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1. Prevalence of a History of Metabolic or Hypertensive Pregnancy Disorder in Patients With Myocardial Infarction and Non-obstructive Coronary Arteries: An Observational Cohort Study

Author: Tobias F. S. Pustjens, Nousjka P. A. Vranken, Gwyneth Jansen, Patty J. C. Winkler, Mera Stein, Loes Hoebers, Bas Kietselaer, Marc E. A. Spaanderman, Saman Rasoul, Chahinda Ghossein-Doha, and Arnoud W. J. van 't Hof
Subjects: MINOCA, gestational hypertension, gestational diabetes, preeclampsia, cardiovascular risk factor, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: IntroductionMyocardial infarction with non-obstructive coronary arteries (MINOCA) predominantly affects younger females. Women with a history of gestational hypertension (GH), preeclampsia (PE), and gestational diabetes mellitus (GDM) are subjected to an elevated lifetime risk of cardiovascular disease. However, data on the potential association between these obstetric complications and MINOCA is lacking. Therefore, the current study aimed to provide insight in the prevalence of metabolic and hypertensive pregnancy disorders (MHPD) in MINOCA patients and their clinical characteristics.MethodsIn this observational cohort study conducted at the Zuyderland Medical Center and Maastricht University Medical Center in the Netherlands, patients were enrolled if they were identified as having MINOCA. Data on individual patient characteristics, laboratory results, electrocardiography as well as (non-)invasive imaging procedures were derived from the electronic health record system. Patients were asked to complete a questionnaire about prior MHPD including GDM, GH, and PE. Patients were grouped into those with MHPD and those with prior uncomplicated normotensive pregnancy (or pregnancies; NP).ResultsAfter excluding patients without 1-year follow-up (n = 53), 86 female MINOCA patients remained eligible for analysis. Of the total female population, 25 (29.1%) patients had MHPD, including GH (n = 19; 22.1%), PE (n = 4; 4.7%), and GDM (n = 7; 8.1%). The MHPD patients showed higher rates of chronic hypertension (84.0 vs. 55.7%; p = 0.013), hypercholesterolemia (64.0 vs. 34.4%; p = 0.012), a family history of CVD (84.0 vs. 45.9%; p = 0.001), gout or rheumatic arthritis (16.0 vs. 1.6%; p = 0.024), and were more often non-smokers (45.8 vs. 78.3%; p = 0.004), compared to the NP patients. Moreover, MHPD patients were more likely to use cardiovascular medications at baseline. A trend toward no specific cause found for the MINOCA event was observed in MHPD patients compared to the NP group (64.0 vs. 42.6%, p = 0.072).ConclusionA history of metabolic and hypertensive pregnancy disorders occurred in one-third of female MINOCA patients. In these patients, conventional cardiovascular risk factors were more prevalent compared to NP patients. In most MHPD patients, the specific cause for MINOCA remained unclear.
Published: 2022
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2. Identification of anatomic risk factors for acute coronary events by optical coherence tomography in patients with myocardial infarction and residual nonflow limiting lesions: rationale and design of the PECTUS-obs study

Author: Peep Laanmets, Martijn Meuwissen, Niels van Royen, Robert-Jan van Geuns, Cyril Camaro, Steven Teerenstra, Saman Rasoul, Erik Lipsic, Rohit M Oemrawsingh, Peter Damman, Jan-Quinten Mol, Anouar Belkacemi, Rick HJA Volleberg, Alexey V Protopopov, Oleg V Krestyaninov, Robert Dennert, Jan-Peter van Kuijk, Karin Arkenbout, Dirk J van der Heijden, and Maarten AH van Leeuwen
Subjects: Medicine
Abstract: Introduction In patients with myocardial infarction, the decision to treat a nonculprit lesion is generally based on its physiological significance. However, deferral of revascularisation based on nonischaemic fractional flow reserve (FFR) values in these patients results in less favourable outcomes compared with patients with stable coronary artery disease, potentially caused by vulnerable nonculprit lesions. Intravascular optical coherence tomography (OCT) imaging allows for in vivo morphological assessment of plaque ‘vulnerability’ and might aid in the detection of FFR-negative lesions at high risk for recurrent events.Methods and analysis The PECTUS-obs study is an international multicentre prospective observational study that aims to relate OCT-derived vulnerable plaque characteristics of nonflow limiting, nonculprit lesions to clinical outcome in patients with myocardial infarction. A total of 438 patients presenting with myocardial infarction (ST-elevation myocardial infarction and non-ST-elevation myocardial infarction) will undergo OCT-imaging of any FFR-negative nonculprit lesion for detection of plaque vulnerability. The primary study endpoint is a composite of major adverse cardiovascular events (all-cause mortality, nonfatal myocardial infarction or unplanned revascularisation) at 2-year follow-up. Secondary endpoints will be the same composite at 1-year and 5-year follow-up, target vessel failure, target vessel revascularisation, target lesion failure and target lesion revascularisation.Ethics and dissemination This study has been approved by the Medical Ethics Committee of the region Arnhem-Nijmegen. The results of this study will be disseminated in a main paper and additional papers with subgroup analyses.Trial registration number NCT03857971.
Published: 2021
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3. MINOCA: The caveat of absence of coronary obstruction in myocardial infarction

Author: Nousjka P.A. Vranken, Tobias F.S. Pustjens, Evelien Kolkman, Renicus S. Hermanides, Sebastiaan C.A.M. Bekkers, Martijn W. Smulders, Yvonne J.M. van Cauteren, Jordi Heijman, Saman Rasoul, Jan P. Ottervanger, and Arnoud W.J. van 't Hof
Subjects: ACS/NSTE-ACS, STE-ACS, MINOCA, Clinical research, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: Aims: Whether patients with MINOCA (myocardial infarction with non-obstructive coronary arteries) have better outcomes than patients with obstructive coronary artery disease remains contradictory. The current study focussed on the clinical profile and prognosis of MINOCA patients. Methods and results: We performed a retrospective analysis of patients with acute coronary syndrome (ACS) admitted to the Isala hospital in Zwolle, the Netherlands, between 2006 and 2014. A total of 7693 patients were categorized into three groups: MINOCA, single-vessel obstructive ACS (SV-ACS), and multi-vessel obstructive ACS (MV-ACS). MINOCA patients (5.2% of the total population) were more likely to be female (51.5% vs. 30.3% and 26.0% in SV-ACS and MV-ACS, respectively, p
Published: 2020
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4. Unraveling the Multitude of Etiologies in Myocardial Infarction With Nonobstructive Coronary Arteries

Author: Tobias F.S. Pustjens, Nousjka P.A. Vranken, Renicus S. Hermanides, Saman Rasoul, Jan P. Ottervanger, Arnoud W.J. van‘t Hof, MUMC+: MA Med Staf Spec Cardiologie (9), Cardiologie, and RS: Carim - H01 Clinical atrial fibrillation
Subjects: Male, MINOCA, Myocardial Infarction, Coronary Artery Disease, Coronary Angiography, Prognosis, Coronary Vessels, Risk Factors, Humans, Female, Cardiology and Cardiovascular Medicine, Cardiomyopathies, POSITION PAPER, Retrospective Studies
Abstract: Although recent studies revealed suboptimal outcomes in patients with myocardial infarction with nonobstructive coronary arteries (MINOCAs), the underlying etiology remains unknown in most patients. Therefore, adequate treatment modalities have not yet been established. We aimed to assess demographics, treatment strategies, and long-term clinical outcome in MINOCA subgroups. We retrospectively analyzed data from a large, prospective observational study of patients with acute coronary syndrome admitted to the Isala hospital in Zwolle, The Netherlands between 2006 and 2014. Patients with MINOCA were divided into subgroups based on the underlying cause of the event. From 7,693 patients, 402 patients (5%) concerned MINOCA. After the exclusion of missing cases (n = 47), 5 subgroups were distinguished: "true" acute myocardial infarction (10%), perimyocarditis (13%), cardiomyopathy (including Takotsubo cardiomyopathy) (19%), miscellaneous causes (21%), and an indeterminate group (38%). Patients with cardiomyopathy were predominantly women (78%) and showed the highest incidence of major adverse cardiovascular events at 30 days follow-up (7%; p = 0.012), 1 year (19%; p = 0.004), and mortality at long-term follow-up (27%; p = 0.010) compared with any other MINOCA subgroup. The cardiomyopathy group was followed by the indeterminate group, with major adverse cardiovascular events rates of 1% and 5%, respectively, and 17% long-term all-cause mortality. In conclusion, long-term prognosis in MINOCA depends on the underlying etiology. Prognosis is worst in the cardiomyopathy group followed by the indeterminate group. This underlines the importance of revealing the diagnosis to ultimately optimize treatment.
Published: 2022
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5. A case report of a myocardial ischaemic attack: a novel hyperenhancement pattern on cardiac magnetic resonance in focal ischaemic injury

Author: Hedwig M J M Nies, Tom Vromen, Casper Mihl, Sebastiaan C A M Bekkers, Saman Rasoul, Robert J Holtackers, Martijn W Smulders, Beeldvorming, RS: Carim - B06 Imaging, MUMC+: MA Med Staf Artsass Cardiologie (9), MUMC+: DA BV Medisch Specialisten Radiologie (9), RS: Carim - H01 Clinical atrial fibrillation, MUMC+: MA Med Staf Spec Cardiologie (9), Cardiologie, MUMC+: DA BV Research (9), RS: Carim - Heart, and RS: Carim - Blood
Subjects: ST-elevation myocardial infarction, ENHANCEMENT, Case report, Delayed enhancement cardiac magnetic resonance, Wavefront phenomenon, Cardiology and Cardiovascular Medicine, Myocardial ischaemic attack
Abstract: BackgroundDelayed enhancement cardiac magnetic resonance (DE-CMR) is the reference standard for the non-invasive assessment of myocardial fibrosis. DE-CMR is able to distinguish ischaemic from non-ischaemic aetiologies based on differences in hyperenhancement distribution patterns. Hyperenhancement caused by ischaemic injury typically involves the endocardium, while hyperenhancement confined to the mid- and epicardial layers of the myocardium suggests a non-ischaemic aetiology.Case summaryThis is a case of a 20-year-old male with an unremarkable medical history with an acute ST-elevation myocardial infarction. DE-CMR revealed two distinct patterns of hyperenhancement: (i) a ‘normal’ wavefront-ischaemic pattern, and (ii) multiple atypical mid-wall and epicardial areas of focal hyperenhancement. Invasive coronary angiography (ICA) and coronary computed tomographic angiography (CCTA) showed multiple intracoronary thrombi and distal emboli in the left anterior descending, ramus circumflexus, and in smaller branches of the LCA. All hyperenhancement patterns observed on DE-CMR perfectly matched the distribution territories of the affected coronary arteries.DiscussionThis case with an acute myocardial infarction showed intracoronary thrombi and emboli on ICA and CCTA. Interestingly, DE-CMR showed two different patterns of hyperenhancement in the same territories of the coronary thrombi. This observation may challenge the concept that these non-endocardial areas of hyperenhancement on DE-CMR are always of non-ischaemic aetiology. It is hypothesized that occlusion of smaller distal branches of the coronary arteries may result in mid-wall or epicardial fibrosis as opposed to subendocardial fibrosis commonly found in patients with a large epicardial coronary occlusion. Clinicians should be aware of these atypical patterns to be able to initiate adequate medical therapy.
Published: 2023
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6. Multivessel versus Culprit-Only Percutaneous Coronary Intervention in Patients with Non-ST-Elevation Acute Coronary Syndrome

Author: Tobias F S, Pustjens, Marijke J C, Timmermans, Saman, Rasoul, Arnoud W J, van 't Hof, On Behalf Of The Pci Registration Committee, The Cardiothoracic Surgery Registration Committee Of The Netherlands Heart Registration, Cardiologie, MUMC+: MA Med Staf Artsass Cardiologie (9), MUMC+: MA Med Staf Spec Cardiologie (9), and RS: Carim - H01 Clinical atrial fibrillation
Subjects: UNSTABLE ANGINA, STRATEGIES, PRIMARY PCI, RATIONALE, NSTE-ACS, PCI, General Medicine, multivessel disease, myocardial infarction, LESION, RANDOMIZED-TRIAL, COMPLETE REVASCULARIZATION, MYOCARDIAL-INFARCTION, ARTERY-DISEASE, ANGIOPLASTY
Abstract: Background: There is uncertainty whether multivessel (MV-PCI) or culprit-only percutaneous coronary intervention (CO-PCI) should be the treatment of choice in patients with non-ST segment elevation acute coronary syndrome (NSTE-ACS) and multivessel disease (MVD). Aims: To evaluate clinical characteristics and outcomes in these patients undergoing MV-PCI or CO-PCI at the index procedure. Methods: Data were retrieved from the nationwide Netherlands Heart Registration. All NSTE-ACS patients with MVD undergoing PCI between 1 January 2017 and 1 October 2019 were grouped into a MV-PCI or CO-PCI group. The primary endpoint was all-cause mortality at long-term follow-up (median 756 days (593–996)). Secondary endpoints were reinterventions, urgent CABG, myocardial infarction (MI) < 30 days, target vessel revascularisation (TVR) and mortality at 1 year. Propensity score matching analyses were performed. Results: In total, 10,507 NSTE-ACS patients with MVD were included into the MV-PCI (N = 4235) and CO-PCI group (N = 6272). Analysing crude data, mortality rates at long-term follow-up (10.7% vs. 10.2%; p = 0.383), mortality at 1 year (6.0% vs. 5.6%; p = 0.412) and MI
Published: 2022
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7. Are There Differences in the Demographics and Clinical Outcomes Between Asian and European Patients Treated With the COMBO Dual Therapy Stent in the REDUCE Trial Populations?

Author: Wan Azman Wan Ahmad, Edouard Benit, Cyril Camaro, Elvin Kedhi, Saman Rasoul, Lucia Barbieri, Jacques Lalmand, René J van der Schaaf, Tian Hai Koh, Arnoud W van‘t Hof, Stephen W Lee, Vincent Roolvink, Marc A Brouwer, Giuseppe De Luca, and Harry Suryapranata
Abstract: Background: This study aimed to assess differences in clinical characteristics and outcomes between Asian and European patients treated with the COMBO dual therapy stent in the REDUCE trial. Methods: In the REDUCE trial, 1,496 patients who underwent successful COMBO stent implantation were randomised to 3- or 12-month dual antiplatelet therapy groups. Of these, 449 (30%) were Asian and 1,047 (70%) were European. Given that no significant differences were observed between the 3- and 12-month dual antiplatelet therapy cohorts for both sites, the overall data of Asian patients were compared with those of European patients in terms of clinical characteristics and outcomes. Results: The Asian cohort was younger and comprised fewer women than the European cohort. They also had more cases of type 2 diabetes (33.0% versus 15.1%), hypercholesterolaemia (54.6% versus 41.7%) and hypertension (55.7% versus 48.5%) but had fewer previous interventions compared with European patients. Regarding procedures, Asian patients had more cases of infarct-related vessel in the left anterior descending artery. The primary endpoint indices among Asian patients at 90, 180, 360 and 720 days were lower than those among European patients, which can be attributed to the lower number of cases of target-vessel revascularisation, bleeding (Bleeding Academic Research Consortium classification II, III or V) and MI among the Asian cohort. Conclusion: Despite having a higher incidence of cardiovascular risk factors, more ST-elevation MI cases and more cases of culprit lesion located at the proximal left anterior descending artery, Asian patients in the REDUCE trial showed lower trends of target-vessel revascularisation, bleeding and MI than European patients in the REDUCE trial.
Published: 2022
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8. Sharing primary percutaneous coronary intervention care: first experiences with South Limburg ST-elevation myocardial infarction network

Author: W. Dohmen, Jindra Vainer, A. W. J. van ’t Hof, A. van Beurden, Arpad Lux, Leo Veenstra, M. Ilhan, P. J. C. Winkler, I. Kasperski, Mera Stein, Saman Rasoul, B. Gho, R. A. L. J. Theunissen, A. W. Ruiters, RS: Carim - H01 Clinical atrial fibrillation, Cardiologie, and MUMC+: MA Med Staf Spec Cardiologie (9)
Subjects: medicine.medical_specialty, task-force, delay, IMPACT, medicine.medical_treatment, Quality indicator, Population, GUIDELINES, Patient pathway, St elevation myocardial infarction, MANAGEMENT, Medicine, University medical, Myocardial infarction, education, education.field_of_study, business.industry, Task force, MORTALITY, Percutaneous coronary intervention, medicine.disease, reperfusion, TIME, Conventional PCI, Emergency medicine, Original Article, Cardiology and Cardiovascular Medicine, business, Primary PCI network, regional care
Abstract: Background In the region of South Limburg, the Netherlands, a shared ST-elevation myocardial infarction (STEMI) networking system (SLIM network) was implemented. During out-of-office hours, two percutaneous coronary intervention (PCI) centres—Maastricht University Medical Centre and Zuyderland Medical Centre—are supported by the same interventional cardiologist. The aim of this study was to analyse performance indicators within this network and to compare them with contemporary European Society of Cardiology guidelines. Methods Key time indicators for an all-comer STEMI population were registered by the emergency medical service and the PCI centres. The time measurements showed a non-Gaussian distribution; they are presented as median with 25th and 75th percentiles. Results Between 1 February 2018 and 31 March 2019, a total of 570 STEMI patients were admitted to the participating centres. The total system delay (from emergency call to needle time) was 65 min (53–77), with a prehospital system delay of 40 min (34–47) and a door-to-needle time of 22 min (15–34). Compared with in-office hours, out-of-office hours significantly lengthened system delays (55 (47–66) vs 70 min (62–81), p p p Conclusions With its effective patient pathway management, the SLIM network was able to meet the quality criteria set by contemporary European revascularisation guidelines.
Published: 2021

9. Impact of age on the comparison between short-term vs 12-month dual antiplatelet therapy in patients with acute coronary syndrome treated with the COMBO dual therapy stent: 2-Year follow-up results of the REDUCE trial

Author: Robaayah Zambahari, Erik Ligtenberg, Marc A. Brouwer, Harry Suryapranata, Jacques Lalmand, Jawed Polad, Dariusz Dudek, Giuseppe De Luca, Lucia Barbieri, Cyril Camaro, Leo Veenstra, Philippe Timmermans, Wan Aw. Ahmad, Sonja Postma, Dagmara Dilling-Boer, Arnoud W van 't Hof, Saman Rasoul, Monica Verdoia, René J. van der Schaaf, Edouard Benit, Sander A.J. Damen, Stephen Wl. Lee, Houng Bang Liew, Elvin Kedhi, Tian H. Koh, Evelien Jj. Kolkman, and Vincent Roolvink
Subjects: Male, 0301 basic medicine, Acute coronary syndrome, medicine.medical_specialty, medicine.medical_treatment, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], Subgroup analysis, 030204 cardiovascular system & hematology, Dual therapy stent, 03 medical and health sciences, Percutaneous Coronary Intervention, 0302 clinical medicine, Internal medicine, Clinical endpoint, medicine, Humans, Prospective Studies, Acute Coronary Syndrome, Stroke, Aged, business.industry, Infant, Stent, Drug-Eluting Stents, medicine.disease, Treatment Outcome, 030104 developmental biology, Drug-eluting stent, Child, Preschool, Conventional PCI, Drug Therapy, Combination, Stents, Cardiology and Cardiovascular Medicine, business, Platelet Aggregation Inhibitors, Follow-Up Studies
Abstract: Contains fulltext : 233810.pdf (Publisher’s version ) (Closed access) BACKGROUND AND AIMS: The impact of advanced age on the optimal duration of dual antiplatelet therapy (DAPT) in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary revascularization (PCI) is still greatly debated. Therefore, the aim of the present sub-analysis of the REDUCE trial was to assess the impact of age on the comparison between a short 3 months vs standard 12 months DAPT in ACS patients treated with the COMBO Dual Stent Therapy. METHODS: The REDUCE trial is a prospective, multicenter, investigator-initiated study that randomized ACS patients undergoing PCI with the COMBO drug eluting stent to either 3 or 12 months of DAPT. The study population was divided according to age (
Published: 2021
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10. Long-term outcome after deferred revascularization due to negative fractional flow reserve in intermediate coronary lesions

Author: Arnoud W J van 't Hof, Saman Rasoul, Mustafa Ilhan, Leo Veenstra, Mera Stein, Lex A. W. Ruiters, Elsa Amin, Jerremy Weerts, Ben C. G. Gho, T. F. S. Pustjens, R. A. L. J. Theunissen, Jindrich Vainer, Cardiologie, RS: Carim - H02 Cardiomyopathy, MUMC+: MA Med Staf Artsass Cardiologie (9), MUMC+: MA Med Staf Spec Cardiologie (9), and RS: Carim - H01 Clinical atrial fibrillation
Subjects: Target lesion, medicine.medical_specialty, Acute coronary syndrome, medicine.medical_treatment, Fractional flow reserve, 030204 cardiovascular system & hematology, Revascularization, GUIDELINES, ANGIOGRAPHY, STENOSIS, Original Studies, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Myocardial Revascularization, MANAGEMENT, Humans, Radiology, Nuclear Medicine and imaging, ACS/NSTEMI, 030212 general & internal medicine, fractional flow reserve, Retrospective Studies, UNSTABLE ANGINA, coronary blood flow, business.industry, Unstable angina, Hazard ratio, percutaneous coronary intervention, ELEVATION MYOCARDIAL-INFARCTION, Percutaneous coronary intervention, General Medicine, Prognosis, medicine.disease, ACS, ANGINA-PECTORIS, Fractional Flow Reserve, Myocardial, PROGNOSTIC VALUE, NSTEMI, Treatment Outcome, SEVERITY, Cardiology, coronary angiography, Cardiology and Cardiovascular Medicine, business, FOLLOW-UP, INTERVENTION, coronary artery disease
Abstract: Objectives The aim was to assess long-term outcome after deferring intervention of coronary lesions with a fractional flow reserve (FFR) value of >0.80 in a real-world patient population and then to identify factors associated with deferred target lesion failure (DTLF). Background Deferring coronary interventions of intermediate lesions based on FFR measurement is safe, irrespective of the extent of coronary artery disease. However, FFR values near the cut-off of >0.80 may have less favorable outcome. Methods A retrospective analysis was performed in patients with deferred coronary intervention based on FFR value >0.80. The primary endpoint was DTLF, a composite of acute coronary syndrome (ACS) and any coronary revascularization, related to the initially deferred stenosis. Results A total of 600 patients, mean age of 66 +/- 10 years, and 751 coronary lesions with negative FFR values (mean 0.88 +/- 0.04) were included. The mean follow-up was 27 +/- 15 months. DTLF occurred in 44 patients (7.3%), revascularization in 42 (7%), and ACS without revascularization in 2 patients (0.3%). Patients with DTLF more often had diabetes mellitus, previous coronary artery bypass grafting, multivessel disease (MVD), and lower FFR at inclusion. Multivariable regression analysis showed that lower deferred FFR values [FFR 0.81-0.85: hazard ratio (HR) 2.79 (95% CI [confidence interval]; 1.46-5.32), p .002], MVD [HR 1.98 (95% CI; 1.05-3.75), p .036], distal lesions [HR 2.43 (95% CI; 1.29-4.57), p .006], and lesions located in a saphenous vein graft (SVG) [HR 6.35 (95% CI; 1.81-22.28), p .004] were independent predictors for DTLF. Conclusions The long-term rate of DTLF of initially deferred coronary lesions was 7.3%. Independent predictors for DTLF are lower deferred FFR value, the presence of MVD, distal lesions, and lesions in SVG.
Published: 2021
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11. Short-term dual antiplatelet therapy in diabetic patients admitted for acute coronary syndrome treated with a new-generation drug-eluting stent

Author: Nousjka P. A. Vranken, Saman Rasoul, Jasper J. P. Luijkx, Tobias F. S. Pustjens, Sonja Postma, Evelien J. Kolkman, Elvin Kedhi, Sodiqur Rifqi, Michael K. Y. Lee, Henning Ebelt, Béla Merkely, Monica Verdoia, Wojtek Wojakowski, Arnoud A. W. J. van ’t Hof, Harry Suryapranata, and Giuseppe De Luca
Subjects: Stroke, Endocrinology, Percutaneous Coronary Intervention, Treatment Outcome, Endocrinology, Diabetes and Metabolism, Dual Anti-Platelet Therapy, Internal Medicine, Diabetes Mellitus, Myocardial Infarction, Humans, Drug-Eluting Stents, Acute Coronary Syndrome, Platelet Aggregation Inhibitors
Abstract: The optimal duration of dual antiplatelet therapy (DAPT) in patients with diabetes mellitus (DM) admitted with acute coronary syndrome (ACS) and treated with a drug-eluting stent (DES) remains unclear. This is a prespecified sub-study from the Randomised Evaluation of short-term DUal antiplatelet therapy in patients with acute Coronary syndromE treated with a new generation DES (REDUCE) trial that was designed to determine the efficacy and safety of short-term versus standard 12 months DAPT in diabetic patients with ACS undergoing percutaneous coronary intervention (PCI) using the COMBO stent.In this study we included ACS diabetic patients enroled in the REDUCE trial treated with the COMBO stent and randomly assigned to either 3 or 12 months of DAPT. The primary study endpoint was the composite of all-cause mortality, myocardial infarction (MI), stent thrombosis (ST), stroke, target vessel revascularisation (TVR), and bleeding complications at 12 and 24 months follow-up.A total of 307 diabetic patients were included, of which 162 (52.8%) in the 3 months DAPT group and 145 (47.2%) in the 12 months DAPT group. Patient characteristics, PCI success, and number of stents used were similar in the 3 and 12 months DAPT groups. Occurrence of the primary study endpoint at 12 and 24 months follow-up was comparable between the two groups (3.1 vs. 3.5%, p = 0.865, and 15.8 vs. 14.9%, p = 0.824, respectively). Moreover, the prevalence of the specific clinical outcome parameters (all-cause mortality), MI, ST, stroke, TVR, and bleeding was similar in both study groups.This sub-analysis shows similar clinical outcomes following 3 months DAPT as compared to 12 months DAPT in diabetic patients undergoing PCI for ACS using the COMBO stent. These results suggest that, even in this particular subset of patients, short duration of DAPT might be considered safe. Future larger studies are warranted to provide more precise estimations in terms of safety and efficacy of short term DAPT in these high-risk patients.
Published: 2022

12. Apolipoprotein B, Residual Cardiovascular Risk After Acute Coronary Syndrome, and Effects of Alirocumab

Author: Emil Hagström, P. Gabriel Steg, Michael Szarek, Deepak L. Bhatt, Vera A. Bittner, Nicolas Danchin, Rafael Diaz, Shaun G. Goodman, Robert A. Harrington, J. Wouter Jukema, Evangelos Liberopoulos, Nikolaus Marx, Jennifer McGinniss, Garen Manvelian, Robert Pordy, Michel Scemama, Harvey D. White, Andreas M. Zeiher, Gregory G. Schwartz, Pierluigi Tricoci, Matthew T. Roe, Kenneth W. Mahaffey, Jay M. Edelberg, Corinne Hanotin, Guillaume Lecorps, Angèle Moryusef, William J. Sasiela, Jean-François Tamby, Philip E Aylward, Heinz Drexel, Peter Sinnaeve, Mirza Dilic, Renato D. Lopes, Nina N Gotcheva, Juan-Carlos Prieto, Huo Yong, Patricio López-Jaramillo, Ivan Pećin, Zeljko Reiner, Petr Ostadal, Steen Hvitfeldt Poulsen, Margus Viigimaa, Markku S Nieminen, Vakhtang Chumburidze, Pablo Carlos, Montenegro Valdovinos, Hung-Fat Tse, Robert Gabor Kiss, Denis Xavier, Doron Zahger, Marco Valgimigli, Takeshi Kimura, Hyo Soo Kim, Sang-Hyun Kim, Andrejs Erglis, Aleksandras Laucevicius, Sasko Kedev, Khalid Yusoff, Gabriel Arturo Ramos López, Marco Alings, Sigrun Halvorsen, Roger M Correa Flores, Rody G. Sy, Andrzej Budaj, Joao Morais, Maria Dorobantu, Yuri Karpov, Arsen D. Ristic, Terrance Chua, Jan Murin, Zlatko Fras, Anthony J Dalby, José Tuñón, H. Asita de Silva, Ulf Landmesser, Christian Müller, Chern-En Chiang, Piyamitr Sritara, Sema Guneri, Alexander Parkhomenko, Kausik K. Ray, Patrick M. Moriarty, Robert Vogel, Bernard Chaitman, Sheryl F. Kelsey, Anders G. Olsson, Jean-Lucien Rouleau, Maarten L. Simoons, Karen Alexander, Chiara Meloni, Robert Rosenson, Eric J.G. Sijbrands, John H. Alexander, Luciana Armaganijan, Akshay Bagai, Maria Cecilia Bahit, J. Matthew Brennan, Shaun Clifton, Adam D. DeVore, Shalonda Deloatch, Sheila Dickey, Keith Dombrowski, Grégory Ducrocq, Zubin Eapen, Patricia Endsley, Arleen Eppinger, Robert W. Harrison, Connie Ng Hess, Mark A. Hlatky, Joseph Dedrick Jordan, Joshua W. Knowles, Bradley J. Kolls, David F. Kong, Sergio Leonardi, Linda Lillis, David J. Maron, Jill Marcus, Robin Mathews, Rajendra H. Mehta, Robert J. Mentz, Humberto Graner Moreira, Chetan B. Patel, Sabrina Bernardez Pereira, Lynn Perkins, Thomas J. Povsic, Etienne Puymirat, William Schuyler Jones, Bimal R. Shah, Matthew W. Sherwood, Kenya Stringfellow, Darin Sujjavanich, Mustafa Toma, Charlene Trotter, Sean F.P. van Diepen, Matthew D. Wilson, Andrew Tze-Kay Yan, Lilia B Schiavi, Marcelo Garrido, Andrés F Alvarisqueta, Sonia A Sassone, Anselmo P Bordonava, Alberto E Alves De Lima, Jorge M Schmidberg, Ernesto A Duronto, Orlando C Caruso, Leonardo P Novaretto, Miguel Angel Hominal, Oscar R Montaña, Alberto Caccavo, Oscar A Gomez Vilamajo, Alberto J Lorenzatti, Luis R Cartasegna, Gustavo A Paterlini, Ignacio J Mackinnon, Guillermo D Caime, Marcos Amuchastegui, Oscar Salomone, Oscar R Codutti, Horacio O Jure, Julio OE Bono, Adrian D Hrabar, Julio A Vallejos, Rodolfo A Ahuad Guerrero, Federico Novoa, Cristian A Patocchi, Cesar J Zaidman, Maria E Giuliano, Ricardo D Dran, Marisa L Vico, Gabriela S Carnero, Pablo N Guzman, Juan C Medrano Allende, Daniela F Garcia Brasca, Miguel H Bustamante Labarta, Sebastian Nani, Eduardo DS Blumberg, Hugo R Colombo, Alberto Liberman, Victorino Fuentealba, Hector L Luciardi, Gabriel D Waisman, Mario A Berli, Ruben O Garcia Duran, Horacio G Cestari, Hugo A Luquez, Jorge A Giordano, Silvia S 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Blok, William Sheldon, Masoud M Azizad, Carsten Schmalfuss, Mark Picone, Robert Pederson, William Herzog, Keith Friedman, Jason Lindsey, Eichenlaub Timothy, Parilak Leonard, Norman Lepor, Mahfouz El Shahawy, Howard Weintraub, Anand Irimpen, Alvaro Alonso, Wade May, Daniels Christopher, Thomas Galski, Alan Chu, Freny Mody, Ebrahimi Ramin, Zachary Hodes, Joseph Rossi, Gregory Rose, James Fairlamb, Charles Lambert, Ajit Raisinghani, Antonio Abbate, George Vetrovec, Marilyn King, Charles Carey, Jaime Gerber, Liwa Younis, Hyeun (Tom) Park, Mladen Vidovich, Thomas Knutson, Dennis Friedman, Fred Chaleff, Arthur Loussararian, Phillip Rozeman, Carey Kimmelstiel, Jeffrey Kuvin, Kevin Silver, Malcolm Foster, Glen Tonnessen, Andrey Espinoza, Mohamadali Amlani, Andreas Wali, Christopher Malozzi, Geert T Jong, Clara Massey, Keattiyoat Wattanakit, Philip J. O’Donnell, Dinesh Singal, Naseem Jaffrani, Sridhar Banuru, Daniel Fisher, Mark Xenakis, Neal Perlmutter, Ravi Bhagwat, James Strader, Ronald Blonder, Ayim Akyea-Djamson, Ajay Labroo, Kwan Lee, H. John Marais, Edmund Claxton, Robert Weiss, Rohr Kathryn, Martin Berk, Peter Rossi, Parag Joshi, Amit Khera, Ajit S Khaira, Greg Kumkumian, Steven Lupovitch, Joshua Purow, Stephen Welka, David Hoffman, Stuart Fischer, Eugene Soroka, Donald Eagerton, Samir Pancholy, Michael Ray, Norman Erenrich, Michael Farrar, Stewart Pollock, William J French, Steve Diamantis, Douglas Guy, Lawrence Gimple, Mark Neustel, Steven Schwartz, Edward Pereira, Seals Albert, Douglas Spriggs, Janet Strain, Suneet Mittal, Anthony Vo, Majed Chane, Jason Hall, Nampalli Vijay, Kapildeo Lotun, F. Martin Lester, Ahed Nahhas, Theodore Pope, Paul Nager, Rakesh Vohra, Mukesh Sharma, Riyaz Bashir, Hinan Ahmed, Michael Berlowitz, Robert Fishberg, Robert Barrucco, Eric Yang, Michael Radin, Daniel Sporn, Dwight Stapleton, Steven Eisenberg, Joel Landzberg, Martin Mcgough, Samir Turk, Michael Schwartz, P. Sandy Sundram, Diwakar Jain, Mark Zainea, Carlos Bayron, Ronald Karlsberg, Suhail Dohad, Henry Lui, William Keen, Donald Westerhausen, Sandeep Khurana, Himanshu Agarwal, Jessica Birchem, William Penny, Mark Chang, Sherrill Murphy, John Henry, Branislav Schifferdecker, John M Gilbert, Gopal Chalavarya, Charles Eaton, John F Schmedtje, Stuart Christenson, Imran Dotani, Douglas Denham, Alexander Macdonell, Paul Gibson, Aref Rahman, Tammam Al Joundi, Nizar Assi, Gary Conrad, Purushotham Kotha, Michael Love, Gregory Giesler, Howard Rubenstein, Dawood Gamil, Laura Akright, Justine Krawczyk, Joanne Cobler, Terry Wells, James Welker, Robert Foster, Richard Gilmore, Jay Anderson, Douglas Jacoby, Bill Harris, Geraldine Gardner, Ramprasad Dandillaya, Kishor Vora, John Kostis, John Hunter, David Laxson, Eric Ball, Flavia Egydio, Anelise Kawakami, Janaina Oliveira, Julianna Wozniak, Alexander Matthews, Caroline Ratky, Janine Valiris, Lisa Berdan, Anita Hepditch, Kirby Quintero, Tyrus Rorick, Melissa Westbrook, Madeleine Bezault, Elodie Drouet, Tabassome Simon, Caroline Alsweiler, Anne Luyten, Julie Butters, Liddy Griffith, Michelle Shaw, Lena Grunberg, Shahidul Islam, Marie-France Brégeault, Nathalie Bougon, Douglas Faustino, Sylvie Fontecave, Judith Murphy, Jean- Francois Tamby, Melanie Verrier, Veronique Agnetti, Dorthe Andersen, Emmy Badreddine, Mhamed Bekkouche, Cecile Bouancheau, Imane Brigui, Maddy Brocklehurst, Joseph Cianciarulo, Dawn Devaul, Szilvia Domokos, Cecile Gache, Caroline Gobillot, Severine Guillou, Jan Healy, Megan Heath, Gayatri Jaiwal, Carine Javierre, Julien Labeirie, Myriam Monier, Ulises Morales, Asmaa Mrabti, Bicky Mthombeni, Betim Okan, Lucile Smith, Jennifer Sheller, Sebastien Sopena, Valerie Pellan, Fadela Benbernou, Nafissa Bengrait, Maud Lamoureux, Katarina Kralova, Raphael Bejuit, Anthony Coulange, Christelle Berthou, Jérôme Repincay, Christelle Lorenzato, Alexis Etienne, Valerie Gouet, Virginie Loizeau, Mickael Normand, Anne Ourliac, Christelle Rondel, Antony Adamo, Pascale Beltran, Pauline Barraud, Helene Dubois-Gache, Benjamin Halle, Lamia Metwally, Maxime Mourgues, Marc Sotty, Marion Vincendet, Raluca Cotruta, Zhu Chengyue, Dominique Fournie-Lloret, Christine Morrello, Aurelie Perthuis, Patrick Picault, Isabelle Zobouyan, Helen M. 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McClanahan, Roe, Matthew T., Blicharski, Tomasz, Bystryk, Leszek, Szpajer, Michal, Korol, Marek, Czerski, Tomasz, Gniot, Jacek, Lubinski, Andrzej, Gorny, Jerzy, Franek, Edward, Raczak, Grzegorz, Vogel, Robert, Szwed, Hanna, Monteiro, Pedro, Mesquita Bastos, Jose, Pereira, Helder H., Morais, Joao, Seixo, Filipe, Mendonça, Carlos, Botelho, Ana, Caetano, Francisca, Minescu, Bogdan, Chaitman, Bernard, Istratoaie, Octavian, Tesloianu, Dan N., Dorobantu, Maria, Cristian, Gabriel, Dumitrescu, Silviu, Podoleanu, Cristian Gc, Constantinescu, Mircea Ca, Bengus, Cristina M., Militaru, Constantin, Rosu, Doina, Kelsey, Sheryl F., Parepa, Irinel R., Matei, Adrian V., Alexandru, Tom M., Malis, Mihaela, Coman, Ioan, Shvarts, Yury, Orlikova, Olga, Kobalava, Zhanna, Barbarash, Olga L., Markov, Valentin, Olsson, Anders G., Lyamina, Nadezhda, Gordienko, Alexander, Zrazhevsky, Konstantin, Vishnevsky, Alexander Y., Gurevich, Victor, Stryuk, Raisa, Lomakin, Nikita V., Bokarev, Igor, Khlevchuk, Tatiana, Shalaev, Sergey, Rouleau, Jean-Lucien, Khaisheva, Larisa, Chizhov, Petr, Viktorova, Inna, Osokina, Natalya, Shchekotov, Vladimir, Akatova, Evgenia, Chumakova, Galina, Libov, Igor, Voevoda, Mikhail I., Tretyakova, Tatyana V., Simoons, Maarten L., Baranov, Evgeny, Shustov, Sergey, Yakushin, Sergey, Gordeev, Ivan, Khasanov, Niiaz, Reshetko, Olga, Sotnikova, Tatiana, Molchanova, Olga, Nikolaev, Konstantin, Gapon, Liudmila, Alexander, Karen, Baranova, Elena, Kosmachova, Elena, Karpov, Yuriy, Karpov, Yuri, Povzun, Anton, Egorova, Liudmila, Tyrenko, Vadim V., Ivanov, Igor G., Ilya, Masterov, Kanorsky, Sergey, Meloni, Chiara, Simic, Dragan, Ivanovic, Nikola, Davidovic, Goran, Tasic, Nebojsa, Asanin, Milika R., Stojic, Stevo, Apostolovic, Svetlana R., Ilic, Stevan, Tosic, Biljana Putnikovic, Stankovic, Aleksandar, Rosenson, Robert, Arandjelovic, Aleksandra, Radovanovic, Slavica, Todic, Branislava, Ristic, Arsen D., Balinovac, Jovan, Dincic, Dragan V., Seferovic, Petar, Karadzic, Ana, Dodic, Slobodan, Dimkovic, Sinisa, Sijbrands, Eric J. G., Jakimov, Tamara, Poh, Kian-Keong, Yee Ong, Hean, Tang I-Shing, Justin, Micko, Karol, Nociar, Jan, Pella, Daniel, Fulop, Peter, Hranai, Marian, Palka, Juraj, Tricoci, Pierluigi, Mazur, Juraj, Majercák, Ivan, Dzupina, Andrej, Fazekas, František, Gonsorcik, Jozef, Bugan, Viliam, Murin, Jan, Selecky, Juraj, Kamensky, Gabriel, Strbova, Jaroslava, Alexander, John H., Smik, Rudolf, Dukat, Andrej, Olexa, Peter, Žuran, Ivan, Poklukar, Janez, Šuligoj, Nataša Černič, Cevc, Matija, Fras, Zlatko, Cyster, Henry P., Ranjith, Naresh, Armaganijan, Luciana, Corbett, Clive, Bayat, Junaid, Makoali Makotoko, Ellen, du Toit Theron, Hendrik, Kapp, Ilse E., de V Basson, Matthys M., Lottering, Hanlie, Van Aswegen, Dina, Van Zyl, Louis J., Sebastian, Peter J., Bagai, Akshay, Pillay, Thayabran, Saaiman, Jan A., Commerford, Patrick J., Cassimjee, Soraya, Riaz, Garda, Ebrahim, Iftikhar O., Sarvan, Mahomed, Mynhardt, Joseph H., Dalby, Anthony J., Reuter, Helmuth, Bahit, Maria Cecilia, Moodley, Rajendran, Vida, Manuel, Fillat, Angel R. 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Matthew, Worner Diz, Fernando, Garcia-Dorado, David, Iñiguez, Andres, Gonzalez-Juanatey, Jose R., Portales, Javier Fernandez, Murillo, Fernando Civeira, Pericas, Laia Matas, Zamorano, Jose Luis, De Mora Martin, Manuel, Cortada, Jordi Bruguera, Clifton, Shaun, Alonso Martin, Joaquin J., Serrano Antolin, Jose Maria, De Berrazueta Fernández, José R., Vázquez de Prada, José Antonio, Díaz Fernández, Jose Francisco, García Lledó, José Alberto, Cosín Sales, Juan, Rodriguez, Javier Botas, Tragant, Gabriel Gusi, Benedicto, Amparo, DeVore, Adam D., Gonzalez-Juanatey, Carlos, Camprubí Potau, Mercedes, Perez, Ignacio Plaza, De La Tassa, César Morís, Rincon, Pablo Loma-Osorio, Recena, Javier Balaguer, Escudier, Juan M., Payeras, Antonio Coca, Orcajo, Norberto Alonso, Constantine, Godwin, Deloatch, Shalonda, Haniffa, Ruvaiz, Tissera, Nirmali, Amarasekera, Stanley, Ponnamperuma, Chandrike, Fernando, Nimali, Fernando, Kaputella, Jayawardena, Jayanthimala, Wijeyasingam, Santharaj, Ranasinghe, Gotabhaya, Ekanayaka, Ruvan, Dickey, Sheila, Mendis, Sepalika, Senaratne, Vajira, Mayurathan, Gnanamoorthy, Rajapaksha, Ajantha, Sirisena, Thilak, Herath, Jagath I., Amarasena, Naomali, Berglund, Stefan, Rasmanis, Gundars, Hagström, Emil, Dombrowski, Keith, Vedin, Ola, Witt, Nils, Mourtzinis, Georgios, Nicol, Peter, Hansen, Ole, Romeo, Stefano, Jensen, Steen Agergaard, Torstensson, Ingemar, Ahremark, Ulf, Sundelin, Torbjörn, Ducrocq, Grégory, Moccetti, Tiziano, Müller, Christian, Mach, Francois, Binde, Ronald, Landmesser, Ulf, Gämperli, Oliver, Chiang, Chern-En, Tsai, Wei-Chuan, Ueng, Kwo-Chang, Lai, Wen-Ter, Eapen, Zubin, Liu, Ming-En, Hwang, Juey-Jen, Yin, Wei-Hsian, Hsieh, I.-Chang, Hsieh, Ming-Jer, Hsiang Lin, Wei, Kuo, Jen-Yuan, Huang, Tsuei-Yuan, Fang, Chih-Yuan, Kaewsuwanna, Pinij, Endsley, Patricia, Soonfuang, Wasant, Jintapakorn, Woravut, Sukonthasarn, Apichard, Sritara, Piyamitr, Wongpraparut, Nattawut, Sastravaha, Krisada, Sansanayudh, Nakarin, Kehasukcharoen, Wirash, Piyayotai, Dilok, Chotnoparatpat, Paiboon, Eppinger, Arleen, Camsari, Ahmet, Kultursay, Hakan, Guneri, Sema, Mutlu, Bulent, Ersanli, Murat, Demirtas, Mustafa, Kirma, Cevat, Ural, Ertan, Koldas, Lale, Karpenko, Oleksandr, Harrison, Robert W., Prokhorov, Alexander, Vakaluyk, Ihor, Myshanych, Halyna, Reshotko, Dmytro, Batushkin, Valeriy, Rudenko, Leonid, Kovalskyi, Ihor, Kushnir, Mykola, Tseluyko, Vira, Mostovoy, Yuriy, Hess, Connie Ng, Stanislavchuk, Mykola, Kyiak, Yulian, Karpenko, Yuriy, Malynovsky, Yaroslav, Klantsa, Andriy, Kutniy, Oles, Amosova, Ekaterina, Tashchuk, Viktor, Leshchuk, Oleh, Parkhomenko, Alexander, Hlatky, Mark A., Rishko, Mykola, Kopytsya, Mykola, Yagensky, Andriy, Vatutin, Mykola, Bagriy, Andriy, Barna, Olga M., Ushakov, Olexiy, Dzyak, Georgiy, Goloborodko, Borys, Rudenko, Anatolii, Jordan, Joseph Dedrick, Zheleznyy, Volodymyr, Trevelyan, Jasper, Zaman, Azfar, Lee, Kaeng, Moriarty, Andrew, Aggarwal, Rajesh K., Clifford, Piers, Wong, Yuk-ki, Iqbal, Syed Mr, Subkovas, Eduardas, Knowles, Joshua W., Braganza, Denise, Sarkar, David, Storey, Robert, Griffiths, Huw, Mcclure, Sam, Muthusamy, Rangasamy, Smith, Simon, Kurian, John, Levy, Terry, Barr, Craig, Kolls, Bradley J., Kadr, Honer, Gerber, Robert, Simaitis, Audrius, Soran, Handrean, Brodison, Adrian, Ayaz, Mohammad, Cheema, Muhammad, Oliver, Richard, Thackray, Simon, Mudawi, Telal, Kong, David F., Rahma, Gohar, Sultan, Ayyaz, Reynolds, Timothy, Sharman, David, Spriging, David, Butler, Rob, Wilkinson, Peter, Lip, Gregory Yh, Ossei-Gerning, Nicholas, Vardi, Gil, Leonardi, Sergio, Baldari, Duccio, Brabham, David, Treasure Ii, Charles, Dahl, Charles, Palmer, Bruce, Wiseman, Alan, Khan, Abul, Puri, Sanjeev, Mohart, Ann Elizabeth, Ince, Carlos, Lillis, Linda, Flores, Enrique, Wright, Scott, Cheng, Shi-Chi, Rosenberg, Michael, Rogers, William, Kosinski, Edward, Forgosh, Les, Waltman, Jonathan, Shoukfeh, Mohammad, Dagher, Georges, Lopes, Renato D., Cambier, Patrick, Lieber, Ira, Kumar, Priya, East, Cara, Krichmar, Perry, Hasan, Mian, White, Lindsey, Knickelbine, Thomas, Haldis, Thomas, Gillespie, Eve, Maron, David J., Amidon, Thomas, Suh, David, Arif, Imran, Abdallah, Mouhamad, Akhter, Faiq, Carlson, Eric, D'Urso, Michael, El-Ahdab, Fadi, Nelson, William, Moriarty, Katie, Mahaffey, Kenneth W., Harris, Barry, Cohen, Steven, Carter, Luther, Doty, Daniel, Sabatino, Kenneth, Haddad, Tariq, Rao, Sunder, Mulkay, Angel, Jovin, Ion, Klancke, Kim, Marcus, Jill, Malhotra, Vinay, Devarapalli, Sai K., Koren, Michael, Chandna, Harish, Dodds Iii, George, Goraya, Tauqir, Bengston, James, Janik, Matthew, Moran, Joseph, Sumner, Andrew, Mathews, Robin, Kobayashi, John, Davis, William, Yazdani, Shahram, Pasquini, John, Thakkar, Maitreya, Vedere, Amarnath, Leimbach, Wayne, Rider, James, Fenton, Sarah, Singh, Narendra, Mehta, Rajendra H., Shah, Anil V., Moriarty, Patrick M., Janosik, Denise, Pepine, Carl, Berman, Brett, Gelormini, Joseph, Daniels, Christopher, Richard, Kerensky, Keating, Friederike, Kondo, Nicholas I., Mentz, Robert J., Shetty, Sanjay, Levite, Howard, Waider, Winfried, Takata, Theodore, Abu-Fadel, Mazen, Shah, Vipul, Aggarwal, Rahul, Kumar, Anil, Hattler, Brack, Do, Rose, Moreira, Humberto Graner, Link, Chad, Bortnick, Anna, Kinzfogl Iii, George, Ghitis, Arnold, Larry, John, Teufel, Edward, Kuhlman, Peter, Mclaurin, Brent, Zhang, Wenwu, Thew, Stephen, Patel, Chetan B., Abbas, Jalal, White, Matthew, Islam, Othman, Subherwal, Sumeet, Ranadive, Nandkishore, Vakili, Babak, Gring, Christian, Henderson, David, Schuchard, Timothy, Farhat, Naim, Pereira, Sabrina Bernardez, Kline, Geoffrey, Mahal, Sharan, Whitaker, Jack, Speirs, Shawn, Andersen, Rolf, Daboul, Nizar, Horwitz, Phillip, Zahr, Firas, Ponce, George, Jafar, Zubair, Perkins, Lynn, Mcgarvey, Joseph, Panchal, Vipul, Voyce, Stephen, Blok, Thomas, Sheldon, William, Azizad, Masoud M., Schmalfuss, Carsten, Picone, Mark, Pederson, Robert, Herzog, William, Povsic, Thomas J., Friedman, Keith, Lindsey, Jason, Timothy, Eichenlaub, Leonard, Parilak, Lepor, Norman, El Shahawy, Mahfouz, Weintraub, Howard, Irimpen, Anand, Alonso, Alvaro, May, Wade, Puymirat, Etienne, Christopher, Daniels, Galski, Thomas, Chu, Alan, Mody, Freny, Ramin, Ebrahimi, Hodes, Zachary, Rossi, Joseph, Rose, Gregory, Fairlamb, James, Lambert, Charles, Raisinghani, Ajit, Abbate, Antonio, Vetrovec, George, King, Marilyn, Carey, Charles, Gerber, Jaime, Younis, Liwa, Park, Hyeun Tom, Vidovich, Mladen, Knutson, Thomas, Jones, William Schuyler, Friedman, Dennis, Chaleff, Fred, Loussararian, Arthur, Rozeman, Phillip, Kimmelstiel, Carey, Kuvin, Jeffrey, Silver, Kevin, Foster, Malcolm, Tonnessen, Glen, Espinoza, Andrey, Shah, Bimal R., Amlani, Mohamadali, Wali, Andreas, Malozzi, Christopher, Jong, Geert T., Massey, Clara, Wattanakit, Keattiyoat, O'Donnell, Philip J., Singal, Dinesh, Jaffrani, Naseem, Banuru, Sridhar, Sherwood, Matthew W., Fisher, Daniel, Xenakis, Mark, Perlmutter, Neal, Bhagwat, Ravi, Strader, James, Blonder, Ronald, Akyea-Djamson, Ayim, Labroo, Ajay, Lee, Kwan, Marais, H. John, Stringfellow, Kenya, Claxton, Edmund, Weiss, Robert, Kathryn, Rohr, Berk, Martin, Rossi, Peter, Joshi, Parag, Khera, Amit, Khaira, Ajit S., Kumkumian, Greg, Lupovitch, Steven, Sujjavanich, Darin, Purow, Joshua, Welka, Stephen, Hoffman, David, Fischer, Stuart, Soroka, Eugene, Eagerton, Donald, Pancholy, Samir, Ray, Michael, Erenrich, Norman, Farrar, Michael, Toma, Mustafa, Pollock, Stewart, French, William J., Diamantis, Steve, Guy, Douglas, Gimple, Lawrence, Neustel, Mark, Schwartz, Steven, Pereira, Edward, Albert, Seals, Spriggs, Douglas, Trotter, Charlene, Strain, Janet, Mittal, Suneet, Vo, Anthony, Chane, Majed, Hall, Jason, Vijay, Nampalli, Lotun, Kapildeo, Lester, F. Martin, Nahhas, Ahed, Pope, Theodore, van Diepen, Sean F. 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Mackinnon, Ignacio J, Caime, Guillermo D, Codutti, Oscar R, Jure, Horacio O, Hrabar, Adrian D, Vallejos, Julio A, Ahuad Guerrero, Rodolfo A, Patocchi, Cristian A, Zaidman, Cesar J, Giuliano, Maria E, Dran, Ricardo D, Vico, Marisa L, Carnero, Gabriela S, Guzman, Pablo N, Medrano Allende, Juan C, Garcia Brasca, Daniela F, Bustamante Labarta, Miguel H, Colombo, Hugo R, Luciardi, Hector L, Waisman, Gabriel D, Berli, Mario A, Garcia Duran, Ruben O, Cestari, Horacio G, Luquez, Hugo A, Giordano, Jorge A, Saavedra, Silvia S, Waites, Jonathon H, Arstall, Margaret A, Rogers, James F, Oqueli Flores, Romulo E, Lehman, Sam J, Garrahy, Paul J, Carroll, Patrick A, Wolf, Luc De, Nicolau, Jose C, Giorgeto, Flavio E, Silva, Ricardo P, Abrantes, José Antonio M, Bodanese, Luiz C, Michalaros, Yorghos L, Eliaschewitz, Freddy G, Vidotti, Maria H, Leaes, Paulo E, Botelho, Roberto V, Manenti, Euler Roberto F Fernandes, Precoma, Dalton B, Moura Jorge, Jose C, Silveira, Jose A, Neto, Jose A Marin, Feitosa, Gilson S, Ritt, Luiz Eduardo F, de Souza, Juliana A, Todorov, Georgi V, Nikolov, Fedya P, Velcheva, Elena S, Tzekova, Maria L, Benov, Haralambi O, Petranov, Stanislav L, Tumbev, Haralin S, Shehova-Yankova, Nina S, Markov, Dimitar T, Raev, Dimitar H, Mollov, Mihail N, Kichukov, Kostadin N, Ilieva-Pandeva, Katya A, Mincheva, Valentina M, Lazov, Petar V, Dimov, Bojidar I, Prieto, Juan C, Raffo, Carlos A, Luna Botia, Diana C, De Salazar, Dora I Molina, Bonfanti, Alberto J Cadena, Barrera Silva, Sandra I, Garcia Lozada, Henry J, Coronel Arroyo, Julian A, Accini Mendoza, Jose L, Fernandez Ruiz, Ricardo L, Quintero Ossa, Alvaro M, Manzur Jatin, Fernando G, Urina Triana, Miguel A, Trujillo, Angela M Fernandez, Poulsen, Steen H, Bang, Lia E, Hove, Jens D, Kristensen, Kjeld S, Lomholdt, Jens D, Klausen, Ib C, Fausto Ovando, Sergio R, Arango Benecke, Juan L, Rodriguez De Leon, Edgar R, Premchand, Rajendra K, Abhyanakar, Atul D, Govinda, Ravishankar A, Patil, Sachin N, Joshi, Abhijeet B, Pothineni, Ramesh B, Monteiro, Minguel R, Iyengar, Shamanna S, Fulwani, Mahesh C, Chopra, Vijay K, Goyal, Naresh K, Manakshe, Gajendra V, Pellegrin, Annamaria De, De Cesare, Nicoletta B, Piatti, Piermarco, Luca, Giuseppe De, Leo, Alessandro De, Petrulionienė, Žaneta, Šakalytė, Gintarė, Šlapikas, Rimvydas, Liew, Houng B, Breedveld, Robert W, Wiersma, Jacobijne J, Troquay, Roland PTh, Viergever, Eric P, Bartels, Gerard L, Cornel, Jan H, Bos, Robert J, Van Der Zwaan, Coenraad C, Groenemeijer, Bjorn E, Willems, Frank F, Munk, Peter S, Calderon Ticona, Jorge R, Durand Velasquez, Julio R, Negron Miguel, Sandra A, Sanabria Perez, Enrique S, Carrion Chambilla, Jesus M, Chavez Ayala, Carlos A, Castillo Leon, Reynaldo P, Vargas GonzalesC, Rolando J, Hernandez Zuniga, Jose D, Camacho Cosavalente, Luis A, Bravo Mannucci, Jorge E, Llerena Navarro, Nassip C, Roldan Concha, Yudy M, Rodriguez Chavez, Víctor E, Anchante Hernandez, Henry A, Zea Nunez, Carlos A, Sy, Rosa Allyn G, Morales, Dante D, Pereira, Helder H, Tesloianu, Dan N, Bengus, Cristina M, Parepa, Irinel R, Matei, Adrian V, Alexandru, Tom M, Barbarash, Olga L, Vishnevsky, Alexander Y, Lomakin, Nikita V, Voevoda, Mikhail I, Tretyakova, Tatyana V, Tyrenko, Vadim V, Ivanov, Igor G, Asanin, Milika R, Apostolovic, Svetlana R, Dincic, Dragan V, Cyster, Henry P, Kapp, Ilse E, de V Basson, Matthys M, Aswegen, Dina Van, Van Zyl, Louis J, Sebastian, Peter J, Saaiman, Jan A, Commerford, Patrick J, Ebrahim, Iftikhar O, Mynhardt, Joseph H, Fillat, Angel R Cequier, Cruz Fernández, Jose M, Gonzalez-Juanatey, Jose R, Alonso Martin, Joaquin J, De Berrazueta Fernández, José R, Escudier, Juan M, Herath, Jagath I, Hsieh, I-Chang, Barna, Olga M, Aggarwal, Rajesh K, Wong, Yuk-Ki, Devarapalli, Sai K, Shah, Anil V, Kondo, Nicholas I, Azizad, Masoud M, Jong, Geert T, O'Donnell, Philip J, Marais, H John, Khaira, Ajit S, French, William J, Lester, F Martin, Sundram, P Sandy, Gilbert, John M, Schmedtje, John F, Colhoun, Helen M, Dempsey, Michael A, and McClanahan, Mark A
Subjects: Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use, Anticholesteremic Agents/adverse effects, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], prevention & control, heart disease risk factors, diagnosis [Cardiovascular Diseases], Antibodies, Monoclonal, Humanized, PCSK9 inhibitors, acute coronary syndrome, apolipoproteins B, LDL cholesterol, Antibodies, acute coronary syndrome, LDL, drug therapy [Atherosclerosis], Risk Factors, Physiology (medical), therapeutic use [Hydroxymethylglutaryl-CoA Reductase Inhibitors], Monoclonal, Humans, Cardiac and Cardiovascular Systems, Humanized, Cardiovascular Diseases/diagnosis, Apolipoproteins B, Kardiologi, diagnosis [Acute Coronary Syndrome], Anticholesteremic Agents, PCSK9 inhibitors, apolipoproteins B, cholesterol, LDL, cholesterol, Atherosclerosis/drug therapy, Cholesterol, LDL, Atherosclerosis, Acute Coronary Syndrome/diagnosis, drug therapy, Cholesterol, Treatment Outcome, Cardiovascular Diseases, Heart Disease Risk Factors, epidemiology, adverse effects [Anticholesteremic Agents], Hydroxymethylglutaryl-CoA Reductase Inhibitors, Cardiology and Cardiovascular Medicine
Abstract: Circulation : an official journal of the American Heart Association / ed.-in-chief Ephraim Donosco 146(9), 657-672 (2022). doi:10.1161/CIRCULATIONAHA.121.057807, Published by Ovid, [Erscheinungsort nicht ermittelbar]
Published: 2022
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13. Feasibility and safety of cangrelor in patients with suboptimal P2Y12 inhibition undergoing percutaneous coronary intervention: the Dutch Cangrelor registry

Author: Jur ten Berg, Maarten A.H. van Leeuwen, Vital Houben, Abi Selvarajah, Wilbert Bor, Koen Teeuwen, Renicus S Hermanides, Erik Lipsic, Giovanni Amoroso, Sjoerd H. Hofma, Saman Rasoul, Eliza Kaplan, Annerieke H Tavenier, and Arnoud W J van ‘t Hof
Subjects: chemistry.chemical_compound, medicine.medical_specialty, P2Y12, Cangrelor, chemistry, business.industry, medicine.medical_treatment, Internal medicine, medicine, Cardiology, Percutaneous coronary intervention, In patient, business
Published: 2021
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14. Lipoprotein(a) and Benefit of PCSK9 Inhibition in Patients With Nominally Controlled LDL Cholesterol

Author: Gregory G. Schwartz, Michael Szarek, Vera A. Bittner, Rafael Diaz, Shaun G. Goodman, J. Wouter Jukema, Ulf Landmesser, Patricio López-Jaramillo, Garen Manvelian, Robert Pordy, Michel Scemama, Peter R. Sinnaeve, Harvey D. White, Ph Gabriel Steg, P.h. Gabriel Steg, Deepak L. Bhatt, Robert A. Harrington, Andreas M. Zeiher, Pierluigi Tricoci, Matthew T. Roe, Kenneth W. Mahaffey, Jay M. Edelberg, Corinne Hanotin, Guillaume Lecorps, Angèle Moryusef, William J. Sasiela, Jean-François Tamby, Philip E. Aylward, Heinz Drexel, Peter Sinnaeve, Mirza Dilic, Renato D. Lopes, Nina N. Gotcheva, Juan-Carlos Prieto, Huo Yong, Ivan Pećin, Zeljko Reiner, Petr Ostadal, Steen Hvitfeldt Poulsen, Margus Viigimaa, Markku S. Nieminen, Nicolas Danchin, Vakhtang Chumburidze, Nikolaus Marx, Evangelos Liberopoulos, Pablo Carlos Montenegro Valdovinos, Hung-Fat Tse, Robert Gabor Kiss, Denis Xavier, Doron Zahger, Marco Valgimigli, Takeshi Kimura, Hyo Soo Kim, Sang-Hyun Kim, Andrejs Erglis, Aleksandras Laucevicius, Sasko Kedev, Khalid Yusoff, Gabriel Arturo Ramos López, Marco Alings, Sigrun Halvorsen, Roger M. Correa Flores, Rody G. Sy, Andrzej Budaj, Joao Morais, Maria Dorobantu, Yuri Karpov, Arsen D. Ristic, Terrance Chua, Jan Murin, Zlatko Fras, Anthony J. Dalby, José Tuñón, H. Asita de Silva, Emil Hagström, Christian Müller, Chern-En Chiang, Piyamitr Sritara, Sema Guneri, Alexander Parkhomenko, Kausik K. Ray, Patrick M. Moriarty, Robert Vogel, Bernard Chaitman, Sheryl F. Kelsey, Anders G. Olsson, Jean-Lucien Rouleau, Maarten L. Simoons, Karen Alexander, Chiara Meloni, Robert Rosenson, Eric J.G. Sijbrands, John H. Alexander, Luciana Armaganijan, Akshay Bagai, Maria Cecilia Bahit, J. Matthew Brennan, Shaun Clifton, Adam D. DeVore, Shalonda Deloatch, Sheila Dickey, Keith Dombrowski, Grégory Ducrocq, Zubin Eapen, Patricia Endsley, Arleen Eppinger, Robert W. Harrison, Connie Ng Hess, Mark A. Hlatky, Joseph Dedrick Jordan, Joshua W. Knowles, Bradley J. Kolls, David F. Kong, Sergio Leonardi, Linda Lillis, David J. Maron, Jill Marcus, Robin Mathews, Rajendra H. Mehta, Robert J. Mentz, Humberto Graner Moreira, Chetan B. Patel, Sabrina Bernardez Pereira, Lynn Perkins, Thomas J. Povsic, Etienne Puymirat, William Schuyler Jones, Bimal R. Shah, Matthew W. Sherwood, Kenya Stringfellow, Darin Sujjavanich, Mustafa Toma, Charlene Trotter, Sean F.P. van Diepen, Matthew D. Wilson, Andrew Tze-Kay Yan, Lilia B. Schiavi, Marcelo Garrido, Andrés F. Alvarisqueta, Sonia A. Sassone, Anselmo P. Bordonava, Alberto E. Alves De Lima, Jorge M. Schmidberg, Ernesto A. Duronto, Orlando C. Caruso, Leonardo P. Novaretto, Miguel Angel Hominal, Oscar R. Montaña, Alberto Caccavo, Oscar A. 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Raffo, Claudia Olivares, Leonardo Nahuelpan, Humberto Montecinos, Jiyan Chen, Yugang Dong, Weijian Huang, Jianzhong Wang, Shi'An Huang, Zhuhua Yao, Xiang Li, Lan Cui, Wenhua Lin, Yuemin Sun, Jingfeng Wang, Jianping Li, Xuelian Zhang, Hong Zhu, Dandan Chen, Lan Huang, Shaohong Dong, Guohai Su, Biao Xu, Xi Su, Xiaoshu Cheng, Jinxiu Lin, Wenxia Zong, Huanming Li, Yi Feng, Dingli Xu, Xinchun Yang, Yuannan Ke, Xuefeng Lin, Zheng Zhang, Zeqi Zheng, Zhurong Luo, Yundai Chen, Chunhua Ding, Yi Zhong, Yang Zheng, Xiaodong Li, Daoquan Peng, Shuiping Zhao, Ying Li, Xuebo Liu, Meng Wei, Shaowen Liu, Yihua Yu, Baiming Qu, Weihong Jiang, Yujie Zhou, Xingsheng Zhao, Zuyi Yuan, Ying Guo, Xiping Xu, Xubo Shi, Junbo Ge, Guosheng Fu, Feng Bai, Weiyi Fang, Xiling Shou, Xiangjun Yang, Jian'An Wang, Meixiang Xiang, Yingxian Sun, Qinghua Lu, Ruiyan Zhang, Jianhua Zhu, Yizhou Xu, Zhongcai Fan, Tianchang Li, Chun Wu, Nicolas Jaramillo, Gregorio Sanchez Vallejo, Diana C. Luna Botia, Rodrigo Botero Lopez, Dora I. Molina De Salazar, Alberto J. Cadena Bonfanti, Carlos Cotes Aroca, Juan Diego Higuera, Marco Blanquicett, Sandra I. Barrera Silva, Henry J. Garcia Lozada, Julian A. Coronel Arroyo, Jose L. Accini Mendoza, Ricardo L. Fernandez Ruiz, Alvaro M. Quintero Ossa, Fernando G. Manzur Jatin, Aristides Sotomayor Herazo, Jeffrey Castellanos Parada, Rafael Suarez Arambula, Miguel A. Urina Triana, Angela M. Fernandez Trujillo, Maja Strozzi, Siniša Car, Melita Jerić, Davor Miličić, Martina Lovrić Benčić, Hrvoje Pintarić, Đeiti Prvulović, Jozica Šikić, Viktor Peršić, Dean Mileta, Kresimir Štambuk, Zdravko Babić, Vjekoslav Tomulic, Josip Lukenda, Stanka Mejic-Krstulovic, Boris Starcevic, Jindrich Spinar, David Horak, Zdenek Velicka, Josef Stasek, David Alan, Vilma Machova, Ales Linhart, Vojtech Novotny, Vladimir Kaucak, Richard Rokyta, Robert Naplava, Zdenek Coufal, Vera Adamkova, Ivo Podpera, Jiri Zizka, Zuzana Motovska, Ivana Marusincova, Premysl Svab, Petr Heinc, Jiri Kuchar, Petr Povolny, Jiri Matuska, Steen H. Poulsen, Bent Raungaard, Peter Clemmensen, Lia E. Bang, Ole May, Morten Bøttcher, Jens D. Hove, Lars Frost, Gunnar Gislason, John Larsen, Peter Betton Johansen, Flemming Hald, Peter Johansen, Jørgen Jeppesen, Tonny Nielsen, Kjeld S. Kristensen, Piotr Maria Walichiewicz, Jens D. Lomholdt, Ib C. 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Fausto Ovando, Juan L. Arango Benecke, Edgar R. Rodriguez De Leon, Bryan P.Y. Yan, David C.W. Siu, Tibor Turi, Bela Merkely, Imre Ungi, Geza Lupkovics, Lajos Nagy, András Katona, István Édes, Gábor Müller, Iván Horvath, Tibor Kapin, Zsolt Szigeti, József Faluközy, Mukund Kumbla, Manjinder Sandhu, Sharath Annam, Naveen Reddy Proddutur, Reddy Regella, Rajendra K. Premchand, Ajaykumar Mahajan, Sudhir Pawar, Atul D. Abhyanakar, Prafulla Kerkar, Ravishankar A. Govinda, Abraham Oomman, Dhurjati Sinha, Sachin N. Patil, Dhiman Kahali, Jitendra Sawhney, Abhijeet B. Joshi, Sanjeev Chaudhary, Pankaj Harkut, Santanu Guha, Sanjay Porwal, Srimannarayana Jujjuru, Ramesh B. Pothineni, Minguel R. Monteiro, Aziz Khan, Shamanna S. Iyengar, Jasprakash Singh Grewal, Manoj Chopda, Mahesh C. Fulwani, Aparna Patange, Patil Sachin, Vijay K. Chopra, Naresh K. Goyal, Rituparna Shinde, Gajendra V. 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De Cesare, Sergio Berti, Claudio Cavallini, Enrico Puccioni, Marcello Galvani, Maurizio Tespili, Piermarco Piatti, Michela Palvarini, Giuseppe De Luca, Roberto Violini, Alessandro De Leo, Zoran Olivari, Pasquale Perrone Filardi, Maurizio Ferratini, Vittorio Racca, Kazuoki Dai, Yuji Shimatani, Haruo Kamiya, Kenji Ando, Yoshihiro Takeda, Yoshihiro Morino, Yoshiki Hata, Kazuo Kimura, Koichi Kishi, Ichiro Michishita, Hiroki Uehara, Toshinori Higashikata, Atsushi Hirayama, Keiji Hirooka, Yasuji Doi, Satoru Sakagami, Shuichi Taguchi, Akihiro Koike, Hiroyuki Fujinaga, Shinji Koba, Ken Kozuma, Tomohiro Kawasaki, Yujiro Ono, Masatoshi Shimizu, Yousuke Katsuda, Atsuyuki Wada, Toshiro Shinke, Junya Ako, Kenshi Fujii, Toshiyuki Takahashi, Tomohiro Sakamoto, Koichi Nakao, Yutaka Furukawa, Hiroshi Sugino, Ritsu Tamura, Toshiaki Mano, Masaaki Uematsu, Noriaki Utsu, Kashima Ito, Takuya Haraguchi, Katsuhiko Sato, Yasunori Ueda, Akira Nishibe, Kazuteru Fujimoto, Motomaru Masutani, Jung Han Yoon, Hack-Lyoung Kim, Hun Sik Park, In-Ho Chae, Moo Hyun Kim, Myung Ho Jeong, Seungwoon Rha, Chongjin Kim, Hae Young Kim, Taekjong Hong, Seung-Jea Tahk, Youngkwon Kim, Arija Busmane, Natalija Pontaga, Aldis Strelnieks, Iveta Mintale, Iveta Sime, Zaneta Petrulioniene, Roma Kavaliauskiene, Ruta Jurgaitiene, Gintare Sakalyte, Rimvydas Slapikas, Sigute Norkiene, Nerijus Misonis, Aleksandras Kibarskis, Raimondas Kubilius, Stojko Bojovski, Nensi Lozance, Aleksandar Kjovkaroski, Snezana Doncovska, Tiong Kiam Ong, Sazzli Kasim, Oteh Maskon, Balachandran Kandasamy, Houng B. Liew, Wan Mohd Izani Wan Mohamed, Armando García Castillo, Jorge Carrillo Calvillo, Pedro Fajardo Campos, Juan Carlos Núñez Fragoso, Edmundo Alfredo Bayram Llamas, Marco Antonio Alcocer Gamba, Jaime Carranza Madrigal, Luis Gerardo González Salas, Enrique López Rosas, Belinda González Díaz, Eduardo Salcido Vázquez, Alfredo Nacoud Ackar, Guillermo Antonio Llamas Esperón, Carlos Rodolfo Martínez Sánchez, María Guerrero De Leon, Rodrigo Suarez Otero, Guillermo Fanghänel Salmón, Jesús Antonio Pérez Ríos, José Angel Garza Ruíz, Robert W. Breedveld, Margriet Feenema-Aardema, Alida Borger-Van Der Burg, Pieter A.M. Hoogslag, Harry Suryapranata, Antonius Oomen, Paulus Van Haelst, Margriet Feenema-Aradema, Jacobijne J. Wiersma, Dirk Basart, Ruud M.A. Van Der Wal, Peter Zwart, Pascalle Monraats, Henricus Van Kesteren, Ioannis Karalis, Johan Jukema, Gerardus J.E. Verdel, Bart R.G. Brueren, Roland PTh Troquay, Eric P. Viergever, Nadea Y.Y. Al-Windy, Gerard L. Bartels, Jan H. Cornel, Walter R.M. Hermans, Johannes P.R. Herrman, Robert J. Bos, Reginald G.E.J. Groutars, Coenraad C. Van Der Zwaan, Refik Kaplan, Raymond Lionarons, Eelko Ronner, Bjorn E. Groenemeijer, Patrick N.A. Bronzwaer, Anho A.H. Liem, Bernard J.W.M. Rensing, Marcel J.J.A. Bokern, Remco Nijmeijer, Ferry M.R.J. Hersbach, Frank F. Willems, Antonius T.M. Gosselink, Saman Rasoul, John Elliott, Gerard Wilkins, Raewyn Fisher, Douglas Scott, Hamish Hart, Ralph Stewart, Scott Harding, Ian Ternouth, Nicholas Fisher, Samuel Wilson, Denise Aitken, Russell Anscombe, Laura Davidson, Tadeusz Tomala, Ottar Nygård, Jon Arne Sparby, Kjell Andersen, Lars Gullestad, Jarle Jortveit, Peter S. Munk, Erlend gyllensten Singsaas, Ulf Hurtig, Jorge R. Calderon Ticona, Julio R. Durand Velasquez, Sandra A. Negron Miguel, Enrique S. Sanabria Perez, Jesus M. Carrion Chambilla, Carlos A. Chavez Ayala, Reynaldo P. Castillo Leon, Rolando J. Vargas Gonzales, Jose D. Hernandez Zuniga, Luis A. Camacho Cosavalente, Jorge E. Bravo Mannucci, Javier Heredia Landeo, Nassip C. Llerena Navarro, Yudy M. Roldan Concha, Víctor E. Rodriguez Chavez, Henry A. Anchante Hernandez, Carlos A. Zea Nunez, Walter Mogrovejo Ramos, Arthur Ferrolino, Rosa Allyn G. Sy, Louie Tirador, Generoso Matiga, Raul Martin Coching, Alisa Bernan, Gregorio Rogelio, Dante D. Morales, Edgar Tan, Dennis Jose Sulit, Adrian Wlodarczak, Krystyna Jaworska, Grzegorz Skonieczny, Lidia Pawlowicz, Pawel Wojewoda, Benita Busz-Papiez, Janusz Bednarski, Aleksander Goch, Pawel Staneta, Elzbieta Dulak, Krzysztof Saminski, Wlodzimierz Krasowski, Wanda Sudnik, Aleksander Zurakowski, Marcin Skorski, Roman Lysek, Beata Miklaszewicz, Jacek Kubica, Jan Andrzej Lipko, Edyta Kostarska-Srokosz, Marek Piepiorka, Anna Drzewiecka, Ryszard Sciborski, Arkadiusz Stasiewski, Tomasz Blicharski, Leszek Bystryk, Michal Szpajer, Marek Korol, Tomasz Czerski, Ewa Mirek-Bryniarska, Jacek Gniot, Andrzej Lubinski, Jerzy Gorny, Edward Franek, Grzegorz Raczak, Hanna Szwed, Pedro Monteiro, Jose Mesquita Bastos, Helder H. Pereira, Dinis Martins, Filipe Seixo, Carlos Mendonça, Ana Botelho, Francisca Caetano, Bogdan Minescu, Octavian Istratoaie, Dan N. Tesloianu, Gabriel Cristian, Silviu Dumitrescu, Cristian G.C. Podoleanu, Mircea C.A. Constantinescu, Cristina M. Bengus, Constantin Militaru, Doina Rosu, Irinel R. Parepa, Adrian V. Matei, Tom M. Alexandru, Mihaela Malis, Ioan Coman, Rodica Stanescu-Cioranu, Doina Dimulescu, Yury Shvarts, Olga Orlikova, Zhanna Kobalava, Olga L. Barbarash, Valentin Markov, Nadezhda Lyamina, Alexander Gordienko, Konstantin Zrazhevsky, Alexander Y. Vishnevsky, Victor Gurevich, Raisa Stryuk, Nikita V. Lomakin, Igor Bokarev, Tatiana Khlevchuk, Sergey Shalaev, Larisa Khaisheva, Petr Chizhov, Inna Viktorova, Natalya Osokina, Vladimir Shchekotov, Evgenia Akatova, Galina Chumakova, Igor Libov, Mikhail I. Voevoda, Tatyana V. Tretyakova, Evgeny Baranov, Sergey Shustov, Sergey Yakushin, Ivan Gordeev, Niiaz Khasanov, Olga Reshetko, Tatiana Sotnikova, Olga Molchanova, Konstantin Nikolaev, Liudmila Gapon, Elena Baranova, Zaur Shogenov, Elena Kosmachova, Yuriy Karpov, Anton Povzun, Liudmila Egorova, Vadim V. Tyrenko, Igor G. Ivanov, Masterov Ilya, Sergey Kanorsky, Dragan Simic, Nikola Ivanovic, Goran Davidovic, Nebojsa Tasic, Milika R. Asanin, Stevo Stojic, Svetlana R. Apostolovic, Stevan Ilic, Biljana Putnikovic Tosic, Aleksandar Stankovic, Aleksandra Arandjelovic, Slavica Radovanovic, Branislava Todic, Jovan Balinovac, Dragan V. Dincic, Petar Seferovic, Ana Karadzic, Slobodan Dodic, Sinisa Dimkovic, Tamara Jakimov, Kian-Keong Poh, Hean Yee Ong, Justin Tang I-Shing, Karol Micko, Jan Nociar, Daniel Pella, Peter Fulop, Marian Hranai, Juraj Palka, Juraj Mazur, Ivan Majercák, Andrej Dzupina, František Fazekas, Jozef Gonsorcik, Viliam Bugan, Juraj Selecky, Gabriel Kamensky, Jaroslava Strbova, Rudolf Smik, Andrej Dukat, Peter Olexa, Ivan Žuran, Janez Poklukar, Nataša Černič Šuligoj, Matija Cevc, Henry P. Cyster, Naresh Ranjith, Clive Corbett, Junaid Bayat, Ellen Makoali Makotoko, Hendrik du Toit Theron, Ilse E. Kapp, Matthys M. de V Basson, Hanlie Lottering, Dina Van Aswegen, Louis J. Van Zyl, Peter J. Sebastian, Thayabran Pillay, Jan A. Saaiman, Patrick J. Commerford, Soraya Cassimjee, Garda Riaz, Iftikhar O. Ebrahim, Mahomed Sarvan, Joseph H. Mynhardt, Helmuth Reuter, Rajendran Moodley, Manuel Vida, Angel R. Cequier Fillat, Vicente Bodí Peris, Francisco Fuentes Jimenez, Francisco Marín, Jose M. Cruz Fernández, Rafael Jesus Hidalgo Urbano, Blas Gil-Extremera, Pablo Toledo, Fernando Worner Diz, David Garcia-Dorado, Andres Iñiguez, José Tuñón Fernández, Jose R. Gonzalez-Juanatey, Javier Fernandez Portales, Fernando Civeira Murillo, Laia Matas Pericas, Jose Luis Zamorano, Manuel De Mora Martin, Jordi Bruguera Cortada, Joaquin J. Alonso Martin, Jose Maria Serrano Antolin, José R. De Berrazueta Fernández, José Antonio Vázquez de Prada, Jose Francisco Díaz Fernández, José Alberto García Lledó, Juan Cosín Sales, Javier Botas Rodriguez, Gabriel Gusi Tragant, Amparo Benedicto, Carlos Gonzalez-Juanatey, Mercedes Camprubí Potau, Ignacio Plaza Perez, César Morís De La Tassa, Pablo Loma-Osorio Rincon, Javier Balaguer Recena, Juan M. Escudier, Antonio Coca Payeras, Norberto Alonso Orcajo, Pedro Valdivielso, Godwin Constantine, Ruvaiz Haniffa, Nirmali Tissera, Stanley Amarasekera, Chandrike Ponnamperuma, Nimali Fernando, Kaputella Fernando, Jayanthimala Jayawardena, Santharaj Wijeyasingam, Gotabhaya Ranasinghe, Ruvan Ekanayaka, Sepalika Mendis, Vajira Senaratne, Gnanamoorthy Mayurathan, Ajantha Rajapaksha, Thilak Sirisena, Jagath I. Herath, Naomali Amarasena, Stefan Berglund, Gundars Rasmanis, Ola Vedin, Nils Witt, Georgios Mourtzinis, Peter Nicol, Ole Hansen, Stefano Romeo, Steen Agergaard Jensen, Ingemar Torstensson, Ulf Ahremark, Torbjörn Sundelin, Tiziano Moccetti, Francois Mach, Ronald Binde, Oliver Gämperli, Wei-Chuan Tsai, Kwo-Chang Ueng, Wen-Ter Lai, Ming-En Liu, Juey-Jen Hwang, Wei-Hsian Yin, I-Chang Hsieh, Ming-Jer Hsieh, Wei Hsiang Lin, Jen-Yuan Kuo, Tsuei-Yuan Huang, Chih-Yuan Fang, Pinij Kaewsuwanna, Wasant Soonfuang, Woravut Jintapakorn, Apichard Sukonthasarn, Nattawut Wongpraparut, Krisada Sastravaha, Nakarin Sansanayudh, Wirash Kehasukcharoen, Dilok Piyayotai, Paiboon Chotnoparatpat, Ahmet Camsari, Hakan Kultursay, Bulent Mutlu, Murat Ersanli, Mustafa Demirtas, Cevat Kirma, Ertan Ural, Lale Koldas, Oleksandr Karpenko, Alexander Prokhorov, Ihor Vakaluyk, Halyna Myshanych, Dmytro Reshotko, Valeriy Batushkin, Leonid Rudenko, Ihor Kovalskyi, Mykola Kushnir, Vira Tseluyko, Yuriy Mostovoy, Mykola Stanislavchuk, Yulian Kyiak, Yuriy Karpenko, Yaroslav Malynovsky, Andriy Klantsa, Oles Kutniy, Ekaterina Amosova, Viktor Tashchuk, Oleh Leshchuk, Mykola Rishko, Mykola Kopytsya, Andriy Yagensky, Mykola Vatutin, Andriy Bagriy, Olga M. Barna, Olexiy Ushakov, Georgiy Dzyak, Borys Goloborodko, Anatolii Rudenko, Volodymyr Zheleznyy, Jasper Trevelyan, Azfar Zaman, Kaeng Lee, Andrew Moriarty, Rajesh K. Aggarwal, Piers Clifford, Yuk-Ki Wong, Syed M.R. Iqbal, Eduardas Subkovas, Denise Braganza, David Sarkar, Robert Storey, Huw Griffiths, Sam Mcclure, Rangasamy Muthusamy, Simon Smith, John Kurian, Terry Levy, Craig Barr, Honer Kadr, Robert Gerber, Audrius Simaitis, Handrean Soran, Anthony Mathur, Adrian Brodison, Mohammad Ayaz, Muhammad Cheema, Richard Oliver, Simon Thackray, Telal Mudawi, Gohar Rahman, Ayyaz Sultan, Timothy Reynolds, David Sharman, null david Sprigings, Rob Butler, Peter Wilkinson, Gregory Y.H. Lip, Julian Halcox, Sean Gallagher, Nicholas Ossei-Gerning, Gil Vardi, Duccio Baldari, David Brabham, Charles Treasure, Charles Dahl, Bruce Palmer, Alan Wiseman, Abul Khan, Sanjeev Puri, Ann Elizabeth Mohart, Carlos Ince, Enrique Flores, Scott Wright, Shi-Chi Cheng, Michael Rosenberg, William Rogers, Edward Kosinski, Les Forgosh, Jonathan Waltman, Misal Khan, Mohammad Shoukfeh, Georges Dagher, Patrick Cambier, Ira Lieber, Priya Kumar, Cara East, Perry Krichmar, Mian Hasan, Lindsey White, Thomas Knickelbine, Thomas Haldis, Eve Gillespie, Thomas Amidon, David Suh, Imran Arif, Mouhamad Abdallah, Faiq Akhter, Eric Carlson, Michael D'Urso, Fadi El-Ahdab, William Nelson, Katie Moriarty, Barry Harris, Steven Cohen, Luther Carter, Daniel Doty, Kenneth Sabatino, Tariq Haddad, Amir Malik, Sunder Rao, Angel Mulkay, Ion Jovin, Kim Klancke, Vinay Malhotra, Sai K. Devarapalli, Michael Koren, Harish Chandna, George Dodds, Tauqir Goraya, James Bengston, Matthew Janik, Joseph Moran, Andrew Sumner, John Kobayashi, William Davis, Shahram Yazdani, John Pasquini, Maitreya Thakkar, Amarnath Vedere, Wayne Leimbach, James Rider, Sarah fenton, Narendra Singh, Anil V. Shah, Denise Janosik, Carl Pepine, Brett Berman, Joseph Gelormini, Christopher Daniels, Kerensky Richard, Friederike Keating, Nicholas I. Kondo, Sanjay Shetty, Howard Levite, Winfried Waider, Theodore Takata, Mazen Abu-Fadel, Vipul Shah, Rahul Aggarwal, Mark Izzo, Anil Kumar, Brack Hattler, Rose Do, Chad Link, Anna Bortnick, George Kinzfogl, Arnold Ghitis, John Larry, Edward Teufel, Peter Kuhlman, Brent Mclaurin, Wenwu Zhang, Stephen Thew, Jalal Abbas, Matthew White, Othman Islam, Sumeet Subherwal, Nandkishore Ranadive, Babak Vakili, Christian Gring, David Henderson, Timothy Schuchard, Naim Farhat, Geoffrey Kline, Sharan Mahal, Jack Whitaker, Shawn Speirs, Rolf Andersen, Nizar Daboul, Phillip Horwitz, Firas Zahr, George Ponce, Zubair Jafar, Joseph Mcgarvey, Vipul Panchal, Stephen Voyce, Thomas Blok, William Sheldon, Masoud M. Azizad, Carsten Schmalfuss, Mark Picone, Robert Pederson, William Herzog, Keith Friedman, Jason Lindsey, Rosemary Nowins, Eichenlaub Timothy, Parilak Leonard, Norman Lepor, Mahfouz El Shahawy, Howard Weintraub, Anand Irimpen, Alvaro Alonso, Wade May, Daniels Christopher, Thomas Galski, Alan Chu, Freny Mody, Ebrahimi Ramin, Zachary Hodes, Joseph Rossi, Gregory Rose, James Fairlamb, Charles Lambert, Ajit Raisinghani, Antonio Abbate, George Vetrovec, Marilyn King, Charles Carey, Jaime Gerber, Liwa Younis, Hyeun Park, Mladen Vidovich, Thomas Knutson, Dennis Friedman, Fred Chaleff, Arthur Loussararian, Phillip Rozeman, Carey Kimmelstiel, Jeffrey Kuvin, Kevin Silver, Malcolm Foster, Glen Tonnessen, Andrey Espinoza, Mohamadali Amlani, Andreas Wali, Christopher Malozzi, Geert T. Jong, Clara Massey, Keattiyoat Wattanakit, Philip J. O'Donnell, Dinesh Singal, Naseem Jaffrani, Sridhar Banuru, Daniel Fisher, Mark Xenakis, Neal Perlmutter, Ravi Bhagwat, James Strader, Ronald Blonder, Ayim Akyea-Djamson, Ajay Labroo, Kwan Lee, H. John Marais, Edmund Claxton, Robert Weiss, Rohr Kathryn, Martin Berk, Peter Rossi, Parag Joshi, Amit Khera, Ajit S. Khaira, Greg Kumkumian, Steven Lupovitch, Joshua Purow, Stephen Welka, David Hoffman, Stuart Fischer, Eugene Soroka, Donald Eagerton, Samir Pancholy, Michael Ray, Norman Erenrich, Michael Farrar, Stewart Pollock, William J. French, Steve Diamantis, Douglas Guy, Lawrence Gimple, Mark Neustel, Steven Schwartz, Edward Pereira, Seals Albert, Douglas Spriggs, Janet Strain, Suneet Mittal, Anthony Vo, Majed Chane, Jason Hall, Nampalli Vijay, Kapildeo Lotun, F. Martin Lester, Ahed Nahhas, Theodore Pope, Paul Nager, Rakesh Vohra, Mukesh Sharma, Riyaz Bashir, Hinan Ahmed, Michael Berlowitz, Robert Fishberg, Robert Barrucco, Eric Yang, Michael Radin, Daniel Sporn, Dwight Stapleton, Steven Eisenberg, Joel Landzberg, Martin Mcgough, Samir Turk, Michael Schwartz, P. Sandy Sundram, Diwakar Jain, Mark Zainea, Carlos Bayron, Ronald Karlsberg, Suhail Dohad, Henry Lui, William Keen, Donald Westerhausen, Sandeep Khurana, Himanshu Agarwal, Jessica Birchem, William Penny, Mark Chang, Sherrill Murphy, John Henry, Branislav Schifferdecker, John M Gilbert, Gopal Chalavarya, Charles Eaton, John F. Schmedtje, Stuart Christenson, Imran Dotani, Douglas Denham, Alexander Macdonell, Paul Gibson, Aref Rahman, Tammam Al Joundi, Nizar Assi, Gary Conrad, Purushotham Kotha, Michael Love, Gregory Giesler, Howard Rubenstein, Dawood Gamil, Laura Akright, Justine Krawczyk, Joanne Cobler, Terry Wells, James Welker, Robert Foster, Richard Gilmore, Jay Anderson, Douglas Jacoby, Bill Harris, Geraldine Gardner, Ramprasad Dandillaya, Kishor Vora, John Kostis, John Hunter, David Laxson, Eric Ball, Flavia Egydio, Anelise Kawakami, Janaina Oliveira, Julianna Wozniak, Alexander Matthews, Caroline Ratky, Janine Valiris, Lisa Berdan, Anita Hepditch, Kirby Quintero, Tyrus Rorick, Melissa Westbrook, Andrea Pascual, Carla Rovito, Madeleine Bezault, Elodie Drouet, Tabassome Simon, Caroline Alsweiler, Anne Luyten, Julie Butters, Liddy Griffith, Michelle Shaw, Lena Grunberg, Shahidul Islam, Marie-France Brégeault, Nathalie Bougon, Douglas Faustino, Sylvie Fontecave, Judith Murphy, Melanie Verrier, null Veronique Agnetti, Dorthe Andersen, Emmy Badreddine, Mhamed Bekkouche, Cecile Bouancheau, Imane Brigui, Maddy Brocklehurst, Joseph Cianciarulo, Dawn Devaul, Szilvia Domokos, Cecile Gache, Caroline Gobillot, Severine Guillou, Jan Healy, Megan Heath, Gayatri Jaiwal, Carine Javierre, Julien Labeirie, Myriam Monier, Ulises Morales, Asmaa Mrabti, Bicky Mthombeni, Betim Okan, Lucile Smith, Jennifer Sheller, Sebastien Sopena, Valerie Pellan, Fadela Benbernou, Nafissa Bengrait, Maud Lamoureux, Katarina Kralova, Raphael Bejuit, Anthony Coulange, Christelle Berthou, Jérôme Repincay, Christelle Lorenzato, Alexis Etienne, Valerie Gouet, Virginie Loizeau, Mickael Normand, Anne Ourliac, Christelle Rondel, Antony Adamo, Pascale Beltran, Pauline Barraud, Helene Dubois-Gache, Benjamin Halle, Lamia Metwally, Maxime Mourgues, Marc Sotty, Marion Vincendet, Raluca Cotruta, Zhu Chengyue, Dominique Fournie-Lloret, Christine Morrello, Aurelie Perthuis, Patrick Picault, Isabelle Zobouyan, Helen M. Colhoun, Michael A. Dempsey, Mark A. McClanahan, Masira, and Laucevičius, Aleksandras
Subjects: Male, Acute coronary syndrome, medicine.medical_specialty, Cardiac & Cardiovascular Systems, Randomization, PCSK9 inhibitor, LOW-DENSITY-LIPOPROTEIN, Antibodies, Monoclonal, Humanized, acute coronary syndrom, Placebo, Gastroenterology, lipoprotein(a), Internal medicine, medicine, Humans, Low-density lipoprotein cholesterol, Aged, Alirocumab, RISK, low-density lipoprotein cholesterol, Science & Technology, biology, business.industry, PCSK9, PCSK9 Inhibitors, Hazard ratio, ALIROCUMAB, acute coronary syndrome, Cholesterol, LDL, Lipoprotein(a), Middle Aged, EFFICACY, medicine.disease, Cardiovascular Diseases, CARDIOVASCULAR-DISEASE, SAFETY, Cardiovascular System & Cardiology, biology.protein, Female, lipids (amino acids, peptides, and proteins), STATIN, low-density lipoprotein, cholesterol PCSK9 inhibitor, CORONARY, Cardiology and Cardiovascular Medicine, business, Life Sciences & Biomedicine, Mace
Abstract: Digital, Background Guidelines recommend nonstatin lipid-lowering agents in patients at very high risk for major adverse cardiovascular events (MACE) if low-density lipoprotein cholesterol (LDL-C) remains ≥70 mg/dL on maximum tolerated statin treatment. It is uncertain if this approach benefits patients with LDL-C near 70 mg/dL. Lipoprotein(a) levels may influence residual risk. Objectives In a post hoc analysis of the ODYSSEY Outcomes (Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab) trial, the authors evaluated the benefit of adding the proprotein subtilisin/kexin type 9 inhibitor alirocumab to optimized statin treatment in patients with LDL-C levels near 70 mg/dL. Effects were evaluated according to concurrent lipoprotein(a) levels. Methods ODYSSEY Outcomes compared alirocumab with placebo in 18,924 patients with recent acute coronary syndromes receiving optimized statin treatment. In 4,351 patients (23.0%), screening or randomization LDL-C was 13.7 mg/dL or ≤13.7 mg/dL; corresponding adjusted treatment hazard ratios were 0.82 (95% CI: 0.72-0.92) and 0.89 (95% CI: 0.75-1.06), with Pinteraction = 0.43. Conclusions In patients with recent acute coronary syndromes and LDL-C near 70 mg/dL on optimized statin therapy, proprotein subtilisin/kexin type 9 inhibition provides incremental clinical benefit only when lipoprotein(a) concentration is at least mildly elevated. (ODYSSEY Outcomes: Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab; NCT01663402), Ciencias Médicas y de la Salud
Published: 2021
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15. Feasibility and safety of cangrelor in patients with suboptimal P2Y

Author: Abi, Selvarajah, Annerieke H, Tavenier, Wilbert L, Bor, Vital, Houben, Saman, Rasoul, Eliza, Kaplan, Koen, Teeuwen, Sjoerd H, Hofma, Erik, Lipsic, Giovanni, Amoroso, Maarten A H, van Leeuwen, Jur M, Ten Berg, Arnoud W J, van 't Hof, and Renicus S, Hermanides
Published: 2021

16. Identification of anatomic risk factors for acute coronary events by optical coherence tomography in patients with myocardial infarction and residual nonflow limiting lesions: rationale and design of the PECTUS-obs study

Author: Niels van Royen, Oleg V Krestyaninov, Karin Arkenbout, Martijn Meuwissen, Maarten A.H. van Leeuwen, Alexey V Protopopov, Peep Laanmets, R.M. Oemrawsingh, Jan-Quinten Mol, Anouar Belkacemi, Rick Hja Volleberg, Robert-Jan van Geuns, Erik Lipsic, Dirk J. van der Heijden, Jan-Peter van Kuijk, Peter Damman, Cyril Camaro, Steven Teerenstra, Robert Dennert, Saman Rasoul, MUMC+: MA Med Staf Spec Cardiologie (9), and RS: FHML non-thematic output
Subjects: Target lesion, medicine.medical_treatment, FEATURES, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], Myocardial Infarction, Fractional flow reserve, 030204 cardiovascular system & hematology, Cardiovascular Medicine, medicine.disease_cause, Coronary Angiography, ANGIOGRAPHY, Coronary artery disease, 0302 clinical medicine, Risk Factors, Intravascular ultrasound, FRACTIONAL FLOW RESERVE, ARTERY-DISEASE, 030212 general & internal medicine, Myocardial infarction, Prospective Studies, medicine.diagnostic_test, Vascular damage Radboud Institute for Molecular Life Sciences [Radboudumc 16], General Medicine, Fractional Flow Reserve, Myocardial, Treatment Outcome, Cardiology, Medicine, coronary intervention, medicine.symptom, INTERVENTION, Tomography, Optical Coherence, PLAQUES, medicine.medical_specialty, Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18], Lesion, 03 medical and health sciences, Percutaneous Coronary Intervention, Internal medicine, Angioplasty, medicine, INTRAVASCULAR ULTRASOUND, MANAGEMENT, Humans, coronary heart disease, ANGIOPLASTY, business.industry, ACQUISITION, medicine.disease, Vulnerable plaque, business
Abstract: IntroductionIn patients with myocardial infarction, the decision to treat a nonculprit lesion is generally based on its physiological significance. However, deferral of revascularisation based on nonischaemic fractional flow reserve (FFR) values in these patients results in less favourable outcomes compared with patients with stable coronary artery disease, potentially caused by vulnerable nonculprit lesions. Intravascular optical coherence tomography (OCT) imaging allows for in vivo morphological assessment of plaque ‘vulnerability’ and might aid in the detection of FFR-negative lesions at high risk for recurrent events.Methods and analysisThe PECTUS-obs study is an international multicentre prospective observational study that aims to relate OCT-derived vulnerable plaque characteristics of nonflow limiting, nonculprit lesions to clinical outcome in patients with myocardial infarction. A total of 438 patients presenting with myocardial infarction (ST-elevation myocardial infarction and non-ST-elevation myocardial infarction) will undergo OCT-imaging of any FFR-negative nonculprit lesion for detection of plaque vulnerability. The primary study endpoint is a composite of major adverse cardiovascular events (all-cause mortality, nonfatal myocardial infarction or unplanned revascularisation) at 2-year follow-up. Secondary endpoints will be the same composite at 1-year and 5-year follow-up, target vessel failure, target vessel revascularisation, target lesion failure and target lesion revascularisation.Ethics and disseminationThis study has been approved by the Medical Ethics Committee of the region Arnhem-Nijmegen. The results of this study will be disseminated in a main paper and additional papers with subgroup analyses.Trial registration numberNCT03857971.
Published: 2021

17. Importance of confirming the underlying diagnosis in patients with myocardial infarction and non-obstructive coronary arteries (MINOCA): a single-centre retrospective cohort study

Author: Mera Stein, Á. Lux, A. W. Ruiters, A. W. J. van ’t Hof, B. Gho, T. F. S. Pustjens, P. J. C. Winkler, Saman Rasoul, M. Ilhan, Nousjka P.A. Vranken, A. Meerman, Leo Veenstra, MUMC+: MA Med Staf Spec Cardiologie (9), RS: Carim - H01 Clinical atrial fibrillation, and Cardiologie
Subjects: Adult, Male, medicine.medical_specialty, Acute coronary syndrome, Myocarditis, Time Factors, Cardiomyopathy, Myocardial Infarction, Coronary Artery Disease, 030204 cardiovascular system & hematology, THERAPY, Risk Assessment, DISEASE, 03 medical and health sciences, 0302 clinical medicine, Predictive Value of Tests, Recurrence, Risk Factors, Internal medicine, medicine, MANAGEMENT, Prevalence, Diseases of the circulatory (Cardiovascular) system, Humans, 030212 general & internal medicine, Myocardial infarction, Stroke, Outcome, Aged, Retrospective Studies, MINOCA, Ejection fraction, business.industry, Research, WORKING GROUP, Retrospective cohort study, Middle Aged, medicine.disease, Prognosis, CARDIOVASCULAR MAGNETIC-RESONANCE, RC666-701, Cardiology, Female, Cardiology and Cardiovascular Medicine, business, Mace, POSITION PAPER
Abstract: BackgroundMany patients with myocardial infarction with non-obstructive coronary arteries (MINOCA) are discharged without a known aetiology for their clinical presentation. This study sought to assess the effect of this ‘indeterminate MINOCA’ diagnosis on the prevalence of recurrent cardiovascular events and presentations to the Cardiac Emergency Department (CED).MethodsWe retrospectively analysed all patients meeting the diagnostic MINOCA criteria presenting at a large secondary hospital between January 2017 and April 2019.ParticipantsPatients were divided into the (1) ‘indeterminate MINOCA’, or (2) ‘MINOCA with diagnosis’ group. The primary outcome was the occurrence of major adverse cardiac events (MACE) defined as the composite of all-cause mortality, non-fatal myocardial infarction, stroke and any revascularisation procedure. Secondary outcomes were all recurrent visits at the CED, and MACE including unplanned cardiac hospitalisation.ResultsIn 62/198 (31.3%) MINOCA patients, a conclusive diagnosis was found (myocardial infarction, (peri)myocarditis, cardiomyopathy, or miscellaneous). MINOCA patients with a confirmed diagnosis were younger compared to those with an indeterminate diagnosis (56.7 vs. 62.3 years,p = 0.007), had higher maximum troponin-T [238 ng/L vs. 69 ng/L,p p = 0.007], and presented more frequently with electrocardiographic signs of ischaemia (71.0% vs. 47.1%,p = 0.002). Indeterminate MINOCA patients more often showed recurrent CED presentations (36.8% vs. 22.6%,p = 0.048), however the occurrence of cardiovascular events was equal (8.8 vs. 8.1%,p = 0.86). Multivariable analysis showed that elevated levels of troponin-T and CK, ST-segment deviation on electrocardiography, reduced left ventricular ejection fraction, regional wall motion abnormalities, and performance of additional examination methods were independent predictors for finding the underlying MINOCA cause.ConclusionsOnly in one-third of MINOCA patients a conclusive diagnosis for the acute presentation was identified. Recurrent CED visits were more often observed in the indeterminate MINOCA group, while the occurrence of cardiovascular events was similar across groups.Trial registrationRetrospectively registered
Published: 2021

18. Guidelines for the management of myocardial infarction/injury with non-obstructive coronary arteries (MINOCA): a position paper from the Dutch ACS working group

Author: A. W. J. van ’t Hof, J. M. ten Berg, Johan Wouter Jukema, M. L. J. van der Wielen, P. Damman, T. F. S. Pustjens, W. R. P. Agema, Yolande Appelman, F. Arslan, R. J. de Winter, and Saman Rasoul
Subjects: medicine.medical_specialty, Acute coronary syndrome, NATIONAL-HEART, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], LONG-TERM PROGNOSIS, Review Article, Non-obstructive coronary arteries, MICROVASCULAR DYSFUNCTION, CHEST-PAIN, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, FACTOR-V-LEIDEN, 030212 general & internal medicine, Myocardial infarction, MINOCA, UNSTABLE ANGINA, CARDIAC MAGNETIC-RESONANCE, business.industry, CLINICAL-FEATURES, Correction, Working diagnosis, medicine.disease, EUROPEAN-SOCIETY, 3. Good health, Coronary arteries, Stenosis, medicine.anatomical_structure, Cardiology, Position paper, DIFFERENTIAL-DIAGNOSIS, Cardiology and Cardiovascular Medicine, business, Psychosocial
Abstract: Contains fulltext : 220920.pdf (Publisher’s version ) (Open Access) Patients with myocardial infarction and non-obstructive coronary arteries (MINOCA), defined as angiographic stenosis
Published: 2019
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19. A randomised, investigator-initiated, clinical trial of the effects of fentanyl on P2Y12-receptor inhibition in patients with ST-elevation myocardial infarction who are pre-treated with crushed ticagrelor

Author: Saman Rasoul, A. W. J. van ’t Hof, Rudolf T Tolsma, E. Kedhi, R. S. Hermanides, J. P. Ottervanger, Robbert J. Slingerland, Anne H. Tavenier, S. van Workum, MUMC+: MA Med Staf Spec Cardiologie (9), RS: Carim - H01 Clinical atrial fibrillation, Cardiologie, and RS: CARIM - R2.01 - Clinical atrial fibrillation
Subjects: Ticagrelor, Platelet inhibition, medicine.medical_treatment, PERCUTANEOUS CORONARY INTERVENTION, MORPHINE USE, 030204 cardiovascular system & hematology, law.invention, 03 medical and health sciences, 0302 clinical medicine, P2Y12, Randomized controlled trial, law, Clinical endpoint, Medicine, cardiovascular diseases, 030212 general & internal medicine, Myocardial infarction, CARDIOVASCULAR EVENTS, TREATMENT PLATELET REACTIVITY, INTRAVENOUS FENTANYL, business.industry, SEGMENT ELEVATION, Primary percutaneous coronary intervention, Percutaneous coronary intervention, ASSOCIATION, AGGREGATION, medicine.disease, Clinical trial, Fentanyl, surgical procedures, operative, ST-elevation myocardial infarction, Anesthesia, Conventional PCI, Cardiology and Cardiovascular Medicine, business, ACETAMINOPHEN, Original Article – Design Study Article, medicine.drug, TASK-FORCE
Abstract: Background Fast and accurate platelet inhibition is an important therapeutic goal in the acute treatment of patients with ST-elevation myocardial infarction (STEMI). Platelet inhibitory effects induced by oral P2Y12-receptor antagonists are delayed in STEMI patients undergoing primary percutaneous coronary intervention (PCI) due to haemodynamic changes and delayed gastro-intestinal absorption. Concomitant use of opioids, although recommended in the American College of Cardiology/American Heart Association and European Society of Cardiology STEMI guidelines, further delays gastro-intestinal absorption. To date, trials investigating alternative analgesics in STEMI patients have been scarce. This trial aims to assess the feasibility of a novel drug strategy for treatment of STEMI patients with crushed ticagrelor in combination with paracetamol (acetaminophen) instead of opioids. Hypothesis STEMI patients who are pre-treated with crushed ticagrelor and paracetamol have a higher level of platelet inhibition after primary PCI than patients pre-treated with crushed ticagrelor and fentanyl. Study design The Opioids aNd crushed Ticagrelor In Myocardial infarction Evaluation (ON-TIME 3) trial is a randomised controlled trial designed to examine whether administration of paracetamol instead of fentanyl can optimise platelet inhibition in STEMI patients who are pre-treated with crushed ticagrelor in the ambulance. One hundred and ninety patients with STEMI will be randomised (1:1 fashion) to intravenous (IV) fentanyl or IV paracetamol. The primary endpoint is the level of platelet reactivity units measured immediately after primary PCI. Summary The ON-TIME 3 trial (NCT03400267) aims to achieve optimal platelet inhibition and pain relief in STEMI patients receiving crushed ticagrelor in the ambulance by investigating IV fentanyl and IV paracetamol as analgesics.
Published: 2019

20. Feasibility and safety of cangrelor in patients with suboptimal P2Y(12) inhibition undergoing percutaneous coronary intervention

Author: A Selvarajah, R. S. Hermanides, A. W. J. van ’t Hof, Giovanni Amoroso, Anne H. Tavenier, V Houben, Koen Teeuwen, W L Bor, J. M. ten Berg, E Lipsic, Emel Kaplan, Saman Rasoul, Sjoerd H. Hofma, M A H van Leeuwen, Cardiologie, RS: Carim - B04 Clinical thrombosis and Haemostasis, MUMC+: MA Med Staf Spec Cardiologie (9), and RS: Carim - H01 Clinical atrial fibrillation
Subjects: P2Y(12) inhibitors, Time Factors, Platelet inhibition, IMPACT, medicine.medical_treatment, Myocardial Ischemia, THERAPY, Percutaneous coronary intervention, Coronary artery disease, chemistry.chemical_compound, DISTAL EMBOLIZATION, P2Y12, Risk Factors, Clinical endpoint, Prospective Studies, Registries, Stroke, Netherlands, Cangrelor, Treatment Outcome, Research Design, CLOPIDOGREL, Cardiology, Patient Safety, Cardiology and Cardiovascular Medicine, TRANSITION, Acute coronary syndrome, medicine.medical_specialty, Risk Assessment, Internal medicine, STENT THROMBOSIS, medicine, Diseases of the circulatory (Cardiovascular) system, Humans, TICAGRELOR, cardiovascular diseases, P2Y12 inhibitors, IMPAIRED BIOAVAILABILITY, business.industry, Research, ELEVATION MYOCARDIAL-INFARCTION, medicine.disease, Adenosine Monophosphate, chemistry, RC666-701, Conventional PCI, Purinergic P2Y Receptor Antagonists, Feasibility Studies, business, Platelet Aggregation Inhibitors
Abstract: BackgroundDespite the advances of potent oral P2Y12inhibitors, their onset of action is delayed, which might have a negative impact on clinical outcome in patients undergoing percutaneous coronary intervention (PCI). Trials conducted in the United States of America have identified cangrelor as a potent and rapid-acting intravenous P2Y12inhibitor, which has the potential of reducing ischemic events in these patients without an increase in the bleeding. As cangrelor is rarely used in The Netherlands, we conducted a nationwide registry to provide an insight into the use of cangrelor in the management of patients with suboptimal platelet inhibition undergoing (primary) PCI (the Dutch Cangrelor Registry).Study designThe Cangrelor Registry is a prospective, observational, multicenter, single-arm registry with cangrelor administered pre-PCI in: (1) P2Y12naive patients with ad-hoc PCI, (2) patients with STEMI/NSTEMI with suboptimal P2Y12inhibition including (3) stable resuscitated/defibrillated patients with out-of-hospital cardiac arrest (OHCA) due to acute ischemia and (4) STEMI/NSTEMI patients with a high thrombotic burden. Primary endpoint is 48 h Net Adverse Clinical Events (NACE), which is a composite endpoint of all-cause death, recurrent myocardial infarction (MI), target vessel revascularization (TVR), stroke, stent thrombosis (ST) and BARC 2-3-5 bleeding.SummaryThe Dutch Cangrelor Registry will assess the feasibility and safety of cangrelor in patients with suboptimal P2Y12inhibition undergoing (primary) PCI in the setting of acute coronary syndrome (ACS) and stable coronary artery disease (CAD) in the Netherlands.
Published: 2021

21. Gender differences with short-term vs 12 months dual antiplatelet therapy in patients with acute coronary syndrome treated with the COMBO dual therapy stent: 2-years follow-up results of the REDUCE trial

Author: Vincent Roolvink, Jawed Polad, Houng-Bang Liew, Marc A. Brouwer, E. J. J. Kolkman, Philippe Timmermans, Stephen Wl. Lee, Sander A.J. Damen, Robaayah Zambahari, A.W.J. van't Hof, Wan Azman Wan Ahmad, Edouard Benit, Tian Hai Koh, Sonja Postma, Saman Rasoul, Cyril Camaro, Harry Suryapranata, Jacques Lalmand, R J van der Schaaf, Erik Ligtenberg, E. Kedhi, M. Verdoia, Dagmara Dilling-Boer, G. De Luca, Lucia Barbieri, and Leo Veenstra
Subjects: Male, Acute coronary syndrome, medicine.medical_specialty, medicine.medical_treatment, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], Hemorrhage, 030204 cardiovascular system & hematology, Dual therapy stent, 03 medical and health sciences, 0302 clinical medicine, Percutaneous Coronary Intervention, Sex Factors, Internal medicine, medicine, Clinical endpoint, Humans, 030212 general & internal medicine, Myocardial infarction, Prospective Studies, Acute Coronary Syndrome, Stroke, business.industry, Stent, Thrombosis, Hematology, medicine.disease, Treatment Outcome, Drug Therapy, Combination, Female, Stents, Cardiology and Cardiovascular Medicine, business, TIMI, Platelet Aggregation Inhibitors, Follow-Up Studies
Abstract: Item does not contain fulltext BACKGROUND: Gender differences in the thrombotic and bleeding risk have been suggested to condition the benefits of antithrombotic therapies in Acute Coronary Syndrome (ACS) patients, and mainly among those undergoing percutaneous coronary interventions with drug eluting stents (DES). The impact of gender on the optimal duration of dual antiplatelet therapy (DAPT) in ACS patients is still unexplored and was, therefore, the aim of the present sub-study. METHODS: REDUCE was a prospective, multicenter, randomized investigator-initiated study designed to enroll 1500 ACS patients after treatment with the COMBO Dual Stent Therapy, based on a noninferiority design. Patients were randomized in a 1:1 fashion to either 3 or 12 months of DAPT. Primary study endpoint was a composite of all-cause mortality, myocardial infarction, definite/probable stent thrombosis (ST), stroke, target-vessel revascularization (TVR) and bleedings (BARC II, III, V) at 12 months. Secondary endpoints were cardiovascular mortality and the individual components of the primary endpoint within 24 months. RESULTS: From June 2014 to May 2016 300 women and 1196 men were included in the study. Among them, 43.7% of females and 51.9% of males were assigned to the 3 months DAPT treatment. Baseline characteristics were well matched between the two arms, with the exception of a lower rate of TIMI flow
Published: 2021

22. Patients undergoing urgent trans-aortic valve implantation suffer from an increased mortality rate

Author: Bart Maesen, Suzanne Kats, Leo Veenstra, Saman Rasoul, A. W. J. van ’t Hof, and Arpad Lux
Subjects: Aortic valve, medicine.medical_specialty, medicine.anatomical_structure, business.industry, Internal medicine, Mortality rate, medicine, Cardiology, Cardiology and Cardiovascular Medicine, business
Abstract: Introduction Information on the outcome of urgent Transcatheter valve implantations (TAVI) is scarce, but available data suggest that it could be a reasonable option for the treatment of decompensated severe aortic valve stenosis. The prospects of an all-comer urgent population, however, are unknown. Here we report our experience with clinically indicated urgent TAVI implantation in an unselected patient population with severe aortic valve stenosis (AS). Purpose To compare the outcome of patients undergoing urgent or elective TAVI and to identify potential predictors of outcome. Methods A retrospective, single centre study of AS patients undergoing femoral or apical TAVI between 01. 01.2013 and 30.09.2018 was performed. Demographic information, medical history, clinical and procedural data were collected from the local electronic database. Urgent implantation was defined as accelerated, in-hospital patient preparation and urgent device placement following an acute admission. Survival was investigated with Kaplan-Meier survival analysis and log-rank test. Regression analysis was performed to identify possible predictors of mortality. Results During the study period TAVI was performed in 631 patients, of whom 53 (8.4%) underwent urgent TAVI. In the case of urgent procedures, the median admission-to-procedure time was 18 [10–29] days. Age, gender and the prevalence of diabetes mellitus, chronic obstructive lung disease (COPD) and a glomerular filtration rate of ≤30ml/min was comparable among the groups. Patients in the urgent group had a lower BMI (26 [23–28] vs. 27 [24–30]; p Conclusion Stabilizing AS patients can mitigate the effect of urgency on peri-procedural survival. Urgency remains, however, an important determinant of one-year TAVI outcome. Funding Acknowledgement Type of funding source: None
Published: 2020
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23. MINOCA: The caveat of absence of coronary obstruction in myocardial infarction

Author: Sebastiaan C.A.M. Bekkers, Jordi Heijman, Renicus S Hermanides, Martijn W. Smulders, Yvonne J. M. van Cauteren, T. F. S. Pustjens, Arnoud W J van 't Hof, Saman Rasoul, Nousjka P.A. Vranken, Jan Paul Ottervanger, Evelien Kolkman, Promovendi CD, Cardiologie, MUMC+: MA Cardiologie (9), RS: Carim - H01 Clinical atrial fibrillation, MUMC+: MA Med Staf Artsass Cardiologie (9), RS: Carim - Blood, RS: Carim - Heart, MUMC+: MA Med Staf Artsass Interne Geneeskunde (9), RS: Carim - B06 Imaging, and MUMC+: MA Med Staf Spec Cardiologie (9)
Subjects: medicine.medical_specialty, Acute coronary syndrome, lcsh:Diseases of the circulatory (Cardiovascular) system, ARTERIES MINOCA, Total population, 030204 cardiovascular system & hematology, GUIDELINES, DISEASE, Clinical research, STE-ACS, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, ARTERY-DISEASE, 030212 general & internal medicine, Myocardial infarction, Original Paper, MINOCA, ACS/NSTE-ACS, Potential risk, business.industry, Mortality rate, medicine.disease, Coronary arteries, medicine.anatomical_structure, lcsh:RC666-701, CARDIOVASCULAR MAGNETIC-RESONANCE, Cardiology, Cardiology and Cardiovascular Medicine, business, POSITION PAPER
Abstract: Highlights • The MINOCA prevalence is 5.2% in the total ACS population. • MINOCA occurs predominantly in the NSTE-ACS population and in females. • MINOCA show an ‘intermediate’ risk profile with mortality rates in between those of SV-ACS and MV-ACS., Aims Whether patients with MINOCA (myocardial infarction with non-obstructive coronary arteries) have better outcomes than patients with obstructive coronary artery disease remains contradictory. The current study focussed on the clinical profile and prognosis of MINOCA patients. Methods and results We performed a retrospective analysis of patients with acute coronary syndrome (ACS) admitted to the Isala hospital in Zwolle, the Netherlands, between 2006 and 2014. A total of 7693 patients were categorized into three groups: MINOCA, single-vessel obstructive ACS (SV-ACS), and multi-vessel obstructive ACS (MV-ACS). MINOCA patients (5.2% of the total population) were more likely to be female (51.5% vs. 30.3% and 26.0% in SV-ACS and MV-ACS, respectively, p
Published: 2020

24. [Myocardial infarction with nonobstructive coronary arteries (MINOCA): indications for additional investigations and treatment]

Author: Tobias, Pustjens, Arnoud W J, van 't Hof, Timo, Lenderink, and Saman, Rasoul
Subjects: Male, Risk Factors, Myocardial Infarction, Humans, Female, Middle Aged, Coronary Angiography, Coronary Vessels, Magnetic Resonance Imaging, Aged
Abstract: Myocardial infarction with nonobstructive coronary arteries (MINOCA) has multiple potential underlying causes which can be subdivided into coronary, myocardial and non-cardiac disorders. On the basis of three case descriptions, we show that additional investigations are crucial in determining the underlying mechanism and starting suitable treatment. Depending on clinical presentation, risk factors and medical history, an LV angiogram, a provocation test with intracoronary acetylcholine and a cardiac MRI can contribute to finding the correct diagnosis. We further present a diagnostic algorithm to guide the clinician in the management of patients presenting with MINOCA.
Published: 2020

25. Design and rationale of ischaemia-driven complete revascularisation versus usual care in patients with non-ST-elevation myocardial infarction and multivessel coronary disease: the South Limburg Myocardial Infarction (SLIM) trial

Author: M. Ilhan, Sebastiaan C.A.M. Bekkers, Leo Veenstra, B. Streukens, A. W. Ruiters, B. Gho, A.W.J. van't Hof, Jindra Vainer, Saman Rasoul, Ruud Theunissen, T. F. S. Pustjens, Mera Stein, Cardiologie, MUMC+: MA Med Staf Spec Cardiologie (9), RS: Carim - H01 Clinical atrial fibrillation, MUMC+: MA Cardiologie (9), and RS: Carim - B06 Imaging
Subjects: unstable angina, medicine.medical_specialty, Acute coronary syndrome, medicine.medical_treatment, PRIMARY PCI, Fractional flow reserve, 030204 cardiovascular system & hematology, culprit-lesion, Complete revascularisation, ANGIOGRAPHY, artery-disease, multivessel disease, acute coronary syndrome, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, non-st-elevation myocardial infarction, FRACTIONAL FLOW RESERVE, medicine, Clinical endpoint, follow-up, cardiovascular diseases, 030212 general & internal medicine, Myocardial infarction, ANGIOPLASTY, Stroke, intervention, Ejection fraction, business.industry, MORTALITY, Percutaneous coronary intervention, medicine.disease, Conventional PCI, cardiovascular system, Cardiology, Cardiology and Cardiovascular Medicine, business, Original Article – Design Study Article
Abstract: Aims To compare ischaemia-driven complete coronary revascularisation by percutaneous coronary intervention (PCI) with usual care in patients with non-ST-elevation myocardial infarction (non-STEMI) and multivessel disease (MVD). Methods The South Limburg Myocardial Infarction (SLIM) trial (NCT03562572) is an investigator-initiated, prospective, multicentre, randomised controlled trial that compares fractional flow reserve (FFR)-guided complete revascularisation during the index procedure with usual care in non-STEMI patients with MVD. A total of 414 patients will be randomised in a 1:1 fashion. The primary endpoint is the composite of all-cause mortality, non-fatal myocardial infarction, and any revascularisation and stroke (MACCE) at 12 months. The secondary endpoints are: MACCE at 24 and 36 months, and the composite of cardiac death, myocardial infarction, any revascularisation, stroke, major bleeding and left ventricular ejection fraction below 45% at 12, 24 and 36 months. Furthermore, quality of life will be assessed by the Patient Health Questionnaire (PHQ-9) and the Short Form (36) Health Survey (SF-36) at 1 and 12 months of follow-up. Conclusion The SLIM trial aims to provide evidence whether FFR-guided complete revascularisation by PCI is superior to usual care with respect to clinical outcomes (major adverse cardiovascular events) in non-STEMI patients with MVD.
Published: 2020

26. Beta-blocker effect on ST-segment

Author: Elvin Kedhi, Vincent Roolvink, Marcel Gosselink, Borja Ibanez, Fernando Alfonso, Valentin Fuster, Gonzalo Pizarro, Sonja Postma, Agustín Albarrán, Niels van Royen, José Luis Zamorano, Arnoud W J van 't Hof, Renicus S Hermanides, Robin Nijveldt, Maarten A.H. van Leeuwen, Erik Lipsic, Javier Botas, Jan J. Piek, Saman Rasoul, Francisco Fernández-Avilés, Jan Henk Dambrink, Victoria Hernandez-Jaras, Bart J. G. L. de Smet, Jan Paul Ottervanger, Enrico Fabris, Alberto García-Lledó, Evelien Kolkman, Alonso Mateos-Rodríguez, Wouter Remkes, MUMC+: MA Med Staf Spec Cardiologie (9), Cardiologie, RS: Carim - H01 Clinical atrial fibrillation, Dutch Heart Foundation (Holanda), Medtronic, Dutch Heart Foundation, Medtronic Inc, Cardiology, ACS - Atherosclerosis & ischemic syndromes, and ACS - Microcirculation
Subjects: Male, medicine.medical_specialty, medicine.drug_class, medicine.medical_treatment, Enfermedad cardiovascular, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], PERCUTANEOUS CORONARY INTERVENTION, METOPROLOL, Coronary Artery Disease, Placebo, STEMI, ST-T changes, Electrocardiography, Bolus (medicine), Double-Blind Method, Internal medicine, Infarto del miocardio, medicine, Antagonistas adrenérgicos beta, ST segment, Humans, REPERFUSION, Myocardial infarction, Beta blocker, Metoprolol, Medicamento, coronary intervention (PCI), Dose-Response Relationship, Drug, beta blockers, business.industry, ELEVATION MYOCARDIAL-INFARCTION, Percutaneous coronary intervention, Vascular damage Radboud Institute for Molecular Life Sciences [Radboudumc 16], Intervención coronaria percutánea, Middle Aged, medicine.disease, Adrenergic beta-1 Receptor Antagonists, Treatment Outcome, SIZE, Conventional PCI, Cardiology, ST Elevation Myocardial Infarction, Female, Cardiology and Cardiovascular Medicine, business, medicine.drug
Abstract: ObjectiveThe effect of early intravenous (IV) beta-blockers (BBs) administration in patients undergoing primary percutaneous coronary intervention (pPCI) on ST-segment deviation is unknown. We undertook a prespecified secondary analysis of the Early Beta-blocker Administration before primary PCI in patients with ST-elevation Myocardial Infarction (EARLY-BAMI) trial to investigate the effect of early IV BB on ST-segment deviation.MethodsThe EARLY-BAMI trial randomised patients with ST-elevation myocardial infarction (STEMI) to IV metoprolol (2×5 mg bolus) or matched placebo before pPCI. The prespecified outcome, evaluated by an independent core laboratory blinded to study treatment, was the residual ST-segment deviation 1 hour after pPCI (ie, the percentage of patients with >3 mm cumulative ST deviation at 1 hour after pPCI).ResultsAn ECG for the evaluation of residual ST-segment deviation 1 hour after pPCI was available in 442 out of 683 randomised patients. The BB group had a lower heart rate after pPCI compared with placebo (71.2±13.2 vs 74.3±13.6, p=0.016); however, no differences were noted in the percentages of patients with >3 mm cumulative ST deviation at 1 hour after pPCI (58.6% vs 54.1%, p=0.38, in BB vs placebo, respectively) neither a significant difference was found for the percentages of patients in each of the four prespecified groups (normalised ST-segment; 1–3 mm; 4–6 mm;>6 mm residual ST-deviation).ConclusionsIn patients with STEMI, who were being transported for primary PCI, early IV BB administration did not significantly affect ST-segment deviation after pPCI compared with placebo. The neutral result of early IV BB administration on an early marker of pharmacological effect is consistent with the absence of subsequent improvement of clinical outcomes.
Published: 2020
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27. Instantaneous wave-free ratio and fractional flow reserve in clinical practice

Author: B. Gho, Ron Pisters, M. Ilhan, Mera Stein, Leo Veenstra, Jan C.A. Hoorntje, Saman Rasoul, MUMC+: MA Med Staf Spec Cardiologie (9), Cardiologie, and RS: CARIM - R2.01 - Clinical atrial fibrillation
Subjects: medicine.medical_specialty, Original Article - E‑Learning, medicine.medical_treatment, INDEXES, PERCUTANEOUS CORONARY INTERVENTION, IFR, Fractional flow reserve, 030204 cardiovascular system & hematology, FFR, CLASSIFICATION, 03 medical and health sciences, Hyperaemia, 0302 clinical medicine, Internal medicine, medicine, 030212 general & internal medicine, Instantaneous wave-free ratio, Receiver operating characteristic analysis, business.industry, Area under the curve, Percutaneous coronary intervention, STENOSIS SEVERITY, PCI, Clinical Practice, Conventional PCI, Cardiology, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Coronary stenosis
Abstract: Objectives To compare fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) measurements in an all-comer patient population with moderate coronary artery stenoses. Background Visual assessment of the severity of coronary artery stenoses is often discordant in moderate lesions. FFR allows reliable functional severity assessment in these cases but requires adenosine-induced hyperaemia with associated additional time, costs and side effects. The iFR is a hyperaemia-independent index. Methods and results Between November 2015 and February 2017, 356 consecutive patients were included in whom 515 coronary stenoses were measured using both iFR and FFR. Mean iFR and FFR were 0.90 +/- 0.09 and 0.86 +/- 0.08, respectively. iFR correlated well with FFR [r=0.75; p
Published: 2018
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28. P5535Gender differences with short-term vs 12 months dual antiplatelet therapy in patients with acute coronary syndrome treated with the COMBO dual therapy stent: a 1-year analysis of the REDUCE trial

Author: Edouard Benit, A. W. J. van ’t Hof, Jeroen J. Kolkman, Marc A. Brouwer, Erik Ligtenberg, G. De Luca, Harry Suryapranata, M. Verdoia, Cyril Camaro, Sander A.J. Damen, Saman Rasoul, Sonja Postma, E Kedhi, Lucia Barbieri, and Vincent Roolvink
Subjects: Acute coronary syndrome, medicine.medical_specialty, business.industry, Medicine, In patient, DUAL (cognitive architecture), Cardiology and Cardiovascular Medicine, business, Dual therapy stent, medicine.disease, Surgery, Term (time)
Abstract: Background Gender differences in the thrombotic and bleeding risk have been suggested to condition the benefits of antithrombotic therapies in Acute Coronary Syndrome (ACS) patients, and mainly among those undergoing percutaneous coronary interventions with drug eluting stents (DES). Therefore, the impact of gender on the optimal duration of dual antiplatelet therapy (DAPT) treated is still unclear and was therefore the aim of the present sub-study. Methods REDUCE is a prospective, multicenter, randomized, investigator-initiated study, designed to enroll 1500 ACS patients after treatment with the COMBO Dual Stent Therapy, based on a non-inferiority design. Patients were randomized in a 1:1 fashion to either 3 or 12 months of DAPT. Primary study endpoint was a composite of all-cause mortality, myocardial infarction, definite/probable stent thrombosis (ST), stroke, target-vessel revascularization (TVR) and bleeding (BARC II, III, V) at 12 months. Secondary endpoints were cardiovascular mortality and the individual components of the primary endpoint. Results From June 2014 to May 2016 300 women and 1196 men were randomized in the trial. Among them 43.7% of females and 51.9% of males were assigned to the 3 months DAPT treatment. Baseline characteristics were well matched between the two arms, but of a lower rate of TIMI flow Conclusions The present study shows that among ACS patients randomized in the REDUCE trial, a 3 months DAPT strategy offers comparable results as compared to a standard 12 months DAPT at 1-year follow-up in both male and female gender. Acknowledgement/Funding None
Published: 2019
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29. Effects of alirocumab on cardiovascular and metabolic outcomes after acute coronary syndrome in patients with or without diabetes: a prespecified analysis of the ODYSSEY OUTCOMES randomised controlled trial

Author: Kausik K Ray, Helen M Colhoun, Michael Szarek, Marie Baccara-Dinet, Deepak L Bhatt, Vera A Bittner, Andrzej J Budaj, Rafael Diaz, Shaun G Goodman, Corinne Hanotin, Robert A Harrington, J Wouter Jukema, Virginie Loizeau, Renato D Lopes, Angèle Moryusef, Jan Murin, Robert Pordy, Arsen D Ristic, Matthew T Roe, José Tuñón, Harvey D White, Andreas M Zeiher, Gregory G Schwartz, Philippe Gabriel Steg, Gregory G. Schwartz, Ph. Gabriel Steg, Deepak L. Bhatt, Vera A. Bittner, Shaun G. Goodman, Robert A. Harrington, J. Wouter Jukema, Harvey D. White, Andreas M. Zeiher, Pierluigi Tricoci, Matthew T. Roe, Kenneth W. Mahaffey, Jay M. Edelberg, Guillaume Lecorps, William J. Sasiela, Jean-François Tamby, Philip E. Aylward, Heinz Drexel, Peter Sinnaeve, Mirza Dilic, Renato D. Lopes, Nina N. Gotcheva, Juan-Carlos Prieto, Huo Yong, Patricio López-Jaramillo, Ivan Pećin, Zeljko Reiner, Petr Ostadal, Margus Viigimaa, Markku S. Nieminen, Vakhtang Chumburidze, Nikolaus Marx, Nicolas Danchin, Evangelos Liberopoulos, Pablo Carlos Montenegro Valdovinos, Hung-Fat Tse, Robert Gabor Kiss, Denis Xavier, Doron Zahger, Marco Valgimigli, Takeshi Kimura, Hyo Soo Kim, Sang-Hyun Kim, Andrejs Erglis, Aleksandras Laucevicius, Sasko Kedev, Khalid Yusoff, Gabriel Arturo Ramos López, Marco Alings, Sigrun Halvorsen, Roger M. Correa Flores, Andrzej Budaj, Joao Morais, Maria Dorobantu, Yuri Karpov, Arsen D. Ristic, Terrance Chua, Zlatko Fras, Anthony J. Dalby, H. Asita de Silva, Emil Hagström, Ulf Landmesser, Chern-En Chiang, Piyamitr Sritara, Sema Guneri, Alexander Parkhomenko, Kausik K. Ray, Patrick M. Moriarty, Robert Vogel, Bernard Chaitman, Sheryl F. Kelsey, Anders G. Olsson, Jean-Lucien Rouleau, Maarten L. Simoons, Karen Alexander, Chiara Meloni, Robert Rosenson, Eric J.G. Sijbrands, John H. Alexander, Luciana Armaganijan, Akshay Bagai, Maria Cecilia Bahit, J. Matthew Brennan, Shaun Clifton, Adam D. DeVore, Shalonda Deloatch, Sheila Dickey, Keith Dombrowski, Grégory Ducrocq, Zubin Eapen, Patricia Endsley, Arleen Eppinger, Robert W. Harrison, Connie Ng Hess, Mark A. Hlatky, Joseph Dedrick Jordan, Joshua W. Knowles, Bradley J. Kolls, David F. Kong, Sergio Leonardi, Linda Lillis, David J. Maron, Jill Marcus, Robin Mathews, Rajendra H. Mehta, Robert J. Mentz, Humberto Graner Moreira, Chetan B. Patel, Sabrina Bernardez-Pereira, Lynn Perkins, Thomas J. Povsic, Etienne Puymirat, William Schuyler Jones, Bimal R. Shah, Matthew W. Sherwood, Kenya Stringfellow, Darin Sujjavanich, Mustafa Toma, Charlene Trotter, Sean Van Diepen, Matthew D. Wilson, Andrew T. Yan, Lilia B. Schiavi, Marcelo Garrido, Andrés F. Alvarisqueta, Sonia A. Sassone, Anselmo P. Bordonava, Alberto E. Alves De Lima, Jorge M. Schmidberg, Ernesto A. Duronto, Orlando C. Caruso, Leonardo P. Novaretto, Miguel Angel Hominal, Oscar R. Montaña, Alberto Caccavo, Oscar A. Gomez Vilamajo, Alberto J. Lorenzatti, Luis R. Cartasegna, Gustavo A. Paterlini, Ignacio J. Mackinnon, Guillermo D. Caime, Marcos Amuchastegui, Oscar Salomone, Oscar R. Codutti, Horacio O. Jure, Julio OE Bono, Adrian D. Hrabar, Julio A. Vallejos, Rodolfo A. Ahuad Guerrero, Federico Novoa, Cristian A. Patocchi, Cesar J. Zaidman, Maria E. Giuliano, Ricardo D. Dran, Marisa L. Vico, Gabriela S. Carnero, Pablo N. Guzman, Juan C. Medrano Allende, Daniela F. Garcia Brasca, Miguel H Bustamante Labarta, Sebastian Nani, Eduardo DS Blumberg, Hugo R Colombo, Alberto Liberman, Victorino Fuentealba, Hector L Luciardi, Gabriel D Waisman, Mario A Berli, Ruben O Garcia Duran, Horacio G Cestari, Hugo A Luquez, Jorge A Giordano, Silvia S Saavedra, Gerardo Zapata, Osvaldo Costamagna, Susana Llois, Jonathon H Waites, Nicholas Collins, Allan Soward, Chris LS Hii, James Shaw, Margaret A Arstall, John Horowitz, Daniel Ninio, James F Rogers, David Colquhoun, Romulo E Oqueli Flores, Philip Roberts-Thomson, Owen Raffel, Sam J Lehman, Constantine Aroney, Steven GM Coverdale, Paul J Garrahy, Gregory Starmer, Mark Sader, Patrick A Carroll, Ronald Dick, Robert Zweiker, Uta Hoppe, Kurt Huber, Rudolf Berger, Georg Delle-Karth, Bernhard Frey, Franz Weidinger, Dirk Faes, Kurt Hermans, Bruno Pirenne, Attilio Leone, Etienne Hoffer, Mathias CM Vrolix, Luc De Wolf, Bart Wollaert, Marc Castadot, Karl Dujardin, Christophe Beauloye, Geert Vervoort, Harry Striekwold, Carl Convens, John Roosen, Emanuele Barbato, Marc Claeys, Frank Cools, Ibrahim Terzic, Fahir Barakovic, Zlatko Midzic, Belma Pojskic, Emir Fazlibegovic, Mehmed Kulić, Azra Durak-Nalbantic, Dusko Vulic, Adis Muslibegovic, Boris Goronja, Gilmar Reis, Luciano Sousa, Jose C Nicolau, Flavio E Giorgeto, Ricardo P Silva, Lilia Nigro Maia, Rafael Rech, Paulo RF Rossi, Maria José AG Cerqueira, Norberto Duda, Renato Kalil, Adrian Kormann, José Antonio M Abrantes, Pedro Pimentel Filho, Ana Priscila Soggia, Mayler ON de Santos, Fernando Neuenschwander, Luiz C Bodanese, Yorghos L Michalaros, Freddy G Eliaschewitz, Maria H Vidotti, Paulo E Leaes, Roberto V Botelho, Sergio Kaiser, Euler Roberto Fernandes Manenti, Dalton B Precoma, Jose C Moura Jorge, Pedro G de B Silva, Jose A Silveira, Wladmir Saporito, Jose A Marin-Neto, Gilson S Feitosa, Luiz Eduardo F Ritt, Juliana A de Souza, Fernando Costa, Weimar KSB Souza, Helder JL Reis, Leandro Machado, José Carlos Aidar Ayoub, Georgi V Todorov, Fedya P Nikolov, Elena S Velcheva, Maria L Tzekova, Haralambi O Benov, Stanislav L Petranov, Haralin S Tumbev, Nina S Shehova-Yankova, Dimitar T Markov, Dimitar H Raev, Mihail N Mollov, Kostadin N Kichukov, Katya A Ilieva-Pandeva, Raya Ivanova, Maryana Gospodinov, Valentina M Mincheva, Petar V Lazov, Bojidar I Dimov, Manohara Senaratne, James Stone, Jan Kornder, Stephen Pearce, Danielle Dion, Daniel Savard, Yves Pesant, Amritanshu Pandey, Simon Robinson, Gilbert Gosselin, Saul Vizel, Gordon Hoag, Ronald Bourgeois, Anne Morisset, Eric Sabbah, Bruce Sussex, Simon Kouz, Paul MacDonald, Ariel Diaz, Nicolas Michaud, David Fell, Raymond Leung, Tycho Vuurmans, Christopher Lai, Frank Nigro, Richard Davies, Gustavo Nogareda, Ram Vijayaraghavan, John Ducas, Serge Lepage, Shamir Mehta, James Cha, Robert Dupuis, Peter Fong, Sohrab Lutchmedial, Josep Rodes-Cabau, Hussein Fadlallah, David Cleveland, Thao Huynh, Iqbal Bata, Adnan Hameed, Cristian Pincetti, Sergio Potthoff, Juan C Prieto, Monica Acevedo, Arnoldo Aguirre, Margarita Vejar, Mario Yañez, Guillermo Araneda, Mauricio Fernandez, Luis Perez, Paola Varleta, Fernando Florenzano, Laura Huidobro, Carlos A Raffo, Claudia Olivares, Leonardo Nahuelpan, Humberto Montecinos, Jiyan Chen, Yugang Dong, Weijian Huang, Jianzhong Wang, Shi'An Huang, Zhuhua Yao, Xiang Li, Lan Cui, Wenhua Lin, Yuemin Sun, Jingfeng Wang, Jianping Li, Xuelian Zhang, Hong Zhu, Dandan Chen, Lan Huang, Shaohong Dong, Guohai Su, Biao Xu, Xi Su, Xiaoshu Cheng, Jinxiu Lin, Wenxia Zong, Huanming Li, Yi Feng, Dingli Xu, Xinchun Yang, Yuannan Ke, Xuefeng Lin, Zheng Zhang, Zeqi Zheng, Zhurong Luo, Yundai Chen, Chunhua Ding, Yi Zhong, Yang Zheng, Xiaodong Li, Daoquan Peng, Shuiping Zhao, Ying Li, Xuebo Liu, Meng Wei, Shaowen Liu, Yihua Yu, Baiming Qu, Weihong Jiang, Yujie Zhou, Xingsheng Zhao, Zuyi Yuan, Ying Guo, Xiping Xu, Xubo Shi, Junbo Ge, Guosheng Fu, Feng Bai, Weiyi Fang, Xiling Shou, Xiangjun Yang, Jian'An Wang, Meixiang Xiang, Yingxian Sun, Qinghua Lu, Ruiyan Zhang, Jianhua Zhu, Yizhou Xu, Zhongcai Fan, Tianchang Li, Chun Wu, Nicolas Jaramillo, Gregorio Sanchez Vallejo, Diana C Luna Botia, Rodrigo Botero Lopez, Dora I Molina De Salazar, Alberto J Cadena Bonfanti, Carlos Cotes Aroca, Juan Diego Higuera, Marco Blanquicett, Sandra I Barrera Silva, Henry J Garcia Lozada, Julian A Coronel Arroyo, Jose L Accini Mendoza, Ricardo L Fernandez Ruiz, Alvaro M. 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Jabir Abdullakutty, Shireesh Saathe, Priya Palimkar, Shireesh Sathe, Shaul Atar, Michael Shechter, Morris Mosseri, Yaron Arbel, Chorin Ehud, Havakuk Ofer, Chaim Lotan, Uri Rosenschein, Amos Katz, Yaakov Henkin, Adi Francis, Marc Klutstein, Eugenia Nikolsky, Robert Zukermann, Yoav Turgeman, Majdi Halabi, Alon Marmor, Ran Kornowski, Michael Jonas, Offer Amir, Yonathan Hasin, Yoseph Rozenman, Shmuel Fuchs, Vered Zvi, Osamah Hussein, Dov Gavish, Zvi Vered, Yoseph Caraco, Mazen Elias, Naveh Tov, Efrat Wolfovitz, Michael Lishner, Nizar Elias, Giancarlo Piovaccari, Annamaria De Pellegrin, Raffaella Garbelotto, Gabriele Guardigli, Valgimigli Marco, Giovanni Licciardello, Carla Auguadro, Filippo Scalise, Claudio Cuccia, Alessandro Salvioni, Giuseppe Musumeci, Michelle Senni, Paolo Calabrò, Salvatore Novo, Pompilio Faggiano, Marco Metra, Nicoletta B De Cesare, Sergio Berti, Claudio Cavallini, Enrico Puccioni, Marcello Galvani, Maurizio Tespili, Piermarco Piatti, Michela Palvarini, Giuseppe De 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Telal Mudawi, Gohar Rahman, Ayyaz Sultan, David Sharman, David Sprigings, Rob Butler, Peter Wilkinson, Gregory YH Lip, Julian Halcox, Sean Gallagher, Nicholas Ossei-Gerning, Gil Vardi, Duccio Baldari, David Brabham, Charles Treasure II, Charles Dahl, Bruce Palmer, Alan Wiseman, Abul Khan, Sanjeev Puri, Ann Elizabeth Mohart, Carlos Ince, Enrique Flores, Scott Wright, Shi-Chi Cheng, Michael Rosenberg, William Rogers, Edward Kosinski, Les Forgosh, Jonathan Waltman, Misal Khan, Mohammad Shoukfeh, Georges Dagher, Patrick Cambier, Ira Lieber, Priya Kumar, Cara East, Perry Krichmar, Mian Hasan, Lindsey White, Thomas Knickelbine, Thomas Haldis, Eve Gillespie, Thomas Amidon, David Suh, Imran Arif, Mouhamad Abdallah, Faiq Akhter, Eric Carlson, Michael D'Urso, Fadi El-Ahdab, William Nelson, Katie Moriarty, Barry Harris, Steven Cohen, Luther Carter, Daniel Doty, Kenneth Sabatino, Tariq Haddad, Amir Malik, Sunder Rao, Angel Mulkay, Ion Jovin, Kim Klancke, Vinay Malhotra, Sai K Devarapalli, Michael 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Zahr, George Ponce, Zubair Jafar, Joseph Mcgarvey, Vipul Panchal, Stephen Voyce, Thomas Blok, William Sheldon, Masoud M Azizad, Carsten Schmalfuss, Mark Picone, Robert Pederson, William Herzog, Keith Friedman, Jason Lindsey, Rosemary Nowins, Eichenlaub Timothy, Parilak Leonard, Norman Lepor, Mahfouz El Shahawy, Howard Weintraub, Anand Irimpen, Alvaro Alonso, Wade May, Daniels Christopher, Thomas Galski, Alan Chu, Freny Mody, Ebrahimi Ramin, Zachary Hodes, Joseph Rossi, Gregory Rose, James Fairlamb, Charles Lambert, Ajit Raisinghani, Antonio Abbate, George Vetrovec, Marilyn King, Charles Carey, Jaime Gerber, Liwa Younis, Hyeun (Tom) Park, Mladen Vidovich, Thomas Knutson, Dennis Friedman, Fred Chaleff, Arthur Loussararian, Phillip Rozeman, Carey Kimmelstiel, Jeffrey Kuvin, Kevin Silver, Malcolm Foster, Glen Tonnessen, Andrey Espinoza, Mohamadali Amlani, Andreas Wali, Christopher Malozzi, Geert T Jong, Clara Massey, Keattiyoat Wattanakit, Philip J. O'Donnell, Dinesh Singal, Naseem Jaffrani, Sridhar Banuru, Daniel Fisher, Mark Xenakis, Neal Perlmutter, Ravi Bhagwat, James Strader, Ronald Blonder, Ayim Akyea-Djamson, Ajay Labroo, Kwan Lee, H. John Marais, Edmund Claxton, Robert Weiss, Rohr Kathryn, Martin Berk, Peter Rossi, Parag Joshi, Amit Khera, Ajit S Khaira, Greg Kumkumian, Steven Lupovitch, Joshua Purow, Stephen Welka, David Hoffman, Stuart Fischer, Eugene Soroka, Donald Eagerton, Samir Pancholy, Michael Ray, Norman Erenrich, Michael Farrar, Stewart Pollock, William J French, Steve Diamantis, Douglas Guy, Lawrence Gimple, Mark Neustel, Steven Schwartz, Edward Pereira, Seals Albert, Douglas Spriggs, Janet Strain, Suneet Mittal, Anthony Vo, Majed Chane, Jason Hall, Nampalli Vijay, Kapildeo Lotun, F. 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Y, Kimura, K, Kishi, K, Michishita, I, Uehara, H, Higashikata, T, Hirayama, A, Hirooka, K, Doi, Y, Sakagami, S, Taguchi, S, Koike, A, Fujinaga, H, Koba, S, Kozuma, K, Kawasaki, T, Ono, Y, Shimizu, M, Katsuda, Y, Wada, A, Shinke, T, Ako, J, Fujii, K, Takahashi, T, Sakamoto, T, Nakao, K, Furukawa, Y, Sugino, H, Tamura, R, Mano, T, Uematsu, M, Utsu, N, Ito, K, Haraguchi, T, Sato, K, Ueda, Y, Nishibe, A, Fujimoto, K, Masutani, M, Yoon, J, Park, H, Chae, I, Kim, M, Jeong, M, Rha, S, Kim, C, Hong, T, Tahk, S, 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, Lozance, N, Kjovkaroski, A, Doncovska, S, Ong, T, Kasim, S, Maskon, O, Kandasamy, B, Liew, H, Wan Mohamed, W, Garcia Castillo, A, Carrillo Calvillo, J, Fajardo Campos, P, Nunez Fragoso, J, Bayram Llamas, E, Alcocer Gamba, M, Carranza Madrigal, J, Gonzalez Salas, L, Lopez Rosas, E, Gonzalez Diaz, B, Salcido Vazquez, E, Nacoud Ackar, A, Llamas Esperon, G, Martinez Sanchez, C, Guerrero De Leon, M, Suarez Otero, R, Fanghanel Salmon, G, Perez Rios, J, Garza Ruiz, J, Breedveld, R, Feenema-Aardema, M, Borger-Van Der Burg, A, Hoogslag, P, Suryapranata, H, Oomen, A, Van Haelst, P, Wiersma, J, Basart, D, Van Der Wal, R, Zwart, P, Monraats, P, Van Kesteren, H, Karalis, I, Verdel, G, Brueren, B, Troquay, R, Viergever, E, Al-Windy, N, Bartels, G, Cornel, J, Hermans, W, Herrman, J, Bos, R, Groutars, R, Van Der Zwaan, C, Kaplan, R, Lionarons, R, Ronner, E, Groenemeijer, B, Bronzwaer, P, Liem, A, Rensing, B, Bokern, M, Nijmeijer, R, Hersbach, F, Willems, F, Gosselink, A, Rasoul, S, Elliott, J, Wilkins, G, Fisher, R, Scott, D, Hart, H, Stewart, R, Harding, S, Ternouth, I, Fisher, N, Wilson, S, Aitken, D, Anscombe, R, Davidson, L, Tomala, T, Nygard, O, Sparby, J, Andersen, K, Gullestad, L, Jortveit, J, Munk, P, Singsaas, E, Hurtig, U, Calderon Ticona, J, Durand Velasquez, J, Negron Miguel, S, Sanabria Perez, E, Carrion Chambilla, J, Chavez Ayala, C, Castillo Leon, R, Vargas Gonzales, R, Hernandez Zuniga, J, Camacho Cosavalente, L, Bravo Mannucci, J, Heredia Landeo, J, Llerena Navarro, N, Roldan Concha, Y, Rodriguez Chavez, V, Anchante Hernandez, H, Zea Nunez, C, Mogrovejo Ramos, W, Ferrolino, A, Sy, R, Tirador, L, Matiga, G, Coching, R, Bernan, A, Rogelio, G, Morales, D, Tan, E, Sulit, D, 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, Miklaszewicz, B, Kubica, J, Andrzej Lipko, J, Kostarska-Srokosz, E, Piepiorka, M, Drzewiecka, A, 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, Mesquita Bastos, J, Pereira, H, Martins, D, Seixo, F, Mendonca, C, Botelho, A, Caetano, F, Minescu, B, Istratoaie, O, Tesloianu, D, Cristian, G, Dumitrescu, S, Podoleanu, C, Constantinescu, M, Bengus, C, Militaru, C, Rosu, D, Parepa, I, Matei, A, Alexandru, T, Malis, M, Coman, I, Stanescu-Cioranu, R, Dimulescu, D, Shvarts, Y, Orlikova, O, Kobalava, Z, Barbarash, O, Markov, V, Lyamina, N, Gordienko, A, Zrazhevsky, K, Vishnevsky, A, Gurevich, V, Stryuk, R, Lomakin, N, Bokarev, I, Khlevchuk, T, Shalaev, S, Khaisheva, L, Chizhov, P, Viktorova, I, Osokina, N, Shchekotov, V, Akatova, E, Chumakova, G, Libov, I, Voevoda, M, Tretyakova, T, 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, V, Ivanov, I, Ilya, M, Kanorsky, S, Simic, D, Ivanovic, N, Davidovic, G, Tasic, N, Asanin, M, Stojic, S, Apostolovic, S, Ilic, S, Putnikovic Tosic, B, Stankovic, A, Arandjelovic, A, Radovanovic, S, Todic, B, Balinovac, J, Dincic, D, Seferovic, P, Karadzic, A, Dodic, S, Dimkovic, S, Jakimov, T, Poh, K, Ong, H, Tang I-Shing, J, 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, Poklukar, J, Cernic Suligoj, N, Cevc, M, Cyster, H, Ranjith, N, Corbett, C, Bayat, J, Makotoko, E, du Toit Theron, H, Kapp, I, de V Basson, M, Lottering, H, Van Aswegen, D, Van Zyl, L, Sebastian, P, Pillay, T, Saaiman, J, Commerford, P, Cassimjee, S, Riaz, G, Ebrahim, I, Sarvan, M, Mynhardt, J, Reuter, H, Moodley, R, Vida, M, Cequier Fillat, A, Bodi Peris, V, Fuentes Jimenez, F, Marin, F, Cruz Fernandez, J, Hidalgo Urbano, R, Gil-Extremera, B, Toledo, P, Worner Diz, F, Garcia-Dorado, D, Iniguez, A, Gonzalez-Juanatey, J, Fernandez Portales, J, Civeira Murillo, F, Matas Pericas, L, Zamorano, J, De Mora Martin, M, Bruguera Cortada, J, Alonso Martin, J, Serrano Antolin, J, De Berrazueta Fernandez, J, Vazquez de Prada, J, Diaz Fernandez, J, Garcia Lledo, J, Cosin Sales, J, Botas Rodriguez, J, Gusi Tragant, G, Benedicto, A, Gonzalez-Juanatey, C, Camprubi Potau, M, Plaza Perez, I, De La Tassa, C, Loma-Osorio Rincon, P, Balaguer Recena, J, Escudier, J, Payeras, A, Alonso Orcajo, N, Valdivielso, P, Constantine, G, Haniffa, R, Tissera, N, Amarasekera, S, Ponnamperuma, C, Fernando, N, Fernando, K, Jayawardena, J, Wijeyasingam, S, Ranasinghe, G, Ekanayaka, R, Mendis, S, Senaratne, V, Mayurathan, G, Sirisena, T, Rajapaksha, A, Herath, J, Amarasena, N, Berglund, S, Rasmanis, G, Vedin, O, Witt, N, Mourtzinis, G, Nicol, P, Hansen, O, Romeo, S, Agergaard Jensen, S, Torstensson, I, Ahremark, U, Sundelin, T, Moccetti, T, Muller, C, Mach, F, Binde, R, Tsai, W, Ueng, K, Lai, W, Liu, M, Hwang, J, Yin, W, Hsieh, I, Hsieh, M, Kuo, J, Huang, T, Fang, C, 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, O, Ushakov, O, Dzyak, G, Goloborodko, B, Rudenko, A, Zheleznyy, V, Trevelyan, J, Zaman, A, Lee, K, Moriarty, A, Aggarwal, R, Clifford, P, Wong, Y, Iqbal, S, Subkovas, E, Braganza, D, Sarkar, D, Storey, R, Griffiths, H, Mcclure, S, Muthusamy, R, Smith, S, Kurian, J, Levy, T, Barr, C, Kadr, H, Gerber, R, Simaitis, A, Soran, H, Mathur, A, Brodison, A, Ayaz, M, Cheema, M, Oliver, R, Thackray, S, Mudawi, T, Rahman, G, Sultan, A, Sharman, D, Sprigings, D, Butler, R, Wilkinson, P, Lip, G, Halcox, J, Gallagher, S, Ossei-Gerning, N, Vardi, G, Baldari, D, Brabham, D, Treasure II, C, Dahl, C, Palmer, B, Wiseman, A, Puri, S, Mohart, A, Ince, C, Flores, E, Wright, S, Cheng, S, Rosenberg, M, Rogers, W, Kosinski, E, Forgosh, L, Waltman, J, Khan, M, Shoukfeh, M, Dagher, G, Cambier, P, Lieber, I, Kumar, P, East, C, Krichmar, P, Hasan, M, White, L, Knickelbine, T, Haldis, T, Gillespie, E, Amidon, T, Suh, D, Arif, I, Abdallah, M, Akhter, F, Carlson, E, D'Urso, M, El-Ahdab, F, Nelson, W, Moriarty, K, Harris, B, Cohen, S, Carter, L, Doty, D, Sabatino, K, Haddad, T, Malik, A, Rao, S, Mulkay, A, Jovin, I, Klancke, K, Malhotra, V, Devarapalli, S, Koren, M, Chandna, H, Dodds III, G, Goraya, T, Bengston, J, Janik, M, Moran, J, Sumner, A, Kobayashi, J, Davis, W, Yazdani, S, Pasquini, J, Thakkar, M, Vedere, A, Leimbach, W, Rider, J, Fenton, S, Singh, N, Shah, A, Janosik, D, Pepine, C, Berman, B, Gelormini, J, Daniels, C, Richard, K, Keating, F, Kondo, N, Shetty, S, Levite, H, Waider, W, Takata, T, Abu-Fadel, M, Shah, V, Izzo, M, Kumar, A, Hattler, B, Do, R, Link, C, Bortnick, A, Kinzfogl III, G, Ghitis, A, Larry, J, Teufel, E, Kuhlman, P, Mclaurin, B, Zhang, W, Thew, S, Abbas, J, White, M, Islam, O, Subherwal, S, Ranadive, N, Vakili, B, Gring, C, Henderson, D, Schuchard, T, Farhat, N, Kline, G, Mahal, S, Whitaker, J, Speirs, S, Andersen, R, Daboul, N, Horwitz, P, Zahr, F, Ponce, G, Jafar, Z, Mcgarvey, J, Panchal, V, Voyce, S, Blok, T, Sheldon, W, Azizad, M, Schmalfuss, C, Picone, M, Pederson, R, Herzog, W, Friedman, K, Lindsey, J, Nowins, R, Timothy, E, Leonard, P, Lepor, N, El Shahawy, M, Weintraub, H, Irimpen, A, Alonso, A, May, W, Christopher, D, Galski, T, Chu, A, Mody, F, Ramin, E, Hodes, Z, Rossi, J, Rose, G, Fairlamb, J, Lambert, C, Raisinghani, A, Abbate, A, Vetrovec, G, King, M, Carey, C, Gerber, J, Younis, L, Vidovich, M, Knutson, T, Friedman, D, Chaleff, F, Loussararian, A, Rozeman, P, Kimmelstiel, C, Kuvin, J, Silver, K, Foster, M, Tonnessen, G, Espinoza, A, Amlani, M, Wali, A, Malozzi, C, Jong, G, Massey, C, Wattanakit, K, O'Donnell, P, Singal, D, Jaffrani, N, Banuru, S, Fisher, D, Xenakis, M, Perlmutter, N, Bhagwat, R, Strader, J, Blonder, R, Akyea-Djamson, A, Labroo, A, Marais, H, Claxton, E, Weiss, R, Kathryn, R, Berk, M, Joshi, P, Khera, A, Khaira, A, Kumkumian, G, Lupovitch, S, Purow, J, Welka, S, Hoffman, D, Fischer, S, Soroka, E, Eagerton, D, Pancholy, S, Ray, M, Erenrich, N, Farrar, M, Pollock, S, French, W, Diamantis, S, Guy, D, Gimple, L, Neustel, M, Schwartz, S, Pereira, E, Albert, S, Spriggs, D, Strain, J, Mittal, S, Vo, A, Chane, M, Hall, J, Vijay, N, Lotun, K, Lester, F, Nahhas, A, Pope, T, Nager, P, Vohra, R, Sharma, M, Bashir, R, Ahmed, H, Berlowitz, M, Fishberg, R, Barrucco, R, Yang, E, Radin, M, Sporn, D, Stapleton, D, Eisenberg, S, Landzberg, J, Mcgough, M, Turk, S, Schwartz, M, Sundram, P, Jain, D, Zainea, M, Bayron, C, Karlsberg, R, Dohad, S, Lui, H, Keen, W, Westerhausen, D, Khurana, S, Agarwal, H, Birchem, J, Penny, W, Chang, M, Murphy, S, Henry, J, Schifferdecker, B, Gilbert, J, Chalavarya, G, Eaton, C, Schmedtje, J, Christenson, S, Dotani, I, Denham, D, Macdonell, A, Gibson, P, Rahman, A, Al Joundi, T, Assi, N, Conrad, G, Kotha, P, Love, M, Giesler, G, Rubenstein, H, Gamil, D, Akright, L, Krawczyk, J, Cobler, 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, 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, Butters, J, Griffith, L, Shaw, M, Grunberg, L, Islam, S, Bregeault, M, 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, 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, Chengyue, Z, Fournie-Lloret, D, Morrello, C, Perthuis, A, Picault, P, Zobouyan, I, Dempsey, M, Mcclanahan, M, ODYSSEY OUTCOMES Comm Investigato, and Ege Üniversitesi
Subjects: Male, BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences, STATIN THERAPY, blood-glucose, Endocrinology, Diabetes and Metabolism, GUIDELINES, PCSK9, 0302 clinical medicine, Endocrinology, GENETIC-VARIANTS, Cardiovascular Disease, Diabetes Complication, Aged Antibodies, Monoclonal, Humanized / therapeutic use* Cardiovascular Diseases / blood Cardiovascular Diseases / prevention & control* Diabetes Complications / blood Diabetes Complications / prevention & control* Female Humans Male Middle Aged Substances, Clinical endpoint, Medicine, guidelines, 030212 general & internal medicine, Prediabetes, Myocardial infarction, myocardial-infarction, genetic-variants, statin therapy, risk, pcsk9, association, liraglutide, evolocumab, RISK, BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti, BLOOD-GLUCOSE, ASSOCIATION, Middle Aged, Cardiovascular Diseases, Female, Life Sciences & Biomedicine, Human, medicine.medical_specialty, Acute coronary syndrome, PCSK9 inhibitor, acute coronary syndrome, lipoprotein(a), low-density lipoprotein cholesterol, 030209 endocrinology & metabolism, Antibodies, Monoclonal, Humanized, Diabetes Complications, Endocrinology & Metabolism, 03 medical and health sciences, Diabetes mellitus, Internal medicine, Internal Medicine, Humans, Aged, Alirocumab, diabetes, PCSK9, hyperlipidemia, Science & Technology, ODYSSEY OUTCOMES Committees and Investigators, business.industry, Unstable angina, EVOLOCUMAB, medicine.disease, MYOCARDIAL-INFARCTION, LIRAGLUTIDE, Human medicine, business
Abstract: Doi, Yasuji/0000-0002-8368-0827; galvani, marcello/0000-0001-5897-667X; Gislason, Gunnar H/0000-0002-0548-402X; Taskinen, Marja-Riitta/0000-0002-6229-3588; Sherwood, Matthew/0000-0002-4305-5883; Malynovsky, Yaroslav V/0000-0002-9118-1104; Viktorova, vic-inna@mail.ru I.A./0000-0001-8728-2722; bastos, jose/0000-0002-9526-3123; Yang, Eric H/0000-0003-4889-7454; Rudenko, Anatoliy Viktorovich/0000-0003-1099-1613; Novotny, Vojtech/0000-0003-3521-9945; Nikolaev, Konstantin/0000-0003-4601-6203; Reshetko, Olga/0000-0003-3107-7636; Leonardi, Sergio/0000-0002-4800-6132; Muenzel, Thomas/0000-0001-5503-4150; Ushakov, Alexei V/0000-0002-7020-4442; Tse, Hung Fat/0000-0002-9578-7808; Podoleanu, Cristian/0000-0001-9987-2519; Raffel, Owen C/0000-0001-5470-7050; Khasanov, Niiaz/0000-0002-7760-0763; Chumakova, Galina A/0000-0002-2810-6531; Ersanli, Murat/0000-0003-1847-3087; cornel, jan hein/0000-0002-1006-2112; Abbate, Antonio/0000-0002-1930-785X; Racca, Vittorio/0000-0002-4465-3789; Urina-Triana, Miguel A/0000-0001-6003-4622; Rasputina, Lesia/0000-0003-1230-4039; Racca, Vittorio/0000-0002-4465-3789; Reis, Gilmar/0000-0002-4847-1034; Sandhu, Manjinder/0000-0003-2538-2079; Keskin, Kudret/0000-0002-9049-1530; PAREPA, IRINEL/0000-0002-7571-9015; Manakshe, Gajendra/0000-0002-4983-4271; Nicolau, Jose C/0000-0002-9680-3689; Strelnieks, Aldis/0000-0003-3493-2562; Budaj, Andrzej/0000-0002-6395-2098; Marin, Francisco/0000-0001-7246-7708; Wongpraparut, Nattawut/0000-0002-1541-3313; Yuan, Zuyi/0000-0002-4141-0298; Jeong, Myung Ho/0000-0003-2424-810X; Mostovoy, Yuriy/0000-0002-7041-1230; Pepine, Carl/0000-0002-6011-681X; Lopez-Jaramillo, Patricio/0000-0002-9122-8742; Garcia-Lledo, Alberto/0000-0002-8986-2584; Tesloianu, Nicolae-Dan/0000-0002-1007-3022; Kosmacheva, Elena/0000-0001-8600-0199; Kunz Sebba Barroso Souza, Weimar/0000-0002-1265-1930; Katz, Amos/0000-0003-0422-934X; Tunon, Jose/0000-0002-1373-0999; Acevedo, Monica/0000-0002-7989-6633; Hove, Jens/0000-0002-5600-5623; Yakushin, Sergey/0000-0001-7202-742X; Gonzalez Juanatey, Jose Ramon/0000-0001-9681-3388; Lyamina, Nadezhda/0000-0001-6939-3234; Aylward, Philip/0000-0002-5358-8552; Apostolovic, Svetlana/0000-0001-9015-297X; Airaksinen, Juhani/0000-0002-0193-568X; Nahhas, Prof. Dr. Ahmed/0000-0002-2887-8187; Barbarash, Olga/0000-0002-4642-3610, WOS: 000475553300016, PubMed: 31272931, Background After acute coronary syndrome, diabetes conveys an excess risk of ischaemic cardiovascular events. A reduction in mean LDL cholesterol to 1.4-1.8 mmol/L with ezetimibe or statins reduces cardiovascular events in patients with an acute coronary syndrome and diabetes. However, the efficacy and safety of further reduction in LDL cholesterol with an inhibitor of proprotein convertase subtilisin/kexin type 9 (PCSK9) after acute coronary syndrome is unknown. We aimed to explore this issue in a prespecified analysis of the ODYSSEY OUTCOMES trial of the PCSK9 inhibitor alirocumab, assessing its effects on cardiovascular outcomes by baseline glycaemic status, while also assessing its effects on glycaemic measures including risk of new-onset diabetes. Methods ODYSSEY OUTCOMES was a randomised, double-blind, placebo-controlled trial, done at 1315 sites in 57 countries, that compared alirocumab with placebo in patients who had been admitted to hospital with an acute coronary syndrome (myocardial infarction or unstable angina) 1-12 months before randomisation and who had raised concentrations of atherogenic lipoproteins despite use of high-intensity statins. Patients were randomly assigned (1: 1) to receive alirocumab or placebo every 2 weeks; randomisation was stratified by country and was done centrally with an interactive voice-response or web-response system. Alirocumab was titrated to target LDL cholesterol concentrations of 0.65-1.30 mmol/L. in this prespecified analysis, we investigated the effect of alirocumab on cardiovascular events by glycaemic status at baseline (diabetes, prediabetes, or normoglycaemia)-defined on the basis of patient history, review of medical records, or baseline HbA(1c) or fasting serum glucose-and risk of new-onset diabetes among those without diabetes at baseline. the primary endpoint was a composite of death from coronary heart disease, non-fatal myocardial infarction, fatal or non-fatal ischaemic stroke, or unstable angina requiring hospital admission. ODYSSEY OUTCOMES is registered with ClinicalTrials. gov, number NCT01663402. Findings At study baseline, 5444 patients (28.8%) had diabetes, 8246 (43.6%) had prediabetes, and 5234 (27.7%) had normoglycaemia. There were no significant differences across glycaemic categories in median LDL cholesterol at baseline (2.20-2.28 mmol/L), after 4 months' treatment with alirocumab (0.80 mmol/L), or after 4 months' treatment with placebo (2.25-2.28 mmol/L). in the placebo group, the incidence of the primary endpoint over a median of 2.8 years was greater in patients with diabetes (16.4%) than in those with prediabetes (9.2%) or normoglycaemia (8.5%); hazard ratio (HR) for diabetes versus normoglycaemia 2.09 (95% CI 1.78-2.46, p, Sanofi; Regeneron Pharmaceuticals, Sanofi and Regeneron Pharmaceuticals.
Published: 2019
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30. Everolimus-eluting bioresorbable scaffolds for treatment of coronary artery disease in patients with diabetes mellitus: the midterm follow-up of the prospective ABSORB DM Benelux study

Author: R. S. Hermanides, G. A. J. Jessurun, Alexander Ijsselmuiden, Balázs Berta, E. Kedhi, Bruno Pereira, T. M. Hommels, Edouard Benit, Saman Rasoul, and G. De Luca
Subjects: Male, Target lesion, Bioresorbable scaffold, lcsh:Diseases of the circulatory (Cardiovascular) system, Time Factors, Cardiac & Cardiovascular Systems, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Myocardial Infarction, Coronary Artery Disease, 030204 cardiovascular system & hematology, Coronary artery disease, Percutaneous coronary intervention, VASCULAR SCAFFOLD, 0302 clinical medicine, Diabetes mellitus, Coated Materials, Biocompatible, Risk Factors, Absorbable Implants, Scaffold thrombosis, Prospective Studies, Registries, Myocardial infarction, BARE-METAL STENTS, POPULATION, Original Investigation, education.field_of_study, Middle Aged, Europe, Treatment Outcome, Cardiology, Female, Cardiology and Cardiovascular Medicine, Life Sciences & Biomedicine, INTERVENTION, medicine.drug, medicine.medical_specialty, CLINICAL-OUTCOMES, Population, 030209 endocrinology & metabolism, Prosthesis Design, 03 medical and health sciences, Endocrinology & Metabolism, Internal medicine, medicine, Humans, Everolimus, education, METAANALYSIS, Aged, Science & Technology, business.industry, Coronary Thrombosis, MORTALITY, Cardiovascular Agents, medicine.disease, EFFICACY, MYOCARDIAL-INFARCTION, lcsh:RC666-701, Conventional PCI, Cardiovascular System & Cardiology, IMPLANTATION, business, Mace, Follow-Up Studies
Abstract: Background Percutaneous coronary intervention (PCI) in patients with diabetes mellitus (DM) remains challenging even with modern drug-eluting stents (DES) due to high rates of repeat revascularization. Everolimus-eluting bioresorbable scaffolds (EE-BRS) might allow for repeat intervention prolonging the time interval of percutaneous treatment options. Methods The ABSORB DM Benelux Study is a dedicated prospective, international study to evaluate the midterm safety and efficacy of EE-BRS in DM patients. All DM patients that received ≥ 1 EE-BRS for any indication were enrolled and prospectively followed. Study endpoints were major adverse cardiac events (MACE): a composite of all-cause death, any myocardial infarction (MI) and ischemic-driven target vessel revascularization (TVR); target lesion failure (TLF): a composite of cardiac death (CD), target vessel MI, and ischemic-driven target lesion revascularization (TLR), as well as definite or probable scaffold thrombosis (ScT). Results Between April 2015 till March 2017, 150 DM patients and 188 lesions were treated and followed up to 3 years. Device implantation success was 100%. MACE occurred in 15.2% (event rate of 8.8 per 100 PY). TLF was reported in 11.7% (7.0 events per 100 PY). CD, target vessel MI, ischemic-driven TLR occurred in 3.4%, 3.6% and 5.5% respectively, while ScT was observed in 1.4%. There were no occurrences of late or very late ScT. Conclusion EE-BRS treatment in DM patients shows comparable midterm safety and efficacy outcomes when historically compared with modern DES. New-generation EE-BRS might offer an attractive alternative to metallic DES in treatment of fast progressing atherosclerosis population as in DM patients. Trial registration NTR5447. Registered 05 October 2015, retrospectively registered
Published: 2019

31. Early or late intervention in patients with transient ST-segment elevation acute coronary syndrome: Subgroup analysis of the ELISA-3 trial

Author: Erik A. Badings, Wouter S. Remkes, Salem H.K. The, Jan-Henk E. Dambrink, Geert Tjeerdsma, Saman Rasoul, Jorik R. Timmer, Marloes L.J. van der Wielen, Dirk J.A. Lok, Rik Hermanides, Jan van Wijngaarden, Harry Suryapranata, and Arnoud W.J. van 't Hof
Subjects: Acute coronary syndrome, medicine.medical_specialty, medicine.medical_treatment, Subgroup analysis, 030204 cardiovascular system & hematology, Revascularization, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Internal medicine, medicine, Clinical endpoint, ST segment, Radiology, Nuclear Medicine and imaging, 030212 general & internal medicine, medicine.diagnostic_test, business.industry, Incidence (epidemiology), General Medicine, medicine.disease, Surgery, Angiography, Cardiology and Cardiovascular Medicine, business
Abstract: Objectives To investigate incidence and patient characteristics of transient ST-segment elevation (TSTE) ACS and to compare outcome of early versus late invasive treatment. Background Optimal timing of treatment in TSTE–ACS patients is not outlined in current guidelines and no prospective randomized trials have been done so far. Methods Post hoc subgroup analysis of patients with TSTE randomized in the ELISA 3 trial. This study compared early ( 48 h) angiography and revascularization in 542 patients with high-risk NSTE-ACS. Primary endpoint was incidence of death, reinfarction, or recurrent ischemia at 30 days follow-up. Results TSTE was present in 129 patients (24.2%) and associated with male gender, smoking and younger age. The primary endpoint occurred in 8.9% of patients with and 13.0% of patients without TSTE (RR = 0.681, P = 0.214). Incidence of death or MI after 2 year follow-up was 5.7 and 14.6% respectively (RR = 0.384, P = 0.008). Within the group of patients with TSTE, incidence of the primary endpoint was 5.8% in the early and 12.7% in the late treatment group (RR = 0.455, P = 0.213), driven by reduction in recurrent ischemia. Enzymatic infarct size, bleeding and incidence of death or recurrent MI at 2 years follow-up was comparable between the treatment groups. Conclusions In high-risk patients with NSTE-ACS, TSTE is frequently seen. Similar to findings in patients with high-risk NSTE-ACS, immediate angiography and revascularization in these patients is feasible but not superior to later treatment. Prospective randomized trials are needed to provide more evidence in the optimal timing of treatment in patients with TSTE-ACS. © 2016 Wiley Periodicals, Inc.
Published: 2016
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32. Early Intravenous Beta-Blockers in Patients With ST-Segment Elevation Myocardial Infarction Before Primary Percutaneous Coronary Intervention

Author: Niels van Royen, Sonja Postma, Elvin Kedhi, Gonzalo Pizarro, Victoria Hernandez-Jaras, Robin Nijveldt, Vincent Roolvink, Maarten A.H. van Leeuwen, Marcel Gosselink, Joaquín Alonso, Felipe Navarro, Borja Ibanez, Jan J. Piek, Alonso Mateos, Jan-Henk E. Dambrink, Fernando Alfonso, Noemí Escalera, Valentin Fuster, Jan Paul Ottervanger, Erik Lipsic, Agustín Albarrán, José Luis Zamorano, Francisco Fernández-Avilés, Arnoud W J van 't Hof, Saman Rasoul, Bart J. G. L. de Smet, Alberto García-Lledó, Javier Goicolea, Evelien Kolkman, Antonio Fernández-Ortiz, Wouter Remkes, Javier Botas, Cardiology, ICaR - Ischemia and repair, Other departments, MUMC+: MA Med Staf Spec Cardiologie (9), and RS: FHML non-thematic output
Subjects: Male, Emergency Medical Services, Premedication, medicine.medical_treatment, Enfermedad cardiovascular, RATIONALE, 030204 cardiovascular system & hematology, 0302 clinical medicine, DESIGN, Medicine, FAILURE, 030212 general & internal medicine, Myocardial infarction, Creatine Kinase, ejection fraction, Netherlands, Metoprolol, education.field_of_study, Ejection fraction, Insuficiencia cardíaca, Middle Aged, Injections, Intravenous, cardiovascular system, Cardiology, Female, Infarto de miocardio, Cardiology and Cardiovascular Medicine, TIMI, medicine.drug, medicine.medical_specialty, Adrenergic beta-Antagonists, Population, METOPROLOL, PROPRANOLOL, Magnetic Resonance Imaging, Cine, Placebo, cardiac magnetic resonance, CLINICAL-TRIAL, 03 medical and health sciences, CARDIOPROTECTION, Percutaneous Coronary Intervention, Double-Blind Method, Internal medicine, Humans, infarct size, cardiovascular diseases, education, Sistema cardiovascular, CARVEDILOL, business.industry, Percutaneous coronary intervention, Arrhythmias, Cardiac, Stroke Volume, medicine.disease, EFFICACY, SIZE, Spain, Paro cardiaco, ST Elevation Myocardial Infarction, business, Mace
Abstract: Background The impact of intravenous (IV) beta-blockers before primary percutaneous coronary intervention (PPCI) on infarct size and clinical outcomes is not well established. Objectives This study sought to conduct the first double-blind, placebo-controlled international multicenter study testing the effect of early IV beta-blockers before PPCI in a general ST-segment elevation myocardial infarction (STEMI) population. Methods STEMI patients presenting
Published: 2016
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33. PROGNOSTIC IMPACT OF AGE WITH SHORT-TERM VS. 12 MONTHS DUAL ANTIPLATELET THERAPY IN PATIENTS WITH ACUTE CORONARY SYNDROME: A SUB-ANALYSIS OF THE REDUCE TRIAL

Author: Houng-Bang Liew, Sander A.J. Damen, Tian Hai Koh, Dagmara Dilling-Boer, Jawed Polad, Giuseppe De Luca, Sonja Postma, Robaayah Zambahari, Elvin Kedhi, Swl Lee, Evelien Kolkman, Monica Verdoia, Frank Timmermans, Abdul Muhaimin Ahmad, Marc A. Brouwer, Leo Veenstra, Cyril Camaro, Harry Suryapranata, Jacques Lalmand, Dariusz Dudek, Arnoud W J van 't Hof, Erik Ligtenberg, Saman Rasoul, R J van der Schaaf, and Vincent Roolvink
Subjects: medicine.medical_specialty, Acute coronary syndrome, business.industry, Internal medicine, medicine, Cardiology, In patient, Cardiology and Cardiovascular Medicine, medicine.disease, business, Term (time)
Published: 2020
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34. Correction to: Guidelines for the management of myocardial infarction/injury with non-obstructive coronary arteries (MINOCA): a position paper from the Dutch ACS working group

Author: T. F. S. Pustjens, M. L. J. van der Wielen, P. Damman, R. J. de Winter, J. M. ten Berg, Willem R.P. Agema, Yolande Appelman, A. W. J. van ’t Hof, Saman Rasoul, F. Arslan, and Joop Jukema
Subjects: medicine.medical_specialty, Acute coronary syndrome, business.industry, 030204 cardiovascular system & hematology, medicine.disease, 3. Good health, Coronary arteries, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, Internal medicine, medicine, Cardiology, Position paper, In patient, 030212 general & internal medicine, Myocardial infarction, Cardiology and Cardiovascular Medicine, business
Abstract: The reference to the term acute coronary syndrome with normal or near-normal (non-obstructive) coronary arteries (ACSNNOCA) from Manolis et al. (2018) was inadvertently omitted to the original published article. Therefore, the following reference should be added to our paper:Manolis AS, Manolis AA, Manolis TA, Melita H. Acute coronary syndromes in patients with angiographically normal or near normal (non-obstructive) coronary arteries. Trends Cardiovasc Med. 2018;28(8):541–51. https://doi.org/10.1016/j.tcm. 2018.05.006. The authors would like to apologise for any inconvenience caused.
Published: 2020
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35. Comparison of Outcomes and Intervention Among Patients With Non-ST-Segment Elevation Acute Myocardial Infarction of Those With a Left Circumflex Versus Those With a Non-Left Circumflex-Related Coronary Artery (From the ELISA-3 Trial)

Author: Erik A. Badings, Renicus S. Hermanides, Salem H.K. The, Jan-Henk E. Dambrink, Saman Rasoul, Jan Van Wijngaarden, Esther Van 't Riet, Evelien Kolkman, Wouter S. Remkes, Geert Tjeerdsma, Marloes L.J. Van Der Wielen, Dirk J.A. Lok, Harry Suryapranata, Arnoud W.J. Van 't Hof, MUMC+: MA Med Staf Spec Cardiologie (9), Cardiologie, and RS: CARIM - R2.01 - Clinical atrial fibrillation
Subjects: Male, medicine.medical_specialty, Acute coronary syndrome, OCCLUSION, Time Factors, medicine.medical_treatment, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], Hemorrhage, 030204 cardiovascular system & hematology, Revascularization, Conservative Treatment, Coronary Angiography, Culprit, 03 medical and health sciences, 0302 clinical medicine, Percutaneous Coronary Intervention, All institutes and research themes of the Radboud University Medical Center, Recurrence, Internal medicine, medicine, ST segment, Humans, 030212 general & internal medicine, Myocardial infarction, Circumflex, Acute Coronary Syndrome, Coronary Artery Bypass, Mortality, Non-ST Elevated Myocardial Infarction, Aged, medicine.diagnostic_test, business.industry, Incidence, Percutaneous coronary intervention, Length of Stay, Middle Aged, medicine.disease, Prognosis, Coronary Vessels, DOMINANCE, Angiography, Cardiology, Female, Cardiology and Cardiovascular Medicine, business
Abstract: Previous studies found that patients with an acute coronary syndrome (ACS) due to occlusion of the left circumflex (LC) coronary artery often present without ST-elevation, leading to a delay in diagnosis and revascularization, a larger infarct size, and a worse prognosis. In this subgroup analysis of the ELISA-3 study (early or late intervention in high-risk non-ST-segment elevation acute coronary syndromes [NSTE-ACS]) incidence, characteristics and prognosis of LC-related NSTE-ACS was investigated, and the outcome of early versus late invasive strategy was compared. In 383 of 542 patients the culprit vessel could be identified, with the LC artery in 112 (29%) of them. Patients with LC-related ACS had more often single vessel disease and underwent percutaneous coronary intervention more and CABG less frequently. The primary end point of the combined incidences of death, myocardial infarction, and recurrent ischemia at 30-day follow-up occurred in 9.0% of LC versus 16.5% of non-LC-related ACS (p = 0.057). Enzymatic infarct size and incidence of bleeding were comparable. Of patients with LC-related ACS, 62 were assigned to an early and 50 to a late invasive treatment with a median time from admission to angiography of 5.5 and 65.7 hours, respectively. The primary end point occurred in 9.7% and 8.0%, respectively (p = 1.00) with comparable enzymatic infarct size and bleeding. In conclusion, no significant differences in outcome were found between patients with an LC- and a non-LC-related NSTE-ACS. In LC-related NSTE-ACS, angiography within 12 hours of admission is feasible but not superior to angiography after more than 48 hours. (C) 2018 Elsevier Inc. All rights reserved.
Published: 2018

36. P2373Long-term outcome of coronary lesions with deferred revascularization due to negative fractional flow reserve

Author: R. A. L. J. Theunissen, E. Amin, J. Weerts, M. Ilhan, Leo Veenstra, Jan C.A. Hoorntje, G.V.A. Van Ommen, Jindra Vainer, L A W Ruiters, and Saman Rasoul
Subjects: medicine.medical_specialty, business.industry, Internal medicine, medicine.medical_treatment, Cardiology, Medicine, Fractional flow reserve, Cardiology and Cardiovascular Medicine, business, Revascularization, Outcome (game theory), Term (time)
Published: 2017
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37. Rationale and design of a double-blind, multicenter, randomized, placebo-controlled clinical trial of early administration of intravenous β-blockers in patients with ST-elevation myocardial infarction before primary percutaneous coronary intervention

Author: Elvin Kedhi, Vicente Sánchez-Brunete, Vincent Roolvink, Arnoud W J van 't Hof, Valentin Fuster, Saman Rasoul, Iwan C. C. van der Horst, Jan-Henk E. Dambrink, Jan Paul Ottervanger, Erik Lipsic, Jan J. Piek, Borja Ibanez, A T Marcel Gosselink, Bart J. G. L. de Smet, Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE), Cardiovascular Centre (CVC), Amsterdam Cardiovascular Sciences, and Cardiology
Subjects: medicine.medical_specialty, Time Factors, medicine.medical_treatment, Adrenergic beta-Antagonists, PROPRANOLOL, Myocardial Infarction, Placebo, law.invention, CARDIOPROTECTION, Necrosis, Percutaneous Coronary Intervention, Double-Blind Method, Randomized controlled trial, law, Early Medical Intervention, Internal medicine, medicine, Clinical endpoint, FAILURE, Humans, cardiovascular diseases, Myocardial infarction, Ventricular remodeling, EARLY METOPROLOL, Metoprolol, CARVEDILOL, CARDIAC MAGNETIC-RESONANCE, Ventricular Remodeling, business.industry, Myocardium, ADRENERGIC-BLOCKADE, Percutaneous coronary intervention, EFFICACY, medicine.disease, Combined Modality Therapy, Magnetic Resonance Imaging, REDUCTION, SIZE, Treatment Outcome, Conventional PCI, Cardiology, Administration, Intravenous, Cardiology and Cardiovascular Medicine, business, medicine.drug
Abstract: Background beta-Blockers have a class 1a recommendation in the treatment of patients with ST-elevation myocardial infarctions (STEMIs), as they are associated with a reduced mortality, recurrent myocardial infarction, life-threatening arrhythmias, and with prevention of unfavorable left ventricular remodeling. Whether early administration before primary percutaneous coronary intervention (PCI) of intravenous beta-blockers reduces the infarct size in the current era is unknown.Hypothesis We postulate that the early administration of beta-blockers will reduce the myocardial infarcted area as assessed by magnetic resonance imaging (MRI) at 30 days.Design In a multinational, multicenter, double-blind, placebo-controlled, randomized trial, patients with symptoms and signs of STEMI and transferred to a hospital for primary PCI will be randomized in a 1:1 fashion to intravenous metoprolol (5 mg twice daily) administration or placebo. Before admission, study treatment will be started as soon as possible after the diagnosis of STEMI. After admission, primary PCI will be performed as per standard of care. After primary PCI, medical treatment will occur as per current guidelines in all patients, including the use of oral beta-blockers. The primary end point is the myocardial infarct size as assessed by MRI at 30 days. Based on a superiority design and assuming an 18% relative infarct size reduction (from 28% to 23.5%), 408 patients are required to be enrolled, accounting for 20% drop-out (alpha =.05 and power = 80%).Summary The EARLY-BAMI trial is a multinational, multicenter, double-blind, placebo-controlled, randomized clinical trial that will investigate the impact of intravenous metoprolol administration before primary PCI for STEMI on myocardial infarct size as measured with MRI at 30 days.
Published: 2014
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38. Direct Drug-Eluting Stenting to Reduce Stent Restenosis

Author: Harry Suryapranata, A T Marcel Gosselink, Vincent Roolvink, Samer Somi, Wouter Remkes, Jan-Henk E. Dambrink, Menko-Jan de Boer, Jan Paul Ottervanger, Jan C.A. Hoorntje, Arnoud W J van 't Hof, and Saman Rasoul
Subjects: medicine.medical_specialty, business.industry, medicine.medical_treatment, Percutaneous coronary intervention, Stent, medicine.disease, Angina, Restenosis, Internal medicine, Conventional PCI, medicine, Cardiology, cardiovascular diseases, Myocardial infarction, Cardiology and Cardiovascular Medicine, business, Mace, TIMI
Abstract: Objectives The aim was to investigate whether a strategy of direct drug-eluting stent (DES) implantation without pre-dilation is associated with a reduced incidence of restenosis compared with CS with pre-dilation or provisional stenting (PS). Background Previous studies were performed comparing direct stenting (DS) with conventional stenting (CS) after pre-dilation; however, none of these in the DES era. Therefore, the STRESSED (direct Stenting To reduce REStenosis in Stent Era with Drug elution) study was designed and carried out. Methods A total of 600 patients with angina pectoris or recent myocardial infarction were randomized to a DS, CS, or PS strategy. The primary endpoint was the mean minimal lumen diameter at 9-month follow-up angiography. Secondary endpoints were clinical procedural success defined as angiographic success without in-hospital major adverse cardiac events (MACE), and MACE at 9-month and 2-year follow-up. Results Stent implantation in the DS group was 98%, 99% in the CS group, and 77% in the PS group. Percutaneous coronary intervention success was 99% in all groups. The minimal lumen diameter at 9-month follow-up was 2.12 ± 0.58 mm (DS), 2.17 ± 0.67 mm (CS), and 1.99 ± 0.69 mm (PS), p = 0.556 for comparison of DS with CS, p = 0.073 for comparison of DS with PS. The absolute difference was −0.05 (DS to CS), 95% confidence interval: −0.19 to −0.09, p = 0.48 and 0.13 (DS to PS), confidence interval: −0.02 to −0.27, p = 0.087. Restenosis was found in 3.4% (DS), 6.7% (CS), and 11.5% (PS), p = 0.025. At 9-month and 2-year follow-up, MACE occurred in 6.8% and 11.5% (DS), 4.6% and 10.3% (CS), and 7.6% and 13.8% (PS) (p = 0.439 and 0.536), respectively. Conclusions Direct DES implantation compared with conventional DES implantation did not reduce restenosis. Provisional stenting, however, was associated with a higher rate of restenosis. This did not translate into a difference in the rate of MACE. (STRESSED study: direct Stenting To reduce REStenosis in Stent Era with Drug elution; ISRCTN41213536 )
Published: 2014
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39. Early or late intervention in high-risk non-ST-elevation acute coronary syndromes: results of the ELISA-3 trial

Author: Erik A. Badings, Salem H.K. The, Jan-Henk E. Dambrink, Jan van Wijngaarden, Geert Tjeerdsma, Saman Rasoul, Jorik R. Timmer, Marloes L.J. van der Wielen, Dirk J.A. Lok, and Arnoud W.J. van ’t Hof
Subjects: Male, medicine.medical_specialty, Acute coronary syndrome, Time Factors, medicine.medical_treatment, Myocardial Infarction, Coronary Angiography, Time-to-Treatment, law.invention, Electrocardiography, Percutaneous Coronary Intervention, Troponin T, Randomized controlled trial, Predictive Value of Tests, Recurrence, Risk Factors, Interquartile range, law, medicine, Clinical endpoint, Creatine Kinase, MB Form, Humans, Prospective Studies, Myocardial infarction, Acute Coronary Syndrome, Aged, Netherlands, Chi-Square Distribution, business.industry, ST elevation, Age Factors, Percutaneous coronary intervention, Length of Stay, Middle Aged, medicine.disease, Surgery, Logistic Models, Treatment Outcome, Anesthesia, Female, Myocardial infarction diagnosis, Cardiology and Cardiovascular Medicine, business, Biomarkers
Abstract: Aims: To compare an early to a delayed invasive strategy in high-risk patients with NSTE-ACS. Methods and results: In this prospective multicentre trial, 542 patients hospitalised with NSTE-ACS were randomised to either an immediate (angiography and revascularisation if appropriate 48 hr after randomisation). Patients were eligible if they had two of the following three high-risk characteristics: evidence of extensive myocardial ischaemia on ECG, elevated biomarkers for myocardial necrosis (TropT >0.10 μg/L), and an age above 65 years. Primary endpoint of the study was the combined incidence of death, reinfarction and/or recurrent ischaemia at 30-day follow-up. Secondary endpoints were enzymatic infarct size as assessed by a single cardiac troponin T, at 72-96 hours after admission or at discharge, and the percentage of patients without a rise in CKMB during admission. Median age was 71.9 (interquartile range [IQR] 64.5-78.4) years. Median time between randomisation and start of angiography was 2.6 (IQR 1.2-6.2) hours in the immediate and 54.9 (44.2-74.5) hours in the delayed intervention group. The composite of death, reinfarction and/or recurrent ischaemia at 30 days occurred in 12% of patients and was not significantly different between the two groups (9.9% and 14.2%, respectively, p=0.135). All secondary endpoints and bleeding complications were comparable. Hospital duration was two days shorter in the immediate intervention group (4 days [IQR 2-10] vs. 6 days [IQR 4-12]). Conclusions: Although no definitive conclusion can be drawn due to a lower than expected prevalence of the primary endpoint, an immediate invasive strategy was safe and feasible but not superior to a delayed invasive strategy in terms of the combined primary endpoint of death, reinfarction and/or recurrent ischaemia at 30 days. These results are consistent with previous randomised trials which studied the effect of timing of angiography in patients with NSTE-ACS. Trial Registration: ISRCTN Register 9230163.
Published: 2013
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40. Two-year outcome after early or late Intervention in non-ST elevation acute coronary syndrome

Author: Erik A Badings, Wouter S Remkes, Salem H K The, Jan-Henk E Dambrink, Geert Tjeerdsma, Saman Rasoul, Jorik R Timmer, Marloes L J van der Wielen, Dirk J A Lok, Renicus S Hermanides, Jan Van Wijngaarden, Harry Suryapranata, and Arnoud W J van ’t Hof
Subjects: medicine.medical_specialty, Acute coronary syndrome, medicine.medical_treatment, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], Subgroup analysis, 030204 cardiovascular system & hematology, Acute coronary syndromes, Percutaneous coronary intervention, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Clinical endpoint, Medicine, 030212 general & internal medicine, medicine.diagnostic_test, business.industry, Incidence (epidemiology), ST elevation, medicine.disease, Interventional Cardiology, Surgery, Relative risk, Angiography, Cardiology and Cardiovascular Medicine, business
Abstract: Contains fulltext : 182932.pdf (Publisher’s version ) (Open Access) OBJECTIVE: To compare long-term outcome of an early to a delayed invasive strategy in high-risk patients with non-ST elevation acute coronary syndrome (NSTE-ACS). METHODS: This prospective, multicentre trial included patients with NSTE-ACS and at least two out of three of the following high-risk criteria: (1) evidence of extensive myocardial ischaemia on ECG, (2) elevated biomarkers for myocardial necrosis and (3) age above 65 years. Patients were randomised to either an early (angiography and revascularisation if appropriate 48 hours after randomisation). Endpoint for this prespecified long-term follow-up was the composite incidence of death or reinfarction after 2 years. Data collection was performed by telephone contact with the patients, their relatives or general practitioner and by review of hospital records. RESULTS: Endpoint status after 2-year follow-up was collected in 521 of 542 initially enrolled patients. Incidence of death or reinfarction was 11.8% in the early and 13.1% in the delayed treatment group (relative risk (RR)=0.90, 95% CI 0.57 to 1.42). No significant differences were found in occurrence of the individual components of the primary endpoint: death 6.1% vs 8.9%, RR 0.69 (95% CI 0.37 to 1.27), reinfarction 6.5% vs 5.4%, RR 1.20 (95% CI 0.60 to 2.38). Post-hoc subgroup analysis showed statistical significant interaction between age and treatment strategy on outcome (p=0.02). CONCLUSIONS: After 2 years follow-up, no difference in incidence of death or reinfarction was seen between early to late invasive strategy. These findings are in line with results of other studies with longer follow-up. Older patients seem to benefit more from early invasive treatment.
Published: 2016

41. Randomised comparison of drugeluting versus bare-metal stenting in patients with non-ST elevation myocardial infarction

Author: Wouter S Remkes, Erik A Badings, Renicus S Hermanides, Saman Rasoul, Jan-Henk E Dambrink, Petra C Koopmans, Salem HK The, Jan Paul Ottervanger, A T Marcel Gosselink, Jan CA Hoorntje, Harry Suryapranata, Arnoud WJ van 't Hof, MUMC+: MA Med Staf Spec Cardiologie (9), Cardiologie, and RS: FHML non-thematic output
Subjects: medicine.medical_specialty, BALLOON ANGIOPLASTY, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], Restenosis, St elevation myocardial infarction, THROMBOGENICITY, Internal medicine, medicine, Clinical endpoint, Bare metal, In patient, UNCOATED STENTS, Myocardial infarction, cardiovascular diseases, METAANALYSIS, OUTCOMES, medicine.diagnostic_test, business.industry, SEGMENT, medicine.disease, Surgery, TRIALS, Angiography, Cardiology, CORONARY, RESTENOSIS, Cardiology and Cardiovascular Medicine, business, INTERVENTION, Mace
Abstract: Contains fulltext : 171333.pdf (Publisher’s version ) (Open Access) OBJECTIVE: The superiority of drug-eluting stents (DES) over bare-metal stents (BMS) in patients with ST elevation myocardial infarction (STEMI) is well studied; however, randomised data in patients with non-ST elevation myocardial infarction (NSTEMI) are lacking. The objective of this study was to investigate whether stenting with everolimus-eluting stents (EES) safely reduces restenosis in patients with NSTEMI as compared to BMS. METHODS: ELISA-3 patients were asked to participate in the angiographic substudy and were randomised to DE (Xience V) or BM (Vision) stenting (ELISA-3 group). The primary end point was minimal luminal diameter (MLD) at 9-month follow-up angiography. In addition, 296 patients with NSTEMI who were excluded or did not want to participate in the ELISA-3 trial (RELI group) were randomised to DE or BM stenting and underwent clinical follow-up only (major adverse cardiac events (MACE), stent thrombosis (ST)). A pooled analysis was performed to assess an effect on clinical outcome. RESULTS: 178 of 540 ELISA-3 patients participated in the angiographic substudy. MLD at 9 months angiography was 2.37+/-0.63 mm (DES) versus 1.84+/-0.62 mm (BMS), p
Published: 2016

42. Predictors of 30-day and 1-year mortality after primary percutaneous coronary intervention for ST-elevation myocardial infarction

Author: Arnoud W.J. van ʼt Hof, Jan C.A. Hoorntje, Menko-Jan de Boer, Harry Suryapranata, Jan-Henk E. Dambrink, A T Marcel Gosselink, Felix Zijlstra, Jan Paul Ottervanger, Saman Rasoul, and Faculteit Medische Wetenschappen/UMCG
Subjects: Male, Time Factors, medicine.medical_treatment, Myocardial Infarction, PRIMARY ANGIOPLASTY, BLOOD-PRESSURE, Coronary Artery Disease, Coronary Angiography, Severity of Illness Index, Ventricular Function, Left, SYSTOLIC HYPERTENSION, Recurrence, Risk Factors, Odds Ratio, Hospital Mortality, Prospective Studies, Registries, Myocardial infarction, Angioplasty, Balloon, Coronary, Ejection fraction, Mortality rate, Age Factors, 30-day outcome, General Medicine, Thrombolysis, Middle Aged, NO-REFLOW PHENOMENON, Treatment Outcome, ST-elevation myocardial infarction, DRUG-THERAPY, Cardiology, HEART-FAILURE, Female, Cardiology and Cardiovascular Medicine, long-term outcome, medicine.medical_specialty, Risk Assessment, Diabetes Complications, Sex Factors, LEFT-VENTRICULAR DYSFUNCTION, Coronary Circulation, Internal medicine, medicine, Humans, cardiovascular diseases, Aged, Proportional Hazards Models, Killip class, OLDER PATIENTS, business.industry, percutaneous coronary intervention, Percutaneous coronary intervention, Cardiovascular Agents, Stroke Volume, medicine.disease, THROMBOLYTIC THERAPY, RANDOMIZED TRIALS, Heart failure, Conventional PCI, business
Abstract: Objective Predictors of 30-day mortality may differ from predictors of mortality at 1 year among 30-day survivors of ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI). We aimed to evaluate the predictors of 30-day and 1-year mortality in unselected patients with STEMI treated with PCI.Methods Individual patient data from 4732 patients with STEMI, who were treated with primary PCI during an 11-year study period, were recorded prospectively. Patient characteristics, 30-day, and 1-year outcome were evaluated.Results At 30-day follow-up, 219 patients (4.6%) died; and out of the 4513 30-day survivors, 109 patients (2.8%) died at 1 year. Patients who died were older, had a higher risk profile. Higher rates of Killip class greater than 2 on admission, multivessel disease, and, more often, lower left ventricular ejection fraction were observed in patients who died. Mortality rate was 7.6% at 30 days among the females when compared with 3.7 among the males, P value less than 0.001. Age and sex-adjusted multivariate analysis revealed that previous myocardial infarction, diabetes, Killip class greater than 2, post-PCI thrombolysis in myocardial infarction flow less than 3, and left ventricular ejection fraction less than 30% were strong predictors of both 30-day and 1-year mortality. However, multivessel disease, anterior myocardial infarct location and in-hospital reinfarction, ischemic time, and pre-PCI thrombolysis in myocardial infarction flow less than 3 were particularly strong predictors of 30-day mortality.Conclusion Despite the fact that most characteristics of 30-day and 1-year mortality among 30-day survivors are similar, we found that variables that affect mortality beyond the acute phase may not necessarily be the same as those that influence early mortality. Coron Artery Dis 20:415-421 (C) 2009 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.
Published: 2009
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43. Primary percutaneous coronary intervention for ST-elevation myocardial infarction: From clinical trial to clinical practice

Author: Jan-Henk E. Dambrink, Jan Paul Ottervanger, Jan C.A. Hoorntje, Arnoud W J van 't Hof, Felix Zijlstra, Harry Suryapranata, Menko-Jan de Boer, Saman Rasoul, A T Marcel Gosselink, and Faculteit Medische Wetenschappen/UMCG
Subjects: Male, REPERFUSION THERAPY, medicine.medical_treatment, PRIMARY ANGIOPLASTY, law.invention, Electrocardiography, Randomized controlled trial, Recurrence, law, Myocardial infarction, Angioplasty, Balloon, Coronary, Primary PCI, Netherlands, Randomized Controlled Trials as Topic, Aged, 80 and over, IMMEDIATE ANGIOPLASTY, SEGMENT ELEVATION, ST elevation, Middle Aged, surgical procedures, operative, DRUG-THERAPY, SURVIVAL, Cardiology, Female, Stents, Cardiology and Cardiovascular Medicine, Adult, medicine.medical_specialty, HEART-DISEASE, STEMI, Young Adult, Age Distribution, Reperfusion therapy, Internal medicine, Angioplasty, medicine, Humans, cardiovascular diseases, Aged, business.industry, MORTALITY, Percutaneous coronary intervention, Length of Stay, medicine.disease, RANDOMIZED-TRIAL, THROMBOLYTIC THERAPY, Conventional PCI, Door-to-balloon, business
Abstract: Background: More than 10 years ago, survival benefit of primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) was demonstrated in several randomized trials. Since then, primary PCI has been implemented in routine daily practice and is in the guidelines of the preferred reperfusion therapy for patients with STEMI. We aimed to assess time-dependent changes in baseline characteristics, concomitant treatment and prognosis in patients with STEMI treated with primary PCI.Methods: Individual patient data from all 4732 patients admitted for primary PCI for STEMI between 1994 and 2004 in our hospital were recorded. Patient characteristics, concomitant treatment and one-year outcome were evaluated.Results: During the 11-year period, mean age and proportion of female were increasing, whereas door to balloon time decreased. Stent implantation rates increased from 2% to 84%. At discharge, prescription of aspirin, beta-blockers, statins, and ADP receptor blockers increased significantly. From 1994 to 2004, hospital stay shortened from 10.4 to 4.5 days pConclusions: Between 1994 and 2004, utilization of stents and recommended pharmacotherapies increased remarkably. Hospital stay and both hospital and one-year mortality decreased significantly. (C) 2008 Elsevier Ireland Ltd. All rights reserved.
Published: 2009
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44. Novel anti-inflammatory mechanisms ofN-Acetyl-Ser-Asp-Lys-Pro in hypertension-induced target organ damage

Author: Hongmei Peng, Saman Rasoul, Umesh C. Sharma, Saraswati Pokharel, Oscar A. Carretero, Pamela Harding, and Nour Eddine Rhaleb
Subjects: Male, medicine.medical_specialty, Physiology, medicine.drug_class, Galectin 3, Blotting, Western, Anti-Inflammatory Agents, Cardiomegaly, Inflammation, Cell Separation, In Vitro Techniques, Pharmacology, Biology, Kidney, Article, Anti-inflammatory, Mice, Heart Rate, Physiology (medical), Internal medicine, Renin–angiotensin system, medicine, Animals, Macrophage, Tumor Necrosis Factor-alpha, Angiotensin II, Myocardium, Stem Cells, Kidney metabolism, Fibrosis, Mice, Inbred C57BL, Blood pressure, Endocrinology, Neutrophil Infiltration, Hypertension, Circulatory system, Collagen, medicine.symptom, Cardiology and Cardiovascular Medicine, Azo Compounds, Oligopeptides
Abstract: Sharma U, Rhaleb NE, Pokharel S, Harding P, Rasoul S, Peng H, Carretero OA. Novel anti-inflammatory mechanisms of N-Acetyl-Ser-Asp-Lys-Pro in hypertension-induced target organ damage. Am J Physiol Heart Circ Physiol 294: H1226–H1232, 2008. First published January 4, 2008; doi:10.1152/ajpheart.00305.2007.— High blood pressure (HBP) is an important risk factor for cardiac, renal, and vascular dysfunction. Excess inflammation is the major pathogenic mechanism for HBP-induced target organ damage (TOD). N-acetyl-Ser-Asp-Lys-Pro (Ac-SDKP), a tetrapeptide specifically degraded by angiotensin converting enzyme (ACE), reduces inflammation, fibrosis, and TOD induced by HBP. Our hypothesis is that Ac-SDKP exerts its anti-inflammatory effects by inhibiting: 1) differentiation of bone marrow stem cells (BMSC) to macrophages, 2) activation and migration of macrophages, and 3) release of the proinflammatory cytokine TNF-α by activated macrophages. BMSC were freshly isolated and cultured in macrophage growth medium. Differentiation of murine BMSC to macrophages was analyzed by flow cytometry using F4/80 as a marker of macrophage maturation. Macrophage migration was measured in a modified Boyden chamber. TNF-α release by activated macrophages in culture was measured by ELISA. Myocardial macrophage activation in mice with ANG II-induced hypertension was studied by Western blotting of Mac-2 (galectin-3) protein. Interstitial collagen deposition was measured by picrosirius red staining. We found that Ac-SDKP (10 nM) reduced differentiation of cultured BMSC to mature macrophages by 24.5% [F4/80 positivity: 14.09 ± 1.06 mean fluorescent intensity for vehicle and 10.63 ± 0.35 for Ac-SDKP; P ˂ 0.05]. Ac-SDKP also decreased galectin-3 and macrophage colony-stimulating factor-dependent macrophage migration. In addition, Ac-SDKP decreased secretion of TNF-α by macrophages stimulated with bacterial LPS. In mice with ANG II-induced hypertension, Ac-SDKP reduced expression of galectin-3, a protein produced by infiltrating macrophages in the myocardium, and interstitial collagen deposition. In conclusion, this study demonstrates that part of the anti-inflammatory effect of Ac-SDKP is due to its direct effect on BMSC and macrophage, inhibiting their differentiation, activation, and cytokine release. These effects explain some of the anti-inflammatory and antifibrotic properties of Ac-SDKP in hypertension.
Published: 2008
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45. Ongoing tirofiban in myocardial infarction evaluation (On-TIME) 2 trial: rationale and study design

Author: Arnoud W J van 't Hof, Saman Rasoul, John F Paolini, Christian W. Hamm, Soneil Guptha, and Jurriën M. ten Berg
Subjects: business.industry, medicine.medical_treatment, ST elevation, Percutaneous coronary intervention, Tirofiban, Clopidogrel, medicine.disease, Clinical trial, Anesthesia, Conventional PCI, Clinical endpoint, medicine, cardiovascular diseases, Myocardial infarction, Cardiology and Cardiovascular Medicine, business, medicine.drug
Abstract: Aims Delays in initiation of treatment because of transportation of high-risk patients with ST-elevation myocardial infarction (STEMI) are associated with worse clinical outcome. Glycoprotein IIb/IIIa receptor inhibitors improve initial patency of the infarct-related vessel and reduce thrombotic complications in patients undergoing percutaneous coronary intervention (PCI). Methods and results The Ongoing Tirofiban In Myocardial infarction Evaluation (On-TIME) 2 trial is a randomised, double-blind, European clinical trial to evaluate the benefits of pre-hospital initiation of high-dose bolus of tirofiban, a glycoprotein IIb/IIIa receptor inhibitor, on background therapy of aspirin, unfractionated heparin and high dose clopidogrel, for patients with STEMI who undergo primary PCI. Eligible patients will be randomised 1:1 to pretreatment with a 25 microg/kg bolus and 0.15 microg/kg/min maintenance infusion of tirofiban or placebo. The primary endpoint is the extent of residual ST-segment deviation (defined as percentage of patients with >3 mm deviation of ST segment) 1 hour after PCI. The key secondary endpoint is the combined occurrence of death, recurrent myocardial infarction, urgent target vessel revascularisation, or thrombotic bailout at 30 days. The trial will continue until 958 patients are randomly assigned to treatment. Conclusions The On-TIME 2 trial evaluates whether pre-hospital initiation of high-dose bolus tirofiban is effective for patients with STEMI who are candidates to undergo PCI. This placebo-controlled trial will provide important evidence regarding the benefit of initiating a GP IIb/IIIa inhibitor, in combination with high-dose clopidogrel and unfractionated heparin.
Published: 2007
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46. One year outcomes after glucose–insulin–potassium in ST elevation myocardial infarction. The Glucose–insulin–potassium study II

Author: Saman Rasoul, Jan-Henk E. Dambrink, Tone Svilaas, Felix Zijlstra, Jorik R. Timmer, Iwan C. C. van der Horst, Jan Paul Ottervanger, José P.S. Henriques, Amsterdam Cardiovascular Sciences, Cardiology, Faculteit Medische Wetenschappen/UMCG, Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE), and Cardiovascular Centre (CVC)
Subjects: long-term outcome, Male, medicine.medical_specialty, Time Factors, Heart disease, medicine.medical_treatment, Myocardial Infarction, Revascularization, THERAPY, STEMI, Reperfusion therapy, Recurrence, Internal medicine, Diabetes mellitus, medicine, Humans, Insulin, ST segment, Thrombolytic Therapy, Myocardial infarction, Angioplasty, Balloon, Coronary, Aged, RISK, business.industry, ACUTE CORONARY SYNDROMES, MORTALITY, ST elevation, INFUSION, glucose-insulin-potassium, DIABETES-MELLITUS, ASSOCIATION, Middle Aged, medicine.disease, RANDOMIZED-TRIAL, Glucose, Treatment Outcome, Heart failure, Potassium, Cardiology, Female, Cardiology and Cardiovascular Medicine, business, Follow-Up Studies
Abstract: Background: There are conflicting data concerning the effect of treatment with glucose - insulin - potassium ( GIK) in ST segment elevation myocardial infarction ( STEMI). Early studies showed beneficial effects of GIK, however, recent large sample size trials did not confirm this, or suggested only benefits in patients without heart failure. We aimed to evaluate long- term effects of GIK in patients with STEMI without signs of heart failure, all treated with reperfusion therapy.Methods: From August 2003 to December 2004, 889 STEMI patients without signs of heart failure were randomized to standard care ( N= 445) or additional GIK infusion ( N= 444). Glucose - potassium ( 20% glucose with 80 mmol potassium/ l) was infused at 2 ml/ kg body weight per hour for 12 h through a peripheral line. Short- acting insulin was started according to admission glucose and adjusted based on hourly measured glucose. Clinical end points were of number of death, reinfarction and revascularization at 1 year.Results: One year follow- up was available in 864 patients ( 97.2%), 432 in the GIK group and 432 in the control group. Mortality rate was 5.3% in GIK and 3.9% in control patients, p= 0.33. Rates of reinfarction and revascularization 4.6% vs. 4.6% and 15.5% and 15.0%, in GIK vs. control patients.Conclusion: In patients with STEMI without signs of heart failure treated with reperfusion therapy, GIK therapy offers no clinical benefit at 1 year. (C) 2007 Elsevier Ireland Ltd. All rights reserved.
Published: 2007
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47. Multivessel revascularisation versus infarct-related artery only revascularisation during the index primary PCI in STEMI patients with multivessel disease: a meta-analysis

Author: Leo Veenstra, V. A. van Ommen, L A W Ruiters, Jan C.A. Hoorntje, M. Ilhan, R. A. L. J. Theunissen, Saman Rasoul, R Erdem, Jindrich Vainer, RS: CARIM - R2 - Cardiac function and failure, Interne Geneeskunde, MUMC+: MA Med Staf Spec Cardiologie (9), Ondersteunend personeel CD, and Cardiologie
Subjects: medicine.medical_specialty, business.industry, Mortality rate, medicine.medical_treatment, Percutaneous coronary intervention, Odds ratio, Lower risk, medicine.disease, STEMI, surgical procedures, operative, Infarct-related artery, Multivessel PCI, Internal medicine, Meta-analysis, Conventional PCI, Cardiology, medicine, Original Article, Myocardial infarction, cardiovascular diseases, business, Cardiology and Cardiovascular Medicine, therapeutics, Mace, Multivessel diseases
Abstract: Background There are controversial data regarding infarct-related artery only (IRA-PCI) revascularisation versus multivessel revascularisation (MV-PCI) in ST-elevation myocardial infarction (STEMI) patients with multivessel disease undergoing primary percutaneous coronary intervention (PCI). We performed a meta-analysis comparing outcome in same stage MV-PCI versus IRA-PCI in STEMI patients with multivessel disease. Methods Systematic searches of studies comparing MV-PCI with IRA-PCI in the MEDLINE and the Cochrane Database of systematic reviews were conducted. A meta-analysis was performed of all available studies. Primary outcome was all-cause mortality. Secondary endpoints were re-infarction, revascularisation, bleeding and major adverse cardiac events (MACE). Results A total of 15 studies were identified with a total number of 35,975 patients. Mortality rate was significantly higher in the MV-PCI group compared with the IRA-PCI group, odds ratio (OR): 1.64 (1.46–1.85). Both the incidence of re-infarction and re-PCI were significantly lower in the MV-PCI group compared with the IRA-PCI group: OR 0.54 (0.34–0.88) and OR 0.67 (0.48–0.93), respectively. Bleeding complications occurred more often in the MV-PCI group as compared with the IRA-PCI group: OR 1.24 (1.08–1.42). Rates of MACE were comparable between the two groups. Conclusions MV-PCI during the index of primary PCI in STEMI patients is associated with a higher mortality rate, a higher risk of bleeding complications, but lower risk of re-intervention and re-infarction and comparable rates of MACE.
Published: 2015

48. A comparison of dual vs. triple antiplatelet therapy in patients with non-ST-segment elevation acute coronary syndrome

Author: Marcel Gosselink, Jan C.A. Hoorntje, Harry Suryapranata, Kor Miedema, Arnoud W J van 't Hof, Menko-Jan de Boer, Jan-Henk E. Dambrink, Jan Paul Ottervanger, Saman Rasoul, and Felix Zijlstra
Subjects: Male, Acute coronary syndrome, medicine.medical_specialty, ACUTE MYOCARDIAL-INFARCTION, Ticlopidine, myocardial infarct size, Myocardial Infarction, PLACEBO-CONTROLLED TRIAL, Disease-Free Survival, antiplatelet therapy, Internal medicine, TIMI flow, Humans, Medicine, TIROFIBAN, Myocardial infarction, cardiovascular diseases, Aged, UNSTABLE ANGINA, Aspirin, business.industry, Unstable angina, ST elevation, non-ST-elevation acute coronary syndrome, Tirofiban, medicine.disease, Clopidogrel, Enzymes, Drug Combinations, Treatment Outcome, CLOPIDOGREL, GLYCOPROTEIN IIB/IIIA RECEPTOR, Cardiology, Eptifibatide, Tyrosine, ISCHEMIC SYNDROME MANAGEMENT, PRISM-PLUS TRIAL, Female, Cardiology and Cardiovascular Medicine, business, EPTIFIBATIDE, INTERVENTION, Platelet Aggregation Inhibitors, TIMI, medicine.drug
Abstract: Aims To compare dual vs. triple antiplatelet pre-treatment in patients with non-ST-elevation acute coronary syndrome (NSTE ACS) who were planned for early catheterization.Methods and results A total of 328 consecutive patients with NSTE ACS were included and were randomized to pre-treatment with dual (n = 166, aspirin, clopidogrel 600 mg) or triple antiplatelet therapy (n = 162, aspirin, clopidogrel 300 mg, and Tirofiban). The primary endpoint was enzymatic infarct size, defined as cumulative LDH release (LDHQ(48)). Initial TIMI flow of the culprit vessel was a prespecified secondary endpoint. Angiography was performed in 98% of patients at a median of 23 h after admission. Enzymatic infarct size (median, 25-75%) was 166 (60-349) IU/L in the triple group compared with 193 (75-466) IU/L in the dual group (P = 0.2). Initial TIMI 3 flow of the culprit vessel was significantly more often observed after triple antiplatelet therapy (67 vs. 47%, P = 0.002). At 30 days follow-up, myocardial infarction (MI) occurred in 46% of patients in the triple antiplatelet group, compared with 57% in the dual antiplatelet group, P = 0.052. No significant difference in bleeding was present.Conclusion This study showed that in patients with NSTE ACS, triple antiplatelet pre-treatment was associated with a non-significant reduction in enzymatic infarct size, a significantly better initial perfusion of the culprit vessel, and a trend towards a better survival without death or MI. Further, large-scale studies should be performed to find whether the beneficial trend in favour of triple antiplatelet pre-treatment can be reproduced.
Published: 2006

49. Circumflex artery related myocardial infarction: Less reperfusion therapy and large infarct size

Author: R. S. Hermanides, Vincent Roolvink, Marcel Gosselink, Harry Suryapranata, Arnoud W J van 't Hof, Saman Rasoul, Jan-Henk E. Dambrink, Jan Paul Ottervanger, and Jan C.A. Hoorntje
Subjects: Male, medicine.medical_specialty, Acute coronary syndrome, medicine.medical_treatment, Myocardial Infarction, Infarction, Myocardial Reperfusion, Reperfusion therapy, Internal medicine, Humans, Medicine, Prospective Studies, cardiovascular diseases, Myocardial infarction, Acute Coronary Syndrome, Aged, ST depression, Cardiovascular diseases [NCEBP 14], business.industry, ST elevation, Percutaneous coronary intervention, Middle Aged, medicine.disease, Coronary Vessels, Anesthesia, Cardiology, Female, medicine.symptom, Cardiology and Cardiovascular Medicine, business, TIMI
Abstract: The initial 12-lead ECG in patients with chest pain differentiates between ST-segment elevation myocardial infarction (STEMI) and non ST-segment elevationmyocardial infarction (non-STEMI) and determines which patients would benefit from urgent reperfusion treatment with percutaneous coronary intervention (PCI). Previous studies have shown that ST-segment elevation or new left bundle-branch block (LBTB) is absent in one third of all patients presenting with an acute MI [1–4]. Especially circumflex artery (CX) related MI often presents without ST segment elevation. Guidelines for acute STEMI are mainly based on randomized controlled clinical trials [5,6]. However, these trials are based on selected patients. CX related myocardial infarctions are less well represented in these trials [1,5,7,8]. Whether the difficult diagnosis of CX related myocardial infarctions also translates into a lower percentage of reperfusion therapy and difference in infarct size is unknown. We evaluated all patients presenting with an ACS (STEMI or non-STEMI) between January 2006 and January 2010 to determine the incidence and treatment patterns of the 3 different culprit arteries, their ECG findings, enzymatic infarct size and clinical outcome. All individual patients were admitted with an acute coronary syndrome (ACS) (between January 2006 and January 2010 were prospectively registered. ACS was defined as the presence of symptoms suggestive of ischemia and at least 1 of the following criteria: (new) ST depression or elevation of more than 1 mm in at least 2 consecutive ECG leads or a positive biomarker (cardiac troponin TN0.05 μg/L, or CK-MB elevation more than twice the upper limit of normal.) Angiographic data (if performed), treatment patterns and follow-up data were obtained. All ECGs were analyzed by an independent core-lab. Reperfusion therapy was defined as angiography and revascularization if appropriate within 3 h of admission. An occluded culprit vessel was defined as TIMI 0 or 1 flowat the index angiogram. Infarct sizewas defined as the peak CK value during the first 48 h of admission and an infarct size larger than the 75th percentile was defined as large. The investigation conforms with the principles outlined in the Declaration of Helsinki (Br Med J 1964, ii: 177). The study was approved by the Committee on Research Ethics of our hospital. During the study period 4909 patients with an ACS were included (Fig. 1). The diagnosis was STEMI in 3216 patients (66%) and non-STEMI in 1693 patients (34%). During admission, 93% of the patients underwent coronary angiography (CAG) and in 85% a culprit artery could be identified in a native coronary vessel (Table 1). The CX was the culprit artery in 19% of patients, as compared to 39% and 42% for RCA and LAD related MIs (pb0.001). Reperfusion was less often performed in patients with CX related MI (67.2%), compared to LAD relatedMI (77.9%) and RCA relatedMI (77.0%) (pb0.001) (Table 1). At CAG, complete occlusion of the CX was present in 49.2%, comparable to LAD related infarctions (48.1%, p=ns). In patients presentingwithout ST-segment elevation an occluded CX was present in 30.8% versus 20.4% occluded LAD lesions and 22.9% occluded RCA lesions (p=0.007) (Table 1). In the total ACS population, enzymatic infarction size (CK max levels larger than the 75th percentile) was equally present in LAD related infarctions (33.2%) and CX related infarctions, (27.7%), p: n.s. In non-STEMI patients, CX-related MIs had significantly larger enzymatic infarction size as compared to the LAD and RCA-related infarctions (Table 1). Non-STEMI patients had a poor prognoses compared to STEMI patients. Mortality at 1 year follow-up was 9.9% in non-STEMI patients and 7.4% in STEMI patients (pb0.001). In this study it was found that CX related MIs more often presented without ST elevation and less often underwent reperfusion therapy. This was associated with large enzymatic infarct size, much larger than RCA relatedMIs. This wasmore pronounced in patients presenting without ST segment elevation: CX relatedMIs more often had a completely occluded infarct–artery and had the largest infarct size, significantly larger than LAD and RCA related MIs. Our results were found despite a strategy of liberal coronary angiography with more than 90% of patients undergoing CAG during admission and the use of reperfusion therapy in more than 20% of patients who presented without ST segment elevation on the admission ECG and therefore emphasize an even more aggressive treatment strategy in these patients. For a better triage and treatment of these patients the GRACE-risk score, the use of high sensitive troponin T, a transthoracic echocardiogram (TTE) with determination of wall motion abnormalities, and additional standard posterior ECG could be helpful in the determination for early revasculariztion. The ratio of STEMI/non-STEMI is higher in our study as compared to other studies [9]. This is probably because STEMI patients are preferably referred to our PCI center. Furthermore, this could also be because major differences in baseline characteristics between STEMI and non-STEMI, comparison between these groups are difficult. In a large all-comer ACS population, CX related MI often presents without ST elevation and therefore less often (immediate) reperfusion therapy is performed. This is associated with a larger enzymatic infarct size. Acute reperfusion therapy should more often be considered in patients who present without ST segment elevation. The authors of this manuscript have certified that they comply with the Principles of Ethical Publishing in the International Journal of Cardiology.
Published: 2013

50. Well begun is half done

Author: Ron Pisters, M. de Booij, O. Reuchlin, Saman Rasoul, MUMC+: MA Med Staf Spec Cardiologie (9), and RS: FHML non-thematic output
Subjects: 03 medical and health sciences, Medical education, 0302 clinical medicine, business.industry, MEDLINE, Medicine, Heart Beat, 030204 cardiovascular system & hematology, Cardiology and Cardiovascular Medicine, business, 030218 nuclear medicine & medical imaging
Published: 2016

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