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11 results on '"Chandran, Sujay"'

1. Observational study of inflammatory profiles in patients with ST-elevation myocardial infarction stratified by plaque erosion or rupture identified by optical coherence tomography : the Plaque Erosion Pilot Study

Author

Chandran, Sujay

Subjects
616.1
Abstract

Background: Plaque erosion is responsible for 30–40% of ST-elevation myocardial infarction (STEMI) cases, but the underlying cause is unknown. Autopsy studies suggest that inflammatory infiltrates are less abundant in erosion compared to plaque rupture, which suggests that other pathological mechanisms are important. So far, different inflammatory profiles have not been demonstrated in vivo. Objectives: We sought to characterise the inflammatory profiles of plaque rupture and plaque erosion in patients with STEMI undergoing primary percutaneous coronary intervention (PPCI). Methods: Forty STEMI patients undergoing PPCI with less than six hours of chest pain were recruited in a single-centre observational study. Blood samples were taken from the infarct-related artery and a peripheral artery. Culprit plaques were imaged using optical coherence tomography (OCT) before PCI and classified by three blinded observers as ruptured fibrous cap (RFC) or intact fibrous cap (IFC). The expression profiles of 102 cytokines were measured using an array, and comparisons of the two pathological groups were performed using the Significance Analysis of Microarrays (SAM) methodology. Significant cytokines were validated with enzyme-linked immunosorbent assay (ELISA) and this was confirmed statistically using Wilcoxon rank-sum tests. Thrombectomy samples were analysed for differential mRNA expression using real-time polymerase chain reaction (RT-PCR). Results: Twenty-three lesions were classified as RFC (58%), fifteen as IFC (38%) and two were undefined (4%). Overall, 12% (12/102) of cytokines were differentially expressed in both coronary and peripheral plasma. We selected the most significant differences and confirmed that IFC was associated with preferential expression of epidermal growth factor (EGF) (coronary samples: SAM adjusted P < 0.001; ELISA IFC 7.42 vs RFC 6.63 log2 pg/ml, P = 0.036) and Thrombospondin-1 (TSP-1) (coronary samples: SAM adjusted P = 0.03; ELISA IFC 10.4 vs RFC 8.65 log2 ng/ml, P = 0.0041). Interferon-inducible T-cell alpha chemoattractant (I-TAC) was preferentially expressed in RFC (coronary samples: SAM adjusted P < 0.001; ELISA IFC 10.2 vs RFC 10.8 log2 pg/ml; P = 0.042). Thrombectomy mRNA demonstrated significantly elevated EGF expression in IFC (P = 0.0264) and I-TAC in RFC (P = 0.0007), but no differences in expression of TSP-1. Conclusions: Distinct inflammatory profiles for RFC and IFC are demonstrable in coronary plasma and thrombectomy specimens in STEMI patients. IFC is associated with elevated intracoronary EGF and TSP-1. These results may help to further understand the pathophysiology of plaque erosion and to potentially tailor future treatment strategies.

Published
2017

3. Colchicine in Patients With Coronary Artery Disease: A Systematic Review and Meta‐Analysis of Randomized Trials

Author

Kofler, Thomas, primary, Kurmann, Reto, additional, Lehnick, Dirk, additional, Cioffi, Giacomo Maria, additional, Chandran, Sujay, additional, Attinger‐Toller, Adrian, additional, Toggweiler, Stefan, additional, Kobza, Richard, additional, Moccetti, Federico, additional, Cuculi, Florim, additional, Jolly, Sanjit S., additional, and Bossard, Matthias, additional

Published
2021
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4. Colchicine in Patients With Coronary Artery Disease: A Systematic Review and Meta‐Analysis of Randomized Trials

Author

Kofler, Thomas, Kurmann, Reto, Lehnick, Dirk, Cioffi, Giacomo Maria, Chandran, Sujay, Attiger-Toller, Adrian, Toggweiler, Stefan, Kobza, Richard, Moccetti, Federico, Cuculi, Florim, Jolly, Sanjit S., Bossard, Matthias, Kofler, Thomas, Kurmann, Reto, Lehnick, Dirk, Cioffi, Giacomo Maria, Chandran, Sujay, Attiger-Toller, Adrian, Toggweiler, Stefan, Kobza, Richard, Moccetti, Federico, Cuculi, Florim, Jolly, Sanjit S., and Bossard, Matthias

Abstract

BACKGROUND: Inflammation plays a pivotal role in coronary artery disease (CAD). The anti- inflammatory drug colchicine seems to reduce ischemic events in patients with CAD. So far there is equipoise about its safety and impact on mortality METHODS AND RESULTS: To evaluate the utility of colchicine in patients with acute and chronic CAD, we performed a systematic review and meta- analysis. MEDLINE, EMBASE, Cochrane CENTRAL and conference abstracts were searched from January 1975 to October 2020. Randomized trials assessing colchicine compared with placebo/standard therapy in patients with CAD were included. Data were combined using random- effects models. The reliability of the available data was tested using trial sequential analyses. Of 3108 citations, 13 randomized trials (n=13 125) were included. Colchicine versus placebo/standard therapy in patients withCAD reduced risk of myocardial infarction (odds ratio [OR] 0.64; 95% CI, 0.46 – 0.90; P= 0.01; I 41%) and stroke/transient ischemic attack (OR 0.50; 95% CI, 0.31– 0.81; P=0.005; I 0%). But treatment with colchicine compared with placebo/standard therapy had no influence on all- cause and cardiovascular mortality (OR 0.96; 95% CI, 0.65– 1.41; P=0.83; I 24%; and OR 0.82; 95% CI, 0.55– 1.22; P=0.45; I 0%, respectively). Colchicine increased the risk for gastrointestinal side effects (P<0.001). According to trial sequential analyses, there is only sufficient evidence for a myocardial infarction risk reduction with colchicine. CONCLUSIONS: Among patients with CAD, colchicine reduces the risk of myocardial infarction and stroke, but has a higher rate of gastrointestinal upset with no influence on all- cause mortality., + ID der Publikation: unilu_54969 + Sprache: Englisch + Letzte Aktualisierung: 2021-10-27 16:06:46

Published
2021

6. Percutaneous Device Closure of Paravalvular Leak

Author

Calvert, Patrick A., primary, Northridge, David B., additional, Malik, Iqbal S., additional, Shapiro, Leonard, additional, Ludman, Peter, additional, Qureshi, Shakeel A., additional, Mullen, Michael, additional, Henderson, Robert, additional, Turner, Mark, additional, Been, Martin, additional, Walsh, Kevin P., additional, Casserly, Ivan, additional, Morrison, Lindsay, additional, Walker, Nicola L., additional, Thomson, John, additional, Spence, Mark S., additional, Mahadevan, Vaikom S., additional, Hoye, Angela, additional, MacCarthy, Philip A., additional, Daniels, Matthew J., additional, Clift, Paul, additional, Davies, William R., additional, Adamson, Philip D., additional, Morgan, Gareth, additional, Aggarwal, Suneil K., additional, Ismail, Yasmin, additional, Ormerod, Julian O. M., additional, Khan, Habib R., additional, Chandran, Sujay Subash, additional, de Giovanni, Joseph, additional, Rana, Bushra S., additional, Ormerod, Oliver, additional, and Hildick-Smith, David, additional

Published
2016
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7. Prosthesis-Patient Mismatch after Aortic Valve-In-Valve Implantation: Insights from the Valve-in-Valve International Data (VIVID) Registry

Author

Bleiziffer, Sabine, Webb, John, Kornowski, Ran, Holzhey, David M., Santos, Matheus S., George, Isaac, Sinning, Jan-Malte, Napodano, Massimo, Nombela-Franco, Luis, Guerrero, Mayra, Nissen, Henrik, Rudolph, Tanja, Brecker, Stephen, Shah, Ashish, Petursson, Petur, Cerillo, Alfredo Giuseppe, Chandran, Sujay, Moat, Neil, Gaia, Diego F., Park, Seung-Jung, Bonaros, Nikolaos, Bekeredjian, Raffi, Lange, Ruediger, Dvir, Danny, Bleiziffer, Sabine, Webb, John, Kornowski, Ran, Holzhey, David M., Santos, Matheus S., George, Isaac, Sinning, Jan-Malte, Napodano, Massimo, Nombela-Franco, Luis, Guerrero, Mayra, Nissen, Henrik, Rudolph, Tanja, Brecker, Stephen, Shah, Ashish, Petursson, Petur, Cerillo, Alfredo Giuseppe, Chandran, Sujay, Moat, Neil, Gaia, Diego F., Park, Seung-Jung, Bonaros, Nikolaos, Bekeredjian, Raffi, Lange, Ruediger, and Dvir, Danny

Published
2015

8. TCT-168 Prosthesis-Patient Mismatch after Aortic Valve-In-Valve Implantation: Insights from the Valve-in-Valve International Data (VIVID) Registry

Author

Bleiziffer, Sabine, primary, Webb, John, additional, Kornowski, Ran, additional, Holzhey, David M., additional, Santos, Matheus S., additional, George, Isaac, additional, Sinning, Jan-Malte, additional, Napodano, Massimo, additional, Nombela-Franco, Luis, additional, Guerrero, Mayra, additional, Nissen, Henrik, additional, Rudolph, Tanja, additional, Brecker, Stephen, additional, Shah, Ashish, additional, Petursson, Petur, additional, Cerillo, Alfredo Giuseppe, additional, Chandran, Sujay, additional, Moat, Neil, additional, Gaia, Diego F., additional, Park, Seung-Jung, additional, Bonaros, Nikolaos, additional, Bekeredjian, Raffi, additional, Lange, Ruediger, additional, and Dvir, Danny, additional

Published
2015
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9. 5 Plaque erosion pilot study

Author

Chandran, Sujay, Watkins, Johnathan, Abdul-Aziz, Amina, Calvert, Patrick A, Bowles, Kristian M, Flather, Marcus D, Rushworth, Stuart A, and Ryding, Alisdair D

Abstract

BackgroundPlaque erosion causes 30% of STEMI cases, but the underlying cause is unknown. Inflammatory infiltrates are less abundant in erosion compared to rupture in autopsy studies.ObjectivesWe hypothesised that erosion and rupture are associated with significant differences in intracoronary cytokines in vivo.Methods40 STEMI patients with <6 hours of chest pain were classified as ruptured fibrous cap (RFC) or intact fibrous cap (IFC) using optical coherence tomography. Plasma samples from the infarct-related artery and a peripheral artery were analysed for expression of 102 cytokines using arrays: results were confirmed with ELISA. Thrombectomy samples were analysed for differential mRNA expression using RT-PCR.Results23 lesions were classified as RFC (58%), 15 as IFC (38%) and 2 were undefined (4%). 12% (12/102) of cytokines were differentially expressed in both coronary and peripheral plasma. CXCL11 was preferentially expressed in RFC (SAM adjusted p<0.001; ELISA IFC 10.2 vs RFC 10.8 log2pg/ml; p=0.042). IFC was associated with preferential expression of Epidermal Growth Factor (SAM adjusted p<0.001; ELISA IFC 7.42 vs RFC 6.63 log2pg/ml, p=0.036) and thrombospondin-1 (TSP-1) (SAM adjusted p=0.03; ELISA IFC 10.4 vs RFC 8.65 log2ng/ml, p=0.0041). Thrombectomy mRNA showed elevated CXCL11 in RFC (p=0.0007) EGF expression in IFC (p=0.0264) and, but no differences in expression of TSP-1.ConclusionsThese results demonstrate differential intracoronary cytokine expression in RFC and IFC. Elevated TSP-1 and EGF may play an aetiological role in erosion.

Published
2017
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10. Outcomes of Patients Undergoing Balloon Aortic Valvuloplasty in the TAVI Era: A Multicenter Registry

Author

Moretti, C., Chandran, S., Vervueren, P. -L, D Ascenzo, F., Marco Barbanti, Weerackody, R., Boccuzzi, G., Lee, D. -H, La Torre Hernandez, J., Omedè, P., Nijenhuis, V., Igbineweka, N., Lim, P., Berg, T., Carriè, D., Hildick-Smith, D., Gulino, S., Cannata, S., Gargiulo, G., Tamburino, C., Conrotto, F., Meynet, I., Quadri, G., Marangoni, L., Taha, S., Biondi-Zoccai, G., Salizzoni, S., Marra, S., Gaita, F., Moretti, Claudio, Chandran, Sujay, Vervueren, Paul-Loui, D'Ascenzo, Fabrizio, Barbanti, Marco, Weerackody, Roshan, Boccuzzi, Giacomo, Lee, Dae-Hyun, de la Torre Hernandez, Jose, Omedè, Pierluigi, Nijenhuis, Vincent, Igbineweka, Norri, Lim, Patrick, ten Berg, Null, Carriè, Didier, Hildick-Smith, David, Gulino, Simona, Cannata, Stefano, Gargiulo, Giuseppe, Tamburino, Corrado, Conrotto, Federico, Meynet, Ilaria, Quadri, Giorgio, Marangoni, Ludovica, Taha, Salma, Biondi-Zoccai, Giuseppe, Salizzoni, Stefano, Marra, Sebastiano, and Gaita, Fiorenzo

Subjects
Aged, 80 and over, Balloon Valvuloplasty, Male, Cardiac Catheterization, Time Factors, Time Factor, Risk Factor, Aortic Valve Stenosis, Aortic Valve Stenosi, Follow-Up Studie, Female, Follow-Up Studies, Humans, Retrospective Studies, Risk Factors, Transcatheter Aortic Valve Replacement, Treatment Outcome, Heart Valve Prosthesis, Registries, Heart Valve Prosthesi, Retrospective Studie, 80 and over, Human, Aged
Abstract

Few clinical data about indications and prognoses of patients undergoing balloon aortic valvuloplasty (BAV) in the transcatheter aortic valve implantation (TAVI) era have been reported.Data from all consecutive patients undergoing BAV in seven European centers from 2006 to 2013 were collected. Acute results and long-term outcomes were assessed.A total of 811 patients aged 82 ± 9 years were included; 416 patients (51%) underwent BAV as palliative destination therapy, 320 patients (40%) as bridge to TAVI, and 75 patients (9%) as bridge to surgical aortic valve replacement (SAVR). Patients undergoing BAV as destination therapy had a higher risk profile (logistic EuroSCORE, 20 ± 17 vs 22 ± 14 vs 11 ± 8, respectively; P.001). Post procedure, peak gradient decreased from 87 ± 22 mm Hg to 66 ± 22 mm Hg (P.001) and aortic valve area increased from 0.61 ± 0.2 cm2 to 0.8 ± 0.2 cm2 (P.001). At 30 days, the all-cause death rate (6.5% vs 6.2% vs 7.4%, respectively; P=.56) and the rate of life-threatening and major bleedings (8.0% vs 5.7% vs 6.0%, respectively) did not differ between groups. After a mean follow-up of 318 days (range, 116-500 days), rates of all-cause death were similar (30% vs 34% vs 31%, respectively; P.99), although patients undergoing BAV as bridge to SAVR showed a lower cardiovascular death rate (11% vs 11% vs 3%, respectively; P=.04).In the TAVI era, BAV may represent a reasonable option for patients with severe aortic stenosis and temporary contraindications to definite therapy. Given the mortality rates at 30 days, patients should be carefully selected, while events at follow-up are deeply influenced by the decision of whether or not subsequent interventions are performed.

11. Outcomes of Patients Undergoing Balloon Aortic Valvuloplasty in the TAVI Era: A Multicenter Registry.

Author

Moretti C, Chandran S, Vervueren PL, D'Ascenzo F, Barbanti M, Weerackody R, Boccuzzi G, Lee DH, de la Torre Hernandez J, Omedè P, Nijenhuis V, Igbineweka N, Lim P, ten Berg, Carriè D, Hildick-Smith D, Gulino S, Cannata S, Gargiulo G, Tamburino C, Conrotto F, Meynet I, Quadri G, Marangoni L, Taha S, Biondi-Zoccai G, Salizzoni S, Marra S, and Gaita F

Subjects
Aged, 80 and over, Female, Follow-Up Studies, Humans, Male, Retrospective Studies, Risk Factors, Time Factors, Treatment Outcome, Aortic Valve Stenosis therapy, Balloon Valvuloplasty methods, Cardiac Catheterization methods, Heart Valve Prosthesis, Registries, Transcatheter Aortic Valve Replacement methods
Abstract

Background: Few clinical data about indications and prognoses of patients undergoing balloon aortic valvuloplasty (BAV) in the transcatheter aortic valve implantation (TAVI) era have been reported., Methods: Data from all consecutive patients undergoing BAV in seven European centers from 2006 to 2013 were collected. Acute results and long-term outcomes were assessed., Results: A total of 811 patients aged 82 ± 9 years were included; 416 patients (51%) underwent BAV as palliative destination therapy, 320 patients (40%) as bridge to TAVI, and 75 patients (9%) as bridge to surgical aortic valve replacement (SAVR). Patients undergoing BAV as destination therapy had a higher risk profile (logistic EuroSCORE, 20 ± 17 vs 22 ± 14 vs 11 ± 8, respectively; P<.001). Post procedure, peak gradient decreased from 87 ± 22 mm Hg to 66 ± 22 mm Hg (P<.001) and aortic valve area increased from 0.61 ± 0.2 cm2 to 0.8 ± 0.2 cm2 (P<.001). At 30 days, the all-cause death rate (6.5% vs 6.2% vs 7.4%, respectively; P=.56) and the rate of life-threatening and major bleedings (8.0% vs 5.7% vs 6.0%, respectively) did not differ between groups. After a mean follow-up of 318 days (range, 116-500 days), rates of all-cause death were similar (30% vs 34% vs 31%, respectively; P>.99), although patients undergoing BAV as bridge to SAVR showed a lower cardiovascular death rate (11% vs 11% vs 3%, respectively; P=.04)., Conclusion: In the TAVI era, BAV may represent a reasonable option for patients with severe aortic stenosis and temporary contraindications to definite therapy. Given the mortality rates at 30 days, patients should be carefully selected, while events at follow-up are deeply influenced by the decision of whether or not subsequent interventions are performed.

Published
2015

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