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1. Takotsubo Syndrome: An International Expert Consensus Report on Practical Challenges and Specific Conditions (Part-1: Diagnostic and Therapeutic Challenges)

Author: Kenan Yalta, John E Madias, Nicholas G Kounis, Shams Y-Hassan, Marija Polovina, Servet Altay, Alexandre Mebazaa, Mehmet Birhan Yilmaz, Yuri Lopatin, Mamas A Mamas, Robert J Gil, Ritu Thamman, Abdallah Almaghraby, Biykem Bozkurt, Gani Bajraktari, Thomas Fink, Vassil Traykov, Stephane Manzo-Silberman, Ulvi Mirzoyev, Sekib Sokolovic, Zviad V Kipiani, Cecilia Linde, and Petar M Seferovic
Subjects: Medicine
Abstract: In the recent years, there has been a burgeoning interest in Takotsubo syndrome (TTS), which is renowned as a specific form of reversible myocardial dysfunction. Despite the extensive literature available on TTS, clinicians still face several practical challenges associated with the diagnosis and management of this phenomenon. This potentially results in the underdiagnosis and improper management of TTS in clinical practice. The present paper, the first part (part-1) of the consensus report, aims to cover diagnostic and therapeutic challenges associated with TTS along with certain recommendations to combat these challenges.
Published: 2024
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2. Takotsubo Syndrome: An International Expert Consensus Report on Practical Challenges and Specific Conditions (Part-2: Specific Entities, Risk Stratification and Challenges After Recovery)

Author: Kenan Yalta, John E Madias, Nicholas G Kounis, Shams Y-Hassan, Marija Polovina, Servet Altay, Alexandre Mebazaa, Mehmet Birhan Yilmaz, Yuri Lopatin, Mamas A Mamas, Robert J Gil, Ritu Thamman, Abdallah Almaghraby, Biykem Bozkurt, Gani Bajraktari, Thomas Fink, Vassil Traykov, Stephane Manzo-Silberman, Ulvi Mirzoyev, Sekib Sokolovic, Zviad V Kipiani, Cecilia Linde, and Petar M Seferovic
Subjects: Medicine
Abstract: Takotsubo syndrome (TTS) still remains as an enigmatic phenomenon. In particular, long-term challenges (including clinical recurrence and persistent symptoms) and specific entities in the setting of TTS have been the evolving areas of interest. On the other hand, a significant gap still exists regarding the proper risk-stratification of this phenomenon in the short and long terms. The present paper, the second part (part-2) of the consensus report, aims to discuss less well-known aspects of TTS including specific entities, challenges after recovery and risk-stratification.
Published: 2024
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3. Smoking and Hypertriglyceridemia Predict ST-Segment Elevation Myocardial Infarction in Kosovo Patients with Acute Myocardial Infarction

Author: Afrim Poniku, Arlind Batalli, Dua Shita, Zarife Rexhaj, Arlind Ferati, Rita Leka, Artan Bajraktari, Genc Abdyli, Edmond Haliti, Pranvera Ibrahimi, Rona Karahoda, Shpend Elezi, Faik Shatri, Ibadete Bytyçi, Michael Henein, and Gani Bajraktari
Subjects: myocardial infarction, risk factors, smoking, diabetes, arterial hypertension, age, Medicine (General), R5-920
Abstract: Background: Myocardial infarction (MI), presented as ST-segment elevation MI (STEMI) and non-ST-segment elevation MI (NSTEMI), is influenced by atherosclerosis risk factors. Aim: The aim of this study was to assess the patterns of presentation of patients with acute MI in Kosovo. Methods: This was a cross-sectional study conducted at the University Clinical Center of Kosovo, which included all patients hospitalized with acute MI over a period of 7 years. Results: Among the 7353 patients admitted with acute MI (age 63 ± 12 years, 29% female), 59.4% had STEMI and 40.6% had NSTEMI. The patients with NSTEMI patients less (48.3% vs. 54%, p < 0.001), but more of them had diabetes (37.8% vs. 33.6%, p < 0.001), hypertension (69.6% vs. 63%, p < 0.001), frequently had a family history of coronary artery disease (CAD) (40% vs. 38%, p = 0.009), and had more females compared to the patients with STEMI (32% vs. 27%, p < 0.001). The patients with NSTEMI underwent less primary percutaneous interventions compared with the patients with STEMI (43.6% vs. 55.2%, p < 0.001). Smoking [1.277 (1.117–1.459), p ˂ 0.001] and high triglycerides [0.791 (0.714–0.878), p = 0.02] were independent predictors of STEMI. Conclusions: In Kosovo, patients with STEMI are more common than those with NSTEMI, and they were mostly males and more likely to have diabetes, hypertension, and a family history of CAD compared to those with NSTEMI. Smoking and high triglycerides proved to be the strongest predictors of acute STEMI in Kosovo, thus highlighting the urgent need for optimum atherosclerosis risk control and education strategies.
Published: 2024
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4. Management and clinical outcome of myocardial infarction in Kosovo: A cross‐sectional study

Author: Arlind Batalli, Michael Henein, Afrim Poniku, Pranvera Ibrahimi, Edita Pllana‐Pruthi, Shpend Elezi, Faik Shatri, Genc Abdyli, Artan Bajraktari, Rona Karahoda, Hamza Selmani, Ibadete Bytyçi, and Gani Bajraktari
Subjects: acute myocardial infarction, Kosovo, mortality, primary PCI, Medicine
Abstract: Abstract Background and Aims Myocardial infarction (MI) is a major cause of mortality worldwide, irrespective of its presentation as non‐ST‐segment elevation MI (NSTEMI) or ST‐segment elevation MI (STEMI). The objective of this study was to assess national results of management and clinical outcome of acute MI patients in Kosovo. Methods This cross‐sectional descriptive study, conducted at the Clinic of Cardiology of the University Clinical Center of Kosovo, in Prishtina, included all patients hospitalized with acute MI over a period of 7 years (2014‐2020). The primary outcome of the study was in‐hospital mortality. Results Among 7353 admitted patients with acute MI (mean age 63 ± 12 years, 29% female) and according to the final diagnosis, 4436 (59.4%) patients had STEMI, and 2987 (40.6%) NSTEMI. More patients with STEMI received primary percutaneous intervention (PPCI) than those with NSTEMI (50% vs. 41%, p
Published: 2024
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5. Ventricular septal defect associated with aortic regurgitation and ascending aortic aneurysm: a case report

Author: Edmond Haliti, Besim Bytyçi, Michael Y. Henein, Gani Bajraktari, and Ibadete Bytyçi
Subjects: Inter-ventricular septal defect, Aortic regurgitation, Venturi effect, Ascending aortic aneurysm, Medicine
Abstract: Abstract Introduction Ventricular septal defect (VSD) is one of the most common congenital cardiac anomalies. Patients with perimembranous VSD may have aortic regurgitation (AR) secondary to prolapse of the aortic cusp. Case presentation We present a case of 23-year-old White man with VSD, AR and ascending aortic aneurysm. The patient presented to outpatient clinic with weakness and gradual worsening shortness of breath for the past 5 years. Clinical examination revealed regular heart rhythm and loud continuous systolic-diastolic murmur (Lewin’s grade 6/6), heard all over the precordium, associated with a palpable thrill. The ECG showed right axis deviation, fractionated QRS in V1 and signs of biventricular hypertrophy. The chest X-ray showed cardiomegaly. Transthoracic and transesophageal echocardiograms showed a perimembranous VSD with moderate restrictive shunt (Qp/Qs = 1.6), aortic regurgitation (AR), and ascending aortic aneurysm. Other clinical and laboratory findings were within normal limits. Conclusions Perimembranous VSD, may be associated with aortic regurgitation and ascending aortic aneurysm as secondary phenomenon if it is not early diagnosed and successfully treated.
Published: 2023
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6. The Rationale and Design of the KOSovan Acute Coronary Syndrome (KOS-ACS) Registry

Author: Gani Bajraktari, Shpend Elezi, Ibadete Bytyci, Pranvera Ibrahimi, Genc Abdyli, Edita Pllana-Pruthi, Rona Karahoda, Arlind Batalli, Afrim Poniku, Mentor Shatri, Drilon Gashi, Artan Bajraktari, Faik Shatri, and Michael Y. Henein
Subjects: acute coronary syndrome, registry, Kosovo, in-hospital mortality, outcomes, Medicine (General), R5-920
Abstract: The KOSovan Acute Coronary Syndrome (KOS-ACS) Registry is established as a prospective, continuous, nationwide, web-based registry that is operated online. The KOS-ACS registry is designed with the following objectives: (1) to obtain data on the demographic, clinical, and laboratory characteristics of ACS patients treated in Kosovo; (2) to create a national database with information on health care in ACS patients treated in Kosovo; (3) to identify the national features of associations between ACS characteristics and clinical outcomes, including mortality, complications, the length of hospital stay, and the quality of clinical care; and (4) to propose a practical guide for improving the quality and efficiency of ACS treatment in Kosovo. The Kosovo Society of Cardiology and University of Prishtina will be responsible for the development of the KOS-ACS registry and centralized data analysis at the national level. The KOS-ACS Registry will enroll all patients admitted, at any of the registered clinical centers, with the diagnosis of ACS and who will be clinically managed at any of the Kosovo hospitals. Data on patient demographics, clinical characteristics, previous and hospital drug treatment, and reperfusion therapy will be collected. The type of ACS (unstable angina, NSTEMI, or STEMI) will also be clearly defined. The time from first medical contact to balloon inflation (FMC-to-balloon) and door-to-ballon time will be registered. In-hospital death and complications will be registered. Data on the post-hospital primary outcome (MACE: cardiac death, all-cause mortality, hospitalization, stroke, need for coronary revascularization) of patients, at 30 days and 1 year, will be included in the registry.
Published: 2024
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7. Step‐by‐step diagnosis and management of the nocebo/drucebo effect in statin‐associated muscle symptoms patients: a position paper from the International Lipid Expert Panel (ILEP)

Author: Peter E. Penson, Eric Bruckert, David Marais, Željko Reiner, Matteo Pirro, Amirhossein Sahebkar, Gani Bajraktari, Erkin Mirrakhimov, Manfredi Rizzo, Dimitri P. Mikhailidis, Alexandros Sachinidis, Dan Gaita, Gustavs Latkovskis, Mohsen Mazidi, Peter P. Toth, Daniel Pella, Fahad Alnouri, Arman Postadzhiyan, Hung‐I Yeh, G.B. John Mancini, Stephan vonHaehling, Maciej Banach, and International Lipid Expert Panel (ILEP)
Subjects: Drucebo effect, Nocebo effect, SAMS, Statin intolerance, Diseases of the musculoskeletal system, RC925-935, Human anatomy, QM1-695
Abstract: Abstract Statin intolerance is a clinical syndrome whereby adverse effects (AEs) associated with statin therapy [most commonly statin‐associated muscle symptoms (SAMS)] result in the discontinuation of therapy and consequently increase the risk of adverse cardiovascular outcomes. However, complete statin intolerance occurs in only a small minority of treated patients (estimated prevalence of only 3–5%). Many perceived AEs are misattributed (e.g. physical musculoskeletal injury and inflammatory myopathies), and subjective symptoms occur as a result of the fact that patients expect them to do so when taking medicines (the nocebo/drucebo effect)—what might be truth even for over 50% of all patients with muscle weakness/pain. Clear guidance is necessary to enable the optimal management of plasma in real‐world clinical practice in patients who experience subjective AEs. In this Position Paper of the International Lipid Expert Panel (ILEP), we present a step‐by‐step patient‐centred approach to the identification and management of SAMS with a particular focus on strategies to prevent and manage the nocebo/drucebo effect and to improve long‐term compliance with lipid‐lowering therapy.
Published: 2022
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8. Nutraceutical approaches to non-alcoholic fatty liver disease (NAFLD): A position paper from the International Lipid Expert Panel (ILEP)

Author: Manfredi Rizzo, Alessandro Colletti, Peter E. Penson, Niki Katsiki, Dimitri P. Mikhailidis, Peter P. Toth, Ioanna Gouni-Berthold, John Mancini, David Marais, Patrick Moriarty, Massimiliano Ruscica, Amirhossein Sahebkar, Dragos Vinereanu, Arrigo Francesco Giuseppe Cicero, Maciej Banach, Julio Acosta, Mutaz Al-Khnifsawi, Fahad Alnouri, Fahma Amar, Atanas G. Atanasov, Gani Bajraktari, Sonu Bhaskar, Agata Bielecka-Dąbrowa, Bojko Bjelakovic, Eric Bruckert, Ibadete Bytyçi, Alberto Cafferata, Richard Ceska, Arrigo F.G. Cicero, Krzysztof Chlebus, Xavier Collet, Magdalena Daccord, Olivier Descamps, Dragan Djuric, Ronen Durst, Marat V. Ezhov, Zlatko Fras, Dan Gaita, Adrian V. Hernandez, Steven R. Jones, Jacek Jozwiak, Nona Kakauridze, Amani Kallel, Amit Khera, Karam Kostner, Raimondas Kubilius, Gustavs Latkovskis, G.B. John Mancini, A. David Marais, Seth S. Martin, Julio Acosta Martinez, Mohsen Mazidi, Erkin Mirrakhimov, Andre R. Miserez, Olena Mitchenko, Natalya P. Mitkovskaya, Patrick M. Moriarty, Seyed Mohammad Nabavi, Devaki Nair, Demosthenes B. Panagiotakos, György Paragh, Daniel Pella, Zaneta Petrulioniene, Matteo Pirro, Arman Postadzhiyan, Raman Puri, Ashraf Reda, Željko Reiner, Dina Radenkovic, Michał Rakowski, Jemaa Riadh, Dimitri Richter, Maria-Corina Serban, Abdullah M.A Shehab, Aleksandr B. Shek, Cesare R. Sirtori, Claudia Stefanutti, Tomasz Tomasik, Margus Viigimaa, Pedro Valdivielso, Branislav Vohnout, Stephan von Haehling, Michal Vrablik, Nathan D. Wong, Hung-I Yeh, Jiang Zhisheng, and Andreas Zirlik
Subjects: NAFLD, Nutraceuticals, Dietary supplements, Liver steatosis, Position paper, Therapeutics. Pharmacology, RM1-950
Abstract: Non-Alcoholic Fatty Liver Disease (NAFLD) is a common condition affecting around 10–25% of the general adult population, 15% of children, and even > 50% of individuals who have type 2 diabetes mellitus. It is a major cause of liver-related morbidity, and cardiovascular (CV) mortality is a common cause of death. In addition to being the initial step of irreversible alterations of the liver parenchyma causing cirrhosis, about 1/6 of those who develop NASH are at risk also developing CV disease (CVD). More recently the acronym MAFLD (Metabolic Associated Fatty Liver Disease) has been preferred by many European and US specialists, providing a clearer message on the metabolic etiology of the disease.The suggestions for the management of NAFLD are like those recommended by guidelines for CVD prevention. In this context, the general approach is to prescribe physical activity and dietary changes the effect weight loss. Lifestyle change in the NAFLD patient has been supplemented in some by the use of nutraceuticals, but the evidence based for these remains uncertain. The aim of this Position Paper was to summarize the clinical evidence relating to the effect of nutraceuticals on NAFLD-related parameters. Our reading of the data is that whilst many nutraceuticals have been studied in relation to NAFLD, none have sufficient evidence to recommend their routine use; robust trials are required to appropriately address efficacy and safety.
Published: 2023
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9. Correlates of In-Hospital Mortality in Patients with Acute Coronary Syndrome in Kosovo

Author: Musli M. Gashi, Gani Bajraktari, Sanije L. Gashi, Hasan R. Ahmeti, and Vesna Degoricija
Subjects: In-hospital mortality, Acute coronary syndrome, Emergency department, Medicine
Abstract: It has been demonstrated that pre-hospital emergency care reduces in-hospital mortality in patients admitted with acute coronary syndrome (ACS). The aim of this study was to analyze the relationship between pre-hospital emergency care and in-hospital mortality in ACS patients treated at the University Clinical Centre of Kosovo Emergency Department (UCCK ED). This observational clinical study included 1498 ACS patients treated at UCCK ED and followed-up by phone call for one year after discharge from the hospital. According to multivariate Cox regression analysis, age (HR=2.37, 95% CI 1.67-3.52), pre-hospital emergency care (HR=3.92, 95% CI 2.35-6.54), STEMI (HR=6.17, 95% CI 3.22-15.31), diabetes mellitus (HR=3.01, 95% CI 1.98-3.78), left ventricular ejection fraction
Published: 2022
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10. Diabetes Is the Strongest Predictor of Limited Exercise Capacity in Chronic Heart Failure and Preserved Ejection Fraction (HFpEF)

Author: Venera Berisha-Muharremi, Michael Y. Henein, Frank L. Dini, Edmond Haliti, Ibadete Bytyçi, Pranvera Ibrahimi, Afrim Poniku, Arlind Batalli, Rina Tafarshiku, Shpend Elezi, and Gani Bajraktari
Subjects: diabetes mellitus, heart failure, 6-min walk test, exercise capacity, Doppler echocardiography, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: Background and AimType 2 diabetes mellitus (T2DM) is a known risk factor in patients with heart failure (HF), but its impact on phenotypic presentations remains unclear. This study aimed to prospectively examine the relationship between T2DM and functional exercise capacity, assessed by the 6-min walk test (6-MWT) in chronic HF.MethodsWe studied 344 chronic patients with HF (mean age 61 ± 10 years, 54% female) in whom clinical, biochemical, and anthropometric data were available and all patients underwent an echo-Doppler study and a 6-MWT on the same day. The 6-MWT distance divided the cohort into; Group I: those who managed ≤ 300 m and Group II: those who managed >300 m. Additionally, left ventricular (LV) ejection fraction (EF), estimated using the modified Simpson's method, classified patients into HF with preserved EF (HFpEF) and HF with reduced EF (HFrEF).ResultsThe results showed that 111/344 (32%) patients had T2DM, who had a higher prevalence of arterial hypertension (p = 0.004), higher waist/hips ratio (p = 0.041), higher creatinine (p = 0.008) and urea (p = 0.003), lower hemoglobin (p = 0.001), and they achieved shorter 6-MWT distance (p < 0.001) compared with those with no T2DM. Patients with limited exercise (300 m. In the cohort as a whole, multivariate analysis, T2DM (p < 0.001), low hemoglobin (p = 0.008), atrial fibrillation (p = 0.014), and reduced septal MAPSE (p = 0.021) independently predicted the limited 6-MWT distance.In patients with HFpEF, diabetes [6.083 (2.613–14.160), p < 0.001], atrial fibrillation [6.092 (1.769–20.979), p = 0.002], and septal MAPSE [0.063 (0.027–0.184), p = 0.002], independently predicted the reduced 6-MWT, whereas hemoglobin [0.786 (0.624–0.998), p = 0.049] and TAPSE [0.462 (0.214–0.988), p = 0.041] predicted it in patients with HFrEF.ConclusionPredictors of exercise intolerance in patients with chronic HF differ according to LV systolic function, demonstrated as EF. T2DM seems the most powerful predictor of limited exercise capacity in patients with HFpEF.
Published: 2022
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11. Non-inferiority of 1 month longer dual antiplatelet therapy in patients undergoing PCI with drug-eluting stents: a systematic review and meta-analysis of randomized clinical trials

Author: Gani Bajraktari, Ibadete Bytyçi, Artan Bajraktari, and Michael Y. Henein
Subjects: Therapeutics. Pharmacology, RM1-950
Abstract: Aim: The aim of this meta-analysis was to evaluate the safety of 1-month dual antiplatelet therapy (DAPT) followed by aspirin or a P2Y12 receptor inhibitor, after percutaneous coronary intervention (PCI) with drug-eluting stents (DES), based on the available evidence. Methods: PubMed, MEDLINE, Embase, Scopus, Google Scholar, CENTRAL, and ClinicalTrials.gov database search identified four RCTs of 26,431 patients who underwent PCI with DES and compared 1-month versus >1-month DAPT. The primary endpoint was major bleeding and co-primary endpoint stent thrombosis, and secondary endpoints included all-cause mortality, cardiovascular death, myocardial infarction (MI), stroke, and major adverse clinical events (MACE). Results: Compared with >1-month DAPT, the 1-month DAPT was associated with a similar rate of major bleeding (OR = 0.74, 95%CI: 0.51–1.07, p = 0.11, I 2 = 67%), stent thrombosis (OR = 1.10, 95%CI: 0.82–1.47, p = 0.53, I 2 = 0.0%), similar risk for all-cause mortality (OR = 0.89, 95%CI: 0.77–1.04, p = 0.14, I 2 = 0%), CV death (OR = 0.80, 95% CI: 0.55–1.60, p = 0.24, I 2 = 0.0%), MI (OR = 1.02, 95% CI: 0.88–1.19, p = 0.78, I 2 = 0.0%), and stroke (OR = 0.76, 95% CI: 0.54–1.08, p = 0.13, I 2 = 29%). The risk of MACE was lower (OR = 0.84, 95% CI: 0.73–0.98, p = 0.02, I 2 = 39%) in the 1-month DAPT compared with the >1-month DAPT. Only patients with stable CAD had lower risk of MACE with 1-month DAPT (OR = 0.81, 95% CI: 0.67–0.98, p = 0.03, I 2 = 21%) compared with >1-month DAPT. Conclusion: This meta-analysis proved the non-inferiority of 1-month DAPT followed by aspirin or a P2Y12 receptor inhibitor compared with long-term DAPT in patients undergoing PCI with DES.
Published: 2022
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12. Left atrial volume index predicts response to cardiac resynchronisation therapy: a systematic review and meta-analysis

Author: Ibadete Bytyçi, Gani Bajraktari, and Michael Y. Henein
Subjects: cardiac resynchronisation therapy, left atrial volume index, cardiac resynchronisation therapy responders, cardiac resynchronisation therapy non-responders, Medicine
Abstract: Introduction In responders, cardiac resynchronisation therapy (CRT) results in improved left ventricular (LV) function and reduced atrial arrhythmia. The aim of this meta-analysis was to assess the potential relationship between the left atrium (LA) volume and CRT response. Material and methods We systematically searched all electronic databases up to August 2018 in order to select clinical trials and observational studies that assessed the predictive value of LA volume index (LAVI) of CRT response. Left ventricular end-systolic volume (LVESV) reduction ≥ 15 ml and/or LV ejection fraction (EF) increase ≥ 10% were the documented criteria for positive CRT response. Results A total of 2191 patients recruited in 10 studies with mean follow-up duration of 10.5 months were included in this meta-analysis. The pooled analysis showed that CRT responders had lower baseline LAVI compared to non-responders, with a weighted mean difference (WMD) of –5.89% (95% CI: –9.47 to –3.22, p < 0.001). At follow-up, LAVI fell in the CRT responders (WMD –4.36%, 95% CI: –3.54 to –5.17, p < 0.001) compared to non-responders (WMD 1.45 %, 95% CI: –0.75 to 3.65, p = 0.20). The mean change of LAVI in the CRT responders was related to the fall in LVESV,  = –1.02 (–1.46 to –0.58), p < 0.001 and the increase in LVEF,  = 2.02 (1.86 to 4.58), p = 0.001. A baseline LAVI 11. Conclusions Baseline LAVI predicts CRT response, and its reduction reflects devise-related LA remodelling. These results emphasis the role of LAVI assessment as an integral part of cardiac function response to CRT.
Published: 2020
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13. Association of statin use and clinical outcomes in heart failure patients: a systematic review and meta-analysis

Author: Agata Bielecka-Dabrowa, Ibadete Bytyçi, Stephan Von Haehling, Stefan Anker, Jacek Jozwiak, Jacek Rysz, Adrian V. Hernandez, Gani Bajraktari, Dimitri P. Mikhalidis, and Maciej Banach
Subjects: Statins, Heart failure, Mortality, Hospitalization, Meta-analysis, Nutritional diseases. Deficiency diseases, RC620-627
Abstract: Abstract Background The role of statins in patients with heart failure (HF) of different levels of left ventricular ejection fraction (LVEF) remains unclear especially in the light of the absence of prospective data from randomized controlled trials (RCTs) in non-ischemic HF, and taking into account potential statins’ prosarcopenic effects. We assessed the association of statin use with clinical outcomes in patients with HF. Methods We searched PubMed, EMBASE, Scopus, Google Scholar and Cochrane Central until August 2018 for RCTs and prospective cohorts comparing clinical outcomes with statin vs non-statin use in patients with HF at different LVEF levels. We followed the guidelines of the 2009 PRISMA statement for reporting and applied independent extraction by multiple observers. Meta-analyses of hazard ratios (HRs) of effects of statins on clinical outcomes used generic inverse variance method and random model effects. Clinical outcomes were all-cause mortality, cardiovascular (CV) mortality and CV hospitalization. Results Finally we included 17 studies (n = 88,100; 2 RCTs and 15 cohorts) comparing statin vs non-statin users (mean follow-up 36 months). Compared with non-statin use, statin use was associated with lower risk of all-cause mortality (HR 0.77, 95% confidence interval [CI], 0.72–0.83, P
Published: 2019
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14. Acute pericarditis as a major clinical manifestation of long COVID-19 syndrome

Author: Frank Lloyd, Dini, Umberto, Baldini, Ibadete, Bytyçi, Nicola Riccardo, Pugliese, Gani, Bajraktari, and Michael Y, Henein
Subjects: Cardiology and Cardiovascular Medicine
Abstract: The long COVID-19 syndrome has been recently described and some reports have suggested that acute pericarditis represents important manifestation of long COVID-19 syndrome. The aim of this study was to identify the prevalence and clinical characteristics of patients with long COVID-19, presenting with acute pericarditis.We retrospectively included 180 patients (median age 47 years, 62% female) previously diagnosed with COVID-19, exhibiting persistence or new-onset symptoms ≥12 weeks from a negative naso-pharyngeal SARS CoV2 swamp test. The original diagnosis of COVID-19 infection was determined by a positive swab. All patients had undergone a thorough physical examination. Patients with suspected heart involvement were referred to a complete cardiovascular evaluation. Echocardiography was performed based on clinical need and diagnosis of acute pericarditis was achieved according to current guidelines.Among the study population, shortness of breath/fatigue was reported in 52%, chest pain/discomfort in 34% and heart palpitations/arrhythmias in 37%. Diagnosis of acute pericarditis was made in 39 patients (22%). Mild-to-moderate pericardial effusion was reported in 12, while thickened and bright pericardial layers with small effusions (5 mm) with or without comet tails arising from the pericardium (pericardial B-lines) in 27. Heart palpitations/arrhythmias (OR:3.748, p = 0.0030), and autoimmune disease and allergic disorders (OR:4.147, p = 0.0073) were independently related to the diagnosis of acute pericarditis, with a borderline contribution of less likelihood of hospitalization during COVID-19 (OR: 0.100, p = 0.0512).Our findings suggest a high prevalence of acute pericarditis in patients with long COVID-19 syndrome. Autoimmune and allergic disorders, and palpitations/arrhythmias were frequently associated with pericardial disease.
Published: 2023
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15. Complete revascularization for patients with multivessel coronary artery disease and ST-segment elevation myocardial infarction after the COMPLETE trial: A meta-analysis of randomized controlled trials

Author: Gani Bajraktari, Ibadete Bytyçi, Michael Y. Henein, Fernando Alfonso, Ali Ahmed, Haki Jashari, and Deepak L. Bhatt
Subjects: Coronary artery disease, ST-segment elevation myocardial infarction, Complete revascularization, Infarct artery only revascularization, Multi-vessel disease, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: Background: The recently published COMPLETE trial has demonstrated that patients with ST-segment elevation myocardial infarction (STEMI) and multivessel coronary artery disease (MVD), who underwent successful percutaneous coronary intervention (PCI) of both culprit and non-culprit (vs. culprit-only) lesions had a reduced risk of major adverse cardiac events (MACE), but not of cardiovascular or total mortality. The aim of this meta-analysis was to assess the efficacy of complete revascularization on cardiovascular or total mortality reduction using available randomized controlled trials (RCTs) including the COMPLETE trial, in hemodynamically stable STEMI patients with MVD. Methods: PubMed, MEDLINE, Embase, Scopus, Google Scholar, CENTRAL and ClinicalTrials.gov databases search identified 10 RCTs of 7033 patients with STEMI and MVD which compared complete (n = 3420) vs. only culprit lesion (n = 3613) PCI for a median 27.7 months follow-up. Random effect risk ratios were used to estimate for efficacy and safety outcomes. Results: Complete revascularization reduced the risk of MACE (10.4% vs.16.6%; RR = 0.59, 95% CI: 0.47 to 0.74, p
Published: 2020
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16. Quality of life questionnaire predicts poor exercise capacity only in HFpEF and not in HFrEF

Author: Artan Ahmeti, Michael Y. Henein, Pranvera Ibrahimi, Shpend Elezi, Edmond Haliti, Afrim Poniku, Arlind Batalli, and Gani Bajraktari
Subjects: Heart failure, The Minnesota Living with Heart Failure Questionnaire, Exercise capacity, 6 min walk test, Echocardiography, Quality of life, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: Abstract Background The Minnesota Living with Heart Failure Questionnaire (MLHFQ) is the most widely used measure of quality of life (QoL) in HF patients. This prospective study aimed to assess the relationship between QoL and exercise capacity in HF patients. Methods The study subjects were 118 consecutive patients with chronic HF (62 ± 10 years, 57 females, in NYHA I-III). Patients answered a MLHFQ questionnaire in the same day of complete clinical, biochemical and echocardiographic assessment. They also underwent a 5 min walk test (6-MWT), in the same day, which grouped them into; Group I: ≤ 300 m and Group II: >300 m. In addition, left ventricular (LV) ejection fraction (EF), divided them into: Group A, with preserved EF (HFpEF) and Group B with reduced EF (HFrEF). Results The mean MLHFQ total scale score was 48 (±17). The total scale, and the physical and emotional functional MLHFQ scores did not differ between HFpEF and HFpEF. Group I patients were older (p = 0.003), had higher NYHA functional class (p = 0.002), faster baseline heart rate (p = 0.006), higher prevalence of smoking (p = 0.015), higher global, physical and emotional MLHFQ scores (p
Published: 2017
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17. Different determinants of exercise capacity in HFpEF compared to HFrEF

Author: Arlind Batalli, Pranvera Ibrahimi, Ibadete Bytyçi, Artan Ahmeti, Edmond Haliti, Shpend Elezi, Michael Y. Henein, and Gani Bajraktari
Subjects: Six-minute walk test, Doppler echocardiography, Heart failure, HFpEF, Exercise capacity, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: Abstract Background Quality of life is as important as survival in heart failure (HF) patients. Controversies exist with regards to echocardiographic determinants of exercise capacity in HF, particularly in patients with preserved ejection fraction (HFpEF). The aim of this study was to prospectively examine echocardiographic parameters that correlate and predict functional exercise capacity assessed by 6 min walk test (6-MWT) in patients with HFpEF. Methods In 111 HF patients (mean age 63 ± 10 years, 47% female), an echo-Doppler study and a 6-MWT were performed in the same day. Patients were divided into two groups based on the 6-MWT distance (Group I: ≤ 300 m and Group II: >300 m). Results Group I were older (p = 0.008), had higher prevalence of diabetes (p = 0.027), higher baseline heart rate (p = 0.004), larger left atrium - LA (p = 0.001), longer LV filling time - FT (p = 0.019), shorter isovolumic relaxation time (p = 0.037), shorter pulmonary artery acceleration time - PA acceleration time (p = 0.006), lower left atrial lateral wall myocardial velocity (a’) (p = 0.018) and lower septal systolic myocardial velocity (s’) (p = 0.023), compared with Group II. Patients with HF and reduced EF (HFrEF) had lower hemoglobin (p = 0.007), higher baseline heart rate (p = 0.005), higher NT-ProBNP (p = 0.001), larger LA (p = 0.004), lower septal s’, e’, a’ waves, and septal mitral annular plane systolic excursion (MAPSE), shorter PA acceleration time (p
Published: 2017
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18. Left ventricular longitudinal systolic dysfunction is associated with right atrial dyssynchrony in heart failure with preserved ejection fraction

Author: Ibadete Bytyçi, Edmond Haliti, Gëzim Berisha, Arbërie Tishukaj, Faik Shatri, and Gani Bajraktari
Subjects: Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: Objective: We aimed in this study to assess the role of longitudinal left ventricular (LV) systolic function in heart failure with preserved ejection fraction (HFpEF) in delayed intra- and interatrial conduction time. Methods: In 85 consecutive patients with HFpEF (age 60±11 years, ejection fraction [EF] ≥45%), a complete M-mode echocardiographic and tissue Doppler imaging (TDI) study was performed. The times from the onset of the P wave on the ECG to the beginning of the A′ wave (PA) from the lateral and septal mitral and tricuspid annuli on TDI were recorded. The difference between these intervals gave the intra- and interatrial dyssynchrony. Based on mitral annular plane systolic excursion (MAPSE), patients were classified as having HFpEF with impaired (MAPSE ≤1.2 cm) or normal (MAPSE >1.2 cm) longitudinal systolic function. Results: Patients with impaired MAPSE were older (p 1,2 cm). Resultados: Os doentes com ESPAM baixa eram mais velhos (p < 0,001), tinham índice de massa VE mais elevado (p < 0,001), volume auricular esquerdo (VAE) superior (p = 0,007), FE auricular esquerda (AE) mais baixa (p < 0,001), rácio E/e’ mais elevado (p = 0,002), onda e’ lateral e septal reduzidas (p = 0,005 e p = 0,006), onda tricúspide PA prolongada (p = 0,03) e aumento significativo da dessincronia da aurícula direita (AD) (p = 0,001), quando comparados com doentes com ESPAM normal. A ESPAM estava correlacionada com a dessincronia AD (r = -0,40, p < 0,001), mas não com a dessincronia interauricular e da AE. Conclusão: Nos doentes com ICFEp e ESPAM baixa, existe dessincronia AD, quando comparada com os doentes com ESPAM normal. Como os doentes com dessincronia AD têm risco mais elevado de arritmia, a avaliação desta dessincronia pode ajudar a melhorar o tratamento, bem como a auxiliar na previsão prognóstica destes doentes. Keywords: Heart failure, Right atrial dyssynchrony, Systolic longitudinal function, Palavras-chave: Insuficiência cardíaca, Dessincronia auricular direita, Função sistólica longitudinal
Published: 2016
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19. Left Ventricular Diastolic and Systolic Functions in Patients with Hypothyroidism

Author: Rina Tafarshiku, Michael Y. Henein, Venera Berisha-Muharremi, Ibadete Bytyçi, Pranvera Ibrahimi, Afrim Poniku, Shpend Elezi, and Gani Bajraktari
Subjects: hypothyroidism, left ventricular function, Doppler echocardiography, Medicine (General), R5-920
Abstract: Background and objectives: Long standing hypothyroidism may impair myocardial relaxation, but its effect on systolic myocardial function is still controversial. The aim of this study was to investigate left ventricular (LV) systolic and diastolic function in patients with hypothyroidism. Materials and Methods: This study included 81 (age 42 ± 13 years, 92% female) patients with hypothyroidism, and 22 age and gender matched controls. All subjects underwent a detailed clinical examination followed by a complete biochemical blood analysis including thyroid function assessment and anthropometric parameters measurements. LV function was assessed by 2-dimensional, M-mode and Tissue-Doppler Doppler echocardiographic examination performed in the same day. Results: Patients had lower waist/hip ratio (p< 0.001), higher urea level (p = 0.002), and lower white blood cells (p = 0.011), compared with controls. All other clinical, biochemical, and anthropometric data did not differ between the two groups. Patients had impaired LV diastolic function (lower E wave [p< 0.001], higher A wave [p = 0.028], lower E/A ratio [p< 0.001], longer E wave deceleration time [p = 0.01], and higher E/e’ ratio [p< 0.001]), compared with controls. Although LV global systolic function did not differ between groups, LV longitudinal systolic function was compromised in patients (lateral mitral annular plane systolic excursion—MAPSE [p = 0.005], as were lateral and septal s’ [p< 0.001 for both]). Conclusions: In patients with hypothyroidism, in addition to compromised LV diastolic function, LV longitudinal systolic function is also impaired compared to healthy subjects of the same age and gender. These findings suggest significant subendocardial function impairment, reflecting potentially micro-circulation disease that requires optimum management.
Published: 2020
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20. Correction to: Association of statin use and clinical outcomes in heart failure patients: a systematic review and meta-analysis

Author: Agata Bielecka-Dabrowa, Ibadete Bytyçi, Stephan Von Haehling, Stefan Anker, Jacek Jozwiak, Jacek Rysz, Adrian V. Hernandez, Gani Bajraktari, Dimitri P. Mikhailidis, and Maciej Banach
Subjects: Nutritional diseases. Deficiency diseases, RC620-627
Abstract: An amendment to this paper has been published and can be accessed via the original article.
Published: 2020
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21. Efficacy and safety of colchicine in patients with coronary artery disease: A systematic review and meta‐analysis of randomized controlled trials

Author: Gani Bajraktari, Michael Y. Henein, Ibadete Bytyçi, Peter E. Penson, and Maciej Banach
Subjects: RM, medicine.medical_specialty, Myocardial Infarction, Coronary Artery Disease, Placebo, Lower risk, law.invention, Coronary artery disease, Randomized controlled trial, law, Internal medicine, Clinical endpoint, medicine, Humans, Pharmacology (medical), Myocardial infarction, Stroke, Randomized Controlled Trials as Topic, Pharmacology, business.industry, medicine.disease, R1, C-Reactive Protein, Treatment Outcome, Meta-analysis, Colchicine, business
Abstract: AIMS Inflammation plays a central role in the pathogenesis and clinical manifestations of atherosclerosis. Randomized controlled trials have investigated the potential benefit of colchicine in reducing cardiovascular (CV) events in patients with coronary artery disease (CAD) but produced conflicting results. The aim of this meta-analysis was to evaluate the efficacy and safety of colchicine in patients with CAD. METHODS We systematically searched selected electronic databases from inception until 10 December 2020. Primary clinical endpoints were: major adverse cardiac events; all-cause mortality; CV mortality; recurrent myocardial infarction; stroke; hospitalization; and adverse medication effects. Secondary endpoints were short-term effect of colchicine on inflammatory markers. RESULTS Twelve randomized controlled trials with a total of 13 073 patients with CAD (colchicine n = 6351 and placebo n = 6722) were included in the meta-analysis. At mean follow-up of 22.5 months, the colchicine group had lower risk of major adverse cardiac events (6.20 vs. 8.87%; P
Published: 2021
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22. Echo- and B-Type Natriuretic Peptide-Guided Follow-Up versus Symptom-Guided Follow-Up: Comparison of the Outcome in Ambulatory Heart Failure Patients

Author: Gani Bajraktari, Nicola Riccardo Pugliese, Andreina D’Agostino, Gian Marco Rosa, Pranvera Ibrahimi, Luan Perçuku, Mario Miccoli, Gian Giacomo Galeotti, Iacopo Fabiani, Roberto Pedrinelli, Michael Henein, and Frank L. Dini
Subjects: Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: Recent European Society of Cardiology and American Heart Association/American College of Cardiology Guidelines did not recommend biomarker-guided therapy in the management of heart failure (HF) patients. Combination of echo- and B-type natriuretic peptide (BNP) may be an alternative approach in guiding ambulatory HF management. Our aim was to determine whether a therapy guided by echo markers of left ventricular filling pressure (LVFP), lung ultrasound (LUS) assessment of B-lines, and BNP improves outcomes of HF patients. Consecutive outpatients with LV ejection fraction (EF) ≤ 50% have been prospectively enrolled. In Group I (n=224), follow-up was guided by echo and BNP with the goal of achieving E-wave deceleration time (EDT) ≥ 150 ms, tissue Doppler index E/e′ 30%; in Group II (n=293), follow-up was clinically guided, while the remaining 277 patients (Group III) did not receive any dedicated follow-up. At 60 months, survival was 88% in Group I compared to 75% in Group II and 54% in Group III (χ2 53.5; p125 pg/ml or decrease ≤30% (HR: 4.90; p=0.0054), while BNP > 125 pg/ml or decrease ≤30% and B-line numbers ≥15 were associated with the combined end point of death and HF hospitalization. Evidence-based HF treatment guided by serum biomarkers and ultrasound with the goal of reducing elevated BNP and LVFP, and resolving pulmonary congestion was associated with better clinical outcomes and can be valuable in guiding ambulatory HF management.
Published: 2018
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23. Left Ventricular Myocardial and Cavity Velocity Disturbances Are Powerful Predictors of Significant Coronary Artery Stenosis

Author: Ibadete Bytyçi, Liliana Alves, Oscar Alves, Carla Lopes, Gani Bajraktari, and Michael Y. Henein
Subjects: Kardiologi, suspected coronary artery disease, insignificant coronary artery disease, dobutamine stress echocardiography, Cardiac and Cardiovascular Systems, General Medicine
Abstract: Background and Aim: Dobutamine stress echocardiography (DSE) is a well-established noninvasive investigation for significant coronary artery disease (CAD). The aim of this study was to evaluate the accuracy of cardiac Doppler parameters in predicting CAD. Methods: We prospectively studied 103 consecutive patients with suspected CAD based on typical symptoms; 59 proved to have CAD, and 44 patients proved to have no-CAD (n = 44). All patients underwent a complete stress Doppler echocardiographic examination. Total isovolumic time (T-IVT) as a marker of cavity dyssynchrony and wall motion score index (WMSI) were also calculated. Results: At peak dobutamine stress, the compromised LV longitudinal excursion (MAPSE), systolic septal and lateral velocities (s’), and diastolic indices were more pronounced in the CAD patients compared with those without CAD, but LV dimension did not differ between groups (p > 0.05). The WMSI was higher and t-IVT more prolonged in patients with CAD (p < 0.01 for both). Similarly, the changes were more pronounced in patients with significant CAD compared with insignificant CAD. On multivariate model, Δ mean s’, OR 2.016 (1.610 to 3.190; p < 0.001), Δ E velocity OR 2.502 (1.179 to 1.108; p < 0.001), Δ t-IVT 2.206 (1.180 to 2.780; p < 0.001) and Δ WMSI OR 1.911 (1.401 to 3.001; p = 0.001) were the most powerful independent predictors of the presence of CAD, particularly when significant (>75%). Δ mean s’ < 5.0 was 85% sensitive, 89% specific with AUC 0.92. Respective values for Δ E velocity 4.5, 78%, 77% and 0.81 and for Δ FT ≥ 150 ms, 76%, 78% and 0.84 in predicating significant CAD. WMSI ≥ 0.7 was 75% sensitive, 77% specific with AUC of 0.81 in predicting significant CAD. The accuracy of DSE was higher in significant CAD compared to insignificant CAD (80% vs. 74%; p = 0.03). Conclusions: Compromised LV longitudinal systolic function, lower delta E wave, prolonged t-IVT, and increased WMSI were the most powerful independent predictors of the presence and significance of CAD. These finding strengthen the role of comprehensive DSE analysis in diagnosing ischemic disturbances secondary to significant CAD.
Published: 2022
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24. Coronary Atherosclerosis Imaging

Author: Michael Y. Henein, Sergio Vancheri, Gani Bajraktari, and Federico Vancheri
Subjects: coronary atherosclerosis, coronary plaque, coronary imaging, Medicine (General), R5-920
Abstract: Identifying patients at increased risk of coronary artery disease, before the atherosclerotic complications become clinically evident, is the aim of cardiovascular prevention. Imaging techniques provide direct assessment of coronary atherosclerotic burden and pathological characteristics of atherosclerotic lesions which may predict the progression of disease. Atherosclerosis imaging has been traditionally based on the evaluation of coronary luminal narrowing and stenosis. However, the degree of arterial obstruction is a poor predictor of subsequent acute events. More recent techniques focus on the high-resolution visualization of the arterial wall and the coronary plaques. Most acute coronary events are triggered by plaque rupture or erosion. Hence, atherosclerotic plaque imaging has generally focused on the detection of vulnerable plaque prone to rupture. However, atherosclerosis is a dynamic process and the plaque morphology and composition may change over time. Most vulnerable plaques undergo progressive transformation from high-risk to more stable and heavily calcified lesions, while others undergo subclinical rupture and healing. Although extensive plaque calcification is often associated with stable atherosclerosis, the extent of coronary artery calcification strongly correlates with the degree of atherosclerosis and with the rate of future cardiac events. Inflammation has a central role in atherogenesis, from plaque formation to rupture, hence in the development of acute coronary events. Morphologic plaque assessment, both invasive and non-invasive, gives limited information as to the current activity of the atherosclerotic disease. The addition of nuclear imaging, based on radioactive tracers targeted to the inflammatory components of the plaques, provides a highly sensitive assessment of coronary disease activity, thus distinguishing those patients who have stable disease from those with active plaque inflammation.
Published: 2020
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25. Care of patients with ST-Elevation MI: an international analysis of Quality Indicators in the Acute Coronary Syndrome (ACS) STEMI Registry of the EURObservational Research Programme (EORP) and ACVC and EAPCI Associations of the European Society of Cardiology (ESC) in 11,462 patients

Author: Peter, Ludman, Uwe, Zeymer, Nicolas, Danchin, Petr, Kala, Cécile, Laroche, Masoumeh, Sadeghi, Roberto, Caporale, Sameh Mohamed, Shaheen, Jacek, Legutko, Zaza, Iakobishvili, Khalid F, Alhabib, Zuzana, Motovska, Martin, Studencan, Jorge, Mimoso, David, Becker, Dimitrios, Alexopoulos, Zviad, Kereseselidze, Sinisa, Stojkovic, Parounak, Zelveian, Artan, Goda, Erkin, Mirrakhimov, Gani, Bajraktari, Hasan Ali, Farhan, Pranas, Šerpytis, Bent, Raungaard, Toomas, Marandi, Alice May, Moore, Martin, Quinn, Pasi Paavo, Karjalainen, Gabriel, Tatu-Chitoiu, Chris P, Gale, Aldo P, Maggioni, and Franz, Weidinger
Abstract: To use Quality Indicators to study the management of ST segment elevation myocardial infarction (STEMI) in different regions.Prospective cohort study of STEMI within 24 hours of symptom onset (11,462 patients, 196 centres, 26 ESC member and 3 affiliated countries). The median delay between arrival at a PCI centre and primary PCI was 40 min (IQR 20 to 74) with 65.8% receiving PCI within guideline recommendation of 60 min. A third of patients (33.2%) required transfer from their initial hospital to one that could perform emergency PCI for whom only 27.2% were treated within the quality indicator recommendation of 120 mins. Radial access was used in 56.6% of all primary PCI, but with large geographic variation, from 76.4% to 9.1%. Statins were prescribed at discharge to 98.7% of patients, with little geographic variation. Of patients with a history of heart failure or a documented LVEF ≤40%, 84.0% were discharged on an ACEI/ARB and 88.7% were discharged on beta blockers.Care for STEMI shows wide geographic variation in the receipt of timely primary PCI, and is in contrast with the more uniform delivery of guideline-recommended pharmacotherapies at time of hospital discharge.
Published: 2022

26. Ecocardiografia e teste de caminhada de 6 minutos na disfunção sistólica do ventrículo esquerdo Ecocardiografía y prueba de caminata de 6 minutos en la disfunción sistólica del ventrículo izquierdo chocardiography and 6-minute walk test in left ventricular systolic dysfunction

Author: Venera Berisha, Gani Bajraktari, Dritero Dobra, Edmond Haliti, Reshat Bajrami, and Shpend Elezi
Subjects: Insuficiencia cardiaca, ecocardiografía, caminata, calidad de vida, Insuficiência cardíaca, ecocardiografia, caminhada, qualidade de vida, Heart failure, echocardiography, walking, quality of life, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: FUNDAMENTO: Insuficiência cardíaca crônica é um grave distúrbio cardiovascular. OBJETIVO: O objetivo deste estudo foi avaliar prospectivamente se o resultado do teste de caminhada de 6 minutos (TC-6M) se correlaciona com as variáveis ecocardiográficas em pacientes portadores de disfunção sistólica do ventrículo esquerdo e insuficiência cardíaca crônica estável. MÉTODOS: Foram estudados prospectivamente 52 pacientes (65% homens; média de idade de 60±11 anos) portadores de insuficiência cardíaca crônica secundária à cardiopatia isquêmica ou miocardiopatia idiopática. Todos os pacientes apresentavam disfunção sistólica do ventrículo esquerdo (fração de ejeção FUNDAMENTO: La insuficiencia cardiaca crónica es un grave disturbio cardiovascular. OBJETIVO: El objetivo de este estudio fue evaluar prospectivamente si el resultado de la prueba de caminata de 6 minutos (PC-6M) se correlaciona con las variables ecocardiográficas en pacientes portadores de disfunción sistólica del ventrículo izquierdo e insuficiencia cardiaca crónica estable. MÉTODOS: Se estudiaron prospectivamente a 52 pacientes (el 65% varones; promedio de edad de 60±11 años) portadores de insuficiencia cardiaca crónica secundaria a la cardiopatía isquémica o la miocardiopatía idiopática. Todos los pacientes presentaban disfunción sistólica del ventrículo izquierdo (fracción de eyección BACKGROUND: Chronic heart failure is a major cardiovascular disorder. OBJECTIVE: The aim of this study was to prospectively examine whether a 6-min walk test (6-MWT) result correlates with echocardiographic variables in patients with left ventricular systolic dysfunction and stable chronic heart failure. METHODS: We prospectively studied 52 patients (65% male; mean age 60±11 years) who had chronic heart failure secondary to ischemic heart disease or idiopathic cardiomyopathy. All patients had left ventricular systolic dysfunction (ejection fraction
Published: 2009
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27. Diabetes Is the Strongest Predictor of Limited Exercise Capacity in Chronic Heart Failure and Preserved Ejection Fraction (HFpEF)

Author: Venera, Berisha-Muharremi, Michael Y, Henein, Frank L, Dini, Edmond, Haliti, Ibadete, Bytyçi, Pranvera, Ibrahimi, Afrim, Poniku, Arlind, Batalli, Rina, Tafarshiku, Shpend, Elezi, and Gani, Bajraktari
Subjects: exercise capacity, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Kardiologi, diabetes mellitus, heart failure, Cardiac and Cardiovascular Systems, Public Health, Global Health, Social Medicine and Epidemiology, 6-min walk test, Cardiology and Cardiovascular Medicine, Doppler echocardiography
Abstract: Background and AimType 2 diabetes mellitus (T2DM) is a known risk factor in patients with heart failure (HF), but its impact on phenotypic presentations remains unclear. This study aimed to prospectively examine the relationship between T2DM and functional exercise capacity, assessed by the 6-min walk test (6-MWT) in chronic HF.MethodsWe studied 344 chronic patients with HF (mean age 61 ± 10 years, 54% female) in whom clinical, biochemical, and anthropometric data were available and all patients underwent an echo-Doppler study and a 6-MWT on the same day. The 6-MWT distance divided the cohort into; Group I: those who managed ≤ 300 m and Group II: those who managed >300 m. Additionally, left ventricular (LV) ejection fraction (EF), estimated using the modified Simpson's method, classified patients into HF with preserved EF (HFpEF) and HF with reduced EF (HFrEF).ResultsThe results showed that 111/344 (32%) patients had T2DM, who had a higher prevalence of arterial hypertension (p = 0.004), higher waist/hips ratio (p = 0.041), higher creatinine (p = 0.008) and urea (p = 0.003), lower hemoglobin (p = 0.001), and they achieved shorter 6-MWT distance (p < 0.001) compared with those with no T2DM. Patients with limited exercise (p < 0.001), arterial hypertension (p = 0.004), and atrial fibrillation (p = 0.001), higher waist/hips ratio (p = 0.041), higher glucose level (p < 0.001), lower hemoglobin (p < 0.001), larger left atrium (LA) (p = 0.002), lower lateral mitral annular plane systolic excursion (MAPSE) (p = 0.032), septal MAPSE (p < 0.001), and tricuspid annular plane systolic excursion (TAPSE) (p < 0.001), compared with those performing >300 m. In the cohort as a whole, multivariate analysis, T2DM (p < 0.001), low hemoglobin (p = 0.008), atrial fibrillation (p = 0.014), and reduced septal MAPSE (p = 0.021) independently predicted the limited 6-MWT distance.In patients with HFpEF, diabetes [6.083 (2.613–14.160), p < 0.001], atrial fibrillation [6.092 (1.769–20.979), p = 0.002], and septal MAPSE [0.063 (0.027–0.184), p = 0.002], independently predicted the reduced 6-MWT, whereas hemoglobin [0.786 (0.624–0.998), p = 0.049] and TAPSE [0.462 (0.214–0.988), p = 0.041] predicted it in patients with HFrEF.ConclusionPredictors of exercise intolerance in patients with chronic HF differ according to LV systolic function, demonstrated as EF. T2DM seems the most powerful predictor of limited exercise capacity in patients with HFpEF.
Published: 2022

28. Left atrial volume index predicts response to cardiac resynchronisation therapy : a systematic review and meta-analysis

Author: Michael Y. Henein, Ibadete Bytyçi, and Gani Bajraktari
Subjects: medicine.medical_specialty, Index (economics), Kardiologi, cardiac resynchronisation therapy responders, business.industry, medicine.medical_treatment, left atrial volume index, Cardiac resynchronization therapy, cardiac resynchronization therapy non-responders, General Medicine, Left atrial, Internal medicine, Meta-analysis, medicine, Cardiology, Cardiac and Cardiovascular Systems, business, Volume (compression), cardiac resynchronisation therapy
Abstract: IntroductionIn responders, cardiac resynchronisation therapy (CRT) results in improved left ventricular (LV) function and reduced atrial arrhythmia. The aim of this meta-analysis was to assess the potential relationship between the left atrium (LA) volume and CRT response.Material and methodsWe systematically searched all electronic databases up to August 2018 in order to select clinical trials and observational studies that assessed the predictive value of LA volume index (LAVI) of CRT response. Left ventricular end-systolic volume (LVESV) reduction ≥ 15 ml and/or LV ejection fraction (EF) increase ≥ 10% were the documented criteria for positive CRT response.ResultsA total of 2191 patients recruited in 10 studies with mean follow-up duration of 10.5 months were included in this meta-analysis. The pooled analysis showed that CRT responders had lower baseline LAVI compared to non-responders, with a weighted mean difference (WMD) of –5.89% (95% CI: –9.47 to –3.22, p < 0.001). At follow-up, LAVI fell in the CRT responders (WMD –4.36%, 95% CI: –3.54 to –5.17, p < 0.001) compared to non-responders (WMD 1.45 %, 95% CI: –0.75 to 3.65, p = 0.20). The mean change of LAVI in the CRT responders was related to the fall in LVESV,  = –1.02 (–1.46 to –0.58), p < 0.001 and the increase in LVEF,  = 2.02 (1.86 to 4.58), p = 0.001. A baseline LAVI < 34 ml/m2 predicted CRT response with summary sensitivity 0.80% (0.53–0.95), specificity 0.74% (0.53–0.89), and odds ratio > 11.ConclusionsBaseline LAVI predicts CRT response, and its reduction reflects devise-related LA remodelling. These results emphasis the role of LAVI assessment as an integral part of cardiac function response to CRT.
Published: 2022

29. Echocardiography: In Specific Diseases

Author: Gani Bajraktari
Published: 2012

30. Percutaneous Coronary Intervention Is Not Superior to Optimal Medical Therapy in Chronic Coronary Syndrome: A Meta-Analysis

Author: Ibadete Bytyçi, Defrim Morina, Sefer Bytyqi, Gani Bajraktari, and Michael Y. Henein
Subjects: chronic coronary syndrome, Kardiologi, percutaneous coronary intervention, optimal medial therapy, Cardiac and Cardiovascular Systems, General Medicine
Abstract: (1) Background and Aim: Conflicting evidence exists regarding the benefits of percutaneous coronary intervention (PCI) on survival and symptomatic relief of patients with chronic coronary syndrome (CCS) compared with optimal medical therapy (OMT). This meta-analysis is to evaluate the short- and long-term clinical benefit of PCI over and above OMT in CCS. (2) Methods: Main endpoints were major adverse cardiac events (MACEs), all-cause mortality, cardiovascular (CV) mortality, myocardial infarction (MI), urgent revascularization, stroke hospitalization, and quality of life (QoL). Clinical endpoints at very short (≤3 months), short- (
Published: 2023
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31. Contemporary Management of Severe Symptomatic Aortic Stenosis

Author: Marc Eugène, Piotr Duchnowski, Bernard Prendergast, Olaf Wendler, Cécile Laroche, Jean-Luc Monin, Yannick Jobic, Bogdan A. Popescu, Jeroen J. Bax, Alec Vahanian, Bernard Iung, Jeroen Bax, Michele De Bonis, Victoria Delgado, Michael Haude, Gerhard Hindricks, Aldo P. Maggioni, Luc Pierard, Susanna Price, Raphael Rosenhek, Frank Ruschitzka, Stephan Windecker, Souad Mekhaldi, Katell Lemaitre, Sébastien Authier, Magdy Abdelhamid, Astrid Apor, Gani Bajraktari, Branko Beleslin, Alexander Bogachev-Prokophiev, Daniela Cassar Demarco, Agnes Pasquet, Sait Mesut Dogan, Andrejs Erglis, Arturo Evangelista, Artan Goda, Nikolaj Ihlemann, Huseyin Ince, Andreas Katsaros, Katerina Linhartova, Julia Mascherbauer, Erkin Mirrakhimov, Vaida Mizariene, Shelley Rahman-Haley, Regina Ribeiras, Fuad Samadov, Antti Saraste, Iveta Simkova, Elizabeta Srbinovska Kostovska, Lidia Tomkiewicz-Pajak, Christophe Tribouilloy, Eliverta Zera, Mimoza Metalla, Ervina Shirka, Elona Dado, Loreta Bica, Jorida Aleksi, Gerti Knuti, Lidra Gjyli, Rudina Pjeci, Eritinka Shuperka, Erviola Lleshi, Joana Rustemaj, Marsjon Qordja, Mirald Gina, Senada Husi, Daniel Basic, Regina Steringer-Mascherbauer, Charlotte Huber, Christian Ebner, Elisabeth Sigmund, Andrea Ploechl, Thomas Sturmberger, Veronica Eder, Tanja Koppler, Maria Heger, Andreas Kammerlander, Franz Duca, Christina Binder, Matthias Koschutnik, Leonard Perschy, Lisa Puskas, Chen-Yu Ho, Farid Aliyev, Vugar Guluzada, Galib Imanov, Firdovsi Ibrahimov, Abbasali Abbasaliyev, Tahir Ahmedov, Fargana Muslumova, Jamil Babayev, Yasmin Rustamova, Tofig Jahangirov, Rauf Samadov, Muxtar Museyibov, Elnur Isayev, Oktay Musayev, Shahin Xalilov, Saleh Huseynov, Madina Yuzbashova, Vuqar Zamanov, Vusal Mammadov, Gery Van Camp, Martin Penicka, Hedwig Batjoens, Philippe Debonnaire, Daniel Dendooven, Sebastien Knecht, Mattias Duytschaever, Yves Vandekerckhove, Luc Missault, Luc Muyldermans, René Tavernier, Tineke De Grande, Patrick Coussement, Joyce DeTroyer, Katrien Derycker, Kelly De Jaegher, Antoine Bondue, Christophe Beauloye, Céline Goffinet, Daniela Corina Mirica, Frédéric Vanden Eynden, Philippe Van de Borne, Béatrice Van Frachen, David Vancraeynest, Jean Louis Vanoverschelde, Sophie Pierard, Mihaela Malanca, Florence Sinnaeve, Séverine Tahon, Marie De Clippel, Frederic Gayet, Jacques Loiseau, Nico Van de Veire, Veronique Moerman, Anne-Marie Willems, Bernard Cosyns, Steven Droogmans, Andreea Motoc, Dirk Kerkhove, Daniele Plein, Bram Roosens, Caroline Weytjens, Patrizio Lancellotti, Elena Raluca Dulgheru, Ilona Parenicova, Helena Bedanova, Frantisek Tousek, Stepanka Sindelarova, Julia Canadyova, Milos Taborsky, Jiri Ostransky, null Ivona simkova, Marek Vicha, Libor Jelinek, Irena Opavska, Miroslav Homza, Miriam Kvrayola, Radim Brat, Dan Mrozek, Eva Lichnerova, Iveta Docekalova, Marta Zarybnicka, Marketa Peskova, Patrik Roucka, Vlasta Stastna, Dagmar Jungwirtova Vondrackova, Alfred Hornig, Matus Niznansky, Marian Branny, Alexandra Vodzinska, Miloslav Dorda, Libor Snkouril, Krystyna Kluz, Jana Kypusova, Radka Nezvalova, Niels Thue Olsen, Hosam Hasan Ali, Salma Taha, Mohamed Hassan, Ahmed Afifi, Hamza Kabil, Amr Mady, Hany Ebaid, Yasser Ahmed, Mohammad Nour, Islam Talaat, CairoMaiy El Sayed, Ahmad Elsayed Mostafa, CairoYasser Sadek, CairoSherif Eltobgi, Sameh Bakhoum, Ramy Doss, Mahmoud Sheashea, Abd Allah Elasry, Ahmed Fouad, Mahmoud Baraka, Sameh Samir, Alaa Roshdy, Yasmin AbdelRazek, Mostafa M. Abd Rabou, Ahmed Abobakr, Moemen Moaaz, Mohamed Mokhtar, Mohamed Ashry, Khaled Elkhashab, Haytham Soliman Ghareeb, Mostafa Kamal, Gomaa AbdelRazek, GizaNabil Farag, Giza:Ahmed Elbarbary, Evette Wahib, Ghada Kazamel, Diaa Kamal, Mahmoud Tantawy, Adel Alansary, Mohammed Yahia, Raouf Mahmoud, Tamer El Banna, Mohamed Atef, Gamela Nasr, Salah Ahmed, Ehab E. El Hefny, Islam Saifelyazal, Mostafa Abd El Ghany, Abd El Rahman El Hadary, Ahmed Khairy, Jyri Lommi, Mika Laine, Minna Kylmala, Katja Kankanen, Anu Turpeinen, Juha Hartikainen, Lari Kujanen, Juhani Airaksinen, Tuija Vasankari, Catherine Szymanski, Yohann Bohbot, Mesut Gun, Justine Rousseaux, Loic Biere, Victor Mateus, Martin Audonnet, Jérémy Rautureau, Charles Cornet, Emmanuel Sorbets, BourgesKarine Mear, Adi Issa, Florent Le Ven, Marie-Claire Pouliquen, Martine Gilard, Alice Ohanessian, Ali Farhat, Alina Vlase, Fkhar Said, Caroline Lasgi, Carlos Sanchez, Romain Breil, Marc Peignon, Jean-Philippe Elkaim, Virginie Jan-Blin, Sylvain Ropars BertrandM'Ban, Hélène Bardet, Samuel Sawadogo, Aurélie Muschoot, Dieudonné Tchatchoua, Simon Elhadad, Aline Maubert, Tahar Lazizi, Kais Ourghi, Philippe Bonnet, Clarisse Menager-Gangloff, Sofiene Gafsi, Djidjiga Mansouri, Victor Aboyans, Julien Magne, Elie Martins, Sarah Karm, Dania Mohty, Guillaume Briday, Amandine David, Sylvestre Marechaux, Caroline Le Goffic, Camille Binda, Aymeric Menet, Francois Delelis, Anne Ringlé, Anne-Laure Castel, Ludovic Appert, Domitille Tristram, Camille Trouillet, Yasmine Nacer, Lucas Ngoy, MarseilleGilbert Habib, Franck Thuny, Julie Haentjens, Jennifer Cautela, Cécile Lavoute, Floriane Robin, Pauline Armangau, Ugo Vergeylen, Khalil Sanhadji, Nessim Hamed Abdallah, Hassan Kerzazi, Mariana Perianu, François Plurien, Chaker Oueslati, Mathieu Debauchez, Zannis Konstantinos, Alain Berrebi, Alain Dibie, Emmanuel Lansac, Aurélie Veugeois, Christelle Diakov, Christophe Caussin, Daniel Czitrom, Suzanna Salvi, Nicolas Amabile, Patrice Dervanian, Stéphanie Lejeune, Imane Bagdadi, Yemmi Mokrane, Gilles Rouault, Jerome Abalea, Marion Leledy, Patrice Horen, Erwan Donal, Christian Bosseau, Elise Paven, Elena Galli, Edouard Collette, Jean-Marie Urien, Valentin Bridonneau, Renaud Gervais, Fabrice Bauer, Houzefa Chopra, Arthur Charbonnier, David Attias, Nesrine Dahouathi, Moukda Khounlaboud, Magalie Daudin, Christophe Thebault, Cécile Hamon, Philippe Couffon, Catherine Bellot, Maelle Vomscheid, Anne Bernard, Fanny Dion, Djedjiga Naudin, Mohammed Mouzouri, Mathilde Rudelin, Alain Berenfeld, Thibault Vanzwaelmen, Tarik Alloui, Marija Gjerakaroska Radovikj, Slavica Jordanova, Werner Scholtz, Eva Liberda-Knoke, Melanie Wiemer, Andreas Mugge, Georg Nickenig, Jan-Malte Sinning, Alexander Sedaghat, Matthias Heintzen, Jan Ballof, Daniel Frenk, Rainer Hambrecht, Harm Wienbergen, Annemarie Seidel, Rico Osteresch, Kirsten Kramer, Janna Ziemann, Ramona Schulze, Wolfgang Fehske, Clarissa Eifler, Bahram Wafaisade, Andreas Kuhn, Sören Fischer, Lutz Lichtenberg, Mareike Brunold, Judith Simons, Doris Balling, Thomas Buck, Bjoern Plicht, Wolfgang Schols, Henning Ebelt, Marwan Chamieh, Jelena Anacker, Tienush Rassaf, Alexander Janosi, Alexander Lind, Julia Lortz, Peter Lüdike, Philipp Kahlert, Harald Rittger, Gabriele Eichinger, Britta Kuhls, Stephan B. Felix, Kristin Lehnert, Ann-Louise Pedersen, Marcus Dorr, Klaus Empen, Sabine Kaczmarek, Mathias Busch, Mohammed Baly, Fikret Er, Erkan Duman, Linda Gabriel, Christof Weinbrenner, Johann Bauersachs, Julian Wider, Tibor Kempf, Michael Bohm, Paul-Christian Schulze, C. Tudor Poerner, Sven Möbius-Winkler, Karsten Lenk, Kerstin Heitkamp, Marcus Franz, Sabine Krauspe, Burghard Schumacher, Volker Windmuller, Sarah Kurwitz, Holger Thiele, Thomas Kurz, Roza Meyer-Saraei, Ibrahim Akin, Christian Fastner, Dirk Lossnitzer, Ursula Hoffmann, Martin Borggrefe, Stefan Baumann, Brigitte Kircher, Claudia Foellinger, Heike Dietz, Bernhard Schieffer, Feraydoon Niroomand, Harald Mudra, Lars Maier, Daniele Camboni, Christoph Birner, Kurt Debl, Michael Paulus, Benedikt Seither, Nour Eddine El Mokhtari, Alper Oner, Evren Caglayan, Mohammed Sherif, Seyrani Yucel, Florian Custodis, Robert Schwinger, Marc Vorpahl, Melchior Seyfarth, Ina Nover, Till Koehler, Sarah Christiani, David Calvo Sanchez, Barbel Schanze, Holger Sigusch, Athir Salman, Jane Hancock, John Chambers, Camelia Demetrescue, Claire Prendergast, Miles Dalby, Robert Smith, Paula Rogers, Cheryl Riley, Dimitris Tousoulis, Ioannis Kanakakis, Konstantinos Spargias, Konstantinos Lampropoulos, Tolis Panagiotis, Athanasios Koutsoukis, Lampros Michalis, Ioannis Goudevenos, Vasileios Bellos, Michail Papafaklis, Lampros Lakkas, George Hahalis, Athanasios Makris, Haralampos Karvounis, Vasileios Kamperidis, Vlasis Ninios, Vasileios Sachpekidis, Pavlos Rouskas, Leonidas Poulimenos, Georgios Charalampidis, Eftihia Hamodraka, Athanasios Manolis, Robert Gabor Kiss, Tunde Borsanyi, Zoltan Jarai, Andras Zsary, Elektra Bartha, Annamaria Kosztin, Alexandra Doronina, Attila Kovacs, Barabas Janos Imre, Chun Chao, Kalman Benke, Istvan Karoczkai, Kati Keltai, Zsolt Förchécz, Zoltán Pozsonyi, Zsigmond Jenei, Adam Patthy, Laszlo Sallai, Zsuzsanna Majoros, Tamás Pál, Jusztina Bencze, Ildiko Sagi, Andrea Molnar, Anita Kurczina, Gabor Kolodzey, Istvan Edes, Valeria Szatmari, Zsuzsanna Zajacz, Attila Cziraki, Adam Nemeth, Reka Faludi, Laszlone Vegh, Eva Jebelovszki, Geza Karoly Lupkovics, Zsofia Kovacs, Andras Horvath, Gezim Berisha, Pranvera Ibrahimi, Luan Percuku, Rano Arapova, Elmira Laahunova, Kseniia Neronova, Zarema Zhakypova, Gulira Naizabekova, Gulnazik Muratova, Iveta Sime, Nikolajs Sorokins, Ginta Kamzola, Irina Cgojeva-Sproge, Gita Rancane, Ramune Valentinaviciene, Laima Rudiene, Rasa Raugaliene, Aiste Bardzilauske, Regina Jonkaitiene, Jurate Petrauskaite, Monika Bieseviciene, Raimonda Verseckaite, Ruta Zvirblyte, Danute Kalibatiene, Greta Radauskaite, Gabija Janaviciute-Matuzeviciene, Dovile Jancauskaite, Deimile Balkute, Juste Maneikyte, Ingrida Mileryte, Monika Vaisvilaite, Lina Gedvilaite, Mykolas Biliukas, Vaiva Karpaviciene, Robert George Xuereb, Elton Pllaha, Roxana Djaberi, Klaudiusz Komor, Agnieszka Gorgon-Komor, Beata Loranc, Jaroslaw Myszor, Katarzyna Mizia-Stec, Adrianna Berger-Kucza, Magdalena Mizia, Mateusz Polak, Piotr Bogacki, Piotr Podolec, Monika Komar, Ewa Sedziwy, Dorota Sliwiak, Bartosz Sobien, Beata Rog, Marta Hlawaty, Urszula Gancarczyk, Natasza Libiszewska, Danuta Sorysz, Andrzej Gackowski, Malgorzata Cieply, Agnieszka Misiuda, Franciszek Racibor, Anna Nytko, Kazimierz Widenka, Maciej Kolowca, Janusz Bak, Andrzej Curzytek, Mateusz Regulski, Malgorzata Kamela, Mateusz Wisniowski, Tomasz Hryniewiecki, Piotr Szymanski, Monika Rozewicz, Maciej Grabowski, Andrzej Budaj, Beata Zaborska, Ewa Pilichowska-Paskiet, Malgorzata Sikora-Frac, Tomasz Slomski, Isabel Joao, Ines Cruz, Hélder Pereira, Rita Cale, Ana Marques, Ana Rita Pereira, Carlos Morais, Antonio Freitas, David Roque, Nuno Antunes, Antonio Costeira Pereira, Catarina Vieira, Nuno Salome, Juliana Martins, Isabel Campos, Goncalo Cardoso, Claudia Silva, Afonso Oliveira, Mariana Goncalves, Rui Martins, Nuno Quintal, Bruno Mendes, Joseline Silva, Joao Ferreira, James Milner, Patricia Alves, Vera Marinho, Paula Gago, Jose Amado, Joao Bispo, Dina Bento, Inocencia Machado, Margarida Oliveira, Lucy Calvo, Pedro von Hate, Bebiana Faria, Ana Galrinho, Luisa Branco, Antonio Goncalves, Tiago Mendonca, Mafalda Selas, Filipe Macedo, Carla Sousa, Sofia Cabral, Filomena Oliveira, Maria Trepa, Marta Fontes-Oliveira, Alzira Nunes, Paulo Araújo, Vasco Gama Ribeiro, Joao Almeida, Alberto Rodrigues, Pedro Braga, Sonia Dias, Sofia Carvalho, Catarina Ferreira, Alberto Ferreira, Pedro Mateus, Miguel Moz, Silvia Leao, Renato Margato, Ilidio Moreira, Jose Guimanaes, Joana Ribeiro, Fernando Goncalves, Jose Cabral, Ines Almeida, Luisa Goncalves, Mariana Tarusi, Calin Pop, Claudia Matei, Diana Tint, Sanziana Barbulescu, Sorin Micu, Ioana Pop, Costica Baba, Doina Dimulescu, Maria Dorobantu, Carmen Ginghina, Roxana Onut, Andreea Popescu, Brandusa Zamfirescu, Raluca Aflorii, Mihaela Popescu, Liviu Ghilencea, Andreeea Rachieru, Monica Stoian, Nicoleta Oprescu, Silvia Iancovici, Iona Petre, Anca Doina Mateescu, Andreea Calin, Simona Botezatu, Roxana Enache, Monica Rosca, Daniela Ciuperca, Evelyn Babalac, Ruxandra Beyer, Laura Cadis, Raluca Rancea, Raluca Tomoaia, Adela Rosianu, Emese Kovacs, Constantin Militaru, Alina Craciun, Oana Mirea, Mihaela Florescu, Lucica Grigorica, Daniela Dragusin, Luiza Nechita, Mihai Marinescu, Teodor Chiscaneanu, Lucia Botezatu, Costela Corciova, Antoniu Octavian Petris, Catalina Arsenescu-Georgescu, Delia Salaru, Dan Mihai Alexandrescu, Carmjen Plesoianu, Ana Tanasa, Ovidiu Mitu, Irina Iuliana Costache, Ionut Tudorancea, Catalin Usurelu, Gabriela Eminovici, Ioan Manitiu, Oana Stoia, Adriana Mitre, Dan-Octavian Nistor, Anca Maier, Silvia Lupu, Mihaela Opris, Adina Ionac, Irina Popescu, Simina Crisan, Cristian Mornos, Flavia Goanta, Liana Gruescu, Oana Voinescu, Madalina Petcu, Ramona Cozlac, Elena Damrina, Liliya Khilova, Irina Ryazantseva, Dmitry Kozmin, Maria Kiseleva, Marina Goncharova, Kamila Kitalaeva, Victoria Demetskay, Artem Verevetinov, Mikhail Fomenko, Elena Skripkina, Viktor Tsoi, Georgii Antipov, Yuri Schneider, Denis Yazikov, Marina Makarova, Aleksei Cherkes, Natalya Ermakova, Aleksandr Medvedev, Anastasia Sarosek, Mikhail Isayan, Tatyana Voronova, Oleg Kulumbegov, Alina Tuchina, Sergei Stefanov, Margarita Klimova, Konstantin Smolyaninov, Zhargalma Dandarova, Victoriya Magamet, Natalia Spiropulos, Sergey Boldyrev, Kirill Barbukhatty, Dmitrii Buyankov, Vladimir Yurin, Yuriy Gross, Maksim Boronin, Mariya Mikhaleva, Mariya Shablovskaya, Alex Zotov, Daniil Borisov, Vasily Tereshchenko, Ekaterina Zubova, A. Kuzmin, Ivan Tarasenko, Alishir Gamzaev, Natalya Borovkova, Tatyana Koroleva, Svetlana Botova, Ilya Pochinka, Vera Dunaeva, Victoria Teplitskaya, Elena I. Semenova, Olga V. Korabel'Nikova, Denis S. Simonov, Elena Denisenko, Natalia Harina, Natalia Yarohno, Svetlana Alekseeva, Julia Abydenkova, Lyubov Shabalkina, Olga Mayorova, Valeriy Tsechanovich, Igor Medvedev, Michail Lepilin, PenzaEvgenii Nemchenko, Vadim Karnahin, Vasilya Safina, Yaroslav Slastin, Venera Gilfanova, Roman Gorbunov, Ramis Jakubov, Aigul Fazylova, Mansur Poteev, Laysan Vazetdinova, Indira Tarasova, Rishat Irgaliyev, Olga Moiseeva, Mikhail Gordeev, Olga Irtyuga, Raisa Moiseeva, Nina Ostanina, Dmitry Zverev, Patimat Murtazalieva, Dmitry Kuznetsov, Mariya Skurativa, Larisa Polyaeva, Kirill Mihaiilov, Biljana Obrenovic-Kircanski, Svetozar Putnik, Dragan Simic, Milan Petrovic, Natasa Markovic Nikolic, Ljiljana Jovovic, Dimitra Kalimanovska Ostric, Milan Brajovic, Milica Dekleva Manojlovic, Vladimir Novakovic, Danijela Zamaklar-Trifunovic, Bojana Orbovic, Olga Petrovic, Marija Boricic-Kostic, Kristina Andjelkovic, Marko Milanov, Maja Despotovic-Nikolic, Sreten Budisavljevic, Sanja Veljkovic, Nataša Cvetinovic, Daniijela Lepojevic, Aleksandra Todorovic, Aleksandra Nikolic, Branislava Borzanovic, Ljiljana Trkulja, Slobodan Tomic, Milan Vukovic, Jelica Milosavljevic, Mirjana Milanovic, Vladan Stakic, Aleksandra Cvetkovic, Suzana Milutinovic, Olivera Bozic, Miodrag Miladinovic, Zoran Nikolic, Dinka Despotovic, Dimitrije Jovanovic, Anastazija Stojsic-Milosavljevic, Aleksandra Ilic, Mirjana Sladojevic, Stamenko Susak, Srdjan Maletin, Salvo Pavlovic, Vladimir Kuzmanovic, Nikola Ivanovic, Jovana Dejanovic, Dusan Ruzicic, Dragana Drajic, Danijel Cvetanovic, Marija Mirkovic, Jon Omoran, Roman Margoczy, Katarina Sedminova, Adriana Reptova, Eva Baranova, Tatiana Valkovicova, Gabriel Valocik, Marian Kurecko, Marianna Vachalcova, Alzbeta Kollarova, Martin Studencan, Daniel Alusik, Marek Kozlej, Jana Macakova, Sergio Moral, Merce Cladellas, Daniele Luiso, Alicia Calvo, Jordi Palet, Juli Carballo, Gisela Teixido Tura, Giuliana Maldonado, Laura Gutierrez, Teresa Gonzalez-Alujas, Rodriguez Palomares Jose Fernando, Nicolas Villalva, Ma Jose Molina-Mora, Ramon Rubio Paton, Juan Jose Martinez Diaz, Pablo Ramos Ruiz, Alfonso Valle, Ana Rodriguez, Edgardo Alania, Emilio Galcera, Julia Seller, Gonzalo de la Morena Valenzuela, Daniel Saura Espin, Dolores Espinosa Garcia, Maria Jose Oliva Sandoval, Josefa Gonzalez, Miguel Garcia Navarro, Maria Teresa Perez-Martinez, Jose Ramon Ortega Trujillo, Irene Menduina Gallego, Daniel San Roman, Eliu David Perez Nogales, Olga Medina, Rodolfo Antonio Montiel Quintero, Pablo Felipe Bujanda Morun, Marta Lopez Perez, Jimmy Plasencia Huaripata, Juan Jose Morales Gonzalez, Veronica Quevedo Nelson, Jose Luis Zamorano, Ariana Gonzalez Gomez, Alfonso Fraile, Maria Teresa Alberca, Joaquin Alonso Martin, Covadonga Fernandez-Golfin, Javier Ramos, Sergio Hernandez Jimenez, Cristina Mitroi, Pedro L. Sanchez Fernandez, Elena Diaz-Pelaez, Beatriz Garde, Luis Caballero, Fermin Martinez Garcia, Francisco Cambronero, Noelia Castro, Antonio Castro, Alejandro De La Rosa, Pastora Gallego, Irene Mendez, David Villagomez Villegas, Manuel Gonzalez Correa, Roman Calvo, Francisco Florian, Rafael Paya, Esther Esteban, Francisco Buendia, Andrés Cubillos, Carmen Fernandez, Juan Pablo Cárdenas, José Leandro Pérez-Boscá, Joan Vano, Joaquina Belchi, Cristina Iglesia-Carreno, Francisco Calvo Iglesias, Aida Escudero-Gonzalez, Sergio Zapateria-Lucea, Juan Sterling Duarte, Lara Perez-Davila, Rafael Cobas-Paz, Rosario Besada-Montenegro, Maribel Fontao-Romeo, Elena Lopez-Rodriguez, Emilio Paredes-Galan, Berenice Caneiro-Queija, Alba Guitian Gonzalez, Abdi Bozkurt, Serafettin Demir, Durmus Unlu, Caglar Emre Cagliyan, Muslum Firat Ikikardes, Mustafa Tangalay, Osman Kuloglu, Necla Ozer, Ugur Canpolat, Melek Didem Kemaloglu, Abdullah Orhan Demirtas, Didar Elif Akgün, Eyup Avci, Gokay Taylan, Mustafa Adem Yilmaztepe, Fatih Mehmet Ucar, Servet Altay, Muhammet Gurdogan, Naile Eris Gudul, Mujdat Aktas, Mutlu Buyuklu, Husnu Degirmenci, Mehmet Salih Turan, Kadir Ugur Mert, Gurbet Ozge Mert, Muhammet Dural, Sukru Arslan, Nurten Sayar, Batur Kanar, Beste Ozben Sadic, Ahmet Anil Sahin, Ahmet Buyuk, Onur Kilicarslan, Cem Bostan, Tarik Yildirim, Seda Elcim Yildirim, Kahraman Cosansu, Perihan Varim, Ersin Ilguz, Recep Demirbag, Asuman Yesilay, Abdullah Cirit, Eyyup Tusun, Emre Erkus, Muhammet Rasit Sayin, Zeynep Kazaz, Selim Kul, Turgut Karabag, Belma Kalayci, Clinical sciences, Cardio-vascular diseases, and Cardiology
Subjects: Male, medicine.medical_specialty, Multivariate analysis, Clinical Decision-Making, Risk Assessment, Severity of Illness Index, decision making, surgery, Risk Factors, Internal medicine, Intervention (counseling), medicine, Clinical endpoint, Humans, 03.02. Klinikai orvostan, guidelines, Symptomatic aortic stenosis, Aged, Retrospective Studies, Aged, 80 and over, business.industry, valvular heart disease, Disease Management, aortic stenosis, Aortic Valve Stenosis, Odds ratio, medicine.disease, Europe, Stenosis, Treatment Outcome, Echocardiography, Aortic Valve, Charlson comorbidity index, transcatheter aortic valve replacement, Female, Morbidity, Cardiology and Cardiovascular Medicine, business, Follow-Up Studies, surgical aortic valve replacement
Abstract: BACKGROUND There were gaps between guidelines and practice when surgery was the only treatment for aortic stenosis (AS). OBJECTIVES This study analyzed the decision to intervene in patients with severe AS in the EORP VHD (EURObservational Research Programme Valvular Heart Disease) II survey. METHODS Among 2,152 patients with severe AS, 1,271 patients with high-gradient AS who were symptomatic fulfilled a Class I recommendation for intervention according to the 2012 European Society of Cardiology guidelines; the primary end point was the decision for intervention. RESULTS A decision not to intervene was taken in 262 patients (20.6%). In multivariate analysis, the decision not to intervene was associated with older age (odds ratio [OR]: 1.34 per 10-year increase; 95% CI: 1.11 to 1.61; P = 0.002), New York Heart Association functional classes I and II versus III (OR: 1.63; 95% CI: 1.16 to 2.30; P = 0.005), higher age adjusted Charlson comorbidity index (OR: 1.09 per 1-point increase; 95% CI: 1.01 to 1.17; P = 0.03), and a lower transaortic mean gradient (OR: 0.81 per 10-mm Hg decrease; 95% CI: 0.71 to 0.92; P < 0.001). During the study period, 346 patients (40.2%, median age 84 years, median EuroSCORE II [European System for Cardiac Operative Risk Evaluation II] 3.1%) underwent transcatheter intervention and 515 (59.8%, median age 69 years, median EuroSCORE II 1.5%) underwent surgery. A decision not to intervene versus intervention was associated with lower 6-month survival (87.4%; 95% CI: 82.0 to 91.3 vs 94.6%; 95% CI: 92.8 to 95.9; P < 0.001). CONCLUSIONS A decision not to intervene was taken in 1 in 5 patients with severe symptomatic AS despite a Class I recommendation for intervention and the decision was particularly associated with older age and combined comorbidities. Transcatheter intervention was extensively used in octogenarians. (J Am Coll Cardiol 2021;78:2131-2143) (c) 2021 by the American College of Cardiology Foundation.
Published: 2021
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32. Non-inferiority of 1 month

Author: Gani, Bajraktari, Ibadete, Bytyçi, Artan, Bajraktari, and Michael Y, Henein
Abstract: The aim of this meta-analysis was to evaluate the safety of 1-month dual antiplatelet therapy (DAPT) followed by aspirin or a P2Y12 receptor inhibitor, after percutaneous coronary intervention (PCI) with drug-eluting stents (DES), based on the available evidence.PubMed, MEDLINE, Embase, Scopus, Google Scholar, CENTRAL, and ClinicalTrials.gov database search identified four RCTs of 26,431 patients who underwent PCI with DES and compared 1-monthCompared with1-month DAPT, the 1-month DAPT was associated with a similar rate of major bleeding (OR = 0.74, 95%CI: 0.51-1.07,This meta-analysis proved the non-inferiority of 1-month DAPT followed by aspirin or a P2Y12 receptor inhibitor compared with long-term DAPT in patients undergoing PCI with DES.
Published: 2021

33. Left atrial structure and function predictors of recurrent fibrillation after catheter ablation: a systematic review and meta‐analysis

Author: Ibadete Bytyçi, Gani Bajraktari, and Michael Y. Henein
Subjects: medicine.medical_specialty, Physiology, Left atrial structure, medicine.medical_treatment, Left atrium, Catheter ablation, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Recurrence, Physiology (medical), Internal medicine, Atrial Fibrillation, medicine, Humans, Heart Atria, Fibrillation, business.industry, Conventional treatment, Atrial fibrillation, 030229 sport sciences, General Medicine, medicine.disease, Treatment Outcome, medicine.anatomical_structure, Meta-analysis, Catheter Ablation, cardiovascular system, Cardiology, Atrial Function, Left, medicine.symptom, business, High recurrence rate
Abstract: Catheter ablation (CA) has become a conventional treatment for atrial fibrillation (AF), but remains with high recurrence rate. The aim of this meta-analysis was to determine left atrial (LA) structure and function indices that predict recurrence of AF.We systematically searched PubMed-Medline, EMBASE, Scopus, Google Scholar and the Cochrane Central Registry, up to September 2017 in order to select clinical trials and observational studies which reported echocardiographic predictors of AF recurrence after CA. Eighty-five articles with a total of 16 126 patients were finally included.The pooled analysis showed that after a follow-up period of 21 ± 12 months, patients with AF recurrence had larger LA diameter with weighted mean difference (WMD: 2·99 ([95% CI 2·50-3·47], P0·001), larger LA volume index (LAVI) maximal and LAVI minimal (P0·0001 for both), larger LA area (P0·0001), lower LA strain (P0·0001) and lower LA total emptying fraction (LA EF) (P0·0001) compared with those without AF recurrence. The most powerful LA predictors (in accuracy order) of AF recurrence were as follows: LA strain19% (OR: 3·1[95% CI, -1.3-10·4], P0·0001), followed by LA diameter ≥50 mm (OR: 2·75, [95% CI 1·66-4·56,] P0·0001), and LAVmax150 ml (OR: 2·25, [95% CI, 1.1-5·6], P = 0·0002).Based on this meta-analysis results, a dilated left atrium with diameter more than 50 mm and volume above 150 ml or myocardial strain below 19% reflect an unstable LA that is unlikely to hold sinus rhythm after catheter ablation for atrial fibrillation.
Published: 2019
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34. Compromised left atrial function and increased size predict raised cavity pressure: a systematic review and meta‐analysis

Author: Gani Bajraktari, Ibadete Bytyçi, Per Lindqvist, and Michael Y. Henein
Subjects: Male, Cardiac Catheterization, medicine.medical_specialty, Heart Diseases, Physiology, 030204 cardiovascular system & hematology, Left atrial strain, Ventricular Function, Left, 03 medical and health sciences, Atrial Pressure, 0302 clinical medicine, Predictive Value of Tests, Left atrial, Physiology (medical), Internal medicine, Ventricular Pressure, medicine, Humans, Heart Atria, Pulmonary Wedge Pressure, Pulmonary wedge pressure, Cavity pressure, Aged, business.industry, Reproducibility of Results, Atrial Remodeling, 030229 sport sciences, General Medicine, Middle Aged, Myocardial function, Echocardiography, Meta-analysis, Cardiology, Atrial Function, Left, Female, business
Abstract: This meta-analysis assesses left atrial (LA) cavity and myocardial function measurements that predict pulmonary capillary wedge pressure (PCWP).PubMed-MEDLINE, EMBASE, Scopus, Google Scholar and the Cochrane Central Registry were searched up to December 2018 for studies on the relationship of LA diameter, LA indexed volume (LAVI max, LAVI min), peak atrial longitudinal (PALS), peak atrial contraction (PACS) strain and total emptying fraction (LAEF) with PCWP. Eighteen studies with 1343 patients were included. Summary sensitivity and specificity (with 95% CI) for evaluation of diagnostic accuracy and the best cut-off values for different LA indices in predicting raised PCWP were estimated using summary receiver operating characteristic analysis.The pooled analysis showed association between PCWP and LA diameter: Cohen's d = 0·87, LAVI max: d = 0·92 and LAVI min: d = 1·0 (P0·001 for all). A stronger correlation was found between PCWP and PALS: d = 1·26, and PACS: d = 1·62, total EF d = 1·22 (P0·0001 for all). PALS ≤19% had a summary sensitivity of 80% (65-90) and summary specificity of 77% (52-92), positive likelihood ratio (LR+) 3·74, negative likelihood ratio (LR-)0·25 and DOR 15·1 whereas LAVI ≥34 ml mCompromised LA myocardial function and increased size predict raised cavity pressure. These results should assist in optimum follow-up of patients with fluctuating LA pressure.
Published: 2019
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35. Impact of nutraceuticals on markers of systemic inflammation: Potential relevance to cardiovascular diseases - A position paper from the International Lipid Expert Panel (ILEP)

Author: Massimiliano Ruscica, Peter E. Penson, Nicola Ferri, Cesare R. Sirtori, Matteo Pirro, G.B. John Mancini, Naveed Sattar, Peter P. Toth, Amirhossein Sahebkar, Carl J. Lavie, Nathan D. Wong, Maciej Banach, Julio Acosta, Mutaz Al-Khnifsawi, Fahad Alnouri, Fahma Amar, Atanas G. Atanasov, Gani Bajraktari, Sonu Bhaskar, Bojko Bjelakovic, Eric Bruckert, Richard Ceska, Arrigo F.G. Cicero, Xavier Collet, Olivier Descamps, Dragan Djuric, Ronen Durst, Marat V. Ezhov, Zlatko Fras, Dan Gaita, Adrian V. Hernandez, Steven R. Jones, Jacek Jozwiak, Nona Kakauridze, Amani Kallel, Niki Katsiki, Amit Khera, Karam Kostner, Raimondas Kubilius, Gustavs Latkovskis, A. David Marais, Seth S. Martin, Julio Acosta Martinez, Mohsen Mazidi, Dimitri P. Mikhailidis, Erkin Mirrakhimov, Andre R. Miserez, Olena Mitchenko, Natalya P. Mitkovskaya, Patrick M. Moriarty, Seyed Mohammad Nabavi, Devaki Nair, Demosthenes B. Panagiotakos, György Paragh, Daniel Pella, Zaneta Petrulioniene, Arman Postadzhiyan, Raman Puri, Ashraf Reda, Željko Reiner, Dina Radenkovic, Michał Rakowski, Jemaa Riadh, Dimitri Richter, Manfredi Rizzo, Maria-Corina Serban, Abdulla M.A. Shehab, Aleksandr B. Shek, Claudia Stefanutti, Tomasz Tomasik, Margus Viigimaa, Pedro Valdivielso, Dragos Vinereanu, Branislav Vohnout, Stephan von Haehling, Michal Vrablik, Hung-I Yeh, Jiang Zhisheng, Andreas Zirlik, Ruscica M, Penson PE, Ferri N, Sirtori CR, Pirro M, Mancini GBJ, Sattar N, Toth PP, Sahebkar A, Lavie CJ, Wong ND, Banach M, International Lipid Expert Panel (ILEP) and International Lipid Expert Panel Experts, Cicero AFG, Ruscica M., Penson P.E., Ferri N., Sirtori C.R., Pirro M., Mancini G.B.J., Sattar N., Toth P.P., Sahebkar A., Lavie C.J., Wong N.D., Banach M., Acosta J., Al-Khnifsawi M., Alnouri F., Amar F., Atanasov A.G., Bajraktari G., Bhaskar S., Bjelakovic B., Bruckert E., Ceska R., Cicero A.F.G., Collet X., Descamps O., Djuric D., Durst R., Ezhov M.V., Fras Z., Gaita D., Hernandez A.V., Jones S.R., Jozwiak J., Kakauridze N., Kallel A., Katsiki N., Khera A., Kostner K., Kubilius R., Latkovskis G., Marais A.D., Martin S.S., Martinez J.A., Mazidi M., Mikhailidis D.P., Mirrakhimov E., Miserez A.R., Mitchenko O., Mitkovskaya N.P., Moriarty P.M., Nabavi S.M., Nair D., Panagiotakos D.B., Paragh G., Pella D., Petrulioniene Z., Postadzhiyan A., Puri R., Reda A., Reiner Z., Radenkovic D., Rakowski M., Riadh J., Richter D., Rizzo M., Serban M.-C., Shehab A.M.A., Shek A.B., Stefanutti C., Tomasik T., Viigimaa M., Valdivielso P., Vinereanu D., Vohnout B., von Haehling S., Vrablik M., Yeh H.-I., Zhisheng J., Zirlik A., and UCL - (SLuc) Service de pathologie cardiovasculaire
Subjects: RM, Arterial disease, Anti-Inflammatory Agents, Inflammation, Disease, C-reactive protein, cardiovascular disease, inflammation, nutraceuticals, omega-3, position paper, red-yeast rice, 030204 cardiovascular system & hematology, Bioinformatics, Systemic inflammation, 03 medical and health sciences, 0302 clinical medicine, Nutraceutical, Medicine, Humans, Position paper, 030212 general & internal medicine, Uncategorized, Omega-3, biology, Cardiovascular disease, Nutraceuticals, Red-yeast rice, Biomarkers, Cardiovascular Diseases, Lipids, Dietary Supplements, Vascular inflammation, business.industry, C-reactive protein, Cardiovascular disease, Inflammation, Nutraceuticals, Omega-3, Position paper, Red-yeast rice, Anti-Inflammatory Agents, Biomarkers, Cardiovascular Diseases, Humans, Inflammation, Lipids, Dietary Supplements, biology.protein, medicine.symptom, Cardiology and Cardiovascular Medicine, business
Abstract: Inflammation is a marker of arterial disease stemming from cholesterol-dependent to -independent molecular mechanisms. In recent years, the role of inflammation in atherogenesis has been underpinned by pharmacological approaches targeting systemic inflammation that have led to a significant reduction in cardiovascular disease (CVD) risk. Although the use of nutraceuticals to prevent CVD has largely focused on lipid-lowering (e.g, red-yeast rice and omega-3 fatty acids), there is growing interest and need, especially now in the time of coronavirus pandemic, in the use of nutraceuticals to reduce inflammatory markers, and potentially the inflammatory CVD burden, however, there is still not enough evidence to confirm this. Indeed, diet is an important lifestyle determinant of health and can influence both systemic and vascular inflammation, to varying extents, according to the individual nutraceutical constituents. Thus, the aim of this Position Paper is to provide the first attempt at recommendations on the use of nutraceuticals with effective anti-inflammatory properties.
Published: 2021

36. Biomarkers predict in-hospital major adverse cardiac events in covid-19 patients : A multicenter international study

Author: Michael Y. Henein, Giulia Elena Mandoli, Maria Concetta Pastore, Nicolò Ghionzoli, Fouhad Hasson, Muhammad K. Nisar, Mohammed Islam, Francesco Bandera, Massimiliano M. Marrocco-Trischitta, Irene Baroni, Alessandro Malagoli, Luca Rossi, Andrea Biagi, Rodolfo Citro, Michele Ciccarelli, Angelo Silverio, Giulia Biagioni, Joseph A. Moutiris, Federico Vancheri, Giovanni Mazzola, Giulio Geraci, Liza Thomas, Mikhail Altman, John Pernow, Mona Ahmed, Ciro Santoro, Roberta Esposito, Guillem Casas, Rubén Fernández-Galera, Maribel Gonzalez, Jose Rodriguez Palomares, Ibadete Bytyçi, Frank Lloyd Dini, Paolo Cameli, Federico Franchi, Gani Bajraktari, Luigi Paolo Badano, Matteo Cameli, Institut Català de la Salut, [Henein MY] Department of Public Health and Clinical Medicine, Umeå University, 90187 Umeå, Sweden. St George London and Brunel Universities, London SW17 0QT, UK. [Mandoli GE, Pastore MC, Ghionzoli N] Department of Medical Biotechnologies, Division of Cardiology, University of Siena, 53100 Siena, Italy. [Hasson F, Nisar MK] Luton and Dunstable University Hospital, NHS Foundation Trust, Luton LU4 0DZ, UK. [Casas G, Fernández-Galera R, Gonzalez M, Rodriguez Palomares J] Servei de Cardiologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain, Vall d'Hebron Barcelona Hospital Campus, Henein, M, Mandoli, G, Pastore, M, Ghionzoli, N, Hasson, F, Nisar, M, Islam, M, Bandera, F, Marrocco-Trischitta, M, Baroni, I, Malagoli, A, Rossi, L, Biagi, A, Citro, R, Ciccarelli, M, Silverio, A, Biagioni, G, Moutiris, J, Vancheri, F, Mazzola, G, Geraci, G, Thomas, L, Altman, M, Pernow, J, Ahmed, M, Santoro, C, Esposito, R, Casas, G, Fernandez-Galera, R, Gonzalez, M, Palomares, J, Bytyci, I, Dini, F, Cameli, P, Franchi, F, Bajraktari, G, Badano, L, and Cameli, M
Subjects: COVID-19, SARS-CoV2, biomarkers, troponin, creatinine, prognosis, Kardiologi, Cardiovascular Diseases [DISEASES], Prognosi, Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections [DISEASES], Biomarker, MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, Epidemiology and Biostatistics::Epidemiology::Health-Disease Process::Prognosis [PUBLIC HEALTH], General Medicine, epidemiología y bioestadística::epidemiología::proceso salud-enfermedad::pronóstico [SALUD PÚBLICA], Sistema cardiovascular - Malalties, Prognosis, COVID-19 (Malaltia), Article, Troponin, Creatinine, virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus [ENFERMEDADES], Medicine, Cardiac and Cardiovascular Systems, Biomarkers, enfermedades cardiovasculares [ENFERMEDADES]
Abstract: COVID-19; Biomarkers; Creatinine COVID-19; Biomarcadores; Creatinina COVID-19; Biomarcadors; Creatinina Background: The COVID-19 pandemic carries a high burden of morbidity and mortality worldwide. We aimed to identify possible predictors of in-hospital major cardiovascular (CV) events in COVID-19. Methods: We retrospectively included patients hospitalized for COVID-19 from 10 centers. Clinical, biochemical, electrocardiographic, and imaging data at admission and medications were collected. Primary endpoint was a composite of in-hospital CV death, acute heart failure (AHF), acute myocarditis, arrhythmias, acute coronary syndromes (ACS), cardiocirculatory arrest, and pulmonary embolism (PE). Results: Of the 748 patients included, 141(19%) reached the set endpoint: 49 (7%) CV death, 15 (2%) acute myocarditis, 32 (4%) sustained-supraventricular or ventricular arrhythmias, 14 (2%) cardiocirculatory arrest, 8 (1%) ACS, 41 (5%) AHF, and 39 (5%) PE. Patients with CV events had higher age, body temperature, creatinine, high-sensitivity troponin, white blood cells, and platelet counts at admission and were more likely to have systemic hypertension, renal failure (creatinine ≥ 1.25 mg/dL), chronic obstructive pulmonary disease, atrial fibrillation, and cardiomyopathy. On univariate and multivariate analysis, troponin and renal failure were associated with the composite endpoint. Kaplan–Meier analysis showed a clear divergence of in-hospital composite event-free survival stratified according to median troponin value and the presence of renal failure (Log rank p < 0.001). Conclusions: Our findings, derived from a multicenter data collection study, suggest the routine use of biomarkers, such as cardiac troponin and serum creatinine, for in-hospital prediction of CV events in patients with COVID-19.
Published: 2021

37. Correction to: Association of statin use and clinical outcomes in heart failure patients: a systematic review and meta-analysis

Author: Maciej Banach, Stephan von Haehling, Gani Bajraktari, Adrian V. Hernandez, Ibadete Bytyçi, Jacek Rysz, Stefan D. Anker, Jacek Jerzy Jozwiak, Agata Bielecka-Dabrowa, and Dimitri P. Mikhailidis
Subjects: medicine.medical_specialty, business.industry, Clinical chemistry, Endocrinology, Diabetes and Metabolism, Biochemistry (medical), Clinical Biochemistry, Correction, Clinical nutrition, Statin treatment, medicine.disease, lcsh:Nutritional diseases. Deficiency diseases, Endocrinology, Text mining, Meta-analysis, Heart failure, Medicine, business, Association (psychology), Intensive care medicine, lcsh:RC620-627, Lipidology
Abstract: An amendment to this paper has been published and can be accessed via the original article.
Published: 2020

38. Corrigendum to '2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk' [Atherosclerosis 290 (2019) 140–205]

Author: Francois Mach, Colin Baigent, Alberico L. Catapano, Konstantinos C. Koskinas, Manuela Casula, Lina Badimon, M. John Chapman, Guy G. De Backer, Victoria Delgado, Brian A. Ference, Ian M. Graham, Alison Halliday, Ulf Landmesser, Borislava Mihaylova, Terje R. Pedersen, Gabriele Riccardi, Dimitrios J. Richter, Marc S. Sabatine, Marja-Riitta Taskinen, Lale Tokgozoglu, Olov Wiklund, Djamaleddine Nibouche, Parounak H. Zelveian, Peter Siostrzonek, Ruslan Najafov, Philippe van de Borne, Belma Pojskic, Arman Postadzhiyan, Lambros Kypris, Jindřich Špinar, Mogens Lytken Larsen, Hesham Salah Eldin, Margus Viigimaa, Timo E. Strandberg, Jean Ferrieres, Rusudan Agladze, Ulrich Laufs, Loukianos Rallidis, Laszlo Bajnok, Thorbjorn Gudjonsson, Vincent Maher, Yaakov Henkin, Michele Massimo Gulizia, Aisulu Mussagaliyeva, Gani Bajraktari, Alina Kerimkulova, Gustavs Latkovskis, Omar Hamoui, Rimvydas Slapikas, Laurent Visser, Philip Dingli, Victoria Ivanov, Aneta Boskovic, Mbarek Nazzi, Frank Visseren, Irena Mitevska, Kjetil Retterstol, Piotr Jankowski, Ricardo Fontes-Carvalho, Dan Gaita, Marat Ezhov, Marina Foscoli, Vojislav Giga, Daniel Pella, Zlatko Fras, Leopoldo Perez de Isla, Emil Hagstrom, Roger Lehmann, Leila Abid, Oner Ozdogan, Olena Mitchenko, Riyaz S. Patel, Stephan Windecker, Victor Aboyans, Jean-Philippe Collet, Veronica Dean, Donna Fitzsimons, Chris P. Gale, Diederick Grobbee, Sigrun Halvorsen, Gerhard Hindricks, Bernard Iung, Peter Juni, Hugo A. Katus, Christophe Leclercq, Maddalena Lettino, Basil S. Lewis, Bela Merkely, Christian Mueller, Steffen Petersen, Anna Sonia Petronio, Marco Roffi, Evgeny Shlyakhto, Iain A. Simpson, Miguel Sousa-Uva, and Rhian M. Touyz
Subjects: Cardiology and Cardiovascular Medicine
Published: 2020
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39. Erratum to '2019 ESC/EAS guidelines for the management of dyslipidemias: Lipid modification to reduce cardiovascular risk' [Atherosclerosis 290 (2019) 140–205]

Author: Francois Mach, Colin Baigent, Alberico L. Catapano, Konstantinos C. Koskinas, Manuela Casula, Lina Badimon, M. John Chapman, Guy G. De Backer, Victoria Delgado, Brian A. Ference, Ian M. Graham, Alison Halliday, Ulf Landmesser, Borislava Mihaylova, Terje R. Pedersen, Gabriele Riccardi, Dimitrios J. Richter, Marc S. Sabatine, Marja-Riitta Taskinen, Lale Tokgozoglu, Olov Wiklund, Djamaleddine Nibouche, Parounak H. Zelveian, Peter Siostrzonek, Ruslan Najafov, Philippe van de Borne, Belma Pojskic, Arman Postadzhiyan, Lambros Kypris, Jindřich Špinar, Mogens Lytken Larsen, Hesham Salah Eldin, Margus Viigimaa, Timo E. Strandberg, Jean Ferrieres, Rusudan Agladze, Ulrich Laufs, Loukianos Rallidis, Laszlo Bajnok, Thorbjorn Gudjonsson, Vincent Maher, Yaakov Henkin, Michele Massimo Gulizia, Aisulu Mussagaliyeva, Gani Bajraktari, Alina Kerimkulova, Gustavs Latkovskis, Omar Hamoui, Rimvydas Slapikas, Laurent Visser, Philip Dingli, Victoria Ivanov, Aneta Boskovic, Mbarek Nazzi, Frank Visseren, Irena Mitevska, Kjetil Retterstol, Piotr Jankowski, Ricardo Fontes-Carvalho, Dan Gaita, Marat Ezhov, Marina Foscoli, Vojislav Giga, Daniel Pella, Zlatko Fras, Leopoldo Perez de Isla, Emil Hagstrom, Roger Lehmann, Leila Abid, Oner Ozdogan, Olena Mitchenko, Riyaz S. Patel, Stephan Windecker, Victor Aboyans, Jean-Philippe Collet, Veronica Dean, Donna Fitzsimons, Chris P. Gale, Diederick Grobbee, Sigrun Halvorsen, Gerhard Hindricks, Bernard Iung, Peter Juni, Hugo A. Katus, Christophe Leclercq, Maddalena Lettino, Basil S. Lewis, Bela Merkely, Christian Mueller, Steffen Petersen, Anna Sonia Petronio, Marco Roffi, Evgeny Shlyakhto, Iain A. Simpson, Miguel Sousa-Uva, and Rhian M. Touyz
Subjects: 03 medical and health sciences, 0302 clinical medicine, business.industry, Medicine, 030209 endocrinology & metabolism, 030204 cardiovascular system & hematology, Lipid modification, Cardiology and Cardiovascular Medicine, Bioinformatics, business
Published: 2020
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40. Complete revascularization for patients with multivessel coronary artery disease and ST-segment elevation myocardial infarction after the COMPLETE trial: A meta-analysis of randomized controlled trials

Author: Michael Y. Henein, Ali Ahmed, Fernando Alfonso, Haki Jashari, Deepak L. Bhatt, Gani Bajraktari, Ibadete Bytyçi, and UAM. Departamento de Medicina
Subjects: lcsh:Diseases of the circulatory (Cardiovascular) system, medicine.medical_specialty, Medicina, medicine.medical_treatment, 030204 cardiovascular system & hematology, Revascularization, Culprit, Coronary artery disease, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Internal medicine, medicine, Cardiac and Cardiovascular Systems, 030212 general & internal medicine, Myocardial infarction, cardiovascular diseases, Original Paper, Kardiologi, business.industry, Percutaneous coronary intervention, Infarct artery only revascularization, Multi-vessel disease, medicine.disease, ST-segment elevation myocardial infarction, lcsh:RC666-701, Conventional PCI, Cardiology, Cardiology and Cardiovascular Medicine, business, Complete revascularization, Mace
Abstract: Background: The recently published COMPLETE trial has demonstrated that patients with ST-segment elevation myocardial infarction (STEMI) and multivessel coronary artery disease (MVD), who underwent successful percutaneous coronary intervention (PCI) of both culprit and non-culprit (vs. culprit-only) lesions had a reduced risk of major adverse cardiac events (MACE), but not of cardiovascular or total mortality. The aim of this meta-analysis was to assess the efficacy of complete revascularization on cardiovascular or total mortality reduction using available randomized controlled trials (RCTs) including the COMPLETE trial, in hemodynamically stable STEMI patients with MVD. Methods: PubMed, MEDLINE, Embase, Scopus, Google Scholar, CENTRAL and ClinicalTrials.gov databases search identified 10 RCTs of 7033 patients with STEMI and MVD which compared complete (n = 3420) vs. only culprit lesion (n = 3613) PCI for a median 27.7 months follow-up. Random effect risk ratios were used to estimate for efficacy and safety outcomes. Results: Complete revascularization reduced the risk of MACE (10.4% vs.16.6%; RR = 0.59, 95% CI: 0.47 to 0.74, p < 0.0001), CV mortality (2.87% vs. 3.72%; RR = 0.73, 95% CI: 0.56 to 0.95, p = 0.02), reinfarction (5.1% vs. 7.1%; RR = 0.67, 95% CI: 0.52 to 0.86, p = 0.002), urgent revascularization (7.92% vs.17.4%; RR = 0.47, 95% CI: 0.30 to 0.73, p < 0.001), and CV hospitalization (8.68% vs.11.4%; RR = 0.65, 95% CI: 0.44to 0.96, p = 0.03) compared with culprit only revascularization. All-cause mortality, stroke, major bleeding events, or contrast induced nephropathy were not affected by the revascularization strategy. Conclusion: The findings of this meta-analysis suggest that in patients with STEMI and MVD, complete revascularization is superior to culprit-only PCI in reducing the risk of MACE outcomes, including cardiovascular mortality, without increasing the risk of adverse safety outcomes.
Published: 2020

41. P791 Left atrial stiffness as a predictor of cardiac events in patients with heart failure and reduced ejection fraction: the impact of diabetes

Author: Matteo Mazzola, Frank Lloyd Dini, Ibadete Bytyçi, Michael Y. Henein, Gani Bajraktari, Artan Bajraktari, and Nicola Riccardo Pugliese
Subjects: medicine.medical_specialty, Ejection fraction, business.industry, Stiffness, General Medicine, medicine.disease, Left atrial, Heart failure, Internal medicine, Diabetes mellitus, medicine, Cardiology, Radiology, Nuclear Medicine and imaging, In patient, medicine.symptom, Cardiology and Cardiovascular Medicine, business
Abstract: Background and Aim Diabetes mellitus (DM) affects left ventricular remodeling in patients with heart failure (HF), but its effect on left atrial (LA) remodeling and their combined effect on survival and other clinical events (CE) remain to be elucidated. We evaluated in this study the relationship between DM and left atrial (LA) remodeling in a group of HF patients with reduced ejection fraction (HFrEF), Methods This studied 136 consecutive HFrEF patients (65 ± 11 years), 36 diabetics, using conventional and tissue Doppler echocardiography. LA dimension and function were measured and cavity stiffness was calculated with the formula: LA stiffness = E/e’ratio/LA strain. Results The age, gender, LV end-systolic dimension, LV end-diastolic dimension, LV EF and BNP level did not differ between diabetic and non-diabetic patients. Diabetic patients with HFrEF had higher NYHA functional class (p = 0.02), reduced right ventricle (RV) systolic function (p = 0.01) and increased LA stiffness (p = 0.02) . At follow up of 55 ± 37 months, survival free from CE was 69% in non-diabetics compared with 44.4% in diabetics (X2 12.7; p< 0.0001). The CE free survival was lower in patients with increased LA stiffnes, irrespective of the presence of DM: 1) Patients with HFrEF without DM and normal LA stiffness (85%); 2) Patients with HFrEF without DM and with increased LA stiffness (50%); 3) Patients with HFrEF with DM and with normal LA stiffness (71%) and patients with HFrEF with DM and with increased LA stiffness (27%) (X2 29.6; p< 0.0001, Figure 1). Conclusion Compromised LA stiffness as surrogate of LA remodeling is associated with poor outcome in patients with heart failure and reduced EF. The presence of diabetes in patients with HFrEF and increased LA stiffness has incremental prognostic value. Abstract P791 Figure.
Published: 2020
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42. Long-Term Outcomes of Patients with Unprotected Left Main Coronary Artery Disease Treated with Percutaneous Angioplasty versus Bypass Grafting : A Meta-Analysis of Randomized Controlled Trials

Author: Zarife Rexhaj, Afrim Poniku, Michael Y. Henein, Shpend Elezi, Gjin Ndrepepa, Fjolla Zhubi-Bakija, Artan Bajraktari, Fernando Alfonso, Gani Bajraktari, and Ibadete Bytyçi
Subjects: medicine.medical_specialty, medicine.medical_treatment, lcsh:Medicine, Review, 030204 cardiovascular system & hematology, law.invention, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, coronary artery bypass graft, Internal medicine, medicine, Cardiac and Cardiovascular Systems, 030212 general & internal medicine, Myocardial infarction, cardiovascular diseases, Stroke, unprotected left main, Kardiologi, business.industry, lcsh:R, percutaneous coronary intervention, Percutaneous coronary intervention, General Medicine, medicine.disease, Relative risk, Conventional PCI, Cardiology, business, Mace, coronary artery disease
Abstract: Background and Aim: Treatment of patients with left main coronary artery disease (LMCA) with percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) remains controversial. The aim of this meta-analysis was to compare the long-term clinical outcomes of patients with unprotected LMCA treated randomly by PCI or CABG. Methods: PubMed, MEDLINE, Embase, Scopus, Google Scholar, CENTRAL and ClinicalTrials.gov database searches identified five randomized trials (RCTs) including 4499 patients with unprotected LMCA comparing PCI (n = 2249) vs. CABG (n = 2250), with a minimum clinical follow-up of five years. Random effect risk ratios were used for efficacy and safety outcomes. The study was registered in PROSPERO. The primary outcome was major adverse cardiac events (MACE), defined as a composite of death from any cause, myocardial infarction or stroke. Results: Compared to CABG, patients assigned to PCI had a similar rate of MACE (risk ratio (RR): 1.13; 95% CI: 0.94 to 1.36; p = 0.19), myocardial infarction (RR: 1.48; 95% CI: 0.97 to 2.25; p = 0.07) and stroke (RR: 0.87; 95% CI: 0.62 to 1.23; p = 0.42). Additionally, all-cause mortality (RR: 1.07; 95% CI: 0.89 to 1.28; p = 0.48) and cardiovascular (CV) mortality (RR: 1.13; 95% CI: 0.89 to 1.43; p = 0.31) were not different. However, the risk of any repeat revascularization (RR: 1.70; 95% CI: 1.34 to 2.15; p < 0.00001) was higher in patients assigned to PCI. Conclusions: The findings of this meta-analysis suggest that the long-term survival and MACE of patients who underwent PCI for unprotected LMCA stenosis were comparable to those receiving CABG, despite a higher rate of repeat revascularization.
Published: 2020

43. Statin therapy in athletes and patients performing regular intense exercise - Position paper from the International Lipid Expert Panel (ILEP)

Author: Niki Katsiki, Dimitri P. Mikhailidis, Gani Bajraktari, Andre R. Miserez, Arrigo F.G. Cicero, Eric Bruckert, Maria-Corina Serban, Erkin Mirrakhimov, Fahad Alnouri, Željko Reiner, György Paragh, Amirhossein Sahebkar, Maciej Banach, Fahma Amar, Atanas G. Atanasov, Marcin A. Bartlomiejczyk, Bojko Bjelakovic, Agata Bielecka-Dabrowa, Alberto Cafferata, Richard Ceska, Xavier Collet, Olivier Descamps, Nair Devaki, Dragan Djuric, Ronen Durst, Marat V. Ezhov, Zlatko Fras, Dan Gaita, Stephan von Haehling, Adrian V. Hernandez, Steven R. Jones, Jacek Jozwiak, Nona Kakauridze, Amit Khera, Karam Kostner, Raimondas Kubilius, Gustavs Latkovskis, G.B. John Mancini, A. David Marais, Seth S. Martin, Julio Acosta Martinez, Mohsen Mazidi, Olena Mitchenko, Patrick Moriarty, Seyed Mohammad Nabavi, Demosthenes B. Panagiotakos, Daniel Pella, Peter E. Penson, Zaneta Petrulioniene, Matteo Pirro, Arman Postadzhiyan, Raman Puri, Ashraf Reda, Jemaa Riadh, Dimitri Richter, Manfredi Rizzo, Massimiliano Ruscica, Naveed Sattar, Abdulla M.A. Shehab, Aleksandr B. Shek, Cesare R. Sirtori, Claudia Stefanutti, Tomasz Tomasik, Peter P. Toth, Margus Viigimaa, Dragos Vinereanu, Branislav Vohnout, Michal Vrablik, Nathan D. Wong, Hung-I Yeh, Jiang Zhisheng, Andreas Zirlik, and Katsiki N, Mikhailidis DP, Bajraktari G, Miserez AR, Cicero AFG, Bruckert E, Serban MC, Mirrakhimov E, Alnouri F, Reiner Ž, Paragh G, Sahebkar A, Banach M
Subjects: 0301 basic medicine, medicine.medical_specialty, Consensus, Sports medicine, Context (language use), Physical exercise, 03 medical and health sciences, 0302 clinical medicine, Athleths, Muscular Diseases, Statin intolerance, Medicine, Humans, Adverse effect, Athleth, Exercise, Mylagia, Dyslipidemias, Pharmacology, biology, business.industry, Athletes, Exercises, Athleths, Exercises, Management, Mylagia, Statin intolerance, Management, medicine.disease, biology.organism_classification, 030104 developmental biology, 030220 oncology & carcinogenesis, Physical therapy, Position paper, Statin therapy, Hydroxymethylglutaryl-CoA Reductase Inhibitors, business, Dyslipidemia
Abstract: Acute and chronic physical exercises may enhance the development of statin-related myopathy. In this context, the recent (2019) guidelines of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS) for the management of dyslipidemias recommend that, although individuals with dyslipidemia should be advised to engage in regular moderate physical exercise (for at least 30 min daily), physicians should be alerted with regard to myopathy and creatine kinase (CK) elevation in statin-treated sport athletes. However it is worth emphasizing that abovementioned guidelines, previous and recent ESC/EAS consensus papers on adverse effects of statin therapy as well as other previous attempts on this issue, including the ones from the International Lipid Expert Panel (ILEP), give only general recommendations on how to manage patients requiring statin therapy on regular exercises. Therefore, these guidelines in the form of the Position Paper are the first such an attempt to summary existing, often scarce knowledge, and to present this important issue in the form of step-by-step practical recommendations. It is critically important as we might observe more and more individuals on regular exercises/athletes requiring statin therapy due to their cardiovascular risk.
Published: 2020

44. P901 Left ventricular diastolic and systolic functions are compromised in patients with hypothyroidism

Author: Gani Bajraktari, R Tafarshiku, Pranvera Ibrahimi, Ibadete Bytyçi, Michael Y. Henein, V Berisha-Muharremi, and A Poniku
Subjects: medicine.medical_specialty, medicine.diagnostic_test, business.industry, Diastole, Physical examination, General Medicine, Doppler echocardiography, Thyroid function tests, Waist–hip ratio, MICROBIOLOGY PROCEDURES, Internal medicine, medicine, Cardiology, Radiology, Nuclear Medicine and imaging, In patient, Systole, Cardiology and Cardiovascular Medicine, business
Abstract: Background and Aim Long standing hypothyroidism may impair myocardial relaxation, but its effect on systolic myocardial function is still controversial. The aim of this study was to investigate left ventricular (LV) systolic and diastolic function in patients with hypothyroidism. Methods This study included 81 (age 42 ± 13 years, 92% female) patients with hypothyroidism, and 22 age and gender matched controls. All subjects underwent a detailed clinical examination followed by a complete biochemical blood analysis including thyroid function assessment and anthropometric parameters measurements. LV function was assessed by 2 dimensional, M-mode and Tissue-Doppler Doppler echocardiographic examination performed in the same day. Results Patients had lower waist/hip ratio (p Conclusion In patients with hypothyroidism, in addition to compromised LV diastolic function, LV longitudinal systolic function is also impaired compared to healthy subjects of the same age and gender. These findings suggest significant subendocardial function impairment, reflecting potentially micro-circulation disease, that requires optimum management.
Published: 2020
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45. P1544 Independent prognostic significance of non invasive left atrial stiffness in outpatients with heart failure and reduced ejection fraction

Author: Matteo Mazzola, Ibadete Bytyçi, Frank Lloyd Dini, Michael Y. Henein, Gani Bajraktari, Artan Bajraktari, and N Riccardo
Subjects: medicine.medical_specialty, Ejection fraction, business.industry, Treatment outcome, Non invasive, Diastole, General Medicine, medicine.disease, Left atrial, Internal medicine, Heart failure, Cardiology, Medicine, Radiology, Nuclear Medicine and imaging, Systole, Cardiology and Cardiovascular Medicine, Heart failure with preserved ejection fraction, business
Abstract: Background and Aim Left atrial (LA) stiffness is an important marker of cardiac pump function, especially in patients with heart failure (HF) and preserved ejection fraction (HFpEF). The aim of this study was to evaluate the relationship between LA stiffness and cardiac events (CE) in HF patients with reduced ejection fraction (HFrEF). Methods This study included 136 consecutive HFrEF outpatients (mean age: 65 ± 11 years). A complete conventional and tissue Doppler imaging study was performed. The LA dimension and function were measured. Non invasive LA stiffness was calculated with the following formula: LA stiffness = E/e’ratio/LA strain. The cardiac events were HF hospitalization and cardiac death. Results During a median follow up of 55 ± 37 months, 51 patients had CE, they had higher NYHA functional class (p = 0.001), higher LV end-diastolic dimension (p = 0.001), higher LV end-systolic dimension (p = 0.04), lower EF (p < 0.001), higher E/A ratio (p = 0.01) and reduced TAPSE (p = 0.001) compared with patients without CE. LA volume index was higher (p = 0.001), LA strain was reduced and LA stiffness was increased in patients with CE compared to those without CE (p = 0.0001, p < 0.0001, respectively). LA stiffness exhibited the closest relationship with E/e’ ratio (r = 0.67, p < 0.001). Survival analyses showed that LA stiffness [HR: 4.026 (1.300–12.468), p = 0.001] was the most powerful independent predictor of cardiac events[C1] . On ROC curve analysis, a LA stiffness < 0.82% was 81% sensitive and 73% specific (AUC 0.81, p < 0.001) in predicting clinical events (Figure 1). Conclusion In this cohort of outpatients with HFrEF, LA stiffness proved the most important predictor of clinical outcome. [C1] Abstract P1544 Figure.
Published: 2020
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46. 2019 ESC/EAS guidelines for the management of dyslipidaemias: Lipid modification to reduce cardiovascular risk

Author: François Mach, Colin Baigent, Alberico L. Catapano, Konstantinos C. Koskinas, Manuela Casula, Lina Badimon, M. John Chapman, Guy G. De Backer, Victoria Delgado, Brian A. Ference, Ian M. Graham, Alison Halliday, Ulf Landmesser, Borislava Mihaylova, Terje R. Pedersen, Gabriele Riccardi, Dimitrios J. Richter, Marc S. Sabatine, Marja-Riitta Taskinen, Lale Tokgozoglu, Olov Wiklund, Stephan Windecker, Victor Aboyans, Jean-Philippe Collet, Veronica Dean, Donna Fitzsimons, Chris P. Gale, Diederick Grobbee, Sigrun Halvorsen, Gerhard Hindricks, Bernard Iung, Peter Jüni, Hugo A. Katus, Christophe Leclercq, Maddalena Lettino, Basil S. Lewis, Bela Merkely, Christian Mueller, Steffen Petersen, Anna Sonia Petronio, Marco Roffi, Evgeny Shlyakhto, Iain A. Simpson, Miguel Sousa-Uva, Rhian M. Touyz, Djamaleddine Nibouche, Parounak H. Zelveian, Peter Siostrzonek, Ruslan Najafov, Philippe van de Borne, Belma Pojskic, Arman Postadzhiyan, Lambros Kypris, Jindřich Špinar, Mogens Lytken Larsen, Hesham Salah Eldin, Margus Viigimaa, Timo E. Strandberg, Jean Ferrières, Rusudan Agladze, Ulrich Laufs, Loukianos Rallidis, László Bajnok, Thorbjörn Gudjónsson, Vincent Maher, Yaakov Henkin, Michele Massimo Gulizia, Aisulu Mussagaliyeva, Gani Bajraktari, Alina Kerimkulova, Gustavs Latkovskis, Omar Hamoui, Rimvydas Slapikas, Laurent Visser, Philip Dingli, Victoria Ivanov, Aneta Boskovic, Mbarek Nazzi, Frank Visseren, Irena Mitevska, Kjetil Retterstøl, Piotr Jankowski, Ricardo Fontes-Carvalho, Dan Gaita, Marat Ezhov, Marina Foscoli, Vojislav Giga, Daniel Pella, Zlatko Fras, Leopoldo Perez de Isla, Emil Hagström, Roger Lehmann, Leila Abid, Oner Ozdogan, Olena Mitchenko, Riyaz S. Patel, HUS Heart and Lung Center, Clinicum, CAMM - Research Program for Clinical and Molecular Metabolism, Research Programs Unit, and University of Helsinki
Subjects: Male, CHRONIC KIDNEY-DISEASE, Very low-density lipoprotein, Apolipoprotein B, Lipoprotein remnants, 030204 cardiovascular system & hematology, INTIMA-MEDIA THICKNESS, chemistry.chemical_compound, 0302 clinical medicine, Risk Factors, 030212 general & internal medicine, High-density lipoproteins, HIGH-DOSE ATORVASTATIN, Hypolipidemic Agents, ALL-CAUSE MORTALITY, biology, Treatment (drugs), Lipoprotein(a), Middle Aged, Lipids, C-REACTIVE PROTEIN, 3. Good health, Treatment (adherence), Treatment Outcome, Cholesterol, DENSITY-LIPOPROTEIN CHOLESTEROL, Cardiovascular Diseases, Drug Therapy, Combination, Female, Low-density lipoproteins, Cardiology and Cardiovascular Medicine, Familial hypercholesterolaemia, Adult, medicine.medical_specialty, Consensus, Very low-density lipoproteins, TYPE-2 DIABETES-MELLITUS, Guidelines, Total cardiovascular risk, Risk Assessment, STATIN-TREATED PATIENTS, Treatment (lifestyle), 03 medical and health sciences, Internal medicine, Journal Article, medicine, Humans, CORONARY-HEART-DISEASE, HOMOZYGOUS FAMILIAL HYPERCHOLESTEROLEMIA, Dyslipidaemias, Triglycerides, Aged, Dyslipidemias, business.industry, C-reactive protein, Type 2 Diabetes Mellitus, Endocrinology, chemistry, Intima-media thickness, 3121 General medicine, internal medicine and other clinical medicine, biology.protein, Lipid modification, business, Risk Reduction Behavior, Biomarkers
Abstract: Correction: Volume: 292 Pages: 160-162 DOI: 10.1016/j.atherosclerosis.2019.11.020 Published: JAN 2020
Published: 2019

47. The exaggerated systolic hypertensive response to exercise associates cardiovascular events: a systematic review and meta-analysis

Author: Ibadete Bytyçi, Michael Y. Henein, Pranvera Ibrahimi, Luan Perçuku, Gani Bajraktari, and Haki Jashari
Subjects: Adult, Male, medicine.medical_specialty, Population, Blood Pressure, Cochrane Library, Sensitivity and Specificity, Likelihood ratios in diagnostic testing, Coronary artery disease, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, Internal Medicine, medicine, Humans, education, Exercise, Aged, Proportional Hazards Models, Aged, 80 and over, education.field_of_study, Proportional hazards model, business.industry, Hazard ratio, 030229 sport sciences, Middle Aged, medicine.disease, Blood pressure, Meta-analysis, Hypertension, Exercise Test, Cardiology, Female, business, 030217 neurology & neurosurgery
Abstract: INTRODUCTION The pathophysiology of exaggerated systolic hypertensive response to exercise (SHRE) is not fully understood, with contradictory data on its role in predicting cardiovascular (CV) events. OBJECTIVES The aim of this review and meta‑analysis was to assess the association of SHRE with CV clinical outcomes in healthy normotensive individuals. PATIENTS AND METHODS We searched PubMed (MEDLINE), Cochrane Library, RefWorks, and Google Scholar to identify clinical studies that reported data on CV event rates and outcomes for patients with SHRE on exercise stress testing. Sensitivity and specificity analysis for assessing the diagnostic accuracy of the SHRE cutoff associated with CV events was estimated using hierarchical summary receiver operating characteristic analysis. RESULTS We included 8 studies with 47 188 participants and a median follow‑up of 19.3 years. Exaggerated SHRE was found in patients with composite events (CV mortality and coronary artery disease; hazard ratio [HR], 1.363; 95% CI, 1.135-1.604; P
Published: 2019
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48. The ESC ACCA EAPCI EORP acute coronary syndrome ST-elevation myocardial infarction registry

Author: Zeymer, U., Ludman, P., Danchin, N., Kala, P., Maggioni, A. P., Weidinger, F, P Gale, C, Beleslin, B, Budaj, A, Chioncel, O, Dagres, N, Danchin, N, Emberson, J, Erlinge, D, Glikson, M, Gray, A, Kayikcioglu, M, P Maggioni, A, K Nagy, V, Nedoshivin, A, A-S, Petronio, Roos-Hesselink, J, Wallentin, L, Zeymer, U, Franz, Weidinger, Uwe, Zeymer, Nicolas, Danchin, Peter, Ludman, Peter, Sinnaeve, Petr, Kala, Roberto, Ferrari, Maggioni, Aldo P., Artan, Goda, Parounak, Zelveian, Kiril, Karamfilov, Zuzana, Motovska, Bent, Raungaard, Toomas, Marandi, Sameh Mohamed Shaheen, Rosa-Maria, Lidon, Pasi Paavo Karjalainen, Zviad, Kereselidze, Dimitrios, Alexopoulos, David, Becker, Martin, Quinn, Zaza, Iakobishvili, Hasan, Al-Farhan, Masoumeh, Sadeghi, Roberto, Caporale, Francesco, Romeo, Erkin, Mirrakhimov, Pranas, Serpytis, Andrejs, Erglis, Sasko, Kedev, Matthew Mercieca Balbi, Alice May Moore, Dariusz, Dudek, Jacek, Legutko, Jorge, Mimoso, Gabriel, Tatu-Chitoiu, Sinisa, Stojkovic, Evgeny, Shlyakhto, Khalid, F AlHabib, Matjaz, Bunc, Martin, Studencan, Mohamed Sami Mourali, Gani, Bajraktari, Marème, Konte, Florian, Larras, Elin Folkesson Lefrancq, Souad, Mekhaldi, Cécile, Laroche, Goda, A, Shuka, N, Pavli, E, Tafaj, E, Gishto, T, Dibra, A, Duka, A, Gjana, A, Kristo, A, Knuti, G, Demiraj, A, Dado, E, Hasimi, E, Simoni, L, Siqeca, M, Sisakian, H, Hayrapetyan, H, Markosyan, S, Galustyan, L, Arustamyan, N, Kzhdryan, H, Pepoyan, S, Zirkik, A, D Von Lewinski, Paetzold, S, Kienzl, I, Matyas, K, Neunteufl, T, Nikfardjam, M, Neuhold, U, Mihalcz, A, Glaser, F, Steinwender, C, Reiter, C, Grund, M, Hrncic, D, Hoppe, U, Hammerer, M, Hinterbuchner, L, Hengstenberg, C, G Delle Karth, Lang, I, Winkler, W, Hasun, M, Kastner, J, Havel, C, Derntl, M, Oberegger, G, Hajos, J, Adlbrecht, C, Publig, T, M-C, Leitgeb, Wilfing, R, Jirak, P, C-Y, Ho, Puskas, L, Schrutka, L, Spinar, J, Parenica, J, Hlinomaz, O, Fendrychova, V, Semenka, J, Sikora, J, Sitar, J, Groch, L, Rezek, M, Novak, M, Kramarikova, P, Stasek, J, Dusek, J, Zdrahal, P, Polasek, R, Karasek, J, Seiner, J, Sukova, N, Varvarovsky, I, Lazarák, T, Novotny, V, Matejka, J, Rokyta, R, Volovar, S, Belohlavek, J, Motovska, Z, Siranec, M, Kamenik, M, Kralik, R, Raungaard, B, Ravkilde, J, E Jensen, S, Villadsen, A, Villefrance, K, C Schmidt Skov, Maeng, M, Moeller, K, Hasan-Ali, H, A Ahmed, T, Hassan, M, Elguind, A, M Farouk Ismail, A Ibrahim Abd El-Aal, A El-sayed Gaafar, H Magdy Hassan, M Ahmed Shafie, M Nabil El-khouly, Bendary, A, Darwish, M, Ahmed, Y, Amin, O, Abdelhakim, A, Abosaif, K, Kandil, H, M A, G Galal, E El Hefny, E, M El Sayed, Aly, K, Mokarrab, M, Osman, M, Abdelhamid, M, Mantawy, S, R Ali, M, D Kaky, S, A Khalil, V, M E, A Saraya, Talaat, A, Nabil, M, M Mounir, W, Aransa, K. Mahmoud A., Kazamel, G, Anwar, S, Al-Habbaa, A, M Abd el Monem, Ismael, A, Amin Abu-Sheaishaa, M., M Abd Rabou, M, T M, A Hammouda, Moaaz, M, Elkhashab, K, Ragab, T, Rashwan, A, Rmdan, A, Abdelrazek, G, Ebeid, H, H Soliman Ghareeb, Farag, N, Zaki, M, Seleem, M, Torki, A, Youssef, M, A AlLah Nasser, N, Rafaat, A, Selim, H, M Makram, M, Khayyal, M, Malasi, K, Madkou, A, Kolib, M, Alkady, H, Nagah, A, Yossef, M, Wafa, A, Mahfouz, E, Faheem, G, M Magdy Moris, Ragab, A, Ghazal, M, Mabrouk, A, El-Masry, M, Naseem, M, Samir, S, Marandi, T, Reinmets, J, Allvee, M, Saar, A, Ainla, T, Vaide, A, Kisseljova, M, Pakosta, U, Eha, J, Lotamois, K, Sia, J, Myllymaki, J, Pinola, T, P Karjalainen, P, Paana, P, Mikkelsson, J, Ampio, M, Tsivilasvili, J, Zurab, P, Kereselidze, Z, Agladze, R, Melia, A, Gogoberidze, D, Khubua, N, Totladze, L, Metreveli, I, Chikovani, A, Eitel, I, Pöss, J, Werner, M, Constantz, A, Ahrens, C, Tolksdorf, H, Klinger, S, Sack, S, Heer, T, Lekakis, J, Kanakakis, I, Xenogiannis, I, Ermidou, K, Makris, N, Ntalianis, A, Katsaros, F, Revi, E, Kafkala, K, Mihelakis, E, Diakakis, G, Grammatikopoulos, K, Voutsinos, D, Alexopoulos, D, Xanthopoulou, I, Mplani, V, Foussas, S, Papakonstantinou, N, Patsourakos, N, Dimopoulos, A, Derventzis, A, Athanasiou, K, P Vassilikos, V, Papadopoulos, C, Tzikas, S, Vogiatzis, I, Datsios, A, Galitsianos, I, Koutsampasopoulos, K, Grigoriadis, S, Douras, A, Baka, N, Spathis, S, Kyrlidis, T, Hatzinikolaou, H, G Kiss, R, Becker, D, Nowotta, F, Tóth, K, Szabó, S, Lakatos, C, Jambrik, Z, Ruzsa, J, Ruzsa, Z, Róna, S, Toth, J, A Vargane Kosik, K S, B Toth, G Nagy, G, Ondrejkó, Z, Körömi, Z, Botos, B, Pourmoghadas, M, Salehi, A, Massoumi, G, Sadeghi, M, Soleimani, A, Sarrafzadegan, N, Roohafza, H, Azarm, M, Mirmohammadsadeghi, A, Rajabi, D, Rahmani, Y, Siabani, S, Najafi, F, Hamzeh, B, Karim, H, Siabani, H, Saleh, N, Charehjoo, H, Zamzam, L, Al-Temimi, T, Al-Farhan, H, Al-Yassin, A, Mohammad, A, Ridha, A, Al-Saedi, G, Atabi, N, Sabbar, O, Mahmood, S, Dakhil, Z, F Yaseen, I, Almyahi, M, Alkenzawi, H, Alkinani, T, Alyacopy, A, Kearney, P, Twomey, K, Iakobishvili, Z, Shlomo, N, Beigel, R, Caldarola, P, Rutigliano, D, L Sublimi Saponetti, Locuratolo, N, Palumbo, V, Scherillo, M, Formigli, D, Canova, P, Musumeci, G, Roncali, F, Metra, M, Lombardi, C, Visco, E, Rossi, L, Meloni, L, Montisci, R, Pippia, V, F Marchetti, M, Congia, M, Cacace, C, Luca, G, Boscarelli, G, Indolfi, C, Ambrosio, G, Mongiardo, A, Spaccarotella, C, S De Rosa, Canino, G, Critelli, C, Caporale, R, Chiappetta, D, Battista, F, Gabrielli, D, Marziali, A, Bernabò, P, Navazio, A, Guerri, E, Manca, F, Gobbi, M, Oreto, G, Andò, G, Carerj, S, Saporito, F, Cimmino, M, Rigo, F, Zuin, G, Tuccillo, B, F Scotto di Uccio, L Scotto di Uccio, Lorenzoni, G, Meloni, I, Merella, P, M Polizzi, G, Pino, R, Marzilli, M, Morrone, D, Caravelliorsini, P, Orsini, E, Mosa, S, Piovaccari, G, Santarelli, A, Cavazza, C, Romeo, F, Fedele, F, Mancone, M, Straito, M, Salvi, N, Scarparo, P, Severino, P, Razzini, C, Massaro, G, Cinque, A, Gaudio, C, Barillà, F, Torromeo, C, Porco, L, Mei, M, Lorio, R, Nassiacos, D, Barco, B, Sinagra, G, Falco, L, Priolo, L, Perkan, A, Strana, M, Bajraktari, G, Percuku, L, Berisha, G, Mziu, B, Beishenkulov, M, Abdurashidova, T, Toktosunova, A, Kaliev, K, Serpytis, P, Serpytis, R, Butkute, E, Lizaitis, M, Broslavskyte, M, G Xuereb, R, M Moore, A, M Mercieca Balbi, Paris, E, Buttigieg, L, Musial, W, Dobrzycki, S, Dubicki, A, Kazimierczyk, E, Tycinska, A, Wojakowski, W, Kalanska-Lukasik, B, Ochala, A, Wanha, W, Dworowy, S, Sielski, J, Janion, M, Janion-Sadowska, A, Dudek, D, Wojtasik-Bakalarz, J, Bryniarski, L, Z Peruga, J, Jonczyk, M, Jankowski, L, Klecha, A, Legutko, J, Michalowska, J, Brzezinski, M, Kozmik, T, Kowalczyk, T, Adamczuk, J, Maliszewski, M, Kuziemka, P, Plaza, P, Jaros, A, Pawelec, A, Sledz, J, Bartus, S, Zmuda, W, Bogusz, M, Wisnicki, M, Szastak, G, Adamczyk, M, Suska, M, Czunko, P, Opolski, G, Kochman, J, Tomaniak, M, Miernik, S, Paczwa, K, Witkowski, A, P Opolski, M, D Staruch, A, Kalarus, Z, Honisz, G, Mencel, G, Swierad, M, Podolecki, T, Marques, J, Azevedo, P, A Pereira, M, Gaspar, A, Monteiro, S, Goncalves, F, Leite, L, Mimoso, J, Manuel Lopes dos Santos, W., Amado, J, Pereira, D, Silva, B, Caires, G, Neto, M, Rodrigues, R, Correia, A, Freitas, D, Lourenco, A, Ferreira, F, Sousa, F, Portugues, J, Calvo, J, Almeida, F, Alves, M, Silva, A, Caria, R, Seixo, F, Militaru, C, Ionica, E, Tatu-Chitoiu, G, Istratoaie, O, Florescu, M, Lipnitckaia, E, Osipova, O, Konstantinov, S, Bukatov, V, Vinokur, T, Egorova, E, Nefedova, E, Levashov, S, Gorbunova, A, Redkina, M, Karaulovskaya, N, Bijieva, F, Babich, N, Smirnova, O, Filyanin, R, Eseva, S, Kutluev, A, Chlopenova, A, Shtanko, A, Kuppar, E, Shaekhmurzina, E, Ibragimova, M, Mullahmetova, M, Chepisova, M, Kuzminykh, M, Betkaraeva, M, Namitokov, A, Khasanov, N, Baleeva, L, Galeeva, Z, Magamedkerimova, F, Ivantsov, E, Tavlueva, E, Kochergina, A, Sedykh, D, Kosmachova, E, Skibitskiy, V, Porodenko, N, Litovka, K, Ulbasheva, E, Niculina, S, Petrova, M, Harkov, E, Tsybulskaya, N, Lobanova, A, Chernova, A, Kuskaeva, A, Kuskaev, A, Ruda, M, Zateyshchikov, D, Gilarov, M, Konstantinova, E, Koroleva, O, Averkova, A, Zhukova, N, Kalimullin, D, Borovkova, N, Tokareva, A, Buyanova, M, Khaisheva, L, Pirozhenko, T, Novikova, T, Yakovlev, A, Tyurina, T, Lapshin, K, Moroshkina, N, Kiseleva, M, Fedorova, S, Krylova, L, Duplyakov, D, Semenova, Y, Rusina, A, Ryabov, V, Syrkina, A, Demianov, S, Reitblat, O, Artemchuk, A, Efremova, E, Makeeva, E, Menzorov, M, Shutov, A, Klimova, N, Shevchenko, I, Elistratova, O, Kostyuckova, O, Islamov, R, Budyak, V, Ponomareva, E, U Ullah Jan, M Alshehri, A, Sedky, E, Alsihati, Z, Mimish, L, Selem, A, Malik, A, Majeed, O, Altnji, I, Alshehri, M, Aref, A, Alhabib, K, Aldosary, M, Tayel, S, M Abd AlRahman, N Asfina, K, G Abdin Hussein, Butt, M, N Markovic Nikolic, Obradovic, S, Djenic, N, Brajovic, M, Davidovic, A, Romanovic, R, Novakovic, V, Dekleva, M, Spasic, M, Dzudovic, B, Jovic, Z, Cvijanovic, D, Cvijanovic, S, Ivanov, I, Cankovic, M, Jarakovic, M, Kovacevic, M, Trajkovic, M, Mitov, V, Jovic, A, Hudec, M, Gombasky, M, Sumbal, J, Bohm, A, Baranova, E, Kovar, F, Samos, M, Podoba, J, Kurray, P, Obona, T, Remenarikova, A, Kollarik, B, Verebova, D, Kardosova, G, Studencan, M, Alusik, D, Macakova, J, Kozlej, M, Bayes-Genis, A, Sionis, A, C Garcia Garcia, R-M, Lidon, A Duran Cambra, C Labata Salvador, F Rueda Sobella, J Sans Rosello, M Vila Perales, T Oliveras Vila, M Ferrer Massot, Bañeras, J, Lekuona, I, Zugazabeitia, G, Fernandez-Ortiz, A, A Viana Tejedor, Ferrera, C, Alvarez, V, Diaz-Castro, O, M Agra-Bermejo, R, Gonzalez-Cambeiro, C, Gonzalez-Babarro, E, J Domingo-Del Valle, Royuela, N, Burgos, V, Canteli, A, Castrillo, C, Cobo, M, Ruiz, M, Abu-Assi, E, M Garcia Acuna, J, U., Zeymer, P., Ludman, N., Danchin, P., Kala, A. P., Maggioni, F., Weidinger, STEMI Investigators, Ac, and Spaccarotella, C.
Subjects: Registrie, medicine.medical_specialty, Acute coronary syndrome, Registry, medicine.medical_treatment, Cardiology, Reperfusion therapy, Retrospective Studie, Medical, medicine, Humans, cardiovascular diseases, Myocardial infarction, Registries, Disease management (health), Acute Coronary Syndrome, Societies, Medical, Quality of Health Care, Retrospective Studies, Acca, biology, business.industry, Health Policy, Primary percutaneous coronary intervention, Percutaneous coronary intervention, Disease Management, Retrospective cohort study, medicine.disease, biology.organism_classification, primary percutaneous coronary intervention, registry, reperfusion therapy, ST-elevation myocardial infarction, Cardiac surgery, Europe, surgical procedures, operative, Emergency medicine, ST Elevation Myocardial Infarction, Societies, Cardiology and Cardiovascular Medicine, business, Human
Abstract: Aims The Acute Cardiac Care Association (ACCA)–European Association of Percutaneous Coronary Intervention (EAPCI) Registry on ST-elevation myocardial infarction (STEMI) of the EurObservational programme (EORP) of the European Society of Cardiology (ESC) registry aimed to determine the current state of the use of reperfusion therapy in ESC member and ESC affiliated countries and the adherence to ESC STEMI guidelines in patients with STEMI. Methods and results Between 1 January 2015 and 31 March 2018, a total of 11 462 patients admitted with an initial diagnosis of STEMI according to the 2012 ESC STEMI guidelines were enrolled. Individual patient data were collected across 196 centres and 29 countries. Among the centres, there were 136 percutaneous coronary intervention centres and 91 with cardiac surgery on-site. The majority of centres (129/196) were part of a STEMI network. The main objective of this study was to describe the demographic, clinical, and angiographic characteristics of patients with STEMI. Other objectives include to assess management patterns and in particular the current use of reperfusion therapies and to evaluate how recommendations of most recent STEMI European guidelines regarding reperfusion therapies and adjunctive pharmacological and non-pharmacological treatments are adopted in clinical practice and how their application can impact on patients’ outcomes. Patients will be followed for 1 year after admission. Conclusion The ESC ACCA-EAPCI EORP ACS STEMI registry is an international registry of care and outcomes of patients hospitalized with STEMI. It will provide insights into the contemporary patient profile, management patterns, and 1-year outcome of patients with STEMI.
Published: 2019

49. Radial Access for Coronary Angiography Carries Fewer Complications Compared with Femoral Access: A Meta-Analysis of Randomized Controlled Trials

Author: Artan Bajraktari, Ibadete Bytyçi, Arlind Batalli, Michael Y. Henein, Fjolla Zhubi-Bakija, Zarife Rexhaj, Gani Bajraktari, and Shpend Elezi
Subjects: Acute coronary syndrome, medicine.medical_specialty, Percutaneous, Review, 030204 cardiovascular system & hematology, Lower risk, radial, acute coronary syndrome, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Internal medicine, medicine, Cardiac and Cardiovascular Systems, 030212 general & internal medicine, Kardiologi, business.industry, femoral, PCI, General Medicine, medicine.disease, stable coronary artery disease, coronarography, Relative risk, Meta-analysis, Conventional PCI, Medicine, business, Mace
Abstract: Background and Aim: In patients undergoing diagnostic coronary angiography (CA) and percutaneous coronary interventions (PCI), the benefits associated with radial access compared with the femoral access approach remain controversial. The aim of this meta-analysis was to compare the short-term evidence-based clinical outcome of the two approaches. Methods: The PubMed, Embase, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov databases were searched for randomized controlled trials (RCTs) comparing radial versus femoral access for CA and PCI. We identified 34 RCTs with 29,352 patients who underwent CA and/or PCI and compared 14,819 patients randomized for radial access with 14,533 who underwent procedures using femoral access. The follow-up period for clinical outcome was 30 days in all studies. Data were pooled by meta-analysis using a fixed-effect or a random-effect model, as appropriate. Risk ratios (RRs) were used for efficacy and safety outcomes.Results: Compared with femoral access, the radial access was associated with significantly lower risk for all-cause mortality (RR: 0.74; 95% confidence interval (CI): 0.61 to 0.88; p = 0.001), major bleeding (RR: 0.53; 95% CI:0.43 to 0.65; p ˂ 0.00001), major adverse cardiovascular events (MACE)(RR: 0.82; 95% CI: 0.74 to 0.91; p = 0.0002), and major vascular complications (RR: 0.37; 95% CI: 0.29 to 0.48; p ˂ 0.00001). These results were consistent irrespective of the clinical presentation of ACS or STEMI. Conclusions: Radial access in patients undergoing CA with or without PCI is associated with lower mortality, MACE, major bleeding and vascular complications, irrespective of clinical presentation, ACS or STEMI, compared with femoral access.
Published: 2021
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50. Left ventricular longitudinal systolic dysfunction is associated with right atrial dyssynchrony in heart failure with preserved ejection fraction

Author: Edmond Haliti, Gëzim Berisha, Arbërie Tishukaj, Gani Bajraktari, Faik Shatri, and Ibadete Bytyçi
Subjects: Male, lcsh:Diseases of the circulatory (Cardiovascular) system, medicine.medical_specialty, animal structures, Systolic function, 030204 cardiovascular system & hematology, Right atrial, Doppler imaging, 03 medical and health sciences, Ventricular Dysfunction, Left, 0302 clinical medicine, Interatrial conduction, Internal medicine, medicine, Humans, In patient, cardiovascular diseases, 030212 general & internal medicine, Heart Atria, Aged, General Environmental Science, Heart Failure, Ejection fraction, business.industry, Stroke Volume, Middle Aged, medicine.disease, Echocardiography, Doppler, lcsh:RC666-701, Heart failure, Cardiology, General Earth and Planetary Sciences, Female, Cardiology and Cardiovascular Medicine, Heart failure with preserved ejection fraction, business
Abstract: Objective: We aimed in this study to assess the role of longitudinal left ventricular (LV) systolic function in heart failure with preserved ejection fraction (HFpEF) in delayed intra- and interatrial conduction time. Methods: In 85 consecutive patients with HFpEF (age 60±11 years, ejection fraction [EF] ≥45%), a complete M-mode echocardiographic and tissue Doppler imaging (TDI) study was performed. The times from the onset of the P wave on the ECG to the beginning of the A′ wave (PA) from the lateral and septal mitral and tricuspid annuli on TDI were recorded. The difference between these intervals gave the intra- and interatrial dyssynchrony. Based on mitral annular plane systolic excursion (MAPSE), patients were classified as having HFpEF with impaired (MAPSE ≤1.2 cm) or normal (MAPSE >1.2 cm) longitudinal systolic function. Results: Patients with impaired MAPSE were older (p 1,2 cm). Resultados: Os doentes com ESPAM baixa eram mais velhos (p < 0,001), tinham índice de massa VE mais elevado (p < 0,001), volume auricular esquerdo (VAE) superior (p = 0,007), FE auricular esquerda (AE) mais baixa (p < 0,001), rácio E/e’ mais elevado (p = 0,002), onda e’ lateral e septal reduzidas (p = 0,005 e p = 0,006), onda tricúspide PA prolongada (p = 0,03) e aumento significativo da dessincronia da aurícula direita (AD) (p = 0,001), quando comparados com doentes com ESPAM normal. A ESPAM estava correlacionada com a dessincronia AD (r = -0,40, p < 0,001), mas não com a dessincronia interauricular e da AE. Conclusão: Nos doentes com ICFEp e ESPAM baixa, existe dessincronia AD, quando comparada com os doentes com ESPAM normal. Como os doentes com dessincronia AD têm risco mais elevado de arritmia, a avaliação desta dessincronia pode ajudar a melhorar o tratamento, bem como a auxiliar na previsão prognóstica destes doentes. Keywords: Heart failure, Right atrial dyssynchrony, Systolic longitudinal function, Palavras-chave: Insuficiência cardíaca, Dessincronia auricular direita, Função sistólica longitudinal
Published: 2016
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