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3 results on '"Robert N. Denham"'

1. Regional management of worsening heart failure: rationale and design of the CHAIN‐HF registry

Author

Abdul Shakoor, Mireille E. Emans, Marco W.F. vanGent, Anneke Hendrix, Nikola Faber, Tirza S. Springeling, Liesbeth C. deVette, Olivier C. Manintveld, Robert N. Denham, Chajja van deMeerendonk, Robert M.A. van derBoon, Jasper J. Brugts, and the Rijnmond Heart Failure Network

Subjects
Worsening heart failure, Medical treatment, Advanced heart failure therapies, Hub‐and‐spoke model, Regional collaboration, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Abstract Aims Heart failure (HF) is a progressive disease in which periods of clinical stability are interrupted by episodes of clinical deterioration known as worsening heart failure (WHF). Patients who develop WHF are at high risk of subsequent death, rehospitalization, and excessive healthcare costs. As such, WHF could be seen as a separate disease stage and precursor of advanced HF. Whether WHF has a substantial health, societal, and economic impact evidence regarding its multifactorial nature and the specific barriers in treatment, including advanced HF therapies, remains scarce. The CHAIN‐HF registry aims to describe the incidence, characteristics, current treatment, and outcomes of WHF. Additionally, it will promote structured regional collaboration and educate on increasing awareness for WHF and describe the implementation of guideline directed medical therapy and utilization of advanced HF therapies in a collaborative network. Methods and results The CHAIN‐HF registry is a prospective, observational, and multicentre study from the collaborating hospitals (Rijnmond HF Network) in the Rotterdam area. Unselected and consecutive patients (irrespective of ejection fraction) with a WHF event will be included. Comprehensive data including demographics, co‐morbidities, treatment, and in‐hospital and post‐discharge outcomes will be collected. Notably, data on socio‐economic status, treatment decisions, and referral for advanced HF therapies will be included. Conclusions CHAIN‐HF will be the first prospective, dedicated WHF registry in a collaborative network of hospitals that will provide robust real‐world evidence on the incidence, characteristics, and outcomes of WHF. Moreover, it will provide information on of the value of regional collaboration to improve awareness and outcomes of WHF.

Published
2023
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2. Effect of additional treatment with EXenatide in patients with an Acute Myocardial Infarction: The EXAMI study

Author

Weena J.Y. Chen, Aernout M. Beek, Pieter A. Doevendans, Flip J.P. Bernink, Yolande Appelman, Leo Timmers, Niels van Royen, Otto Kamp, Martijn Scholte, Robert N. Denham, Koen M. Marques, Albert C. van Rossum, Michaela Diamant, Anton J.G. Horrevoets, Cardiology, Clinical pharmacology and pharmacy, Internal medicine, Molecular cell biology and Immunology, and ICaR - Heartfailure and pulmonary arterial hypertension

Subjects
Glucagon-like peptide-1, Male, medicine.medical_specialty, medicine.medical_treatment, Treatment outcome, Myocardial Infarction, Acute myocardial infarction, Percutaneous Coronary Intervention, Glucagon-Like Peptide 1, Internal medicine, medicine, Humans, In patient, Myocardial infarction, Aged, business.industry, Venoms, Follow up studies, Percutaneous coronary intervention, Middle Aged, medicine.disease, Reperfusion injury, Treatment Outcome, Cardiology, Exenatide, Feasibility Studies, Administration, Intravenous, Female, business, Peptides, Cardiology and Cardiovascular Medicine, medicine.drug, Follow-Up Studies
Published
2013

3. THE GLUCAGON-LIKE PEPTIDE-1 RECEPTOR AGONIST EXENATIDE IS SAFE AND MAY BE CARDIOPROTECTIVE IN ACUTE MYOCARDIAL INFARCTION: THE EXAMI PHASE L TRIAL

Author

Yolande Appelman, Niels van Royen, Leo Timmers, A.J.G. Horrevoets, Aernout M. Beek, Otto Kamp, Robert N. Denham, Michaela Diamant, Weena J.Y. Chen, Flip J.P. Bernink, Martijn Scholte, Albert C. van Rossum, and P. A. F. M. Doevendans

Subjects
Cardiac function curve, business.industry, Placebo-controlled study, medicine.disease, Placebo, Anesthesia, Conventional PCI, medicine, Myocardial infarction, business, Cardiology and Cardiovascular Medicine, Exenatide, TIMI, Glucagon-like peptide 1 receptor, medicine.drug
Abstract

Reperfusion limits myocardial necrosis, however induces reperfusion injury leading to additional necrosis and apoptosis. Glucagon Like Peptide-1 (GLP-1), an incretin hormone, has anti-apoptotic properties and proved to be cardioprotective in experimental studies. This pilot study assessed the safety and feasibility of the GLP-1 receptor agonist exenatide in patients with acute MI undergoing primary PCI. Methods: Seventy-one non-diabetic patients with acute MI undergoing primary PCI were randomized to placebo or exenatide 5μg bolus administered in 30 minutes prior to PCI, followed by continuous infusion of 20μg/ 24 hours for 72 hours. Blood samples were obtained including enzymatic infarct size and glucose levels. Magnetic resonance imaging and echocardiography were conducted 3-5 days and 4 months post MI for measurements including infarct size, cardiac function and myocardial salvage index (MSI), a predictor for mortality and major adverse cardiac events. Results: Forty out of 71 randomized patients completed the full protocol. Exclusion was mainly due to angiographic criteria. Patient characteristics were well balanced between the groups. An equal amount of hypo- and hyperglycemic episodes (glucose 10 mmol/L) were observed in both groups. No deaths, CABG or re-infarction occurred during the 4-month follow-up. Although more patients in the exenatide group experienced nausea (58% v 20%, p = 0.015), no decrease or cessation of exenatide was required. Infarct size, cardiac function and MSI at 4 months did not differ signiicantly. However, a trend towards a higher MSI was seen in patients with TIMI 0 and 1 low receiving exenatide (0.65 ± 0.14 (n = 12) v 0.53 ± 0.17 (n = 11), p = 0.09). Conclusions: We demonstrated that administering exenatide in patients with acute MI undergoing primary PCI is feasible and safe. Although not powered for this analysis, Exami phase l seems to show a trend towards a higher MSI in the exenatide group. A large randomized placebo controlled study is required to assess the eficacy of exenatide on myocardial salvage.

Published
2012
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