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52. Cholesterol levels of high-density lipoprotein (HDL-C), APOB/APOA1 ratio and cardiovascular risk in patients with familial hypercholesterolemia (FH): Data from the HELLAS-FH registry

Author

Rizos, C., primary, Liamis, G., additional, Skoumas, I., additional, Rallidis, L., additional, Tziomalos, K., additional, Skalides, E., additional, Kotsis, V., additional, Garoufi, A., additional, Athyros, V.G., additional, Kolovou, G., additional, Sfikas, G., additional, Bilianou, E., additional, Koutagiar, I., additional, Kiouri, E., additional, Agapakis, D., additional, Zacharis, E., additional, Antza, C., additional, Attilakos, A., additional, Katsiki, N., additional, Koumaras, C., additional, and Liberopoulos, E., additional

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2020
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59. Rivaroxaban for stroke prevention after embolic stroke of undetermined source

Author

Hart, Robert G, Sharma, Mukul, Mundl, Hardi, Kasner, Scott E, Bangdiwala, Shrikant I, Berkowitz, Scott D, Swaminathan, Balakumar, Lavados, Pablo, Wang, Yongjun, Wang, Yilong, Davalos, Antonio, Shamalov, Nikolay, Mikulik, Robert, Cunha, Luis, Lindgren, Arne, Arauz, Antonio, Lang, Wilfried, Czlonkowska, Anna, Eckstein, Jens, Gagliardi, Rubens J, Amarenco, Pierre, Ameriso, Sebastian F, Tatlisumak, Turgut, Veltkamp, Roland, Hankey, Graeme J, Toni, Danilo, Bereczki, Daniel, Uchiyama, Shinichiro, Ntaios, George, Yoon, Byung-Woo, Brouns, Raf, Endres, Matthias, Muir, Keith W, Bornstein, Natan, Ozturk, Serefnur, O'Donnell, Martin J, De Vries Basson, Matthys M, Pare, Guillaume, Pater, Calin, Kirsch, Bodo, Sheridan, Patrick, Peters, Gary, Weitz, Jeffrey I, Peacock, W Frank, Shoamanesh, Ashkan, Benavente, Oscar R, Joyner, Campbell, Themeles, Ellison, Connolly, Anderson DC, Stuart J., Demets, Dl, Kaste, M, Norrving, B, Wyse, Dg, Alet, M, Allende, G, Beinlich, A, Berrios, W, Bruera, G, Castro, D, Chialvo, L, Claverie, S, Contardo, L, Couto, J, Deganutto, R, Diaz, R, Dossi, D, Esnaola, M, Falco, M, Fernandez Pirrone, P, Ferrari, J, Firstenfeld, A, Galli Giqueauk, E, Gilli, M, Gonzalez, L, Gonzalez Toledo, M, Grecco, M, Halac, B, Hawkes, M, Ioli, P, Jure, L, Klein, F, Lepera, S, Lujan, S, Mackinnon, F, Marroquin, M, Martin, J, Parisi, V, Perez Leguizamon, P, Persi, G, Povedano, P, Povedano, G, Pujol Lereis, V, Radrizzani, L, Reich, E, Repetto, M, Rodriguez Lucci, F, Romano, M, Saredo, G, Schneider, M, Simonsini, C, Sumay, G, Thomson, A, Toledo, W, Torres, C, Vila, A, Abdul Rasheed, N, Anderson, C, Bailey, P, Blacker, D, Carcel, C, Clissold, B, Delcourt, C, Field, D, Gangadharan, S, Ghia, D, Kleinig, T, Leyden, J, Ly, J, Ma, H, Mackey, E, Mishra, S, Moey, A, Musuka, T, Pepper, E, Phan, T, Sabet, A, Saw, J, Singh, B, Tryambake, D, Tu, H, Wijeratne, T, Wong, A, Augustin, S, Esterbauer, M, Garnauf, M, Gasiorek, K, Gasser, S, Gaugg, M, Greisenegger, S, Harrasser, M, Heine, M, Huber, B, Joachim, B, Kapeller, P, Krebs, S, Kreuzpointer, R, Kunzmann, J, Lechner, H, Lohninger, B, Luschin, G, Macher, S, Marko, M, Matosevic, B, Mayr, A, Mismas, A, Mitrovic, N, Mutzenbach, J, Oberndorfer, S, Obmann, S, Raffelsberger, T, Roesler, C, Salletmayr, T, Serles, W, Stadler, K, Tinchon, A, Tolino, M, Verocai, V, Vigl, M, Voglsperger, B, Weber, J, Werner, P, Windt, J, Winkler, A, Wurzinger, H, Zelenka, I, Cras, P, Crols, R, De Keyser, J, De Klippel, N, De Pauw, A, De Smedt, A, Dhollander, I, Hermans, S, Ligot, N, Maqueda, V, Maqueda Maqueda, V, Naeije, G, Seynaeve, L, Soors, P, Van Daele, W, Vanacker, P, Vanderschueren, G, Willems, C, Yperzeele, L, Avelar, W, Bacellar, A, Batista, C, Bazan, R, Braga, G, Cardoso, F, Dagnino, M, Fabio, S, Ferreira Junior, G, Freitas, G, Friedrich, M, Gomes Neto, A, Guarda, S, Katsurayama, M, Machado, M, Martins, S, Meira, F, Minelli, C, Morais, R, Moro, C, Neto, O, Polin, M, Silva, D, Weiss, G, Basile, V, Beaudry, M, Berlingieri, J, Blacquiere, D, Buck, B, Chan, R, Coutts, S, Das, S, Desai, J, Ehrensperger, E, Field, T, Gladstone, D, Hachinski, V, Hassan, A, Hegedus, J, Hill, M, Jin, A, Khaw, A, Mackey, A, Maclean, G, Mandzia, J, Mann, S, Mehdiratta, M, Murphy, C, Ng, K, Oczkowski, W, Penn, A, Perera, K, Perez, Y, Pesant, Y, Phillips, S, Poppe, A, Sahlas, J, Shuaib, A, Spence, D, Sposato, L, Stotts, G, Tamayo, A, Teal, P, Wilson, L, Winder, T, Yegappan, C, Yip, S, Andreu, D, Araya, P, Bustamante, G, Figueroa, C, Gasic, K, Herrero, D, Matamala, G, Munoz, S, Olavarria, V, Pasten, J, Polanco, J, Reyes, P, Roldan, A, Salamanca, P, Silva, P, Toloza, C, Verdugo, M, Cai, K, Che, C, Chen, J, Chen, Z, Chen, T, Chen, H, Chen, X, Chen, B, Chen, G, Chen, L, Chu, F, Cui, L, Dai, C, Ding, N, Ding, J, Du, P, Du, J, Fang, L, Feng, J, Gao, Y, Geng, J, Guan, J, Hao, L, Huang, D, Huang, H, Jin, X, Jing, P, Ke, K, Li, G, Li, M, Li, S, Li, J, Liang, Z, Lin, H, Liu, K, Liu, X, Lu, Z, Ma, C, Pei, H, Qiu, J, Qu, X, Shen, W, Sun, X, Tian, J, Tong, L, Tong, Z, Wang, J, Wang, L, Wang, X, Wang, W, Wang, N, Wang, D, Wang, H, Wen, G, Weng, G, Wu, W, Wu, S, Xiao, B, Xiaopeng, W, Xiong, L, Xiong, Y, Xu, Y, Xu, J, Xu, Z, Yang, L, Yang, Y, Yang, X, Yang, J, Yang, Q, Yang, B, Zhang, C, Zhang, B, Zhang, Y, Zhang, S, Zhang, M, Zhang, X, Zhang, J, Zhao, L, Zhou, L, Bar, M, Barteys, M, Bartolottiova, T, Carek, M, Ferencova, K, Fiksa, J, Gallo, J, Goldemund, D, Hanouskova, L, Herzig, R, Hon, P, Jankovych, J, Jura, R, Kadlcikova, J, Kemlink, D, Kopecky, S, Krajickova, D, Kral, M, Krejci, V, Pavlik, O, Peisker, T, Pernicka, M, Peska, S, Rapantova, P, Reif, M, Rekova, P, Sanak, D, Sebejova, M, Skoda, O, Slonkova, J, Stetkarova, I, Tenora, D, Tumova, R, Vaclavik, D, Vasko, P, Veverka, T, Vitkova, E, Volna, J, Andersen, G, Christensen, H, Christensen, T, Damgaard, D, Iversen, H, Krarup Hansen, C, Kruuse, C, Martinussen, M, Modrau, B, Murtuzova, A, Ovesen, C, Papina, M, Svaneborg, N, Von Weitzel-Mudersbach, P, Curtze, S, Fanta, S, Huhtakangas, J, Keskinarkaus, I, Kivioja, R, Koivu, M, Korpela, J, Larjo, T, Linna, M, Marinkovic, I, Martinez-Majander, N, Nieminen, T, Nikkanen, M, Numminen, H, Ortiz, R, Österlund-Tauriala, E, Roine, R, Roine, S, Ruuskanen, J, Saarinen, J, Shulga, A, Sibolt, G, Tapanainen, A, Tapiola, T, Tiainen, M, Tomppo, L, Tumpula, O, Tuomainen, P, Tynkkynen, J, Vainikka, S, Valpas, J, Virta, J, Ylikallio, E, Ylikotila, P, Accassat, S, Aniculaesei, A, Baronnet, F, Bejot, Y, Bindila, D, Birchenall, J, Blanc-Labarre, C, Bodiguel, E, Bouly, S, Cabrejo, L, Calvet, D, Corlobe, A, Crozier, S, Delpont, B, Deltour, S, Diaconu, M, Domigo, V, Epinat, M, Ferreira, A, Fisselier, M, Garnier, P, Gimenez, L, Gueguen, A, Guidoux, C, Guillon, B, Guiraudg, V, Hervieu-Begue, M, Hobeanu, M, Khoumri, C, Lamy, C, Lauer, V, Le Bouc, R, Lecouturier, K, Leder, S, Leger, A, Macian-Montoro, F, Meseguer, E, Morar-Precup, D, Morvan, T, Morvan, E, Obadia, M, Osseby, G, Philippi, S, Pico, F, Quenardelle, V, Reiner, P, Rigual, R, Rosso, C, Sabben, C, Samson, Y, Sevin, M, Sibon, I, Thouvenot, E, Timsit, S, Touze, E, Turc, G, Vahedi, K, Varvat, J, Wacongne, A, Wolff, V, Yalo, B, Zinchenko, I, Bagelmann, H, Bardutzky, J, Barlinn, J, Bathe-Peters, R, Berrouschot, J, Dietzel, J, Ehrlich, S, Fatar, M, Filipov, A, Fluri, F, Gabriel, M, Geran, R, Gliem, M, Graf, S, Griebe, M, Grosse, G, Haeusler, K, Harmel, P, Held, V, Hellwig, S, Henkner, J, Hieber, M, Hoyer, C, Jander, S, Keilitz, J, Kellner, J, Knecht, S, Koch, M, Koehler, L, Kucken, D, Kusnick, G, Lambeck, J, Lee, J, Leisse, I, Lubke-Detring, S, Machetanz, J, Mensch, A, Meyer, N, Molis, A, Mueller, T, Muhl, C, Nave, A, Radtke, A, Roth, Y, Roukens, R, Schlachetzki, F, Schneider, I, Schuppner, R, Schurig, J, Schwarzbach, C, Seidel, G, Sonntag, N, Steinert, S, Stoll, A, Stumpp, A, Taggeselle, J, Trommer, A, Tuetuencue, S, Wartenberg, K, Weissenborn, K, Wittayer, M, Wolf, M, Wolter, C, Worthmann, H, Wunderlich, S, Zitzmann, A, Anagnostou, E, Brokalaki, C, Hatzitolios, A, Kakaletsis, N, Kanellos, I, Kei, A, Korompoki, E, Koutroubi, A, Liamis, G, Makaritsis, K, Manios, E, Michas, F, Milionis, H, Papadopoulos, G, Papadopoulou, E, Papagiannis, A, Polychronopoulou, E, Sagris, D, Satsoglou, S, Savopoulos, C, Solganov, I, Spengos, K, Stamatelopoulos, K, Terentiou, A, Tountopoulou, A, Vassilopoulou, S, Amjad, A, Balazs, A, Bankuti, Z, Bicsak, T, Borcsik, L, Csanyi, A, Csiba, L, Csontos, K, Csuha, R, Czurko, M, Danku, V, Dioszeghy, P, Faust, K, Fazekas, F, Gerocs, Z, Gottschal, M, Gyuker, N, Hajas, A, Horvath, L, Horvath, M, Iljicsov, A, Jakab, K, Javor, L, Kakuk, I, Karasz, O, Kasa, K, Kasza, J, Kerekgyarto, M, Klivenyi, P, Kovacs, K, Kovacs, T, Kovacs, H, Lajos, B, Lovasz, R, Magyar, T, Matoltsy, A, May, Z, Molnar, S, Monosi, C, Motko, T, Nemeth, R, Nemeth, L, Nikl, J, Olah, L, Orosz, V, Panczel, G, Pentek, S, Prendl, B, Rozsa, C, Rum, G, Sas, K, Sas, A, Semjen, J, Simony, Z, Sipos, I, Szabo, K, Szasz, G, Szegedi, N, Szekely, A, Szilagyi, G, Szoboszlai, K, Szpisjak, L, Toth, G, Uhrinyakova, L, Valikovics, A, Varga, Z, Vass, L, Vastagh, I, Vecsei, L, Zboznovits, D, Coveney, S, Horgan, G, Kelly, P, Murphy, S, Smyth, A, Waters, R, Abu Ahmad, F, Bloch, S, Dorodnicov, E, Hallevi, H, Haratz, S, Horev, A, Kolianov, V, Leker, R, Mahagney, A, Marzelik, O, Rephaeli, G, Tanne, D, Weller, B, Acciarresi, M, Adami, A, Agostoni, E, Alemseged, F, Altavilla, R, Angelocola, S, Anticoli, S, Berardi, V, Bravi, M, Candeloro, E, Cappellari, M, Carletti, M, Caruso, P, Castellini, P, Cavallini, A, Cenciarelli, S, Cerrone, P, Condurso, R, Consoli, D, Danese, A, Della Marca, G, Denaro, M, Di Mascio, M, Diomedi, M, Distefano, M, Frisullo, G, Furlanis, G, Galati, F, Gallina, A, Gallinella, E, Giannandrea, D, Giatsidis, F, Greco, L, Impellizzeri, M, Landolfi, A, Lanfranconi, S, Latte, L, Lembo, G, Longoni, M, Marando, C, Marini, C, Marsili, E, Mastrocola, S, Mazzoli, T, Melis, M, Micheletti, N, Moller, J, Monzani, V, Naccarato, M, Paciaroni, M, Padiglioni, C, Persico, A, Pezzella, F, Pieroni, A, Piras, V, Postorino, P, Pozzerese, C, Profice, P, Ricci, S, Rinaldi, C, Rizzato, B, Rocco, A, Roveri, L, Santalucia, P, Semerano, A, Sicilia, I, Silvestrini, M, Sucapane, P, Tomelleri, G, Tropepi, D, Venti, M, Amino, T, Chin, M, Deguchi, I, Fujigasaki, H, Fukuyama, K, Haraguchi, K, Hasegawa, Y, Hattori, M, Hayashi, T, Hirose, M, Honma, Y, Igarashi, S, Irie, S, Itabashi, R, Ito, Y, Kamata, T, Kaneko, C, Kawanishi, M, Kimura, R, Kitagawa, K, Kobayashi, Y, Kondo, T, Kuwashiro, T, Matsumoto, S, Miyake, H, Nagakane, Y, Nishino, S, Nishiyama, Y, Nogawa, S, Ochiai, J, Ohira, M, Okamoto, Y, Okubo, S, Okuda, S, Ooyama, K, Sakai, N, Suenaga, T, Suzuki, H, Takamatsu, K, Takao, M, Taki, W, Takizawa, S, Tokunaga, K, Toyoda, K, Urui, S, Yamada, T, Yamasaki, M, Yoshida, Y, Yuasa, H, Bae, H, Cha, J, Chang, D, Chung, C, Heo, J, Hong, K, Kim, J, Lee, B, Nah, H, Oh, K, Park, M, Park, J, Rha, J, Sohn, S, Amaya Sanchez, L, Arauz Gongora, A, Cantu Brito, C, Chiquete Anaya, E, Felipe Amaya, P, Fernandez Vera, J, Garcia Lopez, R, Gien Lopez, J, Gongora-Rivera, J, Hernandez, J, Leal Cantu, R, Lopez Garza, N, Medina Pech, C, Mendez, B, Pena Sedna, L, Reyes Morales, S, Ruiz Franco, A, Serrano, F, Tovar, M, Uribe, R, Bak, Z, Baranowska, A, Bilik, M, Blazejewska-Hyzorek, B, Brola, W, Brzoska-Mizgalska, J, Buksinska-Lisik, M, Chorazy, M, Czerska, M, Czuryszkiewicz, M, Dalek, G, Dylewicz, L, Fiszer, U, Fraczek, A, Friedman, A, Fryze, W, Gasecki, D, Gębura, K, Geremek, M, Glabinski, A, Gluszkiewicz, M, Goździk, I, Grzesik, M, Jasek, L, Kaczorowska, B, Kalinowska, K, Kaminska, K, Kapica-Topczewska, K, Karlinski, M, Kobayashi, A, Kosarz-Lanczek, K, Kowalczyk, K, Kowalska, M, Kraska, J, Krzyzanowska, M, Kulakowska, A, Kurkowska-Jastrzebska, I, Lasek-Bal, A, Litwin, T, Morton, M, Myśliwy, W, Nosek, K, Nowak, B, Nowakowska-Śledź, E, Odyniec, A, Oleszek, J, Ozdoba-Rot, J, Palasik, W, Pawelczyk, M, Rozanski, D, Rozniecki, J, Sawicka, M, Sieczkowska, E, Skowron, P, Skowronska, M, Sliwinska, B, Sobolewski, P, Sobota, A, Stoiński, J, Szczuchniak, W, Szczyrba, S, Szewczyk, Z, Szlufik, S, Tarasiuk, J, Tutaj, A, Uchwat, U, Wach-Klink, A, Winska-Tereszkiewicz, A, Wisniewska, A, Włodek, A, Wojnarowska-Arendt, A, Zalewska, J, Zielinska-Turek, J, Ziomek, M, Zwiernik, J, Abreu, P, E Silva A, Amaral, Azevedo, E, Barroso, C, Calejo, M, Campillo, J, Campos Costa, E, Coelho, J, Correia, M, Correia, C, Gregorio, T, Lopes, D, Machado, C, Mendonca, T, Pereira, L, Pidal, A, Pineiro, S, Pinto, A, Ribeiro, J, Rodrigues, M, Salgado, P, Salgado, A, Santo, G, Sargento, J, Varela, R, Abroskina, M, Badalyan, K, Balueva, T, Barulin, A, Bazhenova, O, Belkin, A, Bogdanov, E, Daineko, A, Druzenko, I, Fedin, A, Fidler, M, Gogoleva, E, Golikov, K, Gonysheva, Y, Greshnova, I, Guryanova, N, Gusev, V, Kashaeva, E, Kaygorodtseva, S, Khairutdinova, D, Kholopov, M, Kirpicheva, S, Koltsov, I, Konkov, I, Kurenkova, N, Kurtenkova, N, Kurushina, O, Kustova, M, Lagutenko, M, Lenskaya, L, Lupinogina, L, Lvova, A, Melnikova, E, Meshkova, K, Morozova, E, Mozhejko, E, Nikoforova, M, Obrezan, A, Ondar, V, Pizova, N, Polyakov, A, Popov, D, Prazdnichkova, E, Prokopenko, S, Pudov, E, Salnikov, M, Samoshkina, O, Semushina, D, Shchukin, I, Shepeleva, E, Shmonin, A, Smolkin, A, Soldatov, M, Soloveva, L, Solovyeva, E, Stakhovskaya, L, Tcvetkova, S, Varvyanskaya, N, Voznyuk, I, Zhirnova, O, Ahmed, F, Basson, M, Engelbrecht, J, Hobson, B, Jansen, J, Nel, J, Nell, H, Njovane, X, Pretorius, M, Roos, J, Salig, S, Siebert, M, Amaro, S, Arenillas Lara, J, Arias Rivas, S, Baez Martinez, E, Bas, M, Bashir, S, Bragado, I, Cajaraville, S, Camps, P, Cardona Portela, P, Casado-Naranjo, I, Castellanos, M, Cayuela Caudevilla, N, Chamorro, A, Constantino Silva, A, Cortijo Garcia, E, De La Torre, J, De Torres, R, Diaz Otero, F, Diez-Tejedor, E, Escribano, B, Escudero, I, Fernandez, M, Font, M, Fortea, G, Freijo, M, Fuentes Gimeno, B, Gamero, M, Garcia, J, Garcia Pastor, A, Garcia Sanchez, S, Geniz Clavijo, M, Gil Nunez, A, Giralt, E, Gomez-Choco, M, Gomis, M, Gutiérrez, R, Iglesias Mohedano, A, Lago, A, Lara Lezama, L, Lara Rodriguez, B, Llull, L, Lopez Fernandez, M, Lorenzo, A, Maestre-Moreno, J, Marta Moreno, J, Marti-Fabregas, J, Martínez Sánchez, P, Mauri Cabdevila, G, Mengual Chirifie, J, Molina, C, Molina, J, Moniche, F, Morales, L, Morales, A, Nombela, F, Núñez, F, Pagola, J, Perez, S, Portilla, J, Prats, L, Purroy, F, Quesada Garcia, H, Ramirez Moreno, J, Redondo Robles, L, Renu, A, Riveira Rodriguez, C, Roa, A, Rodriguez Campello, A, Rodriguez Pardo De Donlebun, J, Rodriguez Yanez, M, Rudilosso, S, Ruiz Ares, G, Sànchez Cerón, M, Santamaria Cadavid, M, Sanz Cuesta, B, Serena, J, Silva, Y, Soriano Soriano, C, Tejada Garcia, J, Tejada Meza, H, Tembl, J, Terceno, M, Trillo, S, Urra, X, Usero Ruiz, M, Vazquez, P, Vilar, C, Villanueva Osorio, J, Ximenez-Carrillo, A, Zapata, E, Esbjornsson, M, Karlsson, J, Kremer, C, Kuris, A, Staaf, G, Stiehm, M, Timberg, I, Tossavainen, C, Wester, P, Arnold, M, Baumgartner, P, Beer, J, Bicker, H, Boos, L, Cereda, C, Chaloulos-Iakovidis, P, Christian, L, Engelter, S, Fisch, L, Fischer, U, Frey, S, Frick, M, Hauk, M, Hoffmann, M, Kahles, T, Manno, C, Medlin, F, Mircea, D, Nedeltchev, K, Panos, L, Polymeris, A, Schillinger, N, Stocker, R, Sztajzel, R, Alaydin, H, Batur Caglayan, H, Colakoglu, S, Demirci, N, Duman, T, Eren, F, Gokce, M, Inanc, Y, Nazliel, B, Ongun, G, Ozcekic Demirhan, S, Ozyurt, E, Selcuk, D, Sorgun, M, Tezcan, S, Togay Isikay, C, Tokgoz, O, Ulku Acar, R, Uluduz Ugurlu, D, Abdul-Saheb, M, Ahmad, N, Ali, A, Alwis, L, Balogun, I, Bathula, R, Behnam, Y, Bhandari, M, Bhargavah, M, Black, T, Blank, C, Bruce, D, Burn, M, Canepa, C, Chakrabarti, A, Chandrasena, D, Chembala, J, Cheripelli, B, Clarke, R, Cohen, D, Collas, D, Constantin, C, Dani, K, Del Giudice, A, Dennis, M, Devine, J, Dima, S, Doubal, F, Duodu, Y, Dutta, D, El Ta Wil, S, Elyas, S, Evans, N, Eveson, D, Fotherby, K, France, E, Furnace, J, Grabowski, S, Gunathilagan, G, Gutierrez, R, Guyler, P, Hargroves, D, Harkness, K, Harvey, M, Hayhoe, H, Hicken, L, Hussain, M, Kelly, S, Lam, M, Lindert, R, Louw, S, Luder, R, Macleod, M, Majid, A, Mangion, D, Markova, S, Markus, H, Marsh, R, Mcarthur, K, Menon, N, Metcalf, K, Minhas, J, Minns, M, Mistri, A, Moreton, F, Mpelembue, M, Muddegowda, G, Mudhar, O, Musarrat, K, Myint, M, Natarajan, I, Naylor, D, Ngeh, J, Papavasileiou, V, Perry, R, Piechowski-Jozwiak, B, Pradhan, M, Rani, A, Rashed, K, Robinson, T, Roffe, C, Saksena, R, Sattar, N, Sekaran, L, Selvarajah, J, Shah, S, Sinha, D, Sivakumar, R, Sztriha, L, Walters, D, Webb, T, Werring, D, Whiteley, W, Whiting, R, Abdelhamid, N, Abdul Rahman, D, Amin, H, Androulakis, M, Babikian, V, Baker, M, Barker Trejo, S, Benjamin, A, Birnbaum, L, Burke, J, Chen, S, Clark, W, Coull, B, De Havenon, A, Dearborn, J, Degeorgia, M, Essa, B, Fares, M, Favate, A, Furlan, A, Gebreyohanns, M, Goddeau, R, Green, D, Greer, D, Haralur Sreekantaiah, Y, Hasan, R, Hedna, V, Henninger, N, Holmstedt, C, Ishida, K, Jagolino, A, Johnson, M, Jun-Oconnell, A, Kaur, S, Khanna, A, Kirshner, H, Kittner, S, Kleindorfer, D, Leira, E, Loomis, C, Lord, A, Lowenkopf, T, Lutsep, H, Magadan, A, Majjhoo, A, Maud, A, Mayasi, Y, Mccullough, L, Mckinney, J, Mehta, S, Mehta, D, Mehta, B, Messe, S, Miller, B, Milling, T, Moonis, M, Navaratnam, D, Okpala, M, Patel, N, Pettigrew, L, Phinney, T, Ramos-Estebanez, C, Rasmussen, J, Rodriguez, G, Rybinnik, I, Santiago, P, Sarraj, A, Savitz, S, Sawyer, R, Scandura, T, Schindler, J, Sen, S, Shang, T, Sharrief, A, Sila, C, Simpkins, A, Sundararajan, S, Talahma, M, Tayal, A, Thaler, D, Tirschwell, D, Torres, J, Vora, N, Warnack, W, Waters, M, Wilson, C, Xiong, W, Zweifler, R, Zanferrari, C., St Marys Development Trust, Servicio de Neurologia (SANTIAGO - Neurologie), Universidad del Desarrollo, Department of Neurology (Dep Neuro - BEIJING), Tiantan Hospital, Neurology department, Universidade de Coimbra [Coimbra], Department of Internal Medicine, University Hospital Basel [Basel], Laboratoire de Recherche Vasculaire Translationnelle (LVTS (UMR_S_1148 / U1148)), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Department of Neurological Sciences, Università degli Studi di Roma 'La Sapienza' = Sapienza University [Rome], Department of Neurology, Seoul National University Hospital, Institute of Neurosciences and Psychology [Glasgow], University of Glasgow, Neurology Department, Ichilov Medical Center, CIC Brest, Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital de la Cavale Blanche, Yperzeele, Laetitia, NAVIGATE ESUS Investigators, and Selçuk Üniversitesi

Subjects
Stroke/etiology, Male, [SDV]Life Sciences [q-bio], Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, Brain Ischemia, Brain ischemia, 0302 clinical medicine, DESIGN, Rivaroxaban, Hemorrhage/chemically induced, Secondary Prevention, Medicine, Factor Xa Inhibitors/adverse effects, Stroke, Rivaroxaban/adverse effects, ComputingMilieux_MISCELLANEOUS, 11 Medical and Health Sciences, Aspirin, Atrial fibrillation, General Medicine, FORAMEN OVALE CLOSURE, Middle Aged, TRIALS, Intracranial Embolism, SAFETY, Aged, Factor Xa Inhibitors, Female, Hemorrhage, Humans, Platelet Aggregation Inhibitors, Medicine (all), Cardiology, Foramen ovale closure, Platelet aggregation inhibitor, Settore MED/26 - Neurologia, Life Sciences & Biomedicine, medicine.drug, medicine.medical_specialty, Platelet Aggregation Inhibitors/adverse effects, ANTITHROMBOTIC THERAPY, Aspirin/adverse effects, WARFARIN, 03 medical and health sciences, Secondary Prevention/methods, Medicine, General & Internal, Internal medicine, Intracranial Embolism/drug therapy, General & Internal Medicine, NAVIGATE ESUS Investigators, METAANALYSIS, Science & Technology, CRYPTOGENIC STROKE, business.industry, Warfarin, medicine.disease, EFFICACY, ATRIAL-FIBRILLATION, Human medicine, business, Brain Ischemia/prevention & control, 030217 neurology & neurosurgery, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

WOS: 000434263000007, PubMed: 29766772, BACKGROUND Embolic strokes of undetermined source represent 20% of ischemic strokes and are associated with a high rate of recurrence. Anticoagulant treatment with rivaroxaban, an oral factor Xa inhibitor, may result in a lower risk of recurrent stroke than aspirin. METHODS We compared the efficacy and safety of rivaroxaban (at a daily dose of 15 mg) with aspirin (at a daily dose of 100 mg) for the prevention of recurrent stroke in patients with recent ischemic stroke that was presumed to be from cerebral embolism but without arterial stenosis, lacune, or an identified cardioembolic source. The primary efficacy outcome was the first recurrence of ischemic or hemorrhagic stroke or systemic embolism in a time-to-event analysis; the primary safety outcome was the rate of major bleeding. RESULTS A total of 7213 participants were enrolled at 459 sites; 3609 patients were randomly assigned to receive rivaroxaban and 3604 to receive aspirin. Patients had been followed for a median of 11 months when the trial was terminated early because of a lack of benefit with regard to stroke risk and because of bleeding associated with rivaroxaban. The primary efficacy outcome occurred in 172 patients in the rivaroxaban group (annualized rate, 5.1%) and in 160 in the aspirin group (annualized rate, 4.8%) (hazard ratio, 1.07; 95% confidence interval [CI], 0.87 to 1.33; P=0.52). Recurrent ischemic stroke occurred in 158 patients in the rivaroxaban group (annualized rate, 4.7%) and in 156 in the aspirin group (annualized rate, 4.7%). Major bleeding occurred in 62 patients in the rivaroxaban group (annualized rate, 1.8%) and in 23 in the aspirin group (annualized rate, 0.7%) (hazard ratio, 2.72; 95% CI, 1.68 to 4.39; P, BayerBayer AG; Janssen Research and Development, Supported by Bayer and Janssen Research and Development.

Published
2018
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63. Rivaroxaban or aspirin for patent foramen ovale and embolic stroke of undetermined source: a prespecified subgroup analysis from the NAVIGATE ESUS trial

Author

Kasner, Scott E, primary, Swaminathan, Balakumar, additional, Lavados, Pablo, additional, Sharma, Mukul, additional, Muir, Keith, additional, Veltkamp, Roland, additional, Ameriso, Sebastian F, additional, Endres, Matthias, additional, Lutsep, Helmi, additional, Messé, Steven R, additional, Spence, J David, additional, Nedeltechev, Krassen, additional, Perera, Kanjana, additional, Santo, Gustavo, additional, Olavarria, Veronica, additional, Lindgren, Arne, additional, Bangdiwala, Shrikant, additional, Shoamanesh, Ashkan, additional, Berkowitz, Scott D, additional, Mundl, Hardi, additional, Connolly, Stuart J, additional, Hart, Robert G, additional, Abdelhamid, N, additional, Abdul Rahman, D, additional, Abdul-Saheb, M, additional, Abreu, P, additional, Abroskina, M, additional, Abu Ahmad, F, additional, Accassat, S, additional, Acciaresi, M, additional, Adami, A, additional, Ahmad, N, additional, Ahmed, F, additional, Alberto Hawkes, M, additional, Alemseged, F, additional, Ali, A, additional, Altavilla, R, additional, Alwis, L, additional, Amarenco, P, additional, Amaro, S, additional, Amaya Sanchez, LE, additional, Amelia Pinto, A, additional, Ameriso, SF, additional, Amin, H, additional, Amino, T, additional, Amjad, AK, additional, Anagnostou, E, additional, Andersen, G, additional, Anderson, C, additional, Anderson, DC, additional, Andrea Falco, M, additional, Andres Mackinnon, F, additional, Andreu, D, additional, Androulakis, M, additional, Angel Gamero, M, additional, Angel Saredo, G, additional, Angeles Diaz, R, additional, Angels Font, M, additional, Anticoli, S, additional, Arauz, A, additional, Arauz Gongora, AA, additional, Araya, P, additional, Arenillas Lara, JF, additional, Arias Rivas, S, additional, Arnold, M, additional, Augustin, S, additional, Avelar, W, additional, Azevedo, E, additional, Babikian, V, additional, Bacellar, A, additional, Badalyan, K, additional, Bae, HJ, additional, Baez Martinez, EM, additional, Bagelmann, H, additional, Bailey, P, additional, Bak, Z, additional, Baker, M, additional, Balazs, A, additional, Baldaranov, D, additional, Balogun, I, additional, Balueva, T, additional, Bankuti, Z, additional, Bar, M, additional, Baranowska, A, additional, Bardutzky, J, additional, Barker Trejo, S, additional, Barlinn, J, additional, Baronnet, F, additional, Barroso, C, additional, Barteys, M, additional, Bartolottiova, T, additional, Barulin, A, additional, Bas, M, additional, Bashir, S, additional, Basile, V, additional, Bathe-Peters, R, additional, Bathula, R, additional, Batista, C, additional, Batur Caglayan, H, additional, Baumgartner, P, additional, Bazan, R, additional, Bazhenova, O, additional, Beaudry, M, additional, Beer, J, additional, Behnam, Y, additional, Beilei, C, additional, Beinlich, A, additional, Bejot, Y, additional, Belkin, A, additional, Benavente, OR, additional, Benjamin, A, additional, Berardi, V, additional, Bereczki, D, additional, Berkowitz, SD, additional, Berlingieri, J, 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2018
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64. Rivaroxaban or aspirin for patent foramen ovale and embolic stroke of undetermined source: a prespecified subgroup analysis from the NAVIGATE ESUS trial

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Kasner, S. E., Swaminathan, B., Lavados, P., Sharma, M., Muir, K., Veltkamp, R., Ameriso, S. F., Endres, M., Lutsep, H., Messe, S. R., Spence, J. D., Nedeltechev, K., Perera, K., Santo, G., Olavarria, V., Lindgren, A., Bangdiwala, S., Shoamanesh, A., Berkowitz, S. D., Mundl, H., Connolly, S. J., Hart, R. G., Abdelhamid, N., Abdul Rahman, D., Abdul-Saheb, M., Abreu, P., Abroskina, M., Abu Ahmad, F., Accassat, S., Acciaresi, M., Adami, A., Ahmad, N., Ahmed, F., Alberto Hawkes, M., Alemseged, F., Ali, A., Altavilla, R., Alwis, L., Amarenco, P., Amaro, S., Amaya Sanchez, L. E., Amelia Pinto, A., Amin, H., Amino, T., Amjad, A. K., Anagnostou, E., Andersen, G., Anderson, C., Anderson, D. C., Andrea Falco, M., Andres Mackinnon, F., Andreu, D., Androulakis, M., Angel Gamero, M., Angel Saredo, G., Angeles Diaz, R., Angels Font, M., Anticoli, S., Arauz, A., Arauz Gongora, A. A., Araya, P., Arenillas Lara, J. F., Arias Rivas, S., Arnold, M., Augustin, S., Avelar, W., Azevedo, E., Babikian, V., Bacellar, A., Badalyan, K., Bae, H. J., Baez Martinez, E. M., Bagelmann, H., Bailey, P., Bak, Z., Baker, M., Balazs, A., Baldaranov, D., Balogun, I., Balueva, T., Bankuti, Z., Bar, M., Baranowska, A., Bardutzky, J., Barker Trejo, S., Barlinn, J., Baronnet, F., Barroso, C., Barteys, M., Bartolottiova, T., Barulin, A., Bas, M., Bashir, S., Basile, V., Bathe-Peters, R., Bathula, R., Batista, C., Batur Caglayan, H., Baumgartner, P., Bazan, R., Bazhenova, O., Beaudry, M., Beer, J., Behnam, Y., Beilei, C., Beinlich, A., Bejot, Y., Belkin, A., Benavente, O. R., Benjamin, A., Berardi, V., Bereczki, D., Berlingieri, J., Berrios, W., Berrouschot, J., Bhandari, M., Bhargavah, M., Bicker, H., Bicsak, T., Bilik, M., Bindila, D., Birchenall, J., Birnbaum, L., Black, T., Blacker, D., Blacquiere, D., Blanc-Labarre, C., Blank, C., Blazejewska-Hyzorek, B., Bloch, S., Bodiguel, E., Bogdanov, E., Boos, L., Borcsik, L., Bornstein, N., Bouly, S., Braga, G., Bragado, I., Bravi, M. C., Brokalaki, C., Brola, W., Brouns, R., Bruce, D., Brzoska-Mizgalska, J., Buck, B., Buksinska-Lisik, M., Burke, J., Burn, M., Bustamante, G., Cabrejo, L., Cai, K., Cajaraville, S., Calejo, M., Calvet, D., Campillo, J., Campos Costa, E., Camps, P., Can Alaydin, H., Candeloro, E., Canepa, C., Cantu Brito, C. G., Cappellari, M., Carcel, C., Cardona Portela, P., Cardoso, F., Carek, M., Carletti, M., Carlos Portilla, J., Caruso, P., Casado-Naranjo, I., Castellini, P., Castro, D., Castro Meira, F., Cavallini, A., Cayuela Caudevilla, N., Cenciarelli, S., Cereda, C., Cerrone, P., Chakrabarti, A., Chaloulos-Iakovidis, P., Chamorro, A., Chandrasena, D., Chang, D. I., Che, C., Chembala, J., Chen, J., Chen, Z., Chen, T., Chen, H., Chen, X., Chen, G., Chen, L., Chen, S., Cheripelli, B., Chin, M., Chiquete Anaya, E., Chorazy, M., Christensen, H., Christensen, T., Christian, L., Chu, F., Chung, C. S., Clark, W., Clarke, R., Claverie, S., Clemente Agostoni, E., Clissold, B., Coelho, J., Cohen, D., Colakoglu, S., Collas, D., Condurso, R., Consoli, D., Constantin, C., Constantino Silva, A. B., Contardo, L., Corlobe, A., Correia, M., Correia, C., Cortijo Garcia, E., Coull, B., Coutts, S., Coveney, S., Cras, P., Crols, R., Crozier, S., Csanyi, A., Csiba, L., Csontos, K., Csuha, R., Cui, L., Cunha, L., Curtze, S., Czerska, M., Czlonkowska, A., Czurko, M., Czuryszkiewicz, M., Dagnino, M., Dai, C., Daineko, A., Dalek, G., Damgaard, D., Danese, A., Dani, K., Danku, V., Dario Toledo, W., Davalos, A., De Havenon, A., De Keyser, J., De Klippel, N., De La Torre, J., De Pauw, A., De Smedt, A., De Torres, R., De Vries Basson, M. M., Dearborn, J., Deganutto, R., Degeorgia, M., Deguchi, I., Del Giudice, A., Delcourt, C., Delgado-Mederos, R., Della Marca, Giacomo, Delpont, B., Deltour, S., Demets, D. L., Dennis, M., Desai, J., Devine, J., Dhollander, I., Di Mascio, M. T., Diaconu, M., Diaz Otero, F., Dietzel, J., Diez-Tejedor, E., Ding, N., Ding, J., Diomedi, M., Dioszeghy, P., Distefano, M., Domigo, V., Dorodnicov, E., Dossi, D., Doubal, F., Druzenko, I., Du, P., Du, J., Duman, T., Duodu, Y., Dutta, D., Dylewicz, L., Eckstein, J., Ehrensperger, E., Ehrlich, S., Einer Allende, G., Elena Halac, B., Elyas, S., Engelbrecht, J. M., Engelter, S., Epinat, M., Eren, F., Esbjornsson, M., Escribano, B., Escudero, I., Esisi, B., Essa, B., Esterbauer, M., Evans, N., Eveson, D., Fabio, S., Fang, L., Fanta, S., Fares, M., Fatar, M., Faust, K., Favate, A., Fazekas, F., Federica Denaro, M., Fedin, A., Felipe Amaya, P., Feng, J., Ferencova, K., Fernanda Gilli, M., Fernandez, M. D., Fernandez Pirrone, P. N., Fernandez Vera, J., Ferrari, J., Ferreira, A., Ferreira Junior, G., Fidler, M., Field, D., Field, T., Figueroa, C., Fiksa, J., Filipov, A., Firstenfeld, A., Fisch, L., Fischer, U., Fisselier, M., Fiszer, U., Fluri, F., Fortea, G., Fotherby, K., Fraczek, A., France, E., Freitas, G., Frey, S., Frick, M., Friedman, A., Friedrich, M., Frisullo, G., Fryze, W., Fuentes Gimeno, B., Fujigasaki, H., Fukuyama, K., Furlan, A., Furlanis, G., Furnace, J., Gabriel, M., Gabriel Reich, E., Gagliardi, R. J., Galati, F., Galli Giqueauk, E., Gallina, A., Gallinella, E., Gallo, J., Gangadharan, S., Gao, Y., Garcia Lopez, R., Garcia Pastor, A., Garcia Sanchez, S. M., Garnauf, M., Garnier, P., Gasecki, D., Gasic, K., Gasiorek, K., Gasser, S., Gaugg, M., Gebreyohanns, M., Gebura, K., Geng, J., Geniz Clavijo, M., Georg Haeusler, K., Geran, R., Geremek, M., Gerocs, Z., Ghia, D., Giannandrea, D., Giatsidis, F., Gien Lopez, J. A., Gil Nunez, A., Gimenez, L., Giralt, E., Glabinski, A., Gladstone, D., Gliem, M., Gluszkiewicz, M., Goddeau, R., Gogoleva, E., Gokce, M., Goldemund, D., Golikov, K., Gomes Neto, A., Gomez Schneider, M., Gomez-Choco, M., Gomis, M., Gongora-Rivera, J. F., Gonysheva, Y., Gonzalez, L., Gonzalez Toledo, M. E., Gottschal, M., Gozdzik, I., Grabowski, S., Graf, S., Green, D., Greer, D., Gregorio, T., Greisenegger, S., Greshnova, I., Griebe, M., Grzesik, M., Guan, J., Guarda, S., Gueguen, A., Guidoux, C., Guillermo Povedano, P., Guillon, B., Guiraudg, V., Gunathilagan, G., Guryanova, N., Gusev, V., Gustavo Persi, G., Gutierrez, R., Guyler, P., Gyuker, N., Hachinski, V., Hajas, A., Hallevi, H., Hankey, G., Hankey, G. J., Hanouskova, L., Hao, L., Haraguchi, K., Haralur Sreekantaiah, Y., Haratz, S., Hargroves, D., Harkness, K., Harmel, P., Harrasser, M., Harvey, M., Hasan, R., Hasegawa, Y., Hassan, A., Hattori, M., Hatzitolios, A., Hauk, M., Hayashi, T., Hayhoe, H., Hedna, V. 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N., Fernandez Vera, J., Ferrari, J., Ferreira, A., Ferreira Junior, G., Fidler, M., Field, D., Field, T., Figueroa, C., Fiksa, J., Filipov, A., Firstenfeld, A., Fisch, L., Fischer, U., Fisselier, M., Fiszer, U., Fluri, F., Fortea, G., Fotherby, K., Fraczek, A., France, E., Freitas, G., Frey, S., Frick, M., Friedman, A., Friedrich, M., Frisullo, G., Fryze, W., Fuentes Gimeno, B., Fujigasaki, H., Fukuyama, K., Furlan, A., Furlanis, G., Furnace, J., Gabriel, M., Gabriel Reich, E., Gagliardi, R. J., Galati, F., Galli Giqueauk, E., Gallina, A., Gallinella, E., Gallo, J., Gangadharan, S., Gao, Y., Garcia Lopez, R., Garcia Pastor, A., Garcia Sanchez, S. M., Garnauf, M., Garnier, P., Gasecki, D., Gasic, K., Gasiorek, K., Gasser, S., Gaugg, M., Gebreyohanns, M., Gebura, K., Geng, J., Geniz Clavijo, M., Georg Haeusler, K., Geran, R., Geremek, M., Gerocs, Z., Ghia, D., Giannandrea, D., Giatsidis, F., Gien Lopez, J. 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I., Soldatov, M., Solganov, I., Soloveva, L., Solovyeva, E., Sonntag, N., Soors, P., Sorgun, M., Soriano, C., Spence, D., Spengos, K., Sposato, L., Staaf, G., Stadler, K., Stakhovskaya, L., Stamatelopoulos, K., Steinert, S., Stetkarova, I., Stiehm, M., Stocker, R., Stoinski, J., Stoll, A., Stotts, G., Stumpp, A., Sucapane, P., Suenaga, T., Sun, X., Sundararajan, S., Sung Kim, J., Suzuki, H., Svaneborg, N., Szasz, G., Szczuchniak, W., Szczyrba, S., Szegedi, N., Szekely, A., Szewczyk, Z., Szilagyi, G., Szlufik, S., Szoboszlai, K., Szpisjak, L., Sztajzel, R., Sztriha, L., Ta Wil, S. E., Taggeselle, J., Takamatsu, K., Takao, M., Taki, W., Takizawa, S., Talahma, M., Tamayo, A., Tan, J., Tanne, D., Tapanainen, A., Tapiola, T., Tarasiuk, J., Tatlisumak, T., Tayal, A., Tcvetkova, S., Teal, P., Tejada Garcia, J., Tejada Meza, H., Tenora, D., Terceno, M., Terentiou, A., Tezcan, S., Thaler, D., Thomson, A., Thouvenot, E., Tiainen, M., Timberg, I., Timsit, S., Tinchon, A., Tirschwell, D., Togay Isikay, C., Tokunaga, K., Tolino, M., Toloza, C., Tomelleri, G., Tomoyuki, K., Tomppo, L. 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A., Vora, N., Voznyuk, I., Wach-Klink, A., Wacongne, A., Walters, D., Wang, Y., Wang, J., Wang, L., Wang, X., Wang, W., Wang, N., Wang, D., Wang, H., Warnack, W., Wartenberg, K., Waters, R., Waters, M., Webb, T., Weber, J., Weiss, G., Weissenborn, K., Weitz, J. I., Weller, B., Wen, G., Weng, G., Werner, P., Werring, D., Wester, P., Whiteley, W., Whiting, R., Wijeratne, T., Willems, C., Wilson, L., Wilson, C., Winder, T., Windt, J., Winkler, A., Winska-Tereszkiewicz, A., Wisniewska, A., Wittayer, M., Wlodek, A., Wojnarowska-Arendt, A., Wolf, M., Wolff, V., Wolter, C., Wong, A., Wook Nah, H., Worthmann, H., Wu, W., Wu, S., Wunderlich, S., Wurzinger, H., Wyse, D. G., Xiao, B., Xiaopeng, W., Ximenez-Carrillo, A., Xiong, L., Xiong, Y., Xiong, W., Xu, Y., Xu, J., Xu, Z., Yalo, B., Yamada, T., Yamasaki, M., Yang, L., Yang, Y., Yang, X., Yang, Q., Yang, B., Yang, J., Yasuhiro, I., Yee Lam, M., Yegappan, C., Yip, S., Ylikallio, E., Ylikotila, P., Yongwon Jin, A., Yoon, B. W., Yoshida, Y., Yperzeele, L., Yuan, H., Yuasa, H., Zalewska, J., Zanferrari, C., Zapata, E., Zboznovits, D., Zelenka, I., Zhang, C., Zhang, B., Zhang, S., Zhang, M., Zhang, X., Zhang, J., Zhao, L., Zhirnova, O., Zhou, L., Zielinska-Turek, J., Zinchenko, I., Ziomek, M., Zitzmann, A., Zweifler, R., Zwiernik, J., and Della Marca G. (ORCID:0000-0001-6914-799X)

Abstract

Background: Patent foramen ovale (PFO) is a contributor to embolic stroke of undetermined source (ESUS). Subgroup analyses from previous studies suggest that anticoagulation could reduce recurrent stroke compared with antiplatelet therapy. We hypothesised that anticoagulant treatment with rivaroxaban, an oral factor Xa inhibitor, would reduce the risk of recurrent ischaemic stroke compared with aspirin among patients with PFO enrolled in the NAVIGATE ESUS trial. Methods: NAVIGATE ESUS was a double-blinded, randomised, phase 3 trial done at 459 centres in 31 countries that assessed the efficacy and safety of rivaroxaban versus aspirin for secondary stroke prevention in patients with ESUS. For this prespecified subgroup analysis, cohorts with and without PFO were defined on the basis of transthoracic echocardiography (TTE) and transoesophageal echocardiography (TOE). The primary efficacy outcome was time to recurrent ischaemic stroke between treatment groups. The primary safety outcome was major bleeding, according to the criteria of the International Society of Thrombosis and Haemostasis. The primary analyses were based on the intention-to-treat population. Additionally, we did a systematic review and random-effects meta-analysis of studies in which patients with cryptogenic stroke and PFO were randomly assigned to receive anticoagulant or antiplatelet therapy. Findings: Between Dec 23, 2014, and Sept 20, 2017, 7213 participants were enrolled and assigned to receive rivaroxaban (n=3609) or aspirin (n=3604). Patients were followed up for a mean of 11 months because of early trial termination. PFO was reported as present in 534 (7·4%) patients on the basis of either TTE or TOE. Patients with PFO assigned to receive aspirin had a recurrent ischaemic stroke rate of 4·8 events per 100 person-years compared with 2·6 events per 100 person-years in those treated with rivaroxaban. Among patients with known PFO, there was insufficient evidence to support a difference in risk o

Published
2018

67. Fever of unknown origin as the only manifestation of multiple myeloma A case report.

Author

Liontos, A., Koumpis, E., Barkas, F., Hatzimichael, E., and Liamis, G.

Subjects
MULTIPLE myeloma, FEVER, DIAGNOSIS, C-reactive protein, KIDNEY failure
Abstract

Infection is the most usual cause of fever in multiple myeloma (MM), but only a few reports have described fever of unknown origin (FUO) as the first manifestation of MM. We present the case of a 67-year-old female with FUO as the only manifestation of MM. In contrast to previously published reports, our patient had no other signs of MM, such as hypercalcemia, renal insufficiency, anemia or bone lesions, nor was her fever attributed to an infection. She presented with FUO, and was found to have leukocytosis, thrombocytosis and raised C-reactive protein (CRP), and the diagnosis of MM was established on bone marrow biopsy. After excluding the usual causes of FUO, therefore, MM might also be considered in its differential diagnosis. [ABSTRACT FROM AUTHOR]

Published
2021

73. Hyponatremia in patients with infectious diseases

Author

Liamis, G., Milionis, H. J., and Elisaf, M. S.

Abstract

Hyponatremia is a common electrolyte disturbance associated with considerable morbidity and mortality. Hyponatremia may not infrequently be present during the course of an infection, does not cause specific symptoms and may be overlooked by clinicians. Nonetheless, it may reflect the severity of the underlying process. This review focuses on the clinical and pathophysiological aspects of hyponatremia associated with infectious diseases. In the majority of cases, the fall in serum sodium concentration is of multifactorial origin owing to increased secretion of the anti-diuretic hormone either appropriately or inappropriately. Inadvertent administration of fluids may worsen hyponatremia and prolong morbidity. J Infect

Published
2011

76. Pharmacologically-induced metabolic acidosis: a review

Author

Liamis, G., Milionis, H. J., and Elisaf, M. S.

Subjects
Diabetic Ketoacidosis/chemically induced, Acidosis, Renal Tubular/chemically induced, Acidosis, Lactic/chemically induced, Humans, Acidosis/*chemically induced, Bicarbonates/metabolism, Acid-Base Equilibrium/drug effects
Abstract

Metabolic acidosis may occasionally develop in the course of treatment with drugs used in everyday clinical practice, as well as with the exposure to certain chemicals. Drug-induced metabolic acidosis, although usually mild, may well be life-threatening, as in cases of lactic acidosis complicating antiretroviral therapy or treatment with biguanides. Therefore, a detailed medical history, with special attention to the recent use of culprit medications, is essential in patients with acid-base derangements. Effective clinical management can be handled through awareness of the adverse effect of certain pharmaceutical compounds on the acid-base status. In this review, we evaluate relevant literature with regard to metabolic acidosis associated with specific drug treatment, and discuss the clinical setting and underlying pathophysiological mechanisms. These mechanisms involve renal inability to excrete the dietary H+ load (including types I and IV renal tubular acidoses), metabolic acidosis owing to increased H+ load (including lactic acidosis, ketoacidosis, ingestion of various substances, administration of hyperalimentation solutions and massive rhabdomyolysis) and metabolic acidosis due to HCO3- loss (including gastrointestinal loss and type II renal tubular acidosis). Determinations of arterial blood gases, the serum anion gap and, in some circumstances, the serum osmolar gap are helpful in delineating the pathogenesis of the acid-base disorder. In all cases of drug-related metabolic acidosis, discontinuation of the culprit medications and avoidance of readministration is advised. Drug Saf

Published
2010

77. A review of drug-induced hypocalcemia

Author

Liamis, G., Milionis, H. J., and Elisaf, M. S.

Subjects
Parathyroid Hormone/metabolism, Hyperphosphatemia/metabolism, Pharmaceutical Preparations/*adverse effects, Calcium/blood/metabolism, Glucocorticoids/metabolism, Humans, Vitamin D Deficiency/metabolism, Diphosphonates/therapeutic use, Hypocalcemia/*chemically induced/diagnosis/therapy, Diuretics/metabolism, Estrogens/metabolism
Abstract

Hypocalcemia (defined as total serum calcium lower than 8.5 mg/dl or as ionized serum calcium lower than 4.7 mg/dl) is a relatively common metabolic abnormality observed in hospitalized patients. Although it is associated with certain pharmacological agents such as bisphosphonates and cisplatin, hypocalcemia may occasionally develop in the course of treatment with drugs used in everyday clinical practice, including antiepileptics, aminoglycosides, and proton pump inhibitors. Hypocalcemia associated with drug treatment can be easily missed as a consequence of coexistence of multiple factors contributing to low serum calcium levels. Drug-related hypocalcemia is usually mild and asymptomatic but may be severe as well. Effective clinical management can be handled through awareness of this adverse effect induced by certain pharmaceutical compounds on serum calcium concentrations. Herein, we review pertinent clinical information on the incidence of hypocalcemia associated with specific drug treatment and discuss the underlying pathophysiological mechanisms. J Bone Miner Metab

Published
2009

78. Effect of paraoxonase 1 polymorphisms on the response of lipids and lipoprotein-associated enzymes to treatment with fluvastatin

Author

Christidis, D. S., Liberopoulos, E. N., Kakafika, A. I., Miltiadous, G. A., Liamis, G. L., Kakaidi, B., Tselepis, A. D., Cariolou, M. A., and Elisaf, M. S.

Subjects
plasma-lipoproteins, fluvastatin, middle-aged men, cardiovascular-disease, platelet-activating factor acetylhydrolase, lipoprotein-associated phospholipase a(2), serum paraoxonase, factor-acetylhydrolase, paraoxonase, polymorphism, lipids, density-lipoprotein, phospholipase a(2), c-reactive protein, platelet-activating-factor, coronary-heart-disease
Abstract

Background. Decreased paraoxonase 1 (PON1) and increased total serum lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) activities are suggested to be risk factors for vascular disease. Common PON1 genetic polymorphisms (Q192R and L55M) significantly affect PON1 activity and may also influence high-density lipoprotein (HDL)-associated Lp-PLA(2) activity. However, little is known about the possible effect of PON1 common genetic polymorphisms on the response of lipids as well as PON1 and Lp-PLA(2) activities to treatment with statins. Methods. Two hundred two hypercholesterolemic patients were treated with fluvastatin 40 mg/day. Fasting serum lipids, Q192R and L55M PON1 polymorphisms as well as PON1 and Lp-PLA(2) (total serum and HDL-associated) activities were determined before and after 6 months of treatment. Results. Fluvastatin treatment did not affect HDL-cholesterol or apolipoprotein (apo) AI but resulted in significant decreases in total cholesterol, triglycerides, low-density lipoprotein-cholesterol, apo B and apo E, as well as total serum Lp-PLA(2) activity. In contrast, PON1 activity significantly increased. None of these changes was influenced by Q192R or L55M PON1 polymorphisms. Overall, HDL-Lp-PLA(2) did not change but L55M polymorphism significantly influenced its response to fluvastatin. Specifically, LL homozygotes experienced a significant increase, while M carriers (LM or MM) experienced a non-significant decrease in HDL-Lp-PLA(2) activity (p = 0.030 between groups). Conclusions. Q192R and L55M PON1 polymorphisms did not affect the response of lipids, PON1 and total serum Lp-PLA(2) to treatment with a statin. However, L55M PON1 polymorphism significantly modulated the response of HDL-Lp-PLA(2). It should be noted that this is an association study and therefore provides no proof but only indication that PON1 may also exert Lp-PLA(2) activity in HDL. (C) 2007 IMSS. Published by Elsevier Inc. Arch Med Res

Published
2007

80. Hypothyroidism-associated hyponatremia: mechanisms, implications and treatment.

Author

Liamis, G., Filippatos, T. D., Liontos, A., and Elisaf, M. S.

Subjects
*HYPONATREMIA, *HYPOTHYROIDISM
Abstract

Background: Patients with moderate to severe hypothyroidism and mainly patients with myxedema may exhibit reduced sodium levels (<135 mmol/L). Summary: The aim of this short review is the presentation of the mechanisms of hyponatremia and of the available data regarding its implications and treatment in patients with hypothyroidism. Hypothyroidism is one of the causes of hyponatremia, thus thyroid-stimulating hormone determination is mandatory during the evaluation of patients with reduced serum sodium levels. The main mechanism for the development of hyponatremia in patients with chronic hypothyroidism is the decreased capacity of free water excretion due to elevated antidiuretic hormone levels, which are mainly attributed to the hypothyroidism-induced decrease in cardiac output. However, recent data suggest that the hypothyroidism-induced hyponatremia is rather rare and probably occurs only in severe hypothyroidism and myxedema. Other possible causes and superimposed factors of hyponatremia (e.g. drugs, infections, adrenal insufficiency) should be considered in patients with mild/moderate hypothyroidism. Treatment of hypothyroidism and fluid restriction are usually adequate for the management of mild hyponatremia in patients with hypothyroidism. Patients with possible hyponatremic encephalopathy should be urgently treated according to current guidelines. Conclusions: Severe hypothyroidism may be the cause of hyponatremia. All hypothyroid patients with low serum sodium levels should be evaluated for other causes and superimposed factors of hyponatremia and treated accordingly. [ABSTRACT FROM AUTHOR]

Published
2017
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82. Possible cefotaxime-induced Stevens-Johnson syndrome

Author

Liberopoulos, E. N., Liamis, G. L., and Elisaf, M. S.

Subjects
Stevens-Johnson Syndrome/*chemically induced/*diagnosis, Cefotaxime/*adverse effects, Humans, Female, Aged
Abstract

OBJECTIVE: To report a case of possible cefotaxime-induced Stevens-Johnson syndrome (SJS). CASE SUMMARY: A 72-year-old woman with an upper urinary tract infection developed erosions and blisters on the skin and the mucous membranes, as well as fever and prostration, soon after the administration of cefotaxime. This presentation is consistent with the features of SJS. Resolution of the clinical manifestations was observed after discontinuation of the drug; all other drugs, infections, or immunologic disorders that could have caused this syndrome were carefully excluded. An objective causality assessment revealed that SJS was possibly associated with the use of cefotaxime. DISCUSSION: Although cephalosporins have been associated with an increased risk for SJS and cefotaxime has been suspected of being associated with SJS in a previous case-control study, this is the first full report for cefotaxime-related SJS in the literature. An immunologically mediated reaction may be the underlying mechanism. CONCLUSIONS: Although cefotaxime administration seems to be the underlying cause of the SJS observed in our patient, establishment of a definite causal relationship requires additional cases and supportive data. Ann Pharmacother

Published
2003

83. Combined treatment with fibrates and small doses of atorvastatin in patients with mixed hyperlipidemia

Author

Liamis, G Kakafika, A Bairaktari, E Miltiadous, G and Tsimihodimos, V Goudevenos, J Achimastos, A Elisaf, M

Subjects
nutritional and metabolic diseases, lipids (amino acids, peptides, and proteins)
Abstract

Combined statin and fibrate therapy is often imperative for the improvement of the serum lipid profile in patients with mixed hyperlipidemia. However, the potential risk of myopathy has limited the widespread use of such therapy. Preferably this treatment should involve low optimally tolerable doses of hypolipidemic drugs. Thus, we undertook a study to determine the safety and efficacy of combination therapy with fibrates and small doses of atorvastatin. Twenty-two patients with mixed hyperlipidemia were started on a fibrate regimen (micronised fenofibrate 200 mg/day or ciprofibrate 100 mg/day). Because after 12 weeks of therapy the fibrate failed to normalise the serum lipid profile, small doses of atorvastatin (5 mg/day) were added for a further 12 weeks. The administration of the fibrates resulted in a significant decrease in total and LDL-cholesterol levels, as well as in triglycerides, and an increase in HDL-cholesterol levels. The addition of atorvastatin (5 mg/day) resulted in a further decrease in total and LDL-cholesterol levels. Consequently, the hypolipidemic therapy target was achieved in most of the patients. Combination therapy was well tolerated and no significant increases in serum liver and muscle enzymes were noticed. We conclude that the careful administration of small doses of atorvastatin in patients with mixed dyslipidemia receiving fibrates is associated with a significant amelioration of lipid abnormalities.

Published
2002

84. Acid-base and electrolyte disturbances in patients with hypercalcemia

Author

Milionis, H. J., Rizos, E., Liamis, G., Nikas, S., Siamopoulos, K. C., and Elisaf, M. S.

Subjects
Adult, Aged, 80 and over, Male, Water-Electrolyte Imbalance/epidemiology/*etiology, Acid-Base Imbalance/epidemiology/*etiology, Greece/epidemiology, Middle Aged, Neoplasms/complications/diagnosis, Hyperparathyroidism/complications/diagnosis, Statistics, Nonparametric, Case-Control Studies, Humans, Female, Hypercalcemia/*complications/etiology, Aged
Abstract

BACKGROUND: In the present study, we analyzed acid-base and electrolyte disturbances in hypercalcemic patients to determine the principal causes of hypercalcemia. METHODS: We studied a total of 76 hypercalcemic patients and 91 healthy individuals. Acid-base and electrolyte parameters were determined before any therapeutic intervention. RESULTS: Hyperparathyroidism and neoplasias were the most common causes of hypercalcemia. Hypercalcemic patients had increased serum urea and creatinine levels, a higher urea/creatinine ratio, and a higher rate of acid-base disorders, but lower serum albumin, potassium, chloride, phosphorus, and magnesium concentrations than those found in the control subjects. Notably, significant differences in acid-base balance and electrolyte concentrations were evident between patients with hyperparathyroidism and patients with cancer. CONCLUSIONS: Primary hyperparathyroidism and neoplasia are the most common causes of hypercalcemia. A wide array of concurrent acid-base and electrolyte disorders may be evident in hypercalcemic patients. Differences in these laboratory parameters are helpful in diagnostic workup. South Med J

Published
2002

85. The hyponatremic patient: a systematic approach to laboratory diagnosis

Author

Milionis, H. J., Liamis, G. L., and Elisaf, M. S.

Subjects
Diagnosis, Differential, Thyrotropin/blood, Uric Acid/blood/urine, Clinical Laboratory Techniques, Osmolar Concentration, Acidosis/complications, Sodium/urine, Humans, Blood Gas Analysis, Algorithms, Inappropriate ADH Syndrome/complications, Hyponatremia/diagnosis/etiology/urine
Abstract

Hyponatremia (serum sodium level less than 134 mmol/L) is a common electrolyte disturbance. Its high prevalence and potential neurologic sequelae make a logical and rigorous differential diagnosis mandatory before any therapeutic intervention. A history of concurrent illness and medication use as well as the assessment of extracellular volume status on physical examination may provide useful clues as to the pathogenesis of hyponatremia. Measurement of the effective serum tonicity (serum osmolality less serum urea level) is the first step in the laboratory evaluation. In patients with normal or elevated effective serum osmolality (280 mOsm/kg or greater), pseudohyponatremia should be excluded. In the hypo-osmolar state (serum osmolality less than 280 mOsm/kg), urine osmolality is used to determine whether water excretion is normal or impaired. A urine osmolality value of less than 100 mOsm/kg indicates complete and appropriate suppression of antidiuretic hormone secretion. A urine sodium level less than 20 mmol/L is indicative of hypovolemia, whereas a level greater than 40 mmol/L is suggestive of the syndrome of inappropriate antidiuretic hormone secretion. Levels of hormones (thyroid-stimulating hormone and cortisol) and arterial blood gases should be determined in difficult cases of hyponatremia. CMAJ

Published
2002

86. Hyperosmolar syndrome in a patient with uncontrolled diabetes mellitus

Author

Milionis, H. J., Liamis, G. L., and Elisaf, M. S.

Subjects
Hyperglycemic Hyperosmolar Nonketotic Coma/diagnosis/*etiology/therapy, Humans, Female, Aged
Abstract

Nonketotic hyperglycemic hyperosmolar syndrome (HHS) is found mostly in type 2 diabetic patients with marked hyperglycemia. HHS is a metabolic emergency and is associated with a high mortality rate. It is characterized by extreme dehydration and neurologic symptoms, which are related directly to the degree of hyperosmolality. We describe a 65-year-old patient who was admitted because of impaired consciousness caused by HHS. The relevant clinical and laboratory findings are discussed, and a brief overview of the pathophysiology and therapeutic management is provided. Am J Kidney Dis

Published
2001

87. Mechanisms of hypocalcemia in alcoholic patients

Author

Elisaf, M. S., Liamis, G., Liberopoulos, E., and Siamopoulos, K. C.

Subjects
Water-Electrolyte Balance/physiology, Kidney/*physiopathology, Humans, Hypocalcemia/*etiology/*physiopathology, Alcoholism/*complications/*physiopathology
Abstract

Nephron

Published
2001

88. Hypernatremia in hospitalized patients: a sequel of inadvertent fluid administration

Author

Milionis, H. J., Liamis, G., and Elisaf, M. S.

Subjects
Hypernatremia/*etiology/physiopathology, Water-Electrolyte Balance/physiology, Edema/etiology/physiopathology, Humans, Fluid Therapy, Saline Solution, Hypertonic/administration & dosage/adverse effects, Hospitalization, Vasopressins/physiology
Abstract

Arch Intern Med

Published
2000

91. Aminoglycoside-induced metabolic abnormalities

Author

Liamis, G., Alexandridis, G., Bairaktari, E. T., and Elisaf, M. S.

Subjects
Aminoglycosides/*adverse effects/*pharmacology, Male, Creatinine/blood/urine, Gentamicins/adverse effects/pharmacology, Potassium/blood, Ceftriaxone/adverse effects/pharmacology, Fanconi Syndrome/*chemically induced, Humans, Kidney/drug effects, Urinary Tract Infections/drug therapy, Aged
Abstract

Ann Clin Biochem

Published
2000

92. Syndrome of inappropriate antidiuresis associated with multiple sclerosis

Author

Liamis, G. and Elisaf, M. S.

Subjects
Male, Multiple Sclerosis/*complications, Inappropriate ADH Syndrome/*complications/metabolism, Hyponatremia/*etiology/metabolism, Humans, Middle Aged
Abstract

Even though many disorders of the nervous system have been reported to be associated with the syndrome of inappropriate secretion of antidiuretic hormone (SIADH), the association of this syndrome with multiple sclerosis is extremely rare. We describe a patient with multiple sclerosis who developed SIADH and hyponatremia. J Neurol Sci

Published
2000

93. Tamoxifen-induced severe hypertriglyceridemia and pancreatitis

Author

Elisaf, Moses S., Nakou, K., Liamis, G., Pavlidis, Nicholas, Pavlidis, Nicholas [0000-0002-2195-9961], and Elisaf, Moses S. [0000-0003-0505-078X]

Subjects
Pancreatic disease, Hypertriglyceridemia/*chemically induced, medicine.medical_treatment, Mammary gland, dosage/therapeutic use, Amylase blood level, Breast cancer, Antineoplastic Combined Chemotherapy Protocols, Pancreatitis/*chemically induced, Antineoplastic agents, Medicine, Lipoprotein, Methotrexate/administration & dosage, Priority journal, Hypertriglyceridemia, Tamoxifen/*adverse effects/therapeutic use, Breast Neoplasms/*drug therapy, Hematology, Middle Aged, Lipid, Middle age, Triacylglycerol blood level, Fluorouracil/administration & dosage, medicine.anatomical_structure, Cholesterol, Cholesterol blood level, Oncology, Toxicity, lipids (amino acids, peptides, and proteins), Female, Fluorouracil, Pethidine, Drug mechanism, medicine.drug, Human, Adult, medicine.medical_specialty, Abdominal pain, Antineoplastic Agents, Hormonal, Antineoplastic Agents, Hormonal/*adverse effects/therapeutic use, Breast Neoplasms, Triacylglycerol, Article, Internal medicine, Antineoplastic combined chemotherapy protocols, Case report, Humans, Cyclophosphamide, Chemotherapy, Hormonal, business.industry, Amylase, medicine.disease, Antineoplastic Combined Chemotherapy Protocols/administration &, Tamoxifen, Endocrinology, Methotrexate, Pancreatitis, Breast neoplasms, Cisplatin, Gemfibrozil, business, Cisplatin/administration & dosage
Abstract

Tamoxifen exhibits favorable effects on the lipid and lipoprotein profile since it decreases the total and LDL cholesterol levels as well as the Lp(a) levels. Additionally, a small increase in serum triglycerides is commonly found after tamoxifen administration. However, severe hypertriglyceridemia which can sometimes be associated with life-threatening complications is occasionally noticed. Herein, we describe a patient who developed tamoxifen-induced severe hypertriglyceridemia and pancreatitis. An analysis of the underlying pathogenetic mechanisms as well as a review of the relevant literature is also provided. 11 8 1067 1069

Published
2000

94. Mechanisms of hyponatraemia in alcohol patients

Author

Liamis, G. L., Milionis, H. J., Rizos, E. C., Siamopoulos, K. C., and Elisaf, M. S.

Subjects
Adult, Male, Hyponatremia/diagnosis/*etiology/physiopathology, Humans, Female, Prospective Studies, Middle Aged, Urinalysis, Alcoholism/*complications/physiopathology, Blood Chemical Analysis, Aged
Abstract

Hyponatraemia is commonly reported in chronic alcoholic patients. However, the underlying pathogenetic mechanisms are not well delineated. In the current study, we analysed the possible pathophysiological mechanisms of hyponatraemia in a group of alcoholic patients (n = 127) admitted to our hospital for causes related to alcohol misuse. Hyponatraemia (serum sodium

Published
2000

95. Effect of fenofibrate on serum uric acid levels

Author

Liamis, G., Bairaktari, E. T., and Elisaf, M. S.

Subjects
Hyperlipidemias/blood/*drug therapy, Dose-Response Relationship, Drug, Humans, Hypolipidemic Agents/*administration & dosage, Uric Acid/*blood, Drug Administration Schedule, Fenofibrate/*administration & dosage
Abstract

Am J Kidney Dis

Published
1999

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