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1. Research Priorities for Endometriosis

Author

Rogers, Peter AW, Adamson, G David, Al-Jefout, Moamar, Becker, Christian M, D’Hooghe, Thomas M, Dunselman, Gerard AJ, Fazleabas, Asgerally, Giudice, Linda C, Horne, Andrew W, Hull, M Louise, Hummelshoj, Lone, Missmer, Stacey A, Montgomery, Grant W, Stratton, Pamela, Taylor, Robert N, Rombauts, Luk, Saunders, Philippa T, Vincent, Katy, and Zondervan, Krina T

Subjects
Reproductive Medicine, Biomedical and Clinical Sciences, Endometriosis, Contraception/Reproduction, Consensus, Education, Female, Humans, Research, endometriosis, research priorities, international workshop, consensus report, WES/WERF Consortium for Research Priorities in Endometriosis, biological marker, Conference Paper, disease classification, embryo development, epigenetics, female infertility, genetics, genomics, health care policy, human, infertility therapy, lowest income group, oocyte, ovary follicle development, pain, pathogenesis, pathophysiology, pregnancy outcome, priority journal, prognosis, research priority, symptom assessment, workshop, consensus, education, female, research, Paediatrics and Reproductive Medicine, Obstetrics & Reproductive Medicine, Reproductive medicine, Midwifery
Abstract

The 3rd International Consensus Workshop on Research Priorities in Endometriosis was held in São Paulo on May 4, 2014, following the 12th World Congress on Endometriosis. The workshop was attended by 60 participants from 19 countries and was divided into 5 main sessions covering pathogenesis/pathophysiology, symptoms, diagnosis/classification/prognosis, disease/symptom management, and research policy. This research priorities consensus statement builds on earlier efforts to develop research directions for endometriosis. Of the 56 research recommendations from the 2011 meeting in Montpellier, a total of 41 remained unchanged, 13 were updated, and 2 were deemed to be completed. Fifty-three new research recommendations were made at the 2014 meeting in Sao Paulo, which in addition to the 13 updated recommendations resulted in a total of 66 new recommendations for research. The research recommendations published herein, as well as those from the 2 previous papers from international consensus workshops, are an attempt to promote high-quality research in endometriosis by identifying and agreeing on key issues that require investigation. New areas included in the 2014 recommendations include infertility, patient stratification, and research in emerging nations, in addition to an increased focus on translational research. A revised and updated set of research priorities that builds on this document will be developed at the 13th World Congress on Endometriosis to be held on May 17-20, 2017, in Vancouver, British Columbia, Canada.

Published
2017

3. Endometriosis of the groin: the additional value of Magnetic Resonance Imaging (MRI)

Author

R AP Borghans, C IE Scheeren, G AJ Dunselman, and R FA Vliegen

Subjects
Endometriosis, Medical physics. Medical radiology. Nuclear medicine, R895-920
Abstract

We report a rare case of endometriosis of the groin in a young woman. This case shows how difficult the diagnosis of unusual manifestations of endometriosis can be. The diagnosis was suspected by a careful history and physical examination. Diagnosis was supported by timely performed Magnetic Resonance Imaging, which illustrates its additional value. It can be argued that MRI could be the first choice of imaging technique for the assessment of young women with nonspecific or unexplained complaints of the groin. Even more important is the familiarity of physicians other than gynaecologists with rare manifestations of this common disease.

Published
2014
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11. Towards endometriosis diagnosis by gadofosveset-trisodium enhanced magnetic resonance imaging.

Author

Marc H Schreinemacher, Walter H Backes, Jos M Slenter, Sofia Xanthoulea, Bert Delvoux, Larissa van Winden, Regina G Beets-Tan, Johannes L H Evers, Gerard A J Dunselman, and Andrea Romano

Subjects
Medicine, Science
Abstract

Endometriosis is defined as the presence of endometrial tissue outside the uterus. It affects 10-15% of women during reproductive age and has a big personal and social impact due to chronic pelvic pain, subfertility, loss of work-hours and medical costs. Such conditions are exacerbated by the fact that the correct diagnosis is made as late as 8-11 years after symptom presentation. This is due to the lack of a reliable non-invasive diagnostic test and the fact that the reference diagnostic standard is laparoscopy (invasive, expensive and not without risks). High-molecular weight gadofosveset-trisodium is used as contrast agent in Magnetic Resonance Imaging (MRI). Since it extravasates from hyperpermeable vessels more easily than from mature blood vessels, this contrast agent detects angiogenesis efficiently. Endometriosis has high angiogenic activity. Therefore, we have tested the possibility to detect endometriosis non-invasively using Dynamic Contrast-Enhanced MRI (DCE-MRI) and gadofosveset-trisodium as a contrast agent in a mouse model. Endometriotic lesions were surgically induced in nine mice by autologous transplantation. Three weeks after lesion induction, mice were scanned by DCE-MRI. Dynamic image analysis showed that the rates of uptake (inwash), persistence and outwash of the contrast agent were different between endometriosis and control tissues (large blood vessels and back muscle). Due to the extensive angiogenesis in induced lesions, the contrast agent persisted longer in endometriotic than control tissues, thus enhancing the MRI signal intensity. DCE-MRI was repeated five weeks after lesion induction, and contrast enhancement was similar to that observed three weeks after endometriosis induction. The endothelial-cell marker CD31 and the pericyte marker α-smooth-muscle-actin (mature vessels) were detected with immunohistochemistry and confirmed that endometriotic lesions had significantly higher prevalence of new vessels (CD31 only positive) than the uterus and control tissues. The diagnostic value of gadofosveset-trisodium to detect endometriosis should be tested in human settings.

Published
2012
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15. Baseline characteristics of patients in the Reduction of Events with Darbepoetin alfa in Heart Failure trial (RED-HF)

Author

McMurray, John J.V., Anand, Inder S., Diaz, Rafael, Maggioni, Aldo P., OʼConnor, Christopher, Pfeffer, Marc A., Solomon, Scott D., Tendera, Michal, van Veldhuisen, Dirk J., Albizem, Moetaz, Cheng, Sunfa, Scarlata, Debra, Swedberg, Karl, Young, James B., Amuchastegui, M., Belziti, C., Bluguermann, J., Caccavo, M., Cartasegna, L., Colque, R., Cuneo, C., Fernandez, A., Gabito, A., Goicochea, R., Gonzalez, M., Gorosito, V., Grinfeld, L., Hominal, M., Kevorkian, R., Litvak Bruno, M., Llanos, J., Mackinnon, I., Manuale, O., Marzetti, E., Nul, D., Perna, E., Riccitelli, M., Sanchez, A., Santos, D., Schygiel, P., Toblli, J., Vogel, D., Aggarwal, A., Amerena, J., De Looze, F., Fletcher, P., Hare, D., Ireland, M., Krum, H., Lattimore, J., Marwick, T., Sindone, A., Thompson, P., Waites, J., Altenberger, J., Ebner, C., Lenz, K., Pacher, R., Poelzl, G., Charlier, F., de Ceuninck, M., De Keulenaer, G., Dendale, P., Maréchal, P., Mullens, W., Thoeng, J., Vanderheyden, M., Vanhaecke, J., Weytjens, C., Wollaert, B., Albuquerque, D., Almeida, D., Aspe y Rosas, J., Bocchi, E., Bordignon, S., Clausell, N., Kaiser, S., Leaes, P., Martins Alves, S., Montera, M., Moura, L., Pereira de Castro, R., Rassi, S., Reis, A., Saraiva, J., Simões, M., Souza Neto, J., Teixeira, M., Benov, H., Chompalova, B., Donova, T., Georgiev, P., Gotchev, D., Goudev, A., Grigorov, M., Guenova, D., Hergeldjieva, V., Ivanov, D., Kostova, E., Manolova, A., Marchev, S., Nikolov, F., Popov, A., Raev, D., Tzekova, M., Czarnecki, W., Giannetti, N., Haddad, H., Heath, J., Huynh, T., Lepage, S., Liu, P., Lonn, E., Ma, P., Manyari, D., Moe, G., Parker, J., Pesant, Y., Rajda, M., Ricci, J., Roth, S., Sestier, F., Sluzar, V., Sussex, B., Vizel, S., Antezana, G., Bugueno, C., Castro, P., Conejeros, C., Manriquez, L., Martinez, D., Potthoff, S., Stockins, B., Vukasovic, J., Gregor, P., Herold, M., Jerabek, O., Jirmar, R., Kuchar, R., Linhart, A., Podzemska, B., Soucek, M., Spac, J., Spacek, R., Vodnansky, P., Bronnum-Schou, J., Clemmensen, K., Egstrup, K., Jensen, G., Kjoller-Hansen, L., Kober, L., Markenvard, J., Rokkedal, J., Skagen, K., Torp-Pedersen, C., Tuxen, C., Videbak, L., Laks, T., Vahula, V., Harjola, V., Kettunen, R., Kotila, M., Bauer, F., Cohen Solal, A., Coisne, D., Davy, J., De Groote, P., Dos Santos, P., Funck, F., Galinier, M., Gibelin, P., Isnard, R., Neuder, Y., Roul, G., Sabatier, R., Trochu, J., Anker, S., Denny, S., Dreykluft, T., Flesch, M., Genth-Zotz, S., Hambrecht, R., Hein, J., Jeserich, M., John, M., Kreider-Stempfle, H., Laufs, U., Muellerleile, K., Natour, M., Sandri, M., Schäufele, T., von Hodenberg, E., Weyland, K., Winkelmann, B., Tse, H., Yan, B., Barsi, B., Csikasz, J., Dezsi, C., Edes, I., Forster, T., Karpati, P., Kerekes, C., Kis, E., Kosa, I., Lupkovics, G., Nagy, A., Preda, I., Ronaszeki, A., Tomcsanyi, J., Zamolyi, K., Agarwal, D., Bahl, V., Bordoloi, A., Chockalingam, K., Chopda, M., Chopra, V., Dugal, J., Ghaisas, N., Ghosh, S., Grant, P., Hiremath, S., Iyengar, S., Jagadeesa Subramania, B., Jain, P., Joshi, A., Khan, A., Mullasari, A., Naik, S., Oomman, A., Pai, V., Pareppally Gopal, R., Parikh, K., Patel, T., Prakash, V., Sastry, B., Sathe, S., Sinha, N., Srikanthan, V., Subburamakrishnan, P., Thacker, H., Wander, G., Admon, D., Katz, A., Klainman, E., Lewis, B., Marmor, A., Moriel, M., Mosseri, M., Shotan, A., Weinstein, J., Zimlichman, R., Agostoni, P., Albanese, M., Alunni, G., Bini, R., Boccanelli, A., Bolognese, L., Campana, C., Carbonieri, E., Carpino, C., Checco, L., Cosmi, F., DʼAngelo, G., De Cristofaro, M., Floresta, A., Fucili, A., Galvani, M., Ivleva, A., Marra, S., Musca, G., Peccerillo, N., Perrone Filardi, P., Picchio, E., Russo, T., Scelsi, L., Senni, M., Tavazzi, L., Erglis, A., Jasinkevica, I., Kakurina, N., Veze, I., Volans, E., Bagdonas, A., Berukstis, E., Celutkiene, J., Dambrauskaite, A., Jarasuniene, D., Luksiene, D., Rudys, A., Sakalyte, G., Sliaziene, S., Aguilar-Romero, R., Cardona-Muñoz, E., Castro-Jimenez, J., Chavez-Herrera, J., Chuquiure Valenzuela, E., De la Pena, G., Herrera, E., Leiva-Pons, J., Lopez Alvarado, A., Mendez Machado, G., Ramos-Lopez, G., Basart, D., Buijs, E., Cornel, J., de Leeuw, M., Dijkgraaf, R., Dunselman, P., Freericks, M., Hamraoui, K., Lenderlink, T., Linssen, G., Lodewick, P., Lodewijks, C., Lok, D., Nierop, P., Ronner, E., Somsen, A., van Dantzig, J., van der Burgh, P., van Kempen, L., van Vlies, B., Voors, A., Wardeh, A., Willems, F., Dickstein, K., Gundersen, T., Hole, T., Thalamus, J., Westheim, A., Dabrowski, M., Gorski, J., Korewicki, J., Kuc, K., Miekus, P., Musial, W., Niegowska, J., Piotrowski, W., Podolec, P., Polonski, L., Ponikowski, P., Rynkiewicz, A., Szelemej, R., Trusz-Gluza, M., Ujda, M., Wojciechowski, D, Wysokinski, A., Camacho, A., Fonseca, C., Monteiro, P., Apetrei, E., Bruckner, I., Carasca, E., Coman, I., Datcu, M., Dragulescu, S., Ionescu, P., Iordachescu-Petica, D., Manitiu, I., Popa, V., Pop-Moldovan, A., Radoi, M., Stamate, S., Tomescu, M., Vita, I., Aroutiounov, G., Ballyuzek, M., Bart, B., Churina, S., Glezer, M., Goloshchekin, B., Ivleva, A., Kobalava, Z., Kostenko, V., Lopatin, Y., Martynov, A., Orlov, V., Semernin, E., Shogenov, Z., Sidorenko, B., Skvortsov, A., Storzhakov, G., Sulimov, V., Talibov, O., Tereshenko, S., Tsyrline, V., Zadionchenko, V., Zateyshchikov, D., Dzupina, A., Hranai, M., Kmec, J., Micko, K., Murin, J., Pella, D., Sojka, G., Spisak, V., Vahala, P., Vinanska, D., Badat, A., Bayat, J., Dawood, S., Delport, E., Ellis, G., Garda, R., Klug, E., Mabin, T., Naidoo, D., Pretorius, M., Ranjith, N., Van Zyl, L., Weich, H., Anguita, M., Berrazueta, J., Bruguera i Cortada, J., de Teresa, E., Gómez Sánchez, M., González Juanatey, J., Gonzalez-Maqueda, I., Jordana, R., Lupon, J., Manzano, L., Pascual Figal, D., Pulpón, L., Recio, J., Ridocci Soriano, F., Rodríguez Lambert, J., Roig Minguell, E., Roig Minguell, E., Romero, J., Valdovinos, P., Klintberg, L., Kronvall, T., Lycksell, M., Morner, S., Rydberg, E., Swedberg, K., Timberg, I., Wikstrom, G., Moccetti, T.4, Ashok, J., Banerjee, P., Carr-White, G., Cleland, J., Connolly, E., Francis, M., Greenbaum, R., Kadr, H., Lindsay, S., McMurray, J., Megarry, S., Memon, A., Murdoch, D., Senior, R., Squire, I., Tan, L., Witte, K., Adams, K., Adamson, P., Adler, A., Altschul, L., Altschuller, A., Amirani, H., Anand, I., Andreou, C., Ansari, M., Antonishen, M., Banchs, H., Banerjee, S., Banish, D., Bank, A., Barbagelata, A., Barnard, D., Bellinger, R., Benn, A., Berk, M., Berry, B., Bethala, V., Bilazarian, S., Bisognano, J., Bleyer, F., Blum, M., Boehmer, J., Bouchard, A., Boyle, A., Bozkurt, B., Brown, C., Burlew, B., Burnham, K., Butler, J., Call, J., Cambier, P., Cappola, T., Carlson, R., Chandler, B., Chandra, R., Chandraratna, P., Chernick, R., Colan, D., Colfer, H., Colucci, W., Connelly, T., Costantini, O., Dadkhah, S., Dauber, I., Davis, J., Davis, S., Denning, S., Drazner, M., Dunlap, S., Egbujiobi, L., Elkayam, U., Elliott, J., El-Shahawy, M., Essandoh, L., Ewald, G., Fang, J., Farhoud, H., Felker, G., Fernandez, J., Festin, R., Fishbein, G., Florea, V., Flores, E., Floro, J., Gabris, M., Garg, M., Gatewood, R., Geller, M., Ghali, J., Ghumman, W., Gibbs, G., Gillespie, E., Gilmore, R., Gogia, H., Goldberg, L., Gradus-Pizlo, I., Grainger, T., Gudmundsson, G., Gunawardena, D., Gupta, D., Hack, T., Hall, S., Hamroff, G., Hankins, S., Hanna, M., Hargrove, J., Haught, W., Hauptman, P., Hazelrigg, M., Herzog, C., Heywood, J., Hill, T., Hilton, T., Hirsch, H., Hunter, J., Ibrahim, H., Imburgia, M., Iteld, B., Jackson, B., Jaffrani, N., Jain, D., Jain, A., James, M., Jimenez, J., Johnson, E., Kale, P., Kaneshige, A., Kapadia, S., Karia, D., Karlsberg, R., Katholi, R., Kerut, E., Khoury, W., Kipperman, R., Klapholz, M., Kosinski, E., Kozinn, M., Kraus, D., Krueger, S., Krum, H., Kumar, S., Lader, E., Lee, C., Levy, W., Lewis, E., Light-McGroary, K., Loh, I., Lombardi, W., Machado, C., Maislos, F., Mancini, D., Markus, T., Mather, P., McCants, K., McGrew, F., McLaurin, B., McMillan, E., McNamara, D., Meyer, T., Meymandi, S., Miller, A., Minami, E., Modi, M., Mody, F., Mohanty, P., Moscoso, R., Moskowitz, R., Moustafa, M., Mullen, M., Naz, T., Noonan, T., OʼBrien, T., Oellerich, W., Oren, R., Pamboukian, S., Pereira, N., Pitt, W., Porter, C., Prabhu, S., Promisloff, S., Ratkovec, R., Richardson, R., Ross, A., Saleh, N., Saltzberg, M., Sarkar, S., Schmedtje, J., Schneider, R., Schuyler, G., Shanes, J., Sharma, A., Siegel, C., Siegel, R., Silber, D., Singh, V., Singh, N., Singh, J., Sklar, J., Small, R., Smith, A., Smith, E., Smith, E., Smull, D., Sotolongo, R., Staniloae, C., Stapleton, D., Steele, P., Stehlik, J., Stein, M., Tang, W., Thadani, U., Torre-Amoine, G., Trichon, B., Tsai, C., Tummala, R., Van Bakel, A., Vicari, R., Vijay, N., Vijayaraghavan, K., Vittorio, T., Vossler, M., Wagoner, L., Wallis, D., Ward, N., Widmer, M., Wight, J., Wilkins, C., Williams, C., Williams, G., Winchester, M., Winkel, E., Wittmer, B., Wood, D., Wormer, D., Wright, R., Xu, Z., Yasin, M., and Zolty, R.

Published
2013
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21. The European Society of Human Reproduction and Embryology guideline for the diagnosis and treatment of endometriosis: an electronic guideline implementability appraisal

Author

de Sutter Petra, Simons Arnold HM, Nygren Karl G, Bergh Christina, Hermens Rosella PMG, Dunselman Gerard AJ, D'Hooghe Thomas M, Nelen Willianne LDM, van Dijk Lotte JEW, Marshall Catherine, Burgers Jako S, and Kremer Jan AM

Subjects
Medicine (General), R5-920
Abstract

Abstract Background Clinical guidelines are intended to improve healthcare. However, even if guidelines are excellent, their implementation is not assured. In subfertility care, the European Society of Human Reproduction and Embryology (ESHRE) guidelines have been inventoried, and their methodological quality has been assessed. To improve the impact of the ESHRE guidelines and to improve European subfertility care, it is important to optimise the implementability of guidelines. We therefore investigated the implementation barriers of the ESHRE guideline with the best methodological quality and evaluated the used instrument for usability and feasibility. Methods We reviewed the ESHRE guideline for the diagnosis and treatment of endometriosis to assess its implementability. We used an electronic version of the guideline implementability appraisal (eGLIA) instrument. This eGLIA tool consists of 31 questions grouped into 10 dimensions. Seven items address the guideline as a whole, and 24 items assess the individual recommendations in the guideline. The eGLIA instrument identifies factors that influence the implementability of the guideline recommendations. These factors can be divided into facilitators that promote implementation and barriers that oppose implementation. A panel of 10 experts from three European countries appraised all 36 recommendations of the guideline. They discussed discrepancies in a teleconference and completed a questionnaire to evaluate the ease of use and overall utility of the eGLIA instrument. Results Two of the 36 guideline recommendations were straightforward to implement. Five recommendations were considered simply statements because they contained no actions. The remaining 29 recommendations were implementable with some adjustments. We found facilitators of the guideline implementability in the quality of decidability, presentation and formatting, apparent validity, and novelty or innovation of the recommendations. Vaguely defined actions, lack of facilities, immeasurable outcomes, and inflexibility within the recommendations formed barriers to implementation. The eGLIA instrument was generally useful and easy to use. However, assessment with the eGLIA instrument is very time-consuming. Conclusions The ESHRE guideline for the diagnosis and treatment of endometriosis could be improved to facilitate its implementation in daily practice. The eGLIA instrument is a helpful tool for identifying obstacles to implementation of a guideline. However, we recommend a concise version of this instrument.

Published
2011
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23. Treatment of Anemia with Darbepoetin Alfa in Systolic Heart Failure

Author

Karl Swedberg, James B. Young, Inder S. Anand, Sunfa Cheng, Akshay S. Desai, Rafael Diaz, Aldo P. Maggioni, John J. V. McMurray, Christopher O'Connor, Marc A. Pfeffer, Scott D. Solomon, Yan Sun, Michal Tendera, Dirk J. van Veldhuisen, Young J, Grinfeld L, Krum H, Vanhaecke J, Olivera Clausell N, Goudev A, Howlett J, Corbalan R, Hradec J, Kober L, Eha J, Cohen Solal A, Anker SD, Chopra V, Lewis B, Erglis A, Sakalyte G, Cardona Munoz E, Dunselman P, Dickstein K, Ponikowski P, Seabra Gomes R, Apetrei E, Mareev V, Murin J, Dalby A, Lopez Sendon J, Willenheimer R, Cleland J, Adams K, Anand I, Butler J, Dunlap M, Felker M, Ghali J, Levy W, Carson P, Cohn J, Drexler H, Pocock S, Ryden L, Poole Wilson P, Fishbane S, Ivanovich P, Nissenson A, Katz S, Barkoudah E, Campbell P, Desai A, Finn PV, Hartley L, Kasabov R, Odutayo KA, Rajesh V, Solomon S, Weinrauch LA, Albizem M, Cheng S, Chou W, Deegenaars M, Dougherty M, Fouqueray B, Froissart M, Froment A, Gadd S, Ghosh S, Grazette L, Guillet S, Gulabani D, Haddock B, Harris C, Jaffer A, Kerns C, Kim J, Knussel B, Law H, Mather R, Mix C, Moore L, Moyes R, Polu K, Rossert J, Scarlata D, Smirnakis K, Smith L, Snyder W, Sun Y, Trotman ML, Wasserman S, Watkins A, Wong M, Zhang Y, Amuchastegui M, Belziti C, Bluguermann J, Caccavo M, Cartasegna L, Colque R, Cuneo C, Fernandez A, Gabito A, Goicochea R, Gonzalez M, Gorosito V, Hominal M, Kevorkian R, Litvak Bruno M, Llanos J, Mackinnon I, Manuale O, Marzetti E, Nul D, Perna E, Riccitelli M, Sanchez A, Santos D, Schygiel P, Toblli J, Vogel D, Aggarwal A, Amerena J, De Looze F, Fletcher P, Hare D, Ireland M, Lattimore J, Marwick T, Sindone A, Thompson P, Waites J, Altenberger J, Ebner C, Lenz K, Pacher R, Poelzl G, Charlier F, de Ceuninck M, De Keulenaer G, Dendale P, Maréchal P, Mullens W, Thoeng J, Vanderheyden M, Weytjens C, Wollaert B, Albuquerque D, Almeida D, Aspe y. Rosas J, Bocchi E, Bordignon S, Clausell N, Kaiser S, Leaes P, Martins Alves S, Montera M, Moura L, Pereira de Castro R, Rassi S, Reis A, Saraiva J, Simões M, Souza Neto J, Teixeira M, Benov H, Chompalova B, Donova T, Georgiev P, Gotchev D, Grigorov M, Guenova D, Hergeldjieva V, Ivanov D, Kostova E, Manolova A, Marchev S, Nikolov F, Popov A, Raev D, Tzekova M, Czarnecki W, Giannetti N, Haddad H, Heath J, Huynh T, Lepage S, Liu P, Lonn E, Ma P, Manyari D, Moe G, Parker J, Pesant Y, Rajda M, Ricci J, Roth S, Sestier F, Sluzar V, Sussex B, Vizel S, Antezana G, Bugueno C, Castro P, Conejeros C, Manriquez L, Martinez D, Potthoff S, Stockins B, Vukasovic J, Gregor P, Herold M, Jerabek O, Jirmar R, Kuchar R, Linhart A, Podzemska B, Soucek M, Spac J, Spacek R, Vodnansky P, Bronnum Schou J, Clemmensen K, Egstrup K, Jensen G, Kjoller Hansen L, Markenvard J, Rokkedal J, Skagen K, Torp Pedersen C, Tuxen C, Videbak L, Laks T, Vahula V, Harjola V, Kettunen R, Kotila M, Bauer F, Coisne D, Davy J, De Groote P, Dos Santos P, Funck F, Galinier M, Gibelin P, Isnard R, Neuder Y, Roul G, Sabatier R, Trochu J, Denny S, Dreykluft T, Flesch M, Genth Zotz S, Hambrecht R, Hein J, Jeserich M, John M, Kreider Stempfle H, Laufs U, Muellerleile K, Natour M, Sandri M, Schäufele T, von Hodenberg E, Weyland K, Winkelmann B, Tse H, Yan B, Barsi B, Csikasz J, Dezsi C, Edes I, Forster T, Karpati P, Kerekes C, Kis E, Kosa I, Lupkovics G, Nagy A, Preda I, Ronaszeki A, Tomcsanyi J, Zamolyi K, Agarwal D, Bahl V, Bordoloi A, Chockalingam K, Chopda M, Dugal J, Ghaisas N, Grant P, Hiremath S, Iyengar S, Jagadeesa Subramania B, Jain P, Joshi A, Khan A, Mullasari A, Naik S, Oomman A, Pai V, Pareppally Gopal R, Parikh K, Patel T, Prakash V, Sastry B, Sathe S, Sinha N, Srikanthan V, Subburamakrishnan P, Thacker H, Wander G, Admon D, Katz A, Klainman E, Marmor A, Moriel M, Mosseri M, Shotan A, Weinstein J, Zimlichman R, Agostoni P, Albanese M, Alunni G, Bini R, Boccanelli A, Bolognese L, Campana C, Carbonieri E, Carpino C, Checco L, Cosmi F, Angelo GD, De Cristofaro M, Floresta A, Fucili A, Galvani M, Ivleva A, Marra S, Musca G, Peccerillo N, Picchio E, Russo T, Scelsi L, Senni M, Tavazzi L, Jasinkevica I, Kakurina N, Veze I, Volans E, Bagdonas A, Berukstis E, Celutkiene J, Dambrauskaite A, Jarasuniene D, Luksiene D, Rudys A, Sliaziene S, Aguilar Romero R, Cardona Muñoz E, Castro Jimenez J, Chavez Herrera J, Chuquiure Valenzuela E, De la Pena G, Herrera E, Leiva Pons J, Lopez Alvarado A, Mendez Machado G, Ramos Lopez G, Basart D, Buijs E, Cornel J, de Leeuw M, Dijkgraaf R, Freericks M, Hamraoui K, Lenderlink T, Linssen G, Lodewick P, Lodewijks C, Lok D, Nierop P, Ronner E, Somsen A, van Dantzig J, van der Burgh P, van Kempen L, van Vlies B, Voors A, Wardeh A, Willems F, Gundersen T, Hole T, Thalamus J, Westheim A, Dabrowski M, Gorski J, Korewicki J, Kuc K, Miekus P, Musial W, Niegowska J, Piotrowski W, Podolec P, Polonski L, Rynkiewicz A, Szelemej R, Trusz Gluza M, Ujda M, Wojciechowski D, Wysokinski A, Camacho A, Fonseca C, Monteiro P, Bruckner I, Carasca E, Coman I, Datcu M, Dragulescu S, Ionescu P, Iordachescu Petica D, Manitiu I, Popa V, Pop Moldovan A, Radoi M, Stamate S, Tomescu M, Vita I, Aroutiounov G, Ballyuzek M, Bart B, Churina S, Glezer M, Goloshchekin B, Kobalava Z, Kostenko V, Lopatin Y, Martynov A, Orlov V, Semernin E, Shogenov Z, Sidorenko B, Skvortsov A, Storzhakov G, Sulimov V, Talibov O, Tereshenko S, Tsyrline V, Zadionchenko V, Zateyshchikov D, Dzupina A, Hranai M, Kmec J, Micko K, Pella D, Sojka G, Spisak V, Vahala P, Vinanska D, Badat A, Bayat J, Dawood S, Delport E, Ellis G, Garda R, Klug E, Mabin T, Naidoo D, Pretorius M, Ranjith N, Van Zyl L, Weich H, Anguita M, Berrazueta J, Bruguera i. 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Brien T, Oellerich W, Oren R, Pamboukian S, Pereira N, Pitt W, Porter C, Prabhu S, Promisloff S, Ratkovec R, Richardson R, Ross A, Saleh N, Saltzberg M, Sarkar S, Schmedtje J, Schneider R, Schuyler G, Shanes J, Sharma A, Siegel C, Siegel R, Silber D, Singh N, Singh J, Singh V, Sklar J, Small R, Smith A, Smith E, Smull D, Sotolongo R, Staniloae C, Stapleton D, Steele P, Stehlik J, Stein M, Tang W, Thadani U, Torre Amoine G, Trichon B, Tsai C, Tummala R, Van Bakel A, Vicari R, Vijay N, Vijayaraghavan K, Vittorio T, Vossler M, Wagoner L, Wallis D, Ward N, Widmer M, Wight J, Wilkins C, Williams C, Williams G, Winchester M, Winkel E, Wittmer B, Wood D, Wormer D, Wright R, Xu Z, Yasin M, Zolty R., PERRONE FILARDI, PASQUALE, Karl, Swedberg, James B., Young, Inder S., Anand, Sunfa, Cheng, Akshay S., Desai, Rafael, Diaz, Aldo P., Maggioni, John J. V., Mcmurray, Christopher, O'Connor, Marc A., Pfeffer, Scott D., Solomon, Yan, Sun, Michal, Tendera, Dirk J., van Veldhuisen, Young, J, Grinfeld, L, Krum, H, Vanhaecke, J, Olivera Clausell, N, Goudev, A, Howlett, J, Corbalan, R, Hradec, J, Kober, L, Eha, J, Cohen Solal, A, Anker, Sd, Chopra, V, Lewis, B, Erglis, A, Sakalyte, G, Cardona Munoz, E, Dunselman, P, Dickstein, K, Ponikowski, P, Seabra Gomes, R, Apetrei, E, Mareev, V, Murin, J, Dalby, A, Lopez Sendon, J, Willenheimer, R, Cleland, J, Adams, K, Anand, I, Butler, J, Dunlap, M, Felker, M, Ghali, J, Levy, W, Carson, P, Cohn, J, Drexler, H, Pocock, S, Ryden, L, Poole Wilson, P, Fishbane, S, Ivanovich, P, Nissenson, A, Katz, S, Barkoudah, E, Campbell, P, Desai, A, Finn, Pv, Hartley, L, Kasabov, R, Odutayo, Ka, Rajesh, V, Solomon, S, Weinrauch, La, Albizem, M, Cheng, S, Chou, W, Deegenaars, M, Dougherty, M, Fouqueray, B, Froissart, M, Froment, A, Gadd, S, Ghosh, S, Grazette, L, Guillet, S, Gulabani, D, Haddock, B, Harris, C, Jaffer, A, Kerns, C, Kim, J, Knussel, B, Law, H, Mather, R, Mix, C, Moore, L, Moyes, R, Polu, K, Rossert, J, Scarlata, D, Smirnakis, K, Smith, L, Snyder, W, Sun, Y, Trotman, Ml, Wasserman, S, Watkins, A, Wong, M, Zhang, Y, Amuchastegui, M, Belziti, C, Bluguermann, J, Caccavo, M, Cartasegna, L, Colque, R, Cuneo, C, Fernandez, A, Gabito, A, Goicochea, R, Gonzalez, M, Gorosito, V, Hominal, M, Kevorkian, R, Litvak Bruno, M, Llanos, J, Mackinnon, I, Manuale, O, Marzetti, E, Nul, D, Perna, E, Riccitelli, M, Sanchez, A, Santos, D, Schygiel, P, Toblli, J, Vogel, D, Aggarwal, A, Amerena, J, De Looze, F, Fletcher, P, Hare, D, Ireland, M, Lattimore, J, Marwick, T, Sindone, A, Thompson, P, Waites, J, Altenberger, J, Ebner, C, Lenz, K, Pacher, R, Poelzl, G, Charlier, F, de Ceuninck, M, De Keulenaer, G, Dendale, P, Maréchal, P, Mullens, W, Thoeng, J, Vanderheyden, M, Weytjens, C, Wollaert, B, Albuquerque, D, Almeida, D, Aspe y., Rosas J, Bocchi, E, Bordignon, S, Clausell, N, Kaiser, S, Leaes, P, Martins Alves, S, Montera, M, Moura, L, Pereira de Castro, R, Rassi, S, Reis, A, Saraiva, J, Simões, M, Souza Neto, J, Teixeira, M, Benov, H, Chompalova, B, Donova, T, Georgiev, P, Gotchev, D, Grigorov, M, Guenova, D, Hergeldjieva, V, Ivanov, D, Kostova, E, Manolova, A, Marchev, S, Nikolov, F, Popov, A, Raev, D, Tzekova, M, Czarnecki, W, Giannetti, N, Haddad, H, Heath, J, Huynh, T, Lepage, S, Liu, P, Lonn, E, Ma, P, Manyari, D, Moe, G, Parker, J, Pesant, Y, Rajda, M, Ricci, J, Roth, S, Sestier, F, Sluzar, V, Sussex, B, Vizel, S, Antezana, G, Bugueno, C, Castro, P, Conejeros, C, Manriquez, L, Martinez, D, Potthoff, S, Stockins, B, Vukasovic, J, Gregor, P, Herold, M, Jerabek, O, Jirmar, R, Kuchar, R, Linhart, A, Podzemska, B, Soucek, M, Spac, J, Spacek, R, Vodnansky, P, Bronnum Schou, J, Clemmensen, K, Egstrup, K, Jensen, G, Kjoller Hansen, L, Markenvard, J, Rokkedal, J, Skagen, K, Torp Pedersen, C, Tuxen, C, Videbak, L, Laks, T, Vahula, V, Harjola, V, Kettunen, R, Kotila, M, Bauer, F, Coisne, D, Davy, J, De Groote, P, Dos Santos, P, Funck, F, Galinier, M, Gibelin, P, Isnard, R, Neuder, Y, Roul, G, Sabatier, R, Trochu, J, Denny, S, Dreykluft, T, Flesch, M, Genth Zotz, S, Hambrecht, R, Hein, J, Jeserich, M, John, M, Kreider Stempfle, H, Laufs, U, Muellerleile, K, Natour, M, Sandri, M, Schäufele, T, von Hodenberg, E, Weyland, K, Winkelmann, B, Tse, H, Yan, B, Barsi, B, Csikasz, J, Dezsi, C, Edes, I, Forster, T, Karpati, P, Kerekes, C, Kis, E, Kosa, I, Lupkovics, G, Nagy, A, Preda, I, Ronaszeki, A, Tomcsanyi, J, Zamolyi, K, Agarwal, D, Bahl, V, Bordoloi, A, Chockalingam, K, Chopda, M, Dugal, J, Ghaisas, N, Grant, P, Hiremath, S, Iyengar, S, Jagadeesa Subramania, B, Jain, P, Joshi, A, Khan, A, Mullasari, A, Naik, S, Oomman, A, Pai, V, Pareppally Gopal, R, Parikh, K, Patel, T, Prakash, V, Sastry, B, Sathe, S, Sinha, N, Srikanthan, V, Subburamakrishnan, P, Thacker, H, Wander, G, Admon, D, Katz, A, Klainman, E, Marmor, A, Moriel, M, Mosseri, M, Shotan, A, Weinstein, J, Zimlichman, R, Agostoni, P, Albanese, M, Alunni, G, Bini, R, Boccanelli, A, Bolognese, L, Campana, C, Carbonieri, E, Carpino, C, Checco, L, Cosmi, F, Angelo, Gd, De Cristofaro, M, Floresta, A, Fucili, A, Galvani, M, Ivleva, A, Marra, S, Musca, G, Peccerillo, N, PERRONE FILARDI, Pasquale, Picchio, E, Russo, T, Scelsi, L, Senni, M, Tavazzi, L, Jasinkevica, I, Kakurina, N, Veze, I, Volans, E, Bagdonas, A, Berukstis, E, Celutkiene, J, Dambrauskaite, A, Jarasuniene, D, Luksiene, D, Rudys, A, Sliaziene, S, Aguilar Romero, R, Cardona Muñoz, E, Castro Jimenez, J, Chavez Herrera, J, Chuquiure Valenzuela, E, De la Pena, G, Herrera, E, Leiva Pons, J, Lopez Alvarado, A, Mendez Machado, G, Ramos Lopez, G, Basart, D, Buijs, E, Cornel, J, de Leeuw, M, Dijkgraaf, R, Freericks, M, Hamraoui, K, Lenderlink, T, Linssen, G, Lodewick, P, Lodewijks, C, Lok, D, Nierop, P, Ronner, E, Somsen, A, van Dantzig, J, van der Burgh, P, van Kempen, L, van Vlies, B, Voors, A, Wardeh, A, Willems, F, Gundersen, T, Hole, T, Thalamus, J, Westheim, A, Dabrowski, M, Gorski, J, Korewicki, J, Kuc, K, Miekus, P, Musial, W, Niegowska, J, Piotrowski, W, Podolec, P, Polonski, L, Rynkiewicz, A, Szelemej, R, Trusz Gluza, M, Ujda, M, Wojciechowski, D, Wysokinski, A, Camacho, A, Fonseca, C, Monteiro, P, Bruckner, I, Carasca, E, Coman, I, Datcu, M, Dragulescu, S, Ionescu, P, Iordachescu Petica, D, Manitiu, I, Popa, V, Pop Moldovan, A, Radoi, M, Stamate, S, Tomescu, M, Vita, I, Aroutiounov, G, Ballyuzek, M, Bart, B, Churina, S, Glezer, M, Goloshchekin, B, Kobalava, Z, Kostenko, V, Lopatin, Y, Martynov, A, Orlov, V, Semernin, E, Shogenov, Z, Sidorenko, B, Skvortsov, A, Storzhakov, G, Sulimov, V, Talibov, O, Tereshenko, S, Tsyrline, V, Zadionchenko, V, Zateyshchikov, D, Dzupina, A, Hranai, M, Kmec, J, Micko, K, Pella, D, Sojka, G, Spisak, V, Vahala, P, Vinanska, D, Badat, A, Bayat, J, Dawood, S, Delport, E, Ellis, G, Garda, R, Klug, E, Mabin, T, Naidoo, D, Pretorius, M, Ranjith, N, Van Zyl, L, Weich, H, Anguita, M, Berrazueta, J, Bruguera i., Cortada J, de Teresa, E, Gómez Sánchez, M, González Juanatey, J, Gonzalez Maqueda, I, Jordana, R, Lupon, J, Manzano, L, Pascual Figal, D, Pulpón, L, Recio, J, Ridocci Soriano, F, Rodríguez Lambert, J, Roig Minguell, E, Romero, J, Valdovinos, P, Klintberg, L, Kronvall, T, Lycksell, M, Morner, S, Rydberg, E, Swedberg, K, Timberg, I, Wikstrom, G, Moccetti, T, Ashok, J, Banerjee, P, Carr White, G, Connolly, E, Francis, M, Greenbaum, R, Kadr, H, Lindsay, S, Mcmurray, J, Megarry, S, Memon, A, Murdoch, D, Senior, R, Squire, I, Tan, L, Witte, K, Adamson, P, Adler, A, Altschul, L, Altschuller, A, Amirani, H, Andreou, C, Ansari, M, Antonishen, M, Banchs, H, Banerjee, S, Banish, D, Bank, A, Barbagelata, A, Barnard, D, Bellinger, R, Benn, A, Berk, M, Berry, B, Bethala, V, Bilazarian, S, Bisognano, J, Bleyer, F, Blum, M, Boehmer, J, Bouchard, A, Boyle, A, Bozkurt, B, Brown, C, Burlew, B, Burnham, K, Call, J, Cambier, P, Cappola, T, Carlson, R, Chandler, B, Chandra, R, Chandraratna, P, Chernick, R, Colan, D, Colfer, H, Colucci, W, Connelly, T, Costantini, O, Dadkhah, S, Dauber, I, Davis, J, Davis, S, Denning, S, Drazner, M, Dunlap, S, Egbujiobi, L, Elkayam, U, Elliott, J, El Shahawy, M, Essandoh, L, Ewald, G, Fang, J, Farhoud, H, Felker, G, Fernandez, J, Festin, R, Fishbein, G, Florea, V, Flores, E, Floro, J, Gabris, M, Garg, M, Gatewood, R, Geller, M, Ghumman, W, Gibbs, G, Gillespie, E, Gilmore, R, Gogia, H, Goldberg, L, Gradus Pizlo, I, Grainger, T, Gudmundsson, G, Gunawardena, D, Gupta, D, Hack, T, Hall, S, Hamroff, G, Hankins, S, Hanna, M, Hargrove, J, Haught, W, Hauptman, P, Hazelrigg, M, Herzog, C, Heywood, J, Hill, T, Hilton, T, Hirsch, H, Hunter, J, Ibrahim, H, Imburgia, M, Iteld, B, Jackson, B, Jaffrani, N, Jain, D, Jain, A, James, M, Jimenez, J, Johnson, E, Kale, P, Kaneshige, A, Kapadia, S, Karia, D, Karlsberg, R, Katholi, R, Kerut, E, Khoury, W, Kipperman, R, Klapholz, M, Kosinski, E, Kozinn, M, Kraus, D, Krueger, S, Kumar, S, Lader, E, Lee, C, Lewis, E, Light McGroary, K, Loh, I, Lombardi, W, Machado, C, Maislos, F, Mancini, D, Markus, T, Mather, P, Mccants, K, Mcgrew, F, Mclaurin, B, Mcmillan, E, Mcnamara, D, Meyer, T, Meymandi, S, Miller, A, Minami, E, Modi, M, Mody, F, Mohanty, P, Moscoso, R, Moskowitz, R, Moustafa, M, Mullen, M, Naz, T, Noonan, T, O., Brien T, Oellerich, W, Oren, R, Pamboukian, S, Pereira, N, Pitt, W, Porter, C, Prabhu, S, Promisloff, S, Ratkovec, R, Richardson, R, Ross, A, Saleh, N, Saltzberg, M, Sarkar, S, Schmedtje, J, Schneider, R, Schuyler, G, Shanes, J, Sharma, A, Siegel, C, Siegel, R, Silber, D, Singh, N, Singh, J, Singh, V, Sklar, J, Small, R, Smith, A, Smith, E, Smull, D, Sotolongo, R, Staniloae, C, Stapleton, D, Steele, P, Stehlik, J, Stein, M, Tang, W, Thadani, U, Torre Amoine, G, Trichon, B, Tsai, C, Tummala, R, Van Bakel, A, Vicari, R, Vijay, N, Vijayaraghavan, K, Vittorio, T, Vossler, M, Wagoner, L, Wallis, D, Ward, N, Widmer, M, Wight, J, Wilkins, C, Williams, C, Williams, G, Winchester, M, Winkel, E, Wittmer, B, Wood, D, Wormer, D, Wright, R, Xu, Z, Yasin, M, Zolty, R., Faculteit Medische Wetenschappen/UMCG, and Cardiovascular Centre (CVC)

Subjects
Male, CHRONIC KIDNEY-DISEASE, Darbepoetin alfa, Ciencias de la Salud, Kaplan-Meier Estimate, law.invention, Hemoglobins, DOUBLE-BLIND, Randomized controlled trial, law, hemic and lymphatic diseases, Treatment Failure, Hazard ratio, Ética Médica, Anemia, General Medicine, Middle Aged, Shock, Septic, Stroke, purl.org/becyt/ford/3 [https], Female, medicine.drug, medicine.medical_specialty, CIENCIAS MÉDICAS Y DE LA SALUD, Placebo, CONTROLLED-TRIAL, purl.org/becyt/ford/3.3 [https], MORBIDITY, Double-Blind Method, Darbepoetin, Internal medicine, Thromboembolism, parasitic diseases, medicine, Humans, Adverse effect, Erythropoietin, Aged, Proportional Hazards Models, CITY CARDIOMYOPATHY QUESTIONNAIRE, business.industry, Proportional hazards model, MORTALITY, equipment and supplies, medicine.disease, Surgery, REDUCTION, EPOETIN, Heart failure, Hematinics, business, Systolic heart failure, Heart Failure, Systolic
Abstract

BACKGROUND: Patients with systolic heart failure and anemia have worse symptoms, functional capacity, and outcomes than those without anemia. We evaluated the effects of darbepoetin alfa on clinical outcomes in patients with systolic heart failure and anemia. METHODS: In this randomized, double-blind trial, we assigned 2278 patients with systolic heart failure and mild-to-moderate anemia (hemoglobin level, 9.0 to 12.0 g per deciliter) to receive either darbepoetin alfa (to achieve a hemoglobin target of 13 g per deciliter) or placebo. The primary outcome was a composite of death from any cause or hospitalization for worsening heart failure. RESULTS: The primary outcome occurred in 576 of 1136 patients (50.7%) in the darbepoetin alfa group and 565 of 1142 patients (49.5%) in the placebo group (hazard ratio in the darbepoetin alfa group, 1.01; 95% confidence interval, 0.90 to 1.13; P=0.87). There was no significant between-group difference in any of the secondary outcomes. The neutral effect of darbepoetin alfa was consistent across all prespecified subgroups. Fatal or nonfatal stroke occurred in 42 patients (3.7%) in the darbepoetin alfa group and 31 patients (2.7%) in the placebo group (P=0.23). Thromboembolic adverse events were reported in 153 patients (13.5%) in the darbepoetin alfa group and 114 patients (10.0%) in the placebo group (P=0.01). Cancer-related adverse events were similar in the two study groups. CONCLUSIONS: Treatment with darbepoetin alfa did not improve clinical outcomes in patients with systolic heart failure and mild-to-moderate anemia. Our findings do not support the use of darbepoetin alfa in these patients. (Funded by Amgen; RED-HF ClinicalTrials.gov number, NCT00358215.). Fil: Swedberg, Karl. University of Gothenburg; Suecia Fil: Young, James B.. Cleveland Clinic; Estados Unidos Fil: Anand, Inder S.. University of Minnesota; Estados Unidos Fil: Cheng, Sunfa. Amgen; Estados Unidos Fil: Desai, Akshay S.. Brigham and Women’s Hospital; Estados Unidos Fil: Diaz, Rafael. Estudios Clínicos Latinoamérica; Argentina Fil: Maggioni, Aldo P.. Italian Association of Hospital Cardiologists Research Center; Italia Fil: McMurray, John J.V.. University of Glasgow; Reino Unido Fil: O’Connor, Christopher. University of Duke; Estados Unidos Fil: Pfeffer, Marc A.. Brigham and Women’s Hospital; Estados Unidos Fil: Solomon, Scott D.. Brigham and Women’s Hospital; Estados Unidos Fil: Sun, Yan. Amgen; Estados Unidos Fil: Tendera, Michal. Medical University of Silesia; Polonia Fil: van Veldhuisen, Dirk J.. University of Groningen; Países Bajos Fil: Toblli, Jorge Eduardo. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina

Published
2013
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32. EURObservational Research Programme:regional differences and 1-year follow-up results of the Heart Failure Pilot Survey (ESC-HF Pilot)

Author

Maggioni, A. P., Dahlstrom, U., Filippatos, G., Chioncel, O., Leiro, M. C., Drozdz, J., Fruhwald, F., Gullestad, L., Logeart, D., Fabbri, G., Urso, R., Metra, M., Parissis, J., Persson, H., Ponikowski, P., Rauchhaus, M., Voors, A. A., Nielsen, O. W., Zannad, F., Tavazzi, L., Alonso, A., Ferrari, R., Komajda, M., Wood, D., Manini, M., Taylor, C., Laroche, C., Fiorucci, E., Lucci, D., Gonzini, L., Auer, J., Oberrauner, A., Schumacher, M., Ebner, C., Hallas, A., Espersen, G., Gustafsson, F., Mattsson, N., Egstrup, K., Aagaard, S., Gohr, T., Huld, K., Knudsen, A., Refsgaard, J., Charniot, J., Juillard, A., Pon-Gabrielsen, P., Douna, F., Jondeau, G., Jourdain, P., Michel, L., Hamm, C., Lehinant, S., Rieth, A., Goeing, O., Schultheiss, H. P., Von-Schlippenbach, J., Knollmann, R., Neubuser, C., Katus, H. A., Taeger, T., Zugck, C., Fink, H., Schulz, J., Held, S., Karmann, W., Kreuzer, J., Nitsche, K., Winter, K., Fahnrich, A., Bruederlein, K., Turan, C. H., Berentelg, J., Ittel, T., Rubens, C., Hanke, M., Stoerk, S., Chrysohoou, C., Kaldara, E., Karavidas, A., Margari, R., Matzaraki, V., Nanas, J., Pozios, I., Psarogiannakopoulos, P., Pyrgakis, V., Stefanadis, C., Terrovitis, J., Trikas, A., Xydonas, S., Patrianakos, A., Vardas, P., Douras, A., Nastas, J., Ntertsas, K., Tsaknakis, T., Midi, P., Pajes, G., Moretti, L., Partemi, M., Barberini, F., Branzi, A., Gallelli, I., Grigioni, F., Ionico, T., Pasquale, F., Cas, L., Delmagro, F., Tanghetti, E., Vaccari, A., Mercuro, G., Arcuri, G. M., Marinacci, L., Severini, D., Cosmi, F., Bosi, S., Di Tano, G., Pirelli, S., Fucili, A., Minneci, C., Santoro, G. M., Correale, M., Di Biase, M., Buccolieri, M., Mandorla, S., Martinelli, S., Barbiero, M., Giordano, A., Zanelli, E., Agostoni, P., Fiorentini, C., Salvioni, E., Leuzzi, C., Modena, M. G., Reggianini, L., Cobelli, F., Opasich, C., Baldini, P., Romei, M., Pulitano, G., Ruggeri, A., Bologna, F., Piovaccari, G., Brasolin, B., Fedele, F., Merlo, M., Sinagra, G., Albanese, M. C., Miani, D., Linssen, G., Rodijk, E., Pinto, Y., Van Donk, P., Dunselman, P., Lok, D., Brouwers, F., De Jong, R. M., Boen, R., Hole, T., Rasmussen, L., Christiansen, E. M., Gjertsen, E., Lyng, J., German, M., Hogalmen, G., Skardal, R., Apelland, T., Borgen, M., Forfang, E., Baak, T., Dickstein, K., Olsen, I., Stachurski, D., Juszczyk, Z., Stankala, S., Gilewski, W., Sinkiewicz, W., Kasztelowicz, P., Gabryel, J., Kardaszewicz, P., Lazorko-Piega, M., Bellwon, J., Mosakowska, K., Rynkiewicz, A., Olczyk, S., Pagorek, M., Bartlinski, R., Borej, G., Tarchalski, J., Bartkowiak, R., Sosnowska-Pasiarska, B., Wozakowska-Kaplon, B., Krzeminski, A., Bury, K., Grzegorzko, A., Mirek-Bryniarska, E., Nessler, J., Zabojszcz, M., Broncel, M., Poliwczak, A., Retwinski, A., Soska, K., Grajek, S., Straburzynska-Migaj, E., Kuzniar, J., Rzeszuto, T., Bednarczyk, G., Ruszkowski, P., Piasecka-Krysiak, E., Zambrzycki, J., Nowak, T., Szelemej, R., Balsam, P., Folga, A., Kaplon-Cieslicka, A., Kowalewski, S., Mamcarz, A., Marchel, M., Opolski, G., Welnicki, M., Jankowska, E., Nowak, J., Nowalany-Kozielska, E., Rozentryt, P., Zembala, M., Kleinrok, A., Prokop-Lewicka, G., Kudlinska, B., Radoi, M., Macarie, C., Vinereanu, D., Capalneanu, R., Giuca, A., Ionescu, D. D., Nechita, E., Datcu, M., Istrate, C., Vladoianu, M., Christodorescu, R., Salguero, R., Blanco, V. M., Lavilla, M. A., Comin-Colet, J., Cantillo, D., Bernal, J., del Prado, J. M., Pita, A., Aguero, J., Jimenez, J. F., Calvo, F., Gonzalez, R., Molina, B., Luengos, D., Lostal, C., Bonet, L., Gonzalez, P., Soriano, F., Campos, M. J., Karlstrom, P., Nyrinder, I., Olsson, B., Pettersson, T., Stenberg, A., Lindmark, K., Asserlund, B., Faculteit Medische Wetenschappen/UMCG, Cardiovascular Centre (CVC), ACS - Amsterdam Cardiovascular Sciences, Cardiology, Maggioni, Aldo P, Dahlström, Ulf, Filippatos, Gerasimo, Chioncel, Ovidiu, Leiro, Marisa Crespo, Drozdz, Jaroslaw, Fruhwald, Friedrich, Gullestad, Lar, Logeart, Damien, Fabbri, Gianna, Urso, Renato, Metra, Marco, Parissis, John, Persson, Han, Ponikowski, Piotr, Rauchhaus, Mathia, Voors, Adriaan A., Nielsen, Olav Wendelboe, Zannad, Faiez, Tavazzi, Luigi, on behalf of the Heart Failure Association of the European Society of Cardiology (HFA): [.., F. Barberini, A. Branzi, I. Gallelli, F. Grigioni, T. Ionico, F. Pasquale, and ]

Subjects
Registrie, Male, Time Factors, Peripartum cardiomyopathy, Pilot Projects, Cardiovascular Agents/therapeutic use, Acute heart failure, Chronic heart failure, Observational studies, Pharmacological treatments, Prognosis, Aged, Cardiovascular Agents, Europe, Female, Follow-Up Studies, Heart Failure, Hospital Mortality, Hospitalization, Humans, Middle Aged, Prospective Studies, Inpatients, Registries, GUIDELINES, CLINICAL CHARACTERISTICS, Medicine, Prospective cohort study, POPULATION, Hospital Mortality/trends, education.field_of_study, OUTCOMES, Ejection fraction, Mortality rate, HOSPITALIZATION, Inpatient, Cardiology and Cardiovascular Medicine, Pharmacological treatment, Human, medicine.medical_specialty, acute heart failure, chronic heart failure, observational studies, pharmacological treatments, prognosis, aged, cardiovascular agents, female, follow-up studies, heart failure, hospital mortality, hospitalization, humans, male, middle aged, pilot projects, prospective studies, time factors, inpatients, registries, cardiology and cardiovascular medicine, EUROPE, Time Factor, Prognosi, Population, DIAGNOSIS, Follow-Up Studie, Europe/epidemiology, ONE-YEAR MORTALITY, Pilot Project, education, Hospitalization/statistics & numerical data, business.industry, medicine.disease, Heart Failure/drug therapy, Observational studie, Prospective Studie, Cardiovascular Agent, Heart failure, REGISTRY, Cardiovascular agent, Emergency medicine, Physical therapy, Observational study, QUALITY-OF-CARE, business
Abstract

AIMS: The ESC-HF Pilot survey was aimed to describe clinical epidemiology and 1-year outcomes of outpatients and inpatients with heart failure (HF). The pilot phase was also specifically aimed at validating structure, performance, and quality of the data set for continuing the survey into a permanent Registry.METHODS: The ESC-HF Pilot study is a prospective, multicentre, observational survey conducted in 136 Cardiology Centres in 12 European countries selected to represent the different health systems across Europe. All outpatients with HF and patients admitted for acute HF on 1 day per week for eight consecutive months were included. From October 2009 to May 2010, 5118 patients were included: 1892 (37%) admitted for acute HF and 3226 (63%) patients with chronic HF. The all-cause mortality rate at 1 year was 17.4% in acute HF and 7.2% in chronic stable HF. One-year hospitalization rates were 43.9% and 31.9%, respectively, in hospitalized acute and chronic HF patients. Major regional differences in 1-year mortality were observed that could be explained by differences in characteristics and treatment of the patients.CONCLUSION: The ESC-HF Pilot survey confirmed that acute HF is still associated with a very poor medium-term prognosis, while the widespread adoption of evidence-based treatments in patients with chronic HF seems to have improved their outcome profile. Differences across countries may be due to different local medical practice as well to differences in healthcare systems. This pilot study also offered the opportunity to refine the organizational structure for a long-term extended European network.

Published
2013
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33. Abstracts of papers clinical pharmacological meeting

Author

van Harten, J., Burggraaf, J., Danhof, M., van Brummelen, P., Breimer, D. D., Lenders, J. W. M., Morre, H., Thien, Th., de Leeuw, P. W., van ES, P. N., de Bos, R., Birkenhäger, W. H., Cohen, A. F., Posner, J., Harkin, N., van Meijel, J. J. M., Gerlag, P. G. G., Gribnau, F. W. J., Blauw, G. J., van Bnnmelen, P., Vermelj, P., van Zwieten, P. A., van der Voet, G. B., Tebeest, L. G., Stewart, F. A., Bartelink, H., de Wolff, F. A., de Vos, D., Salemans, J., Hoitsma, A. J., de Abreu, R. A., Koene, R. A. P., van den Ouweland, F., van Vliet-Daskalopoulou, E., Wijnand, H. P., van de Putte, L. B. A., Eijsbouts, A., Smits, P., Festen, J., Houben, J. G. G., Folgering, H., Meulenberg, P. M. M., Koopmans, P. P., van Megen, Th., Dunselman, P. H. J. M., Scaf, A. H. J., Kuntze, C. E. E., Lie, K. I., Wesselinq, H., Holtslag, J. C. W. M., Moshage, H. J., van Pelt, J. F., Kleuskens, J. A. G. M., and Yap, S. H.

Published
1987
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34. Clinical pharmacological meeting

Author

Lubsen, J., Tijssen, J. G. P., Sluiter, H. E., Huysmans, F. Th. H., Thien, Th. A., Koene, R. A. P., Vincent, H. H., Derkx, F. H. M., Veld, A. J. Man in 't, Boomsma, F., Schalekamp, H. A. D. H., Hoefnagels, W. H. L., Lenders, J. W. M., Thien, Th., Smits, P., van 't Laar, A., v. Wijk, L. M., Kingma, J. H., Dunselman, P. H. J. M., v. Gilst, W. H., Lie, K. I., Wesseling, H., Lohman, J. J. H. M., Hooymans, P. M., Koten, M. L. P., Verhey, M. T. J. M., Merkus, F. W. H. M., Koopmans, P., Gribnau, F., Demacker, P., Jonkman, J. H. G., Van der Boon, W. J. V., Schoenmaker, R., Holtkamp, A., Hempenius, J., Edelbroek, P. M., Linssen, A. C. G., Zitman, F. G., Rooymans, H. G. M., de Wolff, F. A., Speth, P. A. J., Linssen, P. L. M., Wessels, J. H. C., Haanen, C., Elferink, F., van der Vijgh, W. J. F., van der Poort, S. E. J. M., Vermorken, J. B., Pinedo, H. M., Sonneveld, P., Nooter, K., van den Engh, G. J., Schurgers, N., de Blaey, C. J., and Crommelin, D. J. A.

Published
1984
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37. EURObservational Research Programme: Regional differences and 1-year follow-up results of the Heart Failure Pilot Survey (ESC-HF Pilot)

Author

Maggioni, A.P. Dahlström, U. Filippatos, G. Chioncel, O. Leiro, M.C. Drozdz, J. Fruhwald, F. Gullestad, L. Logeart, D. Fabbri, G. Urso, R. Metra, M. Parissis, J. Persson, H. Ponikowski, P. Rauchhaus, M. Voors, A.A. Nielsen, O.W. Zannad, F. Tavazzi, L. Alonso, A. Ferrari, R. Komajda, M. Wood, D. Manini, M. Taylor, C. Laroche, C. Fiorucci, E. Lucci, D. Gonzini, L. Auer, J. Oberrauner, A. Schumacher, M. Ebner, C. Hallas, A. Espersen, G. Gustafsson, F. Mattsson, N. Egstrup, K. Aagaard, S. Gohr, T. Huld, K. Knudsen, A. Refsgaard, J. Charniot, J. Juillard, A. Pon-Gabrielsen, P. Douna, F. Jondeau, G. Jourdain, P. Michel, L. Hamm, C. Lehinant, S. Rieth, A. Goeing, O. Schultheiss, H.P. Von-Schlippenbach, J. Knollmann, R. Neubüser, C. Katus, H.A. Taeger, T. Zugck, C. Fink, H. Schulz, J. Held, S. Karmann, W. Kreuzer, J. Nitsche, K. Winter, K. Fahnrich, A. Bruederlein, K. Turan, C.H. Berentelg, J. Ittel, T. Rubens, C. Hanke, M. Stoerk, S. Chrysohoou, C. Kaldara, E. Karavidas, A. Margari, R. Matzaraki, V. Nanas, J. Pozios, I. Psarogiannakopoulos, P. Pyrgakis, V. Stefanadis, C. Terrovitis, J. Trikas, A. Xydonas, S. Patrianakos, A. Vardas, P. Douras, A. Nastas, J. Ntertsas, K. Tsaknakis, T. Midi, P. Pajes, G. Moretti, L. Partemi, M. Barberini, F. Branzi, A. Gallelli, I. Grigioni, F. Ionico, T. Pasquale, F. Cas, L. Delmagro, F. Tanghetti, E. Vaccari, A. Mercuro, G. Arcuri, G.M. Marinacci, L. Severini, D. Cosmi, F. Bosi, S. Di Tano, G. Pirelli, S. Ferrari, R. Fucili, A. Minneci, C. Santoro, G.M. Correale, M. Di Biase, M. Buccolieri, M. Mandorla, S. Martinelli, S. Barbiero, M. Giordano, A. Zanelli, E. Agostoni, P. Fiorentini, C. Salvioni, E. Leuzzi, C. Modena, M.G. Reggianini, L. Cobelli, F. Opasich, C. Baldini, P. Romei, M. Pulitano, G. Ruggeri, A. Bologna, F. Piovaccari, G. Brasolin, B. Fedele, F. Merlo, M. Sinagra, G. Albanese, M.C. Miani, D. Linssen, G. Rodijk, E. Pinto, Y. Van Donk, P. Dunselman, P. Lok, D. Brouwers, F. De Jong, R.M. Boen, R. Hole, T. Rasmussen, L. Christiansen, E.M. Gjertsen, E. Lyng, J. German, M. Hogalmen, G. Skardal, R. Apelland, T. Borgen, M. Forfang, E. Baak, T. Dickstein, K. Olsen, I. Stachurski, D. Juszczyk, Z. Stankala, S. Gilewski, W. Sinkiewicz, W. Kasztelowicz, P. Gabryel, J. Kardaszewicz, P. Lazorko-Piega, M. Bellwon, J. Mosakowska, K. Rynkiewicz, A. Olczyk, S. Pagorek, M. Bartlinski, R. Borej, G. Tarchalski, J. Bartkowiak, R. Sosnowska-Pasiarska, B. Wozakowska-Kaplon, B. Krzeminski, A. Bury, K. Grzegorzko, A. Mirek-Bryniarska, E. Nessler, J. Zabojszcz, M. Broncel, M. Poliwczak, A. Retwinski, A. Soska, K. Grajek, S. Straburzynska-Migaj, E. Kuzniar, J. Rzeszuto, T. Bednarczyk, G. Ruszkowski, P. Piasecka-Krysiak, E. Zambrzycki, J. Nowak, T. Szelemej, R. Balsam, P. Folga, A. Kaplon-Cieslicka, A. Kowalewski, S. Mamcarz, A. Marchel, M. Opolski, G. Welnicki, M. Jankowska, E. Nowak, J. Nowalany-Kozielska, E. Rozentryt, P. Zembala, M. Kleinrok, A. Prokop-Lewicka, G. Kudlinska, B. Radoi, M. Macarie, C. Vinereanu, D. Capalneanu, R. Giuca, A. Ionescu, D.D. Nechita, E. Datcu, M. Istrate, C. Vladoianu, M. Christodorescu, R. Salguero, R. Blanco, V.M. Lavilla, M.A. Comin-Colet, J. Cantillo, D. Bernal, J. del Prado, J.M. Pita, A. Aguero, J. Jimenez, J.F. Calvo, F. Gonzalez, R. Molina, B. Luengos, D. Lostal, C. Bonet, L. Gonzalez, P. Soriano, F. Campos, M.J. Karlstrom, P. Nyrinder, I. Olsson, B. Pettersson, T. Stenberg, A. Lindmark, K. Asserlund, B. Heart Failure Association of the European Society of Cardiology (HFA)

Abstract

AimsThe ESC-HF Pilot survey was aimed to describe clinical epidemiology and 1-year outcomes of outpatients and inpatients with heart failure (HF). The pilot phase was also specifically aimed at validating structure, performance, and quality of the data set for continuing the survey into a permanent Registry.MethodsThe ESC-HF Pilot study is a prospective, multicentre, observational survey conducted in 136 Cardiology Centres in 12 European countries selected to represent the different health systems across Europe. All outpatients with HF and patients admitted for acute HF on 1 day per week for eight consecutive months were included. From October 2009 to May 2010, 5118 patients were included: 1892 (37%) admitted for acute HF and 3226 (63%) patients with chronic HF. The all-cause mortality rate at 1 year was 17.4% in acute HF and 7.2% in chronic stable HF. One-year hospitalization rates were 43.9% and 31.9%, respectively, in hospitalized acute and chronic HF patients. Major regional differences in 1-year mortality were observed that could be explained by differences in characteristics and treatment of the patients.ConclusionThe ESC-HF Pilot survey confirmed that acute HF is still associated with a very poor medium-term prognosis, while the widespread adoption of evidence-based treatments in patients with chronic HF seems to have improved their outcome profile. Differences across countries may be due to different local medical practice as well to differences in healthcare systems. This pilot study also offered the opportunity to refine the organizational structure for a long-term extended European network. © 2013 The Author.

Published
2013

39. Intermittent claudication as a predictor of outcome in patients with ischaemic systolic heart failure: Analysis of the controlled rosuvastatin multinational trial in heart failure trial (CORONA)

Author

Inglis, SC, McMurray, JJV, Böhm, M, Schaufelberger, M, Van Veldhuisen, DJ, Lindberg, M, Dunselman, P, Hjalmarson, A, Kjekshus, J, Waagstein, F, Wedel, H, Wikstrand, J, Inglis, SC, McMurray, JJV, Böhm, M, Schaufelberger, M, Van Veldhuisen, DJ, Lindberg, M, Dunselman, P, Hjalmarson, A, Kjekshus, J, Waagstein, F, Wedel, H, and Wikstrand, J

Abstract

To examine the relationship between baseline intermittent claudication and outcomes in patients enrolled in the Controlled Rosuvastatin Multinational Trial in Heart Failure trial (CORONA). Intermittent claudication is an independent predictor of worse outcome in coronary heart disease, but its prognostic importance in heart failure (HF) is unknown. Patients aged ≥60 years with NYHA class II-IV, low ejection fraction HF of ischaemic aetiology were enrolled in CORONA. Rosuvastatin did not reduce the primary outcome or all-cause mortality. Methods and results: To determine whether intermittent claudication was an independent predictor of clinical outcomes, a three-step multivariable model was built: (i) demographic/clinical variables, (ii) biochemical measures added, (iii) high-sensitivity C-reactive protein and N-terminal pro B-type natriuretic-peptide added. Of the 5011 patients, 637 (12.7) had intermittent claudication at baseline. Patients with intermittent claudication were more likely to be male (83 vs. 75), be a current smoker (19 vs. 9), and have diabetes mellitus (36 vs. 29) relative to those without intermittent claudication. Over a median 33-month follow-up, 2168 patients died or were hospitalized for HF. Patients with intermittent claudication had an increased risk of death (any cause) (adjusted hazard ratio 1.36, 95 CI 1.19-1.56, P < 0.0001), death from worsening HF (1.35, 1.03-1.77, P = 0.028), sudden death (1.24, 1.00-1.54, P = 0.05), and risk of non-fatal or fatal myocardial infarction (time to first event 1.67, 1.24-2.27, P < 0.001). In the full multivariable model, intermittent claudication remained an independent predictor of most outcomes evaluated. Conclusion: Intermittent claudication is a relatively common symptom in ischaemic HF and an independent predictor of worse outcome.Clinical Trial Registration Information: NCT00206310-http://clinicaltrials.gov/ct2/show/ NCT00206310?term=corona&rank=2. © 2010 The Author.

Published
2010

40. [Value of basic and intensive management of patients with heart failure; results of a randomised controlled clinical trial]

Author

Jaarsma, T, van der Wal, M H L, Lesman-Leegte, I, Luttik, M L, Hogenhuis, J, Veeger, N J, Sanderman, R, Hoes, A W, van Gilst, W H, Lok, D J A, Dunselman, P H J M, Tijssen, J G P, Hillege, H L, van Veldhuisen, D J, Jaarsma, T, van der Wal, M H L, Lesman-Leegte, I, Luttik, M L, Hogenhuis, J, Veeger, N J, Sanderman, R, Hoes, A W, van Gilst, W H, Lok, D J A, Dunselman, P H J M, Tijssen, J G P, Hillege, H L, and van Veldhuisen, D J

Abstract

OBJECTIVE: To determine the efficacy of 2 nurse-directed programmes of different intensity for the counselling and follow-up of patients hospitalised for heart failure, compared with standard care by a cardiologist. DESIGN: Multicentre randomised clinical trial (www.trialregister.nl: NCT 98675639). METHOD: A total of 1023 patients were randomized after hospitalisation for heart failure to 1 of 3 treatment strategies: standard care provided by a cardiologist, follow-up care from a cardiologist with basic counselling and support by a nurse specialising in heart failure, or follow-up care from a cardiologist with intensive counselling and support by a nurse specialising in heart failure. Primary end points were the time to rehospitalisation due to heart failure or death and the number of days lost to rehospitalisation or death during the 18-month study period. Data were analysed on an intent-to-treat basis. RESULTS: Mean patient age was 71 years, 38% were women, 50% had mild heart failure and 50% had severe heart failure. During the study, 411 patients (40%) were rehospitalised due to heart failure or died from any cause: 42% in the control group, and 41% and 38% in the basic and intensive support groups, respectively (differences not significant). The time to rehospitalisation or death was similar in the 3 groups: hazard ratios for the basic and intensive support groups versus the control group were 0.96 (95% CI: 0.76-1.21; p = 0.73) and 0.93 (95% CI: 0.73-1.17; p = 0.53), respectively. The number of days lost to rehospitalisation or death was 39,960 in the control group; this number was 15% less in the intervention groups, but the difference was not significant. However, there was a trend toward lower mortality in the intervention groups. In all 3 groups, more visits occurred than planned, which may have had a considerable effect on care, notably in the control group. CONCLUSION: The results of this study indicated that the provision of additional counselling and sup

Published
2008

42. Aprotinin in aortocoronary bypass surgery: increased risk of vein-graft occlusion and myocardial infarction? Supportive evidence from a retrospective study

Author

van der Meer, J., Hillege, H. L., Ascoop, C. A., Dunselman, P. H., Mulder, B. J., van Ommen, G. V., Pfisterer, M., van Gilst, W. H., Lie, K. I., and Other departments

Subjects
hormones, hormone substitutes, and hormone antagonists
Abstract

To assess the thrombotic risk of aprotinin in aortocoronary bypass surgery, we retrospectively analyzed the results of a trial, originally designed to compare the effects of one-year treatment with various antithrombotic drugs in the prevention of vein-graft occlusion. Graft patency at one year was assessed by angiography. Myocardial infarction, thromboembolism, major bleeding, and death were clinical endpoints. Of 948 randomized patients, 42 received aprotinin, all enrolled by one of the participating centres. Occlusion rates of distal anastomoses were 20.5% in the aprotinin group and 12.7% in the non-aprotinin group (p = 0.091). The proportions of patients with occluded grafts were 44.1% versus 26.3% (p = 0.029). Perioperative myocardial infarction occurred in 14.3% and 7.0%, respectively (p = 0.12). Mean postoperative blood loss was 451 ml in the aprotinin group compared with 1039 ml in the non-aprotinin group (p

Published
1996

43. Early invasive versus selectively invasive management for acute coronary syndromes.

Author

Winter, R.J. de, Windhausen, F., Cornel, J.H., Dunselman, P., Janus, C.L., Bendermacher, P.E., Michels, H.R., Sanders, G.T.B., Tijssen, J.G.P., Verheugt, F.W.A., Winter, R.J. de, Windhausen, F., Cornel, J.H., Dunselman, P., Janus, C.L., Bendermacher, P.E., Michels, H.R., Sanders, G.T.B., Tijssen, J.G.P., and Verheugt, F.W.A.

Abstract

Contains fulltext : 48732.pdf (publisher's version ) (Open Access), BACKGROUND: Current guidelines recommend an early invasive strategy for patients who have acute coronary syndromes without ST-segment elevation and with an elevated cardiac troponin T level. However, randomized trials have not shown an overall reduction in mortality, and the reduction in the rate of myocardial infarction in previous trials has varied depending on the definition of myocardial infarction. METHODS: We randomly assigned 1200 patients with acute coronary syndrome without ST-segment elevation who had chest pain, an elevated cardiac troponin T level (> or =0.03 mug per liter), and either electrocardiographic evidence of ischemia at admission or a documented history of coronary disease to an early invasive strategy or to a more conservative (selectively invasive) strategy. Patients received aspirin daily, enoxaparin for 48 hours, and abciximab at the time of percutaneous coronary intervention. The use of clopidogrel and intensive lipid-lowering therapy was recommended. The primary end point was a composite of death, nonfatal myocardial infarction, or rehospitalization for anginal symptoms within one year after randomization. RESULTS: The estimated cumulative rate of the primary end point was 22.7 percent in the group assigned to early invasive management and 21.2 percent in the group assigned to selectively invasive management (relative risk, 1.07; 95 percent confidence interval, 0.87 to 1.33; P=0.33). The mortality rate was the same in the two groups (2.5 percent). Myocardial infarction was significantly more frequent in the group assigned to early invasive management (15.0 percent vs. 10.0 percent, P=0.005), but rehospitalization was less frequent in that group (7.4 percent vs. 10.9 percent, P=0.04). CONCLUSIONS: We could not demonstrate that, given optimized medical therapy, an early invasive strategy was superior to a selectively invasive strategy in patients with acute coronary syndromes without ST-segment elevation and with an elevated cardiac troponi

Published
2005

44. Long-Term Effect of Endothelin Receptor Antagonism With Bosentan on the Morbidity and Mortality of Patients With Severe Chronic Heart Failure

Author

Packer, Milton, McMurray, John J.V., Krum, Henry, Kiowski, Wolfgang, Massie, Barry M., Caspi, Avi, Pratt, Craig M., Petrie, Mark C., DeMets, David, Kobrin, Isaac, Roux, Sebastien, Swedberg, Karl, Packer, Milton, Caspi, Avi, Kiowski, Wolfgang, Krum, Henry, Pratt, Craig, Swedberg, Karl, Massie, Barry, McMurray, John, McMurray, John, Connally, Eugene, Petrie, Mark, DeMets, David, Anderson, Susan, Barnet, Jody, Cody, Robert, Dargie, Henry, Francis, Gary, Greenberg, Barry, Reichen, Juerg, Karrasch, J., Krum, H., Horowitz, J., Amerena, J., Sindone, A., MacDonald, P., Jeffrey, I., Button, I., DeAngelis, E., Pacher, R., Davies, R., McAlister, F., Tanser, P., Sussex, B., Baumann, G., Fleck, E., Olbrich, H.-G., Werdan, K., Klein, H., Staffeld, F., Zeiher, A.M., Roediger, C., Caspi, A., Marmor, A., Reisin, L., Vered, Z., Klainman, E., Roguin, N., Tzivoni, D., David, D., Lewis, B., Abinader, E., Omary, M., Rosenman, Y., Kaluski, E., Breedveld, R.W., van der Burgh, P.H., Dunselman, P.H.J.M., Schaafsma, H.J., Hertzberger, D.P., Holwerda, N.J., Kragten, J.A., van Wijngaarden, J., Posma, J.L., Said, S.A.M., Slegers, L.C., Tjon Joe Gin, R.M., Wempe, F.N., Wesdorp, J.C.L., Willems, A.R., Withagen, A.J.A.M., Cornel, J.M., van Kempen, L.H.J., Kiowski, W., Bertel, O., Moccetti, T., McMurray, J.J.V., Greenbaum, R.A., Bennett, P., Swan, J., Davies, G., Findlay, I., Gould, B., Ball, S., Hubner, P., Lahiri, A., McLay, J., Northcote, R., Saltissi, S., Squire, I., Stephens, J., Stewart, M., Bridgen, G., Walsh, J., Webb, D.J., Ansari, Z., Baron, S., Bellinger, R., Bennet, W., Benvenuti, D., Dawley, D., Egbujiobi, L.C., Eisenstein, I., Little, T., Hertsberg, A., Greenspan, M., Grossman, R.J., Hanley, P., Jesrani, M., Kashou, H., Levites, R., Malik, R., Marmorstein, B., Schwartz, M., Nisar, A., Perelman, R., Schwarz, M.L., Sedlis, S., Srebro, J., Taveras, M., Weiss, R., Weitzman, P., Wetherley, G.K., El Shahawy, M., Kereiakes, D., Campos, L., Peterson, G., Small, R.S., Davis, W.R., Olivari, M.-T., Meengs, W., Koren, M., Slagona, P., Jennison, S., Hershberger, R., Browne, K.F., Farnham, D.J., Zelenkofske, S., Lawless, C., Nathan, M., Meyer, T., Kukin, M., Parekh, H., Berkowitz, R., Boehmer, J., Brozena, S., Dandona, P., Dec, G.W., DeQuattro, V., Fenster, P., Fowler, M., Ellaham, S., Geller, M., Gheorgiade, M., Ghali, J., Murali, S., Katz, S., Bott-Silverman, C., Singh, B., Thadani, U., Torre, G., Teerlink, J., Chandraratna, T., Kesselbrenner, M., Mukherjee, A., Che-Pin Tsai, C., Abbo, K., Goldberg, M., Smith, T., and Martin, R.T.

Abstract

The objective of this clinical trial was to evaluate the long-term effect of endothelin receptor antagonism with bosentan on the morbidity and mortality of patients with severe chronic heart failure.

Published
2017
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46. Oral anticoagulation in the prevention of one-year vein graft occlusion after aortocoronary bypass-surgery - optimal therapeutic range and practical limitations

Author

van der Meer, J., Hillege, H. L., Dunselman, P. H. J. M., Mulder, B. J. M., Michels, H. R., Buser, P. T., van Gilst, W. H., Lie, K. I., and University of Groningen

Subjects
CORONARY-ARTERY BYPASS, OPERATIONS, ANTIPLATELET THERAPY, ANTI-COAGULANT THERAPY, PATENCY, LOW-DOSE ASPIRIN, PLUS DIPYRIDAMOLE, TRIAL, PLATELET
Abstract

To assess the optimal level of oral anticoagulation to prevent occlusion of vein coronary bypass grafts, 318 patients from a graft patency trial were analysed retrospectively. Oral anticoagulant therapy was started one day before surgery and continued for one year, after which graft occlusion was assessed by angiography. The aimed level of anticoagulation was 2.8-4.8 International Normalized Ratio (INR). Clinical outcome was assessed by the incidence of myocardial infarction, thrombosis and major bleeding. The observed anticoagulation level was 2.8-4.8 INR for 54%, and 1.8-3.8 INR for 75% of time per patient. Occlusion rates in patients who spent To maintain vein graft patency in the first postoperative year by oral anticoagulation, a level within INR range 1.8-3.8 for greater than or equal to 70% of time seems to be sufficient.

Published
1994

47. Effects of low dose aspirin (50 mg/day), low dose aspirin plus dipyridamole, and oral anticoagulant agents after internal mammary artery bypass grafting: patency and clinical outcome at 1 year. CABADAS Research Group of the Interuniversity Cardiology Institute of The Netherlands. Prevention of Coronary Artery Bypass Graft Occlusion by Aspirin, Dipyridamole and Acenocoumarol/Phenprocoumon Study

Author

van der Meer, J., Brutel de la Rivière, A., van Gilst, W. H., Hillege, H. L., Pfisterer, M., Kootstra, G. J., Dunselman, P. H., Mulder, B. J., Lie, K. I., and Other departments

Abstract

This study was performed to compare the efficacy and safety of aspirin, aspirin plus dipyridamole, and oral anticoagulant agents in the prevention of internal mammary artery graft occlusion. Antithrombotic drugs increase vein graft patency after coronary artery bypass surgery. Their benefit after internal mammary artery grafting has not been established. Angiographic internal mammary artery graft patency at 1 year was assessed in 494 patients who received both internal mammary artery and vein grafts. These patients were a subgroup of a prospective, randomized vein graft patency study in 948 patients assigned to treatment with aspirin, aspirin plus dipyridamole, or oral anticoagulant agents. The design was double-blind for both aspirin groups and open for oral anticoagulant treatment. Dipyridamole (5 mg/kg body weight per 24 h intravenously, followed by 200 mg twice daily) and oral anticoagulant agents (prothrombin time target range 2.8 to 4.8 international normalized ratio) were started before operation, and low dose aspirin (50 mg/day) after operation. Clinical outcome was assessed by the incidence of myocardial infarction, thrombosis, major bleeding or death. Occlusion rates of distal anastomoses were 4.6% in the aspirin plus dipyridamole group and 6.8% in the oral anticoagulant group versus 5.3% in the aspirin group (p = NS). Overall clinical event rates were 23.3% and 13.3% in the aspirin plus dipyridamole group and the aspirin group, respectively (relative risk 1.75, 95% confidence interval 1.09 to 2.81, p = 0.025), and 17.1% in the oral anticoagulant group. Internal mammary artery graft patency at 1 year is not improved by aspirin plus dipyridamole or oral anticoagulant agents over that obtained with low dose aspirin alone. However, there is evidence that the overall clinical event rate increases if dipyridamole is added to aspirin

Published
1994

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