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151. Achievement of treatment goals for primary prevention of cardiovascular disease in clinical practice across Europe: the EURIKA study

Author

Banegas, J. R., primary, Lopez-Garcia, E., additional, Dallongeville, J., additional, Guallar, E., additional, Halcox, J. P., additional, Borghi, C., additional, Masso-Gonzalez, E. L., additional, Jimenez, F. J., additional, Perk, J., additional, Steg, P. G., additional, De Backer, G., additional, and Rodriguez-Artalejo, F., additional

Published
2011
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154. Poster session V * Saturday 11 December 2010, 08:30-12:30

Author

Pham, Q. H., primary, Von Lueder, T. G., additional, Namtvedt, S. K., additional, Rosjo, H., additional, Omland, T., additional, Steine, K., additional, Timoteo, A. T., additional, Mota Carmo, M., additional, Simoes, M., additional, Branco, L. M., additional, Ferreira, R. C., additional, Kato, R., additional, Ito, J., additional, Tahara, T., additional, Yokoyama, Y., additional, Ashikaga, T., additional, Satoh, Y., additional, Na, J. O., additional, Hong, H. E., additional, Kim, M. N., additional, Shin, S. Y., additional, Choi, C. U., additional, Kim, E. J., additional, Rha, S. W., additional, Park, C. G., additional, Seo, H. S., additional, Oh, D. J., additional, Ticulescu, R., additional, Brigido, S., additional, Vriz, O., additional, Sparacino, L., additional, Popescu, B. A., additional, Ginghina, C., additional, Carerj, S., additional, Nicolosi, G. L., additional, Antonini-Canterin, F., additional, Onaindia Gandarias, J. J., additional, Romero, A., additional, Laraudogoitia, E., additional, Velasco, S., additional, Quintana, O., additional, Cacicedo, A., additional, Rodriguez, I., additional, Alarcon, J. A., additional, Gonzalez, J., additional, Lekuona, I., additional, Subinas, A., additional, Abdula, G., additional, Lund, L. H., additional, Winter, R., additional, Brodin, L., additional, Sahlen, A., additional, Masaki, M., additional, Cha, Y. M., additional, Yuasa, T., additional, Dong, K., additional, Dong, Y. X., additional, Mankad, S. V., additional, Oh, J. K., additional, Vallet, F., additional, Lequeux, B., additional, Diakov, C., additional, Sosner, P., additional, Christiaens, L., additional, Coisne, D., additional, Kihara, C., additional, Murata, K., additional, Wada, Y., additional, Uchida, K., additional, Ueyama, T., additional, Okuda, S., additional, Susa, T., additional, Matsuzaki, M., additional, Cho, E. J., additional, Choi, K. Y., additional, Kwon, B. J., additional, Kim, D. B., additional, Jang, S. W., additional, Cho, J. S., additional, Jung, H. O., additional, Jeon, H. K., additional, Youn, H. J., additional, Kim, J. H., additional, Cikes, M., additional, Bijnens, B., additional, Velagic, V., additional, Kopjar, T., additional, Milicic, D., additional, Biocina, B., additional, Gasparovic, H., additional, Almuntaser, I., additional, Brown, A., additional, Foley, B., additional, Mulvihill, N., additional, Crean, P., additional, King, G., additional, Murphy, R., additional, Takata, Y., additional, Taniguchi, M., additional, Nobusada, S., additional, Sugawara, M., additional, Toh, N., additional, Kusano, K., additional, Itoh, H., additional, Wellnhofer, E., additional, Kriatselis, C., additional, Nedios, S., additional, Gerds-Li, J. H., additional, Fleck, E., additional, Poulsen, M. K., additional, Henriksen, J. E., additional, Dahl, J., additional, Johansen, A., additional, Haghfelt, T., additional, Hoilund-Carlsen, P. F., additional, Beck-Nielsen, H., additional, Moller, J. E., additional, Dankowski, R., additional, Wierzchowiecki, M., additional, Michalski, M., additional, Nowicka, A., additional, Szymanowska, K., additional, Pajak, A., additional, Poprawski, K., additional, Szyszka, A., additional, Kasner, M., additional, Westermann, D., additional, Schultheiss, H. P., additional, Tschoepe, C., additional, Watanabe, T., additional, Iwai-Takano, M., additional, Kobayashi, A., additional, Machii, H., additional, Takeishi, Y., additional, Paelinck, B. P., additional, Van Herck, P. L., additional, Bosmans, J. M., additional, Vrints, C. J., additional, Lamb, H. J., additional, Doltra, A., additional, Vidal, B., additional, Silva, E., additional, Poyatos, S., additional, Mont, L., additional, Berruezo, A., additional, Castel, A., additional, Tolosana, J. M., additional, Brugada, J., additional, Sitges, M., additional, Dencker, M., additional, Bjorgell, O., additional, Hlebowicz, J., additional, Szelenyi, Z. S., additional, Szenasi, G., additional, Kiss, M., additional, Prohaszka, Z., additional, Patocs, A., additional, Karadi, I., additional, Vereckei, A., additional, Saha, S. K., additional, Anderson, P. L., additional, Govind, S., additional, Govindan, M., additional, Moggridge, J. C., additional, Kiotsekoglou, A., additional, Gopal, A. S., additional, Loegstrup, B. B., additional, Christophersen, T. B., additional, Hoefsten, D. E., additional, Moeller, J. E., additional, Boetker, H. E., additional, Egstrup, K., additional, Graefe, M., additional, Huang, F. Q., additional, Zhang, R. S., additional, Le, T. T., additional, Tan, R. S., additional, Sattarzadeh Badkoubeh, R., additional, Tavoosi, A., additional, Elahian, A. R., additional, Drapkina, O., additional, Ivashkin, V. I., additional, Fazakas, A., additional, Pepo, L., additional, Janosi, O., additional, Kopitovic, I., additional, Goncalves, A., additional, Marcos-Alberca, P., additional, Almeria, C., additional, Feltes, G., additional, Rodriguez, E., additional, Garcia, E., additional, Hernandez-Antolin, R., additional, Macaya, C., additional, Silva Cardoso, J., additional, Zamorano, J. L., additional, Navarro, M. S., additional, Valentin, M., additional, Banes, C. M., additional, Rigo, F., additional, Grolla, E., additional, Tona, F., additional, Cuaia, V., additional, Moreo, A., additional, Badano, L., additional, Raviele, A., additional, Iliceto, S., additional, Tarzia, P., additional, Sestito, A., additional, Nerla, R., additional, Di Monaco, A., additional, Infusino, F., additional, Matera, D., additional, Greco, F., additional, Tacchino, R. M., additional, Lanza, G. A., additional, Crea, F., additional, Nemes, A., additional, Balazs, E., additional, Pinter, K. S., additional, Egyed, A., additional, Csanady, M., additional, Forster, T., additional, Holte, E., additional, Vegsundvag, J., additional, Hole, T., additional, Hegbom, K., additional, Wiseth, R., additional, Sharif, D., additional, Sharif-Rasslan, A., additional, Shahla, C., additional, Khalil, A., additional, Rosenschein, U., additional, Zagatina, A., additional, Zhuravskaya, N., additional, Tyurina, T. V., additional, Tagliamonte, E., additional, Cirillo, T., additional, Coppola, A., additional, Marinelli, U., additional, Romano, C., additional, Riccio, G., additional, Citro, R., additional, Astarita, C., additional, Capuano, N., additional, Quaranta, G., additional, Desiderio, A., additional, Frattini, S., additional, Faggiano, P., additional, Zilioli, V., additional, Locantore, E., additional, Longhi, S., additional, Bellandi, F., additional, Faden, G., additional, Triggiani, M., additional, Dei Cas, L., additional, Dalsgaard, M., additional, Kjaergaard, J., additional, Iversen, K., additional, Hassager, C., additional, Dinh, W., additional, Nickl, W. N., additional, Smettan, J. S., additional, Koehler, T. K., additional, Scheffold, T. D., additional, Coll Barroso, M. C. B., additional, Guelker, J. G., additional, Fueth, R. F., additional, Kamperidis, V., additional, Hadjimiltiades, S., additional, Sianos, G., additional, Efthimiadis, G., additional, Karvounis, H., additional, Parcharidis, G., additional, Styliadis, I. H., additional, Velasco Del Castillo, M. S., additional, Onaindia, J. J., additional, Telleria, M., additional, Carstensen, H. G., additional, Nordenberg, C., additional, Sogaard, P., additional, Fritz-Hansen, T., additional, Bech, J., additional, Galatius, S., additional, Jensen, J. S., additional, Mogelvang, R., additional, Bartko, P. E., additional, Graf, S., additional, Rosenhek, R., additional, Burwash, I. G., additional, Bergler-Klein, J., additional, Clavel, M.-A., additional, Baumgartner, H., additional, Pibarot, P., additional, Mundigler, G., additional, Kirilmaz, B., additional, Eser, I., additional, Tuzun, N., additional, Komur, B., additional, Dogan, H., additional, Taskiran Comez, A., additional, Ercan, E., additional, Cusma-Piccione, M., additional, Zito, C., additional, Oreto, G., additional, Piluso, S., additional, Tripepi, S., additional, Oreto, L., additional, Longordo, C., additional, Ciraci, L., additional, Di Bella, G., additional, Piatkowski, R., additional, Kochanowski, J., additional, Scislo, P., additional, Grabowski, M., additional, Marchel, M., additional, Roik, M., additional, Kosior, D., additional, Opolski, G., additional, Sknouril, L., additional, Dorda, M., additional, Holek, B., additional, Gajdusek, L., additional, Chovancik, J., additional, Branny, M., additional, Fiala, M., additional, Szymanski, P., additional, Lipczynska, M., additional, Klisiewicz, A., additional, Hoffman, P., additional, Jander, N., additional, Minners, J., additional, Martin, G., additional, Zeh, W., additional, Allgeier, M., additional, Gohlke-Baewolf, C., additional, Gohlke, H., additional, Nistri, S., additional, Porciani, M. C., additional, Attanasio, M., additional, Abbate, R., additional, Gensini, G. F., additional, Pepe, G., additional, Duncan, R. F., additional, Piantadosi, C., additional, Nelson, A. J., additional, Wittert, G., additional, Dundon, B., additional, Worthley, M. I., additional, Worthley, S. G., additional, Jung, P., additional, Berlinger, K., additional, Rieber, J., additional, Sohn, H. Z., additional, Schneider, P., additional, Leibig, M., additional, Koenig, A., additional, Klauss, V., additional, Tomkiewicz-Pajak, L., additional, Kolcz, J., additional, Olszowska, M., additional, Pieculewicz, M., additional, Podolec, P., additional, Przewlocki, T., additional, Suchon, E., additional, Sobien, B., additional, Wilkolek, P., additional, Ziembicka, A., additional, Hlawaty, M., additional, Van De Bruaene, A., additional, Hermans, H., additional, Buys, R., additional, Vanhees, L., additional, Delcroix, M., additional, Voigt, J.-U., additional, Budts, W., additional, De Cillis, E., additional, Acquaviva, T., additional, Basile, D., additional, Bortone, A. S., additional, Kalimanovska-Ostric, D., additional, Nastasovic, T., additional, Vujisic-Tesic, B., additional, Jovanovic, I., additional, Milakovic, B., additional, Dostanic, M., additional, Stosic, M., additional, Frogoudaki, A., additional, Andreou, K., additional, Parisis, J., additional, Triantafyllidi, E., additional, Gaitani, S., additional, Paraskevaidis, J., additional, Anastasiou-Nana, M., additional, De Pasquale, G., additional, Kuehn, A., additional, Petzuch, K., additional, Mueller, J., additional, Meierhofer, C., additional, Fratz, S., additional, Hager, A., additional, Hess, J., additional, Vogt, M., additional, Attenhofer Jost, C. H., additional, Dearani, J. A., additional, Scott, C. G., additional, Burkhart, H. M., additional, Connolly, H. M., additional, Vitarelli, A., additional, Battaglia, D., additional, Caranci, F., additional, Padella, V., additional, Continanza, G., additional, Dettori, O., additional, Capotosto, L., additional, Vitarelli, M., additional, De Cicco, V., additional, Cortez Morichetti, M., additional, Mohanan Nair, K. K., additional, Sasidaharan, B., additional, Thajudeen, A., additional, Tharakan, J. M., additional, Mertens, L., additional, Ahmad, N., additional, Kantor, P. K., additional, Grosse-Wortmann, L., additional, Friedberg, M. K., additional, Bernard, Y. F., additional, Morel, M. A., additional, Descotes-Genon, V., additional, Jehl, J., additional, Meneveau, N., additional, Schiele, F., additional, Kaldararova, M., additional, Simkova, I., additional, Tittel, P., additional, Masura, J., additional, Trojnarska, O., additional, Szczepaniak, L., additional, Mizia -Stec, K., additional, Cieplucha, A., additional, Bartczak, A., additional, Grajek, S., additional, Tykarski, A., additional, Gasior, Z., additional, Babovicvuksanovic, D., additional, Bonnichsen, C. R., additional, Morgan, G. J., additional, Slorach, C., additional, Hui, W., additional, Sarkola, T., additional, Lee, K. J., additional, Chaturvedi, R., additional, Benson, L., additional, Bradley, T., additional, Iancu, M. E., additional, Ghiorghiu, I., additional, Serban, M., additional, Craciunescu, I., additional, Hodo, A., additional, Morgan, J., additional, Roche, L., additional, Lee, K., additional, Milanesi, O., additional, Favero, V., additional, Padalino, M., additional, Biffanti, R., additional, Cerutti, A., additional, Maschietto, N., additional, Reffo, E., additional, Vida, V., additional, Stellin, G., additional, Irtyuga, O., additional, Gamazin, D., additional, Voronkina, I., additional, Tsoyi, N., additional, Gudkova, E., additional, Moiseeva, O., additional, Aggeli, C., additional, Kazazaki, C., additional, Felekos, I., additional, Lagoudakou, S., additional, Roussakis, G., additional, Skoumas, J., additional, Pitsavos, C., additional, Stefanadis, C., additional, Cueff, C., additional, Keenan, N., additional, Steg, P. G., additional, Cimadevilla, C., additional, Ducrocq, G., additional, Vahanian, A., additional, Messika-Zeitoun, D., additional, Petrella, L., additional, Mazzola, A. M., additional, Villani, C. V., additional, Giancola, R. G., additional, Ciocca, M. C., additional, Di Eusanio, D. E. M., additional, Nolan, S., additional, Ionescu, A., additional, Skaug, T. R., additional, Amundsen, B. H., additional, Hergum, T., additional, Torp, H., additional, Haugen, B. O., additional, Lopez Aguilera, J., additional, Mesa Rubio, D., additional, Ruiz Ortiz, M., additional, Delgado Ortega, M., additional, Villanueva Fernandez, E., additional, Cejudo Diaz Del Campo, L., additional, Toledano Delgado, F., additional, Leon Del Pino, M., additional, Romo Pena, E., additional, Suarez De Lezo Cruz-Conde, J., additional, De Marco, E., additional, Colucci, A., additional, Comerci, G., additional, Gabrielli, F. A., additional, Natali, R., additional, Garramone, B., additional, Savino, M., additional, Lotrionte, M., additional, Sonaglioni, A., additional, Loperfido, F., additional, Zdravkovic, M., additional, Perunicic, J., additional, Krotin, M., additional, Ristic, M., additional, Vukomanovic, V., additional, Zaja, M., additional, Radovanovic, S., additional, Saric, J., additional, Zdravkovic, D., additional, Cotrim, C., additional, Almeida, A. R., additional, Miranda, R., additional, Almeida, A. G., additional, Picano, E., additional, Carrageta, M., additional, D'andrea, A., additional, Cocchia, R., additional, Riegler, L., additional, Golia, E., additional, Scarafile, R., additional, Caso, P., additional, Russo, M. G., additional, Bossone, E., additional, Calabro', R., additional, Noman, H., additional, Adel, A., additional, Elfaramawy, A. M. R., additional, Abdelraouf, M., additional, Elnaggar, W. A. E. L., additional, Baligh, E., additional, Sargento, L., additional, Silva, D., additional, Goncalves, S., additional, Ribeiro, S., additional, Vinhas Sousa, G., additional, Almeida, A., additional, Lopes, M., additional, Rodriguez-Manero, M., additional, Aguado Gil, L., additional, Azcarate, P., additional, Lloret Luna, P., additional, Macias Gallego, A., additional, Castano, S. A. R. A., additional, Garcia, M., additional, Pujol Salvador, C., additional, Barba, J., additional, Redondo, P., additional, Tomasoni, L., additional, Sitia, S., additional, Atzeni, F., additional, Gianturco, L., additional, Ricci, C., additional, Sarzi-Puttini, P., additional, Turiel, M., additional, De Gennaro Colonna, V., additional, Uejima, T., additional, Jaroch, J., additional, Polombo, C., additional, Hughes, A., additional, Vinereanu, D., additional, Evanvelista, A., additional, Leftheriotis, G., additional, Fraser, A. G., additional, Lewczuk, A., additional, Sobkowicz, B., additional, Tomaszuk-Kazberuk, A., additional, Sawicki, R., additional, Hirnle, T., additional, Michalski, B. W., additional, Filipiak, D., additional, Kasprzak, J. D., additional, Lipiec, P., additional, Dalen, H., additional, Mjolstad, O. C., additional, Klykken, B. E., additional, Graven, T., additional, Martensson, M., additional, Olsson, M., additional, Brodin, L.-A., additional, Enache, R., additional, Leiballi, E., additional, Penhall, A., additional, Perry, R., additional, Altman, M., additional, Sinhal, A., additional, Bennetts, J., additional, Chew, D. P., additional, Joseph, M. X., additional, Larsen, L. H., additional, Kristensen, T., additional, Kober, L. V., additional, Kofoed, K. F., additional, Moscoso Costa, F., additional, Ribeiras, R., additional, Brito, J., additional, Boshoff, S., additional, Neves, J., additional, Teles, R., additional, Canada, M., additional, Andrade, M. J., additional, Gouveia, R., additional, Silva, A., additional, Miskovic, A., additional, Poerner, T. P., additional, Stiller, C. S., additional, Goebel, B. G., additional, Moritz, A. M., additional, Stefani, L., additional, Galanti, G. G., additional, Moraldo, M., additional, Bergamini, C., additional, Pabari, P. A., additional, Dhutia, N. M., additional, Malaweera, A. S. N., additional, Willson, K., additional, Davies, J., additional, Hughes, A. D., additional, Xu, X. Y., additional, Francis, D. P., additional, Jasaityte, R., additional, Amundsen, B., additional, Barbosa, D., additional, Loeckx, D., additional, Kiss, G., additional, Orderud, F., additional, Robesyn, V., additional, Claus, P., additional, D'hooge, J., additional, Nao, T., additional, Miura, T., additional, Shams, K., additional, Samir, S., additional, Samir, R., additional, El-Sayed, M., additional, Anwar, A. M., additional, Nosir, Y., additional, Galal, A., additional, Chamsi-Pasha, H., additional, Ciobanu, A., additional, Dulgheru, R., additional, Bennett, S., additional, De Luca, A., additional, Toncelli, L., additional, Cappelli, F., additional, Cappelli, B., additional, Vono, M. C. R., additional, Galanti, G., additional, Zorman, Y., additional, Yilmazer, M. S., additional, Akyildiz, M., additional, Gurol, T., additional, Aydin, A., additional, Dagdeviren, B., additional, and Kalangos, A., additional

Published
2010
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160. The authors' reply

Author

Brieger, D, primary, FitzGerald, G, additional, Fox, K A A, additional, Eagle, K A, additional, Budaj, A, additional, Avezum, A, additional, Costa, B, additional, Granger, C B, additional, Anderson, F A, additional, and Steg, P. G, additional

Published
2009
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161. Identifying needs and opportunities for advancing translational research in cardiovascular disease

Author

Sipido, K. R., primary, Tedgui, A., additional, Kristensen, S. D., additional, Pasterkamp, G., additional, Schunkert, H., additional, Wehling, M., additional, Steg, P. G., additional, Eisert, W., additional, Rademakers, F., additional, Casadei, B., additional, Fuster, V., additional, Cerbai, E., additional, Hasenfuss, G., additional, Fernandez-Aviles, F., additional, Garcia-Dorado, D., additional, Vidal, M., additional, Hallen, M., additional, and Dambrauskaite, V., additional

Published
2009
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167. Abstract 2812: Predictors of Reinfarction Following PCI or Medical Management in Patients With Persistent Total Occlusion After Myocardial Infarction: Results from the Occluded Artery Trial (OAT)

Author

White, Harvey D, primary, Steg, P G, additional, Dzavik, Vladimir, additional, Menon, Venu, additional, Reynolds, Harmony R, additional, Carvalho, Antonio C, additional, Barton, Bruce A, additional, Cantor, Warren J, additional, Kruk, Mariusz, additional, Martin, C E, additional, Pearte, Camille A, additional, Knatterud, Genell L, additional, Lamas, Gervasio A, additional, and Hochman, Judith S, additional

Published
2007
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173. Prognostic impact of non-compliance with guidelines-recommended times to reperfusion therapy in ST-elevation myocardial infarction. The FAST-MI 2010 registry

Author

Puymirat, Etienne, Caudron, Julia, Steg, Philippe G, Lemesle, Gilles, Cottin, Yves, Coste, Pierre, Schiele, François, de Labriolle, Axel, Bataille, Vincent, Ferrières, Jean, Simon, Tabassome, and Danchin, Nicolas

Abstract

Aims: Current guidelines recommend short time delays from qualifying ECG to reperfusion therapy in ST-elevation myocardial infarction (STEMI) patients. Recently, however, it has been suggested that shortening door-to-balloon times might not result in lower mortality, thereby questioning the relevance of current guidelines. The aim of this study was to assess in-hospital and one-year mortality in patients with fibrinolysis or primary percutaneous coronary intervention (PPCI) according to guidelines-recommended times to reperfusion therapy.Methods and results: FAST-MI 2010 is a nationwide French registry including 4169 patients, of whom 1580 had ST-elevation myocardial infarction and had PPCI (n=1289) or fibrinolysis (n=291) as part of a pharmaco-invasive strategy. Four groups were constituted: Gr1 (within recommended times from ECG to PPCI; n=708), Gr2 (beyond recommended times from ECG to PPCI; n=581), Gr3 (time from ECG to lysis ?30 min, n=196), and Gr4 (time from ECG to lysis >30 min, n=95). In-hospital mortality was 3.6% in Gr2 vs. 1.0% in Gr1 and 3.2% in Gr4 vs. 1.0% in Gr3. After adjustment, hospital mortality was higher for reperfusion therapy beyond recommended times: odds ratio (OR) 3.29, 95% confidence interval (CI) 1.32–8.18; for PPCI, OR: 4.13; 95% CI: 1.50–11.35 and for fibrinolysis, OR: 2.72; 95% CI: 0.34–21.96. Likewise, one-year mortality was higher in patients with reperfusion beyond recommended times (hazard ratio 2.13, 95% CI:1.29–3.50). The results were confirmed by propensity score analyses.Conclusions: Early and one-year mortality were lower for ST-elevation myocardial infarction patients when the recommended timelines for reperfusion therapy were met, suggesting that, in spite of recent interrogations, compliance with current guidelines remains a clinically relevant objective.

Published
2017
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182. How obesity affects the cut-points for B-type natriuretic peptide in the diagnosis of acute heart failure: Results from the Breathing Not Properly Multinational Study.

Author

Daniels, Lori B., Clopton, Paul, Bhalla, Vikas, Krishnaswamy, Padma, Nowak, Richard M., McCord, James, Hollander, Judd E., Duc, Philippe, Omland, Torbjørn, Storrow, Alan B., Abraham, William T., Wu, Alan H.B., Steg, Philippe G., Westheim, Arne, Knudsen, Cathrine Wold, Perez, Alberto, Kazanegra, Radmila, Herrmann, Howard C., McCullough, Peter A., and Maisel, Alan S.

Subjects
HEART disease diagnosis, HEART failure, CARDIAC arrest, METABOLIC disorders
Abstract

Background: B-type natriuretic peptide (BNP) is valuable in diagnosing heart failure (HF), but its utility in obese patients is unknown. Studies have suggested a cut-point of BNP ≥100 pg/mL for the diagnosis of HF; however, there is an inverse relation between BNP levels and body mass index. We evaluated differential cut-points for BNP in diagnosing acute HF across body mass index levels to determine whether alternative cut-points can improve diagnosis. Methods: The Breathing Not Properly Multinational Study was a 7-center, prospective study of 1586 patients who presented to the Emergency Department with acute dyspnea. B-type natriuretic peptide was measured on arrival. Height and weight data were available for 1368 participants. The clinical diagnosis of HF was adjudicated by 2 independent cardiologists who were blinded to BNP results. Results: Heart failure was the final diagnosis in 46.1%. Mean BNP levels (pg/mL) in lean, overweight/obese, and severely/morbidly obese patients were 643, 462, and 247 for patients with acute HF, and 52, 35, and 25 in those without HF, respectively (P < .05 for all comparisons except 35 vs 25). B-type natriuretic peptide cut-points to maintain 90% sensitivity for a HF diagnosis were 170 pg/mL for lean subjects, 110 pg/mL for overweight/obese subjects, and 54 pg/mL in severely/morbidly obese patients. Conclusions: Body mass index influences the selection of cut-points for BNP in diagnosing acute HF. A lower cut-point (BNP ≥54 pg/mL) should be used in severely obese patients to preserve sensitivity. A higher cut-point in lean patients (BNP ≥170 pg/mL) could be used to increase specificity. [Copyright &y& Elsevier]

Published
2006
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183. Abstract 11884: Comparison of Investigator-Reported and Adjudicated Events From SOLOIST-WHF and SCORED

Author

Gaba, Prakriti, Bhatt, Deepak L, Steg, Philippe G, Banks, Phillip, Davies, Michael J, Szarek, Michael, and Pitt, Bertram

Abstract

Introduction:Sotagliflozin reduced investigator reported cardiovascular (CV) deaths, hospitalizations for heart failure (HHF), and urgent visits for heart failure (UVHF) in SOLOIST-WHF and SCORED. The objective of the present analysis was to determine if the treatment effects on adjudicated events were consistent those on investigator reported events in each trial.Methods:SOLOIST-WHF and SCORED were Phase 3, multicenter, randomized, double-blind, trials evaluating sotagliflozin versus placebo in 1,222 patients with type 2 diabetes (T2D) admitted for a worsening heart failure event and in 10,584 patients with T2D, chronic kidney disease, and other CV risk factors, respectively. The primary composite endpoint was a composite of CV death, HHF, and UVHF. Treatment effects on investigator reported events and available adjudicated events were estimated in proportional hazards models.Results:Rates of the investigator reported primary composite endpoint were higher in the SOLOIST-WHF trial compared with the SCORED trial. However, relative risk reductions for the investigator reported primary composite endpoint were similar between SCORED (0.67[0.53, 0.85]) and SOLOIST-WHF (0.75[0.63, 0.88]). All components of the endpoint positively contributed to the overall outcome, with HHF having the largest effect. When compared with adjudicated outcomes, results were generally similar between the primary and sensitivity analyses using various combinations of total or first occurrences (Figure).Conclusions:Sotagliflozin led to consistent and significant reductions in CV death, HHF, and UVHF in both randomized trials, as determined by blinded investigator-reported assessment as well as by independent, blinded adjudication. These results support the overall robustness of the findings for both trials.

Published
2022
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184. Abstract 13639: Bivalirudin versus Heparin in Patients With STEMI Undergoing PCI: Individual-Patient-Data Pooled Analysis of the 6 Major Randomized Trials

Author

Bikdeli, Behnood, Valgimigli, Marco, Erlinge, David, Kastrati, Adnan, Steg, Philippe G, Yaling, Han, Stables, Rod, Mehran, Roxana, Frigoli, Enrico, James, Stefan K, patrick, GOLDSTEIN, Li, Yi, Shahzad, Adeel, Schuepke, Stefanie, Chen, Shmuel, Mehdipoor, Ghazaleh, Redfors, Bjorn, Crowley, Aaron, Zhou, Zhipeng, and Stone, Gregg

Abstract

Background:Given differences in prior trial designs, the treatment tradeoffs between bivalirudin and heparin in patients with STEMI undergoing PCI remain uncertain. Study-level meta-analyses lack granularity to provide conclusive answers or assess subgroups.Methods:We performed an individual-patient-datapooled analysis from all 6 large (n>1000) RCTs of bivalirudin vs heparin in STEMI pts undergoing PCI (BRIGHT, EUROMAX, HEAT-PPCI, HORIZONS-AMI, MATRIX, and VALIDATE-SWEDEHEART). The primary efficacy outcome was the 30-day rate of all-cause mortality. Subgroup analyses were performed according to planned use of glycoprotein IIb/IIIa inhibitors (GPI), and administration of a post-PCI bivalirudin infusion.Results:A total of 15,254 patients with STEMI undergoing PCI were included (7,306 randomized to bivalirudin and 7,948 to heparin [43.6% with planned GPI use]). Thirty-day mortality was not significantly different between bivalirudin vs heparin (aHR: 0.80; 95% CI: 0.64, 1.01); 30-day cardiac mortality was reduced with bivalirudin (aHR: 0.72; 95% CI: 0.57, 0.91). There was a higher risk of 30-day MI (aHR: 1.29, 95% CI: 1.02, 1.64) and stent thrombosis (aHR: 1.42; 95 % CI: 1.05, 1.91) but lower risk of serious bleeding (aHR: 0.57 (0.47, 0.68) with bivalirudin vs heparin. At 1 year, net adverse clinical events were reduced with bivalirudin (aHR: 0.84; 95% CI: 0.77, 0.93) (Table). All-cause mortality was reduced with bivalirudin when a post-PCI infusion was used. A high-dose post-PCI infusion mitigated the 30-day MI and ST risks, irrespective of planned GPI use with heparin.Conclusions:In patients with STEMI undergoing PCI, procedural anticoagulation with bivalirudin did not reduce all-cause mortality. Cardiac mortality and serious bleeding were reduced with bivalirudin at the cost of increased rates of MI and ST. Full analyses will be presented at AHA 2022.

Published
2022
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185. Abstract 13699: Bivalirudin versus Heparin in Patients With NSTEMI Undergoing PCI: Individual-Patient-Data Pooled Analysis of the 5 Major Randomized Trials

Author

Bikdeli, Behnood, Valgimigli, Marco, Erlinge, David, Kastrati, Adnan, Steg, Philippe G, Yaling, Han, Stables, Rod, Mehran, Roxana, Frigoli, Enrico, James, Stefan K, patrick, GOLDSTEIN, Li, Yi, Shahzad, Adeel, Schuepke, Stefanie, Chen, Shmuel, Mehdipoor, Ghazaleh, Redfors, Bjorn, Crowley, Aaron, Zhou, Zhipeng, and Stone, Gregg

Abstract

Background:Whether there are treatment tradeoffs between bivalirudin and heparin in patients with NSTEMI undergoing PCI is controversial. Study-level meta-analyses lack granularity to provide conclusive answers or assess subgroups.Methods:We performed an individual-patient-datapooled analysis from all 5 large (n >1000) RCTs of bivalirudin vs heparin in NSTEMI patients undergoing PCI (MATRIX, VALIDATE-SWEDEHEART, ISAR-REACT 4, ACUITY, BRIGHT). The primary efficacy outcome was the 30-day rate of all-cause mortality. Other prespecified outcomes included 30-day serious bleeding, 1-year mortality, and 30-day and 1-year MACCE, and net adverse clinical events (NACE). Subgroup analyses were performed according to access site and post-PCI bivalirudin infusion.Results:A total of 12,155 patients with NSTEMI undergoing PCI were randomized to bivalirudin alone (n=6,040, 52.3% with a post-PCI infusion) or to heparin (n=6,115, 53.2% with planned use of a GPIIb/IIIa inhibitor). Thirty-day mortality was not significantly different between bivalirudin vs heparin (aHR: 1.21; 95% CI: 0.84-1.73). There was a lower risk of 30-day serious bleeding with bivalirudin vs heparin (aHR: 0.63; 95% CI: 0.52, 0.76). At 1-year follow-up, there was no significant difference between bivalirudin and heparin for all-cause mortality (aHR: 0.97; 95% CI: 0.79, 1.19), MACCE (aHR: 1.03; 95% CI: 0.94, 1.13) or NACE (aHR: 0.92 0.84, 1.00). There were no significant differences between bivalirudin or heparin in the rates of MI or stent thrombosis (Table). Findings were consistent irrespective of access site (femoral vs radial), and post-PCI infusion of bivalirudin.Conclusions:In patients with NSTEMI undergoing PCI, procedural anticoagulation with bivalirudin was not associated with improvements in 30-day or 1-year mortality or MACCE compared with heparin with or without GPIIb/IIIa inhibitor, although serious bleeding was reduced. Full analyses will be presented at AHA 2022.

Published
2022
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186. Abstract 10291: Elevated C-Reactive Protein Level Amplifies the Association of Lipoprotein(a) With Cardiovascular Risk and Risk Reduction With Alirocumab After Acute Coronary Syndrome

Author

Schwartz, Gregory G, Szarek, Michael, Bhatt, Deepak, Bittner, Vera A, Diaz, Rafael, Garon, Genevive, Goodman, Shaun G, Harrington, Robert A, Jukema, J Wouter W, Manvelian, Garen, Pordy, Robert, White, Harvey D, Zeiher, Andreas M, and Steg, Philippe G

Abstract

Background:In the ODYSSEY OUTCOMES trial (NCT01663402) the PCSK9 inhibitor alirocumab [ALI] reduced the risk of cardiovascular events [CVE] after acute coronary syndrome [ACS] in patients [pts] with elevated atherogenic lipoproteins despite optimized statin treatment, an effect modified by baseline levels of lipoprotein [Lp](a). Levels of the inflammatory biomarker high-sensitivity C-reactive protein [hsCRP] are associated with risk after ACS. In this post hoc analysis, we determined whether Lp(a)-associated risk of CVE after ACS and reduction in that risk with ALI are modified by concurrent hsCRP levels.Methods:18,924 pts were randomized to ALI or placebo [PBO] 1-12 months after ACS and followed for median 2.8 years. Baseline Lp(a) and hsCRP were available in 18,290 pts. CVE [CV death, non-fatal MI, stroke, unstable angina or heart failure hospitalization, ischemia-driven coronary revascularization, peripheral artery events, and venous thromboembolism] were evaluated by baseline quartile of Lp(a) and by hsCRP dichotomized at 0.2 mg/dL.Results:Median (Q1-Q3) baseline Lp(a) was 21.3 (6.7-59.6) mg/dL. In 10,323 pts with baseline hsCRP<0.2 mg/dL (Fig top) risk of CVE in the PBO group increased modestly in Lp(a) Q4 (Ptrend=0.0592). Overall treatment hazard ratio [HR] was 0.91 without significant trend across Lp(a) quartiles. In 7967 pts with baseline hsCRP≥0.2 mg/dL (Fig bottom) risk of CVE in the PBO group was elevated and increased across Lp(a) quartiles (Ptrend<0.0001). Overall treatment HR was 0.82 and decreased across Lp(a) quartiles (Ptrend=0.0003).Conclusion:Elevated hsCRP amplifies the relationship of Lp(a) with risk of CVE after ACS and the reduction in that risk with alirocumab. Funding:Sanofi, Regeneron Pharmaceuticals

Published
2022
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187. Abstract 10470: Projected Lifetime Benefits of Alirocumab in Patients After Acute Coronary Syndrome

Author

Budaj, Andrzej, Elbez, Yedid, Schwartz, Gregory G, Bhatt, Deepak L, Bittner, Vera A, Chua, Terrance Sing Jin, Diaz, Rafael, Goodman, Shaun G, Harrington, Robert A, Jukema, J Wouter, Kedev, Sasko, Laucevicius, Alexander, MORAIS, JOAO, MURIN, Jan, Parkhomenko, Alexander, Pordy, Robert, Scemama, Michel, Szarek, Michael, White, Harvey D, and Steg, Philippe G

Abstract

Introduction:In the ODYSSEY OUTCOMES trial, alirocumab improved cardiovascular outcomes and reduced death after acute coronary syndrome (ACS). Median follow-up was 2.8 yrs (range 2-5). The effects of alirocumab on long-term survival are unknown.Objective:To calculate projected life span and potential survival gains with alirocumab vs placebo after ACS using validated nonparametric age-based methods.Methods:In ODYSSEY OUTCOMES (NCT01663402), 18,924 patients with recent ACS and elevated atherogenic lipoproteins despite high-intensity or maximum-tolerated statin therapy were randomized to alirocumab or placebo. All-cause death was a secondary trial outcome. Age-based estimates of projected survival and event-free (all-cause death, nonfatal myocardial infarction, nonfatal ischemic stroke) survival were calculated. In each treatment arm at every year of age, lifespan was estimated from area under the survival curve, to a maximum of 85 yrs. Differences in areas under the survival curves provide an estimate of the benefit of alirocumab on survival.Results:Mean (SD) baseline age was 58.5 (9.3) yrs. Mean survival benefits with alirocumab vs placebo ranged from 0.03 to 1.62 yrs, decreasing with age and becoming neutral at age 80-85 yrs. For example, at age 40, estimated survival was another 37.5 yrs with alirocumab and 35.9 yrs with placebo (difference 1.62 yrs [95% CI, 0.30-2.94]; P=0.016). At age 60, it was 20.5 vs 19.6 yrs (difference 0.88 [95% CI, 0.16-1.61]; P=0.017); at age 75 it was 8.8 vs 8.3 (difference 0.57 [0.09-1.05]; P=0.019); and at age 80, it was 4.5 vs 4.5 years (difference 0.03 [-0.28 to 0.35]; P=0.83). Mean event-free survival benefit similarly ranged from 1.85 to 0.0 yrs.Conclusions:Modeling suggests that long-term treatment with alirocumab may result in a meaningful increase in survival among patients less than 80 yrs of age. This analysis may facilitate shared decision-making with patients. Funding:Sanofi, Regeneron Pharmaceuticals

Published
2022
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188. Abstract 10209: The Effect of the Dual SGLT1 and 2 Inhibitor Sotagliflozin on Cardiovascular Mortality and Hospital Readmission Rates for Heart Failure at 30 and 90 Days Post Discharge in Patients With Type 2 Diabetes Hospitalized for Worsening Heart Failure in the SOLOIST-WHF Trial

Author

Pitt, Bertram, Bhatt, Deepak L, Szarek, Michael, Sun, Franklin, Davies, Michael J, and Steg, Philippe G

Abstract

Introduction:SGLT inhibitors demonstrate reductions in CV mortality and HHF in patients with diabetes and chronic HF. Despite therapy, patients hospitalized for worsening HF (WHF) are at high risk of death or readmission.Hypothesis:The SOLOIST-WHF trial admitted patients for their index WHF event and initiated randomized therapy during hospitalization. This study evaluated the effect of the SGLT1 and 2 inhibitor sotagliflozin on 30- and 90-day CV death and HF readmission rates after discharge.Methods:Of 1222 randomized patients with T2D, 86% were admitted for their index WHF event. Of them, 46% (n = 563) started study drug prior to or at discharge. In post hoc exploratory analyses, CV death and HF readmission (HHF or urgent visits for HF) rates were determined 30- or 90-days post discharge. Comparisons were done by Cochran-Mantel-Haenszel test stratified by region and baseline LVEF (<50%, ≥50%).Results:Treatment with sotagliflozin showed significant relative risk reduction of >50% for readmission for non-fatal HF-related events or the composite of CV death and readmission for HF-related events within 30 or 90 days of discharge vs placebo (Table 1). The sotagliflozin safety profile in those windows was generally consistent with the overall study duration. Incidence of adverse events (AEs) and serious AEs was similar between groups. Increased incidence of diarrhea and volume-related AEs was noted with sotagliflozin. No appreciable eGFR change from baseline occurred at 30 days, but there was lower incidence of AEs linked to acute kidney injury with sotagliflozin.Conclusions:Sotagliflozin, given to patients with T2D prior to or at hospital discharge after an episode of WHF, was well tolerated and resulted in a significant >50% reduction in CV mortality or readmission for a HF event at 30 and 90 days post-discharge.

Published
2022
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189. Management of acute coronary syndromes. Variations in practice and outcome. Findings from the Global Registry of Acute Coronary Events (GRACE).

Author

Fox, K. A. A., Goodman, S. G., Klein, W., Brieger, D., Steg, P. G., Dabbous, O., and Avezum, Á.

Abstract

Aims Despite advances in the treatment of acute coronary syndromes based on randomized trial data and published guidelines, the extent to which such treatments are applied in practice remains uncertain. Data from clinical trials derive from selected geographical areas and in highly selected populations of patients, and hence may not reflect the overall population. The aim of the study was to investigate variations in hospital management and outcome using unselected data collected in the prospective Global Registry of Acute Coronary Events (GRACE). Methods and Results The 95 hospitals in GRACE were organized into 18 population-based clusters in 14 countries. Information was recorded about patient management and outcome during hospitalization and after discharge. Data on treatments administered were analysed by baseline condition, hospital type, by the presence or absence of a catheterization laboratory, and by geographical region. Of 11543 patients, 44% had an admission diagnosis of unstable angina, 36% presented with myocardial infarction, 9% were admitted to rule out a myocardial infarction, 7% had chest pain and 4% were hospitalized for ‘other cardiac’ and ‘non-cardiac’ diagnoses. Of the total GRACE population 38% had a final diagnosis of unstable angina, 30% ST-segment elevation myocardial infarction, 25% non-ST-segment elevation myocardial infarction, and 7% of ‘other cardiac’ and ‘non-cardiac’ final diagnoses. The event rates for hospital death or reinfarction were six and 2% for non-ST-segment elevation myocardial infarction, seven and 3% for ST-segment elevation myocardial infarction, and 3% hospital death for unstable angina. The use of aspirin was similar across all hospital types and geographical regions. In contrast, the use of percutaneous coronary intervention and glycoprotein IIb/IIIa inhibitors was higher (P<0·0001) in teaching hospitals and hospitals with catheterization laboratories and was also higher in the United States. At discharge a higher percentage (P<0·0001) of patients received angiotensin-converting enzyme inhibitors in hospitals without catheterization laboratories. The use of statins was lower in non-teaching hospitals and in centres without a catheterization laboratory. Conclusions The GRACE study reveals substantial differences in the management of patients based on hospital type and geographical location. Further analyses will determine whether such variations translate into differences in longer term outcomes. GRACE provides a multinational reference for the implementation of therapies of proven efficacy. Copyright 2002 The European Society of Cardiology. Published by Elsevier Science Ltd. All rights reserved. [ABSTRACT FROM PUBLISHER]

Published
2002
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190. The cost implications of an early versus delayed invasive strategy in acute coronary syndromes: the TIMACS study

Author

Bainey, Kevin R., Gafni, Amiram, Rao-Melacini, Purnima, Tong, Wesley, Steg, Philippe G., Faxon, David P., Lamy, Andre, Granger, Christopher B., Yusuf, Salim, and Mehta, Shamir R.

Abstract

AbstractBackground:The Timing of Intervention in Acute Coronary Syndromes (TIMACS) trial demonstrated that early invasive intervention (within 24 hours) was similar to a delayed approach (after 36 hours) overall but improved outcomes were seen in patients at high risk. However, the cost implications of an early versus delayed invasive strategy are unknown.Methods and results:A third-party perspective of direct cost was chosen and United States Medicare costs were calculated using average diagnosis related grouping (DRG) units. Direct medical costs included those of the index hospitalization (including clinical, procedural and hospital stay costs) as well as major adverse cardiac events during 6 months of follow-up. Sensitivity and sub-group analyses were performed. The average total cost per patient in the early intervention group was lower compared with the delayed intervention group (−1170; 95 CI −2542 to 202). From the bootstrap analysis (5000 replications), the early invasive approach was associated with both lower costs and better clinical outcomes regarding death/myocardial infarction (MI)/stroke in 95.1 of the cases (dominant strategy). In high-risk patients (GRACE score 141), the net reduction in cost was greatest (−3720; 95 CI −6270 to −1170). Bootstrap analysis revealed 99.8 of cases were associated with both lower costs and better clinical outcomes (death/MI/stroke).Limitations:We were unable to evaluate the effect of community care and investigations without hospitalization (office visits, non-invasive testing, etc). Medication costs were not captured. Indirect costs such as loss of productivity and family care were not included.Conclusions:An early invasive management strategy is as effective as a delayed approach and is likely to be less costly in most patients with acute coronary syndromes.

Published
2014
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191. Safety and efficacy of drug-eluting stents in women: a patient-level pooled analysis of randomised trials

Author

Stefanini, Giulio G, Baber, Usman, Windecker, Stephan, Morice, Marie-Claude, Sartori, Samantha, Leon, Martin B, Stone, Gregg W, Serruys, Patrick W, Wijns, William, Weisz, Giora, Camenzind, Edoardo, Steg, Philippe G, Smits, Pieter C, Kandzari, David, Von Birgelen, Clemens, Galatius, Søren, Jeger, Raban V, Kimura, Takeshi, Mikhail, Ghada W, Itchhaporia, Dipti, Mehta, Laxmi, Ortega, Rebecca, Kim, Hyo-Soo, Valgimigli, Marco, Kastrati, Adnan, Chieffo, Alaide, and Mehran, Roxana

Abstract

The safety and efficacy of drug-eluting stents (DES) in the treatment of coronary artery disease have been assessed in several randomised trials. However, none of these trials were powered to assess the safety and efficacy of DES in women because only a small proportion of recruited participants were women. We therefore investigated the safety and efficacy of DES in female patients during long-term follow-up.

Published
2013
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195. Improved efficiency of arterial gene transfer by use of poloxamer 407 as a vehicle for adenoviral vectors.

Author

Feldman, L J, Pastore, C J, Aubailly, N, Kearney, M, Chen, D, Perricaudet, M, Steg, P G, and Isner, J M

Subjects
GENE therapy, CARDIOVASCULAR disease treatment, GENETIC transformation
Abstract

Improvement in the efficiency of adenovirus-mediated arterial gene transfer may augment the utility of cardiovascular gene therapy. In vitro studies suggest that poloxamer 407 enhances transfection efficiency of adenoviral vectors in vascular smooth muscle cells. The aim of the present study was to investigate whether poloxamer 407 facilitates adenovirus-mediated arterial transfection in vivo as well. Gene transfer was performed in balloon-injured rat carotid arteries using E1- adenoviral vectors diluted in either poloxamer 407 or phosphate buffered saline (PBS). Transfection efficiency was significantly higher in rats transfected using a nuclear β-galactosidase expressing adenovector diluted in poloxamer 407 versus PBS (morphometry: 13.2 ± 1.3% versus 4.1 ± 0.4% transfected medial cells, P = 0.0001; chemiluminescence: 1.4 ± 0.2 versus 0.4 ± 0.2 mU β-galactosidase/mg protein, P = 0.004). Moreover, in the presence of poloxamer 407, it was possible to reduce the incubation time of adenoviral vectors from 20 to 10 min without compromising transfection efficiency. Poloxamer 407 did not evoke specific tissue toxicity. Site-specificity of arterial gene transfer, assessed by PCR, was not altered by administration of poloxamer 407. These findings suggest that poloxamer 407 may be useful to improve the efficiency of adenovirus-mediated arterial gene transfer. [ABSTRACT FROM AUTHOR]

Published
1997
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196. Uncovering Heart Failure in Patients with a History of Pulmonary Disease: Rationale for the Early Use of B‐type Natriuretic Peptide in the Emergency Department

Author

McCullough, Peter A., Hollander, Judd E., Nowak, Richard M., Storrow, Alan B., Duc, Philippe, Omland, Torbjørn, McCord, James, Herrmann, Howard C., Steg, Philippe G., Westheim, Arne, Knudsen, Cathrine Wold, Abraham, William T., Lamba, Sumant, Wu, Alan H.B., Perez, Alberto, Clopton, Paul, Krishnaswamy, Padma, Kazanegra, Radmila, and Maisel, Alan S.

Abstract

Plasma B‐type natriuretic peptide (BNP) can reliably identify acute congestive heart failure (CHF) in patients presenting to the emergency department (ED) with acute dyspnea. Heart failure, asthma, and chronic obstructive pulmonary disease (COPD) are syndromes where dyspnea and wheezing are overlapping signs, and hence, these syndromes are often difficult to differentiate. Objective:To determine whether BNP can distinguish new‐onset heart failure in patients with COPD or asthma presenting with dyspnea to the ED. Methods:The BNP Multinational Study was a seven‐center prospective study of 1,586 adult patients presenting to the ED with acute dyspnea who had blinded BNP levels measured on arrival with a rapid, point‐of‐care device. This study evaluated the 417 patients with no previous history of heart failure and a history of asthma or COPD as a subgroup from the 1,586 adult patients in the BNP Multinational Study. The reference standard for CHF was adjudicated by two independent cardiologists, also blinded to BNP results, who reviewed all clinical data and standardized CHF scores. Results:A total of 417 subjects (mean age 62.2 years, 64.4% male) had a history of asthma or COPD withouta history of CHF. Of these, 87/417 (20.9%, 95% CI = 17.1% to 25.1%) were found to have CHF as the final adjudicated diagnosis. The emergency physicians identified a minority, 32/87 (36.8%), of these patients with CHF. The mean BNP values (± SD) were 587.0 ± 426.4 and 108.8 ± 221.3 pg/mL for those with and without CHF (p < 0.0001). At a cutpoint of 100 pg/mL, BNP had the following decision statistics: sensitivity 93.1%, specificity 77.3%, positive predictive value 51.9%, negative predictive value 97.7%, accuracy 80.6%, positive likelihood ratio 4.10, and negative likelihood ratio 0.09. If BNP would have been added to clinical judgment (high ≥ 80% probability of CHF), at a cutpoint of 100 pg/mL, 83/87 (95.4%) of the CHF subjects would have been correctly diagnosed. Multivariate analysis found BNP to be the most important predictor of CHF (OR = 12.1, 95% CI = 5.4 to 27.0, p < 0.0001). In the 87 subjects found to have CHF, 39.0%, 22.2%, and 54.8% were taking angiotensin‐converting enzyme inhibitors (ACEIs), beta‐blockers (BBs), and diuretics on a chronic basis, respectively. Conclusions:The yield of adding routine BNP testing in patients with a history of asthma or COPD in picking up newly diagnosed CHF is approximately 20%. This group of patients presents a substantial therapeutic opportunity for the initiation and chronic administration of ACEI and BB therapy, as well as other CHF management strategies.

Published
2003
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197. B-type natriuretic peptide and renal function in the diagnosis of heart failure: An analysis from the breathing not properly multinational study

Author

McCullough, Peter A., Duc, Philippe, Omland, Torbjørn, McCord, James, Nowak, Richard M., Hollander, Judd E., Herrmann, Howard C., Steg, Philippe G., Westheim, Arne, Knudsen, Cathrine Wold, Storrow, Alan B., Abraham, William T., Lamba, Sumant, Wu, Alan H.B., Perez, Alberto, Clopton, Paul, Krishnaswamy, Padma, Kazanegra, Radmila, and Maisel, Alan S.

Abstract

Background:Both B-type natriuretic peptide (BNP) and renal function are prognostic indicators of survival in patients with congestive heart failure (CHF). However, relationships between BNP, renal function, and heart failure as an emergency diagnosis are unknown. Methods:The Breathing Not Properly Multinational Study was a prospectively designed diagnostic test evaluation study conducted in seven centers. Of 1,586 participants who presented with acute dyspnea, 1,452 patients (91.6%) had both BNP level and baseline estimated glomerular filtration rate (eGFR) available. Patients with an eGFR less than 15 mL/min/1.73 m2and those on dialysis therapy were excluded. The final diagnosis was adjudicated by two independent cardiologists who were blinded to BNP results. Results:The final diagnosis was CHF in 715 patients (49.2%). Raw and log-log transformed correlations between BNP and eGFR values were r= −0.19 and r= −0.17 for those with CHF and r= −0.20 and r= −0.31 for those without CHF (both P< 0.0001 for r≠ 0). Mean BNP levels were 561.6 pg/mL (162.3 fmol/mL), 647.5 pg/mL (187.1 fmol/mL), 745.6 pg/mL (215.5 fmol/mL), and 850.7 pg/mL (245.8 fmol/mL) for those with CHF and 85.4 pg/mL (24.7 fmol/mL), 131.7 pg/mL (38.1 fmol/mL), 297.2 pg/mL (85.9 fmol/mL), and 285.0 pg/mL (82.3 fmol/mL) for those without CHF in eGFR categories of 90 or greater, 89 to 60, 59 to 30, and less than 30 mL/min/1.73 m2, respectively. The area under the receiver operating characteristic curve and optimum cut points for BNP were 0.91 and 70.7 pg/mL (20.4 fmol/mL), 0.90 and 104.3 pg/mL (30.1 fmol/mL), 0.81 and 201.2 pg/mL (58.1 fmol/mL), and 0.86 and 225.0 pg/mL (65.0 fmol/mL) for the eGFR categories of 90 or greater, 89 to 60, 59 to 30, and less than 30 mL/min/1.73 m2, respectively. Conclusion:Renal function correlates weakly with BNP and influences the optimal cut point for BNP, particularly in those with an eGFR less than 60 mL/min/1.73 m2. Am J Kidney Dis41:571-579. © 2003 by the National Kidney Foundation, Inc.

Published
2003
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198. Liste des auteurs

Author

Abadie, Y., Abou-Ayache, R., Adhoum, A., Adib-Conquy, M., Adnet, F., Ait Hssain, A., Albanese, J., Alquier, P., Amstutz, P., Anglicheau, D., Annane, D., Annat, G., Ansart, S., Antoun, S., Anxionnat, R., Appéré de Vecchi, C., Argaud, L., Arich, C., Arrault, X., Arrivé, L., Asfar, P., Attaix, D., Aumeran, C., Auneau, J.-C., Ayem, M.-L., Azoulay, E., Barbar, S., Barnoud, D., Baron, D., Barouk, D., Barraud, D., Barry, B., Barthélémy, A., Bastien, O., Baud, F., Baudin, F., Bauwens, M., Bazin, C., Beague, S., †Beaufrère, B., Bedock, B., Bedon-Carte, S., Bédos, J.-P., Bédry, R., Bégueret, H., Belaouchi, F., Belle, E., Benali, A., Bengler, C., Benyamina, M., Bernardin, G., Berré, J., Bertrand, J.-C., Bilbault, P., Binoche, A., Biour, M., Bismuth, C., Blackwell, F., Blanc, P.-L., Blanchard, E., Bleichner, G., Blettery, B., Blivet, S., Blot, F., Bobin, S., Boccheciampe, N., Bohé, J., Boiteau, R., Boncompain-Gérard, M., Bonmarchand, G., Bonnaud, I., Bonnet, N., Bouadma, L., Bouchet, M.-F., Bouffandeau, B., Boulain, T., Boulard, G., Boulétreau, P., Boulo, M., Bourgoin, A., Boussat, S., Boussuges, A., Boyer, A., Bracard, S., Briand, E., Bridoux, F., Brivet, F., Brocas, E., Brochard, L., Bruder, N., Bruel, C., Brun-Buisson, C., Bruneel, F., Brun-Vézinet, F., Bumsel, F., Camou, F., Camus, C., Camus, Y., Canaud, B., Cannesson, M., Capellier, G., Capron, F., Carbonell, N., Cariou, A., Carlet, J., Carpentier, F., Carrat, F., Carrat, X., Cartier, F., Cary, E., Castaing, Y., Castelain, V., Cavaillon, J.-M., Cha, O., Chambrier, C., Chambrin, M.-C., Chanard, J., Chapplain, J.-M., Charbonneau, P., Chastre, J., Chaumoitre, K., Chemla, D., Chenine, L., Chevrolet, J.-C., Chiche, J.-D., Chiras, J., Chopin, C., Chouchane, N., Choukroun, M.-L., Clair, B., Clavier, B., Clec'h, C., Cluzel, P., Cochereau, I., Cohadon, F., Cohen, Y., Combe, C., Combes, A., Cordonnier, C., Coriat, P., Corne, P., Coulange, M., Cros, A.-M., Crozier, S., Dailland, P., Danel, V., Darmon, M., Darnal, E., David, S., de Cagny, B., De Deyne, C., De Jonghe, B., Decousus, H., Deklunder, G., Delabranche, X., Delafosse, B., Delahaye, A., Delarue, J., de Montalembert, M., Demoule, A., Dequin, P.-F., Deray, G., Deriaz, H., Descamps, J.-M., Devictor, D., Deye, N., Dhainaut, J.-F., di Costanzo, J., Diehl, J.-L., Dingemans, G., Djibré, M., Doise, J.-M., Dolz, M., Donati, S.Y., Dreyfuss, D., Drizenko, A., Du Cheyron, D., Ducloy-Bouthors, A.-S., Dugernier, T., Duguet, A., Durand, F., Duranteau, J., Durocher, A., Dussaule, J.-C., Eckert, Ph., Edouard, D., El Esper, N., Essig, M., Esteban, C., Eurin, B., Fagon, J.-Y., Faisy, C., Fangio, P., Fartoukh, M., Faurisson, F., Favarel-Garrigues, J.-C., Feihl, F., Ferrand, E., Ferry, T., Fialon, P., Fischer, E., Flamant, M., Flamens, C., Flesch, F., Folscheid, D., Forget, A.-P., Fourel, D., Fournier, A., Fournier, G., Fourrier, F., François, B., Francoz, C., Frat, J.-P., Frederic, M., Friedlander, G., Frossard, J.-L., Gabinski, C., Gainnier, M., Gajdos, P., Gamelin, L., Garo, B., Garot, J., Garré, M., Garrouste-Orgeas, M., Gastinne, H., Gbikpi-Benissan, G., †Gehanno, P., Gelas, P., Genestal, M., Gerbeaux, P., †Gibert, C., Gibot, S., Girault, C., Girot, M., Goarin, J.-P., Godeau, B., Goetghebeur, D., Goldgran-Toledano, D., Gonzalez, F., Goulenok, C., †Goulon, M., Grimaldi, D., Grosdidier, G., Gruson, D., Guenoun, T., Guérin, C., Guérin, J.-M., Guérot, E., Guervilly, C., Gueye, P., Guglielminotti, J., Guiavarch, M., Guidet, B., Guyomarc'h, S., Hallynck, C., Hamzaoui, O., Haniez, F., Harlay, M.-L., Harrois, A., Harry, P., Hasselmann, M., Hattab, A., Hébuterne, X., Heng, A.-É., Hertig, A., Hervé, P., Hilbert, G., Himbert, D., Holzapfel, L., Hommel, S., Houhou, N., Houillier, P., Hours, S., Hurel, D., Ichaï, P., Isnard-Bagnis, C., Jacobs, F., Jaffrelot, M., Jaffuel, S., Janvier, G., Jardel, B., Jardin, F., Jarrin, I., Jars-Guincestre, M.-C., Joly, L.-M., Joly-Guillou, M.-L., Jonquet, O., Joseph, T., Jourdain, M., Journois, D., Jung, B., Kahn, D., Kanfer, A., Karie-Guigues, S., Kerlan, V., Khalil, A., Koffel, J.-C., Kopferschmitt, J., Korach, J.-M., Kummerlen, C., L'Her, E., Laaban, J.-P., Laarbaui, F., Labrousse, J., Lacroix, D., Lachérade, J.-C., Lambert, H., Lanceleur, A., Langeron, O., Langevin, B., Lannes, B., Lapostolle, F., Larmignat, P., Laterre, P.-F., Laurent, C.h., Lautrette, A., Lavaux, T., Laxenaire, M.-C., Le Conte, P., Le Corre, B., Le Gall, C., Le Gall, G., Le Gall, J.-R., Le Prado, D., Le Tulzo, Y., Lebranchu, Y., Leclerc, F., Leclerc, X., Leclercq, R., Lefevre, M., Legendre, C., Leger, P., Legras, A., Lellouche, F., Lemaire, F., Lemiale, V., Lemonnier, M.-P., Léon, A., Léone, M., Leprince, P., Leray-Moragues, H., Lerebours, E., Leverve, X., Lévy, B., Lévy, Ph., Leys, D., Lheureux, P., Lienhart, A., Lissac, J., Loirat, P., Loubières, Y., Lucet, J.-C., Lutun, P., Luyt, C.-E., Maillet, J.-M., Mainardi, J.-L., Mancebo, J., Manel, J., Mangiapan, G., Manier, G., Manzon, C., Manzo-Silberman, S., Marek, A., Marit, G., Markowicz, P., Marqué, S., Marquette, C.-H., Marthan, R., Martin, C., Martin, O., Mathien, C., Mathieu, D., Mattéi, M., Maury, E., Maxime, V., Mayaud, C., Mayeur, C., Mazighi, M., Mégarbane, B., Melchior, J.-C., Mélot, C., Mentec, H., Mercat, A., Mertes, P.-M., Meyer, G., Meziani, F., Michelet, C., Micheletti, G., Mignon, A., Mira, J.-P., Mira, L., Mismetti, P., Misset, B., Monchi, M., Monnet, X., Monnier-Cholley, L., Moriconi, M., Morinière, P., Moritz, F., Mortier, E., Mottier, D., Mourvillier, B., Nace, L., Naeije, R., Nicolas, F., Nicolas-Chanoine, M.-H., Nitenberg, A., Nitenberg, G., Nousbaum, J.-B., Noyon, V., Obadia, E., Oger, E., Onimus, Th., Orizet, C., Ould Ahmed, M., Outin, H., Ozier, Y., Page, Y., Paillard, M., Pairault, M., Pajot, O., Papazian, L., Parer, S., Parquin, F., Parrot, A., Pavie, A., Pène, F., Penouil, F., Peraldi, M.-N., Perrin-Gachadoat, D., Perrotin, D., Petitjean, T., Philippart, F., Philit, F., Picard, L., Picart-Jacq, J.-Y., Pichené, C., Pillet, O., Pinsard, M., Plantefeve, G., Pochard, F., Pocidalo, M.-A., Podglajen, I., Pointet, P., Pourrat, O., Prat, G., Préveraud de Vaumas, C., Pruvo, J.-P., Puntous, M., Rabaud, C., Rabbat, A., Rackelboom, T., Racy, E., Raherison, C., Ralec, B., Ramakers, M., Rambaud, L., Rameix, S., Raphaël, J.-C., Ramon, P., Raynard, B., Régnier, B., Renault, A., Revest, M., Reynaert, M.-S., Reynaud, J., Ribaud, P., Ricard, J.-D., Richalet, J.-P., Richard, C., Richard, J.-C.M., Ricome, J.-L., Ricot, J., Ridel, C., Rigolet, A., Robert, D., Robert, R., Roger, I., Rondeau, E., Roques, S., Rossert, J., Roujeau, J.-C., Rozenberg, A., Rugeri, L., Rusterholtz, T., Sab, J.-M., Safran, D., Saïkhali, E., †Sainty, J.-M., Saissy, J.-M., Saliba, F., Samuel, D., Sauder, P., Saumon, G., Savineau, J.-P., Savoye, G., Schabanel, J.-C., Schaeffer, A., Schaller, M.-D., Schiano, P., Schlemmer, B., Schlossmacher, P., Schneider, F., Schneider, S.-M., Schortgen, F., Schwartz, A., Segouin, C., Seguin, Th., Seknadji, P., Serre-Sapin, A.-F., Sharshar, T., Silleran-Chassany, J., Similowski, T., Simonneau, G., Sitbon, O., Slama, M., Sollet, J.-P., Somme, D., Sonneville, R., Soubrier, S., Soufir, L., Souweine, B., Spaulding, C., Squara, P., Steg, P.-G., Stéphanazzi, J., Sterkers, G., Straus, C., Subtil, D., Sztrymf, B., Tabah, A., Taboulet, P., Tamion, F., Tardy, B., Tardy-Poncet, B., Taright, N., Tasseau, F., Tattevin, P., Tauzin-Fin, P., Teboul, J.-L., Tempé, J.-D., Tenaillon, A., Terzi, N., Tesnière, A., Textoris, J., Thabut, D., Thaler, F., Théodore, J., Thierry, A., Thille, A.W., Thirion, M., Thomas, R., Thuong, M., Timsit, J.-F., Tissières, P., Touchard, G., Tournoud, C., Tournoys, A., Tourtier, Y., Tranchant, C., Troché, G., Trouillet, J.-L., Trzeciak, M.-C., Tunon de Lara, J.-M., Ubeaud-Séquier, G., Vachon, F., Valatx, J.-L., Valentin, J.-M., Vallée, F., Vallet, B., Van de Louw, A., Vargas, F., Venet, C., Verdon, R., Vergier, B., Vésin, A., Vial, A., Viale, J.-P., Viau, F., Vieillard-Baron, A., Vignon, P., Villers, D., Vinatier, I., Vincent, B., Vinsonneau, C., Wassermann, D., Wattel, F., Willems, V., Woimant, F., Wysocki, M., Yéni, P., Zahar, J.-R., and Zelter, M.

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2009
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