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1. Modifying effect of dual antiplatelet therapy on incidence of stent thrombosis according to implanted drug-eluting stent type

Author

Camenzind, Edoardo, Boersma, Eric, Wijns, William, Mauri, Laura, Rademaker-Havinga, Tessa, Ordoubadi, Farzin Fath, Suttorp, Maarten J., Al Kurdi, Mohammad, Steg, Ph Gabriel, Camenzind, E, Mauri, L, OʼNeill, W, Serruys, P W, Steg, PhG, Wijns, W, Verheugt, FWA, Bertrand, ME, Califf, R, DeMets, D, Wallentin, L, Bocksch, W, Bosmans, J, Garcia, H, Garg, S, Hanet, C, Herrman, J-PR, Kelbaek, H, Mc Fadden, E, Radke, PW, Rutsch, W, Tilsted, HH, Wykrzykowska, J, Alvarez, C, Rodriguez, A, Meredith, I, Muller, D, Whitbourn, R, Worthley, S, Whelan, A, Walters, D, Shetty, S, New, G, Cox, S, Batra, R, van Gaal, W, Bellamy, G, Mayr, H, Heigert, M, Huber, K, Leisch, F, Wijns, W, Desmet, W, Boland, J, Schroeder, E, Chenu, P, Legrand, V, Labinaz, M, Teefy, P, Bertrand, O, Gao, R, Ge, J, Kala, P, Cervinka, P, Ureña, P, Hartikainen, J, Steg, G, Fajadet, J, Carrie, D, Gilard, M, Barragan, P, Lablanche, J-M, Koning, R, Eltchaninoff, H, Darremont, O, Leroy, F, Bertrand, B, Robert, G, Schiele, F, Chassaing, S, Bressollette, E, Brunel, P, Quilliet, L, Brunet, J, Pansieri, M, Sideris, G, Stratiev, V, Teiger, E, Lebreton, H, Bonnet, J-L, Karsenty, B, Delarche, N, Lusson, J-R, Cassagnes, J, Brachmann, J, Kurowski, V, Buerke, M, Schieffer, B, Scholtz, W, Wiemer, M, Fichtlscherer, S, Schächinger, V, Kupatt, C, Boekstegers, P, Genth-Zotz, S, Bode, C, Frey, N, Neumann, F-J, Witzenbichler, B, Pels, K, Strasser, R, Kuck, K-H, Hauptmann, K-E, Baldus, S, Heitzer, T, Haude, M, Hoffmann, E, Jung, W, Hoffmann, S, Schmitt, C, Dissmann, M, Pauschinger, M, Werner, G, Braun-Delleus, R, Burkhardt, D, Manz, M, Voudris, V, Sionis, D, Kang-Yin, M-L, Tse, T-S, Merkely, B, Mehta, A, Parikh, K, Kumar, V, Chandra, P, Rath, P, Hiremath, S, Crean, P, Daly, K, Kornowski, R, Kerner, A, Mosseri, M, Jafari, G, Giudice, P, Trani, C, Manari, A, Prati, F, Pangrazi, A, Bolognese, L, Jeong, M-H, Kim, M-Y, Kim, H-S, Park, S-J, Erglis, A, Kalnins, A, Wagner, D, Zambahari, R, Ong, T-K, Sim, K, den Heijer, P, Appelman, Y, Suttorp, M-J, de Smet, B, Koolen, J, Stella, P, Harding, S, Warwick, J, Maslowski, A, Abernethy, M, Devlin, G, Rotevatn, S, Myreng, Y, Ciecwierz, D, Peruga, J, Reczuch, K, Campante Teles, R, Farto, P, Abreu, E, Leitão-Marques, A, Pereira, H, Vinereanu, D, Alkasab, S, Mhish, H, Al Kurdi, M, Al Turki, F, Wong, P, Teo, S-G, Goicolea Ruigomez, F-J, Valdés Chávarri, M, Bethencourt Gonzalez, A, Iñiguez Romo, A, López Minguez, J, Hernández García, J-M, Diaz Fernández, J, Ruiz Salmeron, R, Martinez Elbal, L, Zueco, J, López-Palop, RF, Melgares, R, Diderholm, E, Kåregren, A, Herterich, O, Olivencrona, G, Fröbert, O, Roffi, M, Verin, V, Girod, G, Vuilliomenet, A, Hsieh, I-C, Wu, C-J, Gershlick, A, Densem, C, Doshi, S, Manoharan, G, McCarthy, P, De Belder, M, Mills, J, Fath-Ordoubadi, F, Simpson, I, Greenwood, J, Chamberlain-Webber, R, Khan, Z, Cotton, J, Gunning, M, Smith, D, Talwar, S, Holmberg, S, Purcell, I, Anderson, R, Alamgir, F, Beatt, K, Kelly, P, Moussavian, M, Aji, J, Prashad, R, Zankar, A, Banerjee, S, Lewis, S, McLaurin, B, Douglas, J, Brener, S, Gupta, A, Walters, L, Driesman, M, Aycock, R, Mego, C, Fisher, D, Frankel, R, and Satler, L

Published
2014
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4. Modifying effect of dual antiplatelet therapy on incidence of stent thrombosis according to implanted drug-eluting stent type

Author

Camenzind, Edoardo, Boersma, Eric, Wijns, William, Mauri, Laura, Rademaker-Havinga, Tessa, Ordoubadi, Farzin Fath, Suttorp, Maarten J., Al Kurdi, Mohammad, Steg, Ph Gabriel, Camenzind, E., Mauri, L., O'Neill, W., Serruys, P W., Steg, PhG, Wijns, W., Verheugt, FWA, Bertrand, ME, Califf, R., DeMets, D., Wallentin, L., Bocksch, W., Bosmans, J., Garcia, H., Garg, S., Hanet, C., Herrman, J-PR, Kelbaek, H., Mc Fadden, E., Radke, PW, Rutsch, W., Tilsted, HH, Wykrzykowska, J., Alvarez, C., Rodriguez, A., Meredith, I., Muller, D., Whitbourn, R., Worthley, S., Whelan, A., Walters, D., Shetty, S., New, G., Cox, S., Batra, R., van Gaal, W., Bellamy, G., Mayr, H., Heigert, M., Huber, K., Leisch, F., Desmet, W., Boland, J., Schroeder, E., Chenu, P., Legrand, V., Labinaz, M., Teefy, P., Bertrand, O., Gao, R., Ge, J., Kala, P., Cervinka, P., Ureña, P., Hartikainen, J., Steg, G., Fajadet, J., Carrie, D., Gilard, M., Barragan, P., Lablanche, J-M, Koning, R., Eltchaninoff, H., Darremont, O., Leroy, F., Bertrand, B., Robert, G., Schiele, F., Chassaing, S., Bressollette, E., Brunel, P., Quilliet, L., Brunet, J., Pansieri, M., Sideris, G., Stratiev, V., Teiger, E., Lebreton, H., Bonnet, J-L, Karsenty, B., Delarche, N., Lusson, J-R, Cassagnes, J., Brachmann, J., Kurowski, V., Buerke, M., Schieffer, B., Scholtz, W., Wiemer, M., Fichtlscherer, S., Schächinger, V., Kupatt, C., Boekstegers, P., Genth-Zotz, S., Bode, C., Frey, N., Neumann, F-J, Witzenbichler, B., Pels, K., Strasser, R., Kuck, K-H, Hauptmann, K-E, Baldus, S., Heitzer, T., Haude, M., Hoffmann, E., Jung, W., Hoffmann, S., Schmitt, C., Dissmann, M., Pauschinger, M., Werner, G., Braun-Delleus, R., Burkhardt, D., Manz, M., Voudris, V., Sionis, D., Kang-Yin, M-L, Tse, T-S, Merkely, B., Mehta, A., Parikh, K., Kumar, V., Chandra, P., Rath, P., Hiremath, S., Crean, P., Daly, K., Kornowski, R., Kerner, A., Mosseri, M., Jafari, G., Giudice, P., Trani, C., Manari, A., Prati, F., Pangrazi, A., Bolognese, L., Jeong, M-H, Kim, M-Y, Kim, H-S, Park, S-J, Erglis, A., Kalnins, A., Wagner, D., Zambahari, R., Ong, T-K, Sim, K., den Heijer, P., Appelman, Y., Suttorp, M-J, de Smet, B., Koolen, J., Stella, P., Harding, S., Warwick, J., Maslowski, A., Abernethy, M., Devlin, G., Rotevatn, S., Myreng, Y., Ciecwierz, D., Peruga, J., Reczuch, K., Campante Teles, R., Farto, P., Abreu, E., Leitão-Marques, A., Pereira, H., Vinereanu, D., Alkasab, S., Mhish, H., Al Kurdi, M., Al Turki, F., Wong, P., Teo, S-G, Goicolea Ruigomez, F-J, Valdés Chávarri, M., Bethencourt Gonzalez, A., Iñiguez Romo, A., López Minguez, J., Hernández García, J-M, Diaz Fernández, J., Ruiz Salmeron, R., Martinez Elbal, L., Zueco, J., López-Palop, RF, Melgares, R., Diderholm, E., Kåregren, A., Herterich, O., Olivencrona, G., Fröbert, O., Roffi, M., Verin, V., Girod, G., Vuilliomenet, A., Hsieh, I-C, Wu, C-J, Gershlick, A., Densem, C., Doshi, S., Manoharan, G., McCarthy, P., De Belder, M., Mills, J., Fath-Ordoubadi, F., Simpson, I., Greenwood, J., Chamberlain-Webber, R., Khan, Z., Cotton, J., Gunning, M., Smith, D., Talwar, S., Holmberg, S., Purcell, I., Anderson, R., Alamgir, F., Beatt, K., Kelly, P., Moussavian, M., Aji, J., Prashad, R., Zankar, A., Banerjee, S., Lewis, S., McLaurin, B., Douglas, J., Brener, S., Gupta, A., Walters, L., Driesman, M., Aycock, R., Mego, C., Fisher, D., Frankel, R., and Satler, L.

Subjects
animal structures, cardiovascular diseases, equipment and supplies
Abstract

Aim To investigate the putative modifying effect of dual antiplatelet therapy (DAPT) use on the incidence of stent thrombosis at 3 years in patients randomized to Endeavor zotarolimus-eluting stent (E-ZES) or Cypher sirolimus-eluting stent (C-SES). Methods and results Of 8709 patients in PROTECT, 4357 were randomized to E-ZES and 4352 to C-SES. Aspirin was to be given indefinitely, and clopidogrel/ticlopidine for ≥3 months or up to 12 months after implantation. Main outcome measures were definite or probable stent thrombosis at 3 years. Multivariable Cox regression analysis was applied, with stent type, DAPT, and their interaction as the main outcome determinants. Dual antiplatelet therapy adherence remained the same in the E-ZES and C-SES groups (79.6% at 1 year, 32.8% at 2 years, and 21.6% at 3 years). We observed a statistically significant (P = 0.0052) heterogeneity in treatment effect of stent type in relation to DAPT. In the absence of DAPT, stent thrombosis was lower with E-ZES vs. C-SES (adjusted hazard ratio 0.38, 95% confidence interval 0.19, 0.75; P = 0.0056). In the presence of DAPT, no difference was found (1.18; 0.79, 1.77; P = 0.43). Conclusion A strong interaction was observed between drug-eluting stent type and DAPT use, most likely prompted by the vascular healing response induced by the implanted DES system. These results suggest that the incidence of stent thrombosis in DES trials should not be evaluated independently of DAPT use, and the optimal duration of DAPT will likely depend upon stent type (Clinicaltrials.gov number NCT00476957)

Published
2017

5. Interventional treatment in diabetics in the era of drug-eluting stents and compliance to the ESC guidelines: lessons learned from the Euro Heart Survey Programme

Author

Onuma Y., Kukreja N., Ramcharitar S., Hochadel M., Gitt A., Serruys P., Marco J., Vahanian A., Weidinger F., Wijns W., Zeymer U., Silber S., Seabra-Gomez R., Eberli F., Manini M., Bramley C., Laforest V., Taylor C., Huber K., Backer G. D., Sirakova V., Cerbak R., Thayssen P., Aziz O. A., Tammam K., Lehto S., Delahaye F., Kobulia B., Cokkinos D., Kremastinos D., Karlocai K., Shelley E., Behar S., Maggioni A., Grabauskiene V., Deckers J., Asmussen I., Stepinska J., Goncalves L., Fonseca C., Mareev V., Vasilijevic Z., Riecansky M. I., Kenda M. F., Lopez-Sendon J. L., Rosengren A., Buser P., Okay T., Sychov O., Schofield P., Gitt A. K., Tavazzi L., Gomes R. S., de la Iglesia J. M., Wallentin L., Kearney P., McGregor K., Simoons M. L., Squibb B. -M., Lilly E., Margaryan K., Khachatryan S., Doerler J., Stocker E. -M., Altenberger I. J., Heigert M., Pichler M., Christ S. G., Glogar H., Lang I., Ingerle S., De Wilde P., de Marneffe M., Vrolix B. M., Dens J., Lierde J. V., De Wagter G. X., Carlier G. M., Weyne G. A., Legrand K. V., Doneux P., Gach O., Davin L., Mievis L. E., Massart P. -E., Holvoet N. G., Giunio L., Glavas D., Vukovic I., Markovic B., Duplancic D., Runjic F., Galic S. E., Mirat J., Kala P., Semenka J., Hlinomaz O., Petrikovits E., Widimsky B. P., Tousek P., Varvarovsky P. I., Cappelen H., Helqvist O. S., Kelbaek H., Jorgensen E., Engstrom T., Saunamaki K., Kastrup J., Clemmensen P., Hansen H., Al Abbadi M., Razek H. A., Aboul el Nasr G., Ragi H., Ibrihim B., Zarif B., el Banhawy N., Sorour K., Meguid M. A., Mahrous A., Al Khashab K. A., Ahmed Abd Elmoniem F., El Emry M., El Naggar A., Saad B. A., Laanmets P., Voitk J., Lutter P., Jarvekulg S., Jalakas M., Reinmets J., Marandi T., Peeba M., Serka T., Syvannne M., Kaihovirta E., Korpilahti H. K., Vaittinen M. -A., Bassand J. -P., Espinosa D. P., Cottin B. Y., Lhuillier I., Buffet P., Lorgis L., Machecourt D. J., Bertrand B., Serrano D., Bonnet G. J. -L., Steg M. P. G., Juliard J. -M., Farnoud R., Delarche P. N., Marco P. J., Petit F., Farah B., Carrie D., Galinier M., Puel J., Cahuzac J., Roncalli J., Tauzin S., Elbaz M., Schachinger V., Gitt F. A., am Rhein Ralf Zahn L., Fraiture B., Haetinger S., Klepzig N. H., Girth E., Hauber A., Firschke O. C., Widmaier J., Hofbauer F., Huttl S., Sechtem P. U., Parade U., Linnartz S. G., Andrianidis S., Tsiavou N., Papaioannou G., Deliargyris E., Attikis M., Alexopoulos D., Davlouros P., Tsikaderis D., Dardas P., Mezilis N., Istvan E., Zoltan B., Turgeman Y., Khaled S., Feldman A., Jafari J., Manevich I., Cafri C., Ilia R., Abu-Ful A., Yaroslavslev S., Wainstain J. M., Rosenchtein G., Sheva B., Krakover R., Yakov B., Halon D., Gruberg L., Markiewicz W., Grenadier E., Boulos M., Roguin A., Kerner A., Amikam S., Ben-Tzvi M., Rezmovitz J., Mosseri H. M., Lotan H., Varshizky B., Nassar H., Daninberg H., Rot D., Vais T., Benhorin J., Keren A., Medina A., Huri Z., Brandis J. S., Schoenmann G., Kornowski N. R., Assali A., Fuch S., Hasdai D., Brosh D., Sela O., Teplitski I., Tikva P., Eisenberg O., Banai S., Finkelstein A., Hasin Y., Aboud M., Nahir M., Qarwani D., Diab G., Meloni L., Lai G., Cadeddu M., Pirisi R., Bonechi F., Nassi F., Nieri M., Taiti A., Naldoni A., Calabro F., Achilli F., Maggiolini S., Piatti L., Tiberti G., Addamiano P., Berti S., Ravani M., Palmieri C., Trianni G., Cardullo S., Cioppa A., Rubino P., Ambrosini V., Salemme L., Sorropago G., Tesorio T., Geraci G., Scalise F., Mazzeti S., Auguadro C., Esposito G., Canali G., Caccia M. E., Ruggieri C., Benedetta B., de Cesare N., De Benedictis M., Coco T., Manzotti S., Fraz O. S., Marraccini P., Danesi A., Ricci R., Ferraironi A., Olivieri E., Chiera A., Garducci S., Grasseli D., McFadden E., Cahill N., Quinn M., Crean P., Caroll E., Foley D., O'Connor S., O'Hanlon R., Lynch B., O'Donnell S., Roy J., O'Brien D., Krastina A., Erglis A., Lawand S., Dorniak W., Klaudel J., Pawlowski K., Trenkner W., Janion M., Sadowski M., Janion-Sadowska A., Skorupa I., Bystryk L., Kern A., Janiak B., Szelemej R., Ruzyllo W., Witkowski A., Deptuch T., Maczynska-Mazuruk R., Budaj A., Cegieska K. L., Opolski G., Wilczyska J., Roik M., Kochman J., Martins D., Goncalves I. M. F. J., Pereira H., Faria H., Calisto J., Matos V., Leitao-Marques A., Costa M., Oliveira H., Mota P., Santos W., Brandao V., Caires F. G., Silva B., Teles F. R. C., Almeida M., Goncalves P., Raposo L., Mourao L., Bernardes L., Pedro P. G., Ferreira R., Conduto R., Quininha J., Patricio L., Cacela D., Goncalves J. M., de Sousa L., Adao M., Carvalho L. H. C., Romeira H., Sousa J. P., Garcia J. M. M., Silva J. C., Magalhaes D., Santos P. R., Mendes S. P. G., Pipa J., Nunes L., Ferreira P., Vinereanu D., Udroiu C., Florescu N., Parvu O., Stoicescu C., Dorobantu M., Balanescu S. M., Niculescu R., Calmac L., Marinescu M., Olinic B. D., Ober M., Homorodean C., Budurea C., Hij A., Anton F., Cluj-Napoca, Ortan F., Suciu C., Ursu M., Baba C., Targu-Mures, Dragulescu S. I., Petrescu L., Slovenski M., Gavrilescu D., Dina C., Mut B., Babic R., Colic M., Topic D., Vilarrasa J. B., Pont M. P., Martorell R. M., Rohlfs I., Moreno R. M., Irurita M., Irurita J., de Gran Canaria L. P., Cervantes C. E., Galvan T., Navarro J., Franco D., Rodriguez I. S., Ramirez V. H., Fernandes-Aviles F., Revilla A., Masson N., Dupertuis V., Kachboura S., Iyisoy A., Erol M. K., Ongen Z., Babalik E., Oskan M., Ozdemir N., Oto A., Aytemir K., Yavuz B., Sahin M., Durna K., Aytekin V., Demiroglu C., Gulbaran M., Aytekin S., Catakoglu A. B., Ozme B., Gemici G., Feray H., Schofield P. M., Kahn S., Clarke S., Millington H., Di Mario C., Dempster D., Henderson R. A., Burton J., Falcon-Lang D., Cardiology, Onuma, Y., Kukreja, N., Ramcharitar, S., Hochadel, M., Gitt, A., Serruys, P., Marco, J., Vahanian, A., Weidinger, F., Wijns, W., Zeymer, U., Silber, S., Seabra-Gomez, R., Eberli, F., Manini, M., Bramley, C., Laforest, V., Taylor, C., Huber, K., Backer, G. D., Sirakova, V., Cerbak, R., Thayssen, P., Aziz, O. A., Tammam, K., Lehto, S., Delahaye, F., Kobulia, B., Cokkinos, D., Kremastinos, D., Karlocai, K., Shelley, E., Behar, S., Maggioni, A., Grabauskiene, V., Deckers, J., Asmussen, I., Stepinska, J., Goncalves, L., Fonseca, C., Mareev, V., Vasilijevic, Z., Riecansky, M. I., Kenda, M. F., Lopez-Sendon, J. L., Rosengren, A., Buser, P., Okay, T., Sychov, O., Schofield, P., Gitt, A. K., Tavazzi, L., Gomes, R. S., de la Iglesia, J. M., Wallentin, L., Kearney, P., Mcgregor, K., Simoons, M. L., Squibb, B. -M., Lilly, E., Margaryan, K., Khachatryan, S., Doerler, J., Stocker, E. -M., Altenberger, I. J., Heigert, M., Pichler, M., Christ, S. G., Glogar, H., Lang, I., Ingerle, S., De Wilde, P., de Marneffe, M., Vrolix, B. M., Dens, J., Lierde, J. V., De Wagter, G. X., Carlier, G. M., Weyne, G. A., Legrand, K. V., Doneux, P., Gach, O., Davin, L., Mievis, L. E., Massart, P. -E., Holvoet, N. G., Giunio, L., Glavas, D., Vukovic, I., Markovic, B., Duplancic, D., Runjic, F., Galic, S. E., Mirat, J., Kala, P., Semenka, J., Hlinomaz, O., Petrikovits, E., Widimsky, B. P., Tousek, P., Varvarovsky, P. I., Cappelen, H., Helqvist, O. S., Kelbaek, H., Jorgensen, E., Engstrom, T., Saunamaki, K., Kastrup, J., Clemmensen, P., Hansen, H., Al Abbadi, M., Razek, H. A., Aboul el Nasr, G., Ragi, H., Ibrihim, B., Zarif, B., el Banhawy, N., Sorour, K., Meguid, M. A., Mahrous, A., Al Khashab, K. A., Ahmed Abd Elmoniem, F., El Emry, M., El Naggar, A., Saad, B. A., Laanmets, P., Voitk, J., Lutter, P., Jarvekulg, S., Jalakas, M., Reinmets, J., Marandi, T., Peeba, M., Serka, T., Syvannne, M., Kaihovirta, E., Korpilahti, H. K., Vaittinen, M. -A., Bassand, J. -P., Espinosa, D. P., Cottin, B. Y., Lhuillier, I., Buffet, P., Lorgis, L., Machecourt, D. J., Bertrand, B., Serrano, D., Bonnet, G. J. -L., Steg, M. P. G., Juliard, J. -M., Farnoud, R., Delarche, P. N., Marco, P. J., Petit, F., Farah, B., Carrie, D., Galinier, M., Puel, J., Cahuzac, J., Roncalli, J., Tauzin, S., Elbaz, M., Schachinger, V., Gitt, F. A., am Rhein Ralf Zahn, L., Fraiture, B., Haetinger, S., Klepzig, N. H., Girth, E., Hauber, A., Firschke, O. C., Widmaier, J., Hofbauer, F., Huttl, S., Sechtem, P. U., Parade, U., Linnartz, S. G., Andrianidis, S., Tsiavou, N., Papaioannou, G., Deliargyris, E., Attikis, M., Alexopoulos, D., Davlouros, P., Tsikaderis, D., Dardas, P., Mezilis, N., Istvan, E., Zoltan, B., Turgeman, Y., Khaled, S., Feldman, A., Jafari, J., Manevich, I., Cafri, C., Ilia, R., Abu-Ful, A., Yaroslavslev, S., Wainstain, J. M., Rosenchtein, G., Sheva, B., Krakover, R., Yakov, B., Halon, D., Gruberg, L., Markiewicz, W., Grenadier, E., Boulos, M., Roguin, A., Kerner, A., Amikam, S., Ben-Tzvi, M., Rezmovitz, J., Mosseri, H. M., Lotan, H., Varshizky, B., Nassar, H., Daninberg, H., Rot, D., Vais, T., Benhorin, J., Keren, A., Medina, A., Huri, Z., Brandis, J. S., Schoenmann, G., Kornowski, N. R., Assali, A., Fuch, S., Hasdai, D., Brosh, D., Sela, O., Teplitski, I., Tikva, P., Eisenberg, O., Banai, S., Finkelstein, A., Hasin, Y., Aboud, M., Nahir, M., Qarwani, D., Diab, G., Meloni, L., Lai, G., Cadeddu, M., Pirisi, R., Bonechi, F., Nassi, F., Nieri, M., Taiti, A., Naldoni, A., Calabro, F., Achilli, F., Maggiolini, S., Piatti, L., Tiberti, G., Addamiano, P., Berti, S., Ravani, M., Palmieri, C., Trianni, G., Cardullo, S., Cioppa, A., Rubino, P., Ambrosini, V., Salemme, L., Sorropago, G., Tesorio, T., Geraci, G., Scalise, F., Mazzeti, S., Auguadro, C., Esposito, G., Canali, G., Caccia, M. E., Ruggieri, C., Benedetta, B., de Cesare, N., De Benedictis, M., Coco, T., Manzotti, S., Fraz, O. S., Marraccini, P., Danesi, A., Ricci, R., Ferraironi, A., Olivieri, E., Chiera, A., Garducci, S., Grasseli, D., Mcfadden, E., Cahill, N., Quinn, M., Crean, P., Caroll, E., Foley, D., O'Connor, S., O'Hanlon, R., Lynch, B., O'Donnell, S., Roy, J., O'Brien, D., Krastina, A., Erglis, A., Lawand, S., Dorniak, W., Klaudel, J., Pawlowski, K., Trenkner, W., Janion, M., Sadowski, M., Janion-Sadowska, A., Skorupa, I., Bystryk, L., Kern, A., Janiak, B., Szelemej, R., Ruzyllo, W., Witkowski, A., Deptuch, T., Maczynska-Mazuruk, R., Budaj, A., Cegieska, K. L., Opolski, G., Wilczyska, J., Roik, M., Kochman, J., Martins, D., Goncalves, I. M. F. J., Pereira, H., Faria, H., Calisto, J., Matos, V., Leitao-Marques, A., Costa, M., Oliveira, H., Mota, P., Santos, W., Brandao, V., Caires, F. G., Silva, B., Teles, F. R. C., Almeida, M., Goncalves, P., Raposo, L., Mourao, L., Bernardes, L., Pedro, P. G., Ferreira, R., Conduto, R., Quininha, J., Patricio, L., Cacela, D., Goncalves, J. M., de Sousa, L., Adao, M., Carvalho, L. H. C., Romeira, H., Sousa, J. P., Garcia, J. M. M., Silva, J. C., Magalhaes, D., Santos, P. R., Mendes, S. P. G., Pipa, J., Nunes, L., Ferreira, P., Vinereanu, D., Udroiu, C., Florescu, N., Parvu, O., Stoicescu, C., Dorobantu, M., Balanescu, S. M., Niculescu, R., Calmac, L., Marinescu, M., Olinic, B. D., Ober, M., Homorodean, C., Budurea, C., Hij, A., Anton, F., Cluj-Napoca, Ortan, F., Suciu, C., Ursu, M., Baba, C., Targu-Mures, Dragulescu, S. I., Petrescu, L., Slovenski, M., Gavrilescu, D., Dina, C., Mut, B., Babic, R., Colic, M., Topic, D., Vilarrasa, J. B., Pont, M. P., Martorell, R. M., Rohlfs, I., Moreno, R. M., Irurita, M., Irurita, J., de Gran Canaria, L. P., Cervantes, C. E., Galvan, T., Navarro, J., Franco, D., Rodriguez, I. S., Ramirez, V. H., Fernandes-Aviles, F., Revilla, A., Masson, N., Dupertuis, V., Kachboura, S., Iyisoy, A., Erol, M. K., Ongen, Z., Babalik, E., Oskan, M., Ozdemir, N., Oto, A., Aytemir, K., Yavuz, B., Sahin, M., Durna, K., Aytekin, V., Demiroglu, C., Gulbaran, M., Aytekin, S., Catakoglu, A. B., Ozme, B., Gemici, G., Feray, H., Schofield, P. M., Kahn, S., Clarke, S., Millington, H., Di Mario, C., Dempster, D., Henderson, R. A., Burton, J., and Falcon-Lang, D.

Subjects
Registrie, Male, medicine.medical_treatment, Angiotensin-Converting Enzyme Inhibitors, Comorbidity, Coronary Artery Disease, Severity of Illness Index, Cardiovascular Disease, Hospital Mortality, Registries, Angioplasty, Balloon, Coronary, Drug-Eluting Stents, Middle Aged, Clopidogrel, Europe, Treatment Outcome, Drug-eluting stent, Cardiovascular Diseases, Practice Guidelines as Topic, Female, Guideline Adherence, Inpatient, Cardiology and Cardiovascular Medicine, Human, medicine.drug, medicine.medical_specialty, Diabetic Angiopathie, Adrenergic beta-Antagonists, Diabetic, SDG 3 - Good Health and Well-being, Internal medicine, Diabetes mellitus, Angioplasty, medicine, Humans, Drug eluting stent, cardiovascular diseases, Risk factor, Aged, European Heart Survey, Inpatients, Clinical Audit, business.industry, Platelet Aggregation Inhibitor, Adrenergic beta-Antagonist, Angiotensin-Converting Enzyme Inhibitor, Guideline, medicine.disease, Surgery, Health Care Survey, Health Care Surveys, Conventional PCI, Hydroxymethylglutaryl-CoA Reductase Inhibitor, Hydroxymethylglutaryl-CoA Reductase Inhibitors, business, Diabetic Angiopathies, Platelet Aggregation Inhibitors
Abstract

Aims: The objective of the study is to determine the demographics and the in-hospital outcome of diabetic and non-diabetic patients treated with percutaneous coronary interventions (PCI) in Europe, to report the type of equipment and technology used for PCI procedures in diabetics and to clarify whether the treatment of diabetic patients complies with current European Society of Cardiology (ESC) guidelines. Methods and results: A total of 14,458 patients treated with PCI were enrolled from 29 member countries of the ESC between June 2005 and January 2006. Data were collected on patient characteristics and treatment, using new Cardiology Audit and Registration Data standards. In total, 3,603 patients (24.9%) were diabetic. Diabetics were older, more often female and had a higher body mass index than non-diabetics. Diabetics had higher rates of hypercholesterolaemia and hypertension, while current smokers were more frequent in the non-diabetics. Diabetics also had significantly higher rates of previous cardiovascular events. Clopidogrel was administered only in 48.1% of diabetic patients before PCI, while IIb/IIIa inhibitors were 22.9% during PCI. At discharge, there was a major adjustment of treatment with increases in the use of Beta-blocker (80.4%), angiotensin converting enzyme inhibitor (ACEI, 71.3%) and statins (89.8%) compared with on admission (Beta-blocker 60.9%, ACEI 55.0%, statin 63.1%). Inhospital mortality was higher in diabetics (1.8% vs 1.2%) although the in-hospital MACCE rate was not significantly different (3.6% vs 3.0%, p=0.09). Conclusions: Diabetic patients treated with PCI were older with more comorbidity. According to ESC guideline, the under-usage of clopidogrel, GP IIb/IIIa inhibitors should be improved. PCI is now taken as a good opportunity to adjust the use of appropriate medication. © Europa Edition. All rights reserved.

Published
2009
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6. Pr�hospitale Behandlung eines Myokardinfarkts unter erschwerten Bedingungen

Author

Pichler M, Heigert M, Michalski T, and Chmelizek F

Subjects
Emergency Medicine
Abstract

Extreme akute internistische Notfalle wie kardial bedingte Reanimationen im alpinen Bereich machen ca. 35 von uber 13.000 Einsatzen/Jahr im Bereich der Christophorus-Flugrettung in Osterreich aus. Anhand einer Kasuistik werden die Moglichkeiten der Durchfuhrung einer prahospitalen Lyse angesichts widriger auserer Umstande dargestellt.

Published
2004
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8. Modifying effect of dual antiplatelet therapy on incidence of stent thrombosis according to implanted drug-eluting stent type

Author

Camenzind, Edoardo, Boersma, Eric, Wijns, William, Mauri, Laura, Rademaker-Havinga, Tessa, Ordoubadi, Farzin Fath, Suttorp, Maarten J., Al Kurdi, Mohammad, Steg, Ph Gabriel, Camenzind, E., Mauri, L., O'Neill, W., Serruys, P W., Steg, PhG, Wijns, W., Verheugt, FWA, Bertrand, ME, Califf, R., DeMets, D., Wallentin, L., Bocksch, W., Bosmans, J., Garcia, H., Garg, S., Hanet, C., Herrman, J-PR, Kelbaek, H., Mc Fadden, E., Radke, PW, Rutsch, W., Tilsted, HH, Wykrzykowska, J., Alvarez, C., Rodriguez, A., Meredith, I., Muller, D., Whitbourn, R., Worthley, S., Whelan, A., Walters, D., Shetty, S., New, G., Cox, S., Batra, R., van Gaal, W., Bellamy, G., Mayr, H., Heigert, M., Huber, K., Leisch, F., Desmet, W., Boland, J., Schroeder, E., Chenu, P., Legrand, V., Labinaz, M., Teefy, P., Bertrand, O., Gao, R., Ge, J., Kala, P., Cervinka, P., Ureña, P., Hartikainen, J., Steg, G., Fajadet, J., Carrie, D., Gilard, M., Barragan, P., Lablanche, J-M, Koning, R., Eltchaninoff, H., Darremont, O., Leroy, F., Bertrand, B., Robert, G., Schiele, F., Chassaing, S., Bressollette, E., Brunel, P., Quilliet, L., Brunet, J., Pansieri, M., Sideris, G., Stratiev, V., Teiger, E., Lebreton, H., Bonnet, J-L, Karsenty, B., Delarche, N., Lusson, J-R, Cassagnes, J., Brachmann, J., Kurowski, V., Buerke, M., Schieffer, B., Scholtz, W., Wiemer, M., Fichtlscherer, S., Schächinger, V., Kupatt, C., Boekstegers, P., Genth-Zotz, S., Bode, C., Frey, N., Neumann, F-J, Witzenbichler, B., Pels, K., Strasser, R., Kuck, K-H, Hauptmann, K-E, Baldus, S., Heitzer, T., Haude, M., Hoffmann, E., Jung, W., Hoffmann, S., Schmitt, C., Dissmann, M., Pauschinger, M., Werner, G., Braun-Delleus, R., Burkhardt, D., Manz, M., Voudris, V., Sionis, D., Kang-Yin, M-L, Tse, T-S, Merkely, B., Mehta, A., Parikh, K., Kumar, V., Chandra, P., Rath, P., Hiremath, S., Crean, P., Daly, K., Kornowski, R., Kerner, A., Mosseri, M., Jafari, G., Giudice, P., Trani, C., Manari, A., Prati, F., Pangrazi, A., Bolognese, L., Jeong, M-H, Kim, M-Y, Kim, H-S, Park, S-J, Erglis, A., Kalnins, A., Wagner, D., Zambahari, R., Ong, T-K, Sim, K., den Heijer, P., Appelman, Y., Suttorp, M-J, de Smet, B., Koolen, J., Stella, P., Harding, S., Warwick, J., Maslowski, A., Abernethy, M., Devlin, G., Rotevatn, S., Myreng, Y., Ciecwierz, D., Peruga, J., Reczuch, K., Campante Teles, R., Farto, P., Abreu, E., Leitão-Marques, A., Pereira, H., Vinereanu, D., Alkasab, S., Mhish, H., Al Kurdi, M., Al Turki, F., Wong, P., Teo, S-G, Goicolea Ruigomez, F-J, Valdés Chávarri, M., Bethencourt Gonzalez, A., Iñiguez Romo, A., López Minguez, J., Hernández García, J-M, Diaz Fernández, J., Ruiz Salmeron, R., Martinez Elbal, L., Zueco, J., López-Palop, RF, Melgares, R., Diderholm, E., Kåregren, A., Herterich, O., Olivencrona, G., Fröbert, O., Roffi, M., Verin, V., Girod, G., Vuilliomenet, A., Hsieh, I-C, Wu, C-J, Gershlick, A., Densem, C., Doshi, S., Manoharan, G., McCarthy, P., De Belder, M., Mills, J., Fath-Ordoubadi, F., Simpson, I., Greenwood, J., Chamberlain-Webber, R., Khan, Z., Cotton, J., Gunning, M., Smith, D., Talwar, S., Holmberg, S., Purcell, I., Anderson, R., Alamgir, F., Beatt, K., Kelly, P., Moussavian, M., Aji, J., Prashad, R., Zankar, A., Banerjee, S., Lewis, S., McLaurin, B., Douglas, J., Brener, S., Gupta, A., Walters, L., Driesman, M., Aycock, R., Mego, C., Fisher, D., Frankel, R., Satler, L., Camenzind, Edoardo, Boersma, Eric, Wijns, William, Mauri, Laura, Rademaker-Havinga, Tessa, Ordoubadi, Farzin Fath, Suttorp, Maarten J., Al Kurdi, Mohammad, Steg, Ph Gabriel, Camenzind, E., Mauri, L., O'Neill, W., Serruys, P W., Steg, PhG, Wijns, W., Verheugt, FWA, Bertrand, ME, Califf, R., DeMets, D., Wallentin, L., Bocksch, W., Bosmans, J., Garcia, H., Garg, S., Hanet, C., Herrman, J-PR, Kelbaek, H., Mc Fadden, E., Radke, PW, Rutsch, W., Tilsted, HH, Wykrzykowska, J., Alvarez, C., Rodriguez, A., Meredith, I., Muller, D., Whitbourn, R., Worthley, S., Whelan, A., Walters, D., Shetty, S., New, G., Cox, S., Batra, R., van Gaal, W., Bellamy, G., Mayr, H., Heigert, M., Huber, K., Leisch, F., Desmet, W., Boland, J., Schroeder, E., Chenu, P., Legrand, V., Labinaz, M., Teefy, P., Bertrand, O., Gao, R., Ge, J., Kala, P., Cervinka, P., Ureña, P., Hartikainen, J., Steg, G., Fajadet, J., Carrie, D., Gilard, M., Barragan, P., Lablanche, J-M, Koning, R., Eltchaninoff, H., Darremont, O., Leroy, F., Bertrand, B., Robert, G., Schiele, F., Chassaing, S., Bressollette, E., Brunel, P., Quilliet, L., Brunet, J., Pansieri, M., Sideris, G., Stratiev, V., Teiger, E., Lebreton, H., Bonnet, J-L, Karsenty, B., Delarche, N., Lusson, J-R, Cassagnes, J., Brachmann, J., Kurowski, V., Buerke, M., Schieffer, B., Scholtz, W., Wiemer, M., Fichtlscherer, S., Schächinger, V., Kupatt, C., Boekstegers, P., Genth-Zotz, S., Bode, C., Frey, N., Neumann, F-J, Witzenbichler, B., Pels, K., Strasser, R., Kuck, K-H, Hauptmann, K-E, Baldus, S., Heitzer, T., Haude, M., Hoffmann, E., Jung, W., Hoffmann, S., Schmitt, C., Dissmann, M., Pauschinger, M., Werner, G., Braun-Delleus, R., Burkhardt, D., Manz, M., Voudris, V., Sionis, D., Kang-Yin, M-L, Tse, T-S, Merkely, B., Mehta, A., Parikh, K., Kumar, V., Chandra, P., Rath, P., Hiremath, S., Crean, P., Daly, K., Kornowski, R., Kerner, A., Mosseri, M., Jafari, G., Giudice, P., Trani, C., Manari, A., Prati, F., Pangrazi, A., Bolognese, L., Jeong, M-H, Kim, M-Y, Kim, H-S, Park, S-J, Erglis, A., Kalnins, A., Wagner, D., Zambahari, R., Ong, T-K, Sim, K., den Heijer, P., Appelman, Y., Suttorp, M-J, de Smet, B., Koolen, J., Stella, P., Harding, S., Warwick, J., Maslowski, A., Abernethy, M., Devlin, G., Rotevatn, S., Myreng, Y., Ciecwierz, D., Peruga, J., Reczuch, K., Campante Teles, R., Farto, P., Abreu, E., Leitão-Marques, A., Pereira, H., Vinereanu, D., Alkasab, S., Mhish, H., Al Kurdi, M., Al Turki, F., Wong, P., Teo, S-G, Goicolea Ruigomez, F-J, Valdés Chávarri, M., Bethencourt Gonzalez, A., Iñiguez Romo, A., López Minguez, J., Hernández García, J-M, Diaz Fernández, J., Ruiz Salmeron, R., Martinez Elbal, L., Zueco, J., López-Palop, RF, Melgares, R., Diderholm, E., Kåregren, A., Herterich, O., Olivencrona, G., Fröbert, O., Roffi, M., Verin, V., Girod, G., Vuilliomenet, A., Hsieh, I-C, Wu, C-J, Gershlick, A., Densem, C., Doshi, S., Manoharan, G., McCarthy, P., De Belder, M., Mills, J., Fath-Ordoubadi, F., Simpson, I., Greenwood, J., Chamberlain-Webber, R., Khan, Z., Cotton, J., Gunning, M., Smith, D., Talwar, S., Holmberg, S., Purcell, I., Anderson, R., Alamgir, F., Beatt, K., Kelly, P., Moussavian, M., Aji, J., Prashad, R., Zankar, A., Banerjee, S., Lewis, S., McLaurin, B., Douglas, J., Brener, S., Gupta, A., Walters, L., Driesman, M., Aycock, R., Mego, C., Fisher, D., Frankel, R., and Satler, L.

Abstract

Aim To investigate the putative modifying effect of dual antiplatelet therapy (DAPT) use on the incidence of stent thrombosis at 3 years in patients randomized to Endeavor zotarolimus-eluting stent (E-ZES) or Cypher sirolimus-eluting stent (C-SES). Methods and results Of 8709 patients in PROTECT, 4357 were randomized to E-ZES and 4352 to C-SES. Aspirin was to be given indefinitely, and clopidogrel/ticlopidine for ≥3 months or up to 12 months after implantation. Main outcome measures were definite or probable stent thrombosis at 3 years. Multivariable Cox regression analysis was applied, with stent type, DAPT, and their interaction as the main outcome determinants. Dual antiplatelet therapy adherence remained the same in the E-ZES and C-SES groups (79.6% at 1 year, 32.8% at 2 years, and 21.6% at 3 years). We observed a statistically significant (P = 0.0052) heterogeneity in treatment effect of stent type in relation to DAPT. In the absence of DAPT, stent thrombosis was lower with E-ZES vs. C-SES (adjusted hazard ratio 0.38, 95% confidence interval 0.19, 0.75; P = 0.0056). In the presence of DAPT, no difference was found (1.18; 0.79, 1.77; P = 0.43). Conclusion A strong interaction was observed between drug-eluting stent type and DAPT use, most likely prompted by the vascular healing response induced by the implanted DES system. These results suggest that the incidence of stent thrombosis in DES trials should not be evaluated independently of DAPT use, and the optimal duration of DAPT will likely depend upon stent type (Clinicaltrials.gov number NCT00476957)

9. OCT or Angiography Guidance for PCI in Complex Bifurcation Lesions.

Author

Holm, N. R., Andreasen, L. N., Neghabat, O., Laanmets, P., Kumsars, I., Bennett, J., Olsen, N. T., Odenstedt, J., Hoffmann, P., Dens, J., Chowdhary, S., O'Kane, P., Rasmussen, S.-H. Bülow, Heigert, M., Havndrup, O., Van Kuijk, J. P., Biscaglia, S., Mogensen, L. J. H., Henareh, L., and Burzotta, F.

Subjects
*MYOCARDIAL infarction, *PERCUTANEOUS coronary intervention, *MAJOR adverse cardiovascular events, *OPTICAL coherence tomography, *ANGIOGRAPHY, *CORONARY angiography
Abstract

BACKGROUND Imaging-guided percutaneous coronary intervention (PCI) is associated with better clinical outcomes than angiography-guided PCI. Whether routine optical coherence tomography (OCT) guidance in PCI of lesions involving coronary-artery branch points (bifurcations) improves clinical outcomes as compared with angiographic guidance is uncertain. METHODS We conducted a multicenter, randomized, open-label trial at 38 centers in Europe. Patients with a clinical indication for PCI and a complex bifurcation lesion identified by means of coronary angiography were randomly assigned in a 1:1 ratio to OCT-guided PCI or angiography-guided PCI. The primary end point was a composite of major adverse cardiac events (MACE), defined as death from a cardiac cause, target-lesion myocardial infarction, or ischemia-driven target-lesion revascularization at a median follow-up of 2 years. RESULTS We assigned 1201 patients to OCT-guided PCI (600 patients) or angiography- guided PCI (601 patients). A total of 111 patients (18.5%) in the OCT-guided PCI group and 116 (19.3%) in the angiography-guided PCI group had a bifurcation lesion involving the left main coronary artery. At 2 years, a primary end-point event had occurred in 59 patients (10.1%) in the OCT-guided PCI group and in 83 patients (14.1%) in the angiography-guided PCI group (hazard ratio, 0.70; 95% confidence interval, 0.50 to 0.98; P=0.035). Procedure-related complications occurred in 41 patients (6.8%) in the OCT-guided PCI group and 34 patients (5.7%) in the angiography- guided PCI group. CONCLUSIONS Among patients with complex coronary-artery bifurcation lesions, OCT-guided PCI was associated with a lower incidence of MACE at 2 years than angiography-guided PCI. [ABSTRACT FROM AUTHOR]

Published
2023
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11. Associations of Menstrual Cycle and Progesterone-to-Estradiol Ratio With Alcohol Consumption in Alcohol Use Disorder: A Sex-Separated Multicenter Longitudinal Study.

Author

Hoffmann S, Gerhardt S, Mühle C, Reinhard I, Reichert D, Bach P, Boroumand-Jazi R, Kuehner C, Aguilera A, Aslan A, Bahr NS, Belanger M, Deeken F, Ebrahimi C, Fischbach PC, Ganz M, Garbusow M, Großkopf CM, Heigert M, Hentschel A, Karl D, Liu S, Mazza M, Pelz P, Pinger M, Reichl M, Riemerschmid C, Rosenthal A, Steffen J, Strehle J, Wedemeyer F, Weiss F, Wenzel J, Wieder G, Wieland A, Zaiser J, Zech HG, Zimmermann S, Kornhuber J, Müller CP, Sommer WH, Spanagel R, Banaschewski T, Deserno L, Ebner-Priemer UW, Flor H, Kirsch P, Rietschel M, Vollstädt-Klein S, Walter H, Meyer-Lindenberg A, Rapp MA, Witt S, Smolka MN, Heinz A, Tost H, Kiefer F, Reichert M, and Lenz B

Subjects
Humans, Female, Male, Adult, Longitudinal Studies, Binge Drinking blood, Binge Drinking epidemiology, Sex Factors, Middle Aged, Young Adult, Estradiol blood, Progesterone blood, Menstrual Cycle blood, Alcoholism blood, Alcoholism epidemiology, Alcohol Drinking blood, Alcohol Drinking epidemiology
Abstract

Objective: Alcohol use disorder (AUD) constitutes a critical public health issue and has sex-specific characteristics. Initial evidence suggests that progesterone and estradiol might reduce or increase alcohol intake, respectively. However, there is a need for a better understanding of how the menstrual cycle in females and the ratio of progesterone to estradiol in females and males influence alcohol use patterns in individuals with AUD., Methods: In this sex-separated multicenter longitudinal study, the authors analyzed 12-month data on real-life alcohol use (from 21,460 smartphone entries), menstrual cycle, and serum progesterone-to-estradiol ratios (from 667 blood samples at four individual study visits) in 74 naturally cycling females and 278 males with AUD between 2020 and 2022, using generalized and general linear mixed modeling., Results: Menstrual cycle phases were significantly associated with binge drinking and progesterone-to-estradiol ratio. During the late luteal phase, females showed a lower predicted binge drinking probability of 13% and a higher predicted marginal mean of progesterone-to-estradiol ratio of 95 compared with during the menstrual, follicular, and ovulatory phases (binge drinking probability and odds ratios vs. late luteal phase, respectively: 17%, odds ratio=1.340, 95% CI=1.031, 1.742; 19%, odds ratio=1.523, 95% CI=1.190, 1.949; and 20%, odds ratio=1.683, 95% CI=1.285, 2.206; difference in progesterone-to-estradiol ratios, respectively: -61, 95% CI=-105.492, -16.095; -78, 95% CI=-119.322, -37.039; and -71, 95% CI=-114.568, -27.534). In males, a higher progesterone-to-estradiol ratio was related to lower probabilities of binge drinking and of any alcohol use, with a 10-unit increase in the hormone ratio resulting in odds ratios of 0.918 (95% CI=0.843, 0.999) and 0.914 (95% CI=0.845, 0.988), respectively., Conclusions: These ecologically valid findings suggest that high progesterone-to-estradiol ratios can have a protective effect against problematic alcohol use in females and males with AUD, highlighting the progesterone-to-estradiol ratio as a promising treatment target. Moreover, the results indicate that females with AUD may benefit from menstrual cycle phase-tailored treatments.

Published
2024
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12. Measuring self-regulation in everyday life: Reliability and validity of smartphone-based experiments in alcohol use disorder.

Author

Zech H, Waltmann M, Lee Y, Reichert M, Bedder RL, Rutledge RB, Deeken F, Wenzel J, Wedemeyer F, Aguilera A, Aslan A, Bach P, Bahr NS, Ebrahimi C, Fischbach PC, Ganz M, Garbusow M, Großkopf CM, Heigert M, Hentschel A, Belanger M, Karl D, Pelz P, Pinger M, Riemerschmid C, Rosenthal A, Steffen J, Strehle J, Weiss F, Wieder G, Wieland A, Zaiser J, Zimmermann S, Liu S, Goschke T, Walter H, Tost H, Lenz B, Andoh J, Ebner-Priemer U, Rapp MA, Heinz A, Dolan R, Smolka MN, and Deserno L

Subjects
Humans, Smartphone, Reproducibility of Results, Reaction Time, Alcoholism, Self-Control
Abstract

Self-regulation, the ability to guide behavior according to one's goals, plays an integral role in understanding loss of control over unwanted behaviors, for example in alcohol use disorder (AUD). Yet, experimental tasks that measure processes underlying self-regulation are not easy to deploy in contexts where such behaviors usually occur, namely outside the laboratory, and in clinical populations such as people with AUD. Moreover, lab-based tasks have been criticized for poor test-retest reliability and lack of construct validity. Smartphones can be used to deploy tasks in the field, but often require shorter versions of tasks, which may further decrease reliability. Here, we show that combining smartphone-based tasks with joint hierarchical modeling of longitudinal data can overcome at least some of these shortcomings. We test four short smartphone-based tasks outside the laboratory in a large sample (N = 488) of participants with AUD. Although task measures indeed have low reliability when data are analyzed traditionally by modeling each session separately, joint modeling of longitudinal data increases reliability to good and oftentimes excellent levels. We next test the measures' construct validity and show that extracted latent factors are indeed in line with theoretical accounts of cognitive control and decision-making. Finally, we demonstrate that a resulting cognitive control factor relates to a real-life measure of drinking behavior and yields stronger correlations than single measures based on traditional analyses. Our findings demonstrate how short, smartphone-based task measures, when analyzed with joint hierarchical modeling and latent factor analysis, can overcome frequently reported shortcomings of experimental tasks., (© 2022. The Author(s).)

Published
2023
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13. Patterns of Alcohol Consumption Among Individuals With Alcohol Use Disorder During the COVID-19 Pandemic and Lockdowns in Germany.

Author

Deeken F, Reichert M, Zech H, Wenzel J, Wedemeyer F, Aguilera A, Aslan A, Bach P, Bahr NS, Ebrahimi C, Fischbach PC, Ganz M, Garbusow M, Großkopf CM, Heigert M, Hentschel A, Karl D, Pelz P, Pinger M, Riemerschmid C, Rosenthal A, Steffen J, Strehle J, Weiss F, Wieder G, Wieland A, Zaiser J, Zimmermann S, Walter H, Lenz B, Deserno L, Smolka MN, Liu S, Ebner-Priemer UW, Heinz A, and Rapp MA

Subjects
Adult, Alcohol Drinking epidemiology, Alcohol Drinking psychology, Cohort Studies, Communicable Disease Control, Female, Germany epidemiology, Humans, Longitudinal Studies, Male, Pandemics, Alcoholism epidemiology, COVID-19 epidemiology, Substance Withdrawal Syndrome
Abstract

Importance: Alcohol consumption (AC) leads to death and disability worldwide. Ongoing discussions on potential negative effects of the COVID-19 pandemic on AC need to be informed by real-world evidence., Objective: To examine whether lockdown measures are associated with AC and consumption-related temporal and psychological within-person mechanisms., Design, Setting, and Participants: This quantitative, intensive, longitudinal cohort study recruited 1743 participants from 3 sites from February 20, 2020, to February 28, 2021. Data were provided before and within the second lockdown of the COVID-19 pandemic in Germany: before lockdown (October 2 to November 1, 2020); light lockdown (November 2 to December 15, 2020); and hard lockdown (December 16, 2020, to February 28, 2021)., Main Outcomes and Measures: Daily ratings of AC (main outcome) captured during 3 lockdown phases (main variable) and temporal (weekends and holidays) and psychological (social isolation and drinking intention) correlates., Results: Of the 1743 screened participants, 189 (119 [63.0%] male; median [IQR] age, 37 [27.5-52.0] years) with at least 2 alcohol use disorder (AUD) criteria according to the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) yet without the need for medically supervised alcohol withdrawal were included. These individuals provided 14 694 smartphone ratings from October 2020 through February 2021. Multilevel modeling revealed significantly higher AC (grams of alcohol per day) on weekend days vs weekdays (β = 11.39; 95% CI, 10.00-12.77; P < .001). Alcohol consumption was above the overall average on Christmas (β = 26.82; 95% CI, 21.87-31.77; P < .001) and New Year's Eve (β = 66.88; 95% CI, 59.22-74.54; P < .001). During the hard lockdown, perceived social isolation was significantly higher (β = 0.12; 95% CI, 0.06-0.15; P < .001), but AC was significantly lower (β = -5.45; 95% CI, -8.00 to -2.90; P = .001). Independent of lockdown, intention to drink less alcohol was associated with lower AC (β = -11.10; 95% CI, -13.63 to -8.58; P < .001). Notably, differences in AC between weekend and weekdays decreased both during the hard lockdown (β = -6.14; 95% CI, -9.96 to -2.31; P = .002) and in participants with severe AUD (β = -6.26; 95% CI, -10.18 to -2.34; P = .002)., Conclusions and Relevance: This 5-month cohort study found no immediate negative associations of lockdown measures with overall AC. Rather, weekend-weekday and holiday AC patterns exceeded lockdown effects. Differences in AC between weekend days and weekdays evinced that weekend drinking cycles decreased as a function of AUD severity and lockdown measures, indicating a potential mechanism of losing and regaining control. This finding suggests that temporal patterns and drinking intention constitute promising targets for prevention and intervention, even in high-risk individuals.

Published
2022
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15. A man in his fifties with dyspnoea and circulatory collapse during general anaesthesia.

Author

Smenes BT, Flade HM, Kudra S, Heigert M, Winnerkvist A, and Grenne B

Subjects
Accidents, Traffic, Anesthesia, General, Echocardiography, Humans, Intraoperative Complications etiology, Male, Middle Aged, Dyspnea etiology, Shock etiology, Tricuspid Valve Insufficiency complications, Tricuspid Valve Insufficiency diagnostic imaging, Tricuspid Valve Insufficiency surgery
Published
2019
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16. Radial versus femoral access site for percutaneous coronary intervention in patients suffering acute myocardial infarction : A randomized prospective multicenter trial.

Author

Schernthaner C, Hammerer M, Harb S, Heigert M, Hoellinger K, Lassnig E, Maurer E, Schuler J, Siostrzonek P, Ulmer H, Winter A, and Altenberger J

Subjects
Acute Disease, Aged, Cohort Studies, Coronary Angiography, Female, Hematoma etiology, Humans, Length of Stay, Male, Middle Aged, Myocardial Infarction diagnostic imaging, Prospective Studies, Radiation Exposure, Femoral Artery, Myocardial Infarction therapy, Percutaneous Coronary Intervention methods, Radial Artery
Abstract

Background: Transradial access (TRA) in percutaneous coronary intervention (PCI) is a widely used standard technique with lower complication rates compared to transfemoral access (TFA). The aim of this study was to evaluate the impact of TRA versus TFA for PCI on clinically significant vascular access complications in the setting of acute myocardial infarction (AMI)., Methods: This multicenter study randomly assigned 250 patients in a 1:1 fashion (TRA vs. TFA) admitted with or without ST-segment elevation AMI undergoing immediate PCI. The primary endpoint was defined as the occurrence of hematoma, pseudo-aneurysm or local bleeding at the access site requiring any further intervention and/or prolonged hospital stay. Radiation exposure to the patient and operator was also investigated., Results: In the study cohort (N = 250 patients, mean age 62 ± 12.7 years, 76% males) 5 patients (2%) achieved the primary endpoint without a significant difference between groups, 4 out of 125 (3.2%) in the TFA group and 1 out of 125 (0.8%) in the TRA group (p = 0.17). Access site hematoma was significantly more frequent in the TFA group compared to the TRA group (24.8% vs. 8.8%, respectively; p < 0.0007). Local bleeding was only seen in the TFA group (3.2% vs. 0%, p = 0.04). Time intervals from admission to catheter laboratory to first balloon inflation were longer in the TRA compared to the TFA group (34 ± 17 min vs 29.5 ± 13 min, respectively; p = 0.018). Radiation exposure to the patient and operator was identical., Conclusion: The use of TRA was accompanied by lower rates of access site complications; however, the need for subsequent treatment or prolonged hospital stays was not observed using either of the two access approaches.

Published
2018
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18. [Transcatheter aortic valve replacement: when should it be used in aortic stenosis?].

Author

Motloch LJ, Reda S, Rottlaender D, Heigert M, and Hoppe UC

Subjects
Clinical Trials as Topic, Cooperative Behavior, Humans, Interdisciplinary Communication, Postoperative Complications etiology, Prosthesis Design, Stents, Treatment Outcome, Angioplasty methods, Aortic Valve Stenosis surgery, Bioprosthesis, Cardiac Catheterization methods, Heart Valve Prosthesis, Heart Valve Prosthesis Implantation methods
Abstract

30% of patients with significant aortic stenosis are not considered for operative aortic valve replacement because of the high perioperative risk. An alternative catheter based option for these patients is the transcatheter aortic valve replacement (TAVI). In general, there are two approaches for TAVI: transfemoral and transapical. Transfemoral aortic valve replacement is performed by transcatheter replacement of an aortic valve via the femoral arteries. Transapical valve replacement is achieved by transcatheter implantation via the fifth intercostal space. The most common complications are vessel injuries, bleeding complications, new onset of AV-block, development of paravalvular insufficiency, acute kidney injury, stroke and TIA. The first long-term observations suggest positive results. First clinical trials in a high-risk population show a promising outcome. Therefore TAVI offers a reasonable therapy option for patients with high perioperative risk. Further long-term clinical trials are still pending.

Published
2012
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19. Rehospitalization rates after transcatheter aortic valve implantation.

Author

Hammerer M, Schuler J, Altenberger J, Kraus J, Prinz E, Matzinger M, Pichler M, and Heigert M

Subjects
Aged, 80 and over, Aortic Valve surgery, Austria epidemiology, Comorbidity, Female, Humans, Incidence, Male, Risk Assessment, Risk Factors, Survival Analysis, Survival Rate, Treatment Outcome, Aortic Valve Stenosis mortality, Aortic Valve Stenosis surgery, Cardiac Catheterization mortality, Heart Valve Prosthesis Implantation mortality, Hospitalization statistics & numerical data, Postoperative Complications mortality, Prosthesis Failure
Abstract

Aims: Comorbidities pose a major challenge to screening, selection and follow-up of transcatheter aortic valve implantation (TAVI) patients as well as to the procedure itself. The aim of the present study was to assess cardiac and non-cardiac readmission rates besides clinical endpoint data in the first 50 patients of a single center TAVI programme., Methods and Results: TAVI was performed using the transfemoral CoreValve system. Procedural success rate was 94%; intraprocedural mortality was 2%. 82% of the patients remained free of a combined safety endpoint at 30 days, and 76.1% remained free of a combined efficacy endpoint at six months (modified criteria of the Valve Academic Research Consortium). At six months, among all surviving patients, 10.3% had experienced readmissions for cardiac causes, and 43.6% had experienced readmissions for non-cardiac causes. Causes of non-cardiac readmissions showed a wide distribution over various medical disciplines, reflecting the high rate of comorbidities. Beyond six months until a predefined reference date (mean follow up 9.9 months), the probability of hospitalization fell by half (1.54 vs. 0.74 hospital days per patient per month), driven by a decrease of non-cardiac readmissions. Karnofsky score before and after TAVI yielded a significant and sustained improvement of performance status, as assessed retrospectively at reference date., Conclusion: The findings of the present study suggest that the high prevalence of comorbidities in high-risk TAVI patients results in a high rate of non-cardiac rehospitalizations during the first 6 months of follow-up. Despite this fact, improvement of global everyday performance following TAVI as perceived by the patients seems to be substantial.

Published
2012
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20. 2-year results of the AUTAX (Austrian Multivessel TAXUS-Stent) registry beyond the SYNTAX (synergy between percutaneous coronary intervention with TAXUS and cardiac surgery) study.

Author

Gyöngyösi M, Christ G, Lang I, Kreiner G, Sochor H, Probst P, Neunteufl T, Badr-Eslam R, Winkler S, Nyolczas N, Posa A, Leisch F, Karnik R, Siostrzonek P, Harb S, Heigert M, Zenker G, Benzer W, Bonner G, Kaider A, and Glogar D

Subjects
Aged, Angioplasty, Balloon, Coronary adverse effects, Angioplasty, Balloon, Coronary mortality, Austria, Coronary Angiography, Coronary Artery Disease diagnostic imaging, Coronary Artery Disease mortality, Coronary Artery Disease surgery, Coronary Restenosis etiology, Female, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Myocardial Infarction etiology, Odds Ratio, Platelet Aggregation Inhibitors therapeutic use, Proportional Hazards Models, Prospective Studies, Prosthesis Design, Registries, Risk Assessment, Risk Factors, Severity of Illness Index, Stroke etiology, Thrombosis etiology, Time Factors, Treatment Outcome, Angioplasty, Balloon, Coronary instrumentation, Coronary Artery Bypass adverse effects, Coronary Artery Bypass mortality, Coronary Artery Disease therapy, Drug-Eluting Stents
Abstract

Objectives: The multicenter AUTAX (Austrian Multivessel TAXUS-Stent) registry investigated the 2-year clinical/angiographic outcomes of patients with multivessel coronary artery disease after implantation of TAXUS Express stents (Boston Scientific, Natick, Massachusetts), in a "real-world" setting., Background: The AUTAX registry included patients with 2- or 3-vessel disease, with/without previous percutaneous coronary intervention (PCI) and concomitant surgery., Methods: Patients (n = 441, 64 +/- 12 years, 78% men) (n = 1,080 lesions) with possible complete revascularization by PCI were prospectively included. Median clinical follow-up was 753 (quartiles 728 to 775) days after PCI in 95.7%, with control angiography of 78% at 6 months. The primary end point was the composite of major adverse cardiac (nonfatal acute myocardial infarction [AMI], all-cause mortality, target lesion revascularization [TLR]) and cerebrovascular events (MACCE). Potential risk factor effects on 2-year MACCE were evaluated using Cox regression., Results: Complete revascularization was successful in 90.5%, with left main PCI of 6.8%. Rates of acute, subacute, and late stent thrombosis were 0.7%, 0.5%, and 0.5%. Two-year follow-up identified AMI (1.4%), death (3.6%), stroke (0.2%), and TLR (13.1%), for a composite MACCE of 18.3%. The binary restenosis rate was 10.8%. The median of cumulative SYNTAX score was 23.0 (range 12.0 to 56.5). The SYNTAX score did not predict TLR or MACCE, due to lack of scoring of restenotic or bypass stenoses (29.8%). Age (hazard ratio [HR]: 1.03, p = 0.019) and acute coronary syndrome (HR: 2.1, p = 0.001) were significant predictors of 2-year MACCE. Incomplete revascularization predicted death or AMI (HR: 3.84, p = 0.002)., Conclusions: With the aim of complete revascularization, TAXUS stent implantations can be safe for patients with multivessel disease. The AUTAX registry including patients with post-PCI lesions provides additional information to the SYNTAX (Synergy Between Percutaneous Coronary Intervention With TAXUS and Cardiac Surgery) study. (Austrian Multivessel TAXUS-Stent Registry; NCT00738686).

Published
2009
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21. Enoxaparin in elective percutaneous coronary intervention.

Author

Schuler J, Altenberger J, and Heigert M

Subjects
Age Factors, Aged, Anticoagulants adverse effects, Enoxaparin adverse effects, Humans, Kidney physiology, Angioplasty, Balloon, Coronary, Anticoagulants therapeutic use, Enoxaparin therapeutic use, Hemorrhage chemically induced, Heparin adverse effects, Myocardial Ischemia therapy
Published
2006

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