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7 results on '"Umans, V.A."'

3. Development and validation of a risk model for long-term mortality after percutaneous coronary intervention: The IDEA-BIO Study

Author

Boven, N. van, Domburg, R.T. van, Kardys, I., Umans, V.A., Akkerhuis, K.M., Lenzen, M.J., Valgimigli, M., Daemen, J., Zijlstra, F., Boersma, E., Geuns, R.J.M. van, Boven, N. van, Domburg, R.T. van, Kardys, I., Umans, V.A., Akkerhuis, K.M., Lenzen, M.J., Valgimigli, M., Daemen, J., Zijlstra, F., Boersma, E., and Geuns, R.J.M. van

Abstract

Item does not contain fulltext, OBJECTIVES: We aimed to develop a model to predict long-term mortality after percutaneous coronary intervention (PCI), to aid in selecting patients with sufficient life expectancy to benefit from bioabsorbable scaffolds. BACKGROUND: Clinical trials are currently designed to demonstrate superiority of bioabsorbable scaffolds over metal devices up to 5 years after implantation. METHODS: From 2000 to 2011, 19.532 consecutive patients underwent PCI in a tertiary referral hospital. Patients were randomly (2:1) divided into a training (N = 13,090) and validation (N = 6,442) set. Cox regression was used to identify determinants of long-term mortality in the training set and used to develop a risk model. Model performance was studied in the training and validation dataset. RESULTS: Median age was 63 years (IQR 54-72) and 72% were men. Median follow-up was 3.6 years (interquartile range [IQR] 2.4-6.8). The ratio elective vs. non-elective PCIs was 42/58. During 88,620 patient-years of follow-up, 3,156 deaths occurred, implying an incidence rate of 35.6 per 1,000. Estimated 5-year mortality was 12.9%.Regression analysis revealed age, body mass index, diabetes mellitus, renal insufficiency, prior myocardial infarction, PCI indication, lesion location, number of diseased vessels and cardiogenic shock at presentation as determinants of mortality. The long-term risk model showed good discrimination in the training and validation sets (c-indices 0.76 and 0.74), whereas calibration was appropriate. CONCLUSIONS: A simple risk model, containing 9 baseline clinical and angiographic variables effectively predicts long-term mortality after PCI and may possibly be used to select suitable patients for bioabsorbable scaffolds.

Published
2018

4. Clinical efficacy of the use of information technology in cardiology: initial results of angiographic teleconsultation in the Netherlands

Author

Otterspoor, L.C., Bronzwaer, J., Huybregts, M., Spruijt, H.J., and Umans, V.A.

Subjects
Original Articles
Abstract

With the increasing use of cineless diagnostic angiography laboratories, modern telecommunication networks provide an excellent opportunity to transfer dynamic cardiac catheterisation images from a referring centre to a cardiac intervention centre. This electronic data transfer may lead to improved patient care and reduced waiting times.Two departments of cardiology started a pilot project using a digital ISDN-30 point-to-point data-line connection between Alkmaar and Amsterdam over which MPEG compressed angiograms are sent. The network consists of a PC based client/server structure and two ISDN modular routers.From June 1998 to January 2001, 127 patients were referred for urgent PTCA or CABG using this network. All patients were admitted to the CCU for unstable angina and had a suitable anatomy for coronary angioplasty or coronary artery bypass surgery. In all cases the MPEG compressed images were successfully stored on the server and could be accessed in Amsterdam. During the pilot phase all X-ray runs (11 + 3) were sent. Following transmission, all patients were accepted for intervention. Review of the DICOM images from the CD-Medical immediately before the PTCA or CABG did not change the planned strategy. The patients were successfully treated 1 to 2 days after data transmission. During this phase, the average variable costs of this network was € 5.90 per patient as opposed to € 69.00 when using a courier service.This study shows that personal computer-based telecommunication network systems are feasible for clinical use in daily practise. Access to a remotely located cardiac intervention centre can be achieved promptly at low costs and improves patient care by reducing waiting times.

Published
2001

5. Costs and effects of combining stenting and abciximab (ReoPro ®) in daily practice

Author

Zwart - van Rijkom, J.E.F., Klungel, O.H., Leufkens, H.G.M., Broekmans, A.W., Schrijver-van Velthoven, S, Umans, V.A, Population-based studies of drug treatment: from molecule to patient outcomes, Universiteit Utrecht, and Dep Farmaceutische wetenschappen

Subjects
Farmacie/Biofarmaceutische wetenschappen (FARM), Ziekenhuisstructuur en organisatie van de gezondheidszorg, Epidemiology, Farmacie(FARM), Public Health, Biomedische technologie en medicijnen
Published
2001

6. Costs and effects of combining stenting and abciximab (ReoPro ®) in daily practice

Author

Population-based studies of drug treatment: from molecule to patient outcomes, Universiteit Utrecht, Dep Farmaceutische wetenschappen, Zwart - van Rijkom, J.E.F., Klungel, O.H., Leufkens, H.G.M., Broekmans, A.W., Schrijver-van Velthoven, S, Umans, V.A, Population-based studies of drug treatment: from molecule to patient outcomes, Universiteit Utrecht, Dep Farmaceutische wetenschappen, Zwart - van Rijkom, J.E.F., Klungel, O.H., Leufkens, H.G.M., Broekmans, A.W., Schrijver-van Velthoven, S, and Umans, V.A

Published
2001

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