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2. Baseline Characteristics and Risk Profiles of Participants in the ISCHEMIA Randomized Clinical Trial

Author

Hochman, JS, Reynolds, HR, Bangalore, S, O'Brien, SM, Alexander, KP, Senior, R, Boden, WE, Stone, GW, Goodman, SG, Lopes, RD, Lopez-Sendon, J, White, HD, Maggioni, AP, Shaw, LJ, Min, JK, Picard, MH, Berman, DS, Chaitman, BR, Mark, DB, Spertus, JA, Cyr, DD, Bhargava, B, Ruzyllo, W, Wander, GS, Chernyavskiy, AM, Rosenberg, YD, Maron, DJ, Mavromatis, K, Miller, T, Banerjee, S, Abdul-Nour, K, Stone, PH, Jang, JJ, Weitz, S, Arnold, S, Shapiro, MD, El-Hajjar, M, McFalls, EO, Khouri, MG, Goldberg, JL, Goldweit, R, Cohen, RA, Winchester, DE, Kronenberg, M, Heitner, JF, Dauber, IM, Cannan, C, Sudarshan, S, Mehta, PK, Hedgepeth, CM, Sahul, Z, Booth, D, Setty, S, Barua, RS, Hage, F, Dajani, K, Arif, I, Trejo (Gutierrez), JF, Gemignani, A, Meadows, JL, Call, JT, Hannan, J, Martin, ET, Vorobiof, G, Moorman, A, Kinlay, S, Rayos, G, Seedhom, A, Kumkumian, G, Sedlis, SP, Tamis-Holland, JE, Saba, S, Badami, U, Marzo, K, Robbins, IH, Hamroff, GS, Little, RW, Lui, CY, Hu, B, Labovitz, AJ, Rodriguez, F, Deedwania, P, Sweeny, J, Spizzieri, C, Hochberg, CP, Salerno, WD, Wyman, R, Zarka, A, Haldis, T, Kohn, JA, Girotra, S, Almousalli, O, Krishnam, MS, Coram, R, Thomas, S, El Shahawy, M, Stafford, J, Abernethy, WB, Zurick, A, Meyer, TM, Rutkin, B, Bokhari, S, Sokol, SI, Hamzeh, I, Turner, MC, Good, AP, Shammas, NW, Chilton, R, Nguyen, PK, Jezior, M, Gordon, PC, Stenberg, R, Pedalino, RP, Wiesel, J, Juang, GJ, Al-Amoodi, M, Wohns, D, Lader, EW, Mumma, M, Dharmarajan, L, McGarvey, JFX, Downes, TR, Cheong, B, Potluri, S, Mastouri, RA, Li, D, Giedd, K, Old, W, Burt, F, Sokhon, K, Gopal, D, Valeti, US, Kobashigawa, J, Govindan, SC, Manjunath, CN, Pandit, N, Dwivedi, SK, Mathew, A, Gadkari, MA, Satheesh, S, Mathur, A, Christopher, J, Oomman, A, Naik, S, Grant, P, Kachru, R, Kumar, A, Kaul, U, Gamma, RA, De Belder, MA, Nageh, T, Lindsay, SJ, Hoye, A, Donnelly, P, Chauhan, A, Barr, C, Alfakih, K, Henriksen, P, Okane, P, De Silva, R, Conway, DSG, Sirker, AA, Hoole, SP, Witherow, FN, Johnston, N, Luckie, M, Sobolewska, J, Jeetley, P, Travill, C, Braganza, D, Henderson, R, Berry, C, Moriarty, AJ, Glover, JD, Mikhail, G, Gosselin, G, Diaz, A, Phaneuf, DC, Garg, P, Chow, BJW, Bainey, KR, Cheema, AN, Cha, J, Howarth, AG, Wong, G, Uxa, A, Galiwango, P, Lam, A, Mehta, S, Udell, J, Genereux, P, Hameed, A, Daba, L, Hueb, W, Smanio, PEP, De Quadros, AS, Vitola, JV, Marin-Neto, JA, Polanczyk, CA, Carvalho, AC, Alves Junior, AR, Dracoulakis, MDA, Figueiredo, E, Caramori, PR, Tumelero, R, Dall'Orto, F, Mesquita, CT, Ribeiro da Silva, EE, Saraiva, JF, Costantini, C, Demkow, M, Mazurek, T, Drozdz, J, Szwed, H, Witkowski, A, Gajos, G, Pruszczyk, P, Loboz-Grudzien, K, Lesiak, M, Reczuch, KW, Kalarus, Z, Musial, WJ, Bockeria, L, Bershtein, LL, Demchenko, EA, Lopez-Sendon, JL, Peteiro, J, Gonzalez Juanatey, JR, Sionis, A, Miro, V, Ortuno, FM, Blancas, MG, Luena, JEC, Fernandez-Aviles, F, Chen, J, Wu, Y, Ma, Y, Ji, Z, Yang, X, Lin, W, Zeng, H, Fu, X, Yang, B, Wang, S, Cheng, G, Zhao, Y, Fang, X, Zeng, Q, Su, X, Li, Q, Nie, S-P, Yu, Q, Wang, J, Zhang, S, Perna, GP, Provasoli, S, Monti, L, Di Chiara, A, Mortara, A, Galvani, M, Sicuro, M, Calabro, P, Tarantini, G, Racca, E, Briguori, C, Amati, R, Russo, A, Poh, K-K, Foo, D, Chua, T, Doerr, R, Sechtem, U, Schulze, PC, Nickenig, G, Schuchlenz, H, Lang, IM, Huber, K, Vertes, A, Varga, A, Fontos, G, Merkely, B, Kerecsen, G, Hinic, S, Beleslin, BD, Cemerlic-Adjic, N, Davidovic, G, Dekleva, MN, Stankovic, G, Apostolovic, S, Escobedo, J, Rosas, EA, Selvanayagam, JB, Thambar, ST, Beltrame, JF, Hillis, GS, Thuaire, C, Steg, P-G, Slama, MS, El Mahmoud, R, Nicollet, E, Barone-Rochette, G, Furber, A, Laucevicius, A, Kedhi, E, Riezebos, RK, Suryapranata, H, Ramos, R, Pinto, FJ, Ferreira, N, Guzman, L, Figal, JC, Alvarez, C, Courtis, J, Schiavi, L, Rubio, M, Devlin, GP, Stewart, RAH, Kedev, S, Held, C, Aspberg, J, Sharir, T, Kerner, A, Fukuda, K, Yasuda, S, Nishimura, S, Goetschalckx, K, Hung, C-L, Ntsekhe, M, Moccetti, T, Abdelhamid, M, Pop, C, Popescu, BA, Al-Mallah, MH, Ramos, WEM, Kuanprasert, S, Yamwong, S, Khairuddin, A, Ferguson, B, Harrington, R, Williams, D, Berger, J, Newman, J, Sidhu, M, Dzavik, V, Jiang, L, Keltai, M, Kohsaka, S, Maggioni, A, Mancini, GBJ, Merz, CNB, Weintraub, W, Ballantyne, C, Calfas, KJ, Davidson, M, Friedrich, M, Hachamovitch, R, Kwong, R, Harrell, F, Kullo, I, McManus, B, Cohen, DJ, Bugiardini, R, Celutkiene, J, Lyubarova, R, Mattina, D, Nwosu, S, Broderick, S, Cyr, D, Rockhold, F, Anstrom, K, Jones, P, Phillips, L, Hayes, SW, Friedman, JD, Gerlach, RJ, Kwong, RY, Mongeon, FP, Hung, J, Scherrer-Crosbie, M, Zeng, X, Ali, Z, Arsanjani, R, Budoff, M, Leipsic, J, Nakanishi, R, Youn, T, Orso, F, Zhang, H, Zhang, L, Diaz, R, Van de Werf, F, Fleg, J, Kirby, R, Jeffries, N, and Hochman JS, Reynolds HR, Bangalore S, O'Brien SM, Alexander KP, Senior R, Boden WE, Stone GW, Goodman SG, Lopes RD, Lopez-Sendon J, White HD, Maggioni AP, Shaw LJ, Min JK, Picard MH, Berman DS, Chaitman BR, Mark DB, Spertus JA, Cyr DD, Bhargava B, Ruzyllo W, Wander GS, Chernyavskiy AM, Rosenberg YD, Maron DJ, Mavromatis K, Miller T, Banerjee S, Abdul-Nour K, Stone PH, Jang JJ, Weitz S, Arnold S, Shapiro MD, El-Hajjar M, McFalls EO, Khouri MG, Goldberg JL, Goldweit R, Cohen RA, Winchester DE, Kronenberg M, Heitner JF, Dauber IM, Cannan C, Sudarshan S, Mehta PK, Hedgepeth CM, Sahul Z, Booth D, Setty S, Barua RS, Hage F, Dajani K, El-Hajjar M, Arif I, Trejo JF, Gemignani A, Meadows JL, Call JT, Hannan J, Martin ET, Vorobiof G, Moorman A, Kinlay S, Rayos G, Seedhom A, Kumkumian G, Sedlis SP, Tamis-Holland JE, Saba S, Badami U, Marzo K, Robbins IH, Hamroff GS, Little RW, Lui CY, Booth D, Hu B, Labovitz AJ, Maron DJ, Rodriguez F, Deedwania P, Sweeny J, Spizzieri C, Hochberg CP, Salerno WD, Wyman R, Zarka A, Haldis T, Kohn JA, Girotra S, Almousalli O, Krishnam MS, Coram R, Thomas S, El Shahawy M, Stafford J, Abernethy WB, Zurick A, Meyer TM, Rutkin B, Bokhari S, Sokol SI, Hamzeh I, Turner MC, Good AP, Shammas NW, Chilton R, Nguyen PK, Jezior M, Gordon PC, Stenberg R, Pedalino RP, Wiesel J, Juang GJ, Al-Amoodi M, Wohns D, Lader EW, Mumma M, Dharmarajan L, McGarvey JFX, Downes TR, Cheong B, Potluri S, Mastouri RA, Li DY, Giedd K, Old W, Burt F, Sokhon K, Gopal D, Valeti US, Kobashigawa J, Govindan SC, Manjunath CN, Pandit N, Dwivedi SK, Wander G, Bhargava B, Mathew A, Gadkari MA, Satheesh S, Mathur A, Christopher J, Oomman A, Naik S, Christopher J, Grant P, Kachru R, Kumar A, Christopher J, Kaul U, Gamma RA, de Belder MA, Nageh T, Lindsay SJ, Hoye A, Donnelly P, Chauhan A Barr C, Alfakih K, Henriksen P, Okane P, de Silva R, Conway DSG, Sirker AA, Hoole SP, Witherow FN, Johnston N, Luckie M, Sobolewska J, Jeetley P, Travill C, Braganza D, Henderson R, Berry C, Moriarty AJ, Glover JD, Mikhail G, Gosselin G, Diaz A, Phaneuf DC, Garg P, Chow BJW, Bainey KR, Cheema AN, Cheema AN, Cha J, Howarth AG, Wong G, Uxa A, Galiwango P, Lam A, Mehta S, Udell J, Genereux P, Hameed A, Daba L, Hueb W, Smanio PEP, de Quadros AS, Vitola JV, Marin-Neto JA, Polanczyk CA, Carvalho AC, Alves AR, Dracoulakis MDA, Figueiredo E, Caramori PR, Tumelero R, Dall'Orto F, Mesquita CT, da Silva EER, Saraiva JF, Costantini C, Demkow M, Mazurek T, Drozdz J, Szwed H, Witkowski A, Gajos G, Pruszczyk P, Loboz-Grudzien K, Lesiak M, Reczuch KW, Kalarus Z, Musial WJ, Bockeria L, Chernyavskiy AM, Bershtein LL, Demchenko EA, Lopez-Sendon JL, Peteiro J, Juanatey JRG, Sionis A, Miro V, Ortuno FM, Blancas MG, Luena JEC, Fernandez-Aviles F, Chen JY, Wu YJ, Ma YT, Ji Z, Yang XC, Lin WH, Zeng HS, Fu, X, Yang B, Wang ST, Cheng G, Zhao YL, Fang XH, Zeng QT, Su X, Li QX, Nie SP, Yu Q, Wang JA, Zhang SY, Perna GP, Provasoli S, Monti L, Di Chiara A, Mortara A, Galvani M, Sicuro M, Calabro P, Tarantini G, Racca E , Briguori C, Amati R, Russo A, Poh KK, Foo D, Chua, Doerr R, Sechtem U, Schulze PC, Nickenig G, Schuchlenz H, Lang IM, Huber K, Vertes A, Varga A, Fontos G, Merkely B, Kerecsen G, Hinic S, Beleslin BD, Cemerlic-Adjic N, Davidovic G, Dekleva MN, Stankovic G, Apostolovic S, Escobedo J, Rosas EA, Selvanayagam JB, Thambar ST, Beltrame JF, Hillis GS, Thuaire C, Steg PG, Slama MS, El Mahmoud R, Nicollet E, Barone-Rochette G, Furber A, Laucevicius A, Kedhi E, Riezebos RK, Suryapranata H, Ramos R, Pinto FJ, Ferreira N, Guzman L, Figal JC, Alvarez C, Courtis J, Schiavi L, Rubio M, Devlin GP, Stewart RAH, Kedev S, Held C, Aspberg, J, Sharir T, Kerner A, Fukuda K, Yasuda S, Nishimura S , Goetschalckx K, Hung CL, Ntsekhe M, Moccetti T, Abdelhamid M, Pop C, Popescu BA, Al-Mallah MH, Ramos WEM, Kuanprasert S, Yamwong S, Khairuddin A, O'Brien SM, Boden WE, Ferguson B, Harrington R, Stone GW, Williams D, Berger J, Newman J, Sidhu M, Mark DB, Shaw LJ, Spertus JA, Berman DS, Chaitman BR, Doerr R, Dzavik V, Goodman SG, Gosselin G, Held C, Jiang LX, Keltai M, Kohsaka S, Lopes RD, Lopez-Sendon JL, Maggioni A, Mancini GBJ, Merz CNB, Min JK, Picard MH, Ruzyllo W, Selvanayagam JB, Senior R, Steg PG, Szwed H, Weintraub W, White HD, Ballantyne C, Calfas KJ, Davidson M, Stone PH, Friedrich M, Hachamovitch R, Kwong R, Harrell F, Kullo I, McManus B, Cohen DJ, Bugiardini R, Celutkiene J, Escobedo J , Hoye A, Lyubarova R, Mattina D, Peteiro J, Nwosu S, Broderick S, Cyr D, Rockhold F, Anstrom K, Jones P, Phillips L, Hayes SW, Friedman JD, Gerlach RJ, Kwong RY, Mongeon FP, Hung J, Scherrer-Crosbie M, Zeng X, Ali Z, Genereux P, Arsanjani R, Budoff M, Leipsic J, Nakanishi R, Youn T , Orso F, Carvalho AC, Zhang HB, Zhang LH, Diaz R, Van de Werf F, Goetschalckx K, Rosenberg YD, Fleg J, Kirby R, Jeffries N.

Subjects
medicine.medical_specialty, Cardiac & Cardiovascular Systems, IMPACT, medicine.medical_treatment, Population, 030204 cardiovascular system & hematology, Revascularization, law.invention, MEDICAL THERAPY, ISCHEMIA Research Group, Angina, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Internal medicine, Severity of illness, SCORE, medicine, BENEFIT, 030212 general & internal medicine, cardiovascular diseases, education, education.field_of_study, OUTCOMES, Science & Technology, business.industry, PCI, medicine.disease, Clinical trial, PROGNOSTIC VALUE, Stenosis, Cardiology, Cardiovascular System & Cardiology, CORONARY-ARTERY-DISEASE, REVASCULARIZATION, Cardiology and Cardiovascular Medicine, business, ECHOCARDIOGRAPHY, Life Sciences & Biomedicine
Abstract

Importance It is unknown whether coronary revascularization, when added to optimal medical therapy, improves prognosis in patients with stable ischemic heart disease (SIHD) at increased risk of cardiovascular events owing to moderate or severe ischemia. Objective To describe baseline characteristics of participants enrolled and randomized in the International Study of Comparative Health Effectiveness With Medical and Invasive Approaches (ISCHEMIA) trial and to evaluate whether qualification by stress imaging or nonimaging exercise tolerance test (ETT) influenced risk profiles. Design, Setting, and Participants The ISCHEMIA trial recruited patients with SIHD with moderate or severe ischemia on stress testing. Blinded coronary computed tomography angiography was performed in most participants and reviewed by a core laboratory to exclude left main stenosis of at least 50% or no obstructive coronary artery disease (CAD) (

Published
2019

4. Cardiopoietic cell therapy for advanced ischemic heart failure : results at 39 weeks of the prospective, randomized, double blind, sham-controlled CHART-1 clinical trial

Author

Bartunek, Jozef, Terzic, Andre, Davison, Beth A, Filippatos, Gerasimos S, Radovanovic, Slavica, Beleslin, Branko, Merkely, Bela, Musialek, Piotr, Wojakowski, Wojciech, Andreka, Peter, Horvath, Ivan G, Katz, Amos, Dolatabadi, Dariouch, El Nakadi, Badih, Arandjelovic, Aleksandra, Edes, Istvan, Seferovic, Petar M, Obradovic, Slobodan, Vanderheyden, Marc, Jagic, Nikola, Petrov, Ivo, Atar, Shaul, Halabi, Majdi, Gelev, Valeri L, Shochat, Michael K, Kasprzak, Jaroslaw D, Sanz Ruiz, Ricardo, Heyndrickx, Guy R, Nyolczas, Noémi, Legrand, Victor, Guédès, Antoine, Heyse, Alex, Moccetti, Tiziano, Fernandez Aviles, Francisco, Jimenez Quevedo, Pilar, Bayes Genis, Antoni, Hernandez Garcia, Jose Maria, Ribichini, Flavio, Gruchala, Marcin, Waldman, Scott A, Teerlink, John R, Gersh, Bernard J, Povsic, Thomas J, Henry, Timothy D, Metra, Marco, Hajjar, Roger J, Tendera, Michal, Behfar, Atta, Alexandre, Bertrand, Seron, Aymeric, Stough, Wendy Gattis, Sherman, Warren, Cotter, Gad, Wijns, W. i. l. l. i. a. m. Collaborators Clinical investigators, Dens, sites Belgium: Ziekenhuis Oost Limburg: J., Dupont, M., Mullens, W., Janssens, M., Dolatabadi, Hoˆpital Civil de Charleroi: D., De Bruyne, Y., Lalmand, J., Dubois, P., El Nakadi, B., Aminian, A., De Vuyst, E., Gurnet, P., Gujic, M., Blankoff, I., Guedes, CHU Mont Godinne UCL: A., Gabriel, L., Seldrum, S., Doyen, C., Andre´, M., Heyse, AZ Glorieux: A., Van Durme, F., Verschuere, J., Legrand, Domaine Universitaire du Sart Tilman: V., Gach, O., D’Orio, V., Davin, L., Lancellotti, P., Baudoux, E., Ancion, A., Dulgheru, R., Vanderheyden, OLV Ziekenhuis Aalst – Cardiologie: M., Bartunek, J., Wijns, W., Verstreken, S., Penicka, . M., Gelev, P. Meeus Bulgaria: Tokuda Hospital Sofia: V., Zheleva Kichukova, I., Parapunova, R., Melamed, R., Sardovski, S., Radev, O., Yordanov, A., Radinov, A., Nenov, D., Amine, I., Petrov, City Hospital Clinic Cardiology Center: I., Kichukov, K., Nikitasov, L., Stankov, Z., Stoyanov, H., Tasheva Dimitrova, I., Angelova, M., Dimitrov, E., Minchev, M., Garvanski, I., Botev, C., Polomski, P., Alexandrovska University Hospital, Vassilev, Sofia: D., Karamfiloff, K., Tarnovska Kadreva, R., Vladimirova, L., Dimitrov, G., Hadzhiev, E., Tzvetkova, G., Andreka, . M. Atanasova Hungary: Gottsegen Gyo¨ rgy Orszagos Kardiologiai Inte´zet: P., Fontos, G., Fabian, J., Csepregi, A., Uzonyi, G., Gelei, A., Edes, Debreceni Egyetem Orvos e´s Ege´szse´gtudomanyi Centrum Altalanos Orvostudomanyi Kar Kardiologia Inte´zet: I., Balogh, L., Vajda, G., Darago, A., Gergely, S., Fulop, T., Jenei, C., Horvath, Pe´csi Tudomanyegyetem Klinikai Ko¨zpont Szıvgyogyaszati Klinika: I., Magyari, B., Nagy, A., Cziraki, A., Faludi, R., Kittka, B., Alizadeh, H., Merkely, Semmelweis Egyetem Varosmajori Szıv e´s Ergyogyaszati Klinika: B., Geller, L., Farkas, P., Szombath, G., Foldes, G., Skopal, J., Kovacs, A., Kosztin, A., Gara, E., Sydo, N., Nyolczas, MH Ege´szse´gu¨gyi Ko¨zpont Kardiologiai Osztaly: N., Kerecsen, G., Korda, A., Kiss, . M., Borsanyi, T., Polgar, B., Muk, B., Sharif, Z. Bari Ireland: HRB Clinical Research Facility: F., Atar, Y. M. Smyth Israel:Western Galilee Hospital: S., Shturman, A., Akria, L., Kilimnik, M., Brezins, M., Halabi, Ziv Medical Center: M., Dally, N., Goldberg, A., Aehab, K., Rosenfeld, I., Levinas, T., Saleem, D., Katz, Barzilai Medical Center: A., Plaev, T., Drogenikov, T., Nemetz, A., Barshay, Y., Jafari, J., Orlov, I., Nazareth Hospital EMMS: M. Omory, N. Kogan Nielsen, Shochat, Hillel Yaffe Medical Center: M., Shotan, A., Frimerman, A., Meisel, S., Asif, A., Sofer, O., Blondheim, D. S., Vazan, A., Metra, L. Arobov Italy: A. O. Spedali Civili di Brescia: M., Bonadei, I., Inama, L., Chiari, E., Lombardi, C., Magatelli, M., Russo, D., Lazzarini, V., Carubelli, V., Vassanelli, AOUI Verona – Borgo Trento Hospital: C., Ribichini, Flavio Luciano, Bergamini, C., Krampera, Mauro, Cicoria, M. A., Zanolla, L., Dalla Mura, D., Gambaro, A., Rossi, A., Pesarini Poland: Jagiellonian University Department of Cardiac, G., Musialek, Vascular Diseases at John Paul II Hospital in Krakow: P., Mazurek, A., Drabik, L., Ka˛dzielski, A., Walter, Z., Dzieciuch Rojek, M., Rubis, P., Plazak, . W., Tekieli, L., Podolec, J., Orczyk, W., Sutor, U., Zmudka, K., Olszowska, M., Podolec, P., Gruchala, Uniwersyteckie Centrum Kliniczne: M., Ciecwierz, D., Mielczarek, M., Burakowski, S., Chmielecki, M., Zielinska, M., Frankiewicz, A., Wdowczyk, J., Stopczynska, I., Bellwon, J., Mosakowska, K., Nadolna, R., Wroblewska, J., Rozmyslowska, M., Rynkiewicz, M., Marciniak, I., Raczak, G., Tarnawska, M., Taszner, M., Kasprzak, Bieganski Hospital: J., Plewka, M., Fiutowska, D., Rechcinski, T., Lipiec, P., Sobczak, M., Weijner Mik, P., Wraga, M., Krecki, R., Markiewicz, M., Haval Qawoq, D., Wojakowski, Gornosla˛skie Centrum Medyczne Sla˛skie j. Akademii Medycznej: W., Ciosek, J., Dworowy, S., Gaszewska Zurek, E., Ochala, A., Cybulski, W., Jadczyk, T., Wanha, W., Parma, Z., Kozlowski, M., Dzierzak, M., Markiewicz Serbia: Clinical Hospital Center Zvezdara, M., Arandjelovic, Cardiology Clinic: A., Sekularac, N., Boljevic, D., Bogdanovic, A., Zivkovic, S., Cvetinovic, N., Loncar, G., Clinical Centre of Serbia, Beleslin, Cardiology Clinic: B., Nedeljkovic, M., Trifunovic, D., Giga, V., Banovic, M., Nedeljkovic, I., Stepanovic, J., Vukcevic, V., Djordjevic Dikic, A., Dobric, M., Obrenovic Kircanski, B., Seferovic, Cardiology Clinic: P., Orlic, D., Tesic, M., Petrovic, O., Milinkovic, I., Simeunovic, D., Jagic, Clinical Center of Kragujevac: N., Tasic, M., Nikolic, D., Miloradovic, V., Djurdjevic, P., Sreckovic, M., Zornic, N., Clinical Hospital Center Bezanijska Kosa, Radovanovic, Cardiology Department: S., Saric, J., Hinic, S., Djokovic, A., Ðordevic, S., Bisenic, V., Markovic, O., Stamenkovic, S., Malenkovic, V., Tresnjak, J., Misic, G., Cotra, D., Tomovic, L., Vuckovic, V., Clinic of Emergency Internal Medicine, Obradovic, Military Medical Academy: S., Jovic, Z., Vukotic, S., Markovic, D., Djenic, N., Ristic Andjelkov, A., Bayes Genis, D. Ljubinka Spain: Hospital Universitario Germans Trias I. Pujol: A., Rodriguez Leor, O., Labata, C., Vallejo, N., Ferrer, E., Batlle, M., Fernandez Aviles, Hospital General Universitario Gregorio Mara~non: F., Sanz Ruiz, R., Casado, A., Loughlin, G., Zatarain, E., Anguita, J., Ferna ndez Santos, M. E., Pascual, C., Bermejo, J., Hernandez Garcia, Hospital Clinico Universitario Virgen de la Victoria: J. M., Jimenez Navarro, M., Dominguez, A., Carrasco, F., Mu~noz, A., Garcia Pinilla, J. M., Ruiz, J., Queipo de Llano, M. P., Hernandez, A., Fernandez, A., Jimenez Quevedo, Hospital Clinico San Carlos: P., Guerra, R., Biagioni, C., Gonzalez, R. A., Gomez deDiego, J. J., Mansson Broberg, L. Perez de Isla Sweden: Karolinska University Hospital: A., Sylve´n, C., Leblanc, K., Winter, R., Blomberg, P., Gunyeli, E., Ruck, A., Silva, C., Fo¨rstedt Switzerland: CardioCentro Ticino, J., Moccetti, Switzerland: T., Rossi, M., Pasotti, E., Petrova, I., Crljenica, C., Monti, C., Murzilli, R., Su¨rder, D., Moccetti, M., Turchetto, L., Locicero, V., Chiumiento, L., Maspoli, S., Mombelli, M., Anesini, A., Biggiogero, M., Ponti, G., Camporini, C., Polledri, S., Hill, G. Dolci United Kingdom: Kings College Hospital: J., Plymen, C., Amin Youssef, G., Mcdonagh, T., Drasar, E., Mijovic, A., Jouhra, F., Mcloman, D., Dworakowski, R., Webb, I., Byrne, J., and Potter, V.

Subjects
0301 basic medicine, Male, Cardiopoiesis, Cardiovascular disease, Disease severity, Marker, Precision medicine, Regenerative medicine, Stem cell, Target population, Adult, Aged, Double-Blind Method, Female, Heart Failure, Humans, Mesenchymal Stem Cell Transplantation, Middle Aged, Myocardial Ischemia, Prospective Studies, Treatment Outcome, Young Adult, Cardiology and Cardiovascular Medicine, Cell- and Tissue-Based Therapy, mesenchymal stem-cells, 030204 cardiovascular system & hematology, Cardiorespiratory Medicine and Haematology, outcomes, Fast-Track Clinical Research, Sudden cardiac death, 0302 clinical medicine, Ischemia, cardiovascular disease, Clinical endpoint, target population, CHART Program, Ejection fraction, bone-marrow, Heart Failure/Cardiomyopathy, 3. Good health, Cohort, Cardiology, Fast Track, disease severity, delivery, medicine.medical_specialty, precision medicine, Clinical Sciences, regenerative medicine, 03 medical and health sciences, cardiopoiesis, Internal medicine, medicine, Adverse effect, marker, disease, business.industry, medicine.disease, mortality, Confidence interval, Clinical trial, stem cell, Editor's Choice, 030104 developmental biology, predictors, Cardiovascular System & Hematology, Heart failure, business
Abstract

Altres ajuts: This work was supported by Celyad, SA (Mont-Saint-Guibert, Belgium). Celyad has received research grants from the Walloon Region (Belgium, DG06 funding). Cardiopoietic cells, produced through cardiogenic conditioning of patients' mesenchymal stem cells, have shown preliminary efficacy. The Congestive Heart Failure Cardiopoietic Regenerative Therapy (CHART-1) trial aimed to validate cardiopoiesis-based biotherapy in a larger heart failure cohort. This multinational, randomized, double-blind, sham-controlled study was conducted in 39 hospitals. Patients with symptomatic ischaemic heart failure on guideline-directed therapy (n = 484) were screened; n = 348 underwent bone marrow harvest and mesenchymal stem cell expansion. Those achieving > 24 million mesenchymal stem cells (n = 315) were randomized to cardiopoietic cells delivered endomyocardially with a retention-enhanced catheter (n = 157) or sham procedure (n = 158). Procedures were performed as randomized in 271 patients (n = 120 cardiopoietic cells, n = 151 sham). The primary efficacy endpoint was a Finkelstein–Schoenfeld hierarchical composite (all-cause mortality, worsening heart failure, Minnesota Living with Heart Failure Questionnaire score, 6-min walk distance, left ventricular end-systolic volume, and ejection fraction) at 39 weeks. The primary outcome was neutral (Mann–Whitney estimator 0.54, 95% confidence interval [CI] 0.47–0.61 [value > 0.5 favours cell treatment], P = 0.27). Exploratory analyses suggested a benefit of cell treatment on the primary composite in patients with baseline left ventricular end-diastolic volume 200–370 mL (60% of patients) (Mann–Whitney estimator 0.61, 95% CI 0.52–0.70, P = 0.015). No difference was observed in serious adverse events. One (0.9%) cardiopoietic cell patient and 9 (5.4%) sham patients experienced aborted or sudden cardiac death. The primary endpoint was neutral, with safety demonstrated across the cohort. Further evaluation of cardiopoietic cell therapy in patients with elevated end-diastolic volume is warranted.

Published
2017

5. Poster Session 5: Saturday 10 December 2011, 08:30-12:30 * Location: Poster Area

Author

Gong, L., primary, Ye, Z., additional, Zeng, Z., additional, Xia, M., additional, Zhong, Y., additional, Yao, Y., additional, Lee, E., additional, Ionescu, A., additional, Dwivedi, G., additional, Mahadevan, G., additional, Jiminez, D., additional, Frenneaux, M., additional, Steeds, R., additional, Moore, C., additional, Samad, Z., additional, Jackson, K., additional, Castellucci, J., additional, Kisslo, J., additional, Von Ramm, O., additional, D'ascenzi, F., additional, Zaca', V., additional, Cameli, M., additional, Lisi, M., additional, Natali, B., additional, Malandrino, A., additional, Mondillo, S., additional, Barbier, P., additional, Guerrini, U., additional, Franzosi, M., additional, Castiglioni, L., additional, Nobili, E., additional, Colazzo, F., additional, Li Causi, T., additional, Sironi, L., additional, Tremoli, E., additional, Clausen, H., additional, Macdonald, S., additional, Basaggianis, C., additional, Newton, J., additional, Bennati, E., additional, Reccia, R., additional, Bigio, E., additional, Maccherini, M., additional, Chiavarelli, M., additional, Henein, M., additional, Floria, M., additional, Jamart, J., additional, Arsenescu Georgescu, C., additional, Mantovani, F., additional, Barbieri, A., additional, Bursi, F., additional, Valenti, C., additional, Quaglia, M., additional, Modena, M., additional, Kutty, S., additional, Gribben, P., additional, Padiyath, A., additional, Polak, A., additional, Scott, C., additional, Waiss, M., additional, Danford, D., additional, Bech-Hanssen, O., additional, Selimovic, N., additional, Rundqvist, B., additional, Schmiedel, L., additional, Hohmann, C., additional, Katzke, S., additional, Haacke, K., additional, Rauwolf, T., additional, Strasser, R., additional, Tumasyan, L. R., additional, Adamyan, K., additional, Kosmala, W., additional, Derzhko, R., additional, Przewlocka-Kosmala, M., additional, Mysiak, A., additional, Stachowska, B., additional, Jedrzejuk, D., additional, Bednarek-Tupikowska, G., additional, Chrzanowski, L., additional, Kasprzak, J., additional, Wojciechowska, C., additional, Wita, K., additional, Busz-Papiez, B., additional, Gasior, Z., additional, Mizia-Stec, K., additional, Kukulski, T., additional, Gosciniak, P., additional, Sinkiewicz, W., additional, Moelmen, H., additional, Stoylen, A., additional, Thorstensen, A., additional, Torp, H., additional, Dalen, H., additional, Groves, A., additional, Nicholson, G., additional, Lopez, L., additional, Goh, C.-W., additional, Ahn, H., additional, Byun, Y., additional, Kim, J., additional, Park, J., additional, Lee, J., additional, Kim, B., additional, Rhee, K., additional, Kim, K., additional, Yoon, H., additional, Hong, Y., additional, Park, H., additional, Ahn, Y., additional, Jeong, M., additional, Cho, J., additional, Kang, J., additional, Grapsa, J., additional, Dawson, D., additional, Karfopoulos, K., additional, Jakaj, G., additional, Punjabi, P., additional, Nihoyannopoulos, P., additional, Ruisanchez Villar, C., additional, Lerena Saenz, P., additional, Gonzalez Vilchez, F., additional, Gonzalez Fernandez, C., additional, Zurbano Goni, F., additional, Cifrian Martinez, J., additional, Mons Lera, R., additional, Ruano Calvo, J., additional, Martin Duran, R., additional, Vazquez De Prada Tiffe, J., additional, Pietrzak, R., additional, Werner, B., additional, Voillot, D., additional, Huttin, O., additional, Zinzius, P., additional, Schwartz, J., additional, Sellal, J., additional, Lemoine, S., additional, Christophe, C., additional, Popovic, B., additional, Juilliere, Y., additional, Selton-Suty, C., additional, Ishii, K., additional, Furukawa, A., additional, Nagai, T., additional, Kataoka, K., additional, Seino, Y., additional, Shimada, K., additional, Yoshikawa, J., additional, Tekkesin, A., additional, Yildirimturk, O., additional, Tayyareci, Y., additional, Yurdakul, S., additional, Aytekin, S., additional, Jaroch, J., additional, Loboz-Grudzien, K., additional, Bociaga, Z., additional, Kowalska, A., additional, Kruszynska, E., additional, Wilczynska, M., additional, Dudek, K., additional, Kakihara, R., additional, Naruse, C., additional, Hironaka, H., additional, Tsuzuku, T., additional, Cucchini, U., additional, Muraru, D., additional, Badano, L., additional, Solda', E., additional, Tuveri, M., additional, Al Nono, O., additional, Sarais, C., additional, Iliceto, S., additional, Santos, L., additional, Cortez-Dias, N., additional, Ribeiro, S., additional, Goncalves, S., additional, Jorge, C., additional, Carrilho-Ferreira, P., additional, Silva, D., additional, Silva-Marques, J., additional, Lopes, M., additional, Diogo, A., additional, Hristova, K., additional, Vassilev, D., additional, Pavlov, P., additional, Katova, T., additional, Simova, I., additional, Kostova, V., additional, Esposito, R., additional, Santoro, A., additional, Schiano Lomoriello, V., additional, Raia, R., additional, De Palma, D., additional, Dores, E., additional, De Simone, G., additional, Galderisi, M., additional, Zaborska, B., additional, Makowska, E., additional, Pilichowska, E., additional, Maciejewski, P., additional, Bednarz, B., additional, Wasek, W., additional, Stec, S., additional, Budaj, A., additional, Spinelli, L., additional, Morisco, C., additional, Assante Di Panzillo, E., additional, Crispo, S., additional, Di Marino, S., additional, Trimarco, B., additional, Farina, F., additional, Innelli, P., additional, Rapacciuolo, A., additional, Polgar, B., additional, Banyai, F., additional, Rokusz, L., additional, Tomcsanyi, I., additional, Vaszily, M., additional, Nieszner, E., additional, Borsanyi, T., additional, Kerecsen, G., additional, Preda, I., additional, Kiss, R. G., additional, Bull, S., additional, Suttie, J., additional, Augustine, D., additional, Francis, J., additional, Karamitsos, T., additional, Becher, H., additional, Prendergast, B., additional, Neubauer, S., additional, Myerson, S., additional, Lodge, F., additional, Broyd, C., additional, Milton, P., additional, Mikhail, G., additional, Mayet, J., additional, Davies, J., additional, Francis, D., additional, Clavel, M.-A., additional, Ennezat, P.-V., additional, Marechaux, S., additional, Dumesnil, J., additional, Bellouin, A., additional, Bergeron, S., additional, Meimoun, P., additional, Le Tourneau, T., additional, Pasquet, A., additional, Pibarot, P., additional, Herrmann, S., additional, Stoerk, S., additional, Niemann, M., additional, Hu, K., additional, Voelker, W., additional, Ertl, G., additional, Weidemann, F., additional, Aytekin, V., additional, Kogoj, P., additional, Ambrozic, J., additional, Bunc, M., additional, Di Salvo, G., additional, Rea, A., additional, Castaldi, B., additional, Gala, S., additional, D'aiello, A., additional, Mormile, A., additional, Pisacane, F., additional, Pacileo, G., additional, Russo, M., additional, Calabro, R., additional, Nguyen, L., additional, Ricksten, S.-E., additional, Jeppsson, A., additional, Schersten, H., additional, Boerlage-Van Dijk, K., additional, Yong, Z., additional, Bouma, B., additional, Koch, K., additional, Vis, M., additional, Piek, J., additional, Baan, J., additional, Scandura, S., additional, Ussia, G., additional, Caggegi, A., additional, Cammalleri, V., additional, Sarkar, K., additional, Mangiafico, S., additional, Chiaranda', M., additional, Imme', S., additional, Pistritto, A., additional, Tamburino, C., additional, Ring, L., additional, Nair, S., additional, Wells, F., additional, Shapiro, L., additional, Rusk, R., additional, Rana, B., additional, Madrid Marcano, G., additional, Solis Martin, J., additional, Gonzalez Mansilla, A., additional, Bravo, L., additional, Menarguez Palanca, C., additional, Munoz, P., additional, Bouza, E., additional, Yotti, R., additional, Bermejo Thomas, J., additional, Fernandez Aviles, F., additional, Tamayo, T., additional, Denes, M., additional, Balint, O., additional, Csepregi, A., additional, Csillik, A., additional, Erdei, T., additional, Temesvari, A., additional, Fernandez-Pastor, J., additional, Linde-Estrella, A., additional, Cabrera-Bueno, F., additional, Pena-Hernandez, J., additional, Barrera-Cordero, A., additional, Alzueta-Rodriguez, F., additional, De Teresa-Galvan, E., additional, Merlo, M., additional, Pinamonti, M., additional, Finocchiaro, G., additional, Pyxaras, S., additional, Barbati, G., additional, Buiatti, A., additional, Dilenarda, A., additional, Sinagra, G., additional, Kuperstein, R., additional, Freimark, D., additional, Hirsch, S., additional, Feinberg, M., additional, Arad, M., additional, Mitroi, C., additional, Garcia Lunar, I., additional, Monivas Palomero, V., additional, Mingo Santos, S., additional, Beltran Correas, P., additional, Gonzalez Lopez, E., additional, Garcia Pavia, P., additional, Gonzalez Mirelis, J., additional, Cavero Gibanel, M., additional, Alonso Pulpon, L., additional, Pinamonti, B., additional, Zaidi, A., additional, Ghani, S., additional, Sheikh, N., additional, Gati, S., additional, Howes, R., additional, Sharma, R., additional, Sharma, S., additional, Calcagnino, M., additional, O'mahony, C., additional, Coats, C., additional, Cardona, M., additional, Garcia, A., additional, Murphy, E., additional, Lachmann, R., additional, Mehta, A., additional, Hughes, D., additional, Elliott, P., additional, Di Bella, G., additional, Madaffari, A., additional, Donato, R., additional, Mazzeo, A., additional, Casale, M., additional, Zito, C., additional, Vita, G., additional, Carerj, S., additional, Marek, D., additional, Indrakova, J., additional, Rusinakova, Z., additional, Skala, T., additional, Kocianova, E., additional, Taborsky, M., additional, Musca, F., additional, De Chiara, B., additional, Belli, O., additional, Cataldo, S., additional, Brunati, C., additional, Colussi, G., additional, Quattrocchi, G., additional, Santambrogio, G., additional, Spano, F., additional, Moreo, A., additional, Rustad, L., additional, Nytroen, K., additional, Gullestad, L., additional, Amundsen, B., additional, Aakhus, S., additional, Maroz-Vadalazhskaya, N., additional, Shumavetc, V., additional, Kurganovich, S., additional, Seljun, Y., additional, Ostrovskiy, A., additional, Ostrovskiy, Y., additional, Segers, P., additional, Orda, A., additional, Karolko, B., additional, Driessen, M. M. P., additional, Eising, J. B., additional, Uiterwaal, C., additional, Van Der Ent, C. K., additional, Meijboom, F. J., additional, Shang, Q., additional, Tam, L., additional, Sun, J., additional, Sanderson, J., additional, Zhang, Q., additional, Li, E., additional, Yu, C., additional, Arroyo Ucar, E., additional, De La Rosa Hernandez, A., additional, Hernandez Garcia, C., additional, Jorge Perez, P., additional, Lacalzada Almeida, J., additional, Jimenez Rivera, J., additional, Duque Garcia, A., additional, Barragan Acea, A., additional, Laynez Cerdena, I., additional, Kaldararova, M., additional, Simkova, I., additional, Pacak, J., additional, Tittel, P., additional, Masura, J., additional, Tadic, M., additional, Ivanovic, B., additional, Zlatanovic, M., additional, Damjanov, N., additional, Maggiolini, S., additional, Gentile, G., additional, Bozzano, A., additional, Suraci, S., additional, Meles, E., additional, Carbone, C., additional, Tempesta, A., additional, Malafronte, C., additional, Piatti, L., additional, Achilli, F., additional, Luijendijk, P., additional, Stevens, A., additional, De Bruin-Bon, H., additional, Vriend, J., additional, Van Den Brink, R., additional, Vliegen, H., additional, Mulder, B., additional, Chow, V., additional, Ng, A., additional, Chung, T., additional, Kritharides, L., additional, Iancu, M., additional, Serban, M., additional, Craciunescu, I., additional, Hodo, A., additional, Ghiorghiu, I., additional, Popescu, B., additional, Ginghina, C., additional, Styczynski, G., additional, Szmigielski, C. A., additional, Kaczynska, A., additional, Leszczynski, J., additional, Rosinski, G., additional, Kuch-Wocial, A., additional, Slavich, M., additional, Ancona, M., additional, Fisicaro, A., additional, Oppizzi, M., additional, Marone, E., additional, Bertoglio, L., additional, Melissano, G., additional, Margonato, A., additional, Chiesa, R., additional, Agricola, E., additional, Mohammed, M., additional, Cusma-Piccione, M., additional, Piluso, S., additional, Arcidiaco, S., additional, Nava, R., additional, Giuffre, R., additional, Ciraci, L., additional, Ferro, M., additional, Uusitalo, V., additional, Luotolahti, M., additional, Pietila, M., additional, Wendelin-Saarenhovi, M., additional, Hartiala, J., additional, Saraste, M., additional, Knuuti, J., additional, Saraste, A., additional, Kochanowski, J., additional, Scislo, P., additional, Piatkowski, R., additional, Grabowski, M., additional, Marchel, M., additional, Roik, M., additional, Kosior, D., additional, Opolski, G., additional, Bartko, P. E., additional, Graf, S., additional, Khorsand, A., additional, Rosenhek, R., additional, Burwash, I., additional, Beanlands, R., additional, Baumgartner, H., additional, Mundigler, G., additional, Kudrnova, S., additional, Apor, A., additional, Huttl, H., additional, Mori, F., additional, Santoro, G., additional, Oddo, A., additional, Rosso, G., additional, Meucci, F., additional, Pieri, F., additional, Squillantini, G., additional, Gensini, G., additional, Postula, M., additional, Park, D.-G., additional, Hong, J.-Y., additional, Kim, S.-E., additional, Lee, J.-H., additional, Han, K.-R., additional, Oh, D.-J., additional, Dal Bianco, L., additional, Beraldo, M., additional, Peluso, D., additional, Al Mamary, A., additional, Aggeli, C., additional, Felekos, I., additional, Poulidakis, E., additional, Pietri, P., additional, Roussakis, G., additional, Siasos, G., additional, Stefanadis, C., additional, Hoshiba, H., additional, Miyasaka, C., additional, Sato, H., additional, Yamanaka, A., additional, Lilli, A., additional, Baratto, M., additional, Magnacca, M., additional, Comella, A., additional, Poddighe, R., additional, Talini, E., additional, Canale, M., additional, Chioccioli, M., additional, Del Meglio, J., additional, Casolo, G., additional, Kuznetsov, V. A., additional, Melnikov, N. N., additional, Krinochkin, D. V., additional, Calin, A., additional, Enache, R., additional, Beladan, C., additional, Rosca, M., additional, Lupascu, L., additional, Purcarea, F., additional, Calin, C., additional, Gurzun, M., additional, Dulgheru, R., additional, Ciobanu, A., additional, Magda, S., additional, Mihaila, S., additional, Rimbas, R., additional, Margulescu, A., additional, Cinteza, M., additional, Vinereanu, D., additional, Sumin, A. N., additional, Arhipov, O., additional, Yoon, J., additional, Moon, J., additional, Rim, S., additional, Nyktari, E., additional, Patrianakos, A., additional, Solidakis, G., additional, Psathakis, E., additional, Parthenakis, F., additional, Vardas, P., additional, Kordybach, M., additional, Kowalski, M., additional, Kowalik, E., additional, Hoffman, P., additional, Nagy, K. V., additional, Kutyifa, V., additional, Edes, E., additional, Merkely, B., additional, Gerlach, A., additional, Rost, C., additional, Schmid, M., additional, Rost, M., additional, Flachskampf, F., additional, Daniel, W., additional, Breithardt, O., additional, Altekin, E., additional, Karakas, S., additional, Yanikoglu, A., additional, Er, A., additional, Baktir, A., additional, Demir, I., additional, Deger, N., additional, Klitsie, L., additional, Hazekamp, M., additional, Roest, A., additional, Van Der Hulst, A., additional, Gesink- Van Der Veer, B., additional, Kuipers, I., additional, Blom, N., additional, Ten Harkel, A., additional, Farsalinos, K., additional, Tsiapras, D., additional, Kyrzopoulos, S., additional, Avramidou, E., additional, Vasilopoulou, D., additional, Voudris, V., additional, Florianczyk, T., additional, Kalinowski, M., additional, Szulik, M., additional, Streb, W., additional, Rybus-Kalinowska, B., additional, Sliwinska, A., additional, Stabryla, J., additional, Kukla, M., additional, Nowak, J., additional, Kalarus, Z., additional, Florescu, M., additional, Mihalcea, D., additional, Magda, L., additional, Suran, B., additional, Enescu, O., additional, Mincu, R., additional, Salerno, G., additional, Scognamiglio, G., additional, D'andrea, A., additional, Dinardo, G., additional, Gravino, R., additional, Sarubbi, B., additional, Disalvo, G., additional, Liao, J.-N., additional, Sung, S., additional, Chen, C., additional, Park, S., additional, Shin, S., additional, Kim, M., additional, Shim, S., additional, Helvacioglu, F., additional, Ulusoy, O., additional, Duran, C., additional, Kirschner, R., additional, Simor, T., additional, Ambrosio, G., additional, Tran, T., additional, Raman, S., additional, Vidal Perez, R. C., additional, Carreras, F., additional, Leta, R., additional, Pujadas, S., additional, Barros, A., additional, Hidalgo, A., additional, Alomar, X., additional, Pons-Llado, G., additional, Olofsson, M., additional, Boman, K., additional, Ledakowicz-Polak, A., additional, Polak, L., additional, Zielinska, M., additional, Fontana, A., additional, Schirone, V., additional, Mauro, A., additional, Zambon, A., additional, Giannattasio, C., additional, Trocino, G., additional, Dekleva, M., additional, Dungen, H., additional, Inkrot, S., additional, Gelbrich, G., additional, Suzic Lazic, J., additional, Kleut, M., additional, Markovic Nikolic, N., additional, Waagstein, F., additional, Khoor, S., additional, Balogh, N., additional, Simon, I., additional, Fugedi, K., additional, Kovacs, I., additional, Khoor, M., additional, Florian, G., additional, Kocsis, A., additional, Szuszai, T., additional, O'driscoll, J., additional, Saha, A., additional, Smith, R., additional, Gupta, S., additional, Lenkey, Z., additional, Gaszner, B., additional, Illyes, M., additional, Sarszegi, Z., additional, Horvath, I. G., additional, Magyari, B., additional, Molnar, F., additional, Cziraki, A., additional, Elnoamany, M. F., additional, Badran, H., additional, Ebraheem, H., additional, Reda, A., additional, and Elsheekh, N., additional

Published
2011
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6. Abstracts

Author

Dunet, V., primary, Dabiri, A., additional, Allenbach, G., additional, Goyeneche Achigar, A., additional, Waeber, B., additional, Feihl, F., additional, Heinzer, R., additional, Prior, J. O., additional, Van Velzen, J. E., additional, Schuijf, J. D., additional, De Graaf, F. R., additional, De Graaf, M. A., additional, Schalij, M. J., additional, Kroft, L. J., additional, De Roos, A., additional, Jukema, J. W., additional, Van Der Wall, E. E., additional, Bax, J. J., additional, Lankinen, E., additional, Saraste, A., additional, Noponen, T., additional, Klen, R., additional, Teras, M., additional, Kokki, T., additional, Kajander, S., additional, Pietila, M., additional, Ukkonen, H., additional, Knuuti, J., additional, Pazhenkottil, A. P., additional, Nkoulou, R. N., additional, Ghadri, J. R., additional, Herzog, B. A., additional, Buechel, R. R., additional, Kuest, S. M., additional, Wolfrum, M., additional, Gaemperli, O., additional, Husmann, L., additional, Kaufmann, P. A., additional, Andreini, D., additional, Pontone, G., additional, Mushtaq, S., additional, Antonioli, L., additional, Bertella, E., additional, Formenti, A., additional, Cortinovis, S., additional, Ballerini, G., additional, Fiorentini, C., additional, Pepi, M., additional, Koh, A. S., additional, Flores, J. S., additional, Keng, F. Y. J., additional, Tan, R. S., additional, Chua, T. S. J., additional, Annoni, A. D., additional, Tamborini, G., additional, Fusari, M., additional, Bartorelli, A. L., additional, Ewe, S. H., additional, Ng, A. C. T., additional, Delgado, V., additional, Schuijf, J., additional, Van Der Kley, F., additional, Colli, A., additional, De Weger, A., additional, Marsan, N. A., additional, Yiu, K. H., additional, Ng, A. C., additional, Timmer, S. A. J., additional, Knaapen, P., additional, Germans, T., additional, Dijkmans, P. A., additional, Lubberink, M., additional, Ten Berg, J. M., additional, Ten Cate, F. J., additional, Russel, I. K., additional, Lammertsma, A. A., additional, Van Rossum, A. C., additional, Wong, Y. Y., additional, Ruiter, G., additional, Raijmakers, P., additional, Van Der Laarse, W. J., additional, Westerhof, N., additional, Vonk-Noordegraaf, A., additional, Youssef, G., additional, Leung, E., additional, Wisenberg, G., additional, Marriot, C., additional, Williams, K., additional, Etele, J., additional, Dekemp, R. A., additional, Dasilva, J., additional, Birnie, D., additional, Beanlands, R. S. B., additional, Thompson, R. C., additional, Allam, A. H., additional, Wann, L. S., additional, Nureldin, A. H., additional, Adelmaksoub, G., additional, Badr, I., additional, Sutherland, M. L., additional, Sutherland, J. D., additional, Miyamoto, M. I., additional, Thomas, G. S., additional, Harms, H. J., additional, De Haan, S., additional, Huisman, M. C., additional, Schuit, R. C., additional, Windhorst, A. D., additional, Allaart, C., additional, Einstein, A. J., additional, Khawaja, T., additional, Greer, C., additional, Chokshi, A., additional, Jones, M., additional, Schaefle, K., additional, Bhatia, K., additional, Shimbo, D., additional, Schulze, P. C., additional, Srivastava, A., additional, Chettiar, R., additional, Moody, J., additional, Weyman, C., additional, Natale, D., additional, Bruni, W., additional, Liu, Y., additional, Ficaro, E., additional, Sinusas, A. J., additional, Peix, A., additional, Batista, E., additional, Cabrera, L. O., additional, Padron, K., additional, Rodriguez, L., additional, Sainz, B., additional, Mendoza, V., additional, Carrillo, R., additional, Fernandez, Y., additional, Mena, E., additional, Naum, A., additional, Bach-Gansmo, T., additional, Kleven-Madsen, N., additional, Biermann, M., additional, Johnsen, B., additional, Aase Husby, J., additional, Rotevatn, S., additional, Nordrehaug, J. E., additional, Schaap, J., additional, Kauling, R. M., additional, Post, M. C., additional, Rensing, B. J. W. M., additional, Verzijlbergen, J. F., additional, Sanchez, J., additional, Giamouzis, G., additional, Tziolas, N., additional, Georgoulias, P., additional, Karayannis, G., additional, Chamaidi, A., additional, Zavos, N., additional, Koutrakis, K., additional, Sitafidis, G., additional, Skoularigis, J., additional, Triposkiadis, F., additional, Radovanovic, S., additional, Djokovic, A., additional, Simic, D. V., additional, Krotin, M., additional, Savic-Radojevic, A., additional, Pljesa-Ercegovac, M., additional, Zdravkovic, M., additional, Saponjski, J., additional, Jelic, S., additional, Simic, T., additional, Eckardt, R., additional, Kjeldsen, B. J., additional, Andersen, L. 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M., additional, Van Kuijk, C., additional, Kogure, S., additional, Yamashita, E., additional, Murakami, J., additional, Kawaguchi, R., additional, Adachi, H., additional, Oshima, S., additional, Minin, S., additional, Popov, S., additional, Saushkina, Y. 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P., additional, Zijlstra, F., additional, Sato, M., additional, Taniguchi, K., additional, Kurabayashi, M., additional, Pop Gjorcheva, D., additional, Zdraveska-Kochovska, M., additional, Moriwaki, K., additional, Kawamura, A., additional, Watanabe, K., additional, Omura, T., additional, Sakabe, S., additional, Seko, T., additional, Kasai, A., additional, Ito, M., additional, Obana, M., additional, Akasaka, T., additional, Hruska, C., additional, Truong, D., additional, Pletta, C., additional, Collins, D., additional, Tortorelli, C., additional, Rhodes, D., additional, El-Prince, M., additional, Martinez-Moeller, A., additional, Marinelli, M., additional, Weismueller, S., additional, Hillerer, C., additional, Jensen, B., additional, Nekolla, S. G., additional, Wakabayashi, H., additional, Tsukamoto, K., additional, Baker, S. M. E. A., additional, Sirajul Haque, K. M. H. 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W., additional, Gama, V., additional, Ciarka, A., additional, Neefjes, L. A., additional, Mollet, N. R., additional, Sijbrands, E. J., additional, Wilczek, J., additional, Llibre Pallares, C., additional, Abdul-Jawad Altisent, O., additional, Cuellar Calabria, H., additional, Mahia Casado, P., additional, Gonzalez-Alujas, M. T., additional, Evangelista Masip, A., additional, Garcia-Dorado Garcia, D., additional, Tekabe, Y., additional, Shen, X., additional, Li, Q., additional, Luma, J., additional, Weisenberger, D., additional, Schmidt, A. M., additional, Haubner, R., additional, Johnson, L., additional, Sleiman, L., additional, Thorn, S., additional, Hasu, M., additional, Thabet, M., additional, Dasilva, J. N., additional, Whitman, S. C., additional, Genovesi, D., additional, Giorgetti, A., additional, Gimelli, A., additional, Cannizzaro, G., additional, Bertagna, F., additional, Fagioli, G., additional, Rossi, M., additional, Bonini, R., additional, Marzullo, P., additional, Paterson, C. A., additional, Smith, S. A., additional, Small, A. D., additional, Goodfield, N. E. R., additional, Martin, W., additional, Nekolla, S., additional, Sherif, H., additional, Reder, S., additional, Yu, M., additional, Kusch, A., additional, Li, D., additional, Zou, J., additional, Lloyd, M. S., additional, Cao, K., additional, Motherwell, D. W., additional, Rice, A., additional, Mccurrach, G. M., additional, Cobbe, S. M., additional, Petrie, M. C., additional, Al Younis, I., additional, Van Der Wall, E., additional, Mirza, T., additional, Raza, M., additional, Hashemizadeh, H., additional, Santos, L., additional, Krishna, B. A., additional, Perna, F., additional, Lago, M., additional, Leo, M., additional, Pelargonio, G., additional, Bencardino, G., additional, Narducci, M. L., additional, Casella, M., additional, Bellocci, F., additional, Kirac, S., additional, Yaylali, O., additional, Serteser, M., additional, Yaylali, T., additional, Okizaki, A., additional, Urano, Y., additional, Nakayama, M., additional, Ishitoya, S., additional, Sato, J., additional, Ishikawa, Y., additional, Sakaguchi, M., additional, Nakagami, N., additional, Aburano, T., additional, Solav, S. V., additional, Bhandari, R., additional, Burrell, S., additional, Dorbala, S., additional, Bruno, I., additional, Caldarella, C., additional, Collarino, A., additional, Mattoli, M. V., additional, Stefanelli, A., additional, Cannarile, A., additional, Maggi, F., additional, Soukhov, V., additional, Bondarev, S., additional, Yalfimov, A., additional, Khan, M., additional, Priyadharshan, P. 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S., additional, Sattar, A., additional, Swadia, T., additional, Chattahi, J., additional, Qureshi, W., additional, Khalid, F., additional, Gonzalez, A., additional, Hechavarria, S., additional, Takamura, K., additional, Fujimoto, S., additional, Nakanishi, R., additional, Yamashina, S., additional, Namiki, A., additional, Yamazaki, J., additional, Koshino, K., additional, Hashikawa, Y., additional, Teramoto, N., additional, Hikake, M., additional, Ishikane, S., additional, Ikeda, T., additional, Iida, H., additional, Takahashi, Y., additional, Oriuchi, N., additional, Higashino, H., additional, Endo, K., additional, Mochizuki, T., additional, Murase, K., additional, Baali, A., additional, Moreno, R., additional, Chau, M., additional, Rousseau, H., additional, Nicoud, F., additional, Dolliner, P., additional, Brammen, L., additional, Steurer, G., additional, Traub-Weidinger, T., additional, Ubl, P., additional, Schaffarich, P., additional, Dobrozemsky, G., additional, Staudenherz, A., additional, Ozgen Kiratli, M., additional, Temelli, B., additional, Kanat, N. B., additional, Aksoy, T., additional, Slavich, G. A., additional, Piccoli, G., additional, Puppato, M., additional, Grillone, S., additional, Gasparini, D., additional, Dunet, V., additional, Perruchoud, S., additional, Poitry-Yamate, C., additional, Lepore, M., additional, Gruetter, R., additional, Pedrazzini, T., additional, Anselm, D., additional, Anselm, A., additional, Atkins, H., additional, Renaud, J., additional, Dekemp, R., additional, Burwash, I., additional, Guo, A., additional, Beanlands, R., additional, Glover, C., additional, Vilardi, I., additional, Zangheri, B., additional, Calabrese, L., additional, Romano, P., additional, Bruno, A., additional, Fernandez Cimadevilla, O. C., additional, Uusitalo, V. A., additional, Luotolahti, M., additional, Wendelin-Saarenhovi, M., additional, Sundell, J., additional, Raitakari, O., additional, Huidu, S., additional, Gadiraju, R., additional, Ghesani, M., additional, Uddin, Q., additional, Wosnitzer, B., additional, Takahashi, N., additional, Alhaj, E., additional, Legasto, A., additional, Abiri, B., additional, Elsaban, K., additional, El Khouly, T., additional, El Kammash, T., additional, Al Ghamdi, A., additional, Kyung Deok, B., additional, Bon Seung, K., additional, Sang Geun, Y., additional, Chang Min, D., additional, and Gwan Hong, M., additional

Published
2011
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10. WHAT IS THE IMPORTANCE OF FUSED IMAGES OF PET-SPECT-CT-CT CORONARY ANGIOGRAPHY AFTER AMI AND REVASCULARISATION IN MULTIVESSEL DISEASE?

Author

Balogh, I., Lengyel, Z. S., Kerecsen, G., Nemeth, G., and Preda, I.

Abstract

Aim:Sought the diagnostic advantages of multimodality and fused images by PET/CT and SPECT and CT coronary angiography (MSCT) in pts with multivessel diseases after myocardial infarction (AMI) and revascularisation procedures (ACBG, PCI). What is the diagnostic importance of simultaneous physiological (perfusion-SPECT and metabolism-PET) and anatomical (MSCT) information: 1 — to decide the effectiveness of revascularisation (open or restenosed arteries), 2 — to detect the “culprit lesion” i.e. which coronary artery is responsible for ischaemia? Material and methods: In 10 Material and methods: cases after AMI and revascularisation procedure (5 patients with PCI, 5 patients with ACBG) in multivessel diseases were analysed the results of F-18-FDG PET/CT (Siemens Biograph) and Tc-MIBI gated SPECT (Mediso-CardioSPECT D90) examinations fused images. For image fusion PMOD 2,75, for 3D display MIP and volume rendering (VolView 2,0), for SPECT reconstruction InterWiew XP1.04 (Mediso Ltd.) were used. We evaluated the myocardial viability analysing PET-SPECT matching (non-viable) or mismatching (viable). Results: After PCI we could in one case (1/5 patients) find by SPECT-PET fused images a large “scare”, without ischaemia (SPECT-PET fused images, “matching”) and by MSCT open arteries without restenoses, in two cases (2/5 pts) restenosed arteries (MSCT) and severe ischaemia (SPECT-PET fused images, “mismatching”) in the field of restenosed arteries. After ACBG 4/5 cases the grafts were open, non-stenosed by MSCT and without ischaemia on SPECT-PET fused images. In the case of stenosed graft (1/5) severe ischaemia (“mismatch”) was verified on SPECT-PET fused image. Conclusion: Our preliminary results by PET-SPECT-MSCT fused multimodality images could give through the simultaneous physiological (SPECT-PET) and anatomical (MSCT) informations about the effectiveness of revascularisation procedure, the most accurate diagnosis of restenosed arteries and their authentic place in AMI patients with multivessel disease after revascularisation procedures ie PCI and ACBG. [ABSTRACT FROM AUTHOR]

Published
2007

11. Need for prophylactic application of verapamil in transradial coronary procedures: a randomized trial. The VITRIOL (is Verapamil In TransRadial Interventions OmittabLe?) trial.

Author

Hizoh I, Majoros Z, Major L, Gulyas Z, Szabo G, Kerecsen G, Korda A, Molnar F, and Kiss RG

Subjects
Aged, Arterial Occlusive Diseases diagnosis, Arterial Occlusive Diseases etiology, Arterial Occlusive Diseases physiopathology, Calcium Channel Blockers adverse effects, Coronary Artery Disease diagnosis, Double-Blind Method, Drug Administration Schedule, Female, Humans, Hungary, Male, Middle Aged, Percutaneous Coronary Intervention adverse effects, Radial Artery diagnostic imaging, Radial Artery physiopathology, Radiography, Time Factors, Treatment Outcome, Unnecessary Procedures, Vasodilator Agents adverse effects, Verapamil adverse effects, Arterial Occlusive Diseases prevention & control, Calcium Channel Blockers administration & dosage, Coronary Artery Disease therapy, Percutaneous Coronary Intervention methods, Radial Artery drug effects, Vasoconstriction drug effects, Vasodilator Agents administration & dosage, Verapamil administration & dosage
Abstract

Background: Verapamil is traditionally applied prophylactically in transradial procedures to prevent radial artery spasm. However, verapamil may have side effects and is contraindicated in some clinical settings., Methods and Results: During an investigator-initiated, randomized, double-blind trial, we evaluated the need for preventive verapamil administration. After vascular access was established, patients received either 5 mg verapamil (n=297) or placebo (n=294). We compared the rate of access site conversions as primary end point using a superiority margin of 5%. Occurrence of code breaks (composite of conversions and unplanned use of verapamil), overall verapamil use, procedural and fluoroscopic times, contrast volume, and subjective pain were investigated as secondary end points. The rate of access site conversions was not different in the 2 arms (placebo 1.7% versus verapamil 0.7%, P=0.28, difference 1.0%, 95% CI for the difference -1.1% to 3.3%). Proportion of code breaks was similar in the 2 groups (3.4% versus 1.3%, P=0.11), whereas overall verapamil use was markedly lower in the placebo arm (2.0% versus 100%, P<0.0001). Procedural time (median [IQR] 16.0 minutes [9.0 to 30.0 minutes] versus 17.0 minutes [10.0 to 31.0 minutes], P=0.37), fluoroscopic time (4.4 minutes [2.1 to 9.6 minutes] versus 4.8 minutes [2.4 to 10.7 minutes], P=0.28), contrast volume (72.5 mL [48.0 to 146.0 mL] versus 75.5 mL [47.0 to 156.5 mL], P=0.74), and pain score (P for trend=0.12) were comparable in the 2 groups., Conclusions: The preventive use of verapamil may be unnecessary for transradial procedures. The omission of prophylactic verapamil may not only reduce the rate of potential complications related to the drug but also allow the safe extension of the transradial method to those with contraindications to verapamil., Clinical Trial Registration Url: http://www.clinicaltrials.gov. Unique identifier: NCT01402427.

Published
2014
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12. Diagnostic value of the left atrial electrical potentials detected by body surface potential mapping in the prediction of coronary artery disease.

Author

Bauernfeind T, Préda I, Szakolczai K, Szucs E, Kiss RG, Simonyi G, Kerecsen G, Duray G, and Medvegy M

Subjects
Adult, Body Surface Potential Mapping standards, Female, Humans, Male, Middle Aged, Predictive Value of Tests, Atrial Function, Left physiology, Body Surface Potential Mapping methods, Coronary Artery Disease diagnosis, Coronary Artery Disease physiopathology
Abstract

Background: The electrocardiographic diagnosis of significant coronary artery stenosis (CAD) is often based on the investigation of the left ventricular repolarization changes during exercise ECG stress test (EST). Our aim was to prove that the electric activity of the left atrium can indicate the ischemic damage of the left ventricle, and furthermore, it is able to indicate CAD without exercise., Methods and Results: Patients with chest complaints but without evidence of acute coronary syndrome were investigated by EST and body surface potential mapping (BSPM, 63 leads). CAD was proven in 45 cases (32 men, years 40-76) and excluded in 50 cases (35 men, years 38-72) with coronary angiography. Left atrial electric potentials (EP-LA) before and after 0.08 mg sublingual nitroglycerine administration differed significantly (p<0.001) in the two groups. According to Fischer linear discriminant analysis, this difference in % (EP-LA(d%)) was the best separating parameter: below limit of -14.17% (CAD prevalence was considered) this parameter predicted CAD with 93% sensitivity, 100% specificity, >10 positive and 0.05 negative likelihood ratio (weighted for prevalence). The EST predicted CAD with 71% sensitivity, 78% specificity, 2.43 positive and 0.28 negative likelihood ratios., Conclusion: The electrical activity changes of the left atrium seemed to be suitable to predict CAD as an EST-alternative resting method., (Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.)

Published
2011
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13. Assessment of coronary artery calcification using dual-source computed tomography in adult asymptomatic patients with type 1 diabetes mellitus.

Author

Maurovich-Horvat P, Móri T, Kerecsen G, Fövényi J, Sallai T, Soós P, Préda I, Merkely B, and Jermendy G

Subjects
Adult, Female, Humans, Male, Middle Aged, Calcinosis complications, Calcinosis diagnostic imaging, Coronary Angiography, Coronary Vessels pathology, Diabetes Mellitus, Type 1 complications, Diabetes Mellitus, Type 1 diagnostic imaging, Tomography, X-Ray Computed methods
Abstract

Background: Experience with dual-source computed tomography (DSCT) for detecting coronary artery calcification (CAC) in patients with type 1 diabetes is limited., Material/methods: A non-contrast DSCT scan was acquired in 46 type 1 diabetic patients. All scans were suitable for evaluating CAC expressed in Agatston-scores (effective radiation dose 0.66 [0.59-0.81] mSv; median [interquartile range])., Results: In 21 patients Agatston scores were > or =1 (range 1-2353), while 25 patients had no detectable calcium deposits in the coronary arteries. Patients with vs. without CAC had higher age (52 [44-59] vs. 41 [38-48] yrs; p=0.0045), longer duration of diabetes (25.3 [23.4-36.3] vs. 23.3 [15.7-30.4] yrs; p=0.0238), greater waist circumference (88 [77-98] vs. 79 [75-87] cm; p=0.0147) and BMI (26.7 [24.5-28.4] vs. 22.6 [21.7-25.6] kg/m(2); p=0.0109). Moreover, patients with vs. without detectable CAC had higher serum LDL-cholesterol (3.35 [3.15-3.53] vs. 2.92 [2.62-3.33] mmol/l; p=0.0069) and serum uric acid values (236 [191-266] vs. 200 [170-219] micromol/l; p=0.0437). Hypertension was more frequent (p=0.0144) in patients with than without CAC. The 2 subgroups did not differ in long-term average HbA1c values (7.97 [7.30-8.56] vs. 8.06 [7.24-9.05]%; p=0.7491); however, estimated insulin sensitivity (estimated glucose disposal rate) was lower in patients with vs. without detectable CAC (7.43 [5.73-8.58] vs. 9.24 [8.22-10.72] mg/kg/min; p=0.0017)., Conclusions: Non-invasive detection of CAC is feasible with a low dose DSCT scan. CAC in type 1 diabetic patients is associated with cardiovascular risk factors rather than with long-term glycemic control.

Published
2010

14. Very late drug-eluting stent thrombosis after nonsteroidal anti-inflammatory drug treatment despite dual antiplatelet therapy.

Author

Merkely B, Tóth-Zsamboki E, Becker D, Beres BJ, Szabó G, Vargova K, Fülöp G, Kerecsen G, Preda I, Spaulding C, and Kiss RG

Subjects
Adult, Angioplasty, Balloon, Coronary, Aspirin administration & dosage, Clopidogrel, Coronary Thrombosis physiopathology, Coronary Thrombosis prevention & control, Cyclooxygenase Inhibitors administration & dosage, Cyclooxygenase Inhibitors adverse effects, Diabetic Angiopathies therapy, Diclofenac administration & dosage, Diclofenac adverse effects, Drug Interactions, Endothelium, Vascular drug effects, Endothelium, Vascular physiopathology, Humans, Intervertebral Disc Displacement drug therapy, Male, Meloxicam, Myocardial Infarction therapy, Platelet Aggregation drug effects, Platelet Aggregation physiology, Thiazines administration & dosage, Thiazines adverse effects, Thiazoles administration & dosage, Thiazoles adverse effects, Ticlopidine administration & dosage, Ticlopidine analogs & derivatives, Time Factors, Coronary Thrombosis etiology, Drug-Eluting Stents adverse effects, Platelet Aggregation Inhibitors administration & dosage
Abstract

Background: Drug-eluting coronary stent implantation emerged as a safe and effective therapeutic approach by preventing coronary restenosis and reducing the need for further revascularization. However, in contrast to bare metal stents, recent data suggest a unique underlying pathology, namely late coronary stent thrombosis and delayed endothelial healing., Objective: To report a case of very late coronary stent thrombosis (834 days after implantation) requiring repeat urgent target-vessel revascularization. Importantly, six days before the acute coronary event, combined nonsteroidal anti-inflammatory drug therapy was initiated., Results: Although a dual antiplatelet regimen was continuously maintained, aggregation measurements indicated only partial antiplatelet effect, which returned to the expected range when nonsteroidal anti-inflammatory drugs were omitted., Conclusions: The observation indicates that, even 834 days after drug-eluting stent implantation, effective combined antiplatelet therapy might be crucial in certain individuals and the possible impact of drug interactions should not be underestimated. Further efforts should focus on the challenging task of identifying patients or medical situations with prolonged, increased risk of stent thrombosis.

Published
2009
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15. Analysis of platelet alpha2-adrenergic receptor activity in stable coronary artery disease patients on dual antiplatelet therapy.

Author

Béres BJ, Tóth-Zsámboki E, Vargová K, László A, Masszi T, Kerecsen G, Préda I, and Kiss RG

Subjects
Adenosine Diphosphate, Adenosine Monophosphate analogs & derivatives, Adenosine Monophosphate pharmacology, Adrenergic alpha-Antagonists pharmacology, Aged, Aspirin, Blood Platelets metabolism, Clopidogrel, Collagen, Coronary Artery Disease blood, Drug Therapy, Combination, Female, Humans, Imidazoles pharmacology, Male, Middle Aged, Norepinephrine blood, Platelet Function Tests, Receptors, Adrenergic, alpha-2 blood, Receptors, Purinergic P2 blood, Receptors, Purinergic P2 drug effects, Receptors, Purinergic P2Y12, Ticlopidine therapeutic use, Treatment Failure, Blood Platelets drug effects, Coronary Artery Disease drug therapy, Drug Resistance, Platelet Aggregation drug effects, Platelet Aggregation Inhibitors therapeutic use, Receptors, Adrenergic, alpha-2 drug effects, Ticlopidine analogs & derivatives
Abstract

Combined antiplatelet therapy reduces recurrent atherothrombotic events in stable coronary disease patients; however, high residual platelet reactivity measured ex vivo still raises concerns as a condition related to treatment failure. Alpha-2 adrenoceptor enhances platelet reactivity and might contribute to this phenomenon. For the present study, 121 stable angina patients on standard dual antiplatelet therapy (75 mg clopidogrel and 100 mg acetylsalicylic acid) were recruited. Born aggregometry was performed with adenosine diphosphate (ADP), collagen and epinephrine. To verify platelet adrenergic activity, potentiation by low-dose epinephrine and inhibition by selective alpha-2 receptor blocker atipamezole were determined. To assess the P2Y(12)-specific residual activity, cangrelor was used. Plasma norepinephrine, soluble CD40-ligand, high-sensitivity-C-reactive protein (hsCRP) - and in 24 subjects platelet P-selectin positivity were measured. Epinephrine - at very low concentration (10(-9)g/ml) - significantly potentiates (1.25 microM ADP: 26.5% vs. 43%; 5 microM ADP: 53% vs. 64.5%; collagen: 17% vs 42%, p < 0.001) while atipamezole inhibits ADP- and collagen-induced platelet aggregations (1.25 microM ADP: 26.5% vs. 23%; 5 microM ADP: 53% vs. 47%; collagen: 17% vs. 11%, p < 0.001). Patients with high adrenergic activity have significantly increased baseline ADP- and collagen-induced platelet aggregation. Based on cangrelor's efficacy, these patients have significantly more residual P2Y(12) activity as well. HsCRP and soluble CD40-ligand levels were similar. In conclusion, stable coronary heart disease patients with prominent adrenoceptor activity in vitro have significantly increased platelet aggregability and more functional P2Y(12) receptor, indicating poor inhibitory response to thienopyridines. Therefore, platelet adrenergic receptor represents a considerable, dynamic factor of high residual platelet reactivity and might contribute to cardiovascular events indicating failure of antiplatelet therapy.

Published
2008

16. Inverse correlation between coronary blood flow velocity and sICAM-1 level observed in ischemic heart disease patients.

Author

Bencze J, Kiss RG, Toth-Zsamboki E, Vargova K, Kerecsen G, Korda A, Molnar F, and Preda I

Subjects
Blood Flow Velocity physiology, C-Reactive Protein analysis, Coronary Circulation physiology, Female, Humans, Interleukin-6 blood, Male, Middle Aged, von Willebrand Factor analysis, Intercellular Adhesion Molecule-1 blood, Myocardial Ischemia physiopathology
Abstract

Systemic factors and blood flow velocity related to atherosclerosis have been examined mainly separately or by in vitro studies. The aim of our study was to investigate the association between local coronary blood flow (corrected TIMI frame count, CTFC) and systemic atherosclerosis-related inflammatory parameters such as soluble intercellular adhesion molecule-1 (sICAM-1), interleukin-6 (Il-6), high sensitivity C-reactive protein (hsCRP) and von Willebrand factor (vWF) in humans. We enrolled the following groups of ischemic heart disease (IHD) patients: patients with coronary stenosis and stable (CAD, n = 96) or unstable angina (ACS, n = 27), patients with documented myocardial ischemia and normal coronary angiogram (NEG, n = 68). Patient groups showed only marginal differences in CTFC or sICAM-1 levels. In contrast, when IHD patients were studied individually, general positive correlation was found between CTFC and sICAM-1 level (r = 0.33; in NEG r = 0.25; in CAD r = 0.37; in ACS r = 0.61), being the strongest in ACS. The relation was independent from age, gender, BMI, smoking, hypertension, diabetes, previous myocardial infarction, family history of IHD, medication, hsCRP, IL-6 and vWF levels. (odds ratio, OR = 6.4; CI 95%: 2.43-16.84; p < 0.05). Nevertheless, correlation between CTFC and IL-6, hsCRP, vWF levels was not found. These results indicate inverse correlation between coronary blood flow and adhesion molecule production independently from conventional cardiovascular risk factors and inflammatory markers.

Published
2006
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