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Milaras N, Kordalis A, Tsiachris D, Sakalidis A, Ntalakouras I, Pamporis K, Dourvas P, Apostolos A, Sotiriou Z, Arsenos P, Archontakis S, Tsioufis K, Gatzoulis K, Sideris S. Ischemia testing and revascularization in patients with monomorphic ventricular tachycardia: A relic of the past? Curr Probl Cardiol 2024; 49:102358. [PMID: 38169203 DOI: 10.1016/j.cpcardiol.2023.102358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 12/18/2023] [Indexed: 01/05/2024]
Abstract
Testing for myocardial ischemia in patients presenting with sustained monomorphic Ventricular Tachycardia(VT) even without evidence of acute myocardial infarction is a tempting strategy that is frequently utilized in clinical practice. Monomorphic VT is mainly caused by re-entry around chronic myocardial scar and active ischemia has no role in its pathogenesis, thus making testing for ischemia futile, at least in theory. This systematic literature review sought to address the usefulness of ischemia testing (mainly coronary angiography) in patients presenting with monomorphic VT through 8 selected studies after evaluating a total of 130 published manuscripts. Particularly, we sought to unveil whether coronary angiography and possibly concomitant revascularization leads to lesser tachycardia recurrence. Our conclusion can be summarized as follows: this approach whether combined with revascularization or not, does not seem to reduce VT recurrence nor does it affect mortality in such patients. Even though most of the published literature points at this direction, validation from randomized controlled trials is imperative.
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Affiliation(s)
- Nikias Milaras
- State Department of Cardiology, "Hippokration" General Hospital of Athens, Greece; School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, Vasilissis Sofias 114, Athens 11527, Greece.
| | - Athanasios Kordalis
- School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, Vasilissis Sofias 114, Athens 11527, Greece
| | - Dimitrios Tsiachris
- School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, Vasilissis Sofias 114, Athens 11527, Greece
| | - Athanasios Sakalidis
- School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, Vasilissis Sofias 114, Athens 11527, Greece
| | - Ioannis Ntalakouras
- State Department of Cardiology, "Hippokration" General Hospital of Athens, Greece
| | | | - Panagiotis Dourvas
- State Department of Cardiology, "Hippokration" General Hospital of Athens, Greece
| | - Anastasios Apostolos
- School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, Vasilissis Sofias 114, Athens 11527, Greece
| | - Zoi Sotiriou
- School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, Vasilissis Sofias 114, Athens 11527, Greece
| | - Petros Arsenos
- School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, Vasilissis Sofias 114, Athens 11527, Greece
| | - Stefanos Archontakis
- State Department of Cardiology, "Hippokration" General Hospital of Athens, Greece
| | - Konstantinos Tsioufis
- School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, Vasilissis Sofias 114, Athens 11527, Greece
| | - Konstantinos Gatzoulis
- School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, Vasilissis Sofias 114, Athens 11527, Greece
| | - Skevos Sideris
- State Department of Cardiology, "Hippokration" General Hospital of Athens, Greece
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Fragoulis C, Polyzos D, Mavroudis A, Tsioufis PA, Kasiakogias A, Leontsinis I, Mantzouranis E, Kalos T, Sakalidis A, Ntalakouras J, Andrikou I, Dimitriadis K, Konstantinidis D, Thomopoulos C, Tsioufis K. One-year outcomes following a hypertensive urgency or emergency. Eur J Intern Med 2024; 120:107-113. [PMID: 37872037 DOI: 10.1016/j.ejim.2023.10.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 09/06/2023] [Accepted: 10/18/2023] [Indexed: 10/25/2023]
Abstract
There are scarce data on the comparative prognosis between patients with hypertensive emergencies (HE), urgencies (HU), and those without HU or HE (HP). Our study aimed to compare cardiovascular (CV) outcomes of HE, HU, and HP during a 12-month follow-up period. The population consisted of 353 consecutive patients presenting with HE or HU in a third-care emergency department and subsequently referred to our hypertension center for follow-up. After both groups completed scheduled follow-up visits, patients with HU were matched one-to-one by age, sex, and hypertension history with HP who attended our hypertension center during the same period. Primary outcomes were 1) a recurrent hypertensive HU or HE event and 2) non-fatal CV events (coronary heart disease, stroke, heart failure, or CV interventions), while secondary outcomes were 1) all-cause death, 2) CV death, 3) non-CV death, and 4) any-cause hospitalization. Events were prospectively registered for all three groups. During the study period, 81 patients were excluded for not completing follow-up. Among eligible patients(HE = 94; HU = 178), a total of 90 hospitalizations and 14 deaths were recorded; HE registered greater CV morbidity when compared with HU (29 vs. 9, HR 3.43, 95 % CI 1.7-6.9, p = 0.001), and increased CV mortality (8 vs. 1, HR 13.2, 95 % CI 1.57-110.8, p = 0.017). When opposing HU to HP, events did not differ substantially. Cox regression models were adjusted for age, sex, CV and chronic kidney disease, diabetes mellitus, and smoking. During 1-year follow-up, the prognosis of HU was better than HE but not different compared to HP. These results highlight the need for improved care of HU and HE.
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Affiliation(s)
- Christos Fragoulis
- First Department of Cardiology, National and Kapodistrian University of Athens, Hippokration Hospital, 114 Vassilissis Sofias Avenue, 11527 Athens, Greece
| | - Dimitrios Polyzos
- First Department of Cardiology, National and Kapodistrian University of Athens, Hippokration Hospital, 114 Vassilissis Sofias Avenue, 11527 Athens, Greece
| | - Andreas Mavroudis
- First Department of Cardiology, National and Kapodistrian University of Athens, Hippokration Hospital, 114 Vassilissis Sofias Avenue, 11527 Athens, Greece
| | - Panagiotis-Anastasios Tsioufis
- First Department of Cardiology, National and Kapodistrian University of Athens, Hippokration Hospital, 114 Vassilissis Sofias Avenue, 11527 Athens, Greece
| | - Alexandros Kasiakogias
- First Department of Cardiology, National and Kapodistrian University of Athens, Hippokration Hospital, 114 Vassilissis Sofias Avenue, 11527 Athens, Greece
| | - Ioannis Leontsinis
- First Department of Cardiology, National and Kapodistrian University of Athens, Hippokration Hospital, 114 Vassilissis Sofias Avenue, 11527 Athens, Greece
| | - Emmanouil Mantzouranis
- First Department of Cardiology, National and Kapodistrian University of Athens, Hippokration Hospital, 114 Vassilissis Sofias Avenue, 11527 Athens, Greece
| | - Theodoros Kalos
- First Department of Cardiology, National and Kapodistrian University of Athens, Hippokration Hospital, 114 Vassilissis Sofias Avenue, 11527 Athens, Greece
| | - Athanasios Sakalidis
- First Department of Cardiology, National and Kapodistrian University of Athens, Hippokration Hospital, 114 Vassilissis Sofias Avenue, 11527 Athens, Greece
| | - John Ntalakouras
- First Department of Cardiology, National and Kapodistrian University of Athens, Hippokration Hospital, 114 Vassilissis Sofias Avenue, 11527 Athens, Greece
| | - Ioannis Andrikou
- First Department of Cardiology, National and Kapodistrian University of Athens, Hippokration Hospital, 114 Vassilissis Sofias Avenue, 11527 Athens, Greece
| | - Kyriakos Dimitriadis
- First Department of Cardiology, National and Kapodistrian University of Athens, Hippokration Hospital, 114 Vassilissis Sofias Avenue, 11527 Athens, Greece
| | - Dimitris Konstantinidis
- First Department of Cardiology, National and Kapodistrian University of Athens, Hippokration Hospital, 114 Vassilissis Sofias Avenue, 11527 Athens, Greece
| | - Costas Thomopoulos
- Department of Cardiology, Helena Venizelou Hospital, 2 Helena Venizelou Street, 11521 Athens, Greece
| | - Konstantinos Tsioufis
- First Department of Cardiology, National and Kapodistrian University of Athens, Hippokration Hospital, 114 Vassilissis Sofias Avenue, 11527 Athens, Greece.
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Pyrpyris N, Dimitriadis K, Beneki E, Iliakis P, Soulaidopoulos S, Tsioufis P, Adamopoulou E, Kasiakogias A, Sakalidis A, Koutsopoulos G, Aggeli K, Tsioufis K. LOX-1 Receptor: A Diagnostic Tool and Therapeutic Target in Atherogenesis. Curr Probl Cardiol 2024; 49:102117. [PMID: 37802161 DOI: 10.1016/j.cpcardiol.2023.102117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 09/30/2023] [Indexed: 10/08/2023]
Abstract
Low-density lipoprotein (LDL) and oxidized LDL (oxLDL) are major contributors to atherogenesis, as endogenous antigens, via several receptors such as LOX 1. A PubMed search was conducted in order to identify relevant articles regarding LOX-1's role in the atherosclerosis, diagnosis, prognostic use and molecules that could be used for therapy. The references of the manuscripts obtained were also reviewed, in order to find additional relevant bibliography. LOX-1 is a lectin-like pattern recognition receptor, mostly expressed in endothelial cells (ECs) which can bind a variety of molecules, including oxLDL and C-reactive protein (CRP). LOX-1 plays a key role in oxLDL's role as a causative agent of atherosclerosis through several pathologic mechanisms, such as oxLDL deposition in the subintima, foam cell formation and endothelial dysfunction. Additionally, LOX-1 acts a scavenger receptor for oxLDL in macrophages and can be responsible for oxLDL uptake, when stimulated. Serum LOX-1 (sLOX-1) has emerged as a new, potential biomarker for diagnosis of acute coronary syndromes, and it seems promising for use along with other common biomarkers in everyday clinical practice. In a therapeutic perspective, natural as well as synthetic molecules exert anti-LOX-1 properties and attain the receptor's pathophysiological effects, thus extensive research is ongoing to further evaluate molecules with therapeutic potential. However, most of these molecules need further trials in order to properly assess their safety and efficacy for clinical use. The aim of this review is to investigate LOX-1 role in atherogenesis and explore its potential as diagnostic tool and therapeutic target.
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Affiliation(s)
- Nikolaos Pyrpyris
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Kyriakos Dimitriadis
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece.
| | - Eirini Beneki
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Panagiotis Iliakis
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Stergios Soulaidopoulos
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Panagiotis Tsioufis
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Elena Adamopoulou
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Alexandros Kasiakogias
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Athanasios Sakalidis
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - George Koutsopoulos
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Konstantina Aggeli
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Konstantinos Tsioufis
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
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Dimitriadis K, Adamopoulou E, Pyrpyris N, Sakalidis A, Leontsinis I, Manta E, Mantzouranis E, Beneki E, Soulaidopoulos S, Konstantinidis D, Fragkoulis C, Aggeli K, Tsioufis K. The effect of SGLT2 inhibitors on the endothelium and the microcirculation: from bench to bedside and beyond. Eur Heart J Cardiovasc Pharmacother 2023; 9:741-757. [PMID: 37500266 DOI: 10.1093/ehjcvp/pvad053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 06/22/2023] [Accepted: 07/26/2023] [Indexed: 07/29/2023]
Abstract
AIMS The beneficial cardiovascular effects of sodium-glucose cotransporter 2 (SGLT2) inhibitors irrespective of the presence of diabetes mellitus are nowadays well established and they already constitute a significant pillar for the management of heart failure, irrespective of the ejection fraction. The exact underlying mechanisms accountable for these effects, however, remain largely unknown. The direct effect on endothelial function and microcirculation is one of the most well studied. The broad range of studies presented in this review aims to link all available data from the bench to bedside and highlight the existing gaps as well as the future directions in the investigations concerning the effects of SGLT2 inhibitors on the endothelium and the microcirculation. METHODS AND RESULTS An extensive search has been conducted using the MEDLINE/PubMed database in order to identify the relevant studies. Preclinical data suggest that SGLT2 inhibitors directly affect endothelial function independently of glucose and specifically via several interplaying molecular pathways, resulting in improved vasodilation, increased NO production, enhanced mitochondrial homeostasis, endothelial cell viability, and angiogenesis as well as attenuation of oxidative stress and inflammation. Clinical data systematically confirm this beneficial effect on the endothelium, whereas the evidence concerning the effect on the microcirculation is conflicting. CONCLUSION Preclinical and clinical studies indicate that SGLT2 inhibitors attenuate endothelial and microvascular dysfunction via a combination of mechanisms, which play a role in their beneficial cardiovascular effect.
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Affiliation(s)
- Kyriakos Dimitriadis
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, 115 27, Athens, Greece
| | - Eleni Adamopoulou
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, 115 27, Athens, Greece
| | - Nikolaos Pyrpyris
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, 115 27, Athens, Greece
| | - Athanasios Sakalidis
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, 115 27, Athens, Greece
| | - Ioannis Leontsinis
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, 115 27, Athens, Greece
| | - Eleni Manta
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, 115 27, Athens, Greece
| | - Emmanouil Mantzouranis
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, 115 27, Athens, Greece
| | - Eirini Beneki
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, 115 27, Athens, Greece
| | - Stergios Soulaidopoulos
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, 115 27, Athens, Greece
| | - Dimitrios Konstantinidis
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, 115 27, Athens, Greece
| | - Christos Fragkoulis
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, 115 27, Athens, Greece
| | - Konstantina Aggeli
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, 115 27, Athens, Greece
| | - Konstantinos Tsioufis
- First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, 115 27, Athens, Greece
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Theofilis P, Vlachakis PK, Mantzouranis E, Sakalidis A, Chrysohoou C, Leontsinis I, Lazaros G, Dimitriadis K, Drakopoulou M, Vordoni A, Oikonomou E, Tsioufis K, Tousoulis D. Acute Coronary Syndromes in Women: A Narrative Review of Sex-Specific Characteristics. Angiology 2023:33197231218331. [PMID: 37995282 DOI: 10.1177/00033197231218331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2023]
Abstract
Acute coronary syndromes (ACSs) encompass a spectrum of life-threatening cardiovascular conditions, including unstable angina (UA) and myocardial infarction. While significant progress has been made in the understanding and management of ACS over the years, it has become increasingly evident that sex-based differences play a pivotal role in the pathophysiology, presentation, and outcomes of these conditions. Despite this recognition, the majority of clinical research in the field has historically focused on male populations, leading to a significant knowledge gap in understanding the unique aspects of ACS in women. This review article aims to comprehensively explore and synthesize the current body of literature concerning the sex-specific characteristics of ACS, shedding light on the epidemiology, risk factors, clinical presentation, diagnostic challenges, treatment strategies, and prognosis in women. By elucidating the distinct aspects of ACS in women, this review intends to foster greater awareness and improved clinical management, ultimately contributing to enhanced cardiovascular care for female patients.
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Affiliation(s)
- Panagiotis Theofilis
- 1st Department of Cardiology, "Hippokration" General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Panayotis K Vlachakis
- 1st Department of Cardiology, "Hippokration" General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Emmanouil Mantzouranis
- 1st Department of Cardiology, "Hippokration" General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Athanasios Sakalidis
- 1st Department of Cardiology, "Hippokration" General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Christina Chrysohoou
- 1st Department of Cardiology, "Hippokration" General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioannis Leontsinis
- 1st Department of Cardiology, "Hippokration" General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - George Lazaros
- 1st Department of Cardiology, "Hippokration" General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Kyriakos Dimitriadis
- 1st Department of Cardiology, "Hippokration" General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Drakopoulou
- 1st Department of Cardiology, "Hippokration" General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Aikaterini Vordoni
- 1st Department of Cardiology, "Hippokration" General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelos Oikonomou
- 3rd Department of Cardiology, "Sotiria" Chest Disease Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Tsioufis
- 1st Department of Cardiology, "Hippokration" General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitris Tousoulis
- 1st Department of Cardiology, "Hippokration" General Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Dimitriadis K, Soulaidopoulos S, Doundoulakis I, Iliakis P, Tsiachris D, Tsioufis P, Beneki E, Sakalidis A, Pagkalidou E, Tsiamis E, Tsioufis K. A network meta-analysis of the antithrombotic strategies in patients with atrial fibrillation and percutaneous coronary interventions: Focus on bleeding. Hellenic J Cardiol 2023; 73:69-72. [PMID: 37080485 DOI: 10.1016/j.hjc.2023.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 03/31/2023] [Accepted: 04/13/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND We performed a network meta-analysis of randomized controlled trials comparing non-vitamin K antagonist oral anticoagulant (NOAC)-based versus vitamin K antagonists (VKA)-based regimens in patients with atrial fibrillation (AF) and acute coronary syndromes or PCI, aiming to examine the precise impact of recently established antithrombotic strategies on major bleeding as primary end-point and other safety and efficacy as secondary end-points. METHODS A literature search was conducted for randomized controlled trials. Our search took place in three major databases. The primary endpoint of our study was bleeding. To combine direct and indirect evidence across trials, a frequentist network meta-analysis with a random-effects model was used. RESULTS Five studies were found eligible for the meta-analysis enrolling a total of 11,542 patients. Five studies (N = 4903 patients) contributed to the network. Compared to the triple antithrombotic therapy (TAT)-based VKA, only the dual antithrombotic therapy (DAT) based NOAC reduced the bleeding (RR 0.57, 95%CI 0.40-0.82). There was no statistically significant difference between DAT-based VKA (RR = 0.66, 95%CI = 0.40-1.09) or TAT-based NOAC (RR = 0.80, 95%CI = 0.43-1.49). DAT-based NOAC ranked best (P-score = 0.91), followed by DAT-based VKA (P-score = 0.67), TAT-based NOAC (P-score = 0.40), and TAT-based VKA (P-score = 0.03). CONCLUSION The network meta-analysis of four antithrombotic strategies, demonstrated that in patients with AF undergoing PCI the combination of DAT-based NOAC is associated with a significantly lower risk of major bleeding events. This strategy does not seem to be less effective in terms of prevention of ischemic events compared to the other regimens.
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Affiliation(s)
- Kyriakos Dimitriadis
- First University Department of Cardiology, National and Kapodistrian University of Athens, Athens, Greece.
| | - Stergios Soulaidopoulos
- First University Department of Cardiology, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioannis Doundoulakis
- First University Department of Cardiology, National and Kapodistrian University of Athens, Athens, Greece; Athens Heart Center, Athens Medical Center, Athens, Greece
| | - Panagiotis Iliakis
- First University Department of Cardiology, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Panagiotis Tsioufis
- First University Department of Cardiology, National and Kapodistrian University of Athens, Athens, Greece
| | - Eirini Beneki
- First University Department of Cardiology, National and Kapodistrian University of Athens, Athens, Greece
| | - Athanasios Sakalidis
- First University Department of Cardiology, National and Kapodistrian University of Athens, Athens, Greece
| | - Eirini Pagkalidou
- Department of Hygiene, Social-Preventive Medicine & Medical Statistics, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eleftherios Tsiamis
- First University Department of Cardiology, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Tsioufis
- First University Department of Cardiology, National and Kapodistrian University of Athens, Athens, Greece
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Brili SV, Gkotzamanis V, Kafouris P, Mystakidi VC, Sakalidis A, Antonopoulos AS, Oikonomou E, Anagnostopoulos C, Tsioufis K. THE USE OF 18-FLUORODEOXYGLUCOSE POSITRON EMISSION AND COMPUTED TOMOGRAPHY IN THE EVALUATION OF MARFAN SYNDROME PATIENTS. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)02461-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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8
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Sakalidis A, Dimitriadis K, Dri E, Mantzouranis EK, Leontsinis I, Doundoulakis I, Ntalakouras I, Vlachakis PK, Bora M, Beneki E, Tsioufis P, Mavroudis A, Tsiamis E, Tsioufis K. CORONARY MICROVASCULAR DYNSFUNCTION IS ASSOCIATED WITH INCREASED ARTERIAL STIFNESS IN PATIENTS WITH ISCHEMIA AND NON OBSTRUCTIVE CORONARY ARTERY DISEASE. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)01705-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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9
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Sakalidis A, Dimitriadis K, Dri E, Leontsinis I, Mantzouranis EK, Ntalakouras I, Doundoulakis I, Iliakis P, Siafi E, Beneki E, Tsioufis P, Manta E, Tsiamis E, Tsioufis K. CORONARY MICROVASCULAR DYSFUNCTION IS RELATED TO REDUCED SKIN CAPILLARY DENSITY IN PATIENTS WITH ISCHEMIA AND NON OBSTRUCTIVE CORONARY ARTERY DISEASE. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)01672-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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10
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Nadarajah R, Ludman P, Appelman Y, Brugaletta S, Budaj A, Bueno H, Huber K, Kunadian V, Leonardi S, Lettino M, Milasinovic D, Gale CP, Budaj A, Dagres N, Danchin N, Delgado V, Emberson J, Friberg O, Gale CP, Heyndrickx G, Iung B, James S, Kappetein AP, Maggioni AP, Maniadakis N, Nagy KV, Parati G, Petronio AS, Pietila M, Prescott E, Ruschitzka F, Van de Werf F, Weidinger F, Zeymer U, Gale CP, Beleslin B, Budaj A, Chioncel O, Dagres N, Danchin N, Emberson J, Erlinge D, Glikson M, Gray A, Kayikcioglu M, Maggioni AP, Nagy KV, Nedoshivin A, Petronio AP, Roos-Hesselink JW, Wallentin L, Zeymer U, Popescu BA, Adlam D, Caforio ALP, Capodanno D, Dweck M, Erlinge D, Glikson M, Hausleiter J, Iung B, Kayikcioglu M, Ludman P, Lund L, Maggioni AP, Matskeplishvili S, Meder B, Nagy KV, Nedoshivin A, Neglia D, Pasquet AA, Roos-Hesselink JW, Rossello FJ, Shaheen SM, Torbica A, Gale CP, Ludman PF, Lettino M, Bueno H, Huber K, Leonardi S, Budaj A, Milasinovic (Serbia) D, Brugaletta S, Appelman Y, Kunadian V, Al Mahmeed WAR, Kzhdryan H, Dumont C, Geppert A, Bajramovic NS, Cader FA, Beauloye C, Quesada D, Hlinomaz O, Liebetrau C, Marandi T, Shokry K, Bueno H, Kovacevic M, Crnomarkovic B, Cankovic M, Dabovic D, Jarakovic M, Pantic T, Trajkovic M, Pupic L, Ruzicic D, Cvetanovic D, Mansourati J, Obradovic I, Stankovic M, Loh PH, Kong W, Poh KK, Sia CH, Saw K, Liška D, Brozmannová D, Gbur M, Gale CP, Maxian R, Kovacic D, Poznic NG, Keric T, Kotnik G, Cercek M, Steblovnik K, Sustersic M, Cercek AC, Djokic I, Maisuradze D, Drnovsek B, Lipar L, Mocilnik M, Pleskovic A, Lainscak M, Crncic D, Nikojajevic I, Tibaut M, Cigut M, Leskovar B, Sinanis T, Furlan T, Grilj V, Rezun M, Mateo VM, Anguita MJF, Bustinza ICM, Quintana RB, Cimadevilla OCF, Fuertes J, Lopez F, Dharma S, Martin MD, Martinez L, Barrabes JA, Bañeras J, Belahnech Y, Ferreira-Gonzalez I, Jordan P, Lidon RM, Mila L, Sambola A, Orvin K, Sionis A, Bragagnini W, Cambra AD, Simon C, Burdeus MV, Ariza-Solé A, Alegre O, Alsina M, Ferrando JIL, Bosch X, Sinha A, Vidal P, Izquierdo M, Marin F, Esteve-Pastor MA, Tello-Montoliu A, Lopez-Garcia C, Rivera-Caravaca JM, Gil-Pérez P, Nicolas-Franco S, Keituqwa I, Farhan HA, Silva L, Blasco A, Escudier JM, Ortega J, Zamorano JL, Sanmartin M, Pereda DC, Rincon LM, Gonzalez P, Casado T, Sadeghipour P, Lopez-Sendon JL, Manjavacas AMI, Marin LAM, Sotelo LR, Rodriguez SOR, Bueno H, Martin R, Maruri R, Moreno G, Moris C, Gudmundsdottir I, Avanzas P, Ayesta A, Junco-Vicente A, Cubero-Gallego H, Pascual I, Sola NB, Rodriguez OA, Malagon L, Martinez-Basterra J, Arizcuren AM, Indolfi C, Romero J, Calleja AG, Fuertes DG, Crespín Crespín M, Bernal FJC, Ojeda FB, Padron AL, Cabeza MM, Vargas CM, Yanes G, Kitai T, Gonzalez MJG, Gonzalez Gonzalez J, Jorge P, De La Fuente B, Bermúdez MG, Perez-Lopez CMB, Basiero AB, Ruiz AC, Pamias RF, Chamero PS, Mirrakhimov E, Hidalgo-Urbano R, Garcia-Rubira JC, Seoane-Garcia T, Arroyo-Monino DF, Ruiz AB, Sanz-Girgas E, Bonet G, Rodríguez-López J, Scardino C, De Sousa D, Gustiene O, Elbasheer E, Humida A, Mahmoud H, Mohamed A, Hamid E, Hussein S, Abdelhameed M, Ali T, Ali Y, Eltayeb M, Philippe F, Ali M, Almubarak E, Badri M, Altaher S, Alla MD, Dellborg M, Dellborg H, Hultsberg-Olsson G, Marjeh YB, Abdin A, Erglis A, Alhussein F, Mgazeel F, Hammami R, Abid L, Bahloul A, Charfeddine S, Ellouze T, Canpolat U, Oksul M, Muderrisoglu H, Popovici M, Karacaglar E, Akgun A, Ari H, Ari S, Can V, Tuncay B, Kaya H, Dursun L, Kalenderoglu K, Tasar O, Kalpak O, Kilic S, Kucukosmanoglu M, Aytekin V, Baydar O, Demirci Y, Gürsoy E, Kilic A, Yildiz Ö, Arat-Ozkan A, Sinan UY, Dagva M, Gungor B, Sekerci SS, Zeren G, Erturk M, Demir AR, Yildirim C, Can C, Kayikcioglu M, Yagmur B, Oney S, Xuereb RG, Sabanoglu C, Inanc IH, Ziyrek M, Sen T, Astarcioglu MA, Kahraman F, Utku O, Celik A, Surmeli AO, Basaran O, Ahmad WAW, Demirbag R, Besli F, Gungoren F, Ingabire P, Mondo C, Ssemanda S, Semu T, Mulla AA, Atos JS, Wajid I, Appelman Y, Al Mahmeed WAR, Atallah B, Bakr K, Garrod R, Makia F, Eldeeb F, Abdekader R, Gomaa A, Kandasamy S, Maruthanayagam R, Nadar SK, Nakad G, Nair R, Mota P, Prior P, Mcdonald S, Rand J, Schumacher N, Abraheem A, Clark M, Coulding M, Qamar N, Turner V, Negahban AQ, Crew A, Hope S, Howson J, Jones S, Lancaster N, Nicholson A, Wray G, Donnelly P, Gierlotka M, Hammond L, Hammond S, Regan S, Watkin R, Papadopoulos C, Ludman P, Hutton K, Macdonald S, Nilsson A, Roberts S, Monteiro S, Garg S, Balachandran K, Mcdonald J, Singh R, Marsden K, Davies K, Desai H, Goddard W, Iqbal N, Chalil S, Dan GA, Galasko G, Assaf O, Benham L, Brown J, Collins S, Fleming C, Glen J, Mitchell M, Preston S, Uttley A, Radovanovic M, Lindsay S, Akhtar N, Atkinson C, Vinod M, Wilson A, Clifford P, Firoozan S, Yashoman M, Bowers N, Chaplin J, Reznik EV, Harvey S, Kononen M, Lopesdesousa G, Saraiva F, Sharma S, Cruddas E, Law J, Young E, Hoye A, Harper P, Balghith M, Rowe K, Been M, Cummins H, French E, Gibson C, Abraham JA, Hobson S, Kay A, Kent M, Wilkinson A, Mohamed A, Clark S, Duncan L, Ahmed IM, Khatiwada D, Mccarrick A, Wanda I, Read P, Afsar A, Rivers V, Theobald T, Cercek M, Bell S, Buckman C, Francis R, Peters G, Stables R, Morgan M, Noorzadeh M, Taylor B, Twiss S, Widdows P, Brozmannová D, Wilkinson V, Black M, Clark A, Clarkson N, Currie J, George L, Mcgee C, Izzat L, Lewis T, Omar Z, Aytekin V, Phillips S, Ahmed F, Mackie S, Oommen A, Phillips H, Sherwood M, Aleti S, Charles T, Jose M, Kolakaluri L, Ingabire P, Karoudi RA, Deery J, Hazelton T, Knight A, Price C, Turney S, Kardos A, Williams F, Wren L, Bega G, Alyavi B, Scaletta D, Kunadian V, Cullen K, Jones S, Kirkup E, Ripley DP, Matthews IG, Mcleod A, Runnett C, Thomas HE, Cartasegna L, Gunarathne A, Burton J, King R, Quinn J, Sobolewska J, Munt S, Porter J, Christenssen V, Leng K, Peachey T, Gomez VN, Temple N, Wells K, Viswanathan G, Taneja A, Cann E, Eglinton C, Hyams B, Jones E, Reed F, Smith J, Beltrano C, Affleck DC, Turner A, Ward T, Wilmshurst N, Stirrup J, Brunton M, Whyte A, Smith S, Murray V, Walker R, Novas V, Weston C, Brown C, Collier D, Curtis K, Dixon K, Wells T, Trim F, Ghosh J, Mavuri M, Barman L, Dumont C, Elliott K, Harrison R, Mallinson J, Neale T, Smith J, Toohie J, Turnbull A, Parker E, Hossain R, Cheeseman M, Balparda H, Hill J, Hood M, Hutchinson D, Mellows K, Pendlebury C, Storey RF, Barker J, Birchall K, Denney H, Housley K, Cardona M, Middle J, Kukreja N, Gati S, Kirk P, Lynch M, Srinivasan M, Szygula J, Baker P, Cruz C, Derigay J, Cigalini C, Lamb K, Nembhard S, Price A, Mamas M, Massey I, Wain J, Delaney J, Junejo S, Martin K, Obaid D, Hoyle V, Brinkworth E, Davies C, Evans D, Richards S, Thomas C, Williams M, Dayer M, Mills H, Roberts K, Goodchild F, Dámaso ES, Greig N, Kundu S, Donaldson D, Tonks L, Beekes M, Button H, Hurford F, Motherwell N, Summers-Wall J, Felmeden D, Tapia V, Keeling P, Sheikh U, Yonis A, Felmeden L, Hughes D, Micklewright L, Summerhayes A, Sutton J, Panoulas V, Prendergast C, Poghosyan K, Rogers P, Barker LN, Batin P, Conway D, Exley D, Fletcher A, Wright J, Nageh T, Hadebe B, Kunhunny S, Mkhitaryan S, Mshengu E, Karthikeyan VJ, Hamdan H, Cooper J, Dandy C, Parkinson V, Paterson P, Reddington S, Taylor T, Tierney C, Adamyan M, Jones KV, Broadley A, Beesley K, Buckley C, Hellyer C, Pippard L, Pitt-Kerby T, Azam J, Hayes C, Freshwater K, Boyadjian S, Johnson L, Mcgill Y, Redfearn H, Russell M, Alyavi A, Alyavi B, Uzokov J, Hayrapetyan H, Azaryan K, Tadevosyan M, Poghosyan H, Kzhdryan H, Vardanyan A, Huber K, Geppert A, Ahmed A, Weidinger F, Derntl M, Hasun M, Schuh-Eiring T, Riegler L, Haq MM, Cader FA, Dewan MAM, Fatema ME, Hasan AS, Islam MM, Khandoker F, Mayedah R, Nizam SU, Azam MG, Arefin MM, Jahan J, Schelfaut D, De Raedt H, Wouters S, Aerts S, Batjoens H, Beauloye C, Dechamps M, Pierard S, Van Caenegem O, Sinnaeve F, Claeys MJ, Snepvangers M, Somers V, Gevaert S, Schaubroek H, Vervaet P, Buysse M, Renders F, Dumoulein M, Hiltrop N, De Coninck M, Naessens S, Senesael I, Hoffer E, Pourbaix S, Beckers J, Dugauquier C, Jacquet S, Malmendier D, Massoz M, Evrard P, Collard L, Brunner P, Carlier S, Blockmans M, Mayne D, Timiras E, Guédès A, Demeure F, Hanet C, Domange J, Jourdan K, Begic E, Custovic F, Dozic A, Hrvat E, Kurbasic I, Mackic D, Subo A, Durak-Nalbantic A, Dzubur A, Rebic D, Hamzic-Mehmedbasic A, Redzepovic A, Djokic-Vejzovic A, Hodzic E, Hujdur M, Musija E, Gljiva-Gogic Z, Serdarevic N, Bajramovic NS, Brigic L, Halilcevic M, Cibo M, Hadžibegic N, Kukavica N, Begic A, Iglica A, Osmanagic A, Resic N, Grgurevic MV, Zvizdic F, Pojskic B, Mujaric E, Selimovic H, Ejubovic M, Pojskic L, Stimjanin E, Sut M, Zapata PS, Munoz CG, Andrade LAF, Upegui MPT, Perez LE, Chavarria J, Quesada D, Alvarado K, Zaputovic L, Tomulic V, Gobic D, Jakljevic T, Lulic D, Bacic G, Bastiancic L, Avraamides P, Eftychiou C, Eteocleous N, Ioannou A, Lambrianidi C, Drakomathioulakis M, Groch L, Hlinomaz O, Rezek M, Semenka J, Sitar J, Beranova M, Kramarikova P, Pesl L, Sindelarova S, Tousek F, Warda HM, Ghaly I, Habiba S, Habib A, Gergis MN, Bahaa H, Samir A, Taha HSE, Adel M, Algamal HM, Mamdouh M, Shaker AF, Shokry K, Konsoah A, Mostafa AM, Ibrahim A, Imam A, Hafez B, Zahran A, Abdelhamid M, Mahmoud K, Mostafa A, Samir A, Abdrabou M, Kamal A, Sallam S, Ali A, Maghraby K, Atta AR, Saad A, Ali M, Lotman EM, Lubi R, Kaljumäe H, Uuetoa T, Kiitam U, Durier C, Ressencourt O, El Din AA, Guiatni A, Bras ML, Mougenot E, Labeque JN, Banos JL, Capendeguy O, Mansourati J, Fofana A, Augagneur M, Bahon L, Pape AL, Batias-Moreau L, Fluttaz A, Good F, Prieur F, Boiffard E, Derien AS, Drapeau I, Roy N, Perret T, Dubreuil O, Ranc S, Rio S, Bonnet JL, Bonnet G, Cuisset T, Deharo P, Mouret JP, Spychaj JC, Blondelon A, Delarche N, Decalf V, Guillard N, Hakme A, Roger MP, Biron Y, Druelles P, Loubeyre C, Lucon A, Hery P, Nejjari M, Digne F, Huchet F, Neykova A, Tzvetkov B, Larrieu M, Quaino G, Armangau P, Sauguet A, Bonfils L, Dumonteil N, Fajadet J, Farah B, Honton B, Monteil B, Philippart R, Tchetche D, Cottin M, Petit F, Piquart A, Popovic B, Varlot J, Maisuradze D, Sagirashvili E, Kereselidze Z, Totladze L, Ginturi T, Lagvilava D, Hamm C, Liebetrau C, Haas M, Hamm C, Koerschgen T, Weferling M, Wolter JS, Maier K, Nickenig G, Sedaghat A, Zachoval C, Lampropoulos K, Mpatsouli A, Sakellaropoulou A, Tyrovolas K, Zibounoumi N, Argyropoulos K, Toulgaridis F, Kolyviras A, Tzanis G, Tzifos V, Milkas A, Papaioannou S, Kyriazopoulos K, Pylarinou V, Kontonassakis I, Kotakos C, Kourgiannidis G, Ntoliou P, Parzakonis N, Pipertzi A, Sakalidis A, Ververeli CL, Kafkala K, Sinanis T, Diakakis G, Grammatikopoulos K, Papoutsaki E, Patialiatos T, Mamaloukaki M, Papadaki ST, Kanellos IE, Antoniou A, Tsinopoulos G, Goudis C, Giannadaki M, Daios S, Petridou M, Skantzis P, Koukis P, Dimitriadis F, Savvidis M, Styliadis I, Sachpekidis V, Pilalidou A, Stamatiadis N, Fotoglidis A, Karakanas A, Ruzsa Z, Becker D, Nowotta F, Gudmundsdottir I, Libungan B, Skuladottir FB, Halldorsdottir H, Shetty R, Iyengar S, Bs C, G S, Lakshmana S, S R, Tripathy N, Sinha A, Choudhary B, Kumar A, Kumar A, Raj R, Roy RS, Dharma S, Siswanto BB, Farhan HA, Yaseen IF, Al-Zaidi M, Dakhil Z, Amen S, Rasool B, Rajeeb A, Amber K, Ali HH, Al-Kinani T, Almyahi MH, Al-Obaidi F, Masoumi G, Sadeghi M, Heshmat-Ghahdarijani K, Roohafza H, Sarrafzadegan N, Shafeie M, Teimouri-Jervekani Z, Noori F, Kyavar M, Sadeghipour P, Firouzi A, Alemzadeh-Ansari MJ, Ghadrdoost B, Golpira R, Ghorbani A, Ahangari F, Salarifar M, Jenab Y, Biria A, Haghighi S, Mansouri P, Yadangi S, Kornowski R, Orvin K, Eisen A, Oginetz N, Vizel R, Kfir H, Pasquale GD, Casella G, Cardelli LS, Filippini E, Zagnoni S, Donazzan L, Ermacora D, Indolfi C, Polimeni A, Curcio A, Mongiardo A, De Rosa S, Sorrentino S, Spaccarotella C, Landolina M, Marino M, Cacucci M, Vailati L, Bernabò P, Montisci R, Meloni L, Marchetti MF, Biddau M, Garau E, Barbato E, Morisco C, Strisciuglio T, Canciello G, Lorenzoni G, Casu G, Merella P, Novo G, D'Agostino A, Di Lisi D, Di Palermo A, Evola S, Immordino F, Rossetto L, Spica G, Pavan D, Mattia AD, Belfiore R, Grandis U, Vendrametto F, Spagnolo C, Carniel L, Sonego E, Gaudio C, Barillà F, Biccire FG, Bruno N, Ferrari I, Paravati V, Torromeo C, Galasso G, Peluso A, Prota C, Radano I, Benvenga RM, Ferraioli D, Anselmi M, Frigo GM, Sinagra G, Merlo M, Perkan A, Ramani F, Altinier A, Fabris E, Rinaldi M, Usmiani T, Checco L, Frea S, Mussida M, Matsukawa R, Sugi K, Kitai T, Furukawa Y, Masumoto A, Miyoshi Y, Nishino S, Assembekov B, Amirov B, Chernokurova Y, Ibragimova F, Mirrakhimov E, Ibraimova A, Murataliev T, Radzhapova Z, Uulu ES, Zhanyshbekova N, Zventsova V, Erglis A, Bondare L, Zaliunas R, Gustiene O, Dirsiene R, Marcinkeviciene J, Sakalyte G, Virbickiene A, Baksyte G, Bardauskiene L, Gelmaniene R, Salkauskaite A, Ziubryte G, Kupstyte-Kristapone N, Badariene J, Balciute S, Kapleriene L, Lizaitis M, Marinskiene J, Navickaite A, Pilkiene A, Ramanauskaite D, Serpytis R, Silinskiene D, Simbelyte T, Staigyte J, Philippe F, Degrell P, Camus E, Ahmad WAW, Kassim ZA, Xuereb RG, Buttigieg LL, Camilleri W, Pllaha E, Xuereb S, Popovici M, Ivanov V, Plugaru A, Moscalu V, Popovici I, Abras M, Ciobanu L, Litvinenco N, Fuior S, Dumanschi C, Ivanov M, Danila T, Grib L, Filimon S, Cardaniuc L, Batrinac A, Tasnic M, Cozma C, Revenco V, Sorici G, Dagva M, Choijiljav G, Dandar E, Khurelbaatar MU, Tsognemekh B, Appelman Y, Den Hartog A, Kolste HJT, Van Den Buijs D, Van'T Hof A, Pustjens T, Houben V, Kasperski I, Ten Berg J, Azzahhafi J, Bor W, Yin DCP, Mbakwem A, Amadi C, Kushimo O, Kilasho M, Oronsaye E, Bakracheski N, Bashuroska EK, Mojsovska V, Tupare S, Dejan M, Jovanoska J, Razmoski D, Marinoski T, Antovski A, Jovanovski Z, Kocho S, Markovski R, Ristovski V, Samir AB, Biserka S, Kalpak O, Peovska IM, Taleska BZ, Pejkov H, Busljetik O, Zimbakov Z, Grueva E, Bojovski I, Tutic M, Poposka L, Vavlukis M, Al-Riyami A, Nadar SK, Abdelmottaleb W, Ahmed S, Mujtaba MS, Al-Mashari S, Al-Riyami H, Laghari AH, Faheem O, Ahmed SW, Qamar N, Furnaz S, Kazmi K, Saghir T, Aneel A, Asim A, Madiha F, Sobkowicz B, Tycinska A, Kazimierczyk E, Szyszkowska A, Mizia-Stec K, Wybraniec M, Bednarek A, Glowacki K, Prokopczuk J, Babinski W, Blachut A, Kosiak M, Kusinska A, Samborski S, Stachura J, Szastok H, Wester A, Bartoszewska D, Sosnowska-Pasiarska B, Krzysiek M, Legutko J, Nawrotek B, Kasprzak JD, Klosinska M, Wiklo K, Kurpesa M, Rechcinski T, Cieslik-Guerra U, Gierlotka M, Bugajski J, Feusette P, Sacha J, Przybylo P, Krzesinski P, Ryczek R, Karasek A, Kazmierczak-Dziuk A, Mielniczuk M, Betkier-Lipinska K, Roik M, Labyk A, Krakowian M, Machowski M, Paczynska M, Potepa M, Pruszczyk P, Budaj A, Ambroziak M, Omelanczuk-Wiech E, Torun A, Opolski G, Glowczynska R, Fojt A, Kowalik R, Huczek Z, Jedrzejczyk S, Roleder T, Brust K, Gasior M, Desperak P, Hawranek M, Farto-Abreu P, Santos M, Baptista S, Brizida L, Faria D, Loureiro J, Magno P, Monteiro C, Nédio M, Tavares J, Sousa C, Almeida I, Almeida S, Miranda H, Santos H, Santos AP, Goncalves L, Monteiro S, Baptista R, Ferreira C, Ferreira J, Goncalves F, Lourenço C, Monteiro P, Picarra B, Santos AR, Guerreiro RA, Carias M, Carrington M, Pais J, de Figueiredo MP, Rocha AR, Mimoso J, De Jesus I, Fernandes R, Guedes J, Mota T, Mendes M, Ferreira J, Tralhão A, Aguiar CT, Strong C, Da Gama FF, Pais G, Timóteo AT, Rosa SAO, Mano T, Reis J, Selas M, Mendes DE, Satendra M, Pinto P, Queirós C, Oliveira I, Reis L, Cruz I, Fernandes R, Torres S, Luz A, Campinas A, Costa R, Frias A, Oliveira M, Martins V, Castilho B, Coelho C, Moura AR, Cotrim N, Dos Santos RC, Custodio P, Duarte R, Gomes R, Matias F, Mendonca C, Neiva J, Rabacal C, Almeida AR, Caeiro D, Queiroz P, Silva G, Pop-Moldovan AL, Darabantiu D, Mercea S, Dan GA, Dan AR, Dobranici M, Popescu RA, Adam C, Sinescu CJ, Andrei CL, Brezeanu R, Samoila N, Baluta MM, Pop D, Tomoaia R, Istratoaie O, Donoiu I, Cojocaru A, Oprita OC, Rocsoreanu A, Grecu M, Ailoaei S, Popescu MI, Cozma A, Babes EE, Rus M, Ardelean A, Larisa R, Moisi M, Ban E, Buzle A, Filimon G, Dobreanu D, Lupu S, Mitre A, Rudzik R, Sus I, Opris D, Somkereki C, Mornos C, Petrescu L, Betiu A, Volcescu A, Ioan O, Luca C, Maximov D, Mosteoru S, Pascalau L, Roman C, Brie D, Crisan S, Erimescu C, Falnita L, Gaita D, Gheorghiu M, Levashov S, Redkina M, Novitskii N, Dementiev E, Baglikov A, Zateyshchikov D, Zubova E, Rogozhina A, Salikov A, Nikitin I, Reznik EV, Komissarova MS, Shebzukhova M, Shitaya K, Stolbova S, Larina V, Akhmatova F, Chuvarayan G, Arefyev MN, Averkov OV, Volkova AL, Sepkhanyan MS, Vecherko VI, Meray I, Babaeva L, Goreva L, Pisaryuk A, Potapov P, Teterina M, Ageev F, Silvestrova G, Fedulaev Y, Pinchuk T, Staroverov I, Kalimullin D, Sukhinina T, Zhukova N, Ryabov V, Kruchinkina E, Vorobeva D, Shevchenko I, Budyak V, Elistratova O, Fetisova E, Islamov R, Ponomareva E, Khalaf H, Shaimaa AA, Kamal W, Alrahimi J, Elshiekh A, Balghith M, Ahmed A, Attia N, Jamiel AA, Potpara T, Marinkovic M, Mihajlovic M, Mujovic N, Kocijancic A, Mijatovic Z, Radovanovic M, Matic D, Milosevic A, Savic L, Subotic I, Uscumlic A, Zlatic N, Antonijevic J, Vesic O, Vucic R, Martinovic SS, Kostic T, Atanaskovic V, Mitic V, Stanojevic D, Petrovic M. Cohort profile: the ESC EURObservational Research Programme Non-ST-segment elevation myocardial infraction (NSTEMI) Registry. Eur Heart J Qual Care Clin Outcomes 2022; 9:8-15. [PMID: 36259751 DOI: 10.1093/ehjqcco/qcac067] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 10/11/2022] [Indexed: 11/12/2022]
Abstract
AIMS The European Society of Cardiology (ESC) EURObservational Research Programme (EORP) Non-ST-segment elevation myocardial infarction (NSTEMI) Registry aims to identify international patterns in NSTEMI management in clinical practice and outcomes against the 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without ST-segment-elevation. METHODS AND RESULTS Consecutively hospitalised adult NSTEMI patients (n = 3620) were enrolled between 11 March 2019 and 6 March 2021, and individual patient data prospectively collected at 287 centres in 59 participating countries during a two-week enrolment period per centre. The registry collected data relating to baseline characteristics, major outcomes (in-hospital death, acute heart failure, cardiogenic shock, bleeding, stroke/transient ischaemic attack, and 30-day mortality) and guideline-recommended NSTEMI care interventions: electrocardiogram pre- or in-hospital, pre-hospitalization receipt of aspirin, echocardiography, coronary angiography, referral to cardiac rehabilitation, smoking cessation advice, dietary advice, and prescription on discharge of aspirin, P2Y12 inhibition, angiotensin converting enzyme inhibitor (ACEi)/angiotensin receptor blocker (ARB), beta-blocker, and statin. CONCLUSION The EORP NSTEMI Registry is an international, prospective registry of care and outcomes of patients treated for NSTEMI, which will provide unique insights into the contemporary management of hospitalised NSTEMI patients, compliance with ESC 2015 NSTEMI Guidelines, and identify potential barriers to optimal management of this common clinical presentation associated with significant morbidity and mortality.
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Affiliation(s)
- Ramesh Nadarajah
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, LS2 9JT Leeds, UK.,Leeds Institute of Data Analytics, University of Leeds, LS2 9JT Leeds, UK.,Department of Cardiology, Leeds Teaching Hospitals NHS Trust, LS1 3EX Leeds, UK
| | - Peter Ludman
- Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK
| | - Yolande Appelman
- Department of Cardiology, Amsterdam UMC-Vrije Universiteit, Amsterdam Cardiovascular Sciences, Amsterdam, Netherlands
| | - Salvatore Brugaletta
- Hospital Clinic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Andrzej Budaj
- Department of Cardiology, Center of Postgraduate Medical Education, Grochowski Hospital, Warsaw, Poland
| | - Hector Bueno
- Cardiology Department, Hospital Universitario 12 de Octubre and Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain.,Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain.,Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Kurt Huber
- 3rd Medical Department, Cardiology and Intensive Care Medicine, Clinic Ottakring (Wilhelminenhospital), Vienna, Austria.,Medical Faculty, Sigmund Freud University, Vienna, Austria
| | - Vijay Kunadian
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.,Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Sergio Leonardi
- University of Pavia, Pavia, Italy.,Fondazione IRCCS Policlinico S.Matteo, Pavia, Italy
| | - Maddalena Lettino
- Cardio-Thoracic and Vascular Department, San Gerardo Hospital, ASST-Monza, Monza, Italy
| | - Dejan Milasinovic
- Department of Cardiology, University Clinical Center of Serbia and Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Chris P Gale
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, LS2 9JT Leeds, UK.,Leeds Institute of Data Analytics, University of Leeds, LS2 9JT Leeds, UK.,Department of Cardiology, Leeds Teaching Hospitals NHS Trust, LS1 3EX Leeds, UK
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11
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Lazaros G, Dimitroglou Y, Sakalidis A, Mavroudis A, Kalantzis C, Valatsou A, Andrikou I, Christofi A, Mantzouranis E, Kachrimanidis I, Bei E, Lazarou E, Tsioufis C, Tousoulis D. Lipoprotein-associated phospholipase A2 in coronary artery disease. Curr Top Med Chem 2022:CTMC-EPUB-127246. [DOI: 10.2174/1568026623666221027145545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 10/03/2022] [Accepted: 10/12/2022] [Indexed: 11/22/2022]
Abstract
Abstract:
Coronary artery disease (CAD) is the leading cause of morbidity and mortality in western societies. Therefore identification of novel biomarkers to be used as diagnostic or therapeutic targets is of significant scientific interest. Lipoprotein-associated phospholipase A2 (Lp-PLA2) is one such protein shown to be involved in endothelial dysfunction, vascular inflammation and atherogenesis. Several epidemiological studies have associated high Lp-PLA2 activity with increased risk for CAD even when other CAD risk factors or inflammation markers were included in the multivariate analysis. These findings were strengthened by the results of relevant meta-analyses. However, randomized trials failed to establish Lp-PLA2 as a therapeutic target. Specifically, pharmaceutical inhibition of Lp-PLA2 when compared to the placebo failed to demonstrate significant association with improved prognosis of patients with stable CAD or after an acute coronary syndrome (ACS). This review focuses on the available data that have investigated the potential role of Lp-PLA2 as a biomarker for CAD.
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Affiliation(s)
- George Lazaros
- First Cardiology Department, Hippokration General Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Yannis Dimitroglou
- First Cardiology Department, Hippokration General Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Athanasios Sakalidis
- First Cardiology Department, Hippokration General Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Andreas Mavroudis
- First Cardiology Department, Hippokration General Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Charalambos Kalantzis
- First Cardiology Department, Hippokration General Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Angeliki Valatsou
- First Cardiology Department, Hippokration General Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Ioannis Andrikou
- First Cardiology Department, Hippokration General Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Angela Christofi
- First Cardiology Department, Hippokration General Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Emmanouil Mantzouranis
- First Cardiology Department, Hippokration General Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Ioannis Kachrimanidis
- First Cardiology Department, Hippokration General Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Evellina Bei
- First Cardiology Department, Hippokration General Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Emilia Lazarou
- First Cardiology Department, Hippokration General Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Costas Tsioufis
- First Cardiology Department, Hippokration General Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Dimitris Tousoulis
- First Cardiology Department, Hippokration General Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
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12
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Balta A, Ceasovschih A, Șorodoc V, Dimitriadis K, Güzel S, Lionte C, Stătescu C, Sascău RA, Mantzouranis E, Sakalidis A, Vlachakis PK, Tsioufis P, Kordalis A, Tsiamis E, Tsioufis K, Șorodoc L. Broad Electrocardiogram Syndromes Spectrum: From Common Emergencies to Particular Electrical Heart Disorders. J Pers Med 2022; 12:jpm12111754. [PMID: 36573711 PMCID: PMC9697753 DOI: 10.3390/jpm12111754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/13/2022] [Accepted: 10/19/2022] [Indexed: 12/30/2022] Open
Abstract
Electrocardiogram (ECG) still remains a very useful diagnostic method in modern cardiology. Its broad availability, noninvasiveness and good sensitivity explain why it plays a capital role in the very beginning of the process of diagnosis for every patient, with or without cardiac-related complaints. For the practitioner, good training in ECG interpretation is mandatory. Sometimes, the ECG trace reveals particular aspects that may cause confusion and complicate decision-making. In this article, we present several less common situations underlying the general context and ECG features. The syndromes studied have a high pathological significance and may range from acute emergencies that call for a rapid therapeutical response to chronic syndromes that require prolonged observation, monitoring and risk stratification.
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Affiliation(s)
- Anastasia Balta
- Faculty of Medicine, University of Medicine and Pharmacy Grigore T. Popa, 700115 Iasi, Romania
| | - Alexandr Ceasovschih
- Faculty of Medicine, University of Medicine and Pharmacy Grigore T. Popa, 700115 Iasi, Romania
- Correspondence: (A.C.); (V.Ș.); (K.D.)
| | - Victorița Șorodoc
- 2nd Internal Medicine Department, Sf. Spiridon Clinical Emergency Hospital, 700111 Iasi, Romania
- Correspondence: (A.C.); (V.Ș.); (K.D.)
| | - Kyriakos Dimitriadis
- 1st Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 11527 Athens, Greece
- Correspondence: (A.C.); (V.Ș.); (K.D.)
| | - Sara Güzel
- Faculty of Medicine, University of Medicine and Pharmacy Grigore T. Popa, 700115 Iasi, Romania
| | - Cătălina Lionte
- Faculty of Medicine, University of Medicine and Pharmacy Grigore T. Popa, 700115 Iasi, Romania
- 2nd Internal Medicine Department, Sf. Spiridon Clinical Emergency Hospital, 700111 Iasi, Romania
| | - Cristian Stătescu
- Cardiology Department, Cardiovascular Diseases Institute, 700503 Iasi, Romania
| | - Radu Andy Sascău
- Cardiology Department, Cardiovascular Diseases Institute, 700503 Iasi, Romania
| | - Emmanouil Mantzouranis
- 1st Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 11527 Athens, Greece
| | - Athanasios Sakalidis
- 1st Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 11527 Athens, Greece
| | - Panayotis K. Vlachakis
- 1st Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 11527 Athens, Greece
| | - Panagiotis Tsioufis
- 1st Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 11527 Athens, Greece
| | - Athanasios Kordalis
- 1st Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 11527 Athens, Greece
| | - Eleftherios Tsiamis
- 1st Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 11527 Athens, Greece
| | - Konstantinos Tsioufis
- 1st Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 11527 Athens, Greece
| | - Laurențiu Șorodoc
- Faculty of Medicine, University of Medicine and Pharmacy Grigore T. Popa, 700115 Iasi, Romania
- 2nd Internal Medicine Department, Sf. Spiridon Clinical Emergency Hospital, 700111 Iasi, Romania
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13
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Lazaros G, Lazarou E, Tsioufis P, Soulaidopoulos S, Valatsou A, Karmpalioti M, Sakalidis A, Vlachakis PK, Vlachopoulos C, Tsioufis C. Incidence and Prevalence of Cardiac Arrhythmias in Pericardial Syndromes. Rev Cardiovasc Med 2022. [DOI: 10.31083/j.rcm2310347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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14
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Lazaros G, Lazarou E, Valatsou A, Vlachopoulos C, Antonopoulos AS, Dimitroglou Y, Sakalidis A, Tsioufis P, Kachrimanidis I, Tsioufis C. The natural history of idiopathic chronic large asymptomatic non-inflammatory pericardial effusions. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background/Introduction
Pericardial effusions (PEFs) are a challenging and often troublesome pericardial syndrome. The most recent 2015 ESC guidelines on pericardial diseases recommend drainage in cardiac tamponade or suspected bacterial/ neoplastic etiology (class IC), which should also be considered in large, idiopathic chronic PEFs.
Purpose
In this work we assessed the natural history of asymptomatic, idiopathic, chronic, C-reactive protein (CRP) negative, large PEFs.
Methods
We assessed retrospectively consecutive patients referred to the pericardial unit of our institution with idiopathic (without definite underlying etiology after extensive work-up), chronic (>3 months), large (maximal effusion diameter at end-diastole >2cm), asymptomatic, without evidence of ongoing pericardial inflammation (without CRP elevation or evidence of pericardial inflammation with cardiac magnetic resonance imaging) PEFs. To define the natural history of this condition, only patients with a follow-up of at least 2 years were included. The change in the PEF diameter from the first evaluation to the last follow-up namely: regression (complete or decrease from large to moderate/small), progression with symptoms appearance requiring drainage, or stability over time (defined as variation of PEF diameter <5mm, but still in the range of large), was assessed. Follow-up according to our institutional protocols was performed every 3 months and included clinical examination and focused echocardiography.
Results
Thirty patients fulfilled the inclusion criteria and were analyzed. No patient was receiving anti-inflammatory treatment during follow-up. Nevertheless, 12 patients (40%) had received from their attending physicians a course of anti-inflammatory treatment (non-steroidal anti-inflammatory drugs, glucocorticoids, colchicine and combinations) before enrollment, without or with temporary results. The mean age of this study population was 64.9 (±16.1) years and the mean follow-up was 49.8 (±17.8) months. Women were numerically more often affected compared to men (57% vs. 43%, p=0.465). History of pericarditis was reported in 13% of cases. The mean maximal PEF diameter was 24.5mm (±3.3) and the median disease duration at first evaluation was 15.5 (7–57) months. Concerning outcome, the effusion size remained stable in 24 out of 30 patients (80%), regressed in 4 (13%,) and increased in size requiring drainage due to symptoms onset in the remainder 2 (7%). During follow-up 2 patients (7%) with stable in size effusions died from non-cardiac causes.
Conclusions
According to this study results the outcome of idiopathic, chronic, large, asymptomatic and without evidence of inflammation PEFs is overall favorable. Patients should be reassured about the benign course of this condition but at the same time, advised to seek medical care should symptoms appear, for a timely intervention with pericardial drainage.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- G Lazaros
- National & Kapodistrian University of Athens Medical School , Athens , Greece
| | - E Lazarou
- National & Kapodistrian University of Athens Medical School , Athens , Greece
| | - A Valatsou
- National & Kapodistrian University of Athens Medical School , Athens , Greece
| | - C Vlachopoulos
- National & Kapodistrian University of Athens Medical School , Athens , Greece
| | - A S Antonopoulos
- National & Kapodistrian University of Athens Medical School , Athens , Greece
| | - Y Dimitroglou
- National & Kapodistrian University of Athens Medical School , Athens , Greece
| | - A Sakalidis
- National & Kapodistrian University of Athens Medical School , Athens , Greece
| | - P Tsioufis
- National & Kapodistrian University of Athens Medical School , Athens , Greece
| | - I Kachrimanidis
- National & Kapodistrian University of Athens Medical School , Athens , Greece
| | - C Tsioufis
- National & Kapodistrian University of Athens Medical School , Athens , Greece
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15
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Mantzouranis E, Leontsinis I, Sakalidis A, Ntalakouras I, Kordalis A, Antonopoulos A, Dagre A, Poulimenos L, Mamarelis I, Tsioufis K. Distinctive characteristics among MINOCA and Takotsubo patients and their prognostic value in a multicenter prospective cohort. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background/Introduction
In the acute care setting, the working diagnosis of MINOCA exhibits increasing recognition and includes a broad spectrum of conditions, most of them yet not adequately understood. TakoTsubo syndrome (TTS) represents a significant proportion of such cases and despite its predominance on female gender as well as its imaging characteristics on the typical apical form it is not easily distinguishable from other MINOCA causes without the contribution of cardiac magnetic resonance (CMR).
Purpose
The aim of our study is to investigate for distinctive characteristics related to the index event among MINOCA cases from a multi-center prospective cohort with a mean follow up period of 18 months.
Methods
We divided our study population (n=74) into TTS (n=30) and non-TTS (n=44) according to multimodality imaging results. Information regarding the index event (Sep 2019-Feb 2021) were retracted from the medical notes.
Results
CMR results led to a post-discharge diagnosis reconsideration in 12 cases (16.2%). Female gender (n=29; 96.7% vs n=22; 50%, P<0.001), older age (mean age 66±11 vs 59±11, P=0.04) and history of hypertension (n=21; 70% vs n=19; 44.3%, p=0.035) were more frequent in TTS group. There was no statistically significant difference in body mass index, baseline renal function, history of dyslipidemia, diabetes and smoking between the two groups. During the index event, peak troponin levels 576 pg/ml (IQR: 184–9915) vs 767 pg/ml (IQR: 47–47000), P=0.005], were lower in the TTS group, whereas NSTEMI presentation was the commonest among all patients. Angina was the dominant symptom for both groups. However, severe angina expressed as more than 2 episodes within 24 hours was more frequent among the TTS population (n=19; 65.5% vs n=10; 22.7%, P=0.001). TTS probability assessed with the INTERTAK score was higher among the TTS group (68±10 vs 38±21, P<0.001). In hospital major cardiovascular events incidence was higher in the non-TTS group (n=2 vs n=11, P=0.06). Multivariate analysis revealed that the presence of severe angina (OR, 8.118, 95% CI: 1.173–56.157, P=0.038) is highly predictive of TTS in the acute care setting even independently of INTERTAK probability.
Conclusions
These preliminary results indicate that the presence of several anginal attacks may strengthen the predictive value of the INTERTAK score during MINOCA evaluation in the acute setting. Confirmation in a larger population is warranted.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- E Mantzouranis
- Hippokration Hospital, First Department of Cardiology, University of Athens , Athens , Greece
| | - I Leontsinis
- Hippokration Hospital, First Department of Cardiology, University of Athens , Athens , Greece
| | - A Sakalidis
- Hippokration Hospital, First Department of Cardiology, University of Athens , Athens , Greece
| | - I Ntalakouras
- Hippokration Hospital, First Department of Cardiology, University of Athens , Athens , Greece
| | - A Kordalis
- Hippokration Hospital, First Department of Cardiology, University of Athens , Athens , Greece
| | - A Antonopoulos
- Hippokration Hospital, First Department of Cardiology, University of Athens , Athens , Greece
| | - A Dagre
- Hippokration Hospital, First Department of Cardiology, University of Athens , Athens , Greece
| | - L Poulimenos
- Hippokration Hospital, First Department of Cardiology, University of Athens , Athens , Greece
| | - I Mamarelis
- Hippokration Hospital, First Department of Cardiology, University of Athens , Athens , Greece
| | - K Tsioufis
- Hippokration Hospital, First Department of Cardiology, University of Athens , Athens , Greece
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Sakalidis A, Dimitriadis K, Soulaidopoulos S, Dri E, Aznaouridis KA, Manta E, Konstantinou K, Tsioufis K. HYPERTENSIVE PATIENTS WITH ANGINA AND NONOBSTRUCTIVE CORONARY ARTERY DISEASE ARE CHARACTERIZED BY INCREASED SYMPATHETIC NERVOUS SYSTEM ACTIVATION. J Am Coll Cardiol 2022. [DOI: 10.1016/s0735-1097(22)02145-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Dimitriadis K, Bletsa E, Lazarou E, Leontsinis I, Stampouloglou P, Dri E, Sakalidis A, Pyrpyris N, Tsioufis P, Siasos G, Tsiachris D, Tsioufis K. A Narrative Review on Exercise and Cardiovascular Events: “Primum Non Nocere”. Heart Mind 2022. [DOI: 10.4103/hm.hm_25_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Mantzouranis M, Leontsinis I, Sakalidis A, Klettas D, Dimitriadis K, Thomopoulos C, Dri E, Ntalianis A, Avramidis D, Stougiannos P, Patsourakos N, Tousoulis D, Tsioufis K. Left ventricular mass index unveils differences in sympathetic nervous system activity between patients with MINOCA and Takotsubo syndrome. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background/Introduction
Left ventricular mass index (LVMI) has been long established as an index of target organ damage. It has demonstrated a prognostic role in cardiovascular morbidity and mortality assessed using either echocardiography or cardiac magnetic resonance (CMR) under the prism of coronary artery disease, hypertension, diabetes mellitus, chronic kidney disease. On the other hand, it has shown a strong association with indices of sympathetic nervous system (SNS) activity.
Purpose
The aim of our study is to investigate for potential associations between LVMI and indices of SNS among patients with a working diagnosis of MINOCA.
Methods
Our study population consists of 50 patients [32% male; mean age: 61±12 years old; 50% hypertensives (HTN), 16% with history of diabetes mellitus (DM), 22% smokers] admitted with acute coronary syndrome (ACS) fulfilling the diagnostic criteria of MINOCA. A subsequent CMR demonstrated an ischemic pattern of late gadolinium enhancement (LGE) in 15 cases (27.8%), findings indicative of Takotsubo syndrome (TTS) in 19 patients (35.2%), whereas failed to reveal any abnormalities in 16 cases (29.8%). LVMI was estimated using left ventricular mass per body surface area (LV mass/BSA) as derived from CMR. SNS activity was assessed using muscle sympathetic nerve activity (MSNA) during the first 30 days of patient discharge.
Results
Univariate analysis failed to demonstrate an association between LVMI and indices of SNS in the total population. This was found to be driven by the TTS group. However, for all other MINOCA cases (n=31; including both LGE CMR and clear CMR cases) LVMI demonstrated a significant positive association with MSNA measured as bursts/min (OR, 0.558; CI 95%, 0.200–0.915; p=0.004). A multivariate analysis was conducted in the same group in which LVMI retained its statistical significance independently of age, gender, ejection fraction derived from CMR, history of HTN and DM (OR, 0.518; CI 95%, 0.030 - 0.952; p=0.038). TTS group did not show any association between LVMI and MSNA.
Conclusions
These preliminary results may imply an underlying mechanism of reverse negative feedback on systematic SNS activity after the acute phase of sympathetic overdrive during a TTS event. Further investigation is warranted to confirm our research findings.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Mantzouranis
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
| | - I Leontsinis
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
| | - A Sakalidis
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
| | - D Klettas
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
| | - K Dimitriadis
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
| | - C Thomopoulos
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
| | - E Dri
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
| | - A Ntalianis
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
| | - D Avramidis
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
| | - P Stougiannos
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
| | - N Patsourakos
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
| | - D Tousoulis
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
| | - K Tsioufis
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
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Mantzouranis M, Leontsinis I, Sakalidis A, Klettas D, Avramidis D, Patsourakos N, Stougiannos P, Dimitriadis K, Thomopoulos C, Poulimenos L, Mamarellis I, Milkas A, Tousoulis D, Tsioufis K. Superiority of cardiac magnetic resonance derived left-ventricular ejection fraction in the identification of true acute myocardial infarction among MINOCA patients. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background/Introduction
MINOCA constitutes a clinical entity characterized by heterogeneous and poorly understood pathophysiological substrate, whereas current knowledge leaves significant gaps regarding the identification, risk stratification and therapeutical approach of these patients.
Purpose
The aim of our study is to investigate the potential role of clinical, hemodynamic, laboratory and imaging parameters in the early identification of true acute myocardial infarction (AMI) among patients with a working diagnosis of MINOCA.
Methods
Our study population included 62 patients admitted with acute coronary syndrome (ACS) fulfilling the diagnostic criteria of MINOCA. A subsequent cardiac magnetic resonance (CMR) performed at 54 patients demonstrated an ischemic pattern of late gadolinium enhancement (LGE) confirming the diagnosis of true AMI in 15 cases (27.8%). Other findings included Takotsubo syndrome (n=19; 35.2%) and myocarditis (n=4; 7.4%), whereas CMR failed to reveal abnormal findings at 16 cases (29.8%).
Results
Focusing on the combined population of true AMI and clear CMR groups (n=31; 51.6% male; mean age: 58±12 years old; 42% hypertensives (HTN), 16% with history of diabetes mellitus (DM), 28.6% smokers) no significant difference was observed regarding classic cardiovascular risk factors (HTN, DM, smoking, age, dyslipidemia) except for a tendency of overrepresentation of female sex (r=0.354; p=0.051) in the true AMI group. Coronary angiographic (CA) findings did not differ between the two groups: clear vessels: 16/31 (51.6%); lesions causing ≤50% stenosis: 7/31 (22.6%); bridges: 4/31 (12.9%); spontaneous coronary artery dissection (SCAD): 2/31 (6.5%); slow flow phenomenon or spontaneous epicardial spasm: 2/31 (6.5%). No difference was observed in treatment approach with beta-blockers, renin-angiotensin system blockers, statins or the selection of no, single or dual antiplatelet strategy. Univariate regression analysis demonstrated that CMR derived left-ventricular ejection fraction (CMR-LVEF) (OR, 0.846; CI 95%: 0.742–0.965; p=0.012), as well as admission ECG abnormalities (OR, 0.154; CI 95%: 0.026–0.914; p=0.04), admission (OR, 5.689; CI 95%: 1.374–23.553; p=0.016) and peak troponin levels (OR, 15.874; CI 95%: 2.486–101.367; p=0.003) were the only parameters significantly related to a true AMI. Statistical significance was retained in multivariate models adjusted for age, gender, history of HTN and DM. On the contrary echocardiography derived LVEF failed to predict true AMI.
Conclusions
These preliminary results further highlight the need of an early CMR evaluation of MINOCA patients. A timely identification of true AMI is expected to improve patient outcomes by guiding the treatment approach.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Mantzouranis
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
| | - I Leontsinis
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
| | - A Sakalidis
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
| | - D Klettas
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
| | - D Avramidis
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
| | - N Patsourakos
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
| | - P Stougiannos
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
| | - K Dimitriadis
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
| | - C Thomopoulos
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
| | - L Poulimenos
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
| | - I Mamarellis
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
| | - A Milkas
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
| | - D Tousoulis
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
| | - K Tsioufis
- First Cardiology Clinic, University of Athens,Hippokration Hospital, Athens, Greece
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