81 results on '"Barbato, E"'
Search Results
2. European Society of Cardiology guidance for the diagnosis and management of cardiovascular disease during the COVID-19 pandemic: part 1—epidemiology, pathophysiology, and diagnosis
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Baigent, C., Windecker, S., Andreini, D., Arbelo, E., Barbato, E., Bartorelli, A.L., Baumbach, A., Behr, E.R., Berti, S., Bueno, H., Capodanno, D., Cappato, R., Chieffo, A., Collet, J.P., Cuisset, T., Simone, G. de, Delgado, V., Dendale, P., Dudek, D., Edvardsen, T., Elvan, A., Gonzalez-Juanatey, J.R., Gori, M., Grobbee, D., Guzik, T.J., Halvorsen, S., Haude, M., Heidbuchel, H., Hindricks, G., Ibanez, B., Karam, N., Katus, H., Klok, F.A., Konstantinides, S.V., Landmesser, U., Leclercq, C., Leonardi, S., Lettino, M., Marenzi, G., Mauri, J., Metra, M., Morici, N., Mueller, C., Petronio, A.S., Polovina, M.M., Potpara, T., Praz, F., Prendergast, B., Prescott, E., Price, S., Pruszczyk, P., Rodriguez-Leor, O., Roffi, M., Romaguera, R., Rosenkranz, S., Sarkozy, A., Scherrenberg, M., Seferovic, P., Senni, M., Spera, F.R., Stefanini, G., Thiele, H., Tomasoni, D., Torracca, L., Touyz, R.M., Wilde, A.A., Williams, B., Task Force Management Covid-19 Eur, Nuffield Department of Population Health [Oxford], University of Oxford, Bern University Hospital [Berne] (Inselspital), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Nutrition, obésité et risque thrombotique (NORT), Institut National de la Recherche Agronomique (INRA)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Paris-Centre de Recherche Cardiovasculaire (PARCC (UMR_S 970/ U970)), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), University of Glasgow, Amsterdam UMC - Amsterdam University Medical Center, University College of London [London] (UCL), Baigent, C, Cardiology, Task Force for the management of COVID-19 of the European Society of, Cardiology, ACS - Heart failure & arrhythmias, Task Force Management Covid-19 Eur, University of Oxford [Oxford], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPC), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), delgado, victoria/0000-0002-9841-2737, BUENO, HECTOR/0000-0003-0277-7596, Karam, Nicole/0000-0002-3861-6914, Baigent, Colin/0000-0003-4856-7420, Behr, Elijah/0000-0002-8731-2853, Williams, Bryan/0000-0002-8094-1841, Rodriguez-Leor, Oriol/0000-0003-2657-5657, BUENO, HECTOR/0000-0003-0277-7596, Rodriguez-Leor, Oriol/0000-0003-2657-5657, Williams, Bryan/0000-0002-8094-1841, Karam, and Nicole/0000-0002-3861-6914
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ACE2 ,Arrhythmias ,Biomarkers ,Cardiogenic shock ,COVID-19 ,Myocardial ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Physiology ,Myocardial injury ,Myocarditis ,Non-invasive imaging ,Humans ,Pandemics ,Prospective Studies ,Cardiology ,Cardiovascular Diseases ,Settore MED/11 - Malattie dell'Apparato Cardiovascolare ,Disease ,Special Article ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,Physiology (medical) ,injury ,Pandemic ,Epidemiology ,Medicine ,AcademicSubjects/MED00200 ,Intensive care medicine ,business.industry ,Pathophysiology ,Human medicine ,Cardiology and Cardiovascular Medicine ,business - Abstract
Aims Since its emergence in early 2020, the novel severe acute respiratory syndrome coronavirus 2 causing coronavirus disease 2019 (COVID-19) has reached pandemic levels, and there have been repeated outbreaks across the globe. The aim of this two-part series is to provide practical knowledge and guidance to aid clinicians in the diagnosis and management of cardiovascular disease (CVD) in association with COVID-19. Methods and results A narrative literature review of the available evidence has been performed, and the resulting information has been organized into two parts. The first, reported here, focuses on the epidemiology, pathophysiology, and diagnosis of cardiovascular (CV) conditions that may be manifest in patients with COVID-19. The second part, which will follow in a later edition of the journal, addresses the topics of care pathways, treatment, and follow-up of CV conditions in patients with COVID-19. Conclusion This comprehensive review is not a formal guideline but rather a document that provides a summary of current knowledge and guidance to practicing clinicians managing patients with CVD and COVID-19. The recommendations are mainly the result of observations and personal experience from healthcare providers. Therefore, the information provided here may be subject to change with increasing knowledge, evidence from prospective studies, and changes in the pandemic. Likewise, the guidance provided in the document should not interfere with recommendations provided by local and national healthcare authorities., Graphical Abstract Graphical Abstract
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- 2022
3. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes
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Knuuti, Juhani, Wijns, William, Saraste, Antti, Capodanno, Davide, Barbato, Emanuele, Funck-Brentano, Christian, Prescott, Eva, Storey, Robert F, Deaton, Christi, Cuisset, Thomas, Agewall, Stefan, Dickstein, Kenneth, Edvardsen, Thor, Escaned, Javier, Gersh, Bernard J, Svitil, Pavel, Gilard, Martine, Hasdai, David, Hatala, Robert, Mahfoud, Felix, Masip, Josep, Muneretto, Claudio, Valgimigli, Marco, Achenbach, Stephan, Bax, Jeroen J, Neumann FJ, Sechtem U, Banning AP, Bonaros N, Bueno H, Bugiardini R, Chieffo A, Crea F, Czerny M, Delgado V, Dendale P, Flachskampf FA, Gohlke H, Grove EL, James S, Katritsis D, Landmesser U, Lettino M, Matter CM, Nathoe H, Niessner A, Patrono C, Petronio AS, Pettersen SE, Piccolo R, Piepoli MF, Popescu BA, Räber L, Richter DJ, Roffi M, Roithinger FX, Shlyakhto E, Sibbing D, Silber S, Simpson IA, Sousa-Uva M, Vardas P, Witkowski A, Zamorano JL, Achenbach S, Agewall S, Barbato E, Bax JJ, Capodanno D, Cuisset T, Deaton C, Dickstein K, Edvardsen T, Escaned J, Funck-Brentano C, Gersh BJ, Gilard M, Hasdai D, Hatala R, Mahfoud F, Masip J, Muneretto C, Prescott E, Saraste A, Storey RF, Svitil P, Valgimigli M, Windecker S, Aboyans V, Baigent C, Collet JP, Dean V, Fitzsimons D, Gale CP, Grobbee D, Halvorsen S, Hindricks G, Iung B, Jüni P, Katus HA, Leclercq C, Lewis BS, Merkely B, Mueller C, Petersen S, Touyz RM, Benkhedda S, Metzler B, Sujayeva V, Cosyns B, Kusljugic Z, Velchev V, Panayi G, Kala P, Haahr-Pedersen SA, Kabil H, Ainla T, Kaukonen T, Cayla G, Pagava Z, Woehrle J, Kanakakis J, Tóth K, Gudnason T, Peace A, Aronson D, Riccio C, Elezi S, Mirrakhimov E, Hansone S, Sarkis A, Babarskiene R, Beissel J, Maempel AJC, Revenco V, de Grooth GJ, Pejkov H, Juliebø V, Lipiec P, Santos J, Chioncel O, Duplyakov D, Bertelli L, Dikic AD, Studenčan M, Bunc M, Alfonso F, Bäck M, Zellweger M, Addad F, Yildirir A, Sirenko Y, Clapp B, Sorbonne Université (SU), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de pharmacologie médicale [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Département de Cardiologie [Hôpital de la Timone - APHM], Hôpital de la Timone [CHU - APHM] (TIMONE)-Assistance Publique - Hôpitaux de Marseille (APHM), Knuuti, Juhani, Wijns, William, Saraste, Antti, Capodanno, Davide, Barbato, Emanuele, Funck-Brentano, Christian, Prescott, Eva, Storey, Robert F, Deaton, Christi, Cuisset, Thoma, Agewall, Stefan, Dickstein, Kenneth, Edvardsen, Thor, Escaned, Javier, Gersh, Bernard J, Svitil, Pavel, Gilard, Martine, Hasdai, David, Hatala, Robert, Mahfoud, Felix, Masip, Josep, Muneretto, Claudio, Valgimigli, Marco, Achenbach, Stephan, Bax, Jeroen J, Neumann FJ, Sechtem U, Banning AP, Bonaros N, Bueno H, Bugiardini R, Chieffo A, Crea F, Czerny M, Delgado V, Dendale P, Flachskampf FA, Gohlke H, Grove EL, James S, Katritsis D, Landmesser U, Lettino M, Matter CM, Nathoe H, Niessner A, Patrono C, Petronio AS, Pettersen SE, Piccolo R, Piepoli MF, Popescu BA, Räber L, Richter DJ, Roffi M, Roithinger FX, Shlyakhto E, Sibbing D, Silber S, Simpson IA, Sousa-Uva M, Vardas P, Witkowski A, Zamorano JL, Achenbach S, Agewall S, Barbato E, Bax JJ, Capodanno D, Cuisset T, Deaton C, Dickstein K, Edvardsen T, Escaned J, Funck-Brentano C, Gersh BJ, Gilard M, Hasdai D, Hatala R, Mahfoud F, Masip J, Muneretto C, Prescott E, Saraste A, Storey RF, Svitil P, Valgimigli M, Windecker S, Aboyans V, Baigent C, Collet JP, Dean V, Delgado V, Fitzsimons D, Gale CP, Grobbee D, Halvorsen S, Hindricks G, Iung B, Jüni P, Katus HA, Landmesser U, Leclercq C, Lettino M, Lewis BS, Merkely B, Mueller C, Petersen S, Petronio AS, Richter DJ, Roffi M, Shlyakhto E, Simpson IA, Sousa-Uva M, Touyz RM, Benkhedda S, Metzler B, Sujayeva V, Cosyns B, Kusljugic Z, Velchev V, Panayi G, Kala P, Haahr-Pedersen SA, Kabil H, Ainla T, Kaukonen T, Cayla G, Pagava Z, Woehrle J, Kanakakis J, Tóth K, Gudnason T, Peace A, Aronson D, Riccio C, Elezi S, Mirrakhimov E, Hansone S, Sarkis A, Babarskiene R, Beissel J, Maempel AJC, Revenco V, de Grooth GJ, Pejkov H, Juliebø V, Lipiec P, Santos J, Chioncel O, Duplyakov D, Bertelli L, Dikic AD, Studenčan M, Bunc M, Alfonso F, Bäck M, Zellweger M, Addad F, Yildirir A, Sirenko Y, Clapp B, Clinical sciences, Cardio-vascular diseases, Cardiology, Knuuti, Juhani [0000-0003-3156-9593], Apollo - University of Cambridge Repository, Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), University of Zurich, Knuuti, J., Wijns, W., Achenbach, S., Agewall, S., Barbato, E., Bax, J. J., Capodanno, D., Cuisset, T., Deaton, C., Dickstein, K., Edvardsen, T., Escaned, J., Funck-Brentano, C., Gersh, B. J., Gilard, M., Hasdai, D., Hatala, R., Mahfoud, F., Masip, J., Muneretto, C., Prescott, E., Saraste, A., Storey, R. F., Svitil, P., Valgimigli, M., Windecker, S., Aboyans, V., Baigent, C., Collet, J. -P., Dean, V., Delgado, V., Fitzsimons, D., Gale, C. P., Grobbee, D. E., Halvorsen, S., Hindricks, G., Iung, B., Juni, P., Katus, H. A., Landmesser, U., Leclercq, C., Lettino, M., Lewis, B. S., Merkely, B., Mueller, C., Petersen, S., Petronio, A. S., Richter, D. J., Roffi, M., Shlyakhto, E., Simpson, I. A., Sousa-Uva, M., Touyz, R. M., Benkhedda, S., Metzler, B., Sujayeva, V., Cosyns, B., Kusljugic, Z., Velchev, V., Panayi, G., Kala, P., Haahr-Pedersen, S. A., Kabil, H., Ainla, T., Kaukonen, T., Cayla, G., Pagava, Z., Woehrle, J., Kanakakis, J., Toth, K., Gudnason, T., Peace, A., Aronson, D., Riccio, C., Elezi, S., Mirrakhimov, E., Hansone, S., Sarkis, A., Babarskiene, R., Beissel, J., Cassar Maempel, A. J., Revenco, V., de Grooth, G. J., Pejkov, H., Juliebo, V., Lipiec, P., Santos, J., Chioncel, O., Duplyakov, D., Bertelli, L., Dikic, A. D., Studencan, M., Bunc, M., Alfonso, F., Back, M., Zellweger, M., Addad, F., Yildirir, A., Sirenko, Y., and Clapp, B.
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anti-ischaemic drug ,chronic coronary syndromes ,medicine.medical_treatment ,[SDV]Life Sciences [q-bio] ,lipid-lowering drugs ,Diagnostic Techniques, Cardiovascular ,antithrombotic therapy ,Disease ,030204 cardiovascular system & hematology ,Guideline ,Coronary artery disease ,0302 clinical medicine ,Disease management (health) ,Societies, Medical ,ComputingMilieux_MISCELLANEOUS ,chronic coronary syndrome ,angina pectori ,Disease Management ,food and beverages ,imaging ,risk assessment ,Syndrome ,3. Good health ,Natural history ,Europe ,Cardiology ,Cardiology and Cardiovascular Medicine ,coronary artery disease ,medicine.medical_specialty ,lifestyle modifications ,anti-ischaemic drugs ,Ischemia ,610 Medicine & health ,vasospastic angina ,Guidelines ,Revascularization ,diagnostic testing ,11171 Cardiocentro Ticino ,2705 Cardiology and Cardiovascular Medicine ,03 medical and health sciences ,angina pectoris ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,Internal medicine ,medicine ,Journal Article ,Humans ,business.industry ,screening ,fungi ,030229 sport sciences ,medicine.disease ,lipid-lowering drug ,Angina pectoris ,Anti-ischaemic drugs ,Antithrombotic therapy ,Chronic coronary syndromes ,Diagnostic testing ,Imaging ,Lifestyle modifications ,Lipid-lowering drugs ,Microvascular angina ,Myocardial ischaemia ,Myocardial revascularization ,Risk assessment ,Screening ,Vasospastic angina ,myocardial ischaemia ,myocardial revascularization ,Heart failure ,microvascular angina ,Chronic Disease ,Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE ,lifestyle modification ,Coronary Artery Disease/diagnosis ,business ,Fibrinolytic agent - Abstract
Coronary artery disease (CAD) is a pathological process characterized by atherosclerotic plaque accumulation in the epicardial arteries, whether obstructive or non-obstructive. This process can be modified by lifestyle adjustments, pharmacological therapies, and invasive interventions designed to achieve disease stabilization or regression. The disease can have long, stable periods but can also become unstable at any time, typically due to an acute atherothrombotic event caused by plaque rupture or erosion. However, the disease is chronic, most often progressive, and hence serious, even in clinically apparently silent periods. The dynamic nature of the CAD process results in various clinical presentations, which can be conveniently categorized as either acute coronary syndromes (ACS) or chronic coronary syndromes (CCS). The Guidelines presented here refer to the management of patients with CCS. The natural history of CCS is illustrated in Figure 1.
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- 2019
4. Management of myocardial revascularisation failure: an expert consensus document of the EAPCI
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Stefanini G. G., Alfonso F., Barbato E., Byrne R. A., Capodanno D., Colleran R., Escaned J., Giacoppo D., Kunadian V., Lansky A., Mehilli J., Neumann F. -J., Regazzoli D., Sanz-Sanchez J., Wijns W., Baumbach A., Vahanian A., Stefanini, G. G., Alfonso, F., Barbato, E., Byrne, R. A., Capodanno, D., Colleran, R., Escaned, J., Giacoppo, D., Kunadian, V., Lansky, A., Mehilli, J., Neumann, F. -J., Regazzoli, D., Sanz-Sanchez, J., Wijns, W., Baumbach, A., and Vahanian, A.
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medicine.medical_specialty ,Percutaneous ,Consensus ,Bypass grafting ,Stent thrombosi ,Psychological intervention ,MEDLINE ,Multidisciplinary Heart Team ,Consensu ,Coronary Artery Disease ,Coronary artery disease ,Quality of life ,medicine ,Myocardial Revascularization ,Humans ,Intensive care medicine ,Prior PCI ,business.industry ,Myocardial revascularisation ,Expert consensus ,Drug-Eluting Stents ,medicine.disease ,Treatment Outcome ,Quality of Life ,Saphenous vein graft ,Cardiology and Cardiovascular Medicine ,business ,In-stent restenosi ,Prior cardiovascular surgery ,Human - Abstract
Myocardial revascularisation represents the most frequently performed therapeutic intervention worldwide. Current percutaneous and surgical revascularisation techniques provide excellent short- and long-term clinical outcomes. However, despite the technological and procedural advances with the widespread use of drug-eluting stents and arterial bypass grafts in contemporary practice, a considerable proportion of patients require repeat revascularisation procedures during long-term follow-up. The need for repeat revascularisation has a major impact on patients' quality of life and is associated with a significant economic burden. This consensus document summarises the views on the management of myocardial revascularisation failure of an expert panel of the European Association of Percutaneous Cardiovascular Interventions (EAPCI). The present document provides a broad and pragmatic overview of the clinical management of myocardial revascularisation failure with a focus on the three key underlying mechanisms leading to repeat revascularisation: 1) failure of percutaneous coronary interventions, 2) failure of coronary artery bypass grafting, and 3) progression of coronary artery disease in native coronary segments previously untreated. The aim of the present position document is to provide a patient-oriented approach for the management of myocardial revascularisation failure.
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- 2020
5. Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease
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Ridker PM, Everett BM, Thuren T, MacFadyen JG, Chang WH, Ballantyne C, Fonseca F, Nicolau J, Koenig W, Anker SD, Kastelein JJP, Cornel JH, Pais P, Pella D, Genest J, Cifkova R, Lorenzatti A, Forster T, Kobalava Z, Vida-Simiti L, Flather M, Shimokawa H, Ogawa H, Dellborg M, Rossi PRF, Troquay RPT, Libby P, Glynn RJ, Novo S, Krum H, Varigos J, Siostrzonek P, Sinnaeve P, Gotcheva N, Yong H, Urina-Triana M, Milicic D, Vettus R, Manolis AJ, Wyss F, Sigurdsson A, Fucili A, Veze I, Petrauskiene B, Salvador L, Klemsdal TO, Medina F, Budaj A, Otasevic P, Lainscak M, Seung KB, Commerford P, Donath M, Hwang JJ, Kultursay H, Bilazarian S, East C, Forgosh L, Harris B, Ligueros M, Bohula E, Charmarthi B, Cheng S, Chou S, Danik J, McMahon G, Maron B, Ning M, Olenchock B, Pande R, Perlstein T, Pradhan A, Rost N, Singhal A, Taqueti V, Wei N, Burris H, Cioffi A, Dalseg AM, Ghosh N, Gralow J, Mayer T, Rugo H, Fowler V, Limaye AP, Cosgrove S, Levine D, Lopes R, Scott J, Hilkert R, Tamesby G, Mickel C, Manning B, Woelcke J, Tan M, Manfreda S, Ponce T, Kam J, Saini R, Banker K, Salko T, Nandy P, Tawfik R, O’Neil G, Manne S, Jirvankar P, Lal S, Nema D, Jose J, Collins R, Bailey K, Blumenthal R, Colhoun H, Gersh B, Abreu M, Actis MV, Aiub J, Aiub F, Albisu J, Alvarisqueta A, Avalos V, Barreto M, Berli MA, Blumberg C, Bocanera M, Botta C, Bowen L, Budassi N, Buhlman S, Westberg JC, Carabajal T, Caruso G, Casala J, Cendali G, Coloma G, Berra FC, Cuneo C, Degennaro N, Dellasa M, Diaz M, Dos Santos P, Espinosa V, Facello A, Facello M, Farias E, Fernandez AA, Ferrari V, Pacora FF, Flores GS, Franco M, Gabito A, Viola HG, Garcia F, Garcia Duran R, Garcia Pinna J, Glenny J, Godoy Sanchez M, Grosse A, Guzman P, Hasbani E, Hominal M, Ibañez J, Jure H, Jure D, Vico ML, Liniado G, Luciardi H, Luquez H, Maehara G, Maffei L, Majul C, Mallagray M, Marinaro S, Martinez J, Massaccesi R, De Los Milagros Had M, Azize GM, Montana O, Montenegro E, Morell Y, Muntaner J, Navarrete S, Olmedo M, Paganini M, Paz S, Perez Manghi F, Piskorz D, Polato C, Recoaro R, Romano A, Salinger M, Sanchez A, Saravia MA, Sarjanovich R, Scaro G, Schiavi LB, Soler J, Tinnirello V, Tomassi A, Valle M, Vallejo MA, Venturini C, Marcela Wenetz LM, Yossen M, Zaidman C, Zalazar L, Zangroniz P, Amerena J, Brady L, Colquhoun D, Eccleston D, Ferreira-Jardim A, French J, Jayasinghe R, Mcintosh C, Ord M, Plotz M, Purnell P, Roberts-Thomson P, Schultz C, Shanahan T, Tan R, Taverner P, Turner F, Vibert J, Vorster M, William M, Youssef G, Bergler-Klein J, Brath H, Brodmann M, Fliesser-Goerzer E, Haider K, Heeren G, Hiden C, Mandic L, Paulweber B, Ploechl A, Prenner A, Steringer-Mascherbauer R, Strohner-Kaestenbauer H, Barbato E, Bouvy C, Briké C, Charlier F, Cools F, De Knijf K, De Wolf L, Delforge M, Deweerdt N, Gits F, Goffinet C, Hermans K, Hollanders G, Mestdagh I, Pirenne B, Servaes V, Simons N, Tahon S, Theunissen E, Van Genechten G, Vervoort G, Vissers C, Vranckx P, Vrolix M, Abib E Jr, Abrantes J, Araujo Fonseca M, Barbosa E, Barroso W, Barroso A, Bodanese L, Botelho R, Costa Amorim R, Da Costa F, Da Silva A, Da Silva O Jr, Da Silva D Jr, Ferreira Dos Santos T, Dos Santos F, Dos Santos A, Duda N, Feitosa G, Felario Junior GA, Ferraz R, Filho P, Fonseca A, Wanderley FF, Freitas E, Fucci F, Marengo Garcia De Carvalho L, Hernandez M, Hettwer Magedanz E, Julião K, Kormann A, Lameira A, Lima F, Lino E, Maia L, Manenti E, Marchi AL, Fischer SM, Michalaros Y, Moraes J Jr, Moreira L, Pagnan M, Pesce F, Pinheiro L, Rassi S, Reis G, Reis H, Resende I, Roel A, Ruschel K, Saporito W, Saraiva JF, Seroqui M, Silva R, Unterkircher B, Vicente C, Vieira N, Xavier JP, Zucchetti C, Angelova I, Dimitrov G, Genova D, Gospodinov K, Goudev A, Grigorova V, Hristova K, Makedonska JJ, Katova T, Kostov K, Lazov P, Manov E, Manukov I, Manukov D, Milanova M, Kabakchieva VM, Petrov D, Petrusheva T, Pramatarova I, Raev D, Runev N, Sirakova-Taseva A, Tisheva-Gospodinova S, Todorova A, Tzekova M, Yakovova S, Yanev T, Abulencia K, Arora S, Baker A, Bata IR, Beaudry M, Belle Isle J, Bilodeau N, Boivin MC, Bolduc H, Bourgeois S, Brons S, Cantor W, Chaussé I, Chhabra A, Chouinard G, Cleveland T, Dattani D, Deslongchamps F, Diodati J, Drouin K, Duchesne L, Fontaine S, d'Amours DG, Gervais B, Gosselin G, Graham J, Grover A, Gupta A, Haldane H, Hartleib M, Hickey L, Huynh T, Johnston J, Julien VE, Lachance P, Lake J, Lamontagne C, Lauzon C, Lepage S, Maheux K, Manyari D, Martin E, McPherson C, Mehta S, Michaud N, Kouz SM, Murphy G, OKeefe D, Otis R, Ouimet F, Pandey S, Peck C, Perkins L, Richert L, Robbins K, Robinson S, Cabau JR, Ross B, Roy C, Roy M, Roy A, Rupka D, Affaki GS, Saunders K, Savard D, Soucy D, St Amour E, Thiessen S, Vertes G, Vezina M, Vincelli G, Weisnagel SJ, Zadra R, Chen J, Chen Y, Dong X, Feng Y, Feng Z, Fu G, Han B, Hao Y, He Y, He Z, Hong T, Jia Z, Jiang T, Jiang J, Jiang X, Ke Y, Li Y, Li Z, Li W, Li X, Liu P, Liu Y, Liu B, Liu S, Liu L, Lu Z, Lv Y, Ma C, Ma G, Peng L, Qing L, Ren 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M., Everett, B. M., Thuren, T., Macfadyen, J. G., Chang, W. H., Ballantyne, C., FONSECA E PIRES, CARLOS EDUARDO, Nicolau, J., Koenig, W., Anker, S. D., Kastelein, J. J. P., Cornel, J. H., Pais, P., Pella, D., Genest, J., Cifkova, R., Lorenzatti, A., Forster, T., Kobalava, Z., Vida-Simiti, L., Flather, M., Shimokawa, H., Ogawa, H., Dellborg, M., Rossi, P. R. F., Troquay, R. P. T., Libby, P., Glynn R., J, CANTOS Trial, Group, Perrone, Filardi, P, ACS - Amsterdam Cardiovascular Sciences, Vascular Medicine, ACS - Pulmonary hypertension & thrombosis, and ACS - Atherosclerosis & ischemic syndromes
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0301 basic medicine ,030204 cardiovascular system & hematology ,law.invention ,0302 clinical medicine ,c-reactive protein ,Randomized controlled trial ,law ,Cardiovascular Disease ,middle aged ,double-blind method ,antibodies ,Myocardial infarction ,humans ,Stroke ,interleukin-1beta ,biology ,Antibodies, Monoclonal ,drug ,General Medicine ,Lipid ,Aged ,anti-inflammatory agents ,monoclonal ,humanized ,atherosclerosis ,cardiovascular diseases ,dose-response relationship ,female ,incidence ,infections ,lipids ,male ,myocardial infarction ,neutropenia ,secondary prevention ,stroke ,Anti-Inflammatory Agent ,aged ,Editorial ,Atherosclerosi ,Monoclonal ,Human ,medicine.drug ,medicine.medical_specialty ,Neutropenia ,Antibodies, Monoclonal, Humanized ,Infections ,Placebo ,antibodies, monoclonal ,dose-response relationship, drug ,infection ,medicine (all) ,03 medical and health sciences ,Internal medicine ,medicine ,Dose-Response Relationship, Drug ,business.industry ,Antiinflammatory Therapy, Canakinumab, for Atherosclerotic Disease ,C-reactive protein ,medicine.disease ,Surgery ,Canakinumab ,030104 developmental biology ,biology.protein ,business - Abstract
Background: Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. Methods: We conducted a randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involving 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of 2 mg or more per liter. The trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously every 3 months) with placebo. The primary efficacy end point was nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. RESULTS: At 48 months, the median reduction from baseline in the high-sensitivity C-reactive protein level was 26 percentage points greater in the group that received the 50-mg dose of canakinumab, 37 percentage points greater in the 150-mg group, and 41 percentage points greater in the 300-mg group than in the placebo group. Canakinumab did not reduce lipid levels from baseline. At a median follow-up of 3.7 years, the incidence rate for the primary end point was 4.50 events per 100 person-years in the placebo group, 4.11 events per 100 person-years in the 50-mg group, 3.86 events per 100 person-years in the 150-mg group, and 3.90 events per 100 person-years in the 300-mg group. The hazard ratios as compared with placebo were as follows: in the 50-mg group, 0.93 (95% confidence interval [CI], 0.80 to 1.07; P = 0.30); in the 150-mg group, 0.85 (95% CI, 0.74 to 0.98; P = 0.021); and in the 300-mg group, 0.86 (95% CI, 0.75 to 0.99; P = 0.031). The 150-mg dose, but not the other doses, met the prespecified multiplicity-adjusted threshold for statistical significance for the primary end point and the secondary end point that additionally included hospitalization for unstable angina that led to urgent revascularization (hazard ratio vs. placebo, 0.83; 95% CI, 0.73 to 0.95; P = 0.005). Canakinumab was associated with a higher incidence of fatal infection than was placebo. There was no significant difference in all-cause mortality (hazard ratio for all canakinumab doses vs. placebo, 0.94; 95% CI, 0.83 to 1.06; P = 0.31). Conclusions: Antiinflammatory therapy targeting the interleukin-1β innate immunity pathway with canakinumab at a dose of 150 mg every 3 months led to a significantly lower rate of recurrent cardiovascular events than placebo, independent of lipid-level lowering. (Funded by Novartis; CANTOS ClinicalTrials.gov number, NCT01327846.)
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- 2017
6. Effects of Alirocumab on Cardiovascular Events After Coronary Bypass Surgery
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Shinke, T, Ako, J, Fujii, K, Takahashi, T, Sakamoto, T, Furukawa, Y, Sugino, H, Mano, T, Utsu, N, Ito, K, Haraguchi, T, Ueda, Y, Nishibe, A, Fujimoto, K, Yoon, JH, Park, HS, Chae, IH, Kim, MH, Jeong, MH, Rha, S, Kim, C, Hong, T, Busmane, A, Pontaga, N, Strelnieks, A, Mintale, I, Sime, I, Petrulioniene, Z, Kavaliauskiene, R, Jurgaitiene, R, Sakalyte, G, Slapikas, R, Norkiene, S, Misonis, N, Kibarskis, A, Kubilius, R, Bojovski, S, Lozance, N, Kjovkaroski, A, Doncovska, S, Ong, TK, Kasim, S, Maskon, O, Kandasamy, B, Liew, HB, Mohamed, WMIW, Castillo, AG, Calvillo, JC, Campos, PF, Fragoso, JCN, Llamas, EAB, Gamba, MAA, Madrigal, JC, Salas, LGG, Rosas, EL, Diaz, BG, Vazquez, ES, Ackar, AN, Esperon, GAL, Sanchez, CRM, De Leon, MG, Otero, RS, Salmon, GF, Rios, JAP, Ruiz, JAG, Breedveld, RW, Hoogslag, PAM, Suryapranata, H, Oomen, A, Wiersma, JJ, Van Der Wal, RMA, Van Huysduynen-Monraats, PSH, Karalis, I, Verdel, GJE, Brueren, BRG, Troquay, RPT, Viergever, EP, Al-Windy, NYY, Bartels, GL, Cornel, JH, Hermans, WRM, Herrman, JPR, Bos, RJ, Groutars, RGEJ, Van Der Zwaan, CC, Kaplan, R, Ronner, E, Groenemeijer, BE, Bronzwaer, PNA, Liem, AAH, Rensing, BJWM, Bokern, MJJA, Nijmeijer, R, Hersbach, FMRJ, Willems, FF, Gosselink, ATM, Elliott, J, Wilkins, G, Fisher, R, Scott, D, Hart, H, Stewart, R, Harding, S, Ternouth, I, Fisher, N, Aitken, D, Anscombe, R, Tomala, T, Nygard, O, Sparby, JA, Andersen, K, Gullestad, L, Jortveit, J, Munk, PS, Hurtig, U, Ticona, JRC, Velasquez, JRD, Miguel, SAN, Perez, ESS, Chambilla, JMC, Ayala, CAC, Leon, RPC, Gonzales, RJV, Zuniga, JDH, Cosavalente, LAC, Mannucci, JEB, Navarro, NCL, Concha, YMR, Chavez, VER, Hernandez, HAA, Nunez, CAZ, Ferrolino, A, Sy, RAG, Tirador, L, Matiga, G, Coching, RM, Bernan, A, Rogelio, G, Morales, DD, Tan, E, Wlodarczak, A, Jaworska, K, Skonieczny, G, Pawlowicz, L, Wojewoda, P, Busz-Papiez, B, Bednarski, J, Goch, A, Staneta, P, Dulak, E, Saminski, K, Krasowski, W, Sudnik, W, Zurakowski, A, Skorski, M, Lysek, R, Miklaszewicz, B, Kubica, J, Lipko, JA, Kostarska-Srokosz, E, Piepiorka, M, Drzewiecka, A, Sciborski, R, Stasiewski, A, Blicharski, T, Bystryk, L, Szpajer, M, Korol, M, Czerski, T, Mirek-Bryniarska, E, Gniot, J, Lubinski, A, Gorny, J, Franek, E, Monteiro, P, Bastos, JM, Pereira, HH, Martins, D, Seixo, F, Mendonca, C, Botelho, A, Minescu, B, Istratoaie, O, Tesloianu, DN, Cristian, G, Podoleanu, CGC, Constantinescu, MCA, Bengus, CM, Militaru, C, Rosu, D, Parepa, IR, Matei, AV, Alexandru, TM, Shvarts, Y, Orlikova, O, Kobalava, Z, Barbarash, OL, Markov, V, Lyamina, N, Gordienko, A, Zrazhevsky, K, Vishnevsky, AY, Gurevich, V, Stryuk, R, Lomakin, NV, Bokarev, I, Shalaev, S, Khaisheva, L, Chizhov, P, Viktorova, I, Osokina, N, Akatova, E, Chumakova, G, Libov, I, Voevoda, MI, Tretyakova, TV, Baranov, E, Shustov, S, Yakushin, S, Gordeev, I, Khasanov, N, Reshetko, O, Sotnikova, T, Molchanova, O, Nikolaev, K, Gapon, L, Baranova, E, Shogenov, Z, Kosmachova, E, Povzun, A, Egorova, L, Tyrenko, VV, Ivanov, IG, Simic, D, Ivanovic, N, Davidovic, G, Tasic, N, Asanin, MR, Stojic, S, Apostolovic, SR, Ilic, S, Putnikovic, B, Stankovic, A, Arandjelovic, A, Radovanovic, S, Balinovac, J, Dincic, DV, Seferovic, P, Dodic, S, Dimkovic, S, Poh, KK, Ong, HY, Micko, K, Nociar, J, Pella, D, Fulop, P, Hranai, M, Palka, J, Mazur, J, Majercak, I, Dzupina, A, Fazekas, F, Gonsorcik, J, Bugan, V, Selecky, J, Kamensky, G, Strbova, J, Smik, R, Dukat, A, Zuran, I, Oklukar, J, Suligoj, NC, Cevc, M, Lipar, L, Cyster, HP, Ranjith, N, Corbett, C, Bayat, J, Makotoko, EM, Kapp, IE, Basson, MMD, Lottering, H, Van Zyl, LJ, Sebastian, PJ, Pillay, T, Saaiman, JA, Commerford, PJ, Cassimjee, S, Ebrahim, IO, Sarvan, M, Mynhardt, JH, Dalby, AJ, Reuter, H, Moodley, R, Vida, M, Fillat, ARC, Peris, VB, Jimenez, FF, Marin, F, Fernandez, JMC, Gil-Extremera, B, Diz, FW, Garcia-Dorado, D, Iniguez, A, Fernandez, JT, Gonzalez-Juanatey, JR, Portales, JF, Murillo, FC, Pericas, LM, Zamorano, JL, Martin, MD, Cortada, JB, Martin, JJA, Fernandez, JRD, Fernandez, JFD, Lledo, JAG, Sales, JC, Rodriguez, JB, Tragant, GG, Benedicto, A, Gonzalez-Juanatey, C, Potau, MC, Perez, IP, De La Tassa, CM, Rincon, PLO, Recena, JB, Escudier, JM, Constantine, G, Haniffa, R, Tissera, N, Amarasekera, S, Fernando, N, Jayawardena, J, Santharaj, W, Ekanayaka, R, Mendis, S, Senaratne, V, Mayurathan, G, Sirisena, T, Rajapaksha, A, Herath, JI, Amarasena, N, Berglund, S, Rasmanis, G, Hagstrom, E, Witt, N, Mourtzinis, G, Nicol, P, Hansen, O, Romeo, S, Torstensson, I, Jensen, SA, Ahremark, U, Sundelin, T, Moccetti, T, Mach, F, Binder, R, Chiang, CE, Tsai, WC, Ueng, KC, Lai, WT, Liu, ME, Hwang, JJ, Yin, WH, Hsieh, IC, Kuo, JY, Huang, TY, Fang, CY, Kaewsuwanna, P, Soonfuang, W, Jintapakorn, W, Sukonthasarn, A, Sritara, P, Wongpraparut, N, Sastravaha, K, Sansanayudh, N, Kehasukcharoen, W, Piyayotai, D, Camsari, A, Kultursay, H, Guneri, S, Mutlu, B, Ersanli, M, Demirtas, M, Kirma, C, Ural, E, Koldas, L, Karpenko, O, Prokhorov, A, Vakaluyk, I, Myshanych, H, Reshotko, D, Batushkin, V, Rudenko, L, Kovalskyi, I, Kushnir, M, Tseluyko, V, Mostovoy, Y, Stanislavchuk, M, Kyiak, Y, Karpenko, Y, Malynovsky, Y, Klantsa, A, Kutniy, O, Amosova, E, Tashchuk, V, Leshchuk, O, Parkhomenko, A, Rishko, M, Kopytsya, M, Yagensky, A, Vatutin, M, Bagriy, A, Barna, OM, Ushakov, O, Dzyak, G, Goloborodko, B, Rudenko, A, Trevelyan, J, Zaman, A, Lee, K, Moriarty, A, Aggarwal, RK, Clifford, P, Wong, YK, Iqbal, SMR, Subkovas, E, Braganza, D, Sarkar, D, Storey, R, Griffiths, H, Mcclure, S, Muthusamy, R, Kurian, J, Levy, T, Barr, C, Kadr, H, Gerber, R, Simaitis, A, Soran, H, Mathur, A, Brodison, A, Oliver, R, Mudawi, T, Reynolds, T, Sharman, D, Butler, R, Wilkinson, P, Lip, GYH, Halcox, J, Vardi, G, Baldari, D, Brabham, D, Treasure, C, Dahl, C, Palmer, B, Wiseman, A, Puri, S, Mohart, AE, Ince, C, Flores, E, Wright, S, Cheng, SC, Rosenberg, M, Rogers, W, Kosinski, E, Forgosh, L, Waltman, J, Khan, M, Shoukfeh, M, Dagher, G, Lieber, I, Kumar, P, East, C, Krichmar, P, White, L, Knickelbine, T, Haldis, T, Gillespie, E, Suh, D, Arif, I, Akhter, F, Carlson, E, D'Urso, M, El-Ahdab, F, Nelson, W, Harris, B, Cohen, S, Carter, L, Sabatino, K, Haddad, T, Malik, A, Rao, S, Mulkay, A, Jovin, I, Klancke, K, Malhotra, V, Devarapalli, SK, Koren, M, Chandna, H, Dodds, G, Janik, M, Moran, J, Sumner, A, Kobayashi, J, Davis, W, Yazdani, S, Pasquini, J, Thakkar, M, Vedere, A, Leimbach, W, Rider, J, Singh, N, Shah, AV, Moriarty, PM, Janosik, D, Pepine, C, Berman, B, Gelormini, J, Daniels, C, Keating, F, Kondo, NI, Shetty, S, Waider, W, Takata, T, Abu-Fadel, M, Shah, V, Aggarwal, R, Izzo, M, Kumar, A, Hattler, B, Link, C, Bortnick, A, Kinzfogl, G, Ghitis, A, Larry, J, Teufel, E, Kuhlman, P, Mclaurin, B, Zhang, WW, Thew, S, Abbas, J, White, M, Ranadive, N, Gring, C, Henderson, D, Schuchard, T, Farhat, N, Kline, G, Mahal, S, Whitaker, J, Speirs, S, Andersen, R, Daboul, N, Horwitz, P, Jafar, Z, Mcgarvey, J, Panchal, V, Voyce, S, Blok, T, Sheldon, W, Azizad, MM, Schmalfuss, C, Picone, M, Herzog, W, Lindsey, J, Nowins, R, Lepor, N, El Shahawy, M, Weintraub, H, Irimpen, A, May, W, Galski, T, Chu, A, Mody, F, Hodes, Z, Fairlamb, J, Lambert, C, Raisinghani, A, Abbate, A, King, M, Carey, C, Gerber, J, Younis, L, Park, H, Vidovich, M, Knutson, T, Friedman, D, Chaleff, F, Loussararian, A, Kimmelstiel, C, Silver, K, Foster, M, Tonnessen, G, Amlani, M, Wali, A, Malozzi, C, Wattanakit, K, O'Donnell, PJ, Singal, D, Jaffrani, N, Banuru, S, Fisher, D, Xenakis, M, Perlmutter, N, Bhagwat, R, Strader, J, Akyea-Djamson, A, Labroo, A, Marais, HJ, Claxton, E, Berk, M, Rossi, P, Joshi, P, Khaira, AS, Kumkumian, G, Lupovitch, S, Purow, J, Welka, S, Hoffman, D, Fischer, S, Soroka, E, Eagerton, D, Pancholy, S, Ray, M, Farrar, M, Pollock, S, French, WJ, Diamantis, S, Gimple, L, Schwartz, S, Pereira, E, Spriggs, D, Strain, J, Vo, A, Chane, M, Hall, J, Vijay, N, Lotun, K, Lester, FM, Nahhas, A, Pope, T, Nager, P, Vohra, R, Bashir, R, Ahmed, H, Berlowitz, M, Fishberg, R, Barrucco, R, Yang, E, Radin, M, Sporn, D, Eisenberg, S, Landzberg, J, Mcgough, M, Turk, S, Schwartz, M, Sundram, PS, Jain, D, Zainea, M, Bayron, C, Karlsberg, R, Lui, H, Keen, W, Westerhausen, D, Khurana, S, Agarwal, H, Birchem, J, Penny, W, Chang, M, Gilbert, JM, Chalavarya, G, Eaton, C, Schmedtje, JF, Christenson, S, Denham, D, Macdonell, A, Gibson, P, Rahman, A, Al Joundi, T, Conrad, G, Kotha, P, Love, M, Giesler, G, Rubenstein, H, Akright, L, Schifferdecker, B, Krawczyk, J, Wells, T, Welker, J, Foster, R, Gilmore, R, Anderson, J, Jacoby, D, Gardner, G, Dandillaya, R, Vora, K, Kostis, J, Hunter, J, Laxson, D, Ball, E, İÜC, and Ege Üniversitesi
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Male ,medicine.medical_specialty ,Acute coronary syndrome ,alirocumab ,030204 cardiovascular system & hematology ,Antibodies, Monoclonal, Humanized ,lipids ,PCSK9 ,03 medical and health sciences ,0302 clinical medicine ,Postoperative Complications ,Double-Blind Method ,coronary artery bypass graft ,Internal medicine ,medicine ,Humans ,Cardiac and Cardiovascular Systems ,030212 general & internal medicine ,Myocardial infarction ,cardiovascular diseases ,Acute Coronary Syndrome ,Coronary Artery Bypass ,Alirocumab ,Aged ,Kardiologi ,business.industry ,Unstable angina ,Hazard ratio ,cholesterol ,Middle Aged ,medicine.disease ,surgical procedures, operative ,Bypass surgery ,Cardiovascular Diseases ,Cardiology ,Drug Therapy, Combination ,Female ,Hydroxymethylglutaryl-CoA Reductase Inhibitors ,Cardiology and Cardiovascular Medicine ,business ,Mace - Abstract
Sherwood, Matthew/0000-0002-4305-5883; Taskinen, Marja-Riitta/0000-0002-6229-3588; Leonardi, Sergio/0000-0002-4800-6132; Raffel, Owen C/0000-0001-5470-7050; Muenzel, Thomas/0000-0001-5503-4150; Ersanli, Murat/0000-0003-1847-3087; Gislason, Gunnar H/0000-0002-0548-402X; bastos, jose/0000-0002-9526-3123; Abbate, Antonio/0000-0002-1930-785X; Chumakova, Galina A/0000-0002-2810-6531; Nikolaev, Konstantin/0000-0003-4601-6203; Tse, Hung Fat/0000-0002-9578-7808; Keskin, Kudret/0000-0002-9049-1530; Reshetko, Olga/0000-0003-3107-7636; Podoleanu, Cristian/0000-0001-9987-2519; Aylward, Philip/0000-0002-5358-8552; LETIERCE, Alexia/0000-0001-6679-5772, WOS: 000483334800002, PubMed: 31466614, BACKGROUND Patients with acute coronary syndrome (ACS) and history of coronary artery bypass grafting (CABG) are at high risk for recurrent cardiovascular events and death. OBJECTIVES This study sought to determine the clinical benefit of adding alirocumab to statins in ACS patients with prior CABG in a pre-specified analysis of ODYSSEY OUTCOMES (Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab). METHODS Patients (n = 18,924) 1 to 12 months post-ACS with elevated atherogenic lipoprotein levels despite high-intensity statin therapy were randomized to alirocumab or placebo subcutaneously every 2 weeks. Median follow-up was 2.8 years. the primary composite endpoint of major adverse cardiovascular events (MACE) comprised coronary heart disease death, nonfatal myocardial infarction, ischemic stroke, or unstable angina requiring hospitalization. All-cause death was a secondary endpoint. Patients were categorized by CABG status: no CABG (n = 16,896); index CABG after qualifying ACS, but before randomization (n = 1,025); or CABG before the qualifying ACS (n = 1,003). RESULTS in each CABG category, hazard ratios (95% confidence intervals) for MACE (no CABG 0.86 [0.78 to 0.95], index CABG 0.85 [0.54 to 1.35], prior CABG 0.77 [0.61 to 0.98]) and death (0.88 [ 0.75 to 1.03], 0.85 [0.46 to 1.59], 0.67 [0.44 to 1.01], respectively) were consistent with the overall trial results (0.85 [ 0.78 to 0.93] and 0.85 [0.73 to 0.98], respectively). Absolute risk reductions (95% confidence intervals) differed across CABG categories for MACE (no CABG 1.3% [0.5% to 2.2%], index CABG 0.9% [-2.3% to 4.0%], prior CABG 6.4% [0.9% to 12.0%]) and for death (0.4% [-0.1% to 1.0%], 0.5% [-1.9% to 2.9%], and 3.6% [0.0% to 7.2%]). CONCLUSIONS Among patients with recent ACS and elevated atherogenic lipoproteins despite intensive statin therapy, alirocumab was associated with large absolute reductions in MACE and death in those with CABG preceding the ACS event. (ODYSSEY OUTCOMES: Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab; NCT01663402) (C) 2019 by the American College of Cardiology Foundation., Fondation Assistance Publique-Hopitaux de Paris, Paris, France, The authors thank the patients, study coordinators, and investigators who participated in this trial. Sophie Rushton-Smith, PhD (MedLink Healthcare Communications, London) provided editorial assistance in the preparation of the manuscript (limited to editing for style, referencing, and figure and table editing) and was funded by Fondation Assistance Publique-Hopitaux de Paris, Paris, France.
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- 2019
7. Effect of Alirocumab on Mortality After Acute Coronary Syndromes An Analysis of the ODYSSEY OUTCOMES Randomized Clinical Trial
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Steg, PG, Szarek, M, Bhatt, DL, Bittner, VA, Bregeault, M-F, Dalby, AJ, Diaz, R, Edelberg, JM, Goodman, SG, Hanotin, C, Harrington, RA, Jukema, JW, Lecorps, G, Mahaffey, KW, Moryusef, A, Ostadal, P, Parkhomenko, A, Pordy, R, Roe, MT, Tricoci, P, Vogel, R, White, HD, Zeiher, AM, Schwartz, GG, Sasiela, WJ, Tamby, J-F, Aylward, PE, Drexel, H, Sinnaeve, P, Dilic, M, Gotcheva, NN, Prieto, J-C, Yong, H, Lopez-Jaramillo, P, Pecin, I, Reiner, Z, Poulsen, SH, Viigimaa, M, Nieminen, MS, Danchin, N, Chumburidze, V, Marx, N, Liberopoulos, E, Valdovinos, PCM, Tse, H-F, Kiss, RG, Xavier, D, Zahger, D, Valgimigli, M, Kimura, T, Kim, HS, Kim, S-H, Kedev, S, Erglis, A, Laucevicius, A, Yusoff, K, Lopez, R, Ramos Lopez, GA, Alings, M, Halvorsen, S, Correa Flores, RM, Sy, RG, Budaj, A, Morais, J, Dorobantu, M, Karpov, Y, Ristic, AD, Chua, T, Murin, J, Fras, Z, Tunon, J, De Silva, HA, Hagstrom, E, Muller, C, Chiang, C-E, Sritara, P, Guneri, S, Ray, KK, Moriarty, PM, Chaitman, B, Kelsey, SF, Olsson, AG, 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Mclaurin, B, Zhang, W, Thew, S, Abbas, J, White, M, Ranadive, N, Gring, C, Henderson, D, Schuchard, T, Farhat, N, Kline, G, Mahal, S, Whitaker, J, Speirs, S, Andersen, R, Daboul, N, Horwitz, P, Ponce, G, Jafar, Z, Mcgarvey, J, Panchal, V, Voyce, S, Blok, T, Sheldon, W, Azizad, MM, Schmalfuss, C, Picone, M, Herzog, W, Lindsey, J, Nowins, R, Lepor, N, El Shahawy, M, Weintraub, H, Irimpen, A, May, W, Galski, T, Chu, A, Mody, F, Hodes, Z, Rose, G, Fairlamb, J, Lambert, C, Raisinghani, A, Abbate, A, King, M, Carey, C, Gerber, J, Younis, L, Park, HT, Vidovich, M, Knutson, T, Friedman, D, Chaleff, F, Loussararian, A, Rozeman, P, Kimmelstiel, C, Silver, K, Foster, M, Tonnessen, G, Amlani, M, Wali, A, Malozzi, C, Wattanakit, K, O'Donnell, PJ, Singal, D, Jaffrani, N, Banuru, S, Fisher, D, Xenakis, M, Perlmutter, N, Bhagwat, R, Strader, J, Akyea-Djamson, A, Labroo, A, Marais, HJ, Claxton, E, Berk, M, Rossi, P, Joshi, P, Khaira, AS, Kumkumian, G, Lupovitch, S, Purow, J, Welka, S, Hoffman, D, Fischer, S, Soroka, E, Eagerton, D, Pancholy, S, Ray, M, Farrar, M, Pollock, S, French, WJ, Diamantis, S, Gimple, L, Neustel, M, Schwartz, S, Pereira, E, Spriggs, D, Strain, J, Vo, A, Chane, M, Hall, J, Vijay, N, Lotun, K, Lester, FM, Nahhas, A, Pope, T, Nager, P, Vohra, R, Bashir, R, Ahmed, H, Berlowitz, M, Fishberg, R, Barrucco, R, Yang, E, Radin, M, Sporn, D, Eisenberg, S, Landzberg, J, Mcgough, M, Turk, S, Schwartz, M, Sundram, PS, Jain, D, Zainea, M, Bayron, C, Karlsberg, R, Lui, H, Keen, W, Westerhausen, D, Khurana, S, Agarwal, H, Birchem, J, Penny, W, Chang, M, Murphy, S, Schifferdecker, B, Gilbert, JM, Chalavarya, G, Eaton, C, Schmedtje, JF, Christenson, S, Denham, D, Macdonell, A, Gibson, P, Rahman, A, Al Joundi, T, Conrad, G, Kotha, P, Love, M, Giesler, G, Rubenstein, H, Akright, L, Krawczyk, J, Wells, T, Welker, J, Foster, R, Gilmore, R, Anderson, J, Jacoby, D, Gardner, G, Dandillaya, R, Vora, K, Kostis, J, Hunter, J, Laxson, D, Ball, E, Camp, A, Lopes, R, Egydio, F, Kawakami, A, Oliveira, J, Wozniak, J, Matthews, A, Ratky, C, Valiris, J, Berdan, L, Hepditch, A, Quintero, K, Rorick, T, Westbrook, M, Pascual, A, Rovito, C, Bezault, M, Drouet, E, Simon, T, Alsweiler, C, Luyten, A, Aylward, P, Butters, J, Griffith, L, Shaw, M, Grunberg, L, Islam, S, Bougon, N, Faustino, D, Fontecave, S, Murphy, J, Verrier, M, Agnetti, V, Andersen, D, Badreddine, E, Bekkouche, M, Bouancheau, C, Brigui, I, Brocklehurst, M, Cianciarulo, J, Devaul, D, Domokos, S, Gache, C, Gobillot, C, Guillou, S, Healy, J, Heath, M, Jaiwal, G, Javierre, C, Labeirie, J, Monier, M, Morales, U, Mrabti, A, Mthombeni, B, Okan, B, Smith, L, Sheller, J, Sopena, S, Pellan, V, Benbernou, F, Bengrait, N, Lamoureux, M, Kralova, K, Scemama, M, Bejuit, R, Coulange, A, Berthou, C, Repincay, J, Lorenzato, C, Etienne, A, Gouet, V, Loizeau, V, Normand, M, Ourliac, A, Rondel, C, Adamo, A, Beltran, P, Barraud, P, Dubois-Gache, H, Halle, B, Metwally, L, Mourgues, M, Sotty, M, Vincendet, M, Cotruta, R, Zhu, C, Fournie-Lloret, D, Morrello, C, Perthuis, A, Picault, P, Zobouyan, I, ODYSSEY OUTCOMES Comm, İÜC, Ege Üniversitesi, Rushton-Smith, Sophie, and ODYSSEY OUTCOMES Committees and Investigators
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Male ,Cardiac & Cardiovascular Systems ,MONOCLONAL-ANTIBODY ,alirocumab ,Hydroxymethylglutaryl-CoA Reductase Inhibitors/administration & dosage ,law.invention ,PCSK9 ,chemistry.chemical_compound ,Randomized controlled trial ,law ,Cardiac and Cardiovascular Systems ,1102 Cardiorespiratory Medicine and Haematology ,Hypercholesterolemia/blood ,Kardiologi ,Hazard ratio ,Middle Aged ,Treatment Outcome ,SAFETY ,Cardiology ,Female ,Drug Therapy, Combination ,Cholesterol, LDL/antagonists & inhibitors ,Cardiology and Cardiovascular Medicine ,Life Sciences & Biomedicine ,REDUCING LIPIDS ,Akutes Koronarsyndrom ,acute coronary syndrome ,cholesterol ,mortality ,PCSK9 protein ,Antibodies, Monoclonal, Humanized/administration & dosage ,medicine.medical_specialty ,Acute coronary syndrome ,Injections, Subcutaneous ,Hypercholesterolemia ,Placebo ,Antibodies, Monoclonal, Humanized ,1117 Public Health and Health Services ,Sterblichkeit ,Double-Blind Method ,Physiology (medical) ,Internal medicine ,medicine ,Humans ,ddc:610 ,Alirocumab ,Aged ,Science & Technology ,Cholesterol ,business.industry ,EVOLOCUMAB ,1103 Clinical Sciences ,Cholesterol, LDL ,medicine.disease ,EFFICACY ,Increased risk ,chemistry ,Peripheral Vascular Disease ,Cardiovascular System & Hematology ,Cardiovascular System & Cardiology ,Acute Coronary Syndrome/blood ,Cholesterin ,Human medicine ,Hydroxymethylglutaryl-CoA Reductase Inhibitors ,business ,Follow-Up Studies - Abstract
bastos, jose/0000-0002-9526-3123; Manakshe, Gajendra/0000-0002-4983-4271; Tse, Hung Fat/0000-0002-9578-7808; Gislason, Gunnar H/0000-0002-0548-402X; Taskinen, Marja-Riitta/0000-0002-6229-3588; Racca, Vittorio/0000-0002-4465-3789; Keskin, Kudret/0000-0002-9049-1530; Sherwood, Matthew/0000-0002-4305-5883; Sandhu, Manjinder/0000-0003-2538-2079; Nikolaev, Konstantin/0000-0003-4601-6203; Ersanli, Murat/0000-0003-1847-3087; Raffel, Owen C/0000-0001-5470-7050; Abbate, Antonio/0000-0002-1930-785X; Muenzel, Thomas/0000-0001-5503-4150; Leonardi, Sergio/0000-0002-4800-6132; Chumakova, Galina A/0000-0002-2810-6531; Podoleanu, Cristian/0000-0001-9987-2519; Pereira, Helder/0000-0001-8656-4883; Reshetko, Olga/0000-0003-3107-7636, WOS: 000476768100007, PubMed: 31117810, Background: Previous trials of PCSK9 (proprotein convertase subtilisin-kexin type 9) inhibitors demonstrated reductions in major adverse cardiovascular events, but not death. We assessed the effects of alirocumab on death after index acute coronary syndrome. Methods: ODYSSEY OUTCOMES (Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab) was a double-blind, randomized comparison of alirocumab or placebo in 18 924 patients who had an ACS 1 to 12 months previously and elevated atherogenic lipoproteins despite intensive statin therapy. Alirocumab dose was blindly titrated to target achieved low-density lipoprotein cholesterol (LDL-C) between 25 and 50 mg/dL. We examined the effects of treatment on all-cause death and its components, cardiovascular and noncardiovascular death, with log-rank testing. Joint semiparametric models tested associations between nonfatal cardiovascular events and cardiovascular or noncardiovascular death. Results: Median follow-up was 2.8 years. Death occurred in 334 (3.5%) and 392 (4.1%) patients, respectively, in the alirocumab and placebo groups (hazard ratio [HR], 0.85; 95% CI, 0.73 to 0.98; P=0.03, nominal P value). This resulted from nonsignificantly fewer cardiovascular (240 [2.5%] vs 271 [2.9%]; HR, 0.88; 95% CI, 0.74 to 1.05; P=0.15) and noncardiovascular (94 [1.0%] vs 121 [1.3%]; HR, 0.77; 95% CI, 0.59 to 1.01; P=0.06) deaths with alirocumab. in a prespecified analysis of 8242 patients eligible for >= 3 years follow-up, alirocumab reduced death (HR, 0.78; 95% CI, 0.65 to 0.94; P=0.01). Patients with nonfatal cardiovascular events were at increased risk for cardiovascular and noncardiovascular deaths (P= 100 mg/dL (2.59 mmol/L) had a greater absolute risk of death and a larger mortality benefit from alirocumab (HR, 0.71; 95% CI, 0.56 to 0.90; P-interaction=0.007). in the alirocumab group, all-cause death declined with achieved LDL-C at 4 months of treatment, to a level of approximately 30 mg/dL (adjusted P=0.017 for linear trend). Conclusions: Alirocumab added to intensive statin therapy has the potential to reduce death after acute coronary syndrome, particularly if treatment is maintained for >= 3 years, if baseline LDL-C is >= 100 mg/dL, or if achieved LDL-C is low., Sanofi; Regeneron Pharmaceuticals, Inc., The trial was funded by Sanofi and Regeneron Pharmaceuticals, Inc.
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- 2019
8. 2018 ESC Guidelines for the management of cardiovascular diseases during pregnancy
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Regitz-Zagrosek, V, Roos-Hesselink, JW, Bauersachs, J, Blomström-Lundqvist, C, Cífková, R, De Bonis, M, Iung, B, Johnson, MR, Kintscher, U, Kranke, P, Lang, IM, Morais, J, Pieper, PG, Presbitero, P, Price, S, Rosano, GMC, Seeland, U, Simoncini, T, Swan, L, Warnes, CA, Deaton, C, Simpson, IA, Aboyans, V, Agewall, S, Barbato, E, Calda, P, Coca, A, Coman, IM, De Backer, J, Delgado, V, Di Salvo, G, Fitzsimmons, S, Fitzsimons, D, Garbi, M, Gevaert, S, Hindricks, G, Jondeau, G, Kluin, J, Lionis, C, McDonagh, TA, Meier, P, Moons, P, Pantazis, A, Piepoli, MF, Rocca, B, Roffi, M, Rosenkranz, S, Sarkozy, A, Shlyakhto, E, Silversides, CK, Sliwa, K, Sousa-Uva, M, Tamargo, J, Thorne, S, Van de Velde, M, Williams, B, Zamorano, JL, Windecker, S, Bueno, H, Collet, J-P, Dean, V, Gaemperli, O, Jüni, P, Katus, HA, Knuuti, J, Lancellotti, P, Leclercq, C, Ponikowski, P, Richter, DJ, Hammoudi, N, Piruzyan, A, Mascherbauer, J, Samadov, F, Prystrom, A, Pasquet, A, Caluk, J, Gotcheva, N, Skoric, B, Heracleous, H, Vejlstrup, N, Maser, M, Kaaja, RJ, Srbinovska-Kostovska, E, Mounier-Vehier, C, Vakhtangadze, T, Rybak, K, Giannakoulas, G, Kiss, RG, Thrainsdottir, IS, Erwin, RJ, Porter, A, Geraci, G, Ibrahimi, P, Lunegova, O, Mintale, I, Kadri, Z, Benlamin, H, Barysiene, J, Banu, CA, Caruana, M, Gratii, C, Haddour, L, Bouma, BJ, Estensen, M-E, Hoffman, P, Petris, AO, Moiseeva, O, Bertelli, L, Tesic, BV, Dubrava, J, Koželj, M, Prieto-Arévalo, R, Furenäs, E, Schwerzmann, M, Mourali, MS, Ozer, N, Mitchenko, O, Nelson-Piercy, C, Regitz-Zagrosek, V., Roos-Hesselink, J. W., Bauersachs, J., Blomstrom-Lundqvist, C., Cifkova, R., De Bonis, M., Iung, B., Johnson, M. R., Kintscher, U., Kranke, P., Lang, I. M., Morais, J., Pieper, P. G., Presbitero, P., Price, S., Rosano, G. M. C., Seeland, U., Simoncini, T., Swan, L., Warnes, C. A., Regitz-Zagrosek, Vera, Roos-Hesselink, Jolien W, Bauersachs, Johann, Blomström-Lundqvist, Carina, Cífková, Renata, De Bonis, Michele, Iung, Bernard, Johnson, Mark Richard, Kintscher, Ulrich, Kranke, Peter, Lang, Irene Marthe, Morais, Joao, Pieper, Petronella G, Presbitero, Patrizia, Price, Susanna, Rosano, Giuseppe MC, Seeland, Ute, Simoncini, Tommaso, Swan, Lorna, Warnes, Carole A, and Cardiology
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Counseling ,Prenatal Diagnosi ,030204 cardiovascular system & hematology ,Guideline ,Cardiovascular ,0302 clinical medicine ,Pregnancy ,Prenatal Diagnosis ,030212 general & internal medicine ,1102 Cardiorespiratory Medicine and Haematology ,Societies, Medical ,Risk assessment ,Advisory Committee ,Advisory Committees ,Cardiology ,Cardiovascular Agents ,Europe ,Female ,Humans ,Poland ,Pregnancy Complications, Cardiovascular ,Practice Guidelines as Topic ,valvular heart disease ,Cardiovascular disease ,Management ,Hypertension ,Drug therapy ,Cardiology and Cardiovascular Medicine ,Arrhythmia ,Human ,medicine.medical_specialty ,Settore BIO/14 - FARMACOLOGIA ,Cardiomyopathy ,Heart failure ,Cardiovascular therapy ,Pulmonary hypertension ,Aortic pathology ,03 medical and health sciences ,SDG 3 - Good Health and Well-being ,Medical ,medicine ,Cardiovascular diagnosis ,Intensive care medicine ,Congenital heart disease ,Pharmacology ,business.industry ,ta3121 ,medicine.disease ,Valvular heart disease ,Pregnancy Complications ,Cardiovascular System & Hematology ,Cardiovascular Agent ,Societies ,business - Published
- 2019
9. Alirocumab Reduces Total Hospitalizations and Increases Days Alive and Out of Hospital in the ODYSSEY OUTCOMES Trial
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DiCenso, D, Gotcheva, N, Sourdille, T, White, HD, Schwartz, GG, Steg, PG, Bhatt, DL, Bittner, VA, Diaz, R, Harrington, RA, Jukema, JW, Szarek, M, Zeiher, AM, Tricoci, P, Mahaffey, KW, Edelberg, JM, Hanotin, C, Lecorps, G, Moryusef, A, Pordy, R, Sasiela, WJ, Drexel, H, Sinnaeve, P, Dilic, M, Gotcheva, NN, Goodman, SG, Prieto, JC, Yong, H, Lopez-Jaramillo, P, Pecin, I, Reiner, Z, Poulsen, SH, Viigimaa, M, Nieminen, MS, Danchin, N, Chumburidze, V, Tse, HF, Xavier, D, Zahger, D, Valgimigli, M, Kim, HS, Erglis, A, Laucevicius, A, Lopez, R, Lopez, GAR, Alings, M, Chua, T, Murin, J, Fras, Z, Dalby, AJ, Tunon, J, De Silva, HA, Chiang, CE, Sritara, P, Guneri, S, Parkhomenko, A, Ray, KK, Moriarty, PM, Roe, MT, Chaitman, B, Kelsey, SF, Olsson, AG, Rouleau, JL, Simoons, ML, Alexander, K, Meloni, C, Rosenson, R, Sijbrands, EJG, Alexander, JH, Armaganijan, L, Bagai, A, Bahit, MC, Brennan, JM, Clifton, S, DeVore, AD, Deloatch, S, Dickey, S, Dombrowski, K, Ducrocq, G, Eapen, Z, Endsley, P, Eppinger, A, Harrison, RW, Hess, CN, Hlatky, MA, Jordan, JD, Knowles, JW, Kolls, BJ, Kong, DF, Leonardi, S, Lillis, L, Maron, DJ, Marcus, J, Mathews, R, Mehta, RH, Mentz, RJ, Moreira, HG, Patel, CB, Pereira, SB, Perkins, L, Povsic, TJ, Puymirat, E, Jones, WS, Shah, BR, Sherwood, MW, Stringfellow, K, Sujjavanich, D, Toma, M, Van Diepen, SFP, Wilson, MD, Yan, ATK, Lopes, RD, Trotter, C, Schiavi, LB, Garrido, M, Alvarisqueta, AF, Sassone, SA, Bordonava, AP, De Lima, AEA, Schmidberg, JM, Duronto, EA, Caruso, OC, Novaretto, LP, Hominal, MA, Montana, OR, Caccavo, A, Vilamajo, OAG, Lorenzatti, AJ, Cartasegna, LR, Paterlini, GA, Mackinnon, IJ, Caime, GD, Amuchastegui, M, Salomone, R, Codutti, OR, Jure, HO, Bono, JOE, Hrabar, AD, Vallejos, JA, Guerrero, RAA, Novoa, F, Patocchi, CA, Zaidman, CJ, Giuliano, ME, Dran, RD, Vico, ML, Carnero, GS, Guzman, PN, Allende, JCM, Brasca, DFG, Labarta, MHB, Nani, S, Blumberg, EDS, Colombo, HR, Liberman, A, Luciardi, HL, Waisman, GD, Berli, MA, Duran, ROG, Cestari, HG, Luquez, HA, Giordano, JA, Saavedra, SS, Zapata, G, Costamagna, O, Llois, S, Waites, JH, Collins, N, Soward, A, Aylward, PE, Hii, CLS, Shaw, J, Arstall, MA, Horowitz, J, Rogers, JF, Colquhoun, D, Flores, REO, Roberts-Thomson, P, Raffel, O, Lehman, SJ, Aroney, C, Coverdale, SGM, Garrahy, PJ, Starmer, G, Sader, M, Carroll, PA, Dick, R, Zweiker, R, Hoppe, U, Huber, K, Berger, R, Weidinger, F, Faes, D, Hermans, K, Pirenne, B, Leone, A, Hoffer, E, Vrolix, MCM, De Wolf, L, Wollaert, B, Castadot, M, Dujardin, K, Beauloye, C, Vervoort, G, Striekwold, H, Convens, C, Roosen, J, Barbato, E, Claeys, M, Cools, F, Terzic, I, Barakovic, F, Midzic, Z, Pojskic, B, Fazlibegovic, E, Durak-Nalbantic, A, Vulic, D, Muslibegovic, A, Goronja, B, Reis, G, Sousa, L, Nicolau, JC, Giorgeto, FE, Silva, RP, Maia, LN, Rech, R, Rossi, PRF, Cerqueira, MJAG, Duda, N, Kalil, R, Kormann, A, Abrantes, JAM, Pimentel, P, Soggia, AP, de Santos, MON, Neuenschwander, F, Bodanese, LC, Michalaros, YL, Eliaschewitz, FG, Vidotti, MH, Leaes, PE, Botelho, RV, Kaiser, S, Manenti, ERFF, Precoma, DB, Jorge, JCM, Silva, PGMD, Silveira, JA, Saporito, W, Marin, JA, Feitosa, GS, Ritt, LEF, de Souza, JA, Costa, F, Souza, WKSB, Reis, HJL, Machado, L, Ayoub, JCA, Todorov, GV, Nikolov, FP, Velcheva, ES, Tzekova, ML, Benov, HO, Petranov, SL, Tumbev, HS, Shehova-Yankova, NS, Markov, DT, Raev, DH, Mollov, MN, Kichukov, KN, Ilieva-Pandeva, KA, Ivanova, R, Mincheva, VM, Lazov, PV, Dimov, BI, Senaratne, M, Stone, J, Kornder, J, Pearce, S, Dion, D, Savard, D, Pesant, Y, Pandey, A, Robinson, S, Gosselin, G, Vizel, S, Hoag, G, Bourgeois, R, Morisset, A, Sabbah, E, Sussex, B, Kouz, S, MacDonald, P, Diaz, A, Michaud, N, Fell, D, Leung, R, Vuurmans, T, Lai, C, Nigro, F, Davies, R, Nogareda, G, Vijayaraghavan, R, Ducas, J, Lepage, S, Mehta, S, Cha, J, Dupuis, R, Fong, P, Rodes-Cabau, J, Fadlallah, H, Cleveland, D, Huynh, T, Bata, I, Hameed, A, Pincetti, C, Potthoff, S, Acevedo, M, Aguirre, A, Vejar, M, Yanez, M, Araneda, G, Fernandez, M, Perez, L, Varleta, P, Florenzano, F, Huidobro, L, Raffo, CA, Olivares, C, Nahuelpan, L, Montecinos, H, Chen, JY, Dong, YG, Huang, WJ, Wang, JZ, Huang, SA, Yao, ZH, Li, X, Cui, L, Lin, WH, Sun, YM, Wang, JF, Li, JP, Zhang, XL, Zhu, H, Chen, D, Huang, L, Dong, SH, Su, GH, Xu, BA, Su, X, Cheng, XS, Lin, JX, Zong, WX, Li, HM, Feng, Y, Xu, DL, Yang, XC, Ke, YN, Lin, XF, Zhang, Z, Zheng, ZQ, Luo, ZR, Chen, YD, Ding, CH, Zheng, Y, Li, XD, Peng, DQ, Li, Y, Wei, M, Liu, SW, Yu, YH, Qu, BM, Jiang, WH, Zhou, YJ, Zhao, XS, Yuan, ZY, Guo, Y, Xu, XP, Shi, XB, Ge, JB, Fu, GS, Bai, F, Fang, WY, Shou, XL, Yang, XJ, Wang, JA, Sun, YX, Lu, QH, Zhang, RY, Zhu, JH, Xu, YZ, Fan, ZC, Li, TC, Wu, C, Jaramillo, N, Vallejo, GS, Botia, DCL, Lopez, RB, De Salazar, DIM, Bonfanti, AJC, Higuera, JD, Silva, SIB, Lozada, HJG, Arroyo, JAC, Mendoza, JLA, Ruiz, RLF, Jatin, FGM, Herazo, AS, Parada, JC, Triana, MAU, Strozzi, M, Car, S, Milicic, D, Bencic, ML, Pintaric, H, Prvulovic, D, Sikic, J, Persic, V, Mileta, D, Stambuk, K, Zdravko, B, Tomulic, V, Krstulovic, SM, Starcevic, B, Spinar, J, Horak, D, Stasek, J, Alan, D, Machova, V, Linhart, A, Novotny, V, Kaucak, V, Rokyta, R, Naplava, R, Coufal, Z, Adamkova, V, Podpera, I, Zizka, J, Motovska, Z, Marusincova, I, Svab, P, Ostadal, P, Heinc, P, Kuchar, J, Povolny, P, Matuska, J, Raungaard, B, Clemmensen, P, Bang, LE, May, O, Bottcher, M, Hove, JD, Frost, L, Gislason, G, Larsen, J, Johansen, PB, Hald, F, Jeppesen, J, Nielsen, T, Kristensen, KS, Walichiewicz, PM, Lomholdt, JD, Klausen, IC, Nielsen, PK, Davidsen, F, Videbaek, L, Soots, M, Vahula, V, Hedman, A, Soopold, U, Martsin, K, Kristjan, A, Taskinen, MR, Porthan, K, Airaksinen, JK, Juonala, M, Kiviniemi, T, Vikman, S, Posio, P, Taurio, J, Huikuri, H, Kaikkonen, K, Coste, P, Ferrari, E, Morel, O, Montalescot, G, Barone-Rochette, G, Mansourati, J, Cottin, Y, Leclercq, F, Belhassane, A, Delarche, N, Boccara, F, Paganelli, F, Clerc, J, Schiele, F, Aboyans, V, Probst, V, Berland, J, Lefevre, T, Citron, B, Khintibidze, I, Shaburishvili, T, Pagava, Z, Ghlonti, R, Lominadze, Z, Khabeishvili, G, Hemetsberger, R, Rauch-Krohnert, U, Stratmann, M, Appel, KF, Schmidt, E, Omran, H, Stellbrink, C, Dorsel, T, Lianopoulos, E, Marx, R, Zirlik, A, Schellenberg, D, Heitzer, T, Laufs, U, Marx, N, Gielen, S, Winkelmann, B, Behrens, S, Sydow, K, Simonis, G, Muenzel, T, Werner, N, Leggewie, S, Bocker, D, Braun-Dullaeus, R, Toursarkissian, N, Jeserich, M, Weissbrodt, M, Schaeufele, T, Weil, J, Voller, H, Waltenberger, J, Natour, M, Schmitt, S, Steiner, S, Heidenreich, L, Gremmler, U, Killat, H, Rieker, W, Patsilinakos, S, Kartalis, A, Manolis, A, Sionis, D, Liberopoulos, E, Skoumas, I, Athyros, V, Vardas, P, Parthenakis, F, Alexopoulos, D, Hahalis, G, Lekakis, J, Hatzitolios, A, Ovando, SRF, Valdovinos, PCM, Benecke, JLA, De Leon, ERR, Yan, BPY, Siu, DCW, Turi, T, Merkely, B, Kiss, RG, Ungi, I, Lupkovics, G, Nagy, L, Katona, A, Edes, I, Muller, G, Horvath, I, Kapin, T, Falukozy, J, Kumbla, M, Sandhu, M, Annam, S, Proddutur, NR, Premchand, RK, Mahajan, A, Abhyanakar, AD, Kerkar, P, Govinda, RA, Oomman, A, Sinha, D, Patil, SN, Kahali, D, Sawhney, J, Joshi, AB, Chaudhary, S, Harkut, P, Guha, S, Porwal, S, Jujjuru, S, Pothineni, RB, Monteiro, MR, Khan, A, Iyengar, SS, Grewal, JS, Chopda, M, Fulwani, MC, Patange, A, Chopra, VK, Goyal, NK, Shinde, R, Manakshe, GV, Patki, N, Sethi, S, Munusamy, V, Karna, S, Adhyapak, S, Pandurangi, U, Mathur, R, Kalashetti, S, Bhagwat, A, Raghuraman, B, Yerra, SK, Bhansali, P, Borse, R, Das, S, Abdullakutty, J, Saathe, S, Abdullkutty, J, Sathe, S, Palimkar, P, Atar, S, Shechter, M, Mosseri, M, Arbel, Y, Lotan, C, Rosenschein, U, Katz, A, Henkin, Y, Francis, A, Klutstein, M, Nikolsky, E, Turgeman, Y, Halabi, M, Kornowski, R, Jonas, M, Amir, O, Rozenman, Y, Fuchs, S, Hussein, O, Gavish, D, Vered, Z, Caraco, Y, Elias, M, Tov, N, Lishner, M, Elias, N, Piovaccari, G, De Pellegrin, A, Guardigli, G, Licciardello, G, Auguadro, C, Cuccia, C, Salvioni, A, Musumeci, G, Calabro, P, Novo, S, Faggiano, P, De Cesare, NB, Berti, S, Cavallini, C, Puccioni, E, Galvani, M, Tespili, M, Piatti, P, Palvarini, M, De Luca, G, Violini, R, De Leo, A, Filardi, PP, Ferratini, M, Ricca, V, Dai, K, Kamiya, H, Ando, K, Takeda, Y, Morino, Y, Hata, Y, Kimura, K, Kishi, K, Michishita, I, Uehara, H, Higashikata, T, Hirayama, A, Hirooka, K, Sakagami, S, Taguchi, S, Koike, A, Fujinaga, H, Koba, S, Kozuma, K, Kawasaki, T, Ono, Y, Shimizu, M, Katsuda, Y, Wada, A, Shinke, T, Kimura, T, Ako, J, Fujii, K, Takahashi, T, Sakamoto, T, Furukawa, Y, Sugino, H, Mano, T, Utsu, N, Ito, K, Haraguchi, T, Ueda, Y, Nishibe, A, Masutani, M, Fujimoto, K, Yoon, JH, Kim, SH, Park, HS, Chae, IH, Kim, MH, Jeong, MH, Rha, S, Kim, C, Hong, T, Tahk, SJ, Kim, Y, Busmane, A, Pontaga, N, Strelnieks, A, Mintale, I, Sime, I, Petrulioniene, Z, Kavaliauskiene, R, Jurgaitiene, R, Sakalyte, G, Slapikas, R, Norkiene, S, Misonis, N, Kibarskis, A, Kubilius, R, Bojovski, S, Kedev, S, Lozance, N, Kjovkaroski, A, Doncovska, S, Ong, TK, Kasim, S, Maskon, O, Kandasamy, B, Yusoff, K, Liew, HB, Mohamed, WMIW, Castillo, AG, Calvillo, JC, Campos, PF, Fragoso, JCN, Llamas, EAB, Gamba, MAA, Madrigal, JC, Salas, LGG, Rosas, EL, Diaz, BG, Vazquez, ES, Ackar, AN, Esperon, GAL, Sanchez, CRM, De Leon, MG, Otero, RS, Salmon, GF, Rios, JA, Ruiz, JAG, Breedveld, RW, Hoogslag, PAM, Suryapranata, H, Oomen, A, Wiersma, JJ, Van Der Wal, RMA, Van Huysduynen-Monraats, PSH, Karalis, I, Verdel, GJE, Brueren, BR, Troquay, RPT, Viergever, EP, Al-Windy, NYY, Bartels, GL, Cornel, JH, Hermans, WRM, Herrman, JPR, Bos, RJ, Groutars, RGEJ, Van Der Zwaan, CC, Kaplan, R, Ronner, E, Groenemeijer, BE, Bronzwaer, PNA, Liem, AAH, Rensing, BJWM, Bokern, MJJA, Nijmeijer, R, Hersbach, FMRJ, Willems, FF, Gosselink, ATM, Elliott, J, Wilkins, G, Fisher, R, Scott, D, Hart, H, Stewart, R, Harding, S, Ternouth, I, Fisher, N, Aitken, D, Anscombe, R, Davidson, L, Tomala, T, Nygard, O, Sparby, JA, Andersen, K, Gullestad, L, Jortveit, J, Munk, PS, Singsaas, EG, Halvorsen, S, Hurtig, U, Flores, RMC, Ticona, JRC, Velasquez, JRD, Miguel, SAN, Perez, ESS, Chambilla, JMC, Ayala, CAC, Leon, RPC, Gonzales, RJV, Zuniga, JDH, Cosavalente, LAC, Mannucci, JEB, Landeo, JH, Navarro, NCL, Concha, YMR, Chavez, VER, Hernandez, HAA, Nunez, CAZ, Ramos, WM, Ferrolino, A, Sy, RAG, Tirador, L, Sy, RG, Matiga, G, Coching, RM, Bernan, A, Rogelio, G, Morales, DD, Tan, E, Sulit, DJ, Wlodarczak, A, Jaworska, K, Skonieczny, G, Pawlowicz, L, Wojewod, P, Busz-Papiez, B, Bednarski, J, Goch, A, Staneta, P, Dulak, E, Budaj, A, Saminsk, K, Krasowski, W, Sudnik, W, Zurakowski, A, Skorski, M, Lysek, R, Miklaszewicz, B, Kubica, J, Lipko, JA, Kostarska-Srokosz, E, Piepiorka, M, Drzewiecka, A, Sciborski, R, Stasiewski, A, Blicharski, T, Bystryk, L, Szpajer, M, Korol, M, Czerski, T, Mirek-Bryniarska, E, Gniot, J, Lubinski, A, Gorny, J, Franek, E, Raczak, G, Szwed, H, Monteiro, P, Bastos, JM, Pereira, HH, Martins, D, Morais, J, Seixo, F, Mendonca, C, Botelho, A, Minescu, B, Istratoaie, O, Tesloianu, DN, Dorobantu, M, Cristian, G, Podoleanu, CGC, Constantinescu, MCA, Bengus, CM, Militaru, C, Rosu, D, Parepa, IR, Matei, AV, Alexandru, TM, Coman, I, Cioranu, RS, Dimulescu, D, Shvarts, Y, Orlikova, O, Kobalava, Z, Barbarash, OL, Markov, V, Lyamina, N, Gordienko, A, Zrazhevsky, K, Vishnevsky, AY, Gurevich, V, Stryuk, R, Lomakin, NV, Bokarev, I, Shalaev, S, Khaisheva, L, Chizhov, P, Viktorova, I, Osokina, N, Akatova, E, Chumakova, G, Libov, I, Voevoda, MI, Tretyakova, TV, Baranov, E, Shustov, S, Yakushin, S, Gordeev, I, Khasanov, N, Reshetko, O, Sotnikova, T, Molchanova, O, Nikolaev, K, Gapon, L, Baranova, E, Shogenov, Z, Kosmachova, E, Karpov, Y, Povzun, A, Egorova, L, Tyrenko, VV, Ivanov, IG, Kanorsky, S, Simic, D, Ivanovic, N, Davidovic, G, Tasic, N, Asanin, MR, Stojic, S, Apostolovic, SR, Ilic, S, Putnikovic, B, Stankovic, A, Arandjelovic, A, Radovanovic, S, Ristic, AD, Balinovac, J, Dincic, DV, Seferovic, P, Dodic, S, Dimkovic, S, Poh, KK, Ong, HY, Micko, K, Nociar, J, Pella, D, Fulop, P, Hranai, M, Palka, J, Mazur, J, Majercak, I, Dzupina, A, Fazekas, F, Gonsorcik, J, Bugan, V, Selecky, J, Kamensky, G, Strbova, J, Smik, R, Dukat, A, Olexa, P, Zuran, I, Poklukar, J, Suligoj, NC, Cevc, M, Cyster, HP, Ranjith, N, Corbett, C, Bayat, J, Makotoko, EM, Kapp, IE, Basson, MMD, Lottering, H, Van Zyl, LJ, Sebastian, PJ, Pillay, T, Saaiman, JA, Commerford, PJ, Cassimjee, S, Ebrahim, IO, Sarvan, M, Mynhardt, JH, Reuter, H, Moodley, R, Vida, M, Fillat, ARC, Peris, VB, Jimenez, FF, Marin, F, Fernandez, JMC, Gil-Extremera, B, Diz, FW, Garcia-Dorado, D, Iniguez, A, Fernandez, JT, Gonzalez-Juanatey, JR, Portales, JF, Murillo, FC, Pericas, LM, Zamorano, JL, Martin, MD, Cortada, JB, Martin, JJA, Fernandez, JRD, Fernandez, JFD, Lledo, JAG, Sales, JC, Rodriguez, JB, Tragant, GG, Benedicto, A, Gonzalez-Juanatey, C, Potau, MC, Perez, IP, De La Tassa, CM, Rincon, PLO, Recena, JB, Escudier, JM, Payeras, AC, Orcajo, NA, Valdivielso, P, Constantine, G, Haniffa, R, Tissera, N, Amarasekera, S, Fernando, N, Jayawardena, J, Santharaj, W, Ekanayaka, R, Mendis, S, Senaratne, V, Mayurathan, G, Sirisena, T, Rajapaksha, A, Herath, JI, Amarasena, N, Berglund, S, Rasmanis, G, Witt, N, Mourtzinis, G, Nicol, P, Hansen, O, Romeo, S, Jensen, SA, Torstensson, I, Ahremark, U, Sundelin, T, Moccetti, T, Muller, C, Mach, F, Binder, R, Tsai, WC, Ueng, KC, Lai, WT, Liu, ME, Hwang, JJ, Yin, WH, Hsieh, IC, Kuo, JY, Huang, TY, Fang, CY, Kaewsuwanna, P, Soonfuang, W, Jintapakorn, W, Sukonthasarn, A, Wongpraparut, N, Sastravaha, K, Sansanayudh, N, Kehasukcharoen, W, Piyayotai, D, Chotnoparatpat, P, Camsari, A, Kultursay, H, Mutlu, B, Ersanli, M, Demirtas, M, Kirma, C, Ural, E, Koldas, L, Karpenko, O, Prokhorov, A, Vakaluyk, I, Myshanych, H, Reshotko, D, Batushkin, V, Rudenko, L, Kovalskyi, I, Kushnir, M, Tseluyko, V, Mostovoy, Y, Stanislavchuk, M, Kyiak, Y, Karpenko, Y, Malynovsky, Y, Klantsa, A, Kutniy, O, Amosova, E, Tashchuk, V, Leshchuk, O, Rishko, M, Kopytsya, M, Yagensky, A, Vatutin, M, Bagriy, A, Barna, OM, Ushakov, O, Dzyak, G, Goloborodko, B, Rudenko, A, Zheleznyy, V, Trevelyan, J, Zaman, A, Lee, K, Moriarty, A, Aggarwal, RK, Clifford, P, Wong, YK, Iqbal, SM, Subkovas, E, Braganza, D, Sarkar, D, Storey, R, Griffiths, H, Mcclure, S, Muthusamy, R, Kurian, J, Levy, T, Barr, C, Kadr, H, Gerber, R, Simaitis, A, Soran, H, Mathur, A, Brodison, A, Oliver, R, Mudawi, T, Reynolds, T, Sharman, D, Butler, R, Wilkinson, P, Lip, GYH, Halcox, J, Vardi, G, Baldari, D, Brabham, D, Treasure, C, Dahl, C, Palmer, B, Wiseman, A, Puri, S, Mohart, AE, Ince, C, Flores, E, Wright, S, Cheng, SC, Rosenberg, M, Rogers, W, Kosinski, E, Forgosh, L, Waltman, J, Khan, M, Shoukfeh, M, Dagher, G, Lieber, I, Kumar, P, East, C, Krichmar, P, White, L, Knickelbine, T, Haldis, T, Gillespie, E, Suh, D, Arif, I, Akhter, F, Carlson, E, D'Urso, M, El-Ahdab, F, Nelson, W, Harris, B, Cohen, S, Carter, L, Sabatino, K, Haddad, T, Malik, A, Rao, S, Mulkay, A, Jovin, I, Klancke, K, Malhotra, V, Devarapalli, SK, Koren, M, Chandna, H, Dodds, G, Janik, M, Moran, J, Sumner, A, Kobayashi, J, Davis, W, Yazdani, S, Pasquini, J, Thakkar, M, Vedere, A, Leimbach, W, Rider, J, Singh, N, Shah, AV, Janosik, D, Pepine, C, Berman, B, Gelormini, J, Daniels, C, Keating, F, Kondo, NI, Shetty, S, Waider, W, Takata, T, Abu-Fadel, M, Shah, V, Aggarwal, R, Izzo, M, Kumar, A, Hattler, B, Link, C, Bortnick, A, Kinzfogl, G, Ghitis, A, Larry, J, Teufel, E, Kuhlman, P, Mclaurin, B, Zhang, WW, Thew, S, Abbas, J, White, M, Ranadive, N, Gring, C, Henderson, D, Schuchard, T, Farhat, N, Kline, G, Mahal, S, Whitaker, J, Speirs, S, Andersen, R, Daboul, N, Horwitz, P, Ponce, G, Jafar, Z, Mcgarvey, J, Panchal, V, Voyce, S, Blok, T, Sheldon, W, Azizad, MM, Schmalfuss, C, Picone, M, Herzog, W, Lindsey, J, Nowins, R, Lepor, N, El Shahawy, M, Weintraub, H, Irimpen, A, May, W, Galski, T, Chu, A, Mody, F, Hodes, Z, Rose, G, Fairlamb, J, Lambert, C, Raisinghani, A, Abbate, A, King, M, Carey, C, Gerber, J, Younis, L, Park, H, Vidovich, M, Knutson, T, Friedman, D, Chaleff, F, Loussararian, A, Rozeman, P, Kimmelstiel, C, Silver, K, Foster, M, Tonnessen, G, Amlani, M, Wali, A, Malozzi, C, Wattanakit, K, O'Donnell, PJ, Singal, D, Jaffrani, N, Banuru, S, Fisher, D, Xenakis, M, Perlmutter, N, Bhagwat, R, Strader, J, Akyea-Djamson, A, Labroo, A, Marais, HJ, Claxton, E, Berk, M, Rossi, P, Joshi, P, Khaira, AS, Kumkumian, G, Lupovitch, S, Purow, J, Welka, S, Hoffman, D, Fischer, S, Soroka, E, Eagerton, D, Pancholy, S, Ray, M, Farrar, M, Pollock, S, French, WJ, Diamantis, S, Gimple, L, Neustel, M, Schwartz, S, Pereira, E, Spriggs, D, Strain, J, Vo, A, Chane, M, Hall, J, Vijay, N, Lotun, K, Lester, FM, Nahhas, A, Pope, T, Nager, P, Vohra, R, Bashir, R, Ahmed, H, Berlowitz, M, Fishberg, R, Barrucco, R, Yang, E, Radin, M, Sporn, D, Eisenberg, S, Landzberg, J, Mcgough, M, Turk, S, Schwartz, M, Sundram, PS, Jain, D, Zainea, M, Bayron, C, Karlsberg, R, Lui, H, Keen, W, Westerhausen, D, Khurana, S, Agarwal, H, Birchem, J, Penny, W, Chang, M, Murphy, S, Schifferdecker, B, Gilbert, JM, Chalavarya, G, Eaton, C, Schmedtje, JF, Christenson, S, Denham, D, Macdonell, A, Gibson, P, Rahman, A, Al Joundi, T, Conrad, G, Kotha, P, Love, M, Giesler, G, Rubenstein, H, Akright, L, Krawczyk, J, Wells, T, Welker, J, Foster, R, Gilmore, R, Anderson, J, Jacoby, D, Gardner, G, Dandillaya, R, Vora, K, Kostis, J, Hunter, J, Laxson, D, Ball, E, Camp, A, Lopes, R, Egydio, F, Kawakami, A, Oliveira, J, Wozniak, J, Matthews, A, Ratky, C, Valiris, J, Berdan, L, Hepditch, A, Quintero, K, Rorick, T, Westbrook, M, Pascual, A, Rovito, C, Bezault, M, Drouet, E, Simon, T, Alsweiler, C, Luyten, A, Aylward, P, Butters, J, Griffith, L, Shaw, M, Hagstrom, E, Grunberg, L, Islam, S, Bregeault, MF, Bougon, N, Faustino, D, Fontecave, S, Murphy, J, Tamby, JF, Verrier, M, Agnetti, V, Andersen, D, Badreddine, E, Bekkouche, M, Bouancheau, C, Brigui, I, Brocklehurst, M, Cianciarulo, J, Devaul, D, Domokos, S, Gache, C, Gobillot, C, Guillou, S, Healy, J, Heath, M, Jaiwal, G, Javierre, C, Labeirie, J, Monier, M, Morales, U, Mrabti, A, Mthombeni, B, Okan, B, Smith, L, Sheller, J, Sopena, S, Pellan, V, Benbernou, F, Bengrait, N, Lamoureux, M, Kralova, K, Scemama, M, Bejuit, R, Coulange, A, Berthou, C, Repincay, J, Lorenzato, C, Etienne, A, Gouet, V, Loizeau, V, Normand, M, Ourliac, A, Rondel, C, Adamo, A, Beltran, P, Barraud, P, Dubois-Gache, H, Halle, B, Metwally, L, Mourgues, M, Sotty, M, Vincendet, M, Cotruta, R, Zhu, CY, Fournie-Lloret, D, Morrello, C, Perthuis, A, Picault, P, Zobouyan, I, ODYSSEY OUTCOMES Comm Inve, Ege Üniversitesi, Cardiology, and Internal Medicine
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medicine.medical_specialty ,Acute coronary syndrome ,Time Factors ,acute coronary syndrome ,alirocumab ,global burden of disease ,hospitalization ,myocardial infarction ,PCSK9 ,030204 cardiovascular system & hematology ,Antibodies, Monoclonal, Humanized ,Placebo ,Patient Readmission ,Risk Assessment ,03 medical and health sciences ,Patient Admission ,0302 clinical medicine ,Risk Factors ,Internal medicine ,medicine ,Humans ,Angina, Unstable ,Hospital Mortality ,030212 general & internal medicine ,Myocardial infarction ,03.02. Klinikai orvostan ,Dyslipidemias ,Alirocumab ,Out of hospital ,business.industry ,Anticholesteremic Agents ,Cholesterol, HDL ,Cholesterol hdl ,Cholesterol, LDL ,medicine.disease ,Treatment Outcome ,Drug Therapy, Combination ,Human medicine ,Hydroxymethylglutaryl-CoA Reductase Inhibitors ,Cardiology and Cardiovascular Medicine ,business ,Cardiovascular outcomes ,Biomarkers - Abstract
Sherwood, Matthew/0000-0002-4305-5883; Abbate, Antonio/0000-0002-1930-785X; Moris, Cesar/0000-0002-2871-190X; Ersanli, Murat/0000-0003-1847-3087; Taskinen, Marja-Riitta/0000-0002-6229-3588; bastos, jose/0000-0002-9526-3123; Reshetko, Olga/0000-0003-3107-7636; Nikolaev, Konstantin/0000-0003-4601-6203; Leonardi, Sergio/0000-0002-4800-6132; Raffel, Owen C/0000-0001-5470-7050; Racca, Vittorio/0000-0002-4465-3789; Podoleanu, Cristian/0000-0001-9987-2519; Gislason, Gunnar H/0000-0002-0548-402X; Muenzel, Thomas/0000-0001-5503-4150; Tse, Hung Fat/0000-0002-9578-7808; Chumakova, Galina A/0000-0002-2810-6531, WOS: 000502609000004, PubMed: 31707826, Background: in ODYSSEY OUTCOMES (Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab), alirocumab was compared with placebo, added to high-intensity or maximum tolerated statin treatment after acute coronary syndrome in 18924 patients. Alirocumab reduced first occurrence of the primary composite end point-coronary heart disease death, nonfatal myocardial infarction, fatal or nonfatal ischemic stroke, or hospitalization for unstable angina-as well as total nonfatal cardiovascular events and all-cause deaths. the present analysis determined whether alirocumab reduced total (first and subsequent) hospitalizations and death and increased days alive and out of hospital (DAOH) and percent DAOH in ODYSSEY OUTCOMES. Methods and Results: in prespecified analyses, hazard functions for total hospitalizations and death were jointly estimated by a semiparametric model, while in post hoc analyses, DAOH and percent DAOH were compared between treatment groups with Poisson regression and one-inflated beta regression, respectively. With 16629 total hospitalizations and 726 deaths, 331 fewer hospitalizations, and 58 fewer deaths were observed with alirocumab compared with placebo, translating to 15.6 total hospitalizations or deaths avoided with alirocumab per 1000 patient-years of assigned treatment. Alirocumab reduced total hospitalizations (hazard ratio, 0.96 [95% CI, 0.92-1.00]; P=0.04) and increased DAOH relative to placebo (rate ratio, 1.003 [95% CI, 1.000-1.007]; P=0.05), primarily through a reduction in days dead (rate ratio, 0.847 [95% CI, 0.728-0.986]; P=0.03). Patients randomized to alirocumab were also more likely to survive to the end of the study without hospitalization (odds ratio, 1.06 [95% CI, 1.00-1.13]; P=0.03). Conclusions: Alirocumab reduced total hospitalizations with corresponding small increases in DAOH and percent DAOH. These outcomes provide alternative patient-centered metrics to capture the totality of alirocumab clinical efficacy after acute coronary syndrome. Clinical Trial Registration: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01663402., Fondation Assistance Publique-Hopitaux de Paris, Paris, France, We thank the patients, study coordinators, and investigators who participated in this trial. Sophie Rushton-Smith, PhD (MedLink Healthcare Communications, London) provided editorial assistance in the preparation of the article (limited to editing for style, referencing, and figure and table editing) and was funded by Fondation Assistance Publique-Hopitaux de Paris, Paris, France.
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- 2019
10. Five-year outcomes with PCI guided by fractional flow reserve
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Xaplanteris, P., Fournier, S., Pijls, N. H. J., Fearon, W. F., Barbato, E., Tonino, P. A. L., Engstrøm, T., Kääb, S., Dambrink, J. H., Toth, G. G., Rioufol, G., Piroth, Z., Witt, N., Fröbert, O., Kala, P., Linke, A., Jagic, N., Mates, M., Mavromatis, K., Samady, H., Irimpen, A., Oldroyd, K., Campo, G., Rothenbühler, M., Jüni, P., de Bruyne, B., Mulder, Barbara J. M., et al, Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National de la Recherche Agronomique (INRA), Department of Cardiology, Örebro University, Cardiovascular Biomechanics, Cardiology, APH - Personalized Medicine, APH - Aging & Later Life, ACS - Heart failure & arrhythmias, Institut National de la Recherche Agronomique (INRA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM), CarMeN, laboratoire, Xaplanteris, Panagioti, Fournier, Stephane, Pijls, Nico H J, Fearon, William F, Barbato, Emanuele, Tonino, Pim A L, Engstrøm, Thoma, Kääb, Stefan, Dambrink, Jan-Henk, Rioufol, Gille, Toth, Gabor G, Piroth, Zsolt, Witt, Nil, Fröbert, Ole, Kala, Petr, Linke, Axel, Jagic, Nicola, Mates, Martin, Mavromatis, Kreton, Samady, Habib, Irimpen, Anand, Oldroyd, Keith, Campo, Gianluca, Rothenbühler, Martina, Jüni, Peter, and De Bruyne, Bernard
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st-segment elevation ,Male ,task-force ,Coronary Stenosi ,Platelet Aggregation Inhibitors/therapeutic use ,medicine.medical_treatment ,[SDV]Life Sciences [q-bio] ,Myocardial Infarction ,Coronary Disease ,Fractional flow reserve ,Kaplan-Meier Estimate ,030204 cardiovascular system & hematology ,Coronary artery disease ,0302 clinical medicine ,Drug-Eluting Stent ,030212 general & internal medicine ,Myocardial infarction ,guidelines ,Medicine (all) ,Angina Pectori ,Hazard ratio ,Drug-Eluting Stents ,General Medicine ,Middle Aged ,Fractional Flow Reserve ,myocardial-infarction ,3. Good health ,[SDV] Life Sciences [q-bio] ,Fractional Flow Reserve, Myocardial ,Antihypertensive Agent ,Coronary Disease/drug therapy ,Aged ,Angina Pectoris ,Antihypertensive Agents ,Coronary Stenosis ,Female ,Follow-Up Studies ,Humans ,Platelet Aggregation Inhibitors ,Retreatment ,Percutaneous Coronary Intervention ,Cardiology ,Platelet aggregation inhibitor ,management ,Human ,medicine.medical_specialty ,Angina Pectoris/therapy ,conservative treatment ,Revascularization ,Follow-Up Studie ,european-society ,NO ,03 medical and health sciences ,Internal medicine ,General & Internal Medicine ,medicine ,Myocardial Infarction/epidemiology ,Myocardial ,coronary ,Antihypertensive Agents/therapeutic use ,business.industry ,Platelet Aggregation Inhibitor ,prospective natural-history ,Percutaneous coronary intervention ,medicine.disease ,medical therapy ,Retreatment/statistics & numerical data ,Conventional PCI ,Coronary Stenosis/drug therapy ,business - Abstract
Background: we hypothesized that fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) would be superior to medical therapy as initial treatment in patients with stable coronary artery disease.Methods: among 1220 patients with angiographically significant stenoses, those in whom at least one stenosis was hemodynamically significant (FFR, ≤0.80) were randomly assigned to FFR-guided PCI plus medical therapy or to medical therapy alone. Patients in whom all stenoses had an FFR of more than 0.80 received medical therapy and were entered into a registry. The primary end point was a composite of death, myocardial infarction, or urgent revascularization.Results: a total of 888 patients underwent randomization (447 patients in the PCI group and 441 in the medical-therapy group). At 5 years, the rate of the primary end point was lower in the PCI group than in the medical-therapy group (13.9% vs. 27.0%; hazard ratio, 0.46; 95% confidence interval [CI], 0.34 to 0.63; PConclusions: in patients with stable coronary artery disease, an initial FFR-guided PCI strategy was associated with a significantly lower rate of the primary composite end point of death, myocardial infarction, or urgent revascularization at 5 years than medical therapy alone. Patients without hemodynamically significant stenoses had a favorable long-term outcome with medical therapy alone. (Funded by St. Jude Medical and others; FAME 2 ClinicalTrials.gov number, NCT01132495 .).
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- 2018
11. Everolimus-eluting stents or bypass surgery for left main coronary artery disease
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Stone, Gw, Sabik, Jf, Serruys, Pw, Simonton, Ca, Généreux, P, Puskas, J, Kandzari, De, Morice, Mc, Lembo, N, Brown WM 3rd, Taggart, Dp, Banning, A, Merkely, B, Horkay, F, Boonstra, Pw, van Boven AJ, Ungi, I, Bogáts, G, Mansour, S, Noiseux, N, Sabaté, M, Pomar, J, Hickey, M, Gershlick, A, Buszman, P, Bochenek, A, Schampaert, E, Pagé, P, Dressler, O, Kosmidou, I, Mehran, R, Pocock, Sj, Kappetein, Ap, van Es GA, Leon, Mb, Gersh, B, Chaturvedi, S, Kint, Pp, Valgimigli, M, Colombo, A, Costa, M, Di Mario, C, Ellis, S, Fajadet, J, Fearon, W, Kereiakes, D, Makkar, R, Mintz, Gs, Moses, Jw, Teirstein, P, Ruel, M, Sergeant, P, Mack, M, Fontana, G, Mohr, Fw, Nataf, P, Smith, C, Boden, B, Fox, K, Maron, D, Steg, G, Blackstone, E, Juni, P, Parise, H, Wallentin, L, Bertrand, M, Krucoff, M, Turina, M, Ståhle, E, Tijssen, J, Brill, D, Atkins, C, Applegate, B, Argenziano, M, Faly, Rc, Dauerman, H, Davidson, C, Griffith, B, Reisman, M, Rizik, D, Sakwa, M, Shemin, R, Romano, M, Hamm, C, Gummert, J, Tamburino, C, Alfieri, O, Savina, C, de Bruyne, B, Machado, Fp, Uva, S, Moccetti, T, Siclari, F, Hildick Smith, D, Szekely, L, Erglis, A, Stradins, P, Abizaid, A, Bento Sousa LC, Belardi, J, Navia, D, Park, Sj, Lee, Jw, Meredith, I, Smith, J, Yehuda, Ob, Schneijdenberg, R, Ronden, J, Jonk, J, Jonkman, A, van Remortel, E, de Zwart, I, Elshout, L, de Vries, T, Andreae, R, Tol van, J, Teurlings, E, Balachandran, S, Breazna, A, Jenkins, P, Mcandrew, T, Marx, So, Connolly, Mw, Hong, Mk, Weinberger, J, Wong, Sc, Dizon, J, Biviano, A, Morrow, J, Wang, D, Corral, M, Alfonso, M, Sanchez, R, Wright, D, Djurkovic, C, Lustre, M, Jankovic, I, Sanidas, E, Lasalle, L, Maehara, A, Matsumura, M, Sun, E, Iacono, S, Greenberg, T, Jacobson, J, Pullano, A, Gacki, M, Liu, S, Cohen, Dj, Magnuson, E, Baron, Sj, Wang, K, Traylor, K, Worthley, S, Stuklis, R, Barbato, E, Stockman, B, Dubois, C, Meuris, B, Vrolix, M, Dion, R, Bento de Souza LC, Costantini, C, Woitowicz, V, Hueb, W, Stolf, N, Beydoun, H, Baskett, R, Curtis, M, Kieser, T, Doucet, S, Pellerin, M, Hamburger, J, Cook, R, Kutryk, M, Peterson, M, Madan, M, Fremes, S, Mehta, S, Cybulsky, I, Prabhakar, M, Peniston, C, Welsh, R, Macarthur, R, Berland, J, Bessou, Jp, Carrié, D, Glock, Y, Darremont, O, Deville, C, Grimaud, Jp, Soula, P, Lefèvre, T, Maupas, E, Durrleman, N, Silvestri, M, Houel, R, Pratt, A, Francis, J, Van Belle, E, Vicentelli, A, Luchner, A, Hilker, M, Endemann, Dh, Felix, S, Wollert, Hg, Walther, T, Erbel, R, Jacob, H, Kahlert, P, Kupatt, C, Näbauer, M, Schmitz, C, Scholtz, W, Börgermann, J, Schuler, G, Borger, M, Davierwala, P, Fontos, G, Székely, L, Bedogni, F, Panisi, P, Berti, S, Glauber, M, Marzocchi, A, Di Bartolomeo, R, Merlo, M, Guagliumi, G, Fenili, F, Napodano, M, Gerosa, G, Ribichini, F, Faggian, Giuseppe, Saccà, S, Giacomin, A, Mignosa, C, Tumscitz, C, Savini, C, Van Mieghem, N, von Birgelen, C, Grandjean, J, Kubica, J, Anisimowicz, L, Zmudka, K, Sadowski, J, Hernández García, J, Such, M, Macaya, C, Rodríguez Hernández JE, Maroto, L, Serra, A, Padro, J, Tenas, Ms, De Souza, A, Egred, M, Clark, S, Trivedi, U, Jain, A, Uppal, R, Redwood, S, Young, C, Stables, Rh, Pullan, M, Uren, N, Pessotto, R, Abu Fadel, M, Peyton, M, Allaqaband, S, O’Hair, D, Bachinsky, W, Mumtaz, M, Blankenship, J, Casale, A, Brott, B, Davies, J, Brown, D, Cannon, L, Talbott, J, Chang, G, Macheers, S, Choi, J, Henry, C, Cutlip, D, Khabbaz, K, Das, G, Liao, K, Diver, D, Thayer, J, Dobies, D, Fliegner, K, Fischbein, M, Feldman, T, Pearson, P, Foster, M, Briggs, R, Giugliano, G, Engelman, D, Gordon, P, Ehsan, A, Grantham, J, Allen, K, Grodin, J, Jessen, M, Gruberg, L, Taylor JR Jr, Gupta, S, Hermiller J., Jr, Heimansohn, D, Iwaoka, R, Chan, B, Kander, Nh, Duff, S, Brown, W, Karmpaliotis, D, Kini, A, Filsoufi, F, Kong, D, Lin, S, Kutcher, M, Kincaid, E, Leya, F, Bakhos, M, Liberman, H, Halkos, M, Lips, D, Eales, F, Mahoney, P, Rich, J, Barreiro, C, Cheng, W, Metzger, C, Greenfield, T, Moses, J, Palacios, I, Macgillivray, T, Perin, E, Del Prete, J, Pompili, V, Kilic, A, Ragosta, M, Kron, I, Rashid, J, Mueller, D, Riley, R, Reimers, C, Patel, N, Resar, J, Shah, A, Schneider, J, Landvater, L, Reardon, M, Shavelle, D, Baker, C, Singh, J, Maniar, H, Wei, L, Strain, J, Zapolanski, A, Taheri, H, Ad, N, Tannenbaum, M, Prabhakar, G, Waksman, R, Corso, P, Wang, J, Fiocco, M, Wilson, Bh, Steigel, Rm, Chadwick, S, Zidar, F, Oswalt, J., Stone, Gregg W., Sabik, Joseph F., Serruys, Patrick W., Simonton, Charles A., Généreux, Philippe, Puskas, John, Kandzari, David E., Morice, Marie Claude, Lembo, Nichola, Brown, W. Morri, Taggart, David P., Banning, Adrian, Merkely, Béla, Horkay, Ferenc, Boonstra, Piet W., Van Boven, Ad J., Ungi, Imre, Bogáts, Gabor, Mansour, Samer, Noiseux, Nicola, Sabaté, Manel, Pomar, José, Hickey, Mark, Gershlick, Anthony, Buszman, Pawel, Bochenek, Andrzej, Schampaert, Erick, Pagé, Pierre, Dressler, Ovidiu, Kosmidou, Ioanna, Mehran, Roxana, Pocock, Stuart J., Kappetein, A. Pieter, for the EXCEL Trial Investigators:, [. . ., Antonio, Marzocchi, DI BARTOLOMEO, Roberto, ], . ., and Cardiothoracic Surgery
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Male ,medicine.medical_specialty ,medicine.medical_treatment ,Coronary Artery Disease ,Kaplan-Meier Estimate ,030204 cardiovascular system & hematology ,law.invention ,Coronary artery disease ,03 medical and health sciences ,0302 clinical medicine ,Percutaneous Coronary Intervention ,Randomized controlled trial ,law ,Internal medicine ,medicine ,Clinical endpoint ,Drug-Eluting Stent ,Humans ,Everolimus ,030212 general & internal medicine ,cardiovascular diseases ,Coronary Artery Bypass ,Aged ,Female ,Middle Aged ,Drug-Eluting Stents ,business.industry ,Coronary Artery Bypa ,Medicine (all) ,Percutaneous coronary intervention ,General Medicine ,medicine.disease ,Surgery ,Cardiac surgery ,Everolimu ,surgical procedures, operative ,Bypass surgery ,Conventional PCI ,Cardiology ,business ,medicine.drug ,Human - Abstract
BACKGROUND: Patients with obstructive left main coronary artery disease are usually treated with coronary-artery bypass grafting (CABG). Randomized trials have suggested that drug-eluting stents may be an acceptable alternative to CABG in selected patients with left main coronary disease. METHODS: We randomly assigned 1905 eligible patients with left main coronary artery disease of low or intermediate anatomical complexity to undergo either percutaneous coronary intervention (PCI) with fluoropolymer-based cobalt-chromium everolimus-eluting stents (PCI group, 948 patients) or CABG (CABG group, 957 patients). Anatomic complexity was assessed at the sites and defined by a Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score of 32 or lower (the SYNTAX score reflects a comprehensive angiographic assessment of the coronary vasculature, with 0 as the lowest score and higher scores [no upper limit] indicating more complex coronary anatomy). The primary end point was the rate of a composite of death from any cause, stroke, or myocardial infarction at 3 years, and the trial was powered for noninferiority testing of the primary end point (noninferiority margin, 4.2 percentage points). Major secondary end points included the rate of a composite of death from any cause, stroke, or myocardial infarction at 30 days and the rate of a composite of death, stroke, myocardial infarction, or ischemia-driven revascularization at 3 years. Event rates were based on Kaplan-Meier estimates in time-to-first-event analyses. RESULTS: At 3 years, a primary end-point event had occurred in 15.4% of the patients in the PCI group and in 14.7% of the patients in the CABG group (difference, 0.7 percentage points; upper 97.5% confidence limit, 4.0 percentage points; P=0.02 for noninferiority; hazard ratio, 1.00; 95% confidence interval, 0.79 to 1.26; P=0.98 for superiority). The secondary end-point event of death, stroke, or myocardial infarction at 30 days occurred in 4.9% of the patients in the PCI group and in 7.9% in the CABG group (P
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- 2017
12. The Frascati Tokamak Upgrade machine: availability analysis, main results and future programme
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Ciattaglia, S, Angelini, B, Buceti, G, Cesario, R, Crisanti, F, Cocilovo, V, Frigione, D, Gravanti, F, Maddaluno, G, Mazzitelli, G, Pieroni, L, Pericoli-Ridolfini, V, Sternini, E, Tuccillo, AA, Vitale, V, Zanza, V, Alladio, F, Apicella, ML, Apruzzese, G, Barbato, E, Bertocchi, A, Bracco, G, Bruschi, A, Buratti, P, Cardinali, A, Centioli, C, Ciotti, M, Cirant, S, De Angelis, R, De Marco, F, Esposito, B, Gabellieri, L, Gatti, G, Giovannozzi, E, Gourlan, C, Granucci, G, Grolli, M, Imparato, A, Kroegler, H, Leigheb, M, Lovisetto, L, Maffia, G, Mancuso, A, Marinucci, M, Micozzi, P, Mirizzi, F, Orsitto, FP, Pacella, D, Panaccione, L, Panella, M, Podda, S, Righetti, GB, Romanelli, F, Santini, F, Sassi, M, Simonetto, A, Sozzi, C, Tudisco, O, Vlad, G, and Zerbini, M
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Physics ,Tokamak ,Engineering Electrical & Electronic ,business.industry ,Physics Applied ,Toroidal field ,Frascati Tokamak Upgrade ,Nuclear engineering ,Cyclotron ,Electrical engineering ,Plasma ,Fusion power ,Electron cyclotron resonance ,law.invention ,Physics Fluids & Plasmas ,law ,Magnetohydrodynamics ,Nuclear Science & Technology ,business - Abstract
The paper presents a general overview of the Frascati Tokamak Upgrade (FTU) machine operation in the last two years. About 3500 pulses were performed (mostly in D/sub 2/) with a toroidal field between 2.5 and 8 Tesla and a plasma current between 0.35-1.3 MA, according to the experimental programmes. An availability analysis of the FTU plant was performed, which pointed out the number of pulses per day and the causes of delay. The main research activities concentrated on plasma MHD studies with different heating scenarios: lower hybrid waves current drive (LHCD) and electron cyclotron resonance heating (ECRH) were used both alone and together to investigate synergetic effects. Strong effort was devoted to high density (1/spl times/10/sup 20/ m/sup -3/) current drive experiments and investigating the possibility of obtaining and sustaining shear reversal configurations. Near term scientific and technological programmes are also reported.
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- 2002
13. ESC guidance for the diagnosis and management of cardiovascular disease during the COVID-19 pandemic: part 2—care pathways, treatment, and follow-up
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Baigent, C., Windecker, S., Andreini, D., Arbelo, E., Barbato, E., Bartorelli, A.L., Baumbach, A., Behr, E.R., Berti, S., Bueno, H., Capodanno, D., Cappato, R., Chieffo, A., Collet, J.P., Cuisset, T., Simone, G. de, Delgado, V., Dendale, P., Dudek, D., Edvardsen, T., Elvan, A., Gonzalez-Juanatey, J.R., Gori, M., Grobbee, D., Guzik, T.J., Halvorsen, S., Haude, M., Heidbuchel, H., Hindricks, G., Ibanez, B., Karam, N., Katus, H., Klok, F.A., Konstantinides, S.V., Landmesser, U., Leclercq, C., Leonardi, S., Lettino, M., Marenzi, G., Mauri, J., Metra, M., Morici, N., Mueller, C., Petronio, A.S., Polovina, M.M., Potpara, T., Praz, F., Prendergast, B., Prescott, E., Price, S., Pruszczyk, P., Rodriguez-Leor, O., Roffi, M., Romaguera, R., Rosenkranz, S., Sarkozy, A., Scherrenberg, M., Seferovic, P., Senni, M., Spera, F.R., Stefanini, G., Thiele, H., Tomasoni, D., Torracca, L., Touyz, R.M., Wilde, A.A., Williams, B., European Soc Cardiology, Behr, Elijah/0000-0002-8731-2853, BUENO, HECTOR/0000-0003-0277-7596, Rodriguez-Leor, Oriol/0000-0003-2657-5657, Karam, Nicole/0000-0002-3861-6914, Williams, Bryan/0000-0002-8094-1841, Baigent, Colin, Windecker, Stephan, Andreini, Daniele, Arbelo, Elena, Barbato, Emanuele, Bartorelli, Antonio L., Baumbach, Andreas, Behr, Elijah R., Berti, Sergio, Bueno, Hector, Capodanno, Davide, Cappato, Riccardo, Chieffo, Alaide, Collet, Jean-Philippe, Cuisset, Thomas, de Simone, Giovanni, Delgado, Victoria, DENDALE, Paul, Dudek, Dariusz, Edvardsen, Thor, Elvan, Arif, Gonzalez-Juanatey, Jose R., Gori, Mauro, Grobbee, Diederick, Guzik, Tomasz J., Halvorsen, Sigrun, Haude, Michael, HEIDBUCHEL, Hein, Hindricks, Gerhard, Ibanez, Borja, Karam, Nicole, Katus, Hugo, Klok, Fredrikus A., Konstantinides, Stavros, V, Landmesser, Ulf, Leclercq, Christophe, Leonardi, Sergio, Lettino, Maddalena, Marenzi, Giancarlo, Mauri, Josepa, Metra, Marco, Morici, Nuccia, Mueller, Christian, Petronio, Anna Sonia, Polovina, Marija M., Potpara, Tatjana, Praz, Fabien, Prendergast, Bernard, Prescott, Eva, Price, Susanna, Pruszczyk, Piotr, Rodriguez-Leor, Oriol, Roffi, Marco, Romaguera, Rafael, Rosenkranz, Stephan, Sarkozy, Andrea, Scherrenberg, Martijn, Seferovic, Petar, Senni, Michele, Spera, Francesco R., Stefanini, Giulio, Thiele, Holger, Tomasoni, Daniela, Torracca, Lucia, Touyz, Rhian M., Wilde, Arthur A., Williams, Bryan, Cardiology, ACS - Heart failure & arrhythmias, Bern University Hospital [Berne] (Inselspital), Centro Cardiologico Monzino [Milano], Dpt di Scienze Cliniche e di Comunità [Milano] (DISCCO), Università degli Studi di Milano [Milano] (UNIMI)-Università degli Studi di Milano [Milano] (UNIMI)-Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), 'Federico II' University of Naples Medical School, St George's, University of London, Fondazione Toscana Gabriele Monasterio, Hospital Universitario 12 de Octubre [Madrid], Centro Nacional de Investigaciones Cardiovasculares Carlos III [Madrid, Spain] (CNIC), Instituto de Salud Carlos III [Madrid] (ISC), University of Catania [Italy], IRCCS San Raffaele Scientific Institute [Milan, Italie], Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases [IHU ICAN], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital de la Timone [CHU - APHM] (TIMONE), Leiden University Medical Center (LUMC), Hasselt University (UHasselt), Jessa Ziekenhuis [Hasselt], Uniwersytet Jagielloński w Krakowie = Jagiellonian University (UJ), Oslo University Hospital [Oslo], Paris-Centre de Recherche Cardiovasculaire (PARCC (UMR_S 970/ U970)), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPC), CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), University College of London [London] (UCL), Università degli Studi di Milano = University of Milan (UNIMI)-Università degli Studi di Milano = University of Milan (UNIMI)-Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Universiteit Leiden, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), SCHERRENBERG, Martijn, Torracca, Luccia, Cardiology, Task Force for the management of COVID-19 of the European Society of, European Soc Cardiology, and Task Force for the management of COVID-19 of the European Society of Cardiology
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medicine.medical_specialty ,COVID-19/diagnosis ,Coronavirus disease 2019 (COVID-19) ,Physiology ,[SDV]Life Sciences [q-bio] ,ACE2 ,Heart failure ,Disease ,Acute coronary syndromes ,Arrhythmias ,Pulmonary embolism ,Thrombosis ,Special Article ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,Physiology (medical) ,Non-invasive imaging ,Pandemic ,Humans ,Medicine ,AcademicSubjects/MED00200 ,Prospective Studies ,shock ,COVID-19 ,Myocarditis ,Venous thromboembolism ,Intensive care medicine ,Pandemics ,Cardiogenic shock ,Cardiovascular Diseases/diagnosis ,business.industry ,Biomarkers ,Cardiogenic ,Cardiovascular Diseases ,Myocardial injury ,Critical Pathways ,Human medicine ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies - Abstract
Aims Since its emergence in early 2020, the novel severe acute respiratory syndrome coronavirus 2 causing coronavirus disease 2019 (COVID-19) has reached pandemic levels, and there have been repeated outbreaks across the globe. The aim of this two part series is to provide practical knowledge and guidance to aid clinicians in the diagnosis and management of cardiovascular (CV) disease in association with COVID-19. Methods and results A narrative literature review of the available evidence has been performed, and the resulting information has been organized into two parts. The first, which was reported previously, focused on the epidemiology, pathophysiology, and diagnosis of CV conditions that may be manifest in patients with COVID-19. This second part addresses the topics of: care pathways and triage systems and management and treatment pathways, both of the most commonly encountered CV conditions and of COVID-19; and information that may be considered useful to help patients with CV disease (CVD) to avoid exposure to COVID-19. Conclusion This comprehensive review is not a formal guideline but rather a document that provides a summary of current knowledge and guidance to practicing clinicians managing patients with CVD and COVID-19. The recommendations are mainly the result of observations and personal experience from healthcare providers. Therefore, the information provided here may be subject to change with increasing knowledge, evidence from prospective studies, and changes in the pandemic. Likewise, the guidance provided in the document should not interfere with recommendations provided by local and national healthcare authorities., Graphical Abstract Graphical Abstract
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14. 2017 ESC focused update on dual antiplatelet therapy in coronary artery disease developed in collaboration with EACTS
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Valgimigli, Marco, Bueno, Héctor, Byrne, Robert A, Collet, Jean-Philippe, Costa, Francesco, Jeppsson, Anders, Jüni, Peter, Kastrati, Adnan, Kolh, Philippe, Mauri, Laura, Montalescot, Gilles, Neumann, Franz-Josef, Petricevic, Mate, Roffi, Marco, Steg, Philippe Gabriel, Windecker, Stephan, Zamorano, Jose Luis, Levine, Glenn N, Badimon, Lina, Vranckx, Pascal, Agewall, Stefan, Andreotti, Felicita, Antman, Elliott, Barbato, Emanuele, Bassand, Jean-Pierre, Bugiardini, Raffaele, Cikirikcioglu, Mustafa, Cuisset, Thomas, De Bonis, Michele, Delgado, Victora, Fitzsimons, Donna, Gaemperli, Oliver, Galiè, Nazzareno, Gilard, Martine, Hamm, Christian W, Ibanez, Borja, Iung, Bernard, James, Stefan, Knuuti, Juhani, Landmesser, Ulf, Leclercq, Christophe, Lettino, Maddalena, Lip, Gregory, Piepoli, Massimo Francesco, Pierard, Luc, Schwerzmann, Markus, Sechtem, Udo, Simpson, Iain A, Uva, Miguel Sousa, Stabile, Eugenio, Storey, Robert F, Tendera, Michal, Van de Werf, Frans, Verheugt, Freek, Aboyans, Victor, Coca, Antonio, Collet, Jean- Philippe, Coman, Ioan Mircea, Dean, Veronica, Delgado, Victoria, Hindricks, Gerhard, Katus, Hugo A, Lancellotti, Patrizio, McDonagh, Theresa, Ponikowski, Piotr, Richter, Dimitrios J, Shlyakhto, Evgeny, Roithinger, Franz Xaver, Aliyev, Farid, Stelmashok, Valeriy, Desmet, Walter, Postadzhiyan, Arman, Georghiou, Georgios P, Motovska, Zuzana, Grove, Erik Lerkevang, Marandi, Toomas, Kiviniemi, Tuomas, Kedev, Sasko, Massberg, Steffen, Alexopoulos, Dimitrios, Kiss, Robert Gabor, Gudmundsdottir, Ingibjorg Jona, McFadden, Eugène P, Lev, Eli, De Luca, Leonardo, Sugraliyev, Akhmetzhan, Haliti, Edmond, Mirrakhimov, Erkin, Latkovskis, Gustavs, Petrauskiene, Birute, Huijnen, Steve, Magri, Caroline Jane, Cherradi, Rhizlan, Ten Berg, Jurrien M, Eritsland, Jan, Budaj, Andrzej, Aguiar, Carlos Tavares, Duplyakov, Dmitry, Zavatta, Marco, Antonijevic, Nebojsa M, Fras, Zlatko, Montoliu, Antonio Tello, Varenhorst, Christoph, Tsakiris, Dimitri, Addad, Faouzi, Aydogdu, Sinan, Parkhomenko, Alexander, Kinnaird, Tim, ESC Scientific Document Group, ESC Committee for Practice Guidelines (CPG), ESC National Cardiac Societies, Valgimigli, Marco, Bueno, Héctor, Byrne, Robert A., Collet, Jean-Philippe, Costa, Francesco, Jeppsson, Ander, Kastrati, Adnan, Kolh, Philippe, Mauri, Laura, Montalescot, Gille, Neumann, Franz-Josef, Petricevic, Mate, Roffi, Marco, Steg, Philippe Gabriel, Zamorano, Jose Lui, Levine, Glenn N., Badimon, Lina, Vranckx, Pascal, Agewall, Stefan, Andreotti, Felicita, Antman, Elliott, Barbato, Emanuele, Bassand, Jean-Pierre, Bugiardini, Raffaele, Cikirikcioglu, Mustafa, Cuisset, Thoma, De Bonis, Michele, Delgado, Victora, Fitzsimons, Donna, Galiè, Nazzareno, Gilard, Martine, Hamm, Christian W., Ibanez, Borja, James, Stefan, Knuuti, Juhani, Landmesser, Ulf, Leclercq, Christophe, Lettino, Maddalena, Lip, Gregory, Piepoli, Massimo Francesco, Pierard, Luc, Schwerzmann, Marku, Sechtem, Udo, Simpson, Iain A., Uva, Miguel Sousa, Stabile, Eugenio, Storey, Robert F., Tendera, Michal, Van De Werf, Fran, Verheugt, Freek, Aboyans, Victor, Windecker, Stephan, Coca, Antonio, Coman, Ioan Mircea, Dean, Veronica, Delgado, Victoria, Gaemperli, Oliver, Hindricks, Gerhard, Iung, Bernard, Jüni, Peter, Katus, Hugo A., Lancellotti, Patrizio, McDonagh, Theresa, Ponikowski, Piotr, Richter, DImitrios J., Shlyakhto, Evgeny, Roithinger, Franz Xaver, Aliyev, Farid, Stelmashok, Valeriy, Desmet, Walter, Postadzhiyan, Arman, Georghiou, Georgios P., Motovska, Zuzana, Grove, Erik Lerkevang, Marandi, Tooma, Kiviniemi, Tuoma, Kedev, Sasko, Massberg, Steffen, Alexopoulos, DImitrio, Kiss, Robert Gabor, Gudmundsdottir, Ingibjorg Jona, McFadden, Eugène P., Lev, Eli, De Luca, Leonardo, Sugraliyev, Akhmetzhan, Haliti, Edmond, Mirrakhimov, Erkin, Latkovskis, Gustav, Petrauskiene, Birute, Huijnen, Steve, Magri, Caroline Jane, Cherradi, Rhizlan, Ten Berg, Jurrien M., Eritsland, Jan, Budaj, Andrzej, Aguiar, Carlos Tavare, Duplyakov, Dmitry, Zavatta, Marco, Antonijevic, Nebojsa M., Fras, Zlatko, Montoliu, Antonio Tello, Varenhorst, Christoph, Tsakiris, DImitri, Addad, Faouzi, Aydogdu, Sinan, Parkhomenko, Alexander, Kinnaird, Tim, Valgimigli, M, Bueno, H, Byrne, Ra, Collet, Jp, Costa, F, Jeppsson, A, Juni, P, Kastrati, A, Kolh, P, Mauri, L, Montalescot, G, Neumann, Fj, Petricevic, M, Roffi, M, Steg, Pg, Windecker, S, Zamorano, Jl, Levine, Gn, Badimon, L, Vranckx, P, Agewall, S, Andreotti, F, Antman, E, Barbato, E, Bassand, Jp, Bugiardini, R, Cikirikcioglu, M, Cuisset, T, De Bonis, M, Delgado, V, Fitzsimons, D, Oliver, G, Galie, N, Gilard, M, Hamm, Cw, Ibanez, B, Iung, B, James, S, Knuuti, J, Landmesser, U, Leclercq, C, Lettino, M, Lip, G, Piepoli, Mf, Pierard, L, Schwerzmann, M, Sechtem, U, Simpson, Ia, Uva, M, Stabile, E, Storey, Rf, Tendera, M, Van De Werf, F, Verheugt, F, Aboyans, V, Byrne, Robert A, Levine, Glenn N, Badimon L, Vranckx P, Agewall S, Andreotti F, Antman E, Barbato E, Bassand JP, Bugiardini R, Cikirikcioglu M, Cuisset T, De Bonis M, Delgado V, Fitzsimons D, Gaemperli O, Galiè N, Gilard M, Hamm CW, Ibanez B, Iung B, James S, Knuuti J, Landmesser U, Leclercq C, Lettino M, Lip G, Piepoli MF, Pierard L, Schwerzmann M, Sechtem U, Simpson IA, Uva MS, Stabile E, Storey RF, Tendera M, Van de Werf F, Verheugt F, Aboyans V, Alma Mater Studiorum Universita' di Bologna, DIPARTIMENTO DI MEDICINA SPECIALISTICA, DIAGNOSTICA E SPERIMENTALE, DIPARTIMENTO DI SCIENZE MEDICHE E CHIRURGICHE, Da definire, and AREA MIN. 06 - Scienze mediche
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Stable angina ,Ticagrelor ,Prasugrel ,Stent thrombosi ,Stent thrombosis ,medicine.medical_treatment ,Vascular damage Radboud Institute for Health Sciences [Radboudumc 16] ,Coronary artery bypass grafting ,030204 cardiovascular system & hematology ,Guideline ,Coronary artery disease ,Percutaneous coronary intervention ,0302 clinical medicine ,Stent ,DAPT score ,030212 general & internal medicine ,Myocardial infarction ,Drug-eluting stents ,reproductive and urinary physiology ,Societies, Medical ,dual antiplatelet therapy ,coronary artery disease ,General Medicine ,Clopidogrel ,Europe ,Cardiothoracic surgery ,Non cardiac surgery ,embryonic structures ,Dual antiplatelet therapy ,Cardiology ,Stents ,Stable coronary artery disease ,Radiology ,Acute coronary syndrome ,biological phenomena, cell phenomena, and immunity ,Cardiology and Cardiovascular Medicine ,PRECISE-DAPT score ,circulatory and respiratory physiology ,medicine.drug ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Acute coronary syndromes ,Guidelines ,03 medical and health sciences ,Non-cardiac surgery ,Internal medicine ,medicine ,Humans ,cardiovascular diseases ,Triple therapy ,Risk stratification ,Aspirin ,business.industry ,urogenital system ,Revascularization ,Bleeding ,Oral anticoagulant ,Recommendation ,medicine.disease ,Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE ,Surgery ,Drug-eluting stent ,business ,Platelet Aggregation Inhibitors - Abstract
none 107 si Non presente mixed Valgimigli, Marco*; Bueno, Héctor; Byrne, Robert A.; Collet, Jean-Philippe; Costa, Francesco; Jeppsson, Anders; Kastrati, Adnan; Kolh, Philippe; Mauri, Laura; Montalescot, Gilles; Neumann, Franz-Josef; Petricevic, Mate; Roffi, Marco; Steg, Philippe Gabriel; Zamorano, Jose Luis; Levine, Glenn N.; Badimon, Lina; Vranckx, Pascal; Agewall, Stefan; Andreotti, Felicita; Antman, Elliott; Barbato, Emanuele; Bassand, Jean-Pierre; Bugiardini, Raffaele; Cikirikcioglu, Mustafa; Cuisset, Thomas; De Bonis, Michele; Delgado, Victora; Fitzsimons, Donna; Galiè, Nazzareno; Gilard, Martine; Hamm, Christian W.; Ibanez, Borja; James, Stefan; Knuuti, Juhani; Landmesser, Ulf; Leclercq, Christophe; Lettino, Maddalena; Lip, Gregory; Piepoli, Massimo Francesco; Pierard, Luc; Schwerzmann, Markus; Sechtem, Udo; Simpson, Iain A.; Uva, Miguel Sousa; Stabile, Eugenio; Storey, Robert F.; Tendera, Michal; Van De Werf, Frans; Verheugt, Freek; Aboyans, Victor; Windecker, Stephan; Coca, Antonio; Coman, Ioan Mircea; Dean, Veronica; Delgado, Victoria; Gaemperli, Oliver; Hindricks, Gerhard; Iung, Bernard; Jüni, Peter; Katus, Hugo A.; Lancellotti, Patrizio; McDonagh, Theresa; Ponikowski, Piotr; Richter, DImitrios J.; Shlyakhto, Evgeny; Roithinger, Franz Xaver; Aliyev, Farid; Stelmashok, Valeriy; Desmet, Walter; Postadzhiyan, Arman; Georghiou, Georgios P.; Motovska, Zuzana; Grove, Erik Lerkevang; Marandi, Toomas; Kiviniemi, Tuomas; Kedev, Sasko; Massberg, Steffen; Alexopoulos, DImitrios; Kiss, Robert Gabor; Gudmundsdottir, Ingibjorg Jona; McFadden, Eugène P.; Lev, Eli; De Luca, Leonardo; Sugraliyev, Akhmetzhan; Haliti, Edmond; Mirrakhimov, Erkin; Latkovskis, Gustavs; Petrauskiene, Birute; Huijnen, Steve; Magri, Caroline Jane; Cherradi, Rhizlan; Ten Berg, Jurrien M.; Eritsland, Jan; Budaj, Andrzej; Aguiar, Carlos Tavares; Duplyakov, Dmitry; Zavatta, Marco; Antonijevic, Nebojsa M.; Fras, Zlatko; Montoliu, Antonio Tello; Varenhorst, Christoph; Tsakiris, DImitri; Addad, Faouzi; Aydogdu, Sinan; Parkhomenko, Alexander; Kinnaird, Tim Valgimigli, Marco*; Bueno, Héctor; Byrne, Robert A.; Collet, Jean-Philippe; Costa, Francesco; Jeppsson, Anders; Kastrati, Adnan; Kolh, Philippe; Mauri, Laura; Montalescot, Gilles; Neumann, Franz-Josef; Petricevic, Mate; Roffi, Marco; Steg, Philippe Gabriel; Zamorano, Jose Luis; Levine, Glenn N.; Badimon, Lina; Vranckx, Pascal; Agewall, Stefan; Andreotti, Felicita; Antman, Elliott; Barbato, Emanuele; Bassand, Jean-Pierre; Bugiardini, Raffaele; Cikirikcioglu, Mustafa; Cuisset, Thomas; De Bonis, Michele; Delgado, Victora; Fitzsimons, Donna; Galiè, Nazzareno; Gilard, Martine; Hamm, Christian W.; Ibanez, Borja; James, Stefan; Knuuti, Juhani; Landmesser, Ulf; Leclercq, Christophe; Lettino, Maddalena; Lip, Gregory; Piepoli, Massimo Francesco; Pierard, Luc; Schwerzmann, Markus; Sechtem, Udo; Simpson, Iain A.; Uva, Miguel Sousa; Stabile, Eugenio; Storey, Robert F.; Tendera, Michal; Van De Werf, Frans; Verheugt, Freek; Aboyans, Victor; Windecker, Stephan; Coca, Antonio; Coman, Ioan Mircea; Dean, Veronica; Delgado, Victoria; Gaemperli, Oliver; Hindricks, Gerhard; Iung, Bernard; Jüni, Peter; Katus, Hugo A.; Lancellotti, Patrizio; McDonagh, Theresa; Ponikowski, Piotr; Richter, DImitrios J.; Shlyakhto, Evgeny; Roithinger, Franz Xaver; Aliyev, Farid; Stelmashok, Valeriy; Desmet, Walter; Postadzhiyan, Arman; Georghiou, Georgios P.; Motovska, Zuzana; Grove, Erik Lerkevang; Marandi, Toomas; Kiviniemi, Tuomas; Kedev, Sasko; Massberg, Steffen; Alexopoulos, DImitrios; Kiss, Robert Gabor; Gudmundsdottir, Ingibjorg Jona; McFadden, Eugène P.; Lev, Eli; De Luca, Leonardo; Sugraliyev, Akhmetzhan; Haliti, Edmond; Mirrakhimov, Erkin; Latkovskis, Gustavs; Petrauskiene, Birute; Huijnen, Steve; Magri, Caroline Jane; Cherradi, Rhizlan; Ten Berg, Jurrien M.; Eritsland, Jan; Budaj, Andrzej; Aguiar, Carlos Tavares; Duplyakov, Dmitry; Zavatta, Marco; Antonijevic, Nebojsa M.; Fras, Zlatko; Montoliu, Antonio Tello; Varenhorst, Christoph; Tsakiris, DImitri; Addad, Faouzi; Aydogdu, Sinan; Parkhomenko, Alexander; Kinnaird, Tim
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- 2018
15. Relationship between peripheral arterial reactive hyperemia and the index of myocardial resistance in patients undergoing invasive coronary angiography
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Fabio Mangiacapra, Emanuele Barbato, William Wijns, Jozef Bartunek, Federica De Luise, Luigi Di Serafino, Stylianos A. Pyxaras, Bernard De Bruyne, Carmine Morisco, Di Serafino, L., Mangiacapra, F., Pyxaras, S., Morisco, C., Bartunek, J., De Bruyne, B., De Luise, F., Wijns, W., and Barbato, E.
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Coronary angiography ,medicine.medical_specialty ,Prognostic factor ,Peripheral endothelial dysfunction ,Hyperemia ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Coronary Angiography ,Coronary artery disease ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Internal medicine ,Humans ,Medicine ,In patient ,030212 general & internal medicine ,Reactive hyperemia ,Framingham Risk Score ,business.industry ,Microcirculation ,Arteries ,medicine.disease ,Peripheral ,coronary artery disease ,coronary microcirculation ,peripheral endothelial dysfunction ,Invasive coronary angiography ,Microvessels ,Cardiology ,Coronary microcirculation ,Endothelium, Vascular ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background Coronary microvascular dysfunction is a powerful prognostic factor in patients with coronary artery disease. We investigated the role of reactive digital hyperemia peripheral arterial tonometry (RH-PAT) as a non-invasive tool to identify patients with impaired coronary microvasculature. Methods Patients undergoing elective coronary angiography were consecutively assessed for peripheral microvascular endothelial function before coronary angiography: both the Reactive Hyperemic Index (RHI) and the Framingham reactive hyperemic index (Endoscore) were measured. During coronary angiography, the Index of microvascular resistance (IMR) was measured in all patients, and an IMR value > 25 identified patients with coronary microvascular impairment. Results A total of 47 patients with chronic coronary syndromes candidate to coronary angiography were included. Those with coronary microvascular impairment (n = 18 [38%]) presented with significantly lower RHI (1.68 ± 0.38 vs. 1.94 ± 0.93, p = 0.04) and Endoscore 0.50 ± 0.23 vs. 0.64 ± 0.23, p = 0.04) values as compared with patients with preserved coronary microvasculature. A significant relationship was observed between IMR with both RHI (r = 0.35, p = 0.02) and Endoscore (r = 0.34, p = 0.02). At the multivariable analysis, RHI and Endoscore were the only independent predictors of an IMR > 25. Conclusions Our study demonstrates that digital reactive hyperemia indexes are lower in patients with high IMR values, suggesting a role for RH-PAT as non-invasive tool for identifying patients with coronary microvascular impairment.
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- 2021
16. Heart failure with preserved ejection fraction or non-cardiac dyspnea in paroxysmal atrial fibrillation: The role of left atrial strain
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G Van Camp, Emanuele Barbato, Z Balogh, A Katbeh, M Albano, T De Potter, J. Bartunek, M. Vanderheyden, G Di Gioia, Martin Penicka, Peter Geelen, M Kodeboina, Katbeh, A., De Potter, T., Geelen, P., Di Gioia, G., Kodeboina, M., Balogh, Z., Albano, M., Vanderheyden, M., Bartunek, J., Barbato, E., Van Camp, G., and Penicka, M.
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Male ,medicine.medical_specialty ,Diastolic function ,Left atrial strain ,Heart failure ,Speckle tracking echocardiography ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine.artery ,Atrial Fibrillation ,medicine ,Humans ,Sinus rhythm ,Heart Atria ,030212 general & internal medicine ,Ejection fraction ,business.industry ,Stroke Volume ,medicine.disease ,Dyspnea ,Pulmonary artery ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,Heart failure with preserved ejection fraction ,business ,Body mass index - Abstract
Background: Diagnosis of heart failure with preserved ejection fraction (HFpEF) in patients with dyspnea and paroxysmal atrial fibrillation (AF) is challenging. Speckle tracking-derived left atrial strain (LAS) provides an accurate estimate of left ventricular (LV) filling pressures and left atrial (LA) phasic function. However, data on clinical utility of LAS in patients with dyspnea and AF are scarce. Objective: To assess relationship between the LAS and the probability of HFpEF in patients with dyspnea and paroxysmal AF. Methods: The study included 205 consecutive patients (62 ± 10 years, 58% males) with dyspnea (NYHA≥II), paroxysmal AF and preserved LV ejection fraction (≥50%), who underwent speckle tracking echocardiography during sinus rhythm. Probability of HFpEF was estimated using H2FPEF and HFA-PEFF scores, which combine clinical characteristics, echocardiographic parameters and natriuretic peptides. Results: Patients with high probability of HFpEF were significantly older, had higher body mass index, NT-proBNP, E/e’, pulmonary artery pressure and larger LA volume index than patients in low-to-intermediate probability groups (all p < 0.05). All components of LAS and LA strain rate showed proportional impairment with increasing probability of HFpEF (all p < 0.05). Out of the speckle tracking-derived parameters, reservoir LAS showed the largest area under the curve (AUC = 0.78, p < 0.001) and the strongest independent predictive value (OR: 1.22, 95% CI 1.08–1.38) to identify patients with high probability of HFpEF. Conclusions: Reservoir LAS shows a high diagnostic performance to distinguish HFpEF from non-cardiac causes of dyspnea in symptomatic patients with paroxysmal AF.
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- 2021
17. Graft patency and progression of coronary artery disease after CABG assessed by angiography-derived fractional flow reserve
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Takuya Mizukami, Bernard De Bruyne, Carlo Gigante, Jeroen Sonck, Eric Wyffels, Carlos Collet, Antonio L. Bartorelli, Daniele Andreini, Saima Mushtaq, Emanuele Barbato, Sakura Nagumo, Giulio Pompilio, Jozef Bartunek, Marc Vanderheyden, Alessandra Tanzilli, Gigante, C., Mizukami, T., Sonck, J., Nagumo, S., Tanzilli, A., Bartunek, J., Vanderheyden, M., Wyffels, E., Barbato, E., Pompilio, G., Mushtaq, S., Bartorelli, A., De Bruyne, B., Andreini, D., Collet, C., ACS - Heart failure & arrhythmias, and Graduate School
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medicine.medical_specialty ,Coronary Artery Disease ,Fractional flow reserve ,030204 cardiovascular system & hematology ,Coronary Angiography ,Coronary artery disease ,03 medical and health sciences ,0302 clinical medicine ,Graft occlusion ,Internal medicine ,medicine ,Humans ,angiography-derived ffr ,In patient ,cardiovascular diseases ,030212 general & internal medicine ,Coronary Artery Bypass ,graft occlusion ,Vascular Patency ,medicine.diagnostic_test ,Graft patency ,business.industry ,Graft Occlusion, Vascular ,competitive flow ,cabg ,ffr ,medicine.disease ,Fractional Flow Reserve, Myocardial ,surgical procedures, operative ,medicine.anatomical_structure ,Angiography ,Coronary vessel ,cardiovascular system ,Cardiology ,Cardiology and Cardiovascular Medicine ,business ,Artery - Abstract
Background: Graft occlusion after coronary artery bypass graft surgery (CABG) has been associated with native coronary artery competitive flow. Objectives: The present study aims to characterize the functional progression of coronary artery disease (CAD) in native vessels after CABG, and to assess the relationship between preoperative FFR as derived from angiography and graft occlusion. Methods: Multicenter study of consecutive patients undergoing CABG between 2013 and 2018, in whom a follow-up angiogram had been performed. Serial vessel-fractional flow reserve (vFFR) analyses were obtained in each major native coronary vessel before and after CABG, excluding post-anastomotic segments and graft conduits. Results: In 73 patients, serial angiograms were suitable for vFFR analysis, including 118 grafted (86 arterial and 32 saphenous grafts) and 64 non-grafted vessels. The median time between CABG and follow-up angiography was 2.4 years [IQR 1.5, 3.3]. Functional CAD progression, by means of decline in vFFR, was observed in grafted but not in non-grafted vessels (delta vFFR in grafted vessels 0.10 [IQR 0.05, 0.18] vs. 0.01 [IQR -0.01, 0.03], in non-grafted vessels, p < 0.001). Preoperative vFFR predicted graft occlusion (AUC: 0.66, 95% CI 0.52 to 0.80, p = 0.031). Conclusions: In patients undergoing CABG, preoperative vFFR derived from conventional angiograms without use of pressure wire was able to predict graft occlusion. Graft occlusion was more frequent in vessels with high vFFR values. Grafted native coronary vessels exhibited accelerated functional CAD progression, whereas in non-grafted native coronaries the functional status remained unchanged.
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- 2020
18. Insulin Resistance the Hinge Between Hypertension and Type 2 Diabetes
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Giuseppe Di Gioia, Maria Angela Losi, Raffaele Izzo, Carmine Morisco, Emanuele Barbato, Costantino Mancusi, Mancusi, C., Izzo, R., di Gioia, G., Losi, M. A., Barbato, E., and Morisco, C.
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0301 basic medicine ,Blood Glucose ,medicine.medical_specialty ,Inflammation ,Blood Pressure ,Type 2 diabetes ,Review Article ,Pathogenesis ,03 medical and health sciences ,0302 clinical medicine ,Insulin resistance ,Risk Factors ,Internal medicine ,Diabetes mellitus ,Internal Medicine ,medicine ,Animals ,Humans ,Insulin ,Vascular inflammation ,biology ,business.industry ,Incidence ,Left ventricular hypertrophy ,medicine.disease ,Cardiovascular risk ,Atherosclerosis ,Prognosis ,IRS1 ,Insulin receptor ,030104 developmental biology ,Endocrinology ,Diabetes Mellitus, Type 2 ,Atherosclerosi ,biology.protein ,medicine.symptom ,Essential Hypertension ,Insulin Resistance ,Cardiology and Cardiovascular Medicine ,business ,030217 neurology & neurosurgery ,Biomarkers ,Hormone ,Microalbuminuria ,Signal Transduction - Abstract
Epidemiological studies have documented a high incidence of diabetes in hypertensive patients.Insulin resistance is defined as a less than expected biologic response to a given concentration of the hormone and plays a pivotal role in the pathogenesis of diabetes. However, over the last decades, it became evident that insulin resistance is not merely a metabolic abnormality, but is a complex and multifaceted syndrome that can also affect blood pressure homeostasis. The dysregulation of neuro-humoral and neuro-immune systems is involved in the pathophysiology of both insulin resistance and hypertension. These mechanisms induce a chronic low grade of inflammation that interferes with insulin signalling transduction. Molecular abnormalities associated with insulin resistance include the defects of insulin receptor structure, number, binding affinity, and/or signalling capacity. For instance, hyperglycaemia impairs insulin signalling through the generation of reactive oxygen species, which abrogate insulin-induced tyrosine autophosphorylation of the insulin receptor. Additional mechanisms have been described as responsible for the inhibition of insulin signalling, including proteasome-mediated degradation of insulin receptor substrate 1/2, phosphatase-mediated dephosphorylation and kinase-mediated serine/threonine phosphorylation of both insulin receptor and insulin receptor substrates. Insulin resistance plays a key role also in the pathogenesis and progression of hypertension-induced target organ damage, like left ventricular hypertrophy, atherosclerosis and chronic kidney disease. Altogether these abnormalities significantly contribute to the increase the risk of developing type 2 diabetes.
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- 2020
19. Clinical outcomes of PCI with rotational atherectomy: the European multicentre Euro4C registry
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Markus Meyer-Gessner, Wojciech Zajdel, Emanuele Barbato, Didier Carrié, Jorge Palazuelos Molinero, Krzysztof Reczuch, Sławomir Dobrzycki, Thibault Lhermusier, Miroslaw Ferenc, Erwan Bressollette, Guillaume Cayla, Frédéric Bouisset, Flavio Ribichini, Hôpital de Rangueil, CHU Toulouse [Toulouse], 'Federico II' University of Naples Medical School, University of Wrocław [Poland] (UWr), University of Bialystok, Augusta Krankenhaus, Nouvelles Cliniques Nantaises - NCN [Nantes], Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Uniwersytet Jagielloński w Krakowie = Jagiellonian University (UJ), Hospital Central de la Defensa Gomez Ulla, University Heart Centre Freiburg - Bad Krozingen, University of Verona (UNIVR), Bouisset, F., Barbato, E., Reczuch, K., Dobrzycki, S., Meyer-Gessner, M., Bressollette, E., Cayla, G., Lhermusier, T., Zajdel, W., Molinero, J. P., Ferenc, M., Ribichini, F., and Carrie, D.
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Atherectomy, Coronary ,Male ,Registrie ,Atherectomy ,MESH: Registries ,medicine.medical_treatment ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,MESH: Stroke Volume ,Ventricular Function, Left ,MESH: Aged, 80 and over ,0302 clinical medicine ,Retrospective Studie ,Undilatable lesion ,Prospective Studies ,Registries ,030212 general & internal medicine ,Myocardial infarction ,Stroke ,MESH: Atherectomy, Coronary / instrumentation ,MESH: Treatment Outcome ,Aged, 80 and over ,education.field_of_study ,Ejection fraction ,Calcified stenosi ,Multiple vessel disease ,3. Good health ,Europe ,Treatment Outcome ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,MESH: Percutaneous Coronary Intervention ,Rotablator ,Human ,MESH: Atherectomy, Coronary / methods ,medicine.medical_specialty ,Acute coronary syndrome ,MESH: Coronary Artery Disease / diagnosis ,Population ,MESH: Ventricular Function, Left / physiology ,03 medical and health sciences ,Percutaneous Coronary Intervention ,MESH: Coronary Artery Disease / surgery ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,Internal medicine ,Left main ,medicine ,Humans ,education ,Retrospective Studies ,Aged ,Interventional cardiology ,business.industry ,Percutaneous coronary intervention ,Stroke Volume ,MESH: Retrospective Studies ,medicine.disease ,MESH: Prospective Studies ,Prospective Studie ,MESH: Europe ,business ,Mace - Abstract
International audience; Aims: Despite the use of rotational atherectomy (RA) in interventional cardiology for over three decades, data regarding factors affecting the clinical outcomes of the RA procedure remain scarce. The aim of the present study was to describe the contemporary use and outcomes of RA in Europe.Methods and results: We conducted, for the first time, a prospective international registry in 8 European countries and 19 centres and included patients treated by percutaneous coronary intervention with RA. Between October 2016 and July 2018, 966 patients with complete data were recruited. Mean age was 74.5 years, 72.4% were male and 43.4% had diabetes. Initial presentation was an acute coronary syndrome (ACS) for 25.1% of the patients. Clinical success was observed in 91.9% of the procedures. The rate of in-hospital major adverse cardiac events (MACE) - defined as cardiovascular death, myocardial infarction, target lesion revascularisation, stroke and coronary artery bypass grafting - was 4.7%. At one year, the rate of MACE was 13.2%. Factors independently associated with the occurrence of MACE at one year were female gender, renal failure, ACS at admission, depressed left ventricular ejection fraction (LVEF) and presence of a significant left main coronary artery (LMCA) lesion.Conclusions: Despite the high level of complexity of the studied population, RA turned out to be an effective procedure with a low rate of in-hospital complications and demonstrated good immediate and midterm results.
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- 2020
20. Assessment of carotid cross-sectional area in hypertensive patients: phenotyping and prognostic validation in The Campania Salute Network
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Grazia Canciello, Costantino Mancusi, Maria Angela Losi, Emanuele Barbato, Maria Virginia Manzi, Maria Immacolata Arnone, Nicola De Luca, Francesco Rozza, Raffaele Izzo, Carmine Morisco, Mancusi, C., Canciello, G., Losi, M. A., Barbato, E., Morisco, C., Manzi, M. V., Arnone, M. I., Rozza, F., De Luca, N., and Izzo, R.
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Male ,medicine.medical_specialty ,Blood Pressure ,030204 cardiovascular system & hematology ,Left ventricular hypertrophy ,Carotid Intima-Media Thickness ,03 medical and health sciences ,0302 clinical medicine ,medicine.artery ,Internal medicine ,Internal Medicine ,Humans ,Medicine ,cardiovascular diseases ,030212 general & internal medicine ,Common carotid artery ,Aged ,Ldl cholesterol ,medicine.diagnostic_test ,business.industry ,Prognosis ,medicine.disease ,Target organ damage ,Pulse pressure ,Carotid Arteries ,Hypertension ,Cardiology ,Female ,business ,Lipid profile - Abstract
Increased intima-media thickness (IMT) of common carotid artery (CA) is considered the hallmark of vascular hypertension-mediated target organ damage, even if vessel remodeling due to mechanical stress may also induce changes in diameter. We developed a method computing both diameter and IMT of CA, to assess correlates and prognostic impact of carotid cross-sectional area (CCSA) in a large registry of treated hypertensive patients. We selected 6300 hypertensive patients of the Campania Salute Network registry free of overt cardiovascular (CV) disease and with available CA ultrasound (54 ± 11 years; 57% male). CCSA was computed as:π×(CAdiameter+2×(meanIMT)2)2−π×(CAdiameter2)2. CCSA was considered high if >90th percentile of the sex-specific distribution (>48 mm2 in men and >41 mm2 in women). Patients with high CCSA were male, with older age, higher pulse pressure (PP), more prevalent obese and diabetic, with higher total and LDL cholesterol (p < 0.01 for all). During a median follow-up of 60 months (IQR 19–87), 206 incident composite major and minor CV events occurred. In Cox regression analysis high CCSA was associated with more than 100% increased risk of incident CV events ((HR 2.11, 95%CI 1.46–3.1, p < 0.0001), independently of the effect of older age, male sex, PP > 60 mmHg, presence of left ventricular hypertrophy (LVH), carotid plaque (CP), and less anti-RAS therapy (p < 0.05 for all). In treated hypertensive patients, increased CCSA is associated with worse metabolic and lipid profile and predict incident CV events, independently of high PP, presence of LVH and CP.
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- 2020
21. EAPCI Position Statement on Invasive Management of Acute Coronary Syndromes during the COVID-19 pandemic
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Raúl Moreno, Dariusz Dudek, Stephan Windecker, Giulio G. Stefanini, Guido Tavazzi, Andreas Baumbach, Giuseppe Tarantini, Marco Roffi, Franz-Josef Neumann, Alaide Chieffo, Kurt Huber, Josepa Mauri Ferre, Stefan James, Sigrun Halvorsen, Martine Gilard, Helge Möllmann, Susanna Price, Nicole Karam, Gill Louise Buchanan, Emanuele Barbato, Chieffo, A., Stefanini, G. G., Price, S., Barbato, E., Tarantini, G., Karam, N., Moreno, R., Buchanan, G. L., Gilard, M., Halvorsen, S., Huber, K., James, S., Neumann, F. -J., Mollmann, H., Roffi, M., Tavazzi, G., Ferre, J. M., Windecker, S., Dudek, D., and Baumbach, A.
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Disease ,030204 cardiovascular system & hematology ,law.invention ,Clinical pathway ,0302 clinical medicine ,law ,Health care ,Medicine ,Viral ,030212 general & internal medicine ,610 Medicine & health ,Non-ST Elevated Myocardial Infarction ,PCI ,Intensive care unit ,Interventional Cardiology ,Europe ,Current Opinion ,ACS ,COVID-19 ,NSTEMI ,STEMI ,Acute Coronary Syndrome ,Cardiology ,Coronavirus Infections ,Humans ,Infection Control ,Pandemics ,Pneumonia, Viral ,ST Elevation Myocardial Infarction ,Cardiology and Cardiovascular Medicine ,Algorithms ,Human ,medicine.medical_specialty ,Acute coronary syndrome ,Context (language use) ,Betacoronavirus ,03 medical and health sciences ,Intensive care ,Intensive care medicine ,Disease burden ,Management of acute coronary syndrome ,Pandemic ,SARS-CoV-2 ,Coronavirus Infection ,business.industry ,Pneumonia ,Evidence-based medicine ,medicine.disease ,Heart catheterization ,business ,Fibrinolytic agent - Abstract
The coronavirus disease 2019 (COVID-19) pandemic poses an unprecedented challenge to healthcare worldwide. The infection can be life threatening and require intensive care treatment. The transmission of the disease poses a risk to both patients and healthcare workers. The number of patients requiring hospital admission and intensive care may overwhelm health systems and negatively affect standard care for patients presenting with conditions needing emergency interventions. This position statements aims to assist cardiologists in the invasive management of acute coronary syndrome (ACS) patients in the context of the COVID-19 pandemic. To that end, we assembled a panel of interventional cardiologists and acute cardiac care specialists appointed by the European Association of Percutaneous Cardiovascular Interventions (EAPCI) and from the Acute Cardiovascular Care Association (ACVC) and included the experience from the first and worst affected areas in Europe. Modified diagnostic and treatment algorithms are proposed to adapt evidence-based protocols for this unprecedented challenge. Various clinical scenarios, as well as management algorithms for patients with a diagnosed or suspected COVID-19 infection, presenting with ST- and non-ST-segment elevation ACS are described. In addition, we address the need for re-organization of ACS networks, with redistribution of hub and spoke hospitals, as well as for in-hospital reorganization of emergency rooms and cardiac units, with examples coming from multiple European countries. Furthermore, we provide a guidance to reorganization of catheterization laboratories and, importantly, measures for protection of healthcare providers involved with invasive procedures.
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- 2020
22. Cost Effectiveness of a CYP2C19 Genotype-Guided Strategy in Patients with Acute Myocardial Infarction: Results from the POPular Genetics Trial
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Richard M. Tjon Joe Gin, Emanuele Barbato, Thomas O. Bergmeijer, Arnoud W J van 't Hof, Pim W. M. van Dorst, Daniel M.F. Claassens, Arend Mosterd, Vera H.M. Deneer, Renicus S Hermanides, Carmine Morisco, Folkert W. Asselbergs, Willem Dewilde, Gerrit J.A. Vos, C. Boersma, Pim van der Harst, Jean-Paul R. Herrman, Jurriën M. ten Berg, Maarten J. Postma, Claassens, D. M. F., van Dorst, P. W. M., Vos, G. J. A., Bergmeijer, T. O., Hermanides, R. S., van 't Hof, A. W. J., van der Harst, P., Barbato, E., Morisco, C., Tjon Joe Gin, R. M., Asselbergs, F. W., Mosterd, A., Herrman, J. -P. R., Dewilde, W. J. M., Postma, M. J., Deneer, V. H. M., ten Berg, J. M., Boersma, C., RS: Carim - H01 Clinical atrial fibrillation, Cardiologie, MUMC+: MA Med Staf Spec Cardiologie (9), RS: Carim - B04 Clinical thrombosis and Haemostasis, Cardiovascular Centre (CVC), Value, Affordability and Sustainability (VALUE), Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), and Microbes in Health and Disease (MHD)
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SELECTION ,Acute coronary syndrome ,Prasugrel ,Cost effectiveness ,AMERICAN-COLLEGE ,GUIDELINES ,ACUTE CORONARY SYNDROME ,PRASUGREL ,Medicine ,Pharmacology (medical) ,ST-SEGMENT ELEVATION ,TICAGRELOR ,health care economics and organizations ,Genetics ,ANTIPLATELET THERAPY ,business.industry ,Standard treatment ,General Medicine ,Clopidogrel ,medicine.disease ,CLOPIDOGREL ,Conventional PCI ,Cohort ,Cardiology and Cardiovascular Medicine ,business ,Ticagrelor ,medicine.drug ,TASK-FORCE - Abstract
INTRODUCTION: The POPular Genetics trial demonstrated that a CYP2C19 genotype-guided P2Y12 inhibitor strategy reduced bleeding rates compared with standard treatment with ticagrelor or prasugrel without increasing thrombotic event rates after primary percutaneous coronary intervention (PCI).OBJECTIVE: In this analysis, we aimed to evaluate the cost effectiveness of a genotype-guided strategy compared with standard treatment with ticagrelor or prasugrel.METHODS: A 1-year decision tree based on the POPular Genetics trial in combination with a lifelong Markov model was developed to compare costs and quality-adjusted life-years (QALYs) between a genotype-guided and a standard P2Y12 inhibitor strategy in patients with myocardial infarction undergoing primary PCI. The cost-effectiveness analysis was conducted from a Dutch healthcare system perspective. Within-trial survival and utility data were combined with lifetime projections to evaluate lifetime cost effectiveness for a cohort of 1000 patients. Costs and utilities were discounted at 4 and 1.5%, respectively, according to Dutch guidelines for health economic studies. Besides deterministic and probabilistic sensitivity analyses, several scenario analyses were also conducted (different time horizons, different discount rates, equal prices for P2Y12 inhibitors, and equal distribution of thrombotic events between the two strategies).RESULTS: Base-case analysis with a hypothetical cohort of 1000 subjects demonstrated 8.98 QALYs gained and €725,550.69 in cost savings for the genotype-guided strategy (dominant). The deterministic and probabilistic sensitivity analysis confirmed the robustness of the model and the cost-effectiveness results. In scenario analyses, the genotype-guided strategy remained dominant.CONCLUSION: In patients undergoing primary PCI, a CYP2C19 genotype-guided strategy compared with standard treatment with ticagrelor or prasugrel resulted in QALYs gained and cost savings.TRIAL REGISTRATION: Clinicaltrials.gov number: NCT01761786, Netherlands trial register number: NL2872.
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- 2022
23. Reducing Cardiac Injury during ST-Elevation Myocardial Infarction: A Reasoned Approach to a Multitarget Therapeutic Strategy
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Emanuele Barbato, Giuseppe Di Gioia, Raffaele Izzo, Bruno Trimarco, Alessandro Bellis, Ciro Mauro, Carmine Morisco, Costantino Mancusi, Bellis, A., Di Gioia, G., Mauro, C., Mancusi, C., Barbato, E., Izzo, R., Trimarco, B., and Morisco, C.
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0301 basic medicine ,medicine.medical_specialty ,Percutaneous ,extracellular matrix ,Review ,030204 cardiovascular system & hematology ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,Internal medicine ,Medicine ,cardiovascular diseases ,Ventricular remodeling ,Therapeutic strategy ,left ventricular remodeling ,remote ischemic conditioning ,business.industry ,coronary microvascular obstruction ,General Medicine ,Blood flow ,medicine.disease ,primary percutaneous coronary intervention ,Clinical trial ,030104 developmental biology ,Heart failure ,Cardiology ,business ,Reperfusion injury - Abstract
The significant reduction in ‘ischemic time’ through capillary diffusion of primary percutaneous intervention (pPCI) has rendered myocardial-ischemia reperfusion injury (MIRI) prevention a major issue in order to improve the prognosis of ST elevation myocardial infarction (STEMI) patients. In fact, while the ischemic damage increases with the severity and the duration of blood flow reduction, reperfusion injury reaches its maximum with a moderate amount of ischemic injury. MIRI leads to the development of post-STEMI left ventricular remodeling (post-STEMI LVR), thereby increasing the risk of arrhythmias and heart failure. Single pharmacological and mechanical interventions have shown some benefits, but have not satisfactorily reduced mortality. Therefore, a multitarget therapeutic strategy is needed, but no univocal indications have come from the clinical trials performed so far. On the basis of the results of the consistent clinical studies analyzed in this review, we try to design a randomized clinical trial aimed at evaluating the effects of a reasoned multitarget therapeutic strategy on the prevention of post-STEMI LVR. In fact, we believe that the correct timing of pharmacological and mechanical intervention application, according to their specific ability to interfere with survival pathways, may significantly reduce the incidence of post-STEMI LVR and thus improve patient prognosis.
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- 2021
24. Interaction Between Diabetes Mellitus and Platelet Reactivity in Determining Long-Term Outcomes Following Percutaneous Coronary Intervention
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Marialessia Capuano, Elisabetta Ricottini, Michele Matia Viscusi, Germano Di Sciascio, Fabio Mangiacapra, Ilaria Cavallari, Emanuele Barbato, Edoardo Bressi, Iginio Colaiori, Silvia Spoto, Mangiacapra, F., Bressi, E., Colaiori, I., Ricottini, E., Cavallari, I., Capuano, M., Viscusi, M. M., Spoto, S., Barbato, E., and Di Sciascio, G.
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Male ,0301 basic medicine ,Time Factors ,Platelet Aggregation ,Physiology ,medicine.medical_treatment ,Drug Resistance ,Myocardial Infarction ,Pharmaceutical Science ,030204 cardiovascular system & hematology ,Coronary artery disease ,Percutaneous coronary intervention ,0302 clinical medicine ,Risk Factors ,Long term outcomes ,Clinical endpoint ,Prospective Studies ,Myocardial infarction ,Genetics (clinical) ,Aspirin ,Dual Anti-Platelet Therapy ,Middle Aged ,Clopidogrel ,Treatment Outcome ,Cardiology ,Molecular Medicine ,Female ,Stents ,Platelet function ,Cardiology and Cardiovascular Medicine ,medicine.drug ,Diabetes mellitu ,medicine.medical_specialty ,Risk Assessment ,Platelet reactivity ,03 medical and health sciences ,Diabetes mellitus ,Internal medicine ,Diabetes Mellitus ,Genetics ,medicine ,Humans ,cardiovascular diseases ,Aged ,Pharmacology ,business.industry ,Coronary Thrombosis ,medicine.disease ,030104 developmental biology ,Conventional PCI ,business ,Platelet Aggregation Inhibitors ,Mace - Abstract
Diabetes mellitus (DM) is an independent predictor of adverse outcomes in patients with coronary artery disease (CAD). We investigated the interaction between DM and high platelet reactivity (HPR) in determining long-term clinical outcomes after percutaneous coronary intervention (PCI). We enrolled 500 patients who were divided based on the presence of DM and HPR. Primary endpoint was the occurrence of major adverse clinical events (MACE) at 5 years. Patients with both DM and HPR showed the highest estimates of MACE (37.9%, log-rank p
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- 2019
25. Imaging in ESC clinical guidelines: chronic coronary syndromes
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Davide Capodanno, Emanuele Barbato, Eva Prescott, Jeroen J. Bax, Thor Edvardsen, Stephan Achenbach, William Wijns, Juhani Knuuti, Antti Saraste, Saraste, A., Barbato, E., Capodanno, D., Edvardsen, T., Prescott, E., Achenbach, S., Bax, J. J., Wijns, W., and Knuuti, J.
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medicine.medical_specialty ,CAD ,030204 cardiovascular system & hematology ,Single-photon emission computed tomography ,cardiac magnetic resonance ,Coronary artery disease ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Medical imaging ,Humans ,echocardiography ,Radiology, Nuclear Medicine and imaging ,030212 general & internal medicine ,Thrombus ,Intensive care medicine ,Societies, Medical ,Cardiac imaging ,positron emission computed tomography ,medicine.diagnostic_test ,single-photon emission computed tomography ,business.industry ,Syndrome ,General Medicine ,Guideline ,medicine.disease ,Europe ,Functional imaging ,Practice Guidelines as Topic ,coronary computed tomography angiography ,Cardiology and Cardiovascular Medicine ,business ,coronary artery disease - Abstract
The European Society of Cardiology (ESC) has recently published new guidelines on the diagnosis and management of chronic coronary syndromes (CCS). The 2019 guideline identified six common clinical scenarios of CCS defined by the different evolutionary phases of coronary artery disease (CAD), excluding the situations in which an acute coronary event, often with coronary thrombus formation, dominates the clinical presentation. This review aims at providing a summary of novel or revised concepts in the guidelines together with the recent data underlying the major changes on the use of cardiac imaging in patients with suspected or known CCS. Based on data from contemporary cohorts of patients referred for diagnostic testing, the pre-test probabilities of CAD based on age, sex and symptoms have been adjusted substantially downward as compared with 2013 ESC guidelines. Further, the impact of various risk factors and modifiers on the pre-test probability was highlighted and a new concept of ‘Clinical likelihood of CAD’ was introduced. Recommendations regarding diagnostic tests to establish or rule-out obstructive CAD have been updated with recent data on their diagnostic performance in different patient groups and impact on patient outcome. As the initial strategy to diagnose CAD in symptomatic patients, non-invasive functional imaging for myocardial ischaemia, coronary computed tomography angiography or invasive coronary angiography combined with functional evaluation may be used, unless obstructive CAD can be excluded by clinical assessment alone. When available, imaging tests instead of the exercise electrocardiogram are recommended when following the non-invasive diagnostic strategy.
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- 2019
26. Rational and design of the INtentional COronary revascularization versus conservative therapy in patients undergOing successful peripheRAl arTEry revascularization due to critical limb ischemia trial (INCORPORATE trial)
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Marianne Brodmann, Stanislaw Bartus, Laura Schneller, Robert J. Gil, Fabio Mangiacapra, Viktor Óriás, Gabor G. Toth, Emanuele Barbato, Jacek Bil, Zoltán Ruzsa, Toth, G., Brodmann, M., Barbato, E., Mangiacapra, F., Schneller, L., Orias, V., Gil, R., Bil, J., Bartus, S., and Ruzsa, Z.
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medicine.medical_specialty ,medicine.medical_treatment ,Ischemia ,Coronary Artery Disease ,Fractional flow reserve ,030204 cardiovascular system & hematology ,Conservative Treatment ,Revascularization ,Coronary artery disease ,Peripheral Arterial Disease ,03 medical and health sciences ,Percutaneous Coronary Intervention ,0302 clinical medicine ,Internal medicine ,Catheterization, Peripheral ,medicine ,Humans ,Multicenter Studies as Topic ,030212 general & internal medicine ,Myocardial infarction ,Randomized Controlled Trials as Topic ,Leg ,business.industry ,Percutaneous coronary intervention ,Critical limb ischemia ,medicine.disease ,Fractional Flow Reserve, Myocardial ,Clinical trial ,Early Diagnosis ,Cardiology ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business - Abstract
Critical limb ischemia is associated with excessively high risk for cardiovascular events, including myocardial infarction and death. Additionally, in this patient population non-invasive evaluation of coronary artery disease is limited due to (1) inability of exercise testing, (2) frequent occurrence of balanced ischemia and (3) frequent occurrence of diffuse coronary calcification. Intentional Coronary Revascularization Versus Conservative Therapy in Patients Undergoing Peripheral Artery Revascularization Due to Critical Limb Ischemia trial (INCORPORATE trial) is a multicentric international randomized open label clinical trial. Trial will recruit patients, who underwent successful peripheral artery revascularization due to critical limb ischemia and randomize 1:1 to conservative medical therapy versus an immediate invasive strategy to investigate and treat coronary artery disease. The objective is to evaluate whether intentional invasive strategy with ischemia targeted reasonably complete coronary revascularization is superior as compared to conventional primarily conservative approach in terms of spontaneous myocardial infarction and overall survival at 12 months follow-up. The trial is registered at clinicaltrials.gov (NCT03712644).
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- 2019
27. Association of improvement in fractional flow reserve with outcomes, including symptomatic relief, after percutaneous coronary intervention
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Bernard De Bruyne, Pim A.L. Tonino, Nico H.J. Pijls, Stephane Fournier, Emanuele Barbato, Anastasios Milkas, Panagiotis Xaplanteris, Gabor G. Toth, William F. Fearon, Giovanni Ciccarelli, Fournier, S., Ciccarelli, G., Toth, G. G., Milkas, A., Xaplanteris, P., Tonino, P. A. L., Fearon, W. F., Pijls, N. H. J., Barbato, E., De Bruyne, B., and Cardiovascular Biomechanics
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Male ,medicine.medical_specialty ,medicine.medical_treatment ,Myocardial Infarction ,Fractional flow reserve ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Coronary Angiography ,law.invention ,Coronary artery disease ,03 medical and health sciences ,0302 clinical medicine ,Percutaneous Coronary Intervention ,Randomized controlled trial ,law ,Internal medicine ,Outcome Assessment, Health Care ,medicine ,Humans ,030212 general & internal medicine ,Myocardial infarction ,Aged ,business.industry ,Brief Report ,Hazard ratio ,Percutaneous coronary intervention ,Middle Aged ,medicine.disease ,Symptomatic relief ,United States ,Death ,Europe ,Fractional Flow Reserve, Myocardial ,Treatment Outcome ,Conventional PCI ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Human - Abstract
Importance Whether the improvement in myocardial perfusion provided by percutaneous coronary intervention (PCI) is associated with symptomatic relief or improved outcomes has not been well investigated. Objective To investigate the prognostic value of the improvement in fractional flow reserve (FFR) after PCI (ΔFFR) on patients’ symptoms and 2-year outcomes. Design, Setting, and Participants This study is a post hoc analysis of data from patients undergoing FFR-guided PCI in the randomized clinical trials Fractional Flow Reserve vs Angiography for Multivessel Evaluation (FAME) 1 (NCT00267774; 2009) and FAME 2 (NCT01132495; 2012), with inclusion of 2 years of follow-up data. The FAME 1 trial included patients with multivessel coronary artery disease from 20 medical centers in Europe and the United States. The FAME 2 trial included patients with stable coronary artery disease involving up to 3 vessels from 28 sites in Europe and North America. Lesions from the group in the FAME 1 trial from whom FFR was measured and the group in the FAME 2 trial who received FFR-guided PCI plus medical therapy were analyzed. Data analysis occurred from May 2017 to May 2018. Interventions Measure of post-PCI FFR. Main Outcomes and Measures Vessel-oriented clinical events at 2 years, a composite of cardiac death, target vessel-associated myocardial infarction, and target vessel revascularization. Results This analysis included 639 patients from whom pre-PCI and post-PCI FFR values were available. Of their 837 lesions, 277 were classified into the lowest tertile (ΔFFR≤0.18), 282 into the middle tertile (0.19≤ΔFFR≤0.31), and 278 into the highest tertile (ΔFFR>0.31). Vessel-oriented clinical events were significantly more frequent in the lowest tertile (n = 25 of 277 [9.1%]) compared with the highest tertile (n = 13 of 278 [4.7%]; hazard ratio, 2.01 [95% CI, 1.03-3.92]; P = .04). In addition, a significant association was observed between ΔFFR and symptomatic relief (odds ratio, 1.33 [95% CI, 1.02-1.74]; P = .02). Conclusions and Relevance In this analysis of 2 randomized clinical trials, the larger the improvement in FFR, the larger the symptomatic relief and the lower the event rate. This suggests that measuring FFR before and after PCI provides clinically useful information.
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- 2019
28. Comparison of long‐term clinical outcomes in multivessel coronary artery disease patients treated either with bioresoarbable polymer sirolimus‐eluting stent or permanent polymer everolimus‐eluting stent: 5‐year results of the CENTURY II randomized clinical trial
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Emanuele Barbato, Gert Richardt, Didier Carrié, Bernard Chevalier, William Wijns, Antoinette Neylon, Andrés Iñiguez, Mariano Valdés-Chávarri, Raúl Moreno, Shigeru Saito, Vincenzo Guiducci, Century Ii study investigators, Victor Alfonso Jimenez, Ran Kornowski, Antoni Serra-Peñaranda, Junji Yajima, Iniguez, A., Chevalier, B., Richardt, G., Neylon, A., Jimenez, V. A., Kornowski, R., Carrie, D., Moreno, R., Barbato, E., Serra-Penaranda, A., Guiducci, V., Valdes-Chavarri, M., Yajima, J., Wijns, W., and Saito, S.
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Target lesion ,Male ,Time Factors ,percutaneous coronary intervention, stent ,Polymers ,medicine.medical_treatment ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Coronary artery disease ,Original Studies ,law.invention ,0302 clinical medicine ,Clinical trials ,Randomized controlled trial ,Japan ,law ,Risk Factors ,Absorbable Implants ,Clinical endpoint ,Medicine ,Single-Blind Method ,030212 general & internal medicine ,Myocardial infarction ,Prospective Studies ,Drug eluting ,coating ,clinical trial ,Drug-Eluting Stents ,General Medicine ,Middle Aged ,drug eluting ,Europe ,Treatment Outcome ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,medicine.medical_specialty ,Complex PCI ,Prosthesis Design ,03 medical and health sciences ,Percutaneous Coronary Intervention ,Internal medicine ,Multicenter trial ,complex PCI ,Republic of Korea ,Humans ,Radiology, Nuclear Medicine and imaging ,structure ,Everolimus ,Aged ,Sirolimus ,clinical trials ,business.industry ,Stent design/structure/coating ,percutaneous coronary intervention ,stent design ,Coronary Stenosis ,Stent ,Percutaneous coronary intervention, stent ,Cardiovascular Agents ,medicine.disease ,Clinical trial ,stent design/structure/coating ,stent ,business - Abstract
ObjectivesTo assess the long-term safety and efficacy of a sirolimus-eluting stent with bioresorbable polymer (BP-SES; Ultimaster), in comparison to a benchmark everolimus-eluting, permanent polymer stent (PP-EES; Xience), in a prespecified subgroup of patients with multivessel coronary artery disease (MVD) enrolled in the CENTURY II trial. BackgroundThe use of coronary stenting in high-risk subgroups, like MVD patients, is rising. The clinical evidence, including long-term comparative analysis of the efficacy and safety benefits of different new-generation drug eluting stents, however, remains insufficient. MethodsAmong 1,119 patients (intention-to-treat) enrolled in the CENTURY II prospective, randomized, single-blind, multicenter trial, a prespecified subgroup of 456 MVD patients were allocated by stratified randomization to treatment with BP-SES (n =225) or PP-EES (n =231). The previously reported primary endpoint of this study was freedom from target lesion failure (TLF: a composite of cardiac death, target vessel-related myocardial infarction [MI] and clinically-indicated target lesion revascularization) at 9months. ResultsIn this MVD substudy, baseline patient, lesion and procedure characteristics were similar between the treatment arms. At 1 and 5 years, both BP-SES and PP-EES displayed low and comparable rates of TLF (5.3 vs. 7.8%; p =.29 and 10.2 vs. 13.4%; p =.29), and definite or probable stent thrombosis (0.4 vs. 1.3%; p =.33 and 0.9 vs. 1.7%; p =.43), respectively. Composite endpoint of cardiac death and MI, and patient-oriented composite endpoint of any death, MI, and coronary revascularizations were also similar. ConclusionsThese results confirm good long-term safety and efficacy of the studied bioresorbable polymer stent in this high-risk patient population.
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- 2019
29. Clopidogrel Versus Ticagrelor or Prasugrel After Primary Percutaneous Coronary Intervention According to CYP2C19 Genotype A POPular Genetics Subanalysis
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Vera H.M. Deneer, Renicus S Hermanides, Carmine Morisco, Richard M. Tjon Joe Gin, Gerrit J.A. Vos, Arend Mosterd, Pim van der Harst, Daniel M.F. Claassens, Jean-Paul R. Herrman, Johannes C. Kelder, Willem Dewilde, Paul W.A. Janssen, Bakhtawar K. Mahmoodi, Arnoud W J van 't Hof, Jurriën M. ten Berg, Folkert W. Asselbergs, Thomas O. Bergmeijer, Emanuele Barbato, Cardiovascular Centre (CVC), Cardiology, Claassens, D. M. F., Bergmeijer, T. O., Vos, G. J. A., Hermanides, R. S., Van 'T Hof, A. W. J., Van Der Harst, P., Barbato, E., Morisco, C., Tjon Joe Gin, R. M., Asselbergs, F. W., Mosterd, A., Herrman, J. -P. R., Dewilde, W. J. M., Janssen, P. W. A., Kelder, J. C., Mahmoodi, B. K., Deneer, V. H. M., Ten Berg, J. M., Afd Pharmacoepi & Clinical Pharmacology, Pharmacoepidemiology and Clinical Pharmacology, RS: Carim - H01 Clinical atrial fibrillation, Cardiologie, MUMC+: MA Med Staf Spec Cardiologie (9), and RS: Carim - B04 Clinical thrombosis and Haemostasis
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Prasugrel ,IMPACT ,medicine.medical_treatment ,VARIANT ,030204 cardiovascular system & hematology ,GUIDELINES ,THERAPY ,Clopidogrel/adverse effects ,0302 clinical medicine ,ARTERY-DISEASE ,Medicine ,030212 general & internal medicine ,Percutaneous Coronary Intervention/adverse effects ,pharmacogenetics ,Genetics ,Hazard ratio ,ASSOCIATION ,Prasugrel Hydrochloride/adverse effects ,Clopidogrel ,Ticagrelor/adverse effects ,Treatment Outcome ,myocardial infarction ,pharmacogenetic ,Cardiology and Cardiovascular Medicine ,Ticagrelor ,medicine.drug ,Platelet Aggregation Inhibitors/adverse effects ,Acute coronary syndrome ,Genotype ,CYP2C19 ,CARDIOVASCULAR OUTCOMES ,acute coronary syndrome ,genetic testing ,ticagrelor ,03 medical and health sciences ,Acute Coronary Syndrome/drug therapy ,ANTIPLATELET TREATMENT ,Humans ,POLYMORPHISMS ,clopidogrel ,business.industry ,percutaneous coronary intervention ,Percutaneous coronary intervention ,CYP2C19-ASTERISK-17 ,medicine.disease ,Cytochrome P-450 CYP2C19 ,THROMBOSIS ,MYOCARDIAL-INFARCTION ,Conventional PCI ,Cytochrome P-450 CYP2C19/genetics ,business ,Prasugrel Hydrochloride ,Platelet Aggregation Inhibitors ,TASK-FORCE - Abstract
Background: Guidelines favor ticagrelor or prasugrel over clopidogrel in patients with myocardial infarction. However, the POPular Genetics trial (Patient Outcome After Primary Percutaneous Coronary Intervention [PCI]) showed that in patients with primary PCI, a CYP2C19 genotype–guided strategy was associated with a lower bleeding risk without increasing thrombotic risk, compared with routine ticagrelor/prasugrel treatment. Nevertheless, optimal P2Y 12 inhibitor treatment in specific CYP2C19 genetic subgroups is still a subject of debate. Methods: A prespecified subanalysis of the POPular Genetics trial was performed, using patients in whom CYP2C19 *2, *3, and *17 genotypes was determined. Two different analyses were planned. The first assessed the effect of the CYP2C19 *17 allele in clopidogrel-treated patients. The second compared the effect of clopidogrel in noncarriers of a loss-of-function allele with ticagrelor/prasugrel–treated patients, irrespective of CYP2C19 genotype. Main outcomes were a thrombotic outcome (cardiovascular death, myocardial infarction, stent thrombosis, and stroke) and a bleeding outcome (PLATO [Platelet Inhibition and Patient Outcomes] major and minor bleeding) after 12 months. Results: A total of 2429 patients were used for analyses. In the first analysis, the CYP2C19 *17 polymorphism was not found to have a significant influence on thrombotic (adjusted hazard ratio, 0.95 [95% CI, 0.45–2.02]) or bleeding outcomes (adjusted hazard ratio, 0.74 [95% CI, 0.48–1.18]). In the second analysis, clopidogrel was associated with a lower number of bleeding events compared with ticagrelor/prasugrel (9.9% versus 11.7%, adjusted hazard ratio, 0.74 [95% CI, 0.56–0.96]), without a significant increase in thrombotic events (3.4% versus 2.5%, adjusted hazard ratio, 1.14 [95% CI, 0.68–1.90]). Conclusions: In patients with primary PCI not carrying a CYP2C19 loss-of-function allele, the use of clopidogrel compared with ticagrelor or prasugrel was associated with lower bleeding rates, without an increase in thrombotic events. No effect on clinical outcomes was found for the CYP2C19 *17 polymorphism. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01761786. URL: https://www.trialregister.nl/ ; Unique identifier: NL2872.
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- 2021
30. 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation
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Collet, Jean-Philippe, Thiele, Holger, Barbato, Emanuele, Barthélémy, Olivier, Bauersachs, Johann, Bhatt, Deepak, Dendale, Paul, Dorobantu, Maria, Edvardsen, Thor, Folliguet, Thierry, Gale, Chris, Gilard, Martine, Jobs, Alexander, Jüni, Peter, Lambrinou, Ekaterini, Lewis, Basil, Mehilli, Julinda, Meliga, Emanuele, Merkely, Béla, Mueller, Christian, Roffi, Marco, Rutten, Frans, Sibbing, Dirk, Siontis, George, Kastrati, Adnan, Mamas, Mamas, Aboyans, Victor, Angiolillo, Dominick, Bueno, Hector, Bugiardini, Raffaele, Byrne, Robert, Castelletti, Silvia, Chieffo, Alaide, Cornelissen, Veronique, Crea, Filippo, Delgado, Victoria, Drexel, Heinz, Gierlotka, Marek, Halvorsen, Sigrun, Haugaa, Kristina Hermann, Jankowska, Ewa, Katus, Hugo, Kinnaird, Tim, Kluin, Jolanda, Kunadian, Vijay, Landmesser, Ulf, Leclercq, Christophe, Lettino, Maddalena, Meinila, Leena, Mylotte, Darren, Ndrepepa, Gjin, Omerovic, Elmir, Pedretti, Roberto, Petersen, Steffen, Petronio, Anna Sonia, Pontone, Gianluca, Popescu, Bogdan, Potpara, Tatjana, Ray, Kausik, Luciano, Flavio, Richter, Dimitrios, Shlyakhto, Evgeny, Simpson, Iain, Sousa-Uva, Miguel, Storey, Robert, Touyz, Rhian, Valgimigli, Marco, VRANCKX, PASCAL, Yeh, Robert, Collet, Jean-Philippe, Thiele, Holger, Barbato, Emanuele, Barthélémy, Olivier, Bauersachs, Johann, Bhatt, Deepak L, Dendale, Paul, Dorobantu, Maria, Edvardsen, Thor, Folliguet, Thierry, Gale, Chris P, Gilard, Martine, Jobs, Alexander, Jüni, Peter, Lambrinou, Ekaterini, Lewis, Basil S, Mehilli, Julinda, Meliga, Emanuele, Merkely, Béla, Mueller, Christian, Roffi, Marco, Rutten, Frans H, Sibbing, Dirk, Siontis, George C M, Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut de cardiologie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Collet J.-P., Thiele H., Barbato E., Bauersachs J., Dendale P., Edvardsen T., Gale C.P., Jobs A., Lambrinou E., Mehilli J., Merkely B., Roffi M., Sibbing D., Kastrati A., Mamas M.A., Aboyans V., Angiolillo D.J., Bueno H., Bugiardini R., Byrne R.A., Castelletti S., Chieffo A., Cornelissen V., Crea F., Delgado V., Drexel H., Gierlotka M., Halvorsen S., Haugaa K.H., Jankowska E.A., Katus H.A., Kinnaird T., Kluin J., Kunadian V., Landmesser U., Leclercq C., Lettino M., Meinila L., Mylotte D., Ndrepepa G., Omerovic E., Pedretti R.F.E., Petersen S.E., Petronio A.S., Pontone G., Popescu B.A., Potpara T., Ray K.K., Luciano F., Richter D.J., Shlyakhto E., Simpson I.A., Sousa-Uva M., Storey R.F., Touyz R.M., Valgimigli M., Vranckx P., Yeh R.W., Barthelemy O., Bhatt D.L., Dorobantu M., Folliguet T., Gilard M., Juni P., Lewis B.S., Meliga E., Mueller C., Rutten F.H., and Siontis G.C.M.
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unstable angina ,Myocardial ischaemia ,[SDV]Life Sciences [q-bio] ,Vascular damage Radboud Institute for Health Sciences [Radboudumc 16] ,dual antithrombotic therapy ,Guideline ,heparin ,030204 cardiovascular system & hematology ,Platelet inhibition ,antiplatelet ,0302 clinical medicine ,ST segment ,Medicine ,dabigatran ,Myocardial infarction ,guidelines ,glycoprotein iib/iiia inhibitors ,anticoagulation ,Non-ST Elevated Myocardial Infarction ,rivaroxaban ,ComputingMilieux_MISCELLANEOUS ,reproductive and urinary physiology ,diabetes ,bleedings ,bivalirudin ,atherothrombosi ,Disease Management ,angioplasty ,Guidelines • acute cardiac care • acute coronary syndrome • angioplasty • anticoagulation • antiplatelet • apixaban • aspirin • atherothrombosis • betablockers • bleedings • bivalirudin • bypass surgery • cangrelor • chest pain unit • clopidogrel • dabigatran • diabetes • dual antithrombotic therapy • early invasive strategy • edoxaban • enoxaparin • European Society of Cardiology • fondaparinux • glycoprotein IIb/ IIIa inhibitors • heparin • high-sensitivity troponin • minoca • myocardial ischaemia • myocardial infarction • nitrates • non-ST-elevation myocardial infarction • platelet inhibition • prasugrel • recommendations • revascularization • rhythm monitoring • rivaroxaban • stent • ticagrelor • triple therapy • unstable angina ,enoxaparin ,General Medicine ,Clopidogrel ,3. Good health ,early invasive strategy ,myocardial infarction ,triple therapy ,030220 oncology & carcinogenesis ,High sensitivity troponin ,embryonic structures ,Cardiology ,Platelet aggregation inhibitor ,revascularization ,biological phenomena, cell phenomena, and immunity ,Cardiology and Cardiovascular Medicine ,Ticagrelor ,medicine.drug ,Human ,recommendation ,Acute coronary syndrome ,medicine.medical_specialty ,aspirin ,glycoprotein IIb/IIIa inhibitor ,non-ST-elevation myocardial infarction ,apixaban ,rhythm monitoring ,European Society of Cardiology ,ticagrelor ,03 medical and health sciences ,nitrate ,atherothrombosis ,betablockers ,Internal medicine ,acute cardiac care ,minoca ,chest pain unit ,Diseases of the circulatory (Cardiovascular) system ,Humans ,In patient ,Acute Coronary Syndrome ,clopidogrel ,Unstable angina ,urogenital system ,nitrates ,business.industry ,fondaparinux ,betablocker ,Arrhythmias, Cardiac ,030229 sport sciences ,bleeding ,medicine.disease ,myocardial ischaemia ,platelet inhibition ,prasugrel ,diabete ,Glycoprotein IIb/IIIa inhibitors ,RC666-701 ,bypass surgery ,Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE ,recommendations ,edoxaban ,high-sensitivity troponin ,stent ,business ,Platelet Aggregation Inhibitors ,cangrelor - Abstract
2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation
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- 2021
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31. Modulation of Insulin Sensitivity by Exercise Training: Implications for Cardiovascular Prevention
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Emanuele Barbato, Guido Iaccarino, Danilo Franco, Teresa Strisciuglio, Carmine Morisco, Daniela Sorriento, Iaccarino, G., Franco, D., Sorriento, D., Strisciuglio, T., Barbato, E., and Morisco, C.
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Health Status ,medicine.medical_treatment ,Pharmaceutical Science ,Review ,030204 cardiovascular system & hematology ,Bioinformatics ,Essential hypertension ,Diabete ,Risk Assessment ,03 medical and health sciences ,0302 clinical medicine ,Insulin resistance ,Diabetes mellitus ,Genetics ,medicine ,Animals ,Humans ,Healthy Lifestyle ,030212 general & internal medicine ,Obesity ,Exercise ,Genetics (clinical) ,biology ,business.industry ,Insulin ,Diabetes ,Insulin sensitivity ,Protective Factors ,Prognosis ,medicine.disease ,Cardiovascular risk ,Metabolic syndrome ,Resistance exercise ,Insulin signaling ,Insulin receptor ,Cardiovascular Diseases ,Heart Disease Risk Factors ,Physical training ,biology.protein ,Molecular Medicine ,Cardiology and Cardiovascular Medicine ,business ,Risk Reduction Behavior ,Biomarkers - Abstract
The beneficial effects of physical activity on the cardiovascular system nowadays have achieved the relevance of clinical evidence. In fact, several studies have documented the benefits of exercise training in the prevention of the cardiovascular risk. Abnormalities of insulin signaling transduction account for the impairment of insulin sensitivity and development of insulin resistance, which, in turn, is responsible for the enhancement of cardiovascular risk. Insulin sensitivity is related to the degree of physical activity, and physical training has been shown to ameliorate insulin action in insulin-resistant subjects. This effect is mediated by the improvement of the molecular abnormalities that are responsible of the insulin resistance, contributing in this way to restore the physiological insulin sensitivity. However, it should be underlined that mechanisms that account for this phenomenon are extremely complex and still unclear. Further studies are required to better clarify the molecular basis of the exercise-evoked improvement of insulin signal.
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- 2021
32. Global Fractional Flow Reserve Value Predicts 5-Year Outcomes in Patients With Coronary Atherosclerosis But Without Ischemia
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Panagiotis Xaplanteris, Stephane Fournier, Iginio Colaiori, Gabor G. Toth, Nico H.J. Pijls, Carlos Collet, Giuseppe Di Gioia, Pim A.L. Tonino, Peter Jüni, Emanuele Barbato, Bernard De Bruyne, William F. Fearon, Frederik M. Zimmermann, Fournier, S., Collet, C., Xaplanteris, P., Zimmermann, F. M., Toth, G. G., Tonino, P. A. L., Pijls, N. H. J., Colaiori, I., Di Gioia, G., Barbato, E., Juni, P., Fearon, W. F., and De Bruyne, B.
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Male ,Time Factors ,medicine.medical_treatment ,Myocardial Infarction ,Fractional flow reserve ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Coronary Angiography ,0302 clinical medicine ,Cost of Illness ,Cause of Death ,Myocardial Revascularization ,Coronary Heart Disease ,030212 general & internal medicine ,Prospective Studies ,fractional flow reserve ,Original Research ,Middle Aged ,Prognosis ,Coronary Vessels ,Fractional Flow Reserve, Myocardial ,medicine.anatomical_structure ,Cardiovascular Diseases ,coronary atherosclerosis ,percutaneous coronary intervention ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,medicine.medical_specialty ,Ischemia ,Risk Assessment ,03 medical and health sciences ,Percutaneous Coronary Intervention ,Predictive Value of Tests ,Internal medicine ,medicine ,Humans ,In patient ,Coronary atherosclerosis ,Aged ,business.industry ,Percutaneous coronary intervention ,medicine.disease ,Atherosclerosis ,Coronary arteries ,coronary atherosclerosi ,Case-Control Studies ,business ,Value (mathematics) ,Follow-Up Studies - Abstract
Background Global fractional flow reserve (FFR) (ie, the sum of the FFR values in the 3 major coronary arteries) is a physiologic correlate of global atherosclerotic burden. The objective of the present study was to investigate the value of global FFR in predicting long‐term clinical outcome of patients with stable coronary artery disease but no ischemia‐inducing stenosis. Methods and Results We studied major adverse cardiovascular events (MACEs: all‐cause death, myocardial infarction, and any revascularization) after 5 years in 1122 patients without significant stenosis (all FFR >0.80; n=275) or with at least 1 significant stenosis successfully treated by percutaneous coronary intervention (ie, post–percutaneous coronary intervention FFR >0.80; n=847). The patients were stratified into low, mid, or high tertiles of global FFR (≤2.80, 2.80–2.88, and ≥2.88). Patients in the lowest tertile of global FFR showed the highest 5‐year MACE rate compared with those in the mid or high tertile of global FFR (27.5% versus 22.0% and 20.9%, respectively; log‐rank P =0.040). The higher 5‐year MACE rate was mainly driven by a higher rate of revascularization in the low global FFR group (16.4% versus 11.3% and 11.8%, respectively; log‐rank P =0.038). In a multivariable model, an increase in global FFR of 0.1 unit was associated with a significant reduction in the rates of MACE (hazard ratio [HR], 0.988; 95% CI, 0.977–0.998; P =0.023), myocardial infarction (HR, 0.982; 95% CI, 0.966–0.998; P =0.032), and revascularization (HR, 0.985; 95% CI, 0.972–0.999; P =0.040). Conclusions Even in the absence of ischemia‐producing stenoses, patients with a low global FFR, physiologic correlate of global atherosclerotic burden, present a higher risk of MACE at 5‐year follow‐up.
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- 2020
33. The Rationale for Angiotensin Receptor Neprilysin Inhibitors in a Multi-Targeted Therapeutic Approach to COVID-19
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Alessandro Bellis, Ciro Mauro, Carmine Morisco, Emanuele Barbato, Bruno Trimarco, Bellis, A., Mauro, C., Barbato, E., Trimarco, B., and Morisco, C.
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Angiotensin receptor ,Tetrazoles ,Review ,Substance P ,030204 cardiovascular system & hematology ,Pharmacology ,angiotensin II ,Sacubitril ,lcsh:Chemistry ,Adrenomedullin ,0302 clinical medicine ,Drug Combination ,030212 general & internal medicine ,Neprilysin ,lcsh:QH301-705.5 ,Tetrazole ,Spectroscopy ,Angiotensin Receptor Antagonists ,Aminobutyrates ,Angiotensin Receptor Antagonist ,General Medicine ,Computer Science Applications ,Drug Combinations ,Valsartan ,apelin ,Angiotensin-converting enzyme 2 ,Coronavirus Infections ,Human ,medicine.drug ,Aminobutyrate ,Pneumonia, Viral ,Catalysis ,neprilysin ,Inorganic Chemistry ,03 medical and health sciences ,medicine ,Animals ,Humans ,Sacubitril/valsartan ,Physical and Theoretical Chemistry ,Pandemics ,Molecular Biology ,Pandemic ,natriuretic peptide ,Animal ,Coronavirus Infection ,business.industry ,Biphenyl Compounds ,Organic Chemistry ,fungi ,COVID-19 ,Angiotensin II ,lcsh:Biology (General) ,lcsh:QD1-999 ,bradykinin ,business ,Sacubitril, Valsartan - Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease (COVID-19) determines the angiotensin converting enzyme 2 (ACE2) down-regulation and related decrease in angiotensin II degradation. Both these events trigger “cytokine storm” leading to acute lung and cardiovascular injury. A selective therapy for COVID-19 has not yet been identified. Clinical trials with remdesivir gave discordant results. Thus, healthcare systems have focused on “multi-targeted” therapeutic strategies aiming at relieving systemic inflammation and thrombotic complications. No randomized clinical trial has demonstrated the efficacy of renin angiotensin system antagonists in reducing inflammation related to COVID-19. Dexamethasone and tocilizumab showed encouraging data, but their use needs to be further validated. The still-controversial efficacy of these treatments highlighted the importance of organ injury prevention in COVID-19. Neprilysin (NEP) might be an interesting target for this purpose. NEP expression is increased by cytokines on lung fibroblasts surface. NEP activity is elevated in acute respiratory distress syndrome and it is conceivable that it is also high in COVID-19. NEP is implicated in the degradation of natriuretic peptides, bradykinin, substance P, adrenomedullin, and apelin that account for prevention of organ injury. Thus, NEP/angiotensin receptor type 1 (AT1R) inhibitor sacubitril/valsartan (SAC/VAL) may increase levels of these molecules and block AT1Rs required for ACE2 endocytosis in SARS-CoV-2 infection. Moreover, SAC/VAL has a positive impact on acute heart failure that is very frequently observed in deceased COVID-19 patients. The current review aims to summarize actual therapeutic strategies for COVID-19 and to examine the data supporting the potential benefits of SAC/VAL in COVID-19 treatment.
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- 2020
34. Effect of Sex on Outcomes of Coronary Rotational Atherectomy Percutaneous Coronary Intervention (From the European Multicenter Euro4C Registry)
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Erwan Bressollette, Frédéric Bouisset, Benjamin Faurie, Nikolaos E. Mezilis, Wojciech Zajdel, Euro C Registry Investigators, Markus Meyer-Gessner, Krzysztof Reczuch, Guillaume Cayla, Didier Carrié, Leonardo Spedicato, Sławomir Dobrzycki, Jorge Palazuelos, Vincent Bataille, Flavio Ribichini, Emanuele Barbato, Mariano Valdés, Miroslaw Ferenc, Beatriz Vaquerizo, Bouisset, F., Ribichini, F., Bataille, V., Reczuch, K., Dobrzycki, S., Meyer-Gessner, M., Bressollette, E., Zajdel, W., Faurie, B., Mezilis, N., Palazuelos, J., Spedicato, L., Valdes, M., Vaquerizo, B., Ferenc, M., Cayla, G., Barbato, E., and Carrie, D.
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Atherectomy, Coronary ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Treatment outcome ,MEDLINE ,Myocardial Infarction ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Rotational atherectomy ,Atherectomy ,03 medical and health sciences ,0302 clinical medicine ,Age Distribution ,Percutaneous Coronary Intervention ,Postoperative Complications ,Sex Factors ,Internal medicine ,medicine.artery ,Female patient ,medicine ,Humans ,030212 general & internal medicine ,Registries ,Renal Insufficiency ,Radial artery ,Acute Coronary Syndrome ,Coronary Artery Bypass ,Vascular Calcification ,Aged ,Aged, 80 and over ,business.industry ,Percutaneous coronary intervention ,Middle Aged ,Vascular System Injuries ,Cardiac Tamponade ,Europe ,Stroke ,Treatment Outcome ,Cardiovascular Diseases ,Conventional PCI ,Radial Artery ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
Data regarding the potential influence of gender on outcomes of rotational atherectomy (RA) percutaneous coronary intervention (PCI) are scarce and conflicting. Using the Euro4C registry, an international prospective multicentric registry of RA PCI, we evaluated the influence of gender on clinical outcomes of RA PCI. Between October 2016 and July 2018, 966 patients were included. In them, 267 (27.6%) were females. Female patients were older than males (77.7 years old ± 9.8 vs 73.3 ± 9.5 years old respectively, p < 0.001) had a poorer renal function (43,1% of females had a GFR < 60 ml/min:1.73m² vs 30.4% of males, p < 0.001) and were more frequently admitted for an acute coronary syndrome (32.2% vs 22.3% p = 0.002). During RA procedure, women were less likely to be treated by radial approach (65.0% vs 74.4%, p = 0.004). In-hospital major adverse cardiac event rate—defined as cardiovascular death, myocardial infarction, stroke/transient ischemic attack, target lesion revascularization, and coronary artery bypass grafting surgery—was higher in the female group (7.1% vs 3.7%, p = 0.043). However, coronary perforation, dissection, slow/low flow and tamponade did not significantly differ in gender, neither did cardiovascular medications at discharge. At 1 year follow-up, rate of major adverse cardiac event was 18.4% in the female group vs 11.2% in the male group (adjusted Hazard Ratio 1.82 [1.24 to 2.67], p = 0.002). No significant bleeding differences were observed in gender, neither in hospital, nor during follow-up. In conclusion women had worse clinical outcomes following RA PCI during hospitalization and at 1 year follow-up than did men
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- 2020
35. Motorized fractional flow reserve pullback
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Takuya Mizukami, Jean F. Argacha, Daniele Andreini, Emanuele Barbato, Jeroen Sonck, Antonio L. Bartorelli, B Vandeloo, Carlos Collet, Bernard De Bruyne, Bernard Cosyns, Clinical sciences, Cardiology, Cardio-vascular diseases, Graduate School, ACS - Heart failure & arrhythmias, Sonck, J., Collet, C., Mizukami, T., Vandeloo, B., Argacha, J. F., Barbato, E., Andreini, D., Bartorelli, A., Cosyns, B., and De Bruyne, B.
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Male ,Cardiac Catheterization ,medicine.medical_specialty ,Myocardial revascularization ,Clinical Decision-Making ,Coronary Artery Disease ,Fractional flow reserve ,030204 cardiovascular system & hematology ,Coronary Angiography ,Severity of Illness Index ,Coronary artery disease ,03 medical and health sciences ,Percutaneous Coronary Intervention ,0302 clinical medicine ,Pullback ,Predictive Value of Tests ,Internal medicine ,FRACTIONAL FLOW RESERVE ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,In patient ,030212 general & internal medicine ,Aged ,Reproducibility ,business.industry ,Coronary Stenosis ,Reproducibility of Results ,General Medicine ,Repeatability ,Middle Aged ,medicine.disease ,Fractional Flow Reserve, Myocardial ,Anatomical landmark ,myocardial revascularization ,Cardiology ,Female ,Stable coronary artery disease ,motorized FFR pullbacks ,business ,Cardiology and Cardiovascular Medicine - Abstract
Objectives The present study aimed at determining the accuracy and reproducibility of motorized FFR pullbacks in patients with stable coronary artery disease. Background Fractional flow reserve (FFR) is recommended for decision making regarding myocardial revascularization. The distribution of epicardial resistance along coronary vessels can be assessed using FFR pullbacks. Methods Duplicated FFR pullbacks were acquired using a motorized device at a speed of 1 mm/s in intermediate coronary stenosis. In addition, a single FFR value was measured at an anatomical landmark. The agreement between FFR measurements was assessed using the Bland-Altman method, Pearson's correlation coefficient and area under the pullback curve (AUPC). Results In 20 vessels, 37,326 FFR values were obtained. The mean FFR from the pullbacks was 0.91 ± 0.08 whereas the mean FFR at the distal location was 0.85 ± 0.09. The mean difference between pullbacks was -0.002 (LOA -0.058 to 0.054). The difference in AUPC between the two FFR pullbacks was 2.1 ± 1.6%. At pre-specified anatomical locations, the mean difference between the FFR derived from the pullback data and the measured FFR was 0 (LOA -0.040 to 0.039). The repeatability of the distal FFR measurement was high (bias -0.003, LOA -0.046 to 0.041). Conclusion A motorized FFR pullback was accurate to assess the distribution of epicardial resistance in patients with intermediate coronary artery disease. The reproducibility of the FFR pullback was high. Further studies are required to determine the potential usefulness of a hyperemic FFR pullback strategy for decision making and treatment planning.
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- 2020
36. A personal tribute to Maurizio Galderisi
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Emanuele Barbato and Barbato, E.
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2019-20 coronavirus outbreak ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Medicine ,Tribute ,Cardiology and Cardiovascular Medicine ,business ,Virology - Published
- 2020
37. Novel Indices of Coronary Physiology
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Roberto Scarsini, Kazuhiro Dan, Carlos Collet, Adrian P. Banning, Giovanni Luigi De Maria, Joost Daemen, Antonio Maria Leone, Alexandre Hideo-Kajita, Allen Jeremias, Giovanna Sarno, Nieves Gonzalo López, Ron Waksman, Shengxian Tu, Yuichi Ozaki, Evan Shlofmitz, Hector M. Garcia-Garcia, Hiram G. Bezerra, Pedro A. Lemos, Nils P. Johnson, Matteo Tebaldi, Emanuele Barbato, De Maria, G. L., Garcia-Garcia, H. M., Scarsini, R., Hideo-Kajita, A., Gonzalo Lopez, N., Leone, A. M., Sarno, G., Daemen, J., Shlofmitz, E., Jeremias, A., Tebaldi, M., Bezerra, H. G., Tu, S., Lemos, P. A., Ozaki, Y., Dan, K., Collet, C., Banning, A. P., Barbato, E., Johnson, N. P., and Waksman, R.
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Cardiac Catheterization ,medicine.medical_specialty ,Prognosi ,intravascular imaging ,Reproducibility of Result ,Predictive Value of Test ,Fractional flow reserve ,Cardiac Catheters ,Coronary artery disease ,Predictive Value of Tests ,Internal medicine ,Transducers, Pressure ,medicine ,Humans ,angiography ,fractional flow reserve ,Coronary Vessel ,Cardiac Imaging Technique ,medicine.diagnostic_test ,Cardiac Catheter ,business.industry ,Gold standard ,Reproducibility of Results ,computed tomography ,Prognosis ,medicine.disease ,Coronary Vessels ,Pressure wire ,Fractional Flow Reserve, Myocardial ,Cardiac Imaging Techniques ,Angiography ,Coronary vessel ,Cardiology ,hyperemia ,Cardiology and Cardiovascular Medicine ,business ,Coronary physiology ,coronary artery disease ,Intravascular imaging ,Human - Abstract
Fractional flow reserve is the current invasive gold standard for assessing the ischemic potential of an angiographically intermediate coronary stenosis. Procedural cost and time, the need for coronary vessel instrumentation, and the need to administer adenosine to achieve maximal hyperemia remain integral components of invasive fractional flow reserve. The number of new alternatives to fractional flow reserve has proliferated over the last ten years using techniques ranging from alternative pressure wire metrics to anatomic simulation via angiography or intravascular imaging. This review article provides a critical description of the currently available or under-development alternatives to fractional flow reserve with a special focus on the available evidence, pros, and cons for each with a view towards their clinical application in the near future for the functional assessment of coronary artery disease.
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- 2020
38. Evaluation of epicardial coronary resistance using computed tomography angiography
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Emanuelle Barbato, Danny Schoors, Takuya Mizukami, Johan De Mey, Dries Belsack, Bram Roosens, J. F. Argacha, Bert Vandeloo, Kaoru Tanaka, Stijn Lochy, Daniele Andreini, Carlos Collet, Jeroen Sonck, Bernard De Bruyne, Bernard Cosyns, Hiroshi Suzuki, Radiology, Medical Imaging, Clinical sciences, Cardiology, Cardio-vascular diseases, Intensive Care, Supporting clinical sciences, Body Composition and Morphology, Translational Imaging Research Alliance, Mizukami, T., Tanaka, K., Sonck, J., Vandeloo, B., Roosens, B., Lochy, S., Argacha, J. F., Schoors, D., Suzuki, H., Belsack, D., Andreini, D., Barbato, E., De Mey, J., De Bruyne, B., Cosyns, B., Collet, C., Graduate School, and ACS - Heart failure & arrhythmias
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Male ,medicine.medical_specialty ,Cardiac Catheterization ,medicine.medical_treatment ,Coronary Vessels/diagnostic imaging ,Fractional flow reserve ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Coronary Angiography ,Proof of Concept Study ,030218 nuclear medicine & medical imaging ,Coronary artery disease ,03 medical and health sciences ,0302 clinical medicine ,Pullback ,Predictive Value of Tests ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,Coronary resistance ,Computed tomography angiography ,Cardiac catheterization ,Aged ,Medicine(all) ,medicine.diagnostic_test ,business.industry ,Coronary ct angiography ,Middle Aged ,medicine.disease ,Coronary Vessels ,medicine.anatomical_structure ,fractional flow reserve, myocardial ,Radiology Nuclear Medicine and imaging ,Vascular resistance ,Cardiology ,Feasibility Studies ,Female ,Vascular Resistance ,reproducibility of results ,Cardiology and Cardiovascular Medicine ,business ,computed tomography angiography ,Pericardium ,Coronary Artery Disease/diagnostic imaging - Abstract
Aims: Fractional flow reserve (FFR) pullback allows to assess the distribution of pressure loss along the coronary vessels. FFR derived from CT (FFR CT) provides a virtual pullback curve that may also aid in the assessment of the distribution of epicardial coronary resistance in the non-invasive setting. The present study aims to determine the accuracy of the virtual FFR CT pullback curve using a motorized invasive FFR pullback as reference in patients with stable coronary artery disease. Methods and results: FFR values were extracted from coronary vessels at approximately 1 mm to generate pullback curves. Invasive motorized FFR pullbacks were acquired using a dedicated device at a speed of 1 mm/s. A total of 3172 matched FFR CT and FFR values were obtained in 24 vessels. The correlation coefficient between FFR CT and FFR was 0.76 (95%CI 0.75 to 0.78; p < 0.001). The area under the pullback curve was similar between FFR CT and invasive FFR (79.0 ± 16.1 vs. 85.3 ± 16.4, p = 0.097). The mean difference in lesion gradient between FFR CT and FFR was −0.07 (LOA -0.26 to 0.13) whereas in non-obstructive segments was −0.01 (LOA -0.06 to 0.05). Conclusion: The evaluation of epicardial coronary resistance using coronary CT angiography with FFR CT was feasible. FFR CT virtual pullback appears to be accurate for the evaluation of pressure gradients. FFR CT has the potential to identify the pathophysiological pattern of coronary artery disease in the non-invasive setting.
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- 2020
39. FFRCT and CT perfusion
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Bernard De Bruyne, Daniele Andreini, Alessandra Tanzilli, Emanuele Barbato, Takuya Mizukami, Carlos Collet, Flavia Nicoli, Jeroen Sonck, Edoardo Conte, Saima Mushtaq, Clinical sciences, Conte, E., Sonck, J., Mushtaq, S., Collet, C., Mizukami, T., Barbato, E., Tanzilli, A., Nicoli, F., De Bruyne, B., and Andreini, D.
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medicine.medical_specialty ,Cardiac CT ,Coronary artery disease ,FFR ,CT ,Myocardial CT perfusion ,Clinical Trials as Topic ,Computed Tomography Angiography ,Coronary Angiography ,Coronary Stenosis ,Fractional Flow Reserve, Myocardial ,Humans ,business.industry ,Coronary computed tomography angiography ,Hemodynamics ,Perfusion scanning ,Functional impact ,Coronary stenosis ,030204 cardiovascular system & hematology ,medicine.disease ,03 medical and health sciences ,Stenosis ,0302 clinical medicine ,medicine ,030212 general & internal medicine ,Radiology ,business ,Cardiology and Cardiovascular Medicine ,CARDIAC CT ,coronary artery disease - Abstract
Coronary computed tomography angiography (CCTA) is at the frontline of the diagnostic strategies to detect coronary artery disease (CAD). Anatomical information have proven to be insufficient to detect hemodynamic significant epicardial stenosis. In the present invited review we discuss on FFRCT and stress CTP, emerging technologies for an accurate and comprehensive evaluation of patients with suspected CAD, offering both anatomical (i.e. luminal and plaque) and functional assessment in one single technique.
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- 2020
40. Double-kissing culotte technique for coronary bifurcation stenting
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Gernot Plank, Emanuele Barbato, Gyula Szántó, Anton J. Prassl, Luigi Di Serafino, William Wijns, Gabor G. Toth, Hui Ying Ang, Laura Schneller, Viktor Sasi, Danilo Franco, Jaryl Ng, Toth, G. G., Sasi, V., Franco, D., Prassl, A. J., Di Serafino, L., Ng, J. C. K., Szanto, G., Schneller, L., Ang, H. Y., Plank, G., Wijns, W., and Barbato, E.
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education.field_of_study ,business.industry ,Bench model ,medicine.medical_treatment ,Population ,Stent ,X-Ray Microtomography ,Coronary Artery Disease ,Coronary Angiography ,Bench test ,Main branch ,Treatment Outcome ,Clinical validity ,Left main ,Procedure Duration ,Medicine ,Bifurcation ,Stents ,Drug-eluting stent ,Cardiology and Cardiovascular Medicine ,education ,business ,Nuclear medicine ,Coronary bifurcation - Abstract
Aims: The aim of this study was to assess whether the culotte technique could be improved by an additional kissing dilation prior to main branch (MB) stenting. Methods and results: Double-kissing (DK) culotte was compared to the culotte and DK-crush techniques in a bench model (n=24). Results were evaluated for stent apposition, luminal opening and flow dynamics. The total procedure duration of DK-culotte was 18.3±3.4 minutes, significantly lower than for DK-crush (24.3±5.7 min; p=0.015), but similar to culotte (21.6±5.9 min, p=0.104). In DK-culotte the overall rate of moderate (200-500 μm) and significant (>500 μm) malapposition was 2.1±1.9% and 0.4±0.2%, similar as compared to culotte (3.7±3.8%, p=0.459 and 1.0±1.0%, p=0.517, respectively), and lower as compared to DK-crush (8.1±2.5%, p
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- 2020
41. Physiology-guided revascularization versus optimal medical therapy of nonculprit lesions in elderly patients with myocardial infarction: Rationale and design of the FIRE trial
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Francesco Giannini, Andrea Santarelli, Ferdinando Varbella, Iginio Colaiori, Raul Moreno, Enrique Gutiérrez Ibañes, Mila Menozzi, José Luis Díez Gil, Marco Ruozzi, Alfredo Redondo, Javier Escaned, Valerio Lanzilotti, Antonio Colombo, Matteo Tebaldi, Elisa Maietti, Emanuele Barbato, Simone Biscaglia, Francisco Fernández-Avilés, Dariusz Dudek, Ignacio Amat Santos, Gianluca Campo, Giuseppe Biondi Zoccai, Luca Fileti, Vincenzo Guiducci, Biscaglia, S., Guiducci, V., Santarelli, A., Amat Santos, I., Fernandez-Aviles, F., Lanzilotti, V., Varbella, F., Fileti, L., Moreno, R., Giannini, F., Colaiori, I., Menozzi, M., Redondo, A., Ruozzi, M., Gutierrez Ibanes, E., Diez Gil, J. L., Maietti, E., Biondi Zoccai, G., Escaned, J., Tebaldi, M., Barbato, E., Dudek, D., Colombo, A., and Campo, G.
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Male ,medicine.medical_specialty ,Prognosi ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,Revascularization ,Coronary Angiography ,Conservative Treatment ,Severity of Illness Index ,Article ,NO ,03 medical and health sciences ,0302 clinical medicine ,Postoperative Complications ,Quality of life ,Internal medicine ,Functional Statu ,Clinical endpoint ,medicine ,Myocardial Revascularization ,Humans ,Multicenter Studies as Topic ,030212 general & internal medicine ,Myocardial infarction ,Mortality ,Non-ST Elevated Myocardial Infarction ,Stroke ,Randomized Controlled Trials as Topic ,Aged ,business.industry ,Cardiovascular Agents ,medicine.disease ,Prognosis ,Aged, Coronary Angiography, Cardiovascular Agents, Conservative Treatment, Functional Status, Mortality, Prognosis, Severity of Illness Index, Myocardial Revascularization, Non-ST Elevated Myocardial Infarction, Postoperative Complications, ST Elevation Myocardial Infarction ,Functional Status ,Cardiovascular Agent ,Sample size determination ,cardiovascular system ,Cardiology ,ST Elevation Myocardial Infarction ,Female ,Postoperative Complication ,Cardiology and Cardiovascular Medicine ,business ,Medical therapy ,All cause mortality ,Human - Abstract
Background Myocardial infarction (MI) in elderly patients is associated with unfavorable prognosis, and it is becoming an increasingly prevalent condition. The prognosis of elderly patients is equally impaired in ST-segment elevation (STE) or non-STE (NSTE), and it is markedly worsened by the common presence of multivessel disease (MVD). Given the limited evidence available for elderly patients, it has not yet been established whether, as for younger patients, a complete revascularization strategy in MI patients with MVD should be advocated. We present the design of a dedicated study that will address this research gap. Methods and design The FIRE trial is a prospective, randomized, international, multicenter, open-label study with blinded adjudicated evaluation of outcomes. Patients aged 75years and older, with MI (either STE or NSTE), MVD at coronary artery angiography and a clear culprit lesion will be randomized to culprit-only treatment or to physiology-guided complete revascularization. The primary endpoint will be the patient-oriented composite endpoint (POCE) of all cause death, any MI, any stroke, any revascularization at one year. The key secondary endpoint will be the composite of cardiovascular death and MI. Quality of life and physical performance will be evaluated as well. All components of the primary and key secondary outcome will be tested also at 3 and 5years. The sample size for the study is 1400 patients. Implications The FIRE trial will provide evidence on whether a specific revascularization strategy should be applied to elderly patients presenting MI and MVD in order to improve their clinical outcomes.
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- 2020
42. The Rationale of Neprilysin Inhibition in Prevention of Myocardial Ischemia-Reperfusion Injury during ST-Elevation Myocardial Infarction
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Alessandro Bellis, Giuseppe Di Gioia, Daniela Sorriento, Emanuele Barbato, Carmine Morisco, Bruno Trimarco, Ciro Mauro, Bellis, A., Mauro, C., Barbato, E., Di Gioia, G., Sorriento, D., Trimarco, B., and Morisco, C.
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0301 basic medicine ,medicine.medical_specialty ,Cardiotonic Agents ,medicine.drug_class ,substance P ,Tetrazoles ,Myocardial Reperfusion Injury ,Review ,myocardial ischemia-reperfusion injury ,030204 cardiovascular system & hematology ,angiotensin II ,neprilysin ,Mice ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Natriuretic peptide ,Animals ,Humans ,Cardioprotective Agent ,Myocardial infarction ,Neprilysin ,lcsh:QH301-705.5 ,Ventricular Remodeling ,natriuretic peptide ,business.industry ,Aminobutyrates ,Biphenyl Compounds ,General Medicine ,medicine.disease ,Survival Analysis ,Angiotensin II ,Adrenomedullin ,Drug Combinations ,030104 developmental biology ,Gene Expression Regulation ,lcsh:Biology (General) ,apelin ,sacubitril/valsartan ,adrenomedullin ,Cardiology ,ST Elevation Myocardial Infarction ,Valsartan ,bradykinin ,business ,Reperfusion injury ,Atrial Natriuretic Factor ,Sacubitril, Valsartan - Abstract
During the last three decades, timely myocardial reperfusion using either thrombolytic therapy or primary percutaneous intervention (pPCI) has allowed amazing improvements in outcomes with a more than halving in 1-year ST-elevation myocardial infarction (STEMI) mortality. However, mortality and left ventricle (LV) remodeling remain substantial in these patients. As such, novel therapeutic interventions are required to reduce myocardial infarction size, preserve LV systolic function, and improve survival in reperfused-STEMI patients. Myocardial ischemia-reperfusion injury (MIRI) prevention represents the main goal to reach in order to reduce STEMI mortality. There is currently no effective therapy for MIRI prevention in STEMI patients. A significant reason for the weak and inconsistent results obtained in this field may be the presence of multiple, partially redundant, mechanisms of cell death during ischemia-reperfusion, whose relative importance may depend on the conditions. Therefore, it is always more recognized that it is important to consider a “multi-targeted cardioprotective therapy”, defined as an additive or synergistic cardioprotective agents or interventions directed to distinct targets with different timing of application (before, during, or after pPCI). Given that some neprilysin (NEP) substrates (natriuretic peptides, angiotensin II, bradykinin, apelins, substance P, and adrenomedullin) exert a cardioprotective effect against ischemia-reperfusion injury, it is conceivable that antagonism of proteolytic activity by this enzyme may be considered in a multi-targeted strategy for MIRI prevention. In this review, by starting from main pathophysiological mechanisms promoting MIRI, we discuss cardioprotective effects of NEP substrates and the potential benefit of NEP pharmacological inhibition in MIRI prevention.
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- 2020
43. From fallacies to reality: Focus on fractional flow reserve
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Emanuele Barbato, Juhani Knuuti, William Wijns, Barbato, E., Knuuti, J., and Wijns, W.
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Coronary angiography ,medicine.medical_specialty ,Focus (computing) ,business.industry ,MEDLINE ,Coronary Stenosis ,Hemodynamics ,Fractional flow reserve ,Coronary stenosis ,Coronary Angiography ,Fractional Flow Reserve, Myocardial ,Internal medicine ,Cardiology ,medicine ,Humans ,Cardiology and Cardiovascular Medicine ,business - Published
- 2020
44. Role of endothelial dysfunction in determining angina after percutaneous coronary intervention: Learning from pathophysiology to optimize treatment
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Marco Giuseppe Del Buono, Tommaso Gori, Antonio Abbate, Emanuele Barbato, Fabio Mangiacapra, Giampaolo Niccoli, Rocco A. Montone, Filippo Crea, Mangiacapra, F., Del Buono, M. G., Abbate, A., Gori, T., Barbato, E., Montone, R. A., Crea, F., and Niccoli, G.
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medicine.medical_treatment ,Coronary Vasospasm ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Percutaneous coronary intervention ,Angina ,Coronary artery disease ,0302 clinical medicine ,Risk Factors ,Coronary Restenosi ,Stent ,030212 general & internal medicine ,Endothelial dysfunction ,Coronary Vessel ,Angina Pectori ,Coronary Vessels ,Pathophysiology ,medicine.anatomical_structure ,Treatment Outcome ,Microvascular dysfunction ,Cardiology ,Stents ,Cardiology and Cardiovascular Medicine ,Human ,medicine.medical_specialty ,Coronary Thrombosi ,Revascularization ,Angina Pectoris ,Coronary Restenosis ,03 medical and health sciences ,Internal medicine ,Recurrent angina ,Coronary Circulation ,medicine ,Humans ,cardiovascular diseases ,Hemodynamic ,business.industry ,Coronary Thrombosis ,Microcirculation ,Risk Factor ,Hemodynamics ,medicine.disease ,Coronary arteries ,Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE ,Conventional PCI ,Endothelium, Vascular ,business - Abstract
Endothelial dysfunction (EnD) is a hallmark feature of coronary artery disease (CAD), representing the key early step of atherosclerotic plaque development and progression. Percutaneous coronary intervention (PCI) is performed daily worldwide to treat symptomatic CAD, however a consistent proportion of patients remain symptomatic for angina despite otherwise successful revascularization. EnD plays a central role in the mechanisms of post-PCI angina, as it is strictly associated with both structural and functional abnormalities in the coronary arteries that may persist, or even accentuate, following PCI. The assessment of endothelial function in patients undergoing PCI might help to identify those patients at higher risk of future cardiovascular events and recurrent/persistent angina who might therefore benefit more from an intensive treatment. In this review, we address the role of EnD in determining angina after PCI, discussing its pathophysiological mechanisms, diagnostic approaches and therapeutic perspectives.
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- 2020
45. Validation of the all-comers design: Results of the TARGET-AC substudy
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Christoph J Jensen, Lene Holmvang, Jose Sevilla, Luc Maillard, Ferdinand Kiemeneij, Luc Janssens, Salvatore Brugaletta, Anastasios Milkas, Henning Kelbæk, Christoph Naber, Peter Nørkjær Laursen, Felix Pucher, William Wijns, Emanuele Barbato, Alexandra Lansky, Koen Ameloot, Carlos Robles, Gabor G. Toth, Andreas Baumbach, Niels van Royen, Cardiology, ACS - Atherosclerosis & ischemic syndromes, G Toth, G., Lansky, A., Baumbach, A., Kelbaek, H., van Royen, N., Holmvang, L., Janssens, L., Brugaletta, S., Barbato, E., Maillard, L., Kiemeneij, F., Naber, C. K., Pucher, F., Laursen, P. N., Ameloot, K., Robles, C., Milkas, A., Sevilla, J., Jensen, C., and Wijns, W.
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Male ,medicine.medical_specialty ,Patient demographics ,Population ,Context (language use) ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Percutaneous Coronary Intervention ,medicine ,Humans ,In patient ,030212 general & internal medicine ,Angina, Stable ,Prospective Studies ,Registries ,Acute Coronary Syndrome ,education ,Non-ST Elevated Myocardial Infarction ,Sampling bias ,Aged ,Protocol (science) ,education.field_of_study ,business.industry ,Patient Selection ,Coronary Stenosis ,Vascular damage Radboud Institute for Molecular Life Sciences [Radboudumc 16] ,Drug-Eluting Stents ,Middle Aged ,Clinical trial ,Clinical research ,Research Design ,Emergency medicine ,ST Elevation Myocardial Infarction ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
Item does not contain fulltext BACKGROUND: Results of clinical trials are often criticized by low inclusion rate and potential sampling bias in patient recruitment. The aim of this validation registry is to evaluate how far an all-comers design in the context of clinical research can ensure the representation of the true all-comers population. METHODS: This validation registry is a prospective international multicentre registry, conducted at 10 out of the total 21 centers, participating in TARGET-AC (registered under NCT02520180). During a predefined four-week period data were recorded prospectively on all PCIs performed in the participating centers, whether or not patients were enrolled in TARGET-AC. Data were collected on patient demographics, angiographic lesion- and procedural characteristics. For patients who were not enrolled in the study, operators were asked to declare the reason for not enrolling the patient, using a single-choice questionnaire. RESULTS: A total of 131 patients were enrolled in the TARGET-AC study during the investigated period (ER group), standing as 20% (range 4% and 54%) of all eligible cases per protocol. In the ER group more patients presented with stable angina (61% vs. 43%, respectively; P
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- 2020
46. Sustained Safety and Performance of the Second-Generation Sirolimus-Eluting Absorbable Metal Scaffold: Pooled Outcomes of the BIOSOLVE-II and -III Trials at 3 Years
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Ron Waksman, Emanuele Barbato, Ralph Toelg, Nicolas M. Van Mieghem, Clemens von Birgelen, Hüseyin Ince, Michael Haude, Stefan Verheye, Hector M. Garcia-Garcia, Stephan Kische, Evald Høj Christiansen, Cardiology, Haude, M., Ince, H., Kische, S., Toelg, R., Van Mieghem, N. M., Verheye, S., von Birgelen, C., Christiansen, E. H., Barbato, E., Garcia-Garcia, H. M., and Waksman, R.
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Target lesion ,Bioresorbable scaffold ,medicine.medical_specialty ,Scaffold ,Stable angina ,Stent thrombosis ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Prosthesis Design ,Coronary artery disease ,03 medical and health sciences ,Percutaneous Coronary Intervention ,0302 clinical medicine ,Absorbable Implants ,Humans ,Medicine ,Prospective Studies ,030212 general & internal medicine ,Myocardial infarction ,Aged ,Sirolimus ,business.industry ,Unstable angina ,Drug-Eluting Stents ,General Medicine ,Middle Aged ,medicine.disease ,Thrombosis ,Surgery ,Resorption ,Treatment Outcome ,Cardiology and Cardiovascular Medicine ,business ,medicine.drug - Abstract
BACKGROUND/PURPOSE: To avoid long-term effects associated with permanent implants, bioresorbable vascular scaffolds were developed as they provide transient vessel support and disappear thereafter. The aim of the BIOSOLVE-II and -III studies was to assess the safety and performance of a magnesium based sirolimus-eluting scaffold; we report the clinical outcomes at 3 years, 2 years after scaffold resorption.METHODS/MATERIALS: BIOSOLVE-II and BIOSOLVE-III are international, prospective multi-center studies, including 184 patients with 189 de novo lesions and stable or unstable angina, or documented silent ischemia. Acute myocardial infarction, 3-vessel coronary artery disease and heavily calcified lesions were excluded. Antiplatelet therapy was recommended for 6-months.RESULTS: Patients were 65.5 ± 10.8 years old, and lesions were 12.1 ± 4.5 mm long and located in vessels with a diameter of 2.7 ± 0.4 mm. More than half of the lesions (56.5%) were type B2/C lesions. At 2 years, 92.5% (160/173) of patients were symptom-free and 91.5% (151/165) at 3 years; all the other patients had stable angina. At 3 years, target lesion failure occurred in 11 patients (6.3%), consisting of 4 cardiac deaths (2.3%), one target-vessel myocardial infarction (0.6%), and 6 clinically-driven target lesion revascularizations (3.4%). There was no definite or probable scaffold thrombosis.CONCLUSION: In a low-risk patient population, treatment with a sirolimus-eluting magnesium bioresorbable scaffold can be considered safe, in particular with no definite or probable scaffold thrombosis.ANNOTATED TABLE OF CONTENTS: BIOSOLVE-II- and III are prospective international, multi-center studies including 184 patients with de novo lesions. At 3 years, target lesion failure was 6.3%, consisting of 4 cardiac deaths (2.3%), one target-vessel myocardial infarction (0.6%), and 6 clinically-driven target lesion revascularizations (3.4%). There was no definite or probable scaffold thrombosis.
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- 2020
47. The impact of the extent of side branch disease on outcomes following bifurcation stenting
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Zimarino, Marco, Barbato, Emanuele, Nakamura, Sunao, Radico, Francesco, Di Nicola, Marta, Briguori, Carlo, Gil, Robert J., Kanic, Vojko, Perfetti, Matteo, Pellicano, Mariano, Mairic, Kristina, Stankovic, Goran, the European Bifurcation Club, Zimarino, M., Barbato, E., Nakamura, S., Radico, F., Di Nicola, M., Briguori, C., Gil, R. J., Kanic, V., Perfetti, M., Pellicano, M., Mairic, K., and Stankovic, G.
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Registrie ,Male ,Time Factors ,medicine.medical_treatment ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,0302 clinical medicine ,Retrospective Studie ,Risk Factors ,Clinical endpoint ,Registries ,030212 general & internal medicine ,Myocardial infarction ,side branch lesion ,Hazard ratio ,General Medicine ,Middle Aged ,3. Good health ,Treatment Outcome ,outcome ,Cardiology ,Female ,Stents ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,Human ,medicine.medical_specialty ,Time Factor ,stenting ,Risk Assessment ,Lesion ,03 medical and health sciences ,Percutaneous Coronary Intervention ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,coronary bifurcation ,cardiovascular diseases ,Aged ,Retrospective Studies ,business.industry ,Risk Factor ,Percutaneous coronary intervention ,medicine.disease ,Confidence interval ,Conventional PCI ,business ,Mace - Abstract
Objectives: To define the impact of side branch (SB) lesion length on clinical outcomes after percutaneous coronary intervention (PCI) on bifurcation lesions. Background: The role of the SB lesion length remains questionable in PCI planning and its implication on clinical outcome is controversial. Methods: Data from the retrospective multicenter EBC-P2BiTO registry were analyzed. The primary endpoint was the occurrence of major adverse cardiac events (MACE), defined as the composite of cardiac death, myocardial infarction excluding periprocedural, or stent thrombosis at 13 months median follow-up (IQR 11-28). By using propensity scores for inverse probability of treatment weighting (IPTW), the comparison of treatment groups was adjusted to correct for potential confounding. Results: Among 1, 252 patients, SB was normal in 489 (39%), diseased in 763 (61%) cases. MACE occurred in 68 patients (5.4%). The optimal discriminant SB lesion length for MACE was ≥10 mm, with an area under the curve of 0.71 (p < .01). The incidence of MACE was higher among patients with SB lesions ≥10 mm (8%) than with normal SB (4.1%) (hazard ratio [HR], 2.8 ; 95% confidence interval [CI], 1.5-5.3 ; p = .001, IPTW-adjusted) or SB lesions
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- 2020
48. Bioresorbable vascular scaffold versus metallic drug-eluting stent in patients at high risk of restenosis: the COMPARE- ABSORB randomised clinical trial
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Yoshinobu Onuma, Robert-Jan van Geuns, Nick E.J. West, Giovanni Esposito, Adrian Wlodarczak, Giuseppe Tarantini, Tommaso Gori, Dariusz Dudek, Bernard Chevalier, Stephan Achenbach, Javier Escaned, Jan G.P. Tijssen, Marie-Claude Morice, Mohamed Abdel-Wahab, Emanuele Barbato, Chun Chin Chang, Viktor Kočka, Pieter C. Smits, Cardiology, Amsterdam Cardiovascular Sciences, ACS - Heart failure & arrhythmias, Smits, P. C., Chang, C. C., Chevalier, B., West, N. E. J., Gori, T., Barbato, E., Tarantin, G., Kocka, V., Achenbach, S., Dudek, D., Escaned, J., Wlodarczak, A., Abdel-Wahab, M., Esposito, G., Tijssen, J. G. P., Morice, M. -C., Onuma, Y., and Van Geuns, R. J.
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Bioresorbable scaffold ,medicine.medical_specialty ,Stent thrombosi ,Stent thrombosis ,medicine.medical_treatment ,Vascular damage Radboud Institute for Health Sciences [Radboudumc 16] ,030204 cardiovascular system & hematology ,Prosthesis Design ,03 medical and health sciences ,All institutes and research themes of the Radboud University Medical Center ,0302 clinical medicine ,Percutaneous Coronary Intervention ,Restenosis ,Tissue Scaffold ,Absorbable Implant ,Internal medicine ,Absorbable Implants ,medicine ,Clinical endpoint ,Humans ,030212 general & internal medicine ,Myocardial infarction ,Prospective Studies ,Prospective cohort study ,Tissue Scaffolds ,business.industry ,Hazard ratio ,Stent ,Drug-Eluting Stents ,medicine.disease ,Thrombosis ,Prospective Studie ,Treatment Outcome ,Drug-eluting stent ,Cardiology ,Cardiology and Cardiovascular Medicine ,business ,Human - Abstract
Aims: The aim of this study was to investigate clinical outcomes of patients at high risk of restenosis after implantation of a bioresorbable vascular scaffold (BVS). Methods and results: The COMPARE-ABSORB trial was an investigator-initiated, prospective randomised study. Patients at high risk of restenosis were randomly assigned to receive either a BVS or an everolimus-eluting stent (EES). A dedicated implantation technique was recommended for BVS. The primary endpoint was target lesion failure (TLF), defined as the composite of cardiac death, target vessel myocardial infarction (TVMI) or clinically indicated target lesion revascularisation at one year. The enrolment was discontinued prematurely because of a high thrombosis and TVMI rate in the BVS arm. A total of 1,670 patients were recruited (BVS 848 patients and EES 822 patients). TLF occurred in 43 patients (5.1%) of the BVS group and 34 patients (4.2%) of the EES group (absolute difference 0.9%, 95% confidence interval [CI]: −1.2%-3.0%, p non-inferiority
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- 2020
49. Procedural microvascular activation in long lesions treated with bioresorbable vascular scaffolds or everolimus-eluting stents: The PROACTIVE trial
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Emanuele Barbato, Panagiotis Xaplanteris, Giuseppe Di Gioia, Jozef Bartunek, Frederik Van Durme, Giovanni Ciccarelli, Bernard De Bruyne, Eric Wyffels, Gabor G. Toth, Alex Heyse, Leen Delrue, Marc Vanderheyden, Mariano Pellicano, Pellicano, M., Di Gioia, G., Ciccarelli, G., Xaplanteris, P., Delrue, L., Toth, G. G., van Durme, F., Heyse, A., Wyffels, E., Vanderheyden, M., Bartunek, J., de Bruyne, B., and Barbato, E.
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Bioresorbable scaffold ,medicine.medical_specialty ,Stable angina ,medicine.medical_treatment ,Everolimus eluting stent ,Coronary Artery Disease ,Coronary Angiography ,Prosthesis Design ,law.invention ,Postoperative Complications ,Percutaneous Coronary Intervention ,Randomized controlled trial ,law ,Absorbable Implant ,Internal medicine ,Absorbable Implants ,medicine ,Clinical endpoint ,Drug-Eluting Stent ,Humans ,Platelet activation ,Everolimus ,Fractional flow reserve ,Other technique ,Tissue Scaffolds ,business.industry ,Stent ,Percutaneous coronary intervention ,Drug-Eluting Stents ,Everolimu ,Treatment Outcome ,Conventional PCI ,Cardiology ,Postoperative Complication ,Cardiology and Cardiovascular Medicine ,business ,Long lesions ,Tomography, Optical Coherence ,Human - Abstract
Aims Significant platelet activation after long stented coronary segments has been associated with periprocedural microvascular impairment and myonecrosis. In long lesions treated either with an everolimus-eluting bioresorbable vascular scaffold (BVS) or an everolimus-eluting stent (EES), we aimed to investigate (a) procedure-related microvascular impairment, and (b) the relationship of platelet activation with microvascular function and related myonecrosis. Methods and results Patients (n=66) undergoing elective percutaneous coronary intervention (PCI) in long lesions were randomised 1:1 to either BVS or EES. The primary endpoint was the difference between groups in changes of pressure-derived corrected index of microvascular resistance (cIMR) after PCI. Periprocedural myonecrosis was assessed by high-sensitivity cardiac troponin T (hs-cTnT), platelet reactivity by high-sensitivity adenosine diphosphate (hs-ADP)-induced platelet reactivity with the Multiplate Analyzer. Post-dilatation was more frequent in the BVS group, with consequent longer procedure time. A significant difference was observed between the two groups in the primary endpoint of ΔcIMR (p=0.04). hs-ADP was not different between the groups at different time points. hs-cTnT significantly increased after PCI, without difference between the groups. Conclusions In long lesions, BVS implantation is associated with significant acute reduction in IMR as compared with EES, with no significant interaction with platelet reactivity or periprocedural myonecrosis.
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- 2020
50. Comparative Methodological Assessment of the Randomized GLOBAL LEADERS Trial Using Total Ischemic and Bleeding Events
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Sergio Leandro, Jan G.P. Tijssen, Norihiro Kogame, Masafumi Ono, Christian W. Hamm, Johan Verbeeck, Margit Niethammer, Hideyuki Kawashima, Rutao Wang, David van Klaveren, Rodrigo Modolo, Chao Gao, Marco Valgimigli, Mariusz Tomaniak, Emanuele Barbato, Peter Jüni, Yoshinobu Onuma, Vasco Gama Ribeiro, Kuniaki Takahashi, Hironori Hara, Stephan Windecker, Géza Fontos, Faisal Sharif, Patrick W. Serruys, Ply Chichareon, Philippe Gabriel Steg, Michael Angioi, Hara, H., Van Klaveren, D., Takahashi, K., Kogame, N., Chichareon, P., Modolo, R., Tomaniak, M., Ono, M., Kawashima, H., Wang, R., Gao, C., Niethammer, M., Fontos, G., Angioi, M., Ribeiro, V. G., Barbato, E., Leandro, S., Hamm, C., Valgimigli, M., Windecker, S., Juni, P., Steg, P. G., Verbeeck, J., Tijssen, J. G. P., Sharif, F., Onuma, Y., Serruys, P. W., University of Zurich, Serruys, Patrick W, Graduate School, Cardiology, ACS - Heart failure & arrhythmias, ACS - Atherosclerosis & ischemic syndromes, ACS - Microcirculation, and Public Health
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medicine.medical_specialty ,Time Factors ,Endpoint Determination ,aspirin ,medicine.medical_treatment ,Hemorrhage ,610 Medicine & health ,Equivalence Trials as Topic ,Revascularization ,Rate ratio ,Risk Assessment ,11171 Cardiocentro Ticino ,2705 Cardiology and Cardiovascular Medicine ,ticagrelor ,Risk Factors ,Internal medicine ,medicine ,Humans ,Myocardial infarction ,Stroke ,Aspirin ,business.industry ,Dual Anti-Platelet Therapy ,Hazard ratio ,percutaneous coronary intervention ,Percutaneous coronary intervention ,medicine.disease ,mortality ,Treatment Outcome ,myocardial infarction ,Research Design ,Data Interpretation, Statistical ,Cardiology ,Cardiology and Cardiovascular Medicine ,business ,Ticagrelor ,Platelet Aggregation Inhibitors ,medicine.drug - Abstract
Background: Time-to-first-event analysis considers only the first event irrespective of its severity. There are several methods to assess trial outcomes beyond time-to-first-event analysis, such as analyzing total events and ranking outcomes. In the GLOBAL LEADERS study, time-to-first-event analysis did not show superiority of ticagrelor monotherapy following one-month dual antiplatelet therapy (DAPT) after percutaneous coronary intervention to conventional 12-month DAPT followed by aspirin monotherapy in the reduction of the primary composite end point of all-cause mortality or new Q-wave myocardial infarction. This study sought to explore various analytical approaches in assessing total ischemic and bleeding events after percutaneous coronary intervention in the GLOBAL LEADERS study. Methods and Results: Total ischemic and bleeding events were defined as all-cause mortality, any stroke, any myocardial infarction, any revascularization, or Bleeding Academic Research Consortium grade 2 or 3 bleeding. We used various analytical approaches to analyze the benefit of ticagrelor monotherapy over conventional DAPT. For ischemic and bleeding events at 2 years after percutaneous coronary intervention, ticagrelor monotherapy demonstrated a 6% risk reduction, compared with conventional 12-month DAPT in time-to-first-event analysis (hazard ratio, 0.94 [95% CI, 0.88–1.01]; log-rank P =0.10). In win ratio analysis, win ratio was 1.05 (95% CI, 0.97–1.13; P =0.20). Negative binomial regression and Andersen-Gill analyses which include repeated events showed statistically significant advantage for ticagrelor monotherapy (rate ratio, 0.92 [95% CI, 0.85–0.99; P =0.020] and hazard ratio, 0.92 [95% CI, 0.85–0.99; P =0.028], respectively), although in weighted composite end point analysis, the hazard ratio was 0.93 (95% CI, 0.84–1.04; log-rank P =0.22). Conclusions: Statistical analyses considering repeated events or event severity showed that ticagrelor monotherapy consistently reduced ischemic and bleeding events by 5% to 8%, compared with conventional 1-year DAPT. Applying multiple statistical methods could emphasize the multiple facets of a trial and result in accurate and more appropriate analyses. Considering the recurrence of ischemic and bleeding events, ticagrelor monotherapy appeared to be beneficial after percutaneous coronary intervention. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01813435.
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- 2020
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