doi] PST - ppublish SO - Eur J Cardiothorac Surg. 2000 Apr;17(4):396-9. doi: 10.1016/s1010-7940(00)00380-8. PMID- 10740135 OWN - NLM STAT- MEDLINE DCOM- 20000601 LR - 20190626 IS - 0002-8703 (Print) IS - 0002-8703 (Linking) VI - 139 IP - 4 DP - 2000 Apr TI - Patient-specific dosing of IIb/IIIa antagonists during acute coronary syndromes: rationale and design of the PARAGON B study. The PARAGON B International Steering Committee. PG - 563-6 AB - BACKGROUND: Acute coronary syndromes, the leading cause of hospitalizations among adults, are frequently the sequelae of atherothrombotic events associated with coronary arterial plaque rupture. Beyond the usual antithrombotic therapies (aspirin and heparin), potent antiplatelet agents, glycoprotein IIb/IIIa receptor antagonists, have been shown to improve patient outcome. Lamifiban is a short-acting, renally excreted IIb/IIIa antagonist that was found in post hoc analyses of the Platelet IIb/IIIa Antagonism for the Reduction of Acute Coronary Syndrome Events in a Global Organization Network (PARAGON A) study to reduce the 30-day incidence of death or myocardial infarction by 40% when plasma concentrations of 18 to 42 ng/mL were achieved. METHODS AND RESULTS: To determine if lamifiban, dosed according to creatinine clearance, could decrease the rates of death, myocardial infarction, or refractory ischemia, a randomized, double-blind, placebo-controlled trial was undertaken. In 26 countries, 5228 patients seen within 12 hours of symptom onset of a non-ST-elevation acute coronary syndrome were randomly assigned to placebo or lamifiban bolus and infusion. CONCLUSION: The plasma concentration of small-molecule IIb/IIIa inhibitors is strongly influenced by renal function, and renal-specific dosing of these agents may improve outcome among patients with acute coronary syndromes. The PARAGON B trial is testing this hypothesis. FAU - Moliterno, D J AU - Moliterno DJ AD - Department of Cardiology and C (Cleveland Clinic Cardiovascular Coordinating Center), The Cleveland Clinic Foundation, Cleveland, OH 44195, USA. molited@ccf.org LA - eng PT - Clinical Trial PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 RN - 0 (Acetates) RN - 0 (Platelet Aggregation Inhibitors) RN - 0 (Platelet Glycoprotein GPIIb-IIIa Complex) RN - 42HK56048U (Tyrosine) RN - 9XOE28082S (lamifiban) SB - IM MH - Acetates/*administration & dosage/adverse effects MH - Adult MH - Aged MH - Cohort Studies MH - Coronary Artery Disease/diagnosis/*drug therapy/mortality MH - Dose-Response Relationship, Drug MH - Double-Blind Method MH - Drug Administration Schedule MH - Electrocardiography/drug effects MH - Female MH - Humans MH - Infusions, Intravenous MH - Male MH - Middle Aged MH - Myocardial Infarction/diagnosis/*drug therapy/mortality MH - Myocardial Revascularization MH - Platelet Aggregation Inhibitors/*administration & dosage/adverse effects MH - Platelet Glycoprotein GPIIb-IIIa Complex/*antagonists & inhibitors MH - Survival Rate MH - Tyrosine/administration & dosage/adverse effects/*analogs & derivatives EDAT- 2000/03/31 09:00 MHDA- 2000/06/03 09:00 CRDT- 2000/03/31 09:00 PHST- 2000/03/31 09:00 [pubmed] PHST- 2000/06/03 09:00 [medline] PHST- 2000/03/31 09:00 [entrez] AID - S0002-8703(00)90031-0 [pii] AID - 10.1016/s0002-8703(00)90031-0 [doi] PST - ppublish SO - Am Heart J. 2000 Apr;139(4):563-6. doi: 10.1016/s0002-8703(00)90031-0. PMID- 10426831 OWN - NLM STAT- MEDLINE DCOM- 19990826 LR - 20190626 IS - 0002-8703 (Print) IS - 0002-8703 (Linking) VI - 138 IP - 2 Pt 1 DP - 1999 Aug TI - Long-term oral platelet glycoprotein IIb/IIIa receptor antagonism with sibrafiban after acute coronary syndromes: study design of the sibrafiban versus aspirin to yield maximum protection from ischemic heart events post-acute coronary syndromes (SYMPHONY) trial. Symphony Steering Committee. PG - 210-8 AB - BACKGROUND: Despite progress, atherosclerotic vascular disease remains a major cause of morbidity and mortality. Intravenous therapy with platelet glycoprotein (GP) IIb/IIIa receptor antagonists improves outcome in patients with acute coronary syndromes (ACS). Whether potent long-term antiplatelet therapy with oral GP IIb/IIIa antagonists will further improve outcome at a dose that is tolerable in long-term treatment is unknown. TRIAL DESIGN: SYMPHONY (Sibrafiban versus aspirin to Yield Maximum Protection from ischemic Heart events post-acute cOroNary syndromes) was a randomized, double-blind, aspirin-controlled trial with 2 concentration regimens of sibrafiban, an oral peptidomimetic GP IIb/IIIa antagonist, for long-term treatment instead of aspirin in patients after an ACS. Patients were eligible for SYMPHONY if they presented within 7 days of an ACS (>/=20 minutes of ischemic symptoms), had been clinically stable for at least 12 hours, and met one of the following inclusion criteria: ST-segment depression or elevation of at least 0.5 mm or new left bundle branch block with the ACS or elevated creatinine kinase MB more than the upper limit of normal and >3% of total creatine kinase or, if creatine kinase MB was not measured, an elevated level of troponin T or I. Approximately 9000 patients post ACS were randomized 1:1:1 to treatment with either aspirin (80 mg every 12 hours) or high-dose or low-dose sibrafiban every 12 hours. Assignment of tablet strength (3, 4.5, or 6 mg) within the sibrafiban arms was based on body weight and renal function to achieve a target steady-state plasma concentration. The duration of study drug therapy was 90 days. Patients who had intracoronary stenting during the course of the study initially received a blinded stent medication assignment for 2 to 4 weeks based on their initial randomization as follows: aspirin/ticlopidine 250 mg twice daily, low-dose sibrafiban/ticlopidine placebo twice daily, and high-dose sibrafiban/ticlopidine placebo twice daily. After the second interim safety assessment by the Data and Safety Monitoring Board the stent regimen for the low-dose group was modified to include ticlopidine 250 mg twice daily. END POINTS: The primary efficacy end point of SYMPHONY was the 90-day incidence of a composite of all-cause mortality, myocardial infarction or reinfarction, and severe recurrent ischemia. A clinical events classification committee was established to determine the end points of reinfarction and severe recurrent ischemia. The primary safety end points were the incidence of major bleeding or minor bleeding and the combined incidence of major and minor bleeding. Bleeding classification was done by computer algorithm. Tolerability was assessed by the rate of study drug discontinuation from bleeding. FAU - Newby, L K AU - Newby LK AD - Duke Clinical Research Institute, Durham, NC 27715, USA. LA - eng PT - Comparative Study PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 RN - 0 (Oximes) RN - 0 (Piperidines) RN - 0 (Platelet Aggregation Inhibitors) RN - 0 (Platelet Glycoprotein GPIIb-IIIa Complex) RN - 0 (Prodrugs) RN - R16CO5Y76E (Aspirin) RN - YUE443B0NF (sibrafiban) SB - IM MH - Angina, Unstable/*drug therapy MH - Aspirin/therapeutic use MH - Clinical Trials, Phase III as Topic MH - Double-Blind Method MH - Humans MH - Myocardial Infarction/*drug therapy MH - Oximes/*administration & dosage/therapeutic use MH - Piperidines/*administration & dosage/therapeutic use MH - Platelet Aggregation Inhibitors/*administration & dosage/therapeutic use MH - Platelet Glycoprotein GPIIb-IIIa Complex/*antagonists & inhibitors MH - Prodrugs/administration & dosage/therapeutic use MH - Randomized Controlled Trials as Topic MH - Research Design MH - Syndrome MH - Treatment Outcome EDAT- 1999/07/30 00:00 MHDA- 1999/07/30 00:01 CRDT- 1999/07/30 00:00 PHST- 1999/07/30 00:00 [pubmed] PHST- 1999/07/30 00:01 [medline] PHST- 1999/07/30 00:00 [entrez] AID - S0002870399000083 [pii] AID - 10.1016/s0002-8703(99)70104-3 [doi] PST - ppublish SO - Am Heart J. 1999 Aug;138(2 Pt 1):210-8. doi: 10.1016/s0002-8703(99)70104-3. PMID- 10411250 OWN - NLM STAT- MEDLINE DCOM- 19990831 LR - 20170214 IS - 0267-6591 (Print) IS - 0267-6591 (Linking) VI - 14 IP - 3 DP - 1999 May TI - Effect of low-dose methyl prednisolone on serum cytokine levels following extracorporeal circulation. PG - 201-6 AB - The systemic inflammatory response to cardiopulmonary bypass (CPB) is associated with increased production of cytokines. This systemic inflammatory response characterized by the activation of interleukin-6 (IL-6) and interleukin-8 (IL-8) during and after CPB is well documented. A prospective, randomized, double-blind study was performed so as to understand the effects of low-dose methyl prednisolone sodium succinate (MPSS) on the circulating levels of serum cytokines and clinical outcome. Twenty patients were randomly divided into two groups on the basis of the administration of low-dose (1 mg/kg) MPSS (n = 10) and placebo (n = 10) into the pump prime solution. All patients were scheduled to undergo a primary elective coronary artery bypass grafting operation. Patients receiving concurrent corticosteroids, salicylates, dipyridamol or anticoagulants were excluded from the study. Other exclusion criteria were concurrent chronic obstructive pulmonary disease, chronic renal failure, insulin-dependent diabetes, congestive cardiac failure, peptic ulcer history, prior cardiac operations, recent (in a one-month period) myocardial infarction and steroid dependency. Mild systemic hypothermia (30-32 degrees C, rectal) was assured during the CPB. Four blood samples were drawn from the radial artery catheter immediately before starting CPB (T1), following protamine administration (T2) and at 24 (T3) and 48 h (T4) after completion of CPB. In each sample, creatine kinase-myocardial band (CK-MB), white blood cell (WBC), IL-6 and IL-8 levels were measured. IL-6 and IL-8 concentrations were measured by enzyme immunoassay and enzyme-linked immunoabsorbant assay methods. Serum IL-6 T2 and serum IL-6 T3 levels were significantly higher than IL-6 T1 levels in both groups (p < 0.001) and (p < 0.01), and there was no significant elevation in serum IL-8 levels in either group. Serum IL-6 levels were significantly higher in the placebo group than in the MPSS group at T3 (p < 0.009). There was no significant difference in CK-MB T1 levels between the groups. Although there was no significant difference between CK-MB T1 and T2 levels in the MPSS group, the CK-MB T2 and CK-MB T3 levels were significantly higher than T1 levels in the placebo group (p < 0.001) and (p < 0.05). There was significant elevation of WBC levels at T2 and T3 in both groups without notable difference between the groups (p < 0.05). This study has shown that low-dose MPSS suppresses CPB-induced inflammatory response. Further clinical studies (on larger and higher risk groups) may reveal more information on relations between morbidity and cytokine levels which may have some predictive value on clinical outcome following CPB. FAU - Yilmaz, M AU - Yilmaz M AD - Department of Cardiovascular Surgery, Uludag University Medical Faculty, Bursa, Turkey. mertyilmaz@superonline.com FAU - Ener, S AU - Ener S FAU - Akalin, H AU - Akalin H FAU - Sagdic, K AU - Sagdic K FAU - Serdar, O A AU - Serdar OA FAU - Cengiz, M AU - Cengiz M LA - eng PT - Clinical Trial PT - Journal Article PT - Randomized Controlled Trial PL - England TA - Perfusion JT - Perfusion JID - 8700166 RN - 0 (Anti-Inflammatory Agents) RN - 0 (Cytokines) RN - X4W7ZR7023 (Methylprednisolone) SB - IM MH - Adult MH - Anti-Inflammatory Agents/*administration & dosage MH - Cardiopulmonary Bypass/*adverse effects MH - Cytokines/*blood MH - Female MH - Humans MH - Male MH - Methylprednisolone/*administration & dosage MH - Middle Aged MH - Postoperative Complications/blood/*prevention & control MH - Systemic Inflammatory Response Syndrome/*blood/etiology/prevention & control EDAT- 1999/07/20 00:00 MHDA- 1999/07/20 00:01 CRDT- 1999/07/20 00:00 PHST- 1999/07/20 00:00 [pubmed] PHST- 1999/07/20 00:01 [medline] PHST- 1999/07/20 00:00 [entrez] AID - 10.1177/026765919901400308 [doi] PST - ppublish SO - Perfusion. 1999 May;14(3):201-6. doi: 10.1177/026765919901400308. PMID- 10385771 OWN - NLM STAT- MEDLINE DCOM- 19990729 LR - 20191210 IS - 0002-8703 (Print) IS - 0002-8703 (Linking) VI - 138 IP - 1 Pt 1 DP - 1999 Jul TI - Self-reported differences between cardiologists and heart failure specialists in the management of chronic heart failure. PG - 100-7 AB - BACKGROUND: Heart failure (HF) is responsible for considerable mortality morbidity rates and resource utilization. Recently, several studies have reported improved outcomes when patients are managed by special HF clinics, but it is uncertain whether this improvement reflects differences in physician practices or other aspects of the operation of these clinics. OBJECTIVES: This study was designed to identify differences in HF management practices between general cardiologists and cardiologists specializing in the treatment of patients with HF. METHODS: A survey examining diagnostic and treatment practices in patients with HF was sent to a sample of cardiologists derived from the American Medical Association Masterfile and to HF specialists who were members of the Society of Transplant Cardiologists or principal investigators in HF trials. Responses were examined in relation to guidelines issued by the Agency for Health care Policy and Research released 9 months previously. RESULTS: In general both groups practice in conformity with published guidelines. However, there were important differences between the practice patterns of general cardiologists and HF specialists. For instance, in patients being evaluated for the first time, cardiologists reported using a chest radiograph to assist in the diagnosis more than did HF specialists (47% vs 12%), whereas HF specialists were more likely to use an echocardiogram (73% vs 48%). Both groups were likely to evaluate their patients for ischemia and possible revascularization, even in patients not having angina. However, HF specialists tended to use coronary angiography as the initial diagnostic test, whereas cardiologists were more likely to use stress testing. HF specialists more often used angiotensin-converting enzyme inhibitors as part of their initial therapy in patients with mild to moderate HF (94% vs 86%) and during maintenance therapy (91% vs 80%). Also, HF specialists were more likely than cardiologists to titrate angiotensin-converting enzyme inhibitors to higher doses (75% vs 35%), even in the presence of renal dysfunction. CONCLUSION: Cardiologists and HF specialists generally manage their patients in conformity with guidelines. However, in many areas, such as angiotensin-converting enzyme inhibitor use, HF specialists do so more aggressively. These approaches may, in part, explain the success of the HF clinic model and raise the possibility that some portion of the HF population may be more optimally managed by cardiologists with a special interest in and additional training or experience with this condition. FAU - Bello, D AU - Bello D AD - Department of Medicine and Cardiovascular Research Institute of the University of California, San Francisco, USA. FAU - Shah, N B AU - Shah NB FAU - Edep, M E AU - Edep ME FAU - Tateo, I M AU - Tateo IM FAU - Massie, B M AU - Massie BM LA - eng PT - Journal Article PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 SB - IM CIN - Am Heart J. 1999 Jul;138(1 Pt 1):14-6. doi: 10.1016/s0002-8703(99)70238-3. PMID: 10385756 MH - Adult MH - Cardiology/*statistics & numerical data MH - Case Management MH - Confounding Factors, Epidemiologic MH - Female MH - *Heart Failure/diagnosis/therapy MH - Humans MH - Male MH - Middle Aged MH - Practice Patterns, Physicians'/*statistics & numerical data MH - Severity of Illness Index MH - Specialization/statistics & numerical data MH - Surveys and Questionnaires MH - United States EDAT- 1999/07/01 00:00 MHDA- 1999/07/01 00:01 CRDT- 1999/07/01 00:00 PHST- 1999/07/01 00:00 [pubmed] PHST- 1999/07/01 00:01 [medline] PHST- 1999/07/01 00:00 [entrez] AID - S0002-8703(99)70253-X [pii] AID - 10.1016/s0002-8703(99)70253-x [doi] PST - ppublish SO - Am Heart J. 1999 Jul;138(1 Pt 1):100-7. doi: 10.1016/s0002-8703(99)70253-x. PMID- 10212709 OWN - NLM STAT- MEDLINE DCOM- 19990616 LR - 20190319 IS - 0310-057X (Print) IS - 0310-057X (Linking) VI - 27 IP - 2 DP - 1999 Apr TI - Clonidine and cardiac surgery: haemodynamic and metabolic effects, myocardial ischaemia and recovery. PG - 137-47 AB - Clonidine may have beneficial effects in patients undergoing major surgery. We enrolled 156 patients having elective CABG surgery in a double-blind, randomized trial. Patients were randomized to receive either two doses of placebo (Group PP) or clonidine 5 micrograms/kg (Group CC). Perioperative measurements included haemodynamics, anaesthetic and analgesic drug usage, creatinine clearance, cortisol excretion, recovery times and quality of life (SF-36) after surgery. Overall, there was no significant difference with time to tracheal extubation (median [10-90 centile]): CC 7.1 (3.4-18) h vs PP 8.0 (4.3-17) h, P = 0.70; but there was a higher proportion of patients extubated within four hours: CC 20% vs. PP 8%, P = 0.038. Clonidine resulted in a number of significant (P < 0.05) haemodynamic changes, particularly pre-CPB: less tachycardia and hypertension, more bradycardia and hypotension. Clonidine was associated with a significant (P < 0.05) reduction in anaesthetic drug usage, higher creatinine clearance, lower cortisol excretion and improvement in some aspects of quality of life. This study lends support to consideration of clonidine therapy in patients undergoing CABG surgery. FAU - Myles, P S AU - Myles PS AD - Department of Anaesthesia, Alfred Hospital, Melbourne, Victoria. FAU - Hunt, J O AU - Hunt JO FAU - Holdgaard, H O AU - Holdgaard HO FAU - McRae, R AU - McRae R FAU - Buckland, M R AU - Buckland MR FAU - Moloney, J AU - Moloney J FAU - Hall, J AU - Hall J FAU - Bujor, M A AU - Bujor MA FAU - Esmore, D S AU - Esmore DS FAU - Davis, B B AU - Davis BB FAU - Morgan, D J AU - Morgan DJ LA - eng PT - Clinical Trial PT - Journal Article PT - Randomized Controlled Trial PL - United States TA - Anaesth Intensive Care JT - Anaesthesia and intensive care JID - 0342017 RN - 0 (Adrenergic alpha-Agonists) RN - 0 (Anesthetics, Intravenous) RN - AYI8EX34EU (Creatinine) RN - MN3L5RMN02 (Clonidine) RN - WI4X0X7BPJ (Hydrocortisone) RN - YI7VU623SF (Propofol) SB - IM MH - Adrenergic alpha-Agonists/pharmacology/*therapeutic use MH - Aged MH - Anesthetics, Intravenous MH - Clonidine/pharmacology/*therapeutic use MH - *Coronary Artery Bypass MH - Creatinine/metabolism MH - Double-Blind Method MH - Female MH - Hemodynamics/*drug effects MH - Humans MH - Hydrocortisone/urine MH - Hypertension/drug therapy MH - Intraoperative Complications/prevention & control MH - Male MH - Myocardial Ischemia/*prevention & control MH - Oxygen Consumption/drug effects MH - Postoperative Complications/prevention & control MH - Propofol/administration & dosage MH - Prospective Studies MH - Quality of Life MH - Tachycardia/drug therapy EDAT- 1999/04/23 00:00 MHDA- 1999/04/23 00:01 CRDT- 1999/04/23 00:00 PHST- 1999/04/23 00:00 [pubmed] PHST- 1999/04/23 00:01 [medline] PHST- 1999/04/23 00:00 [entrez] AID - 1998250 [pii] AID - 10.1177/0310057X9902700202 [doi] PST - ppublish SO - Anaesth Intensive Care. 1999 Apr;27(2):137-47. doi: 10.1177/0310057X9902700202. PMID- 10077374 OWN - NLM STAT- MEDLINE DCOM- 19990430 LR - 20190513 IS - 1010-7940 (Print) IS - 1010-7940 (Linking) VI - 15 IP - 1 DP - 1999 Jan TI - Tolerance to ACE inhibitors after cardiac surgery. PG - 55-60 AB - OBJECTIVES: Several studies have shown angiotensin-converting enzyme (ACE) inhibitors to confer significant mortality and morbidity benefits in heart failure. First-dose hypotension may necessitate interruption of such therapy. This is more likely to occur if the ACE inhibitor is administered early after coronary artery bypass grafting (CABG). The purpose of this study was to analyse the haemodynamic tolerance to early post-operative treatment with perindopril and enalapril in patients with impaired renal and ventricular function. METHODS: Eighty one consecutive CABG patients with a previous myocardial infarction, impaired pre-operative left ventricular ejection fraction (LVEF) on ventriculography and moderately impaired renal function (serum creatinine of 115-150 micromol/l) were randomised into three groups to receive oral placebo, perindopril (4 mg) or enalapril (5 mg) once daily. Groups were subdivided into those with mild ventricular dysfunction (LVEF = 35-65%, n = 20) and significant ventricular dysfunction (LVEF < 35%, n = 7). Exclusion criteria included oliguria (<0.5 ml/kg per h) or inotrope dependance at the point of entry on the first post-operative day. Intolerance to ACE inhibitor was defined as hypotension (<95 mmHg systolic blood pressure or a decrease exceeding 25 mmHg in systolic blood pressure) leading to oliguria (<0.5 ml/kg per h) which was unresponsive to intravenous furosemide (20 mg). In such cases ACE inhibitor treatment was discontinued and patients commenced on dopamine. RESULTS: In the groups with mild ventricular dysfunction (LVEF = 35-65%) perindopril was discontinued in 1/20 and enalapril in 4/20 patients (P = n.s). However, in the groups with significant ventricular dysfunction (LVEF < 35%) perindopril was discontinued in 2/7 and enalapril in 7/7 patients (P = 0.02). CONCLUSION: Our results suggest that after CABG, patients with moderately impaired renal function and significant ventricular dysfunction do not tolerate ACE inhibitors well when these were commenced on the first post-operative day. However, perindopril was associated with less haemodynamic deterioration than enalapril and consequently may be advantageous in this setting. rights reserved. FAU - Manche, A AU - Manche A AD - Department of Cardiothoracic Surgery, St. Luke's Hospital, Guardamangia, Malta. FAU - Galea, J AU - Galea J FAU - Busuttil, W AU - Busuttil W LA - eng PT - Clinical Trial PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial PL - Germany TA - Eur J Cardiothorac Surg JT - European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery JID - 8804069 RN - 0 (Angiotensin-Converting Enzyme Inhibitors) RN - 0 (Indoles) RN - 69PN84IO1A (Enalapril) RN - Y5GMK36KGY (Perindopril) SB - IM MH - Administration, Oral MH - Angiotensin-Converting Enzyme Inhibitors/*adverse effects MH - *Coronary Artery Bypass MH - Drug Hypersensitivity/*physiopathology MH - Enalapril/adverse effects MH - Feasibility Studies MH - Follow-Up Studies MH - Heart Failure/*drug therapy/etiology/physiopathology MH - Hemodynamics/*drug effects MH - Humans MH - Indoles/adverse effects MH - Length of Stay MH - Middle Aged MH - Myocardial Infarction/complications/*surgery MH - Perindopril MH - Prognosis MH - Renal Insufficiency/*drug therapy/etiology EDAT- 1999/03/17 00:00 MHDA- 1999/03/17 00:01 CRDT- 1999/03/17 00:00 PHST- 1999/03/17 00:00 [pubmed] PHST- 1999/03/17 00:01 [medline] PHST- 1999/03/17 00:00 [entrez] AID - S101079409800253X [pii] AID - 10.1016/s1010-7940(98)00253-x [doi] PST - ppublish SO - Eur J Cardiothorac Surg. 1999 Jan;15(1):55-60. doi: 10.1016/s1010-7940(98)00253-x. PMID- 10063952 OWN - NLM STAT- MEDLINE DCOM- 19990422 LR - 20190921 IS - 0886-0440 (Print) IS - 0886-0440 (Linking) VI - 13 IP - 2 DP - 1998 Mar TI - Comparison of risk profile and outcomes in patients undergoing surgical and catheter-based revascularization. PG - 81-9; discussion 90-2 AB - BACKGROUND: The effects of the randomized revascularization trials and improved strategies and techniques for coronary artery bypass graft (CABG) surgery and percutaneous transluminal catheter-based revascularization (PTCR) on current patient selection and clinical outcomes are unknown. METHODS: We evaluated a concurrent, contemporary (1995 to 1997), and consecutive group of patients undergoing CABG (n = 982) or PTCR (n = 939) in a single institution that participated in the Bypass Angioplasty Revascularization Investigation (BARI) trial. Results are presented as percent or mean +/- SD. Compared to PTCR, patients undergoing CABG were older (66.2+/-10.7 vs. 62.0+/-11.8 years, p<0.05) with a higher incidence of hypertension (73.3% vs. 52.4%, p<0.05), diabetes (32.5% vs. 23.1%, p<0.05), active smoking (67.8% vs. 27.2%, p<0.05), prior myocardial infarction (MI)(66.8% vs. 28.5%, p<0.05), peripheral vascular disease (19.8% vs. 7.7%, p<0.05), prior cerebrovascular accident (CVA)/transient ischemic attack (TIA) (6.4% vs. 2.8%, p<0.05), and a lower ejection fraction (48.7%+/-14.5% vs. 55.3%+/-11.7%, p<0.05). The presenting functional class and incidence of female gender were similar for both revascularization strategies. RESULTS: Compared to patients undergoing CABG, those undergoing PTCR were more likely to have single or two vessel coronary artery disease (88.6% vs. 23.1%, p<0.001) and had fewer vessels revascularized per patient (1.08+/-0.30 vs. 3.5+/-0.98, p<0.001). Outcomes were comparable for CABG and PTCR with a similar incidence of death (1.0% vs. 0.9%, NS), renal insufficiency (0.7% vs. 0.6%, NS), and CVA/TIA (0.9% vs. 0.3%, NS). Patients undergoing CABG had a higher incidence of pulmonary complications (5.2% vs. 1.0%, p<0.05), a lower incidence of periprocedural MI (1.1% vs. 4.1%, p<0.05) and major complication (5.9% vs. 9.4%, p<0.05), but longer hospital stays (6.5+/-5.1 vs. 3.1+/-2.6 days, p<0.05). CONCLUSIONS: Despite higher clinical and angiographic risk profiles in patients undergoing CABG, clinical results, morbidity, and mortality were comparable to those of PTCR. With evolving techniques, continued reevaluation of indications and outcomes are necessary. FAU - Aldea, G S AU - Aldea GS AD - The Department of Cardiothoracic Surgery, Boston University School of Medicine, Boston University Medical Center, Massachusetts 02117-2393, USA. FAU - Gaudiani, J A AU - Gaudiani JA FAU - Shapira, O M AU - Shapira OM FAU - O'Gara, P AU - O'Gara P FAU - Bao, Y AU - Bao Y FAU - Lazar, H L AU - Lazar HL FAU - Shemin, R J AU - Shemin RJ LA - eng PT - Comparative Study PT - Journal Article PL - United States TA - J Card Surg JT - Journal of cardiac surgery JID - 8908809 SB - IM MH - Aged MH - *Angioplasty, Balloon, Coronary MH - *Coronary Artery Bypass MH - Coronary Disease/*therapy MH - Female MH - Humans MH - Length of Stay MH - Logistic Models MH - Male MH - Middle Aged MH - Myocardial Infarction/therapy MH - Prospective Studies MH - Risk Assessment MH - Risk Factors MH - Stents MH - Treatment Outcome EDAT- 1999/03/04 00:00 MHDA- 1999/03/04 00:01 CRDT- 1999/03/04 00:00 PHST- 1999/03/04 00:00 [pubmed] PHST- 1999/03/04 00:01 [medline] PHST- 1999/03/04 00:00 [entrez] AID - 10.1111/j.1540-8191.1998.tb01238.x [doi] PST - ppublish SO - J Card Surg. 1998 Mar;13(2):81-9; discussion 90-2. doi: 10.1111/j.1540-8191.1998.tb01238.x. PMID- 10049195 OWN - NLM STAT- MEDLINE DCOM- 19990225 LR - 20221207 IS - 0003-4819 (Print) IS - 0003-4819 (Linking) VI - 130 IP - 3 DP - 1999 Feb 2 TI - Use of cardiovascular procedures among black persons and white persons: a 7-year nationwide study in patients with renal disease. PG - 173-82 AB - BACKGROUND: Black persons historically undergo fewer invasive cardiovascular procedures than white persons. OBJECTIVE: To determine whether acquisition of Medicare health insurance and comprehensive care for severe illness reduce ethnic disparity in use of cardiovascular procedures. DESIGN: 7-year longitudinal analyses in a cohort from the United States Renal Data System. SETTING: Health care institutions in the United States. PATIENTS: Nationwide random sample of 4987 adult black and white patients with incident end-stage renal disease (ESRD) from 303 dialysis facilities in 1986 to 1987. MEASUREMENTS: Medical history and service use records, physical examination, and laboratory data. Main outcome measures were receipt of a coronary catheterization or revascularization procedure before (baseline) and after (follow-up) development of ESRD and acquisition of Medicare, adjusted for clinical and socioeconomic variables. RESULTS: At baseline, 9.9% of white patients and 2.8% of black patients had had a cardiac procedure; the odds were almost three times greater in white than in black patients (adjusted odds ratio, 2.92 [95% CI, 2.04 to 4.18]). During follow-up, white patients were only 1.4 times more likely than black patients to have a procedure (adjusted relative risk, 1.41 [CI, 1.13 to 1.77]); rates were 7.8% for white persons and 8.5% for black persons. In patients with Medicare coverage before development of ESRD, the initial three-fold difference in procedure use was eliminated over follow-up (odds ratio, 1.05 [CI, 0.56 to 1.60]). For procedures after hospital admission for myocardial infarction or coronary disease, no difference between ethnic groups was seen during follow-up (relative risk, 1.12 [CI, 0.68 to 1.85]). CONCLUSIONS: Differences between ethnic groups in use of cardiovascular procedures narrowed markedly once a serious illness (ESRD) developed and adequate insurance coverage was ensured; the disparity was eliminated in patients with previous Medicare insurance or a stronger indication for a procedure. These findings suggest that almost equal access to care is attainable by combining insurance with delivery of comprehensive, clinically appropriate care. FAU - Daumit, G L AU - Daumit GL AD - Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. FAU - Hermann, J A AU - Hermann JA FAU - Coresh, J AU - Coresh J FAU - Powe, N R AU - Powe NR LA - eng GR - 5T32HLO7024/HL/NHLBI NIH HHS/United States GR - R01DK47797/DK/NIDDK NIH HHS/United States PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Research Support, U.S. Gov't, P.H.S. PL - United States TA - Ann Intern Med JT - Annals of internal medicine JID - 0372351 SB - IM CIN - Ann Intern Med. 1999 Feb 2;130(3):231-3. doi: 10.7326/0003-4819-130-3-199902020-00028. PMID: 10049202 MH - Adult MH - *Black or African American/statistics & numerical data MH - Angioplasty/*statistics & numerical data MH - Cardiac Catheterization/*statistics & numerical data MH - Cardiovascular Diseases/complications/diagnosis/*ethnology/therapy MH - Coronary Artery Bypass/*statistics & numerical data MH - Data Interpretation, Statistical MH - Disease Progression MH - Humans MH - Insurance, Health MH - Kidney Failure, Chronic/*complications/therapy MH - Longitudinal Studies MH - Middle Aged MH - Myocardial Revascularization MH - Socioeconomic Factors MH - *White People/statistics & numerical data EDAT- 1999/02/27 03:15 MHDA- 2000/09/08 11:01 CRDT- 1999/02/27 03:15 PHST- 1999/02/27 03:15 [pubmed] PHST- 2000/09/08 11:01 [medline] PHST- 1999/02/27 03:15 [entrez] AID - 199902020-00002 [pii] AID - 10.7326/0003-4819-130-3-199902020-00002 [doi] PST - ppublish SO - Ann Intern Med. 1999 Feb 2;130(3):173-82. doi: 10.7326/0003-4819-130-3-199902020-00002. PMID- 9973020 OWN - NLM STAT- MEDLINE DCOM- 19990302 LR - 20220410 IS - 0735-1097 (Print) IS - 0735-1097 (Linking) VI - 33 IP - 2 DP - 1999 Feb TI - A prospective randomized trial of prevention measures in patients at high risk for contrast nephropathy: results of the P.R.I.N.C.E. Study. Prevention of Radiocontrast Induced Nephropathy Clinical Evaluation. PG - 403-11 AB - OBJECTIVES: This study was done to test the hypothesis that a forced diuresis with maintenance of intravascular volume after contrast exposure would reduce the rate of contrast-induced renal injury. BACKGROUND: We have previously shown a graded relationship with the degree of postprocedure renal failure and the probability of in-hospital death in patients undergoing percutaneous coronary intervention. Earlier studies of singular prevention strategies (atrial natriuretic factor, loop diuretics, dopamine, mannitol) have shown no clear benefit across a spectrum of patients at risk. METHODS: A prospective, randomized, controlled, single-blind trial was conducted where 98 participants were randomized to forced diuresis with intravenous crystalloid, furosemide, mannitol (if pulmonary capillary wedge pressure <20 mm Hg), and low-dose dopamine (n = 43) versus intravenous crystalloid and matching placebos (n = 55). RESULTS: The groups were similar with respect to baseline serum creatinine (2.44+/-0.80 and 2.55+/-0.91 mg/dl), age, weight, diabetic status, left ventricular function, degree of prehydration, contrast volume and ionicity, and extent of peripheral vascular disease. The forced diuresis resulted in higher urine flow rate (163.26+/-54.47 vs. 122.57+/-54.27 ml/h) over the 24 h after contrast exposure (p = 0.001). Two participants in the experimental arm versus five in the control arm required dialysis, with all seven cases having measured flow rates <145 ml/h in the 24 h after the procedure. The mean individual change in serum creatinine at 48 h, the primary end point, was 0.48+/-0.86 versus 0.51+/-0.87, in the experimental and control arms, respectively, p = 0.87. There were no differences in the rates of renal failure across six definitions of renal failure by intent-to-treat analysis. However, in all participants combined, the rise in serum creatinine was related to the degree of induced diuresis after controlling for baseline renal function, r = -0.36, p = 0.005. The rates of renal failure in those with urine flow rates greater than 150 ml/h in the postprocedure period were significantly lower, 8/37 (21.6%) versus 28/61 (45.9%), p = 0.03. CONCLUSIONS: Forced diuresis with intravenous crystalloid, furosemide, and mannitol if hemodynamics permit, beginning at the start of angiography provides a modest benefit against contrast-induced nephropathy provided a high urine flow rate can be achieved. FAU - Stevens, M A AU - Stevens MA AD - William Beaumont Hospital, Royal Oak, Michigan, USA. FAU - McCullough, P A AU - McCullough PA FAU - Tobin, K J AU - Tobin KJ FAU - Speck, J P AU - Speck JP FAU - Westveer, D C AU - Westveer DC FAU - Guido-Allen, D A AU - Guido-Allen DA FAU - Timmis, G C AU - Timmis GC FAU - O'Neill, W W AU - O'Neill WW LA - eng PT - Clinical Trial PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - United States TA - J Am Coll Cardiol JT - Journal of the American College of Cardiology JID - 8301365 RN - 0 (Cardiotonic Agents) RN - 0 (Contrast Media) RN - 0 (Crystalloid Solutions) RN - 0 (Diuretics) RN - 0 (Isotonic Solutions) RN - 0 (Plasma Substitutes) RN - 0 (Rehydration Solutions) RN - 3OWL53L36A (Mannitol) RN - 7LXU5N7ZO5 (Furosemide) RN - AYI8EX34EU (Creatinine) RN - VTD58H1Z2X (Dopamine) SB - IM MH - Aged MH - Cardiotonic Agents/administration & dosage/therapeutic use MH - Contrast Media/*adverse effects MH - Coronary Angiography MH - Coronary Disease/diagnostic imaging MH - Creatinine/blood MH - Crystalloid Solutions MH - Diuresis MH - Diuretics/administration & dosage/*therapeutic use MH - Dopamine/administration & dosage/therapeutic use MH - Drug Therapy, Combination MH - Female MH - Follow-Up Studies MH - Furosemide/administration & dosage/therapeutic use MH - Humans MH - Isotonic Solutions MH - Kidney Diseases/blood/chemically induced/*prevention & control MH - Male MH - Mannitol/administration & dosage/therapeutic use MH - Plasma Substitutes/administration & dosage/therapeutic use MH - Prospective Studies MH - Pulmonary Wedge Pressure MH - Rehydration Solutions/administration & dosage/therapeutic use MH - Risk Factors MH - Single-Blind Method MH - Treatment Outcome EDAT- 1999/02/11 00:00 MHDA- 1999/02/11 00:01 CRDT- 1999/02/11 00:00 PHST- 1999/02/11 00:00 [pubmed] PHST- 1999/02/11 00:01 [medline] PHST- 1999/02/11 00:00 [entrez] AID - S0735109798005749 [pii] AID - 10.1016/s0735-1097(98)00574-9 [doi] PST - ppublish SO - J Am Coll Cardiol. 1999 Feb;33(2):403-11. doi: 10.1016/s0735-1097(98)00574-9. PMID- 9645829 OWN - NLM STAT- MEDLINE DCOM- 19980709 LR - 20190812 IS - 0003-9926 (Print) IS - 0003-9926 (Linking) VI - 158 IP - 12 DP - 1998 Jun 22 TI - Diuretic-based treatment and cardiovascular events in patients with mild renal dysfunction enrolled in the systolic hypertension in the elderly program. PG - 1340-5 AB - BACKGROUND: It is expected that the treatment of hypertension in patients with renal disease decreases the risk of cardiovascular events, but the evidence in these patients is lacking. OBJECTIVE: To assess the effect of diuretic-based treatment on cardiovascular events in patients with isolated systolic hypertension and renal dysfunction. METHODS: A total of 4336 persons aged 60 years and older with systolic blood pressures of 160 mm Hg and higher and diastolic blood pressures of less than 90 mm Hg were randomly assigned to receive either placebo or chlorthalidone (12.5-25.0 mg/d), with the addition of atenolol (25-50 mg/d) or reserpine (0.05-0.10 mg/d) if needed, and observed for 5 years. The risk of first-occurring cardiovascular events, including stroke, transient ischemic attack, myocardial infarction, heart failure, coronary artery bypass surgery, angioplasty, aneurysm, endarterectomy, sudden death, or rapid death, was stratified according to baseline serum creatinine levels (35.4-84.0, 84.1-101.6, 101.7-119.3, and 119.4-212.2 micromol/L [0.4-0.9, 1.0-1.1, 1.2-1.3, and 1.4-2.4 mg/dL]). RESULTS: Systolic blood pressure reduction was not affected by baseline serum creatinine levels. Active treatment did not affect the risk of serum creatinine levels becoming elevated during follow-up. The risk of hypokalemia with active treatment decreased significantly with increasing baseline serum creatinine levels. In the 4 baseline serum creatinine groups, the relative risk (95% confidence interval) of cardiovascular events developing with active treatment was 0.73 (0.54-0.97), 0.63 (0.49-0.82), 0.62 (0.44-0.87), and 0.59 (0.38-0.91). The results were similar for the outcomes of stroke or coronary artery events and in analyses stratified by sex or age. CONCLUSION: Diuretic-based treatment of patients with isolated systolic hypertension prevents the development of cardiovascular events in older persons with mild renal dysfunction. FAU - Pahor, M AU - Pahor M AD - Department of Preventive Medicine, University of Tennessee, College of Medicine, Memphis 38105, USA. mpahor@utmem1.utmem.edu FAU - Shorr, R I AU - Shorr RI FAU - Somes, G W AU - Somes GW FAU - Cushman, W C AU - Cushman WC FAU - Ferrucci, L AU - Ferrucci L FAU - Bailey, J E AU - Bailey JE FAU - Elam, J T AU - Elam JT FAU - Applegate, W B AU - Applegate WB LA - eng PT - Clinical Trial PT - Journal Article PT - Randomized Controlled Trial PL - United States TA - Arch Intern Med JT - Archives of internal medicine JID - 0372440 RN - 0 (Diuretics) RN - AYI8EX34EU (Creatinine) RN - RWP5GA015D (Potassium) SB - IM MH - Aged MH - Cardiovascular Diseases/blood/etiology/*prevention & control MH - Creatinine/*blood MH - Diuretics/*therapeutic use MH - Female MH - Humans MH - Hypertension/blood/*complications/*drug therapy MH - Kidney Failure, Chronic/blood/*complications MH - Male MH - Middle Aged MH - Odds Ratio MH - Potassium/blood MH - Severity of Illness Index MH - Systole MH - Treatment Outcome EDAT- 1998/06/30 00:00 MHDA- 1998/06/30 00:01 CRDT- 1998/06/30 00:00 PHST- 1998/06/30 00:00 [pubmed] PHST- 1998/06/30 00:01 [medline] PHST- 1998/06/30 00:00 [entrez] AID - 10.1001/archinte.158.12.1340 [doi] PST - ppublish SO - Arch Intern Med. 1998 Jun 22;158(12):1340-5. doi: 10.1001/archinte.158.12.1340. PMID- 9588408 OWN - NLM STAT- MEDLINE DCOM- 19980519 LR - 20220330 IS - 0002-8703 (Print) IS - 0002-8703 (Linking) VI - 135 IP - 5 Pt 1 DP - 1998 May TI - Randomized, controlled trial of RheothRx (poloxamer 188) in patients with suspected acute myocardial infarction. RheothRx in Myocardial Infarction Study Group. PG - 797-804 AB - BACKGROUND: Patients with acute myocardial infarction (AMI) who are not eligible for thrombolytic therapy or primary coronary angioplasty are distinguished by advanced age, complicated medical histories, relatively frequent use of prior revascularization procedures, and worse outcomes than their counterparts who are eligible for reperfusion therapy. METHODS AND RESULTS: The purpose of this randomized, controlled trial was to determine whether RheothRx, a hemorheologic agent, reduced myocardial infarct size and improved left ventricular function in patients who had suspected AMI at the time of hospital admission and were not eligible for reperfusion therapy. Patients were randomly assigned to RheothRx (n = 97) or placebo (n = 99). Patients in the two groups were similar with respect to age, sex, medical history, and clinical presentation. Enzyme evidence of AMI was present in 69% of the treatment group and 70% of the placebo group. Infarct size measured before hospital discharge was similar in the two groups (14.1% +/- 18.5% vs 11.7% +/- 14.1%, p = 0.60), although left ventricular ejection fraction was lower in the treatment group (47 +/- 14 vs 52 +/- 11, p = 0.026). Hospital mortality rate was 11.3% and 7.1% in patients receiving RheothRx and patients receiving placebo, respectively (p = 0.30). There was a higher occurrence of acute renal dysfunction in the RheothRx group (12% vs 2%, p = 0.005). Because of changes in drug dosage necessitated by the occurrence of acute renal dysfunction, the trial was stopped. CONCLUSIONS: In this study of patients who had suspected AMI and were not eligible for thrombolytic therapy, RheothRx did not decrease infarct size or favorably alter outcome. The need for effective treatment for this large patient population remains largely unmet. FAU - Maynard, C AU - Maynard C AD - Department of Medicine, University of Washington School of Medicine, Seattle, USA. FAU - Swenson, R AU - Swenson R FAU - Paris, J A AU - Paris JA FAU - Martin, J S AU - Martin JS FAU - Hallstrom, A P AU - Hallstrom AP FAU - Cerqueira, M D AU - Cerqueira MD FAU - Weaver, W D AU - Weaver WD LA - eng PT - Clinical Trial PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - United States TA - Am Heart J JT - American heart journal JID - 0370465 RN - 0 (Fibrinolytic Agents) RN - 9003-11-6 (Poloxalene) SB - IM MH - Acute Kidney Injury/chemically induced MH - Coronary Circulation/drug effects MH - Electrocardiography/drug effects MH - Fibrinolytic Agents/adverse effects/*therapeutic use MH - Follow-Up Studies MH - Humans MH - Infusions, Intravenous MH - Kidney Function Tests MH - Myocardial Infarction/*drug therapy MH - Poloxalene/adverse effects/*therapeutic use MH - Stroke Volume/drug effects MH - Treatment Failure MH - Treatment Outcome MH - Ventricular Function, Left/drug effects EDAT- 1998/05/20 00:00 MHDA- 1998/05/20 00:01 CRDT- 1998/05/20 00:00 PHST- 1998/05/20 00:00 [pubmed] PHST- 1998/05/20 00:01 [medline] PHST- 1998/05/20 00:00 [entrez] AID - S000287039800252X [pii] AID - 10.1016/s0002-8703(98)70037-7 [doi] PST - ppublish SO - Am Heart J. 1998 May;135(5 Pt 1):797-804. doi: 10.1016/s0002-8703(98)70037-7. PMID- 9468207 OWN - NLM STAT- MEDLINE DCOM- 19980306 LR - 20190623 IS - 0009-7322 (Print) IS - 0009-7322 (Linking) VI - 97 IP - 4 DP - 1998 Feb 3 TI - Randomized trial of an oral platelet glycoprotein IIb/IIIa antagonist, sibrafiban, in patients after an acute coronary syndrome: results of the TIMI 12 trial. Thrombolysis in Myocardial Infarction. PG - 340-9 AB - BACKGROUND: Inhibitors of the platelet glycoprotein IIb/IIIa receptor given intravenously have been shown to be effective in reducing ischemic complications after coronary angioplasty and in unstable angina, making this a promising new class of agents for the treatment and prevention of ischemic events in patients with acute coronary syndromes. Sibrafiban (Ro 48-3657) is an oral, peptidomimetic, selective antagonist of the glycoprotein IIb/IIIa receptor. METHODS AND RESULTS: The Thrombolysis in Myocardial Infarction (TIMI) 12 trial was a phase II, double-blind, dose-ranging trial designed to evaluate the pharmacokinetics (PK), pharmacodynamics (PD), safety, and tolerability of sibrafiban in 329 patients after acute coronary syndromes. In the PK/PD cohort of TIMI 12, 106 patients were randomized to receive one of seven dosing regimens of sibrafiban, ranging from 5 mg daily to 10 mg twice daily for 28 days. In the safety cohort, 223 patients were randomized to one of four dose regimens of sibrafiban (ranging from 5 mg twice daily to 15 mg once daily) or aspirin for 28 days. High levels of platelet inhibition were achieved: mean peak values ranged from 47% to 97% inhibition of 20 micromol/L ADP-induced platelet aggregation on day 28 across the seven doses. Twice-daily dosing provided more sustained platelet inhibition (mean inhibition, 36% to 86% on day 28), whereas platelet inhibition returned to baseline levels by 24 hours with once-daily dosing. Major hemorrhage occurred in 1.5% of patients treated with sibrafiban and in 1.9% of patients treated with aspirin. Protocol-defined "minor" bleeding, usually mucocutaneous, occurred in 0% to 32% of patients in the various sibrafiban groups and in none of the patients treated with aspirin. Minor bleeding was related to total daily dose (P=.002), once- versus twice-daily dosing (P<.0001), renal function (P<.0001), and presentation with unstable angina (P<.01). CONCLUSIONS: The oral glycoprotein IIb/IIIa antagonist sibrafiban achieved effective, long-term platelet inhibition with a clear dose-response but at the expense of a relatively high incidence of minor bleeding. Oral IIb/IIIa inhibition deserves further study as a new treatment strategy in patients after acute coronary syndromes. FAU - Cannon, C P AU - Cannon CP AD - Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass 02115, USA. FAU - McCabe, C H AU - McCabe CH FAU - Borzak, S AU - Borzak S FAU - Henry, T D AU - Henry TD FAU - Tischler, M D AU - Tischler MD FAU - Mueller, H S AU - Mueller HS FAU - Feldman, R AU - Feldman R FAU - Palmeri, S T AU - Palmeri ST FAU - Ault, K AU - Ault K FAU - Hamilton, S A AU - Hamilton SA FAU - Rothman, J M AU - Rothman JM FAU - Novotny, W F AU - Novotny WF FAU - Braunwald, E AU - Braunwald E LA - eng PT - Clinical Trial PT - Clinical Trial, Phase II PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - United States TA - Circulation JT - Circulation JID - 0147763 RN - 0 (Oximes) RN - 0 (Piperidines) RN - 0 (Platelet Aggregation Inhibitors) RN - 0 (Platelet Glycoprotein GPIIb-IIIa Complex) RN - YUE443B0NF (sibrafiban) SB - IM CIN - Circulation. 1998 Feb 3;97(4):312-4. doi: 10.1161/01.cir.97.4.312. PMID: 9468202 MH - Acute Disease MH - Administration, Oral MH - Aged MH - Cohort Studies MH - Coronary Disease/*drug therapy/physiopathology MH - Dose-Response Relationship, Drug MH - Double-Blind Method MH - Female MH - Hemorrhage/chemically induced MH - Humans MH - Male MH - Middle Aged MH - Oximes/*administration & dosage/adverse effects/therapeutic use MH - Piperidines/*administration & dosage/adverse effects/therapeutic use MH - Platelet Aggregation/drug effects MH - Platelet Aggregation Inhibitors/*administration & dosage/adverse effects/therapeutic use MH - Platelet Glycoprotein GPIIb-IIIa Complex/*antagonists & inhibitors MH - Recurrence EDAT- 1998/02/19 00:00 MHDA- 1998/02/19 00:01 CRDT- 1998/02/19 00:00 PHST- 1998/02/19 00:00 [pubmed] PHST- 1998/02/19 00:01 [medline] PHST- 1998/02/19 00:00 [entrez] AID - 10.1161/01.cir.97.4.340 [doi] PST - ppublish SO - Circulation. 1998 Feb 3;97(4):340-9. doi: 10.1161/01.cir.97.4.340. PMID- 9458450 OWN - NLM STAT- MEDLINE DCOM- 19980318 LR - 20220408 IS - 0195-668X (Print) IS - 0195-668X (Linking) VI - 18 IP - 9 DP - 1997 Sep TI - The 60 minutes myocardial infarction project. Treatment and clinical outcome of patients with acute myocardial infarction in Germany. PG - 1438-46 AB - AIMS: To describe patient characteristics, pre-hospital delay, treatment, complications and outcome in patients with acute myocardial infarction admitted to hospitals in Germany. METHODS AND RESULTS: The study was of prospective observational multicentre design. Those involved were consecutive patients with acute Q-wave myocardial infarction admitted within 96 h of onset of symptoms to 136 German hospitals between July 1992 and September 1994 (n = 14980, median age 66 (quartiles 57, 74) years, 68% male, 48% anterior wall infarction). Median pre-hospital delay was 170 (90, 475) min, with 17% arriving within the first hour and 61% within 4 h of onset of symptoms. The following patient groups had a short pre-hospital delay: males, those aged less than 65 years, those admitted at night or the weekend, those with a previous myocardial infarction, those in need of cardiopulmonary resuscitation, and those with a diagnostic first ECG. The first ECG was diagnostic in 67.6% of cases. Reperfusion therapy was used in 53%, with thrombolytic therapy in 51.6%. Median time from admission to initiation of treatment was 30 (20, 55) min. Respective rates of treatment with aspirin, nitrates, and beta-blockers were 81%, 83%, and 16%. Major complications were cerebral bleeding (0.4%), bleeding requiring transfusions (0.9%), left ventricular rupture (0.6%) and anaphylactic shock (0.1%). Median hospital stay was 20 (13, 26) days. In-hospital death rate was 17.2%. Increased hospital mortality was observed with female gender, an unknown or long pre-hospital delay, a diagnostic first ECG, anterior wall infarction, trauma or major operation within the last 14 days, renal insufficiency and malignoma. CONCLUSIONS: 'Real-life' hospital mortality is much higher than previously reported in clinical trials. To reduce hospital mortality, the efficacy of thrombolysis should be increased by shortening the pre-hospital delay, and the use of concomitant therapy, especially beta-blockers, should be increased. FAU - Rustige, J AU - Rustige J AD - Herzzentrum Ludwigshafen, Germany. FAU - Schiele, R AU - Schiele R FAU - Burczyk, U AU - Burczyk U FAU - Koch, A AU - Koch A FAU - Gottwik, M AU - Gottwik M FAU - Neuhaus, K L AU - Neuhaus KL FAU - Tebbe, U AU - Tebbe U FAU - Uebis, R AU - Uebis R FAU - Senges, J AU - Senges J LA - eng PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't PL - England TA - Eur Heart J JT - European heart journal JID - 8006263 SB - IM MH - Aged MH - Angioplasty, Balloon, Coronary MH - Female MH - Germany MH - Hospital Mortality MH - Humans MH - Male MH - Middle Aged MH - Multivariate Analysis MH - Myocardial Infarction/*drug therapy/mortality MH - *Myocardial Reperfusion MH - Prognosis MH - Prospective Studies MH - Registries MH - Survival Analysis MH - *Thrombolytic Therapy MH - Time Factors MH - Treatment Outcome EDAT- 1998/02/12 00:00 MHDA- 1998/02/12 00:01 CRDT- 1998/02/12 00:00 PHST- 1998/02/12 00:00 [pubmed] PHST- 1998/02/12 00:01 [medline] PHST- 1998/02/12 00:00 [entrez] AID - 10.1093/oxfordjournals.eurheartj.a015470 [doi] PST - ppublish SO - Eur Heart J. 1997 Sep;18(9):1438-46. doi: 10.1093/oxfordjournals.eurheartj.a015470. PMID- 9097484 OWN - NLM STAT- MEDLINE DCOM- 19970506 LR - 20141120 IS - 0010-6178 (Print) IS - 0010-6178 (Linking) VI - 61 IP - 3 DP - 1997 Mar TI - Minimally invasive coronary artery bypass grafting: initial Connecticut experience. PG - 135-41 AB - We report the initial Connecticut experience with minimally invasive coronary artery bypass grafting. This procedure allows bypass grafting to the left anterior descending coronary artery utilizing the internal mammary artery as the conduit. The procedure is minimally invasive because it is performed through a mini-thoracotomy incision in the fourth anterior intercostal space and it is conducted without the use of cardiopulmonary bypass. The procedure has been applied to 13 patients operated between February and October 1996. All but one patient selected were poor candidates for conventional coronary artery bypass surgery because of advanced age (6), chronic renal failure/dialysis/kidney transplant (4), redo status with vulnerable grafts (1), severe peripheral vascular disease (6), severe chronic obstructive pulmonary disease (4). All patients survived operation and were discharged in good condition. Mean postoperative intubation time was seven hours and mean hospital stay was 4.5 days despite the very high pre-existing comorbidity of these patients. All patients are alive at the current follow-up time. Two patients required a conventional bypass procedure for occlusion of the minimally invasive graft, the first because of diffuse disease in the target artery and the second attributable to the technical limitations of minimally invasive coronary artery bypass grafting; both tolerated the subsequent procedure well. All patients are now angina-free. All four grafts studied by routine postoperative angiography were widely patent. Routine post-operative exercise nuclear imaging was normal in an additional patient. This procedure of minimally invasive coronary artery bypass grafting offers significant advantages compared to the conventional bypass procedure (short hospital stay, quick recovery, and, especially, avoidance of cerebrovascular accidents caused by the heart-lung machine). This minimally invasive procedure is expected to apply to a growing percentage of patients. The procedure, especially vis-a-vis angioplasty, may well offer the superior long-term patency of the mammary conduit achieved with a modest initial "investment" in hospital stay, costs of medical care, and discomfort and disability. A prospective, randomized trial comparing angioplasty and minimally invasive coronary artery bypass grafting is warranted. FAU - Tellides, G AU - Tellides G AD - Section of Cardiothoracic Surgery, Yale University School of Medicine, New Haven, USA. FAU - Maragh, M R AU - Maragh MR FAU - Smith, J M AU - Smith JM FAU - Kopf, G S AU - Kopf GS FAU - Ezekowitz, M AU - Ezekowitz M FAU - Remetz, M AU - Remetz M FAU - Elefteriades, J A AU - Elefteriades JA LA - eng PT - Journal Article PL - United States TA - Conn Med JT - Connecticut medicine JID - 0372745 SB - IM MH - Aged MH - Aged, 80 and over MH - Coronary Artery Bypass/*methods MH - Female MH - Humans MH - Male MH - Middle Aged MH - Minimally Invasive Surgical Procedures/methods EDAT- 1997/03/01 00:00 MHDA- 1997/03/01 00:01 CRDT- 1997/03/01 00:00 PHST- 1997/03/01 00:00 [pubmed] PHST- 1997/03/01 00:01 [medline] PHST- 1997/03/01 00:00 [entrez] PST - ppublish SO - Conn Med. 1997 Mar;61(3):135-41. PMID- 8776643 OWN - NLM STAT- MEDLINE DCOM- 19961107 LR - 20190909 IS - 1053-0770 (Print) IS - 1053-0770 (Linking) VI - 10 IP - 4 DP - 1996 Jun TI - Effects of human atrial natriuretic peptide in patients after coronary artery bypass surgery. PG - 490-6 AB - OBJECTIVES: To determine the effects of synthetic human atrial natriuretic peptide (ANP) on renal function, hemodynamics, and levels of vasoactive peptides when infused in the immediate postoperative period after coronary bypass surgery in patients with normal kidney function. DESIGN: A prospective, randomized, double-blind, placebo-controlled study. SETTING: The Department of Cardiothoracic Anaesthetics and Intensive Care of a university hospital. PARTICIPANTS: Thirty patients with normal kidney function scheduled for elective coronary bypass surgery. INTERVENTIONS: During the first 3 hours postoperatively, patients received an infusion of either ANP 7.5 pMol/kg/min (ANP) or vehicle alone (C). MEASUREMENTS AND MAIN RESULTS: No differences were found between the two groups in respect to sex, degree of coronary disease, preoperative medical treatment, or duration of cardiopulmonary bypass and aortic occlusion. Plasma ANP levels increased nearly 10-fold from a mean of 7.0 +/- 1.1 pMol/L in ANP and remained at baseline levels in C, (p < 0.001). In ANP, there occurred significant increases in urine flow (p < 0.001), inulin clearance (p < 0.001), filtration fraction (p = 0.007), and fractional clearance of sodium (p < 0.001) and of osmoles (p < 0.001) compared with C. During the study, no differences in mean arterial pressure, heart rate, and right atrial or pulmonary capillary wedge pressure were detected between the groups. Cardiac index decreased by 5% in ANP compared with a 9% increase in C (p = 0.027). Vasopressin levels significantly increased in C but remained at baseline levels in ANP (p = 0.031). There were no changes in levels of catecholamines or angiotensin II. CONCLUSIONS: The results of this study show that ANP increases diuresis, natriuresis, and glomerular filtration in the immediate postoperative period after coronary bypass surgery. FAU - Bergman, A AU - Bergman A AD - Department of Anaesthesiology and Intensive Care, Karolinska Hospital, Stockholm, Sweden. FAU - Odar-Cederlof, I AU - Odar-Cederlof I FAU - Westman, L AU - Westman L FAU - Ohqvist, G AU - Ohqvist G LA - eng PT - Clinical Trial PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - United States TA - J Cardiothorac Vasc Anesth JT - Journal of cardiothoracic and vascular anesthesia JID - 9110208 RN - 85637-73-6 (Atrial Natriuretic Factor) SB - IM MH - Aged MH - Atrial Natriuretic Factor/*pharmacology MH - *Coronary Artery Bypass MH - Double-Blind Method MH - Female MH - Glomerular Filtration Rate/drug effects MH - Hemodynamics/drug effects MH - Humans MH - Kidney/*drug effects/physiopathology MH - Male MH - Middle Aged MH - Prospective Studies EDAT- 1996/06/01 00:00 MHDA- 1996/06/01 00:01 CRDT- 1996/06/01 00:00 PHST- 1996/06/01 00:00 [pubmed] PHST- 1996/06/01 00:01 [medline] PHST- 1996/06/01 00:00 [entrez] AID - S1053-0770(05)80010-2 [pii] AID - 10.1016/s1053-0770(05)80010-2 [doi] PST - ppublish SO - J Cardiothorac Vasc Anesth. 1996 Jun;10(4):490-6. doi: 10.1016/s1053-0770(05)80010-2. PMID- 7554207 OWN - NLM STAT- MEDLINE DCOM- 19951114 LR - 20190623 IS - 0009-7322 (Print) IS - 0009-7322 (Linking) VI - 92 IP - 8 DP - 1995 Oct 15 TI - A multicenter, double-blind, placebo-controlled trial of aprotinin for reducing blood loss and the requirement for donor-blood transfusion in patients undergoing repeat coronary artery bypass grafting. PG - 2236-44 AB - BACKGROUND: Aprotinin is a serine protease inhibitor that reduces blood loss and transfusion requirements when administered prophylactically to cardiac surgical patients. To examine the safety and dose-related efficacy of aprotinin, a prospective, multicenter, placebo-controlled trial was conducted in patients undergoing repeat coronary artery bypass graft (CABG) surgery. METHODS AND RESULTS: Two hundred eighty-seven patients were randomly assigned to receive either high-dose aprotinin, low-dose aprotinin, pump-prime-only aprotinin, or placebo. Drug efficacy was determined by the reduction in donor-blood transfusion up to postoperative day 12 and in postoperative thoracic-drainage volume. The percentage of patients requiring donor-red-blood-cell (RBC) transfusions in the high- and low-dose aprotinin groups was reduced compared with the pump-prime-only and placebo groups (high-dose aprotinin, 54%; low-dose aprotinin, 46%; pump-prime only, 72%; and placebo, 75%; overall P = .001). The number of units of donor RBCs transfused was significantly lower in the aprotinin-treated patients compared with placebo (high-dose aprotinin, 1.6 +/- 0.2 U; low-dose aprotinin, 1.6 +/- 0.3 U; pump-prime-only, 2.5 +/- 0.3 U; and placebo, 3.4 +/- 0.5 U; P = .0001). There was also a significant difference in total blood-product exposures among treatment groups (high-dose aprotinin, 2.2 +/- 0.4 U; low-dose aprotinin, 3.4 +/- 0.9 U; pump-prime-only, 5.1 +/- 0.9 U; placebo, 10.3 +/- 1.4 U). There were no differences among treatment groups for the incidence of perioperative myocardial infarction (MI). CONCLUSIONS: This study demonstrates that high- and low-dose aprotinin significantly reduces the requirement for donor-blood transfusion in repeat CABG patients without increasing the risk for perioperative MI. FAU - Levy, J H AU - Levy JH AD - Department of Anesthesiology, Emory University Hospital, Atlanta, GA 30322, USA. FAU - Pifarre, R AU - Pifarre R FAU - Schaff, H V AU - Schaff HV FAU - Horrow, J C AU - Horrow JC FAU - Albus, R AU - Albus R FAU - Spiess, B AU - Spiess B FAU - Rosengart, T K AU - Rosengart TK FAU - Murray, J AU - Murray J FAU - Clark, R E AU - Clark RE FAU - Smith, P AU - Smith P LA - eng PT - Clinical Trial PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - United States TA - Circulation JT - Circulation JID - 0147763 RN - 0 (Hemostatics) RN - 0 (Serine Proteinase Inhibitors) RN - 9087-70-1 (Aprotinin) SB - IM CIN - Circulation. 1996 Oct 1;94(7):1791-2. PMID: 8840885 MH - Aged MH - Aprotinin/*administration & dosage/adverse effects MH - Blood Loss, Surgical/*prevention & control MH - *Blood Transfusion MH - Blood Volume MH - *Coronary Artery Bypass MH - Dose-Response Relationship, Drug MH - Double-Blind Method MH - Female MH - Hemostatics/*administration & dosage/adverse effects MH - Humans MH - Incidence MH - Male MH - Middle Aged MH - Myocardial Infarction/epidemiology MH - Postoperative Complications/epidemiology MH - Prospective Studies MH - Renal Insufficiency/epidemiology MH - Reoperation MH - Risk Factors MH - Serine Proteinase Inhibitors/*administration & dosage/adverse effects EDAT- 1995/10/15 00:00 MHDA- 1995/10/15 00:01 CRDT- 1995/10/15 00:00 PHST- 1995/10/15 00:00 [pubmed] PHST- 1995/10/15 00:01 [medline] PHST- 1995/10/15 00:00 [entrez] AID - 10.1161/01.cir.92.8.2236 [doi] PST - ppublish SO - Circulation. 1995 Oct 15;92(8):2236-44. doi: 10.1161/01.cir.92.8.2236. PMID- 7475162 OWN - NLM STAT- MEDLINE DCOM- 19951128 LR - 20190913 IS - 0022-5223 (Print) IS - 0022-5223 (Linking) VI - 110 IP - 4 Pt 1 DP - 1995 Oct TI - Recombinant aprotinin in coronary artery bypass graft operations. PG - 963-70 AB - OBJECTIVE: To evaluate the role of recombinant bovine aprotinin in reducing blood loss in coronary artery bypass graft surgery. DESIGN: An open-label, randomized, controlled study evaluating two dosage levels of recombinant aprotinin. SETTING: Two acute care hospitals (Northwestern Memorial Hospital, Chicago, Ill., and the Scott & White Memorial Hospital, Temple, Texas). PATIENTS: Patients undergoing primary and reoperation coronary artery bypass grafting were assigned to groups by means of a computer-generated table of random numbers. Treated (n = 48) and control (n = 36) patients did not differ significantly in age, sex, weight, number of grafts, or preoperative hemoglobin level. INTERVENTIONS: Recombinant aprotinin was given at two dosages. Dosage level 1 consisted of a bolus of 2 mg/kg intravenously immediately after the induction of anesthesia, 1 mg/kg added to each liter of the oxygenator prime, and 0.5 mg.kg-1.hr-1 infused continuously during operation. At dosage level 2, doses were doubled. Intraoperative monitoring of anti-factor Xa activity was performed, and additional doses of heparin were given on the basis of anti-factor Xa results. MAIN OUTCOME MEASURES: Preoperative and postoperative hemoglobin levels, amounts of autotransfusion device and chest tube drainage blood, and transfusions of allogeneic red blood cells. Adverse clinical events (alterations in renal function, graft thrombosis, myocardial infarction, and death) were recorded. RESULTS: Additional heparin was given to 48% patients in the aprotinin group and to 44% of control patients. Overall red blood cell loss (in milliliters, mean +/- standard deviation [SD]) was decreased with aprotinin at dosage level 1 for reoperations (1040 +/- 162 vs 1544 +/- 198, p < 0.01), and at dosage level 2 for all operations (primary operations, 886 +/- 362 vs 1333 +/- 618, p = 0.02; reoperations, 1191 +/- 560 vs 1815 +/- 1116, p = 0.2). Fewer patients in the aprotinin than in the control group had transfusions of donated blood (6/48 vs 12/36, p = 0.02) or reinfusion of chest tube drainage blood (12/48 vs 20/36, p < 0.01). Among patients receiving dosage level 1, there were no myocardial infarctions or deaths. At dosage level 2, one patient had profound bradycardia and died on day 12 and two patients had late graft closures. Two control patients had hypotension after bypass necessitating intraaortic balloon pumps, and one of these patients died. Postoperative increases in blood urea nitrogen and creatinine levels were small in both aprotinin and control groups. No hypersensitivity or other allergic reactions occurred. CONCLUSION: We conclude that, at the dosages given, recombinant bovine aprotinin decreases surgical blood loss and transfusion requirements in patients undergoing coronary artery bypass grafting, but its use requires appropriate monitoring of heparin use during bypass. Whether higher dosages of aprotinin increase the risk of graft thrombosis must be further assessed with a larger patient sample. FAU - Green, D AU - Green D AD - Department of Medicine, Northwestern Memorial Hospital, Chicago, Ill., USA. FAU - Sanders, J AU - Sanders J FAU - Eiken, M AU - Eiken M FAU - Wong, C A AU - Wong CA FAU - Frederiksen, J AU - Frederiksen J FAU - Joob, A AU - Joob A FAU - Palmer, A AU - Palmer A FAU - Trowbridge, A AU - Trowbridge A FAU - Woodruff, B AU - Woodruff B FAU - Moerch, M AU - Moerch M AU - et al. LA - eng PT - Clinical Trial PT - Journal Article PT - Randomized Controlled Trial PL - United States TA - J Thorac Cardiovasc Surg JT - The Journal of thoracic and cardiovascular surgery JID - 0376343 RN - 0 (Factor Xa Inhibitors) RN - 0 (Recombinant Proteins) RN - 9005-49-6 (Heparin) RN - 9087-70-1 (Aprotinin) SB - IM MH - Aged MH - Aprotinin/*administration & dosage/adverse effects/therapeutic use MH - Blood Loss, Surgical/*prevention & control MH - Blood Transfusion MH - Blood Transfusion, Autologous MH - *Coronary Artery Bypass MH - Factor Xa Inhibitors MH - Female MH - Heparin/administration & dosage MH - Humans MH - Male MH - Middle Aged MH - Monitoring, Intraoperative MH - Postoperative Complications MH - Recombinant Proteins/administration & dosage/adverse effects MH - Reoperation EDAT- 1995/10/01 00:00 MHDA- 1995/10/01 00:01 CRDT- 1995/10/01 00:00 PHST- 1995/10/01 00:00 [pubmed] PHST- 1995/10/01 00:01 [medline] PHST- 1995/10/01 00:00 [entrez] AID - S002252239500345X [pii] AID - 10.1016/s0022-5223(05)80163-1 [doi] PST - ppublish SO - J Thorac Cardiovasc Surg. 1995 Oct;110(4 Pt 1):963-70. doi: 10.1016/s0022-5223(05)80163-1. PMID- 7637351 OWN - NLM STAT- MEDLINE DCOM- 19950912 LR - 20220409 IS - 0022-5223 (Print) IS - 0022-5223 (Linking) VI - 110 IP - 2 DP - 1995 Aug TI - A randomized study of the influence of perfusion technique and pH management strategy in 316 patients undergoing coronary artery bypass surgery. I. Mortality and cardiovascular morbidity. PG - 340-8 AB - The impact of perfusion technique and mode of pH management during cardiopulmonary bypass has not been well characterized with respect to postoperative cardiovascular outcome. METHODS: This double-blind, randomized study comparing outcomes after alpha-stat or pH-stat management and pulsatile or nonpulsatile perfusion during moderate hypothermic cardiopulmonary bypass was undertaken in 316 patients undergoing coronary artery bypass operations. RESULTS: Cardiovascular morbidity and mortality were not affected by pH management, and the incidence of stroke (2.5%) did not differ between groups. Overall in-hospital mortality was 2.8%, eight of the nine deaths occurring in the nonpulsatile group (5.1% versus 0.6%; p = 0.018). The incidence of myocardial infarction was 5.7% in the nonpulsatile group and 0.6% in the pulsatile group (p = 0.010), and use of intraaortic balloon pulsation was significantly more common in the nonpulsatile group (7.0% versus 1.9%; p = 0.029). The overall percentage of patients having major complications was also significantly higher in the nonpulsatile group (15.2% versus 5.7%; p = 0.006). Duration of cardiopulmonary bypass, age, and use of nonpulsatile perfusion all correlated significantly with adverse outcome. CONCLUSIONS: Use of pulsatile perfusion during cardiopulmonary bypass was associated with decreased incidences of myocardial infarction, death, and major complications. FAU - Murkin, J M AU - Murkin JM AD - Department of Anaesthesia, University Hospital, University of Western Ontario, London, Canada. FAU - Martzke, J S AU - Martzke JS FAU - Buchan, A M AU - Buchan AM FAU - Bentley, C AU - Bentley C FAU - Wong, C J AU - Wong CJ LA - eng PT - Clinical Trial PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - United States TA - J Thorac Cardiovasc Surg JT - The Journal of thoracic and cardiovascular surgery JID - 0376343 RN - 142M471B3J (Carbon Dioxide) SB - IM CIN - J Thorac Cardiovasc Surg. 1996 Apr;111(4):900-1. doi: 10.1016/s0022-5223(96)70355-0. PMID: 8614155 MH - Aged MH - Arrhythmias, Cardiac/etiology MH - Blood Pressure MH - Carbon Dioxide/*blood MH - Cardiopulmonary Bypass/adverse effects/*methods MH - Cerebrovascular Disorders/etiology MH - *Coronary Artery Bypass/adverse effects/mortality MH - Double-Blind Method MH - Female MH - Humans MH - Hydrogen-Ion Concentration MH - Intra-Aortic Balloon Pumping MH - Male MH - Middle Aged MH - Myocardial Infarction/etiology MH - Postoperative Care MH - *Postoperative Complications MH - Prospective Studies MH - Pulsatile Flow MH - Renal Insufficiency/etiology MH - Risk Factors EDAT- 1995/08/01 00:00 MHDA- 1995/08/01 00:01 CRDT- 1995/08/01 00:00 PHST- 1995/08/01 00:00 [pubmed] PHST- 1995/08/01 00:01 [medline] PHST- 1995/08/01 00:00 [entrez] AID - S0022-5223(95)70229-6 [pii] AID - 10.1016/S0022-5223(95)70229-6 [doi] PST - ppublish SO - J Thorac Cardiovasc Surg. 1995 Aug;110(2):340-8. doi: 10.1016/S0022-5223(95)70229-6. PMID- 7525162 OWN - NLM STAT- MEDLINE DCOM- 19941209 LR - 20190514 IS - 0012-3692 (Print) IS - 0012-3692 (Linking) VI - 106 IP - 5 DP - 1994 Nov TI - The impact of aprotinin on coronary artery bypass graft patency. PG - 1370-5 AB - STUDY DESIGN: Aprotinin has recently been shown to reduce postoperative bleeding and transfusion requirements associated with coronary artery bypass grafting. One concern with its use, however, is that it may have a deleterious effect on graft patency because it promotes hemostasis. Forty-seven patients undergoing coronary artery bypass. Forty-seven patients undergoing coronary artery bypass grafting were enrolled in a prospective, randomized double-blind trial of aprotinin to determine the effect of this agent on postoperative bleeding, transfusion requirements, renal function, and graft patency. The study group was comprised of the 32 patients who underwent technically adequate ultrafast CT scans 6 to 8 weeks postoperatively to determine graft patency. Sixteen patients received aprotinin (aprotinin group) and 16 received placebo (control group). RESULTS: Demographic and operative descriptors were comparable between groups. Postoperative mediastinal and chest tube drainage in the aprotinin group was significantly less than that in the control group (722 vs 1,540 mL; p = 0.0006) and the mean blood transfusion requirements were less, but this did not reach significance (125 vs 297 mL; p = 0.42). Analysis of graft patency by patients revealed that 5 patients in the aprotinin group (31%) had at least one occluded graft, while none of the patients in the control group had an occluded graft (p = 0.04). Analysis by graft revealed that 38 of 43 grafts placed in the aprotinin group were patent, while all 38 grafts placed in the placebo group were patent (88.4 vs 100%; p = 0.057). There was no difference in the incidence of myocardial infarction, renal dysfunction or hematologic indexes at discharge between the groups, or evidence of other thrombotic complications. CONCLUSION: We conclude that high-dose aprotinin is effective in reducing hemorrhage after coronary artery bypass grafting. However, its routine use should be approached cautiously due to its possible adverse effects on graft patency. FAU - Laub, G W AU - Laub GW AD - Department of Surgery, Deborah Heart and Lung Center, Browns Mills, NJ 08015-1799. FAU - Riebman, J B AU - Riebman JB FAU - Chen, C AU - Chen C FAU - Adkins, M S AU - Adkins MS FAU - Anderson, W A AU - Anderson WA FAU - Fernandez, J AU - Fernandez J FAU - McGrath, L B AU - McGrath LB LA - eng PT - Clinical Trial PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - United States TA - Chest JT - Chest JID - 0231335 RN - 9087-70-1 (Aprotinin) SB - IM MH - Aged MH - Aprotinin/administration & dosage/adverse effects/*pharmacology MH - Blood Transfusion MH - Chi-Square Distribution MH - *Coronary Artery Bypass MH - Coronary Vessels/*drug effects MH - Double-Blind Method MH - Follow-Up Studies MH - Hemorrhage/physiopathology/therapy MH - Humans MH - Logistic Models MH - Middle Aged MH - Postoperative Care MH - Postoperative Complications/physiopathology/therapy MH - Prospective Studies MH - Vascular Patency/*drug effects EDAT- 1994/11/01 00:00 MHDA- 1994/11/01 00:01 CRDT- 1994/11/01 00:00 PHST- 1994/11/01 00:00 [pubmed] PHST- 1994/11/01 00:01 [medline] PHST- 1994/11/01 00:00 [entrez] AID - S0012-3692(15)44324-7 [pii] AID - 10.1378/chest.106.5.1370 [doi] PST - ppublish SO - Chest. 1994 Nov;106(5):1370-5. doi: 10.1378/chest.106.5.1370. PMID- 7508070 OWN - NLM STAT- MEDLINE DCOM- 19940308 LR - 20220316 IS - 0022-5223 (Print) IS - 0022-5223 (Linking) VI - 107 IP - 2 DP - 1994 Feb TI - Aprotinin for coronary bypass operations: efficacy, safety, and influence on early saphenous vein graft patency. A multicenter, randomized, double-blind, placebo-controlled study. PG - 543-51; discussion 551-3 AB - The purpose of this study was to evaluate the efficacy and safety of aprotinin in a U.S. population of patients undergoing coronary artery bypass grafting. Early vein graft patency rates were assessed by ultrafast computed tomography. A total of 216 patients at five centers were randomized to receive either high-dose aprotinin or placebo during the operation; 151 patients underwent primary operation, and 65 underwent repeat procedures. Total blood product exposures in the primary group were 2.2 per patient receiving aprotinin as compared with 5.7 per patient receiving placebo (p = 0.010). The repeat group had 0.3 exposures per patient receiving aprotinin as compared with 10.7 per patient receiving placebo (p = < 0.001). Consistent reductions in the percent of patients requiring donor red blood cells and in the number of units of platelets, fresh frozen plasma, and cryoprecipitate required were associated with the use of aprotinin in both primary and repeat groups. Mortality was 5.6% in the aprotinin group and 3.7% in the placebo group (p = 0.517). In the primary group, clinical diagnoses of myocardial infarction were made in 8.9% of patients receiving aprotinin as compared with 5.6% of the patients receiving placebo (p = 0.435). In the repeat group, infarctions occurred in 10.3% of patients receiving aprotinin and 8.3% of patients receiving placebo (p = 1.000). Secondary analysis of electrocardiograms and available enzyme data showed no significant difference in infarction rates between the treatment groups. There was no difference in clinically significant renal dysfunction. The early vein graft patency rates were 92.0% in the aprotinin group and 95.1% in the placebo group (p = 0.248). In this study, aprotinin was effective in reducing bleeding and blood product transfusion rates, and its use was not associated with an increase in complications. An adverse effect on early vein graft patency rates was not demonstrated, but the number of grafts assessed was insufficient for absolute conclusions in this regard. FAU - Lemmer, J H Jr AU - Lemmer JH Jr AD - Department of Surgery, University of Iowa College of Medicine, Iowa City. FAU - Stanford, W AU - Stanford W FAU - Bonney, S L AU - Bonney SL FAU - Breen, J F AU - Breen JF FAU - Chomka, E V AU - Chomka EV FAU - Eldredge, W J AU - Eldredge WJ FAU - Holt, W W AU - Holt WW FAU - Karp, R B AU - Karp RB FAU - Laub, G W AU - Laub GW FAU - Lipton, M J AU - Lipton MJ AU - et al. LA - eng PT - Clinical Trial PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PL - United States TA - J Thorac Cardiovasc Surg JT - The Journal of thoracic and cardiovascular surgery JID - 0376343 RN - 9087-70-1 (Aprotinin) SB - IM MH - Aprotinin/adverse effects/*therapeutic use MH - Blood Loss, Surgical/*prevention & control MH - Blood Transfusion MH - Blood Volume MH - *Coronary Artery Bypass/mortality MH - Double-Blind Method MH - Graft Occlusion, Vascular/chemically induced/diagnostic imaging MH - Hemostasis, Surgical/*methods MH - Humans MH - Myocardial Infarction/etiology MH - Postoperative Complications MH - Reoperation MH - Tomography, X-Ray Computed EDAT- 1994/02/01 00:00 MHDA- 2001/03/28 10:01 CRDT- 1994/02/01 00:00 PHST- 1994/02/01 00:00 [pubmed] PHST- 2001/03/28 10:01 [medline] PHST- 1994/02/01 00:00 [entrez] AID - S0022-5223(94)70101-6 [pii] PST - ppublish SO - J Thorac Cardiovasc Surg. 1994 Feb;107(2):543-51; discussion 551-3. PMID- 1357450 OWN - NLM STAT- MEDLINE DCOM- 19921116 LR - 20220330 IS - 0140-6736 (Print) IS - 0140-6736 (Linking) VI - 340 IP - 8826 DP - 1992 Oct 24 TI - Coronary revascularisation in insulin-dependent diabetic patients with chronic renal failure. PG - 998-1002 AB - Insulin-dependent diabetic patients found to have substantial coronary artery disease at the time of assessment for renal transplantation have 2-year survival of less than 50%. Because most of these patients have no angina symptoms their management is controversial. We tried to find out whether coronary artery revascularisation in such patients might decrease the combined incidence of unstable angina, myocardial infarction, and cardiac death. 151 consecutive insulin-dependent diabetic candidates for renal transplantation underwent coronary angiography. 31 had stenoses greater than 75% in one or more coronary arteries, atypical chest pain or no chest pain, and a left ventricular ejection fraction greater than 0.35. Of these, 26 agreed to be randomly assigned medical treatment (a calcium-channel-blocking drug plus aspirin) or revascularisation (angioplasty or coronary bypass surgery). 10 of 13 medically managed and 2 of 13 revascularised patients had a cardiovascular endpoint within a median of 8.4 months of coronary angiography (p < 0.01). 4 medically managed patients died of myocardial infarction during follow-up. Thus, revascularisation decreased the frequency of cardiac events in insulin-dependent diabetic patients with chronic renal failure and symptomless coronary artery stenoses. These findings suggest that diabetic renal transplant candidates should be screened for silent coronary artery disease, because revascularisation may decrease cardiac morbidity and mortality in this population. FAU - Manske, C L AU - Manske CL AD - Department of Medicine, University of Minnesota, School of Medicine, Minneapolis. FAU - Wang, Y AU - Wang Y FAU - Rector, T AU - Rector T FAU - Wilson, R F AU - Wilson RF FAU - White, C W AU - White CW LA - eng GR - DK13038/DK/NIDDK NIH HHS/United States GR - HL 39185/HL/NHLBI NIH HHS/United States GR - MOI RR004400/RR/NCRR NIH HHS/United States PT - Clinical Trial PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, U.S. Gov't, P.H.S. PL - England TA - Lancet JT - Lancet (London, England) JID - 2985213R RN - 0 (Calcium Channel Blockers) RN - R16CO5Y76E (Aspirin) SB - IM MH - Adult MH - Angina, Unstable/epidemiology/etiology MH - Angioplasty, Balloon, Coronary/*standards MH - Aspirin/*therapeutic use MH - Calcium Channel Blockers/*therapeutic use MH - Coronary Angiography MH - Coronary Artery Bypass/*standards MH - Coronary Disease/complications/diagnosis/*therapy MH - Diabetes Mellitus, Type 1/*complications MH - Drug Therapy, Combination MH - Electrocardiography MH - Female MH - Follow-Up Studies MH - Hospitals, University MH - Humans MH - Kidney Failure, Chronic/*complications/surgery MH - Kidney Transplantation MH - Male MH - Middle Aged MH - Minnesota/epidemiology MH - Myocardial Infarction/epidemiology/etiology/mortality MH - Patient Admission/statistics & numerical data MH - Stroke Volume MH - Survival Rate MH - Treatment Outcome EDAT- 1992/10/24 00:00 MHDA- 1992/10/24 00:01 CRDT- 1992/10/24 00:00 PHST- 1992/10/24 00:00 [pubmed] PHST- 1992/10/24 00:01 [medline] PHST- 1992/10/24 00:00 [entrez] AID - 0140-6736(92)93010-K [pii] AID - 10.1016/0140-6736(92)93010-k [doi] PST - ppublish SO - Lancet. 1992 Oct 24;340(8826):998-1002. doi: 10.1016/0140-6736(92)93010-k. PMID- 3275808 OWN - NLM STAT- MEDLINE DCOM- 19880220 LR - 20121003 IS - 0741-5214 (Print) IS - 0741-5214 (Linking) VI - 7 IP - 1 DP - 1988 Jan TI - Multicenter prospective study of nonruptured abdominal aortic aneurysms. I. Population and operative management. PG - 69-81 AB - This article describes the patient population and operative management of 666 patients with nonruptured aneurysms of the abdominal aorta. Statistical significance of variables was determined by the chi-square test and logistic regression analysis. There were no statistically significant differences (p greater than 0.05) in mortality rate for abdominal aortic aneurysm (AAA) on the basis of indication for surgery (asymptomatic, 3.9%; asymptomatic but with evidence of enlargement, 4.9%; and symptomatic, 7.2%) or the urgency of operation (elective operation, 4.5%; and urgent operation, 7.1%). Characteristics of the 72 participating surgeons did not influence the operative mortality rate. A family history of AAA was documented in 6.1% of cases and was more common if the patient was female (p = 0.03) and less than 65 years of age (p = 0.04). Patients without clinical evidence of coronary artery disease had a 0.8% mortality rate from cardiac disease compared with 6.2% if any stigmata of coronary disease were present. Prior aortocoronary bypass surgery did not reduce the incidence of postoperative cardiac events or operative mortality rate. Patients having "routine" angiography did not have a less complicated operative course, fewer thrombotic complications, or lower mortality rate than those not having it. Those patients with an inflammatory AAA (4.5%) did not have a significantly higher incidence of pain. Heparin administration (84.8%) did not reduce the complications of graft thrombosis, "trash," distal thrombosis, and/or amputation. The 6.8% of patients requiring suprarenal aortic cross-clamping had a higher incidence of postoperative renal dysfunction (p = 0.02) and intraoperative blood loss (p less than 0.001), but cardiac events were not more frequent. When the aortic cross-clamping time was prolonged (more than 70 minutes), the requirement for crystalloid fluid administration increased (p less than 0.001) and postoperative myocardial infarction was more common (p = 0.004). After ligation of the left renal vein in 7.9%, renal damage or dialysis was more frequent (p = 0.01). Patients having an intra-abdominal graft (tube, 38.5% and biiliac, 30.7%) had fewer wound infections (p = 0.02) and graft thromboses (p less than 0.001) than the patients with a femoral anastomosis. When the internal iliac artery flow was interrupted bilaterally (12%), diarrhea (p = 0.03) and ischemic colitis (p = 0.03) were more frequent complications. Reimplantation of the inferior mesenteric artery was carried out in 4.8%. After renal artery bypass in 2.1%, the mortality rate was not increased, but the incidence of transient renal dysfunction was increased (p = 0.03).(ABSTRACT TRUNCATED AT 400 WORDS) FAU - Johnston, K W AU - Johnston KW AD - Toronto General Hospital, Ontario, Canada. FAU - Scobie, T K AU - Scobie TK LA - eng PT - Clinical Trial PT - Journal Article PL - United States TA - J Vasc Surg JT - Journal of vascular surgery JID - 8407742 SB - IM MH - Aged MH - Aorta, Abdominal MH - Aortic Aneurysm/epidemiology/etiology/*surgery MH - Canada MH - Clinical Trials as Topic MH - Female MH - Humans MH - Male MH - Prospective Studies MH - Regression Analysis MH - Risk Factors EDAT- 1988/01/01 00:00 MHDA- 2001/09/06 10:01 CRDT- 1988/01/01 00:00 PHST- 1988/01/01 00:00 [pubmed] PHST- 2001/09/06 10:01 [medline] PHST- 1988/01/01 00:00 [entrez] AID - S0741521488000151 [pii] PST - ppublish SO - J Vasc Surg. 1988 Jan;7(1):69-81. PMID- 3485028 OWN - NLM STAT- MEDLINE DCOM- 19860415 LR - 20131121 IS - 0278-2677 (Print) IS - 0278-2677 (Linking) VI - 5 IP - 1 DP - 1986 Jan TI - Digoxin prophylaxis following coronary artery bypass surgery. PG - 55-8 AB - The effect of the postoperative administration of digoxin to patients undergoing coronary artery bypass surgery on the incidence of supraventricular arrhythmias was studied. Patients were randomly assigned to a control group (n = 51) or digoxin group (n = 47) on a prospective basis. Patient characteristics were similar in both groups, and no patients were receiving digoxin therapy preoperatively or other antiarrhythmic medications. All patients had normal systolic ejection fractions, renal function, and hepatic function. Eight patients (16%) in the control group developed postoperative arrhythmias while seven patients (15%) in the digoxin group developed supraventricular arrhythmias. This difference was not significant. Two patients in the digoxin group developed digoxin-induced arrhythmias, and two other patients experienced digoxin-related nausea and vomiting, which were resolved with discontinuation of the drug. The postoperative administration of digoxin to patients undergoing coronary artery bypass surgery had no effect on the incidence of supraventricular arrhythmias. The prophylactic use of digoxin therapy in this patient population is not recommended unless there is a history of arrhythmias responsive to digoxin therapy. FAU - Weiner, B AU - Weiner B FAU - Rheinlander, H F AU - Rheinlander HF FAU - Decker, E L AU - Decker EL FAU - Cleveland, R J AU - Cleveland RJ LA - eng PT - Clinical Trial PT - Journal Article PT - Randomized Controlled Trial PL - United States TA - Clin Pharm JT - Clinical pharmacy JID - 8207437 RN - 73K4184T59 (Digoxin) SB - IM MH - Adult MH - Aged MH - Angina Pectoris/surgery MH - Arrhythmias, Cardiac/etiology/*prevention & control MH - Coronary Artery Bypass/*adverse effects MH - Digoxin/*therapeutic use MH - Female MH - Humans MH - Male MH - Middle Aged EDAT- 1986/01/01 00:00 MHDA- 1986/01/01 00:01 CRDT- 1986/01/01 00:00 PHST- 1986/01/01 00:00 [pubmed] PHST- 1986/01/01 00:01 [medline] PHST- 1986/01/01 00:00 [entrez] PST - ppublish SO - Clin Pharm. 1986 Jan;5(1):55-8.