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103. CT or invasive coronary angiography in stable chest pain

Author

Maurovich-Horvat, Pál, Bosserdt, Maria, Kofoed, Klaus F., Rieckmann, Nina, Benedek, Theodora, Donnelly, Patrick, Rodriguez-Palomares, José, Erglis, Andrejs, Štěchovský, Cyril, Šakalyte, Gintare, Čemerlić Adić, Nada, Gutberlet, Matthias, Dodd, Jonathan D., Diez, Ignacio, Davis, Gershan, Zimmermann, Elke, Kępka, Cezary, Vidakovic, Radosav, Francone, Marco, Ilnicka-Suckiel, Małgorzata, Plank, Fabian, Knuuti, Juhani, Faria, Rita, Schröder, Stephen, Berry, Colin, Saba, Luca, Ruzsics, Balazs, Kubiak, Christine, Gutierrez-Ibarluzea, Iñaki, Schultz Hansen, Kristian, Müller-Nordhorn, Jacqueline, Merkely, Bela, Knudsen, Andreas D., Benedek, Imre, Orr, Clare, Xavier Valente, Filipa, Zvaigzne, Ligita, Suchánek, Vojtěch, Zajančkauskiene, Laura, Adić, Filip, Woinke, Michael, Hensey, Mark, Lecumberri, Iñigo, Thwaite, Erica, Laule, Michael, Kruk, Mariusz, Neskovic, Aleksandar N., Mancone, Massimo, Kuśmierz, Donata, Feuchtner, Gudrun, Pietilä, Mikko, Gama Ribeiro, Vasco, Drosch, Tanja, Delles, Christian, Matta, Gildo, Fisher, Michael, Szilveszter, Bálint, Larsen, Linnea, Ratiu, Mihaela, Kelly, Stephanie, Garcia del Blanco, Bruno, Rubio, Ainhoa, Drobni, Zsófia D., Jurlander, Birgit, Rodean, Ioana, Regan, Susan, Cuéllar Calabria, Hug, Boussoussou, Melinda, Engstrøm, Thomas, Hodas, Roxana, Napp, Adriane E., Haase, Robert, Feger, Sarah, Serna-Higuita, Lina M., Neumann, Konrad, Dreger, Henryk, Rief, Matthias, Wieske, Viktoria, Estrella, Melanie, Martus, Peter, and Dewey, Marc

Abstract

Background: \ud In the diagnosis of obstructive coronary artery disease (CAD), computed tomography (CT) is an accurate, noninvasive alternative to invasive coronary angiography (ICA). However, the comparative effectiveness of CT and ICA in the management of CAD to reduce the frequency of major adverse cardiovascular events is uncertain.\ud \ud Methods: \ud We conducted a pragmatic, randomized trial comparing CT with ICA as initial diagnostic imaging strategies for guiding the treatment of patients with stable chest pain who had an intermediate pretest probability of obstructive CAD and were referred for ICA at one of 26 European centers. The primary outcome was major adverse cardiovascular events (cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke) over 3.5 years. Key secondary outcomes were procedure-related complications and angina pectoris.\ud \ud Results: \ud Among 3561 patients (56.2% of whom were women), follow-up was complete for 3523 (98.9%). Major adverse cardiovascular events occurred in 38 of 1808 patients (2.1%) in the CT group and in 52 of 1753 (3.0%) in the ICA group (hazard ratio, 0.70; 95% confidence interval [CI], 0.46 to 1.07; P=0.10). Major procedure-related complications occurred in 9 patients (0.5%) in the CT group and in 33 (1.9%) in the ICA group (hazard ratio, 0.26; 95% CI, 0.13 to 0.55). Angina during the final 4 weeks of follow-up was reported in 8.8% of the patients in the CT group and in 7.5% of those in the ICA group (odds ratio, 1.17; 95% CI, 0.92 to 1.48).\ud \ud Conclusions: \ud Among patients referred for ICA because of stable chest pain and intermediate pretest probability of CAD, the risk of major adverse cardiovascular events was similar in the CT group and the ICA group. The frequency of major procedure-related complications was lower with an initial CT strategy. (Funded by the European Union Seventh Framework Program and others; DISCHARGE ClinicalTrials.gov number, NCT02400229.

Published
2022

104. Microcirculatory Function in Nonhypertrophic and Hypertrophic Myocardium in Patients With Aortic Valve Stenosis

Author

Sabbah, Muhammad, primary, Olsen, Niels Thue, additional, Minkkinen, Mikko, additional, Holmvang, Lene, additional, Tilsted, Hans‐Henrik, additional, Pedersen, Frants, additional, Joshi, Francis R., additional, Ahtarovski, Kiril, additional, Sørensen, Rikke, additional, Linde, Jesper James, additional, Søndergaard, Lars, additional, Pijls, Nico, additional, Lønborg, Jacob, additional, and Engstrøm, Thomas, additional

Published
2022
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105. Bleeding Episodes in Patients With Non-ST-Segment Elevation Acute Coronary Syndrome Undergoing Very Early Versus Standard Care Invasive Examination (from the Very EaRly vs Deferred Invasive Evaluation Using Computerised Tomography [VERDICT] Trial)

Author

Sadjadieh, Golnaz, primary, Kelbæk, Henning, additional, Kofoed, Klaus F., additional, Køber, Lars V., additional, Hansen, Peter Riis, additional, Torp-Pedersen, Christian, additional, Elming, Hanne, additional, Gislason, Gunnar, additional, Høfsten, Dan E., additional, Engstrøm, Thomas, additional, and Holmvang, Lene, additional

Published
2022
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107. Long-Term Outcome After Drug-Eluting Versus Bare-Metal Stent Implantation in Patients With ST-Segment Elevation Myocardial Infarction: 5 Years Follow-Up From the Randomized DEDICATION Trial (Drug Elution and Distal Protection in Acute Myocardial Infarction)

Author

Holmvang, Lene, Kelbæk, Henning, Kaltoft, Anne, Thuesen, Leif, Lassen, Jens Flensted, Clemmensen, Peter, Kløvgaard, Lene, Engstrøm, Thomas, Bøtker, Hans E., Saunamäki, Kari, Krusell, Lars R., Jørgensen, Erik, Tilsted, Hans-Henrik, Christiansen, Evald H., Ravkilde, Jan, Køber, Lars, Kofoed, Klaus Fuglsang, Terkelsen, Christian J., and Helqvist, Steffen

Published
2013
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108. Association Between Early Q Waves and Reperfusion Success in Patients With ST-Segment–Elevation Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention: A Cardiac Magnetic Resonance Imaging Study

Author

Topal, Divan Gabriel, Lønborg, Jacob, Ahtarovski, Kiril Aleksov, Nepper-Christensen, Lars, Helqvist, Steffen, Holmvang, Lene, Pedersen, Frants, Clemmensen, Peter, Saünamaki, Kari, Jørgensen, Erik, Kyhl, Kasper, Ghotbi, Ali, Schoos, Mikkel Malby, Göransson, Christoffer, Bertelsen, Litten, Høfsten, Dan, Køber, Lars, Kelbæk, Henning, Vejlstrup, Niels, and Engstrøm, Thomas

Published
2017
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110. Coronary CT and timing of invasive coronary angiography in patients ≥75 years old with non-ST segment elevation acute coronary syndromes.

Author

Ratcovich, Hanna, Sadjadieh, Golnaz, Linde, Jesper J., Joshi, Francis R., Kelbæk, Henning, Kofoed, Klaus F., Køber, Lars, Hansen, Peter Riis, Torp-Pedersen, Christian, Elming, Hanne, Gislason, Gunnar Hilmar, Høfsten, Dan Eik, Engstrøm, Thomas, and Holmvang, Lene

Subjects
HEART failure, ACUTE coronary syndrome, CORONARY angiography, MYOCARDIAL perfusion imaging
Abstract

Background: The ability of coronary CT angiography (cCTA) to rule out significant coronary artery disease (CAD) in older patients with non-ST segment elevation acute coronary syndromes (NSTEACS) is unclear since valid cCTA analysis may be limited by extensive coronary artery calcification. In addition, the effect of very early invasive coronary angiography (ICA) with possible revascularisation is debated.Methods: This is a posthoc analysis of patients ≥75 years included in the Very Early vs Standard Care Invasive Examination and Treatment of Patients with Non-ST-Segment Elevation Acute Coronary Syndrome Trial. cCTA was performed prior to the ICA. The diagnostic accuracy of cCTA was investigated. Presence of a coronary artery stenosis ≥50% by subsequent ICA was used as reference. Patients were randomised to a very early (within 12 hours of diagnosis) or a standard ICA (within 48-72 hours of diagnosis). The primary composite endpoint was 5-year all-cause mortality, non-fatal recurrent myocardial infarction or hospital admission for refractory myocardial ischaemia or heart failure.Results: Of 452 (21%) patients ≥75 years, 161 (35.6%) underwent cCTA. 19% of cCTAs excluded significant CAD. The negative predictive value (NPV) of cCTA was 94% (95% CI 79 to 99) and the sensitivity 98% (95% CI 94 to 100). No significant differences in the frequency of primary endpoints were seen in patients randomised to very early ICA (at 5-year follow-up, n=100 (46.9%) vs 122 (51.0%), log-rank p=0.357).Conclusion: In patients ≥75 years with NSTEACS, cCTA before ICA showed a high NPV. A very early ICA <12 hours of diagnosis did not significantly improve long-term clinical outcomes. [ABSTRACT FROM AUTHOR]

Published
2023
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111. Scar border zone mass and presence of border zone channels assessed with cardiac magnetic resonance imaging are associated with ventricular arrhythmia in patients with ST-segment elevation myocardial infarction.

Author

Thomsen, Anna F, Bertelsen, Litten, Jøns, Christian, Jabbari, Reza, Lønborg, Jacob, Kyhl, Kasper, Göransson, Christoffer, Nepper-Christensen, Lars, Atharovski, Kiril, Ekström, Kathrine, Tilsted, Hans-Henrik, Pedersen, Frants, Køber, Lars, Engstrøm, Thomas, Vejlstrup, Niels, and Jacobsen, Peter Karl

Abstract

Aims Late gadolinium enhancement cardiac magnetic resonance (CMR) permits characterization of left ventricular ischaemic scars. We aimed to evaluate if scar core mass, border zone (BZ) mass, and BZ channels are risk markers for subsequent ventricular arrhythmia (VA) in ST-segment elevation myocardial infarction (STEMI). Methods and results A sub-study of the DANish Acute Myocardial Infarction-3 multi-centre trial and Danegaptide phase II proof-of-concept clinical trial in which a total of 843 STEMI patients had a 3-month follow-up CMR. Of these, 21 patients subsequently experienced VA during 100 months of follow-up and were randomly matched 1:5 with 105 controls. A VA event was defined as: ventricular tachycardia, ventricular fibrillation, or sudden cardiac death. Ischaemic scar characteristics were automatically detected by specialized software. We included 126 patients with a median left ventricular ejection fraction of 51.0 ± 11.6% in cases with VA vs. 55.5 ± 8.5% in controls (P = 0.10). Cases had a larger mean BZ mass and more often BZ channels compared to controls [BZ mass: 17.2 ± 10.3 g vs. 10.3 ± 6.0 g; P = 0.0002; BZ channels: 17 (80%) vs. 44 (42%); P = 0.001]. A combination of ≥17.2 g BZ mass and the presence of BZ channels was five times more prevalent in cases vs. controls (P ≤ 0.00001) with an odds ratio of 9.40 (95% confidence interval 3.26–27.13; P ≤ 0.0001) for VA. This identified cases with 52% sensitivity and 90% specificity. Conclusion(s) Scar characterization with CMR indicates that a combination of ≥17.2 g BZ mass and the presence of BZ channels had the strongest association with subsequent VA in STEMI patients. ClinicalTrials.gov Unique identifier: NCT01435408 (DANAMI 3-iPOST and DANAMI 3-DEFER), NCT01960933 (DANAMI 3-PRIMULTI), and NCT01977755 (Danegaptide). [ABSTRACT FROM AUTHOR]

Published
2023
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112. Long-term risk of new-onset arrhythmia in ST-segment elevation myocardial infarction according to revascularization status.

Author

Thomsen, Anna F, Jøns, Christian, Jabbari, Reza, Jacobsen, Mia R, Stampe, Niels Kjær, Butt, Jawad H, Olsen, Niels Thue, Kelbæk, Henning, Torp-Pedersen, Christian, Fosbøl, Emil L, Pedersen, Frants, Køber, Lars, Engstrøm, Thomas, and Jacobsen, Peter Karl

Abstract

Aims Emerging data show that complete revascularization (CR) reduces cardiovascular death and recurrent myocardial infarction in ST-segment elevation myocardial infarction (STEMI). However, the influence of revascularization status on development of arrhythmia in the long-term post-STEMI phase is poorly described. We hypothesized that incomplete revascularization (ICR) compared with CR in STEMI is associated with an increased long-term risk of new-onset arrhythmia. Methods and results Patients with STEMI treated with primary percutaneous coronary intervention (PPCI) at Copenhagen University Hospital, Rigshospitalet, Denmark, with CR or ICR were identified via the Eastern Danish Heart registry from 2009 to 2016. Using unique Danish administrative registries, the outcomes were assessed. The primary outcome was new-onset arrhythmia defined as a composite of atrial fibrillation/flutter (AF), sinoatrial block, advanced second- or third-degree atrioventricular block, ventricular tachycardia/fibrillation (VT), or cardiac arrest (CA), with presentation >7 days post-PPCI. Secondary outcomes were the components of the primary outcome and all-cause mortality. A total of 5103 patients (median age: 62.0 years; 76% men) were included, of whom 4009 (79%) and 1094 (21%) patients underwent CR and ICR, respectively. Compared with CR, ICR was associated with a higher risk of new-onset arrhythmia [hazard ratio (HR), 1.33; 95% confidence interval (CI), 1.07–1.66; P = 0.01], AF (HR, 1.29; 95% CI, 1.00–1.66; P = 0.05), a combined outcome of VT and CA (HR, 1.77; 95% CI, 1.10–2.84; P = 0.02) and all-cause mortality (HR, 1.27; 95% CI, 1.05–1.53; P = 0.01). All HRs adjusted. Conclusion Among patients with STEMI, ICR was associated with an increased long-term risk of new-onset arrhythmia and all-cause mortality compared with CR. [ABSTRACT FROM AUTHOR]

Published
2023
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115. Impact of diabetes on 1‐year clinical outcome in patients undergoing revascularization with the BioFreedom stents or the Orsiro stents from the SORT OUT IX trial

Author

Hansen, Kirstine Nørregaard, primary, Maeng, Michael, additional, Raungaard, Bent, additional, Engstrøm, Thomas, additional, Veien, Karsten Tange, additional, Kristensen, Steen Dalby, additional, Ellert‐Gregersen, Julia, additional, Jensen, Svend Eggert, additional, Junker, Anders, additional, Kahlert, Johnny, additional, Jakobsen, Lars, additional, Christiansen, Evald Høj, additional, and Jensen, Lisette Okkels, additional

Published
2022
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116. Fractional Flow Reserve–Guided PCI as Compared with Coronary Bypass Surgery

Author

Fearon, William F., primary, Zimmermann, Frederik M., additional, De Bruyne, Bernard, additional, Piroth, Zsolt, additional, van Straten, Albert H.M., additional, Szekely, Laszlo, additional, Davidavičius, Giedrius, additional, Kalinauskas, Gintaras, additional, Mansour, Samer, additional, Kharbanda, Rajesh, additional, Östlund-Papadogeorgos, Nikolaos, additional, Aminian, Adel, additional, Oldroyd, Keith G., additional, Al-Attar, Nawwar, additional, Jagic, Nikola, additional, Dambrink, Jan-Henk E., additional, Kala, Petr, additional, Angerås, Oskar, additional, MacCarthy, Philip, additional, Wendler, Olaf, additional, Casselman, Filip, additional, Witt, Nils, additional, Mavromatis, Kreton, additional, Miner, Steven E.S., additional, Sarma, Jaydeep, additional, Engstrøm, Thomas, additional, Christiansen, Evald H., additional, Tonino, Pim A.L., additional, Reardon, Michael J., additional, Lu, Di, additional, Ding, Victoria Y., additional, Kobayashi, Yuhei, additional, Hlatky, Mark A., additional, Mahaffey, Kenneth W., additional, Desai, Manisha, additional, Woo, Y. Joseph, additional, Yeung, Alan C., additional, and Pijls, Nico H.J., additional

Published
2022
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117. Usefulness of Preprocedure High-Sensitivity C-Reactive Protein to Predict Death, Recurrent Myocardial Infarction, and Stent Thrombosis According to Stent Type in Patients With ST-Segment Elevation Myocardial Infarction Randomized to Bare Metal or Drug-Eluting Stenting During Primary Percutaneous Coronary Intervention

Author

Schoos, Mikkel Malby, Kelbæk, Henning, Kofoed, Klaus F., Køber, Lars, Kløvgaard, Lene, Helqvist, Steffen, Engstrøm, Thomas, Saunamäki, Kari, Jørgensen, Erik, Holmvang, Lene, and Clemmensen, Peter

Published
2011
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118. Angiography after Out-of-Hospital Cardiac Arrest without ST-Segment Elevation

Author

Desch, Steffen, primary, Freund, Anne, additional, Akin, Ibrahim, additional, Behnes, Michael, additional, Preusch, Michael R., additional, Zelniker, Thomas A., additional, Skurk, Carsten, additional, Landmesser, Ulf, additional, Graf, Tobias, additional, Eitel, Ingo, additional, Fuernau, Georg, additional, Haake, Hendrik, additional, Nordbeck, Peter, additional, Hammer, Fabian, additional, Felix, Stephan B., additional, Hassager, Christian, additional, Engstrøm, Thomas, additional, Fichtlscherer, Stephan, additional, Ledwoch, Jakob, additional, Lenk, Karsten, additional, Joner, Michael, additional, Steiner, Stephan, additional, Liebetrau, Christoph, additional, Voigt, Ingo, additional, Zeymer, Uwe, additional, Brand, Michael, additional, Schmitz, Roland, additional, Horstkotte, Jan, additional, Jacobshagen, Claudius, additional, Pöss, Janine, additional, Abdel-Wahab, Mohamed, additional, Lurz, Philipp, additional, Jobs, Alexander, additional, de Waha-Thiele, Suzanne, additional, Olbrich, Denise, additional, Sandig, Frank, additional, König, Inke R., additional, Brett, Sabine, additional, Vens, Maren, additional, Klinge, Kathrin, additional, and Thiele, Holger, additional

Published
2021
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119. Comparison of Effect of Ischemic Postconditioning on Cardiovascular Mortality in Patients With ST-Segment Elevation Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention With Versus Without Thrombectomy

Author

Madsen, Jasmine Melissa, primary, Glinge, Charlotte, additional, Jabbari, Reza, additional, Nepper-Christensen, Lars, additional, Høfsten, Dan Eik, additional, Tilsted, Hans-Henrik, additional, Holmvang, Lene, additional, Pedersen, Frants, additional, Joshi, Francis Richard, additional, Sørensen, Rikke, additional, Bang, Lia Evi, additional, Bøtker, Hans Erik, additional, Terkelsen, Christian Juhl, additional, Mæng, Michael, additional, Jensen, Lisette Okkels, additional, Aarøe, Jens, additional, Kelbæk, Henning, additional, Torp-Pedersen, Christian, additional, Køber, Lars, additional, Lønborg, Jacob Thomsen, additional, and Engstrøm, Thomas, additional

Published
2021
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120. Combined In-silico and Machine Learning Approaches Toward Predicting Arrhythmic Risk in Post-infarction Patients

Author

Maleckar, Mary M., primary, Myklebust, Lena, additional, Uv, Julie, additional, Florvaag, Per Magne, additional, Strøm, Vilde, additional, Glinge, Charlotte, additional, Jabbari, Reza, additional, Vejlstrup, Niels, additional, Engstrøm, Thomas, additional, Ahtarovski, Kiril, additional, Jespersen, Thomas, additional, Tfelt-Hansen, Jacob, additional, Naumova, Valeriya, additional, and Arevalo, Hermenegild, additional

Published
2021
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121. Clopidogrel, prasugrel, and ticagrelor for all-comers with ST-segment elevation myocardial infarction

Author

Jacobsen, Mia Ravn, primary, Engstrøm, Thomas, additional, Torp-Pedersen, Christian, additional, Gislason, Gunnar, additional, Glinge, Charlotte, additional, Butt, Jawad Haider, additional, Fosbøl, Emil Loldrup, additional, Holmvang, Lene, additional, Pedersen, Frants, additional, Køber, Lars, additional, Jabbari, Reza, additional, and Sørensen, Rikke, additional

Published
2021
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123. Importance of Risk Assessment in Timing of Invasive Coronary Evaluation and Treatment of Patients With Non–ST‐Segment–Elevation Acute Coronary Syndrome: Insights From the VERDICT Trial

Author

Butt, Jawad H., primary, Kofoed, Klaus F., additional, Kelbæk, Henning, additional, Hansen, Peter R., additional, Torp‐Pedersen, Christian, additional, Høfsten, Dan, additional, Holmvang, Lene, additional, Pedersen, Frants, additional, Bang, Lia E., additional, Sigvardsen, Per E., additional, Clemmensen, Peter, additional, Linde, Jesper J., additional, Heitmann, Merete, additional, Hove, Jens Dahlgaard, additional, Abdulla, Jawdat, additional, Gislason, Gunnar, additional, Engstrøm, Thomas, additional, and Køber, Lars, additional

Published
2021
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124. Safety of Selective Intracoronary Hypotheria during Primary Percutaneous Coronary Intervention in Patients with Anterior St-Elevation Myocardial Infarction

Author

El Farissi, Mohamed, Good, Richard, Engstrøm, Thomas, Oldroyd, Keith G., Karamasis, Grigoris V., Vlaar, Pieter J., Lønborg, Jacob T., Teeuwen, Koen, Keeble, Thomas R., Mangion, Kenneth, De Bruyne, Bernard, Fröbert, Ole, De Vos, Annemiek, Zwart, Bastian, Snijder, Roel J. R., Brueren, Guus R. G., Palmers, Pieter-Jan, Wijnbergen, Inge F., Berry, Colin, Tonino, Pim A. L., Otterspoor, Luuk C., and Pijls, Nico H. J.

Subjects
cardiovascular diseases
Abstract

Objectives-\ud \ud The aim of this study was to determine the safety of selective intracoronary hypothermia during primary percutaneous coronary intervention (PPCI) in patients with anterior ST-segment elevation myocardial infarction (STEMI).\ud \ud Background-\ud \ud Selective intracoronary hypothermia is a novel treatment designed to reduce myocardial reperfusion injury and is currently being investigated in the ongoing randomized controlled EURO-ICE (European Intracoronary Cooling Evaluation in Patients With ST-Elevation Myocardial Infarction) trial (NCT03447834). Data on the safety of such a procedure during PPCI are still limited.\ud \ud Methods-\ud \ud The first 50 patients with anterior STEMI treated with selective intracoronary hypothermia during PPCI were included in this analysis and compared for safety with the first 50 patients randomized to the control group undergoing standard PPCI. In-hospital mortality, occurrence of rhythm or conduction disturbances, stent thrombosis, onset of heart failure during the procedure, and subsequent hospital admission were assessed.\ud \ud Results-\ud \ud In-hospital mortality was 0%. One patient in both groups developed cardiogenic shock. Atrial fibrillation occurred in 0 and 3 patients (P = 0.24), and ventricular fibrillation occurred in 5 and 3 patients (P = 0.72) in the intracoronary hypothermia group and control group, respectively. Stent thrombosis occurred in 2 patients in the intracoronary hypothermia group; 1 instance was intraprocedural, and the other occurred following interruption of dual-antiplatelet therapy consequent to an intracranial hemorrhage 6 days after enrollment. No stent thrombosis was observed in the control group (P = 0.50).\ud \ud Conclusions-\ud \ud Selective intracoronary hypothermia during PPCI in patients with anterior STEMI can be implemented within the routine of PPCI and seems to be safe. The final safety results will be reported at the end of the trial.

Published
2021

125. Diagnostic performance of angiography-based fractional flow reserve by patient and lesion characteristics: FAST-FFR substudy

Author

Kobayashi, Yuhei, Collet, Carlos, Achenbach, Stephan, Engstrøm, Thomas, Assali, Abid, Shlofmitz, Richard, Fournier, Stephane, Kirtane, Ajay J., Ali, Ziad A., Kornowski, Ran, Leon, Martin B., De Bruyne, Bernard, and Fearon, William

Subjects
Fractional Flow Reserve, Myocardial, Clinical Research, Predictive Value of Tests, Coronary Stenosis, Humans, Coronary Artery Disease, Prospective Studies, Coronary Angiography, Severity of Illness Index
Abstract

BACKGROUND: A large, prospective, multicentre trial recently showed that fractional flow reserve (FFR) derived from coronary angiography (FFR(angio)) has an accuracy of 92% compared with conventional guidewire-based FFR (FFR(wire)); however, little is known about whether specific patient/lesion characteristics affect the diagnostic performance. AIMS: The primary goal of the present study was to investigate whether specific patient or lesion characteristics such as high body mass index (BMI), presentation with an acute coronary syndrome, or lesion location affect the diagnostic performance of FFR(angio) in patients enrolled in the FAST-FFR study. METHODS: FFR(angio) was measured in a blinded fashion in 301 patients (319 vessels) who were undergoing FFR(wire) assessment. Using an FFR(wire) ≤0.80 as a reference, the diagnostic performance of FFR(angio) was compared in pre-specified subgroups. RESULTS: The mean FFR(wire) and FFR(angio) were 0.81±0.13 and 0.80±0.12. Overall, FFR(angio) had a sensitivity of 93.5% and specificity of 91.2% for predicting FFR(wire). Patient characteristics including age, sex, clinical presentation, body mass index, and diabetes did not affect sensitivity or specificity (p>0.05 for all). Similarly, lesion characteristics including calcification and tortuosity did not affect sensitivity or specificity (p>0.05 for all), nor did lesion location (proximal, middle, versus distal). Sensitivity was equally high across all target vessels, while specificity was highest in the LAD and lower (~85%) in the RCA and LCx (p

Published
2021

131. Efficacy and safety of zotarolimus-eluting and sirolimus-eluting coronary stents in routine clinical care (SORT OUT III): a randomised controlled superiority trial

Author

Rasmussen, Klaus, Maeng, Michael, Kaltoft, Anne, Thayssen, Per, Kelbæk, Henning, Tilsted, Hans Henrik, Abildgaard, Ulrik, Christiansen, Evald Høj, Engstrøm, Thomas, Krusell, Lars Romer, Ravkilde, Jan, Hansen, Peter Riis, Hansen, Knud Nørregaard, Abildstrøm, Steen Zabell, Aarøe, Jens, Jensen, Jan Skov, Kristensen, Steen Dalby, Bøtker, Hans Erik, Madsen, Morten, Johnsen, Søren Paaske, Jensen, Lisette Okkels, Sørensen, Henrik Toft, Thuesen, Leif, and Lassen, Jens Flensted

Published
2010
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133. Selective intracoronary hypothermia in patients with ST-elevation myocardial infarction. Rationale and design of the EURO-ICE trial: Intracoronary hypothermia in STEMI

Author

El Farissi, Mohamed, Keulards, Danielle C.J., van 't Veer, Marcel, Zelis, Jo, Berry, Colin, De Bruyne, Bernard, Engstrøm, Thomas, Fröbert, Ole, Piroth, Zsolt, Oldroyd, Keith G., Tonino, Pim A.L., Pijls, Nico H.J., and Otterspoor, Luuk

Subjects
Percutaneous Coronary Intervention, Treatment Outcome, Abciximab, Short Report, Humans, ST Elevation Myocardial Infarction, Hypothermia, Angioplasty, Balloon, Coronary
Published
2021

136. Outcome In Elderly Patients With Cardiogenic Shock Complicating Acute Myocardial Infarction

Author

Ratcovich, Hanna Louise, primary, Josiassen, Jakob, additional, Helgestad, Ole Kristian Lerche., additional, Linde, Louise, additional, Jensen, Lisette Okkels, additional, Ravn, Hanne Berg, additional, Joshi, Francis R., additional, Engstrøm, Thomas, additional, Schmidt, Henrik, additional, Hassager, Christian, additional, Møller, Jacob E., additional, and Holmvang, Lene, additional

Published
2021
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138. Diagnostic performance of angiography-based fractional flow reserve by patient and lesion characteristics

Author

Kobayashi, Yuhei, primary, Collet, Carlos, additional, Achenbach, Stephan, additional, Engstrøm, Thomas, additional, Assali, Abid, additional, Shlofmitz, Richard A., additional, Fournier, Stephane, additional, Kirtane, Ajay J., additional, Ali, Ziad A., additional, Kornowski, Ran, additional, Leon, Martin B., additional, De Bruyne, Bernard, additional, and Fearon, William F., additional

Published
2021
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139. Effect of Alirocumab Added to High-Intensity Statin Therapy on Coronary Atherosclerosis in Patients With Acute Myocardial Infarction

Author

Räber, Lorenz, Ueki, Yasushi, Otsuka, Tatsuhiko, Losdat, Sylvain, Häner, Jonas D, Lonborg, Jacob, Fahrni, Gregor, Iglesias, Juan F, van Geuns, Robert-Jan, Ondracek, Anna S, Radu Juul Jensen, Maria D, Zanchin, Christian, Stortecky, Stefan, Spirk, David, Siontis, George C M, Saleh, Lanja, Matter, Christian M, Daemen, Joost, Mach, François, Heg, Dik, Windecker, Stephan, Engstrøm, Thomas, Lang, Irene M, Koskinas, Konstantinos C, PACMAN-AMI collaborators, University of Zurich, Räber, Lorenz, and Cardiology

Subjects
Male, Anticholesteremic Agents, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], PCSK9 Inhibitors, Myocardial Infarction, 610 Medicine & health, Cholesterol, LDL, Coronary Artery Disease, 2700 General Medicine, General Medicine, Middle Aged, Antibodies, Monoclonal, Humanized, Plaque, Atherosclerotic, Treatment Outcome, Double-Blind Method, 540 Chemistry, 10209 Clinic for Cardiology, Humans, Female, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Cardiology and Cardiovascular Medicine, Original Investigation, Aged, 10038 Institute of Clinical Chemistry
Abstract

Contains fulltext : 252150.pdf (Publisher’s version ) (Closed access) IMPORTANCE: Coronary plaques that are prone to rupture and cause adverse cardiac events are characterized by large plaque burden, large lipid content, and thin fibrous caps. Statins can halt the progression of coronary atherosclerosis; however, the effect of the proprotein convertase subtilisin kexin type 9 inhibitor alirocumab added to statin therapy on plaque burden and composition remains largely unknown. OBJECTIVE: To determine the effects of alirocumab on coronary atherosclerosis using serial multimodality intracoronary imaging in patients with acute myocardial infarction. DESIGN, SETTING, AND PARTICIPANTS: The PACMAN-AMI double-blind, placebo-controlled, randomized clinical trial (enrollment: May 9, 2017, through October 7, 2020; final follow-up: October 13, 2021) enrolled 300 patients undergoing percutaneous coronary intervention for acute myocardial infarction at 9 academic European hospitals. INTERVENTIONS: Patients were randomized to receive biweekly subcutaneous alirocumab (150 mg; n = 148) or placebo (n = 152), initiated less than 24 hours after urgent percutaneous coronary intervention of the culprit lesion, for 52 weeks in addition to high-intensity statin therapy (rosuvastatin, 20 mg). MAIN OUTCOMES AND MEASURES: Intravascular ultrasonography (IVUS), near-infrared spectroscopy, and optical coherence tomography were serially performed in the 2 non-infarct-related coronary arteries at baseline and after 52 weeks. The primary efficacy end point was the change in IVUS-derived percent atheroma volume from baseline to week 52. Two powered secondary end points were changes in near-infrared spectroscopy-derived maximum lipid core burden index within 4 mm (higher values indicating greater lipid content) and optical coherence tomography-derived minimal fibrous cap thickness (smaller values indicating thin-capped, vulnerable plaques) from baseline to week 52. RESULTS: Among 300 randomized patients (mean [SD] age, 58.5 [9.7] years; 56 [18.7%] women; mean [SD] low-density lipoprotein cholesterol level, 152.4 [33.8] mg/dL), 265 (88.3%) underwent serial IVUS imaging in 537 arteries. At 52 weeks, mean change in percent atheroma volume was -2.13% with alirocumab vs -0.92% with placebo (difference, -1.21% [95% CI, -1.78% to -0.65%], P

Published
2022

141. Five-year clinical outcomes of zotarolimus-eluting stents in coronary total occlusions: Five-year outcomes with chronic total occlusions

Author

Kelbæk, Henning, Yeh, Robert W., Engstrøm, Thomas, Neumann, Franz-Josef, Serruys, Patrick, Windecker, Stephan, Belardi, Jorge A., Qiao, Shubin, Xu, Bo, Liu, Minglei, and Silber, Sigmund

Subjects
Male, Sirolimus, China, Time Factors, Myocardial Infarction, Cardiovascular Agents, Drug-Eluting Stents, Coronary Artery Disease, Middle Aged, Prosthesis Design, Percutaneous Coronary Intervention, Treatment Outcome, Coronary Occlusion, Clinical Research, Humans, Female
Abstract

AIMS: Reports of long-term outcomes of patients treated with drug-eluting stents in total coronary occlusions are limited. We analysed clinical outcomes of patients treated with the zotarolimus-eluting Resolute stent (R-ZES) implanted in coronary total occlusions versus non-occluded lesions. METHODS AND RESULTS: Patients treated with R-ZES and included in four trials (RESOLUTE All Comers, RESOLUTE International, RESOLUTE China RCT, and RESOLUTE China Registry) were pooled and divided into three groups – patients with chronic total occlusions (CTO), patients with total occlusions that had occurred recently (rec-TO), and patients without total occlusions (non-TO). Clinical outcomes at five years were analysed. Of 5,487 patients treated with R-ZES in these trials, 8.0% had CTOs, 8.5% rec-TOs and 83.5% non-TOs. Patients had a mean age of 62.8 years, approximately 25% were female and 30% were diabetics. TLF was similar in the three groups at five years (TLF was 13.2%, 12.5% and 13.3% in the CTO, rec-TO and non-TO groups, respectively, p=0.96). Stent thrombosis tended to occur more frequently for rec-TO compared to CTO and non-TO patients (2.6% vs 1.2% and 1.3%, respectively, p=0.11). CONCLUSIONS: In this large population of patients who had R-ZES implanted, five-year clinical outcomes were similar whether or not the stents were implanted in total occlusions.

Published
2021

146. Insulin resistance genetic risk score and burden of coronary artery disease in patients referred for coronary angiography

Author

Skals, Regitze, primary, Krogager, Maria Lukács, additional, Appel, Emil Vincent R., additional, Schnurr, Theresia M., additional, Have, Christian Theil, additional, Gislason, Gunnar, additional, Poulsen, Henrik Enghusen, additional, Køber, Lars, additional, Engstrøm, Thomas, additional, Stender, Steen, additional, Hansen, Torben, additional, Grarup, Niels, additional, Lee, Christina Ji-Young, additional, Andersson, Charlotte, additional, Torp-Pedersen, Christian, additional, and Weeke, Peter E., additional

Published
2021
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148. Quantitative Flow Ratio to Predict Nontarget Vessel–Related Events at 5 Years in Patients With ST‐Segment–Elevation Myocardial Infarction Undergoing Angiography‐Guided Revascularization

Author

Bär, Sarah, primary, Kavaliauskaite, Raminta, additional, Ueki, Yasushi, additional, Otsuka, Tatsuhiko, additional, Kelbæk, Henning, additional, Engstrøm, Thomas, additional, Baumbach, Andreas, additional, Roffi, Marco, additional, von Birgelen, Clemens, additional, Ostojic, Miodrag, additional, Pedrazzini, Giovanni, additional, Kornowski, Ran, additional, Tüller, David, additional, Vukcevic, Vladan, additional, Magro, Michael, additional, Losdat, Sylvain, additional, Windecker, Stephan, additional, and Räber, Lorenz, additional

Published
2021
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149. Ischemia From Nonculprit Stenoses Is Not Associated With Reduced Culprit Infarct Size in Patients with ST-Segment–Elevation Myocardial Infarction

Author

Ekström, Kathrine, primary, Nielsen, Julie V.W., additional, Nepper-Christensen, Lars, additional, Ahtarovski, Kiril A., additional, Kyhl, Kasper, additional, Göransson, Christoffer, additional, Bertelsen, Litten, additional, Ghotbi, Adam A., additional, Kelbæk, Henning, additional, Høfsten, Dan E., additional, Køber, Lars, additional, Schoos, Mikkel M., additional, Vejlstrup, Niels, additional, Lønborg, Jacob, additional, and Engstrøm, Thomas, additional

Published
2021
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150. Selective intracoronary hypothermia in patients with ST-elevation myocardial infarction. Rationale and design of the EURO-ICE trial

Author

El Farissi, Mohamed, primary, Keulards, Daniëlle C.J., additional, van 't Veer, Marcel, additional, Zelis, Jo M., additional, Berry, Colin, additional, De Bruyne, Bernard, additional, Engstrøm, Thomas, additional, Fröbert, Ole, additional, Piroth, Zsolt, additional, Oldroyd, Keith G., additional, Tonino, Pim A.L., additional, Pijls, Nico H.J., additional, and Otterspoor, Luuk C., additional

Published
2021
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