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Gatta F, Haqzad Y, Gradinariu G, Malvindi PG, Khalid Z, Suelo-Calanao RL, Moawad N, Bashir A, Rogers LJ, Lloyd C, Nguyen B, Booth K, Wang L, Al-Attar N, McDowall N, Watkins S, Sayeed R, Baghdadi S, D'Alessio A, Monteagudo-Vela M, Djordjevic J, Goricar M, Hoppe S, Bocking C, Hussain A, Evans B, Arif S, Malkin C, Field M, Sandhu K, Harky A, Torky A, Uddin M, Abdulhakeem M, Kenawy A, Massey J, Cartwright N, Tyson N, Nicou N, Baig K, Jones M, Aljanadi F, Owens CG, Oyebanji T, Doyle J, Spence MS, Brennan PF, Manoharan G, Ramadan T, Ohri S, Loubani M. Redo aortic valve replacement versus valve-in-valve trans-catheter aortic valve implantation: a UK propensity-matched analysis. Monaldi Arch Chest Dis 2023; 94. [PMID: 37074089 DOI: 10.4081/monaldi.2023.2546] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 02/08/2023] [Accepted: 03/21/2023] [Indexed: 04/20/2023] Open
Abstract
This study sought to compare the morbidity and mortality of redo aortic valve replacement (redo-AVR) versus valve-in-valve trans-catheter aortic valve implantation (valve-in-valve TAVI) for patients with a failing bioprosthetic valve. A multicenter UK retrospective study of redo-AVR or valve-in-valve TAVI for patients referred for redo aortic valve intervention due to a degenerated aortic bioprosthesis. Propensity score matching was performed for confounding factors. From July 2005 to April 2021, 911 patients underwent redo-AVR and 411 patients underwent valve-in-valve TAVI. There were 125 pairs for analysis after propensity score matching. The mean age was 75.2±8.5 years. In-hospital mortality was 7.2% (n=9) for redo-AVR versus 0 for valve-in-valve TAVI, p=0.002. Surgical patients suffered more post-operative complications, including intra-aortic balloon pump support (p=0.02), early re-operation (p<0.001), arrhythmias (p<0.001), respiratory and neurological complications (p=0.02 and p=0.03) and multi-organ failure (p=0.01). The valve-in-valve TAVI group had a shorter intensive care unit and hospital stay (p<0.001 for both). However, moderate aortic regurgitation at discharge and higher post-procedural gradients were more common after valve-in-valve TAVI (p<0.001 for both). Survival probabilities in patients who were successfully discharged from the hospital were similar after valve-in-valve TAVI and redo-AVR over the 6-year follow-up (log-rank p=0.26). In elderly patients with a degenerated aortic bioprosthesis, valve-in-valve TAVI provides better early outcomes as opposed to redo-AVR, although there was no difference in mid-term survival in patients successfully discharged from the hospital.
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Affiliation(s)
- Francesca Gatta
- Department of Cardiology and Cardiothoracic Surgery, Castle Hill Hospital, Hull; Department of Cardiology and Cardiothoracic Surgery, Liverpool Heart and Chest Hospital.
| | - Yama Haqzad
- Department of Cardiology and Cardiothoracic Surgery, Castle Hill Hospital, Hull.
| | - George Gradinariu
- Department of Cardiology and Cardiothoracic Surgery, Golden Jubilee National Hospital, Glasgow.
| | | | - Zubair Khalid
- Department of Cardiology and Cardiothoracic Surgery, Castle Hill Hospital, Hull.
| | - Rona L Suelo-Calanao
- Department of Cardiology and Cardiothoracic Surgery, Castle Hill Hospital, Hull.
| | - Nader Moawad
- Department of Cardiology and Cardiothoracic Surgery, Derriford Hospital.
| | - Aladdin Bashir
- Department of Cardiology and Cardiothoracic Surgery, Derriford Hospital.
| | - Luke J Rogers
- Department of Cardiology and Cardiothoracic Surgery, Derriford Hospital.
| | - Clinton Lloyd
- Department of Cardiology and Cardiothoracic Surgery, Derriford Hospital.
| | - Bao Nguyen
- Department of Cardiology and Cardiothoracic Surgery, Derriford Hospital.
| | - Karen Booth
- Department of Cardiology and Cardiothoracic Surgery, Freeman Hospital, Newcastle.
| | - Lu Wang
- Department of Cardiology and Cardiothoracic Surgery, Freeman Hospital, Newcastle.
| | - Nawwar Al-Attar
- Department of Cardiology and Cardiothoracic Surgery, Golden Jubilee National Hospital, Glasgow.
| | - Neil McDowall
- Department of Cardiology and Cardiothoracic Surgery, Golden Jubilee National Hospital, Glasgow.
| | - Stuart Watkins
- Department of Cardiology and Cardiothoracic Surgery, Golden Jubilee National Hospital, Glasgow.
| | - Rana Sayeed
- Department of Cardiology and Cardiothoracic Surgery, John Radcliffe Hospital, Oxford.
| | - Saleh Baghdadi
- Department of Cardiology and Cardiothoracic Surgery, John Radcliffe Hospital, Oxford.
| | - Andrea D'Alessio
- Department of Cardiology and Cardiothoracic Surgery, John Radcliffe Hospital, Oxford.
| | - Maria Monteagudo-Vela
- Department of Cardiology and Cardiothoracic Surgery, John Radcliffe Hospital, Oxford.
| | - Jasmina Djordjevic
- Department of Cardiology and Cardiothoracic Surgery, John Radcliffe Hospital, Oxford.
| | - Matej Goricar
- Department of Cardiology and Cardiothoracic Surgery, John Radcliffe Hospital, Oxford.
| | - Solveig Hoppe
- Department of Cardiology and Cardiothoracic Surgery, John Radcliffe Hospital, Oxford.
| | - Charlotte Bocking
- Department of Cardiology and Cardiothoracic Surgery, John Radcliffe Hospital, Oxford.
| | - Azar Hussain
- Department of Cardiology and Cardiothoracic Surgery, Leeds General Infirmary.
| | - Betsy Evans
- Department of Cardiology and Cardiothoracic Surgery, Leeds General Infirmary.
| | - Salman Arif
- Department of Cardiology and Cardiothoracic Surgery, Leeds General Infirmary.
| | - Christopher Malkin
- Department of Cardiology and Cardiothoracic Surgery, Leeds General Infirmary.
| | - Mark Field
- Department of Cardiology and Cardiothoracic Surgery, Derriford Hospital.
| | - Kully Sandhu
- Department of Cardiology and Cardiothoracic Surgery, Liverpool Heart and Chest Hospital.
| | - Amer Harky
- Department of Cardiology and Cardiothoracic Surgery, Liverpool Heart and Chest Hospital.
| | - Ahmed Torky
- Department of Cardiology and Cardiothoracic Surgery, Liverpool Heart and Chest Hospital.
| | - Mauin Uddin
- Department of Cardiology and Cardiothoracic Surgery, Liverpool Heart and Chest Hospital.
| | - Muhammad Abdulhakeem
- Department of Cardiology and Cardiothoracic Surgery, Liverpool Heart and Chest Hospital.
| | - Ayman Kenawy
- Department of Cardiology and Cardiothoracic Surgery, Liverpool Heart and Chest Hospital.
| | - John Massey
- Department of Cardiology and Cardiothoracic Surgery, Northern General Hospital, Sheffield.
| | - Neil Cartwright
- Department of Cardiology and Cardiothoracic Surgery, Northern General Hospital, Sheffield.
| | - Nathan Tyson
- Department of Cardiology and Cardiothoracic Surgery, Nottingham City Hospital.
| | - Niki Nicou
- Department of Cardiology and Cardiothoracic Surgery, Nottingham City Hospital.
| | - Kamran Baig
- Department of Cardiology and Cardiothoracic Surgery, Nottingham City Hospital.
| | - Mark Jones
- Department of Cardiology and Cardiothoracic Surgery, Royal Victoria Hospital, Belfast.
| | - Firas Aljanadi
- Department of Cardiology and Cardiothoracic Surgery, Royal Victoria Hospital, Belfast.
| | - Colum G Owens
- Department of Cardiology and Cardiothoracic Surgery, Royal Victoria Hospital, Belfast.
| | - Tunde Oyebanji
- Department of Cardiology and Cardiothoracic Surgery, Royal Victoria Hospital, Belfast.
| | - Joseph Doyle
- Department of Cardiology and Cardiothoracic Surgery, Royal Victoria Hospital, Belfast.
| | - Mark S Spence
- Department of Cardiology and Cardiothoracic Surgery, Royal Victoria Hospital, Belfast.
| | - Paul F Brennan
- Department of Cardiology and Cardiothoracic Surgery, Royal Victoria Hospital, Belfast.
| | - Ganesh Manoharan
- Department of Cardiology and Cardiothoracic Surgery, Royal Victoria Hospital, Belfast.
| | - Taha Ramadan
- Department of Cardiology and Cardiothoracic Surgery, Southampton General Hospital.
| | - Sunil Ohri
- Department of Cardiology and Cardiothoracic Surgery, Southampton General Hospital.
| | - Mahmoud Loubani
- Department of Cardiology and Cardiothoracic Surgery, Castle Hill Hospital, Hull.
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Birch M, Challenger S, Crochard JP, Fradet D, Jackman H, Luan A, Madigan E, Mathew JS, McDowall N, Meldrum K, Gordon CM, Peach P, Yeo S. A Simplified Process for the Manufacture of Imagabalin Hydrochloride (PD-0332334), an α2δ-Ligand for the Treatment of Generalised Anxiety Disorder. Org Process Res Dev 2011. [DOI: 10.1021/op2002326] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Melissa Birch
- Department of Chemical Research and Development, Pfizer World Wide Research and Development, Sandwich Laboratories, Ramsgate Road, Sandwich, Kent CT13 9NJ, United Kingdom
| | - Stephen Challenger
- Department of Chemical Research and Development, Pfizer World Wide Research and Development, Sandwich Laboratories, Ramsgate Road, Sandwich, Kent CT13 9NJ, United Kingdom
| | - Jean-Philippe Crochard
- Department of Chemical Research and Development, Pfizer World Wide Research and Development, Sandwich Laboratories, Ramsgate Road, Sandwich, Kent CT13 9NJ, United Kingdom
| | - David Fradet
- Department of Chemical Research and Development, Pfizer World Wide Research and Development, Sandwich Laboratories, Ramsgate Road, Sandwich, Kent CT13 9NJ, United Kingdom
| | - Hayley Jackman
- Department of Chemical Research and Development, Pfizer World Wide Research and Development, Sandwich Laboratories, Ramsgate Road, Sandwich, Kent CT13 9NJ, United Kingdom
| | - Amy Luan
- Department of Chemical Research and Development, Pfizer World Wide Research and Development, Sandwich Laboratories, Ramsgate Road, Sandwich, Kent CT13 9NJ, United Kingdom
| | - Evelyn Madigan
- Department of Chemical Research and Development, Pfizer World Wide Research and Development, Sandwich Laboratories, Ramsgate Road, Sandwich, Kent CT13 9NJ, United Kingdom
| | - Jinu S. Mathew
- Department of Chemical Research and Development, Pfizer World Wide Research and Development, Sandwich Laboratories, Ramsgate Road, Sandwich, Kent CT13 9NJ, United Kingdom
| | - Neil McDowall
- Department of Chemical Research and Development, Pfizer World Wide Research and Development, Sandwich Laboratories, Ramsgate Road, Sandwich, Kent CT13 9NJ, United Kingdom
| | - Kevin Meldrum
- Department of Chemical Research and Development, Pfizer World Wide Research and Development, Sandwich Laboratories, Ramsgate Road, Sandwich, Kent CT13 9NJ, United Kingdom
| | - Charles M. Gordon
- Department of Chemical Research and Development, Pfizer World Wide Research and Development, Sandwich Laboratories, Ramsgate Road, Sandwich, Kent CT13 9NJ, United Kingdom
| | - Philip Peach
- Department of Chemical Research and Development, Pfizer World Wide Research and Development, Sandwich Laboratories, Ramsgate Road, Sandwich, Kent CT13 9NJ, United Kingdom
| | - Stephen Yeo
- Department of Chemical Research and Development, Pfizer World Wide Research and Development, Sandwich Laboratories, Ramsgate Road, Sandwich, Kent CT13 9NJ, United Kingdom
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Birch M, Challenger S, Crochard JP, Fradet D, Jackman H, Luan A, Madigan E, McDowall N, Meldrum K, Gordon CM, Widegren M, Yeo S. The Development of a Practical Multikilogram Synthesis of the Chiral β-Amino Acid Imagabalin Hydrochloride (PD-0332334) via Asymmetric Hydrogenation. Org Process Res Dev 2011. [DOI: 10.1021/op2001639] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Melissa Birch
- Department of Chemical Research and Development, Pfizer World Wide Research and Development, Sandwich Laboratories, Ramsgate Road, Sandwich, Kent CT13 9NJ, United Kingdom
| | - Stephen Challenger
- Department of Chemical Research and Development, Pfizer World Wide Research and Development, Sandwich Laboratories, Ramsgate Road, Sandwich, Kent CT13 9NJ, United Kingdom
| | - Jean-Philippe Crochard
- Department of Chemical Research and Development, Pfizer World Wide Research and Development, Sandwich Laboratories, Ramsgate Road, Sandwich, Kent CT13 9NJ, United Kingdom
| | - David Fradet
- Department of Chemical Research and Development, Pfizer World Wide Research and Development, Sandwich Laboratories, Ramsgate Road, Sandwich, Kent CT13 9NJ, United Kingdom
| | - Hayley Jackman
- Department of Chemical Research and Development, Pfizer World Wide Research and Development, Sandwich Laboratories, Ramsgate Road, Sandwich, Kent CT13 9NJ, United Kingdom
| | - Amy Luan
- Department of Chemical Research and Development, Pfizer World Wide Research and Development, Sandwich Laboratories, Ramsgate Road, Sandwich, Kent CT13 9NJ, United Kingdom
| | - Evelyn Madigan
- Department of Chemical Research and Development, Pfizer World Wide Research and Development, Sandwich Laboratories, Ramsgate Road, Sandwich, Kent CT13 9NJ, United Kingdom
| | - Neil McDowall
- Department of Chemical Research and Development, Pfizer World Wide Research and Development, Sandwich Laboratories, Ramsgate Road, Sandwich, Kent CT13 9NJ, United Kingdom
| | - Kevin Meldrum
- Department of Chemical Research and Development, Pfizer World Wide Research and Development, Sandwich Laboratories, Ramsgate Road, Sandwich, Kent CT13 9NJ, United Kingdom
| | - Charles M. Gordon
- Department of Chemical Research and Development, Pfizer World Wide Research and Development, Sandwich Laboratories, Ramsgate Road, Sandwich, Kent CT13 9NJ, United Kingdom
| | - Magnus Widegren
- Department of Chemical Research and Development, Pfizer World Wide Research and Development, Sandwich Laboratories, Ramsgate Road, Sandwich, Kent CT13 9NJ, United Kingdom
| | - Stephen Yeo
- Department of Chemical Research and Development, Pfizer World Wide Research and Development, Sandwich Laboratories, Ramsgate Road, Sandwich, Kent CT13 9NJ, United Kingdom
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Affiliation(s)
- Melissa Birch
- Pfizer Global Research and Development, Ramsgate Road, Sandwich CT13 9NJ, United Kingdom
| | - Steven J. Fussell
- Pfizer Global Research and Development, Ramsgate Road, Sandwich CT13 9NJ, United Kingdom
| | - Paul D. Higginson
- Pfizer Global Research and Development, Ramsgate Road, Sandwich CT13 9NJ, United Kingdom
| | - Neil McDowall
- Pfizer Global Research and Development, Ramsgate Road, Sandwich CT13 9NJ, United Kingdom
| | - Ivan Marziano
- Pfizer Global Research and Development, Ramsgate Road, Sandwich CT13 9NJ, United Kingdom
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Kuo EA, Hambleton PT, Kay DP, Evans PL, Matharu SS, Little E, McDowall N, Jones CB, Hedgecock CJ, Yea CM, Chan AW, Hairsine PW, Ager IR, Tully WR, Williamson RA, Westwood R. Synthesis, structure-activity relationships, and pharmacokinetic properties of dihydroorotate dehydrogenase inhibitors: 2-cyano-3-cyclopropyl-3-hydroxy-N-[3'-methyl-4'-(trifluoromethyl)phenyl ] propenamide and related compounds. J Med Chem 1996; 39:4608-21. [PMID: 8917650 DOI: 10.1021/jm9604437] [Citation(s) in RCA: 72] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The active metabolite (2) of the novel immunosuppressive agent leflunomide (1) has been shown to inhibit the enzyme dihydroorotate dehydrogenase (DHODH). This enzyme catalyzes the fourth step in de novo pyrimidine biosynthesis. A series of analogues of the active metabolite 2 have been synthesized. Their in vivo biological activity determined in rat and mouse delayed type hypersensitivity has been found to correlate well with their in vitro DHODH potency. The most promising compound (3) has shown activity in rat and mouse collagen (II)-induced arthritis models (ED50 = 2 and 31 mg/kg, respectively) and has shown a shorter half-life in man when compared with leflunomide. Clinical studies in rheumatoid arthritis are in progress.
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Affiliation(s)
- E A Kuo
- Hoechst Marion Roussel, Wiltshire, England
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