12 results on '"Hausenloy, DJ"'
Search Results
2. Prognostically relevant periprocedural myocardial injury and infarction associated with percutaneous coronary interventions: a Consensus Document of the ESC Working Group on Cellular Biology of the Heart and European Association of Percutaneous Cardiovascular Interventions (EAPCI).
- Author
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Bulluck H, Paradies V, Barbato E, Baumbach A, Bøtker HE, Capodanno D, De Caterina R, Cavallini C, Davidson SM, Feldman DN, Ferdinandy P, Gili S, Gyöngyösi M, Kunadian V, Ooi SY, Madonna R, Marber M, Mehran R, Ndrepepa G, Perrino C, Schüpke S, Silvain J, Sluijter JPG, Tarantini G, Toth GG, Van Laake LW, von Birgelen C, Zeitouni M, Jaffe AS, Thygesen K, and Hausenloy DJ
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- Biomarkers, Consensus, Humans, Risk Factors, Treatment Outcome, Coronary Artery Disease, Heart Injuries, Myocardial Infarction etiology, Percutaneous Coronary Intervention adverse effects
- Abstract
A substantial number of chronic coronary syndrome (CCS) patients undergoing percutaneous coronary intervention (PCI) experience periprocedural myocardial injury or infarction. Accurate diagnosis of these PCI-related complications is required to guide further management given that their occurrence may be associated with increased risk of major adverse cardiac events (MACE). Due to lack of scientific data, the cut-off thresholds of post-PCI cardiac troponin (cTn) elevation used for defining periprocedural myocardial injury and infarction, have been selected based on expert consensus opinions, and their prognostic relevance remains unclear. In this Consensus Document from the ESC Working Group on Cellular Biology of the Heart and European Association of Percutaneous Cardiovascular Interventions (EAPCI), we recommend, whenever possible, the measurement of baseline (pre-PCI) cTn and post-PCI cTn values in all CCS patients undergoing PCI. We confirm the prognostic relevance of the post-PCI cTn elevation >5× 99th percentile URL threshold used to define type 4a myocardial infarction (MI). In the absence of periprocedural angiographic flow-limiting complications or electrocardiogram (ECG) and imaging evidence of new myocardial ischaemia, we propose the same post-PCI cTn cut-off threshold (>5× 99th percentile URL) be used to define prognostically relevant 'major' periprocedural myocardial injury. As both type 4a MI and major periprocedural myocardial injury are strong independent predictors of all-cause mortality at 1 year post-PCI, they may be used as quality metrics and surrogate endpoints for clinical trials. Further research is needed to evaluate treatment strategies for reducing the risk of major periprocedural myocardial injury, type 4a MI, and MACE in CCS patients undergoing PCI., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2021. For permissions, please email: journals.permissions@oup.com.)
- Published
- 2021
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3. A call to action for new global approaches to cardiovascular disease drug solutions.
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Figtree GA, Broadfoot K, Casadei B, Califf R, Crea F, Drummond GR, Freedman JE, Guzik TJ, Harrison D, Hausenloy DJ, Hill JA, Januzzi JL, Kingwell BA, Lam CSP, MacRae CA, Misselwitz F, Miura T, Ritchie RH, Tomaszewski M, Wu JC, Xiao J, and Zannad F
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- Biomarkers, Drug Discovery, Humans, Cardiovascular Diseases drug therapy, Cardiovascular Diseases prevention & control, Pharmaceutical Preparations
- Abstract
Whilst we continue to wrestle with the immense challenge of implementing equitable access to established evidence-based treatments, substantial gaps remain in our pharmacotherapy armament for common forms of cardiovascular disease including coronary and peripheral arterial disease, heart failure, hypertension, and arrhythmia. We need to continue to invest in the development of new approaches for the discovery, rigorous assessment, and implementation of new therapies. Currently, the time and cost to progress from lead compound/product identification to the clinic, and the success rate in getting there reduces the incentive for industry to invest, despite the enormous burden of disease and potential size of market. There are tremendous opportunities with improved phenotyping of patients currently batched together in syndromic 'buckets'. Use of advanced imaging and molecular markers may allow stratification of patients in a manner more aligned to biological mechanisms that can, in turn, be targeted by specific approaches developed using high-throughput molecular technologies. Unbiased 'omic' approaches enhance the possibility of discovering completely new mechanisms in such groups. Furthermore, advances in drug discovery platforms, and models to study efficacy and toxicity more relevant to the human disease, are valuable. Re-imagining the relationships among discovery, translation, evaluation, and implementation will help reverse the trend away from investment in the cardiovascular space, establishing innovative platforms and approaches across the full spectrum of therapeutic development., (This article has been co-published with permission in the European Heart Journal and Circulation. All rights reserved. © the Author(s) 2021. The articles are identical except for minor stylistic and spelling differences in keeping with each journal's style. Either citation can be used when citing this article.)
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- 2021
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4. Procedural myocardial injury, infarction and mortality in patients undergoing elective PCI: a pooled analysis of patient-level data.
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Silvain J, Zeitouni M, Paradies V, Zheng HL, Ndrepepa G, Cavallini C, Feldman DN, Sharma SK, Mehilli J, Gili S, Barbato E, Tarantini G, Ooi SY, von Birgelen C, Jaffe AS, Thygesen K, Montalescot G, Bulluck H, and Hausenloy DJ
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- Biomarkers, Humans, Troponin, Coronary Artery Disease, Myocardial Infarction, Percutaneous Coronary Intervention adverse effects
- Abstract
Aims: The prognostic importance of cardiac procedural myocardial injury and myocardial infarction (MI) in chronic coronary syndrome (CCS) patients undergoing elective percutaneous coronary intervention (PCI) is still debated., Methods and Results: We analysed individual data of 9081 patients undergoing elective PCI with normal pre-PCI baseline cardiac troponin (cTn) levels. Multivariate models evaluated the association between post-PCI elevations in cTn and 1-year mortality, while an interval analysis evaluated the impact of the size of the myocardial injury on mortality. Our analysis was performed in the overall population and also according to the type of cTn used [52.0% had high-sensitivity cTn (hs-cTn)]. Procedural myocardial injury, as defined by the Fourth Universal Definition of MI (UDMI) [post-PCI cTn elevation ≥1 × 99th percentile upper reference limit (URL)], occurred in 52.8% of patients and was not associated with 1-year mortality [adj odds ratio (OR), 1.35, 95% confidence interval (CI) (0.84-1.77), P = 0.21]. The association between post-PCI cTn elevation and 1-year mortality was significant starting ≥3 × 99th percentile URL. Major myocardial injury defined by post-PCI ≥5 × 99th percentile URL occurred in 18.2% of patients and was associated with a two-fold increase in the adjusted odds of 1-year mortality [2.29, 95% CI (1.32-3.97), P = 0.004]. In the subset of patients for whom periprocedural evidence of ischaemia was collected (n = 2316), Type 4a MI defined by the Fourth UDMI occurred in 12.7% of patients and was strongly associated with 1-year mortality [adj OR 3.21, 95% CI (1.42-7.27), P = 0.005]. We also present our results according to the type of troponin used (hs-cTn or conventional troponin)., Conclusion: Our analysis has demonstrated that in CCS patients with normal baseline cTn levels, the post-PCI cTn elevation of ≥5 × 99th percentile URL used to define Type 4a MI is associated with 1-year mortality and could be used to detect 'major' procedural myocardial injury in the absence of procedural complications or evidence of new myocardial ischaemia., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissions@oup.com.)
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- 2021
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5. The Fourth European-South African Cardiovascular Research Workshop.
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Lecour S, Hausenloy DJ, and Madonna R
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- 2020
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6. ESC Joint Working Groups on Cardiovascular Surgery and the Cellular Biology of the Heart Position Paper: Perioperative myocardial injury and infarction in patients undergoing coronary artery bypass graft surgery.
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Thielmann M, Sharma V, Al-Attar N, Bulluck H, Bisleri G, Bunge JJH, Czerny M, Ferdinandy P, Frey UH, Heusch G, Holfeld J, Kleinbongard P, Kunst G, Lang I, Lentini S, Madonna R, Meybohm P, Muneretto C, Obadia JF, Perrino C, Prunier F, Sluijter JPG, Van Laake LW, Sousa-Uva M, and Hausenloy DJ
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- Biomarkers, Coronary Artery Disease complications, Coronary Artery Disease surgery, Humans, Perioperative Period, Practice Guidelines as Topic, Thoracic Surgery organization & administration, Coronary Artery Bypass adverse effects, Myocardial Infarction, Postoperative Complications
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- 2017
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7. Targeting reperfusion injury in patients with ST-segment elevation myocardial infarction: trials and tribulations.
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Hausenloy DJ, Botker HE, Engstrom T, Erlinge D, Heusch G, Ibanez B, Kloner RA, Ovize M, Yellon DM, and Garcia-Dorado D
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- Adenosine therapeutic use, Cardiotonic Agents therapeutic use, Clinical Trials as Topic methods, Combined Modality Therapy, Coronary Vessels physiology, Cyclosporine therapeutic use, Enzyme Inhibitors therapeutic use, Humans, Hypothermia, Induced methods, Ischemic Postconditioning methods, Metoprolol therapeutic use, Mitochondrial Membrane Transport Proteins physiology, Mitochondrial Permeability Transition Pore, Myocardial Reperfusion adverse effects, Myocardial Reperfusion Injury etiology, Nitric Oxide metabolism, Nitric Oxide therapeutic use, Nitrites therapeutic use, Nucleotides, Cyclic metabolism, Oligopeptides therapeutic use, Oximes therapeutic use, Patient Selection, Protein Kinase C antagonists & inhibitors, ST Elevation Myocardial Infarction etiology, ST Elevation Myocardial Infarction therapy, Secosteroids therapeutic use, Signal Transduction physiology, Vasodilator Agents therapeutic use, Myocardial Reperfusion Injury prevention & control, ST Elevation Myocardial Infarction complications
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- 2017
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8. Position Paper of the European Society of Cardiology Working Group Cellular Biology of the Heart: cell-based therapies for myocardial repair and regeneration in ischemic heart disease and heart failure.
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Madonna R, Van Laake LW, Davidson SM, Engel FB, Hausenloy DJ, Lecour S, Leor J, Perrino C, Schulz R, Ytrehus K, Landmesser U, Mummery CL, Janssens S, Willerson J, Eschenhagen T, Ferdinandy P, and Sluijter JP
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- Cell Tracking methods, Clinical Trials as Topic, Data Accuracy, Ethics, Medical, Heart Failure physiopathology, Humans, Myocardial Ischemia physiopathology, Patient Safety, Patient Selection, Regeneration physiology, Stem Cell Transplantation methods, Stroke Volume physiology, Treatment Outcome, Cell- and Tissue-Based Therapy methods, Heart physiology, Heart Failure therapy, Myocardial Ischemia therapy
- Abstract
Despite improvements in modern cardiovascular therapy, the morbidity and mortality of ischaemic heart disease (IHD) and heart failure (HF) remain significant in Europe and worldwide. Patients with IHD may benefit from therapies that would accelerate natural processes of postnatal collateral vessel formation and/or muscle regeneration. Here, we discuss the use of cells in the context of heart repair, and the most relevant results and current limitations from clinical trials using cell-based therapies to treat IHD and HF. We identify and discuss promising potential new therapeutic strategies that include ex vivo cell-mediated gene therapy, the use of biomaterials and cell-free therapies aimed at increasing the success rates of therapy for IHD and HF. The overall aim of this Position Paper of the ESC Working Group Cellular Biology of the Heart is to provide recommendations on how to improve the therapeutic application of cell-based therapies for cardiac regeneration and repair., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.)
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- 2016
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9. Effect of remote ischaemic conditioning on clinical outcomes in patients presenting with an ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention.
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Hausenloy DJ, Kharbanda R, Rahbek Schmidt M, Møller UK, Ravkilde J, Okkels Jensen L, Engstrøm T, Garcia Ruiz JM, Radovanovic N, Christensen EF, Sørensen HT, Ramlall M, Bulluck H, Evans R, Nicholas J, Knight R, Clayton T, Yellon DM, and Bøtker HE
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- Adult, Aged, Female, Humans, Male, Middle Aged, Multicenter Studies as Topic methods, Myocardial Reperfusion Injury prevention & control, Randomized Controlled Trials as Topic methods, Treatment Outcome, Young Adult, Ischemic Preconditioning, Myocardial methods, Myocardial Infarction therapy, Percutaneous Coronary Intervention methods
- Abstract
The rationale and study design for the multicentre, randomized, controlled CONDI2/ERIC-PPCI study are discussed.
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- 2015
10. Myocardial reperfusion injury: looking beyond primary PCI.
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Fröhlich GM, Meier P, White SK, Yellon DM, and Hausenloy DJ
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- Animals, Arrhythmias, Cardiac etiology, Atrial Natriuretic Factor therapeutic use, Blood Glucose metabolism, Calcium metabolism, Cardiotonic Agents therapeutic use, Cell Death physiology, Coronary Occlusion etiology, Disease Models, Animal, Hemorrhage etiology, Humans, Hydrogen-Ion Concentration, Hyperbaric Oxygenation methods, Hypothermia, Induced methods, Ischemic Postconditioning methods, Microvessels, Mitochondria, Heart physiology, Mitochondrial Membrane Transport Proteins physiology, Mitochondrial Permeability Transition Pore, Myocardial Contraction physiology, Myocardial Infarction pathology, Myocardial Reperfusion Injury pathology, Myocarditis etiology, Myocytes, Cardiac pathology, Nitric Oxide physiology, Oxidative Stress physiology, Myocardial Infarction therapy, Myocardial Reperfusion Injury prevention & control, Percutaneous Coronary Intervention
- Abstract
Coronary heart disease (CHD) is the leading cause of death and disability in Europe. For patients presenting with an acute ST-segment elevation myocardial infarction (STEMI), timely myocardial reperfusion using either thrombolytic therapy or primary percutaneous coronary intervention (PPCI) is the most effective therapy for limiting myocardial infarct (MI) size, preserving left-ventricular systolic function and reducing the onset of heart failure. Despite this, the morbidity and mortality of STEMI patients remain significant, and novel therapeutic interventions are required to improve clinical outcomes in this patient group. Paradoxically, the process of myocardial reperfusion can itself induce cardiomyocyte death-a phenomenon which has been termed 'myocardial reperfusion injury' (RI), the irreversible consequences of which include microvascular obstruction and myocardial infarction. Unfortunately, there is currently no effective therapy for preventing myocardial RI in STEMI patients making it an important residual target for cardioprotection. Previous attempts to translate cardioprotective therapies (antioxidants, calcium-channel blockers, and anti-inflammatory agents) for reducing RI into the clinic, have been unsuccessful. An improved understanding of the pathophysiological mechanisms underlying RI has resulted in the identification of several promising mechanical (ischaemic post-conditioning, remote ischaemic pre-conditioning, therapeutic hypothermia, and hyperoxaemia), and pharmacological (atrial natriuretic peptide, cyclosporin-A, and exenatide) therapeutic strategies, for preventing myocardial RI, many of which have shown promise in initial proof-of-principle clinical studies. In this article, we review the pathophysiology underlying myocardial RI, and highlight the potential therapeutic interventions which may be used in the future to prevent RI and improve clinical outcomes in patients with CHD.
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- 2013
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11. Taking lizard saliva to heart.
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Hausenloy DJ and Yellon DM
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- Exenatide, Female, Humans, Male, Cardiotonic Agents therapeutic use, Myocardial Infarction therapy, Myocardial Reperfusion Injury prevention & control, Peptides therapeutic use, Venoms therapeutic use
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- 2012
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12. Peri-procedural myocardial injury during percutaneous coronary intervention: an important target for cardioprotection.
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Babu GG, Walker JM, Yellon DM, and Hausenloy DJ
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- Cardiotonic Agents therapeutic use, Coronary Thrombosis etiology, Coronary Vasospasm etiology, Electrocardiography, Heart Injuries diagnosis, Heart Injuries therapy, Humans, Ischemic Preconditioning, Myocardial methods, Magnetic Resonance Angiography, Myocardial Infarction etiology, Myocardial Revascularization adverse effects, Oxidative Stress physiology, Platelet Aggregation physiology, Prognosis, Stents, Angioplasty, Balloon, Coronary adverse effects, Biomarkers metabolism, Coronary Artery Disease therapy, Heart Injuries etiology
- Abstract
Percutaneous coronary intervention (PCI) has become the predominant procedure for coronary revascularization in patients with both stable and unstable coronary artery disease (CAD). Over the past two decades, technical advances in PCI have resulted in a better and safer therapeutic procedure with minimal procedural complications. However, about 30% of patients undergoing elective PCI sustain myocardial injury arising from the procedure itself, the extent of which is significant enough to carry prognostic importance. The peri-procedural injury which accompanies PCI might therefore reduce some of the beneficial effects of coronary revascularization. The availability of more sensitive serum biomarkers of myocardial injury such as creatine phosphokinase MB isoenzyme (CK-MB), Troponin T, and Troponin I has enabled the quantification of previously undetectable myocardial injury. Peri-procedural myocardial injury (PMI) can also be visualized by cardiac magnetic resonance imaging, a technique which allows the detection and quantification of myocardial necrosis following PCI. The identification of CAD patients at greatest risk of sustaining PMI during PCI would allow targeted treatment with novel therapies capable of limiting the extent of PMI or reducing the number of patients experiencing PMI.
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- 2011
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