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1. International longitudinal registry of patients with atrial fibrillation and treated with rivaroxaban: RIVaroxaban Evaluation in Real life setting (RIVER)

Author

Beyer-Westendorf, J., Camm, A. J., Fox, K. A. A., Le Heuzey, J. -Y., Haas, S., Turpie, A. G. G., Virdone, S., Kakkar, A. K., Pieper, K. S., Kayani, G., Gersh, B. J., Hildebrandt, P., Dominguez, H., Comuth, W., Frost, L., Moller, D. S., Christensen, H., Bruun, L. M., Milhem, A., Gauthier, J., Mielot, C., Chanseaume, S., Chopra, S., Amlaiky, A., Tricot, O., Sierra, V., Dompnier, A., Zannad, N., Pinzani, A., Quatre, A., Mansourati, J., Fauchier, L., Badenco, N., Gandjbakhch, E., Chachoua, K. F., Malquarti, V., Pierron, F., Sacher, F., Taieb, J., Davy, J. M., Marijon, E., Lellouche, N., Leenhardt, A., Salem, A., Lesto, I., Muller, J. J., Garcia, R., Neau, J. P., Berneau, J. B., Schon, N., Gulba, D., Appel, K. F., Merke, J., Dshabrailov, J., Bauknecht, C., Scheuermann, O., Schroder, T., Jung, W., Kopf, A., Brachmann, J., Leschke, M., Taggeselle, J., Seige, M., Lassig, T., Appel, S., Schmiedl, M., Muller, K., Heinz, G. U., Axthelm, C., Eberhard, K., Hugl, B., Schwarz, T., Sechtem, U., Falanga, A., Rubino, V., Calo, L., Ageno, W., Massari, F., Imberti, D., Di Gennaro, L., Gaita, F., Margonato, A., Cannava, G., Capasso, F., Diemberger, I., Pelliccia, F., Cafolla, A., Bardari, S., Mattei, L., Ruocco, L., Boriani, G., Poli, D., Testa, S., Indolfi, C., Quintavalla, R., Mos, L., Ladyjanskaia, G., Aksoy, I., Van De Wetering, M., Theunissen, L., Den Hartog, F., Nijmeijer, R., Van De Wal, R., Reinders, S., Patterson, M., Melker, E. D., Troquay, R., Korecki, J., Szyszka, A., Diks, F., Sumis, J., Cygler, J., Miklaszewicz, B., Litwiejko-Pietrynczak, E., Napora, P., Drelich, G., Kawka-Urbanek, T., Wranicz, J. K., Mierzejewski, M., Drzewiecka, A., Wronska, D., Fares, I., Baska, J., Stania, K., Krzyzanowski, W., Miekus, P., Tyminski, M., Dronov, D., Zenin, S., Isaeva, E., Lopukhov, A., Yakusevich, V., Kuznetsov, D., Kameneva, T., Pokushalov, E., Karetnikova, V., Dik, I., Karpushina, I., Nikolin, D., Doletsky, A., Ardashev, A., Timofeeva, A., Miller, O., Lyamina, N., Shubik, Y., Boldueva, S., Blanco Coronado, J. L., Gonzalez Juanatey, C., Otero, E., Alonso, D., Torres Llergo, J., Gonzalez Lama, J., De Prada Tiffe, J. A. V., Garcia Seara, F. J., Gomez Doblas, J. J., Riancho, J. A., Clua-Espuny, J. L., Motero, J., Arrarte, V. I., Martin Raymondi, D., Isasti Aizpurua, G., Marin, F., Nieto, J. A., Fernandez Portales, J., Alvarez Garcia, P., Torstensson, I., Cederin, B., Kalm, T., Rosenqvist, U., Thulin, J., Hajimirsadeghi, A., Crisby, M., Manoj, A., Bakhai, A., Mistri, A., Krishnan, M., Kumar, S., Kirubakaran, S., Thomas, H., Camm, J., Ahmed, F., Ross, A. M., Barry, K., Stockwell, R., Broadley, A., Mamun, M., Chatterjee, K., Cooke, J., Mccready, J., Dutta, D., John, K., Pandya, P., Howlett, R., Vinson, P., Lim, Foley, P., Bruce, D., Dixit, A., Broughton, D., Taylor, J., Schilling, R., Leon, K., Saeed, K., Shaheen, S., Tawfik, M., Mortadda, A., Seleem, M., Aly, M. S. I., Kazamel, G., Elbadry, M., Kamal, S., Hassan, M., Mostafa, M., Medhat, M. E. S., Ekhlas, Ghaleb, R., Taha, M. O., Daoud, I., Al Din, H., Imam, A. M., El Hameed, M. A., Helmy, Al-Murayeh, M., Akhtar, N., Matto, B. M., Ghani, M. A., Amoudi, O. A., Morsy, M. M., Bashir, A. A. F., Al Hossni, Y. M., Al Ghamdi, B., Zia-Ul-Sabah, Mir, S., Dardir, D., Masswary, A., Al Shehri, A. R., Iqbal, J., Almansori, M. A. J., Venkitachalam, C. G., Kurian, J., Rao, J., Aisheh, A., Albawab, A. A., Subbaraman, B., Amanat, A., Esfehani, K. J., Lochan, R., Bin Brek, A., Mittal, B., Ghazi, Y., Krishna, M., Tabatabaei, S. B., Thoppil, P. S., Nasim, S., El Khider Nour, S., Barros, P., Almeida, A. P., Andrade, M., Garbelini, B., Silvestrini, T. L., Alves, A. R., De Lima, C. E. B., Kormann, A., De Lima, G. G., Halperin, C., Salvadori Junior, D., Freitas, A. F., Gemelli, J. R., Ornelas, C. E., Dantas, J. M. M., Aziz, J. L., Backes, L. M., Barroso, W. S., Paiva, M. S., De Figueiredo Neto, J. A., Dos Santos, F. R., De Lima Neto, J. A., Bergo, R., Salvador Junior, P. R., Lopez, A. G., Alva, J. C. P., Gamba, M. A. A., Padilla-Padilla, F. G., Ruiz, A. E. B., Berlingieri, J., Bakbak, A., Gupta, M., Saunders, K., Costa-Vitali, A., Beaudry, P. R., Bhargava, R., Khaykin, Y., Healey, J. S., Crystal, E., Nadeau, Dhillon, Begg, A., Anderson, C., Baveja, S., Cross, D., Catanchin, A., Brieger, D., Lim, K. T., Davidson, P., Tan, R., Bhindi, R., Hickey, J., Layland, J., Bloch, M., Itty, C., Singh, B., Carroll, P., Lee, A., Starmer, G., Lehman, R., Universidad de Cantabria, Beyer-Westendorf J., Camm A.J., Fox K.A.A., Le Heuzey J.-Y., Haas S., Turpie A.G.G., Virdone S., Kakkar A.K., RIVER Registry Investigators: [..], A. Falanga, V. Rubino, L. Calo, W. Ageno, F. Massari, D. Imberti, L. Di Gennaro, F. Gaita, A. Margonato, G. Cannava, F. Capasso, I. Diemberger, F. Pelliccia, A. Cafolla, S. Bardari, L. Mattei, L. Ruocco, G. Boriani, D. Poli, S. Testa, C. Indolfi, R. Quintavalla, L. Mo, .., Beyer-Westendorf, J, Camm, A, Fox, K, Le Heuzey, J, Haas, S, Turpie, A, Virdone, S, Kakkar, A, Pieper, K, Kayani, G, Gersh, B, Hildebrandt, P, Dominguez, H, Comuth, W, Frost, L, Moller, D, Christensen, H, Bruun, L, Milhem, A, Gauthier, J, Mielot, C, Chanseaume, S, Chopra, S, Amlaiky, A, Tricot, O, Sierra, V, Dompnier, A, Zannad, N, Pinzani, A, Quatre, A, Mansourati, J, Fauchier, L, Badenco, N, Gandjbakhch, E, Chachoua, K, Malquarti, V, Pierron, F, Sacher, F, Taieb, J, Davy, J, Marijon, E, Lellouche, N, Leenhardt, A, Salem, A, Lesto, I, Muller, J, Garcia, R, Neau, J, Berneau, J, Schon, N, Gulba, D, Appel, K, Merke, J, Dshabrailov, J, Bauknecht, C, Scheuermann, O, Schroder, T, Jung, W, Kopf, A, Brachmann, J, Leschke, M, Taggeselle, J, Seige, M, Lassig, T, Appel, S, Schmiedl, M, Muller, K, Heinz, G, Axthelm, C, Eberhard, K, Hugl, B, Schwarz, T, Sechtem, U, Falanga, A, Rubino, V, Calo, L, Ageno, W, Massari, F, Imberti, D, Di Gennaro, L, Gaita, F, Margonato, A, Cannava, G, Capasso, F, Diemberger, I, Pelliccia, F, Cafolla, A, Bardari, S, Mattei, L, Ruocco, L, Boriani, G, Poli, D, Testa, S, Indolfi, C, Quintavalla, R, Mos, L, Ladyjanskaia, G, Aksoy, I, Van De Wetering, M, Theunissen, L, Den Hartog, F, Nijmeijer, R, Van De Wal, R, Reinders, S, Patterson, M, Melker, E, Troquay, R, Korecki, J, Szyszka, A, Diks, F, Sumis, J, Cygler, J, Miklaszewicz, B, Litwiejko-Pietrynczak, E, Napora, P, Drelich, G, Kawka-Urbanek, T, Wranicz, J, Mierzejewski, M, Drzewiecka, A, Wronska, D, Fares, I, Baska, J, Stania, K, Krzyzanowski, W, Miekus, P, Tyminski, M, Dronov, D, Zenin, S, Isaeva, E, Lopukhov, A, Yakusevich, V, Kuznetsov, D, Kameneva, T, Pokushalov, E, Karetnikova, V, Dik, I, Karpushina, I, Nikolin, D, Doletsky, A, Ardashev, A, Timofeeva, A, Miller, O, Lyamina, N, Shubik, Y, Boldueva, S, Blanco Coronado, J, Gonzalez Juanatey, C, Otero, E, Alonso, D, Torres Llergo, J, Gonzalez Lama, J, De Prada Tiffe, J, Garcia Seara, F, Gomez Doblas, J, Riancho, J, Clua-Espuny, J, Motero, J, Arrarte, V, Martin Raymondi, D, Isasti Aizpurua, G, Marin, F, Nieto, J, Fernandez Portales, J, Alvarez Garcia, P, Torstensson, I, Cederin, B, Kalm, T, Rosenqvist, U, Thulin, J, Hajimirsadeghi, A, Crisby, M, Manoj, A, Bakhai, A, Mistri, A, Krishnan, M, Kumar, S, Kirubakaran, S, Thomas, H, Camm, J, Ahmed, F, Ross, A, Barry, K, Stockwell, R, Broadley, A, Mamun, M, Chatterjee, K, Cooke, J, Mccready, J, Dutta, D, John, K, Pandya, P, Howlett, R, Vinson, P, Lim, Foley, P, Bruce, D, Dixit, A, Broughton, D, Taylor, J, Schilling, R, Leon, K, Saeed, K, Shaheen, S, Tawfik, M, Mortadda, A, Seleem, M, Aly, M, Kazamel, G, Elbadry, M, Kamal, S, Hassan, M, Mostafa, M, Medhat, M, Ekhlas, Ghaleb, R, Taha, M, Daoud, I, Al Din, H, Imam, A, El Hameed, M, Helmy, Al-Murayeh, M, Akhtar, N, Matto, B, Ghani, M, Amoudi, O, Morsy, M, Bashir, A, Al Hossni, Y, Al Ghamdi, B, Zia-Ul-Sabah, Mir, S, Dardir, D, Masswary, A, Al Shehri, A, Iqbal, J, Almansori, M, Venkitachalam, C, Kurian, J, Rao, J, Aisheh, A, Albawab, A, Subbaraman, B, Amanat, A, Esfehani, K, Lochan, R, Bin Brek, A, Mittal, B, Ghazi, Y, Krishna, M, Tabatabaei, S, Thoppil, P, Nasim, S, El Khider Nour, S, Barros, P, Almeida, A, Andrade, M, Garbelini, B, Silvestrini, T, Alves, A, De Lima, C, Kormann, A, De Lima, G, Halperin, C, Salvadori Junior, D, Freitas, A, Gemelli, J, Ornelas, C, Dantas, J, Aziz, J, Backes, L, Barroso, W, Paiva, M, De Figueiredo Neto, J, Dos Santos, F, De Lima Neto, J, Bergo, R, Salvador Junior, P, Lopez, A, Alva, J, Gamba, M, Padilla-Padilla, F, Ruiz, A, Berlingieri, J, Bakbak, A, Gupta, M, Saunders, K, Costa-Vitali, A, Beaudry, P, Bhargava, R, Khaykin, Y, Healey, J, Crystal, E, Nadeau, D, Begg, A, Anderson, C, Baveja, S, Cross, D, Catanchin, A, Brieger, D, Lim, K, Davidson, P, Tan, R, Bhindi, R, Hickey, J, Layland, J, Bloch, M, Itty, C, Singh, B, Carroll, P, Lee, A, Starmer, G, Lehman, R, Beyer-Westendorf, J., Camm, A. J., Fox, K. A. A., Le Heuzey, J. -Y., Haas, S., Turpie, A. G. G., Virdone, S., Kakkar, A. K., Pieper, K. S., Kayani, G., Gersh, B. J., Hildebrandt, P., Dominguez, H., Comuth, W., Frost, L., Moller, D. S., Christensen, H., Bruun, L. M., Milhem, A., Gauthier, J., Mielot, C., Chanseaume, S., Chopra, S., Amlaiky, A., Tricot, O., Sierra, V., Dompnier, A., Zannad, N., Pinzani, A., Quatre, A., Mansourati, J., Fauchier, L., Badenco, N., Gandjbakhch, E., Chachoua, K. F., Malquarti, V., Pierron, F., Sacher, F., Taieb, J., Davy, J. M., Marijon, E., Lellouche, N., Leenhardt, A., Salem, A., Lesto, I., Muller, J. J., Garcia, R., Neau, J. P., Berneau, J. B., Schon, N., Gulba, D., Appel, K. F., Merke, J., Dshabrailov, J., Bauknecht, C., Scheuermann, O., Schroder, T., Jung, W., Kopf, A., Brachmann, J., Leschke, M., Taggeselle, J., Seige, M., Lassig, T., Appel, S., Schmiedl, M., Muller, K., Heinz, G. U., Axthelm, C., Eberhard, K., Hugl, B., Schwarz, T., Sechtem, U., Falanga, A., Rubino, V., Calo, L., Ageno, W., Massari, F., Imberti, D., Di Gennaro, L., Gaita, F., Margonato, A., Cannava, G., Capasso, F., Diemberger, I., Pelliccia, F., Cafolla, A., Bardari, S., Mattei, L., Ruocco, L., Boriani, G., Poli, D., Testa, S., Indolfi, C., Quintavalla, R., Mos, L., Ladyjanskaia, G., Aksoy, I., Van De Wetering, M., Theunissen, L., Den Hartog, F., Nijmeijer, R., Van De Wal, R., Reinders, S., Patterson, M., Melker, E. D., Troquay, R., Korecki, J., Szyszka, A., Diks, F., Sumis, J., Cygler, J., Miklaszewicz, B., Litwiejko-Pietrynczak, E., Napora, P., Drelich, G., Kawka-Urbanek, T., Wranicz, J. K., Mierzejewski, M., Drzewiecka, A., Wronska, D., Fares, I., Baska, J., Stania, K., Krzyzanowski, W., Miekus, P., Tyminski, M., Dronov, D., Zenin, S., Isaeva, E., Lopukhov, A., Yakusevich, V., Kuznetsov, D., Kameneva, T., Pokushalov, E., Karetnikova, V., Dik, I., Karpushina, I., Nikolin, D., Doletsky, A., Ardashev, A., Timofeeva, A., Miller, O., Lyamina, N., Shubik, Y., Boldueva, S., Blanco Coronado, J. L., Gonzalez Juanatey, C., Otero, E., Alonso, D., Torres Llergo, J., Gonzalez Lama, J., De Prada Tiffe, J. A. V., Garcia Seara, F. J., Gomez Doblas, J. J., Riancho, J. A., Clua-Espuny, J. L., Motero, J., Arrarte, V. I., Martin Raymondi, D., Isasti Aizpurua, G., Marin, F., Nieto, J. A., Fernandez Portales, J., Alvarez Garcia, P., Torstensson, I., Cederin, B., Kalm, T., Rosenqvist, U., Thulin, J., Hajimirsadeghi, A., Crisby, M., Manoj, A., Bakhai, A., Mistri, A., Krishnan, M., Kumar, S., Kirubakaran, S., Thomas, H., Camm, J., Ahmed, F., Ross, A. M., Barry, K., Stockwell, R., Broadley, A., Mamun, M., Chatterjee, K., Cooke, J., Mccready, J., Dutta, D., John, K., Pandya, P., Howlett, R., Vinson, P., Foley, P., Bruce, D., Dixit, A., Broughton, D., Taylor, J., Schilling, R., Leon, K., Saeed, K., Shaheen, S., Tawfik, M., Mortadda, A., Seleem, M., Aly, M. S. I., Kazamel, G., Elbadry, M., Kamal, S., Hassan, M., Mostafa, M., Medhat, M. E. S., Ghaleb, R., Taha, M. O., Daoud, I., Al Din, H., Imam, A. M., El Hameed, M. A., Al-Murayeh, M., Akhtar, N., Matto, B. M., Ghani, M. A., Amoudi, O. A., Morsy, M. M., Bashir, A. A. F., Al Hossni, Y. M., Al Ghamdi, B., Mir, S., Dardir, D., Masswary, A., Al Shehri, A. R., Iqbal, J., Almansori, M. A. J., Venkitachalam, C. G., Kurian, J., Rao, J., Aisheh, A., Albawab, A. A., Subbaraman, B., Amanat, A., Esfehani, K. J., Lochan, R., Bin Brek, A., Mittal, B., Ghazi, Y., Krishna, M., Tabatabaei, S. B., Thoppil, P. S., Nasim, S., El Khider Nour, S., Barros, P., Almeida, A. P., Andrade, M., Garbelini, B., Silvestrini, T. L., Alves, A. R., De Lima, C. E. B., Kormann, A., De Lima, G. G., Halperin, C., Salvadori Junior, D., Freitas, A. F., Gemelli, J. R., Ornelas, C. E., Dantas, J. M. M., Aziz, J. L., Backes, L. M., Barroso, W. S., Paiva, M. S., De Figueiredo Neto, J. A., Dos Santos, F. R., De Lima Neto, J. A., Bergo, R., Salvador Junior, P. R., Lopez, A. G., Alva, J. C. P., Gamba, M. A. A., Padilla-Padilla, F. G., Ruiz, A. E. B., Berlingieri, J., Bakbak, A., Gupta, M., Saunders, K., Costa-Vitali, A., Beaudry, P. R., Bhargava, R., Khaykin, Y., Healey, J. S., Crystal, E., Nadeau, Dhillon, Begg, A., Anderson, C., Baveja, S., Cross, D., Catanchin, A., Brieger, D., Lim, K. T., Davidson, P., Tan, R., Bhindi, R., Hickey, J., Layland, J., Bloch, M., Itty, C., Singh, B., Carroll, P., Lee, A., Starmer, G., and Lehman, R.

Subjects
medicine.medical_specialty, Registry, medicine.drug_class, Population, Thromboembolic stroke, Outcomes, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Antithrombotic, Rivaroxaban, Anticoagulant, Atrial fibrillation, medicine, 030212 general & internal medicine, Risk factor, education, Stroke, Outcome, education.field_of_study, business.industry, lcsh:RC633-647.5, Research, Hematology, lcsh:Diseases of the blood and blood-forming organs, medicine.disease, ddc, Clinical trial, Emergency medicine, business, medicine.drug
Abstract

Background: Real-world data on non-vitamin K oral anticoagulants (NOACs) are essential in determining whether evidence from randomised controlled clinical trials translate into meaningful clinical benefits for patients in everyday practice. RIVER (RIVaroxaban Evaluation in Real life setting) is an ongoing international, prospective registry of patients with newly diagnosed non-valvular atrial fibrillation (NVAF) and at least one investigator-determined risk factor for stroke who received rivaroxaban as an initial treatment for the prevention of thromboembolic stroke. The aim of this paper is to describe the design of the RIVER registry and baseline characteristics of patients with newly diagnosed NVAF who received rivaroxaban as an initial treatment. Methods and results: Between January 2014 and June 2017, RIVER investigators recruited 5072 patients at 309 centres in 17 countries. The aim was to enroll consecutive patients at sites where rivaroxaban was already routinely prescribed for stroke prevention. Each patient is being followed up prospectively for a minimum of 2-years. The registry will capture data on the rate and nature of all thromboembolic events (stroke / systemic embolism), bleeding complications, all-cause mortality and other major cardiovascular events as they occur. Data quality is assured through a combination of remote electronic monitoring and onsite monitoring (including source data verification in 10% of cases). Patients were mostly enrolled by cardiologists (n = 3776, 74.6%), by internal medicine specialists 14.2% (n = 718) and by primary care/general practice physicians 8.2% (n = 417). The mean (SD) age of the population was 69.5 (11.0) years, 44.3% were women. Mean (SD) CHADS2 score was 1.9 (1.2) and CHA2DS2-VASc scores was 3.2 (1.6). Almost all patients (98.5%) were prescribed with once daily dose of rivaroxaban, most commonly 20 mg (76.5%) and 15 mg (20.0%) as their initial treatment; 17.9% of patients received concomitant antiplatelet therapy. Most patients enrolled in RIVER met the recommended threshold for AC therapy (86.6% for 2012 ESC Guidelines, and 79.8% of patients according to 2016 ESC Guidelines). Conclusions: The RIVER prospective registry will expand our knowledge of how rivaroxaban is prescribed in everyday practice and whether evidence from clinical trials can be translated to the broader cross-section of patients in the real world. Funding: This work is supported by an unrestricted research grant from Bayer AG (Berlin, Germany) to the Thrombosis Research Institute (London, UK), which sponsors the RIVER registry. The funding source had no involvement in the data collection, data analysis or data interpretation.

Published
2019

3. Poster Session Saturday 14 December - AM: 14/12/2013 08:30-12:30 * Location: Poster area

Author

Muraru, D., Addetia, K., Veronesi, F., Corsi, C., Mor-Avi, V., Yamat, M., Weinert, L., Lang, R., Badano, L., Faita, F., Di Lascio, N., Bruno, R., Bianchini, E., Ghiadoni, L., Sicari, R., Gemignani, V., Angelis, A., Ageli, K., Ioakimidis, N., Chrysohoou, C., Agelakas, A., Felekos, I., Vaina, S., Aznaourides, K., Vlachopoulos, C., Stefanadis, C., Nemes, A., Szolnoky, G., Gavaller, H., Gonczy, A., Kemeny, L., Forster, T., Ramalho, A., Placido, R., Marta, L., Menezes, M., Magalhaes, A., Cortez Dias, N., Martins, S., Almeida, A., Pinto, F., Nunes Diogo, A., Botezatu, C.-D., Enache, R., Popescu, B., Nastase, O., Coman, M., Ghiorghiu, I., Calin, A., Rosca, M., Beladan, C., Ginghina, C., Grapsa, J., Cabrita, I., Durighel, G., O'regan, D., Dawson, D., Nihoyannopoulos, P., Pellicori, P., Kallvikbacka-Bennett, A., Zhang, J., Lukaschuk, E., Joseph, A., Bourantas, C., Loh, H., Bragadeesh, T., Clark, A., Cleland, J., Lomax, S., Putzu, P., Diercx, R., Parsons, S., Dicken, B., Vered, Z., Adirevitz, L., Dragu, R., Blatt, A., Karev, E., Malca, Y., Roytvarf, A., Marek, D., Sovova, E., Berkova, M., Cihalik, C., Taborsky, M., Lindqvist, P., Tossavainen, E., Soderberg, S., Gonzales, M., Gustavsson, S., Henein, M., Sonne, C., Bott-Fluegel, L., Hauck, S., Lesevic, H., Hadamitzky, M., Wolf, P., Kolb, C., Bandera, F., Pellegrino, M., Generati, G., Donghi, V., Alfonzetti, E., Castelvecchio, S., Menicanti, L., Guazzi, M., Buchyte, S., Rinkuniene, D., Jurkevicius, R., Smarz, K., Zaborska, B., Jaxa-Chamiec, T., Maciejewski, P., Budaj, A., Santoro, A., Federico Alvino, F., Giovanni Antonelli, G., Roberta Molle, R., Matteo Bertini, M., Stefano Lunghetti, S., Sergio Mondillo, S., Henri, C., Magne, J., Dulgheru, R., Laaraibi, S., Voilliot, D., Kou, S., Pierard, L., Lancellotti, P., Szulik, M., Stabryla-Deska, J., Kalinowski, M., Sliwinska, A., Szymala, M., Lenarczyk, R., Kalarus, Z., Kukulski, T., Yiangou, K., Azina, C., Yiangou, A., Ioannides, M., Chimonides, S., Baysal, S., Pirat, B., Okyay, K., Bal, U., Muderrisoglu, H., Popovic, D., Ostojic, M., Petrovic, M., Vujisic-Tesic, B., Arandjelovic, A., Petrovic, I., Banovic, M., Popovic, B., Vukcevic, V., Damjanovic, S., Velasco Del Castillo, S., Onaindia Gandarias, J., Arana Achaga, X., Laraudogoitia Zaldumbide, E., Rodriguez Sanchez, I., Cacicedo De Bobadilla, A., Romero Pereiro, A., Aguirre Larracoechea, U., Salinas, T., Subinas, A., Elzbieciak, M., Wita, K., Grabka, M., Chmurawa, J., Doruchowska, A., Turski, M., Filipecki, A., Wybraniec, M., Mizia-Stec, K., Varho, V., Karjalainen, P., Lehtinen, T., Airaksinen, J., Ylitalo, A., Kiviniemi, T., Gargiulo, P., Galderisi, M., D' Amore, C., Lo Iudice, F., Savarese, G., Casaretti, L., Pellegrino, A., Fabiani, I., La Mura, L., Perrone Filardi, P., Kim, J. Y., Chung, W., Yu, J., Choi, Y., Park, C., Youn, H., Lee, M., Nagy, A., Manouras, A., Gunyeli, E., Gustafsson, U., Shahgaldi, K., Winter, R., Johnsson, J., Zagatina, A., Krylova, L., Zhuravskaya, N., Vareldzyan, Y., Tyurina, T., Clitsenko, O., Khalifa, E. A., Ashour, Z., Elnagar, W., Jung, I., Seo, H., Lee, S., Lim, D., Mizariene, V., Verseckaite, R., Janenaite, J., Jonkaitiene, R., Sanchez Espino, A., Bonaque Gonzalez, J., Merchan Ortega, G., Bolivar Herrera, N., Ikuta, I., Macancela Quinones, J., Gomez Recio, M., Silva Fazendas Adame, P. R., Caldeira, D., Stuart, B., Almeida, S., Cruz, I., Ferreira, A., Freire, G., Lopes, L., Cotrim, C., Pereira, H., Mediratta, A., Moss, J., Nayak, H., Al Amri, I., Debonnaire, P., Van Der Kley, F., Schalij, M., Bax, J., Ajmone Marsan, N., Delgado, V., Schmidt, F. P., Gniewosz, T., Jabs, A., Munzel, T., Jansen, T., Kaempfner, D., Hink, U., Von Bardeleben, R., Jose, J., George, O., Joseph, G., Adawi, S., Najjar, R., Ahronson, D., Shiran, A., Van Riel, A., Boerlage - Van Dijk, K., De Bruin - Bon, H., Araki, M., Meregalli, P., Koch, K., Vis, M., Mulder, B., Baan, J., Bouma, B., Marciniak, A., Elton, D., Glover, K., Campbell, I., Sharma, R., Batalha, S., Lourenco, C., Oliveira Da Silva, C., Caballero, L., Garcia-Lara, J., Gonzalez-Carrillo, J., Oliva, M., Saura, D., Garcia-Navarro, M., Espinosa, M., Pinar, E., Valdes, M., De La Morena, G., Barreiro Perez, M., Lopez Perez, M., Roy, D., Brecker, S., Venkateshvaran, A., Dash, P. K., Sola, S., Barooah, B., Govind, S. C., Brodin, L. A., Saura Espin, D., Caballero Jimenez, L., Gonzalez Carrillo, J., Oliva Sandoval, M., Lopez Ruiz, M., Garcia Navarro, M., Espinosa Garcia, M., Valdes Chavarri, M., De La Morena Valenzuela, G., Gatti, G., Dell'angela, L., Pinamonti, B., Benussi, B., Sinagra, G., Pappalardo, A., Hernandez, V., Saavedra, J., Gonzalez, A., Iglesias, P., Civantos, S., Guijarro, G., Monereo, S., Ikeda, M., Toh, N., Oe, H., Tanabe, Y., Watanabe, N., Ito, H., Ciampi, Q., Cortigiani, L., Pratali, L., Rigo, F., Villari, B., Picano, E., Yoon, J., Sohn, J., Kim, Y., Chang, H., Hong, G., Kim, T., Ha, J., Choi, B., Rim, S., Choi, E., Tibazarwa, K., Sliwa, K., Wonkam, A., Mayosi, B., Oryshchyn, N., Ivaniv, Y., Pavlyk, S., Lourenco, M. R., Azevedo, O., Moutinho, J., Nogueira, I., Fernandes, M., Pereira, V., Quelhas, I., Lourenco, A., Sunbul, M., Tigen, K., Karaahmet, T., Dundar, C., Ozben, B., Guler, A., Cincin, A., Bulut, M., Sari, I., Basaran, Y., Baydar, O., Kadriye Kilickesmez, K., Ugur Coskun, U., Polat Canbolat, P., Veysel Oktay, V., Umit Yasar Sinan, U., Okay Abaci, O., Cuneyt Kocas, C., Sinan Uner, S., Serdar Kucukoglu, S., Zaroui, A., Mourali, M., Ben Said, R., Asmi, M., Aloui, H., Kaabachi, N., Mechmeche, R., Saberniak, J., Hasselberg, N., Borgquist, R., Platonov, P., Holst, A., Edvardsen, T., Haugaa, K., Eran, A., Yueksel, D., Er, F., Gassanov, N., Rosenkranz, S., Baldus, S., Guedelhoefer, H., Faust, M., Caglayan, E., Matveeva, N., Nartsissova, G., Chernjavskij, A., Ippolito, R., De Palma, D., Muscariello, R., Santoro, C., Raia, R., Schiano-Lomoriello, V., Gargiulo, F., Lipari, P., Bonapace, S., Zenari, L., Valbusa, F., Rossi, A., Lanzoni, L., Canali, G., Molon, G., Campopiano, E., Barbieri, E., Ikonomidis, I., Varoudi, M., Papadavid, E., Theodoropoulos, K., Papadakis, I., Pavlidis, G., Triantafyllidi, H., Anastasiou - Nana, M., Rigopoulos, D., Lekakis, J., Ozen, G., Durmus, E., Kivrak, T., Atas, H., Direskeneli, H., Stevanovic, A., Dekleva, M., Trajic, S., Paunovic, N., Simic, A., Khan, S., Mushemi-Blake, S., Jouhra, F., Dennes, W., Monaghan, M., Melikian, N., Shah, A., Maceira Gonzalez, A. M., Lopez-Lereu, M., Monmeneu, J., Igual, B., Estornell, J., Boraita, A., Kosmala, W., Rojek, A., Bialy, D., Mysiak, A., Przewlocka-Kosmala, M., Popescu, I., Mancas, S., Mornos, C., Serbescu, I., Ionescu, G., Ionac, A., Gaudron, P., Niemann, M., Herrmann, S., Hu, K., Liu, D., Wojciech, K., Frantz, S., Bijnens, B., Ertl, G., Weidemann, F., Cosin-Sales, J., Ruvira, J., Diago, J., Aguilar, J., Cruz, C., Pinho, T., Madureira, A., Lebreiro, A., Dias, C., Ramos, I., Silva Cardoso, J., Julia Maciel, M., De Meester, P., Van De Bruaene, A., Herijgers, P., Voigt, J.-U., Budts, W., Franzoso, F., Voser, E., Wohlmut, C., Kellenberger, C., Valsangiacomo Buechel, E., Carrero, C., Benger, J., Parcerisa, M., Falconi, M., Oberti, P., Granja, M., Cagide, A., Del Pasqua, A., Secinaro, A., Antonelli, G., Iacomino, M., Toscano, A., Chinali, M., Esposito, C., Carotti, A., Pongiglione, G., Rinelli, G., Youssef Moustafa, A., Al Murayeh, M., Al Masswary, A., Al Sheikh, K., Moselhy, M., Dardir, M., Deising, J., Butz, T., Suermeci, G., Liebeton, J., Wennemann, R., Tzikas, S., Van Bracht, M., Prull, M., Trappe, H.-J., Martin Hidalgo, M., Delgado Ortega, M., Ruiz Ortiz, M., Mesa Rubio, D., Carrasco Avalos, F., Seoane Garcia, T., Pan Alvarez-Ossorio, M., Lopez Aguilera, J., Puentes Chiachio, M., Suarez De Lezo Cruz Conde, J., Petrovic, M. T., Giga, V., Stepanovic, J., Tesic, M., Jovanovic, I., Djordjevic-Dikic, A., Piatkowski, R., Kochanowski, J., Scislo, P., Opolski, G., Vareldzhyan, Y., Bombardini, T., Gherardi, S., Leone, O., Michelotto, E., Ciccarone, A., Tarantino, N., Ostuni, V., Rubino, M., Genco, W., Santoro, G., Carretta, D., Romito, R., Colonna, P., Cameli, M., Lunghetti, S., Lisi, M., Curci, V., Cameli, P., Focardi, M., Favilli, R., Mondillo, S., Hoffmann, R., Barletta, G., Von Bardeleben, S., Kasprzak, J., Greis, C., Vanoverschelde, J., Becher, H., Machida, T., Izumo, M., Suzuki, K., Kaimijima, R., Mizukoshi, K., Manabe-Uematsu, M., Takai, M., Harada, T., Akashi, Y., Martin Garcia, A., Arribas-Jimenez, A., Cruz-Gonzalez, I., Nieto, F., Iscar, A., Merchan, S., Martin-Luengo, C., Brecht, A., Theres, L., Spethmann, S., Dreger, H., Baumann, G., Knebel, F., Jasaityte, R., Heyde, B., Rademakers, F., Claus, P., D'hooge, J., Lervik Nilsen, L. C., Lund, J., Brekke, B., Stoylen, A., Giraldeau, G., Duchateau, N., Gabrielli, L., Penela, D., Evertz, R., Mont, L., Brugada, J., Berruezo, A., Sitges, M., Kordybach, M., Kowalski, M., Hoffman, P., Pilichowska, E., Baran, J., Kulakowski, P., Wahi, S., Vollbon, W., Leano, R., Thomas, A., Bricknell, K., Holland, D., Napier, S., Stanton, T., Teferici, D., Qirko, S., Petrela, E., Dibra, A., Bajraktari, G., Bara, P., Sanchis Ruiz, L., Andrea, R., Falces, C., Perez-Villa, F., Sulemane, S., Panoulas, V., Bratsas, A., Tam, F., Abduch, M., Alencar, A., Coracin, F., Barban, A., Saboya, R., Dulley, F., Mathias, W., Vieira, M., Buccheri, S., Mangiafico, S., Arcidiacono, A., Bottari, V., Leggio, S., Tamburino, C., Monte, I. P., Spitzer, E., Beitzke, D., Kaneider, A., Pavo, N., Gottsauner-Wolf, M., Wolf, F., Loewe, C., Mushtaq, S., Andreini, D., Pontone, G., Bertella, E., Conte, E., Baggiano, A., Annoni, A., Cortinovis, S., Fiorentini, C., Pepi, M., Gustafsson, M., Alehagen, U., Dahlstrom, U., Johansson, P., Faden, G., Faggiano, P., Albertini, L., Reverberi, C., Gaibazzi, N., Taylor, R. J., Moody, W., Umar, F., Edwards, N., Townend, J., Steeds, R., Leyva, F., Mihaila, S., Piasentini, E., Peluso, D., Casablanca, S., Naso, P., Puma, L., Iliceto, S., Vinereanu, D., Ciciarello, F. L., Agati, L., Cimino, S., De Luca, L., Petronilli, V., Fedele, F., and Tsverava, M.

Subjects
medicine.medical_specialty, Bundle branch block, business.industry, Left bundle branch block, Speckle tracking echocardiography, General Medicine, 030204 cardiovascular system & hematology, medicine.disease, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, Radial function, Ventricle, Internal medicine, Cardiology, medicine, Radiology, Nuclear Medicine and imaging, In patient, Cardiology and Cardiovascular Medicine, business
Published
2013
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4. Left atrial function measured by cardiac magnetic resonance in patients with heart failure: clinical associations and prognostic value

Author

Muraru, D., Addetia, K., Veronesi, F., Corsi, C., Mor-Avi, V., Yamat, M., Weinert, L., Lang, R., Badano, L., Faita, F., Di Lascio, N., Bruno, R., Bianchini, E., Ghiadoni, L., Sicari, R., Gemignani, V., Angelis, A., Ageli, K., Ioakimidis, N., Chrysohoou, C., Agelakas, A., Felekos, I., Vaina, S., Aznaourides, K., Vlachopoulos, C., Stefanadis, C., Nemes, A., Szolnoky, G., Gavaller, H., Gonczy, A., Kemeny, L., Forster, T., Ramalho, A., Placido, R., Marta, L., Menezes, M., Magalhaes, A., Cortez Dias, N., Martins, S., Almeida, A., Pinto, F., Nunes Diogo, A., Botezatu, C.-D., Enache, R., Popescu, B., Nastase, O., Coman, M., Ghiorghiu, I., Calin, A., Rosca, M., Beladan, C., Ginghina, C., Grapsa, J., Cabrita, I., Durighel, G., O'regan, D., Dawson, D., Nihoyannopoulos, P., Pellicori, P., Kallvikbacka-Bennett, A., Zhang, J., Lukaschuk, E., Joseph, A., Bourantas, C., Loh, H., Bragadeesh, T., Clark, A., Cleland, J., Lomax, S., Putzu, P., Diercx, R., Parsons, S., Dicken, B., Vered, Z., Adirevitz, L., Dragu, R., Blatt, A., Karev, E., Malca, Y., Roytvarf, A., Marek, D., Sovova, E., Berkova, M., Cihalik, C., Taborsky, M., Lindqvist, P., Tossavainen, E., Soderberg, S., Gonzales, M., Gustavsson, S., Henein, M., Sonne, C., Bott-Fluegel, L., Hauck, S., Lesevic, H., Hadamitzky, M., Wolf, P., Kolb, C., Bandera, F., Pellegrino, M., Generati, G., Donghi, V., Alfonzetti, E., Castelvecchio, S., Menicanti, L., Guazzi, M., Buchyte, S., Rinkuniene, D., Jurkevicius, R., Smarz, K., Zaborska, B., Jaxa-Chamiec, T., Maciejewski, P., Budaj, A., Santoro, A., Federico Alvino, F., Giovanni Antonelli, G., Roberta Molle, R., Matteo Bertini, M., Stefano Lunghetti, S., Sergio Mondillo, S., Henri, C., Magne, J., Dulgheru, R., Laaraibi, S., Voilliot, D., Kou, S., Pierard, L., Lancellotti, P., Szulik, M., Stabryla-Deska, J., Kalinowski, M., Sliwinska, A., Szymala, M., Lenarczyk, R., Kalarus, Z., Kukulski, T., Yiangou, K., Azina, C., Yiangou, A., Ioannides, M., Chimonides, S., Baysal, S., Pirat, B., Okyay, K., Bal, U., Muderrisoglu, H., Popovic, D., Ostojic, M., Petrovic, M., Vujisic-Tesic, B., Arandjelovic, A., Petrovic, I., Banovic, M., Popovic, B., Vukcevic, V., Damjanovic, S., Velasco Del Castillo, S., Onaindia Gandarias, J., Arana Achaga, X., Laraudogoitia Zaldumbide, E., Rodriguez Sanchez, I., Cacicedo De Bobadilla, A., Romero Pereiro, A., Aguirre Larracoechea, U., Salinas, T., Subinas, A., Elzbieciak, M., Wita, K., Grabka, M., Chmurawa, J., Doruchowska, A., Turski, M., Filipecki, A., Wybraniec, M., Mizia-Stec, K., Varho, V., Karjalainen, P., Lehtinen, T., Airaksinen, J., Ylitalo, A., Kiviniemi, T., Gargiulo, P., Galderisi, M., D' Amore, C., Lo Iudice, F., Savarese, G., Casaretti, L., Pellegrino, A., Fabiani, I., La Mura, L., Perrone Filardi, P., Kim, J. Y., Chung, W., Yu, J., Choi, Y., Park, C., Youn, H., Lee, M., Nagy, A., Manouras, A., Gunyeli, E., Gustafsson, U., Shahgaldi, K., Winter, R., Johnsson, J., Zagatina, A., Krylova, L., Zhuravskaya, N., Vareldzyan, Y., Tyurina, T., Clitsenko, O., Khalifa, E. A., Ashour, Z., Elnagar, W., Jung, I., Seo, H., Lee, S., Lim, D., Mizariene, V., Verseckaite, R., Janenaite, J., Jonkaitiene, R., Sanchez Espino, A., Bonaque Gonzalez, J., Merchan Ortega, G., Bolivar Herrera, N., Ikuta, I., Macancela Quinones, J., Gomez Recio, M., Silva Fazendas Adame, P. R., Caldeira, D., Stuart, B., Almeida, S., Cruz, I., Ferreira, A., Freire, G., Lopes, L., Cotrim, C., Pereira, H., Mediratta, A., Moss, J., Nayak, H., Al Amri, I., Debonnaire, P., Van Der Kley, F., Schalij, M., Bax, J., Ajmone Marsan, N., Delgado, V., Schmidt, F. P., Gniewosz, T., Jabs, A., Munzel, T., Jansen, T., Kaempfner, D., Hink, U., Von Bardeleben, R., Jose, J., George, O., Joseph, G., Adawi, S., Najjar, R., Ahronson, D., Shiran, A., Van Riel, A., Boerlage - Van Dijk, K., De Bruin - Bon, H., Araki, M., Meregalli, P., Koch, K., Vis, M., Mulder, B., Baan, J., Bouma, B., Marciniak, A., Elton, D., Glover, K., Campbell, I., Sharma, R., Batalha, S., Lourenco, C., Oliveira Da Silva, C., Caballero, L., Garcia-Lara, J., Gonzalez-Carrillo, J., Oliva, M., Saura, D., Garcia-Navarro, M., Espinosa, M., Pinar, E., Valdes, M., De La Morena, G., Barreiro Perez, M., Lopez Perez, M., Roy, D., Brecker, S., Venkateshvaran, A., Dash, P. K., Sola, S., Barooah, B., Govind, S. C., Brodin, L. A., Saura Espin, D., Caballero Jimenez, L., Gonzalez Carrillo, J., Oliva Sandoval, M., Lopez Ruiz, M., Garcia Navarro, M., Espinosa Garcia, M., Valdes Chavarri, M., De La Morena Valenzuela, G., Gatti, G., Dell'angela, L., Pinamonti, B., Benussi, B., Sinagra, G., Pappalardo, A., Hernandez, V., Saavedra, J., Gonzalez, A., Iglesias, P., Civantos, S., Guijarro, G., Monereo, S., Ikeda, M., Toh, N., Oe, H., Tanabe, Y., Watanabe, N., Ito, H., Ciampi, Q., Cortigiani, L., Pratali, L., Rigo, F., Villari, B., Picano, E., Yoon, J., Sohn, J., Kim, Y., Chang, H., Hong, G., Kim, T., Ha, J., Choi, B., Rim, S., Choi, E., Tibazarwa, K., Sliwa, K., Wonkam, A., Mayosi, B., Oryshchyn, N., Ivaniv, Y., Pavlyk, S., Lourenco, M. R., Azevedo, O., Moutinho, J., Nogueira, I., Fernandes, M., Pereira, V., Quelhas, I., Lourenco, A., Sunbul, M., Tigen, K., Karaahmet, T., Dundar, C., Ozben, B., Guler, A., Cincin, A., Bulut, M., Sari, I., Basaran, Y., Baydar, O., Kadriye Kilickesmez, K., Ugur Coskun, U., Polat Canbolat, P., Veysel Oktay, V., Umit Yasar Sinan, U., Okay Abaci, O., Cuneyt Kocas, C., Sinan Uner, S., Serdar Kucukoglu, S., Zaroui, A., Mourali, M., Ben Said, R., Asmi, M., Aloui, H., Kaabachi, N., Mechmeche, R., Saberniak, J., Hasselberg, N., Borgquist, R., Platonov, P., Holst, A., Edvardsen, T., Haugaa, K., Eran, A., Yueksel, D., Er, F., Gassanov, N., Rosenkranz, S., Baldus, S., Guedelhoefer, H., Faust, M., Caglayan, E., Matveeva, N., Nartsissova, G., Chernjavskij, A., Ippolito, R., De Palma, D., Muscariello, R., Santoro, C., Raia, R., Schiano-Lomoriello, V., Gargiulo, F., Lipari, P., Bonapace, S., Zenari, L., Valbusa, F., Rossi, A., Lanzoni, L., Canali, G., Molon, G., Campopiano, E., Barbieri, E., Ikonomidis, I., Varoudi, M., Papadavid, E., Theodoropoulos, K., Papadakis, I., Pavlidis, G., Triantafyllidi, H., Anastasiou - Nana, M., Rigopoulos, D., Lekakis, J., Ozen, G., Durmus, E., Kivrak, T., Atas, H., Direskeneli, H., Stevanovic, A., Dekleva, M., Trajic, S., Paunovic, N., Simic, A., Khan, S., Mushemi-Blake, S., Jouhra, F., Dennes, W., Monaghan, M., Melikian, N., Shah, A., Maceira Gonzalez, A. M., Lopez-Lereu, M., Monmeneu, J., Igual, B., Estornell, J., Boraita, A., Kosmala, W., Rojek, A., Bialy, D., Mysiak, A., Przewlocka-Kosmala, M., Popescu, I., Mancas, S., Mornos, C., Serbescu, I., Ionescu, G., Ionac, A., Gaudron, P., Niemann, M., Herrmann, S., Hu, K., Liu, D., Wojciech, K., Frantz, S., Bijnens, B., Ertl, G., Weidemann, F., Cosin-Sales, J., Ruvira, J., Diago, J., Aguilar, J., Cruz, C., Pinho, T., Madureira, A., Lebreiro, A., Dias, C., Ramos, I., Silva Cardoso, J., Julia Maciel, M., De Meester, P., Van De Bruaene, A., Herijgers, P., Voigt, J.-U., Budts, W., Franzoso, F., Voser, E., Wohlmut, C., Kellenberger, C., Valsangiacomo Buechel, E., Carrero, C., Benger, J., Parcerisa, M., Falconi, M., Oberti, P., Granja, M., Cagide, A., Del Pasqua, A., Secinaro, A., Antonelli, G., Iacomino, M., Toscano, A., Chinali, M., Esposito, C., Carotti, A., Pongiglione, G., Rinelli, G., Youssef Moustafa, A., Al Murayeh, M., Al Masswary, A., Al Sheikh, K., Moselhy, M., Dardir, M., Deising, J., Butz, T., Suermeci, G., Liebeton, J., Wennemann, R., Tzikas, S., Van Bracht, M., Prull, M., Trappe, H.-J., Martin Hidalgo, M., Delgado Ortega, M., Ruiz Ortiz, M., Mesa Rubio, D., Carrasco Avalos, F., Seoane Garcia, T., Pan Alvarez-Ossorio, M., Lopez Aguilera, J., Puentes Chiachio, M., Suarez De Lezo Cruz Conde, J., Petrovic, M. T., Giga, V., Stepanovic, J., Tesic, M., Jovanovic, I., Djordjevic-Dikic, A., Piatkowski, R., Kochanowski, J., Scislo, P., Opolski, G., Vareldzhyan, Y., Bombardini, T., Gherardi, S., Leone, O., Michelotto, E., Ciccarone, A., Tarantino, N., Ostuni, V., Rubino, M., Genco, W., Santoro, G., Carretta, D., Romito, R., Colonna, P., Cameli, M., Lunghetti, S., Lisi, M., Curci, V., Cameli, P., Focardi, M., Favilli, R., Mondillo, S., Hoffmann, R., Barletta, G., Von Bardeleben, S., Kasprzak, J., Greis, C., Vanoverschelde, J., Becher, H., Machida, T., Izumo, M., Suzuki, K., Kaimijima, R., Mizukoshi, K., Manabe-Uematsu, M., Takai, M., Harada, T., Akashi, Y., Martin Garcia, A., Arribas-Jimenez, A., Cruz-Gonzalez, I., Nieto, F., Iscar, A., Merchan, S., Martin-Luengo, C., Brecht, A., Theres, L., Spethmann, S., Dreger, H., Baumann, G., Knebel, F., Jasaityte, R., Heyde, B., Rademakers, F., Claus, P., D'hooge, J., Lervik Nilsen, L. C., Lund, J., Brekke, B., Stoylen, A., Giraldeau, G., Duchateau, N., Gabrielli, L., Penela, D., Evertz, R., Mont, L., Brugada, J., Berruezo, A., Sitges, M., Kordybach, M., Kowalski, M., Hoffman, P., Pilichowska, E., Baran, J., Kulakowski, P., Wahi, S., Vollbon, W., Leano, R., Thomas, A., Bricknell, K., Holland, D., Napier, S., Stanton, T., Teferici, D., Qirko, S., Petrela, E., Dibra, A., Bajraktari, G., Bara, P., Sanchis Ruiz, L., Andrea, R., Falces, C., Perez-Villa, F., Sulemane, S., Panoulas, V., Bratsas, A., Tam, F., Abduch, M., Alencar, A., Coracin, F., Barban, A., Saboya, R., Dulley, F., Mathias, W., Vieira, M., Buccheri, S., Mangiafico, S., Arcidiacono, A., Bottari, V., Leggio, S., Tamburino, C., Monte, I. P., Spitzer, E., Beitzke, D., Kaneider, A., Pavo, N., Gottsauner-Wolf, M., Wolf, F., Loewe, C., Mushtaq, S., Andreini, D., Pontone, G., Bertella, E., Conte, E., Baggiano, A., Annoni, A., Cortinovis, S., Fiorentini, C., Pepi, M., Gustafsson, M., Alehagen, U., Dahlstrom, U., Johansson, P., Faden, G., Faggiano, P., Albertini, L., Reverberi, C., Gaibazzi, N., Taylor, R. J., Moody, W., Umar, F., Edwards, N., Townend, J., Steeds, R., Leyva, F., Mihaila, S., Piasentini, E., Peluso, D., Casablanca, S., Naso, P., Puma, L., Iliceto, S., Vinereanu, D., Ciciarello, F. L., Agati, L., Cimino, S., De Luca, L., Petronilli, V., Fedele, F., and Tsverava, M.

Published
2013
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7. Spontaneous Coronary Artery Dissection in Relation to Physical and Emotional Stress: A Retrospective Study in 4 Arab Gulf Countries.

Author

Daoulah A, Al-Faifi SM, Hersi AS, Dinas PC, Youssef AA, Alshehri M, Baslaib F, Maghrabi M, Al-Murayeh M, Ghani MA, Refaat WA, Eldesoky A, Balghith M, Soofi MA, Alasmari A, Alasnag M, Hamad AK, Morshid M, Morsi YMA, Dahdouh Z, ElSayed O, Alama MN, Alasousi N, Tammam K, Almansori M, Khan AS, Alkhushail A, Aithal JK, Alqahtani AH, and Lotfi A

Subjects
Arabs, Coronary Angiography, Coronary Vessels, Dissection, Humans, Retrospective Studies, Coronary Vessel Anomalies etiology, Coronary Vessel Anomalies psychology, Percutaneous Coronary Intervention, Psychological Distress, Stress, Physiological, Vascular Diseases etiology, Vascular Diseases psychology
Abstract

Spontaneous coronary artery dissection (SCAD) has emerged as an important cause of acute coronary syndrome and sudden cardiac death. The triggers for SCAD often do not include traditional atherosclerotic risk factors. The most commonly reported triggers are extreme physical or emotional stress. The current study compared in-hospital and follow-up events in patients with SCAD with and without reported stress. Data from 83 patients with a confirmed diagnosis of SCAD were collected retrospectively from 30 centers in 4 Arab Gulf countries (KSA, UAE, Kuwait, and Bahrain) from January 2011 to December 2017. In-hospital myocardial infarction (MI), percutaneous coronary intervention (PCI), ventricular tachycardia/ventricular fibrillation, cardiogenic shock, death, ICD placement, dissection extension) and follow-up (MI, de novo SCAD, death, spontaneous superior mesenteric artery dissection) events were compared between those with and without reported stress. Emotional and physical stress was defined as new or unusually intense stress, within 1 week of their initial hospitalization. The median age of patients in the study was 44 (37-55) years. Foty-two (51%) were women. Stress (emotional, physical, and combined) was reported in 49 (59%) of all patients. Sixty-two percent of women with SCAD reported stress, and 51 % of men with SCAD reported stress. Men more commonly reported physical and combined stress. Women more commonly reported emotional stress (P < 0.001). The presence or absence of reported stress did not impact on overall adverse cardiovascular events (P = 0.8). In-hospital and follow-up events were comparable in patients with SCAD in the presence or absence of reported stress as a trigger., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Published
2021
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8. Spontaneous Coronary Artery Dissection in the Gulf: G-SCAD Registry.

Author

Daoulah A, Al-Faifi SM, Alhamid S, Youssef AA, Alshehri M, Al-Murayeh M, Farghali T, Maghrabi M, Balghith M, ElSayed O, Alasmari A, Arafat AA, Elmahrouk AF, Eldesoky A, Refaat WA, Alshahrani SS, Ghazi AM, Al-Azizi KM, Dahdouh Z, and Lotfi A

Subjects
Adult, Coronary Angiography, Coronary Artery Bypass statistics & numerical data, Coronary Vessel Anomalies diagnostic imaging, Coronary Vessel Anomalies therapy, Dual Anti-Platelet Therapy, Female, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use, Male, Middle Aged, Middle East epidemiology, Non-ST Elevated Myocardial Infarction epidemiology, Percutaneous Coronary Intervention statistics & numerical data, Pregnancy, Pregnancy Complications, Cardiovascular epidemiology, Pregnancy Complications, Cardiovascular therapy, Prevalence, Registries, Retrospective Studies, ST Elevation Myocardial Infarction epidemiology, Tomography, Optical Coherence, Vascular Diseases diagnostic imaging, Vascular Diseases epidemiology, Vascular Diseases therapy, Coronary Vessel Anomalies epidemiology, Vascular Diseases congenital
Abstract

Data on spontaneous coronary artery dissection (SCAD) is based on European and North American registries. We assessed the prevalence, epidemiology, and outcomes of patients presenting with SCAD in Arab Gulf countries. Patients (n = 83) were diagnosed with SCAD based on angiographic and intravascular imaging whenever available. Thirty centers in 4 Arab Gulf countries (Kingdom of Saudi Arabia, United Arab Emirates, Kuwait, and Bahrain) were involved from January 2011 to December 2017. In-hospital (myocardial infarction [MI], percutaneous coronary intervention, ventricular tachycardia/fibrillation, cardiogenic shock, death, implantable cardioverter-defibrillator placement, dissection extension) and follow-up (MI, de novo SCAD, death, spontaneous superior mesenteric artery dissection) cardiac events were recorded. Median age was 44 (37-55) years, 42 (51%) were females and 28.5% were pregnancy-associated (21.4% were multiparous). Of the patients, 47% presented with non-ST-elevation acute coronary syndrome, 49% with acute ST-elevation myocardial infarction, 12% had left main involvement, 43% left anterior descending, 21.7% right coronary, 9.6% left circumflex, and 9.6% multivessel; 52% of the SCAD were type 1, 42% type 2, 3.6% type 3, and 2.4% multitype; 40% managed medically, 53% underwent percutaneous coronary intervention, 7% underwent coronary artery bypass grafting. Females were more likely than males to experience overall (in-hospital and follow-up) adverse cardiovascular events ( P = .029).

Published
2021
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9. The Prognostic Impact of Pulse Pressure in Acute Heart Failure: Insights from the HEARTS Registry.

Author

Aljohar A, Alhabib K, AlFaleh H, Hersi A, Habeeb WA, Ullah A, Elasfar A, Almasood A, Ghabashi A, Mimish L, Alghamdi S, Abuosa A, Malik A, Hussein GA, Al-Murayeh M, and Kashour T

Abstract

Background: Low pulse pressure predicts long-term mortality in chronic heart failure, but its prognostic value in acute heart failure is less understood. The present study was designed to examine the prognostic value of pulse pressure in acute heart failure., Methods: Pulse pressure was tested for its impact on short- and long-term mortality in all patients admitted with acute heart failure from October 2009 to December 2010 in eighteen tertiary centers in Saudi Arabia (n = 2609). All comparisons were based on the median value (50 mmHg). Heart failure with reduced ejection fraction was defined as less than 40%., Results: Low pulse pressure was associated with increased short-term mortality in the overall population (OR = 1.61; 95 CI 1.17, 2.22; P 0.004 and OR = 1.51; 95% CI 1.13, 2.01; P = 0.005, for hospital and thirty-day mortality, respectively), and short-term and two-year mortality in the reduced ejection fraction group (OR = 1.81; 95% CI 1.19, 2.74; P = 0.005, OR = 1.69; 95% CI 1.17, 2.45; P = 0.006, and OR = 1.29; 95% CI 1.02, 1.61; P = 0.030 for hospital, thirty-day, and two-year mortality, respectively). This effect remained after adjustment for relevant clinical variables; however, pulse pressure lost its predictive power both for short-term and long-term mortality after the incorporation of systolic blood pressure in the model. Conversely, low pulse pressure was an independent predictor of improved survival at two and three years in heart failure with preserved ejection fraction (OR = 0.43; 95% CI 0.24, 0.78, P = 0.005 and OR = 0.49; 95% CI 0.28, 0.88; P = 0.016, respectively)., Conclusion: In acute heart failure with reduced ejection fraction, the prognostic value of low pulse pressure was dependent on systolic blood pressure. However, it inversely correlated with long-term survival in heart failure with preserved ejection fraction., Competing Interests: The authors have no conflict of interest to declare., (© 2020 Saudi Heart Association.)

Published
2020
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10. The first survey of the Saudi Acute Myocardial Infarction Registry Program: Main results and long-term outcomes (STARS-1 Program).

Author

Alhabib KF, Kinsara AJ, Alghamdi S, Al-Murayeh M, Hussein GA, AlSaif S, Khalaf H, Alfaleh H, Hersi A, Kashour T, Al-Saleh A, Ali M, Ullah A, Mhish H, Abdo AN, Almutairi F, Arafah MR, AlKutshan R, Aldosari M, AlSabatien BY, Alrazzaz M, Maria AM, Aref AH, Selim MM, Morsy AM, AlTohari FA, Alrifai AA, Awaad AA, El-Sayed H, Mansour S, Atwa AA, Abdelkader S, Altamimi N, Saleh E, Alhaidari W, ElShihawy EHA, Busaleh AH, Abdalmoutaleb M, Fawzy EM, Mokhtar Z, Saleh AM, Ahmad MA, Almasswary A, Alshehri M, Abohatab KM, AlGarni T, Butt M, Altaj I, Abdullah F, Alhosni Y, Osman HB, Bugti N, Aziz AA, Alarabi A, and AlHarbi IA

Subjects
Adult, Aged, Disease Management, Emergency Medical Services, Female, Health Surveys, Humans, Male, Middle Aged, Myocardial Infarction mortality, Prospective Studies, Saudi Arabia epidemiology, Sex Characteristics, Acute Coronary Syndrome epidemiology, Emergency Treatment statistics & numerical data, Myocardial Infarction epidemiology, Myocardial Infarction therapy
Abstract

Background: Prior acute coronary syndrome (ACS) registries in Saudi Arabia might not have accurately described the true demographics and cardiac care of patients with ACS. We aimed to evaluate the clinical characteristics, management, and outcomes of a representative sample of patients with acute myocardial infarction (AMI) in Saudi Arabia., Methods: We conducted a 1-month snap-shot, prospective, multi-center registry study in 50 hospitals from various health care sectors in Saudi Arabia. We followed patients for 1 month and 1 year after hospital discharge. Patients with AMI included those with or without ST-segment elevation (STEMI or NSTEMI, respectively). This program survey will be repeated every 5 years., Results: Between May 2015 and January 2017, we enrolled 2233 patients with ACS (mean age was 56 [standard deviation = 13] years; 55.6% were Saudi citizens, 85.7% were men, and 65.9% had STEMI). Coronary artery disease risk factors were high; 52.7% had diabetes mellitus and 51.2% had hypertension. Emergency Medical Services (EMS) was utilized in only 5.2% of cases. Revascularization for patients with STEMI included thrombolytic therapy (29%), primary percutaneous coronary intervention (PCI); (42.5%), neither (29%), or a pharmaco-invasive approach (3%). Non-Saudis with STEMI were less likely to undergo primary PCI compared to Saudis (35.8% vs. 48.7%; respectively, p <0.001), and women were less likely than men to achieve a door-to-balloon time of <90 min (42% vs. 65%; respectively, p = 0.003). Around half of the patients with NSTEMI did not undergo a coronary angiogram. All-cause mortality rates were 4%, 5.8%, and 8.1%, in-hospital, at 1 month, and at 1 year, respectively. These rates were significantly higher in women than in men., Conclusions: There is an urgent need for primary prevention programs, improving the EMS infrastructure and utilization, and establishing organized ACS network programs. AMI care needs further improvement, particularly for women and non-Saudis., Competing Interests: Astra Zeneca and Algorithm pharmaceutical companies are the commercial funders of the (STARS-1 Program). This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Published
2019
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11. The prognostic impact of hyperglycemia on clinical outcomes of acute heart failure: Insights from the heart function assessment registry trial in Saudi Arabia.

Author

Aljohar A, Alhabib KF, Kashour T, Hersi A, Al Habeeb W, Ullah A, Elasfar A, Almasood A, Ghabashi A, Mimish L, Alghamdi S, Abuosa A, Malik A, Hussein GA, Al-Murayeh M, and AlFaleh H

Abstract

Background: The prognostic impact of hyperglycemia (HG) in acute heart failure (AHF) is controversial. Our aim is to examine the impact of HG on short- and long-term survival in AHF patients., Methods: Data from the Heart Function Assessment Registry Trial in Saudi Arabia (HEARTS) for patients who had available random blood sugar (RBS) were analyzed. The enrollment period was from October 2009 to December 2010. Comparisons were performed according to the RBS levels on admission as either <11.1 mmol/L or ≥11.1 mmol/L. Primary outcomes were hospital adverse events and short- and long-term mortality rates., Results: A total of 2511 patients were analyzed. Of those, 728 (29%) had HG. Compared to non-HG patients, hyperglycemics had higher rates of hospital, 30-day, and 1-year mortality rates (8.8% vs. 5.6%; p  = 0.003, 10.4% vs. 7.2%; p  = 0.007, and 21.8% vs. 18.4%; p  = 0.04, respectively). There were no differences between the two groups in 2- or 3-year mortality rates. After adjustment for relevant confounders, HG remained an independent predictor for hospital and 30-day mortality [odds ratio (OR) = 1.6; 95% confidence interval (CI) 1.07-2.42; p  = 0.021, and OR = 1.55; 95% CI 1.07-2.25; p  = 0.02, respectively]., Conclusion: HG on admission is independently associated with hospital and short-term mortality in AHF patients. Future research should focus on examining the impact of tight glycemic control on outcomes of AHF patients.

Published
2018
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12. Atrial Fibrillation in Patients Hospitalized With Heart Failure: Patient Characteristics and Outcomes From the HEARTS Registry.

Author

Ajlan M, Almazroa L, AlHabib KF, Elasfar AA, Alfaleh H, Albackr H, Kashour T, Hersi A, Hussein GA, Mimish L, Almasood A, AlHabeeb W, AlGhamdi S, Alsharari M, Chakra E, Malik A, Soomro R, Ghabashi A, Al-Murayeh M, and Abuosa A

Subjects
Aged, Atrial Fibrillation complications, Atrial Fibrillation mortality, Coronary Artery Disease complications, Coronary Artery Disease epidemiology, Coronary Artery Disease mortality, Female, Heart Failure complications, Heart Failure mortality, Hospitalization statistics & numerical data, Humans, Male, Middle Aged, Registries statistics & numerical data, Saudi Arabia, Stroke complications, Stroke epidemiology, Stroke mortality, Atrial Fibrillation epidemiology, Heart Failure epidemiology
Abstract

Effect of atrial fibrillation (AF) on short- and long-term outcomes in heart failure (HF) is controversial. Accordingly, we examined this relationship in a national multicenter project using data from the Hearts Function Assessment Registry Trial in Saudi Arabia that studied the clinical features and outcomes of patients admitted with de novo and acute on chronic HF. Out of 2593 patients with HF, 449 (17.8%) had AF at presentation. Patients with AF were more likely to be males and older (mean age 65.2 ± 15.0 vs 60.5 ± 14.8 years) to have a history of ventricular tachycardia/ventricular fibrillation (3.1% vs 1.9%) or cerebrovascular accident (15.0% vs 8.5%). However, they were less likely to have diabetes (66.0% vs 55.9%) or coronary artery disease (55.6% vs 42.3%). The 1-, 2-, and 3-year crude mortality rates were significantly higher in patients with AF (23.2% vs 18.3%, 27.4% vs 22.3%, and 27.8% vs 23.2%, respectively). However, there was no significant difference in mortality after adjusting for covariates. Thus, in patients admitted with HF, AF upon presentation was not associated with increased mortality.

Published
2018
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13. Worsening heart failure in 'real-world' clinical practice: predictors and prognostic impact.

Author

AlFaleh H, Elasfar AA, Ullah A, AlHabib KF, Hersi A, Mimish L, Almasood A, Al Ghamdi S, Ghabashi A, Malik A, Hussein GA, Al-Murayeh M, Abuosa A, Al Habeeb W, and Kashour T

Subjects
Acute Disease, Disease Progression, Diuretics administration & dosage, Drug Therapy, Combination, Female, Follow-Up Studies, Heart Failure diagnosis, Heart Failure mortality, Humans, Infusions, Intravenous, Length of Stay trends, Male, Middle Aged, Prognosis, Prospective Studies, Saudi Arabia epidemiology, Survival Rate trends, Time Factors, Treatment Outcome, Adrenergic beta-Antagonists administration & dosage, Cardiotonic Agents administration & dosage, Furosemide administration & dosage, Heart Failure drug therapy, Registries, Vasodilator Agents administration & dosage
Abstract

Aims: The aim of this study was to compare the clinical features, predictors, and clinical outcomes of patients hospitalized with acute heart failure (AHF), with and without worsening heart failure (WHF)., Methods and Results: We used data from a multicentre prospective registry of AHF patients created in Saudi Arabia. WHF was defined as recurrence of heart failure symptoms or signs-with or without cardiogenic shock. In-hospital short- and long-term outcomes, as well as predictors of WHF are described. Of the 2609 AHF patients enrolled, 33.8% developed WHF. WHF patients were more likely to have a history of heart failure and ischaemic heart disease. Use of intravenous vasodilators, inotropic agents, furosemide infusions, and discharge beta-blockers was significantly higher in WHF patients, while use of discharge ACE inhibitors was higher in patients without WHF. Length of hospital stay was significantly longer for WHF patients than for those without WHF [median (interquartile range) 13 (14) vs. 7 (7) days, P < 0.001]. In-hospital, 30-day, 1-year, and 2-year mortality rates were higher in WHF patients than in non-WHF patients. The adjusted odds ratios for in-hospital, 30-day, and 1-year mortality were 4.13 [95% confidence interval (CI) 2.74-6.20, P < 0.001], 3.17 (95% CI 2.21-4.56, P < 0.001), and 1.34 (95% CI 1.04-1.71, P = 0.021), respectively. The strongest predictors for WHF were having ischaemic cardiomyopathy, AHF with concomitant acute coronary syndrome, and low haemoglobin., Conclusion: In real-world clinical practice, WHF during hospitalization for AHF is a strong predictor for short- and intermediate-term mortality, and a cause for longer hospital stays., (© 2016 The Authors. European Journal of Heart Failure © 2016 European Society of Cardiology.)

Published
2017
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14. Socioeconomic Factors and Severity of Coronary Artery Disease in Patients Undergoing Coronary Angiography: A Multicentre Study of Arabian Gulf States.

Author

Daoulah A, Elkhateeb OE, Nasseri SA, Al-Murayeh M, Al-Kaabi S, Lotfi A, Alama MN, Al-Faifi SM, Haddara M, Dixon CM, Alzahrani IS, Alghamdi AA, Ahmed W, Fathey A, Haq E, and Alsheikh-Ali AA

Abstract

Introduction: Coronary artery disease (CAD) is a leading cause of death worldwide. The association of socioeconomic status with CAD is supported by numerous epidemiological studies. Whether such factors also impact the number of diseased coronary vessels and its severity is not well established., Materials and Methods: We conducted a prospective multicentre, multi-ethnic, cross sectional observational study of consecutive patients undergoing coronary angiography (CAG) at 5 hospitals in the Kingdom of Saudi Arabia and the United Arab Emirates. Baseline demographics, socioeconomic, and clinical variables were collected for all patients. Significant CAD was defined as ≥70% luminal stenosis in a major epicardial vessel. Left main disease (LMD) was defined as ≥50% stenosis in the left main coronary artery. Multi-vessel disease (MVD) was defined as having >1 significant CAD., Results: Of 1,068 patients (age 59 ± 13, female 28%, diabetes 56%, hypertension 60%, history of CAD 43%), 792 (74%) were from urban and remainder (26%) from rural communities. Patients from rural centres were older (61 ± 12 vs 58 ± 13), and more likely to have a history of diabetes (63 vs 54%), hypertension (74 vs 55%), dyslipidaemia (78 vs 59%), CAD (50 vs 41%) and percutaneous coronary intervention (PCI) (27 vs 21%). The two groups differed significantly in terms of income level, employment status and indication for angiography. After adjusting for baseline differences, patients living in a rural area were more likely to have significant CAD (adjusted OR 2.40 [1.47, 3.97]), MVD (adjusted OR 1.76 [1.18, 2.63]) and LMD (adjusted OR 1.71 [1.04, 2.82]). Higher income was also associated with a higher risk for significant CAD (adjusted OR 6.97 [2.30, 21.09]) and MVD (adjusted OR 2.49 [1.11, 5.56]), while unemployment was associated with a higher risk of significant CAD (adjusted OR 2.21, [1.27, 3.85])., Conclusion: Communal and socioeconomic factors are associated with higher odds of significant CAD and MVD in the group of patients referred for CAG. The underpinnings of these associations ( e.g. pathophysiologic factors, access to care, and system-wide determinants of quality) require further study.

Published
2017
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15. Inter-ethnic marriages and severity of coronary artery disease: A multicenter study of Arabian Gulf States.

Author

Daoulah A, Al-Kaabi S, Lotfi A, Al-Murayeh M, Nasseri SA, Ahmed W, Al-Otaibi SN, Alama MN, Elkhateeb OE, Plotkin AJ, Malak MM, Alshali K, Hamzi M, Al Khunein S, Abufayyah M, and Alsheikh-Ali AA

Abstract

Aim: To assess the association of inter-ethnic vs intra-ethnic marriage with severity of coronary artery disease (CAD) in men undergoing angiography., Methods: We conducted a prospective multicenter, multi-ethnic, cross sectional observational study at five hospitals in Saudi Arabia and the United Arab Emirates, in which we used logistic regression analysis with and without adjustment for baseline differences., Results: Data were collected for 1068 enrolled patients undergoing coronary angiography for clinical indications during the period of April 1 st , 2013 to March 30 th , 2014. Ethnicities of spouses were available only for male patients. Of those enrolled, 687 were married men and constituted the cohort for the present analysis. Intra-ethnic marriages were reported in 70% and inter-ethnic marriages in 30%. After adjusting for baseline differences, inter-ethnic marriage was associated with lower odds of having significant CAD [adjusted odds ratio 0.52 (95%CI: 0.33, 0.81)] or multi-vessel disease (MVD) [adjusted odds ratio 0.57 (95%CI: 0.37, 0.86)]. The adjusted association with left main disease showed a similar trend, but was not statistically significant [adjusted odds ratio 0.74 (95%CI: 0.41, 1.32)]. The association between inter-ethnic marriage and the presence of significant CAD and MVD was not modified by number of concurrent wives ( P interaction > 0.05 for both)., Conclusion: Among married men undergoing coronary angiography, inter-ethnic, as compared to intra-ethnic, marriage is associated with lower odds of significant CAD and MVD., Competing Interests: Conflict-of-interest statement: There are no conflicts of interest to report.

Published
2017
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16. Widowhood and severity of coronary artery disease: a multicenter study.

Author

Daoulah A, Alama MN, Elkhateeb OE, Al-Murayeh M, Al-Kaabi S, Al-Faifi SM, Alosaimi HM, Lotfi A, Asiri KS, Elimam AM, Abougalambo AS, Murad W, Haddara MM, Dixon CM, and Alsheikh-Ali AA

Subjects
Aged, Chi-Square Distribution, Coronary Angiography, Coronary Artery Bypass, Coronary Artery Disease diagnostic imaging, Coronary Artery Disease epidemiology, Coronary Artery Disease surgery, Coronary Stenosis diagnostic imaging, Coronary Stenosis epidemiology, Coronary Stenosis surgery, Female, Humans, Logistic Models, Male, Middle Aged, Odds Ratio, Prognosis, Prospective Studies, Risk Assessment, Risk Factors, Saudi Arabia epidemiology, Severity of Illness Index, Sex Factors, Socioeconomic Factors, United Arab Emirates epidemiology, Coronary Artery Disease psychology, Coronary Stenosis psychology, Widowhood psychology
Abstract

Objectives: The aim of this study was to assess the association of widowhood with the severity and extent of coronary artery disease (CAD), and whether it is modified by sex or socioeconomic status., Patients and Methods: A total of 1068 patients undergoing coronary angiography at five centers in Saudi Arabia and the United Arab Emirates were included in the study. CAD was defined as more than 70% lumen stenosis in a major epicardial vessel or more than 50% in the left main coronary artery. Multivessel disease was defined as more than one diseased vessel., Results: Of 1068 patients, 65 (6%) were widowed. Widowed patients were older (65±15 vs. 59±12), more likely to be female (75 vs. 25%), less likely to be smokers (18 vs. 47%), of lower economic and education status, and more likely to have undergone coronary angiography for urgent/emergent indications (75 vs. 61%) (P<0.05 for all). There was a significant association between widowhood and the number of coronary arteries with more than 70% lumen stenosis. Consequently, such a high degree of lumen stenosis in those who were widowed was more likely to require coronary artery bypass graft surgery (38 vs. 16%; P<0.01). After adjusting for baseline differences, widowhood was associated with a significantly higher odds of CAD [adjusted odds ratio (OR) 3.6; 95% confidence interval (CI) 1.2-10.5] and multivessel disease (adjusted OR 4.6; 95% CI 2.2-9.6), but not left main disease (adjusted OR 1.3; 95% CI 0.5-3.1). All associations were consistent in men and women and not modified by age, community setting (urban vs. rural), employment, income, or educational levels (Pinteraction>0.1 for all)., Conclusion: Widowhood is associated with the severity and extent of CAD. The association is not modified by sex or socioeconomic status.

Published
2017
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17. Divorce and Severity of Coronary Artery Disease: A Multicenter Study.

Author

Daoulah A, Al-Murayeh M, Al-Kaabi S, Lotfi A, Elkhateeb OE, Al-Faifi SM, Alqahtani S, Stewart J, Heavey J, Hurley WT, Alama MN, Faden M, Al-Shehri M, Youssef A, and Alsheikh-Ali AA

Abstract

The association between marital status and coronary artery disease (CAD) is supported by numerous epidemiological studies. While divorce may have an adverse effect on cardiac outcomes, the relationship between divorce and severe CAD is unclear. We conducted a multicenter, observational study of consecutive patients undergoing coronary angiography during the period between April 1, 2013, and March 30, 2014. Of 1,068 patients, 124 (12%) were divorced. Divorce was more frequent among women (27%) compared to men (6%). Most divorced patients had been divorced only once (49%), but a subset had been divorced 2 (38%) or ≥3 (12%) times. After adjusting for baseline differences, there was no significant association between divorce and severe CAD in men. In women, there was a significant adjusted association between divorce and severe MVD (OR 2.31 [1.16, 4.59]) or LMD (OR 5.91 [2.19, 15.99]). The modification of the association between divorce and severe CAD by gender was statistically significant for severe LMD ( P interaction 0.0008) and marginally significant for CAD ( P interaction 0.05). Among women, there was a significant adjusted association between number of divorces and severe CAD (OR 2.4 [95% CI 1.2, 4.5]), MVD (OR 2.0 [95% CI 1.4, 3.0]), and LMD (OR 3.4 [95% CI 1.9, 5.9]). In conclusion, divorce, particularly multiple divorces, is associated with severe CAD, MVD, and LMD in women but not in men.

Published
2017
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18. Polygamy and Risk of Coronary Artery Disease in Men Undergoing Angiography: An Observational Study.

Author

Daoulah A, Lotfi A, Al-Murayeh M, Al-Kaabi S, Al-Faifi SM, Elkhateeb OE, Alama MN, Hersi AS, Dixon CM, Ahmed W, Al-Shehri M, Youssef A, Elimam AM, Abougalambou AS, Murad W, and Alsheikh-Ali AA

Abstract

Epidemiologic evidence suggests a link between psychosocial risk factors such as marital status and coronary artery disease (CAD). Polygamy (multiple concurrent wives) is a distinct marital status practiced in many countries in Asia and the Middle East, but its association with CAD is not well defined. We conducted a multicenter, observational study of consecutive patients undergoing coronary angiography during the period from April 1, 2013, to March 30, 2014. Of 1,068 enrolled patients, 687 were married men. Polygamy was reported in 32% of married men (1 wife: 68%, 2 wives: 19%, 3 wives: 10%, and 4 wives: 3%). When stratified by number of wives, significant baseline differences were observed in age, type of community (rural versus urban), prior coronary artery bypass grafting (CABG), and household income. After adjusting for baseline differences, there was a significant association between polygamy and CAD (adjusted OR 4.6 [95% CI 2.5, 8.3]), multivessel disease (MVD) (adjusted OR 2.6 [95% CI 1.8, 3.7]), and left main disease (LMD) (adjusted OR 3.5 [95% CI 2.1, 5.9]). Findings were consistent when the number of wives was analyzed as a continuous variable. In conclusion, among married men undergoing coronary angiography for clinical indications, polygamy is associated with the presence of significant CAD, MVD, and LMD., Competing Interests: The authors declare that they have no conflict of interests.

Published
2017
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19. Sex Differences in Patients With Acute Decompensated Heart Failure: Insights From the Heart Function Assessment Registry Trial in Saudi Arabia.

Author

AlFaleh HF, Thalib L, Kashour T, Hersi A, Mimish L, Elasfar AA, Almasood A, Al Ghamdi S, Ghabashi A, Malik A, Hussein GA, Al-Murayeh M, Abuosa A, Al Habeeb W, and Al Habib KF

Subjects
Aged, Comorbidity, Female, Heart Failure diagnosis, Heart Failure mortality, Heart Failure physiopathology, Humans, Male, Middle Aged, Patient Discharge, Prospective Studies, Registries, Risk Assessment, Risk Factors, Saudi Arabia epidemiology, Sex Factors, Smoking adverse effects, Smoking epidemiology, Treatment Outcome, Cardiovascular Agents therapeutic use, Health Status Disparities, Healthcare Disparities, Heart Failure therapy
Abstract

We assessed sex-specific differences in clinical features and outcomes of patients with acute heart failure (AHF). The Heart function Assessment Registry Trial in Saudi Arabia (HEARTS), a prospective registry, enrolled 2609 patients with AHF (34.2% women) between 2009 and 2010. Women were older and more likely to have risk factors for atherosclerosis, history of heart failure (HF), and rheumatic heart and valve disease. Ischemic heart disease was the prime cause for HF in men and women but more so in men (P < .001). Women had higher rates of hypertensive heart disease and primary valve disease (P < .001, for both comparisons). Men were more likely to have severe left ventricular systolic dysfunction. On discharge, a higher use of angiotensin-converting enzyme inhibitors, β-blockers, and aldosterone inhibitors was observed in men (P < .001 for all comparisons). Apart from higher atrial fibrillation in women and higher ventricular arrhythmias in men, no differences were observed in hospital outcomes. The overall survival did not differ between men and women (hazard ratio: 1.0, 95% confidence interval: 0.8-1.2, P = .981). Men and women with AHF differ significantly in baseline clinical characteristics and management but not in adverse outcomes., (© The Author(s) 2015.)

Published
2016
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20. Acute heart failure with and without acute coronary syndrome: clinical correlates and prognostic impact (From the HEARTS registry).

Author

AlFaleh H, Elasfar AA, Ullah A, AlHabib KF, Hersi A, Mimish L, Almasood A, Al Ghamdi S, Ghabashi A, Malik A, Hussein GA, Al-Murayeh M, Abuosa A, Al Habeeb W, and Kashour TS

Subjects
Acute Coronary Syndrome diagnosis, Acute Coronary Syndrome mortality, Acute Coronary Syndrome physiopathology, Acute Disease, Aged, Comorbidity, Female, Heart Failure diagnosis, Heart Failure mortality, Heart Failure physiopathology, Hospital Mortality, Humans, Kaplan-Meier Estimate, Logistic Models, Male, Middle Aged, Multivariate Analysis, Odds Ratio, Prevalence, Prospective Studies, Registries, Risk Assessment, Risk Factors, Saudi Arabia epidemiology, Survivors, Time Factors, Treatment Outcome, Acute Coronary Syndrome therapy, Heart Failure therapy
Abstract

Background: Little is know about the outcomes of acute heart failure (AHF) with acute coronary syndrome (ACS-AHF), compared to those without ACS (NACS-AHF)., Methods: We conducted a prospective registry of AHF patients involving 18 hospitals in Saudi Arabia between October 2009 and December 2010. In this sub-study, we compared the clinical correlates, management and hospital course, as well as short, and long-term outcomes between AHF patients with and without ACS., Results: Of the 2609 AHF patients enrolled, 27.8 % presented with ACS. Compared to NACS-AHF patients, ACS-AHF patients were more likely to be old males (Mean age = 62.7 vs. 60.8 years, p = 0.003, and 73.8 % vs. 62.7 %, p < 0.001, respectively), and to present with De-novo heart failure (56.6 % vs. 28.1 %, p < 0.001). Additionally they were more likely to have history of ischemic heart disease, diabetes, dyslipidemia, and less likely to have chronic kidney disease (p < 0.001 for all comparisons). The prevalence of severe LV systolic dysfunction (EF < 30 %) was higher in ACS-AHF patients. During hospital stay, ACS-AHF patients were more likely to develop shock (p < 0.001), recurrent heart failure (p = 0.02) and needed more mechanical ventilation (p < 0.001). β blockers and Angiotensin Converting Enzyme inhibitors were used more often in ACS-AHF patients (p = 0.001 and, p = 0.004 respectively). ACS- AHF patients underwent more coronary angiography and had higher prevalence of multi-vessel coronary artery disease (p < 0.001 for all comparisons). The unadjusted hospital and one-month mortality were higher in ACS-AHF patients (OR = 1.6 (1.2-2.2), p = 0.003 and 1.4 (1.0-1.9), p = 0.026 respectively). A significant interaction existed between the level of left ventricular ejection fraction and ACS-AHF status. After adjustment, ACS-AHF status was only significantly associated with hospital mortality (OR = 1.6 (1.1-2.4), p = 0.019). The three-years survival following hospital discharge was not different between the two groups., Conclusion: AHF patients presenting with ACS had worse hospital prognosis, and an equivalent long-term survival compared to AHF patients without ACS. These findings underscore the importance of timely recognition and management of AHF patients with concomitant ACS given their distinct presentation and underlying pathophysiology compared to other AHF patients.

Published
2016
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21. Clinical features, management, and short- and long-term outcomes of patients with acute decompensated heart failure: phase I results of the HEARTS database.

Author

AlHabib KF, Elasfar AA, Alfaleh H, Kashour T, Hersi A, AlBackr H, Alshaer F, AlNemer K, Hussein GA, Mimish L, Almasood A, AlHabeeb W, AlGhamdi S, Alsharari M, Chakra E, Malik A, Soomro R, Ghabashi A, Al-Murayeh M, and Abuosa A

Subjects
Adult, Aged, Coronary Artery Disease diagnosis, Coronary Artery Disease drug therapy, Coronary Artery Disease mortality, Databases, Factual, Diabetes Mellitus epidemiology, Female, Heart Failure mortality, Humans, Hypertension epidemiology, Male, Middle Aged, Prospective Studies, Registries, Risk Factors, Saudi Arabia epidemiology, Heart Failure diagnosis, Heart Failure drug therapy
Abstract

Aims: The HEart function Assessment Registry Trial in Saudi Arabia (HEARTS) is a national multicentre project, studying clinical features, management, short- and long-term outcomes, and mortality predictors in patients admitted with acute decompensated heart failure (ADHF)., Methods and Results: Our prospective registry enrolled 2610 ADHF patients admitted to 18 hospitals in Saudi Arabia between October 2009 and December 2010, and followed mortality rates until January 2013. The patients included 66% men and 85.5% Saudis, with a median age (interquartile range) of 61.4 (15) years; 64% had acute on chronic heart failure (HF), 64.1% diabetes mellitus, 70.6% hypertension, and 55.7% CAD. Exacerbating factors for hospital admission included acute coronary syndromes (37.8%), infections (20.6%), non-compliance with low-salt diet (25.2%), and non-compliance with HF medications (20%). An LVEF<40% was found in 73%. In-hospital use of evidence-based medications was high. All-cause cumulative mortality rates at 30 days, 6 months, 1 year, 2 years, and 3 years were 8.3, 13.7, 19.5, 23.5, and 24.3%, respectively. Important independent predictors of mortality were history of stroke, acute on chronic HF, systolic blood pressure<90 mmHg upon presentation, estimated glomerular filtration rate<60 mL/min, and haemoglobin<10 g/dL., Conclusion: Patients with ADHF in Saudi Arabia presented at a younger age and had higher rates of CAD risk factors compared with those in developed countries. Most patients had reduced LV systolic function, mostly due to ischaemic aetiology, and had poor long-term prognosis. These findings indicate a need for nationwide primary prevention and HF disease management programmes., (© 2014 The Authors. European Journal of Heart Failure © 2014 European Society of Cardiology.)

Published
2014
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22. Cor triatriatum with persistent levoatrial cardinal vein late presented as severe mitral stenosis.

Author

Aliter H, Youssef A, Al-Murayeh M, and Gallo R

Abstract

Cor triatriatum is a rare congenital cardiac anomaly that usually becomes symptomatic in the first years of life. We present a 28-year-old pregnant female patient presented with shortness of breath, palpitations and decreased exercise tolerance. Transthoracic (TTE) and transesophageal (TEE) echocardiography showed cor triatriatum, features of severe mitral stenosis and atrial septal defect (ASD). The patient underwent successful surgical correction with an uneventful postoperative course.

Published
2012
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23. Age and its relationship to acute coronary syndromes in the Saudi Project for Assessment of Coronary Events (SPACE) registry: The SPACE age study.

Author

Al-Saif SM, Alhabib KF, Ullah A, Hersi A, Alfaleh H, Alnemer K, Tarabin A, Abuosa A, Kashour T, and Al-Murayeh M

Abstract

Objective: To characterize risk profile of acute coronary syndrome (ACS) patients in different age groups and compare management provided to in-hospital outcome., Design: Prospective multi-hospital registry., Setting: Seventeen secondary and tertiary care hospitals in Saudi Arabia., Patients: Five thousand and fifty-five patients with ACS. They were divided into four groups: ⩽40 years, 41-55 years, 56-70 years and ⩾70 years., Main Outcome Measures: prevalence, utilization and mortality., Results: Ninety-four percent of patients <40 years compared to 68% of patients >70 years were men. Diabetes was present in 70% of patients aged 56-70 years. Smoking was present in 66% of those <40 years compared to 7% of patients >70 years. Fifty-three percent of the patients >70 years and 25% of those <40 years had history of ischemic heart disease. Sixty percent of patients <40 years presented with ST elevation myocardial infarction (STEMI) while non-ST elevation myocardial infarction was the presentation in 49% of patients >70 years. Thirty-four percent of patients >70 years compared to 10% of patients <40 years presented >12 h from symptom onset with STEMI. Fifty-four percent of patients >70 compared to 64-71% of those <70 years had coronary angiography. Twenty-four percent of patients >70 compared to 34-40% of those <70 years had percutaneous coronary intervention. Reperfusion shortfall for STEMI was 16-18% in patients >56 years compared to 11% in patients <40 years. Mortality was 7% in patients >70 years compared to 1.6-3% in patients <70 years. For all comparisons (p < 0.001)., Conclusions: Young and old ACS patients have unique risk factors and present differently. Older patients have higher in-hospital mortality as they are treated less aggressively. There is an urgent need for a national prevention program as well as a systematic improvement in the care for patients with ACS including a system of care for STEMI patients. For older patients there is a need to identify medical as well as social factors that influence the therapeutic management plans.

Published
2012
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24. Usefulness of Tei index in patients with rheumatic mitral regurgitation and apparently normal left ventricular ejection fraction.

Author

Nasr G, Moselhy MS, Elattar G, Zaghlool S, and Al-Murayeh M

Abstract

Background and Aim: Rheumatic mitral regurgitation is rather common in developing countries. It usually progresses insidiously, because the heart compensates for increasing regurgitant volume by left-atrial enlargement, causes left-ventricular overload and dysfunction, and yields poor outcome when it becomes severe. Doppler-echocardiographic methods can be used to quantify the severity of mitral regurgitation. It is known that ejection fraction underestimates the presence of left ventricular dysfunction in these patients. This study aimed to study global cardiac function of these patients by using LV Tei index., Methods: One hundred patients with rheumatic mitral regurge predominantly were included (40 males and 60 females; aged 10-24 years, median 20.6 years). All participants were subjected to full echocardiographic study including total isovolumic index (Tei index = isovolumic relaxation time IRT + isovolumic contraction time ICT/ejection time ET) for the left ventricle. Special attention was paid to grading of severity of the mitral regurgitation., Results: LV ejection fraction was preserved in all cases but, however, the total left isovolumic index was prolonged 0.56 ± 3 in 64 of them (34 females and 30 males) denoting masked LV dysfunction P < .00001. There was a correlation of increasing severity of dysfunction with the degree of mitral regurgitation., Conclusion: Ejection fraction underestimates the presence of left ventricular dysfunction in these patients. However, this was unmasked by the Tei index which could be an additive data for detecting early left ventricular dysfunction.

Published
2011
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