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2 results on '"Meiracker, A.H. van den"'

1. High D-dimer levels increase the likelihood of pulmonary embolism

Author

Tick, L.W., Nijkeuter, M., Kramer, M.H.W., Hovens, M.M., Buller, H.R., Leebeek, F.W., Huisman, M.V., Halkes, C.J., Heggelman, B.G., Nix, M., Sohne, M., Bresser, P.J., Kool, D.R., Phoa, S.S., Rekke, B., Kaasjager, K.A., Kwakkel-van Erp, J.M., Grandjean, H.M., Kesselring, F.O.H.W., Mol, J.J., Ullmann, E.F., Guldener, C. van, Mijnsbergen, J.Y., Sturm, M.F., Swart, C. de, Kuijer, P.M., Schrama, J.G., Velde, A. van de, Huisman, P.M., Eerden, M.M. van der, Janssen, P.J., Jansen, R., Lobatto, S., Compier, E.A., Eikenboom, H.C., Roos, A. de, Belle, A. van, Prins, M.H., Snoep, G., Korte, H. de, Kos, C.B., Laterveer, L., Veldhuizen, W.C. van, Kamphuizen, P.W., Bredie, S.J.H., Die, C.E. van, Heijdra, Y.F., Lenders, J.W.M., Kruip, M.J., Jie, K.S., Kars, A.H., Meiracker, A.H. van den, Pattynama, P.M., Borst, J.M. de, Houten, A.A. van, Teng, H.T., ACS - Amsterdam Cardiovascular Sciences, Vascular Medicine, and Hematology

Subjects
medicine.medical_specialty, Health aging / healthy living [IGMD 5], Vascular medicine and diabetes [UMCN 2.2], Malignancy, Sensitivity and Specificity, Fibrin Fibrinogen Degradation Products, Internal medicine, D-dimer, Internal Medicine, medicine, Humans, In patient, Cardiovascular diseases [NCEBP 14], business.industry, Vascular disease, Respiratory disease, Middle Aged, medicine.disease, Surgery, Pulmonary embolism, Pathogenesis and modulation of inflammation [N4i 1], Management strategy, Treatment Outcome, Cardiology, Female, business, Pulmonary Embolism, Venous thromboembolism, Tomography, Spiral Computed, Algorithms, Biomarkers
Abstract

Contains fulltext : 70029.pdf (Publisher’s version ) (Closed access) Objective. To determine the utility of high quantitative D-dimer levels in the diagnosis of pulmonary embolism. Methods. D-dimer testing was performed in consecutive patients with suspected pulmonary embolism. We included patients with suspected pulmonary embolism with a high risk for venous thromboembolism, i.e. hospitalized patients, patients older than 80 years, with malignancy or previous surgery. Presence of pulmonary embolism was based on a diagnostic management strategy using a clinical decision rule (CDR), D-dimer testing and computed tomography. Results. A total of 1515 patients were included with an overall pulmonary embolism prevalence of 21%. The pulmonary embolism prevalence was strongly associated with the height of the D-dimer level, and increased fourfold with D-dimer levels greater than 4000 ng mL(-1) compared to levels between 500 and 1000 ng mL(-1). Patients with D-dimer levels higher than 2000 ng mL(-1) and an unlikely CDR had a pulmonary embolism prevalence of 36%. This prevalence is comparable to the pulmonary embolism likely CDR group. When D-dimer levels were above 4000 ng mL(-1), the observed pulmonary embolism prevalence was very high, independent of CDR score. Conclusion. Strongly elevated D-dimer levels substantially increase the likelihood of pulmonary embolism. Whether this should translate into more intensive diagnostic and therapeutic measures in patients with high D-dimer levels irrespective of CDR remains to be studied.

Published
2008
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2. The benefit of stent placement and blood pressure and lipid-lowering for the prevention of progression of renal dysfunction caused by atherosclerotic ostial stenosis of the renal artery. The STAR-study: rationale and study design

Author

Bax, L., Mali, W.P.Th., Buskens, E., Koomans, H.A., Beutler, J.J., Braam, B., Beek, F.J.A., Rabelink, T.J., Postma, C.T., Huysmans, F.T.M., Deinum, J., Thien, Th., Schultze Kool, L.J., Woittiez, A.J.J., Kouwenberg, J.J., Meiracker, A.H. van den, Pattynama, P.M., Ven, P.J. van der, Vroegindeweij, D., Doorenbos, C.J., Aarts, J., Kroon, A.A., Leeuw, P.W. de, Haan, M.W. de, Engelshoven, J. van, Rutten, M.J.C.M., Montfrans, G.A. van, Reekers, J.A., Plouin, P.F., Batide Alanore, A. La, Azizi, M., Raynaud, A., Harden, P.N., Cowling, M., Vascular Medicine, Radiology and Nuclear Medicine, Internal Medicine, Radiology & Nuclear Medicine, and Research & Education

Subjects
Arteriosclerosis, Vascular medicine and diabetes [UMCN 2.2], Kidney, Renal Artery Obstruction, urologic and male genital diseases, Combined Modality Therapy, Renal disorders [UMCN 5.4], Renal Artery, Heptanoic Acids, Research Design, Atorvastatin, Disease Progression, Humans, Pyrroles, Stents, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Angioplasty, Balloon, Antihypertensive Agents
Abstract

Item does not contain fulltext BACKGROUND: Atherosclerotic renal artery stenosis (ARAS) is associated with progressive loss of renal function and is one of the most important causes of renal failure in the elderly. Current treatment includes restoration of the renal arterial lumen by endovascular stent placement. However, this treatment only affects damage caused by ARAS due to the stenosis and ensuing post-stenotic ischemia. ARAS patients have severe general vascular disease. Atherosclerosis and hypertension can also damage the kidney parenchyma causing renal failure. Medical treatment focuses on the latter. Lipid-lowering drugs (statins) could reduce renal failure progression and could reduce the overall high cardiovascular risk. The additional effect on preserving renal function of stent placement as compared to medical therapy alone is unknown. Therefore, the STAR-study aims to compare the effects of renal artery stent placement together with medication vs. medication alone on renal function in ARAS patients. METHOD: Patients with an ARAS of > or = 50% and renal failure (creatinine (Cr) clearance < 80 mL/min/1.73 m2) are randomly assigned to stent placement with medication or to medication alone. Medication consists of statins, anti-hypertensive drugs and antiplatelet therapy. Patients are followed for 2 yrs with extended follow-up to 5 yrs. The primary outcome of this study is a reduction in Cr clearance > 20% compared to baseline. This trial will include 140 patients.

Published
2003

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