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1. Incidence and pattern of urgent revascularization in acute coronary syndromes treated with ticagrelor or prasugrel

Author

Aytekin, Alp, Scalamogna, Maria, Coughlan, J. J., Lahu, Shqipdona, Ndrepepa, Gjin, Menichelli, Maurizio, Mayer, Katharina, Wöhrle, Jochen, Bernlochner, Isabell, Witzenbichler, Bernhard, Hochholzer, Willibald, Sibbing, Dirk, Angiolillo, Dominick J., Hemetsberger, Rayyan, Tölg, Ralph, Valina, Christian, Müller, Arne, Kufner, Sebastian, Liebetrau, Christoph, Xhepa, Erion, Hapfelmeier, Alexander, Sager, Hendrik B., Joner, Michael, Richardt, Gert, Laugwitz, Karl-Ludwig, Neumann, Franz Josef, Schunkert, Heribert, Schüpke, Stefanie, Kastrati, Adnan, and Cassese, Salvatore

Published
2024
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4. High on-aspirin treatment platelet reactivity and restenosis after percutaneous coronary intervention: results of the Intracoronary Stenting and Antithrombotic Regimen-ASpirin and Platelet Inhibition (ISAR-ASPI) Registry

Author

Mayer, Katharina, Ndrepepa, Gjin, Schroeter, Mira, Emmer, Christopher, Bernlochner, Isabell, Schüpke, Stefanie, Gewalt, Senta, Hilz, Raphaela, Coughlan, John Joseph, Aytekin, Alp, Heyken, Clarissa, Morath, Tanja, Schunkert, Heribert, Laugwitz, Karl-Ludwig, Sibbing, Dirk, and Kastrati, Adnan

Published
2023
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6. Ticagrelor or prasugrel in patients with acute coronary syndrome with off-hour versus on-hour presentation: a subgroup analysis of the ISAR-REACT 5 trial

Author

Behnes, Michael, Lahu, Shqipdona, Ndrepepa, Gjin, Menichelli, Maurizio, Mayer, Katharina, Wöhrle, Jochen, Bernlochner, Isabell, Gewalt, Senta, Witzenbichler, Bernhard, Hochholzer, Willibald, Sibbing, Dirk, Cassese, Salvatore, Angiolillo, Dominick J., Hemetsberger, Rayyan, Valina, Christian, Müller, Arne, Kufner, Sebastian, Hamm, Christian W., Xhepa, Erion, Hapfelmeier, Alexander, Sager, Hendrik B., Joner, Michael, Fusaro, Massimiliano, Richardt, Gert, Laugwitz, Karl-Ludwig, Neumann, Franz-Josef, Schunkert, Heribert, Schüpke, Stefanie, Kastrati, Adnan, and Akin, Ibrahim

Published
2023
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9. Periprocedural myocardial injury according to optical characteristics of neointima and treatment modality of in-stent restenosis

Author

Nano, Nejva, Aytekin, Alp, Ndrepepa, Gjin, Seguchi, Masaru, Bresha, Jola, Alvarez Covarrubias, Hector Alfonso, Nicol, Philipp, Lenz, Tobias, Lahu, Shqipdona, Gewalt, Senta, Voll, Felix, Rheude, Tobias, Wiebe, Jens, Schunkert, Heribert, Kufner, Sebastian, Cassese, Salvatore, Joner, Michael, Kastrati, Adnan, and Xhepa, Erion

Published
2022
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10. Índice de masa corporal y eficacia y seguridad del ticagrelor frente al prasugrel en pacientes con síndrome coronario agudo

Author

Lahu, Shqipdona, Behnes, Michael, Ndrepepa, Gjin, Neumann, Franz-Josef, Sibbing, Dirk, Bernlochner, Isabell, Menichelli, Maurizio, Mayer, Katharina, Richardt, Gert, Gewalt, Senta, Angiolillo, Dominick J., Coughlan, John Joseph, Aytekin, Alp, Witzenbichler, Bernhard, Hochholzer, Willibald, Cassese, Salvatore, Kufner, Sebastian, Xhepa, Erion, Sager, Hendrik B., Joner, Michael, Fusaro, Massimiliano, Laugwitz, Karl-Ludwig, Schunkert, Heribert, Schüpke, Stefanie, Kastrati, Adnan, and Akin, Ibrahim

Published
2022
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12. Coronary no-reflow and adverse events in patients with acute myocardial infarction after percutaneous coronary intervention with current drug-eluting stents and third-generation P2Y12 inhibitors.

Author

Ndrepepa, Gjin, Cassese, Salvatore, Xhepa, Erion, Joner, Michael, Sager, Hendrik B., Kufner, Sebastian, Laugwitz, Karl-Ludwig, Schunkert, Heribert, and Kastrati, Adnan

Abstract

Background: The frequency and prognostic value of coronary no-reflow (CNR) was investigated in studies that have used an outdated reperfusion therapy in terms of stent technology and antithrombotic drugs. We assessed the association of CNR with adverse outcomes in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI) with drug-eluting stents (DES) and newer antithrombotic drugs, ticagrelor or prasugrel. Methods: This study included 3100 patients with AMI who underwent PCI with current DES and third-generation P2Y12 inhibitors. CNR was defined as Thrombolysis in Myocardial Infarction (TIMI) blood flow grade ≤ 2 at the end of PCI. The primary end point was 1-year incidence of net adverse clinical and cerebral events—a composite end point of death of any cause, myocardial infarction, stroke or major bleeding. Results: CNR was diagnosed in 130 patients (4.2%). The primary end point occurred in 28 patients in the CNR group and 354 patients in the reflow group (cumulative incidence 23.2% and 12.8%; adjusted hazard ratio = 1.53, 95% confidence interval 1.01–2.33; P = 0.049). The 1-year incidences of death or myocardial infarction (14.6% vs. 7.6%; P = 0.003), myocardial infarction (8.8% vs. 3.9%; P = 0.007) and major bleeding (10.9% vs. 5.6%; P = 0.008) were significantly higher in patients with CNR than patients with reflow. The risk of adverse events in patients with CNR was highest within the first 30 days after PCI. Conclusion: In patients with AMI undergoing PCI with current DES and third generation P2Y12 receptor inhibitors, CNR was associated with a higher risk of adverse outcomes at 1 year. [ABSTRACT FROM AUTHOR]

Published
2024
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14. Efficacy and safety of ticagrelor versus prasugrel in smokers and nonsmokers with acute coronary syndromes

Author

Lahu, Shqipdona, Ndrepepa, Gjin, Gewalt, Senta, Schüpke, Stefanie, Pellegrini, Costanza, Bernlochner, Isabell, Aytekin, Alp, Neumann, Franz-Josef, Menichelli, Maurizio, Richardt, Gert, Cassese, Salvatore, Xhepa, Erion, Kufner, Sebastian, Sager, Hendrik B., Joner, Michael, Ibrahim, Tareq, Fusaro, Massimiliano, Laugwitz, Karl-Ludwig, Schunkert, Heribert, Kastrati, Adnan, and Mayer, Katharina

Published
2021
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15. Ticagrelor or Prasugrel in Patients With Acute Coronary Syndrome and High Bleeding Risk

Author

Lahu, Shqipdona, Presch, Antonia, Ndrepepa, Gjin, Menichelli, Maurizio, Valina, Christian, Hemetsberger, Rayyan, Witzenbichler, Bernhard, Bernlochner, Isabell, Joner, Michael, Xhepa, Erion, Hapfelmeier, Alexander, Kufner, Sebastian, Rifatov, Nonglag, Sager, Hendrik B., Mayer, Katharina, Kessler, Thorsten, Laugwitz, Karl-Ludwig, Richardt, Gert, Schunkert, Heribert, Neumann, Franz-Josef, Sibbing, Dirk, Angiolillo, Dominick J., Kastrati, Adnan, and Cassese, Salvatore

Published
2022
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18. Aspirin loading and coronary no‐reflow after percutaneous coronary intervention in patients with acute myocardial infarction.

Author

Ndrepepa, Gjin, Cassese, Salvatore, Xhepa, Erion, Joner, Michael, Sager, Hendrik B., Kufner, Sebastian, Laugwitz, Karl‐Ludwig, Schunkert, Heribert, and Kastrati, Adnan

Subjects
*MYOCARDIAL infarction, *PERCUTANEOUS coronary intervention, *ASPIRIN, *DRUG-eluting stents, *BLOOD flow
Abstract

Background: The association of aspirin loading with the risk of coronary no‐reflow (CNR) after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI) has not been investigated. We assessed the association of aspirin loading before PCI with CNR in patients with AMI. Materials and Methods: This study included 3100 patients with AMI undergoing PCI. Of them, 2812 patients received aspirin loading (a single oral [or chewed] or intravenous dose of 150–300 mg) and 288 patients did not receive aspirin loading before PCI. The primary endpoint was CNR, defined as Thrombolysis in Myocardial Infarction blood flow grade of <3 after the PCI. Results: CNR occurred in 130 patients: 127 patients in the group with aspirin loading and 3 patients in the group without aspirin loading before PCI (4.5% vs. 1.0%; odds ratio [OR] = 4.50, 95% confidence interval, [1.42–14.21], p = 0.005). After adjustment, the association between aspirin loading and CNR was significant (adjusted OR = 4.49 [1.56–12.92]; p < 0.001). There was no aspirin loading‐by‐P2Y12 inhibitor (ticagrelor or prasugrel) interaction (pint = 0.465) or aspirin loading‐by‐chronic aspirin therapy on admission (pint = 0.977) interaction with respect to the occurrence of CNR after PCI. Chronic low‐dose aspirin therapy on admission was not independently associated with higher risk of CNR after PCI (adjusted OR = 1.06 [0.65–1.72]; p = 0.824). Conclusion: In patients with AMI undergoing PCI, aspirin loading before the PCI procedure at the guideline‐recommended doses was associated with higher odds of developing CNR. However, due to the limited number of events, the findings should be considered as hypothesis generating. [ABSTRACT FROM AUTHOR]

Published
2024
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28. Qualitative and quantitative neointimal characterization by optical coherence tomography in patients presenting with in-stent restenosis

Author

Xhepa, Erion, Byrne, Robert A., Rivero, Fernando, Rroku, Andi, Cuesta, Javier, Ndrepepa, Gjin, Kufner, Sebastian, Valiente, Teresa Bastante, Cassese, Salvatore, Garcia-Guimaraes, Marcos, Lahmann, Anna Lena, Rai, Himanshu, Schunkert, Heribert, Joner, Michael, Pérez-Vizcayno, María José, Gonzalo, Nieves, Alfonso, Fernando, and Kastrati, Adnan

Published
2019
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39. Coronary No-Reflow after Primary Percutaneous Coronary Intervention—Current Knowledge on Pathophysiology, Diagnosis, Clinical Impact and Therapy.

Author

Ndrepepa, Gjin and Kastrati, Adnan

Subjects
*MYOCARDIAL infarction, *PERCUTANEOUS coronary intervention, *ST elevation myocardial infarction, *CARDIAC magnetic resonance imaging, *PATHOLOGICAL physiology, *CONGESTIVE heart failure
Abstract

Coronary no-reflow (CNR) is a frequent phenomenon that develops in patients with ST-segment elevation myocardial infarction (STEMI) following reperfusion therapy. CNR is highly dynamic, develops gradually (over hours) and persists for days to weeks after reperfusion. Microvascular obstruction (MVO) developing as a consequence of myocardial ischemia, distal embolization and reperfusion-related injury is the main pathophysiological mechanism of CNR. The frequency of CNR or MVO after primary PCI differs widely depending on the sensitivity of the tools used for diagnosis and timing of examination. Coronary angiography is readily available and most convenient to diagnose CNR but it is highly conservative and underestimates the true frequency of CNR. Cardiac magnetic resonance (CMR) imaging is the most sensitive method to diagnose MVO and CNR that provides information on the presence, localization and extent of MVO. CMR imaging detects intramyocardial hemorrhage and accurately estimates the infarct size. MVO and CNR markedly negate the benefits of reperfusion therapy and contribute to poor clinical outcomes including adverse remodeling of left ventricle, worsening or new congestive heart failure and reduced survival. Despite extensive research and the use of therapies that target almost all known pathophysiological mechanisms of CNR, no therapy has been found that prevents or reverses CNR and provides consistent clinical benefit in patients with STEMI undergoing reperfusion. Currently, the prevention or alleviation of MVO and CNR remain unmet goals in the therapy of STEMI that continue to be under intense research. [ABSTRACT FROM AUTHOR]

Published
2023
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47. Research update for articles published in EJCI in 2015

Author

Al‐Daghri, Nasser M., Batzel, Jerry J., Burgmann, Heinz, Carbone, Federico, Charmandari, Evangelia, Chrousos, George P., Distelmaier, Klaus, Cvirn, Gerhard, Dullaart, Robin P. F., Dumitrascu, Dan L., Esteve‐Pastor, María A., Gervasini, Guillermo, Goliasch, Georg, Goswami, Nandu, Gruppen, Eke G., Hernández‐Mijares, Antonio, Kalantaridou, Sophia N., Krause, Robert, Latini, Roberto, Makrigiannakis, Antonis, Marín, Francisco, Masson, Serge, Montecucco, Fabrizio, Ndrepepa, Gjin, Nicolaides, Nicolas C., Novelli, Deborah, Orasan, Olga H., Qorbani, Mostafa, Ratzinger, Franz, Roessler, Andreas, Sabico, Shaun, Sciatti, Edoardo, Stefanaki, Charikleia, Stoner, Lee, Tabatabaei‐Malazy, Ozra, Tatar, Erhan, Toz, Huseyin, Uslu, Adam, Victor, Victor M., and Vizzardi, Enrico

Published
2017
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48. De Ritis ratio and long‐term major cardiovascular adverse events in patients undergoing elective percutaneous coronary intervention.

Author

Ndrepepa, Gjin, Holdenrieder, Stefan, and Kastrati, Adnan

Subjects
*MAJOR adverse cardiovascular events, *PERCUTANEOUS coronary intervention, *PROPORTIONAL hazards models, *MYOCARDIAL infarction, *ALANINE aminotransferase
Abstract

Background: The association of aspartate aminotransferase to alanine aminotransferase ratio (De Ritis ratio) with clinical outcomes in patients with chronic coronary syndromes (CCS) remains unclear. This study aims to assess the association of De Ritis ratio with adverse cardiovascular events in patients with CCS. Materials and Methods: The study included 5020 patients with CCS undergoing percutaneous coronary intervention. Patients were categorized into groups according to tertiles of the De Ritis ratio: tertile 1 (De Ritis ratio: <.75; n = 1688 patients), tertile 2 (De Ritis ratio:.75–1.08; n = 1666 patients) and tertile 3 (De Ritis ratio: >1.08; n = 1666 patients). The primary endpoint was 3‐year mortality. Results: At 3 years, there were 384 deaths, 176 myocardial infarctions and 61 strokes. In groups with De Ritis in the 1st, 2nd and 3rd tertiles, deaths occurred in 5.0%, 7.5% and 14.5% of the patients, respectively (adjusted hazard ratio = 1.09, 95% confidence interval [1.06–1.12], p <.001); myocardial infarctions occurred in 2.6%, 3.5% and 5.1% of the patients, respectively (p <.001); strokes occurred in 1.0%, 1.2% and 1.9% of the patients, respectively (p =.030); bleeding at 30 days (n = 112) occurred in 1.4%, 1.6% and 3.7% of the patients, respectively (p <.001). The C‐statistic of the Cox proportional hazards model for all‐cause mortality with baseline data without the De Ritis ratio was.815 [.794–.836] and.818 [.797–.838] after the inclusion of the De Ritis ratio (delta C‐statistic =.003; p =.005). Conclusions: In patients with CCS undergoing percutaneous coronary intervention, an elevated De Ritis ratio was associated with long‐term major adverse cardiovascular events. [ABSTRACT FROM AUTHOR]

Published
2023
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49. Association of De Ritis Ratio with Prognosis in Patients with Coronary Artery Disease and Aminotransferase Activity within and outside the Healthy Values of Reference Range.

Author

Ndrepepa, Gjin, Cassese, Salvatore, Scalamogna, Maria, Lahu, Shqipdona, Aytekin, Alp, Xhepa, Erion, Schunkert, Heribert, and Kastrati, Adnan

Subjects
*CORONARY artery disease, *REFERENCE values, *CORONARY disease, *ALANINE aminotransferase, *ASPARTATE aminotransferase
Abstract

Background: The aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio (De Ritis ratio), obtained from AST and ALT activities in the healthy range, has not been studied in association with mortality. Methods: This study included 3392 patients with stable coronary heart disease and aminotransferase activity in the reference range. Patients are categorized into two groups: a group with AST and ALT activity in the healthy range (n = 1697), and a group with AST and/or ALT activity outside the healthy range but in the reference range (n = 1695). The primary endpoint was all-cause mortality at three years. Results: The De Ritis ratio (median 5th–95th percentile] was 0.94 [0.61–1.41] in patients with AST and ALT in the healthy range and 0.93 [0.45–1.96] in patients with AST and/or ALT outside the healthy range (p = 0.700). At three years, there were 86 deaths in patients with AST and ALT in the healthy range: 27 deaths (3.9%) in patients with a De Ritis ratio ≤median, and 59 deaths (8.2%) in patients with the De Ritis ratio >median (adjusted hazard ratio [HR] = 1.16, 95% confidence interval [CI] 0.94 to 1.42; p = 0.159); in patients with AST and/or ALT outside the healthy range, there were 148 deaths: 49 deaths (6.6%) in patients with a De Ritis ratio ≤median, and 99 deaths (14.1%) in patients with De Ritis ratio >median (adjusted HR = 1.27 [1.09–1.48], p = 0.002), with both HRs calculated per unit higher values of the De Ritis ratio. Conclusions: The De Ritis ratio obtained from AST and ALT activity in the healthy range was not independently associated with higher risk of mortality. The De Ritis ratio obtained from aminotransferase activity outside the healthy range (but still in the reference range) was independently associated with the risk of mortality. [ABSTRACT FROM AUTHOR]

Published
2023
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50. Association between Platelet Count and Treatment Effect of Ticagrelor or Prasugrel in Patients with Acute Coronary Syndromes.

Author

Koch, Tobias, Lahu, Shqipdona, Coughlan, J. J., Cassese, Salvatore, Voll, Felix, Ndrepepa, Gjin, Menichelli, Maurizio, Valina, Christian, Hemetsberger, Rayyan, Witzenbichler, Bernhard, Bernlochner, Isabell, Joner, Michael, Xhepa, Erion, Mayer, Katharina, Kessler, Thorsten, Laugwitz, Karl-Ludwig, Richardt, Gert, Schunkert, Heribert, Angiolillo, Dominick J., and Sibbing, Dirk

Published
2023
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