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7. Microbiome and metabolome features of the cardiometabolic disease spectrum

Author

Fromentin, Sebastien, Forslund, Sofia K., Chechi, Kanta, Aron-Wisnewsky, Judith, Chakaroun, Rima, Nielsen, Trine, Tremaroli, Valentina, Ji, Boyang, Prifti, Edi, Myridakis, Antonis, Chilloux, Julien, Andrikopoulos, Petros, Fan, Yong, Olanipekun, Michael T., Alves, Renato, Adiouch, Solia, Bar, Noam, Talmor-Barkan, Yeela, Belda, Eugeni, Caesar, Robert, Coelho, Luis Pedro, Falony, Gwen, Fellahi, Soraya, Galan, Pilar, Galleron, Nathalie, Helft, Gerard, Hoyles, Lesley, Isnard, Richard, Le Chatelier, Emmanuelle, Julienne, Hanna, Olsson, Lisa, Pedersen, Helle Krogh, Pons, Nicolas, Quinquis, Benoit, Rouault, Christine, Roume, Hugo, Salem, Joe-Elie, Schmidt, Thomas S. B., Vieira-Silva, Sara, Li, Peishun, Zimmermann-Kogadeeva, Maria, Lewinter, Christian, Søndertoft, Nadja B., Hansen, Tue H., Gauguier, Dominique, Gøtze, Jens Peter, Køber, Lars, Kornowski, Ran, Vestergaard, Henrik, Hansen, Torben, Zucker, Jean-Daniel, Hercberg, Serge, Letunic, Ivica, Bäckhed, Fredrik, Oppert, Jean-Michel, Nielsen, Jens, Raes, Jeroen, Bork, Peer, Stumvoll, Michael, Segal, Eran, Clément, Karine, Dumas, Marc-Emmanuel, Ehrlich, S. Dusko, and Pedersen, Oluf

Published
2022
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9. Outcomes and predictors of left ventricle recovery in patients with severe left ventricular dysfunction undergoing transcatheter aortic valve implantation

Author

Witberg, Guy, primary, Levi, Amos, additional, Talmor-Barkan, Yeela, additional, Barbanti, Marco, additional, Valvo, Roberto, additional, Costa, Giuliano, additional, Frittitta, Valentina, additional, de Backer, Ole, additional, Willemen, Yannick, additional, van Der Dorpel, Mark, additional, Mon, Matias, additional, Sugiura, Atsushi, additional, Sudo, Mitsumasa, additional, Masiero, Giulia, additional, Pancaldi, Edoardo, additional, Arzamendi, Dabit, additional, Santos-Martinez, Sandra, additional, Baz, Jose A., additional, Steblovnik, Klemen, additional, Mauri, Victor, additional, Adam, Matti, additional, Wienemann, Hendrik, additional, Zahler, David, additional, Hein, Manuel, additional, Ruile, Philipp, additional, Aodha, Brídóg Nic, additional, Grasso, Carmelo, additional, Branca, Luca, additional, Estévez-Loureiro, Rodrigo, additional, Amat-Santos, Ignacio J., additional, Mylotte, Darren, additional, Bunc, Matjaz, additional, Tarantini, Giuseppe, additional, Nombela-Franco, Luis, additional, Sondergaard, Lars, additional, Van Mieghem, Nicolas M., additional, Finkelstein, Ariel, additional, and Kornowski, Ran, additional

Published
2024
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11. The real-world safety of sacubitril / valsartan among older adults (≥75): A pharmacovigilance study from the FDA data

Author

Lerman, Tsahi T., primary, Greenberg, Noam, additional, Fishman, Boris, additional, Goldman, Adam, additional, Talmor-Barkan, Yeela, additional, Menachem, Bauer, additional, Goldberg, Idan, additional, Goldberg, Elad, additional, Kornowski, Ran, additional, Krause, Ilan, additional, Levi, Amos, additional, and Cohen, Eytan, additional

Published
2023
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16. Myocarditis after BNT162b2 Vaccination in Israeli Adolescents

Author

Witberg, Guy, primary, Magen, Ori, additional, Hoss, Sara, additional, Talmor-Barkan, Yeela, additional, Richter, Ilan, additional, Wiessman, Maya, additional, Aviv, Yaron, additional, Grinberg, Tzlil, additional, Shiyovich, Arthur, additional, Schamroth-Pravda, Nili, additional, Auster, Oren, additional, Dagan, Noa, additional, Birk, Einat, additional, Balicer, Ran, additional, and Kornowski, Ran, additional

Published
2022
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19. Management and Outcome of Acute Ischemic Stroke Complicating Transcatheter Aortic Valve Replacement

Author

Levi, Amos, primary, Linder, Matthias, additional, Seiffert, Moritz, additional, Witberg, Guy, additional, Pilgrim, Thomas, additional, Tomii, Daijiro, additional, Talmor-Barkan, Yeela, additional, Van Mieghem, Nicolas M., additional, Adrichem, Rik, additional, Codner, Pablo, additional, Smith, David Hildick, additional, Arunothayaraj, Sandeep, additional, Perl, Leor, additional, Finkelstein, Ariel, additional, Loewenstein, Itamar, additional, Findler, Michael, additional, Søndergaard, Lars, additional, De Backer, Ole, additional, Wang, Christina, additional, Barnea, Rani, additional, Tarantini, Giuseppe, additional, Fovino, Luca Nai, additional, Vaknin-Assa, Hana, additional, Mylotte, Darren, additional, Lunardi, Mattia, additional, Raphaeli, Guy, additional, Webb, John G., additional, Akodad, Mariama, additional, Colombo, Antonio, additional, Mangieri, Antonio, additional, Latib, Azeem, additional, Kargoli, Faraj, additional, Giannini, Francesco, additional, Ielasi, Alfonso, additional, Cockburn, James, additional, Higgen, Focko L., additional, Aviram, Itay, additional, Gitto, Mauro, additional, Hokken, Thijmen W., additional, Auriel, Eitan, additional, and Kornowski, Ran, additional

Published
2022
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20. Center Valve Preference and Outcomes of Transcatheter Aortic Valve Replacement: Insights From the AMTRAC Registry

Author

Witberg, Guy, Landes, Uri, Talmor-Barkan, Yeela, Richter, Ilan, Barbanti, Marco, Valvo, Roberto, De Backer, Ole, Ooms, Joris F., Islas, Fabian, Marroquin, Luis, Sedaghat, Alexander, Sugiura, Atsushi, Masiero, Giulia, Armario, Xavier, Fiorina, Claudia, Arzamendi, Dabit, Santos-Martinez, Sandra, Fernández-Vázquez, Felipe, Baz, Jose A., Steblovnik, Klemen, Mauri, Victor, Adam, Matti, Merdler, Ilan, Hein, Manuel, Ruile, Philipp, Codner, Pablo, Grasso, Carmelo, Branca, Luca, Estévez-Loureiro, Rodrigo, Benito-González, Tomás, Amat-Santos, Ignacio J., Mylotte, Darren, Bunc, Matjaz, Tarantini, Giuseppe, Nombela-Franco, Luis, Søndergaard, Lars, Van Mieghem, Nicolas M., Finkelstein, Ariel, Kornowski, Ran, and Cardiology

Abstract

Background: Data on outcomes of transcatheter aortic valve replacement (TAVR) using balloon-expandable valves (BEVs) or self-expandable valves (SEVs) as well as the impact of center valve preference on these outcomes are limited. Objectives: The aim of this study was to compare outcomes of TAVR procedures using third-generation BEVs and SEVs stratified by center valve preference. Methods: In a multicenter registry (n = 17), 13 centers exhibited valve preference (66.6%-90% of volume) and were included. Outcomes were compared between BEVs and SEVs stratified by center valve preference. Results: In total, 7,528 TAVR procedures (3,854 with SEVs and 3,674 with BEVs) were included. The mean age was 81 years, and the mean Society of Thoracic Surgeons score was 5.2. Baseline characteristics were similar between BEVs and SEVs. Need for pacemaker implantation was higher with SEVs at BEV- and SEV-dominant centers (17.8% vs 9.3% [P < 0.001] and 12.7% vs 10.0% [P = 0.036], respectively; HR: 1.51; P for interaction = 0.021), risk for cerebrovascular accident was higher with SEVs at BEV-dominant but not SEV-dominant centers (3.6% vs 1.1% [P < 0.001] and 2.2% vs 1.4% [P = 0.162]; HR: 2.08; P for interaction < 0.01). Aortic regurgitation greater than mild was more frequent with SEVs at BEV-dominant centers and similar with BEVs regardless of center dominance (5.2% vs 2.8% [P < 0.001] and 3.4% vs 3.7% [P = 0.504], respectively). Two-year mortality was higher with SEVs at BEV-dominant centers but not at SEV-dominant centers (21.9% vs 16.9% [P = 0.021] and 16.8% vs 16.5% [P = 0.642], respectively; HR: 1.20; P for interaction = 0.032). Conclusions: Periprocedural outcomes, aortic regurgitation greater than mild, and 2-year mortality are worse when TAVR is performed using SEVs at BEV-dominant centers. Outcomes are similar regardless of valve type at SEV-dominant centers. The present results stress the need to account for this factor when comparing BEV and SEV outcomes. (The Aortic+Mitral Transcatheter [AMTRAC] Valve Registry; NCT04031274)

Published
2022

21. Center Valve Preference and Outcomes of Transcatheter Aortic Valve Replacement:Insights From the AMTRAC Registry

Author

Witberg, Guy, Landes, Uri, Talmor-Barkan, Yeela, Richter, Ilan, Barbanti, Marco, Valvo, Roberto, De Backer, Ole, Ooms, Joris F., Islas, Fabian, Marroquin, Luis, Sedaghat, Alexander, Sugiura, Atsushi, Masiero, Giulia, Armario, Xavier, Fiorina, Claudia, Arzamendi, Dabit, Santos-Martinez, Sandra, Fernández-Vázquez, Felipe, Baz, Jose A., Steblovnik, Klemen, Mauri, Victor, Adam, Matti, Merdler, Ilan, Hein, Manuel, Ruile, Philipp, Codner, Pablo, Grasso, Carmelo, Branca, Luca, Estévez-Loureiro, Rodrigo, Benito-González, Tomás, Amat-Santos, Ignacio J., Mylotte, Darren, Bunc, Matjaz, Tarantini, Giuseppe, Nombela-Franco, Luis, Søndergaard, Lars, Van Mieghem, Nicolas M., Finkelstein, Ariel, Kornowski, Ran, Witberg, Guy, Landes, Uri, Talmor-Barkan, Yeela, Richter, Ilan, Barbanti, Marco, Valvo, Roberto, De Backer, Ole, Ooms, Joris F., Islas, Fabian, Marroquin, Luis, Sedaghat, Alexander, Sugiura, Atsushi, Masiero, Giulia, Armario, Xavier, Fiorina, Claudia, Arzamendi, Dabit, Santos-Martinez, Sandra, Fernández-Vázquez, Felipe, Baz, Jose A., Steblovnik, Klemen, Mauri, Victor, Adam, Matti, Merdler, Ilan, Hein, Manuel, Ruile, Philipp, Codner, Pablo, Grasso, Carmelo, Branca, Luca, Estévez-Loureiro, Rodrigo, Benito-González, Tomás, Amat-Santos, Ignacio J., Mylotte, Darren, Bunc, Matjaz, Tarantini, Giuseppe, Nombela-Franco, Luis, Søndergaard, Lars, Van Mieghem, Nicolas M., Finkelstein, Ariel, and Kornowski, Ran

Abstract

Background: Data on outcomes of transcatheter aortic valve replacement (TAVR) using balloon-expandable valves (BEVs) or self-expandable valves (SEVs) as well as the impact of center valve preference on these outcomes are limited. Objectives: The aim of this study was to compare outcomes of TAVR procedures using third-generation BEVs and SEVs stratified by center valve preference. Methods: In a multicenter registry (n = 17), 13 centers exhibited valve preference (66.6%-90% of volume) and were included. Outcomes were compared between BEVs and SEVs stratified by center valve preference. Results: In total, 7,528 TAVR procedures (3,854 with SEVs and 3,674 with BEVs) were included. The mean age was 81 years, and the mean Society of Thoracic Surgeons score was 5.2. Baseline characteristics were similar between BEVs and SEVs. Need for pacemaker implantation was higher with SEVs at BEV- and SEV-dominant centers (17.8% vs 9.3% [P < 0.001] and 12.7% vs 10.0% [P = 0.036], respectively; HR: 1.51; P for interaction = 0.021), risk for cerebrovascular accident was higher with SEVs at BEV-dominant but not SEV-dominant centers (3.6% vs 1.1% [P < 0.001] and 2.2% vs 1.4% [P = 0.162]; HR: 2.08; P for interaction < 0.01). Aortic regurgitation greater than mild was more frequent with SEVs at BEV-dominant centers and similar with BEVs regardless of center dominance (5.2% vs 2.8% [P < 0.001] and 3.4% vs 3.7% [P = 0.504], respectively). Two-year mortality was higher with SEVs at BEV-dominant centers but not at SEV-dominant centers (21.9% vs 16.9% [P = 0.021] and 16.8% vs 16.5% [P = 0.642], respectively; HR: 1.20; P for interaction = 0.032). Conclusions: Periprocedural outcomes, aortic regurgitation greater than mild, and 2-year mortality are worse when TAVR is performed using SEVs at BEV-dominant centers. Outcomes are similar regardless of valve type at SEV-dominant centers. The present results stress the need to account for this factor when comparing BEV and SEV outcomes. (Th

Published
2022

22. Management and Outcome of Acute Ischemic Stroke Complicating Transcatheter Aortic Valve Replacement

Author

Levi, Amos, Linder, Matthias, Seiffert, Moritz, Witberg, Guy, Pilgrim, Thomas, Tomii, Daijiro, Talmor-Barkan, Yeela, Van Mieghem, Nicolas M., Adrichem, Rik, Codner, Pablo, Smith, David Hildick, Arunothayaraj, Sandeep, Perl, Leor, Finkelstein, Ariel, Loewenstein, Itamar, Findler, Michael, Søndergaard, Lars, De Backer, Ole, Wang, Christina, Barnea, Rani, Tarantini, Giuseppe, Fovino, Luca Nai, Vaknin-Assa, Hana, Mylotte, Darren, Lunardi, Mattia, Raphaeli, Guy, Webb, John G., Akodad, Mariama, Colombo, Antonio, Mangieri, Antonio, Latib, Azeem, Kargoli, Faraj, Giannini, Francesco, Ielasi, Alfonso, Cockburn, James, Higgen, Focko L., Aviram, Itay, Gitto, Mauro, Hokken, Thijmen W., Auriel, Eitan, Kornowski, Ran, Levi, Amos, Linder, Matthias, Seiffert, Moritz, Witberg, Guy, Pilgrim, Thomas, Tomii, Daijiro, Talmor-Barkan, Yeela, Van Mieghem, Nicolas M., Adrichem, Rik, Codner, Pablo, Smith, David Hildick, Arunothayaraj, Sandeep, Perl, Leor, Finkelstein, Ariel, Loewenstein, Itamar, Findler, Michael, Søndergaard, Lars, De Backer, Ole, Wang, Christina, Barnea, Rani, Tarantini, Giuseppe, Fovino, Luca Nai, Vaknin-Assa, Hana, Mylotte, Darren, Lunardi, Mattia, Raphaeli, Guy, Webb, John G., Akodad, Mariama, Colombo, Antonio, Mangieri, Antonio, Latib, Azeem, Kargoli, Faraj, Giannini, Francesco, Ielasi, Alfonso, Cockburn, James, Higgen, Focko L., Aviram, Itay, Gitto, Mauro, Hokken, Thijmen W., Auriel, Eitan, and Kornowski, Ran

Abstract

Background: Despite advances in transcatheter aortic valve replacement (TAVR), periprocedural acute ischemic stroke remains a concern. Objectives: The aims of this study were to investigate acute ischemic stroke complicating TAVR (AISCT) and to describe the indications and outcomes of interventions to treat AISCT. Methods: An international multicenter registry was established focusing on AISCT within 30 days of TAVR. Stroke severity was assessed using the National Institutes of Health Stroke Scale. Primary outcomes were 1-year all-cause death and neurologic disability status at 90 days according to modified Rankin scale score. Results: Of 16,615 TAVR procedures, 387 patients with AISCT were included (2.3%). Rates of 1-year death were 28.9%, 35.9%, and 77.5% in patients with mild, moderate, and severe stroke, respectively (P < 0.001). Although 348 patients were managed conservatively, 39 patients (10.1%) underwent neurointervention (NI) with either mechanical thrombectomy (n = 26) or thrombolytic therapy (n = 13). In a subanalysis excluding patients with mild stroke, there was no clear 1-year survival benefit for NI compared with conservative management (47.6% vs 41.1%, respectively; P = 0.78). In a logistic regression model controlling for stroke severity, NI was associated with 2.9-fold odds (95% CI: 1.2-7.0; P = 0.016) of independent survival at 90 days. Conclusions: AISCT carries significant morbidity and mortality, which is correlated with stroke severity. The present findings suggest that neurologic disability for patients with moderate or worse stroke could potentially be improved by timely intervention and highlight the importance of collaboration between cardiologists and neurologists to optimize AISCT outcomes.

Published
2022

23. Temporal Trends in Complex Percutaneous Coronary Interventions

Author

Kheifets, Mark, primary, Vons, Shelly Abigail, additional, Bental, Tamir, additional, Vaknin-Assa, Hana, additional, Greenberg, Gabriel, additional, Samara, Abed, additional, Codner, Pablo, additional, Wittberg, Guy, additional, Talmor Barkan, Yeela, additional, Perl, Leor, additional, Kornowski, Ran, additional, and Levi, Amos, additional

Published
2022
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24. Center Valve Preference and Outcomes of Transcatheter Aortic Valve Replacement

Author

Witberg, Guy, primary, Landes, Uri, additional, Talmor-Barkan, Yeela, additional, Richter, Ilan, additional, Barbanti, Marco, additional, Valvo, Roberto, additional, De Backer, Ole, additional, Ooms, Joris F., additional, Islas, Fabian, additional, Marroquin, Luis, additional, Sedaghat, Alexander, additional, Sugiura, Atsushi, additional, Masiero, Giulia, additional, Armario, Xavier, additional, Fiorina, Claudia, additional, Arzamendi, Dabit, additional, Santos-Martinez, Sandra, additional, Fernández-Vázquez, Felipe, additional, Baz, Jose A., additional, Steblovnik, Klemen, additional, Mauri, Victor, additional, Adam, Matti, additional, Merdler, Ilan, additional, Hein, Manuel, additional, Ruile, Philipp, additional, Codner, Pablo, additional, Grasso, Carmelo, additional, Branca, Luca, additional, Estévez-Loureiro, Rodrigo, additional, Benito-González, Tomás, additional, Amat-Santos, Ignacio J., additional, Mylotte, Darren, additional, Bunc, Matjaz, additional, Tarantini, Giuseppe, additional, Nombela-Franco, Luis, additional, Søndergaard, Lars, additional, Van Mieghem, Nicolas M., additional, Finkelstein, Ariel, additional, and Kornowski, Ran, additional

Published
2022
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25. Tricuspid Structural Valve Deterioration Treated with a Transcatheter Valve-in-Valve Implantation: A Single-Center Prospective Registry

Author

Schamroth Pravda, Nili, primary, Vaknin Assa, Hana, additional, Levi, Amos, additional, Witberg, Guy, additional, Shapira, Yaron, additional, Vaturi, Mordechai, additional, Orvin, Katia, additional, Talmor Barkan, Yeela, additional, Hamdan, Ashraf, additional, Mishaev, Raffael, additional, Sharoni, Ram, additional, Perl, Leor, additional, Sagie, Alexander, additional, Kornowski, Ran, additional, and Codner, Pablo, additional

Published
2022
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27. Impact of Valve Size on Paravalvular Leak and Valve Hemodynamics in Patients With Borderline Size Aortic Valve Annulus

Author

Talmor-Barkan, Yeela, primary, Kornowski, Ran, additional, Bar, Noam, additional, Ben-Shoshan, Jeremy, additional, Vaknin-Assa, Hanna, additional, Hamdan, Ashraf, additional, Kruchin, Boris, additional, Barbash, Israel M., additional, Danenberg, Haim, additional, Perlman, Gidon Y., additional, Konigstein, Maayan, additional, Finkelstein, Ariel, additional, Steinvil, Arie, additional, Merdler, Ilan, additional, Segev, Amit, additional, Barsheshet, Alon, additional, and Codner, Pablo, additional

Published
2022
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28. 5 Year Outcomes of Patients With Aortic Structural Valve Deterioration Treated With Transcatheter Valve in Valve – A Single Center Prospective Registry

Author

Schamroth Pravda, Nili, primary, Kornowski, Ran, additional, Levi, Amos, additional, Witberg, Guy, additional, Landes, Uri, additional, Perl, Leor, additional, Shapira, Yaron, additional, Orvin, Katia, additional, Mishaev, Raffael, additional, Talmor Barkan, Yeela, additional, Hamdan, Ashraf, additional, Sharoni, Ram, additional, Vaknin Assa, Hana, additional, and Codner, Pablo, additional

Published
2021
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29. Device Selection in Patients with Borderline Size Aortic Valve Annulus Undergoing Transcatheter Aortic Valve Implantation

Author

Talmor-Barkan, Yeela, primary, Kornowski, Ran, additional, Bar, Noam, additional, Ben-Shoshan, Jeremy, additional, Vaknin-Assa, Hanna, additional, Hamdan, Ashraf, additional, Kruchin, Boris, additional, Barbash, Israel M., additional, Danenberg, Haim, additional, Perlman, Gidon Y., additional, Konigstein, Maayan, additional, Finkelstein, Ariel, additional, Steinvil, Arie, additional, Merdler, Ilan, additional, Segev, Amit, additional, Barsheshet, Alon, additional, and Codner, Pablo, additional

Published
2021
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31. Biodegradable polymer drug-eluting stents versus durable polymer drug-eluting stents for percutaneous coronary intervention: a contemporary registry-based analysis

Author

Levi, Amos, primary, Kheifets, Mark, additional, Bental, Tamir, additional, Perl, Leor, additional, Codner, Pablo, additional, Witberg, Guy, additional, Talmor-Barkan, Yeela, additional, Landes, Uri, additional, Samara, Abed, additional, Greenberg, Gabriel, additional, Erez, Aharon, additional, Vaknin-Assa, Hanna, additional, and Kornowski, Ran, additional

Published
2021
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32. 10 K: a large‐scale prospective longitudinal study in Israel

Author

Shilo, Smadar, primary, Bar, Noam, additional, Keshet, Ayya, additional, Talmor-Barkan, Yeela, additional, Rossman, Hagai, additional, Godneva, Anastasia, additional, Aviv, Yaron, additional, Edlitz, Yochai, additional, Reicher, Lee, additional, Kolobkov, Dmitry, additional, Wolf, Bat Chen, additional, Lotan-Pompan, Maya, additional, Levi, Kohava, additional, Cohen, Ori, additional, Saranga, Hila, additional, Weinberger, Adina, additional, and Segal, Eran, additional

Published
2021
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33. Myocardial extracellular volume quantification by computed tomography predicts outcomes in patients with severe aortic stenosis

Author

Hammer, Yoav, primary, Talmor-Barkan, Yeela, additional, Abelow, Aryeh, additional, Orvin, Katia, additional, Aviv, Yaron, additional, Bar, Noam, additional, Levi, Amos, additional, Landes, Uri, additional, Shafir, Gideon, additional, Barsheshet, Alon, additional, Vaknin-Assa, Hana, additional, Sagie, Alexander, additional, Kornowski, Ran, additional, and Hamdan, Ashraf, additional

Published
2021
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34. Cohort profile: 10K - a large-scale prospective longitudinal study in Israel

Author

Shilo, Smadar, primary, Bar, Noam, additional, Keshet, Ayya, additional, Talmor-Barkan, Yeela, additional, Rossman, Hagai, additional, Godneva, Anastasia, additional, Aviv, Yaron, additional, Edlitz, Yochai, additional, Reicher, Lee, additional, Kolobkov, Dmitry, additional, Wolf, Bat Chen, additional, Lotan-Pompan, Maya, additional, Levi, Kohava, additional, Cohen, Ori, additional, Saranga, Hila, additional, Weinberger, Adina, additional, and Segal, Eran, additional

Published
2021
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40. NOVEL BIOMARKERS OF CORONARY ARTERY CALCIUM INCIDENCE OR PROGRESSION: INSIGHTS FROM THE DALLAS HEART STUDY

Author

Eisen, Alon, primary, Kornowski, Ran, additional, Hamdan, Ashraf, additional, Talmor-Barkan, Yeela, additional, Witberg, Guy, additional, Deshpande, Kaivalya, additional, Paixao, Andre, additional, Ayers, Colby, additional, Joshi, Parag, additional, Rohatgi, Anand, additional, Khera, Amit, additional, de Lemos, James, additional, and Neeland, Ian, additional

Published
2019
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43. Coronary Artery Disease and Microvascular Ischemia in Patients with Cardiac Amyloidosis.

Author

Itzhaki Ben Zadok O, Vaxman I, Hoss S, Talmor-Barkan Y, Steinmetz T, Raanani P, Kornowski R, and Hamdan A

Abstract

Introduction: The prevalence of pre-existing obstructive coronary artery disease (CAD) and the occurrence of anginal chest pain as a presenting symptom in patients with light chain (AL) and transthyretin (ATTR) cardiac amyloidosis (CA) are undetermined., Methods: A single-center analysis of clinical, laboratory, imaging and angiographic characteristics of CA cohort., Results: Included were 98 CA patients (43 AL, 47 wtATTR, 8 mutant ATTR). Eighteen patients (18%) had pre-existing obstructive CAD at the time of CA diagnosis. These patients were older and had worse left ventricular ejection fraction, yet revealed similar cardiac biomarkers' levels. The 3-year survival rate was comparable between patients with versus without pre-existing CAD (p=0.974). Anginal chest pain was a presenting symptom of newly-diagnosed CA in 24% (n=19) of patients with no pre-existing CAD, 53% (n=10) of which had AL-CA. Two patients had an acute myocardial infarction. The prevalence of diabetes mellitus, dyslipidemia, hypertension and smoking was similar among CA patients presenting with versus without chest pain. Of the newly-diagnosed CA patients with no pre-existing CAD who underwent symptoms evaluation (n=37), 99mTc-Sestamibi myocardial perfusion scintigraphy demonstrated stress-induced perfusion defects in 45% (9/20) and normal study in 45% (9/20) of patients. Coronary evaluation revealed non-obstructive coronary artery lesions or normal coronaries in 75% of patients (18/24)., Conclusion: CA patients may initially present with anginal chest pain and myocardial perfusion defects which may reflect coronary microvascular ischemia. CA should be considered in the differential diagnosis of patients presenting with chest pain, non-obstructive CAD and elevated cardiac biomarkers., (S. Karger AG, Basel.)

Published
2024
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44. Head-to-head efficacy and safety of rivaroxaban, apixaban, and dabigatran in an observational nationwide targeted trial.

Author

Talmor-Barkan Y, Yacovzada NS, Rossman H, Witberg G, Kalka I, Kornowski R, and Segal E

Subjects
Humans, Dabigatran adverse effects, Rivaroxaban adverse effects, Retrospective Studies, Anticoagulants, Gastrointestinal Hemorrhage chemically induced, Brain Ischemia, Stroke diagnosis, Stroke epidemiology, Stroke prevention & control, Atrial Fibrillation diagnosis, Atrial Fibrillation drug therapy, Atrial Fibrillation chemically induced
Abstract

Aims: The advantages of direct oral anticoagulants (DOACs) over warfarin are well established in atrial fibrillation (AF) patients, however, studies that can guide the selection between different DOACs are limited. The aim was to compare the clinical outcomes of treatment with apixaban, rivaroxaban, and dabigatran in patients with AF., Methods and Results: We conducted a retrospective, nationwide, propensity score-matched-based observational study from Clalit Health Services. Data from 141 992 individuals with AF was used to emulate a target trial for head-to-head comparison of DOACs therapy. Three-matched cohorts of patients assigned to DOACs, from January-2014 through January-2020, were created. One-to-one propensity score matching was performed. Efficacy/safety outcomes were compared using KaplanMeier survival estimates and Cox proportional hazards models. The trial included 56 553 patients (apixaban, n = 35 101; rivaroxaban, n = 15 682; dabigatran, n = 5 770). Mortality and ischaemic stroke rates in patients treated with rivaroxaban were lower compared with apixaban (HR,0.88; 95% CI,0.78-0.99; P,0.037 and HR 0.92; 95% CI,0.86-0.99; P,0.024, respectively). No significant differences in the rates of myocardial infarction, systemic embolism, and overall bleeding were noticed between the different DOACs groups. Patients treated with rivaroxaban demonstrated lower rate of intracranial haemorrhage compared with apixaban (HR,0.86; 95% CI,0.74-1.0; P,0.044). The rate of gastrointestinal bleeding in patients treated with rivaroxaban was higher compared with apixaban (HR, 1.22; 95% CI,1.01-1.44; P, 0.016)., Conclusion: We demonstrated significant differences in outcomes between the three studied DOACs. The results emphasize the need for randomized controlled trials that will compare rivaroxaban, apixaban, and dabigatran in order to better guide the selection among them., (© The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Published
2022
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