236 results on '"Stähli, Barbara E"'
Search Results
2. Impact of age and sex on left ventricular function determined by coronary computed tomographic angiography: results from the prospective multicentre CONFIRM study
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Gebhard, Catherine, Buechel, Ronny R, Stähli, Barbara E, Gransar, Heidi, Achenbach, Stephan, Berman, Daniel S, Budoff, Matthew J, Callister, Tracy Q, Chow, Benjamin, Dunning, Allison, Al-Mallah, Mouaz H, Cademartiri, Filippo, Chinnaiyan, Kavitha, Rubinshtein, Ronen, Marques, Hugo, DeLago, Augustin, Villines, Todd C, Hadamitzky, Martin, Hausleiter, Joerg, Shaw, Leslee J, Cury, Ricardo C, Feuchtner, Gudrun, Kim, Yong-Jin, Maffei, Erica, Raff, Gilbert, Pontone, Gianluca, Andreini, Daniele, Chang, Hyuk-Jae, Leipsic, Jonathon, Min, James K, and Kaufmann, Philipp A
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Biomedical and Clinical Sciences ,Cardiovascular Medicine and Haematology ,Clinical Sciences ,Heart Disease - Coronary Heart Disease ,Prevention ,Clinical Research ,Biomedical Imaging ,Cardiovascular ,Heart Disease ,4.2 Evaluation of markers and technologies ,Detection ,screening and diagnosis ,Adult ,Age Factors ,Aged ,Analysis of Variance ,Cohort Studies ,Computed Tomography Angiography ,Coronary Angiography ,Coronary Artery Disease ,Female ,Humans ,Male ,Middle Aged ,Prognosis ,Prospective Studies ,Registries ,Risk Assessment ,Severity of Illness Index ,Sex Factors ,Statistics ,Nonparametric ,Survival Rate ,Ventricular Dysfunction ,Left ,cardiac computed tomography ,left ventricular ejection fraction ,Cardiovascular medicine and haematology - Abstract
BackgroundLeft ventricular (LV) volumetric and functional parameters measured with cardiac computed tomography (cardiac CT) augment risk prediction and discrimination for future mortality. Gender- and age-specific standard values for LV dimensions and systolic function obtained by 64-slice cardiac CT are lacking.Methods and results1155 patients from the Coronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicenter registry (54.5% males, mean age 53.1 ± 12.4 years, range: 18-92 years) without known coronary artery disease (CAD), structural heart disease, diabetes, or hypertension who underwent cardiac CT for various indications were categorized according to age and sex. A cardiac CT data acquisition protocol was used that allowed volumetric measuring of LV function. Image interpretation was performed at each site. Patients with significant CAD (>50% stenosis) on cardiac CT were excluded from the analysis. Overall, mean left ventricular ejection fraction (LVEF) was higher in women when compared with men (66.6 ± 7.7% vs. 64.6 ± 8.1%, P < 0.001). This gender-difference in overall LVEF was caused by a significantly higher LVEF in women ≥70 years when compared with men ≥70 years (69.95 ± 8.89% vs. 65.50 ± 9.42%, P = 0.004). Accordingly, a significant increase in LVEF was observed with age (P = 0.005 for males and P < 0.001 for females), which was more pronounced in females (5.21%) than in males (2.6%). LV end-diastolic volume decreased in females from 122.48 ± 27.87 (70 years; P < 0.001) and in males from 155.22 ± 35.07 (70 years; P < 0.001).ConclusionOur findings indicate that the LV undergoes a lifelong remodelling and highlight the need for age and gender adjusted reference values.
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- 2017
3. Twenty-five-year trends in incidence, angiographic appearance, and management of spontaneous coronary artery dissection
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Würdinger, Michael, Schweiger, Victor, Gilhofer, Thomas; https://orcid.org/0000-0002-1708-156X, Cammann, Victoria L; https://orcid.org/0000-0001-7240-6593, Badorff, Annika, Koleva, Iva, Di Vece, Davide, Niederseer, David; https://orcid.org/0000-0003-3089-1222, Candreva, Alessandro; https://orcid.org/0000-0002-6676-7541, Michel, Jonathan, Gotschy, Alexander; https://orcid.org/0000-0001-8655-3244, Stehli, Julia; https://orcid.org/0000-0003-3089-1062, Stähli, Barbara E; https://orcid.org/0000-0002-3058-6407, Ghadri, Jelena R; https://orcid.org/0000-0002-4862-0562, Templin, Christian; https://orcid.org/0000-0003-0287-4193, Würdinger, Michael, Schweiger, Victor, Gilhofer, Thomas; https://orcid.org/0000-0002-1708-156X, Cammann, Victoria L; https://orcid.org/0000-0001-7240-6593, Badorff, Annika, Koleva, Iva, Di Vece, Davide, Niederseer, David; https://orcid.org/0000-0003-3089-1222, Candreva, Alessandro; https://orcid.org/0000-0002-6676-7541, Michel, Jonathan, Gotschy, Alexander; https://orcid.org/0000-0001-8655-3244, Stehli, Julia; https://orcid.org/0000-0003-3089-1062, Stähli, Barbara E; https://orcid.org/0000-0002-3058-6407, Ghadri, Jelena R; https://orcid.org/0000-0002-4862-0562, and Templin, Christian; https://orcid.org/0000-0003-0287-4193
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BACKGROUND Spontaneous coronary artery dissection (SCAD) has been described as an infrequent cause of acute coronary syndrome (ACS). Knowledge about the disease is still limited and SCAD might still be underdiagnosed. OBJECTIVES Trends in incidence, presentation, angiographic appearance, management, and outcomes of SCAD over 25 years were analyzed. METHODS Patients with SCAD between 1997 and 2021 at the University Hospital Zurich, Switzerland, were included. Incidences were assessed as total numbers and proportions of ACS cases. Clinical data were collected from medical records and angiographic findings were reviewed. Major adverse cardiac events (MACE) were defined as the composite of all-cause death, cardiac arrest, SCAD recurrence or progression, other myocardial infarction, and stroke. RESULTS One hundred fifty-six SCAD cases were included in this study. The incidence increased significantly in total (p < 0.001) and relative to ACS cases (p < 0.001). This was based on an increase of shorter lesions (p = 0.004), SCAD type 2 (p < 0.001), and lesions in side branches (p = 0.014), whereas lesions in the left main coronary artery and proximal segments were decreasing (p-values 0.029 and < 0.001, respectively). There was an increase in conservative therapy (p < 0.001). The rate of MACE (24%) was stable, however, there was a reduced proportion of patients with a need for intensive care treatment (p = 0.017). CONCLUSIONS SCAD represents an important entity of ACS that still might be underappreciated. The increasing incidence of SCAD is likely based on better awareness and familiarity with the disease. A lower need for intensive care treatment suggests positive effects of the increasing implementation of conservative management.
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- 2024
4. Inflammation in acute myocardial infarction: the good, the bad and the ugly
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Matter, Michael A; https://orcid.org/0009-0004-1905-5586, Paneni, Francesco; https://orcid.org/0000-0001-6483-7844, Libby, Peter; https://orcid.org/0000-0002-1502-502X, Frantz, Stefan; https://orcid.org/0000-0002-0301-6185, Stähli, Barbara E; https://orcid.org/0000-0002-3058-6407, Templin, Christian; https://orcid.org/0000-0003-0287-4193, Mengozzi, Alessandro; https://orcid.org/0000-0003-2834-9725, Wang, Yu-Jen; https://orcid.org/0000-0001-8387-3947, Kündig, Thomas M; https://orcid.org/0000-0003-3863-8766, Räber, Lorenz; https://orcid.org/0000-0003-0824-3026, Ruschitzka, Frank; https://orcid.org/0000-0001-5972-0596, Matter, Christian M; https://orcid.org/0000-0002-8124-1767, Matter, Michael A; https://orcid.org/0009-0004-1905-5586, Paneni, Francesco; https://orcid.org/0000-0001-6483-7844, Libby, Peter; https://orcid.org/0000-0002-1502-502X, Frantz, Stefan; https://orcid.org/0000-0002-0301-6185, Stähli, Barbara E; https://orcid.org/0000-0002-3058-6407, Templin, Christian; https://orcid.org/0000-0003-0287-4193, Mengozzi, Alessandro; https://orcid.org/0000-0003-2834-9725, Wang, Yu-Jen; https://orcid.org/0000-0001-8387-3947, Kündig, Thomas M; https://orcid.org/0000-0003-3863-8766, Räber, Lorenz; https://orcid.org/0000-0003-0824-3026, Ruschitzka, Frank; https://orcid.org/0000-0001-5972-0596, and Matter, Christian M; https://orcid.org/0000-0002-8124-1767
- Abstract
Convergent experimental and clinical evidence have established the pathophysiological importance of pro-inflammatory pathways in coronary artery disease. Notably, the interest in treating inflammation in patients suffering acute myocardial infarction (AMI) is now expanding from its chronic aspects to the acute setting. Few large outcome trials have proven the benefits of anti-inflammatory therapies on cardiovascular outcomes by targeting the residual inflammatory risk (RIR), i.e. the smouldering ember of low-grade inflammation persisting in the late phase after AMI. However, these studies have also taught us about potential risks of anti-inflammatory therapy after AMI, particularly related to impaired host defence. Recently, numerous smaller-scale trials have addressed the concept of targeting a deleterious flare of excessive inflammation in the early phase after AMI. Targeting different pathways and implementing various treatment regimens, those trials have met with varied degrees of success. Promising results have come from those studies intervening early on the interleukin-1 and -6 pathways. Taking lessons from such past research may inform an optimized approach to target post-AMI inflammation, tailored to spare ‘The Good’ (repair and defence) while treating ‘The Bad’ (smouldering RIR) and capturing ‘The Ugly’ (flaming early burst of excess inflammation in the acute phase). Key constituents of such a strategy may read as follows: select patients with large pro-inflammatory burden (i.e. large AMI); initiate treatment early (e.g. ≤12 h post-AMI); implement a precisely targeted anti-inflammatory agent; follow through with a tapering treatment regimen. This approach warrants testing in rigorous clinical trials.
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- 2024
5. Coronary microevaginations characterize culprit plaques and their inflammatory microenvironment in a subtype of acute coronary syndrome with intact fibrous cap: results from the prospective translational OPTICO-ACS study.
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Seppelt, Claudio, Abdelwahed, Youssef S, Meteva, Denitsa, Nelles, Gregor, Stähli, Barbara E, Erbay, Aslihan, Kränkel, Nicolle, Sieronski, Lara, Skurk, Carsten, Haghikia, Arash, Sinning, David, Dreger, Henryk, Knebel, Fabian, Trippel, Tobias D, Krisper, Maximilian, Gerhardt, Teresa, Rai, Himanshu, Klotsche, Jens, Joner, Michael, and Landmesser, Ulf
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RELATIVE medical risk ,CONFIDENCE intervals ,INFLAMMATION ,MULTIPLE regression analysis ,HEART assist devices ,ACUTE coronary syndrome ,CORONARY thrombosis ,RISK assessment ,DISEASE susceptibility ,OPTICAL coherence tomography ,IMMUNOPHENOTYPING ,CORONARY artery disease ,DESCRIPTIVE statistics ,RESEARCH funding ,TRANSLATIONAL research ,T cells ,VASCULAR remodeling ,LONGITUDINAL method ,MONOCYTES ,DISEASE risk factors ,DISEASE complications - Abstract
Aims Coronary microevaginations (CMEs) represent an outward bulge of coronary plaques and have been introduced as a sign of adverse vascular remodelling following coronary device implantation. However, their role in atherosclerosis and plaque destabilization in the absence of coronary intervention is unknown. This study aimed to investigate CME as a novel feature of plaque vulnerability and to characterize its associated inflammatory cell–vessel–wall interactions. Methods and results A total of 557 patients from the translational OPTICO-ACS study programme underwent optical coherence tomography imaging of the culprit vessel and simultaneous immunophenotyping of the culprit lesion (CL). Two hundred and fifty-eight CLs had a ruptured fibrous cap (RFC) and one hundred had intact fibrous cap (IFC) acute coronary syndrome (ACS) as an underlying pathophysiology. CMEs were significantly more frequent in CL when compared with non-CL (25 vs. 4%, P < 0.001) and were more frequently observed in lesions with IFC-ACS when compared with RFC-ACS (55.0 vs. 12.7%, P < 0.001). CMEs were particularly prevalent in IFC-ACS-causing CLs independent of a coronary bifurcation (IFC-ICB) when compared with IFC-ACS with an association to a coronary bifurcation (IFC-ACB, 65.4 vs. 43.7%, P = 0.030). CME emerged as the strongest independent predictor of IFC-ICB (relative risk 3.36, 95% confidence interval 1.67–6.76, P = 0.001) by multivariable regression analysis. IFC-ICB demonstrated an enrichment of monocytes in both culprit blood analysis (culprit ratio: 1.1 ± 0.2 vs. 0.9 ± 0.2, P = 0.048) and aspirated culprit thrombi (326 ± 162 vs. 96 ± 87 cells/mm
2 , P = 0.017), while IFC-ACB confirmed the accumulation of CD4+ T cells, as recently described. Conclusion This study provides novel evidence for a pathophysiological involvement of CME in the development of IFC-ACS and provides first evidence for a distinct pathophysiological pathway for IFC-ICB, driven by CME-derived flow disturbances and inflammatory activation involving the innate immune system. Trial registration Registration of the study at clinicalTrials.gov (NCT03129503). [ABSTRACT FROM AUTHOR]- Published
- 2024
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6. Inflammation in acute myocardial infarction: the good, the bad and the ugly
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Matter, Michael A, primary, Paneni, Francesco, additional, Libby, Peter, additional, Frantz, Stefan, additional, Stähli, Barbara E, additional, Templin, Christian, additional, Mengozzi, Alessandro, additional, Wang, Yu-Jen, additional, Kündig, Thomas M, additional, Räber, Lorenz, additional, Ruschitzka, Frank, additional, and Matter, Christian M, additional
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- 2023
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7. Sex discrepancies in pathophysiology, presentation, treatment, and outcomes of severe aortic stenosis
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Stehli, Julia, primary, Zaman, Sarah, additional, and Stähli, Barbara E., additional
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- 2023
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8. “Puncture-to-Loop” Technique to Retrieve Embolized Patent Foramen Ovale Occluder
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Chen, Mi, primary, Michel, Jonathan M., additional, Stähli, Barbara E., additional, Gilhofer, Thomas S., additional, Tanner, Felix C., additional, and Kasel, Albert Markus, additional
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- 2023
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9. A roadmap for gut microbiome-derived aromatic amino acids for improved cardiovascular risk stratification
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Stähli, Barbara E, primary, Scharl, Michael, additional, and Matter, Christian M, additional
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- 2023
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10. Intraventricular Thrombus Formation and Embolism in Takotsubo Syndrome: Insights From the International Takotsubo Registry
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Ding, Katharina J., Cammann, Victoria L., Szawan, Konrad A., Stähli, Barbara E., Wischnewsky, Manfred, Di Vece, Davide, Citro, Rodolfo, Jaguszewski, Milosz, Seifert, Burkhardt, Sarcon, Annahita, Knorr, Maike, Heiner, Susanne, Gili, Sebastiano, D’Ascenzo, Fabrizio, Neuhaus, Michael, Napp, L. Christian, Franke, Jennifer, Noutsias, Michel, Burgdorf, Christof, Koenig, Wolfgang, Kherad, Behrouz, Rajan, Lawrence, Michels, Guido, Pfister, Roman, Cuneo, Alessandro, Jacobshagen, Claudius, Karakas, Mahir, Pott, Alexander, Meyer, Philippe, Arroja, Jose D., Banning, Adrian, Cuculi, Florim, Kobza, Richard, Fischer, Thomas A., Vasankari, Tuija, Airaksinen, K.E. Juhani, Paolini, Carla, Bilato, Claudio, Carrilho-Ferreira, Pedro, Opolski, Grzegorz, Dworakowski, Rafal, MacCarthy, Philip, Kaiser, Christoph, Osswald, Stefan, Galiuto, Leonarda, Dichtl, Wolfgang, Chan, Christina, Bridgman, Paul, Delmas, Clément, Lairez, Olivier, El-Battrawy, Ibrahim, Akin, Ibrahim, Gilyarova, Ekaterina, Shilova, Alexandra, Gilyarov, Mikhail, Kozel, Martin, Tousek, Petr, Widimský, Petr, Winchester, David E., Galuszka, Jan, Ukena, Christian, Horowitz, John D., Di Mario, Carlo, Prasad, Abhiram, Rihal, Charanjit S., Pinto, Fausto J., Crea, Filippo, Borggrefe, Martin, Braun-Dullaeus, Ruediger C., Rottbauer, Wolfgang, Bauersachs, Johann, Katus, Hugo A., Hasenfuß, Gerd, Tschöpe, Carsten, Pieske, Burkert M., Thiele, Holger, Schunkert, Heribert, Böhm, Michael, Felix, Stephan B., Münzel, Thomas, Bax, Jeroen J., Lüscher, Thomas F., Ruschitzka, Frank, Ghadri, Jelena R., Bossone, Eduardo, and Templin, Christian
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- 2020
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11. Is spontaneous coronary artery dissection (SCAD) related to local anatomy and hemodynamics? An exploratory study
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Candreva, Alessandro; https://orcid.org/0000-0002-6676-7541, Lodi Rizzini, Maurizio, Schweiger, Victor, Gallo, Diego, Montone, Rocco A, Würdinger, Michael, Stehli, Julia; https://orcid.org/0000-0003-3089-1062, Gilhofer, Thomas, Gotschy, Alexander; https://orcid.org/0000-0001-8655-3244, Frank, Ruschitzka, Stähli, Barbara E; https://orcid.org/0000-0002-3058-6407, Chiastra, Claudio, Morbiducci, Umberto, Templin, Christian; https://orcid.org/0000-0003-0287-4193, Candreva, Alessandro; https://orcid.org/0000-0002-6676-7541, Lodi Rizzini, Maurizio, Schweiger, Victor, Gallo, Diego, Montone, Rocco A, Würdinger, Michael, Stehli, Julia; https://orcid.org/0000-0003-3089-1062, Gilhofer, Thomas, Gotschy, Alexander; https://orcid.org/0000-0001-8655-3244, Frank, Ruschitzka, Stähli, Barbara E; https://orcid.org/0000-0002-3058-6407, Chiastra, Claudio, Morbiducci, Umberto, and Templin, Christian; https://orcid.org/0000-0003-0287-4193
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AIMS: Spontaneous coronary artery dissection (SCAD) is an increasingly diagnosed cause of myocardial infarction with unclear pathophysiology. The aim of the study was to test if vascular segments site of SCAD present distinctive local anatomy and hemodynamic profiles. METHODS: Coronary arteries with spontaneously healed SCAD (confirmed by follow-up angiography) underwent three-dimensional reconstruction, morphometric analysis with definition of vessel local curvature and torsion, and computational fluid dynamics (CFD) simulations with derivation of time-averaged wall shear stress (TAWSS) and topological shear variation index (TSVI). The (reconstructed) healed proximal SCAD segment was visually inspected for co-localization with curvature, torsion, and CFD-derived quantities hot spots. RESULTS: Thirteen vessels with healed SCAD underwent the morpho-functional analysis. Median time between baseline and follow-up coronary angiograms was 57 (interquartile range [IQR] 45-95) days. In seven cases (53.8%), SCAD was classified as type 2b and occurred in the left anterior descending artery or near a bifurcation. In all cases (100%), at least one hot spot co-localized within the healed proximal SCAD segment, in 9 cases (69.2%) ≥ 3 hot spots were identified. Healed SCAD in proximity of a coronary bifurcation presented lower TAWSS peak values (6.65 [IQR 6.20-13.20] vs. 3.81 [2.53-5.17] Pa, p = 0.008) and hosted less frequently TSVI hot spots (100% vs. 57.1%, p = 0.034). CONCLUSION: Vascular segments of healed SCAD were characterized by high curvature/torsion and WSS profiles reflecting increased local flow disturbances. Hence, a pathophysiological role of the interaction between vessel anatomy and shear forces in SCAD is hypothesized.
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- 2023
12. Sex discrepancies in pathophysiology, presentation, treatment, and outcomes of severe aortic stenosis
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Stehli, Julia, Zaman, Sarah, Stähli, Barbara E, Stehli, Julia, Zaman, Sarah, and Stähli, Barbara E
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This review gives an overview of sex-based differences in aortic valve stenosis, spanning from pathophysiological mechanisms and disease progression, clinical presentation, presence of comorbidities, and diagnostic assessment, to treatment and outcomes. In particular, sex-related differences in the degree of aortic valve calcification, the response of the left ventricle to pressure overload, as well as in the referral to procedures, with women being less frequently referred for surgical aortic valve replacement and experiencing longer waiting times for transcatheter procedures, will be discussed. Sex-related differences are also particularly evident in outcomes of patients with severe aortic stenosis undergoing surgical or transcatheter procedures. The apparent sex paradox seen in women undergoing transcatheter aortic valve implantation refers to the phenomenon of women experiencing higher rates of short-term mortality and bleeding events, but demonstrating improved long-term survival as compared to men. Women who undergo surgical aortic valve replacement have generally worse outcomes as compared to men, which is reflected by the inclusion of female sex in surgical risk calculation scores. Hence, a thorough understanding of sex-related differences in aortic valve stenosis is important to provide optimal and personalized patient care.
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- 2023
13. Prognostic impact of fractional flow reserve measurements in patients with acute coronary syndromes: a subanalysis of the FLORIDA study
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Gerhardt, Teresa, Stähli, Barbara E; https://orcid.org/0000-0002-3058-6407, Rudolph, Tanja K, Lutz, Matthias, Schatz, Anne-Sophie, Zanders, Lukas, Schubert, Tino, Stueve, Magnus, West, Nick E J, Boone, Els, Landmesser, Ulf; https://orcid.org/0000-0002-0214-3203, Leistner, David M; https://orcid.org/0000-0002-4351-420X, Gerhardt, Teresa, Stähli, Barbara E; https://orcid.org/0000-0002-3058-6407, Rudolph, Tanja K, Lutz, Matthias, Schatz, Anne-Sophie, Zanders, Lukas, Schubert, Tino, Stueve, Magnus, West, Nick E J, Boone, Els, Landmesser, Ulf; https://orcid.org/0000-0002-0214-3203, and Leistner, David M; https://orcid.org/0000-0002-4351-420X
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Randomized trials suggest benefits for fractional flow reserve (FFR)-guided vs. angiography-guided treatment strategies in well-defined and selected patient cohorts with acute coronary syndromes (ACS). The long-term prognostic value of FFR measurement in unselected all-comer ACS patients, however, remains unknown. This subanalysis of the Fractional FLOw Reserve In cardiovascular DiseAses (FLORIDA) study sought to investigate the long-term effects of FFR in the management of lesions in patients with acute coronary syndrome (ACS). FLORIDA was an observational all-comer cohort study performed in Germany, that was population-based and unselected. Patients enrolled into the anonymized InGef Research Database presenting with ACS and undergoing coronary angiography between January 2014 and December 2015 were included in the analysis. Patients were stratified into either the FFR-guided or the angiography-guided treatment arm, based on the treatment received. A matched cohort study design was used. The primary endpoint was all-cause mortality. The secondary endpoint was major adverse cardiovascular events (MACE), a composite of death, non-fatal myocardial infarction (MI), and repeat revascularization. Follow-up time was 3 years. Rates of 3-year mortality were 10.2 and 14.0% in the FFR-guided and the angiography-guided treatment arms (p = 0.04), corresponding to a 27% relative risk reduction for FFR in ACS patients. Rates of MACE were similar in both arms (47.7 vs. 51.5%, p = 0.14), including similar rates of non-fatal MI (27.7 vs. 25.4%, p = 0.47) and revascularization (9.9 vs. 12.1%, p = 0.17). In this large, all-comer observational study of ACS patients, FFR-guided revascularization was associated with a lower mortality at 3 years. This finding encourages the routine use of FFR to guide lesion revascularization in patients presenting with ACS.
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- 2023
14. Modification of the GRACE Risk Score for Risk Prediction in Patients With Acute Coronary Syndromes
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Georgiopoulos, Georgios, Kraler, Simon, Mueller-Hennessen, Matthias, Delialis, Dimitrios, Mavraganis, Georgios, Sopova, Kateryna, Wenzl, Florian A, Räber, Lorenz, Biener, Moritz, Stähli, Barbara E, Maneta, Eleni, Spray, Luke, Iglesias, Juan F, Coelho-Lima, Jose, Tual-Chalot, Simon, Muller, Olivier, Mach, François, Frey, Norbert, Duerschmied, Daniel, Langer, Harald F, Katus, Hugo, Roffi, Marco, Camici, Giovanni G, Mueller, Christian, Giannitsis, Evangelos, Spyridopoulos, Ioakim, Lüscher, Thomas F, Stellos, Konstantinos, Stamatelopoulos, Kimon, Georgiopoulos, Georgios, Kraler, Simon, Mueller-Hennessen, Matthias, Delialis, Dimitrios, Mavraganis, Georgios, Sopova, Kateryna, Wenzl, Florian A, Räber, Lorenz, Biener, Moritz, Stähli, Barbara E, Maneta, Eleni, Spray, Luke, Iglesias, Juan F, Coelho-Lima, Jose, Tual-Chalot, Simon, Muller, Olivier, Mach, François, Frey, Norbert, Duerschmied, Daniel, Langer, Harald F, Katus, Hugo, Roffi, Marco, Camici, Giovanni G, Mueller, Christian, Giannitsis, Evangelos, Spyridopoulos, Ioakim, Lüscher, Thomas F, Stellos, Konstantinos, and Stamatelopoulos, Kimon
- Abstract
IMPORTANCE The Global Registry of Acute Coronary Events (GRACE) risk score, a guideline-recommended risk stratification tool for patients presenting with acute coronary syndromes (ACS), does not consider the extent of myocardial injury. OBJECTIVE To assess the incremental predictive value of a modified GRACE score incorporating high-sensitivity cardiac troponin (hs-cTn) T at presentation, a surrogate of the extent of myocardial injury. DESIGN, SETTING, AND PARTICIPANTS This retrospectively designed longitudinal cohort study examined 3 independent cohorts of 9803 patients with ACS enrolled from September 2009 to December 2017; 2 ACS derivation cohorts (Heidelberg ACS cohort and Newcastle STEMI cohort) and an ACS validation cohort (SPUM-ACS study). The Heidelberg ACS cohort included 2535 and the SPUM-ACS study 4288 consecutive patients presenting with a working diagnosis of ACS. The Newcastle STEMI cohort included 2980 consecutive patients with ST-elevation myocardial infarction treated with primary percutaneous coronary intervention. Data were analyzed from March to June 2023. EXPOSURES In-hospital, 30-day, and 1-year mortality risk estimates derived from an updated risk score that incorporates continuous hs-cTn T at presentation (modified GRACE). MAIN OUTCOMES AND MEASURES The predictive value of continuous hs-cTn T and modified GRACE risk score compared with the original GRACE risk score. Study end points were all-cause mortality during hospitalization and at 30 days and 1 year after the index event. RESULTS Of 9450 included patients, 7313 (77.4%) were male, and the mean (SD) age at presentation was 64.2 (12.6) years. Using continuous rather than binary hs-cTn T conferred improved discrimination and reclassification compared with the original GRACE score (in-hospital mortality: area under the receiver operating characteristic curve [AUC], 0.835 vs 0.741; continuous net reclassification improvement [NRI], 0.208; 30-day mortality: AUC, 0.828 vs 0.740; NRI, 0.312; 1-y
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- 2023
15. 'Puncture-to-Loop' Technique to Retrieve Embolized Patent Foramen Ovale Occluder
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Chen, Mi; https://orcid.org/0000-0003-3265-4618, Michel, Jonathan M, Stähli, Barbara E; https://orcid.org/0000-0002-3058-6407, Gilhofer, Thomas S, Tanner, Felix C; https://orcid.org/0000-0002-4315-2667, Kasel, Albert Markus; https://orcid.org/0000-0002-1090-9213, Chen, Mi; https://orcid.org/0000-0003-3265-4618, Michel, Jonathan M, Stähli, Barbara E; https://orcid.org/0000-0002-3058-6407, Gilhofer, Thomas S, Tanner, Felix C; https://orcid.org/0000-0002-4315-2667, and Kasel, Albert Markus; https://orcid.org/0000-0002-1090-9213
- Abstract
A 62-year-old man experienced embolization of a patent foramen ovale (PFO) occlusion device in the pulmonary artery. The device was successfully retrieved using "puncture to loop" technique, without the need of specific materials. This is a challenging retrieval situation, confirming the feasibility and flexibility of the technique. (Level of Difficulty: Advanced.).
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- 2023
16. Preventing Lower Limb Graft Thrombosis after Infrainguinal Arterial Bypass Surgery with Antithrombotic Agents (PATENT Study): An International Expert Based Delphi Consensus
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Meuli, Lorenz; https://orcid.org/0000-0001-7493-2319, Stadlbauer, Thomas, Stähli, Barbara E; https://orcid.org/0000-0002-3058-6407, Espinola-Klein, Christine, Zimmermann, Alexander; https://orcid.org/0000-0003-0635-8591, Meuli, Lorenz; https://orcid.org/0000-0001-7493-2319, Stadlbauer, Thomas, Stähli, Barbara E; https://orcid.org/0000-0002-3058-6407, Espinola-Klein, Christine, and Zimmermann, Alexander; https://orcid.org/0000-0003-0635-8591
- Abstract
(1) Background: High-level evidence on antithrombotic therapy after infrainguinal arterial bypass surgery in specific clinical scenarios is lacking. (2) Methods: A modified Delphi procedure was used to develop consensus statements. Experts voted on antithrombotic treatment regimens for three types of infrainguinal arterial bypass procedures: above-the-knee popliteal artery; below-the-knee popliteal artery; and distal, using vein, prosthetic, or biological grafts. The treatment regimens for these nine procedures were then voted on in three clinical scenarios: isolated PAOD, atrial fibrillation, and recent coronary intervention. (3) Results: The survey was conducted with 28 experts from 15 European countries, resulting in consensus statements on 25/27 scenarios. Experts recommended single antiplatelet therapy after above-the-knee popliteal artery bypasses regardless of the graft material used. For below-the-knee popliteal artery bypasses, experts suggested combining single antiplatelet therapy with low-dose rivaroxaban if the graft material used was autologous or biological. They did not recommend switching to triple therapy for patients on oral anticoagulants for atrial fibrillation or dual antiplatelet therapy in any scenario. (4) Conclusions: Great inconsistency in the antithrombotic therapy administered was found in this study. This consensus offers guidance for scenarios that are not covered in the current ESVS guidelines but must be interpreted within its limitations.
- Published
- 2023
17. Timing of Complete Revascularization with Multivessel PCI for Myocardial Infarction
- Author
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Stähli, Barbara E, Varbella, Ferdinando, Linke, Axel, Schwarz, Bettina, Felix, Stephan B, Seiffert, Moritz, Kesterke, Rahel, Nordbeck, Peter, Witzenbichler, Bernhard, Lang, Irene M, Kessler, Mirjam, Valina, Christian, Dibra, Alban, Rohla, Miklos, Moccetti, Marco, Vercellino, Matteo, Gaede, Luise, Bott-Flügel, Lorenz, Jakob, Philipp, Stehli, Julia, Candreva, Alessandro; https://orcid.org/0000-0002-6676-7541, Templin, Christian; https://orcid.org/0000-0003-0287-4193, Schindler, Matthias, Wischnewsky, Manfred, Zanda, Greca, Quadri, Giorgio; https://orcid.org/0000-0003-4164-2758, Mangner, Norman; https://orcid.org/0000-0003-0793-7923, Toma, Aurel, Magnani, Giulia, Clemmensen, Peter, Lüscher, Thomas F; https://orcid.org/0000-0002-5259-538X, Münzel, Thomas; https://orcid.org/0000-0001-5503-4150, Schulze, P Christian, Laugwitz, Karl-Ludwig, Rottbauer, Wolfgang, Huber, Kurt, Neumann, Franz-Josef; https://orcid.org/0000-0002-0921-8351, Schneider, Steffen, Weidinger, Franz, Achenbach, Stephan; https://orcid.org/0000-0002-7596-095X, Richardt, Gert, Kastrati, Adnan, Ford, Ian, Maier, Willibald, Ruschitzka, Frank; https://orcid.org/0000-0001-5972-0596, MULTISTARS AMI Investigators, Stähli, Barbara E, Varbella, Ferdinando, Linke, Axel, Schwarz, Bettina, Felix, Stephan B, Seiffert, Moritz, Kesterke, Rahel, Nordbeck, Peter, Witzenbichler, Bernhard, Lang, Irene M, Kessler, Mirjam, Valina, Christian, Dibra, Alban, Rohla, Miklos, Moccetti, Marco, Vercellino, Matteo, Gaede, Luise, Bott-Flügel, Lorenz, Jakob, Philipp, Stehli, Julia, Candreva, Alessandro; https://orcid.org/0000-0002-6676-7541, Templin, Christian; https://orcid.org/0000-0003-0287-4193, Schindler, Matthias, Wischnewsky, Manfred, Zanda, Greca, Quadri, Giorgio; https://orcid.org/0000-0003-4164-2758, Mangner, Norman; https://orcid.org/0000-0003-0793-7923, Toma, Aurel, Magnani, Giulia, Clemmensen, Peter, Lüscher, Thomas F; https://orcid.org/0000-0002-5259-538X, Münzel, Thomas; https://orcid.org/0000-0001-5503-4150, Schulze, P Christian, Laugwitz, Karl-Ludwig, Rottbauer, Wolfgang, Huber, Kurt, Neumann, Franz-Josef; https://orcid.org/0000-0002-0921-8351, Schneider, Steffen, Weidinger, Franz, Achenbach, Stephan; https://orcid.org/0000-0002-7596-095X, Richardt, Gert, Kastrati, Adnan, Ford, Ian, Maier, Willibald, Ruschitzka, Frank; https://orcid.org/0000-0001-5972-0596, and MULTISTARS AMI Investigators
- Abstract
BACKGROUND In patients with ST-segment elevation myocardial infarction (STEMI) with multivessel coronary artery disease, the time at which complete revascularization of nonculprit lesions should be performed remains unknown. METHODS We performed an international, open-label, randomized, noninferiority trial at 37 sites in Europe. Patients in a hemodynamically stable condition who had STEMI and multivessel coronary artery disease were randomly assigned to undergo immediate multivessel percutaneous coronary intervention (PCI; immediate group) or PCI of the culprit lesion followed by staged multivessel PCI of nonculprit lesions within 19 to 45 days after the index procedure (staged group). The primary end point was a composite of death from any cause, nonfatal myocardial infarction, stroke, unplanned ischemia-driven revascularization, or hospitalization for heart failure at 1 year after randomization. The percentages of patients with a primary or secondary end-point event are provided as Kaplan-Meier estimates at 6 months and at 1 year. RESULTS We assigned 418 patients to undergo immediate multivessel PCI and 422 to undergo staged multivessel PCI. A primary end-point event occurred in 35 patients (8.5%) in the immediate group as compared with 68 patients (16.3%) in the staged group (risk ratio, 0.52; 95% confidence interval, 0.38 to 0.72; P<0.001 for noninferiority and P<0.001 for superiority). Nonfatal myocardial infarction and unplanned ischemia-driven revascularization occurred in 8 patients (2.0%) and 17 patients (4.1%), respectively, in the immediate group and in 22 patients (5.3%) and 39 patients (9.3%), respectively, in the staged group. The risk of death from any cause, the risk of stroke, and the risk of hospitalization for heart failure appeared to be similar in the two groups. A total of 104 patients in the immediate group and 145 patients in the staged group had a serious adverse event. CONCLUSIONS Among patients in hemodynamically stable condition with STE
- Published
- 2023
18. Culprit plaque morphology determines inflammatory risk and clinical outcomes in acute coronary syndrome.
- Author
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Gerhardt, Teresa, Seppelt, Claudio, Abdelwahed, Youssef S, Meteva, Denitsa, Wolfram, Christopher, Stapmanns, Philip, Erbay, Aslihan, Zanders, Lukas, Nelles, Gregor, Musfeld, Johanna, Sieronski, Lara, Stähli, Barbara E, Montone, Rocco A, Vergallo, Rocco, Haghikia, Arash, Skurk, Carsten, Knebel, Fabian, Dreger, Henryk, Trippel, Tobias D, and Rai, Himanshu
- Subjects
ACUTE coronary syndrome ,MAJOR adverse cardiovascular events ,TREATMENT effectiveness ,ANGINA pectoris ,GINGIVITIS - Abstract
Aims Rupture of the fibrous cap (RFC) and erosion of an intact fibrous cap (IFC) are the two predominant mechanisms causing acute coronary syndromes (ACS). It is uncertain whether clinical outcomes are different following RFC-ACS vs. IFC-ACS and whether this is affected by a specific inflammatory response. The prospective, translational OPTIcal-COherence Tomography in Acute Coronary Syndrome study programme investigates the impact of the culprit lesion phenotype on inflammatory profiles and prognosis in ACS patients. Methods and results This analysis included 398 consecutive ACS patients, of which 62% had RFC-ACS and 25% had IFC-ACS. The primary endpoint was a composite of cardiac death, recurrent ACS, hospitalization for unstable angina, and target vessel revascularization at 2 years [major adverse cardiovascular events (MACE
+ )]. Inflammatory profiling was performed at baseline and after 90 days. Patients with IFC-ACS had lower rates of MACE+ than those with RFC-ACS (14.3% vs. 26.7%, P = 0.02). In 368-plex proteomic analyses, patients with IFC-ACS showed lower inflammatory proteome expression compared with those with RFC-ACS, including interleukin-6 and proteins associated with the response to interleukin-1β. Circulating plasma levels of interleukin-1β decreased from baseline to 3 months following IFC-ACS (P < 0.001) but remained stable following RFC-ACS (P = 0.25). Interleukin-6 levels decreased in patients with RFC-ACS free of MACE+ (P = 0.01) but persisted high in those with MACE+ . Conclusion This study demonstrates a distinct inflammatory response and a lower risk of MACE+ following IFC-ACS. These findings advance our understanding of inflammatory cascades associated with different mechanisms of plaque disruption and provide hypothesis generating data for personalized anti-inflammatory therapeutic allocation to ACS patients, a strategy that merits evaluation in future clinical trials. [ABSTRACT FROM AUTHOR]- Published
- 2023
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- View/download PDF
19. Transcatheter Aortic Valve-in-Valve Replacement for Degenerated Homograft and Pseudoaneurysm of the Mitral-Aortic Intervalvular Fibrosa
- Author
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Chen, Mi, primary, Michel, Jonathan M., additional, Schmiady, Martin Oliver, additional, Stähli, Barbara E., additional, Gilhofer, Thomas S., additional, Tanner, Felix C., additional, and Kasel, Albert Markus, additional
- Published
- 2023
- Full Text
- View/download PDF
20. Mammalian Target of Rapamycin Inhibition in Patients With ST-Segment Elevation Myocardial Infarction
- Author
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Stähli, Barbara E., primary, Klingenberg, Roland, additional, Heg, Dik, additional, Branca, Mattia, additional, Manka, Robert, additional, Kapos, Ioannis, additional, Müggler, Oliver, additional, Denegri, Andrea, additional, Kesterke, Rahel, additional, Berger, Florence, additional, Stehli, Julia, additional, Candreva, Alessandro, additional, von Eckardstein, Arnold, additional, Carballo, David, additional, Hamm, Christian, additional, Landmesser, Ulf, additional, Mach, François, additional, Moccetti, Tiziano, additional, Jung, Christian, additional, Kelm, Malte, additional, Münzel, Thomas, additional, Pedrazzini, Giovanni, additional, Räber, Lorenz, additional, Windecker, Stephan, additional, Templin, Christian, additional, Matter, Christian M., additional, Lüscher, Thomas F., additional, and Ruschitzka, Frank, additional
- Published
- 2022
- Full Text
- View/download PDF
21. Transcaval transcatheter aortic valve implantation in bicuspid aortic valve: A step-by-step procedural guidance
- Author
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Chen, Mi, Michel, Jonathan, Stähli, Barbara E, Templin, Christian, Jakob, Philipp, Tanner, Felix C, Kasel, Albert Markus, University of Zurich, and Kasel, Albert Markus
- Subjects
2740 Pulmonary and Respiratory Medicine ,10209 Clinic for Cardiology ,610 Medicine & health ,2705 Cardiology and Cardiovascular Medicine ,2746 Surgery - Published
- 2022
22. Algorithm for systematic valve-crossing in transcatheter aortic valve implantation
- Author
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Chen, Mi, Michel, Jonathan, Stähli, Barbara E, Templin, Christian, Jakob, Philipp, Tanner, Felix C, Kasel, Albert Markus, University of Zurich, and Kasel, Albert Markus
- Subjects
Pulmonary and Respiratory Medicine ,610 Medicine & health ,Aortic Valve Stenosis ,General Medicine ,2705 Cardiology and Cardiovascular Medicine ,2746 Surgery ,Transcatheter Aortic Valve Replacement ,Treatment Outcome ,2740 Pulmonary and Respiratory Medicine ,Aortic Valve ,Fluoroscopy ,Heart Valve Prosthesis ,10209 Clinic for Cardiology ,Humans ,Surgery ,Cardiology and Cardiovascular Medicine ,Algorithms - Abstract
Summary The retrograde valve-crossing of a stenotic aortic valve is a crucial step in the transcatheter aortic valve implantation procedure. In addition to being time-consuming and associated with an increased stroke risk, inappropriate valve-crossing may cause devastating complications. This tutorial review summarizes systematic and detailed techniques to cross the aortic valve. First, the main challenges in retrograde valve-crossing are depicted. Next, a step-by-step guidance on valve-crossing is provided, along with an in-depth description of the three-dimensional anatomy under a two-dimensional fluoroscopy view. Finally, modified techniques for different anatomies are described.
- Published
- 2022
23. Perforation of multipolar electroanatomic mapping catheter in the left atrial appendage during left atrial mapping
- Author
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Guan, Fu, primary, Stähli, Barbara E., additional, Jakob, Philipp, additional, and Wolber, Thomas, additional
- Published
- 2022
- Full Text
- View/download PDF
24. Predictors of mortality in hospital survivors with type 2 diabetes mellitus and acute coronary syndromes
- Author
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Savonitto, Stefano, Morici, Nuccia, Nozza, Anna, Cosentino, Francesco, Perrone Filardi, Pasquale, Murena, Ernesto, Morocutti, Giorgio, Ferri, Marco, Cavallini, Claudio, Eijkemans, Marinus JC, Stähli, Barbara E, Schrieks, Ilse C, Toyama, Tadashi, Lambers Heerspink, HJ, Malmberg, Klas, Schwartz, Gregory G, Lincoff, A Michael, Ryden, Lars, Tardif, Jean Claude, and Grobbee, Diederick E
- Published
- 2018
- Full Text
- View/download PDF
25. Preventing Lower Limb Graft Thrombosis after Infrainguinal Arterial Bypass Surgery with Antithrombotic Agents (PATENT Study): An International Expert Based Delphi Consensus.
- Author
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Meuli, Lorenz, Stadlbauer, Thomas, Stähli, Barbara E., Espinola-Klein, Christine, and Zimmermann, Alexander
- Subjects
DELPHI method ,FIBRINOLYTIC agents ,POPLITEAL artery ,ATRIAL fibrillation ,ORAL medication ,ARTERIAL grafts - Abstract
(1) Background: High-level evidence on antithrombotic therapy after infrainguinal arterial bypass surgery in specific clinical scenarios is lacking. (2) Methods: A modified Delphi procedure was used to develop consensus statements. Experts voted on antithrombotic treatment regimens for three types of infrainguinal arterial bypass procedures: above-the-knee popliteal artery; below-the-knee popliteal artery; and distal, using vein, prosthetic, or biological grafts. The treatment regimens for these nine procedures were then voted on in three clinical scenarios: isolated PAOD, atrial fibrillation, and recent coronary intervention. (3) Results: The survey was conducted with 28 experts from 15 European countries, resulting in consensus statements on 25/27 scenarios. Experts recommended single antiplatelet therapy after above-the-knee popliteal artery bypasses regardless of the graft material used. For below-the-knee popliteal artery bypasses, experts suggested combining single antiplatelet therapy with low-dose rivaroxaban if the graft material used was autologous or biological. They did not recommend switching to triple therapy for patients on oral anticoagulants for atrial fibrillation or dual antiplatelet therapy in any scenario. (4) Conclusions: Great inconsistency in the antithrombotic therapy administered was found in this study. This consensus offers guidance for scenarios that are not covered in the current ESVS guidelines but must be interpreted within its limitations. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
26. Transcaval transcatheter aortic valve implantation in bicuspid aortic valve: A step-by-step procedural guidance
- Author
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Chen, Mi; https://orcid.org/0000-0003-3265-4618, Michel, Jonathan, Stähli, Barbara E, Templin, Christian, Jakob, Philipp, Tanner, Felix C, Kasel, Albert Markus, Chen, Mi; https://orcid.org/0000-0003-3265-4618, Michel, Jonathan, Stähli, Barbara E, Templin, Christian, Jakob, Philipp, Tanner, Felix C, and Kasel, Albert Markus
- Abstract
We report the case of a 78-year-old female with Sapien 3 transcatheter heart valve implantation in the transcaval approach. In this setting, we describe the step-by-step management and technique of the transcaval transcatheter aortic valve implantation. Keywords: bicuspid aortic valve; transcatheter aortic valve implantation (TAVI); transcaval TAVI
- Published
- 2022
27. Perforation of multipolar electroanatomic mapping catheter in the left atrial appendage during left atrial mapping
- Author
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Guan, Fu, Stähli, Barbara E, Jakob, Philipp, Wolber, Thomas, Guan, Fu, Stähli, Barbara E, Jakob, Philipp, and Wolber, Thomas
- Published
- 2022
28. Gender-Specific Performance of One- Compared to Two-Catheter Concepts in Transradial Coronary Angiography - Insights From the Randomized UDDC-Radial-Trial
- Author
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Schneider, Vera S, Lübking, Laura, Stähli, Barbara E, Skurk, Carsten, Lauten, Alexander, Mochmann, Hans-Christian, Schauerte, Patrick, Riedel, Matthias, Steinbeck, Lisa, Rauch-Kröhnert, Ursula, Klotsche, Jens, Landmesser, Ulf, Fröhlich, Georg, Leistner, David M, Schneider, Vera S, Lübking, Laura, Stähli, Barbara E, Skurk, Carsten, Lauten, Alexander, Mochmann, Hans-Christian, Schauerte, Patrick, Riedel, Matthias, Steinbeck, Lisa, Rauch-Kröhnert, Ursula, Klotsche, Jens, Landmesser, Ulf, Fröhlich, Georg, and Leistner, David M
- Abstract
OBJECTIVES The present sub-analysis from the randomized UDDC-Radial-Trial sought to compare one-catheter concepts (OCC) with two-catheter concepts (TCC) in different patient subgroups, particularly in those depending on gender and age. BACKGROUND There is an ongoing debate regarding potential performance differences of OCC compared to TCC for transradial coronary angiography in specific patient subgroups. METHODS The randomized UDDC-Radial-Trial enrolled a total of 300 patients planed for coronary angiography in a 2:1 ratio to either OCC by Tiger II (n = 100) and BLK (n = 100) or TCC by Judkins (n = 100) catheters. Predefined patient subgroups stratified for age, gender and patient constitution were analyzed with regard to the primary outcome measure of time required for a complete coronary angiography. RESULTS In male patients time for coronary angiography was significantly shorter in the TCC group compared to the OCC group (510 ± 37 s vs. 615 ± 35 s; p = 0.046). No difference between the catheter concepts was observed in the subset of female patients (525 ± 34 s vs. 583 ± 54 s; p = 0.43). TCC was associated with shorter coronary angiography time in patients aged <71 years compared to OCC (462 ± 23 s vs. 570 ± 38 s; p = 0.018). In patients ≥72 years of age no difference was detected (573 ± 41 s vs. 636 ± 45 s; p = 0.31). Other subgroups showed no relevant differences in angiography time among OCC and TCC. CONCLUSIONS The present subgroup analysis from the UDDC-radial trial demonstrates the use of OCC in transradial diagnostic angiography to be inferior compared to TCC in terms of angiography time in younger and male patients.
- Published
- 2022
29. Imaging of heart disease in women: review and case presentation
- Author
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Mikail, Nidaa, Rossi, Alexia, Bengs, Susan, Haider, Ahmed, Stähli, Barbara E, Portmann, Angela, Imperiale, Alessio, Treyer, Valerie; https://orcid.org/0000-0002-4584-3031, Meisel, Alexander, Pazhenkottil, Aju P, Messerli, Michael, Regitz-Zagrosek, Vera, Kaufmann, Philipp A, Buechel, Ronny R, Gebhard, Cathérine; https://orcid.org/0000-0001-7240-5822, Mikail, Nidaa, Rossi, Alexia, Bengs, Susan, Haider, Ahmed, Stähli, Barbara E, Portmann, Angela, Imperiale, Alessio, Treyer, Valerie; https://orcid.org/0000-0002-4584-3031, Meisel, Alexander, Pazhenkottil, Aju P, Messerli, Michael, Regitz-Zagrosek, Vera, Kaufmann, Philipp A, Buechel, Ronny R, and Gebhard, Cathérine; https://orcid.org/0000-0001-7240-5822
- Abstract
Cardiovascular diseases (CVD) remain the leading cause of mortality worldwide. Although major diagnostic and therapeutic advances have significantly improved the prognosis of patients with CVD in the past decades, these advances have less benefited women than age-matched men. Noninvasive cardiac imaging plays a key role in the diagnosis of CVD. Despite shared imaging features and strategies between both sexes, there are critical sex disparities that warrant careful consideration, related to the selection of the most suited imaging techniques, to technical limitations, and to specific diseases that are overrepresented in the female population. Taking these sex disparities into consideration holds promise to improve management and alleviate the burden of CVD in women. In this review, we summarize the specific features of cardiac imaging in four of the most common presentations of CVD in the female population including coronary artery disease, heart failure, pregnancy complications, and heart disease in oncology, thereby highlighting contemporary strengths and limitations. We further propose diagnostic algorithms tailored to women that might help in selecting the most appropriate imaging modality.
- Published
- 2022
30. Coexistence of calcified- and lipid-containing plaque components and their association with incidental rupture points in acute coronary syndrome-causing culprit lesions: results from the prospective OPTICO-ACS study
- Author
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Abdelwahed, Youssef S, primary, Nelles, Gregor, additional, Frick, Clara, additional, Seppelt, Claudio, additional, Meteva, Denitsa, additional, Stähli, Barbara E, additional, Rai, Himanshu, additional, Riedel, Matthias, additional, Skurk, Carsten, additional, Rauch-Kröhnert, Ursula, additional, Haghikia, Arash, additional, Sinning, David, additional, Dreger, Henryk, additional, Knebel, Fabian, additional, Trippel, Tobias, additional, Krisper, Maximillian, additional, Klotsche, Jens, additional, Joner, Michael, additional, Landmesser, Ulf, additional, and Leistner, David M, additional
- Published
- 2021
- Full Text
- View/download PDF
31. Postprocedural Troponin Elevation and Mortality After Transcatheter Aortic Valve Implantation
- Author
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Schindler, Matthias, primary, Stöckli, Florin, additional, Brütsch, Rico, additional, Jakob, Philipp, additional, Holy, Erik, additional, Michel, Jonathan, additional, Manka, Robert, additional, Vogt, Paul, additional, Templin, Christian, additional, Kasel, Markus, additional, Ruschitzka, Frank, additional, and Stähli, Barbara E., additional
- Published
- 2021
- Full Text
- View/download PDF
32. Case Report: Sapien 3 Transcatheter Heart Valve Embolization: Cause, Management, and Redo
- Author
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Chen, Mi, primary, Stähli, Barbara E., additional, Michel, Jonathan M., additional, Brinkert, Miriam, additional, Tanner, Felix C., additional, and Kasel, Albert Markus, additional
- Published
- 2021
- Full Text
- View/download PDF
33. Coexistence of calcified- and lipid-containing plaque components and their association with incidental rupture points in acute coronary syndrome-causing culprit lesions: results from the prospective OPTICO-ACS study.
- Author
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Abdelwahed, Youssef S, Nelles, Gregor, Frick, Clara, Seppelt, Claudio, Meteva, Denitsa, Stähli, Barbara E, Rai, Himanshu, Riedel, Matthias, Skurk, Carsten, Rauch-Kröhnert, Ursula, Haghikia, Arash, Sinning, David, Dreger, Henryk, Knebel, Fabian, Trippel, Tobias, Krisper, Maximillian, Klotsche, Jens, Joner, Michael, Landmesser, Ulf, and Leistner, David M
- Subjects
RESEARCH ,ACUTE coronary syndrome ,OPTICAL coherence tomography ,DESCRIPTIVE statistics ,CORONARY artery calcification ,CALCIUM ,LONGITUDINAL method ,LIPIDS - Abstract
Aims Rupture of the fibrous cap (RFC) represents the main pathophysiological mechanism causing acute coronary syndromes (ACS). Destabilization due to plaque biomechanics is considered to be importantly involved, exact mechanisms triggering plaque ruptures are, however, unknown. This study aims at characterizing the relation between plaque components and rupture points at ACS-causing culprit lesions in a large cohort of ACS-patients assessed by high-resolution intracoronary imaging. Methods and results Within the prospective, multicentric OPTICO-ACS study program, the ACS-causing culprit plaques of 282 consecutive patients were investigated following a standardized optical coherence tomography (OCT) imaging protocol. Each pullback was assessed on a frame-by-frame basis for the presence of lipid components (LC), calcium components (CC), and coexistence of both LC and CC (LCC) by two independent OCT-core labs. Of the 282 ACS-patients, 204 patients (72.3%) presented with ACS caused by culprit lesions with rupture of the fibrous cap (RFC-ACS) and 27.7% patients had ACS caused by culprit lesions with intact fibrous cap (IFC-ACS). When comparing RFC-ACS to IFC-ACS, a preferential occurrence of all three plaque components (LC, CC, and LCC) in RFC-ACS became apparent (P < 0.001). Within ruptured culprit lesions, the zone straight at the rupture point [extended rupture zone (RZ)] was characterized by similar (24.7% vs. 24.0%; P = ns) calcium content when compared with the proximal and distal border of the culprit lesion [border zone (BZ)]. The RZ displayed a significantly higher amount of both, LC (100% vs. 69.8%; P < 0.001) and LCC (22.7% vs. 6.8%; P < 0.001), when compared with the BZ. The relative component increase towards the RZ was particularly evident for LCC (+233.8%), while LC showed only a modest increase (+43.3%). Conclusions Calcified- and lipid-containing components characterize ruptured fibrous cap ACS-causing culprit lesions. Their coexistence is accelerated directly at the ruptured point, suggesting a pathophysiological contribution in the development of RFC-ACS. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
34. Incremental Prognostic Value of Coronary Artery Calcium Score for Predicting All-Cause Mortality after Transcatheter Aortic Valve Replacement
- Author
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Eberhard, Matthias, primary, Hinzpeter, Ricarda, additional, Schönenberger, Amadea L. N., additional, Euler, Andre, additional, Kuzo, Nazar, additional, Reeve, Kelly, additional, Stähli, Barbara E., additional, Kasel, Albert M., additional, Manka, Robert, additional, Tanner, Felix C., additional, and Alkadhi, Hatem, additional
- Published
- 2021
- Full Text
- View/download PDF
35. Carbamylated low-density lipoprotein induces endothelial dysfunction
- Author
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Speer, Thimoteus, Owala, Frederick O., Holy, Erik W., Zewinger, Stephen, Frenzel, Felix L., Stähli, Barbara E., Razavi, Marjan, Triem, Sarah, Cvija, Hrvoje, Rohrer, Lucia, Seiler, Sarah, Heine, Gunnar H., Jankowski, Vera, Jankowski, Joachim, Camici, Giovanni G., Akhmedov, Alexander, Fliser, Danilo, Lüscher, Thomas F., and Tanner, Felix C.
- Published
- 2014
- Full Text
- View/download PDF
36. Residual inflammatory risk at 12 months after acute coronary syndromes is frequent and associated with combined adverse events
- Author
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Klingenberg, Roland, Aghlmandi, Soheila, Gencer, Baris, Nanchen, David, Räber, Lorenz, Carballo, David, Carballo, Sebastian, Stähli, Barbara E, Landmesser, Ulf, Rodondi, Nicolas, Mach, François, Windecker, Stephan, Bucher, Heiner C, von Eckardstein, Arnold, Lüscher, Thomas F; https://orcid.org/0000-0002-5259-538X, Matter, Christian M, Klingenberg, Roland, Aghlmandi, Soheila, Gencer, Baris, Nanchen, David, Räber, Lorenz, Carballo, David, Carballo, Sebastian, Stähli, Barbara E, Landmesser, Ulf, Rodondi, Nicolas, Mach, François, Windecker, Stephan, Bucher, Heiner C, von Eckardstein, Arnold, Lüscher, Thomas F; https://orcid.org/0000-0002-5259-538X, and Matter, Christian M
- Abstract
BACKGROUND AND AIMS: Residual inflammatory risk (RIR) after acute coronary syndromes (ACS) may identify patients likely to benefit from anti-inflammatory therapies. METHODS: Patients from the Special Program University Medicine ACS cohort were divided into four groups according to level of hsCRP at baseline and after 12 months: persistently high RIR, increased RIR (first low, then high hsCRP), attenuated RIR (first high, then low hsCRP), or persistently low RIR. High RIR was defined as hsCRP ≥ 2 mg/L. An independently adjudicated incident of combined adverse events was defined as the composite of myocardial infarction, clinically indicated coronary revascularization or cerebrovascular events. RESULTS: Among 1209 patients with available hsCRP, clinical and demographic data, 295 (24.4%) patients had persistently high RIR (delta hsCRP median (IQR): 2.3 (-9.9; 0.3) (mg/L) and 72 (5.96%) patients had increased RIR (delta hsCRP median (IQR): +2.45 (1.2; 8.35) (mg/L). A total of 390 (32.26%) patients had attenuated RIR (delta hsCRP median (IQR): 3.55 (-10; -2) (mg/L) and 452 (37.38%) patients had persistently low RIR (delta hsCRP median (IQR): 0.2 (-0.6; 0.1) (mg/L). Of 90 combined adverse events, 31 (10.5%) occurred in the persistently high (multivariable adjusted OR: 1.71, (95% CI 1.08-2.7), p = 0.022) compared with the three other groups combined (increased RIR: 3 (4.2%), attenuated RIR 30 (7.7%), persistently low RIR 26 (5.8%). CONCLUSIONS: Persistently elevated hsCRP after ACS is found in a quarter of patients with the highest risk of combined adverse events. This underlines the need to perform anti-inflammatory intervention trials in RIR patients.
- Published
- 2021
37. Impact of real-time angiographic co-registered optical coherence tomography on percutaneous coronary intervention: the OPTICO-integration II trial
- Author
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Schneider, Vera S, Böhm, Felix, Blum, Katharina, Riedel, Matthias, Abdelwahed, Youssef S, Klotsche, Jens, Steiner, Julia K, Heuberger, Andrea, Skurk, Carsten, Mochmann, Hans-Christian, Lauten, Alexander, Fröhlich, Georg, Rauch-Kröhnert, Ursula, Haghikia, Arash, Sinning, David, Stähli, Barbara E, Landmesser, Ulf, Leistner, David M; https://orcid.org/0000-0002-4351-420X, Schneider, Vera S, Böhm, Felix, Blum, Katharina, Riedel, Matthias, Abdelwahed, Youssef S, Klotsche, Jens, Steiner, Julia K, Heuberger, Andrea, Skurk, Carsten, Mochmann, Hans-Christian, Lauten, Alexander, Fröhlich, Georg, Rauch-Kröhnert, Ursula, Haghikia, Arash, Sinning, David, Stähli, Barbara E, Landmesser, Ulf, and Leistner, David M; https://orcid.org/0000-0002-4351-420X
- Abstract
AIMS Longitudinal geographic mismatch (LGM) as well as edge dissections are associated with an increased risk of adverse events after percutaneous coronary intervention (PCI). Recently, a novel system of real-time optical coherence tomography (OCT) with angiographic co-registration (ACR) became available and allows matched integration of cross-sectional OCT images to angiography. The OPTICO-integration II trial sought to assess the impact of ACR for PCI planning on the risk of LGM and edge dissections. METHODS A total of 84 patients were prospectively randomized to ACR-guided PCI, OCT-guided PCI (without co-registration), and angiography-guided PCI. Primary endpoint was a composite of major edge dissection and/or LGM as assessed by post-PCI OCT. RESULTS The primary endpoint was significantly reduced in ACR-guided PCI (4.2%) as compared to OCT-guided PCI (19.1%; p = 0.03) and angiography-guided PCI (25.5%; p < 0.01). Rates of LGM were 4.2%, 17.0%, and 22.9% in the ACR-guided PCI, in the OCT-guided PCI, and the angiography-guided PCI groups, respectively (ACR vs. OCT p = 0.04; ACR vs. angiography p = 0.04). The number of major edge dissections was low and without significant differences among the study groups (0% vs. 2.1% vs. 4.3%). CONCLUSION This study for the first time demonstrates superiority of ACR-guided PCI over OCT- and angiography-guided PCI in reducing the composite endpoint of major edge dissection and LGM, which was meanly driven by a reduction of LGM.
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- 2021
38. Feasibility and diagnostic reliability of quantitative flow ratio in the assessment of non-culprit lesions in acute coronary syndrome
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Erbay, Aslihan, Penzel, Lisa, Abdelwahed, Youssef S, Klotsche, Jens, Schatz, Anne-Sophie, Steiner, Julia, Haghikia, Arash, Landmesser, Ulf, Stähli, Barbara E, Leistner, David M, Erbay, Aslihan, Penzel, Lisa, Abdelwahed, Youssef S, Klotsche, Jens, Schatz, Anne-Sophie, Steiner, Julia, Haghikia, Arash, Landmesser, Ulf, Stähli, Barbara E, and Leistner, David M
- Abstract
Several studies have demonstrated the feasibility and safety of hemodynamic assessment of non-culprit coronary arteries in setting of acute coronary syndromes (ACS) using fractional flow reserve (FFR) measurements. Quantitative flow ratio (QFR), recently introduced as angiography-based fast FFR computation, has been validated with good agreement and diagnostic performance with FFR in chronic coronary syndromes. The aim of this study was to assess the feasibility and diagnostic reliability of QFR assessment during primary PCI. A total of 321 patients with ACS and multivessel disease, who underwent primary PCI and were planned for staged PCI of at least one non-culprit lesion were enrolled in the analysis. Within this patient cohort, serial post-hoc QFR analyses of 513 non-culprit vessels were performed. The median time interval between primary and staged PCI was 49 [42-58] days. QFR in non-culprit coronary arteries did not change between acute and staged measurements (0.86 vs 0.87, p = 0.114), with strong correlation (r = 0.94, p ≤ 0.001) and good agreement (mean difference -0.008, 95%CI -0.013-0.003) between measurements. Importantly, QFR as assessed at index procedure had sensitivity of 95.02%, specificity of 93.59% and diagnostic accuracy of 94.15% in prediction of QFR ≤ 0.80 at the time of staged PCI. The present study for the first time confirmed the feasibility and diagnostic accuracy of non-culprit coronary artery QFR during index procedure for ACS. These results support QFR as valuable tool in patients with ACS to detect further hemodynamic relevant lesions with excellent diagnostic performance and therefore to guide further revascularisation therapy.
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- 2021
39. Postprocedural Troponin Elevation and Mortality After Transcatheter Aortic Valve Implantation
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Schindler, Matthias, Stöckli, Florin, Brütsch, Rico, Jakob, Philipp; https://orcid.org/0000-0002-2443-6090, Holy, Erik, Michel, Jonathan, Manka, Robert, Vogt, Paul; https://orcid.org/0000-0001-9649-2940, Templin, Christian; https://orcid.org/0000-0003-0287-4193, Kasel, Markus, Ruschitzka, Frank, Stähli, Barbara E; https://orcid.org/0000-0002-3058-6407, Schindler, Matthias, Stöckli, Florin, Brütsch, Rico, Jakob, Philipp; https://orcid.org/0000-0002-2443-6090, Holy, Erik, Michel, Jonathan, Manka, Robert, Vogt, Paul; https://orcid.org/0000-0001-9649-2940, Templin, Christian; https://orcid.org/0000-0003-0287-4193, Kasel, Markus, Ruschitzka, Frank, and Stähli, Barbara E; https://orcid.org/0000-0002-3058-6407
- Abstract
Background This study sought to investigate the role of postprocedural troponin elevations in mortality prediction after transcatheter aortic valve implantation and to define the threshold at which clinically relevant postprocedure myocardial injury determines mortality. Methods and Results A total of 1333 consecutive patients with transcatheter aortic valve implantation with available postprocedural high-sensitivity cardiac troponin T measurements were included in the analysis. The threshold at which postprocedure myocardial injury determines long-term mortality was identified using restricted cubic spline analysis. A >18.3-fold increase of troponin above the upper reference limit was identified as threshold for relevant postprocedure myocardial injury. Associations remained significant in a landmark analysis between 30 days and 2 years (hazard ratio [HR], 1.61, [95% CI, 1.13-2.28]; P=0.01), after adjusting for known confounders (adjusted HR, 1.90 [95% CI, 1.40-2.57]; P<0001), and in subgroups of patients with coronary artery disease (adjusted HR, 2.17 [95% CI, 1.44-3.29]; P<0.001), renal dysfunction (adjusted HR, 1.88 [95% CI, 1.35-2.62]; P<0.001), and intermediate/high surgical risk (adjusted HR, 2.70 [95% CI, 1.40-5.22]; P=0.003). Conclusions This study determined a troponin threshold for the identification of patients at increased mortality risk after transcatheter aortic valve implantation. The proposed definition of postprocedure myocardial injury advances risk stratification in patients with transcatheter aortic valve implantation and may assist in postprocedural patient management.
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- 2021
40. Case Report: Sapien 3 Transcatheter Heart Valve Embolization: Cause, Management, and Redo
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Chen, Mi, Stähli, Barbara E, Michel, Jonathan M, Brinkert, Miriam, Tanner, Felix C, Kasel, Albert Markus, Chen, Mi, Stähli, Barbara E, Michel, Jonathan M, Brinkert, Miriam, Tanner, Felix C, and Kasel, Albert Markus
- Abstract
The transcatheter heart valve (THV) embolization is a rare but challenging complication in transcatheter aortic valve implantation (TAVI). We report the case of an 81-year-old man with Sapien 3 embolization caused by interrupted rapid pacing. In this setting, we describe the embolized THV management and the technique of the second Sapien 3 implantation.
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- 2021
41. Intraventricular Thrombus Formation and Embolism in Takotsubo Syndrome: Insights From the International Takotsubo Registry
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Ding, Katharina J, Cammann, Victoria L, Szawan, Konrad A, Stähli, Barbara E, Wischnewsky, Manfred, et al, Templin, Christian, and University of Zurich
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10209 Clinic for Cardiology ,610 Medicine & health ,10060 Epidemiology, Biostatistics and Prevention Institute (EBPI) ,2705 Cardiology and Cardiovascular Medicine - Published
- 2020
42. Impact of a nationwide COVID-19 lockdown on acute coronary syndrome referrals
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Holy, Erik W, Jakob, Philipp, Manka, Robert, Stähli, Barbara E, Siegrist, Patrick T, Ruschitzka, Frank, Templin, Christian, Holy, Erik W, Jakob, Philipp, Manka, Robert, Stähli, Barbara E, Siegrist, Patrick T, Ruschitzka, Frank, and Templin, Christian
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- 2020
43. Rationale and design of the MULTISTARS AMI Trial: A randomized comparison of immediate versus staged complete revascularization in patients with ST-segment elevation myocardial infarction and multivessel disease
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Stähli, Barbara E, Varbella, Ferdinando, Schwarz, Bettina, Nordbeck, Peter, Felix, Stephan B, Lang, Irene M, Toma, Aurel, Moccetti, Marco, Valina, Christian, Vercellino, Matteo, Rigopoulos, Angelos G, Rohla, Miklos, Schindler, Matthias, Wischnewsky, Manfred, Linke, Axel, Schulze, P Christian, Richardt, Gert, Laugwitz, Karl-Ludwig, Weidinger, Franz, Rottbauer, Wolfgang, Achenbach, Stephan, Huber, Kurt, Neumann, Franz-Josef, Kastrati, Adnan, Ford, Ian, Ruschitzka, Frank, Maier, Willibald, Stähli, Barbara E, Varbella, Ferdinando, Schwarz, Bettina, Nordbeck, Peter, Felix, Stephan B, Lang, Irene M, Toma, Aurel, Moccetti, Marco, Valina, Christian, Vercellino, Matteo, Rigopoulos, Angelos G, Rohla, Miklos, Schindler, Matthias, Wischnewsky, Manfred, Linke, Axel, Schulze, P Christian, Richardt, Gert, Laugwitz, Karl-Ludwig, Weidinger, Franz, Rottbauer, Wolfgang, Achenbach, Stephan, Huber, Kurt, Neumann, Franz-Josef, Kastrati, Adnan, Ford, Ian, Ruschitzka, Frank, and Maier, Willibald
- Abstract
About half of patients with acute ST-segment elevation myocardial infarction (STEMI) present with multivessel coronary artery disease (MVD). Recent evidence supports complete revascularization in these patients. However, optimal timing of non-culprit lesion revascularization in STEMI patients is unknown because dedicated randomized trials on this topic are lacking. STUDY DESIGN: The MULTISTARS AMI trial is a prospective, international, multicenter, randomized, two-arm, open-label study planning to enroll at least 840 patients. It is designed to investigate whether immediate complete revascularization is non-inferior to staged (within 19-45 days) complete revascularization in patients in stable hemodynamic conditions presenting with STEMI and MVD and undergoing primary percutaneous coronary intervention (PCI). After successful primary PCI of the culprit artery, patients are randomized in a 1:1 ratio to immediate or staged complete revascularization. The primary endpoint is a composite of all-cause death, non-fatal myocardial infarction, ischemia-driven revascularization, hospitalization for heart failure, and stroke at 1 year. CONCLUSIONS: The MULTISTARS AMI trial tests the hypothesis that immediate complete revascularization is non-inferior to staged complete revascularization in stable patients with STEMI and MVD.
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- 2020
44. Coronary artery stents: influence of adaptive statistical iterative reconstruction on image quality using 64-HDCT
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Gebhard, Cathérine, Fiechter, Michael, Fuchs, Tobias A., Stehli, Julia, Müller, Ennio, Stähli, Barbara E., Gebhard, Caroline E., Ghadri, Jelena R., Klaeser, Bernd, Gaemperli, Oliver, and Kaufmann, Philipp A.
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- 2013
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45. Regurgitation after Edwards SAPIEN valve implantation: truly paravalvular or ‘supra-skirtal’?
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Stähli, Barbara E., Gebhard, Catherine, Falk, Volkmar, Corti, Roberto, Jenni, Rolf, and Tanner, Felix C.
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- 2013
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46. Isolated right ventricular ballooning syndrome: a new variant of transient cardiomyopathy
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Stähli, Barbara E., Ruschitzka, Frank, and Enseleit, Frank
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- 2011
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47. Differential immunological signature at the culprit site distinguishes acute coronary syndrome with intact from acute coronary syndrome with ruptured fibrous cap: results from the prospective translational OPTICO-ACS study
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Leistner, David M, primary, Kränkel, Nicolle, additional, Meteva, Denitsa, additional, Abdelwahed, Youssef S, additional, Seppelt, Claudio, additional, Stähli, Barbara E, additional, Rai, Himanshu, additional, Skurk, Carsten, additional, Lauten, Alexander, additional, Mochmann, Hans-Christian, additional, Fröhlich, Georg, additional, Rauch-Kröhnert, Ursula, additional, Flores, Eduardo, additional, Riedel, Matthias, additional, Sieronski, Lara, additional, Kia, Sylvia, additional, Strässler, Elisabeth, additional, Haghikia, Arash, additional, Dirks, Fabian, additional, Steiner, Julia K, additional, Mueller, Dominik N, additional, Volk, Hans-Dieter, additional, Klotsche, Jens, additional, Joner, Michael, additional, Libby, Peter, additional, and Landmesser, Ulf, additional
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- 2020
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48. Impact of a nationwide COVID-19 lockdown on acute coronary syndrome referrals
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Holy, Erik W., primary, Jakob, Philipp, additional, Manka, Robert, additional, Stähli, Barbara E., additional, Siegrist, Patrick T., additional, Ruschitzka, Frank, additional, and Templin, Christian, additional
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- 2020
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49. Multimodality imaging derived energy loss index and outcome after transcatheter aortic valve replacement
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Holy, Erik W, primary, Nguyen-Kim, Thi Dan Linh, additional, Hoffelner, Lisa, additional, Stocker, Daniel, additional, Stadler, Thomas, additional, Stähli, Barbara E, additional, Kebernik, Julia, additional, Maisano, Francesco, additional, Kasel, Markus A, additional, Frauenfelder, Thomas, additional, Ruschitzka, Frank, additional, Nietlispach, Fabian, additional, and Tanner, Felix C, additional
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- 2020
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50. Age-Related Variations in Takotsubo Syndrome
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Cammann, Victoria L., primary, Szawan, Konrad A., additional, Stähli, Barbara E., additional, Kato, Ken, additional, Budnik, Monika, additional, Wischnewsky, Manfred, additional, Dreiding, Sara, additional, Levinson, Rena A., additional, Di Vece, Davide, additional, Gili, Sebastiano, additional, Citro, Rodolfo, additional, Bossone, Eduardo, additional, Neuhaus, Michael, additional, Franke, Jennifer, additional, Meder, Benjamin, additional, Jaguszewski, Miłosz, additional, Noutsias, Michel, additional, Knorr, Maike, additional, Heiner, Susanne, additional, D’Ascenzo, Fabrizio, additional, Dichtl, Wolfgang, additional, Burgdorf, Christof, additional, Kherad, Behrouz, additional, Tschöpe, Carsten, additional, Sarcon, Annahita, additional, Shinbane, Jerold, additional, Rajan, Lawrence, additional, Michels, Guido, additional, Pfister, Roman, additional, Cuneo, Alessandro, additional, Jacobshagen, Claudius, additional, Karakas, Mahir, additional, Koenig, Wolfgang, additional, Pott, Alexander, additional, Meyer, Philippe, additional, Roffi, Marco, additional, Banning, Adrian, additional, Wolfrum, Mathias, additional, Cuculi, Florim, additional, Kobza, Richard, additional, Fischer, Thomas A., additional, Vasankari, Tuija, additional, Airaksinen, K.E. Juhani, additional, Napp, L. Christian, additional, Dworakowski, Rafal, additional, MacCarthy, Philip, additional, Kaiser, Christoph, additional, Osswald, Stefan, additional, Galiuto, Leonarda, additional, Chan, Christina, additional, Bridgman, Paul, additional, Beug, Daniel, additional, Delmas, Clément, additional, Lairez, Olivier, additional, Gilyarova, Ekaterina, additional, Shilova, Alexandra, additional, Gilyarov, Mikhail, additional, El-Battrawy, Ibrahim, additional, Akin, Ibrahim, additional, Poledniková, Karolina, additional, Toušek, Petr, additional, Winchester, David E., additional, Galuszka, Jan, additional, Ukena, Christian, additional, Poglajen, Gregor, additional, Carrilho-Ferreira, Pedro, additional, Hauck, Christian, additional, Paolini, Carla, additional, Bilato, Claudio, additional, Kobayashi, Yoshio, additional, Shoji, Toshihiro, additional, Ishibashi, Iwao, additional, Takahara, Masayuki, additional, Himi, Toshiharu, additional, Din, Jehangir, additional, Al-Shammari, Ali, additional, Prasad, Abhiram, additional, Rihal, Charanjit S., additional, Liu, Kan, additional, Schulze, P. Christian, additional, Bianco, Matteo, additional, Jörg, Lucas, additional, Rickli, Hans, additional, Pestana, Gonçalo, additional, Nguyen, Thanh H., additional, Böhm, Michael, additional, Maier, Lars S., additional, Pinto, Fausto J., additional, Widimský, Petr, additional, Felix, Stephan B., additional, Braun-Dullaeus, Ruediger C., additional, Rottbauer, Wolfgang, additional, Hasenfuß, Gerd, additional, Pieske, Burkert M., additional, Schunkert, Heribert, additional, Borggrefe, Martin, additional, Thiele, Holger, additional, Bauersachs, Johann, additional, Katus, Hugo A., additional, Horowitz, John D., additional, Di Mario, Carlo, additional, Münzel, Thomas, additional, Crea, Filippo, additional, Bax, Jeroen J., additional, Lüscher, Thomas F., additional, Ruschitzka, Frank, additional, Ghadri, Jelena R., additional, Opolski, Grzegorz, additional, and Templin, Christian, additional
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- 2020
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