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101. Prognostic Value of Serial Galectin‐3 Measurements in Patients With Acute Heart Failure

Author

van Vark, Laura C., primary, Lesman‐Leegte, Ivonne, additional, Baart, Sara J., additional, Postmus, Douwe, additional, Pinto, Yigal M., additional, de Boer, Rudolf A., additional, Asselbergs, Folkert W., additional, Wajon, Elly M. C. J., additional, Orsel, Joke G., additional, Boersma, Eric, additional, Hillege, Hans L., additional, Akkerhuis, K. Martijn, additional, Nagelsmit, Michiel J., additional, Brunner‐La Rocca, Hans‐Peter, additional, Linssen, Gerard C.M., additional, Terpstra, Willem F., additional, Liem, Anho H., additional, Wardeh, Alexander J., additional, van Miltenburg, Addy J.M., additional, van den Bos, Ewout J., additional, and de Ridder, Stijn P.J., additional

Published
2017
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102. Prognostic Value of Serial ST2 Measurements in Patients With Acute Heart Failure

Author

van Vark, Laura C., primary, Lesman-Leegte, Ivonne, additional, Baart, Sara J., additional, Postmus, Douwe, additional, Pinto, Yigal M., additional, Orsel, Joke G., additional, Westenbrink, B. Daan, additional, Brunner-la Rocca, Hans P., additional, van Miltenburg, Addy J.M., additional, Boersma, Eric, additional, Hillege, Hans L., additional, and Akkerhuis, K. Martijn, additional

Published
2017
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104. Serially measured circulating microRNAs and adverse clinical outcomes in patients with acute heart failure

Author

van Boven, Nick, primary, Kardys, Isabella, additional, van Vark, Laura C., additional, Akkerhuis, K. Martijn, additional, de Ronde, Maurice W.J., additional, Khan, Mohsin A.F., additional, Merkus, Daphne, additional, Liu, Zhen, additional, Voors, Adriaan A., additional, Asselbergs, Folkert W., additional, van den Bos, Ewout‐Jan, additional, Boersma, Eric, additional, Hillege, Hans, additional, Duncker, Dirk J., additional, Pinto, Yigal M., additional, and Postmus, Douwe, additional

Published
2017
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105. Development and validation of a risk model for long-term mortality after percutaneous coronary intervention: The IDEA-BIO Study

Author

van Boven, Nick, primary, van Domburg, Ron T., additional, Kardys, Isabella, additional, Umans, Victor A., additional, Akkerhuis, K. Martijn, additional, Lenzen, Mattie J., additional, Valgimigli, Marco, additional, Daemen, Joost, additional, Zijlstra, Felix, additional, Boersma, Eric, additional, and van Geuns, Robert-Jan, additional

Published
2017
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107. Near-infrared spectroscopy-derived lipid core burden index predicts adverse cardiovascular outcome in patients with coronary artery disease during long-term follow-up

Author

Schuurman, Anne-Sophie, primary, Vroegindewey, Maxime, additional, Kardys, Isabella, additional, Oemrawsingh, Rohit M, additional, Cheng, Jin M, additional, de Boer, Sanneke, additional, Garcia-Garcia, Hector M, additional, van Geuns, Robert-Jan, additional, Regar, Evelyn S, additional, Daemen, Joost, additional, van Mieghem, Nicolas M, additional, Serruys, Patrick W, additional, Boersma, Eric, additional, and Akkerhuis, K Martijn, additional

Published
2017
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108. Cohort profile of BIOMArCS: the BIOMarker study to identify the Acute risk of a Coronary Syndrome—a prospective multicentre biomarker study conducted in the Netherlands

Author

Oemrawsingh, Rohit M, primary, Akkerhuis, K Martijn, additional, Umans, Victor A, additional, Kietselaer, Bas, additional, Schotborgh, Carl, additional, Ronner, Eelko, additional, Lenderink, Timo, additional, Liem, Anho, additional, Haitsma, David, additional, van der Harst, Pim, additional, Asselbergs, Folkert W, additional, Maas, Arthur, additional, Oude Ophuis, Anton J, additional, Ilmer, Ben, additional, Dijkgraaf, Rene, additional, de Winter, Robbert-Jan, additional, The, S Hong Kie, additional, Wardeh, Alexander J, additional, Hermans, Walter, additional, Cramer, Etienne, additional, van Schaik, Ron H, additional, Hoefer, Imo E, additional, Doevendans, Pieter A, additional, Simoons, Maarten L, additional, and Boersma, Eric, additional

Published
2016
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109. TCT-93 Near-infrared spectroscopy derived Lipid Core Burden Index predicts major adverse cardiovascular events in patients with coronary artery disease during 4.3 year follow-up

Author

Schuurman, Anne Sophie, primary, Kardys, Isabella, additional, Oemrawsingh, Rohit, additional, Diletti, Roberto, additional, Geuns, Robert-Jan van, additional, Van Mieghem, Nicolas, additional, Regar, Evelyn, additional, Serruys, Patrick, additional, Akkerhuis, K. Martijn, additional, and Boersma, Eric, additional

Published
2016
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110. The temporal pattern of immune and inflammatory proteins prior to a recurrent coronary event in post-acute coronary syndrome patients.

Author

Vroegindewey, Maxime M., Oemrawsingh, Rohit M., Kardys, Isabella, Asselbergs, Folkert W., van der Harst, Pim, Oude Ophuis, Anton J., Etienne Cramer, G., Maas, Arthur, Hong Kie The, S., Wardeh, Alexander J., Mouthaan, Henk, Boersma, Eric, and Akkerhuis, K. Martijn

Subjects
ACUTE coronary syndrome, BLOOD sampling, PROTEIN expression, BIOLOGICAL tags, PROTEOMICS
Abstract

Purpose: We assessed the temporal pattern of 29 immune and inflammatory proteins in post-acute coronary syndrome (ACS) patients, prior to the development of recurrent ACS. Methods: High-frequency blood sampling was performed in 844 patients admitted for ACS during one-year follow-up. We conducted a case-control study on the 45 patients who experienced reACS (cases) and two matched event-free patients (controls) per case. Olink Proteomics' immunoassay was used to obtain serum levels of the 29 proteins, expressed in an arbitrary unit on the log2-scale (Normalized Protein eXpression, NPX). Linear mixed-effects models were applied to examine the temporal pattern of the proteins, and to illustrate differences between cases and controls. Results: Mean age was 66 ± 12 years and 80% were men. Cases and controls had similar baseline clinical characteristics. During the first 30 days, and after multiple testing correction, cases had significantly higher serum levels of CXCL1 (difference of 1.00 NPX, p = 0.002), CD84 (difference of 0.64 NPX, p = 0.002) and TNFRSF10A (difference of 0.41 NPX, p < 0.001) than controls. After 30 days, serum levels of all 29 proteins were similar in cases and controls. In particular, no increase was observed prior to reACS. Conclusions: Among 29 immune and inflammatory proteins, CXCL1, CD84 and TNFRSF10A were associated with early reACS after initial ACS-admission. [ABSTRACT FROM AUTHOR]

Published
2019
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112. Integrated Biomarker and Imaging Study 3 (IBIS-3) to assess the ability of rosuvastatin to decrease necrotic core in coronary arteries

Author

Oemrawsingh, Rohit M., primary, Garcia-Garcia, Hector M., additional, van Geuns, Robert J.M., additional, Lenzen, Mattie J., additional, Simsek, Cihan, additional, de Boer, Sanneke P.M., additional, Van Mieghem, Nicolas M., additional, Regar, Evelyn, additional, de Jaegere, Peter P.T., additional, Akkerhuis, K. Martijn, additional, Ligthart, Jurgen M.R., additional, Zijlstra, Felix, additional, Serruys, Patrick W., additional, and Boersma, Eric, additional

Published
2016
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115. Smoking in Relation to Coronary Atherosclerotic Plaque Burden, Volume and Composition on Intravascular Ultrasound

Author

Buljubasic, Nermina, primary, Akkerhuis, K. Martijn, additional, de Boer, Sanneke P. M., additional, Cheng, Jin M., additional, Garcia-Garcia, Hector M., additional, Lenzen, Mattie J., additional, Oemrawsingh, Rohit M., additional, Battes, Linda C., additional, Rijndertse, Melissa, additional, Regar, Evelyn, additional, Serruys, Patrick W., additional, van Geuns, Robert-Jan, additional, Boersma, Eric, additional, and Kardys, Isabella, additional

Published
2015
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117. Real‐Life Use of Neurohormonal Antagonists and Loop Diuretics in Chronic Heart Failure: Analysis of Serial Biomarker Measurements and Clinical Outcome.

Author

Brankovic, Milos, Akkerhuis, K. Martijn, van Boven, Nick, Manintveld, Olivier, Germans, Tjeerd, Brugts, Jasper, Caliskan, Kadir, Umans, Victor, Constantinescu, Alina, and Kardys, Isabella

Subjects
NEUROHORMONES, HORMONE antagonists, LOOP diuretics, HEART failure, BIOLOGICAL tags, C-reactive protein, ACE inhibitors
Abstract

We determined the temporal effects of neurohormonal antagonists and loop diuretics on serially assessed (3‐monthly) cardiorenal biomarkers, functional status, and clinical outcomes in 250 patients with chronic heart failure (CHF) with reduced ejection fraction. In blood, we measured NT‐proBNP, troponin T, C‐reactive protein, creatinine, cystatin C; in urine, N‐acetyl‐beta‐ d‐glucosaminidase and kidney‐injury‐molecule‐1. Angiotensin converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs) were inversely associated with cardiac impairment, inflammation, and renal tubular damage, but not with glomerular dysfunction. Diuretics were associated with worse biomarker profiles and with a hazard ratio for adverse clinical outcome of 1.12 (95% confidence interval: 1.03–1.22) per 40 mg higher doses. ACE‐inhibitors/ARBs were more frequently downtitrated and diuretics more frequently uptitrated in patients who experienced endpoints than in those who did not. In conclusion, a decrease or withholding of ACE‐inhibitors/ARBs solely based on glomerular function is not justified because of the beneficial effects on the heart, inflammation, and renal tubules. Higher and increased diuretic doses mark progression towards endstage CHF. [ABSTRACT FROM AUTHOR]

Published
2018
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118. Short- and Long-term Prognosis of Patients With Acute Heart Failure With and Without Diabetes: Changes Over the Last Three Decades.

Author

van den Berge, Jan C., Constantinescu, Alina A., Boiten, Hendrik J., van Domburg, Ron T., Deckers, Jaap W., and Akkerhuis, K. Martijn

Subjects
HEART failure, DIABETES, CRITICAL care medicine, INTENSIVE care patients, HEART transplantation, HEART assist devices, PROGNOSIS, BIOLOGICAL assay, HOSPITAL care, INTENSIVE care units, LONGITUDINAL method, BODY mass index, ACQUISITION of data, DISEASE prevalence, ACUTE diseases, DIAGNOSIS
Abstract

Objective: We studied differences in long-term (i.e., 10 year) prognosis among patients with acute heart failure (HF) with and without diabetes over the last three decades. In addition, we investigated whether the degree of prognostic improvement in that period was comparable between patients with and without diabetes.Research Design and Methods: This prospective registry included all consecutive patients aged 18 years and older admitted to the Intensive Coronary Care Unit with acute HF in the period of 1985-2008. A total of 1,810 patients were included; 384 patients (21%) had diabetes. The outcome measure was the composite of all-cause mortality, heart transplantation, and left ventricular assist device implantation after 10-year follow-up.Results: The 10-year outcome in patients with diabetes was significantly worse than in those without diabetes (87% vs. 76%; adjusted hazard ratio [HR] 1.17 [95% CI 1.02-1.33]). Patients admitted in the last decade had a significantly lower 10-year event rate than patients admitted in the first two decades, both among patients without diabetes (adjusted HR 0.86 [95% CI 0.75-0.99]) and patients with diabetes (adjusted HR 0.80 [95% CI 0.63-1.00]).Conclusions: The long-term outcome of patients with diabetes is worse than that of patients without diabetes. However, the long-term prognosis improved over time in both groups. Importantly, this improvement in long-term prognosis was comparable in patients with and without diabetes. Despite these promising results, more awareness for diabetes in patients with acute HF is necessary and there is still need for optimal treatment of diabetes in acute HF. [ABSTRACT FROM AUTHOR]

Published
2018
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120. A simple risk chart for initial risk assessment of 30-day mortality in patients with cardiogenic shock from ST-elevation myocardial infarction

Author

Cheng, Jin M, primary, Helming, Anne Mijn, additional, van Vark, Laura C, additional, Kardys, Isabella, additional, Den Uil, Corstiaan A, additional, Jewbali, Lucia SD, additional, van Geuns, Robert-Jan, additional, Zijlstra, Felix, additional, van Domburg, Ron T, additional, Boersma, Eric, additional, and Akkerhuis, K Martijn, additional

Published
2015
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121. Near-Infrared Spectroscopy Predicts Cardiovascular Outcome in Patients With Coronary Artery Disease

Author

Oemrawsingh, Rohit M., primary, Cheng, Jin M., additional, García-García, Héctor M., additional, van Geuns, Robert-Jan, additional, de Boer, Sanneke P.M., additional, Simsek, Cihan, additional, Kardys, Isabella, additional, Lenzen, Mattie J., additional, van Domburg, Ron T., additional, Regar, Evelyn, additional, Serruys, Patrick W., additional, Akkerhuis, K. Martijn, additional, and Boersma, Eric, additional

Published
2014
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122. Antibodies to periodontal pathogens are associated with coronary plaque remodeling but not with vulnerability or burden

Author

de Boer, Sanneke P.M., primary, Cheng, Jin M., additional, Rangé, Hélène, additional, Garcia-Garcia, Hector M., additional, Heo, Jung Ho, additional, Akkerhuis, K. Martijn, additional, Meilhac, Olivier, additional, Cosler, Guillaume, additional, Pussinen, Pirkko J., additional, van Geuns, Robert-Jan, additional, Serruys, Patrick W., additional, Boersma, Eric, additional, and Kardys, Isabella, additional

Published
2014
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123. Circulating chemokines in relation to coronary plaque characteristics on radiofrequency intravascular ultrasound and cardiovascular outcome

Author

Cheng, Jin M., primary, Oemrawsingh, Rohit M., additional, Akkerhuis, K. Martijn, additional, Garcia-Garcia, Hector M., additional, de Boer, Sanneke P. M., additional, Battes, Linda C., additional, Buljubasic, Nermina, additional, Lenzen, Mattie J., additional, de Jaegere, Peter P. T., additional, van Geuns, Robert-Jan, additional, Serruys, Patrick W., additional, Kardys, Isabella, additional, and Boersma, Eric, additional

Published
2014
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124. Circulating cytokines in relation to the extent and composition of coronary atherosclerosis: Results from the ATHEROREMO-IVUS study

Author

Battes, Linda C., primary, Cheng, Jin M., additional, Oemrawsingh, Rohit M., additional, Boersma, Eric, additional, Garcia-Garcia, Hector M., additional, de Boer, Sanneke P.M., additional, Buljubasic, Nermina, additional, Mieghem, Nicolas A. van, additional, Regar, Evelyn, additional, Geuns, Robert-Jan van, additional, Serruys, Patrick W., additional, Akkerhuis, K. Martijn, additional, and Kardys, Isabella, additional

Published
2014
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125. Stent thrombosis in early-generation drug-eluting stents versus newer-generation everolimus-eluting stent assorted by LVEF

Author

van Boven, Nick, primary, Windecker, Stephan, additional, Umans, Victor A, additional, van Domburg, Ron T, additional, Kardys, Isabella, additional, Akkerhuis, K Martijn, additional, van Geuns, Robbert-Jan, additional, Serruys, Patrick W, additional, Magro, Michael, additional, Räber, Lorenz, additional, and Boersma, Eric, additional

Published
2014
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126. Circulating Osteoglycin and NGAL/MMP9 Complex Concentrations Predict 1-Year Major Adverse Cardiovascular Events After Coronary Angiography

Author

Cheng, Jin M., primary, Akkerhuis, K. Martijn, additional, Meilhac, Olivier, additional, Oemrawsingh, Rohit M., additional, Garcia-Garcia, Hector M., additional, van Geuns, Robert-Jan, additional, Piquer, Dominique, additional, Merle, Delphine, additional, du Paty, Emilie, additional, Galéa, Pascale, additional, Jaisser, Frederic, additional, Rossignol, Patrick, additional, Serruys, Patrick W., additional, Boersma, Eric, additional, Fareh, Jeannette, additional, and Kardys, Isabella, additional

Published
2014
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127. HIGH-SENSITIVITY TROPONIN T IN RELATION TO CORONARY PLAQUE CHARACTERISTICS IN PATIENTS WITH STABLE CORONARY ARTERY DISEASE: RESULTS OF THE ATHEROREMO-IVUS STUDY

Author

Oemrawsingh, Rohit M., primary, Cheng, Jin, additional, Garcia, Hector Garcia, additional, Kardys, Isabella, additional, van Schaik, Ron H.N., additional, Regar, Evelyn, additional, van Geuns, Robert, additional, Serruys, Patrick, additional, Boersma, Eric, additional, and Akkerhuis, K. Martijn, additional

Published
2014
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128. In vivo detection of high-risk coronary plaques by radiofrequency intravascular ultrasound and cardiovascular outcome: results of the ATHEROREMO-IVUS study

Author

Cheng, Jin M., primary, Garcia-Garcia, Hector M., additional, de Boer, Sanneke P.M., additional, Kardys, Isabella, additional, Heo, Jung Ho, additional, Akkerhuis, K. Martijn, additional, Oemrawsingh, Rohit M., additional, van Domburg, Ron T., additional, Ligthart, Jurgen, additional, Witberg, Karen T., additional, Regar, Evelyn, additional, Serruys, Patrick W., additional, van Geuns, Robert-Jan, additional, and Boersma, Eric, additional

Published
2013
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133. Individualized Angiotensin-Converting Enzyme (ACE)-Inhibitor Therapy in Stable Coronary Artery Disease Based on Clinical and Pharmacogenetic Determinants: The PERindopril GENEtic (PERGENE) Risk Model.

Author

Oemrawsingh, Rohit M., Akkerhuis, K. Martijn, Van Vark, Laura C., Redekop, W. Ken, Rudez, Goran, Remme, Willem J., Bertrand, Michel E., Fox, Kim M., Ferrari, Roberto, Jan Danser, A. H., de Maat, Moniek, Simoons, Maarten L., Brugts, Jasper J., Boersma, Eric, Danser, A H Jan, and PERGENE investigators

Published
2016
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138. Short- and Long-Term Major Adverse Cardiac Events in Patients Undergoing Percutaneous Coronary Intervention with Stenting for Acute Myocardial Infarction Complicated by Cardiogenic Shock

Author

Marcolino, Milena Soriano, primary, Simsek, Cihan, additional, de Boer, Sanneke P.M., additional, van Domburg, Ron T., additional, van Geuns, Robert-Jan, additional, de Jaegere, Peter, additional, Akkerhuis, K. Martijn, additional, Daemen, Joost, additional, Serruys, Patrick W., additional, and Boersma, Eric, additional

Published
2012
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139. Multimarker Analysis of Serially Measured GDF-15, NT-proBNP, ST2, GAL-3, cTnI, Creatinine, and Prognosis in Acute Heart Failure

Author

Gürgöze, Muhammed T., van Vark, Laura C., Baart, Sara J., Kardys, Isabella, Akkerhuis, K. Martijn, Manintveld, Olivier C., Postmus, Douwe, Hillege, Hans L., Lesman-Leegte, Ivonne, Asselbergs, Folkert W., Brunner-la-Rocca, Hans-Peter, van den Bos, Ewout J., Orsel, Joke G., de Ridder, Stijn P.J., Pinto, Yigal M., and Boersma, Eric

Published
2023
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141. A pharmacogenetic analysis of determinants of hypertension and blood pressure response to angiotensin-converting enzyme inhibitor therapy in patients with vascular disease and healthy individuals

Author

Brugts, Jasper J, primary, Isaacs, Aaron, additional, de Maat, Moniek PM, additional, Boersma, Eric, additional, van Duijn, Cock M, additional, Akkerhuis, K Martijn, additional, Uitterlinden, Andre G, additional, Witteman, Jacqueline CM, additional, Cambien, Francois, additional, Ceconi, Claudio, additional, Remme, Willem, additional, Bertrand, Michel, additional, Ninomiya, Toshiharu, additional, Harrap, Stephen, additional, Chalmers, John, additional, MacMahon, Stephen, additional, Fox, Kim, additional, Ferrari, Roberto, additional, Simoons, Maarten L, additional, and Danser, AH Jan, additional

Published
2011
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142. High-Frequency Biomarker Measurements of Troponin, NT-proBNP, and C-Reactive Protein for Prediction of New Coronary Events After Acute Coronary Syndrome

Author

Oemrawsingh, Rohit M., Akkerhuis, K. Martijn, de Mulder, Maarten, Umans, Victor A., Kietselaer, Bas, Schotborgh, Carl, Ronner, Eelko, Lenderink, Timo, Liem, Anho, Haitsma, David, van der Harst, Pim, Asselbergs, Folkert W., Maas, Arthur, Oude Ophuis, Anton J., Ilmer, Ben, Dijkgraaf, Rene, de Winter, Robbert J., Kie The, S. Hong, Wardeh, Alexander J., Hermans, Walter, Cramer, Etienne, van Schaik, Ron H., Hoefer, Imo E., Doevendans, Pieter A., Simoons, Maarten L., and Boersma, Eric

Published
2019
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144. MULTIMARKER RISK MODEL CONTAINING TROPONIN, INTERLEUKIN-10, MYELOPEROXIDASE AND PLACENTAL GROWTH FACTOR PREDICTS LONG-TERM CARDIOVASCULAR RISK AFTER NON-ST-SEGMENT ELEVATION ACUTE CORONARY SYNDROME

Author

Oemrawsingh, Rohit M., primary, Lenderink, Timo, additional, Akkerhuis, K. Martijn, additional, Heeschen, Christopher, additional, Baldus, Stephan, additional, Fichtlscherer, Stephan, additional, Hamm, Christian W., additional, Simoons, Maarten L., additional, and Boersma, Eric, additional

Published
2010
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147. Abstract 12012: Subphenotypes of Heart Failure With Reduced Ejection Fraction Based on Repeated Measurements of 4210 Circulating Proteins Are Driven by Protein Subsets Reflecting Different Biological Mechanisms

Author

Petersen, Teun B, de Bakker, Marie, Asselbergs, Folkert W, Akkerhuis, K. Martijn, Brugts, Jasper J, van Ramshorst, Jan, Lumbers, Tom, Ostroff, Rachel, Katsikis, Peter D, van der Spek, Peter J, Umans, Victor A, Boersma, Eric, Rizopoulos, Dimitris, and Kardys, Isabella

Abstract

Introduction:Subphenotyping of HF may lead to pathophysiological insights and treatment opportunities. We aimed to identify novel circulating-protein based subphenotypes (SP) in patients with HFrEF. We used repeated proteomic assessments to account for the dynamic nature of HF.Methods:In 382 patients, we performed trimonthly blood sampling during a median follow-up of 2.1 years. We selected all baseline samples and two samples closest to the primary endpoint (PEP; composite of cardiovascular mortality, HF hospitalization, LVAD implantation, and heart transplantation) or censoring and applied an aptamer-based multiplex proteomic approach. We used unsupervised machine learning to derive subphenotypes from 4210 protein trajectories per patient represented by linear mixed effect intercept and slope coefficients.Results:We identified 4 SPs. SP1 was older with higher SBP, EF and history of hypertension. SP2 was older with lower SBP, lower EF, more comorbidities, and worse prognosis (adjHR(95% CI): 4.06 (2.07-7.96)) compared to SP1. SP3 was younger, had lower SBP and EF, more frequently cardiomyopathy (in particular dilated), and a worse prognosis (2.70 (1.33-5.48)). SP4 contained few patients and thus was harder to interpret. It differed from SP3 via higher SBP, higher EF, and seemingly better prognosis. SP allocation was driven by subsets of proteins associated with various biological functions and diseases, e.g. myocardial stress, inflammation, and renal dysfunction. Clinical characteristics of the SPs were aligned with these associations. The prognostic model using SPs based on repeated measurements had a better fit than using SPs based on baseline values (c-index: 0.78 vs 0.72).Conclusions:We found 4 circulating-protein based HFrEF subphenotypes driven by varying protein subsets, with different clinical characteristics and prognosis. Repeated protein measurements improved discriminative ability of the subphenotypes for clinical outcomes.

Published
2022
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148. Minor Myocardial Damage and Prognosis

Author

Akkerhuis, K. Martijn, primary, Alexander, John H., additional, Tardiff, Barbara E., additional, Boersma, Eric, additional, Harrington, Robert A., additional, Lincoff, A. Michael, additional, and Simoons, Maarten L., additional

Published
2002
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149. A simple risk chart for initial risk assessment of 30-day mortality in patients with cardiogenic shock from ST-elevation myocardial infarction

Author

Cheng, Jin M, Helming, Anne Mijn, van Vark, Laura C, Kardys, Isabella, Den Uil, Corstiaan A, Jewbali, Lucia SD, van Geuns, Robert-Jan, Zijlstra, Felix, van Domburg, Ron T, Boersma, Eric, and Akkerhuis, K Martijn

Abstract

Aims: Early risk stratification is important in patients with cardiogenic shock from ST-elevation myocardial infarction (STEMI). We aimed to develop a simple risk chart that includes clinical parameters that are readily available at time of hospital admission to assess risk of 30-day mortality.Methods and results: A series of 544 STEMI patients admitted to undergo primary percutaneous coronary intervention and presenting with cardiogenic shock were included between 2000 and 2012. Overall 30-day mortality was 38.4% and did not change over the years (p-trend=0.64). Baseline variables that were available at time of hospital admission were entered into a logistic regression model in a forward stepwise manner. Only age (odds ratio (OR) per year 1.05, 95% confidence interval (CI) 1.04–1.07, p<0.001), initial serum lactate level (OR per mmol/l 1.17, 95% CI 1.11–1.24, p<0.001) and initial creatinine level above the upper limit of normal (OR 2.89, 95% CI 1.90–4.37, p<0.001) remained independent predictors, and were subsequently used to develop a risk chart that stratifies risk of 30-day mortality into categories ranging from 0–20% to 80–100%. The calibration plot showed a close relationship between expected and observed mortality. The risk chart had a higher discriminative accuracy than the GRACE score (c-index 0.75 vs. 0.66, p=0.009). Adding variables that were obtained from coronary angiography and during clinical course did not significantly improve discriminative accuracy of risk chart (c-index 0.77, p=0.48).Conclusion: Mortality of patients with cardiogenic shock from STEMI undergoing primary percutaneous coronary intervention can be well predicted already at time of hospital admission by a risk chart that uses only three variables, namely, age, initial serum lactate and creatinine level.

Published
2016
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150. Sex-based differences in cardiovascular proteomic profiles and their associations with adverse outcomes in patients with chronic heart failure.

Author

de Bakker, Marie, Petersen, Teun B., Akkerhuis, K. Martijn, Harakalova, Magdalena, Umans, Victor A., Germans, Tjeerd, Caliskan, Kadir, Katsikis, Peter D., van der Spek, Peter J., Suthahar, Navin, de Boer, Rudolf A., Rizopoulos, Dimitris, Asselbergs, Folkert W., Boersma, Eric, and Kardys, Isabella

Subjects
*HEART failure patients, *EXTRACELLULAR matrix proteins, *SEX factors in disease, *PROTEOMICS, *DISEASE risk factors, *HEART assist devices
Abstract

Background: Studies focusing on sex differences in circulating proteins in patients with heart failure with reduced ejection fraction (HFrEF) are scarce. Insight into sex-specific cardiovascular protein profiles and their associations with the risk of adverse outcomes may contribute to a better understanding of the pathophysiological processes involved in HFrEF. Moreover, it could provide a basis for the use of circulating protein measurements for prognostication in women and men, wherein the most relevant protein measurements are applied in each of the sexes. Methods: In 382 patients with HFrEF, we performed tri-monthly blood sampling (median follow-up: 25 [13–31] months). We selected all baseline samples and two samples closest to the primary endpoint (PEP: composite of cardiovascular death, heart transplantation, left ventricular assist device implantation, and HF hospitalization) or censoring. We then applied an aptamer-based multiplex proteomic assay identifying 1105 proteins previously associated with cardiovascular disease. We used linear regression models and gene-enrichment analysis to study sex-based differences in baseline levels. We used time-dependent Cox models to study differences in the prognostic value of serially measured proteins. All models were adjusted for the MAGGIC HF mortality risk score and p-values for multiple testing. Results: In 104 women and 278 men (mean age 62 and 64 years, respectively) cumulative PEP incidence at 30 months was 25% and 35%, respectively. At baseline, 55 (5%) out of the 1105 proteins were significantly different between women and men. The female protein profile was most strongly associated with extracellular matrix organization, while the male profile was dominated by regulation of cell death. The association of endothelin-1 (Pinteraction < 0.001) and somatostatin (Pinteraction = 0.040) with the PEP was modified by sex, independent of clinical characteristics. Endothelin-1 was more strongly associated with the PEP in men (HR 2.62 [95%CI, 1.98, 3.46], p < 0.001) compared to women (1.14 [1.01, 1.29], p = 0.036). Somatostatin was positively associated with the PEP in men (1.23 [1.10, 1.38], p < 0.001), but inversely associated in women (0.33 [0.12, 0.93], p = 0.036). Conclusion: Baseline cardiovascular protein levels differ between women and men. However, the predictive value of repeatedly measured circulating proteins does not seem to differ except for endothelin-1 and somatostatin. Highlights: Baseline levels of circulating proteins related to extracellular matrix organization were dominant in women, while those related to regulation of cell death were dominant in men. A significant interaction is present between sex and the circulating proteins endothelin-1 and somatostatin, in the longitudinal associations with adverse cardiovascular outcome. Even if circulating proteins entail similar risk in women and men, the use of the same thresholds in both sexes to ascertain the risk of future cardiovascular events may not result in equitable risk stratification, because of sex differences in baseline levels combined with underlying differences in risk of adverse events. Altogether, inherent sex differences in baseline levels may reflect sex differences in disease risk, suggesting that a sex-specific interpretation could be beneficial when circulating proteins are used for risk prediction in patients with chronic HF. [ABSTRACT FROM AUTHOR]

Published
2023
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